2280 Travelers TrPERMIT
City of Eagan Permit Type:Building
Permit Number:EA128578
Date Issued:11/19/2014
Permit Category:ePermit
Site Address: 2280 Travelers Tr
Lot:002 Block: 003 Addition: Whispering Woods 4th
PID:10-83953-03-020
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Edward G Engen
2280 Travelers Tr
Eagan MN 55122
Superior Remodeling Inc
1013 Fairway Drive SE
New Prague MN 56071
(952) 292-7267
Applicant/Permitee: Signature Issued By: Signature
Date:
City of Eapli
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
Permit #:
Permit Fee:
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Tenant:
Site Address:
Suite #:
RESIDENT / OWNER
Name: T' °' -t'o ll)J eim Phone: ^- " i;_:,9 % " _53:3C.,
"
Address / City / Zip: L / 00 I"'fcq J e...4 €1-5 T i— r 67-` ') IM./'d'; /7 Z�
Applicant is: Owner f Contractor
TYPE OF WORK
Description of work: Re- Roo r
Construction Cost: /0 (*VC Multi -Family Building: (Yes / No )
CONTRACTOR
Name: r1.V 4 5+Z ,r �' .x-i.Q,C iCv 11 L Licensee #: % (3 r,0 S 9
Address: ) 7, CI L (/'j CC- '.-- City: 16t'[f S'1 (`Lc
State: `(r11) Zip: -,C----5-73 0 r: Phone: c't ?f , u'- .9
Contact:II; .Q „'n 1.4'1' --4, J''1.-(3 % 7)Wmail: 1,- ,(1,77 A ', i F:rY. <-'-.j AM -'1:"'"A -1 -
c:7"'",_COMPLETE
COMPLETE
In the last 12 months, has
Yes No If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information" `Portions
the information may be classified as non-public if youprovide specific reasons that would permit the';''' City to
'': conclude that 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 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.
Applicant's Printed Name
Applicant's Signature
Page 1 of 2
DATE: 2/13/90
22$0 1'RAVELERS TRA1L, L2, 113. WH1SPERING WOOD3 4th RE: '
xx
Your Sewer & Water Permit for the above property has been completed. It will be held at the I
# Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
° CALL PUBUC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON. I
~ Your Sewer & Water Permit for the above property cannot be completed for the following 'I
`reasons: !
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectars - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAI UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW. _
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLIGY.
Secretary, Building Inspeetions Depi.
- DATE: 2/13/90
RE: 2280%TRAVBL6RS tRAlL' L2` B3• WH13PBRIl1G WOODS 4th ~
Yx
Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
1 16ALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
~
` 9Your Sewer & Water PeRnit for the above property cannot be completed for the following
~easons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
CASH RECEIPT ~
, CITY aF EAGAN
,
3830 PILOT KNOB ROAD :
EAGAN, MINNESOTA 55122 '
/ a
oATE
snda WNf
n
AMOUNT
(U c~
a oaLuas
? CASH ~CHECK
115)b ikz Qv~~a
Tz,
FUND OBJECT /1MOUNT
Thank You
By ~
C r I, ~-ftYm ~PY
6^/ C~ 4 ? Yalow--POStlnp COPX
Pi~k~Me C,opy
~ .
SEWER de WATER PERMIT OFFlCE USE ONLY
CITY OF EAGAN
3830 Pilot Knoh Rd. M~R ~ 37~7/ 1~3 PERMIT DATE 2/1- EBd~n, MN 55122-1897 ~IP PERMIT # 11~1~
, METER SIZE ~ B.P. RECEfPT # ~ 62=+~
DATE t) ISSUE DATE B.P. RECEIPT DATE 4: r-•
PRV _ BOOSTER PUMP
SITE ADDRESS _ E = 28 fl _TPA Y r!- L fi ~ t~ 1 L pERM1T RE~IUESTED
LOT ~1 BLOCK 2 SEC/SUB F o - t h yq -
wH T s~EuI~NG WQ0ns L SEwER WATEF~ - TAPS
APPLICANT: /or S 7 i N~-
ADDRESS: ~ - CAMM/IND ~ RESIDENTIAL
CITY, STATE f"'`' S Y 1j1{ ZIP NEyy _ EXISTING
PHONE: 7 F G
PLUMBER: Lawn Sprinkler Meters are to be Installed
~ Ahead of Domestic Meters on Water Line.
ADDRESS: ~69 %4he-C ~ Credit WILL NOT be given for Deduct Meters.
CITY, STATE 1^~ c Ic~ ZIP -':2~ ~
PHONE: 1 AGREE TO COMPLY WITH CtTY OF
OWNER: fr A G I/~ l,Ig h- V y 'C / EAGAN ORDINANCES
ADDRESS:
CITY, STATE A ? /~'1 N ZIP zvq~'~
PHONE: SIGNATURLO'WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEMIER PERMITS, CONTACT ENOINEERINGl DEPT.
rSEWER & yVATER PERMIT ~ OFFICE USE ONLY
CITY OF EAGAN METER # PERMIT DATE
3830 Pilot Knob Hd. 11223
Eagan, MN 55122-1897 ~~P ~ PERMR ~
METER SIZE B.P. RECEIPT # ~ 6242
- j- ~ U
DATE ISSUE DATE B.P. RECEIPT DATE
~
_ PRV _ BOOSTER PUMP
~ SITE ADDRES 22 TJ2 A 1 l. PERMIT REOUESTED
LOT -..-BLOCK ^ SEC/SUB 0 cldf f rJ/' • -
:~t:ISP R W OUS SEWER WATEFi _ TAPS
APPLIC9INT: ~ , ` , ~ r : „ t /an S ~
ADDRESS: - COMM/IND ' RESIDENTIAL
CITY, ST/4TE 1: e_T? f`' ZIP 2S_ NEW _ EXISTING
PHONE: G 7 ~ t•°
Lawn Sprinkler Meters are to be Instailed
PLUMBER: Ahead of Domestic Meters on Water Line.
ADDRESS: Credit WILL NOT be given for Deduct Meters.
CITY, STATE ZIP
PHONE: sc-
J I A(iREE TO COMPLY WITH CITY OF
OWNER: EAGAN ORDINANCES
ADDRESS:
CITY, STATE ~ A E ZI P.~
PHONE: SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERINO DEP?.
• CITY OF EAGAN 17506
•~3830 Pilot Knvb Road, P.O. Box 21-199, Eagan, MN 55121
' PHONE: 454-8100
BUILDTNG PERMIT Receipt #
To sedfor sF ~/GAR Est.value .;168s000 Date YEs 9
Site Address 2280 TRAVELERS TR Lot 2 Block 3 Sec/Sub. ~japBRIliG ili00D8 OFFICE USE ONLY
Parcel No. 4TH 0-uva-r R^'3 -L FEES
S1IPHRTOR CEMENT CQi~13TRUCTION ~n9 V-11
Z
W Name 1109 W 1 S8Tl1 (ACtual) Const f.~.~ Bidg. Permit 878.00
I Address (niiowawe) ~.pp
0 Cit~/ ~NSVI~.~.E PhOne 892'~67~ # ol Siories Surcharge
Lenglh ~ Plan Review $70•00 +
~o Name SAM Deot+ sAC, cry lOQ.00 ,
~i AddreSS S.F. Total _ b~•~
9 City Phone S.F. Foolprints _ SAC. MCWCC
~ On Site Sewage _ Water Conn 62 5.00
~W Name qp~pp
W W O^ ~1e W~~ iw Water Meter
~Z Address MwCC syscem
gV w City Phone Gry Water ~ "e`". °ep0$1t
PRV Required _ S/W Permit ~ ~ ~
I hereby acknowlege that I have read this application and state that the Booster Pump - 5NV Surcharge 1•00
inlormatfon is correct and agree to comply with all applicable State ot
Minnesota Statutes and City.o( Eagan Ordinances. . Treatment P1 252.00
SignatureofPe?mitee _ - c APPROYALS RoadUrnt 335•00
A Building Permit is issued to: SUPBRIOR Ct.!l611T CONS? Planner _ Park Ded
on the express condiGOn that all work shall be done in accordance with all Co+ncil 1.00
applicable State ol Minnesota Statutes and City of Eagan Ordinances. gldg, pff. _ Copies
Building Official ~ Variance - TOTAL 3,616.00
permit No. Permit Holder Date Telephonr #
w~aTEJ • //d'a? 3 j~c.~ . /3 SJ
sEwER
awMsuNc
i
H.V.A.C. ELEcrRIc tc. fEe-- .
Inspection Date Insp. Comments
Footings I ~
Foundation
Framirg Roo}ing
A«+sti Pib9. - U
ao„yn ?ny.
Iwl.
Fireptwe y~ w~ ~-Z7`~'D FmW ?ng. c~
Final PIb9
CorksL Meier ~ Plbg. Inspector - Nouty Plumber
Engr.iPlan
eay. Fw%W
Dedc Ftg.
Oeck Final
Well
Pr. Oisp.
.v .~~~~`iM.~.....~.. -r.s'+~'T'~`~..~.~. ~.+w..~ '^S~'I'•T'MI~ j r+IT'o'r'~IPV4 . .
PERMIT li
MECHANICAL PERMIT RECEIPT N
CITY OF EA(3AN "
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE PHONE: 454-8100 For Office Use Only:
Site Address
"BLDCi. TYPE WORK DE8CRIP'T10N
Lot Blorck .T.=7/.". Sec/Sub Res. X New ~
. i r t~ ~ f~', i *V ~i 1~7~ Q V r r t i-;
~ Name ~•1r''i S Vi 1 I_ T" ' t i rl Mult Add-on
lComm. Repafr
<'~~3 i i:'.1ude ~ T'>11nd Ave.
a~g Address pther
c City S ? ~Phone 844- 0 `i
FEES
cL.~~erior Cer~ent
Name RES. HVAC 0-100 M BTU - $24.00
c Address . ~ y ' t" ADDITIONAL 50 M B7U - 6.00
~ C~~ "a t' 7 s vi 1 I e Phone y 2- 6%~;3 ' CONSTRUCTION) INCLUDES A/C ON NEW
GAS OUTLETS (MINIMUM - 1 PER PERM") - 1.50 EA.
TYPE OF WORK ~ COMM/IND FEE - 1% OF CONTRACT FEE
FOrGed Air M BTU APT. BLDGS. - COMM. RATE APPUES
TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
Boiler M BTU -It MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMOOELS - 12.00
Air Cond. M BTU MINIMUM COMMEACIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - ,50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping OuUets # 9EYOND $1.000)
Other
FEE
SIGNATURE OF PERMITTEE
S/C: '
TOTAL• FOR: CITY OF EAGAN
. . ~~`r T.-siV'~-'^T`+r . svw_+n4T'"C'r_~lwlF"!"~.R.7~s,+Ti :F__ . • . . ' . . ~
l
PERMIT #
PLUMBIN(3 PERMIT CITY OF EAGAN RECEIPT #
3830 PILOT KNOB ROAD, EAGAN, MN 55122 OATE: A
CONTRAG? PRICE: PHONE: 454-8100 Site Address ' ~BLDG. TYPE WORK DESCRIPTION
Lot Block ,1Sec/Sub Res. New
~ Mult. Add-on
~ Name 1 ; Comm. Repair
~ Addresg ~]a~ (o=i ~ a--/ Other
c City Phone e RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Name ~ -;~_Water Closet - $3.00 '
3 Address ` • I Bath Tubs - $3.00
` Lavatory - $3.00 ~
p city Phone ~'17_ • L "?V1_ Shower - $3.00 ~ -_I Ki?chen Sink - $3.00
FEES Urin21/Bidet - $3.00
COMM/IND FEE - 196 OF CONTRACT FEE 1_Laundry Tray -$3.00 '
APT. BLDGS - COMM RATE APPLIES -LFloor Drains -$1.50
TOWNHOUSE 8CONDO - RES. RATE APPLIES t Water Heater -$1 50 I~:]
MINIMUM - RESIDENTIAL FEE - $12.00 -L_Whiripool - $3.00
MINIMUM - COMM/IND FEE - a20.00 ; Gas Piping Outlets -$1.50 immkl
STATE SURCHARGE PER PERMIT - _50 (MINIMUM - 1 PER PERMIT)
(ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00
BEYOND $1,000.00) Well - $10.00
Private Disp. - $10.00
j Y
Rough Openings - $1.50
SIGNATUFiE OF PERMI . EE FEE MEW' 4!
STATE S/C:
FOR: CITY OF EAGAN GRAND TOTAL•
~ 6 ~9
2 329 . ' ~
Requasl Date Fre No RougMm In clion
~ - a 7 - 9o RBqVestl' ?No ?ReatlYNOw ~'When,Readypedor
I[g licensed contractor O owner hereby request inspecLOn of above electncal work at.
Job Aatlress (Slreet. BOx or Rama No.) Cny
D £ - c-
Sectmn No Towns~ip Name or No Range No Caunty
ai9 fro 7x'
OccupantlPRINT) Phone No
o C~vmf.,1T ei7 a -G 7f
Power Suppiier AOtlress
A ill E c 772 c ~/f-2~12 ~JG o~
Elecmcal Conlranor ComOany Narl Conlractor's License No
MaiLng Atlmeu l6COnaaCtor oc Own¢t Making In5id11du0nl
li2'7G ieJ
Aulhonzetl SignaWreonvacmrlOwner Mabng Installalion, Pbone Null
MINNESOTA STATE BOARD OF ELECTRIQ THIS INSPECTION RWUEST WILL NOT
Gdggs-MlEwey Bltlg. - Room 5-173 BE ACCEPTED 9V TME STATE BOARD
1801 Unlverelty Ave., SL Paul. MN 55104 UNlESS PROPEP INSPECTION FEE IS
Phone(612) 602-01 ENCLOSED
3/7/rj U REQUEST FOR ELECTRICAL INSPECTION •=~='":~eeooom-m
? See insimcLons for compleung this brm on back ol yellow ropy. Q~ G
0 2.2f~ ~^9 "X" Below Work Covered by This Request / ~y /
ew Atltl Rep. TypeolBudtlmg AppliancesWiretl EquipmeniWiretl
Home Range Temporary Service
Duplex Water Heater Electric Heating
ApL Bwltling Dryer Other (Specify)
Comm./Intlustrial Fumace
Farm Air Conditioner
Other(spealy) Convactor5 Remarks.
Compufe Inspectron Fee Below:
x Olher Fee n ServiceEniranceSize Fee # Circuns/Feetlars Pee
Swimming Pool 0 to 200 Amps g~ 0 to 100 Amps vZ Q
Transtormers Above 200 _ Amps A We 10 Amps ~
S19n5 lnspectors Use Only TOTAL 'J
Irrigatwn Booms cr 6 Q S~
Special Inspection
Alarm/Communicatwn THIS INSTALLATION MAY BE ORDE EDDISCONNECTED IF NOT
Other Fee COMPLETED WITHI 8' ONTH6.
I, the Electrical Inspector, hereby Rouqn,o ~,c~ / oaie3_ ~ ya
ceridy that the above inspection has F,,,ai ~ oa~e
been matle.
OFFICE USE ONLY
This requesl witl 18 mOnlM1S Imm
CITY OF EAGAN NO 17506
_ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 5512 n
PHONE: 454-8100 /../1~y~
BUILDING PERMIT Receipt # (7` o
Tobeusedlor SF DWG/GAR Est.Value $168,000 Date FEB 9 , 1990
Site Address 2280 TRAVELERS TR
Lot z Block 3 Sec/Sub. WHISPERING WOODS OFFiCE u5E oNLY
Parcel No 4TH occuPancy R-3 M--L FEFS
Zoning R-1
w Name SUPERIOR CEMENT CONSTRUCT70N (ACtuap Const V-N Bldg. Permit 878.00
3 Address 1109 W 158TH (Allowable) N
Surcharg
0 City BURNSVILLE Phone 892-6786 xofSrones e 84.00
Length 70' PlanReview 570.00
~o Name Sd1ME Depih 38 ~ SnG Cuy 100.00
gQ Address SF Total - SAC.MCWCC 600.00
~ City Phone S F. Foolprints -
OnSiteSewa9e - WaterConn 625.00
~
Fw Name on sne weu waier Meter 90. 00
Address Mwcc sYstem XXX
¢i Acct.Deposn 30.00
<W City Phone CtlyWater XXX
aavaequired - s,waermii 30.00
I hereby acknowlege that I have read this application and state that the Booster Pump - S/W Surcharga 1.00
information i5 correct and agree to comply with all applicable Slate of
Minnesota Statutes antl Ci o( Eagan Ordinanc/es1 " 7reatment PI 252.00
SiynaWrOO(Permitee_ ~1" APPROVALS RoadUmt 355.00
A Building Permn is issued lo: SUPERIOR CEMENT CONST Piannar - park Dad.
on the express condtlion that all work shall be done in accordance with all Council 1. 00
apphcable State o1 Minn`eJ~sota Statutes anfd City of Eagan Ordinances. Bitlg.0i1. _ Copies
BwldingOHicial IIMIfI PAfA ~~,~1 Vanance _ 707AL 3,616.00
~
• ! ~rrfifir~tr nf (~rru~pttnr~ .
~itp of Cagan
lgP}1F1Pt11lPIlI of Illttlailtg AIA{IP11lUCl` '
Thrs Cerlificate issued pursuant to the requiremen[s ojSection 306 ojlhe Unrjorm Building
Code cenifying that at the time ojrssuance this structure was in compliance witk the various
ordiwnces of !he City regula6rsg bur(dtng construction or use. For the fo(lowing:
u. cloor.d. SF I1IJG/G1R mae. Pcmit rvo 17506
oa~a~~r rya ~~11 O Zmna D.~ RI ryx ca.. VN
a.rerore.ae~~ ~()R CEIDNf aeaoss 1109 4FM 188'lll SP•. WmvIILE
euilat" /afearm 2280 1RAVFdERS TRAII. L~e1y L2, B3, S7EiISPERIIVG 410M 4IH
o,o,. MAY 22. 1980
euaaine ar" .
POST IN A CONSPICUOUS PUCE
r` \
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF SNERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be (Jsed For: 50)0- Valuation: J 6>V,000^ Date:
Site Address ~ T~` ~1 V~Z LIz~s T TCE USE ONLY
y: ~y
Lot ~ Block ~ uj ~1i5Rg~IN4 ~0~~b5 FEES
Occupancy R-3 M -I
Zoning R-I
Parcel/Sub N`4,f u, 1(0r Actual Const V-N Bldg. Permit g78.00
I Allowa6le V -/,4 Surcharge gq,Op
Oemer it,y~, S+ffp L~ha(e# of stories Plan Review ,j Q1017
Length 70 SAC, City / Dc), 0
0
Address Depth 38 SAC, MWCC 600, OD
S.F. Total Water Conn 6Z $,OQ
City/Zip Code Footprint S.F. Water Meter
Acct. Deposit 3~j•p~
Phone On site sewage_ S/W Permit 3c7,
On site well S/W Surcharge 1,c7p
Contractor Sv~''Cv+c%' (~CinL~l 4)mit lMWCC System Treatment Pl. 2$2.0 O
City water Road Unit 12,51510
p
Address U y Vi PRV _ Park Ded.
Booster Pump Copies ,00
City/Zip Code QV'1nj oille 5- S^3 T7 SUBTOTAL
p /APPROVALS Penalty
Phone Planner _ TOTAL ~I f~.nn
Council
Arch./Engr. P~ /I1I J~ Spc'S~j Bldg. Off. 61LI-(q
/ ~~J Variance
Address l~(Y~t1' ~rv'~ s-
City/Zip Code Aep)L ~r~]8))~
Phone #
GL~RAC~ff
32~(ZZ= 70~{
i 2 x Z :
`i X 2 =
1~~2 /5= Ibo~,p
j3sn'1 T
3o u 4 v_ 1200
/ L9 K Z ~ Cz o)
I`dX/b = Z~`6
~c.~(,gk 14 - 2b.S52
I ST ~Looy~
3sMT~. i y 6 s
lt,XZ = 3Z
ISOp xSn: ~Sooo
Z Na FL oor<
3L x 35S = 12?6
Z'/2 K i o
c~7~S = <?9~
( ;t
ToD BLoc-Kr ~L, .979,7-
6A~-~EMEN7 ~L. 911.0
T ~A~ EL
p1 N 9~ s, 4 N ~ R'°~ ~ L ,
~ ' ~ I o N 7?~3 ~ 'i~ • y z~ JA
71-00,3 Z
~
~ ~~M ~ ~,o~ /o ~m r
,
` oo .~i~; > ~o ti . ~ ~ ~ ~~jy
37.b7 aw9~b't ~ J
AK'4LiE ~ Fi., 97$.k 3o Q
/0 1 01
; ~m PRoG ~ Ep ~ 97 , g f ~
4o -
`vE % 1=,0 ~ 970,4 58,0 •_D ~ o a( Z
~r J l F~u97i,o ~ I~jo~ rY
? 1 o¢auawF pNO f~ ~ ^Ll
' S~ ~ lST1lt'cy ~AyEMENT j ~ 1i
F„4
?69.4 `Al WV ~
~
>9
DEScRrvrloni ~14i'';'~"-
L OT z, BL OCK 3_,
WHISPERlNC W80DS EAGAV1/ ENGINEERIhlTQ'a 3EP~'
FOURTH ADDIT/01v, ~ ~NOR T H
DAKOTA COUNTY, SCALE 1 -30
M1NNE50TA ALL BEAR/NG5 A55UMED
o DENOTES 1RON MONUM6NT
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 of the State of Minnesota.
Date: J.....~ Y~ /z"S'o Z--~
LeRoy H. ohlen
Registered Land Surveyor No. 10795
s~
s~~ 2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date J / -~7 ! 09 .
Site Street Address Cc~ ~~V2~'<t~5 \ Unit #
Property Owner ~p (1'fl ~-e ^ Telephone # (65~ ) ds3-Ua~
Contractor _'Qgc-~Nr~ QCO Telephone # ffiz ) qbci' 6cj4 j
Address aLAA~ Ntu,lU~w ~~t city LAk-ov:\l~e StateM .0 zip SSo
The Applicant is: ~ Owner \4Contractor _Other
Alterations to existing dwelling $ 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required)
Other:
Water'Softener Water Heater $ 15.00
_ replacement _ additional
Lawn Irrigation System RPZ_ new _ repair Xrebuild $ 30.00
State Surcharge $ 50
S~
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, 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.
TZz.ot-< ocZOO~~~
~ ApplicanYs Printed Name ~ Appli- c~ nature
2004 RESIDEN'TIAL BiTILDING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 3wcq
Telephone # 651-675-5675 FAX # 651-675-5694 ~
New ConsWdion Reamrements RemodeVReoair Reamremenis Offce Use Onlv
3 registered site surveys showing sq. ft of l04 sq. ft. of house; and all roofed areas 2 copies oi plan Cert o( Survey Recd % Y': _ N
(20°h maximum lot mverege allowed) 1 sel of Energy Calculations for heated additions Tree Pres Plan Recd -_N ` N,
2 copies of plan showing beam 8 window sizes, poured found des'gn, etc. 1 site survey for addifions & decks Tree Pres Required _Y N
isetolEnergyCalculalions Adddion-indicatei7on-silesepticsystem On-gileSepticSystem_Y__N_
3 copies of Tree P2servation Plan if lot platted affer 7!7193
Rim Joist Detail Options selection sheet (bldgs wifh 3 or less un'As
Date / Q9 / 014 Cons[ruction Cost~ ~ y.J u
. y
Site Address ja 'DO IC' fa V 2 ~ ~Q f S `f [7.n ~ UnitlSte #
Descrip[ion of Work &4~COoM
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner Cd d&(1T1U E4'\9,PJl Telephone #({y~ I) l.0 f 3-7
Contractor lD~ VAI lPU LWV~-dSLalo
Address 3" City FbAYN,VJV,J5?\
State ~ ~YV Zip Cj~ 0 1-~ Telephone#((pT~l ) 9
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Ca[eeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissionlype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously consiructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone J
,,~1- IIIIIi
Mechanical Contractor i1~ UiQR 9 3 2004 I u ~ Telephone )
UU v i
Sewer/Water Contractor l Telephone # ( ) .4 41 i3y i
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the appioved plan in the case of work which requires a review and
approval of plans.
Li ~A W()R' 4o 9,9~e~-- C Il) uvvw
ApplicanYs Printed Name ApplicanYs Signature
OFFICE USE ONLY
Sub Types
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
~ 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of_ plex ? 09 07-ptex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screenlgazebo) O 36 Muiti Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation 0 45 Fire Repair
'?1, 33 Alterafion ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation (qcjp~7 Occupancy MCES System
Census Code y 3N _ Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) ~ FinaUNo C.O.
_ Footings (addition) Plumbing
_ Foundation ~ HVAC
Drain Tile Other
Roof Ice & Water Final _ Pool _ Ftgs _ Air/Gas Tests Final
~ Framing _ Siding _ Stucco _ Stone _ Brick
~ F'ueplace _ R.I. _ Air Test _ Final _ Windows
Insularion _ Retaining Wall
Approved By: T 7 , Building Inspector
Base Fee
Surcharge
Plan Review iv I rr
MC/ES SAC ~601ULId 10, L
City SAC
Utility Connection Charge
S&W Permit 8 Surcharge
Treatment Plant
License Search
Copies rr~
Other
Total
,
FSB
. .
12006 12th Avenue South Office 890-2813
Burnsville, Minnesc~~~R ENVELOPE AVERAGE "U" COMPUTATION Model 890-3000
Plan If Date 2- ~-~v
` Owner: ~cN ~ ST~Pf~ G/N1)Ek~~~L
Contractor: $vJ~Lr/or (~osn[N'r t /!o~-r /NL .
Site Addreas: LaT 2 B1k 3 I~w ~~"1 Woo~ ~ ~vY'r~`
1. TOTAL EXPOSED WALL AREA ~ I~ 'f~ sq.ft. x"U" 3`"!
iI~J i
' 2. TOTAL EXPOSED ROOF/CEILING ~~y~/ aq.ft. x"U" ,O = I3~,~ ~
AREA WALL AREA CALCULATIONS:
Total Window Area sq•ft. x"U" b' Z~
Ov~i~- Glazed
Total Door Area sq.ft. x"U" ~ b~ = 2~Gl 'I` ~
Total Glass Door Area ~~q . sq.ft. x"U" = 3~'~. L~-~
rh~-+L Glazgd ~
Total Fireplace Wall Area ~ jJ~ sq.ft. x"U" ,~J~p = I, i~j~
Total Wall Framing Area ~ ~ sq.ft. x "U" ,'~~j = ~ ~ ~
Net Insulated Wall Area ~_~,Yy sq.ft. x"U" q~
Total Rim JoiNt Area ~~p • sq.ft. x"U" ~Q_ = 6• y~
~ Total Foundation Area ~ sq.ft. x"U" • ~ ~J
(Expoaed) 2] ~ ~j, ~
Total Foundation Windov sq.ft. x"U" °
Area
3. TOTAL
If item 3 is the same as, or less than item 1, you have
met the inGent of 2 MCAR 1.16008 A and O.
4. RQOF/CEILING CALULATIONS
Total Skylight Area / aq.ft. x"U" °
Total Roof/Ceiling `J sq.ft. x"U" ,~LY =~F
Framing Area
Net Insulated Roof Ceil- ~ sq.ft. x"U" ,OLZ
ing Area ~ q""±
ro-F.} L ~ !
I hereby certify that [he h~+ilding here described meets or exceeds~th~
~t~te of t~llnne~otn ~c~ergy Cnnserya~ion ~lct. i,~~F''"V
. .
.
' i•1
. . .
CONSTRUCTION
WALL FRAMING SECTION
Tntnrinr air film .068
Z
; e f~ft wood G • 9'1
y Si4~hL ,~1 . 4/
F.,.eri...- air fi7m .017
0
' TOTAL R
U = I/R . ~8
WALL SECTION (INSULATED)
' ~ 068
2 `i S.(1.. ,Ys
~ M1.Sv
s 1 d(K
8 Exterior air film •011
TOTAL R 23 • 17
' • U = I/R
RIM .TOIST SECTION
1 Interior air film .068
2 S fr 13 a+ ) NS, 19
`/2 wvJG/ ' I 1S£9,
t3 ?d r~
S Sid~n
6E°t°"a^r ir film .017_
' TOTAL R t
U~I/R ,oy
FOUNDATION SECTION
I r r i { fil 068 ,
• • . ' 2 ~.~..-~g+.~(o - ~
. ~ ' 3 12' [ ~311tr 1•2 $
4px« rior air film .017
. (5 -
' • + . TOTAL R 6,13
~ .~~~.I.•. ~ ORAOE . U = I/R
. . ' `
CONSTRUCTION
CEILING SECTION (INSULATED)
(1 In[erior air film .61 "
(2 S/f S.qT /lock sL
YJ
(3 owr i
(4 Exterior air film 61
TOTAL R T fl
U = I/R CEILING FRAMING SECTION
. ~ (1 TnrPrior air film .61
fLOW (2 S/8 S, .f(3 g/nv~ ~lv1. 33
FrEC)
(4 Interior air ilm _ .61
( 5 5`12 " S e-pt w o e 3r-
' TOTAL R 3 q,
' U = I/R
CEILING SECTION (INSULATED)
• ~1 Interior air fi m .61
(Z
(3
- (4 E..ro.inr nir film (atill) .61
. TOTAL R
' U = I/R
i • ' CEILING FRAMING SECTION
Interior air Pilm .61
VENTED (3
' (4 Interior air film .61
(5 inches of soft wood
TOTAL A
. U = I/R
4 '
~ EXPOSED BEAM CEILING SECTION
(1 Interior air film .61
(2
(3
(4
, (5 Exter or air film .17
• TOTAL R
' U = I/R
(
9
LOT ~ BLOCK ~ SUBD.
RECEIPT # 7,y ~ 33 DATE /a- ~Z-9l0
1996 CITY OF EAGAN
IRRIGATION PERMIT (FOR BACKFLOW PREVENTER)
COMMERCIAL INSTALLATIONS: FORM MUST BE COMPLETED BY LICENSED PLUMBER
Date: 9-6-96 _ Commercial GPM
_ Residential (boulevards) GPM
xx Existing residential
Area/address to be irrigated:
Installer: RAt HAEG PLUMBING Owner ? Plumber Eli
Street address: 7226 CE°AR AvE sourH
City, state & zip code: R1::HF1ELD MN 55423 Phone , l~( /00 9 Z
Owner Name•
Street address: 22 80 - %,r.a 7,a ~
City, state & zip code: 62.na/l., !'Y)ll Phone 920 - 1-/3 %:Z
Irrigation contractor, if different than installer:
Telephone
I hereby acknowledge that I have read this application, state that the information is correct, and agree to
comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property
owner that the City of Eagan assumes no liability for any damages caused by tfie City during its normal
npo.aIlO!33l dS3d m3iniaranCC 2Ctl:r:}iur_, te ti•n :acil;±;es consir:sc:ed undpr .h:3 ^ri'!!.^.2L •1V9ih7[: Clt,
p roperty/right-of-way/easement.
4!,/irr9 w CO, S~.GCk ~5/ 1 A.
Applicant're Title
Approved hy: _ Date: _
PRV ? Yes ? No New service ? Yes ? No
hteter Size & Cost
Fnes due: Ca!cu!ated by:
PROCEDURE FOR IRRIGATION SYSTEMS - 1996
An irrigation permit js required - please contact Protective Inspections at 681-4675.
Fees
Commercial project: $25.50 irrigation permif to cover installation of backflow preventer.
$50.50 water permit fee only if new service is installed.
$300.00 per tap if installed by City.
Residential project: $20.50 irrigation permit to cover installation of backflow preventer.
QF~;,Fn W7tPr narmit foo If f1P.N(,S!?~`!If~P._!S If~S~llp~
$760.00 Qer connection - WAC.
$396.00 oer connection - water treatment facility.
Existing residence: $20.50 irrigation permit to cover installation of backflow preventer -(not
required if backflow preventer previously installed).
Meter charge: If gallons per minute are less than 25, a 1" meter will be required at a cost of
$182.00. If gallons per minute are more than 25, a 2" turbo with strainer will
be required at a cost of $822.00. This information is to be supplied by the
designer of the system.
No meter will be sold before all sewer and water inspections are complete on a new service. If new
service lines are not reauired, one check may be written for meter and permit costs. Receipt will be coded
to 20-3716 (meter portion only) with pink copy forwarded to Utility Billing Clerk.
The installer is to contact Protective Inspections at 681-4675 for inspection of the inside water line and
hackflrnv prev?r.ter. The Pii6lic Works Deqartment may be reached at 681-4300 for water turn-on and set
and seal or the meter. Inspection hours are 8:30 a.m. to 3:30 p.m. ivionday iFuougn i rioay. RequeSiti lur
A.M. inspections should be made on the preceding work day. Requests for PM inspections will be accepted
until 12:00 noon.
it-citV oF eagan
3830 VILOT KNOB ROAD THpMA5 EGAN
EAWN, MINNESOTA 55142-1897 hmy°
PHONE(612) 454-8100 DAND K. GUSTAFSON
FAX- (614) 454-8363 PAMEV`McaLA
TIM PAWlEN1Y
BACRFLOW pRSVSNTSR THEODORE WACHTER
CWI%d M[II*~
. TSST RBPORT THOMA5 NEpGEs
' CM ~nwrator
EUGENE VAN OVERBENE
All information must be typed or clearly printed in ink. caycrrk
sice address 2280- raveler Trail Zip code 55122
Occupant John Lindekugal Phone no. #890-4377 Tast date 9_4-96
Device make 6 model ConbrdCO Size j" Serial no. F3414
Device location In the basement
System that device serves
Pressure Pressure
Check valve Check valve diff across diff vhen Strainer
N1 #2 al check relief opens
Test before Leaked Leaked psi psi None
repairs Closed ( ) Closed ( ) Clnd ( )
Final test Closed (x) Closed (x) 6-1[2psi 3-1/4 psi
~sra
Describe
repair
75 line pressure
Certifica[io
I hereby certify the foregoing data to be correct and that the tested device is functioning
ithin the limits of the standards.
Firm name. *Ravmond E. Haeq Plumbinq, Inc. nddress 7226-Cedar Ave. So.
By Tester's certification no. ~92-762T Phone no. 866-6092
: certifie % ester)
*Raymond E. Haeg Plumbing, Inc.
7226,-Cedar Ave. So.
Richfield, MN 55423
THE LOME OAK TREE...THE SYMBOL OF STRENGTH AND 6ROWTH IN OUR COMMUNITY
Equal OpporlunitylAffirmalive Acfion Employer
a~-~=-
~ Foi Office Usa ~
Clty Of Ea18Il ~ PertnR #
3830 Pilot Knob Road I Permit Fee:
Eagan MN 55722 j / i
Phone: (651) 675-5675 I oate Reeeived:
Fax:(651) 675-5694
Staff: v - I
L -----------------I
200 POLUMBIN PERMIT APPLICATION
Date: t5-I Z~ o SiteAddress: T~Z_
Tenant: S& ~ Suite
PROPERTY Name: Phone:
OWNER +
CONTRACTOR e
Name: - ar~, FDrd Licenseu: (7SS~7(P $'M
Address: 31 %"_>2 Cedar Creel, oad State: _ Zip:
HincKiey,
Phone: SrdSIS~ Contact Person:
TYPE OF New Replacement _ Repair J~ Rebuil _ Modify Space _ Work in R.O.W.
WORK - - !~~7-7~
Destription of work: I~ I" '~i
PERMIT TYPE COMMERCIAL
New Construction Modify Space
-~Srrigation System yes / _ no) (:t-QPZ PVB)
• Rain sensors required on irrigation systems
• Avg. GPM _(2" turbo required unless smaller size allowed by Public Works)
Meters Call (651) 675-5646 to verity that tests passed orior to oidcina uo meter.
Domestic: Size 8 Type Fire: Size & Price 3/4" me er 203.00
Avg. GPM High demand devices? Yes No Flushometers Yes No
COMMERCIAL FEES:
$50.50 Minimum (includes State Surcharge) OR convactvawe $ x tY,
_ $ Permit Fee
Required on ALL new buildings and boulevard irrigation systems 4 = 8 Radio nneter Read
- It Pertnit f-u is less than $1.000, surcharge is $.50 Meter(s)
- It rtnit Fee is > 51.000, surcharge increases 6y $ 50 tor eech $1,000
$1,000 Permit Fee (i.e. 8 $1.001-$2,000 Permit Fee requires a $1.00 surcharge). State SUfchafge
Following fees apply when installing a new lawn irrigation system. $ Water Pertnit
Call the Ciry's Engineering DepaAment, (651) 675-5646, for requiretl fee amowts.
$ Treatrnent Plant
$ ater Supply 8 Storage
$ State Surcha e ^
TOTAL FEES S
I hereby acknowledge that this infortnahan is wmplete and accurate; that the work will be in wnformance vrith the ordinances and codes of the Ci of Eagan; that
I untlerstand this is not a pertnil, but only an application for a pertnil, antl work is not to slart without a pertnit. ihat the wark will be in accortlance with the approved
plan in the case of work which requ/i~re~s a review and approval of plans.
x l7ft'I(u/1 rUa~ x
ApplicanYs Printed Na e ApplicanYs Signature FOR OFFICE USE Approved By: Date:
Required Inspections: _Under Ground _Rough-In _AirTest _Gas Test _Final
PRV Required: _ Yes _ No
Page 1 of 3
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 2280 Travelers Tr
Lot: 002 Block: 003 Addition: Whispering Woods 4th
PID:10- 83953- 020 -03
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: New
Description: Fumace & Air Conditioner
Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952)
445 -2840
Fee Summary:
Contractor:
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824 -2656
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Owner:
Edward G Engen
2280 Travelers Tr
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$50.00 0801.4088
$0.50 9001.2195
$50.50
Issued By: Signature
Mechanical
EA090718
08/18/2009
ePermit
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
, Use BLUE or BLACK Ink
r-------------.._._._-
I For Office Use I
I IL
Aa~ , Permit#:
: ~
City of Ea 0
Permit Fee:
3830 Pilot Knob Road f
Eagan MN 55122 Date Received: M I! f 2
Phone: (651) 675-5675
Fax: (651) 675-5694 I Staff:
I
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name Phone:
RESIDENT / ii
OWNER Address / City / Zip: Z2 O C4 ~I~rS i C<
Applicant is: Owner Contractor ~j
tG"J S
TYPE OF WORK Description of work: \ (IJ0t,_~ C C.uL i"o®
Construction Cost: Multi-Family Building: (Yes /No
7C )
Company: l Tt G/ c~QA c Contact: c L- v
CONTRACTOR Address: ~j, i ways City: tsz,
State: _ Zip: S ~O~) Phone: -I S-2-- ~ -Z- -22-(2
License # x-69 *'~>1 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 BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
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.
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.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
of permit issuance.
x~ x,
Applican jnt d Name Applican re
Page 1 of 3
t
' Use BLUE or BLACK Ink
For Office Use
Permit _ I I I VJ T~ I
City of Eakan
I
'
~ Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 1 Date Received:
Phone: (651) 675-5675 Staff:
Fax: (651) 675-5694 1
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 10-1 Site Address.•S -U j~ ~ G7~~ ~V~~ /I" l C~ rt r•~ PW
Tenant: Suite
0,0 Resident/Own "er;; Name: Phone: -
Address / City / Zip:
Name: MILBERT COMPANY INC dba CULLIGAN WATER License 063031-WC
Address: 1801 50T" STREET EAST City: INVER GROVE HGTS
Contractor
State: MN Zip: 55077 Phone: 651-451-2241.
Contact: BILL MILBERT Email:
e
placement _ Repair _ Rebuild _ Modify Space -Work in R.O.W.
Type of Work , -New ~-Cl
Description of work:
RESIDENTIAL
Water Heater ~4ater Softener
Lawn Irrigation l- RPZ PVB)
Permit Type Add Plumbing Fixtures Septic System g L Main Lower Level)
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (Includes $5.00 State Surcharge)
1 $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)
$.105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
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..qopherstateonecall.oro
hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of pia
Applicant's. Printed Name F= Applicant's Signature
r
FOR OFFICE` USE ~a r o. <z ay , 1
< Reviewed By.
1
7 ~~t t'v tl yFrt wy° w~ F ` k c }'S Y.,tfC i ~ i~St"'M~,~ ^f4~+"4Wn~7 F rt
Required Inspections ;=Under y RoU h In: _Air Test;, r Gas Test , Fin{
al