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3645 Sibley Memorial HwyCITY OF EAGAN Remarks ?- Addition Section 17 Lot Bilk Parcel 10 01700 010 50 Owner a"2»g1W- 9- Street 3645 Sibley Hwy. State E2gan,MN 5514L Imprbvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1972 907.42 10 Paid STREET RESTOR. GRADING P-0 S 2 % to -313&.3 TRK S rScw 3/3G • 3a G'O /S??- .3 3 6 SAN SEW TRUNK 1968 140-00 30 Paid SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA 1977 730-00 48.66 1 t C0 07 STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK EAGAN TOWNSHIP Nc 247 ,--.BUILDING PERMIT Owner ? ..?i..?_...._ ... ?-----..._.... Eagan Township Address (present) '.- .. -.1.--.. .... ... `._.. Town Hall C? Builder .......... .'----------- ........ ..... ....... --..... _...._... rC.C.t-ate / ? Address --------------------------------------- ---------------- -------------- -------- ---------- . DESCRIPTION Stories T Be Used For Front Depth Heig Ed. Cost Permit Feel ; 1n- Z , Remarks / 0 4 e am 5-0 ' . 17'a - or LOCATION or 50 5c,? t-ro This permit es not authorise the use of streets, roads, alleys or sidewalks nor does if give the owner or his agent the right to eate 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?u-T ON TH P)jI]]jjWHILE THE WORK IS IN PROGR X45. -??/ This is to certify, Thai. '? .Qru@ /? i / ------- - -has permission to erect a---- - --._-upon the above descr' premise sub" to the provisions of the Building Ordinance for Eagan Tow adopted April 11, 1955. .....------.....,. t G .. ...__..... Per ----- .------- -..- ................-----' ---------------------- Chairman of To n card Building Inspector EAGAN TOWNSHIP BUILIDING PERMIT Owner ---(,..L/ s..1.----------------- Address (present) Builder .--........................ -------- -.__---- ------------- ---------- ----------------- ---- Address ---------------------- -------------------------------- ............. ......... DESCRIPTION N° 839 Eagan Township Town Hall Date Stories To Be Used For Front Depth Height Est. Cos! Pe rmit Feel Remarks er - LOCATION Street, Road or other Description of Location Lot Blo k Addition or Tract I c i This permit does not authorize the use of streets, roads, aNeys or sidewalks nor does if 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 BE?yKEPT O?N? THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that..a- ---L.r ................ has permission to erect a----- ------------- ......................... upon the above des pr 'se sub'ecI to t 'rovisions of the Building Ordinance fo?hagan wnship adopted April 11, 1955. /,/?;?? .............._..........--....---_......-" ---................................. Per ___......-.G.G.C ./,: t?....d ' .. Chairman o Tnwn Board Building Inspector Permit #: t- `, l (-d Receipt Date: n -7 CITY OF EAGAN 2004 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES 11 __ nn EXISTING RESIDENTIAL PROPERTY Address 31° 4? tQ h tin\ e Vdl c1V ` p.Q ,? l?J OFFICE USE ONLY Property Owner Y ?c? c I stn s ., n Cc t/ ? PRV required Telephone# 3z'SS'13 /0-Tr Plumber Date of Inquiry '8 /?/ 0 Contact Name yyl, k<- / 1'r/* a s7 n Sewer 4" Sewer Service $ 600.00 Lateral charge @ $24.60/ff Trunk @ $1,000/connection City SAC 1000 MCES SAC ,135000 Receipt # , Date Septic abandonment 50.00 Permit Fee 50.00 State Surcharge .50 Total / $ `" City 7" County R-O-W Permit Water 1" Water Service Lateral charge @ $24.85/ff Trunk @ $1,040/connection Water supply & storage Receipt # Date Treatment plant Permit Fee State Surcharge Plumbing pe required - water meter to b cquired with plbg permit 930.00 588.00 50.00 .50 Sewer and Water 4" Sewer Service I" Water Service Sewer lateral charge @ $24.60/ff Water lateral charge @ $24.85/ff d 0,3 , 58 Sewer trunk @ $1,000/connection Water trunk @ $1,040/connection City SAC MCES SAC Receipt # Date Water supply & storage Receipt # , Date Treatment plant Septic abandonment Permit Fee State Surcharge Total Plumbing permit required Water meter to be acquired with plbg permit J ors-8?b %??? F-??i ? us F/Me? b,. a. .ivrn..t.f 930.00 588.00 50.00 100.00 50 $?Iri7, A116 0 6 4`004 JJ,III h_ cc: Carolyn Krech, Finance Department I. CITY OF EAGAN SEWER & WATER CONNECTION CHARGES - 1989 EXISTING PROPERTIES SEWER CONNECTION CHARGES SAC Previously Pd. Receipt # ACCOUNT DEPOSIT SEWER PERMIT TOTAL: WATER CONNECTION CHARGES $ 675.00 WATER CONNECTION $ 580.00 Previously Pd. Receipt S 15.00 WATER METER 10.50 TREATMENT SURCHARGE $ 700.50 ACCOUNT DEPOSIT WATER PERMIT PLUMBING PERMIT TOTAL: TOTAL FOR SEWER & WATER HOOK-UP: $1,636.50 OFFICE USE ONLY C? C-C ?- PROPERTY OWNER: fl (?LLL??/I?L!rvrL? ADDRESS: 0(, V,(- JGG ` "/ L:()/() B: .?D ADD: 4y r7tt -2, 1-7 90.00 228.00 15.00 10.50 12.50 $ 936.oo •? rn //- z.g- 8q /r Arfra, s fA0. - 7,H5Y w;// 8.e toDK;nj at fAe;i sapkia 7 NF1R w 11 Sar,, 4.1 S@w?r 7!l Sys 7 Is D, K. Sas M? ?? 'Cod CITY OF EAGAN Remarks x` Addition Section 17 Lot Rik Parcel 10 01700 010 50 Owner' i t.'. tL "2 !? ¢" Street 3645 Sibley Hwy State Eagan,1N 551•2a"? //i Imprbvement Date Amount Annual Payment Remipt Date STREET SURF. 1 2 0 2 Paid STREET RESTOR. GRADING r k O?O S8?- 33 6 SAN SEW TRUNK Vp 1968 1 0.00 3 Paid v SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA 1 0,00 15 -Pa a t co 07 9-3- 7b STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CITY OF EAGAN Remarks 17 Lot plk Parcel 10 01700 010 50 Addition Section Owner.' ,i { ?'? Q!???M;?/NL 9 Street 3645 Sible4 HW-y State Eagan,MN 551 Imprbvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1972 907,42 10 Paid ' STREET RESTOR. GRADING 2p S' 2 / !o /3G•3 TRp( s7.Sew 3/3L.3a CO /S??- 33 E SAN SEW TRUNK 'VD 1968 140-00 30 Paid v SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA 1977 0,00 4b.66 1 1 t CO 07 9-.3- 7Z STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK i? - 1 07 ?ftr? y /f,/0 14e Lt./ A r4 T S To ? o o ?? v / ?o S,e wR? c. >L s( -p ?TR„NK 30o AW4y w7?1? 5'ee ?, Face. fFen,a. 1--4 n Xx? ?sT7mafld CoJ?J C/1 aa7o4, ala7 rv?f?l T??,r??%?n ?dl3, T?Ptl`i0.00 -/Co.0u -so?? ar73, Sd' I ?4A r, ? -v l ItialI" 5l=tA,- Q 14 en=. _ kp, ? O v Ott i P11 V 06 7 O .+• tI. -- l?rye t! +s--? j o io Pp ,w ?1 J ?, / 9 ' ? Y .1 ?r? io \O 40 t Qd td ? AAlk? AZi? i 40 a a 09-20-'11 11:18 FROM- T-146 P005/006 F-548 44IP C!tyofEaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675.5675 Fax: (651) 675-5694 t( Ltt Use BLUE or BLACK Ink For Office Use /� Permit #: /�) /0 &? Permit Fee: 7C) Date Received: Staff: 2011 SEWER AND WATER REPAIR / DISCONNECT PERMIT J Date: Q//s11/ Fee: $55.00, X City Sewer City Water Repair '� Disconnect / Description Of Work: �l2ii,i f is �J' £-%-,' •Iger/;A Street Address for Proposed Work Mi / -5— -Cb Aim, 0/: d /7'i OWNER Name: "CivtSo{Ma. V4/4 7 ,.si if-' AA1.41on,/y Phone: 1 -)-grg.- 7S`ao Address / City / Zip: /%SSv / i, ,dr,VL -- 374.,,Asv//4 AIN S-5-93 7 Applicant is: Owner Contractor Licensed Name: lit,./' Alt s t 4 Pipelayer iC Master Plumber Property Owner 194 Wo 4S) l.... -.C. Phone:�Sy� ---dtP//tr Address/City/Zip: 17/5130 W, Ct ¥?j furh- /OS- — at,e,5v'IJ ?IN 55337 Pipelayer Training Certification Card #: !a / 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. Ow, 12,11/t /---JEL� 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.gopherstateonecall.orq 09-20—'11 11:17 FPOM- 41,11'CitJorBaQau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 C lug T-146 P002/006 F-548 Use BLUE or BLACK Ink For Office Use Permit It /�"�j / 0e.4� Permit Fee: qr . 0 0 Date Received; Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Name: ! i i,v,Ks04,a Y/Yl /£ y `ft4rfr'- ,444.0.40"4 Phone: 95.--1 " cr8. — 75700 Address/City/Zip: ltss0 C trivE. %'1N S5337 Applicant is: Owner W Contractor /� Description of work: 44~/fig. • eK%Sfis� f-,trsrc. �r�� (�iv=?/6S Company: /'M4 f17» * Wor,cj ,' ,. G . Contact: 1 -;;Tat Address; .2 -COO Cok,ay ,Qd r2 -1S 4't/orCity: State: /y N Zip: CS'_ 3 37 Phone: fl) - gs11 67/1 License #: Lead Certificate #; If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) fid,)/4;9 .G4Jc .44••• A44 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: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: Phone: ._ 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.aonherstatoonecall.org 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 Coda must be completed within 180 days oo�f^permit issuance.. X ` /4M g£✓W1 d Applicant's Printed Name Applicant's Signature Page 1 of 3