4276 Carlson Lake Lane N# -_. ,
' BUILDING PERMIT APPLICATION
CITY OF EAGAN 03
3830 PILOT KNOB RD - 55122
651-681-4675 CQ lla,? 5'31 lo l
w I
New Constructlon Reauiremants RemadallReoair Reauiremenb
• 3 registered site surveys shovring sq, ft. of lol, aq. ft. of house; and all roofed areas • 2 copies of plan ?
(20%maximum lotcoverage all(ywed) . 1 set of Eneryy Cakulations for heated addi6ons
• 2 copies of plan ahowing beam & w(indow sizes; poured found design, etc.) • 1 site survey for ezterior addNOns & decks
• 1 set ot Energy Calculations . Indicate if home served by septic system for additions
• 3 copies of Tree Preservatlan %an N lat platted after 711N3
• Rim Jaist DeWd Oplians seleclion sheet (bWgs wilh 3 or less untts)
DATE S-aIZJ-UJ VALUATION !?aCXb. ?
JOBSITEADDRESS L/o?7? ?,??-ISOr? IG?10n4,
IF MULTI-FAMILY BUILDING. HOW MANY UNITS? 19114
PROPERI
TYPE OF
APPLICANT J/4
ADDRESS _ q 7__
PHONE# CIS?-y?3?-/1c70
CODE 55'/?Ll
PAGER # CELL PHONE #?'.So7- N3l-1676 /? FE?x # ci?`v2-4%31-15-
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Eneryy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet 5ubmitted
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
New Energy Code Worksheet 5ubmitted
Plumbing Contractor. _
Plumbing System Includes:
Mechanical Contractor:
Mechanical System Includes:
Sewer/Water Contractor:
Air Conditioning
_ Heat Recovery System
All above information must be submitted prior to processing of application.
Fee: $70.00
Phone _
I hereby acknowledge that I have read this application, state that ihe information is correct, and agree to comply
with all appiicable State of Minnesota Statutes ond City of Eagan Ordinances
SlgnafureofApplicant ?
RESIDENTIAL
_ Water Softener
_ Water Heater
_ No. oF Baths
Phone #:
I,awn Sprinkler Fee: $90.00
No. of R.I. Baths
Phone #
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1l01
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 OS-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
p 17 10-plex ? 19 Lower Level
? 12 12-plex Plbg Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
1?10 22 Porch/Addn. (4-sea.)
? 23 Porch(screened)
? 24 Storm Damage
? 25 Miscellaneous
• .
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
p 31 New O 35 Int Improvement O 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. O 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement "Demolition (Entire Bidg only) - Give PCA handout to applicant
Valuation v 0-D/)/J aa? Occupancy )Ie- 3 MClES System
Census Code ? Zoning ? ? City Water
SAC Units Stories Booster Pump
Nbr, of Units ? Sq. Ft. jpO PRV
Nbr. of Bldgs Length as Fire Sprinklered
Type of Const .J ` W idth
REQUIRED INSPEC710NS
Footings (new bldg)
T FinaUC.O.
Footings (deck) FinaVNo C.O.
? Footings (addition) Plumbing
Foundarion HVAC
Drain Tile
Roof _?o Ice & Water W Final Other
? Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final
F'ueplace _ R.I. Air Test Final Siding Stucco Stone
? Insulation ? Windows (new/replacement)
Approved By GG6 , Building Inspector
Base Pee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
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CITY OF EAGAN WATER SERVICE PERMIT
3795• 9ilot ICnob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zonin9: No. of Units:
Owner:
Address:
Site Address: - I
Plumber:
Meter No.: Connection Charge: - •. '?n •
Size: - Account Deposit;
I
Render No.: Permit Fee: -- ? ? =
{ ngree to eomply wiH+ the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Totol: !
BY _ Date Poid:
Date of Insp.: Insp.:
SEWER SERVICE PERMIT
CITY OF EAGAN
3795'Pilot Knob Road PERMIT NO.:
an
MN 55122'
Ea DATE:
,
g
Zoning: No. of Units:
Owner:
Address: -
Site Address:
Plumber:
--_--
1 ogree M eomply with the City of Eagan Connection Charge: •
Ordinantes. Account Deposit:
R..
Date ot Insp.
I nsp.:
Permit Fee:
SurCharge: . • ?,? .
Misc. Chorges:
Total:
Date Paid:
CITY Of EAGAN
` 3795 Pilot Knob Road
Eogan, Minnesota 55122
Phone: 454-8100
' - PERMIT
Date: t-)pi? 25, 1977
No £3 ?}7
.
Receipt No.:
Singfe ?
Residentiol ?
Site Address: 1276 I-arlsun L'ake Tane
Lot Block rSub/Sec
WR 5th
Multi Res., Comm./Ind. I
Nome
Ti3 sen ?tor.:es, Inc. New/Alter./Repair. ? } Address Cost of Installation
O
. P3u1 -?,• _ ?.,,
City Phone: Permit Pee
-•?.zis '.'. PQter Co. • `? %
` Name ` Surcharge
? Address 1854 Grand Ave.
e
? C?? ='r . P3u1 55105 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 flfficial
CITY OF EAGAN
- `3795 Pilot Knob Road
Eugon, Minnesotc 55122
Phone: 454-8100
t?'EATING
Date: 7+pril 25, 1977
PERMIT
Site Address: ?M Carlson I.ake Laite
Lot Block _
Sub/Sec
WR Sth
Name
q r27 :=ne] linc? Ave.
3 Address
O
v City St. Pdul Phone:
Name A. 3incier & Sor.
..
? Address 0 But1 F r _-,t.
?
0
v :•est St. Pau1
City Phone:
This Permit is issued on the express condition that oll work shall be
Minnesoto Statutes and City of Eagan Ordinances.
No
8713
,'?3
Receipt No.:
$ingle
Residential
Multi Res., Comm./Ind. I
New/Alter./Repair
Cost of Instollntion
2n.00
Permit Fee
.511
Surcharge
. ^.5n
Tota I
done in occordance with all applicnble Siote of
Building Official
CITY OP EAGAN
. 3795 Pilor Knob Road Eagan, MN 55122 N2 4262
PHONE: 464-8100
Receipt #
BUILDING PERMIT
14
$itC
Lot i. '- Block ? Sec/Sub. t4l 5th
Parcel #
a? Nome •••°?•• ??aru.ea aua..
3 Address 627 So. Snel 1 ing Ava.
O . T__.•
0? Ncme Ti lsFrt iIrnnF•& Tnr.
0
?a Address ~ -
?
F tt?.. DF..,.,o
Erect [3y.; Occupancy
Alter ? Zening
Repair ? Fire Zone
Enlarge ? Type of Const.
Move ? # Stories
Demolish ? Front ft.
Grode ? Depth ft.
Approvals Fees
Assessment _
Woter 8 Sew.
PoliCe
" Name
? w Fire
Address Eng.
Q W Ci Phone Planner
Council
I hereby acknowledge that I hove read this opplication ond state that gldg. Off.
the informotion is correct ond agree to comply with all upplicoble APC
State of Minnesota $tatutes and City of Eogan Ordinonces.
Signature of Permittee -Tu
A Building Permit is issuad to:
oll work sholl be done in occordance
Building Official
Permit
Surcharge }?• ?t?
Plan check
SAC _ ?
t)!)
Water Conn.
Water Meter
Totol i' gI •
on the express condition that
e State of Minneseto Statutes and City of Eacan Ordinonces.
?w
# DaM Iwued hewlllw
Plumbing 1:'7 ??,.5/y ' , ?,,? dw
_Mechonical ? y 9 /.;2.-S'7
.
INSPECTIONS DATE INSP. Rouph-In Find
Footings ? Oote lnsp. Date Imp.
Foundation plumbinp -b?5" 7)
Frome/ins. _p5__2 7 Methoniool
Finol a't 0' 7 ')
Remorks:
CITY OF EAGAN
Addition W11d2I
Remarks
on Lot 11 BIk 6 Parcel 10 84354 110 06
4276 No. Carlson Lake Ln. ?*,*o Eaganr MN 55123
Improvement Date Amount Annual Years r Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 $132.60 $6.63 20 99.45 7-18-77
SEWER LATERAL
WATERMAIN
WATER LATERAL
' WATER AREA 1 149.34 C003435 7-18-77
STaRM SEW TRK
1
98 1
998
1
7
1988 1 198.82 A015574 (j- -8
STORM SEW LAT -
- -1
-
' CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 230.00 #05615 4-11-77
BUILDING PER,
SAC 475.00 #
PARK
} crrr oF EncaN
3795 Pilot Knob Road Eagan, MN 55722 N2 4262
PHONE: 454-8100
BUILDING PERMIT APPLICATION $37,000 Receipt # 5615
To be use8 for Sitlg. Fam W. GBTg, Dote igTi 1 11 , 1 9 77
._
Site Address 4276 No, CarlSOn Lklce Lri. _ Erect ?g Occuponcy I
Lot1.l- Block_6L Sec/Sub.WR 5th Alter ? Zoning Rl
ParLel # Repair ? Fire Zone _
Enlorge ? Type of Const. V
w Name Tilsen Homes IriC. Move ? # Stories
3 Address 697 SpSnallin__ oa_.AVe, Demolish ? Front ft.
? Cit St, Paul, Phone Grode ? Depth ft.
? N Ti 7 ecn H c Tnr APProvals Fees
p ame NM
Z? n
u? Address
? Citv Phone
Name _
Address
I hereby acknowledge that I have read this application and state that
the ininrmotion is correct and agree to comply with all applicable
State of Minnesota Statutes and City of Eagon Ordinances.
Assessment _
Water & Sew.
Police -
Fire
Eng.
Pbnner _
Council _
Bldg. Off. -
APC -
Permit """"
Surcharge 18.50
Plon check
snc 475.00
Water Conn.?30.00
Water Meter _.60...B0
Torol $91.50
Signature of Permittee - -- I
n Hpmes Inc,
A Building Permit is iss?to: on the ezpress condition that
all work shall be done r ccord nce with o K ble Sta f Minnesota Statutes ond City of Eagan Ordinonces.
Building Official ?N- ?(;-
.
jP'4;L(vy
Date:
BUII,DZi7G PERMIT P..£PLICATIO_d
LOT l? HLOCK C/ ADDITIOiJ (i1/.fi/l
°AiirEL & SL•'CTION P]CiHRFR 2F iTiTP7.ATTF.iI
ISDUR,F,$
7.OS3I_'G
SZ'LMF,.iED CO? .• y_
B r
??'T=i''? U?Z -jZl- grv? TELEPHONE N.0
k1.DIJ&ESS
ApS'1P-PSS
TELEPHONE :TO.
'tdote: Include si.te plan, building plans, and enerqy calculations mith t!ii.s
anplication
Signed
A-r- C:PTCE USE
V_x1Li7?1.t70i? LY (/a ? ?
5AC
S'L'liE:2 C0;:7itEC^20"tl
11ATEIt h9LTER
BUILDSNG PERl3IT F?iF,'
uIIRCHAItGL^` FEE
FLt1Y7 CF:P.CK FSE
PAFtIC DEDICATIOid PEE
? v ?-
_ /37 7
OTF:ER
TOTFiL* FSPPP.OVIILS:
ASSESS+lE`i!T CLEPSC BUILDIidG DL`PT. POLZCE DEPT.
!^]A1'ER & STiF)ER DrPT. FI'2h' DrPT. P11RK DEPT
FOR TYPEWRITER OR HAND USE m
WILL FIT WINDOW ENVELOPES FLFF ORDIR
h;wl M?,
OUICiC-LETTERSGETAN5WER5FASi
USETHEMFORPkOMPTREPlIE51 ...o.,.r-o:..«........o.......o..,.w.
Tilsen Homes, Inc.
627 SOUTH SNELLING AVENUE
ST. PAUL, MINNESOTA 55116
PHONE: 698-5501
1
SU6jeCt Date oi 1912
Message oL& ? (?(a???C,D'yZ,Q Q'i'Yl? J
G?ea ?m
. 4'jc 76 ?Z QA&aL7U
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PLEASE REPLY TO signed
Repty
Signed Date
Form No. QL3 SEND PARTS 1 AND 3 WITH CARBON INTACT - PART 3 WILL BE RETURNED WITH REPLV
_
OETAC01 HIS P-Y -RET9h%l-FU"NSWER
552; S05 G t?L U r:c rA?
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PLEASE REP4Y TO ? Lol_'7 Cf - CL 2 y&l SiQnod .??,A P ,
,
Reply
Signed Date
Form No. QL-3 SEND PARTS 1 AND 3 WITH CARBON INTACT - PART 3 WILL BE RETURNEO WITH REPIY
PMz!?N ApL1f'?7-71 ` - RETURN THAS COPY TCl SEMIlER
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4- LOT -P L A'N
? C4TY OF EAGAN
3793 PILOT KNOB ROAD
EAGAN, MINNESOTA
58722
Uecember 12, 1976
PHONE 454$100
?i
Tilsen Homes
627 So, Snelling Ave.
St. Panl, MN 55116
3es Variance Lota 6 thY-u 17 Block b Wildarneae Ruxi 5th
Lot 1 Block 3+,Ilderness Run 6th
Dear Sirs:
E.hclosed for your attention is a copy af the minutes of the Advisory
Ylanning Cwmnittee and the Eagan City Council approving a frcnt yard
setback variance from 30' to 201 on the above mentioned lots in
Wilderness Run 5th and 6th.
Very truly yours.,
(rTrs.) Alyce Bolke
C2wk - City of Eagan
Encl.
AB/cjb
at, Dale Peterson ?i
a
/o - / 9 - 76
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115337
Date Issued:09/25/2013
Permit Category:ePermit
Site Address: 4276 Carlson Lake Lane N
Lot:011 Block: 006 Addition: Wilderness Run 5th
PID:10-84354-06-110
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
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: 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 -
Christopher J Parker
4276 Carlson Lake Lane N
Eagan MN 55123
Exteriors Of Excellence
4580 Scott Tr
Suite 204
Eagan MN 55122
(952) 239-0560
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA154833
Date Issued:04/15/2019
Permit Category:ePermit
Site Address: 4276 Carlson Lake Lane N
Lot:011 Block: 006 Addition: Wilderness Run 5th
PID:10-84354-06-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$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 -
Christopher J Parker
4276 Carlson Lake Lane N
Eagan MN 55123
(507) 317-0520
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature