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1778 Silver Bell RdClrr OF EAGAN 3796 Pilot Knob Rood F-Son, MI+J 55?22 Zoning; O 'ner: ??- Address:? ! Site Address: -?_ Plumber; SEER SERVICE PERMIT PERMIT Np DATE: t N . of Units: _ i agree to comply with Ordinances. the City of Eogon . Connection Char 9e: Account Deposit; By Permit Fee: Fee- Date of l Surcharge. _ Ins p.: Misc. Charges, Total: Dote Paid. CiTy OF EAGAN 3795 Pilot Knob Road Eagan, M Zoning. N 55122 owner: Address: Site Address: _ Plumber; - • '- Meter No.; Size: *AT ER SERvICE PERMIT PERMIT No.: DATE: No. of Units: Reader No.. Connection Char count Deposit9e. r t .. Ordtoa to COmPJY with the c Per onoes CrfY of Eo9an mit Fee: B Surcharge: y Misc. Date Charges: ; of Insp.. Total; Dote Paid: Insp.: 1? CITY OF EAGAN f 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 4548100 BUILDING PERMIT Receipt # To be wed For l' 1 C)t . Est. Value 500 Date 19 ' - Site Address Lot Block /Sub. w z Parcel No. Name Address J ,a City Phone Erect U Occupancy _ Remodel ? Zoning Repair ? Type of Const. Enlarge ? No. Stories _ Move ? Length Demolish ? Depth Grade ? Sq. Ft. Name ZZ O? Address U9 City Phone Assessment Water & Sew. Police G t! Name Fin X,3 Address Eng. City Phone Planner I hereby acknowledge that I how rood this application and state that Council Bldg. Off. the information is correct and agree to comply with all applicable APC State of Minnesota Statutes and City of Eagan Ordinonces Var. Date Signature of Perrnittee Permit Surcharge . Plan Review. SIC Water Conn. Water Meter Road Unit Parks Total A Building Permit is issued to: • an the expross condition that oil work sholi be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Permit No. Permit HoMw Dete TNs hone Plumbing H.VA.C. Ekwde Softener Inspection Date Insp. Other Footings Foundation Framing Roofing Rough Pibg. Rough HVAC Insulation Final Pibg. Final HVAC Final Cert/Ooa. Water Describe Location: Mil Sewer Pr. Disp. MECHANICAL PERMIT DATE: 6/4/91 RECEIPT: 101653 SITE ADDRESS 1778 SILVER RF.T.T. ROAn Unit # Permit # 13073 L 9 B 3 Sect./Sub. CEDAR GROVE 1 1 TH BURNSVILLE HTG. & A/C-894-0005 INSPECTION INSPECTOR DATE COMMENTS %/c f4w yo9 CASH RECEIPT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 AMOUNT & DOLLARS To o CASH CHECK BY NUMERICAL FILE COPY CITY OF EAGAN Remarks Addition Cedar Grove 11 Lot 9 Blk 3 Parcel owner trees 1778 Silver Bell Rd. State Eagan,MN 55122 6/ V Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1 1 261.65 26.16 10 (c STREET RE3Tqfi. rr' 1975 124.31 12.43 10 / GRADING SAN SEW TRUNK c 1968 0.09 2.00 30 # SEWER LATERAL -< C( 1975 1493.96 297-79 4 6 / WATERMAIN WATER LATERAL « 1973 200-45 13-36 15 WATER AREA x Wtr lat & area 1975 STORM SEW TRK iy 1971 33.5 1.67 20 STORM SEW LAT 1971 22.37 1 .11 20 u / G 197 2 .39 3• CURB & GUTTER SIDEWALK 7-27- STREET LIGHT WATER CONN. +? p6 BUILDING PER. SAC PARK CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 N2 6786 PHONE: 454-8100 BUILDING PERMIT Receipt To be used for Est. Value Date 19 Site Address Erect ? Occupancy Lot Block Set/Sub. Alter ? Zoning Parcel # Repair ? Fire Zone Enlarge ? Type of Const. ed Name Move ? # Stories Z Address Demolish ? Front ft. 3 ° city Phone Grade ? Depth ft. Name Approvals Fees 0 Add u Assessment Permit ress ' city Phone Water & Sew. Surcharge Police Plan check W Name Fire SAC v? Address Eng. Water Conn. <W city Phone Planner Water Meter Council Road Unit I hereby acknowledge that I have read this application and state that Bldg Off. the information is correct and agree to comply with all applicable . State of Minnesota Statutes and City of Eagan Ordinances. APC Total Signature of Permittee A Building Permit is issued to, on t he express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official htmlt # pate befell peAOttee Plumbing l E t Mechanical ?c CC- -tISI6's INSPECTIONS DATE INSP. Rough-in Final Footing s Date Insp. Date Insp. Foundation Plumbing Frame/ins. Mechanical Final t - 1 1 Remarks: Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. Date 2. Installation Cost 3. Job Address 4. Owner Tract 5. Contractor Phone 6. Address 7. City 8. Building Type: Residential GD 9. Work Description: New ? 10. Describe 11. State Zip Commercial ? Institutional ? Add Alter ? Repair ? No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Se tic Tank Lavatory p Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed: for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 464-8100 PERMIT # 4 MECHANICAL PERMIT . r? X ' CITY OF EAGAN RECEIPT # - 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE U I _ ? CONTRACT PRICE: PHONE: 454-8100 T Site Address ° BLDG. TYPE WORK DESCRIPTION Lot -Bloc k Sec/Sub Z 1 4j Res -1- New ? Name Mult Add-on 'R _ Address Comm. Repair c City hone L Other Name TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent. Gas Piping Outlets # Other 2SM BTU M BTU M BTU M BTU CFM FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPUES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & REMODELS - 12.00 MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000) FEE: 1 S/C: SIGNAT P TOTAL FOR: CITY OF EAGAN BUILDING PERMIT Sing. Fam Dw1g. CITY OF EAGAN 3745 Pilot Knob Road Eagan, MN 55122 PHONE: 454-8100 r.; s Receipt # „_, _ ate Site Address i ' ' ' ' k:' . e L i nu. Erect Q Occupancy Lot Block 3 Sec/Sub. r? Alter ? Zoning } Parcel #)` Repair ? Fire Zone _ Enlarge ? Type of Const. W. Nome W Move ? # Stories Z Address - e Demolish ? Front ft. o City Phone Grade E] Depth -- ft. Approvals Fees °C Name o ? } oou Address Assessme nt - Permit • ?cc: Water & Sew. Surcharge 14.00 I- city Phone Pl h k Ww Name Police Fire an c ec SAC /4-75.00 Address - Eng. Water Conn. °' 310.00 <W Ci Phone _ Planner Water Meter C, 7 5 Council Don . I hereby acknowledge that I have read this application and state that Bldg. Off the information is correct and agree to comply with o!I applicable . State of Minnesota Statutes and City of Eagan Ordinances. APC Total <<' Signature of Permittee A Building Permit is issued to: Maxell Const on t he express condition that / N° 4368 6365 all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances Building Official permit # Deb hwW rwWMIN Plumbing Mechanical INSPECTIONS DATE INSP. Rough-In Find Footings Dote Insp. Dote Insp. Foundation Plumbing Frame/ins. Mechanical Final Remarks: • CITY OF EAGAN • 3795 Pilot Knob Rood • Eagan, Minnesota 55122 Phone: 454-8100 PERMIT Date: June 14, 1977 Site Address: 1778 Silver Bell Rd. Lot Block Sub/Sec. CG 11 Name v Address Phone: Cit y Name- Q` Ti Address tg Phone: City _ This Permit is issued on the express condition tha t all work shall be Minnesota Statutes and City of Eagan Ordinances. No. 841 Stco titent 03',' Receipt No.: Single Residential Multi Res., Comm./Ind. new New/Alter. /Repair Cost of Installation 20.00 Permit Fee .50 Surcharge 20.50 2:illed Total - done in accordance with oil applicable State of Building Official This requsst,•'oid fQ )( 18 months Fro E 319x7 z, q f3,5 ? ,Y_ o- //'k' 8??7/v Request Late Fire No. Rough- in Inspection Required? ' Ready Now ? Will No illy Inspec- L 7/ A ? , .J Dyes 0NO for When Ready k Licehsed Electrical Contractor 1 hereby request inspection ql above ftb.ner electrical work installed at: Street Address, Box or Route No. 1 -5/'/ , / "r- City J .1l 11 Section No. Township Name or No. Range No. County Occupant (PRI T) Phone Nn.. owe, Supplier Address E)ec/?(y//?]a//I-Contr r (Comp y Name) /Cy1 Z/,` G°le,d-, /Coot,a?mu,'s License No. CiJ /o° L-) -5 Mailing Address (Contractor or Owner Making Installation) /-xc - ? J .1Ae?.t?h.?ri,?ec1 Signature (Contractor Owner Making Ins [allation) Phone Number MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs•Midwny Bldg. - Room N•191 BE ACCEPTED BY THE STATE BOARD 1821 UNLESS PROPER INSPECTION FEE IS Univil lv Ave.. St. Paul, MN 66104 Phone (612) 642-0800 ENCLOSED. ,2 E -9.7 REQUEST FOR ELECTRICAL INSPECTION Ii, See instructions for completing this form on beck of yellow copy. "X'' Below Work Covered by This Request ES-00001-06 .? Fdd Rep. Type of Building Appfmnces Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Healing Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Omer peel v Other IS ne_rifyl t er Specify Other Other Compute Inspection Fee Below Al Fee Service Entrance Size M Fee FaedersrSubfeeders b Fee Circuits o to 200 qm fs 0 to 30 Am DS 0 to 30 Amos Above 200 gmps?. 31 to 100 Amps 31 to 100 A s Swimming Paol Above 100_Antps Above 100_Amn Transformers Irrigation Booms Partial. Other Fee I I Signs ' I ISpecial Inspection ?S J? 1 Remarks T74) FEEO?/ This request void 18 months Thisre74dstvoid L4 i i C G. I ( NCO?Cj'j ]8 months fr om Date of this Request C( - _ I Fire No. aT 15165 I, as ? Licensed Electrical Contractor Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No./ ?? ??1& Cityz?'B! Section Township Range County Which is occupied by Is a roughin inspection required on this job? No ? YesX Ready Now ? Power Supplier tt?6k-a_ EJ F-C '-i\t n'Address Electrical Mailing Address or Authorized Will Call P( Contractor's License No. (,??j /} n SUARD COPY This inspection request wii not accepted the ?j ?J (,? (-0? State Board unless ess proper inspection fee is enclosed. min- sofa atate ooaru or mWITIGIcy Gr ;s Midway Bldg. - Room N191 '21 _VniversitvA re.. St. Paul, Minn. 55104 - Phone 297.2111 REQUEMOR ELECTRICAL INSPECTION CHECK BELOW WORK COVERED BY THIS REQUEST EB-00001-02 T 15165 Type of Building New Add. Rep. Cbeck Appliances Wired For Check Equipment Wired For Home J ? ? Range ? Temporary Wiring ? Duplex ? ? Water Heater ? Lighting Fixtures AR_ Apt. Bldg. ? ? ? Dryer ? Electric Heating OL- Commercial Bldg. ? ? ? Furnace ? Silo Unloader ? Indugtrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ? Farm ? ? ? List List Other - O ? ? p Herer Hereers COMPUTE INSPECTION FEE BELOW Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Circuits: # Fee 0 to 100 Am s. 1 1 0 to 30 Amperes a2 0 to 30 Amperes i Sb 101 to 200 Amps. 31 to 100 Amperes 31 to 100 Amperes Above 200_Amps. Above 100 Amps. Above 100 Amps. Transformers Remote Control Circ. Partial or other fee Signs Special Inspection Minimum fee $5.00 S Remarks TOTAL FEE J , OV I, the (Final) This request void 18 months from certify th t Aire inspection has bee? a/d /. Date Date /L /D/ CITY OF EAGAN 3795 Pilot Knob Rood Eagan, MN 55122 _ PHONE: 4548100 BUILDING PERMIT APPLICATION $28,000. Receipt # - To be area for Sing. Fam Dwlg. Date June Site Address Lot 9 Block 3 Sec/Sub Parcel # CG 11 W (Name Karell Const. 3 Address 10111710 Lynda I AY SO 0 1 0 z or, f Name _ Address Name _ Address Phone 77 Erect fC] Occupancy Hl Alter ? Zoning . Repair ? Fire Zone _ Enlarge ? Type of Const. V Move ? # Stories Demolish ? Front 38 ft. Grade ? Depth 24 ft. Aoarovols Fees Assessment - Water & Sew. Police Fire Eng. Planner - Council Permit o7.7u _ Surcharge 14.00 Plan check SAC 475.00 Water Conn. 230.00 Water Meter Park Don 75.00 I hereby acknowledge that I hove read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. APC Total 879.50 Signature of Permittee A Building Permit is issued to: Mar-" ('04St on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official tI Na 4368 6365 CITY OF EAGAN ? 3795 Pilot Knob Road Eagan, MN 55121 Ne 6786 PHONE: 454-8100 BUILDING PERMIT A TIOI r Receipt # a rO O 4? 7'p ?jy? To be used for GAEW & BSW.Es. Value $10YO00 Date Jll1Y 31 19 8 Site Address 1778 Silver Bell Road Erect Occupancy Ni Lot 9 Block 3 Sec/Sub. Cedar Grove 11 Alter ? Zoning 10 16711 09 0 03 Repair ? Fire Zone Parcel # Enlarge I$ Type of Const. W Phil ReYee Name Move ? # Stories k 1778 Silver Address Bell Road Demolish E3 Fret q? °. yt om 18 ? ft. ?,- Eaean a,___ 454-8766 Grade n Depth 24 18 ft. of Name (100 Nawat on atruntien «PPf°•°1O 0 Address 1 3277 Hirmhol d t Ave Assessment Permit 0.50 , u? BtIIRIBVille 894-3841 Water & Sew. Surcharge 5•? Phone City Police Police Plan check Gw Name Fire SAC Address Eng. Water Conn. city Phone Planner Water Meter Council Road Unit 1 hereby acknowledge that 1 have read this application and state that Bldg. Off. ' the information is correct and agree to comply with all applicable $85 50 State of Minnesota Statutes a ' y of Eagan Ordinan es. APC . Total Signature of Pennittee A Building Permit is issued to: Nem .,?.?.?tl om on t he express condition that all work shall be done in accords ce with all applicable take of Min nesoto Statutes and City of Eagan Ordinances. Building Official r ?I ?I CITY OF FAGAN Include 2 sets of plans, IVI7 1 ?(/ 1 site plan w/elevations & BUILDING PEPMU APPLICATION 1 set of energy calculations. G r+?wy? To Be Used For rto0Xw.4 &senwrValuation /?r?lm0 Date 3A-Y? ryr M+j Site Address 9 a ,Pp. Lot Block _J'- Sec./sub. a Parcel #: to 1(0-10 octto O'-'? Owner: f yiL 4s6tes Address: 177 y3 Si/ve-/ R leU City/Zip Code: Phone #: YS - 76 G Contractor: C-?noQ Ue e .s C?zct ?eitcr4ay Address: 132.7 /lu Idl- /wc city/Zip Code: g &Aea,5rll, WAK Phone #: av?/ -39 Arch. /Ehg.. OFFICE USE ONLY Erect V Occupancy Alter Zoning - Repair Fire Zone M-01 - p ')o Enlarger Type of Const. Address: city/Zip Code: Phone #: 3 ;q 4a Move # Stories _ Detmlish _ Fronts ft Grade Depth ft ?dater/Sewer Surcharge_ Police Plan check Fire SAC Eng. Water Conn. Planner Water Meter Council Road Unit Bldg. Off. APC TOTAL K5 CITY OF EAGAN N0 1 0 2 5 0 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 4548100 Receipt # r? ADDITION 1,500 Site Address 1778 SILVER BELL RD Lot 9 Block 3 -wjSub. CED GRV 11 Parcel No. Name KADUM UM Address SAME City ' Phone 452-7795 Name SAME Address City Phone Name - - --- --- - - 6t6 - -- - - -- -- Phon6 ----- --- - -- I he"y o2kn6wledpe that i_h JIM inloimnfien Is [e'reet tm State of Mlniriota Stational Slpiiefatd of PetriNNw -__ A 9iiildinp Permit to ieoued to: ell dark "it be done In occo Bagditg Official - - Erect LJ Occupancy Remodel ? Zoning Repair ? Type of Const. Enlarge ? No. Stories Move ? Length Demolish ? Depth Grade ? Sq. Ft. Install ? Approvals Fees; Assessment Water d Sew. Police klie - - _-_ -__ IDIOM& - Goin;211. - -_-_ 9Bap: 5/2 0/ 8 5 .Pei; Date ----- Permit ge Surcharge Plan Review §Mt2 ---- - -- - Watai Land, - - - Water Meter - - Road Unit Parks Total 0- -_ an the ex ren c"flen that and City of Eagan Ordirieniea. BUILDIPIG PERMIT APPLICATION ,bP'V Date: Cis - /-?/ r LOT BLOCK 3 AilDITIOCJ ,r?s?ez i?,z,..? C? PARCEL & SECTION 11URBER IF Ui1PLATTED h ppt? ADDRESS OF PARCEL (? g 3< 'LONIZIG -OCCUPANCY ESTIMATED COST ADDRESS TELEPHONE 1110. CONTRACTOR :=?Z TELEPHONE 110. </K?T- ADDRESS Note Include site plan, building plans, and energy calculations with this application Signed OFFICE USE VALUATIOi? SAC WAVER CaL i3EC210:' WATER METER BUILDING PERI•iIT FEE SURCHARGE FEE PLAIT CHECK FEE PARK DEDICATIOU FEE OTHER TOTAL' ,A?30 . ao ,rd 6? APPROVALS. ASSESSMKI.T CLERK BUILDING DEPT POLICE DEPT TTATER & SIsb7ER DEPT. FIR= -DEPT. PARK DEPT. Yan1 ?I.wwiw{ sll?Il (i'Y171 n{7S Nf?voy W.?s N.C. lewd sm." • pml Ali- Cldl lnaineor iw{ }elephono 704-0006 "'""'tipol fopls"eri"{ Engineers 6 Surveyors Area Cc" 012 Mortgage Loan Survey for CE'DAC? GROVE CONST CO. S1LV?R BELL POND n m LO LO 0 r m / / 'f I LOT -9 QLOCIL 3 CMAR GROVE NO. 11 DAKOTA C011?1ZY -- - Denotes Drainage $ Uhli Y Casement VIA$.h • It" and secret[ repretewtmet" of a wr"y of who ?omm"tie. of tow food also" described mad of tbe .letatfon of all beitdirys, If pry, shamed, and all iH?to owtroethme"N Nary, Mw or e" said Mod. This seedy is terde tlnly he semeettlem wish m otr"we" Mow mom lseie{ pieced r the property mod ao liability 6 msse"ted _ - .amto?t tm tie AoYor of wsA .rrtpym or may osier MNrost mtgWnd by the rooNO Of '"Is worm"". it is wdetwmd and 0boood w?o?it.n?owontoa • how boo" eted far the pmrpo" N "fabfishiwa lot Yaps or Fwn/ory .. oormirmc, Dosed- tbh twy of?A. O. R, fULURRAN ENGINEERING, INC. ` ??. Scalp: 0'942 40 Cut w ?e. l . ? -r??" , WI C W pl ?I h r»a s,/Vc z l3E6a (A/ ?au2 FGP{/Nf, /CO2 ?a? RDO/t?o"/ Qc %) (4/ (N?rc mesNCF/ /QE a2 40010 J - 4/" S/ab 7// &lc% 69;540y ?,n. F?opR /w NC.d r. • /7 'G" 3k 1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN INCLUDE 2 SETS OF PLANS 3 CERTIFICATES OF SURVEY 1 SET OF ENERGY CALCULATIONS To Be Used For: ?771rt10A3 Valuation: Date: Site Address: 5?, SILII? Pl))FFICE USE ONLY Lot: Parcel # Block Cl- Sect/Sub{?/Erect Occupancy Remodel Zoning Repair Type of Const Enlarge # of Stories Owner PA () V M ?,l {vl Move Length Demolish Depth Address Sj M L Grade Sq Ft City/Zip Code j !3? Z - C S? Phone Contractor Address City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Phone # NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN APPROVALS Assessments Permit 2S. Water/Sewer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council Road Unit Bldg Offs •/p Parks APC Treatment P1 Variance TOTAL ST.PAULTITLE INSURANCE CORPORATION - RE: Payment of Special Assessments Gentlemen: 127 South Seventh Street Minneapolis, Minnesota 55402 (6121339-4894 Enclosed please find our check in the amount of $ for payment in full of the special assessment(s) for on the following property. If there is any question on this payment of assessment(s) please contact us immediately. Also, please send all receipts for payment as soon as possible with our fiel 1fia= aLQ--aSreferenced on the receipt. Thank you for your cooperation. Sincerely, Escrow Closer St. Paul Title Ins. Corp. 'I SA C) C) J('!? h li o n CA ?Qi?c?vr, Phone ' ? - ? g Af ilims of THE ST. PAUL COMPAN I ES INC. I r -I'] I Vkne.A' • `'1)V VY I_\l?lC.lX Il,-I(D'/1k"'y'9V'l Property Address Plat and Parcel CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 "90940 "mm FOR CITY USE ONLY 3 / (o l PERMIT # /?073-- RECEIPT # DATE: PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION NEW CONST ADD ON 171- REPAIR OWNER NAME: K)k-hum_ `(-km- SITE ADDRESS: 111 9 SI'LJ?fsSL?? LOT:9 BLOCK ,3 SUBD. (&(A?C AYWVC_ INSTALLER: ADDRESS: 12481 Rhode Island Ave. So. MN 55378-H22 r CITY: 894-00A?; PHONE # FEES ADD-ON MINIMUM 00 HVAC 0-100 M BTU 4.00 ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 OF 1 PER PERMIT J SUBTOTAL: $ L S STATE SURCHARGE: x.50 TOTAL: i/ SIGNA'TURE,pF PERMTTTEE PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: _ SITE ADDRESS: LOT: BLOCK _ SUBD. INSTALLER: ADDRESS: CITY: ZIP: PHONE #: FOR: 18 OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR EACH $1,000" OF PERMIT FEE. PROCESSED PIPING - $25.00 $25.00 MINIMUM FEE. CONTRACT PRICE x 18 $ STATE SURCHARGE $ TOTAL: (SIGNATURE) CITY OF EAGAN 411. C!tyofEaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use n� Permit #: ! °�/�!-C� Permit Fee: Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: ent) O�IV!ner ' Name: Phone: 12-61y nr_Z-2 � Address / City / Zip: I -114Z V'liter ed/ EX Applicant is: Owner Contractor Description of work: -.1 ir f # Construction Cost: a _ Multi -Family Building: (Yes / N ) Pt ,/". Company: •_ A i►$i, _ l Contact: 01,1 Address:L/l i oiln/19 fr Z r 4Y City: FlvtA State: MV Zip: 554/6S— Phone: V"Ck�)Email: 4ADM,66 E 4L CO 1 License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: In the last 12 months, Yes No COMPLETE THIS AREA ONLY has the City of Eagan issued a If yes, date and address of master IF CONSTRUCTING A NEW BUILDING permit for a similar plan based on a master plan? plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Fire Suppression Contractor: Phone: Phone: Phone: Phone: E 1 ns a � upport ng dorm t tha u sub ` fie cons' erer publf the 1 ormati n b «.: a ��a��lffe� � jJub1LC � ®� ° �� paii+4 thetg ode CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of peps issuanc Applicant's Printe • ame X nytiv Rro Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA141720 Date Issued:03/27/2017 Permit Category:ePermit Site Address: 1778 Silver Bell Rd Lot:9 Block: 3 Addition: Cedar Grove 11th PID:10-16711-03-090 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Leah Tototzintle 1778 Silver Bell Rd Eagan MN 55122 (651) 335-3892 Croix Crystal 3440 Yoerg Dr Hudson WI 54016 (715) 386-8667 Applicant/Permitee: Signature Issued By: Signature