1284 Carlson Lake LaneCITY„OE.XAGAN WATER SERVICE PERMIT
3795 Pitot Knob Road PERMIT NO.:
Eagon, MN 55122 DATE:
Zoning: No. of Units: '
Owner: a.'.':. - -
Address:
Site Address: ? ?'•?'?? '?'
Plumber:
Meter No.: Connection Charge:
Size: - Account Deposit:
Reader No.: Permit Fee: '
I agree to eomply with the City of Eogan Surchurge:
Ordinanaes, Misc. Chorges:
Tatal :
BY Dote Paid:
Date of I nsp.: I nsp.:
CITYo.C?F EICGAN
3795 Pilot Knob Rood
Ecgan, MN 55122
Zoning: -
Owner: --
Address:
Site Address:
Plumber: -?'D
1 ogree to wmply with the City of Eagcn
Ordinances.
R?
Date of Insp.:
I nsp.:- __ __
SEWER SERVICE PERMIT
PERMIT NO.:
DATE: f
No. of Units:
Connection Chorge: ? -
Account Deposit:
Permit Fee:
5urcharge:
Misc. Chorges:
Total:
Date Paid:
, CITY OF EAGAN
' -. 3795 Pilat Knob Rood
' . Eogan, Minnesota 55122
Phone: 454-8140
PLCIMBIl`':'
PERMIT No.
Date: - Receipt No.:
Single I
Site Address; Residential
- -? ? ,p 4 t.h
Lot Block Sub/Sec. Multi Res., Comm./Ind.
. ... _?- +ir'!:•.c__ . . .,
Name _ New/Alter./Repoir
c AcJdress Cost of Installotion
P3U 1_ -
City Phone: Permit Fee
T,c)uis H. Peter Co.
` IVame - 5urcharge
Address ". 74 Grand Aver, ;r
e
0
City Phone: Total . .
This Permit is issued on the express condition thot oll work sholl be done in accordance with all appiicable Stote of
Minnesota Stotutes and City of Eagnn Ordinances.
Building Official
?
:
Date: 1"k
CITY OF EAGAN
3795 Pilot Knob Rood
Eogan, Minneaota 55122
Phone: 454-8100
PERMIT
Site Address; 1284 Carlson ?'.ake Iane I
Lot Block Sub/Sec. WR 4t`
.3
No. ?
Receipt No.:
5ingle I
Residentiol x
Multi Res., Comm./Ind. I
Name =1sen FIoraeS Iru:.. - NewlAlter./Repair. '
?
Address i-'o• Sne Cost of lnstaliation
City i'al` Phone: Permit Fee 20' 00
? Name A. Binciei & 5on InC. Surchorge .50
?
Add ress 120 E. .]e- T-_
c
0
? Cify Phone: Total ??'• ?,^
This Permit is issued on the express condition that oll work sholl be done in accordance with all applicable State of
Minnesoto Statutes and City of Eagan Ordinances.
Building Official
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 18245
? PHONE: 454-8100
BUILDING PtRPAT Receipt # •
To be used foro,, * GAJtAGTs Est. Value =4.000 Date AUG 9 ?a 90
Site Address 1284 CJIRLS0n LA1CL I+N
Lot 24 Block 3 Sec/Sub. WILDERMSS RUl1 i
Name SAL'?
Address -
Phone
w ?" Name
W
?? Address
a W City Phone
I hereby acknowlege that I have read this application and state that the
information is correct and agree to comply with all applicabli'), 5tate of
Minnesota Statutes and Citypi Eagan Ordinance!5w _. '
5ignature of Permitee' A Building Permit is issued to: CHAPJM KUCKLER
on Ihe express condition that all work shall be done in accordance with all
applicable State of Mfnnesota Statutes and City ot Eagan Ordinances.
Building Ofticial
DFFICE USE ONLY
Occupancy ?l FEFS
Zoning _
(Actual) Const - Bldg. Permit 63.00
JAllowable} - Surcharge 2.
# of Stories
Length q? Plan Review
Depth -14' SAC, City
S.F. Total _
SAC, MCWCC
S.F. Footprints -
On Site Sewage _ Water Conn
On Site Well Waler Meter
MWCC Syslem xx
Water
City ? ?t• ?Posit
PRV Required - S/W Permit
Booster Pump - S/W Surcharge
Trealment PI
APPROVALS Road Unit
Planner - Park Ded.
Council ?
e
BIdg.OfL _ Copies
65,30
Variance - TOTAL
Permit No. Permft Holder Date Telephone #
WATER
SEWER
PLUMBINr
H.V.A.C.
ELECTRIC
Inspection Date Insp. CommeMs
Footings I ? • Z ? ?s
Foundation
Framing
ROpling
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Fnal Plbg.
Const. Meter Plbg. Inspector - Notify Plumber
EngrJPtan
Bldg. Final
Deck Ftg.
Declc Fnal
We0
Pr. Disp.
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 59122
PHONE: 454-8100
BUILDING PERMIT ReceiPt #
To 6e used for . ir'? _... i-t:i.?. :_ ti.'•T+;,. Dete '•kf?
I
Site Address 1404 ?. ?? a i svs? a.ai?e t.u
? `.? 4,'"rl 4 i21
Lot 6!ock Sec/Sub. `-
Porcel # --
a Name 2:: i 3 Tt2
W
z Address
0
i^:... oL,.__
, o Name Ti LSeri iiOmeT-IttC.
oQ Address 677 `.n. ?nr•! ] ing AYe.
u
10:- r.... 5t. P813 f oi.,...., b98-5501
Nome _
Address
Erect p
Alter ?
Repair ?
Enlarge ?
Move ?
Demolish ?
Grade f-1
Assessment _
Woter & Sew.
Police
Fire
Eng.
Plunner
Council
N? 4297
io Occupancy j
Zening
Fire Zone
Type of Const.
# Stories _
Front ft.
Depth ft.
Pees
Permit • ?`' _
5urcharge r -.
Plan check
SAC
Woter Conn.
Water Meter
I hereby acknowledge thot I hove read this application and stote that B!dg. Off.
the information is correct ond ogree to comply with a'I opplicab!e APC Total {tU3• ?31)
Stafe of Minnesota Statutes und City of Eagan Ord:nonces.
Signature ot Permittee
A Building Permit is issued to: Inc• on the express condition that
oll work sholl be done in occordance with oll applicable Sfote of Minnesoto Stotutes and City of Easan Ordinonces.
Building Officiol
PwmM # Dafe Iswed pansMtM
Plumbing J'i 7 !:v 9 &t.
Mechanicol
INSPECTIOMS ? DATE INSP. Rouph-In Finol
Footings Date Irup. Dcte (nsp.
Foundotion Plumbing
Frome/ins. Mechanical ! -f0 -
Final 7
Remorks:
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
?
N0 `
12480
BUILDING PERMIT Receipt# 4?'T,l ?
To be usad tor FAM I L Y ROOM E
$1 b, 0 OU D
t v
t
l AU(;U S'F 2 U
19 66
s
a
ue a
e ,
SiteAddress 1284 CA RL50iJ Y,AKE LN Erect ? Occupancy R3
Lot 29 elock ; Se clsub. WILDERiVESS tti3ti Remodel ? Zoning R l
Parcel No. 4 Tl: Repair ? Type ot Const yn
Addition ? No. Stories
W Name CiiAtZLES iCUCiCLER Move ? Length
?Ar? Demolish ? Oepth
o Address Int Impr. ? Sq. Ft.
City Phone 454-7148 Install ?
Zo Name- KATHY - 733-3936 ('rv)
0 a Address
~ City Phone
rc
tz = Name
'
,8 Address
x
W City Phone
I hereby acknowledge that I have read this application and state that the
information is correct and a tq.comply ith all applicable;State of
Minnesota Statutes and o gan Or inarlCds
?.
Signature of Permittee `--
CHARL ,S i{UCK.LFR
A Building Permit is issued to:
all work shall be done in accordance wfth all applic le State of Minnesot?
Buildinn nffir.ial ?
Water & Sew. Surcharge
Police Plan Revie
Fire SAC
Conn.
Council Road Unit
Bldg. Off. 5/7?86 Tr. PI.
APC Parks
Var. date Copieg
Total $182•75
on the express conditlon that
and City oi Eagan Ordinances.
I I PemiB No• I Pwmf1 HokNr I Dafe I TNsphone M 1
Commrnb
Plby.
Nty.
Htg.
Plby.
Final
Oee.
Dkp.
CITY UF EAGAN Remarks
Addition Wilderness Run 4th Addition Lot 29 aik 3 Parcel 10 84353 290 03
Owner CL)a + 1f'-`? ''•? ? ?[ Street 1284 Carlson Lake Ln. State Eagan, MN 55123
1C?t.CI?IP Y"
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
3 SAN SEW TRUNK 1973 $163.26 $8.16 za 122.46 004351 7-6-77
SEWERLATERAL 1975 716.60 71.66 10 501.62 004351 7-6-77
WATERMAIN
WATER LATERAL
WATER AREA 1977 160-00 10.66 15 149.34 004351 7-6-77
STORM SEW TRK 11-51,1 1981 2
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 210-4) j _
BUILDING PER. ,#-
sac
PARK
CITY OF EAGAN NO 18245
3830 Pilat Knob Road, P.O. Box 27-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERfI)IIT Receipt # ? ?p [/
L'" `?`
To be used foc GARAGE Esc Value $4,000 Date AUG 9 , 1990
Site Address 1284 CARLSON LAKE LN
Lot 29 Block 3 Sec/Sub.WILDERNESS RUN 4 oFFICE USE ONLv
P2fC01 N0. Occupancy M-1 FEFS
zoning
a CHARLES KUCKLER
Name (Actuaq Const Permit 63. 00
Bldg
W
3 Address 1284 CARLSON LAKE LN -
(Allowa6le)
- .
2
00
? Cit EAGAN
y Phone 454-7148 xorstodes -
Surcharge
9 , Plan Review
Length
F Name SAMF. Oepth 2? Sn0.ci
?
?a
Address
S.P.7otal - ry
?
City Phone
S.F. Footprinis - SAC. MCWCC
`N
C
? On Site Sewage _ arer
onn
Fw Name On Sile Well W
- ater Meter
'E ?O Addf05S MWCCSystem tY$_
t
D
it
A
sW City PhOne Ciyyyyter x]? cc
.
epos
PRV Required _ S/W Permit
I hereby acknowlege that I ye read Ihis application and state thal the
' Booster Pump - SM/ Surcharge
inlormation is correcl a ag?
e •to comply with all. applic I tale of
Minnesota Statutes an ib?bf- agan ?nance ' Treatment PI
Signature of Permite ?? .? APPROVALS Road Unit
A euilding Permit is issued to: CHARLES KUCKI.ER Planner - park Ded,
on the express condition that all work shall be done in accordance with all Coumil
50
applicable State of Minnesota Statutes and City
ol Eagan Ordinances. gld9 pff Copies .
1,
Building Otficial ?fiT?,O L/? J I y lyd Variance -
0
TOTAL 65.5
This reqaest voitl
18 mon[hs from .
C 44327
u v,,, c- ? ? .3l
kuY\
Req st Date
a
9
96 Fire No. ' Rouph-in Insper.tion
Re4wretl?
aYes ?NO
OReady Now
ill Notify Inspe
c-
?or When Ready
? censed ElecVical Convactor 1 hereby request ins0ection at ebove
?wner eleelrical work installed aC
Stree
[
Atldres , 80
'/or Rou(8 No. Ci?y
^
?
/
/
?el " f?/ G?CTrL !41, ?'ly ii E. Rr /TiL/
ecuon o. Township Name or No. Range No. C unty
?b-6?
OccHINT)
' Phone No.
t7i; /eV
< okle e
Po r SupOleer Address
/? A
ElecVical ConVac[or (ComDany Namel CoMractor's License No.
Mailing Address (C nVactor or Owner Making InstailatioN
a / ?
Auffio ' ed i ture IC ractor4wn a V. 1 allation) Phone NumOer
MINNESOTq STATE BOAPD OF ELECTRICITY THISINSPECTION REQUEST WILL NOT
Griggs-Midway Bld9. - Room N-191 BE ACCEPTED BY THE STATE BOARD
1821 Univarsitv Ava., St. Paul. MN 56704 UNLESS PROPER INSPECTION FEE IS
Phone I6121297.2111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION EB-W001-04
IP See inahucxions for com' 'tinp this form on Eeck of vellow copy.
(C44327 "X" 8elow Work Covered by lhis Request Gv7 93/
Fda Reo. TVpe of euiltlm0 AGDlioncea Wirad Equiumem WireA
riome Range 7emporary Serviw
.,uplex- Water Heater Liyhtiny Fixtures
Apt. Buildinq Dryer Electric HeaUn
Commercial Bldy. Furnace Silu Unlonder
InAustrial BIAg. Air Conditioner Buik Milk Tank
Farm oinei peci y Oiher ISneclfyl
t er Suecify Othe. Oth"
Compute lnspecuon fee Below
tl Fee Service EntrBncaSize N Fee Fexders/5ubfeeders 1+ Fee Circa,ts
0 to 200 qm s 0 to 30 Am s 0 to 30 Am s
Above 200 qmps 31 to 100 Amps 31 to 100 A s
Swimming Pool Above 100-Amps Above 100_Amin
Transiormers Irrigation Booms Partial.'Other Fee
Signs Spec- I is ction
$ ?
5?
TOTAL FEE
em?rks ? ? • U?
Rough-in
IJ2 Dn?
the Elechical
nspectoq hereby
certity Ihet ihe nbove
Final r inspection hes been
made.
rnls repueet v0id 18 moM-
cITr oF enGAN
e ? 3795 Pilet Kneb Road Eagan, MN 55122 H2 4297
PHONE: 454-8100
BUILDING PERMIT APPLICATION $41,000. Receipt # 579U
To ba usea Fo. Sing. Fam Uwlg, o Garg. Date April 29, 1 q 77
Site Address 1284 Cel1sOA LSkE LII Erect ? Occupancy I
Lot 29 Blotk 3 Sec/Sub. WR 4th _ qlter ? Zoning Rl
Porcel # Repoir ? Fire Zone -
Enlorge ? Type of Gonst. V
w Name Robert Galintine Move ? # Stories
3 Address Demolish ? Front 5U ft.
?
Cit Phone
Grade E]
Depth ff.
??
? Neme 'J;4l aen u.....es r..,. ApDrovals Fces
0
o? Address 627 So. Snelling Ave.
Assessmer,t
Permit 118,00 _
u? Cit St. Paul phone 698-5501 Water & Sew. Surcharqe 20.50
Police Plon check
? Name
Fw
Fire 475.00
SAC
Address Eng. Woter Conn. 230.00
L Ci Phone Planner Woter Meter 60•00
Council
I hereby acknowledge that I have read this application and stote ihat gldg. Off.
the information is correct and agree to mmply with all applicabie 9U3
5U
Stote of Minnesota $tatutes and City of Eagan Ordinances. APC .
Total
Signature of Permittee -
A Building Permit is issufa co: Tilsen Homes, IIIC, on the express condition that
oll work sholl be done (n-,accordance i all oppliwble 5 te of Minnesota Statutes and City of Eagan Ordinances.
Building Officiol
???}?
Date : -?7
BUILDZidG PERM2T P.FFLSCATIO:T
LOT 21 Cl BLOCR 3 ADDTTIO;d __ZSj.2C 'y
PAF2CEL & SECTIOT_I PIUIlBER IF UIIPLATTED
11DllRESS OF PARCEL L? F 41 l. ?Y7 ,o/
ZOedI,dG )?'l OCCUPANCY ,L USE ?'/cp-/ SG,?'"?2YP?t _ _
?'t56 ,?Co S ,
ESTIi?iP.i'ED COu.ri'
?
nT'Ms'%R Ll z TELEPHOItE iQO.
ADJRESS
C?-.
coLarRAcTOR _..e? TELEPHONE I?O. IO I?-LS?OJ
P.IlJRESS
"t:ote- Include si.ta plan, building plans, and energy calculations with thi.s
aonlication
Signed
07;2CE USE
V.A.T.,U?1^t I02.3
S&SC
i;AW_Z CoidDTEC^IOcI
Wa2'rFi METER 1pd
BUILDING PEIiI-iIT FBr'
uiJRCHARGE FEE a O
FLt117 CF.=K FE;
PAFtK DEDICATIO:d PEE "
OTFiER
TOTIiL* ?a/
PFPROVALS:
ASSE5^a9Et:T CLERI<-J'?
k IBi7ILpII4G DEPT. POZICE DEPT.
?7F1TSR E SLi.tER DiPT. FI?L DEPT.
PARK DEPT.
v??,?
_ • ? •.? ?
I?
I ,
?
v?
Q
a (
`
(y
V
. AeoAERTY LwE
?
lU
3d f 4---Zo
-247
L%NE
.?
Q
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i
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LlNE
I
E:i
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lddc,&tozrn X?A, X ?
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YRON"f',_?ROPF_f+LT_Y._. LING`
PLC] 1 -PL A N
CITY OF EAGAN Np p
-- 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127 ??? o?
y PHONE: 454-8100
BUILDING PERMIT Receipt # 12/ L(2?
To be used for FAMILY ROOM Est. Value $16,000 Date AUGOST 20 19$_6
,
SiteAddress 1284 CARLSON LAKE LN Erect ? Occupancy R3
Lot 29 Block 3 Sec/Sub. WILDERNESS RUN Remodel ? Zoning R1
Parcel No 4TH Repair ? Type of Const. {J.n
. Addition 0 No.Stories
a Name CHARLES KUCKLER Move ? Length
i
S?E Demolish ? Depth
o Address Int. Impr. ? Sq. Ft
ciry phone 454-7148 hsta11 ?
olName KATHY - 733-3936 (W) APProvals
$ i Address Assessment
m
Ciry Phone Water & Sew.
t a
W Name
Address
a W Ciry Phone
I hereby acknowledge thaf I have read this application and state tha(tthe
information is correct and a?e complyyy/// with all applicabl?t e of
Minnesota Statutes and i a an O in . ,
tY 9 ?9
Signature oi PermiHee
CHARLES KUCKLER
Police
Fire _
Eng.
Planner
Council
Bldg. Ofl. 5/7/ 8 6
Var.
Permit Y11 V. J V
Surcharge 8.00
Plan Review 58.25
Water Conn.
Water Meter
Road Unit
Tr. PI.
Parks
Copies
Total $182.75
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applic 1 State of I?Ainn t. tutes and Ciry of Eagan Ordinances.
Building ORicial ??
;
1986 BOILDING PERNIIT APPLICATIOH - CITY OF EAG9N
BiOTS: ALL CONTRACSOHS MUST BE LICE9SSD HITH THE CITY OF EAGAN
SIBGLE FAlIILY DAELI.IBGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
MOLTIPLE DiiSI.LINGS - HESIDENTIAL RENT9L D6ITS FOH SALS ONITS
INCLUDE 2 SETS OF PLANS, CfiRTIFICATE OF SIIRVSY - CHIiCg iiITH BLDG. DEPT.,
1 SET OF SNERGY CALCULATIONS
COlQIL+RCIAI:
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 116•00}
1 SET OF SPECIFICATIONS AND 1 SET OF 8•50+
ENERGY CALCULATIONS, 58•25+
$2,000 LANDSCAPE HOND 182•75#
AA5ru . ,. ... ...
To Be Used For: ?i`? ' ?ra.i Valuation: Date: ?O
Site Address /v'1(?y7
Lot ??Block?
Parcel/Sub
Owner
Address 1Q?? -r (Sf},Q?S?9r ??'i(?/
City/21p Code A't)
Phone :?Ly 71 yd
Contractor C5E.lf''
Address
City/Zip Code
Phone
Areh./Engr. _
Address
City/Zip Code
Phone 0
Erect
Remodel
Repair
Addition
Move
Demolish
Int.Zmpr.
Install
Oecupancy JP-S
Zoning
Type oF Const
1F of Stgries
Length
Depth
Sq Ft
AernovaL.s FsEs
Assessments Permit
Water/Sewer Sureharge
loo
Po13ce Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Couneil ? Road Unit
Bldg Off Treatment P1
APC Parks
Varianee Copies
?OTAL
HOIE: ADDRESSBS FOR CORNEB LOTS - CONTRACYOR/HOMEOtiNEH HIIST DESIGNA?8 i1HICH ADDRESS
IS D&SIESD. NO CHANGES NILL HE ALLOiiED ONCS BDILDING PEAMIT IS ISSQED.
`ri 5-0 =? Z036536
,-
7SxSjJIZ?I(»
?
?
(7 /,lIs ? 1 ?
? /,/y-C)
:
1990 BIIILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL iINITS
_# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQiIESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS- CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO GHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMSER.
AT"CA4-"Qr-?
To Be Used For: Ut??-4r CADD,Valuation
Site Address
Lot 10 Block '
Parcel/Sub
Oomer ?4kIr-S 6
Address Zod 1/(l
City/Zip Code
Phone
Gontractor
Address
City/Zip Code
Phone
Arch./Engr. _
Address
City/Zip Code
Phone #
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F
OFFICE USE ONLY
M-I
-i
2'f"
On site sewage_
On site well
MWCC System ?
City water
PRV
Booster Pump _
APPROVALS
Planner
Council .
Bldg. Off. pe>
Variance
FEES
B1dg. Permit
Surcharge
P1an Review
SAC, Gity
SAC, MWCC
Water Conn
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Copies
SUBTOTAL
Penalty
TOTAL
?'3. Oo
2,00
156
AU6 U 5 RECD
?
L'I ?? Date :
, . R
V Al. ? a. Nt iD /J
ool I
--• ?• •• ?
?,1 X Z:q = 21 ? x1s " 3 2L[0 0tz cLDoa
? ? p•?
? 63•00+
I 2•pp+
0•50+
65•50*+ ,
e
}
?
I ?
I ,
O
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i
I I O ?
Z
f G /
ti
1? r
?
f'.e'?PE,e ry
L lNE
,s?ERRL topoOEATY LvE
?
?
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36
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LoT M -5Lnck M
° W ra_oNr__?gaaF?rY ._?i?t ?
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I
UN?
m
VDLOT t?LAN
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Kno6 Road, Eagan MN 55122
Telephone # 651=675-5675 FAX # 651-675-5694
95`1o,?O
New ConsWction Reauicements
RemotleVReoair Reauiremenfs .-
?itfe??4ae?ml¢
3 registered site surveys showing sq. ft. of lot sq. ft. of house; and all roofed areas 2 copies of plan Ced of Suresy RVal
(20%maximumbtcoverageallowed) isetofEnergyCalculationsforheatedadditions Tre6'p2s'pIa0Reodr _P!
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for addifions & decks TrgeP-resggquaed Y N
1 set of Energy Calculatlons Addrtion - indicafe Aoo-sife sep6'c sysfem qn si`6 S?b'tic System
3 copies of Tree Preservation Plan if lot plal!ed after 7/1193
Rim Joist Detail Optlons selection sheet (bldgs with 3 or less unAs
Date Z
/ 3
Site Address IA19 ?J
/
cv-? SU h[/.? Ke
Construction Cost
(? S? UniUSte #
Description of Work /(1 Ct R'2 ./I,26
Multi-Family Bldg _ Y? N Fireplace(s) /-? 0 _ 1 _ 2
Property Owner ?? r \ 1 ? ?IJLI?-,Q? Telephone # (65k
Contractor G? Y1 ' ?N1?,f
Address '
State r r`yL A n IV
Zip ( c;? City ?iM
Telephone #()&'?) •- V
COMPLETE THIS AREA ONLY IF
Energy Code Category Minnesota Rules 7670 Cateeorv I
(J submission type) • Residential Ventilation Category 1 Worksheet
Submitted
• Energy Envelope Calculations Submitted
A NEW BUILDING
Minnesota Rules 7672
. New Energy Code Worksheet
Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone #(
Telephone #(
U T
I hereby apply for a Residential Building Pernut and acknowledge that the informati n is complete and acc rate;
that the work will be in conformance with the ordinances and codes of the City 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
approval of plans.
N If so, 25% plan review
?I `
App icanYs Printed Name Applicant's Signature
?5a59
2004 RESIDENTIAL BUII.DING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
?ftr-i 0_a 0
New ConsWdian Reouirements RemodeVReuair Renuirements
3 registered site surveys showing sq. R of bt, sq. R of twuse; and all roofed areas 2 copies of pWn 0f
(20% maximum lot coverage allowed) i set of Energy Calculations for heated additlons
2 copies of plan shaxing beam & window sim; poured found design, e[c. 1 site survey for additions & dedcs i Pr Re?u?? ? Y? N
isetofEnergyCalwlatians Addifion - irrdicateilonsifesepticsystem
3 copies of Tree Preservatlon Plan if lot platted after 711193
Rim Joist Detail Optiore selection sheet (bldgs witlh 3 or less unih
Date
Site Address Constructlon Cost
4A/Z-E LQ NX UniUSte #
Description of Work 5"7' L? L `-? t? O N-Gi
Multi-Family Eldg _ Y x N Fireplace(s) _ 0 _ 1 _ 2
Property Owner C ?1 q Rd ? f A'A / 4y k+IG /l fP RTelephone # ((o.$% )
Contractor 41 3 gie 7
address 2T20
State r%V1 i W Ls9RP4rRr-,7-E!-R Av&
ci Zip ?l '2 1 Ciry 54t
Telephone X P.4q-c
4r.r^ /9? //
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Iviinnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Enefgy Code Category . Resfdential VenUlaUon Category 1 Worksheet • New Energy Code Worksheet
(J suhmission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Telephone #(
Telephone #
Sewer/Water Contractor Telephone # nT vT 0 T N
I hereby apply for a Residential Building Permit and aclrnowledge that the infox*jion is complete and apcurate;
that the work will be in conformance with the ordinances and codes of the Ci yW°EWU A-a of MIN
Statutes; I understand this is not a pernut, but only an application for a perit, and work is not to start without a
pernut; that the work will be in accordance with the approved plaplin; the c s of work wjiiFh requires a review and
approval of plans.
57rP11?A,A A
ApplicanYs Printed Name
I
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd 4 °� Permit Number: EA149333
e, E AG
ifk
Eagan,MN 55122 Date Issued: 05/17/2018
(651)675-5675 Permit Category:ePermit
www.ci.eagan.mn.us
Site Address: 1284 Carlson Lake Lane
Lot: 029 Block: 003 Addition: Wilderness Run 4th
PID: 10-84353-03-290
Use:
Description:
Sub Type: Windows/Doors Construction Type:
Work Type: Replace
Description: One Window/Door
Census Code: 434-Residential Additions,Alterations Occupancy:
Zoning:
Square Feet: 0
Comments: Improvements to the home require smoke detectors in all bedrooms.If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes(Minnesota
Fee Summary: BL-Base Fee$1500 $62.50 0801.4085
Valuation: 1,500.00 Surcharge-Based on Valuation$1500 $0.75 9001.2195
Total: $63.25
Contractor: - Applicant Owner:
Renewal Andersen Charles Kuckler
1920 County Road C West 1284 Carlson Lake Lane
Roseville MN 55113 Eagan MN 55123
(651)264-4777
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