3344 Sibley Memorial HwyCITY OF EAGAN Remarks
Addition Section 8 Lot Rik Parcel 10-00800-024-75
Owner AL I11f ' - !,U +:, 1 6111 ? 4-6 ?,C L,Street State EAGAN MN 55121
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK 4110 1979 294.47 19.63 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
CITY OF EAGAN
Addition See'
7
Remarks.
1?UU
Ik 75 Parcel 10 008oo 031 75
State Eagan,MN 55121
AI
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK go 1968 430-50 14-35 30 paid
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 1917 1 /976
1
STORM SEW TRK Zito 1979 3137.19 209.15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
/a 60 X6,n o3-) 71?'
TOWN OF EAGAN
3795 Pilot Knob Road
St. Paul, Minn. 55111
PERMIT NO.: 31
The Board of Supervisors hereby grants to Weierke Trenching d Excavating
of u r Mi s5n?n a rrecpnnl.
Permit for: (Owner) t 1 r s at 4144 SIM PU Momnr_L1 Highway
pursuant to application dated 12/21/70
Fee Paid: $1n-on Dated this 21st_ day of nargmhor , 19-70
Building Inspector
EAGAN TOWNSHIP
BUILDING PERMIT
Owner --°'--------------------------
Address (present) ............ ..........°--. .. . /? _....
Builder ------- ...!. .............
Address ....------- .......................-----------...._..--------------.."------_._........
DESCRIPTION
N° .. 797
Eagan Township
Town Hall
20 /%6 Z,
Date - -------------?-
Stories To Be Used For Front Depth Height Est. Cost Permit Fee Remarks _
V i LOCATION C/
Street, Road or other Descripfion of Location I Lo! I Block I Addition or Tract
This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST B -
E,?gyEPT N, T
lhesabove descnbedhpremise s HE PREMISE WHILE THE WORK IS IN PROGRESS.
y, ./N... .....................................................has permission to erect a--------------------------- ...._....... upon
''??} to provisions of the Building Ordinance for Eagan Townshi adopted April 11,
1955. .?/ .J/ ///] 41741.& ................ `.'.::_. ?-`..-.?(_. ............ Per _....---------'?-?c!7. :------- . -
.......... ...................
Chairman of Tnwn Board Building Inbpector
9528917000 / 14.4K
MAY-06-2008(TUE).16:d3 Okota County POD (FRX)9528917000 P._001/001
V N?? n
WATER RESOURCES OFFICE 1?/'??-?'?? ?-?'"
GROUNDWATER PROTECTION SECTION
14955 Galaxio Avenue • Apple Valley, MN 55124
952.891.7557 - Fax 952.891.7588 • www.co.dakota.mn.us'
MUNICIPAL NOTICE OF WELL SEALING PERMIT APPLICATION
DATE: May 6, 2008
TO: Tom Colbert(Wayne Schwan (EM)
RE: Well Permit #: 08-11262016
Municipality: Fagan
Fax #: (651) 675-5694
Well Type: Domestic
Water Resources Specialist: Luehrs
The Dakota County Water Resources Office has received the following permit application for the well described. If
you require further review of the application or if you have any questions or concerns about it, contact the Water
Resource Specialist listed above or our office at (952) 891-7557. If there is no response from your office within 24
HOURS (excluding weekends and holidays), we will assume that you have no objections to the issuance of the
permit. Please note that permit issuance is always conditioned on the permit applicant's observance of and
compliance with all applicable state, county, and municipal laws and codes.
Well Contractor,
Date Application Received:
Anticipated Drilling Date:
Anticipated Grouting Date:
Property Owner:
Well Owner: '
WELL LOCATTON:
Jaeckels Well Inc.
5/1/2008
James Christesen
Best Brands Inc
Time:
Time:
PLS Coordinates: 1/4, NE 1/4, SE 1/4, SE 114, Sec 08 Town 027 Range 23
Street Address: 3344 Sibley Memorial HWY
PIN Number: 100080003175
WELL INFORMATION:
Diameter:
Casing Depths
Total Depth:
Static Water Level:
Aquifer:
259
288
Prairie du Chien
COMMENTS:
Property Owner Assessing Sales
PIN: 100080003175 PID: 100080003175 Year Built: 1960 Sale Year; 2007
House#: 3344 Full Name: ANTHONY K PRICE Land Value: 173400 Sale Month: 5
Street: SIBLEY MEMORIAL HWY Address 1: 3344 SIBLEY MEMORIAL HWY Building Value: 174600 Sale Value: 387450
ADC Address 2: Total Value: 348000 Sale Tax: 119.18
Din 551210000 Oty ST: EAGAN MN 55121 Net Tax: 2485.98
Code:
Total Tax: 2605.16
Lot: 8 2723
Plat: SECTION 8 TWN 27 RANGE 23 Zoning
N 270 FT OF S 819.24 FT OF SE 1/4 OF Zone Cade R-1
SE 1/4 LYING E OF M #13 EX BEG (SpFt):
Legal: 549.24 FT & 407.30 FT W OF SE COR N Zone Desc: Residential Single
73D OOM 115 W 162.99 FT S 23D 05M W LandUSe Code; LD
TO N LINE OF S 549.24 FT E TO BEG
LandUse Desc; Low Density (04
units/am)
C I T Y O F E A G A N
CERTIFIED LISTING OF POSTPONED
SPECIAL ASSESSMENTS
LEGAL DESCRIPTION:
See Exhibit A attached
COUNTY IDENTIFICATION NUMBER: XXXXX XXX XX
POSTPONED SPECIAL ASSESSMENT:
Postponed Assessment
Pursuant to M.S.A. 429.061, Subd. 2, as amended by the
1980 Session Laws, Chapter 560, Section 5, I hereby certify
that the City of Eagan has approved the postponement of the
special assessments as set forth above on the property described.
Dated this 27TH
day of June 1984
EXEMPT FROM STATE DEED TAX STAMPS
This Document Drafted By:
City of Eagan
3830 Pilot Knob Road
Eagan, MN 55122
.44 01re,
E. VanOverbere
tit Clerk/Finance Director
Certificate
I, E.J. VanOverbeke, City Clerk of 4thee ty of Eagan, do Hereby
certify that the foregoing is a true rec cc
nOverbeke, City Clerk
n
/'--That part of the South 549.24 feet of Government Lot 6, Section 8, Township 27, Range 23 described as follows:
Beginning at the point of intersection of the North line of said South 549.24 feet and the East line of said
Government Lot 6, said point being marked by a Judicial Landmark; thence South 76 degrees 01 minutes 26 seconds
West (assuming the East line of said section has a bearing of North 0 degrees 54 minutes 46 seconds West) 231.09
feet to a Judicial Landmark; thence North 74 degrees 03 minutes 10 seconds West 50.81 feet to a Judicial Landmark;
thence Northwesterly to a point on the North line of said South 549.24 feet; which is 407.30 feet Westerly of the
East line of said Government Lot 6 when measured along said North line, said point being marked by a Judicial
Landmark; thence Easterly to the point of beginning.
659 732
C I T Y O F E A G A N
CERTIFIED LISTING OF POSTPONED
SPECIAL ASSESSMENTS
LEGAL DESCRIPTION:
Section 8 Twn 27 Range 23 N 270 Ft of S 819.24 Ft of SE;
Of SE4 Lying E of STH #13 Ex Beg 549.24 Ft & 407.30 Ft W of SE
Cor N 73D OOM 11S W• 162.99 Ft S 23D 05M W to N Line of S 549.24
Ft E to Beg
COUNTY IDENTIFICATION NUMBER: 10 00800 031 75
POSTPONED SPECIAL ASSESSMENT:
Water Area Assessment
Pursuant to M.S.A. 429.061, Subd. 2, as amended by the
1980 Session Laws, Chapter 560, Section 5, I hereby cbrti£y
that the City of Eagan has approved the postponement of the
special assessments as set forth above on the property described.
Dated this day of :ju vta_ 1984
FROM STATE DEED
This Document Drafted By:
City of Eagan
3830 Pilot Knob Road
Eagan, MN 55122
from State Deed Tax
Dakota Ceurty Treasurer
?,\ ° LOAaE.J.( noverbeke
City Jerk/Finance Director
Certificate
I;:i.;VanOverbeke, City Clerk of 4E y of Eagan, jdo Hereby
certiE+..tfiat'ahe foregoing is a true c cop .
nOverbeke, City Clerk
`j 7; 2
STATE OF MINNESOTA ss.
County of Dakota
Office of County Recorder
This is t.? cert'y lsat the vriti;in
ins#Sr as filed for reco a^ theda19_co and as fy recorded in
Dakota County Records.
JAMES N. DOLAN
Cou . y Recorder
By S
Deputy
-VcJ
&
70
C I T Y O F E A G A N
CERTIFIED LISTING OF POSTPONED
SPECIAL ASSESSMENTS
LEGAL DESCRIPTION:
Section 8 Twn 27 Range 23 Pt of Govt Lot 6 Beg Int E
Line & N Line of S 549.24 Ft S 76D 01M 26S 231.09 Ft N 74D 03M
10S W 50.81 Ft NW to Pt on N Line of S 549.24 Ft 407.30 Ft W
of Beg E to Beg
COUNTY IDENTIFICATION NUMBER: 10 00800 024 75
POSTPONED SPECIAL ASSESSMENT:
Water Area Assessment
Pursuant to M.S.A. 429.061, Subd. 2, as amended by the
1980 Session Laws, Chapter 560, Section 5, I hereby certify
that the City of Eagan has approved the postponement of the
special assessments as set forth above on the property described.
Dated this P-l T 1} day of V u Kp 1984
EXEMPT FROM STATE DEED TAX STAMPS
This Document Drafted By:
City of Eagan
3830 Pilot Knob Road
Eagan, MN 55122
l1?
E. an verbeke
Cit. Clerk/Finance Director
Certificate
I, E.J. Vanoverbeke, City Clerk of the City of Eagan, o Hereby
certify that the foregoing is a true rr,ecit cop .
E. anover eke, city Cler
y
C I T Y O F E A G A N
CERTIFIED LISTING OF POSTPONED
SPECIAL ASSESSMENTS
LEGAL DESCRIPTION:
Section 8 Twn 27
& N Line of S 549.24
W 50.81 Ft NW to Pt
Beg E to Beg
Range 23 Pt of Govt Lot 6 Beg Int E Line
Ft S 76D 01M 26S 231.09 Ft N 74D 03M 10S
on N Line of S 549.24 Ft 407.30 Ft W of 011
0-7 7 0/e- v
S
COUNTY IDENTIFICATION NUMBER: 10 00800 024 75
POSTPONED SPECIAL ASSESSMENT:
Water Area Assessment
Pursuant to M.S.A. 429.061, Subd. 2, as amended by the
1980 Session Laws, Chapter 560, Section 5, I hereby certify
that the City of Eagan has approved the postponement of the
special assessments as set forth above on the property described.
Dated this 51Tl4 day of Zu.Ae _ 1984
EXEMPT FROM STATE DEED TAX STAMPS
This Document Drafted By:
City of Eagan
3830 Pilot Knob Road
Eagan, MN 55122
U0a,,.L L
E. Van Overbeke
Ci Clerk/Finance Director
Certificate
I, E.J. VanOverbeke, City Clerk of the City of Eagan, do Hereby
certify that the foregoing is a true and cor ct opy.
LL
E. anOverbeke, City Clerk
° 6078 7
^.i F
Certificate No. Document No. 124022 District Court No. 78511
Transfer from No. 5 4 3 5 8 Originally registered the 11th day of May 19 77
i
Volume One hundred eighteen page 356
State of Minnesotaq?S
County of Dakota. ` J?G1 Cd 1(0 cewYY, Me'd James H. Christesen and Darlene A. Christesen,
husband and wife,
3344 Sibley Highway
{ of the City of Eagan
County of Dakota and State of Minnesota
® are now the otuner s of an estate, to wit: fee simple as joint tenants and not as tenants in common of and in the
following described land situated in the County of Dakota and State of Minnesota, to wit:
That part of the South 549.24 feet of Government Lot 6, Section 8, Township 27, Range 23 described as follows:
Beginning at the point of intersection of the North line of said South 549.24 feet and the East line of said
Government Lot 6, said point being marked by a Judicial Landmark; thence South 76 degrees 01 minutes 26 seconds
West (assuming the East line of said section has a bearing of North 0 degrees 54 minutes 46 seconds West) 231.09
feet to a Judicial Landmark; thence North 74 degrees 03 minutes 10 seconds West 50.81 feet to a Judicial Landmark;
thence Northwesterly to a point on the North line of said South 549.24 feet; which is 407.30 feet Westerly of the
1
Last line of said Government Lot 6 when measured along said North line, said point being marked by a Judicial
Landmark; thence Easterly to the point of beginning.
Subject to the encumbrances, liens and interest noted by the memorial underwritten or endorsed hereon; and subject to the following
rights or encumbrances subsisting. as provided in M. S. A. Section 508.25 namely:
1. Liens, claims, or rights arising or existing under the laws or the constitution of the United States, which this state cannot require to
appear of record;
2. The lien of any tax or special assessment for which the land has not been sold at the date of the certificate of title;
i. Any lease for a period not exceeding three years when there is actual occupation of the premises thereunder;
MAR ? ? 200 r ? ? ?5?-6 ? 5? ?? ss
- ILLLI I///,
011: Minnesota Pollution Compliance Inspection Form
Control Agency ,
520 Lafayette Road North Existing Subsurface Sewage Treatment Systems (SSTS)
St. Paul, MN 55155-4194 Instructions on page 7
Parcel number: For Local Tracking Purooses, ... -?
System status: ?Compliant Woncompliant pvJncv s
(based on all compliance require) ants) •d H k
av, 9 hcs
Summary form ?0 SoK X1940
Property Information
Property owner name(s): 94QA%e ' -'?Tt-m=
Property address: 3344 Sibley Memorial Hwy, Eagan, MN 55122
Property owner's address (if different):
County: Dakota Property owner phone: 651-248-004 Permittingauthority:
Date system constructed: Reason for inspection: Sale
System Description
Brief system description: 3 Cesspools
Local permit number. _
Number of bedrooms: Design flow rate:
Is the system:
In Shoreland area? ? Yes IXNo In Wellhead Protection Areal ? Yes 12440
An U.S. Environmental Protection System serving a Minnesota Department
y (EPA) Class V Injection Well?.? Yes ?No of Heath (MDH) licensed facility? ? Yes: JAM
Agency
erequirements-additional local requirements 'mayalso-apply.)-
Compliance Status (eased on state \
Based on the information gathered and reported orrattached forms, the compliance status of this system is (check one)::
? Certificate of Compliance - valid until (3 years from date of report):
Notice of Noncompliance - For Noncompliant systems:
The reason for noncompliance
This noncompllant system is class) d as Lcheck one below):
? Imminent threat to public health & s fety Failing to protect ground water d Not in compliance with operating permit
Certification (Completed form must be submitted to the local unit of government within 15 days.)
I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No
- determination of future system performance has been nor can be made due to unknown conditions during system construction,
possible abuse of the system, inadequate maintenance, or future water usage.
Name: Bob Freiermuth Certification number: 7913
Business license name and number. Freiermuth Sanitation #492 or
Name of local
Signature: ;2
ty
Date:
Required Attachments Inspector Complete: This Inspection Report is 4 pages long.
Check compliance forms attached: ydraullc Performance ? "k integrity oil Separation ? operating Permit Form (if
applicable) ? System drawing/As-built drawing ? An assessment of any local requirements that are different from what is required on this -
form ? Soll Boring Logs ? Abandonment form (If appropriate) ? other information (list): -
. Upgrade Requirements (derived from Minn. Stat § 115.55) An Imminent threat to pubrchealth andsafW (ITPHS) muatba upgraded, replaced, or
Its use disconfinued wWn ten months of iecelpt of th/s notice or wfthin a shorter period ifmqulmd bylacel orclmnce. ff the system is falling to protect gmund
water, the system mutt be upgraded, replaced, orits use discnnfinued within the time requlretl by boal onfinance. Iran existing system is not failing as defined In
low, and has at least fwn feet of design soli separation, then the system neednot be upgraded repaired, repliced,, orris use disconb'nued, notwithstanding any
local ordinance malls morestrict Trds provision does not apply fosystems m shore/and areas, weifhead Protectfon Areas, orthose usedin connection withfood,
beverage, end Wolag estebNrhmerds as defined in law.
wq-ww1sts4.31
411108
Compliance Inspection Form for Existing 55TS
Parcel number.
Hydraulic Performance and Other Compliance
System status: ? Compliant Noncompliant
(as determined by this form)
Compliance Issue #1 of 4
Date of observation: Reason for observation: Sale
This form expires upon next inspection or in three years, whichever occurs first _
Compliance questions/criteria: (Required)
1rhark the annroariate box)
Does the system discharge sewage to the ? Yes o
ground surface?
Does the system discharge sewage to drain ? Yes []? No
a
9k,
the or surface waters? .
Does the system cause sewage backup ((es ? No
'
into dwelling or establishment? ??
``
Do other situations exist that have the ? Yes [?(fJ0
potential to immediately and adversely 1a
impact or threaten public health or safety
(electrical, unsafe covers, ate.)?
Any "yes" answerlndicates that the system Is an imminent
threat to public health and safety.
Does the system pose a threat to ground Yes ? No
water for any conditions deemed non-
Drotedlve as determined by the inspector?
"Yes" Indicates that the system Is failing to protect
ground water. If "yes ; describe the condition noted:
Verification Method': (Optional)
(Check the appropriate box)
Searched for surface outlet
? PerformGcl.hydraulic test
'Searched for seeping in yard
Checked for backup in home
? Excessive ponding in soil system/D-Boxes
? Homeowner testimony
? Examined for surging in tank
? "Black soil" above soil dispersal system
? System requires "emergency" pumping
? Perfonned:dye test
? Other.
No standard protocol exists. This list is not exhaustive
in sequential order, nor does it indicate which
combinations are necessary to make this determination.
Certification
This form is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency's (MPCA) Compliance
Inspection Form for Existing Subsurface Sewage Treatment Systems. Observations, interpretations, and conclusions must be
completed by an inspector. Completed form must be submitted to the local unit of government within 15 days.
Property owner name(s); Steve Lemke - Realtor
Property address: 3344 Sibley Memorial Hwy Eagan MN 55122
Property owner's address (if different):
County: Dakota Phone:
651-248-0046 cell
l hereby certify that I personally made the observations, interpretations, and conclusions reported on this form and that they are
Conrad.
Name: Bob Freiermuth
Certification number. 798
Business license name and number. Freiermuth Sanitation #492 or
Name of lc^? ^^" er^^ a^}' Dakota County
Signature:
wq-wwlsts4.31
411108
Date: Z Z-y- Q 7
Compliance Inspection Form for Existing SSTS
Parcel number. .
Tank Integrity and Safety Compliance
System status: ? Compliant?Noncompliant
(as determined by this form)
Compliance Issue #2 of4
Date of clBservation: .3-AV- d ?? Reason for observation:
This form expires on (three years):
Compliance questions/criteria: (Required)
Check the appropriate box)
Does the system consist of a seepage pit', Yes [I No
cesspool drywell or leachih it?
Do any sewage tank(s) leak below their ? Yes ? No
designed operating depth?
If yes, identify which sewage
tank leaks. }} LL e?]
Any yes" answer indicates that the system is fatting to protect
ground water. -
Seepage pits meeting 7080.2550 may be compliant if allowed
in ordinance by local permitting authority.
Sale
Verification Method": (Optional)
(Check the appropriate box)
I?Probed tank bottom
Y?,Observed low liquid level
? Examined construction records
Examined empty (pumped) tank
? Probed outside tank for "black soil"
? Pressure/vacuum check
? Other:
No standard protocol exists. This list is not exhaustive, In
sequential order, nor does It Indicate which combinations
are necessary to make this determination.
Safety Check
1. Are.any maintenance hole covers damaged, cracked, or appeared to be structurally unsound? ? Yes` ? No
2. Were all maintenance hole covers replaced In a secured manner (e.g., all screws replaced)? ? Yes ? No'
3. Was secondary access restraint present (safety pan, second cover, or safety netting) - highly recommended. ? Yes ? No
4. Was any other safety/health issue present? ? Yes' ? No
Explain:
"System is an imminent threat to public health and safety.
Certification
This form is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency's (MPCA) Compliance
Inspection Form for Existing Subsurface Sewage Treatment Systems. Observations, interpretations, and conclusions must be
completed by an inspector, maintainer, or service provider. Completed form must be submitted to the local unit of government within
15 days,
f roperty owner name(s): Steve Lemke - Realtor
Property address: 3344 Sibley Memorial Hwy, Eagan, MN 55122
Property, owner's address (if different):
Qounty: Dakota' Phone:
651-248-0046 cell
I hereby certify thatI personally made the observations, interpretations, and conclusions reported on this form and that they are
correct,
Name: Bob Freiermuth Certification number. 798
A ber Freiermuth Sanitation #492 of
Business license name an num
Name of local unit of
Signature:
wq-ww1sts4-31
411108
Date" - ?1
Compliance Inspection Form for Existing SSTS
Parcel number:
System status: D Compliant YA Noncompliant
(as determined by this form) T??
Soil Separation Compliance and Other Compliance
Compliance Issue #3 of 4
Date of observation: .5 - 2 &1-4 4 Reason for observation: Sale
cw --?
This information on this form does not expire-
questions/criteria: (Required)
For systems built prior to April 1, 1996, and not
located in Shoreland or Wellhead Protection
Area or not serving a food, beverage or
lodging establishment:
Does the system have at least a two-foot
vertical separation distance from periodically
For non-performance systems built April 1,
1996, or later or for non-performance systems
located in Shoreland or Wellhead Protection
Areas or serving a food, beverage or lodging
establishment:
Does the system have a three-foot vertical
separation distance from periodically saturated
For reduced separation distance systems (i.e.,
*perfonmance* systems under old 7080.0179 or
Type IV or V system under new 7080. 2350 or
7080.2400):.
Does the system meet the designed vertical
separation distance from periodically saturated
Any "no" answer Indicates that the system Is falling to protect
ground water.
Verification Method**: (Optional)
(Check the appropriate box)
D Conducted soil observation(s) (attach boring logs)
D Two previous verifications (attach boring logs)
D Other.
Soil observation does not expire. Previous observations
by two independent parties are sufficient, unless site
conditions have been altered.
" May be reduced by up to 15 percent if allowed in local
ordinance.
"No standard protocol exists. This list is not exhaustive,
in sequential order, nor does it indicate which
combinations are necessary to make this
determination.
Certification
This form is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency's (MPCA) Compliance
Inspection Form for Existing Subsurface Sewage Treatment Systems. Observations, interpretations, and conclusions must be
completed by an inspector or designer. Completed form must be submitted to the local unit of government within 15 days.
Property owner name(s): Steve Lemke - Realtor
Property address: 3344 Sibley Memorial Hwv Eagan, MN 55122
Prooerty owner's address (if different):
County:, Dakota Phone:
651-248-0046 cell
1 hereby certify that f personally made the observations, interpretations, and conclusions reported on this form and that they are
correct.
Name: Bob Freiermuth Certification number.
Business license name and number: Freiermuth Sanitation #492
Name of local
Signature, 4
wq-wwists4-31
411108
No
798
or
Date,
Compliance inspection Form for Ex/sting SSTS
Permit #: Receipt Date:
CITY OF EAGAN
2005 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES
EXISTING
Address
PROPERTY
Property Owner rr f?
Telephone # (D l l b (0
- 1 U
Plumber tt I
Date of Inquiry
Contact Name V-Z
Sewer
4" Sewer Service N
Lateral charge @ $26.71
Trunk @ $1,085/connec
City SAC
MCES SAC
Receipt # ,
Septic abandonment
Permit Fee /
State Surcharge
Total
meter to be acquired wjEh plbg permit
S 651.00 1" Water Service
Lateral charge @ $26.95/
Trunk @ $1,130/connectio
100.00 Water supply & storage
1,450.00 Receipt # , Date
50.00 Treatment plant
Permit Fee
50.00 State Surcharge
.50 Plumbing permit require - water
$ I Total
Sewer and Water
4" Sewer Service
1" Water Service
Sewer lateral charge @ $26.70/ff
Water lateral charge @ $26.95/ff
Sewer trunk @ $1,085/connection
Water trunk @ $1,130/connection
City SAC
MCES SAC
Receipt # , Date _
Water supply & storage
Receipt # , Date
Treatment plant
Septic abandonment
Permit Fee
State Surcharge
Total
Plumbing permit required j J. i
Water meter to be acquired with plbg permit
OFFICE, USE ONLY
PRV required
YPs City /1(o County R-O-W Permit
Water
1130
100.00
1.450.00
1.009.00
612.00
50.00
100.00
.50
$ 727.00
1.009.00
612.00
50.00
.50
$
yllelor
Y//3?d s
0
cc: Carolyn Krech, Finance Department
----------?
j C- f
roaf e-w
CW?rr?k61
?•7_
?11 w? Gh e
J ? 55?'?'?f ce
1 I
YCcG-,? /cs
I J?G? ?sr-?75
For office
Perm it e : U
Cat of Eaali Permit Fe:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I
Fax: (651) 675-5694 Staff:
2009 MECHANICAL PERMIT APPLICAT1ON
Date: Ilk Site Address: _3 ' ML"-N
Tenant: Suits t:
RESIDENT / OWNER Name: L) \ C~~~ S Phone: 1. 2-- r(~~"'t""t+~ 'M(
Address ! City I Zip: 33
c
CONTRACTOR Name:
Address: .
City: State Y i Zip:
Phone: Contact Person:
TYPE OF WORK New y_ Replacemennt Additional Alteration Demolition
-Description of work: Km(6l\ t C
NOTE: Both roof mounted and ground mounted mechanical equipment Is required to
be screened by City Code. Please contact the Mechanical Inspector or one of the
Planners for Infomratlon on permitted screening methods.
RESIDENTIAL COMMERCIAL
PERMIT TYPE New Construction Interior Improvement
• Furnace
-Air Conditioner Install Piping _ Processed
-Air Exchanger Gas _ Exterior HVAC Unit,
Heat Pump _ Under / Above ground Tank Install / Remove)
When installingiremoving tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
$___Q • L TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x1%
$50.50 Minimum (indudes$tate Surcharge)
= $ Permit Fee
If Permit Fie is less than $1,000, surcharge is $.50.
If PermitFee is > S1,000, surcharge increases by$.50foreach = $ State Surcharge
$1 ,000 Permit Fee (i.e. a $1,001-52,000 Permit Fee requires a $1.00 surcharge).
$ TOTAL FEE
I hereby acknowledge that this information is complete and accurate: that the work writ be in conformance with the ordinances and codes of the City of Eagan; that
I understand the 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.
z ~ IVLX~_
CX-&1 X_
Applicants Printed Name Applicant's Signature
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: _UnderGround _Rough In ___Air Test ___Gas Service Test __In-floor Heat -Final
Exterior HVAG Screening Inspection
-
~'t Fn r O~ficc Use
Olt
of Eaaau Permit
City ff t
3830 Pilot Knob Road Permit Fee:
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff:
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: lef Site Address: ? i e`~ _ " lE. r'i i' ~ 1 [
Tenant: 1f -t CI k~ S Suite
RESIDENT / OWNER Name: Phone:
Address/ City/Zip: CONTRACTOR Name: License Cn ~a`
Address: r kv-\ 5
City: l'~151 t StateM-Vk) Zip: K0O t`
Phone: & (Z -57 o(o L 3V Z Contact Person: IL-G, C7(- C_a
TYPE OF WORK New _ Replacement Repair /V Rebuild Modify Space -Work in R.O.W.
Description of work: ea- ;p;,po- e- Y~ a 1
PERMIT TYPE RESIDENTIAL
Water Heater 2 Water Softener
Lawn Irrigation Ad Plumbi g Fixtures
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 $165.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as 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 Le J r- e..- I ds~",. x
Applicant's Printed Name cants Signat e
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In __Air Test Gas Test _Final
AUG 1
2009
2 City of Wan U1/- l~ZS 6 Permit#:
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 I Date Receiv
Phone: (651) 675-5675 I
Fax: (651) 675-5694 L Staff:
L----------------
2009 RESIDENTIAL PLUMBING PERMIT APPAvy LICATION
Date: O Site Address: 33'y $I BLgy Me,"age,K. Owe
Tenant: Suite
RESIDENT / OWNER Name: * ,,A C/ ~e Phone: G LL'G`lg' gyyy
- J 57 Z (
Address / City / Zip: 3 s slialev A0001-jW_
CONTRACTOR Name: lT tt;('CK j)fCk4off t .S&PTtG License#: 8,34
Dk 5~3
Address: P.O.
City: Ei State: NfK Zip SS'`113eZ
Phone: 3'D 2 • &74 a 14D Contact Person: IJk1tG0- H 4s J t
TYPE OF WORK _ New 'eplacement - Repair - Rebuild - Modify Space - Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
J RPZ / _ PVB) Main _ Lower Level)
Sep ' 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 $165.00 if a 5/8" meter is required)
$100.50 eptic System New ($10.00 per as 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 6weo. A& x
Applicant's Printed Name Applicant's Si atur
. : ''::i:::.i' i................ iii:
i::':: . ~ s:: .....................:::.}::i:i::i::i::iii:v:;::i
i:'n.':..:.::':.:::
FOR OFFICE$E »:.>:<:.>.>lfit4t1)t'$:::»
quire spin.... lct~l >,:::..-13r1dx fled _R+gtr l.t...............
.:.:-fi r..:::..;:...
PERCOLATION
TEST
AND
SEPTIC DESIGN
Prepared For: David Hughes
Prepared By: Advanced OnSite, Inc.
Prepared: May 11, 2009
3344S ibley Memorial Hwy (Hwy 13)
Eagan, Mn. 55121
VIEWED
BY.
DATE g"Z
BUILDING INSPECTIONS DEPT.,
PERCOLATION TEST DATA SHEET
Percolation Test Readings made by Tom Klanchnik on May 10, 2009 starting at 4:40 pm.
Test Hole Location: 3344 Sibley Memorial (Hwy 13), Hole Number: P1, Date hole was prepared: 5/10/09.
Depth of hole bottom is 24 inches, Diameter of hole is 6 inches.
Soil data from test hole:
Depth in Inches Soil Texture
0" - 8" 10 YR 2/2 Sandy Loam
10" - 18" 10 YR 3/3 Medium Sand
18" - 24" 10 YR 4/4 Medium Sand
Method of scratching sidewall is 2 x 2 with nails. Depth of gravel in hole is 2 inches
Date and hour of initial water filling 5/10/09, 4:05 pm. Depth of initial filling is 12 inches above hole bottom.
Method used to maintain at least 12 inches of water depth in hole for at least 4 hours is 12" drop in 10 minutes,
Presoak is Not Required. Maximum Water depth above hole bottom during test is 8 inches.
Time Time Interval, Measurement, Drop in Water Percolation Rate Remarks
Minutes Inches Level, Inches Minutes Per
Inch
4:40 7"
8" Water Head
4:41 1 Minute 6 5/8" 3/8" 2.7 Refill to 8"
R
4:42 1 Minute 6 5/8" 3/8" 2.7 Refill to 8"
R
4:43 1 Minute 6 5/8" 3/8" 2.7 Refill to 8"
4:44 1 Minute 6 5/8" 3/8" 2.7
Percolation Rate = 2.7 Minutes Per Inch
PERCOLATION TEST DATA SHEET
Percolation Test Readings made by Tom Klanchnik on May 10, 2009 starting Y at 4:30
Pm.
Test Hole Location: 3344 Sibley Memorial (Hwy 13), Hole Number: P2, Date hole was prepared: 5/10/09.
Depth of hole bottom is 24 inches, Diameter of hole is 6 inches.
Soil data from test hole:
Depth in Inches Soil Texture
0" - 8" 10 YR 2/2 Sandy Loam
1011 - 181 10 YR 3/3 Medium Sand
18" - 24" 10 YR 4/4 Medium Sand
Method of scratching sidewall, is 2 x 2 with nails. Depth of gravel in hole is 2 inches
Date and hour of initial water filling 5/10/09, 4:05 pm. Depth of initial filling is 12 inches above hole bottom.
Method used to maintain at least 12 inches of water depth in hole for at least 4 hours is 12" drop in 10
minutes,
Presoak is Not Required. Maximum Water depth above hole bottom during test is 8 inches.
Time Time Interval, Measurement, Drop in Water Percolation Rate Remarks
Minutes Inches Level, Inches Minutes Per
Inch
4:30 7" 8" Water Head
4:31 1 Minute 6 5/8" 3/8 2.7 Refill to 8"
4:32 1 Minute 6 5/8" 3/8" 2.7 Refill to 8"
4:33 1 Minute 6 5/8" 3/8" 2.7 Refill to 8"
4:34 1 Minute 6 5/8" 3/8" 2.7
Percolation Rate = 2.7 Minutes Per Inch
PERCOLATION TEST DATA SHEET
Percolation Test Readings made by Tom Klanchnik on May 10, 2009 starting at 4:20 pm.
Test Hole Location: 3344 Sibley Memorial (Hwy 13), Hole Number: P3, Date hole was prepared: 5/10109.
Depth of hole bottom is 24 inches, Diameter of hole is 6 inches.
Soil data from test hole:
Depth in Inches Soil Texture
0" - 8" 10 YR 2/2 Sandy Loam
10" - 18" 10 YR 3/3 Medium Sand
18" - 24" 10 YR 4/4 Medium Sand
Method of scratching sidewall is 2 x 2 with nails. Depth of gravel in hole is 2 inches
Date and hour of initial water filling 5/10/09, 4:05 pm. Depth of initial filling is 12 inches above hole bottom.
Method used to maintain at least 12 inches of water depth in hole for at least 4 hours is 12" drop in 10 minutes,
Presoak is Not Required. Maximum Water depth above hole bottom during test is 8 inches.
Time Time Interval, Measurement, Drop in Water Percolation Rate Remarks
Minutes Inches Level, Inches Minutes Per
Inch
4:20 7"
8" Water Head
4:21 l Minute 6 5/8" 3/8" 2.7 Refill to 8"
4:22 1 Minute 6 11/16 5/16" 3.2 Refill to 8"
4:23 1 Minute 6 11/16" 5/16" 3.2 Refill to 8"
4:24 1 Minute 6 11/16" 5/16" 3.2
Percolation Rate = 3.2 Minutes Per Inch
LOG OF SOIL BORINGS
Location of Project: 3344 Sibley Memorial (Hwy 13
Borings made by Tom Klanchnik Date: Mn 10, 2009
Classification System: AASHO USDA-SCS X Unified Other
Auger Used (check two): Hand X Power Flight Bucket X Other
3 Inch Hand Au er
Depth Depth
In Boring Number B I In Boring Number B2
Feet Surface Elevation Feet Surface Elevation
10 YR 2/2 Sand Loam 10 YR 2/2 Sandylpam
10 YR 3/3 Medium Sand
10 YR 3/3 Medium Sand
2-_ 2---
3--- 3---
4 4
5 10 YR 4/4 Medium Sand 10 YR 4/4 Medium Sand
10 YR 5/4 Fine Sand 5 10 YR 5/4 Fine Sand
6 6--
Mottled at 60" Mottled at 60"
7 7
8 8
End of Boring at 5.5 feet. End of Boring at 5.5- feet.
Standing Water Table: Standing Water Table:
Present at feet of depth, Present at feet of depth,
hours after boring, hours after boring.
Not Present in boring hole x Not Present in boring hole x
Mottled Soil: Mottled Soil:
Observed at 5.0 feet of depth. Observed at 5.0 feet of depth
Not Present in boring hole Not Present in boring hole
LOG OF SOIL BORINGS
Location of Project: 3344 Sibley Memorial (Hwy 13)
Borings made by Tom Klanchnik Date: May 10.2009
Classification System: AASHO USDA-SCS X Unified Other
Auger Used (check two): Hand X Power Flight BucketX Other
3 Inch Hand Auger
Depth Depth
In Boring Number B3 In Boring Number B4
Feet Surface Elevation Feet Surface Elevation
10 YR 2/2 Sandy Loam 10 YR 2/2 Sand Loam
1--
10 YR 3/3 Medium Sand
10 YR 3/3 Medium Sand
2 2
3 3
4 4
5 10 YR 4/4 Medium Sand 5 10 YR 4/4 Medium Sand
10 YR 5/4 Fine Sand 10 YR 5/4 Fine Sand
6 6
Mottled at 60" Mottled at 60"
7 7
8
End of Boring at 5.5 feet. End of Boring at 5.5 feet.
Standing Water Table: Standing Water Table:
Present at feet of depth, Present at feet of depth,
hours after boring. hours after boring.
Not Present in boring hole x Not Present in boring hole -x
Mottled Soil: Mottled Soil:
Observed at _5.0 feet of depth. Observed at 5.0 feet of depth
Not Present in boring hole Not Present in boring hole
SEPTIC SYSTEM DESIGN
DESIGN CRITERIA;
Existing 4 bedroom type 1 single family home, without a garbage disposal. Has
been remodeled to a 3 bedroom type 1 single family home, without a garbage
disposal. Customer requests additional capacity for possible addition of detached
garage with guest bedroom and bathroom. Design as a 4 bedroom type 1 single
family home, with a garbage disposal
WATER USAGE;
600 gallons per day maximum.
PERCOLATION RATE;
3.2 minutes per inch.
SEPTIC TANK;
Pump, Collapes, and fill existing tanks. Install one 1,500 gallon double
compartment septic tank. Please see detail. Note: tank requires pumping once
every three years.
q~g o
DRAINFIELD;
Drainfield trenches„ 76square feet required, ITsquare feet proposed. Each
trench is 36 inches wide with 6 inches of rock below the pipe. meal feet of
trench proposed. 00
GENERAL CONSTRUCTION PRACTICES;
Divert all surface water away from the drainfield area. Do not disturb the
drainfield area during construction. Fence off the drainfield area before permit
application. If there are any questions regarding this design please contact Tom
Klanchnik at (952) 461-2356.
Trench and Bed Worksheet
All boxed rectangles must be entered, the rest will be calculated.
1. AVERAGE DESIGN FLOW A 1.
5elav~smGa6rpoi+
A. Estimated 600 gpd (see figure A-1)
or measured x 1.5 (safety factor) = gpd bps Oat I CIM ll lm a Iv
B. Septic tank capacity 1500 gallons 2 300 225 )80 60%
3 450 3 218 oflhe
Se* ka) 4 600 375 256 vaL%
5 750 450 294 in tie
332
h berc Minimum Lied ljqmd ~t k 6 900 525 Ckwl,
I with dipW& 7 Ima 600 370 4
&ds trtt lifti 8 1211 v :DS cam
2or less 1 12
50r6 1500=,p V- 15: Chandmishm aid s Seft
facto (sue) (y ,
separaum
}
$ or 9 2i P"no
P" Wch 60a Inft"
2. SOILS (Site evaluation data)
C. Depth to restricting layer = feet 1 1.:7
D. Maximum depth of system Item C 3 ft = 2 feet = %tLmx
E. Texture Sand 04Y. tw= 0
Percolation rate 3.2 MPI
F. SSF 0.&1' ~a za ao
o gpd (see figure 0-15) G. /o Land slope g~x°
~ '~'tQft Cdsi Il
3. TRENCH OR BED BOTTOM AREA r "
At X te
H. For trenches with 6 inches of rock below the pipe: Qt
Ax F = 600 gpd x 0.83 fttgpd = 498.0 ft2 Use 600 Sq Feet
1. For trenches with 12 inches of rock below the pipe:
A x F x 0.8= gpd x ft/gpd x 0.8 = ft2
J. For trenches with 18 inches of rock below the pipe:
AxFx0.66= gpdx ftlgpd x 0.66= ft2
K. For trenches with 24 inches of rock below the pipe:
AxFx0.6= gpdx ft/gpd x 0.6= {
L. For gravity beds with 6 or 12 inches of rock below the pipe;
1.5 x A x F =1.5 x gpd x _ ft/gpd = ft,
For pressure beds with 6 or 12 inches of rock below the pipe;
A x F = gpd x ft/gpd = ftz
4. DISTRIBUTION (Check all that apply)
Bed (<6% slope) X Drop Boxes (any slope) X Rock
Drop Boxes (any slope) Distribution Box (<3%) Chamber
Pressure X Gravity Gravelless
'5. SYSTEM WIDTH, LENGTH AND VOLUME
M. Select width = 3,0 ft
N. If using rock, divide bottom area by width: (H, 1, J or K) divided by P = lineal feet
600.0 ft2 / 3.0 ft = 200.0 lineal feet
Rock depth below distribution pipe plus 0.5 foot times bottom area:
(Rock depth + 0.5 foot) x Area (H, I, J, K, L)
( 0.5 ft + 0.5 ft) x 600.0 ft2 = 600.0 f3
Volume in cubic yards = volume in cubic feet divided by 27
600.0 / 27= 22.2 yd3
Weight of rock in tons = cubic yards times 1.4
22.2 x 1.4= 31.1 tons Use 33 Tons
0. If using 10" Graveiless Pipe, length = Flow (A) x Gravelless SSF (see figure D-9)
gpd x 1 ft/gpd = lineal feet
P. if using a Chamber (H, I, J, K [based on height of chamber slats] divided by width of chamber in ft)
/ it = lineal feet
D-9: Soil sand Soil sizing
factors (SSP) for Gravstk" Pipe
ps rt talk n rate tisteal foal
ftnnu /trnta). saaitOtttre gattoFaJciay
FttsRtta°ih tat' CtWaeSan4
at toy MedlamaSnad 0.28
01.to5 RtteId. U
bto2$
1bto30 YFc tt 0.56
31 to 4S .9It W am 0.67
Q& mbJ geLaa m CGS? 0.74
5a1 t
skxrer them 6II"
S"y
`Scy+1aetratttnmtt
"'Stall nt gg50%crrrie lirteshevsdis
sx tuscsattd
" dl with toahlplt a petmttaged day tr
tt,attatlett d a standwd ht$n nd systsart
7. LAWN AREA
Q. Select trench spacing, center to center = (~3 ]feet
R. Multiply trench spacing by lineal feet R x Q = sq. ft. of lawn area
3 x 200.0 600 ft2
8. LAYOUT
Select an appropriate scale; one inch = 40 Net
Show pertinent property boundaries, rights-of-way, easements.
Show location of house, garage, driveway, and all other improvements, existing or proposed.
Show location and layout of sewage treatment system, well and dimensions of all elevations, setbacks and separation distances.
X
I hereb t I have completed this work in accordance with all applicable ordinances, rules and laws
signature) 2656 (license 5-11-09 (date)
r=ails. s t asr tv ? Cl a O a .ai s r. X Jr{!i$7 oral es~ ty
REQUIRED INFORMATION Check bas it eangleted:
? North eisrow Q Lakes, risms, _tr.ams, wrtlaads ? load rift ffos,(s)
? Drdptkd soil tsstas.at sera Q Ordinary hllt wscs heel of public aster 0 Lot lases
? Altoraatm soil ftwobamt asss Q ?oa"W aloud .ices o* ? Lot dim adsas
? soil boeasp $ pore test lo.etioas wash 0 rlooaias pobatliad now ? Lot s.wmeats
hodgeoW a vesdeai setoressm pods! 0 Loostaoa of distssb.d or compoestod agrees Q Sedmaka how b ap
Weals w 100 l. i
No" Loesa;liesm of ran-vs
Paton" arses ? Propvsrd i sade~ltsf bsnd~t
S.w.s Baas -I*, s0 foot of writs ? boa of bettam of soil bust ut as s foundudem
? mood" of dep.(s) Q Aacess roue for took medabaasa.
SCALE. 1 inch
cig&
I i
i S
VIM
e 1 { C~i ( /e ; i x 1
ALA I
Vk.
777
1w
Db"
t •3
VNIV
W
4iti
-A ir,
1 j i ! i ; 1 { { i i
{ r ,
SatsOC trks . ~•+t~t u:t apytt~sba :+>;taits ott.~;y` RscSm Chapitc ?oiii.'1 a 7s+t { i ' i
1' YAitr,'SfoGi it dz c M the bot o o°*t S m.
z: She S?ffi tA6at:fvs' in y+i: repo... NO d e2 e!IX a *ott o.°5lesie
hY3esutie :ne to ?•r:. wz:ds 6tsagp ovCt' ASS' L-Pe OtftYK svsxr
L3
{
D'°ipe.r Lie:et:zas 1l ber Dols
36 r*X 3,2)e'FJP4 &;~e
TRENCH CROSS-SECTION
FINISHED GRADE
--.0r Inches of 12 Original Grade Original Grade
Backfill Over Rock
Fill Soil to a Minimum
of 6 Inches Over Rock
Nonwoven Geotextile Fabric
Maximum Trench Depth
!2 " - - . - . t
E
a J ches 2 Inches of Rock Over Pipe
j'
.
4 Inch Pipe 4" Distribution Pipe
Af, Inches
of 3 4 " to 2 %2 " 6 to 24 Inches of
Washed Sewer Rock Washed Sewer Rock
Below Distribution Pipe
AWWV- INCH WIDE TRENCH
a
(J\J
f\J
c r
1r`.
V
J
V t
t'~
1>..
~.:Z I For Office Use
Permit IF
City of Eaall
~ Permit Fee: 70, - '
3830 Pilot Knob Road
Eagan MN 55122 Date Received: I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 LStaff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION L?~lI-` 1_N_0.1
Date: 9 ! - I ® Site Address: 33t J Ib\Q ' - rNa; I 4q, III, i:SQ an 5121
Tenant: c'Y % U Suite
RESIDENT I OWNER Name: C k-4 Phone: 61~- "~L1t( 'mod Yyt
Address / City / Zip: ;L t t , G e) ti -o
Applicant is: Owner Contractor
TYPE OF WORK Description of work: 116410Q10Ae 12 a 4 ~s~S2 do4 Ck nA
~ortruction Cdst: Multi-Family Building: (Yes / No
(Yes -f~
CONTRACTOR Name: License
Address:
City: State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
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:
Sewer & Water Contractor: Phone:
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 they are trade secrets.
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 permi , rk 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 royal o ans.
~~es' 0"-_1
X_ y\\j I Applicant's Printed Name ® lica4nat
Page 1 of 3
,lU~_ 0 7 2009
ICI
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Fireplace Porch (3-Season) _ Storm Damage
Single Family - Garage - Porch (4-Season) - Exterior Alteration (Single Family)
Multi - Deck - Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi)
01 of Plex Lower Level Pool Miscellaneous
Accessory Building
WORK TYPES
New Interior Improvement Siding Demolish Building*
Addition Move Building Reroof Demolish Interior
Alteratio Fire Repair Windows - Demolish Foundation
- Replace Repair _ Egress Window - Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation GY~Ct~ Occupancy /?C L MCES System
Plan Review Code Edition SAC Units
(25%_ 100% Zoning /2 City Water
Census Code y3y Stories - Booster Pump
# of Units - Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC 44- Drain Tile Other:
Roof: _Ice & Water _Final Pool: Footings Air/Gas Tests _Final
Framing j Siding: _Stucco Lath -Stone Lath -Brick
Fireplace: _Rough In Air Test -Final Windows
2 Insulation Retaining Wall
Meter Size: Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee 75G
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
4
r
Far Office rise
C!tyof Eapft Permit (1 1 e 1
Permit Fee: o CIO
3830 Pilot Knob Road (5 MN 55122 Date Received:
Phone: (651) 675 -5675
Fax: (651) 675 -5694
L) Staff:
2009 RESIDENTIAL BUILDING L PERMIT APPLICAT ON t` /Iz'L
Date: J D9 Site A dd r ss: 9 t� 4
f
Tenant: ■y 6.,\ eS Suite
RESIDENT OWNER Name: G i C: 1' Phone: 1 D- L -ly 3�y
Address /City /Zip:, gam' 1 C 1 L i -'1 a 94 7 1 �1' 5S 2 1
Applicant is l' Owner Contractor
r-
TYPE OF WORK Description of work: S. A G ),-e Gk
Construction Cost: q ___STQ 0 CD Multi- Family Building: (Yes No
CONTRACTOR Name: v-_ P1-t License
Address: f
City: State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
('1 submission type) Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes f/No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer Water Contractor: Phone:
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 they are trade secrets.
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�.a ork is not to start without a per ;that the work will be in
accordance with the approved plan in the case of work which requires a review an(approval o Ions.
i
x 2 6 N/ 1 r_ j 1\ Q–e S Applicant's Printed Name f I (-C -7 I -I Vi 'r` ppl icant's Signa re
Pa 1 of 3
u S E, 0 8 2009
i 7
DO NOT WRITE BELOW THIS LINE it
SUB TYPES
Foundation Fireplace Porch (3-Season) Storm Damage
Single Family Garage Porch (4- Season) Exterior Alteration (Single Family)
Multi Deck Porch (Screen /Gazebo /Pergola) Exterior Alteration (Multi)
01 of Plex Lower Level Pool Miscellaneous
Accessory Building
WORK TYPES
New Interior Improvement Siding Demolish Building*
y- Addition Move Building Reroof Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
Replace Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building give PCA handout to applicant
DESCRIPTION
Valuation a0a Occupancy Mc 1. MCES System
Plan Review Code Edition A.oa7 SAC Units
(25 100 Zoning 1?- J City Water
Census Code L 3/. Stories Booster Pump
of Units Square Feet 6 PRV
of Buildings Length c t,o Fire Sprinklers
Type of Construction R Width o
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final C.O. Required
Footings (Addition) Final /No C.O. Required
Foundation HVAC
Drain Tile Other:
Roof: Ice Water _Final Pool: _Footings _Air /Gas Tests _Final
Framing Siding: _Stucco Lath _Stone Lath Brick
Fireplace: _Rough In _Air Test _Final Windows
Insulation Retaining Wall
Meter Size: Radon Control
Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee 30
Surcharge
Plan Review OVA
MCES SAC
City SAC
Utility Connection Charge
SSW Permit Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
Receipt#: 53034 2667831
ABSTRACT FEE $46.00
Recorded on: 6/3012009 09:00:01AM
By. TMC, Deputy
r 1,~
Return to:
DAVID HUGHES
EAGAN, M219"
121 Joel T. Beckman County Recorder
Dakota County, MN
CERTIFICATION OF PURPOSE OF SECONDARY
KITCHEN FACILITIES WITHIN SINGLE FAMILY DWELLING
1, l C~ VS C.~ ~e 5 duly sworn and under oath, certify that I am the Owner of the one-family detached
fiw~tlt~±g ~.d~fine _ 'he-€-aga?a-~i#y-Co _ tl~ - - - -
described as Lot 31, Block 75, Section 8. Twin 27, Range 23, PID #10-00800-031-75.
A building permit application has been submitted on my behalf to the City to enlarge, alter, improve, remodel,
and/or finish the above-referenced dwelling, or a portion thereof, to include the installation of facilities for a
secondary kitchen within the dwelling.
The secondary kitchen facilities to be installed under the building permit are for the sole purpose of providing
cooking and food service facilities for private entertainment of guests by the property owner at the dwelling.
I acknowledge that the Eagan Zoning Code prohibits the existence of a second kitchen facility within a dwelling unit
to serve a complete, independent and secondary living or housekeeping use within the dwelling. I certify that the
installation of the secondary kitchen facilities under the building permit is t for the purpose of providing a second
complete, independent and separate living and/or housekeeping unit with Tthe
kk
Dated: ) R2_ 06-
2009 per's Signature
Subscribed and sworn to before me this V6 ay of v n - , 2009.
JUDY K AMN8
Nota ubliC ;VOTARY PUBW- MWNESQTA
My Commission Expk 0s Jam 31,2010
I hereby verify that the above said Certification of Purpose of Secondary Kitchen Facilities Within Single Family
Dwelling was recorded at the County Recorder's Office on 2009.
By:
Its:
THIS INSTRUMENT WAS DRAFTED BY:
City of Eagan
Community Development Department
3830 Pilot Knob Road
Eagan, MN 55122
G:\Building Inspections\FORMS\Certification of Kitchen
To : Mike Lence Mon Aug 17th
From : David Hughes / 3344 Sibley Hwy
Re : Here are the drawings with signatures, etc.
Mike -
Sorry about that - Darren Hofshulte ( Septic Installer)
must have given you one of the copies. Here is the original
It has all the signatures from Tom Klanchnik. He is the Certified
Septic Designer who did all the Perc Tests and Soil Borings,
and he designed the system.
There were about 10 copies floating around that I had blacked
Out Tom's name so that I could get a fair bid because the Septic
Community is a very small community and I did not want the bidders
To call Tom, etc. FYI...the only reason we have drawn the "future
guest quarters above garage" is because the 80/20 laws will change
this January ...and if I don't put that in here now....they may require
me to install a 2nd Septic System for an apt over the garage. I do not
plan on building that apt for at least 3 or 4 years...but since the Septic
Im putting in is for 4 bedrooms...and since the house is now only 3
bedrooms....the Septic is designed to handle a 4th bedroom/bathroom
[EC 7--OW75
~!,r 1 7 2009
over the garage if I decide to build it in 3 or 4 years. In addition...it could
easily be tied into the pipe in the Bomb Shelter at that time. All
plumbers on site have strongly urged me that "this is the way to
go...put it into the print now...and then build it later... otherwise..
you will not be able to do it later when you apply for your garage
apt permit in 4 years". I fully understand that there might be additional
hurdles at that time...and I will cross those bridges later ...lm just
trying to maximize possibilities and minimize future costs right now.
Thanks again
David Hughes
3344 Sibley Hwy
Eagan
24 hr ph # 612-644-8444
Em: dhh222@gmail.com