1149 Tiffany Cir NCITY OF EAGAN Permit No: Date: 7-8-87
3830 Pilot Knub Road Meter No: 3 87 /y3 S/ Size: S?8'r "tebl{
P.O. Box 21199 Reader No. 0 !L- P 3 S, Date: $-??-
Eagan, MN 55121
Owner. °' Peterson Const.
Site Address 1149 Tiffany Circle 'North :..° B1 Canterbury
Plumber. Cenz- Ryan Forest
Conn. Chg: 525.00pd WARM g: n1
Acct Dep: 15. 0 d I 1
Permit Fee: 10
Surchar
e:
EtEff?? • G9 fit
g agree to comp
2 ly with the City of Eagan
1 J.13
Tr. Plant ?*
f t I D C n BtirAW
Meter f,7 n o pj
Misc.: BY,??
WATER SERVICE PERMIT
CITY OPEAGAN Permit No. Date: 7-8-87 +
3830 Pilot Knob Road Meter No: Size:
.P.O. Box 21199 Reader No: Date:
Eagan, Mil 55121
Owner. Svend Peterson Const.
Site Address: Tiffany Circle North L8 R1 !'snror},,.,...
Forest
Conn. Chg:
• 00
5'S
Zoning:
Acct. Dep:_ • 0 ad No. of Units. 1
Permit Fee: 10. 00;d
Surcharge: . 50pd
00
d
180 I agree to comply with the City of.Eagan
Tr. Plant_ .
p Ordinances.
Meter. - 67 nnrd
WATER SERVICE PERMIT
CITY OftEAGAN
3830 Pilot Knob Road
° SEWER SERVICE PERMIT
P.O. Box 21199 PERMIT NO.: 10025
Eagan, MA 155121 DATE: ' - " - ` 7
Zoning: 11 No. of Units: 1
Owner. -event P t ra on Const
Address:
BY
Date of Insp.:
Insp.:
Connection Charge: 525 04.44
Account Deposit: -- I S - gapd
Permit Fee: lq 9Apd
Surcharge: , 50pd
Misc. Charges:
Total:
Date Paid:
I agree to comply with the City of Eagan
Ordinances.
BLDG. PERMIT NO.,,,,
-3 -7
i
d
.
,
01-3210 T,rm
Bl
g
t
01-3422 Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit G 5
20-2275 SAC
20-3865 Water Conn. a u
20-3868 Water Trutt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL .'a -7/
CASH RECEIPT
,,''CITY OF EAGAN{3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
RECEIVEO
FROM /
AMOUNT
& DOLLARS
loo
? CASH Q CHECK
FOR
BY White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
Thank You
a
' CITY OF EAGAN
' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for Est. Value ' 14t ? "?°L Date ,19
Site Address , OFFICE USE ONLY
'
Lot Block L Sec/Sub. `ht Ry FW ES `1 On Site Sewage T Occupancy
1
MWCC System Zoning
Parcel No. On Site Well Type of Const
City Water (Actual)
os Name GONST iNc (Allowable)
W
CI)` * of Stories
-
=
3 Address Length
o City
Phone y ?-
Depth
S.F. Total
c Name Footprint S.F.
0 i Address APPROVALS FEES
¢
?-
City Phone
Assessments
Permit
? )0
?
Q Water/Sewer Surcharge
-
W W Name Police Plan Review S
Address Fire SAC, City
a Z
z
cit
Ph Engr. SAC, MWCC?
s ' y
one Planner Water Conn.
I hereby acknowledge that I have read this application and state Council
Bldg. Off. Water Meter
Road Unit
that the information is correct and agree to comply with all applicable APC Treatment P1
State of Minnesota Statutes and City of Eagan Ordinances. Variance Parks
Copies
Signature of Permittee TOTAL
A Building Permit is issued to: 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
_ Permit No. Permit Holder Date Telephone ar
PI?krfibing
Electric l ?? /gyp ?r ??0 oz?
Softener
Inspection Date Insp. Comments
Footings I s- ?. F x
Footings II
Foundation
Framing 7-iBa _
Roofing
Rough Plbg_ _
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Plbg.
Bldg. Final
Cert. Occ.
Temp. LP
Deck Ftg.
Deck Frmg.
Wel l
Pr. Disp.
r---
T•er#ifira#e of (Orrupaury
Ctp of Qlagan
10p frit t of lWlbbv ptttmt
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following.•
Use GlmOmdon G Bldg. Permit No. 13564
O-UP-y Type :? Zoniag District R1 Type COW V
Building Address
Date: ',LK M S. lw
POST IN A CONSPICUOUS PLACE
PERMIT #
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: July 1987
CONTRACT PRICE: PHONE: 454-8100
Site Address
Lot R Block 1 Sec/Sub
Name Geny-1
Address 14745 Smith Robert 2"41
c City Pto?emwatii MIN Phone
Name-
C main
Address 2.9'234 Park- X4ew CA
p
1 City 810 Phone
5 6417
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE -$12.00
MINIMUM - COMM/IND FEE -$20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. WMXXX New XXX-"
Mult. Add-on
Comm. Repair
Other
PLBG. ONLY -
_ e Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
_/--Laundry Tray - $3.00
_/ Floor Drains - $1.50
Water Heater - 51.50
Whirlpool - $3.00
?L-Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
STATE SIC:
GRAND TOTAL
FOLLOWING:
T?I
4;2• CIO
v?
C9t3
fs
/. S?7
• S?
PERMIT #
' MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE July 6?, 1967
CONTRACT PRICE PHONE: 454-8100
Site Address 114 9 Tiffany Circle North BLDG. TYPE WORK DESCRIPTION
Lot 8 Block 1 Sec/Sub XX)0=X XXXxxx
Canterb ury Forest Addit ion Res. New
Gen
z-R n P&H Mutt Add-on
m Name
147
t
45 South Rob
T
ail Comm. Repair
er
Address r Other
c City R089MOU nt, M Phone 4 23-1144
550 68
FEES
Name S. etersen j2Rnstru ction RE8.-HVAG 0-100 M BTU _ -$24.00
c Address 102 14 P1111 VIVVe O - ADDITIONAL 50 M BTU - 6.00
p City S I oosnin uton. phone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
1 554 37 MINIMUM - 1 PER PERMIT) - 1
50 EA
GAS OUTLETS
.
.
(
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air 1 M BTU APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # -? D BEYOND $1,000)
Other _
.
FEE ??
ES/C: SIGNATURE OF P MITTEE
OZco
TOTAL:
FOR: CITY OF EAGAN
This request void (PY?Q/Y 2_
18 months from _
C,` 9650 ! s
Coll b~tT /
Electrical Contractor
No
on
(:)Ready
I herebV request inspection of above
_ electrical work installed at:
-;7S/SZC
;2"Jo ?
ill Notify Inspec-I
I When Ready
Street Address. Box or Route No.
cUOn No.
ft- I
Towns me or N
Range o.
Couut '
Occuo4n, Phone No.
o(%
P er S plier I Address
leclrical Cont pr (Company Namel nn tractor's Lic -o No.
D c??36
Mailing Ad r s Contractor or Owner kin Instai ion)
?
o ? v
u1 orixetl Signature ( actor/Owne aking Ins Ilatio Phone Numb r
NNESOTA STATE BOA BD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
MI
NNE-Midway Bldg. -Boom BE ACCEPTED BY THE STATE BOARD
Griggs N-191 1821 University Ave., St. Paul, MN 55106 UNLESS PROPER INSPECTION FEE IS
Phone (612) 297-2111 ENCLOSED.
lj?,/$7 REQUEST FOR ELECTRICAL INSPECTION ?jEe-outrot.oa
Ii, See instructions for completing this form on back of Vellow copy.
6 50 "X• • Below Work Covered by this Request
RYmAAdd1 Rep.l Tvpe of Building 1 Appliances Wirad 1 Equipment Wired I
urnace
g Fee Service Entrance Size n Fee Feeders/Subfeeders g Fee Circuits
U to 200 Am S 0 to 30 Am s 0 to 30 Am s
Above 2 0 Amps 31 to 100 Amps 31 to 100 Am
Swimming Pool Above 100_Am s Above 100-Amps
Transformers Irrigation Booms s Partia L'Oth r Fee
Signs I I (Special Inspection J.
"°°u-••• i ??. I J J I I, the Electrical
/I,"e /'3?z Inspector, hereby
certify that the above
final inspection has been
made.
request void 18
CASH RECEIPT •
CITY OF EAGAN
3830 PILOT KNOB ROAD
55122
RECEme,
L
AMOUNT //,; I r c,
19 ??
& 00LLARS
CASH CK 1
r a C Ir_ /?"GJ
717-
U/ l
n
FU NO CODE AMOUNT
J
L
.d-
Cl
o
do d-
La o
?
-' 9/ lo.
Thank You
N_ 7 5 313 Whita-Payee Copy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN N2 13 5 6 4
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454.8100
#? ?
BUILDING PERMIT Receipt
To be used for SF DWG/GAR Est. Value $141,000 Date MAY 7 1987
Site Address 1149 TIFFANY CIR NO OFFICE USE ONLY
Lot 8 Block I Sec/Sub. CANTERBURY FOREST On Site Sewage Occupancy R3
RI
?-
MWCC System Zoning
Parcel No. On Site Well Type of Const V
City Water (Actual)
a Name SVEND PETERSEN CONST INC (Allowable) V
W
z
Address 10214 PARK VIEW CIR e of Stories
Length 61
City BLNGTN Phone 884-5144 Depth 36
S.F. Total
Name SAME Footprint S.F.
R
ow Address APPROVALS FEES
uF
City Phone
Assessments $
Permit 626.50
70
50
S
h
Ww
W Name Water/Sewer
Police .
urc
arge
Plan Review 33 25
=oW Address Fire SAC, City -ivS?O
,a Engr. SAC, MWCC -525. ^0
aW City Phone Planner Water Conn.00
Council Water Meter 67. 0
1 hereby acknowledge that I have read t ap ation and a e Bldg. Off. _ Road Unit ?0.?0
that the information is correct and agree co ywith site c I APC Treatment Pt X50
State of Minnesota Ste and CI gan Ordi Variance _ Parks
Copies
Signature of Per - TOTAL $2,712, 5
A Building Permit is Issued to: SVEND PETERSEN CONS C on the express condition that
all work shall be done in accordance with all T 'c I State of M ' ep? sote Statutes and City of Eagan Ordinances.
Building Official 4[et
CITY OF EAGAN Remai
Addition CANTERBURY FOREST
Owner ?4 r;c? n, :..??)!Fl Q.:; . / Street
State EAGAN MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. yr,r, 1979 Paid unde r original yl? rcel
STREET RESTOR.
GRADING 1981 106.78 5.34 20 85.46 A013446 1-12-84
SAN SEW TRUNK ? 1-1 1973 Paid unde original reel
* SEWER LATERAL 1981 439.42 21.97 2
WATERMAIN
* WATER LATERAL 1981 20
WATER AREA 1979 Paid under original rcel
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
5-5 97 RESIDENTIAL ?
BUILDING PERMIT APPLICATION
CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 P? . (J
651-681-4675
New Construction Requirements RemodellRegair Requirements
• 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan
(20% maximum lot coverage allowed) • 1 set of Energy Calculations for heated additions
• 2 copies of plan showing beam & window sizes; poured found design. etc.) • 1 site survey for exterior additions & decks
• 1 set of Energy Calculations • Indicate it home served by septic system for additions
• 3 copies of Tree Preservation Plan if lot plafted after 711193 9
Rim Joist Detad Options selection sheet (bldgs with 3 or less wilts) ?J Q 6
DATE 7-50 -oz VALUATION r
SITE ADDRESS 11Y9 T/,?'1'19A"Y GK //, MULTI-FAMILY BLDG _Y XN
TYPE OF WORK /g6 P-dD? FIREPLACE(S) _ 0 XI _ 2
APPLICANT /vI/'KK S TE felt/ -S
STREET ADDRESS 1I'19 77F7-.¢nly G/l?. /I/ CITY &,-19'? STATE/;?,VZIP SS/ Z 3
TELEPHONE # 6S1' CELL PHONE # 9S L Lf D (?06 FAX # 6S l 6?? ?O
PROPERTYOWNER IWI -k f7_t /_ _TELEPHONE#
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: Phone #
Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00
Water Heater _ No. of R.I. Baths
No. of Baths
Mechanical Contractor. Phone #
Mechanical system includes: _ Air Conditioning Fee: $70.00
Heat 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 Ord' anc
v?-
Signature of Applicant
OFFICE USE ONLY
Certificates of Survey Received - Tree Preservation Plan Received - Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 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 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plax ? 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 Plbgyour_ 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 Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
- Footings (new bldg) Final/C.O.
- Footings (deck) _ Final/No 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. _ Air Test _ -
Final _ _
_
Windows (new/replacement)
Insulation - Retaining Wall
Approved By
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
Building Inspector
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR /HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL
1 SET OF SPECIFICATIONS AND 1
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For:
Site Address
Lot er Block
& STRUCTURAL PLANS,
SET OF
[4- f DOO
Valuation:
Parcel /Sub 6?hv z;eeo2y
Owner CS. !7k'i2;;es&:4? ?-
Address lD 141 %?i?f Y1?7./ Cf e
City/Zip Code 13LouAre.w6a01
Ss4?3/
On Site Sewage_
MWCC System ?
On Site Well
City Water ?
Phone f5 APPROVALS
Contractor S?sf/?e C
Address
City/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code
Phone #
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Council
Bldg Off
APC
Variance
Date:
- ??
Occupancy P 5
Zoning I
Type of Const
(Actual)
(Allowable)
# of Stories
Length (? I
Depth
S.F. Total
Footprint S.F.
FEES
(
Z& -
Permit 0
Surcharge -ja. ?Ka-
Plan Review I J, ?D
SAC, City 100.
SAC, MWCC S2 S.
Water Conn 525
Water Meter Col.
Road Unit 30S
Treatment Pl ?P.
Parks
Copies
TOTAL 7J d _R
-ti
l ? ?JJ? ? Q? ? ?JZ ? S I
o? 95
L = Z) ? ?J°1 2Z ? ?Z
- 009)
t; CG X
? Y
?7 ?7
1
Certi€icate For: -
Svend Peterson Construction
4701 West 110th Street
Bloomington, MN 55437
DELM R H. SCHWANZ
LAND q wjffvo & Ow.
ft9woe~L1 an.rwa MMawoa
14700 SOUTH ROBERT TRAIL ROSEMOUNT. MINNESOTA 55008 6IV423.1789
SURVEYOWS CERTIFICATE
?yP
0
t?'y f
5x
h . '
;::? ( 43i ?? y29 ,
'I?porb' ??r
'
10
RZ7fo
93?
AlP °r7 8 E
f
rh
Drainage & Utility asements
r
G
s f 2
1?/ o ?' ? ??2P9? 8B
Scale: 1 inch = 30 feet
qJ 7 = Existing elevation
i" Lot 8, Block 1, CANTERBURY FOREST, according to the recorded
:4 g
, AF plat thereof, Dakota County, Minnesota.
4W` IMsgurdy.VIM ofrapwtwa Also showing the location of a proposed house as
by Y11giMM?dW,0WWJpWVWD1Md staked thereon.
? r ll, OM IaMEI fis15 at IMM111 (?:.
ALM
x..:..;011 0 Mbmwow Real ft Mm 1020
K. .. $-
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
NOTE: PAYMFF:WP OF FEE AT TIME OF
APPLICATION DOES NOT CONSTITUTE
APPROVAL OF PERMIT.
INSPECTION OF SEWER AND/OR WATER
INSTALLATIONS WILL NOT BE SCHED-
ULED UNTIL PERMIT HAS BEEN
APPROVED.
-----------------------------------
(Please Print)
1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
IF EXISTING STRUCISUME, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE:
(Mn ear)
PRESENT ZONING/PROPOSED USE:
CU41ERCIAL/RETAIL/OFFICE
INDUSTRIAL
INSTIT TTIONAL/GOVERAP'TEM
R-1 SINGLE FAMILY
0 -2 DUPLEX (Two Units)
R-3 TOWNHOUSE (Three + Units) i Units)
? R-4 APARTMENT/CONDOMINILM ( Units)
2)
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
S- PETERSEN CONSTRUCTION INC.
10214 Park View Circle
Bloomington, MId 55437
881-4155
3) u is a
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
MASTER LICENSE#
1849M
4)
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
5)
GENZ-RYAN PLUMBING & HEATING
14745 South Robert Trail
_Rosemount; MN 55068
423-1144
CONNECTION TO CITY SEWER
CONNECTION TO CITY WATER
Active
Expired
Not recorded
Staff Initial
? OTHER
6) • ? PLEASE HOLD APPROVED PERMIT FOR PICK- BY ONE OF ABOVE
P
X LEASE MAIL APPROVED PERMIT TO 1, 2, 3, 41 ABOVE
X (Ciro one)
7)
FOR CITY USE ONLY
PERMIT # ISSUED
1s b 7 O
Pd W/Bldg. Permit FEES:
$ $ /C) - SC? SEWER PERMIT (INCLUDE SURCHARGE)-
$ e••- .WATER PERMIT (INCLUDE•SURCHARGE)
$ $ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ ?? c Za ACCOUNT DEPOSIT - SEWER
$ $ / 5 Z) ACCOUNT DEPOSIT - WATER
$ Z- S L $ WAC
$ $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER.ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ r( $ LATERAL BENEFIT/TRUNK WATER
•I C! o --o $ WATER TREATMENT PLANT SURCHARGE
$ OTHER: : .
$ % G ?) $ 11?J TOTAL
73
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS: l 1. 1.
c
APPROVED BY:
A /? y
z
TITLE:
DATE: 71'e If x,
i
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115005
Date Issued:09/23/2013
Permit Category:ePermit
Site Address: 1149 Tiffany Cir N
Lot:8 Block: 1 Addition: Canterbury Forest
PID:10-16350-01-080
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Eric Brehe
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Mark W Stevens
1149 Tiffany Cir N
Eagan MN 55123
Aspen Contracting/ASI
4651 Nicols Rd
Eagan MN 55122
(952) 583-2641
Applicant/Permitee: Signature Issued By: Signature