4228 Carlson Lake Lane NCITY OF EAGAN . 1. 6 4 "1 8
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT
To be used for ???-?' •
Est. Value $i s 0W
Receipt #
1989
Site Address 4IL 111-1 P` I.AICE L11
Lot `- Block b Sec"Sub. WALDERNIISS RtfN
Parcel No. ?
W Name •?0?f?] EKFkS
3 Address 4225 LAKi; Lt+,
0
City OAC" Phone 1J41-'r300
,o Name S?
z?
?Q Address
? City Phone
Name _
Address
Phone
I hereby acknowlege that I have read this application and state that the
intormation is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permitee
A euilding Permit is issued to: ?dit?? F?'•x?
on the express condition that all work shall be done in accofdance with all
applicable State of Minnesota Statules and City of Eagan Ordinances.
Building Official
Occupancy
Zoning
(Actual) Const
(Albwabie)
# of Stories
Length
Depth
S.F. Total
S.F. Footprints
On Site Sewage
On Slte Well
r,+wCC Systern
City Water
PRV Required
Booster Pump
APPROVALS
Planner
Council
Bldg. Off.
4ariance
OFFICE USE ONLY
lkftb
1242
FEES
Btdg. Permit
Surcharge
Plan Review
SAC. City
SAC, MCWCC
Water Conn
Water Meter
Acct. Deposit
S!W Permit
S W Surcharge
Treatment PI
Road Unit
Park Ded.
Copies
TOTAL
26XD
.50
26.50
Permit No. Permit Holder Date Telephone #
WATEfl
SEWEF
PLUMBING
H.V.A.C.
ELECTRIC
Inspection Date Insp. Comments
Footings 1
Foundation
Framing
Roofing
Rough Pibg.
Rough Htg.
Isul.
Fireplace
Fnal Htg.
Finel Plbg.
Const. Meter Plbg. Inspector - Notily Plumber
Engr.lPlen
Bldg. Final
Deck Ftg.
Deck Final
weli
Pr. Disp.
?
TION
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITEADDRESS:
! t? 1: ?, Ei1_ u(. h:
A1? 1•,11N t AF. i i ANt N
i?rl ??t f.Wl •. , tc??Pl ??fll
? PERMIT SUBTYPE:
i 101
I I 1. 1 1 ,}F I p1l;
?I I
{;1 PIRbr'.'.. {.'iMI I t.li,
?
CCORD
PERMIT TYPE:
Permit Number: " •' ' ?' 6
Date Issued: "`• ' •' ?' APPLICANT:
;Ij,t I !. . I'fi I 1'!1l I I fli,
i n ! .' ; ?i .' % 11 3 j
TYPE OF WORK:
i,; [I'i i ? f [IN
ht r•A tf?
';1 Otl?M Cil1MlAfii N!O !°Uf '
?
?
Permit No. Permft Holder Date Telephone k
ELECTRIC
PLUMBING
HVAC
Inapectlon Date Insp. Commenta
FOOTINGS
FOUND
FRAMING
ROOFING L '
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST •
BLDG FINAL
BSMT R.I,
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN Remarks
Addition Wilderness Run 5th Addition Lot 5 Rlk 6 Parcel 10 84354 050 06
Owner 5treet 4228 No. Carlson Lake Ln. scate Eactan. MN 55123
improvement Date Amount Annual Years Payment Receipt Date
STREET SUR F.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 $132.60 $6.63 20 PAID
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA connecti( n 1/75
STORM SEW TRK d ?y ?3-
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. $320.00 747 7-22-75
BUILDING PER. *3719 747 7-75
sAC $425.00 747 7-22:.-75
PARK
_ YILLAGE OF EAORN
3795 Pilot Knob Road
Eogon, MN 55122
'Loning: Rl
WATER SERVICE PERMIT
PERMIT NO.: 1829L
DATE:
No. of Units: 1 OWnei: ' 7 Hn C TIH' sen Ada[ESS:
Site Addre 472o . r 1 aon 7?k@ Ln L586 47R5
'I- 4
Plumber:
Reader No.: G'' --?'
c
1 ogrea to comply wifh the Village ef Ea9on
O.a
I )ate of Insp.:
Connection Charge: 320.00 pd
Account Deposit:
Permit Fee: 10.00 Pd
Surcharge: .50 pd
Misa Charges: 60.00 pd
Total:
Date Paid:
Insp.: -
PERMIT
C
SEWER SERV
Y4!l,A3EAFEAOAN SB
Z
3795 Pilof Knob Rood PERMIT NO.: 9?16/75
Eagan, MN 55122 DATE:
Zoningtj _ No. of Units: I
Owner:
Addresa:
?,,, r Sn?waS
Site Addm6s:
Plumber:RPY-ROr
I oq.as fo comply wifh Me Vlllago of Eaqae Connection Charge:425 00 Pd
Ordinances. Aceaunt Deposit. 10.00 P?-
Permit Fee: P
Surchazge:
Hy. Misc. Chazges:
Date of lnsp.: Total:
Inep.: Dace Paid:
7 RESIDEPITIAL
BUILDING PERMIT APPLICATION
cirr oF eacnri
3830 PILOT KNOB RD, EAGAN MN 55122
851-881-4675
New Conetruction Beauiremenh
. 9 replstered sMe surveys showing sq. it. ol bt, sq, il. ot Muse; enU all roofed areas
(20% maximum bt coverege allowed)
. 2 copies of plan showing Gesm & window saes; poured fouM tlesign, etc.)
• 1 set of Energy Calculatbns
• 3 wDles M Tree Praservetlon Plan'rf bt platled fltter 7l1/93
• Rim Joist Detail Optbns seleclbn sheet (bltlgs with 3 or less unBS)
DATE ?E /? U Z_'-
ZIP ='?'Z
51TE ADDRESS MULTI-FAMILY BLDG _Y _ N
NPE OF WORK FIREPLACE(S) _ 0_ 1 _ 2
APPLICANT
STREET ADDRESS 1?701/ ?//U?U7?Ll/L JIO CITY?
TELEPHONE # CELL PHONE # 5?401? FAX #
/l 3- 7 5
PROPERNOWNER /"'!5%24? iELEPHONE#
------------------------------------------------- -------- ------------ --------- ---------------
COMPLETE THIS SECTION POR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ D
(4 submission ty{>e) . Residential Ventilation Category 1 Worksheet Submitted •
• Energy Envelope Calculations Submitted
Mumbing Conhactor: ___
Plumbing system includes:
Mechanical Conhactor:
Mechanical system includes:
Sewer/Wcter Contractor:
Air Conditioning
Heat Recovery System
Phone #
Fee: $70.00
I hereby acknowledge that I have read This application, state That the informatio is correct, gcil agree to comply
with all applicable STate of Minnesota Stcrtutes and City of Eagan Ordin7%
Signature of Applicant
OFFICE USE ONLY
_ Water Softener
_ Water Heater _
No. of Baths
VALUATION T ??6(Z?
RemotleNieoair Reaulremente
• 2copiesoFplen
• 1 setWEnergyCabulationsbrheate4atlGAbns /
. lsilesurveyforexlerioradtlNions&decks ',S
/t _
• Indlcate il home serveA by septic system for additbns G4s,.,??,
_ Phone #
Iawn Spiinkler
No. of R.I. Baths
Phone #
*S%7Z
s 11D2t
Fee: $90.00
Certiflcates of Survey Received _ Tree Preservation Pian Received _ Not Required _
Updated 4102
PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMITTYPE: BuzLozNG
E2g8n, Minnesota 55122-1897 PermitNumber: 027666
(612) 681-4675 Date Issued: 0 5/ 2 3/ 9 6
SITE ADDRESS:
4228 CARLSON LAK.E LANE N
LOT: 5 BLOCK: 6
WILDERNESS RUN 5TH
P.I.N.: 19-84354-050-06
DESCRIPTION:
STORM DAMAGE-NQ FEE S
ermit Type 9?{i?hE?
q,rk Type REPAIR
434 ALT. RE5IDENTIAL
lp ?a
idt?C ?,? Nl?" at? w t''v, is a'°?`s aa 'rs
? ,si zs 4L< Tf ? t mm y ?a& v?a^. ?d ts? bi at
-w?
i?
REMARKS:
ROOFING
FEE SUMMARY:
CONTRACTOR: - Applicant - sT. Lzc.OWNER:
QUALT7Y CONTRACTING 14277733 0007035 EKERS JOHN
11412 W RIVER RD 4228 CARLStlN LAKE LIY N
CHAMPLIN MN 55316 EA6AN MN
(612) 427-7733 (612)688-7554
?'• _ „:
f(gla ISBL BY: IG TUR?
RESIDENTIAL BUILDING
Pertnit Application
City Of Eagan
3830 Pilot I{nob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
NewCOnsWClionReauiremenls RemodellReoairReauirements OKce UseOnlv
3 registered site surveys showirg sq. ft oi l04 sq. R of house; and all roofed areas 2 copies of plan Cert of Survey Recd
(20% maximum lot average albwed) 1 set of Energy Calculadons for heated addNOns Tree Pres Plan Recd
2 copies of plan showing beam 8 window sizes; poured found desgn, etc. 1 site survey for additions & decks Trce Pres Not Reqd
1 set of Energy Calculatbns Add'rtion - indicafe i/ on-site septk system _ On-site Septlc System
3 copies of Tree Preservation Plan if lot platted after 711/93
Rim Joist Delail Options salection sheet (bldgs with 3 or less units
Date 9 /I I
+
/ ?U 1 Construction Cost
/
r/
? e
Site Address ? L C O CA h' LS dN UniUSte #
LaQ. LI I, a,
Description of Work
Multi-Famil
Bld YSri 2
Fi
l
0
1
y
g _ ace(s) _
_
_
rep
Property Owner NOELQ h d R
_ _ _ L{ _!\ C( V! 71 Telephone #( IDS I)`? ? J- I
rE C
T ?
Contractor &n
-a1
t (,Q
?'?'f j y?rJOl?/ -?, Sldlll(A
.
_
Address 105 n
0 L? 1Q d City
(, UT k
State G
Zip ??_ Telephone #(q 5 2) O? ??
COMPLETE THIS AREA ONLY IF
Energy Code Category Minnesota Rules 7670 Categorv 1
• Residential Ventilafion Category 1 Worksheet
(J submission type) Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber
_? ?t, ??
Mechanical Contractor I!?t? ?L" _,.-.
SewedWater Contractor
A NEW BUILDING
Minneso[a Rules 7672
• New Energy Code Worksheet
Submitled
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building 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 State of MN
Statutes; I understand this is not a permit, but only an applicarion 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.
,,IhE )?tAr?N? -
ApplicanYs Printed Name
,P , CA -?-
Applicant's Si ature
BUILDING PERMIT
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
N° 16498
Receipt # C --'2 C) -11
Date MAY 19 , 19 _$2_
To be used for DECK Est. Value $1, 000
Site Address 4228 N CARLSON LAKE LN
Lot 5 Block 6 SeGSub. WILDERNESS R rN
Parcel No. STH
w Name .70HN EKERS
o Address 4228 N CARLSON LAKE LN
City EAGAN Phone 941-3300
Name 5AME
Address
City Phone
ww Name
? ; Address
aw City Phone
I hereby acknowlege that I have reatl this application and state that the
infortnation is correct and agree to comply Ii[h all applicable Sta[e of
Minnesota StaNtes and Ciry? f agan Or i?rillies
.
Signature of Pertnite
A 8uilding Permit is iss d.TOHN EKERS
on the express condition tfiat all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Olficial -?.?d?? ?
OFFICE USE ONLV
Occupancy - PEES
Zoninq -
(ACNap Const - Bldg. Permil 26•01
(Allowabie) - Surcharge •50
# of Stories -
Length ]-42C,].6 Plan Review
Depth 1242 SAC, Cily
S.F.TOtaI - SAC,MCWCC
S.F. Fooryrints -
On Site Sewage _ Water Conn
On Site Well - Water Metar
MWCC System -
Accl. Deposit
Ciry Water -
PRV Required - S/W Permit
Booster Pump - g/W Surcharge
Treatmenl PI
APPROVALS Road Unit
Planner - park Ded.
Council -
BIdg.OfE _ Copies
26.50
Variance - TOTAL
.
;
1989 BIIILDIAG PERHTT IPPLICATION
CTTY OF EAGAN
14qqj
SINGLE F9MILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED 3ITB SDRYEYS
1 3ET OF ENEAGY CALCS.
MOLTIPLE Di1ELLINGS
2 3Sf3 OF PLAN3
6EGISTfiAED 3ITE SIIRYET3 -
(CHECE IiITH BLDG DIV.)
1 SEf OF F19ERGY CALCS.
C0I8MERCIAL
2 SETS OF ARCHITECTURAL
8 ST60CTQRAL PLANS
1 SET OF 3PECIFICATIONS
1 SET OF ENEAGY CALCS.
MULTIPLE DHEL.LINGS RENTAL DNITS FOR SgLE DHITS 1 OF UNIT3
HOTEt ADDAES3ES F08 CORNEH LOTS - C0I9TR9CTOA/HOMEO1dRER MOST DF.32GN4TE WflICS 1DDRESS
IS DESIRED. AO CHANGFS NII.L HE ALLOIiED 0NCE HOILDING PERMIT 13 I3SQED..
3EWER 6 A9T£R PERMIT fEES AND ACCOUNT DfiPOSIT FSFS WILL BS INCLODED itlTH THE HOILDINt3
PERMIT FEE. PAOCFSSIIdG TIME FOA SEWER ARD li9TEA PEIUlI75 IS TiiO DAYS ONCE A PfiAMIT HAS
BEEN COMPLETED INDICATIAG • LICEN3ED PLOlIDER.
PENALTY 9PPLIFS FIFIEN: PERMIT IS NOT P9ID FOR IN SAME MONTH IT IS REQUESTED.
LOT CQANGE IS REQUESTED ONCE PERMIT IS ISSIIED.
7 1989
`1
To Be Used For: PE GK Yaluation: Date: 14Ny l7 , /f8
Site Address 112 2$?Carlsorr LakE Ln
Nb
Lot 6 Bloek ?
Parcel/Sub
Owner Jo t+ /)
/bao-
Occupaney
2oning
Actual Const
Alloxable
E of stories
Length /y X 16'
DEpth 12,X IZ'
S.F. Total
Footprint S.F.
Address yZZ 9' Curlson Zx k P Lh NL
City/Zip Code ?aq a.n ? SS I Z 3
wor k ?
?/-/o/?? 688-7SSY
Phone 9y1-3300
Exr 267
Contraetor
Address
City/Zip Code
Phone
Arch./Engr. _
Address
City/Zip Code
Phone #
On aite sewage
On aite well _
MWCC System _
City water _
PRV required _
Booster Pump _
iPPAOVALS
Planner _
Couneil
Bldg. Off.
nariance
wm
Bldg. Permit .?b.oa
Surcharge • So
Plan Aeview
SAC, City
SACO MWCC
Nater Conn
Water Meter
Acet. Deposit
S/A Permit
S/fl 3urcharge
Treatment P1.
Road Unit
Park Ded.
Copies 56-
3DBTOT6L
Penalty
i0T6L
426.s'b
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M
1
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?PLOT `P L 44
JL CITY OF EAGAN
IL 3830 PILOT KNOB RD - 55122
Lt 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Conslruclion Reauirements
RemodeVReoair Reauirements
? 3 registered sHe surveys ? 2 eopies of plan
? 2 wpies of plans (include beam & wfrMow sizes; poured fnd. design; ete.) ? 2 site surveys (ezterior additions & decks)
? 1 energy calculations , ? t energy catculations for heated additions
? 3 wpies ot hee preservatfon plan N lot platted efter 7/1/93
required: _ Yes Na
DATE: S? f Ic ?i CONSTRUCTION COST: ,,,? 7 7?/
DESCRIPTION OF WORK:
STREETADDRESS:
LOT ? BLOCK
?
SUBD./P.I.D. #:
PROPERTY Name: ?lli'p S 79 ?.%-??_ Phone #: & 79' 75?
OWNER """
Street Address- Ca r ?S o'?- /,a ler- Z- w ?
City: State: 2!:?c°-- Zip:
CONTRACTOR Company:lo%cc a/.¢?( vacA,r-? Phone#: -?7-12 7-77
Street Address: (.?l`riJrKyLicense #: ?03Sr
City: /1 ' State: 2L --,- Zip: S -L3( ?v
ARCHITECTf Company: Phone #:
ENGINEER
Name: Registration #-
Street Address,
City: State: Zip:
Sewer 8, water Iicensed plumber:
change are requested once permit is issued.
Penalty appiies when address change and lot
I hereby acknowledge that I have read this application and state that the infortnation is correct an agree to compl with all
applicable State of Minnesota Statutes and City af Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Ves
17?
No
Tree Preservation Plan Received Yes No
.
CITY of EAGAN
BUILDING PERMIT
.2_....
Oaaos ..............??51 .?........?C>!.r.S4:....................................
Address (Pre4en!) .......G?::Z......?:....tiSr.1.J
Sutlder
Addreu
.; i.
N2 3719
3795 PiloY Rnob Aoad
Eagan, Minnesola 55122
459-8100
Dale ..•----.... 7: ?.?..?...?.?.?.5........
6toziea To Ba Ueed For Fron! Deplh Heighf Eet. Coct ermi! Fea Rsmests
s{,,?9i? dweil?a?
E A#. dbub.? a?? $is
? io' sd? /at
- s?de
or
,Axzs, /j• C/w;/sa,') [?rxF 'L'q"-4 I S I (, I w,?dEeN?ss 'C-ua -Dt"
This permit does noi aulhozise the use oi streeia, roads, alleys or sidewalka nor doee it give the ownes or hfs sgen!
the rf9h! !o creale anp siluation whieh is a nuisance or whieh prasenls a ha:ard !o the heallh, sefelp, ooaveaianea and
ganeral welfere !o anyona in the eommunifp.
THIS PERMIT MUST SE KEPT ON THE PREMISE WAILE THE WORK IS IN PAOGAESS.
Thla is !o eerlifp, ...... C.......... -.............. aepermSssioa !o areei .. L.4.IL(.'..a1..9Cl.e.upea
the above described premise subjec3 !o the provisions of all applicable Ordinances fox the Cifp of Eagan.
................. ?._..... ._.....: 1?.?.LllJ1.?!.? ................................
---°°-°---------°°--....--°---- Per .................°.._. °°---.. . ?
Mayor Suildlny Impeetor
16 19
Ct3 CfS
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36
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? oNT._?ROi?Ff?LTY ._LI.NE ? J
. ILQT -P L A`+N
MASTER CARD
OWNER
STRUCTURE AND
IAND USED AS
Permit
No.
Issued Issued To
Coniractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING V-V6 SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL
HEATING I
7 r DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL ? O
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
095(p RESIDENTIAL BUILDING
Perroit Application ?
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction ReauiremenGs
3 ragistered site surveys showirg sq. R ot lot sq. ft. of house; and all roofed areas
(20 % maximum lot coverage allaxed)
2 copies of plan showing beam & window sizes; poured found design, etc.
1 set of Energy Calcul2tions
3 oopies of Tree Preservation Plan'rf lot platted after 711193
Rim Joist Dehil Optlons selecGOn sheet (bklgs witli 3 or less units
RemodeVReoair Reauirements
2 copies of plan
7 set o( Energy Calculations for healed addi6ons
7 site survey for additions & decks
Add'rtion - indicate d on,sife septlc system
J,
?-?
?
Office Use Onlv
Cert of Survey Recd
Tree Pres Plan Reoi
Tree Pms Not Reqd
_ On-site Septic System
Date $_ / 15 / 0` ?
SiteAddress __ 228 rpRiSOY? L f? U a
Construction Cost
4k-e LQ1')P /\4 UniUSte#
Description of Work T1e, n I VVUC. ? 4 W 11,3 D0-? + ? QP?n U
Multi-Family Sldg _ Y x N Fireplace(s) _ 0 _ 1 _ 2
PropertyOwner 1`???I n"'d Nanc.)! A2Vrojq Telephone#((oS!) yO5
Contractor GRectf- LaKec U1d (A) ?; IcfIY1G1 l.n
Address M0.5o (311-e
State MI {?1 i7-f'sh t-Gl k, City /
Zip 55 2 Telephone #('?S2)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ven6lation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calculatlons Submitted
Licensed Plumber T.e!ephone #( j
Mechanical Contractor Telephone # ( )
Sewer/Water Contractor Tele,pD q?e"(- ?} ? II
?? IK n ?- If
jjn AUG 1 9 2003 i?? ?
I hereby apply for a Residential Building Permit and acknowledge that e information is compl'te and accurate;
that the work will be in conformance with the ordinances and codes of ffie-City-ofzEagan:-anccL-Ithe 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
pemut; that the work will be in accardance with the approved plan in the case of work which requires a review and
approval of plans.
Jb! L I 11?7 PLi r-,tJ 4, / N/Li v` ? ?
Applicant's Printed Name Applicans Si? ature