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4260 Carlson Lake Lane NCITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: Eater MN 55121' DATE: Zoning:. No. of Units: Owner: S 733e L: - Address: Site Address •r: ?' _ ?• ? :z n:_?? :i Plumber: Meter No.: Connection Charge: Size: Account Deposit: Reeder No.: Permit Fee: I Gene to eo u,pip wkly the City of Sege¦ Surcharge: OrliMnoee. Misc. Charges: Total: Dote Paid: Insp.: Insp.: CITY OF EAGAN 3830 Pilot Knob Road P. O. Box 21199 Eagan, MN 5512T Zoning: Owner: AddresSite Plum I agree ft eewolp wlI the City of I.g.. ordie.ncss. By Date of Insp.: SEWER SERVICE PERM PERMIT NO.: DATE: No. of Units: Connection Charge: Account Deposit: Permit Fee: Surcharge: Misc. Charges: Total: - Date Paid: CONTRACT PRICE Site Address t r r , i _ _ Lot -Block Lf Sec Name Address c City ( Phone PERMIT # RECEIPT # MN 55121 DATE - BLDG. TYPE Res. Comm. Other WORK DESCRIPTION New Add-on Repair Name Address ?D ) p City Phone _ TYPE OF WORK Forced Air M BTU Boiler M BTU Unit Heater M BTU Air Cond. M BTU Vent ? CFM Gas Piping Outlets # Other FEE SIC: TOTAL FEES RES. HVAC 0-100 M BTU - $24.00 ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 ADDITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE MINIMUM - RESIDENTIAL FEE - 10.00 MINIMUM - COMM/IND FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN Permit No. Permit Holder Date Telephone Plumbhq_ L, L, it -? g S 9?s H.VA.C. - h D Electric / ) f . . ) ( , I Softener Inspection Daft Insp. Other Footings I c,J -'IA, /C, Footings 11 Foundation Framing Roofing i ST.4l S i / - ?, - 9° Rough Plbg. ,. (?FTZG/2Cl'N 7 //- /- Rough Htg E? C/11N E o .? Inaul. C%a?NGc' tii?r7L- //?C ?f Fireplace Final Htg. Final Plbg. f -a1. e - / Final Tb AAaC4 cO&AZIC Cert/Occ. ?; 6'S' kJ? Y3-Sc Water Describe Location: Well Sewer Pr. Disp. { Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C 1. Date \ - k 3. Job Address 't 4. Owner Type or rrrnt /egwbty Tot. 2. Installation Cost Lot Blk. Tract 5. Contractor I : Phone 6. Address 7. City } State - Zip 8. Building Type: Residential 0-- Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair ? 10. Describe '111-' I 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed: <t- for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 ' INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: r L 0 1 NO 3830 Pilot Knob Road Permit Number: 184 Eagan, Minnesota 55122-1897 I . ! f Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: I Ak.I I /1N1 ho i. i ' I'i1'. I I ESL I #JI {, k9i'J I,II ( . I. i i 14;; 00". ti PERMIT SUBTYPE: TYPE OF WORK: HE PA Ii? 4L.c*IDI NF}) FRAM (l I INAI Permit No. Permit Holder Date Telephone # ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: l I%l 1 '.!'r4 1 i\h 1' I i-,I.l i`d I t i irtdl l I Iii I-ill 0, i- h?{ . I ;IN ?• I Ft 7 t ±=.f 1 PERMIT SUBTYPE: TYPE OF WORK: II I 'c:Cr: 11-11 II)N k3111-.I( )LN(.1 00407 ii_1/111/91 "U w GAS FTI?FPt AC1 INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR. Permit No. Permit Holder Date Telephone # ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE 9 7 AIRIEST E 9 4 ISO DG d G a 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 9 Rik 6 Parcel 10 84354 090 06 Owner - Street 4260 No N. .a 1 son Take T.n _ State Eacfan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK a3 1973 $132.60 $6.63 20 0/ SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA 1977 160.00 10.66 15 (j . O G, /1p,3 .)' /a STORM SEW TRK 1QR1 -463 On 24 - 20 a a . OD ('3 /O //,T s c STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT Roaa IT, i t- 280.00 56638 11/17/85 WATER CONN. 500.00 11 It BUILDING PER. 11127 SAC PARK This request void 2- B0193 18 hs f L r v;((1 rE 3 Request Date Fire No. Rough-in Inspection Requ rred? DROatly Now Will Notify Inspec- t Dyes No for When Ready Licensed Electrical Contractor I hereby request inspection of above Owner electrical work installed at: Street Address. Box or Route No. City R bo L k v a ? e _ ection Township Name or No. flange No. _ __ County t p Occupant (PRINT) Phone No. SSA$ . Pt\EAFE Power Supplier Address NsP Electrical Contractor (Company Name) Contractors License No. tlectR\C. Coow;?Q ;oiu O(//(o//5' Mailing Address (Contractor or Owner Making Instailatioal la7_s/ 11+h St- Su Autho ized Signature (ContractorOwner Making Installation) Phh he Number_ IF MINNESOTA STATE BOARD OF ELECTRICITY Griggs-Midway Bldg. - R. N-191 1821 University Ave.. St. Paul. MN 55109 Phone 16121 297-2111 THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. 5REQUEST FOR ELECTRICAL INSPECTION ' S. instructions for completing this form on back of yellow copy. B42163 ,.,X-- Below Work Covered by This Request EB-00001-04 Add Rep. Tyte of Building Appliances Wired Equipment Wired Home - Range Temporary Service Duplex Water Heater Lighting Fixtures Apt Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm other (Sw,.fVl Other (Specify) I r pecity Other Other Compute Inspection Fee Below # Fee ServiceEntrarceSize g Fee Feeders/Suhteeders # Fee Circuits 0 to 200 Amps 0 to 30 As Oto 30 Amps Above 200 Amps 31 to 100 Amps 31 to 100 Arni? Swimming Pool Above 100_Amps Above 100-Amps Transtormers irrigation Booms 'G Partial.'Other Fee- Signs Special Inspection TOTAL FE V5 ?„jYJ Rennrks • ?/ Rough-i. U40 are ectrical , r, hereby the above r ha' Final ? on has been in-?cti this request void 18 monere horn w CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-84354-090-06 DESCRIPTION: PERMIT PERMIT TYPE: BUILDING Permit Number: 029084 Date Issued: 10/21/96 4260 CARLSON LAKE LANE N LOT: 9 BLOCK: 6 WILDERNESS RUN 5TH (SIDING) ermit Type SF (MISC.) m,rk Type REPAIR #`" 434 ALT. RESIDENTIAL ew to 'ta' a?s tg e,% 61 a sg,'. } REMARKS: FEE SUMMARY: VALUATION Base Fee Surcharge Total Fee $87.25 $2.00 $89.25 $4,000 CONTRACTOR: - Applicant - OWNER: MALECHA CONST 16869025 PALEAFEI ISAAC 4398 BRADDOCK TR 4260 CARLSON LAKE LANE N EAGAN MN 55123 EAGAN MN 55123 (612) 686-9025 (612)454-7865 I hereby 'ackni information , Statutes and`I E SSUED BM SIGNATURE CITY OF EAGAN n O3830 PILOT KNOB RD - 55122 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) IT 0 4 ? 681-4675 New Construction Requirements Remodel/Reoair Requirements ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions & decks) ? t energy calculations ? 1 energy calculations for heated additions ? 3 copies of tree preservation plan if lot platted after 711/93 required: _Yes _ No qr DATE: 0C I ,;L- 7 & CONSTRUCTION COST: TI yOO4 a DESCRIPTION OF WORK: RCj /R , e .5 l i Al STREET ADDRESS: 0 N• Cat! Sy))U 4 L LOT g BLOCK U SUBD./P.I.D. #: ?u'x 11h?P?? PROPERTY Name: rSgg c / Rte qt 9 Ir Phone #: JSL '6 c OWNER "ST 11R., Street Address: ya6 0 Iv tL+i , u/ZsoN /Qke C (,,, City: F 6t /?a ?Ledo( State: Zip: 5,02 3 CONTRACTOR Company: Mg /c sItxI stone #: 6 S6?9das Street Address: 839' S 1-),ca da 8C/ 7c License #: City: Fag ai? Stater N Zip: ?$ ARCHITECT/ Company: Phone #: ENGINEER Name: Registration #: Street Address: City: State: Zip: Sewer & water licensed plumber: . Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the information is correct and a 0e to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ral/j? OFFICE USE ONLY Certificates of Survey Received _ Yes - No Tree Preservation Plan Received Yes No CItY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERMIT PERMIT TYPE Permit Number: Date Issued: 4260 CARLSON LAKE LANE N LOT: 9 BLOCK: 6 WILDERNESS RUN 5TH P.I.N.: 10-84354-090-06 DESCRIPTION: GAS FIREPLACE ermit Type FIREPLACE rk Type NEW e'? 434 ALT. RESIDENTIAL BUILDING 030407 07/11/97 R REMARKS: FEE SUMMARY: Base Fee $50.00 Surcharge $.50 Total Fee $50.50 CONTRACTOR: - Applicant - ST. LIC. OWNER: FIRESIDE CORNER INC 16332561 2009091 PALEAFEI ISAAC 2 00 N FAIRVIEW AVE - 4260 CARLSON LAKE LANE N SEVILLE MN 55113-0847 EAGAN MN 55123 12) 633-2561 (612)454-7865 I hereby.acknowled e tU `informations correct; $tatutes°and'"City f EF APPLICANT/PERMITEE SIGNATURE ISSUED SIGNATURE -3 CITY OF EAGAN S S O 3830 PILOT KNOB RD - 55122 1996 FIREPLACE PERMIT APPLICATION 681-4675 DATE: DESCRIPTION OF WORK: .INSTALL NEW FIREPLACE: WOOD BURNING GAS - INSTALL GAS LOG ONLY IN EXISTING FIREPLACE INSTALL GAS LINE ONLY IN EXISTING FIREPLACE OTHER: AREA TO BE INSTALLED IN: UI/rL- P- °t S T REE r ADDORESS: " 1 U'1 LOT BLOCK SUBD.IP.I.D. #: w -_-t4 eee? S APPLICANT: (circle one only) OWNER CONTRACTOR 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. PROPERTY Name: Phone #: OWNER Signature: Street Address W 7 City: State: Zip: FIREPLACE Company: 1I I r Err- 1e Phone #: ??? 3 a5 I-1 INSTALLER Signature: ?` ?1 nc i -c ?kn T+ Street Address: 6I" License #• City: State: 1 Zip Mr- GAS LINE BYCompany: -IiIl?r_' L- iclP Phone #- / 3.3._.29r<'/ INSTALLER R=1V Name: SignatL Street Address r n rev, Uiti_ ",'- City: State: rq - Zip: `) `711 j CITY OF EAGAN N_° 11127 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 4548100 BUILDING PERMIT (WF) Receipt # r To ba eea ter SF DWG/GAR Est. Volue $66,000 Date OCTOBER 6 i9 85 Site Address 4260 N. CARLSON LAKE LN Lot 9 Bl ock 6 Sec/Sub. WILD RUN 5TH Parcel No. Name CITADEL HOMES INC = Address 3880 LAVERNE AVE NO City LAKE ELMO Phone 779-0671 Name SAME Address City Phone Name 2 Address 0 <w City Phone I hereby acknowledge that I tw read this applicat and state that the information is correct a gree to cod ply it all applicable State of Minnesota Statutes on City of gon r finance . Signature of Permittee A Building Permit Is issued to, CITADEL HOMES INC all work shall be done in accordance avith,,oll applicable State o" f Mohr Erect LX Occupancy R3 Remodel ? Zoning R1 Repair ? Type of Const. X7 Addition ? No. Stories Move ? Length 64 Demolish ? Depth 28 Int Impr. ? Sq. Ft. Install ? Approvals Fees Assessment Water & Sew. Police Fire Eng. Planner - Council Bldg. Off. 10/16/8 APC V Date Permit +? 331 . UU Surcharge 33.00 Plan Review 165.50 SAC 525.00 Water Conn. 500.00 Water Meter 63.00 Road Unit 280.00 Tr. Pi. 132.00 Parks ar. Copies 2 029.50 Total $ r on the express condition that sots Statutes and City of Eagan Ordinances. Building Official 1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN COMMERCIAL SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1-SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS $2,000 LANDSCAPE BOND (s'?,ooo To Be Used For: <i fAOAi,,i Valuation: •_a_a,_. Date: h g g? Site Address 42,. C /4,LL5o,, LNco L4oF_ OFFICE USE ONLY Lot `1 Block C' n $ t \ L1 Parcel/Sub Ka, +r.05n.? 5 ,.., Owner L (ft 2Q;c. C-L&. 4 Address Sc. LrLyrirtu?e?li,. /s. City/Zip Code LAS LM , nl(a 9 4 Phone 771 -062 Contractor Address City/Zip Code Phone Arch./Engr. 2u,-1A=AA 3 _ Address City/Zip Code Phone if Erect X Remodel Repair Addition Move Demolish Int.Impr. Install APPROVALS Occupancy Zoning Type of Const if of Stories Length Depth Sq Ft FEES Assessments Permit Water/Sewer Surcharge Police Plan Review Fire SAC Engr Water Conn Planner Water Meter Council d Unit Bldg Off a Treatment P1 APC Parks Variance '5 1& Copies TOTAL .S0 I A'a 5?7w <sru n-F_- rS 4 MAC-.k]FL1GSi'J2 ?.? ct?-ISM F_ Ms Ce) -rv Sr T? + 'Sr crrrn-ts t ?/`/ Acha'_ (? AArS Z4x 42 IC?c? X, S ° S°34(,:,4- 22x4S4x 12 ` 2Z- 800 ?? x ID = loci X 8 - 65072- + 6.°50+ 25°00+ 5 0.00+ 63°G0+ 2B0°00+ 132°0C+ 2,029°50k ertlficate for: Bk: 87/36 itadel Homes 3880 Laverne Avenue North Lake Elmo, Minn. 55042 DELMAR H. SCHWANZ LAND SURVEYORS INC RPQi61P•M Under Laws or The state of M.nnP601F 14750 SOUTH ROBERT TRAIL ROSEMOUNT, MINNESOTA 55068 PHONE 612 423-1769 SURVEYOR'S CERTIFICATE 3 $ o .1 LR fit, t' IV NN, Al ?iFl rib y'1 bT\ y I N ? b LiNC .4? l0 30 V Zzi, 876.0 Denotes existing elevation O Denotes proposed elevation I hereby certify that this is a tsoe and correct representation of Lot 9, Block 6, KILDffitN883 148* VMH ADDITION, according to the recorded plat thereof, Dakota County, Minnesota. Also showing the location of a proposed house as staked thereon. Dated: September 30, 1985 MINNESOTA REGISTRATION NO. 8625 N9s ?3.a¢ P & Scale : ti n ry` s 1 inch a 40 feet O Denotes iron monument 0 Denotes set wood hub T Buyer I`?n L ra r- c Model i ti ? M« t4 4 t Building Envelope (Chapter 6, 1983 Model Enery Code - Building Design by Acceptable Practices - and revisions) Criteria Design (table 6-11) Roof/Ceiling Ceiling R-Value (Rr) 4o 39._ 38 (min.) Ceiling Area (Ao) Skylite R-Value (R1) 2.5" Skylite Area (Al) Walls Wall R-Value 2Z, 20 (min.) Floors (over unheated spaces) Floor R-Value /A 20 (min.) Windows - Double glazed %c. Percent of Wall area 12% (max.) Sliding Glass Doors - Double glazed 124.6 •i¢3tt Percent of wall area (all glass) 10% (max.) Doors - Metal Insulated Door R-Value (Lo 3.0 (min.) Foundation (602.2.6) Insulation R-Value (exterior, to footing) Z2 5 (min.) 6 -F-to4LS CITY OF EAGAN 3830 PilovKnob Road P. O. Box 21199 Eagan, MN. 55121" Owner: - I L. _C3tMt p cic Address: Site Address: 4260 N. Car2SOn L Plumber: "] elson Plu>vbi3t? Meter No.: 6? .3100 42-' Size:/%' • / ?e.c(w i Reader No.: 1 19 in ?/ A . ?0 1 -am- to comply with the of ingem Ordineme •i ?a( By Date of Insp.: WATER SERVICE, PERMIT PERMIT NO.: -- ?; H DATE: No. of Units: j Connection Charge: Account Deposit: Tt pd Permit Fee: 1 Upd Surcharge: p Misc. Charges: i3.0L?pa Total: 5 .O.p_? 'act,-?r Date Paid: •:1' • • 7• • 11 • •' :i1 1 11 ?I • • ; CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION 1) PROPERTY ADDRESS: /' _ to C) LEGAL DESCRIPTION: k1AL/bIOCK/JUDO.1V1S1on or •rax farces 1.U. j umoer; IF EXISTING STRUC'TU'RE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: (Month Year) PRESENT ZONING/PROPOSED USE: R-1 SINGLE FAMILY R-2 DUPLEX (Two Units) R-3 TOWNHOUSE (Three + Units) ( Units) R-4 APARTMENT/CONDOMINIUM ( Units) COMMERCIAL/RETAIL/OFFICE INDUSTRIAL INSTITUTIONAL/GOVERNMENT 2) /)// NAME: h 0/-? L -C-t?l ADDRESS: CITY, STATE, ZIP: PHONE: 7s 3) ADDRESS: CITY, STATE, ZIP: PHONE: MASTER LICENSE # For City Use Plumber icense Activ CI (ed C7 Recorc Staff I 1 1 4) •a • , ia• NAME: ADDRESS: CITY, STATE, ZIP: PHONE: 17- 5) 1 :• • :1' 1 :.:¦ • 7• 71 CONNECTION TO CITY SEWER CONNECTION TO CITY WATER Q OTHER (Please Describe) 6) D • i PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE CI PLEASE ?MAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE (Circle one) 7)E?. /l- r7- f FOR CITY USE ONLY PERMIT u_ ISSUED FEES: $ $ $ S S- 7 $ $ /l'on $ ?c cc:u $ SJ-S vc, S $ .: .. NC. :JLr R.C?.: SEWER PERMIT (L1\L`-' SURCHARGE) WATER PERMIT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP CCC'U::'T POSIT - SEWER ACCOUNT DEPOSIT - WATER WAC SAC TRUNK WATER ASSESS:IENT TRUNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SEWER LATERAL BENEFIT/TRUNK WATER WATER TREATMENT PLANT SURCHARGE OTHER: TOTAL AMOUNT PAID/RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE C] NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: l? ??/? S5(.-705 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Requirements • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house: and all roofed areas (20% maximum lot coverage allowed) • 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 set of Energy Calculations • 3 copies of Tree Preservation Plan if lot platted after 7/1/93 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE I' ag - dc'9 SITE ADDRESS TYPE OF WORK n e - tSC)O fi APPLICANT ugeDel1l7 R®®Ifiuug & RO>ld r IlM° STREET ADDR 49 SOnih OWasso B1Yd. Little Canada, MN 55117 TELEPHONE #OSI _L£S ' 1??1G____,,,,?,•? ,r- CITY STATE ZIP FAX # PROPERTY OWNER SIlQ 2 P Q.,PeI TELEPHONE# (JS L 1 bS-1S (7 COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672 (4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: __ Plumbing system includes: Mechanical Contractor: _ Mechanical system includes: Sewer/Water Contractor: MULTI-FAMILY BLDG _ Y _ N FIREPLACE(S) _ 0 - 1 - 2 Water Softener Water Heater No. of Baths Air Conditioning Heat Recovery System Phone # Fee: $90.00 Fee: $70.00 -------------------------------------------------------------------------------------------------------------------------- I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Orrvdiinances. SlgnatureofApplicant @QMMJ pL I I LWYIM OFFICE USE ONLY IZg?2S Remodel/Repair Requirements • 2 copies of plan • 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks • Indicate if home served by septic system for additions VALUATION S ) c? Phone # Lawn Sprinkler No. of R.I. Baths Phone # Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required Updated 4102 5V93 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651.681.4675 New Conelruetbn Reaulromenle RemodegReosk Re • 3 registered site surveys showing sq. of lot, sq. ff. of house; and Ull rooted areal . 2 copies of plan (20% maximum btcoverage allowed) pI 0,7- • leer of Energy • 2 copies of plan showing beam & windows ;poured found design, etc.) p 16 1 Ste survey for • 1 set of Energy cakwlatlons Indicate If home • copies of etail Preservation ns it platted a r7/1193 RJoist Detail Options selection sheet (bldgs with or orle less units) Rim DATE -? oZ ?° fit- VALU o SITE ADDRESS TYPE OF WORK APPLICANT -A STREET AD RffE$S TELEPHO # PROPERTY CELL PHONE COMPLETE THIS Energy Code Category _ p (+/ submission type) FOR (lvi.?d additions addnbns & decks by septic system for sections 60`d MULTI-FAMILY BLDG _Y _N FIREPLACE(S) - 0 - 1 - 2 L CITIkSTATZI FAX # G a?7d7-lid 97 TELEPHONE#` 4 `7ZC -------------------------------------------- RESIDENTIAL BUILDINGS ONLY IOTA RULES 7670 CATEGORY vial Ventilation Category 1 Worksheet Envelope Calculations Submitted Plumbing Contractor: Ph Plumbing system inc des: _ Water Softener _ Lawn ! Water Heater _ No. of No. of Baths Mechanical Co actor: Mechanical stem includes: - Air Conditioning Heat Recovery System Sewer/W er Contractor. --------------------------------------------------------------------------- I hereby acknowledge that I have read this application, state that the with all applicable State of Minnesota Statutes and City of Eagan Signature of Applicant MINNESOTA RULES 7672 • New Energy Code Worksheet Submitted Fee: $90.00 Baths Fee: $7( Phone# ,,,e o iun7 OFFICE USE ONLY Certificates of Survey Received - Tree Preservation Plan Received - Not Required Updated 4/02 CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot4(nob Road P. O. Box 21199 PERMIT NO.: Eagln, MN, 55121` w ., DATE: Zoning: No. of Units: L Owner: 3C'? rCY^ s . - i? , ; Address: Site Address: 1250 N. ''a . n Lake ._ Ln . t,1 . dernew Run 5 Plumber: Meter No.: do ?0C .' Connection Charge: ; tix, - Sze: ?? Account Deposit: Mpd T7. p S Reoder No.: Q ?1 gO Permit Fee: 10 - pu .lm to aa.Pir wli Ow Icitar of t.p. Surcharge: Ordi w"45,? Misc. Charges .... ?' :. ... Total: By Date Paid: Date of Insp.: Insp.: PERMIT City of Eagan Permit Type:Building Permit Number:EA114806 Date Issued:09/19/2013 Permit Category:ePermit Site Address: 4260 Carlson Lake Lane N Lot:009 Block: 006 Addition: Wilderness Run 5th PID:10-84354-06-090 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Elizabeth Hess 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 - Isaako Paleafei 4260 Carlson Lake Lane N Eagan MN 55123 Sela Roofing Remodeling 4100 Excelsior Blvd St. Louis Park MN 55416 (612) 823-8046 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA162742 Date Issued:07/27/2020 Permit Category:ePermit Site Address: 4260 Carlson Lake Lane N Lot:009 Block: 006 Addition: Wilderness Run 5th PID:10-84354-06-090 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door 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 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 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 - Isaako Paleafei 4260 Carlson Lake Lane N Eagan MN 55123 (651) 983-0355 Home Depot Usa Dba The Home Depot 2455 Paces Ferry Rd Atlanta GA 30339 (763) 852-1044 Applicant/Permitee: Signature Issued By: Signature