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1131 Tiffany DrCITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P.O. Box 21199 PERMIT NO.: 8102 Eagan, MN 55121 DATE: 10-23-86 Zoning: _ R1 No. of Units: - 1 Owner. Rvend Petercnn rnnst Address: SiteAddess: 1131 Tiffany Drivp T1% R1 Ca tcrh" : Pone-st Plumber. r-ear-R-nn Meter No.: -3 7V YIA' 3 15- har e: 500 nOTd Size: 4r?t,,tes 15 OOPd Reader No.: a_2Q? g ?Ei0le 0% ? { ?;?$ E1Ia. tJt 40pd 1 agree to comply with the City Uwjp S rc ar e: Ordinances. REUt^tVIRODCf r es 1t Total: Meter Date Paid: Date of Insp.: Insp.: - - ?? f - k6 CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P.O. Box 2118) PERMIT NO.: P, 102 Eagan, MN 55121 DATE:- 1 o-23-86 Zoning:• r'-1 No. of Units: - 1 Owner 4v nd P tnrSon fnnS? Address: SiteAddess: 11 31 Tiffany Drime T 1 S TO r-terbu ry >?orect: Plumber: _ Meter No.: Size: Reader No.: 1 agree to comply with the City of Eagan Ordinances. Connection Charge: 500 00Pd Account Deposit: 15 , 0411 Permit Fee: 11) 00pd Surcharge: . 50Pd Misc. Charges: 156.00pd TV Total: By Date Paid: Date of Insp.: Insp.: CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: ` Eagan, MN 55121 DATE Zoning: No. of Units: ' Owner: r;- Address: - Site Address: -? 'L.Lffar. Plumber: - -"'• I agree to eoaytlr wtdr as Cky of Itysu Connection Charge: -00 Ordirreftem Account DepoeR: - Permit Foe: Surchome: BY - Date of Insp.: Misc. Charges: Total: Doty Paid: BLDG. PERMIT NO. „ (o 01-3210 Bldg. lgermit? 01-3422 Plan Check 01-3445 Surch./Adm. 01-3446 SAC/Adm. 01-2155 Surcharge 17-3860 Road Unit 20-2275 SAC 20-3865 Water Conn. 20-3868 Water Trmt. 20-3716 20-2252 20-3713 20-3743 79-3866 11-3855 Water Meter Acct. Dep. Water Permit Sewer Permit Sewer Conn. Park Ded. TOTAL CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATA 19 L RECEIVED- i? FROM AMOUNT DOLLARS too ? GASH ? CHECK FUND I CODE I AMOUNT Thank You 666V White-Payers Copy Yellow-Posting Copy Pink-File Copy ' CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 124Ss PHONE: 454-8100 BUILDING PERMIT Receiptff SF DWG/GAR $117,000 86 AUGUST 18 To be used for Est Value Date 19 Site Address 15 1131 TIFFANY DRIVE CA14TERB Erect J' l_i}x? URY ?O: " Occupancy R3 PD Lot . Block Sec/Sub. J4 el [I Zoning Repair ? Type of Const V n Parcel No. Addition ? No. Stories 'WEND PETERSEN CONST Move ? Length Name 3 b 1 Demolish 11 Depth Address U W 10TH ST 4 71 I I t 11 S FT c 'P 8134-5144 ''S mpr. n . q. City Phone Install ? o Name SAM Approvals Address Assessment ~ City Phone Water & Sew. Police au i Name Fire a Address Eng. W City Phone Planner I hereby acknowledge that I have rei information is correct and agree to Minnesota Statutes anct_City of EaA Signature of SvEiiU ;TS1'11.4 A Building Permit is issued to: all work shall be done in accordance with all applicable State of A Bldg. Off. 0/J-010 APC Permit rasa 475.51 Surcharge -"T' 51 Plan Review 7 .7' SAC --575• 0 i Water Conn. 5U0.01 Water Meter b3. 51 Road Unit --2'gV` 01 Tr. Pl. Iti6. 01 Parks Copie 52,356.2.' Ti.MI on the express condition that and City of Eagan Ordinances. Building Official Permit No. Permit Holder Date Tslaphone N Plumbbig izLier I H.V.4.C. Electric tioflener Inspection Date Insp. Comnwnts Footings I ?? ! It !> Footings 11 Foundation Framing Rooting Rough Pibg. Rough Htg. Insul. i7 Q C?K! Fireplace ,?s p Final Hill. Final Plbg. _ g! Bldg. Final Deck Fig. Deck Fnng. Well Pr. Dlsp. s :. . PERMIT # l lC i - PLUMBING PERMIT RECEIPT # CITY OF EAGAN i 3830 PIL OT KNOB ROAD, EAGAN, MN 55121 DATE: / CONTRACT PRICE: PHONE: 454-8100 Site Address. BLDG. TYPE WORK DESCRIPTION Lot Block i Sec/ ub S . - ( - , .. Res. New m Name -----`' Mull Add-on Address Comm. Repair c City Phone ?? - Other NO. FIXTURES TOTAL L Name Water Closet - $3 L 00 $ _: - . 3 Address Bath Tubs - $3.00 p _ I City- -' Phone - - Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 FEES COMM/IND FEE - 1% OF CONTRACT FEE -T-Urinal/Bidet - $3.00 Laundry Tray - $3.00 MINIMUM - RESIDENTIAL FEE _$10.00 -/Floor Drains - $1.50 MINIMUM - COMM/IND FEE - 20.00 : Water Heater - $1.50 STATE SURCHARGE PER PERMIT - .50 Whirlpool - $3.00 (ADD $50 S/C IF PERMIT PRICE GOES Gas Pi in Outlets - $1 50 BEYOND $1,000.00) g . p Softener - $5.00 Well - $10 00 . Private Disp. - $10.00 ?- Rough Openings - $1.50 SIGNATURE OF PERMITTEE FEE: STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL- PERMIT # MECHANICAL PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE CONTRACT PRICE: PHONE: 454-8100 Site Address BLDG. TYPE WORK DESCRIPTION Lot Block Sec/Sub Res. New Name A Mint Add-on Address 9 Comm. Repair c City Phone Other Name FEES 3 Address RES. HVAC 0-100 M BTU -$24.00 p City Phone ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 TYPE OF WORK GAS OUTLETS - 1.50 EA. Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50 (ADD $.50 SIC IF PERMIT PRICE GOES Vent CFM BEYOND $1,000.00) Gas Piping Outlets # Other FEE- S/C: SIGNATURE OF PERMITTEE TOTAL: FOR: CITY OF EAGAN CITY OF EAGAN Remarks by) r1U2 l y Addition, CANTERBURY FOREST Lot 15 Owne x. C4 ti 4 51 .. ` i { Street 1131 TIFFANY DRIVE uu u ,.f 1tv r ?, r State EAGAN FIN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1979 Paid Un a ri 'na STREET RESTOR. GRADING $ 1981 106.78 5.34 20 8S.46 A013446 1-12-84 SAN SEW TRUNK Z 1973 Paid und@ original pd rcel * SEWER LATERAL 1981 439.42 21.97 20 A013"6 1-12-84 WATERMAIN * WATER LATERAL 1981 20 WATER AREA qo 1979 Paid unde r original pd rcel STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 13UILDING PER. SAC PARK This request void 1 8 months from C- 9 6 3 6 cis. gi, l!? lag/a/ CGY'60 Re uest Oite? - e e. 1 Fire No. I Req Ro ug H_iredA?Inspection ui ?Ready Nuw ? Will Nntifv. In.pec- for Wh n R ? ?t Dyes ?No e eady ? Licensed Electrical Contractor I hereby request inspection of above ? Owner electrical work installed at: Street Address, Be. or Ro e No. v- f Cit, r ac 1 n We. Township Name or N z Rangq No. _ County ?r Occupant I pxw-,-- Phone No. O V / f' eT u plier F? Address 'l + V EIg c} ncal Contra r (Company Name) / ntractor's License No. t7 o b 3 Mailing Address (Contractor or Ow r Ma mg Instaila I v S Author iz. of 51gpa l on r for,wn aking I stalls nl Phon Number MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS 1821 University Ave.. St. Paul. MN 55104 19 1111 2471111 ENCLOSED. rG / o tp REGUFSTTUR I L 1 m- EB-00001-04 dA^ See instructions for completing this form on back of yellow copy. C 9636 "X'. Below Work Covered by This Request Add ype of Building Appliances Wired Equipment Wired me Range Temporary Service plex Water Heater Lighting Fixtures I t. Building Dryer Electr ic Heabn mmercial Bldg. Furnace Silo lJnloader. ustrial Bldg. Air Conditioner Bulk Milk Tank m Omer peel y Othee (Sper.ify) Other pecify OI er Oiher ompute Inspection Fee Below N Fee Servic ce Size h Fee bfeeders a Fee cacu,ts 0to OOA s p? Otn 30 Am s ove 200 Am ps mps 31 to 100 Arn s Swimming Pool g _Am s bove 100_Amps Transformers ooms Pa ial.Oer ee Signs pection $ ? TOTAL FE Bough-in r/ Date I, the Electrical nspactpr, hereby certify that the above Final ` D '}tPy 'napec tion has been 71 de. This request vold 18 months from • CASH RECEIPT • CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MIN TA,55122 DATE REC V ?I AMOUNT ^y ...5%? n Q &DOLLARS ? CASH / ??CY FOR 41 FUND CODE AMOUNT U ell ?L 0 i ooc / b Thank You N-2 67741 BY White-Payers Copy Yellow-Posting Copy Pink-File Copy CITY OF EAGAN t . N2 12466 ° . 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 j BUILDING PERMIT Receipt# To be used for SF DWG/GAR Est value $117,000 Date AUGUST 18 y 86 Site Address 1131 TIFFANY DRIVE Erect L Occupancy R3 Lot 15 Block 1 Sec/Sub. CANTERBURY FORIAS%del ? Zoning PD Repair Parcel No ? Type of Const V.p . Addition ? No. Stories SVEND PETERSEN CONST Move ? Length 56 z Name 4701 W 110TH ST Demolish ? Depth 16 c Address Int. Impr. MPLS 884-5144 ? Sq. Ft City Phone Install ? SAME o Approvals Fees Name $ 475.51 8¢ Address Assessment Permit City Phone Water & Sew. Surcharge 58.51 Police Plan Review 237.7' W Name Fire SAC 575.01 ua Address Eng. Water Conn. 500.01 a W City Phone Planner Water Meter 63.51 Council Road Unit 290.01 I hereby acknowledge that l have read sapp ation and state that the BIdg.Off. 8/18/86 Tr. PI. 156.01 information is correct and agree to mp ith a is ble tate of Minnesota Statutes of rdina APC Parks r. Date Copies Signature of Pe rmt $2 Total ! ,356.2 A Building Permit is issued to. SVEND PETERSEN CONST on the express condition that all work shall be done in accordance with all ap i le State of inne t-oaS-ttatutes and City of Eagan Ordinances. Building Official W7 NOTE: ALL p''Z 1?I770 ei SINGLE FAMILY DWELLINGS Sf9/??= ? s -413 3 0 Lz:7-en INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS 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 INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: Site Address Lot Block Parcel/Sub eWA/76?7p, e/j,ey f0124-Z-s7-- Owner A0.v5,--- '"d Address dV2 o / W // o 72:( S-15- City/Zip Code Phone 2'P'e71 - S % 4t 4z Contractor Address City/Zip Code Phone Arch./Engr. _ Address mac` City/Zip Code Phone # e 7 Date: -?? Erect Occupancy Remodel Zoning Repair Type of Const Addition # of Stories Move Length Demolish Depth Int.Impr. Sq Ft Install APPROVALS FEES Assessments Permit y75 Water/Sewer Surcharge 4amm f56, 5o Police Plan Review 3 7 7 Fire SAC S 7 Engr Water Conn >00 Planner Water Meter ^ Council Road Unit U Bldg Off Treatment P1 / APC Parks Variance Copies TOTAL / } S 2:7 NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR /HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MUST BE LICENSED WITH THE CITY OF KAGAN Certificate for: _ Bk: 100/19 vend Peterson 4701 West 110th Street Bloomington, Minnesota 55437 DELMAR H. SCHWANZ LAND SURVEYORS INC Rnq.itwwl Undw Laws N Ina Stay nl M. wmM. 14750 SOUTH ROBERT TRAIL ROSEMOUNT. MINNESOTA SSM PHONE 613 432-1769 SURVEYOR'S CERTIFICATE .I , Scale: 1 inch = 30 feet O Denotes iron monument I VF ?4GCK s Denotes set wood hub M N ? I 0 Denotes existing elevation i ? Denotes proposed elevation 0 a n/?j?8 48 /0/ a /oy, y r R #Uts 1/ 3G S6 dub •6S 26 Proposed ?'f w all - - - I hereby certify that this ? 10 is a true and correct represen- 4 House 6 ?Q, tation of Lot 15, Block 1, M 32 `e 99.9) Garage y/S CANTERBURY FOREST, according 6 to the recorded plat thereof, Ile -I/-3S j- ___ 30 7aP? Dakota County, Minnesota. y4 2 /? O O /0%2 ` 10Y 60 Also showing the location of a proposed house as staked M O thereon. r y4 O /00,3 Dated: August 7, 1986. -110j ZZ-/'Y-S8 L. /20.00 /C'= i09.U2 x ?? MINNESOTA REGISTRATION NO. 8625 CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION Y***#**********fifiYYY#Yfifi#**aa#Y* !1107 11: PAyww..C OP F TT, AT Tlt,:; OF APPLICATION DOES NOT CONSTIt^•'IE APPROVAL OF PERMIT. INSPECTION OF SEWER AND/OR W T R INSTALLATIONS WILL NOT BE SC.•iE>- ULED UNTIL PERMIT HAS BEEN APPROVED. -- P ease PrintI 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: (Mon Year) PRESENT ZONING/PROPOSED USE: M COMMERCIAL/RETAIL/OFFICE Q INDUSTRIAL n INSTITUTIONAL/GOVERR4= R-1 SINGLE FAMILY Q R-2 DUPLEX (Two Units) R-3 TOWNHOUSE (Three + Units) ( Units) R-4 APARTMENT/CONDOMINIUM ( Units) 2) NAME: ADDRESS: S17ND PETERSEN CONSTRUCTION INC. 4701 West 110th Street CITY, STATE, ZIP: Bloomington, MN 55437 PHONE: u&1_155_ NAME: GENZ-RYAN PLUMBING & HEATING COMPANY CITY, STATEf ZIP: --Rosemount, MN 55068 PHONE: 423-1144 MASTER LICENSE# 1849M .. Active Expired Not recorded Staff Ial 4) oea o ia• NAME: ADDRESS: CITY, STATE, ZIP: PHONE: -5) d jMXIgaiia. x. a ocyo-cyuo-? { CONNECTION TO CITY SEWER EC CONfU=ION TO CITY WATER OTHER 6) LUID?i• PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE " ®C PLEASE MAIL APPROVED PERMIT TO 1, 2,P 4, ABOVE _?./f? O (Circ e one) ADDRESS: 14745 South Robert Trail FOR CITY USE ONLY PERMIT # ISSUED al l Pd w/Bldg. Permit FEES: $ $ m .?? SEWER PERMIT (INCLUDE SURCHARGE) $ $ //} S d WATER PERMIT (INCLUDE SURCHARGE) // $ G;.3 SZ $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ J 6--0 ACCOUNT DEPOSIT - SEWER $ $ / S 'Ct d ACCOUNT DEPOSIT - WATER s n n C $ WAC $ J 7 S CZ7 $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER-ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ WATER TREATMENT PLANT SURCHARGE ... f7 $ $ OTHER: $ TOTAL RECEIPT RECEIPT DOES UTILITY CONNEC TION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? 0 YES IF YES, THEN A " PERMIT FOR WORK IWITHIN PUBLIC NO Q ROADWAY" MUST BE DIVISION LIST ISSUED BY THE ENGINEERING . AS A CONDITION. SUBJECT TO THE FOLL OWING CONDITIONS: APPROVED BY: TITLE: DATE: r/ 0( 2006 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Corm udion Rsauirements 3 registered site surveys showing sq. It, of lot, sq. R of house; and all roofed aress (20% maximum lot coverage allayed) 2 copies of plan shaving beam & window sizes; poured found design, etc. 1 set of Energy Calculations 3 copies of Tree Preservation Plan if lot platted after 711!93 Rim Joist Detail options selection sheet (buildings with 3 or less units) Mimregasco mechanical ventilation farm RemodeWeoair Reouiremenls 2 copies of plan showing footings, beams, joists 1 set of Energy Calculations fa heated additions i site survey for additions & decks Addition-indicate ffon sits septic system ?-)o.a) office Use Only Carl of Survey Recd _ Y _ N Tree Pres Man Recd _ Y _ N. Tree Res Required _ Y _ N On-site Septic System _Y _N Date .: Construction Cost Site Address 3114 unit/Ste # Description of Work r 1 C? G /&-A Multi-Family Bldg _ Y _ NFireplace(s) - 0 _ 1 - 2 Property Owner ? Telephone #(421;'0 394- -I -A/ a2 Contractor The Gopher Company License # 8617 - Address 2701 - 36th Avenue South CityMinneapolis State MN Zip 55406 Teiephone#(1512) 331-1555 . COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cate orv 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Y - N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone # ( Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the c Zwhich requires a review and approval of plans. MAR I, ???pE2 Applicant' Printed Name Applicant Signa ure DO NOT WRITE BELOW THIS LINE Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Acoessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenigazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows(Doors ? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant Description: Water Damage _ Yes Valuation Occupancy MCES System Plan Review _ 100% or _ 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) _ Sheetrock _ Footings (deck) _ Final/C.O. _ Footings (addition) _ Final/No C.O. Foundation HVAC Drain Tile Other Roof Ice & Water Final Pool _ Figs _ Air/Gas Tests _ Final _ Framing _ _ _ Siding _ Stucco Lath - Stone Lath -Brick R.I. _ Air Test _ Final _ Fireplace Windows _ _ Insulation Retaining Wall Approved By: Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total 7ato9g Zoos 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. /, ,6-D Date 3 1 A J? Site Street Address Unit # T ephone # i,5-/) s'?- R 76Cj Property Owner Telephone # (6j A Y•l r-'?? Contractor 2State'Mn) Zip Address 1;2JlIS? City The Applicant is: _ Owner Contractor her Septic System _ New _ Refurbished Sub i 2 ets of plans and MPC license Includes County fee 100.00 Per as-built $ 10.00 $ 50.00 Alterations to existing dwelling Add plumbing fixtures. This fee Intl stallation of a water softener and/or water - - _ heater at the same time. If you ar r falling onl a water softener and/or water heater, do not complete this ; move to the next section and check the , appliance(s) you are installing. - -Septic System Abandonment Water Turnaround (add $130.00 a 5/8" meter is required) Other: - Water Softener -Water Heater $ 15.00 _ new replacement _ Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00 .50 State Surcharge $ Total __ ,., ea o tha} Oho information is complete and accurate; that the I hereby apply for a rtesicenuai riurnuuiy Ve . , ain+ ?- - -• - - work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that 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 t e reviewed and a roved. 1 Air s ??- pli ant's Printed Name A lit nt's Signature r7,-;tb7X 2006 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. Date I 1_ Unit # Site Street Address y / Telephone # -p - Property Owner d ? / t?11 Telephone # (?? o?- ??-? 7 d Contractor Stated Zip&:,-?7 SG"1 L' ? L ' _ , City ? 6 Address The Applicant is: _ Owner _ Contractor -Other plans and MPC license Refurbished Submit New stem tic S S fee fee Includes 1 : _ y ep _ 00.00 Per as-built $ 10.00 $ 50.00 Alterations to existing dwelling Add plumbing fixtures. This fee includes installation of a water softener and/or water- .. _ heater at the same time. If you are installing onl a water softener and/or water) heater, do not complete this section; move to the next section and check the ^( you are installing. appliance(s)y , Septic System Abandonment Water Turnaround (add $130.00 if a 518" meter is required) - - --- -?_.___ _ - Other: Water Softener -Water Heater $ 15.00 new 3< replacement Lawn Irrigation _RPZ _PVB ,-new -repair -rebuild $ 30.00 I $ 50 State Surcharge $ S . l Total Inrnrmntinn is compl ete and accurate; that the I hereby apply for a Residential Plumbing rennu dnu 4„", °•- .-- -- - 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 accords a with the approved plan in the event a plan is required to be reviewed and approved. A plicant's Printed Name Ap ica is Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA107829 Date Issued:10/30/2012 Permit Category:ePermit Site Address: 1131 Tiffany Dr Lot:15 Block: 1 Addition: Canterbury Forest PID:10-16350-01-150 Use: Description: Sub Type:e - Furnace Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to Mark Anderson , State Electrical Inspector, 952-445-2840 Janel Behrends 122 West 3rd S Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 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 - Stephen J Martyr 1131 Tiffany Dr Eagan MN 55123 Haley Comfort Systems 122 West 3rd St Hastings MN 55033 (651) 437-0338 Applicant/Permitee: Signature Issued By: Signature