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3025 Woodlark Lane cirir oF E?GAN 3795 Pilot Knob Roed Euges, MN 35122 N° 5220 pHOrre: 454-8100 BUILDING PERMIT rteceict # To b~ w~d for :1 d o n t o ! t ~ u~ e Est. Va l ue Dote , 19 Site Address 2 7 •-)c,;?ar k Ercct ? OccuPoncY Lot Blxk ` Sec/Sub. 1`ZtAlter Q Zoninfl Pamel # Repalr ? Firo Zons . , ~ Enlarye ~ Type of Const. aWe Name Move ? # Stories ~ Address Demolish ? Front ft. Grode ? Depth ff. Ci Phone ~ Approvab Fees p Name :..•~-~~.~.t e-c u~ ~re~ /lssessment Permit CI Phone Water & Sew. Surchorfle L Police Plan theck ~W Na^e Firo SAC Nddress Eny. Water Conn. <W Ci Phone Plonner Water Meter Counci I I hereby ocknowled9e tiwt I have read this opplication und state that gld9 Off. the information is correct ond agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. APC Total ...,%'r; Sigrature of Permittee A Building Permit is issued to: on the express oondition thaT oll work shall be done in accordonce with all appliceble State of Minnesota Statutes ond Clty of Eagan Ordinonces. Buildinp Officiul ?wwl~ lt Od~ lo~d h~lffw ~ Plumbing Mechanicol INSPECTIOh15 DATE INSP. Rqph..In Final Footin93 ~'vc Dota Inw. Date Irnp. Foundation Plumbing Frame/ ins. Mechanicol Finol Remarks: ~ . . -T---- . : For OMIce Use Only: MECHANICAL PERMIT PERMR # dTY OF EAGAN RECEIPT # 9890 PILOT KNOO ROAO, EAG11N, MN S5122 DATE: CONTRACT PRICE ~~l.'• ~~v PMONE: 454-6100 Site Adoreas ~ °'o-: .'rG BLDO. TYPE WORK DE8CRIPTION Lot Block - L Sec/Sub Res. ? New ~ Name "/c ~ Mult Add-on -f m Comm. Repeir ~ Address / J'w 'V`~-/2j c City Phone 'y- S i- Other FEES Name RES. HVAC 0-100 M BTU - $24.00 c Address -f AAo.,:nL or *.A' ? ADDITIONAL 50 M BTU - 8.00 p City Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM -1 PER PERMin - 1.50 EA. . TYPE OF WORK COIIAMlIND FEE -1'K OF CONTRACT FEE ForCed Air M BTU APT. BLDGS. - C.OMM. RATE APPLIES 8oller M BTU TOWNHOUSE & CONDOS - RES. RATE APPIJES Unit Heater M BTU MOMUY RESIDENTIAL FEE - ALL ADD-ON 8 - Alr Cond. Tg~ M BTU REMODELS 12.00 MINIMUM COMMERCL4L FEE - 20.00 Vent. CFM STATE SURCHARGE PER PERMIT - .50 Caas Piping Outlets # (ADD 550 S/C PER EACH $7000.00 OF PERMIT FEE) odw PERIAITFEE: j• ~d / , ' ~ SlC: • S ° F~,/ ~ ~ / TOTAL: FOR: CITY OF EAGAN _ ~~1• ~4'. . . PLUMBING PERMIT ~ For Offip~ 41ae nl • CITY OF EAGAN PERMIT # CONTRACT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT ~ PRICE PHONE 454-8100 DATE: ~ Sv SRe Addrsyss BLDG. TYPE WORK DESCRIPTION Lot B6oc4y SeC/Sub Res. New MuR. Add-on Name WENZEL MECHAIVICAL Comm. Repair 1959 SHAWNEE ROAD Other ~ Address c City Phone 452-1565 RES. PLBG. ONLY - COMPLETE THE FOLLOWING: ' NO. FIXTURES TOTAL Wafer Closet - $3.00 $ Name IDLARK E Bath Tubs - $3.00 ~ Addre~aY - ~ City Phone lGtchen Sink $3.00 UrinaVBidet - $3.00 FEES Laundry Tray - $3.00 COMMAND. FEE - 1% OF CONTRACT FEE _ Floor Draina - $1.50 APT. BLDGS. - COMM. RATE APPLIES > =•Water Heatei"- $1.50 TOWNHOUSE 8 CONDO - RES. RATE APWES Whirlpool - $31.00 MINIMUM - RESIOENTIAL FEE $12.00 Gas Piping Oudets - $1.50 MINIMUM - COMM.IND./FEE ;20.00 (YINIMUIiA -1 PER PERIu11T) STATE SURCHARGE PER PERMIT .50 Softener - $5.00 (ADD $.50 S/C PER EACH $1,000 OF PERMIT FEE) Well -$10.00 Private Disp. -s10.00 i ~ Rough Openings - $1.50 SI TURE OF PERM E U. G. 5prinkler System -$12.00 PERMIT FEE: O D STATES S/C: ~ FOR: CITY OF EAGAN GRAND TOTAL: Control No. ~ INSPECTIQN RECORD GITY QF EAGAN PERMtT TYPE: allf tu; me ~ 3830 Pi1at Kr?ob Road Permit Number. Mf Z 1 Z.' ~ Eagan, Minnesota 55123 Date Issued: (612) 681-4675 I E SITE ADDRESS: 101 4 l, t „f k, w APPLICANT: ~ 141l(Iljt ANK LAltf I FQ00E) ' 11'i i 1)hfl1 1 tlINE k I I Ht ~ h!.' i bh 3 9+~:•q ' PEAMIT SUBTYPE: TYPE OF WORK: I t,r ~ R MEU I FIMAL FQOT 1 MO a. ~ ~ II~M~lR~C~.t ~l~Cl~IPT ~ 6 i ~ ~ ~ ~ PWnlt Na PWmlt NoYlK Dob liWiwne • S11N PtUMBING NO H11AC ELECTRIC ELELTRIC ' 1u~palion Drb irap. Conrn~et~ FOOO I FoundNdon Frarnk9 ` Floolinp ` ~o Pba- I Pwo Ht& FY~PMo~ F#W Hlp. OrW7i0 _ Firrt PbQ Pbp. Yspacaa?- No1My PMnfhw . C.Onlt. 11sW Er+WRhn .v' It, Bh4 RMI .~fdC~ ~svf C 4 °'d` F'°' n.ok ftw lvi~ P~.,.r ~a•~-~ G.~.t lv WON i Fr or.p. CITY OF EAGAN Remarks Addition Oslund Timberline Lot 4 pik 2 Parcel 10 55300 040 02 , owner tf r street 3025 Woodlark Ln. State Eagan, MN 55121 ~~if J V ( Improvement Date Amount Annual Years Payment Receipt Oate STREET SURF. STREET RESTOR. GRADING SAN 5EW TRUNK 1968 $100. 00 $3.33 34 PAID *SEWERLATERAL 1970 1210.00 60.50 20 PAID WATERMAIN WATER LATERAL WATER AREA *STORM SEW TRK 1970 ZO STORM SEW LAT CURB & GUTTER 51DEWALK STREET LIGHT WATER CONN. IBUILOING PER. s,ac 275.00 8436 7-6-73 I PAR IC N 7 RESIDENTIAL BUILDING PERMIT APPLICATION ~ CITY OF EAGAN 3830 PILOT KNOB RD - 55722 651-681-4675 N4wConstructfon Reauirements RamudeUReoairReauinments • 3 regisiered s'de surveys shvxing sq.1L of bL sq. R of house; aneA ioafed areas . 2 copies of plan (20%maximum bl coverage albwed) . 1 set of Eneyy Calculations for heated aCdilions • 2 copies of plan shaving beam 6 window sizes; poured found design, etc.) . 1 s'de survey for exteria additions 8 dedcs • 1setUEnergyCakuWtions • Indicaledtameservedbysepticsystembraddilbns • 3 copies of T2e Preservalion Plan if bt platted after 71153 • Rim Joist Detail Options sekction sheet (bkys wiM 3 of bss wuts) DATE ci I a~ I U~ I 1 VALU/~fION ~aI•"I ~ JOB SITE ADDRESS ~A~~C'~F~ ` I~L l Ctry,:> ' SSI IF MULTI-FAMILY BUI ING, HOW MANY UNITS? PROPERTY OWNER TYPE OF WORK FIREPLACE(S) _ 0_ 1_ 2 APPLICANT Oftrwil 11hUMMI8L PHONE#-1I05 '-FLb 2~0) ADDRESS 9920 Zille Street IIP CODE PAGER # CELL PHONE # FAX # ~Io~-T~~~ NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY Energy Code Category _ MINNFSOTA RULFS 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted _ MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Contrac4or: Phone Plumbing System Includes: _ Water Softener _ lawn Sprinkler Fee: $90.00 _ Water Heater _ No. of R.I. Baths _ No. of Baths Meehanical Contraetor: Phone Ik Mechanical System Includes: _ Air Conditioning Fee: $70.00 _ Heat Recovery System Sewer/Water Conhaetor. Phone # LJ u All above infortnatbn must be subrtiitted prior to processing of application. • gY-`- 1 hereby acknowledge that I have read this appiication, state that t information i cortect, and agree to comply with all applicable State of Minnesota Statutes and City of Eogan ttmances. " Slynatur~ of Applieant Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 1101 r OFFICE USE ONLY ? 01 Foundation O 07 05-plex O 13 16-plex O 20 Pool 0 30 Accessory Bldg ? 02 SF Dwelling O OS Ofrplex O 16 Fireplace 0 21 Poreh (3-sea.) 0 31 Ext. Alt - Multi ? 03 Ot of _ plex O 09 07-plex 0 17 Garage O 22 PorchlAddn. (4-sea.) O 33 Ext. Alt - SF Q 04 02-plex 0 10 08-plex Q 18 Deck O 23 Porch (screened) O 36 Multi ? 05 03-plex 13 17 10-ptex O 19 Lower Level O 24 Startn Uamage O 06 04•plex O 72 721plex Plbg Yor_N O 25 Miscellaneous O 31 New O 35 Int Improvement O 38 Uertolish (Interior) O 44 Siding ? 32 Addition O 36 , Move Bldg. O 42 Demolish (FOUndetion) O 45 Fire Repair ? 33 Alteration O 37 Demolish (Bldg)• 0 43 Remof p 46 WindowslDoors O 34 Replacement 'DrmollUon (Endn Bldq only) - GNe PCA handout to applleant Valuation Occupancy MC/ES System Census Code Zor,ing City Water SAC Units Stories Baoster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fine Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ FiaallC.4. _ Footings (deck) , Final/No C.O. _ Footings (addition) ~ Plumbing Foundarion HVAC Drain Tile Roof Ice & Water Final OtLer _ Framing _ Pool _ Ftgs _ AidGas Tests Finsl _ Fireplace _ R.I. ^ Air Test _ Final ~ Siding Stucco Stone _ InsulaHon ~ Windows (newhepLcement) Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAG Ciry SAC Water Supply & Sforage S&W Petmit & Surcharge Treatment Plant • Plumbing Permit ` Mechanical Permit License Search Copies ' Other Total . VILLpOE OF EAOAN SEWER SERVICE PERMIT 3795 Pilot Knob Rond PERMIT NO.: 2043 Eagon, MN 55122 DATE: July_ 6, 191'3 Zoning: R-1 No. of Units: 1 owner: Robert Oatermann Address: ~ sice nadress:3025 Woodlark Lane, Ea$an 55121 Plumber: All-State Plumbing Co. pd I ogree to comply witA the Villoge of Eagon ConneC[ion ChazgeXgfi§ixx 275. 00 Ordinancea. Accounl Depasit: Permit Fee: 10.00 pd 7 6/3 Surcharge: •SO pd 7 6/3 BY' Misa Chnrges: Uate of Insp.: To[al: Insp.: Date Paid: EAGAN TOWNSHIP N° 926 q BUILDING PERMIT Ownex~ _Eagan Township Address (preseni) ......0...~!..~s~:. ~..~.__~Town Hall Builder . ~G L Dale Address DESCRIPTION Siories To Be Used For Froni Depih Heighi Esi. Cost Permif Fee Remarks dAv--e~A, --a, .Z19-1 3s (o ~o~ 72~lz-U ..~2. LOCATION Sireef, Aoad or oiher Descripiion of Location Lo! Block Addiiion or Tract This permii does aot auihorise the use of sfreets, roads, alleps or sidawalks nor does if give the owner or his agent the righi !o creaie anp sifuation which is a nuisance or which presenls a hazard fo the healih, safefp, aonvenienee end general welfare fo enpone in the eommunity. THIS PERMIT MUST BE- /KpEPT O7N~ TH~E+ PAg MISE WHILE TH£ WOAK IS IN PROGRESS. 1 e ~ This is fo cerfify. 1haf...4S.~.'....'.(e~]~r/~..h..-I=-'./ ...................has permission !o erecf a. ~ ..upon !he above descri'_ e! !o ! e Provisions of the Buildin4 Ordinance for Ea n Townshippfed ril 11, 1955. . Per ...~.~--...~i~'t.-~.'~. f....~`~.r............--.. Chairman of Tnwn Board Building Inspector cin oF EacnN 9793 Pilaf Knob Rood Eagan, MN 55122 N2 5220 PHONFs 454-8100 BUILDING PERMIT APPLICATION $15,000. RemiPt # To be uted for Addn to house Est. Vnlue Date 19-Zi--- Si*, ,Wdrea 3025 Woodlark Erect ? Occuponcy R3 Lor 4 Bi«kZ Sec/Sub. Os Timberline lWCIgiter ? Zonin9 Rl porcel # Repoir ? fire Zone 3 Enlarge pg Type of Const. V c Nome 3025 Woodlark Move ? # Stories z Address Demolish ? Front ft. Ci EagBn Phone 452-6280 Grode ? Depth 23 N. Name 4i ADD~ovols Fees 0 erfh SCar 6eraices Address 688 H8gu8 Assessment Permit LR_!1(1 Ci St_ Paul phane 227-7061 Water & Sew. Surcharge 7- 50 tw Police Plon check 94 _ Oh w Nome Fire $AC r Address Eng. Wofer Conn. <`O C( Phone Planner Woter Meter Councii I hereby ackrrowledge that I have reod this apDlication and state that gld9 Off the Information is correct ond ogree ro wmply with all applicable APC Totol ~ SMfe of Minnewta $tatutes and City of Eagan Ordirwnces. Signature of Permittee A Bullding Permit is iuuad to: N Ith taI SeiviC2S on the express condition that oll work shall be done in occordoit oll app co e St te inne c5tatutes and City of Eagan Ordinances. Building Officinl /~C o.-~oCo Tkjs ce,yuest void 18 months from /°'S 0 Date of this Request July 25 , 1979 R 90162 1, as Pg Licensed Electrica( Contractor OOwner, do hereby request inspection of the above electri- cal wiring installed at: L_ 14 B a 1• ~ ~~u'v~. Street Address or Route No. 3025 Woodlark City s,agan Section Township Range County Uakota Which is occupied by Ron JurewicA (Name ot OccuDant) Is a roughin inspec[ion required on [his job? No ? Yes 0 Ready Now ? Will Call ? Power Supplier Address ElectricalContractor Standard Electric Co In _ Contractor's License No. 6190 (COmpany Name) Mailing Address 1424 White B A ct n actot o wner Making hls InstallaHon) ? Authorized Signature Phone No. _ 77~6-8681 ~o p~ (ei~ cai contraS o pppw~~~7nar Makinq 7his Instauatlon) @~~~~!~o ~9 Giltl~~ ~ C6~ Fiel ~ This inspection request will not be accepted by the ~dJ State Board unless praper inspection fee is endosed. Minnesota State Board of Electricity ` 1954 Uitiversity Ave., St. Paul, Minn. 55104-Phone 645-7703 - FiEQUEST FOR ELECTRICAL INSPECTION R 9O1.GZ CHECK BELOW WORK COVERED BY THIS REQUEST Type of Building New Add. Rep. Check Appliances W'ved For Check Fquipment W'ved Foc Home ? 12 ? Rangc ? Temporary Wiring ? Duplex ? ? ? Water Heater ? Lighting Fixtures ? APt. dld6. El El ? Dryer ? Electric Heating ? Commercial Bldg. ? ? ? Purnace ? SJo Unloadei ? Industrial Bidg. ? ? ? p'v Conditioner ? Bulk Milk Tank ? Farm ? ? ? Lis[ List Other ? ? 0 hetq Others~ ere Aere COMPUTE INSPECTION FEE BELOW Service Entrance Size: # Fce Feeders&S eed Fee Citcui[s: # Fee 0 to 100 Am s. re 9,111111 0 to 30 Am eres 101 to 200 Amps. 3 0 r 31 ro 100 Am eres Above 200_Amps. ve 1 Above 100 Amps. Transformers RemoteControlCirc. Partialorothertee Signs Special Inspection Minimum tee SS.00 Remazks $OOID addition TOTALFEE MiII. 10.5 I, [he Electrical Inspector, hereby certify [hat the above inspection has been made. O• (Rough-in) f Date (Final) _ Da[e rf - This request void 18 months from ~ / i rr~y lo, 1979 ! D.~TE I BL'Ii.DiNC P°3`!I7 aP°C?f.aT?Q': Include sets of p:ar.s, 1 site plan v/elevacions ar.2 1 se[ of ener,gy ca: vatiens. To be uszu fo[ ~LlD^alua[:on $15J00.00 Si_e azd:ess:30 ~2 k5~~ Ln[ Black Sec.!Sub. Parcel `:u-ber C Ron & Connie Jurewicz Sele?hone 452-6280 ad:tress 3025 wood Lark Ea,ga.n. B'u1. 55121 Con[ractor North Star Services Telephone 227-7061 688 Hague Ave, Ad?ress St Paul MN 5510Q` Arch/rng. Telephcne ~ pddrzss OFFICE CSE 0NILY I Erec[ Occupancy Al:ar Zoning Repair Fire Zone Enlarge Type oE Cons[. tl yove Q of Stories i Demalish Front Grade Depth a3/ Date of Ao-.)roval and Initial ' Fees o-a Assessmen[ Permit ~ Waczr/Sewer Surcharge 7 o-u Police Ylan Check . Fire SAC • En3lneer Water Connection Plannet iJater ?teter Council Bl-,g. Off. A.P.C. TOSAL PERMIT C°" 0894 , A CITY OF EAGAN P~p MITTYPE: BUILDING 3830 Pilot Knob Road {.4 Eagan, Minnesota 55123 Permit Number: 001122 (612) 681-4675 Date Issued: 0 8/ 0 3/ 9 2 SITE ADDRESS: 3025 WOODLARK LANE LOT: 4 BLOCK: 2 OSLUND TIMBERLINE DESCRIPTION: . ''Building Permit Type DECK ~ Building`,Work Type NEW ~ \ ~ ~ . ~ ~i'r, ~~)%i, - ~ A~~ REMARKS: RECEIPT q ~C)~rl~y FEE SUMMARY: Base Fee $25.00 COPY $.50 Surcharge $.50 Total Fee $26.00 Subtotal $25.50 CONTRACTOR: - Applicant - ST. LICOWNER: APPLEWOOD 16539624 0003740 MARVIN MIKE 675 STILLWATER 3025 WOODLARK LANE MAHTOMEDI MN 55115 EAGAN MN (612) 653-9624 (612)952-3811 I hereby acknowledge that I have read this application and state that the inPormation is correct and agree to comply with all applicable State of Mn. Statutes and City of Eagan Ordinances. L J (2• Q, fipAlp APPLICANT/PERMI EE SIGNATUR I UED V: IGNAT FiE PERMIT N { CITY OF EAGAN REACTIVATE 1992 BUILDING PERMIT APPLICATIOe681-4675 RECO SINGLE b MULTI-FAMILY 2 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 when typing of permit is requested, but not picked up by last working day of month in Nhich re uest is made or lat chan e is re uested once ermit is issued. Date -7- Valuation of work Site Address:-34~~ ZAL/t/ SiREET SUITE ~ Tenant Name: (commercial dnly) IAT BIACR Z SU9D~.,l~. .yCe-i ,-tl~ J ~aL Oescri tion of work: ::7yC -2.3, LD (FC/C• The applicant is: 13 Owner CKContractor ? Other (Destribe) Name Phone Property LAST F,RST Owner Address 3 U~ ~ 4v-z57-w1 4e,~,/c <G~~ STREET STE / City z--fiolv-, State Zip 0 , Company Phone Contractor Address 6 7,:~ STr '&411172SiL License a3 v ~ - Exp. City State )t27/V Company Phone ArchitecU Engtneer Name / Registration # Address City / State Zip Sewer 3 water licensed plumber . Processing tlme for sewer d water permits is two days once area has een 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. ` Signature of Applicant: OFFICE USE ONLY r , BUILDING PERMIT TYPE O Oi Foundation ? 06 Duplex ~ 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwg. ? 07 4-Plex O 12 Multi. Misc. ? 17 Swim Pool ? 03 SF Addition ? 08 8-Plex O]3 Garage/Accessory ?]8 Comm./Ind. • ? 04 SF Porch O 09 12-Plex 0 14 Fireplace ? 19 Comm./Ind. Misc. -9105 SF Misc. ? 10 Multi. Add'1. ~15 Deck ' ? 20 Public Facility ? 21 Miscellaneous WORK TYPE 31 New- O 33 Alterations O 35 Tenant Finish O 37 Demolish O 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual) lp. Basement sq. ft. MWCC System (Allowable) lst F1. sq. ft. City Water UBC Occupancy 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump t of Stories Footprint Sq. ft. Fire Sprinkler Length _9L~ On-site well Census Code E3r~ Depth • On-site sewage SAC Code APPROVALS Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ? Site E) Footing O Framing 0 Insulation 0 Wallboard p Final ? Draintile ? Fireplace Permit Fee rsimcim: $ Surcharge Plan Review License MWCC SAC City SAC Mater Conn. Mater Meter ~ Acct. Deposit . S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Copies ,So Other Total: SAC % SAC Units - - - - - - - - •1-~r' - - ~ - - - - - ~ - - - ~ y ~ 2@@~~~ RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN ~)o 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date ~ / 30 / 0(,o Site Street Address 30 ;l.S ~.c ~OOG~~ rk o Unit # Property Owner I Telephone # ( } Contractor n_cl 10 Telephone #(7(p,3 755- la~l~ Address aS ~atth 4(~- 5~-• City State Zip The Applicant is: _ Owner ? Contractor _Other Alterations to existing dwelling $ 50.00 _ Add plumbing fixtures. This fee includes putting in a water softener and/or water heater at the same time. If vou are installinq 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) Othec - Water Softener _ZWater Heater $ 15.00 _ new ? replacement Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ 50 I Total $ /S'SU 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 approved. 'i,ud.1 62t.lrl L 4~~f ApplicanYs Printed Name ApplicanYs Signature For Office Use Permit V City of Eaa Permit Fee: 3830 Pilot Knob Road Date Received: Eagan MN 55122 Phone: (651) 675-5675 Staff: Fax: (651) 675-5694 2009 RESIDENTIAL BUILDING PERMIT APP (CATION Date: Site Address: Suite Tenant: RESIDENT/ OWNER Name: G ~ Ph Address/ City/ Zip: 53 Applicant is: Owner Contractor TYPE OF WORK Description of work: rz, Multi-Family Building: (Yes / Na ) Construction Cost: - - - 1~ CONTRACTOR Name: S 7 License Address: City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 CategoN 1 _ Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet 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: Phone: Licensed Plumber: Phone: Mechanical Contractor: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. 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; th he work will be in proved plan in the case of work which requires a review and approval of I accordance with the ap x ' X Applic nt's Signature e 1 of 3 Name Pag App4ct'Mild PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA162930 Date Issued:08/05/2020 Permit Category:ePermit Site Address: 3025 Woodlark Lane Lot:4 Block: 2 Addition: Oslund Timberline PID:10-55300-02-040 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 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 - Michael D Kegley 3025 Woodlark Lane Eagan MN 55121 (651) 788-6160 DDN Mechanical LLC 3033 Independence Ave N Golden Valley MN 55427 (763) 913-1323 Applicant/Permitee: Signature Issued By: Signature