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4195 Topaz Dr41°P' City otEapu 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit #: 7 Permit Fee: -Uv Date Received: Staff: 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: )Ji -fid// Site Address: 6// - 40/1 z_ Tenant: - J Suite #: RESIDENT / OWNER Name: e!'f/frdrS /1 FST ( Phone:14/377 `-Zet25.9 Address / City / Zip. 1/5� .---- z- A - &-&-,4,1--t--/f 7/4,' - -53---/...)z CONTRACTOR Name: 1_ A A. ' �✓ License #: g-VP 44 ✓ ¢� Address:�c% D ely,"/Z `L- City: (se5`� State:4%A' Zip: �/ e Phone: it' 7) yj "2 -- Contact: - `A .f Email: TYPE OF WORK _ New ot.eplacementt Repair Rebuil Modify/Space- Work in R.O.W. Description of work: �lfre / A✓ 91 ,�` '2W (/int eV PERMIT TYPE RESIDENTIAL Water Softener Water Heater Add Plumbing Fixtures ( Main / 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 be you intend to dig to r eive locates of underground utilities. www.qopherstateonecall.orq I hereby ackno e.ge hat this inf a on complete and accurate; that the work will be in conformance with the ordinances d codes of the City of Eagan; that I r'e and this isof pe mit, but only an application for a permit, and work is not to start without 4 rmit. at the work will be in acco nce approved p�ann ' t - case of work which requires a review and approval g( plans. nature Required Inspections: nder Ground' ough-In AirTest RESIDENTIAL BUILDtNG PERMIT APPLICATION 3830 PIL'OT KNOB RD - 55122 4)i3t7~, O-P 651-6814675 N~w Condmctan Rwuirsmenls RamodeVRewir Reauirements calA ~ ~1b~01 . 3 registeied sitesurveys showug sq. 8, of bt sq. fi. of house; and all roofed areas • 2 coqes of qan (20%maximumbtcoverageallaxed) . iseto(EnergyCalculations faheatedadditbns ~ • 2copiesofqanstawirgbeam&wirdowsizes;pouredfouMdesign,etc.) • isHesurveyTorextenaradditiom &decks . 1 set of Energy Calqdations . Indipte'rf lame served by septic system kr addKions . 3 copies of Tree Preservation Plan if IW platted after 711193 • Rim,bisl Detail Oplions selection sheet (bldgs with 3 a less w&) DATE D- I I' C) I VALUATION 300 n JOB SITE ADDRESS 5 T r IF MULTI-FAMILY BUILDING, HOpW- M-ANY UNIT . PROPERTY OWNER C~ Ir~C~,/~X.. lJ TYPE OF WORK -2 C--k FIREPLACE(S) _ 0_ 1~ 2 APPLICANT 6IZ ( PHONE# ADDRESS / 45'9--1 QLcnrP ZIP CODE PAGER # 64 a- g`g a-~72 CEL! PFIQNE # FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RUI.ES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Submi D - Energy Envelope Calculations Submitted _ MINNESOTA RULES 7672 gY $7'1 - New Energy Code Worksheet Submitted Plumbing Confractor: Phone Plumbing System Includes _ Water Softener Iawn Sprinkler Fee: $90.00 WaLer Heater No. of R.I. Baths _ No, of Baths Mechanical Conhactor: Phone # Mechanical System Includes: _ Air Conditioning Tee: $70.00 _ Heal Recovery System Sewer/Water Contractor. Phone # All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the information is c r , nd agree to compiy with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Sfgnature of Applicant Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 1/p1 OFFICE USE ONLY O 01 Foundation O 07 05-plex O 13 16-plex ? 26 Pool ? 30 Accessory Bldg 13 02 SF Dwelling 13 08 06-plex O 16 Firepkxe ? 21 Porch (3-sea.) p 31 Ext. Alt - Multi 0 03 01 of _ plex ? 09 07-piex O 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Ait - SF ? 04 02-plex ? 10 08-plex 'f[18 Deck ? 23 Porch(screened) ? 36 Multi 13 05 03-plex O 11 10-plex O 19 Lower Level O 24 Stortn pamage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N O 25 Miscellaneous ? 31 New 0 35 Int Improvement O 38 Dertalish (Interior) O 44 Siding ? 32 Addition ? 36 Move &dg. O 42 Dertalish (Foundation) O 45 Fire Repair 33 Alteratan 13 37 Demolish (Bldg)• O 43 Reroof 13 46 WindowslDoors O 34 Replacement `Damolitlon (Entlre Bldy oni» - Glve PCA handout to applieant Valuation dccupancy MC/ES System Census Code _T~ Zoning City Water SAC Units Siories Boaster Pump Nbr. of Units Sq. Ft PRV Nbr. of Bldgs Lenglh Fire Sprinklersd Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) FinaUC.O. ~ Footings (deck) FinaUNo C.O. _ Footings (addition) _ Plwmbing Foundation HVAC Drain Tile ~ Roof Ice & Water Final Other _ Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone Insulatiou _ Windowa (newheplacement) Approved By Z , Building Inspector - - - Base Fee 704 Surcharge p 9.,u1G Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search r/ b Copies Other Total EAGAN TOWNSHIP No sos , I BUILDING PERMIT _ . . 4~!.._..... ~ Eagan Township . Own r fi ' Address' (Present)Town Fiall - Suilder.--------------------- . . ~ Date ..............._............__J ~ Address " ~ " DESCRIPTION ~ ~ Sfories' To Be Used Foa Fron1 Dep1h Heighf Esf. Cas! rmif Fee ~cT e atks LOCATION , Streei. Aoad or o her De cripiion of Location I Lo! Block . Addition or Traci /4 ~ is t do ~auiha ' the use of slreeis, roads, alleys ar si Walks nor d s ii give e owner or his agenf the righ! !o creafe any siluation which is a nuisance or which presenis a hazard !o the healfh, safefy, convenience and general welfare !o anyone in the eommunity. " . . ~ TFiIS PERMIT MUST ILEP N TH E SE WHILE THE WOAK IS IN_ PROGRESS. This is So ceriifp, fha~yl! F.r~fL'Z~.has permissio fo erec! 6.~..'.~~.. ~~C.. . _upon the above described premise su jec! !o the provisions of the Bu' ing dinance n xs' adopfed April 11. 1955. f~<?; ; Pes' _ _ . . ' C h a i r m a n of Town Board ~ ~ Bu ecior !l/ ~ EAGAN TOV!/N S H I P N° 1612 BUILDING PERMIT Owner ..~~T~r..-------- Eagan Township Address (preseni)~....----------------- Town Hall Builder .~.Z/ ......R-~......4Sa`i._.~.......'.._'..._'...._.......... r V Address ' n. .o . Dafe . /.7f..~.g.6 f ~ _ - DESCAIPTION Sfories To Be Used For Proni Depih Heighf Esl. Cosf •Permit Fee Remarks LOCATION 5lreel, Road or olher Descripfion of Locafion I Lo! Block ~ Addition or Traci This permif does noi auihorize the use of sireefs, roads, alleys or sidewalks nor does it give the owner or his ageni the zighf to creaYe anp situafion which is a nuisance or which presents a hazard io the healih, safeip, convenienae and general welfare to anyone in the cammunify. THIS PEAMIT MUST ByE/~KEPT ON TXF~ PREMIS~ .WHILE THE WOAK IS IN PROGRESS. This is !o cerlify, Shai..(AJ_ ........_.L~.r.•~ c._.__.haspermission fo erect a.... _ upon ~ ' the above described premise subject So the pzavisions of the Suilding Ordinance for E an To nship adopfed April 11. 1955. ~ ~ . ( ",i-'?f`-~C..:-J_........... Per 4......'. Chai~han of Tn 4n Spard Building Insp eetor !3 -CITV O AEF GAN Remarks * Cedar Grove AcCrUisition Additio CEDAR GROVE I#~1^ Lot 5 Blk $ Parcel 10 16700 050 0$ Owner o V I.' Y' 1+~ V!_1 Street 4195 10pdZ DL'iVe State ~4an, MN 55122 Improvement Date Amount Annual Vears Paymen[ Recefpt Date STREETSURF. ~ 1985 1266.95 84.46 15 STREET RESTOR. GRADING SAN SEW TRUNK SEWER LATERAL,., ~ Pdl WATERMAIN • WqTER LATERAL 1972 WATER AREA STORM SEW TFK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. C U BUILDING PER. SAC PARK 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN l ' 01 3830 PII.OT KNOB RD - 55122 651-681•4675 New Construction Reauirements RemodeVReoav Requvements ? 3 registered site surveys showing sq. ft. o/1of, sq. k. o/house ? 2 copies of plan and all roofed areas (20% maximum lot coverepe allowed) ? 1 set of energy calculations for heatetl addihons • 2 copies ot plans (show beam 8 window s¢es; poured fntl. design; etc.) ? 1 site survey for exterior additions 8 decks ? 1 set of energy wlculations • 3 copies of tree preservation plan if lot platted afler 7!1/93 DATE: I)I)kI6 -c1 S CONSTRUCTION COST: DESCRIPTION OF WORK: ~ p~~ G~cJ~r/~ ?`-~~~0~1/.~, ~ STREETADDRESS: LOT: ~ BLOCK: SUBD.IP. . C~ o.~ ~ ? ~l ~i t + Name:_ e S SQ-Q JCJJ Phone k: `_0 _0 nl PROPERTY lasi First O'VVT ER ^ Street Address:_ y i y7 cr~ c_ ?_~J~-c-cr-P Ciq---~ Siate: __M ( N N _ 'LiP: Comp:m}':__BK1!~~" U.~ Z-Q°~ c- d/~l Yhone N: 61 a- CONTR9CTOR ~ ~ q Street Address:_~S~ I~U~~ Lccnse M?-06 Lj5 L_L,p. - State: d/J i S Citv ~ ~ ~'p' -AM ----~--~.~2-- ARCHITECT/ ENGINEER Compwi~: _ Phonc N:vnc:----- - Registiauon N: Svicet Address: _ Cit}' Statc: Zip: Sewer 8 water licensed plumber (required for new construction onlv): Penalty applies when address change and lot change is requested once permit is issued. 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 of Applicant: \j OFFICE USE ONLY Certificates of Survey Received _ Yes _ No , ~ i~J;R 2 6 ISSa2 iTree Preservation Plan Received _ Yes _ No _ Not Required- 1 OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 PorchlAddn. (4sea) ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE ? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 SidinglSoffits/Fascia ? 32 Addition O 36 Move Bldg. ? 40 Gas Insert O 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg. ? 41 Wood Stove ? 45 Fire Repair ? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. SAC Code UBC Occupancy sq. ft. No. of Units Zoning sq. ft. No. of Bldgs # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Treils Ded. Other Copies Total: SAC Units Q CITY USE ONLY 3q5O BL O RECEIPT SUBD. -CpAav~ GF~O-e ~ I RECEIPTDATE' ' -Uo PERMIT# r 2000 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 651-681-4675 Please complete for: ? single family dwellings ? townhomes and condos when pertnits are required for each unit ? backFlow preventer for underground sprinklersystem FIXTURES EACH # TOTAL Alterations to existing dwelling - minimum fee $ 30.00 Describe: Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas piping outlet ' minimum - 7 3.00 x = $ Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x = $ Laundry tray 3.00 x = $ Lavato 3.00 x = $ SeptiC SyStem new/refurbished ' requlres MPC Ilc. 75.00 X = $ Septic System abandonment 30.00 x = $ RPZ new installation/repair/rebuild 30.00 X = $ Rough opening 1.50 x = $ Shawer 3.00 x = $ Underground sprinkler if dwelling is under wnstruction 3.00 x = $ Underground sprinkler if existing dwelling 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water softener if dwelling under oonstruction 5.00 x = $ Water softener if e:isting dwelting 30.00 x = $ Waterturnaround 30.00 x $ State Surcharge 50 $ 50 TOtal $ Reminder: Call for inspections of alteretions, i.e. water heaters, water softeners, etc. 30 • S~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1 hereby acknowledge that I have read this application, state that Ne infortnation is wrred, and agree to wmpty wiN all applicable City of Eagan ordinances. It is the applicant's responsibiliry to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its nortnal operational and maintenance activities to the facilities consUUCted under this permit within City propertylright-of-way/easement. SITEADDRESS: 4795 TOPA7 DR, FA('AN MN 95122 OWNERNAME:: runuTFS vF.SFr. TELEPHONE#: F6S1 499-1561 (AREA CODE) INSTALLER NAME: Maux scHT rNx TELEPHONE#: sn7 33G-1; i 7 1 (AREA CODE) STREETADDRESS 9389 140TH GT W - C ITY: MONTCOMERY STATE: ZI P: SIGNATURE F ERMITTE 2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN ~ ~ % 3830 PILOT KNOB RD - 55122 651-681-4675 C- Reaulrements • °l " : 2 copies ol plan DATE: _9~/ vv CONSTRUCTIONCOST: V V V.~ DESCRIPTION OF WORK: Drcu,l`Tr(D If mulfi-famlly bldg., how many unlfs9 IPIDICAiE THE FOLLOWING EAUIPAAEAIT TO BE REPLACED APfD BY UVHOPA: _ Plumbing _ Homeowner g[ Conhoctor Name _ Mechanical _ Homeowner g[ Conhactor Name ••NOte: If somebody oTher Than the homeowner is performing plumbinq or mechanlcal work fhey musT appry forappropriate permit. Only Iicensed plumbing conhactor or homeowner may compleTe plumbing work. STREET ADDRESS: !q/ 3 I b PlY Z NI UC IOT: ~ BLOCK: ~ SUBD./P.I.D. q: ~ Cl ~ C-~ ~0\I'~~ I Name: I/EEL - ^l fCS ~ //Iky Phone#: (!/sy"1 PROPERN Last First I OWNER Street Addreu: / City Stafe: Zip: VSIa~ Company: ~ I A)0.~ Phone &W_ - Ve (area code) CONTRACTOR /o~ / nA/ aoaa SheetAddress: vrt•N c_H ucensea exp.3~/ e/ Clty ~~~i State: Zip: I hereby acknowledge fhaf I hwe read fhis applicaHon, state fhat fhe infortnaNon is correcf, and agree to compry with all applicable State of Minnewta Statutes and Cify of Eagan Ordinances. v Signature of Applicanf: Qblj �Cityofbpi' Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 RECEIVED FEB 222012 Use BLUE or BLACK Ink For Office Use /1) -) -co Permit* Permit Fee: Date Received: Staff: INFLOW & INFILTRATION PERMIT APPLICATION X Plumbing / Sewer & Water Site Address: 1 5 To J9 z 1) r; ves__ Tenant: Suite #: Name: C -'(/k/ ,V.e. _ , .,u, ....... �4/ Phone: Address / City / Zip: LI 1 q s- %4 f- Q/1 . , �sl �5 Name: 1- e.S S. IC. r1 PI in w% h i1,15 e r v �`�� T'i, L License #: P C (o I L, 3 5 3. Address: P. 0 ) e y a J a City: 3, State: yrl Zip: 5 S / a Phone: lv 5 I - Contact: 1Y) ,` r< s cin ) f z. PLUMBING (Within the building envelope) i< Sump Pump Repair Other. SEWER & WATER (Outside the building envelope) Repair Other. ~ +,-• `^ ►"^� 1=0 o +.r r' d ., FEES, $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEES (0,00 *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit Ifi repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeaaan.com/inflow, or City Hail at 3830 Pilot Knob Rd. 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.gopherstateonecali.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 to start without a permit; that the work will be in accordance with the approved plan in the case of wrork which requires a review and approval of plans. X r'1 11<4.- S'` C. t,1 ! ' " 2. x Applicant's Printed Name Applicant's Signature FOR 0I PICE'USi q+ Reviews fly: tinderGround _, Rough -In Final PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA110705 Date Issued:05/23/2013 Permit Category:ePermit Site Address: 4195 Topaz Dr Lot:5 Block: 8 Addition: Cedar Grove 1st PID:10-16700-08-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Kris Oien 3670 Dodd Rd Eagan, MN 55123 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 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 - Charles J Vesel 4195 Topaz Dr Eagan MN 55122 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink I For Office Use ITD- Permit Af City of Ea~aii f I Permit Fee. ~ d S I 3830 Pilot Knob Road I I Eagan MN 55122 I Date Received: /7 1-3 f I I Phone: (651) 675-5675 Fax: (651) 675-5694 f Staff: I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: / p / Unit Name: Phone: j~ 1 `C.-q_6® Resident/ Owner Address / City / Zip: Applicant is: Owner Contractor Type of Work Description of work: '2 Construction Cos 4115-66 Multi-Family Building: (Yes / No Company: (-h15MN/C' C(?>1 G `1~C3~ Contact: Contractor Address: q R ) I a ~j tAj city: 116 State: ` " t i Zip: Phone: 0'7 l ` 3.2 ~3 License ~ L 3 g Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A .NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: i Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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.gopherstateonecall.org 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 to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. t d x Applicant's Printed Name Appl cant's Sign turd Page 1 of 3 � �� -� `�� ss5� � �- � C.�� Use BLUE or BLACK Ink �-----------------, � For Office Use � Cl�� U�L� �� j Permit#: ��(:� I � I G:� I 3830 Pilot Knob Road � Permit Fee: � Eagan MN 55122 � � Phone:(651)675-5675 � Date Received: I Fax:(651)675-5694 I I � Staff: � ��J 2015 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: Site Address: Tenant: Suite#: Name: � Y �� _ �� r, e � � � Phone:�Q S�` � � ,,t � Address I City/Zip: �� Name: Q 1"t 0 �� "� � _License#: � � � O �� j �j Address: � T City: � ' State:�Zip: S,-�j�� Phone:_(0� �' `t",�j ! - �� Contact: Email: GJ��•��lVl a� �Yl��lf�l�CG'l,t.l Y' �GVYi _New �Replacement Additional Alteration Demolition � � .: Description of work: � �'� � �/�� G�„:� �� — �"� �,�e �� .�a�� ,y� !� . �� , ,�� r ,i�� qsf RESIDENT/AL COMMERCIAL �Fumace _New Constructi�on _Interior Improvement _Air Conditioner _Install Piping Processed _Air Exchanger _Gas Exterior HVAC Unit _Heat Pump _UndedAbove n�und Tank 9 (_Install/ Remove) _Other — RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge) $100.00 Residential New(includes$5.00 State Surcharge) _$ TOTAL FEE COMMERCIAL FEES iContract Value$ x.01 $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal °_$ Permit Fee *If contract value is LESS than$10,010,Surcharge=$5.00 **If contract value is GREATER than$10,010,Surcharge=Contract Value x$0.0005 -$ Surcharge* **'If the project valuation is over$1 million,please call for Surcharge ==$ TOTAL FEE 1 hereby acknowledge that this information is complete and accurate;that the work will be in confomiance 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 to start without a permit;that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. l X �C� ��,��✓� X ApplicanYs�rinted Name ApplicanYs Sigmature '�'��. ''`i 4 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA130182 Date Issued:04/09/2015 Permit Category:ePermit Site Address: 4195 Topaz Dr Lot:5 Block: 8 Addition: Cedar Grove 1st PID:10-16700-08-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Applicant: Jennie Wood 5720 International Pkwy New Hope, MN 55428 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 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 - Charles J Vesel 4195 Topaz Dr Eagan MN 55122 (651) 454-6099 Benjamin Franklin Plumbing 5720 International Parkway New Hope MN 55428 (612) 604-4285 X61 Applicant/Permitee: Signature Issued By: Signature � � U Use BLUE or BLACK Ink �(�� ForOfficeUse ---------� I pn V � � �� (�E N:�� Permit#: I � ui !1 (�' � I 3830 Pilot Knob Road �� `�. � Permit Fee:� • � � Eagan MN 55122 Phone:(651)6�5-5675 j Date Received: " " i Fax:(651j 675-5694 ,�u` ry 1915 i � 1 J � Staff:�� _��__�__-��_�_��_J 2015 MECHANICAL PERMIT APPLICATION ❑ Piease submit two(2)sets of plans with aii commercial applications. Date: Site Address Tenant: Suife#: Name: �� -S � Phone: 11C�( `�S�'�"��_ Address/City/Zip: � Q G1� ��V� Name: � � I"f 0 Y � "�� License#:_ � � � U �i � �j Address_�� VU)I � � ��(3'Vl �� City. State:_��Zip:� `��j Phone: I O cCi�' `I"�7 � �7 � � Contact: EmaiL•��51�•'YCI.��lci OYIeI/LG�t�t.1rGL/y',CCJjiG1 _New �Replacement _Additional _Alteration Demolition Description of work: RESIDENTIAL COMMERCIAL Furnace New Construction Interior improvement �Air Conditioner _Install Piping _Processed _Air Exchanger _Gas _Exterior HVAC Unit _Heat Pump _Under/Above ground Tank (_Instail/_Remove) Other RES/DENTIAL FEES $60.00 Minimum Add or alteration to an existing unit(inciudes$5.00 State Surcharge) (�� $100.00 Residential New(includes$5.00 State Surcharge) _$ V TOTAL FEE COMMERCIAL FEES Contract Value$ x.01 $55.00 Permit Fee Minimum $70.00 Underground tank instaflation/removal =$ Permit Fee *If contract value is LESS than$10,010,Surcharge=$5.00 =� Surcharge* **If contract value is GREATER than$10,010,Surcharge=Contract Value x$0.0005 ***If the project valuation is over$1 million,please call for Surcharge _$ TOTAL FEE 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 to start without a permit;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 �G�. t� � �(n.v� X � �.. ��. Applic nYs Prinfed Name Applicant's�Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA159927 Date Issued:01/29/2020 Permit Category:ePermit Site Address: 4195 Topaz Dr Lot:5 Block: 8 Addition: Cedar Grove 1st PID:10-16700-08-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 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 - Charles J Vesel 4195 Topaz Dr Eagan MN 55122 (651) 454-6099 One Hour Heating & Air 11825 Point Douglas Rd S Hastings MN 55033 (651) 437-4177 Applicant/Permitee: Signature Issued By: Signature