3160 Sibley Memorial HwyCITY OF EAGAN
Addition Sec
Owner i I
Parcel 10 00900 010 32
State Eagan,MN 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. \
STREET RESTOR.
GRADING
SAN SEW TRUNK 0 1968 0.00 30 az
SEWER LATERAL 1973 2237, 62 15 az
WATERMAIN
?
WATER LATERAL, 1973 11 . 77-84 -T5
- Ma
WATER AREA b 0 1 80-QQ 2 1 Al e - ' 7
-
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 2su. 00 12098 0-17-78
BUILDING PER.
SAC 500.00 12098 0-17-78
PARK
`Receipt' PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fee -i
Fill in numbered spaces S/C
Type or Print legibly Tot.
1. Date 2. Installation Cost
3. Job Address LotZ_BIk. Tract - r?
4. Owner U? ! C?.?? -? \'? C ! 1 r ; ??
5. Contractor k i I t c i o -,?,i?Phone
8. Address ??u- '1 i, ; • , ; ?_ '??r 1
7. City State Zip
8. Building Type: Residential Commercial ? Institutional ?
9. Work Description: New ? Add 01, Alter ? Repair ?
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn. -?
Slop Sink
Gas Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed
Rough
for
Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
f
DATE 18
RIECCI V ED
FROM
AMOUNT $ I
& DOLLARS
lea
? CASH ? CHECK
.Zla
0062ao __L
BY
4'?J. White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
Thank You
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fee
Fill in numbered spaces S/C
Type or Print legibly Tot.
1. Date 2. Installation Cost
3. Job Address Loi
4. Owner
Blk.3?-d Tract
5. Contractor Phone
6. Address
7. City State Zip
8. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New ? Add Q Alter ? Repair ?
10. Describe Fuel Type
11.
No. Equipment BTU - M. Ea.
Forced Air No. Equipment CFM
Air Handlin
:
Mfg. g
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
a CITY OF EAGAN ?? • . --,
° r. 3795 PRO Knob Road Eagan, MH 55122
PHOHEr 454-8100
BUILDING PERMIT Receipt #
To be Used for - Est. Value Date )9
Site Address Erect ? Occupancy
Lot Block Sec/Sub. Alter ? Zoning
Parcel # Repair ? Fire Zone
Enlarge ? Type of Const.
sac Name Move ? # Stories
Z Address Demolish ? Length
city Phone Grade ? Depth Sq. Ft.
Name
Approvals
Fees
~
Address
u Assessment Permit
u
city Phone Water 8 Sew. Surcharge
Police Plan check
Name Fire SAC
C, Address Eng. Water Conn.
U
?W City P Planner Water Meter
Council Road Unit
I hereby acknowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
APC
Total
Signature of Permittee
A Building Permit Is issued to: on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
Permit No. Permit Holder Misc. Permit No. Holder
Plumbing
H.V.A.C.
Well
Rter
Disp.
Sewer
Electric 7.Zti o3c` E(tc, q-l0-s3
Inspection Date Insp. Other
Footings
Foundation
Framing 34
Rough Plbg. f (?
Rough HVAC
Insulation
Final Plbg cj
Final HVAC
Final
Water Describe Location:
Well
,
Sewer a
Pr. Disp.
CITY OF EAGAN
DEPT. OF BUILDING INSPECTIONS
Correction Notice
Located at 1 b0 S 6?o kdw 44tv
I have this day inspecte this structure and
these premises and have found the following
violations of city codes governing same:
When corrections have been made, please
call 400 for inspection.
A- gars
Date
o1i -q 14-L
Inspector City of Eagan
DO NOT REMOVE THIS TAG
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
f 1 46 0 rA4 0Q co 1 i
SITE ADDRESS: ! f I rt I rr+ f APPLICANT:
ofMORIA1 RWY tlF;f+'itfN
PEFjMIT. SUBTYPE:.,,,
TYPE OF WORK: Nr W
F1111 I rt i N (;
fll : 8 :' t+ h
f 7
L
NFMAVIK?- , '•.fPAkArf I't F141 f Pf 111)1k1II IOR f IFI Iit(fAI WOO)
f
Permit No. Permit Holder Date Telephone A
ELECTRIC // 5 9 °D
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS tug
FOUND x/
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL ?I_Z`-4` Awe
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
OF EAGAN SEWER SERVICE PERMIT
Pilot Knob Rod PERMIT NO.:
MN 55122 DATE:
?. No. of Units:
Address:
to oomply with the City of Eagan
of I nsp.:
CITY OF EAGAN
3795 Pilot Knob Road
'..agan, MN 55122
Zoning:
Owner:
Address:
Site Address:'' ` n $7 is
Plumber: ,.i
Meter No.:
Size:
Reader No.:
1 agree to comply with the City of Eagan
Ordinances.
BY
Dote of I nsp.: ---
CITY OF EAGAN
3795 Pilot Knob Road
"Son, MN 55122
Zoning: -
Owner: _?-- -'?
Address: ----
Site Address: 1
z
Plumber: -=
Connection Charge:
Account Deposit: _
Permit Fee:
Surcharge:
Misc. Charges: -
Total: --
Date Paid:
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
_ No. of Units:
? O/dam
_ Connection Charge:
Account Deposit:
_ Permit Fee:
Surcharge:
Misc. Charges:
Total :
Date Paid:
nsp.:
SEWER SERVICE PERMIT
-------
PERMIT NO.: -
DATE-
No. of Units:
I agree to comply with the City of Eagan
Ordinances.
BY ---
Date of 1nsP.:
i nso.:-
Connection Charge:
Account Deposit:
Permit Fee:
Surcharge:
. Misc. Charges:
_ Total:
Date Paid:
This request void Q // D ?. [ 3 3? 1 SEC ` .1-1
3A19c1ths from T&&7-7
Date of this Request Fire No. T 2 6 0 5 1
1, as fkLicensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No, z Ufa D /L Aaar.ii d Cit
Section Township Range County
Which is occupied by
Is a roughin inspection required on this job? No ? Yesjk Ready Now ? Will Call JZ
Power Supplier n
n ? /'?, // Address ? n 44AAse ///?
Electrical Contractor ( ??1-T??o q =e - Contractor's License o.
Mailing Address
EI rim Contractor r wner Making This Inst at)on)
Authorized Signature Phone No.41 e-li-&
( ect al Contractor or Owner Making This Installation)
SUM B'IF(,e{? l? (?' BOARD 00ply This inspection request will not accepted the
State Board unless proper inspection fee is enclosed.
amnneaera arare edam ar oecmcrcy
Griggs Midway Bldg. - Boom N191
1821 University Ave., St. Paul. Minn. 55104 - Phone 297.2111
,REQUEST FOR EL ECVICAL INSPECTION
CON BELOW WORK COVERED BY THIS REOUEST
EB-?0"00'0^1-0
m2 U' W 4 1'7
T 26051/
Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For
Home ? ? Range ? Temporary Wiring ?
Duplex ? ? Water Heater ? Lighting Fixtures ?
Apt. Bldg. ? ? ? Dryer ? Electric Heating ?
Commercial Bldg. ? ? ? Furnace ? Silo Unloader ?
Industrial Bldg. ? ? ? Au Conditioner ? Bulk Milk Tank ?
Farm ? ? ? List List
Other ? El ? Here rS?
11 Herers?
1111
COMPUTE INSPECTION FEE BELOW
Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Circuits: # Fee
0 to 100 Amos. O." 0 to 30 Am res 0 to 30 Amperes _4' 1Z3_<D
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Amperes / V O
Above 200-Amps. Above 100 Amps. Above 100 Amps.
Transformers Remote Control Ciro Partial or other fee
Signs &T 5 ecial Ins ection Minimum fee $5.QJL
Remarks [
(1
TOTALF p-p
I, the Ele ricadijape t re g ify t to alSove inspection has been ma e.
(Rough-in) f Date
(Final) Date
This request void
18 months from
6u OFFICE USE ONLY This regoestvoid 18 months from wlidolion dale printed in this box.
Illl111111llllll11lol1111111111111111111111 1111111
4j,
$3°A r. F"c
L b sad
PLEAS
0 4 1 6 1 3 1 L x
PLEASE PRINT OR TYPE
Request Dajm.
f Roughin inspection required? es ? No Inspecion Other Than Roaghln: ? Ready Now W II Call
{
/ 5 g? (Yoe most mll the inspe when ready] Date Ready.
I, ? licensed contractor owner hereby request inspection of the above electrical work at:
bb Address (Street, gox, or Rate No.) City Ztp Cade
3i6o SfBLE ?ltw?- t=AC7L^7 551 21
Section No. Township Name or No. Roige No. Fire No. County
5AGAf t DAKOTA
Occapain
WA4fzEN C, PETCF?SON Phone No.
,454-120
Pourer Supplier Address
Elo t ool Contractor (Company Name( CorWoor license No. Master tic. No. (Plant Elect. Only)
SE4F
Mahn,, Address (Contracbr or Owner Performing Installation)
SAME
Athoneed Signature lContra tar or Ow er Par ming holdofionl Phase No.
a, ,,,i (! 7? 6/z-gs -X zcy(
? REQUEST FOR ELECTRICAL INSPEC ON?j'
416 0r -L 1821 University ABe, Rm. Electricity 8, St. Paul, MN 55104
Phones) 842-0800 S a.4 0
Home Duplex Apt. Bldg. Other: New Addn
Commercial Industrial Farm F.-mod i% it
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer
Range
Elec. Heat
Tem . Service ?? P.
"X" above the work covered by this request. Enter remarks in this space and on the bock of the white copy only.
Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee:
Other Fee It Service Entrance Size Fee # Circuits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200_Am s 7CC>ove 100Am s
Transformer/Generator tsSPECTOR's Use ONLY TOTAL
Sign/Outline Ltg. Xfmr. U
Alarm/Remote Control
Swimming Pool I here cerfi Ihm I' s the : i.. d ribed herein on the dares s d
Irrigation Boom Roughtn Cew
?
S
ecial Ins
ection `
t
p
p
Investigative Fee Finol oek ?r .
THIS INSTALLATION MAY BE ORDERED DI D ED WITHIN 18 MONTHS.
CITY OF EAGAN
3795 Pilot-Knob lived Bogen, MH 55122
PHONE: 454-5100
BUILDING PERMIT RI'MOD. Receipt #
To be used for GAR. Est. Value $1500 Date
Site Address ?ivv .r..uu.cy mv+avi ictl I.J.
Lot 1 Block 32 Sec/Sub. Section 9
Parcel # 10 00900 010 32
a: Name • ° ' `•• " °`
z Address 3160 Sibley Mem. Hwy.
_ Tiena.. S5l')7 _
A (Name Jim Williams
g Address 3770 S. Lexington Ave.
Fagan 55121 ou...._ 454-5191
Name _
Address
I hereby acknowledge
the information is co
State of Minnesota
Signature of Permi
A Building Permit is is
all work shall be done
love read this application and state that
id agree to comply with oil applicable
and City, o?, "7 Ordinances.
s
N° 6856
2
Erect ? Occupancy H-3
Alter 17, Zoning
Repair ? Fire Zone
Enlarge ? Type of Const.Vn
Move ? # Stories
Demolish ? Length NA
Grade ? Depth Sq. Ft.-
Approvals Fees
Assessment _
Water & Sew.
Police
Fire
Eng.
Planner
Council _
Bldg. Off. -
APC
Permit 47•UU
Surcharge 1.00
Plan check
SAC
Water Conn.
Water Meter
Road Unit
Total $?% of)_
to: U---- nlyyaa.wp/ a411cr +. Q w .. Vo on the express condition Thal
:cordonce ;xa oppli a of Minnesota Statutes and City of Eagan Ordinances.
Building Official
??? Cl! ? r CITY OF EAGAN
?i(? BUILDING PERMIT APPLICATION
l9 Q.
Th Be Used For as 10FJJT -t"-Valuation /.410
Site Address a
Lot t ' Block
Parcel #: CC
Owner: klc?
Address: 3 L
City/Zip Code:
Phone #:
Contracts
Address:
City/Zip Code: .
Phone #:
Arch./Eng.. _
Address:
City/Zip Code:
Phone #:
'3,;'-Sec./Sub'
o0g00 alo
Include 2 sets of plans,
1 site plan w/elevations &
1 set of energy calculations.
Date
e 77-t"(6*%61N OFFICE USE ONLY
Erect Occupancy ,?-3
Alter ^?- Zoning
Repair Fire Zone
Enlarge _ Type of Const.
Move # Stories
Darolish Front ft.
_
Grade Depth ft.
APPROVALS FEES
Assessments Permit 2 5
Water/Sewer Surcharge f
Police Plan Check
Fire SAC
Eng. Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off.
APC
TOM I e
PERMIT
it k CITY OF EAGAN.
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE: BUILDING
Permit Number: 0 2 8 2 6 6
Date Issued: 07/18/96
SITE ADDRESS:
P.I.N.: 10-00900-010-32
3160 SIBLEY MEMORIAL HWY
LOT: 1 BLOCK: 32
SECTION 9
DESCRIPTION:
Permit Type
4,ork Type
s
GARAGE/ACCESSORY
NEW
434 ALT. RESIDENTIAL
V 'Irt- AP" 9f'%
.vIW yE` ry
REMARKS:
SEPARATE PERMIT REQUIRED FOR ELECTRICAL WORK
FEE SUMMARY: VALUATION $7,000
Base Fee
Surcharge
Total Fee
$124.75
$3.50
$128.25
CONTRACTOR: OWN0N ~pp1WARREN-
3160. S-IBLEY MEMORIAL HWY
EAGAN MN
(612)454-1206
' CITY OF EAGAN
3830 PILOT KNOB RD - 55122 as
U 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construction Reouirement Remodel/Repair Reoutrements
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plans (include beam d window sizes; poured ind. design; etc.) ? 2 stte surveys (exterior additions 8 decks)
? t energy calculations ? 1 energy calculations for heated additions
? 3 copies of tree preservation plan H lot platted after 7H193
required: _Yes _ No f
DATE: -7 I9? CONSTRUCTION COST: Al's-66
DESCRIPTION OF WORI
STREET ADDRESS:
LOT l BLOCK
PROPERTY
OWNER
Name: Pe l ev-So I . W cL-r" t, Phone #: `??`F 2 C
Street Address-
City: L-a-F
.3
State: MIQ Zip- 5:5-(24
CONTRACTOR Company: ex a Phone #: So.L,? e
Street Address: S O V -,e License #• N
City: ?1 State: Zip.
ARCHITECT! Company: A) Phone #
ENGINEER
Name: Registration #
Street Address-
City: State: Zip:
Sewer 8 water licensed plumber: N Z A Penalty applies when address change and lot
change are requested once permit is Issued.
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 Eagan Ordinances.
Signature of Applicant.
OFFICE USE ONLY R E C? 0 M rE D
Certificates of Survey Received _ Yes _ No I I i I 16 9996
Tree Preservation Plan Received Yes No
------------
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem.
0 03 SF Addition ? 08 8-piex ?13 Garage/Accessory
? 04 SF Porch ? 09 12-plex ? 14 Fireplace
? 05 SF Misc. ? 10 = piex ? 15 Deck
WORK TYPE
31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
? 36 Move
? 37 Demolition
r %
? 16 Basement Finish
? 17 Swim Pool
? 20 Public Facility
? 21 Miscellaneous
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
APPROVALS
Planning
Building
MCNVS System
City Water
Fire Sprinkiered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Engineering Variance
?L
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
SAN Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies Z , 00
Total:
0Z,/- « '376 xt"6
% SAC
SAC Units
W?,,,?reU ? ?•e?2v-So V?
?_-!Z+
------------
-- -------;? - --- ---------- -- ------ -- -----
---- ---- --- ---------- ----------- - --- - - - --- -- - - - --
-- - -- - - -- -- -
Na? .?--, -- -- -
'All
C!ty of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
r 1
For Office Use N �Permit #: % , `� (‘
Permit Fee: (9-c
Date Received: '1- i 1 3
Staff: (061
2013 SEWER AND WATER REPAIR / DISCONNECT PERMIT
Date:
City Sewer XCity Water
Repair
Disconnect
Description Of Work: 0 GCCp6-7#7e c CA- ," /7,0,2
Fee: $65.00
Street Address for Proposed Work
% l�
Name:
aV-6-tekC
Owner Information Address / City / Zip:
Applicant is:
Licensed Pipelayer
Name:
Phone:
Owner
Address / City / Zip:
ontractor
Master Plumber Property Owner
Phone:
Pipelayer Training Certification Card #: O-7Ck6 ' "/2 1 or Master Plumber License #:
I acknowledge that the information is complete and accurate and 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.
Applicant (Print Name) Applicant's Signature
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq
C!ty of kap
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use J,^,
Permit #: ! 01 ��€
/6 0
D'�
Permit Fee:
Date Received: ( - *S' k 3
Staff: ik'�
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 9--'13
Resident/
Owner
Type of Work
Site Address:
/Ca s/t�-/ 04-6f Ot L t `1 k Unit #:
Name: (- /7 ,9"
Phone:
Address / City / Zip: ile24 ✓1-G og ci,n 6 Set-. 4014 > "1
Applicant is: Owner Contractor
Description of work: 0e-i/rid fl /'inn .
Construction Cost: /Tj 000 Multi -Family Building: (Yes / No )
Contractor
Company: 4/) -e i -m & cowck Z14 j'
Address: 4) 3() -2 5 7 rte ✓ ✓V vtJ City:
Contact:
State: /1211 Zip:
License #:
Phone:
Ieenc1 S cil'(l1
-6'/7 725 Z
/Z- 322 C? j
Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Phone:
Sewer & Water Contractor:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.00pherstateonecall.orq
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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit)6suance.
—Applicants -Printed -Name
ted -Name
—Applicant's Signature
Page 1 of 3