No preview available
 /
     
3807 Laurel Ct..,nnesota State Board of Electricity Griggs Midway Bidg. -•Room N191 .,t1 University Ave.,_ St. Paul, Minn. 55104 - Phone 297-2111 _"''*`flEDUEST FOR ELECTRICAL INSPECTION CHECK BELOW WORK COVEREB BY TH(S RF.OI IF.ST EB-00001-02 2512`t T 40009 Type of Building New Add. Rep. Check Apptian ces Wired Foc Check Equipment Wired For Home 7-C ? ? Range • ` Tempoxary W'ving ? Duplex ? ? ? Water Heater ? Lighting Fixtures 7cd:iC Apt. Bldg. ? ? ? Dryer ? Electric Heating ? Commercial Bldg. ? ? ? Fumace 192000 Silo Unloader ? Industrial Bldg. ? ? ? Au Conditioner p Bulk Milk Tank ? List 4?? List- Othei ? ? ? p Hehers? g •70CX% p HeieIS? COMPUTE INSPECTION FEE BELOW Service Enuance Size: # Fee Feeders&Subteeders: # Fee Circuits: # F 0 to 100 Am s' s 0 to 30 Am res 0 to 30 Am tes 101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am 'eres Above 200 Amps. Above 100 Amps. Above 100 Amps. Transf Remote Conuol Circ. Partial or othei fee Signs , Special Ins ection " Minimum fee Remazk - .T@ff D• TOTAL F E 4.00 l,the ElectricalIns`pector;h'ereby (Final) This request void 18 months from th nhas been m`ader----' Date c _J'c? ?ate /a'??- 1 CASH RECEIRT CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 weceIveo AMOUNT $ [:] CASH ? CHECK FOR FUNp CODE pMOUNT Thank You '-..?1 . ?/-. BY- &DOLLARS 1 oo White-Peyers Cop? Velloov-Posting Copy Pink-File Copy CITY.OF EAGAN Remarks AdditionTkriax Hi1-1 --Additinn 2nd Loc 3 eik ]^ parcel #10, 14991 030 01 OwneQ)Y1Ll AI.!! JI'ti l Street 3Wti .a iT 7 .O uT State ES$12t. MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. D 1982 600.76 120.15 5 600.76 C007282 9-24-81 STREET RESTOR, i GRADING 1975 114.43, 11.44 10 114.43 A009870 1 27 81 Grading 19 . 9-24=81 SANSEW TRUNK 6-, 1968 47,91 1.60 30 47 91 A009870 1 27 81 * SEWERLATERAL 1968 52.47 2.62 20 52.47 A009870 1 27 81 WATERMAIN * WATER LATERAL 1968 ZO WATER AREA 1977 95.81 6.39 15 95.81 A009870 1 27 81 *** S/W Lat Stm L5 1982 1431.44 286,2 . -- STORM SEW TRK I.9 Z OZ . . S . COU/zbz - ' STORM SEW LAT CURB & GUTTER SIDEWALK STREETt'f9fIT 1009 1986 153.70 15.37 10 153. C-/C2?0-6lp /6 Road Unit 24460 5-1-91 WATER CONN. 13UILDING PER. sac 0 24460 5-1-81 PARK 250.00 20263 8/4180 `. ?• CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 N2 6632 ' PHONE: 454-8100 BUILDING WMIT keceipt # _ _ To be nsad fsr Est. Value Dete , 19 Site Address Erect j? Occupancy Lot Block Sec/Sub. ? Alter ? Zoning porcel # Repoir ? Fire Zone Enlarge ? Type of Const. W Name Move ? # Stories ; Address Demolish ? Front ft. 0 Ci Phone Gmde ? Depth ff. cc Name r pprovo s ees ? ? f uu Address Assessment Permit ?' Water & Sew. Surcharge Ci p??e F ?W Police Plon check Name W,,, Fire . SAC _? Address Erig. Woter Conn. a W Ci Phw?e Planner Woter Meter `• r,?• i7r . ? ?. Council ? Road Unit 1 hereby acknowledge that I have read this application and stote that gldy. Off. the information is correct and ogree eo mmply with all applicoble ?^ Stote of Minnesoto Statutes and City of Ecgan Ordirances. APC Total Signature of Permittee A Building Permit is issued to: 1'" ?('?' on the express condition that cll work shalt be done in ecoordance with oll applicable State of Minnesota Stotutes and City of Eagan Ordinances. Buiiding Official l F A .«mue ? od. I...a ....Ma. Plumbing e2 S- ?O Mechanical 25? 3 ° 3- F? f'ttiC h?` ? i n €ckf""cez `C oaC,e- -rlo? T c^r.,. pf5v/l INSPECTIONS DATE INSP. Rough-In Final Footings -?/ Date Insp. Oate Inep. Foundation Plumbing 3 ' Frame/ins. Mechonical Final Remarks: Receipt PLUMBING PERMIT Parmit No. CITY OF EAGAN Fee fill in numbered spaces S/C Type or Print /egib/y Tot. 1. Date Z. Installation Cost 3. Job Address ?u'd? Lot Blk. Tract 4. Owner 5. Controctor Phone ? 6. Address 7. City -U/v;T/hN. State li l/r' . Zip 8. Building Type: Residential a' Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe 11. No. Fixtures Water Closet No. Fixtures Cess ool/Drainfield _ _ Bath tubs p Septic Tank _ Lavatory Softner Shower Well _ Kitchen Sink Urinal/Bidet Other _ Laundry Tray Floor Drains Drinking Ftn. Slop Sink 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 Final Inspections: Date Insp.__ Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8700 -? - ReceiptMECHANICAL PERMIT Permit No. CITY OF EAGAN -? Fee fill in numbered spaces S/C ? Type or Print legib/y Tot. 1. Date 2. Installation Cost 3. Job Address Lot ,.- Blk. Tract -- 4. Owner 5. Contractor Phone 6. Address , 7. City State Zip 8. Building Type: Residential ? Commercial ? Institutional O ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe Fuel Type 1 11• No. Equioment BTU - M. Ea. Forced Air No. Equipment CFM Ai H dli Mfg. r an ng: Boilers - Mfg. - Mech. Exhaust Unit Heater Mfg. Other _ Air Cond. Mfg, Gas, Piping Outlets 12. 1 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 Fough Final ,Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 ciTr oF earaaN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: MN 55122 E DATE: agan, Zonirtg: No. of Units: Owner ' : Adrf ress: , Site Address: Plumber: n Cil F E l ith t6 1 •Connection Chorge: aga y o agree to aomp y w e Ordinunces. Account Deposit: Pertnit Fee: Surcha- rge: B es: Misa Ehar y g D t f I Total: a e o nsp.: Insn.: Date Paid: WATER SERVICE PERMIT CITY OF EAGAN 3795 Pilot Knob Road PERMIT NO.: DATE: Ea9an, MN 55122 Zoning: No. of Units: Owner: - Address: - - Site Address: Plumber: Meter No.: Connection Charge: : Siz qccount Deposit: e Reader No.: Permit Fee: I agree to eomply with tha City of Eagan Surcharge: Ordinunces. Misc. Charges: Total: BY Date Paid: - Dote of Insp.: Insp.: This req?fu(est (? void LT, B t i Brk.'ai, h,' ll ? 18 months from -25 t Date of this Request 6..11 ?1 ?8'1 Fire No. T40O O V I, asc?l Licensed Electrical Contractor El Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. 3807 Le,uxel Court City?? vection Township Range County DekOta Which is occupied by Tollefpon (Name of Occupant) Is a roughin inspection required on this job? No ? Yes Ee Ready Now ? Will Call EasC Power Supplier DskOte, Cty. Address Far23.219t0II Electrical Contractor ().33- rFhom?n El.eotrie Co. Contractor's License NoA4.2602 12201 ktCom i any Namek t? 55343 ?ca lvd., Mailing Address ( lectrlcal Contr?ctor o ner I This Insta?tfon) 33 '- pn 2521 Authorized Signature ??? 0 ? ?",PHone`Iqo. (Eleetrica ontractor or Owner Makfng This lostallatl") (?' j? (? j?? p O n?D ?I'On? This inspection request will not 6e accepted by the ??J (r?? ?J [?? `?? U' State Board unless proper inspection fee is enclosed. CITY OF EAGAN 3795 Pilot Knob Rood Eagan, MN 55122 N2 6632 PHONE: 454-8100 BUILDING P,ERMIT APPLICATION Receipt #p e1`l?leQ To be uaed for 1 of 4 PLEX Est. Volue 52,000 Date 5-1 , 19-81_ Site Address 3807 Laurel Ct Ered :Rk Occupancy R3 lot 3 Block 1 sec/sun. Briarhill 2nd Alter p Zoning R3 Parcel # 10 14991 030 Ol Repoir ? Fire Zone NA V Ibllefson 131dY's ' Enlarge ? Type of Const. x Nome . . Mo # Stori w z 13816 Holyoke Ln ve ? es 44 ; o Addr ?? ' d ? Demolish ? Pront _ ft. C? - P??e 454-6873 Grade ? Depth 24 ft. w N Approvats Fees 'o ame -- Z? Address s? Name Address 1 hereby acknowledge thut I have read this applicotion and state thaf the information is correct and agree to rnmply with all nppiicable Stote of Minnesota Statutes and City of Eagan Ordinances. Water & Sew. Police Fire Eng. Planner _ Council _ Bldg. Off. _ APC Permit LYJ*?v Surchorge 26.00 Plan check 71•75 snc 525.00 Water Conn. 335. 00 Water Meter 60.00 Road Unit 185•00 Total 11346.25 Signoture of Permittee I A Building Permit is iuued ro: Tollefson Bldsrs. on the express condition that oll work shall be done in occordanceAith qJl applic,oble Styte of Minnesota Statutes and City of Eagan Ordinonces. Building Officio! ? ? CITSi UE' EACANt Include 2 sets of plans, 1 site plan w/elevatians & HUILDING PEANII'T APPLICATION 1 set of energy calculatians. Tb B@ UBBd Fbl' ? VdlU3tio1 Ddt2 . r' _ - - Site Addx?ess3?o;,-?i3???? CPFICE USE ONLY LOt/?P'v B1GCk ? SeC./Sub t•c4/?'?F_ c Erect X_ OccupancY A?-5 . Parcel / Alter 2onin9 Pepair Fire zone iU A . ?'• ' FSnlazge Type of Oonst. Addre8: Nbve N Stories Deriolish Front 5' ft, atY/ZiP Oode: • Gxade Depth s? ft. Ptfone #: Address: citi+/zip ooaesf!;?' Phone t: ?ff ?S ?- Arch./%ng. t Address: • CitY/Zip Oode: Phare #: APPRCx7ALS FEES Assessnents .? Pernut y Water/Seaer Surcharge. Pelioe Plan ChecJc ? Fire SAC sQ IIig. Water Gom. ,33Y ...._ Planner Water Meter OfL Qouncil Iioad Unit Hldg. Off.' APC 7MAL a' /J °,'i6 ? X x 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN • 3830 PILOT KNOB RD - 55122 r?( ? 651-681-4675 --? ?- l ?S(? New Conahucllon Reaulrements Remodel/Reoair Reaulremenls ?"? > 3 reglatered alte wrveys showinp sq. N. of loi, sq. H. of house and go roofed areas (2076 mmclmum bt coveraae ollowed) ? 2 coples o1 plana (show beam & window sizes; poured fnd design; etC.) a i set of energy caiculaflons > 3 copies of fiee preaervaflon plmn if Iof platfed a(ter 7/1/93 DATE: f,- f ? / i ?L 0?00 DESCRIPTION Of WORK: T2GVl 0" d' 2 coPiea of plan 1 sef of energy cdculaflons tor heated addiflons 1 site wrvey for extedor addfnons !c decka CONSTRUCTION COST: L ?? cl-4- ',g-v 3 :39 U( C, .3 05 O 7 (. T STREET ADDRESS: !J? ? LOT: I BLOCK: SUBD./P.I.D. #: ?•?? ? ? ? ? `? Name: Phcne #: PROPERTY Los? flist OWNER Street Address: City Stata: Zip: . Company: r`C Ok 46 dOAJS? CD Phone #: !Z 72! (area code) • CONTRACTOR `/ ? S 6 Exp. Street Address: 3?7" 4 A vE -5-o ucense a5-Y CHy /V 1(? State: &n2 Zip: ?? 7" d rO ARCHITECT/ ENGINEER Company: Name: Telephone #: ( ) Sheet Address: Registraflon C ' Gfy State: ZiP: Sewer/water licensed plumber (if installina sewer/waterPhone #: ( I hereby acknowledge that I have read thls applicaHon, sfate that Ihe infortnation is cortecf, and agree to comply wNh aq appRcable State o! Minnesota Statutes and CMy of Eagan Ordinancea Signaiure of Applicanh OFFICE USE ONLY Certificates of Survey Recelved Yes No Tree Preservation Plan Received - Yes - No - Not Required . •' ` SRIAR HILL 2ND 14991 PERMIT DATE & USE LOT BL ADDRESS sisi 4-PLEX 010 01 3803/ LAUREL CT 020 Ol 3801/ 030 01 3807/ 040 01 3805 3i81 a-rLEx 050 01 3813/ LAUREL CT 060 01 3811/ 070 01 3817/ 080 01 3815 sisi a-Pr.ex 090 01 3821/ LAUREL CT 100 01 3819/ 110 01 3825/ 120 01 3823 ioiso a-rLEx 130 01 3835/ LAUREL CT 140 01 3833/ 150 01 3839/ 160 01 3837 APPROVED 7/80 3 CITY OF EAGAN 3830 PIIAT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 FOR CITY USE ONLY PERMIT # RECEIPT # Do? 7 . DATE : la 1 `??;;; PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & Y:i?.v..2.::.w:Jv:::: ..?::::.::.?::::. TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. ------------------------ --------------------------------------------------------- WORK DESCRIPTION COMPLETE THE FOLLOWING: NEW CONST ADD ON REPAIR N0. FIXTURES EA. ADD-ON MINIMUM 15.00 SHOWER 3.00 WATER CLOSET 3.00 BATH TUB 3.00 ? $jppgaj pM - -- - - - _ LAVATORY 3.00 OWNER NAME: 3807.LMIEL C OURj _ KITCHEN SINK 3.00 ERON'I ,('M 55124 _ LAUNDRY TRAY 3.00 SITE ADDRESS:_ H 452-2044_ . N $%-4702_ „ _ HOT T[JB/SPA 3.00 WATER HEATER 3.00 LOT: BLOCK? FLOOR DRAIN 3.00 dool G G OUT. (MINIMUM - l) 3.00 ?,u??n??? p???r?n,?nl?ra ROUGH OPENINGS 1.50 ADDRESS: OTHER /' ?? C-M? ? lNut ° "Ju: WATER SOFTENER 5.00 CIZy; ;Ve::?,NIL:,-70LI$, MlMT5;dOf,G j?`:073 PRIVATE DISP. 15.00 827-4033 o 827-4311 _ U.G. SPRINKLER 3.00 TOTAL SUBTOTAL $ / ?CA) ST. SURCHARGE .50 TOTAL : S /J^ .S?v dOMMEkG?ALf?IT T?Z SAL:;? PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND ` MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. ------------------ ----------- ---________--------- CONTRACT PRICE: FEES OWNER NAME: 18 OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR SITE ADDRESS;_ F.ACH $1,000 Oi' Ti'EFchfIT FEE. LOT: SLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: ADDRESS: CITY: PHONE #: FOR: ZIP: CONTRACT PRICE x 1% $ STATE SURCHARGE $ TOTAL: $ (SIGNATURE) CITY OF EAGAN ? -. . . . ? City of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r - _ _ _ _ _ _ _ _ _ - - ? I Far;???1.7se ? ? Permit#: -? (D ? Permit Fee: 1 ? Date Received: Cb';? ?J I I I Staff: ? I I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION h 1- r ? ,?? ?ss? J e ?f (?? Date: Site Address: ? a? r A R MG L ; co w.J l-/v ".,, L S 7enant: Suite #: RESIDENT I OWNER Name:?/-o phone: ??z-ySv-sn?7 Address / City 1 Zip: ?? D 7 Lk+,> R£ L C-' Applicant is: _ Owner X Contractor TYPE OF WORK Description of work: Construction Cost: MuRi-Family Buiiding: (Yes x I No ? CONTRACTOR Name: iQl£/ £'x ;- r?z? a2 m•s ir4 :. Z.? P. License #: .7-Ox S'// 3 i Address: y° ?- &J City: /77 1/1 L S, State: Mw Zip: SS -Vr ?y Pfione: 6-- rZ- $ & ? - &2 Y3 Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rutes 7670 Cateqory 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 suhmission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE:.Plans and supporting-documents thaf'you submif are considere`tl to be pubGc inforination: Porfions of '4; , the informatlon°may be classified,as'non-pubiic if you provide specific reasons that woultl pe"rmit fhe `Gty, to r- ?. ?- . . conclude that the are trade secrets I hereby acknowledge that this information is complete and accurate; that the work will be in wnformance 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 wp is not to sta out a permit; that the work will be in accordance with the approved plan in the case of work w i ires a review and approv of ans. ? ? ?? X - X ApplicanYs Printed Name i ?? ApplicanYs Signature Page 1 of 3 + - . Y DO NOT WRITE BELOW THIS LINE SUB TYPES ' ? Foundation ? 05-plex ? 16-plex ? Accessory Building ? Pool ? Single Family ? 06-plex ? Fireplace ? Porch (3-season) ? Ext. Alt. - Multi ? 07 of _ Plex ? 07-plex ? Garage ? Porch (4-season) ? Ext. Alt. - SF ? 02-Plex ? 08-plex tO Deck ? Porch (screenlgazebo/pergola) ? Multi Misc. ? 03-Piex ? 10-plex ? Lower Level ? Storm Damage ? 04-Plex ? 12-plex ? Miscellaneous WORK TYPES ? New ? Interior Improvement ? Siding ? Demolish Building* ? Addition ? Move Building D Reroof ? Demolish Interior ? Alteration ? Fire Repair ? Windows ? Demolish Foundation i2l Replacement ? Egress Window ? Water Damage " Demolition (entire building) - give PCA handout to applicant DESCRIPTION: Valuation p00 . r- Occupancy „? (ZG I MCES System Plan Review Code Edition 2 ao 7 SAC Units (25%_ 100% _) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length 1a Fire Sprinklers Type of Const. yyidth 2 a REQUIRED INSPECTIONS Footings (new bldg) Sheetrock )0 Footings (deck) Final/C.O. Footings (addition) Final/No C.O. Foundation HVAC Drein Tile Other: Roof: _Ice & Water _Final Pool: _Footings Air/Gas Tests _Final Framing Siding: _Stucco Lath _Stone Lath _Brick Fireplace:_R.I. _AirTest _Final Windows _ Insulation Retaining Wall Reviewed By: Building Inspector RESIDENTIAL FEES: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total Page 2 of 3 x . f 11/04/2011 07:51 6128616267 41111 C!tyofEaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5676 Fax: (651) 675-5694 Date: /11311/ Tenant: BEI EXTERIOR MAINT Plea SG cu// weff>'aewvyi7` Qpd c..rr t.Jrl/ bnny d o%4A a C.huk. N PAGE 02 Use BLUE or BLACK Ink L. For+ot( tine rmPerm#, I(/c/c2 Remit Fee: *'" ;J - co Date Received: Star: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION 1 Site Address: 324°1, 3s63, 3£05, 3 'D7 4-4K412k7-- Calde- — Suite S: RESIDENT / OWNER - Name: So As9o4-00"no41 le,,,,4,""6vu Al &And r Phone: 763 -V9y- 372 7 _ Address / City / Zip: 702,2 F. F/SA/ £.4*- Applicant is: Owner g- Contractor TYPE OF WORK Description of work: IQCmh ANp got,"cC 700 A"' Construction Cost: $/(490o — Multi -Family Building: (Yes / No ) CONTRACTOR Name: Bel rere-i2/u,e nUavtir doieA? Licen3e #: 000e,/,/ Address; y%s Lip .D City: /.wNr7ape)s..s• State: MA Zip: ,53 5 Phone: d i2 -4P6 /- 4 273 Contact:d:lvao Email: //Jk+ (4 hal it" 64:'m COMPLETE In the last 12 months, has Yes No If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? • date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portion of the information may be classiflectes nonpublic if you provide specific masons that would permit the City to _ conclude that t They are trade secrets. M . Call Gopher State One Call at (651) 454.0002 for protection against underground utility damage. Cali 48 hours before you intend to dig to receive locates of underground utilities. y nnr.00aherstateonecali.org e hereby acknowledge that this Information is complete and accurate; that the work will be In conformance wtth tho ordlnaneae gird Codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work la not to start without a permit that the work will be In accordance With the approved plan in tt f case of work which requlres a review and approval op} , x Cu/e4 s A,voLear.so, Applicant's Printed Name Applicant's Signature Page 1 of 2 i Use BLUE or BLACK Ink . ~ For 01111100 W ~ l • I Pem* V. I of Eslan I Pw mit Fee' a 1 3830 PUot Knob Road ~~`j A P716 I Egan MN 56122 Date Received: I ~3 I l Phone: (661)676"6675 Fax: (651) 6764094 1 Std 1 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: /o -7- I3 Site Address: gO/ 3~'O3, 36of; ~'e7 ,GAS?. E L C Unit 6:.r , e -J. ACT /y1,gw3>4 44 M ZAJ-7- phone; 7103 -xs3 - 9`70 Name: Rd~1~ Gri'~✓~2 />tt! 19 Goi.J~•J ~iFGLt-y Address I City / Zip: ~Sd Apprimant is: Owner ,L Cont actor Type, -T «.t~2 ©F Q E ' Desatiptionof wok Construction Cost: / • lJt~ Mull-Family Building: (Yeah 1 NO Company: GCE / Z)a -r cA e o R OA7,A3 f . ~ Conrad ~r4vi d ft R 5 Address: y/os bort ` . City: PC. s . Sute: Ct i sv' NAJ Zip: SS'"Vl 9 Phone: !o ~,t • ~b 6 x ~/3 Uosrtse tt C Z S!! / 3 / Lead Cerf icate 1P If the project is exempt from lead modHkcadon, please eVIatn why: (sea Page 3 for additional informsWil) ! 47 E12E.' 18~/LY" Po S-, COMPLETE THIS AREA ONLY IF CONSTRUCTING A Min BUILDING. In the last 12 month. has the City of Eagan Issued a pwmit for a sknilar'plan based on a maatw plan? ' Yes No If yes, date and address of master plan: Licensed Plumber: Phone; Mechanical Conbadpr: Phone: Sewer 4 Waterer Contractor: Phone: C BEFORE YOU 01% (Op GopherMab One Cog at (651) 4.44= for pr op against underground uft damage. C41148 hours balers you WNW to dig to racaiye loco w of und"taund utWgw. www.Q00h6mbd@0ngcgjj.0m I hereby adrnowledge that tlls inkrrrnatien b complete and axurate: that the work wWll be in oon6amsneo with the ordina m= and codes of the Ciy of that I undemiend this is not a permit. but only an appkeW for a permit. and mowk is net to alert wid w a permit that the wens voW be in aaordar,m with vw apprv-d pan in vw cme or York vwloh mqulree a review and approval Of plane. tbCberior work =*Wf iad by a bulking Pernk Issued In acowdanee with so Minnea0lt► Stale 13011di Code must be completed within 100 days od permit feauaneo. ,k. bow, ~v wzJ_S Applicant's Primed Name AppgcoWs S$igna we Page 19(3 TO 39Vd 1NIVW 1X3 13E L9Z9T98ZT9 ZO:bT ETOZ/LO/OT r ty 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 4%_ IPA , " 1 Use BLUE or BLACK Ink For Office Use (�j54/ Permit #: l Permit Fee: g.13' � Date Rece11 illi ived: Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION %, 3 P3 3 8 oSIgo? MULEL i t Unit#: J nate: ' • ' • oiw /luuffiSO. — - Resident! e% 4C' »ti 4bE/ Ea;T' J.z. c- Phone: 743 - s53- 977 Name: �o� D £:� 14141-1 y /OA) Address / City / Zip: :So Q E C o4TU 2 4v, , ,t A S's Y.t. 7 Applicant is: Owner KContractor Type 'Of:ilVOft'k Description (' f- a- £ PL 4f- J' .6 i "� b d *.5c.i a PI LTA L of work: /14 Y' • W Multi -Family Building: (Yes I No _„J Construction Cost . Contractor Company: a £ 1 £,c 7- gle, a 2 /) 4I ,J -T . Ca a? Contact DA u r t Qdd2R/ S Address: 4/°.3' LO 100 =` J.; - City: ///P[. S State: %I i Zip: 55'1,// ry Phone: 6,, Z - i3 (o / - Lv 2 Y 3 '1'- 2 Y/ / 3 / Lead Certificate #: License*: If the project is exempt ILNC0S- from lead certification, please explain why: (see Page 3 for additional information) 11..a/LY Pos"' /5'7r 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: Pians ancl aaptincting itst # noets/de>I iri1°; . �.J itiia* < the:infon»abon maybe ds Ilk floe *awe sP c �a�p� . ccfc cee 1t" ya,efrade secs. 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.00pherstateonecall.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 1 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 BuildinLCode must be completed within 180 days of permit issuance. x 4 ✓' Applicant's Printed Name x Applicant's Signature 7 L.3 Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA153378 Date Issued:12/14/2018 Permit Category:ePermit Site Address: 3807 Laurel Ct Lot:3 Block: 01 Addition: Briar Hill 2nd PID:10-14991-01-030 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 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 - Karl T Pederstuen 3807 Laurel Ct Eagan MN 55122 Minneapolis St. Paul Plumbing Heating Air 640 Grand Ave St. Paul MN 55105 (651) 228-9200 Applicant/Permitee: Signature Issued By: Signature