4269 Carlson Lake Lane NCITY OF. EAGAN WATER SERVICE PERMIT
3795 Piloe Knob Road PERMIT NO.:
Eagon, MN 55122 DATE:
Zoning: No. of Units:
Owner.
Address: ?
Site Address:
Plumber,
Meter No.: Connection Charge:
Size: Actount Deposit:
Reader No.: Permit Fee: '
1 ogree to eompiy with !he CHy of Eagan Surcharge:
Ordinonces. Misc. Charges:
Totol:
By Dote Poid:
Date of Insp.; _ Insp.:
CITY OF EAGAN
3 7
,95 Pilot Knob Road
Eogan, MN 55122
Zoning:
Qwner:
Address:
Site Address: ' •" r? ?
Plumber.
SEWER SERYICE PERMIT
PERMIT NO.:
DP.TE:
No. of Units:
1 ogree to comply with the City of Eagan
Ordinances.
By --
Date of Insp.
Connection Charge:
Account Deposit:
Permit Fee:
Surcharge:
Misc. Chorges:
Tota I:
Date Paid:
, CITY OF EAGAN
" 3795 Pilot Knob Road
Eagoe, Minnesotn 55122
P6one: 454-8100
I MRTIP+(-. _ PERMIT
Dote: ''?'toher 17, 1977
Site Address:
Lot Block 1 Sub/5ec. WR St"
Nome l =lseIt ilomes I'dc.
.
m
? Address
City c t. Pat` l Phone:
` Npme A. rinc'.er Fy San Ir .r..
? Address 120 E. Sutler
e
0
V City t•ies'_. St. i dul Phone:
This Permit is issued on the express condition that oll work shall be
Minnesota Statutes and City of Eagan Ordinances.
No 3. `3
.
Receipt No.: q- D7729
Single I
Residerrtial !
Multi Res., Comm./Ind. ?
New/Alter./Repair. ?
Cost of Instollation
20.0n
Permit Fee
Surchorge
Toto I ?
done in accordance with all applicable State of
Building Official
?
? R
.
?
PI .UMBI IvG
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, MinnewM 55122
Phone: 454-8100
Date:
Septemher 29, 1977
PERMIT
(,3r _.SOfi ??.. ._?
? Lot Slock , Sub/Sec. _ Wi Sth
Name
. . , Sn(3'
; Address
O
n-
City .,..• :.ta_+. _ Phor?e:
?iis Y. Peter P1usiil
` Nnme
''4 Grand Rvenue
Address
City Phone:
This Permit is issued on the express condition that all work shall be
Minnesota Stotutes and City of Eogon Ordinances.
Na
Receipt No
Single
Residential
Multi Res., Comm./Ind, I
New/Alter./Repair "
Cost of Instalfation -
Permit Fee
Surcharge Total - done in accordance with all applicable State of
Building Official
CITY OF EAGAN
. 3795 Pilot Knob Rood Eagon, MN 55122 N? 4 5 2 3
- PHONE; 454-8100
.
BUILDING PERMIT , . Receipt ' "
.#
To be uaed for Date 19 '
Site Address Erect 0 Occupancy
Lot " Block Sec/Sub. Alter ? Zoning
Parcel # Repair ? Fire Zone -
, Enlarge ? Type of Const.
W Name Move ? # Stories
Z Address
3 Demolish Ej Front ft.
0 Cit Phone Grade ? Depth ft.
ce Name Approvals Fees
,o
`• oQ
Assessment
- Permit _
UAddress • ?-
?
~
Water & Sew.
Surcharge
Cit Phone
Police
Plan check
F
Wo?
W Nome
W
Fire
SAC
'=
L9 Address
Eng. ?1 00
Water Conn.
U
aW Cit Phone Pinnner Woter Meter
Council
I hereby ocknowledge thot I have read this application and state that gld9, Off. -
the informotion is correct and agree to comply with a:l applicoble
State of Minnesota Statutes and City of Eagan Ordinonces. APC Totaf
Signnture of Permittee
A Building Permit is issued to: • S•' }' ? on the express condition that
all work shall be dona in accordance with all applicoble State of Minnesota Statutes and City of Eocan Ordinances.
Building Offitiar
ParmM # DaN InWed PvwMtw
Plumbing
Mechanical
/ o O Sf g'-- a y- 77
so -/ 7- 7 -??
INSPECTIONS DATE INSP. Rough-In Flnd
Footings Date 1nsp. Dote InW
Foundotion Plumbing ?
Frame/ins. ? Mechonicul
Final
Remarks:
INSPECTION RECORD
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
I . I I ,,;, I
li i kil, f. ril . ilirt
PERMIT SUBTYPE:
PERMIT TYPE: 1.11 ? 1 01140
Permit Number: s % q 0
Date Issued: / r / / `) 4
, 6 111 APPLICANT:
! A M E N ? , t ?'. 1 1 I Y
i i, 1_' 1 .'i•? tl iiiN
TYPE OF WORK:
wf 11
INSPECTION .A . .A
? ?
Permit No. Permft Holder Date Telephone f!
SNV
PLUMBING
HVAC
ELECTRIC
ELECTRIC
inapection Dab Insp. Comments
Footingsl
FoundaGon
Framing
Rooring
Rough Pibg.
Rou9h Ht9_
Isul.
Freplace
Final Htg.
Orsat Test
Final Pibg. Plbg. Inspector - Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final Yr.73 ,?-.- A,-Ie
Well
Pr. Disp. ?
INSPECTIQN RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: 1 A P I ".t?N t AK I
i LtiFkHE'.3% KIfN 1.111
? PERMIT SUBTYPE:
.:
{ ? ; -ithFi 1 N
..?
tiuttviwc;
{1: 9 14 1 !
H6/16/97
' ?? II `' I ? APPLICANT:
.>;. t? I ?,?? t.
U r?wr N
TYPE OF WORK:
?at t?i
t6 AiNtii k f)
f JHAI
..k... .......?
Permit No. P*rmit Holder Data Telephone #
ELECTRIC
PLUMBING
HVAC
Inspectlon Data Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
QYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
. ?
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
?
CITY OF EAGAN Remarks
Addition Wilderness Run 5th Addition Lot 26 Rlk 1 Parcel 10 54354 260 01
.
Ow?er treet 4269 No. Carlson Lk. Ln• State Eagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 $132.60 $6.63 20 A005311 . 12-14-77
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATERAREA 160.00 10.66 15 13$.6$ A005311 12-14-77
STORM SEW TRK S7
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILOING PER.
SAC 475 00 7763 -18-77
PARK
?
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITEADDRESS: LoT: ze BLOCK: 1 APPLICANT:
4269 CARLSON LAKE LANE N COOLEY
WILDERNESS RUN 5TH (612) 688-6675
PERMIT SUBTYPE:
SWIFI POOL
TYPE OF WORK:
DESCRIPTION
?
?
Control No. 0675
BUILDING
000855
06J19/92
DAVE
NEW
18' DIAMETER
-1
-1
... REp1ARKS: ABOVE-GROUND
C°"t °
INSPECTION RECORD I "°. r' ? '
?
CITY OF EAGAN PERMIT TYPE: Nu ? t o? NA
3830 Pilot Knob Road Permit Number: Yslbeb?,
Eagan, Minnesota 55123 Date Issued: pF / 19 /y?
(612) 681-4675
SITE ADDRESS: h w ioc k: t APPLICANT:
4 269 i:AkLSUN 1_AKE' LFlNL N f.UPlt`Y tlqVE
WIL.M.RNE.iS H11N 61`14 (6t2) 6F1H--6575
PERMIT SUBTYPE:
suxM 11001.
TYPE OF WORK:
NEW
43ESCpIp11UN !e' LIlAMt'fF!R
RFMARKSr AHOVF 40Mt1N1,
Permit No. Permil Holtler Date Telephone #
SNV
PLUMBING
HVAC
ELECTRIC
ELECTRIC
InspecHOn Date Inap. Comments
Footings I
Fountletion
Freming
Rooting
Rough Plbg. '
Rough Htg.
isui. ST/l O njr1- GUo
Fireplace Q,-C4-_ ZG % /vG- .
Fnal Htg. `
OrsatTest
Fnal Pibg. Plbg. InspeIXOr - Naily Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Pog.
Deck Fnal
Well
Pc Disp.
?i CITY OF'EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
PERMIT
4269 CARLSON
LOT: 26 BLOCK: 1
WILDERNESS RUM 5TH
DESCRIPTION:
18' OIAMETER
'Build"€ng Permit Type
Suilding',Work 7ype
uac accupaRcy
f
v , 4nY- ?
f -
t\
t -t
PEiiMIT TYPE:
Permit Number:
Date Issued:
LRKE LANE N
SWIM POOL
NEW
M-2
f :4
?J€ 4?
r
i
r7ti...?'I_ •I!?.Jda 1 Ll
?i
BUILDZN6
000855
06/19/92
REMARKS:
ABOVE-GROUPID
FEE SUMMARY:
VALUATION =508
Base Fee ;15.00 COPIES $1.00
Surcharge .50 Total Fee $16.50
Subtotal $15.50
CONTRACTOR: OWNER: - APPlicant -
COOLEY oave
4269 N CARLSON LAKE LN
EAGAN MN 55123
(612)688-6675
I hereby acknowledge that I h-ave read this applicatiart and state th•aC the
infibrmation is correcC and agree ta eomply with all applicahl,e State of Mn•.
Statutes and City af Eagan Ordinances.
APPLICANT/PERMITEE SIGNAJURE SUED V: SIG UR?
Control No. 0675
This request void 18 months from
. . ;. ,
Date of this Request 9-1e-77 " 22988
I, asCl Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street A dress or Ro te No. 26 North Carl;on Lalie Lane CityEs?an
?
Sectlon Township Range County Dakota
Which is occupied by Tilsen Homes
. (Nama of OccuPant)
Is a roughin inspection required on this job? No ? Yes ? Ready Now ? Will Call ?
Power Supplier Dakota Caunty Electric Address Farmirigrton
ElectricalContractor O.B. Thomnson Eleetric Co. Contractor's License NoA3=
(COmOany Name)
MailingAddress 12201 ,t?tka I31vd., P.itka 55343
(E?le/ttric?j 1 Contract or r r Making Thls Inatalla[lon)
Authorized Signature Phone No933•2521
(Electrical o tor or Owner Making Thls Installation)
????? ?? ?? ??P'V
Minnesota State Board of Electricity
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
` RE'QZfEST FOR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REQUEST
07e" e-' 7
p 22988
Type o[ Buildirg New Add. Rep. Check Appliancea Wired Foi Check Fquipment Wued For
Home U- ? ? Range 121 Temporary Wuing ?
Duplex ? ? ? Water Heater -im LighUng Fixtures - 3iibv_
Apt. Bldg. ? 11 ? Dryer )B Electric Heating 0
Commeicial Bldg. ? ? ? Fumuce 32 Silo Unloader ?
IndustrialBldg. ? ? ? A'v Conditioner 0 Buik Milk Tank ?
Fum List List
O hei o o ? p
Heiet$jL S.X?CXX Rereecs?
f
COMPUTE INSPECTION FEE BELOW _ ee-?04?
Seivica Entiance Size: # Fee Fceders&Sub Fee C¢cuits: # Fee
0 ro 100 Am s. 0[0 3` e",t; 0 to 30 Am tes
101 to 200 Am ¢0 IIG 31 10 ?"" s' 31 m 100 Am eres
Above 200 Amps. Ifo`v 1 Amps. Above lOQ_Amps.
Transformers teC volCirc. Partialor otherfee
Signs S # Ins ection Minimum fee $5.00
Remazks Ha.ll TOTAL FEE 2 0.'51)
I, the Electrical Inspector, hereby certify
(Final) -
This request
ion has been made. c/p , ao
,,.?pp1e ,.tj ` ?2 .
t n..a . i -a7y-? ?
9/Y' c-o- G/U/YS C/L`
4 2 79 9
Request Dale
??.
'/?a_ Fire No. Rough-in Ins ion
q ired?
? ileatly Now
I Notiry Inspecior
A-II
J es GNo henF
Weatly?
I i] licensed contractorp-!I?wner hereby request inspection of above electrical work at :
Job ACdr ss (SVeet. Bax oute o4 ?"
?
L
? Ciry
r1 •
tc
1 r Son ?-
(o
SecimnNO. Township Name or No. qange No. Counly
ca" artl ?PRWT) phone No.
IUC L/
Powar SupPlier Atltlress
ElecvMal Con ac r (COmpany Name) Conhactor§ License No.
'/
??w??Lr
Mailing A IConVador or Owner Making Installatqn)
UV
Av?horize Ignature ICo r c?orlOwn aking Ins?allation)
PM1One Numb
/--
MINNESOTq STATE BOAFD OF EIECTRICI Y THIS INS ECTION REOUEST WILL NOT
Griggs-Mitlway Bltlg. - Noom S173 BE ACCEPTEO 6YTME STATE BOARD
1821 University Ave., SL Peul. MN 55106 UNIESS PROPER MSPECTION FEE IS
Mane (612) 600-0800 ENCLOSEO.
(41 REQUEST FOR ELECTRICAL INSPECTION °?kyEB-OOOOb08
^
? Sae iisimctions for completing lhls form on back oi yellav copy.
W C?v?9s ?
"X
" 2799 " Below Work Covered by This Request r?
e Atld Rep. , TypeofBuiltling AppliancesWired EquipmeniWired
Home Range Temporary Service
Duplez Water Heater ElecUic Heating
Apt. euilding Dryer OMer (Specify)
Comm./Industrial Fumace
Farm Air Conditioner
Other(specity) Contraccor§ Remarks:
Compute ection Fee Below:
# . Other Fee # ServiceEntranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 ta 700 Amps
Transformers A6ove 200 _ Amps ve 100 _ Am
ps
Signs Inspecto.5 Use Only; ?
7pp ?
'
Irrigation Booms 0
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDEflED DISCONNECTED IF NOT
• Other Fee COMPLETED WRHIN 1 HS.
I, the Electrical Inspector, hereby
tif
th
t
h Rough-in ? uate/
d
y
cer
t
a
e above inspection has
been made. Fn,ai oa (?
OFFICE USE 3NLY ?
This request witl 18 mamhs irom
PERMIT # r
REACT7VA; E ifi5
CITY OF EAGAN
1992 BUfLDING PERMIT APPLICATION
681-4675
JUN
..$I L.So
?'n?"?./f L4
? RECO
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural 8 structural plans, 1 set of
specifications, 1 copy af energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date Jo ae- / iz/ -2 zi Valuation of wark 9so0
Site Address: 4:L6 5 'I1 Caa,LSo?-. Lc...,? L?.sz L#a- h.,-? 5S12.3
STREET "SUtiE /
Tenant Name: (commercial only)
LOT ZL BLOC& SUSD. a. ljy(,I0y,l?pUa.. 9?,Udl ???,lv
UJ TP-I. D. k
Descri tion of work:PV6
? ' boL-- 4 'X rQ'
The applicant is: [9 Owner ? Contractor ? OtI181" (Deacribe)
Name eoo le? Phone ?2.-Gf?P-C,6?ti
Property uST FIRST
Owner qddre
L L
4ic
Ca-
.L
L
ss
? ?
c?,
m?
,
Sd,.,
' STREET STE N
city Eo-.!? cL.? state r_' ZiP SS (Z3
Company Phone
COntf8Ct0r Address License # Exp.
City _ State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer 6 water licensed plumber . Processing time for
sewer 8 water permits is two days once area has een approved.
I hereby acknowledge that I have read this application and state that the informatton is
correct and agree to comply with.all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation
? 02 SF Dwg.
11 03 SF Addition
0 04 SF Porch
O 05 SF Misc.
WORK TYPE
1 New
32 Addition
? 06 Duplex
? 07 4-Plex
O 08 8-Plex
? 09 12-Plex
? 10 Multi. Add'1
? 33 Alterations
? 34 Repair
GENERAL INFORMATION
O 11 Apt./Lodging ? 1G Basement Finish
O 12 Multi. Misc. ?17 Swim Pool
? 13 Garage/Accessory O 18 Comm./Ind.
? 14 Fireplace ? 19 Comm./Ind. Misc.
? 15 Deck O 20 Public Facility
? 21 Miscellaneous
O 35 Tenant Finish ? 37 Demolish
? 36 Move
Const. (Actual) Basement sq. ft.
SAllowable) lst Fl. sq. ft.
UBC ccupancy ? 2nd F1. sq. ft.
Zoning Sq. Ft. total
i of Stories Footprint Sq. ft.
Length ?AMetCK On-site well
Oepth On-site sewage
APPROVALS
Planning Building
Engineering Variance
REGIUIRED INSPECTIONS A 9d04ffr=au1.tN,o Pawk?
? Site ? Footing O framing
? Nallboard ? Final ? Draintile
MWCC System
City Water
PRY Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Assessments
? Insulation
0 Fireplace
Permit Fee ,f pv v,i,,,t;,,,:
Surcharge ?
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter .
Acct. Deposit
S/W Permit
S/W Surcharye
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total: IL -
g
k,
4
SAC %
SAC Units
f,,1 0 wrH ---?
, ?? r e • i.V ` ?
?
1?t}???k???2
i I
. ?I
7fi?.x'/?.,L "01oF.JQT y L?NE ? I
I
,J
S ?
.\ ?
?
-2410?ry
UNE'?
?
i
(
3
i
.P.ea?E.e rY
LINE'
.
?
?
i`I
?
? ?C?? "rL, .J.J ie ?o,
?E,c??2c?,?•
,
J146,9 k;",'?_ tzQ.oO-)
PaqCLj").
L oT a? BLoc k 0
,
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F?LO -s 4 L AN
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITEADDRESS: Lor: 26 BLOCK: 1 APPLICANT:
4269 CARLSON LAKE LANE N COOLEY KATHI
WILDERNESS RUN 5TH (612) 726-4388
PERMIT SUBTYPE:
DECK
TYPE OF WORK:
NEW
BUILDING
023740
05/27/94
INSPECTION .. . ,.
FOOTINGS FINAL
1- 7
? ?
l
CITY OF EAGAN
% 3830 Pilot Knob Road
Eagan, Mfnnesota 55123
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-84354-260-01
DESCRIPTfON:
PERMIT
4269 CARL50N
LOT: 26 BLOCK:
WILDERNESS RUN 5TW
Beiilding'-.Permit Type
8uilding Wqr-k Type
f ?
/
\
_.?. f o. .
\ j f
?
DECK
NEW
REMARKS:
J`a? - i4
BUZLDZNG
023740
05/27/94
FEE SUMMARY:
Base Fee $36.00 COPIES $1.00
Surcharge $.50 7ota1 Fee $31.50
Subtotal $80.50
CONTRACTOR:
PERMIT TYPE:
Permit Number:
Date Issued:
LAKE LANE N
1
OWNER: - Applicant -
COOLEY KATHT
4269 GARLSON LAKE LN N
EAGAN MN 55123
(612)726-4388
I here6y acknowledge that I have read this
information is carrect end agree ta c-omply
Sta,utes and City af Eagari Ordihanoes.
APPLICANT/PERMITEE SIGNATU E
applieaCion anzl' state that the
wkth a12 applioable S'tate of Mn.
Ja R?.?,l I 17?1
Dr??BY: IGN TURE
J
t
23140
C9TY OF EAGAN
1994 BUILDING PERMIT APPLICATION
687-4675
fF.i r? S1. T n n n rs.+r.a
SINGLE & MULTI-FAMILY 2 sets of plans, 3 register d site surveys, 1 opy of energy
calcs. ?IWY 2 w 19 9 tf
COMMERCIAL 2 sets of architectural & s r?uctaral. dACr+L et of
specifications, 1 copy of energy ca cs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date
Valuation of work
Site Address: '4M
STREET SU2TE tt
Tenant Name: (commercial only)
LOT _J_4__ SLOCK ? SUBD. 9e Y J??L?-?
l,lJ 1 P.I.D. #
Descri tion of work: ?-?- 04-3 Pos t,
The applicant is: Owner ? Contractor ? Other (Describe)
Name OJDE) F}=Tttt Phone 6%(0^ 4_?(0
^
Property LAST
FIRST f Idto -438s dpi
Owner 42(
R ?1
o
qddress
•
STREET STE #
City State Zip 5 512-?
Company Phone
Co ntractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address '
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have r d this application and state that the information is
correct and agree to com ly ith 11 1'cable State of Minnesota Statutes and City of
Ea9an Ordinances. ?
Signature of Applic
?uRr
-e
Ln d
i o i
? • ??+ ? ? I „? `
40 ?.
\? k
eaR.. "o0ERTY LwE ? 1.
I
?4-'•?b ?+?
lis ?t
? AzAw N
? UNE'?
s,
?
0 .
?
I
I
I ti?
?
n
lJ
n:
\
C..J
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LINE
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C-D
(AtT.o4 ') L I k!U C?"?") lQ
e?ZF ?2L1,?/' C [LfL'TLI?"7L_? I
?
Lor .? ? BLack [T?f I
?
?
cri PNT ?aoaF?rY _Ll.?? ? I
f
-- 'i")1 n r• ?
PERMIT
% s(;CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: s u=Lo r N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 9 9 7 7
(612) 681-4675 Date Issued: 0 5(15 ( 9 7
SITE ADDRESS:
4269 CARLSON LAI<E LANE N
LOT: 26 BLOCK: 1
WTIDERNESS RUN 5TH
P.I.N.:10-84359-260-81
DESCRIPTION:
(GAS INSERT)
Ouildx???..Pei°miC TYPe FIREPLACE
'$uildi;ng 4o_r.,k Type NEW
Gensas Code ? 434 ALT. RESIDENTIAL
, ._..,?
i
_j
i
`.
?
L, C,rliFa • . .. ? ?45 ....
? t1 i ?s F
? a e^ .'E? t4? v J n?..z"s' `? `^,,.? °?`ci y} "` ty? '•?.,.7 ? f r. ??:s
REMARKS:
FEE SUMMARY:
Base Fee $50.00
Surcharge ?_58
Total Fee $50.50
CONTRACTOR: - Appiicant - OWNER:
FIPESIDE CORN[R INC 16331092 KLEIN NANCY
2700 N FflIRVIEW AVE 4269 CARLSON LAKE LN
RO$EVILLE MN 55113 EAGAN MN 55123
(612) 633-1042 (612)681-1702
? . 1
I hereby acknawledqe that S have read this application and staCe ChaC the
informaCion is correct and agree ta comp,ly witfa all applicable State Qf Mn.
? Stdtu$es, and Gity Pf_Eaig,an F3Kdic74nGts. «g. ,
?I
APPLICANT/PERMITEE SIGNATURE
?a14 RI1A,1242-- I E 5 ATU E?
CTTY OF EAGAN
3830 PILOT KNOB RD - 55122 I"qq 1997 FII2EPLACE PERMTf APPLICATION ? ? ? •?- '"
681-4675
DATE: PERMIT FEE: $50.50
DESCRIPTION OF WORK: _ CONSTRUCT ?{,' FIREPLACE _ Ai.'r'F'RATIONS TO EXISTING
ZINSTALL GAS INSERT ONLY
_ INSTALL GAS LINE ONLY
OTEIER:
STREET ADDRESS: Ik Z(O / C?9 L S e
LOT It,_ BLOCK SUBDJP.I.D. #:
APPLICANT: (cucle one only) OWNER C,
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
PROPERTY
OWNER
FIItEPLACE
INSTALLER
GAS LINE
INSTALLER
Name: ?Lel 1,3 t?RWL? Phone#: ?eI -17UC5
Signature:
Street Address: 4 2- ? 9 CIYI vcL' ss? +,,3 L-04 KE L7Jj
City: ?^ C'i IQ ?l1 5tate?(.J Zip: s? ? Z-?
Company: ALLiY ID12.?1A?_ 90 o T Z 5
Signature: ?v
Street Address: :3 g S t> - W- Id-Y ??rcense #: Z o0 90 ?//
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City?U?LnTSvlL??9- State: ?N Zip: ? 1737
Compar^•
Name:
Signature:
Street A
City:
Dbnnn :U•
State: Gip:
CITY OP EAGAN
3795 Pila Knob Raod Eayan, MN 55722 N2 4523
PHONE: 954-8100
BUILDING PERMIT APPLICATION
000
30 Rece?Pt # 7763 _
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$
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To be uaed fer Sin Fnm ilvl d Car
e e?-e pa}e October 1$, 19 77
Site Address 4269 No.Carlson Lake Ln Erect 25 Occupancy I
Lot 26 Block 1 Sec/Sub. WR Sth Alter ? Zoning RL
Repair ? Fire Zone 3 _
Porcel #
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l of Const
T
arge ?
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ype v
w Name Gte?Ory Johnson Move ? # Stories
3 Address Demolish ? Front 58 -- ft.
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Phone
6rade ?
Depth
ft.
Q: ApDrorats Fees
p Name 'Cibg6rr uea,^2g , !R6?-
6 Address 627 Se_ SnPll ang AvP
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? ,-... St_ Paul ??___ 698-SB91
Nome
I hereby acknowledge thot I hove read this application ond state that
the informotion is correct and agree to comply with all applicable
Stote of Minnesota Statutes and City of Eogon Ordinances,
Signature of Permittee _
A Building Pertnit is issued
all work shall be done in a
Building Official ?
Assessment Pertnit 90.1U_
Water&Sew. Surcharge 1$.00
Police Plan check
Fire SAC 475.00
Eng. Water Cann. 23).00
Plonner WoterMeter 60.?0
COUncil
BId9
Off
.
.
APC
Totol 870.50
on the express condition that
Minnesata Stotutes and City of Eagan Ordinances.
DATE /? -/% - i7
HUiLDIN6 DS3tMIT APPLICA'MON
InClulte Z eeta cf.p].ana, 1 sita plan w/elevations and 1 set oY energy calculations.
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To be used for pf,k A luation
Site Address :
Lot Block Sec. S1ib. Parcel Nwnber
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Owner ? Telephone
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Contracto?% Telephone D/ d - -0?4) ?
Addresa
Arch./En9• Telephone ...
Address
OFFICE USE
Ereat Occupancy
Y ?
Alter Zoning
Repair Fire Zone
Eniarge Type of Oonst. V_ _
pqovg # of Storiea ?
Deaalish Front
Grade Depth 2
OFFICfi USE
Date of Approval 6 Initial FES
j1888881RE21t 1 Pezmit
Water/Secoer Surcharge ?/5' ?
Police Plan Check y
Fire SAC
FYi4• F7ater Conn.
Planner Slater Meter
Oouncil
Bldg. Off.
A.P.C. TOTAL
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-PLOi ? L AN
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
TJ ?`? 3 3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construetbn BeaulremeMe
• 3 registere0 sile suneys showing sq. iL of b6 sq. M. of Muse; and AU roofed areas
(20% meximum bt coverage elbwetl)
• 2 copies ot plan show'vig heam & window sizes; poured fountl design, etc.)
• tsetofEnergyCalcuWCOns
• 3 coplas of 7ree Preservatbn Plan il bt platled after 711193
. Rim ,bisl Detail OptlOns selectbn shaet (bldgs wAh 3 or less units)
DATE /? - ? 9
SITE ADDRESS
TYPE OF WOR
APPLICANT
STRE ADSD E
TELEP O?1 #
PROPERTY ON
pemodeVBeoalr HeauirameMs
. 2copiesofplan
• lsetofEnergyCakulatbnstorheatedaAdftions
• lsttesurveyforMerioraddnbns&decks
• hMkate tl home served by septic system for additlons
VALUATION
5-)6
MULTI-FAMILY BLDG _ Y _ N
_ FIREPLACE(S) _ 0 _ 1 _ 2
TATE/?ZIP?
_ FAx # ? ?7U7 -l?d 97
it
TELEPHONE#/
---------- --------- ----- -d--------------- ----------- ---------------°-------------------
COMPLETE THIS SECTION FOR %NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672
(4 submission type) • Residential Ventilation Category 1 WoACShaet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Conhactor:
Plumbing system includes:
Mechanical Contractor:
Mechanical system includes:
Sawer/Water Contracfor.
_ Air Conditioning
_ Heat Recovery System
I hereby acknowledge that I have read this applicaTion, state that ihe
with all applicable State of Minnesota StatuTes and City of Eagan Or¢
Signature of Applicant
OFFICE USE ONLY
_ Water Softener
_ Water Heater
_ No. of Baths
Phone #
Lawn Sprinkler
No. of R.I. Baths
Phone #
Fee: $90.00
Fee: $70.00
?T 0- U T
comply
CeRificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updaled 4102
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA131196
Date Issued:06/08/2015
Permit Category:ePermit
Site Address: 4269 Carlson Lake Lane N
Lot:026 Block: 001 Addition: Wilderness Run 5th
PID:10-84354-01-260
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 -
Justin P Lee
4269 Carlson Lake Lane N
Eagan MN 55123
Pavel Enterprises LLC
3935 71st Ct E
Inver Grove Heights MN 55076
(651) 353-4783
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA164911
Date Issued:10/12/2020
Permit Category:ePermit
Site Address: 4269 Carlson Lake Lane N
Lot:026 Block: 001 Addition: Wilderness Run 5th
PID:10-84354-01-260
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
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 -
Craig Smith
4269 Carlson Lake Ln N
Eagan MN 55123
(612) 638-6068
Blue Ox Heating & Air Llc
5720 International Pkwy
New Hope MN 55428
(612) 238-9709
Applicant/Permitee: Signature Issued By: Signature