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
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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.
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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