1240 Carlson Lake Lane
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA089500
Eagan, MN 55122 . Date Issued: 06/03/2009
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 1240 Carlson Lake Lane
Lot: 6 Block: 3 Addition: Wilderness Park
PID 10-84250-060-03
Use
Description:
Sub Type: e-Windows/Doors Construction Type:
Work Type: Windows/Doors-New/Replacement
Description: House
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: huprovements 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 by law in ALL single family homes.
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Renewal Andersen Darnel P Maloney
1920 County Road C West 1240 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
CITY OF EAGAN WATER SERVICE PERMIT
3795 Wat Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
1 agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
BY Date Paid:
Date of I nsp.: I nsp.:
CITY 06 EAGAN SEWER SERVICE PERMIT
3745 Pilot Knob Road PERMIT NO.:
Edgan, MN 55722 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber.
I agree to comply with the City of Eagan Connection Charge:
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
BY Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
CITY OF EAGAN
9795 Pilot Knob Road Eagan, MN 55122 N! 5076
PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for Est. Value Dote , 19
Site Address -rls Erect Occupancy
Lot Block Sec/Sub. Alter Zoning
❑
Parcel # Repair ❑ Fire Zone
t-
, _ Enlarge ❑ Type of Const.
W Nome Move ❑ Stories
3 Address Demolish ❑ Front ff.
C ` r- 44 Grade ❑ Depth ff.
City Phone
Name Approvals Fees
0
OOU Assessment Permit
U9 Address
~ Cf Phone Water & Sew. Surcharge
Police Plan check
1W Name
~z Fire SAC
ua Address Eng. Water Conn.
<W city Phone Planner Water Meter
Council
I hereby acknowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to comply with all applicable
State of Minnesota Statutes and City of-.Eagan,.Ordinonces. APC Total
Signature of Permittee
A Building Permit is issued to: 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
Pencil # Date laced ►eraMtee
Plumbing /b ( /
Mechanical / $L, J - / /K 7 ;'Q + y
INSPECTIONS DATE INSP. Rough-In Final
Footings Date Inap. Date Insp.
Foundation Plumbing -,8 7 J
~4-
Frame/ins. Mechanical
Finol z Y~x
Remarks:
CITY OF EAGAN
3795 Pilot Knob Rood
Eagan, Minnesota 55122
Phone: 454-8100
PERMIT No.
Date: Receipt No.:
Single
Site Address: Residential
Lot Block Sub/Sec. Multi Res., Comm./Ind.
Name New/Alter. / Repair
3 Address Cost of Installation
C City Phone: Permit Fee
Name Surcharge
Address
V
City Phone: Total
This Permit is issued 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
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
Phone: 454-8100
L!'C+l i 7 -v Z ~
PERMIT No,
79 1 "126
Dote: Receipt No.:
Single I `
Site Address: 2 ~`7r~ T k r u'. Residential
~'77_~C~E'2T12.4'3 ari _
Lot Block Sub/Sec. lkulti Res., Comm./Ind.
Name New/Alter./Repair
3 Address Cost of Installation
O
,Y r ~ ~ , nr >lr
City Phone: Permit Fee
' rn
/me - Surcharge TV. ~)or
"745 q
P Address
C
0
City 4` Phone:
Total
This Permit is issued 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
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: I I+ t rats
3830 Pilot Knob Road Permit Number: I
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
t t, tt 1 i
I - i• i /1!•'t ~tpl I Ali I ANi 1 I1 1, 1 t rJ! P1!!Itl I I fltr
Ilt 11!1 I !11 I iii i ~ ~ i ~ 7((1 d;.
1
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION TYPE .DATE INSPTR. INSPECTION DATE INSPTR.
I
I
r
Permit No. Permit Holder Date Telephone B
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
1
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
i
FINAL HTG
CRSAT
TEST
BLDG FINAL
SSMT R.I. 1
BSMT FINAL
DECK FTG
DECK FINAL
ICI
CITY OF EAGAN Remarks
Addition Wil de3mess Park Lot 6 Blk 3 Parcel 10 811250 060 03
Owner ( t street 1240 Carlson Lade Lane State Eagan,MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. y 974.65 1977 974-65 97-47 1 f)
AOO-7802 5-24-79
STREET RESTOR.
GRADING
SAN SEW TRUNK; 1973 176.o5 8.80 20
SEWER LATERAL
WATERMAIN 114.45 A007802 5-24-79
WATER LATERAL 1 972 0 29 1 21 2. 1n A007802 ~5-24-70
WATER AREA ~dl 1977 160.00 10.66 1 160.00 A007802 5-24-79
STORM SEW TRK 7-7-80
STORM SEW LAT `
CURB & GUTTER
SIDEWALK
STREET LIGHT
Road Unit Charge 75.00 12540 11-29-78
WATER CONN. 250.00 12540 11-29-78
BUILDING PER. #5076
SAC SOO.00 2540 11-29-78
PARK
0 -l -.0l
Cd 1
Orrfifirtttr of (Orrnpttnry
Citp of Cagan
19rVarimrui of Nuilhiny Imyrdilm
f.~ This Certificate issued pursuant to the requirements of Seniors 306 of the Uniform Building
IJ Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of tht City regulating huilding construction or use. For the following:
5076
u.a.ml SF Dwlg & Garage Bd&PemritNo.
O..p yTrt<L ryPC...wu.. V Fia.r 3 zom%Dntdd R-1
o ~.re.oa;q S. Petersen Const. Add= M~nneap0"SE MN
@j a 1240 lson Lake 7fi;,Y Fagan, M s
'Y' 18e 1979
er,wwomrm May
an ~sl Vii.
a4ra
This request void 18 months from 3 /oZ y9 7
Le- R 21114
Date of Phis Request Ilovember 20, 1978
1, a;"g Licensed Electrical Contractor ❑ Owner, do hereby request inspection of the above electri-
cal wiring installed at:
StrtA Address or Route No. 1240 Carlson Lake Lane City Eagan
Section Township Range County X= Dalmtn
I
Which is occupied by Svend Peterson Construction
(Name of Occupant)
Is a roughin inspection required on this job? No 19 Yes ❑ Ready Now ❑ Will Call ❑
Power Supplier Dakota Electric Assn, Address 821 S 3rd St. , Farmirrgton,idd
Ken Sorenson Electric 55024
Electrical Contractor Contractor's License No. 3 533
(Company Name)
Mailing Address 8070 12th Ave. So., Bloomington, I'M 55420
L~ (Electrical ~nlritl ' or Owner Making This Installation)
Authorized Si ature (jjL+~ ~J /J (✓✓-L.tL/f7-r Phone No. S 0
(Electrical Contractor or Owner Making This Installat n)
S f~ ~f (t? NAM /f'QlM11~/ This inspection request will not accepted the
~J ~f, ~l jJ State Board oerd unless proper inspection fee is enclosed.
Minnesota State Board of Electricity s
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703 'oe 42,41 7
REQUEST FOR ELECTRICAL INSPECTION R 21114
CHECK $ELOW WORK COVERED BY THIS REQUEST ~A
Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For
Home ❑ ❑ ❑ Range ❑ Temporary Wiring 121
Duplex ❑ ❑ ❑ Water Heater ❑ Lighting Fixtures ❑
Apt. Bldg. ❑ ❑ ❑ Dryer ❑ Electric Heating ❑
Co. Anercial Bldg. ❑ ❑ ❑ Furnace ❑ Silo Unloader ❑
Industrial Bldg. ❑ ❑ ❑ Air Conditioner ❑ Bulk Milk Tank ❑
Farm ❑ ❑ ❑ pLList List 1}
Other ❑ ❑ ❑ Herers eiesf
COMPUTE INSPECTION FEE BELOW 11
Service Entrance Size: # Fee Feeders&Subfeeders: Circuits: # Fee
0 to 100 Am s. 0 to 30 Am res res
101 to 200 Am s. 31 to 100 Ameres
Above 200 Amps. Aboe 100 Amps.
Transformers Remote Control fee
Signs Special InRemarks Install Temporary Service 6.50
1, the Electrical Inspector, hereby certify that the above inspection has been made.
(Rough•in) r Date
(Final)
This request void 18 months from -
This request void 18 months from 3 5-4 -r
Date of his Request o7 `off l R 21123
I, asLicensed Electrical Contractor ❑ Owner, do hereby request inspection of the above electri-
cal ng installed at: qqL63/P A-d.c1-4-\
/
Street Address or ute No, i~Cx r CiG !/SDI L/TE'Z;,7& City/
/ Hess f4-
Section
Which p Range County AA-0
Which is occupied by nr SPIT Co/~S/ UC~X%D4
(Name o7 Oooupant)
Is a roughin inspection required on this job? No D Yes.< Ready Now ❑ Will Call
Power Supplier.2z fV ~C( AFIP G ff / G Address
Electrical Contractor A w 17 ~D/P~ szr L 7/ ie Contractor's License N-Q,
(Company Name)
Mailing Address 3 L02 70 (g '14a -57.
(Elec ri onf trac~~`` or Ow er Making This Inst on
Authorized Signature~`,~TrVlYlZQ6y/ Ph eNo. SS`f
(Electrical Contractor or Owner Making This Installation)
0 ~ (~j' /off ~1~ This impaction request will not accepted the
1~ A Ll, v lJ State Board unless proper inspection fee is enclosed.
NA
Minnesota State Board of Electricity vC~4
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703 /
REQUEST FOR ELECTRICAL INSPECTION 'R 21123
CH CK BELOW WORK COVERED BY THIS REQUEST 6!
Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For
Home ❑ ❑ Range 0 Temporary Wiring ❑
Duplex 11 ❑ Water Heater 11 Lighting Fixtures ❑
Apt. Bldg. ❑ ❑ ❑ Dryer ❑ Electric Heating ❑
Commercial Bldg. ❑ ❑ ❑ Furnace ® Silo Unloader ❑
Industrial Bldg. ❑ ❑ ❑ Air Conditioner Bulk Milk Tank ❑
Farm 0 C3 poList ) List
Otter - ❑ 0 ❑ Heiers} pHa ers~
COMPUTE INSPECTION FEE BELOW f
Service Entrance Size: # Fee 11 Feeders&Subfeeders: 0*Fee Circuits: it Fee
WRemarks, 0 r 31 to ft:VnpjWfk 31 to 100 Am eres 11 Abov 0 Above 100 Am s.
Remote Con 1 Cir . Partial or other fee
Special lns ection Minimum fee TOTAL FEE
e e
1, the Electrical In ector, hereby cerf at th irrs to has been made.-X15`-- .
(Rough-in) Date
(Final) / f Date
This request void 18 months from C r
ti PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 8 4 9 0
(612) 681-4675 Date Issued: 0 8/ 0 7/ 9 6
SITE ADDRESS:
1240 CARLSON LAKE LANE
LOT: 6 BLOCK: 3
WILDERNESS PARK
P.I.N.: 10-84250-060-03
DESCRIPTION:
(ROOFING)
'ldin% Permit Type SF (MISC.)
^f` uz.Ldlr -Us rk Type REPAIR
gnus Codes, 434 ALT. RESIDENTIAL
App
r
A f
1 9@f
F1 b~k" ~n~
ism
0, "A
n n
s3 Up; R ff. M m.~ 491$-2I
ei III
REMARKS:
FEE SUMMARY:
VALUATION $5,000
Base Fee- $99.75
Surcharge $2.50
Total Fee $102.25
CONTRACTOR: - Applicant - ST. LIC.OWNER:
SELA ROOFING & REMODELING 18238046 0001050 MALONEY DAN
4100 EXCELSIOR BLVD 1240 CARLSON LAKE LN
ST LOUIS PARK MN 55416 EAGAN MN 55123
(612) 823-8046 (612)688-6759
M1nk .I• ffi r ' E £ R.£
I here=by 0odsno-wlati;gs that=vl have reads applFleatlon dn`il stage that '1
irifiQratxxrl $s co£retn agzeo£to cosplyw1sh a.13 apphica~le.tat0 )P Mn
-gk
tatt.r'eFta~1r C
ult r3f~ga Drctak~iclc.'
I A,
. . £ we Y .n ti V E
APPLICANT/PERMITEE SIGNATURE f ISSUED BY. IGN URE
CITY OF EAGAN
3830 PILOT KNOB B RD
RD - 55122
01996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construction Reouiroments Remodel/Repair Reeufrements
♦ 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)
♦ 1 energy calculations ♦ 1 energy calculations for heated additions
♦ 3 copies of tree preservation plan If lof platted after 711/93
required: _ Yes _ No
DATE: o ~ ~ 144 CONSTRUCTION COST: ~
DESCRIPTION OF WORK: ~aA tU Clf,& 4
STREET ADDRESS: k 24 b AO i sm^k Q L A(A £~la Wm' S 5 ~ 23
LOT _ BLOCK SUBD./P.I.D. WJ1U101~.~lihl~.
PROPERTY Name: t . D A tl "01A F.4 Phone* OWNER mw U ~-~t~~
Street Address, ~2~~ ~°~nl~dtn LA(Az City: ~M StatJ. Zip. 5S t 2S
CONTRACTOR Company: Phone U y
SELA ROOFING & REMODELING, INC. G5~
Street Address: 4100 EXCELSIOR BLVD. License #
ST LOUIS PARK, MINNESOTA 65416
City: ID# 0001050 State: 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.
1 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.
Signature of Applicant'
OFFICE USE ONLY
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No
CITY OF EAGAN
t 3795 Pilot Knob Road Eagan, MN 55122 N? 5076
PHONE: 454-8100
BUILDING PERMIT APPLICATION Receipt
To be used for SF DWlg & Garage Est. Value 56,000. Date 11-29. , 19'8-
Site Address 1240 Carlson Take Ta12 Erect Occupancy I
Lot 6 Block 3 Sec/Sub. j Alter ❑ Zoning R1 -
Parcel # Repair ❑ Fire Zone 3
S. Petersen COI15t. Tnc. Enlarge ❑ Type of ConsJ
e: Name Move ❑ # Stories 54 ft.
Z Address 4701 W. 110th St. Demolish ❑ Front
° City Mpls 55437 Phone 884-5144 Grade ❑ Depth 36 ft.
Name Same Approvah Fees
°
Assessment Permit 149.50
uu Address
f Water & Sew. Surcharge 28.00
C Phone
Police Plan check
W Name Fire SAC 500.00
z Address Eng. Water Conn. 250.00
aw City Phone Planner Water Meter 60.00
Council Rd. Unit 75.00
1 hereby acknowledge that I have read this n and state that Bldg. Off. Park Ded.120.00
the information is correct and agree y i applicable 1,182.50
State of Minnesota Statut and races. APC Total
Signature of Permittee
A Building Permit is issued to: S. Petersen on the express condition that
all work shall be done in accordance with all appl' a e State of Minn Soto Statutes and City of Eagan Ordinances.
Building Official -~~c ~
#11 i'
DATE
BUILDING PERMIT APPLICATION
Include 2 sets of plans 1 site plan w/elevations and 1 set of energy calcuations.
To be used for Valuation ~i CZrZ~
Site Address: /o2`/O , 5s
Lot Block Sec./Sub. Parcel Number
Ownerd'7j 777~lSeV C?0~li~ i Telephone
Address.~/(S / //b 5~-
/9✓-'L s , /,Y/ 5 y
Contractor Telephone
Address
Arch/Eng. Telephone
Address
OFFICE USE ONLY
Erect Occupancy
Alter Zoning t~f
Repair Fire Zone 3
Enlarge Type of Const.
Move # of Stories
Demolish Front ~y
Grade Depth
Date of Approval and Initial Fees
Assessment 11:27/7ff- Permit J4/`T
Water/Sewer
Surcharge o°1
Police Plan Check
Fire SAC 6700 o-~o
Engineer Water Connection ,'16.0
Planner Water Meter
Go
Council ~VY4,; ~ 7S
Bldg. Off. 4Y 0~4 /
A.P.C. TOTAL
60
a
9CI-1- 2004 RESIDENTIAL BUILDING PERNUT APPLICATION 70
City Of Eagan
3830 Pilot Knob Road, Eagan NIN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Requirements Remodel/Repair Requirements
3 registered site surveys showing sq. it of lot, sq, ft, of house; and all roofed areas 2 copies of plan
(20% maximum lot coverage allowed) 1 set of Energy calculations for heated additions
2 copies of plan showing beam & window saes; poured found design, etc. 1 site survey for additions & decks
Iset of Energy calculations Addition - indicate N on-skeseptic system
3 copies of Tree Preservation Plan k lot platted after 7/1193
Rim Joist Detail options selection sheet (bldgs with 3 or less units
Date 4 / 3a / 0~1 ConstrucIII Cost d
Site Address Zoo dAr?GS-e--V N" Unit/Ste #
Description of Work 14A02- `,-~,-vEL `f/✓/s
Multi-Family Bldg - Y ~ON Fireplace(s) - 0 & 1 _ 2
r
Property Owner / r fE DL pn/~ Telephone # (bT/) r 1 ° ~7
Contractor t i/~ilY E -5 /f J
Address City
State zip 2;W7 Telephone # (40`2-) of60 `7.3SZi
COMPLETE THIS AREA ONLY IF CONSTRUCTING.A NEW BUILDING
Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
(J submission 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 V Telephone Mechanical Contractor felt}phone Sewer/Water Contractor ~~~¢Te 60 hone )
I hereby apply for a Residential Building Permit B ow ge 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 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.
Applicant's Printed Name Applicant's Signature
i
OFFICE USE ONLY
Sub Types
❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg
❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi
❑ 03 01 of- plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF
❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc.
❑ 05 03-plex ❑ 11 10-plex 19 Lower Level ❑ 24 Storm Damage
❑ 06 04-plex ❑ 12 12-plex Plbg-Yor-N ❑ 25 Miscellaneous
Work Types ~c^C I ✓ D les /3r7 7N ~2 m vv-
❑ 31 New (9 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding
❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair
❑ 33 Alteration ❑ 37 Demolish Building` ❑ 43 Reroof ❑ 46 Windows/Doors
❑ 34 Replacement `Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation ) &64~ Occupancy Fz 3 MCES System
Census Code clr,~ q Zoning f2- - r City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const V U r Width
REQUIRED INSPECTIONS
Footings (new bldg) _ Final/C.O.
Footings (deck) ~n Final/No C.O.
Footings (addition) - Plumbing
_ Foundation _ HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests -Final
~J Framing _ Siding -Stucco -Stone -Brick
Fireplace _ R.I. -Air Test -Final - Windows
Insulation Retaining Wall
Approved By: 00~ l , Building Inspector
- - -
Base Fee
Surcharge F Y44 rif t
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
1n5097
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 0 1 Q/ 1 0
Site Street Address Unit#
Property Owner Telephone # ( )
Contractor O [ 5 k.v~,e 5 S [ u ,nn [-j ow, Telephone # (~~3 75 o70 3
Address 31.71 16 ve e^j city 1417 0i^e stated zip 5536y
The Applicant is: _ Owner Contractor Other
Alterations to existing dwelling $ 50.00
XAdd fixtures to rooms, excluding water softener and water heater
-Septic System Abandonment
-Water Turnaround (add $121.00 if a 5/8" meter is required)
Other:
Water Softener _ Water Heater $ 15.00
- replacement _ additional.
Lawn Irrigation System RPZ_ new - repair -rebuild $ 30.00
State Surcharge $ .50
Total $
1 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.
Applicant's Printed Name Applicant's Signature
PERMIT
City of Eagan Permit Type: Building
Permit Number: EA106466
Date Issued: 0812312012
~it~ of 11QR Permit Category: ePermit
Site Address: 1240 Carlson Lake Lane
Lot: 006 Block: 003 Addition: Wilderness Park
PID: 10-84250-03-060
Use:
Description:
Sub Type: e-Windows/Doors Construction Type:
Work Type: Windows/Doors-New/Replacement
Description: House
Census Code: 434 - Occupancy:
Zoning:
Square Feet: 0
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 by law in ALL single family homes.
Fee Summary: BL - Base Fee $4K $103.25 0801.4085
Valuation: 4,000.00 Surcharge - Based on Valuation $4K $2.00 9001.2195
Total: $105.25
Contractor: - Applicant - Owner:
Renewal Andersen Daniel P Maloney
1920 County Road C West 1240 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
Use BLUE or BLACK Ink
I For Office Use
I ,1
Permit
City of EaACID I al` ~
Permit Fee: V7
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I
20'13 RESIDENTIAL BUILDING PERMIT APP (CATION
Date; Site Address: G: r Unit
Name: &4-C Phone-
Resident/
Owner Address / City / Zip: lac( .
Applicant is: Owner Contractor
Type of Work Description of work: 2 izoQ
Construction Cost: Ci (jC Multi-Family Building: (Yes / No )
Company: ZG'r Contact: r `C le.,
Contractor Address:
State: "-I Zip: ~S l 7 Phone: (4-5-1
License C (p -7 7 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 ANEW 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:
I Licensed Plumber: Phone:
i
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone: I
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 (651) 454-0002 for protection against underground utility damage.A Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
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 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.
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.
Applicant's Pr' ted Name App icant's Sign ture
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA122196
Date Issued:04/29/2014
Permit Category:ePermit
Site Address: 1240 Carlson Lake Lane
Lot:006 Block: 003 Addition: Wilderness Park
PID:10-84250-03-060
Use:
Description:
Sub Type:Residential
Work Type:Underground Sprinkler System
Description:PVB
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Jason Larson
25 S Sutton Lake Blvd
Jordan, MN 55352
Fee Summary:PL - RPZ/PVB/Lawn Irrigation $55.00 0801.4087
Surcharge-Fixed $5.00 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 -
Daniel P Maloney
1240 Carlson Lake Lane
Eagan MN 55123
Jay's Plumbing
25 South Sutton Lake Blvd.
Jordan MN 55352
(612) 868-4102
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA170004
Date Issued:06/17/2021
Permit Category:ePermit
Site Address: 1240 Carlson Lake Lane
Lot:006 Block: 003 Addition: Wilderness Park
PID:10-84250-03-060
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Fixtures
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087
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 -
Daniel P & Jamie R Moloney
1240 Carlson Lake Ln
Saint Paul MN 55123--171
(000) 000-0000
Accurate Plumbing Inc
PO Box 74
Andover MN 55304
(612) 221-1221
Applicant/Permitee: Signature Issued By: Signature