3816 Willow Way
CITY OF EAGAN ~T
3830 Pilot Krab Rosd, P.O. Box 21-199, Eagan, MN 55121 N Oo 9003
PHONE: 454-8100
BUILDING PERMIT RKeiat #
To M wnd for P I: T' X Est. Volue Dote ' T, 75 19
Site Address 3? 1~, ti'~ T LLOj' '".'I? Y E~ " R:~
OccupanCy
Lot (-1 Blcek I Sec/Sub. r~I/11ter 0 Zonirq -
Parcel No. IC-19 99 3-F 3 0-01 Repoir ? Firc Zone
T'')J,T.?"FS01`' T'sI,D?C Enlaroe ? TYPeofCanst.
aWC Name ~ Move p „ # Storie~
~
Address ~y Demolish p Length
City Phone ~ Grade Q Depth ~ Sq, Ft.
Approvals Fees
~ Nane _ . U 0
OU Address Assessment Permit
1-- City Phone Wofer 8 Sew. Surchorpe i
---r~~ ~
Police Plon check "
uce G W Name Firo SAC .00
Address Eny, Water Conn. • 0 0
~ W City Phone Plonner Water Meter
Council Rood Unit
I hereby acknowledqe fhot I have road this opplicotion and state fhat Bldp. Off.
the informotion fs oorrect and agree to wmply with all applicebla ^PC Taol
Stote of Minnesoto Stotutes and City of Eagan Ordinonces.
Signafurc of Permittes
A Building PeRnit is isswd to: an.the axpress condition thni
oll work shall be ne iry ocpordante wifh og;dp-t1dicable Sfofe of Minnesota Stotutes ond City of Eapan Ordinonca.
.-G~1 _
Bulldinp OffiNot -
Permit No. Permit Holdsr Miac. Permit No. Holder
Plumbing y a 9
H.V.A.C. Y2 1'IC£Oe Cl~ 10I~-11a,
w.u
Disp.
Sswer
Electric 23 -!g
Inspection Date Insp. Other
Footingt 4• I ~ = l71Z
Foundation
Fnminq
Rouph Plbp.
Rougohi HVA
Inwlation ~
6
Final Pibp.
Final HVAC ~
Final .j 0-
Wmer Dacribe Location:
YVell
Sewsr
Pr. Disp.
, . . .
,
A CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagsn, MN 55121 N4 9094
PHONE: 454-8100 r
RUILDING PERMIT aeceipr #
Te M wed for 1 O F 4 P L 1; :ti Est. Value 3 ri , 0 0 G pme 1 1, 2 5 lq ~4
Site Address 3 `'l 8 W 7 LLO6; AY Erect 0 ~~upancy R 3
Lot Blcek 1 SecISub. BRZARHILL 4 qlter ? Zoninp
Parcel No. 10 -14 9 9 3- 6 4 0- O J. Repoir 0 Firc Zone
~Lnr c Enlarqe p Type of Const.
oe r~ Name nLJ~]?FSO'~1 , Move D # Srories
i 1655 r~~OR.•1o0D nr? 4 11~
Address Demotish ? Leng[h
~ City T' n(;A1Q phone 4 5 4- 6 R 7 3 Grode
? Depth Sq. Ft.
oe r, AN j' APProvais Faa
z~ Name
Addresa Assessment Permit r
ou
v~ City Phone Water & Sew. Surchorpe 1 1~'•~ ~
Police Plan check y a`''' )
~ W Name Ffro SAC 5 2 5. 0')
u~ Address Enp. Woter Conn. 170.00
gxW City Phone Plonner Woter Meter
Council Road Unit -777' oo.
1 hereby otknowledge that I hove reed this opplication and state that gldg. Off.
the inlormotion is correct and ogree to tAmply with oll applicabls A~ T«a~ , ~~"i 11 . 5')
State of Minnesoto Stotutes and Cify of Eogon Ordinances.
Sipnoturc of Pertnittee
A Building Permit is issuesl-4o:. i+.T,I: i;: on the express condlTion tFxii
oll work shall be done ie{ pcrrdonce with alt~applicable Stote of Minnesoto Statutet nnd Ciry of Eoflan Ordinonces.
Buildiny Offitiol ~ ( ' ?
Permit No. Permit Holder Mise. Permit No. Holder
f'`_'
Plumbing ~~r+2
H.V.A.C. ~ ~ AI~ICKSo &Idl~~ ~
Well
Water
Disp.
Sewer
ENctrie
Inapsction Dats IOther
Footings L{-!~ -Q Y Foundation ~ Framinp Fto
• d~ i
uph Plbp.
X't
Rouph HVA ~
~nsulnian
7~31~~
Final P16p. /Z• ~
Finai HVAC j.
Final d~ ~ ~ -
Water Dsscribe Loeation:
4Ve11 ~
Sewar
Pr. Disp.
. . . _
' CITY OF EAGAN
„ J830 Pilot Knob Road, P.O. Box 21-199, Eayem, MN 55121 N~ 91~~ ~
- PHONE: 454-8100 ~
BUILDING PERAAIT - Receipt
To M w~d fee 1 OF 4 PLF;ti' Value , 000 Dote A?R I L 25
3820 ~~ILLOin' ~~',~Y' R3
site naareaa Erect 6 Occuponcy
1 f3i.:Ln:,.irr_,L 4 Lot Block ~/Sub. Alter Q Zoning . N/A
Percel No. 10 -14 9 9 3- h 10 - G 1 - Repoir 0 Firc Zone
.
TOLLs~l':~C~" AI,DRS. Enlaroe ? Type oF Const.
W Name Move ? # Storie~
Z Address 1~i S_`; ';O~'.f''OC~D 1'R Demolish p Length_,r_
~ Ctt F. n,( e~,i'' Phone Q S,~ - 687 j
y 6rode ? Depth 5 Sq. Ft.
Approrah Fees
A Neme ~ _ 7y . ;
ul A~~s Assessment Permit 19 0
~ City Phone Woter 3 Sew. Surchorpe
Police Plan check 1111.50
_23 .OU
W Name
F W Fim SAC
Address Enp, Water Conn. 470.60
CZ W City Phone plan~r Woter Meter G 3. 0 G
Council Road Unit 25 0. 00
I hereby acknowledge that I have reod this applicotion ond state thct Bipf{,
the inlormation is correct and agree to comply wifh oll applicoble TaQ~ _ TT-. ~1
$tote of Minnewta $totutes ond City of Eagon Ordinances. ,
Sipnoture of Pem+ittee
'I'~ ~,L' ;;Ol;
A Bullding Permit Is issued to: . . on the express cadition that
oIt work sholl be done in oc~onc* with ell opp!!Pble $tate of Minnesota Statutes and Ciry of Eognn Ordinonces.
Buildinp OfHciol ~ ~ ~ `'`1 ` • ~
E. Parmit No. Permit FFoldrr Misc. Permit No. Holder
Plumbin9 `t
H.V.A.C. 4 1/ b~ Q GK I,~ ~
YWII
Watsr
Disp.
Sawar '
~Etectric
Irupaction Dm Insp. Other
Footino ~ • ~ - ~ ~
Foundation
Framing 7
Rouyh Plbp.
Rouqh HVA -
Inwlation
Final Plbg. c
Final HVAC 3 jy
Final
Wat~r a~ibe Location:
weu '
5ewer
Pr. Disp. ~
. . . ,
~ t CITY OF EAGAN
~ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N00 9001;
° PHONE: 454-8100
BUILDING PERMIT Re«ipt # L/
Te w wMd fer 1 OF 9 'L 1; X Est. Vol ue .i O O G Date AF R I', 25 , 1 q f; 4
SiteAddrese 3'v'22 WILL(-):; j,'AY Erect Occupancy 3
Lot ~ Qlock 1 Sub. BR I~~,n I i~~ T,L Alter ? Zoniny t 1' ' i
Parcel No. 9- 6~O - O 1 Repotr ? Fire Zone
T(-,r,LFFF,n;'i BLr)?., Enlaroe ? TYPe of Const. v
oc
W Name Move ? # Stories
11Tl
Z (,r• ~
Address )C}r' ~J Demoliah p Length
~ City Pnone 4 5 4- G 8 7 3 Grode ? Depth Sq. Ft.
APprorab Fees
o Name
74
ou Addreas /lssessment Permit '
u?- City Phone Water 8 Scw. Surchorpe 1
Police Plan check 114 C~
a r~
y~W Neme Firo SAC O
x~ Addrese Enp. Wote? Conn. • 0 0
WZ, City Phone plan~r Wnter Meter ~ fi G ~
Council Rood Unit
1 hereby acknowled9e that I hove reod this applicotion and stote that BI . Off.
the inlormofion is wrrect and agree to comply wifh all upplicoble T~a~ .~I- n
State of Minnesoto Stotutes and City of Eugon Ordinonces.
Slynaturc of Permittee
A Bufiding Pertnit is issued t• t~1~nr~,~ on the express condition thn?
oll work sholl be done i oooordorlce~ oll opplitoble $toTe of Minnesofa Stotutes and City of Eopan Ordinonces.
Buildinp Official ~ s"J
Permit No. Permit Holder Misc. Permit No. Holder
C \1
f~£D~ Ic Kso ~l~g y
p~we
E lectric
Inspection Date Insp. Other
Footings Vr)Q
Foundation
Framing k
Rouph Plbp.
Rouph HVAC
Inwlation 71
Final Plbg. ~
Final HVAC
Final 3
Waur Dsscribe Location:
1Ne11
Nr
Sewsr
/
Pr. Oiap.
CITY OF EAGAN Remarks
i4ddition BRIAR HILL 4TH ADDN Lot 63 gIk 1 Parcel 10-14993-630-01
Owner street 3816 WILLQW WAY state EAGAN AN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. loz, 1971 Paid under original-Pircel
STREET RESTOR. 1975 70.69 7.07 10 aid
RRMRM Street 1984 1227.78 245.56 5 982.23 A014545 9-11-84
**S w r Lateral 1984 2136.20 427.24 1708.96 " "
SAN SEW TRUNK 46 1968 29.60 .99 30 12.94 " "
SEWERLATERAL TRK Z 1983 237.37 23.74 10 189.91 " "
*SEWER LATERAL 101 1971 32.42 1.62 20 9.74 " "
**WATERMAIN 1984 5
*WATEFi LATERAL 197j 20
WATER AREA ~bg 1977 59.19 3.95 IS 27.67 **STu s 1984
STORM SEW TRK 1984 323.50 64.70 5 258.80 *STORM SEW LAT 1971 20
**Storm Sew Lat 1984 5
CURB & GUTTER
SIOEWALK
STREET~'*9W 1009 1986 153.70 15.37 10 53. U - dJT i0 -
ROAD UNIT 260.00 #42796 4-25-84
WATER CONN. 470.00 11 it
BUILDING PER.
n n 9005 SAC
PARK
CITY OF EAGAN Remarks
Addition BRIAR HILL 4TH ADDN Lot 64 Rik 1 Parcel 10-14993-640-01
Owner Street 3818 WILLOW WAY State EAW MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURf.
STREET RESTOR. -
~~~RM Street 198 1227.78 245,56 _/36
**SEwer Lat r Q 1984 2136.20 2 r' Z
SAN SEW TRUNK (o
SEWER LATERAL TRK Z5 1983 237.37 .
* Z
**WATERMAIN 1984 5
+t WATER LATERAL 1971
WATER AREA
**Stubs 1984
STORM SEW TRK g'j 1984 323.50 64.70 5 ~9
*STORM SEW LAT 1971 20
**STorm Sew Lat 1984 S
CURB & GUTTER
SIDEWALK
STREET
ROAD UNIT 260.00 #42796 4-25-84
WATER CONN. 470.00 11 IF
BUILDING PER. to QnQ6 SAC 995-00 ri
PARK
CITY DF EAGAN Remarks
Addition BRIAR HILL 4TH ADDN Lot 61 eIk 1 Parcel 10-14993-610-01
owner Street 3820 wILLOW WAY state EAGAN MV 55122
Improvement Daie Amount Annual Years Payment Receipt Date
STFiEETSURF, ji 1971 P 1 T. 1
STREET RESTOR. 7 197$ 70.69 7.07 10 paid
#9CADQIM Street 1984 1227.78 245.56 5 - 82,23 A014544 9-11-84
**Sewer Lateral 8Zq 1984 2 36.20 427.24 5
SAN SEW TRUNK 1968 29.60 .99 30 --84
SEWERLATERAL TRK 1983 237.37 23.74 10
*SEWER LATERAL 1971 32.42 1.62 20
**WATERMAIN 1984 $
* WATER LATERAL 1971 20
WATER AREA 1977 59.19 3,9$ 1$ 9-11-84
1984 5
STORMSEW TRK 1984 323 50 6.70 5 258.80 A014544 9-11-84
*STORM SEW LAT 1971 ZO
**S o 1984 5
CURB & GUTTER
SIDEWALK
STREETttQfTf 1009 1986 153.70 15.37 10 'f-33. U 4-~5-
260.00 #42796 4-25-84
WATER CONN. 470.00 if
9UILDING PER. 9003
sAC 525.00 " PARK
CITY OF EAGAN Remarks
Addition BRIAR HILL 4TH ADDN Lat 62 Blk 1 Parcel 10-14993-620-01
Owner Street 3822 RLL0Yd_'WAX f/:: State EAGAN NIlN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF, fQZ 1971 Paid und ori inal r el
STREETRESTQR. 1975 70.69 7.07 10 PAID
~RMRM STreet 530 1984 1227.78 245.565 982.23 A014438 8-16-8
**SEwer Lateral $Z 1984 2136.20 427.24 5 1708.96 g 8-16-84
SAN 5EW TRUNK Z/O 1968 29.60 .99 30 12.94 0 438 8-16-84
SEWERLATERAL TRK 2 1983 237.37 23.74 0
*SEWER LATERAL 1971 32.42 1.62 20 74 443 8-1 -8
**WATERMAIN 1984 $
* WATER LATERAL 1971 ZO
WATER AREA 1977 59.19 3.95 15 27.67 A014438 8-16-84
**Stubs 1984 5
STORMSEW TRK 1984 323.50 64.74 5 258.80 A014438 8-16-54
*STORMSEW LAT 1971 20
**Storm Sew Lat 1984 5
CURB & GUTTER
SIDEWALK
STREET'tF6tiT 1009 1986 153.70 15.37 10 153.70 /o-
ROAD UNIT 260.00 42746 4-25-84
WATER CONN, 470.00 " "
8UILDING PER. 9004
sac 525.00
PARK
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN Fee
Fill in numbered spaces S/C
Type or Prrnt legib/y
Tot.
1. Date f V 2. Installation Cost
, (O,i
3. Job Address 3~~.~ f-v~~~p~c~~~4+ y Lot Blk. Tract ~
4. OwnerJ~~EFScA-) \Z'~.uL~.~~~ ;
5. Contractor Phone
6. Address
-
7. City State Zip 1 2
8. Building Type: Residential Q. Commercial ? Institutional ~
9. Work Description: New P" Add ? Alter ? Repair ?
10. Describe Fuel Type
11. No. Equioment 9TU - M. Ea. No. Equipment CFM
' Forced Air Air Handling:
Mfg.
Boilers
Mech. Exhaust
Mfg.
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outleu
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.
--r
Signed :
for
Rough Final
lnspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454,8100
Receipt ~16; l0' PLUMBING PERMIT Permit No.
CITY OF EAGAN
. Fee ~
F Fil1 in numbered spaces 5/C
Type or Print legibly
Tot.
1. Date ' - ~ Z- 2. Installation Cost
J ~
- . . _r. . f . ~ i , .
3. Job Address Lot ` Blk. ' Tract ~
~
4. Owner
5. Contractor ~Z - 6Yil4c l Phone •i'.:; /9 y~ j'
6. Address 7 /iCir/'~-.
7. City State Zip
8. Building Type: Residential Commercial ? Institutional ?
9. Work Description: New Add O Alter ? Repair ?
10. Describe
11. No. Fixtures No. Fixtures
Water Closet Cesspool/Drainfield
~ Bath tubs Sep#ic Tank
1 Lavatory Softner
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 : 1. • ~
for
Rough Final
Inspection5: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-6100
Receipt MECHANICAL PERMIT Permit No,
CITY OF EAGAN
Fee
Fill in numbered spaces S/C
Type or Prini legib/y
Tot.
1. Date 2. Instaliation Cost
3. Job Address Lot 81k. Tract
4. Owner
5. Contractor Phone
6. Address
7, City State 2ip
8. Building Type: Residential 0 Commercial ? Institutional ?
9. Work Description: New El Add ? Alter ? Repair ?
10. Describe Fuel TYpe
11, No. Equioment STU - M. Ea. No. EQUiament 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 1 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 numhered and approved.
Approved CITY OF EAGAN 454-8100
Receipt ~1' t0 PLUMBING PERMIT Permit No.
CITY OF EAGAN Fee
Fill in numbered spaces S/C
Type or PirnL legibl y Tot.
1. Date 2. Installation Cost '
3. Job Addre s , IJ I J Lot - Blk. ~ Tract ~
4. Owner
5. Contractor Phone
6. Address • , f- - ~ /~Zic 7 -
. - ;
7. City State ? ~:•l Zip
8. Building Type: Residential Commercial 0 Institutional ?
9. Work Description: New Add ? Alter ? Repair ?
10. Describe
11. No. Fixtures No. Fixtures
Water Closet Cesspool/Drainfield
' Bath tubs Septic Tank
Lavatory Softner
Shower Well
1 Kitchen Sink
Urinal/Bidet Other
Laundry Tray
~ Floor Drains
Drinking Ftn. j Siop 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 : f0r
Rough Fina)
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Receipt MECHANICAL PERMIT Permit No. ~
CITY OF EAGAN Fee
Fill in numbered spaces S/C
Type or Prinr legibly
Tot
1. Date 2. Installation Cost
3. Job Address '.~ot Bik. T'ract
4. Owner - • 5. Contractor ' ' r : ~ ` ,C .c,• ~ Phone
6. Address " " ` ~ ~ ' ` •
7. City State 2ip
8. Building Type: Residential C~l Commercial ~ Institutional O
9. Work Description: New C~1 Add O Alter O Repair ?
10. Describe Fuel Type
11. No. Eauioment 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 454-8100
.
INSPECTIQN~.RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: E~ i•,
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
1 J,4 140„33 f_ 'SU e~ 1
SITEADDRESS: I r I<t 0~ APPLICANT:
I t i k I Wi i.1AY I ItIN 'tl
PEF*T,$UBTXPq: , TYPE OF WORK:
INSPECTION .
NI Mfl;: h ( 14, I 1 1 1 ~1 N1~
1.64 J
F
L
~1
Pertnit No. Permit Holder Date Telephone N
ELECTRIC
PLUMBING
HVAC
Inapection Data Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
~
CASH RECEIPT
CITY OF EAGAN ` t
,
P. O. BOX 21-199
EAGAN, MINNESOTA 55121
DATE 19
neceiveu
FROM
AMOUNT $ I
6 DOLLARS
~oo
~ CASH ? CHECK
FOR
FUND CODE AMOUNT
f
Thank You
6Y
White-PaVers Copy
Yellow-Posting Copy
Pink-File CopV
~
CASH R EC E I PT
CITY OF EAGAN
P. O. BOX 21-199
EAGAN, MINNESOTA 55121
.
DATE 18 RECtIVED
FROM
AMOUNT $ ~
~
& DOLLARS
~oo
CASH -alCFiECK
.
'i
S~~' i~ L, '
FUND CODE AIAOUNT
1
~ J y
~t
~
. - .
Thank You a v
White-Payers Copy
Yellow-Posting Copy
Pink-File CopY
CORRECTION 11(aTICE
DA'FE:
~
Addre ~ Site Name
Owner/Agent Telephone
Owner/Agent Ad ress
Ordinance Nos. and Correctians 9correct By
< < ~
Far reinspection
Eagan Dept. of Inspection InSpe I': ,
3795 Pilot Kno6 Rd.
Eagan, Minnesota 55122
454-8100 Dept.:
CITY OF EAGAN SEWER SERIIICE pEWj
3830 Pilot ICnob Roihd pERAIT NO•: .
P. O. Box 21-199 D^TE:
Eagan, MN 55121 No, o{ Units: ZOr1iflQ: ~ ,,r, ~ - t_
~ -
oM/1Mr-
A,ddrcss: . . ~ j "
Slte Addross:
Plumber.
~ ~ ~ ~ ~ y~~
M*~• Connectiw+ Ch~-
1 tO °0'r~hr /?ccount D°0osw.
OrilMnas. Permit Fes:
Surdwi'W,
Misc. G+orO°s:
BY TaRol: .
p4te of Insp.: 134" paid;
1~W: -
CITY OF EAGAM WATER SERVICE PERMIT
3830 Pilot Knob '-ibad pERMIT NO.:
P. Q. Box 21199
. DATE:
Eagan, MN 55,7,~1 u='-
No. of Units:
zo~+?nfl: ;o ~fson 11 u r.crs
pwner.
T t.
Mdre:s: - L 2
~ ~ ~ 2 ;illc.~ ;,av i
Site /?ddress:
i:r:'nz
Plumber: Connection Charye:
Meter No.: ' P
AcoouM Deposit: , , p
Siu: permit Fee:
Reader No.: • ~ F
~ ~ ~ ~y~o Surchar9e:
~ ~ Til Z'
I M~ to eomPh Misc. Charoes:
_ M~ ~
Torol: horn
Dote Paid:
BY Insp.:
Date of Insp.:
_.,,r.,._.
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road PERMIT NO.:
P. O. Box 2119? DATE: Esgan, MN 55121 un it
t n t:> ^
Zaninp: No. af Units:
Owner.
Address:
-
Site Mdrcss: '
-'.vt.;~
PlN111ber. rx:c
Meter No.: Connedion Charge: 4 15 . OU p~
Size: Account Deposit: 10.04 pd
Recder No.: Permit Fee: . SO pd
1gqm fo eamoh wkb !M City of Eps• Surchar9e:
Misc. Choryes:
Ordineecr.
Totnl: • . OrSl
Date Paid:
By
Date of Insp.: Insp.:
-
CITY OF EAGAN SEVVER SEMCE pERM
3830 Pilot Knoh Road Jr,
PERMIT NO.: _.,_.r
P. O. Box 21199
Eagan, MN 55121 ~ATE` 7:~ i t
ZorJng: Na of Units:
OvVf1or:
Address: 7~ i a r 1: i ji jt'-._
Site /lddross: ~ ~ ~ -11 y '`i 1
~enz P_van pc.
Plumber. , , • ~
, . . ' . _ 7 -
y': , OC PC~
1 pne to esnnVy' wiN+ !IN Gtf? of Ea~on Connection {harpe: 1.~ .'a0 pa
o.~i..~... ~M o.~: ~;:~.ao pa
~mat F..: . ~o
surci,aro.:
By Misc. Charoes:
Date of Insp.: Totol:
InsR: Oaft Paid:
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road • P. O. Box 21199 - PERMIT NO.:
Eagan, MN 55121 DATE:
Zoninp ' No. of Units: T1711t
-
ner. 3 a,E r S
;y
te ~i~ddmss. 7 r r i r Fi_ ' 1
I r No.: 3~~ 1,2 b° z r q ~ction Charye: 4 7 0 0'.J 1.
~ ~ . • i i ~~.J 0 1 ~unt Deposit: I 5 .•0 n
Reode No.: I} 3 L- 3 Y S ~ e, Pertnit Fee: 10. Ol~ j~~
I aorse to * vrilU Nw Cit~? of Eoy~n Surcharge: .50 jx1,
O.dina Mlac. Chorpes: E~•~ n pd m t r
Totol: hQ -n
gy Date Paid:
Date of I nsp.: J/~ / G•.,( _ I rap.:
T
- ~
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Kno6 4oad
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: ' Zoning: No. of Units: 1 l; 1 t t.: i'~ . E'
4wner.
Address:
Site Address: O'..
Plumber. •
Meter No.: Connedion Chorge: ' ~ • o rj
~ . r`) nri
Siu: /lccount Deposit:
Reader No.: Permit Fee:
1agroe to ooroply wieb 1hs Gty of Eagan Surcharge: pci
Ordiuanoa. Mlsc. Charges: 5 3• 0 0 X` u": t Z'
Totnl: }i~.n-
By Date Pcid:
Date of Insp.: Insp.:
CITY OF EAGAN SEINER SERVICE PERMIT
3830 Pitot Knob !'oad
P. O. Box 21199 PERMIT NO.: '
Eagan, MN 551g1 p^TE;
Zoninp: No. of Units: 1llni t•c
01Nnlf: U:: I ~ i: r..
/lddress:
Stre Add.ess. _ 3 c 1-?~li 1 loor ~ti av L~~' n 1''ri ar r'i I I .S tt,
'
Plumber i r
rt--~z?
, lnf)
1 yn~ te eo~y wieh e1e qty ef Eevs• Connection Chor~pe: 42'' .00 P;3
Ordis.eas. Account Depo:it: 15. 00 pd
Pertnit Fee: 10.00 Pci
SurchorDe: . 50 Pd
By Mise. Chorpes:
Date of (nsp.: Totol:
I nsp.: Date Pald:
CIT1` OF EAGAN WATER SERVICE PERMIT ~
3830 k'il t Knob Rosd I
P. O. Box 21199 PERMIT NO.: 54 4
Eagan, MN 55121 DATE: 5' 1-~1 t+ ~
Zoning: F r No. of Units: 1 tulit t:1?' ~ F
Owner: T'n 1 1 ci z..,.
I rcss: . . . ite Address• 4fi1-
a r fT i 1 1
Plumber: l C•:~
~tee: re. No.:.~ vz5 g' w_ 'ttteition Chorfle: 4~ 7 Cl n n
L.
~ ~ i4ccount oepostt: 15. pd
, R r No.: 6 ~~S 3~_ Permit Fee: - 10.00 pd
I a9mg !e eon1* wkb tb Ciryr of Eagen Surchorge: .50 pd
; Ordil10~ ~ Misc. Chorpes: 6 1 _ n n r' m tr
~ ~ Totai:
' By, -'Date Paid: • o r n
I~ Date of Insp.: 1nsp.:
CITY OF EAGAN WATER SERVICE PERMIT
383f.Pilo: hnob Road p~RMIT NO.: P. Q. Box 21199 5-1- >4
Eagan, MN 55121 DATE:
Zoning: n i t t n~ c~'
No. of Units:
~,Oi1.E` 'UE'1'S
fESS:
ite Address: 7
P'lumber: , r` ".A 11.,.w
~ crge:
Meter No.: -3 ~r G'~~ ~ { .,-•--.-r =r Co~apectian Ch
, r
DeP~t. ` ~,c~.
ize: i ' ,r d , _ i^ A nt : ,
Reader No.: Fee: .
50 nu
1 ag~ to aomply whl~ !be Citr of Eegon . Surcharge: i' c.
Misc. Choroes: h G r ff:
otal:
Ord7L:~~c
cid:
BY te P
Date of Insp.: Irisp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot K`hob Road p~~~T NO.•
P. O. Box 21199 ' - ,
Eagan, MN 55121 DATE: 'u. r21. t. t t11~ sc,
Zoninp: No. of Units:
Owner. 'd
Mdress: . I•~ t;t<~ r ~
n1 ~riax i;i1.] t
fi 1 ot~,
Site Addross:
C~Cri.Z ,:31t3II
Piumber: r • p F ~ r, ~1 ~ n rt j.,
,
~ ~
A h
1 yne !o co~nplf? wila tIN p!1? of Epes Connection Charqs: i
Acco~mt Deposit: 15.0 p
O?din~nas. r' . (l €7 pd
Pem,R Fas: .
Surehorpe: SO »d
.
By Miac. Chorges:
Date of Insp.: Total:
Insp.: DaM Paid:
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Krv~b Road • •
P. Q. SoX 11 i99 PERMIT NO.: 4`+ 5
Eagan, MN 55121 DATE: 5-
Zonin9: Na. of Units: T - t
nEr: ~:,r#'F-c`f°_ c' F,i"i'•~ c7 e~"S
ress: _
ite Addres4i r• ih~av. `'M4 P 1 P ri c7 r= i l I 4 t~
Piumber: . ~~?Il? }'~•~,3z .
~N~ter No.: 2 V0 ~ 2 3 g' lo ' :Gonnection Charge: '..777 ~ 0 n
Size: ~ - - - /1ecour~t Deposit:
Reod r No.: l~ 3 3~~z ~z ;z permit Fee• ' tili P
1 pnae to comply w1Nh Na Cihr of Eagew Surdh
orge: pC
Ordiwan " Misc. Chorges: r3•o0 F~C.
Totol: -
?i
BY Qate Paid:
Date of Insp.: ~ Insp,;
CITY OF EAGAN
} 3830 Pilot Kno6 Road, P.O. Box 21•199, Eagan, MN 55121 ~T
1~I ~ 9003
PHONE: 454-8700 ~
BUILDING PERMIT Receipt
Ta 60 YNA IOr 1 OF 4 PLEX Esr.Value $38,000 pate APRIL 25 , 19 84
SiteAddress 3816 WILLOW WAY Erett 15X ~~upoMy R3
Lot 63 giock 1 SedSub. RRTARHTi.i. 4 Alter ? Zoning 3S3 lPi1)
ParcelNo. 10-14993-630-01 Repoir ? FlreZone N/A
Enlarge ? Tvce of Const. V
rc Name TOLLEFSON BLDRS Move ? # Slories
Z Address 1655 NORWOOD DR Demolish ? Length 44
~ City EAGAN Phane 454-6873 Gmde ? Depth 26 Sq. Ft.-
SAME ADVrovala Faea
o Name
o~ Address Assessment Permit $ 2 29 . 0 0
CitY Phane Water 8 Sew. SurcFwrge 1 g-B~
F Police Plon check 114.50
ww Name Fire SAC 525.00
~
_2 Address Enq. Water Conn. 470.00
~ city vnone 63.00
~W Plonner WorerMeter
Council Road Unit 260.00
I hereby acknowledge that I have read this opplicotion ond state that Bldg. Off.
the information is correct and agree fo comply with all oDDlicable APC Totol $1 , 680.50
State of Minnewta $totutes and City of Eagan Ordinances.
Signature of Permittee
TOLLEFSON SLDRS on the ex ress condition thm
A Building Permit Is is to: P
oll work sholi be ne i a rd ame w h al~ 'coble Stafe of Minnesoto Statutes ond City of Eagon Ordinancea.
8uilding Official ~V`t
CITY CY' FAl'~AN Irrlude Z sete of plang, -
BUIIDING PEAM2T APPLICATION 1 aite plan v/elevaticna
1 set of erietqy calwlat3aM.
:To Be udea For AMM.ValUatiOn 3~raao nate &,nriI iG
ssce
aFFILE USF QVL.Y
. 1Ot(2116LO810Ck I_ ;W./JI]b.
j
ErecPar~aal - O / Alte,rt h zonin9 3
~ Owne=i 520. 7y AnA) - AePair Fire Tone
qe _ Rypa of Cbnst.
# Stnrie9
; atir/ue aoae: _ GradeFrMt
Pham 1: Depth ft'
~ CottCtaCtGCt APPIi0NAL3 p~ .
~ Assessrer,re pernuc ~a9
; aaaruaa: ~ ce~~ s~~--
atY/~A Qx3e: ~(A~it ~ JGS~aio~ Fire plan Q~eclc Y~-
SAC
; • I'!rna i : rl~aruker Water Cann, ~U - '
Watet Metet
' At'ch./FYrg. s Couricil R3ad Unit
~ Acir3xeras • 8ld9. off.~~
APC
~ atY/Zip Code:'__
9
10TAL
_
~ . , . S .
11 • {fi]AN lIYlude 2 BEti YL piane
~ V $
site plan w/elevatians i
&1IIDIw PEIihIIT APPISCATION 1 eet Of erwxW CalqAUticy.
. ab Be ueed btor valuatton }ao aarr K_h~Yi I IG,
' Stte hddteee ~FI~ USF Qii.Y
~ Iote BlOdc I_ Sec./Sub. FYeCt ~ O=vparicy
a ~
nicer zoni„y
' n.e,` AeL~air Fire ?one ~
1YPe of Const.
Addrusa. Movie N SGOrieB
DarolieT'~ ? Fmnt ~
; atY/Z1P Ow@. - Grade Depth 06 ft.
' Fhone
~ ~~~~vr ~ APPAOVAIS 6~'i '
~ OOnttaCb~ari ~pfJ.rk Assessmnte Pendt
~
i Addresas 11~L~ IvrrnA/~/~'',l, l~Yi Z PoLio%~r r~ Z
'atY/ZiP dude: ~QG1/,1M J 55/0~ o~ Fire SAC
i Ptxm i: Eri3. water Crnn, v. ,
~ Planner Wdtelc Net@s
71 '
' rd?./EYr3. s Ca.v~cil R~ad Unit ~
I Hldg, Off.' ~ ,
Addreras • AFC
~ atY/2ip Code: • _
o .
Phow'+: o, 5 0
, . ~
CITY---- CY^-_FA(''M
Include 2 sets of piang,
~i ~ ~ BUII1]II~G PEAMIT APPL.ICATION 1 site plan w/elevatians i '
• ' 1 eet of er~r ~~~cy.
. 'ib Be Ueed ~O~ y~,... Q fbr \taluation 0'3 .
~ Siate ~Rdd.teee MS~o nate A I G 19~-
USE QJLY
~ yptbJ= ',Bl,pcC ' CFFI~-
6~ L_ SeC./Sub. EYect
i r.~ t: r~~ Y' ~ 3-,o,o
;
Fire 2or~e ,r, a
' ~~s ~JB _ ZYPa of Oonet. _ Move .r___ #Stosies
~ atY/L~P OodBi e G'liah Fl'oni' y ~
' A1cne 1: Depth a~ ft.
~ Contrac.'tor: T I lP~YI
Agsessnente Pernut a ~ 9
~ 1dd~+~a: 11~1~i I\~19Y1A//~~r/ l~,•i~/Qi Water/~ Surdhazge --~r
? ah'/Z1P [bdes Police ~dGV,IMJ 55/a,a Fire plan Qieclc~
IPtiaia 1: /-4 ~'--z Dg. waSAC
ter conn, v- ,
~ Plarv~er Water Ffer°r
• 71td?•/FYnq• s Cauwil
Aoad Unit ec
I Mdrma: • Bld9, Off. -
' atY/Zip Code:• RPC
I Pho'e
102AL ~ ~ C)
00 / CITY cY' Fl+cAN Iriclude 2 sets o` plav~s. .
1 site plan v/e~iv~at~ana i
r ~ BUIIDTNG PEEM[T APPLSCATION 1 eet Of pnecgy Ca1wL':t1
• / y~ .
Muu Be ttaad Fbr Valuation -5~I 000 oate y2pLl I IG,10034
' Site Addrum ~F'I~ USF ONLY
Lot6~~81,o[it SeC./Sub. ' L Fr'ert __y_ Occu1ka~,Y /P3
I Parml a 0 - pf Altez' Zonin9 ~77 -/'3^
; AFire N
dmert ra0. ~if ,h7~ ZYPe of Ow?et.
add~a; N Stories
• DanolisT~ Ftont.
` CSh'/Z1P (.1ode: - Grade Depth aG ft.
' P11cne
~ APPAOVAIS gEES
~ oontrector: -161 IdIC-01-7w r~~s/s~ew~.~.tsr S t a~9 C2
Addres
~ a: ~__Nrn~rn~~'A, urcr"uve /9 ~
i at7f/ZiP Oodes ,V,IN( J 55/aio~ F'uece 5AC Mack
i Plut* ~r Water Crnn. ~
` lltdt./E}rl. s water ~
Couvicil Ao~id Uni
I Addreaas • Bld9, Off.'T7APC
i C1iy/21p COC]e:
I - .
'ro~. / d 75
y,.. "^A 1 i
632
•
4 ~
229-'r 67L2•0 C$
1 g . p r +
1 1 4 • ` 0 +
G j 5. n p.~
4 7 0~ 0 C'
6
2 O O ^ 0 C'F ~ V~ V
1 5 cC • 5 G'k Q~
~
~ ~ r
in« ml.~ w;a
18 ~~ths f~ q q 9 G (7 (o gy
A'H82 4 0 L-t,(f v~ 4„ 1_~. I ''j
~ s~
I Request Da I Fire No. IbugRin Irepection y~
• Nequrted? QNCady Now ~~~y(ill Not:ty. Inspec-
es ~No ' Iw When fleady
icensed Electrical Comraaor
1 lyroby ruqunst iubpeefim ot above
? Owner aleelrital Yrvk imtallad at
Street Atldress, Bos r Citv
/ o i azJ,E 444 w
ectaon TownShip Name p Na 'ge No. Gm'n~Y
~4 a G~
Occupnn IPRI 1 Phme No.
o r ~ ~ y5y 7- 3
Power $upplie/ ~ Address ~
II..V Y iet Elep~iy~ Contra lm (Cy~p}ny Napcl - GmtrO r0
Y/ I L.% T.CiiiK C~ ~
Mailin0 dJCnvactw a Owtr Yaki Irtsteilation)
~~7
~ 0 0 ~ S
Authorized ipe~amre ( nbauar Oue~er kinp IreblWiion) R~one Nu~Aer
0-355
MINNESOTA STATE BD OF ElEG1NlGf7Y TMI3 INSPECTIOM BFflUFSr mILL NOT
Gripgs-MidweY Bldy. - Room 1&191 BE ACGEPIED 6y iXE 8TAlE BOANU
1821 Unirxsiry Ara.. SL Paul, IOC 55104 Up1ES5 PHOPEB INSIEC710N FEE IS
un..... 18121 2912111 E~LOSED•
REnuESr rox aECrfJcaL iNSPEcrioro
~ ~ . 'sea na+ncc:mr.~~$. amq9eti+o mia_form m mek of wim. wor- ~
••x-- &iow wo.k coveree by rn;s Revuesr
hdd ReP. Type of BuiWinp ApWienps 9iratl EpuiO.a pired
Hortie Range Trnqprary $ervice
Duplex ' Water Heiter Lighdrqg Fiatures
Apt Buildin9 Drm Electric HeaLn
Cortmercial 81dg. Fiunace Sila Un9oader
Industrial 81 _ Air Cadi[ioner Bulk Milk Tank
~ Other 4eo tMr ISpeciNY
Olheff
ompute lnspection Fee Be%w
p Fee SBfviceFirtROCeSita A Faa Feaders/SUbfeede~s Y Fee Circuiq
D 0 to200 Anips Om30A 2~ 0 tn30 Anme;
Above 20D q~ 37 to 100 A~ 31 to 100 Anvs
Swimmi Pool A6ove 100- Above 100_
Tra~iamers I'ri~tian Boars U PartiaL'Other Fee
Signs Special In.spection S
~i. TOT
Rertmrks
floWh-in Dai¢ 1Eleetri
i~ . ..w
pnifp tldt iM ahme
Final ~ a ~ ~ ~ / i~hm les bsen
•f mde-
Tttle fepu,g vWd 18 mantle/mm
Thiwre9uest voiA "I15
L~' 1 gI I[~'('l ~L.~'~ y~ ~Z l u 9
18 months from
21375 --o,oC2:,
Re4yest ate Fire No. pequl ed?InsPe ion Reatly Now Q Will Nntifv. Inspec-
2 ?Ves No lor When Reatly
Licen ed lecVical Con[ractor I herab reauest inspection oi above
Owner electrical work ins:alled et
StteeF Atldress, Box or Rou[e No. City
0 2d ~ o /_o f~i~ }3I0 j!54ctr..
ection o. I Towrehi0 Nama o o.. ange No. COUnt
b~~
Occupaqt~Rl[J71 Phone No.
Power Su plier Atltlress
Da o~-;=, ' , ,6~/PCf. '
Elecvical Conhactor IComp y Nemel ConVector's License No. ~ 641WyP-3
14 Ma linp Addreas IContractor or Owne kinO ~nstallatioN
~ s ~
Auth ize Siena re 1 onv cmr Owner Making Installation) Phone Number
~
MIN ESOTp STATE BOAR OF CTFICITY THIS INSPECTION PEQUEST WILL NOT
Gripes•Midwey Bldg. - Poom N- 91 ' BE ACCEPTED BY THE STATE 80ARD
7821 Univeraity Ave., St. Peul, MN $6106 UNLESS PqOPER INSPECTION FEE IS
e.___ ~a~~~ ~oi_~i~• ENCLOSEO.
ryy^I REQUEST FOR ELECTRICAL INSPECTION EB-00001-03
Vn~ 21375 / See ins[ruc[ions for comolating this form on back of Vel low cooV. . q
'"X~~,BaFawW6rk Covered by 7his Request f 3~ l. gq
l
Jow A flep. Type af Bviltling Appliances Wired EquiVment Wired
Home Range Tempor2ry Service
Duplex Water Heater Lightin fixtures
Apt. Building Dryer Electric Heatin Commercial Bldg. Furnace Silo Unloader
Industrial BIAg. Air Conditioner 8ulk Milk Tank
Farm 0MTTr pec~tv . other Ispeciryl
[ er Specify ther Oth.r
Campute lnspection Fee Below
k Fee Sarvice Entrance Size d Fee Feaders/Sabfeetlers M Fee Circuits
0 to100qm s 0 to30Am s 0 to30Am s
101 to 200 Amps 31 to 100 Amps 31 to 100 qm s
Above 200 Am s Above 100-Am s Above 700_Am s
Transformers RemoteControl Circ. Partial;'Other Fee
Signs Special Inspection g/ 5!~ T AL pEE
Reinarks ! _
DO
Roaph-in Date .
I, Elect'
' Inspector, hereby
certify that the ebove
Final Date inspection has been
This request void o
18 months from
,h; ,equr a;d ~ 4 ~ ~ 3 (2 ~ g y
,e ~pm'~
A~`OM241 L [ ~~i ~
Neques[9~ ~e Fir¢ No. pough-in Inspeclian ~ -
flequf ed? ReaAy Nuw Wiil Notifv. ~~spec-
os ~ry~~ cor When Ready
Licensed Electncal ConVactor 1 hereby requast inspaction of above
Ow~er electricel wark installed at:
Street Atldress. Box oTflou No. City
5kM !.J/~rrW 14) E~'t h--
ecuon a. Townsn ip Neme or No. Range o. Cnwt
Occupan 1 I TI Phone No.
67"c~s~ -6,,PZ
Wwer Supp ier ~ 41- Atldress ~
D Qf~ '
Electrical Conhactor ICOmpany Nam - Contracmr's License No.
'n ~0 7 p'
Mailing A dress IConvactor or Owner Making I tailationl
4'V4
AuMOr' ed SiBnatu IContrac Owner akinB Installaiionl one Number
9 ~ 5
MINNESOTA STATE AND OF ELECTflICITV THIS INSPECTION pEQUEST WILL NOT Grippa-Midwey Bidg - Room N•197 BE ACCEPTED BY THE STATE BOARD
1821 Univeraitv Ave., Sl. Paul, MN 56104 UNLESS PROPER INSPECTION FEE IS
Pn- 16121 297 Z111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION Ee-ooooi:a JIM A ' Sea instructions lor completing this torm on beck ot yellow eooV. ~
p~ t6t~,1 "'X" Bg/ow Wsrk Covered by This Request
AAtl Rep• TYPe of BuilEine Appliancee %'iraA Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Buildiog Dryer Elec[ric Neatin
Commercial Bldg. Fumace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tenk
Farm oinP. uecl v rne. 15uer.ifv1
c y ther Oth.r
Compute lnspe ion Fee e aw
p , Fee ServiceEnimnceSize p Fea FeaAers/SUbfeaders N Fa ~ Circuies
. Q U to 200 qm s 0 to 30 qm s i 0 to 30 Am
Above 200 qmps 37 to 100 Amps 31 to 100 Amps
Swimming Pool Above 100_Am s Above 100_Am
Transformers Irrigation Booms Partial:Other Fea
Signs Speciallnspection S
Nemarks TO FjEE J,
oC
Nouah-in ) Date
CJ~ I, th mal
((p.y ~nsoecmq hereby
' ertity thet the Tbove
Final ' ~~ie insoeccion has been
mede.
~ ~ I
' tMerequeatvolAlBmomMfrom
0,64010 ~i i - ~ Q /o
Request Oate Fire o. 1 RoLgh-In InFxaction ReqvireU Inspectlon Other Tnan Rougn-In
7/ 19 / 94 nou Ol cyl~ignspeclar when reatly) qeady Now ? WIII Notity Inspedor
El No Date ReeOy
I[~ licensed contractor D owner hereby request inspection ot above electrical work at:
Job Atltlress (StreeL Box or Route No.1 Ciry
•3820 Willow Way Ea an
Sedion No. Township Name or No.' Range No, County
Dakota
Occupant(PRMT) Phone No. -
~Rachel Cooper 452-6013
Power Supplier Atltlress Dakota Electric Co. 300 220th St. Farmin ton, NIN
Electnwl Contractor COmOany Name) Conlredor's license No.
Total Electric, Inc. CA01834
Mailrng ptltlress (COntractor or Owner Making Installation)
1537 92nd Lane N.E. Blaine, MN 55449
Nmni ICOmracmr,Owner Makmg Instailationl Phone Numbe~
~ //o,,,' 786-8484
MINNESOTA STATE BOARD OF ELECTNIGTY THI$ INSPECTION REOUEST W4L NOT
Grigge-MlEway Bltlg. - qoom 5-173 p BE ACGEPTED BV THE STATE 90AR0
1821 University Ave.. SL PeW. MN 55100 ~V UNLE55 PROPEF INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSEO.
~ REQUEST FOR ELECTRICAL INSPECTION ~6y'.~~, he-~
? See insimctions tor rom0leting tpis brm on back oi yellOw copy. l~i .J~~
64010
"X" Be/ow Wcuk Cov_ered by This Request i1
e 9er.. Type of Building AppliancesWired EquipmeniWired
X Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt Builtling Oryer Load Management
CommJlndustrial Furnace Other (Specify)
Farm X Air Conditioner
OtM1er(spe[ilyl Conlractor's Remarks:
CampLte Inspection Fee Belaw:
# Other Fee # ServiceEMrancaSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to i06 Amps
Transformers Above 200 _ Amps A6ove 1 Amps
SignS Inspecmri Use Only: ~ TOTAL
trrigation Booms 10,50
Special Inspection
Alarm/Communication THIS INSTALLATION MAV BE DER DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, here6y Rough-in oa~e
certify ihat the a6ove inspection has F;nai ` osy
been made. a / y J ~7
OFPICE USE ONLY ~
TM1is requ45t voitl 18 months imm
1 nt s voie
* 0 6 8 2 4 42 L~ f n
`
Request Dat Fire No. Nauph-in {nsneciion
~ Reywred? ~Neady Nuwy1 Will Notlfy. InsDec-
es oPla <or When Ready
Licensed Electrical Contractor I qKeby meqwyt inypaction ot a0ova
? Owner a/scbieal ~ :rafelied at:
Sveet Address, Box or RQute N City
3~'~a yv,aw E Q~.
ection o. Township ame or No. age o. C4~5'1 ~ y/
'~lJ / L
Occ ~ ~11yNe ^Sj Phwre No. -4 P!
( ~~.,r ~5 3
Power Supp} ier ~L AOtlress
04 /1.6~ LCIG~.~. FR rm~ n?~--~
Ele I CoMr m ~ mpa y Na 1 ~ Contracmr"s Licen No~
7~
MailinB Atldress (Contractor or Ownar Makinp Ireta+lation.)
AuMor' d Si9^at ICOmr tor er Makinq Inrsbllationl Piwne NuM¢r ?9D- 3-555
MINNESOTA STATE OAXD OF ElEC7XICITr TH~ IKSPEGTION REQUEST WILL NOT
Oripps-Mitlway Bldg. - Moom N•781 BE ACCEPTED BY THE STATE BOAND
1821 Univeraity Ave., St. Paul, MN 55106 UNLESS PROPEfl INSPECTION FEE IS
ENCLOSED.
oI.....e 161212972111
REQUEST FOR E6ECTRICAI. 4I1tFEGTION Ee-00001 -oa
' See instructions ta totriptetnq thisfmm m back of yatlam wpv.
~
A X"' 8e/ow Wmk Covered by This Request
9ddrROP.] TvPe ni Bailtlinp Appliaatea iSirW Equioment Wired
Home Range Temporary Service
Duplex Water Heater Lightin fixtures
Apt. Building Dryer £lectric Heaiin
. Commercial Bldg. Fumace Siio Unloader
Industrial Bldg. Air Cmditioner Bu7k Milk Tank
p ch.:r ce<~ MMer ISceciryl
t Ofher
ompute lnspection fee Below
q Fee ServiceEntrenceSlze p f-aa feederyl5ubteadars b Fee Circuib
l(d 0 to 200 Am 50to 30 q Z 0 [0 30 Am
Above 20 _qm - 31 to tOD Amps d 31 to 100 q
Swimmin Pooi Above 700_Above 700_Am s
Transtortners Irti tion 8ooms Partiai!Other Fee
Signs Special InspetSion 4s 0
Remerks T AL FEE
d 4A
flouph.in DaSe 1.
43 Inspeetar. herebv
CRI~V ~he1 tiq above
Finat ~}e~ ~paction has baen
c
1MsropueetvoldtBmonthetrom '
• CITY OF EAGAN AT
3830 Piiot Knob Road, P.O. Box 21-199, Eagan, MN 55121 1~I ~ 9004
• PHONE:454-8100 ~ ~
BUILDING PERMIT ReceiPr #
Te M uwd fer 1 OF 4 PLEX Est. Volue $38,000 Date APRIL 25 , ~q 84
SiteAddress 3818 WILLOW WAY Ered u Occuponcy R3
Lot 64 Biock 1 Sec/Sub. BRIARHILL 4 Alter ? Zoning R3 PD )
Parcel No. 10-14993-640-01 Repalr ? Fire Zone N A
Enlarge ? Type of Const. V
a Name TOLLEFSON BLDRS Move ? # Stories
Z Address 1655 NORWOOD DR Demolish ? Length 44
~ city EAGAN phone 454-6873 Grode ? Depth 86 Sq. Ft.-
4AMF APVrovab Feas
Name
O
ou Address Assessment Perm+it $ 229.00
u~ City Phone ~Noter & Sew. Surcharge 19 .A0
Palice Plan check 114.50
Gw Nama Fire SAG 525.00
~
Address Eng. Woter Conn. 470•00
~W City Phane Plonner WaterMeter_ 63.00
Coun[il Rood Unit 260.00
I hereby acknowledge thof I have read fhis ap0lication and state that Bldg. Off.
fhe inlormofion is Correct and ogree to comply with oll applimble $1 680.50
State of Minnewta Statutes and CiN o4 Eogan Ordirances. APC Totol , .
Slpnuture of Permittee
A Building Permit is issue TOLLEFSON BLDRS on tha express conditlon thnt
oli work sholl be dorro i ac .r once avith a116 licobp~ le State of Minnewta Sfatutes ond City of Eapan Ordinances.
Buildinp Officiol
14-9
CITY OF EAGAN
?$30 Pilot Knob Road, P.O. Box 21-799, Eagan, MN 55721 N ? 9005
PHONE: 454-6100
BUILDING PER(NIT Receipt # 4_
T. bs urod ier 1 OF 4 PLEX Est.Value $38,000 pete APRIL 25 jq $4
SiteAddress 3820 WILLOW WAY Erect N Occuponcy R3
Lot 67 elock 1 ~eclSub.BRIARHILL 4 qltef ~ Zo~ing R3 (PD)
Parcel No. 10-14993-610-01 Repolr ? Fire2one N/A
Enlarpe ? Type ot Const. V -
w Name TOLLEFSON BLDRS Move ? # Stories
Z Address 1655 NORWOOD DR Demolish ? Length 44
~ City FA(;AN Phone 4 S 4- F R 71 6rode ? Depth 2 6 Sq. Ft.-
SAME ADVrovols Fees
o Name
O'-' Address Assessment Pertnit $ 229 . ~ 0
u~ City Phone Water & Sew. Surchorge 1 9.80
F Police Plon check 1 1 4_ 50
Fw Name Fire SAC 525_00
=Z-v Address Eny. Water Conn. 4 7 0- ~ Q
u
~ Z. City Phone Planner Water Meter hI -!10
Council Road Unit 26n ~ Q
I hereby acknowledge fhot 1 have reod this apDlication and state ihat gldg. Off.
the information is correct and agree fo wmply with oll opplicoble APC Totol $1,680.50
Stato of Minnesota $totutes and City of Eogon Ordinances.
$ignofure of Permittee
A Building Permit Is issued ro: TOLLEFSON BLDRS. on the express corrditlon thni
CII work shull be done in accydrn+,e with oll o ~ ble State of Minnesoto $tatutes ond Cify of Eagan Ordinances.
\ / \ - C~_
Building Officiol 7rJ
CITY OF EAGAN
' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N? 9006
~ PHONE: 454-8100 L`
BUILDING PERMIT Receipt # T~ Z
Te ha uted fer 1 OF 4 PLEX Est. Volue $38,000 Dare APRTT 25 , 19_-89
SiteAddress 3822 WILLOW WAV Erect Occupanq R3
Lot 62L 81ock 1 Secf5u6. BRTARHTT.T. 4 Alter ? Zoning R3 (PD )
Farcet NO. 10-14993-620-01 Repotr ? Fl.eZone N/A
Enlarga ? Type of Const. V
u Neme TOLLEFSON BLDRS Move ~ # $tories
Z Address 1655 NORWOOD DR Demolish ? Length 44
~ Citv EAGAN phone 454-6873 Grode ? Depth 26 Sq. FL_
Approrals Fees
a Name SAME
ot Address Assessment Permit $ 229•00
V~ City Phone Water & Sew. Surchorge 19 • 00
Police Plan check 114.5
V„ W Name Fire SAC 525.00
~
Address Eng. Woter Conn. ~0
u
a Z. City Phone Planner WaterMeter2S1Q-Q0
Countil Road Unif
1 hereby ackrwwledge that I have read this npplicotion ond state that Bidg. Off.
the inlormotion Is correcf and agree to comply with all applicoble APC Tofal 1, 680 . 50
State of Minnewto $totutes and City of Eagan Ordirances.
Signature of Pertnittee
A Building Permit Is issued to: TOLLEFSON SLDRS on the ezDress condition Ihni
all work shall be done i accorda e wilh al opD ~'~ble~Sfate of Minnesota Statutes ond Ciry of Eagan Ordinances.
Building Official
~y
j5 So
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please compiete for modifications to existing residential dwellings.
Date 7 I So I C)~S r~~ I
Site Street Address 3U o W ~ ~ l~f).) Unit #
Property Owner YC.V"C l/~ ~~1~~~ Telephone # ~l-~Wb
Contractor -up Telephone # (0) ' ~/.J, -~Z~
Address~~7 o Cit_y C~ G/V1 State Zip UJ
The Applicant is: _ Owner X'Contrector _Other
Alterations to existing dweiling $ 50.00
_ Add plumbing fixtures. This fee includes putting in a water softener and/or water
heater at the same time. ff y~ou are insialfinq onlv a water softener and/or water
heater, do not complete this section. Move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
_ Water Turnaround (add $125.00 if a 5!8" meter is required)
Other:
_ Water Softener ~ Water Heater $ 15.00
_ new ~ replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
SU
Total $
I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, hut only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and 77 d.
ApplicanYs Printed Name plicanYs Signature ~I., U ~ Z~pS
E ] 5: scr~I-3=1
PERMIT # s -I r~ D 1K RECEIPT DATE:
EOOE RUID$RTL&L PLUM$INFi PEiiM1T APPLICATION
CrrY oF EAHAN
S$SO PILOT KAOB BD
$AHRN, MN SSIEE
651-881-4675
Piease complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
SITEADDRESS: 321 [D W( ~(O
OWNERNAME:: vlli{.YSulf-(/Yl, /~lQ•(U TELEPHONE#: bo~ I- QQS- 9S7(p
(AREA CODE)
INSTALLER NAME: N r P. PI D<WoY ks TELEPHONE Io~ I--t~IoS - J-S`tO
S7REETAGuRE5S:3G7 o DoDb Rb (AREA CODE)
CITY: _ C(,l(JI(,Ly'1 STATE: m /V ZIP: J~ I
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply
• MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water turnaround - existing dwelling unit 5/8" meter if needed -$118)
Other:
_ RPZ: new installationlrepair/rebuild $ 30.00
_ lawn irrigation system
ReplacemenUadditionaL _ water softener I water h llate $ 15.00
~ ~1I
State Surcharge I_$ 50
I
Total _ J $
I hereby acknowledge that I have read this application, sfate thatthe informafion is correct, and agree to complywith all applirable Cityof Eagan ordinances. It
is fhe applicanPs responsibiliry to notify the property owner that the City of Eagan assumes pliabilityfor am~ damages caused 6y the City dunng its nortnal
operational and maintenance activities to the facilities constructed under this permit thi T. property/r'~ ~o y/easement.
~
A URE OF PERMITTEE 1102
To1leNon Buildero Inc. Or. 11505
183-80
JACKSON - SURVEYORS
N0I9T[R[O UNO[N tAWf Or RAT[ OI YINNtfOTA ~
. . 9, p /9818 EAST 65th STREET, MIMNEAPOIIS, MN 66417 7II7•3484 ' $C<IB : L° =401
&a ~ o Deaptao ITSn
. / OpihtpOT'fi 6t[ftG[att -i Draipage
' ~ , o.e.o Ezi~«og
99s ~P ~ ~ Elev,
L O T 63 'gs ~ I
~ c
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o ~
LOT 61
9 .t
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~ > a`'~ „ ~ _ 97, c
S a, v
Lo7 64 N
o. ~
23 v9 ,995~ ~-a I
> q9 I
~ ~LO? bZ 9B.a (
s
lropased Garage Flaor Elev. Q
Propoaad First Floar Elev.
frpposed Eaeement Flaor Elev. byoy
1~B ^
t H[RLYY C[RTIFY TNAT TN[ ABOV[ 15 A TRU[ AND CORR[CT PLAT OF j U/tV[Y OF
~
Lote 61,62.63,64 Black 1, Briar Hill 4th Additioa,
Daketa Csuncy, 3[taneeota
AS OURVlY[D DY Ml TMtf lstb oA. wMarch A.D. 1984
fiON ~
F. C. JACKfON. MIM RmMrIR?now. Mo. 2600
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Toilafson Buikdcri Inc. Or. 11505
183-80
' , JACKSON - SURVEYORS §
ruesuruco unecw uAwa or srArc W YINNypTA 9, 0 /3616EA5T55thSTREE7,MINNEAPOLIS,MN55417 727-3484 SCill: 1"= 4Q1
o DglfO[!Y Ii`po
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~ ,ee.e Exi4i~B
99-s P ? ~ Biev.
l O T 63
00 0 ~\v h~x .3i ti
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~
23 y S, I.
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lropoaed Garage Floor 81ev. 3y
Propoeed First Flaar Elev.
Pzeposed 8aeement Floor Elev. byoy
~ I MEMEYY C[RTIA' TMAT TX[ ABOY[ 19 A TRUE ANp CORR[CT PLAT OF A SURV[Y W
~
Lota 61,62,63,64 Block 1, Sriar Hill 4th Additian~
Daketa County. I4ianesou
As suwv[rao w r[ rMU 15th nwv wAItch A.D. 1984
fION[ ~
F. C. JACKiON. MBrru R[a~s711.nT~ow. NO. fQ00
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` JACKSDN - SURVEYOR5 /V
lIt61ST[RW VNCtR LAW[ OF R04T[ Or YIMNWTA '
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Toliefsoa Buildsre Inc. Or. 11505
183-80
JACKSON - SURVEYORS W
R[6SST[/lEC UND[11 LAWt O/ fTAT[ Of YlMNfpTA - /
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~ - ~ PERMIT CITY OF EAGAN
3830PilotKnobRoad • PERMlTTYPE: suzLozreG
028012
Eagan, Minnesota 55122-1897 Permit Number: (612) 681-4675 Date Issued: 0 6/ 2 0/ 9 6
SITE ADDRESS:
_ 3816 WIILOW WAY
LO7: 63 BIQCK: 1
BRIAR HILL 4TH
P.I.N.: 10-14993-630-01
DESCRIPTION:
RERQOF
tIta Permit Type MULTI. (MI5C.)
~L~Sl~rif ork Type REPAIR
/cataE;us P~or~ 434 ALT. RESIDENTIAL
,
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REMA~rp~UDE5s 3818, 3820, AND 3822 WILLpW WAY
L64 L61 L62
FEE SUMMARY:
VALUA7ION $9,000
Base Fee $149.75
Surcherge $4.50 •
Tatel Fee $154.25
ChTlfTRM6Ha`Q-C'tlNSTRUCTION CO 117211107 5456 0gR7WHSLLS AS50CIA7ION
3414 SNELLING AVE S WII.LOW WAY
MINNEAPDLIS MN 55406 EAGAN MN
(612) 721-1107
G . , . • _ - .
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APPLICANT/PEFMITEE SIGNATURE ~ISSUED BY: VNATUR/ E "'=~C
` CITY OF EAGAN
r2 3830 PILOT KNOB RD - 55122
6 1996 BUILDING PERMIT APPLICATiON (RESIDENTIAL)
681-4675
New Construclion Reauirements RemodeVReoair Reauirements
? 3 registered eita surveys ? 2 copies of plan
? 2 eopies of plans (indude beam & window sizes; poured Md. dasign; elc.) ? 2 slle surveys (exterior add'Rions & decks)
? 7 energy plculations ? 1 energy calculations tor heated edditions
? 3 copies of tree preservet(on plan H lot platted aRer 7/1193
required: _ Yes _ No
DATE: ~\i.w-e (51 b CONSTRUCTION COST:
DESCRIPTION OF WORK: 7-c u /L 4-- 1 r- o ~
STREET ADDRESS: 3 0 3b ~`3d 1?, i~ v~ 3 g~ 2 l/d
LOT BLOCK , SUBD./P.I.D.
PROPERTY Name: rLl~~~~ l~~ll5 Phone
OWNER
Street Address,
City: State: Zip:
CONTRACTOR ComPanY: /~~~h~Y~~ll•~S (~o~V~• (e) Phone#: -7 Z
~/5~ S~~e!li S~
_ 3 ~'g vE License
StreetAddress:
City:Al)f S State: 'k" Zip:
ARCHITECTI Company: Phone
ENGINEER
Name: Registration
Street Address•
City: State: Zip:
Sewer 8 water iicensed plumber: . Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this appiication and state that the inform ion is correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
/
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes No '
Tree Preservation Plan Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
0 02 SF Dwelling ? 07 4-plex o 12 Multi Repair/Rem. ? 17 Swim Pool
0 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 _-plex ? 15 Deck
WORK TYPE
0 31 New ? 33 Alterations ? 36 Move
0 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowahle) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq, ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bldg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge ~
Plan Review
License
MCNVS SAC .
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S1W Surcharge
Treatment Pi.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
.r .
o~ '~`.:>..~i:S~i. ~ a'W:A`. C' [y .~Y.: . . R.
~;3. ' ya4,'€,',~;~~: ~ ~ ~ c:4 c~~ ~ ' » ~ . s•, "
~~•:<::~~a:'c:<:~: i~°'~:.~,. , . ?~..'~S~- ~ . ..'g. ' g; L
a.,k~ . d:'..g( .~c,::;~:<~~.:>, . .a;: ~ aY a: ;rz'.'...'..-..••, ~ ,
~a3"niE<Y::a~"i,~:s.n:i~ ~.:,'`b:$>$3`~~~'~::8.:~.'a°°se,„1,~:: .k. ~ ~
e.
~ ~c^.,.. ' ~ . ~ . ' $
~s~R,•..C~.:.:.. . . ::„c.x:8:2~. . : . x u'_*.'.~tr'a`a.'~~.
1994 MECHANICAL PERMIT (RESIDENTIAL)
C1TY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMII.Y DWELLINGS. ALSO, FOR TOWNHOMES AND
COND05 WHEN PERMTTS ARE REQUII2ED FOR EACH UN1T.
- - - - - - -
NEW CONSTRUCTION
?,DD-.72d n/C
ADD-ON FURNACE
FII2EPLACE INSERT
DATE
FEES
HVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1 @ $3.00 EACH)
ADD-ON/REMODEL (ExISTIIVG CoNSTRUGTION) $ 20.00
STATE SURCHARGE .50
TOTAL
srrEanDxEss:31 _Jdlnr.v Wcw ~acr~r~ i~'Ih _
OWNER NAME: GZC'_kpl CrUDAar TELEPHONE
INSTALLER: Ron's Mechanical, Inc.
ADDRESS: 1812 East Shakopee Avenue
CITY; Shakopee STAT'E: m ZIP CODE: 55379
TELEPHONE 445-8585
S GNA PERMTITEE
_ .
v~x~~~.z~~•.w..<~::.: ~°~:':$~3~:>~~~,s.,~.~`~b:±` ~a. ~s~~~~"w.~~~~>~s~'c" .a3~~~ . "°n~.~'...~w~'~.a~£~'s~~ 4.:~s<~.m. . 4 .
1994 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMMERCL4LJINDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APAR'TMENT BUILDINGS OR OTHER MULTI-FAMII.Y BUILDINGS W"HEN SEPARATE
PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
- - -
T)ATF.- r'ONTF 4:.':' PRTCE: W
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTTON:
FEES
1% OF ~V,FE$ $
PROCESSED PIPING: $25.00
MINIMLJM FEE: $25,00
STATE SURCHARGE $.50 FOR EACH $1,000 OF FEE.
,
TOTAL $
S'TE .4uDRESS•
OWNER NAME: TELEPHONE
TENANT NAME: (41PROVEMENTS oNL1)
INSTALLER:
ADDRESS:
CITI': STATE: ZIP CODE:
TELEPHONE
SIGNATURE OF PERMITTEE CTTY INSPECTOR
~
2i84
CITY OF EAGAN
APPLICATION FOR PERMIT
- SEWER AND/OR WATER CONNECTIO.T
(PLEASE PRINT)
1) PROPER'I'Y ADDRESS:
T.Ff:~%L nESCzTprzcN:
(LOt/Biock/Sub3ivision or Tax Parcel I.D. Nu-iber)
S'IRL'CTL'RE, 6aT:.' G' GRIG^T~L :.UZi,L'L"G Y-=.ST _T=:?NC°_:
I FP.=S4 ~ ~':;]i:i:/~.-~0_°OS~ i;.5:• ? R-1 SINCTE FPNiI:.Y - •
? R-2 DUP?E.{ ('I~nO Wi ITS) -
- " H<R-3 TG[vTiE3CL?SE (TIiRE" + UNITS) Wi ITS)
F-I R-? ApAR'I°'~'`~T/CO~.'D~~lDIIL?~I ( UiIITSi
? CQ^^j=CLAL/Rt.`TAII,/OFF'ICE
? Il\DL'STRSP.L
? INSTITUTIC.'`TAL/Gv'k7E'u~n=
z) ppni,TC!~'\r . (PLEASE PRINI)
NAl,!E: TOLLEFSON BUILDERS, INC.
P.DDRESS: 1655 Norwood Drive
CITY, STATE, zIP: Eaqan, MN 55122 -
PxO.IE: (612)454 - 6873
3) PE17IBEP, ~y~ PLEASE PRINT) . . FOR CITY USE 0,5LY
- 6ENZ-RYAN PLUMBING AND HEATING
PLUMBERS LICE45E:
ADDRESS: 14745 South Robert Trail ? Attive
CITY, STATE, ZIP: Rosemount MN 55068 ~ Expired
PHOVE: Sit Q Not of Recard
(612) 423-1144 PLUMBER LICENSE N 1849M e9
. . arSE ~
4) OCCLTA%T/GF. vilER , (PLEpSE PAINi) N7V`IE; SAME
ADDRESS: AS
CITY, STA'I'E, ZIP; n6qU€
PFKh`IG:
5? INDICA'PE V7HZCH PEPALT IS BEItiG RDQUESTEp: -
[kl CC,-,-]ECPION 'Il7 CITY SETrIER
El CO`;'VECI'ICN TO CITY WATER
E] dI'IER (PLP7ISE DESCRIBE)
6) rIDIG;.:: O:W:
? PL1'sSE F:OID APPROVF.D PERYLiT FOR PZCF:-[.P BY ONE OF AFC,Z'E
J2 +?:aiL APPROt,c"'D. PEF~•ffT 'IO 1, 2, 3~ 4 P.BGVE
(Circle one)
7) SIC.^yTC~E: DATE:
Rz R F4 iW ii Kr3-.lO ii ?O 1i ~oid:a-SS~ f4 R s:s~i e o4 R! Y~~[i:i:lo Le4 et ~F ~.eo ~i.•.. Ws i i ii ~@ 0[:SY~i• t~
F O R C I T Y U S E O N L Y
PER+1IT ISSUED
~ . .
FrEs: $ !`OS O ~F:':iD D~D\7T'^ r•' SliR` .
~ (I`;C...:DE H?RGE)
$ %o. S e WATER PERMIT (INCLUDE SURCHARGE)
WATER METER/COPPERHORN/OUTSIDE READER
S WATE_°. TA? (I.\'Ci,iiDE CORPORATICti SiOP)
~ SEWER TAP
$ ACCOUNT DEPOSIT - SE;dER
$ /Se-~+ ACCOUNT DEPOSIT - WA;ER
$ wac
$ sac
$ T4UNR ?4ATER ASSESSP•IE:7T
$ TRliNK SEI4ER ASSESSMEiVT
$ LATE°.AL BENEFIT/TRUNK SE;-;ER
$ - LATERAL BENEFIT/TRUNK Z4P.TER .
$ ' OTAER
$ TOTAL
$ v-/.i G~ d AMOUNT PAID/RECEIPT
DOES UTILITY CONNEC^1ION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
E:-~] YES IF YES, THEN A"PERMIT FOR WORK WITHIPI
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEEr2ING DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO TIiE FOLLO?9ING CONDITIOiQS:
APPROVED BY: ~ef_ ~
T T T T i:
D:,TE:
~ RM 04S'9 q Y.iY eFA t EJo Bl~ R Y il wJt PI}6 Wii C4m iQ qp A P11 rfi0 D* iM 3a W:ti Pki Row IR i li m m
. i, . . , ,
~J ~k `i • 2/84
•
CITY OF EAGAN
APPLICATION FOR PERMIT'
' ' . . : •
SEWER AND/OR WATER CONNECTIODI (PLEASE PRINT) 1) PROPII7PY~ AL7DRESS:
=I, DESGRIn'I'IC:I:
- - (Lot/Bloc]c/Subclivision or Tax Parcel I.D. Nu~rber)
iE{I53_'=_:G STitI;CPr 2E, DAi:.. G^' CRIGii:AL ,'-:uiILL'I:`;G P=--.,ST 35SU?NC°:
CS-: . R-1 S~iGLE rPMILY - - ,
DUP"T~.Y --(74N1~ Wi ITS)
~~R-3 'IrI-v-NII-IOLTSE (THRE' + U.~LTS) W ITS)
? R-4 A1)AR'IP'~'^:T/Cc`IDQ`,LTiIIL;m ( II~TITSi
(j CCN1i^=CLAL/RETr1ZI,/OFFICE
? L\ML'STRI?L <
? IbISTITUTIONAL/GOVE%-~TNIEN'I`
- z) ppnLIG NT (PLEASE PR1NT)
. . . . . , . : . -
N7utiiE: TOLLEFSON BUILDERS, INC. -
ADDaESS: 1655 Norwood Drive
CI'PY, STaTE, ZIP: Eagan, MN 55122
PHO`E: (612) 454 - 6873
3) P=msm PLEASE PRINT) FOR CITY USE OkLY
GENZ-RYAN PLUMBING AND HEATING
PLUMgERS LICENSE:
ADDRESS: 14745 South Robert Trail ~ Active
CIT`!, STATE, ZIP: Rosemount MN 55068 Expired
PHO~_ Sic ~ Nat of Record
(612) 423-1144 PLIIM6ER LICENSE # 1849M
atr initia
4) Q.CLTA-NT/G!•NM . (PLEASE PRINT) . . , NA"E= SAME
ADDF2ESS: pS
CITY, STATE, ZIP:
PF3d:IE:
5) INDIC ;TE WHIC?i PEP,hiiT IS BEI[Z REQUFSTID: _
ky CCtiNECPZON 'IO CITl' SEr7ER
~ COC].IF]CPZCN 2U CITY WATER .
El df!'.ER (PI,EA.SE DESCRIBE)
6) D+DIG;, C:..T..:
? P=ASE E?OID APPROVID PERmIT FOR PICN-UP BY ONE OF '1BC',r.-
:P.RO~ '•LIT TO 1, 2, 3~ 4 ABOVE
/ (Circle one) ` ~~41
7) 'SIQ.?TL'RE: ~ D:,TE: ~
- -
F O R C I T Y U S E O N L Y
PERMIT " SSSUED ' - - '
F°ES: $ /O, mS-Q ' ,.G~..i.D •DtD\ITy J^
- (I"iC~~ ..U.... r~•J(`
.HlR.riE)
WATER PERf1IT (INCLUDE SURCEARGE) -
WATER METER/COPPERHORN/OUTSIDE REAGER
$ W,1TER TAP (INCiUDE COP.:OR:,TICN STOP)
SEWEB T._D .
$ -v~.` ACCOUNT DEPOSIT - SEidER
$ j~ a-dACCOUNT DEPOSIT - WATER
wac
sac ~ -
S TBU>IK ?4AT°R ASSESS:IE:IT
~ .
S TRliNK SEZIER ASSESS.IENT
S - LATE°.AL BENEFIT/TRUNK SE:•7ER
S LATERAL BENEFIT/TRUNK WATER Y"
$ . OTHER
(
$ TOTAL
AMOUNT PAID/RECEZ PT
DOES UTILITY CONNECTION REQUZRE EXCAVATION IN PUBLTC RIGiIT OF WAY?
~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN
~ PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO TfIE FOLLOWING CONDITIONS:
APPROVED BY:
T T_ 1 LL :
DlTF:
Iv c3-~et ~.sa 00
o s~ sk~ et a ni ~w R~ w a w s~.lE w~ w.~ riw w w i4 vs~ w~+s e+t ~~a or w~.4 st o ia f ia .
n ! . .
~ No"2, a 4
_ / CITY OF EAGAN
} .
APPLICATION FOR PERMIT -
' SELdER AND/OR WATER CONNECTIOri v y ~
(PLEASE P4INT)
13 PP.OPIITY ADDRESS: ..rFral, DESGRIPTIC.7: 'zp
.
- (Lot/Block/Subdivision-or Tax Parcel Z.D. N r
i: =_^__:G STRL'CTL'f'~E, Da'IE GF QRIGi :AI. BuILCL`7G P:=~ST ISSZ:aNCE:
tiS:: ? R-1 SD1G12 rPMILY - ,
0 R-2 DUP~- (ZSN Wi ITS)-
. ~~~t-3 ZCnv~h3L~I5E (THRE" + TJ~IjTS) I7~7ITS)
? R-4 ApAR`*_:'~'`:T/CO`IDQnTiIILnl ( IINITSi
? CQ'4CLAL/RETAiI,/OFFICE
? L-MUSTRIr'1L
. . . . ? INSTITUTIO1qAI,/GC7v7M%MENT .
z) AppL7C V+p . (PLEASE PRINi) - WtE: TOLLEFSON BUILDERS, INC.- ADDRESS: 1655 Norwood.Drive
CITY, STaTE, ziP: Eaqan, MN 55122 •
' PHO-NE: (612) 454 - 6873
3) PIk:,!B-= ~y~- (PLEASE PAiNT) FOR CITY I15E GNIY
GENZ-RYAN PLUMBING AND HEATIN6
ADDRESS: 14745 South Robert Trail PLU!!BEJiS LILENSE:
~ Active
CIT'Y, STATE, 2IP: Rosemount MN 55068 ~ Ezpired
PHOi~E: (t H. Q Not of Retord
(612) 423-1144 PLf1MBER LICENSE N 1849h1
3{arr init3a
9) =Tp;,~/~-;NM (PIEASEPAIxi) . NA~IE= SAME
AIJDRE55: AS
CITY, STATE, ZIP: ~$~UF
PHC}:JG:
S) INDZG,TG 4VHZCH PEPMIT IS BEIM REQUESTED:
~ CO„NE(_~I'ION 'IY) CITY SEYIER
~ CO`.'1=I0V 'Ib CITY S4ATER
? 0r= (PLEASE DESCftiBE)
6) I:DIG=," C:E:
[I PI: 'SE I:OID nPrROVID PF7?,%1IT FOR PICr-UP BY Oh'E OF ABC7.'E
_ ~6E +TAiL AFPRO\= PE;~•LiT 'IO 1, 2, C) 4AEOVE
(Circle one)
7) SICZn=RE: DAT'E:
r
r-, G: c.a:i~ rfa aym ir aa ssi at ctm-~:a~ a~ +n't ~f-ssa a as sa ~s r: oc~:m :m sa f~ vsa ar.l~:r o;z•s.T+u s aa fm 1~.# B c~,i Q:saa4• s
• . .
F O R C I T Y U S E O N L Y
PERMIT ° ZSSUED ' . _
FEES: $ ~O.SO CC1.yD DrA\ITy (I`;CL:;D' SiiP.C?i?RGE)
$ i~ - .SJQ t'7ATETZ PERP1IT (INCLUDE SURCY.ARGE)
WATER tdETER/COPPERHORN/OUTSIDE READER
$ WATER T:,P (I:VCiUDE COR?ORATION STOP)
$ SEWER T=.D
$ ACCOUNT DEPaSIT - SEiIER
$ ACCOUNT DEPOSIT - WA:ER
$ WAC
$ SAC x••,
$ TRUNK WATER ASSESSt-IENT •
$ TRliNK SEWER ASSESSMEVT
$ LATEP.AL BENEFIT/TRUNK SEidER i
$ LATERAL BENEFIT/TRUNit [dATER
$ • OTHER
$ TOTAL
Pi40UNT PAID/RECEIPT
DOES UTILITY CONh'ECTION REQUZRE EXCAVATION-IN PUBLIC RIGHT OF WAY?
~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN
PUBLIC ROAD"vTyY" MUST BE ISSUED BY THE
~ NO ENGINEERING DIVISZON. LIST AS A CONDI-
TION.
SUIIJECT TO TFIE FOLLO?9ING CONDITIONS:
APPROVED EY: ~~ef
TITLE:~~,z-F
DHTr:
R FJa Rv 4 i~ o:A YtB /i 6lO R~ ii ~/4 iJ4 PI f~ R+~ ~4B ~M 4 i4 ~i~ ~I.a ~4 s 34 ~A !4a Wk~ /4 M.l~ ~1 ~
City of Eaan Permit
9 Permit Fee: t~
3830 Pilot Knob Road
Eagan MN 55122 Date Received; Phone: (651) 675-5675
Fax: (651) 675-5694 Staff:
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ^ ~ ` d S Site Address: 3 $ /ta A' ac' 2 'L'J' t.,.) / Y
Tenant: Suite
RESIDENT I OWNER Name: -;.•f I•tf Ay4.J.¢4,r 1 L:-f 'r Phone: - 3 - q14 - - 3 7 z -
Address I City I Zip: '7°AR E. oa,,sow Lra 1 fib. /)74 l-f- £2?L I4iu
Applicant is: Owner 2 Contractor
O r L
TYPE OF WORK Description of work: o d. + Q - ° G i - r -s
Construction Cost: g £ OO Multi-Family Building: (Yes / No
CONTRACTOR Name: S,xT' ° 2 !V.4-rw License # . o R
Address; 4' 3 W a
City: P'I PLS State: /'2 Zip:
Phone: k 1z - x6 G V Contact Person: -b4V £
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
New Energy Code Worksheet
Energy Residential Ventilation Category I Worksheet
Code
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone.
NOTE: Plans. an d supporting documents shat you submit are considered to a .pudic ho ?natfon. port ons of
the !nfo r adore mlay be c(Isslffed as non-pu,blia'if you provide specific reasons that Would permit the city to
c crets.:
y are trade se
orrcl~idf3that the
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
I ans
accordance with the approved plan in the case of work which requires a review and approval 0
x i4 ~a c~ (t-~~ 5 x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
TO 39Vd 1NIVW d0Id31X3 139 L9Z9I98ZI9 50:ET 6OOZ/ZO/60
L9E9T98ET9
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 3816 Willow Way
Lot: 63 Block: 1 Addition: Briar Hill 4th
PID:10- 14993 - 630 -01
Use:
Description:
Sub Type: e - Air Conditioner
Work Type: Replacement
Description: Air Conditioner
Comments: Questions regarding electrical perm
952- 445 -2840.
Fee Summary:
Contractor:
Sedgwick Heating & Air
8910 Wentworth Ave S
Minneapolis MN 55420
(952) 881 -7739
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Permit Type:
Permit Number:
Date Issued:
Permit Category:
equirements should be directed to Mark Anderson, State Electrical Inspector,
Owner:
Mary L Wierschem
3816 Willow Way
Eagan MN 55122
$50.00 0801.4088
$0.50 9001.2195
$50.50
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Mechanical
EA078076
06/04/2007
ePermit
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 3816 Willow Way
Lot: 63 Block: 01 Addition: Briar Hill 4th
PID:10- 14993 - 630 -01
Use:
Description:
Sub Type:
Work Type:
Description:
Census Code:
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264 -4777
e- Windows/Doors
Windows/Doors-New/Replacement
House
434-
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Construction Type:
Occupancy:
Carbon monoxide detectors are required by law in ALL single family homes.
$88.50
$1.50
Total: $90.00
Owner:
Mary L Wierschem
3816 Willow Way
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
0801
9001
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Building
EA091425
10/02/2009
ePermit
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City of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use ����
Permit #: 40, to /to
Permit Fee:
Date Received;
Staff:
45- act /fz
199
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Data: 014-Y i9 i.2 Site Address: 3VG, 311 / 8, 3 8:t e , 3 S'2.2
,..
.;RESIDENT!.
("INNER -,.
Name: c% ASSo4-t r} -r1") P �.4.J �'+1 4 r 44i- 0 4, 7" -;Phone: 7 4, 3 - 4/141
3 74- 7
Address/city/zip: 7ozZ £..756( 44/ Jea /4»Pi or .S:i-3/1
.
Applicant is: Owner k Contractor
T ` 1.'•`.. I
T'fpE:;.:..:
QF 11N( .
Description of work: 7+/o a. QX•2c uF 0 w L`c. r ..s 4, R.010f-"S 0.a L y
Construction Cost 7, 4/ULA. Da Multi -Family Building; (Yes )<:. / No
)
PONT7'OIR'',
•
Company: !fie/ Z'x 7.-42iGI. 2 /4474.- r. deo2P, Contact; t - L RIS,
Address: yo s— /3. 10o rbc S`r, City: /SPG .5 ,.
State: M A Zip: SZ -V/ 9 Phone: 6 IA -• 8 4I , 6 2. V 3
License #: a -- .7 c/1/ 3 I Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
_Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan Issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber: - Phone:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
NOTE:-RIQf4#nfi;$it!p 11 tj,o! 1 a
theanf',. 800::maybe a led': :`von,Opblic.:ff,` w'p,:.vide<.. ,cift; � p. o/�u/Ipner�
Vit:..... �±� �'��iGCth � �`
..,... .,.:-.:,,,..,... A 6/Rthat ,they '.fire.areiie.secrets: . •"'`: i' : ... ..- , ..
•:�
.
CALL BEFORE YOU DIG, Call Gopher State One Call at (661) 454.0002 for protedion against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.aopherstateonecali,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 wort 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 Buildir3p»Cpde must be completed within 160
days of permit issuance.
x 6/44/1 Aof2i.
Applicant's Printed Name
t'0 39dd
Applicant's Signature
Page 1 of 3
1NIdW el0I?l31X3 I3S L9Z9I98Zt9 SZ :Ca ZIOZ/6Z/S0
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Use BLUE or BLACK Ink
1 _ -
For Office Use /
j Permit e:
MY of Eatan I Pearnh Fee:
3630 Pilot Knob Road
Eagan MN 65122 Date Received: j
Phone: (651) 6755675 i~
Fax: (661) 6766694 I I
I - - - -
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
babe: /1 /3 Bite Address: `3S 1 (o , g I T, 1816, 3 ? A 11 W11-Lei',.9 JOY units:
Name: A1.4^1 <i b £ /•t ,s:. r C. Phone: 7 3 - S ! 3 - 9 '7 710.
Resid.~nt1
Owher Addms / City / Zip: Sso Q t ewYu Q Av, Al\, A Coc6ta£~ 11i-Ll.E r IWA)
. Ss' yx 7
Applicant is: _ Owner Contractor
Type.at.:Wc R DewAption ofwwk: (4-6-f- a- RE PI-4-c->: ~%d ~ w► b a >~,~-sc.~a :m-rO4
Construction cost; do • CrO Multi-Family Building: (Yes ~ / No
Company: g E J r £.~i c 2 IY~ieti ~T . Cv p Contact I)A+~ r p Q`' ~ S
coqtmctor Address: IVo.s' CO &,D) r. City: n? PL S
State: Zip: 5S'`// /r Phone: lv/ - to / Co Z X13
License m x 4
/ Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional Information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW 6UILOINt3
In the last 12 months, has the City of Eagan inued a permit for a similar plan based on a master plan?
„-Yes -No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: iris~yjtgr
i~i►ibrntattfon ~°Y~+►iRr1id
CAS BEFORE YOU DIG. Call Gopher Sh ter One Call at (691) 454-0082 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utl", v6ww.gopherstateonecall.ora
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
a0m; that I understand this is not a permit, but only an application forreawpermit, and work is not to start without a penult; that the work will be in
accOrdance wttn the approved plan in the case of work which requires a vie entl approval of plans.
Exterior work authorked by a building permit issued In acconlankas with the Minnesota State Building Code must be cote leted within 180
days of permit issusnw. p
~aV,
Applicanre Printed Name X
AppllcanCs Signature
Page 1 of 3
TO/T0 39Vd 1NIVW 1X3 139 L9Z9T98ZT9 TT:ST £TOZ/80/TT
Use BLUE or BLACK Ink
f;or Office use
Poynas; i I ~~FI
of &qan t~+~5
Dbenit Fee:
am PNOt Knob Road I I
Eagan UN 55122 I hate Re=Wd: ~ 3 ~ t I
Phofw: (601) 6704676 I
Fate (661) 67"664 I I
2413 RESIDENTIAL BUILDING PERMIT APPLICATION
Data. / o - i i3 Site Addnt 9: Uf , 38/ p . 32,L0 . 3~:i:Z (A..j,41_O W LJp4 r Unit#:
Names 'V& R C r V j4 AJ 4 le 4M LAJi xa C Phone: 7t'oI -.s'r 3- 9 7 70
Address / City ! Zip: V S0 c G W-r--u Q 491 AJ A (ao1. ~l -9 V" U*
•J~ ~ AJ
Appiftnt is; Owner Contr=tor
Downption ofwork: '7'£.4Q oAF't a• 2E - Po=F
Consttudion Cost 7th, crc Multi-Famly Building: (Yes k' ! No I
Company!E ) Sim r-t2Io,t' /947.a L..arG.lp Co' I~tAVi d Ts%1PR.R 5
-I
Addn3ss yo S W 6 ~ > . Chy: /h PL S
State: ✓VJJ zp SS'Sr/ 9 Phone: &,.I
Licanea;le read Cerfiiieate d
If the project is eXMPt from lead cerdfif~rdvn, please explain why; (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In !!w fast 12 monnta, hae ttte City of ftgan Issued a permit for a similar plan based on a mas*r plan?
_Yes _.I'lo If yes, date and addreas of mwW plan:
Licsnaed Plumber per,
Machaamw Contraction; Phone:
Eswsr I>< 1NaoEtr Cot>,>~tor,
No Phone:
tlFle4j.
Y M • Ca Godwr &me One Cep St r
tD 49 t0 fwgv-b f p~ Z for QIt Of) a"198Y~t tl~iQeV(OWIf~ UdrrQl dflffl~@. ( 1{$ to=
wWarw~o InMd tttllWL iWLN ..r
I hereby actawWWge dmt this inlott WOW is LO
Ft~C that I undeMMW is not a Damn X"P °;1tWt the v,** Wdl be in cor~Eoenattaa with dre orglaanoes and codes of the of
+ccordar►tc wLn the wvp+ou.d pin in ms 0s0 a a andvm*~ no to sun %idud a pwrMt #w the WWk VA be kv
"Wked by bsmwm a bWldltVPermit issued In M wHdt ttw Minne9oel State Mcligp Code must be
days of P$Mdt
oanplitod wlWn 180
~~~~e, ~uma is
ApPltcaM's PHntaed teatne
A"UcWs SlgrwMm
+ Pa9a 100
9
ZO/TO 39Cd 1NIVW 1X3 139 L9Z9T98ZT9 ZT:60 ETOZ/TE/0T
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA139494
Date Issued:10/25/2016
Permit Category:ePermit
Site Address: 3816 Willow Way
Lot:63 Block: 01 Addition: Briar Hill 4th
PID:10-14993-01-630
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Mary L Wierschem
3816 Willow Way
Eagan MN 55122
(952) 806-5009
Crew2 Inc
2650 Minnehaha Ave
Suite 100
Minneapolis MN 55406
(612) 276-1680
Applicant/Permitee: Signature Issued By: Signature