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3050 Shields Dr,. - _ .. Qate: ? 7 ... CITY OF EAGAN Permit No. 3830 Pilot Knob Road Meter No: Size: 1 P.O. Box 21199 Reader No: Date. Eagan, MN 55121 Conn. Chg Acct. Dep: 1-' • vvaRa Permit Fee: 10.OOpd Surcharge .50pd Tr. Plant 156.0 Opd Meter. {?"nom Zoning: " s No. of Units: R.P104 I agree to comply with the City of Eagan Ordinances. By WATER SERVICE PERMIT CITY OF EAGAN SEWER SERV,C"ERMIT 3830 Pilot Knob Road I 9;5i - P.O. Box 21199 PERMIT NO.: 7--27-81 Eagan, MN 55121 DATE: S-plea Zoning: - ?3 No. of Units: RavDO Inc. Addi Site Plun I agree la comply with the City of Eagan Ordinances. By Connection Charge: 2-5-U 1P`t Account Deposit: t5 n?"`t Permit Fee: Surcharge: 50 Misc. Charges: Date of Insp.: Total: Insp-, Date rY OF EAGAN Permit Na Data 2--27-1,17 Pilot Knob Ra,d Meter No: ?7? a 9 Sizcc 5 g,, o P.O. Boni 21199 Reader No: D 707 ?L Date: .6L?E ;7- Eagan, MN 55121 ftaypo, Inc. Owner. Site Address: Conn. Chg: .. , 'e a rrs... - -- Zoni? Acct Dep , 111 Ca i? 114bfiUi`rts: q ? Permit Fee: ` ` rtLC 4J? ` Surcharge gtAbompiy with the City of Eagan Tr. Plant s .?h i6ances. Meter t Misc.: By WATER SERVICE PERMIT Of EAGAN 4 SEWER Pilot Knob Road " PERMIT NO.: 3652 No. Site Address: 3050 Shields Dr v g J I 2- 9 R LeMa t Lk N11 i Plumber :alley Plumbing 3 s- 6-29-96 6607S I agree to comply with the City of Eagan 100.0ope Connection Charge: Ordinances. Account Deposit: Permit Fee: 0 (H) T . LI Surcharge: 50 By 13d Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: CITY OF EAGAL 3830 Pilot Knob Road P.O. Box 21199 Eagan, MN 55121 Site Addi Plumber. 1 &f ?"Vvlllll Permit No: Meter No. Reader No: Inc. Conn. Chg: - ?-10.00 d Acct. Dep:_ 15, OOpd Zoning: F'3 Permit Fee: 10.00 pd No. of Units: ? _Ple. Surcharge: . 5ead Tr. Plant la6,t-?,u I agree to comply with the City of Eagan Meter. Ordinances. Misc.: WATER SERVICE PERMIT CITY Or ^uAF 3830 Pik.,Anob Road Permit No: _ Meter Not -?? D 9 Dafh 277 :" Size P.O. Bx 21199 E a Reader No. O 7e 7 z/r!.i Date, /4 -Srz w n, MN 55121 Owner. ,--typ o, I-hc. Site Address: JQJ0 Shields Drilke 102 L? &2 ie` c< Lip !-ills Plumber Tjal ey Plum inb Conn. Chg; Acct Dep:_ Permit Fee: Surcharge; Tr. Plant_ Meter. _ Darr: 2-27_•87 Size. Date: s 9-1)] ex with the City of Eagan I WATER SERVICE PERMIT 1?? 1 _.i 5Vf. Date. q - CITY OF EAGAN ' „ Perm No: Size: 3830 P.I,ot Knob Road Meter No, Date. p .O. Box 21199 Reader No: Eagan, MN 55121 9_L, Plumber. 1dJ'" - R3 500 04pd Zoning: ?...?leY Conn. Chg: 15 00 No. of Units: Acct. Dep: Permit Fee. . 10.00 d 50 1 agree to comply with the City of Eagan Surcharge: . 15& 0 Ordinances. Tr. Plant Meter. By Misc.: WATER SERVICE PERMIT 2-27-87 35l}? CITY OF EAGA Date: N Permit No: 3830 Pilot-.?nt,:) Road Meter No: 7 e 5 .23 Size: 577"11',0cWf P.O. Sox 21199 Reader No: O 76 Date: Eagan, MN 55121 Owner. iRavno, Inc. 'J( t Site Address: 3LI50 Shields Prijid "103 Iii 1?2 I.e1>}Ry Lk Hills Plumber 11e Conn. Chg: r3 5 t?0. 0 (? T .P Acct Dep:_ ? ,&ggInR b -- N Lt WS: 8-R1ex iiJ Permit Fee: - ;? lti il?r' E E Surcharge: ? ??/ • 5 QD? 9: yaj?tlbtomply with the City of Eagan Tr. Plant I5 _ Ordinances. Meter. r * 5114; Misc.: By -? WATER SERVICE PERMIT CITY OF EAGAN Permit No: _ Date. 7 3830 Pilot Knob Egad Meter.No: 376 ?S!Z -Lf Size. - /9" /2o?C P.O. Box 21199 Reader No. d 7A 7 V-! !5? 3 Date: -/601 '/F 7 Eagan, MN 55121 , T-ajPo, _I tic. Owner. 7? n Site Address: ``050 Shields Drf ?b- 04 143-2- Le' Plumber Valley Plumbing Conn. Chg: 500.00pd WI& R-3 Acct. Dep: 15.00 d ,of.i1l ` B-ple-: ?:... i . c4', l.o. oo, ore Igg Permit Fee: .: _ -SAS Etc. L'=' Surcharge:---------! 5ur-TILEPHONE" ree with the City of Eagan f•? gree to comply Tr. Plant 1?5 - ()0' f &dB*c? Y1f Meter r, Sn., - A - AA WATER SERVICE PERMIT CITY OF EAGAN 3830 Pilot Knob Fkad SEWER SERVICE?PERMIT P.O. Box 21199 Eagan, MN 54121 PERMIT NO.: f,54 Zoning: "3 DATE: 27-'77 Owner"` ;-ayno Inc, No. of Units: - -plea Address: 1 agree to comply with the City of Eagan Ordinances. Connection Charge: 1-; 7 5 - 0()Pd- Account Deposit; 15- " Permit Fee: - 1 a 0 By Surcharge: - St3nrt Date of Insp.: Misc. Charges: Insp.: Total: L Date Paid: Pilot Box 2 Meter No. _ Reader No: Inc. nn. Chg: 500.00pd ct. Dep. 15.00ppd mit Fee. 10.OOnd charge: . 50r)d Plant 156.00yd t , ?t Zoning: No. of Units: Date: 'e -2 7 - fl,7 Size: Date: I agree to comply with the City of Ordinances. .c.: BY WATER SERVICE PERMIT CITY OF LAGAN u SEWER SERVICEPERMIT 3830 OIlot Knob Road P.O. Box 2119 PERMIT NO.: 9 657 Eaganr M"121 DATE Zoning: No. of Owner- M"o Inc. Address: Site Address: 3050 Shields Drive 01, Plumber Valley Plumbine I agree to comply with the City of Eagan Ordinances. By Date of Insp.: Connection Charge: 47 5.00ac? Account Deposit: - 15 . nojd Permit Fee: 10 _ nrlna Surcharge: s npd Misc. Charges: Total: f OF 9A 3AN Permit No. 3506 1 Pilot Knob Road Meter No. Box 21199 Reader No., m, MN 55121 Date: 2--27 -3 7 Size: Date: r-lumber Vail Pluiablrt- V r?v' L--9' B2- Lea Conn. Chg: 500.00 d Acct Dep. 15.00 d Zoning: P3 Permit Fee: 10.00 d No. Of Units l ex Surcharge: .50 d Tr. Plant 155.00 d 1 agree to comply with the City of Eagan Meter. Ordinances. Mier. ;s` WATER SERVICE PERMIT CITY OF EAjAN rerrim ivu. ----C/f 3830 Pilot Knob Road Meter No. 3 76 jo -6° Size: -zq ?o P.O. Box.21199 Reader No: O 7D 7 .? 0'O.S Date: 24-0 ',7 Eagan; MN 55121 } i'avuo. Inc. Site Addi Plumber jj Conn. Chg: 5c)0.Ot7?A a ° - `C s!?Ci9'S a Acct. Dep: hQ g5 -.?., a.1 Units: Plex R ??L1 Permit Fee: ?EJ-- Surcharge: a?womply with the City of Eagan Tr. Plant 1 ' Ordinances. Meter. ' Misc.: By WATER SERVICE PERMIT I .. i Road SEWER SERVICE PERMIT PERMIT NO.: No. of Plumber. 1 agree to comply with the City of Eagan Ordinances. By Date of Insp.: Insp.: Connection Charge: `! 1 ? • UQI)d Account Deposit: 15. ()Ond Permit Fee: 10 00nd Surcharge: S ?Jtad Misc. Charges: Total: Date Paid: CITY OF EAGAN 3830 Pilot Knob Road Permit No. "J?i Date: x-.27 ?7 P.O. Box 21199 Meter No. Size. Eagan, MN 55121 Reader No: Date: Owner. n Tarn _ Site Address Plumber. yaT]PS ?1:?*?+ninv Conn. Chg: t?_Q ODD _ Zoning: R3 Acct. Dep. _t No. of Units: 3-- I Permit Fee: _ l c, (N3 Surcharge: cnn?t I agree to comply with the City of Eagan Tr. Plant 1 54 tlt?nr? Ordinances. Meter. Micr• '- -. WATER SERVICE PERMIT CITY OF EAGAN ,ab+tor K.lob Road Permit No Date: .3e •J Meter Box 21199 No: Size: " o cf? Eagan, MN 55121 Reader No Q TOT 7 ?!/ fC?,?, Date: 7wnn.- Site Address:-;") 5 l Plumber. 17 , u Conn. Chg: 5o Acct Dep:0!e1Qi;r'S Permit F GU• Surcharge: ????// Tr. Plant r ., 0*rJA) nply with the City of Eagan Meter. Ordinances. Misc.: - WATER SERVICE PERMIT i CITY OF EAG %N 3830 Pilot Knob Road SEWER SERVICE 4ERMIT d P.O. Box 21199 Eagan, Mb 5512] ILI Zoning., R Owner. PAYPo Inc. PERMIT NO.: , S DATE: 2---27-87 No. of Units: -P ex Add Site Plun 1 agree to comply with the City of Eagan Ordinances. Connection Charge: 475, 0011d Account Deposit: 15, 00nd Permit Fee: 10.001 d Surcharge: - S 1p By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: CITY OF EAGP' - 0 SU 1 Permit No: 7 Date: 3830 Pilat Knob Road Meter No. Size: " P.O. Box 21199 Reader No: Date: Eagan, MN 55121 Site Conn. Chg: 500.001)4:1 Acct Dep: 15.00pd Permit Fee: 10.00yd Surcharge: - • 50pd Tr. Plant 155.000,4- Meter. 61 sn-A Zoning: R3 No. of Units: S-21ex I agree 10 comply with the City of Eagan Ordinances. By CITY OF EAGP N Permit No: 3830 PP:)t K,?tlb Road Date: 8 7 Meter No: ?e Size: P.O. Box 21199 Reader No: x_70 7?1L / Eagan, MN 55121 10 Date: -/0 ff Owner. RaYPo, Jac. Site Addrp.q r S e ? onn.Chg: - U(). - gimcallI&'I Cct. Dep. 15 ?? ??;}n niN i ?? F'9Ns F ECTj ? ?, ermitFee: 10>`" oCynits: MAI urcharge: .5 - t.t1W r. Plant-----I 5 6. r; t1., agree to comply with the City of Eagan eter. Ordinances. lse.: By WATER SERVICE PERMIT OF EAGAN Pilot K?.ob Road 55121 P3. Plumber. Y 111 Cy j LLLLISUIII -86 666078 1 agree to comply with the City of Eagan of Insp.: CITY OF EAGAN Permit No:_ 3830 Pilot Knob Road Meter No. _ P.O. Box 21199 Reader No: Eagan, MN 55121 Owner. Raypo Inc. SEWER SERVICE PERMIT PERMIT NO.: S No. of Connection Charge: Account Deposit: - Permit Fee: Surcharge: Misc. Charges: - Total: Date Paid: Date. Size: Date: Address: last') ct.1A7 d? nri ye " I [IS 2 1-mu u r ? fiber Chg: 500 Q??d Zoning: )ep:-_ 15 OOnU No. of Units: - f....ry7 ov Fee: Ili. oop:.i t - agree to comply with the City of Eagan P ` Ordinances. WATER By SERVICE PERMIT ITY OF EAGAN 30 Pilot.Kmo Road Permit No: Date: :7 Meter Nd: • 3 y,?e 0 6 Size: "'f -'l O. Box 21199 Reader No. 676 7 ,SO o Date: Ao - J 7 gan, MN 55121 caner. :, o Inc. iteAddress: -5i S},inl.#? r,.r;rr!?;;lj T-ff 1191 t lumber nn. Chg: 50 ct Dep: Z??1rr1??i Q , ??' *+ ?" thltYZ?Units: ° rmit Fee: rchar a Plant 1 ;., 1 comply with the City of Eagan mdfnances. eter -Kt n ", isc-- WATER SERVICE PERMIT `A CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121r .x PH ONE: 454-8100 BUILDING PERMIT Receipt To be used for D= Est. Value $1 *000 Date 39" 19 '1988 Site Address 3050 SHIELDS DR 0149 Lot 31 Block I Sec/Sub`, H1,IJ-9 Parcel No. a Name TznY M ZATS = Address 3030 SHILLD6 bZ #11A c City E/!G1?ti Phone 690-'1571 452-0785 o Name . ci < Address City Phone ?W Name W F g Address W City Phone I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of ';. Minnesota Statutes and City_of-15agan Ordinances. Signature of Permittee A Building Permit is issued to:___g%RkY XAT on the express condition that all work hall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. c,,;iA.- nsri';.i OFFICE USE ONLY On Site Sewage Occupancy MWCC System Zoning On Site Well (Actual) Const City Water (Allowable) PRV Required * of Stories Booster Pump Length Depth ?. S.F. Total Footprint S.F. APPROVALS FEES Engr./Assess. _ Permit 24.00 Planner Surcharge • 50 Council Plan Review Bldg. Off. _ SAC, City Variance _ SAC, MWCC Water Conn. Water Meter Road Unit Treatment P1 Parks - - .W 2w TOTAL Permit No. Permit Holder Date Telephone x Plumb4gg H.V.AMC. Electric Softener Inspection Date Insp. Comments Footings I Footings II Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. _ a Final Plbg. ya7J 6N O?TJO?rv? Bldg. Final ?cC,h' 7 7 2 42 Cert Occ. Temp. LP Deck Ftg. Deck Final Well Pr. Disp. CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE RECEIVED FROM 1e.. j w AMOUNT $ `.. ` I C & -DOLLARS son ? CASH ? CHECK White-Payers Copy Yellow-Posting Copy Pink-File Copy Thank You ' 66078 B" BLDG. PERMIT NO. °7S 01-3210 gidg; Permit 01-3422 Plan Check 01-3445 Surch./Adm. 01-3446 SAC/Adm. 01-2155 Surcharge 17-3860 Road Unit 20-2275 SAC 20-3865 Water Conn. 20-3868 Water Trmt. 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permi 20-3743 Sewer Permi 79-3866 Sewer Conn. 11-3855 Park Ded. TOTAL This request void -J /.?/ay7 33 e9, tea, 70? ?Sl '06 S-. 00 I?Ready Now (M Will Notify. tnspec-I ?Np for When Ready ® Licensed Electrical Contractor .I hereby request inspection of above ? Owner electrical work installed at: Street Address. Box or Route No. City 3050 Shields Drive # 108 Eagan action No. Township Name or o. Range No. County Dakota Occupant (PRINT) Phone No. Ra o Inc. Power Supplier Address Dakota Electric Farmin ton Electrical Contractor ICompany Name) 3600 Kennebec Drive Ragnj Contractor's License No. 04044S Mailing Address (Contractor or Owner Making Installation) Hilite Electric Autho i ignature ( tra t Oy+n king Installation) Phone Number 452-1565 THIS INSPECTION REQUEST WILL NOT MINNESOTA STATE BOARD OF ELECTRICITY Griggs-1Aidwey Bldg. -Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul. MN 56104 UNLESS PROPER INSPECTION FEE IS Ph^no 1A11l Ra2nann ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION Es-00001-05 (t See instructions for completing this form on beck of yellow copy. '"X" Below Work Covered by This Request p4.4Addl ltep.l Type of Building I Appliances Wired I Equipment Wired I I I I Duplex I I water-Heater _ I I Lighting Fixtures Bulk Milk M Fee Service Erdrence Size d Fee bteeders d Fee- Circuits 0 to 200 A. P1 s 0 to 30 An! 1 25. 0 0 Above LO 0 Q mps 11 5 . 0 mps E 1 5.00 31 to 100 Am s Swinlmin Pool _Amps Above Above 100_Amps Transformers ooms . 5 Partial-'Otherfee? Signs Spec ial Inspection S 65.50 TOTAL FE/j (?'1 Hemerks 1 6 3 3 9 / I, the El ectricel c hereby certify rtify that the above inspection has been made. This request void -2-41113? 7 7'O Cn o:1/? 18 months from C 71132 Requgst Date Fire No. Roug„-gin Inspection Regmred7 Ready Nuw fD Will NolitY Inspec- t 10 87 65yes ONo for When ReatlY R] Licensed Electrical Contractor 1 hereby request inspection of above ? Owner electrical work installed at: Street Address, Box or Route No. City 30 0 Shj- i sDri a if 107 E a ecUon no. Township Name or No. Range o. County Dakota Occupant (PRINT) Phone No. Ra o Inc. Power Supplier Address Dakota Electric Farming ton Electrical Contractor (Company Name) Contractor's License No. Hilite Electric 040445 Mailing Address (Contractor or Owner Ma king Installation) 3600 • Authoriz?d,,ZTotature (Con ct r caner aking Installation) Phone Number `/ MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Grimm-Midway Bldg. - Room N•191 BE ACCEPTED BY THE STATE BOARD 1921 University Ave.. St. Paul. MN 68194 UNLESS PROPER INSPECTION FEE IS Phone (812) 842-0800 ENCLOSED. i/87 REQUEST FOR ELECTRICAL INSPECTION Ee-00001-005 Ii, See instructions for completing this form on back of yellow copy. C 71 1 -?7 "X'' Below Work Covered by This Request PlowiAh3}R-.900? Type of Building 1 Appliances Wired I Equipment Wired 1 xtures Of Fee' Service Entrance Size s Fee Feeders/subteedera s Fee Circuits 0 to 200 Amps 0 to 30 Amps 1 30.0 0 1o 30 Am! Above 20 -Amps 11 5 . 0 01 31 to 100 Amps 31 to 100 Amps Swimming Pool Above 100_Am s Above 100_Am Transformers Irrigation Booms Partial•'Other Fee Signs Special Inspection 40 ?jj em?rks TOTAL FEE the ElecIr VT7 •• 1 Inspector, hereby Final rr l Date r'? t A:J7© certify that the above meetion has bean made. This request gold This request void . X//,'p 7 18 months from 7 C.71131 II Request Date Fire No. ffugh-in Inspection I 0 / 7 egyiretl7 ? Ready Now Will Notify. Inspec- / 87 es No for When en Ready Licensed Electrical Contractor 1 hereby request inspection of above ? Owner - electrical work installed at: Street Address, Box or Route No. City 3050 Shields Drive # 106 Eagan emion o. Township Name or No. Range o. County Dakota Occupant (PRINT) Phone No. Ra o Inc. Power Supplier Address Dakota Electric/ Farmington Electrical Contractor (Company Name) Contractors License No. Hilite Electric 040445 Mailing Address (Contractor or Owner Making Installation) 360Q Kennebec Drive Eagan Authorized g tuEe (Con r/ er akine^sta llation) Phone Number 452-1565 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midwav Bldg. - Room N-181 BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS 1821 Univers itv Ave.. St. Paul, MN 66104 vw....e ratm am.nwnn ENCLOSED. ??18 9 REQUEST FOR ELECTRICAL INSPECTION EB-00001-05 IF See instructions for completing this form on beck of veil" copv. 70 C-,?2X Cl- 71 1 'l l -X" Below Wock Covered by This Request bewAAdd1 eeo.l Tvoe of guildina 1 Appliances Wired Equipment Wired I e% ce 0 Fee Service Entrance Size a Fee Feeders/Subteedera q Fee Circuits 0 to 200 AMPS 0 to 30 Amps 0 to 30 Amos Above 20 _gmp5 1 5 .0 0 31 to 100 Amps 31 to 100 A s Swimming Pool Above 100_Am s Above I00_Anis Transformers Irrigation Booms Partial.'Other Fee Signs Special Inspection 8errerks1 ? ? -L4 0.50 TOTAL FEEQ l ^""w"-"' ? ('??YLQ? I? ?7? I, the Electriceab Inspector, hery certify that the above Final Data inspection has been //?/,, t re made. request vold 18 months from This request void -;21,111,? 7 18 months from C 71130 c 9. 70&-1 5z Request Osta Fire No. Ro gh-in Inspection R uir- Ready Now gf Will Notify. Inspec- 9 / 1 0 / A 7 . [2 yes F1 No for When Ready Licensed Electrical Contractor 1 hereby request inspection of above ? Owner electrical work installed et: Street Address, Box or Route No. City 3050 Shields Drive # 105 Eagan action No. Township Name or No. Range No.. County Dakota Occupant (PRINT) Phone No. Ra o Inc Power Supplier Address Dakota Electric Farmin ton Electrical Contractor (Company Name) Contractor's License No. Hilito Electric 040445 Mailing Address (Contractor or Owner Making Installation) 3600 Kennebec n Authorized Signature (Contra for Own akmg Installation) Phone Number 452-1565 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. -Room N-191 B ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS 1821 University Ave.. St. Paul, MN 66106 ENCLOSED. - Phan. (6121 642-0800 ,1-1111Y 7 REQUEST FOR ELECTRICAL INSPECTION ?ESe-00001-05 t? See instructions for completing this form on back of yellow copy. / ??O?T C ?1 1 _-in "X" Below Work Covered by This Request "Addl Rep.1 Type of Building I Appliances Wired I Equipment Wired I I I T I Industrial dicta. I I Air Conditioner I I Bulk Milk Tank I a Fee Service Entrance size # Fee FeadersrSubleedere # Fee circuit. 0 to 200 Amps 0 to 30 Amos 0 to 30-Am Above 200 Amts 5 . 001 31 to 100 Amps 1 5 , 00 31 to 100 A Swinvnin Pool Above 100_Am s Above 100_Am s Transformers Irrigation Booms Partial."Other Fee blgns apeclal Inspection S emnrk. 16339 _ 40.50 TOTAL FEEra a? J This request void This request void ,?///?7 7G (o of 18 months from -7 C 71129 ?c) Request D;!ta Fire No. Roy h-in Inspection Ra'quiretl. ?fleady Now E ]Will Notify Inspeo- 'z 10 87 [yes ?No for When Ready ® Licensed Electrical Contractor 1 hereby request inspection of above ? Owner electrical work installed at: Street Address, Box or Route No. City 3050 shields # 104 Eagan action O. Township Name or No. Range No. County Dakota Occupant (PRINT) Phone No. Raypo, Inc. Power Supplier Address Dakota Electric Farmington Electrical Contractor (Company Name) Contractors License No. Hilite Electric 040445 Mailing Address (Contractor or Owner Making lnstailation) 3600 Kennebec Drive Eagan Authorized Signature (C Ira glor Owner Making Installation) Phone Numbe r CALZ 452-1565 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Grippe-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD 1821 University Ave.- St. Paul, MN 55106 UNLESS PROPER INSPECTION FEE IS - Phone (612) 642-0800 ENCLOSED. ANIFIL ES-00 001-05 oZ/REQUEST FOR ELECTRICAL INSPECTION NWV% See instructions for completing this form on beck of Yellow copy. C 'T 1 (? "X"' Below Work Covered by This Request Adtl Rep-.314 Tvpe of Building T Apolioncee Wired Equipment Wired Ik p Fee Service Entrance Size k Fee Feeder./Subfeeders Of Fee circuits U to 200 qm 5 1 3 0 . to 30 Am Above 200 Amps 1 5 . 0 E M 1 to 100 Amps Swirmnin Pool m s Above Above 100_Am Transformers boo? , $ artia l•'O th er fee Signs special Inspection s 40.5 TOTAL FEE 8?1 "' 16339 ? , ? / r 6 /n t[ " , 1. the Ele?Uicat' Inspector, hereby certify that the above inspection has been mode. This request void -? A //r7 7C(p y- 18 months from C 711281.9 00 Req UE'st Ue F re No. Rou" -in Inspection Req ired7 ?Ready Nuwr] Will Notify tnspec- 2 ? 10 ? 8 ] ®yes ?NO or When Ready k] Licensed Electrical Contractor I hereby request inspection of above ? Owner electrical work installed at: Street Address, Soz or Route No. City 3050 Shields Drive # 103 Eagan action o. Township Name or No. Range o. County Dakota Occupant(PRINTI Phone No. Ra o Inc Power Supplier Address Dakota Electric Farmington Electrical Contractor (Company Name? Contractor's License No. Hilite Electric 040445 Mailing Address (Contractor or Owner Making Installation) 3600 Kennebec Drive Eagan Authorize Signature (Co Ira ctor40 net Making Installation) Phone Number X. 1 452-1565 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Grippe-Midway Bldg. - Room N-181 BE ACCEPTED BY THE STATE BOARD 1821 Unlvars HV Ave.. St. Paul. MN 65104 UNLESS PROPER INSPECTION FEE IS Pence. 18141 Ra2-l1RDD ENCLOSED. EB-00001-05 111y 7 REQUEST FOR ELECTRICAL INSPECTION Ift Sea inalructians fpr compietinp this form on beck of yellow copy. C " W AP 7 8 "X- Below Work Covered by This Request Nsv? Add Rep. Type or Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm they peel y Char (Sper-ify) t - you y ter Other Compute Inspection Fee Below Is Fee Service Entrance Size p Fee Feeders/Subfeadera a Fee Circuits 0 to 200 Amps 0 to 30 Amps 30 0 0 to 30 Am Above 200 Am is 31 to 100 Amps 31 to 100 A Swimming Pool l t? Above 100_Am s Above 100_Am Transformers Irrigation Booms Partial-'Other Fee Signs Special Inspection 5 1 Remarks 16339 40.50 TOTAL EF / :... r,,l Rough-in Date / I, the FLectrica-f s M Inpwtor, hereby certify that the above Final Dg1a inspection has been ? made. This request vole 18 months from 7c 9 ? This request void /i 7 1.9 (p 18 months from C .711.27 Request Date Fire No. RegeireG?l aspect ion Ready Now Will Notify InsOec- 2/10/87 yes ?- for When Ready [X Licensed Electrical Contractor I hereby request inspection of above ? Owner electrical work installed at: Street Address. Box or Route No. City 3050 Shields Drive 102 Eagan ectlon No. Township Name or No. enge No. County Dakota Occupdnt )PRINT) Phone No. Raypo, Inc. Power Supplier Address Dakota Electric Farmin ton Electrical Contractor (Company Name) Cort[ractor's License No. Hilite Electric 040445 Mailing Address (Contractor or Owner Making Installation) 3600 Kennebec Drive, Fngqln Authorized Signature It'pn[raCtor Owne Making Installation) Phone Number 452-1565 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS 1931 Univare ity Ave.. St. Paul. MN 66104 phnnu ra»t aaarmnn ENCLOSED. 7 REQUEST FOR ELECTRICAL INSPECTION 10 ES-00001-05 See instructions for completing this form on back of yellow copy. - 7Olnn2 Ir 71 -:)7 "X" Below Work Covered by This Request NmJAddl Rep.l Tvoe of Buildina 1 ',A pPlinnees Wired 1 Equipment Wired I Bulk k Fee Service Entrance Size N Fee FeedersrSubfesders k Fee Circuits U Io 200 Amps 0 to 30 Amps 1 3 0. 0 0 to 30 Amos Above 2UU Amps 31 to 100 Amps 1 5 . 0 31 to 100 Amps Swimming Pool Above 100_Am s Above 100_Am s Transformers rngation Booms Partial-'Other Fee Signs ,Special Inspection ?s ?? emarks T (?'; ?q 1 1 40.5 TDTAL FEE ( 110'rx'? certify that the above Final ?.r,-''7 Dale Inspection has been This request void 7 18 months from C71125 7e;6 -:2 5;/ ?XC-OC Kaouesi uaie nre rYp. mepacr'O" R ' uired7 IC]Ready Now ? Will Notify inspec- ? 110/97 J Yes MNO for When Ready ® Licensed Electrical Contractor 1 hereby request inspection of above ? Owner electrical work installed at: Street Address, Boz or Route No. City 3050 Shields Drive Eagan action No. Township Name or No. Range NO. County Dakota Occupant (PRINT) Phone No. Ra o Inc Power Supplier Address Dakota Electric Farmin ton Electrical Contractor (Company Name) Hilita Rlrartrir 1 Contractor's License No. 040445 Mailing Address (Contractor or Owner Making Installation) Aut orized Signature CContractor Owner Making Installation) one umber 452-1565 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION BEQUEST WILL NOT Griggs-Midway Bldg. - Room N•191 BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS 1921 University Ave.. St. Paul. MN 66104 ENCLOSED. Phnnw f619 649-nRDD ?21111a7 REQUEST FOR ELECTRICAL INSPECTION EB-000?0i1-06 Il, See instructions for completing this form on beck at yellow copy. Ir - ?'1'7-7 r, "X" Below Work Covered by This Request 1aslAddl Rep.l Tvos of Buileina I Appliances Wired I Equipment Wired I Conditioner p Fee Service Entrance Size b Fee Feedera/Subfesders 7! Fee Circuits O to 200 qms Oto 30 Amps 0 .0 0 to 30 Amps Above 200 Amps 1 5. 0 31 to 100 Amps 5 '0 31 to 100 A mps SWimmin Pool Above 100_Am s Above 100_Am Transformers rn gation Booms , 5 Partial-'Othe" e Signs special inspection S / -' 4 0. 5 0 TOT L FEE errerka 16339 (fp el. I tnspecct.rtor. , hereby I ce rtity that the above Final 17,L11 P Oate?f inspection has been 114 t?7 made. requestvold IS TOWNHOUSE CITY OF EAGAN RENTAL UNITS 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N °- 12535 BUILDING PERMIT PHONE: 454-8100 Receipt tf Cy 6607 /J Yl To be used for 8 UNIT M.D. Est. Value $487,000 Date AUGUST 28 19 86 Site Address 3050 SHIELDS DR Erect C Occupancy RI Lot--9 Block-2-1Sec/Sub. LEMAY LAKE HILBBnodel ? Zoning Pr) Parcel , I Repair ? Type of Const._VR Addition ? No. Stories a 0 ZU Name ALBERT' C KEMPF Address 7101 FRANCE 'AVE SO City EDINA Phone 920-8831 Name REYPO CONST ppro Address SAME Assessment City Phone ?Q F w Name Fe a Address w City Phone Move ? Length 160 Demolish 13 Depth 54 Int Impr. 11 Sq. Ft. Install ? A vals Fees Water & Sew. Police Fire Planner Council I hereby acknowledge that l haveread thisapplication andstatethatthe Bldg.Off. 8/12/8E information is correct and agree to comply with all ap 'cab] Sta of Minnesota Statutes and City of a rdine c APC Var. Date Signature of Permittee _ A Building Permit is issued to: REYPO all work shall be done in accordance with all,apoli Permit $ 1,400.50 Surcharge 243.5C Plan Review 725.2_ SAC 4,600,101C Water Conn.4 , 000 . OC Water Meter N/A Road Unit 2, 320. OC Tr. PI. 1,248.0( Parks N/A Copies Total $14,537.2E NSTJ(UCT ION on the express condition that State of Minn ota Sta tes and City of Eagan Ordinances. Building Official CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121N? 15610 PHONE: 454.8100 Or7? ry BUILDING PERMIT Receipt# DD !! D To be used for T ECK Est. Value $1,000 Date SEPT 19 19$8__ Site Address 3050 SHIELDS DR #108 OFFICE USE ONLY Lot 31 Block 1 Sec/SUb.LEMAY LAKE HILLS On Site Sewage Occupancy "rUWNHUMES MWCC System _ Zoning Parcel No. On Site Well (Actual) Const a Name TERRY M ZATS City Water (Allowable) W T Address 3050 SHIELDS DR #108 PRV Required # of Stories 3o City EAGAN Phone 690-1571 452-0785 Booster Pump Length Depth p Name S.F. Total O a Address Footprint S.F. um City Phone APPROVALS FEES uw Name Engr./Assess.- Permit _24.DD ?= Planner Surcharge _ _50 i- Address Council Plan Review aw City Phone Bldg. Off. SAC, City _ I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC information is correct and agree comply with all pplicable State of Water Conn. Minnesota Statutes and City ?r2es. Water Meter Signature of Permitte 'r t Road Unit y, E>,TS A Building Permit is issued o: Treatment P1 on the express condition that adone in accordancewith all ?okale applicable State of Minnesota City of Eagan Ordinances. Perks 24 50 {? pp Building Official-4B-9 _1?-_l . TOTAL z ? 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan ?a C f - 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX 9 651-675-5694 New Construction Requirements 3 registered site surveys showing sq. ft. or lot, sq. P, of house; and all roofed areas (2D% maximum lot coverage allowed) 2 copies of plan showing beam & window sizes; poured found design, etc. 1 set of Energy Calculations 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail options selection sheet (buildings with 3 or less units) Remodel/Repair Requirements 2 copies of plan 1 set of Energy Calculations for heated additions 1 site survey for additions & decks Addition - indicate fonsite septic system Office _C1set:Only Cerl 6f Survey llecd Tree Pres Plan Recd _ Y -NTree Pres Rerlyrted ,_ y N. C.7nslle.5epfic:5yslem..,......_ Y.: _ N Date / Construction Cost j d? T? D oa Unit/Ste # Site Address 31) 1 0 k W or Description of G1Y11 I Multi-Family Bldg Y _ N , Fireplace(s) _ 0 - 1 - 2 (T?fW A, Telephone # tp s?) 9qy- 6 f2n 77 Property Owner t Contractor Address t St City Zip h D I ?F Telephone # ?i- a e COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7672 Minnesota Rules 7670 Category y 1 - Code Worksheet Energy Code Category Residential Ventilation Category 1 Worksheet New Energy (J submission type) Submitted Submitted . Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N if so, 25% plan review fee applies. ; Licensed Plumber Telephone #( 1 Mechanical Contractor Telephone # ( 1 O G Sewer/Water Con tractor Telephone#( ) n N . I hereby apply for a Residential Building Permit ack ovV-4&dge that the information is complete and accurate; that the work will be in conformance with the ordin ceps`and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan the case of work which requires a review and approval of plans. I cJ"-0\I VC ?v u i ,. 05 Applicant's Pri ted Name Applicant's ig ure OFFICE USE ONLY Sub Types r ?r' 1h ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg ) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ Final/C.O. _ Footings (deck) _ Final/No C.O. _ Footings (addition) _ Plumbing Foundation _ HVAC _ Drain Tile Other _ Roof Ice& Water Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ - Siding _ Stucco - Stone - Br ick _ Fireplace _ R.I. - Ai r Test - Final _ Windows Insulation - Retaining Wall Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector lf, k' 4b? City of Eapn Pat Geagan MAYOR Peggy Carlson Cyndee Fields Mike Maguire Meg Tilley COUNCIL MEMBERS Thomas Hedges CRY ADMINISTRATOR MUNICIPAL CENTER 3830 Pilot Knob Road Eagan, MN 55122-1810 651.675.5000 phone 651.675.5012 tax 651.454.8535 TDD MAINTENANCE FACILITY 3501 Coachman Point Eagan, MN 55122 651.675.5300 phone '651,675.5360 fax 651.454.8535 TDD www.cityofeagan.com THE LONE OAK TREE The symbol of strength and growth in our community. Monday, March 07, 2005 CUSTOM REMODELERS INC ATTN: JOY RICHARDSON 474 APOLLO DR LINO LAKES MN 55014 RE: PERMIT TO INSTALL WINDOWS AND/OR DOORS Dear Joy: One of your applications for window/door replacement cannot be processed because the building is multi-family, but the check is only a single-family fee ($70). Please return the application with a check for the correct amount, which based on your current contract valuation of $12,438.00 would be $229.75. Also, please clarify whether these windows and patio door are being replaced in the same openings or require new or modified framing. Please remember that we use fixed fees for single family homes and duplexes. In contrast, we use fees based on valuation for multi-family buildings. Enclosed, please find a copy of our building permit fee schedules, which show exact fee amounts for various building types and contract valuations up to $30,000.00. Please callus at 651- 675-5675 if you have any questions or need fee schedules for larger amounts. City of Eagan Building Inspections A- CITY OF EAGAN BUILDING PERMIT FEES - YEAR 2000 SO OK ZOQS Q 0 f ts. Kk4: e,.r +w PERMIT STATE PERMIT & PLAN VALUATION FEE SURCH SURCH REVI W TOTI,I 1 - 500 30.00 0.50 30.50 .00 30.50 501 - 600 32.60 0.50 33.10 .00 33. 0 601 - 700 35.20 0.50 35.70 .00 35. 0 701 - 800 37.80 0.50 38.30 .00 38. 0 801 - 900 40.40 0.50 40.90 .00 40. 0 901 - 1,000 43.00 0.50 43.50 .00 43. 0 1,001 - 1,100 45.60 0.55 46.15 .00 46. 5 1,101 - 1,200 48.20 48.80 .00 48 80 1,201 - 1,300 50.80 51.45 .00 5145 1,301 - 1,400 53.40 54.10 .00 541.10 1,401 - 1,500 56.00 56.75 .00 56.75 1,501 - 1,600 58.60 59.40 0.00 5 .40 1,601 - 1,700 61.20 62.05 0.00 6 .05 1,701 - 1,800 63.80 64.70 0.00 6 .70 1,801 - 1,900 66.40 67.35 0.00 67.35 1,901 - 2,000 69.00 0 70.00 0.00 0.00 2,001 - 3,000 83.25 0 1 84.75 0.00 4.75 3,001 - 4,000 97.25 0 99.25 0.00 9.25 4,001 - 5,000 111.25 0 113.75 0.00 1 3.75 5,001 - 6,000 125.25 0 12$.25 0.00 1¢8.25 6,001 - 7,000 139.25 0 .00 1142.75 7,001 - 8,000 153.25 0 157.25 0.00 8,001 - 9,000 167.25 0 171,75 0.00 9,001 - 10,000 181.25 0 186.25 0.00 10,001 - 11,000 195.25 0 200.78 12 6.91 q- 11,001 - 12,000 209.25 .0 6.00 - 149 1 86.01 12,001 - 13,000 __ _ 223.25 6.50 Qa; _ 1 5.11 13;001 - 14,000 237.25 7.00 1 54.21 . 14,001 - 15,000 251.25 7.50 258.75 1 03.31 4 2.06 15,001 - 16,000 265.25 8.00 273.25 1 72.41 16,001 - 17,000 279.25 8.50 287.75 1 8,1.51 17,001 - 18,000 293.25 9.00 302.25 1 9p.61 18,001 - 19,000 307.25 9.50 316.75 1 99.71 4 19,001 - 20,000 321.25 10.00 331.25 2 0$.81 20,001 - 21,000 335.25 10.50 345.75 2 17.91 21,001 - 22,000 349.25 11.00 360.25 2 27.01 58 22,001 - 23,000 36125 11.50 37475 2 36.11 61 .86 23,001 - 24,000 377.25 12.00 389.25 2 45.21 634.46 24,001 - 25,000 391.25 12.50 403.75 2 54.31 65$.06 25,001 - 26,000 401.85 13.00 414.85 2 611.20 67 .05 26,001 - 27,000 411.95 13.50 425.45 2 67.77 69 .22 27,001 - 28,000 422.05 14.00 436.05 27;4.33 71 .38 28,001 - 29,000 432.15 14.50 446.65 2, 1 72 .55 29,001 - 30,000 442.25 15.00 457.25 % 6 287.46 74 .71 lsJDctts l RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Requirements Office Use Only 3 registered site surveys showing sq. ft of lot, sq. ft of house; and all roofed areas 2 copies of plan Can of Survey Recd -Y -N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd -Y -N 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Read -Y -N 1 set of Energy Calculations Addition - indicate if on-site septic system On-site Septic System -Y -N 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date to / 14D / a3 P R- Construction Cost 4,1" Site Address joib St}JL3l D( 4"*?' Unit/Ste # Description of Work /Aj 5i i /rev (!? S 6 `J l ?i> O I Multi-Family Bldg _ Y _ N Fireplace(s) - 0 - 2 - Property Owner " l0)3 Telephone # (6V ) ZJ6 - 2a(o? Contractor ???c5t !lam [ l Address C.?. 1 (3 City 1AV State zip 553-7 Telephone # ( 7f4) 5L') COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Catego1y 1 - Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone #( Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, aiAwork is not to start without a permit; that the work will be in accordance with the approved plan in a case of or which requires a review and approv 1 of pla ?,1. CI+??r r. I, I I I _s Applicant's Printed Name - Applicant' Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi ? 03 01 of - plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_v or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement `Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) Final/C.O. _ Footings (deck) _ Final/No C.O. Footings (addition) _ _ Plumbing Foundation _ HVAC _ Drain Tile Other Roof - Ice & W ater _ F inal _ Pool _ Ftgs _ Air/Gas Tests _ Final - Framing _ Siding _ Stucco _ Stone _ Fireplace - R.I. _ Air Test - Final _ Windows (new/replacement) - Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector 6??q3 2004 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 X35 . -70 New Construction Requirements Remodel/Repair Requirements ....................... Office Use?Sn 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan C41 of Survey Recd y _ YJ (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated addilions Tree Pres Plan Recd _ Y 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres RRg4rred :1' Y N 1 set of Energy Calculations Addition - indicate if on-site septic system On-sde Septic System ?_' Y ,.._N- 3 copies of Tree Preservation Plan if lot platted after 71153 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date 1 / ?_ / V U Site Address 3o ?jo Jh?ei a DRi ve ?y q Construction Cost , C o i Unit/Ste # Description of Work Multi-Family Bldg Y - N Fireplace(s) - 0 _ 1 - 2 Property Owner DQYia Phi yyjehcl? 1 mr) a rl Telephone#( j?) ?I7 G-g1o9? w Contractor 1711 I bktr C? l?"I Address ILIV"A State zip 5511-4 City Appl-le It Telephone # (q`5 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( ) Telephone # ( ) !I nl (? (a F? n CSI r ?I ) I?fll nFf n R Anna J Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information isYcomplete-and--accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Ut LIE 2N S Applicant's Printed Name LAA y` , Applicant's ignature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi ? 03 01 of-plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or_N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) _ FinalIC.O. Footings (deck) Final/No C.O. - Footings (addition) _ _ Plumbing _ Foundation _ HVAC _ Drain Tile Other Roof _ Ice & Water _ Final - Pool _ Figs _ Air/Gas Tests _ Final _ Framing - Siding _ Stucco - Stone - Bri ck _ Fireplace _ R.I. - Air Test - Final _ Windows _ Insulation _ Retaining Wall Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector J# RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Ma 55122 Telephone # 651-675-5675 FAX # 651-675-5674 q I c. Ob V? 311`j X03 New Construction Requirements RemodeVReoair Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. fl. of house; and all roofed areas 2 copies of plan _ Ced of Survey Recd (20% maximum lotcoverege allowed) 1 set of Energy Calculations for heated additions _ Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, eta 1 site survey for additions & decks -Tree Pres Not Regd 1 set of Energy Calculations Addition - indicate if on-site septic system _ 0mite Septic System 3 copies of Tree Preservation Plan if lot platted after 711/93 Rim Joist Detail options selection sheet (bldgs with 3 or less units Date -51- / 16 / Site Address ?&, M 03 3 ® $ d SSI Z Construction Cost ( 0o , ou s k i elds Q f'i ye Unit/Ste # /V Stark a Eror /QS Description of Work Deck Multi-Family Bldg Y- N Fireplace(s) AT 0 X 1 _ 2 Property Owner S o ? h P4 sh W leer Telephone # (AL ) 3 9-T , 'Sol 90 Contractor Address State City zip a hone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Catesorv 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted , Licensed Plumber Telephone #( Mechanical Contractor Sewer/Water Contractor Telephone #( MAR 1 2 I hereby apply for a Residential Building Permit and acknowledge that mformatiot mpl to and accurate; that the work will be in conformance with the ordinances and codes of ft? e State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. -?o ar.? PP?SN ou1JEi? Applicant's Printed Name App ec is Signature OFFICE USE ONLY Sub Types r ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi ? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt- SF ? 04 02-plex ? 10 08-plex T 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types 0 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors 10 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Z, U a Occupancy 2 ' 3 MC/ES System Census Code y3 y Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const 1? rt Width Footings (new bldg) Footings (deck) Footings (addition) _ Foundation _ Drain Tile Roof Ice & Water Final Fireplace _ R.I. -Air Test -Final Insulation REQUIRED INSPECTIONS _ Final/C.O. ?Q Final/No C.O. Plumbing _ HVAC Other Pool _ Ftgs _ Air/Gas Tests _ Final Siding _ Stucco _ Stone Windows (new/replacement) Retaining Wall Approved By Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total 1 a CERTIFICATE OF SURVEY FOR LEISURE LANE Z. Scale: 1," a 40' it Denotes Iron fbn. N 500.01'11"W $ ? ° ? vBlb4 12 ?. r3 _ ?1 1i Z 9.56 - - Noa•ta'si W 1 979 a ' _ LOT 9 z J /f. 884.7 _ .a x.15 ._.._ ?ei -,xss R. N ? I t+e? Pn'OPOSE ?K-?OI? Ot:Cs'F '?' i ?n I - m'61 ha . 14° G.1X. a ti: B9 ? 40 88 d IaS a 1 1 • I^ 59.50 n.5 - 225( II se X y I 891.4 8941 X L 892.8 P'O w Sanitary Sewer Jnvert Elev._ Lc..est Ir e! tN N 892 s 193.24 No0a00'07"E xe9xz -x Denotes Proposed Elevation 12.61 ?- • ? ? east Top of Basement Floor %091.6 ? 7.895.2 3 ©so SHIELDS DRIVE ?`?"°5° LEGAL DESSCRIPTION Lot 9, Block 2 LEMAY LAKE HILLS Dakota County, Minnesota I hereby certify that this is a true and correct representation of a survey of the boundariesof the shove described land and of the location of all buildings, MERILA & ASSOCIATES, INC. if any, thereon, and all visible encroachments, if any, from or on said land. ENGINEERS, SURVEYORS, SITE PLANNERS As surveyed by ethic day of,l9 frL. 1601. 67th Avenue North - Brooklyn Canter, Minnesota 55430 ?JI (/_ Aol Minn. Reg. No. `fy Telephone: (612) 5602660 Jab No. 9 C- /. 'Y Book - Page - EAGAN n_ so 2 ` RESIDENTIAL r BUILDING PERMIT APPLICATION CITY OF EAGAN U ?l 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 1 . New Construction Requirements • 3 registered site surveys showing sq. ft. of lot. sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) • 2 copies of plan showing beam & window saes; poured found design, etc.) • 1 set of Energy Calculations 3 copies of Tree Preservation Plan if lot platted after 711193 • Rim Joist Detail Options selection sheet (bldgs with 3 or few units) DATE SITE ADDRESS TYPE OF WORK •fijx/ MULTI-FAMILY BLDG >LY - N FIREPLACE(S) _ 0 _ 1 _ 2 `JTr?G„/il?r APPLICANT AtiiJ fQ -AIVZIP 9??/Z/ STREET ADDRESS ?Ay'JLE ia-5 krP.SUjS CITY STATE TELEPHONE # h6I?y5Z-.368 CELL PHONE #,!551-Z-06-1-045,0 FAX # -- PROPERTY OWNER LIotjk) 0. TELEPHONE# 65LI/CZ-2687 COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ y[I\ V FS01':\ RULES 7670 G\"f I:GORt" I MINNESOTA RULES 7672 (v submission type) • Residential Ventilation Category 1 Worksheet Submitted New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Plumbing system includes: Mechanical Contractor. NIC(hanical System includes: Sewer/Water Contractor: Air Condluonlttg Heat RccovM- System Phone # Lawn Sprinkler No. of R.I. Baths Phone --------------------------------------------------------------------------- I hereby acknowledge that I have read this application, state that the with all applicable State of Minnesota Statutes and City of Eagan Or( Signature of Applicant OFFICE USE ONLY Water Softener _ Water Heater No. of Baths RemodallReoair Requirements ( ?fZ?? 4C)? • 2 copies of plan • ].set-ef{roergyCaiadaflons for heated additions N o • 1 site survey for exterior additions & decks • Irrdi are4yed by septic system for additions VZ) VALUATION j'?4,&D Phone Fee: $90.00 ------------------------------------------ motion is correct, and agree to comply Certificates of Survey Received - Tree Preservation Plan Received _ Not Required Updated 4102 OFFICE USE ONLY ? 01 Foundation ,,o(Z-02 SF Dwelling ? 03 01 of_ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex ? 07 05-plex ? 13 16-plex ? 08 06-plex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 o8-plex ? 11 10-plex ? 19 Lower Level ? 12 12-plex Plbg_Y or - N ? 20 Pool ? 21 Porch (3-sea.) ? 22 Porch/Addn.(4-sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous ? 31 New ' 3 ratio ? 34 Replacement J, I ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation d(t21.) Occupancy Q.. MC/ES System _ Census Code t-! 3 Zoning City Water SAC Units Stories Booster Pump _ Nbr, of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered _ Type of Const A) Width REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. V Footings (deck) F i _ FinaVNo C.O. oot ngs (addition) Plumbing Foundation HVAC Drain Tile _ Other Roof _ Ice & Water - Final - Pool _ Ftgs _ Air/Gas Tests _ Final Framing _ Siding _ Stucco Stone _ Fireplace _ R.I. -Air Test - Final _ _ Windows (new"replacement) Insulation - Retaining Wall Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Approved By Building Inspector .y ' gap Scale: V - 40' o Denotes Iron ('c 500.0!'11"W Z 9.56 879 x Q 89?- 10 Sanitary Sewer a°_ ?• nvert Elev. _ Il,1YY W N P N Q• CO N N x Denotes Prc 1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS I ' 0 INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES.OF S VEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CO RACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE LOWED ONCE BUILDING PERMIT IS TSSrI£n_ MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS OFFICE USE ONLY INCLUDE 2 SETS OF PLANS, CERTIF ATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS SEP 16 1988 To Be Used For: bftk Fx?gvsimM Site Address 3o6'a sh,o/ds Dn , ? Valuation: ) Date: SsP-L• lit, JIT7 Lot .31 Block On site sewage- MWCC system Parcel/Sub 11kl„ In 1i ?VA, f trn?=,A, On site well T" City water Owner AC 7E?y ? zg4s PRV required Address -30-<0 S{1iE95 AP. -A /07 Booster Pump City/Zip Code rAc6 s? NIV $Sl:Z 1 /loh,E 4?52•o7PS/we.er Phone 69a -15'7)- APPROVALS Contractor _ Address City/Zip Code Phone Arch./Engr. R 4yUOA/I kwec Address 02801 64- "L4x &Y.O, City/Zip Code /W4. /W Phone n 791 -345-4) 0 OF UNITS Occupancy Zoning Actual Const Allowable # of stories Length Depth S.F. Total Footprint S.F. FEES Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn Water Meter Road Unit Treatment P1 Parks Copies TOTAL -2 C'O Engr/Assess Planner Council Bldg. Off . Gj1 9 19 Variance Scale: V = 40' o, Denotes Iron ;1o; W N K1 p• 0 CD Z Bey Z 9.56 x ? - l ' I_ LOT 9 1 1 ~ _ 1 J a` And wm fr easemnt 47 r? f36 N n?? Sanitary Sewer O/N `°_ ?•`? j6 overt Elev. d 8 ?k asaa _ t o ,. `7- -?1 z 3a.i5- - - - - 34-.81 b+T 34 S2 34 s9 N ? r Y." o PROMOS 04/NH000fE '? 4 ? S ?.? 892 n - n 59. 50 1? N H X? N x N 89/.4 Fla ,IN GaK. t'z ; 993 @92.1 1 99.24 i•% x 892.8 N 00.00' 07" E X 896 Z 0 J s NI -? x sis.2 x Denotes Pro CERTIFICATE OF SURVEY FOR LEISURE LANE Scale: 1' = 40' o Denotes Iron tbn. Ift g. +n 11' , o r. to Z $00°Of'11"W 126,23 - 2 9.56 - - - Npb°la'21"w B7y x \ r - LOT 9 ^ I QUM9! aA vgltt n e? O '36 Y easteent N" \ ?^ A 510 / i '?ppi 0 e 7s\? ? ? ` ? l2"E ? ?k 834.7 +2? 34.'15 34.61 .a 43. d Js 1 ^' < 34.52 34 N t' PROPOSED TOI?NH0(CfE V n N ` o g3 GAR. IL 1/ : B 93 Y I I 12,47 17.0 Q. 4.4 1 N t 11.53 4D 'a OS v 10.5 la, Z _ - 0 - - - I.5 - - - - - N 59- 50- - ? ?N N ? lV I X Y tV 891-4 842./ - - d - 1% T Y 97fr_ 4 ?1 W ?t f1 C . ? T,7 55 0 ?Z 1 s N Q 10.63 ? IS a5 1 1 TI.S 1 - 22.85 r 'W 11f X896 X 892.8 892 x 12.514--'? 193.24 Noa°00'07"E x a91.6 0 SHIELDS DRIVE Z. 514 ,4 a J? w N -0 X 895. Z X 815. 2 Sanitary Sewer Invert Elev., = 976.2 Lowes-? r.'.) x Denotes Proposed Elevation 885R2 Top of Basement Floor -.0, L+\lA II0 `S 0 LEGAL DESCRIPTION Lot 9, Block 2 LEMAY LAKE HILLS Dakota County, Minnesota MERILA & ASSOCIATES, INC. ENGINEERS, SURVEYORS, SITE PLANNERS 1601 - 67th Avenue North - Brooklyn Center, Minnesota 55430 Telephone! (612) 560-2660 I hereby certify that this is a true and correct representation of a survey of the boundariesof the above described land and of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or on said land. As surveyed by a this day of /fd, 19 ?6. Minn. Reg. No. Job No. 9 C-Z EV Book - Page t " 13 3?y 2000 FIREPLACE PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD - 55122 651 681-4675 I bo.50 Date: /D • / / • (X) Description of Work: Q Construct new fireplace Install was insert only Other Gas -Masonry Alterations to existing Install gas line only Job address: ?5U Lot: Bock: Subdivision/P.I.D. #: 666 L04 Hll Applicant (circle one only): Owner ontractor Permit Fee. 860.50 Name: S' 1 A?a It ( P)ft A ? Phone #: UEJ - L PROPERTY Last First OWNER " Street Address:Qi ? S h tzb i d/L?I A i A l fl 'CI 104 City On Wi) State: M L \ Zip: sn) Company:, .LdO l V of 1 I Q I ?,Phone #: (D sl _?4 (J (area code) FIREPLACE INSTALLER Street City nvv &(NY ik4 State: (nx-) Zip: ssb-n v Company: 0, ` r" ),/ Un liLn- - Phone #: (area code) GAS LINE INSTALLER Street City State: Zip: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and Cityp'f Eagan: - dinances. /?f OCT i 2.C0 OFFICE USE ONLY BUILDING PERMIT TYPE ? 16 Fireplace WORK TYPE ? 31 New ? 33 Alterations ? 39 Gas Line ? 41 Wood Stove ? 32 Addition ? 34 Repair ? 40 Gas Insert GENERAL INFORMATION Census Code 434 SAC Code 01 REMARKS Chimney/flue must be inspected before concealing. /as3 s _. 1986 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.0 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, ?y $2,000 LANDSCAPE BOND UNITS Io1,loZ,103, 101l4i1OS 10h,1(??,IOg To Be Used For: 7 , txr? T /' Valuation: 1 A n . ,r n ... -T Site Address J O 'I L11 -51 Lot J Block 2 Parcel/Sub L-SMA'f LAVE-- OILLS Owner 04 z AG I L /t'?EILI '/" Address ]/D/ E6, ye A i14 5G City/Zip Code Phone O? Contractor 42-- Lfv Address-??--? - c City/Zip Code Phone Arch./Engr. Address City/Zip Code Phone # Erect Remodel Repair Addition Move _ Demolish Int.Impr. Install Date: 7 // T/ F Occupancy Zoning Type of Const T7 C/ 0 of Stories Length Depth 5 41 Sq Ft APPROVALS FEES Assessments Permit /Z/? So Water/Sewer Surcharge C _3 'w Police Plan Review 725 25 Fire SAC ?- Engr Water Conn ?,/OC?D Planner Water Meter A114 Council Road Unit 20- Bldg Off / Treatment P1 /.2 APC Parks /I Variance Copies TOTAL S3--l 1 NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. 4/6 357v? 1/33 1171 ?' 5o ?Woe- ,1017,V- . 5 = 2 3.5 2?/3, Sri 7546 S75x ? = ?G? /?mz C/?r ,?,exs 2320 i2 /o of eec lan 3830 PILOT KNOB ROAD, P.O. BOX 21199 BEA BLOMQUIST EAGAN, MINNESOTA 55121 mayor PHONE: (612) 454-8100 THOMAS EGAN "ES A SMITH MC ELLISON THEODORE WACHTER OCTOBER 30, 1987 Ommil KAO ne THOMAS HEDGES CW PCminimalw EUGENE VAN OVERBEKE C,NCe TO WHOM IT MAY CONCERN: Please be advised that the city of Eagan does not issue Certificate of Occupancy statements on individual units of multiple dwellings. Once the building is completed, we will issue one Certificate of Occupancy for the entire building. At present,3050 SHIELDS DRIVE, UNIT (1108 by the City of Eagan for occupancy. Sincerely, r Doug Reid Chief Building Official DR13s has been inspected and approved THE LONE OAK TREE ...THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY SNOW STORAGE DRAINAGE AND UTILITY EASEMENT THIS INDENTURE, mace and entered into this 61?- clay of MAY 1986, by and between MARTIN E. SHIELDS and MYRTLE E. SHIELDS, husband and wife, as Grantors, and the CITY OF EAGAN, Dakota County, Minnesota, as Grantee, WITNESSETH WHEREAS, said Grantors, in consideration of One Dollar ($1.00) and other good and valuable consideration, to them in hand paid by the said Grantee, the receipt whereof is hereby acknowledged, do hereby Grant, Bargain, Convey and Warrant to said Grantee, its' successors and assigns, the snow storage, drainage and utility easements situate in Dakota County, Minnesota, as follows: The westerly twenty (20) feet of the following lots, all being in the plat of Lemay Lake Hills, Dakota County, Minnesota: r4 ? Lots 1, 7, 8,-9, 10 and 11 of Block-2. said twenty (20) feet being immediately adjacent to the easterly right-of-way line of Shields Drive in said plat. The Grantee shall have the right to do whatever is necessary for the enjoyment of the rights herein granted, including the right of clearing the right-of-way of ingress and egress to and from said tract of land and over and across said easement only for the purpose of snow storage, drainage, laying, maintaining, operating and repairing said utility lines. By acceptance of these easements, the Grantee agrees that it shall replace any shrubs or son removed by it in the exercise of its rights hereunder to as near the condition which existed immediately before such rights were exercised as is reasonably possible. IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seals the day and year first above written. Martin E. Shields &e.7e ,??.?"Q Myrtl E. Shields STATE OF MINNESOTA) ss. COUNTY OF 1 ?O) On this 5 day of 19'"° before me a Notary gP,ubl within and for said County, pers nally appeareat'J,,,t," e ' 1'4w X42&'!g" ? me personally known to be the person described in and who execu[ the 4,1.4"4/.. foregoing instrument and acknowledged that 4-hrecutea the 7ame asrhg4,4 free / act and deed. (S E A L) ry Public THIS DOCUMENT DRAFTED BY: _.____""""'" ----"""'"""" HAUGE, EIDE s KELLER, P.A. HAROLD L9VA JRR. NOTARY PURJO-VNMA 1200 Yankee Doodle Roaa Water View Office Tower, Suite 303 ? comm. Dom JUNE 11 19M rv?nnrn?v. Eagan, MN 55123 (612) 456-9000 EXEMPT FROM STATE DEED TAR STAMPS W31 i MEMO TO: TOM COLBERT, DIRECTOR OF PUBLIC WORKS -JI14 STURM, PLANNING DEPARTMENT BILL AKINS, ELECTRICAL INSPECTOR CRAIG KNUDSEN, ENGINEERING TECH FROM: DOUG REID, BUILDING INSPECTIONS DEPT DATE: SEPTEMBER 23, 1987 The Protective Inspections Department will be performing a final inspection for occupancy of 38396&-3050 MM_DS DRIVE on SEPTEMBER 30, 1987 Please return within 48 hours with your approval or denial. Failure of response within that time frame will be determined as approval. It will be each departments responsibility to contact the construction firm with necessary requirements before final inspection and notifying the Building Inspections Department when all requirements have been taken care of. Thank-you. DR/js APPROVAL Y'12. ?l,?J ti'i DENIAL- & DATE) (SIGNATURE & DATE) 4F - M .. y (gex#ifiratr of Mrruvttnrij 4'Citp of eagan arvar#nrnt of 11dibing Jwwrrtim This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following.' U. Ctmr"(ioo 8 UNIT "-I). Pemil No. 19515 O=? Wy Type R! Zoning Diadd FI) Type C v Vn - Kam (; PFTg Add, 7101 RRAT747 ARn PTITNA Owns n(Bvildins Builein Addrcs 3050 SI12FdIi ?Atit/F: 1.aiar A, 5 IM= ee t MUM 74IQ87 BoldloB Olrui l f'" POST IN A CONSPICUOUS PLACE RECORD OF COMPLAINT Date: October 12, 1993 Type of building: Multi-family Name: Laurel Moran Address: 3050 Shields Drive, Unit 107 Legal description: Lot 30, Block 1, LeMay Lake Hills Townhomes' Phone number: 681-1757 Complaint: Patio door problem Action taken: The threshold was drooping on the basement patio door. I told Laurel that more support would have to be placed under the threshold on the outside to fix the problem. Dale Schoeppnet/ Building Inspector J ' S I 1) 4 CITY OF•'EA-GAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION NOTE: PAYMENT OF FEE AT TIME OF APPLICATION DOES NOT CONSTITUTE APPROVAL OF PERMIT. INSPECTION OF SEWER AND/OR WATER INSTALLATIONS WILL NOT BE SCHED- ULED UNTIL PERMIT HAS BEEN APPROVED. e Print) 3070 /o7 PROPERTY ADDRESS:0 - ?® a L?? fa yn 4E? ?` LEGAL DESCRIPTION: Lot Block Subdivision or Tax Parcel ID ) „ IF EXISTING STRCCTLTE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: PRESEN'T ZONING/PROPOSED USE: Mon Year) ? COMMERCIAL/REPAIL/OFFICE ? INDUSTRIAL ? INSTITUTIONAL/GOVERNMENT R-1 SINGLE FAMILY ? R-2 DUPLEX (Two Units) R-3 TOWNHOUSE (Three + Units) (j Units) ? R-4 APARTMENT/CONDOMINIUM ( Units) 2) ?i NAME: ADDRESS: CITY, STATE, ZIP: L--_• PHONE: y=?_ 9 /V - oz (oi r 3) c a• NAME• *"=V "e- 7 For City Use Plumbers License: ADDRESS: P Active i CITY, STATE, ZIP: Expired Not recorded PHONE: Sy.S c?7/o If LICENSEW-yU Stoma Initial 4) NAME: ADDRESS: CITY, STATE, ZIP: PHONE: -5) n r• : a •: :: • a• a• CONNECTION TO CITY SEWER CONNECPION TO CITY WATER OTHER 6) " '_ •?" PLEASE HOLD APPROVED PERMIT FOR PICK-[JP BY ONE OF ABOVE - f PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE (Circle one) F ., FOR CITY U8E ONLY PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ $ /o- 5-6 SEWER PERMIT (INCLUDE SURCHARGE) $ $ / D s ( WATER PERMIT (INCLUDE SURCHARGE) / $ 6 3 S -D ` 6& 73 $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER ' rr 7 3 R adn / $ $ / •`J i r ACCOUNT DEPOSIT - WATE - $ _57:) 0 .69 O $ WAC $ > 7S'v 0 $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ ?Z ;;?j /r Ci z) $ TOTAL RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC NO Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING DIVISION LIST . AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: ?, /? 7 APPLICATION FOR PERMIT CITY OF EAGAN SEWER AND/OR WATER CONNECTION xwxxzwwzxxxxxxwwx:xzxsxxxzxwz*****•q *XYTF': PAV4Wr OF FEE AT TIME OF APPLICATION DOES NOT CONSTITUTE APPROVAL OF PERMIT. INSPECTION OF SEWER AND/OR WATER INSTALLATIONS WILL NOT BE SCHED- ULED UNTIL PERMIT HAS BEEN APPROVED. (Please Print) 1) PROPERTY ADDRESS: 3Q lO -f 3 Ship Z4& LEGAL DESCRIPTION: (Lot/Block/Subdivision or Tax Parce ID ) IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: i (Mon Year) PRESENT ZONING/PROPOSED USE: COMMERCIAL/RETAIL/OFFICE INDUSTRIAL INSTITUTIONAL/GOVERNMENT 2) r? NAME: ADDRESS: r7 R-1 SINGLE FAMILY R-2 DUPLEX (Two Units) ( R-3 TOWNHOUSE (Three + Units) R-4 APARTMENT/CONDOMINIUM CITY, STATE, ZIP: PHONE: ?Z6? a t - °_ (_ff Units) ( Units) 3) u r /? C For City Use 9?' Plumbers License: ADDRESS: P Active i CITY. STATE, ZIP: Expired Not recorded PHONE:_ JCL ?? a 74g 1ER LICENSE# ?ta?Initial 4) •• • is NAME: ADDRESS: CITY, STATE, ZIP: PHONE: CONNECTION TO CITY SEWER C• CONNECTION TO CITY WATER OTHER 6) n • r PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE _ (Circle one) J' TOR CITY USE ONLY PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ SEWER PERMIT (INCLUDE SURCHARGE) $ WATER PERMIT (INCLUDE SURCHARGE) $ G 3 SZ - CEO ?? $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ /L L-2% ACCOUNT DEPOSIT - SEWE $ R 7? ACCOUNT DEPOSIT - WATER (G $ SUc?`U C7 $ WAC $ c? ??^? CJ (J $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ I<< 'oo $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ / 1--?2 3 G Z? $ 2(2 Z) TOTAL 49 sl?' RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC NO Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING DIVISION LIS . T AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: A/ -^-- J A -,g /-/L TITLE: DATE: 2`7 /?? CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION xxxxxxxxxxxxzxxxxxzzxxxxxzxx####**x, NOTE': Pikywwr OF FEE AT TIME OF APPLICATION DOES NOT CONSTITUTE APPROVAL OF PERMIT. ± INSPECTION OF SEWER AND/OR WATER IES?TALLATIONS WILL NOT BE SCHED- ULED UNTIL PERMIT HAS BEEN APPROVED. '•xxxxxxxxxxxxxxxxxxxxl?xxxxxxxxxxxllxx (Please Print) -7? 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: (Lot/Block/subdivision or Tax Parcel ID ) IF EXISTING STRU=VR2E, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: " hon Year) PRESENT ZONING/PROPOSED USE: Q C0SMCIAL/RETAIL/OFFICE r7 INDUSTRIAL n INSTITUTIONAL/GOVERNM[ENT R-1 SINGLE FAMILY 0 R-2 DUPLEX (Two Units) R-3 TOWNHOUSE (Three + Units) ( -Units) ? R-4 APARTMENT/CONDOMINIUM ( Units) 2) v?I NAME: ADDRESS: CITY, STATE, ZIP: PHONE: 3) u .:• NAME: ADDRESS: i CITY, STATE, ZIP: PHONE: 4) i? NAME: ADDRESS: CITY, STATE, ZIP: PHONE: i LICENSE# Q y 7 'l=DerS L1Cense: Active Expired Not recorded Staff initi7al 5) ?• a •:• :? a? al a - ?IS CONNECTION TO CITY SEWER CONNECTION TO CITY WATER C1 OnM ' 6) PLEASE HOLD APPROVED PERMIT FOR PICK-LIP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE (Circle one) ) TOR CITY' USE ONLY PERMIT # ISSUED 2 Pd w/Bldg. Permit FEES: $ $ /O -/, D SEWER PERMIT (INCLUDE SURCHARGE) $ p $ /G`J WATER PERMIT (INCLUDE SURCHARGE) 73 $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ /S Q-c ACCOUNT DEPOSIT - SEWER 6 fQ /3 $ $ ACCOUNT DEPOSIT - WATE> y $ $ WAC $ $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $_ 5 C ro e-q $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ Z ?j b C) O $ Z TOTAL ?o7y/? j RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CbNDITIONS: APPROVED BY: TITLE: ??Z /? 7 DATE: CITY OF EAGAN .APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION -wxwxxxxxxwwwxwxxxwwxxwwwww**#***#*iq NOTE: PAYMENT OF FEE AT TIME OF APPLICATION DOES NOT CONSTITUTE APPROVAL OF PERMIT. i y INSPECTION OF SEWER AND/OR WATER INSTALLATIONS WILL NOT BE SCHED- k ULED UNTIL PERMIT HAS BEEN • k : APPROVED. % - ^wxwwxxxxxxxxwwwxxxxxxwxwwwwwxxxxxwx (Please Print)/ 1) PROPERTY ADDRESS: ?O 50 - I /J / S/ i ?Cy $" ?Y i d P LEGAL DESCRIPTION: (Lot/Block/Subdivision or Tax Parcel ID IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT'ISSUANCE: PRESENT ZONING/PROPOSED USE: Mon Year ? CO.RCIAL/RfiTAIL/OFFICE INDUSTRIAL n INSTITUTIONAL/GOVERNMENT 2) r? R-1 SINGLE FAMILY R-2 DUPLEX (Two Units) R-3 TOWNHOUSE (Three + Units) (Units) R-4 APARTMENT/CONDOMINIUM ( Units) NAME: ADDRESS: CITY, STATE, ZIP: PHONE: r z .f - scri L 41 3) NAME./ For City Use .. Plumbers License: ADDRESS: Active Expired i CITY, STATE, ZIP: Not recorded PHONE S/5- tL7Ca c? LICENSE# h 37 ZVO Sta Initial 4) "w • is • NAME: ADDRESS: CITY, STATE, ZIP: PHONE: •5) :s w i a •:• :: ?'• CONNECTION TO CITY SEWER C8' CONNECTION TO CITY WATER cl OTHER 6) • ?" ® PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE (Circle one) 7) FOR CITY USE ONLY PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ $ 10 - S SEWER PERMIT (INCLUDE SURCHARGE) $ $ WATER PERMIT (INCLUDE SURCHARGE) / $_ $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER $ pp R 646 3 $ U ACCOUNT DEPOSIT - WATE $ J d L-) $ WAC $ 7S "C?' O $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ LATERAL BENEFIT/TRUNK WATER U U $_ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $_ 2- U 6 $ 2- l ` ?7) TOTAL RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAV ATION IN PUBLIC RIGHT OF WAY? O YES IF YES, THEN A "P ERMIT FOR WORK WITHIN PUBLIC NO Q ROADWAY" MUST BE DIVISION LIST A ISSUED BY THE ENGINEERING S . A CONDITION. SUBJECT TO THE FOLLOWING cbNDITIONS: APPROVED BY: c , TITLE: DATE: c'?/ /1 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION NOTE: PAYMENT OF FEE AT TIME OF APPLICATION DOES NOT CONSTITUTE APPROVAL OF PERMIT. INSPECTION OF SEWER AND/OR WATER ROIAL ATIONS WILL NOT BE SCBED- OLED UNTIL PERMIT HAS BEEN APPROVED. ----------------------------------- (Please Print 1) PROPERTY ADDRESS:30 $U _) Or ?? ?? ?? / dP " LEGAL DESCRIPTION: (Lot/Block/Subdivision or Tax Parcel ID F) IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT•ISSUANCE: PRESENT ZONING/PROPOSED USE: (hbn Year) [] COIDMCIAL/RE!'AIL/OFFICE Q INDUSTRIAL ? INSTITUTIONAL/GOVERNMEM 2) R-1 SINGLE FAMILY R-2 DUPLEX (Two Units) ICI R-3 TOWNHOUSE (Three + Units) R-4 APARTMENT/CONDOMINIUM ADDRESS: CITY, STATE, ZIP: PHONE: y y , a,/ (Lnits) ( Units) 3) u ::• NAME: For City Use Plunbers License: ADDRESS:--Z,2 //-. A r A Active led "° icla?i LHl i CITY, STATE, Not recorded PHONE: MAS LICENSE#, 4 2 /7 U4 Sta Initial NAME: ADDRESS: CITY, STATE, ZIP: PHONE: CONNECTION TO CITY SEWER CONNECTION TO CITY WATER OTHER 6) v • i. PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE r f1 ' (Circle one) FOR CITY USE ONLY , PERMIT # ISSUED 5v Pd w/Bldg. Permit FEES: $ $ ?? 5 d SEWER PERMIT (INCLUDE SURCHARGE) $ $ / e,5?6 WATER PERMIT (INCLUDE SURCHARGE) $ Ion 7 3 $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER > 7-3 $ $ / ?j C-V ACCOUNT DEPOSIT - WATER $ .?7o-oo $ WAC $ . 7 7 S L? $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ 12- 3 /. $ Zl, !/ Z) TOTAL ??G G 7f RECEIPT RECEIPT DOES UTILITY CONNEC TION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC NO Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING DIVISION LIST AS O . A C NDITION. SUBJECT TO THE FOLLOWING CONDITIONS: 1 ? APPROVED BY: TITLE: DATE: /Z' cs J r CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION *RYIa•: PAYMENT OF FEE AT TIME OF APPLICATION DOES NOT CONSTITUTE APPROVAL OF PERMIT. INSPECTION OF SEWER AND/OR WATER INSTA .[ATIONS WILL NOT BE SCH D-- ULED UNTIL PERMIT HAS BEEN APPROVED. (P -- lease Print) -------- 1) PROPERTY ADDRESS: vC? LEGAL DESCRIPTION: (Lot/Block/Subdivision or Tax Parcel ID ) IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: PRESENT ZONING/PROPOSED USE: (rbn Year) CCM4ERCIAL/RETAIL/OFFICE INDUSTRIAL INSTITUTIONAL/00VERNM4T R-1 SINGLE FAMILY Q R-2 DUPLEX (Two Units) 1"-Iv R-3 TOWNHOUSE (Three + Units) (Units) R-4 APARTHM/CONDOMINIUM ( Units) 2) NAME: ADDRESS: CITY, STATE, ZIP: .??w :,G PHONE 3) u m a• For City Use .. NAPE:- /-" 6:'0 Plumbers License: ADDRESS: P Y i Active Expired i CITY, STATE, ZIP: Not recorded PHONE: 5?1 5 ?? GG TER LICENSE# Staff -Initial 4) •.« • i? NAME: ADDRESS: CITY, STATE, ZIP: PHONE: •5) • v i a •:• :o • a• CONNECTION TO CITY SEWER CONNECTION TO CITY WATER Q OTHER 6) • • r rn PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE ,7/7 (Circle one) s 4k TOR CITY USE ONLY PERMIT # ISSUED JTS o c Pd w/Bldg. Permit FEES: $ $ /7 S? SEWER PERMIT (INCLUDE SURCHARGE) $ $ WATER PERMIT (INCLUDE SURCHARGE) $ 73$ WATER METER/COPPERHORN/OU DE S T I READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER d'd Z3 $ $ J 'O D ACCOUNT DEPOSIT - WATER $ ?I? • D C? $ WAC $_? JS' ltd $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ /. • U U $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ A2 () $ ?' UZ) TOTAL ? 6 6 -7 RECEIPT. RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION . LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: ?2 G? J TITLE: r/ y DATE: ! ... CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION NOTE: PAYM1M OF FEE AT TIME OF APPLICATION DOES NOT CONSTITUTE APPROVAL OF PERMIT. INSPEMON OF SEWER AND/OR WATER INSIALLATIONS WILL NOT BE SCHED- ULED UNTIL PERMIT HAS BEEN APPROVED. P ease Print) 1) PROPERTY ADDRESS:03p-/pZ LEGAL DESCRIPTION: Lot B ock Subdivision or Tax Parcel ID) IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: " PRESENT ZONING/PROPOSED USE: (Mon Year) ? MUIERCIAL/RETAIWOFFICE Q INDUSTRIAL ? INSTITUTIONAL/GOVERNMENT U 2) ® NAME: ADDRESS: CITY, STATE, ZIP: PHONE: 3) Q- :1• NAME: ADDRESS: i CITY, STATE, ZIP: PHONE: 4) NAME: ADDRESS: CITY, STATE, ZIP: PHONE: Plumbers License: Active Expired Not recorded to Initial CONNECTION TO CITY SEWER CONNECTION TAD CITY WATER ? OTHER '. 6) "• • r PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE - PLEASE MAIL OVID PERMIT TO 1, 2, 3, 4, ABOVE (Circle one) 7) r r. 1/ d ,? 1'd a?L?J mail-046 -) , ---L -7- 4r-' 7 ? R-1 SINGLE FAMILY ? R-2 DUPLEX (Two Units) R-3 TOWNHOUSE (Three + Units) ( ' Units) ? R-4 APARTMENT/CONDOMINIUM ( Units) cv: - /176 MASTER LICENSE# r 1_ C 5 lrI TOR CITY USE ONLY PERMIT # ISSUED g To Pd w/Bldg. Permit FEES: $ $ n SEWER PERMIT (INCLUDE SURCHARGE) $ WATER PERMIT (INCLUDE SURCHARGE) $ h 3-S - G3D23S WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ (7 ACCOUNT DEPOSIT - SEWER $ $ /SD O ACCOUNT DEPOSIT - WATER $ d?O7 $ WAC $_ 7. S^ O O $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ / G o $ WATER TREATMENT PLANT SURCHARGE $ $ 7 OTHER: $ U O TOTAL c 7 S -71o RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: Z 71J 7 i CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx*xN07E: PAYMENT OF FEE AT TIME OF APPLICATION DOES NOT CONSTITUTE APPROVAL OF PERMIT. INSPECTION OF SEWER AND/OR WATER INSTATSATIONS WILL NOT BE SCHED- ULED UNTIL PERMIT HAS HEW APPROVED. (Please Print 1) PROPERTY ADDRESS: =Q? LEGAL DESCRIPTION: " (Lot/Block/Subdivision or Tax Parcel ID IF EXISTING STRL•XM.''RE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: (Mn Year PRESENT ZONING/PROPOSED USE: [] CM1MERCIAL/RSTAIL/0FFICE INX''STRIAL INSTI'IL'TIONAL/GOVERNMENT M R-1 SINGLE FAMILY rl R-2 DUPLEX (Two Units) R-3 TOWNHOUSE (Three + Units) R-4 APARTMENT/CONDOMINIUM ( Units) ( Units) 2) ADDRESS: CITY, STATE, ZIP: PHONE: 3) y c:• - NAME: ADDRESS: i CITY, STATE, ZIP: 4) ••r • is NAME: ADDRESS: CITY, STATE, ZIP: PHONE: L? _ ? / /1? f??a/L /?L Gtkc-tt, y !' 1 I V .J S ?F L- 5 ?J 1 7?n / MASTER LICENSE 62-b -)-7 t'Yl Active Expired Not recorded Ste Initial CONNECTION TO CITY SEWER C] CONNECTION TO CITY WATER [3 ann. 6) r • r PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE "- - 0 PLEASE MAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE (Circle one) L FOR CITY USE ONLY : PERMIT # ISSUED ?s6 7 Pd w/Bldg. Permit FEES: $ $ / S SEWER PERMIT (INCLUDE SURCHARGE) $ $ WATER PERMIT (INCLUDE SURCHARGE) $ (1J?i- S? 'yv?' ? WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ (F ACCOUNT DEPOSIT - SEWER 73 $ $ ACCOUNT DEPOSIT - WATER $ ?O C1Z? $ WAC $ ?.? Q o $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER -7 $_ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ 1 2 3 1' o o $ G Z TOTAL RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? 0 YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: /? 7 /? 7 wl) COMMERCIAL BUILDING 5?V9O Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 S "-4 I4 S Foundation Only New Building Interior Improvement • Structural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) sets • Civil Plans (2) • Structural Plans (2) • Code Analysis (1) " • Certificate of Survey (1) • Civil Plans (2) • Project Specs (1) • Code Analysis (1) " • Landscaping Plans (2) • Key Plan (1) • Project Specs (1) • Code Analysis (1) • Master Exit Plan (1) • Spec. Insp. & Testing Schedule " • Certificate of Survey (1) • Energy Calculations (1) not always" • Soils Report (1) • Spec. Insp. & Testing Schedule (1) • Elec. Power & Lighting Form (1) not always" • Meter size must be established • Meter size must be established • Meter size must be established-if applicable 1 • Project Specs (1) l • Energy Calculations (1) " l y • Electric Power & Lighting Form (1) l • Master Exit Plan (1) 1 1 • Emergency Response Site Plan (1) l • Soils Report (1) l • SAC determination - call 651.602-1 000 • SAC determination - call 651-602-1 000 SAC determination -call 651-602-1000 Call MN Dept of Health at 651-215-0700 for details regarding food & beverage or lodging facilities. *• Contact Building Inspections for sample and if required when it states "not always". *** Permit for new building or addition will not be processed without Emergency Response Site Plan. Date / 26 > / D Construction Cost l C61 ?l -? Site Address W ? (? ? AIaJs [)t. unit/Ste # Tenant Name Ler v. ??" ? y ?,.( OMM y? r !f c tFormer Tenant Name r , n TOr 'D?1 f ?ro? Description of Work C Property Owner Lv t %loo9 me, R55 L h or) Telephone #R 5?,) C1 - Z3 Q D Contractor itCfi? ?J Address ?2 II ?^4_) 1?( Z ?-0(J I City b-kri-6 tG Statepp lgR zip 55307 Telephone #(,5Z)7D7 Arch/Engr Registration # Address City State Zip Telephone # ( ) Licensed plumber installing new sewerlwater service: i Phone #: () I hereby apply for a Commercial Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Dl(.tX??NL?i&?r Applicant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Types C 01 Foundation 14 Apartments 15 Lodging L 25 Miscellaneous Work Types ? 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement Valuation Census Code SAC Units Nbr. of Units Nbr, of Bldgs Type of Const 26 Public Facility C 27 Commercial/Industrial 28 Greenhouse _I 29 Antennae 30 Accessory Bldg. ? 32 Ext Alt - Apts. 34 Ext Alt - Comm. 71 35 Ext Alt - PF ? 37 Nail Salon ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors `Demolition (Entire Bldg only) - Give PCA handout to applicant Occupancy MC/ES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered Width REQUIRED INSPECTIONS - Footings (new bldg) Footings (deck) Footings (addition) _ Foundation _ Drain Tile Roof _ Ice & Water _ Final Framing - Fireplace _ R.I. _ Air Test _ Final Insulation _ Final/C.O. _ Final/No C.O. Plumbing _ HVAC Other Pool _ Ftgs _ Air/Gas Tests - Final Siding _ Stucco _ Stone Windows (new/replacement) Retaining Wall Approved By Base Fee Surcharge Plan Review IVC/ES SAC City SAC Water Supply & Storage S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Copies Other Total Building Inspector RESIDENTIAL BUILDING (OJ Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 9 7o. eo 1, New Construction Requirements RemodeVReoair Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. ft, of house; and all roofed areas 2 copies of plan _ Can of Survey Recd (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions -Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & ded(s -Tree Pres Not Reqd 1 set of Energy Calculations Addition - indicate iron-site septic system _ On-site Septic System 3 copies of Tree Preservation Plan it lot platted after 7/1193 Rim Joist Detail options selection sheet (bldgs with 3 or less units Date r ex 0, lie, Construction Cost - Site Address _?Q ,S (> ?, hl eMs on Unit/Ste # e a PS 6-Jldi( Description of Work i K 1 a e c Multi-Family Bldg XY - N Fi Property Owner /' 7 a I?,j / & ? C 13 3 One Telephone # & f/) VO S 9 ? b 7 Contractor ry . f;kY/ Address 31 ? (a O S 1, City State n . Zip S,5 o 3 / (Telephone # vds/) (a 3 3 2 a0399071 - COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minne eta Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category , Res a t'- venEliit_W "I' Category?Worksheet New Energy Code Worksheet (J submission type) Sul?rj)l eth ?P7 f -, F-9 Submitted Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. DwoVnc L-• Laird Applicant's Printed Name Telephone #( Telephone #( D?? Ti Applicant's Signature OFFICE USE ONLY i i r Sub Types = ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of- plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-piex ? 10 08-plex x 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding JZ 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement "Demolition (Entire Bldg) - Give PGA handout to applicant Valuation tow Occupancy /Z `3 MC/ES System - Census Code y 3 y Zoning d City Water SAC Units _ Stories Booster Pump - Nbr. of Units Sq. Ft. / PRV J Nbr. of Bldgs _ Length ?2 Fire Sprinklered r Type of Const Width /z REQUIRED INSPECTIONS _ Footings (new bldg) Final/C.O. Footings (deck) _ Final/No C.O. Footings (addition) _ Plumbing Foundation _ HVAC Drain Tile Other Roof _ Ice & W ater _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final Framing Siding Stucco Stone Fireplace - R.I. Air Test - _ _ _ Final - Windows (new/replacement) Insulation - Retaining Wall Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Approved By Building Inspector CERTIFICATE OF SURVEY FOR LEISURE LANE Z.. Seale: 1.' • 40' o Denotes iron lbn. W x N m .n t N ? s So 0.01'11"W $ _ _ ? ? xe7a.e 29.56 ___ Nlosa?v?w ;w 879 X " r 1 t z LOT 9 O ?_? 1N We S 1 •'•mf t- ..? = 13 s besee?nt N fuse w: Y ?,A 980.7 N I t g PROPOJE f;K"?OG/ OUJF ' 's 1 N -? ' n 64it. N: B +sl 4.4 tN l? ,1896 X Y 89/.9 @9{I IN. X L 892.8 ( fp JO 892 a eJCf <= - X 091.6 Soso Sanitary Sewer )nvert Elev., • e71- .z Loweab Ir '.l ----_-_1s 14 199.24 NOW 7"E' xe7s2 X Denotes Proposed Elevation asst' Top of Baseplent Floor X B9s I . SHIELDS DRIVE MERILA & ASSOCIATES, INC. ENGINEERS, SURVEYORS, SITE PLANNERS 1601 • 671h Avenue North- Brooklyn Center, Minnesota 66400 Telephone: (612) 56&2660 LEGAL DESCRIPTION Lot 9, Block 2 LEMAY LAKE HILLS Dakota County, Minnesota I hereby certify that this is • true and comae representation of a survey of tha bounds imol she above dawibed land and of the location of all buildings, if any, thereon, and all visible encroachmenta, If any. from or on mid land As surveyedby this 7-7 01 day of"&&IL, 19 frt.. -, Minn. R4 No. ?? Job No. I? C-IS Sy Book - Pape G/`1GA V R WED BY DATE BUILDING INSPECTIONS DEPT. RESIDENTIAL BUILDING f7p Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 al? New Construction Requirements RemodeVReoair Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan _ Can of Survey Recd (20% maximum lot coverage allowed) l set of Energy calculations for heated additions -Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks -Tree Pres Not Recd 1 set of Energy Calculations Addition - indicate if on-site septic system _ On-se Septic System 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail options selection sheet (bldgs with 3 or less units Date /,)0 / 03 ^^ / Site Address 30 Construction Cost _ / t? O D r Unit/Ste # e Description of Work f 20 ? Multi-Family Bldg Y N Fireplace(s) _ 0 - 1 - 2 Property Owner p,r „rt YQ LIfy1 / Telephone # (b5 ?) 7ES'/ ?c? Contractor LnJ?1P "??iq / `r Address _Zc Ze ?- C L . City - two ? J - State Zip s S? ? Telephone Of (6_Vh 3 COMPLETE THIS AREA ONLY IF Energy Code Category - Minnesota Rules 7670 Cateeorv 1 • Residential Ventilation Category 1 Worksheet (J submission type) Submitted • Energy Envelope Calculations Submitted Licensed Plumber Mechanical Contractor Sewer/Water Contractor A NEW BUILDING _ Minnesota Rules 7672 • New Energy Code Worksheet Submitted Telephone # ( Telephone #( Telephone #II(J I hereby apply for a Residential Building Permit and acknowledge that the inforhitttion is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and-tlw-_S ate of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. D(k av1) P •To Applicant's rinted Name Applicant's Signa e OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of-plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex W. 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Yor_N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldgr ? 43 Reroof ? 46 Windows/Doors x 34 Replacement "Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Z 00 Occupancy- MC/ES System Census Code Zoning' D City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const V Width Footings (new bldg) Footings (deck) Footings (addition) Foundation Drain Tile Roof _ Ice & Water _ Final Framing Fireplace - R.I. -Air Test -Final Insulation REQUIRED INSPECTIONS Final/C.O. Final/No C.O. Plumbing _ HVAC Other Pool _ Ftgs _ Air/Gas Tests - Final Siding _ Stucco _ Stone Windows (new/replacement) Retaining Wall Approved By 5 F" -,Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total CERTIFICATE OF SURVEY FOR LEISURE LANE Scale: 1" = 40' o Denotes Iron Ion. 500.01'11"w z 4.56 Sanitary Sewer ?nvert Elev. = 876.z L(! N H 1(896 L Oa .o e W a rt? 892 x? rV vv- VO O I .. t %891.6 0 M 3 0 60 SHIELDS MERILA & ASSOCIATES, INC. ENGINEERS, SURVEYORS, SITE PLANNERS 1601 - 67th Avenue North - Brooklyn Center, Minnesota 55430 Telephone: (612) 560-2660 % 895, p x Denotes Proposed Elevation Basz Top of Basement Floor % 895 2 DRIVE LEGAL DESCRIPTION Lot 9, Block 2 LEMAY LAKE HILLS Dakota County, Minnesota I hereby certify that this is a true and correct representation of a survey of the boundaries of the above described land and of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or on said land. r As surveyed by e this day of - i , 19 ?6. ?.. // J606a-t Minn. Reg. No. Sy Job No. '9 C' Ir5l Book - Page ? oz n 2006 RESIDENTIAL MECHANICALPERMrr APPLICATION City of Eagan 3830 Pilot Knob Road, Fagan MN 55122 Telephone # 651-675-5675 I'h'asc. c.nmplcly fur: sin;*Ir. ralnily dwellings R; Intvnltnmes/cnndus when permils arc equircd liw each unit Hate -10...._?_.fD 7_6--( l'ropcrly lhvncr - - - - ---------- ('nlltlaetnl' --_____._..._ fi(reet Address - 3__Q - - --- Slate 0 Zip 5-5 { Bona It: Expires: Unit It % A -1 city Owner ? contractor I he Applicant is ,tad/nJ? nr :dteration to existing dwelling unit (ilmace __Additional _ReF air exchanger air conditioner _ heat pump other `;Infi? tinrelun•gc --------- ---- 1 olill Ollie, 30.00 New OCT `r) I +? 1 I .50 h rrr.hy apply Iti(8 I20aIdC.lll.l al MCGhnniCfll PCrtol tll)l?r !nY WiflBgmi "'(1 Will, Ow N/Ieehanica il Cndesltd that l il understand this is work 11will I ro in cunfnrLIUIII e will) the, ordinances o-uid codes permit, ()ill . only an apiilicat ion for a Perrnit, and work is nor to start withnnl ;1 perniil; That the work will he in accordance with the s work which requires a review and approval of )1,9 pe' lil l`i'cfl plan in the case of 'SSIBnnlure - ?Pp ten yolihcants Printed Name *10.50 4100 - - - - ---------, City of Capp 1 Permit #: ?--f-? I nnnn I Permit Fee: 3830 Pilot Knob Road o 5 ZOU' I S I Eagan MN 55122 1 Date Received: /I- Phone: (651) 675-5675 1 <? I Fax: (651) 675-5694 Staff: ? RESIDENTIAL P?LIUMBING PERMIT APPLICATION ?'(h ei C S ( Date: Z Z'U 1 Site Address: 2 " p'5 V #: Tenant: Suite RESIDENT / OWNER Name: F-361( Phone: D 2 e 1 CL Address / City / Zip: amc ' CONTRACTOR Name: License#: W_00'eM. Champion Address: 651 365 13-40 City: 3670 Dodd Rd. #100 State: Zip: Eagan, A S U Phone: Contact Person: TYPE OF WORK _ New Replacement _ Repair _ Rebuild Modify Space _ Work in R.O.W. Descri lion of work: PERMIT TYPE SIDENTIAL - Water Heater Water Softener Lawn Irrigation _Add Plumbing Fixtures L- RPZ / _ PVB) (_ Main - Lower Level) _ Septic System _ Water Turnaround _ New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) 'Water Turnaround (add $136.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 pares built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge). TOTAL FEES $ I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x ??l2VY? 6- ajey'- x /! Applicant's Printed Name Applicant's' u City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 3050 Shields Dr 107 Lot: 030 Block: 001 Addition: Lemay Lake Hills Townhomes PID:10- 44651- 300 -01 Use: Description: Sub Type: e - Fumace & Air Conditioner Work Type: Replacement Description: Fumace & Air Conditioner Comments: Questions regarding electrical permit requirements should be directed to Mar k Anderson, State Electrical Inspector, 952- 445 -2840. Cindy Lilienthal 2 1210 Eaton Ave Farmington, mn 55024 651- 344 -4253 cilienthal@controlledai r.net Fee Summary: Contractor: Controlled Air 21210 Eaton Ave Farmington MN 55024 (651) 460 -6022 X253 Surcharge -Fixed ME - Permit Fee (Replacements) Total: I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - $0.50 $30.00 $30.50 Owner: Troy E Grossman 3050 Shields Dr #107 Eagan MN 55121 Permit Type: Permit Number: Date Issued: Permit Category: 9001 0801 Issued By: Signature Mechanical EA074346 07/18/2006 ePermit