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871 Sudberry Lane4/16 City of Eatan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: •-7 Tenant: 4...�.)1Ain i r �t•lI 1 0 Use BLUE or BLACK In Permit*: Permit Fee: Date Received: Staff: 2010 MECHANICAL PERMIT APPLICATION Site Address: Cl 7 / SGt d tc-rev 5�+i RESIDENT / OWNER Name: '7 �^ Address 1 City/ Zip: T7 j J � 11 CONTRACTOR Suite #: Phone: Co +s -D-" S Irtery . CA",v1"�,v, r'4t . 5 3 Name: " f ' p gee t" Oro fl11 injr s A "�1. $cams$#:Alt". Address: Address: 3 6 $ Sb,i 1 S''A" .33 • City: gr -01/..a./ State: VIA Zap: J J 0 Phone: Contact: to Email: TYPE OF WORK New t% Replacement Additional Alteration Demolition Description of work: tCk lrtliy�a; tom" tip PERMIT TYPE tt RESIDENTIAL COMMERCIAL -`Furnace New Construction „__ Interior Improvement i/ Air Conditioner ^. Install Piping ____ Processed Air Exchanger — Gas .__._r Exterior HVAC Unit Heat Pump_Under !Above ground Tank L,_ install / _ Remove) " When installing/removing tank(s), call for inspection by Fire _ Other Marshal and Plumbing Inspector RESIDENTIAL. FEES: $55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) 55-A° TOTAL FEE COMMERCIAL FEES: $76.00 Underground tank installation/removal OR $55.00 Mi imum (includes State Surcharge) - If the Permjt Etc Is less than $10,010, surcharge is $ 5.00 - If the Permits Is >$10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) Contract Value $ x1% $ Permit Fee =$ Surcharge =$ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (681) 454-0002 for protection against underground utility damage. Cali 48 hours before you Intend to dig to receive locates of underground utilities. www.aooherstat@onecall.ore 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 withouLa permit; that the work will be in accordance with the a roved plan In the case of work which requires a review and approval of plans. ' ✓� x 1414 Appi ant's Printed IKame Appll x nt's Signature T•al XEJd 13CJ13SU1 dH WESt.: B 0T02 BO I nC ---------------1 FL r Office Use ~ I m t ~ O!f ~n ll Permit 4 "r City 1 Permit Fee: I 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: ~4 O Site Address: Tenant: ,..SSG 414, L Suite RESIDENT / OWNER Name: ~ r , r"Y~,.a y LJ Phone: Address / City/ Zip: 7/ 6 e [ h ~1 ` V- V C O N T R A C T O R Name: SeVn /3/ . License Address:37?( If1~~'S v' ' y~ City: State: Zip: Phone: ~?S oC ~ Contact Person: TYPE OF WORK New 4/1-211eplacement Repair _ Rebuild b<Modify Spac _Work in R.O.W. Descri tion of wor : PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation' Add Plumbing Fixtures ( RPZ / _ PVB) (3 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 approval of plans. th/ Applicant's Printed Name Applicants Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final CITY OF EAGAN SEWER SERVICE PERMIT 3830 Piiot Knob Road p~M1T NO.: " 1I' P.O.Box21199 +i-3a~s3 Eagan, MN 551i'I~ ~ATE: Zor,Jng: No of Units: ose~~ t ~ i CT OTiSL - Owner: Aedress: u erry anu~ e ic ~ Slro Address: Piur„ber. =1cGuire Vlec39272 h ` 3 , ~pQ 1 pm te eonlf wilb tM Citi of E*se¦ Connwctlon CJhorpe: 42 S. 0 0 Ordimeceis. Acoount DaDodt: Permit Fea: 10.0() }:,c1 Surdarpe: .50 ~c1 _ By Ahisc. Choroes: Dote of Insp.: Totol: - Insp.: DoM Pold: CITY OF EAGAN WATER SERVICE PERMR 3830 Pilot Knob Road P. O. Box 21199 pERµlT NO.: 5031 Eegan, MN 551 i1 DATE: 3-131-33 Zoniny: RNo. of Units: Owner: Jose ti ~1iller consL Addrosx Sit* ~rc~: 87I Suciberry Lane LG B1 Shef.`ie2d tilcGuite Me~h Plumber Matsr No ~r,nection Q+arfle: 450.00 j•ci Sixe: Aooount Oeposit: Reodsr No.: Permit Fee: 10 QQ--gd 1 Mmo !e a~df wfth elN Ciep of EMr¦ Surcho?ye: Mjm 60.4 gd moter OI~IMIIOM. Totol: By Date Paid: ` Dots of Irup.: irnp.: k - cirr oF EA"N i ' $4~.4 3795 /'ilot Kno6 Road Eayon, MN 55122 ' PHONEi 454-8100 BUILDING PERMIT Receipt # Te M wed Mr SF' DWG/GAR Est.Value $57,000 Dote August 23 _ 19 83 671 u erry ane R--3 Site Addrcss 1 S;le t f ield Erect ~ Occuponcy _ Lot Block Set/5ub. Alter ? Zoninfl Paroel # 10-67600--060-•01 Repal? 0 Fire Zone ``A t~ osep er ons . nc. Enlarys p Type of Consr. ` oc Name Move p # Stories ~ A~~ 16133 e ar _ ve, o. ~~~ish 0 Length 39 c+ Farminrton Phone 454-4753 Grnde ? Depth 25 Sq. Ft. ~ Narne Owner Approvals Fees Address Assessment Permit : ~ Cit Phone Woter & Sew. Surcharge Police Plnn check F W W Na^'e Flre S11C /lddress Enp. Water Conn. ' ~W Ci phone Plonner WoterMeter-TT. T)s Councii Road Unit ~ I hereby ocknowledge thot I hove road this applicotion and stote thot gldg, pff, the information is correct and ogree to comply with oll upplicable ] 9.$0 Stote of Minnesota Statutes ond Ciry of Eagon Qrdinonces. APC Total Sipncture of Permittee ep . Miller o st., Inc. /1 Buildiny Pennif is issued to: - ~ on ths express tondition thm oll work sholl be done in atcordonce with all oppl1cabte.5t2t sota Statutes ond City of Eopen Ordinancea. Building OffiNcl ' . JWAOg - ~ IIMA ~ ~ .uolvx*ol e4lAmW 17 / MuId 1 3VAH IQU!~ 0 'sqld leuiA , ~ uo~le~nsu~ VAH 46noH 'd41d 4s-k1 Bulwa:l uoi4opuno:l abui400j ,eyip •dsul eieQ uoiIaedsu~ T.Q-Li- p vro~~.' W bLator? ~„~~3 'dqa ~e3oM IIeM v Z~ `q 3•J`•~n ~ ~ L- ~ Bu, qwnid J+PIeH 'oN 3iwj9d -ss'W iaPloH Pwiad •oW i!wiad Receipt - MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill rn numbered spaces S/C Type or Print /egib/y Tot - 1. Date 2. installation Cost 3. Job Address • Lqt1 Blk. ~ Tract - ~ l~ 4. Owner 5. Contractor ~ , ! ~ : ~ Phone 6. Address ~ ~ - i 7. City State Zip 8. Building Type: Residential M Commercial Cl Institutional ? 9. Work Description: New Add ? Alter ? Repair ? 10. Describe Fuel Type 11. No. Eau'ipment STU - M. Ea. No. EQUipment CFM ~ Forced Air ~ Air Handling: ' Mfg. Boilers Mech. Exhaust Mfg. Unit Heater Mfg. Other j Air Cond. ~ Mfg. Gas. Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : - for Rough Finel Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt PLUMBING PERMIT Permit No. ~-7 r CITY OF EAGAN F~ 20.01a ~ FrU in numbered spaces S/C .50 Type or Prinr legibly Tot. 2 U bQ~ ~ 1. Date r/^ Z ts-~ ~ 2. Installation Cost La .3. Job Address c-~ Lot&_81k. I_ Tract 'i j 4. Owner Joe :-:iller Construction 5. Contractor l;G :i?' t,7 hanir-a1 Phone 4r9_4,V26 6. Address ~ 71 F f3~1t AYe 7. Cityl a t- ~v; State Zip 55644, 8. Building Type: Residential)( Commercial ? Institutional ? 9. Work Description: New X Add O Alter ? Repair ? 010. Describe 11. No. Fixtures No. Fixtures : - - Water Closet Cesspool/Drainfield Bath tubs ~ ~ Septic Tank ~ ~ Lavatory Softner z Shower Well Kitchen Sink Urinal/Bidet ~ Other - L.aundry Tray ~ - Floor Drains ~ ' Drinking Ftn. SIDp Sink $ Gas Piping Outlets ' 12. I hereby certify that the above information is true and correct, and I agree to comply witb all ordinances and codes governing this type of work. ~ - Signed : for Rough Finel Inspections: Date Insp. date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454,8700 , CASH RECEIPT . CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE wccoVeo ~ FROM AMOUNT $ I & DOLLARS too ? CASH ? CHECK FOR ~ \ FUND CODE pIADUNT Tha u BY White-Payers Copy Yellow-Posting Copy Pink-File Copy ....wnGhb.P -.-+.v Receipt PLUMBING PERMIT Permit No. , , CITY OF EAGAN ~ t ~ Fee Fill rn numbered spaces S/C ~ Type or Print legibly Tot. ii 1. Date 2. Installation Cost ~ J J ~j / ~ 3. Job Address 7~ ~ 1 LotBlk.Tcaltj". 4. Owner _LnZ4 5. Contractor Phone ~ ~ 'r • ~J• 6. Address Z 7. City State Zip ~ ~ 8. Building Type: Residential ~ Commercial ? Institutional ? - 3~ 9. Work Description: New ? Add ? Alte ~ y i$4 Repair O 10. Describe 11. No. Fixtures No. Fixtures Water Closet Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Wel I Kiichen Sink Urinal/Bidet Other Laundry Tray Floor Drains . ' Drinking Ftn. ~Slop Sink , Gas Piping Outlets I 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Dete Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt MECHANICAL PERMIT Permit No, p1_ 7~ _ CITY OF EAGAN - , Fee Fill rn numbered spaces S/C Type or Print legib/y Tot. 1. Date 2. Installation Cost 3. Job Address ~ ~ • ':~~~Blk. ~ Tract- - ~ 4. Owner ~ 5. Contractor_~,/ ' ~~~1// 'J ~ Phone f 6. Address fJ4~ -J~~ 7. City State Zip --r. 8. Building Type: Residential LM Commercial ? Institutional ? ~ 9. Work Description: New ET' Add O Alter O Repair 10. Describe Fuel Type 11. No. Fpuioment BTU - M. Ea. No. EQUipment CFM Forced Air Air Handling: Mfg. Boilers Mech. Exhaust Mfg. Unit Heater Mfg. Other : ?2,GIb ~ Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with,all or¢inances and codes governing this type of work. Signed : for Rough F inal Inspections: Date Insp. Date Insp. ' This is your permit when numbered and approved. Approved CITY OF EAGAN 464$100 .r... ~ CITY OF EAGAN Remarks Addition SHEFFIELD ADDN Lot 6 Rlk 1 Percel 10-67600-060-01 Owner Street 871 SUDBERRY LANE State EAGAN MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 8 28.68 4 20 STREET RESTOR. lg 19$4 178.09 17.81 10 GRADING 51 1981 1.10 6.o7 1 Sewer Lateral 5,21 1981 1 2.98 10.20 15 112-22 of it SAN SEW TRUNK 1981 63.30 4.22 15 46.42 SEWER LATERAL 1981 6. 0 6.43 15 77 Sewer Lateral 6 1$2 6.06 4.31+ 1 WATERMAIN 1981 128.08 8.54 15 t~ • WATER LATERAL 2 1982 48.16 3.21 1 WATER AREA 1981 6. O 4.22 1 * Powerline 1()82 1 STORM SEW TRK 89 1985 456.09 91.22 5 jG . o ed o 93-7,6 27'i7- STORM SEW LAT 91.75 C008395 9-6-83 emoy 16 -~7-d CURB & GU ER SIDEWALK STREET LIGHT 1941-64 5 3 3 Cao93zL ~-i7-,,W WATER CONN. 4SO.00 " " 13UILOING PER. 14 SAC 1~ n PARK ~$~F" ~ rV . _w~Pa . ~ n+w~~• -.«ar : rg*'~'~ca ~FlN7.~t(a ~nnra~"°r~',~~, ' ._A mOkr ~ 'P i _t~.T :c,_. .?.^cv..c._'`.,.•cs :.-~r __~-Q"`~~,_YC'_~e~~..~:s~~_ ~o ,rz- ' i . (E.er#ifirtt#r of vlvrrupttnrLi Citp of (Eagan ~ Orparfmrni n# +~uilbittg Aispertiutt 7hir CntiIitate irsued urJUant to tbr re uivemrn[t o Seaion 306 o the Uni orm Buildin P 9 f 1 / 8 Cade certifying that ar the limt aJ itruanct tbit ttrutture wac in tomplianrr with tbe vanoue ordinancuof theCityregalatingbuilrlingronnructronoruse. Farrbe fallowing: ~ SF DAG/GAR 8414 U. cmmr,n. ela, ft~t xo. ocwwa.yTYw R3 ryp cod~em V FirtZon NA z~~u~a a„.,of..eJoseph M. Miller Aad. 18133 Cedar Ave. So. , Farmi~'~ B~ua+, Aaa,~, $71 Sudberry Lane L~;,YLot 6,Block 1,Sheffield I',"~ By . October 14 1983 ~ B I g Offioil ~ Dat ~ I'..v:~.'4 \ 3.,>.~v~"T°i..~'~vs~.. ~ ~..-a 'va~~w~s..~_~•ns`+ .i-c.z._I a ~ . • ~ ~ ' ' . ~ ~g ~ • y ~ ~ ~ ~ • u ~ - ~ Thie~p uest voidq'Z~ L4) SV~~~I E l~` ~g o~` -18' .AFnths tmm IA107879J 3a.sa Reque Date Fire No. Rough-in InsVection ~ ~ Peau red? Ready Nn~TFlotify. Inspec- / ,0 N,~ ror When Heady icensed Electrical Convnctor I herahy request inspection of aby~p ? Owner elechicnl work instellad at ' i Street AtlAress, Box or Ro te No. Ciiv 7/ .4-0P ection o. Township Name or N Range No. County Occup-n[ (PFINT) Phune n. \i. Power up lier Atld ss 4 n lac[ric Contractor ICOmpany Namel Contracror's License No. Maili 9Ad res ConVacmt or Owner kinB ~ stailationl , , ~ % ifitsvSS33 Auihorize Si ature Co clor/Owner Making Ins[ ationl Phone Number ~ MINNESOTA STATE BOAHD OF ELECTRICITV THIS INSPECTION REUUEST WILL NOT Griggs-Midwav Bldg. - Room 1,1•791 BE ACCEPTED BY THE STATE BOAflD UNLESS PROPEH INSPECTION FEE IS 1821 University Ave., St. Peul. MN 55104 ..1__- 1c.o1 ,n o.« ENCLOSED. , REQUEST FOR ELECTRICAL INSPECTION EB-00001-04 ` ' Sea instruetions for completing this lorm on back of yellow copy. "xl BerOw ork Po5ered by This Request 3$fjSR evqA4djReP.j Type ol Builtline Apnliancas Wired Epuipment Wired Home Range Temporary Service Duplex Water Heater itiny Fixtures Apt. Buildinq Dryer Etectric Heatin Commercial Bldg. ace ' Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm Othei pnci y Othel (SPecify) t er peu y t cr Other ompute Inspection Fee Below k Fee ServiceEntraneeSize A Fee Feaders/5ubiaeders k Fee Cucults 6,pn 0 to 200 qm s 0 ro 30 Amps O 0 to 30 Am>s Above 200 qmps 31 to 100 Amps 31 to 100 Am Swimming Poal Above 100_Amps Above 100_Amps Trensiormers Irrigation Booms Partia6`Other Fee SignS Special Inspection S 33 Hemarks FEE ~ 3a.~-~ RouBh-in Oote p I, Poe Eleclrical Insoector, heroby certify that ihe »bove Final inspection hes been made. Thls reoues[ voitl 18 mOn1hS from CITY OF EAGAN N~ 8414 . . 3795 Pilof Keob Raed Eayan, MN 55122 ~ ` BUILDING PHONEs 454-8100 //.-k S~ P~ PERMIT Receiv~ # To 6a wad fer SF DWG/GAR Est. Value $57,000 Date Aueust 23 i9--81 Site Address $71 SudbeTry Lane Ered gg Occupancy R-3 Lot 6 Blxk 1 Set/Sub. Sheff3eld Alter ? Zoning R-1 Parcel # 10-67600-060-01 Repoir ? Fire Zone NA Joseph M. Miller Const., Inc. Enlar9e ? Type of Const. V at Nama Move ? Stories z Address 18133 Cedar Ave. So. Demolish ? Length 39 c; Farmington phone 454-4753 Grade ? Depth 26 Sq. Ft.- p Name Owaer ApProrola Faea Address Assessment Permit 304.0 Z8.5~ F C.~ P~~ Water 8$ew. Surchorge Police Plan check 152.00 Gw Nome Fire SAC 450.001~ Address Enp. Water Conn. 525.00 1L i W Ci Phone Planner Woter Meter 60.00 Council Road Unit 250.00 1 hereby acknowledge that I have read this avPlication and state thot Bldg. Off. the information is correct and ogree to comply withall applicuble APC Total $1769.50 Stnfe of Minrrewto Statutes and Ciry of Eagan Ordinnnces. Signofure of PermiMea Joseph M. Mill onst., Inc. A Building Permit Is issued fo: on tha ezpress condiNon ihnr oll work sholl be done in accordon[e wit I opplicol tate esoto Stotutes and Ciry of Eogon Ordinances. Buildinp Official ~ 2 2007 RESIDENTIAL MECHANICAL rExnuT arrLicATiorr City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 ^ caC Plcase'coinplete for. single family dwellings& townhomes/condos when permits are mquired for each unit Date _J Site Address ~ I Unit # Property Owner fr I l CA G~1 Telephone #(LS I)4'S a- S S~O ~ Contractor H(7~k(n0.c\ L-F6Q 44-Uon d- 141,lX: Street Address F?04 5 r e UV 13T (^C_e_I City Li Q'tC~f State r 1'~ Zip SS o~a Telephone# ((qSI )4~~9^5_770 Bond o q ~ n 'S ) SS Expires: ~ o The Applicant is _ Owner ~ Contractor _ Other Fire repair (replace burned out appliaoces, ductwork, etc.) $ 90.00 This fee applies when extensive mechanical repairs are made to a building. Add-on or alteration to existing dwelling unit $ 50.00 ~ furnace _Additional ~Replacement _ New air exchanger ~ MEn ~ air conditioner FEB~(~ l ~ 3 20 07 • heat pump lU, J other State Surcharge $ 50 Total s I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; [hat 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 permit, bu[ only an applicarion 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 plan~s. De_n65 Applicant's Printed Name Applic t's Signature 2007 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complcte for: commercial/indushial buildings , multi-famil buildin s when se arate ermits aze not re uired for each dwellin uni[ - Date Site Street Address Unit # Tenant Name (if applicable) Previous Tenaut Name Property Owner Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) Bond k: Expires: The Applieant is _ Owner Contcactor Other Work Type _ New Consauction _ Intedor Improvement _ Install Piping _ Processed _ Gas Under/Above ground Tank Install Remove When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector Nature ofWork: Permit Fees $70.50 UndergrounA lank installatinn/removal $50.50 Minimum (indudes State Surcharge) or ContractValue $ x 1% PemutFee $ Sta[e Surcharge To calculatesurcharge If Permit Fee is less tNan $1,000, surchargc is 50 cents. . If Permit Fce is> $I,OOQ surcharge increases by $.50 for each $ 1,000 Pcrmit Fee (i.c. a$1,001-$2,000 Permit Fee requires a $1.00 surcharge). 5 T'otal Fee I hereby acknowledge that this infbrmation 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 permit, but only an application for a permit, and work is not to start without a permir, 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 Applican['s Signahue Approved By: , Inspector Date: Required Inspections: - U.G. _ R.I. - Air Test - Gas Service Test Infloor Heat Pinal zoos RESIDENTIAL PLUMBING PeRnniT,aPPUCarioN . CITY OF EAGAN . 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date~I029oJ~-~p~ ~ 6 ~ Site Street Address O uL/ i L4)- Unit # Property Owner Telephone # ( ) Contractor H• P• Po peuuorks Telephone # (US1 ) 'Ag:512410 Address 3670 Dodd RopcJ City State Zip Eagonfi IVIN 55123 The Applicant is: _ Owner -e--~Contractor _Other Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Alterations to existing dwelling $ 50.00 Add plumbing fixtures. This fee includes installation of a water softener and/or water heater at the same time. If you are installing onl a water softener and/or water heater, do not complete this section; move to the next section and check the appliance(s) you are installing. _Septic System Abandonment _Water Tumaround (add $130.00 if a 5J8" meter is required) Other: Water Softener Water Heater $ 15.00 _ new -Y-Ireplacement Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ 50 Toca1 $ ly" I hereby apply for a Residential Plumbing Permit and acknowiedge 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, wor ' out a permit and work will be in accord nce with the approved plan in the event a olan is requi reviewed and aporove . Appli anYs Printed Name Appliants i u[~ U 12°6. 25 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 ~ 657-681-4675 New Construclion Reauiremenls RemadaUReoair RequiremeMs • 3 regislered sile surveys showing sq. fi. of lol, sq. ft. of hoLise; and all rooted areas • 2 copies of plan (20% mazimum lot coverage allowed) • 1 sel of Energy Calculations for heated additbns • 2 copies of plan showing heam & wiMow sizes; poured (ound design, etc.) • 1 site survey for exterior additions 8 decks • 1 set of Energy Calculatbns • Indicate M home served by sepfic system for additions • 3 wpies of Tree Preservation Plan if lot platted after 7l1193 • Rim Joist Detail Oplions selection sheel (bidgs wilh 3 or less units) DATE / I 5 I 02 VALUATION l SITEADDRESS gc-I l gud.ht>rr~,' aV~_~ MULTI-FAMILYBLDG _Y _N TYPE OF WORK FIREPLACE(S) _ 0_ 1_ 2 K - - APPLICANT! uEctellu9 STREET ADDRESS 49 SOQIh OW88E0 BIYd. CITY STATE_ZIP TELEPHONE # , Linle Canada, NN 55114 FAX # - - ' PROPERTYOWNER gChuermaC" TELEPHONE# l o%l.r S11'?',0 COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULX,-S 7670 CATEGORY 1 _ MINNESO'1'A RLJLrS 7672 (d submission Type) • Residentlal Ventilation Category 1 Worksheet Submitted • New p r~C('de p~orIJ ~sli~t r" d • Energy Envelope Calculations Submitted U l~ I~ 1~1 MAY 1 6 20U2 Plumbing Contwctor: Phone # Plumbing systcm includes: _ Water Softener _ Lawn Sprinkler By Water Heater No. of R.I. Badis No. of IIaths Mechanical Contractor: Phone # Mcchanical system includcs _ Air Conditioning Fec: $70.00 _ Heat Recovery 5ystem Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ? 01 FoundaGOn ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg • ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07•plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-pfex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bidg. ? 42 Demolish (FOUnda6on) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy _ MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) FinallNo C.O. _ Footings (addirion) _ plunibing _ Foundation HVAC _ Drain Tile Other Roof Ice & Water _ Final _ Pool Ftgs Au/Gas Tests Final _ Framing " _ Siding Stucco Stone _ Firepface _ R.I. Air Test _ Final Windows (new/replacement) _ Insulation _ Rebining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant I Plumbing Permit Mechanical Permit License Search Copies Other Total 2~ 2006 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan AJ 3830 Pilot Knob Road, Eagan MN 55I22 Telephone 9 651-675-5675 FAX # 651-675-5694 New Construdion Reouirements RemodellReoair Reauirements Office Use OnH 3 registe2d sHe surveys showing sq. It, of lot, sq. ft. of house; and all rooted areas ?2 copies of plan showing footings, beams, joists Cert of Survey Reoi _ Y_ N (20% maximum lol wverege aIlowed) 1 set of Energy CalcuWtions for heated addilbns Tree P2s Plan Recd _ Y_ N. 2 copies of plan showing beam & vnndow s¢es; poured found design, etc. j/ 1 site sumey for addAions & decks Tree Pres Required _ Y_ N 7 sel of Energy Caiculalions Addkion - indicafe doo-sfle sepGc system On-site SepGc System _Y _ N 3 copies oiTree Preservation Plan H lot platted atter 711193 Rim Joist Detail Op6ons selection sheet (buildingswilh 3 or less unlGS) Minnegasco mechanical ventilation form Fot ! ffo Constructio n Cost ss 97/ S~JCrr`J ~ UniUSte # an of Work 1/LG~ Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 Z ProperTy Owner Telephone # y~ ~D6 Contractor A- /1'~S n Address /d0 ~i~iG~~l ~ j'!.A`/ S~I~TL I~O City 5-51 Ajn/ zip 55075 Telephone#((V) 59-t" 905;-- State W- d-/y-5256 moklt- COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Ener Code Cate9o ~ r'' • New Ener Code Worksheet 9Y rY . Residential Venfilalion Category 1 Worksheet,l 9Y (J submission tYPe) Submifled ~ Submitted . Energy Envelope Calculations Submit[ed/ In the last 12 months, has the City of Eagan issued a permit for a similar plan based ori,a master plan? _ Y _ N It yes, date and address of master plon y\ l Licensed Plumber ` Teleph_one1#/( ) Mechanical Contractor Telephone # Sewer/WaterContractor Teiephone ) . 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 approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name ApplicanYs Signature DO NOT WRITE BELOW THIS LINE Sub Tvpes ? 01 Foundation ? 07 05-plex ? 13 15-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling O 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 07 oi_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 E#. Alt- SF 0 04 02-plex ? 10 08-plex JEP 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc. ? 05 03-plex ? 17 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Tvpes P) 31 New ?•.35- Intlmprovement ? 38 Demolishlnterior O, 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/DooB 34 Replacement •Demolition (Entire Bldg) • Give PCA handout to applicant DBSCripflOtl: WaterDamage_Yes ~ Valuation - Occupancy ~ MCES System Ptan Review _ 100% or _ 25% Census Code Zoning ~ D City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs „ Length Fire Sprinklered Type of Const v~3 Width - REQITIRED INSPECTIONS Footings (new bldg) Sheetrock ,4 Footings (deck) _ FinaVC.O. _ Footings (addition) ~ FinaUNo C.O. _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool Ftgs Air/Gas Tests Final _ Framing _ Siding _ Stucco Lath . Stone I.ath Brick _ Fireplace _ R.I. _ Air Test Final Windows _ Insulation _ Retaining Wall Approved B: 2 , Building Inspector - - - - Base Fee Surcharge Plan Review MC/ES SAC City SAC Utiiity Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total 7 ;,tlfi;cate for: • oe MiZ1er Construction /i8133 Cedar. Ave. So. -i Rarmingt,on, Mn.. 55024 ~ i - ~ DEtMAR H. SCHWANZ i. ' . . ' - . lANO5U0.VEVORs,7j~/~• . ' . . HeqisteraE U.Bar Lawi oi The Stab af Minnesob ' 2976-146TH STREET W. -.BOX M ROSEMOUNT, MINNESOTA 56088 PHONE 612423-1769 ~ i , SURVEYOR'SCERTIFICATE ~ SCALE.: 1 inch =.3~ feet Denotes propoaed elevation - , Denotes prqposed drairiage Proposed garage floor ~ i, elevatiori --9';f-~-~- . f ~ f~ 01'O~°5 1 Propoaed top~of block• , D~K •%~Zelev. - ( i _ . Propoaed basement.floor ~ M.S 34 /9.0 ~ %elev. ~ m . . . . d . . . ~ kj v ! ~iK • a N ~ /Z37 ' . ~ ! /9.c ~ . . _ , --~a` I he by certify that this is a true and correc representation of Lot 6, Block 1, SHEFFIE , according.to the recorded plat thereof, akota County, Minnesota. Revised to ahow the location of a proposed ; house th , eon June 21, 1983 ' Revised h use location August 19, 1983 M M . ____~(~~G,~'~~ /~t'~?E ^ FAMM RE@/10EWED /D au!i1,9Mf'a MW~CRO'a~r+s W8SIOM1! - . . y 4 r~ { y1 7.,.> 1 - . 1 f ' , . . . . , . MINNESOTA REGISTRATION N0.8625~1~ / ~ ~iflcate for: je Miller Conetructfon ! ?¢o 18133 Cedar Ave. 50. Farmfington, Mn. 55024 ~ DELMAR. H. SCHWANZ . LANO SUAVEYOaSf.T/w' . Reqietetetl UAea Laws_of The SUU of MinnScota , 2976 - 165TH STREET W. - BO% M ROSEMOUNT, MINNESOTA 66068 PHONE 612 423-1769 4 SU EYOR'SCEHTIFICATE ~ ~'D vec*- tccm-s~ SCALE.: 1 inch = 31 feet 9a6 • ~ ~ ~ Danotea propoeed elevation ; Denotes propoffied drainage 9 Proposed gaxaBe floor ~ ~ T 6 j0G e?.evation p ~ py~~5~ ~ Proposed top of block ;~l pclL 2m~~'"' elev. Propo.eed basement•floor ,J + ~ elev. ~ 1M.~' 3a 90 ~ I . ~ (1n'?!E':.'r ~Ei~ \ ^ Y M y ~ ! ~qeo5~o N Q 2 - m ~ i 51 r v ~g,e a t, . n V~ R ~3 Q~, I hereby.certlfy thst this is a true and r correct representation of i.ot 6, Block l, SHEFFTEI,D, according to the recorded plat N thereof, Dakota County, Minnesota. N~ i_ _T --1 ' . '..f C' • q~ob i° \.~1°~' Revisad to ahoW the location of a propoaed houee thereon .June 21, 1983. Revised tiouse locatlon Auguat 19, 1983 M M EAGAN ' REVIEWED BY: --l?V) 0 0 DATE: ~ I la z BUILD{NG INSPECTIONS DIVlSION P ~ i ~ s , . . . . ','/;!li;%;•?.~,•' % J . / . . . MINNES0T4 REGISTRATION N0.8625 -7(j RESIDENTIAL BUILDINC PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4875 Naw Conetrvetian Reauiremenb RamodaYRecair RwulremenN • 3 registered sde wrveys showing sq. ft. of bC sq. ft. of Muse; and afl mofed amas • 2 wPies uf Dlan (20% maximum IW coverdge allowed) • 7 set af Eneyy CakWaGuns lor healed additlans • 2 copies o( plan stawing beam 8 window s¢es; paured found design, etc.) • 1 site survey fw extenor additions 8 decks • 7 ul of Energy Calculations . Indicate if home served by sepGc system for adEidans • 3 copies of Tree Preservation Plan if IM platted after 711N3 • Run JoislOetaJ Optlons sHection slket (bldgs wiM 9 or less unib) DATE VALUATION e4 Lo 2- 00 SITE ADDRESS g~ ~C=Suc,l Y>errt-1 LL9.rle. MULTI-FAMILY BLDG _Y _ N iYPE Of WORK g i cL t r~c`} FIREPLACE(S) _ 0_ 1_ 2 APPLICANT 1 EChen~ STREET ADDRESS 4 cl A v~ _CITY STATE_ZIP TELEPHONE #62A \q~a ln CELL PHONE # FAX # PROPERTYOWNER _TELEPHONE# LJ911) (3A?)t) COMPIETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOT:1 RULES 7670 CATEGORY I ML Mee: (J submission rype) • ResidenUal Ventllation Calegory 1 Worksheet Submitted • itted • EnergyEnvaloDeCalc ulatians5ubmitted Plumbing Conhactor: Phone # Plumbing system includes: Water Softener Iawn Sprinkler Water Heater _ No. of R.I. Baths No. of Baths Mechanical Contractor. Phone # Vlechanical system includes: _ Air Conditioning Fee: $70.00 _ Heat Recovery System Sewer/Water Confractor. Phone # I hereby acknowledge that I have read ihis opplication, state that the information is corcect, and agree to comply with ail applicable State of Minnesota Sfatutes and Cit of Ea n Ordinances. Stgnaturo pF+ - OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ? Ot Foundatlon ? 07 OS-plex ? 13 16-plex ? 20 Pool 0 30 Accessory 81dg ? 02 SF Dwelling ? OS 06-plex 0 16 Fireplace ? 21 Porch (3-sea.) ? 37 EM. Alt - Multi ? 03 01 of _ plex O 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF ? 04 02•plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) 0 36 Mutti ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Sfortn Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N 13 25 Miscetlaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 AddiUon ? 36 Move Bldg. ? 42 Demolish (Foundation) 13 45 Fire Repair ? 33 Alteratlon ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demolitlon (Entire Bldg only) - Giva PCA handout to applicant Valuatfon Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings(new bldg) FinaVC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addirion) _ Plumbing _ Foundation HyqC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests _ Final _ FrairunB _ Siding Stucca Stone _ Fireplace _ R.I. _ Au Test _ Final _ Windows (new/replacement) _ Insulaaon _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply 8 Storage S&W Permit 8 Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Certiflcate for: . • Joe Miller Construction '18133 Cedar Ave, So, Farrci.ngton, Mn. 55024 DELMAR H. SCHWANZ LANDSURVEVOR/, JjVG. I Regiftered Under Laws of The 5[ale of M,nnafota 2978 - 146TH STHEET W. - BOX M ROSEMOUNT, MINNESOTA 55068 PHONE 672 423-1769 ~ I r SURVEYOR'S CERTIFICATE , SCALE: 1 inch = 31 feet ~ Denotea propoaed elevation Denotes propoaed drainage : Propoaed garage floor ! elevation --75'-r-a- ~ - P.+ I 1 Proposed top of block elev, . k9 141 / I Iz Propoeed basement floor ~ ~ M.5 ~ y f s ; a o . e le v. ,---r---r-- I n . ~ . . v OSEiJ v* I ~i t 1A~ ~ I r 4.,TSa \ ~ zWk ~4 y. N W /239 ' ~ N I hereby certif,y that thia Ss a true and correct representation of Lnt 6, Bloc:k 1, \0 SHEFFIELD, according to the rer.orded plat . ~ ~ im \ thereof, Dakota County, Minnesota. ~~fP1Reviaed to ahow the location of a propoaed house thereon June 21, 1983, M 9u9, ~ a-'~1 ~ Revised house location August 14, 198 i M jG~(~~~~J~" Lf!/?~ ~ ~ . , MINNESOTA REGISTRATION NO 8625 Certificate fors ~ 'Joe Miller Conetruction . '18133 Cedar Ave. 30. Fl, Farmington, Mn. 55024 DELMAR H. SCHWANZ LANDSVRVEVORf' r)w • R"ifbrW UnUer 1.++'s of Tbe StatO of Minnesota 2978 - 746TH STREET W. - BOX M ROSEMOUNT. MINNESOTA 56068 PHON 812 4T31789 ''F SURVEYOR'S CERTIFICATE , I SCAI.E: 1 inch = 3 feet k an4,- t ~ (7)Denotea proposed ~levation 6 i s-- Denotea ProPoeed drainage h 9'3 ~ I O Propoeed gara~e floor 5II ~ T G 906 elevation ~ I Propoead op oP block ~ e1ev. 911,38 ~ prop ed basement•floor ~t 903.~ • 1 ele . 0 - . 34 ~ (<ow~~r Le7:. ~ ~ p,zoPOSEti I O i s N5 E. 33 z 3 0 zZ•33 N n.sy ~ ~ z233 ~ Yhereby Qertify t#tkt thia ia a true lo c k n l I 9(/ aorrect rePresentation o f L o t 6, , cv~ ; ~ o o gggvglELD, according to the recorded plat N thereoP, Dakota County, Minnesota. i qrob ~ , Renieed to ehoN the location of a proposed houee thereon June 21, 1983, 6 3.5b .v9~1 5b9. ~ 906.~ M M ~ ~ CP~t v V J Al t •~J/ i~/~// ~ - ' / ~ ' , MINNESOTA REGISTRATION N0.9625 ~ . ~ 03i 00J 10:56 ERGRN EN6+COM DEV 4 96519851745 N0.058 D02 E007 RESIDENTIAL BUILDTNG PE12WT APPT,YCATI0N i City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5644 u MfWtPonRewllE1114P15 RentedellR8CE4ReauiIBRR~ifl CPfIOf$Y~ -y-N roounAS,E~emSidsa . . 3replstna0dlawrveKS~nASQ.ftdIaLSG.Rdhase:AnA~roO~defeas ?~~~~WsfahcdfeAaCtliYoas SuasReporf _y _N . F%d . (26q,n6dtremlule~~ae9e3Urcaed~ 1dlesurvOyMraddiUOnsBdadcs TreePras PWI:_K..-.N. , iSoPSReO~IfprapaedhuYtllnpis~beP~~^alsoirhedsdl AddVian•lndcafelfms~aoPHCeyStem TreePrasi1Bq41e0.-:...~Y:_N pcop,=dplansreowingeaamRalnaowdres,wureafomacesign,em on~seylCsra~m:.~.._y`~n . . 1 setdF.~r9Yf310.11aLm5 S capies of Tcve Pr06Pe0m P7en B IU pisimd afte+TI119J i6m JdatPNa~l OpGarc selecGen sheel (buMngs ViU 3 wless unl5j Wnepa6m medwtiul ren6Wlloniarm COY9LTYCt10n COSS ~ C) v / - - Date~_! ~ 1 S~ niNS~e il Site Addreac U pescription of Work Multi-Family 61dg N Flrepleu(e) PropcrtyOrmer Telopfione#((4~5~j Contracror ciq' Addrue N1 Zip Telephone # ( Stste COMPl.E7E THiS AREA C~LY IF CONSTRl1CT1 G A NEW BUILDING ~ Mi ot les 76i , Minne ota Rules 7670 CatetYorv 1 - ,t,)SW energy co& WoM1shest Energy Code Category . Residsrifial YantliaUmCategory 1 WmKSheet Suomitted (dBUbmiealonfrye) Su6mittetl , Eiretgy Envalope C31cu181{ona SuhmltWd In ihe last 12 months, has mf yes date aand na issued a es ~ o permit aste~p aomilar pion basad on a mas?er plce~? Y _ Licensed Plumber 7elephone ii ( 1 Mechnnical Canlractor Telephone #1( } Sewar/water Gontroctor Talephone C hereby app1Y for s Residential Building Permit and ecknowledge that the informatian is complete and accurate; that thc work will he in conformance wish the ordinances and codes of the City of Eagan and the State of MN 5tahttes; I understaud this is not a permit, but only an applicarian fot a permit, and work is not to start A+ithout a pcrsnit; that the work will be in accordance with the approved plan in the case of work which requires a re iew and approval ofplans. 70 py\n ~e Applicant's Prinbul Nama A pli t's Si@nature f RI R/ 111/ /III 11 Mt/II 11 1. 11 Ila 1,1 1.7 1.11 l.OKr11I 2012 06 18 11:06 » 651975 5694 Clly olEatau 3830 Pilot Knob Road Eagan MN 55122 Phone: (661) 676.5675 Fax (661) 876-6694 I" r. A 11 11 11' 1 1- 1 (-1-'111'11/ 11111 111111 P 117 use DLut or tsLACK Ink For Office Use Permit u.: 1ggq 3 Penh Fee: C(.20 o irV Date Received: Staff: 2012 RESIDENTIAL PLUMBING PERMIT APPLICATION Data: le D Site Address: ♦ 1 1 Slid Tenant; Sults S: Phone: 'QS I lS S57Q� • RESIDENTIAL Water Heater Lawn Irrigation(RPZ / T PVB) Septic System / New Abandonment �. N %!t RESIDENTIAL FEE$: 560.00 Mum Water Heater, Water Softener. or Water Heater and Softener (includes 55.00 State Surcharge) $60.00 Lawn Irrigation (Includes $5.00 State Surcharge) $80.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $5.00 State Surcharge) 'Water Turnaround (add $189.00 If a 518' meter is required) $105.00 Sebtic Svatem New ($10.00 per as bunk) (Includes County fee and $5.00 State Surcharge) TOTAL FEES $ Water Softener Add Plumbing Fixtures (` Main/ Lower Level) Water Turnaround CALL BEFORE YOU DIG. Call Gopher slate One Call at (661) 454.0002 for protection against underground utility damage. Call 48 hours before you Intend to dig b receive locates of underground W ittes. rtetrffiggattammorguag I Y acknowledge that Cris Information is complete and accurate: that be work veil be In conformance whh the ordinances and codes of the City of , twl-omyl-.n_appialba-for.s.permIe,.aad-warlsis-not.do-staR-Nlttou rk—s11 be -in---- - acordanoe with the approved plan in fhn case of work which requires a review and approval damns. x`--)rl 1 Arcal Applicant's Printed Name 2012.04-9016:40 6519755694 Pogo PERMIT City of Eagan Permit Type:Building Permit Number:EA167102 Date Issued:02/23/2021 Permit Category:ePermit Site Address: 871 Sudberry Lane Lot:6 Block: 1 Addition: Sheffield PID:10-67600-01-060 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations 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 within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Cynthia K Gerlach 871 Sudberry Ln Eagan MN 55123 (612) 558-3718 Apex Energy Solutions 9655 Newton Ave S Bloomington MN 55431 (651) 688-2739 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA178069 Date Issued:07/29/2022 Permit Category:ePermit Site Address: 871 Sudberry Lane Lot:6 Block: 1 Addition: Sheffield PID:10-67600-01-060 Use: Description: Sub Type:Fixtures Work Type:Replace Description:Bathroom(s) 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. All tiled shower bases require a water test. Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Dustin D Erickson 871 Sudberry Ln Eagan MN 55123 (651) 717-5004 Mad City Windows & Baths 5020 Voges Road Madison WI 53718 (651) 500-0514 Applicant/Permitee: Signature Issued By: Signature