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1208 Carlson Lake Lane CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: Eagan, NN 55121 DATE: Zoning: _ No. of Units: Owner: Address: Site Address: Plumber: - Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee: 1 agme ro =Mpl r wuh The City of I mpa Surcharge: Orllwaaoee. Misc. Charges: Total: By Date Paid: Date of Insp.: Insp.: CITY OF EAGAN SEWER SERVICE PERM 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: Eagan; MN .56121 DATE: Zoning: No. of Units: Owner SV4°7td ~BtGi'^if,: `;n;,SL . Address: Site Address: ^'Jf? Car1sco, T ~ e I. rrc.. ss Plumber. re nz -Rynn ..w. to «Hrb V46 as ch, N E.,.. Connactlon aWf ga: orel..mom Account Deposit: • r - Permit Fm: Surcharge: By Misc. Charges: Date of Insp.: Total: Irnp.: Dots Paid: CITY OF EAGAN G 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 J PHONE: 454-8100 r7 BUILDING PERMIT Receipt # 6~.f To be used for SF DWG/GAR Est. Value $16 2, 0 0 0 Date AUGUST 20 19 8 6 Site Address 1208 CArtLSON LAKE Lip Erect C~ Occupancy !13 Lot 21 Block 3 Sec/Sub- WILL &CIESS PK Remodel ❑ Zoning R1 Parcel No. 1 ST ADD Repair ❑ Type of Const. Vu Addition ❑ No. Stories c , , Move ❑ Length 52 W Name SV l,~~ii. I ETERSEN CONST INC Demolish 1:3 Depth 40 3 Address 4701 W 110TH S7' Int. Impr. ❑ Sq. Ft c City i•tPL Phone 864-5144 Install ❑ o Name `i.yl,'ti Approvals Fees 0i Address Assessment Permit $ 58ii.00 City Phone Water & Sew. Surcharge 81.00 ~s Police Plan Review 294.00 la = Name Fire SAC 575'00 ~a Address Eng. Water Conn. 500.00 'C W City Phone Planner Water Meter 63.50 Council Road Unit 290.00 Ihereby acknowledge that Ihave read th!,s3pplicationandstate that the gldg.Off. 8/113/8 Tr. PI. 156.00 information is correct and agree to c ply with all applicab State of Minnesota Statutes and City of E n Ordinances. APC Parks 9 Var. Date Copies Signature of Pe4 tae 4 , . 50 Total A Building Permit is issued to. SVEND PF TERLSLN CONS' Tj4C 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 - Permit No. l~ Permit Holder C~ Date Telephone Of Plumbing HN.A.C. 7 - I z t C fe VI M Electric Softener Inspection Date Insp. Comments Footings I Tj L~ Footings II Foundation Framing Roofing h", e Rough Plbg. Rough Hig. Insul. Fireplace Final Mtg. r1 Final Plbg. G y' ` Bldg. Final Cert. Occ. Deck Fig. Deck Frmg. Well Pr. Disp. l PERMIT # MECHANICAL PERMIT RECEIPT # `f U CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: Sept./Op 1986 CONTRACT PRICE: PHONE: 454-8100 j Site Address r son :e arse BLDG. TYPE WORK DESCRIPTION Lot Block Sec/Sub { il"Ierness Park Addition Res. New Name nz- yan ?&1_1 Mult Address out : 1 obert Trail Comm. Add-on Comm. Repair c City "OsemOant Phone !;23-11/g; Other Name etersen Construction FEES c Address RES. HVAC 0-100 M BTU -$24.00 p City Phone ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 TYPE OF WORK ADDITIONAL 6 M BTU - 6.00 c f GAS OUTLETS - 1.50 EA. Forced Air M BTU COMM/IND FEE - 1% OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50 Vent CFM (ADD $50 SIC IF PERMIT PRICE GOES BEYOND $1,000.00) Gas Piping Outlets # ^a - Other _ FEE: a7 U ' S/C: ~ SIGNAT RE OF PERMITTEE TOTAL -yytT ' FOR: CITY OF EAGAN - PERMIT # PLUMBING PERMIT RECEIPT # D a` CITY OF EAGAN 1986 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE Sept./Vs CONTRACT PRICE: PHONE: 454-8100 Site Addr ss 1208 Carlson Lake Lane BLDG. TYPE WORK DESCRIPTION Lo~TiI2s 1 %_r c ,sW Ad itim Res. XXX New MM L Name Gent-Ryan P&H Mult Add-on 14745 South Robert Trail Address Comm. Repair c City Rosemount phone 423.1144 Other i etersen onstruct oin FIXTURES OTAL Name TWater Closet - $3.00 00 Address Bath Tubs - $3.00 jvo City Phone Lavatory - $3.00 Shower - $3.00 FEES Kitchen Sink - $3.00 U COMM/IND FEE - 1% OF CONTRACT FEE Urinal/Bidet - $3.00 MINIMUM - RESIDENTIAL FEE -$10.00 Laundry Tray - $3.00 MINIMUM - COMM/IND FEE - 20.00 Floor Drains - $1.50 STATE SURCHARGE PER PERMIT _ 50 Water Heater - $1.50 t" (ADD $.50 S/C IF PERMIT PRICE GOES Whirlpool - $3.00 Gas Piping Outlets - $1.50 BEYOND $1,000.00) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 C L Rough Openings - $1.50 SIGNATURE OF FERMITTEE FEE: f 5 G'J STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL: CITY OF EAGAN ' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for Est. Value 11 + i I'C Date A P121 .1 19 ' ~ Site Address 1C..Ri.-SON. ;.A",E LN Lot 1 Block Sec/Sub.!" ;JEbLY1:'>S : ARC OFFICE USE ONLY Parcel No. Occupancy FEES Zoning Name CAR r. = (Actual) Const Bldg. Permif 25 oc W Address 120fj (Allowahle) } Surcharge City 6AC•Ai~ Phone rt 1- g i # of Stories length Plan Review =p Name S~* Depth - SAC, City Uq Address S.F. Total SAC. MCWCC City Phone S.F. Footprints On Site Sewage Water Conn i F m Name On Site Well Water Meter Address MWccsystem 4 v= Acct. Deposit W City Phone City Water PRV Required S;W Permit I hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Treatment Pf Signature of Permitee APPROVALS Road Unit vAfkf w1A►t'•t1JU Planner Park Ded. A Building Permit is issued to: on the express condition that all work shall be done in accordance with all Council 1 • f applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg Off Copies a j Building Official Variance TOTAL • 5U n Permit No. Permh Holder Date Telephone # WATER SEWER PLUMBING H.V.A.C. ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Roofing Rough Plbg. Rough Htg. IsuF. Fireplace Final Htg. Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final Deck Ftg. V-2 S Deck Final f di << f Well Pr. Disp. its request void 18 months from O 47973 Date of this Request I, as K Licensed Electrical Contractor ❑ Owner, do hereby request inspection of the above electri- cal wiring installed at ' l / ` _ (,lnt~Ci. Sect Street Ad>jreo oute o. ! 2 ~d K- 05~ x . C;ty_~~+~ any ion,,//~ Towns 'p Range County Which is occupied by >y . e _m-W ua« c4 m x (Name of Occupant) Is a roughin inspection required on this job? No O Yes o Ready Now ❑ Will Call ❑ Power Supplier ~~Z- aaeac- Address J:9 3+n/ -LA fa~Lircc Electrical Contractor WL 4 -sue ex ec Contractor's License No. g r~ (Company Name) ~ q ,//Mailing Address dOJO /..k -<4 1cly.~ri /LGU S~-z( (Elactrlca ntractor Owner Making This Wit, Authorized Signatu I~vyr rN~ Phone No. F-5-41 I'Y7o (Electrical contractor or Owne Making This Installatl ) Minnesota State Board of Electricity Olm a 1954 University Ave., St. Paul, Mign..55104-Phone 645-7703 REQUEST FOR ELECTRICAL INSPECTION O 47973 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 11 Duplex ❑ ❑ ❑ Water Heater Lighting Fixtures ❑ Apt. Bldg. ❑ ❑ ❑ Dryer ❑ - Electric Heating ❑ Commercial Bldg. ❑ ❑ ❑ Furnace ❑ Silo Unloader ❑ Industrial Bldg. ❑ ❑ ❑ Air Conditioner ❑ Bulk Milk Tank ❑ Farm ❑ ❑ ❑ pLList pList Other ❑ ❑ ❑ HerersI Rtehers COMPUTE INSPECTION FEE BELOW Service Entrance Size: # Fee Feeders ' u.' # ;Fee Circuits: # Fee 0 to 100 Amps. D to 30 m r' 0 to 30 Amperes 101 to 200 Amps. 31 to 10 Amperes 31 to 100 Amperes Above 200_Amps. Above 100 Amps. Above 100 Amps. Transformers Remote Control Circ. Partial or other fee Signs Special Inspection Minimum fee $5.00 Remarks TOTAL FEE SD I, the Electrical Inspector, hereby certify that the above inspection has been made. o~ (Rough-in) Date (Final) r tel. Date 7 -7 7 7 This request void 18 months from 2004 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date 91 h_ 1 D ~4_ Site Street Address O C a_4,10 y-0 01k_e ,oc &4,4~ Unit # Property Owner Telephone # Contractor ¢ LP b ~/2etc~ Telephone# (/51) 66"I344 Address t~ ?A _ `~PdQ city a4 ~1- state thin- zip r 42.3 The Applicant is: _ Owner ✓Contractor -Other Alterations to existing dwelling $ 50.00 -Add fixtures to rooms, excluding water softener and water heater -Septic System Abandonment Q -Water Turnaround (add $121.00 if a 518" meter is required) i~ 6 200 -Other: 3y _ Water Softener ►'~Water Heater $ 15.00 ✓ replacement _ additional 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 approved. 2 rL fig V ~fieyprL3 Q Applicant's rinted Name Applicant's nature CITY OF EAGAN N4 16343 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454-8100 Receipt # _ ( lf' To be used for DECK Est. Value $1,000 Date APR 71 19-89-- Site Address 1208 CARLSON LAKE LN OFFICE USE ONLY Lot 22 Block 3 Sec/Sub. WILDERNESS PARK Parcel No. Occupancy FEES Zoning - w Name GARY STANULL (Actual) Const Bldg. Permit 26.00 o Address 1208 CARLSON LAKE LN (Allowable) SO Surcharge . City EAGAN Phone - L of Stories Length Plan Review Name SANE Depth SAC, City 26R Address S. F. Total _ SAC, MCWCC ¢ City Phone S.F. Footprints - On Site Sewage Water Conn Ww Name On Site Well Water Meter i~ Address MWCC System si Acct. Deposit aw City Phone city water - PRV Required SSW Permit I hereby acknowlege that I have read this application and state that the Booster Pump SM Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and of Eagar/y~ygr~dina~,,esn.,~ y/ / Treatment PI Signature of Permitee - ~r l' ' V ,y J APPROVALS Road Unit A Building Permit is issued to: GARY STANULL Planner Park Ded. on the express condition that all work shall be done in accordance with all Council 1.00 applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. OH. Copies Building Official ,tcLl~~ ~ l f I✓~ Variance TOTAL 27.50 1989 BUILDING PERMIT APPLICATION - CITY OF EAGAN i SINGLE FAMILY DWELLINGS 4 INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS APR 1 9 1989 rte`',/q,U _ To Be Used For: Valuation: 4461- Date: /9 eq 1i09; CARL,91N 4Aa CE , Site Address /06,60 - OFFICE USE ONLY Lot LP,(V Block 0:3 Occupancy FEES Zoning Parcel/Sub WIl-MA10>5 )0.4ie; AbpjwpAd Actual Const Bldg. Permit 2("00 Allowable Surcharge .50 Owner Cs.s.QX S-r!AA,1U1L # of stories Plan Review Length SAC, City Address /SOS CA44Son) LA,PC LAA/E Depth SAC, MWCC S.F. Total Water Conn City/Zip Code S46.4nI Wy 5 s'i~3 Footprint S.F. Water Meter Acct. Deposit Phone ~.S!- 1979' 600R1<' 697-1778 On site sewage S/W Permit On site well S/W Surcharge Contractor MWCC System Treatment P1. City water Road Unit Address PRV required _ Park Ded. Booster Pump Copies OV City/Zip Code TOTAL APPROVALS Phone Planner _ Council Arch./Engr. Bldg. Off. Variance Address City/Zip Code Phone # NOTE: Sewer & Water Permit fees and account deposit fees will be included in the building permit fee. Processing time for sewer and water permits is two days once a licensed plumber has applied for a permit at City Hall. to for: Carlson ~ f7 -j1d Peterson 4701 West 110th Street Bloomington, Mn. 55437 DELMAR H. SCHWANZ LAND SURVEYOR Registered Under Laws of Tna Slats of Minnaaou 797E - 146TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 56088 PHONE 612 423-1769 SURVEYOR'S CERTIFICATE 3 m n osr r rn N68 AT °m o z \ 502 O Q"~x' w° LOT 22 i fo c a ,p R n p~~ E 1. P' o s$$ 2 N ,a . y a° SCALE: 1 inch - 50 feet b Elevations shown are existing O \ .p0 109.99 lOP NUB of Drainage is utility easement T c. \ Proposed garage floor elevation- _ 'Sp I hereby certify that this is a true and correct representation of Lot 220 Bloek 3, WILDERNESS PARK ADDITION, according to the recorded plat thereof, Dakota County, Minnenota. Dated: May 30, 1979 House staked and elevations shot August 12, 1986 i f ! I y/~'~.~( ✓ ' it ,G(/ t. j MINNESOTA REGISTRATION NO. 08626 CITY OF EAGAN N' 110 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 r J BUILDING PERMIT PHONE: 454-8100 Receipt# !f` To be used for SF DWG/GAR Est value $162,000 Date AUGUST 20 19 86 Site Address 1208 CARLSON LAKE LN Erect In Occupancy R3 Lot 22 Block 3 Sec/Sub. WILDERNESS PK Remodel ❑ Zoning R1 Parcel No. 1ST ADD Repair ❑ Type of Const. Irn Addition ❑ No. Stories z Name SVEND PETERSEN CONST INC Move ❑ Length 52 3 Address 4701 W 110TH ST Demolish ❑ Depth 40 o City MPLS Phone 884-5144 install Sq. Ft. c - Approvals Fees o Name SAME Address Assessment Permit $ 588.00 City Phone Water & Sew. Surcharge 81.00 Police Plan Review 294.00 8WZ Name Fire SAC 575.00 xa Address Eng. Water Conn. 500.00 aw City Phone Planner Water Meter 63.50 Council Road Unit 290.00 have hereby acknowledge that I I read th' apl li ion and state thatthe. 81dg.Off. 8/18/8 Tr. PI. 156.00 information is correct and agree to wmpl rth all appHca a St teff Minnesota Statutes and Gity.of Eada rdinanc ' APC Parks Y Var. Date Copies Signature ofPer(nittoe-~ $2,547.50 Total A Building Permit is issued to: SVEND PETERSEN CONST INC on the express condition that all work shall be done in accordance with all applicable 37 of Minne o atutes and City of Eagan Ordinances. Building Official 1 z a 4 ` 1 1986 BUILDING PERMIT APPL CATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET 0F-'SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: /b F lq~jcy~n Valuation: Date: Site Address k3L & (a-1 OFFICE USE ONLY Lot 22- Block 3 Erect Occupancy S J~ Remodel Zoning IC/ Parcel/Sub Lf//LUe9Z6C. S JATGC~ /'/L'CJ. Repair Type of Const (-J Addition # of Stories Owner ~FTTY~✓ ~~(/G . Move Length_ ll Demolish Depth 4129 Address Install city/zip code,/ pGlS`./~/S~L/37 Phone Y - S/ 7 y APPROVALS FEES Contractor Assessments Permit Water/Sewer Surcharge Address Police Plan Review Zfs_ Fire SACS City/Zip Code Engr Water Conn Planner Water Meter a_3, f50 Phone Council Road Unit 24162 Bldg Off Treatment P1 Arch./Engr. APC Parks Variance Copies Address TOTAL City/Zip Code Phone d! NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. certifigate for: Arnold Carlson ' Svend Peterson 4701 West 110th Street Bloomington, Mn. 55437 DELMAR H. SCHWANZ IANO SURVEYOR Registered UnUn Law, of The Stab of M1nn„0ta 2878 - 145TH STREET W. - BOX M ROSEMOUNT, MINNESOTA 88068 PHONE 812 423-1788 SURVEYOR'S CERTIFICATE 3 ro 09` E to N 68o Al m p z 302 O Qt~~""U0 LOT 22 o' Nbop 112.8 ,yp ,p ~.Aa ~A tao.a . aO / ~t ,i J~ 9. \ ~ v ~i~ ~o o \ ~ N 64 b 100, k \ 1 try ~o r 4~ 26 SCALE: 1 inch 50 feet 1024 a! S 0 4oA ios.es Elevations shown are existing MP we ioze-Drainage & utility easement cc. Proposed garage floor elevation 'Sp I hereby certify that this is a true and correct representation of Lot 22, Bloek 3, WILDNESS PARK ADDITION, according to the recorded plat thereof, Dakota County, Minnenota. Dated: May 30, 1979 House staked and elevations shot August 12, 1986 ' lo MINNESOTA REGISTRATION NO. 8625 y n EXTERIOR EP7VELC Dr AVERAGE 'U ` COt"PUTATION OWNER J ~ ? SITE ADDRESS CONTRACTOR DATE ~S PHONE ZY V-S/4e S~ Determine working square footage of each. 1. Total exposed wall area . Yo zy sq. ft. x .11 = 2. Total roof/ceiling area / y0 sq. ft. x .0112 = Total exposed wall area above floor = 77 a. Total wall windc;r area AU b. Total door area c. Total sliding glass area 00 d. Total fireplace wall area oZ.o e. Total wall framing area (average 10p)... 3c4 f. Total net wall area above floor ozle 3 g. Total rim joist area BZ So Total exposed foundation area = 'PO h. Total foundation window area /O i. Total net foundation area above grade . 70 Determine "U" value of each wall segment. a. 19.3 x "U" 9S' _ b. 3 b X "U" 0. /,Zly = S c . Al0 X "U" C9. 1.2r = S D . C) X 'tJ' O. /d a' ° 3 e. 302. X '•U" 0. = 36 f. o21P-% X "U" ().0116 = R. .2 SD X "U' O. U 7 = /a h. i o X "U' l9. SS- G i. 70. X "U" /o 3 ............................................Total If item Y3 is the same as, or less than item ,H1, you have met the intent of SBC 6006(c)2. Total exposed roof/ceiling area `l C? Total skylight area k. Total roof/ceiling framing area (average 107, /02 V 1. Total net insUlated roof/ceiling area Determine "U' value for each roof/ceiling segment. k. X -Ut, p b = 0, 019 4 .........................................Total = 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 Desij,n 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. + 4. CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. 0. W 21-199 PERMIT NO.: Eaga:., MN 55121 DATE: Zoning:. L No. of Units: Owner: --5ve.id Yetersc Address: Site Address: K~ ,e ,..S7 _ Plumber. ' t Meter No.: ~6 oZ a All ion Charge: ' Size: " /Loc /4 f1 ot: Reader No.: D 70 t Bc 1 else to a moply wbb the ~Lt u 5 pZ - Of, rd, Or~iw.eose. . . owl, 2 otai: BY , Date Paid: Date of I nsp.: Insp.: G I i Y OF S A G A fV *h71 P : Of Iu TAI `1•'. O *t APPLICATION DOES NOT CONSTITUTE irr'MM rt APPROVAL OF PERMIT. APPLICATION FOR PERMIT * INSPECTION OF SEWER AND/OR WATER * INSTALLATIONS WILL NOT BE Sam- SEWER AND/OR WATER CONNECTION ULED UNTIL PERMIT HAS BEEN *w APPROVED. * * * * * * P ease Print 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: PLOfBfl L~St ck Subdivisio or Tax Parcel ID ) IF EXISTING STRUCLME, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE- PRESENT ZONING/PROPOSED USE:' ftn Year) COA1MERCIAL/RETAIL/0FFICE SINGLE FAMILY 0 INDUSTRIAL Q R-2 DUPLEX (Two Units) n INSTITUTIONAL/GOvacZE•NT ❑ R-3 TOWNHOUSE (Three + Units) ( Units) ❑ R-4 APARTMENT/CONDOMINIUM ( Units) 2) n 1 NAME: SEa- W PETERSEN CONSTRUCTION INC. ADDRESS: 4701 West 110th Street CITY, STATE, ZIP: Bloomington, MN 55437 PHONE: RR1~/155 3) a ::I- For City Use NAME: GENZ-RYAN PLUMBING & HEATING COMPANY Plumbers License: ADDRESS: 14745 South Robert Trail Active CITY, STATE, ZIP: Rosemount, MN 55068 Not red Not recorded PHONE: 423-1144 MASTER LICENSES 1849M St Initial 4) eoa o la• NAME: ADDRESS: CITY, STATE, ZIP: PHONE: .5) i:~ a• i e oe s~ X CONNECTION TO CITY SEWER EF CONNECTION TO CITY WATER OTHER 6) ,o r PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL AP R PERMIT TO 1, 2, 3 4, ABOVE (CircP-eI 'one) 7) r r u - Q 7 Ia• •o r• u~• • a• t - a..s • ao o• o 0 n n0 • 1:•.. - n• I. ' 6641 • n a•,•.r.o, I ~ I r a- a no a• • , i ao. Y FOR CITY USE ONLY PERMIT # ISSUED Pd W/Bldg. Permit FEES: $ $ SEWER PERMIT (INCLUDE SURCHARGE) $ / $ WATER PERMIT (INCLUDE SURCHARGE) $ $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ e, b~ ACCOUNT DEPOSIT - SEWER $ $ / S ACCOUNT DEPOSIT - WATER $ SZO f C j $ WAC $ -5-7 S D C> $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ ~S D O $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ y" $ 67,60 TOTAL s_ 76 z_ 64 X16 - z-RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? 0 YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: r APPROVED BY: A, A~ TITLE: cy DATE: d NOTICE OF SPECIAL ASSESSMENT The Eagan City Council met on Mav 6 1980-- and approved a special assessment against your property described as Lot 22 Block 3 Wilderness Park in the amount of $ 128 40 FOR THE IMPROVEMENT OF Storm Sewer Trunk You have the privilege of paying the total amount within thirty (30) days of adoption of the assessment roll without interest at the Eagan City'Hall or the total amount will be certified to the Dakota County Auditor at Hastings in annual installments and appear on your tax statement. If the entire assessment is not paid within the 30 days but is paid prior to October 15th in the year of adoption, interest will be charged from the date of adoption to December 31st of that year. If the assessment is not paid by October 15th in the year of adoption, it must be paid in.annual installments with 8% interest from the date of adoption to December 31st of the following year to be included in the first installment.' In addition partial payments of Special Assessments will be accepted within the 30 day period and the balance will then be certified to the Dakota County Auditor. The law provides that unpaid assessments become a lien against the property. State law, Minnesota Statutes Section 429.081, provides that you may appeal your assessment within 30 days after the adoption of the assessment, which was May 6 1980 By serving a notice of appeal upon the Mayor or City Clerk of Eagan. You must file the notice of-appeal with the Clerk of District Court, Dakota County, within 10 days after.serving it on the Mayor or Clerk. SPECIAL ASSESSMENT DEPARTMENT City of Eagan 3795 Pilot Knob Road Eagan, MN 55122. CITY OF EAGAN Remarks Addition Wilderness Park Lot 22 Blk 3 Parcel 10 8425Q 220 03 Owner Street 1208 Carlson Lake Lane State Eagan,MN 55123 i.. 1 / Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK -;22 1973 176.o5 0 20 L f SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA 1977 160.00 10.66 15 eL D STORM SEW TRK rj STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK 5--3,573,5 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 1 3830 PILOT KNOB RD, EAGAN MN 55122 651.681.4675 New Construction Requirements RemodelfReoair Requirements . 3 registered site surveys showing sq. tt. of'ot, sq. 5. of house; and all roofed areas • 2 copies of plan 120% maximum lot coverage allowed) . I set of Energy calculations for heated additions • 2 comes of plan showing beam 3 wmdew saes; poured found design, etc.) • 1 site survey for exterior additions 8 decks . I set of Energy Calculations . Indicate f home served by septic system for additions . 3 ccpies of Tree Preservation Plan if lot platted after 7/1193 Rim Joist Detail Options selection sheet (bidgs with 3 or less units) S3 DATE -7-)S-(OZ VALUATION SS3(o-71 SITE ADDRESS 1ZOX 0-AlUS00 L.AU L.ti MULTI-FAMILY BLDG _Y AN TYPE OF WORK RC-900(- I FIREPLACE(S) _ 0 ZC 1 - 2 APPLICANT L }-(21 SrmpS 1"C_ //FF~~~ STREET ADDRESS I WO PAfUC kcjAn CITY ~WSSjW STATE MO ZIP SQ)-7 TELEPHONE # cISZ-CLl^7~0--Zoo 1 CELL PHONE # FAX # gSZ- Z7J'-5903 PROPERTY OWNER flQ ~ IGI 1~ J (,Jt,, TELEPHONE # f al I q 7$ COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 G1"!'.GORY I _ NIIN VESOTA RULES 7672 (i submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted Energy Envelope Calculations Submitted Plumbing Contractor: Phone n Plumhin.- system includes-: _ Water Softener Lawry Sprinkler Fee: 590.00 Water Heater _ No. of R.I. Baths No. of Baths Mechanical Contractor: Phone # Mcchailical system includes: Air Conditioning; Fee: S70.00 Heat Recover' System Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the information is corr ct, and agree to with all applicable State of Minnesota Statutes and City of Eagan Ordinanc n fl Signature of Applicant t1" l~ .1111 OFFICE USE ONLY By. Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 43D.6~, 2006 RESIDENTIAL MECHANICAL PERMIT APPLICATION pZ City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits arerequired for each unit Date J, //("N / 06 [ Site Address / o(dl~ 1 l t (,~j / ,(/JU Unit # Property Owner Telephone # Contractor SOGWICK HEATING &ARGUND111UNINU LW Street Address 8910 Wentworth Ave. city Minneapolis, MN 55420 ( ) State (957) ARC 9006ip Telephone # Bond 040 9-0).HOIL0 Expires: O(p t0 The Applicant is Owner ✓ Contractor Other Add-on or alteration to existing dw,ell~' g unit $ 30.00 ✓ furnace A itional ✓ Replacement _ New air exchanger air conditioner heat pump other State Surcharge $ .550/0,, Total $ 6.10 I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; 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 a in accordance with the approved plan in the case of work which requires a review and approval of plans. SEDGIMGK HEATING R AIR CONDITIONING I I C ~ Applicant's 1$9tlf W&ftorth Ave. Applicant's Signature D Minneapolis, MN 55420 n (952) 881-9000 MAR 0 IuuiJ 2 2006 SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOBNO ?•2C MN 55420 (952) 881-9000 TEST RECORD 8910 WENTWORTlTH AVENUE SOUTHI • MINNEAPOLIS, L91+-~ n.' ADDRESS I d ®n CAr (S~ N Cr' r CITY r' 7 OCCUPANT l 0``y S-1 U ll OWNER k--,2 ^ SOLD BY S1t d l e i ~ ~ INSTALLED BY 2~2 jj V p MAKE _ 4 Z, N y G T MODEL G/ u, Y ✓ G G% Zl c/ d 3`+"7 22 ~h G ~i~GecS SERIAL NO. ~n INPUT THERMOSTAT `~L C VENT SIZE ~n^ VALVE / ~f Z L/ •%a/'~. L/ TYPE OF LINER R U V 3 y LIMIT I X'-T ~ LINER SIZE LIMIT SETTING Z- 6 FILTERS: SIZE G C NUMBER FAN SETTING WIRING r Y b ~ PILOT TYPE TESTTAG IGNITION MODEL I 4r LIGHTING INST IL) Li~ U LE PILOT TIMING DATE TESTED ~ n PRESSURE 3(~PERCENT CO, - 2006 C1L~ MAR 0 g INPUTCFH V a COMPANY TESTING sue' J U PERCENT Oz J STACK TEMP. ~ 3 ZK PERCENT CO 0 NAME OF TESTER P" /z'u S FORM 235(REV11/89) FORM DISTRIBUTION: WHITE COPYJOB FILE YELLOW COPYCITY Use BLUE or BLACK Ink I For Office tlsc 1 Permit City Eap i Permit Fee: bC .00 I 3830 Pilot Knob Road Date Received: l Eagan MN 55122 1 Phone: (651) 675-5675 j staff: Fax: (651) 675-5694 ` I ----------------l BUILDING PERMIT APPLICATION 2011 RESIDENTIAL Date: Site Address: 1 y~ vltir`S~~ L~ Unlt#: c Name: ~Ihone: RESIDENT ! 1 OWNER Address/ City /Zip: Applicant is: Owner Contractor Description of work: in TYPE OF WORK - G' A It Construction Cost: IT Multi-Family Building: (Yes _ / No Company: l' Contact: V CONTRACTOR Address: I(D City: K, State: i Zip: ✓ Phone: ~;2- ✓ [ License Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a perm# 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 they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (851) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.om 1 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 approvalof n 1) x cl) - X Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type: Plumbing Eaaan. Permit Number: EA102284 Date Issued: 11/30/2011 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 1208 Carlson Lake Lane Lot: 022 Block: 003 Addition: Wilderness Park PID: 10-84250-03-220 Use: Description: Sub Type: e - Water Softener Work Type: New Description: Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Gary Kes 32018 Dahomey Avenue Northfield. MN 55057 507-645-4037 Fee Summary: PL - Permit Fee (WS &or WH) $50.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 Total: $».00 Contractor: - Applicant - Owner: Benjamin Franklin Plumbing Northfield Inc. Gard P Stanull 32018 Dahomey Ave. 1208 Carlson Lake Lurie Northfield NIN 55057 Eagan NIN 55123 (507) 645-4037 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 Cite of Eaaan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type: Plumbing Permit Number: EA104830 ~it~ Date Issued: 06/12/2012 of Et] QR Permit Category: ePermit Site Address: 1208 Carlson Lake Lane Lot: 022 Block: 003 Addition: Wilderness Park PID: 10-84250-03-220 Use: Description: Sub Type: e - Fixtures Work Type: New Description: Basement Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Mark Johnson 7145 Oakland Ave So Richfield, mn 55423 612-243-3965 Fee Summary: PL - Permit Fee (miscellaneous) $55.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 Total: $60.00 Contractor: - Applicant - Owner: Johnson Plumbing & Heating Gary P Stanull 7145 Oakland Ave. S 1208 Carlson Lake Lane Richfield MN 55423 Eagan MN 55123 (612) 243-3965 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 Use BLUE or BLACK Ink, 1---- se-----------i Clt f E ~ Permit o 2 y jam , 3830 Pilot Knob Road i Permit Fee: i Eagan MN 55122 i I Date Received: , i Phone: (661) 675-5675 l Fax: (1551) 6754694 Stott: I 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Site Address: ~Jn Tenant: Butte RESIDENT / OWNER Name: p.~ Phone: 6 t -7,0 ~ 1172 Add; ass / City / Zip; 13 o* S',r7 CONTRACTOR Name:.MILBERT COMPANY INC.dba CULLIGAN WATER Address: 1801 50"' ST EAST City IN M. GROVE HGTS State:' MN Zip: 55.077 Phone: 651 •:451-2241 Contact BILL•MILBEifff. Email: TYPE OF WORK _ New eplacement _ Repair _Rebuild _ Modify Space Work In.R.O.W. Description work:.. PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrlgatlon RPZ PV13) Add Plumbing Fixtures Main LoWer Level) Septic System Water Turnaround _ New -Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation'(inclddes $5.06 State Surcharge) t $55.00 Add Plumbing Fixtures, Septic System Abandonment. Water Tumaround* (includes $5.00 State Surcharge) 'Water Turnaround (add $166.00 if a 5/8' meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEES $ CALL BEFORE YOU Did. 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.oro I hereby admowledge that this in0mador b complete and accurate; that the work win 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 wok win be in accordance with the approved pla j i the case of work which requires a raviow and ap/p I of p s. x kel2V---~.- • xW Appli a s Pfinte_ d Name App cants.. ignature T ~ F M r at qe r c . Review,1,e.d B U at 071 bpwfrW 6t.y!'~S.C{' J h de r, i Q~. M , • 1 PERMIT City of Eagan Permit Type:Building Permit Number:EA154412 Date Issued:03/20/2019 Permit Category:ePermit Site Address: 1208 Carlson Lake Lane Lot:022 Block: 003 Addition: Wilderness Park PID:10-84250-03-220 Use: Description: Sub Type:Windows/Doors Work Type:Overhead Garage Door Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 1,500.00 Fee Summary:BL - Base Fee $1500 $62.50 0801.4085 Surcharge - Based on Valuation $1500 $0.75 9001.2195 $63.25 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 - Gary Tstes P Stanull 1208 Carlson Lake Lane Eagan MN 55123 (651) 324-4876 Twin City Garage Door Co 5601 Boone Avenue North Minneapolis MN 55428 (763) 533-3838 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA160583 Date Issued:03/23/2020 Permit Category:ePermit Site Address: 1208 Carlson Lake Lane Lot:022 Block: 003 Addition: Wilderness Park PID:10-84250-03-220 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner 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 - Gary Tstes P Stanull 1208 Carlson Lake Lane Eagan MN 55123 Golden Valley Heating & Air 5182 West Broadway Crystal MN 55429 (763) 535-2000 Applicant/Permitee: Signature Issued By: Signature r For Office Use /J' A� VC/ 4 'ø tq E AGA N Permit Fee: t Lk ' v° E�CE�VE y._ b Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 m ,- Z i Staff: buildinginspections(a�cityofeagan.com r , ,� v 2020 2020 RESIDENTIAL BUIL ING PERMIT. APPLICATION Date: 4/8/20site Address: 1208 Carlson Lake Lane Unit#: Name: Gary & Dona Stanull Phone: 651-324-4876 Resident/ 1208 Carlson Lake Ln Owner Address/City/Zip: P r/� IA licant is: Owner Contractor ✓ i n 7)P-- demo r : 1 � J demo existing deck build new 11x14 use existing footings and build✓✓✓aad`dditional 13x16 deck with new helical footings Type of Work Description of work: Construction Cost: 14036'43 Multi-Family Building: (Yes /No ✓ ) Company: Home Pro America, LLC Contact: Matt Lundquist Contractor Address: 22516 Natchez Ave Cly: Lakeville State: MN Zip: 55044 Phone: 612-470-6677 Email: mlundquist©homeproam.com Lead Certificate#: NAT F182108-1 License#: BC716807 If the project is exempt from lead certification, please explain why: house was built after 1978 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: Fire Suppression 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-.ubllc if ou rovide .ecific reasons that would .ermit the Ci to conclude that the are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. 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.qopherstateonecall.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_; Kti -rmit; that the work will be in accord nce with the approved/ plan in the 'case {of work which requires a review and approval of pl..-. Applicant's Printed Name Ap! 'ant's Signa jag CA i sal 2.-/q1)/6 2-n- /4 Pi 12-/ DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration (Single Family) XSingle Family _ Garage _ Porch(4-Season) Exterior Alteration(Multi) _ Multi K Deck _ Porch(Screen/Gazebo/Pergola) Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPES _ New Interior Improvement Siding Demolish Building* Addition Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair Windows _ Demolish Foundation XReplace Repair _ Egress Window Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION _ Valuation G/ C.00 Occupancy 442-(..-/ MCES System Plan Review Code Edition 2,o1.O,M,A)2(. SAC Units (25%_ 100%/c) Zoning iZ—1-- City Water Census Code Stories Booster Pump #of Units Square Feet 3 yp PRV #of Buildings Length Fire Suppression Required Type of Construction Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: X Footings(Deck) Final/C.O. Required Footings(Addition) X Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood Roof:_Ice &Water _Final Pool: _Footings Air/Gas Tests Final )( Framing 30 Minutes 1 Hour Drain Tile Fireplace: Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall: Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: --) , Building Inspector RESIDENTIAL FEES (� Base Fee (2-e 7 l a. C� " u� I L r ii __ Surcharge 1 Plan Review r (� I MCES SAC t) /te(,.) J .ej 0 et,- City SAC d Utility Connection Charge / �,/ S&W Permit&Surcharge 1 X 2b = '46( 2 r sy U S! Ft: Treatment Plant Radio Meter Read �/ p Copies (05 IAF- K 4z0 = S 6;C�0° TOTAL Page 2 of 3 - - Certifigate for: / 0 ' ARL( v( b9/ '' IA. �' /4L Arnold Carlson Svend Peterson lib,l, 4701 West 110th Street Bloomington, Mn. 55437 DELMAR H. SCH WAN Z LAMOSURVEYOR Rogistorfid Undo,Laws of The Stats of Minn•iota 25TS-145TH STREET W.- SOX M ROSEMOUNT,MINNESOTA 66068 PHONE 812 423-1788 SURVEYOR'S CERTIFICATE 3 6 E in on N 6a°A� Oaso °o z 30„ Og LOT Z 2 �tg 4 �ti O, 112.8 . \O 4A`• �O°6. /P .S �ao.3 i o .......----.0 d( Y a \ 5 °G Os .1.0 .,£ �`- 05d Ort l � 101\ric:\ ` rfr '��° ` • N�'h Oe 7- '-yrs1J 92\o\ .o bza �° z6 SCAL : 1 inch - 50 feet X..SpA ra9.es Elevations shown are existing TOP NUB • roar Drainage utility easement . Proposed garage floor elevation fP I hereby certify that this is a true and correct representation of Lot 22,. Sleek 3, WILDNESS PARK ADDITION, according to the recorded plat thereof, Dakota County, Minnesota. Dated: May 30, 1979 House staked and elevations shot August 12, 1986 MINNESOTA REGISTRATION NO.81326 PERMIT City of Eagan Permit Type:Building Permit Number:EA167128 Date Issued:02/24/2021 Permit Category:ePermit Site Address: 1208 Carlson Lake Lane Lot:022 Block: 003 Addition: Wilderness Park PID:10-84250-03-220 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. We encourage you to retain an electronic copy of photos until the project passes a final inspection. *Roof permits issued between December and March will be inspected in the spring or when weather warms up. 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 - Gary P & Dona M Tstes Stanull 1208 Carlson Lake Ln Eagan MN 55123 Northface Construction Llc 657 Main St NW, Suite 90 Elf River MN 55330 (763) 433-2269 Applicant/Permitee: Signature Issued By: Signature