1932 Carnelian Lane10/06/2010 WED 14:35 FAX 612 822 5408 Al's Master Plumbimg
Gity of Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
INFLOWINFILTRATION
Plumbing /
Date 0071_,1 Site Address:
0002/002
Use BLUE or BLACK Ink
c9
Permit it: q47 3
Permit Fee:
Date Received:
Staff:
PERMIT APPLICATION
Sewer&Water
Tenant: _ _L\Rzr S P u r e r
J
RESIDENT/OWNER
CONTRACTOR
Name: !q a: e (-rl �e
Suite #:
Phone: 657 - S-) . C/r2
)
Address / City / Zip; r(7 5' -2- eq /-71c err) G n 9G Gn / ivy SSIa;
Address:
License #:
�/ic-(,\ 7 S City: ,—,A7/2S
(
State:✓ " I r (/ Zip: Ci r✓!' Phone: 6 -C;–? cL)—..
Contact: J G S 1 7"/c6„%'e Email;
TYPE OF WORK
DESCRIPTION
FEES
PLUMBING (Within the building enveiope)
XSump Pump Repair
Other:
Description of work; K(' I'
SEWER & WATER (Outside the building envelope)
Repair
Other:
rr r
$55,001 Each (includes $5.00 State Surcharge)
TOTAL FEE $, 55-
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit III repair Costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.cityofeacian.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 to dig to receive locates of underground utilities. www.gopherstateonecall.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 nota 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.
x d5/1v rc
Applicant's Printed Name
CITY OF EAGAN Remarks * Cedar Grove Acquisition
Additipn CEDAR GROVE #5 Lot 9 Blk 11 Parcel 10 16704 Q90 13
Ownerl~2-' i i ' L-' i Street 1932 Carnelian Lane State EAgan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWER LATERAL ( 1972 1,304.00 52.16 25 Paid
WATERMAIN
* WATER LATERAL 1972
WATER AREA
STORM SEW TRK 1971 70.00 3.50 20 Paid
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road " r.
Permit Number:
Eagan, Minnesota 55122-1897 0 I I,
Date Issued:
(612) 681-4675 1
SITE ADDRESS: APPLICANT:
i ; . i at Nt I AN I ANI .I ~ , i)N
lit .r.~ I'. ae+.
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR.
I
Permit No. Permit Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDGFINAL
BSMTR.1.
BSMT FINAL
DECK FTG
DECK FINAL
L -
EAGAN TOWNSHIP
~~BU~I~L)DING ,PERMIT N° 181'7
Owner . Eagan Township
Address (present) .~.Q 3 Town Hall
Builder _
Date ---7~!O- -6r
Address
DESCRIPTION
Stories To Be Used For Front Depth Height Est. Cos! Permit reel Remarks
AV 'ZJ CA
LOCATION
Street, Road or other Description of Location Lo! Block Addition or Tract
/3 N
This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE PT o 1 HE-PREMISE WHILE THE WORK IS IN PROGRESS. u
This is to certify, thaf__.....6 ...............has permission to erect a-._..s.Sr.. .........y. i upon
IS
the above described premise subject to the provisions of the Building Ordinance for Eagan owns ip a opted April 11,
1955.
P
. - - 1---...°-..°......... Per g airman of Town Board Buildin Impactor
B'B
EAGAN TOWNSHIP
N° 1413
Q~J ~J BUILDING PERMIT
Owner ....1411 ..e.....S...... eo-.---------- Eagan Township
Address (present) Town Hall
Builder 614.4u.:..........................
Address Date
DESCRIPTION
Stories To Be Used For - Front Depth Height Est. Cost Permit Fee Remarks
- LOCATION
Street, Road or other Description af_ Location Lo! Block - Addition or Tract
_q
This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE KEPT, ON. THE PREMISE WHILE THE WORK IS.IN PROGRESS.
This is to certify, that-c- ~P! . ~ upon
- the above described premise subject to the provisions of the Building Ordinance for Eagan T nship adopted April 11,
1955.
1 c ' /~:Nr y.. Per bI < ! -..:_Clv
Chairman of Tnwn Board / Building Inspector
PERMIT MD .1-6 SEW
'CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: BUILDING
Eagan, Minnesota 55122-1897 Permit Number: 027561
(612) 681-4675 Date Issued: 05/15/96
SITE ADDRESS:
1932 CARNELIAN LANE
LOT: 9 BLOCK: 13
CEDAR GROVE 5TH
P.I.N.* 10-16704-090-13
DESCRIPTION:
(EGRESS WINDOW)
iiidn+ Permit Type SF (MISC.)
3udxt~rk Type ALTERATION
C....... 434 ALT. RESIDENTIAL
1 ~Y A
g3'tr " k • 1 _ d
# l
~'",ss r`°?~ ter`s».
y` L 'i b§T ¢3 ~m; icWa F
~ms° art mom. .T' ai ~_r >S s„ TS
%
REMARKS:
FEE SUMMARY:
VALUATION $1,000
Base Fee $34.75
Surcharge $.50
Total Fee $35.25
CONTRACTOR: OWNER: - Applicant -
SEURER LEON
1932 CARNELIAN LN
EAGAN MN 55122
(612)452-4026
heg by. 1t' l'i'd, 46 h,a~t. f h",v~ raAc! -has ~}~F7 iceation and stag t~~~"n~the r;
ihffi it~atia4r .3s cta r r t a,i5'y1 t~rae to gomP7y ;W, i h a13- 'aPP~ cabl - t ate :qf Mn
S1$~LtCP"$€xd,Clt}€f ES
cJ4{ fl'rdtrt~FCfeS - i
"lo
bun APPLIC PPERMITEE 5 ATURE ISSUED BY. GN 1R,
CITY OF EAGAN~ n
d jq 3830 PILOT KNOB RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construction Requirements RemodelfReoair Requirements
♦ 3 registered site surveys ♦ 2 copies of plan
♦ 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ♦ 2 site surveys (exterior iaddtions & decks)
♦ t energy calculations ♦ 1 energy calculations for heated additions
♦ 3 copies of Use preservation plan if lot platted after 711193
required: _ Yes _ No
DATE: S- /5-96 . / CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS: I 3 Gs{ N6Gi<u'1 61-4
LOT BLOCK_ SUBD./P.I.D.
PROPERTY Name: S.9uje,_'? /..,tFoH „Phone#:
OWNER UST FIRST
Street Address: 2932 CAM M Gissic tt74
City: EAG, ,44 State: &zr Zip:
CONTRACTOR Company: Phone
Street Address: License
City: State: Zip:
ARCHITECT! Company: Phone
ENGINEER
Name: Registration
Street Address:
City: State: Zip:
.e'f ' k a
Sewer & water licensed plumber: Penalty applies when address change and lot
change are requested once permit is issued.
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.
Signature of Applicant:~`~!
OFFICE USE ONLY
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish
❑ 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool
❑ 03 SF Addition ❑ 08 8-plex ❑ 13 GaragelAccessory ❑ 20 Public Facility
0 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous
PI-05 SF isc. ❑ 10 _ plex ❑ 15 Deck
4j faro A w v.
WORK TYPE
❑ 31 New .0433 Alterations ❑ 36 Move
❑ 32 Addition ❑ 34 Repair ❑ 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MCNVS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code ~L
Census Bldg -1-
Census Unit a
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $ O®~
Surcharge
Plan Review
License
MCNUS SAC C7
City SAC jo~
Water Conn. _
Water Meter
Acct. Deposit CX15
ATTACHED
SAN Permit NF1
011T FOR FURTHER INFORAIATfOk
SNV Surcharge 9-
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies R E N I F W F 5
Total: 3Y
% SAC FATE S ~s
SAC Units
0 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAOAN~ a~ . a
3830 PILOT KNOB RD - 55122
651.681-4675
Now Construction Renuiremenh gmodet/Reoalr Reauiremenh
> 3 registered site surveys showing sq ff. of lot, sq. ff. of house 2 copies of pion
and go roofed areas M% maximum lot coverage allowed) 1 set of energy calculations for heated additions
> 2 copies of plans (stow beam & window sizes; poured Intl. design; etc.) I silo survey for exterior additions & decks
> 1 set of energy calculations
> 3 copies of tree preservation plan If lot platted alter 7/1/93
DATE: y- 7_ ° y CONSTRUCTION COST: X5-0 0
DESCRIPTION OF WORK: S / psi, 12eBGaG~;
STREET ADDRESS: / 9.3 GA e ~l r / /J / [ G N
LOT: BLOCK: 13 SUBD./P.I.D. r ell- `r0 Je'
Name: Sr"ccRF~ &30 Al Phone GSI- ~lra• S'oa.G.
PROPERTY Last First
OWNER
Street Address:/~S .2 Ga62Nr~Gii~ L1
City State: 12~7 1q Zip:
Company: Phone
(area code)
CONTRACTOR
Street Address: Ucense # EXP.
City State: Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone ( )
Street Address: Registration
City State: Zip:
Sewer/water licensed plumber (if installing sewerlwaterPhoine
I hereby acknoryledge that I have read this application, state that the Information is correct, and agree to comply with aU 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
f1~0397 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) 3.~5
77 CITY OF EAGAN
3830 PILOT KNOB RD - 55122 /
651-681-4675 Called 9/141 oD }hY1
New Construction Reaulremenls Renodel/Reodr ReaNremenh )1D dl Swer
> 3 registered site surveys stowing sq. ft. of lot, sq. fl. of house 2 copies of plan
and !a roofed areas (2D% maximum lot coverage allowed) 1 set of energycdculanons for hooted additions
> 2 copies of plans (show boom & window sizes: poured fnd. design: etc.) 1 site survey for exterior additions S decks
> 1 set of energy calculations
> 3 copies of free preservation plan If lot platted after 7/1/93
DATE: 3 J CONSTRUCTION COST:
DESCRIPTION OF WORK: ✓.l n U°7 -ro 9,7ra&
STREET ADDRESS: 19 3 i a ~t 1. /l { 11 P. nV1 air l
LOT: BLOCK: 43 SUBD./P.I.D. Cedar Ciro ye -ff
Name: sru~-~ L,6 0,14 Phone 6
PROPERTY Lost Fiat
OWNER
Sheet Address: / g 3 a- C /SRN G i t 4~11
City State: -'~7 14~ Zip: s
Company: Se 1 Phone
(area code)
CONTRACTOR
Street Address: License # Exp.
City State: zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone ( )
Skeet Address: Registration
city State: Zip:
Sewerlwater licensed plumber (if installing sewerhnterPhone (
1 hereby acknowledge that I have read this application, state that the information is coned, and agree to comply with all applicable Sta
of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant.
OFFICE USE ONLY
y'
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No Not Required r
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
❑ 01 Foundation ❑ 07 05-piex ❑ 13 16-plex ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi
❑ 02 SF Dwelling ❑ 08 06-plex ,1Et:~-17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Aft - SF
❑ 03 01 of _ plex ❑ 09 07-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Mufti
❑ 04 02-plex ❑ 10 08-plex ❑ 19 Lower Level ❑ 24 Storm Damage
❑ 05 03-plex ❑ 11 10-plex PIN _Yor_N ❑ 25 Miscellaneous
❑ 06 04-plex ❑ 12 12-plex ❑ 20 Pool ❑ 30 Accessory Bldg.
WORK TYPE
31 New ❑ 36 Move Bldg. ❑ 43 Reroof
❑ 32 Addition ❑ 37 Demolish (Bldg)' ❑ 44 Siding
❑ 33 Alteration ❑ 38 Demolish (Interior) ❑ 45 Fire Repair
❑ 34 Repair ❑ 42 Demolish (Foundation) ❑ 46 Windows/Doors
" Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code 0 1 # of Stories sq. ft.
No. of Units 0 Length 2 H sq. ft.
No. of Buildings 1 Width 12 Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Allowable) g1/ Main level sq. ft. MC/ES System
UBC Occupancy U-k Ga sq. ft. 0 91r City Water
Zoning- sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
❑ Stucco/Stone
APPROVALS
Planning Building C7 Engineering Variance
Permit Fee Valuation: $ L/, 200
Surcharge
Plan Review
License 28 2r x 16 ' `l 7 a a
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
EAGAN TOWNSHIP
BUILDING PERMIT N° 2952
Owner . .1 .1... B'=" Eagan Township
Address (present) ---J_ 3. z........_L.l i.' -:Lt:?-e'- - Town Hail
Builder
per. w~_ Date g..-..
Address'.'
DESCRIPTION
Stories To Be Used For Front Depth Heigh! Est. Cos! ~IPermit Fee Remarks
LOCATION / p, a-b
Street, Road or other Description of Location Lo! Block Addition or Tract
This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE T ON THE PREMISE WHILE THE WORK IS IN PROGRESS.
This is to certify, that...... ~ ----7 .................has permission !o esacLa.. upon
the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11,
1955. rr p
Per ...-----...........................'e`...--- - - g -I.a p•.-.ior.........................
Chairman of Tnw Bearat Huildin Ina eofor
MASTER CARD
LOCATION
OWNER )
STRUCTURE AND /f
LAND USED AS J'1~rr~rr/17
Issued To
I
Permit No. I Issued Contractor Owner
BUILDING ~-t-
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
t
ELECTRICAL
HEATING
GAS INSTALLING I
SANITARY SEWER fff
OTHER
OTHER F
Approved
Items (Initial) Date Remarks Distance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
DEPTH
HEATING OF WELL
GAS INSTALLATION 11
SEPTIC TANK
CESSPOOL l
DRAINFIELD
I'
i
PLUMBING 1
WELL
SANITARY SEWER
~L
Violations Noted
on Back
COMMENTS:
le-17
, g~ 023 " - _ I
IZ
I
I
Z
a
~ I
~ i
II
I
Use BLUE or BLACK Ink
I For OMce tJse I
411100 j Permit
OR y of EaEntidn I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 j Date Received: j
Phone: (651) 675-5675 I
Fax: (651) 675-5694 i staff.
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: Diane Sourer Phone:-;b
RESIDENT 1 1932 Carnelian Lane
OWNER Address / City / Zip: - Eagan, I VIN 55122 _ y 7 s:zo;.
Applicant is: Owner Contractor
TYPE OF WORK Description of work: f e_
Construction Cost: Multi-Family Building: (Yes / No Zj
Company: Contact:
CONTRACTOR Address: City:
State: Zip: Phone:
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 ANEW 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 th 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 Minbe completed within 180
days of permit issuance.
x x =ust
App
licant's Printed Name Applicant's Signature
Page 1 of 3
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING
1408 NORTHLAND DRIVE, SUITE 310 • MENDOTA HEIGHTS, MN 55120 • (952) 881-9000 TEST RECORD
JOB NO 3 5 7 " 2- F
ADDRESS ! '3 2 \`'� + u • V �-+ L•3 CITY
OCCUPANT (4).4t...
OWNER 5 e U -
SOLD BY INSTALLED BY CEJ G.
MAKE iS44511QC3 MODEL tte-EnU I / i Ob * -7 I
SERIAL NO.
S-A' z, O Js'S`
INPUT
713
�
/
THERMOSTAT , , ' `{ ' v— VENT SIZE L tt
VALVE h#1i:9 U 1 C CI TYPE OF LINER rQ " '
LIMIT ED' LL* a c,C_ LINER SIZE
LIMIT SETTING 1 Q ® FILTERS- SIZE 1 6fS/ 1 NUMBER
FAN SETTING ` ' Pd WIRING ((rec.
PILOT TYPE /* 1 TEST TAG V -
IGNITION MODEL LIGHTING INST. /V/1/4-
1
PILOT TIMINGI
- ( 1
PRESSURE -i r 6, q DATE TESTED PERCENT CO2 (�-c..._.'[
gt ,7 COMPANY TESTING Se'`'d`
INPUT CFH L PERCENT O2 /� J
STACK TEMP. / `� PERCENT CO v NAME OF TESTER '�0 -
FORM 235 (REV. 10/10) FORM DISTRIBUTIO : HITE COPY - JOB FILE YELLOW COPY - CITY
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA108327
Date Issued:11/30/2012
Permit Category:ePermit
Site Address: 1932 Carnelian Lane
Lot:9 Block: 13 Addition: Cedar Grove 5th
PID:10-16704-13-090
Use:
Description:
Sub Type:e - Furnace
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to Mark Anderson , State Electrical Inspector,
952-445-2840
Joy Post
1408 NORTHLAND DRIVE
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Diane Seurer
1932 Carnelian Lane
Eagan MN 55122--294
Sedgwick Heating & Air Conditioning
1408 Northland Drive, Suite 310
Mendota Heights MN 55120
(952) 881-9000
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
rr
1 For Office Use
Permit I
Ina I
City of Ea
Q I Permit Fee: • 1
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: 1
Phone: (651) 675-5675 I 1
Fax: (651) 675-5694 1 Staff: I
----------------J
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Q> 2013 Site Address: /9 32 6WAle l,w,J L...-J Unit
Name: j6n4h,4m ~i e4igfi ,5se Phone: (off/- 4128- ) 5-79
Resident/
Owner Address / City / Zip: 9 3 Z 6J4y"nl a j"] L t3 o 6yo n s/2Z
Applicant is: Owner ✓Contractor
Type of Work Description of work: 4, ZA91 4 •il•C,
Construction Cost: ~ 1-7 DDo " Multi-Family Building: (Yes / No
Company: AeA s-fohe. 44"101(161 q- R A44i l Contact:
Contractor Address: cR"C 22-0'M sfi• City: OCrAe1l
State: 1N3= Zip: " 732- Phone: &5/- 2-191 License S-S°9 73 b 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 ~y„xy
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 Building Code must be completed within 180
days of permit issuance.
x 12
Applicant's Printed Name Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA178131
Date Issued:08/02/2022
Permit Category:ePermit
Site Address: 1932 Carnelian Lane
Lot:9 Block: 13 Addition: Cedar Grove 5th
PID:10-16704-13-090
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 -
Abraham S Gemtessa
1932 Carnelian Ln
Eagan MN 55122--294
(651) 428-1579
Window Concepts Mn
291 Eva St
St Paul MN 55107
(651) 905-0105
Applicant/Permitee: Signature Issued By: Signature