4252 Carlson Lake Lane N
Use BLUE or BLACK Ink
For Office Use
1 1
V I
of I Permit S
I o~S I
City ~U R a n
~ Permit Fee:
3830 Pilot Knob Road I
Eagan MN 55122 Date Received: ' j
I I
Phone: (651) 675-5675
Fax: (651) 675-5694 1 Staff: I
I I
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: a~ ( Z Site Address: `A ~0 5A C, A ?ti ,so VDLAIGe ti Unit
Name: S-9_ A; Q & Phone: V31- ~93 --0 ~ 35
RESIDENT I _
OWNER Address /City /Zip: A y-tcd ~-AIse, C-- .AQ 9- Ndr2 y
Applicant is: y Owner Contractor
TYPE OF WORK Description of work: T-~ Fi v cl~~ be A'
Construction Cost Multi-Family Building: (Yes / No )
Company: S C t- Contact: S/kWl e Ams A-40 V140-
CONTRACTOR Address: City:
State: Zip: Phone:
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City; to
conclude that the 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.aooherstateonecall.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.
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. - y~
x MAF, ILI x
Applicant's Printed ame Applicant's Si ature
Page 1 of 3
Use BLUE or BLACK Ink
1-------
For Office Use
y of 1 i Permit#:
Eanon
Cit
6
Permit Fee. ~at, 1
3830 Pilot Knob Road
Eagan MN 55122
j Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 Staff.
2010 MECHANICAL PERMIT APPLICATION
Date: Site Address: b-, 6P-2, 1=a-ze- 4__2n=
Tenant: -Suite
RESIDENT / OWNER Name: ~ Phone: l0 533 4
Address / City / Zip: 4,o;,,
CONTRACTOR Name: -t, T License 62 /l0 3
Address: 7d~OJ~ A'Gl t/ City: OKf- ~ z7a
d?'
State: A_7~ Zip: 7 S"90/ Phone: 5-0> 7' 112,9
Contact: ~&jc;f ~jrpGe~fi t Email: 1, 6
TYPE OF WORK New C)Replacement Additional Alteration Demolition
Description of work: G
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
RESIDENTIAL COMMERCIAL
PERMIT TYPE Furnace New Construction _ Interior Improvement
Air Conditioner Install Piping _ Processed
Air Exchanger Gas _ Exterior HVAC Unit
Heat Pump _ Under / Above ground Tank 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) $ J3 • C20 TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal OR Contract Value $ x1%
$55.00 Minimum (includes State Surcharge)
Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge
(i.e. a $10,010411,010 Permit Fee requires a $ 5.50 surcharge)
TOTAL FEE
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.popherstateonecall.om
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.
x kck- e Pal,,rz x '44-;, -
;,0!(--Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground -Rough In -Air Test -Gas Service Test -In-floor Heat; --Final
Exterior HVAC Screening Inspection
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knrload
P. O. Bbx 2,099 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner: o me:-
Address:
Site Addross
Plumber: S
Meter No.: 370Z5,-',~ S action Charge: )0.'lOp
:
Size: co-, j
Reads No. ep
1 eem to - Ph W" Su~ tiC.
REQUIRED B
Total:
BY Date Paid:
of Insp.: Insp.:
7-ZS-
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road
P. O, Box-21199 PERMIT NO.:
Erman, MN 55121 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address -
Plumber. ti a
Meter No.: Connection Charge: 0,00L,
Size: Account Deposit:
Reader No.: Permit Fee:
1 agree to aesieply wilt The City of Began Surcharge:
OnIbeaae. Misc. Charges:
Total:
By Date Paid:
Date of Insp.: Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road
Mr. Box 21199 PERMIT NO.:
f Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner: 3
Address:
`2 Cazls,. r -
sib Address
Pfumber: ` c Sick
1 ague to sent* via tdte city of iymr Connection Charge:
OrrirnNeee. Account Deposit;
Permit Fee:
Surcharge:
BY Misc. Charges:
Dote of Insp.: Total:
Inep,: Dab Paid:
CITY OF EAGAN 1 5432
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 !
BUILDING PERMIT Receipt # - 1
To be used for BASEMENT FINISH Est. Value $1,500 Date OCT S t 9_90
Site Address 42 52 N CARLSON 1 AU LN
8 WILDERNESS RUN S OFFICE USE ONLY
Lot Block Sec/Sub.
Parcel No. Occupancy FEES
Zoning
w Name DO$RINC (Actual) Const Bldg. Permit 55•~
4252 CARL.SON L.AKB LN
1.00
o Address (Allowable) - Surcharge
City EAGAN Phone 452-8829 # of Stories
Lepglh Plan Review
c Name DAVID SCHiIEKA CONSTRUCTION Depth SAC, City
o0 Address 17160 HAMILTON DR S.F.Total
U'- City LAUVILU Phone 447-8$013 S.F. Footprints SAC, MCWCC
On Site Sewage Water Conn
ULU W w Name On Site Well Water Meter
Address MWCC System
W City Phone City Water Acct. Deposit
PRV Required S/W Permit
I hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Earn Ordinances: Treatment PI
Signature of Permitee APPROVALS Road Unit
A Building Permit is issued to: DAVID SQAW" CONST Planner Park Ded.
on the express condition that all work shall be done in accordance with all Council - • 50
applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies
Variance TOTAL 36.50
Building Official ,
Permit No. Permit Holder Date Telephone #
WATER
SEWER
PLUMBING
H.V.A.C.
ELECTRIC
Inspection Date Insp. Comments
Footings l
Foundation
Framing
Roofing
Rough Pibg. p p , G
Rough Htg. if
Isul. /0 / 2 p U 0 x e
Fireplace
Final Htg.
Final Plbg. ~d
Const. Meter Plbg. Inspector - Notify Plumber
Engr./Plan
Bldg. Final
Deck Fig.
Deck Final
Well
Pr. Disp.
IV- wt,
• PLUMBING PERMIT N For Office se gnly
CITY OF EAGAN PERMIT #
CONTRACT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT #
PRIC f PHONE 4548100 DATE: SU
Site Add ss C BLDG. E WORK DESCRIPTION
New
Lot =lock Sec/S b Res. BLDG.
_
r 2 v _ Mult. Add-on
Name Comm. Repair
1 S 3 1 1. Other
Address
City t1a~t ~1\t Phone a3 RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Name
Bath Tubs - $3.00
3 Address Li L >~1 c~ w • Lavatory - $3.00
O City Phone I Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
FEES Laundry Tray - $3.00
COMMAND. FEE - 1% OF CONTRACT FEE Floor Drains - $1.50
APT. BLDGS. - COMM. RATE APPLIES Water Heater - $1.50
TOWNHOUSE & CONDO - RES. RATE APLLIES Whirlpool - $3.00
MINIMUM - RESIDENTIAL FEE $12.00 Gas Piping Outlets - $1.50
MINIMUM - COMM.IND./FEE $20.00 (MINIMUM -1 PER PERMIT)
STATE SURCHARGE PER PERMIT .50 Softener - $5.00
(ADD $.50 S/C PER EACH $1,000 OF PERMIT FEE) Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
U. G. Sprinkler System - $12.00
SIGNAMREOF PERMITTEE PERMIT FEE:
STATES S/C:
FOR: CITY OF EAGAN GRAND TOTAL: f l
CITY OF EAGAN . • 1r, •
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 '
f + PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for I= Est. Value Date AIJG S 1991
Site Address
Lot A Block 6- Sec/Sub. OFFICE USE ONLY
Parcel No. Occupancy FEES
i
Zoning
W Name (Actual) Const Bldg. Permit 21_00
a Address (Allowable) Surcharge .50
City EACM Phone # of Stories
Length$ Plan Review
i4 Name SAME Depth SAC, City
013
U-9 Address S.F. Tot0 SAC, MCWCC
City Phone S.F. Footprints
On Site Sewage Water Conn
W W Name On Site Well Water Meter
Address MWCC System
~
A=l. Deposit
am City Phone City Water s
PRV Required S/W Permit
I hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge
information is correct and agree to comply with all applicable State of 3
Minnesota Statutes and City of Eaggin Ordi ces. Treatment PI
Signature of Permitee APPROVALS
_ Road Unit t
A Building Permit is issued to: ALLAN & DRIDRE 1ING Planner Park Ded.
on the express condition that all work shall be done in accordance with all Council
applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies
Building Official i Variance TOTAL 25.50
Permit No. Permit Holder Date Telephone #
WATER
r
SEWER
PLUWBING
H.V.A_C.
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orstat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Fig_ . lS D:5
Deck Final 3 D
Well
Pr. Disp.
CITY OF EAGAN 11900
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt If~'
To be used for SF DWG/GA~2 Est. Value $62, 0 0 0 Date MAY 5 19 -d(i
Site Address4252 N CARLSON LAKE LN Erect OX Occupancy R3
Lot J Brock _ 6 SecISub. WILDEIRU SS RUNRemodel ❑ zoning ill
Parcel No. Repair ❑ Type of Const.
Addition ❑ No. Stories
¢ Name PCM Ii(]r9 Move El Length
z Demolish ❑ Depth 4
o Address 1.14108 MURPHY LAKKE BLVD Int. lmpr. ❑ Sq. Ft.
city ::R TOR b%ne 432-2440 Install ❑
Approvals Fees
o Name SAME
~s Address Assessment Permit 319.111C
City Phone Water & Sew. Surcharge 31.0
0
Police Plan Review 159.50
LUW Name A.P..S. HOME DESIGN Fire SAC 575.010,
ox Z5 Address 500.00;
= Eng. Water Conn.
W City Phone Planner Water Meter 63 • 50
Council Road Unit 290 • ()u
I hereby acknowledge that I have read this application and state thatthe Bldg. Off. 515186 Tr. PI. 156.01)
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. APC Parks
var. Da t- .13178 Copies
Signature of Permittee $ 2 U 9 4. 0 U
Total
A Building Permit is issued to: RSM HOMES ` on the express condition that
all work shall be done in accordance with all appligable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official-
Permit No. Permit Holder Dab Telephone k
Plumbing - 1
HN.A.C. _
Electric
Softener
Inspection Date Insp. Comments
Footings 1
Footings 11
F/~~~~~
t%'ti 1000
7
Insul.
Fireplace
Final Htg. 7
Final Plbg.
Bldg. Final
Cert. Occ.'
Deck Fig.
Deck Frmg.
Well
Pr. Disp.
PERMIT #
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 21 DATE
CONTRACT PRICE PHONE: 454-8100
Site Address -J' eA. e-l BLDG. TYPE WORK DESCRIPTION
Lot Block 6 Sec/Sub
Res. X New x
m Name -.f e Mutt Add-on
2 Address YI S Comm. Repair
to
City Phone Other
Name O~L NIO. FIXTURES TOTAL
` Water Closet - $3.00 $
Address -7-Bath Tubs - $3.00
p City Phone 7-Lavatory - $3.00
=Shower - $3.00 -
Kitchen Sink - $3.00 -
FEES
COMMAND FEE - 1% OF CONTRACT FEE Urinal/Bidet -7-Laundry Tray - - $33.00 00 ~
. '
MINIMUM -RESIDENTIAL FEE -$10.00 Lau
-Floor Drains - $1.50
MINIMUM - COMMAND FEE - 20.00 -7-Water Heater - $1.50
STATE SURCHARGE PER PERMIT - .50 Whirlpool - $300
(ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets - $1.50
BEYOND $1,000.00) Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
SIG URE OF PERMITTEE FEE `
STATE S/C:
GRAND TOTAL-
FOR: CITY OF EAGAN
I
PERMIT #
MECHANICAL PERMIT RECEIPT # CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address L L~ BLDG. TYPE WORK DESCRIPTION
Lot Block- Sec/ju
Res. X New X
Name ,L 'J n/s ' L Mult Add-on
Address o o x c. 3
Comm. Repair
c City ~xJc~ Phon v~J Other
Name FEES
c Address cJPf'` Sl~L T RES. HVAC 0-100 M BTU -$24.00
p City Phone 113 7, - L O ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
TYPE OF WORK ADDITIONAL 6 M BTU - 6.00
o~ GAS OUTLETS - 1.50 EA.
Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00
Air Cond. M BTU $ STATE SURCHARGE PER PERMIT .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # BEYOND $1,000.00
Other
FEE
a SIGNATURE OF P E
S/C:
TOTAL- 2)
FOR: CITY OF EAGAN
CITY OF EAGAN Remarks
Addition Wilderness Run 5th Addition Lot 8 Blk 6 Parcel 10 84354 080 06
Owne F'/t~. Street 4252 No. Carlson Lake Ln. State Eagan, MN 55123
r
C(V ~Lc : . d~ i
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK as 1973 $132.60 $6.63 20
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 1q77 160-00 10-66 15
STORM SEW TRK 36'4 00' ?4 - 71) is
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
CITY OF EAGAN NO 18432
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt # ~ L
Tobeusedfor BASEMENT FINISH Est.Value $1,500 Date OCT 5 1g-Q--
Site Address 4252 N CARLSON LAKE LN
Lot 8 Block 6 Sec/Sub WILDERNESS RUN ST OFFICE USE ONLY
Parcel No. Occupancy FEES
Zoning _
M Name AL DOERING (Actual) Const Bldg. Permit 35.00
Address 4252 CARLSON LAKE LN (Allowable) Surcharge 1.00
City EAGAN Phone 452-8829 aofStories
Length Plan Review
Zp Name DAVTD SCHWRKA CONSTRHCTTON Depth SAC, City
3!j Address17160 HAMTT.TON DR S.F. Total SAC, MCWCC
City T.AKF.VTT.T.K Phone 447-RAOR S.F. Footprints -
On Site Sewage Water Conn
r
W Name On Site Well Water Meter
u~m Address MWCC System
0z Acct. Deposit
<w City Phone city water -
PRV Required SAN Permit
I hereby acknowlege that I have read this application and state that the Booster Pump SAN Surcharge
information is correct and agree to comply with all a plicable State of
Minnesota Statutes and Cl f Ea an Orcystan & Treatment PI
Signature of Permitee ty Ay APPROVALS Road Unit
SCI' WEIGH Planner
A Building Permit is issued to: DAVID CONST Park Ded.
on the express condition that all work shall be done in accordance with all Council .50
applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Oft. Copies
Building Official 'toAll I\.n rl !a A Variance TOTAL 36.50
CITY OF EAGAN N2 19526
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDINIfPERMIT PHONE: 454-8100 Receipt# L W'340
To be used for DECK Est. Value Date AUG 5 1 g 91
Site Address 4252 N CARLSON LAKE LN
Lot 8 Block 6 Sec/Sub WILDERNESS RUN 5 OFFICE USE ONLY
Parcel NO. Occupancy FEES
X Name ALLAN & DEIDRE DOERING Zoning
w (Actual) Const Bldg. Permit 25.00
Address 4252 N CARLSON LAKE LN (Allowable) Surcharge .50
City EAGAN Phone 683-4425 W # of Stories
Length 131ct8 Plan Review
0 Name SAME Depth 1OK16 SAC, City
i
Address S.F. Total 10x14 sac, Mcwcc
City Phone S.F. Footprints
On Site Sewage Water Conn
W Name on site well
~w Water meter
Address MWCC System
aw City Phone City Water Acct. Deposit
PRV Required S/W Permit
I hereby acknowlege that I have read this application and state that the Booster Pump SAW Surcharge
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Ea Ordi ces. ! Treatment PI
Signature of Permitee APPROVALS Road Unit
A Building Permit is issued to: ALLAN & DEIDR ' DOERING Planner Park Ded.
on the express condition that all work shall be done in accordance with all Council
applicable Stale of Minnesota Statutes and City of Eagan Ordinances. Bldg, Off, Copies
Building Official 804 W.i 111k& Variance TOTAL 25.50
/0/.5/50 C~ 3 3 5 8 5ti~
Reguest Date Fire No. Rough-in Inspection
Reguired? ❑ Ready Nowi Jill Notify inspector
Wes ❑ No When Ready?
I ❑ licensed contractor ,/owner hereby request inspection of above electrical work at:
Job Address (Street x or Route No.) Clty
BLS f bon LA L Lane loo
Section No. Township Name or No. Range No. County
x
Dauo~(f~'C!n PhoneN51~
PDWer pher comas
< Q LN)o tm o~A ~
Electrical Contractor (Company Name) Contractor's License No.
Mailing or s (Contractor ar O er akin, Installation)
Au or d Sign ure ontracto akir4L Installation) Phone Numb
MINNE STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Mldwey Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD
1821 Unitrers" Ave., St. Psul, MN 55106 UNLESS PROPER INSPECTION FEE IS
Phone (812) 842-0800 ENCLOSED.
/c7/jam/cj0 REQUEST FOR ELECTRICAL INSPECTION Irk! NN" EB-00001-07
/ ► See instructions for completing this form on hack of yellow mpy, { y j /i/05-7911
C 3 3 5 8 5, X" Below Work Covered by This Request : • /
e Add jt~p. _S,jype of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) Contractor§ Remarks: -y1- C
Compute Inspection Fee Below: S
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps /5 0 to 100 Amps
Transformers Above 200 Amps Above 100 Amps
Signs Inspectors use only. TOTAL SCE
Irrigation Booms ~l5•~~
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN{/7:i NTHS:5,
I, the Electrical Inspector, hereby Rough-in Date .d O
certify that the above inspection has
Final Date
been made.
/!n n~ o L
OFFICE USE ONLY
This request void 18 months from
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New construction Requirements RemodeVReoairReouiremems s
3 registered site surveys stowing sq. tt of lot, sq. R of house; and all roofed areas 2 copies of plan -
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions
2 copies of plan showing beam & window sizes; poured found design, etc 1 site survey for additions & decks
l set of Energy Calculations Addition- indicate ffonste septic system
3 copies of Tres Preservation Plan if lot platted after 7/1193
Rim Joist Detail Options selection sheet (blld/gs with 3 or less units
Date 0 / ztT / (b v I Construction Cost
Site Address L052- eAPC5-~>IJ LAKE Cn) py Unit/Ste#
Description of Work Ir- S /)4~L L 6A 5 5 7ak
Multi-Family Bldg - Y b<N Fireplace(s) _ 0 0-2
Property Owner / 7 K O Telephone # ( 65) 663
Contractor A--75
7
Address ~J ci. f~W7 /J' City
State Zip SS37 Telephone 9 (917)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code Category • Residential ventilation Category 1 Worksheet New Energy Code Worksheet
(~i submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan r or plgrio _ N If so, 25% plan review
fee applies. PSG tt.~
Licensed Plumber ne )
Mechanical Contractor 0y Telephone )
Sewer/Water Contractor Telephone )
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, an work is not to start without a
permit; that the work will be in accordance with the approved plan in a cKofk ich re quires a review and
approval of plans.
Applicant's Printed ame Applican Signatu
CITY OF EAGAN N p 119 U
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt R 7
J
To be used for SF DWG/GAR Est. Value $62,000 Date MAY 5 tg86
Site Address 4252 N CARLSON LAKE LN Erect C~} occupancy R3
Lot 8 Block 6 Sec/SuhWILDERNESS RUN Remodel El Zoning R1
.
Parcel No. 5TH Repair ❑ Type of Const. Vn
Addition ❑ No. Stories
36
W Name RSM HOMES Move ❑ Length
3 Address 18308 MURPHY LAKE BLVD Demolish ❑ Depth 46
° City PRIOR 1PNune 432-2440 Inst,11 O Sq. Ft
O Name SAME Approvals Fees
$r°a Address Assessment Permit 1 .00
City Phone Water & Sew. Surcharged 00
50
Name A.P.S. HOME DESIGN Police PlanReviewv 00
~ i Fire SAC
Z5 Address Eng. Water Cone' 00
a w City Phone Planner Water Meter 50
Council Road Unit 00
I hereby acknowledge that l have read this application and statethatthe Bldg-off. 5/5/86 Tr. PI -•00
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City o Eagan Ordinances. APC Parks
var.Dati/3/78 Copies
Signature of Permittee Total 00
A Building Permit is issued to: RSM HOMES on the express condition that
all work shall be done in acco dance with all appt ble Ste a of Mi neso nd City of Eagan Ordinances.
Building Official
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN
COMMERCIAL SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS
ENERGY CALCULATIONS-
$2,000 LANDSCAPE BOND
To Be Used For: Valuation Date S`
Site Address Z N . Co,t1$6N kyy tOOF-FI=CE-USE ONLY
Lot Block C
Erect Occupancy 3
Remodel Zoning /
Parcel/Sub - ~~~er nPCc Rv.n ,SLh Repair Type of Const
Addition 0 of Stories
Owner RSM HOMES, INC. Move Length
Demolish Depth t/
Address 18308 Murphy Lake Blvd. Int.Impr. Sq Ft
Install
City/Zip Code Prior Lake, MN 55372
Phone 432-2440 APPROVALS FEES
Contractor Same Assessments Permit 3/9
Water/Sewer Surcharge 3/
Address Irv 131 65 s Isie-W Police Plan Review 159.
Fire SAC
City/Zip-Code s Engr Water Conn
----7 Planner Water Meter efv ,
Phone Council Road Unit 29®
Bldg Off Treatment P1
Arch./Engr._ A.P.S. Home Design APC Parks
\ Variance Copies
Address TOTAL p
City/Zip Code
Phone p
Bm z PAvE5
ROBF. CDHSULTIHO 4HOHICIRS
ENGINEERING and IS aL
pIANNEAS and LAND iURVEVDflS
COMPANY, INC.
1000 CAST 1461A STREET, euflNSVILLE, MINNESOTA 55337 PH X32'5000
Cerzi}`i c ~Szcrv-e y
~¢04t CYacr4e21on • LOT 8, BLOCK 6, WILOERN655 RUN 5TN ADD17-10A1,
DAKOTA UN WTY, I0IAIAJE50TA
NORTH
6/. So
SCALE : I"= 40
To.a? DENOTES EXISTIKIG ELL:VATIOAI
Ceio.n) DEA10TE5 FKOPt~ .L'U ELEVA- IOAl
WOICATE5 DIREcTIDAL o!= O~ n
SURFACE DR II'JAGE L c,
FIP.IISHED ~t3R616.~ Fl_00l? ~ I r''~ ; ~
F_ I. VAT/oA1
n W 2
Z In
\ POND N
tl V ~ -
I - ° nl O
O
' m
lo,o
f 10,
201 FIZOA.17ESUIl.DIAIa q,o I~,°
DRAINAGE AKIP F 45 W o
o_ 14o3t}lo 6
UTILITY EA'SENICN1 5
~•p•,~o-~ ~q 9~ R:613,16 ~ /N K15
L06 ~v$'i
C°ll~c 335 , OLj l.A
t I CA~L
I hereby certify that this is a true and correct representation of a tract of
land as shown' and described hereon.. As prepared by me on this 3o-nl day of
Hinn. Reg. No.146fS-
CITY OF E A G A iV * APPmmwigw Fm AT Tim LICATION DOESFNOTCONSFITUTEF
* APPROVAL OF PERMIT.
APPLICATION FOR PERMIT
* INSPECTION OF SEWER AND/CR WXNR
* iNsmAul m oNS WILL NOT BE SCHED-
SEWER AND/OR WATER CONNECTION * ULED UNTIL PST HAS BEEN
* APPROVED.
a '
Please Print) /
1) PROPERTY ADDRESS: LS-d,U G.V~E ie
LEGAL DESCRIPTION: 4elA'ff 5•5- ~-L
(Lot Bl-ock7S-u-bdiv-ision or Tax Parce ID
IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE:
i
PRESENT ZONING/PROPOSED USE: (Mon Year)
❑ COMMERCIAL/RETAIL/OFFICE R-1 SINGLE FAMILY
❑ INDUSTRIAL ❑ R-2 DUPLEX (T4.a Units)
❑ INSTITUTIONAL/GOVERNME•NT ❑ R-3 TOWNHOUSE (Three + Units) ( Units)
❑ R-4 APARTMENT/CONDOMINIUM ( Units)
2)
NAME
ADDRESS: Z ; elJ . r N
CITY, STATE, ZIP: Z4J
PHONE:_ z r2
3) u NAME:) For City Use
~-r O ti tt r PluThers License:
ADDRESS: Active
i CITY, STATE, ZIP: Expired
w ~rj 7 Not recorded
PHONE: MASTER LICENSE#
St Initial
4) •aa • ia-
NAME:
ADDRESS: 3 O t5' w ~0 GRsj.`L` ~c%rn a
CITY, STATE, ZIP: f, \
PHONE:_
. a•y. .YY}.
CONNECTION TO CITY SEWER CONNECTION TO CITY WATER OTHER
6) • r ❑ PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE
❑ PLEASE MAIL APPROVED T TO 1, 2 3; 4, ABOVE .
(Circ one)
• r a• • . • a ia• ► r• YJI• • i • • a• •
.FOR CITY USE ONLY
PERMIT # ISSUED
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLUDE SURCHARGE)
$ $ 16 WATER PERMIT (INCLUDE SURCHARGE)
$ $ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ /S 0-o ACCOUNT DEPOSIT - SEWER
$ $ , ACCOUNT DEPOSIT - WATER
$ d`~ C7 T: $ WAC
$ 7.~ ! Z) $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ $ WATER TREATMENT PLANT SURCHARGE
$ yy $ OTHER:
$ ~T J S'~~ $ / l1-Z3 TOTAL
~3i/o - G~6SS/
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC
ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
Q
SUBJECT TO THE FOLLOWING CbNDITIONS:
APPROVED BY:
TITLE:
DATE : G ~Z S d
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
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.
,~GT 0 4 RECn
YYmT 'F%Njty
To Be Used For: Afvxlls-~ Valuation: -~~-i~-v- Date: /O/y / 4D
Site Address C,i~2S) Al ~6 ~n AJ~ ~,>o OFFICE USE ONLY
Lot $ Block &480'010 FEES
Occupancy
Zoning
Parcel/Sub )Al tIL All p. Actual Const Bldg. Permit 3S'00
Allowable Surcharge [to
Owner 0(1t12iA16 # of stories Plan Review
Length SAC, City
Address ~Z JV~ CAR6s0A/ t,44, - Z7$ Depth SAC, MWCC
S.F. Total Water Conn
City/Zip Code Footprint S.F. Water Meter
Acct. Deposit
Phone yYZ~~~Zs On site sewage_ S/W Permit
On site well S/W Surcharge
Contractor 1014J7e 5-&11L1-11P1- COQ., MWCC System Treatment Pl.
City water _ Road Unit
Address /716 U/L?®~ f/ PRV Park Ded.
Booster Pump Copies so
City/Zip Code 12) SUBTOTAL
~j APPROVALS Penalty
Phone Planner TOTAL
Council
Arch./Engr. Bldg. Off.
Variance
Address
City/Zip Code
Phone #
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
C 3830 PILOT 651-681 46 5- 55122 l 3
New Construction Reaulrements Remodel/Repair Reaulremenh
D 3 registered site surveys showing sq. R. of lot, sq. M. of house 2 copies of plan
and 90 roofed areas f20% maximum lot coverage allowed) 1 set of energy calculations for heated additions
D 2 copies of plans (show beam & window sizes; poured find. design; etc.) 1 site survey for exterior additions 6 decks
D 1 set of energy calculations
D 3 copies of free preservation plan I lot platted after 7/1/93
DATE: S'lU -9q CONSTRUCTION COST: ~4z--7 cp
DESCRIPTION OF WORK: /l ~naVe %Z~elc~& ~~o~, okm rx~ r a r
STREETADDDRRESS: yZSZ IS-fUSbtj LR..ke LAJ
LOT: O BLOCK: SUBD./P.I.D.
Name: Phone
PROPERTY Lost First
OWNER i / f J
Street Address: U zsz ~R ~SOIJ LE u t 1L1 f
City State: h 1N Zip: 5W ZZ
Company: Le •LoL/~ Phone 997- Z2-7
(area code)
CONTRACTOR
Street Address: I cog SS l q ('P~ S i (J License #70/~ZZ'~ Exp. ld-1 0
City 24.42je yJLz 4 State: V-)-I1A1 Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
Street Address: Registration
City State: Zip:
Sewer s water licensed plumber freaulred for new construction only
Penally applies when address change and lot change Is requested once permit Is Issued.
I hereby acknowledge that I have read this application, state that the Information is correct, and agree to comply with all appiicabl
State of Minnesota Statutes and City of Eagan Ordinances. l,
Signature of Applicant: G
OFFICE USE ONLY RECEIVED
Certificates of Survey Received Yes No MAY 12 1999
Tree Preservation Plan Received Yes No Not Required BY:
193
1991 BUILDING PERMIT LICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
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.
To Be Used For: ~e r Valuation: Date: TJ - ~`l
Site Address Q.-6- [E L. OFFICE USE ONLY
Lot t5~ Block C:I, FEES
Occupancy Bldg. Permit °D
Zoning Surcharge Sa
Parcel/Sub w ~L~ ERA Qw.1 SHAn1, Actual Const Plan Review
Allowable SAC, City
Owner J'. F 1b 4 Jro e # of stories SAC, MWCC
Length Z AY B Water Conn.
Address Depth lo K14 Water Meter
S.F. Total tp xc 4 Acct. Deposit
City/Zip Code Ss: I Footprint S.F. S/w Permit
S/W Surcharge
Phone I-- "15~ &S )Lg u,- 6F3-Vll,)-! On site sewage- Treatment Pl.
On site well Road Unit
Contractor jc C MWCC System Park Ded.
City water Trail Ded.
Address PRV Copies
Booster Pump _
City/Zip Code SUBTOTAL
APPROVALS Penalty
Phone Planner Lot Change
Council TOTAL
Arch./Engr. Bldg. Off. 5•aLL C
Variance
Address
City/Zip Code
Phone #
Sewer/Water Licensed Contr.
agrees that all work shall be done in accordance with
(Signature of ontractoy!
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
PHONE 454.9100
CITY OF EAGAN 141-6 w/Lff
3785 PILOT KNOB ROAD
EAGAN. MINNESOTA
88122
December 12, 1976
I,
I
Tilsen Homes
627 So. Snelling Ave.
St. Paul, MN 55116
Res Variance Lots 6 thra 11 Block 6 Wilderness Run 5th
Lot 1 Block 3 +:ilderness Run 6th
Dear Sirs:
Enclosed for your attention is a copy of the minutes of the Advisory
Planning Committee and the Eagan City Council approving a front yard
setback variance from 30' to 201 on the above mentioned lots in
Wilderness Hun 5th and 6th.
Very truly yours,
(ars.) Alyce Bolke
Clerk - City of Eagan
Encl.
AB/cjb
go. Dale Peterson
2007 RESIDENTIAL PLUMBING PERMIT APPLICATION r
CITY OF EAGAN ~r..
3830 PILOT KNOB ROAD, EAGAN MN 55122 w
651-675-5675
Please complete for modifications to existing residential dwellings.
Date
Site Street Address "f"c";~Isza Unit#
l
)r~~S
Property Owner 1~ Telephone #V31
Contractor ! - l "`mac' nTelephone #
Address ~J~ ~
j(/17r 4- City ST• Ctr State j
The Applicant is: _ Owner Contractor -Other
Septic System - New _ Refurbished Submit 2 sets of pla=Per Includes County fee
$ 100.00
$ 10.00
Fire Repair (replace burned out fixtures, etc.) $ 90.00
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 only 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 Turnaround (add $136.00 if a 5/8" meter is required)
Other:
Water Softener Water Heater $ 15.00
new replacement
Lawn Irrigation _RPZ _PVB -new -repair -rebuild $ 30.00
State Surcharge $ .50
Total $1
I hereby apply for a Residential Plumbing Permit and acknow ge that the information is complete and accurate; that the
or will be in conformance with the ordinances and de of the City of Eagan an t!2 t n erstand this is not a permit, but only an application for
p mit, w rk is not to start witho n k i in
tcord ance with theroved plan in the event a plan is r red to a revewappro 12007
ant' s Pr nted Name Applicant's Sign lure
By
~ • "[CGS
coHSULnIro lHOIHEEfli
Rose NEe RING
IMING1 PU11111AS and LA14D 3URVEVOAS
COMPRNY1 INC.
1000 [AST 1461h STREET, BURNSVILLE, MINNESOTA 555337 PH 432-55000
cep-~i}Lz y
Legal l~G.>t rle2iOn LOT 8, BUICK 6, WILOERNE55 Run/ 5711 ADDn"I0ti7,
£)AKO-01 Cnr AITY, NJIAJAJE5O-M
NORTH - s 07.5a, /s" L1,
6/. Sig
SCALE I"= {O
($70_..0? DEKJOTES FXISTIN';~ Etl.VAfIMJ
(Ma DEMOTES PKL'W'V(A) EI DIX110A/
...i WDICA-rES I+IK6Ci1av of-
SURFACE hRAIP.IAC-E i-0-'r fA i._lJ
k:_1 VAT/OA/
41 -Z
n PO r l
I.. lfl O
I (11
(1v 11
57- t1o
C~~2.~ • _ 34.0
logo N 1~'v' _
o x T_
20~ FK0711- b0/1.G/A/a 1•° ~1 llvO I ' .
5_ rtgaCK LIME b ° s~ -Y 5)
DRAIM4&E.. AMP i 5
Ida 4~ -
J71L17 ti' E/l: f lAE'AI I C-1 IB tj
E -
4t5_' 613.1 \t, RL500~
,.I
CA
I hereby certify that this is a true and correct representation of a tract of
land as shmm'and described hereon.. As prepared by me on this 3rnl day of
q9~'-'t.. , 19 57L
G'
.~....f Hinn. log. No. /G~r r
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA153481
Date Issued:12/20/2018
Permit Category:ePermit
Site Address: 4252 Carlson Lake Lane N
Lot:008 Block: 006 Addition: Wilderness Run 5th
PID:10-84354-06-080
Use:
Description:
Sub Type:Windows/Doors
Work Type:Skylight
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Mary A Roy
4252 Carlson Lake Lane N
Eagan MN 55123
(952) 250-0767
Pro Exteriors LLC
9001 E Bloomington Freeway, Suite 126
Bloomington MN 55420
(952) 250-0767
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA173854
Date Issued:12/08/2021
Permit Category:ePermit
Site Address: 4252 Carlson Lake Lane N
Lot:008 Block: 006 Addition: Wilderness Run 5th
PID:10-84354-06-080
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Mary A Roy
4252 Carlson Lake Ln
Saint Paul MN 55123--172
Paul Bunyon Plumbing Llc
5718 International Pkwy
Brooklyn Park MN 55428
(612) 822-5292
Applicant/Permitee: Signature Issued By: Signature