1285 Vildmark Drcity of Eaku
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
•ForCffice Use
Permit #:/ 6/66(0
Permit Fee: votaD
Date Rec- e
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICAT
Date: /0 13 _-/ / Site Address: /486- _ t 1� L
Tenant:
N
J
Suite #:
ALL 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.bopherstateonecall.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.
/19/9/J
Applicant's Printed Name
Applican s Signature
Page 1 of 2
- 7c5-06-/
RESIDENT / OWNER
Name: 6a6 Y It�_ Phone: &i S6/56
Address / City / Zip: /&86 a'1/}7 L` , Lead
Cert
No:
�v
Applicant is: Owner
%C Contractor NAT
27064
OF WORK
f �' (XO�r
Description of word.- ACK (A -Cit �u? aidt„ -',� ? a letryp O
CZ/
Construction Cost: A - Multi -Family Building: (Yes
/ No K,
CONTRACTOR
Name: , A. " iecab J cho C , License : / 744?
Address: /WO ') . City: y�
State: Zip: os 07 7 Phone: (QS/ - 7CPqr_ c2 / 6
Contact:u i O'7 G6/ Email:
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:
I
Mechanical Contractor: Phone:
Sewer & Water Contractor:
. '
Phone:
YOB: Plans and su ortin documm'rei tsa hat ti
� 9 YQur;�tl)iin'ft�ai�icoed':to ',. mom:oil.
the inifannation: may: be:s/a'ssined . 101.P. ubiic y/nL`opr =p � "i 1 pab fC e t *lapel*
. _. : .... ". ..: .': .. ,... .. Mclude that.they;,e 5
'�%�Pris of
i a ity}to
.... .?... ...nF.a ... .. ..,
ALL 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.bopherstateonecall.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.
/19/9/J
Applicant's Printed Name
Applican s Signature
Page 1 of 2
f
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Bex 21-199, Esgan, MN 55121
PHON E: 454-8100
BUILDING PERMIT Receipt#
To be used for ' Est Value Date ' ,19
Site Address OFFICE USE ONLY
fcL~:: On Ske Sewage Occupency
Lot ' Block Sec/Sub. `
. 3r;' . MWCC Syatem Zoning
Parcel No. , On Site Well (Actual) Conat
fc Name • r.: V. ° •'UNf ~F-L`f'- Citywater (Allowable)
= Address PRY Required # of Stories
3 Booster Pump Len th
° City Phone '4- 5U4 9
Depth
. o Name S.F. Total
o ~ Address i '~t, Footprint S.F.
U?¢- Ciry • Phone 77APPROVALS FEES
~ W Engr./Assess. Permit
y~ W Name
~ ~ Address Planner Surcharge
`W Clty PhOnB Council Plan Review
Bldg. Off. SAC, City
I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC
information is correct and agree to comply with aU applicable State of Water Conn.
Minnesota Statutes and City of Eagan Ordinances:
Water Meter
Signature of Permittee Road Unit
A Building Permit is issued to: Treatment P1
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. Parks
Building Official TOTAL
Permit No. Permit Holder Data Telephona # Plumbing
H.V.A.C.
EI@CtrIC ,.~/~i~ Z41 L
Softener
Inspectlon Date Insp. Comments
Footings I
Footings II
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Plbg.
Bldg. Final
Cert Oca
Temp. LP
Deck Ftg.
Deck Final
weu
Pr. Disp.
CITY OF EAGAN Remarks
Addition Wilderness Run 3rd Addition Loc 23 Blk 1 Parcel 10 84352 230 Ol
OwnerlbL_rk ~t~o+1j ,1 cGt{41(j QI(Q Street 1285 Vilmark bf"iVp- State Eagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF. 1977 818.39 81.84 10 818.39 C002365 10-4.76
STREET RESTOR.
GRADING
SAN SEW TRUNK $175.00 $8.75 20 PAID
SEWER LATERAL
WATERMAIN
WATERLATERAL I T 1972 $1441.33 $96.08 15 PAID
WATER AREA
STORM SEW TRK ( 1983 29 •2T 19.75 15 296.27 c007714 3-10-2
STORM SEW TRK 1981 6-9-80
SEW LAT
CURB & GUTTER
SIDEWALK
STREETLIGHT 107.94 21.$9 $
WATER CONN. $280.00 11814 10-2-74
BUILDING PER. #3538 13059 -
sAC 400.00 1181.4 10-2-74
PARK
INSPECTIQN RECORD
CITY OF EAGAN PERMIT TYPE: .~3830 Pilot Knob Road Permit Number: .
Eagan, Minnesota 55122-1897 Date Issued: ~
(612) 681-4675
SITE ADDRESS:' APPLICANT:
, i itM/tr; F- tifi
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION . D.
~ ~
Permk No. PermR Motder Oate Telephone ~
ELECTRIC
PLUMBING
HVAC
Inspecrion Date Insp. Commente
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUM8ING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARO
FIREPLACE
FIREPLACE
AIR TEST
FlNAL PLBG
FINAL HTG
ORSAT
TEST
BlD(3 FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
~ - / ZA)Z- -3
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, PIir.nesota 55122
PERMI`I' NO.: 521
The City of Fagan hereby grants to _Iienzel Plur&inq & Reating Inc.
of 3600 Y.ennebec Drive
a PLUMBING Permit for: (Owner) Wensmann r-onstruction
at 1235 Vildmark Drive ~ pursuant to app'Lieation dated 10/24/7#
Fee Paid: $20.00 dated this 28th day of October , 19 74.
.50 s/c
Bus.lding Inspectcr
N:acranical Permits:
Bid T:)tal:
I
i w.2.~
013 -
CI7f Or^ EAG,`-u
3795 : i].ot Iix:ob F,:;aa
Ecgw1, Minnesota 55122
PERIUT NO.: ~9g
The City o£ Eagan hereby grants to ue,+s.,gF i?,46
°f ~307~ &innaer arail
a Permit £or: (0-vner) w~m~rn c,onQt
at p.- , pursuant to application dated ~ 1412,174
Fee Paid: $20. 00 da.ted this y_q__day of '974 .50 s/c
Building Inspeci:or
Mechanical Permits:
Bid Total:
,~3 - / i,~ •
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT NO.: F51 _
The City of Eagan hereby grants to ^01 I +r.a
of 7 85 Vil rk nraoe -
a_ pTZTMRrW(; ~ Permit for: (Owner) a+.e - ,
at ,,,,m> j pursuant Eo applicatian dated. 3/95/M
Fee Paids y$c;-nn dated this iarh day of nwr_ e_19uZ5:
.50 s/c
Building Inspector
NSechaaiiezl Permits:
IIid Tota1:
CITY OF EAGAN N2 15208
. 3830 Pllot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100
BUILDING PERMIT Receipt# -7 ~L
To be used for POOL Est. Value $5,000 Date JUNE 16 1988
Site Address 1285 VILDMARK DR OFFICE USE ONLY
Lot 23 Block i sec/Sub. WILDERNESS RUN on sne sewage _ Occupancy
3RD MWCC System _ Zoning
Parcel No.
On Site Well _ (Actuel) Const
a Name ROBERT & SANDRA EDENFIELD CiryWater _ (Allowable)
; Address 12$5 VILDMARK DR PRVRequiretl _ #ofStones
. 0 City EAGAN phone 454-7504 BoosterPump _ Length
Depth
, o Name THE POOL STORE S.F. Total
oQ Address 1990 CHRISTENSEN AVE FaotprintS.F.
U~ City W ST PAUL Phone 451-7778 qppROVALS FEES
w W Name Engr./ASSess. Permit 66.00
~ = Planner Surcharge 2.50
x - Address
a w City PhOn2 Council Plan Review
Bldg. Off. SAC, City
I hereby acknowledge that I have read this appiication and s ate that lhe Va ce SAC, M WCC
information is correct and a to c pl with al p c le St e of Water Conn.
Minnesota Statutes and City of Ea an r na ~
Water Meter
Signature of Permittee Road Unit
A Builtling Permit is issued to: ROBERT OR SAND EDENFIE D Treatmenl P1
on the express condition that all work shall be done in acc dancewithall
applicable State of Minnesota Statu[es and Ciry of Eagan Ordinances. Parks
~f
Building OMicial -1fU11 T -yy~ _I TOTAL 68.50
~
~
?
` CITY of EAGAN N4 3418
BUILDING PERMIT
3795 Piloi Knob Aoad
Ownar Eagan. Mianesola 55122
Addrea (Psecanl) . 654-8100
Hullder e~`..~"':.'.`.:...~.......: fp_ .~-7 ~
• Dals
Addrasa ~
DESCRIPTION
Siories To Be Uaed For Fron! Daplh Heighf Eet. Coet erm!! Fsa Ramuks
5le 9d. So 70 I~~-R
..o--zz--Y-
LOCATION
SYreel. Road or olher DeaertpSion of Loeelfon I Lo! Block I Addilfoa os T:ae!
~ ~ "_._e
This permit does aot aulhorise the use of sixeels, zoads, alleqs or sidewalks aor does it give the owner os his agan!
the righ! Yo ereale enp ai2uafion whieh is a auisanee oe which preseale a haza:d !o the heelth, satelp, convsaienn and
ganeral welfare !o anpone in the eommunily.
THIS PEAMIT MUST BE KEPT ON THE PAEMISE WFIILE THE WORK IS IN PAOGA S. ,
This is !o cerlifp. 2ha!-lt-.4haspesmiseion !o ereet e.........._.: p L`,!upen
the a6ove deseribed premise subjeek io the provisions of all applicable Ordiaances fox !he Ci o! Eagan.
e-<-d:
.........'-"_.........c."-
l Per
a~ Suildinq ImPacfos ~
CITY of EAGAN N° - 3538
BUILDING PERMIT
Owaet 3795 Pilot ICnob Aoad
vL.c J
...............~..~_g" r....~.~ n~~<.~.................
/ ' , Eagan, Minna:o:a ssiza
Address (Presenl) - l 454•8100
Huilder N............................"'-............_......_......................
~
Dsla ~•...s-
Addrees
DESCRIPTION
Bloriea To Be Ueed Fos Fron! Deplh Heighf Eei. Cost srm!! Fee Ramarks
9' : e
LOCATION
3tzee2, Road or ofhar Deseripiion ol LoaeSion Lo! Bloek AdditSoa or Trae!
~
~ ,-)3 i l.~ -)e -P Z
T6is permit does not aulhorise the use of stree2s, roads, alleys or sidewalks aor doee 1t give the owaar or hU agsn!
the right to creale aey ailvation w6ieb fe a nuisenea or whieh presen2s a hazard !o the health, safetp, eonvaniean and
genasal welfare !o anpone in the communiip.
THIS PERMIT MUST BE EPT ONP THE PREMISE WHILE THE WORIC IS IN PAOGRE$S..
This ie !o cer!lfp, ihal..... r---_..e..............................hasparmisaioa !o ereat a.:. :•-.'~-.~`:.`.::~:...:..°`°`-~..._upen
the above d
escribed premi subjeci io the provisions of all applicable Ordinances for ihe Citp of Eagan.
~
` e
• Pez .
Mayor Hvildinq I~ector ~
?
YILLApE OF EA6RN SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.: 2369
Eogan, MN 55127 DATE: 10/28/74
Zoning: P1 No. of Units: 1
Owner:
Address:
SiteAddress: 12q5 Il'I dm'~t.?3B1 WR rTr
Plum6er: 1 i Plurd)inq & lleatinq Inc.
1 aqras ro eomply wi}h ehe Villo9e of Eagan Connec[ion Chazge:400.00 pd.
Ordinanws. Account Deposlt:
pd
Permit Fee: }gXg$ 10.00
.
Surchazge: 5 0 pd
gy, Misc. Charges:
Date of Insp.: Tatal:
In8p,; Date Paid:
YILLAGE OF EAGAN WATER SERVICE PERMIT ;
379'_Pi:a: ".sob Rood PERMIT NO.: 1608 ,
Eogon,MN $5124 DATE: 10/28/74
Rl No. of Unite: 1
Zoning:
Owner: W emw n fbnst^+c*iOn
i
Address:
Site Addreea. ~2 .8 .5--•-' I`~ ^ ~r 23B1 WR III
Plumber: _FlenzeLPj^' ina & Heatinq Zg0.00 pd
Meter No.: 24.002536_ Connection Charge:
Size: 518" Account Deposit:
permit Fee: 10.00 pd
Reader No.: 534122 50 pd
1 ogrea to eomplr with the Village of Eagan Surcharge: 60.00 p me eI
Ordinonc". . \ Misa Charges:
1 Total: .
By Date Paid:
Date of ]nsp.: Insp.:
2006 RESIDENTIAL BUILDING PERMIT APPLICATION v~
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 ~
Telephone # 651-675-5675 FAX # 651-675-5694
New Construdion Reauiremenls RemodellReoair Reouiremenis Qtfiee Use ONV
3 registered site surveys showing sq. ft. oi bt sq. ft of house; and all roofed areas 2 copies of plan showing footings, beams, joists Cart 4f Surr`e~ ReGd','" _ Y N
(20% maximumlotcoversgeallowed) 1se(ofEneigyCalculatlonsforheatedadditions TraBPresP~tt-€i~1
2 copws of plan showing beam & window sizes; poured found desgn, etc. 1 site survey for additions & decks Yiee pres Requir~ Y wN
15etofEnergyCakulations Addi6on-indicafeAon-sifesep6'csystem On+sReSepticSy5lem,°. =1` .N,
3 copies of Tree Preservation Plan if lot platted aker 717193
Rim Joist Detail Options selection sheet (buildings with 3 or less units) .
Minnegasco mechaniqlventilatlonform
Date ~ /Lk_ / 0~ ~ Construction Cost
Site Address (~j~v~ ~ ~ UniUSte #
Description of Work I%K. ir) ~ Vv'7 Wj~
~
Multi-Family Sldg _ Y_ N Fireplace(s) _ 0 ~ 1 _ 2
Property Owner Telephone # ) Li )lJ -~y
'-leArth & NapM IpC. Contractor F1fe8f~
Address N~_City
State 651~~ Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category , Residential Ventllation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
In the last 12 manths, has ihe City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber E Telephone )
Mechanical Contractor I Telephone )
Sewer/WaterContractor Telephone#( )
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a pe it, and work is not to start without a
ork which requires a review and
permit; that the wark will be in accardance with the approved pl ' the T
approval of plans.
c~r~,,. V°1(j"` 4
ApplicanYs Pnnted Name Appl canYs Signatur
DO NOT WRITE BELOW THIS LINE
Y
Sub Tvpes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Firepiace ? 21 Porch (3-sea.) ? 31 E#. Alt- Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Muiti Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvaes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Founda6on ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
D25CI'IptlOft: WaterDamage_Yes Valuation Occupancy MCES System
Pian Review 100% or 25%
Census Code Zoning City Water
SAC Units Stories Boos er
# of Units Sq. Ft a~wM ebica ,
# of Bldgs Length Fire M
,)Fi.
Type of Const Width tl~tW~jdo
REQUIRED INSPECTIONS
_ Footings (new bldg) _ Sheetrock
Footings(deck) ` FinallC.O.
_ Footings (addition) _ FinaUNo C.O.
Foundarion AVAC
Drain Tile Other
Roof Ice & Water Final Pool Ftgs Air/Gas Tests Final
Framing _ Siding _ Stucco L,ath _ Stone Lath _Brick
_ Fueplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wal]
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge •
Treatment Plant
License Search
Copies
Other
Total
CERT/f/CATE Of SURVEY
WILDERiJESS Q..U1J
' 92 `.r-- r ?
0.'1-3 `~.2.•(e°00"1e" 70.89
. •
.
1i71
m 48.00 w
i" 4) 0 in
00 ~ p
O IJ~ ~ pROPOSEA H4U6C O , , '
d 't N N ~ Q ' . .
o ~ p
O 120 Q
Z 22.s `]21.3j Z
r,3 0 0
N ~
• N N
29,9 .
q~~ ~ L1~'1lLITY
- p EA~j~ME~tT_._
m
9~9 ; o 'o
9 5 SS w q\4b ' SCALE (~=31:p~
A~-L BEAQI~lCsS ASSUMtD
9/x6 ~o oDEWDTE9 IRAN MpIJC1MENT
VILDMARI< DRI~lE
/ H£R£8Y CERrIFY TNAT TN/S SGRVEl; PLAN OR REPORT pE5CRIPTIOIJ
WAS PR£PAREO BY ME OR UNOER mY O/RfCf SlA°ERV/S/ON
AND THAT I AM A DULY REG/STERED LAND SURVEYI'AP LOT 2 G k ti 1
UNDER TME LAWS AF T//E STATE AF M/NNESOTA.
: . W1LD'ER11~j~j RL1N 1-1A1RD ADVITIOF-t -
pAK-oTA,, coU1.lT'Y) MINNE~oTA
DATE Qcro[3E2 1 1974 REG M0. /0T95
buandt snmincaring company
13301 olivar ovanva ioulh,
burnivilla, nninnapolo S5337
~
.
, • /
° MASTER CAftD
/ i
Loca,noN
OWNER
STRUCTURE AND
LAND USED AS g
Issued To
Permit No. Issued Coniractor Owner
BUILDING OQ/X
-f//~~---
PLUMBING s~ .1 ~D^ 2 q'7( ~l~N Ll~I
CESSPOOL - $EPTIC TANK WELL
ELECTRICAL
HEATING ~s-l--" zz -
GAS INSTALLING
SANI7ARY SEWER
OTHER
OTHER
ApproVeCJ
Items (Initial) Date Remarks Distance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING _ ~ a~ l FT.
FINAL
ELECTRICAL DEPTH
HEt>TING -17" 7 OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING 25~
WELL
SANITARY SEWER
S
Violations Noted
on Back
COMMENTS:
'
COMPLIANCE INSPECTION REPORTS
TO BE USED ONIY IN EVENT OF OBSERVED VIOlAT10N5
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
NO EVIDENCE OF NON-COMPLIANCE NON-COMPLIANCE. BUILDER DOES NOT
OBSERVED. ~ INTEND TO COMPLY.
~ ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS. ? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DEIAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
? REINSVECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CE RTI FICATI ON - I certify that I have carefully inspected the ahove in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed ta be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site imprwements relating to the property inspected.
? ALL IMPROVEMENTS AGCEPTABLY COMPLETED
BUILpING INSPECTOR OATE
COMMENTS:
~ ~3
PERMIT COUP
~ CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 5 5 3 6
(612) 681-4675 Date Issued: 05/ 0 5/ 9 5
SITE ADDRESS:
1285 VILDMARK DR
LOT: 23 BLOCK: 1
WILDERNESS RUN 3RD
P.I.N.: 10-84352-230-01
DESCRIPTION:
&(SIDING/WINppW5)
Btaiid5.rtg~'~R,ermiti Type SF (MTSC. )
~u.ilding LJa*-~ T y p e NEW
~w
I^y{y R g Tt .
fr~ ~
~ ~ c ~3•=w.',,. :
REMARKS:
FEE SUMMARY:
VALUATIQN $24,000
Base Fee $243.00
Surcharge $12.00
Total Fee $255.00
CONTRACTOR: - Applicant - ST. LxC. OWNER:
AMERICAN REMOOELING INC 15530020 0002406 EDENFIELD ROBER7
3700 ANNAPOLTS LN 1285 VILDMARK DR
PLYMOUTH MN 55447 EAGAN MN 55123
(612) 553-0026 (612)454-7504
I-hereb;Y' acknowlredge Chat I6ave read this appl.icati,on ~ &rid' state that thso
inf4rmatiarr is dorrecC and agree 'CP comply witit all appi3cable atate of' Mnm
S-fiaCUtes~ and City d°f Eagan Ordinasnces.
~ A I 01
-
APPUCANTlPERMITEE SIGNATIIRE -Z~SSUED B SIG TUREI I
PERMIT # CITY OF EAGAN
9EAC7ivaTE _ 199-2-BUILDING PERMIT APPLICATION
Q5 681-4675
SIN6LE 5 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COhM1ERCIAI 2 sets of architectural & structural plans, I 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 which re uest is made lot chan e is re uested once ermit is issued.
Date _6~_ / ,3 Valuation af work
S i t e Address:)~;',,~ ~dn'?~'l2~ ,LJfJI U~
STREET SUITE R
Tenant Name: (commercial only)
LOT ~ BIACR SUSD.p,,~ P.I.D. N .
Descri tion of work: i~ l "
The applicant is: 0 Owner ontractor 0 Other (Descrlbe)
Name Phone q,2-l'250y
Property LASi FIRSi
Ow"er Address yS' ~1l /a?f~'If~-f:~~ If~~~r~E
STREET STE A
CitY State _/nN. Zip SS/~( 3
~ .
Company i arc7 ll"r+ Phone
Contractor Address&7M Cicense Exp.
CityState Z i p ~511-1/-%7
U
ArChiteCt/ Company Phone
Engineer Name Registration #
Address
CitY State Zip
Sewer 3 water licensed plumber . Processing time for
sewer 3 water permits is two days once area has been approved.
I hereby acknowledge that I have read this applicatian and state that the information is
correct and agree to comply ith all applicable State of Minnesota Statutes and. City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY ,
BUILDING PERMIT TYPE
? Ol Foundation ? 06 Duplex ? 11 Apt./Lodging %~[1.16.8asemeRt~ft1sh
? 02 SF Dwg. ? 07 4-Plex ? 12 Mu7ti. Misc. ? U Swim Pool
? 03 SF Addition ? OS 8-Plex ? 13 Garage/Accessory O 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 5F Misc. ? 10 Multi. Add']. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
? 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
, Const. (Actual) Basement sq. ft. MWCC System
(A7lowable) Ist F1. sq. ft. City Water
UBC Occupancy 2nd Fl. sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pump
~t of Stories Footprint Sq. ft. Fire Sprinkler
Len9th On-site well Census Code
Depth On-site sewage SAC Code
APPROVALS
Planninq Building Assessments
Engineering Yariance
REQUIRED INSPECTIONS
? Site O Footing p Framing ? Insulation
? Wallboard ? Final 0 Draintile ? Fireplace
Permit fee v.tuac;a,:
5urcharge T
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter .
4f ct. Depos; i
8%W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Coptes
Other
Tatal: ~
sac %
SAC Units
1988 HUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS ' 5 ot
INCLUDE 2 SETS OF PLANS, 3 CEAIIFICATES OF SUAVEY, 1 SET OE ENERGY CALCULATIONS
NOTEt ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BOILDING PERMIT I3 ISS[IED.
MULTIPLE DWELLINGS RENTAL ONITS FOR SALE IINITS 0 OF UNITS
INCLUDE 2 SETS OF PLANS, CEATIFICATE OF SURVEY - C$ECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMIIMERCIAL ,
INCLUDE 2 SETS OF ARCHITECTIIRAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENJRGY CALCULATIONS
&
~+8cw~ 9r~o~,Nd 'p,s-~ o ~ /L 8
To Be Used For: Pi~ p(_, Valuation. Date:
Site Address 1z9S VtLbMpkk ctrz`w OFFICE USE DNLY
Lot Z 3 Block 1 On site sewage_ Oceupancy
MWCC system Zoning
Parcel/Sub (,uiL4eR1ueSS Ruw DDR ll7oill On site well _ Aetual Const
J,r~ n City water Allowable
Owner RvL36't2,T fSHAdDf~q3. t~ICNhc~~ PRV required ~ 1F of stories
Booster Pump _ Length
Address (~.$S VILL)~k Depth
S.F. Total
City/Zip Code a~%j+~J Mwi s'SIZ3 Footprint S.F.
Phone 14 Sq - 7 SOy APPROVALS FEES
Contractor •-~r PcroL, STOQL;7- Engr/Assess Permit
Planner Surcharge Q ,sJ
Address 199o c,gr~jsr~~'&n, AU'e- Council Plan Review
Bldg. Off. SAC, City
City/Zip Code W. ST,'PRt/1- S'S-I/ ~ Variance SAC, MWCC
Water Conn
Phone 4/ 5-1 - 77 7~ Water Meter
Road Unit
Arch./Engr. ;JIM Mv55M14N Treatment Pl
Parks
Address lQa(:) Cl+'!'t157't%iJSffN A'V'f- Copies
J TOTAL
City/Zip Code W.
Phone !I 4 5 1 - `J77 ~
~ ~ " ~ ~ ~
~ ~ eAo,4,,,,
~
!
I
~
~ i
,
,
,
.
,
~ ,
.
i
i
I -
f
`
~ , ry
. .
i
. S
- ~ MASTER CARD
LOCA710N /,Ij&~r_ ,-23-I LV /e• ?
OWNER .J_ ~O ~I ~YIS
STRUCTURE AND
LAND USED AS ~
Issued Ta
Permit No. Issued ConTrador Owner
BUILDING ,73i8 . . se ' f
PLUMBING ~ ~-25'75
CESSPOOL - SEPTIC TANK
WELI
EIKTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER I
O7HER i
Approved
Items (Initial) Date Ramarks Distance From Well
FOOTING $EPTIC
FOUNDATION CESSPOOL
FRAMING i TILE FIELD FT.
FINAL
ELECTRICAL DEPTH
HEATING OF WELL
GAS INSTALLATION
SEP71C TANK
CESSPOOL
DRAINFIELD
PLUMBING -37- J
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION R,EPORTS
TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE ? NON-COMPLIANCE. BUILDER DOES NOT
OBSERVED. INTEND TO COMPLY.
? ACCEPTABLE SU&STITUTIONS OR
DEVIATIONS. ? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED A5 FOLLOWS:
? REINSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CERTI FICATION - I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to The property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR DATE
COMMENTS:
RESIDENT /OWNER
Name: go 6 ,c e t Phone: 5/" V.5 7 Y
Address City Zip: 5 V rGr f ill ark i5 r
'r
CONTRACTOR
Name: `iA�`ii r 64Lw l y License 3a 7
v /r t
GG% e t
Address: C.'et(t /IC( e' i -C
City: /3 _‚k 1` Ui i� State: n Zip: 5137 7
Phone: 1 6 6 ;`3 Contact Person: a-- 7 c A S_-�`C
TYPE OF WORK
New Replacement Repair Rebuild \r1 Modify Space Work in R.O.W.
Description of work: .767,6 fl-r 70 "'=f y`
PERMIT TYPE
RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
RPZ PVB) Main Lower Level)
Septic System Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation
$50.50 Add Plumbing
*Water Turnaround
$100.50 Septic System
$90.50 Fire Repair (replace
(includes $.50 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
(add $165.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES
City of Eaall
Tenant:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
x
Applicant's Printed Name
Applicant's Signature
Use BLUE or BLACK Ink
Fo(Office
L
Permit
Permit Fee:
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: /C)'` Site Address:
f (14 YO dc e s
Date Received:
Staff:
Suite
1
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.
Reviewed By: Date:
FOR OFFICE USE
Required Inspections: Under Ground Rough -In Air Test Gas Test Final
11,[11/
City of Ea�au RECEIVED
FEB 13 2012
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
2012 RESIDENTIAL BUILDING PERMIT APPLICATION C -(16
Unit #:
Use BLUE or BLACK Ink
For Office Use
Permit #:
//-ooQ
4i
Permit Fee:
Date Received:
Staff:
Date: , 1 131 2• o t "!. Site Address: 1'2-8 5 V I C. DM Arles DV e
RESIDENT /
OWNER
Name: Zo AND 5-,,NA1 ra„,„. int f_e_.p Phone: 51— f -- 7c 1j
V
Address / City / Zip: 1 2,8 S V -40 (Y\ 41' %'_ V t L. -:e _
Applicant is: Owner K Contractor
TYPE OF WORK
Description of work: %w e 2 (p .rte 'Rerto
Construction Cost: *12_, D 0 0 Multi -Family Building: (Yes / No( )
CONTRACTOR
(6,12.-7-tv"I1.64/
Company: flb, (Ft- thO u s - Contact Dcu C.
Address: 9 2 D nvv-tem iltyA-t..L r City: i ft- n )
State: VY\ IVB Zip: cSI V; Phone: (0 12. - 2-I 0 --1 6 b f
License #: S if 5' I b 8 Lead Certificate #: NAfi - 8 I ci' 4 -/
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
1, 1k— ‘9,11-1
In the last 12 months,
Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE Plans and supporting documents that you submit are considered to be public information. Portions of
the information maybe 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.qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
ulAk
Applicant's P ted ' am
C' R c pfe_r`-401-.
Applicant's 4i', nature
Page 1 of 3
SUB TYPES
Foundation
Single Family
(_ Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
Addition
"c Alteration
—Replace-
_ Retaining Wall
DESCRIPTION
Valuation
Plan Review
DO NOT WRITE BELOW THIS LINE
Fireplace
Garage
Deck
Lower Level
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
L-- .
tA
Interior Improvement
Move Building
Fire Repair
Repair
(25%_ 100% \)
Census Code
# of Units
-# of Buildings
Type of Construction
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water Final
Framing —
Fireplace: Rough In Air Test
Insulation
Meter Size:
Reviewed By:
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
— Siding
Reroof
Windows
— Egress Window
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
— Wafer Damage
*Demolition of entire building — give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Sheetrock
Final / C.O. Required
Final / No C.O. Required
HVAC
Other:
Pool: _Footings Air/Gas Tests Final
Siding: Stucco Lath _Stone Lath Brick
_Final Windows
Retaining Wall: Footings — Backfill _ Final
Radon Control
Erosion Control
Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
L� 116mtoorrio-
Gvp-nfr
I )040
344
Page 2 of 2
4,b'
City of Eagan
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit #:
/& _ ~/e 3/C
Permit Fee:L,� C/ -�
Date Received:
Staff:
L
2012 RESIDENTIAL PLUMBING PERMIT APPLICATION
Tenant:
Site Address:
Suite #:
Name: GYJ cI n 1/2ta a
Address/City/Zip: I? Ufl4G" '*
Name:
tk(f .w 07, C C C
Address: Soo Clk4
Phone: 0 l ' y 7-5—G
State:4- Zip: -C- 3 3 ? Phone:
Contact: ®G 4 C/ 5-e ( Email:
License #: 5j3a 7 /214,%-,
City: (3".rA stjrlC{
Ja els-z / r r
New _ Replacement Repair _ Rebuild
Modify Space _ Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation (_ RPZ / PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures (_ Main / J_ Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $166.00 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.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.
x 'PJ t(,) HeCtis
Applicant's Printed Name
x
Applicant's Signature
City atEtan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
1 gL 3
Permit Fee: 1 05
Date Received: l (/ 1 / 13
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
J
Date: 1 I' I 2,a t,2 Site Address: I -2-' S I% Lp t1nz ✓ K Vies m ire Unit 8:
Resident/
Owner
Name: R O‘),e r4 ElSt -e L I) Phone:
Address / City / Zip: i 2. $ 'c V, (-- 0 InA-tr� w U:e
Applicant is: Owner )C
Type of Work
Contractor
Description of work: 0_ — \ t la,
Construction Cost `b r Co D'3 Mum -Family Building: (Yes / No )
Contractor
Company: ab O •r\- \e u -0 us -e_. Contact 4 .J�� G
Address: 110 Cu r r y -1-12441 i. City: �- }(� 1A-fJ
State: 111\ IN( Zip: c— Z1 (3 Phone: (Q► L -- 2.1 U —I (a (o tf
License #: '1 5--7 {p� Lead Certificate #: iV -1 ' — %.1'? ? --1
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
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.00nherstateonecait.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x _
yOOG
^"Apr rimo Name �Y '�
x V
Applicant's ignature
Page 1 of 3
r
City of Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use (,�
3 [ y'
Date Received:
Permit #:
Permit Fee:
Staff:
j 2016 RESIDENTIALpBUILDING PERMIT APPLICATION
Date: ;/(24 I Site Address: 2 -US U 4C.0 nn..(gZX- OV -2- Unit #:
R sident!
Owner
Name: 13 5A - -'''`S -r)4.c.. �- Phone: 6S1 --q5(1-7
/
Address / City / Zip: 12.-a 5 tit c..o iv,$fLtc DR__
Applicant is: Owner - Contractor e.:—/-
{
Description of work: V--c‘K_cc,"-- (15=‘,A—L
Construction Cost: `,(3/C.X.X� ..-- Multi -Family Building: (Yes / No z )
h
C�dntr
Company:S `I P�FL rt� fiw� Contact: J tc�V. \-
Address: i 1C(� c4%-( u IL -V1.- f City: - tet--E�,..
'� ` f f
Statek►� Zip: Ss -,- Phone: Co;I �}�� Email: �JQkf-er e v`t &r' -CO
License #: 1 1-4--'2--- /'ead Certificate #: / v 1z T - F d)16.901,-/
If the project is exempt
from lead certification, please explain why:
J gU"Lf i> 711
In the last 12 months,
Yes No
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?
If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Fire Suppression Contractor:
Phone:
Phone:
Phone:
Phone:
nd
i»ation
sup. ®#rng locum ® ab nforma ron Po o
m " e clas f n • Ic rf ou prro pe' a e
Cl � that theyarle� ecrats,
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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x
Applicant's Printed Name
cant's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
•
SUB TYPES
Foundation
y Single Family
Multi
01 of Plex
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100% ✓ )
Census Code
# of Units t
# of Buildings 4
Type of Construction 1413
-- ) \CO y" 1q('c �y-
Fireplace
Garage
Deck
Lower Level
Interior Improvement
Move Building
Fire Repair
Repair
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: _Ice & Water Final
Framing
Fireplace: _Rough In _Air Test
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Shower Pan
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
Porch (3 -Season)
Porch (4 -Season),•
•
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Siding
Reroof
Windows
Egress Window
/-3-51(0
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
2.043-
-t
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
IX Final / No C.O. Required
HVAC — Gas Service Test/. has Line Air Test
Brick
Pool: __Footings __Air/G ests _Final
Drain Tile
Final - Siding: _Stucco Lath _Stone Lath
Windows
Av
TOTAL
Retaining Wall: Footings Backfill
Radon Control
Fire Suppression: _Rough In Final
Erosion Control
Other:
, Building Inspector
0 @ ,LO
PA* pa ,(,
Si44. Barr;
Final
..-
Page 2 of 3
411'
City of Eaaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Perm it#: %''C_
Permit Fee: l -e • QC-)
Date Received:
Staff:
2015 RESIDENTIAL PLUMBINGWitev,k_
PERMIT APPLICATION
Date: 4-1,116 Site Address: /2g $ DK •
Tenant: f L 4- Eat
Suite #:
ACL
t•
11
v . w
Name: Name: Phone:
Address / City / Zip:
lt�b
Name: ivy -7_ P64'n .% S /1 7J `/` License #: ��✓79�6S�
Address: 24Vra r-tu G'�City:G,/fC V/GSC
State: /V%lv Zip:-C-3-0V� Phone: -5 7--z-/('V F9
Contact: l " rark Email: Sc-X/hi /y1'%6'(2.9 ja.,(vo- c'9 /71
....
New >CReplacement Repair Rebuild Modify Space Work in R.O.W.
Description of work:
_
I A- J i �% C�'i6
�. ermi1t T ype f
RESIDENTIAL
Water Heater°i
Water
RPZ /_ PVB)
/+/G 1 ki S', /2/ -r-6.4..,--(-/c.,.__
Water Softener
Lawn Irrigation (_
Add Plumbing Fixtures ( Main / Level)
Septic System
_Lower
Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,
$60.00 Lawn Irrigation
$60.00 Add Plumbing
'Water Turnaround
$115.00 Septic System
Water Softener, or Water
(includes State Surcharge)
Fixtures, Septic System Abandonment,
Heater and Softener
(includes State Surcharge)
Turnaround* (includes State Surcharge)
TOTAL FEES $
Water
(add $280.00 if a 3/4" meter
New (includes County fee
is required)
and State Surcharge)
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.
Applicant's Printed Name
Applicant's S
City of Eagan
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA143521
Date Issued: 06/19/2017
Permit Category: ePermit
Site Address: 1285 Vildmark Dr
Lot: 023 Block: 001 Addition: Wilderness Run 3rd
PID: 10-84352-01-230
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:
PL - Permit Fee (WS &/or WH) $59.00
Surcharge -Fixed $1.00
0801.4087
9001.2195
Total: $60.00
Contractor:
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
- Applicant -
Owner:
Robert E Edenfield Tste
1285 Vildmark Dr
Eagan MN 55123
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.
Applicant/Permitee: Signature
Issued By: Signature