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4235 Carlson Lake Lane NCiTY OF EAGAN 3795 PRof Knob Road Eogan, MN 55122 N2 6296 PHONE: 454-8100 BUILDING PERMIT OU1 Site Address Lot Blxk Sec/Sub. Parcel # W Name ; b Address ce Name _ ??0 Address ? r..., Name _ Address I hereby acknowledge that I have rend this opplicotion ond state that the information is correct ond agree to comply with all opplicable State of Minnesota Statutes and City of Eagcn Ordinances. Signature of Permittee A Building Permit is issued to: oll work shcll be done in accordance with oll Building Official i Receipt # Date , 19 Erect 0 Occuponcy Alter ? Zoning Repair ? Fire Zone Enlarge ? Type of Const. Move ? # Stories Demolish ? Front ft. Grode ? Depth ft. Approvals Fees Assessment Permit Woter & Sew. Surcharge Police Plan check Fire SAC Eng. Water Conn. Plonner Woter Meter Council Road Unit Bidg Off . . APC Total - on tfie express condition thot of Minnesota Statutes ond City of Eagon Ordinances. remk # pste !eoW hrwMlM Plumbing hAechonical INSPEGTIONS DATE INSP. Rough-In Final Footings Foundotion Frome/ins. Final 6 ? Plumbing Mechonirnl Date Insp. Dote Irnp. Remarks: r• r,/ s/p?r A,: f L CtifA4vTfd1 . CITY OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 P6one: 454-8100 H?ATII3 SOFTEM PERMIT 3/18/,10 Date: Receipt No.: Single Site Address: 4235 No- Car?o= _ Residential Lot Block ? Sub/Sec. 7? ?-- ? _ Multi Res., C No. _ 1'202 33'l x ? ?7i Name /Re air w/Alter N . p e . 3 Address $Eimc- tallation t f In C ? os o s City Phone: Permit Fee ' ??f.lbert Co. Nome e Surchor ? ' g ? 1r! t-Alarie Ave. xo. Address Y T"-. . . r , - City ' ?' Phone: Total This Permit is issued on the express condition that all work shall be done in accordonte with ull opplicable State of Minnesota Statutes ond City of Eogan Ordinances. Building afficial CITY OF EAGAN Remarks Addition Wilderness Run 5th Addition Lot 11 Blk 3 Parce1 10 84354 110 03 ?ner u?}` _? ? f-f%' t--' Street 4235 No. Carlson Lake Ln. State Eagan, MN 55123 ,. Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING 5AN 5EW 7RUNK ?a),/ 1973 $132.60 $6. 63 20 SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA _Wd th W C?I onnect on 6 76 STORM SEW TRK 1981 237.36 15.82 j$ STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $320.00 Jib9 - BUILDING PER. 3977 SAC 4 .00 3169 6-10-76 PARK ? BUILDING PERMIT APPLICATION N4 6296 Receipt # ':? ' VO? / Te 6o uted fdi FIREPLACE Est Value $1 000 Date l n-l 7 19--80. Site Address 4235 N. Carlson Lk. Lri. __ Erect ?j Occuponcy R3 Lot 11 Black 3 $ec/Sub. Wild. RUT1 5 Alter ? Zoning Rl P 10-84354 110 03 Repoir ? Fire Zone arcel # l E r r f C NA n arge ? ons . yPe o a Nome Da.lAfi A . Johnson Move ? # Stories NA ; Address Same Demolish ? Front NA ft. b Ci Phone 454 -3007 Grade p Depth NA k. w N Approvals Feea o ame _ r- ?U Address f r:... Name _ Address I hereby acknowledge thot I hove read this application and stute thot the information i rrect ond Cgree to cqmply with all applicable Stote of Minnesota Statu and Ciri of Ehaan Ordinences. Signature o4 Pertnitt A Bullding Permit Is issued to: all work shall be done in uccordance with CITY OF EAGAN 3795 Pilo! Knob Road Eugen, MN 55122 PHONE: 4548100 Assessment _ Water & Sew. Police Fire Eng. Planner - Council _ Bldg. Off. - APC Permit 7. VV Surchorge .50 Plan check SAC Water Conn. Water Meter Road Unit Torol 5.50 A. Johnson on the express condition that )le Styt@ of tvlinnemta $tututes and City of Eagan Ordinonces. Building OFficial t ??q'?q G CITY OF EAGAN BUILDING PERhIIT APPLICATION 'Ib Be Used For ?? Rre lAtZ Valuation Site Pddress: Lot Block :8_ Sec./Sub. 4Erect ? Parcel #: zQ /?Ly ?ter Repair Runer: ?i Cl M • Enlarge _ hbve Ptidress: cr,Yl$G'K Lk• (4A , Demolish City/Zip Cocle: ? S:SIX7 Phone # : A5;i+- :7 '7 Contractor: V?Xyr.r, Address: City/Zip Cade: Phone #: Arch./En4• : T PdCZT255: Grade Include 2 sets of plans, 1 site plan w/elevations & 1 set of energy calculations. Date )0?l7 ?SU OFFICE USE ODII,Y Occupancy Zoning Fire Zone Type of Const. # Stories Fmnt ft. Depth ft. APPROUAI.S FEES IO Assessments ?? Permit l, ? ? Water/Se?r _ ?Surcharge' - Police Plan Check Fire SAC Eng, Water Conn. Plannes Council Water Meter Road Unit Bldg. Off. APC. City/Zip Cade: Phone #: 'IOTAL ir? Ln7 11 $k 3? k/ Run 6?= ? -.. ° ClTY OF Ee!,Gl1D1 3795 Pilot Knob Road Eagan, Minnesota 5519-2 PERNLCT NO.: 866 The Cit3 of Eagan hereby grants to A. Bindar s Son Inc. of 120 E. Butler Glietafaon - Gold Msdnllion a Heating Permit for: (Owner) Tils4n 8omee Inc 395?r. at 4235 Carleon Iake Laneo , pursuant to apnlication dated 7/21/76 Fee Faid: $40.00 dated this 26 day o£ July . 19 76_, 1.00 s/c Buildi^.g Inspe,tor D"=2char.ical Permits: Bid Total: CITY OF EE1Gt917 3795 Pilot Knob F.oad Eagan, Minnesota 55122 PERNiIT NO.: 704 The City of Eagan hereby grants to Louis A. Peter Coo o£ 1854 Graad Ave., a PIAMBING Permit for: (Owner) Tilsen Homes Lane (NOrth) a 4235 s 4261 Carleon Lake , pursuant to zpplication dated __ 7/20/76 ? Fee Paid: $40.00 dated this 21 day of JulY ?.19 76? 1.00 s/c Euilding Inspector Mechanical Permits: Bid Total: YILLAOE OF EAGAN WATER SERVICE PERMIT 3`s95 P-'at Knob Rood PERMIT NO.: _2426 Eagan. MN 55142 DA'I'E: 7/29/76 Zoning: RI2 No. of Units: 1 Owner: T9,Igen_flomas 7n - Address: Site Address: d-aS ('aUSOn Iak WR 5 h Ptumher: B?Y-ROC - PeteY Plb4. Meter No -- Connection Charge }. : 160.00?? $ize: - Account Deposit: R"kder No,; Permit Fee: 10.00 Iugr? l 'wi rhe Village of Eagan Surcharge: . 50 DI?111OIIC66. / ? Misc. Chazges: 6?10 p? ? Total: BY Dare.Paid: Date of Insp.: lnsp.: YILLAOE AF E4ppN SEWER SERVICE PERMIT 3?. ? nob Road PERMIT NO.: Eagon, MN 551I2 DATE: 7T29/7F Zoning: RIi No. of Units: 1 Owner: milsen HomPa 7 r Addresa: Site Addrees: 4235 a on =ti r?n T.11 g3 WR h Plumber: -Hev-R - p t r Pl F« 6/10/76 #3167 100.00 pd I agree ro comply wieh ehe YIIMga oF Eagen Connection Chazee: 350.00 pd Ordinanees. SY: Date of Insp.: lnep.: Account Deposit: Permit Fee: 10.00 Surchazge: • 50 i Misc. Charges: Total: Dare Paid: sag4o RESIDENTIAL BUILDINC PERMIT APPLICATION CITY OF EACAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 NewConatruction ReauiremeMs • 3 regstered site surveys showing sq. R ot lol, sq. ft. of house; and all roafed areas (20% mauimum lot coverege allowed) • 2 copies ot qan showing beam & wirdow saes; poured found design, etcJ • iselofEnergyCalalallans •? 3 copies of Tree P2servatlon Plan if bl pladed after 1l1193 • Rim Jolsl Detail Options seledlon sheet (61dgs with 3 or less units) DATE S -?6 -a RemodeVReoair Reauirementa . 2 copies of plan • 7setMEreygyCalculationsforheatedadditiore . 1 site survey for exterior additions 8 decks • Indicate N home served by septic system for add'Nons VALUATION 3 eA0 ?? Z-Q-M d SITE ADDRESS u a35 CU-Isoa Uc '04 MULTI-FAMILY BLDG _ Y N TYPE OF WORK _2Gf 09-- ? R2 ?IZpS FIREPLACE(S) _ 0 rk 1_ 2 APPLICANT /7/^f!`iLGN 000AiA/ Cd STREETADDRESS I4-47 /Ji(OIkj A4 S, CITY AJf4V1I STATE-/-VziP1c1AM5533? TELEPHONE #0jI09" CELL PHONE # FAX # 9 5o1=I07 -29 d5 9Sd )0?-6959 PROPERTYOWNER griW TELEPHONE# W-'6A`207 -----------------------------------------------°------------------------°-------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNFSOTA RiJI.FS 7670 CAI'EGORY 1 (4 submission type) . Residential Ventllation Category 1 Worksheet Submitted D • Energy Envelope Calculations Submitted Plumbing Contractor: Phone # B Plumbing system includes: _ Water Softener _ Lawn Sprinkler _ Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor: Phone # Mechaziical system includes: Air Conditioning _ Heat Recovery System Sewer/Water Contractor. Phone # MAY 2 9 2002 P'ee: $70.00 ---------------°------------------------------------°--------°-----------°-------°----°---------------.._......----- I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all appiicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant?/?/ -----------°----------°--------------------------------------__......--'---"--------'----• OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 RESIDENTIAL s c?8??a BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 Naw ConsW Nion Reauirements • 3 registered site surveys showiig sq. fl. of lot, sq. ft. of houu; and all roofed areas (20% mmcimum lot coyewge allowed) • 2 copies of plan showing 6eam & window sizes; poured found design, etc.) • 1 set of Energy Calculatians • 3 copies of Tree Preservation Plan if lot platted afler 711/93 • Rim Joist Detail Options selection sheet (61dgs with 3 or less units) DATE 5 ? ds- oa Remodel/Reoair ReouiremeMs • 2 copies ot plan • 1 set of Energy Calculations tor heaied additions . 1 site survey tor exterior additions 8 decks . Indicate if home served by septic system for add'Nons VALUATION SITEADDRESS ? 4d35 G4-ISad 0,' LIJ /i MULTI-PAMILYBLDG _Y XN TYPE OF WORK_ Qcl" ?ff '?C 4v-Sh FIREPLACE(S) _ 0X 1_ 2 APPLICANT SiREETADDRESS IaP47 Ai(j&J CITYSTATE,?Od ZIP"AAT TELEPHONE # 95d')7 )-6959 CELL PHONE # FAX # PROPERTYOWNER(xgPSYWI TELEPHONE# 65f - ?$8-7y)2 - COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RiJI.ES 7670 CATEGORY 1 MINNFSOTA (J submission type) . ResidenEal Ventilation Category 1 Worksheet Submitted • New ? rC • Energy Envelope Calculations Submitted MAY 2 9 20OZ Plumbing Contractor: __ Plumbing system includes: Mechanical Contractor: Mechanical system includes: Water Softener _ Water Heater _ No. of Baths Air Conditioning Heat Recovery Sys[em _ Phone # Lawn Spiinkler No. of R.I. Baths Phone # Sewer/Water Contractor: Phone # -----------------------°--°------°^----------------°-°--------°-------------------- Fee: $70.00 I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicabfe State of Minnesota Statutes and City of Eagan Or 'nances. Signature of ApplfcanT \Ij OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 ? ' J CITY of EAGAN BUILDING PERMIT owR.: .:-.1..-?. n. ........................ Addsesc (P=esan!) ......... Huilder ..... Addrau N0- 3977 3795 Pilo! Kaob Road Eagan, Mianesof8 55122 454•8100 Da3s W..-7? ....................... Sforias To Be Used For Fson! De°!h Heig6! Eel. Coe! Permi! Fsa Rameske ? ,??? `7:.00 This permit does aot aulhorise the use of siree2s, roada, alleys or sidewalks aos does it give !6e owna[ oi h[a ayen! the righ! !o creaie any situation which is a auisance or whieh presenls a hesard to the health, safety, convenienee aad genezal welfaxe !a anyone in the eommunily. THIS PEAMIT MUST BE EPT ON TH£ PREMISE WHILE THE WOAK IS IN PROGRESS.?? o This ia !o cerlifp, ihat.,,2......................................... has parmission !o areet a._? . ,npon the above described premise subjecY io the pravisions of all appliaable Ordinances for the CiYy of Eagan. ....../V........i ...:.. .. : . . ................................- . par . ...D......--- ayor Sutlding Impeclo?,? DA'!'L: E'JI1TJ:NG MMIIP &Pr^rSr,A;Ir,pl CIiECK ? / Blcox-2 Ad::? tion Lot_ rt'7? Parcel and soctiari nw;:oer Streot X Ou,*ner tld3ress_ Develope.r 1 ,4::, Ac3: ees -, 4 Zcne-Ordin2nce #52 Lot Size Z Totzl area Platted Unplatted Bu11dir_g 3ize Ocoupax?.cy Typo of cczstniction Setbacks: Stres+ eides 'r Sicles Parlrir_ec Total area I NW mbcr '.?; c?•,?? .._?_.._ Total area T..le Ts l o Rear Total d3C_.._.???.._ . ,._. ?.<. Parkipo area setbae3:s: Street side jt dscaa appr ci Assess Jer areai / Asspssed if assessed: If 1li1F156u8::°.d: ? F{ear :iIae5 .ra.?..-...?.?d ?._ ? Bond requ3rod__.??7.._.a._._.. ge ? @ $450.00 °' . ,?.? :? ?? - 6 Lo Ut:assessad Comz-00t:i.o?z chsrga Connectiun cha:ge Lot di??.;.sion: Additional assessmenta needed Later.als: Assessed Wai,*er of hearing: Need.e3 Assessm;-nt clk Police Dept Nob riesded 1- )/J Net a:;ses:,ed Watar & Sewer Dept__^^ 33uilding Dept Fire Uept, (Caumt G Ind only) Not n.aedod ? 4 0 ,? - --- ? I? ? I ' II ? , ? ?S r? D ? ti r::? . ,P_ERk_ oOkoPffATY LwE L1 +1 Jr y1 / ?J- _Ho?sE ? ? - i !i '9 ? s ?. ? ??PEk 7'Y LINE ( E7j \ a M11 ?I I ztt??r LJNE'? ? Q I .? . .`o 1 ? i I ? I L oT / / BLQC K M s£ vya y rtiOrW I ? ?ROPFrLTY ..LINE -PLC]T 1 L AN ??,.-, J . ;? •.? ?. ? , ? ... ? . MTERIOR ENVELOPE SPACE "b" COMPITPAP= (To be subaittad with building permit application) laa or tvo family dwelling jL_ 111 other Oaner Site Addrem 1 L/ :ontractor i`t 1 _%:).-? f•-45,-5 Date Phoae ' , INEAL FT, OF OCPOSED WALL + + + xM- ft, above gsade- ?q L04P TOTAL ERPOSED iIALL AREA SQ, FT, IPAQUE iiALL CONSTRUCTION: "U" velue R area "U" a sq. !K..w.2.}44n?..41„? ? "U" ,1.3-? z sq. iuil referenae z sy, from sq. tached eheete ? ????.ta-?.• S?. ?3,?, .4 p = eq . touli . : eq. "Q" x sq. •wllVASi , V" vlflaVli A {00a ft. ? (t) fL. 1 fa Iq . (U) ft. ? (D) ft. ? (i) ft. ?S?w:.? ' A 'I.«?.. (U) ft. ? (U) ft. ? (II) (A)' (A)? (A)' (A), (A)i (A) (A), RS i M`11z.? .?i.dN ? . .?--L? sq. ft. eq, ft, ? eq.ft, sq.ft, to. 0 sq.ft, eq.ft, ? eq.ft, ke 6 type „ n „ ft. 4•?,.? (U) (A ft. (U) (A) fc, (U) (A) ft. (u) (A) OORS: "U" velue E area ake & tqpe x sq. f[. ka!rCJ (U) (A) ? x sq. ft. ? (U ) (A), 4 Z sq. ? ft. -S ! ., ,?=i eee / .4 5. ? ?..b (U) (A); er 'v" . ?.?: sq. fc. (v) i (A) t OTAL (U) (A) pALUES .44 I1IDED BY TOTAi. WAI,L AREA j` ?,}?, G. "U" RRACB "RT" ,17 or less for 1 fi 2 family dvellinga ,22 or less for all other buildings OOF/CEILING: (YfAL AREA: _ ?C) sq: ft. *tail referenee . ?A.?-,x sq, frm x sq. ttachod sheeta x sq. @scriba openinsa "U" a sq. n roof "U" x sq. TOTALS (S_Q4., aq, ft, 2,17, U) (k f t. 1 t7 a a ? 45, A,- (U) (A) ft. (U) (A) ft. ' (lJ) (A) ft, ? (U) (A) ft, (U) (A) DTAL (11) (A) VALUES 4?: 'A ' ??.? TALS sq. ft. A•?, 4. (U) (A) CVID? BY TOTAL ROOF/ ? ° ?, an,nNc Aaaa C St,, '-r's !t! l y?aF>,h•^..? "?"-Q--,z sq. . fluit = eQ . :J i 6"f3.N:cS "U" a a sq. ll-1 d^,G X sq. %?- ?y .OS for wntialitod roofs • .10 for all other constru¢tion ROOF/CEII.IIaGs B- valne 2. 3. ,..,?iR?.l ..A.? 4. !5...l? a??'-. Aqa »le? 4 5. 6. CUS?RUCTIOP PRA)[ING: R- value 1. 2, 3, 4. s. 6. ? S? i? c!?1 I_? . I? 1 4.. ?. e-, ?'•,@,.'S's?.? ? kt ' '? • ??? a?' I ? 1 N.? n ?!. 14 , q-1 ?=- gO ! ?- HOTE: If average "U" value• as oalculated abv?a do not mat the Boetgy Code reqnireMista, the "Altarnate Emelope Design" ae wtlinad in SBC 6006 (g) aar be ussd. Additioaal rheate msy be used to ehw caleulations. MASTER CARD LOCATION & (7e.0?7 OWNER AND D AS Permit No. ? Issued Issued To Coniractor Owner BUILDING PLUMBING CESSPOOL - SEPTIC TANK 39 7 ? ?J?/f /-? ? ?/J'J ??/I ?z/•7G ?@A7 1 ? oa,T? V?ELL ELECTRICAL HEATING GAS INSTALLING SANI7ARY SEWER I OTHER I OTHER Ifems Approved (Initial) Date Remarks Distance From Well FGOTING ? SEPTIC FOUNDATION CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTRICAL HEATING 7 ??76 DEPTH OP WELL GAS WSTALLATION I SEPTIC 7ANK J CESSPOOL DRAINHELD PLUMBING WEIL ? ? . SANITARY SEWER ? Violations Noted on 8ack COMMENTS: -1 ?)41 co 2006 RESIDENTIAL BUILDING PERMIT At'PLICAT[ON City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Caehuctlon Reauirerands 3 regislaed si0e surveys shoM"vg sq. R oF W1. sQ-ft d hwae: and aA roMeE areas (20%mmdmum lot caveraqe allowo 2 copies af plai shwwiig beam & wkidwv sizes: Pwretl faund design, dc. 1 set of Enetgy CaladaGOra 3 copies of Tree P2servatian Poan'rf lot platted afler 711/93 Pom Joist Detail Optians selecdpn sheet (bWdings witlh 3 or less uni@) Minnegasco mechenical ventilation form RemodellReoair Reauremenls 2 capies of plan showm9 froUngs, beems. jdsls 7 set of Energy Calculetians for heated addiGans 1 sife suneyfor adtlitions & dedcs Adfton - irc6cate A oo-sda septic system Low ? affice usa omv CerlofSurveYRed _Y _N TreePreSPIan Recd _Y _N. TreePresRequted _Y _N On-sileSepScSystem _Y _N tp,ca _ ?t-" S \k 51 ,-)A _ CaDa ?3V< D ? ?'? i ?y i ? qIG , ?,on C? ?-I C t a ao 9 ti ? Site Address ?Ci? la eb I?'/ Y? o?t-' Unit/Ste # .tu, , ?L/' l7Za i? Description of Work C( 4( Gf ? // 0,1 /A YC. ?/l Multi-Family Bldg _ Y? N Fireplace(s) ? 0 _ 1 _ 2 PropertyOwner a-4I ?l ?4go e'? Telephone#( 4"lJ'h 0kk--7q1 1 Coulractor M{`I 196 lI 6 )6GL{lC? ?yh:L )C'Y? t• i C Ric ' 2 L Y-5 2-7 /S-t Address City ?`ev/ /1 L?it-IN State Zip S=;g Tdep6one # (%3) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category - Minnesoh Rules 7670 Category 1 _ Minnesota Rules 7672 (? submission type) • Residentiat VerNlation Category 1 Worksheet • New Fsergy Code Worksl?eet Submitted Submittetl • Erreiyy Ernelope Calculations Submitted In The last 72 months, has the Ci1y of Eagan issued a permit for a similar plan based on a mastei plan? _ Y _ N If yes, date and address of masTer plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone # ( Telephone # ( I hereby apply for a Residenti IjEuilding-Eermit and acknowledge that the information is complete aod 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 plan in the case of work which requires a review and app ova , of plans. ? ApplicanPs Printed Name ApplicanYs Signature DO NOT WRTl'E BELOW THIS LINE Sub Tvues O 07 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg X, 02 SF Dwelling ? 08 06-plex ? 16 Fireptace * 21 Porch (3-sea.) ? 31 Ext Ak - MuNi ? 03 Ot of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext.Alt - SF ? 04 02-plex ? 10 08-pleu ? 18 Dedc ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Stortn Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Tvoes 1-P -Pc? K ? 31 New ? 35 Int improvement ? 38 Demolish Interior ? 44 Siding ?' 32 Addition ? 36 Move Buildirg ? 42 Demolish Foundation ? 45 Fi2 Repair ? 33 Atteration ? 37 Demolish Building' ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement •Demolition (EiMire Bldg) - Give PCA hendoutto applkant DESCriDti00: VYaterDamage`Yes rZ Valuation Occupancy MCES System Plan Review 100% or 25% Census Code 1' L Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft PRV # of Bldgs Length Fire Sprinklered Type of Const V 1 Width REQUIItED INSPECTIONS _ Footings (new bldg) Sheetrcek Footings (deck) _ Final/C.O. P Footings (additio ) T:? ? S d FOO q Z°. Final/No C.O. -Fem[daEiea- HVAC Drain Tile Other Roaf Ice & Water Final Pool Ftgs A'v/Gas Tests Final )0 Framing _ Siding _ Stucco Lath _ Stone Lath _Brick Fireplace R.I. Air Test Final Windows _ Insulation ? /)) I Retaining Wall Approved By: (R//!`9!L' tv 7/J"'/ffMoilding Inspector Base Fee Surcharge Plan Review a MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge l Treatment Plant license Search Copies Other Total EAGAN REVIEW Bv: BuiLDiNG iNsPEcTIoNs DIdosoow -r9.mm':--- ?----------?----?, 1 N ? 1 r? 1 ? 1 ?p ? w ? r 0 1 "9 1 ? ' cs 1? Z ?-_-L_------?. SIGPRID 9TREET E. O SITEPLAN AI bCALE : P . 90'-0^ N ? PLdH6 FEVIELLED lWD APPRpvED A8 MApCEp Dd}E:_ PFOJEGih4YUYaER: QIIffR OWNdNREdI?ER ?NNfEi NORTNERJ EXP03URE exTeRioRs ? JOB NWI5ER :78D CU6TOMERS NM7E : SHARI I BR,41N NEP5T4D ADDRE93 ; 4135 CARL9pN LCKE LANE N. CITY / STATE / ZIP : EACsAN, MN 55173 HCf1E PHONE : UYO'd: FFIONE IWW P # : F OPoE : CELL PHCNE : 5ALE5 REP : BFUCE GOWIAY DR4WING DATE : 3129106 REVI510N pATE : 0 Al 411' C!tyofEaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: (y0 Tenant: Use BLUE or BLACK Ink For Office Use /Ma Permit #: Permit Fee: Date Received: Staff: INFLOW & INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water 0,I(3 Site Address: Lia 35 Car tsmr, Ln 14v5ta3 Tyr:tc,LA/A 4 S\flial N Suite #: 1 J Name: sir a- Sri t• -sq 5-k Phone(4p57) Cage- 77-y1 Address / City / Zip: d;35 CGx-r l ` 1-1;0 2-1- CO C:attduvel, Name: ,k0.x:( License #: Address: ! 4,1111. City of Eapll Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use ,----:i Permit #: /z/ zyj Permit Fee: yv Date Received: -3—z/ J/ Staff: 46) 2014 RESIDENTIAL BUILDING PERMIT APPLICATION 36-11 1`1 Site Address: '4&35 efiuV l6hrk. Laik L- J Unit #: Resident/ Owner Name: YJ CI (�Y\ A S 1\t,L ii. t N 5T04 Phone: LCI) - -1 Li) Address / City / Zip: Lia. -.-s- C A r fr (Yr L,-oJL.e_ L 1 i-) ►^ 1 /� 5-5-/(33 i ' Applicant is: Owner Contractor Type of Work Description of work: Construction Cost: Multi -Family Building: (Yes / No ) Contractor Company: 6 {-4-An el -v‘ Ex po5a(4 44Uk)(5Contact: rrtA ' CCi1wet. williNiellirm ' Address: City: - gli.oNmayeAa:.-- (1' State: iAll Zip: Phone: ((ICJ 1 �-1 62 —1(i3 9 License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, _Yes _No If COMPLETE THIS AREA ONLY IF CONSTRUCTING ANEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: N0T_E Planc and the information suiting -documents -that you-submit-arm-considered-afo--be /blie-iniar-nnatisn. Portions-of— may be classified as non-public if you provide specific reasons that would permit the City to conclude that they 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.gooherstateonecall.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 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 au orized by a building permit issued in accordance with the Minnesota State Buildi g Code must be completed within 180 days of per t '- . uanc x Applica is rinte Name �0ir. 1 v� x Applicant's Signature Atui, 4 -Wad Page 1 of 3