1391 Cosmos LaneCITY OF EAGAN Remarks
Addition Wilderness Run 2nd Addition Lot 12 sik 2 Parcel 10 84351 120 02
Ownerl-&?11CIVlflrtivri) Lt4X.OUT''- Street 1391 Cosmos Lil. State Eagang MN 55123
rL;S, r.}? ` AILl+l,& 0?3*M(,4L
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 $175. 00 $8. 75 20 PAID
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK L'/ A010321 6-25-81
STORM SEW LAT
CURB & GUTTER
SIDEWALIC
STREET LIGHT
WATER CONN. $300.00 8760 8-14-73
BUILDING PER.
sAC $260.00 8760 8-14-73
PARK
? INSPECTIUN REC4RD ? Control No. 0573
?
CITY OF EAGAN PERMIT TYPE: Hll t 1 111 Nu
3830 Pilot Knob Road Permit Number: 000 ! 1! /
Eagan, M innesota 55123 Date Issued: of, ro 3/9 2
(612) 681-4675
SiTE ADDRESS: t, o r t 1W 0100.1 ? APPLICANT:
t t9! CqSMQs t pME pL IESE CIIRY D
WILDEItMESS Rt1N 2M D (612) 457-8412
PERMIT SUBTYPE:
.• ?; ? t H 1• r? r? ? TYPE OF WORK:
N E W
I)F=`01- kIF f iUN ,' [iFEP IM1ft(1Vf hRiiNN
.A • .A
t1Nal i
RFMARk`+, kF1:UIPT i
?- ?` - -}
? . . ...!a.? _`r . . ...r.. -- ?7:_._:T1FS?, - -'- 'a. , ?_. .. ., . _. . -- . _ - . . . • ? .-
? J
PermR No. Perntlt Holder Dste TNaphone i
S/UV
PLUMBING
HVAC
ELECTRIC
ELECTRIC
laspectlon Deie Insp. Comments
Footings I
Foundatlon
Framing
RooNng
Rough Plbg.
Rough Hlg.
Isul.
Flreplece
Flnal HbB.
pBat Test
Finel Plbg. P16g. Inspector - Notiiy Plumber
Cwut. Meler
EngrJPlan
Bldg. Final
DeCk Ftg.
Deck Flnal
Well
Pr. Diap.
?, ?o? ?
0,o.lC?IR?.\ 'il? vndti[..
EAGAN TOWNSHIP
BUILDING PERMIT
Ownex --..... _..... _-....----'--
Address (Presenl) ?7
f(.'.._.--??'S?'CC???:l_.___...-
--........... ........... _........
Suildcr .............----'--....... ......
....._.._.._..._
naa:e:: .................... ...._...
DESCRIPTION
N° 2922
Eagan Township
Town Hall
Date..i.?."...?9- 7z_
...........
.
Sioriesl To Be Used For Front Depih Height Est. Cosf PermiY Fee Ramarka
'' LOCATION P'e'
/ 367.r713
This permii does not aulhorize the use of slreeis, roads, alleqs or sidewalks nos does it give the owner or his agen!
the right !o ereafe any sifuafion which is a nuisance or whiah presenls a hazard !o fhe healSh, safefp, eonveaienee and
general welfara fo anpone in the eommunifp.
THIS PERMIT MUST BE EI? ?.T ON THE PREMISE WHILE THE WOAK IS IN PROGRESS.
This is !o eeriify. Yhal......?:?r.?•.?_-...??...^?.4? .............. has permisaion !o ereef a_..?.. ....._:.. ....----- u oa
!he above described premise subjec! !o the provisions of the Suilding Ordinance for Eagan T wnshipd April 11.
1955.
......... .^..-.:-c`.----...-..--- .... .... .`:5:..Per .... --....... ....3a:
'..._ _..............................._.---._............
Ch°' - ---- --rd .r.; Building Inapeclor
I&
..
f+? `
u
faA. : ? .
. VILLAt#S QF $aOAN
3795 Pilot Bnob 10ad
. '
Eagean, Minnesota 55122-
%,?- - .?- - 2
The 4illage of Eagan hereby grants to ..-;i t u,.w?.a Hd_ tiua z A/C
Of uo n c 111 a S} Panl .
aMA "M Permit Yor: (Ownar) Tils.n rnonetr•,•,ciIg Co•
391 Clsome, 391 Oosmos and
a? 4296 6vea , PLIrsuant to application dated 10/4/77
Fee Paid: ?`60 ?00 _ dated this 17th day of pctg"3 _? ?9 7}?•
1.50 e/c
Bui ding Inspector
9????'ST•-
Niechanical Pennite:
Bid Total:
PFTiFffT N0. eao
VILLAGE OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT NO.: 395
The Village of Eagan hereby grants to Louia H. Peter oo.
of 1954 Grand Avanue, St. Paul 55105
a PLUPBiNG Permit for: (Owner) Tilsen donstrnction
at 1391 Oosmos Lane , pursuant to application dated 9/20/73 ,
Fee Paid: $20.00 dated this 26th day.of 5ept. , 19 73 ,
. O e c '
Building Inspector
Mechanical Permits:
Bid Total:
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITEADDRESS: APPLICANT:
L oT: iz BLOCK: Z
1391 COSMOS LANE BLIESE
WILDERNESS RUN 2ND (612) 452-8412
PERMIT SUBTYPE:
swzM POOL
TYPE OF WORK:
DESCRIPTION
REMARKS: RECEIPT M
F_
?
I Control No. 0573
BUILDENCaw°t :.;
008727
06/03/92
CARY D
NEW
4' DEEP ABOVE GROUN
7
I
nunce oc eacne WATER SERVICE PERMIIT
3795 Pilot Kno6 Rood PERMI'C NO.: .1296 . ._ ,_ .
Eagan,MN $5172 . DATF.: 9/7f7.3..(12/29/72)_._.-_
"].nninG:R'-1Nu-ofUnits:...
nwnt):.___..Tilsen_Conatruction Co.
nadie,s: _ -- --- ?A - _--..
1391 Cosmoe Lane r?
Sue Address?.
Hur„i,,[ Luecken ExcavaCing _,_____
----
Mcter No.- Connecnon Charge 300.49 pd 8/14
Sve ?/? ? ._. .. _.. .._. Account Ueposit ? -_-
Header No.: 7 Permit Fee: .10 00 pd 9f7/13 ?..
7pd.-_
1 ogree ro eomply wiih eM Villoge of Eoyon SurchargB: --__, 50 ..
O.dina e s. Misc Ch vKes:
.'Potal. ? -- -- - --- ?
DatePaid
Insp.: -----.._-.--.--.-- -..,__--'_- -
EAGAP1 TOWNSHIP
3795 Pilot Krtob Road
SL. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNSCTION
DATE: 12/29/72 (9/7/73)
OWNER:Tilsen Construction Co.
PLUMBERL. Gallati £or Luecken Ex
Fxc.
N[1M$ER 1405
Add-re?2-?3??-?? 1391 Cosmos Lane 12-2-2
TYPE OF PIPE heavy cast iron
DESCRIPTION OF BUILDING
Industriall Commercfall Residential I Multiple Dwelling I No, of units
xx
Location of Connections:
Connection Charge 2fin_oo na Q/14/73
Permit Fee 10.00 d 12422a2
.50 pd 12 29 72 -
Street Repairs
Total
Inspected by:
DaCe
Remarks•
By
Chief Inspector
Ia consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulationa of Eagan Township, Dakota County, Minneaota
By
L. Gallati for Iuecken Exc.
Please aotify wheu ready for inspection aud cosmection and before any portion
of the work is covered.
? w . •
MASTER CARD
LOCATION
T
OWNER
STRUCTURE AND
LAND USED AS
Permit
No.
Issued ? Issued To
Coniractor Owner
BUILDING
PLUMBING 29?? is
-7 I
CESSPOOL - SEPTIC TANK
WELI
ELECTRICAL
HEATING
GAS INSTALLING
I
SANITARY SEWER
i
OTHER
OTHER I ?
Items Approved
(Initial)
Da}e
Remarks
Distan[e From Well
FOOTING 7) SEPTIC
FOUNDATION -3- J 3 CESSPOOL
PRAMING L{• 3•9? TILE FIELD FT.
FINAL
ELECTRICAL
HE.4TING
GAS INSTALLATION DEPTH
OF WELL
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING y- ) • ) 5
WEIL
SANITARY SEWER 46)
Violations Noted
on Back
COMMENTS:
?
July il, 1990
Re: Project 466, Pilot Rnob Itoad, Final Assessment Searinq
MoBification of Final Assessment Roll to Delete Storm Sewer
Lateral Assessment for Lots 1, 11, 12, 21, 22, 23,
Nilderness Run 2nd AdBition
Dear Property Owner:
As you are aware, you recently received a notice informinq you of
a proposed special assessment for the above-referenced project that
would be presented to the City Council on July 10, 1990. Several
of you contacted City staff expressing concerns over the storm
sewer lateral assessments due to the fact that the proposed
assessable portion of your property drains into an existing system
rather than into the new assessable system installed under Project
466.
The City staff subsequently researched your concerns and confirmed
your contentions. As a result, the City Council accepted the
staff's recommendations and deleted the lateral storm sewer
assessment from the final adopted assessment roll for Project 466
as it pertains tn the lateral storm sewer assessment only. If you
had a proposed assessment for other types of improvements, they
were adopted and will remain. A revised assessment notice is
enclosed for your information.
We apologize for any unnecessary concerns created by this issue and
appreciate the manner in which it was brought to our attention so
that we could respond in a timely manner. Thank you for your
patience and understanding during this process.
Sincerel
omas A. C lbert,P.E!
Director of Public Works
TAC/jj
cc: Deanna Kivi, Special Assessment Clerk
Jerry Wobschall, Special Assessment Consultant
Enclosure
CITY OF EAGAN
NOTICE OF SPECIAL ASSESSMENT
Project #1OP466
July 12, 1990
The EAGAN CITY COUNCIL met on the lOth day of July, 1990, at the Eagan Municipal Center,
3830 Pi1ot Knob Road, Eagan MN, and approved and adopted the listed special assessments
against the following described property:
10-84351-120-02
BLIESE CARY D
1391 COSMOS LN
EAGAN MN 55123
The special assessments are:
TOTAL
TYPE OF IMPROVEMENT S A a PRINCIPAL
SANITARY SWR LTRL 2065 0.00
WATER LATERAL 2066
SERVICE(WATER ONLY) 2067
STORM SEWER LATERAL 2068
STREET 2069
TRAIL 2070
TOTAL
0.00
0.00
0.00
0.00
0.00
0.00
ANNUAL
PRINCIPAL
0.00
0.00
0.00
0.00
0.00
0.00
0.00
FIRST YEAR
INTEREST
0.00
0.00
0.00
0.00
0.00
0.00
0.00
FIRST YFea
NSTALLMENTS
0.00
0.00
0.00
0.00
0.00
0.00
0.00
You may pay any portion of these special assessments within thirty (30) days, specifically
on or before the 9th day of August, 1990, without interest at the Eagan Municipal Center.
If you pay after the thirty (30) day period but prior to October 15, 1990 interest wi11 be
charged from July 10, 1990 to December 31, 1990. After October 15, 1990 the first years
installments cannot be prepaid and it includes interest from July 10, 1990 to December 31,
1991.
Any unpaid portion wi11 be collected in annual installments of principal and interest for
the next 10 YEARS on your future property tax statements which will be issued through the
Dakota County Auditor's office. The annual installments include interest at the rate of 9.0
PER CENT per year on the unpaid balance.
Notice of Special Assessment
Page - 2 -
The proposed assessment roll is on file vith the City Clerk. The assessments zelated to
Lhis project total $1,221,403 and the area is as follows:
1'he SoatLrest Quatter of Section 15 Parcel Pos. 030-52, 040-52, and 050-52; the Sou[heast
Quarter of Section 16 Parcel Sos. 010-77, 010-80, 012-78, 020-80, 040-79 and 014-79; the
Hortheast Quarter Sectian 21 Parcel Fos. 010-04, 011-80, and 020-01; the SortMrest Quarter
Section 22 Parcel Aos. 012-26; the Horthvest and Southrest Quarter Section 27 parcel Hos.
010-56, 020-25, and 020-29; the Southeast Quarter Section 28 Parcel Bos. 010-77, 010-79, 010-
80, 020-79, and 030-81; and the Fortheast Quarter Section 33 Parcel Bos. 030-03, 010-03, and
012-01; and Lot 1, Block 1, Beautiful Savior First; APID Part of Iots 1 aad 2. Block 1, Bratm
Sumrise (Parcel Po. 10-15100-021-01) AAD Lot 4, Block 1, Buffer Hills; AHD Lots 1 thrwgh
15, Carlson Acres; AAD Ivts 1 through 3, Block 1, Icts 1 through 11, Block 2, Lots 1 through
12, Block 3, and Ivts 1 tbrough 9, Block 4, Guttara Bidge Firct; AAD Iots 1 through 4, Block
1, and Lots 1 thzough 5, Block 2, Cutters Hidge Secoad; AND Ivt L, Block 1 and Lots 1 and
2, Block 2, Cvtters Fidge 7hird; AND Lot 2, Block 1, and Ivt 1, Block 2, Duclcvood Crossings;
!AD Ivt 1, Block 1, Faster Iutheran; AND Outlot A, Lots 1 through 18, Block 1, Ivts 1 through
30, Block 2, and Lots 1 through 36, Block 3, Hngstroa'a Deerrood; AAD Lots 1 through 6, Block
2, aad Lots 1, 8, 9, and 10, Block 4, Evergreen Park; AAD Lots 1 thrangb 13, Block 1, Lots
1 througL 15, Block 2, Lots 1 through 16, Block 3, Lots 1 through 17, Block 4, and Lots 1
througL 14, Block 5, Faizvay Hills; AND Dutlots A, B, C, and Lots 1 through 15, Slxt 1, Lots
1 and 2, Block 2, Ints 1 thraugh 5, Block 3, Icts 1 through S, Block 4, and Ivts 1 and 2,
Block 5, Pairray Hills Second; AND Lots 1 and 2, Block 1, lst Mianehaha Addition; AFD Lots
1 and 16, Heine lst Addition; AND Iots 1 through 11, Block 1, Lots 1 through 11, Block 2,
and Ivts 1 thrwgh 3, Block 3, Hidden Valley; AAD Iots 1 and 2, Block 3, Hillcrest Addition;
!ND LotB 1, S, and 6, Block 5, and Lots 18, 19, 20 and 23, Block 7, Hilltop Estates; AND
Parcel Aos. 10-33050-101-01 througb 10-33050-108-01 and 10-33050-210-01 througb 10-33050-
208-01 (file A' 53), flilltop of Pagan; AND Lots 1 tIIrough 3, Block 1, Hilltop Plaza; ARD iots
1 thraugh 31, Block 1, snd Lots 1 througb 25, Block 2, Ringsvood Second; AAD Outlot D(Parcel
Bo. 10-42500-041-00), %nob Hill of Eagan; AND Iots 1, 11 and 12, Block 1, aad Lots 1 through
3, Block 2, Ynob flill Professional Part; AND Ivt 1, Block 1, Yondviev; ARD Lot 1, Block 1,
St, John Reuxann Addition; AHD Outlot A. 1'homas ]ake Addition; AHD Iots 2 and 3, Block 1,
and Lot 1, Block 3, RYrin Vier 1[anor lst, AND Lots 1 through 4, Block 1, 1Yin Vier 1(anor 2nd;
AND Outlot B and lots 1 through 3, Block 1, Yalden Seights lst; AND Lota 1, 11, 12, 21, 22,
and 23. Block 2, Yilderness Bum 2nd; AND Lots 1 tLrough 6. Block 1, Lots 1 and 2, Block 4,
and Iots 3 thraugh 12, Block 5, Yilderness Btim Sth; AAD Lots 1 through 9, Block 5, Qilderness
Btm 6th; AAD Dnits 101 through 104, 201 through 204, 301 thrwgh 305, 401 through 404, 501
through 504, and 601 though 605 (File No. 69), The Pines; all in tLe City of Eagan, County
af Dakota, llinnesota.
Written or oral objections will be considered; no anveal mav be taken as to the amount of
any assessment unless a sianed written objection is filed with the Clerk prior to the
bearine or vresented to the vresidino officer at the bearinst. An appeal to distzict court
may be made by serving notice upon the lSayor or Clerk of the City vithin 30 daps after
adoption of the asseasment and filing such notice rith the district court vithin ten days
after service upon the 2layor or Clerk. The City has a Senior Citizen defermant ordinance
based on income and homestead status. Details are available by calling the Assessment
Department, 454-8100.
Please note that vou vill receive additional notice on this matter oniv if the amount due
is amended. If qou have any questions about this statement, please call Special Assessments
at the C1ty of Eagan (454-8100).
City of Eagan
3830 Pilot Knob Road
Eagan, 2iinnesota 55122
CITY'OF F-AGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
DESCRIPTION:
?
..,.: ? ??'.:•
s
* .
\
PERMIT ? ?
PERMIT TYPE:
Permit Number: Date Issued:
1391 COSMOS LANE
LOT: 12 BLOCK: 2 WILDERNESS RUN 2N0
4' DEEP
Build3hg Permit Type
r Bailding'Work Type
Building Len,gth
I
? f.
REMARKS:
RECexPr r L 01 R.?
ABOVE GROUND
SWIM POOL .--
NEW
29
Control No. 0573
BUILDING
000727
06/03/92
{
((
L t?I i4 S b?! .. k??Y ? a
FEE SUMMARY:
VALUATION
8ase Fee
Surcharge
Subtotal
$45.00
$1.00
$46.00
$2,000
COPY $.50
7ota1 Fee ;46.60
CONTRACTOR: OWNER: - Applicant -
BLIESE CARY D
1391 COSMOS LANE
EAGAN MPI
(612)452-8412
I hereby acknowledge tMat I have read this applicaCaion and stata tha•fi the
information is aprrect and agree Co comply with all ap}a-l3cable State o'f 14o-.
Stat'utes end City of Eagan 0-rdinaneee, J
?
?
'L&? ??--_.-?
APPLIC T?/ ER IT SIGNATURE ISSUED BY: NA UFE
PERMIT N
r - ?
?7,,?L
CITY OF (EAGAN
1992 BUILDING PERMIT APPLICATION
681-4675
SINGLE & MULTI-fAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural.& structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typinq of permit is requested, but not.picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date Valuation of work ,?OocY"
Site Address: ??J?l ?-CJS/lZOS ?•
STREET STE #
Tenant Name: (comnercial only)
LOT BLOCK ? SUBD-? P.I.D. Y
Descri tion of work: PWt?f?? I?I 4?bO-? GrdUrJ od
The applicant is: Owner ? Contractor ? Other (Describe)
, Phone
Name J?$Ll Fi56 CA"ie_x P
.
Property usT ?,RST
Uwner . !V
) 3? ?C6 Sn1 U S ?
,
Address
STREEi STE N
Zip
t
J St
A GA
a
e
City V
/
Company Phone
C011tt'8Ct01' Address License # Exp.
City State ZiP
Company , Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with ali applicable State of Minnesota Statutes and City of
Eagan Ordinances.
?
' -
Signature of Applicant: r
OFFICE USE ONLY
BUILDING PERMIT TYPE
? O1 Foundation O 05 Apt. Bldg
? 02 SF Dwg. 0 06 6arage/Accessory
O 03 Two family ? 07 Fireplace
? 04 Multi-fam. T.H. ? 08 Deck
WORK TYPE
151 31 New ? 33 Alterations
? 32 Addition E3 34 Tenant finish
GFNERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy I -?z
Zoning
# of Stories
Length _aEF'_D iA .
Depth ?t- ?EUp
APPROVALS .
Planning
Engineering
Jo ? A?GI?aO`
5i500 +f.
0 09 Basement Finish
g 10 5wim Pool
C3 11 Res. Add.
C 12 Res. Porch
? 35 Move
O 36 Demolish
Basement sq. ft.
Ist fl. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
REG1UlRED INSPECTIUNS ABav? (aaaL-
? Site ? footing [3 Framing
? Mallboard P.'Final O Draintile
0 Insulation
? .Fireplace
Permit Fee y5°I UJ vsimc;a,:
Surcharge ? , ua
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Nater Meter
Acct. Deposit
S/W Permit
S/W Surcharge
?reatment Pl.
Road Unit
Park Ded.
7rails Ded.
!:opies , so
0?her
Tntal: ?
SAC %
SAC Units
700v ._ .
? 13 tomm/Ind New
? 14 Comm/Ind Add
? 15 Comn/Ind Rem
? 16 Public Fac.
? 17 Agricultural
MWCC System
City water
PRY Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Assessments
(5--
?
1? A-??
$y??-i rad o a
A?
?
NLY 9, 1990
RE: SPECIAL ASSESSMENT PROJECT I110P466
MY LAND HAS ALWAY DRAINED INTO THE SEWER THAT WAS TFiERE
WHE:I WE FIRST MOVED TO EAGAN ABOUT FIVE YEARS AGO. I AM
SEING TAXED FOR SOMETHING THAT WAS ALWAY THERE. IT HASN'T
INCREASED THE VALVE OF MY HOUSE OR PROPERTY. IN FACT THE
VALVE OF MY HOUSE HAS DECREASED. MY NEIGHBOR, KEN FREEMAN
TALKED WITN TOM COBERT ON SULY 6, 1990 AND HE SAID TRE
ASSESSMENT WOULD BE DROPPED FOR HIS PROPERTY AND MINE.
SINCERELY,
MR. AND MRS. CARY D. BLIESE
1391 COSMOS LANE
EAGAN, MN 55123
452-8412
63? 39
2005 RESIDENTIAL BUILDING PERMPC APPLTCATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 9 651-675-5694
?If 110 - C-:1
Nevr Construction Reauirements RemodeVReoair Reauirenents 0lfice Use Onlv
3 registered site suroeys shmving sq. R. of lot, sq. R. of house; and all roofed areas 2 copies of plan Cert of Survey Recd _ Y_ N
(20°k maximum lof coverage allowed) i sel of Energy Calculations for heated additions Tree Pres Plan Recd _Y _ N.
2 copies of plan showing 6eam & window s¢es; poured found design, ela t site survey for additions 8 decks Tree Pres Required _ Y_ N
1 set of Energy Calculations Addftion ? indicate Non-stite septic system On-sHa Septic System _ Y_ N
3 copies of Tree Preservation Plan if lot platted aifer 711/93
Rim Joist Defail OpAOns selection sheet (buildings with 3 or less units)
Date j:21/ q / 05 Construction Cost
U
iUSt
#
YI
COsmes A
f
SiteAddress -
-
- n
e
w\?S N
W
mS4i
'
?
Description of Work ?
/ t
rq1 CJ
F.?-?/ T`?
,fQ•
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner Telep6one #(? 00 D' 7 0 0" 0
RMA HOME SERVICF,S, INC.
ContraCtor Home Depot InstalleA Sales
Address 3200 Cobb Galleria Pkwy., Ste. #200
Atlanta? GA 30339 City
State 763-542-8826 Telephone lt ( )
BC-20268257
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
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previousiy constructed a building in Eagan with a similar plan?
fee applies.
Licensed Ptumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
N If so, 25% plan review
I hereby apply for a Residential Building 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 State of MN
5tatutes; 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
aIon va l of plans.
'Co. ?c156 rl
VApplicant's Printed Name
Signature
???L
Installed
Siding and Windows
LIMITED POWER.OF ATTORNEY
c:ui1NTY OF COBB
STATE OF GEORGIA
KNOW ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a licensed contractor of RMA Home Services, Inc., DBA Home
Depot Installe3 Sales located at 660 Mendelssehn Avenue North, Cso'.der, ValleV, MN
55427, having a license number of BC- 20268257, do hereby appoint, name and
constitute Elder-Jones Building Permit Service, Ina ("Agent") as my true and lawful
attorney-in-fact and do authorize and grant said attorney-in-fact for me and in my
name, place and stead the power to execute, acknowledge, sign and deliver (in such
form as may be required by the municipality) a permit application, or any other
instrument(s) which may be necessary and appropriate, in order to obtain the proper
permit(s) from the City of Eagan, Minnesota for the installation, maintenance and
repair of windows and siding (the "Work").
The powers conveyed to the Agent by this Limited Powe: of Atterriey are
]imited solely to the express powers delineated herein and apply solely to the Work.
This Limi,*.ed Power of Attomey sha11 expire and automatically be revoked on the 21 st
day of May, 2004, which date is one year from the executiou hereof. Further, the
powe:s conveyed by this Limited Power of Attorney may be revoked by Principal at
any time by express revocation and shall also be revoked by the Principal's death,
disability, incapacity or incompetence.
IN WI"I'NESS WHEREOF this Limited Power ofAttarney is elecurted this
21 st day of May, 2003
D? .
David N. Katz
SWORN TO AND SUBSCRIBED BEFORE ME by llavid N. Katz on this
21 st day of May, 2003.
Notary Plaic in for the State oYCieorgia
h7y Commission Expires: January 21, 2006
396816.0
Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor.
3200 Cobb Galleria Parkway, Suite 200 • Atianta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT
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VILLAGE OF EAGAN WATER SERVICE PERMIT
3795 Pilot Kno d PERMIT NO.• 1296
Eagan, MN 55122 DATE: 9/7/73(12/29/72)
Zoning: R -1 No. of Units: 1
Owner: Tilsen Construction Co.
Address:
Site Address: 1391 Cosmos Lan 12-2-2
Plumber: Luecken Excavating
Meter No.: Connection Charge: 300,00 Pd 8/1'
Size: Account Deposit:
Reader No.: Permit Fee: 10.00 pd 9/7/73
I agree to comply with the Village of Eagan Surcharge: .50 El+
Ordinances. Misc. Charges:
Total:
By Date Paid:
s•..
Date:
City of Etall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
L
Use BLUE or BLACK Ink
For Office Use u
Permit #: 1 L11l&v
Permit Fee:
Date Received: / '( DI 3
Staff:
INFLOW & INFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Tenant:
Site Address:
e > � L)-pasL.�
Suite #:
RESIDENT/ OWNERS
Name 1.-) (' lini 00C cr,„ � it CoY0 e_00 Phon : S7
}—.
Address / City / Zip: /3/ j a23,770\' Li? ' -1-- 0 ( h JP A. --3-Q 3
CONT CTOR
Name: License #:
Address: City:
State: Zip: Phone:
Contact: Email:
TYPE OF WORK
PLUMBING (Within the building envelope)
Sump Pump Repair
SEWER & WATER (Outside the building envelope)
Repair
Other:
Other:
ON
DESCRIPTIrect,',,_0A--
Description of work:
s,.,,,
ru......_f ei :SC1-igrD 9 i -z. -t-ke c..,s i-st'd
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 Ill repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.cityofeagan.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.gopherstateonecall.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.
p" 1 I 1 (k
Applicant's Printed Name
x
Applic 's --Signature f
FOR OFFICE U
Required Inspections: Under Ground Rough -In Final`
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114489
Date Issued:09/16/2013
Permit Category:ePermit
Site Address: 1391 Cosmos Lane
Lot:012 Block: 002 Addition: Wilderness Run 2nd
PID:10-84351-02-120
Use:
Description:
Sub Type:Reroof & Siding
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.
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.
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 -
Juan M Carrazco
1391 Cosmos Lane
Eagan MN 55123
Custom Creations Remodeling Inc
1321 Andover Blvd NE Ste 112
Andover MN 55304
(763) 441-5907
Applicant/Permitee: Signature Issued By: Signature