1340 Balsam St ECITY OF EAGAN Remarks
addicion Wilderness Run 5th Addition Loc 15 sik 1 Parcell0 84354 150 Dl
Owner '-.tii5treet 1340 East Balsdm a*1 State Eagan, MN 55123
7?'In.tt! -?i ? L
Improvement Date L Amount Annual Vears Paymen[ Receipt Date
STR E ET SUR F.
STREET RESTOR.
GRADING
?SAN SEW TRUNK 1973 $132.60 $6.63 20 106.08 A003294 10-15-76
SEWER LATERAL -
WATERMAIN
WATER IATERAL
WATER AREA n 7 76
STORM SEW TRK 1981 363.00 24.20 $
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER. 7? D„Z 3-y -?Zs ;fC,
SAC
PARK
YILA.AQE4E EpOAN
3795 Piloe Kne6 Road
Eagon,MN 55142
WATER SERVICE PERMIT
Pr.RMIT NO.: 2022
DATE: 7/26/76
Zoning: A7Z No. of Units: 1
Owner: ntarPt l ons *'u tion Cb
Address:
Sire Address: _134
Plumber: 'M+?
Meter No.: -,? -`? "
No.: 'r 9 S ?LG 8
with fM Villoge o4 Eagan
By
Date ESP.:
Connection Charge: }§g 00-
Account Deposit:
Permit Fee: 10.00 billed 888
Surchazge: • SD billed 88
Misc. Charges: !':9-6 •
Total:
Date Pafd:
Insp.: -
VIL4.40E 47.EAOAN
3795 Pilot Knob Rood
Eagon, MN 55122
SEWER SERVICE PERMIT
PERMIT NO.: --a
DATE: 7/26/76
1
Zoning: RT7 No. of Units:Owner. Marpl l COI15trUCt10A CO.
Address:
Site Address: 1140 E BalsamSt. L15 B1WR5
Plumber: Thomoson Plumbina Co.
100.00 pd
I agroa to eomply with the Vflla9a o{ Eogan
Ordinenem.
By:
Date of Insp.:
Insp.: -
Connection Chazge:350.00 pd
Account Deposit: _-?
Permi[ Fee: 10.00 b111-?Ce
Surcharge: • 50 billed 888
Misc. Chazges:
Total: -
Date Paid:
,p ? ,-
L% ??L5 ?'Cei.lo ? ? `?. ? o
Reques Date Fira No. Rough-in Inspection
Required?
ti Ves C rb
? Ready Now ? Will Notity Inspector
When Rea0y9
IDl'icensed contractor p owner hereby request inspection of above electrical work at
Job tl ss 1 tre Box or te i City
SecM1On No. Township Name or No. Farige No. Coun
O nt(PRIN P?on No ^
PowerSUpplier . tltlre3s '
EI Iri al Contrac? r IC ptny N L, Co actor Li s o
Mai g tltl i on ractor r wner Making stalletio )
Aot rixetl Si raWre IC V ctor%Owner Makin I a a?pn?
\
CY' Ph o r 1
U?
MINNESOTA STAE BOAFD OF ELECTNICITY TMIS INSPECTION FEQUEST WILL NOT
Griggs-MlEwey Bldg. - Room 5473 BE ACGEPTED BY THE $TATE BOARD
1821 UnlveraHy Ava.. SL Vaul. MN 55100 UNLESS PROPER INSPECTION FEE IS
Phone (613) 642-OB00 ENCLOSED.
? REQUEST FOR ELECTRICAL INSPECTION ? .6, Es ooom-oe
? Sae instmcnons Por completinq tnis brm on back ol yeilow copy. ?I
0 8 4 7 3 °X" Below Work Covered by This Request
aw Add 7ypeofBuildinq AppliancesWiretl EquipmentWiretl
Home Range Temporery Service
Duplex Water Heater Electric Heating
Apt Building gryer Other-jSpecify)
Comm./Industrial Furnace
Farm Air Conditioner
Other(syecily) CoNrador5 qemflrks:
Campute Mspeciion Fee Below:
8 Olher Fee # ServicaEniranceSize Fee # Cimuits/Feetlers Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps A6ove 100 _ Amps
SignS inspecior§ Use Only: ? TO
Irrigation Booms
Spacial Inspection
AiarmiCommunication TNIS INSTALLATION MAY BE ORDERED DISCONNECTED IP NOT
Other Fee COMPLETED WITHIN 18 MONTNS.
I, the Electrical Inspector, hereby
if Rough-in oata
cert
y that the above inspection has
been made. F;rai o
OFFICE USE ONIY
This request wi0 10 monIDS from
CLTY Or EE;GAN
3795 Pilot Knob F.oad
Eagan, Minnesota 55122
PEM'iIT NO.: 868
The City of Eagan hereby grants to Ray N. Re1Cer 8eatina Co.
of 4637 Chicaao Ave.
a 8eating Permit for: (Owner) Marall Const Co
at 1340 E. Balsam Tane , pursuant to application dated 7/26/76 _
Fee Paid: $20.00 dated this 28 day of Julv
.50 s/c
Euilding Inspector
Mechanical Permits:
Bid Total:
Z,
/<-5-- /
l Jle -J
CiTY OF E(tGAN
3795 t'ilot Knob Foad
Eagan, P:innesota 55122
PERNIIT NO.: 705
The City of Eagan hereby grants to
1 plumbing
Permit for: (Owner) Marell (.bnstruction (70.
at C=ft.'gg?gRjk ? pursuant to apnlication dzted 7/??aT?6
Fce p
"A7CX:ed $40.00 dated this ?16 day of ?,u_?. 19,44_
1.00 s/c Statement k686
Euilding Inspector.
7cchar_ca1 Perm:i.ts.
3id Total:
Thompson Plumbing Cb.
,)p 12201 Minnetonka alvd.
?
,
cf.
CITY OF PAG?N
3755 Yilot Enob Road
Baf;r--, NL-ir.ne3ota 55122
PEStivIIT Pv'0 , : 7 6
Tne City of Eagan hereby grants to MILFiF.RT CO.=?CSJLLIGAN
oi' 1001 fiP.RIE nVF • SO.
F.ICHARP FiORSLEY
a SOF ? R Per,nit for: (Owner) pAVID NELSON
134 F. Salsam
eu 3782 So, xilZs Ct. , Pursuant to application dated 9/24/76
Fee Paid: S10.00 dated thie 21 day of October 1 1? 7b •
1.00 s/c
E3uilding Inspectoi•
P4echanical Permits:
Bid Tota.le
?
CITY of EAGAN
BUIL/DIING
own.: ... ?'.y.?-?..."`'"'•`' '-' ........j./??,,.y ........ ....
Addreac (P=eien!) ..I...??.Q..?...C. .`?l???l•??.•-,'"?
/
suiiae: ..............
Addrees .... -? ..... . . . . ........... .ff. . .. .:.......... ??7..?d
PERMIT
4 ;•
N°_ 4024
3795 Pilo! Knob Road
Eagan. Minnesoia 55132
454-8100
a8:. /.....?..?Cfl.lJta.
ri
5forieo To Used Fos Fron! Deplh Heigh! Eel. Coe! Pesmi! ZAA Asmuks
?? f 3
Per ...?..w:?-'...`l.Tl!?!Ll:?'?" .:............
Huilding Ieupaelor
This permit does not avihoxize the use of alreeL, roads, alleys or sidewalks aos does it give the ownet os his agea!
the :ighi !o creafe anp siluation whieh is a nuisance or whtch presenls a hasard to ffie heallh afetp, toaveniencs aad
general welfare !o anpone in the eommunifp.
THIS PERMIT MUST BE ON P EMIS WHILE THE WOAK IS IN PRO 8
This is Yo certif ihal ..... .. ... .......Y.k-......... has ermission to erec! a. .... ... ..??(/...j?..?u os
the above descF?d premi;?3Sci io ihe provisions of all aPPpcable?sidinextees fos ii ?'iegan / _ p
?tbz 4/
a..t
r ?
DAmr: 7-A9, ?6
IIUTLAIPIG ?M°I"IT Ay: r?r,9?a ;'r?T C;IECK
Lot_ /4 Slock j Addition_ jP ?j
Parcel and section number
Street ?dq idumUer_,Z , j Y(j
Owner. ? Address Z'?l`'• ,._._?
Developer Address Te ='
Zone-Ordinance #52
Lot Size
Platted
Building Size
X
Occupar!cy
Type of ccnstruction
Setbacks: Street sides
Sides
Parlcng: Total area
Parking area setbacks: I
Street side , ftear
Landscape approval
Special. Assessms.ntse
U
uY.C charge
Water areae
Assessed
T£ assessed: Connection charga
If unassessed: Connection chnrge
Lot clivisiona
Additional assessments needed
Lateralse
Assessed
Waiver of hearing;
Naeded
Tota1 area
Unplatted
g Tc :al -..rea
IJPotGl spaces
?tv ? ?.
? 5ide?
_ Bond required
59?r
Q $1150.00
Unassessed ; ( ?
Not needed
Not assessed
Not needed
Assessment clk InTater 8= Sewer Dept Auilding Dept
Police Dept Fire Dept (Coir¢n & Ind only)
1
MASTER CARD
LocnrioN Cfa.a,7`; / 3!30 /3 -J W
OWNER XkAAZ49o?
STRUCTURE AND ?+// /?i? w/1 y,
LAND USE? AS v?'",?J.il?Y E?" /?j d4A,__
Permit
No.
Issued Issued Ta
Contractor Owner
BLIILDING
PLUMBING
?DK
_
.?7 ?.b 76
?Le1..Qnra 6?
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INS7ALLING
SANITARY SEWER
OTHER I .
O7HER ? I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTWG
? SEPTIC
FOUNDATION CESSPOOL
FRAMING 7_?i? ?/
??•" TILE fIELD FT.
FINAL
ELECTRICAL ? -?
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUM8ING
WELL
SANITARY SEWER
/ . > .
/ ViolaTions Noted
on Back
COMMENTS:
ities Di itg a1 Qualitv Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
• - - ? .ik1'? i''? ? '; i?i '.
. .le rvenue Soo a\-s a55
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• ?nn c?:nr.>ao?a cereo
55?+n? Z/IP
- ? 1M. SSCcaWAM:?
? 4AMOSURVFYOw
ReBsa[uo0 UnQa LOe+4 ef TNa Stata of M1nnawol0 .
--1
9G395 SOUYG9 P.ODERYYRAfd P.O. COIS C, nOSEl:70URfY. R71WRtESOYA 55C30 PHOCJE 893 433.tYW ? SUFLNEVOR'SCERYIGICA4a
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Block l, ti'IY11RTth&1;s R'7?d F?FTH aDDTTIOa, DakoCr_ CovnCyn uinrpsaCae l?l
Plso shoxfng Che Yeca2fon o4' a nropo:,-c mu423ing therecn.
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• i1?-rn%1
MINtdESOTA REGISTFtATIOPI N0.8625
PERMIT# qN 50 k
RECEIPT DATE: 2- /"
fiES]I}ENTIAL PLUM$1Nfi PERM1T APPLICATION
crrY or EAsAv
3830 PaoT xiuos Rn
EikflikN. IrtN 8818E
651-6$1-4675
Please compiete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for irrigation system
HGR3LEY, NIYNNA
SITE ADDRESSJ! 1340 eALSF,rn SrREe F Ea:;r
EAGAN, MN 55123
OWNER NAME: : (ssi) 4e2-8727 TELEPHONE #:
' (AREA CODE)
INSTALLERNAME: 0 rt??UW1?lU?VA61f1? TELEPHONE#: 1Z l?Z7"?0?3
STREETADDRESS: ZGIDS 6(.[4_4 Qld , SO . (AREACODE)
CITY: STATE: MV? ZIP: SSqd?
Place a check mark next to the oermit work tvae
New residential dwelling unit under construction and not owner/occupied $ 90.00
Add-on, modification or alteration to existin dwelling unit, inciuding: $ 50.00
• abandonment of septic system
• new installation/repair/rebuild of RPZ
• lawn irrigation system
• water turnaround
Nature of work: ('S.eXr7iG.C?. IJcu_:17e,'r Fte-a.'GP--4
Septic System, new/refurbishad - $ 225.00
• includes County & Consulting Inspector fees
. requires MPC license
State Surcharge I! ? ???? ?? $ .50
?
III I ?I Ii
;
'
-
LJ1
Total fu
? 0
$ 50.5
R v
Reminder. Be sure to schedule inspections of alterations, Ce, water heaCer;; water'softeners, etc.
I hereby acknowledge that I have read this application, state that lhe information is correct, and agree to complywith all applicable Ciryof Eagan ordinances. It
is lhe applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal
operational and maintenance activities to the facilities constructed under this permit within City property/rightof-way/easement.
SIGNAT PERMITTEE
Updated 1/01
i
so
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAPI MN 55122
651-681-4675
New Construction ReauiremeMs
• 3 regislered sile surveys showing sq, ft. of IoL sq. fl. of house; aM all roofed areas
(20% maximian lof wveraqe allowed)
• 2 copies of plan showing 6eam & window s¢es; poured found design, etc.)
• t sel of Energy Cakulalions
• 3 copies ot iree Preservation Plan If lot platted afler 711/93
• Rim Joist Det2il OpUons selection sheel (bldgs with 3 or less unifs)
DATE
?"J' (S -D?Z
9q as
RemodellReoair ReauiremaMs
. 2 copies of plan
. 1 set of Energy Calculations far healed addNOns
. 1 site survey torexterbr additlons &decks
• Indicate if home served 6y septic system for addiGons
VALUATION ? ?? 700 , 06
SITE ADDRESS 1 3 ?O i /?nt cST• MULTI-FAhIIILY BLDG
TYPE OF WORK_ RarO??-r ?C FIREPLACE(S) _
APPLICANT
STREET ADDRESS
TELEPHONE
#" -66 7- 3 7002 "' Fax #
SS/d
PROPERTYOWNER.5•KlU"?? ?nW ? TELEPHONE#????B_?.2-7
--------------------------°-----------------------------------------------------------------..
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CA1'EGORY 1
(4 submission type) . Residential Ventilation Category 1 Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contrqctor:
Plumbing system includes:
Mechanical Conhactor:
Mechanical system includes:
Sewer/Water Contractor:
Air Conditioning
Heat Recovery System
Phone #
Fee: $70.00
Phone #
----------------------------°-------°---°-----------------------------------------------°-----°------°-----°-------
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
__..__.._ .............°•°--°-°--°-----__......_..------.._-----------------_--_---------------------
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
Phone #
_ Water Softener
Water Heater
No. of Baths
Lawn Sprinkler
No. of R.I. Baths
!/Y N
_1 _2
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
, 3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675 -s ?
Please complete for modifications to existing residential dwellings.
Date a, -.41 /_/A8 /
Site Street Address ???? Unit #
Property Owner S Telephone #??-?'`'f
Contractor Telep/h'one # ?
Address City /r
?7/?,?2117?/?/GL StateLi2vZio
The Applicant is: _ Owner ? Contractor _Other
Alterations to existing dwelling
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required)
Other: $ 50.00
? Water Softener _ Water Heater
x replacement _ additional $ 15.00
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ 50
Total
I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approv .
?d? ?k'
ApplicanYs Printed Name ' ApplicanYs ' ure h
APR 1 3 2004 D
7
7
s
?
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
7n °°
SV-70 .oU
New ConsWCtion Reaui2ments RemodeVfieoair ReouiremenCs
3 registered sAe surveys showing sq. N. o( lot, sq. R of house; and all roofed areas 2 copies o( plan ne'`N
(20% maximum lot coverege allowed) 1 set of Energy Calculatlons for heated additions
2 copies of plan showirg beam & window sizes; poured found design, etc. 1 site survey for addNOns 8 dedcs Tte? ies Reqtl6*
7setofEnergyCalalatbns qdo7lion-iridiaate8on-aitesepticsystem s:'•?Y;0
3 copies o( Tree Preservatlon Plan'rf bt plattad afler 711193
Rim Jolst Defail Options selection sheet (61dgs wiN 3 or less uniLs
Date
au
Construction Cost
Site Address 12,>4 90? S-? -izj GL?SO,YY1 ?'t UniUSte #
Description of Work 1 a 9,Q 9 (.s?nAQ?xYj u3f? $^{i Inp„
Multi-Family Bldg _ Y x N Fireplace(s) _ 0_ 1 _ 2
PropertyOwner Telephone#(IpSI)
RMA HOME SERVICES, INC.
Contractor Home Deopt Installed Sales
Address 3200 Cobb Galleria Pkwy.Ste. #200 CitY
State Atlanta, GA 30339 Tetephone #( )
763-542-8826 BC-20268257
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Enefgy CodB Category . Residentlal Vantilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone # ( )
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the informarion 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 plan in the case of work which requires a review and
ap roval of plans.
o?c a ? ?r,Scs? '/4\
Applicant s Printed Name Apphcant s Signature
Ins#alled
Siding and Windows
LIMITED POWER OF ATTORNEY
COUNTY OF COBB
STATE OF GEORGIA
KNOW ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a]icensed contractor of RMA Home Serviccs, Inc., DBA Home
Depot Insta(led Sa!es loca±Pd at 660 Mendelssohn Avenue North, Croiden Valtey, M1V
55427, having a license number oF BC- 20268257, do hereby appoint, name and
constitute Elder-Jones Building Permit Service, Inc. ("Agent") as my true and lawful
attorney-in-fact and do authorize and grant said attarney-in-fact for me and in my
name, place and stead the power to execute, acknowledge, sign and deliver (in such
form as may be required by the municipality) a permit application, or any other
instrument(s) which may be necessary and appropriate, in order to obtain the proper
permit(s) from the City of Eagan, Minnesota for the installation, maintenance and
repair of windows and siding (the "Work").
The powers conveyed to the Agent by this Limited Powe: of fl:tcrr.ey are
limited sotely to the express powers delineated herein and apriy solely to the Work.
This Limi*,ed Power of Attorney shall expire and automatically be revoked on the 21 st
day of May, 2004, which date is one year from the execution hereo£ Further, the
powe:s conveyed by this Limited Power of Attorney may be revoked by Principal at
any time by express revocation and shall also be revoked by the Principal's death,
disability, incapacity or incompetence.
W, WI'1_'NFSS WIIEREOF this Limited Potver of A±?orr.e-y is e.;,ecirtc:d this
21 st day of May, 2003
David N. Katz
SWORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this
21st day of May, 2003.
E
Notary P t?hlic in for the State o eorgia
b2y Commission Expires: 7anuary 21, 2006
3968i6.v3 -
Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor.
3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toli free (800) 79-DEPOT
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118790
Date Issued:11/07/2013
Permit Category:ePermit
Site Address: 1340 Balsam St E
Lot:015 Block: 001 Addition: Wilderness Run 5th
PID:10-84354-01-150
Use:
Description:
Sub Type:Reroof
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.
Carbon monoxide detectors are required by law in ALL single family homes .
Chelsea Laughlin
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 -
Lorelei J Remick
1340 Balsam St E
Eagan MN 55123
(651) 336-6234
Window World Aka Probuilt America
2211 11th Ave E, #130
N St. Paul MN 55109
(651) 770-5570
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA149612
Date Issued:05/31/2018
Permit Category:ePermit
Site Address: 1340 Balsam St E
Lot:015 Block: 001 Addition: Wilderness Run 5th
PID:10-84354-01-150
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 -
Anders P Moe
1340 Balsam St E
Eagan MN 55122
Air Mechanical
16411 Aberdeen St NE
Ham Lake MN 55304
(763) 434-7747
Applicant/Permitee: Signature Issued By: Signature