1768 Walnut Lane04/12/2011 TUE 14:36 FAX 952 925 1471 ROBERT B HILL CO.
*City afEaQall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Q001/001
Use BLUE or BLACK Ink
Permit #: 7g. -7q/
Permit Fee: g 6-06
Date Received:
Staff:
J
2011 RESIDENTIAL PLUMBING PERMIT APPLICATION f
Date: �-f 2—I Site Address: 1 W G 101Ln �i G�''� t T S5` '2.2
464 04 `1 ire
Tenant
Suite #:
RESIDENT ! OWNER
Name: -14 ti 0+ Te )1.e.. Phone: 65-1- ‘ 3(- I/2, C' Si
Address I City / Zip: 0-6 O W a i r"t U" Li -1 e G 3pi y-1 PIN 5512 2
CONTRACTOR
Name ':)ber'ir- 13.. 4111 CO License #: 04' 1 ?TO --W C
Address: 9-`O 1 0 X40 rd T City: S IS Pa i
State: NI P Zip: 55424, Phone: 152. — c72-5 -- 1/1-1 I
Contact: 2i tezei oY✓IU Yl Email: el I e -2.61/0....h( 11 W a+& < Cor.-. .
TYPE OF WORK
"New Replacement Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
PERMIT TYPE
RESIDENTIAL
I Water Softener
Water Heater
Add Plumbing Fixtures C___, Main / Lower Level)
Lawn Irrigation ( RPZ / PVB) -- _
Water Turnaround
Septic System
New
Abandonment
RESIDENTIAL FEES: -
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (Includes $5.00 State Surcharge)
$35.00 Lawn Irrigation
$55.00 Add Plumbing
*Water Turnaround
$105.00 Septic System
$95.00 Fire Repair (replace
(includes $5.00 State Surcharge)
Fixtures, Septic System Abandonment, Water Tumaround* (includes $5.00 State Surcharge)
(add $166.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
burned out appliances, ductwork, etc.) (includes $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.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 st- 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
xle2emt 'T dYY'LG'r-)
Applicant's Printed Name
x
YILLAOE OF EApAN WATER SERVICE PERMIT
3795 Pilot Knob Roed PERMIT NO.: _1751
Eogon,MN 5S122 DATE: 6/19/75
Zoning: MD No, of Units:
Owner: Np _ II
Address:
Site Address:
Plumbe paon ing Lp.
~2 17/ ~ Connection Chazge:140.00 pd
ize: ~ Arcount Deposit:
Reader No.: ~perynit Fee; 10. 00 -Pi
~ ~ wilb tM Vlllog~ et Eoque Sumharge: • 50 !d P~
~0~L,7 Misc. Charges: s
/ ~ Total:
By 6~~~~Date Paid:
Date df Inep.: InBp :
YILLAAE OF EA6AN SEWER SERVICE PERMIT
3795 ?ibt Knob Roe/ PERMIT NO.: 2512
Eagem• AN ssi'2 DATE: - 6119175
Zoning: PL1n No. of Units:
OWI1lf: Nnt.r 1inYi 7nn HnmPg Wnnr1gatE, TT
Address:
S1te Address: 176AWllnut L-ine
Pluiltlber: mhnm,= Gnn P1 umh i ng !`n _
I mOrw te eemPlr wM6 tlw Vlllaqe ef Leyan Connection Chazge: d$S . OOz
~rdleences. Account Depodt:
Permit Fee: 10.00 t~ Pd
Surcharge: .50 Pd
BY: Misc. Charges:
Date of lnsp.: Total:
Iaep.: Daee Paid:
~CITY OF EAGAN Remarks
Additio~ Woodgate 2nd Lot 5 Rlk 6 Per~l 10 $l~b01 054 06
O ner Street 1768 w8l11ut I'&Tl@ State Eagan,,MN 55122
• .r , PA,k, t (4
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 33 1974 8.52 1.70 5 Paid
STREET RESTOR. 3i 1976 103 •75 •92 3 paid
GRADING
SAN SEW TRUNK ~ 197 114.72 7.64 1 Pgdd
*SEWER LATERAL .71 1022.9O 3 P3iC1
WATERMAIN
-}tWATER LATERAL 1976 3
if4VATER AREA 1976 3
-}(&TORM SEW TRK 197 3
4TORM SEW LAT 197 6 3
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 140-00 316 _3-75 I
13UILDING PER. 3 3
sAC (
~
PARK 120.001 1 .510
' - . ' . ' . ' " , . . . . . , . . - I'. ik-' . . n . • . . ` . CITY OF EAGAN ~
! 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
~ PHONE: 454-8100
IBUILDIRO''p"ERMIT Receipt #
To be usad tdr DECK Est. Value $1,0000 Date JULY 9
Site Address 1768 iJA1.NUT LN
Lot S Block b SeGSub. WOODGATE 2KD OFFICE USE ONIY
P3rC@I NO. Occupancy ~ FEES
GRSG 6 LIBA LIKIC zoning ~ 2$.00 .
, W Name (ActuaU const ~ aid9. Permit
~ Address 1768 NAI.NIR LN (alowabte) SO
~ Surcharge '
City EAGAN PhOne A~ of Stories
length _ Plan Review
~p Name • '~'~M Depth - SAC, City
~ Address S.F. To1al
~ - snc, rncwcc
Clty Phone S.F. Footprints _
On Site Sewage _ Water Conn
y~j W Name On Site well - Wa1er Meter
Address MWCC System _
i W City Phone City water _ Acct. oeposit
PRV Required _ S/W Permil
I hereby acknowlege Ihat I have read this applica6on and state Ihat the Booatar Pump - S/W Surcharge
inlormalion is cwrecl and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. , Treatment PI
Signature of Permilee APPROVALS Road Unit
A Building Permil is issued to: GM b LIa/1 LINK Plenner - park Ded,
on Ihe ezpress Condition thal all work shall be done in accordance with all Council -
applicable State of Minnesota Statutes and City of Eagan Ordinances. gldg. pff, _ Copies ~
BuildingOfficial Variance - TOTAL ~
;
Parmk No. Pe.mR Ho1dK Date TaIMMons +M
WATER '
SEWER
PLUNtBING .
H.VA.C.
ELECTRIC
WqpKtfon pste Insp. Comrtwnts
Footin9sI
Foundation
Freming •
ROO"
Fiarpft Plbg•
Ragh hMB•
Isld. .
FkeWace
Final H1g.
Final Plbg. •
Const. Meter PIb9_ inspetlor - Notify Plumber
Engr•/Plan
Bldg. Final
osdc Ftg. ?o
- oec* Finai
weu
Fr, oap. , •
j 5. I
`~~.r!.T. ~ 9 ~ . cr ~ • PERMIT #1
MECHANICAL PERMIT RECEIPT #
cirv OF E?aAN
' 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ~
CONTRACT PRICE: PHONE: 454-0100 For Office Use Only:
Site Address ~ 4 1? V*- I'^ gLpG. TYPE WORK DESCRIPTION
Lot - Block _ 61).r3S~C/Sub Res. New 'T
Name Mult Add-on
~ Address 1 % - ' • ~ T , r Comm. Repair
~ Other
c Ciry Phone A1 Sa ' 7i 3S
FEES
~ Ngme RES. HVAC 0-100 M BTU - $24.00
~C Addreas f t ~ ADDITIONAL 50 M BTU - 6.00
39 p City P hone (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERIrA1T) - 1.50 EA .
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPUES
TOWNHOUSE 8 CONDOS - RES. RATE APPUES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
` Vent CFM STATE SUfiCHARGE PER PERMIT - .50
(ADD $•50 S/C IF PERMIT PRICE GOES
Gas Piping OuUets # BEYOND $1,000)
Other
FEE: •f r -
SIGNAT IJ1 EqKPERM
wrL
E
3/ C: " i ivE?~ - Na a~ ffa.~(E
! TOTAL• f'- FOR: CITY OF EAGAN (j-30- Tr
T
This reQUest voiC
18 nnmhs trom ' ' .
~ • '
Request Date • Fre No. ROUph-in InsUecuon
~ Requiretll E)Ready Nuw ? WiII Noufy, Insper,-
?Yes DNO «or Whn.n Ready
E] Licensed ec[ncal Convactor I hereby request mspaction ot ebove
'o Own elactncal work installad at
Sveat Atldress, Bon or Flwte No. CieV
1-7 HK~
ecuon o. Township N.M. or No. ftanee No. Co y
OccuVam (PPINT) Phune No.
.~rr~ or A/.L -71 35
Power Suppli Adtlress
IC mpany Name) Contrac~or's License No.
Elec[ncal ConVa/cmrf
S~
Mading AdJress (COMractor or Owner Making Instailauon)
Authonz iBnmure (Convactor/Own MaA ng MstalldEmN Phone Number ~
MINNESOTA pT /OqRD OFELECTqIGITV THISINSPECTION flEQUEST WILL NOT
Gnggs-Midway Bldg. - Hoom N497 BE ACCEPTED BV THE STATE 90AHD
UNLESS PFOPER INSPECTION PEE IS
1821 Universitv Ava.. St. Paul, MN 55104
Phon> (6121642-OBW ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION iii7iZ ee-ooooi_os
See instrucbons lor completing this iorm on back ol yellow coDV.
- "X" Be/ow Work Covered by This Request
Fdcl Rep. Tyoe ol Bwltlin9 Apolwncea WireA Equipment Wire•1
Home Range Temporauy Serviee
Duplex Wate, Heater Liyhhnq Fix1ures
Apt Buildmg Dryer Electnc Heannc
4 Conunercial Bldg. Fumace Silo Unloader
InAustnal Bidg. Anr Corxirtioner Bulk Milk Tenk
Farm Otnr, We,-i v .~~~er ~Snecilvl
, . ueci(y ther Oihcr
ompute Inspecuon Fee Below
N Fee ServmaEntmnceSae M Fee Faeders/5uble«ders a Frte Circmts
0 to 200 qm~s 0 to 30 qm s 0 m 30 Am>s
Above 200 qmpy 31 to 100 Amps 31 to 100 Fm s
Swmmiing Pool Above 100_Amps Above 100_nmps
Transmrmers Irrigation Booms Partial. Other Fee
$igns Special inspectioii
$ /0. 50 pem-~~ks TOTAL FEE.~ ,
flouBh-in Date ~he Elecvical
InsOec~oq heraby
e~ dy lhflt [he nbove
Fnal spection has been
TMa reQuest vold 18manitu Irom
. j
CITY ' of EAGAN N'°- 3603
. ~
BUILDING PERMIT
3795 Pilof Krtob Aoad
Owne: . .............l.................................. Eagan. Minaesota 55145
Addre (pratsa!) I..~.a'
u
454•8100
Butldss •
- ~ ~
Dale
Addr~u
DESCRIPTION
8to:i*c To Bs Usad For Faon! Deplh HeSph! Esf. Cos! Porm[f Foa A~muk~
l G ~ 7 Sul
LOCATION -Z-Z 90 .,5-o
i Sirsei, Road or oiher Daeriplton of Location I Lol Bloek Addllloe oe Trsd
i S
Thh psrmit does aot auShorise the use of slreeL, roeds, ellsps or sidswelks nor doq it give the owaes or h4 epen!
the righ! !o ereste nny situalion which b e nuiasnce or whieh yrsseNs s hazerd !o the hoalth, snfelp, oonveabace aad
paearal wsllare io anyona in the eommuaitp.
THIS PERMIT MUST HE KEPT ON THE PAEMffiE WHILE THE WORH IS IN PAOGAESS.
ihL L fo eertiip. lhat._~7.1~u.!~ . . . . ...........has parmLsloa !o oree! a..r7.zL..... 7~..........._ °pea
/
~ the above desaribed premise subjecf !o !h roviaions of all applieable Ordinanees for the Cifp oi agan
7
................_~...._`...SL..'.':.'.~. f,...'..~ `r•°~°............ Per .............~t'......_~.:`~':.'.......................
i Mayor BulldlnQ ~tpeetor
I
CITY OF E.4:32N
3795 Pilot Knob 8oad
Eagan, t+linnesota 55122
' PERNIIT NO.: 678
The City of Eagan hereby grants to r SAamaink AwajinC r. A*+. Gb.
•f inc)l taniw Avw Co ~ Mola SS416
S Permit for: (Owner) N Ftn ;non Homan -
~177_2, 1774, 1765, and
at , pursuant to application dated r~1qz 75
'~,~-,.~M~ro-
Fee Paid: 00 00_ dated this ~gay of >>9 ~a
1.00 e% •
t.:.=~..
BuildlagoIif;eyeoto
Mechanical Permits:
Bid Total:
j
• - - S_
CITY OF E_AG.iN
3795 Pzlot Knob noad
Eagan, Dlinnesota 55122
PEFiNIIT NO.: 571
The City of Eagan hereby grants to Tha=son Plumbina m.
ef 12201 Minnetonka Blvd. -
a oTinmT Permit for: (Owner) New 90rizon Homea - Noodaate
1775,76,74,72,70, ,66,64,62,60,58,56, and 54 Nalnut I.nne and 1757,59,61,65,67,
at 17AQ 71 ,,,,A qi pirkarv w+llursuant to application dated 6/16/75
Fee Paid: Sd7n pn dated this lorh day of June , 19 75
10.50 s/c
Building Inspector
Mechanical Permits:
Bid Total:
CITY OF EAGAN Np 18117,
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 n
BUILDING PERMIT Receipt #
7o be used for DECK Est VaWe $1, 000 Date JULY 9 ,1920
Site Address 1768 WALNUT LN
Lot 5 Black 6 SeGSub. WOODGATE 2ND OFFICE USE ONI.Y
Parcel No. aapancy - cees
` Zoning _
w Name GREG & LISA LINK (ACtuapConsl - BIdg.Permit 25.00
o AddresS 1768 WALNUT LN (pllowable) - Surcharge -5n
Cit EAGAN Phone 688-6738 r of Siones _
y Le(gin _ Plan Review
ip Name SAME Depih - SAC,Ciiy
0,¢ AddfQSS S.F.iotal -
SAC,MCWCC
• City PhOf10 S.F. Footpnnls -
- On Site Sewage _ H'ater Conn
r~
Fw Name On Sne Well - Water Meter
~a AddfBSS MWCCSystem _
Q i AccL Deposit
aw Clty PhOn2 QlyWater _
PRV Repuiretl _ SlW Parmit
I hereby acknowlege that I have read this application and state Ihal the Booster Pump - S/W Su¢harge
information is correct and agree to comply wrth all apphcable State of
Minnesota SlaWtes dnd Cit o j gan Ordinas. ~ / ~ Treatment PI
SignaWre of Permitee ~r 2 -!tj /,T APPROVALS qoad Unn
A BuilEing Permil is issued to: GREG & LI SA L.INK Pianner - park Ded
on Ihe ezpress condRion ihal all work shall be done in accordance with all Counal
app6cable Stale o1 Minn~esota S(taWteIs anydyG~ty ) of Eagan Ordinances. Bidg.011. _ Copias
BuiltlingOtticial Vanance - TOTAL 25.50
HOUSE HEATING TEST RECORD ~ •S~G
D-217724VA
ADDRE55 1768 Walnut L8. APT.-F100fZ~TCIT7 SUBURB Eag~
OCCUPANT OLr 6 o II OWNER 13ew norizons
HEAT LOSS DATE HTG. INST.
SOLD 8Y INSTALLED BY Sedgwick Htg.
n u
Elechical Work By Gos Line By
TYPEOFHEA7 GA_FAX HW STEAM SPACEHTR. UNITHTR. OTHER
GAS DESIGN CONVERSION
MAKE ~~a MAKE OF BURNER
Model C' -
Model
Seriol AbU4UUZbU Max. BTU Rating
INPUT 1 tu r. MAKE OF FURNACE
Model
CONTROLS
THERMOSTAT T87 Heat P Vent Size 5
Valve C'C W59RO4 KIND OF LINER UM. SIZE NONE
Limit CtC 20-1-180-FCW Draft Hood VerticalReg„ia,,,
Limit Sstting 1 S()0f Filters $ize 1611 x 25"N.mber 1
Fan Seteing 900f F. 1250f Chimney Location Inside Yes Outside
Pilot Typa r011P12. Chimney Construction M0t81}7E6COS
Pilot Make
Pilot Model Smoke Bomb Wiring
Pilot Timing 75 Seconds p„ft ok 7e:r Ta9 Yes
L.W. Cut Off Door Pressura L;9h+ing ins+. Yes
Pressure ~ 3.S"WPghentCO~ $'0% Date Tested 9/25/75
Input CFH 104 Percant O 7•0% Company Testing C. S. BRIGHT COMPANV
2 6
Stack Tamp. 420 f percent CO •00% Name o( Tester A
Form 235
1990 BUILDZNG PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS M[TLTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PIANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PL?14S
1 SET OF ENERGY 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.
'~1,
To Be Used For: h2 C~ - Valuation:-44~1 ~ate: Z-~. ne. L.(o
Site Address LO0.`o11,_f ~Qn OFFICE USE ONLY
Lot ~ Block (1P FEES
Occupancy
1,~p -,n~ Zoning
Parcel/Sub ~I~AO~dl~e. G-CS~IIfU Actual Const Bldg. Permit zSe
~ Allowable Surcharge ..S-O
Owner ~1' ~~0. L~ n k # of stories Plan Review
Length SAC, City
Address tTA Uki.\na~- kanG Depth SAC, MWCC
S.F. Total Water Conn
City/Zip Code ~CLqail, I~nN ~~1c~ Footprint S.F. Water Meter
~
Acct. Deposit
Phone lD 0 0~~G 1 JJ On site sewage_ S/W Permit
I On site well S/W Surcharge
Contractor~ arv~e G\5 0.0 Otif MWCC System _ Treatment Pl.
City water _ Road Unit
Address PRV _ Park Ded.
Booster Pump _ Copies
City/Zip Code SUBTOTAL
APPROVALS Penalty
Phone Planner TOTAL ~
n~,_~' Council /
Arch./Engr. IW~ A-Dpt1C0, b If, Bldg. Off. /-L
Variance
Addrr_ City/Zip Code
Phone #
. r
N 132, z3' . '
. 2~, .
~
~
Deck Nouse- j.
r . ~
~u.
Greg i Lisa L'Inl<
17(nZ Walnu+ Lane
03 ~ EQLrn,MRI SSIZZ
LSg-10137
Lot 5, B lock 6, Woociqqte Znd E41i-lon .
RESIDENTIAL
BUILDING PERMIT APPLICATION ~i
CITY OF EAGAN ~
3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
New Conetruction ReauiramenU RemodellRenair Reouiremems
• 3 registered sile surveys showing sq. ft. of IoL sq. fl. ot house; anM all rooled areas • 2 capies of plan
(20% maximum lot coverage allawed) . 1 set of Energy Cakulations for heated addi6ons
• 2 copies of plan showing beam 8 window s¢es; poured found desgn, elc.) • 1 site survey for exlenor add'Nons & decks
• 1 set of Eneryy CalculaUons • Indirate il home served by se0fic system for addifions
• 3 copies of Tree Preservation Plan if lot platled after 711193
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units) ~
DATE VALUATION
SITE ADDRESS ~6:1S 606~61f~- Z 'Ale- MULiI-FAMILY BLDG _ Y C~V
TYPE OF WORK FIREPLACE(S) _ 0_ 1_ 2
APPLICANT Cc~/'/'1
STREETADDRESS 9:~inc) /~:S?5 ~~CITY STATEZLAZIp5sw
TELEPHONE #Z:C~ ~~~'~YICELL PHONE # fAX #
PROPERTYOWNER ~LTELEPHONE# ~SJr~a'`Sl/3
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ M[1VNLSOTA RULTS 7670 G\'1'LGORY ( MINNLSO'f'A RliLI'S 7672
(J submission rype) . ResidenUal Ventdation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: Phonc 4 (Z2 (n)_ f-e n nn r~ r~
P1umUing sys[em includes: ~Vater Sof[cner Laiv~i Spnukle~r ~'s T~L-'` ~FeL 9,bA0
Water Heater _ No. of R.I. Ba OCT 2 5 2002 U
No. of Baths uu
Mechanical Contractor: Phoneg#
Mech:mical system includes: tlir Condiuoning Pcr. :i70.00
HcaL Rccovcry Systcm
Sewer/Water Contractor: Phone #
I hereby acknowledge that I have read ihis application, state that the information is correct, and agree to compiy
with all applicable State of Minnesota StaTutes and City of Eagan Or~~
Signature ot Applicant1-7~
OFFICE USE ONLY
Certificates of Survey Received Tree Preservation Plan Received _ Not Required _
.
- Updated 4102
~5935 ~6,0
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complcte for. single family dwellings & towmhomes/wndos when pertnits are required for each uni[
Date
Site Address Unit #
Property Owner g/ U 5 j4,Q, Telephone
Contractor
STANDAAO HEATING & AIR CONDITIONINU •
Street Address 410 WEST LAKE STREET City
MINNEAPOLIS, MN S •
State 61$.824-2658 Zip Telephone# ( )
Bond Expires:
The Applicant is _ Owner -Z?N\ Conlracror _ Other
Add-on or alteration to existing dwelling unit 2pp4 S 30.00
x pU G 1 9
furnace _Additional AReplacement
air exchanger
airconditioner _IJew _Replacement gy
other
State Surcharge $ 50
Total $ 3o • S(-::)
I hereby appty for a Residentral Mechanical 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 with the Mechanical Codes [ha[ understand this is no[ a
pernnt, but only an application for a permit, and work is not to start withou p hat the wo wbe acwrdance with Ihe
app ved plan in the case of ~ c ~ich requires a revi w and approval of ans. ~
i ~M lw?~e,,,~-
A p icant's Printed Name Applicant's Si a u
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 1768 Walnut Lane
Lot: 5 Block: 6 Addition: Woodgate 2nd
PID:10- 84601 - 050 -06
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspec
acceptable in lieu of inspections.
Fee Summary:
Valuation: 3,000.00
Contractor:
Maus Construction
1502 Cty Rd 42 E
Burnsville MN 55337
(612) 703 -5025
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Bermitee: Signature
- Applicant -
Construction Type:
Occupancy:
$90.00
Owner:
Hiwot Mehari
1768 Walnut Lane
Eagan MN 55122 -2420
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Building
EA084735
07/29/2008
ePermit
on prior to final, you must meet inspector with ladder and flat bar. Pictures are not
$88.50 0801.4085
$1.50 9001.2195
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
Issued By: Signature
Use BLUE or BLACK Ink
r
For Office Use
��/�,• 5i
Eaaall Permit#: y.
Permit Fee: 12-
3830 Pilot Knob Road .�p nEagan MN 55122 Date Received:
Phone:(651)675-5675
Fax:(651)675-5694 Staff:
J
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
tt 4 l
Date: ,3 X .... Site Address: t t k4 r..-1 tt\�.�.- - <:*__ ,,.C- Unit#:
# t
Name: e e,; ''" �t..` �. \44.._. �VQ.,. \ ._(.10 .. a Phone: ,1 . " L• ( :.�_ �I I%+1
Resident/ \\,.,.1
y
Owner Address/City/Zip: 1 % �r u.1 c,,.\t'g; „.. . ',---,...-.t•.. '-0_,--,:3„...„-\, iv\ pssi 073-,1 la.
Applicant is: Owner ' Contractor
Type of WorkDescription of work:V ,,. 1 c,,,,-,,,,,-- (')\ ty, ",,r. 0 t. a_
c', ) `""" Multi-Family Building:(Yes /No )
0 Company: cr ", ca.f . ,.• c Contact: ; cv '� �.. _
Contractor
Address: ;.5 ..)II t 10' A. -Z I i , ' _ City: N • n )z,�'. -%
State:oi\ Zi.p. ..a.': Phone: ' 1 tmail: a it . •, '' _ xK.-.,! R, ,,,_,L. Q.3
License# .)^.. .O t t(,)c Lead Certificate#: A ,),,c, :),,,,
If the project is exempt from lead certification, please explain why:
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:
Fire Suppression 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_ a
i ., .a, ,.._ ,,, _,� canciude that the!are trade secrets. e, ,_,, ._ ,,,.u a y_�,,,___ ,,,,
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.
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Applicant's Printed Name Applicalit's Signature
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