1298 Easter LaneC1TY OF EAGAN Remarks
Addition WILDERNESS RUN 6TH ADDITION Lot 16. Blk 3 Parcel 10 84355 160 03
owner 'L' `' ?? ? Street 1298 Easter Lane stace Eagan,Minnesota 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 161.21 8.04 20 1
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATERAREA 19]] 162.14 ,%0S:66 LS
STORM SEW TRK ?.- lq7g $,. SO 12-29-78
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 250. ?? 11199 -- 8
9UILDING PER,
sAC 500.00 11199 8-8-78
PARK -
- r
• CASH RECEIPT ?
CITY OF EAGAN
3795 PIIOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
RECEIY6D
FROM
19
AMOUNT $ I
& DOLLARS
7oo
? CASH ? CHECK
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
?
Tha kYou
? , BY
cirY oF EaGAN
3795 Pilot Kno6 Reod Eagan, MN 55122 N2 4926
PHONE: 454-8100
BUILDING PERMIT
Te ba und for Est. Value Receipt #
Dote
, 19
Sfte Address ` Erect Occupancy '
Lot , I Blotk Sec/Sub. ' i?• Alter ? Zoning '
Parcal # Repair p Fire Zone "
Enlurge ? Type of Const. 4
ad Name i EZ'T3i1C2 ?. Move ? #' Stories
i
Address 4924 05t?.
Demolish
? 5ts
Front h.
t ' ^.? ?' fC evines f%L___ Grode fl Deoth 44 k.
ce Name + 115e[t ^rr••••••.•
Address 27 aOULk: ::;?u ).1 ?, R? Assessment , i2
F ? :tUi L.
Ci Phone Woter & Sew.
?-
W N
Police
ame
F Fire
U? Address Eng.
<`Z" Ci Phone Planner
I hereby acknowledge thot I have read this applicntion and state that Council
gidg. Off. '-
the information is correct and agree to comply with all applicable APC
State of Minnesota Statutes ond Ciry of Eogan Ordinances.
Signoture ef Permittee
Permit 1 .1 p •LA''
Surchorge
Plan check
SAC "`U
Water Conn. =? • ?' `"
Water Meter ??l • ?'`'
I Torat 948' 50
A Building Permit is issued to: on the express condition that
all work sholl be done in accordanoe with all applicoble State of Minnesota Stotutes and City of Eogan Ordinonces.
Building Officiol
f
PonM # Oafe Ifwed Pomkt»
Plumbing
Mechanicol 7S
\Ac._
1 )6 - ?7 -7 -
INSPECTI DATE INSP.
Rough-In
f(nd
Foori?,g5 ocrte irksp. nate in.a.
Foundntion Plumbing
Frame/ins. Mechanical
Final
I
Remarks:
. CITY OF EAGAN
3795 Pilot Knob Rood
Fagan, Minnesota 55122
Plwne: 454-8100
HEATING _ pERMIT
Dote:
September 11, 1978
1298 Easter I,ane
Site Address:
lE: 3
Lot Block Sub/Sec.
WR 6th
?:t_I.. -.. ..r. _.-: 7..?.
Name
.
? Address 627 Snelli.7?•.-r F,viF. <;,
?
Ciry St. Paul 55116 Phone:
Nome A. Bfndex' & S^
?
? Address ' ?0 E. f3utler Ave.
?
0
t)
City i'dUl Phone:
This Permit is issued on the express condition thot ali work shall be
Minnesota Statutes ond City of Eogan Ordinances.
No.
275
Receipt No.:
$ingle
Residential
Multi Res., Comm./Ind. I
new
New/Alter. / Repai r
Cost of Installation _
,'01-Mt?S'TION AIR REQUIRF'
Permit Fee •
Surchorge
Total
done in accordance with all applicable Stote of
Building Official
.. ? .
Date:
- CITY OF EAGAN
3795 Pilot Knob Road
- " Eogan, Minnesota 55122
Phone: 454-8100
wATM SOFTTTR PERMIT
10-27-78
Site Address: 1298 Easter Lane
Sub/5ec. _ bth
Lot 16 Block 3 ?''?
No.
243
Receipt No.: 1219()
5ingle Ix
Residential
Multi Res., Comm./Ind. I
I'll8@Tl gOmt9
Nome New/Alter./Repoir
- 627 Sa. Snelling
3 Address CosY of Installation
0 SL. Paul 6,98-5501 29.5.00
City Phone: Pertnit Fee
Liadsa7 Water Grnid. Sof-. Sc., In?^, .5?'
Name Surchorge
.
? 4215 Cedar Av?. 50.
ddress
e
U
City Phone: Total
This Permit is issued on the express condition thot oll work shall be done in accordance with oll applicoble State of
Minnesota Statutes ond City of Eagan Ordinonces.
Building Official
CITY OF EAGAN -49 17JZ$
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100 . - ,
BUILDING PERMIT Receipt # -r
To be used for ??E ADDITYON Est. Value =7•000 Date SEP 6 ,1 989
Site Address 1298 EASTLTR LN
16 Block 3 SeciSub. i?1ILDERlY'E5S RUN b
Lot OFFIC E USE ONLY
PdfC@I No. Occupancy M'1 FEFS
Zoning
W Name 7'ERRANCE CARlSON (Adual) COnst Y'N Bldg. Permit ?•?
1298 EA$T£R ? V?
o Address (Allowable) Surcharge 3.?
City EAG" Phone 452-7186 # o( Stories
221 Plan Review
Lenglh
o Name S? Depth 29 SAC
Cily
,
0? Address S.F. Tolal - SAC, nnCwcC
? Clty Ph0118 S.F. Footprints -
Water Conn
On Site Sewage _
?
? W
Name
On Site Well -
Waler Meter
_=
U = Address MWCC System _
Acct. Oeposit
a W City Phone ciry water -
+W P
it
S
PRV Required _ erm
.
I hereby acknowlege that I have read this application and state that the Boosler Pump - SfW Surcharge
intormation is correct and 2gree to comply with all applicable State of
Minnesota Statutes and City ot Eagan Ordinances. Treatment PI
Signature of Permitee APPROVALS Road Unit
A Building Permit is issued to: rERuNCE cARt,soN Planner - Park Oed.
on the express condition that all work shall be done in accordance with all Council --
applicable State of Minnesota Statutes and City of Eagan Ordinances. gldg, pff. _ Copies
Building Ofiicial ?
Variance -
TOTAL
93.50
Permit No. Permit Holder Oate Telephone #
WATER
SEWER
PLUMBING
H.V.A.C.
ELECTRIC
Inspection Date Insp. Comments
Foornys i 9?/ r,9 4J
Foundation
Framing
Roo(ing
Ragh Plbg.
Rou9h Htg.
Isul.
Freplace
Final Htg.
Fnal Plbg.
Consl. Meter Plbg. Inspeclor - Notify Plumber
Engr.IPian
eldg. Final
Oeck Ftg.
Deck Final
wen
Pr. Disp.
OF EAGAN
.795 Pilof Knob Road
Eagon, MN 55122
Zoning: _
Owner.
Address:
Site Address: T
Plumber:
Meter No.: _
Size: _
Reader No.:
I agree to comply wiffi the City of Eagan
Ordinances,
BY -
Dote of
. OF EAGAN
.795 Pilot Knob Roed
Eogun, MN 55132
zoning:
Owner:
Address: _
Site Address: _
Plumber: ?
I agree to eomplp with !he City of Eagan
Ordinances,
Bv
Connection Charge:
.: f .? . 11 f.".
Account Deposit:
Permit Fee: • ?
Surcharge:
Misc. CMrges:
Totol;
Date Poid:
SEWER SERVICE PERMIT
PERMIT NO.: -
DATE: - - --- -- ?
No, of Units:
Connection Chorge:
Atcount Deposit:
Permit Fee:
Surchorge:
Misc. Charges:
Totol:
Date Puld:
Oote of Insp,:
I nsp.: -
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units: _ _? _ _
CITY OF EAGAN NO 17028
-• 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 q
BUILDINGPERMIT Receiptu ? o+'a?
Tobeusedfor GARAGE ADDITION Esi.Value $7>000 Date SEP 6 , 1989
Site Address 1298 EASTER LN
Lot 16 Block 3 Sec/Sub.
Parcel No.
W Name TERRANCE CARLSON
3: Address 1298 EASTER LN
° Cjty EAGAN Phone 452-7186
o Name SAMR
tU
?a Address
¢ City Phone
?.
ww Name
0? Address
aW City Phone
I hereby acknowlege that I have read this application and state that the
informanon is correct an r lo comply with allippplic?ble State ol
Mmnesola Statutes and ot E an Ordmances. /P /Y
Signature ol Permnee/ _la„A Xe4-0-`/
A euilding Permit is issued to: TERRANCE CARLSON
on the espress condrtion ihat all work shall be done in accordance with all
applicable State of M/?mnesota Stalutes and City of Eagan Ordmances
BuildingOfficial .1?I1Aih olll. I lb k '3
OFFICE USE ONLY
Occupancy M-1 FEFS
Zoning
(ACluap Const V-N Bldg. Permit 90•00
(aiiowaoie) V'N
Suroharge 3.50
N ol Stories
Lenglh 22' Plan Remew
Dapih SAC, Cny
S.f. Tolal - SAC, MCWCC
S F. Footprints _
On Ste Sewage _ Water Conn
On Site Well - Water Meter
MWCC System -
qcct. Deposit
Ciry water -
PRV Reqwre0 _ 3NV Permit
Boos[er Pump - S/yy Surcharge
Treatmem PI
APPROVALS Road Unit
Planner - Park Ded.
Council
&dg.Ofl. _ CoPies
Variance - TO7AL 93.50
crrr oF EncaN
5795 Pilot Knob Raad Eagan, MN 55122 N? 4926
PHONE: 4548100
BUILDING PERMIT APPLICATION Rece+pt
To be used for$F DWlg. 8 Gar. Est
Value 41,000 Dafe 8/7 1978
-_
. ?
Site Address 1298 Easter Lane Erect E] Occuponcy I
Lot 16 Block 3 $ec/Sub. W11(a. Run b Alter ? Zoning Rl
Repair ? Fire Zone 3
Porcel # V
Enlarge ? Type of Con st.
m Nome Terrance Carlson Move ? # Stories
; Addre 4924 105th Lane N.E. pe,,,oush ? Fronr 58 ft.
o CI 1TC e ines Phme Grade ? Depth - 44 ft.
T1• 15@n ApprovoH Fees
? Nome
o?< Addre ss, 627 South Snelling
VF f?n, b• dU Pl.nna .
Name
I hereby ackrwwledge thot I hove recd this application and state that
the infnrmation fs correct end egree to wmply with all applicabie
Stah of Minnesota SMtutes and City af Eagan Ordinances.
Signature of Permittee -
A Building Permit is issued
cll work shail be done in c
Assessment?47478
WOtEf Ri $EW.
Police
Fire
Eng.
Plonner
CAUncil
Bldg. Off. _8/7/711_
APC
Permit ++o.vv _
Surcherge 20•50
Plan check
SAC 500.00
Water Conn. 250.00
WaterMeter 60•00
Total 948 • 50
on the express condiNon thct
oll oppli 1 cate of Minnewtq Stntutes and City of Eo9en Ordinances.
Building Official
TO 3uest void 18 months from / / 7,0 ?
4 >l? - 3
r,v2 &h?d R 4627
Date of this Request 9-13..1978
I, asik Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No. 1298 Eaater Lane City. Fagan
Section Township
1Vhich is occupied by
Tileen Homes
Range County DBkota
Is a roughin inspection required on this job? No ? Yes Pgx Ready Now ? Will Call Ox
Power Supplier Dakota Ety. Address Farminaton
Electrical Contractor O.B. Thompaon Electxic Co. Contractor's License No?33735
(COmpany Name)
Mailing Address 12201 Mtka Blvd. $ Mtka 5,5343
Authorized Signature
nQn o OQG°3D
or Vwner MaNing rnls Inztallaxlon)
,?u-?Phonexo. 933.•2_5.21.
This inspectian requast will not he accepted 6y ffie
State Board unfess proper inspection fee is enclosed.
Minnesota State Board of Electricity
'fA4 University Ave., St. Paul, Minn. 55104-Phone 645-7703
; REQUEST FOR ELECTRICAL INSPECTION
CHECK BELOW WOKK COVERED BY THIS REQUEST
// 70-e-I
? 4627
Type of Budding New Add. Rep. Check Apptiances Wired Foi Check Fquipment Wired For
Home CC ? ? Range ? Temporaty W'ving ?
Duplex ? ? ? Watet Heate[ ? Lighting F'ixtuies ?
Apt. Bldg. ? ? ? Dry Electric Heating ?
Commercial Bldg.
?
?
? F
Fum
?
Silo Unloader
?
Industrial Bldg. ? ? ? Air Buik Milk Tank ?
Farm List List
Other ? ? ? peheis?
y Oehers?
Fi
COMPUTE INSPECTION FEE BELOW
Service Enttance Size: # Fee Feeders$Su6fcedeis: # Eee Cucuits: # Fee
0 to 100 Am s. 0 to 30 Am eres 0 to 30 Am etes 8
101 m 200 Amp 31 to 100 Am eres 31 to 100 Am res
Above 200 Amps. qbove 100 Amps, Above 100 Amps.
Transformeis RemoteContiolCirc. Partial or other fee
.
5' ns Special Ins ection Minimum fee
Remarks F?gll TOTAL F E?
0.50
I,the Electricallnspector,hereby ce?Y at a veflnspection has been made. ?
(Rough-in) Date 9-
(Final) ?,2r ? . it,, Date 1„2-1-7Y
This request void 18 months from
REQUEST FOR ELECTRICAL INSPECTION ee oo/am/-m
' n ?$ee mslmcGOn5:4Uzmpletrtg Mis form On back ol yelbw copy
7 g X" Below Work Covered by This Request
ew Adtl Rep. Typeof8uilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Elechic Heating
ApL Building Dryer Olher (Specify)
Comm./Industrial Furnace
Farm ' Air Conditioner
Other (specity) ConVacror§ Remarks:
Compute lnspection Fee Befow:
# Other Fee # ServiceEniranceSiza Fee # Circuits/Feetlers Fee
Swimming Pool 0 to 200 Amps o ta 1oD Amps
TranSformers Above 200 _ Amps Above 700 _ Amps
Signs inspectors use onN! 70iAL
Irrigation Booms
Special Inspection L?
Alartn/Communication
Other Fee
I, the Electrical Inspector, hereby
Kif
h
h AougMm • Oat ?/ 4
O
ce
y t
ai t
e above inspection has
been made. F,nei
,
OFFICE USE ONLY
This requeSt vatl 18 monMS from
`?/&, /lj C' _-? ZI-;V1 5
N 95979 ?. G°-?
Request Oete
/
5 e
` Fre No. Fough-in Inspeclion
ire0?
? Reedy Now WIII Notity Inspeclor
R
d
?
Wh
b Yes ? No en
y
ea
I p licensed contraclor kowner hereby request inspection of above electricel work at:
Job Atldress (SVeet, Boz or Routa No )
la 5ke;1sT.e qry
Sectbn No Taxnship Name or No. Renge W. Courp?O 64
V
OcCUpaM (PRIN'n
Cee.q.1 r C?J?ISan/ Phoire N.
?5" - 7/?Ga
Pa erSuppb Atldress
Elec i I Contractor (GOmparry Neme)
S` Conrcacror9 Licenu No
Malirg Adtlreys (ConM1actor w Owrier Making Inatelletnn)
or' ed Signature (COnlracfor/qvnar Meldng la?on) Phone Number
MINNESOTA STA1E BOAqD OF ELECTHICITY THIS INSPECfION REOUEST WILL NOT
Grigga-MiEway Bidg. - Raom 8-173 BE ACGEPTEO BY THE STATE BOARD
1821 UnWerotly Ave., SL iaul, MN 55104 UNLE55 PqOPER INSPECTION FEE IS
Phona(672)865-0800 ENCLOSEO.
RESIDENTIAL
. ` BUILDINC PERMIT APPLICATION
/-? CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New ConsWCtion ReuuiremeMs
• 3 registered site surveys showing sq. ft of lot, sq. fl. at house; and all roofed areas
(20°k mazimum lot coverage allowed)
• 2 copies of plan shaxing beam & window saes; poured found design, elc.)
• 1 sel of Energy Calalafions
• 3 copies ot Tree Preservation Plan it lot platted aRer 711193
. Rim Joist Depil Optrore selection sheet (bidgs wNh 3 or less uniis)
DATE 61a?-?-
SITE ADDRESS
TYPE OF
APPLICANT
j?,s+er- lk/7Q-
STREET ADDRESS `l /Q7 I J i"RP /I
TELEPHONE # '7G3`6II "03i CELL PHONE #
MULTI-FAMILY BLDG _Y /N
FIREPLACE(S) _ 0 _ 1 _ 2
iAVZ STATE /q.-/ ZIP-q0Y1
FAX #
PROPERTYOWNER ???V lnCJll TELEPHONE# Ca5h-
?
-------------------------------------------------°--------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNFSOTA RIJLFS 7670 CATEGORY I
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted
• Energy Envelope Caiculations Submitted
Plumbing Contractor: __
Plumbing systcm includes:
Mechanical Contractor.
Mcchanical system includes:
Sewer/Water Contractor:
Air Condilioning
_ Hca[ Recovery System
Phone #
Phone #
Fer. $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 Ordinan
Signature of AppllcaM ,
OFFICE USE ONLY
Water Softener
_ Water Heatcr
No. of Baths
_ Phone #
Lawn Spiinkler
No. of R.I. Baths
.-?
RemodellReoair Reauirements
. 2 copies of plan
. 1 set of Energy Calculations for heated additians
• 1 sAe survey for exterior additions & decks
• Indicate if home served by septic system for additions
VALUATION it cm o
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updated 4102
? .
D... 6 -';z 1--7 S
SUILDZNG PERMIT APPLICATION
include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations.
7b be used far ?j?'?,
T
Valuation / 1I00
Site }lddresc;
! (0 {4i-
Lot Block Sec. Sub, Parcel Number
oamerc?Q-C?2- GCUZ.6e117Y?J
Address AAR 49a y'll . N. E" '
Contractor C) ?O?YYLk,O o(7??'
Address (007
?'.t • /?'1?1? • SSI 1
Arch./Eng.
Address
Telephone 766 " / /8 7
Telephone & 98 /
Telephone
OFFICE USE
Erect
Alter
Fepair
Enlarge
Nbve
nenolish
Grade
OFFICE USE
Date of Approval & Initial
Assessment
water/Sewer
Police
Fire
Eng.
Planner
Cbuncil
Bldg. Off.
A.P.C.
Occupancy /
Zoning
Fire Zone
Type of Const.
S of Stories
Front 6`Sf
Depth
FF,ES
?
O
Perinit ? ?O
Surcharqe ?
St o
Plan Check
SAC V OJ c_?
Ftater Conn• z6"O
S•later Meter ( 0 ?
TOTA7 q g, So
SIIiGLE FJINILY DYELLI8G5
2 SETS OF PL9NS
- 3 BEGISTEAED SITE 3DR9EYS
_1 ser oF Maci ceLCS.
1989 BOILDIAG PEAMIT APPLICASIOti
CITY OF Eil
io MULTIPLE DWELLINGS
2 SEiS OF PLStIS
BEGI3iMSD 3IiE 3QROEI3 -
(CMM iRifl HLDG DI9. )
1 3Kf OF' BMEAGI Ctl.6S.
1lULTIPLE DWELLING3 BEIiTAL DNI'P3 FOA SLLE UbITS f OF IIBITS
N0?Et ADDAFS3ES F09 CORAER I.OTS - CO1vTAlCTOH/80tEOiiREA M.ST DOIGNdiE iTBICfl 1DDRFSS
IS DESIAED. BO CHANGFS AZLL BE iLLOWED ONCE HIIII.DING PERMIT 13 ISSOED..
SLr{iER i FA2£R PERFSIT FEE3 iND ?CCOONT DEPOSIT FM iIII.L Bfi INCLDDED YITH SHE SUILDINa
PERMIT FES. FAOCFSSI?iG !IM FOA SEWEA 1ND QATER PERMIIS I3 TiiO DAYS ONCE A PERMIT HA3
HEEN COMPLETED INDICATIAG A LICEIiSED PLOWEfl.
PENALTY APPLIES WFIENs PENMIT IS NOT PAID FOR IN SAME MONTH IT IS REQiJESTED.
` LOT CAANGE IS REQUESTED ONCE PERMIT IS ISSIIED.
G??kfkCrE ADD?zlnr.j
To Be Used For: r4? ? j,,/O!C"aluation:L?? Date:
Slt@ Addl'ess
Lot &7 Block ?
Parcel/Sub W; lWe,eAJr55 l4wd (o
Owner
lddress Xd,
Citq/Zip Code mAl,
Phone 44vl2 ' 7/Pt
Contractor S e /F
Oceupanep !"j - I
Zoning
Actual Const ?
Allowable
# of stories
Length Z Z '
Depth 20'
S.F. Total
Footprint S.F.
On site sewage
On aite well _
MWCC System _
City water _
PAV required _
Booater Pump _
CDMKERCIAL
'•) -"
? .rf,
2 3ETS OF lBCHISECTURAI.
i SiHDCTURIL PLENS
1 3Ef OF BPECIFICATIONS
1 8ET OF EBERGT CALC3.
Hldg. Permit
Sureharge
Plan Reviev
SAC, City
SAC, MNCC
iiater Conn
Nater Meter
Acet. Deposit
S/N Permit
S/H Surcharge
TreatmenE Y1.
doad IIASt
Park Ded.
Copies ?_
39BTOTAL
Penaltq
TOTAL •nn
Address
Citp/Zip Code
Yhone
Arch./Engr.
lddress
City/Zip Code
Phone # '7' /.3
1PPADVAIS
Planner •
Couneil
Bldg. Off.
Yariance
A L?I? , i 1
L "=l ?
I
?
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uNt?
N ,
?---- '
I I
a
?a I
? No?sE ?
?
n
,
,
??oPE.e rv ct
?A
LiNE zJ ?s0-D?rZ ?
? LoT ? BLOCK ?
? O I
?c,Z?e? u ?le-rr,. c?0 o6?z-C. •
i
F?LOT 1 L AN
. _
r
?. I
?
we
i
.
3 $?
?
?XIST?N? ?
lu
? Q ---
',
,
gaq 5e?
?
j'P-9QRn1 C,E l &P/so,J
/,4 9k- EfIST-e 4 4,J. I
4 of l(o a1oci ?3]
l.v; /de,e,uess /jwil (o
. j •/S e?J l?IGM e.'S ?G
/0" IFIqStMItNr
dnrf
P4 oT- N Ny
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115261
Date Issued:09/24/2013
Permit Category:ePermit
Site Address: 1298 Easter Lane
Lot:016 Block: 003 Addition: Wilderness Run 6th
PID:10-84355-03-160
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 .
Ryan Davis
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 -
Kevin Geppert
1298 Easter Lane
Eagan MN 55123
R Davis Construction Inc
710 N 4th St #306
Minneapolis MN 55401
(612) 259-5363
Applicant/Permitee: Signature Issued By: Signature
M� ,�. t � {•':.
. ' „t; � 7 1•,r� 1 .�Y, y. , ' . . .
' � � �t� ��yl. ,�� . � . . .. .
� - � . . .� . . ••�• . � . . .
' ' . , ' . ' • ' .. . . . � Use BLUE or BLACK Ink
. . . • �____--__ _
. . � � • � For Oiftca Uso�� ———-- ��
.Clt of . ,.
�a aIl , � Pe����: � � � �
. � � � . . . � . �
3830 Pllot Knob Road i Pe`�'��FB�� � ��� �
Eagan MN 6b122 , , � �
Phone: (651)$76-6676 . j Date Receivec7:���. � .
Fax: (661)676L6694 � �
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� 2011 RESIDE�ITlAL 6UIL.'`DING�PERMIT APPLICATION
Oate: . �� C Site Addre�s: � C •� (�/l/�� • Unit�;
Name: '�i • ��(�lS ��.�l1.S'T!z t,�CT/Dlv �• .. �—�S`C°�
RESIDENT/ , , Phone: �5 ��q�
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OWNER . Address/City I Z(p;_��-.��� E��S��/� !_.;JI.� � �6¢l�rtJ j"��,,��
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Appilcant is: � .Own�er. �.Contractor• . , -•
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TYPE OF WORK Oescriptlon o(wotk�_7��.�'G�L�v �i'�'�..A�lsF 1��
Constructlon CosC � ��r��� . • • Muld-Femliy B ild(ng: (Yes_�No��
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Company:'��`C.d�'�!(�t4�}(� �R G.¢,� Contact:�?���° �`/���1.�4��lL
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CONTRACTOR Address�_��/ ��'j��'�_ • ' �m,; �}'J�L� ,
State:�_z(p.•`5����4� Rhone: • .S• ' 8 i
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'� �. �9 �'�54
� �� ucense�:� �''-��3.5�o�S�'�—� r: l.oad�Cett►flcate#: /V'14,7`� 7 --/
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If the project is exempt.from lead certlflcatlort, please ex,plaln Why:(see Page 3�for additfonai information)
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COMPLETE THIS AR�A QN��F_CQNS�RUCTIN;A NE,____W BUII.DING ,
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In the last 12 months,has the City of Eagan'Issued a pertnit fo�.a slmliaw,plan basad�on a master plan?
_Yes _No If yes,date a�d addtesa of master plan: � • �' .
l;Jcensed Plumber. '
__ Phone:
Mechsnica!Contractor. ' � Phone: `
Sewer b Water Contractor. • � ' ' . phone;
NOTE:P/ans and supporting docur»en }tha�,�ypu;stibin/t.�t'!�cp�.s/,�/�red.to.be pubilc lnforrrraUon. Portlons of
. the lnformaUon may be�classlfl�I a��,pp:�,u�l/C,Ifyvu p,�v,Yf.de�s�l�fil�lr�ressons that wou/d permlt'the Clty ro
. . '. ,�cd�icludA'�f at:tXe�:ar�. d �
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CALL 6EFORE YOU DIQ. a � ' "' r..�.;�,,.•.• ..3 ...;•: �.•::,� . �; y, .; :....
���o C A Gophor Stiu O�v,Ci!!�l t46,1)�4b{-QQQZ��pf pfp(pCtlpt18fl81tt8t underyround uQlity damage. Call 48 hou�
yW IrltBtld l0 dl�10 f6C81V8�OCBIQi 0�UfX�6l�f0Ur1d U�ll�l�{� .
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I hereby acknowted9e U7at Ws In1om18Uon is COmpl9(@ g�d BCCUra(8;4het!h8 Y�Nr1f 1MU b8'In Cpnformence ydlh lhe ordinances and codes of tne City o�
Eagan; �hat I understand Uila Is not a p�'rmlt, but oNy an eppucaUon for e permit, �ndr;yyprk is,nol to atert without a permit; lhaf Ihe work rrili be in ,
axoroance wilh!he approved plan in the'case o(wv�ic wfilch roqvlro'a raNew arid epprovai of.plano.• .
Exterlor work autha�ized by�bulldinp pertnit Itsued U accordanCe With'the Minn��ota Statp 8ullding Code muat be completed within 180
days ol perm(t Issuance. . . ,
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App!(cant's Pr►nted Name X
Ap cant's Slgnature
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