1291 Easter Lane• CASH RECEIPT ?
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN. MINNESOTA 55122
DATE 19
AMOUN7 ? I
& DOLLARS
IDO
? CASH ? CNECK
ROR
, ? .
FUND
f. ,
COD6 A??6UNT
I ?
Thank You
/ BY
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Whice-Payers CopY
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN Remarks ?.••?
WILDERNESS RUN 6TH ADDN
Addition Lot
Owner X4. aVt ' ?` ?+'•CL 1?,'? ? l? Street 4:22-11
3 B1k 5 Parcel 10 84355 031 OS
Improvement Date Amount Annual Years Payment Receipt Oate
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 1
STORM SEW TRK 1978 31d under OY'1 inal 10
STORM 5EW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILOING PER.
SAC
PARK
D".
CITY OF EAGAN R e m a r k s
Addition WILDERNESS RUN 6TH ADDITION Lot ?1 3 Blk 5-- - Parcel 10 84355 0-V OS
Owner??/?i?'' Stree*1291 F.aGter Lane State Eagan, Minnesota 55123
c.{ "LO 11'C'F•
Improvement pate Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
5AN SEW TRUNK 1973 • • -96 7
SEWER 4ATERAL "
WATERMAIN
WATER LATERAL
WATER AREA • •
STORM SEW TRK aL. 21 : 46 15 257.62 A00$
STORM SEW LAT ?
CURB & GUTTER
SiDEWALK
STREET LIGHT
WATER CONN,
BUILDING PER. 5467 79
sac 1050.00 16510 10 16/79
PARK S . -.5r- --y
I
? CITY OF EAGAN PERMIT TYPE:
? 3830 Pilot Knob Road Permit Number:
? Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: ' APPLICANT:
? , . .?rFR I. nar
? ? ; . . • ? ? r f , , , , ; . ? , ?.
PERMIT SUBTYPE: TYPE OF WORK:
Ilf Sr.:p rPr I ON i ?I F* R[. kout
:no1i i N?
-1
J
Permit Holder Date Telephone #
PLUMBING
H VAC
Inspection Date Insp. Comments
FOOTINGS I
FDUND
FRAMING
ROOFING / /• S' g?
!
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
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUC7iVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
- cIrir oF EAG+?N
? 3795 Pillof Knob Road Eagon, MN 55122
PHONE: 454-8100
BUtLDING PERMIT ,
Te be ased fa Est. Value
Site Address
Lot Block Sec/Sub.
Pcrcel 4
W rvome _
z a,de?s
Q! Name ?o - -
o'?' Address
uq - .-r..?
w,,,.,e
I hereby acknowledge that I have read th+s application ond state that
the inforr»ation is correct and agree to comply with all opplicable
State of Minnesota 5totutes and City of Eagan Ordinunces.
Receipt #
N2 5467
Erect ? Occupancy
Alter ? Zoning ?
Repair p Fire Zone ?
Enlarge ? Type of Const.
More ? # Stories
Demolish ? Front ft.
Gmde ? Depth ft.
Approvais Fees
Assessment _
Water & Sew.
Police
Fire
Eng.
Planner
Council
Bldg. OfF. _
APC
Permit
Surchcrge
Plon check
SAC
Woter Conn.
Woter Meter
Total
Signature of Permittee I
A Building Permit is issued to: on the express condition that
oll work sholl be done in occordance with cll applitable Stote of Minnesoto Stotutes and City of Eagan Ordincnces.
Building Official
Pennit # Duh 1 ed P
Plumbing (r ?j 7 D `? f
Merhanical
,7
INSPECTIpN5 DATE INSP. Rough-In Final
Footings Insv. Dofe Insp.
Foundation Plumbing j !
Frame/ins. ` Mechanirnl ? "
Final
?
Remarks:
,
PLII?v'?3ING
Dote: 3/?
crnr oF EAGAN
3795 Pilot Knob Road
Eagon, Minneaota 55122
Phone: 454-8100
PERMIT
No.
2?Z(? 1624
Site Address: 12*91 & 2293 EaeteT I,ane
?or '` Biock ' Sub/Sec??'3lderness Rim 6th
Name R`tl8@Ti HomeB ZAC.
? Address 627 So• Snel?linr Ave.
?
City :=t. Pat11,NDi Phone: 698-55!,1
Name ? ?tUhs Pl?zT:!1?i.-tF?'
.
? Address `-)()Oo KP.STrf Ck Ave. N0.
0
(.i
City - Phane: ' S
This Permit is issued on the express condition that all work shall be
Minnesoto Statutes ond City of Eagan Ordinances.
Receipt No.:
Single I
Residentiol
Multi Res., Comm./Ind.
New/Alter./Repoir
Cost of Installation
Permit Fee 40' 01
Surtharge
Tota I
done in accordance with all applicoble State of
Building Officiol
__ ..r ?.
CITY OP EAGAN
3795 Pilot Knob Road
Eagun, Minnesofa 55122
Phone: 454-8100
-iEAT ING PERMIT
? !1 r? /t;?
Dote:
Site Address:
Lot _ _ _
1292 - 1293 Esater Lem
Block ? Sub/Sec..
Til I
Wilderness &m 6th
No. :.?2-:1 -
Receipt
Single
11,1112
Multi ftesa Comm./Ind. '-uUlex
Nome aen
iomse nc.
/Repair
New/Alter
.
. -
. 5207 °,o . Sen-11? ztg h ve
; Address Cost of Instalintion -- - T
- °??.:1,'?d
City Phone: Permit Fee ; --
Name 3inder & C'T? zT.C . ?
Surchorge J .. 1
??
? Address
s . ` , , •_ _
City Phone; Total l
This Permit is iuued on the express condition that all work shall be done in occordance with all applicable Stote of
Minnesoto Stotutes and City of Eagon Ordinonces,
Building Otficial
CITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMfT NO.:
Eogan, MN 55122 QATE:
Zoning: - No. of Units:
Owner;
Address-
Site Address:
Plumber. _
Meter No.: _ Connection Charge:
Size: - Acwunt De
osit:
p
Reader No.: Permit Fee:
I agree to comply with the City of Eagan ' Surchorge:
r
Ordinancss. . .:ti'. .
Misc. Charges:
Total:
BY Date Paid:
Date of I nsp.: I nsp.:
CITY aF EAGAN SEVIIER SERVICE PERIIAIT
374b Pilot Keob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. af Units:
Addres: :
Site Address:
Piumber. ' -
m
with !he Cit
of Ea
oe
to
l
1 Connection Charge: ' ??•?:'r}
y
y
g
p
agree
eo
Ordinances. Account Deposit:
Permit Fee:
Surchorge:
g Charges:
Misc
y _ .
of I
s
D
t Totol:
p.
n
a
e :
Inso.: Date Paid:
CITY I"E EAGAN WATER SERVICE PERMIT
3795 -..ot Knob Rood PERMIT NO.:
Eagan, MN 55123 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
Meter No.: Connection Chorge: '
Size: _ Account Deposit:
Reader No.: Permit Fee:
I ogree fo eomplr wifh fhe City of Eogon $urcharge:
Ordinances. Misc. Chorges: .,?,..r
Total:
BY Dote Paid:
Dote of Insp.: Inso.:-
cInr ' EAGAN SEWER SERVICE PERMIT
l745 Pilo! Knob Road PERMIT NO.:
Eagon, MN 55122 DATE:
Zoning;
No. of Unltr. ? •
Owner: .
Address: _
5ite Address: _ , , • -
Plumber. __ ' . 1- L1 -.:1, -L.
( agree to eom I r?C .??f,l ?id
ply w$h the City of Eagan Connection Charge: ••:?
Ord7nonees. Account De
posit:
Permit Fee:
B 5urcharge:
Y Misc. Charges:
Dnte of Insp.; .
_ Totol:
'Tlfis ieqae,:v?ZWmonths from . - "
_ /--3, B 30631
Date of this Request ? q_?_1 q ?
I, as ?;Licensed E]ectrica?l Contractor ? Owner, do hereby request inspection of the a6ove electri-
cal wiring installed at:
Street Address or Route No. 1293 E,:.ster Lane City Ea?an
Section Township Range County Daknta
Which is ocwpied byTilsen Homea
(Name o1 Occupant)
Is a roughin inspection required on this job? No ? YesIg Ready Now ? Will Call a
Power Supplier Dakota Cts. Address Fnrruington
Electrical Contractor 0 RThowpzoxi- Flastxas Ce Contractor's License Nd1374F?
(COmDany Name)
Mailing Address 12201 TStka Blvd., Mtka 55343
(Elactrical Contrector orOwner Making Thls Installatlon)
Authorized Signature I :! "•:-'-=Phone No.
(Elactrical Contiactor-or Owner Making TNS Installatlon)
SVnLOQ??pU This iFISpection request will not be accepted 6y tUe
?; L ? State Board unless proper inspection fee is endosed.
Minnesota SWte 8oard of Electricity
1954,dniversity Ave., St. Paul, Minn. 55104-Phone 645-7703
. k'EQUESTFOR ELECTRICALINSPECTION
CHECK BELOW WORK COVERED BY THIS REQUEST
? 30631
Type oP Building New Add. Rep. Check Appiiances Wired For Check Equipment Wired Frn
Homj ? ? 0 Range ?• Tempotary Wuing ?
-7?'m .ic ? ? ? Water Heatec ? Lighting Fixtuies ?
.+pt. Bldg. ? ? ? Dryec ? Electric Heating ?
CommercialBldg. ? ? ? Fumace Mcz•CO SOoUNoadei ?
Industrial Bldg. ? ? ? Air Conditioner ? Buik Milk Tank ?
Farm ? ? ? List
) List
Other ? ? ? p
}
Heretsl - ? p
Hereers?
l
COMPUTE INSPECTION FEE BELOW
Seivice Entrance Size: # Fce e'`So4f? ' "# Fee C'ucuits: # Fee
0 to 100 Am s. s D to 30 Am eres , 00
101 to 200 Amps. to 1?J Amperes 31 to 100 Am e[es
Above 200_Amps. A ve 100 Amps. Above 100 Amps.
Transformers RemoteControlCirc. Parimloro[herfee
Signs Special Inspection Minimum f
Remarks Halj 1'pTAL F .3/f 32.00
I, the Electrical Inspector, hereby
(Final)
This request void 18 months from
Ospection has been made.
/1Z Date ! ?? ? / 7Y
Date
'1 _ Minnesota State Board of Electricity
` 1554 tMiversity Ave., St. Paul, Minn. 55104-Phone 645•7703
- REQUEST FOR ELECTRICAL INSPECTION
CHECYC BELOW WORK COVERED BY THIS REQUEST
S
Type of Building New Add. Rep. Checlc Appliancea W ired For Check Fquipment Wirod For
Home 43 ? ? Range EK • Temporaxy Wuing ?
Duplex ? ? El Water Heatei ? Lighting Fixmres taC
Apt. Bldg. ? ? ? Dryer ? Elecuic Heating ?
Commetcial Bldg. ? ? ? Fumace EPC2•0 Silo Unloader ?
Industrial Bldg. ? 11 ? Air Conditioner ? Bulk Milk Tank ?
Fum [] List ) ist
L
Other ? 0 ? p
y,?
HeielSWl i2 X p
Heiets?
0 to
1 to
Remazks
FI811 I TOTAL
I, the Electrical Inspector, hereby certif??th o ' s ec '94 has been
(Rough-in) ? ?Date J
,
(Final) Date_
This request void 18 months from
_13-7
- ?-
.00
w J4.VV-- »»V
This rec?„void IS months &om
Date of this Request 1 1-7-197g s 3 0 6 3 0
I, as iEtLicensed Electrical Contractor OOwner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No. 1291 Faater T,anc City Eagan
Section Township Range Counry Dakota.
Which is occupied by Tilsen FIomes
(Name of OccuPant)
Is a roughin inspection required on this job? No ? Yes3a Ready Now ? Will CalliG
PowerSupplier Dakota Cty. Address FArmingtnn
ElectricalContractorO,B, Thompcon Electrie Co. Contractor'sLicenseNC7qh9
(COmpany Name)
Mailing Address 12201 IuYtka Blvd., IlItka 55343
(Electrical Conttactor or Ownar Meking This Installatlon) .
? ?' ?,r, '%.i?
Authoriud Signature Phone No.
(Electrlcal Coritiactor or owner Making 7his Installatlon)
(? ?(} ?7? nn _?? C0P?17 ' This inspection reqP Pwill npt be accapted 6y the
?[`? ?j UL% ?f State Board unless ro er ins ection fee is endosed.
cinr oF eacaN
, 3795 PIIot Kno6 Roed Eegen, MN 55122
' PHONE: 4548100
BUILDING PERMIW?CATION Receipt #
Te 6e used for Esi. Value 63, 000. pate N2 5467
12/ e-)
10-1$ 19T9
ress 1291 Easter
$Ite Add
- Lane ?1
'
rect [X
OccupancY R3
5
1T PS
P?SS ?2UTl?fit
•?
I R2
2
i
Lot Block Sec/Sub. ter ? on
ng
Porcel # 10 84355 030 OS Repair ? Fire Zone 3
Enlarge ? Type of Const. V
? Name ?1? Move ? .# Stories
i 291-93 Easter Lane
a? Addr¢?q
Demolish ? 90
Front ft.
an
? Ci ?ag Phone Grade ? Depth 34 ft.
? Name 1 5211 Hcms, I11C. Approvals Fees
0
o' Address b2i . ne Siling ve.
Assessment
Permit •
Ci St. Paul 55116ph
698-5501 Water&Sew. Surchor9e 31.50
one Police Plan check 79.50
Q!
Name
p;m
SqC2@SZ?r-1050.00
?? Address
Eng. ,?@a?o=sao.
Water Con
6W Ct Phone Planmr WoterMete?@60=1ZO.
Council
I hereby acknowledge that I have reod this appiitation and state that Bldg. Off.
the informotion is correct ond agree to comply with all appliwble 1
980
00
StoM of Minnesofa $fatutes and City of Eagon Ordinonces. APC Total
?
•
Signofure ot Permittee
Tilsen Hanes, Inc.
A Building Permit is issued fo:
oil work sholl be done in uccordonce with ail applicab?tote of Mii
Buildirg Offlctcl (Q C p
_ on the express condition that
and City of Eagan Ordinances.
v??Taa,TeE
CI7'Y OT' PflGAd 3-6'v
'795 Pzzo'r IMos Roan
M916N, MI?"l^TES03"A 5?c'122
The Council oS 'Phe C3ty o£ Eagau hereby grants a variance
pussuant to appl3catian of Tilven Homes Tnc. <md Arriold Carlson
da'tecl Un 5, 197$ for tha £o11ow3.ng purpose for vaxiarzce
from 15,000 squa_^e foat pf°ovision on Iats 1 through 9, IIlack 5
Sdildarness Rur: 61;h Addition.
nate approved: Jw1e 6, 1978 rees Paia: 50.00
$y: c4.
r
Abt@eb:
' Clerlc
., .V* DaTLP /a -5-79
BUIyDIAIG PF•RMIT APPLICAT20N
znclude 2 seta o£ plans. 1 site plan w/elevations and 1 set of enerqy calculations.
?
Tb be used for . Valuation
Site Addresc:
Lot Block See. Sub. Parcel Number
Owner L
Address
Telephone
Telephane 4 y? J`5O ?
Address
Arch./Eng.
Address
Telephone
Erect
Alter
Repair
Enlarqe
Movo
i?emolish
r,rade
OFFICE USE
Date of Approval & Initial
Assessment D „Z 'O1`'%
9
OE'FICE USE
Occupancy T?.>
Zoning ??-
Fize Zone -?
Type of Const. /-?
#i of Stozies
Front
Depth -? ?
Permit
4ca
Rtater/sewer
Police
Fire
Eng.
P2annex
Council
Aldg. Off.
A.P.C.
Surcharge
p3an Check
5AC
taater Conn.,
V7ater Meter
TOTA.i, +
?_. .n. -•- - .FY'F' 'e'TY 1 . _: ?• ' ..pa.v1 .OF.•£^'' ` s. ?+ i
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PERMIT
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMITTYPE: au1LoING
Permit Num6er: 0 3 3 6 5 8
Date Issued: 10 / 1 A i 9 8
SITE ADDRESS:
1291 EAS7ER LANE
LO7a 32 BLOCK: 5
WILDERNESS RUN 6T11
P.I.N.: 10-84355-032-05
DESCRIPTION:
r' -,?.._ T.O. & REROOF
Bq'i3din6l,E?ermit Type
8uilding Wo'rk Type
?=(Y"eFtrs 41s CQCI@ 's`E,
?..
ti
a,
f?`
I
? ,. . . _,
1o ,-?.?.?•
4
'°f
0?2 4 N
STORM DAMAGE
REPAIR
434 ALT. RESIDEN7IAL
4?4 w_a
i..d
REMARKS:
FEE SUMMARY:
CONTRACTOR: - Applicant - sT. Lzc. OWNER:
NEEDHAM CONSTRIJCTION 17765500 20143425 SIEBOLD THOMAS
1983 510AN PLACE #5 1291 EASTER LANE
MAPLEWOOU MN 55117 EAGAN MN 55123
(612) 776-6600 (651)686-0988
Zhereby acknowled-ge tfiat-I have read thie? app'lioation 'and' stat`re tAat the
information is correct and agree to comply with a11 applicable State af Mn.
Statu.tas,and Ci-tY o1` tagan-Ordinances. IL, .
APPLICANT/PERMITEE SIGNATUFiE
ISSUED BY: SIGNATURE
_ , . 1998 BUILDING PERMIT .APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 65122
681-4675
New Construction Reauirements RemodellReoair Reauirements
• 3 registerea site surveys ? 2 wpies of plan
? 2 wpies of plans (inGude beam 8 window sizes; poured fid. design; etc.) ? 2 ske surveys (ezlerior adErtions 8 deeks)
? 1 energy plwlatinns ? 1 energy wiculations for heated addkions
? 3 eopies of tree preservation plan if lot plaGed after 7/1193
requirad: _ Ves _ No
DATE: CONSTRUCTION COST; D
DESCRIPTION OF WORK: o7' 7? fz: A
?
STREET ADDRESS: azz 4L45/Zie ,a/.
LOT: O_ ?? ? BLOCK: 1?7 SUBD./P.I.D. #:
Name: S P L( /( Y>/7') S Phoae !€: 6
PROPERTY Last ' Fim
owrrEx Street Address:
City La (T? _ State: ? Zip:
Company:-A? ??em Phone#: / /(L ?S
CONTRACTOR
Street Address: (J License
City ?'/J/f r.t? State: Zip:
? ?
ARCHITECTI
ENGINEER Company: Phone #:
Name: Registration #:
Street
City State:
Sewer 8 water licensed plumber (new wnstruction only):
and lot change is requested once permit is issued.
Zip:
Penalty applies when address chang
I hereby acknowledge that I have read this application and state that the inTortnation is correct and agree to comply with all applicabl
State of MinnesoW Statutes and City of Eagan Ordinances.
Signature of
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received - Yes - No - Not Required
. , ,
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dweiling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
O 05 SF Misc. 0 10 = plex
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual) _
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
? 11 Apt./Lodging ?
? 12 Multi Repair/Rem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
? 15 Deck
? 36 Move
? 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq.ft.
sq. ft.
sq.ft.
Footprint sq. ft.
Building
Engineering
Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Pertnit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
ToWI:
Valuation: $
16 Basement Finish
17 .Swim Pool
20 Public Facility
21 Miscellaneous
MC/WS System
City Water
Fire Sprinkiered
PRV
Booster Pump
Census Code.
SAC Code
Census Bidg
Census Unit
% SAC
SAC Units
RE90LUTZOti
- - CTTY OF E.;GA:I
,
b1HEP,EAS, a public heariag pursuaat to notice was held at a r qLiar
meeting of the Eagan Advisory Planning Cacinissian on November 27, 1979
cancerning the applicatian of Tilsen Homes. Inc.
for waiver of subdivision requiremeats under fiagan Ordinance Mo. 10 covering the
following described premises: Lots 1 through 9 Block 5 Wilderness Run 6th
Addition, Section 2 7 T27 R23
t7HER:AS, a majority vote of the members of the Advisory Pianning Commission,
with a quonmi being present at the hearing, voted in favor of reconmmendiag approval
of anch application; and,
1:2ER»AS. arpQtilar meeting of the Eagan Citq Camcil, Dakota Crnmty,
Minnesota, was held on De mhar 4. 1979 at the City Aall at 6:30 P.M.
all members beino present eaccept: ?
NOFT TEEREFORE, upon motion of Smith , seconded by
Parranto aIl Council members votiag in favor except: -
it was RESOLVED that said application for waiver af snbdivision requirements covering
the abwe described premises be, aad it hereby is, apprwed.
D9?ED:_ Dec. 4. 1979
CITY COUrICIL - CITY OF EAGAC7
$7CETIPT FP.Oif STATE gy;
DEED TAX STAi?S Its Mayor ??
C E A T I F I C A T I 0 N
I. t,tgrA RnikA , Clerk o£ the City of Eagan, Dakota Crnmty,
Minnesota, do hereby certify that the foregoing is a true and correct copy of a
RE50LUTION adopted by the City Cowcil of the City of Eagan, Dakota County, Minneaota
on _ Dec. 4, 1979
DRAFTED SY:
CIT7 OF EAGAN
3795 Pilot Rnob Road
Eaoan, Minnesota 55122
&"te
City Cler
City of Sagan '
, (SEAL)
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''
VARiAVCE
. CIY'Y OF EAGA -[
3795 PILO'C IGVOB ROAD
Fa3Ai1? MD'd"JFSOTA 515122
The Council of 'fhe City of Eagan hereby grants a variance
pursuant to application of Tilsen Homes Inc. and Arnold Carlson
dated Mav 5. 1978 for the following purpose for variance
from 15,000 square foot provislon on Lots 1 through 9, Block 5
Wllderness Fttm 6th Additian.
Date approved: June 6, 1978 F s Paid: 50.00
By:
Mffor
Atteat: Iu¢-e ,?-Q??c../ •
Clerk
PERMIT #:
CITY USE ONLY
RECEIPT DATE:
XQ3
S E MID£PTIAL MECi3ANICAI. PERMTf
crrY oF Rtshx
3830 Paor exoa an
$A6AN MlY 85 Y EE
651-681-4675
9 .W,?Sb
lkPPLICATIOR
Please complete for:
Date:
single family dwellings
townhomes and condos when permits are required for each unit
-2a-Q)
SITEADDRESS: 1293 RacTrn r nnrr --
OWNERNAME: LONNA ORTLOFF TELEPHONE#: 6931-q44 _1951
INSTALLERNAME: RON' S MECHANICAL INC. TELEPHONE#: 952-445-895--
STREETADDRESS: 12ni n nr n nRTru vaun un
CITY. Sx,nKOiJFF STATE: pN ZIP: 553:79
Place a check mark next to the permit work type
L' Add-on, modification or alteration to existina dwelling unit $ 30.00
= f;:rnacereplacement
• air exchanger
• air conditioner
• other _
Nature of work:
L? '?
JAN 3 1 2003 ?
State Surchar e $ .50
Total BY
SIGNATCTRE PERMITTEE
t l02
?
F70 I
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SEWER IN,ERT
TILSEN HOMES INC. ?
LOT AND BLOCK ` - 3
ADDITION A/0-
NAME?
ADDRESS
ciz?r
r1?oNr _?RO?E?r,r . L i r? t Q I
.
1- LOT ?4 L AN .
Use _ or BLACK Ink
For Office Use I
a f EaF
n City Ul on I Permit 3830 Pilot Knob Road I Permit Fee: i/O 0.00
Eagan MN 55122 I I•
Phone: (651) 675-5675 I Date Received: A" G -d
Fax: (651) 675-5694
I I
Staff: M1(~
-
2013 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date: Site Address:
Tenant: Suite
Resident/Owner Name: ct Phone: Z,/Z 3 o , F 7 `
Address / City / Zip: (7 3 ~ /-Awe AJLCJ Crya,y d `t4 pf~S S,5 9,33
Name: _ /eU;4n1 ple w-- /4C".-7-, License
Address: Lt_ n>r 0Z5.4-5 Tti City: $ ! ~~u r
Contractor
State: u/ Zip: Phone: b 57/ - 22-4 - g/ 7 7
Contact: RW.J, Email:
New Replacement Additional Alteration Demolition
Type of Work Description of work: .s rw►fco 'Z-10,J 4c- qN,, 7d, ~cOr 7~.c.rytc~
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
RESIDENTIAL COMMERCIAL
Furnace _ New Construction _ Interior Improvement
Permit Type X Air Conditioner _ Install Piping _ Processed
_ Air Exchanger Gas Exterior HVAC Unit
_ Heat Pump _ Under / Above ground Tank L_ Install Remove)
_ Other
RESIDENTIAL FEES:
$60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ TOTAL FEE
COMMERCIAL FEES:
$70.00 Underground tank installation/removal Contract Value $ x1%
$55.00 Minimum Permit Fee
'If the project valuation is over $1 million, please call for Surcharge 5.00 Surcharge"
TOTAL FEE
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.
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.
x x
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE
Required Inspections: Reviewed By: Date:
Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening
Use?BLUE or BLACK Ink
For Office Use I
I 11 (~'j I
I Permit#: 1
I I
City of Ea
I Permit Fee: U,
I
3830 Pilot Knob Road I A
Eagan MN 55122 I Date ReceivedPhone: (651) 675-5675 I I
I Staff:
Fax: (651) 675-5694 1 - - - - - - - I
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: -/3 Site Address: ~q l ~ ~A P1 e--
Tenant: ~A) ( 6-f ~ v7-1o 7 / Suite
Resident/Owner Name; A&y~ E-U' Y1Phone!l/-Z-30q^ X;7
Adv11
Address /City /Zip:F~s3 ~~Pl ~fvA'A w Is
Name: ` )U l f~ Licens #
Address: '7 City:Wo T 17
Contractor
State: N Zip: Phone: 4:2
Contact: Ix- Email:
Type of Work -New ZReplacement _Repair -Rebuild - Modify Space - Work in R.O.W.
Description of work:
RESIDENTIAL
y Water Heater
Water Softener
Lawn Irrigation RPZ / - PVB)
Permit Type Add Plumbing Fixtures Main Lower Level)
Septic System
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
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.aopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordin ces 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 'thout a mit; that the work will be in
V
aaC,
accordance with the approv /dplplann in the case of work which requires a review and approv f plans.
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118246
Date Issued:10/29/2013
Permit Category:ePermit
Site Address: 1291 Easter Lane
Lot:000 Block: 005 Addition: Wilderness Run 6th
PID:10-84355-05-032
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Daryl H Funk
683 86th Ln Nw
Coon Rapids MN 55433
Custom Creations Remodeling Inc
1321 Andover Blvd NE Ste 112
Andover MN 55304
(763) 441-5907
Applicant/Permitee: Signature Issued By: Signature