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1296 Balsam Tr E CITY OF EAGAN 6401` 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 r ' BUILDING PERMIT Receipt # To be used for r p•' Est. Value Date f;. 19 t n Site Address 1;9f, E MLSAr' "r Lot Block 1 Sec/Sub. W! Lrl''-- t: OFFICE USE ONLY Parcel No. t a Occupancy FEES Zoning Name n4 . DiW (Actual) Const Bldg. Permit 3 Address 1295 L EALSA'•i P (Avowable) Surcharge t O City ''_a,y=.'AV Phone 452--2416 # of Stories - Plan Review Length Zp Name `'AtfF Depth SAC, City cUi¢ 191 Address S.F. Total SAC, MCWCC City Phone S.F. Footprints On Site Sewage Water Conn w W Name On Site Well Water Meter Address MWCC System Acct. Deposit aw City Phone City Water S /W Permit PRV Required II I hereby acknowlege that I have read this application and state that the Booster Pump S.,W Surcharge I . information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Treatment PI Signature of Permitee APPROVALS Road Unit A Building Permit is issued to: &ONAL0 G~, •KARY z LEARCI' 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 Variance TOTAL 60' i Permit No. Permit Holder Date Telephone # WATER SEWER PLUMBING I H.V.A.C. ELECTRIC Inspection Date Insp. Comments Footings I f 2 ~I Foundation I Framing Yin Rooting Rough Plbg. Rough Htg. Isut. Fireplace Final Htg. Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final Deck Fig. Deck Final Well Pr. Disp. l CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN .S3122 N2 5612 PHONE: 454.8100 BUILDING PERMIT Receipt # To be used for Est. Value Dote , 19 Site Address Erect ❑ Occupancy Lot Block Sec/Sub. Alter ❑ Zoning Parcel # Repair ❑ Fire Zone Enlarge ❑ Type of Const. W Name Move ❑ # Stories 3 Address Demolish ❑ Front ft. Grade ❑ Depth ft. city Phone Name Approvals Fees 0 Address Assessment Permit ~ City Phone Water & Sew. Surcharge Police Plan check ~i Nome Fire SAC u~ Address Eng. Water Conn. <W City Phone Planner Water Meter Council I hereby acknowledge that I have read this application and state that Bldg. Off. the information is correct and agree to comply with all applicable APC Total State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permit-tee A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Permit # oee. Plumbing _ Mechanical 7705 INSPECTIONS DATE INSP. Rough-In Final Footings Date Insp. Date Insp. Foundation Plumbing Frame/ins. Mechanical Final Remarks: q4, / r rPBUST10" ATT'. FIQUIP CITY of EA"N 3745 Pilot Knob Road Eagan, Minnesota 55122 Phone: 554.5100 TMATTNG PERMIT No. 17r Date: 2/7/80 Receipt No.: ,r Single I Site Address: Z.?96 r_ast Balsam Tri . Residential Lot Block Sub/Sec. ''er* c s IF'Ir Cli Multi Res., Comm./Ind. Name =i1'e;~ :iC?!e>3 Iric New/Alter./Repair 8 027 So. Sne1"l-I of Address Cost of Installation St. Paul, gy City Phone: Permit Fee r r. ~ ~ i- Name `sinc`,T 'Ifm Surcharge =2G Last T' . Address City Phone: Total This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official CITY OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 Phone: 454-8100 PERMIT No. Date: Receipt No.: Single Site Address: _ Residential Lot Block Sub/Sec. ildei'IleBs Ran t 4 ' Multi Res., Comm./Ind. 3F _r~ Name - New/Alter./Repair Address Cost of Installation City _ Phone: Permit Fee iT. t1i Name Surcharge F^Y'iri tv Address _CQ V City Phone: I TotoI This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official SEWER SERVICE PERMIT , CITY- OF EAGAN 3795 Pilot Knob Road PERMIT NO.: Eagan, MN $5122 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: I 1 agree to comply with the City of Eagan Connection Charge: Ordinances. Account Deposit: Permit Fee: Surcharge: By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: CITY OF EAGAN WATER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eagan, MN 55122 DATE: Zoning: No. of Units: Owner: Address: Site Address: Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: agree to comply with the City of Eagan Surcharge: Ordinances. Misc. Charges: Total: By Date Paid: Date of Insp.: Insp.: CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 \ SITE ADDRESS: r nt t APPLICANT: PERMIT SUBTYPE: TYPE OF WORK: INSPECTION TYPE DATE INSPTR. INSPECTION TYPE .DATE INSPTR. Permit Holder Date Telephone N PLUMBING HVAC Inspection Data Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST 42 Z;/ FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG - - - DECK FINAL L INSPECTION RECORD Control No. 0429 CITY OF EAGAN PERMIT TYPE: ~,t, I L n Mss 3830 Pilot Knob Road Permit Number: 0pr6~~ Eagan, Minnesota 55123 Date Issued: • S 2 (612) 681-4675 SITE ADDRESS: L O T: 6 BLOCK 1 APPLICANT: , 1296 BALSAM TR E PANCLGRAFT WILDERNEV RUN 6TH (6]. S 721-6620 PERI 4Ty~P ANPt TYPE OF WORK: ALTERATION INSPECTION SPL .DATE INSI3TR. rr FINAL I.. I. , II RFMARKS: SIDING. SOFFITS. 6 FASCIA ..-r Pwmk No. Pem it Holder Dale Telephone # S/W PLUMBING HVAC ELECTRI ca4 ELECTRIC Inspection Date Inep. CommeMe it Footings l Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Flreplace Final Htg. Orsat Test Final Plbg. Plbg. inspector - Notify Plumber Coast. Meter EngrJPlan Bldg. Final Deck Ftg. Do& Final wen Pr. [Nap. CITY OF EAGAN Remarks Addition Wilderness Run 6th Lot 5 BIk 1 Parcel 10 84355 050 01 OwnerL`__~,T Street 1296 East Balsam Trail State Eagan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 1973 161.21 8.04 20 96.73 A009023 4/21/80 Q1CV SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA 3141977 162.14 15 118.94 A009023 4/21/80 STORM SEW TRK 331.75 22.11 15 265.42 A009023 4/21/80 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. SIDS, 00 17962 2111/80 BUILDING PER. 17862 2.11 I/Ro SAC 1; 5 n 17A62 7.1111 R PARK This uest void 18 months from G 1. Jr 4'" Date of this Request 11-7-1979 3 0 6 3 2 I, as€2Licensed Electrical Contractor ❑ Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. 1296 Fast Balsam City Eagan Section Township Range County Dakota Which is occupied by Tilsen Homes (Name or occupant) Is a roughin inspection required on this job? No El YestR Ready Now ❑ Will Call$ Power Supplier Dnknta. Cty. Address Farmington Electrical Contractor O.R. Thomnaon F.1 entric Co. Contractor's License N(AIBL2 (company Name) Mailing Address Mtlcp 553.43 (Electrical Cont actor or Qwner a ing This Installation) Authorized Signature f'a. Phone No. (Electrical Contractor or Owner Making'TNs Installation) 2787 0VaLd~ ~OpW This inspection rProper eriinp accepted by the L State Board unless ins inspection fee is is enclosed. A Minnesota State Board of Electricity University Ave., St. Paul, Minn. 55104-Phone 645.7703 REQUEST FOR ELECTRICAL INSPECTION n CHECK BELOW WORK COVERED BY THIS REQUEST 0 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home a ❑ ❑ Range :U4 U0 Temporary Wiring ❑ Duplex ❑ ❑ ❑ Water Heater ❑ Lighting Futures 30 Apt. Bldg. ❑ ❑ ❑ Dryer ❑ Electric Heating ❑ Commercial Bldg. ❑ ❑ ❑ Furnace fR2.00 Silo Unloader ❑ Industrial Bldg. ❑ ❑ ❑ Air Conditioner ❑ Bulk Milk Tank ❑ Farm [j Lis[ List ❑ ❑ pp pp other ❑ ❑ ❑ Hertersf Dish- Herreers COMPUTE INSPECTION FEE BELOW Service Entrance Size: # Fee Feeders&Sub.f6eclem Fee Circuits: Fee 0 to 100 Am s. 0 for 4Am res 0 to 30 Amperes 101 to 200 Am s. 2 0II t 'A h _ rps 31 to 100 Am eres Above 200_Amps. - Tj Ol> Amps. Above 100 Amps] Transformers em " Control Ciro. Partial or other fee Signs [:Special Inspection Minimum fee Remarks $-.11 TOTAL FE 36-5C I, the Electrical Inspector, hereby c }Ghatjt~e{overinspection has been made. (Rough-in) LL Date 3- 7 (Final) Date -3 This request void 18 months from Request Date Fire No. Poul Inspection Required? 'Ready Now ❑ Will Notify Inspector d' ❑ Yes It-4. When Ready? I i~1icensed contractor ❑ owner hereby request inspection of above electrical work at: Job Addre's^s (Street, Box or Route No.l City &LS4m l(Yli Qv\_ Section No. Township Name or No. Range No Coun I}~ Occu t(PRINT) Phone No. i CSVWI_dn__, 4510t-aL O Po er Supplier Atldmss fries ~d C~rfL° tk55~ 340- S~ W F4rmt 40 Electrical Contractor (Company Name) Conlracto 5 License No. 'A%& - fonc4 rn E jrit InC , Q 7 Miring Aad,ess (Coml. or or Owner Makipgi tallalion) 04 I an _ M N SS I~ 1 v d on) k_ e _1U l 1 E Aulhgnz 19 plure (Co w g Install ion) T Pho ' Number { \I YJO_~q MINNES TE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S,173 BE ACCEPTED BYTHE STATE BOARD 1821 University Ave.. St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) (PIMB00 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION 6 yy~~ EB-ooom-oe f• See instructions for completing this form on back of yellow cony. °g°": V1` 5 8.9~, "X" Below +NVrk Covered by This Request ew Add Rep. Type 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 (spacifyl Contractors ~Remarks: <y. W -r Compute Inspection Fee Below: Keoue al A r(3%tgd I Ed.) # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 700 Amps Transformers Above 200 Amps Above 100 _ Amps Signs inspectors Use Only. TOT li- Irrigation Booms / 1 Gr, ~,Jd Special Inspection t v Alarm/Communication THIS INSTALLATION MAY BE ORDE CONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in oate certify that the above inspection has Final ( oat been made. OFFICE USE ONLY This request void 18 months from d 09960-P,~ 0 as p C1Q- ' , 413 Request Date ire No. Rough-in Inspection ! Required? f0 featly Now Owill Notify Inspector ` Yes No When Ready? D r I Oficensed contractor ❑ owner hereby request inspection of above electrical work at: clfi; rL Job Adder. (Street Box or Route No,) City Section No. Township Name or No. Range No. County A v~ r°- hF~ Occupant (PRINT) Phone No. 1) L///(/ "Y Power Supplier Eleclocal Conlrador (Company Name) Contractors License No. Mailing Adorers (C0 tractor or Owner Making Instaaa,o^.) V/ S Auth etl Signalur nO er axing Installation, Phone Number MINNESOTA ST OE BOARD OF LECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1621 University Ave., St. Paul. MN 55106 UNLESS PROPER INSPECTION FEE IS Phone (612) 6,12.0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB 00001-09 ► See ins(maions fWn,pleting this form on back of yellow copy. 74 l 1/2-Y I 6 A _d 0 9,9 6 Q - iX" Below Work Covered by This Request `•y 3/a/ s New Ad ep. Typeot 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 lspecifyf Contractors Remarks: Compute Inspection Fee Below: #r Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 _ Amps Above 100 _ Amps Signs Inspectors Use Only TOTAL Irrigation Booms )i~ /_j/~Q ISpecial Inspection I° Alarm/Communication THIS INSTALLATION MAY BE ORDE ISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Roulti - Date certify that the above inspection has Final Date been made. OFFICE USE ONLY This repuest void is months from g . rt (Urtifiratr of Orruvaury Citp of (Eagan l9quitrimeni of BuilDittg Jnspertion This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building r j ~1I Code certifying that at the time of issuance ibis structure was in compliance with the various ordinances of the City regulating building construction or use. For the f ollouvng:. .1 SF DWLG/GARAGE 5612 F U. ck ifiwo. ewe. Nm INo. o~wm'ryw R3 Ty,,c uW . V F.z. III zem~wm« Rl Omer o( BUUaiµ Donald Shearon Add. 2494 E.Meadow Dr. t.Paul,." a+ r, r BwmftAae,. 1296 East. Balsam T& Y L5 Bl Wilderness Run 6th to ft r - euw~comcid o..: 4/14!80 r, PERMIT "Y OF EAGAN Pilot Knob Road PERMIT TYPE: B U I L D I N G Minnesota 55122-1897 Permit Number: 0 3 2 9 5 2 (612) 681-4675 Date Issued: 08/18/98 SITE ADDRESS: 1296 BALSAM TR E LOT: 5 BLOCK: 1 WILDERNESS RUN 6TH P.I.N.: 10-84355-050-01 DESCRIPTION: Bu~,XdAl,rrggPermit Type FIREPLACE BW'1:Ld"dng 64~-k Type ALTERATION pnsu,s5 Code 434 ALT. RESIDENTIAL f E yea }q. 1? 3 HI gR $ YW" y _ W 7- o f i t6 d! - ms as ali ~ n's vr~ Su` is'. -4"'1 E '4 ~ 6 a "sJctt np~' qg i 1 ci un„ c acre r< se Ria ~ ~a @ 4 REM&.EY/FLUE MUST BE INSPECTED BEFORE CONCEALING. FEE SUMMARY- Base Fee $50.00 Surcharge $.50 Total Fee $50.50 ~~±±~~NNTRRp~!TO - Applicant - ST. LIC. OWNER: HEST-N"G'Cb FIREPLACES 18900758 20090911 SHEARON DON 3850 W HWY 13 1296 BALSAM TR E BURNSVILLE MN 55337 EAGAN MN 55123 (612) 890-0758 (651)452-2416 I he e!a'y ackrci:wledge 'th t S have°=read ,thie app'- Y at%on an.d~state- =Cbat,-th* zr~formittan it carre`ci airui` agree 'to ct mPly yi.1 h X11 -zpplcatl .Stt~ °1s Mn, S'- atute~ ~rttt° City af: Eagan Drd3ria~deis: J a APPLICANT/PERMITEE SIGNATURE -,j ISSUED BY. SIGNATURE CITY O EAGAN CASHIER: S TERMINAL_ N0: 780 DATE: 08/iS/98 TIME: 15ai9.:Lt ID." NAME: ALLIED FIRESIDE INC. 320 9001 i296 BALSAM TR 50.00 RJ.55 9001 1296 BALSAM TR 0.50 3ta7. Receipt Amau t. 50.50 0962G<7 -R ID NANCY 3agSa ~o SCE CITY OF EAGAN l 3830 PILOT KNOB RD - 55122 1998 FIREPLACE PERMIT APPLICATION 681-4675 q /n DATE: PERMIT FEE: $50.50 DESCRIPTION OF WORK: Construct new fireplace - Alterations to existing Install gas insert onW _ Install eas line only Other t)ct- SC0. JOB ADDRESS: / pC E-"f U, I Q VVl r LOT: BLOCK: 1 SUBDMSION/P.I.D. W-KIAU~-VI ~ ~U n APPLICANT (circle one only): OWNER CONTRACTOR 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. Name: G(rr)P, ~Q Phone PROPERTY Last First OWNER Signature: Street Address: ip t~ - /~(Q SO 1 --rraf j c~7 City O N ri h State: & Wj Zip: /off Company: lcre S(`~ P LW t4 &10 S1W0 Phone FIREPLACE r INSTALLER Signature: Street Address: i 5 License # ~2a L2 qv city 6 U r dl S V t Tt? State: WV' Zip: Company: Phone GAS LINE INSTALLER Signature: Street Address: D PERMIT Control No. 0429 CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: BUILDING Eagan, Minnesota 55123 Permit Number: 000543 (612) 681-4675 Date Issued: 05/14/92 SITE ADDRESS: 1296 BALSAM TR E LOT: 5 BLOCK: 1 WILDERNESS RUN 6TH DESCRIPTION: Building Permit Type MISCELLANEOUS Building Work Type ALTERATION UBC Occupancy R-3 REMARKS: d -17-7-7 SIDING, SOFFITS, & FASCIA FEE SUMMARY: VALUATION $6,000 Base Fee $81.00 Surcharge $3.00 Total Fee $84.00 CONTRACTOR: - Applicant - ST. LI OWNER: PANELCRAFT 17216628 000217 SHEARON DONALD 3118 SNELLING AVE S 1296 E BALSAM TR MINNEAPOLIS MN 55406 EAGAN NN (612) 721-6628 (612)452-2416 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 Mn. Statutes and City of Eagan Ordinances. L-! A PLICANT/PERMI E SIGNATURE ISSUED ST. SIGNATURE INSPECTION RECORD Control N 0429 CITY OF EAGAN PERMIT TYPE: ` BUILDING_ 3830 Pilot Knob Road Permit Number: 000543 Eagan, Minnesota 55123 Date Issued: 05/14/92 (612) 681-4675 SITE ADDRESS: LOT: 5 BLOCK: 1 APPLICANT: 1296 BALSAM TR E PANELCRAFT WILDERNESS RUN 6TH (612) 721-6628 PERMIT SUBTYPE: TYPE OF WORK: MISCELLANEOUS ALTERATION INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR. FINAL REMARKS: SIDING, SOFFITS, & FASCIA F L PERMIT # CITY OF EAGAN 1992 BUILDING PERMIT APPLICATION 681-4675 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural.& structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which re jest is made jr lot change is re guested once permit is issued. Date / ~ C_ / 9Z- Valuation of work Syd U Site Address: 12,7 "34-L5,+/'1 `77i/lL STREET STE A' Tenant Name: (commercial only) LOT _ BLOCK SUED. Y~ P.1.D. 9 (,V~P1~I19/~- ~JAA{, L..W Description of work: /,L'J 51DitK,- Sow P= 5ccv°r- The applicant is: ❑ Owner _.0-6ontractor ❑ Other (Describe) Name SH454,, oAD /Do Phone Property LAST FIRST Owner Address 12.76 3,sa T,~XHL STREET STE M City IIU,l=J State r~iV Zip Company f Phone 7Z1 628 Contractor Address Q/8 SAIcLLItill ,q've S6 License #CV62in Exp. City P/fO State 141,V Zip 5> ~O6 Company _ Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber. Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this appplication and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 05 Apt. Bldg ❑ 09 Basement Finish ❑ 13 Comm/Ind New lp:02 SF Dwg. ❑ 06 Garage/Accessory ❑ 10 Swim Pool ❑ 14-Comm/Ind Add ❑ 03 Two family ❑ 07 Fireplace ❑ 11 Res. Add. ❑ 15 Comm/Ind Rem ❑ 04 Multi-fam. T.H. ❑ 08 Deck ❑ 12 Res. Porch ❑ 16 Public Fac. ❑ 17 Agricultural WORK TYPE ❑ 31 New ❑ 33 Alterations ❑ 35 Move C7-paip~ ❑ 32 Addition ❑ 34 Tenant Finish ❑ 36 Demolish GENERAL INFORMATION Const. tActual) Basement sq. ft. MWCC System (A1Towable) 1st F1. sq. ft. City Water UBC Occupancy R-3 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code Depth On-site sewage SAC Code APPROVALS Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ~-ma New 51501 ❑ Site ❑ Footing O Framing ❑ Insulation ❑ Wallboard ® Final ❑ Draintile ❑ Fireplace Permit Fee ~l. a n Valuation: s Ob D Surcharge 3,0 Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Copies Other Total: F SAC % SAC Units CITY OF EAGAN N? 16408 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for GARAGE Est. Value $4,000 Date MAY 4 to 89 Site Address 1296 E BALSAM TR Lot _5 Block 1 Sec/Sub. WILDERNESS RUN OFFICE USE ONLY Parcel No. 6TH Occupancy FEES Zoning M Name DONALD & MARY SHEARON (Actual)Const Bldg. Permit 64.00 o Address 1296 E BALSAM TR (Allowable) Surcharge 2.00 City EAGAN Phone 452-2416 #of Stories Length Plan Review io Name SAME Depth SAC, City 0~ Address S.F.Total sA0.MCwcc City Phone S.F. Footprints On Site Sewage Water Conn ww Name On Site Well Water Meter i'a Address MWCC System of Acct. Deposit <w City Phone City Water PRV Required S/W Permit I hereby acknowlege that I have read this application and state that the Booster Pump Snm Surcharge information is correct and agree to co ply with pit applicable State of Minnesota Statutes and City of Eag di nce Treatment PI Signature of Permitee APPROVALS Road Unit DONALD OR MARY SHEARON Planner Park Ded. A Building Permit is issued to: on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of agan Ordinances. Bldg, Off, Copies Building Official J_!/ `u. I~ . 1I Variance TOTAL 66.00 1989 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS I WO J INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SIIRVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNEB MOST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS t OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS APR 2 8 1989 /o e / To Be Used For: Valuation: ui~--=J Date:/ z/`J Site Address r,41 S;4M ri"I OFFICE USE ONLY Lot -5570 Block 0 Occupancy FEES / Zoning Parcel/Sub W/Lpi5AAi,6SS RNN /dT~'AOh Actual Const Bldg. Permit Allowable Surcharge z. Owner JfpIV/r~/J /'7l~/2) sffL`/{~°o/V # of stories Plan Review Length SAC, City Address 120J( F__ rALSyAj Depth SAC, MWCC S.F. Total Water Conn City/Zip Code r--19 G/f N y- L /2 3 Footprint S. F. Water Meter Acet. Deposit Phone z- - -7- On site sewage- S/W Permit On site well S/W Surcharge Co tractor eo 6-L. y'A"o on sj MWCC System Treatment Pl. ~F'cR ryy~o Nab v con c k~~~ City water Road Unit Address Col SAX S'a, PRV required Park Ded. Booster Pump Copies City/Zip Code 70.i" "f-2 TOTAL APPROVALS Phone fry _ 2 h v Planner Council Arch./Engr. Bldg. Off. !M5/I Variance Address City/Zip Code Phone 9 NOTE: Sewer & Water Permit fees and account deposit fees will be included in the building permit fee. Processing time for sewer and water permits is two days once a licensed plumber has applied for a permit at City Hall. F-71751 ' ,P_E/~,2 O,eoyE~eTY LwE -r ~ S L7.~ N GAK^E I I "ou / rsoreKRSS 0 6--~- 2r ~~oP~erY ~D'YIGL~Ln~ ~~~~2r/J LINE loZ 9(o G .Q~~'37 .J/~Q.c~` , - .clam. r'}Ytm . 55r 23 M I LOT i3Lae K GYLC1dd. ~oncT_~R~?aFrzrY _LINE L~ -P I nT -4 1. AN CITY OF EAGAN .r 3795 Pilot Knob Road Eagan, MN 55122 N?5612 PHONE: 454.8100 BUILDING PERMIT APPLICATION Receipt # ~7 l%~ To 1, ■and for SF Dwlg/Garage Est. vol1e 52,000.00 Date February ll,lq 80 Site Address 1296 East Balsam Trail Erect 6 Occupancy R3 Lot 5 Block 1 Sec/SubWii derness Run 6th Alter ❑ Zoning Rl Parcel # Repair ❑ Fire Zone III Enlarge ❑ Type of Const. V c Name Donald J. Shearon Move ❑ # Stories z Address 2494 E. Meadow Drive Demolish ❑ Front 5A ft. Ci St.Paul 55109 Phone 777-2092 Grode ❑ Depth 37 ft. o: 7 Tilsen Homes Inc. Approvals Fees p Nama u13 Address 627 So. Snelling Avenue Assessment 2 80 Permit 143.50 _ Ci St. Paul, 55186 phone 698-5501 Water & Sew. Surcharge 26.00 Police Plan check 71.75 Ww Name Fire SAC 525.00 t-w ua Address Eng. Water Conn, n3 5 - 00 aw CI Phone Planner Water Meter hh _ 00 Council 1 hereby acknowledge that I have read this application and state that Bldg. Off. 2 6 80 the information is correct and agree to comply with all applicable APC Total 1.131.25 State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Building Permit is issued to: Ti l aai Pa Tnn on the express condition that all work sholl be done in accordance w't all applicob Stote of Minnesota Statutes and City of Eagan Ordinances. Building Off(cioi~~~`- "Q~"~_>✓~f • DATE BUILDING PERMIT APPLICATION Mrrclude 2 sets of plans, 1 site pln w/elevations and 1 set of energy calculations. To used for p,5'//~ Y-/ C bet--- Valuation 6 cif Site Address: 4"` Lot Block r See. Sub. Parcel Number Owner Telephone o'tO9C2 Address p? 10 Contractor r q Telephone fO Y Q " ~JQ Address &a1 Arch./Eng. Telephone Address OFFICE USE Erect Occupancy R 3 Alter Zoning Repair Fire Zone 3 Enlarge Type of Const. Move # of Stories Demolish Front Js7S Grade Depth OFFICE USE Date of royal & Initial FEES Assessment Permit fy3 Water/Sewer Surcharge Police Plan Check Fire SAC Eng. D/ateX Conn. Planner 4Tater P9eter O Council N41 P. Bldg. Off. f/D A.P.C. TOTAL 94/. 3 f ;r/902 AooooeATY L.WE I ' S rl N ~a v 0 G y 30 i LINE AEP T 1/ OV D'Y) L~.XGK ~~YZ~ I 1a9~ amp .~/lLzc~ . 55123 M LOT 3Lac k ~orsT'.. ?RO i~Fft2T Y L i_[1 G' -PLOT -4 L NN EXTERIOR ENVELOPE SPACE "U" COMPUTATION (To be submitted with building permit application) One .or twjo family dwelling ~ Owner All other site Address Date Z- - n('-) Phone ry~,ratetor pT 017 ?Fii 3 1 7. +142y+ + + + + X4 ft. above grade= W•L ' -4 TOTAL EXPOSED W LL AREA S FT t •5= 4•z 13.ga i 13.9z+1~X 1 50 N. a+~ 5*20~c c~ 7 -z >F I$3D.''f . [~r~• - `1,~~' ~I. `f.YINSTRUCTION: "U" VA11ze X area 17 3-2.'-,, + 2'~ 7 1r r ~t k4 „U„ X sq. ft. _ (U) W F } d; nl]" X Sq. ft. (U) (4),, pull s. ft. Der£ls.reference Pax Sr [ CRAR7£ X s q ft. _ R (U)' rom q' attachgd,aheeta COnI Ci2EtF ~ P-_-„U„-- - -X s sq. ft. ft. / 7 a _V ((t ; „U„ x sq. ft." _(d1) {A)#*;;-. 1t14i ~litT131={~ ~Ji~~1 11~ W~~ppWS UVALUE IF AREA .-Li - '7 )(•44 "7 aq. ft "'@ chi.-1 ~c~ X ~ T7 (o aq. ft @ x...■i xY20 a ; aq. fC Wr L 7-7 _ att. €t U., r~r x sq. ft. Make`6 t1'Pe „U„ --X sq. ft,,_J__±_l_a Z ' 1U} „ ra , ~X sq. ft. (It}~ -„U„- r-,ta_X sq. ft: r C7QSE~ gpgRg nUie`value X area jy (11 • X sq. ft. IGd x s €t. _ All U 4aC1.: U., X sq. ft A E ; w ..U.. G.._-X sq f,t. .C7 {'c1~7t AT, TOTALS 1 sq,.t• TOkI. ; (Q VALUES z75~. llT~II7BD 87!" TOTAL WALL AREA AVG. "U /gam' ir' ~ s ,e` AVIMGE #'U' .17 or leas for 1 & 2 family dwellings ,22 or less for all other buildings K CONSTRUCTION FRAMING R-Value' ~ ~1, -rte i-r~nc .~.\L2 a ` ~3'•<..`;. 2.. ~l 01 1.r -~-1- 3 2- •-x-1EA-rt-11 •i~Cy 2uc~ y r r 4. 11-nC2- 6. t1ySve4 vita .67 R[!OF/CEILIt7G: DOTAL AREA: Sot Z sq. ft. UX sq. ft. ~.~..6 KD~O ( (Aj¢ Detail reference U.. X sq. ft. ' from - PU„ X sq. ft. cached sheets IOU" X sq. ft. `Describe openings nUn X sq.,ft. { in roof TOTALS - E~ Z. eq. ft TOTAL (U) .(A) VALUES SD7• Q . DIVIDED BY TOTAL ROOF/ 0+3 CEILING AREA. AVERAGE "U"' .OS for ventialated roofs .10 for all other construction *600CEILING: R-value 2. 1[~ t1J~~11_Ar~b~ 72 't d M Jroy S s ~PS~m o45 x i 4.jMS10E 1R 5. 6. lIOTE* Zf-.average`values as calculated above do not meet the Enebgy C-dQ t&e "Alternate: Envelope Design as outlined in SBC 6006 (g)'may be. used v, ' r sTieets may be used to show calculations. Uaax'n.: {A' 1 _ '~r'£i~v e,y(' r y. iyrp q Fc5`x'S' 1 q4 f.H "MA VD £`fr Au Y ..+n b g~V i S.~},isa,F, e 7 ryE9}+jyiL t, ~ },u',✓ry r - 3 7`" ~ , r fro R'.: _ aka . f~ ity of engnn 3795 PILOT KNOB ROAD, P.O. BOX 21199 REA BLOMQUIST EAGAN, MINNESOTA 55121 Mavor PHONE: (612) 454-8100 THOMAS EGAN JAMES A. SMITH JERRY THOMAS THEODORE WACHTER Coun fl Members February 11, 1983 THOMAS HEDGES City Adm miratar - EUGENE VAN OVERBEKE ON Clerk Tilsen Homes, Inc. 627 S. Snelling Avenue St. Paul, MN 55116 Attention: Doug Re: Donald Shearon Residence, 1296 E. Balsam Trail, Eagan, MN 55123 Dear Doug: On Sunday, Janaury 2, 1983 the Shearons were nearly overcome by carbon monoxide. People's Natural Gas and this department have attempted to locate the cause and remove the problem. The installation of the furnace meets the requirements of the City and the natural gas supplier, but out attempts to find the problem have been only partially successful. As the original builder of the home and a sup- plier of quality homes in the area for many years I feel your past experience may be of great value in helping us solve this problem. When the furnace is used any length of time it turns the furnace B-vent into a combustion air intake, even though the home has an operating combustion air intake in place. We have tried closing a return air grill in the furnace room and have added an additional grill in the air supply side of the plenum. This has helped somewhat, but we still have not eliminated the whole problem. We are now contemplating the possibility of adding extra combustion air and changing the connector pipe to the B-vent. Please contact me if you could be of any help. Sincerely, Dal;,XAeteK~ on Chief Building Official CC: Ken Henzie, People_'s- Natural Gas Co. Parcel File Lot 5, Block 1, Wilderness Run 6th Addition DSP/bar THE LONE OAK TREE ...THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY John Gorder, Assistant City Engineer November 10, 2003 Page 2 F. Drainage and Utility Easement dated July 12. 2001 and recorded July 30, 2003 with the Dakota County Recorder as Document No. 2086169 (Donald and Mary Shearon- Easement No. 961/Project 835); G. Drainage and Utility Easement dated July 16, 2001 and recorded July 30, 2003 with the Dakota County Recorder as Document No. 2086170 (Eugene and Catherine Heuer- Easement No. 962/Project 835); H. Drainage and Utility Easement dated August 14. 2001 and recorded July 30, 2003 with the Dakota County Recorder as Document No. 2086171 (David Sutliff - Easement No. 1002/Project 828); 1. Drainage and Utility Easement dated August 13. 2001 and recorded July 30, 2003 with the Dakota County Recorder as Document No. 2086172 (ScottJ. Greer -Easement No. 1003/Project 830); J. Drainage and Utility Easement dated August 3, 2001 and recorded July 30, 2003 with the Dakota County Recorder as Document No. 2086173 (Charles and Catherine Cunninham Butler - Easement No. 1005/Project 836); K. Drainage and Utility Easement dated August 27, 2001 and recorded July 30, 2003 with the Dakota County Recorder as Document No. 2086174 (Mark and Pamela Leiferman - Easement No. 1008/Project 824); L. Drainage and Utility Easement dated September 7, 2001 and recorded July 30, 2003 with the Dakota County Recorder as Document No. 2086175 (Rykart J. and Nancy M. Sharpe - Easement No. 1006/Project 848); and M. Drainage and Utility Easement dated July 11, 2001 and recorded July 11, 2003 with the Dakota County Recorder as Document No. 2086176 (Dennis and Mary Nelson -Easement No. 956/Project 833). o CE aCC~~ A115W Chi L 2086(69 W za p ❑ IS W ~p O W O ul xz, CV ' w 0 Zr, ~yxs z v < ~ w= O V O :UM) gu) U r y\ _ t.0 LU co 5% OPY co x o '7 Y p ? O a cs o0 0W m w o z N LL W N F❑ 3 W lu DATE RECEIVED a DAKOTA QdONTY CD v3 G LL V I U n DRAINAGE AND UTILITY EASEMENT THIS EASEMENT, made this '2 day of / , 2001, between DONALD J. and MARY C. SHEAROW(W&M61 r$~'e~re as "Landowner"), and the CITY OF EAGAN, a municipal corporation, organized under the laws of the State of Minnesota, (hereinafter referred to as the "City"). WITNESSETH: That the Landowner, in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does hereby grant and convey unto the City, its successors and assigns, a permanent drainage and utility easement, over, across and under the following described premises, situated within Dakota County, Minnesota, to-wit: A permanent drainage and utility easement over east 10' of Lot 5, Block 1, Wilderness Run, 6`h Addition. The grant of the foregoing permanent easement for drainage and utility purposes includes the right of the City, its contractors, agents and servants to enter upon the premises at all reasonable times to construct, reconstruct, inspect, repair and maintain pipes, conduits and mains; and the further right to remove trees, brush, undergrowth and other obstructions. After completion of such construction, maintenance, repair or removal, the City shall restore the premises to the condition in which it was found prior to the commencement of such actions, save only for the necessary removal of trees, brush, undergrowth and other obstructions. And the Landowner, its successors and assigns, does covenant with the City, its successors and assigns, that it is the Landowner of the premises aforesaid and has good right to grant and convey the easement herein to the City. RECEIVED _H3 DAKOTA COUNTY TREASURER-AUDITOR IN TESTIMONY WHEREOF, the Landowner has caused this easement to be executed ' as of the day and year first above written. DONALD J. HEARON MAY C. ARON STATE OF MINNESOTA) )ss. COUNTY OF Ar, ~ ) The foregoing instrument was acknowledged before me this 11 ) `day of 2001, by DONALD J. and MARY Cr.SHEARON,husband and wife. Km NDA MARIE DRALLEOTARYPUBM-M ESOTA NotaryPublic ommissbn Expires Jan. St. 2005 asseaaaeAl APPROVED AS TO FORM: City Attorney's Office Dated: 5("'/o/ APPROVED AST CONTE Public Work Department Dated: THIS INSTRUMENT WAS DRAFTED BY: SEVERSON, SHELDON, DOUGHERTY & MOLENDA, P.A. 7300 West 147th Street, Suite 600 Apple Valley MN 55124 (952) 432-3136 Easement #961 Project #835 2 SEVERSON,SHELDON, DOUGHERTY & MOLENDA, P.A. SUITE 600 7300 WEST 147TH STREET APPLE VALLEY, MINNESOTA 55124-7580 (952)432.3136 TELEFAX NUMBER (952) 432-3780 E-MAIL hauerclr@sevesonsheldon.com TO: Jo order, Assistant City Engineer J 1 //7 p b~fFC~ J ~f C 7 V ,ea FROM: Robert B. Bauer, City Attorney DATE: November 10, 2003 RE: Various Easements John, Enclosed please find the original recorded easements regarding Project 819 as follows: A. Drainage and Utility Easement dated July 11, 2001 and recorded July 30, 2003 with the Dakota County Recorder as Document No. 2086163 (Daniel and Janet Adrian - Easement No. 9541Project 819); B. Drainage and Utility Easement dated August 27, 2001 and recorded July 30, 2003 with the Dakota County Recorder as Document No. 2086164 (Daniel and Marie Grinols - Easement No. 964/Project 823): C. Drainage and Utility Easement dated July 16, 2001 and recorded July 30, 2003 with the Dakota County Recorder as Document No. 2086165 (Ann L. Johnson - Easement No. 955/Project 835); D. Drainage and Utility Easement dated July 9, 2001 and recorded July 30, 2003 with the Dakota County Recorder as Document No. 2086166 (Larry and Marcia Miller - Easement No. 958/Project 819); E. Drainage and Utility Easement dated July 11, 2001 and recorded July 30, 2003 with the Dakota County Recorder as Document No. 2086167 (Phillip F. and Mary E. Popehn - Easement No. 959/Project 833); A'` C 2086 164 W--i a ~ ~ ❑ ZS -AW, 1-4 W2K 0 town N W O 6 Z. Wo W W i 2U O n ¢ ¢ i Sri, rL FO N U U~ _ N ¢ U Oo 3= W v ~ yZ w ❑ N v a W ~ Y U ^y X0 0 O¢ V I~ U6 Uj 130 3: LLJ y~Y L U '"J ■ l C7 CD C, U 0 Z 6 W o ~ r=n Q DATE RECEIVED L6 in Lu 0 O U 3 ev ' LL U U DAKOTA COUNTY DRAINAGE AND UTILITY EASEMENT TREAS ~fl~~i- L9 ii``~4jj~yJJ//GG L THIS EASEMENT, made t ~'s o 2001, between DANIEL L & MARIE C GRINOLS(lierema er re erred to as "L owner" and the CITY OF EAGAN, a municipal corporation, organized under the law f the State of Minnesota, (hereinafter referred to as the "City"). WITNESSETH: That the Landowner, in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does hereby grant and convey unto the City, its successors and assigns, a permanent drainage and utility easement, over, across and under the following described premises, situated within Dakota County, Minnesota, to-wit: A permanent drainage and utility easement over, under, and across Lot 13, Block 3, Beacon Hill Addition described as follows: RECEIVED Beginning at the northeasterly corner, thence SO0°33'52"W a distance of 25.00 feet, thence N66°48'56"W a distance of i 65.00 feet more or less to the northerly property line, thence S89°26'08"E a distance of 60.00 feet more or less to the DAKOTA COUNTY point of beginning. TREASURER AUDITOR P The grant of the foregoing permanent easement for drainage and utility purposes includes the right of the City, its contractors, agents and servants to enter upon the premises at all reasonable times to construct, reconstruct, inspect, repair and maintain pipes, conduits and mains; and the further right to remove trees, brush, undergrowth and other obstructions. After completion of such construction, maintenance, repair or removal, the City shall restore the premises to the condition in which it was found prior to the commencement of such actions, save only for the necessary removal of trees, brush, undergrowth and other obstructions. And the Landowner, its successors and assigns, does covenant with the City, its successors and assigns, that it is the Landowner of the premises aforesaid and has good right to grant and convey the easement herein to the City. IN TESTIMONY WHEREOF, the Landowner has caused this easement to be executed as of the day and year first above written. 2L/Z ~I DANIEL L GRINOLS I~"1Q A~ C . Gl:y ~ MARIE C GRINOLS STATE OF MINNESOTA) )ss. COUNTY OF DAVori-) The foregoing instrument was acknowledged before me this Lday of 2001, by DANIEL L GRINOLS and MARIE C GRINOLS, husband and wi it) N r APPROVED lic AS TO FORM: , ~ JUl1Y M. JENIMNS _ NOTMYPUBUC-INNESOTA City Attorney's Office W'C0mnsS1ME*=JA3t,= Dated: t/total APPROVED AS TO CONTENT: Public Works D ent Dated: Z -24-;~ THIS INSTRUMENT WAS DRAFTED BY: SEVERSON, SHELDON, DOUGHERTY & MOLENDA, P.A. 7300 West 147th Street, Suite 600 Apple Valley MN 55124 (952) 432-3136 Easement #964 Project #823 2 Use BLUE or BLACK Ink - For Office Use _;20 0 City of EaRan j Permit j I I Permit Fee:' C i 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff. I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 6 u Tenant: Suite M RESIDENT / OWNER Name: _pm Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: Multi-Family Building: (Yes / No CONTRACTOR Name: C ~ W', g License Address: d W i5 CY City: State:lM A Zip: Phone: lW__A2_(,` l Contact Person:" 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.gopherstateonecall.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. x L!~j -p' " x A" - Applicant's Printed Name App an ignature Page 1 of 3 Use BLUE or BLACK Ink � ForOfficeUse---------� � � I �� Clty of�a�aIl ; Permit#: l ��a� � Permit Fee: � 3830 Pilot Knob Road Eagan MN 55122 j Date Received: j Phone:(651)675-5675 I I Fax:(651)675-5694 I Staff: I I I L��J 014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: � � Site Address: � ' Unit#: Name: Y t Phone: �I ° `T'',l�. �11 Resident/ �� (] J � Owner Address l City I Zip: !J`�� ^� � - Applicant is: Owner �Contractor Type of Woi'k Description of work: ��DOf v� r s � v� � � Construction Cost: � ��' Multi-Family Building:(Yes /N6 ) Company:\C,�� l�Y LUI Contact: ��,��n ' Contractor Address:-!1�� /1��V� �� City: S� �yL�t� ��T�-- State: �!�' Zip: �'J''j�►� Phone: �Y1L` ��!/� ��`i1� License#: �� i V�/ � Lead Certificate#: IV� � � �V'�� 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 pian? 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 spec+fic reasons thaf would permif the City to conclude that they 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.gopherstateonecall.orq I hereby acknowiedge 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 complefed within 180 days of permit issuance. X�1��t��t t�'SS X OU Applicant's Printed Name Appiic Si ure Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA150608 Date Issued:07/17/2018 Permit Category:ePermit Site Address: 1296 Balsam Tr E Lot:005 Block: 001 Addition: Wilderness Run 6th PID:10-84355-01-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - Donald J Shearon 1296 Balsam Tr E Eagan MN 55123--170 Wenzel Heating & Air Conditioning 4145 Old Sibley Memorial Hwy Eagan MN 55122 (651) 894-9898 Applicant/Permitee: Signature Issued By: Signature