4251 Carlson Lake Lane N
C1 *F EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner. 't•_~. _
Address:
Site Address: l Win„ ~'T'
Plumber:
Meter No.: Connection Charge: 2'-L l'
Size: - Account Deposit:
Reader No.: Permit Fee:
1 agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.: Insp.:
CIT F EAGAN SEWER SERVICE PERMIT
X3795 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address: ' Ea C,% r) an,i r - x -
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp.: Total:
Insp.:-_ Date Paid:
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota $5122
Phone: 454-8100
PERMIT No.
Date: tray - 19-77 Receipt No.: ^6133
Single
Site Address _x a e -a , ~ Residential
Lot Block Sub/Sec. Multi Res., Comm./Ind.
Name _ +c r:..,
New /Alter./ Repair
a Address Cost of Installation
L r
ity , Paul _ Phone: Permit Fee
.
` Name _ . Peter Co. Surcharge ,ten
i654 Grand Ave.
Address
a
0
ca "t .
:SiOS : Total 2(-).S,-.
City Paul Phone
This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Building Official
CITY OF EAGAN
a 3795 Pilot Knob Road
Eagan, Minnesota 55122
l Phone: 454-8100
PERMIT No. '
c. 197/ Receipt No.: 05856
Date: ' '
Single
Site Address: Residential
Lot Block Sub/Sec. Multi Res., Comm./Ind.
Name New/After./Repair
f 27 So. Sr",e-!' inq "?1v.-..
dress Cost of Installation
44
City ' L Paul Phone: Permit Fee 2
Binder & Son Inc. -5n
` Name Surcharge
Address '0 E. Butler 7%ve.
C
O
City Phone: Total
This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Building Official
CITY OF EAGAN =2 18079
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PEF #fli Receipt # C
To be used for 3-SEASON (PORCH Est. Value $8,000 Date JULY 2 1990
Site Addr ss 4251 R CARLSOII LAU LN
Lot s Block Sec/Sub. U OFFICE USE ONLY
Parcel No. Occupancy FEES
JIN DREMR zoning - ".00
W Name (Actual) Const Bldg. Permit
Address (Allowable) 4.00
Surcharge
C City. Phone # of Stories
Length Plan Review
=o Name DRENTLAV BROTHERS CONST Depth SAC, City
U~ Address 4 NAATI11DAl.E St NE S.F. Total SAC, Mcwcc
City PR'91 LAKE Phone "5-570S.F. Footprints -
On Site Sewage Water Conn
W Name On Site Well Water Meter
=
Address MWCC System
Acct. Deposit
City
City Phone Water -
a W
PRV Required S/W Permit
I hereby acknowlege that I have read this application and Mate that the Booster Pump SNY Surcharge
information is correct and agree to cc ly wi a t .abl S of
Minnesota Statutes and City of Eagan OrniFtances- Treatment PI
Signature of Permitee 'j~, APPROVALS Road Unit
A Building Permit is issued to: D W BROTHERS CWST Planner Park Dad.
on the express condition that all work shall be done in accordance with all Council
applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies 103.00
Building Official Variance TOTAL
Permit No. Permit Holder Date Telephone N
WATER
SEWER
PLUMBING
H.V.A.C. `
ELECTRIC (pQ ~/o O ~amp
Inspection Date Insp. Comments
Footings 1 ~Z
Foundation
Framing ~0 E~2
Roofing
Rough Plbg.
Rough Hig.
Isul.
Fireplace
Final Htg.
Final Plbg.
Const. Meter Plbg. Inspector - Notify Plumber
EngrJPlan
B14 Final
Deck Fig.
Deck Final
Weil
Pr. Disp.
/ j !
sAtrt✓
fell -7
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 N~ 4 2 9 6
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for Att_ rimma_ Date a 19
Site Address x,251 a`--'• Clarlson Lake 3.X1 Erect Q Occupancy
Lot Block t Sec/Sub. Alter ❑ Zoning
Parcel # Repair E] Fire Zone _
Enlarge [I Type of Const.
W Name JAM?'- °-r - Move ❑ # Stories
z Address Demolish ❑ Front ` ft.
a City - Phone _ Grade E] Depth ft.
0 Name sen i:,,i T ??2 r., Approvals Fees
0
od Address r: ayr Assessment Permit
U~ - Water & Sew. - Surcharge i -
i
~ city Phone Police Plan check
FW Name Fire SAC I` ;a
-Z '2
1:7, Address Eng. Water Conn. So•tltl
¢°Z' City Phone Planner Water Meter ` ` •'jU
Council
I hereby acknowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to comp!y with ail app!icable
State of Minnesota Statutes and City of Eagan Ordinances. APC Total
Signature of Permittee
A Building Permit is issued to: on the express condition that
' all work shall be done in accordance with all applicable State of Minnesoto Statutes and City of Eagan Ordinances.
r
Building Official - -
r
i
Permit # Date Imed pamMiee
Plumbing ~a - y, ,
Mechanical mac-- - 7 7 e~ Q
INSPECTIONS DATE INSP.
Rough-In Final
Footings Date Insp. Date Insp.
Foundation _ Plumbing
Frame/ins. Mechanical
Final
-p->>
Remarks:
II
I
CITY OF EAGAN Remarks
Additi Wilderness Run 5th Addition Lot 23 Blk 1 Parcel 10 84354 230 01
Owner h L [A l 4251 No. Carlson Lake Ln. State Eagan, MN 55123
U. r-~ ..1 Street
Improvement Date Amount Annual Years Payment Receipt Date
STREET SUR F.
STREET RESTOR.
GRADING
SAN SEW TRUNK a~ 1973 4&:-63- !03 20 _ _
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA
W1 rn03469
1977 r248.93 60 10.66 15 149 4
STORM SEW TRK 1981 16.60 15
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. a O6 3 y_ 1.9 -
BUILDING PER.
SAC 'JPARK
CITY OF EAGAN N.o 18079
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 C S~
BUILDING PERMIT Receipt # O
To be used for ° 3-SEASON PORCH Est. Value $8,000 Date JULY 2 19900
Site Address 4251 N CARLSON LAKE LN
Lot 23 Block 1 Sec/Sub.WILDERNESS RUN OFFICE USE ONLY
Parcel No. Occupancy FEES
Zoning
a Name JIM DREGGER (Actual) Const Bldg. Permit 99.00
3 Address 4251 N CARLSON LAKE LN (Allowable) Surcharge 4-nn
o City EAGAN Phone a of Stories -
Length 141 Plan Review
',o Name DRFNTI.AW BROTHERS CONST Depth 141 SAC, City
Address 4994 MARTTNDAT.F. ST NE S.F. Total SAC, MCWCC
City PRTOR I.AKF. Phone 445-5707 S.F. Footprints
On Site Sewage Water Conn
ww Name On Site Well Water Meter
z
MWCC System
E Address Acct. Deposit
aw City Phone City Water -
PRV Required SM Permit
I hereby acknowlege that I have read this application and State that the Booster Pump SNd Surcharge
information is correct and agree to comp] with II-a . le State of
Minnesota Statutes and of Eagan Or i ance. Treatment PI
Signature of Permitee APPROVALS Road Unit
DRENTLAW BROTHERS CONST Planner Park Ded.
A Building Permit is issued to:
on the express condition that all work shall be done in accordance with all Council
applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies
df Variance TOTAL 103.00
Building Official ~~.~.~P1rAf A 11dJ
p 4672 ,?3 j~
tc' ' -
Request Date Fire No. Rough-tin Inspection
Z ` Requin, D F ~ Now O Will Notify Inspector
7 - Yes OL@o rv ! When Ready?
I W Lcensed contractor D owner hereby request inspection of above electrical work at:
J Job Address (Street. Box or Route No.( City
`t2- 5-1 Section No. Township Na" or No. Range No. County
Occupant lPRINTI Phone No.
Power Supplier Aden..
Electncal Contra r (Company el Contractors License No.
l „ A, 0 3oz ~y
McAmg AOaress t moctor or Owne Mak g Installation,
/75~ k<nfs St A.~ SSioY
Asthorrzea Sig ture (C0 <tor• ¢.,g Installation, Pnone ber
YG- 71s/
'ri
MINNEB A E BOARD OF ELECTRICITY THIS INSPECTION REODEST WILL NOT
Griggs-Midway Bldg. - Room S170 BE ACCEPTED BY THE STATE BOARD
1821 University Ave.. St. Paul. MN 551()4 UNLESS PROPER INSPECTION FEE IS
Phone 1612)642-0880 ENCLOSED.
4 yry REQUEST FOR ELECTRICAL INSPECTION EB-00001-08
0/10? ► See irstruc-lions for completing this form on back of yellow copy
1446,72 "X" Below Work Covered by This Request
ew Adtl Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial k Furnace
Farm S(, Air Conditioner
Other (speatyl Coutrtincre Remarks'
Compute Inspection Fee Below:
# Other Fee f# Service Entrance size I Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above200f Amps Above 100Amps
Signs Inspectors Use Only. TOTAL
Irrigation Booms / 1 S ~U
Special Inspection G
AlarmiCOmmunication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rooghin Date
certify that the above inspection has Firi oche
been made.
OFFICE USE ONLY
This request void 18 months from
7~io/So C &wc?
CM 33560Z A/ Q °O
Request Date Fire No. Rough-in Inspection
CI' v' Re imd? ❑ Ready Now /VAI Notify Inspector
Ves El No / \ When Reatly?
I ❑ licensed contractor owner hereby request inspection of above electrical work at:
Job Address (Street. Box or Route No I City
Section No. Township Name or No. Range No. ' unty
Ottupanl (PRINTI Phone No.
Power Supplier Address
Electrical Com actor (Company Name) Contractors License No.
Mailing Address (Contractor or Owner Making Installation)
A&VE
thou 0 Signature ICOnaactortOwner kin Installation) Phone Number
2-^ 2 !
SOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
r gs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD
2t University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone(612)642-01100 ENCLOSED,
~~/go REQUEST FOR ELECTRICAL INSPECTION ~ f,=s EMOMI-07
See instructions for completing this form on back of yellow copy.
€A~ Q ~q
"ua« v
0 3 3 5 6 0 'X" Below Work Covered by This Request
New A[Qj Prep, Typeot Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
CommAndustrial Furnace
Farm Air Conditioner
Other (specify) Contractors Remarks:
Compute Inspection Fee Below.:
# Other Fee # Service Entrance Size Fee # Circuas/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps A ove 100 Amps
Signs Inspectors Use Only: TOTAL ,SO
• d~C,/7
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION BE ORDERED DISCONNECTED IF NOT JVAX Other Fee COMPLETED WIT 1 MO TH
I, the Electrical Inspector, hereby Rough-in lie~,( 1i 61"A Date'
certify that the above inspection has Final oat
been made.
OFFICE USE ONLY
This request void 16 months from
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55112 N2 4296
W PHONE: 454-9100
BUILDING PERMIT APPLICATION 5369000, Receipt # 5789
To be used for Sim- Fam llrni 8_ A Arr r.:..- Date April 29+ , I9 77
Site Address 4251 No. Carlson Lake Ln Erect occupancy 1
Lot 23_._ Block _I Sec/Sub.- WR-501.- Alter ❑ Zoning Rl
Parcel # - Repair ❑ Fire Zone _
Enlarge ❑ Type of Const. V
a Name James Dra¢er Move ❑ # Stories
3 Address Demolish ❑ Front 64 ft.
Grade ❑ Depth 24 ft.
city Phone
Nome rilsen Homes, Inc. Approvals Fees
0
o13 Address 677 Sn_ Snellinoe AVe Assessment Permit 108.00 _
U~ Water & Sew. Surcharge 18.50
i- City SL. Paul Phone Police Plan check
U„w Name Fire SAC 475.00
~W 230.OU
xz Address Eng. Water Conn.
¢w Cit Phone Planner Water Meter 60.00
Council
I hereby acknowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to comply with all applicable APC Total 891.50
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to, Tilsen Homes Inc. - on the express condition that
all work shall be done in accord ce witli\all/app ruble State of Minnesota Statutes and City of Eagan Ordinances.
Building Official ~~ie
1 -4
Date:
BUILDING PERMIT APPLIC:NTIO_d
LOT _T BLACK ADDITIOII Ge)
PARCEL & SECTION mU MER IF U't1PLATTED
ADDRESS OF PARCEL J4!7
7O01!,TG - OCCUPANCY USE w. 4U~ Oitl!<
7s'STLIMTED COST
:'Fi,IIiR TELEPHONE W.O.
ADORES
A
COQ p-TSCTOR TELEPHONB. '10.
ADDRESS
Notes Include site plan, building plans, and energy calculations with this
application
Signed
OPrICE USE
V.ALUt1TI0i3~~(o 66o
SAC A 7S
DATER MUTEC _ IO 1 ~~go -
CTATER IdETER ^T^^ ~ 60
BUILDING PERMIT F,2;
SURCHARGE M. ) 5;/ _
PLdUi C P.CK FEE
PARK DEDIC.ATIOid FEE
OTY,ER _
TOTAL*
APPROVALS.
ASSESSIvM@u CLERIC BUILDING DEPT. POLICE DEPT._______
WATER & M,%R DEPT. FIRE DEPT. PARK DEPT.
To- ' Tilsen Homes, Inc.
627 SOUTH SNELLING AVENUE
ST. PAUL, MINNESOTA 55116
7C~ PHONE: 698-5501
j Subject btu c e.~~~ c~ Date
Message
5/ ~2 ~'c2dn~
PLEASE REPLY TO Signed
Reply
4 4
§14044,1f- eoffW"
t
Signed Date
Form No. QL-3 SEND PARTS 1 AND 3 WITH CARBON INTACT - PART 3 WILL BE RETURNED WITH REPLY
f
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LoT BLOCK
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-PLC) T P L A~4
00
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
OF RENTAL UNITS
OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
c/ JUN 2 6 RECD
To Be Used For: 3 564561v1 P" Valuation: b ycD~ Date:
Site Address 6{2sl OFFICE USE ONLY
Lot 23 Bl~ocAk~'~I ~v_- I FEES
Y'GY/.a dw Occupancy
Zoning
Parcel/Sub {vy• Actual Const Bldg. Permit 99•o O
Allowable Surcharge ~1<yJ
Owner t lyl., {~(P( # of stories Plan Review
J /r j ,9 Length t4' SAC, City
Address Depth I SAC, MWCC
S.F. Total Water Conn
City/Zip Code L-4R,,. 5Sf~ Footprint S.F. Water Meter
Acct. Deposit
Phone On site sewage- S/W Permit
On site well _ S/W Surcharge
Contractor Q~Ei~~t ;ADS MWCC System Treatment Pl.
'94 5 City water Road Unit
Address ja p PRV Park Ded.
Booster Pump Copies
City/Zip Code SUBTOTAL
APPROVALS Penalty
Phone ~~5 Planner TOTAL
Council 7
Arch./Engr. Bldg. Off. Z,
Variance
Address
City/Zip Code
Phone #
f , X
V QLU
i t4 i
r~r xr4 = f q` x r) L(~ ~ri~ gv a z
i ~
I 0•*
99.00+
4.00+
103.00*+
5
P 79~ 4WAffArY LruE
I o, ~ I
1 - ^
~ I lJ, ~ UNE~
C\(1° 'I 1
I I
yQ~sE
-2
LiN
L oT BLac k 1 I
CITY OF EAGAN FOR CITY USE ONLY
~j ~p19~Jr/ ~dI54"" 3830 PILOT KNOB ROAD
EAGAN MN 55122 PERMIT #
PHONE (612) 454-8100 RECEIPT # O 9
(~CAr I'F DATE: o? /
RBSIpZALs PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION FEES
NEW CONST ADD-ON MINIMUM 15.00
ADD ON HVAC 0-100 M BTU 2 00
REPAIR ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
OWNER NAME: J/m fief _
/ SUBTOTAL: $ / OG
SITE AADppDRESS: SI /G.. Ci IS<~ ! ~r G" STATE SURCHARGE: .50
LOT:, BLOCK SUBD. TOTAL'
INSTALLER: DAKOTA
HEATING AND COOLING
ADDRESS: 2npn c!i VER 0966 ROAD _ SIGNATURE OF PERMITTEE
EAGAN, MN 55122 0
CITY: .t54-44608 ZIP: _ ~/~3a•.~9/~ ~~sp~'"~
PHONE
I;OMI4ERCIALfINDUSTR AL PLEASE COMPLETE THIS FJKTiON FUR ALL COMMERUiAL/INDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE: FEES
OWNER NAME: _ 18 OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
SITE ADDRESS: EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING - $25.00
LOT: BLOCK SUBD. _ $25.00 MINIMUM FEE.
INSTALLER: _ CONTRACT PRICE x 18 $
ADDRESS: _ STATE SURCHARGE $
CITY: ZIP: _
TOTAL: $
PHONE
(SIGNATURE)
FOR:
CITY OF EAGAN
Use BLUE or BLACK Ink
r
For Office Use
-7
Permit
City of EaEd I Permit Fee: C/o c I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 i Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: K I S - V s A c7 Phone:
RESIDENT / All
OWNER Address / City / Zip: Z° S 0 Applicant is: Owner contractor
Description of work: ✓ f A/ S Z L eI ~Ly II I" 141~$e-f A4, 4
TYPE OF WORK
Construction Cost: ® Multi-Family Building: (Yes / No
I tt `
Company: e r h I Contact: ~1 L V-
{ ;.3 6 a I- City:
CONTRACTOR Address:
~o
} State: ~L Zip: SS Phone: Z
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateoner-all.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Min es to State Building de ust be completed within 180
days of permit issuance. Q
x c 2~ 0 •J-~ x
Applicant's Printed Name nt's Sig atur
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA142298
Date Issued:04/25/2017
Permit Category:ePermit
Site Address: 4251 Carlson Lake Lane N
Lot:023 Block: 001 Addition: Wilderness Run 5th
PID:10-84354-01-230
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Dakota County 55123 4251 Carlson Lake
12701 County Road 9 Blvd
Goodhue MN 55027
(651) 208-2602
Todd Evavold Construction
227 1st Street South
Nerstrand MN 55053
(612) 221-1123
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA155484
Date Issued:05/17/2019
Permit Category:ePermit
Site Address: 4251 Carlson Lake Lane N
Lot:023 Block: 001 Addition: Wilderness Run 5th
PID:10-84354-01-230
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jesse N Chase
4251 Carlson Lake Lane N
Eagan MN 55121
Golden Valley Heating & Air
5182 West Broadway
Crystal MN 55429
(763) 535-2000
Applicant/Permitee: Signature Issued By: Signature