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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