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1363 Cosmos Lane Use BLUE or BLACK Ink r For Office Use City of Ea~d~ 1 Permit#: 1 I I I Permit Fee: /~~w 3830 Pilot Knob Road 1 Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: I 10 RESIDENTIAL BUILDING PERMIT APPLICATION r r Date: Z1 Site Address: LO'~ V Tenant: Suite RESIDENT/ OWNER Name: Cap /~Z, Phone:/ Address / City / Zip: ! ~LLd~~ d2~~ t `tT_~ ~l Jam( J Applicant is: Owner Contractor 1 TYPE OF WORK Description of work: P1~6 L_ Construction Cost: Multi-Family Building: (Yes / No l} ) CONTRACTOR Name: License #:,?o / z I ~j /12 Address: City: State: Zip: Phone: We7 Contact: / Email: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued -a perm); 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 the 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 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; th a work ' e in accordance with the approved plan in the case of rk which requires a review and approval of plans. X r. Applicant's Printed Name Applicant's Signature Page 1 of 2 CITY OF EAGAN Remarks Addition _f' '-derness Run 4th Addition Lot 4 Bik 1 Percei 10 84353 040 Ol Owner f I Street 1363 Cosmos Lane State Eagan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SUR F. STREET RESTOR. GRADING SAN SEW TRUNK Aal 1973 $163. 26 $8.16 20 PAID SEWERLATERAL WATERMAIN WATER LATERAL WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $280,00 10877 6-18-74 BUILDING PER. sAC $400.00 1C877 6-18-74 PAR K INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: ? . ? ??•;?f? : E F?hii. ? t f?F kNF'?:? Fr11N rt! tl ? PERMIT SUBTYPE: 11 tol-1 I IV APPLICANT: 4i TYPE OF WORK: !it ';i:f; i F I 1014 t ti AS fN-,EPT jGA-1 i rmr t rri A I Permlt No. Permit Holder Date Telephone A ELECTRIC PLUMBING HVAC Inapectlon Date Insp. Comments FOOTINGS FOUND FRAMING RDOFING ROUGH PLUMBING PLBG AIR TEST ROUGN HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE ,7 47;gl ? l r FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R_I. BSMT FlNAL DECK FTG DECK FlNAL CITY GF Et:GAPd 3795 Pilot Knob Road Eagan, Nlinnesota 55122 PE:iP?'fIT NO.: 550 The City of Eagan hereby grants i,o vie,.e uenri„g yA4r rnr_ of 13075 Pieneer Traii. FAnn Praarip Saa4'4 a irA22xG Permit for: (Cwr:er) wen=an„ (:onetniction r!e_ at i363 [bamos tane , pursuant to application dated 7/30/74 Fee Paid: SZO.on dated this 8th day of Alim,st ,.I 9 7a• .so e/c Bu.ildino Inspector N:achw-iical Permits: Bid Totala y-1 CITY OF EeiGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 PrRPCT NO.: 497 The City of Eagar. hereby grants to Wenzel Plwnbing & Aeating INC. o; 3600 Kennebec Dzive, Eagan 55122 aPLUHBING Permit for: (Owr.er) Wensmann Construction at _ 1363 Cosmoa Lane ? pursuant to application dated 7/30/74 ` Fee Paid: $20.00 dated this 8th day of Auguet ? 1 9 74 .50 s/c Building Inspeetor Machanical Permits: Bid 7'otals CITY OF EAG?N 3795 1'ilot Knob Road Eaga_7, blinnesota 55122 PEFsNLLT NO.: 644 The City of Eagan hereby grants to Kleve xeating & A/C of Eden Prairie a AIR COND. Permit £or: (Owner) Rimz el at 1363 Cosmos Lane , pursuant to application dated 3/3/75 Fee Paid: $5.00 dated this 13 day of Mar. , 19 75 .50 s/c Suilding Inspector Mechanical Permits: Bic To'ual: tl-? • " CITY of EAGAN BUILDING PERMIT OWO6! .. x.e-- - ..... •'•-t?.:.. ................:....','.:.:....r.............._. Address (Presenf) ......?`.`-?"'?e'.c?Z??f=t ........................... Builder ........ Addresa ...... DESCAIPTION N? 3323 3785 Pilo! Knob Road Eagaa MinnesoYa 55122 454•8100 Date ....?.?... ..??..?._?.??...... _....... ories To Be Uaed For Fsonf Depth Hetgh! Est. Coe! ermlt Fee Remarks 7 /Gt? ? • 2Z 9-2-- ?gi0°? Q ?i/S " LOCATION /.t?:-:SU Slrael, Aoed or olhar Deceription of Localion I Lo! Bloek Addilioa or Tzaet A.,..i 4t '2E This permi2 does aot au2hoxize the use of slreeffi, roads. alleys or sidewalks nor doee it give the ownas or Lia egent the xigh! !o oreale enq silualion whiah is a nuisenca or which presents a hasard !o the beallh, safatp, eonvaetenee aad general weliare !o anpone in the eommunilp. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PAOG ESS. 4...._upen Thia ia !o eertifp. !hal..'??!`?"!?.°..?C"? ................hea permisslon !o ereM a.. ?:`. :?.. ................ the above described pxemise subjeci !o the pzovisions of all applicable Ordinanees for the C of Eagaa. ...................... ?:..:....-'-.Y...a.`.?`.1""'i.................... ._.. Per _ ...................... ..I`°?`:._""??...?.`:'...................... Ma or?/ 12j, Bullding Insyeclor ? VILLAGE OF EAGAN WATER SERVICE PERMIT 3795 rilor ii.c6 Road 1'ERMIT NO.: 1559 Eagan, MN 55124 llATE: __ 8 8 74 Zoning: No. of Units: 1 . owner: _-Wensmdnn Construction. Address: Sice Address: _1363_-Cosmos Lane - - - ---- Pluinbec _.._WePZel__P_lumbinq_ & Heating INC. Mete?,a.?3p7,3?."j? Connection Charge:340.00 pd Size: _ _?i]._ed C_+? • a Account Deposia Reader Pennit Fee: 10.00 pd I n9fea To complr with the Villoga of Eagan Surcharge: •$0 pd Ordinonee:. Misc Charges: Total: _ t-' ''J _ llate Paid: Date of Insp.: Insp.: YILLAGE OF EAGAN 3795 : ilot !;nab Rood Eogan, MN 55122 `Loning: P.3 Owner: Address: SEWER SERVICE PERMIT YERMCI' NO.: 2319 DATE: £181 74 No. of Units: I5ite Address; 1363 Cosmos Iane Plumber: venzel P1uml;ing & Heating IP;c. I °9'°° to ComDlr wi}6 fhe Villoge oi Eogon Connection Charge: 249yiog p(; OrdinanC06' Accoun[ Ueposih Permit Fee: 1-0.00 pd Surcharqe: • SO j?d BY' Misa Charges: Uare of Insp.: Total: Insp.: Da[e Paid: PERMIT CITY OF EAGAN 3830`Piiot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: 1363 COSMOS LANE LOT: 4 BLOCK: 1 WILDERNESS RUN 4TH P.I.N.: 10-84353-040-01 DESCRIPTION: " `- C,AS INSERT/GAS BuiJ;dinq-Permiti Type ;9uilding Wt?r-k Type 'E Census Code -, , 1x? , 434 PERMIT TYPE: Permit Number: Date Issued: LINE FIREPLACE NEW ALT. RESIpENTIAL ? a, f-L rFj?t''Ety'.'`r ??`?{j ( tt *?? ?-''?..:.," `....?,,,3 c2B 1L 4 BUILDING 031159 11/21/97 REMARKS: FEE SUMMARY: Base Fee $50.00 Surcharge $.50 To[al Fee $50.50 CONTRACTOR: - ppplicant - OWNER: GAS LINE PLUS INC 12266220 FRANKLIN MITCHELL 4806 RUTLEDGE ST 1363 COSMOS LANE PRIOR LAKE MN 55372 EAGAN MN (612) 226-6220 (612)405-1458 I hereby acknouledge that, T have?-1 reasf this a pp-I 3,a?atiq» ?r d,5ta?e t?i-at.?t he,. ' ic?formation is correct artd agreeto'comply'uith a.tl applitrable 5taie of Pfn. Statutes and City ezf Eaga?? Ord1n°anc4,s.,' , • ._,, , ,; r_ ° . . ? _: . . ? ? .01,PM1 I I' I? APPLICANT/PERMITEE SIGNA7URE -ISSUEb BYI SIG ATU EJ ? CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1997 FIREPLACE PERNIIT APPLICATION A51,-1?6q 681-4675 DATE: I I1,19 I 97 PERMIT FEE: $50.50 DESCRIPTION OF WORK; _ CONSTRUCT NM FIREPLACE _ ALTERATIONS TO EXISTING _ INSTALL GAS INSERT ONLY INSTALL GAS LINE ONLY ? OTHER: ? STREETADDRESS: - I 3Ln3 l,oSYVio 5 rt (1 LOT ? BLOCK SUBD./P.I.D. #: t0APll a,IJ IVAAI, 4& APPLICANT: (circle one only) OWNER ONTRACTO I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. PROPERTY OWNER FIREPLACE INSTALLER Nazne: Frav\ot I\ Phone #: 405 - Signature: Street Address: City: State: Zip: Company: G? ?e Plne, Iac. Phone Signahue: Prlor Lake, MN 66878 a , Sueet Address: City: GAS LWE Company: INSTALLER Phone #: Name: Signature: WV " ;; III III Street Address: License #: State: Zip: City: State: Zip: MASTER CARD OWNER ftleph f fj/[ ot_A STRUCTURE AND LAND USED AS ? z Permit No. Issued Issued To ContractOr Owner BUILDING o33 .?3 PLUMBING ,[? g 'f t?? ('?_ ? 7FJ CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER OTHER I (DTHER I Items Approved (Initial) Date Remarks Distance From Well FOOTING ;L ' 7? SEPTIC FOUNDATION S?- R' 7q CESSPOOL FRAMING ?• Z''J ' ?- )? TILE FIELD FT. FINAL ELECTRICAL HEATING ? ?J.• 7 -2 DEPTH OP WELL GAS INSTALIATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER Violations Noted on Back COMMENTS: PERMIT # RECEIPT DATE: II `I ?"U I /a 19G?-?-}9 ?? . RESIDENTL4LL PLUM$1NG PERMIT Af'PI1CATION .:". ? C1N OF EAHAN S$SO PILOT KPOB RD ? EA&AN, A1N S51 EE 651-6$1-4675 Please complete for: i single family dwellings ? townhomes and condos when permifs are required for each unit > backflow preventer for ircigation systerrm SITEADDRESS: _ V?(n-?j C OS`MCfj \ OWNERNAME:: tY\;ic Vrnr1\4.l TELEPHONE#:[?C,;k_E-10S- ' 145% (AREA CODE) INSTALLER NAME: rR,,, TELEPHONE #: g,c-;. q31-q('? ? ? -T- STREETADDRESS: 605 12th A40f1Ue 5uu? (??cooE) „ Lnn 1wiii gvw CIn: STATE: ZIP: Place a check mark next to the ermit work t e New residential dwelling unit under construction and not ownerJoccupied $ 90.00 ? Add-on, modification or alteration to existin dwelling unit, including: $ 50.00 • abandonment of septic system • new installation/repair/rebuild of RPZ • lawn irrigation system • waterturnaround Natureofwork:_RPplnnar WC&A" V\2sLl2.Y ?U VOU j 4LUU) Septic System, new/refurbished - -$ - 225.00- -? • includes County 8 Consulting Inspector fees • requires NIrC license State Surcharge $ .50 Tota l O $4 7) ? - _ - Reminder: Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc. I hereby acknowledge that I have reatl this application, sUte that lhe information is cor fithin nd agree to comply with all appliwble Ciryof Eagan ordinances. It is Ihe applicanPs responsibility [o noli(y the property owner that the Ciry of Eagan ass no liabili wag0_s caused by the City during its normal operetional and maintenance activities to the facilities constructed under this permit City p aperty/riglhLod-waq/easement. Updated t/01 �City afEapli 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink 1 For Office Use Permit #: iC / Permit Fee: �k^ Date Received: —1 J INFLOW & INFILTRATION PERMIT APPLICATION x Plumbing / Sewer & Water Date: 2-/ Z- 17 Site Address: 1 b 3 C o s o S n g Tenant: Suite #: esi en Name: 2 Address / City / Zip: l 3 li 3 C w-0 Phone: ( (- `-LO 5 - f 47.57 Mti ss 123 !n1 rac1 Name: License #: Address: City: State: Zip: _ Phone: Contact: Email: Hype scription PLUMBING (Within the building envelope) Sump Pump Repair Other: SEWER & WATER (Outside the building envelope) Repair Other: Description of work: FEES $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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.qopherstateonecall.orq 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. s /1 x TecK M. _ Applicant's Printed Name Applic s ignat re Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - - - I For Office Use I~ I Cit of EanoEdn Permit#: 14/'J I Permit Fee: V 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit c Name: Phone: (oSJf L/6 5• Resident/ Owner Address / City / Zip: ~J Applicant is: Owner ✓ Contractor Type of Work Description of work: ~ lit- Y DID 1 Construction Cost: Multi-Family Building: (Yes /No ) (0 5 Company:- f ~,e,& 6u~ ~ K ~Contact: Contractor Address: 1VC City: ~t.l l State: Zip: ~53 6 Phone: i License e 42 ?2, $ Lead Certificate M, 76 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 i 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.oopherstateonecall.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 b ilding permit issued in accordance with the Minnesota State Buildin Cod ust b pleted within 180 days ermit issuance. X x pplic t 's Printe N7 aphe App ' s g ature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA153178 Date Issued:11/28/2018 Permit Category:ePermit Site Address: 1363 Cosmos Lane Lot:004 Block: 001 Addition: Wilderness Run 4th PID:10-84353-01-040 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 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 - Jean M Erickson 1363 Cosmos Lane Eagan MN 55123 (651) 247-7309 Homestead Remodeling & Consulting Llc 6053 Hudson Rd, Suite 340 Woodbury MN 55125 (952) 994-6102 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA154697 Date Issued:04/05/2019 Permit Category:ePermit Site Address: 1363 Cosmos Lane Lot:004 Block: 001 Addition: Wilderness Run 4th PID:10-84353-01-040 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Jean M Erickson 1363 Cosmos Lane Eagan MN 55123 (651) 247-7309 Homestead Remodeling & Consulting Llc 6053 Hudson Rd, Suite 340 Woodbury MN 55125 (952) 994-6102 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA156752 Date Issued:07/17/2019 Permit Category:ePermit Site Address: 1363 Cosmos Lane Lot:004 Block: 001 Addition: Wilderness Run 4th PID:10-84353-01-040 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. 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: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Jean M Erickson 1363 Cosmos Lane Eagan MN 55123 (651) 247-7309 Krech Exteriors Inc 5866 Blackshire Path Inver Grove Heights MN 55076 (651) 688-6368 Applicant/Permitee: Signature Issued By: Signature