4295 Carlson Lake Lane NCITY OF EAGAN WATER SERVICE PERMIT
3795 Piloe Knqb Road ' PERMIT NO.:
Eagae, MN 55122 DATE:
Zoning: No. of Units:
Owner:
. . ~ •
Address:
Site Address:
Plumber: - -- -
Meter No.: Connection Charge:
Size: Account Deposit:
Reoder No.: Permit Fee:
1 agree to eomplp with the Ciryr of Eagan Surcharge:
Ordinantes. Misc. Charges:
Total:
By Date Paid: -
Date of Insp.: Insp.:
CITY OF EAGAN SEVUER SERVICE PERIIAIT
3795-Pilot Iteob Rood PERMIT NO.: 2380
Eogon, MN 55122 DATE: 4/!?P/7?
Zoning: No. of Units: ?
Owner.
Address:
Site Address: 42?3+ rvi. Carl??? ?s.: -'f.' BY WI: ath
Plumber.
- ,nn.0o r?
I agree to eomplr with t6e City of Eagan Connection Charge: '?`;, 00,
Qrdinanaes. Ateount Deposit:
Permit Fee:
5urcharge: -_
BY Misc. Char9es:
Date of Insp.: Total:
Insp.:-- Date Poid:
CITY OF EAGAN
. ? 3795 Pilot Knob Road
? Eogan, Minnesota 55124
Phone: 454-8100
PERMIT
Date: F"ay 9, 1977
I Site Address: ' ' ' r `' ' ? ? • ?? I.3kE I,ane
?
' Lot ' Block i Sub/Sec. ?th
I
' ' =iGCte ;
Name
.
; Address -'G. snelling Ave.
O
? City 5t_ Paul Phone:
` Name 1?°1is fi. Peter Cb.
? Addreu1854 Grand Ave.
e
? City _ . Da . ... ? 5 i r ; = Phone:
This Permit is issued on the express condition that ull work sholl be
Mlnnesoto 5totutes and City of Eagan Ordinances.
12
No. -
?!; ,
Receipt No.:
Single I
Residential v
Multi Res., Comm./Ind. I
New/Alter./Repair. ' "-w
Cost of Instullation
Permit Fee 20.00
Surcharge ' So
Total ??'
done in accordonce with all applicoble 5tate of
Official
CITY OP EAaAN
3795 Pilef Knob Roo1 EoyeA, MN 55122
/HONEs I54-8100
BUILDING PERMIT Receipt #
To be wed fw Est. Value Dote 19
Site Address Erect
? Occuponq
Lot Block Sec/5ub, AIter p Zoning
pamel # Repoir ? Fire Zone
W Ncme _
? Address
Ci
$? Name _
H
uS Address
?
W W Name _
P =Z Address
Enlorfle ?
Move O
Derrwlish Q
Grode ?
Asseument _
Woter & $ew.
Policr
Fin
Enp.
Planner
Counci I
Type of Const.
# Stories
Length
Depth Sq. Ft.
Permit
Surchorye
Plan check
SAC
Water Conn.
Woter Meter
Road Unit _
1 hereby ocknowledge that I hove read this opplication and store That Bldy. Off.
the intormation is torrect ond ogree to tomply with oll applicoble APC Total
State of Minnesotc Statutes and City of Eagan Ordinonces.
Slpnoture of Permittee A Building Pertnit is iuued to: on ths express oonditlon fhat
all work sholl be done in octordarxe with all appliwble State of Minnesoto Statutes and Gity of Eaflon Ordinonces.
Buildirq Offtcial
Parmit No. Parmit Holdsr Misc. Permit No. Holdar
Plum6iny
H.V.A.C.
WaII
Weter
Disp.
Sawer
EMevk
Intpection Date Insp. Other
Footinyt ?
Foundstion
Framin9
Rouyh Plba
Rouqh HVA
Inwlation
Final P16a
Finsl HVAC
Final
Weter Dbcribe Location:
Yllall
£wvwr
Pr. D'ap.
CITY OF EAGAN a 10 ' 7
3830 Pilot Knob Road, P.O. Box 21•199, Eagsn, MN 55121 ?
PHONE:454-8100
BUILDING rERMIT Rece+vt #
RD
Lot -
Parcel Na. _
Name
Address
? •I`,'1' ,
City Phone
? t?' .• ?r,t
? Name
Addrost
? Clty . Phone
Name
?W
u? Addresi
?W City Phone
I hereby ocknowlodqs that 1 hove road this application ond te that
tM In(ormation is correct ond agree to comply with all; pplicoble
Stoh of Minnesota Stotutes ond Cfty of Eaqan OrdinqiScas.
Sipnoture of Permiftes
H Buildir?p Penmit is issuwd to:
411 work shall be dons in otaordance with oll opplioobls StotR of Mir
8uildirq Offidal - - - ,
500
Erect U Occupency _
Remodel ? Zoning
Repair ? Type of Congt.
Enlerge 11 No. Stories _
Move ? Length
Damolish ? Depth
Grode ? Sq. Ft.
Assessment
Water 3 Sew.
Police
Fin
E^0•
Plonewr
Caundl
_-
eid9. otf. - / 17 6
APC
Var. Date
Permit .) . . ? :
Surtharpe
Plan Review.
SAC
Water Conn.
Woter AAeter
Rood Unit
Perks
Total °? .; .. . .• , .
on tM express condiNon thoi
i Stotutoa and Gty of Eopon Ordlnanca.
PKmit No. Pwmk Ho1dK Daa Tele hone ?
Plumbiiq
H.VA.C.
ENctric
Sohernr
Inspection Date Insp. Other
Fcotings ?y
Foundation
Framino
Rooting
Rou41? Plbq.
Rouph HVAC
Insulation
Final Plbp.
Final HVAC
Finsl ?
CKe/Occ.
Water ?i? Locaeion:
YWII
S?w?t
Pr. Di?p.
PERMIT #
MECHANICAL PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN
MN 55122 RECEIPT #
DATE
:QNTRACT PRICE: ,
,
PHONE: 454-8100 :
iite Address >°
OA' N'=- %J L``:':'--
f'--
`? ?G. TYPE
WORK DESCRIPTION
.otBlock ? Sec/Sub
Res. ? New
Name STMOARn Mult Add-on
°-'
Address
- ?? ?? ? NYI Comm. Repair
? City
? 01A55108 Other
4)
c
3
O
Name _
Address
City _
TYPE OF WORK
Forced Air
Boiler.
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
- 22 M BTU
FEES
RES. HVAC 0-100 M BTU
ADDITIONAL 50 M BTU
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIn
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE AP
M BTU ' $ REMOI
M BTU s MINIMUM COMMERCIAL FEE
$ STATE SUFiCHARGE PER PERMIT
CFM
(ADD $.50 S/G IF PERMIT PRICE GOES
BEYOND $1,000)
- $24.00
- 6.00
- 1.50 EA.
- 12.00 -?
- 20.00
- .50 ?
FEE:
S/C: S1GN 1 E
TOTAL:
FOR: CITY QF EAGAN
_ 1
• CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 56122 N2 4295
PHONE: 464-8100
BUILDING PERMIT
Site Address
Lot Block
Parcel #
$369OCj'. , Receipt .#
Sec/Sub. S Ch
0? Name L?1r1te1. Hiks s:
W
3 Address
0
` Nome . ? ""•• •, ?`?• ?iiY•
0
oQ Address :,77 !=n. ?..<,I1;ttp --
u? -
Name _
Address
I hereby acknowledge that I have read this application and stote that
the informotion is correct and ogree to comply with a!I applicoble
State of Minnesoto Stotutes and City of Eogan Ordinances.
il 29. ,0 77
Erect (3 Occupancy
Alter ? Zoning
Repoir ? Fire Zone _
Enlarge ? Typa of Const. •`',
Move ? # Stories
Demolish [D Front ft.
Grode ? Depth ft.
Approvols Fees
Assessment _
Water & Sew.
Police
Fire
Eng.
Plonner
Council
Bidg. Off. _
APC
Permit 'Oti=0 UU _
Surcharge ''?• 50
Plan check _
5AC
,, .. .
Wafer Conn.
Water Meter
Total `'`) 1. • 50
Signature of Permittee I
A Buiiding Permit is issued to: _ on the express condition thot
all work shall be done in accordance with ?II applicable State of Minn_s,)ta Stotutes and City of Eagon Ordinances.
Building Official
P?M a# OaH Iswd PMwNtM
Plumbing / ?r- 9- y 7r •??/ •?J ej -
Mechanicol t
INSPECTIONS I DATE INSp.
Rouph-In
Flnd
Footings Dota Irap. Dote InW.
Foundotion t? Plumbing -,?
Frome/iru. Mxhanical
Final ?.? j ?
Remarks:
CITY OF EAGAN Remarks
o,,,,;,;,,,, Wilderness Run 5th Addition ,_. 28
84354 280 01
4295 No. Carlson Lake Ln. ?.,,.,, Eaqan, MN 55123
Impravement Qate Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 $132.60 $6.63 20 99.45 A004527 8-17-77
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATERAREA 1977 160-00 10.66 15 149.34 A004$27 $-I7-77
STORM SEW TRfC .WA 1981 363 . 00 24.20 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STFIEET LIGHT
WATER CONN, 40
y - 77
BUILDING PER, ?
SAC
PARK
I
CITY Of EAGAN N.° 718 5
.? 3795 Pqot Kno6 Raad Eoyan, MH SS1]1 _
< PNONBa 454-8100
BUILDING PERMIT
T. i.. .A f.. DECK
Site Address 4L7j 1V. 1,111=isv[1 1.90e inaic
Lot 28 Block 1 Sec/Sub.W1d2ZS1ESS PA.81
Pa,ui # 10 84354 280 Ol
W Nome LM RAE1111% rLIlUiOn
? naerea 4295 N. Carlson Ialce Iane
_ _ cn,11-2 _ LC9_9971
p Name (kM=
?? Address
`- r?.., o?....?
Nume _
Addreu
1 hereby ackmwledge thot I hove read this oppp Olicotion ond stote that
the informotion is correct and agree to cgmply/with oll applicoble
Stote of Minnewto Stq2utoZOn¢ Ciry o; agqA Ordirwnces.
Sipnature of Permi
A Building Permit ls issued to: ?
atl work shnli be done in nccordonce with
8uildirp Official
Re[eipt # 54?f ?-
Erect [K Occupancy
Alfer ? Zoning
Repoir ? Fire Zone
Enlarge ? Type of Const.
Move ? # Stories
Demolish ? Length 20
Grode ? Depth 10 Sq. Ft.-
Avororals Fees
Assestment Permit 1/.7V
Water 8 $ew. SurcFarge _ •50
Police Plan check
Fire SAC
Eny. Water Conn.
planmr WoterMeter
Council Road Unit
Bldg
Off
.
.
APC
Totol .?-00.
_ on the express conditlon 1ha+
City of Eagon Ordirwnces.
CITY OF EAGAN
BUILDING PERMIT APPLICATION
Include 2 sets of plans, ,
1 site plan w/elevations &
1 set of energy calculations.
To Be Used For ??eae_ Valuation gDO ?! Date F'--
Site Address: .5, e195 4) QAu.SeN G~ g? OFFICE USE ONLY
Iot Z-g Block I Sec./Sub. W?P i S Erect Occupancy
Parcel % C?. 3G-,( Z$O o? Alter Zoni:ng
Repair Fire Zone
Owner: ?,? ??}(Sc? n; Enlarge Type of Const.
Move # Stories
Psidress: ?,?qS n) Desmlish Front ft.
Cit
/Zi
Code Grade Depth ft.
y
p
:
Phone #: /,S.Z - 33 7 3 APPROVALS FEES
Contractor: Assessments Pennit /2
Adclress:
City/Zip Code:
Phone #:
Arch./Ehg..
Address:
City/Zip Ccde:
Phone
Water/Sewex Surcharge
-?
Police Plan Check
Fire SAC
tng. Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off.
APC
4e?
ZCYi'AL
Project Planning
Guide
p K= 65 ? ? ? ' :
?
?
?--
I<_?--z? --yl
?
N
{ ? f
1 ? I
;
BILL OF MATERIALS FOR - X DECK PLAN
Pleces Slze Cost Plecas Size
BEAMS
DECKTOP
FACIA
POSTS
Estimated Total
not including tax _
OSMOSE
PRESSUNETNEATFO ?
??
Q; ? (xrttosF
?" Osmosa Wood Preserving Co.
of America, Inc.
980 EI licov Street
8utfalo, NewYork 14209
ALL MATLNIFI.S AND TRADEMAPK9 MEPEIN CI
p?lnl¢Oin1154. R?62/MA3W
cost
Cut hoth ends ot stringer according
to pattern shown i n stringer diagram.
Aft¢r cutting, measure from point 1
along Edge A, 1'%". Mark ihis point,
and measure olf another 1'%" for
each atltlitional cleat needetl. Place
the corner of your square on the
marks you have made so that the 10"
mark on the long arm of the square
intersects Etlge B of the stringer.
Mark the stringer. Thia line
determines the location ofthe
Boftom ot each step cieat Place the
comer of your square on Point 1. in
the same manner as above to maik
the position of the i sl cleaL (See
illusiration right.)
Attaching Cleats
Attach cleats to the inside surtace of the stringers by
nailing ihru the cleat into the stringer with tOd
galvanized nails.
Treads
Cut 2" x 6" material into 4'0" len9ths. 2 pieces tor each
tread. Assem6le treads antl completetl slringers on the
ground as a unit, by nailing thru treads into cleats. Lay
completed unit aside until later. Step Posts
Sink two (2) 4 x 4's alongside tleck at the location you
want your steps The posts should be 4'3" apart. Drill
antl 6011 the posts }o the deck with X" x 6" galvanized
carria9e bolts as shown in a6ove illustrations.
Railings
This attractive, functional and easy ro builtl railing
desi9n is included to help you finish off your ALL
WEATHER WOOD deck.
Railing stanchions are on 2'0" centers, so that the
deaign is easily adaptable to any moAule size.
To assemble railing, mortice out the stanchions antl
pre-0rill tor the naiis that will attach stanchions to tleck
surtace (see diagram). This will eliminate splitlin9 the
-1
I
35
1
T
Securing Steps to Posts
Place completetl step unit in place beiween posts. A
piece of All Weather Wood 2" x 6" laid fIaL or a ilat
stone may also be needed as support under the 6ottom
end of the stringer to reduce settling. Drill and bolt ihru
steps and posts as shown. The 4" x n" posts may 6e
cut otf flush wi}h the deck top or used as raiting
stanchions for step railings.
stanchions. Use 10d common, galvanized nails and pre-
drill with 5/ z" size drill. DRILL THE STANCHION ONLY
- NOTTHE DECK FRAMING. ,
Assem6le the railing section for each side of the deck
on the ground as a unit, minus the top 2" x 6" plate.
The top Olate can be cut to sire and attachetl afier the
railing stanchions are in place. Reter to TOP Elevation
diegram for placement ot corner stanchions.
zx6 (IAID FLAT)
2x4
18" 2.6e?2x8
DEVEN4INGOX
MOWLESRE
2.C._22'on
n•n.
2AILING
STANCHION 5me EIEVnTiON FRONT ELEVATION TOP ELEVATiON
SIDE ELEVATION OFSTRINGER
??105 g,
''
0 3 a? s?`
Re s? ate Fire No. Rough-Inlnspecfion Repuired Ins ecM1On herThan Rough-In
J ?VOU musl call inspoclor when r y) etly Now/ n Will Notify Inspcto'
?`-?
a_ ? Yes Dite Reatly
I i ensed contractor ? owner hereby request inspection of above electncal work at:
Jab tldrvss (
Slreel, Boe or RaNe No.) Ciy
/
V mryAh v 1 J
Section Na. Township ame or No. Renge No. Coun
Occupam (PpINn
\ ' ` ^
?L?'CV Phone/ ?No.
(?){? ?7
?/L.?` l L
Pawer Supplier petlress
Elec ' I Contrecior (Company Name)
ConVaciois license No.
1?
f?
Mailin tltlress (COnUactor or Ownar Making InsUllalion)
Aulhoriietl SidQture (COnlreqod ne Making Installalion) Phone u /r
? ` ?
/'r "
M SOTA STATE 9 RU OF
ECT TY THIS INSPECTION REQUEST WILL NOT
I II
rIB9s-MiEwey BIOg. - oom 5-
128 BE ACCEPTED BY THE STATE BOAFD
1ffi1 Univrsity Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
PM1One 161216420&4I mn nccn
REQUEST FOR ELECTRICAL INSPECTION
r 10, See inslrmdons tor campleling thle farm on back ot yellow cop¢
Below Wo,2- vered by Thrs Request
Ne Acjd Rep. Type of 6uilding Appiiances Wired Equipment Wired
ome Ran ge Temporary Service
uplex Water Heater Electric Heating
pt. Building Dryer Load Management
V omm./Industrial Fumace Other (Specify) l
arm Air Conditioner
he/ (speolfy) GonVacror's Remarks:
ot
Compute lnspection Fee Below:
# Other Fee # Service Entrance Size Fee # CircuitslFeeders Fee
Swimming Pool 0 to 200 Amps D ta 100 Amps
Transformers Above 200 Amps 100 -Amps
SIgnS Inspecror's Use Only: TOTAL
Irrigation Booms ?
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDEREO DISCONNECTED iF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby
tif
th
t
i
i
h
h R°O9n-in D.I.
cer
y
e above
nspect
on
a
t
as
been made. oa
? (B
OFFICE USE ONLY
This request vatl 18 monihs Vom
Tbis request vaid
18 ennnths imm
Do 519 8 2?.?,?
__
Requestpate . ,. .
Fi?e No. _., . ?.
Rouph-in Insoection I
Fequrted? ?' ReaAY Now Q Will No?ify. Inspeo
?1'es vfi- ?or When ReaAy
unvaccor I hereby request inspection of abova
Ow?IE! elBCfrical wmk insewlled nt
Stree[ Address, Box or ftoule Na.
? CiiY
ectmn o. Towns ip ame or No. Range o. County
Occup' PR TI Phone No.
o a_ ?
D er •
Power SuP L f ;:
•:T:?
. .
1937 ST [ LL'•'lA ER AVS.
Electrical CanVacmr IComuany me?
. . . ?.,. ? •.a?? 55119
Conhactor's License No.
?
Ma?ling AdJress ICOnvac[or or Owner Mekine instailationl
Authorized 8??? re ICoMrac Owner ing Installatinnl Phone Number
esul q qTE BO F ELEGTRICII
s-MiEwey . - Room N•191
Vni? v ve., St. Peul, MN 55704
3d=Z?
THIS INSPECTION FEQUEST WILL NOT
BE ACCEPTED BY THE STqTE BpqqD
UNLESS PROPEH INSPECTION FEE IS
ENCLOSED.
?/ w`? b REQUEST FOR ELECTRICAL INSPECTION ?y-
L Il, See inshuctiens for comoleting this form on back ot VBllow copV-
. 5 1982 "X" Below Work Covered by Ihis Request
Fdd PeO7YCe o1 BWltling APClianeee WireE _ EquiVment Wired l
Water Heater
Commercial Bidg. ??Furnace Silo Unloader
n- -? Industrial Blda. Air Conditioner Bulk Milk Tenk
rta ms
M r Fee Service Entrenca5iza n Fee Fextlers/Subteetlers p Fae Gircults
0 to 200 Am s 0 to 30 Am ps 0 to 30 An s
Above 20 _Amps 31 to 100 qmps 31 to 100'Am s
Swimming Pool Above 100-Amps <lbove 700_AmPs
TransPormers Irrigation E3ooms Partial,'Other Fee
? I I Signs ISpecial inspection
--
?
TOTAL F
Ramarks S /O .
l
pouBh-i^ Dme I, the ElecLieal
Inspector, heroby
cartify thxt the above
Final
42 C'oE
/01?0 inspection hes bean
metla.
Thin reQUeat voiE 18 months from
RESIDENTIAL
?S? 621 BUILDINC PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New ConsW ction ReauiremeMs
• 3 registered site surveys showing sq. ft of lot, sq. ft. W house; aM all raofed areas
(20% mauimum lot caverage allowed)
. 2 copies M plan showirg beam & wirMow s¢es: paured fau+M design, etc.)
• 1 set of Eneqy CalcWZtions
• 3 copies of Tree Preservatbn Plan'rf lat platted after 711/93
. Rim Jorst DetalOptdom seleMon sheet (bldgs with 3 or less unils) '
DATE l °% 'Ss. o-}? tYZ
SITE ADDRESS
TYPE OF
?q5 ca? ??
APPLICANT
a?p
RemodeVReoair Raouirements
. 2 copies of plan
. t set of Eneyy CalalaUons for heated additions
• fsdesurveyforextenoraddiUons&decks
. Indicale rf home served by septlc system for eddiqons
VALUATION 15'? (O S • `o
L_ Ln i-t MULTI•FAMILY BLDG _Y _N
e?QO ? FIREPLACE(S) _ 0_ 1_ 2
"-,=14a.c L ? ? L4 C';?
STREETADDRESS 4o7L.r2 ? Pe--zAITY6?`a?R.- STATE?? l-JZIP S?2S
TELEPHOTJE #^N?1-7 ` 9?g? CELL PHONE # Z 72 "'?11G'3 FAX #
PROPERTYOWNER ?? '_"n 4- :? uA y ?J?1a TELEPHONE# '-1510- o2-72-
COMPLETE FOR "NEW" RESIDENiIAL BUILDINGS ONLY
Energy Co atag?ry (? 11 C?? ESOTA RLJLES 7670 CATEGORY 1 MINNESOTA RULES 7672 77
?
(J submi? rype) ??, r l . Re?s,i Q?ntial Ventilafion Category 1 Warksheet Submitted • New Energy Code Worksheet Submitted
III
r Envelope Calculations Submitted
$ E p 2 0 2082E? uJ?
?lll?
Plumbing CQt?jr9ctor?-- Phone # _
Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00
_ Water Heater _ No. of R.I. Baths
_ No. of Baths
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Contractor.
_ Air Condilioning
_ Heat Recovery System
Phone #
Phone #
Fee: $70.00
I hereby acknowledge that I have read this application, 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
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
RE5IDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681•4675
New Construction Raauirementa
• 7 registered stle surveys showing sq. ft. af lol, sa. R. of house; and all moted areas
(20°/a maximum lot coverage allowed)
. 2 copies of plan showing beam 8 window s¢es; poured found design, etc.)
. 1 set of Energy Calalations
• 3 copies af Tree Preservation Plan if lot platted after 711193
• Rim Joist DeGd Oplians sHection sheM (bldgswith 3 orless unils)
DATE S ?A ? ?`7-.
SITE ADDRESS y a9s c 4<?? ? L-o&D- MULTI-FAMILY BLDG _ Y ?CJ
TYPE OF WORK>?Q a r-,f Q q 1_1 2-Y,? (.?. J?'?1.N1 FIREPLACE(S) _ 0 _ 2 APPLICANT
STREET ADDRE55 i Renewal By Anderseng Inc. ? STATE_ZIP
t'
c? ? , 1920 County Road "C" WesY -
TELEPHONE #I(S4 •akykCELL I Roseville, MN 55113 ?
PROPERTYOWNER ?l?GjU \!LQ1n TELEPHONE#(oSl•HSZD'?1GI
---------------------------------------------------------------------------------------------?-
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDING3 ONLY
Energy Code Category _ MINNESO'1':1 RCLES 7670 GA"CEGORY 1 NIINVESOT:1 RliLES 7672
(J submission type) . Residential Ventilation Category 1 Worksheet Submitted • New Ener9Y Code Worksheet Submitted
. Energy Emelope Calculatlons Submitted
Piumbing Contractor: __
Plumbing system includes:
Mechanical Conhactor:
Nfcclianical scs[em inclu<lcs:
Sewer/Water Contractor:
Air Conditioning
Hrat Rccoven 5ystcm
Phone #
Phone #
Fee: 57O.00
---°------------------^-°--------------°---...-------------.....--------------------------....----..._.....----....-°.
I hereby acknowiedge that I have read this opplication, state ihat the nformation is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan r inances.
Signature of Applica
OFFICE USE ONLY
_ Water Softener
Water Heater
_ No. of Baths
RemodeURaoair Reauirements
• 2 copies ot plan
• 1 set of Eneryy CalculaGOns (or heated addi6ons
• 1 site wrvey foreztenor additions 8 decks
. Indicate if home served by septic system for additions
_ Phone #
Laim Sprinkler
No. of R.I. Baths
VALUATION 1 D'q??
?flp,?)3_
Fee: $90.00
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required ^
Upda[ed 4102
°", "• ,°"•? ,••? ??. ?o rm 194 aeoo tmntsnjh, bratvunttbutv
7une 7, 2001
City of Eagan
3836 Pilot Kuob Rosd
Eagan, MN 55122
To Whom Ic May Concern:
Eider 7ones is authorized to pulllmiiding pennits for genewal6y Attdersen_ plr,ase a]low
F1dnr Jones to provick this servitec for us in L7agan. 'I'[tia suthorizst;rm is valid for any
date beyond 6/6l01; uAti1 a Ronawal by Andtrsen managar expresely revakes it in wricIng
to the City_
I request ttus authorization be accepted expedidously, ac to not delay m tha proaessing of
ovr baiidiag pormi.ta any ?rfficr. Plcasc cait mc If thcre src any questlons. I can Ua
contacted at 763-502-4706.
,
Your immydiate aucntion to fhis maticr 3s appreciaced.
Sinceivly, Si d R. Raee
on Ma?tager
Renewt?1 by A.ndcrscn Corporatian
WUU'G/ UU
C'c: Kstrn-F.lder Jnnec
gm:1014- DA?ry ??
Mlu?pffi
?on?.kn.?t?w0.s
Received Time Jun. 7. 1 :OZpM
?
BUILDING PERMIT
CITY OF EAGAN
3630 Pilot Kno6 Road, P.O. Box 21•199, Eagan, MN 55127
PHONE: 4548100
Receipt
SimAddreet 4295 NO CARLSON LAKE RD La 28 Bixk 1 ec/Sub. WILD RUN STH
Parcel No.
W I Name DON HIXQN
? Addrms SAME
cicv anone 452-2273
; Name DURABILT GARAGE
?U Acdd?s 7 43 ANNE CT
? citv EDEN PR phone 938-9350
Name
City
Phone
I hercby ackrowledqe that I Vave read this npvlication and re thaf
Nie inlormotion is corre[f ond ngre9 to comply wifh ol pOlicable
Srota of Minrosoto Stotutas on %ry of Ea? o Ordin s.
Sipnofun of PermiMaa •••. e
A euildlnp Permlt Is issued ro: DURABILT GARAGE:
dl work sholl be dona in acmrdonee.with oll applicobs StaZe oumh
Erect LJ Occupancy
Remodel ? Zoning
Repeir ? Type of Conrt.
Enlarge 0 No. Storiea
Move ? Lengeh
Demolish ? Depth
Grade 0 Sq, Ft.
Install ?
Appwah Fees
Assesunenf
Woter 3 Sew.
Dol{ce
Fim
En9•
Plannar
Councfl
aida. otf. 5 17 E 5
APC
Ver. Date
Permit 576.7U
Surchorpa 3 _ 00
Plan Review
SAC
Wofer Conn.
Water AAetar
Rood Unit
Parks
Taai $59.50
on N+s asVro++ corditlan thal
Statutes ond Ciry of Eapan Ordirances.
N_ 10276
.?-a J 0
Buildirq Offidal
/
1985 SUILDING PERNIT APPLICATZON - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED NITH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
To Be I1sed For• V ) Valuation: 5560-00 Date: S?I'7/ gS
Site Address: QqS nb,Nk Ct6r(W L4ki B-140
lrl(w Qu-
Lot:t'Zg Bloek ? Sect/Sub ?
Parcel #
Owner _DQ&) pI myJ
Address LQ25 f1)odih C-WrlSavJ LaN1 L(qrrt
Address ?t OFFICE OSE ONLY
City/Zip Code 1??aqeyv
Phone 452- 20-23
Contractor p(]d(¢?i)4 CpAfgfe S
Address 73q3 ONN CAC1,/-t
City/Zip Code P.1,41j..e Mi/n
Phone 931- S 6
Arch./Engr. -TQ? iQ OP/71a?
Erect _ Oceupancy
Remodel Zoning
Repair Type of Const
Enlarge ? !1 of Stories
Move Length
Demolish _ Depth
Grade Sq Ft
APPROYALS
Assessments Permit
Water/Sewer Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Road Unit
Bldg Off„s Parks
APC Treatment P1
Variance
TOTAL
City/Zip Code ?(
Ca?, ?3D
3. =
Phone 1{ 13 g- g3 SO
??a?s r?o. c?v?s??? C??? C?a?? '
CITY OF EAGAN
3795 Pilot Kneb Road Eagan, MN 55122 NP 4295
PHONE: 454-8700
BUILDING PERMIT APPLICATION Receipt
36
00 # 5788
$
,
0. _
To be uaed for S in.
Fam Owi Dote
i7nr
d Att
apzil
29, lq 77
_ e_
$_
_
Site Address 4295 No, CBTLSOII 1.ekE LII Erect ? Occupancy I
t 2$ B
L k 1
lo WR
Sec/S
b SYh
Alter ? Zoning
o c u
. _
Repair ? Fire Zone -
Porcel #
Enlarge ? Type of Const. Y
w Name DeIIi el HikSO[! Move ? # Stories
3 Add Demolish ? Front 49 ft.
ress
?
Grade ?
Depth
44 fi.
Cit Phone
Til Ho
I
A........,.1.
Fnwc
sen
mes
nc.
N ?
A ame
? Address 627 Cp. Snplling AVa
~ Cit Phone
u?
Name
FW
?? Address
<z
"'
CitV
Phone
I hereby ocknowledge that I have reod this opplication ond state thot
the information is correct and agree to comply with all applicable
State of Minnesota Statutes ond City of Eagan Ordinances.
Signature o4 Permittee -
A Building Permit is issued to:
all work shall be done in acco
Assessment - Permit lUtl.UV _
Woter & Sew. Surchorge 19 250
Police Plan check
Fire SAC 475. 00
Eng. Water Conn. Zj0.00
Planner Water Meter 60•00
Council
Bldg
Off.
.
APC Total 891.50
on the express condition that
of Minnesota Statutes ond City of Eagan Ordinances.
Building Ofticial
BUSLDIbtG PEfudIi P.PPLICn.TIO_4
Date e
BLOCK ? ADDTTIOPI Z-C)
PARCEL & SECTIO?d 1•9X18ER IF UiIPLi4TTED
ADDRESS OF PARCEL gt,-7
7,Oi3Ti,?G
LSTLqATZD COST < < ` !
TELEPSODIE N0.
AJDFiE:SS 2LRy24
CO[S'i"t2ACTOR "i$'j.EPHONT. i'TO.
aDaIREss
tdote? Include si.ta plan, building plaas, and energy calculations with this
aPplication
Si9ned
O^'^SCE USE
St?C
S'7a'tER COi3iV*EC_SOi7
C=IATER 17ETER
BUILDING PERLiIT FEA1
SJRCHARGE FEE
FLtui CFS.CK F£3
PAF.K DEDICATI03 ?
OTHER
TOTFiL*
?
'J6 ? ._
SL7
/ :5
APPROVALS:
ASSESSME:`?T CLERK BUILDIidG DEPT. POLICE DEPT.
?•TA.ER E SEF7ER DEPT. FI*_L BrPT, PAtiK DEPT.
?
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rRowT.._?ROpF2TY..,_LiNE ?
--
V?- LUT -PL AN
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CITY USE ONLY
LBL RfCEIPT #: 9 ?
SUBD. ? 5 ? DATE: /D 5 U
e•97f/98/0' 1005 1995 MECHANICAL PERMIT (RESIDENTIAL)
?e'?j? A*MC_ae. t?) °' CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
New construction Add-on furnace
? Add-on air eondi;;onirtg ? Add-csn sirexcnan-yer, i.e. i/anee sys-iem, etc.
Date: N-otig`gJ
EEM
? Minimum Fee: Add-on/Remodei (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL
SITE ADDRESS: ?AE) N0CO--r rA1rISdr1 1.a1hF, I.Q_ne,
OWNER NAME: PHONE #:4??-
INSTALLI
STREET
CITY: ? STATE: ZIP: LL22?111p)
PHONE #:
OF
3795 PILOT KNOB ROAD, P.O. BOX 21199
EAGAN. MINNESOTA 55121
PHONE: (612) 454-9100
October 26, 1982
DON HTR50N
4295.N0_.CARLSON LAKE. RDJ
EAGAN MN 551213
Re: Tree Planting on Residential Property
Dear Mr. Hixson:
BEA BLOMOl115T
naav«
THOMASEGAN
JAMES A. SMITN
JERRY TViOMAS iHEODORE WACHTER
CounCil Members
iHpMAS HEDGES
Ciry Atlm'vtlskalor
EUGENE VAN OVERBEKE
City Clerk
Per our telephone conversation of October 26, 1982, you raised two questions
about the replanting of trees on your property at 4295 North Carlson Lake
Road. The questions pertain to setback requirements for the planting of
trees and a qualified list of trees that are approved for planting within
the City of Eagan.
Regarding setback requirements, there are no specific regulations provided
in Ordinance 46. However, it is usual and customary that property owners
plant trees far enough back from their property lines so that future over-
hang is contained within their own property. If a tree does overhang
on adjoining property, it is permissible that the adjoining property owner
trim that portion of branches or foliage that overhangs his or her property.
As your question relates to trees that are permissible on residential pro-
perty, I have enclosed a list and any tree that is listed as. a permitted
tree to be planted in the City of Eagan under Section 46.04 is allowable.
Your consideration and action to conform with enforcement of the City ordi-
nance is greatly appreciated. If you have any further concerns or ques-
tions, please inform the City's forester, Tom Schuster, or me at any time.
Sincerely,
?.-
Thomas L. Hedges
City A dministrator
TLH/hnd
Enclosure
cc: Tom Schuster, City Forester
THE LONE OAK TREE...THE SYMBOL AND GROWTH IN OUR COMMUNIiY
/
SECTION 46.0,
:•.?
Th?
No:
CL
Em,
Scl
Rea
Su!
Oh:
Hai
Wh:
Aut
Gri
Mai
$UI
Gii
ZmF
Sk}
Kec
FlE
Rac
Var
Irc
AID4
$WBwp-waa1LC VaK kqUeLC11S OlCOlOI)
Pin Oak (Quercus palustris)
Sovereign Pin Oak (Quercus palustris "Sovereign')
White Oak
Japanese Tree Lilac (Syringa amurensis japonica)
American Linden (Tilia americana)
Littleleaf Linden (Tilia cordata)
Greenspire Linden (Tilia cordata 'Greenspire')
Redmond Linden (Tilia x euchlora 'Redmond')
Eagan:
I,Queen')
le`)
'urple')
[arshall Seedless')
I )
All Evergreen species
SECTION 46.05 -- NON-PERMITTED TREES FOR THE VILLAGE OF EAGAN
It is unlawful to plant any of the following trees within the Village
of Eagan:
Ulmus All species All Elms
Ginkgo biloba Ginkgo (Maiden Hair Tree - female only)
Quercus Red species All Red or Black Oaks (sharp, pointed leaf)
Acer negundo Boxelder (Ash-leaved Maple)
Populus :deltoides Eastern Cot[on-wood
Populus nigra italica Lombardy Poplar
- 3 -
THc?c A-? 2
y ?; r CITY OF EAGAN NEI4ftUK-s
OFFICE INFORMATION MEMO WEEo C?o...
TO DATE TIME
?
C
?
l ?
FROM O
PHONE NO. RECEIVED 8V
431-7733 S
Was here to sae you Will call again
Please call your call
ACT{ON
4 RE///M???ARKS/MESSAGES?'I
R Review and sae me ?r\?G?p u eI Y? A1TL/ 0
V " F'? j ?/1 U wf
DATENEEDEO
sV&,JSE
FOUGH OIiAF7
SINGLE SPACE
DOVBlESPACE
? RUSH
FINALCOPV
CARBONS-
BEA BLOMOV I5T
MAYOR
THOMASEGAN
JAMES A. SMITH
JERRYTHOMAS
THEODORE WACHTER
COUNCIL MEMBENS
I
Mr. Don Aixson
4295 North Carlson Lake Rd.
Eagan, Minnesota 55121
RE: Tree Planting
Dear Mr. Hixson:
CITY OF EAGAN
.?b...?
PICOT KNOB R04D
;\';,`.P.0 ;BO%211H - ?
° 'EAGAN, MINNESOTA
.ti•,? ?sstzn . .. .? ,
? PHONE 450-8100
?.. .? .
[...?;;; .
r .:T S ..t .:v..1., .
t '
y?Kt
?
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.?. ,..._
October 20 , 1982
Fli-4
TNOMASHEDGES
GIiY AOMINISiRAiOP
EUGENE VPN OVERBEKE
CIiY CLEflK
As you may or may not be aware, there has been a complaint made with the City re-
garding trees that you recently planted in your yard. These trees have been examin-
ed and foimd to be Lombardy Poplars, which are a non-permitted tree under the City's
Tree Ordinance.
Because of the complaint or complaints, and the obvious Ordinance violation, we
are requesting that you remove the trees as soon as possible to prevent the uoten-
tial hardship of moving trees that are more mature than these that you recently
planted. Apparantly, trees other than the non-permitted trees under the Ordinance
can be planted in place of the Lomtiardy Poplars.
If you have any questions, feel free to contact me.
Very truly yours,
CITY OF EAGAN
Thomas Hed'? ??????
ges
City Administrator
TEI ; ras
TME LONE OAK TREE ... THE SyMBOL OF STRENGTH AND GROWTN IN OUR COMMUNITY.
? -
. P?.5 2-942238
RECEIPT FOR CERTIFIED AAAIL
NO INSURANCE COVERAGE PPOVIDED-
NOT FON INTERNATIONRL MAIL
(See Reverse)
SEN/TnTiO ///
ST/REETANONQ
P.O.. STATE ANO ZIP COOE
? .- / .
POSTAGE S
CERTIFlED FEE ¢
SPECIALpELIVERY E
RESTRICTEDOELNERV ¢
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DfSEDELIVENEO
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SHOW TO WHOM. DATEAND
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xesraicreooeuveev
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^ TOTAL POSTAGE AN D FEES S ,
a POSTMARK
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SENDER: B¢ sure }o follow instrucfiens on olh¢r side
PLEASE FURNISH SERVICE(S) INDICATED BY CHECKED BLOCK(S)
(Additfonrtl chcr4ea rspidred {or these aervioea)
Show address Deiiver ONLY
? where delivered ? to addressee
U.S. POSTAL SERVICE
OFFICIAL BUSINESS
?
8
PENALTY FOR PRIVATE
U5[ TO AVOID PAYMENT
OF POSTAGE, $300 ?
U.S.N7AIL
?
? Pasimark ot DeHverinR Dffice
r
n
SEYDER INSTRUCTIONS
yri FPmt e s0ec e beloer yaur namo, addrass, including ZIP Code.
? special services ere desir:d, check black(s) an aiher sido.
? vi<ton gummed enCs antl attacA to 6zck of article.
00 11 CJC ?.?..........
? 3795 Pilot Knvb Road
@ Ea[G.RPT, MIP7F(. 5512$
LL
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n
RETURN
TO °
? :? r? / a ? (??::,?i??;rv,YCK-?? ?.?u^"? J ?G'
410 W. LAKE ST. 7072 PAYNE AVE.
MINNEAPOLIS, MN 55408-2998 ST. PAUL, MN 55101-3892
612/824-2656 HEATING AND AIR CONDITIONING CO 612/772-2449
Serviv¢ TheTwin Cities Sinm 1930"
ORSAT TEST RECORD .
ADDRESS CITY
OCCUPANT OWNER ?JD N'
DATE HTG. INST. INSTALLED BY NT?j
GAS LINE BY Sw /lI?
TYPE OF HEAT: GA FA_k- HW STEAM SPACE HTR. UNIT NTR._OTHER
GAS DESIGN CONVERSION
MAKE ,&f YW /.? ? MAKE OF BURNER
MODEL MODEL
SERIAL O?p,?g MAX. BTU RATING
INPUT cSyk, ?O MAKE OF FURNACE
---?
CONTROLS
MODEL
? ` ??
THERMOSTAT YfUL HEAT PLUG VENT SIZE ??,?"
vALUE KC ?2/J"j KING OF LINER
NONE ?
LIMIT _" y?9,cJ'T DRAFT HOOD_6jQpr-REfULATOR
LIMIT SETTING CHIMNEY CONSTRUCTION ?//?,
FAN SETTING l/iylel-jS DRAFT p 1 TJY,4-' TEST TAC zw 6?j'L?AtE
PILOT TYPE_ LIGHTINS INST.
PILOT MAKE ? r y/j1(.J r
PILOT MODEL
PILOT TIMING Z.-S- ,
PRESSURE Z•,S v PERCENi CO2 .--1 DATE
INPUT CFH F?P- PERCENT 02
STACK TEMP. (}" PERCENT CO /UDA,?C NAME
TESTED
OF TESTEP,?_(..,
SIZE
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117689
Date Issued:10/22/2013
Permit Category:ePermit
Site Address: 4295 Carlson Lake Lane N
Lot:028 Block: 001 Addition: Wilderness Run 5th
PID:10-84354-01-280
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 .
David Pederson
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 -
John Velo
4295 Carlson Lake Lane N
Eagan MN 55123
Dun Rite Roofing
4086 Miller View Road
Elko MN 55020
(952) 461-5155
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
. r----------------�
I For Office Use ��,`,:
' � Permit#: !��� �� V.�'� ��
Clty of ����� � �, f� .�;�
� Permit Fee: �" �
3830 Pilot Knob Road j ��_ � �
Eagan MN 55122 I Date Received: �" I
Phone: (651) 675-5675 � I
Fax: (651) 675-5694 s`'�� �;� I Staff:
.,� _ � �-----------------�
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: �������Site Address: -T���C�IS4 tt �� ��z /�
Tenant: Suite#:
� �� { ` / �5�/� y�S� --o�7z
� Name: �1"r h ��L�3?� Phone:
� +esid�r�#/�'lwner
����.;:. . _#�� ,; Address/City/Zip: �.��Car"��' �� Lfz /Y �ic Cc./7 5���
�;..
�
���� �� a Name: License#:
�t� ��
� � � . ,
�����` ����� Address: ` City:
� Cc�r�#ractor �� ��
�:�����
���� ��� � State: Zip: Phone:
�
��' Contact: Email:
���� ����� �.� ���
� - New �Replacement _Repair _Rebuild _Modify Space Work in R.O.W.
, T�pe�� �r�� .� — � —
�"' �. , . " Description of work: r"` /� Er�-u-��� �--�Se�`^-��
�� ����y" RESIDENTIAL
� _: :
�
Water Heater
��� ���� � �#w
Water Softener
���� "��* Lawn Irrigation(_RPZ/_PVB) .
� �������� y Add Plumbing Fixtures(_Main/_Lower Level)
�� ;`� � Septic System
� ���� �� � � = Water Turnaround
�..n� � ���� �� �� _New
� *�;
�;�. :::�
��_¢ �"� � Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Turnaround*(includes State Surcharge)
"Water Turnaround(add$210.00 if a 5/8"meter is required)
$115.00 Septic SVstem New(includes County fee and State Surcharge)
TOTAL FEES$
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. i2//�s� C.o
X ���,�t ��t� X �
ApplicanYs Printed Name Applican ignature
,. . � ��:* � �� � �
'��� �'���- r r . :� ,�����.� �:�..°° ; ��. `�2.:r�' `��
f OR OFFJCE�! ��- ` �.*�� ���*�.� �� R� �d�3� �� ��� � €N: ��#e �.�...�.�
� �� ���� �� � �.�, . , ������ ,
Requ�red lns��������� � ��r� �� � ��n ��r'��st G�s Test ' Fira�����
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Mete�rl�+�lated 1���r��s� Meter����"�`'�: �. .�adio#Ze�� �' ; Manc��ter ` �: ,��.�,. t�� ��~,,
,.���.�if t.r. � �
Use BLUE or BLACK Ink (
`► � r---------------
_,
I For Office Use ��(GW
. J
� Permit#: / ���� ' �.�✓f�
�lt� 0� ���1�I1 � � ���,,
Permit Fee.
3830 Pilot Knob Road � / ��
Eagan MN 55122 r s - �w� � Date Received:�" c�c� '/� �
Phone: (651)675-5675 � �
Fax: (651)675-5694 {� ;.j�. I Staff: �
� �L�� Z � �.�.3r� � ------�
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7�-Z��-� Site Address: /��/���-e�r��fi ��-c.. L� /� Unit#:
fi T Name: ��h ��-( D Phone: ��/" fj'rS�—O���
F��,s�d�n�` �r �/
� ��� ° Address/City/Zip: TOZ �S C�A�/` �Sc�fi L�.�e.. L-tr :/y o �a�'1�h �S��j
o � �� � . � � a
� ; Applicant is: X Owner C3on#ractor �'`
l� ,a.c_� � �.e�ec.^ � �-�c-7"-�"'�`crt� i.vc9r
° 6L
Description ofwork:�d�ev' �-��e �,_ `''.��a�.�' p�h e�,".�'�" �����c�uc� r.e- �i�c�-
�'�A�'t����'1��, � ��—� ���,-c
�I ; Construction Cost: � ��� Multi-Family Building: (Yes /No� d"``' j
e
� �d S
Company: Contact: '
�
`` ;,.�
�������, Address: City:
�,.
` State: Zip: Phone: EmaiL•
'� License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
.
v/6. /� c% /� �� %J'Q/1�-i oR. � .
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: I
Sewer 8�Water Contractor: Phone: I
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Fire Suppression Contractor: " ` � Phone:
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the l�#��r�i"�r���ta�+��c�����1 e�����r���t' ��e����r�ror���t�a'�1��'�����r��
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CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.popherstateonecall.ora
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Build' Code must be completed within 180
days of permit issuance. r
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ApplicanYs Printed Name Applicant's g ature
Page 1 of 3
���'/'� ����._ ,Lf�}}� �� � �DO NOT WRITE BELOW THIS LINE 1 �����
SUB TYPES ,
Foundation Fireplace Porch(3Season) Exterior Aiteration(Single Family)
Y 5ingle Family _ Garage _ Porch(4Season) _ Exterior Alteration(Multi)
_ Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex Lower Levei Pooi Accessory Building
WORK TYPES
_ New _ Interior Improvement _ Siding Demolish Building*
dition 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 �_ Occupancy Z G� MCES System --
Plan Review Code Edition /�'�' SAC Units ""
(25%_ 100%� Zoning � -- City Water -- I
Census Code �13y Stories -- Booster Pump ^ I
#of Units i Square Feet PRV -- i
#of Buildings t Length �, Fire Suppression Required `� I''�
Type of Construction � Width .� I
REQUIRED INSPECTIONS �
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings (Addition) " Final/No C.O. Required
Foundation � HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice &Water _Final Pool: Footings _Air/Gas Tests _Final
� Framing . • Drain Tile
Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick
� Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Other:
Reviewed By: �i� , Building Inspector
�
' RESIDENTIAL FEES �_ ,[��� �f ,i(,L /C�N � ,�.Q� l�p�O�
7-
Base Fee $'g'�
Surcharge
Plan Review ,�7 ,�-'3--
MCES SAC
City SAC
Utility Connection Charge
S�W Permit 8�Surcharge
Treatment Plant
Copies
TOTAL
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