1230 Balsam Tr E
Use BLUE or BLACK Ink
r
For Office Use
I s~ --7 I
Permit#: oC / j
City of EaRd
J b I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I 1 1
Fax: (651) 675-5694 I Staff: I
I I
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: p 7 /0 Site Address: 1,-;2 30 ~ 69G 5-6,1 s T<
Tenant: Suite
RESIDENT / OWNER Name: LOPAZ _X20.,WV Phone: - q,910-7
Address/ City/ Zip: /,,,2,3o 97 A6¢G.561/"1 7-ix~
Applicant is: Owner Contractor
TYPE OF WORK Description of work: ~t°9l vow-
Construction Cost: Lf le0,60 Multi-Family Building: (Yes / Nd1_,S:_)
CONTRACTOR Name: /7" 10 YcN~re~- License 1/)6)637nd
Address: lw o )e, lohe- City:
State: /ll!°j Zip: fS 1/ 7 Phone: ~5 76 7
Contact: eerli~- 26ir~1 Email:
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 pl s.
x Z ee~S x
Applicant's Printed Name Applicant's Signa
Page 1 of 2
CITY _ oAGAN WATER SERVICE PERMIT
3195 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
Meter No.: Connection Charge.
Size: Account Deposit:
Reader No.: Permit Fee:
agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
BY Date Paid:
Date of I nsp.: I nsp.:
CITY - EAGAM SEWER SERVICE PERMIT
3195 Pilot Knob Rood PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning:
No. of Units:
Owner:
Address: ,
Site Address:
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge: _
By
Date of Insp.: Misc. Charges:
Total:
Insp.: Date Paid:
CITY OF EAGAN
t 3795 Pilot Knob Road Eagan, MN 55122 N2 4775
PHONE: 454-8100
BUILDING PERMIT ti r Receipt #
To be used for i Est. Value Date 19 }
Site Address Erect Occupancy
Lot Block Sec/Sub. Alter ❑ Zoning
Parcel # Repair ❑ Fire Zone
Enlarge ❑ Type of Const.
W Name Venn Pet Inc. Move ❑ # Stories
3 Address 7t t~ Demolish ❑ Front ft.
o i. 44 Grade ❑ Depth ft.
City Phone
o Name Approvals Fees
~ Assessment Permit
ul Address
~ city Phone Water & Sew. Surcharge
F~ Police Plan check
FZ Name Fire SAC
u3 Address Eng. Water Conn.
<W City Phone Planner Water Meter
Council
I hereby acknowledge that I have read this application and state that Bldg. Off. 0.00
the information is correct and agree to comply with all applicable APC Total 58. Sr
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to: 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 Official
►erstt # Deft Issyed hnelttw
Plumbing ~i
Mechanical
INSPECTIONS DATE INSP. Rough-In Find
Footings Date Insp. Date Insp.
Foundation Plumbing f!lj
-
Frome/ins. - Mechanical 4 -
Final
i
Remarks:
/ftr r~r nor e.x,.•'Te1
- o rr
r , n~ ( r/.T Ilo1~,
CITY OF EAGAN
3795 Pilot Knob Rood
Eagan, Minnesota 55122
Phone: 454-8100
PERMIT No. 1149
r . ' 2276
Date: Receipt No.:
Single
Site Address: Residential
Lot Block Sub/Sec. Multi Res., Comm./Ind.
Nome Now/Alter./Repair
• 1 t~. 19th ~i.
Address Cost of Installation _
City Phone: Permit Fee
(-:.nnz-Ryan
Nome - Surcharge
14745 :)oath Trail.
P Address
e
City Phone: Total
This Permit is issued on the express condition that all work shall be done in accordance with all applicable State of
Minna to Statutes and City of Eagan Ordinances.
Building Official
CITY OF EAGAN
3795 P" Knob Read Eagan, MN 55122 N? 5790
PHONE: 454.8100
BUILDING PERMIT Receipt #
To be used for Est. Value Date x 19
Site Address Erect ❑ Occupancy
Lot Block Sec/Sub. Alter ❑ Zoning
Parcel # Repair ❑ Fire Zone
Enlarge ❑ Type of Const.
W Name Move ❑ # Stories
3 Address Demolish ❑ Front ft.
0
City Phone Grade ❑ Depth ft.
Name Approvals Fees
0
Address Assessment Permit
~ city Phone Water & Sew. Surcharge
Police Plan check
W Name Fire SAC
X5 Address Eng. Water Conn.
<W city Phone Planner Water Meter
Council Road Unit
I hereby acknowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to comply with all applicable APC Total
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee i
A Building Permit is issued to. 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 Official
P~ # Date Rued hneMISS
Plumbing
Mechanical
INSPECTIONS DATE INSP.
Rough-in Final
Footings ,,,p Date Insp. Dote Insp.
Foundation ` Plumbing
Frame/ins. Mechanical
Final t-- tie
Remarks:
CITY OF EA"H
3796 Pilot Knob Rood
Eagan, Minnesota 55132
Phone: 454-8100
PERMIT No.
Date: ' ` ~e 12 i 19T,
X91
Receipt No.:
Single
Site Address % 0 Ea s f- 11, a 1 - a n i r;7; Residential
Lot Block 1 Sub/Sec. _ Multi Res., Comm./Ind.
Name New/Alter./Repair. °
Address Cost of Installation
O City _ Phone: Permit Fee 20 • 0 0
Nome Gen-7 Ryan P 1 um I r- r i r ° , i r47 " Surcharge r'0
Address 14745 South Pn'-,-r1- 1
City 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 Official
CITY OF EAGAN Remarks
Additi n Wilderness Park Lot 25 Blk 1 Parcel 10 84250 250 01
Owner_ I11~_street 1230 East Balsam Trail State Eagan,MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK I 1973 1$ .0 d.do 0 C 00S160 1-5,79
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA ~Yl 1977 160.00 10.66 15 7-25 79
STORM SEW TRK 0005507 8 5 }30
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit Charge .00 9833
- -
WATER CONN. 250.00 - -
BUILDING PER. #4775
SAC 500.00 9833 - -
PARK 120.00 9833
- -
This request void 18 months from O 3a g
Dato bf this Request June b, 1978 P 68037
I, as M icensed Electrical Contractor ❑ Owner, do hereby request inspection of the above electri-
cal wiring installed at: 2S ~r / W A,,& L
Street Address or Route No. 1230 E. Balsam Tr- City Fagan
Section Township Range County Dakota
Which is occupied by Svend Feterson Construction
(Name of Occupant)
Is a roughin inspection required on this job? No ❑ Yes E Ready Now ❑ Will Call rKI
Power Supplier Dakota Electrical Assn. Address 821 3rd., Farmington, 1,2
Electrical Contractor Ken Sorenson Electric Contractors License No'
(company Name)
Mailing Address 8070 12th Ave. So., Bloomington, IIN 55420
~7t (Electrical Contractor Y Owner Making This Installation)
Authorized Signature El y I~ i Phone No. 854-U70
(Electrical Contractor or Owner Making This Installatrom)
COPY This inspection request will not accepted the
State Board unless proper inspection fee is encl closed.
minnesota state tloaro of Llectncity a
,954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
REQUEST FOR ELECTRICAL INSPECTION GHO37
CHECK BELOW WORK COVERED BY THIS REQUEST
Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For
Home ® ❑ ❑ Range ❑ Temporary Wiring ❑
Duplex ❑ ❑ ❑ Water Heater ❑ Lighting Fixtures ❑
Apt.-Bldg. ❑ D El Electric Heating 1:1
Commercial Bldg. ❑ 1-] ❑ F a Silo Unloader ❑
Industrial Bldg. ❑ ❑ ❑ A di Bulk Milk Tank ❑
Farm ❑ ❑ ❑ L 1}}1 7 r List
Other ❑ ❑ ❑ Herers) Heiers
COMPUTE INSPECTION FEE BELOW
Service Entrance Size: # Fee Feeders& Subfeeden: # Fee Circuits: # Fee
0 to 100 rp s. 0 to 30 Amperes 0 to 30 Amperes
101 ti6 2 raps. 31 to 100 Amperes 31 to 100 Amperes
Above 00 Amps. Above 100 Amps. Above 100 Am s.
Transformers Remote Control Circ. Partial or other fee
Signs f " 5 cial Inspection Minimum fee
TOTAL F 4.VC
Remarks Complete House Tiring
1, the Electrical Inspector, hereby c tha a ose ins ction has been ma
(Rough-in)_ Date - Y' 7 y
(Final) Date
This request void 18 months from
This request void 18 months from p~ l
Date of this Request P' 6 0 0 1
1, as Licensed Electrical Contractor ❑ Owner, do hereby request inspection of the above electri-
cal wrong installed at:
r 1 WP ~ ,
Street Address or Route No.ZA 30 ff~ 13~iS % r~ cQ City-4 l; d-
Section Township Range County ~cy/t.c7a_
Which is occupied by ::~tl e KJ P i~t -X 4 (20,-Sf
• (Name of occupant)
Is a roughin inspection required on this job? No 1k Yes ❑ Ready Now ❑ Will Call ❑
Power Supplier Do-ko'tz~- 4z74baf. 4 Address,-Z24 3%& 4t . %un.~u co
s .acf
Electrical Contractor Ke_;t Scr F_ t cam(. ;c Contractor's license No.343 ass
(Company Name)
Mailing Address c 7 c I Z ~f 4JE Si < a a 1 ate. /k K Ssyzc
r~ (Electrical Co cttoror ner Making Thls In allation)'
Authorized Signature / 3Ai4 (7,9 r.-aB-. - hone No. ~'S O
Iectrical Contractor or Owner M ing This Installation)
UE. SURD COPY This inspection request will not be accepted by the
~s State Board unless proper inspection fee is enclosed.
Minnesota State Board of Electricity
.1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
REQUEST FOR ELECTRICAL INSPECTION P 68031
CHECK BELOW WORK COVERED BY THIS REQUEST
Typt of Bu_ i.ding New Add. Rep. Check Appliances Wired For Check Equipment Wired For
Home ❑ ❑ ❑ Range ❑ Temporary Wring
Duplex ❑ ❑ ❑ Water Heater - ❑ Lighting Fixtures ❑
Apt. Bldg. El [I El Dryr r Electric Heating ❑
Commercial Bldg. ❑ ❑ ❑ Furu--'~•`ace ~ { (I`❑, Silo Unloader 11
Industrial Bldg. El ❑ 1:1 Air-Condifibner Bulk Milk Tank ❑
List 1 List )
Farm 0 D El Other -C] ❑ El pp Hehe s y 1 Oeyers>
COMPUTE INSPECTION FEE BELOW fff A 1
Service Entrance Size: j* Fee 11 Feeders&Subfeeders: # Fee Circuits: # MFw
0 to 100 Amps. 0 to 30 Amperes 0 to 30 Amperes
101 tb 200 Amps. 31 to 100 Amperes 31 to 100 Am res
Above 200_Amps. Above 100 Amps. Above 10Q_-Amps.
Transformers Remote Control Circ. Partial or other fee
Signs 11 Special Inspection Minimum f / .0
Remarks r ~ ~¢-t'-t) i TOTAL F E(p1, the Electrical Inspector, hereby certify that the above inspection has been made.
(Rough-in) _ Date
(Final) Date
This request void 18 months from
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 N2 - 5790
PHONE: 454-8100
BUILDING-.PERMIT APPLICATION Receipt #
To be used for DECK Est. Value 1, 500.00 Date 19_80-
Site Address 1230 E. Balsam Trl Erect g7 Occupancy R3
Lot 25 Block 1 Sec/Sub. Wild.Pk.lst Alter ❑ Zoning R1
Parcel # Repair ❑ - Fire Zone III _
Enlarge ❑ Type of Const. V
s Name Ron Kirby Move ❑ # Stories
3 Address 1230 E. Balsam Trl. Demolish ❑ Front ft.
o agan, 2-5212 Grode ❑ Depth ft.
City Phone
s e e er Approvals Fees
o Name
RAddress 4372 Kaufmanis Way Assessment Permit 9.00
city Eagan,MM Phone 452-5778 Water & Sew. Surcharge 1.00
Police Plan check
Fw Name Fire SAC
u~u Address Eng. Water Conn.
<"Z' City Phone Planner Water Meter
Council Road Unit
I hereby acknowledge that 1 have read this application and state that Bldg. off. 4/25/80 IKM
the information is correct and agree to comply with all applicable APC Total 7-0.00
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to: Mel Raeker on the express condition that
all work shall be done in accordance with al(lglpplicable States/of Minnesota Statutes and City of Eagan Ordinances.
Building Official ~Q L-~
CITY OF EAGAN Include 2 sets of plans,
1 site plan w/elevations &
BUILDING PERMIT APPLICATION 1 set, of energy calculations.
To Be Used For Ll~ c Valuation Date nn N O e/)
Site Address A).5 Arn'~/t14~I1 OFFICE USE ONLY
Lot 25 Block sec./Sub. Erect V_ Occupancy 3
Parcel Alter Zoning
Repair Fire Zone 3
Owner: f} O k, 1~ b4 Enlarge _ Type of Const.
Address: 3Q j3~SAin 7~~ Move # Stories ft.
/ Demolish _ Front
City/Zip Code: Grade Depth ft.
Phone y
APPROVALS
Permit
Contractor: Assessments FF
y ` Water/Sewer Surcharge /
Address: 3 ~l A k~ t» Oyta is C iJ A i Police Plan Check
City/zip Code: F,4n ~Q(N 41 35 3 Fire SAG
Phone S/Sa -~5 q~18 water Conn.
Planner -Water Meter
Arch./Eng.: Council Road Unit
Bldg. Off.
Address: APC
City/Zip Code:
Phone TOTAL 14
CITY OF EAGAN
' 3795 Pilot Knob Road Eagan, MN 55122 N? 4775
PHONE: 454-8100
BUILDING PERMIT APPLICATION $46,000. Receipt # 9833
To ba used for SF Dwlg. S Carg?.. Value Date May 2, 19 78,
Site Address 1230 E. Balsam Tr, Erect ❑X Occupancy I
tot 25 Block I Sec/sub. Wilderness Park E Alter ❑ Zoning R1
Parcel # Repair ❑ Fire Zone 3
Enlarge ❑ Type of Const. V
w Name Svenn Petersen Const., Inc. Move ❑ # Stories
Address 4701 W. 110th St. Demolish ❑ Front 52 ft.
Ci B loomingto~hone 884-5144 Grode ❑ Depth .26 ft.
Name Same Approvals Fees
0
o~ Address Assessment Permit 130.50
V~ G Phone Water & Sew. Surcharge 23.00
Police Plan check
L'w Name Fire SAC 500.00
Address Eng. Water Conn. 250.00
G phone Planner Water Meter 60.00
Council _ Road Unit 75.00
1 hereby acknowledge that I have read this application and state that Bldg, Off. Park Don 120.00
the information is correct and agree to comply with all applicable APC Total 1158.50
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to: p t c n .onc _ Co. on the express condition that
all work shall be done in acwr/~ rrrrrr~~~'~~~~cccccc//eeeeee w',~kh all icable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official `r-i-
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan Q1 `U v
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Requirements RemodellReoair Requirements Office Use Only
3 registered site surveys showing sq. ft. of lot, sq. ft, of house; and all roofed areas 2 copies of plan Carl of Survey Reed _ Y _ N
(20% maximum lot coverage allowed) I set of Energy Calculations for heated additions Tree Pros Plan Recd _Y _ N,
2 copies of plan showing beam & window saes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required _Y _ N
1 set of Energy Calculations Addition - indicate d on-site septic system On-sfte Septic System -Y _ N
3 copies of Tree Preservation Plan it lot platted after 711193
Rim Joist Detail Options selection sheet (buildings with 3 or less units)
jC~ 32
Date Construction Cost
Site Address 1'11 W&M DQ _
c', Unit/Ste #
Description of Work
Multi-Family Bldg _ Y N Fireplace(s) - 0 k1 - 2
Property Owner , Lf LV. Telephone # (6, (4 1 Z ' L( LJ)
Contractor J l I v L 1~
Address t.j„ l7 3 City
State A J Zip Telephone # ( C ~-L) g J
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code Category . Residential 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 _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone ) _
Mechanical Contractor Telephone ) I
U
MAR 1 7 2005
Sewer/Water Contractor Telephone )
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the 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
permit; that the work will be in accordance with the approved pl in the ca e of work which requires a review and
approval of plan
Applicants Printed Name Ap licant s Signa ure
15
DATE - 7
BUILDING PERMIT APPLICATION
Include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations.
To be used for s / f' Valuation
Site Address. G O l - - / Zellz- r-
/Z _'3o 51-111 % X-~?i~
Lot Block See. Sub. Parcel Number
Owner C/0/LA-c- 11V(L, Telephone 46~1'o
Address 4/70/ /6' /-/0 'r-d r=;7-
Contractor Telephone
Address
Arch./Eng. Telephone
Address
OFFICE USE
Erect Occupancy
Alter Zoning
Repair Fire Zone
Enlarge Type of Const.
Move # of Stories
nemolish Front S~
Grade Depth ,Jz
OFFICE USE
Date of Approval & Initial FEES
/1 ~yDf~ ~O
Assessment L4• .FL Permit
Water/Sewer - SurcAarge
Police Flan Check
Fire SAC S"Co
Eng. water Conn. f C>
~G
Planner Water Meter
ZS
Council /Q ) a o
Bldg. Off.
A.P.C. TOTAL
EXTERIOR ENVELOPE AVERAGE "U'' COMPUTATION
OWNER
SITE ADDRESS~dHGSiCi. Tn°%I/C
CONTRACTOR.. Sz PZ ;70-)~'.SS N C 7/u DATE WHONE~ ~ x
Determine working~square_.footage of.each...
1. Total exposed wall area sq:=ft. X .17 = d loop
2. Total roof/ceiling area....:. /r>re9o sq.- ft. x .,05
Total exposed wall<area above floor =
a. Total wall window area
5
b.:' Total door area s o 0
c. Total sliding glass area o.;
d. Total fireplace wall area .Y .cra
e. Total wall framing area.(average-10%).':./ n no
f. Total net wall area above floor ........0
.g.'...Total rim joist area........
Total exposed foundation area =O
h. Total foundation window area
i. Total net foundation area above grade 7
Determine "U'` value of each wall segment.
a. x lfui: 5 S 5
b.,36., -o X "U" r9 /A JP
C c> X "U°` e), s5- = Ao 90 .
D. ~ln. n a X "U" D -S 5 = 2 2. O o
e. 140- o00o X "U" 4 Y19 . ( G
f . /oso. o o X U" D, 41V17 :57. 1/
h. X "U" 0.55 =
X "U" /7.57 = 5 zi
3 ........Total =O J~
If item #3 is the same as, or less than item #1, you have met the
intent of SBC 6006(c)2.
Total exposed roof/ceiling area = ~7C9 0
J. Total skylight area
k. Total roof/ceiling framing area (average 10 /44o
1. Total net insulated roof/ceiling area %2g o
Determine IV' value for each roof/ceiling segment.
k. 1171
X :U1,
4 ............................................Total = 7
r
If total of #4 is the,.same as, or less than #2, you.have met the
intent of SBC 6006(c)l:
Alternate Building Envelope Design .
To utilize the total envelope system method; the values established
by the sum of items #3 and #4 shall not be greater,than the sum of
items #1 and #2.
1. + 2. _
3. + -
SVef6 Petcr7.or,
,'o7)1 We-1- 11 _Ith Street 000 .500,
i.oOrii ,ton, t•n. 5 )437
DELMAR H. SCHWANZ 7
LAND SURVEYOR
Registered Under Laws Of The State of Minnesota
2878 - 148TH STREET W. _ BOX M ROSEMOUNT, MINNESOTA 66068 PHONE 612 4231769
SURVEYOR'S CERTIFICATE
0
O to
M
R=488.90
87.00 Ae 10051'44"
o Drainage 8c utility
0 easement
O N
N M
O n PROPOSED," ,Z 3•°/7 O
GAR. /ROUSE N N
l o
O / 520 M
~ Z
L '
v LOT 25 gr SCALE: 1 inch = 40 feet
0
P ~
N
Of
118.39 N86°89'48W
I hereby certify that this is a true and correct reprcoenr:tio?
Lot 25, Block 1, WILDERNESS PARK. ADDITION, according to the
recorded p13t thereof, Dakota County, Minnesota.
Also showing the location of a proposed house as staked theroorti.
As surveyed by me this 11th day Elf April, 197,'.
I
MINNESOTA REGISTRATION NO 8625
For Office Use I
i Permit i
I ,
City Ol E
I Permit Fee:
'
3830 Pilot Knob Road j(-
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff:
2009 MECHANICAL PERMIT APPLICATION
Date~_-QSite Address: » ~;o
Tenant: 1 Xy Suite
RESIDENT / OWNER Name. DEW-) -7--~~ 'l Phone: 0 !~A - Lrp`
Address / City / Zip:
CONTRACTOR Name: CA License
A ress` Q
Ci Sta Zip:
Phoneme Contact Person:
TYPE OF WORK New 1\,~Replacern t Addition l Alteration Demolition
Description of work: t'1 t~LC Pi^~ v t C . XC Ito
NOTE: Both roof mounted and ground mounted mechanical equipment is required to
be screened by City Code. Please contact the Mechanical Inspector or one of the
Planners for information on permitted screening methods.
PERMIT TYPE RESIDENTIAL COMMERCIAL
Furnace _ New Construction _ Interior Improvement
,,Air Conditioner _ Install Piping _ Processed
_ Air Exchanger _ Gas _ Exterior HVAC Unit
Heat Pump Under / Above ground Tank ( Install / _ Remove)
" When installing/removing tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) f
TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x1%
$50.50 Minimum (includes State Surcharge)
$ Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50.
If Permit Fee is > $1,000, surcharge increases by $.50 for each State Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
$ TOTAL FEE
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.
X_ x
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: -Under Ground _ Rough In -Air Test -Gas Service Test -In-floor Heat Final
Exterior HVAC Screening Inspection
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA091709
Eagan, MN 55122 . Date Issued: 10/21/2009
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 1230 Balsam Tr E
Lot: 025 Block: 1 Addition: Wilderness Park
PID 10-84250-250-01
Use
Description:
Sub Type: e-Fireplace Construction Type:
Work Type: Gas Fireplace (new)
Description:
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: huprovements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Hearth and Home Technologies Daniel Sloan
2700 N. Fairview Ave 1230 Balsam Tr E
Roseville MN 55113 Eagan MN 55123
(651) 633-2561
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.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA116827
Date Issued:10/11/2013
Permit Category:ePermit
Site Address: 1230 Balsam Tr E
Lot:025 Block: 001 Addition: Wilderness Park
PID:10-84250-01-250
Use:
Description:
Sub Type:Reroof & Siding
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.
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 -
Daniel Sloan
1230 Balsam Tr E
Eagan MN 55123
Sela Roofing Remodeling
4100 Excelsior Blvd
St. Louis Park MN 55416
(612) 823-8046
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA121093
Date Issued:03/13/2014
Permit Category:ePermit
Site Address: 1230 Balsam Tr E
Lot:025 Block: 001 Addition: Wilderness Park
PID:10-84250-01-250
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
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 by law in ALL single family homes .
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 -
Daniel Sloan
1230 Balsam Tr E
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:Mechanical
Permit Number:EA158737
Date Issued:10/29/2019
Permit Category:ePermit
Site Address: 1230 Balsam Tr E
Lot:025 Block: 001 Addition: Wilderness Park
PID:10-84250-01-250
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Daniel Sloan
1230 Balsam Tr E
Eagan MN 55123
(651) 452-4207
Liberty Comfort Systems Inc
627 East River Rd
Anoka MN 55303
(763) 422-8760
Applicant/Permitee: Signature Issued By: Signature