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1257 Wilderness Curve , ~0"'°°'*. CASH RECEIPT . ~ . CITY OF EAGAN f3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 ~ D A T E •~I`°'s~ 19 !y' RECEIVED - FROM AMOUNT $ & DOLLARS 1 oo ? CASH CHECK FOR j: FUND CODE AMOUNT % .:.J Thank You BY White-Payers Copy Yellow-Posting Copy Pink-File Copy CASH RECEIPT ~ - CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 - DATE 19 RECEIVED . FROM . . . . ~ . AMOUNT ~ I ` & DOLLARS ~1 oo ~ CASH Q CHECK FOR . . . . ( ' FUND CODE AMOUNT Thank You BY White-Payers Copy Yellow-Posting Copy Pink-File Copy w~ BLDG~,,P5RMI'P NO. ~ 01-3210 Bf dg. Permit 01-3422 Plan Check 01-3445 Surch./Adm. 01-3446 SAC/Adm. 01-2155 Surcharge 17-3860 Road Unit 20-2275 SAC 20-3865 Water Conn. 20-3868 Water Trmt. 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. 11-3855 Park Ded. I TOTAL f CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 BUILDING PERMIT Receipt# To be used for Est. Value Date ,19 Site Address OFFICE USE ONLY Lot Block Sec/Sub. On Site Sewage _ Occupancy ' MWCC System _ Zoning i PafCel NO. On Site Well _ Type of Const City Water _ (Actuaq a Name (Allowable) w # of Stories 3 Address Length ~ City Phone Depth S.F. Total , p Name Footprint S.F. ~ < Address APPROVALS FEES P City Phone Assessments _ Permit Water/Sewer Surcharge pj W NBme Police _ Plan Review = Z Address Fire _ SAC, City uc Engc _ SAC,MWCC ~ 6 W City Phone Planner _ WaterConn. , Council _ Water Meter I hereby acknowledge that t have read this application and state Bldg. Off. _ Road Unit thatthe information iscorrectand agree to comply with allapplicable APC _ TreatmentPl State of Minnesota Statutes and City of Eagan Ordinances. Variance _ Parks Copies Signature of Permittee TOTAL A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official c Permit No. Permit Holder Date Telephone # Plumbing ~5 ,f, H.V.A.C. (J lD (P r . E lectric ~ /Y.d?JECt/ C~ d. Softener Inspection Date Insp. Comments Footings I Footings II Foundation - b Framing Roofing Rough Plbg. •9 46 Rough Htg. ISUI. z Fireplace Final Htg. 6 Sn 7 4. Final Plbg. Bldg. Final Cert. Occ. Temp. LP Deck Ftg. Deck Frmg. Well Pr. Disp. _ , T . . _ , ' • PERMIT # 5',22 ~ PLUMBING PERMIT RECEIPT 1# '3 702 CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: 01,5- 7 CONTRACT PRICE: PHONE: 454-8100 Site Address/ ' BLDG. TYPE WORK DESCRIPTION Lot Block ~ Sec/Sub Res. ~ New „ Mult. Add-on y Name ' 42 Comm. Repair ~ Address Other c City Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAII~ Name - ~ __~2,_Watef Closet - $3.00 $ ~_Bath Tubs - $3.00 3 Address _?-Lavatory - $3.00 p Ciry Phone _,,'__Shower - $3.00 __Z__Kitchen Sink - $3.00 FEES Urinal/Bidet - $3.00 COMM/IND FEE - 1% OF CONTRACT FEE Laundry Tray -$3.00 APT. BLDGS - COMM RATE APPLIES -/-Floor Drains -$1.50 TOWNHOUSE & CONDO - RES. RATE APPUES -,/-Water Heater -$1.50 MINIMUM - RESIDENTIAL FEE - $12.00 Whirlpool - $3.00 MINIMUM - COMM/IND FEE - $20.00 -;Z_Gas Piping Outlets - $1.50 ' STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT) (ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00 BEYOND $1,000.00) Well - $10.00 Private Disp. - $10.00 ,%:J¢.s--?-~ ~ Rough Openings - $1.50 SI r ATURE OF PERMITTEE FEE: STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL: j~• . ; ~ PERMIT # 29 ,f'o Co ~ MECHANICAL PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Address 2 ~ BLDG. TYPE WORK DESCRIPTION Lot .-:2 Block Sec/Sub - Res. ~ New ~ Mult. Add-on ~ Name ~a Address Comm. Repair c City Phone _ Other FEES Name RES. HVAC 0-100 M BTU -$24.00 3 Address V~ ADDITIONAL 50 M BTU - 6.00 p City Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA. TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE a) Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU $ MINIMUM COMMERCIAL FEE - 20.00 Vent. ~ CFM ~ STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # $ BEYOND $1,000) Other U:. J'F~ , ~ • FEE: S/C: SIGNATURE OF PERMITTEE TOTAL: FOR: CITY OF EAGAN f!':i,~; : : v 1."' a. . . . - . . w...'K:- . t lS . _ m. :f. - i-,~• 4'4~?RQ"Pr , . •a• . _ . . . . . , . . . -C,~ CITY OF EAGAN 17191 ~ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454-8100 Receipt # To be used for POOL Est. value $iZo000 Date OC7 17 ~g89 ~ Site Address 1257 ilILDERNESS CtJRVE ~ Lot 22 Block 2 Sec/Sub. ~~E~Ess ~Nn OFFICE USE ONLY ~ P2fC@I N0. Occupancy _ FEES ~ Zoning _ W Name ~8 FAUS= (Actuaq Const _ Bldg. Permit 136.00 i o Address 1257 WILDERNE33 CUBVE (Allowabte) - b.pp ~ Surcharge City EAGAN Phone 1741 # ot stories Length PlanReview 68•~ ~ o Name EAGAN POOL 6 SPA Depth 2-0-T sAC, cicy Z Address 2020 SZLVER B~ELL BD, #2C S.F. Total - ~ ~QV SAC, MCWCC ~ City EAGAN Phone 68$-0860 S.F. Footprints - On Site Sewage _ N/ater Conn ~ ~ W Name On Sile Well - Water Meter Addf@SS MWCC System _ ~ = Acct. Deposit ~ a W City Phone City water _ i ` PRV Required - S/W Permit ~ I hereby acknowlege that I have read this application and state that the Booster Pump _ A information is correct and agree to comply with all applicable State of SiW Surcharge Minnesota Statutes and City of Eagan Ordinances. Treatment PI Signature of Permitee APPROVALS Road Unit ~ A Building Permit is issued to: EA"N pWL &$pA Planner - park Ded. ~ on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. gldg. Off. _ Copies ; 210.00 Variance - TOTAL ~ Building Official ' Permit No. Permit Holder Date Telephone # WATER SEWER PLUMBING H.V.A.C. ELECTRIC Inspection Date Insp. Comments Footings I Foundation 1 Framing o•~S -1(~ 2~ 00 A h,kC P Roo(in9 C10 C 1e4 i 4 wi~l e ehe %a ROUgh Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. ~4e u ' ~ ~ . . , . :~J,7~'::..~.eWJ'~t . ~ . . . , . . _ . ; . . . , . . `~d~' CITY OF EAGAN AQ 17067 ~ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ~ ~ PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for DECK Est. Value ;1 ,000 Date SEP 14 11989-- ~ Site Address 1257 VILtlgRNfiSS CUItVB ~ LOt 22 Block 2 SeGSub.WILDERNZ8g POND8 OFFICE USE ONLY , P8fC21 NO. Occupancy - FEFS Zoning ~ W Name ~ e" ~~~T (Actual) Const - BIdg.Permit 26•~ ; Address 1257 WTI.aERNESS CUxVE (Allowable) 0 Clt "~N Phone # of Stories Surcharge • ~ y length ZZ ' Plan Review o Name JOSEPH R MIl.LBx Depth 14' sac, ciry ~ ~Q Address 17~ ~RGUS AVS S.F.Total _ S SAC, MCWCC ~ ~ Cit JO~~ Phone 4~"'6625 S.F. Footprints - Y On Site Sewage _ Water Conn ~ ~ W Name On Site Well - Water Meter ~ Addf2SS MWCC System _ ~ a W City Phone City Water t_ AccL Deposit ~ PRV Require4, i _ S/W Permit ~ t I hereby acknowlege that I have read this application and state that the Booster Pump' SNV Surcharge ~ mformation is correct and agree to comply with all applicable State of ~ Minnesota Statutes and City ot Eagan Ordinances. - ' Treatment PI Signature of Permitee APPROVALS Road Unit i t A Building Permit is issued to: JO'SEPH R MI=R Planner - park Ded. ~ on the express condition that all work shall be done in accordance with all Council ~ applicable State of Minnesota Statutes and City of Eagan Ordinances. Bidg. Off: _ Copies • Buiiding Official Variance - TOTAL 27.00 Permit No. Permit Holder Date Teiephone # WATER SEWER PLUMBING H.V.A.C. ELECTRIC Inspection Date insp. Comments Footings I Foundation Framing aoorny Hough Plbg. Rough Htg. Isul. Fireplace Fnal Htg. Final Pibg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bidg. Final Deck Ftg. ,(,j~ Dedc Final wen Pr. Disp. Date: CITY OF EAGAN Permit No: Size: 3830 ir`~ot Knob Road Meter No: 3f~ 'D 6_~ 3d-47 P.O. Box 21199 Reader No: 2-3 7J~'~ Date: Eagan, MN 55121 Owner. Ozmu~~ ~ ederson Inc. Site Address: 1 257 WildeT~PGS Curve ~^'ilclernesG Ponds Plumber. pe'ne b Conn. Chg: 52S N0Jt ~ Acct. Dep: ~-5 0 UA 8 a{I IGC61 01.illl I@S . Permit Fee: i', L Surcharge: 44dA~69AQpiy with the City of Eagan Tr. Plant 0 ~f3/"~ r ~ VIRGV u Meter. Misc.: By WATER SERVICE PERMIT , •=-:r~-^•e--~`r~-+~'z..~`."t,m, CITY OF EAGAN Permit Na r Date: 4"30-F7 , 3830 Rilot Knob Road Meter No: Size: P.O. Bo)C 21199 Reader No: Date: Eagan, MN 55121 Owner. :'~~.'rsu - iac. SiteAddress:" 1?57..W11dP^'eas GtirvQ L22 R? t-'iIJera_,ss Fonrla Plumber. Petn~ Pyumbinig Conn. Chg: `525. 0Ogd Zoning: Acct. Dep: 15.001!J No. of Units: ~ Permit Fee: 10• 00Pd Surcharge: •50pd I agree to comply with the Clty of Eagan Tr. Plant 180• ~0pd Ordinances. Meter. nn-a Misc.: By WATER SERVICE PERMIT ; i CITY Ok EAW SEWER SERVICE PERMIT ~ 3830 -Filot Knob Road 9835 P.O{ Box 21199 PERMIT NO.: _ Eagan, MN 55121 DATE: 1 ; Zoning: No. of Units: ; Ozr.n.in-Pederson Tnc. Owner: Address: a Lailderness Curve L72 32 t~Tilderness ~'or!~1s , SiteAddress eine rlut4blnf Plumber. 4 72 _?7 72720 1Q0.40=°d ~ S~5 ~?~Jns_ 1 agree to comply wRh the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: 50nd By Misa Charges: Date of Insp.: Total: Insp.: Date Paid: ; ~ CITY OF EAGAN [\j° 13 4 91 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 - BUILDING PERMIT PHON E: 454-8100 Receipt# To be used for SF DWG/GAR Est. Value $164, 000 Date APRIL 21 19 87 Site Address 1257 WILDERNESS CliRVE OFFICE USE ONLY 22 2 WILDERNESS PONDS On Site Sewage Occupancy R3 Lot Block Sec/Sub. MWCC System Zoning R1 Parcel No. On Site wen Type of Const City Water X (Actuaq rc Name OZMiiN-PEDERSON INC (Allowable) V w # of Stories Z Address 15136 GALAXIE AVE ~engtn ~ ~ City A• V• Phone 431-5000 Depth 50 S.F. Total , p Name SAME Footprint S.F. ~ Q Address APPROVALS FEES P City Phone Assessments Permit $ 695.50 Water/Sewer Surcharge W W Name Police _ Pian Review 347 _ 75 ~ W Fire _ SAC, City 100.00 ~g Address Engr. _ SAC, MWCC 525.00 Q W City PhOne Planner _ WaterConn. 5 S_(l0 Council _ WaterMeter F,7 nO I hereby acknowledge that I have read this application and state Bldg. Off. _ Road Unit 305.00 thattheinformationiscorrect dagree~toc lywithallapplicable APC _ TreatmentPt _i8o.e0 State of Minnesota StatuXt~ r inances. variance Parks Copies Signature of Permittee TOTAL $2, 827 . 25 A Building Permit is issued to: OZMUN DERSON INC on the express condition that all work shall be done in accordance with all applicabl tate of Minne ta SXatutes and City of Eagan Ordinances. Building Official a CITY OF EAGAN N D 17 0 6 7 ~ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ~ . - PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for DECK Est. Value $1, 000 Date SF.P 14 Site Address 1257 WILDERNESS CURVE Lot 22 ! Block 2 Sec/Sub.WILDERNESS PONDS OFFICE USE ONLY PSfC81 N0. Occupancy - FEFS Zoning _ W Name MRS FOUST (Actuai) Const - Bldg. Permit 26.00 o Address 1257 WILDERNESS CURVE (Allowable) - Surcharge .50 Clt EAGAN Phone # of Stories _ Y Length ?2' Plan Review Zo Name JOSEPH R MILLER Depih 14' sac, cicy ~a Address 17900 VERGUS AVE S.F. Total _ m City JORDAN Phone 440-6625 S.F. Footprints _ SAC, nncwcc On Site Sewage _ Water Conn ~ F W Name On Site Weil - Water Meter =~~-y Addf2SS MWCC Sys?em _ a W Clty PhOne City Water _ Acct. Deposit PRV Required _ S/W Permit I hereby acknowlege that I have read this application and state that the Booster Pump - SiW Surcharge information is correct and agree to comply with all appli ble State of Minnesota Statutes and C' of Eag n Ordi ces Treatment PI Signature of Permitee APPROVALS Road Unit A Building Permit is iss d to: JOSEPH R MILLER Planner - Park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Oft. _ Copies .50 Variance - TOTAL 27.00 Building Official CITY OF EAGAN N2 17191 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for POOL Est. Value $12 , 000 Date OCT 17 , 1989 Site Address 1257 WILDERNESS CURVE Lot 22 Block 2 Sec/Sub. WILDERNESS POND OFFICE USE ONI.Y Parcel No. ~ Occupancy _ FEES Zoning _ 0 W Name BOB FAUST (Actual) Const _ Bldg. Permit 136.0 o Address 1257 WILDERNESS CURVE (Allowable) - Surcharge 6.00 City EAGAN Phon~-1741 # of Stories _ Length ~ Plan Review 68.00 ~ Name EAGAN POOL & SPA Depth 20 ' o - sac, cry ~cc Address 2020 SILVER BELL RD, #2C S.F. Total - ~ City EAGAN Phone 688-0860 S.F. Footprints _ SAC, nncwcc On Site Sewage _ Water Conn r- ~ WQName On Site Weil - Water Meter OR~ AddreSS MWCC System _ <W CItY Phone City Water _ Acct. Deposit PRV Required - S/W Permit 1hereby acknowlege that I have read this appiication and state that the Booster Pump - Siw Surcharge intormation is correct and agree to compiy with all appiicable State of Minnesota Statutes and City of Eagan Ordinances. Treatment PI Signature of Permitee APPROVALS Road Unit A Building Permit is issued to: EAGAN POOL & SPA Planner - park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Oft. _ Copies Building Official _~~~.Q16 111 Variance - TOTAL 210.00 P4 2s~ 118 Request Date Fire o. Rough-in Inspection eq 'red? ? Ready Now ~lill Notify Inspector Yes ? No f`~ When Ready? I icensed contractor ? owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) City uAAAx- Section No. rship Name or No. Range No. Co b c4 OccuP~ifi'pF3(~ ` V,~a u~ Pho e ~ ~ ~ / I ~~J Power Supplier Address Electrical Contractor (Company Name) Contractor§ License No. ? _ Mailing Address (Contractor or Owner Making Installation) 3 le S 5+ ~ Authorized Signatu ractor/Owner aking Installation) Phone Number MINNESOTA BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room 5773 BE ACCEPTED BY THE STATE BOARD 1827 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. J~~ REGIUESTV<JR ELECTRICAL INSPECTION 9"• ea-00001-07 ? See iG4tructions for completing this form on back of yellow copy. P 42-.18 "X" Below Work Covered by This Request ew Add Rep. TypeofBuilding AppliancesWired _ EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace ~ Farm Air Conditioner Other (speciTy) Contractor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps SignS lnspector's Use Only: TOTAL Irrigation Booms Special Inspection Alarm/Communication Other Fee I, the Electrical Inspector, hereby Rough-in . Date certify that the above inspection has Final ~ D~~ p_ been made. O OFFICE USE ONLY This request void 18 months from This request void ~ j~~/~. ~ 18 months from D 5 ~ Q 5 ,9 Reques+i Date'•=~ Fire No. Rough-in InsVection i~'7 Required? ~Ready Now~ ill Notifv. IInspec- ~v `J/' Yes No '[or When Ready [{"Licensed Electrical Contractor I hereby requast inspection of above ? Owner electrical work installed at: Street Address, Box or Route No. City I .2,T -7 1,,T . zGf-G6ihec146~~IV ecuon o. Township Name or No. Range No. County OccuVent (PRINT) Phone No. i r Power Suppiier Address Electrical Contractor (Company Name) Contractor's License No. ~ `1 i Aze Oev u r'd f Maili Address (Contractor or Owner Makmg Instailation) ~73'a 61~ Authori d turer,(C ntr ctor/Owne akin Installation) Phone Number ~ ~ MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WiLL NOT Griggs-Midway Bldg. - Room N.191 BE ACCEPTED BY THE STATE 80ARD 1827 Universitv Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. --iEQUEST FOR ELECTRICAL INSPECTlON s-« Ea-oooot-os ~ See instructions tor completing this form on back oi yellow copy. " ~39 5 ""X"' Below Work Covered by Thrs Request We. Add Rep. Type ot Building Apptiances Wired Equipment Wired Nome Range Temporary Service Duplex Water Neater Liyhtin,y Fixtures Apt. Bui Iding Dryer Electrie Heatin Commercial Bldy. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank . Farm Othr.r Specify Other ISPer.ify) t er Suecify Other Qther ompute lnspection Fee Below ;~tt Fee ServiceEntranceSize #t Fee Feeders/Subfeeders # Fee Circuits Op U to 200 Am s O to 30 Am s '3.(0 0 to 30 Am s Above 200 qmpy~ 31 to 100 Amps 31 to 100 Am s Swimming Pool Above 100_Amps Above 100_Amps Transformers Irrigation Boorns Partial-`Other Fee Signs Specialinspection Rema rks $ ~ TOTAL F~, ,W,~ s Rough-in Date i, the Elec Inspector, hereby ~ certify that the above Final :+te insDection has been C./ ~ ~ ?ma aa. fhis request vofd 18 months f rom . (gtr#i#tratt of (Orrupttnry Citp of eagan _ . lorpar#mmt u# loitilbing JnmPrtintt This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building Code cenifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following.•. Use Classificauon - Bldg. ftrmit No. UccupancY Type Zoning Disvict '.5 d Type Const. . ~ Owner of Building' Address ' I 7 . . . Building Addres ' . . . , . , " I.ocality , . ~ DBte: Budding Ofticial ' - POST IN A CONSPICUOUS PLACE 4`l0 .M ~ 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirements RemodellRepair Reauirements Qffice t7se Only 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Qert of Survey Recd _-Y N (20% maximum lot coverage ailowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd _ Y_ N. 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required _ Y_ N 1 set of Energy Calculations Addition - indicate if on-site septic system On=site S66fic Sqstero ~Y N 3 copies of Tree Preservation Plan if lot piatted after 711193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Date : /I~ / ~ Construction Cost Site Address , ~i-) -5 Unit/Ste # I3escripiion of VVork S L-Aq 645 /i4J S4A 1, Multi-Family Bldg _ Y~ N Fireplace(s) _ 0 *1 _ 2 Property Owner Telephone # 2y0 - - - - - - _ - - Fireside Hearth&Home i Contractor I 14399 Huntington Avenue ~ Address I Savage, MN 55378 City State 952.736.7761 Telephone # ( ) ; License #20512060 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code Category . • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y ` N !f so, 25% p!an review fee applies. Licensed Plumber Telephone # ( ) Mechanical Contractor Telephone # ( ) Sewec/Water Contractor Telephone # ( ) I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; 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 wark will be in accardance with the approved pl in the case of work which requires a review, and approval of plans. - ~ .N Appiicant's Printed Name Appl tant's-Si'gnai4e OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-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 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05; 03-plex ? 11 10-piex ? 19 Lower Level ? 24 Storm Damage 0 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Misceilaneous Work Types ? 31 New ? 35 Int lmprovement ? 38 Demolish Interior ? 44 Siding ? 32_ Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof O 46 Windows/Doors ? 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 af Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ Final/C.O. _ Footings (deck) _ Final/No C.O. _ Footings (addition) _ Plumbing 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 Appraved By: , Buifdiny Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when pennits are required for each unit Date ~ 2)_ Site Address 1 a5~ W 1I 3eA- rIF"5 5C_ t-)r Ve Unit # Property Owner 1r'c Telephone #((fl51 )/45a - a'-t 5 7 Contractor c ?1~" 1--' ~ ~ ~ A < . Street Address a l c~l 1 U~ p,,'~'Dr~ V~::) City ~ State (Yl~ Zip c_z~,bp3`-3 Telephone # (~,~'j ) ) W (QCZ- (~0 0~ <D Bond Egpares: ~ The Applicant is Owner Contractor Other Add-on or alteration to existing dwelling unit $ 30.00 urnace _Additional _Replacement New air exchanger air conditioner ~ heat pump other State Surcharge $ .50 A' 1 TOtal ~ ~ ~'1$ ~ ~ •~Q ~ I hereby apply for a Residential Mechanical:Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances"and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a pernut, but only an application for a pernut, and wark 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. ~ f , C_l Applicant rinted Name 4Apcant's S g tu 7 2005 COMMERCIAL MECHANICAL PERNIIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commerciaUindustrial buildings multi-family buildings when separate permits are not required for each dwelling unit • Date Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) Sond Eapires: . . . . ..c , . . , n. The Applieant is Owner Contractor Other ' Work Type _ New Construction _ Underground Tank _ Install Remove **see below _ Interior Improvement _ Instail Piping _Processed _Gas Nature of Work: 'k'kVl/hen installing/removing underground tank, call for inspection by Fire Marshal and Plumbing lnspector ` Permit Fees: $70.50 Undergound tank installation/removal $50:50 Mbtimum (includes State Surchazge) , or Contract Value $ x 1% Permit Fee h t $ State Surcl~arge ~ If permit fee is less than $1,000, add $.50 t' If p 't fee is more than $1,000, surcharge ' is $.50 for every $1,000 owed.. . $ Total Fee' I hereby apply for a Commercial Mechanical Pernut and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand ttus is: ' not a pernut, but only an application for a permit, and work is not to start without a pemut; that the work'will be in accordance withJ, the approved plan in the case of work which requires a review and approval of plans. - Applicant's Printed Name Applicant's Signature Approved By: , Inspector Date: Required Inspections: _ U. G. _ R.I. _ Air Test _ Gas Service Test _ Infloor Heat Final RESIDENTIAL ' BUILDING PERMIT APPLICATION ;qqq3 CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Reauirements RemodellReaair Reauirements ~ v • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan (20% maximum lot coverage allowed) • 1 set of Energy Calculations for heated additions • 2 copies of plan showing beam & window sizes; poured found design, etc.) . 1 site survey for exterior additions & decks • 1 set of Energy Calculations • Indicate if home served by septic system for additions • 3 copies of Tree Preservation Plan if lot platted after 7/1193 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE 06'' 2q~DZ VALUATION SITE ADDRESS I Z 5'7 MULTI-FAMILY BLDG _ Y _N TYPE OF WORK T4-A-- FIREPLACE(S) _ 0-' 1_ 2 APPLICANT i American Building Contractors ' 12247 Nicollet Ave. So. STREET ADDRESS ; Burnsville, MN 55337 ~ STATE ZIP TELEPHONE #CsZ- 7 °7-(-5 s~r CELL PHONE # ~ FAX #'9 rL J-000-4=~~~tD 6SI- PROPERTYOWNER A A v ~ K C-.- TELEPHONE # YS Z- Z- y S-~ S COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category MINNESOTA RLJLES 7670 CATEGORY 1 ~ ~ 2 (4 submission type) • Residential Ventilation Category 1 Worksheet Submitted 1~ev@n fgyl_ o~~ ~ s t Submitted • Energy Envelope Calculations Submitted AUG 2 9 2002 Plumbing Contractor: Phone # Plumbing system includes: Water Softener Lawn Sprinkl ~y .---------°-e e:~0.00 Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor: Phone # Mechanical system includes: Air Conditioning Fee: $70.00 Heat Recovery System Sewer/Water Contractor: Phone # 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 Ordi s. ~ Signature of Applicant C._ OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY ~ . ? 01 Foundation ? 07 05-plex ? 13 16-plex 0 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Muiti ? 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 (screened) ? 36 Multi ? 05 03-plex ? 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 ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 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 _ 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 Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insularion _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant ' Plumbing Permit Mechanical Permit License Search Copies ' Other ' Total ' a ~ d f 7 l 1987 BIIILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS . INCLIIDE 2 SETS OF PLANS, 3 CERTIFICATES OF SQgdVEY, 1 SET OF ENERGY CALCIILATIONS NOTE: ADDRESSE3 FOR CORNER LOTS - CONTRACTOR/HOME06iNER MIIST DESIGNiTE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE AL.LOWED ONCE BIIILDING PERMIT IS ISSIIED. MtJL.TIPLE DWELLZNGS - RESIDENTIAL RENTAL. UgdITS FOR SgLE UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRVEY - CHECg 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, $2,000 LANDSCAPE BOND To Be Used For : S F D Valuation: I(AODO Date : Ap,r i 1 13 . 1987 Site Address 1257 W i 1 d e r n e s s C u r v e OFFICE IISE ONLY Lot 22 Bloek 2 On Site Sewage Occupaney MWCC System v Zoning 2,1 Parcel/Sub W i 1 d e r n e s s P o n d s On Site Well Type of Const City Water ? (Actual) Owner Ozmun-Pedenson. Inc. (Allowable) SL' # of Stories Addres s 1 5 T 3 6 G a 1 a x i e A v e Length to'~ Depth SCa City/Zip Code Ap p 1 e V a 1 1 e v. M N 55124 S. F. Total Footprint S.F. Phone 4 31- 5 0 0 0 APPROVALS FEES Sa Contractor S a m e a s a b o v e Assessments Permit Water/Sewer Surcharge 07-. Address Police Plan Review -54-7- Fire SAC, City O o- City/Zip Code Engr SAC, MWCC SZS- Planner Water Conn SZJPhone 4 31- 5 0 00 Couneil Water Meter (,~,"j • Bldg Off Road Unit 3C~ S• Arch./Engr. APC Treatment P1 I gD. Variance Parks Address Copies TOTAL City/Zip Code Phone # . Y S-b - 2:7(-Pd e) ~ '~2~ Z~? ~Z6 ~ (2, " 632~0 2C,12c~-xcz~ _ '3 (&S 362 x 8 ~/Z~~ ~ o.• 695•5u+ ~ 8Z•OU+ j 4`T • I 5+ . G25•OU+ 525•Oil+ ~ 6'7°OU+ ' 305°OU+ ~ ,18 0 - 0 0 2~827•2,5* ~ f,_._,..... _ , t~1 ~ i 2 ~ I~ f / ~ ~ . ~ 1 r ~ O 1 's . ~3' ~ ~~;RAs~ N +0'6' o ~ Z Z, , Z id, ~ +'~SPilAt,.~- ~RlV6 OZM pEt~E-9-501\1, 111,1G, Z LoT Z Z--, ,17-5 LOG<- EXTERIOR ENVELOPE AVERAGE " U" COMPUTATION Owr?et^: Ozmun-Pederson ~ Tnn- Site Address: 1257 Wi ldernPGG C'iirvp Contractor: OZMU?.i-R.,;S~N , I gG.-. Date: A2,:,_Phone: Determine working square footage of each. 1. Total exposed wall area 33"7,'~j _Sq. Ft. x.11 = 5`7 2. 1'otal roof/cei 1 ing area ;1b`~~„~`0 _Sq. Ft. x.026 • Total exposed wall area above floor - a. Total wa11 window area... b. Total door area 691 c. Total sliding glassdoor area d. Total fireplace wall e. Total wall framing area (averagel0%) f. -Total net wall area above floor ~Q.11 j,-7 g. Total rim joist area _e"Q Total exposed foundation area = f ~ ~ h. Total foundation window area.................................... ' i. Total net foundation area above grade Determine " U" Value of each wall segment. a. 7 X u ~30 b. Cal X u„ C: X u 4-1 = ~33~ d, r. xu e. x u .30,'7 f: ~I11~7 X „ u „ ,043 4~ - 9. x"u" 10471 Y II ~7 h : X „ u lCI EJ . o X u u , I ll- = C,Z 3. TnTAI. Total exposed..roof / ceiling area = 20,30 . . • j. Total skylight area..................................... A. Total roof / ceiling framing areal0% 1. total net insulated roof / ceiling area Determine " U" value for each roof / ceiling segment. J. x u K. X „ u X„ u„ TOTAL 4• 40,40 Tf total of 4 is the same as, or less than #2, you have met the intent of SBC 6006 ; (c) 1. To utilize the total envelope systPm mPthod, the values establishPd hy ±he sum of lines #3 and #4 shall not be greatEr than the s4m oF lines #1 and #2. 1. .371 +2. 3 , ~ 3.• o2-liiq +4. i : t k . I ` ; ' r { » 1 * . T L • 1989 BUILDIPG PERMIT APPLICATION CITY OF EAGAN 110(0 SINGLE FJIMILY DWELLINGS l~TLTIPLE DWELLINGS COMBdERCIAL 2 SETS OF PLANS 2 3ETS OF PLiNS 2 SETS OP 1RCHI?ECTURAL. 3 AEGISTERED SITE SIIRVEYS REGISTSRED 3ITE 3IIRQE?S - & STRDCTQRSL, PLdNS 1 SET OF ENERGY CAI.CS. (CHECg NITH BLDG DIV.) 1 SET OF SPECIFICITIONS 1 SET OF EAERG2 CALCS. 1 SET OF F.NERGT CALCS. NULTIPLE DNELLINGS WMIL UNITS FOR SALE UNITS t OF ONITS _ iCYTEi IDDRESSES FOH CORHEB LtyTS - C4lPTRDLTORAKWOWNEA !lQST DESIGNATE iiHICH IDDRFSS IS DFSIRED. AO CHANGES WILL BE iLLOiiED ONCE BOILDIING PERMIT 13 ISSDED.. SEWER & WiTER PERMIT FEES AND ACCOONT DEP0.SIT FEES iiILL BE INCLODED WITH THE HUILDIN(3 PERMIT FEE. PROCFSSIIIG TIME FOR SMMR iFD MATER PERHITS IS TWO DIYS ONCE A PERMIT HAS BEEN COMPLETED INDIC?TING 1E LICEpSED PLUMIDER. PENALTY APPLIFS WHEN: PERMIT YS NOT PAID FOR IN SAME MONTH IT IS REQUESTED. LOT CHANGE IS REQOESTED OAICE PERMIT IS ISSi1ED. To Be Used For: Valuation: ~ O v~3 Date: Mn APR 12 1989 Site Address OFFICE OSB ONLY Lot Block ~ Occupancy FEES ~ ~.~1~2~ir+.e,~o Zoning Pareel/Sub /t Aetual Const Bldg. Permit Allowable _ Surcharge ~ Owner 912 2.5 1::--C tA S I' +i of stories Plan Review Length SAC, City Address 5,4~ M'~;- Depth 13'la_ SAC, MWCC S.F. Total Water Conn City/Zip Code Footprint S.F._ iTater Meter Acet. Deposit Phone On site sewage S/N Permit On aite Well S/ii Surcharge Contractor'70SS P~ R• lAl [--L--~~~- MWCC System Treatment P1. City vater Boad Unit Ad dres s1-7')00 V5-K(~U sALI,'-- PIRV requtred Park Ded. - Baostex° Pump Copies SUBTaTII. City/Zip Code fJ Ao1l~,~~~ 33? / iP'PAOVILS ?enalty Phone Planner • ?OTgI. 771_7_ p Couneil _ Arch./Engr. S0(~~i5UJ Bldg. Off. Variance Address City/Zip Code Phone # ; , p- , r + ~ „ • ~i . sA 0 , y U + ':~-6~ 27 uu:, ~ ~ . ~ • f_ - ~ ~ t~1 o E~ . i t~I o2~2 2 ~ I~ . 1 / ~ ~ , ~ C41,- 8 /7-0 . Q~z - ~ ? N ~°~~E _ rll -F.2 _ 4 • +c z ~ x~s'` ~~s ~ 'v ~~';~44E N +0_6 ~ - d-I- N N c o 0 ' z L It ~o. Aspyq`r ~t f VE ' D ~j PLOT PLAN ' . o:oa OZM G~~~ L//YE LoT Z Z, -F;)C.OG< Z ~Q~I L 'j ~9~7 ~JG~{Lr'b ~ri~ 3~r / . ~ : ` F 1989 BUILDIAG PERNiIT APPLICATION CITY OF EAGAN ~ , ;iGLE F9MILY DiiELLIBGS l~JLTIPLE DWELLINGS t'iERCIAL 2 SETS OF PLANS 2 3ETS OF pLJLN3 2 SETS OF ARCHTIECTURAL 3 BEGISTERED SITE SIIRVEYS HEGISYRUD SITE 3tTit0E?S - & STHOCTQRAL PLANS 1 3ET OF ENERGY CAI.CS. (COM idITH BL1IG DIV.) 1 3ET OF SPECIFICiTIONS 1 3L'P OF ENEAGi CALCS. t SET OF EIiERGY CAI.CS. MULTIPLE DWEI.LINGS RENTIL DNITS _ FOR SALE UIQITS # OF OBITS _ NDTEs aDDRESSES FOR CORNER LOTS - COATRACTORlHQMEOidKEB lUST DESIGNA?E iiHICH iDDRESS IS DESIAED. N0 CSANGES iiILL BE ALLOiiED ONCE BUILDIHG PERMiIT I3 ISSIIED.. SEWER & WATER FEE1TP FEES AItD ACGOUNT DEP0.SIT FEES iTILL BE IpCLODED iIITB THE BUILDIN(i PERMIT FEE. PROCESSING TIME FOR SEiiER lAD NATER YER+iITS IS TWO DiYS ONCE i PERMIT flAS BEEN COMPLETED INDICATING A LICENSED PLtMBER. PENALTY APPLIES WHENt PERMIT IS NOT PAID FOR IN SAME MONTH IT IS REQUESTED. LOT CHANGE IS REQOESTED ONCE PERMIT IS ISSUED. s Wy ~~Y r74/6 Valuation: 14r/24 Gt's41' Date• . To Be Used For: Site Address 1 15.7 A?rz~&-1';i!?C S-r OFFICE OSE ONLY G u~ v4z- Lot Z Z- Black 'Z Oceupaney FEES Zoning parcel/Sub ~IL'D&-pa-,15S Ap23M Actual Const Bldg. Permit 3C.- Allowable Sureharge 6.00 Owner 8ee e=ifC~S # of stories Plan Review ~68_oo Length 0' SAC, City Address 12s7 jrY.ZZ.,f~~d?Xf~~S G4/~!/E DePth 2c~' SAC, MWCC S.F. Total Water Conn City/Zip Code EqGAAI /7`y SS/ Z Z- Footprint S.F. Water Meter Acet. Deposit Phone Ltar 2- ) 7y/ On site sewage Slii Permit On site Well S/N Surcharge ~ Contraetor 046AW pG'rn- JI('S^ MFICC System Treatment P1. Cfty water Road Unit _ Address 2- G 2G S.~Z~/E~?f3~ZG~p~2G PRV required Park Ded. Boaster Pump Copies City/Zip Code 57Ad.40 /YAI SC ~ZZ SUBTOTII. apppppgLS Penalty Phone Planner TOTA- ~ Council Arch./Engr. Bldg. Off. ~101'1 Variance Address City/Zip Code Phone # i Y c j O•A , a ~ 136•O0t 6'U9+ 68- oo# 21U • O0*+ 135•(7U+ 6°Oo+ 68 • 00+- 21U=00*+ ~ ~ , Q- i Z0 / ~ a- I ~ • ~ ~ r - cr . ~ 17-a ^Q~~ j O z 7.V . N . ~ Hov.-~ o w \ ~ , iS IF + I'1:Ro,rE N ~0=6 O ~ t L 1 t ~O. ASPyA~T DRIV~ • - D 62 .q~ ~ PLOT PLA/J . OZM V N- QEVE-9-501\1, _t/\.IC, GufZb LI /`~E LoT Z Z, >LOG< Z WILDc^2"Et~,5 fONfJj , P\f fZ i L'7~ l 9 8 7 1 <<= 30 .r******#****************#**# ' AYMFM OF F'F.E AT TINJE OF * . - - ~ r%rrjj.Li;rMON DOFS NOrI' OONSTIZSTI'E * * APPROVAL OF PERMIT. . ~ ~ ~ APPUCATION FOR PERMIT ~ INSPELTION OF SEWE32 ADID/OR {nAM ~ nsm.r.amONS WIIZ IaOT BE SCfim- * SEWER AND/OR WATER CONNECTION UNTIL PE1:zM9T HAS BEw * ~ , • • * APPR()VID. . . . ~ * ~ Please Print) ) PROPERTY ADDRESS: f a S7 W,'/~~rheSS LEGAL DESCRIpTION: ~ r 2 Z Q/ac.k Z ~?,'/~~r-ytes5 ~o r1Ar ' Lot Block Subdivision or Tax Parcel ID ) . IF EXISTING STRCCIL'RE, DATE OF ORIGINAL.BL'ILDING PERMIT ISSL'ANCE: " . (Mon Year ) PRFSENr ZONING/PROPOSID USE: C0,^VEFtCIAL/FtETAIL/0FFICE 0_R-1 SINGLE FAMILY ' INIDL'STRIAL ~ R-2 DLPLEX (Two L~nits) INSTI'IL'TIONAL/GOVERM4MT ~ R-3 ZOWNiOT-ISE (Three + Units Linits ) . ~ R-4 APARTMEN'T/CONDOMINIL'M ( Units ) M' . NAME 4J o r? ADDRESS:10J'dS- ~.'crfl y ~Qlc~cQ . CITY, STATE, ZIP h ri'e r ~-o i.e- S- PHONE: Z/-S-/ -jr-ySlv . 3) • u , For City L~se 1`?AME=-~~-~ Plumbers Li.cense: ADDRESS: - Active Exp1r2CZ CITY, STATE, ZIP: - "q,'-t .;2 3.- Not recorded PHONE: MASTER LICF,NSE# 002-St Initial • • ~ i~• . NAME:_ _ ADDRESS : /.C/ 3 CITY, STATE, ZIP: /e- 5, - _PHONE: ~~1 ~s-~do • i) 1:1 v• i•1 a• • DI• I •~k . OL-CONNECTION T0 CITY SEWEFt Qt-CONNDCTION TO CITY WATER ~ O'I'HER ~ • PLF.A.SE HOLD APPROVID PEPMIT F'OR PICK-UP BY ONE OF ABOVE ~ PLF.ASE MAIL APPROVED PERMIT TO 1, 2, 04, ABOVE : • (Circle one) v ~ • r: ?:i: ww ~ • ~ i- a~r •,a ~ r• ~u ~ • • y• U • V M ~ v M w~~~~ r~ r : s «:r• •,na~ ~ ~ 1 : - ~ • kijil :4 • • 4.11 I t • . t . FOR CITY USE ONLY . PERMIT # ISSL'ED Pd w/Bldg. Permit FEES: . $ $ SEWER PERMIT (INCLUDE SL'RCHARGE ) $ WATER PERMIT (INCLUDE SL'RCHARGE ) $ 6-~ S WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLL'DE CORPORATION STOP) ' - $ $ SEWER TAP ` $ $ ACCOLNT DEPOSIT - SEWER $ ACCOL'NT DEPOSIT - WATER $ ~ 2- WAC $ Z% $ SAC $ $ TRLNK WATER ASSESSMENT $ $ TRL'NK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRLNK SEWER . $ $ LATERAL BENEFIT/TRLNK WATER $ /k6` d Z $ WATER TREATMENT PLANT SLiRCHARGE $ $ ' OTHER: $ $ TOTAL - 7, 7/0 RECEIPT RECEIP DOES LTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY? a YES -IF YES, THEN A"PERMIT FOR WORK WITHIN PLBLIC Q ROADWAY" MLST BE ISSLED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY; TITLE: I DATE : ~ . c3 C F,7 ' PERMIT # RECEIPT DATE: PXSIDENTIAL PLiJ1K$INCi f ERIVIIT APPLICATION crrY oF E*sm 3$30 PILOT KAOB iiD E*fAlv, MN 55188 651-6$1-4675 Please complete for: ? singie family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for irrigation system SITE ADDRESS: OWNER NAMF: : 1-4p TELEPHORE (q,6.J- 4~'52- - 2 q-5 :1 (AREA CODE) INSTALLER NAME: ~..Q4~.. V,QV_rj.,p fVl..~<<uXTELEPHONE 5J_1 ,_~,3~'" Q STREET ADDRESS: cs~ (AREA CODE) CITY: STATE: JV_\.V\_j ZIP: 60 (0 Place a check mark next to the ermit work t e New residential dwelling unit under construction and not owner/occupied $ 90.00 ~ Add-on, modification or alteration to existina dwelling unit, including: $ 50.00 • abandonment of septic system • new installation/repair/rebuild of RPZ • lawn irrigation system • water~t ca nd ~ Nature of work: Septic System, new/refurbished - $ 225.00 • inc!udes Cou.^.ty & Gonsulting Ir,spectcr fees • requires MPC license State Surcharge $ .50 Total $ Reminder. Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicanYs responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property right-of- y/easement. SIGNAT OF PE ITTEE Updated 1/01 City of Eaaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5685 Fax: (651) 675-5694 Email: planningt citvofeaoan.com ZONING PERMIT APPLICATION For Office Use Permit #: Date Received: L o Please identify improvements on a scaled site plan drawing that shows lot lines, structures and existing conditions. PROPERTY Site Address: j` � Oji 5 7 i4 /d'rhe S s Cu r ti CONTACT/ Name: fr,`S Tovc r +thee pe. alit') Phone: 65/ -335 2/04 I PI, Ala vv).,fci Address: 7d1 D 5 41 Yl fi CYO e'x s+,#111 City/State/Zip: Qte,See.V �t 4)1 4$ 1/PZ/ 57121/ Applicant Signature: Date: 2 -- Email address: j 6 Ljv+ �A �atrosq-o chi. l i C . CcTh.i TYPE OF WORK etaining Wall <4 feet 0 Driveway 0 Other: 0 Patio 0 Sport Court 0 Sidewalk 0 Fence Description of work: (eplC(ee Old — hib 'r 4)a// PLANNING Setbacks, hard su ce coverage, shoreland zoning, bluff zones Approved: Notes: Date of Approval: ) — /2 Staff. 5., ?c. S /G H-tc(c•.0 ( EAU h.c.:ylwf vi-ta5V1 tom/ SrScp.e.ea_tt. 1 Revised Plans Approved: Yes / No Date of Approval: Staff: ENGINEERING Grading, drainage, utility easements, wetlands, erosion control, i prow Right -Way, e Approved: Notes: / No Date of Approval: 5/2 c/ -2 t3 / 2 Staff. Revised Plans Approved: Yes / No Date of Approval: Staff COMMENTS 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.00pherstateonecaliorq G:1Building Inspections\PERMIT APPLICATIONS\011VO11 Permit Applications ia57 J'J4efnes$ dvrve 5'4tV re Res to4q eephee `1 ember Rei, wed Pr's T ` 4 loic/cereS A r Zj®' ..�Br7f. of- W Il •.••;� %op oft i j.' pct // Tap oWall /001 (to, gr.S- 1.„c) fit I tielA N'1 2$4° L" g ZIP rfter � N " map oak 4.,.'"' 1 at, r N N: in rsi 1 J 40 ittos ciP• Am i .9J vb I X O• is O h u"' g r?rn —ID 2 D z m - _ m c r ISI 0 —1 0 -77 z I 1 I z 0 Fri0 U 0 D C 0 O m z n D I ri0 Cz m I C cin 0 D D --110 > N m Fri O `O> z < v 0 c mz 0 0 ;:7C = --1 ® 1-7-1 v D > 2) iz I'! ©fix 3c --I z Z z K D --I -0 2 o x •x cn m m C) 0 D D m x r— PERMIT City of Eagan Permit Type:Building Permit Number:EA118665 Date Issued:11/06/2013 Permit Category:ePermit Site Address: 1257 Wilderness Curve Lot:022 Block: 002 Addition: Wilderness Ponds PID:10-84275-02-220 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 500.00 Fee Summary:BL - Base Fee $500 $40.00 0801.4085 Surcharge - Based on Valuation $500 $0.50 9001.2195 $40.50 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 - Paul D Savre 1257 Wilderness Curve Eagan MN 55123 (651) 452-2457 J Carver Construction Inc 1345 Schletti St St. Paul MN 55117 (651) 645-5488 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA120447 Date Issued:02/11/2014 Permit Category:ePermit Site Address: 1257 Wilderness Curve Lot:022 Block: 002 Addition: Wilderness Ponds PID:10-84275-02-220 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - 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 by law in ALL single family homes . 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 - Paul D Savre 1257 Wilderness Curve Eagan MN 55123 (651) 452-2457 Sandau Construction 9925 Lyndale Avenue South Bloomington MN 55420 (952) 403-9100 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA125807 Date Issued:08/04/2014 Permit Category:ePermit Site Address: 1257 Wilderness Curve Lot:022 Block: 002 Addition: Wilderness Ponds PID:10-84275-02-220 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - 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 by law in ALL single family homes . Brett Ehret Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Paul D Savre 1257 Wilderness Curve Eagan MN 55123 Mastercraft Exteriors Inc 330 E Main St Suite 600 Rockton IL 61072 (815) 624-6840 Applicant/Permitee: Signature Issued By: Signature 09-14-15;02;47PM; ; # 2/ 2 Use BLUE or BLACK Ink �------ ---------i ' � Fo►Offico Usa I , � ��e�--�--; �� � City of Ea��Il ; Pe���#: � , , j Pertnit Feo: i 3830 Pilot Knob Road I � � '�, Eagan MN 55122 I Date Recelved: � I Phone:(651)675-5675 ' I FaX: (651)675-5694 � Statf: � II -----------------� 2015 RESIDENTIAL PLUMBING PERMIT APPLICATION !� Dato: ��� Slte Address:�ril/•�l��t/'/i�SS 1�L✓U� Tenant• Suite#: ResidentlOwner Name: �1/YP �i s�e/!t Phane: �, Address/Clty/Zlp. .3`'qA�e. Name• /� A-��e�'S ��eense#� S95/a3�� Contractor Address����/1 /`�^• Cicy: � State: �� Zlp: ���:�'+. Phone:,,�,$���=as� Conlact:_���'�"�^ EmaiL• � �r-rJ•CO� Type of Work —N°"' —' ReP'ycement _Repalr _Rebulld Modify Space _Work In R.O.W. Description of work: �L� ' -�E'v/�G �tt �- :�1 �'�'' RESIDENTIAL `S _Water Heater Lawn Irrigation(_RPZ/_PVB) Water Soflener Permit Type Add Plumbing Fixturos(_,Main/_Lowor Level) Septic System _New Water Tumaround _Abandonment RESIDENTIAL,FEES: 560.00 Water Heater,Water Softener, or Water Heater,�n Softene�(Includes State Surcharge) $60.00 LaW11 Itrigation(Includes State Surcharge) $60.00 Add Plumbing FixtureS,Septic_Svstem Abandonment,Water Turnaround`(includes State Surcharge) 'Water Turnaraund(add$210.00 if a 5/8"meler is required) S'115.00 Seotic Svsfem New(includes County fee and State Surcharge) TOTAL FEES S O� CALL BEFORE YOU DIG. Call�opher State One CaI1 a1(65'I)454-0002 for protection againsc underground utlilty damage. Call 48 heurs before you intend to dig lo recelve locetes of underground utilities. www.gouhe�stateonecali.org i hereby acknowledga that thls information is complete a�d accurate;lhat tha work wlll be in eonfortnanca wilh the ordlnances and eodes of tAe Clty o( Eagan; that I understand this is not a pertnif, but only an appilcatlon for a permit, and work Is nol lo staR wl�hout a pertnit; that tha work wili be In accordanee wlih tha appraved plan in the case of work which requires a reviaw and appraval of pl s. X �a�i- B?�1�. x App�cant's Printed ame Apptica t's Sign ro FOR OFFICE USE Reviewed By: Date: Requi�ed Inspections: Under Ground Rough-In Ait Test Gas Test Flnal Meter Related items: Meter Size Radio Read Manometer Staff; � � � I Use BLUE or BLACK ink '., r-----------------+ . '� I For Office Use � � � Permit#:�,�."]( 1'7� j Clty of ����� �s� . � l � �� � Permit Fee: t � 3830 Pilot Knob Road S, - � -'' � Eagan MN 55122 � Date Received: �' '�� � Phone: (651)675-5675 I I , Fax: (651)675-5694 i Staff: � I � ---------------- \ � 2015 RESIDENTIAL BUILDING PERMIT APPLICATION q,��b � � Date: Site Address: Unit#: ' �� Name: ��� �� r� � Phone: � �t�e�t�i��l � �� , 1,� . ��� � �� {,'���' Address/City/Zip: ' � �'�-� S l-(,�Oj. ; Applicant is: Owner ' �ontractor • . ��--- r Description of work: � � ( n(�'.QiC1l `� T�9�!:1��O�'�� --� ' Construction Cost: ��!{Z7"Cy �' Multi-Family Building'. (Yes /No� ' Com an : �j�iK�,�;�Ks�_ ��� Contact: V ''�`� ? p Y Ct?�t�C�Cti{�1` Address: �3�� �C�1Z;� i City: "---`"��'''�{{ State: 1�/V Zip: � �Z Phone: (�5��-�3�` � h� Email: C. �r`H� ����� License#: � � l�� Lead Certificate#: + If the project is exempt from lead certification, please explainswhy: ��\ 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: � . - • � , Fire Suppression Contractor: ` ° � " ' Phone: N�?T€:P���r��nd s�parl���cur��ant�t#��t,��c���►�i#a�re cc����er�d tv�e�b���#�r��ti�r�. 1'�0�0�ot' ' thei►r#�rmaf�vn��y�ie cla�s��d�s,�ort prr,bf�c if,y�u:prfl�i�l�s��c���.re�sv�t�t�vai�#d`per�a�t t�e:C�y t� cor�cic�al�e t1��� are�rad�s��nCs. ' 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.gopherstateoneca►I.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 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 ompleted within 180 days of permit issuance. X � ��I�C � X � ��s�� Applicant's Printe Name Applica gna re Page 1 of 3 ,��" l c��3p��� �' fa� � W���t`�f;SS (..u�D� NOT WRITE BELOW THIS LINE � SUB TYPES Foundation Fireplace Porch (3-Season) _ Exterior Alteration(Single Family) � Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi) Multi Deck Porch (Screen/Gazebo/Pergola) _ Miscellaneous 01 of Plex Lower Level Pool Accessory Building WORK TYPES _ Neyv _ Interior Improvement _ Siding _ Demolish Building'" Addition _ Move Building _ Reroof _ Demolish Interior � Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Damage Retaining Wall "`Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation 30p1j• Occupancy .L"/2G-/ MCES System ' Plan Review � Code Edition !!/� SAC Units ^ (25%_ 100% ✓ ) Zoning /Z�/ City Water � �-- Booster Pum � Census Code �34 Stories p #of Units _� Square Feet �'` PRV -- #of Buildings � Length �_ Fire Suppression Required � Type of Construction __,�� Width � REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) � Final/No C.O. Required Foundation � HVAC�Gas Service Test Gas Line Air Test Roof: Ice &Watec Final Pool:_Footings _,Air/Gas Tests _Final Framing Drain Tile Fireplace: _Rough In Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick Insulation Windows Sheathing Retaining Wall:_Footings! Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control , � Other: ��✓01.v�/L l�Ait�' �iYf��1D.lc%%rY Reviewed By: , Building Inspector RESIDENTIAL FEES _ J �� ,� �/!���� Q �.O �/� 02.7 � � Base Fee ��'i- Surcharge Plan Review �7 �-- MCES SAC City SAC Utility Connection Charge S8�W Permit&Surcharge Treatment Plant Copies ' TOTAL Page 2 of 3 : t `'For Office Use)5V1117 I I .� , * t•, Permit#: •,,*.. r0.X i r Pewit Fee' iei � .r.---t. 1 Date Received: -- I i 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 i' `s, (651)675-56751 TDD:(651)454-8535 I FAX (651)675-5694O U L 32018 I Staff "%'" ; kuildingi nsoectipnsacitvpfErapart.COm I `5 2018 RESIDENTIAL BUILDING PERMIT APPLICATION `1;x Date: 07/12/2018 Site Address: 1257 Wilderness Curve i DA Unit*: Paul & Nance SayPhone: Sayre 612-850-0653 =� Name: Address r City/Zip: 1257 Wilderness Curve, Eagan, MN . 123 I Apt,iicantis: Owner x Contractor Description of work: Bathroom Remodel Construction Cost: 5000 Multi-Family Building: (Yes' /No X ) Great Lakes Window & Siding Derek Company: Contact: I. Address: 14690 Galaxe Ave city: Apple Valley MN 55124 952-891-3400 derek. lwsco ma .com ili, State: Zip. Phone: Email: 9 1; License BC060427 Lead Certificate#: NAT-23297-2 If the project is exempt from lead certification, please explain why: 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: Fire Suppression Contractor: Phone: You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.comisubscribe. 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. CALL BEFORE YOU Dia Call Gopher State One Cali at(651)454.0002 for protection against underground utility damage: Cali 48 hours before you intend to dig to receive locates of underground utilities. www:000herstateonecaii.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 {', xapproved plan in the case of work which requires a review and approval of plans. 4� 3tx...,-Xtie f'" Applicant's Printed Name Applicant's Signa DO NOT WRITE BELOW THIS LINE SUB TYPES Y,, _ Foundation ` Fireplace _ Porch(3-Season) Exterior Alteration(Single Family) Single Family Garage _ Porch(4-Season) Exterior Alteration(Multi) r _ Multi _ Deck Porch(Screen/Gazebo/Pergola) — Miscellaneous I 01 of—Flex - Lower Level ____ Pool - Accessory Building WORK TYPES _ New Interior improvement _ Siding Demolish Building* _ Addition — Move Building T Reroof _ Demolish interior Alteration Fire Repair Windows _ Demolish Foundation Replace _ Repair — Egress Window _ Water Damage _ Retaining Wall *Demolition of entire building–give PCA handout to applicant; DESCRIPTION Valuation 0 (9' Occupancyju , MCES System Plan Review ( Code Edition t 1 I.J'r,C I)" SAC Units i (25% 100%Niv) Zoning City Water Census Code Stories Booster Pump . #of Units Square Feet PRV i #of Buildings Length Fire Suppression Required Type of Construction --"Vit-i— Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O.Required ? Footings(Addition) )(,. Final I No C.O.Required Foundation Foundation Before Backfill x HVAC Gas Service Test Gas Line Air Test Hood Roof: , Ice&Water .Final Pool: Footings _ Air/Gas Tests Final Framing 30'Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath Stone Lath Brick !EFIS 4 Insulation Windows Sheathing Retaining Wall: Footings,®,Backfill Final Sheetrock Radon Control Fire Walls Fire Suppression: Rough In_;Final Braced Walls Erosion Control XShower Pan Other: Reviewed By: 1 ,Building Inspector RESIDENTIAL FEES Base Fee Surcharge 14' Plan Review rip, MCES SAC Y)(1/\' City SAClikilt‘A°\,(1_, v Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies 4, TOTAL ' Page 2 of 3 1or Aug 22 18, 10:16a Cities 1 Plb&Htg 651-487-1474 p.2 , c For Office Use i S a s ea0 ® s / "� " ' r Permit*: / / / / aee• deo Permit Fee: � 0 O 3830 PILOT KNOB ROAD j EAGAN,MN 55122-1810 Date Received (651)675-5675)TDD:(651)454-8535 I FAX:(651)675-5694 Staff_ buildinoinspectionslacityofeagan.com L -' 2018 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: g/221ig Site Address: 12.57 W It vrieSS CU-vVe- Tenant: Suite#: Jt&.tte �vf� 1 Resident/Owner Name: r /� �P"hone: b51- yS�'�tf$`T Address I/City/Zip: 12. 7 W1 e vriess t�utvve-,f titaY1 MV 5c/23 Name: C rhes 1 Pi u. i to l'en ctiriot Lieafrill License#: 1R 6 439th ContractorAddress: I S 7 )"th bu,-d j�,Erl.(,t ei city: Si--PQ. I ry I State: YtiI1 1 Zip: SS-I()Li Phone: 6 SI 97&4 547 Contact: I(D CO MG-Y3 Email: r ig-I/("0 Of)�' i 7"(e- / plumy(y( tA9- Type of Work New rt'Replacement _Repairer V Rebuild —Modify Space Work in R.O.W. Po� n r 1 r ' Description of work:5I10W(X 7Tt'T3 Shoe)/COnye ion. � j(neg./ avi. �,:1- p+ t & RESIDENTIAL -TOY V0..►�w`I1�.Si n K. t Water Heater 0 I Lawn Irrigation( RPZ/ PVB) i Water Softener t Permit Type — I Septic System k Add Plumbing Fixtures( X Main/_Lower Level) i New Water Turnaround 1 Abandonment I RESIDENTIAL FEES: ' $60.00 Water Heater,Water Softener,or Water Heater and Softener(includes State Surcharge)1 $60.00 Lawn Irrigation(includes State Surcharge) I i $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) 1 *Water Turnaround(add$280.00 if a 3t4"meter is required) '' II , $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ I"iJo.n 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.orq You may subscribe to receive art electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeeagan.com/subscribe. f 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�ofyplans. x CCivo i C6vt roucL x (;Q 4,_e _ 6-71.A.01,6e_ Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final Meter Related Items: Meter Size Radio Read Manometer Staff: