4296 Svensk Lane
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: , APPLICANT:
t ANN „r 11
PERIUIIT SUBTYPE: TYPE OF WORK:
INSPECTION .
F
~
L
Permit No. PertnR Holder Date Telephone # I
S/WI I
~
PLUMBING I
I
HVAC I
ELECTRIC I
ELECTRIC I
Inspectlon Date Insp. Comments I
Footings I
Foundatan
Framing
Roofirtg
Rough Plbg.
~
Rough Htg. ~
IsuL ~
I
Fireplace I
Ffnal Htg. ~
I
Orsat Test I
Final Pibg. P16g. Inspector - Notity Plumber I
I
Const. Meter I
Engc/Plan I
I
Bldg. Fnal I
Deck Ftg. s o I
I
Deck Finel
t
Well
Pr. Disp. I
I
I
CITY OF EAGAN Remarks
Addition Wilderness Run 5th Addition Lot 16 Bik 1 Parcel 10 84354 160 Ol
~ 4296 No. Svensk
Owner 5treet a`~ State Eagan, MN 55123
r~t~~ L
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR.
GRADING
5AN SEW TRUNK a,a,\ 1973 132 .60 6. 63 20 . 3oS //5 ~
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA P8i(] th water onnection 7/76
STORM SEW TRK 1981 • ;~4.20
D
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. $320.00 3542 7-23-76
BUILDING PER.
sAC 450.00 3542 7-23-76
PARK
YILLAOE OF EAGAN
3795 "yt !!wqb R,,d WATER SERVICE PERMIT
Eogon. MN 53 122 PERMIT N0.: 2021
Zoning: RII DATE: 7/26 76
Owner: Mdre.Zl ~ No. of Untts: 1
Address: nstruction Co.
Site Address; 4296 NTo, gvensk
Plumber; 6 Bl WR 5
Thomp,son P~umbfn
ete ~ ~ ~ .
ze• Connection Chaz
eader No.: 7-~.2, Account D $e~
~ eposi t:
'ag~~ 'i w~h ~ Vilfe pe~'t Fee: 10 . 00 bf 11ed 888
OM1n~~,~y,~.(,~COn J~ 94 oi Eospn Surcharge: . 50 bille
Misc. Chaz a 888
By ~ ~ - Total: ges:
Date of Ins Date paid; `
Insp.;
VILLAOE OF EApAN
3795 Pibt Knob Rood SEWER SERVICE PERMIT
EOg°^. MN 55122 PERMIT NO.:
Zoning: I
DATE: 7/26/76
Owner: ~ MarellF ~10. oF Units: I
Addrees; nstruction CO
Site Addreas: 4296 Ido, civ
ensk
Plurni~er: Thompson Plumbfn~- L16 B1 WR5
9 Co
~ro eo~ NN vill l00 . 00
~Minaney, r ~h °ge of Eay~ Connection Cha~.$e: 350. 00 ~
Account Depqsit;
Permit Fee: 10• 1 e
By- Surchazge: • e
Date of Inep.; Misc. Char
ges:
Inep.: Tota1:
Dace Paid;
?
` CITY of EAGAN N2 4025
~ UILDING PERMIT
. ~.~T7d . . .......f 3795 Pilot Knob Road
Ownex • Eagen. Minnesoia 55122
Address (P=esan!) ....~.I.~FF.IO........ ...~j1~~.~.--'°cri.r/•--• 454•8100
Builder ° .
. sS~7O ~
Dals
. . . . P~
Addreae
DESCAIPTION
6lories To Be Uaed For Fron! Dapth Heigh! Eet. Cm! Permit a Aemasln
LOCATION
Slreel, Roed or olhar DeacripSion ot Locafion I Lo! Block AddflSon or Tsae!
1'his pesmii does not auShorize the use of sSreels, roads, elleys or sidewalks nor doea it give the owaes o[ his sgen!
the sig6lfo ereafe anp aifuarion whieh is a nuisaace or whieh presenls a hazard !o the heallh, aefelp, eoovealenca aad
geaeral weliare io anyone in the eommuaily,
TFIIS PERMIT MUST 8 EP ~~E P.~EMIS WHILE THE WORK IS SN PAO
This is fa cer!ltY. !ha!!-~:B?-.........has permissioa to erec! ..~F ....a-_~.~.l~<•..~~...._npon
the above described pveynise subjeci !o the provisions of all appliceble Ordinances for Y~e Ci agan.
'-!L,y.s„°--......_•- Per .
' • '
ayor BuildiaA Inspaclos
. ' CORRECTION NOT9CE
DATE: Z'~~~
Address O ~ Site Name
Owner/Agent Telephone
Owner/Agent Address
Ordinance Nos. and Corrections - Correct ~ G/
For reinspeCtion
Ea9an Dept. of Inspection In5p0ttOf:
3795 Pilot Knob Rd.
Eagan, Minnesota 55122
454-87 00 Dept.:
. / o i,135.d
CITY OF EAGAN
3795 Pilot Knob Poad
Eagan, Minnesota 55122
PERNfIT NO. • 705 '
The City of Eagan hereby grznts to Y'hemPson Plumbing Co.
of 12201 Minnetonka Blvd.
a Plumbing Permit for: (Owner) Marell Oonstruction Oo.
at BftrAk ~ pux'suant to application dated 7/76,/79
Fee AWd S40.00 dated this Ia day of 79
1.00 a/c Statement A898
Euilding Inspector
Mechanical Permits: ,
Bid Total: r
ld ~~/.~55~ /lv6 a/
CITY OF F.ACr..V
3795 Pilot Ifnob Road
Eagr~n, M_r.neae-ca 55122
F-=GUT P7C. ; 858
The City of Eagai; herety gra~-its to Ray N. Vlelter Heating 8 11/C
sf 4637 Chicago Ave
a. Heatinq S A/C. Yermit for: (Owner) Marell Const.
at 42% No. Sventik pursuant to application dated 6/30/76 _
Fee Paid: $40.00 dated this 9 day of July ~'o_ 76
1.00 s/c
Building Ir_spectoi•
Mechanical Permits: .
Bid Totn.l:
~
. REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-os '
,7 ~ ' See'nsVUClions for complefing Ihis totm on back of yellow copy.
"X" BelouD Wdrk Covered by This Request
Ne Add Rep. Type ot Building Appliances Wired . . Equipment Wired
Home - Range Temporary Service
Duplex Water Heater Electric Heatin
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (Specify)
Farm Air Conditioner p_
(specily) Contractor's Remarks:
-C.~~.u. .~a.w- o,~.
Compute Inspection Fee 8elow:
# Other Fee # Service Entrance Size Fee f1 Circuits/Feeders Fee
Swimmin Pool 0 to 200 Amps 0 to 100 Amps 06
Transformers Above 200_Amps A6ove 100 _Amps
Si ns inspeaors use Oniy: ~G TOTAL (iH IN
Irrigation Booms
5 ecial Inspection arm/Communication THIS INSTALLA710N MAV B CONNECTED IP NOT
Other Fee 5 COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rouqn-m ~ oa~e
. certiy that the above inspection has F~~~ oa
been made. ~
OFFICE USE ONLY
This reduesl vaid 18 monfis hom '
o _ g4~7~17
Requ[es~e 0 e Fire No. ugh-In Inspec6an Requiretl I Inspetlion Ot~er Than Rough-In
l ~ I ~ S - ou must call inspeclor wh n rea ~ Reatly Now ~ Will Notlly Inspector
? Yes No Oa[e Rea
I licensed contractor ?owner hereby request inspection of aboveilectrical work at:
Job AC,drg~s(S1ree( Box or Route No.) cib
`~t~-`~ Ce 3V ~NS LN ~'l~
Section No. Township Name or No. Range Na. Count
~A
Occupant(PFINT) Pno
~ LO ~ e
~
Power Supplier Atltlrws
ElectncaAl C'ontraclor (COmpeny Neme) Comractor's License No.
O -2S
Meiling Atltlress (COnhactor or Owner Making Installalion)
l 1)O /Lin.)
Authonzetl Ignalure (ConttactorlOwner Ma ing Installat n) ~l Phone Number
u6 ~~~Lp
MINNESOT 7E BOA F ELECTRICITY THI$ INSPECTION REOUEST WILL NOT
Grlggs-Mltlwey Bldg. - Floom 5-128 BE ACCEPTED BY THE STATE BOARD
18Y1 1lnivereHy Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642•OB00 mi I 1. 1111111111. 111. 11111111111111 ENCLOSED.
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
~ ~ - 3830 PILOT KNOB RD, EACAN MN 55122 rs
651-681-4675
New Conatrudion ReouiremeMa RamodellReoair Reauirements
• 3 registered site surveys shaving sq. ft. of lot, sq. ft of house; and all roated areas • 2 copies af plan
(20°h maximum lot coverage allowed) • 1 set of Energy Calculations for heated additions
• 2 copies of plan showing 6eam 8windowsizes; poured found design, etc.) • i site survey for extenoraddifions & decks
• 1 set of Eneyy CalculaUore • Indicate if home served 6y septic system for additions
• 3 copies of Tree Preservation Plan if lot platted after 711193
• Rim Joist Delail Options selectbn sheet (bldgs wilh 3 or less units)
~ Z- VALUATION ~~qC~ e~
DATE
SITE ADDRESS MULTI-FAMILY BLDG _Y _ N
TYPE OF WORK ~PC~raf-~ asvvt I'LtsUSo_ FIREPLACE(S) _ 0_ 1_ 2
SELA ROOFING & REMODELING, MU
APPLICANT 41pn,r-vC€'_RIQR gcvD
STREET ADDRESS ST. LOUIS PARK, MN 55418 CITY STATE_ZIP
luvouulubu
TELEPHONE #(nC2-$Z3 - 9'O q(aCELL PHONE # FAX #
PROPERTY OWNER L.u S6Y7 TELEPHONE # GI b S- L« I
COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESO'PA RLILLS 7670 CATEGORY 1 MINNESO'l'A RULES 7672
(J submission lype) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submltted
. Energy Envelope Calculations Submitted
Plumbing Contractor: Phone #
P1umUing system includes: Water Soflener Lawn Sprinkler Fee: $90.00
Water Heater No. of R.I. Baths
No. oF Baths
Mechanical Contractor: Phone #
Mechaiucal system includes: _ Air Conditioning Fec: $70.00
_ Hcat Recovery System
Sewer/Water Contractor: Phone #
i hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature ot Applicant
________________e_ W
OFFICE USE ONLY
Certiflcates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundation ? 07 OSplex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement "Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings(new bldg) FinaUC.O.
_ Foofings(deck) FinaUNo C.O.
_ Footings (addition) - plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final Pool Ftgs Air/Gas Tests Final
_ Framing Siding Stucco Stone
_ Fireplace _ R.I. _ Au Test _ Final Windows (new/replacement)
_ Insulation _ Retaining Wall I
APProved BY , Building Inspectar
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
DATL':_
BUILDING PERKTT AP: r TCp"I'Mt? CftECK
Lot_Z6 Block_ ~ Addition )_.,f
Parcel and section number _
Street la,..~~n.,,~y~ ~ber 9l0 _
Owner P,~, Address_^
Developer 114-0~111a _ Address Tela~
Zone-ordinance #52
Lot Size X Total area
Platted Unplatted
Bul.lding Size X o°1-!,l Total area
Occupancy
Type of construction
Setbacks: Street sides ar _
Sides
Parking: Total area Total spaces ~O~%~
Parking area setbacks: ~
Street side R az' Si3a3
Lazdscapa appraval Bond required
Special Assessments
l
S.:C charge @ $450.00
Water area:
Assessed Unassessed
If assessed: Connection charga
If wiassessed: Connection charge
Lot division:
Additional assessments needed Not neaded
Laterals: ~
Assessed Not assessed
Waiver of hearing;
Needed Not needed „
Assessment clk Water & Sewer Dept Auilding Dept _
Po19.ce Dept Fire Dept (Comm & Ind only)
i
MASTER CARD
LoCATIoN vw5~
OWNER ///A W,4~
~ Y
STRUCTURE AND
LAND USED AS U f.~
Issued To
Permit No. Issued Contractor Owner
BUILDING PLUMBING
I
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING 83g ~-9 7L
.
GAS INSTALLWG
SANITARY SEWER
OTHER I
OTHER I
Approved
Items (Initial) Date Remarks Distance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
DEPTH
HE.4TING OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
violarions Noted
on Back
COMMENTS:
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 OP NON-COMPLIANCE a NON-COMPLIANCE. BUILDER DOES NOT OBSERVED. INTEND TO COMPLY.
ACCEPTABLE $UBSTITUTION$ OR
DEVIATIONS. ? COMPLETION OF CERTAIN IMPROVEMENTS
WILL 8E DELAYED BY CONDITIONS BEYOND
CONTROL.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLIOWS:
? 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 hsve reported herein
all significant conditions obwrved to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
menu for off-site imprwements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPIETED
BUILDING INSPECTOR DATE
COMMENTS:
23
PERMIT
~ CITY OF EAGAN PERMITTYPE: eurtini~p~~
383t Pilot Knob Road Permit Number: 020969
Eagan, Minnesota 55723
(612) 681-4675 Date Issued: 0 5/ 19 / 9 3
SITE ADDRESS:
4296 3VENSK LANE
LOT: 16 BLOCK: 1
WZLpERNESS RUN 5TH
P.I.N.: 10-84354-160-01
DESCRIPTION:
B,uildirrq. Permit Type DECK
)B.uil-ding 4q~rk Type NEW
`Build~.ng len~~h 3e
Building W3dth~-1 16
~ )
,
,r
~ i
,
.~.f_.,^ n, . . .i'~•
1
\
11 t~
:
REMARKS:
FEE SUMMARY:
Base Fee $25.00 COPY $.50
Surcharge $.50 Total Fee $26.00
3ubtotal $25.50
CONTRACTOR: OWNER: - APplicant -
BAKER CHARLQTTE
4296 SVEN5K LANE
EAGAN MN
(612)454-1390
' Z hereby acknbwledge th$t I have read this applicat3.an and state'that the
infawmat;ton is corrsct and agree to comply with all Applieable 5tete of Mrt,
Statutes and C3ty of'Eagan Ordinances.
L ~
'd, I -
APPANT/ MIT IGNATUfiE I D B: 5 NATU E
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: BuiLpxNG
3830 Pilot Knob Road Permit Number: 020969
Eagan, Minnesota 55123 Date Issued: 05 / 19 / 93
(612) 681-4675
SITEADDRESS: Lor: a.s sLocK: 1 AFFLICANT:
4296 SVENSK LANE BAKER CHARLQTTE
WILDERNESS RUN 5TH (612) 454-1390
PERMIT SUBTYPE: TYPE OF WORK:
DECK NEW
INSPECTION „ . iA
FOOTIMG FINAL
~ ~
REACTIYATE _ {rl l T Vt CA4HIV
PERMIT # , Uu'~~,~~~~~ 1993 BUILDING PERMITAPPLICATION
~ 681-4675 ~ a
~ i MAY 14 1993 6'
SIN6LE 8 MULT - of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural b structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month.
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date Yaluation of work
Site Address: ~~('l~ !?G~ ~
STREET SUITE •
7enant Name: (commercial only)
IAT BLOC& ~ SUBD. ~~I ~~'{SS P.I.D. M
- tt-
bescri tton of work:
The applicant is: [~l wner ? Contra tor O 0 her coes«;be>
Name r Phone ~ ~~1~~_
Property AST FIRSi ~.,.7Z
Owner Address XwGi'rke a h-0
SiREET STE M
City A State Zip ~Slc~_3
Company Phone
Contractor Address License # Exp.
City State Zip
Architect/ Company Phone
Engineer Name Registration S
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknawledge that I have read this application and state that the information is
correct and agree to comply w'th all applicable State of Minnesota Statutes and City of
Eagan Ordinances. l ~
Signature of Applicant
z ~
OFFICF USE ONLY
BUILDING PERMIT TYPE
_
? 01 Foundation p 06 Ouplex ? 11 Apt./Lodging 0 16 Basemeni Finish
? 02 SF Dwg. ? 07 4-Plex O 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comn./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireptace ? 19 Comm./.Ind. Misc.
0 05 SF Misc. O 10 Multi. Add'1. 12 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
tg 31 New ? 33 Alterations ? 35 Tenant finish ? 37 Demalish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy 2nd F1. sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pump
N of Stories Footprint Sq. ft. fire Sprinkler
length o On-site well Census Code -3- -4L/
Depth On-site sewage SA~C Cod bfd /
APPROVALS ;5~E ~
Planning Building Assessments
Engineering Yariance
REGlUIRED INSPECTIOh(S
O Site 11~; Footing ~rtg- ? Insulation
? Wallboard ;ff Final O Oraintile ? Fireplace
Permit Fee 25. 0a $
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Lapies .5~
Other
Total:
sac %
SAC Units
For:
.rc . .
,.vnuale 11ver.ue $o
rin~-to-r., 'Y.inr.ccct.a 5502 Cert. W57 DELMAR H. SCHWANZ..
LANDSVAVEYDR
~ . RepistetWUntlu1_aw3olTneStneof MmneroU . . . . .
; . . . .
14515 SOLlTH A08ERT TRAIL P.O. 80% M ROSEMOUNT, M11/NESOiA 5806B . iHONE 812, 423-1789 ,
$URVEYOR'S CERTlFICATE -
y 48,33~~ 9i3 0
\ ab ~2 ~ ~`'E
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3
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cvQ ~g, 9a' ~ ~ ~ v
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• tr..ear:i c~~r~~~ci ripree~ i;~at;r,n
7vu
F't171 -TT'n 7~?Ynte r
S Elk'- •h~ !'1ilISf;Y,
Vj1::iF1~i:'..
' E7~n •;~e ?oc&'-i:~^ eP a ^rc•ansed b3'_lc'.-', ttie^eon. ~ ~
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°-~e1N1FIN£SOTA REGiSTRA {pNNO 8625 r
~ f~..R~s~~
Clty Of E~18Il Pe~„t I~~ 7 I
3830 Pilot Knob Road ~ PermitFee:
, Eagan MN 55722 Date Received:
Phone:(651) 675-5675
Fax: (651) 675-5694 j srarr: (i,~= I
I
2008 RESIDENTIALrPLUMSING PERMITAPPLICATION
Date: ~9_ Site Address: 'T 2J40 Ln• ~j
Tenant:
Suite
RESIDENT/OWNER Name:~~'~i` ~riiA.Y~ST)~ Phone: ~JI-q0S-"IL_J /
Address/City lZip: ' C{,1'7lQJ /v OLS
CONTRACTOR Name: License Ip Ino- PM
Pion
Address:_ 851 385-1340
3670 ()odd Rd. #100
C'ty: Eegan, AAUL.5512AAAAA Sta2e: Zip:
Phone: Contact Person:
~f I S I P
TYPE OF WORK _ New ~Replacement _ Repair _ Rebuild _ Modiy Space _ Work in R.O.W.
Descri tionotwork: ~
PERMIT TYPE RESIDENTIAL
LWater Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
~ RPZ PVB) Main _ Lower Level)
SepticSystem WaterTurnaround .
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 $136.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (inGudes Counry 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 the work will be in conformance -wAh the ordinances and codes of fhe City of
Eagan; that 1 understand this is not a permit, but only an application for a pertnit, and xrork is not W sWrt without a pertnit that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
X 6Cu'-y)2 SC7 .M.P U e-r
_ X
ApplicanYs Printed Name ApplicanYs gnature'
FOR OFFICE USE
Required Inspections ~ UnderGround
. , , . . _ .
} j ~8Lf
_ 2C804 Lvndale ~57
Cert.
~ ~ .
DELMAR H. SCHWANZ.
Li41`10 SURVEV4R
ReOjslcr*d UnAU l,aws of Tlfe 51+ts of M,nnesota
14515 SOUTH R08ERT TRAIL P.O. BOX AA ROSEIIIOIiNT, MINNESOTA 55088 PHONE 912 423-1789
SURVEYOR"S CEFiT?FlCATE
111" ~ 9~3 0
~b048 qZ.oy ~
p6t~
zo
' >6
. 60 '0 0 ~
r z¢
~ ~ t7
,BLOGf( ~
5'90
•
0
nf Tnt. lf, :,]ock i,
RI1E-rOta. ;To Fhcwitiq thE Ic?caLlon cf a rrnpc::e.d hu? 2d?r:E, Lhereor. ~
~
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^;`,IFSOT a REGISTRATION N4. 8625 '