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3820 Sibley Memorial Hwy T:w request void L~ t 8 k/ ] 8 tsonUis ;rom Date o this Request 1 o Fire No. S 7 6 8 3 0 I, as censed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal wiring instatied at: Street Address or Route No.J?B/o Cit Section Township Range County Which is occupied by l- (Name ot O[cupant) Is a roughin inspection required on this j b? No ? Yes ? Ready Now lil~-Will Call ? Power Supplier. SE Q Address Electrical Contractor 3 99 ~ Z ~ ~Contractor's License No. _ ~(jCOmp/any Nama) MailingAddress ~FJO~J"-" / ~ (Elettrical Contractor o~ wner Making ThIS lnstallatlon) thorized Signature//(/, a. ~/Ze Phane Na4.S~~ (Ele~ctricI~al Contractor or Owner MakingThis InztalNtlon) I l~ II q~~ ~a;' ~`i~,~ ~D ~,('O~~ This i~pection requert will not-6e accepted by the C: ~ U1~vu~ State Board unless proper inspection fee is enclosed. Minnesota State Board o Griggs Midway Bldg. - ty 6 g ~ EB-00001-02 ~University Ave.. St. Paul, Minn. 55104 - phone 297-2111 /aU REQUEST FOR ELECTRICAL INSPECTIO CHECK BELOW WORK COVERED BY TH1S REQUEST r f 76 83O - Type oP Building New Add. Rep. Check Appliances Wired Foi Check Fquipment Wired Frn Home ? ? ? Range ? Temporazy Wiring ? 'Duplex ? ? ? Water Heater ? Lighting Fixtutes ? Apt. Bldg. ? Dryec ? Electric Heating ? Commercial Bldg. Fumace ? Silo Unloader ? Indus[rial Bldg. ? A'v Conditioner ? Bulk Milk Tank ? Farm ? ? ? List List Other ~ ~ ~ RIhers~ ~theis~ ere ere COMPUTE INSPECTION FEE BELOW Secvice Entnnce Size: # Fce 11 Feede P J~ F*] Circuits: it Fee 0 to 100 Am s. 0 to 0[0 30 Am eres O O ]Ol to 200 Amps. 31 to 1 Ames 31 [0 100 Am res Above 200 Amps. Above Amps. Above 100 Amps. Transfoxmecs RemoteContiolCitc. Partialorothe[tee Si ns Special Ins ection Minimum fee v J Remarks / - / ~J,,, - TOTAL FEE 8, O'~/ , sa i, the Electrical Inspector, hereby certify that the above inspection has heen made. (Rough-in) Date (Final) ^)Date This request void ~ 18 months from - " INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: . 1pLi 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: .,.i ; MFMf?RIAI. It1.JY NViNnNMrNt~: INJ `PERMIT SUBTYPE: TYPE OF WORK: INSPECTION .A ~ ~ ~ Permit No. Permlt Holder Date Telephone # S/W PLUMBING HVAC ELECTRIC ELECTRIC Inspectlon Dete Insp. Comments Footings I Foundation Framing '13 % } !J s ~ on f ~ ~ ~ Roofing v y-~i 3 ~~v Rouqh Plbg. Rough Htg. Isul. Fireplace Final Htg. Orsat Test Final Plbg. Pibg. Inspector -Notify Plumber Const. Meter EngrJPlan Bldg. Final Deck Ftg. Deck Final Well ' Pr. Disp. cirY oF EAGaN 3795 Pilot Knob Road Eeyan, Minnesoto 53122 INSPECTOR NOTIFICATION No. Phone: 454-Q100 REQUIRED BY LAW • - PERMIT FOR ALL INSPECTIONS Dote: Receipt No.: _ Single I Site /lddress: Residential Lot i5- Block ~ Sub/Sec. Multi Res., Comm./Ind. Nome New/Alter./Repoir ? 7 ; Address Cost of Insfallation O City Phone: Pertnit Fee Name ,.-•ti ' ,~~ti~, ~ Surcharge ~ Address City Phone: I Total This Permit is issued on the express condition thot oll work shall be done in accordance with all applicoble Stote of Minnesoto Stotutes and City of Eogon Ordinances. Buildin9 Offitial CITY OP EAGAN 3793 Pilof Knob Road 6ogon, Mienesota 55122 Phone: 454-8100 MBM- RffTdC• PERMIT No. 336 Date: 4-3-79 Receipt No.: 13753 Single I Site Address: 3820 ~W Hwy• Residentiol Lot Block Sub/Sec. W-9,101h f?.56,01L Multi Res., Comm./Ind. I Nome (7bWtri ~rketS New/Alter./Repoir 3 Address 084 Oxford Sr• Cost of Installation 0 City st' ~is Pa& Phone: Permit Fee 20.00 . Nome r"~ ~M r~~ Surcharge ' 5n . g Address 26 Nb. 5tl1 SfZeE_'t e 0 u City Phone: Total This Permit is issued on the express condition that ol) work sholl be done in accordance with oll opplitnble State of Minnesota Statutes and City of Eagan Ordinances. Buildirg Official CITY OF EAGAN Remarks Addition Section 19 Lot Rik Parcel 10 01900 030 04 owner VJ(z'1.: street Ag/o S1bl• state _ EAGAN MV 55122 ~ 7 - ~ Improvement Date Amount Annual Years Peyment Receipt Date 1 STREET SURF. 31 7 1976 6010.88 601. 08 10 STREET RESTOR. GRADING SAN SEW TRUNK * SEWER LATERAL 1973 $2556.00 $127.80 20 tv 02 122e - WATERMAIN * WATER LATERAL 1973 20 WATER AREA 1972 $524.30 $34.95 15 STORM SEW TRK STORM 5EW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CiTY OF EAGAN Remarks ~io "1 r," - A 0-4'r Addition Section 19 Lot Rik Parcel 10 01900 050 04 EAGAN MN 55122 Owner sreet ate S C i,r p y JJq , -l'-; p r J-:;~~ 7- E improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1485 9753.75 975.38 10 STREET RESTOR. pApINC 1975 2 GRADING SAN SEW TRUNit 'Yn 1968 140.00 SEWER LATERAL WATERMAIN ID * WATERLATERAL 1972 $1270.00 $84.66 F15 PA * WATER AREA 1972 STORM SEW TRK STpRMSEWLAT 1985 8740.74 874,07 10 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. 5AC PARK . , CITY OF EAGAN ' • 3795 Pilot Knob Roed Eagnn, Mienesma 55122 Phowa: 454-8100 VE!M. PERMIT Amo. 378 Date: 2~ 80 Receipt No.: 17n4- Single I Site Address: 3820 Sib1Cy Mem. fty. Residential Lot Block Sub/Sec. Multi Res., Comm./Ind. '~'~~"'~'•I Nome ~'v~~ty r? ub l(arket New/Alter./Repuir AIter - RefriR. ; Address 6014 OxfOZ'd Si,., Cost of Instollation rr, 0 •001 ~ City St. 1A11iB'mw Phone: Permit Fee -110•00 8!'k Name Carlaon_store 'Fj y. iyc' Surcharge ~ ~ Address NOI'tti 5t.$ ~ ~ . ~ Cit ~~.:L'1LIi'8- I i 8 Phone• Z ZI~ 5r y . Total This Permit is issued on the express condition thut oll work shall be done in accordance with all opplicuble State of Minnesota Statutes and City of Eogan Ordinances. -#.5 S'~7~pD y/e~?D Building Official CITY OF EAGAN y795 Pibf Knob Road Eagon, MN 55122 N° 5975 ~ . PHOME: 4548100 BUILDING PERMIT Receipt # To be and for Est. Value Dcte , 19 Site Address ~;;j}~1E-'~ t•c Erect ? Occuponcy Lot Blxk Sec/Sub. Alter p Zoning partel Repoir Q Fire Zone Enlarge ? Type of Const. j T W Nnme Move ~ # Stories 3 qddress • Demolish ? Front _ h. ~ Ci Pho?re Grode ? Depth ff. cc Name "c. Approrah Fees o . - 09 Addreu ' Assessment Permit ~ Cit s p~e Water & Sew. Surcharge Polite Plan check FZ Name Fim SAC Address Eng. Water Conn. <W Ci Phone Plonner Water Meter Cauncil Rood Unit I hereby ocknowledge thct I hove reod this application and state that Bldg. Off. the information is correct and agree to wmply wifh afi oppliwble $tate of Minnesota Stotutes and City of Engcn Ordinances. APC Total Signature of Permittee A Building Permit is issued ta ' on the express condition that oll work sholl be done in occordonce with oll applicable State of Minnesota STatutes and City of Eogon Ordfnonces. Building Official f . ?wsk # DaM Iwnd Pwslttr Plumbing Mechanical 2- 7 rc.~~ 5~ 7!o D f- O n INSPEGTIONS DATE INSP. Rouph-In Finul footings Dots Insp. Date irup. Foundation Plumbing Frome/ins. Mechonical Finel Remarks: CITY OF EA('~AN Include 2 sets of plans, 1 site plan w/elevations & fflJII,DING PERiAZT APPLICATION 1 set of energy calculations. ~~ro iYf~ i~ rf - 7.U Be Used For / l_c u,)Tr4t ~/up~ Valuation ~35 ~ ~-6 Date / 7 p U ~ site paaress McMmv„a / ll; j A,raf OFFICE USE ONLY rAt Rlocac sec./sub. Erect (Dccupancy - Paroel # : 5"D O ~ ~ D,~iO d ~ Alter zoning j~ Fire Zone 3 ~ Repair- Raner: I~D tn a~ 'y 6)u ~)9R ?rr E~ EnlarJe _TyPe of Const. Address: ~ rf ~ c> ~ e ri /0') N~°ve # Stories Sbf E+~~v;nf Nw Dgiulish Front ft. lelA City/Zip Caie: ¢ q7 y r' y d7 Grade Depth ft. Phone APPROVP,LS FEES Contractor: ~ o J e , i H J7!55vc • Assessments Pexmit ~ Pddress: f4ater/Sewer Surcharqe ~ 7 ~'AL-k~ Police Plan Cl~eck City/Zip Code: :5T Fog aAl,'h u1 Fire SAC ~ Eng. Water Conn. Phone planner Water Meter Council RAad Unit Arch,/Enq.; ~c ve e ; A g ~ssnr Bldg. Off. Pddress. , r APC .~S City/Zip Code: Phone TOTAL / ~'O CITY OF EAGAN 3795 Pilot Knob Rmd Eagun, MN 35722 N? 5975 , PHONE: 444-8700 BUILDING PERMIT APPLICATION Receipt # ~ ro ee u.ee ~r Storm Repair/CO~ s Va ueb T&t" 35.000 Dote 7_17 Site Addrew 3820 Sihlay MPmnrial Hwv_ Erect ? Occupanty lot s Black ~ Sec/Sub. ~ 9 Aker ? Zoning CSC parcel r0 oi QO D O$Ca o y Repair g7 Fire Zone 3 II N Enlurge ? Type of Const. w Name Oun .'Y'y Cl ih MaT'k . Move ? # Stories Np Z Addrew 3820 Sibley Memorial Hwy. Demoiish ? Front _ NA ft. 0 C. Eagan I phone Grade ? Depth NA fr. o Name L eT'lIIg ASSOC. ADProvale Fees 05 Addrew 555 Wabasha St. Asussment Permit 103.00 u~ Ci St. Paul pho~e 225-fi511 Woter 8 Sew. Surcharge 17.50 Police Plan check F z w Name T*Taring Aqqno Fire SAC Addrew Eng. Water Conn. <w Ci Phone Planner WaterMeter Council Road Unit I hereby acknowledge that I have read this aDPlication and state that gldg. Off. the information is mrrect and agree to comply with all applicable l 0.50 StaM of Minnesota Sfatutes and City o4 Eagun Ordinances. APC Totul - SignGture of Pertnittee A Building Permif Is issued to: L erin ASSOC. on the express condition that ull work sholl be d in cco an liwble State of Minnewta Stututes and qty of Eogan Ordinances. Building Official ~.~~.~4&!11 EAGAN T`OV1/N S H I P BUILDING PERMIT N°• 2607 i~ y~--- Ownez :..-d.a,--- ................-----./i.:~r.'.?/v~: :T~... Eagan Township Addrese (presen!) .I..~Z?c' ~~•..._.l-.~~.'`~ Town Hall . Bailder ~R.° Dale Addrees •---`~=~-5-----.. .....:ff~:...~.~t.3 /o...... DESCRIPTION Siories To Se Used Fos Froni Deplh Heighi Esl. Cos! ermif Fee Aemarks 6e7 la~i av.~2;~ P.ck, ~d .L... /.~.,~-...t. .~cc.~..+....~~~i ! ~ i4~° ///x~7/ 0 LOCATION Slreet, Road or olher Deseripiion of Loea![on I Lof ~Block Additioa or Trae! /op Oi 9oa Osa o y This permit does not autharize the use of alreels, roads, alleys or sidewalka aor doea it give the owner or dis agen! the :igh! !o creafe aap silualion which is a nuisanae or whieh presenis a hezard !o the healih, tefelp, eonvenience and general welfare fo anpona in the communifp. THIS PERMIT MUST Sg-/~~KEPT ON THE PAEM;SE WHILE THE WORK I5 SN PAOG ESS. Shia ia !o eertifp. !hel.. . _ . N- . OzYe^""'~ has permusion !o eree! a--. '41r.r.: _-..t=.... _upo0 the above described premiee aubJeM !o the provisiona of the Building Ordinanee for Eagan Township adopled April 11, 1935. Per fl Chai~nan of Tnwn Boqrd Hvilding Inspeelor~ PS COMBUSTION TEST PERMIT# EA044300 ADDRESS 3820 Sibley Memorial Hwy APT. FLOOR CITY Eagan SU8UR6 OCCUPANT All American Recreation OWNER All American Recreation HEAT LOSS 80,000 BTU DATE HEATING INST. Fel>01 SOLD BY INSTALLED BY Nordic Services Inc Electrical Work by Owner responsibility Gas Line By Nordic Services Inc TYPE OF HEAT: GAS_X FORCED AIR_X_ HOT WATER_ STEAM_ SPACE HTR_ UNIT HTR_ OTHER_ GAS DESIGN MAKE (ManuFacturer) York Model 072N09925 Serial INPUT 99,000 BTU CONTROLS THERMOSTAT Honeyweli Heat Plug N/A VaNe Honeywell LimR Whde Rodgers Limit Setting 180 deqrees Fan Setting Timed Pilot Type Direct Pilot Make Direct Pilot Model Direct Pilot Timing 5 Sec Trial L.W. Cut Off N/A Pressure 3.5 Percent C02 8.3 InpW CFH 99CFH Percent 02 6.3 Stack Temp 406 Percent CO 52 CONVERSIONBURNER YES NO_X MAKE OF BURNER Model Max BTU Rating MAKE OF FURNACE Model Vent Size Design KIND OF LINER SIZE NONE X Drafl Hood Desian Regulator 0.3 Fitters S¢e 2- 15X20X2 1- 14X25X2 Number Chimney Location Inside Outside X Chimney Construction DeSign Smoke Bomb Wiring DraR Test Tag - Door Pressure Lighting Inst. Date Tested 2/25107 Com an Testin Nordic Services Inc. Name of Tester Ton Ravnikar ~ COMMERCIAL S~~R (y ~ 1~ BUILDING PERMIT APPLICATION CITY OF EAGAN 7~ 651-681-4675 ~ ~~j 1~~~ Il-a3-~I Foundation ON ` New Constnuction Inter~ior lm rovemen • Structural Plans (2) sets • Nchitectural Plans (2) sets• Architectural Plans (2) sets • Civil Plans (2) . SWCtural Ptans (2) • Code Malysis (1) " . CeNficateofSurvey (1) • CivilPlans (2) • ProjectSpecs (1) • Code Malysis (1) " . Landspping Plans (2) • Key Plan (1) • ProjectSpecs (1) • CodeAnalysis (1) " • MasterEbtPlan (t) • Spec.lnsp.&TestingSchedule" • CertifipteofSurvey (1) • EnergyCalculaUOns (1)notalways" • Soils Report (1) • Spec. Insp. & Testing Schedule (1) " • Elec. Poxer & Lightlng Form (1) not always" • Meter size must be established • Meter sizB must be established • Meter sim must be esta6lished -if applicable • ProJectSpecs (1) 1 • EnergyCalcNations (1) 1 • Electdc PoKer & Lighting Form (1) 1 1 • Master Ept Plan (1) 1 1 • Fire ProtectionPlan (1)" 1 1 • SoilsReport (1) 1 • MC/ES SAC determination letter • MC/ES SAC determination letter • MGES SAC detertninatlon letter call 651-602-1000 call 651-602-1000 call 651-602-1000 " Contact Building Inspections for sample Food & beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health - call 651-215-0700 for details. DATE MP zo WORK TYPE _ NEW ~ REMODEL CONSTRUCTION COST SITE ADDRESS 3820 ~ 1-01-iY 14W - 13 TENANTNAME ALL--44_"r-eI c41L/ i2er- SUITE# FORMER TENANT NAME DESCRIPTION OF WORK Ol.4~Fe 146-A-VI D:iD`R Name: AL1- - •4fnER IC4/1/ P46~C I dC Phone#: ( W' ) PROPERTY Last First OWNER StreetAddress 36Z S(731o- {J1~Jr1t~iJL J-~1'/~- /J(ti'N 13 City Shte /10!7/C/ Zip ,S3-177^ CompanY A-LL- *lWe-le! C41? &2 (~-C Phone # CONTRACTOR StreetAddress: Sgxo Sl-RW ,%94Wx2t~- b2#L-'L_ City State Zip ARCHITECT/ ENGINEER Company Phone # ( ) Name Registrarion # Street Address J~~-~-o c) I City State Zip ~ Licensed plumber installina new sewer/water service: Phone I hereby acknowledge that I have read this application, state that the information is cortect, and agree to comply with all appiicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applica~ C; Y~~'r OFFICE USE ONLY SUBTYPE ? 01 Foundation ? 26 Public Facility ? 30 Accessory Bldg. ? 14 Apartments tC27 Commercial/Industrial ? 32 ExtAlt - Apts. ? 15 Lodging ? 28 Greenhouse ? 34 Ext Alt - Comm. ? 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt - PF ? 37 Nail Salon WORK TYPE ? 31 New ~ 35 Tenant Impr ? 42 Demolish (Found) ? 46 Windows/Doors ? 32 Addition ? 36 Move Bidg ? 43 Reroof ? 47 Repair ? 33 Alterations ? 37 Demolish (Bidg) ? 44 Siding ? 48 Authorization ? 34 Replacement 0 38 Demolish (int) ? 45 Fire Repair GENERAL INFORMATION Census Code 4-3'~ Zoning CjjG Sq, ff. SAC Code Itp # of Stories sq. ft. No. of Units c:~, Length sq. ft. No. of Bldgs. I Width sq. ft. Const. (Actual) ~ Basement sq. ft. MC/ES System (Allowable) TL First Floor sq. ft. City Water UBC Occupancy F- sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ? Gas Service Test ? Heating ? Insulation ? Plumbing ? Stucco/Stone APPROVALS Planning Building Engineering Variance VALUATION $ Permit Fee Surcharge Plan Review MGES SAC % SAC City SAC SAC Units Water Supply & Storage Meter Size S/W Permit S/VV Surcharge Treatment Plant Park Dedication Traiis Dedication Water Quality Other Copies Totai ~S `~v L y- coMMERCiai. t BUILDING PERMIT APPLICATION S'L C~1 O V\ CITY OF EAGAN t 1 FS ,g7_ o(p 18~ 651-681-4675 ~I ~ I Foundation Onl NewConstruction Interior Im rovement • Slructural Plans (2) sets• Architectural Plans (2) sets • Archltectural Plans (2) sets • Civil Plans (2) • SWcWreI Plans (2) • Code Analysis (1) " • Certificate of Survey (1) • Civil Plans (2) • ProJect Specs (1) • Code Analysis (1) " • Landscaping Plans (2) • Key Plan (1) • ProJectSpecs (1) • CodeMalysis (t) " • MasterEbtPlan (t) • Spec.lnsp.&TestingSchedule" • CertificateofSurvey (1) • EnergyCaiculations (1)notalways" • Soils Report (1) . Spec. Insp. & Testing Schedule (1) " • Elec. Poxer & Lighting Form (1) notalways" • Meter size must be esfablished • Meter sim must be established • Meter siae must be established -if appiipble • ProjectSpecs (1) 1 • EnergyCalculations (1) 1 • Electric PoNer & Lightfng Farm (1) 1 • Master Ebt Ptan (1) 1 1 • Fire Protection Plan (1) ! • SoilsReport (1) 1 • MClES SAC determination letter . MC/ES SAC detertnination letter • MC/ES SAC determinalion er call 651-602-1000 call 651-602-1000 call 651-602-1000 Contact Building Inspections for sample Food 8 beverage or lodging facilitles: Plan must be submitted to Minnesota DepaRment of Health - II 651-215-0700 for details. DATE Z E 0I WORK TYPE _ NEW XREM EL CO STRUCTION COST /~OCI ,iHw SITE ADDRESS 3$ZO 5 i b~ey ~jpy~pr~ -qr TENANT NAME 411-'9A'WIO~") SUITE # /OZ FORMER TENANT NAME ~ DESCRIPTION OF WORK J_h&wrvv1" Name: Air-AY/E+'ftIrl- K@ 4c; Phone#:( 651 )LI(jS-/f lf PROPERTY Last First OWNER StreetAddress 3Nc7 lswev cicy L~G aq stace ztP SSr2/ 1.4 Company 1(-Ae"'It~-lCu•~ dPet,. Phone# ( lD~l ~ ~O.S =(/~l corrrRa.crox StreetA dress: 3ry20 13 ciry% 0~^ 1 state //wN zip SSIZI ARCHTTECT/ ~ ~ ENGINEER Company rhe # n 11 Name Registtarion # I I i I I I Street Address I~ I I`~ I Ciry Stete Zipi4;'-- Licensed plumber installina new sewerlwater servlce: Phone I hereby acknowledge that I have read this application, state lhat the information is corred, and agree ply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Appli~nt: OFFICE USE ONLY SUBTYPE ? 01 Foundation ? 26 Public Facility ? 30 Accessory Bldg. ? 14 Apartments 27 Commercial/Industriai ? 32 ExtAlt - Apts. ? 15 Lodging ? 28 Greenhouse ? 34 ExtAlt - Comm. ? 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt - PF ? 37 Nail Salon WORK TYPE ? 31 New ? 35 Tenant Impr ? 42 Demolish (Found) ? 46 Windows/Doors ? 32 Addition ? 36 Move Bldg ? 43 Reroof ? 47 Repair ? 33 Alterations ? 37 Demolish (Bidg) ? 44 Siding ? 48 Authorization ? 34 Replacement ? 38 Demolish (Int) ? 45 Fire Repair GENERAL INFORMATION Census Code Zoning sq. ft. SAC Code ~ # of Stories sq. ft. No. of Units o Length sq. ft. No. of Bldgs. Width sq, ft. Const. (Actual) N Basement sq. ft. MC/ES System ~ (Ailowabie) First Floor sq. ft. City Water UBC Occupancy 5l ./k3 sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ? Gas Service Test ? Heating ? Insulation ? Plumbing ? Stucco/Stone APPROVALS Planning Building UfIktu Engineering Variance Permit Fee 2S I. 25 VALUATION $ 15, ODD ~ Surcharge 1~ o Plan Review 11"3 '3 I MC/ES SAC I I5-0. 00 % SAC I oo ° o City SAC ~ o o. c o SAC Units Water Supply & Storage - Meter Size S/W Permit - S/W Surcharge - Treatment Plant 51(, . o G Park Dedication - Trails Dedication - Water Quality - Other - Copies - Total ~ 2l 86, O S• Ae 019,0.4 A5a oy MASTER CARD ~ LOCATION OWNER STRUCTURE AND IAND USED AS Issued To Permit No. Issued Conirattor Owner BUILDING ZZIbI7 PLl1MBWG ~ CESSPOOL - SEPTIC TANK WELL ELECTRICAL H EATI NG GAS INSTAILWG SANITARY SEWER ~ OTHER (6) -11 OTHER I • Appraved Items (Ini}ial) Date Remarks Distance From Well rOOTING , ID ~Jr SEPTIC FOUNDATION CESSPOOL + y FRAMING TILE FIELD FT. # FINAL ELECTRICAL DEPTH HEATING OF WELL GAS INSTALLATION SEPTIC TANK ~ CESSPOOL . DRAINFIELD r-~ PLUM8ING j/ WELL SANITARV SEWER 'Ar 7 . • Violations Noted on Back COMMENTS: COMPLIANCE INSPECTION REPORTS 70 BE USEO ONLY IN EVENT OF OBSERVED VIOLATIONS . PERMIT NO. DATE Of INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE NON-COMPLIANCE. BUILDER DOES NOT OBSERVED. INiENO 70 COMPLY. . ~ ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYE? BY CONDITIONS BEYOND CONTROL. ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZFD AND DESCRIBED AS FOLLOWS: ? REINSPECTION REQUIRED DATE OF REINSPECTION • REINSPE<TION REVEALED CERTI FICATION -1 certify that 1 have carefW ly inspected the a6ove in which I have no interest presenc ar prospeciive, and that I have reported herein all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the proner[y inspected, ~ ALL IMPROVEMENTS ACCEPTABIY COMPLETED BUILDING INSPECTOR pATE COMMENTS: • PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Permit Number. 0 2 2 2 0 5 Eagan, Minnesota 55723 Date Issued: 10 / 12 / 9 3 (612) 681-4675 SITE ADDRE5S: 3820 SIBLEY MEMQRIAL HWY 10T: 5 6LOCK: 4 SECTION 19 P.I.N.: 10-01900-050-04 DESCRIPTION: (SPLATBALL) B YldiirtJ Permit Type COMM./ZND. MZSC. ilding Wrark Type Al7ERA7ION JUBC Occupan~ a-9 f ~ ` `Q~ S-`-~ ~ ~i S ? r7i rl~ REMARKS: FEESUMMARIF VALUHTION $20,000 Bese Fee $207.00 Plan Review $194.55 Surcharge $10.00 Total Fee $351.55 CONTRACTOR: - Applicant - pWNER: BUILOING ENVIRONMENTS INC 29461581 WOLKQFF DENNIS 9979 VALLEY VSEW R? 255 46 NEPTUNE ST EDEN PRAIRIE MN 55344 BEVERLY MA 01915 (612) 946-1581 (508)927-9485 I hereby ackn>owledge that I have read this application and stats that the information 3s correct and agree to comply w3th ali appticable State of Mn. Statutes and City of Eagan Ordirtances. - APPLIC~ I SIGNATURE ISSU ~8: SI NA UREI M~ , . . . r IN5PECTION RECORD CITY OF EAGAN PERMIT TYPE: B U I L D I N G 3830 Pilot Kno6 Road Permit Number: 022205 18/12/93 Eagan, Minnesota 55123 Daie Issued: I (612) 681-4675 I SITE ADDRESS: Lo T: 5 B L 0 C K: 4 APPLICANT: 3820 SI6LEY MEMORIAL HWY 6UILDING ENVIRONMENTS INC 5EC7IqN 19 (612) 946-1581 PERMIT SUBTYPE: TYPE OF WORK: COMM./IND. MISC. ALTERATION pESCRIp7IQN (SPLATBALL) INSPECTION D . .A FRAMING FINAL F- ' RfACTIYATE _ CITY OF EAGAN PEAHi 1993 BUILDING PERMIT APPUCATION $_LK, 4LPA 681-4675 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. , COMMERCIAL 2 sets of architectural E structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month. in which request is made, 2) address is changed or 3) lot thange i.s requested once permit is issued. Date 9 /30/93 Yaluation af work S2o ooo 00 Site Address: Sjhlpy °iai xwy,i,Ea.qaL s9122 fTREET SU[iE 0 Tenant Name: (commercial only) Solatball sndoor LOT SLOCK ~ SUSD. Gedar-v P.I.D. M 01900 050 04~ 2„a n,~,~;+;.,~ 01900 060.-0'4 Descri tion Of war'k: General Construction on Interior of Buildin --~~-~~~~~~a~ y cl - 28 The applicant is: ? Owner 0 Contractor (C~1 Other (Deceribe) m--na~~ Name wolkoff Dennis Phone( 508) 927-9485 Property LAST FIRSi ~ Owner Address 40 Neptune Street SiREET STE / ' Cjty Beverly $tdte MA Zip 01915 Company Buildina Environments Phone 946-1F81 CO(1tf8CtOf Address 9979 Va> > PW v; Aw Rd ii-n License # Exp. Lliy Eden PrairiP State mN Zip 55344 Companyslumen ha7 ArrhifP[`±11YP T„c,_ Phone S61-5757 Architect/ Engineer Name Janis Blumenthals Registration f 8561 c't 1?fl Address Fi^ -rla Rrn<n T)rixzp . City Brookivn Center State MN Z1p 55430 Sewer 8 water licensed plumber . Processing time for sewer 8 water permits is two days once area has been approved. 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 MinnesoYa Statutes and City of Eagan Ordinances. 5ignature of Applicant: ~ •~~~ff'~ y ' OFFICE USE ONLY t M' BUILD{NG PERMIT S1fPE ~ . ? 01 Foundation ? 06 Duptex ? 11 Apt./Lodging 0 16 Basement F9nisfi` ~ ? 07 4-Plex ? 12 Multi. Misc. Q 17 Swim Pool O 03 SF Additian ? OB B-Plex ? 13 Garage/Accessory ? 18 Coam./Ind. ? 04 SF Porch 009 12-Plex ? 14 Fireplace 19 Comm.Jlnd. Misc. ? 05 SF Misc. ? 10 Multi. Add'l. ? 15 Beck 20 Public Facility ? 21 Miscellaneous WORK TYPE ? 31 New 33 Alterations O 35 Tenant Finish 037 Oemolish ? 32 Addition O 34 Repair ?.36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. NWCC System ~ S Allowable) lst F1. sq. ft. City Mater UBC ccupancy 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump 1' of Stories Footprint Sq. ft. Fire Sprinkler ~ length On-site well Census Code Depth On-site sewage SAC Code ~ APPROVALS P)anning Building Assessments Engineering Variance REQUIRED INSPECTIONS ? Site ? Footing 12 framing [3 Insulation 0 Wallboard ~ Final ? Draintile ? Fireplace Permit fee c~ `l,oo v.irc;an: Surcharge to : o_o Plan Review J34,sS license l1WCC 5liG City SAC Water Lonn. Water Meter Acct. Deposit S/W Permit 5/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Lopies Other Total: SAC % SAL Units *;M; J & C Nordberg Inc. o~ SPLATBALL INDOOR 601 N. PriorAve. St. Paul, MN 55104 (612) 644-2855 ELIMINATE TME COMPEfIT10N / a IN TME ULTIMATE INDOOR GAME October ist,1993 Joe Merchak City of Eagan 3830 Pilot Knob Road Eagan,HN. 55122 Dear Mr. Merchak, I beleive you are allready aware from speaking with our architect "Janis Blumenthals" that the attached building plans have been completed with the design of future restrooms to be installed at a later date. At this time we are planning on the construction of the restrooms in May or June of 1994. Janis has informed us that in order for us to comply with City Handicapped Requirements we must have the restrooms installed on the first floor level in order for them to be handicapped accessible. Due to the nature of the sport and the nearly non-existent number of handicapped players we receive, we do not forsee any major problems with being able to accomodate any seriously handicapped patrons who are not able to access the lower level restrooms by themselves prior to the installation of the maln floor restrooms next spring. I certainly hope you find this proposal adequate and should you have and questions or concerns regarding our building desiqn please feel free to call me personally. Sincer ly, ames C. Nordb rg Presldent Experienoe tlae Adnentaret t t CITY ClF' 1=(1(;,FlN (;AiH:I:E.Ft: JS TF.RMINAL N0: 001 DAT'Ea 01125/00 T:f.t1Ea 12:2204 . IN. NAME;; f,[:I...A I;nOFTN(a F:EMOD[L'INIG SNC 3210 9001 3820 EiT.1BI..V MEM 67E3.75 205 9001 3820 !:ISL.Y. MI=M 27.50 Toi;al fteceiot, Amount; 706.25 CR122E,p3 USE:Fi :LIJn _IRN ~F~KXt9F>k>kxx:kmXt*>X~C~~C>k~K>'r:~k~%~<~kW###~jk1k* 'M~K?k>k~RX<~I'#~ 2000 BUII.DING PERNIIT APPLICATION (COMME~L) CITY OF EAGAN ~ 651-681-4675 Re uirements Foundation Onl New ConsVuction Interior Im rovement • SWdural Plans (2 sets) • Architectu2l Plans (2 sets) . fvchitecturel Plans (2 seLS) • Civil Plans (2 sets) • Strudurzl Plans (2 sets) • Code Malysis (1) " • Certficate of Survey (1) • Clvil Plans (2 sets) • ProJect Specs (1 set) • Cotle Analysis (1) " • Landscaping Plans (2 sets) • Key Plan (1) • ProjectSpecs (1) • CodeMalysis (1)" • MaslerExitPlan (1) • Spac. Insp. 8 Testing Schedule " • Certifipte af Survey (1) • Energy Calculations (1) not always" 1 • Spec. Insp. 8 TesGng Schedule (1) " • Elec. Power 8 Lighting Fortn (1) not always" 1 • ProjectSpecs (t) 1 1 • EnergyCalculations (1) 1 • EleUric Power & Lighting Form (1) 1 • Master Exit Plan (7) 1 1 • Fire Profection Plan (7) 1 1 1 . MClES SAC determinatlon lerier . MC/ES SAC delertnination letter . MC1ES SAC detertninaUOn lerier pll 651-602-1000 call 651-602-1000 wll 651-602-1000 " Contact Building Inspections for sample Food 8 beverage or lodging facilities: Plan must be submitted to Minneso[a Department of Health - call 651-275-0700 for details. ~ DATE: WORK TYPE: NEW EMODEL CONSTRUCTION COST: Sa J~ DESCRIPTION OF WORK: ' LeSS TENANT NAME: /dc 6 SUITE: y( ;z2 h n~? FORMER TENANT NAME: SITE ADDRESS: ~ OT ~BLOCK ~ SUB~ , Name: Phone#: PROPERTY Last First OWNER Street Address: Ciry Smte: Zip: Company: 47 /~-,V Phone CONTRACTOR Street Address: City a I % S 6 r( State: Zip: E- ARCHITECT/ ENGINEER Company: Phone ( ) Nazne: Registration , Street Address: City State: Zip: V Sewerlwater licensed plumber (if installina sewerlwater): Phone I hereby acknowledge that I have read this application, state that the information is rr d re comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant. OFFICE USE ONLY BUILDING PERMIT SUBTYPE ? 01 Foundation ? 26 Public Facility ? 30 Accessory Bldg. ? 14 Apartments 27 Commercial/industrial ? 32 ExtAlt- Apts. ? 15 Lodging ? 28 Greenhouse ? 34 Ext Alt - Comm. ? 25 Miscelianeous 0 29 Antennae ? 35 Ext Alt - PF WORK TYPE ? 31 New ? 34 Repair ? 37 Demolish Bldg. 43 Reroof ? 32 Addition ? 35 Tenant Impr ? 38 Demolish (Interior) ? 44 Siding ? 33 Alterations ? 36 Move Bldg. ? 42 Demolish (Found) ? 45 Fire Repair ? 46 Windows/Doors GENERAL INFORMATO~I Census Code / Zoning sq. ft. SAC Code # of Stories sq. ft. No. of Units ~ Length sq. ft. No. of Bldgs. Width sq. ft. Const. (Actual) -%T Basement sq. ft. MC/ES System (Allowable) First Floor sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ? Gas Service Test ? Heating ? Insulation ? Plumbing ? Stucco/Stone APPROVALS Planning Building ~ Engineering Variance VALUATION:$ Permit Fee Surcharge Plan Review MC/ES SAC % SAC City SAC SAC Units Water 5upply & Storage Meter Size S/W Permit S/W Surcharge Treatment Plant Paric Dedication Trails Dedication Water Quality ' Other ~ Copies Total CITY OF EAGAN CASHIER: JS TERMINAL NO: 691 DATE: 08/28/00 TIME: 14:30:34 ID: NAME: ALL'AMERICAN RECREATION 3210 9001 3820 SBLY MEM H 993.75 3422 9001 3820 SBLY MEM H 645.94 2155 9001 3820 SBLY MEM H 50.00 Total Receipt Amount: 1,689.69 CR136563 USER I?: JAN ? 2000 BUILDING PERNIIT APPLICATION (COMMERCIAL) CITY OF EAGAN q ~ 651-681-4675 ~ ~ (p ~ • L Re uirements C. Lu'o g".~ Foundation Onl New Construction Interior Im rovement • Structural Plans (2 sets) . ArchitecWral Plans (2 sels) • Architectu2l Plans (2 sets) • Civil Plans (2 sets) • Structu2l Plans (2 sefs) • Code Malysis (1) " • Certificale of Survey (1) • Civil Plans (2 sets) • Pmject Specs 0 seq • Code Analysis (1) " • Landscaping Plans (2 sels) • Key Plan (1) • ProjectSpecs (1) • CodeMalysis (7) " • MasterEzitPlan (1) . Spec. Insp. 8 Testing Schedule . Certifipte of Survey (1) • Energy Calculatlons (1) not always" ! • Spec. Insp. 8 TesUng Schedule (7) " - Elec. Power & Lighting Fortn (1) not always" l . PrqectSPecs (1) 1 1 • Energy Calwlations (1) " 1 ! • Electric Power & Ughting Form (t) " 1 1 • Master Exit Plan (1) 1 l . Fire Protection Plan (7) 1 1 1 1 . MGES SAC determination letter • MC/ES SAC determinatian letter • MC1ES SAC determination letter call 651-602-1000 call 851-602-1000 call 651-602-1000 Contact Building Inspections for sample Food 8 beverage or bdging facilities: Plan must be submitted to Minnesota Department of Health - call 651-215-0700 for details.., / ~Jv DATE: Io O WORK TYPE: _ NEW & REMODEL CONSTRUCTION COST: 925zlta-eO DESCRIPTION OF WORK: TENANTNAME: j~LL%.Qi~i~lf'l'[~?~ /P~G•' ~~UITE: ~'~/°.~1P /~/9<P/~,~~ FORMER TENANT NAME: p~ ~ SITE ADDRESS: &AA2O ~L11/~ LOT _ -r BLOCK ~ SUBD ~ C) Name: b/z/.r L'. Phone#: (,lp/61~ 1 Slo B- Sry91 PROPEItTY Last First OWNER 'J Street Address:~~e 49 ' City State: ~i~/~' Zip: Company: 14141-/l`~i~'~~~~G°~~ Phane#: ( lD~~ ) 8~0 `~~OD CONTRACTOR Street Address: p~A~9 0e'4o gg6~.~!}' "O~'.ge- .5rO . City State: /W- Zip: _6~~,4*'d^S~ ? ARCHITEGT/ ENGINEER Company: i 6;A94>iv Phone Name:~/o,~~~~•S' Registration 9G~~~n Saeet Address: `I'le Ciiy r'0~J' State: Zip: ~~1•~ Sewerfwater licensed plumber (if installina sewadwater): Phone ~ I hereby acknowledge that I have read this application, state that the information is cortect, and agree to comply wi all i e State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: / 4 s . OFFICE USE ONLY BUILDING PERMIT SUBTYPE ? 01 Foundation ? 26 Public Facilfty O 30 Accessory Bldg. ? 14 Apartments >(27 Commercial/lndustrial ? 32 Ext Alt - Apts. ? 15 Lodging ? 28 Greenhouse ? 34 Ext Alt - Comm. ? 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt - PF WORK TYPE ? 31 New ? 34 Repair ? 37 Demolish Bldg. ? 43 Reroof ? 32 Addition ? 35 Tenant Impr ? 38 Demolish (Interior) ? 44 Siding ,;!c 33 Alterations ? 36 Move Bldg. ? 42 Demolish (Found) ? 45 Fire Repair ? 46 Windows/Doors GENERAL INFORMATION ,o Census Code 3~-~ Zoning sq. ft. SAC Code I'a # of Stories sq. ft. No. of Units Length sq. ft. No. af ~Idgs. 1 Width sq. ft. • Consf. "(Actual) JMM Basement sq. ft. MGES System ~ .,(ikllowable)- - ~ First Flopr sq. ft. . ,City Water 1 S U~'BC Occupaqcx*p~ ' ' sq. ft. ' • ' ' ` ~ FYre Sprinkfered . ,--r;..;~." • .•;Y. . . .:z:cs~• . MISCELLANEOUS INSPECTIONS ? Gas Service Test ~ Heating ?In'sulation 'a:',`.'~'•'Plurpbing,7.,? Stucco/Stone APPROVALS Planning Lilding Engineering' 'Variance ' :'_?1 • . • - VALUATION:$ Permit Fee ~"_X~ 5urcharge Plan Review ~~-t S•~ 4; r.~,, , MC/ES SAC ~ % SAC City SAC Water Supply & Storage Meter Size • - S/W Permit T SI/V-Surcharge ' . Treatment Plant . _ Park Dedication Trails Dedication " ' Water Quality - ~ ` - Other Copies Total ~ ~ ~ ~ MT etropolitan Council Working for the Region, Planning for the Future EnvironmentaI Seruices July 26, 2000 Dale Schoeppner Building Official City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Dear Mr. Schoeppner: The Metropolitan Council Environmental Services Division has determined SAC for the All American Recreation to be located at 3820 Sib!ey Memorial Hwy. within the CiYy of Eagan. This project should Be credited 1 SAC Unit, as determined below. SAC Units Charges: Office 2280 sq. ft. @ 2400 sq. R.JSAC Unit 0.95 Warehouse 8340 sq. ft. @ 7000 sq. ft./3AC Unit 1.19 Grocery Store 3050 sq. ft. @ 3000 sq. ft./SAC Unit 1.02 Stock 4800 sq, ft. @ 7000 sq. ft./SAC Unit 0.69 Tota! Charge: 3.85 Credits: Country Club 14776 sq. ft. @ 3000 sq. ft./SAC Unit 4•93 Net Credit: 1.08 or 1 srs*es.rs~s~~rs*v*sssrs~rsss..stsr:+t**~*s«ars*sst.sar~****s*s*sss+s+s:*«r If NET SAC iJNITS is a CREDIT BALANCE, please indicate how many will be reserved as Site Specific _ units of credits (Form 92ACR) or taken as City -wide _ units of credit (Form 92A). After credits are taken in this section, send a copy of this letter to the SAC Auditor at the Metropolitan Council Environmental Services. :.:•s*:rssssa*se?*?***?a*?*~s~***s~r..¦¦~*.***r***+«+¦s*s*~?rr*r~.¦.ss.* 230 East Flkh Streel SL Paul, Minnesota 55I01-1626 (651) 602-1005 Fax 602-1183 9'DD/TTY 229-3760 ~ July 26, 2000 Page Two All American Recreation If you have any questions, call me at 602-1113. Sincnerely, / b-~•~.Q ~~.1'i..~l~~ Il~l Jodi L. Edwards Staff Specialist Municipal Services Section JLE:(425) 000726SG cc: S. Selby, MCES Carolyn Krech, Finance Department, Eagan Jerry Schiltz, Jr. Mega Inc. I _ L~ S y 5--e G-k- 0 h COMMERCIAL BUILDING PERMIT APPLICATION C_~~~ 4~I r CITY OF EAGAN 1 651-681-4675 Foundation Onl New Construction Interior Im rovement • SWCtural Plans (2) seLs • Architectural Pians (2) sets • Archiiectural Plans (2) se[s • Civil Plans (2) • SWCtural Plans (2) • Code Analysis ~ (t) • CertificateofSurvey (1) • CivilPlans (2) • ProJectSpecs (1) • CodeMalysis (1) " • WndscapingPlans (2) • KeyPlan wl*~ (1) • Project Specs (1) • Code Malysis (1) " • Master Exit Plan (1) • Spec. Insp. 8 Testing Schedule " . Certifipte af Survey (1) • Energy CalculaGons (1) noi aiways" • Soils Report (1) • Spec. Insp. & Tesling Schedule (1) " • Elec. Power 8 Lighting Fortn (1) not always" . Meter size must be established • Meter size must be esWblished • Meter size must be establisheC - if applicable • ProjeClSpecs (1) 1 • EnergyCalwlations (1) " 1 1 • Electric Power & Lighting Form (1) 1 1 Master Exit Plan (7) 1 1 • Fire Protection Plan (1)" 1 ! • Soils Report (1) 1 • MGES SAC determination letter • MClES SAC detertnina6on letter • MC/ES SAC determination letter wll 657-602-1000 pll 651-602-1000 call 657-602-1000 " Contact Building Inspections for sample Food & beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health - ca11651-215-0700 for details. DATE 4 -16 -2001 WORK TYPE NEW /REMODEL CONSTRUCTION COST SITEADDRESS ,38ZD SiBLfy InfMOR/AL y~r/~ E6.4AI, M/? TENANT NAME PETUSH/N ENi E121PJ5 E5, T c: SUITE # FORMER TENANT NAME ADVEN?uR£ ZpA/E DESCRIPTION OF WORK ln/AGt,S p,uD CN.4n/G/.t96 906)h75 Name: ACI// LT Z -gegAt-0 Phone#: (~'1 S2, ) 919- 5600 PROPERTY Last First OWNER SaeetAddress 290& ~AytS DR1VE Ciry !lW~NS~/~/-1.E State Zip Company ~PeruSN/.t? ~il/TF,PP.2/SES, 1NC. 'Phone# ( 763 ~ 588 -6D33 CONTRACTOR StreetAddress: 2373 (JN/N Xl/E.UciE /VkTf/ City 1104DEAJ ?~UFy State /W Zip SS4ZZ ARCHITECT/ ENGINEER Company Phone # ( 1 Name l~7 LS I.I U~ Registrarion # i SReet Address ~ AP R 1 C) 2D, ~ ~ i City - State Zip Rv Licensed plumber installina new sewerlwater service: Phone f hereby acknowledge that I have read this appiication, state that Me information is wrrect, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: Updated V( OFFICE USE ONLY SUBTYPE ? 01 Foundation ? 26 Public Facility ? 30 Accessory Bldg. ? 14 Apartments ? 27 Commercial/Industrial ? 32 Ext Alt - Apts. ? 15 Lodging ? 28 Greenhouse ? 34 Ext Alt - Comm. ? 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt - PF ? 37 Nail Salon WORK TYPE 0 31 New ? 35 Tenant Impr ? 42 Demolish (Found) ? 46 Windows/Doors El 32 Addition ? 36 Move Bldg ? 43 Reroof u 47 Repair ? 33 Alterations ? 37 Demolish (Bldg) ? 44 Siding [3 48 Authorization ? 34 Repiacement ? 38 Demolish (Int) ? 45 Fire Repair GENERAL INFORM4TION Census Code 3-7 Zoning sq. ft. SAC Code O # of Stories sq. ft. No. of Units ° Length sq. ft. No. of Bidgs. Width sq. ft. Const. (Actuap ~ Basement sq. ft. MC/ES System (Allowable) First Floor sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered MISCELLANEOUS INSPECTIONS ? Gas Service Test ? Heating ? Insulation ? Plumbing ? Stucco/Stone APPROVALS Planning Building Cl" Engineering Variance VALUATION $ I 000 Permit Fee Surcharge Plan Review MClES SAC % SAC City SAC SAC Units Water Supply & Storage Meter Size S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Copies Total City of Eayan - Conversion Cash fteceipt Receipt Date 10/3/61 Titae Printed 12:12:57 Receipt Nuober, 1166 BDVANCED HEGHANICpL 3828 SIBLEV MEifQRIpL RHY 4801.2195 .51 FF 43@81 9081.4187 167.10 PP 43061 Tatal Receipt Amount 107.60 Us?r HFiCGRaN L7'4 B CITY USE ONLY PERMIT I Z, J ~ SUBD. ~2CU RECEIPT # CHK CHG RECEIPT DATE SOUO MUM$IN& PERHIT ((:Ol1lWRCLM.) CTP1f OP BA6AF 8880 PILOT HROB gD i:A6AF, !IR 55122 e51-681-4875 INCOMPLETE APPLICATlONS W1LL NOT BF PROCESSED Date: Sen4-121 ~ Ov WORK TYPE New Bldg Add-on Repair RPZ PVB ' Irrigation system ' Must wmplete reverse side of application also. Required meter size is 2" turbo uniess smatier size permitted by Public Worlcs DESCRIPTIONOF WORK (5ct'~ ~ rfJB7?l S IfiLan ~ ru"~K--C' 13,2-r 5+x /C To inquire if Pressure Reducing Ive is required on new s'ce, c 6a~11 51-681-4646 ME1'ERS - Call 651-6814300 to verify that hydrostatic, conductivity, and bacteria tests passed orior to oickine ao meter Irrigation _ Size _ Avg GPM Fire _ Size _ Avg GPM Domestic _ Size _ Avg GPM Does this include high demand devices? _ Yes _ No FLUSHOMETERS _ Yes _ No PRV REQUIRED _ Yes _ No Site Address: Tenant Name: &&P f i C' GC.'~ ke-L Telephone t"-01cf '1y - (AreaCode) p t rJ Was there a previous tenant in this space? ~11Y _ N. If Yes, Name: (,,t )C h DUJ 4 Installer Name: H/1' yj, redfi~P r/I t,t n i C CR / Telephone 5 InstallerAddress: 16 12 (Area Code) Ciry: /7cc~A ~l iA:Z State: M 6l Zip Code FEES Contract price $ ~ la x 1% ($30.00 minimum) Contract Fee $ `0 , Meter $ Required on all new buildings & boulevard irrigation systems Radio Read $ - S v Surcharge: $.50 Minimum. If rontract fee exceeds $1,000, calculate at State Surcharge $ 50 cents per $1,000 contract fee. Total From Reverse New Service $ Total S 1 U -1 ~D 0 I hereby acknowledge that I have read this application, state that the infonnation is coaect, and agree m comply with all applicable City of Eagan ordinances.ItistheapplicanPsresponsibilirytonotifythepropertyownerthattheCiryofEaganassumesnoliaDiliryf a agescausedbytheCiry dwing its nomial operational and maintenance activiries to the facilities constructed is permit within City r rty/right-o ay/easemert. SIGNATURE OF PE TEE CITY USE ONLY REQUIRED INSPECTIONS: U.G. Air Test _ Gas Test _ Rough In _ Fi al~~p ~jx2emn_ SE!' 2 9 000 APPROVED BY: BUILDING INSPECTOR ~ BY: ~ IRRIGATION SYSTEM (CONT) Service: _ existing (if coming off domestic line) OR _ new If "new service", contact.7erry Wobschall, Finance Consultant, to confirm addingfees for: Water Permit & Surcharge - $ 50.50 $ Water Supply & Swrage - $ 840.00 $ Water Treatment Plant Charge - $ 492.00 $ Fees to be added to front side of application $ GENERAL INFORMATION Year 2000 Prices Water meters (includes copperhorn/strainer, remote wlre, and touch-pad meter) 5/8" x 3/4" meter $ 114.00 1-1/2" turbo meter $ 726.00 3/4" meter $ 148.00 2" turbo meter $ 897.00 1" meter $ 193.00 2" compound meter $ 1,761.00 1-1/2" meter $ 426.00 Meters requiring30-dav advance notice orior m oick un 3" turbo meter $ 1.180.00 4" compound meter $ 3,459.00 3" compound meter $ 2,222.00 6" turbo meter $ 3,973.00 4" turbo meter $ 2,130.00 6" campound meter $ 5,797.00 ~ Radio Read $159.00 (required on all new buildings & boulevazd irrigation systems) Comments • To schedule inspection of the inside water line and backflow preventer, call 651-681-4675. • To arrange for water tum-on, call 651-681-4300. ec: Kns Forster, Maintenance Division Clerical Technician ¦ /0- 0/9D0-O5o -p~ ~ s~` ~x i ,s MEMO - city of eagan TO: ACTING COMMUNITY DEVELOPMENT DIRECTOR HOHENSTEIN FROM: ZONING ADMINISTRATOR RIDLEY . DATE: JUNE 1, 1993 SUBJECT: FACTORY FURNITURE OUTLET As discussed, on May 20 I spoke to Mr. Paul Walker, Owner of Factory Furniture Outlet (FFO) locatedrat 3820 Sibley Memorial Highway, to inform him that the January 19, 1993 City Council Variance approval required the painted building signage to be replaced with standard signage by April 15, 1993. Mr. Walker indicated that he was interested in reapplying for the Variance for the following reasons: ° The cost to conform to the City's condition that signs be attached, rather than painted on the building, would be just under $6,000.00. Mr. Walker says he cannot justify spending that amount of money on a leased building. ° FFO is on a month-to-month lease. The company has 60 days from notice to vacate the premises. In return for this type of arrangement, the tenant receives a very attractive lease rate. Signing a long-term lease wouid result in doubling the rent. ° When FFO first moved to Eagan, the landlord was approached regarding signage. The landiord had no objection, so a professional sign company was hired to paint the signage on the building. It was not FFO's intent to violate any City ordinances. I informed Mr. Walker that once a Variance request has been heard by the City Council, the same request cannot be made for one year. He said conforming to the City's requirements for signage is not feasible and would most likely result in moving his business out of the building and Eagan. I asked Mr. Walker to send me a letter (attached) summarizing the situation from his point of view. If you would like further information, please do not hesitate to contact me. ornng A mirnstrator MR/js attach. , , ~ FACTORY FURNITURE OUTLET 3820 SibleyMemoria/Hwy., Eagan, Minnesota 55122 612-452-3070 R ~~~1V D May 24, 1993 MQy 2 61993 Mike Ridley City of Eagan 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 RE: Variance to the City Sign Code As discussed in our telephone conversation today, it would cost us $5,985 to conform to the City's condition that our signs be attached rather than painted on the building. We have a month to month lease. Signing a long term lease would mean doubling our rent. We cannot justify spending that kind of money on a leased building. When we first moved to Eagan, we contacted the landlord regarding signs on the building. He had no objections and we hired a professional to paint the signs on the building. It was not our intent to break any city ordinances. We wisn to continue as a member of tne rzgan re[ail community and hope this matter can be settled quickly. Sincerely, Piou~ w1011(6x Owner Factory Furniture Outlet ity oF eegen 3830 GILOT KNOB ROAD, P.O. BOX 27199 BEA BLOM9UISi EAGAN, MINNESOTA 55121 nnoyor PHONE: (612) 454-8100 THOMAS EGAN JAMES A. SMITH JERRV THOMAS THEODORE WACHTER October 3, 1984 ` CouncilMembers A THOMAS HEDGES City ACmirJSfrator ~O EUGENEVAC Ok ERBEKE City . b` MR SHELDON KRANZ COUNTRY CLUB MARKETS I~ 38~9 IBLEY MEMORIAL HWY E MN 55122 Re: Landscaping Improvements at Country Club Market Dear Mr. Kranz: At the April 17, 1984, City Council meeting and later in a letter to Country Club Markets, the City expressed concerns about the condition of landscaping around the Country Club Market located at 3820 Sibley Memorial Highway in our community. At the April 17 meeting, you objected to the addendum bid that would require landscaping as a part of Contract 84-7, stating that your organiza- tion is capable of performing landscaping that would be desirable to the City at a lesser cost to Country Club Markets. The City Council emphasized that landscaping has been less than desirable around the Country Club Market facility and with all the improve- ments to the area, specifically asked that landscapinq be performed in a consistent fashion with Minnesota Eederal, Perkins and Rax Roast Beef. It was the decision of the City Council at that time to exclude the addendum bid with the understanding that Country Club Market would do your own landscaping, however, the motion further indicates that if this landscaping is not performed in a manner acceptable to the City, that such additional work will be included in the next project that will be commenced by the City in that general area and you would be assessed for those improvements. To date there is no indication that Country Club Market is planning to provide the landscaping desired by the City which was outlined to you at the April 17, 1984, meeting. Please indicate what your intentions are so the City can either be assured that land- scaping will be performed in an acceptable manner or that arrange- ments can be made to perform the landscapinq this fall. THE LONE OAK TREE. ..THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNIN LANDSCAPING IMPROVEMENTS/COUNTRY CLUB MARKET OCTOBER 3, 1984 PAGE TWO Please. respond by October 15 of your intentions or the City will assume responsibility for the landscaping. If you have any questions, please feel free to contact this office or the office of the Director of Public Works, Mr. Thomas Colbert, at any time. Sincerely, Thomas L. Hedges ~ City Administrator cc: Honorable Mayor, Bea Blomquist City Councilmembers Director of Public Works, Thomas Colbert TLH/kf S~. J 9 /d D/9D0 O50 di/ T , EAGAN 'POWNSHIP 3795 Pilot Knob Rosd St. Paul, Mianesota 55111 Telephone 454-5242 PERt9IT FOR WATER SERVICE CONNECTION Date: March 10, 1972 Number: 786 Billing Name: Country Club Market Site Address; 3820 Sibley Memorial Highway agan 55122 Owner: same Billing Address Plumber; Wenzel Plumbing & Heating, Inc. Location of Coanection Meter Size Coanectioa Chg. s2785~0 Meter No, 201972$ Permit Fee 10.00 pd 3/9/72 0000 .50 P~~~72 s/c Meter Reading Meter Dep.392 GS IRA ~;42~/72 Meter Sealed: Yes` Add'1 Chg. NO Total Chg. Inspected by Date Suilding is a: Remarks: Residence ..i.' _ . ' 14ultiple No. Units - • ' if.~":.._.... Commercial s= Industrial Hy: Chief Inspector Other In consideration of the iseue end delivery to me of the abwe permit, I hereby agree to do the proposed work in accordance with the rulea and regulatioas of Eagaa Towaship, Dakota Cou Min sota. By: Wanzel Plwnbing & Heating, Inc. Please aotify the above office when ready for inspectioa and connecCion. r /D 0/9ao oso 0V 1 ~ EAGl3N TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SBRVICE CONNECTION DATE; March 10, 1972 NI1M$ER 947 OWNER: Conntry Club Market Address 3820 Sibley Memorial Hwy. Eagan 55722 . PLUMBERWenzel Plumbing & Heating qypE OF PIPE Heavy Cast Iron DESCRIPTION OF BUILDING Industrial Commercial Residential Multiple Dwellfng No. of un£ts xxc Location of Connectfona: Conaection Charge;~s~- Permit Fee 10,00 pd 3/9/72 ~ p s/c Street Repairs Total Inspected by: Date Remarka- By Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulationa of Eagan Toi•mship, Dakota County, Minneaota BY Wenzel Plumbing & Heating, Inc. 3600 Kennebec Drive, Eagan 55122 Please notify when ready for.inspection and coYmection and before any portion of the work is covered. MASTER CARD LOCATION 3 g a o o.~oo o~~ os OF OWNER STRUCTURE AND LAND USED AS Issued To Permit No. I Issued Coniractor Owner BUILDING PLUMBI NG i CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING /~20~~~ - • GAS INSTALLING SANITARY SEWER OTHER ~ OTHER I I Approved Items (Initial) Date Remarks Distance From Well FOOTING $EPTIC FOUNDATION CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTRICAL DEPTH HEATING OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER Violations Nofed on 8ack COMMENTS: COMPLIANCE INSPECTION REPOR,TS TO BE USEO ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTION {ONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE ? NON-COMPLIANCE. BUILDER DOES NOT OBSERVED. INTEND TO COMPLY. ? ACCEPTABLE SUBSTITUTIONS OR ~ DEVIATIONS COMPLETION OF CERTAIN IMPROVEMENTS . WILL BE DELAYED 8Y CONDITIONS BEYOND CONTROL. ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: ? REINSPECTION REQUIRED DATE OF REINSPECTION REINSPECTION REVEALED CERTI FICATION -I certify that I have carefully inspeCted the above in which I have no interest present or prospective, and that I have reported herein all significant conditions oLserved to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected. ? ALL IMPROVEMENTS ACCEPTABIY COMPLETED BUILDING INSPECTOR OATE COMMENTS: PT,FQSE SIGN THIS WAIVER AYD RETURN THIS COFi TO US. L` O./ _ y JfIN 231972 RSQl1EST POR UTILITY URROVEI4ENTS -=h i~ ~ r I/We hereby requeat of Lhe Board of Supervisors, 8agaa Township,~ Aiiaaesota, utility improvemexite on and ovex property owned by me/us as follows: (Mention type of i,mprwement, e.g, water,: sanitary aewer, etc,) SE41ER LATERAL, 1973 The location of aai@ atiliCy improvemeats shall be generally es follows: Parcel 3257-e, Section 19 vsv,A I/We liereby waive naYice of any and atl hearings necessary for the installation of said Improvements end further consent to auy assessmeats neceesarilq lenied by Che Township q£ Eagan €ar euch improvemeats. I/We further agree to grant to Che Township of fiagan eny easemente necea- sary for the iastallation of such improvemeats. It is further uaderstood t6at tfiis request shall be seviewed 6y the Board of Supervisore pf Sagan Tocansh3p or its agenC aad I/we will he given reasonable cwtice as to ahether Chis requeat ia possible uader preaent utility planning as to timing, location, etc. Dated: MaY 3i . l,AZ? X Request accepted by Date ~ Ba an g lbwnshfp Request referred to Tawn Sag3.~peer; Bate Copies: 1, Township Z. Town $ngineer 3. Applicant CITY USE ONLY PERMIT Lq L-4~ U L~ RECEIPT DATE: APPROVED BY: INSPECTOR C,OMMERCiIAj. M$C,H"C,A. P$RMff APPLICiATIOR C1TY OF E46m S$SO PILOT KNOB RD E,aE6AN,1HR 551 E8 651-8$1-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: J ' D7 - 6) siTEnnDREss: 3$,Pb S)~6L2// ?''}LInOlZ;A-/ ~-Iilotll~.PA-~ OWNERNAME:.L}7I A-M&1`C9-) 2Y1~A'Tl`G~ PHONE#: %A- (AREA CODE) TENANTNAME(IMPROVEMENTSONLY): S WAS THERE A PREVIOUS TENANT IN THIS SPACE? _ Y_Y~N. NAME: INSTALLER: (1)V2.D,"L ,M~L H(~ %C~ ~ ~S aDDREss: 1~ 6 12~ ~S D PHONE 9-ci2- - (AREA CADE) crrY: sTnTE: nj .J zrp: S 3> WORK TYPE: New construction Install U.G. Tank Interior Improvement Remove U.G. Tank _ Processed Piping SpecifyNature of Work: 9 '1R~1) )C}-A !)A-C Uv'T FD2J~67-d P206'! 015c. ~ t=.5 When installing/removing underground tank, call 651-681-4675 far inspection Fire Marshal and P1ttm6inglinspector. U n !2 @~ a ~ ~S ~ Fees: I% of contract price OR $50.00 minimum fee, wluchever is greater. JAN D Underground tank removaUinstallation = mitumum fee 2 9 100r Contract price: $ nx 1 % _ $ 7;?~ (Base Fee) By State surcharge calculate at $.50 for each $1,000 Base'Fee-- ~ TOTAL 7Yso ~ OF PERMITTEE Updated 1 /O1 CITY USE ONLY ~ I PERMIT RECEIPT DATE: ~ RSIDEPTIAL MECHANICAI. PEgMIT APPLICATIOR crrYoFEtsnx sgso Pu o r Kvoe itu Ewseuv Mx ssraE 651-681-4675 Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit Date: SITE ADDRESS: OWNERNAME: I 1'ZSLiCJa^7 TELEPHONE#: ~ Sl'- REA CODE) INSTALLER NAME: `C ,Mf-644J' %ep-/ S~~J[~ ~CL TELEP (AREA CODE) STREET ADDRESS: (Corro T~ CITY: &e1 J lI~ STATE: ZIP: cCj v 3 3~ Place a check mark n to the ermit work t e _ New resid tial dwelling unit under constructionand not owner/occupied $ 70.00 _ Add-on, modification or alteration to existina dwelling unit $ 50.00 • furnace replacement • air exchanger • air conditioner • other Nature of work: State Surchar e $ 50 Total $ Reminder: Call for inspecteons. SIGNATURE OF PERMITTEE Updated 1101 ' j F------------- orOffice~Us - I I Permit Clty of EapIl 3830 Pilot Knob Road j Pennrt Fce: E8g8nMN55122 ~ DateReceived: C~~ y i ~ Phone: (651) 675-5675 Fax: (651) 675-5694 i SyaK: j 2008 COMMERCIAL BUILDING PERMIT APPLICATION Date: 51glup Site Address: ScZ ~ M h'10Y'1 ~~,~~WA TenantName: YQCQYSr WvYYIPr Qll QKCYICp11 CrtCAIOh (TenaMis: New!_Existing) Sui[eiF: PROPERTYOWNER Name: I.:IT11 01- ~EQAQ?1 EbA Pnone: (a51-14~f5 -5~7~ ~ address/ crty/ zP: 3`630 Pi In+ knob P-ood, ta1qni Mnl ra6Iza Applicant is: _ Owmer X Contrac0or TYPE OF WORK Description of work: QU f-)2M0 1i+l On ConsWCtion CasiAab,Ona . On CONTRACTOR Name:LbOSZCrlS~a -r JronS rnc. License#: Adaress: 95a0 Coun+4 120ad 19 c.ity: Love*a srace:z+P:~53.57 Pnone:7l!5~~ 9 Contact Person: TOm Pierrnc+ ARCHITECT/ Name:A'aFebSionql , rvvice 1ndu!s-Ir'ir Registrationn: ENGINEEH qddress:a.ly-I UYiiver31-bj Ave.W. #a05 cny: 5+. Pav I srace: M14 zP: 55114 Phone:l,Sl-le4lr-HI4$ CY4 II ('qntactPerson: MILIIACI nden Licensed plumber inslailirg new sewer/water service: Pttone ffi: NOTE: Plans and supporting documents that you submit are considered to be public intormation. Portions of the inlvrmation may be classified as nonpubJic if you pravide specific reasons that would permit the City to conctude that the are fraUe secreta 1 hereby acknowledge that this irdwmalion is complete and accurate; that the work vAp be in contorrtiance with the ordinarces arid codes oi the City of Eagan; that I understand Ih'r„ 's not a permiy but oMy an appiicatipn fw a permd, antl wor1c 's not to start wdhout a permit: ihat the work will be in accordarxe wi[h the approved plan in the case ot xork atuch requires a review and approval W pans. X 4dIYlfi %'-'!'rr~d ...42 ApplicanYs Printed Name ApFdicaM's ig re Page 1 of 3 ~ `~.iLar Minnesota Pollution Control Agency Notification ofIntenf to Periorm a Demolition ~ TypeoflVotidtotion: horiginal ( Jpmeaded ~ JProjeetCaat:llatioh • ~ ~ Demo?ition Contractor: Bui3diaeInformation: ~3fTfC: ;!-A`~JS4.Fni~~ krvL' .Sr,aN.~ • • BvildingNurs:' _~puS£ o~ d?:nc~~_ I Address lZa.a-6'/ l Q . Adc'res1Loation:_ y0~ L~ec~.a.r~A/£ pM~E . . Ci7.S:ate,2ip:_ .eA Ayi 11JN Ss~a,3 f Ciry.SuiqZi~r. /Gaa?FA-ki 55; zS7 cevn~-' Dnl~of~a . ConiactPerson: lgnr :VEf,y¢PhoneNumbc(s): PhoneNumber(s} Age otBldg (yearsk S'r: rof Bldg. (sq, ftr LA0 y~,~;;, f. $IIi1dtB2~wIIeY• . NumbeofFlooalneludiagBzsrnentLevel(s):~~ r Ptaent Use of 81dg::_1/•4Gi.r..r! ' ! h*amc /~t~~-- n ~-s C f].A ' . . * . ~ . , , PriorUuofBidg,: 2ES~.ax:,rsr...a~ • . Addrrss:_ ~c.~.? ~f ,d'CL ~N ~tlG . • . . • • Aates wLen demotition or intentioaal bnraiag wi7] Begin S s o & Ead I~lN S$/a3 . , ' f/'t~,~ ~'-„~y~~ • NOUBc+tioa mcst be postaizked or reeeived taa (10) worldaL dsys ~ Conta~pasoa• . betorc dunolition be;Ies •Sec item Yr5 tor emer=eary dr~q~q= Flsone Number(s): 8oih Bepinaintaad Ending d:ta Bhould be smmded iu writiae•rs • " . . aecsu;ry to retlect rnrrmt project dxtes. ~ • ' I If tb ere is >260 line¢r feet or>16D square feM of Regnlated Asbatos-Contaiafng 11Iaterial(RA(l4) in tLe bstlldIng . to be demolis6ed, ft mcst be removed by a Iiceased asliesEOS eonlrado.r prior to desaoliGOa. T'he Stale ofMN Notiee. of Infent io Perform an Asbutos Abztement Projeet mnst be nSed to nofify for the ssbestos removal. Is n oafriable ACMgrueat ia.the strnctare fo be demotished ? yES ~NO ' If YES complete iterns I-9. -IfNO complete itans 3.9. h= ~j h,e.P - ' . fpr,or F, otir waF~ 1- IfAC1VF wSI1 be,Ieft in p2ace for the demolition Indiute tbe smoant of Category I and/or Catrgory II • noafriableACMIeftiapIace. Gteg) ' I.inarFe:x; Caieg.Il ' LinarFeet Squarc Feet • ' Syuare Feet • . . - Cnbie'Feet ' - Cubie Feet Cat~e~..~ 1 nonfriable i,CM ~ans tsbestos-contsinin . . . . • . • . , . S Prl:h85. • Cateeor Ii aonfrinble AGM rne=s any material, ezdv3'm; Saskes, milimtlloor eavcring, aad,asphalt roofmg pro3u;u ' Cat 1 nonkiable A :ontainin more ~n one ~Ory a`+ ~~~~g ~.~an one pacent 6 percrnt utxatos, . • ps+ystos that, when dry, cannot be ervmbled, pnivqaed, or 'Cateeory 1 nocfrisble At'hS is aot anawed to nmain fn place reduc_d te: powdc 6y hand premm for demoGtion 3f it it ia poor condition. . •Ca[eeory II noa(riable ACM is not sIlotired to remain in place for deipolttioa it it, bas a AigL prob:biliry of becoining enmb7ed, pc}rerSzeQ orrrduerd to a pow6erdnrin` 6emolFt3on,lnaspori, . ' or dispasaL (ex tnasitq cement, slate roofia:) , I)escription & Loeation of ACM rerazining iapIace (iidudiag floor# ind room 'm): ' , ' • Revised 11199 , I Comp1ny and/or individuai that conducted the buildiag inspecfion and the procedure used to determioe the ~ pr-espnce"or absence oiACM (intludiag anaIytic method): 'Ptior to Qemolition al1 buildirtgs musi be'vupeaed 3v an U. S. pE`nv,i~ronmentc! ProlcctionAgenry (EPA) accredired in;peclor., ~ F-eolre....s . Descriptioa of planned demolitioa and the specific met6od(s) that will be used: ~ _ ~i £.c?y fstc.ln+ns,~dt -d- d G~ i~Fs~i f s ~ . If the demolition was ordered by a government ageacy, please identify the ageacy aad attach a copy of the ~ order: Harnc: Titlc. ~ Authority: Date of Order (1vi/D/I): • • • Date Ordered to Begin (M/Dfy): . . ~ * rtoti6c2tioa tor xn emereenq demoGtioa murt be snbmitted as nry u possble betore deawlition beeins, baLnot taler lpxy tbe ' toilowing workine day. A demoGtioe is cocsidered u ernirgmry ONLY whea Ne f:eiliry hss beea dmmed stroctunily ca'soand:ad iadsngerotimriaentcoDzpsa ]fttiestruanralJyaasayodbuildingfsknawntarentain:nyretulnedACMorissasprcted taroatsfn ~ say rctnlaled ACM, special proetdures MUST Ee toilowed. Ityou 2te nnawsn of lhe speciil proeednres, instruetSo¢s+tegn!=6oys pn pe obttined by contaaiag the MPCA at tb'eaddress or p6one aumberl&ted bdow. ' . . beseription'of proeedvre to be followtd in the event that nnezpected RACM is fonad 6r CaL II aonfriabte ACM beeomes crnmb3ed, pu]verized or seduced to powder: a ~,l° ('r?..ed 1E a'I 4045.., " . WasteTraaspozter(s)Information: 8. WasteDisposalInformation: ~ TrmuporterT`ur~ /'~-fa~~5ms.a-l ~6- r .t LandfillNarnc_ R.'vc.r. La..,.! 4 Z/ . • .TrattsporiaCo'nha: Rn;AN •Pr'c.-f-.r . Owner/Op:rator._ WAs..t-~ N2An.a..re aM nh'' . TransyortsAddre= =2.2 /1~/Gitne.Q. pV Addras9.ocatiom v9„2Ll60 44~,u /69NGf/ ~ c«y. state, ti1N S sY// C/%c. ,P ~ ~ Ciry, SatqZip:_~ r?a~.. MN S~~ 30 PhoneNvmber._ 4 ~ - /o V 3 . Phone Numba: ~6 ~ - `t5`/- ~.4~5c • I certify that the above information is-correct and I.am a boaafide represeatative of tfie4emoli6on ~ coatractor or bnildiag owner and have anthoriiy to enter into agreements for my employer >i aturc of Contractor/Owner Date' Scnd to: Nfinncsota Pollution Control Agrney . For questions eall: • • 1vlevo Districts - Regular Faeilities Scetion 651-296-7300 . ~ 520 Lafayette Road North . I-800-657-3864 . StPaul,MN S5I55-4194 • FAX:651-215-1593 1103 ReTilOYxl IIIf0- rEt12ti0ri Pnlyehlorinated biphmyls (PCBs) murr bc ronoved from ihe building prior to demoTitiorr. PCBs , aay be found in lighr ballasts, sma11 eapaeiton found in old appliaxcer, and traruforma oi1t: For qvutioru ealf the MPC:i' . ~ f~ardovs Waste (HF3~ bvsiness cssistance unit ct 1-80~657-372d. . ' 'CB remova aamJaddress/pLone nvxnber: • ~ 'CS seceivcr aamrladdrets/phone number. ' 1'(eTCAry Remov2l ZIIform2ti0II Merarry tonfaining material- must be remavedfrom the 6uilding prior ro demoliHon ~ dercxry'conlaining mcterials may includc fluoracext, metal halide; high prersure sodium, neoa; mercury vapor famps, mercury ~ ivitchu, t6ermaster prober, manometers, and g¢ges. For quesriarrs call the MPG! HW busrness assurance unit af 1•800-657-3714. • rlercvry temovcr namrJaddress/phone number. ~ +1=zeury receivcr'nzmdaddras/phone numbet; • • 2efrigerauts/CFCs/HCFCs Recovery Informatioa A cerrr'ficd rechaicien musr recover refrigerenrsfrom rejrtgerarion ~ qvipment and rysfems in nce building prior to demolirion. Forquestions ca11 rl:t CrCprogram'at 1•800•657.3364. :efrigerant recovcrer nanc/address/phone number:' tefrigeram rcccivcr name/address!phone number: . . Z . , . ' ~ . a , . 2004 Application f'or fireworks SnlES And Storaqe City Of £nqnn 3830 Pilot Knob Rond, £nqnn, MN 55122 TelephonE 651-675-5635 f nx 651-635-5694 _R~turn Applicant requirements 1. This application must be completed and returned at least 30 days prior to sales and/or storage of fireworks. 2. A letter from the property owner granting permission to the applicant to seil and/or store fireworks on the property shall accompany the application. 3. A floor plan designating the area where the fireworks will be sold and/or stored shall accomparty the application. 4. A list of the fireworks that will be sold and/or stored along with the name, weight, quantity, and material safety data sheets (MSDS) shall be included. 5. A copy of the certificate of insurance coverage as per City of Eagan City Ordinance No. 378, Chapter 6, Section 6.53 Fireworks is required. 6. Fee upon application for retail seilers selling exclusively consumer fireworks-$350; all other retail sellers-$100 per vendor annually payable to the City of Eagan. 7. The fire chief or his/her designee will inspect the proposed location for selling andlor storing fireworks to determine if it is a suitable location. 8 A criminal record check will be done on all applicants. 9. A copy of the City of Eagan license (permit) shall be displayed by the register. Date: Applicant Name: Street Address: c5'~0 -S-46,eZy .~'.01• j' !3 ciry: ~i9G~~t/ State: i.~!'~• Zip: ~/W Telephone V/A "C57- - - - - - - - - - - - - - - - Business Name: /~LG-.~iL1~~'d'~°~9it/ /flf~• Telephone#: (g6,51) .5Z0-6' DisplayAddress:'~u~i~0 cJ'L,~L~y d~~yIO~ ~~G~~ Retail seller selling exclusively consumer fireworks: _Yes or No Indoor Sales _Outdoor Sales ~~C~~~ See Outdoor Sales of Fireworks) r' Fee: Outdoor Sales -$350.50 All other retail sellers -$1 00.50 MAY 2 6 20u~3 e ' Y Fireworks are regulated by MN Statutes 624.20-624.25. In addition to these state laws, all displays, saies, storage and use of fireworks shall comply with City of Eagan Ordinance No. 378, Section 6.53 Fireworks. I understand and agree to comply with all the provisions of this applicaquireme~ts of t issuing authority. ignat e r r • 2004 Applicntion fbr f ireworks Snles And Stornqe ` City OF £aqan 3830 Pilot Knob f2oad, £aqnn, MN 55122 TelEphone 651-635-5675 f ax 651-b75-5694 y ~rizu;aar: }~4§RV'+i tp~ eay Apqlicant requirements 1. This application must be completed and returned at least 30 days prior to sales and/or storage of fireworks. 2. A letter from the property owner granting permission to the applicant to sell and/or store fireworks on the property shall accompany the application. 3. A floor plan designating the area where the fireworks will be sold andlor stored shall accomparry the application. 4. A list of the fireworks that will be sold and/or stored along with the name, weight, quantity, and material safety data sheets (MSDS) shall be incfuded. 5. A copy of the certificate of insurance coverage as per City of Eagan City Ordinance No. 378, Chapter 6, Section 6.53 Fireworks is required. 6. Fee upon application for retail sellers selling exclusively consumer fireworks-$350; all other retail sellers-$100 per vendor annually payable to the City of Eagan. 7. The fire chief or hislher designee will inspect the proposed Vocation for selling andlor storing fireworks to determine 'rf it is a suitable location. 8 A criminal record check will be done on all applicants. 9. A copy of the City of Eagan license (permit) shall be displayed by the register. Date: Applicant Name: VZ&!Pr Street Address: y/.3 City: AJrtG~/~if~ State: ~d/~• Zip: ~Slda~ Telephone (dlA " • 9 - - - - - - - - - - - - - - - - - 6usiness Name: '~WC• Telephone#: (~s/) 4e0,5' Display Address: cy~i~4 c3'~.BLZir i~ ~~yK~ ~ZdZ Retail seller selling exclusively consumer fireworks: _Yes A~ No i°>> r^, ' Indoor Sales _ Outdoor Sales (See Outdoor Sales of Fireworks) E-- Fee: Outdoor Sales -$350.50 All other retail sellers -$100.50 4 ~U' Fireworks ~~il ~ are regulated by MN Statutes 624.20-624.25. In addition to these state laws, all displays, sales, storage and use of fireworks shall comply with City of Eagan Ordinance No. 378, Section 6.53 Fireworks. l understand and agree to comply with all the provisions of this aQplicaequirements of t issuing authority. Signat e tFire+Norks Application Page 2 bf 8 TennESSen Wnrninq License Applicntion Minnesota law requires that you be informed of the purposes and intended uses of the information you provide to the City of Eagan (the City) during the license application process. Any information about yourself that you provide to the City during the license application process will be used to identify you as an applicant and to assess your qualifications for selling fireworks within the City. If you wish to be considered for a permit to sell fireworks, you are required to provide the information requested in the permit application. If you refuse to supply information requested by the City, it may mean that your application will not be considered. All individuals in the City who need to know information will have access. ze!& Applicant Signature Date Authorization and Consent for f2elensE of Information freely and voluntarily authorize the City of Eagan to conduct an Name of individual authorizing release investigation to obtain the following information for the purpose of determining my eligibility for a permit to sell fireworks: Name: elo " Last First Middle Date of Birth: GO`8` yS Driver's License #:.r- ~~a7'o7T-s' P87' Zy5 State Ay//1~- I also release the City of Eagan from any and all liability for its receipt and use of information and records received pursuant to this consent. I further acknowledge that I have carefully read this release, fully understand its terms and legal significance, and execute it voluntarily. Executed this 090 day of 200,e Signature ~ .FireWo'rks•Application Page 3 bf 8 Wr The Police Department has conducted a criminal background check on the aforementioned applicant. Comments: Police Department Representative Date Conditions of Issuance: Background check completed and approved by EPD: ~ Yes _ No Zoning approval _ Yes _ No Facility inspection complete and ali violations corrected _ Yes _ No Insurance policy approved _ Yes _ No License approved by Date approved: