4538 Villa Dr
CLAIMVOUCHER-REFUNDREQUEST 0-51
CITY OF EAGAN
MAKE CHECK PAYABLE TO: VALLEY PLUMBING
ADDRESS: 860 QUAKER AVE
JORDAN MN 55352
RECEIPT #1DATE: 50926 7/10/03
51203 7/15l03
52185 7/31/03
52788 8/13/03
REASON FOR REFUND: INCORRECTLY CHARGED PERMIT 60180,60183, 60271,40272
60273,60561,60562,60563
60564,60769
TYPE OF REFUND:
Plumbing Pemvt 9001.4087 $
Mechanical Pemvt 9001.4088 $
Building Peraut Fee 9001.4085 $
Plan Review Fee 9001.4222 $
SAC (MC/WS) 92202275 $
SAC (City) 9379.4681 $
SAC (Admin) 9001.4246 $
Water Connection 92203865 $
Sewer Permit 9220.4532 $
Water Permit 9220.4507 $
Account Deposit 9220.2252 $
Water Meter 9220.4509 $
WaterTreatment 9220.4685 $
Water Supply & Storage 9220.4680 $
Surcharge 9001.2195 $ 26.50
Overpayment 9001.2250 $
Curb Box Deposit Refund 9220.2253 $
Construction Meter Dep ReFund 92202254 $
Other - Fire Permit 9001.4096 $
TOTAL $ 26.50
I declare under the penalties of law that this account, claim, or demand is just and that no part of it has been paid.
G,•l.,C.t, ?ajt„. 8/19/03
~GNATURE DATE
PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan ~ U
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required for each unit
Date -7) 03
SiteAddress 753F \Aikt Dl1Ve ~d"?„''t 1701o'n9;Y ~ Unitl! _
Property Owner FA1111 J-SOns Telephone # ( ) _
Contractor ~AItGj lPl?016i0q _
Address o lYO oJAk~e_r /rve - City ,Joid917 _
State /14 ynnt3o+~ Zip S535~~) Telephone# (9r~)
The Applicant is _ Owner -14 Contractor _ Other _
Septic System New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00
Includes County fee. Additional consultant fees may apply.
Alteratians To Existing Dwelling Unit, Including $ 50.00
_ Adding f~ctures to lower levels ar room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water tumaround 5/8" meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
Wa[er softener Water heater $ 15.00
- - ~ I
_ replacement _ additional II , i1
$ 50
State Surcharge
Total $
t hereby apply for a Residential Plumbing Pertnit and acknowledge that the infortnation is complete and accurate; that the worl: will
be in conformance with the ordinances and codes of the Ciry of Eagan and with the Plumbing Codes; that I understand this is noi .i
permit, but only an application for a permit, and work is not to start without a permiY, [hat the work will be in accordance wiih ihc
approved plan in the case oFwork which requires a review and approval of plans.
TshL/A 41Iy
Applicant's Printed Name Ar6plicant's Signature
RESIDENTIAL MECHANICAL
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122 ~I
Telephone # 651-675-5675 O. S~
6~II--~3
Please wmplete for: Single Faznily Dwellings & Townhomes and Condos when permits are required for each unit
Date ei / .1 / o2
Site Address '441 Unit #
Property Owner J Telephone #6V_ )OE
Contractor Pr_
E~ 10 lh'eniworth r,v; . So
Street Address ?Ainneg~..t~ r.. ~w City
State 04881.9 n.Zip Telephone # ( )
Bond Expires:
The Applicant is _ Owner ? Contractor _ Other
Add-on, modification or altera[ion to eaisting dwelling unit $ 30.00
furnace replacement
air exchanger
air conditioner _ New _ Replacement
other
r ~
State Surcharge D $ .50
- _ ;r I
~~~iL,/,
Total X $ OYfJ.SD
~I
I hereby apply for a Residential Mechanical Permit and acknowledge that ffie information is-complete and accwafe; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a
pemiit, but only an application for a pemrit, 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.
SEDGWi'V'ii FlC- 6 A{r-: "uQNG CO
Applicant's Printed Name Applicant's Signature
4
COMMERCIAL MECHAIVICAL
Permit Application
City Of Eagan
3830 Piiot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675
Please complete for. commerciaUindustrial buildings
multi-family buiidings when sepazate pemtits are not required for each dwclling unit
Date / /
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond Eapires:
The Applicant is _ Owner _ Conhactor _ Other
Work Type
_ New construction _Install _Remove Underground Tank
Interior Improvement Schedule inspection during Installatfon or removal of tank
Processed Piping
Nature of Work:
Permit Fee $50.50 Minimum Fee (includes State Surcharge)
Contract Value $ x 1% Permit Fee
• If permit fee is $1,000 or less, add $.50 $ State Surcharge
If permit fee is over $1,000, add $.50 pex
$1,000 Permit Fee
$ Total Fee
I hereby apply for a Commercial Mechanical Pemut and aclmowledge 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 with the Mechanical Codes; that I understand this is
not a pemrit, 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 requues a review and approval of plans.
Applicant's Printed Name ApplicanYs Signature
Approved By: , Inspector Date:
conCKERCiar,
2002 BUILDING PERMIT APPLICATION
CITY OF EAGNN Ok~.~ fo
~ n -b ~-4 651-681-4675
Foundation Onl New Construction Interior Im rovement
• S6ucWral PWns (2) sets • ArchRecWral Plans (2) sets • Architedural Plans (2) sets
. Civil Plans (2) . ShueWral Plans (2) • Code MalYSls (1)
• Certificate of Survey (1) . GvilPlans (2) • ProlectSpecs (1)
. CoCeMalysis (1) " . LandscapingPoans C2) PWn (1)
. PmJectSpecs (1) . CodeAnalysls (1) " .
• Spec. lnap. & Testing Sdhedule " . CeRificate of Survey (1) . Energy Calwlations (t) not always"
• Soils Report (1) • Spec. Insp. S Testing Schedule (1) " • Elec. Power & Lighting Form (1) rrot always"
• Meter size must be established • Meter size must be esfablished • Meter size must be esfabUshed -'rf applicable
. ProjectSpecs (1) 1 .
1 • EnergyCalculaBons (1)
1 • Electric Power & Ughtlng Form (1)
1 . Master Exit Plan (1) 1
! • Emetgency Resporee SNe Plan (1)
1 • Soils Report (1)
?
• MCJES SAC determinatlon letter • MGES SAC determination lettu • MC/ES SAC deteimination letter
ca11651-602-7000 ca11651-602-1000 ca11651-602-1000
Food & heverage or lodging faalides - submft plan to MN Department of Health. Call 651-215-0700 for details.
" Corrtad Butiding Inspections for sample.
PermRfor new buildings or addHions will rwt be processed witlwut Emeigency Response Site Plan. Ask Buiiding InspecUons for requiremerrts.
DATE: ~//X/02 WORKTYPE: X NEW REMODEL CONSTRUCTIONCOST: iJ~D ",%D
c}S3$~/;l\0. VYV`~Z~ I/
SITEADDRESS: - '
TENANTNAME: Cedar Villas Housing SUITE#: ~
FORMER TENANT NAME, IF APPLICABLE:
DESCRIPTION OF WORK ° it.2 611) ~5,771/C
Name: Cedar Villas, LLP. Phone#: 6( 12 ) 341-7800
PROPERTl' Last First
OWNER
SueetAddress: 900 Second Avenue South, Suite 880
City: Minneapolis gtate: MN Z{p; 55402
Frana and Sons, Inc. Phone#: 952 ) 935-8600 -
ComPanY:
-ONTRACfOR
StreetAddress: 633 Second Avenue South
~1y'~.~_ ,
Clty: HOpk1riS State: MN ~Zip: . 55~4'3~'
4fiCHITECT/ ~
ENGINEER Company: Elness Swenson Graham ArchitectsPhone#: ( 612 a,1) 333`5508
~
Name; David Graham Regisuation#: 14808
StreetAddress: 700 Third Street South
City: Minneapolis State: MN Zlp: 55415
JcensedplumberinsWllingnewsewarlwaterservlce: Imperial Developers Phone#: 6( 51 ) 454-3330
hereby ecknowledge that I have read ttds application, state that the IMormallon Is correct, d agree com I th all applicable State of
Ninr~eaota Statutes and City of Eagan Ordinances. ~
Signature of Applicant ~.i
Updated 7/02
OFFICE USE ONLY
SUBTYPE
? Ol Foundarion ? 26 Public Facility 0 30 Accessory Bidg.
? 14 Aparhnents ? 27 Commercial/Industrial ? 32 Ext Alt - Apts.
? 15 Lodging ? 28 Greenhouse ? 34 Ext Alt - Comm
? 25 Miscellaneous O 29 Antennae ? 35 F.xt Alt - PF
? 37 Nail Salon
WORK TYPE
? 31 New ? 35 Tenant Impr ? 42 Demolish (Foundafion) ? 46 Windows/Doors
O 32 Addition ? 36 Move Bidg ? 43 Reroof ? 47 Repair .
? 33 Alteiarions ? 37 Demolish (Bldg) ? 44 Siding ? 48 Authorization
? 34 Replacement ? 38 Demolish (Int) ? 45 Fire Repair
GENERAL INFORMATION ,
Census Code Zoning sq. ft.
SAC Code # of Stories gy, g;
No. of Units sq. fL
No. of BidSs• Width sq, ft:
Const. (Acxual) Basement sq. R. MGES System
(Allowable) First Floor sq, ft, City Water
UBC Occupancy sq. ft. Fire Sprinklered
MISCELWNEOUS INSPECTIONS
Cl Gas Sffvice Test ? Heating ? Insularion Q Plumbing ? Stucco/Stone
APPROVALS
Planning Buildin8 Engineering Variance
°ermit Fee /p C 03, VALUATION $
iurcharge .5sa. 6 0 '
'lan Review
'AC/ES SAC % SAC ;2-
:ity SAC SAC Units
Nater Supply & Storage Meter Size
i/W PeRnit a-o
i/W Surcharge
"reatment Plant E , 7 6 ,Y•
-'~e '~'orr
'M1ls=D@dk9#Gn -
~
iOPPes
/ " o`L6'n.
'otal ~ S , 1'7.
~ ~
-------------1
Fr Office Use
City of Ea iii Permit
Permit Fee: t/ _ I
3830 Pilot Knob Road c I
Eagan MN 55122 Date Received: (J y
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff:
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: ) -C `t Site Address: Y"
Tenant: Suite
RESIDENT / OWNER Name: ~e ~T t r' d Y La c? ~ _ i ~27~ . Phone:
Address/ City /Zip: /6()(j / 'k
CONTRACTOR Name: 3i` 1t L1,- % License 0 Li o y t lY )
Address: ~rr-1 C IG.v1
City: State: k &J Zip: ` b23
Phone: l' L1 5- -29LSS- Contact Person:
TYPE OF WORK New Replacement -Repair Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
RPZ / _ PVB) L_ 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 (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
`Water Turnaround (add $165.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
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 approv plans.
Applicant's Printed Name A . n s igna ure
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Use BLUE or BLACK Ink
I For Office Use Z
Permit 150
CitIla
of EaRd~
d I Permit Fee: ✓ 4 • I
3830 Pilot Knob Road I
Eagan MN 55122 I I
Phone: (651) 675-5675 Date Received: ?J
Fax: (651) 675-5694 I I
I Staff: I
L-----------------I
2013 COMMERCIAL BUILDING/ PERMIT APPLICATION
Date: 3 Site Address: ! 539 61119 Dr
Tenant Name: Ila S (Tenant is: New / Existing) Suite
Former Tenant:
Name:- / 4 foy"PcrAD" o'l P Phone:
Property Owner Address / City / Zip: U00 joi
Applicant is: Owner Contractor
Description of work: AOC4 I h r :5,i j I "I
Type of Work
Construction Cost: 1
License `q 6Name:
Address: ~NL 1 Y( City: 6-o ld e i y> 1 111
Contractor
State: Zip: Shy Phone: '76 3- _/300
Contact: 06V j\ v1 / Email: &ul.
M I - '~'~f! G~
i Name: Registration
Address: City:
a Arch ltect/Engineer
State: Zip: Phone:
I Contact Person: Email
i
Licensed plumber installing new sewer/water service: 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 i
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.goi)herstateonecall.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.
x 471nJ / MOD x
Applicant's Printed Name Applica t s Signature
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