930 Wild Rose Ct
Address: 930 Wild Rose Ct Zip: 55123
Lot: 22 Block:l Subdivision: RoyalOaks
THE FOLLOWING ITEMS WERE/WERE NOT COMPLETE AT FINAL INSPECTION ON
Yes No Comments
Finai grade - 6" from siding
Permanent ste s - garage
Permanent steps - main entry
Permanent driveway
Permanent gas
Sod/Seeded lawn
Trail/curb damage
Porch ,x
Lower level finish
Deck
Fireplace ~ c &/,v
• Verify with your builder that roof test caps from the plumbing system have been removed.
• Turn off water supply to the outside lawn faucets before freeze potential exists.
• Call the City's Engineering Department at 651-675-5646 prior to working in right-of;way or installing
irrigation system.
~ BUILDING INSPECTOR:
i
CONTRACTOR:
Santanni Homes
783 Gilfillan Court
White Bear Township MN 55127
Site address: 9--749 //f/ /1"~,S e~~• Lot~~2- Block ~ Subd. On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air
tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be
submitted pnor to issuance of a Certificate of Occupancy.
v This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
_ This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674
~
APPLIANCE GAS MANUFACTURER MODEL BTU'S VENTING TYPE
Water Heater ELEC ; A- r T'T 2-
t Furnace $r h f 3So m.4 1/0 D 1,00 lDDOqD ,Dire c.
Dryer oo
' d!, A trGG
ItAl
s
VENTED
EXHAUST SYSTEM LOCATION TYPE MODEL CFM's YES No
Kitchen kitchen lr)(kfi(dgj~ 4me41 3 S<D $S 300
Bathroom 1 ! Z, A. D ~
Bathroom 2 ,600 a loy
~
Bathroom 3 /I I,
Bathroom 4 Qih Br0 4~ s l~ ~ ~
. Other
VENTING
FIREPLACE S LOCATION GAS WOOD MANUFACTURER MODEL BTU'S DIRECT ATMOS
ALeA-1w epl 0O 7 DA Daa V/
ArdivG/O 0 D D -rey 0 00 ?
~ #0~i % ? y,2 uJood
MAKE-UP AIR MODEL TYPE CFM's
c~'YD - K NO4 AN fJ'n D O
I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan
requirements.
P'el J.
1~~ l~~iy~o 3
Sign u~r ~ • Date
r
Company Name
* This form is the responsibility of the General Contractor.
~
LITTFIN InRUSS
,
~
E'ABRICATOR OF ROOF 6 FLOOR TRQSS SYST£M.S N
558 Baker Ave °o
p.p. Eox 666 ~
Winsted, MN 55395 s
C
O
~
Metsa: 952-473-2551 w
E'a3c: 952-473-1295 -
3
Watts : 888-678-7737 Date :
To :
Attn_ z
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5end;,,n4 a tota2 af e2 , vages, includirg this cover s4ieet. „D
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Lot: Lampesta hpple V CuaGaaer;Apple Yslley xo:324350 TI:R
TC 702G8 AEL ypD CSZ TC: 7z 4 8PP 01/07 CIn Hottom eAasd iive loads baied os .....a....a.v.soint Loeationse.«.......a..~ t
1- 0 -864 0.01 0.24 0.75 HC: 1: 4 9PV !1/A2 (!t) nainLabltable areaa rithant •tazage 1) A- 0- 0 4) 17- 7- 8 71 0- G- o '
0- 2-;2li 0.03 0.31 4.41 7: 7 8PP 9SVD (R) losded son-coacutzrstly per IYC-00 A101.4. 2) 5-10- 9 5) 17- 7- B
7- 3-1G56 0_01 0.75 G.7i 2x 4 8Pp #I/62 «1 t- 5,1- 1 MiLTm13 tA11D3 Shia dasign ia tLe. 31 11- 9- C 6) 8- 9-17
! •156 0.00 0.74 0_7; ul C10KPRSS9201t Chorda sse aaawmd tn be ea¢podlts reaalt eE multipls loads. 7MVmR 80a23CtPAL COl112WMOSt pMR 8C88DVL8
1coutlaucusly bcaced unEeas wotsd otherri:a. Rigiti Sad vert3cal deoigniod for viad_ blrppoct 1 3300 N
8C PORCS A= BA'p CSI Wftd&cd p° ASCZ 7-98, NMYRB' v` 94mti' PROVIDB 4PLSPT CONNECCZON PBR 9C7tWDQLBt Snildiag Deeiqner ahall pcovida adequato p
8. 23.0 !t, im 1.00, &up.Cat. C, Rat. 1.0 8uppart 1 1174 Deu3mg azea md anchorage. O
T• 6 1123 0.17 0.83 1.00 Bld Sypa. m=l T_ 17. 6 ft W. 17.5 tt Tsuee S1uppaet 2 701A ggArtIIap Nti7? RgQ~~...........
W
6- 5 620 0.09 0.83 0.92 ia 8!m zoae, TCOL. 6.0 pei. BCDL. 6.0 psE ~ Z~CI coatinuoua latezsl bzace attaehed v/(7) In.~ B:g Btze Mia glze -or- Win Area
A1B n 5.15 13d nnils each member:8race KLtS? be locRted 1 0- S- 8 0- 1- 8 7.29 ai S
Yab POACS Keb pORCB ^---X11[. R8A47'=QNS PH1t HBl1AIIM LOCATIOd(--._- to psovida equal uabracod aegaaaGe OA; for 1 0- 1- a 0- 1- 8 2.27 ei C
1- 6 -402 3- S -919 x-Lx VezG Rariz Upiift Y-Wc lypo •;aqls ply txvas a•T' Lraee say be nailad W-pyL M" pgrygC7TpN9
0- 2-14 972 354 -117 BOT Pia tlet ta ~
6- 3 54d S- { ~2I5 edge oE reb r/16d naila A 8• a.c., Ly TL 9- 0 -513 37- 6-12 967 0 -70I Bo? H Roll usicg aaae •iza, grads irpeeiea as Nab. in./Ratia ln./Ratio Jnt(a). ~
Brace muat estmd 904 ot reb laagth. S.Byan .a.22/999 -0.36/571 5-6 W
TRUSSREPAIR aracing :ee.auta: xotl:. _o.o+ -o.aa w?
Kaba Szaeo pt .Toint to Joint llax DL naElection ]./657 .-0.24 D
1/4 3- 5,4- S 3
2' isto besnubbed from rigAtend. 9reeing abo«a ie for .rssvai Purpoaea anif.
Cat 2' from righc mQ. ..r~
2. InstaU nav h3 9 142 5PF d'eaganal %.cb and ~
relowtc rnd venical wcb as shaltin. (Glu LT- 7-8 ~
cods sccurauly [o hear.) t 2 3 4 z
3. Applg'h" APA rated 32116 sheathing to
each face of truss al (3) localions as shaitin, C=
c; ~ nailing ro all members with (12) 6d common ~ 1~z4 ~
o~.~ ~ nails per lineal faat io a sggered pactem.
. ^
4. Relacate btazing as shor+ . i' o
7
y~~3 I N Kepair for R 1 truss is ideRdcaJ 0 ~ 3
j.
`ci. ~ • I 9~ 6-] 2 ~ j 91- 6-12
1SYd
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u :n x
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MN50•• 967# 1.52" ~
17- 7-8
6 y~
87CCSP? A3 SBdNN BL7iT89 ARS TL20 ciA TFBTBD PSR ]?N92/TPZ 1-1995 Salea 0.1455
- ' tgRMNN6: Sng Jobs Ati]: 224950
FMAD u3. rADT6s orr .Rxs sMEss. a corr aF :=S as"nrc S+o ae pMqa TSa R
GCV}IQ RO ERYG'lSl76 CONTRACTO+t. HP.ACIi7G SIAIHnM:
BrwicgehownmYiisdnwingoaoterac+ionE+~n3,w9ndbadeRye~ult~s2-,.;artimi~a(ra:~ DsgIIl:9N9 G'hk- Dates 9/9/2003 -
isapmo(dw aWec4es,-3 aed.hie5mo bemmkwad eyeiee,"M ra;yKe•ar„caW TC G9L 35.0* sf DurPsator - Lbr: 2.15 ~
ITTRION' 1h0~YOll~Ol,QiLODt71[l~F"Y10111~ap (V
4°`°'3~°'mwttr~ad~°'d`°'°'p°°°'°ds°°'m"asae,TC Dead i0.9 psf . ~pACtor - Pit: 1.15
O.C. 9paciaga a- o- a
- lbrian aammmea c4=abwUna dftww Crnm rse lawnea sPt is baosa u 513 8C Liva 0. 0 pst -
- DeanCr: 7P2-95/IAC-00
o~esiopi.t~taauoyRnxmo~537191. HC Dead 10_0 paE Cbde Deeee ZRC
" TOTAL 55.0 f v: 3.6.19-297163
Desigar Ifatziz Aaalysia #Saov Load hss bean adiuatadDetA9f$ 7-98 .
s
C ERTI FI CATE 0 F S U RVEY 4
~
Survey for: SANTANNI HOMES
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Z:z ROSE COURT
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~ a OInv, = 881.0 (per plan) ~ catv ' - ~
895.3 co U) U) ~ 890.7 elect
o N ~ 895.0 a°fo 895 0 9Okt~
y - - - - ~
5.5 14.17 10.5 i
~ -13.2- ~ I o 1.83 891.0 ~ ~ 891.9
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894.5 w w o°~ ~ . I^
1.67 Porch
0 11.0 895.0 0)
1 0 14.33
~ I o 13.0
Z
O I v 10.0
PROPOSED
a OCIO)' w 0 5.0
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5.5 `89 / 0 2~ OQ Q 15.0 10.5 ~
-IU---- 2910 -
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SCALE: 120' Drainage & Utility
Eosement ~
m S~~
• Denotes Iron Monument Found W~1 ~
~
O Denotes Iron Monument Set ~ ~ 6+~5~ 8¢\ \ 5
, ~
AREA OF lOT = 13,744.7 sq.ft. F ~ ~
AREA OF PROPOSED HOUSE = 3.251 sq.ft. ~ ~
LOT COVERAGE =23.65 %
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I`;~GaTEET~'.N~'7 DEFZ
.
DESCRIPTION; Lot 22, Block 1, ROYAL OAKS
& q~~~'~ 1 hereby certify that this survey wos prepared by me vr under y direct supervision, and that 1 am a
registered land surveyor under the laws of the State of nne ot .Dated thig 2~i doy f Aprii. 2003.
~
CARLS01V & C/~RL.SON, INC. BY ~
LAhiD ~'J'~~JEYORS ~,.f' Larry~uture. Land Surveyor -
uNc suWVUoRS Tele. No. (952) 888-2084 Minnesota License No. 9018 .
Proposed Grades: Top of black 895• Garage F"loar 895•2 Basement Floor 886.9 ~r
341-43
NOTE: Circled elevations are proposed, others are existing. Arrows denote direction of drainoge. G'evised 6-17-03
10 C_k__. i "fi w ~ o q 3sv 3 t~ . ~0 3 c~ ~s ~9 . ~-l'3
qo YnI (.003~~ -~o S-T
~U C)~S RESIDENTIA~I. UIB LDING l,,,l vl
_ Permit Application ~ 3 ~
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
New Construction Reauirements a-''Remodel/Reoair Requirements ice Use Oni
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas ~ 2 copies of plan ert of Survey Recd
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Not Reqd
1 set of Energy Calculations Addition - indicate if on-site septic system On-site Septic System
3 copies of Tree Preservation Plan if lot platted after 711/93 ~CAil, d
Rim Joist Detail Options selection sheet (bldgs with 3 or less units C`,-V_CD\
Date
F~p l(,a 3 Construction Cost ?r^ 7S B 00
Site Address All's e Unit/Ste #
Description of Work 12p 5/den-l~Gt l -5l R C! f Cmr r/~ A)ett-) j604<5' TTU Lb~i'/
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2 ~
Property Owner 114 A A I !7 Telephone # 3 - „2q 7 ~
~
Contractor
Address (~oir/'1Ia n City &A~l-e A~Q/ wp A
State M n. Zip s/a -7 Telephone 1,s1) VO 7"/.S 7l
r7;, Gs j"' Q`"7"/s7I e
Cll ~P~~^ "d~0~
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
~Minnesota Rules 7670 Cate~orX 1 Minnesota Rules 7672
Energy Code Category
• Residenfial Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) . Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber c Telephone #(9.3"Z) YN-7400
Mechanical Contractor l,UAY ~ idet.- l'VCC/4i1/c6c ~ Telephone #(AV) 4.r3 "~'0 76 7
Sewer/WaterContractor Telepho e#(9,~'~~'
i~
'~I'il _IVtV :J r.~,r,-I III
~J
I hereby apply for a Residential Building Permit and acknowledge that the informatiocomplete and accurate;
that the work will be in conformance with the ordinances and codes of therity 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 1
Applicant s P' ted Name Applicant's Signature
OFFICE USE ONLY
Sub Types J
. ;
0 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
F Dwelling ? 08 06-plex ? 16 Firepiace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
x 02 S
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Mufti 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 ,
X 31 New ? 35 Int Improvement ? 38 Demofish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 ReplaCement *Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation 61 ~ Occupancy - ~ MC/ES System
Census Code ~Zoning ID City Water
SAC Units Stories 8ooster Pump
Nbr. of Units ~ Sq. Ft. PRV
Nbr. of Bldgs ~ Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
~ Footings (new bldg) ~ FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ plumbing
~ Foundation _ HVAC
_ Drain Tile Other
Roof _ Ice & Water ~ Final _ Pool Ftgs Air/Gas Tests _ Final
Framing Siding ;;p
Stone
Fireplace ~ R.I. q~ Air Test ~ Final [3) Windows (ne ement
)
Insulation ~ Retaining Wall
Approved By Building Inspector
Base Fee n
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant I 1-11
License Search
Copies
t'C--
Other ~f
Total qt
~ ~
Y t Mike 13. A final subdivision (River Run Addition) to create two single family lots at 2987 Pilot
Knob Rd was approved.
Mike 14. An extension of time to record the final plat for Children's Therapy Addition
(Northco Real Estate), located north of Avalon Ave on the west side of Pilot Knob Rd
in the northeast quarter of Section 4 was approved.
Mike15. An extension of time to record the final plat for Heine 2"a Addition (William Heine &
Laura Burrach) located at 1480 and 1490 Diffley Rd in the northeast quarter of
Section 28 was approved.
Mikel6. The Findings of Fact, Conclusions & Resolution of Denial of a request by Anderson
Builders for a Planned Development Amendment to allow an in-line retail center with
a drive-through facility for Lot 2, Block l, Oakview Center, located at 3025 Holiday
Ln in the northwest quarter of Section 12 was confirmed.
TC 17. The time extension of the development agreement for Project O1-Q (Perron Acres -
Street & Utility Improvements) to August 31, 2003 was authorized.
TC 18. The t ime e xtension o f t he d evelopment a greement f or P roj ect 01-5 ( Finch P lace -
Street & Utility Improvements) to September 30, 2004 was authorized.
TC 19. The time extension of the development agreement for Project 02-C (Natures Edge -
Street' & Utility Improvements) to August 31, 2003 was approved.
TC 20. Change Order No 2 to Contract 02-17 (Central Pkwy & Cedar Grove Area -
Streetscaping & Lighting Improvements) was approved and the Mayor and City Clerk
were authorized to execute all related documents.
Craig 21. The Dakota County Mutual Aid Fire Service Agreement between the cities of Apple
Valley, Burnsville, Cannon Falls, Eagan, Farmington, Hastings, Inver Grove Hts,
Lakeville, Mendota Hts, Miesville, Northfield, Rosemount, So St Paul and West St
Paul, the Metropolitan Airports Commission and the Randolph-Hampton Fire District
was approved.
Mira 22. An amusement device license for ACMUSugarloaf for amusement devices at Cub
Fooda and Wal-Mart was approved.
Ken 23. The fee schedule for the Community Center Child Care facility was approved.
EJV 24. The service agreement-terms & conditions to be accepted with the proposal from
AET for a Phase I ESA for the Kopacek property was approved.
PUBLIC HEARINGS
Mike 25. A variance to exceed the 20% max building lot coverage allowed in an R-1 (Single
Family Residential) zoning district for Lynn Langevin for a house with attached
garage at 930 Wildrose Ct was approved.
From : PHONE No. : 3un.04 2003 9:53AM P01
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From : PHONE No. : Jun.04 2003 9:53AM P02
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From : PHONE No. : Jun.04 2003 9:54AM P04
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0-(-P05~ C=u-c- eopY
TREE PRES,ERVATIQN PLAN SUMIUI~ `
~
~ C~TY QF EA~~4N FORES;RY
.
651 67 5 530(1
(SEE ATTACHMENTS)
Development R oft-S
Lot Number Block Number ~
Address °il, 0 U11,LD KOST-1- C`cr
Builder ~j (VS tf77lwt ~
Coo-TWC--[ Rb N
T&Mf: b'~J - 4M - 1S -I(
Tree Protection Requirements:
Tree Fencing
- ~ Oak Tree Pruning (Immediately seal wounds during April 1 to July 31) .
° Therapeutic Pruning
Retaining Wall
- Other: .
Replacement Trees: '
Not Required
As Follows:
Attachments: EMAN FoREMY OIVISION
Yes No REVQ~MB,
~
. , .
Additional Notes:
6 'vi
.
, i
H:\ghove\2002fi1e\treepres\Tree Preservation Plan Summary-2002
, C ERTI FI CATE O F S U RVEY
' ~ ' • Survey for: SANTANNI HOMES
,
o ROS f
~
890.4 `0 COURT
~'02•s
R;670~ 006~ 1
89 34.42
~ ~teie ssi ~ a' Rcg22S'
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I ~ I Cc6 33o,0 890.2
36
E y 1
. 5 $'S re vlc\ cntv ~
- - 895.3 0 '0 N ~ 890.7 \ elect
^
Q 0 m I - 119
. c ao 895.0 _ _ ~ 895.0 }
- - ~
5.5 1417 ro 1 , 10.5 1
~ j 1.83 , 891.0 1 ~ I 5 4191.9
~o ~
, ,894.5 Porch
. I f 1.67 ~ ^ I ~
11.0 895.0 .0 I
14.33 N
. I 73.0
o ~e
s.o PROPOSED ~
p I I
00 ~ o je9?>`.~ ~ HOUSE'
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2
. 5.511 BJ2.O o N~ 2 O.00 O 1.0 rotO.S m~ Gl
29.
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DESCRiPT10N: Lot 22, Block 1, ROYAL OAKS
1 hereby certify that this survey was prepared by me or under direct supervision, and that I am a
registered land surveyor under the laws of the State of 'nn so a. Dated thi,s 25 oy of Aprii, 2003.
/
CARLSON Qc CARLSON, INC. BY
LAND SURVEYORS Larry . Couture, Land Surveyor
ww sum.erM 7ele. No. (952) 888-2084 Minnesota license No. 9018
341-43 Proposed Grades: Top of block _ 895•7 Garage Floor 895•2 Basement Floor 886•9
NOTE: Circled elevations are proposed, others are existing. Mrows denote direction of drainage.
< LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
~ . PROPERTY LEGAL: L.,,, Df"' 2 ~ 2/e,
DATE OF SURV~ -f-
LATEST REVISION: ~ - / y -D 3
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O ~ Q DOCUMENT STANDARDS
? ? • Registered Land Surveyor signature and company
? ? • Building Permit Applicant
? ? • Legal description
I~ D ? • Address
C~ • North arrow and scale
L~ • House type (rambler, walkout, split w/o, split entry, lookout, etc.) ? 0 • Directional drainage arrows with slope/gradient %
Gd" • Proposed/existing sewer and water services & invert elevation
4}/ ? ? • Street name
C~ ? ? • Driveway
? ? • Lot Square Footage
? ? • Lot Coverage
, ELEVATIONS
Existina
? ? • Sewer service (or Proposed)
? ? • Properry comers
C~L?? • Top of curb at the driveway and property line extensions
t9' • Etevations of any existing adjacent homes
?ly 11 • Adequate footing depth of structures due to adjacent utility trenches
? ~ ? • Waterways (pond, stream, etc.)
Proposed
Eg/ ? ? • Garage floor
C/ ? ? • Basement floor
C,Y ? ? • Lowest exposed elevation (walkouUwindow)
? • Property comers
• Front and rear of home at the foundation
PONDING AREA (if applicable)
? a/ o • Easement line
? C/ ? • NWL
? IV ? • HWL
? I/ ? • Pond # designation
? ? • Emergency Overflow Elevation
? Q~ ? • Pond/Wetland buffer delineation
DIMENSIONS
A/ cl ? • Lot Iines/Bearings & dimensions
11 ? • Right-of-way and street width (to back of curb)
? Cl • Proposed home dimensions inciuding any proposed decks, overhangs greater than 2', porches, etc.
(i.e. ali structures requiring permanent footings)
~ o ? • Show all easements of record and any City utilities within those easements
13// • Setbacks of proposed structure and sideyard setback of adjacent existing structures
[7' ? ? ? • Retaining wall requirements, 'rf any
~
Reviewed: n 'U
Nam Date
G:/FORMS/Building Permit Appllcation Y
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Use BWE or BLACK Ink
---------
� For Offtce Use j
' �10 Ol �� �i�.�++�����,�� i Pertnit#:�� c.� � !v �
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SEP � 7 2�14 � � j Permit Fee: � �
3830 Pilot Knob Road � � �
Eagan M N 55122 �'' I Date Received: � —�',�'L
Phonet (651)675=5675 i'(:____�__ I
Fax: (651).675-5694 � Staff: �
' ' � . �����������������J
2014 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site address:
Tenant: Suite#:
� �� �.� �� �. ..
�Re �d ntlOW1,1 Name: � 1'� l� i� Phone: �D�-7�D�'7��✓
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� . � �' � �Address+�City/Zip:� �� � / � �t'oy� �� ��,
�* ' `,-�� �m���.�` ' .:�.
e � ,; Milbert _ompany Inc dba Culfign Water�nse#: WC643176
� � �� � � Aad�esS: 180150t Street East c;�,: Inver Grove Hgts.
� o�ntraca ,
� �� � ; state: :IVI N., zp: 55077 Pho�e: 651-451-2241
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' Milbert
' ��� .� , co�ta�: W i l l i a m'.R. _ Emai�:
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~� "` New Replacement _Repair _Rebuild _Modify Space Work in R.O.W.
T pe of��Vo: — —
:r�, ��!,�
{,� , �.�:, . Description of work:
F_ ��.:��v�� .���.
��_ RESIDENTIAL
€
� Water Heater
�Water Softener
;� y Lawn Imgation�RPZ/_PVB)
;w � r��
A�,= ��� Septic System Add Plumbing Fixtures�Main/_Lower Level)
��� �rv New Water Tumaround
� —
;� ����
,� , �,� Abandonment
:RESIDENTIAL FEES:
$60.00 L^J�„er,-iea4er,il`Jater So`ie�2�i, o�'Water Hester and S�ftener(inciudes$5.�0 Sta#e Surcharge}
$60:00 Cawn'Irngation(i.ncludes$5.00 minimum State Surcharge)
$6'0.00.Add'Rlumbing Fixtures,Septic Svstem-Abandonment,Water Tumaround*{includes$5.00 State Surcharge)
"Water Turnaround(add$200.00 if a 5/8"meter is required) / �
$115A0 Septic Svstem New($10.00 per as built)(includes County fee and$5.00 State Surcharge) G,��} �
' TOTAL FEES$ �
CAL-L BEFORE YOU DIG. Call Gopher State One Cali at(B51)454-0002 for protection against underground utility damage.
Call 48 haurs'before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.or4
' I hereby acknbwledge fhat this informa:ion is complete and accurate;that the work will be in confortnance with the ordinances and codes of the City of
: Eagan;'that I understand#his is not a permit, but ony an application for a permft, and work is not to start without a permit; that the work will be in
, ' accordance wi th8 approyed plan in t e case of work which requires a review and approval of pla .
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;•Applica rinte .Name Applicant's Signature
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