Loading...
1281 Carlson Lake LaneCITY OF EAGAN 3745 Pilot Knob Rood Eagan, MlnnesoM 55122 Phone: 454-8100 f?TG. s A/( PERMIT Date: "Ou`•-"mher 15 ; 1-q i' Receipt No.• Single Site Address: - T-c:ne Residential Lot Nome Block Sub/Sec. 9 084 New/Alter./Repair "1f`-'ratj.on ? ; qddreu "1 Carlson L3ke Ldr,r Cost of Installation O City c?an Phone: c n,. Permit Fee Name Fay N. Welter Heatinr C? . Surclwrge ? ? P Address4e'3' C?!'ticago T ,v<?. e 0 V - City `? r ? ?-' Phone: Totol This Permit is issued on the e xpress condition thot oll work shell be done in occordance with al) applicable Stote of Minnesota $tatutes ond City of Eagan Ordirtances. ? ? Building Official io gy?s? aya os No. 1 ( 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: I I + p1RI f-rt1N I_A} i 1 ,:Si: (•1! ??ii'r F t 1^? (' .cf ? i{) F 12NF S`; M2 t? It! A 1 N !?? 1 1 l 4'? MIT SUBTYPE: hClilf I Nli TYPE OF WORK: io r- •-, t: R- I V f r0 N raIF PAxw ( HCit) f 114 c4 3 ? I - -I .??? PermN No. Parmit Holder Date Telephone # ELECTRIC PLUMBING HVAC Inapection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBiNG PLBG AIR TEST ROUGH HEATING GAS SVC TEST JNSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. CITY OF EAGAN Remarks Addition Wilderness Run 4th Addition Lot 4 Bik 5 Parcel 10 84353 040 05 5tate Eagan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR, GRADING SAN SEW TRUNK 1973 163.26 8.16 20 PAID SEWERLATERAL 1975 714.00 71.40 10 PAID WATERMAIN WATER LATERAL WATER AREA STORM SEW TRK t14,1 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. I BUILDING PER. sac 400.00 10031 2-13-74 PARK ? • YruAe? OF EAGAN WATER SERVICE PERMIT 3795 PiIM Knob Road PERMII' NO.: - 1423 Eogan,MN 55122 vA-rE: . 3/15/74 Zaning: R"1 No, of Units: _-1 Owner: GEtZ ni+i 1 A Address: 4 ' - 6 Site Address: -1281..CaYl T ? 'P L ^P Plumber: Wanzp.L-F!ll+mhina &-HeBtiiliJ Tnc Meter No.: Connection Charge: gjye; Accoun[ Deposit _ I;f!]Cae. Reader No.: Permit Fee: 1 agree ro comply with tha Villoge of Eagon Surcharge: .50_pd Ordinonces. Misc. Charges: Tolal: gy Date Yaid: - Date of insp.: Insp.: - VIlLT10E &EI16AN SEWER SERVICE PERMIT 3795 Pilot Knob Roud PERMIT NO.: 2177 Eogan, MN 55144 DATE: _ 3/15/74 Zoning: _ R-1 No. of Units: I Owner: ry+ pe t Ru' 3 dc> Address: SiteAddress: 7281 farlson iak ianr Plumber: WanZal Plnmhyng-fi_}jgating In.C Rec. #10031 1 agree ta comply with tha Villoge of Eogan Connec[ion Charge:400.00 Ad 2/1 Ordinancas. Account Deposit .. Permit Fee: 10.00 pd Surcharge: • 50 pd . BY: Misa Chxr es: g . Date of Insp.: Total: __ fnsp.: Date Paid: This?t void 18 months from O g?? 9 Date oF u Request p 26009 I, as 'censed Electric Contractor ? Owner, do hereby request inspection of the above electri- cal wiringinstalled at: ?yt ?/, j6 J? 4( Street Address or Route No. Section Township Range Countyl?d/ Which is occupied 6y Is a roughin inspection required on this job? No ? Power Supplie[ Electrical Contractor ??•? ?/"`? omDany fyam?!' ? 6,C Mailing Address 4F/ 7 (Elxtrical Conftf tor c Authorized Sienature ?,??.?/? ?, ? Yes ? Ready NowE?--- Will Call ? Contractor's No. 7 ?SF9d (Electrical Contractor or Owne STATE BOARD COPY MinnesoW State Board of Electricity 1954kJniversity Ave., St. Paul, Minn. 55104-Phone 645•7703 `- :-- 'REQUEST FOR ELECTRICAL INSPECTION CHECK BELOW WORK COVERED BY THIS REQUEST ? ??iy 26009 Type oi Building New Add. Rep. Check Applian ces Wired For Check uipment Wired For Home ? ? ? Range ? Temporazy Wiring ? Duplex 0 ? ? Water Heater ? Lighting Fixtutes ? Apt. Bldg. ? ? ? Dryer ? Electric Heating ? Commereial Bldg. ? ? 0 Fumace ? Silo Unloader 13 IndusVial Bldg. ? ? ? A'v Conditioner ? Bulk Milk Tank ? Other ? ? ? H iersf Heiers? COMPUTE INSPECTTON FEE BEIAW Seivice Entmnce Size: # Fee Feedas&Subteeders: F uits: # Fce 0 to 100 Am s. 0 to 30 Am eres . o3 m eres 101 to 200 Amps. Above 200 Amps. 31 to 100 Am res Abme 100 Amp Am etes ve lOQ_Amps. Transformers RemoteControlCirc. Paitialorotherfee S' s S ecial Ins ection Minimum fee $5.00 Remazks TOTAL ? I, the Electrical Inspector, hereby certify that the above inspection has bA?. (Rough-in) 9 Date (Final) f Fj?_? Date %a- 3-7 7 This request void 18 monffis rom i \ 4 CARLSON LAKE ," =209 z NVVL = 840.5 HWL = 845.4 > O ? ? 351 Z L F ? - ?- -D 357 ; TRAIL E DOC# 4 ASEMENT 64245 4363 1299 1293 1287 1281 1277 1273 1265 CARLSON LqKE ? !_,qNE ? U O ? < p Q ? G E+hibits isc STAFFORD PARKI NC 054603 Existing Trail Easement - Doc # 464245 May 6, 2003 City of Eagan Wilderness Run 4th Add. -- . . ? .. . , - , r - , TrF.IL FASL'_'!??JT r q THZS INDEPTLriLR, mnde aad euiere3 iato thxs rl-day of 19 7!f3, Py and be2c:e_a Arnold A. Carlson& Anna C. Carlson, husba & wif ? ? Robert S. Tilsen & Jovice Tilsen hus_ b?ndaawifez"or. s, and City qf Eagan,;. Da%ota Cvu,zty, MInnesota, as Grantee, ??hd ,a 0 Fri?? "? WITNESSLTH WH?EAS, said Grantors a e the ou-ners of the?[racta sf ` RIOER fS q`.?. rd ia th2 City of Eagan, Dakota County, Miunesota, legally ??s be ? R1j?? PART u." TNf? folloas: 29IDER- IS _ Jl .'.. ?-. ?•ii L1 trail casement ovcr that parC of Lots 1, 2, 3, 4, 5, 6, 10, and 11, all in B1ocY. Pive of WIi,DERNL•'5:; RUN L+pg•1'Ii AI7DITIOU 7.yiny beCiveen the L'ark in Wiliit.rne!;;; `-<iin 4',1i nddition and a linc S ieet SouLherly of the fol.iowinrt desrtibed .ti.nc; Beqirininq a;: a point on the nort}l ],ine of: said Lot 11 di.stant 55.7f, foei- o;esterly o`_ the norlheast cornr_r thereo.`'; thence South 89 deyr.er•s, 35 mi.nur.es, 37 srcond;; [9est alor.n (:he north ].i.ne qf. sl.id Loi: 11 a distance o!` i:5.:'4 ;eet to the northwe?;t corner o£ sa5d I,ot ll.; thencc South 00 daqrec•s 24 :ir,utes, 23 seccudg Eus;t a distance o` 85.00 feeT.; thr-nce South ftl dr.gre.es, 53 r-;inutes, 31 second, t•lest alunq the nor.the?.].y line of said 61ock E•'ive n ?ii.s?l.ance pt 513.35 feet: t:o C.ite rtorthwesL- corner ut' :;aid Lot 1.; Lhence South 57 iieqrees, 16 mi.nutes, 52 secondc L'..,t a disCance of ; 'Jorih 37 de?crree;, p0 mi.nuLe,, .50.19 f???et; thenec? ?37 secnnd:; I;ast a d;.GLance o_° P.35.00 fec•t; I:!-u,nr:;, ;.jo??th 67 derrees, 25 r,ti.nuCes:, 37 seconds liast a di:;tance of 160.00 IChonre Slnrth 26 dcqrne,s, 55 minutec, 37 ,econds F:asC a distance uf. fect to the yoinC oE boginninq. 2fld flCLOSS WS11Ci] cne parce. Vi aau? aac?c.) .........?.... ? '_ecation, gradiag, coastructioa, maintenance, and useVof a public tsa:l over nad upon the prenises hereby conveyed aad from the uaea iccident t:.er=to, n3d the said Citq' of Eagan shall have the right to use and zemove all eart.*h, acd other msterials lying within the parcel of land hereby conveyad aad the right to construct and maintain, upoa the Lands adjoiniag the parcel hereby conveycu, iuaa porta6le snow fences during such mor.tt,s as weather conditions make aecese.:rv. All stumps and other debris resulting from the clearing of the right of way will be disposed of by Gran[ee by burnin3 or ot4erwise, accordiq; to law. The Grantee sFall have the right to post su_h signs ar.d posters a2ono s?i.d trail as are deemed neceasary and suitable to defiae the aboce land3 and locate taer for puhlic use. IN WITTIESS WIMLOF, said Grantors ha ve hereiato set their hsed s aad seals t:le day a„d year first above written. ? 1-'? /n A Ia Fresence Of: ? rno v C? son? - --^_ ?. CT1 I9 !1c vtan .nrvn? ? ?r? ..?._ ?"?'? NCW TIiE.nL+FORE, the sald Grantors, in consSderation of One ($1.00) Do1:^r r.nd other good end va.T:sble conaideretiou co th em paid by Gxan*ee, recelpt whereof is her.eby acI;azoorledged, hereby conveys, warrants and dedicates to said Grantee, i.ts heirs aad aseigns, for trail purposes, together with the un- :estricted righ= to iti?prove the same, free and clear of all incunbrances, the above descrioa3 tracts of land for trail purposes. The Grantorsfor themselves , their heirs, esecutors, admi^istratozs and assions, da covenant never to cut, damage, destroy or remove any tree or shrub or other natural grovrth upon the hezeinbefore descrihed premises for the cantinuance of thia easemeat, and do kereby grant and convey to the said City of Eagan all grasses, shrubs, trees and naturat growth nrw existirg on said lands or that may 6e hereafter planted or groan thereon. The Grantor s, for them aelves , their heirs, executors, administra:ors and a3sigZS dc hereby release the said City of Eagen, its su_c>ssors ar3 asrigna, frcm all claims for any and all damages resulting to the lan3: th_eu^?i and across whicil the parcel of land hereby conveyed is located by reasca of t:ie '_ecation, grading, constructian, maintenance, and use of a public tra:l over nnd upon the premises hereby conveyed and from the uses iacident tw.ereto, an3 the said Citq' of Eagan shall have the right to use and remove bll earth std other msterials lying within the garcel of land hereby conveyad and the right ` t.o construct and maintain, upon the lands adjoining the parcal hereby co?aveyc3, cu=h portable snow fences during such mor.ths as weather conditions make necessary. All stumps and other debris resulting from the clearing of the right of way will be disposed of by Grantee by burnic3 or otherwise, accordiqg to law. The Grantee etall haae the right to post such signs ard posters aloae aqid traiZ as a:e deemed neceasary and suitable to define the aboce lands and lo:ate ther for public use. IN WITPIESS T,::E:2LOF, said Grantors ha ve hereuato set theirhse3 s and aeals t:ie dny aad year first above written. /?? /,7 r ? ??u Ia Fresence Of: ?--W?cnn^ .? Arnold . (: lson Robert S. Ti s n ?1... , , ?i7_ , ?J ? _.._..,.._.:_.... .....?.._..?.,..?, STATE OF MkJIC!SG(d ? Covnty of Oakoin, ss. • Office ot Reg:ster of Deeds, This is to c^rlify [haf tha within ? inslrument as filed for record Ir tbis offie ot os;i--.!is, oa fhe ;hs : D. 19 ? o'ciock Ve, nd th ui me was u ded ina Cou y R c, R 1er of Ds ed& oe,ofy ? Transfer Fhtered This .?? ? 1 ?. ? 1 . /I/ ? /? j PERMIT -?- C?,ITY OF EAGAN \ 3 0 Pilot Knob Road PERMIT TYPE: NG Eagan, Minnesota 55122-1897 Perm it Number: 031608 (612) 681-4675 Date Issued: 03 J16 /98 SITE ADDRESS: 1251 CARLSQN LAKE LANE LOT: 4 BLOCK: 5 WILDERNESS RUN 4TM P.I.N.: 10-84353-040-05 DESCRIPTION: (R00FING) SUifdi h§rrRermzt Type SF (MISC.) TYPe REPAIR ? Ceus G?rcle -'? 434 ALT. RE3IpENTIAL Q RS g S dq?' ,? .rv" fi ? *a5k4 ?e ! Yq ?^?,w gqe....: t'm bi ?,? ? ? `56 t 9' REMARKS: FEE SUMMARY: VAIUpTION Base Fee $74.75 Surcharge $1.50 Total Fee $76.25 $3,000 CONTRACTOR: ., OWNER: _ ppplicant - SMEBAKKEN C S 1281 CARLSON LAKE LN EAGAN MN 55123 (612)452-3063 ;acknai ' a?rrforr?ia??an is L APPLICANTlPERMITEE SIGNATURE ISSUED ?1': 91GN ? ? RE ? ? 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) ? 0§ CITY OF EACiAN 3830 PIIAT I{NOB RD - 55122 681-4675 New Construdion ReauiremeMs ? S registered ske surveys • 2 copies of plans (inGuEe beam 8 window sizes; poured fnd. design; eta) ? 1 energy calwfatlons • 3 copies of tree preservation plan'rf lot plalted after 717/83 required: _ Yes _ No DATE: _ 3 ^16 - 9? DESCRIPTION OF WORK: RemodaVRenair Reauirements • 2 copies of plan • 2 sde aurveys (axterior addkions 8 dedcs) ? 1 energy calwlatlons for heated additions CONSTRUCTION COST; `°? --5,0 STREET ADDRESS: _/x S ? C-ct µls ea /" (t'- ` c[`?y LOT: j BLOCK: ? SUBD./P.I.D.#: 0462VA,U4?bn,4;IL PROPERTY OWNER CONTItACTOR Name: S/Yt2 h c. e' / c,,? Phone #t: ?S?°Z ^ 3 d?e 3 Last First Street Address:_L??S' ? ??u (?' • ?{ f `R ?' ^ eA?- City f i ?r- 5? s State: /k /-? Zip: / .4,:7 Company: S t !/' Phone #: Street City License # State: ARCHITECT/ ENGINEER Company: Phone 9: Name: Registration !i: Street City Sewer 8 water licensed plumber (new construction only): and lot change is requested once permit is issued. Zip: Zip: Penalty applies when address chang I hereby acknowledge that I have read this application and state that the informa6on is cort and agree to campty with all applicabl 5tate of Minnesota Statutes and Ciry of Eagan Ordinances. SignatureofAp'licant: ? OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received - Yes _ No _ Not Required State: e¢-S G<1 "2. x CITY OF EAGAN 3795 Pi1ot Knob Road Eagan, Minnesota 55122 P=T NO o : 475 The City of Eagan hereby grants to Ray N. Welter Heating s A/C Co. of 4627 Chicaqo Ave. So., Mpls. 55407 a HRATiriG Permit for: (Owner) Don Getz - Builder at 1281 a ison Aka L*+e , pursuant to application dated 3/15/74 Fee Paid: S20.00 dated this 20th day of March ? 19 74 , .50 s/c Building Inspector Mechanical Permits: Bid Total: *_ * CITY of EAGAN BUILDING PERMIT / L Ownes .................. ...... ......................... ............ .?.?........... -........ Addxecs (pzesen!) ................................................................... Huilder ........ Addrese ...... ? ..;. N2 3211 3795 Pilo! Knob Road Eagan, MinnesoSa 55122 454-8100 Dals .. °?.- ?`.3.?. ?. ` .................... Stosiec To Be Used For Fr a1 D ep Heigh! Eel. Co ! Pesmi?ea Rsmuk? ? y & c ? I f o- o 1.38• so / /b Sa, 0.'zT l1'?o?" 4 ;;L-4 LOCATION / G, 2. ? v Street. Road or ofher Descriprion of Loeaffon I Lo! Block AddiHoa or Tree! ) a 3'/ 12-- .? TF- This pezmit does not authorize the usa of slreels, roads, alleps or cidewalks nor does it give the owae= o[ Lit ngeat the righS !o ereaYe anp sifuation whieh is a nuisenee os which presenls a ha:ard !o the healffi, satelp, coaveaieaee and general welfare !o eapone in the communify. THIS PERMIT MUST BE KEPT N THE PREMISE WHILE THE WORK IS IN PAO ESS. This is io eerlifY, thal.,..---- ' -.....---..has pasmisaioa !o erect a ??...°` °1, . . ................................ ........ ........ . . . ......... the above deseribed premise s ject to the provisions of all applicable Ordinanees for the sYy of Eagan -7? ,(J .........--'....---...._-/•`!`='-_l.o:?? . :: -" , --°.._"-...."""'_"-"... Per ...................... ?v:.....`......""' :..........."'........_......_....................... Mayor ro Suildinq Ina,psetos ? . . ? ?j s / v `o -r 4 w ch 5 !.? i '/d e, /r,? es s /f v?- Y?'?. ?C?.-Y. V G 1 Z^ / 3 a( i.?/ ;/ d? I?•?. G f f/?v.Y I I 1 I ; I i I 1 ; ? 11 a M r i - _ ,.'r-? . _- --• ?s . ? 04 G f4 /V J /?/ , , .V.? V MASTER CARD Loca OWNER t^?41 STRUCTURE AND / LAND USED AS l//UI V /l.I./?f?+? Az-f Issued To Permit Na _ Issued I Contractor Owner BUILDING 7 y PLUMBING ? ? ii? v ? ? CESSPOOL - SEPTIC TANK ` WELL ELECTRICAL HEATING ? v GAS INSTALLING SANITARY SEWER OTHER OTHER FOOTING FOUNDATION FRAMING Items Approved (Initial) Da}e ?7-0- 74 v d ? J /^ LA Remarks Distance From Well SEPTIC CESSPOOL TILE FIELD F ? ' r DEP7H OF WELL HEATING GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WEIL SANITARY SEWER ' /.J - Violations Noted on Back MEMO TO: BUILDING INSPECTOR PETERSON FROM: CITY ADMINI5TRATOR HEDGES DATE: SEPTEMBER 6, 1978 SUBSECT: RESIDENCE A 1281 CARLSON LAKE LANE ? _?- City Council Member Parranto asked to have the residence that is under construction at 1281 Carlson Lake Lane checked out by your department to see if it conforms with the side yard set back requirements. It appeared to Council Member Parranto that the house was rather close to the property line and possibility did not conform with regulations. Your response is appreciated. ??Ob? City Administrator Y ...•'?: ?7% I-?i;?xa::?? tlI',: Ci1RLS0;1 LAI<:F LAnT, Ilr.'fTF.RFTJ'. 2O AS 1281 CARLSOA1 IJLK'. Counci]nen Parrantc was not aware that 52.07 Subdivision 5, Table z1 allowed gara;es tc be 5 fcet fran side property lines. The above dwe111ngs garage si.de ls 6.5 Feet frarn the property 1:Ine and therefore rr.eet;s the .?*?ninnnn side yard setback. '.1;ere seemed to Ue a misunderstanditig on whether or not the garage Maas Y,o be unattachea or no?; and in m,y opinion ordinat7ce 52 does not di^ferenciate betwnen detached or attached. Therefore there cnuld poss_biy !;e as littlc as 10 feet between tio;res with attached garar',es. 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) % ld / .2 3830 PILI T KNOB RD - 55122 651-681t-4675 New Conctniciion RewiremeMs Remodel/Reoair Reauiremenh ? 3 regfstered aite wneys ahowing aq. H. of bt, aq. R. of house 2 coplea of plan antl qJ( roofed areas (20% maximum lot coveraae atloweN ? 1 set of energy calculaflona for heafetl addlHms ? 2 copfes of plans (slww Deam 8 window sizea; pouretl fnd. design; etc.) ' 1 alfe wrvey for extedor addiHons & decks > 1 set of energy cadculaNOns ? S coplea of hee preservatlon pWn If lot plalfed aRer 7/1/99 DATE: 74?6" 00 CONSTRUCTION COST: •I?a DESCRIPTION OF WORK: II mulH-famiry bldg., how many unitsT SPRSE? aDDRESS: I .( lcXn,/e_- LOT: 4 BLOCK: 5 SUBD./P.I.D.#: JN111lgrhP0 2U11 q16 Name: Sm ?fG?/? Phone #: PROpERTY last Flror OWNER Sheet Address: ?it-1S 1 4-rl( 0? L'ZL?& 1'G2Yl "e Ciry ?-rl 1211-) State: Xh zfp: Company:?? P4Cf7t)/)-I6 /MP9&1/ePiUi.9Tone #: &A( :?%J? (area code) corrrRncroe Street Address: SJ? 01_-;t3?'?QLGZhGe Ai-e IV ucenga t2Q29ZyfXa. 4(- a?r Ara Q/GZ44?2 422`? srofe: tri.n zip: ARCHITECT/ ENGINEER Company: Name: Telephone #: ( ) Sheet Address: Regishaflon #: Cly Stpte: Zip: Sewer/water licensed plumber (if installirw sewerlwater): PFrone #: I hereby acknowledge fhat I have read this applicaHon, state that the fnfortnation is coneet, and agree fo comply wNh all appiicable Sfate of Minnesota Stalutes and City o( Eagan Ordinances. Q I Signafure of OFFICE USE ONLY --'T- JUL Certiflcates of Survey Received Tree Preservation Plan Received _ Yes _ No L _ Yes _ No _ Not Required 2000 ?& c7 cl y 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX 4 651-675-5694 New ConsWCtion Requiremenfs 3 registered site surveys showing sq. ft. oi lot, sq. R. of house; antl all roofed areas (20% maeimum lo[ coverage allowed) 1 SoPs Report if pmposed 6uiltling is to 6e placed on disturbetl soil 2 rqpies ot plan showing 6eam 8 window sizes; pouretl found design, etc. 1 set of Energy Calculations 3 copies of Tree Preservafion Plan if Iot plaped after 711193 Rim Joist Detail Op6ons selec6on sheet (buildings wflh 3 orless units) Minnegasco mechanical venfila6on form %?;S-7S RemodeVRepair Reouiremenls OfficeUse OnN 2 copies of plan showing footings, heams, joists Ced of Survey Recd Y 'rN lsetofEnergyCalculafionsforheatedadditlons SoilsRepoR ` Y N 1 site survey for addi6ons 8 decks Tree Pres Plan Recd Y 'N, Addifion - indcafe tl on-sik sepfic system Tree Pres Required Y' _ N OnsiteSepiic$y5tem _Y,. _N PEans are considered public inforrriation unless ou state the are trade secret and the reason. Date 3 / 17 / 07?_ Site Address onstructiou Cost l??Q 0 ? ? &L?? ??? ?Zeq yap Uni[/Ste # Description of Work '7+• ?! lh? f ?? ?? ? u> ? Multi-Family Bldg _ Y? N Fireplace(s) _ 0 _ 1 _ 2 PropertyOwner Telephonee,.?j?l Contractor 7 ?'???-?U? ?'?'?/ ` Address C90 ?.-t a State m, A- Ue Cih' Zip,332& Telephone # COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv I _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Gode Worksheet (q submissiontype) Submitted Submifted . Energy Envelope Calculations Submitled In the lasT 12 monihs, has the City of Eagan issued a permit for a similar pian based on a master plan? _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contracfor Telephone #( Telephone #( Sewec/Water Contractor Telephone # ( J T herehv annlv fnr a Rrciriential RnilAino Pa.rmiT anri aeknnwlerlae thaT the infOiY1'Iat1011 is comnlete and accurat e; 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 noY a permit, but only an application for a permit, and work is not to sfart without a permit; that the work will be in accordance with the approved p in the of work which requires a review and appr val of plans. ?'?v? ApplicanPs Printed Name ppltcant's Signature Use BLUE or BLACK Ink r For Office Use ( ~Q I f can Permit#: City of Ea Ed i 05 a 111000 In Permit Fee. I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 1 I Fax: (651) 675-5694 I Staff: I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit Name: r-G, Phone-4 ~3 Resident/ I Owner Address/City/Zip: EScs7' Applicant is: Owner Contractor Description of work: a Type of Work Construction Cost: Multi-Family Building: (Yes / No ) Jam, 14" o ar Company: r P2GY 57,e ~bos~V t 4 e- ontact: Contractor Address: fQ~~. - City: 4 Stater Zip: ,5~5_ o ~ Phone: p5_ 3Al 3 License M C_ 1~ ;R, 8 -Y 3 to 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 A NEW 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: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: 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. 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 B ildi Code must be completed within 180 days of permit issuance. Applicant's Printed Name Applicant's Signature Page 1 of 3