1217 Carlson Lake LaneCITY OF EAGAN WATER SERVICE PERMIT
?
3795 Pilot Knob Road
PERMIT NO.:
-Eagan, MN 55122 DATE:
Zoning; No, of Units:
Uvner: _
Address:
Site Address:
PI umber:
Meter No.: Connedion Cherge:
Size: Acwunt Deposit:
Reader No.: Permit Fee:
1 ogrse to compFy wieh the Ciry of Eagan Surcharge:
Ordinaneec. Misc. Charoes:
Total:
Bv Dute Poid:
Date of Insp.: Insp.:
CITY ?' EAGAN
3795, ot Knob Rood
Epgnn, MN 55122
Zoning:
Owner: -
Address:
Site Address;
Plumber:
I agree to eompip wifh the Citp of Eagan
Ordinonces.
By -
Dote of I nsp.:
I nsp.:-- -
SEWER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
Connection Charge:
Account Deposit:
Permit Fee:
Surchorge:
Misc. Chorges:
TotoL•
oare Poid:
CITY OF EAGAN
i ? • 8795 Pilot Knob Read
V/ Eayen, Mlnnesota 55122
Phone: 464-8100
PLtJMBZI?'G _ PERMIT
No.
015
Dote: ? ? . ... - . - , Receipt No.. ?
Singie
Site Address: Residential
Lot 1! Block SublSec.
Nome New/Alter./Repair n w
.
? Address Cost of Instullation
City ,".=inc7tc. . Phone: Permit Fee
Nome ?='nz-Ryan r'ltunljina c?atinv SurcFwrge
.
? Address
V
City Phone: Toto l -
This Permit is issued on the express condition that oll work shall be done in accordance with all applicabie State of
Minnesoto Statutes and City of Eagan Ordinonces.
Officiol
CITY OF EAGAN
? 3795 Pilot Knob Rood
Eo9oa, Minneaota 55122
Phone: 454-8100
! IIEATINC; _ PERMIT
No. 1 1 03
DOte: "':-.YJTUdry 24, I 1723
1 Receipt No.:
/-?-/ 7 Single ?
Site Address: -'? `irZson Ldke I°'..Residential '
17
Lot ?- Block Sub/Sec. Multi Res., Comm./Ind. I
Nome ,;d Petersen
New/Alter
/Re
oir
p
.
Address = 101 '. _ ? .= e
Cost of Installatlon
? _
City `;ioonington Phone: P
it F
erm
ee
Name I.-=`yan I'.ltu:lbin4 riE-.:i.r; ,, I,ar-
SurcF?orge
.
? Address '5 So. Robert Tr i.'
e
0
City Phone: Total
This Permit is issued on the express mndition that all work shall be done in occordorxe witfi ell applicable 5tate of
Minnesoto Statutes and City of Eagon Ordirwnces.
Building Official
CITY OF EAGAN
, 3795 Pilot Knob Rood Eagan, MN 59721 N? 4 6 2 ?
? PHONE: 454-8100
BUILDING PERMIT Receipt #k '
, To be usad for Date ? 19
Site Address - - Erect ? Occuponcy
Lot 4*17 Block SeclSub. - Alter ? Zoning
! Parcel # _ ; E1 Repair ? Fire Zone - -
lo
E
? T
of Const
n
rge ype
.
c
C Name ^r • 'Move ? # Stories
W
Z
3 Addreu Demolish ? Front ft.
0
r:... nL___ Grade fl Depth tt.
C? Nome _
0
0? Address
~ Ci
u?
?y W Name _
?
Address
I hereby acknowledge that i hove reod
the informotion is correct ond agree
State of Minnesoto Statutes and City
Signoture of Permittee
A Building Permit is issued to:
all work shall be done in occordonce with all
Building Official
me
applicoble
and stote thc
all applicabl
iontes.
Assessment _
Wcter 8 Sew.
Pol ice
Fire
Eng.
Planner
Council
BId9. Off. -
APC
Permit
$urchorge
Plon check
SAC
Water Conn. _
Water Meter
Totol
" on the express condition that
of Minnesota Statutes and City of Eocan Ordinances.
PsrnM # DaN Isaed hrealMM
Plumbeng /o
Mechcnical ?-
INSPECTIONS DATE INSP.
Rouph-In
Finol
Footings ? Dote Inap. Date Inap.
Foundation Plumbing
_ Frome/ins. ? - 2•5/_ ? ? ' 3'J •'7 9 Mechanicol
Fincl
Remarks:
Receipt???J MECHANICAL
? CITY OF EA
1. Date 1'02/' fl4F y 2. Installation Cost
/'W/ 7
3. Job Address Lot i ?
4. Owner
? Permit No. I ? 11 (0-
i
? Fee ?
J-2 s/c Tof' 7 80 I -
i
Ik. . , ? Tract ? ? 1 !
? -?T
5. Contractore-?F_ Phone yz
6. Address
7. City T State Zip '"
8. Building Type: Residentiall'o Commercial D Institutional ?
9. Work Description: New 0 Add O Alter -)Sf Repair ?
10. Describe Ae- ,^?=-? -- ?---•. \-.? _2 Fuel Type
11.
No,
? Eauinment BTU • M. Ea.
Forced Air No. Equipment CFM
Air Handlin
:
? Mfg. z- -- "" v o x g
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. 1 hereby certi that the above.-information is true and corre.ci, and I agree to
oomply wi;6r d;?aQd codes governing this type of work.
Signed : i G !72'?-'-- for
Rough Final
Inspections: Date Insp. Dat ? 3s Insp.,9zZ
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
IN
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITEADDRESS: ? ; ?; + ?, ;:.?.. . ., °, :
i f?! 1; 1+1 uF-
• . 11ft1 9,1114 I :1F'F 1 AM?-
,i?:.. •,:. . .
PERMIT SUBTYPE:
, t.rjJ-,j ,
ON REC4RD
PERMIT TYPE:
Permit Number:
Date Issued:
litt 11 111
NA
63WR6g
y14J25/!?7
APPLICANT:
"iEIA R()DFIW, -
TYPE OF WORK:
Mltf1[: 1 i 14+
RFFDnrR
i R(1t?!- TNEi)
J
v
15 '?Z?5 i"
?°
I
R
. 7 5 ? ?- ??.?
Permk No. PermR Holder Date Telaphona;
ELECTRIC
PLUMBING
HVAC
Inepectfon Date Inep. Commerris
FOOTINGS
FOUND
FRAMING
ROOFING
uo{
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAI PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK F7G
DECK FINAL
CITY OF EAGAN Remarks
Addition Lot 17 Bik 1 Parcel 10 8250 T30 01
Owner street 1217 Carlson Lake Lane State Eagan,MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK ??l 1973 176.05 8.80 20 123.25
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 3'
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 230.00 8630 12-29-77
13UILDING PER. #4621
-
-
sa,c 475.00 8630 TT-
ZD
-77
PARK
This aequest void 18 months from e4
Date of this Request /- ??? -;7CY P 14816
I, as kN Licensed Electrical Contractor O Owner, do hereby request inspection of the above electri-
cal'wiring installed at:
S6reet Address or Route N CityJ=-
7-
Section Townslup Range County
Which is occupied by '4-c? r%oreA.o.
Is a roughin inspeciion required on this job? No
Power Suppliet
Electrical Contractor ?
fCOmoanv Namel
Mailing Add
(Name of Oc<upant)
? Yes ? Ready Now O Will Call ?
Address Sig I 4.2d. Z?-' i
?- ontractor's License N0'135'S
Authorized
SYRi?E WARD CoPv
1 Minnesota State Board of Electricity
M4 University Ave., St. Paul, Minn. 55104-Phone 645-7703
REQUEST FOR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REOUEST
? jr oo 'r /
p 14816
Type oi Building New Add. Rep. Check Appliancea W'ved Fot Check Equipment W'ved Fm
Home ? ? ? Range ? Temporaiy Wiring
Duplex ? ? ? Water Heatei ? Lighting Fixtures ?
Apt. Bldg. ? ? ? Dryer ? Electric Heating ?
!'ommercial Bldg. ? ? ? Fumace ? Silo Unloader ?
Industrial Bldg. ? ? ? Air Condilioner ? Bu ank
. ?
Farm ? ? ? Lth ? L
?
-----
Other -
? ? ? ers
p
Here ? 14 t
r'
e
COMPUTE INSPECTION FEE BELOW -'7
Service Entrance Size: it Fee Feedera&Subfceders: # Fee Ciccuits: # Fee
0 to 100 Am s. 0 to 30 Am res 0 to 30 Am eres
101 to 200 Amps. 31 to ]00 Am eres 31 to 100 Am eces
Above 200 Amps.
1
1 Above 100 Amps.
Abave 100 Amps.
Transformers Remoce Conuol Ciic. Paztial or other fee
S' ns 1 1 Special lns ection Minimum fe
Remarks
.z,?or-n_?Y ?e-r??cP?
TOTALF E .?
G•-5
I, the Electrica! Inspector, hereby certify that the above inspection has been nlade-.-'
(Rough-in) Date
(Final) _
This request
months from
This,Xquest void 18 months from
11
U? a?-Zk
Date of this Request Februar.y 22, 1978 P 14 824
I, as 55 Licensed Electrical Contractor O Owner, do hereby request inspection of the above electri-
cal wiring installed at: /? ?
? 'fT
Street Address or Route No. 1217 Cnrl non T, k Ln - Lt. l7 Bl k 1 CityE,g2n
SecUon Township Range County Dakota
Whtch is occupied by Svend Peterson Consi:ruction
(Name of Occupant)
Is-a roughin inspection required on this job? No ? Yes 0 Ready Now ? Will Call 0
PowerSupplierDakota E7ectric Assoc. Address821 3rd St. Farningtony b1N
Electrical Contractor Ken Sorenson ELectric Contractor'sLicenseNo34385
(Campany Name)
MailingAddress 8070 12th Ave So, Bloomington. I•linnesota 55420
10?2 (Electrl ?a j?C,onira?° r? or Ownef Makfng 7hls Installatlon)
Authorized Signature/ ?L%:s??/ ?-Q.O?RIL4-D lIIIl Phone No.854-4470
Contractor or Owner Making This
STA71 BOARD COPY
Minnesota State Board of Electricity
?;,se154 University Ave., St. Paul, Minn. 55104-Phone 645-7703
REQUEST FOR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REOUEST
P 14824
Type o[ Building New Add. Rep. Ch¢ck Appliances Wired For Chock Fquipment Wited For
Home W ? ? Range ur Temporazy Wrting ?
Duplex ? ? Cl Watei Heater Q' Lighting Fixtuces ?
Apt. Bldg. ? ? ? Dryer e' Electric Heating ?
Commeccial Bldg, ? ? ? Fumace ? Silo UNoader ?
Industrial Bldg. ? ? 0 A'u Conditionec ? Bulk Milk Tank ?
Farm ? ? ? L' d? W List
Other
?
?
? p
A pthers
Hete
INSPECTION FEE
1 "]Ol to 200 Amps. I I 1131 to 100 Amperes 12 I 11.0e N 31 to 100 Amceces I I I
Remarks
Conplete House Wiring TOTALF yS0
I, the Electrical Inspector, hereby cerXtbat a ?nspe 'on has beep4n2 .
(Rough-in) .: . Date d
(Final) Date
This request void 18 months from
RESIDENTIAL BUILDIYC
Permit Application
City OfEagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
NewConstmclmnReouirement5 RemodeVReoairReauirements OKceUseOaN
3 regislered site surveys shaxing sq. ft. of lot sq. ft of house; and all roofed areas 2 copies of plan Cert of Survey Recd
(20°h mazimum bt coverage allowed) 1 set of Energy Cakulatbns tor heated additions Tree Pres Plan Recd
2 copies of plan showing beam 8 wiMow saes; poured found design, etc. 1 site survey for additions 8 decks Tree Pres Not Reqd
lsetotEnergyCakuWtlons Add'Non-indicateilrnsifesep6csystem _Oo-siteSeptlcSystem
3 mpies of Tree PreservaUOn Plan if lot plaUed after 7/1193
Rim Joist Oelail Opllons selec6on sheel (bldgs wAh 3 or less unAs
Date - 17- / /(Q / 6 3 Cons
tructiou Cost
Site Address ?2 /I (% /
Y? sz h?/y ( Q hC/il O UpiUSte # 1
Description oT Work ?? s-? qH g_/,y aS ( 1^ P dV&4,? rm 5p?^ I dh l? {1 /
aFi S!/la g,
Multi-Family Bldg _ Y? N 1
?7 EX/Sfl"N u
Fireplace(s) _ 0X 1
Property Owner (/ !/ 1 / k .0 , 1 3e il S (, A Telephone # 4_47)
Contractor Fl rC' j (')
Address ' L'ity
State Zip Telephone # (?5?
?176 . oa
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code CategOry . Residential Ventiladon Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber
Mechanical Contractor
Telephone #(
Sewer/Water Contractor
Telephone ??? ??2?
TelL
?44#(' II TEII..
I hereby apply for a Residential Building Permit and acknowledge thati(Che info_rmation is com lete and accurate;
that the work will be in conformance with the ordinances and codes oT-the City ofEagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved pin the case of work which requires a review and
approval of plans. //) 7 ?
?
AuU1?1 ;f , klo s1<,' S? ? Z,// A???'
Applicant's Printed Name App icant's Signatur
PERMIT
., ?TY OF EAGAN
383 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
51TE ADDRESS:
1217 CARLSON
LOT: 17 BLOCK:
WSLDERNESS PARK
P.I.N.: 10-84250-170-01
DESCRIPTION:
(ROOFIN6)
-:-.Building"?fsrmit Type
Building WiYH?, Type
' Census Co.de<°
?
?f
t ,ao
PERMIT TYPE:
Permit Number:
Date Issued:
LAKE LANE
1
SF (MISC.)
REPAIR
434 RLT. RESIpEN7IAL
?? {_r?f 11
e ?"?'J ?"a ?1 I
BUILDING
030859
09/25/97
REMARKS:
FEE SUMMARY:
VALUATION
Base Fee
Surcharge
Totel Fee
$112.25
$3.00
$115.25
$6,000
CONTRACTOR: _ ppplicant - sT. Lzc OWNER:
SELA ROOFING & REMOOELING 18236046 0001050 BENSON MIKE
4160 EXCELSIOR BLVD 1217 CARLSON LAKE LN
ST LOUI3 PARK MN 55416 EAGAN MN 55123
(612) 823-8046 (612)688-3365
i hereby acknowledg,e ,that.2 hav,e read,this.`appliGat,ion and.?statE that the
kn'Formetiotl is correct.and,agree to_c;ortiply wi'th allapplicable §tafe of fqn.' r .. = av!. m.. . r F_
?
? Stetutes aotl City qf Eagan Ordtnances.=
.9;?1_? m.?
R
APPLICANT/PERMITEE SIGNATURE - lED EIY: SI AT R
CITY OF EAGAN
3830 PILOT KNOB RD - 55722 &41 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) °?•?
681 -1675
RemedeVReoeir Reeuiremenls
? 3 repistered sRe eurveys ? 2 copies af plan
? 2 copies of plana (include beam 3 window sizes; poured fid. design; etc.) ? 2 sfte surveys (axterior addRions & decks)
? 1 energy eelculations ? 1 energy calculatlons Tor heated addkions
? 9 copies of tree pieseevsrion plen N bt pfatted sfler 711193
requfred: _ Yea _ No DATE: 91""7 CONSTRUCTION COST: _5,2 6 a
DESCRIPTION OF WORI
STREET ADDRESS:
LOT ? BLOCK _-L- SUBD.lP.I.D. #:
PROPERTY
OWNER
CONTRACTOR
Name: ??ikP AU6'bd Phone #: 6?g"3?b5?
w, ?..
Street Address' ?/
Ciry: i96f9? State: IXt) Zip:
Company: . Phone #: 90218oL'
4100E1tMLO"BLVD.
Street Address: ST. LOUISPARiC.MINNES= 5541F License #• /DSo
??5lto001ti?v
City: 5tate: Zip•
ARCHITECTI
ENGINEER
Company: Phone M
Name: Registration #:
5treet Address,
City:
Sewer & water licensed plumber:
change are requested once pertnR is issued.
State: Zip'
Penaity applies when address change and lot
f hereby acknowfedge that 1 have read this application and state that the information is conect and agree to comply with atl
applicable State oi Minnesota Statutes and City of Eagan Ordinances.
'l
Signature of Applicani:
OFFICE USE ONLY
Certificates of Survey Received _ Yes No
Tree Preservation Pian Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
1?'' '•,? •i,?• 'Cqpi ?"s` ?n
0 01 Foundation 13 -06 Duplex o 11 Apt./Lodging ? 16 Basement Finish
0 02 SF Dwelling o 07 4-plex o 12 Multi Repair/Rem, 0 17 Swim Pool
0 03 SF Addition o 08 8-plex o 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch o 09 12-plex o 14 Fireplace o 21 Miscellaneous
a 05 SF Misc. 0 10 _-plex o 15 Deck
WORK TYPE
0 31 New o 33 Alterations a 36 Move
n 32 Addition t)K 34 Repair N aG o 37 Demolition
GENERAL INFORMATION
ConsL (Actual) Basement sq. ft. MClWS 5ystem
(Allowable) Main Ievel sq. ft. City Water
USC Occupancy sq. ft. Fire Sprinklered
Zoning s4. ff. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bidg
Census Unit
APPROVALS
Ptanning Buiiding Engineering Variance
Permit Fee fia, a5
5urcharge ?
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Pertnit
S/VY 8urcharge
Treatment PI.
Road Unk
Park Ded.
Trails Ded.
Other
Copies
Total: 0?5
Valuation: $
92, SAC
SAC Units
_ • ciTr oF EAcaN
e 3795 PiIM Knob Rond Eagan, MN 53722
< PHONE: 4548100
BUILDING PERMIT APPLICATION $76,500. Receipt #
N° 4621
8630
To ba und for SinE_ Fam 7hul e_R l:a ? Date DeC. 29, 19 77
sire nddreu 1217 Carlson Lake Ln Erect px OccuPar,cy I
Lor 1P Block 1 sec/Sub. Wilderness Park AdORer 0 Zpning Rl
parml .# 10 R4250 1 70 Ol Repair ? Fire Zone 3 _
Enlorge ? Type of Const. V
w Nome Svend Petersen Const Move
?
# Srories
z
Z Address 4701 W. 110th St, pemolish ? Front 46 ff.
o OotR n ton 884-5144
? Grnde ? Depth 48 fr.
Ci hone
p Name _
r
?? Addreu
? ?:..
Name
I hereby acknowledge that 1 hove read this
the information is correct and agree iog
$tate of Minnesota StaTytec-erd?Cit' _c?Qf '
Signature of Permittee
A Building Permit is issue
all work sholl be done in
oll
Feea
Assessment Permit L251. VU
Water & Sew. Surchorge 38.50
Police Plan check
Fire SAC 475.01
Eng. Water Conn. 230.00
Plonner Water Meter 60.00
CounCil
Bidg
Off
.
.
APC
Total 984.50
?
end Petersen Const:'
on the expreu candition that
apDliwble/5tote of Minnesota Stotutes and City of Eagon Ordinances.
Buildirg Official _ac
. .. . . DnTa
BUILDING PF.RMIT APPLICATION
2nclude 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations.
Zb be used for G
Site AddresE: % 2.17 4CC1e_
Valuation
a ??11--
??/G DL>r%?G'f'
Lot 17 Block / Sec. Sub, Parcel Number / 6 Yy-J??e5
OwneT .?jJ?/L:? ??G ? c.2 5 C= it/ (i C%?'?S?".
Address 417c/ 1e/ 1/O-E'' SE-
?Lc:u;'siiv'? 7d:? s 5 Y> 7
Contractor
Address
Telephone lf 7 -
Telephone 5,7 y ? `7 / y ?z
Arch./Enq.
Address _
Telephone
OFFICE USE
Erect
Alter
P.epair
Enlarqe
Move
Iemolish
Grade
Occupancy Z
Zoning ? !
Fire Zone 3
Type of Gbnst. ?
# of Stories ?-
Front
Depth
OFFICE USE
Date of Approval & Initial
Assessment 9P/] y
Water/Sewer
Police
Fire
Enq.
Planner
Council
81dg. Off.
A.P.C.
FEES
Petmit _'za=
Surcharge 3 ?
Plan Check
SAC - n`
..".a -
A?ater Conn.
tlater Meter O
TOTAI,
- certif3cate for:
_ $,vgnd Peterson
4711 Weat 11^th sr,
.„
,?Id(a.'+:t!Lj.y:.)(1 -'. +
DELMAR H. SCH WA N Z
LAND StJR V E V OR
Reyistered Untlar lAws of The Slate o} M-nnesota
14516 SOUTH ROBEpT TRAIL P.O. OOX M R08EMOUNT, MfNNESOTA 55068 V-y:.;??P ?•fi?
S
??.4'•? _
: IM
30
30
T hereby certiPy that thia ia a true a.nd correct repregentation oP
Lot 17, Block 1, W?LU'-7RNFSa PAFK ADLITION, sccorQing to the recorded
plat thereof, Daknta Courity, Minneaot a.
Aldo showing the location of a propoBed house as #taked thereon.
D3ted: Dec. 9, 1977
,4
• ? 1 / 7 ?. ??'
MINNESOTA REG15TFtATION N0.8625
PHONE 812 423-1769
' SURVEYOR'S CERTIFICATE
Dakota County Real Estate Inquiry
Dakota County Real Estate Inquiry
Data Updated 1112512005.
? i.
F ?? rF
..'.`?...,v??• ls°
f j
r
10-84250-170-01 2005 Est. Value (Payable 2006): $313,500
er: MICHAEL D& WENDY E BENSON 2004 Taxable Value (Payable 2005): $280,
ess: 1217 CARLSON LAKE LN Pavable 2005 Tax: $2,718.42
EAGAN, MN 55123 Total Acreape: 0.47
Year Built: 1978
Page 1 of 1
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2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
,? 15.5a
Date ? 1 ? ! (6)_
I
Site Street Address l'ca`tb}`-? lo U l? Unit #
Property Owner Telephone #(lg?) U?? ?13 ?XS
Contractor?? Tetephone
Address l--?Z OCity V\_-11J?. State_U.?__ Zip??
The Applicant is: _ Owner ? Contractor _Other
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes putting in a water softener and/or water
heater at the same time. If you are insiallinq onlv 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 $125.00 if a 5/8" meter is required)
Other:
7 Water Softener _ Water Heater : $ 15.00
_ new ? replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total $?
I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved. ,
Applicant's Printed Name IicanYs Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA122852
Date Issued:05/21/2014
Permit Category:ePermit
Site Address: 1217 Carlson Lake Lane
Lot:017 Block: 001 Addition: Wilderness Park
PID:10-84250-01-170
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Audrey Flattum
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Timothy J Star
1217 Carlson Lake Lane
Eagan MN 55123--171
(651) 434-0480
Pro Tech Restoration Inc
1355 Geneva Ave N
Suite 210
Oakdale MN 55128
(651) 776-8324
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA131955
Date Issued:07/16/2015
Permit Category:ePermit
Site Address: 1217 Carlson Lake Lane
Lot:017 Block: 001 Addition: Wilderness Park
PID:10-84250-01-170
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Timothy J Star
1217 Carlson Lake Lane
Eagan MN 55123--171
Haley Comfort Systems
122 3rd St W
Hastings MN 55033
(651) 437-0338
Applicant/Permitee: Signature Issued By: Signature