1253 Carlson Lake LaneEAGAN WAT ER SERVICE PERMIT
ot Knob Rood
F PERMIT NO.:
N 55122
M DATE:
Zoning: No. of Units:
Owner:
Address:
Site Addresr.
Plumber:
Meter No.: Connection Charge:
Size: _ Account Deposit:
Reoder No.: Permit Fee:
1 ogroe to eomplp with tbe City of Eogon Surcharge:
Ordinances. Misc. Charges:
Total:
BY Dote Paid:
Date of Insp.: - Insp.:
ciT' >F EAGAN SEWER SERVICE PERMIT
37 Plrot Knob Road PERMIT NO.:
,F.ogon, MIJ 55122 DATE:
Zoning: No. of Units=
Owner:
Address: -
Site Address:
Plumber.
•
I agree to wmply with the City of Eagan Connection Charge: ' '
Ordinances. Account Deposit:
Permit Fee:
Su?chorge: -
BY -- Mist. Chorges:
Date of Insp.; Totol:
Insp.:__ Dote Poid:
? Date:
ril 20. 1971
PERMIT
sire Address: -!58 Carlson Lake
Lot ? Block
CITY OF EAGAN
3795 wla Knob Rooe
Eayan, Mineeeota 55I22
Pbone: 45I-8100
Sub/Sec. _ W rk
No. 11r ",
Receipt No.: 09687
5ingle
Residentiol
Multi Res., Comm./Ind. ?
n ,
Nome
?New/Alter./Repair. ?
.
g Address Cost of Installatlon
O
City Phone: Permit Fee 20• 0 0
Name _ <'riZ-Ryari Plumbizl- ? & t?e?ating Surchar?e n
.
? Address ! +_745 SO. ROhc-v `
0
? City - ' ?" ? ?l • `- Phone: Total .
This Permit is issued on the express condition thot all work shall be done in occordance with all applimble State of
Minnesoto atutes and City of Eagan Ordinonces.
Buildin9 Official
? CITY OF EAGAN
3795 Pilot Knob Roed
? Ea9en, Minnesah 55122
• Phone: 454-eI00
- PERMIT
?*p• ',epteat ber 13, 1978
Site Address: , ?'•?
Lot Blxk _
Nome
.
; Address
O
City omingtc
Name RYan
n Phone:
No.
Receipt No.:
Single
Residentiol
New/Alter./Repoir. Cost of Installation
Permit Fee
SurcFwrge
I City Phone: I Total _•,.
This Permit is issued on the express condition that oll work shall be done in accordante with oll cpplicnble State cf
Minnesota $totutes ond City of Eagon Ordinances.
Sub / Sec.
Building Official
.
` cIrr oF EA"N -
3795 Pilot Knob Raad Eogan, MN 55122 N2 4719
I PNONE: 454-81 QO
BWLDING PERMIT Rec eipt #
Te be used for :?r' Uwl s?. d G:;. Est. Volue Dat
• f.4 1 19`7
e ???gr.
Site Address 1253 Carlsr Erect ? X Occupancy
Lot Block ? Sec/Sub. -Alter ? Zoning
Partel # Repair ? Fire Zone 3
E
l f Const
T
n
arge ? .
ype o
oe Nome t-- Move ? # Stories
W
3
Address t' 1?'? ?? ?•
Demolish
?
Front 54 ft.
°
r:w, - e?....._ ooi Grade rl Depth 36 ft.
ce NCme 131 11 e Approvals
?a
V? A???
~ Ci Ph
ne
Assessment
Woter & Sew.
o
F- oc Police
WW Name
W
Fire
F
?? Address Eng.
a W Ci Phone Plonner
I hereby acknowledge that I have read this application ond state that Council
Bld
Off
.
g.
the information is correct ond ogree to comply with oll applicable
5tate of Minnesota Statutes cnd City of Eogcn-.Ordinantes: APC
Feea
Permit ! 4 ?. 50
Surcharge 6 _ 06
Plan check -,,,_
SAC
Water Conn.
Wat?eMeter { '?1
'ar n T-ZO.-MT
Total 117 6 s0
Signature of Permittee I 1_- .?- '`-, f' I
A Building Permit is issued to: Svend f'ctersen ?.• " t, on the express condition that
all work shall be done in occordance with alf applicable Stote of Minnesota Statutes ond City of Eagon Ordinances.
Building Officiul
.«mk # Deft b...a r«.Ne..
PI umbing / , *? / 3 -rf - / -,,?- 7
Mechcnical 6.49- D - ?
INSPECTIONS DATE INSP. Rouph-In Final
Footings - Date Insp. Date Irup.
Foundotion Plumbing -
F?ame/ins. ? Mechanical '
Finol
Remorks:
CITY OF EAGAN Remarks
Addition Lot 2 Rlk 1 Parcel lo 84270 020 01
owner???tr<;,?r. ?, ..,Street 1253 Carlson Lake LanB scace Ea.gan?MMNL55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRAdING
SAN SEW TRUNK O_\ 1973 1 123.35 C005183 9-21-78
SEWERLATERAL
WATERMAIN
WATER LATERAL
WATER AREA 13$.6$ 005183 9-21-78
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 250.00 9449 3-24-78
BUILDING PER. #4719
SAC
PARK
This request void 18 months from
/ o3aJ4
,
' 68035
Date o1hu Requesf Co
I, as I'Licensed Electrical Contractoi ? Owner, do hereby request inspection of the a6ove electri-
cal wiring installed at: ?a ?, /
Street Address or Route No. / a 53 Cityj?0--
Section
Range County.7c.i{Gn`{"a._
Which is occupied by
Is a roughin inspection required on this job? No ?
Yes 9 Ready Now ? Will Call X
Power Supplier d)re.4?o7'"n. Eleclo-. Asxsrt . Address ooa? 3/u4• ST, 1izs-.n.Aq1px.
, . ssoay
Electrical Contractor ?o?^e++san JFl ech"C Contractor's License No.4_Y,34S
(COmpany Name)
Mailing Address Fo?o S, . a(?nc ?.co7c?x 417, 4;_S_9Q_.C>
Authorized
c'l ll AM BORER) COPU
No.R9V"-9r4ifZ0
This iMpection request will not 6e accepted 6y the
State Board unless proper inspectian fae is enclosed.
minnesota acate esoara ot tiectncity
;,.1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
EZQUEST FOR ELECTRICAL INSPECTION
("HECK,BELOW WORK COVERED BY THIS REOUEST
/O 3a40
? 68035
Type ef Building New Add. Rep. Check Appliances Wired Foi Check Fquipment W'ved For
Home ? ? Range ? Temporary Wiring ?
Duplex ? ? W atei LightingFinWres ?
ApL Bldg. ?? ? D Electric Heating ?
Commercial Bldg. ? ? Y Silo Unloadet ?
Industrial Bldg.
Fazm
Other
? ?
? ?
00
?
?
?
'qer
uri
pList ? t S
Heiers? o
)
Bulk Milk Tank ?
List
Hehers?
f
COMPUTEINSPECTION FEE BELOW
Selvice Entrantt Size: # Fce Feede[s&Subfeede[s: # Fee Ci[cuits: # Fee
0 to 100 Am s, 0 to 30 Am eres 0 to 30 Am eres
]Ol t 200 mps. 31 to 100 Am eres 31 to 100 Am eres
Above 200_Amps. Above 100 Amps. Abave I00 Amps.
Transfonners RemoteConnolCixc. Partial or other fee
Signs Special Inspection Minimum fee
Remacks ?? ?? ? ?? ?o Lt-S ?- W tv„` k!]i TOTAL F . CO
I, the Electrical Inspector, hereb tify t t Se Oove inspection has beena?
(Rough-in) Date 0
(Final) Date
This request void 18 months fro
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot I{nob Road, Eagan Mn 55122
Telephooe # 651-675-5675 FAX # 651-675-5694
$dSl? !_15'
New ConsWCGOn Reauirements RemodeUReoair Reauirements Office Use Onlv
3 registered site surveys shaxing sq. ft. of lot, sq. fl. of house; and all roofed areas 2 copies of plan Cert of Survey Recd
(20%maximum lot coverage allowed) 1 set of Ene?gy Calala6ons far healed additlons Tree Pres Plan Recd
2 copies of plan showing heam & window sizes; poured found design, etc. 1 sde suney for addNOns 8 decks Tree Pres Not Reqd
1 set of Energy Galalations AdUiUon - irMkate ilon-sife sepfie sysfem _ On-sile Septic System
3 copies of Tree Preserva6on Plan d bt platled after 7/1193
Rim Jaist De4il Qptions selecUon sheef (bldgs wiN 3 ar less units
Date 09 / 10
SiteAddress / Q
1253 ('arlsnn Taka Tana Construetion Cost 14 , Q99.00
,_Eagya, MnT UniUSte #
Description of Work Renlace sidi nga sof fi t& fasci a
Multi-Family Bldg _ Y_X N Fireplace(s) _ 0_ 1 _ 2
ProperTy Owner _ Jim Vance Telephone #( 651) 686-4814
Contractor
er-
Address 4635 Humboldt Ave. S.
State MN
City Bloomi_ng-on.,
Zip 55431 Telephone #( 952 ) 884-0814 '
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateeorv 1
• Residential Ven6lation Category 1 Worksheet
(J submission rype) Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
A NEW BUILDING
Minnesota Rules 7672
• New Energy Code Wodcsheet
Submitted
Telephone # (
Telephone # (
Telephone #'n
iui
I hereby apply for a Residential Building Permit and acknowledge that the inform?Yion is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of EagSn'an-Ic -thetate Iof 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 plan in the case of work which requires a review and
approval of plans. Applicant's Printed Name AppY?ca?ps`Signature
CITY Of EAGAN
? 3794 Pitot Knob Road Eagan, MN 55722 No 47 19
PHONE: 454-8700
BUILDING PERMIT APPLICATION $52
000 Receipt # 9449
.
, _
To be used for SF Dwle. S GaLB. Est. Value Date MBL, 24,_ _ 19_78
Site Address 1253 Garlson Lake Ln Erecr ?x Occupancy I
lot Z Block 1 Sec/Sub. Wila?TneSs SeTk Alter ? Zoning RI
Parcel # 10 84250 020 01 Repair ? Fire Zone 3
Enl
r
e ? e of Const
T
V
g
a .
yp
w Name S P t rc Cnnstr_ Move ? # Stories
3 Addreu 4701 W. LIOthSt. Demolish ? Frant SG ft.
? Ci Phone Grade ? Depth 36 - fr.
z SeIDe Approvalt Feae
p Name
H
?Q Addrea
s
Nome _
Address
I hereby acknowledge that I have read this
the informotion is correct ond agree to c
State of Minnewta Statutes and City yf?;
Assessment Permit 143 _
Woter & Sew. Surchorge Zb., 00
Police Plan check?.?
Fire SAC
En9. _ Water Conn. 9 50 00
Planner ter___bQDO
gTk
Council p
DoII
120 90
Off
BId Oe g
.
9.
APC Total ? 1- 7?0-
Signoture of Permitt
A Building Permit is issued o: S end ?et rSe Coust. on the express mndition that
all work shall be done in /c,cordance th'o??y? a icable Stote of Minnesota Statutes and City of Eagan Ordinonces.
Buiiding Official ?"?- ' ""`-""L `-/.? 9:::?
.. . ?
nATE
BUILDING PF.RMIT APPLICATION
Include 2 sets of plans, 1 stte plan w/elevations and 1 set of energy calculations.
?i ?oZ06e
To be used for y???%//>E??i /?? L Valuation
5ite Addrese: 1g53 ?a,(s. i"?L
- /,ll/LG/7NL=5S
?? re <<
Lot ..Z Block ? SeC. 5tib, ? s r Parcel Number Oe'10 0I
Owner ??': J??i?,?"5Ei? CXO/?SE /rvc- Telephone
Adclress Z{70
L j? L(D 'rF'` S? /YyG.S. S 5-Y ??
Contractor S< i`?6= %? R s e_=.? ?o?vSE ??-?2- TelepRone Vj'
Address
Arch./Eng.
AddreSs
Erect ?
Alter
Repair
Enlarge
Move
ilecaolish
Grade
Telephone
OFFSCE USE
Occupancy ?
Zoning
Fire Zone
Type of Const.
$ of Stories
Front
Depth ?
OFFICE USE
Date of Approval u initial
n 3/
Assessment A.
Water/Sewer
Police
Fire
Eng.
Plannes
Council -7
Bldg. O£f.
A.P.C.
?? ?
FEES
Permit 1'13-11cr
Surcharge -Az le -
Plan Check
SAC •_hn
water c:onn. -&.Ke . tl6
I•7ater hfeter LA ._ 17t3-
TOTAI,
f??
/ /
EXTERIOft ENVELOPE AVERAGE "U" COA7PUTATION ,lg
OGINER 7&/"c ?l
SITE AI?DRESS _'-??r• -r'---:9 }.-#?::?, .: ??'i.?;??. ...C?/??CSO,v,,.G.4??C-/l??
CONTRACTOR 5', fG"T?r',3'?-?,/ Cgc;+??Jr i,,,. ? DATE 3,:Z PHOIdE
Determine ororking square footage.of each.
1. Total exposed wall area .... ??? sq.. ft. x.17 =
2. Total roof/ceiling area 6 sq. ft. x.05 =0-0
.. , _ . ._ ... .
Total exposed wall„.4rea aboye floor =?7 7/
a. Total wall windorr area ................. // 7
b. Total door area ......... ...... . 36 . . ..
e. Total sliding glas"sarea ....:.... .,. p
d. Total fireplace vrall area ....... ... 20
e. Total wall framing.area,(averagel0.?)....., 9
f. Total net wall area'above floor ......... 3/
g. Total rim Joist area . ....Y 7 3.
Total exposed foundatton`area = ?3
h. Total Foundation window area .......... .5
i. Total net foundation area above grade
Determine "U!' value of each wall segment. a. 7 x "U`: D,SS = /W 35-
b . ,36 X srUs;
%"U19
D.'?30 X "U" O o = ?/ ??o
e. X l,Us'.
f. 3/ iy X':U" 0, 0 9= GV39
P, .173 X"U" o. oq7= 8, / 3
h. 5 X "Ul' ?;55 = 75
i.?_ X ,:U`' O.v7 = zl/. 3?
3 .... .......................................Total = 6 7. 5
?
If item #3 is the same as, or less than item #1, you have met the
intent of SBC 6006(c)2.
,
. ?.. ._.,
Total exposed roof/ceiling area =
J., _^otal. skylight ar.ea.........e:......,...._.
k. Total roof/ceiling framing area (average 16
_l,._ Total net.insulated roof/ce3.7.ing area ..:....
... ,
Determine P4U' value for each roof/ceiling segtnent:
j, g"v
k : I V
_ 1. ,5 7G x' u" . o, 04,a,
..
4 ............ .........
.... Total
. ?
.........
....
...
If total of #4 is the same as, or less thah #?2; you haue met the
intent of SBC 600E(61:
Alternate Suilding Envzlope Desirn _
To utilize Lhe.total envelope system method, the values e5tablished
by the sum of items #3 and N4 shall not be greater than the sum of
items fil and h2.
1. + 2. o-n
3.?i67. 37 ,. + u.
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)?
CITY OP EACAN
3830 PILOT KNOB RD - 55122
651-681-4675 ?
New Consfrucfion Reauiremenh
7eiephone #: araa co.ie ( j
/1--s 73?
-?' 3-9 Ql
? 3 reglatered sfle surveys showing sq. fl. of 101, sq. fl. of house . 2 copies of plan
and gp roofed areaa (20% maximum lof coveraae allowed) 1 set of energy calcuIcHona (or heated addiHOns
? 2 coples o1 plans (show beam 3 window skes; pouretl Ind. deslgn; elc.) 1 sRe survey for exferim addHions R decks
? 1 set o( energy calculafiona \
? 3 eoples ol hee preaenation plan 81ot plafted aHer 711/93 S C? U
DATE: ? R-3 49 CONSTRUCTION COST:
DESCRIPTION OF WORK: ReRafl4 p,-,P-
STREET ADDRESS:
3 1 soh /a r, e
LOT: --)- BLOCK: ? SUBD./P.I.D. #:
ES %
Name: VGt h C?' , Jam CS phone #: X'fsp-r7'
PROPERTY Last Ftrst
OWNER
Street Address:
City State: Zlp:
Company: Phone#: 6 1OZ 8--:2-3
619teA HOU • ' (area code)
CONTRAC70R 4100 EXCELSIOR BLVD•
Sheet Address: FIT: L6UIS PARK, MN 55416 License # /05- ° Expl° °
City
ARCHRECT/
ENGINEER
Remodel/Reoalr ReauiremeMs
Name:
StreeT Address: Registration #:
City State:
Sewer 3 water Itcensed plumber (reautred for new conshuetion onlvl:
Zip:
Zip:
Penalfy applfes when address change and lot change Is requested once permfl is issued.
Phereby acknowledge fhat I have reod this appllcation, staite that the intormation is correct, and agree fo comply wMh all applicabl
State ot Minnesota Statutes and CNy of Eagan Ordtnances.
, Signafure of Applicant: i/
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
State:
Tree Preservation Plan Received - Yes - No - Not Required
. ?-.
CNICAGO TITLE INSURANCE
4820 West 77th Street Edina, MN 55435
- , Phones 835-3100
TO: EAGEN DATE: 07/28/78 ADDRES& 1253 CARL,SUN LAKE LANE
FROMi DONNA
?
FILE NO.: M45952
FILE NAME: S7EVEPd5 RAYMUND L. DIS: 10 84250 PLAT: 020 Ol
COUNTY: DAKOTFI
AESTRpCT TORRENS
LEGAL DESCRIPTION:
PLEA&E CHECK TO SEE IF TfIERE ARE ANY
LEVIED/PENDING AS5ESSMENTS
LOT=LiLGGK l W]:LD1_RNf_SS ADLIN
Wilderness Park Addition
?if?iif???iRA?Ri#iffii*f4kfiil?RR?!/rR4R?ARiiRiM?A?M!#A1*ffiAit?F?kAfiRR
PL[ASE FURNISH Tf1E FOLLOWIN, LEVIED ASSESSMENT INFORMATION ON THE ABOVE
DGSCRIBED PROPERTY:
? T}'I-e of Improvement Dalance Due Original Amount
San Sew Trunk 123.25 176.05
Water Area 138.68 160.00
?
PLEASE FURNISH THE FOLLOWING PENUING ASSESSMENTS THAT ARE ESTIMATED AT
TNIS TIME:
NONE
«
?
AL50 REQUESTING ANY ASSESSMENTS CBRTIFIED TO THE AUDITORS AT TNIS TIME
AND INTEREST:
r
Signed: Assessment Clerk D" J/"ta?Date: August 3, 1978
v
AMOUtIT OF UNPAID WATER BILL, IF ANY: $
/
? CertiPicate fi_?r :
avend Petersan
47?,1 WeBt 110th St. '
V1r i. 4 3 7
A4
,
1
DELMAR H. SCHWANZ
LANOSURVEYdR
QpiSterW UndOr l.aws of The State of Mlnnosota
2970 - 146TM fTR@ET W. - dOX M R08EMOUNT, MINNE50TA 5G064 PMONE 612 423-1769
SURVEYOR'S CERTIFICATE
I?
.
SCALL: 1 inch • 40 feet
: hereby eertify that this i.s a true and
:orrect representation of Lot 2, Block 1,
?II.PERNESS PARK ADDITION, according to the
-ecorded plat thereof, Dakota County,
[inneeota.
?2so showing the loaation of a proposed
koude ds staked thereon.
>ated s Maroh 2 0, 1978.,
oainage da utility aaeement
0
M
0
?
MINNESOTA NEGI$TRATION NO. 8625 j'
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PERMIT
Permit Type: Plumbing
City of Eagan
Permit Number: EA105248
Date Issued: 07/05/2012
Permit Category: ePermit
Site Address: 1253 Carlson Lake Lane
Lot: 002 Block: 001 Addition: Wilderness Park
PID: 10-84250-01-020
Use:
Description:
Sub Type: e - Water Heater
Work Type: New
Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Crystal Cochran
Comments:
7588 Washington Ave S
Eden Prairie, MN 55344
952-835-7777
PL - Permit Fee (WS &/or WH) $55.00 0801.4087
Fee Summary:
Surcharge-Fixed $5.00 9001.2195
Total: $60.00
Contractor: Owner:
- Applicant -
Pronto Heating & Air Conditioning James H Vance
7588 Washington Avenue South 1253 Carlson Lake Lane
Eden Prairie MN 55344 Eagan MN 55123
(952) 835-7777
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.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118663
Date Issued:11/05/2013
Permit Category:ePermit
Site Address: 1253 Carlson Lake Lane
Lot:002 Block: 001 Addition: Wilderness Park
PID:10-84250-01-020
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 .
Stephen Kanoff
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 -
James H Vance
1253 Carlson Lake Lane
Eagan MN 55123
Associated Exteriors Inc
937 117th Ln NW
Coon Rapids MN 55448
(763) 370-2010
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA126226
Date Issued:08/19/2014
Permit Category:ePermit
Site Address: 1253 Carlson Lake Lane
Lot:002 Block: 001 Addition: Wilderness Park
PID:10-84250-01-020
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
James H Vance
1253 Carlson Lake Lane
Eagan MN 55123
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(130) 651-2644 X777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA129293
Date Issued:01/28/2015
Permit Category:ePermit
Site Address: 1253 Carlson Lake Lane
Lot:002 Block: 001 Addition: Wilderness Park
PID:10-84250-01-020
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
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 -
James H Vance
1253 Carlson Lake Lane
Eagan MN 55123
Spotless & Seamless Exteriors
8715 Jefferson Highway North
Osseo MN 55369
(763) 428-1111
Applicant/Permitee: Signature Issued By: Signature
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Oo e For Office Use16,a, 1
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,, E AGA N
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RECEIVED t Date Received: '1
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3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 AUG 1 3 2018 Staff:
buildinginsoectionscityofeagan.com L __
2018 RESIDENTIAL BUILDING PERMIT� APPLICATION
Q
Date: 0 19 11 Site Address: gg\-5-6 �C 'v1 t' late ` .n Unit#:
Name: cAmP S U(: \ 1��. Phone:(19a. 1^OV)O
Reaident, I. C�r 1a �( C)owner Address/City/Zip:
A licant is: Owner Contractor
Type of Work Description of work: 65 1 ,,1 c)OC I \ QA9 C
Construction Cost: 1I . k /41 al • i Multi Family Building: (Yes /No )
Company: a�CM V ‘ \‘.f..•Contact: i& t
Address: o 5 11����►!� IPI .Sk XCf y: L�
Contractor 1 `` —
State:c0N Zip: _.111 I Phone:(ôI"23J flEmail: triC Cns% Q(OSloninc cw-
License#: 1� # b 4,,,Lead Certificate#: 1 1(A
If the project is exempt from lead certification, please explain why:
MP\
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:
Fire Suppression Contractor: Phone:
NOTE:Plans and supportingdocuments that you submit are considered to be=public I= # - ons)4t ,•n may be
classified as non-public if ,: • •vide •- ific reasons that would•, it the C to conclude that ;= a ..•„4:,,,,,,144,1 a,
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.com/subscribe.
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.
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.gooherstateonecall.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
X c� rd ce with the appy ved plan the case of work which requires a review and apprgval plans.
C n --\--r()Nt Nr x
Applicant's P 'nt Name Applicant's ig ature
p DO NOT /5-3 e r/Sari Lk) e-.
WRITE BELOW THIS LINE
SUB TYPES
Foundation Fireplace
Porch(3-Season) _ Exterior Alteration(Single Family)
• Single Family Garage _ Porch(4-Season)
Multi Deck _ Exterior Alteration(Multi)
_ Porch(Screen/Gazebo/Pergola) Miscellaneous
— 01 of_flex Lower Level Pool —
_ Accessory Build-ng
WORK TYPES
New — Interior Improvement
_ Addition _ Siding _ Demolish Building*
_ Move Building Reroof
Alteration _ Fire Repair Windows , Demolish Interior
_ Demolish Foundation
— Replace Repair
Egress Window Water Damage
— Retaining Wall —
*Demolition of entire building–give PCA handout to applicant
DESCRIPTION
Valuation I 000 "
Plan - Occupancy 'L7 - i MCES System
Review Code Edition yy/n 24,:vc- SAC Units
(25% 100% ) Zoning _
Census Code I City Water
—_______ Stories Booster Pump
#of Units Square Feet
#of Buildings PRV
Length Fire Suppression Required
Type of Construction _ Width
REQUIRED INSPECTIONS
Footings(New Building)
Footings(Deck) Meter Size:
Final/C.O. Required
Footings(Addition) Final I No C.O. Required
Foundation foundation Before Backfill HVAC Gas Service Test
Roof: Ice&Water Final Gas Line Air Test Hood
Pool: Footings Air/Gas Tests Final
Framing 30 Minutes 1 Hour Drain Tile
20 Fireplace: X Rough In Air Test )Final Siding: Stucco Lath __Stone Lath Brick EFIS
Insulation
SheathingWindows
Shet Retaining Wall: Footings Backfill Final
Radon Control
Fire Walls
Braced Walls Fire Suppression:_Rough In Final
Shower Pan Erosion Control
Other:
Reviewed By: t`)lit r�'ii1
Building Inspector
RESIDENTIAL FEES
Base Fee J f
e 6
Surcharge �/
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies /74.,
TOTAL
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