4390 Woodgate Lane NDate:
City of Bain
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
O\
<\
Use BLUE or BLACK Ink
Permit Fee: 90 • 00
Date Received:
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
za I Site Address: q'3 /U N IAJ O A E
J
Unit #:
RESIDENT /
OWNER
Name: g4.i, t BuS UI 4M Phone: 65/ - g$B-gi.3Z
J
Address / City/Zip: 1-13 %Q N Wvo/JGATT (.N . 44441 ivAi
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: '%' p /400 - Z,5"56, 7:30
Construction Cost: 17 600.01, Multi -Family Building: (Yes / No )
CONTRACTOR
Company: /AC goPKeiQ l p Contact: .5�.-pr k,
Address: Z.70/ —g6' Ater S. City: fdielyyuitirgjjjL25
State: PIK) Zip: .5.71.04. Phone: 6/L.-SII—JOS::°
License #: 86/7 Lead Certificate #:
Does this project require Lead Remediation? 0 Yes 4No (see Page 3 for additional information)
If no, please explain:
In the last 12 months,
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:
_Yes _No
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
TE: Plans and supporting documents tha• t you submit are considered to be public information. Portions
the information maybe classified as non-public if you provide specific reasons that *06,permitthe jCity to
r . `_ ..conclude / at` they are trade: secrets,.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 stawithout 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.
x Az,' -
Applicant's Prided Name
x
Appli
ature
Page 1 of 3
CITY OF EAGAN WATER SERVICE PERMR
38WFila-Knob Rwd
P. O. 8ox 21199 ~ PERMIT NO.: u~c- :
Epan, MN 55121 p,~~; 7-3-35
ZO'^i~'~D: ~ No. of unih: 1 ~
i0i[1°S
OwrKr, ='-i-dZ1 T
S+t. llddrow n9a] 1 ard Pk-3 -
Plixnber.
Mft~r No.: 5 ~ Corinection Cha 500.00pd
St~s• C,~,n r, • I5. ti)U
Pemnit Fee: 10.00
I Mw ft esnpll wft !IN Ciy of "o 5urohorye: .50
~1 S C
odt.see... Mtsc. C?w.pn: 132.00 -63. 00ndmeter
l _ ) Totol: ;
BY Data Paid:
Oote af Irnp.: Irpp,;
CITY F EAGAN WATER SERVICE PERNUT
3830 Pilot Krwb Road
P. n. Box 21189 PERMIT NO.:
Epan, MN 55121 DATE:
ZonlnD: No. of Units:
Ownw:
Addrat:
Sih /1ddrom
Plurrbor.
Mehr No.: Connoetion Chow:
Sir.e: Aooount Deposit: ,
Reoder No.: Peemit Fes:
1s/m bSSE,* MMh tw Qep oi Wr+ Surchorpe:
0rdlewww& MIsC. Chorpes: .
Tatnl:
' By Dah Poid:
Doh of lewp.: {nlp.:
CITY OF EAGAN SlWER SERVICE PERMIT
3830 Pil3t Knob Rosd ,
P. O. Brr 21199 PERMIT NO.:
Eagan, MN 55121 DAT'E: 7--r--
Zordno; No, of Unlts:
Ownwr.
llddress: 7 '~'la
Site Addr~sss: - -
Plumber. `•'f'~~l'~'7x~,'r - E'~hr~ ~s .
1.JJ. UU'"r-~`•,
1 Mno !r MMhr wft IM'GMf Of MMO C,orwocticn Chorqt
Aooount Deposit: • • . :'1 ~
Oe~~eN. Pgnrit FM:
Surdwrpo:
By Miu. C1wrpm
Date of Irop.: Totol: ~
Infp.: Dah Raid:
CASH RECEIPT
! CITY OF EAGAN
' P. O. BOX 21-199
I EAGAN, MINNESOTA 55121
DATE
~ wcee~vso f _Y,~
I
wMOUNT
s oo~~wws
~oe
~ CASH CHECK
a
.oR J~i ; r,•r.r.~" r G'.~~-C~'L..~
n ~ .
rUNO CODg AMOUNT
- - r~
/
Thank You
er , . ~ ?"._.i'
. . .
YVhite-Psyen Copy I
Yellow-Portinp Copy i
Pink-File Copy I
Receipt (f ~ MECHANICAL PdRMIT Pe?mit No.
~ CITY OF GA
fiA N
Fes $ 26.00
=
ff!l i» numbered spaces S/C
Type or Prinr legiblY ' Tot a 20. SO
1. Date 7' 23- 95 2. Installation Cost
3. Job Address 4~9() wc,odqate Lot 81k. TraGt1
j _
4. Owner V'enslmn.*~ H:xnes, Inc.
5. ContractorKlevF HeatinR &A/C Inc. phone 941-423.1
6. Address 13075 Pioneer Tra i 1
7. City Eden p.rairic gtate Flinnesota Z;P 55344
8. Building Type: Residential E] Commercial 0 Institutional ?
9. Work Description: New t] Add ? Alter ? Repair ? 'J
10. Describe ~'ew Hotise !4eatinq FuelType Natnral Gas
11. No. Epuioment 8TU • M. Ea. No. Equiament CFM
1. Forced Air jennox A"cx9e1 Air Handling:
Mfg, r12^3E-110, 110,00
Boilers x venti, ~
Mech. E~Cha st
Mfg, onl for kitcen hood
Unit Heater & 3 bath fans
Mfg. Other
Air Cond. ,
Mfg, j
1 Ga:, Piping Outlets 17'iirnace lv I
i
1
I
12. 1 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 end approved.
Approved CITY OF EAGAN 464-8100
Receipt PLUMBING PERMIT Parmit No.
CITY OF EAGAN • ~
Fee
Fi/l in numbered spaces S/C
Type or Prin[ legib/y • Tot. ,
1. Date 2. Installation Cost !
. a
3. ,lob Address Lot ' Blk, Tract
,
4. Owner 4,,,,,~i
5. Contractor Phnne
6. Address
7. CitY State Zip
~
ype: Residential ['t7 Commercial ? Institutional O ~
8. Building T ~
9. Wnrk Description: New ~ Add ? Alter O Repair ? ~
,
10. Describe ~
j
~
11. No. Fixtures No, Fixtures ~
-
~ Water Closet Cesspool/Drainfield
. ~
~ Bath tubs $eptic Tank ~
l.avatory
$oftner j
s
Shower vye ll ~
Kitchen Sink ~
Urinal/8idet Other ,
~ Laundry Tray ' Floor Drains ` i
Drinking Ftn.
Slap 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 : „ ~for ?
' Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved. I
Approved CITY OF EAGAN 454-8100 i
a4'F-=.
PERMIT ~k
PLUMBING PERMIT RECEIPT lf
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE PHOHE: 454-8100 l
Site Address ~ BLDG. TYPE WORK OESCRIPTION
lot Block S%Sub Res. New
Z-:- tt;L Mult. Add-on
m Name Comm. Repair
~ Address ` Other
c City Avy Phone y ' b RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAI
Water Closet - $3.00 ~
Name Bath Tubs - $3.00
; Address Lavatory - $3.00
p City Phone Shower -$3.00
Kitchen Sink - $3.00
FEES Urinal/Bidet - $3.00
COMM/INO FEE - 1% OF CONTRACT FEE Laundry Tray -$3.00-
APT. BLDGS - COMM RATE APPLIES Floor Drains -$1.50
TOWNHOUSE 8 CONDO - RES. RATE APPLIES Water Heater -$1.50
MINIMUM - RESIDENTIAL FEE - a12.00 Whirlpool -$3.00
MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets -$1.50
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIn
(ADD $.50 S/C IF PERMIT PRICE GOES So(tener -$5.00
BEYOND $1.000.00) Welt - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
tf
,
~4~-
SIGNATURE OF PERMITTEE fEE
' ~J ? r- >
STATES/C:
FOR CITY OF EAGAN __6_4
GRAND TOTAL•
Reoeipt PLUMBING PERMIT Permit No. r
CITY OF EAGAN FN
~ fill in numbered spacea S/C
Type oi Prini /eyib/y TaL
1. Date 2. Installation Cost
3. Job Address Lot Blk. Tract
4. Owner • - , -
-
b. Contractor'- ~-+r.~ 0-1
~[l~one
6. AddfefS tJr
7. City State Zip
8. Building Type: Residential 13 Commercial O Institutional ?
9. Work Description: New O Add 0 Alter O Repair 0 I
;
:10. Describe
"t
11. No. Fixtures No. Fixtures I
Water Closet Ceispool/Orainfield
Bath tubs Septic Tank
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.
i
Signed: 41 for
Rouyh F insl
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
' Approved CITY OF EAGAN 464-5100
1
0 CASH RECEIPT ~ I
CITY OF EAGAN
P. 0. BOX 21-199 I
EAGAN, MINNESOTA 55121
DATE 19
wccwco .
..7
AMOUNT $ f" I[ I
' II
a DoLLwRS I
I
[3 CASFI CHECK ~I
i
~ I
I
RUND CODi AMOUNT I
p I
' C. • ` .1 I
L
' f/ G v j P
• ~ =
I
Thank You ~ . .
_
i? k
White-Payen CoPY
Ysllow-Pottinp CoPY
Pink-Ffle CoPY
CITY OF EAGAN Remarks
Addition M.13.1ard ParY Third Addition Lot 17 Blk 7 Parcel #10 47252 170 n2
Owner st?eet 4390 North Woodgate Lane state Eagan, MIIV 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 269$.43 . 539.69 5
STREET RESTOR,
GRADING
SAN SEW TRUNK 17 `J
~
* SEWERLATERAL :yjyq 1981 3412.34. 682,47 682.50 88 10-25-84
WATERMAIN
.
* WATER LATERAL igRi
~
WATER AREA ~eAl
STORM SEW TRK ~ 10-25-84
* STORM SEW LAT 198
CURB & GUTTER
SIDEWALK
STREET LIGHT
280,00 53310 8
WATER CONN. 500.00 " "
BUILDING PER, pO if
SAC
25-00
PAR K
INSPECTI4N RECORD
CITY OF EAGAN PEhMIT TYPE:
3830 Pilot Knob Road Permit Number: ''0"''4
Eagan, Minnesota 55123 Date Issued: f~•~"`
(612) 681-4675
SITE ADDRESS: l 1,45 HI rit r. APPUCANT: .
, i rtirlfl[i111 F" t A1M1` N ~ I~ 1, I•s~~~t
Ftr~l I ril~l~ t J\F,t t+~l.') A~•4 '•~9r,,-
PERMIT SUBTYPE• TYPE OF WORK:
~,t!, , ji!i-.1i i..~,1
INSPECTION
II ~ - - - - - - ~ ~
wrn+n No. ae.mn ?+olde. aes Tikphor.
SNV
PLUMBING
HVAC
ELECTRIC
ELECTRtC
Inspection Dab Msp. Commsnb
Fooli?gs I
Foundation
F'am"° 0`719 3
D
Roofft
PIMO Pft.
R°uo ?n9. L
Firoplece
Fnal Hlg.
Orpl Test
Fn91 Plbg. PIbg. Irmpedor - NotHy Plumber
Corret. Meter
ErgrJPlan
eldg. Fffug
Dedc FLg.
DeCk Fk181
VIIaN
Pr. Diep.
CITY OF EAGAN !
. ~ PHot Knob Roid, P.O. Box 21-199. Esysn, MN 55121 , 9~~~~
PHONE: 4548100 ~
eviLDiNa PMMff Rec.ia . TO M we/ iK Est. Vclus Date 14 : J
Stte Ad . F% .i. [ i Erect Q Occupamey -
Lot ~r Block ^ See/Sub. ' LA~ Remodel ? ZonirN
Repafr ? Type of CorMt,
PWCGI No' Addkfon ? No. Sta?iw
i C; M F ` Wtove O l.tnytn .
Name " ' Demollsh ? depth
~ Addnss Int lm ?
Pr• Sq. Ft.
City Phons ' 2 Install ?
App.en.b ~ .
~ Name
A~~ Assesunent Permit
~ City Phons Watar 3 Sew. Suroherye • J
Poliu Plan Revfew ~
d Narrn Fiee SAC
k: ~z
Addroa Enp. Water Conn.
City Phone Plonntr Water MeMr
Councll Road UNt
- ,
I heroby ocknowledye thof I how read this opplication ond storo thot Bldg. Off. Tc PI.
A~
fhe inlwr»otion is oorted ond opree ro comply with oll opplicable
Stob of Minnwsota Stotuta ond Gry of Ea9on Ordinoncss. Park&
Var. Date C~~~
Slpnotun of P~nnitt«
Total . ~
A Build{nq Ptrmit Is isswd to: an !M tnpnm eadifion thoi
all work shall be daw in oooordonce with oil Qppliooble Stoft of Mlnnesota Sfatuta ond Gty at Eoqan Ordinonpm
SuI14in0 Offkid r •
r~
- Pwmk No. ?nmit Ho1dK DOA TNePhoM ~
Plumbirp 3
H:VA.C. 5~ 'ra Y r~~ q v
Ebatria yv6 15 Pe~~ o
sofan..
Inrp~dion Dab Insp. Other
Footings I 5
Footlnpsll
Foundatlon
F?ominp -
Rooflnp 4w
Rouph Plbg. -
Rough Hty.
Inwl
Flnplace
Final Htq.
FIwN Mbp. ~ -
Finul
C1VOQc•
yl~
Wder io ~h~ i•! ~
Wa11
seMlef
Pr. DIspk.
~r
;
K~42 70
Repu ~ Oale Frt o a M1. n Inspe<UOn
Repwretl7 ? Reatly Now JI Notdy Inspetlor
i l Ves C No W~en ReaCyl
I" licensed contractor p owner hereby request inspection of above elecirical work at.
Jab rqtleess ISlre¢i. Bos or Poute No I Qty
4140
Section TownsM1ip Name or No Range No ounty
Occupam IRNT~ Ppona No.
Y - S~Z
Power Suppeer AtlOreu
Eleclncal Conhactar ICOmpany Namel COniraclors L¢ense No
MaOr, Atltlrasz IConvaclor or Owner Makin InstallaL0n7
/
S ! /
Aulhonxetl S~gnalure Gon raclor•prvner Ma4ing Instailalion, Pnone umber
60
MINNESOTA STATE BOAflD OF ELECTqICITY THIS INSPECTION REOUEST WILL NOT
Grlp9s-MiEway BIEg. - poom S173 LIh 1I BE ACGEPTED BY THE STFTE BOARD
1021 University Ave.. SL Gaul, MN 55104 UNlE55 PROPER INSPECTION FEE IS
1x1rone (612) 6024600 ~+1~ ENCLOSED.
9 REOUEST FOR ELECTRICAL INSPECTION ea-ooo01-
? See mstmcliQns br comAlenng tnis lorm on buck ol yellow mpy
K4 2 0 7 O °X" Below Work Covered by This Request
ew Atltl Rep. TypeotBmlding AppliancesWiretl EqwpmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Co /Industrial Fumace
Farmmm Air Conditioner
Omer (syecdy) Comrxtor's Remarks:
Compufe Inspection Fee Below:
# Other Fee fF ServiceEntranceSrze Fee # Circmts/Feeders Fee
Swimming Pool 0 to 200 Amps o to 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
SignS inspecmr§ Use Oniy. 7pTpl~~y
Irrigation Booms ~ Q
Special Inspection
Alarm/COmmunication THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS. ~
I, the Elecirical Inspector, hereby ROUgh-in ta /
certify that the above inspecnon ha5 F,~ai ~ oa~e
been made.
OFFICE USE pNLY
Tms raquest voitl 18 momns imm "
Thit requast void 5 3 g a-(g s
B~~~~~
Renunst Date Fire No. Muph-in Inspeciion
He u retl? DNeatly NuwWWill Nolily Inspec-
7-19-85 Yes ?NO I., N'henReaAy
~ LicenseA ElecLical ConUacmr I hamb request i
y nspection uf xbovo
?Owner eleehical wwk installeE aC
SIree1 Atldress, Ibx or Raule No. Giv
4390 Woodgate Eagan
ecuon o. Township Name or No. Nange No. County
~ Dakota
Ocr,upnntlPNINTI Phune No.
Ste h-An Homes
Power Supplier Address
Dakota Electric Farminton
Electrical Convacmr (COmpuny Name) Conlraclur's License No.
041192
MaJ~ng AtlJr~ss (Convuclar ar Owner Making Instailation)
13359 Foliage Ave Apple valley, MN 55124
Authorize ign'turc ( ontract OwB lnstallatiun) Phone Number
432-4022
MINNESOTA STpTE BOAP F ELECTBICI7Y THIS INSPECTION NEQUEST WILL NOT
Griggs-btidwaY Blde. - poom N-191 BE ACCEPTED BY THE STq7E BOAHD
1821 UniversitY Ave., St. Paul, MN SStOC UNLE55 PNOPEH INSPECTION FEE IS
Plwne (612) 297-2111 ENCLOSED.
!x/ REQUEST FOR ELECTRICAL INSPECTION M. Ee-ooum-na
' Sea inshuctiens tor co ~
q mpletirrc~ this form on back of Ve4ow cooV~
1;4 O O 1 5 "X" Belnw Work Coveied by Thrs Request X ~
HAd Rap. Type of Building AoPliancea WiraJ Equiumem Wired
Home Range Temporary Service
Duplex Water Heater Lightiny Fixtures
Apt. Building Dryer Electnc Heatin
Commercial Bldy. Furnace Silo Unloader
Industrial BIAg. Air Conditioner Bulk Milk Tank
Farm Oint, veci v Olne, Isne~,~y)
n,r Succity Oihm 01her
ompute lnspection Fee Below
p Fee SarviceEntrenceSize A Fee Feetlers/Subleeders M Foe Grcuits
0 to 200 Am 5 0 to 30 qm s 0 m 30 Am ~s
Above 200 qmps 31 to 100 Anyps 37 to 700 qm
Swinvnfng Pool Above 700-Amps Above 100_Amps
Transformers Ivigation BoortS Partial.'Other Fee
Signs Speciallnspection
flemarks $52.50 TOTAL-F^E E~
/ 'G v
flouBh-in D~b \ /
'/`'f~ I,~heElecvical
~ Inspector, M1e~oby
Ffnal p: 1e certdy that me above
~ uuepection has been
TMs repuest vo1018 montns Irom
,
CITY OF EAGAN .
3830 Pilot Krrob Road, P.O. Box 21•199, Eagan, MN 55121 N0- 10509
BUILDING PERMIT PHONE:454-5700 Receipf # ~ ~
,16
T. b. med fer sf DWG/GAR Esr. Vaiue $93, 000 pate JULY 3 1 y 85
SiteAddrese 4390 NO WOODGATE LN Erect C.i Occupency R3
, 2 Sec/Sub. MALLARD PK 3 Remodel ? Zoning Rl
Lot 17 Block
?
Parcel No. Repair Type of Const. V
' AdCition ? No. Stories
W Name STEPH-AN HOMES Move ? Langth rj2
Damolish ? Depth 40
; Address 14340 PILOT KNOB RD ~~~,~mP~ ? Sq.Ft.
b Citv A.V. Phone 423-3322 Insteu ?
o Name SAME AVworab Feas
oU Address Asuzsment Permit • ~
u~ City Phona Water d Sew. Surcharge 46 . 50
Police PlanReview 206.00
~ Name Fire gpC 525.00
Addrns Erq. WaterConn. 500.00
~W City Phone Plonner WaterMetar 63.00
Council RoadUnit 280.00
I hereby acknowledge thaf I hav r d t OPlic h und ztote fhaf Bldg. Off. 7I2/$ 5 Tr. PI. 132 . 00
fhe in(ormofion is correct and to pl 't all oPPlicable APC
Sfata o4 Minnewto Stafutes on o r rqnces. Parka
Var. Dete Gopies
Siprwruro of Permittea Total $2.164.50
A Buildinp Permit is iuued to: STEPH-AN HOMES on tha axDmu cordiflon ihat
oll work shali be done in ocmrdonce with oll o icoble Stafe in to Sfatules ard Ci1y of Eaqan Ordironces.
BuHdlrp Official ~ ,d~n ~
So
2006 RESIDENTIAL MECHANICAL rExnuT arrLicaTioN
City Of Eagan
3830 Pilot Kaob Road, Eagan MN 55122
Telephone # 651-675-5675
~;,,r~i:..
:
Pleasecomple[e for. single Family dwellings & townhomes/condos when permits are requ¢ed for each unit
Date %-b /Cj'(n
Site Address A5q 0 l_a)2&(y0+C_ ~_Yl 1~ • Unit #
PropertyOwner Telephone#451 )LaK-QS3Z
d
Contractor Wohlers Southside Htg. & Air, Inc.
6950 W. 146' St., #106
Street Address Apple Valley, ARN 55124 City
(952) 431-7099
State Telephone # ( )
Bond R La- ()S,4 9 8,7 Expires: U8-
The Applicant is _ Owner X Contractor _ Other
Add-on or alteration to existing dwelling unit $ 30.00
~ furnace _Additional ~ Replacement _ New
air exchanger
air conditioner
heat pump
other
State Surcharge $ .50
p
Totei OCT 2 3 2^u~,
I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; tha[ the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; [hat I understand this is not s
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.
ch~d La-,WfY3 n1-1
Applicant's Printed Name Applicant's Signature.
~ s sG s . . 30.s6
2006 RESIDENTIAL MECHANICAL rERMtT arrLicATiorr
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single family dwellings & townhomes/condos when permits are roquired for each unit
Date I l~ DOC
S 3 wvod GC4 Unit #
Site Address
Property Owner Sh pYOYI n ~ SoN Telephone i1( b-5I ) la ,5FrS- 006
Contractor h{r mrt~S tCYS ..Z~
Street Address .S1 W~~~ Ci1Y 1..~~ e U o-1 I e-4
State rn IV Zip ,S~512V TelephoneH T 3/- Scl 3_:~
Rond Expires:
The Applicant is _ Owner ;X Contractor _ Other
Add-on or al[eration to existing dwelling unit S 30.00
~ furnace _Additional X Replacement _ New
_ air exchanger n
W / 9
air conditioner
heat pump
other
I
i
State Surcharge $ .50
~
Total S 2c)
I hereby apply for a Residential Mechanical Permit and acknowledge that the information is compled: and accurate; that the work will
be in conformance with the ordinances and codes of the Ciry of Eagan and wi[h the Mechanical Codes; diat I unders[and this is not a
permit, but only an application for a permit, and work is uo[ ta star[ without a permi[; [hat the work will be in accordence with Uhe
approved plan in the case of work which requires a review and approval of plan .
Jk `i__ Fm vY, e r ~~'~?~-J'i~i~
Applicant's Printed Name Appl' nt's Signature
221 ~rs.so
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION C k' ~`0 Z Z~ Z
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date
Site Street Address c) ~ ~-v %l-~~ ~-11 ~ • Unit #
PropertyOwner2F %,C- L f\ Telephone# ~051) LGjn" 15
~
contractor` Qj7-C .t relephone # ( ~I'~i Address'-T)Z) `V~ R ~-4LlMJ ciry -I -L ~Cl~l 1 State l ~ l z;p
The Applicant is: _ Owner _?C-1 Contractor _Other
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures (exciudes water softener and/or water heater--complete next
section if installing these appliances).
_Septic System Abandonment
_ Water Turnaround (add $125.00 if a 5/8" meter is required)
Other:
_yWater Softener _ Water Heater $ 15.00
_ new ~ replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
Total $1 ~
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, but 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 approv d.
ApplicanYs Printed Name ~ p IicanYs~ nature
4 7 2 • +
~ 46•5+
.296a..+ '
1985 BUILDING PERNIT APPLICATION - CITY OF EAGA 525•+
500 • +
NOTE: ALL CONTRACiORS MUST BE LICENSED 1fITH ?HE CIiY 63•+
280 • +
INCLUDE 732•+
3 CERTIFi 22164•5 *
1 SET OF ENEI
/ _
To Be Used For: ~ Valuation: Date: (p '01~~J
Site Address: ~~/v /Ll7LFi~ ~pFFICE USE ONLY
Lot: Block -2- Sect/Sub Erect ~ Occupancy
~ Remodel _ Zoning ~-I
Parcel U Repair _ Type of Const ~
Enlarge fl of Stories
Owner Move _ Length 52
Demolish Depth 40
Address Grade _ Sq Ft
City/Zip Code
Contractor APpROVALS
Address /y3yo ya/pssessments Permit Q12 ~
Water/Sewer Surcharge 4~.so
City/Zip Code Police Plan Review
Fire SAC 525.°°
Phone Engr Water Conn Soo.°'
Planner Water Meter
Arch./Engr Council Road Unit 2~•='
Bldg Off 7 2 K5 Parks
Address APC Treatment P1 132.~°
Variance /
Phone ll ?OiAL to y( S O
.
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o OENOTE/~ 12otJ MoNtiNIENT
I hereby certify that this survey was prepared by_ me or
under my direct supervision and that I am a duly Registered
Land Surveyor under the laws o#' tne State of Minnesota.
Dat e: Al
LeRoy . Bohlen
Registered Land Surveyor No. 10795
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STEPH-AN FIONES NC.
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EXTERlOR ENVELOPE AVERAGE "U" CDMPUTATION ~~~•~z~~:
ONNER
SITE ADORESS
, CONTRACTOR yte'VW.AU I40M47,1e(e-. DATE PHONE 4L3-;,)22
Determine working square footage of each.
1. Total exposed wall area 206Q%qv sq, ft, x i .
2. Total roof/ceiling area [ p 7 d sq. ft. x_.OSS • 00
Total exposed wall area above floor =_LMLeD
a. Total wail window area Zo 0 00
b. Total door area
3 7 2?
c. Total sliding ylass door area
d. Total fireplace wall area........................
~
e. Total wall framiny area (average 10%) .ZO6-94
f, Total net wall area above floor ~l~
. 9, Total rim joist ar•ea 7 B.ZZ
Total e:<posed foundation arQa = 00.40
h. Totai foundation window area 13-r2
i. Toal net foundatiun area above gra6e
Determine "U" value of each u411 segment.
a. 20voa _ X "U" , 51_ ~ l/O.vO
b. V7-S/ z ^U" - 13
C. X "U" ~ •
d. X ~,UN ~
e. 206.9y z „Ue , 04
r, l3G(o.o3 x°u^ .04 • Svcy
y._ 178-zz x 1.u° 04 • -7-rz
h. ~-3 -lZ x "U° • 5Y • ?-Z/
i. G7-z8 X "U" • , ~f .
9
3.......,...~~.~?9: 4a ..............Total • Oj.
]f item 13 is the same as, or less than item il, you have met the intent
of SBC 6006(c)2. .
?otal exposed roof/ceiling area = (072-00 ~
j. Total skyliqht area.............................
k. Total roof/ceilinq framing area (average 10%)...
1. Total net insulate6 roof/ceiling area...,,,.....
Determine "U" value for each roof/ceiling se9ment.
~ x ,luil ~
k. X "U" •
1, D y'L OD X~~U"
a .................ID.7.?:QU....... Total
if total of 04 .1s the same as, or less than 12, you have met the intent, of
SBC 6006(c)1.
Alternate Buildinq Envelope Design
To utilize the total envelope system method, the values established Dy the
sum of ltems A3 and 94 shall not be greater than the sum of items 11 and 02.
t._ Zz7.c:3 t 2. ZGW
3. Za%;a+ a._zGro
WEPJA CO. PLAN SERVICE
ED ANDERSON
ARCMITECTURAL OE9IGNING AND PLANNING
5397 Vppar 147th SVeet
Apple Valley, Minnesota
ResiCence: Office:
423•5658 6233775
PERMIT i";7
CITY OF EAGAN PERnnirrvPe: sur~o
3830 Pilot Knob Road
Eagan, Minnesota 55123 Permit Number: 020924
(612) 681-4675 Date Issued: 0 5/ 12 / 9 3
SITE ADDRESS:
4390 WOODGATE LANE N
LOT: 170 BLOCK: 2
MALLARD PARK 3
P.I.N.: 10-47252-170-02
DESCRIPTION:
Buildirig_Permit Type BASEMENT FINISH
Building lJark Type ALTERATION
i ~ .
~
~ -
REMARKS:
SEPARATE ELECTRICAL PERMITS REQIURED
FEE SUMMARY:
Base Fee $35.00
Surcharge $.50
Total Fee $35.50
CONTRACTOR: OWNER: - Applicant -
VETTER PAUL
4390 WOODGATE LANE N
EAGAN MN
(612)954-5062
I hereby acknowledge that I have read this application and state that the
infiormation is correct and agree to comply with all applicable State ot Mn.
Statutes and City of Eagan Ordinances.
, J
A~.~°//r~c ,
A~CANT/PERMITEE SIGNATURE SSU D BV: S TURE
INSPECTION RECORD
CITY OF EAGAN PERMITTYPE: BuiLoiNs
3830 Pilot Knob Road Permit Number: 020924
Eagan, Minnesota 55123 Date Issued: 05 / 12 / 9 3
(672) 681-4675
SITE ADDRESS: Lor : 17e B L 0 C K: 2 APPLICANT:
4390 WOODGFlTE LANE N VETTER PAUL
MALLARD PARK 3 (612) 454-5062
PERMIT SUBTYPE: TYPE OF WORK:
BASEMENT FINISH ALTERATION
INSPECTION , „
FRAMIN6 FINAL
REMARKS: SEPARATE ELECTRICAL PERMITS REQIURED
- ~
REACTIVATE:_ ` 1ECEWED CITY OF EAGAN
PERMIT N MaY ~ q~993 1993 BUILDING PERMIT APPLICATION 0
681-4675
ao~a
SINGLE & MULTI-FAMILY 1_sets of plans; 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date / / Valuation of work
Site Address: 439D N, Wea4y44c LA"e,
STREET SUITE N
Tenant Nia-me. ;;:o,~imarcial uniyj
IAT 9 0 BIACK 01, SUBD. ,y~ 4I IA~ Parl( 3~,~ j~. P.I.D. M
~i
Descri tion of work: W_-.,a...f ;r's k
The applicant is: 9 Owner ? Contractor ? Other (Desaribe)
I Name ~erte~ P..., I OPI-l M 0.•4 Phone y Sy - Sa 6~
Praperty LAST FIRST ~
Owner Address 43`~a N. W oody„-ee~,.,G
STREET STE X
City a~Aya~ State h1N Zip SS1d'a
Company Phone
Co ntractor Address License p Exp.
City State Zip
Company Phone
Architect/
Engfneer Name Registration N
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer 8 water permits is two days once area has been approved.
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.
i U
Signature of Applicant: 1
OFFICE USE ONLY '
BUILDING PERMIT TYPE O 01 Foundation ? 06 Duplex ? 11 Apt./Lodging X16 Basement Finish
13 02 SF Dwg. ? 07 4-Plex 13 12 Multi. Misc. ? 17'Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory O 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex O 14 Fireplace ? 19 Comm./Ind. Misc.
O 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
O 21 Miscellaneous
WORK TYPE
31 New 0 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair D 36 Move
GENERAL INFORMATION
Const. (Actual) Basemeni sq. ft. ~wrc SystaT ,
(Allowable) lst F1. sq. ft. Lity Water
UBL Occupancy ~ 2nd Fl. sq. ft. PRV Required
Zoning Sq. ft. total Booster PumP
# of Stories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code V3-ZT
Depth On-site sewage SAd6g1 /
APPROVALS ~SuS u+wt o
Planning Building Assessments
Engineering Variance
REDUIRED INSPECTIONS
? Site O Footing jg Framing 0 Insulation
? Wallboard 9 Final ? Draintile ? Fireplace
Permit Fee 35#00 vaiuac;on: S
Surcharge .
Plan Review
I ir_ence
MWCL SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
5/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAL %
SAC Units
r.o . . . . . . :
I
2/84
' ° CITY OF EAGAN
APPLICATION! FOR PERMIT
SEWER AND/OR WFITER CONNECTION
, (PLEASE PRIHT)
1) PROPII7I1' ADDRESS _
IEGAL DGSCI2IPTICN:
; (Lot/Bloclc/Subdivision or TaY Parcel I.D, NuTtber)
g' ST':~:' :T<_, J.; ^~_".^i"r _ . . -
t,..~z:•iT
PRESENIT 7^;I1PX:/P20POSED L. E1 R-1 'STNGLE FANLZLY
p -R-2 DUPLE{ (Z470 UNITS)
, 0 R=.i'.TOWNHC(ISE (TI-RZEE + Wi ITS) ( UNITS)
' - ? R-4 APAF2'imENT/CONDa,4iiILM ( UNITS)
? CIXMMERCIAL/REI'AII,/OFFICE
0 IIvD' USTRIAL '
' p INSTITUTIONAL/13OVERNMENr
z) APPLICANr ~(ALEASE PRINT).
Y~H
ADDREss:
CITY, STATE, ZIP:
PHONE:
3) PLUM$gl - - - - PLEASE PRINT-) - -
NAME: ' FOR CITY USE OXLY
, ADDRESS : ~ ~ C~ tFP++
. EEAGAN MINN.55122 . PLUMBERS LICEHSE:
CITY, STATE, zIP• -~-.W..~~452•1565,~,~...._--- ~ Active
Erpired "
PHONE: pLUMBER.LICENSE 001445M2 - !?ot of.eecord
4) OC.~C[JPANT/aa[`1II2 ' . ~ a n i i a
` . . (PLEASE PRIMi) , . . , ,
nDDRESS : : , , . , ,
CITY. STATE, ZIP: . .
PHO:IE:
5) INDICAT'E WHICH PLRMIT IS BEING gDQUESTED: ~ .
- - ° - '
Q COrR`1ECTION TO CITY Sa]ER
CONNFX.TION Tp CITY WATER
? C7I'[fER (PLEASE DESCRIBE)
6) J1NDIGl7j-: CN'E: . . - ,
? PL.EASE fIOID APPRWEp PEgMIT. FOR PICK-f.Tp BY ONE OF ABpVE .
Q PLE7L;E MAIL .AF?PROVED PERMIT TO 1, 2, 6 q p,BOVE ~
i;
• (Circle one) '
DAT'E:
ii
~C. ~ . . . . %'i~ll ~T!
i~F~T
I~!{!! I
. .
~,y~~ : • . . ' ~ .i 7:'i.i , ~ .
F O R
C' I1' . ~ 't. . ~ .
TY: .fn.U S E O'N L Y~ . rEr::~~.is~~~Jps,~~~:~}'~'r.°•^+~ f~T•`(
. ".r._.,ti; Y; . ~ ' .'.c~21 yFi~T i tr:, .t
. . : • ~ y....i'~' :ri•'r,..
. PERMIT ~ ZSSUED
•
FEES: $ SEWER n~RMIT (IUCLUDE SUP.C(?P.RrE) . .
WATER PERA12T (ZNCLUDE SURCtIARGE) '
~ "='WATER METER'/COPPERHORN/OUTSZDE READER
$ • ' WATER TAP (INCLUDE COP.PORATIGN STOP)
$ SEWER TAP
~ACCOUNT GEPOSIT - SEWER
$ 'ACC~UNT DEPOSIT - SaAmEF.
$ : AC
$ S'AC • .
. ~ ' TRUNIC. WATER ASSESSMENT
$ ~TRUNK SEWER ASSESSMENT
S L'ATERAL BENEFIT/TRUNF: SESdER
S LATERAL"BENEFIT/TRUNK WATER
S • ' OTHER
_ . . . .
,
.
. . $ ` TOTAL .
S ' ' + -?'•t'P:MOUNT, PAID%RECEIPT.' #
DOES UTILZTY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT Oc WAY?
' 'r . . • ' ~ . .
YES IF YES, THEN A`'`"PERMIT FOR WORK WITHIN
PUBLIC ROADWAY." MUST.BE ISSUED BY THE ~
NO ENGINEERING.DIVISION. LIST.RS A COIvDI- ~ -
TION. -
SUBJECT TO TEIE FOLLOWING CONDITIONS:•
F . . . . . . .
' .
APPROVED BY:
TZTLE:
' DATE:
, i
. . . . !1r~T . . ~ i!! . . :T~ s~ rt+ rr ~
11 ' ~ tF101
•~1J[ ~~JLry~^iL.jrl~l(~ Addrea f'A-r-0ys~.~-- PlonDala_[L~1.im_
HEAT LOSS CALCULATIONS
~ [ Loss ~-p~ .f'L T 65 x t.ie C~otel B[u InpUt I All windows & doon aro woatheretrippatl
1~1-,
qoom I lBthl~ Wlh HL FI. .4 Room ~ L9th. Wth. H~. '
MoOh. No.ol Linnalh. Arre WoAth HuOht No.ol linul 1. Rrn
'~n~ ol ~wn oi oene II n6 al cuct ul.ll Na. of wna ol Van. II ht, ol a.cA p,.lt.
L
2
o- ~ Z , ,i'- l~h?'
i
o r~
rtloen 1 ~ ~ ~doon
laoon Coal. BTU /tloon; CwL NlU /
IAV.tlonwinAnw~ - 47 InldballonwlMOm 47 -L~--i-.
LuJ_u-
~1u1mionwromw. ne Innn,.tionw/ooon itA
A~Wnom 910oon 71 Inlilvnion 57OOOn 71
w.Y/a1 E.P. Wol1
L[ ~t
uhw 6 Dorn~ i~~ 48
Glm. b Doon Q-~-
n EiO.WalI 7 Nat E.G. Wdl
1=Lll- L+
~ J L o
.irna 6 c.ulno 5
Ioo, r> 731 h Floor
41~~ BIV. Q TOtCl BtY.
FI. ~j • oom LBth.l Wth. " Ht. ' FI. Foom l9th " Wth. ( lit.
OI p~ No.ol L,nemn. Aree Wpeitllh Moi M Na.ol LmeeuL P.ue
No, W'dm f ~Pn~
w ol psn~ 11 ~I~ OI Cro[4 p.1L No' of ne ol pene li hII of cncM un.lt.
i/ 2.d 30~ z ,r 6/r
~ •
- ~a " • ~aoo.~ La 2 d" 6 C
lEOOn Co./. BTU /COOn C.I. BTU
~hhniionWiMOw1 47 1324-0 InfilveuonWinEOw. 47 7Y1
JJVO~im WlOnw~ 1~ 118 Inhlveban W/Doon 118
2 71
dUVnianS/Owrt Inlil[retion5/DOOn
1 3,0
ypp 144- Exo. Well Q
Iw,6 Ooan 4B GIU~6 Doai O 48 *41
nE~p.Wdl G 7 NetEvo.Wdl v~E " O 7' ~
B Cdlinp 8
4w.. ~3~~g Fioor ~ 5I
n~d Ow. o 91 Toul 9m.
Room Lgth "Wth. Ht.% ' FI. Room ~ LOth. ' "Wth. Ht.
No. W'em M.iah, No.ol linealtt. aree wiatn Maiqnt No.ol linnu'. A.u ~
OI W nu OI Pone Ii9hU of <re<4 M. ll. N0• OI p!M OI pOne I' 1, ol crlCk tp. tt.
L
3,
- ;
1000.~ ~aoon
JEOOn Co.l. BTU /yoon. CoaL BTU
mi,.aon wi,.,w. 47 ( 6 ldrn,.lianwincow. ai
lihmion WlDoon 118 Inlihniion W/Ooon 118
71 Inlihmtlon 5lDOOn 71
hM1mion 8/Dwn
W. WalI ~s E.P. WaII
60oa1 48 3¢¢ GIm. bDOm, 48
*i Eao. Wall z 7 Nn Exo. Well ' 7
e,l.nq 5 Ceilin9 6
1O°C Fioor 7 3105 -
,n•Iew. 7aulBm.
#io1
Jwnn~~~ ni ~6r..d~?~~^"N'V Addreu Plan # _Dota.~~~l- .
MEAT LOSS CALCUTATIONS
.otufl~ca[ LosS T gg x 1A ° °Total Btu Input I All windows & doors oro wootnorsirippotl
%I. Y f7oom I Lpt^. Wlh. " HL ' FI. . Room L9thj Wth. Ht.
Wnnn HnIpM No.at An. No. W,J,n MuP~~ No.ot Ane
NO. ol P.M OI P.... 11 ~I\ ol crncA MI. 11. . Ot Mna OI pan~ II ~b ol c~nC4 p. 11.
1
~ ~ ~ .2./.c d d 9 7
7, 91
~ - e°°(• iaoon
C.O. BTIJ ~4~~~ C.O. PTU
/tlaan -
dibnibnwllonM - 47 ~ In1iltntlon Wlndowi 47 ~..1 ~
rdJ~u~ion W/Oonn 118 InlilveJOn W/Doan 11B -
NwntlanS/orwn 71 Inlillrntlon5/OOOn p 71 ~
Wdl 1) lp E KP. WaII L
ae ~ Glew B Doon 48
i
JnEw.W.ll F. NatEwp.Wa11
7 I L 7
~ 6 C.inn9
'nilinp
^ 6 Floar
Iool
7 10 7 10
Iaul Bm. O Toul Btu.
FI.~ . Bc.~ Room I Lgtb. 17' ' Wih. Ht. FI. Room I LOth.~ ~•••Wth.1 Mt_.. •
WiJln Ib9~~ No.ol lin et~1. Ar~~ Huylll No.01 Linatlll. A,o
!N0• ol Ven. OI P.n. 11 hb OI CnC4 YI.1t, ol Wn~ ol P~n~ 11 U ol crN\ 41.11.
V
gp f, Z e N
laoon laoon
Coaf. BTU ~DOpl. Caer. BTU
laoon
nblunGOn Wmoowa ~ 67 Inliltntion WvWOw~ 47
118 INiltmuonw/DOOn ~IA
Inlil~mion W/Ooon
71 I nillvmion Sl~oon 71
Inldou~lon 5/Ooon
F rD. W4i , E~0. W cll
48 Gleo d Ooan Q
6 G
6uw 6 Daw~
~ 7 NnEro.W~il ~ ~YP
Hn EvO.%IalI LXL~
8 ~
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T"'_
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA113227
Date Issued:09/03/2013
Permit Category:ePermit
Site Address: 4390 Woodgate Lane N
Lot:17 Block: 2 Addition: Mallard Park 3rd
PID:10-47252-02-170
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Matthew J Pauly
4390 Woodgate Lane N
Eagan MN 55122
All Craftsmen Exteriors Llc
1020 East 146th St
Ste 226
Burnsville MN 55337
(952) 898-4680
Applicant/Permitee: Signature Issued By: Signature
City ef Eaaii
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Lod_
Date Received:
Staff:
t_
2014 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: %– 9 ` 1 I' Site Address:
Tenant: ...C2-41/1
939 ' 410"
P �y
Name: _ ,rn
Address / City / Zip:
Address: _
State: Zip:
Suite #:
Phone: 6/2 U9" Ji‘VO
Gc2.�t e.
Weld & Sons Plumbing
3410 Kilmer Law North
Plymouth, MN 55441
763-415-0196
Phone:
License ##:.,..3�
City: •
Contact: Email:✓s1 r�4_� G l SOhir. C -r
_ New Replacement , Repair - Rebuild — Modify Space Work in R.O.W.
Rel °`
Description of work: 1� /fid' i" / i9
RESIDENTIAL
Water Heater
Lawn Irrigation (_ RPZ / _ PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures ( Main / Lower Level)
Water Turnaround
RESIDENTIAL FEES;
$60.00 Water Heater, Water Softener, or Water Heater and Softener (Includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as bulk) (Includes County fee and $5.00 State Surcharge)
TOTAL. FEES $
CALL BEFORE YOU DIG. Call Gopher State One Cali 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_ora
I hereby acknowledge that this information Is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that 1 understand thls is not a permit, but only an application for a permit. end worts is not to start without a permit that the work will be In
accordanoa with the approved plan In the case of work which requires a review end approval of plans.
rfrt/
Applicrnr
's PrintedName
x
Applicant's Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA126429
Date Issued:08/25/2014
Permit Category:ePermit
Site Address: 4390 Woodgate Lane N
Lot:17 Block: 2 Addition: Mallard Park 3rd
PID:10-47252-02-170
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Troy Good
3670 Dodd Rd
Eagan, MN 55123
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
$60.00 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 -
Matthew J Pauly
4390 Woodgate Lane N
Eagan MN 55122
(952) 956-4162
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature