1258 Carlson Lake LanecIrir eF ZAa.;N
3795 Pilot Knob Road
Eogon, MN 55122
Zoning:
Owner:
Address:
Site Address:
1/l,lf-!7 W0
[rZEsfl41 Lake
1 ogree to complr with the City of Eagan
Ordinances.
gy
Date of Insp.
I nsp.:__
SEWER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
Connection Charge:
Account Deposit: _
Permit Fee:
Surcharge:
Misc_ Charges: _
Totol:
Dote Paid:
CITY OF E/la6N
3745 Pilot Knob Road "
Eagon, IVtN 55122
Zoning:
Owner;
Arl(Irnee•
WATER SERVICE PERMIT
PERMIT NO.:
DATE: _
No. of Units: ?
Tane !' 7 ^2 '-
Site Address: 5,9 r?
Pl umber:
Meter No.: ,
Size: __
Reader No.:
I agree to wmplq with tha City of Eogon
Ordinanees.
By
Dote of Insp.:
Connectiorr Charge: ?
Account Deposit:
Permit Fee:
Surcharge:
Misc. CFarges: ?
Totol:
Date Paid:
BUILDING PERMIT
CITY OF EAGAN
3795 Pilof Knob Road Eagen, MN 55122 N0- 4219
PHON E: 454-8100
S?- S7
Receipt #
Fam Dwlg• d GerR,. Dote - .19 7
Site Address ?, 1 Zi?? ?:arl adn La+._e Ln
Erect
Lot Block Sec/Sub. 1"11dfrnCss T'zTk `tAlt*r ?
Parcel # r Repair ?
Enlor
e ?
g
Name Move p
W
Z Addres s - - ' ' •
• Demolish ?
? /,'..- ..,
n?--- -54N6639 Grade ?
? Nome k '`T? ti??es, Inc. j0'
0
o?
?
Assessment
Address
-- -
Ua
? Water & 5ew.
~ Ci Phone '
°f Pol ice
Name
Fi
F W re
? Address Eng.
u
<W Ci Phone Plonner
Council
I hereby ocknowledge that I have read this opplication and state thot gldg. Off. _
the information is correct and agree to comply with oll opplicable
Stote of Minnesota Stotutes and City of Eagon Ordinonces. AP?
/
5ignature of Permittee
A Building Permit is issued to:
all work shall be done in accordonce with all
Building Official _
Occuponcy -
Zoning I 2
Fire Zone _
Type of Const. '
# Stories
Front it.
Depth ft.
Fees
Permit _
Surchorge
Plan check _
SAC
Water Conn. _
Water Meter
Totol 1037 _ SU
ZG• _ on the express condition thot
of Minnesota Statutes ond City of Eogan Ordinances.
rwmM # ooft i..me r.?.?+..
?i+?wieol _ ?r ?.
?6rc c
; o
•(
.
.
-t-
INSPECTIONS DATE INSP.
Rough-In
Final
Footings Date Irap. Date Inap.
Foundation Plumbing
Frome/ins. _
? Mechonical
Finol
Remorks:
INSPECTI4N RECORD
CIT.Y OF EAGAN PERMIT TYPE: ???? ? i i? F N?? ?
3830 Pilot Knob Road Permit Number, kt:? ] 3t?.' ?
Eagan, Minnesota 55122-1897 Date Issued: +^ 4 ! -' if ' `y+`.
(612) 681-4675
SITE ADDRESS: `' "4, ' `' " ` APPLICANT:
NO
, ?:+c t ?•?+ 1. At• 1 1 iaNl ... , Pb'. 1 I
? ? IFk 1"Mi.. f'fit,? r t i. I. j :?'.'• 1. 4 71i
PERMIT SUBTYPE:
TYPE OF WORK:
r•: I i i t, Fl i 1ON
I?i',?t l? II?JIi t??IM1'• il?'il???
iNSPECTION D. ON TYPE D,
F
e .
i?
I
.z- uY7 J,'... ::k 9? -. 't e E - ?
Permit No. Permit Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
InapecUon Dete Inap. Comments
FOOTINGS
FOUNO
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
?
AIR TESTCE S' W
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
.
ie1TY OF EAGAN
383U Pilot Knob Raad
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS: ,., f . a. • ?, y,
?
12 1:11 H 1''AR!
1171 IIF FtNf `,'; PAfaF
PERMIT SUBTYPE:
t,+i : ! H i.u?.R a
?H. ! AKC 1 ANf
RECQRD
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
TYPE OF WORK:
? f F'ATEt
, i. ; , ., ;, ;1n1NS)
?
?
- - - - - - - - - - - - - - - - -
Pormit No. Permft Hoider Dab Telephone N
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTlNOS
FOUND
FRAMiNG I
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUQH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREFLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL i
DECK FTG
DECK FlNAL
I
L-
CITY OF EAGAN
Owner LCI?Vi° y
i» ri???Pr
Remarks
Lot ? Rlk 2 Parcel 10 84250 010 02
5treet 12 Carlson Lake Lane State Eagan,MN 55123
Improvemen Date Amount Annual Years Payment Receipt Date
STREETSURF, ? 1977 794.55 79.46 10 794.55 C002368 10-4-76
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 176.05 8.80 20
SEWER LATERAL
WATERMAIN
WATER LATERAL 1972 4554-34 0.29 1 q-9-77
WATER AREA 29 1977 6 66 -9-77
SEW TRK j/j'•
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGNT
WATER CONN. 220.00 $257 2-11-77
BUILDING PER.
SAC _ ']
PARK
PERMIT
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, MinnesotaN65122-1897
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-84250-010-02
DESCRIPTION:
PERMIT TYPE:
Permit Number:
Date Issued:
1258 CARLSON LAICE LANE
IOT: 1 BLOCK: 2
WSLDERNESS PARK
(szoxNS)
?uildYng`*?,Permit Type
6uildkng Wdr,k 7ype
:Census Code
?S
v ?LL
Y.
SF (MISC.)
REPAIR
434 ALT. RESIDENTIAL
,r
F'? te?.a3 °.
t??
?,.5 b.`?
REMARKS:
BUILDING
031235
12/08/97
FEE SUMMARY:
VALUA7ION
Base Fee
Surcharge
Total Fee
?
$149.74
$4.50
$154.24
$9,00@
CONTRACTOR: - ppplicant - s7. I.IC OWNER:
FZRST CHOICE EXTERIORS INC 15531918 0004266 YOUNGER 2ANE
2405 ANNAPOLIS LN N 240 1258 CARLSON IAKE LN
PLYMOUTH MN 55441 EAGAN MN 55123
(612) 553-1918
I her.eby aoknowledge that,]C have'read; Ch3s,appl3;catian anda-state thaP,tht
infarmation is correot and agree to comply_wzth all a,ppiicable State ofi Mn,
?Statu?es and City '6f rEagan `Or?lir1ances
? --
AQ_
-
APPLICANT/PERMITEE SIGNATURE IISSUEL) EV: SI AIURE
? 7997 BUILDING PERMIT APPUCATION (RESIDENTIAL)
CITY OF EAGAN
• 3830 PILOT KNOB RD - 55122
681-4675
New ConstruMion ReauiremeMS Remodel/Reoair Reauirements
? 3 regisMred site surveys ? 2 copies of plan
? 2 copies of pians (inGUde beam 8 window sizes; poured tntl. design; etc.) • 2 ske surveys (exterior additions & decks)
? 1 energy calculations ? 7 energy plculations kr heated atlEitions
? 3 eopies of tree prexrvation pfan if lot platted after 711/93 required: _ Yes _ No "
DATE: f d-9- p2 CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS: r a ,) o
LOT ? BLOCK ?
.. L-. X.? 2,
SUBD./P.I.D.
PROPERTY
OWNER
CONTRACTOR
ARCHITECT!
ENGINEER
1o
Name: ?o U "+ 5`pr Z.q y)0 Phone #:
?
Street Address:l d 5 R C? r15 0?
Ciry: ?C,? State: /L?,(-) Zip: 5-5 Company: F;ks? ??e r cIt- Phone #:
Street Address: o? ?(e? J T? NNe. ? Lti ? License #:- 9l d L?
City: State: /v/
Company:
Name:
Phone
Registration #:
Street Address:
City: State: Zip:
Sewer 8 water licer•n•ed plumber (new construction only):
and lot change are oequested once permit is issued.
Penaity applies when address change
I hereby acknowledge that I have read this appliption and state that the information is correct and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances. ?
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received
_ Yes
No
Tree Preservation Plan Received - Yes - No - Not Required
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-84250-010-02
DESCRIPTION:
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
1258 CARLSON LAKE LANE
IOT: 1 BLOCK: 2
WILDERNESS PARK
(GAS INSERT)
83uildsng,.Permit Type FIREPLACE
;Building W'o-r?k Type ALTERATION
Cerrsus Code '?-, 434 ALT. RE5IDENTIAL
x-
?i
Fl?
t
1 ; F
?'..? ? ... .«,.. .... `:?l i L G> (s
REMARKS:
WoSS6o4v
BUILDING
027362
@4/24/96
FEE SUMMARY:
Base Fee $25.00
Surcharge $.50
Total Fee $25.50
CONTRACTOR: - Applicant - OWNER:
6AVIC & SONS PLBG 17556468 YOUNGER ZANE
12725 NIGHTENGALE ST NW 1258 CARLSpN LAKE LN
COON RAPIDS MN 55448 EA6AN MN
(612) 755-6468 (612)458-6639
I hereby acknowledge thaG I have read th3s application and state that the
inFormation ' aorrect artd agree'to Comply'with all applicable State af Mn.
L Statutes aCity pfi Eagan ardinanpes, ?
? ? -
APPLICANT/PERMITEE SIGNATURE ? ISSU D SI?U??'?-
Iq CITY OF EAGAN
? 3830 PILOT KNOB RD - 55722
1996 FIREPLACE PERMIT APPLICATION
661-4675
DATE:
DESCRIPTION OF WORK: _ INSTALL HEbL FIREPLACE: _ WOOD BURNING
INSTALL GAS LOG ONLY IN EXISTING FIREPLACE
INSTALL GAS LINE ONLY IN EXISTING FIREPLACE
OTHER:
AREA TO BE INSTALLED IN: ?-??' ?`?''? ???G•
4 iff•.D" 0
? GAS
0
STREET ADDRESS: I a,5-P ???'r /s 2,14 `- /
LOT I_ BLOCK ? SUBD./P.I.D. #: ?.? lJXl?1D1Ln1Di?l-, T2
APPLICANT: (circle_p_neonly) „/,OWNER
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.
PROPER7Y Name: Phone #: "LL
OWNER
Signature:
Street Address•
City: State: Zip:
FIREPLACE Company: Phone #:
INSTALLER
Signature:
ense #• ?y?yv'?
Li
Street Address: c
GAS LINE
INSTALLER
City:
Company:
State: Zip'
Phone i?? -ZILL'? k612
v
C?y; z-CaJ_ State: Zip: ?.
Street Address ?°? 7 ?J ???/-e ° °? /c Sj i-Al IJ
crrr oF eac,AN J
3795 Pi1M Knob Road Eagan, MN 55117 N2 4219
-i PHONE: 454-8700
w BUILDING PERMIT APPLICATION $49,000. Rece+pt # ?? r7
To be used fo. Sing. Fam Dwlg, & Garg. Date ,19 77_
Site Address 1259 C2llson Lake Ln Erect Zc] Occuponcy T
Lot 1 Block Z sec/s,b. Wilderness PHIk AA)10r ? Zoning Rl
Parcel .fk Repair ? Fire Zone
E
l
r V
e of Const
T
n
ge ?
o .
yp
w Name Mi d Mrs Zane Youn?ver Move ? # Stories
Z
o Address - 4016 MiCa TT, Demolish ? Front 52 _ ft.
C.t Eagan phone 454-6639 Grade ? Depth 36 4t.
p »
.
Name
z? 627 So. Snelling AVe. Assessment_
?? Address
? Cit St P 1 M' Phone 698-5501 Water & Sew
Police
F
?w
F Nome
Fire
Z
i? Address - Eng.
V
¢w
L
Cit Phone
Planner -
Council _
I hereby acknowledge that I have read this application ond state that gldg. Off. _
the infrormation is correct ond agree to comply with oll applicoble
Srate oF Minnesota Statutespwd_C,.ity of Fpgon Ordinapfps. ApDrovals Fees
T1158II H
RlES I11C
APC
Signoture of Permittee `??r?9vsrw
A Building Permit is issued to: _ Tilsen H
all work sholl be done in accord ` a /a/pp
Buildin9 Officiol ?`?C? , l4 ?
Permit --- 1-3a_00 _
Surcharge 24-50
Plan check _
SnC 475.00
Water Conn. 220.Q0
Water Meter 60.00
Park 120.00
Totol 1037.50
on the express condition that
Minnesoto Stotutes and City of Eagan Ordinances.
?,'?`??I? ?
- ^ - ' .
V'
?
N I
?
?
+
E?
;
?2ol?E.e ry
LINE
?
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33
pA?El9R- Aec70eA Ty LNE
s
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I
-4,??
UNE'
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Q ?
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zo ?-
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Lor ? BLack ? I .
,
?
rRonsT PROPFrLT_Y_--_ Li_NE ?-1 I
r1U• v
OI -PL AN
RESIDENTIAL
BUILDING PERMIT APPLICATION
? ciTV oF encaw
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
Naw Constructbn peauhemerrta
• 3 regMered site surveys showing sq. ft of bt, sq. ft of Iwuse; and II roofed areas
(20% maximum lol coverege allowed)
• 2 coples of plan showing 6eam & wiMOw s¢es; poured found design, etc.)
• 1 set ol Energy Cekuletbns
• 3 copies W Tree Preservaian Plan H bt platleA afler 711193
• Rim JoM Detell Optlons seleclion sheel (bldgs wiN 3 w less uni5)
DATE G'D S? D Z
SITE ADDRESS ?(7 H' 1?2-L Sd oi
NPE OF WORK TCf] 2?1/1 /dd o,
APPLICANT
STREET ADDRESS lf 71 / L-Pt Z-C__ =1-N
TELEPHONE #?S ? $?JS? 9?CELL PHONE #
Fnx a -7
PROPERN OWNER 3Y"3 4e-- .!?!1 a o.1 ?-P/t - TELEPHONE # lW
------------------------- ---------------- -------°-----------°----------------°--------------
COMPLETE THIS SECTION FOR aNEW• RESIDENTIAL BUILDIWGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672
(4 submission type) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet SubmiRed
• Energy Envelope Calcuiations Submitted
Plumbing Confractor: Phone #
Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00
_ Water Heater _ No. of R.I. Baths
_ No. of Baths
MeChanical Conhactor: Phone ri
Mechanical system includes: _ Air Conditioning Fee: $70.00
_ Heat Recovexy System
LI
SewedWater Conhactor. Phone N
I hereby acknowiedge that I have read this application, staTe That the information is c?Wct, and agree to comply
wiTh all applicable State of Minnesota Statutes and Cify of Eagan Ordin c s.
Signature of Applicant /Gv???
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
?
AamotleVNanair Requirementa
• 2 roples of plan
• lsetofEnerqyCalwlationslorheatedaddilbns
• lsdesurveyforaNerpradd'AionsBdecks
. Intlicate tt home served by septic system lor addRbns
VALUATION ,? 7. I c?f3•'S`?
Ale MULTI-FAMILY BLDG _ Y
FIREPLACE( )?. 0 _ 1 _ 2
??? 2004 RESIDENTIAL BUII.DING PERMIT APPLICATION
I_ City Of Eagan
?D 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
?I57 as
New ConsWcOon Reauiremen5 RemodeVFteoair Reouirements
t? 1? ?N
Get?'pt 6'
eC??
3 registared site surveys showing sq. ff_ of lot sq. ft of house; and all roofed areas 2 copies of plan y
?
?
P?n A
E ? Y N
T
(20% mazimum bt coverage a?lowed) 7 set of Energy Calalations for heated additbns
k
dditi
& d
f p,c
m
ree
Ylited? Y? "N
2 copies of plan slwwing beam 6 window sizes; poured found design, etc. ec
s
ons
7 site survey
or a
7setofEnergyCalculatlons Add'NOn-indicateHon-sResepticsysfem Qyrs?Se, oftrm <_Y ?N
3 capies of Tree Piaservation Plan'rf kt platled atler 711193
Rim Jolsl Detail Options selection shaet (bldgs vrith 3 or less uniLe
Date 7 /? l d y Construction Cost ? U 63
Site Address (_r, n 4' Unit/Ste #
? >n 5 423
-
Description of Work
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2
Property Owner ?.? rF yOtt +vSC• 72- Telephone #((?/ ) ys y-r?37
Contractor A+5 GVIe+rir"ne ii,-,t???
naaress / oo i3y,'6,k o115V0 l'-,'r w Su;?"Q >/o city S- Sfi- Awl
State )Yl!'v ip rj 5?D7i Telephone#(/ps1) 10??---
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEMI BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Enefgy Code Category . Residentlal Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Coniractor
Telephone #(
Telephone #(
Telephone # (
N If so, 25% plan review
I hereby apply for a Residential Building Pernut and acknowledge that the informatidlNg co111p14YP'anri accnrate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and th`e State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
pemut; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
Applicant's Printed Name ApplicanYs Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation O 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ;K 21 Porch (3-sea.)
? 03 01 of _ plex ? 09 07-plex ? 17 Garage b 22 PorchlAddn. (4-sea.)
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screenlgazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 MiSCellan00us
Work Types
X 37 New ? 35
? 32 Addition ? 36
? 33 Alteration ? 37
? 34 Repiacement
boo
9
Valuation 1
Census Code y3y
SAC Units
# of Units
# of Bldgs
?-
V Y 1
Type of Const
r
.
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Ait - SF
? 36 Multi Misc.
Int Improvement ? 38 Demolish Interior ? 44 Siding
Move Building ? 42 Demolish Foundation ? 45 Fire Repair
Demolish Building' ? 43 Reroof ? 46 WindowslDoors
'Demolidon (Entire Bldg) - Give PCA handout to applicant
Occupancy 2-3 MCESSystem
Zoning K? 1 City Water
Stories Booster Pump
Sq. Ft. PRV
Length L
Fire Sprinklered
Width Z yI
_ Footings (new bldg)
Footings (deck)
Footings(addition)fill pyl a°?S
Foundarion
Drain Tile
Roof C?1 Ice & Water ? Final
? Framing
Fireplace _ R.I. _ Air Test _ Final
?Q Insulation
?. .
Approved By:
REQUIRED INSPECTIONS
FinaUC.O.
? FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Poo] Ftgs Air/Gas Tests Final
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wall
Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
IyXIq ' ?' 40,60 = ?S'ID.oU
, ? ? ? . .l? ' .. . . ?. w.
? i
`.'
. . . . . _ . _ 'J .
DELMAR H: SCHWANZ
i nrvn s, i.vi vcIH ?
11??.1.?.?••r?OJU..?Lnn?..llnlil.llr, ..,.?rv ?
74515 SOUTH RGBEft; TRAIL p,0. BO% M r ROSENOUNT. MINNESOTA 55068 CHONE 612 •723-1764 -
?"s?o e4RL SUHVEYOR"S CERTIFICA7E
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G , ,..
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N H\ o ?l 'r i y 'j ??.
Gq N ,. p 4--
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lj
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P.?po,?'' .? ?•"?'" '
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: ??' . , • . . ?_,.-I ? ?'' ?+ __ c 1
i .. ---- --- :? ---
---
8I.66 - SBaI 7*2eW
WILDERNESS? RUN ROAD
?
,
??-17 ?
_ a.
,. ,
?s N 1 ?1' /h? '? ?? ? j
quDLDsNG BNSPECTIONS
Use BLUE or BLACK Ink
For Office Use
I
I
O f EatIft Permit n
Vl6 I I
~ Permit Fee: I
3830 Pilot Knob Road
Eagan MN 55122 I Cate Received:
Phone: (651) 675-5675 staff:
Fax: (651) 675-5694 L----------------i
INFLOW & INFILTRATION PERMIT APPLICATION
L"O" Plumbing / Sewer & Water
Dater Z Site Address: A A. VS LA1,4::
Tenant: Suite
Name: -,~.N4 6°tny rOE , cLn1 r~ Phone:
RESIDENT / OWNER
Address / City Zip:
? C.ra.n L l.,~f r4 N~
s9~yt I z3
Name: License
CONTRACTOR Address: City:
State: Zip: Phone:
Contact: Email
PLUMING (Within the building envelope) SEWER $ WATER (Outside the building envelope)
TYPE OF WORK Sump Pump Repair Repair
Other: Other:
Description of work: Ro c4~ S L& m Q aAr&p 8'1 S `mot k A j C!
DESCRIPTION
°74 e7 t
FEES
$60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.cityofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
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 tD dig to receive locates of underground utilities. www.gopherstateonecall.om
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 whi h requires a review and approval of plans.
x ~ ~ x
Applican Printed a e A I" ant's i n
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground -Rough-In <_Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA116168
Date Issued:10/03/2013
Permit Category:ePermit
Site Address: 1258 Carlson Lake Lane
Lot:001 Block: 002 Addition: Wilderness Park
PID:10-84250-02-010
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 .
Patrick Swanson
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 -
Zane A Younger
1258 Carlson Lake Lane
Eagan MN 55123
Trinity Exteriors Inc
4204 Park Glen Rd
Minneapolis MN 55416
(952) 920-9520
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA125433
Date Issued:07/23/2014
Permit Category:ePermit
Site Address: 1258 Carlson Lake Lane
Lot:001 Block: 002 Addition: Wilderness Park
PID:10-84250-02-010
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Zane A Younger
1258 Carlson Lake Lane
Eagan MN 55123
Trinity Exteriors Inc
4204 Park Glen Rd
Minneapolis MN 55416
(952) 920-9520
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA156968
Date Issued:07/26/2019
Permit Category:ePermit
Site Address: 1258 Carlson Lake Lane
Lot:001 Block: 002 Addition: Wilderness Park
PID:10-84250-02-010
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 -
Andrew Schroepfer
1258 Carlson Lake Lane
Eagan MN 55123
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA174596
Date Issued:02/07/2022
Permit Category:ePermit
Site Address: 1258 Carlson Lake Lane
Lot:001 Block: 002 Addition: Wilderness Park
PID:10-84250-02-010
Use:
Description:
Sub Type:Fixtures
Work Type:Alteration
Description:Bathroom(s)
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
All tiled shower bases require a water test.
Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087
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 -
Andrew Schroepfer
1258 Carlson Lake Ln
Eagan MN 55123
(651) 247-4941
Peterson Plumbing Llc
4209 Diamond Dr
Eagan MN 55122
(612) 655-4022
Applicant/Permitee: Signature Issued By: Signature