1256 Carlson Lake LaneW7Y'tFr EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.:
Eogon, MN 55122 DATE:
Zoning: No. of Units: '
n,.,.,a- :, ,
Address:
Site Address: , "•''
Plumber:
Meter No.:
Size:
Reoder No.: ?
I egree to wmpiy with fhe City of Eagan
Ordinonces.
gy -
Qate of I nsp.:
_ Connection Charge: "
_ Account Deposit:
_ Permit Fee:
Surcharge:
Misc. Cherges
Total:
_ Date Paid:
- I nsp..
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, MN 55122
7nni?•
SEWER SERVICE PERMIT
PERMIT NO.:
DATE: ___
No. of Units.
Owner.
AA.i-•
Site Address: C' 'r1. nOn
Plumber: _ ___
I agree to aomply with the City of Eogan
Ordinancas.
R.?
Dote of Insp.:
I nso_ c
Connectron Charge:
Actount Deposit: _
Permit Fee:
Surcharge:
Misc. Chorges: -
Total:
Date Poid:
cirir oF EA"N
3795 Pilot Knob Road Eagan, MN 55122 N0- 4204
e PHONE: 454-8100
, .
BUILDWG PERMIT Receipt #
Site Address • `j ` ': '..: ?r •.u
Lot Block Sec/Sub. ? '- jQ nje r s
Porcel #
oc Name "' ? i .?,r?:•? > F ;
3 Address - , _ .. f ` - L?I•
457-6604
Erect ? Occupancy
Alter ? Zoning
Repair ? Fire Zone
Enlarge ? Type of Const.
Move ? .# Stories
Demolish ? Front ft.
Grade ? Depth ft.
Permit
5urchorge
Plan check
SAC
Water Conn.
Woter Meter
t hereby ocknowledge thot I hove read this opplicotion and state that gldg. Off.
the informotion is carrect and og?ee to comply with all applicoble APC Total GState of Minnesota 5tatutes ond City of Eagan Ordinances.
Signoture of Permittee , -
`:•.JL:-;•' -?l?rl?G?..?t •
A Building Permit is issued to: ? on the express condition that
all work shull be done in accordance with oll opplicoble Stote of Minnesota Statutes ond City of Eogon Ordinanccs.
Building Official ' -
.
P?M # DaN Iawd IwwlFtr
Plumbing 12 S -Pp-? ? r
Mechonical ??- •
?
INSPECTIONS DATE INSP.
Rouph-In
Finol
Footings 1 -0-? Date irqp. Date Imp.
Foundotion _ Plumbing 3-11`2 6=a,
Frame / ins. Mechonicol
Final . t•
Remarks:
INSPECTIDN RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
? (651) 681-4675
: ,, ;;• +.c, ,?:ct Ff
, SITE ADDRESS: APPLICANT:
+as?o I;1 StlN I AKF I ANf
ARK
PERMIT SUBTYPE:
{11iltt)19 I N
I : r 1•1
IF
rMNr rlr-i.ur ail`,i RF TN', F'(
TYPE OF WORIG:
ii + i I I i I Iii.
1 ia Jl t
i Nt.FAI itdi,
'34 ?L-1-3
a f I.a
11100b '?; t rIvF 3
7
( L --1
Permit Holder Date Telephone #
SEWER/
WATER
PLUMBING
HVAC
Inspectlon Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUh981NG
PLBG
AIR TEST
ROUGH
HEATING I
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
?
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTt3
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRFiIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN
Owner
Lot 2 Blk 2 Parcel 10 84250 020 02
street 1256 Carlson Lake Lane state Eagan,MN 551 ?3
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF, g' 1977 7$$,13 78.81 IO 6/12178
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 17600 8.80 20 123.25 A006132 6 Iz 78
SEWER LATERAL
WATERMAIN
WATER LATERAL (:5'r 1972 494-34 0.29 15 242,38 A 6132 6 12 78
WATER AREA 60 10.66 15 -- 12 78
STORM 5EW TRK ` q, 1981 201-47 11 - 43
570RM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 0.00 #5017 -5-
9UILDING PER.
SAC 475. 5017 - 1-5-77
PARK
This requeat void 18 months &om n"/
?f
Date of this Request vl- 7-7Z P 4157
I, as ? Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No. 12 .S6 c..flQk] 0.() U& 4M City bN
SecUon Township Range County 194610 7W
Which is occupied by Nu' L.U dy 1P?/In--B?E?f/2S
. (Name o1 Occupant)
Is a roughin inspection required on this job? No ? Yes)4 Ready Now ? Will Call X
Power Supplier Address
ElectricalContractor ?Q6 G-l2a? Contractor'sLicengNo?o?
Mailing Address /?2Z"? mpany
Al Ale- 14WAE
?.t
( ectrical C ntrac or o O?rer Making This Installatlon)
Authorized Signature - Phone No.
icai contractor or owne n9 Thls Installation)
SVRTE B(eA, RD COPY
Minnesota State Board of Electricity
. 1954'University Ave., St. Paul, Minn. 55104-Phone 645-7703
- REQUEST FOR ELECTRICAL INSPECTION
CMEGIC BELOW WORK COVERED BY TH[S REOUEST
.o3.p
p ? 4157
Type of Building New Add. Rep. Check Appliances Wired For Check uipment Wired Fw
Home ? :R ? Range ? Temporazy Wiring El
Duplex ? ? Water Heater ? Lighting Pixtuies ?
Apt. Bldg. ? ? ? D Electric Heating 0
Comme:cial Bldg. ? ? ? F Silo Unloadex ?
Industrial Bldg. ? ? ? Aond' Bulk Milk Tank ?
O h
O her ? ? ? ?eheis?
) ers?
H )
COMPUTE INSPECTION FEE BELOW
Service Entrance Size: # Fee Feeders&Subfeedeis: # Fee Cirwits: # Fce
0 to ]00 Am s. 0 to 30 Am eies 0 to 30 Am eres
101 to 200 Am s. 31 to 100 Amperes 31 to 300 Am eres
Above 200 Amps. Above 100 Amps. Above 100 Amps.
Transformers RemoteContcolCirc. Paitialorothecfee
S' ns Special Ins ection Minimum fce E5.00
Remazks
7'OTAL FEE
?
I,the Electrical Inspector, hereby
(Final) -
This request
ihspection has been,,madg. Q OCI
? Date (o Y
21 „ , ^ -,Date ^"?' ?
CITY OF EAGAN
, 3795 Pilot Knob Roud Eagan, MN $5122
PHONE: 454-8100
BUILDING PERMIT APPLICATION ReceiPt
To be used for S;n¢le Familv $41,000, Date T ?
N° 4204
# 5???
a++ G , 19_-77
Site Address 1256 Carlson Lake Ln Erect [7? Occupancy
Lot? Block 2 Sec/Sub.--Wi-lder=sPark Addrier ? Zoning .
Porcel # Repair ? Fire Zone _
Enlarge ? Type ofi Const.
z Name Solat Development Co Move ? $F' Stories
Z Address $395 College Tr, Demolish ? Front 4$ 4T.
? Ci IGH Phone 451-6604 Grade ? Depth 44 ft.
s
Name Solar Development Co.
Avvravals
Fees
p
?Q Address 8395 College Tr.
Assessment-
-- Permit 118.00
F Water & Sew. Surcharge 20.50
Clt IGH Phone 451-6604
Police Plan check
???
Fw Nome Fire SAC
?? Address Eng. Woter Conn. 2 ?.,?
¢w Ci Phone Planner Water Meter 60.00
Council
I hereby acknowledge that I have read this apPlicotion ond stote that Bldg. Off.
the information is correct ond agree to comply wifh pll opplicable $C)3
5?
State of Minnesota Statutes ond City of Eagon Ordinonces. APC .
Total
X
?
L
Signoture of Permittee ; -
? ar Developmetit Co.
A Building Permit is issued t on the express condition thot
all work shall be ne in a o n wt happlicable State of Minnesoto Starutes and City of Eagon Ordinances.
Building Official
A
RESIDENTIAL
y4-? BUILDING PERMIT APPLICATION ?
CITY OF EAGAN
3830 PILOT KN06 RD - 55122 I U
651-681-4675
New Constructian Reouiremenls RemodellReoairReauirements
• 3 registered site surveys showing sq. k. of bt, sq. ft. of house, an?ll roofed areas • 2 copies o( plan
(20 % maximum Iotcove2ge albwed) . 1 sel of Energy Calculations for heated atlditions
• 2 copies of plan showing beam 8 window sizes; poured found design, etc.) . 1 site survey for ex[enor additions 8 decks
• t set of Energy Calculatwns • indicate if home served by septic system for adtlitions
. 3 copies of Tree Preservation Plan if lot platted aker 711193
• Rim Joist Detail Options selecUon sheet (bldgs with 3 or less units)
DATE / ip" /.Z "E' /
Od
VALU9ION
U O
JOB SITE ADDRESS
If MULTI-FAMILY BUILDING, HOW MANY UNITS?
r1`CCLTi Pv<.1. ?wv,t-
PROPERTY OWNER
TY°P OFWOR!C J:?,lfc'hN C. PoL.TI - w-e.t ?7b??c-. F,UEPL.;CE(S) _ G 0_ 2
APPLICANi PHONE#
ADDRESS River ity ee e a, n. ZIPCODE
Q9^°-oiuc`viTa-St. N.W
PAGER # Coon Rap1Eg, MM9S483 PAX # 7?i3-7sf?-a '?l?8
754-2199
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Category _ VIINNESOTA RULLS 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Woirksheet Su6mitted
- Energy Envelope Calculations Submitted
MINNESO'I'A RULES 7672
New Energy Code Worksheet Submitted
Plumbing Contractor:
P1umUina System Includes:
Water Softener
Water Heater
vo. oFBaths
Phone
Iawn Sprinkler
No. of R.I. Baths
Mechanicai Conhactor. 1Ct1/mCt n Sh?Att NtisyL -
Mechanico-il Sys[em Includes: ?ir CondiUoning
Heat Recovery System
Sewer/Water Contractor.
All above information must be submitted prior to processing of application.
I hereby acknowledge ihat I have read ihis application, state that ihe
with all applicable State of Minnesota Statutes and City of Eagan Orc
?
Signature of Appiicant
I'ee: $90.00
Phone # ?l! 3- '7S r~_Vf
Fec: $70.00
Phone #
lU
is correct, and,agree to comply
G/
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1/Ot
? CITY OF EAGAN•
3830 Pilot Kno6 Road
Eagfan, kAiPVraesota 55122-1897
(651) 681-4675
SITE ADDRESS:
PERMIT
PERMIT TYPE: su 1101 : u G
Permit Num6er: 034263
Date Issued: i? 1 2 2/ 9 S
12 r? e c.nR L.s0 i\i i.A K F i.A N C
Lore 2 aLeirr,: 2
WzLOeRNEss aAtzrt
Pez.nr.: 1e-e42sO-0-20-02
DESCRIPTION:
(fWOOD STUVEI
i3i.fS1d'I riqriniC l'yr,e Ftf2!`L,4t:E
`?pikdStte! Wa'P*Qk, Type NEW
rE:'enSUs Code 434 F1LT. RE';:[U;:I'JTIF,L
.?
r
;
REMARKS:
CI-1:LhiNE'Y/FL.UF' IqUST EtE 7`N:?F'FOTEf`) H i?f=CJRt: Cn N(;EAI_1'NG<
FEE SUMMARY:
Base ree $50.00
Surchai-9e ". =•B
__... _.. _... ..._„__......?z?_?.r._.
Tota1 Fee $541,?',9?
CONTRACTOR: - APp.1.7-cane - 5" L. OWNER:
P,IRESIDE CORNEft tNC 1e331?i?}?' ?i?iA?I093,1 K?JER GAFlY
>?+P? Pl FAIRVJE4J AVF_ i2S?i C+?Ri_SO;V LAKE LRNF_
)SEVIL.LIc MN 55113 F A t3At! f4N 557.2:i
('612 ) 583--1042 i651Y454-?081
I herebv ackiiowledQe that I ha*.Ei, r'ead thi5 apRlication anct ?tate Eha'C tlas
intarmatiuin z5 co.rrect arTr1 aqree to campivwS.T,h a.11 appl:iCable.. State oi' Mn.
Sratutc? anct Ci CV at Eaqan Urdi,nanrres,
?
APPLICANTIPERMITEE SIGNATURE
_j
U•CT? 6 i SUt?
UED eY: SIGNATURE?`
CITY OF EAGAN
3830 PILOT KNOB RA - 55122
1998 FIREPLACE PERMIT APPLICATION
681-4675
DATE:_ QG, ?SA \(Q
? 7?
DESCRIPTION OF R'ORK: ? Construc? ?}ne„w? fire?Iace
U1 v
_ Install Pas insert onW
Other
? t?-D. S6
PERMIT FEE: $50.50
^ Alterations to existing
_ Install paa line oniv
Jos.4nnxESS: _ IaSGl
LOT: ?
BLOCK: ,-
?-. SUBDMSION/P.I.D. #: n Y?-x_?.b
i?%f---
APPLICANT (circle one only): OWNER C NTRA
I hereby acknowledge that I have read this application and state that the information is coaect
and agree to comply with all applicable State of Minnesota Statutes and City of Eagan
Ordinances.
a L /
Name: CAi \ e.t' Phone tl:
PROPERTY Last First
OWNER
FIREPLACE
INSTALLER
GAS LINE
INSTALLER
Street Adc
City i
Company:
Signature;
Street Adc
ZL?-License #
stau: ,0 2,& . zip: 7
P6oae #:
City ?a?? ? State: ,? ? Zip:
Use BLUE or BLACK Ink
F-----------------
I For Office Use I
j Perm it#:~ j
City of E an ;
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received: j
I I
Phone: (651) 675-5675
Fax: (651) 675-5694 1 Staff: I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: 1 Zsto son L4_15. e Lr` Unit
Name: Phone:
Resident/
Owner Address/ City/ Zip: 173-1- 14Z Zh M N 5372, 3
Applicant is: Owners/ Contractor
-4~t
Type of Work Description of work.
Construction Cost: Multi-Family Building: (Yes / No )
Compan . OC. u Contact:
Contractor Address: 700 L`f 110 City:
State: 'Zip: Phone:
License EC~, U3sq L4-7 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 the 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.gopherstateonecall.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 Minnesota State Buildin Code m e completed within 180
days of permit issuance. F
x ~1G ~1~Svt l'~ x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
Ai& .
For Office.Use� e ��� 7
%� � PZe:
..., E AGA N
P (0
r k 1.s t V ED Date Received:
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694MAR 2 2 2018 LStaff:
buildincinspections(�citvofeagan.com
a
2018 RESIDENTIAL PLUMBING PER- IT A PPLIC ION
Date: r' Site Address: `).< C4/1"t•'dA f1 .L /
Tenant: C,r+ , 'k„
t •;.ri; %, � 4 Suite#:
_ �` rr. . /
Vi'SROs n .t;� erne; _ u Il .J� Phone: 1
t ;:,..14,- //4
� � �? Address/City/Zip: .. ; . �_�. /.g ' ,�� y
w
Name: MILBERT COMPANY dba CULLIGAN WATER License#: WC6 1376
i_ 1801 50TH STREET EAST
-v.,*9n ac ® 31, Address: City: INVER GROVE HEIGHTS
- ; 1� tk State: MN Zip: 55077 Phone:
651-451-2241
'*WW 1 ' z�i`'' Contact: BILL MILBERT
y, , Email: •loria.abas@culligan4water.com
F .- -
it y•e1*'°• of —New —Replacement _Repair _Rebuild Modify Space Work in R.O.W. .
. r6,t.- . tr { Description of work:
£ � Y RESIDENTIAL
e d .;. 11. s _Water Heater
4`4° t} .�* #:',,°:' Lawn Irrigation RPZ/____PVB X,Water Softener
e°
Permit T p — g (-- PVB)
+e. /' x` ' Septic System Add Plumbing Fixtures( Main/ Lower Level)
r' b - Water Turnaround
4�- ,# .,,: M t Newp..-w ?: t" a '.. Abandonment
RESIDENTIAL FEES: ___
$.00.00 Water Heater,Water Softener,or Water Heater and Softener(includes State Surcharge)
$40.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
• *Water Turnaround(add$280.00 if a 3/4"meter is required)
$115.00 Septic System New(Includes County fee and State Surcharge) TOTAL FEES$ 60.00
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.comisubscrfbe.
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 en application for a permit, and work is not to start without a permit; that the work will be In
acc�rdance with he approved pla In th ase.o Work: which re ulres a review and approval of.lans.
Applicant's Printed Name x
Li.
Applicants Sig tura
`FD 11 �F vi f's °`Ari yj ., ,, � �, ,«" {, gut ;
2 4 .b jh�,�,',.�j,, '� a;; 1 y. �p'X.,,, RQVIe. ad1p • �r :tea s e 'y#, i` ,,+� f .� ,,dam z.-'' `4
r'.f A fir.. $ '#* Si1, C Y G R 4 ,..ez �S'.€ ..,.. -• `9� i,. .,'-k,'3
k ay�j Date' r
} s v ;C st ,` 1�I `Y ;,,,m-1' � v, Y s ss"- as it
Requ ed3lnspe io s de,G 'itri: ,. 5 ,t �� r � a
o� 4 Z �El• n ._ Air T t .� _" .,,s�, a -ate F nal
'Meter Relate• ltemSar s s ete S e� � ' �� anom er .1: ..',•.1,-.''%z. q ����a z
_,(( ad(o
� Read �; �a��!I;an�me�er Staff �. ����, �"��`��, ' 'i;'.