4200 Sibley Memorial Hwy
CITY OF EAGAN
8795 POO Knob Rea1 Eage., MH 55122 Ng 4972
~ 4,~ d Y1'lL/K4.Ak'-atPHON1: 454-8100
BUILDING PERMIT ~ 1`~'~ ~ Receipt #
To be wed fer rE Est. Value ' Dote 19
Site Address • 4Z~ St ei < Erect [:I Occupancy
Lot Black Sec/Sub. y~, 'r`atyUr14 Alter ? Zoning -
Porcel Repair ? Fire Zone '
# -
Enlarge ? Type of Const.
~e Nome Move p # Stories
~ qddress Demolish ? Front ft.
Plions 612/459-125~ Grode ? Depth ft.
ix NQnw Approvob Fses
,o
a~ Address Assessment Permit t
uF Wuter $,$gvl(.y-7.~_ 5urcharge
Ci Phone Police N' Plan check
. . ~ c:~
,,,W Name Fire SAC
, .
r
x~ /,ddreu - ` • Eng, ' Woter Conn.
~Z
<W Ci Phone t: l -114 Planner Woter Meter
Counci I
I hereby acknowledge thot I hove read this npplication and stote that gl. p{.~.
the information is mrrect ond cgree to comply with all opplicable ~ • 7~
State af Minnesota Stntutes ond City of Eogon Ordinonces. APC Total
5lgnature of Permittee ,
A Building Permit is issued to: on the express condition thot
all work sholl be done in accordance with oll oppliovble Stote of Minnesato Statutes and Ciry of Eogan Ordinances.
Building Officlal
PMnk ~ DeN Iswd fuwMtN
(T*F•PIun,birvs .-3 ttk 17 - 0 ~
Mechanical + 3
c~~rc-~ - 6 l -L,
INSPECTIONS DATE INSP. Rouph-In Find
Footings 7 '17' 19 Dote Insp. Dare Insp.
FoundoYion Plumbing ~•ti2~- ~ •
Frome/ins. Mechonicol - -
Finnl -1
Remorks:
r
o KY wpt YPor t" vn TSIa n4
~ CITY OF EAGAN
, 3795 Pila ICnob Rood
' Eagon, Minnesola 55122
Phone: 454-8100
MEM• PUPIMU PERMIT No. 348
Dote: 7-17-79 Receipt No.: 15076
HwySingle I
Site Address: • 13 & C~. PC~. ~ Residentiol
#10 01-900 01058 I
Lot Block Sub/Sec. Multi Res., Comm./Ind. ~n~ X
Name ~~~i~
New/Alter./Repoir
; Address 2-240 Wb3t 98t1 StxeE.''t _ 14~O~d.dn
Cost of Installation
O
City BloaWjlgtM Phone: Permit Fee 100• 00
Nome BMX"y MWbardcaI' Surthorge ~ 51
~
~ 1977 West RivieX Poad N.
2: Address
a
c
0
: ~)ls. 55411 59-9-9516 1on.5^
City Phone: Total
This Permit is issued on the express condition that oll work shall be done in accordance with nll cpplicoble State of
Minnesota Statutes ond City of Eogan Ordinances.
Building Officiat
CITY OF EAGAN
' 3795 Pilot Knob Rood
Eagon, Minnesofa 55122
Phone: 454-8100
PERMIT No. 154
Date: 9/4/79 Reteipt No.: 15756 x
4244 Sib16y 4wy. Single I
Site Address: (Hwy• 13 f0OlIIlty Rd. 30) _ Residential
Lot Block Sub/Sec. _1,~'u}%~~~~'`~~- Multi Res., Comm./Ind.
Name New/Alter./Repnir :Je47
~ }~ty. 13 & Co~ty F~. 30 21 ' ii:~ . ;
; Address Cost of Installction ' '
O
City Phone: Permit Fee 1~9' 00
a
Nome Ryan OD• Surchorge
P Address 14745 So. Roibett Tx'ail ~
e
0
City Phone: Total
This Permit is issued on the express condition that oll work sholl be done in accordance with all applitoble State of
Minnesota Statutes and City of Eagon Ordinances.
Building Official
CITY OF EAGAN
3795 Pilot Knob Raed Eogon, MN 55122 N! 4 644
PHONE: 454-8100 ,
BUILDING PERMIT Receipt #
o:. ,
To be uaed for ".d:ltl t;~js ; taf zjE5t. Value Dote , 19
Site Address Ge. , . 39 & iiwy. 13 Erect ? Occupancy
Lot Bfock Sec/5ub. Alter ~ Zoning
parcel # O 1 S! O Q 010 58 Repair ? Fire Zone _
Enlorge ~ Type of Const.
W Name Move ? # Stories
z Addreas PuRnY 74R Demolish ? Front ft.
Ci u 1 PQrk Phone 459-11 5 5 Grade ? Depth ft.
~ . Approvois Fees
~p Nome ~gmn
v~ ~re~ Assessment Permit
~ Water & Sew. _ Surchorge %+i.'?' •
Ci Phone
~ Police Pian check
W W Name Fire SAC
utD Address Eng. Wnter Conn.
aW Ci Phone Pianner Water Meter
Counci I
I hereby ocknowledge that I have read this opplication and state that Bldg. Off. _
the informotion is correct and agree to comply with all applicable APC Total State of Minnesota Statutes and City of Eagon Ordinances.
Signoture of Permittee
A Building Permit is iuued to: -+-on the express condition that
all work shall be done in accofdance wlth all applicable State of Minnesota Stetutes ond City of Eogan Ordinonces.
Building Official ,
Pa.it # oate l.swa Panxr«
Plumbing
Mechaniwl
INSPECTIONS DATE INSP. RouqMin Fir?d
Footings Date Insp. Dote Insp.
Foundation Plumbing
Frome/ins. Mechonicol
Finol
Remorks:
CITY OF EAGAN ~T
3830 Pilot Knob Road, P.O.Box 21-799, Eagan, MN 55121 l~! 9 8944
PHONE: 454-8100
BUILDING PERMIT Recespt #
To be wW fw STORAGE ADD. Est. Vclue $ 16,000 Date APRIL 6 , 1984
Site Addri 4200 SmBLF,Y MFMORIAL 1(~9Y. Erect 0 p«„~„~, B-1
ss
Lot BITck 58 Se,/Sub. SECT. 19 Alter ? Zoniny GB
Parcel No. 0- 019 0 0- O 10 - 5 FS Repolr p Flre Zone
SUPERAMEI:ICA - ROBT. i"ICCLt1N Enlorye OX Type of Const. Vn
W Name Move ? # Stories 1240 ~ Address W.
~3 ~ F' c T. Demolish Q Length 9 x 4 8 4 3 2 S y. f
City BLP~ITN. Phone 8 8 7- 61 U 0 Grode
? Depth Sq. Ft.
~ Approvals Feaa
o Name 11650
oU Address Assessment Permit •
u§
I.- City Phone Woter & Sew. Surchorye 8.00
Police Plon check 58.25
~W Name Firo SAC
Address Enp. Woter Conn.
~W City Phone Vlonrxr WoterMeter
Council Road Unit
1 hereby ocknowledge that I have reod this opplicotion and stote tfiot Bldg. aff.
the informotion is correct ond ogree to comply with oll opplicoble ^PC Total $ 182 ' 7~'
Stote of Minnesota Srotutes and Ciry of Eogon Ordinoncr,s.
, .
Sipnoture of Permittea {,~fSdbrr
A Building Permit ls issued to: SUPERAi~i~;RICA on the express condition thai
all work sholl be done in accor anc th ol~ opiplica e St te of Minr?esotu Statutes and City of Eayen Ordinances.
BuildinQ Official ~ .,r
7D
Permit No. Permit Holdsr Mise. Permit No. Holdsr
Plumbing
H.V.A.C.
Wsll
Watsr
Disp.
Sswer
E kctric
Inapection Date Insp. Other
Footinys %K4
Foundation
Freminp
Rouyh P16q.
Rouph HVA
Inwlation
Final Plbq.
Final HVAC
Final
Wster Describe Location:
YVell
Sewer
Pr. Dhp.
. ~ 4:R.i. . " ' " ^'SC."r . . ~~c . , ..:~n^. .-ywv ..y: . ; --'T•-.. ~,ts .c ~ ^ v o . r • . . _ n~
CITY OF EAGAN RO 17364
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
IYfERIOR
To be used for I-MPROVEMENT Est. Value $5,000 Date DEC 7 1909
Site Address 6204 SIBLEY NSMOxIAL HWY
Lot 1 Block ~ SeclSub. SECTION 19 OFFICE USE ONLY
P3fCel NO. Occupancy - FEES
Zoning
W Name SUPLRAMEkICA (Actuaq Const - Bldg. Permfl 72.00
o Address 1240 u 98T[i ST (Allowable) - Surcharqe 2•~
City a~INGTONPhone 887-6100 # ot sior+es -
Length _ Plan Review
=F Name KB1?US AIIDEg3(ria CONSTRISCTION Depth - SAC, aiy
00Q Address 2 ~ HINNEHAHA AVE S.F. Total - SAC, MCWCC
~ City MP1.5 Phone 721_7S8t SF. Footprinis _
(MkRV F On Site Sewage _ Water Conn
~ W NBme On Site Well - Water Meter
v~ Addr2SS MWCC System _
a W Clty PhOne City Water _ Acct. Deposit
PRV Required _ S/W Permil
I hereby acknowlege that I have read this application and state that the Booster Pump - SNJ Surcharge
intormation is correct and agree to compy with all applicable State of
Minnesota Statutes andf Eagan Ordinances. Trealmenl PI
Signature of Permitee ' 11 _ l ` - APPROVALS Road Unit
A Building Permit is issued to: KRAU$ ANQEQ$ON CONSr Planner - Park Ded.
on the express condition that all work shall be done in accordance with all Council
applicable State ol Minnesota Slatutes and City of Eagan Ordmances. gld9. pX _ Copies
Variance - TOTAL 74.50
Building O(fiCidl
Permit No. PermR Holder Date Telephone #
WATER
SEWER
PLUMBING
H.V.A.C.
ELECTRIC
Inspection Oate Insp. Comments
Footings I
Foundation
Framing
Aoofing
Rough Pibg.
Rough Hig.
Isul.
fireplaCe
Final Htg.
Final Plbg.
Const. Meter Plbg. Inspector - Notity Plumber
Engr./Plan
Btdg. Final
Deck Ftg.
Declc Final
Well
Pr. Disp.
CITY OF EAGAN 16140
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100 .
BUILDING PERMIT Receipt #
To be used for ' 1~*~;a~' Est. Value $21 , ocQ Date , 19 Q C
Site Address 42na SIEL.EY t+lrEM17&IAL 'rt4.'Y
Lot ~I- Block 58 Sec/Sub. 3ECTIQt? 1~1 OFFlCE USE ONLY
Parcel No. occuPancy ~-x FEES
Zoning
W Name S~ER AMERICII (Aclual) Const - Bldg. Permit 216.00
o Address 1240 ~1 9E~ti ST (Allowable) - Surcharge 10.
City ELOdMII~"1'4N Phone 887-6100 # or srories
Lerg1h _ PlanReview 108•00
Zo Name AM
~ Depth - SAC. City
00¢ Address S.F. Total - SAC. MCWCC
~ City Phone S.F. Footprints -
On Site Sewage _ Water Conn
~ ¢ KUMAti MlJE1.LFK
F W Name On Site Well - Water Meter
Address b~ nnwcc system _
QZ Acct. Deposit
au+ Cit)I PhOfl@ City Water -
PRV Required _ S%W Permit
I hereby acknowlege that I have read this applicition and state that the Booster Pump - SMI Surcharge
information is corcect and agree to comply witM all applicable State of
Minnesota Statutes and City of Eagan Ordinances. Treatment PI
Signature of Permftee APPROVALS Road Unit
A Building Permit is issued to: Planner - Park Ded
on the express condition that all work shall be done in accordance with all Councii
applicable State of Minnesota Statutes and City of Eagan Ordinances. gldg. pft. _ CoP'eS
Vaziance - TOTAL 334.5o
Building Official
Permit No. Permit Holder Date Telephone #
YVATER
SEWER
PLUMBING
H.V.A.C.
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg. • ~ ~ . : ' -
Isul.
Firepiace
Fnal Htg.
Final Plbg.
Const. Meter Plbg. Inspector - Notify Plumber
Engf./Plan
Bldg. Final
Decic Ftg.
Deck Final
Well
Pr. Disp.
PERMIT #
' PLUMBING PERMIT 1 I - ~
CITY OF EAGAN RECEIPT Ik ~
3830 PILOT KNOB RaAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE PHONE: 454-8100
Site Address BLDG. TYPE WORK DESCRIPTION
Lot ~IL) Block -X~ Sub Res. New
Mult. Add-on
m Name . Comm. Repair
~ Address • P ~ Other
c Ciry t•. Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
` NO. FIXTURES TOTAL
Name ' Water Closet - $3.00 R
d ~ Bath Tubs - $3.00
3 Address Lavatory - $3.00
O City E Phone -7 Shower - $3.00
Kitchen Sink - $3.00
FEES UrinaliBidet - $3.00
COMM/IND FEE - 1a/o OF CONTRACT FEE Laundry Tray -$3.00
APT. BLDGS - COMM RATE APPLIES Floor Drains -$1 50
TOII?JNHOUSE & CONDO - RES. RATE APPLIES Water Heater - St 50
MINIMUM - RESIDENTIAL FEE - $12.00 Whirlpoal - $3.00
MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets -$1.50
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT)
(ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00
BEYOND $1,000.00) Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
SIGNATUR OF PE(IMITTE T FEE:
~ STATE S/C:
FQR: CITY OF EAGAN GRAND TOTAL: -
. ,
~PERMIT #
MECHANICAL PERMfT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAO, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100 For Office Use Only:
Site Address C' L, - gLpr,, TypE WORK DESCRIPTION
Lot Block Sec%Sub ~
Res. New
Mult Add-on
~ Name Li ~ A f_' ic• t i-J
Comm. Repair ~c Address
c City Phone Om~
FEES ~
Name - { ~ ti ~ ~ RES. HVAC 0-100 M 8TU - $24.00
c Address ~ ~ ADDITIONAL 50 M BTU - 6.00
3 . (RES. HVAC INCLUDES A/C ON NEW
p City , l phone CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
ForCed Air M BTU APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent . CFM I (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # BEYOND S1,000)
Other .
FEE
S/C: SIGN T RE OF PERdjMTTEZ'
J .L • f ~
TOTAL: ~-t > FOR: CITY OF EAGAN
Rsaipt MECHANICAL PERM17 Pennk No.
CITY OF EAGAN
FM
FIIJ Jn numbered pacas S/C
Type or Prini /egIbly TOL -
1. Date 2. Installation Cost '
3. Job Addrass Lot'' ~ Blk. TnM' l ~
4. Owner V&st g L~!" • r/1 r L-4 5. Contractor:
8. Addrsss " ' r . i r, . . . .1 ,
7. Cityfr` State i Zip B. BuildinyType: Residential ? Commerciall~, Institutional O
9. Work Deac?iption: New O Add ? Alter ~ Repair ?
10. Describe Fuel Type
11. No. EqujpMrit 8TU - M. Ea. No. Equiamsnt CFM
Forced Air Air Handling:
Mfg.
Boilan Mech. Exhautt
9
Mf
Unit Fleater
F
Mfg. Other
Air Cond.
Mfg.
Gss, Piping Outlets
12. 1 hareby certify that the above information is true and correct, and I aqree to
oomply with all ordinanaes and codes governiny thia type of work.
Signed' I for
Rnuqh Final
Inspections: Oate Insp. Date Insp.
This is your psrmit when numbered and approved.
Approved CITY OF EAGAN 464$100
~ : INSPECTION RECORD
CITY OF EAGAN PERMITTYPE:
3830 Pilot Knob Road Permit Number.
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
,i i ~'tl ? MI Inny rAI II14Y
PERIIAIT SUBTYPE: TYPE OF WORK:
, , , ~f I't?1 t~~vd
INSPECTION DA • DA
,
; • ~ ~ ~ i ~ , f i I r ~ ! i 4 : ~ ~ i , . ~ , ; I 1 N I I I
I 1 Ni:l
~ ~
PermR No. Permit Holdsr Qete Telaphone #
ELECTRIC
y PLUMBINC3
HVAC
Inspeedon Dabe Insp. Commente
FOOTINGS
FOUND
FRAMING
L 7
ROOFINQ
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLE3G
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
1
,
. . _.l . . . .~.--s.--7
+I.riA ~ . . .
i
~ •
(fCL`tifiCQfe Of CCC1tpQ1iCv
CfitV oF Cfagan
20 «t 1 cut of IBRmbtg a,~~pecnon
This Cenificale issaed pursuartt ro rhe nequirements of rhe Uniform Building Code
certifying that at the tiixe of issuance this strvcture was in compliance with the various
ordinances of rlu City rrgulating building construction or use. For the fo!lowing:
ux cassir.s;w MV. /MID MIqC aa& Peffnit ro. 29517
OccuP-Y TYDe Zoning Distria Type Consu
Ownerof Building StNERAHMMJe1 Ad~ass 41240 PIAM
aWwinB Ade,= 42M STHIRY MDMTAT. NWY Loo?icy I.L,R.58,_S=fN 19
Due:
~
Buildiag Official
POST IN A CONSPICUOUS PLACE
. . . r . ; , 7:. ~41 o.q~.~-r... . . . .l.:a? 77
(hEw EAsciA oH stoRa) CITY OF EAGAN ~822 ~
_ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILGING PERMIT Receipt # "u- cl~0`CS
To be used for REMM61' Est. Value $10`000 Date AUGUgT i , 19 90
Site Address 4200 SId1.EY lISIi0R1AL HWY
Lot 1 Block ~ Sec/Sub. gECT• 1 OFFICE USE ONLY
PBfC@I N0. Occupancy - FEES
SUPBR/1NERICA zoning - $117,00
¢ Name (Aduaq Const _ Bldg. Permtl
z
3; Address 1240 W QM sT (Allowahle) 5•00
o - Surcharge
City g~1~~ Phone 887-6100 # or stories -
Length _ Plan Review
=o Name SANE ~ln _ sac, city
ou s Address S.F. Total - SAC, Mcwcc
~ City Phone S.F. FoolpriMS -
_ r On Site Sewage _ Water Conn
ui W Name On Site Well - Water Meter
AddfeSS MWCC System _
Acct. Deposit
s W Clty PhOn@ City water _
PRV Required _ SNV Permit
I hereby acknowlege that I have read this application and state that the Booster Pump - SNV Surcharge
information is correct and agrh all applicable State of
Minnesota Statutes and City os. . 7reatment PI
Signature of Permitee APPROVALS Road Unit
A Bui lding Permit is issued to: sv RAkRI Planner - park Ded.
on the express condition that all work shall be done in accordance with all Council
applicatle State of Minnesota Statutes and City ol Eagan Ordinances. Bldg. Off. _ Copies =1 ~
.
Building Official - ` / - ~ Variance - TOTAL
~ ,
Permit No. Permft Holder Date Telephone ~k
WATER
SEWER
PLUMBING
H.V.A.C.
ELECTRIC
Inspection Oate Insp. Comments
Footings I
Foundation
Framing
Ropfmg
Rough Plbg.
Rvugh Htg.
ISUI.
Fireplace
Fnal Htg.
Fnal Plbg.
Const. Meter Plbg. Inspector - Notify Plumber
Ergr.lPian
Bldg. Final Dedc Ftg.
Deck Final
Well
Pr. Disp.
~
DEfEA s P M ~ Mu ~CULAR ()Y',,
jOPPORT Mq ite_: ~USA
~
RECEIVED
Burnsville Fire Department 14011 Burnhaven Drive ~
Burnsville, MN 55337 A'Y 3 01984
CI1Y OF
. BURNSVILt E
~
. . I~i~l~~i~l~~~ll~~,li~l~~?Il~~~il
/Q
r- -
CONFIRMATIDN OF CLEANING
Location cleaned Super America Hwy413 & Co. Rd. 30
Name of Restaurant/Business Super America
Company doing cleaning Enviromatic Corporation of America
Date & time cleaned 5/ /84 - 10 : 00 P. M.
Foreman's signature (X) ~
Cleaning company telephone number
CITY OF EAGAN Remarks I I `E )
Addition SeCtiOri 19 Lot Blk Parcel 10 01900 010 58
Owner S,treet _ . ~ ~ , state EAGAN MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRAOING
SAN SEW TRUNK YL) 1965 273. 00 $9.10 30 PAID SEWER LATERAL 1^ $25.43 15
s •
jIM1IATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK 3227.80 OQ 1-1-78
-
STpRM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
,,od 8g44 42388 4-6-84
WATER CONN.
BUILOING PER. ' #352 #4972 12927 3-75
sAC 500.00 11688 9-19-78
PARK
CITY OF EAGAN
3795 Pilof Knob ~ I Eagan, MN 55122 N2 4644
S4-8100
PHO1*
8906
BUILDING PERMIT APPLICATION $409000. ReceiPt #
Te be wed for Addn Gas StBtio&r. Voi.e Dote Jan. 27, 19 78
Site Address r^.._-Rd. 30 8 ElW3'. 13 Erect ? Occupancy
Lot Block Sec/Sub. SeC. 19 Alter ? Zoning
parcel # 10 01900 010 58 Repcir ? Fire Zone
Enlarge IS Type of Const.
W Name RuTerAmerica Move ? # Stories
~ ,q~res, POBOX 248 Demolish ? Front ft.
C~ St. Paul Psrk Phone 459-1155 Grade Q Depth ft.
~ Nome 58ttle APDroyals Fees
, o 1150
5.-
50
~d~~ Assessment Permit 2~ ~ 00
~ Ci Phone Water & 5ew. Surcharge
Police Plan theck 57 AX
Nome
~uW Fire SAC
Address Eng. Water Conn.
<W Ci Phone Planner Woter Meter
Council
I hereby acknowledge that I have read this appliwtion and state thnt gldg. Off.
the information is correct and ngree to comply with oll applicoble AP~ Total 193.25
Stote of Minnesota Statutes and City of Eugan Ordinances.
Signoture of Permittee
A Building Permit is issued ta: on the express condition thot
ail work shcll be done in a on with a applicable tate of Minnesoto Statutes and Ciry of Eagan Ordinances.
Building Official
CITY "-F EAGAN SEWER SERVICE PERMIT
3"'95 Pilot Knob Road PERMIT NO.:
Lgan, MN 55122 DATE:
Zoning: No. of Units:
•,,~i _~s
Owner. '
Address: ~
Site Address:
, ~oct:.:•.
Plumber.
1 agree fo oomply witf+ fhe City of Eogae Connection Charge:
Crdinanees. Account Deposit: _
Permit Fee:
Surcharge:
BY Misc. Charges:
Dote of Insp.: Totol:
Insp.: Date Paid:
cIrr oF Eaaww WATER SERVICE PERMIT
3795 Pilot Knvb Road PERMIT NO.:
'Cagon, MN 55122 DATE:
Zoning: No. of Units:
Owner: _
Address: 15;7 /
5ite Address:
Plumber:
Meter No.: ~ Connection Charge:
Size: Account Deposit:
Reader No.: Pennit Fee:
I agree to tompyr w7lh tlie City of Eagon $urcharge:
Ordinonoes. Misc. CFarges:
Totul:
BY Date Poid:
Date of I nsp.: I nsp.:
EA?l;AN 'rOWNSHIP N? 1477
BUILDING PERMIT
Ownez L----_....'..Eagan Tawnship
Addsess (Present..44-, ~f.~k4 ..-_f?-.-~--------------------- Town Hall
Builder ---"----.....7------ - cY~ 6 ~L
DaYe i
.-----r ..................Address
DESCRIPTION
Siories To Be Used For Fron! Depin I HeighS Esl. Cos! Pezmit Fee_i , arRemks
f':7
LOCATION
Sireef, Road or olher Descripiion of Locaiion ~ Lo! Block ' Addifion or Traci
~;Y~,,,y, -'&i d- Q,d R'r{ 3--0 O/O 5$ O1g00 O/d 58'
This permit does nof a ihoriae the use of sireefs, roads, alleps or sidewalks aor does it give the owner or his agant
the righ!!o cseafe anp siSuaiion which is a nuisance or which psesenls a hazard !o the healih, safely, convenience and
general welfare !o anyone in the eommunifp.
THIS PERMIT MUST BE KEPT O~.Ij THE PR MIS£p WE3ILE THE WORK IS IN PAOG EI} 55.
This ie !o eaxfify. 2hat~--.. er......-~~r."..~permission !o exeef a,..•~~'°~~4"~4'....... upon
the above deseribed premisi subjecf 30 the provisiona of the Building Ordinance for Eagan Township adopled April 11,
1955.
G(~!~-?>.../L:..-~.~_""-........ Per - ' _
Chairman of Tnwn Boatd Building fnspecior
~G `
~~y•
V
~~Xi o
EAGAN TOWNSHIP
BUILDING PERMIT N° 1717
Owner RRr.!.c!l........... ~ Eagan Township
Address (pxesen2) Town Ftall
Builder
Dele
Addreas
DESCRIPTION
5SOries To Be Used For Fronf Depih Heiqhi Esl. Cosf Parmif Fee Remarks
IC
LOCATION
Streef, Road or ofher Desaripfion ot Loca2ion I Lo! Block Addifion or Tsae!
This pesmit doea not authorise the use of c2reels, roads, alleys or sidewalks nor does it give the owner or hfs egent
the righilo creale aap aifualion whieh is a nuisance or which presenffi a hasard fo the healih, safefy, eonvenienca and
geaeral welfare !o anyone in the communiip.
THIS PERMIT MU5T BE PT ON E PREMISE WHILE THE WORK 23 IN PROGAESS.
. . . . .
This is So cerlify, fha!_._. I..«~....._.`.z-_..._......has permissioa !o ereci a........... upon
!he ebove described pzemise Bubjee! !o the provisions of the Building Ordinance for Eagan Tow sh adopied April 11,
1955.
l......... Per ~l~~~.""'.........-
i~rman of Tnwn Soard Builng Inspeelos
l'( • ~
CITY of'EAGAN N..2 3522
BUILDING PERMIT
Ownee 3795 Pilo! Knob Aoad
Addrece (psasen!) ~ p' g" - y.,.,.-~. Eagan, Minaesota 55122
7 ..'3 . 454-8100
Builder
Dals
7........................
Add:au
DESCAIPTION
82oriea To Be Used For -Fson! Daplh Heigh! Eft. Cw1 Pssmi! Fee Aemasks
-
LOCATION
3lreel, Roed or ofher Descripiion of Loeafion I Lo! Block Addilioa or Trse!
I oio sS /D e~ po0/p s30'
This permii does aof aulhoxise the use of streels, zoads, alleys or sidewalka nor doas it give the ownes or hG ayen!
the righ! !o creale anp silualion whieh is s nuisanae or whieh prasenffi a hasard !o the health, sefely, conveateaes aad
general welfare to anyone' in the community.
THIS PERMIT MUST BE EPxHE.PREMISE WHILE THE WORS IS IN PA06RE83.
~
This ia !o eeztifp, iha2---- ---°°-°°•--.has permissioa !o aseet a...~S _npoa
the above described premise ubjee! !o the provisions of all applicable Ordinanees fos the City of Eagan
0
Per
Mapor SuAdinp Inapec!¢;
7T'
Bonesiroo, Rosene, Anderlik & Associates, Inc.
TO --5. ~ 2335 W. HIGHWAY 36
ST. PAUL, MN 55113
636-6800
SUBJECL _ .r'-.o/- , T/?~1~( 'T-s.°'~& ~
DATE:
~~2~+~~ ? v ~
n J
~
~
- -
P L E A S E R E P L Y TO D SIGNED:
DATE: ~ SIGNED:
DETACH YELLOW COPY - SEND WHITE AND PINK COPIES WITN CARdONS INTACT
~ FOPM NO.PR100F.3 ,
AVAIIABLE FqOM BUSINE55 ENVELOPE MANUFACTl1RERS, INC. • PEARL FNER. N.Y.. BFON%, N.Y. • CIINTCN, TENN. . ANAMEIM, CALIF. PRIWTED IN U.S.A.
w
THIS COPY FOR PERSON ADDRESSED ~2i3~
cIrY oF EAcnN
8795 Pilot Knob Rood Eugan, MN $5722 N2 4972
PHONF: I548100 ~j
BUILDING PERMIT APPLICATION Rececpt
To be used for Station Store En. Volue 85,000 Date September 19 19 78
Site Addrea Hwy. 13 & Cty. Rd. 30 Erecr (7~ Occupancy Fz
Lot Block Sec/Sub. _ Alter ? Zoning
parcel 10-01900-01058 Repair ? Fire Zone 3
Enlarge ? Type of Const.
w Name Superamerica Move ? # Sro.ies
~ AddressP• 0. BoX 248 Demolish 0 Front 70 50 fr.
Ci St. Paul Parkphone 612/459-1155 Grada ? Depth k.
~ Name Avvrovals Fees
O
4, o0
Address Assessment Permit 19
~ Ci Pha~e Water & S w. Surcharge
Police $721/ 78 Plan check 96.00
,~,w Na,,,e Superamerica p;re 5AC 500.00
~W P.O. Box 248 En9. 9/13/78 Woter Conn.
~ Address
x <w Ci t. Paul Park Phone 612/459-1155 Plonner WcterMeter
c ;i 6-6-78 Road Unit 439.00
I hereby ackrrowledge that I have read this applicction and stote that gldg. Off. 9 19 78
the inTormation ts correct and agree to com ly 'th all applicable A~ Total State of Minnesota StntWe~ ad Ci of on dinance . Uv
Signature of Permittee ~E{
A Building Permit is iss to•~ on ihe express rnndition that
oll work shall be don cordance i cll pliwble St/aof Minnesota Statutes and City of Eagan Ordinances.
Building Officiol ~
CITY OF EAGAI~ ~T
3830 Pilot Knob Road, P.O. Box,'~1-13:~Eagan, MN 55121 l~l ? 8944
PHONE: 454810041
54f6100
BUILDING PERMIT Receipt #
To be utad ior STORAGE ADD. Esr. Vulue $ 16, 000 Date APRIL 6 ,`I9_.d_4_
Site Addrpss 4200 SIBLEY MEMORIAL HWY. Erect 0 p«„po„cy R-1
Lot 1 81ock 58 sec/sub. SECT . 19 Alter ? Zoning C'B
Percel No. 10-01900-010-58 Repair ? FireZone
Enlorge Type ot Const. Vn
ec Name SUPERAMERICA - ROBT. MCCLUN Move ? # Stories
Z Addr~s 1240 W. 98TH ST. pemolish ? Length 9 x 48 432 sq. f
~ City BLMTN. pnone $$7-6100 Grode p Depth Sq. Ft.-
Name Approrals Feef
o
o~ Addrass Assessment Permit $ 116, 50
V~ City Phone Woter 8$ew. Surcharge 8• 0 0
r Police Plan check 58, Z 5
E. Name Fire SAC
Address Eng. Water Conn.
°CZ City Phone Plonner WaterMeter
Council Road Unit
1 hereby atkrqwledge that I have read Ihis application ond state that Bidg. Off.
fhe inlormofion is wrrect nnd o9ree to comply with all applicoble $ 182.~ r)
State of Minnesota Statutes and City of Eagon Ordirwnc . APC Totol
Signoture o4 Permittee 164 PltV ~
A Building Permif is issued to: SUPERAMERICA on ihe express condition thm
oll work sholl be done in acco da e ith q{I o vli le ate of Minnesota Stctutes ond Ciry of Eagon Ordinances.
Buildiag Official (,liC{ y
S
/TS , 71" ,Y ~'y~ CITY OF F11GAN ~ Include 2 sets of plans,
U ~ 1 Gertificate of Survey-&
BUILDING PE%K[T APPLICATION 1 set cf energy calculations.
S - - 8'Y
To Be used For valuation ~poe? Date
-T
Site Pddress n OFFICE USE ONLY
Lot ~ Bloclc ~ Sec./Sub. r-;Z'r f~ Erect Occupancy -
Ol9ob - Alter Zoning ~
Parcel # :/D • ~.,Teo - o~ - ,S' 9~ Fepair Fire Zone
Owner: vY~Lram o v i c-~( Enlar4e k- TYPe of Const.
Address: 1 7 A~. G~q fl+ S7'- M°~ # Stories
~fi? / Dsnolish Front q X4 t) 3
City/Zip Code: ' o Grade Depth ft.
Phone ~i Q-J
~~5 ~,S
14
Contractor: . s~yy/p Assessments Pesmit
?4ater/Sewer Surcharge
Pddress: Police Plan Check ~ x
City/Zip Code: Fire SAC
Phone Eng• water Conn.
Planner Water Meter
Council Road Unit
Arch./E~J•: SqYI'7~°- Bldg. Off• T[.
Address: APC
City/Zip Code: _
Phone TCfrAL ~
2 L 1-9 7 3 0This request roid 18 monAs fmm volidation doie pnnted in ihis bum.
/V
~ \1
PIEASE.PRINT OR TYPE 10 OO - 0/0 -
J~ d
Requasl / I Rough-in inspeaion rcqvired2 ? Yes ~frtYNo Inspetlion Olher oigh-In: Ready Now Wiil Call
/ f~J I~ou must <all Me fnsp«ror..Mo reaay) Dofa Ready:
I, licensed confrador ? owner here6y requesf inspection of fhe above eledrical wor ai:
b6 Pddrcv (St ~ n, or Roula No.) / Ciry „ Zp Code
Seclion No. Townahip Name or Na. Ranga No. Fre No. Co
' ,
PhoM No. ~
Poxer Supplier Address
EI 1 Canhocmr (Comparry Name) Contgelpor nLiai~ue No. Maekr Lic No. (Plam Fen. Only)
Mailiig/d onlmdo, or
A)rj
Au rixed Signotun (Conhaaor r sbllotlanl Phan No.
EB-00001 STATEBOqpO -SEEINSTfiUC710N50N6ACKOFYELLOWCOVV
REQUEST FOR ELECTRICAL INSPECTION5 ±
21 U essity AvearRrof Slectricity Paul, MN 55104 d~
IIII I III I I~I~ 181 n
* 2 1 9 7 3 s phon si2) 642-0e00 nW//7 91i
Home upex Apt. Bldg. Other: New Addn
ommerciol Indushial Parm Remod Re air
Air Cond. Hfg. Equip. Water Hh. Laad Mgm}, Other:
D er Ran e Elec. Heaf Tem . Service
"X" above the work covered by this request. Enter remarks in Mis space and on the back of the white copy only.
A- Cc % 0-~ /'.-e°ss Tia--~" 44--t- 1 7-5
Colculate InspecFion Fee - This Inspection Requesf will not be occepted without the corred fee:
Olher Fee # Service EMrance $ae Fee # Ciraih/Feeders Fee
Mobile Home Park Stall 0 fa 200 Amps toffW Amps
Sheet Ltg./Traffic Sig. Above 200 Amps bove Amps
Transformer/Genemtor IqSPECTOF'SUSEONLY T~
Sign/Outline Ltg. Ximr. ~ J ~
Alartn/Remofe Conhal ~
$wimming Pool I hereb mel that I inspe~d ihe deckical' II on de:c' n o~Me do~m:hrtd
Irtiga}ion Boom Rough-ln b
Special Inspecfion 1 A~
Final C
Invesfigafive Fee ~
THIS INSTALLATION MAY BE ORDERED OISCONNECT T N 18 MONTHS.
91 3 7~
~ 05893 i ~o
Fequest Oala Fire o. Rough-ln InpsBClion Required InsOectbn Olher T~en Raugh*ln
Q
(VOU must call inapeclor whan metly) ~ qeatly Naw ~II NotHy Inspaclor
~ ! ? Ves No Dete ReaJy
I)<f'i'censed coniractor ? owner hereby request inspection of above eleciri .
Job Atltlress IStreel. Box or Roule No.) - Ciry
/
Sedion Na. Townshl0 Name or No. Range No. n
OccupantlPRINT) Phone No.
Power SuDPiie Adtlress
EleMrical Conlrador (GOmpany Name) ConVedarS LicenSe No. .
i / *t4,e
Mailing Atltlress (COnttactor o^r Owner Making Installalion) /J
o l~ D
Nuthonz gnawre ICOnttatlon ner Making bstalla~mn~ Pho e Numher
MINNESOTA STATE BOAPD OF ELECTRICITY TMiS INSPECTION REQUEST WILL NOT
Grlgge-Mldway BIUg. - qoom 3-173 BE ACCEPTED 8V THE STATE BOARD
1821 Univerc'Ty Ave.. 51. Paul. MN 55104 UNlE55 PROPER INSPECTION FEE IS
Phone(fi12)e6Y-0B00 ENCLOSED,
REQUEST FOR ELECTRICAL INSPECTION •N9.~ eaooomoe
See instmcticns ior compieting this lorm on back of yenow capy. ~4; aVY`J 9
?
M05893 !"J!I''Be/ow Work Covered by This Request
ew k,7a Rup: Type of Building AppliancesWiretl EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. 8uilding Dryer Load Menagement
Comm.ilndustrial Furnace Other (Specity)
Farm Air Conditioner
Oiher IsVecily) Contrector's Remerks: q
~yaS71qLC. eCpfS ~02 UH:2 G'.~~~,
Compufe /nspection Fee Below: S~qnr.~1
8 Other Fee # ServiceEntrence Size Fae # CircuitsiFeetlers Fee
Swimming Pool 0 to 200 Amps O l0 100 Amps
Transformers Above 200 _ Amps Abov~L00 _ Amps
Signs lnspector§ Use Only: TOTAL
Irrigation Booms ~V
Special Inspection
Alarm/Communication THIS INSTALLATION MAV B R SC~ONNECTED IF NOT
. Other Fee COMPLETED WITHIN 18 HS. ; I, the Electrical Inspector, hereby Rough-in ~ e
certify that the above inspection has Finai ( oete
been made.
OPPICE USE ONLV p
This request void 18 manfis trom ,
i 31Wi97 $,,/q 7 , ; 791,7% 9
0 d 8`732 1
Pequest Oae Fire No. RnugM1in Inspection Requiretl Inspedion Other Than Rough-In
(VOU vs call inspector when ready) ~ Reatly Now ~Will N tily I~o~
es N. Data Reetl
IXlicensed contractor ? owner hereby request inspection oi~ elecir al wo aur
~
Job Atltlress (Stree1,Gp oute No.) Cuy '
lil
Sec[ion No. ~ Township Nan, r N. Rangc No. Coun
^
iY
Occupan RINT) Phone No.
L.~C, 2rlL~a'h- ~ Q,l,~
Power SupPlier Address
Eledri I Contraclor (COmpany Name) Condaclors Liwnse No.
Mailin Atltlress (GanVacror or Owner Making Ins[allation) ) Gza ~
AutM1Orizetl - re (COnlra<lorl wn Makin Ins allation) Phone Number
, ~--~4-.~/"v ~ ~ ~..1~•
G8P1 UNVers ~y pltl~.B RoP m S~Ne s ~a ~C~TY II N~ BII II~ N B N~ 1~1 ~bl II~I UN I OT
ESS EP EOP ER INSPECTIONF EE
Phonef612)602-OB00 ENCLOSED.
/REQUEST FOR ELECTRICAL INSPECTION es-ooooi-os
jl~ See'msimctions tor mmpleling this form on back of yellow copy.
O~ 8 73 "X" Below Wo rCouere~d by This Request
New Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Servica
Duplex Water Heater Electric Heating
, Apt. Building Dryer Load Management
Comm.llndustrial Furnace Other (Specify)
Farm Air Conditioner
Ofier (%pacl(y) Contr clofs Fem/a~rks:
Compufe Mspection Fee Below: ~~~la~~~~'
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps -tcri-O-O-A-rWN
Transformers Above 200-Amps Abo e 100 Amps
Signs . i"Peao;s use oniy. ~ TOTIrr igation Booms Special Inspection Alarm7Communication 7Hf51NSTALLATION (AY BE CONNECTED IF NOT
Other Fee COMPLETED WITHIN O
i , the Electrical Inspector, hereby Roo9n-in Date
certify that Ihe above inspection has Finai oate
6een made.
OiFICE USE ONLV ~
This request voitl 18 mon[hs from
This reVUe:J void~
lI}'nqmIlS (!OT ~./t.~ Y =~D/ -2~ D 97840
p~nuast Data TF,,e No. Renuhe~?lnsuection paAy Now Q WiII Notfty InsPec-
S~ E]Ves ?Nu tor When ReadY
Licensed Electrical Contractor I herebv reVUest insoeetion of above
? Owner electrical work installetl at:
Sueet Atldress. Box o~ Route No. C'Iy
tmn o. Townshi Name or o RanBe No. Coam
Occo an[ 1 FINTI one No.
~e
Pawer SuoV~~er Atldress
Ele rical Vactor 1 OanY Namel Cunlr:eclms Licens'e No.
~ A AAJress 1 ractor r ner Ma n nst'ilatlonl `
-rr= SS3 ~
Autho,i SiB^ature ICon Iny [allationl Phone Number /
TMIS INSPECTION flEQUEST WILL NOT
MINNESOTA STATE 90APD OF ELE ITV eE ACCEPTED 6Y THE STATE BOAHO
Grigga•MitlwaV Bldg. - Noom N•197 UNlESS PPOPEN INSPECTION FEE IS
1821 Universitv Ave.. SL Paul, MN 65106 ENCLOSED.
Pnone (612) 642-0800
REQUEST FOR ELECTRICAL INSPECTION oo~o
15 See insbuctiens lor complatirq this form on beck of Vellow copR
9 7 8 4 0 ""J(" Below Woik Covered by lhis Requesf
FAd Ilep. TyDe ol BuilEing Apalinncea Wiretl Equiumenl Wired
Home Range Temporary Service
Duplex Water Heater liyhtinq Fixtures
Apt. Building Dryer Electric HeaUn
Cominercial Bldy. Fumace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm 01he1 pe'a v (SUan'rvl
t er Succlfy the, Olh~;~
ompute Inspection Fee Belaw
p Fea ServiceEntrence5ize p Fae Fexdars/Suhfeede~s N Fca Circuits
0 tp 200 qm ~s 0 to 30 Am )s 0~ 0 to 30 Am s
Above 200 qmps 31 to 100 Amps 31 to 100 Am
Swimming Pool Above 100-Amps Above 100_Amps
Transiormers Irrigation Booms Partial-'Other Fee
$igns Special Inspection S
Remarks ~ TOTAL E
0.6
HouBh-in Da te I. the EI hicel
InSpBCtoq
c rtily thal the ebovB
Final ' ~ mspection has been
~ea.
rninrea~ ~.oiei ~ n •
U '
n 14. a~4
5 Zf 'Nk 4 S ~
Repue t Date Fire No. ough-in In3peGtion
ReQUired? _ I ? Reedy Now Iii(,iviu taotiry mspena
oL J Ves -X No NTan ReatlYP
Ilj~licensed contractor D owner hereby request inspection of above electrical work at:
Jab Adtlress (SheeL BoM or Route No.) Ciry
C)c.~ I.tJ ~-O
$ection No. Township Nema or . Range No. County
OccupaM (PqINT) Phone No.
Power SupOlier Atltlress
Eiacv al Contraclor (COmpany ~Nalme) Contrecmr's Lbanse No.
Meiling AtlOress ICOntractor or Owner Making Inslellation,
6 (~2
AmOO~ $1gnatura ICOntradonpwner Making.LWhallalionj r Phone Numbar
MINNESOTp STATE BOARD OF ELECTRICRY THIS INSPECTION REOUEST WILL NOT
GrIgga,Mltlway Bldg. - Room 5-173 8E ACGEPiED BV THE STATE BDARO
1821 UnivanNy Ave., Sc Gaul. MN 55109 UNLESS PROPER INSPECTION FEE 15
Plwne (612) 8624800 ENCLOSED.
fi REQUEST FG -ELECTRICAL INSPECTION EB-00001-OB
~p O~
6 45 See instmeAOns forpleting Ihis form on back oi yellow cnpy.
~ ~ O
'X" Below Work Covered by This Request ~
e Atld Rep. 7ypeof8uilding AppliancesWired EquipmeniWiretl
Home Range Temporary Service
Duplex Waler Heater Electric Heating
Apt. Building Dryer Other-(Specify)
Comm./Industrial FurnaCe
Farm Air Contlitioner
rnnet (wKM) Coi Remarks'.
Compute lnspection Fee Below:
# Other Fee # ServiceEntrenceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 ro 200 AmpS 0 to 100 Amps
Transtormers Above 200 _ Amps Above.100 _ Amps
$iyn5 inwecmr5 Use Onty: l TOTAL
Irrigation Booms cJ'
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspectoc hereby Rough-in Date
certify that the above inspection has F;~a~ oa
been made.
OFFICE USE ONLV
This request voitl 18 months Irom
zus rer' voidlSmonthsfrom '41~
f Zo 1979 ' R 85470
Date or ' Request JulY j 1, asf;Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at:
9OZ10 0l100 aiDSg
Street Qddress or Route No. #13 & CountV ROad 30 city Eagen
Section Township Range County DakOta
Which is occupied by Sunerameiica
(Name of Occupant)
Is a roughin inspection required on this job? No ? YesFLI Ready Now ? Will Call 0
Dakota Electric $21- 3rd St.
Power Supplier Address 4
r
Electrical Contractor Cramer EleCtziC Contractor's License No 36052
(COmpany Name)
MailingAddress 3101 Irving Ave So - Mpls 55408
X (Eiectdc Contractor o wner aking Thls Installation)
AuthorizedSignatu PhoneNo. 927-3541
p~ (E ectprl~cal Contractor or O~~~wppp er Making This Installatlon)
~~ATE p~,~~~~q~ ~g This impaction request will not be accepted by ffie
F79 00 Et State Board unless proper inspection fee is endosed.
Minnesota State Board of Electricity ~!11
University Ave., St. Paul, Minn. 55104-Phone 645•7703
~EQUEST FOR ELECTRICAL INSpECTION Rt
CHE ELOW WORK COVERED BY THIS REQUEST
Typenf Building New Add. Rep. Check Appliancea Wired For Check Equipmen[ Wired For
Home` ? ? ? Aange ? Temporary Wving ?
Duplex D Water Heater ? Lighting Fixtuies ?
Apt. Bldg. Dryet ? Electric Heating ?
Commercial Bldg. Q 11 ? Fumace ? Silo Unloader ?
Industrial Bldg. ? 0 0 Air Conditioner ? Bulk MHk Tank ?
Farm ? ? ? List List
p p
Ot er ? ? ? Hehetsl Hereers~
COMPUTE INSPECTION FEE BELOW
Smice Entrance Size: u Fee Feeders&Sublceders: n Fee C"vcuita: * Fee
0 to 100 Am s. 0 to 30 Am eres 0 to 30 Am eres 24 0. 0
101 to 200 Amps. • 31 to 100 Am res 31 to 100 Am eres Q
Above 200_Amps. 2 .00 Above 100 Ainps. Above 100 Amps.
Transformers Remote Contxol Circ. Partial or other fee
' s Special Ins ction Minimum fee $5. 0
Remazks 1000 AIRp service- circui S d5 TOTALFEE S,OL .50
necessary. ~ -29450
I, the Electrical lnspector, hereby ttha~ e ins tion has been ma"d"e".~~ ~ 3' o~
(Roughan) - Date ~r" ~
(Final) • ' Date 3x4* -X)-3 .5 7 - 0
This request void 18 months from
' •
.y ~
d~
7,P
t
~
zv ~.A~4rn?'~j ~ ,~.y7-~• s~~l'r?i~'4!.y+' ...:_T' ~ ,
~ .
_ -=~:.w:..A~ ~
-Lw=
lgrrti#irtt#r. of Orrixpttnry - ~
,
eitp uf (Eagan .
t~ Eeparimrtti irf BuilDmg Insprrticm ~
Tbir Cntificatc irtutd purtaant to the rrquirementt oJ Satiott 306 0( the Uniform Build'mg
Cale cMifyiag thst ut the timt of iuuatta thit ttracttrtt wret in tomPliartrt with the varioat
ordinanta o f the City ngulating bnildmg ronn+urtiors ar ax. Far the /o!louRng:
{ f
y~
U. cyydg.ym STATION/STORE Bldy. Po~t Na. 4972
i
~ a awwnr~YVa FZ iYwc~um F„~z III zo.ft oman
-$uperAmerica PO Box 24$,St.Paul Park,MN~ . '
w~ o.. dsmmu A"de~ b~ . A
~y1 42nC1 Sibl Parcel #10 01900 01058
~ 6a e~amn,we. a~ MPm_HwvtAwny i 'i
k
BmMwoffi.W Februapy 13, 1980
~
« - : .
SUPER ArERICA nELI CITY OF EAGAN NQ 16140
3830 Pilot Knob Road, P.O. Box 31-199, Eagan, MN 55121 ~
PHONE:454-810P
BUILDING PERMIT Receipt #
INTERIOR
To be used for IMPROVEMENT Est. Value $21,000 Date 64 :eT , 1989
$itBAddreSS 4900 STATFV MRMORTAT. NWY
Lot I Block 5$_ Sec/Sub. SECTION 19 OFFICE USE ONLV
PefC01 NO. Occupancy B-2 FEES
Zoning -
w Name SUPER AMERICA (AClual) Const - Bldg. Permil 216.00
o AddreSS 1240 W 98TH ST (Allowable) - Sumharge 10.50
city RLOOMINGTON phone 887-6100 #oisiodes -
Lang(h _ Plan Revlew 108.00
, o Name SAME oepm - SnG ciiy
84 AddreSS S.F. Total - SAC, MCWCC
~ Cl(y Phone SF. Faotprims _
On Site Sewage _ Water Conn
ww Name ROMAN MUELLER On Sile We0 - Water Meter
Address SAME MWCCSystem - qccLDeposit
aw City PhOf1B CiryWater -
PRV Required _ SN1 Permit
I hareby acknowlege that I have d th applic ion a te that ihe Booster Pump - Syd Surcharge
intormation is cortect and agr co ly wit all ap c le State of
Minnesota Statutes and City gan inanc . Treatment PI
Signature ot Permitee - APPROVALS Road Unit
A Builtling Permit is issued to: Planner - park Ded.
on ihe express corMition that all work shall be done in accordance with all Council -
applicable State of Minnesota Statutes and City of Eagan Ordinances. gyy. pry Copies
euilding ONicial 'n. n11,or f~d variance - 7orAL 334.50
CITY OF EAGAN N2 17364
3830 Pilot Knob Road, P.O. Bo2 21-~9, Eagan, MN 55121
PHONE: 454-6100
BUILDINGPERMIT Receipt#
To be used for INTERIOR Est. Value $5,000 Date DEC 7
IMPROVE T , 1989
Site Address 4200 SIBLEY MEMORIAL HWY
Lot 1 Block 58 SeclSub. SECTION 19 OFFICE USE ONLY
Parcel No. ocaPancy - Fees
2oning _
w Name SUPERAMERICA (Actua1) Const - BIdg.Permit 72-00
; Address 1240 W 98TH ST (Allowable) -
° Surcharge 2.50
Clty BLOOMINGTON PhOne 887-6100 #otSmries -
Lengih _ Plan Review
o Name KR6IIS ANnFRSf1N ('(1N9TRIiCTT0N Depcn - SAQCity
i~
~a Address 75f1(1 MTNNFHAHA AVF S.P.TOIaI -
" SAC
Clty MpLS Phone 791-]S$1 S.F.Footprinis _ ,MCWCC
On Site Sewage _ 'Nater Conn
r¢
W w Name On Site Well - Waler Meter
Address MWCCSystem _
Acct. Deposit
iw Clty PhOnB City Water _
PRV Required _ SNJ Permit
I hareby acknowlege iha[ I have read this lication and state ihat the gooster Pump - SNJ Sumharge
inbrmation is correct antl agree lo comp ith all applicable State ol
Minnesola StatNes and " f Eagan Or r anc s. Treatment PI
Signature ol Permitee APPROVALS Road Unit
A Building Permit is issued to: KRAUS ANDERSON CONST Planner - park Ded.
on iha express Condition that all work shall be done in accordance with all Council
applicable Slaie of Minnesota Statutes and Ciry of Eagan Ordinances. gldg_ pff_ _ Copies
Variance ~ . TOTAL 74.50
BuildingOflicial Q(,l~
(NEW FASCIA oN STORE) Y OF EAGAN
~y?~'~ 3830 Pilot KnW R. P.O. Box 21-199, Eagan, MN 55121 NO 18221
P ONE: 454-8100
BUILDING PERMIT Receipt #
7o be used for REMODEL Est. value $10, 000 Date AUGUST 1 19 90
Site Address 4200 SIBLEY MEMORIAL HWY
LOf 1 BIOCk 58 SBGSUb. SECT. 19 OFFICE USE ONLV
P8fC0l NO. Occupancy - FEFS
Zoning
w Name SUPERAMERICA (ACtuaqConst _ 81dg.Permit $117.00
3 Address 1240 W 98TH ST (Allowa6le) - 5.00
0 City B1A10MINGTON Phone 887-6100 k of Stories _ Surcna~ge
Lenglh _ Plan Review
iF Name SAME Depth - SAQ City
QQa Address S.F.Total - SAC,MCWCC
~ City Phone S.F. Poolprints _
IN On Sile Sewage _ Waler Conn
Name On Site Well - Waier Meter
Addf@SS MWCCSystem _
OIfy PhOf1B Ciry Water _ A~ct. ~eposit
PRV Required _ SM' Permil
I hereby acknowlege thaCl have read this application and state that the Booster Pump - Siw Sumharqe
inlormation is correct and agree to cOrdinces ith all applicab le Stale of
Minnesota Statutes and City of Aan Trealmem PI
SignaNre ol Permftee ~ . f APPROVALS Road Unit
A Building Permit is issued to: SUPERAMERIC Planner - park Ded.
on ihe express condition that all work shall be done in accordance wilh all Council
applica6le Slate of Minnesota tatutes and ity,of Eagan Ordinances. Bldg. Oo. _ CoPies
8uilding OtfiCial ~ Vanance - TOTAL $122.00
. ~
EAGAN TOWNSHtP
BUILDING PERMIT N? 2337
Owaex i..~F.4.q!,r.4~.~.......... o.....' Eagan Townahip
Addresa (Presen!) ..?.?'^.'~'~:...~3..d......:...1`~..~:.._.... Towa Hall
U ~ )
Builde: .......it..a..-~: `c^.'.~........_'--•°-° .
0 Dase .._~~.'~3 a ~70
Address
DESCAIPTION
5toriesI To Be Used Fox Fsoni Deplh FIeigh! Eai. Cos! Permlt Fee Aemarks
LOCATION
8lreel, Aoed oe othar Deecxiplion oi Loeelfon I Lo! S1oek Additioa os Tzac!
D/n 5Y /e eio.,a 4/0•92'
7'his permit doea aot authorlse the use of elseels, roads, alleys or sidewellea nor doee it give the ownes or Lia agen!
the righ! !o ereate anp silvafion which ia a auisaace or whieh presenYs a hasard !o the health, eafely, eonvenieace and
geaesal weifare 2o anpone in !he eommuaifp.
TFIIS PERMIT MUST BE JFEPT ON THE PAEMISE WAILE THE WOAK IS IN PROG SS.
This ia !o eerlitp, lhai--,~t,f has pexmission fo erect the above deacrihed premise ubjee! !o the provisioas of the Building Ordinenoa for Eagan Township adopled Apsil 11,
1955.
,7:'"'__!..:'.'.-..~:':._.......... Per ................IL1'.-ytL~:.. 17 .._.~-'C°-ta..
Cheirman~of Tnwn Board 6 _.y Building Inspeclor
, t /4 D/9o0 O/l 58~
MASTER CARD
• LOCATION 30
OWNER C?~W1e KiCa
STRUCTURE AND
LAND USED AS ///t0h
Issued To
Permi} No. Issued Conirecfor Owner
BUILDING ~6 ~O O
PWMBING
CESSPOOL - SEPTIC TANK
WELL
EIECTRICAL
HEATING
GAS INSTAILING
SANITARY SEWER
OTHER
OTHER I
• Approved
Items (Initial) Date Remarks Distance From Well
FOOTI NG SE PTIC
FOUNDATION CESSPOOL
FRAMING TILE fIELD FT.
FINAL
ELECTRICAL DEPTH
HEATING OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
'DY-- 7 I
• Violations Noted
on Back
COMMENTS: '
I
i .
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
•
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE ? NOtJ-COMPLIANCE. BUILDER DOES NOT
OBSERVED. INTEND TO COMPLY.
ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS. ? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
NON-COMPLIANCE. BUILDER WILI COMPLY
WITHOUT DELAY.
ITEMIZFD 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 otserved to be at variance with ordinances o4 the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the propeny inspected.
~ ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPEGTOR DATE
COMMENTS:
•
~-r;y sa
. , , 1989 BQILDING PfiRMIT AP~LICATION - CITY OF fiAGAN
SIIPGLS FAMILY DWELLINGS l 4 1110
I
" INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTEs ADDR&SSES F08 CORNER LOTS - COPTRACTOR/HOMEOWNER MQST DESIGNATE i1flICH ADDRFSS
IS DESIRED. NO C9ANGES NILf. BE ALLOWED ONCE EIIILDING PERHIT IS I3SOED.
MULTIPLE DWELLINGS RENTAL ONITS FOR S9LE OBIT3 • OF U9IT3
INCLUDE 2 SETS OF PLANS, CERTIFIC9TE OF SORVEY - CHECS WITH BLDG. DEPT., 1 SET OF ENERGY
CALCULATIONS
COIRMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIDNS
AEC'D FEB 1 '1989
To Be Used For: ~ tLi A2EA Valuation: p ZI o_ Uate:
~
• Site Address 1~1-08 yrtnfxag 2)-oaL Ra OFFICE O5E ONLY
Lot ~ Block Oceupancy FM
2oning I_
Pareel/Sub Actual Const Bldg. Permit 21 6, LV
Allowable Sureharge 01S0
Owner JUPERAmE2IcFl A of stories Plan Review D8r00
Length SAC, City
Address 12 4 0 W. 58TM' S7- ' Depth SAC, MWCC i
S.F. Total Water Conn
City/Zip Code 9L.oorvtiniGroal 'Lj+v 5~43 Footprint S.F. Water Meter
Aect. Deposit ~
Phone 612- -g-S-7 -6 [oo On site sewage- S/W Permit ~
On site well S/W Surcharge ~
Contractor $E f- MWCC System ~ Treatment P1.
C3ty water _ Road Unit
Address 1.1-4o w R8 T' Si PRV required _ Park Ded.
~p Booster Pump _ Copies
City/Zip Code D Loo"vii,~~i7~n1 _ T~T9I'
APPROVAI.S
Prione R5ii-G l o 0 Planner _
Council
Areh./Engr. IZo Mw-nc Bldg. Off.
Variance
Address ~2.4-o Wq87~L S i Couneil
City/Zip Code ?)LQQwtuu~-7a,J ON sst34
Phone # ~l FC 7-G I o O
NOTE: 3exer & Water Permit fees and account deposit fees tirill be ineluded in the building
permit Fee. Processing tlme for sexer and water permits is bwo days onoe a licenaed
plumber has applied for a permit at City Aall.
1989 B[TILDIAG PER;iTT APPLICllTION
CTTY OF H1GAN
q .3
SINGLE FAMILY DWELLIBGS !&ILTIPLE DYiELLINGS COtRMERCIAL
2 SETS OF PLANS 2 3ET5 OF PLAt13 2 SE15 OF IRCHISECTURAL
3REGISTERED SITE SURVEYS BEGISTfiRED SITE SIIRVEYS - A STEOCT9RAL PLiNS
t SET OF E[iEAGY CALCS. (CHECB iIITH BLDG DIY. ) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALC3. 1 SET OF ENERGY CAI.CS.
MULTIPLB D1iELLINGS AENTAL OHITS FOR SALE pNITS f OF UBITS
90TEt ADDRFS3ES FOA COANER LOTS - COATRACTOR/80MEOiiNER MOST DESIGAIiE iiHICH iDDRFSS
IS DFSIRED. 60 CH9NGES i1II.L BE ALLOftED ONCE HtlILDIAG PERMIT 14 ISSOED..
SEiiER 8 WATER PERMZT FEES LAD 1CCOONT DEP03IT F6S3 WII.L HE INCLODED WITH THE HOILDIN(i
PERMIT FEE. PAOCFSSIHG TIME FOR SEWEA ARD WATEA PERMITS I3 Ti10 DAYS ONCE d PEAMIT 6A5
BEEN CONIPLETED IHDICATING A LICENSED PLUlBER.
PENALTY iPPLIES S3HEN: PERMIT IS NOT PAID FOR IN SAME MONTH IT IS REQ[TESTED.
LOT CHANGE IS REQDESTED OA7CE YERMIT IS ISSIIED.
To Be Used For: Valuation: ` n-i, Date:
Site Address OFFICE D5S ONLY
Lot ~ Block J'r-g Oceupancy FEES
Zoning
Pareel/Su6 ,~3 eeTlcny ~R Actual Const Bldg. Permit ~12,00
Allowable Surcharge a,5a
Owner SG ~P r a tx, r v r c 0. A of stories Plan Reniew
Length SAC, City
Address ~~/p [,r~rt1 Cl~~~ Depth SAC, MWCC
S.F. Total Water Conn
City/Zip Code 31iIM r f-C-2(1'4TAw~ Footprint S.F. Water Meter
' Acet. Deposit
Phone ~iF )-/D/p7l On aite aewage S/A Permit
On aite xell S/YI Surcharge
Contraetor /~rnu fAudn.s r~ 6v t~• MWCC 3yatem _ Treatment Pl.
Citq water Aoad Unit
Address /PNV required _ Park Ded.
Booster Pump _ Copies
City/Zip Code /G(/~C/, ,(7irll, 5'G~ yoy 3UBTOTkL
APPROVALS Penalty
Phone Planner _ iOTAL .47
Couneil
Areh./Engr. Bldg. Off. t(1
Varianee
Address
City/Zip Code
Phone #
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERiviIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
~1 PERMIT MUST SHOW A LICENSED PLUMBER.
{Ve' vj rc.sCion o n S6v e~ - so,rnc as L~ I, Sv f e6- Fr.w~/`i C.~
~ ~ ~
To Se Used For:/I 1CtiV1~ 'L1 Valuation: Date: ~ D
Site Address +'P-od Sj bMen"1•~ 11 OFFICE USE ONLY
Lot ~ Block S O l FEES
Occupancy
Zoning
Parcel/Sub R' C'~ Actual Const Bldg. Permit
X Allowable Surcharge
Owner ~amQ"~I CG. # of stories Plan Review
( Length SAC, City
~ Address ~40 L.J • C~~~'\ Cj~}- Depth SAC, MWCC
( S.F. Total Water Conn
City/Zip Code Footprint S.F. Water Meter
7 J ~ ~ Q Acct. Deposit
Phone l On site sewage_ S/W Permit
On site well S/W Surcharge
Contractor ~ G\ yn c-, MWCC System _ Treatment P1.
City water _ Road Unit
Address PRV Park Ded.
Booster Pump _ Copies
City/Zip Code SUBTOTAL
APPROVALS Penalty
Phone Planner _ 1'OTAL
Council
Arch./Engr. Bldg. Off.
Variance '
Address
City/Zip Code
Phone #
~
.1 ,
minnesota department of heaith
0 717 s.e. delaware st. minneapolis 55440
(612) 296-5221
. oQtY#~ 301, W4 ~^^a`
G~
~ 19j9
Sup~r Axwt~cts itt8.
1240 Wan 98th gtmeac ~ ~
tloen4aStono Himesau $5431 Ap- L 9
Contlwnes+
Rat Yl+ad>ing faz liagsr 1motriea 8" Isatiou xieth Dsli, in tiasep,
!litaarsara,.
fie ssra en¢lasiog s aop' ei anr r*part eawxstaX ont axaefnatian af
p1aeu aad apaeLifaatf.nnr oa khn aiwe-Aasilgnsroi projrct.
tans astsrttion. to tirsatsd to sho xttaain+aQ .tuement pore.lpise
to ittpfttisn ef thk pfroohieg. It !o IMareomt t1+:2 ws xse+eies
the iatarastfotx tnd#e*tad ia ardez Lhae r.tea wwarrary iaspeatiow
vwY be ar+ule.
Tha ptaes asnd oyecif3asa6foas apPwpe Ro !e $a gafetai Genfarrerity
vitla tLe rCmctarda at t1?in DaparGimt. Whan du prajaat 5:s
aonplrted. Plarae temmuaiaata trith !r. J(a wit*oralc#. Saaita:im
in eux betuapai4r.as+ Bi.xrlae oi3ies in niasae+peiisr in ssftv tARt
ke suy wao* finsl i"Dmtitat.
if pvu tuvn ang qwsttotta in r+agarA te eha p,ufaswatioi? •asbainad
fu this itiporCi yltasxe renCSct lbr. fAtr1 1. Yau" bf liti9 affbW
t~f.g96-5~27?.
YetUt11 pfY ttu17•
Gary L. lAgtando P.E., t9c5sf
1{4ati.am oL Water 6t+ppiq
t~A asnaxs1 i~gi~rrait~
~rt+elaeet~a
Cac Mz. Jim Th+aopsea. 9P."isert
. M1"• D$1$ ~Ps~s"$1'fmY ciQy ~lbsy 1CtsQoctQr,/
an equal opportunity employer ~ 3
- _ ~
i
PfINidi:SO'C:t Dir:YAH'I'MF:?i'l' PY IIIiA1:Cf1 . .
. Division of 'ci:vi.ronmeuc:il ilGalth
RL'11011'1' Ot~' YLANIS i
Plans and Speciticatiens on Plumbing_for Super Amer}ca Gas Station with Deli
-
i
Location _ Eagan= Minnesota _
Date F.xar.iined September 11, 1979
Prepared and Subcaitted by Jim Thompson; Engineer, 3040 Inglewood Avenue South,
Mir.neapolis, Minnesota 55416
Date keceived Sepiember 4, 1979 Plan Eile No., A-4576
Ownership - Super America, Inc.', 1240 West 98th Street, Bloomington, Minnesota 55431
Scope - This exanination is limited to the design of this particular groject only
and irsofar as the provisions of the Minnesota Plumbing Code, as amended; apply ar.d
• does not covcr the water suppiy or sewerage system to Which this plumhing system is
conaec:ed.
Conclusion
These plans and specifications comply with the provisions of the Minnesota Plucnbing
Code, and are reco;,onended for approval with the undeistanding as stated in the
preceding oaragraph, aad with the usu>1 reservations as stated on the 2ppendzd
sheet entitled, "Infornation Relative to Plan Examination."
\ C1iin.(I,~uZ
°aul T. PoR8gG5, P.E
Pu61ic Health Engineer Section of Water Supply
App~d:. ~ and General Engineering
F~
aul B. Jo6 son, , P.E.
Senior En~q~ neer
Sectior. Sdater Supply
.and General Engineeriag 8
MINNESOTA DEPARTMENT OF HEALTH
Division of Environmental Health
Information Relative to Plan Examination
The examination of plans and specificationa for water supply and sewerage systema
(Regulation MHD 136(a)), plumbing systems (RegulaCion MHD 139(a)(1)), and
awimming pools (8egulation MHD 141(c)), is made to pxovide information concerning
the sattitary features of projecta presented for consideraCion in accordanee wiYh
the above regulations of the Commisaioner of Aealth. The approval of such plans
is given upon the eupposition that the avrvey and other data on which the design
ia based are correct, and that necessary legal authority has been obtained to
conatruct the project. The responsibility for tte deaign of structural features
and the efficiency of equipment muat be taken by the engineer or architect who
designa the project.
Water supply plans are exsmineu with regard to the location, construction and
operational featurea of the design and maintenance of all parts of the system which
may affect the eafety and sanitary quality of the water. Examination is based on
the standards of this Depaxtment.
P1ana of sewage disposal systems considered by this Department are limited to those
syetems that can utilize soil absorption. They are examined with regard to the
features of design which concern Location, construction, operation and maintenance
of the system and which may atfect the public health. The examination is based
upon in£ormation contained in the lulletins entitled "Tentative 5tandards for
Design af Small Sewage Works," July 1962, and the recovmended "Ordinance and Code
Regulating Individual Sewage Dispoeal System," 1971.
Plans on pluinbing syatems are examined only ineofar as the provisions of the
Mianesota Plumbing Code apply.
Swimmiag pool plans are examined with regard to the features of location and design
which may affect the safety and sanitary quality of the wster for public bathing.
The examination is based upon Regulation t4FID 141, Public Swimming Poo2s.
The Commisaioner of Health zeserves the right to withdrsw hia approval of plans if
construction of the project is not undertaken within a period of two years. The
fact that plans have been approved by the Cort:mieaioner of Health does not
neceasarily mean that recommendations for alterationa or additions may not be
offered aC some later time when changed conditions or advanced knowledge make
improvements neceseary.
MINNESOTA DEPARTNEIiT OF HEALTH
Division of Environmental Health
Plumbing Inspections
Special care should be taken to insuxe that the material
and installation of Che plumbing system are in accordance with
the provisions of the Minnesota Plumbing Code. It is necessary
that the State Health Department make roughing-in and final
inspections of the plumbing system to determine whether it complies
with the Code. Provisions should be made for applying an air
test at the time of the roughing-in inspection as outlined in
MHD 134 of .the Code. In order to facilitate this work, there
is attached a self-addressed card which should be returned,
indicating the name of the plumbing contractor so that arrange-
ments can be made for the State Health Department to be notified
by him as to the Cime that the installation wi11 be ready for
test and inspections.
No acceptance of the plumbing installation can be given until
the inspection and test of the roughing-in work (N?HD 134(d)(1)),
finished plwnbing (11HD 134(d)(2)), and the inspection of the
completed installation have been made by a representative of the
State Health Department and found to be in accordance with the
provisions of the Code.
m
SAINT PAUL PARK, MINNESOTA 55071
SUPERAMERICA~ POST OFFICE aoX 9
9 W. BROAOWAY
DIVI9iDN OP 46XLANG OIL, INC. 612-459-1155
October 27, 1978
City of Eagan
3795 Pilot Knob Road
Eagan, MN 55122
Subject: Storm Sewer Trunk Assessment - Burnsville, Minn.
Your File-Section 19,
Gentlemen:
Reference is made to your Notice of 5pecial Assessment dated September 29,
1978, copy of which is attached.
Also attached is Superamerica check no. 74456 for $3,227.80, representing
payment in full for said assessment.
Yours truly,
W. W. Sei ert
Manager, Real Estate
RWJ:db
Encl.
h 5 s,
P
~
~w SuperAmerica Group, Inc.
veclf 70 1240 West 98th Street
Bloomington, MN 55431
SUPERAMERICAe (612) 887-6100
(612) 887-6158 FAX
May 16, 1996 ~~~~~~~J [E D
("!r'4Y L O I996
Mr. Mike Ridley
City of Eagan Planning Office
3830 Pilot Knob Road
Eagan, MN 55122
RE: Proposed Car Wash
SuperAmerica Store #4049
6512 East Highway 13
Eagan, MN
Dear Mike:
This will confirm our proposal to construct a free-standing car wash structure to be
located north of the exisring SuperAmerica Store at the above referenced location. We
originally contacted you last fall and forwarded a preliminary site plan and tree inventory
for your review.
As requested today in our phone conversation we are re-sending the information for your
review. We would also like to confirm the following preliminary plan review comments
noted last fall:
1. The proposed wood trash enclosure was approved with doors to provide screening on
all sides. Attached is a copy of the proposed details for the enclosure.
2. The two (2) existing outside salt-storage-sheds will no longer be allowed and must be
removed from the site.
3. Per your request we had the existing softwood and hardwood trees inventoried to
deternvne if the number of trees proposed to be removed complies with the city tree
ordinance. We have deternvned that our proposal does comply with the tree
ordinance. A copy of the study is attached.
4. All new drives proposed for the car wash shall have a curb and gutter.
5. We were informed that we do not need to go before Planning Commission and City
Council for approval.
Please review the attached information at your earliest convenience. We have started the
process of completing bid documents and will forward a copy to you for your review and
SUBSI6IARY OF ASHLAND OIL, INC.
Letter to Mike Ridley
Page 2
approval before they are finalized. We are hoping to start construction around July 1. I
will telephone you early next week to discuss any concerns you may have. As always,
Feel free to call me if you have any questions at 887-6157.
Sincerely,
~Jerry V. Narlock R.A.
Proj ect Manager
cc: Roman Mueller - SuperAmerica Group
Attadunents
c:\jeay\4049Ve11e2.doc
L / s
svsn
NEW RECEIPT #
RECEIPT DATE
DATE /
TO /5-
j[)b Zrs~j /7`''u/,-V
OWNER
- -T - -
PLEASE BE ADVISED THAT THERE IS A FEE SHORTA6E ON THE ABOVE
ELECTRICAI, INSTALLATION IN THE AMOUNT OF $ 1 Z
- REMARxS
0 - 30 AMP CIRCUITS = - _
- 31 - 100 AMP CIRCUITS =
0 - 100 AMP SERVICE
101 - 200 AMP SERVICE _
TOTAL FEE DLTE
LESS F'EE RECEIVED
TOTAL FEE SHORTAGE DUE
PERMIT # 7 3 ~ -
ORIG RECEIPT #
- RECEIPT DATE G
PLEASE RETURN A COPY OF T$IS FORM WITH YOUR REMITTANCE.
THANR YOU
2005 CONIMERCIAL BUILDING PERMIT APPLICATION
City Of Eagan ~ lb~ 1
, 0
3830 Pilot Knob Road, Eagan Mn 55122 -r~
Telephone # 651-675-5675 FAX # 651-675-5694
x RMVMMME- a o a
a o. x ~
. Structural Plans (2) sMs • Architecturel Plans ~ (2) sets • Archftectural Plans (2) sets
. Civil Plans (2) • Structural Plans (2) • Code Analysis (1) "
. Certificate of Survey (7) • Civil Plans (2) • Project Specs (1)
. Code Analysis (1) " • Landscaping Plans (2) • Key Plan (1)
. Prqect Specs (1) • Code Analysis (7) " • Master Exit Plan (7)
. Spec. Insp. 8 Testing Schedule " • Certificate of 5urvey (1) • Energy Calculations (1) not always"
. Soils Report (1) • Spee. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always"
. Meter size must be established • Meter size must be established • Meter size must be established-If applieable
4 . Project5pecs (7)
1 • EnergyCalculations (1) " L
1 . Electric Power & Lighting Fortn (1) " 1
y . Master Exif Plan (7) y
1 • Emergency Response Site Plan (1)
y ~ . Soils Report (1) 1
• SAC delermination - call 1-602-1000 • SAC determination - call 651-602-1000 • SAC determination - call 651-602-1000
• Fire Sto in SubmiNals
Call MN Dept of Health at 651-215-0700 for details regazding food & beverage or lodging faalities.
Contact Building Inspections for sample and if required
Peani[ for new building or addition will not be processed without Emergency Response Si[e Plan.
Date 7 / o S Construcdon Cost t, So„o Do 0 -C)e
5iteAddress L1a.00 f• . Me~nnrria~~ UnitlSte #
Tenant Name S~erA ~-•,C'~ Former Tenant Name
O\~ l~
Desc~77ption of Work -I j
Property Owner 9~_c 11--Z V.1i~ S UJkE.fP- C?S Telephone 9 3-1) r~6 3- 16 ~-2--
Contractor Cla«o`^wo ~ S,.,-
Address 94,~1 c) City
State M+J zip 553 69 Telephone #(16) ) 4a~- 3 3~i 1
Arch/Engr V Q(A-N Registration #
Address City
State Zip Telephone 93 ~(Y~ 3..,'~ 9 Q
Licensed plumber installing new sewer/water service: Phone
I hereby apply for a Commercial Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work wh'ctt~equires~ ,
approvalofplans. ~1~
~ , ~l~T 0 4 200` '
ls+ ef{~cT J,,
Applicant's Printed Name Applicant's ~ Signature
-
OFFICE USE ONLY •
Sub Types ,
? 01 Foundation ? 26 Public Facility ? 30 Accessory Building
? 14 Apartrnents EY 27 CommerciaUlndustrial ? 32 Ext Alt-Apartments
? 15 Lodging ? 28 Greenhouse ? 34 Eart Alt-Commercial
? 25 Miscellaneous ? 29 Antennae ? 35 Eact Alt-Public Facility
? 37 Nail Salon
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (interior) ? 44 Siding
? 32 Adddion ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
Ei"/33 AReration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant
~
Valuation J~v~ b G Type of ConstWidth 'J
Plan Rev 1D0%,&_ 25% _ Occupancy MCES System ~lt.5
Census Code ~3? Zoning ~ City Water
SAC Unfts Stories ~ Booster Pump ~
Nbr. of Units Sq. Ft. PRV -
Nbr. of Bldgs ' Length ~ Fire Sprinklered M
Required Inspections
_ Footings (new bldg) _ Fireplace _ RI. _ Air Test _ Final
_ Footings (deck) Insulation
_ Foo[ings(addition) FinallC.O.
_ Foundation FinaUNo C.O.
Drain Tile Other
_ Driveway Apron _ Pool _ Ftgs _ Ait/Gas Tests _ Final
Roof Ice Pr Decking _ Insul Final Siding Smcco Stone
? Framing Windows
r
Approved By: rlf2_~ Planning Building Inspector
8ase Fee 6 q~,o~s
Surcharge 115,06
Plan Review Z{!91
7~0
SAC-MCES
SAGCity
SIW Pertnit
SIW Suroharge
Treatrnent Plant Financial Guarantee ~
Treatment Plant (Irrigation) Storm Sewer Trunk
Park Dedication Sewer Lateral Sewer Trunk
Trail Dedcation SVeet '
Water Quality Water Lateral Water Trunk
Water Supply & Storage (WAC) Other
Total ~~D$g, O!
s o S 61
2005 CONLMERCIAL PLUMBING PERMIT APPLICATION
~ CITY OF EAGAN
~p. 3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Date 11 / ftz l o5
SiteAddress y°2.on t. t~P~aNP?'VnlyVIaI Unit#~
TenantName Su~zv~zv~ner. k c.G Former Tenant Name
PropertyOwner Telephone )
Contractor Ca4xAo-XV
Address "-13 \1 Lo,k~ Ov=.v~ City L~~^o ~--w~4S
State ~N Zip ~ 5p ~y Telephone # (&Sk) -1 ~Co-3 S S` S
License# Expires: 1z(3k to 5
The Applicant is _ Owner Contractor Other
Work Type New Bldg ?'Modify Tenant Space RPZ PVB New Repair/Rebuild _ Replace
_ Irrigation system Work within public right of-way/easement _ Yes _ No
Rain sensors are re uired on irri adon s stems
Description of Work ro.~l.- -r~ ~or 5'N~c kc~'aa- ~b-k
To inquire if P'Itssum Reducin alve is required on new service, call 651-675-5646
Meters - Ca11 65 1-675-5 300 to verify that hydrostafic, conductiviry, and bacteria tests passed prior to pickine uo meter.
ImgaNon Size & Type Avg GPM 2" turbo req'd uniess smaller size allowed by Public Works
Fire Size & Price 3/4" disolacement $161.00
Domestic Size &.Type Avg GPM includes high demand devices? _ Yes _ No
Flushometers _ Yes _ No PRV Required _ Yes _ No
Permit Fee $50.50 minimum (includes State Surcharge)
c~
ContractValue $ x 1% PemutFee
$ Meter(s)
Required on all new buildings & boulevard iaiearion systems $ Radio Meter Read
If permit fee is $1,000 or less, surcharge is $.50 $ State Surchazge
If permit fee is over $1,000, surcharge is $.50 per $1,000 of the Permi[ Fee
Foltowing fees apply only when installing new irrigation system $ ~ Water Permit '
Call Jeay Wobschall at 651-675-5024 for required fee amounxs
$ TreatmentPlant
$ Water Supply & Storage
$ State Surcharge
------------------SQ- S
-
$ Total Fee
I hereby apply for a Commercial Plumbing Pem'tit and acknowledge that the information is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; thaz I understand this is not a pemut, but only an
application £or a pemvt, and work is not m start vrithout a permit; that the work will be in acc {dance wi[h the app ved plan in the case of work
which uires a review and approval of plans.
ne~.+.i ~evavd,
ApplicanYs Pnnred Name App~ Ps pature
1
CITY USE ONLY
REQUIRED INSPECTIONS: _ U.G. _ Air Test _ Gas Test _ Rough In _ Final
PLANS SUBMITTED APPROVED BY: , BUILDING INSPECTOR
General Information
• Radio Meter Read (required on all new buildings & boulevazd irrigation systems- $141.00
• RPZ's must be tested every yeu and rebuilt every five years. Test results should be mailed to Paul Heuer at the City oF Eagan.
• A minimum fee pemut per address is required for the following RPZ's: new, rebuild, renair, remove.
• Water meters include copper hom/strainer, remote wire, and toucb-pad meter.
METERS REOUIRING 4-HOUR ADVANCE NOTICE PRIOR TO PICK UP
GPM METERS USE PRICE GPM METERS USE PRICE
1-20 5/8" residenrial $125.00 4-120 1-1/2" irrigation syst $ 735.00
displacement sm commercial turbine*' public Works
maximum must approve
continuous meter size
10
2-30 3/4" lawn irrigarion $161.00 4-160 2" turbine lg irrigation syst $ 931.00
maxitnum displacemem residenrial &
continuous sm commercial production lines
15
3-50 1" displacement very lg res $296.00 1/4 to 160 2" compound bldgs over $ 1,849.00
bldg to 24 units 65 uniu
maximum sm commercial &
continuous Bc lg comm bldgs
25 irri arion s stems
5-100 1-1/2" bidgs 25-64 units $429.00
maxunum displacement &
continuous most comm bldgs
50
METERS REOUIRING 30-DAY ADVANCE NOTICE PRIOR TO PICK UP
GPM METERS USE PRICE GPM METERS USE PRICE
5-350 3" turbine very Ig irrigation $1,182.00 6-500 4" compound +300 unit bldgs & $3,563.00
syst & production very Ig comm bldgs
tines
1/2-320 3" compound +200 unit bldgs $2,282.00 10-1000 6" compound +400 unit bldgs $6,076.00
very Ig comm bldgs very Ig comm bldgs
15-1000 4" turbine very Ig irrigation $2,226.00
syst
& production lines
Commenu
• To schedule inspection of the inside water line and backflow preventer, ca11651-675-5675.
• To arrange for water turn-on, cal1651-675-5300.
cc: Maintenance Division Clerical Technician January 2005
' C7TV :~IGP.N ' .
CASy=Er^+e 5 'E3MINpL NC!: 78 .
';4TE: , 72/25/97 T:itiE: G9e37^.12•
YD: ' ' . .
AAMEw COTTOP'NQOD Ct]AISTR'JCTIUN IN^
22t0 900; a20U SIH t~M. F'Jv • 574, r-,
342E 9G41 420p SI8 t`EM HW 373.5?
P155 9031 4200 5I' M:n H4S 25.a0.
?430 9001 4200 iIB MFM 'IW ' Z.00
. . , ' , • .
. 1
; ' . .
•M Yota' '~eceipt Amo+.rn+.: ' 974.34
+*CY . ' .
~ . .
7F~NnItY:7Y~k*`Y.~#7k7F7k "~:k7k**:kA'•7Kk~nk~k7c**7kA«:*#M
PERIVIIT
Cf i Y OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 029517
(612) 681-4675 Date Issued: 0 2/ 2 5/ 9 7
SITE ADDRESS:
4200 SIBLEY MEMORIAI HWY
LOT: 1 BLOCK: 68
SECTION 19
P.I.N.: 10-01900-010-58
DESCRIPTION:
.
nt~Permit Type COMM./IND. MISC.
_-1$uYlding Wo,r-k Type ALTERATION
Gensy:s Code 437 ALT. NONRES.
~A
j
. . . ' ' ~
'4...;;.v"`.~J`,•• y. {
REMARKS:
FEE SUMMARY:
VALUATION $50,000
Base Fee $574.75 COPIES $1.00
Plan Review $373.59 Total Fee $974•34
Surcharge $25.00
5ubtotal $973.34
CONTRACTOR: - Applicant - OWNER:
Cp7TONW00D CONST INC 24243341 SUPERAMERICA
92(t0 COTTONWOOD IANE 41240 WEST 98TH ST
MAPLE 6ROVE MN 55369 BLOOMING70N MN 55431
(.512) 424-3341 (612)887-6100
I hereby acknctwled9e that I have read this aRpl,ication and state that the
informatron is correct and agr'ee tti comply wi^th all applicable SCate of Mn.
5tatutes and City af Eagan Ordinances.
APPIICANT/P EE SIGNATURE -~ISSU D EfY. NA E
y ~ 49,6/11997 BIIILDING PERMIT APPLICATION (COMMERCIAL)
CITY OF EAGAN
681,4675 CU:~`v 0.°
The Mllowing are requirod with eppropriate certifica6on kr aIl Bm conaWCtion:
• 2 eacb: architetlural plans; mech. & elec. plans; fire eprinkler plens; struGuql plens; atte piens; landscaping plan6; gradinp/tlrainage/erosion control plan;
utilky plan
• 1 each: set of speciRcetions; cet ot energy calalatiorks; ebqrlcal power & iighling foim; Special Inspedions S Teatlng Schedule
~ Letter Trom MCANS (phone A222-8423) indieatlng SAC detertninaUon
• Code analysis frWicating: Caies uaed; oxupanq dassifications; setbedcs; maxhnum allowa6k aiae es per Builtling and City Codes elong xdth aq.
ft. per floor, ype ot construction (synopsis of eonstructlon camponenfs) & any oceupancy or area separatlon walls;
occupancy loatls; exit synopsis with a diagram indicaNng enRing toatla Nom eaeh room or area, travel paths 3 all reted
cortidors; plumbing faWres; and parking.
DATE: aZ ' I U~ 9~ WORK TYPE _ NEW _Y~ REMODEL
DESCRIPTION OF WORK: kz~~~
nr .
nLnV~ ~JLnsict~~~~rIn~~ V.+CJ1.
Q0o ~civniv(
~V~C
SITEADDRESS: f'FaOC) CriS'~ ~w4 13 E.a nr, SiG1e emoria,( PV?4
/ 90 D- O/O - S
LOT O( D BLOCK 5 g SUBD. 19 P.I.D. # )
PROPHRTY Name: S!n:eer- Ar-cfi c~ Phone 5~.&_11'41191a
OWNER
Street Address: 19,"4 0 W c5"\ 9 8~~ ~~c o\
~
City: State: i''.p_ Zip: SsLr ~I
CON7RAC7oR Company: Co~\7c~woctl 7n~.Phone#: 92,4'3141
Street Address: 9 a 4 0 C°1C~6`NV_10°J_ b^ c Alw oftpkp
city: /Y14- cr o~ t.- M/'\ Z;p: r04 p
ARCHITECT/ Company: S'kolf- Nrtf~ c~ Phone ZK2- 620
ENGINEER
Name: Registration
RECEIVEU
F EB 1 2 1997 Street Address: loL 4 0 W~sC 9' ~1~~ S`Cs ~ cC
BY: City: State: /Yt.` Zip. f~`t 3 I
Sewer & water licensed plumber (only H instaAing sewer 8 water): N0
I hereby acknowledge that I have read this application and state that the information is correct and agree to compry Nrith ail
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
t,y ! /Yy~ i
OFFICE USE ONLY •`m
BUILDING PERMIT TYPE
? 01 Foundation ,Q( 19 Comm./lnd. Misc. 0 21 Miscellaneous
0 18 Comm./lnd. 0 20 Public Facility
WORK TYPE
? 31 New A"~33 Afterations o 35 Tenant Finish
0 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actuaf) Basement sq. ft. MCNVS System _
IAIIrJ:ya!)le\ C iS
i i f~iv^^v e .
v.a} lr faaaa..~ -
i / . f oL'j. P.
UBC Occupancy sq. ft. Fire Sprinklered
2oning sq. ft. Census Code
# of Stories sq. ft. SAC Code 3 a
Length sq. ft. Census Bldg. ~
Depth Footprint sp. ft. Census Unit o
APPROVALS
P[anning Building sM8 Engineering Variance
Permit Fee Valuation: $ sO. voD, ~
Surcharge
Plan Review
MClWS SAC
City SAC
Water Conn.
S/W Permit
S/W Surcharge
Tr32:m=t D!.
Road Unit
Park Ded.
Trails Ded.
Water Qual.
Other +Copies I.00 4) ~
Total:
% SAC
SAC Units
Meter Size
16:00 RPR 12. 2006 FR: THERESR SCHOSTAG #34185 PRGE: 114
t w
~
C O U ~
ENVIRONMENTAL MANAGEMENT DEPARTMENT
GRDUNDWATER PROTECTION SECTION
14955 Galaxie Avenue • Apple Valley, MN 55124
952.691.7557 - Fax 952.891.7588 - www.co.dakota.mn.us
MUNICIPAL NOTICE OF WELL PERMIT APPLICATION
DATE: April 12, 2006
TO: Tom Colbert/Wayne Schwanz (EIvI) Fax (651) 675-5694
RE: Well Permit 06-738429 Wetl Type: Monitor well
Municipality: Eagan Environmental Specialist: Olsen
The Water and I.and Management Section of the Dakota County Environmental Management Department has received the
following permit applicarion for the well described. If you require further review of the applicarion or if you have any
questions or concems about iy contact the Environmental Specialist ]isted abwe or our office at (952) 891-7557. If there is
no response from your office withiii 24 HOURS (excluding weekends and holidays), we will assume that you have no
objections to the issuance of the permit. Please note that pennit issuance is always conditioned on the pennit applicant's
observance of and compliance with all applicable state, county, and municipal ]aws and codes.
W ell Contractor. Tltein Well Company
, Date Application Received: 4/11/2006
3 Anticipated Drilling Date: Time:
Anticipated Grouting Date: Time:
Property Owner: Speedway Super America Llc
Well Owner: Speedway Super America Llc
WELL LOCATION:
PLS Coordinates: 1/4, SW 1/4, SW 1/4 SW 1/4, Sec 19 Town 27 Range 23 ~
Street Address: 4200 ~Ele;{y~Pm , ;N ti. ~
PIN Number. 100190001058 ~
WELL INFORMATION:
Diameter: 2
Casing Depth: 5
Total Depth: 15
Static Water Level:
Aquifer:
COMMENTS: ~
~ ~
L
16:00 RPR 12, 2006 FR: THERESR SCHOSTRG #34185 PA6E: 2/4
• ~ ~
~
V N,~
ENVIRONMENTAL MANAGEMENT DEPARTMENT GROUNDWATER PROTECTION SECTION
14955 Galaxie Avenue - Apple Valley, MN 55124
952.891.7557 - Fax 952.891.7588 • www.co.dakota.mn.us
MUNICIPAL NOTICE OF WELL PERMIT APPLICATION
DATE: Apri112, 2006
TO: Tom Co1berUWayne Schwanz (EIvI) Fax (651) 675-5694
RE: Well Permit 06-738430 Well Type: Monitor well.
Municipality: Eagan Environmental Specialist: Olsen
The Water and Land Management Secrion of the Dakota Counry Environmental Management Depaztment has received the
following pemat applica6on for the well described. If you require further review of the application or if you tiave any
questiona or concerns about it, contact the Environmental 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 pennit issuance is always conditioned on the pemut applicanYs
observance of and compliance with all applicable state, counry, and municipal laws and codes.
W ell Contractor: Thein Well Company
Date Application Received: 4/11/2006
Anticipated Drilling Date: Time:
Anticipated Grouting Date: Time:
Property Owner: Speedway Super America I1c
W ell Owner: Speedway Super America L1c
W ELL LOCATION:
PLS Coordinates: 1/4, SW 1/4, SW 1/4, SW 1/4, Sec 19Town 27 Range 23
StreetAddress: 4200f3*mvag-13-E Sb~ec, r)e~r, }a~,
PIN Number: 100190001058
W ELL INFORMATION:
Diameter: 2
Casing Depth: 5
Total Depth: 15
Static Water Level:
Aquifer:
COMMENTS:
1E:01 RPR 12, 2006 FR: THERESA SCHOSTRG #34185 PRGE: 3i4
ENVIRONMENTAL MANAGEMENT DEPARTMENT .
GROUNDWATER PROTECTION SECTION
74955 Galaxie Avenue • Apple Valley, MN 55124
952.891.7557 • Fax 952.897.7588 • www.co.dakota.mn.us
MUNICIPAL NOTICE OF WELL PERMIT APPLICATION
DATE: Apri112, 2006
TO: Tom Colbert/Wayne Schwanz (EIv) Faa (651) 675-5694
RE: Well Permit 06-738431 Well Type: Monitor well
Municipality: Eagan Environmental Specialist: Olsen
The Water and Land Management Section of the Dakota County Environmental Management Deparknent has received the
following permit application for the well described. If you require furthec review of the applicarion or if you tiave any
questions or concerns about it, contact the Environmental 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 cvill assume that you have no
objeclions to the issuance of the pernrit. Please note that pemu[ issuance is always condirioned on [hc pernut applicanYs
observance of and compliance with all applicable state, county, and municipal laws and codes.
W ell Contractor: Thein Well Company
Date Application Received: 4/11/2006
Anticipated Driiling Date: Time:
Anticipated Grouting Date: Time:
Property Owner: Speedway Super America L1c
W ell Owner: Speedway Super America Llc
WELL LOCATION:
PLS Coordinates: 114, SW 1/4, SW 1/4, SW 1/4, Sec 19 Town 27 Range 23
Street Address: 4200 Higxway43 E S,61 e{r± f~ rz. ws~ <
PIN Number: 100190001058 ~ G
WELL INFORMATION: •
Diameter: 2
Casing Depth: 5
Total Depth: 15
Static Water Level:
Aquifer:
COMMENTS:
~
1E:01 RPR 12, 2006 FR: THERESA SCHOSTRG 034185 PAGE: 4i4
" .?`~v'_t~
ENVIRONMENTAL MANAGEMENT DEPARTMENT
GROUNDWATER PROTECTIDN SECTION
14955 Galaxie Avenue • Apple Valley, MN 55124
952.891.7557 - Fax 952.897.7588 - www.co.dakota.mn.us
MUNICIPAL NOTICE OF WELL PERMIT APPLICATION
DATE: April 12, 2006
TO: Tom Colbert/Wayne Schwanz (EM) Fax (651) 675-5694
RE: Well Permit 06-738432 Well Type: Monitor well
Municipality: Eagan Environmental Specialist: Olsen
The Water and Land Management Section of the Dakota County Environmental Management Department kias received the
following pernut applica6on for the well described. If you require further review of the appGcation or if you have any
questions or concems about it, contact the Environmental Specialis[ listed above or our office at (952) 891-7557. If there is
no responsa from your office within 24 HOURS (excluding weekends and hoGdays), we will assume that you have no
objections to the issuance of the pemut. Please note that peimit issuance is always conditioned on the pemut applicant's
observance of and compliance with all applicable state, county, and municipal laws and codes.
Well Contractor: Thein Well Company
Date Application Received: 4/11/2006
AnYicipated Drflling Date: Time:
Anticipated Grouting Date: Time:
ProperTy Owner: Speedway Super America Llc
W ell Owner: Speedway Super America L,lc
~I WELL LOCATION:
PLS Coordinates: 1/4, SW 114, SW 1/4, SW 1/4, Sec 19 Town 27 Range 23
Street Address: 4200 -1E, S:b~e 1~'k:rncs~~ c~ 4 v, -
PIN Number: 100190001058 C;
WELL INFORMATION: .
Diameter: 2
~ Casing Depth: 5
Total Depth: 15
Static Water LeveL•
~ Aquifer:
~ COMNtENTS:
a t~idi
[L..n •~rr-'~W ~~•S'~••rrr.-r.v ~w`y~l5 ~L~: . . 119LYAGSEOFTHt13IXPTCF
PORCEL 215C OF STH RfVt PLAT
N0145
~ 0 %N: . 1W15UOO1f5B
p FilName: SPEEDWAYSUPEkAMERICaLLC
in
13 Ovmer Ad9eZ 1: %e GROP9tTY TA%RECCPD^a
M ~~.2:53950M4WST
g ' 0 ct'/ SYMB: FIId%AY pi
~ ~ tf m z7: 95B40
t \t I `^'i
. .I 1 ~I 1 bg}5' ! Q ZOnBCOde: GB . , ~
C M1~ { Zi ~ ILl2CYd[: CY3B3@6lIBSS
is 1YM15@COde: RC
_ ~ ~ ~ Landlse Desc: PeW CammeMd -
o - - iFFLEY&0 - '
~ I
- a [3 Yav BJ[: 1419 0 laMYalc: 3912f10
o a+nN VaLts: zermo _
O ToW Valu: 67Bi00
!i
- ~ Sale Year: 0
_ i;i o sde r-wnm: a
_ o sah v": o
s, ~ I I o sam r.: o
O NeiTaz: 1fi694.52
•s w..n,cwn~zm
: s'..a.
Mp 5}SN).l1, t3%]) 69 Imeqe:551.11 SuMFeROr: ).SBJ6B66198atB96
owom J J
'062 ~100. S6
(9 ~ 2005 Application For Fireworks Sales And Storage
City Of Eagan
3830 Pilot I{nob Road, Eagan, MN 55122
Telephone 651-675-5675 Fax 651-675-5694
Return' a es:1=3 onl '
Apqlicant reauirements
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 and/or stored shall accompany 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. 387, Chapter 6, Section 6.53
Fireworks is required.
6. Fee upon application for retail seliers selling exclusively consumer fireworks-$350; all other retail sellers-$100 per
vendor annually payable to the City of Eagan.
7. The Fire Marshal or his/her designee will inspect the proposed location for selling and/or storing fireworks to
determine if it is a suitabie 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: 05/03/05
Applicant Name: CAII-1QttIlVE A. Ula4k9aq for SPEWtIAY 41PFRdMFRTCA TIC
Street Address: P.O. R'X 159D LICETSE DFFf. City: SPEtIIE=
State: CfIIO Zip: 45501-1580 Telephone ( 937 ) 863-6473
Business Name: 3JPHRX4ItICA # 4049 Telephone#: ( 651 ~ 836-2495 '
~~LpDO S;b" VYle.mar;4 Ff+`~l.wa.yZ~ Eyy~
Display Address: 4200 EASPHIQEM 13 AISb'VI17E, W 55337-1065
Retail seller selling exclusively consumer fireworks: _Yes X No ' 7svriich ~
X IndoorSales Outdoor Sales Dates: to to Temporary outdoor event means an exhibition or sale with a duration of 10 continuous d not occur
more than once every 30 days and more than three times per year or a combination of 20 days total in a calendar year. (See
Outdoor Sales of Fireworks)
Fee: Outdoor Sales-$350.50 All other retail seliers-$100.50
Fireworks are regulated by MN Statutes 624.20-62425. In addition to these state laws, all displays, sales, storage and use of fireworks
shall comply with City of Eagan Ordinance No. 387, Section 6.53 Fireworks and NFPA 1124 Standards.
I understand and agree to comply with all the provisions of 4rAUMERUE lication and the requirements of the issuing authority.
Applicant Signature
FP ~ qa~2 A. M]124~9~ aSsrsrars CjqlRo=
Fireworks Application
Page 2 of 9
Tennessen Warning
License Application
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.
App ic t Signa ure Dat- e
CA'nEumE A. 1I1V9CN ASSISTANI' (TNII2CxTFu
Authorization and Consent for Release of Information
('A'IHFRrn1F A. TOM9M for
I, SPEE3tAY STERAMEUCA IIL , 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 4or a permit to sell fireworks:
Name: UUW1KV CATHRm1F'' AM
Last First Middle
Date of Birth: 10/02/52 Driver's License RYDD5008 State OffO
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 3rd day of MY , 2005 .
Signature
L (q ('A'IHFR7NF A. TFII4~9~ ASSB7ANI' 01UPOIFIt
91
Fireworks Application
- Page 3 of 9
:
~
. •
4 fa
OFFICE USE ONLY
, , ; • DO NOT WRITE BELOW'TH_IS The Police Department has conducted a criminal background check on the aforementioned applicant.
Comments:
Police Department Representative Date
~ e 9~
Conditions of Issuance:
Background check completed and approved by EPD: x Yes _ No
Zoning approval X Yes _ No
Facility inspection complete and all violations corrected k Yes _ No
Insurance policy approved ~ Yes _ No ,
License approved b~ I~XQ IWLe,& Date approved:
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Iw ~ Z~Z' W~plry
M anaa~an ~ f @ a s: ~ e n
Wpa Smell Sm~ll I p
22
i. Caokle~ Cookl~s Cook4~ ~ a I U U ~ U i ~ ~ n G
I~ 6 8eaao~ul a~
6GIOw XBC HBC L° PrLn~ry
10PkPep
Ohqsy
CNCmxceu
P~eleWl m
<O T y
a n-1 ~4 n~ GhpM1y O
S ~;p
w^ xaw.oaoers e a reu
ow w~ m
Building Type: Medium Non Standard
SSA Store # 4049
Burnsville, Mn
~ ProFloor 7/14/2004
. ~(4049 12082004) ~ Last Modified: 12/812004
~ Minnesota Division
Region 1& Region 2
250 L-es MAx Gross G~qht
FIREWORKS* Wl C~2.5L& PVro-&chnicConYenf
Guaranteed Product at 51% Margin hl0 S7"Di2AGE
A B
Item Descri tion Barcode Cost Retail Volume Volume
BC313-06 BC Momin Glo 715244010111 2.49 4.99 12 6
428010 420 Bamboo S arkler 652009991003 1.29 2.59 12 6
P9003 436 Momin Glo Winda 705108900336 1.34 2.99 24 12
BC230 BC Mammoth 715244002306 3.99 7.99 12 3
BC2008 BC Pot of Gold 715244020089 2.99 5.99 12 3
BC255 BC Ratta Tat 715244002559 2.99 5.99 12 3
BC277 BC Nuclear Meltdown 715244002771 4.49 8.99 4 2
LC1 Lar e Assortment Ba 652009001085 9,50 18.99 12 6
BC825 BC Ground Bloam 715244008254 4.49 8.99 20 10
BC336 BC Ba 5naps 75244003143 1.39 2.79 24 12
JP110 #10 Bamboo 680149001290 2.00 3.99 24 12
BC270 BC Ma num reloadable 715244002702 6.49 12.99 12 3
BC702 BC Colored Smoke Balls 12 k 715244007028 1.29 2.59 24 12
BC810 BC Tasmanian Devil 715244008100 1.49 2.99 24 6
BC218 BC Karaoke 715244002184 1.49 2.99 12 0
B2206 BC To Soldier each 715244020065 1.49 2.99 12 3
BC340 BC Cracker Ball 715244003402 0.49 0.99 12 6
BC344 Snakes 0.99 1.99 24 12
Y36033 USA Smoke 705834360336 1.24 2.49 12 3
Y22058 Hells' Fire 705834220566 4.99 9.99 6 0
Y22073 Mount Everest 705834220739 13.99 28.99 3 0
WB4005 Ma ic Stick 693019040374 1.40 2,99 24 12
W64007 Tro ical Sunli ht 693019040077 149 5.99 6 3
WB4026 Powerful Fountain 693019040268 3.25 6.49 12 3
MWC2107 Jumpin Jacks Parcel 805253021075 2.95 6.99 20 10
WB4006 Devil's Trian le 693019040060 3.25 6.49 12 3
WB4010 Dream World 693019040107 3.25 6.49 12 3
WB4010 Northem Li hts Fountain 693019040664 325 6.49 12 3
W64026 Home Sweet Home Fountain 693019040602 4.49 9.49 4 2
W84028 Jul 4th Fountain 693019040565 4.99 9.49 4 2
Vendor:
M & D Distributing, Inc.
Phone: 651-641-0930 / Fax: 651-641-0940
(Please Note: Vendor is set up through the Enon Marketing Department)
*Some cities require permits for the sale of fireworks. Permits are being obtained through licensing in
Enon and permits will be sent to each location. You are not allowed to receive/sell the fireworks until
your permit has been received. The following page lists all of the stores that will be selling fireworks,
permit requirements and the product distribution level.
MARSH ` CERTI:FICATE QF.INSUR"ANCE `E"T"""'E"°"BER
NVC-002308092-01
PRODOCER TNIS CERTIFICATE IS ISSUED AS A MATTER OF INiORNATION ONLY ANO CONFERS
MBfSh USA IfIC. NO RIOHTS UPON THE CERTIi1CATE XOLGER OTHER TNAN TXOSE PROVIDED IN THE
1166 Avenue of the Americas POLICY. THIS CERTIFICATE DOE$ NOT AMEND, E%TENO OR ALTER TME COVERAGE
New York, NY 10036 AFFORDEO BY THE POtICIES UESCRI6ED MER&IN.
COMPANIES AFFORDING COVERAGE
COMPANV
A AMERICAN HOME ASSURANCE CO
INSURED CpMPANY
SPEEDWAYSUPERAMERICALIC B N/A
500 SPEEDWAY DRIVE
ENON, OH 45323 COMPANY
C WA
COMPANY
D
~COVERAGES. . . , . . . . .
THIS IS TO CERTIFY THAT POLICIES OF INSUftANCE OESCRIBED NEREIN HAVE BEEN ISSUED TO THE INSURED NAMEO HEREIN FOR THE POLICY PERIOD INOICATEO.
NOTWITHSTFNDING ANY REpUIREMENT, TEftM OR CANDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICM THE CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN, THE MSURANCE AFFOROED BV THE POLICIES OESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDRIONS AND E%CWSIONS OF $UCH POLICIES. AGGREGATE
LIMITS SHOWN MAY HAVE BEEN REDUCEO BV PAIO CLAIMS.
CO POLICVEFFECTIYE POLICYEXPIRATION LIMITS
LTR TYPEOFINSURANCE POLICYNIlMBER DATE(MM/DD)YY) DATE(MMIDUIYY)
A GENERALLIABILITY GL5442484 04I07/05 04101106 GENERALAGGREGHTE $ 1,000,000
X COMMERCIALGENERALIIABILITY PROOUCTS-COMP/OPAGG $ 1.000,000
X CLAIMSMADE ?OCCUR PERSONAL&ADVINJURY $ 'I,OOO,OOO
OWNER'S 8 CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000
FIRE OAMAGE (An one fire) $
MEO EXP An ane erson $
AVTOMOBILE LIABILIN
COM9INEDSINGLELIMIT $
ANY AUTO
ALLOWNEOAtlT05 BOOILYINJURV $
SCHEDULEOAUTOS (Per person)
HIREDAUTOS BOpILYINJURY $
IP& ecdtlenq
NON-0W NEDAUTOS
PROPEftTY DAMAGE $
GAfiAGELIABILITY AUTOONLY - EAACCIOENT $
ANY AUTO OTHER THAN AUTO ONLV:
EACHACGDENT $
AGGREGATE $
EXCE55 LIABILITV EACH OCCURRENCE $
UMBRELLAFORM AGGREGPTE $
OTHER THAN UMBREILA FORM $ .
WORKERSCOMPENSATIONAND A EMPLOYERS' 1IA61LITY TORV LIMITS ER -
EL EACH ACCIDENT $
-
THE PROPRIETOW INCL FL DISEPSE-POUCV LIMIT $
PARTNERSIEXECUTIVE
OFFICERS ARE: E%CL EL DISEASE-EACH EMPLOYEE $
HER
DESGRIPTION OF OPERATIONSILOCATIDNSlVEHICLES/SPECIAL ITEM$
Certificate covers Fireworks Permits for all Speedway SuperAmenca LLC locations within the City of Eagan, Minnesota. The City of Eagan, Minnesota shall
be named as Additional Insured, su6ject to the policy terms and condiGons.
CERTIFICATEHOLDER CANCELLATION. SMOULD ANV OF THE POLICIES DESCft18E0 MEREIN 9E CHNCELLEO 9EFORE THE E%PIRATION DAiE THEPEOF,
THE INSURER NFFORDING COVE0.AGE Wlu ENDEAVOR TO MAIL 30 DAYS WRITiEN NOTICE TO THE
CiTy of Eagan pEfliIFICAIE HOLDEF NFMED HEftEIN, BUT FFIWRE TO MAIL SUCH NOTICE SHAIL IMPOSE NO OBLIGATION OR
3830 Pilot Knob Road
Eagan,MN 55122 LIqBILIttOFAM'qNOVPONTHEINSURERqFFOR01N6COVEFNGE.ITSAGENi30RREPRESENTATIVES,OFIHE
19SUEft OF tH15 CEftTIFICATE.
MPRSH USA INC.
er: Shertie Boatman
. . , _ . . MMM1I3102). . VALIDASOR05/03/05..._. . .
~
s .
DATE
BUILpING PERMIT APPLICATZON
Include 2 sets of plans, 1 site plan w/elevations and 1 set of enerqy calculatioins.
To be used for Skvm~- S:fb LL Valuation N6r~ /DO
Site AddresE: oI.f1f. /3 C0.;0. lO /L) - 0000 -610 `V-F
Lot Block See. SuD. Parcel Number
Owner £ygme IL ,4,tdL sA Telephone
AddressT pmr
Contractor Telephone
Address
Arch./En9• ~ Telephone 12 J~'S'S
Address Re.
.
~ OFFICE USE
Erect occupancy F
Alter Zoning
gepyiz Fire'Zone 3
gllazqe Type of Const.
Ntove # of Stozies
I)emolish Front y~
Grade Depth
OFFICE USE
pate of Approval & Initial FEES
A fl
rssessment permit / 9 3 •
Watex/Sewe . liar e ~
al.an Check 9G~y ,
Police
Fire SAC •5 O ~
En4• 3 Ptater Gbnh.
Planner 41a er Meter
Oouncil
Rldq. Off.
9
A.P.C. TOTAI,
Slil/u''e~ L-~r'2~'_r"- /U'? % ` .
i~
Date:
BUILDItdG PEW1IT APPLSCA:I'ON ~
LOT BLCCK 21DDI:ION l /
i
PARCFL & SLCTIOP] P]UP4IIER IE UNPi.ATTED rd DJQ/J/l /)/U
ADDRFSS QF FIiRCEL Go /~d 30 l3
70iQITdG6~OCCJPAtICY~1 USE~fvs~i,te~ ~W~vrce~Jf~Y°~°! ~QCJr .
BSTISHA?'ED COuIO~'el'oj
o?cnTER Su~ e~~, ~,^a ~ mELErxentE ivo. 5~sy /i,3.S~
AnuP.Fss f? o.. ,Q~:r ~ 4~ 8, o~'~,•( ~v~-/c~ ~/~,v 3so
COP]TRACTOR TELEFHONS N0.
ADDRESS
Note: Inclede site plan, building plans, and energy calculations raith this
application
Signed
OPFICE USE
VALU21TIOid -go
SAC
FIITER C0I7tVECTIOTI
YdATER 14ETER
BUILDING PER[iIT FEE
SURCHAFtGE FEE
PLAtt CF:ECK FEr:
~
PARK DEDICATIOIJ FEE
OTHER
TOTAL'~
APPl;OVALS:
ASSiSSME1T CLERKHIIII,DING DEPto
ICE DEPT.
L
t~7ATER & SLkIER DEPT. FIRE DEPT. PARK DEPT.
/O oiPpo a/,P -s8,
MASTER CARD
LoCATIoN
OWNER
STRUCTURE AND
LAND USED AS
~
Issued To
Permit No. Issued Conirador Owner
BUILDING
.
PLUMBING LI 2 / p-
CESSPOOL - SEPTIC TANK
WELL
ELECTRiCAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER I
Approved
Items (Initial) Date Remarks Distance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FFiAMING TILE FIELD FT.
FINAL
ELECTRICAL
DEPTH
HEATING OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBI NG ryAA ' 7 f
~
WELL
SANITARY SEWER
Violafions Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USEO ONIY 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. El INTEND TO COMPLY.
a ACCEPTABIE S1165TITUTIONS OR ?
DEVIATIONS COMPLETION OF CERTAIN IMPROVEMENTS
.
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
? REINSPECTION REdUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CERTI FICATION-1 cenify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant canditions observed to 6e at variance with ordinances of the Town of Eagan, approved plans and specificetions, and any specific require-
menn for off-site improvements rela[ing to the property inspected.
F-I ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILOING INSPECTOR DATE
COMMENTS:
06/04/200 15:55 7637865927 GRIFFIN PETRDLEUM PAGE 02/04
, i'7 i
S1~ ? "D
2007 COMMERCIAL MECHANICAL PERMTT APPLICATION
r City Of Eagan
3830 Pilot Knoh Road, Eagan MN 55122
Telephone # 651-675-5675 ~
Please complete for: commerciaUindustrial buildings
multi-famil buildin s when s arate rmits sre not re uired for each dwellin unit
Date (0 I + I 2C07 S( 0jQ~j Ale(/YlDv'i0.d ljwll
Site Street Address Unit N
Tenant Name (if applicablc) 5(p Previous Tenant Name IVIA"
Property Owner 5{jl f_2J64WNk_" CA Telephone#( )
Contractor 6r(ZWF1IV pkTVL"AA ff5F=VA lN~%•
streetndaress 700 .XYL.I~JyG 5~, city '5L4WTC
Stxte M/V Zip Telephone 7(73)`~-6~~
Bond N ll~r Expires: 4` ~
The Applicant is _ Owner X Contractor _ Other
Work Type
New Construction Interior (mprovement _Install P3ping _ Processed _Gas Exterior HVAC Unit**
- - **HVAC units must be screened
D~- Under/Above ground Tank X Install ~ Remove
When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector
NatureofWork: Y*r'VU~, lr4v1C,5 k PIpIN6i f'Y~MU- 1A45 t Pr/lV(.T
Pe?mit F¢PS 57050 Undergrnund tank installatinnfremnval
556.50 M7nimNm (ncludes State Surcharge)
Contract V alue $ y"-j- 11 x 1% $ '7 00 Pertnit Fee
$ ~ 5Q 5tate Surcharge
To calcolate surcbarge
~ ]f Permit Fee is less fhan $7,000, surcharge is 50 cents.
rj K.-S Dci r If Permit Fee is > $1,000, suroharge increases by $.50
for each $ 1,000 Permit Fee (i.e. a $I,001-$2,000 Permit
~',ANJ r__S - Fee requires a $1.00 surcharge).
$ 77(~7 Si/ Total Fee
I hereby acknowledge that this information is complete and accurate; that the work will be in confomiance with the ordinances and
codes of the CiTy of Eagan and with the Mechanical Codes; that I understand this is not a permit, but only an application for a permit,
and work is no[ to start without a permit; that the work will be in accordance with the approved p in the case of work which
requires a review and approval of plans.
_
VAVID M%MDF_(LG
ApplicanPs Printed Name Appli4Si -
-
Approved 6y: Inspector Date:
Required Inspec[ions: _ U.G. ~ R.I. r~ Air Test _ Gas Service Test - Infloor Heat Y Final
,
.
,r
A + m
y(i A
!j. 'f• ~ y, A.~ ~ ~
n:. , a ' ~ N
u ~ 1
N ' m
. . . y . . ~ .
m
5
~ pi ` . . . . I'. . ~l
~ i~+~. ~ ~ ~ . , . . , .
S~ .ti . . , .
Cll
y ~ LyMinn~~ota U~d~rround ~'torage ~'a~~ ~
. g~, . 1/7.~~~~~~~~
T ,
. . . . .
m
, . . . , z. - ~
~ vmi
LO
.n
~
.
Campany Nam-ie Grif£'in Pettoleum Serv~ces;
Atlclress 8700 te Street~E C~ty BI_'~
- 9
The cainpnn,y:issued ~has ce~#~~~~ h~s m~t the r'e~urr~rt~~~2ts o't~n~s
, Chapter 7105; ahd is eOOt fed to lerform-undergroz~ndsOMgo tpnk wark ~n the ~
~'tate o~~n~e~sat~ tv~ th~ dis~c~lang(s);z~f
- ;
W~l011
~
i7s; ;
~
~ MirLnesnt~ ~bllution ~antrol Agency
_
D
m
` ~~F ~i FV A
>R14.`i° , ~ / ~
ip 0~ / \ J •
~0~6~/y0~4/2007~+ 15D:55 7637805927 GRIFFIN PETROLEUM PAGE 04/04
%~.~+v~ LrE7'~~~~IC,A I. I- Ut' LIA61L] 1 T 1140U1'SHJY1rG - 06/29/2006
ooucEx (952) 545-1230 FAX (952) 593-8733 7HIS CERTIFICATE IS ISSUED AS A MAl"fER OF INFORIIAATlON
x ONLY AND CONFERS NO RIGHTS UPON THE CERTiFICATE
meri can agency Inc HOLDER. THIS CERTIFICA7E DOES NOT AMEND, EXTEND OR
;151 Cedar Lake Road . ALTER THE COVERAGE AFFORDED BY THE POLICtES BELOW.
' 0 Box 16527
nneapoT INSURERS AFFORDING COVERAGE NAIC #
is, MN 55416-0527.
suxso Gri fin.Petro7eum Services Inc ir+sua~rin: Western National Insurance 15377
Griffin Cantracting irvsuaeRe~ American Interstate Ins Co 31895
8700 Xylite St NE insur~rzc: .
Blaine, MN 55449 °~sur~RO:
- Il6URERE
O E
THE POLICIES OF INSURANCE LISTEO BELOW HAVE BEENISSUED TO THE INSURED NM4ED ABOVE FOR THE POLICY PERI00INOtCATED. NO7WlTl'ISl'ANDING
ANY REOUIREMFNi. TERM OR CONDITiON OF ANY CONTRACT OR OTiiER DOCUMENT `NfTH RESPECT TO W HIC1i THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE IN6URANCE AFFORDED BY THE POLICIES OESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. IXCLUSIONS AND CANDfTIONS OF S" .
POLICIES. AGGREGATE LIMRS SHOWN MAY NAVE BEEN REWCED BY PA~D CLAIMS' srt oa rvreoFmsurtaruE . raucrwnaeER .
EcFEcrne POLICY'IXPotAT70N ueerts
GFtJFRA,unMurv CP300000151 07/01/2006. 07/01/2007 ~G~o~ $ 1~1~
X core.~Ereev~i c~eauuaeiu[v c•
cwws Mwe rX~ accurc SUDDEN 8 ACCIDENTAL . nIM orn cAnv «b v~l s I S 0
4 7( SS00 Deductible POLLUTEOP) IS iNCLUDED PFRSONPI'8ADV MURY $ 1 000,00
cIDIERA.nccaECn~ . s 2 000
.Mq
. . aaoouers-hoe,~r.-ovncc $ - 2000
CEM.AGGfi~TEIWF:APPIIESPEit '
POLIGY ~ LoC .
AIffONOBB.El1ABLLIfY CA022109429 07/01/2006 07/01/2007 CAA1&NEDSIH6L.EIJA/fT q .
sQ00.
(EaaccH&If) 1
X ANY A11fD .
qLL OWNEOAUT05 ' BOOILYINIUM g .
(PerPr+sm)
Sf}1EDUIFD AUTOS A X HU;U3) AUTOS (BOPVDeLY INJtRy $
J( WpµpWNEDAUTOS
PFOPEM DANA6E . $ .
- MJI'DOHLY-EAACCIDETR t-
.t;nrswaE iIaeitm - . . ' EA ACC S
ANYAUTO.07HER7HAM .
. . AU700NLY: qrG f.
acEswMSaE, L• uwssi,m. N300000121 07/01/2006 07/02/2007 Enc" occursaEwe % S 000,
S 000 ~
occurt ~ a.aius wwe nGGREGAre $
.
$
A
oEDucrIBLE. $
wcsraru- onti .
rtet&Nrwn $
ware~ascoet+sanowaao AVWQHN1198832003 07/01/2006 07/01/2007 X
EWLorErssLweiurr . eL Ena+nccIoart $ 500,00
$ ANY PROPRIEfORIPAR7NEWE%EC1ME . E.L. DIEFASE - EA EPAPLOYEN S SOO O
0FRCERimEMBER IXCLuDED? ' ELD6FASE-PoLICYLIMfi 1 S~r~
tlyas Eesalbau~ker
Sf+EGAL PROV1510NS bebw . .
Oil¢R OESCRW710NOFOPERAT101611OCATON5IVEMCLE`+fIXCLUSODW ADD~M SMYRSEMENT lSPECW'PROVtMNS. '
ihe following named certificate holder is hereby named as additional insured on the General liability
inly with respects to the solen`egligence of the Insured and.not the negligence of the additional
insureds.
CERTIFICATE 0
sxaw arc oF nHE aeove oFSCnmm roucMee cu+ceu.En eeFonEn{e
pwuennoN onTE nEnEOF.nE MMmciorwneevauENDEnvaxmeu.iL 30 oRrsw2mEwrmncsTO-rHE carriscnTE xaLoEawwmron+ELEFr,
Ci ty of Napl e+xood evr cnu.uaETO Man. sucH rance sxau imrosE em oeucanox oa uneIurr
1830 Caunty Road B East OFANYIUIIDUPONI7ig RLSUREft.RSA6BNT50RREPRESEHTAT1VEg•
NaplewOOd, Mltl 5SI09 AUIHORRmREP12ESEtITA71vE
Vi cki Thel en RT
~ACORD CORPORATION 9988
ACORD 25 (2001108) -
j F- - - - - - - - - - - - - - - - -
or Of(ce Use I
Pe
City of EalaIl ; .,t#:
~ Permit Fee: I
_71
3830 Pilot Knob Road i i
Eagan MN 55122 ~ Date Received: La `q' Ot i
Phone: (651) 675-5675
Fax: (651) 675-5694 1 scae:
2008 COMMERCIAL BUILDING PERMIT APPLICATION
oate: d,-~(4 -C1 SlteAddress: 416C~ MeMO~~~ vi w
TenaM Name: 5v0 cf G~ (TenaM is: _ New / X Existing) Suite
PROPERTYOWNER Name: I5U4EP.Ar,r~7.CP Phone: r-51- 454-~~-16 xa13
Address/Cily/Zip: 5-00 St'EfDWAY D(-Jz ErJo~1 CjHSO
Applicant is: _ Owner Contrac[or
TYPE OF WORK Description of work: wCA WuS (ZQw.vved
Construction Cost: c~ 000 .00
AL License lU.00o.VA
CONTRACTOR Name: =
AddreSS: g~`Y) Coo\U L.[.'_'
Ciry: M"VA~ r( o state: /4 ~j zip: SS369
Phone: ContactPerson:
ARCHITECT / Name: S~eea f S~Pa~Ar-~.~SC A Registration 1f:
ENGINEER
Address: G,s
~ ~~^^t_ ~r
Ciry: State: Zip:
Phone: Contact Person:
Licensed plumber installing new sewer/water service: ~ Phone
NO7E: Plans and supporting documents that you submN are considered to be public informatfon. Portlons ot
the information may be clasalfied as nwr-public li you provPole specific reasons that would permit the Clty to
conclude that the are trade secrets.
I hereby ackrwwletlge Ma[ this infortnazion is compete and accurate; that the work will be in conformance with the ordinances antl codes of Me CAry of
Eagan; that I urrclerstand this is not a permit, but only an appRcalion for a permit, arM work is rwt to start without a permit that the woric will be in
accordance with ths approved plan in the case of work which requires a review and approval of plare.
x -t"o,-..~ Loe~~1~~ x ~ lfl~l~-
ApplicanYs Printed Name Applicant's Signeture Page 1 of 3
c ' ?"1x
DO N07 WRITE BELOW THIS LINE
SUB TYPES:
? Foundatlon ? Public Facility ? Accessory Building
? Apartments BK Commercial / Irniustrial ? Ext. AlteraUon-Apartments
? Lodging ? Greenhouse ? Ext. Atteration-Commercfal
? Miscellaneous ? AMennae ? Ext. Alteretlon-PUblic Facility
? Nail Salon
WORK TYPES:
? New ? Interior Improvement ? Sfding ? Demolish Building'
? AddiCwn Q MOVe Building ? Reroof ? Demolish IMerior
ET'Alteration ? Fire Repalr ? Demolish Foundation
? Replacement ? Windows ? Water Damage
' DemWitlon (eMire buiWing) -give PCA hsndout to applicant
DESCRIPTION:
Valuation Occyapancy MCES System
Plan Review Code Edition -2 os& 'SG SAC Units
(25%_ 1000/c 2oning City Water v-^
Census Code Stories Booster Pump
# of Units V' Square Feet ~ PRV ^
# W 8uildings Length ~ Flre Sprinklers
Type of Const. Width -
REQUIRED INSPECTIONS
Footings (new bldg) Sheetrock
Footings (deck) FinallC.O.
Footfngs (adtlition) ,/Final/No C.O.
Foundation HVAC
Drain Tile pther.
Roof: _Ice & Water Final Pool: _Footings Air/Gas Tests Final
-V~Framing ~ Siding: _Stucco Lath _Stone Lath _Brick
Fireplace:_R.I. _AirTest _Final Windows
_ Insulffiion Retelning Watil
Final C/O Inspectlon: Schedule Fire Marshal to be present. _ Yes ~No
Reviewed By: rkkf. L . Building Inspector Reviewed By: . Planning
COMMERCIAL FEES:
Sase Fee 77, JS
Surcharge bpo
Plan Review
SAC-MCES
SAGCity
SM! Pertnit Financial Guarantee
S/W Surcharge Storm Sewer Trunk
Treatment Plant Sewer Lateral
Treatment Plant (Irrigation) Street Sewer Trunk
Park Dedication Water Lateral
Trail Dedication Other WaterTrunk
Water Quality
Water Supply & Storage (WAC) TOtal 10 77 9. 15~
Page 2 of 3
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IfSUE NO DATE DRAWN BT CHECKED BY ISSUE DATE
~J I T ~ F~N ~ I E L. -20_0 ` •
~ SUPERAMERICA
~ SAINT PAUL ~ARK DIVISIONAFASHLANDOILINC MINNESOTA
~
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P~urz.r~svI L LE,
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DRAWN BY: W. H. F. SCAIE: 1`~ 2 O' -
av~ovEO NO.
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PRGPERiY DESCRIPT;ON I _ _ . - - - - I %
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~i~aC p~rt of Section 19, ~ _ N, {
`,o4-~nsi~ip 27 ~Jor~h, Ranye 23 West of the 4th Prir,cTpal ~~erid~an ar~d Section ~
~ io~:anship 27 i~~orth, Range 24 West of ~he 4th Rr~ncipal ~ie~°idiai~, I)aKOta ! ~ / ~
i;cuntv, "4i~~nesota, described as follows: Beginning at a poir~t on tV~e South ~ , ~ . r f li~~e ot said Sectio,i 19 distant 200.0 feet East of the ~ou~h~vest corner o~
~ ~nere~f; ~hence i~orth parallel with the West line of sai~l Sect~on 19 a d~s- ~
~~~nce of 575.4~ feet, ~~~ore or less, to the Southeaster•ly right of «ay line i ~
of ~tate Ni h4~a Piuinber 13; thence Southwes~.erly along said Sout~easterly ' ~ ' 9 Y
~ ~~icnt of ~ra line a distance of 692.1~3 feet, more or 1ess, to the it~ter•sec- ~ ~ ± Y ,
~ion ~>>iti~ tr~e South line of said Section 24; thence E~st along the South ~ ~ ~
~~~o f 7.7 f t to the actual ~ ~ ~ ~~~,,s ~f sa~d Sect~ons 24 antl 19 a distance o 3~ 8 ee ,
noi~~t of b~yi~~~~7i~~,g; except that part thereof platted ~s i~II~JNESOTA UEPARTv1EPi~ ~ ~ , ~ / ~"(,f~P1Si'ORTATION RiGFIT OF WAY PLAT ~d0. 19-5, accordin~ to the recorde~i plat ~
~ ;:~~~ereofi, Dakota County, I~~~nnesota. Sub~ect to a permanent ease~i~er~t for ~
~or~rr~ty Road PJuinber 3G over and aeross the South ~0 feet ihereof and su~ject ~ ~ ~
4 'I ~ ~ . ar~ easeme~~t for purposes of ingress and egr°ess over and ac,oss the fol~,l~~- ~
i;~~ ~~escribed tract: All that part of the above described prope~~ty d~~hich /
' ~:~s i~,o~~th of a line dra~~vn 4Jest at right angles fro~>> a point on the Fast ~ ~
i;,,e of the above described ~roperty distant 200.0 feet Soutk~ of the most ~ r'.~erlv c~rner~ thei°eof. ~ ~ ~ ~ ~ ~ .
~ , ~ ~ ~
~"dOTE ~
r~ ~~n '~er n was coin~osed b Si~~~~de ~ The propex°ty desc ipt7on sho ~ eo p y ~
Land Surve in , Inc.per data obtained fron~ survey pei°formed ~ i Y 9 ~ o O O
b~ . Coulter dated Jul~ 16, 1966 and fro~n the lat of ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ' o ~ F f~ i~SP RTATI Pl RiGI~1T OF WAY PLA? PlU. ~ I ~ ~ ~ ~ ~ i~I~~iiESOTr~ OEP~,R1r~~ErJT 0 T A! 0 0 / ~ ~ o O .
a 1 9-5. '~Je reserve t he ~°~r h t to amen d our sur~vey upon rece~p t ~ - i N i ; . O N
; ~ ot a c u r r e nt a t t ~ r n e y s t i t l e o C~i ni on. /
~ i i / i ~v:
i
r nd orr c` re i~esen- ~ ~ ~le hereby certify that th~s ~s a t ue a c e ~ p ~ ~
atio~; ~f a s~n~ve of the bour~tlaries of the land above . ~ ~ ~ y ~ I ~ ~~w~ described a~:d of the location of all buildings, if any, ~ ~ ; ~~Q y
~roio or on said 1ar~d, ' ~ o~ ~
~ ; ~
Dated this 8th da of February 1980. ' ` y ~ I ~ ~
? o , . i ~ so ,
SUPIDE LAi~iD SU~?U~YIfdG> INC. / ' ~ ~ ~ / ~ ~ ~
~ . ; ,e" ~ 3Y~ ~
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6LOOMINGTON MiP OMINGTON, MiNNESOTA 55420
, PNONE 612 - 881- 2 NE 612 - 881- 2455
392- 78- A 75/24 M.R.O. ,
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