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1220 Carlson Lake LaneCity of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 1220 Carlson Lake Lane Lot: 16 Block: 3 Addition: Wildemess Park PID:10- 84250- 160 -03 Use: Description: Sub Type: e- Fireplace Work Type: Gas Insert Description: Census Code: 434 - Occupancy: Zoning: Square Feet: 0 Comments: Fee Summary: Valuation: 3,000.00 Contractor: Fireside Hearth & Home 20802 Kensington Blvd Lakeville MN 55044 (952) 985 -6675 PERMIT City of Eaan Chimney /flue must be inspected prior to concealing. Smoke detectors are required in all sleeping rooms prior to final inspection. When wall studs or ceiling joists are exposed, hard -wired detectors are required. Battery operated types are acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector. Andrew Hoffman BL - Base Fee $3K Surcharge - Based on Valuation $3K Total: $90.00 Applicant/Pemiitee: Signature - Applicant - Construction Type: Owner: Mark G Parupsky 1220 Carlson Lake Lane Eagan MN 55123 Permit Type: Permit Number: Date Issued: Permit Category: $88.50 0801.4085 $1.50 9001.2195 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. Issued By: Signature Building EA086254 09/22/2008 ePermit CITY OF EAGAN 3795 Pilot Knob Road 41 Eogon, MN 55122 7nninn• Owner: Address: Site Address: Plumber: Meter No.: _ Si 'i+• Reader No.: 1 agree to compiy wiN+ the City of Fagon Ordinances. R., Date of Insp.: WATER SERVICE PERMIT PERMIT NO.: DATE No. of Units: Connection Charge: ACCOUflf DePOSIt: ----- Permit Fee: Surchcr9e: Misc. Chorges: Totol: Date Paid: I nsp.. CITY OF EAGAN ?795 Pilot Knob Roed ? Eogan, MN 55122 Zoning: Owner. 4ddress; 'te Address _ imber: SEWER SERVICE PERMIT PERMIT NO.: DATE: No. of Units: rl ann T.&ka f.arus T.1 Fi A3 UJ7 ree to wmply with the City of Eagon lonees. I nsp.: Connection Charge: Account Deposit: Permit Fee; Surchorge: Misc. Chorges: Total: Date Poid: , '"BUILDING PERMIT Te 6& ?d Fee - '-?.;? r t, : ss]',?it:l": Site /lddress ' uarl. Lot Biock Porcel # , m W z ? ? 0 ?u u? ? Ncme 50,000. N4 5148 Receipt # ? ,n?) - Ered ? Occupancy P3 '17\Iter ? Zoning p Repoir ? Fire Zone ? Enlarge ? Type of Const. - Move Q # Stories A.Mress ?s?•110 th `'i . Demolish p Front ft. Name Address I hereby acknowledge thot I hove read this applicotion ond state that the information is correct and agree to comply with oll opplicable State of Minnesota Statutes and Ciry of Eogon Ordinonces. Assessment _ Woter & Sew. Police Fire Eng. Planner Countil Bldg. Off• - APC Permit lDi}•:>V 5urchcrge 30-00 Plan check 77. ?5 SAC -r7? . 11) n ?? ? Wnter Conn. 2?'-• • Water Meter "(" • ,)n Totol I = ? '7 C; r_ Signoture of Permittee I A Building Permit is issued to: on the express condition thot oll work shall be done in acwrdcnce with all opplicable 5tate of Minnesota Stotutes and City of Eogon Ordinances. Building Official cirY oF EA"N 8795 Pilo! Kneb Rood Eagan, MN 55122 PHONEs 45I-8100 Gmde ? Depth ft. ? Aeorovalt Faes • t, Peneit ;j Daft laued POMNFt?w Plumbing f`?_ Mechanical / _EJU__L R (F -?`i 6 INSPECTIONS DATE INSP. Rough-In Finat Footings Dcta Inap. Dote Irup. Foundation Plumbing - Frome/ins. Mechanical Finol ry Remarks: „ • ' CITY OF EAGAN 3795 Pilot Knob Road °-'.sll'?..-f`7="? ?TP WT, Eagan, Minnesota 55122 Phone: 454-8100 MIT= PERMIT 5-ZI-79 Dote: Site Address: 1220 cbrlgan ?,ake r.ane p Lot . Block Sub/Sec. ? a? S . Feberom owatrwtim Op. Name ?`l. 11.0 L-h e Address a No. 1452 14070 Receipt No.: Single I Residential x 7?AuYti Res., Comm./Ind. '? I iliew New/Alter./Repoir Cost of Installotion Permit Fee Surchorge . 5{1 3A745 So. -Tbbert Ts-ail. g Addreu 0 r (? ir•¢;F+lRr.*•-•-?f- ?^nr? .t_)-y ?-. . ? -:?„'.1 icity Phone: Total This Permit is issued on the express condition that all work shall be done in atcordance with oll opplicoble State of Minnesoto Statutes ond City of Eagan Ordinonces. Building Officiol Ciry -'e ?Ls 55437 (,M2-F2ym :F4-Sld4 Phone: ?0.00 CITY OF EAGAN , 3795 Pilot Keob Road , Eogan, Minnesota 55122 • Pbone: 454-8100 _ PERMIT No. 1.351 Date: 5-23-79 Receipt No.: Singl ?.?'??' C;c?'i?Y?"! TBkE ?f? Resideentiol _ ' Site Address; ? lt; 3 .;1Z3eYTIE'SS !'a1'k 11"In. I Lot Block Sub/Sec. _ Multi Res., Comm./Ind. !;Nome . I New/Alter. /Repair 3 Address 470I W. ?.flt.?l ?. Cost of Installation ? .?s:, r, ? ? ^Ilt : Ip1s 55437 2y City _ Phone: Permit Fee Na Surchorge . g 1_474; So. "±-,?ii ddress e City Phone: .?4. Totol This Permit is issued on the express condition thot oll work sholl be done in accordance with all applicable Stote of Minnesoto Stotutes and City of Eagan Ordinonces. Building Official CITY OF EAGAN 3795 Pilot Knob Road Eagan, Mineesota $5122 Pbone: 454-8100 Water SOFteAer pERMIT Dote: 12 /20/79 Site Address: 1220 ?',aTl$l? Lak@ L2 Lot 6? Block J Sub/Sec. Name Brian MaCD6IlSld g Address Sa? Qs abOVB ? City Phone: 454-7180 Nar„e _ Lindsay Water Candt. . ? Address =147 River9rood r1rive 0 ? CitY Phone: .:/+, This Permit is issued on the express condition that all work shall be Minnesota Statutes and City of Eagan Ordinances. No. Receipt No.: 1 `193 Single Residentiol Multi Res., Comm./Ind. I New/Alter./Repair Cost of Installotion Permit Fee g • Y) Surcharge • 51 Total 'l done in occordartce with oll appliwble State of Building Offitial -, CITY OF EAGAN PERMIT TYPE: i ti 1;11, I , 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 I . . _ I SITE ADDRESS: APPUCANT: i ? .,; ??r ? ???, ? . .??•?? , ? ,i; . :i ? ? ; ?+; i PGtrL: ?ts I , I PERMIT SUBTYPE: TYPE OF WORK: ,.r i,A T 17 INSPECTION D . DATE INSPTR. F L ? Permit Holder Date Telephone # PLUMBING HVAC Inspection Date Insp. Camments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH NEATING GAS SVC TEST INSUL GYP80ARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FIUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN Remarks Addition _ Lot 16 Blk 3 Parael 10 81.250 160 03 Owner l treet 1220 Carlson Lake T,az18 State Eagan,MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 176.o5 8.88 20 SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA 160.00 10.66 15 ° STORM 5EW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 13799 4-9-79 WATER CONN. 270.00 13799 4-9-79 BUILDING PER. SI H sAC 525.00 13799 4-9-79 PARK (Itr#ifirate vf Orrupttnry ?itp of eagan Eepttrimrnt nf Building lnsprrticm Tbir Cnti ficate irraed purrwant to tbe nqniremrrut of Sertion 306 0( the Unifmm BNilding Cade cMifying thar at the timc of ittaana tbil ttrutturt waJ in comQliantt with 1!x vatiart ordlwxnt of lht Citr regn/ating baiWirsg ranrtrrutioa a utr. For t!x (o!lowing: UwCLalfv6m SE Dwlg & Garage Bldyhmul NO. SZYS Oooo? Tvw R3 TYc.coo?am V Fo., 3 zooaw?t Rl p.,ewemasog S. Peters?n Cc+St. em? Minri2dW11S. MN d.,,,--•..? 1220 Carl.son Ik. Ln._.,__ Eauan. M By. Septanber 2, 1979 Wh: pi IM . CONMICUW. AAC. This request void 18 months from R 49961 Date of this Request 5- I, as k Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal wiring installed aY. Street Address or Route No. ) a o"t 0`'?h.r ?SQ `t ho-Re ?-h • City. oE?qo-#,? Section Township Range County CD Which is occupied by !E;,v e.o-J ?2J-eV-Sa rL o rl ST1-u-e?evl, Is a roughin inspection required on this job? No ? Yes tA Ready Now ? Will Call Power Supplier aU<ota. c ASSKlddress 82 ! 3" . ST. i A- A[I 6Te " R;V. sso2?/ Electrical Contractor?en .?re.t?Sc?K FZl e-Cr`t"t-tc, Contractor's License NA3?y?3 (COmpany Name) . I . - _ - . e . , Mailing Address b'o (ElectHCal tr r Owner Makin9 Thls0stallatlon) Authorized Signature Lf:5?12 O-d77 Phone No.BS `-?411O (eiectrlcal contractor or wner akin nis Installatlon) S 1? /? ?? ?:p O??pj? ? `,, p???? This inspection request will nat 6e accepted by the t!l??1 t? Stete Board unless proper inspectian fee is endosed. Minnesota State Board of Electricity 1.964 University Ave., St. Paul, Minn. 55104-Phone 645•7703 + REQUEST FOR ELECTRICAL INSPECTION C ECK BELOW WOAK COVERED BY THIS REQUEST ;R49969. Type of Building New Add. Rep. Check Appliances Wired For Check Fquipment Wired Foi Home ? ? Rxnge ? 'Cemporary Wiring ? Duplex ? ? WaterHeater ? LightingFixtures ? Apt. Bidg. ? ? ? Dryei ? Electric Heating ? Commercial Bldg. ? ? ? Fumace ? Silo Unloader ? Industrial Bldg. ? ? ? Air Conditionec ? Bulk Milk Tank 0 Farm ? ? ? List 0 ;SltuSn.5lle.p- List Othet ? ? 0 _ pthcrs Here_ ? ? ( sQa sc .??- - - -- pthers Rete ?OMPUTEINSPECTION FEF.BELOW $ervice Entrance Size: # Fee Feedets&Subfeeders: # Fee Ci[cults: # Fce 0 to 300 Am s. jFqLAqfi&Ts G,eo 0 to 30 Am etes Ul [0 200 Amps. i ,po _ 3 0 31 to 100 Am eres bove 200_Amps. - A e 1 15 Abave 100 Amps. ransformeis Remote ntro Partial or other fee " ns - Special lns ection Minimum Cee $5.00 Re arks (t,p'4?p IPtiil kc? [,a-1. e 1,c)?r'c VtJ G TOTALFEE ,Ro Electrical Inspector, hereby cer ghat ty?aJ?veSnspe ion has been made. 3G -mv ( gh-in) Date ? iD- 2'!?' (Fin ) ) Date ? -/j - 2Z This request void 18 months from CITY OF EAGAN 3830 PiISt Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-84250-160-03 FERMIT PERMITTYPE: BuzLorwG PermitNumber: 032949 Date Issued: e S/1$ /9 g 1220 CARL50N LflKE LANE LOT: 16 BLOCK: 3 WILDERNESS ?FltPd? DESCRIPTION: T.O. & REROOF/STORM 6u.??.cJ,Permit Type STQRM DAMAGE 8di3d3rtg!?Uq?7-k 7ype REPAIR 1'e.n, 9.u-t..?ad-e??434 ALT. RESIDENTTAL pH* E Y9 ?g 9 rsi s" ? -A;atsiu ?i i? Gfit 9 snw ? q5 b.i ?i_p u? ? ub? ?S ?5t4F { i REMARKS: bi$tt3 c.m v9 ???' i?g 6 fi V 1nUy9 I&L' ?M 3+.@? ?:JS &19 FEE SUMMARY: ?±? Tp??7? - nNNilUaflW - JI. LL4. ^I???p: B:1'OqKS'fh'ANTiRCOMPANIES INC 14525598 0008676 i+i?ANy?uNri1 p BRIAN 4116 DIAMONp DR 1220 CARLSON LflKE LANE EAGAN MN 55122 EAGAN MN 55123 (612) 452-5598 (651)454-7180 ? I h&reby ackn' -irtfe??$tatu' ge.tha.t ? have?,readr.tapP,?icati£ar?,.and:stat?,kM.z??G ?s"• reat and,-'agroa ''compky with ae $t a te?"of '-ldn, a'?gantOr.rJfr???res5.?.? ,. ? APPLICANUPERMITEE SIGNATURE 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) 3830 PII.OT KNOB RD 65122 681-4675 U New Construdion Reauirertrents ? 3 registered site surveys ? 2 copies of plans (inciuCe beam & window sizes; poured fnd. design; etc.) ? 7 energy wlculaNons ? 3 copies of trae preservetion plan H lot platted after 711/93 required: _ Yes _ No DATE: ? DESCRI ION OF WORK: STREET ADDRESS: RemodeVReoair ReauiremenGs ? 2 copies of plan ? 2 site surveys (exterior additions 8 dedcs) ? 1 energy calculations Mr heated add'Rions CONSTRUCTION COST; ?, 7 ? ?? J-11" ? p J LOT: (P BLOCK: ? SUBO./P.I.D. PROPERTY OWNER Street First Phone N: 71,fQ a City ?aAl State: Zip: Company:T?Q'//Q C!//None#: CONTRACTOR / / Street Address: License # ?(P/ 7.1 City State: Zip: ARCHITECT/ ENGINEER Name: Street City Sewer 8 water licensed plumber (new construction only): and lot change is requested once permit is issued. Penalty applies when address chang I hereby acknowledge that I have read this application and sfate that the information is cortect and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature af Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received Yes No Phone #: Regis7ation State: Zip: cinr oF encaN N2 5148 • 3795 Pilot Knob Rmd Eagan, MN $3152 t - PHONE: 4548100 Recei t BUILDING PERMIT APPLICATION P To be uaed fe SF DWlg & Garage Est. Value 60,000. oate 1979 =- Sita Address 1220 Cdr150T1 I.3k2 Ta'le Erect gg Occupancy R3 Rl ?,p} 16 BIOCIC I SECISUb. Wl I(IPTTIPCS P ark pI?C3Alter p Zoning 1 0 Repair ? Fira Zo^e V po?? # 10 94950 6 Enlorge ? Type of Const. Name S. Petersen COT]5t. 711C. Move ? # Stories z Z Address 4701 W.110 t11 St. Demolish [] Front ft. ? 5144 R84 Grode ? Depth - - fr• - Ci MP2 S 55437 Phone " Avvromb . Fee. o Name _ ??r- Address r r... Name _ Address I hereby ocknowledge thai I have reod this application and state that the information is correct and agree to comply with all upplicable Smte of Minnewta Statutes and Ciry of Eagan Ordinances. Sigrwture of Permittee _ A Building Permit is issued to: ell work shall be dona in acco Building Official ? AssesSment Water & Sew. Police Fire Eng. Planner Council Bldg. Off. APG Pemit 154.50 $urcharge Plan theck 77.25 SAC Water Conn. --270_.a0 Woter Meter _.6-Q-RO Totai 1 F 1711 . 1 C1C. on the express condition thot MinnesoM Stotutes ond Gity of Eagan Ordinances. ' ' . . . DATE BL'ILDI`vG PER'?IT APPLICATIO\ Include 2 sets of plans, 1 site plan w/elevations and 1 set o?f ene?gv caicuations. To be used for - Valuation J Site Address: „'?D r? ? / ? CDiC Ve2?vL ?5 ?rIRK M_?- Lot /? Block 3 Sec. /Sub. Parcel Vumber 'Aj? /b O 43 S - % 6-72'R) « Telephone 'P'y Ovnez Address-,?/;20/ l.// ll0 77-'<?rt- /yiv ?.? ? Y '' 7 Con[ractor Address Arch/Eng. Address Telephone Telephone OFFICE [JSE ONLY Erect Alter Repair Enlarge Morre Demolish Grade Occupancy i ? joning ? Fire Zone 3 Type of Const. ? li of Stories Front Depth Date of A roval and Initia Fees Assessment Permit n Water/Sewer Surcharge Police Plan Check 77 a5 Fire SAC . Engineer Water Connection ? ? G 7 Planner Water Meter Council Bldg. Off. A.P.C. TOTAL 9 ? rertificate for: : verid Peter$an a 7'71 west l l??th bl Domi rigton , Mn. 4 3 7 , . . ? : DELMAR H. SCHWANZ LANOSURVEVOR RpisterW UntlN l.aws oi Tne Stato of Minneiota 2M - 146TN STREET W. - BOX M ROSEMOUNT, MINNESOTA 65068 SURVEYOR'S CERTIFICATE 30 151.20 N 860 51 1 0541YV ? 322' ?5„ ? 0 ?4 J. 2 'Y -1 M ? c C;'Qij N N I ^ v a I „ l p"0poSe ? N L 0 T 4t ° o ? 1s - l,z 27 ? 2G p I iti 1 DTainage Sc ut.i 1 i ty easement SCAL!?: 1 inch = 40 feet PHONE 812 423-1789 ? GO O o, 0 Z N ? I hereby certify that this iB a true and c?)rrect rapresentKtion •.?-f Lot 16, Plock 3, W?LDERNESS PARlC ADDITION, accorning to the recorded plat thereof, Dalati County, Minneaota. Also ahowing the location of a proposed hause as staked thereon. Dated: March 9, 1979 , //; ? j \ , • `.i ? MINNESOTA REGISTRATION NO. 86 ? i kb": 0 I CITY USE ONLY LOT 16 BL ? PERMIT #: SUBD. wdo'1'Rlt??'. fQ A RECEIPT #: Y//93 7 RECEIPTDATE: v - /-'Ci(_j 2000 MECHANICAL PERMIT (RESIDENTIAL) Date: ?? 3c) !cx\ Complete this section onlv if you aze instalfing HVAC in a singfe family dwelling, townhome or condo under construcrion and not owr.er/occuoied. • HVAC: 0-100 M B T U ADDITIONAL 50 M BTU • Gas outlets (minimum of one required @$3.00 ea.) $ 30.00 6.00 State Surchazge .50 Total $ Complete this section onlv if you aze remodelina, addine to, or re airin an existing single-family dwelling, townhome, or condo. Please indicate if it is a new item, alteration, or repair. re J4c`e _ New _ Alteration x Rt?air _ Other Furnace _ Air exchanger ? Air conditioning Other Fee $ State Suichazge Total $ Reminder: Call for inspections SITEADDRESS: /a?qO P o L(.I E- Ld-YlE?' 30.00 .so 30.50 OWNER NAME: 2 l o Ck PHONE #: LOS I - ' y `?J ??' /l (?D (AREA CODE) INSTALLER NAME: ?(? ?(-i .? (/;?Yl )S 1 PHONE #: 7& 3 -3 ? 3- S3 0-i (AREA CODE) STREET ADDRESS: CITY: • CITY OF EAGAN 3830 PILOT tINOB RD EAGAN r47 55122 651-681-4675 STATE: MN_ ZIP: SIGNATCTRE OF PERMII E PERMIT City of Eagan Permit Type:Building Permit Number:EA114501 Date Issued:09/16/2013 Permit Category:ePermit Site Address: 1220 Carlson Lake Lane Lot:016 Block: 003 Addition: Wilderness Park PID:10-84250-03-160 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Robert Antonsen 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 - Mark G Parupsky 1220 Carlson Lake Lane Eagan MN 55123 Antonsen Construction Inc 411 marie Ave Ste B South St Paul MN 55075 (651) 340-1791 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA152263 Date Issued:10/05/2018 Permit Category:ePermit Site Address: 1220 Carlson Lake Lane Lot:016 Block: 003 Addition: Wilderness Park PID:10-84250-03-160 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Mark G Parupsky 1220 Carlson Lake Lane Eagan MN 55123 Haley Comfort Systems 4320 Hwy 52 N West Frontage Rd Rochester MN 55901 (507) 281-0138 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA154555 Date Issued:04/01/2019 Permit Category:ePermit Site Address: 1220 Carlson Lake Lane Lot:016 Block: 003 Addition: Wilderness Park PID:10-84250-03-160 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 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 - Mark G Parupsky 1220 Carlson Lake Lane Eagan MN 55123 Tony's Appliance 2090 County Road 42 West Burnsville MN 55337 (952) 435-2442 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA178244 Date Issued:08/08/2022 Permit Category:ePermit Site Address: 1220 Carlson Lake Lane Lot:016 Block: 003 Addition: Wilderness Park PID:10-84250-03-160 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the water damage. 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 - Mark G & Barbara A Parupsky 1220 Carlson Lake Ln Eagan MN 55123--171 (651) 724-3124 Perfect Exteriors Of Mn Inc 516 Pine St PO Box 297 Monticello MN 55362 (763) 271-8700 Applicant/Permitee: Signature Issued By: Signature