3538 Widgeon Way
WATER SERVICE PERMIT
CITY OF EAGAN pERMIT NO•_
3795 Pilot Knob Road pqTE:
Eagan, MN 55122
No. of Units:
Zoning:
Owner:
Address:
Site Address:
Plumber:
Connectior? Charge:
Merer No.: qccounr Deposit:
S'ZQ' Permit Fee:
Reader No.:
I agree to oomPlY with the City of Eogue M sc.aChorges:
^.:4
Ordinunces. ' Total:
Oate Paid:
By 1 nsp.:
Date of Insp.:
SEIIVER SERVICE PERMIT
aTy OF EAGAN pERMIT NQ.:
3795 Pilot Kno6 Rood DATE:
Eayon, MN 55722 No. of Units:
Zoning:
pwner:
Address: .
Site Address:
Plumber:
~ agree 4o eon+PIY with ehe City of Ea9<+^ Connection Charge: .
Account Deposit:
Drdinanees. Permit Fee:
Surcharge:
Misc. Charges:
BY Totoi:
Date of Insp.: pate Paid:
I nsp.:
I
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE ~ g
wceerveo
FROM
AMOUNT $ ~
4 DOLLARS
~oo
? CASH ? CHECK
ROR
I"'UND COOg AMOVNT
k You
~ BY
~
' White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN Remarks
,4ddition DUCKWOOD ESTATES l.oc 26 Blk 1 Parcel 10 21900 260 01
Owner Street 3539 F.ast Wirlgenn Wa.y State FSgan, b'IN,_ 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTO mp. 9 3~.3 347.87 $
GRADING
SAN SEW TRUNK 1971 109.77 $.49 20
+R SEWER LATEfiAL ' 1980 ,3 ~
WATERMAIN
* WATER LATERAL
WATERAREA / 1972 jjj.$j $.$9 20
ftervice
* STORM SEW TRK
* STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 250.00 10864 7-14-7$
BUILDING PER. 14984
SAC 100-00 10864 7-14-78
PAR K
y CITI( OF EAGAN
~ 3795 Pllot Keo6 Road Eaqan, MN 55122 N2 4884
` PHONE: 464-8100
BUILDING PERMIT Receipt # d V,
To be wed foe •,t~~` - • Est. Value - Date 19
Site Address Erect Occupancy
Alter Zonin
Lot s~ Block Sec/Sub. 9
Parcel r"ij C i Repair ? Fire Zone
Enlcrge ? Type af Const.
aWe Nome Move ? #f Stories
; Address "t . i e i'k..,r.,, Demolish ? Front ff.
b
&9Ci c+uTS i~v i:; Pha~ •6-;~ Grade ? Depth ft.
Approrab Feet
°C Name
o~ ~d~~ Assessment ' ~ - Permit f
U~ Woter & 5ew. Surcharge
Ci Phone
Police Plan check
~
FW Narne Fire 5AC
Addreu Eng. Water Conn.
`W C~ pho~ Plonner Water Meter
Counti I
I hereby acknowledge that I hnve read this application ond state thet gld9, pff, , a 4-f 7U
the information is correct and ogree to comply with oil applicoble APC Totol SMte of Minnesota Stotutes and City of Eagan Ordinances.
Signature of Permittee
A Building Pertnit is issued to: on the express condition thot
ell work shall be done in acrnrdance with all oppliwble State of Minnesoto Statutes and City of Eagan Ordinances.
Bullding Officiol
~
.
hnnM # pat* lawd hewMtim
Plumbireg 1-330 CF-/ 3-.? 5
Methonical 1 ~-}e11 Lf - - - 1'-(,-?Lc~
ct1'
INSPECTIONS DATE INSP. RougMln Flnd
Footings ~ Date nsp. Dafs Inap.
Foundation Plumbing s-
F rame f ins. lVlecFwniool
Finol ~
I
Remarks: 44^-• ~
~~q ~
j
' CITY OF EAGAN
3795 Pilot Knob Road
~ Eagen, Minnesota 55122
Phone: 454-8100
PERMIT No. 1411
Date: 4-13-79 Receipt No.:
I Jf
Site Address: 35~ NTig?~1 ~ FaSt Single
Residentiol
Lot 26 Block 1 Sub/Sec. BLlckwMd %'~~tes Multi Res., Comm./Ind. I
Nome M. f"a1T]
New /Alter. / Repoir
; Address 1721 W. Bwn-zvi1 l`' PV'-., Cost of Installation
O }
T3'L']..UP 7r3^"~? :i~T4-t?'j 3 2
City Phone: PermiT Fee
c~~
Name Surchorge
.
~
P Address
e
City Phone: Total
This Permit is issued on the express condition that all work sholl be done in accordonce with all uppliCOble Stote of
Minnesoto Statutes and City of Eogan Ordinances.
Building Otficial -
~ CITY OF EAGAN
3795 Pilot Knob Rood
' Eugan, Minnesota 55122
Phone: 454-8100
PERMIT No. 1330
Date: 4-D-79 ReceiPt No.: 13850
3538 Single I
$ite Address: Residentiol
~ I
Lot ~ Blxk 1' Sub/SecA~~d ~~~ty-,5 Multi Res., Comm./Ind.
Nume c~~ M. ~ein - New/Alter./Repoir. ; Address 1721 W. Burn4V]_lle ~-'Y34ry.
Cost of Installation
O
City '.:'ville 5533; Phone: 454--4732 Permit Fee 20 ~
Name ~±am Surchorge .50
~
~ Address
e
V
City _ Phone: Total
This Permit is issued on the express condition thot all work shell be done in accordance with oll opplicoble Stote of
Minnesoto Stotutes and City of Eagan Ordinances.
Building Officiol
Ws,n!quest void 18 months from
• ~ R 5264
Date of this Request a- ii - 7~
I, as O I.icensed Electrical Contractor wner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No C' y
Section Township Range County
Which is occupied by~%~
(Name ot O~ccup J
Is a roughin inspection required on this job? No ? Yes L7 Ready Now ? Will Call B~
~sa a ~,C
Power Supplie~ ~ Addres
Electrical Contrac(,;;~~ Contcactor's License Pio. _
(COmpany Name)
Mailing Addres
trital Contmc r or O aking This Installation)
Authori zed Si atu Phone No.-il
Elet ontract r or Owner Makl g Thl InstalltSlon)
yus ins ection r uest will not 6e acce ted b the
~~4-, o~~~D Q Q State B ard unless proper inapection fee is en losed.
~ Minnesota State Board of Electricity
.1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703 V- ~~.REQUEST FOR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REQUEST ~ 5264
sPype of Building New dd. Rep. Check Appliances W'ved For Check Fquipment Wrted For .
Home ? El Range ? Temporary Wiring ?
Duplex ? ? ? Water Heate[ ? Lighting Fix[uxes ?
Apt. Bldg. Dryei ? Electric Heating ?
Commercial Bldg. ? ? ? Fucnace ? Silo Unloader ?
Industrial Bldg. ? A'v Conditioner ? Bulk Milk Tank ?
pList Lpist 1}
TM'....9:...
O he ? ? ? Hehers _ Heheigf
COMPUTE INSPECTION rEEx^$EW1Y '~X
Service Entnnce Size: '~&S is: u Fee C'vcuits: n Fce
0 to 100 Am s. i ~ to 90 m res 0 to 30 Am eres
101 to 200 Am s. 31 to 100 Amperes 31 to 100 Am eres
Above 200_Amps. Above 100 Amps. Above 100 Am s.
Transformers Remote Control Cuc. Pa[tial ot other fee o
Signs Special Ins ection Minimum fee E5.00
Remarks ;ectio TOTAL FEE ~'Q ~d
I, the Electrical Inspector, hereby certify Ui t°the as been made. -
(Rough-in) ate - '
(Final) ate
This request void 18 months from "
cirr oF Er?G?N
3795 Piler Kneb RoedEagan, MN SSI?S N4 4884
~ PHONE: 454-8100 lfi
BUILDIN6 PERMIT APPLICATION Receipt # A~~~~~
To be used lar SF Dwe11. 8 G2T. Est. Value 50 1000 paFe 7/14 19 78
Site Addre ~9eon ~lay Erect Occuponcy I
Lot ~ BI«k 1 see/sut. Duckwood Estates qlter ? Zoninq Rl
parrel # 11 21900 260 Ol Repnir ? Fire Zone
Enl,.ga ? Type of Const. v
n Name St@VB M. Klein Move ? # Stories
Z Addrea 1721 W. BuTnsv111e Pkwy Demolish ? Front 65 h.
~O ~i Burnsville ~~e 890-7949 Grode ? Depth 34 n.
Name AvVro"ls Fees
g 140-50
7 1 • same Assessment Permit
o~ Address
~ 8~ WaMr 8 Sew. Surcharge
Ci Phone
Police Plan check
~+w Name CaPP Fire SAC 50090 00
q~reo Erg. Woter Conn. 2
<w p~ Planner Water MeMr 60•~
Councit
I hereby ackrwwledge tFwi I have rend this aDPI'cotion and stote that gld9. pff, 7 14 78
ehe iniormation is rnr n cgree ro co with ali applicabie 975.~
State of Minneso t u es un ity of gan Ordi nce A~ Totol
~
Signmure of Pe '
A Building Permit is' ue Io: on the express mndition that
oll work shall be d i ac rda e ith oll applicabie ate of Minnewta Statutes and City ot Eagon Ordinances.
Building Ofifid
. ~ I DFfTE Co
BUILDITdG PBRMIT APPLICATION
include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculationa.
7b be used for SI A.)GLE Rm. l ~LJc~. Valuation 119 6r7 /7
0 &ASite Address;~6 2~~L
toibGE'c2/ kj/j V •
1~2 / OGICKLJODo .Lsr-tro~ .
Lot Block See: Sub. Parcel Number ai9p0 ~60 d~
Oxmer STC cjr N ~ KLt= iN Telephone e70
Address - P4wY 9d0 ~ O 65S uJ
'cr'~A1Si/iL.[c' i/L'N ~APr 2r5)
Contractor SAmz~' Telephone s4m.' -
Addresa
Arch./Eng. Telephone
Address
OFFZCE USE
Erect l~ Occupancy
Alter Zoning
Fepair Fire Zone
g1Zarge Type of Const
Nbve # of Stories
Ilemolish Front
Grade Depth ~
OFFICE USE
Date of Approval & Initial FEES ~p
Assesslnent Pe=aiit ~v~ ~
vaater/Sevrer surcnarqe
Police r1.an Check
Fire SAC S"m•o0
Eng. V!ater Conn.
Planner t7ater Meter
C,buncil
Rldg. Off. - d
A.P.C.
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1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
~ CITY OF EAGAN
7~` ~ 3830 PILOT KNOB RD • 55122 1 ~
651-681-4675
New Constructlon Reaulrements l l o~
Bemodel/Reoair Reauirements
? 3 regisiered sHe suneys showing sq. N. of lot, sq. B. of house 2 copfes of plcn
and all roofed areas (207, maximum lot coveraae allowed) 1 set ot energy calculaflons lor heated addHions
D 2 coples of plans (show beam R window sizes; poured Ind. design; Mc.) 1 sRe survey for exterlor addNions R decks ~
D 1 set of energy calculafions Fj
A 3 copies of free preservaFlOn pian M lot plaMed aHer 7/1/93
DATE: Z6`( / CONSTRUCTION COST:
~
DESCRIPTION OF WORK:TC'sYt gE ZEIP S/~tiv6 L cS' ~/L1 ~N /~Q~A-~i E TZ-A cl ~
O .1-i e.t.5 E /J 6
STREET ADDRESS: O•S 13S r~1 a IZ~~+~Scc. 4A-T7 a'j
3538 wi "EoN wA.%l ~F 1~~rED CEre-lw .
LOT: BLOCK: I_ SUBD./P.I.D.#: _
Name: eLE( A-) Phone V/
PROPERTY Lost FfM
OWNER Street Address:,:? J 3O GV! 06
City StaFe: "49'Ll Zip:
Company~~ /-x Phone
(area code)
CONTRACTOR ~
Street Address:47 38 ~l ~p S m License 9 4--C"- Exp. ~
crty Be'Ns o.r-L& stat4e~ Zip: ~'~Zf- ZZ
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
Street Address: Registration .
City State: Z(p:
Sewer & water Iicensed plumber (reaulred for new construeNon onlv~/
Penolty applies when address ehange and lof change Is requested once permff i sue
i hereby acknowledge that I have read this applicatlon, state that fhe inform on I o t, d agree to comply wNh all applicabl
4tate of Mlnnesota Stafutes and City of Eagon Ordinances.
Signafure of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-piex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 af _ 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 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 WindowslDoors
? 33 Alteration ? 37 Demolish Bldg.' ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
" GIVE YI:A h8n00UtT0 BPpIICBII[ TUi tirit10iiiijii
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowabte) Main level sq. ft. 5AC 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 Buiiding Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
iUIC/ES SAC
City SAC Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PL s
Park Ded. .
Trails Ded.
Other 'Copies
Total:
SAC Units
% SAC
Use BLUE or BLACK Ink
I For Office Use rr I
Permit _ W I
City of ~a an I Permit Fee: V
3830 Pilot Knob Road f I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 I Staff; 1
I
- - - - - - - - - - - - - - - -
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 40-Ak Site Address: Js-38, W` Unit
RESIDENT Name:
C~✓~ Phone: OWNER Address / City / Zip: 1^44 C&I-11 At/-
01
Applicant is: Owner . Contractor
TYPE OF WORK Description of work:
Construction Cost: ) od Multi-Family Building: (Yes / No )
/ a /
Company: ~&-qac' ~r ll',~la f 4LG Contact:
CONTRACTOR Address: _ -2 City: G si ,l y
State: - Zip: Phone: / Vf- C) 7 BIZ
License _ 8C &3Q 3 Y 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:
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.gol)herstateonecall.ora
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.
x~~) Ln Applicant's Printed Name sS ature
Page 1 of 3