3610 Widgeon Way
CITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Rood PERMIT N~.: a
Eagnn, MN 55122"Y D/1TE: 1
Z~ing. L No. of, Units:
Owner: 'al.,p lior.:en ic,,
Address:
Site Address: 3610 Widgeon - 3_. ~t ariC~#
Plumber: , nn ~
Meter No.: Connection Charge: `
Size: Account Deposit:
~ .
Reader No.: ' Permit Fee:
1 ageee to canplp wifh Nre City of Eagaw Surchorge:
Ordinanus. MEst. Charfles: .
Total:
By Dute Paid:
Date of Insp.: Insp.:
ciTir oF Rr?"N SEWER SERVICE PERMiT
. :
9795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE: : .
Zoning: No. of Units: 1-
Owrer: ra Homes - -o:' ('Elrt~e
Address:
Site Address: ~ laid~a~n ''jvi" °2 Gt FXanci^u ~:QOL9
~ Plumber.
",r:_" l_'_r~.~.. 0 r~
1 oy?ee to oanplp with tba City of Eoyon Connection Charge: t'ltl nr'
Ordinanoes. Accourrt Deposit:
~ Pertnit Fee:
Surchorge:
gy Misc. Chorges:
Date of Insp.: Totci:
Insp.: Dats Pofd:
CITY OP EAGAN
' 3795 Pilot Knob Rood Eagen, MN 55122 N2 6739
~ PHONE; 454-8100
BUILDING PERMIT Receipt #
To be and for Esc. Value Dote , 19
$ite Address Erect 0 Occupancy
Lo! Block Sec/Sub. Alter ? Zoning
parcel # Repoir Q Fire Zone
Enlarge ? Type of Const.
W Name Move ? # Stories
Z
3 Address . • Demo(ish ? Front ft.
O „ CI Phone Grade ? Depth ft.
°t Name Approvols Fees
o
Addresa Assessment Permit
~ Ci p~e Water & Sew. Surcharge
Police Pion check
~W Name Fire SAC
Addreu Eng. Water Conn.
<W Ci Phone Plonner Water Meter
Council Road UniT
I hereby acknowledge that 1 hove read this appiication ond stote that gld9 Off
the information is correct and agree to comply with all opplicnble APC Totol
State of Minnesota Statutes and City of Eagon Ordinances.
Signature of Permittee
A Building Permit is issued to: on the express condition that
oll work shcli be done in accordanCe with ali applicable Stote of Minnesotu $tatutes and City of Eagan Ordinances.
Building Offitial
r
. ~
PermiF ~ psM Iaw~ rwoiftw
Plumbing AssQ - I( ^ Tr 'To r'` E
Methnnical 3 0 41 - (v j t r r
EIEC p?(SISU -7-z.Z-gl o•~
Ec_ ~~L 3•- - 5~? ` 1/ ~~~,~cLl
tNSPECT10N5 DATE INSP. Rough-In Finol
Footings Dote Insp. Date Insp.
Foundotion Plumbing ~ /%'-•7f/ ~ '2 t~ Z ej~f
Frame/ins. ~ Mechonical S/~L•4Z ' K~ a!
Finol
Remarks: s ~
CJ~r
i!
y1-01 ly.
o,
;A?
~a.~.:, •~'R'~- ; IO"~'~?.V..~~'r~•~,lTl•,~.r~•17'~. i. _ TPa~?~ -rj-~,I~'-"~!s -~,r ,
; , ' . _ ~ '
Trr#if ira#r uf "W""rrupttnr . ~ -
y
of
Orpa#mmi ,af luilding Jnsppriimt
Tbis Certi f icatc ttsrud prn.nor,tru to tbt nqxiseauntt o f SrctroR 306 o f tlx Unif om Building
Code artif ying that at t& timt of issuanu tbu .rtrxctun war in coaa plranrr wirb tlx varieur
ordinaxut o f tht City ngu/ating brdldiag roruirxction or xte. For tix f ollouring:
u.. ahmiguw. SF DWG/GAR ma4 r.,,.n no. 6739 I i'+
y ~*v~r''r R 3 'iYP c~no, V zo.. NA zoft nb„W Rl , i
- Owea d,,,N,, Tom Gerde A4&,,8718 21st Ave. So Bloominqt0
V~ aAft,w6..,3610 Wid4eon WaY L.,,j+ot 9,Hlock 2,St. Francis
WOOC~S 18
~
~
June 30, 1982
.
~r ~ .,.5 • . ~ ~ 1 1~ ,
~ _ 'ORrir.i'. _ ~ , ~I' ''~rl. '~i-~'~"/?--~ '
~ITnOiN u.9.w.
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fae
FiII in numbered spaces S/C ,
Type or Print /egibty
i Tot.
1. Date ' 2. Installation Cost
~ _ • . ~1
3. Job Address Lot~Blk. Tract ~
4. Owner
5. Contractor Phone
6. Address '
7. City State Zip
8. Building Type: Residential ? Commercial ? Institutional ?
9. Work Description: New O Add ? Al;er ? Repair ?
10. Describe Fuel TYpe
11. No, Enuipment 8TU - M. Ea. No. Equipment CFM
~
Forced Air Air Handling:
Mfg.
Boilers Mech, Exhaust
Mfg.
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-6100
_ - -
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fee -
Fill in numbered spaces S/C
Type or Prini /egibty :
Tot.
1. Date 2. Installation Cost
3. Job Address 1' Lot Blk. - Tract
_ .4
4. Owner
5. Contractor Phone
6. Address
7. CitY ' State Zip
8. Building Type: Residential ~ Commercial ? Institutional ?
9. Work Description: New t.'I Add ? Alter ? Repair O
10. Describe
11. No. Fixtures No. Fixtures
Water Closet Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory $oftner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : ; I for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
RECEIVED FROM
AMOUNT $r-- I
& DOLLARS
+oo
? CASH ? GFiECK
~ i
~ _ ~
1
FUND CODE AMOUNT
~
c1
Thank You B
~
White-Payero CoPY
Yellow-POSting CoPY
Pink-File Copy
CITY QF EAGAN Remarks
Addition-ST. FRANCIS WOOD Lot 9 Bik 2 Parcel 10 65900 090 02
dPnn Wav State F.agan. 14![V S51 23
Owner ~ . Street 3.61(1 Wi 9
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 1230.97 A011262 7-15-82
STREET RESTOR. Ililp. ' . . 45.00 GRADING
*SAN SEW TRUNIC 3 2926.87 of i~
*SEWER LATERAL
WATERMAIN
• WATEF LATERAL
*WATER AREA laRn
*
*STORM SEW TRK lqAfo)
*STORM SEW LAT
CURB & GUTTER
SIOEWALK
STREET LIGHT
Road Unit 185.00 25377 6-22-81
WATERCONN. 335.00 25377 6-22-81
BUILDlNG PER. 6739
5AC
PARK
Thi, reques~ vo,d
ta L l ( 3 TrCl ACl S Ul) id a 1 a 0 V
montns trom
T ~16?4 ya
FequesI Da[e Fve No. Reunh-~n Insper.t lon
Rr;quireA? cady Nuw QWfll Nntifv. t"spec-
~ ;0V,,s ? No ror When ReadY
.?~.~I Licensed Eleclrical ConVac[or I lietehy request Inspection of above
YYOwner elacfrical work installed ec
Sveet AdAress, Box or Route No. City
lo ~ D ~,U wA-t( r Ac~}~J
ecLOn o. Township Namo or No. R~nue Nu. Counry
Occvu=n-it (PRINTI Phone No.
am~ . C~ ~r 4ss°hl -~3 4 3
Power Sup0lier AAtlress
Electrica~ ContraclortCOmpany Namel Conhar.tor~s Lice No.
~..L~ ~
MailinN Adtiress (Contractor or Owner Makine Installationl
I_ `v
Autho 'zed Signature ICon ctor/O n.r Maki hisG+llatiunl Phone Number '
MINNESOTASTATE BOABO OF'ELECTRICITY TH19 INSPECTION REQUEST WILL NOT
Griggs-Midway Bida• - Room N-191 BE ACCEPTED BV THE STATE BOARO
UNLE55 PNOPEN INSPECTION iEE IS
1821 University Ave., SL Peul, MN 55104
ow--- 1a11t on7_>in ENCLOSE~.
q LJ REQUEST FOR ELECTRICAL INSPECTION es-ooooi-os
B M
~ 1f ~7~:'74 , See instractions tor conryleting this form on hnck ui yellow cnoV~'X" Below W~rk Covered by 7his Request
New Atl R.P. iype al Building Appliances Wired Equipment Wired
Home Range Temporery Service
Duplex Water Heater Lightin< Fixtures
Apt. Building Dryer Electric He2tinCommercial 81dg. Fumaoe Silo Unloader
Indtistrial Bidg. Air Conditioner Bulk Mi Ik Tank
Pafm Other Speafy Othor ISper,iFy)
Othor Speci(Y Other Other
Compu[e Inspection Fee Belnw
p Fee Service EnVanceSine p Fee Feeders%S~~bieeders # Fee Circui!s
0 to 100 Am s D to 30 qm ps 1.5 0 to 30 Am s
101 to 200 Amps 31 to 100 Amps ,O~ 31 to 100 Am s
Above 200 Amps Above 100-Amps Above 100_AmPs
Trans*ormers RemoteControl Circ. ~~°jG Partial:'Other F
Signs Speciai Inspcction $ i~j-j 'P
- Remarks TAL PE ~~,j
Rouph-in ~ f / eie
i. tna Eiaco-ioai
oector, hereby
i• cerlify that the above
Final D:ne
insPection has been
~ F:^• y maAe.
This mquest void
8 months hom
~~P. Ll s},Fcar\cc,-s wc,~d%6, 17 evo
This request void
18 months from
Date of thic Request Fire No. T 15150,
I, as O Licensed Electrical Contractor 0 Owner, do hereby request inspection of the above electri-
cal wi~ng installed at:
Street Address or Raute No. WA\tCity ~;7&si"w
Section Township Range County 11011N1Ll.`144
1Vhich is occupied by jz)lM GF,.r°ZV-
(Name of occu0ant)
ls a roughin inspection required on this job? No ? Yes ~ Ready Now ? Will Callld\
Power Supplier Address
Electrical Contractor ow Contractor's License No: _
- (COmpany Name)
Mailing Address 1S 2-0~1 AV C~_- S 8 ~zfvi •
(Electric Contra°o.r~ o~r Or Makin9 Thls Ins[alla[lon)
Authorized Signature J lC! l.~J.? Phone No. ~5~ ~9 ~
(Electrlcal Contractor of Owner Making hls Installation)
This irrspection request will not 6e accepted by the
t~ p,,~ D o 11 State Boerd unless proper inspection fee is endosed.
unggs miaway umg. - Hoom rvia] E'uwoi z
University Ave.. St. Paul, Minn. 55109 - Phone 297-2111
REQUEST FOR ELECTRICAL INSPECTION T 15150
CHECK BELOW WORK COVERED BY THIS REQUEST
Type oi Beiiding New Add. Rep. Chwk Appliances Wired For Check Equipmen! Wired For
Homc ? ? Range ? "Cempoiary Wiring ?
Duplex ? ? Water Heater 0 Lighting Fixtures ?
ApL$Idg. 0 ? ? Dryer ? ElectricHeating ?
Cominercial Bldg. Fumace ? Silo UNoader ?
lndustrial Bldg, ? Au Conditioner ? Bulk Milk Tank ?
Faifn ? ? ? List List
Other ? o [I $ehers# Reheers~
)
COMPUTE INSPECTION FEE BELOW
Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Circuits: it Fee
0 to lOQ Am s.. 0 to 30 Am eres 0 to 30 Am eies ,OD
101 to 200 Am s. sO 31 to 100 Amperes 31 to 100 Am eies
Above 200 Amps. Above 100 Amps. Above 100 Amps.
Tiansfoimeis RemoteConUo1C'vc. Pac[ialorotherfee ~
Signs S ecial lnspection Minimum fee $5.0 ~
Remarks
70TAL FEE /,7, ac ,
I, the El~ s tcti, er certify t ab i edtion has been ma
(Rough i _ te
(Finai) te
Tlus request void
18 months trom
CITY OF EAGAN
4w; 3795 Pilo? Kno6 Raad Eagan, MN 55173 N2 6739
PNONE: 454-8100
BUILDING PERMIT APPLICATION rzeceipt # 277
To be uted for Sr 22/riAR, Est. Value 58~000 Dute' .T11SlB 22 , 19-Al
Site Address 3610 W3dg20n Wfly Erect g] Occuponcy R3
Lot 9 Block 2 $ec/Sub. $t. PY'ancia WOOdS Alter ? Zoning Rl
Parcel # 10 65900 090 02 Repair ? Fire Zone MA
Tom Gerde Enlorge ? Type of Const. 0
w Name Move ? # Stories
3 Address 8~g zlBt AIe. SO. Demolish ? front 50 k.
oCi Phone 854~-9393 Grode ? Depth '4g ft.
~ Name CBpp xOIIlQB, IRC. AOProvalt Feea
0
o~ Address Assessment Permit 152.50
u
r C. . P~~ Woter 8 Sew. Surcharge ~•00
Police Plon check 76.25
~w Nome Fire SAC 525.00
L-Z
Addreu Eng. WaterConn335•00
aW Ci Phone Planner WaterMeter 6o.oo
Council Rood Unit. NA
I hereby ecknowledge that I hove reod this appliwtion and state that Bldg. Off.
the informotion fs mriect ond agree to comply with oll applicable APC TMai $1177.75
Stote of Minnesota Stat1~ute~and City of Eogun Ordinances.
Slgnoture of Pertnittee/' ~~''i 4~
A Buflding Permit is issued ro: on the express condltion tFwt
all work shall be done in accord with all pli able State of Minnesota Statutes ond Cfty of Eagan Ordinances.
/
Building Officiol
~L pF EAGAN ' Include 2 sets of plans,
1 site plan w/elevations &
BUILDING PE13~ffT APPLICATION 1 set of energy calculations.
7U Used FoiZfV-aluation U 6- o Date 6 "/'-0
Site Pddress OFFICE USE ONLY
I,ot ~ Blocx 6Z Sec. ub. prect ~T occupancy
Parcel & 4;~~(!i7 Alter Zonin4
Repair Fire Zone N
Owner: -vz~m ~7/xn7` Enlar9e _ TYPe of Const.
Address: $71$ 24QF7 PcIE SO M°"e # stories ~t-
Dsnolish Front l~
City/Zip Code: -QM IV\. "-&tZ40 Grade Depth ft.
~ Pt10IlE D s d? 5 ~ .
1 ~ APP%3VAIS FEES
Cuntractor: Qb~ A,~-~S Assessments 124 Pezmi.t
?aater/Seaer Surchazge _====1¢~-
Address: Police Plan Checlc
City/Zip Code: Fire
: ~4 • ~ ater Conn. . ,3S ~ "
Phone #
Planner Water Meter ZO ~
Arch./Eng.: Council Road Unit A14
Bldg. Off.
Address: APC . zf2
City/Zip Code: 7 ~ k/a~A,.ie.p2-~ ~ •~o~/
'hone # : 7=0TAL
2004 RESIDENTIAL BUII,DING PERMIT APPLICATION \
City Of Eagan U v
S~- 3830 Pilot Knob Road, Eagan MN 55122
~ Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWdion Reauirements RemodeVReoair Reouiremenfs Office Use OnM
3 registered site surveys showing sq. R. o( Wt, sq. ft of house; and all roofed areas 2 copias of plan Cerl of Survey Reod _ Y_ N
(20%maximumbtcoverageallaxed) lsetofEneigyCalculations(orheatedaddilions TreePresPlanReoi _Y _N,
2 capies of plan shovnng beam & windovr sizes; poured fuund design, etc. 1 site survey for addilions & decks Tree Pres Required _ Y_ N
1 setofEnergyCalcula6ons Adtlifion-indiceteNon-sifesepNcsystem On-siteSeptlcSyslem _ Y _N
3 copies of Tree Presenaiion Plan N bt platted afier 7/1193
Rim Joist Dehail Options selecUon sheet (bldgs wiN 3 orless unils
Date `i / ,1 ,A Construction Cost oC ~
Site Address ?
2, 1 ~ oi CA (l1 UniUSte #
~ U
Description of Work
Multi-Family Bldg _ Y ~ N Fireplace(s) _ 0 _ 1 _ 2
PropertyOwner 0;-tx-A e J Telephone#Q'~j~)
Contractor 1a 7s11f
Address ~(1,1.1U~ 21 '-~h1 4-7C:~ City \ry1:~Y*
State ~1 N J Zip l~ 31 Telephone #
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
(4 submissionrype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone ~
Mechanical Contractor Telephone # Q ~
Sewer/Water Contractor Telephone ~ I hereby apply for a Residential Building Permit and aclaiowledge that the info is eo~l~t~-&tldu&I ccurate;
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 case of work which requires a review and
approval of plans.
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY •
Sub Types
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory 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 PorchfAddn. (4-sea.) ? 33 Eut. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 MiSCellaneouS
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
0 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy . MCES System - -
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) _ FinaUC.O.
_ Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Plum6ing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC1ES SAC '
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
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