4219 Carlson Lake Lane NCITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-189, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT Receipt ?
To be used for Est. Value Date ??•? ,19
Site Address Lot 11 Block Sec/Sub. ? R'v'hl ST
Parcel No.
? Name L
; Address ' ? '
° City 'J • Phone
¢
0 Name U ? Address
P City Phone
a
W Name_
W
Z Address
a
W City _
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.
Signature of Permittee
A Building Permit is issued to:
on the express cond ition that all work shal I 6e done in accordance with al I
applicable Slate of Minnesota Statutes and City of Eagan Ordinances.
Building Official
OFFIC E USE ONLY
On Site Sewage Occupancy
MWCC System Zoning
On Site Well (Actual) Const
City Water (Allowable)
PRV Required # of Storiea
Booster Pump Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit ?
Planner Surcharge
Council Plan Review
Bldg. Off. SAC, City
Variance SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
.:r.
TOTAL '
Permit Na. Parmit Holder Date Teiephons it
Plumbing
H.V.A.C.
E lectric
Softener
Inspection Dats Insp. Comments
Footings I
Footings II
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Plbg.
Bidg. Final
cert occ.
Temp. LP
Deck Ftg.
DBck Final
Well
Pr. Disp.
PERMIT #
' • • ' MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
?
? 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: IWAP
f. CONTRACT PRICE 276, •Oca PHONE: 454-8100
Site Add?ss 2!
-ff f'y V BLDG. TYPE _ WORK DE
? Lot
Block -
Sec/S
ub
, Res. New -
Mult Add-on ?
Name
? -?
Address
'?'jz+%?° i`
?c',> • Comm. Repair _
City ??tb•? Phone y 52 _' .;-6 r Other
FEES ?
Name ?''?R? RES. HVAC 0-100 M BTU -$24.00
c Address ADDITIONAL 50 M BTU - 6.00
O Ciry Phones y7 (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PEkMIT) - 1.50 EA.
TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE
Forced Air ? M BTU APT. BLDGS. - COMM. RATE APPLIES
? TOWNHOUSE & CONDOS - RES. RATE APPLIES
Boiler
M BTU
MINIMUM RESIDENTIAL FEE - ALL ADD-ON & ?
? Unit Heater M BTU REMODELS - 12.00
I Air Cond. M BTU MINIMUM COMMERCIAL FEE _ 20.00
,
STATE SURCHARGE PER PERMIT .50
' Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
? Gas Piping Outlets # ? BEYOND $1,000)
Other $
` ?-
? FEE: / .Z • o,? ._ ?
S/C: 8IGN U E OF PERMITTEE
? TOTAL•
FOR: CITY OF EAGAN
CITY OF EAGAN Remarks- _
Addition W' lderness Run 5th Addition _1 ?.et ?13 ___Blk,._.. 3- -Parce?
Owner 10 84354 130 03
?, ? Street- 4214 Nr?_ Car1S6n T.airP i.aras te Eagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 $132.60 $6.63 20 99.45 403442 11-30-76
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 5. 3 A0121 5-11- 3
STORM SEW TRK 1, 210.91 A012184 5-11 3
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. aa
BUILOING PER. ? . ?
SAC
PARK
VI6LA4F OF EAOAN WATER SERVICE PERMIT
3795 Pilor Knob Road I'ERMIT NO.: z 07 9
Eagon,MN 55122 , llATE;: 11/17/76
Zoning: RI _ No. of Units: 2
Owner: T].lsen liomes
Address:
Site Address: 4219 No. Cdrlson I?a?6
?P?I 'm6er: gey-ROCk -- peter Plumbl a
yMeter Nsa?s
i17' Connection Charge:Z20.00 pd
?
Size:-''?? Accoun[ Depos
t
i
00-
0
d
Reader No.: .
ri
Permit Fee:
-
1 agree o comply with Ma Village o4 Eogan
?? Surcharge: .50 p?
60.00 pd metet
Misc. Charqes:
Total:
By Date Paid:
Date,oFInsp.:
? Insp.:
VILAOE OF E40AN SEWER SERVICE PERMIT
3795 PiloFKnob Road PERMIT NO.: 2329
Eugon, MN 55122 DATE; 1 1/ 17 7 6
l.oning: F,i No. of Units: i
7wner. T115et1 tlofieS
kddress:
>i[e Address: 4219 t?o. Carlson TaY.e 7,n. 1,13 A3 S0R Sth
:'lumber: Tiev-P.oc -- Peter Plumhi-nrt
9/16/76 k42t2 #,1129 100.00 pd
o9ree ro complr wifh the Villoge of Eogon Connection Chazge:350. 00 pd
).dinencas. Accounl Depasit:
Permit Fee: 1. 0 ' 0 0 nd
Surcharge: •50 Fd
ly: Misa Chazges:
)ate of Insp.: Total:
nsp.: Date Paid:
? 2007 RESIDENTIA.L PLUMBING PeRmiT APPUCaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAG?;N MN 55122
651-675-5675
?? .
?
=_ase complete for modifications to existing residential dwellings. ?(C,
?
26
?OD
??
te D']
I
e Street Address Unit #
O Telephone # (Qsi ) ?J - 5 ;
wner
aperty
Hone * ; IpSii
'.' ??`? ?
+ "?r ?Se
ntrac:or ,
G
I'r°5s 11.ek SCeTO;P
i,apr.ucant is: _ Cwner Concractor _ Cther
ic Svstan • ivcw Re*?:oisned Suom,[ 2 s2[s :r plans and ;viFC ,icensa .:nc:uczs County ree
:r
.
?ar _s buitc 1 s ,o.oo
Repairlrepiace 6urned ouc ?i:.ures. atc.; ? 90.00
?rations to ?xisYing dwelling ' °0'`???
:da ;wmcing ri;:tures. -':,,is ;e_ :nc.uces ns?ailaiicn ?. _ :a.er ;oiten-: _n7ler +ater
?eacer at .he s2me ume ;f vou ire ns.aiiing onni , N;ier soitener 3na/or ivater
7eater, :o not :omoiete :his ;ec;ion; mo«w? :o he ?
rext 3ec,ion a d n°ci: ne :
3pch2rr_2is) ,X:, pre ??Eailinq. •
i
_3eptic System Abandonrner.c
i I
Water Turnaround (add $136.00 if a 5/8" meter is required) I
_Other:
_ Water Softener ? Water Heater $ 15.00
_ new ? replacement
_ Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
$ 50
ate Surcharge
tal
p Y
:reby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the
rk will be in conformance with the ordinances and codes of the Cily of Eagan and the plumbing codes; that I
jerstand 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
;ordance with the approved plan in the event a plan is required to be reviewed a? d? approv d.
plicanYs Printed Name ApplicanYs Signature
?
i,3-&
w2S
_i
CITY CF E:,GAN
3795 Pilot Knob Road
Eagan, Mir.nesota 55122
pERNIT NO. : _ n n P
The City of Eagan hereby grants to A Binder & Son rnr_ -
op 120 E. butl8r AVe.
a HEATING . permit for: (Owner) Tilsen Construct;on Co______
at 4219 No. Carlson Lake, pursuant to application datedvaai76
Fee Paid: $20.00 dated this 7th day of .gQror.er 9 19.1fi_
.50 s/c
Buiiding Insp°etor
Biechanical Permits:
Bid Total:
C71f CF El1GPN
3755 Pilot Kiiob Road
Eagan, 1Sinnesota 55122
PaTDMT NO.
The City of Eagan hereby grants to T,o..<s n rPter ro_
/.3 - 3
w,? s
oP i R;a r a.,d AVPTt10 St! .. pAa r5t ns
a Equy1Brpr. Permit for: (Owner) m' 1wi+n HnmPS r„c_
atd.7 79 ,,,y_ rA,-1An., T.atiPI pursuant to application dated in/s/7A
Fes Paid: $20.00 dated this 7 day of October 1976 .
.50 s/c
Euilding Inspector
Mechanical Permits:
Bid Total:
CITY OF EAGAN N2 15 5 4 0
3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121
PH O N E: 454-8100
esuiLulrvo rersmi I
7o be used for RE-ROOFING Est. Value $
Receipt #
Date AUGUST 30 ,1988
Site Address 4219 N CARLSON LAKE LN
Lot 13 Block 3 Sec/Sub. WILDERNESS RUN ST
Parcel No.
a Name RICHARD L OKERLUND
w
3 Address 4219 N CARLSON LAKE LN
? City EAGAN phone 688-6947
¢ Name SAME
.o
zoa Address
: Ciry Phone
1-'
w w Name
?
i g Address
a W Ciry Phone
I hereby acknowledge that I have reatl this application antl state that the
information is correcf and agree to comply wi[h all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature ol Permitlee
A Builtling Permit is issued to: RICHARD L OKE?LIIND_
on the express condition that all work shall be done in accordance with all
applicable Sta[e of Minnesota Statu[es an?d, City of Eagan Ordinances.
Building OHicial4.?Ur' w W
i i 1 ?.
? `
OFFICE USE ONLY
On Site Sawage _ Occupency
MWCCSystem _ Zoning
On Site Well _ (ACtual) Const
Ciry Water _ (Allowable)
PRV Required - # of Stories
Booster Pump _ Length
Depth
S.F. Total
FootOrint S.F.
APPROVALS FEES
Engr./ASSess. Permit NC
Planner Surcharge
CounCil Plan Review
eldg.Off. SAC,City
Variance SAC, MWCC
waterConn.
Water Meter
Road lJnit
Treatment P7
Parks
NC
TOTAL
7
1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCL[IDE 2 SETS OF PLANS, 3 CERTIFICA2ES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WF3ICH ADDRESS
IS DESIRED. NO CHANGES WILL HE ALLQWED ONCE HUILDING PERMIT IS ISSUED
MULTIPLE DWELLINGS RENTAL QNITS FOR SALE UNITS U OF QNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COhMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
7 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For: ?{ e -rpD F Valuation: !c 5 ? Date: $
Site Address
Lot -L?_ Block ?_
Parcel/Sub AIIInmeaA P\un 19
Qwner Le.HARfl L. OKER1_G1tJE?
Address j- c_f?, CAl2LScn?J LJ?
City/Zip Code EA6ar.1 . 55I L? 3
Phone (o $g- jy q 4-7
Contractor
Address
City/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code
Phone li
On site sewage_
MWCC system `
On site well _
City water
PAV required
Booster Pump _
APPROVALS
Engr/Assess
Planner
Council
Bldg. Off. G/??3o
Variance
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Eootprint S.F.
FEES
Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Aoad Unit
Treatment P1
Parks
Copies
TOTAL ?
CITY of EAGAN
BUILDING PERMIT
o wa.: .^r : ?GT?y...1.... ?..'?i....... . ............
Address (Psecea!) ...... ??.?.......?Q....... . .... .....
....?... /?... .. .. ....... .....................................l..........
Huildee ....
Addseu y?..........o.?.... ? f.L .-.?...
DESCRIPTION
r.i.
N°_ 4076
3795 Pilot Knob Road
Eagan, Minnesoia 55122
954-8100
Dals a .??.?..?..?.../??.1•-e..••?'...
SSOrias T?o e U.sad For
- Froei Deplh Heigh! £si. Coe! erml! Fse Asmasin
?V?7?? /I .tirlQ? ? ?/1, • 4
0
?/ ` / LOCATION I ?
or
3
This permit does not suihosise the use of clzeele, roada, alleys or sidawalks nor doea it glve the owae= or h!s ageat
ffie right to ereale anp siluation whiah is a nu3sance os which presanfs a hasard !o the deallh, satelp, eonvenienes and
general welfare !a anyone in the communiiy.
THIS PERMIT MUST PT ON/THE PREM E WHILE THE WOAK IS IN PAOGRE
This is 2o aeriiip, fha?F?x.-...h?it.!aT...x?..........haspermisaioa to arae! a_. ? ...°?..?..:........_npon
the above described premise subjeaf io the provisions of all applicable Ordinanees for l?Citp of Eagaa.
? --::?.? :............................. Pes ......C?I y?:t? ...........................
._------......-- . °-........°• °--._..... or . BuildinQ Impector
r
Ddt0:
$I)ILDIYdG PERPSIT APPLICATJ??
LAT BLOCK ? ADDITION
PARCEL & SF.CTIOII PNPIBER IF UNPI,ATTED
ADDRF.3S OF
701QT?dG
OCCUPANCY
USE
ESTIb1ATED COST
097L7ER / ? /j 10/'\ TE;LEPHONE NO.
RrIDRESS -
CO?VTRACTOR
ADDRESS
TELEPHONE DIO.
elote: Include site plan, building plans, and energy calculations vyith this
application ?i k 9' / 4^ 76 "
siyn a
? ?C7-L? OFFICE USE
JALUATIOid , 00
d!V
SAC
UdATER C017NECTI027
PJATER P-YETER
BUILDIIdG PERI•IIT FEE
SURCHARGE FEE
PLADI CfiECK FEE
°ARK DEDIC2ITIOI4 FEE
OTHER
TO`PAL*
APPRUVAIS:
A5SES53dENT CLERK SUILDING
DEPT.
PIATER & SL4dER DEPT. FIRE DEPT. PARK DEPT.
a
IT?
.?
c
?
??N% 4 ? _ ?
. . _-
?
i ?
E?
1°?P?e rv
LINE
?
a
S
0 1
;R
?I
I
-2410??
UNE
?
?
?
?
I ?
? m
=i
??\\\\\I L?
L oT BLOG k ?
7;
rRom'T'_PROPF_rLTY_ LiNE o I
,t?ERk.. AeooEieTY LavE
W
F?LQT -PL AN
t?l S ?- 4v2co
' . ' ti7ERI0R ENVELOPE SPACS "b" COKPQTA'PIS
---v , (To be submitted with building pecmit •pplieatioe)
One or tvo family drelling? Owner t:j2, lk MR.C-,, Ro6ERT ?.lCLcOl.l
All other
Site Address I
Contraceor -rt LC,,FiI .?ApMFS 1\C., Date ?]-'2_-`(!fl Phone
LII7EAI, FT, OF
EICPOSED WALL 'ILCI +Ad 0__+2k_+2L+ t + ± z14L_ft. abave gsads- PS?A fS4. F7'.
(o. ?j x 2 = 13 x 14 = Ig`.L' TOTAL E%POSSD WALL AREA SQ. FT.
1.1 x 5 = 1 35 18a$
OPAQUE WALL CONSTRIJCTION: "U" value % area -3rl - 153?
lout, z sq. ft. ?- (0) (A
mammm=w--- "U" z sq. ft. ? (U) (A,
)etail reference ASic CQAr4 6141_L "U° ,[Y'I z sq. ft, G_ (0) (A
from 'RI" z sq. ft. ' (th (A
Beteehsd sheeta CoN c.er=frE "U" •4-L x sq. ft. 41 . O (U) (A
"U" x eq, ft. ? (i) (A
"U" a sq, ft, ? (0) (A
WIIIDOWS: "U" VALUE X i8ee kjiopot..15 I BRtto 17>oo{Z ? IrIEATHER S141El.D
? ft.
? ft,
? ft.
? ft.
? ft,
? ft.
? ft,
? FT,
!Yka 6 type t): sq. ft. q4. _?X) ' Si.GI (U) G
x sq. Et, ? (U) (A
n n , o '?IJ" . 55 a sq. ft. ?..q (U) (X
L? "U" .? _, 5 x e fc. 4 A,
q. ?'. -1 . 2 N) (
DOORS: "U" value % area bOC)P_So P EASF--
!lake 6 type x lo-? "U" i_3 x sq. ft. 20.0 (U) (A;
7C sq. ft. ? (ZT) (A;
n r? "U" : sq. ft. ' (U) (A,
"U" . 15a x sq. ft. Qf').n N) (A,
SO'fAI. (U) (A) VALUES `?IIa•? ?. 14-5 TOTALS1 Jsq, ft.214•f') (D)G
D1YIDED BY TOTAL WALL ARLA1cj?,j AVf, "U"
?VRRAGE "U" .17 or less for 1& 2 family cJvellings
.22 or lesa for all other buildings
MM/CEILING:
TOTAL ARAA: 10 dn sq. ft, ,
Detail referenee "lT" .04? x eq, ft, 1040 ° 44. `l (lT) (A;
frm "U" x sq. ft. m (ln (A.
atached sheeca "U" x aq, fc, ((f) (A;
Describe openinsa "U" x eq, ft. ? (0) (A;
in roof "U" x sq. ft. ' (II) (A.
TOTAL (U) (A) VALUES
DIpIDF.D $y 'POTAI, RppF/
eannNc nxan
?
4141.1 -TatS 1040 sq. ft. 44,1 (U) (A;
1p 40 = .04 3
.
„
?
?6'• -?4???? _.?.??
11?.T,?
1? ?
t 4 9•?1 ? o -
,
if lHer#p IN", J'tRmfm MMYOW. O.oy*:O A.Oz mw 4*W 6900 n"xq"pitpp
f4 Wdtp" !7p 81f;?$#O ikm W OW ($) dRly' *M*t , AMi4tkqW
dowd w A? ?Aw P4 OQ!' M?,;#?:9a?r
•
Y .
? ' . . , r .1 . ' .
f
MASTER CARD
LOCATION y a/ q 13- 3
r7. . _
STRUCTURE AND
LAND USED AS
Permit
No.
Issued Issued To
Coniractor Owner
BUILDING
PLUMBING
?
??
Z-
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING gQir
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Items Approved
(Initial)
Date
Remarks
Distance From Well
FODT I NG
FOUNDATION .? SEPTIC
CESSPOOL
FRAnnING TILE FIELD fT.
F I NA L
ELECTRICAL
HEATING
? DEPTH
OF WELL
GAS INSTALLATION -
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
.-
WELL
SANITARY SEWER
?
-?
Violations Noted
on Back
COMMENTS:
1
1
i
11
?\(
-i4c)Y4
2006 RESIDENTIAL MECHANICAL rExmyr nrrLicaTiorr
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
P(ease complete for: single family dwellings & townhomes/condos when pelmits are required for each unit
4$3D5D
Date??. 14
Site Address 1A11 1*A CQ?r t jCVl kL( Uw1-`l *%Q Unit #
Property Owner -Xf Telephone # ( US\ ) y S Li - .,5?; Z.(t?
Contractor
SheetAdaress Clty S\
State ZiP c)1'?1t2 Telephone #( lp?t `ll4'?'
Bond ")C?yl, ExPres:
i UQ
C ZOC?
'•
TLe Applicant is _ Owner ? Contractor Other
Add-on or slteratian to existing dwelling unit $ 30.00
_ fumace _Additional Replacement
4- _ New
air exchanger ,
? air conditioner ?
?
?
LS
_ heat pump "
u u D
_ other JIJN 3 2006
State Surcharge $ 50
Total
I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the woxk will
be in confomiance with the ordinances and codes of the Ciry of Eagan and with the Mechanical Codes; that I understand this is not a
permit, but only an application for a pernilt, and work is not.m start wiWout a permih, that the work will be in accordance with the
approved plan in the case of work which requires a review and approval of lans. ?.o i t'"tV`(? ?.v_C, t-L&C1V-vo
Apphcant's Pnnted Name Applicant's Signature
Citi of Eaoaii
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Date: �rO
Use BLUE or BLACK Ink
For Office Use
/30-0 i/
Permit #:
Permit Fee: fi
Date Received: 02 -A) -/ 4
Staff: /744-1
2016 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plan with all commercial applic tions.
Site Address: Lig/9 r ikP A ®v
Tenant:
Suite #:
J
l esld ner
Name: 5 % Y.^ &tA 7: C/
.5/ 4 / 4/
Phone: J a�
Address / City / Zip: l ` / � -/s1-ct ' /-/ -7
Name: l° /-d k' -7 ` (LG License #:
Address: Re- 2 ‘711-ThCit
State: n(P1 Zip: O 7 7 Phone: ��/'-� ��
�/1-)-----/1-)-----�"1L"
Contact: � � -
/'0
Email: ,� 111"7(T 11.14',-/C-
PY
aof
$
New " Additional Alteration Demolitionem
Replacement
Description of work: ACe �'O% �/f�Ce�� �O��dOUrn��
NOT w ted a yr ulnd
tact eco
d echanical eq R ent'is
9 for Info t t non@ ° screening �►+ ds
it Type
RESIDENTIAL
li Furnace
COMMERCIAL
New Construction Interior Improvement
Air Conditioner
Install Piping Processed
Air Exchanger
Gas Exterior HVAC Unit
Heat Pump
Under/Above ground Tank ( Install /
Other
_Remove)
RESIDENTIAL FEES
$60.00 Minimum Add or alteration
to an existing unit, includes State
includes State Surcharge
Surcharge �}
= $ / w TOTAL FEE
$100.00 Residential New,
COMMERCIAL FEES
$60.00 Permit Fee Minimum
Contract Value $ x .01
= $ Permit Fee
$70.00 Underground tank installation/removal
Surcharge = Contract Value x $0.0005
If the project valuation is over $1 million, please call for Surcharge
_ $ Surcharge
= $ TOTAL FEE
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.
O6eY-74-
Applicant's Printed Name
Applicant's Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA136458
Date Issued:05/13/2016
Permit Category:ePermit
Site Address: 4219 Carlson Lake Lane N
Lot:013 Block: 003 Addition: Wilderness Run 5th
PID:10-84354-03-130
Use:
Description:
Sub Type:Reroof & Windows/Doors
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.
Windows/Doors: If altering the opening size, a framing inspection is required.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Ja Gullickson Inc
6538 Babcock Trl
Inver Grove Heights MN 55077
Gullickson Homes
12701 Co. Rd. 9
Goodhue MN 55027
(651) 208-2602
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r
For Office Use
City of Eaall Permit#: I `�i/
'CI?- •
3830 Pi t Knob ad Permit Fee: Ce 0 - ()--C) CC.
Eagan MN 55122 RECEIVED �
Phone:(651)675-5675 Date Received: $ w2-4--I
Fax: (651)675-5694 At)ti 14 70117 Staff:
L
2017 MECHANICAL PERMIT APPLICATION
❑ Please submit two(2)sets of plans withthall commercial applications. ,
Date: r `� 7 Site Address: (7/0)1 9 (firisOi, 4,6-ft.
,6-r[` e .. e i Ui YE
Tenant:_____ e°1 &40,-/,'e Suite#:
..
A-
Name.,.,. ��� � �/ �.-,� .�.. .�.�, ���..,....,_A,-,.. _
Phone:
......,�,. -,.__w.-..w..�.... ..�.�....,.�,.��.
Resident/Owner
-.ov.ke G•et — )1° i
Address/City/Zip r°` ���� �_ I
Name: 1-(C"A10 /1-4-47:)" ( License#:
3 Address: 06 `-f�94 S
� '/ City: /-- 1,---Ic tit.r"--- 1
Contractor 3 /
State: / v\ Zip: � 3 6 r 0 7/ Phone: Sr
° Contact:
Contaw ct..a .._. . ..v,.w�4_w� ,��.u• ,. ,..._,�. .•...,rEu.,m�..ail..�. ..a,.�..,. . ��G �jrco 1' e.,, ,,,/, 0 ,_
..�
New Replacement Additional Alte ation Demolition
Type of WorkDescription of work: _4, ter
( C 94� e I
.- e
NOTE: Roof mounted and grogmechanical d mounted equipment i required to-be Greened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods. i
d ... ..� ,. a N_ �,H u.,,..M • ._ a _,-�_,a,.A . _ -uKnrv� �._a.. w. ,w....�
RESIDENTIAL COMMERCIAL
i
Furnace New Construction Interior Improvement
Permit Type ' ? Air Conditioner Install Piping Processed ,
Air Exchanger ? Gas Exterior HVAC Unit
_Heat Pump t Under/Above ground Tank ( Install/_Remove)
— I
Other
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge //
$100.00 Residential New includes State Surcharge =$ ( D° CSU TOTAL FEE `
COMMERCIAL FEESContract Value$ x.01
$60.00 Permit Fee Minimum I
$75.00 Underground tank installation/removal, includes State Surcharge =$ Permit Fee
_$ Surcharge
Surcharge= Contract Value x$0.0005
If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE 4
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 withou = 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. //
L6'/— )/K 120 J , MS(7^ x
Applicant's Printed Name Applicant's Signature
FOR OFFICE U.
Required Inspections: Reviewed By: Date:
Underground Rough In —,Air Test Gas Service Test In-floor Heat . Final T„_HVAC Screening
r 4
Use BLUE or BLACK Ink
r For Office Use
iq3 in
Cita
M of Eai � Permit#:�Ju ____ _441,•5_3_'
Permit Fee:
3830 Pilot Knob Road ,l 1,
Eagan MN 55122 Date Received: 10
Phone:(651)675-5675 RECEIVED
buildinginspections(acityofeagan.com Staff:
AUG 1 1 1017 1,-NA
2017 RESIDENTIAL BUILDING PERMIT APPLICATION kt``�
i i n� �f
Date: j Site Address: I Y ` 1 `► r•.a4AUnit#: r
Name: --37e (A_r' Sc r 1.:--e, Phone: 6S)-(3-411-a l fi.9
Resklenti
Owner ` Address/City/Zip: 491 131 Oa Y" '1 (da. (.-ri e.--a ct i.-,
Applicant is: Owner Contractor
to
Description of work: U� C t D
Type of Work i �
r „,,, __or)
, Construction Cost: (P 7 Multi-Family Building:(Yes /No 1
r
Company: 1 Contact:
Contractor Address: City:
State: Zip: Phone: Email:
`� License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
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:
'N°TE.Plans and supporting is that tr submit are considered t`o be pubfio'rn�ation. Portions cfdie
information may be classified as nea-pablic If you provide,?peoitto MastMswouldper�t��1 ale'Eliot their,
are'trade secrets. _,
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.cityofeagan.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.gopherstateonecall.orq
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
pthe
�approved plan in the case of work which requires a review and appro of plans.
x -'e.W \ S\-- )Y-\\,.t, x
Applicant's Printed Name Applica Signature
Page 1 of 3
. f ii i C tsa, Lq Lq, 1 L/SZJ3
DO NOT WRITE BELOW THIS LINE t
y SUB TYPES
Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex Lower Level I Pool _ Accessory Building
WORK TYPES
New _ Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof Demolish Interior
_
Alteration _ Fire Repair _ Windows _ Demolish Foundation
Replace _ Repair _ Egress Window Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION
Valuation 7 eldif f Occupancy pzG-1 MCES System
Plan Review Code Edition ,„0/5" SAC Units _
(25%_100%__ ) Zoning n„ j City Water
Census Code L,/34 Stories -- Booster Pump
---
#
#of Units 1 Square Feet PRV
#of Buildings I Length -- Fire Suppression Required ...---
Type of Construction Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings(Addition) Final I No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof: Ice&Water Final X71." Pool: ,Sootings , Air/Gas Tests *nal
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: 0 -4-1, , Building Inspector
1
RESIDENTIAL FE
Base Fee ,All 0
Surcharge
Plan Review 95 a-
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies /0 "Y'" 13'
TOTAL
Page 2 of 3
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Permit /C(6-0.6� �]���
Cityof E� a� 47° , Permit Fee �°
3830 Pilot Knob Road • 1 �1
Eagan MN 55122 Date Received: I
Phone: (651)675-5675 /]/
buildinciinspectionsAcityofeagan.com Staff: '7
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
2 i
Name: v` '.-t) r l I' -2- Phone: 6'S 1 • .7---(-? 1 - 247111.
Resident/ (:Aid-004 L/91;6_ La N,
I Owner , Address/City/Zip: L-1 Z- t 42- O Z O .
I
lApplicant is: Owner X Contractor
I
I Description of work: C iJ v► v e r}" lel ► 'vim\-(:) of \RO —
1 Type of Work
Construction Cost /( 019 . 0-0 Multi Family Building: (Yes /No X )
I Company: Okppi�. viCLLV U
i' l oiiSf' lc.6 ' Contact: —S U-& i KkVs >^
In
I i Address: ( z• ,s ? C., I v v e e w L,N City: u r v� s v l 1 1--2
I Contractor P� ocelt
n
i State: Zip:c 5 Phone:4 / 1/y Z Email:-ive I Tq lctc irne+n / b I 0 G Itith i ) e
1
License#:
$L 7 Z U'1. 4(1 Lead Certificate#:
If the project is exempt from lead certification, please explain why:
e_ ,
___11..oteeilleiii'A.c-1 G> ,,(i-,y,,,,) ai9u.s .
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?
1 Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
W
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression 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 they
1 are trade secrets.
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.cityofeagan.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.qopherstateonecall.orq
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. j� ®�
x --...)d----) -1c k 1</'v,..e.-� x C�c.�"vv `^
Applicant's Printed Name Ap licant's Signature
Page 1 of 3
-46N n DO NOT WRITE BELLOW THIS LINE / 7.� .
SUB TYPES L1Cc/ )g 1 CA Lyi . Al,
Foundation Fireplace Porch (3-Season) Exterior Alteration (Single Family)
o Single Family Garage Porch (4-Season) Exterior Alteration (Multi)
Multi Deck Porch (Screen/Gazebo/Pergola) Miscellaneous
01 of_Plex Lower Level Pool Accessory Building
WORK TYPES
New Interior Improvement Siding Demolish Building*
Addition Move Building Reroof Demolish Interior
;) Alteration Fire Repair Windows Demolish Foundation
Replace Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation o`)to, Occupancy __e.0 t MCES System
Plan Review Code Edition yy)A z )c; SAC Units
(25%_ 100%/' ) Zoning ( City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction ` J Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/ C.O. Required
Footings (Addition) y) Final/ No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof: _Ice &Water Final Pool: _Footings Air/Gas Tests Final
/44 Framing 30 Minutes 1 Hour Drain Tile
Fireplace: Rough In _Air Test Final Siding:_Stucco Lath _Stone Lath Brick EFIS
Insulation Windows
Sheathing Retaining Wall: _ Footings_ Backfill_ Final
Sheetrock Radon Control
Fire Walls Fire Suppression: _Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: Tv wt. 11 • c.h , Building Inspector
RESIDENTIAL FEES l
Base Fee //0 E-7-
Surcharge j , , o
Plan Review
MCES SAC H rP 4), /`e
City SAC
Utility Connection Charge
S&W Permit& Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
Use BLUE or BLACK Ink
r -
OF E,q For Office Use
Z Permit#: /4/107v
/10 ..SZ)
`Isis c Permit Fee:
@t t s H ISMS' Date Received: /,y'- 7 -/ 7
3830 Pilot Knob Road I Eagan MN 55122 Staff: 41L,
Phone:(651)675-5675 I Fax: (651)675-5694
buildinginspectionsa_cityofeagan.com
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
gym Name: .....) `,\.---\ 5 4 0 C I .' --'--- Phone: lJ e I `z.._7 f - -z-"'t I `T'
Resident/
Owner Address/City/Zip: 1 t '� c, k S r., t;1 4-Ki 'I
7, Applicant is: Owner X Contractor
Description of work: 1,',---'-k"-=‘-- '4".`� -Q 'r t VvO{0,
Type of Word p
Construction Cost: �" CW`" Multi-Family Building:(Yes /No ?(' )
Company: (7\T p( v i'v_v4 �'-.c t -s 4-cut k'ilC
0 ♦ Contact: --1 ,< _ 1 I\kk tit v-1
t
Address: l 2 `5 .~� ex. 1-i k,,r'+. C..,> ::-.r—• City: rr-->(-,Br v, '�,: )/2
Contrapto ('
, 1f&
State:l'" N\Zip: 5��. 34)Phone: G 5-( `,-/t Email: -VJ0-.(7a ti's. ,`r,.,h ) P ) e
¢. tr. . , License#: 4:- -1'2- w !7 LI `zi Lead Certificate#: °t j.`-.
If the project is exempt from lead certification, please
explain why: 1-- -/
- --S,-.1/1,--,,.e <-- - 1.1,.: i,yi-<'_,10 C. i'V b F L'.�'p-'' PI u1^,t,. C,✓ vt Ui a ( \ .
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**porting documents that ou su i 1'4.1tidered tobe public information. Portions ifthe" iformation ay be 1
classified as noipieoik if you rov`ide PaOlfic reaso *:`,Irlf.tvould permit the lik .conclude that they are trade secrets ,=M
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.citvofeacian.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.qopherstateonecall.orq
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 ----loc., i -1-c.:.:-0,(1,c: - ;L\•,. s,...a x (i' tjai- l o
Applicant's Printed Name Applicant's Signature
Page 1 of 3
For Office Use
Sb
E AG Permit#:
Permit Fee: LO
Nt'
\\:\
3830 PILOT KNOB ROAD I EAGAN, N 55122-1:11i 2.0A% 4iNci
Date Received
(651)675-5675 j TOD:(651)454-8535 I FAX: i _ ' iffrF-5gi94
‘4.
Email:Cuildinsinssectionsecit-ofealian.com
Staff:
Commercial Plan Submittal:egjansPoityofeacian.corn
2018 RESIDENTIAL MECHANICAL PERMIT APPLICATION
Date:
6/22/2018 Site Address: 4219 CARLSON LAKE LN N
Tenant: Suite#:
NJEAN STORLIE
ResidentiOwner ame: Phone: 651-271-2999
Address/City/Zip:Zip: 4219 CARLSON LAKE LN N
=
Name:
KRAMER MECHANICAL License#: MB003033
7860 FAWN LAKE DR NE STACY
Contractor
Address: City.
State: MN Zip: 55079 Phone: 651462-2194
Contact:
RICK KRAMER Email: KRAMERMECHANICAL@YAHOO.COM
RESIDENTIAL
Furnace
Air Conditioner
Permit Type
Air Exchanger
; Heat Pump
*
Other GAS LINE TO POOL HEATER
New Replacement Additional VI
Alteration Demolition
Type of Work Description of work: RUN GAS LINE TO POOL HEATER
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit,includes State Surcharge
„ .00
$100.00 Residential New,includes State Surcharge = 60TOTAL FEE
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.cityoreacan.comisubscribe.
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.
.MATT KRAMER
/
x
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE
Required Inspections: Reviewed By: Date:
Underground Rough In Air Test Gas Service Test In-floor Heat Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA167842
Date Issued:03/31/2021
Permit Category:ePermit
Site Address: 4219 Carlson Lake Lane N
Lot:013 Block: 003 Addition: Wilderness Run 5th
PID:10-84354-03-130
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Jean Storlie
4219 Carlson Lake Ln N
Eagan MN 55123
(651) 271-2999
Monarch Home Improvmeent
686 Mendelssohn Ave N
Golden Valley MN 55427
(612) 509-6939
Applicant/Permitee: Signature Issued By: Signature