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4290 Sunrise Rd _ < < CITY OF EAGAN Ne ~ 91'~ ~ ` 3630 Pilot Knob Road, P.O. Box 21-199, Eagan,lNN 55121 PHONE: 454-8100 BUILDING PERMIT • tteceipt 7 Te M wnd ier SF DWG!(;AR Est. Value $73,000 pate JUNE 18 19 84 Site Adfiress 4290 SUNRISE RD Er~t R3 Occupancy Lot Biock 4 S,,/Sub. SYN CMIFF tS7' AIter ? Zoninp 'I Parcel No. 10 - 7 2 9% 5- 0 7 G- Q 4 Repoir p Fire Zone N A BRUCE & f.i!SAN JENSI;N Enlarye ? Type of Cornt. V W Name Move O # Stories 3~ z Address Demolish ? Length City Phone Grade p Depth LO Sq. Ft. SRAND UAICS Aporovols Feet t~ Name , . 7623 U O~ Addrea UAKEVILLI' I~sseument Permit 36 u City Pnone -6561 Wuter b Sew. Surchorpe .~0 Police Plon check 176.00 ~ W Na'^e Firo 5AC 525.00 U~ Address Eny. Woter Conn. 470.00 ~ W City Fhone Plonner Water Meter 63.00 Council Road Unit 260.00 1 hereby ocknowledge thot I have read this epplication and stote thot gldg. Off. the intormotion is correct and agree to comply with oll applicable r 882. U State of Minnesoto Statutes and City of Eogan Ordinonces. APC Total SiQnoture of Permittee j?nr;-} , A Building Permit Is issued to: on the express conditlon thai oll work shall be done in occordonta wl1,h oll opplYcable State of Minnesoto Statutes and Ciry of Eapan Ordinances. Buildinp Offkiol 1 Permit No. Permit Holdkr Mise. Permit No. Holder Plumbiny q 1~ ~ H.V.A.C. J w.u w.ee. Disp. Sewer Electric 05'790MAS r 71S-Ify VI•50 Inspection Date Imp. Other ~ Footin4c D I-Z Faundation Framing Rouyh Plbp. Rou¢i HVAC "I-2 -'6`( Inwlatian Flnal Plbp. ~ Final HVAC ~ Finei -,~-~y ~ Water Dneribe Lotation: YVsll Sewer Pr. Disp. Receipt MECHANICAL PERMIT Permit No. J CITY OF EAGAN Fee Fi1/ In numbered spaces S/C Type or Print legidly Tot. 1. Date ' 2. Installat'on Cost ~ ~Z' r^ ~S2 . 3. Job Address Lot , Blk. Tract 4. Owner 5. Contractor Phone 6. Address ~`i ' • • 7. CitY State 'Zip 8. Building Type: Residential (D Commercial ? (nstitutional ? 9. Work Description: New El Add ? Alter ? Repair ? 10. Describe Fuel Type 11. No. E,quioment 8 TU - M. Ea. No. EQUiament CFM ' Forced Air Air Handling: Mfg. Boilers Mech. Exhaust Mfg. Unit Heater Mfg. Other Air Cond. Mfg. , f Gas, Piping Outlets 12. I 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 ugh ~ Final Inspections: Date 3Insp_ Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 CITY OF EAGAN t 920-1 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PH O N E: 454•8100 BUILDING PERMIT Receipt# To be used for "~j~ Est. Value ~'t ?i'~u Date i ~ S ,19 • SiteAddress 42~)o ~`•'i '~l OFFICE USE ONLY Lot 7 Block 4 Sec(Sub. ' t"i CLI FF 1-31T On Site Sewage Occupancy MWCC System zoning Parcel No. On Site Well \ , (r4ctuaq Const a Name CityWater (Allowabie) z Address f 2~' ' P u PRV Required ~ of Stories ~ a~• e S Booster Pump Length ~ City ~;~Gl~.. Phone Depth , p Name Sr\i,*. S.F.Total ~ a Address Footprint S.F. ~ City Phone pPPROYALS FEES ~M Engr./Assess. Permit W ame W y, Planner Surcharge z, Address ~ W City Phone Council Plan Review Bldg. Off. SAC, City I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC information is correct and agree to comply with a11 applicable State ot Water Conn. Minnesota 5tatutes and City of Eagan Ordinances. Water Meter Signature of Permittee Road Unit A Building Permit is issued t0: Treatment P1 on the express condition that all work shall be done in accordance with all ;,pa&-j C n1, ; OL~ applicable State of Minnesota Statutes and Gity of Eagan Ordinances. Building Official TOTAL Permft No. Permit Nolder Dals Talephone Plumbing H.V.A.C. E lectric Softener Inspection Date Insp. Comments Footings i Footings II Foundation Framing Roofing Rough Plbg.11 Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Bldg. Final Cert. Occ. Temp. LP ~ Deck Ftg. Deck Final Well Pr. Disp. Receipt rPLUMBING PERMIT Permit No. ' CITY OF tAGAN ' Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date " 2. Installation Cos aqO 54 n r , SP- . ; 3. Job Address LotBlk. Tract 4. Owner ` ~ , 5. Contractor,~' ; ,`c-z.'? Phone -7/ . 6. Address ~ 7. City State Zip - 8. Building Type: Residential Cl, Commercial ? Institutional ? 9. Work Description: New C~- `Add O Alter ? Repair 0 10. Describe 11. No. Fixtures No. Fixtures - Water Cioset Cesspool/Drainfield ~ Bath tubs Septic Tank =f~ Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray ~ Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that tiie above information is true and correct, and I agree to comply with aFl 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 454-8100 ~ INSPECTIUN RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (fi 12) 681-4675 SITE ADDRESS: APPLICANT: , ,i~~.~ i i , i ~ ~ ~ , . PERMIT SUBTYPE: TYPE OF WORK: r! r 1 ~ ~ i; ~ i~.~i f ~ i, ' I; I~1 I il~ , i INSPECTION TYPE DA • D. L.~ ~ Permit No. Permit Holder Date Telephone # S/W PLUMBING HVAC ELEC7RIC /0 ~f qq ELECTRIC Inspection Date Insp. Camments Footings I G Foundation Framing Roofing Rough Plbg. Rough Htg. ISUI. Fireplace Fnal Htg. Orsat Test Final Pibg. Plhg. lnspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final Deck Ftg. IG.Z y- Sj s Deck Final Well Pr. Disp. INSPECTION RECORD CITY OF EAGAN PERMITTYPE: ~,.i.i~~ 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: . ,1• f+E? ~ r < <<, :,l'rli , 10, i~~; ~ i ~ i i ~ . , , . i~i~l. PERMIT $UBTYPE: TYPE OF 1NORK: • ~ ~ ~ i i ,~~r r . ~ INSPECTION • .A F L ~ Permit No. Permit Holder ate Telephone N ELECTRIC z SG ~ PLUMBING HVAC Inepectlon Date Insp. Commenta FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS TEST VC INSUL GYP BOARD FIREPLACE d 7 /1/ FIREPLACE AIR TEST FINAL PLBG FlNAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK Fifl DECK FlNAL CITY OF EAGAN RemarksLd Addition SUN CLIFF 1ST Lct 7 Bik a Parcel 10-72975-078-44 owner.,14 Z.-,--• street 4290 SUNRISE MAD state EAGAIV MN 55222 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. ?55 1 2775.79 C009651 10-12-84 STREET RESTOR. GRADING SAN SEW TRUNK 30.64 C008799. 8-7-84 EWERLATERAL 1082.39 C009651 10-12-84 1099-19 216-48 5 WATERMAtN WATERLATERAL 18899.22 1 9-84 5 899.22 C009651 10-12-84 WATER AREA 1973 93.55 6.24 15 18.79 C008799 8-7-84 STORMSEW TRK 1971 322.29 16.11 20 96.75 C008799 8-7-84 STORMSEWLAT ~E 2985 789.70 157.94 5 789.70 C009651 10-12-84 Services 1985 776.63 155.33 776.63 C009651 10-12-84 CURB & GUTTER ' SIDEWALK 57REET LIGHT ROAD UNIT $260.00 #44137 6-18-84 WATER CONN. 470.00 ~UILDING PER. ~~gj]7 SAC $525.00 PARK CITY OF EAGAN WATER SERVICE PERMR 3830 Pilot K nob Road 5 ; 3 P. O. Box 21199 PERMIT NO.: 6-26-84 Eagan, MN 55121 DATE: 1 Zonirg: R; No. of Units: Owner, Grand Oaks Address: L n Site AMress: unISYKriee Road L7 B4 Sun Cliff let Plumber: '-:_)onald rlbfi 4 . 00 pd Meter No.: Connection Charye: -75. pd Sixe: Account Deposit' T0. 00 pd Reader No.: Permit Fee: .50 pd 1mgm to eanoy? wio tw CRY of Ea9sn Surchorge: 63.03 pd w@t!!T pnnM"ces, Misc. Charoes: Totol: By pote Puid: Date of Insp.: I^sP•: CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Roed p~{~IT NO.: P. O. Box 21199 ' Eagan, MN 551~'~ D'`~' Zoniny: ' No. of Units: ,ran a ~ pwnsr: /lddress: un s H unr ee a Slta Address: ..c ona 8 Plumber. ' , - 425.00 pci 1.em to eaePh +vhh elN C" ef Ea4e" Cannsction aorqe: , P AdiMnea. /?coount OePosit: 10.00 pd P°""it F°°' .50 pd Surcharpe: BY Misc. Choroes: Date of Insp.: Totol: Insp.: pote Paid: ~ , , `~•Y t ,~i .i. . t• y -~-jt ClT" OF EAGAN WpTER SERVICE PERIWT 38 Pilot Knob Rosd P. C SaX 2,199 PERMIT NO.: Eagan, MN 55121 DATE: 6-26-84 Zoninp: No. of Units: 1 Owner, _ /lddress: - ~ - Site /lddrcss: se T,7 34 Si~Z Cliff l~t Plumber. Meter No.: 470.00 pd Stze: Acco . unt pos~t: 15.00 pd Reoder No.: ti• ffn;t Fee; 14.00 Pd 1~gree to of e Surcharge: .50 pd ""anem ~ Misc. Chorpes: 63.00 pd meter O~ Totol: BY Date Paid: Date of Insp.: Insp,; CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road - P.0.8oxe21i99 PERMIT NO.: Eagan, MN 55121 DATE: - ' Zoninp: ' No. of Units: ` Owner: r ~ r..(_'a }c:~ Addresr. Site /lddress: c ac: L% E ~ ~ un C: l-i r ~ ? s t •PlumbEr: t.c - ~ i, : i : ,14 .44,13- 00 nd I .Yn• aFy; o~f E.~ew . ca,.iectrorr a,orOs: " Accou ~,u ~ / ~ ~ll.oo hC Pi'?mlt Fee: surc,a.ge: 50 BY ~ Misc. Charges: Date of Insp.: Totnl: Insp.: Date Paid: CITY OF EAGAN WATER SERVICE PERMR 3830 Pilot Knob Road 5553 P. O. Box 21799 PERMIT NO.: Ea~an, MN 55121 DATE: b-26-84 Zoninp: R1 No. of Units: 1 Owrwr: Grand Oaks a ' SunNUrise Road L7 B4 Sun Cliff lst ,Vkumber McDonald Plbg AAetar No.: 2a 2 n,~ ~ Connettion Charoe: 470.00 pd rr ocKst oi pep~t; 15.00 pd Siza: Reoder o.: D~L 62 3 7~ Permit Fee: 10. ~0 pd _ 1 pwe to oomwb wil6 el» Cilp of Eggsw Surcharge: . 50 pd 63.00 pd mete ~y Totol: gy~`~~:~ Date Poid: Date of Insp.: ~ ~ ~ Irop.: , y CITY OF EAGAN 7~~ 3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121 1~1 ? 9177 PHONE: 454-8100 BUILDING PERMIT Receipt ~t 7Y1j~7 Te ba und fer SF DWG/GAR Est. Vnlue +573,000 pate JUNE 18 q 84 SiteAdtlress b rec~t Occuponq R3 Lot ~ elock 4 qec/Suh, Sdig CI;IFF 1ST Alter ? Zoninq Rl Parcel nlo. 10-72975-070-04 Repair ? Fire Zone N/A BRUCE & SUSAN JENSEN Eniarae p Type of Const. V W Name Move ? # Stories ; Address Demolish ? Length 38 b City Phone 6mde 50 ? Depth Sq. Ft.- rc GRAND OAKS Approvalt Fees Name o /623 Addres UPPER 167TH Assessment Permit .SD o~ V~ Cit KEVILLE Pha„Q 432-6561 Water 8 Sew. Surcharge 36 v Police Plon check 176, ~ 0 ~Z Name Fira SAC 525.~0 Address Erq. Water Conn. ~Q 'W City Phone Planner WaterMeter63.QO < Council Rood Unit 260_O0 I hereby ucknowledge that I heve read this apvlication ond state that Bldg. Otf. the inlormotion is correct ond ogree to comDlY with oll applicoble TMOI •50 State of Minnesoto Statutes and City of Eagan Ordinoncet. APC - Signofure of PermiMee A Building Permif Is issusd to: GRAND OAK$ on tho express condition thnl all work sholl be done in accorda wi II appliwbl State f Mfnnewta Statutes and Ciry of Eagan Ordinances. Building pffitiol . CITYOFfAGAN N-° . 1 5201 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE:454•8100 Receipt #~0373 To 6e used for DECK Est. Value $1 , 000 pate JUNH 15 ~ g 88 Site Address 4290 SDNRISE RD OFFICE USE ONLY Lot 7 Block 4 Sec/Sub. SIIN CLIFF 1ST OnSiteSewage Occupancy MWCCSys[em - Zoning ParcelNo. on 5itewen (ACtual)Const a Name BROCE JENSEN Ciriwater (Allowable) W Address 4290 SUNRISE RD PRV Required # of Stories z - 3 eoos[er Pump Leng[h 0 City EAGAN Phone 454-4416 464-8325 - Depth a Name SAME S.F.7otal 0 ~ a Address Footprint S.F. ~ City Phone ppPROVALS FEES ww Name engc/ASSess. Permit 24•00 Planner Surcharge •$0 _ - Address aw City Phone Council PlanReview Bidg. Off. SAC, City I hereby acknowledge that I have read this application and state that the Variance SAq M WCC information is correct and agree to co ly with all applicable State of Water Conn. Minnesota Statutes andC ot Eaga r inances. Water Meter Signature of Permittee ~ Road Unit A Building Permit is issued to: RliCE JENSEN Treaiment Pt ontheexpresscontlitionthatallworkshailbedoneinaccordancewithall 7ggKWCOjJieS 1_00 applicahle State of{~M~in~ne~so.~ta S~[atutes and City of Eagan Ordinances. BuildingOfficial i_lLHlll-1\'PSS,~,_I~~- TOTAL Z5.5~ _ CORRECTION NOTICE DATE:~ Address ~s~~1 Site Name ~ ~1 ~ Owner/Agent 4,a4 ,k ~ Telephone Owner/Agent Address Ordinance Nos. and Corrections - Correct By ~ . Z . + / ~ For reinspection Eagan Dept. of Inspection Inspec 3795 Pilot Knoh Rd. Eagan, Minnesota 55722 454-8100 Dept.: L L.`3 51 Requ st Dat Fire No. Pough-i pection ~ yyill Notlfy Inspeclor a re s ? No nen Ready? I; licensed contractor Xowner hereby request inspection of above electrical work at Jo0 Atltlress (StreeL Box or Route No.) Giry 4a?0 sr,ua.ssLe. aa E,q~'*V Seclion No. Township Name or No. Range No. Counry .D~4KOTA Occupant(PRINT) Ppone No. 13euer- C, ~FUS~ii/ 4~s>f-'!t'!G Po~wer ~Suypplier Atltlress Yi9'~i j9-4l Elecvical Convaciw (Company Neme) ConrrectorY License No. Sak rvti'e, Mailinq Atltlress iConvactor or pwnar Making Installalion) AutM1Orizetl Slgnature (GOnhac~ r/0 ner Making Installaiion) Phome Number ,a~~~ -ily- 5111 MINNESOTA STATE 80ARD OF ELECTRICITV * THIS iNSPECTION REOUEST WILL NOT Grlggs-Mitlway BIUg. - Hoom S1]3 n1l~ BE ACCEPTED BV THE STATE BOAFD 1821 UnlversHy Ave., 56 Paul, MN 55104 Y~O~V~ ~ UNLE55 PROPER INSPECTION FEE IS Vhane(61R)6E2-0B00. ~ . ENGlOSEO. ~ REQU FOR ELECTRICAL INSPECTION °'"`EB-00 e_ , See in~ns far mmpletlng [his farm on beak of yellow copy. 3 9 8 51 "x" Below Wark Covered by This Request eve'Adtl Rep.' TypeolBuilding AppiiancesWired EquipmentWired Home Range Temporary Service Ouplex Water Heater Electric Heating Apt. Building Dryer Otheo (Speci(y) Comm./Industrial Furnace Farm Air CorWitioner Othar [specily) CanVecrorS Remarks: Compute lnspection Fee Below: # Other Fee # ServiceEntranceSize Fee # Circuks/Feetlers Fee Swimming Pool D to 200 Amps o to ioa Amps Transtormers A6ove 200 _ Amps Above 100 _ Amps SignS Inspecfor5 Use Oniy: TOTAL Irrigation Booms O S~ Specialinspection AlarmlCommunication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, here6y Ro,n-m ~ oare -~s certify that the above inspection has Fr,,a, oaie } been made. - -1- OFFIGE USE'JNLY ,his reauest vo,d 18 mon,h= f,om 31 S¢A-Itoi 2 7 9- 0 8 4~OFFIpCF,~SE /oNLY This reqaest void IB months from mlidoean dok pnmed i s is i~ a • /fi,lJ~ PLE4SE PRINT OR TYPE ~ C.7`(/ Reqoasl Do r ~ ~ - ! Rough.in impecMOn required2 ? Yes Inspedion Oiher Than Rooghln: 0 0.eady Now Will Call L o mustmlllhe Inspenorwhen ready) Wk Reody: I, licensed contractor 13 owner hereby requesf inspedion of tfie above eledrical work at: lo6lddress (Street, B r, or kook No.) 1 Ciry Zip Code ~ ylwPi at Saclion No. TowneFip Nome ar No. Ronge No. Fire Na. Coanry O 1 1 r P ne No. r d, p r ey- 33- o y z- Power Supplier e,aa,e„ EI 'wl Conhoaor ~Company Namel Conkactor licenu No. Maxbr Lia No. (Plonl Elen. Only~ (2C S - Ca • DD O Mo~u~ <ddne,. (eom r", re,ro i~~ouono~i 0/ Aolho' Si aNm (Comrocbr or Ovmer PeAormi In IlaHOn) PMm No. ZZ -M3 EB-00001A-106/95 11LRV'~ BOAFib COPV-SEEINSTRUCTIONSONBACKOFYELLOWCOPY IIIIIII~iII I~II III IIII I~ IIIIIIIIIIIIII~II I~I az~unE' e sry Bea Rm. S-~1c6ASt P6ul, 04 i ~w , 0 2 7 9 0 8 4 8 Phone (812) 842-0800 G77V Nome Duplec Apt. Bldg. Other. ' New Addn Commercial IndusNial Form Remod Re air Air Cond. . H}g. Equip. Wo}er Hfr. Load Mgmt. Other; D er Ran e Elec. Heaf Tem $ervice "X" o6ove tfie work covered by this request Enfer remarks in this space ond on the 6ack of ihe whife <opy only. Wire ~qs ~iw~ePlclce, , Calculate Inspecfion Fee - 7his InspecFion Requesi will nof be accepted without the mr2d fee: Onher Fee =n" Mrunce Sae 11 # Circuih/Feeders Fee o- Mobile Home Park Stall Amps "Ir 0 ta 100 Amps Sfreet Ltg./Traffit Sig. 0 ps Above 100 Amps Tronsformer/Generaior SE O~ TOTAL ~ ~ Sign/O utline lfg. Xfmr. Alarm/Remote Control $wimming Paol t I m ected the ale ~ml ~nsmllanon des<nbed hnein on Ma daks smred Irrigafion 8aom ~+e Special Inspedion fl;Ee ' 3 Inves}igative Fee THIS INSTALLATION MAY BE ORONNECTED IF NOT COMPLETED WITHIN 18 M NTHS. h: ~uew ~;a ~ y Sa sr /.17- ~a . s o ,e „ ~„ms r.~ A 0578 09 L 7, 8 N 5~~1 C~ciFF 7-s-~ Reque~ t~ta ~ Fire No. IbupMin Irepection . ire~? ~]ReadyWow ill Notity InsPec- ~ j ~ ? ryp ror When R¢ady Licerc~ed Elec[rical Cm[rac[or 19~ 1 MreOy request i~wpeccion o1 above ? Ow"r elecbi'al wmk imtalleE a[: S[reet A dress, Baz or lOOUre. No. ' Ciry 90 r' aC q R ti ecUOn T N me o. o. Couaty [o l c,,n D af~ Occu nt IPRINT) ( Phon,ef' . Yi Yl Gt~ rb+«e~ sumi;/~ naa,ess r a L o Elec rical Gon actm (C m L Contractor's Licen e No. ~ -4/0 7V3 Maiii n Address IC ctor or kinp Imm:latiml 7 7 ~~lvt 4 MN 5S 3 AuMo " ed SiB ure IC ctar r Makinp IreTalWtiml Mane Number i YINNE$OTA STp Bppqp OF ELECIRICT' THIS INSPECTION REUl1EST WILL NOT Grigps-Yidway dg. - Rodn N-197 ~ ACCEPTEO BY THE STATE BOARD 1ffi7 UniveraiHp.e..31 Peul. YN ~101 UNLESS PpOPEB INSPECTIDN FEE IS PM..o f81212972177 ENClO5E0. qqc-'• mQUEST FOR B.ECiRICAL IwECTION 07Ee-ooooi_oa S. irmtruetiam for m~btim tl.is farm on bxk of yetlow eoav. A 057869 "X'" Belor Woik iwered by This Request - 5T ~ o r e nao• Troe ot auiuine Apptie.;;Wired EQUipmeni Wired . Ho1ce Range Temporary Service Duplex Water Heater Lightinp Fixtures Apt Buildirg Dryer Electrfc Heatin Conmercial Bidg. Fumace Silo UMoader IndisVial Bldg. Air Caditioner Bulk Milk Tank Fam OtMr pecl ther ISUer.ihyl t r pec, y Otber 01her \ Compu[e nspec[ion Fee Be/aw \ p Fee SeniesEM.aaeSize A Fee Feeders/Subfeetlera M Fee Circuifa a 0 to 200 Affq)s 0 to 30 Airps o7•S 0 tn 30 Am • Above 200 q 31 to 100 Ar~s ) D• 1 to 100 Afftus\ Swimmi Pool Above 100-Amps A6ove 100-Am • 7runsfonmers Irri tion Booms f - Partial- O Fee Signs Speciai ins pection TO L FEE emarks ~ \ ifl Rough•in ct.' - ~nspec[or, he~eby certify thni tlp nbove I Final ~ spection hes Eaen J aa. nbmama voiuummonth~ G(o~G1 /S.SO 2004 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date6 ? / 6! I 0 / q Site Street Address Unit # Property Owner U Telephone # (4dO365 Contractor Telephone # (dgl ) 3"-1 3,V[) -P Address E3& gD ~~"Ae9. woq City 0_4.J State /?7~7. ZI /-_13 The Applicant is: _ Owner ?Contractor _Other Alterations to existing dwelling $ 50.00 _Add fixtures to rooms, excluding water softener and water heater _Septic System Abandonment _Water Turnaround (add $121.00 if a 5/8" meter is required) Other: Water Softener ?Water Heater $ 15.00 ir"'~ replacement _ additional Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00 State Surcha ZQ13 4 $ 50 Total I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. m_ Gr2 v W-.h 5 ApplicanYs rinted Name Applicant's ignature a/5 ,6X a•* tE6 2•5 0 + 352•O0 + 1 0 •03 + 36•5 0 + 1912=50t 176~0 0 + ' S25•OC+ 470•C0+ E3~uG+ 2 6 0• 0^ r 1682•50 % ~ CITY OP PAGFIN Inclucle 2 sets of plans, ~ ' ' ` ~x~ • 1 site plan"v;/elevAYionss BUILDINr PERKIT APPL.7C7VT70N 1 set o£ enereTy ca1culatrons. ~ ~'~~w '~~z• ~ 22 Zb f3e Used For Valuation Date site Address yjgp ri5 oFTICE UsG ONL't int B1oCk f Sec./SUb. Cxect X OccuPancY K'"> Parcel U' 7,) y7~ ~ D 7D- D~ nlter zoninc7 Repair Pire Zone N- p,oner; P:.nlarc7e _'lype of Const. S[ Address: ~bve # Stories DExmolish Fivnt ft. City/Zip Caie: _ Grade Depth G ft. Phoree # : A 11PPRC)1771i S Ff:FS Contractor: Assessments Perntit 3 ~2. Water/Scwer Surcharge 3 50 Fddress: `7 (o 'L ~3 Police - Plan Check I -1 Co. °v City/Zip Code: Fire _ SI~C 525. Ilx9. Water Conn. 41 D. Phone ~ 3 2(D S1o ( I>,~anncr Watcr Meter (p°j. Counr,il Fkoad Unit /Eng IIldg. Off. Pddress: AIIC T^T - City/2ip Caie: Phone H: 'It7['AL ' S d ~ f C r , i , ; c7ill _ ~ x ot~zl o b :P • . O~ ~s x ~ x ol C. R. WINDEN b ASSOCIATES, INC. lANO SuRVErpRS Tot 945•3646 1981 EUSTIS ST., ST. PAUL, MINN. 55100 FOR: GRAND OAKS DEVELOPMENT N iJob No. QQ Aat. Na • 198~F O o" Date Reo'di~1CE1VED IAY 22 na~wOwa er. ~,hp` Qo ~r ~ft ~cale: 1" = 30' ~~OO ~PB~ O Denotes Iron W Monument Check Mo. A1 ' /0~ / `ro o ~ Ohyb ~ 00 ~ y ~0 ss pQ ~ ?6 s, z o' ~ F l~o O`ri0 \ \ ~ w s \ \ \ / So 99 ~ ~ ?9. NQTE: o Denotes Wooden Stake \ ~ 01 Proposed Garage Floor E1.903.9i (903.6) Denotes Prvposed \ , ~p Finished Ground E1. l .f--- nenotes Direction Of Surface Drainage Vertical Datum - N.G.V.D. 1929 ~e 6 h~/•o ~(po3p ~ OJ 6'a 5 Lot 7, Block 4, SUN CLIFF FIRST / ADDITION, Dakota County, Minnesota. WE MERElY CERTIFY iMAT TMIS IS A TRUE AND CORRECT RfVRESENTATION Of A SURVEI' OF TME •OUNOA11E5 Of THE tAND A?OvE DFSCRIIED AND Of TME IOCATION Of All 6U1LDINGS, tf ANY, TMEREON, AND Atl VISISIE ENCROACMMENTS, If ANY, FROM OR ON SA10 IAND. Datod this ZrJt day o1 Ma A.D. 1984 C. R. WINDEN 8 ASSOCIATES, INC. ?r ll'"= Sur•yer. Minniswla Rpi~trofise No. ']'726 N~v ` Preparedfor ~l'/9NaOt*k5 /~e(~t/ay~f~orr'{' SheetNo. RESIDENTIAL Address Date HEAT GAIN & LOSS -~rg, k • a ,,c Job No. RAPID ESTIMATE Estimator AID 1.5.1 REV 2 S71BSf118n DATE 7/15177 DESION CONDITIONS INSULATION HOUSE FACES OVERHANG OR SHADING COOLING DB °F HEATING DB °F Cei9ng A?-3r ? North Outside Temp y' Inside Temp 7 O WalI .2 O-East ~ Inside Temp Outside Temp a O Fba ? Soulh TemP Diff Temp DHt p'U Window Cl West LOAD TMPE AREA COOLING HEATING FACING Factor Sens Btuh Factor 8tuh/°FTD 1 GROSS WALL AREA 2 WINDOWS & N- NE 5~. 6 Rr . awz i,~~, y , , g, 17,1 3 GLASS DOORS E- SE 19` 9,y7. S3 1.3 4(Tables I and II) S- SW 7 ay / 7s z, . 8-3 5 W-NW Sr.~ 6 7 8 9 10 DOORS L' D 3(o oZ D ;;2 . •q?, 11 (Tables II and III) 12 13 NET WALLS C l. N53•4 ia (TableIII) w a 5, x 1,7 ,ysa, g os 13•3 15 N .A! 1 ,7 . as ia•y ,s s a41 8~ 1.7 Na2-CN' ,as 1xs 17 CEILING OR ROOF b . I 76, G .ZS 3041 18 (Table IV) 19 20 FLOOR 91S 193 21 (Table V) 22 23 PEOPLE (NO.) 300 66.0 74' r 24 COOKING 1200 6, y A Total Sensible Heat Load (Add all Btuh) F 5 6,41 .y ;r 59 B Duct Heat Gain (See Table No. VI.) 0 / 75 11S C Grand Total Sensible Heat Gain (Line A+ B) 09, l , D Grand Total Heat Gain (Line C x 1.3) G/, y E Adjusted GTHG (Line D x Swing Factor) F Total Heat Loss (Line A x Design Temp Difference) 9,61 53 (0 76. ~ G Duct Heat Loss (See Tahle VI.) a Q i p 735, x H Grand Total Heat Loss (Lines F+ G) .y yw, ~ Prepared fa a N ~ Sheel No. RESIDENTIAL Address & .7 Urd..-~ > s~ s,~ • u~,s ~ oate s/si ~8'S' HEAT GAIN & LOSS ~~-u~ ~ ~'/n • Job No. RAPID ESTIMATE Estimator RE~257 Salesm8n DATE 7/15/77 DESI6N CONDRIONS INSULATION HOUSE FACES O'VERHANO OR SHADIN6 COOLING DB °F HEATING DB °F CeiBng K ? North Outside Temp 95- Inside Temp 70 yyall 9[}-Eest ~ Inside Temp 73- putside Temp a O Fbor ? Soulh Tertip Ditf a0 Temp Ditf 4U Wfndow ? West LOAD ~PE AREA COOLING HEATING FACING Factor Sens Btuh Factor Btuh/°FTD 1 GROSS 1NALL AREA 'x: ; " - . , _ 2 WINDOWS & N- NE 91. 6 z ~y. , gI 7, 2 3 GLASS DOORS E- SE 17.3 a f 9y7. .S'3 3 4(Tables I and II) S- SW 7 a y / 7 S;t, .813 5 W-NW F.F ~ -2.Z 6 7 8 9 10 DOORS ~ D (o 90 :,Z • . Ff 11 (Tables II and III) 12 13 NET WALLS ' ~/5 3• .015 I 3 14 (rabieuq i.t9 a 51 2- 7 yso•9 as 13.3 ,s N a , 4 l '7 64aQ, 1, . os /a•4 ,s s a yrl 1.7 4112. Tf , os 1zs 17 CEILING OR ROOF 6 113 7614 ,ZS oq 18 (Table IV) 19 20 FLOOR S 133 21 (Table V) 22 23 PEOPLE (NO.) 300 (e p p % 3 ~ n u re ~ 24 COOKING 1200 A Totai Sensible Heat Load (Add all Btuh) $ 5 6 •6 S 91"y B Duct Heat Gain (See Table No. VI.) C Grand Total Sensible Heat Gain (Line A+ B) 10609" D Grand Total Heat Gain (Line C x 1.3) 13 E Adjusted GTHG (Line D x Swing Factor) 1.0 Cf F Total Heat Loss (Line A x Design Temp Difference) 90 53 (0 76. O G Duct Heat Loss (See Table VI.) 90 /Q 735, z H Grand Total Heat Loss (Lines F+ G) y.y// PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: 8 U I L p I N G Eagan, Minnesota 55123 Permit Number: 021811 (612) 681-4675 Date Issued: 08 J23 /93 SITE ADDRESS: 4290 SUNRISE RD LOT: 7 BLOCK: 4 3UN CLIFF P.I.N.: 10-72975-070-04 DESCRIPTION: (16'x 16' DECK INCL) B.uildingt,Permit Type SF PORCH Building lJo;rk Type NEW i'UBG Oacupancy", R-3 /'COnstruction Type V-N ~ Building Length 1__, 16 ~Building WidCh ~ 16 Ci~ (7-1; REMARKS: FEE SUMMARY' VpLUATION $15,000 Base Fee $162.00 Plan Review $105.30 Surcharge $7.50 Total Fee $274.80 CONTRACTOR: OWNER: - Applicant - JEN3EN BRUCE 4290 SUNRISE RD EAGAN MN 55122 (612)688-8827 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable 3tate of Mn. Statutes and City of Eagan Ordinances. APPLIC /PEflMITEE SIGNATURE 'ISTSUED Y: SI NATURE INSPECTION RECORD CITYOFEAGAN PERMITTYPE: suxLoxNe 3830 Pilot Knob Road Permit Number: 021811 Eagan, Minnesota 55123 Date Issued: 0 B/ 2 3/ 9 3 (612) 681-4675 SITE ADDRESS: LoT : 7 B L 0 C K: q APPLICANT: 4290 SUNRISE RO JEN3EN BRUCE SUN CLIFF (612) 688-8827 PERMI Po~U~BTYPE: TYPE OF WORK: NEw DESCRIPTION (16'x 16' DECK INCL) INSPECTION . FOOTING FRAMING INSULATION FINAL I ~ ( - REALTIVATE ~ C~~~~ ~y~~~@ CITY OF EAGAN P~'i~rr ~ 1993 BUILDING PERMIT APPLICATION clit I I UG 17 1993 681-4675 ^/4_Aj -a3 - SINGLE Q MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. , COMMERCIAL 2 sets of architectural 6 structural plans, l set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month• 1n which request is made, 2) address is changed or 3) lot change 1,s requested once permlt is issued. Date R //6_ /$R3 Yaluation of work U'CinC7 -/S-/Wo Site Address: SW 9o Seu.Rrs~ ~ STREEi SU1TE r Tenant Name: (commercial only) IAT 7 S1ACK SUBD.Sun P.I.D. M r Descri tion of work: Se v~ "T-,t)rc ~ The applicant is: '5f Owner ? Contractor ? Other (Deseribe). Name SF~vsE.r/ L3.F~l~ Phone/rl /sf/-s<%/G Property LAsr FIRST c~ ~88-SSZ7 . Owner Address 4/.290 ScUI,2.rs~ SiAEEi tTE M City State A-(Il~ Zip Company Phone COntfeCtOf Address License d Exp. City 5tate ZjP Company Phone Architect/ Engineer Name Registration r Address City State tiP Sewer & water licensed plumber . Processing time for sewer 6 water permits is two days once area has been approved. 1 hereby acknowledge that I have read this application and state that the fnformation is correct and agree to comply with all applica6le State of Minnesota Statutes and City of Eagan Ordinances. 5ignature of Applicant: OFFICE U5E ONLY BUILDING PERMIT TYPE O OI Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finlsh ? 02 SF Dwg. ? 07 4-Plex ? 12 Mu1ti. Misc. ? 17 Swim Pool O 03 SF Addition ? OB 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind. 9- 04 SF Porch ? 09 12-Plex ? 14 Fireplace O 19 Comm./Ind. Misc. 05 SF Misc. 13 10 Multi. Add'1. ? 15 Deck O 20 Public Facility ? 21 Miscellaneuus woRK nrPe ~ 31 New 13 33 Alterations O 35 Tenant finish 0 37 Demolish 32 Addltion 0 34 Repair ?_36 Move GENERAL INFORMATION Const. (Actual) V-1J Basement sq. ft. MWCC System Allowable) lst F1, sq. ft. City Mater UBC Sccupancy RT-~ 2nd fl. sq. ft. PRY Required 2oning Sq. Ft. total Booster Pump i of 5tories Footprint Sq. ft. Fire Sprinkler Length 79r On-site well Census Lode tI~3~l Depth On-site sewage SAC Code APPROVALS ~ ~ Planning Building Assessments Engineering 4ariance REQUIRED INSPECTIONS L) P&P_C,µ Fuu.S ' 16 X/6 1 ,DZ O Site q Footing Framing P~ Insulation ? Wallboard [Pinal Draintile [3 Fireplace Permit Fee (5, 'L, b0 v.iu.c;a,: Surcharge ~ Plan Review ~05 }2Ci- License f ~ CWty SAC 6~' Water Conn. IJater Meter Acct. Deposit S/W Permi t S/W Surcharge Treatment Pl. Road Unit /4~~?? Park Ded. Trails Ded. Lopies Other Total: SAC % SAC Units C.R. WINDEN d ASSOCIATES, INC. tAND SURVErORS fal i45.3649 1381 EUSTIS ST., ST, ?AUt, MINN. 65i0s FOR: GRAND OAKS DEVELOPMENT N ~ob No. Q Acct. Na • - o" oate Reed#iEGEIVED ;tAY 2 2 1~4 APOroved BY% po Pey DstBc cale: 1" = 30' w ~ . O Denotes Iron Monument Check !No. 1 . / ~ S 3 L~/ h\~ 23 a ~ G Q ti' Q s ~ r 2 F• 2 ~ `Q e~ ~y ~ 6',j~9•, F F ` A Q~X9 s \ \ \ 99 ~ / \ . 11,06 ~9. NOTE: F \ % ~ o Denotes Wooden Stake \ Q1 Proposed Garage Floor El. 903.93 (903.6) Denotes Yroposed Finished Ground E1. J -4-- Oenotes Direction Of Surface nrainage (~SO~ Vertical Datum - N.G.V.D. 1929 3 soJ o 6~0 Lot 7, Block 4, 5UN CLIFF FIRST ADDITION, Dakota County, Plinnesota. . WE MERE6Y CERitfY THAT THIS IS A TRUE AND CORRECT REPRFSENTATION OF A SURVEY OF THE SOUNOARIES OF THE IAND AlOVE DESCRIlED AND OF THE IOCATION Of All 6UILDINGS, If ANY, TMERfON, AND All VISISIE ENCROACMMENTS, IF ANY, FROM OR ON SA10 LAND. Dored tti;i Zt- °f der •1 M a A.D. I98¢ C. R. WINDEN d ASSOCIATES, INC. ~ ,Y Svr.trwr, Minnebete RNittratien Ne,17,726 M31~ , 1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN zor SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLMIS, 3 CER/1CATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: 9DDAESSES FOR CORNE LOTS - CONTR9CTOR/HOMEOWNER MOST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHAN S WILL HE ALLOWED ONCE BIIILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RE AL ONITS FOR SALE UNITS # OF UNIT3 INCLUDE 2 SETS OF PL S, CERTIFICATE OF SURVEY - CHECK WITA BLDG. DEPT., 1 SET OF ENERGY CA ULATIONS COfM4ERCIAL INCLUDE SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET F SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: 'JEG< Valuation: 4*6~11 Date: Site Address y29o $uql/2.s"5E ,Jr p 07 OFFICE USE ONLY i Lot Block ~i On site sewage, Occupancy MWCC system _ Zoning Parcel/Sub - - On site well Actual Const - City water Allowable Owner ,$QI[de, PRV required _ ll of stories Booster Pump _ Length Address -42D SUA/2Z'S6 "-q(~ Depth S.F. Total City/Zip Code Footprint S.F. Phone k) APPROVALS FEES Contractor Engr/Assess Permit Z U, Planner Sureharge Address Couneil Plan Review Bldg. Off. . "2/(7 ~c/1SSAC, City City/Zip Code Variance SAC, MWCC Water Conn Phone Water Meter Road Unit Arch./Engr. Treatment P1 Parks Address Copies O o ~ TOTAL City/Zip Code Phone li ICITY OF EAGAN PERMIT 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 02 - 8339 (612) 681-4675 Datelssued: gy/z2/g6 SITE ADDRESS: 4290 SUNRISE RD L07: 7 BLpCK: 4 5UN CIIFF 15T p,I.N.: 10-72975-070-04 DESCRIPTION: ~ ( GA s ) €clil'"ta~ Permit Type FIREPLACE r~3r~?l,dsnI rk Type NEW ~ ~e'ri°eLLa C+sc1i N 434 ALT. RESIDEN7IAL P Jr ~ ~ °uy.e d''rE i~u "p:. s^" ~~`~ia'~ 4a•,,~-~ c:..t REMARKS: FEE SUMMARY: Base Fee $25.00 Surcharge $.50 Total Fee - $25.50 CONTRACTOR: - Applicant - 5T. LIc OWNER: FIRESIDE CORNER INC 16331042 0001068 JENSEN BRUCE 2700 N FAIRVIEW AVE 4290 SUNRI5E RD ROSEVILLE MN 55113 EAGAN MN 55122 (612) 633-1042 (612)454-4416 I.Fi.era`dy acknawlecijs'wtita t T ha Ve r^eazl this appl£cation aad ~tate tha"t Che. ,€nfor~r~faG~rtri aor-~eL ~tlri`ac~roa tq e,amply t~ith a2l,applicab7.e ~"tat~ af ~~1rt. Statu~~s aT+t--GttY"af E49a~ ~l I T-~ APPLICANT/PERMITEE SIGNATURE SSUEY) 3F.jSIUNATURE- 2"59 CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1996 FIREPLACE PERMIT APPLICATION 681-4675 DATE: /Z 06 DESCRIPTION OF WORK: ~ INSTALL MW FIREPLACE: _ WOOD BURNING 1-Y GAS _ INSTALL GAS LOG ONLY IN EXISTING FIREPLACE _ INSTALL GAS LINE ONLY IN EXISTING FIREPLACE OTHER: AREA TO BE INSTALLED Ion-e-k 'tV S~ a/~~ ~ S7l~t (~/GCJ~C-e~ ,SL3 Z~ l STREET ADDRESS: 4- Z 9'0 LOT BLOCK ~ SUBD./P.I.D. APPLICANT: (circle one only) OWNER CONTRACTOR 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. PROPERTY Name~'J~`1~SQI~ BYLQ"t--6' Phone ~S ¢ ¢¢1f° OWNER ~T Rnsr Signature: Street Address~"Z~d t Sc pt::) City: 5tate: /1'L~ Zip: / Z Z 0 7,5'0 FIREPLACE Company: Phone 6 33 2-s~ 1 INSTALLER Signature: Stre Address:3 KvF'o - W' License b/~ City:VE uAg:,e ?t L-(--c State: ~ zip.~33 GAS LINE Company: Phone INSTALLER Name: Signature: Street Address- City: State: Zip: t . .m~ s- ~ OFFICE USE ONLY ~ ~ BUILDING PERMIT TYPE a 14 Fireplace WORK TYPE 0 31 New o 33 Alterations 0 32 Addition ? 34 Repair GENERAL INFORMATION Census Code. SAC Code REMARKS: Chimney/flue must be inspeeted before concealing. FEES Permit Fee Surcharge Other Copies Total: L ~',c~' 8y y~ ~'~So 5 ;i CITY USE ONLY L BL -4- ~ RECEIPT LS ' SUBD. DATE: ~ 1996 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 68111675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit New construction Add-on furnace ~d on air con itiontng Add-on a'sr exchanger, ;.e. Vanee system, s!c: Date: FEES , ? Minimum Fee: Add-oNRemodel (existing residence only $ 20.00 , ,a. , ~ e? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ' ? Gas Outiets (minimum of 1 required @$3.00 each) ` ? State Surcharge TOTAL , ti . . - SITE ADDRESS: ;~Z~ t , ' . OWNER NAME:A/&i~ PHONE . . INSTALLER NAME~'lfC i STREET ADDRESS: , CITY: STATE:~ ZIP:--;~~-°~"' PHONE ( ~ CITY USE ONI.Y L BL RECEIPT SUBD. DATE: 1996 MECHANICAL PERMIT (COMAAERClAL) • CITY OF EAGAN , 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? all commercial/industrial buildings. ? multi-family buildings when separate permits are ~ required for each dwelling unit. DA?F: C[)NTRACT PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: P $25.00 minimum fee pl 1% of contract price, whichever is greater. w Processed piping - $25.00 State suroharge of $.50 per $1,000 of rmit fee due on all permits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL 51TE ADDRESS: OWNER NAME: TELEPHONE TENANT NAME: (innPROVeMeNrs oNLv) INSTALLER: ADDRESS: CITY: STATE: ZIP: PHONE SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR . , - ~ 2/S4 y CITY OF EAGAN APPLICATZON FOR PEILMIT - SEWER AND/OR WATER CONNECTIO;T (PLEASE PRINiI 1) PROPERTY ApDRESS : 3-~{ G S u n r; 5~ 'Rd . r.Fraz. DFSCZitirzcv: 7 Q\ pe k y SvYi C 1,~F 1~-~ (1.4Dt/31ock/Subdivlsion or Tax Parcel I.D. NLmter) ir =;=:C ST.°.L'C1172E, DclT' GF CRIGi.iF1L BiiIL=:G F~_~.IT ISs'i::.NC°.: ~ P°.ESy;~ U5:: 5t -R-1 SINGL.°. r^?in_II,Y ? R-2 CUPLE.Y (7ti0 Wi ITS) ? R-3 TCdvNHCUSE (T'IIRF;c + =TS) ( iTiVITS) ? R=4 App.R71'z'^:T/CCNDC',t%=,1 I Wi ZTSi • N ? CCMr'IERCIAL/f2ETAIL?OFFICE ' ? LmL'STR= ? INSTITUTZO:VP.L/GCV~.~~SE"V'i f 2) APPI,IGnV"P ~ (PLEASi PRI4I) NAh~ : l JY^ A n ADDRESS: _L_SP a3 LJo P~ Y' 1~o ~ tl-~ ST CTTY. STATE, ZIP: Yt g` ~ (7 L-f ''"l PHONE: 3) p=mBER . ' ' PLEASE PFINi) FOR CITY USE ONLY r~%IE: M c f)J~~d p1 ±~m~2z~i~- : PLU ERS LICE45E: , aDOPEss: Active CITY, STATE, ZIP: Lri ~G P~ ~~~Q /Y7n . s; S a t/ y [=Ezpired IAIIL~ Not of Record - PHOiVE: PLUMBER IICENSE arr nitia Q) pCCJpn2IT/d,,7N-PR NAME(PLEASEPRINI) : ADDF2E55: n. ?1~1 ~ / ~ /1 k_A CITY, STATE, ZIP: : PHONE: 5) INDIG+TE WHICIi PEP•MIT IS BEZ[vG RIIQUESTEp; CMIECPION 'ICJ CITY SEZ^7ER CO:AVECPICN TO CITY WATLT2 r~. ? CYI'f'.II2 (PLF.ASE DESCRIIIE) 6) ~1DIC~,.~ C:~: ? P=E F?OLLI P,PPROVID PERHIT FOR PIC,:-UP gY pNE OF I1BWE ?°I.E1SE tilAIL APPROVID PR`LIT 'IO 1, (D 3, 4 FIBOVE (Circle one) 7) DATE:. i FOR C I TY U SE ONLY PER'NIT ° ISSL'ED F°ES: $ S liRCE $ WATER PERr1IT (INCLUDE SURCI:ARGE) $ ~~•d--p WATER M$TER/COPPERHORN/OUTSIDE READER $ WaTSR TA? (IUCLUDE CORPCRATZO:J S:OP) $ SE:~= Tr D $ ACCOUNT GEPOSIT - SEi4ER $ iG-- "---cJ ACCOUNT DEPOSIT - WAT°_R $ WAC $ SAC $ TRUNF: WATER ASSFSSP-:ENT $ TRliVK SES4ER ASSESSMENT $ LATE°,AL BENEFIT/TRUNK SELv*ER ~ $ LATERAL BENEFIT/TRUNK WATER $ OTHF.R $ TOTAL $ A-M0U:;T PAID/RECEIPT DOES UTILSTY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUIIJECT TO TFIE FOLLO:JING Cp:IDITIONS: APPROVED SY: TITLE: DATE: e; i i ~ Pam,~i n: I ~ City of EaiaIl ~ Permit Fee: 3830 Pilot Knob Road Eagen MN 55122 j Date Received: I Phone: (651) 675-5675 I ~ Fax: (651) 675-5694 ~ Staif: 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: SiteAddress: NZ90 :amn54, TG- Tenant: Suite RESIDENT/OWNER Name:~~arer M(~llQ1/ Phone:051' J~~q (~,S Address / City / Zip: • 2~- CONTRACTOR Name: License (o i 1no ko~A, Address: Champion City: 3670 Elodd Rd. #100 State: Zip: agan, MN 55123-133P Phone: Contact Person: 4~((S ol,e_ o TYPE OF WORK _ New _ Replacement _ Repair Rebuild Modify Space _ Work in R.O.W. Descri tion of work: PERMIT TYPE RESIDENTIAL ~ Water Heater _ Water Softener Lawn Irrigation Add Plumbing Fixiures RPZ PVB) Main _ Lower Level) Septic Sys[em _ Water Tumaround New Abandonment RESlDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System•Abandonment, Water Turnaround' (includes $.50 State Surcharge) "Water Turnaround (add $165.00 if a 5/8" me[er is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace bumed out appliances; ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES I hereby acknowledge that this infortnation is complete and accurate; that ihe work will be in confortnance with ihe ordinances and codes of the City of Eagan; ihat I understand this is not a permlt, but only an application for a permit, and vrork is not to start without a permit; ihat the work will be in accoMance wi[h ihe approved plan in the case of work which requires a review and approval of plan/i~~ . x ~ J(JU 1 KA l.~ - M.~1.rOT x ApplicanYs PriMed Name Applicant's nature ~ FOR OFFICE USE ' RewewedBy: ' Dafe: Requirei! Inspectioris ~Urder Grou ~nti Rw~h In _Rv Test Gas Test Final ac,,. ' ~6 -~2~ • CASH RECEIPT ~ CITY OF EAGAN • ~ P. 0. BOX 21-199 , EAGAN, MINfdESOTA 55121 . DATE ' 19 ~ nacaiven . FROM ~ AMOUNT $ ac DOLLAR3 ~oo [)CASH Q CHECK FOR - FUNO CODE AIAOUNT ' ~ . ` - i.. ~ Thank You e v White-Payers CoPY Yellow-Posting Copy • Pink-File Copy CASH RECEIPT ~ V - k ~ CITY OF EAGAN P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE 19 . RECEIV ED FROM ~ aMOUNr $ I. S DOL ARS ? casH p c • _ FO r---~ _.FUNO , J GODE AIAOU _ u c= rJ i ~ 4po 7Z 7-7-3 - - IL. c:: ~ , Thanl~ YQu BY White-Payers Copy Ysllow-Posting Copy Pink-File Copy RESIDENT OWNER e---O 4 f 4.2-.7-00 4.2-.7-00 C> Name: Phone: �l ;7t.> 4.% C° Address City Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: i rr Construction Cost: Multi Family Building: (Yes No CONTRACTOR Name: Lat' `�4.'' r'. f'- License ;'i'` 7 v �C' Address: t'r' City: I 1 "z State: Pi O Zip: r°' /r1f' Phone: .5 J Contact Person: <J ()Ix) COMPLETE In the last 12 months, has Yes No If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer Water Contractor: Phone: NOTE: Plans and supporting the information may documents that you submit are considered to be public information. Portions of be classified as non public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 4 City of Eagan Date: Tenant: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 (i X Applicant's Printed Name For,C ffice Usse Permit l Permit Fee: Staff: Date Received: 009 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: Suite Use BLUE or BLACK Ink I hereby acknowledge that this information is complete and accurate; that the work will be in confo mance with tt7 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 of to start w out a per it; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of ins. X Applic•( is Signa Page 1 of 3