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4176 Topaz Dr tr7' . . ~ CITY OF EAGAN ~a 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE:454-8100 - ' BUtLDING PERMIT Receipt To be used for ?,!:?"ODZL Est. Value $ 4 r 000 Date 19 y ~ Site Address 4176 TOP11Z DTc Lot 15 Block ~Z Sec/Sub.CSDAR Gf~{fE iSP OFFICE USE ONLY Parcel No. °ccuaancy - FEEs Zoning - W Name ~N =SCti ZDA (Actuaq Const - Bldg. Permit 64.00 I Address 4174 TUPA2 !'+R (quowable) o Suroharge City PA~i Phone 452-7325 ~rof sion~ - Length _ Plan Review ,o Name CLZ~' W~KERI*Y IIUILliLRS Depth - SAC,ciy ~Q Address 4411 W CJI.D Sbl?i~•Od'LE ~tU S.F. Total - SAC. MCWCC ~ City 814=4ITAGTUA1Phone 881'-0941 S.F.Footprints - - On Site Sewage _ Water Conn ~ W W Name On Site Well - Water Meter Addr@SS MwCC System - Acct o it 7 City Phone city water - ~ PRV Required _ S;W Permit I hereby acknowlege that I have read this application and state that the Booster Pump - S/W Surcharge Inforrnation is correct and agree to comply with all applicable State of Mfnnesota Statutes and Cfty ot Eagan Ordinances. Treatment Pi Signature of Permitee - APPROVALS Road Unit A Building Permit is issued to: CLI eT IIANGP,!; 1:7 3LDR5 Planner - Perk Ded on the express condition that all work shall be done in accordance with all Council _ applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. g~, pH. _ Copies I Building Ofticial Varianoe - TOTAL b~'' Pern?k Nc• Parmit FIoWer Date TNWphaw # JJVATER SEWER PLUMBING IC..~ gl' LyLC,: 3h'~~~ H.V.A.C. ELECTRIC Yapmtlon Dob Imp. Commsnts Footings I Foundation Framing RoofiN ~O pb9• Rou9h H19• leul. Fireplace Fnal Hig. Fnal Plbg. Conat Meter Plbg. Inspector - Notify Plumber Ergt.IPlan eae. Final f Dedc Ftg- Deck Final weli R. Diap. CITY OF EAGAN Remarks * Cedal Gz+ove ACqulsitiAn Addition CEDAR GROVE #1 Lot 15 Blk 10 Parcel 10 16700 150 10 Owner • 'f~' ~ ~ Street 417 'lb 3Z Drive State ~g~ , ~ 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1985 1266.95 84-46 15 STREET RESTOR. GRADING SAN SEW TRUNK * SEWER LATERAL 1972 52.16 25 WATERMAIN * WATER LATERAL 1972 WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK I INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 PilOt Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: ` (612) 681-4675 SITE ADDRESS: I t, I. p. ti 1 +1, r: APPLICANT: ; i ti4'Ar nft ~ PERMIT SUBTYPE: TYPE OF 1NORK: E4 INSPECTION ON TYPE D. f+i,~~i I t~+~ I I ~ ~ J Permit No. Permit Holder Data Telephone N ~ I ELECTRIC ~ PLUMBING HVAC Inapection Dift Insp. Commem FOOTINGS FOUND I FRAMING ROOFINC3 I ROUGH PLUMBING PLBG AIR TEST I ROUGN I HEATING GAS SVC I TEST I INSUL I I vYP80ARD I FIREPIACE I FIREPLACE I AIR TEST I FINAL PLBG I FINAL HTG I I ORSAT I fEST I ' 3LD0 FINAL i 3SMTR.L I I F'SMTFINAL I I ' "?ECK FTG I~ I ~cCK FINAI I I--- - i CITY of EAGAN N~4 4086 BUILDING PERMIT ' 3795 Pilo1 Knob Road vl...d..1N~~G~? Eagan, Minnesola 55122 Addrecs (Preteni) -..~//.7b......... ..~.C~{ 454-8100 8uilder Dnle Addceas DESCRIPTION Stories Be UsiAd For F~:o -t- epih Height Eai. Cosf Perml! Fse Aomuke LOCATION Slreei. Raad or olhes Deceripiion ot Loealion I ! 81oek Addiifon or Tract This permit does ot ay orize the use of atraels, roads, elleye ox sidewalkt nor does it give !h owner or hfs ageat ffie righ! !o ereafe eny siiuaiion which is e nuisanee or which presenls a hazerd !o the health, eafely, convenienes aad general welfare !o enyone in the communi2y. THIS PERMIT MUST SE EP O/g~~ E PREMISE WHILE THE WOAK IS IN PAO/GyJ~ SS./ This is !o aerlify, thal..,4.~~..~:" .Qv.lLI.C.~-i hasparmissioa !o ereet-efi/~!jy(~tLl.~~}~,tL±-G.G.. o the a6ove escWZ' mise subjeci fo the provisions of all appli e r ances for !h i f EagaxL ........c r..aY, o~ Per . . . . . . ~uttdi peetor CITY OF EAGAN N? 16177 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for REMODEL Est. Value $4, 000 Date 19 _L e Site Address 4176 TOPAZ DR Lot 15 Block 1 Sec/Sub. rEDAR GROVE 1 ST OFFICE USE ONLY P8fC21 NO. Occupancy - FEES Zoning _ m Name KEN TSCHIDA (ActuapConst - BIdg.Permit 64.00 3 Addtess 4176 TOPAZ DR (Allowable) ° Sumharge 2.00 City EAGAN Phone 452-7325 notsiories - Length _ Plan Rewew , o Name CLIFF WANGERIN BUILDER5 Depth - SAC, Qty 0, a Address 4411 W OLD SHAKOPEE RD 5F rotai - ¢ City BLOOMINGTONPhone 881-0941 S F Foo1prmts snc, Mcwcc On Site Sewage _ Water Conn r~ FW NamB OnSiteWell - WaterMeter ~ MWCC System Address Acct De osn aw City Phone cirywaier - P PRV Required S/W Permit I here6y acknowlege that I have read this apphcation and state that ihe Booster Pump - SrW Sumharge mformanon is correc7 and agree o comply wrth all applicable State of Minnesota Statutes and Qty o an Ortlinances Treatment PI SignaWre of PermM1ee APPROVALS Roatl Unrt A Bwlding Permit is issued ro. CLIFF WANGERIN BLDRS Ptanner - park Ded on ihe express condtlion that all work shall be tlone in accordance wrth all Council _ apphcable State of Mmnesota StaNtes and Ciry of Eagan Ordinances. gid9, pry Copies Building Oflicial l ~ ~ QL~~ ' -R~f Vanance - TOTAL 66.00 ./J - EAGAN TOWNS6-IIP No 361 /J BUILDING PERMIT Ownex Eagan Township ~ Address (PresenS) 1.'_------------------- . : . ~ Town Fiall Buildar L.Lc,c.e......... ~ Date ~ q . ~ - _l Address " ~ DESCRIPTION ~ Stories To Be Used For Fron! Depih Heigh! Esi. Cos! Permil Fee Remarks ~ LOCATION Sireel, Road or olher Deseripfion of LocaYion ~ I. Lo! Slock Addition or Trac~f ~ ~l /9. ~o. / This ~p,,mit does nv! aulhorize !he use of s2reefs, road , allewalks nor d s ii give ihe owner or his ager.f .ihe right fo ereate any siiuation which is u nuisance or which presenis a hazard fo the healih; safety, convenicnce and ' geaeral welfare fo anyone in ihe communily. ~ . THIS PEAMIT MUST BE E O THE PR MIS WHELE THE WOAK IS IN PAOGRESS. . This is !o, cerfify, thai. .(X!~..~.fkd:~..rC....f~;W~-'..has permission fo erect _ upon fhe abo e descxibeOman'of- 'eci to the ptovisions of the Building Ordinance for Eagao Townshion:ed Aoril 11. 1955. - ..,7..- - Per - - - .._Coard Building -I- nspe - - - cior RESIDENTIAL BUILDING PERMIT APPLICATION ~ CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Reauiremenq RemodellReoair Reuuirements • 3 registered site surveys showing sq ft. of IoL sq. ft. of house; and all roofed areas • 2 copies of plan (20% mazimum lot coverage allowed) . 1 set of Energy Calculations for heated addihons • 2 copies of plan showing beam & window saes, poured found design, etc.) . 1 site survey tor exlenor additions 8 decks • 7 sel of Energy Calculations . Indicate if home served 6y septic system for addi6ons • 3 copies ot Tree Preservation Plan if lot platted aRer 711193 . Rim Joisl DeWtl Optrons selection sheet (bldgs with 3 or less uniLs) DATE ~j1 - OC.'C - ~ 01 VALUATION SITE ADDRESS MULTI-FAMILY BLDG _ Y _ N TYPE Of WORK 1c tCo ~_~w ,1rv U-s,~ FIREPLACE(S) _ 0_ 1_ 2 v APPLICANT _,ViMA • kril Clt S.v-.SAo.\\'td S0.1tS STREET ADDRESS 32on C6bIo 6oAfx1o~C.W%4. CITYA-4'IGt~ STATi4\ ZIP3I_ TELEPHONE+(.03 54a•$B31[o CELL PHONE # L:c~nta'~'6Gan~$~S~ FAX # PROPERTY OWNER CA'.n-k- NOOpp,vJ TELEPHONE # LdS' 1•ySi • yt102l' COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS JO,NL,Y ri~ r_ ~ l'~ i~ ~V 08 2C(1_z Energy Code Category _ p~(~.N1~:50'1'A RULES 7670 CA"I'liGORY I MINN~:SOTA RUI.L•S 767~ (J submission type) • Residenlial Venhlation Category 1 Worksheet Submitted :J'New Energy Code WorksheetlSubmitted • Energy Envelope Calculations Submitted LE Plumbing Contractor: _ _Plionc # Plwnbing sysLcm includcs: _ Watcr Softcncr _ Liwn Spriuklcr Fce: $90.00 ~/1'atcr Hcatcr No. ul R.I. Balhs No. ot 13aUis Mechanical Contractor. Phone # Mcchanical systcm includcs: _ Air Conditioning 1'ec: $70.00 I-Icat Rccovcry Syslcm Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the infor ion is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordina Signature of Appl(canf ~MA&np_ - OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY ? 01 Foundation ? 07 OS-piex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Eut. Alt - Multi ? 03 01 of _ plex ? 09 07-plex O 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? OS 03-plex 0 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 O 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alleration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 WindowslDoors ? 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 _ Footuigs (new bldg) _ FinaVC.O. _ Footings (deck) _ Final/IQo C.O. _ Footings (addition) _ Plumbing Foundation H V AC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ AirTes[ _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply 8 Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total ~ Installed Siding andl*MMsPOWER OF ATTORNEY , . OUNTY OF COBB . STATE OF GEORGIA KNOW ALL PEOPLE BY THESE PRESENTS: THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania ("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home Depot Installed Sales iocated at 660 Mendelssohn Avenue 2Qorth, Golden Valley, MN 55427, having a license number of BC- 20268257, do hereby appoint, name and constitute Elder-Jones Building Permit Service, Inc. ("Agent") as my true and lawful attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my name, place and stead the power to execute, acknowledge, sign and deliver (in such form as may be required by the municipality) a permit application, or any other instrument(s) which may be necessary and appropriate, in order to obtain the proper permit(s) from the City of Eagan, Minnesota for the installation, maintenance and repair of windows and siding (the "Work"). The powers conveyed to the Agent by this Limited Power of Attorney are limited solely to the express powers delineated herein and apply solely to the Work. This Limited Power of Attorney shall expire and automatically be revoked on the 30t1i day of May, 2003, which date is one year from the execution hereof. Further, the powers conveyed by this Limited Power of Attorney may be revoked by Principal at any time by express revocation and shall also be revoked by the Principal's death, disability, incapacity or incompetence. IN WI"I'NESS WHEREOF this Limited Power of Attorney is executed this 3dTA day of Mh`f , 2002. David . z SWORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this 30'h day of May, . Notary blic in for the Stat of eorgia • My Commission Expires: January 21, 2006 796816 v3 Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized coniractor. 3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPO qw Date: ~ BUILDIPTG PERMIT P.,PPLICATION LOT ' BI,GCK ~ll ADDITION^ PARCEL & 3ECTIOP] PNMDER IF UYdP;.ATTED - ADDRFSS OF FARCEL 17117 ZOTQITTG OCCUPARICY USE I ~ . ESTZAIAi`ED COS^t ~ O?:AdER_ TEI.EPHONE iVO. 517 -ty [IDDL4'aSJ N CONTRACTOR TELEPHONE 1\70. _ ADDRESS tJOte: Include site plan, buildinq plans, and energy calculations with this application Si9ned OFFICE USE \ n 9 VALOATIO1117 SAC 1,IATEZ2 CO1•1NECTIOt7 - 47ATER hIETER BUILDING PERI4IT FEE SURCHARGE FEE ~ - - PLALI CFECK FEE PAFtK DEDICATIOtI FEE OTHER - TOTAL* APPROVALS: , ASSESSME.TT CLERK SUIi,DING 6EPT. POLICE DEPT. WAiER & SEWER DFPT. £SRE DEPT. PARK DEPT. PERMIT CIy'Y OF EAGAN BUILDING 3830 Pilot Knob Road PERMIT TYPE: Eagan, Minnesota 55122-1897 Permit Number: 028409 0 7/ 2 9/ 9 6 (612) 681-4675 ' Date Issued: SITE ADDRESS: 4176 TOPAZ DR LOT: 15 BLOCK: 10 CEDAR GROVE 1ST P.I.N.: 10-16700-150-10 DESCRIPTION: . (ROOFIN6) Building,Permit Type STORM DAMAGE Build3ng lJork Type REPAIR i`Census Code ` 434 AIT. RESIDENTIAL ~ i ir , . . , : " , . . . REMARKS: FEE SUMMARY: CONTRACTOR: - flpplicant - sT. Lzc.pWNER: ' SELA ROOFING & REMODELING 18238046 0001050 TSCHIDA KEN 4100 EXCElSIOR BLVD 4176 70PAZ DR ST LOUIS PARK MN 55416 EAGAN MN 55122 (612) 823-8046 (612)452-7325 I hereby ecknowledge that I have read this application and state that the information is correct and agree to comply with all applicable 5tate af Mn. Statutes and City of Eagan Ordinances. R4a~~.~111.~- APPLICANT/PEFMI7EE SIGNATURE -SSUEO BV: IGN TUFE ~ CITY OF EAGAN IS4o4 3830 PILOT KNOB RD - 55122 996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Construelion Reaulremenls RemodeVReoair Reavlremenfs ? 3 registerod aNe surveys ? 2 copies ot plan ? 2 copiea of plane (Indude beam b window s@ea; poured Md. design; etc.) ? 2 site surveys (exterior addRions S decks) ? 1 energy calculellons ? 1 energy calcufations for heated addilions ? 3 wpiea of tree preaenetion plan H bt platted aRer 7/1183 requircd: _Yes No DATE: 7 -zs" ,?6 ^7~~ o0 CONSTRUCTION COST: DESCRIPTION OF WORK: T~~~~ t~~1LO~f= f/OUS~ f- C~':~G•-~ 0- STREET ADDRESS: y~7(~ % ~~~`~'L n~- • LOT _1~1 BIOCK ~ SUBD./P.I.D. PROPERTY Name: T~'G~IfDA PhOne#: OWNER Street Address- 76 i Dr~LL D.c? . City: State: Zip: ~5 17s/02- CoN7w?c7oR Company: ' Phone#: titLA IivG & REMODELING, INC. Street Address: 4100 EYCELSIOR BLVD. License bb4 16 ID# 0001050 City: State: Zip, ARCHITECT! Company: Phone #ENGINEER Name: Registration Street Address• City: State: Zip: Szwer & water licensed piumber: Penalty applies when address change and lot change are requested once pertnit is issued. I hereby acknowiedge that I have read this application and state that the iniormation is correct and agree to comply with ail applicable SWte of Minnesota Statutes and City of Eagan Ordinances. ~ Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes No Tree Preservation Plan Received Yes No OFFICE USE ONLY ~ , •r ~y~A~ BUILDING PERMIT TYPE 0 01 Foundation o 06 Duplex o 11 Apt./Lodging ? 16 Basement Finish 0 02 SF Dwelling ? 07 4-plex o 12 Multi Repair/Rem. ? 17 Swim Pool 0 03 SF Addition o 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch o 09 12-plex ? 14 Fireplace o 21 Miscellaneous ? 05 SF Misc. 0 10 = plex ? 15 Deck WORK TYPE 0 31 New ? 33 Alterations o 36 Move 0 32 Addition o 34 Repair o 37 Demolition GENERAL INFORMATION Const. (Adual) Basement sq. ft. MC/WS System (Ailowable) Main level sq, ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bldg Census Unit APPROVALS Planning Buiiding Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. , Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units It 1989 BIIILDING PfiRMTT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS I 'T I I ri INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTEs ADDAFSSFS FOR CORNER LOTS - CONTRACTOR/HOME01iiNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. AO CHANGFS WILL HE ALLOWED ONCE HOILDING PERMIT IS ISSIIED. MQLTIPLE DWELLINGS RENTAL DNITS FOB SALE OAITS i OF OHIT3 INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURYEY - CHECS WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS REMvD'cl- 3A?t4R00/+h To Be Used For:£ Er~'RESS YV,NncWS Valuation: 14000 Date: MARc.H S9 ?9@q Site Address /-I 17(~ Tona,Z Dp,,uF OFFZCE OSE ONLY Lot Is Block 10 Occupancy FEES CEDAR GRO~T ApDN. Zoning Parcel/Sub ~ Actual Const Bldg. Permit oy, Allowable Surcharge Z.oo Owner /fa4 (tlc,~ /IC~l~iyq U of stories Plan Review Length SAC, City Address 117(o T„~qq] Depth SAC, MWCC ~ S.F. Total Water Conn City/Zip Code Ea.9v h Footprint S.F. Water Meter Aeet. Deposit Phone 41(-Z _ 73 Z5-- On site sewage_ S/W Permit waNGERiN~7 ~A On site well S/W Surcharge Contractor ~PF t.JtwS ei.'n E//..G/s MWCC System _ Treatment Pl. /Jg City water Road Unit Address ~St D/Z /lGE' PRV required _ Park Ded. / / Hooster Pump _ Copies City/Zip Code ;61dan-'~Tern. TOTAL F~G~,vo 88'! APPROVALS ~~,~/2 ~ - Oy y/ Planner _ Phone - Council Arch./Engr. Bldg. Off. Var ianee Address Council ~ City/Zip Code Phone # NOT6: Sewer & Water Permit Pees and account depoait fees xill be ineluded in the building permit fee. Processing time for aewer and water permits is two days once a licenaed plumber has applied for a permit at City Hall. City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4176 Topaz Dr Lot: 15 Block: 10 Addition: Cedar Grove 1st PID:10- 16700 - 150 -10 Use: Description: Sub Type: e- Reroof Work Type: Replace Description: House & Garage Census Code: 434 - Zoning: Square Feet: 0 Comments: If there is no ice protection inspec acceptable in lieu of inspections. Fee Summary: Valuation: 3,000.00 Contractor: Roncor Construction 10740 Lyndale Ave S #11 Bloomington MN 55420 (952) 888 -5578 BL - Base Fee $3K Surcharge - Based on Valuation $3K Total: Applicant/Bermitee: Signature PERMIT City of Eaan - Applicant - Construction Type: Occupancy: on prior to final, you must meet inspector with ladder and flat bar. Pictures are not Owner: Chad E Stambaugh 4176 Topaz Dr Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: $88.50 0801.4085 $1.50 9001.2195 $90.00 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Issued By: Signature Building EA087120 10/27/2008 ePermit Date: City of Eaaan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit #: /CY/ ©3; Permit Fee: =J5` Date Received: Staff: 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Tenant: Suite #: Site Address: J RESIDENT / OWNER Name: _.. 4-D1 - Phone: (0E57 J3d�-2 Address / City / Zip:4151-/n. ,.,p CONTRACTOR Name: MILBERT COMPANY INC.dba CULLIGAN WATER Address: 1801 50Th ST EAST City, INVER GROVE HGTS State: MN Zip: 55077 Phone: 651 451-2241. Contact BILL .MILBERT; Email: TYPE OF WORK _ NewReplacement Repair Rebuild Modify Space Work ira.R.O.W. _ _ _ Description of ork• PERMIT TYPE RESIDENTIAL ?Vater Water Heater�Softener Add Plumbing Fixtures ( Main 1 Lower Level) Lawn Irrigation ( RPZ / _ PVB) _ Water Turnaround Septic System New _ Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation $55.00 Add Plumbing *Water Turnaround $105.00 Septic System $95.00 Fire Repair (replace (includes $5.00 State Surcharge) Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) (add $166.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not t• start wiut a permit; that the work will be in accordance with the approved plan in the case of work whicp requires a review and approval . �- ns. Wi /h, m,/M Applicant's Printed Name x A • p icant's Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA151631 Date Issued:09/05/2018 Permit Category:ePermit Site Address: 4176 Topaz Dr Lot:15 Block: 10 Addition: Cedar Grove 1st PID:10-16700-10-150 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Michael R Johnson 4176 Topaz Dr Eagan MN 55122 Norwest Contractors Inc 1370 Crestridge Lane Eagan MN 55123 (763) 420-8268 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA165869 Date Issued:11/24/2020 Permit Category:ePermit Site Address: 4176 Topaz Dr Lot:15 Block: 10 Addition: Cedar Grove 1st PID:10-16700-10-150 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 1,500.00 Fee Summary:BL - Base Fee $1500 $62.50 0801.4085 Surcharge - Based on Valuation $1500 $0.75 9001.2195 $63.25 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 - Michael R Johnson 4176 Topaz Dr Eagan MN 55122 (651) 341-2245 Crew2 Inc 2650 Minnehaha Ave Suite 100 Minneapolis MN 55406 (612) 276-1680 Applicant/Permitee: Signature Issued By: Signature