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4126 Lantern LanePERMIT City of Eagan Permit Type:Mechanical Permit Number:EA112415 Date Issued:08/12/2013 Permit Category:ePermit Site Address: 4126 Lantern Lane Lot:12 Block: 4 Addition: Coventry Pass 2nd PID:10-18401-04-120 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Phil Holmin 900 Park Knoll Drive Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 9001.2195 $60.00 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 - Daryle L Petersen 4126 Lantern Lane Eagan MN 55123 Holmin Heating & Cooling Llc 900 Park Knoll Drive Eagan MN 55123 (651) 405-3853 Applicant/Permitee: Signature Issued By: Signature ?^ ^ INSPECTION RECORD I CITY OF EACAN PERMIT TYPE: ':"' 3830 Pilot Knob Road Permit Number: 0•' ?/•"= i Eagan, Minnesota 55123 Date Issued: 0 N/-' 0!'-I (612) 681-4675 ' SITE ADDRESS: . , . •. . ? r?r.i I ? ? r.; i 6Nt ? PERMIT SUBTYPE: 114 1 f I r r APPLICANT: +1 I . Yr ! ! ( " I 1 '..' i !?! i,. j , •i i, ii yii, TYPE OF WORK: rqi ii INSPECTION ., . .• ? ? PermR No. Permtt Holder Date Telephone A S/W PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Insp. CommeMs Footings I Foundation Freming Rooting Rough Pibg. Rough Htg. Isul. Fireplace Final Htg. Orsat Test Final Plbg. Plbg. Inspector - Notity Plumber Const. Meter Engr./Plan &dg. Final Deck Ftg. a12Y?3 ' Deck Final O !O ?3 .? ? Well Pr. Disp. ? CfTY OF EAGAN 3830 Piiot Knob Road Eagan, Minnesota 55123 (612) 681-4675 INSPECTION RECORD PERMIT T1(PE: Permit Number: Date Issued: Control No. 0092 kt?? ? i F?,xwr? ec+ew{?.? 03J2A/42 SITE ADDRESS: i Ofi = 12 i 4 176 LANit.itN IANE' CUVENTkY FA ; ; :'W17 PERMIT SUBTYPE: '.I fi4lt1 TYPE OF WORK: N F_ lJ INSPECTION ., • Fb£?1 IN6 .A ?. fRAM3NO Itfv;llLA1"TUN 13R1 t.NCtAkt1 FIPfAL F EkEPI-AI:F- l ?.??` ? a??a. APPLICANT: MIfTR:LtiTAF.Dt 14RG111ER5 (612) A 5!i -912 fi J Permlt No. Permit Hofder Date Telephone # S/W •f-: - PLUMBING HVAC ELECTRIC c° ELECTRIC Inspoction Dete Insp. Comments Foonnys 1 Foundation < Framing t! } gZ DS Rooflng Rough Plbg. Rough Htg. 20 Isul. Firepiece Z f/r?° J'41DC r 1?! ?y?7?9?-? Flnal Htg. IF- 1 , ? orsat resc =2 ??TL ? S-/%-q7 ti?w .•? .Tls?a Final Plbg. 57,:,77-ft Plbg. Inspector - Notify Plumber ? Const. Meter Engr./Plen Bldg. Pinal Deck Ftg. Deck Final Well Pr. Disp. 3x sx CASH RECEIPT a CITY OF EAGAN r 3830 PILOT KNOB ROAD ? EAGAN, MINNESOTA 55122 DA7E vnw AMOUNT S = .-- :? 8 DOLLARS ?m ? CASH ? CHECK FUND OB.IECT AMOUNT Thank You BY C 017948 wnite--PaYm CWv v4w.-aosag copy ? Pink--File Copy SEWER & WATER PERMIT CITY OF EAtAN 3830 Pilot Knob Rd. Eagan, MN 551?2-1897 DATE +MAR 24s 1992 METER # CHIP # OFFICE USE ONLY Pzhnnirna,re 03/25/92 PE'-.MiT # 12633 B.P. RECEIPT # C 017948 B.P. RECEIPT DATE 03/24/92 X PRV - BOOSTER PUMP METER SIZE ISSUE DATE SITEADDRESS 4126 LARI'ER:; 1.^; LOT 12 BLOCK 4 SEC/SUB ?%?VEf< t'' , ',S 2ND APPLICANT: ADDRESS:_ CITY, STATE PHONE: _ PLUMBER: MCDONALD PLBG ADDRESS: 18271 KENHOOD TR CITY, STATE LAKEVILLE MN Zlp 55044 PHONE: 435-3334 OWNER: MITTELSTAEDT BROS ADDRESS: 785 SUNSET DR CITY, STATE EAGAN !1N Zip 55123 PHONE: 456-9125 ZIP PERMIT REQUESTED X SEWER x WATER - TAPS - COMM/IND x NEW X RESIDENTIAL ! EXISTING Lawn Sprinkler Meters are to be Installed Ahead of Domestic Meters on Water Line. Credit WILL NOT be given for Deduct Meters. I AGREE TO COMPLY WITH CITY OF EAGAN ORDINANCES SIGNATURE WHEN METER ISSUED PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. SEWER & WATER PERMIT GTY OF EAGAN , 3830 Pilot Knob Rd. ? Eagan, MN 55122-1897 DATE 4MAR 24. 1992 OFFICE USE ONLY METER #q-"9 '7 7Z T PERMIT DATE 03/25/92 CHIP # n? 9/ ? 3? 6 pERMIT # 12633 METER SIZE *fr PA B.P. RECEIPT # C 017945 ISSUEDATE B.P.RECEIPTDATE 03/24/92 X PRV _ BOOSTER PUMP SITE ADDRESS 4126 LANTERN LN LOT 12 BLOCK 4 SEC/SUB COVENTRY PASS 2ND APPLICANT: ADDRESS:_ CITY, STATE PHONE: - PLUMBER: MCDONALD PLBG ADDRESS: 18271 KENWOOD TR CITY, STATE LAKSVILLE MN Zlp 55044 PHONE: 435-3334 PERMIT REQUESTED X SEWER X WATER - TAPS ' • i _ COMM/INQ X RESIDENTIAL i X NEW - EXISTING Lawn Sprinkler Meters are to be Installed ? Ahead of Domestic Meters on Water Line. i Credit WILL NOT be given for Deduct Meters. I AGREE TO COMPLY OF OWNER: MITTELSTAEDT BROS EAGA RDIN NCE? ADDRESS: 785 SUNSET DR CITY, STATE EAGAN MN Zlp 55123 ? PHONE: 456-9125 31G TURE WH N METER ISSUE ? ,? ` --- J fFF'?.n;s:.. f- :lc:iu?1.. PLEA3E ALLO??O ?ORIZING ?AYS?OR PROCESSING.?CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. ZIP Z 3 7 A95 3d,y 06 8 9 ),u, Req?ue%' t Date Fire No- ?'/ ? jugh-in Inspection uired? ...,,,((('''''' 0 Reatly Now ill Notity Inspeclor W R ? Yes GNo hen eady? I licensed contractor O owner hereby request inspection of above electrical work at: J b Address (Street. Box or Route Na.) ?/a E Zf1N4E Ciry Section No- Township Name or No. Range No. County Occupa (PRINT) Phone No . . ' 4S?'A? 4?5-'6 -- Power Supplier Atltlress ? A k x EG c_ ? ,Ci9?2?? pJ Elacincal Contmctor (Company Name) 1A15 Connactor's License nlo. I'z y901 Mailing Adoress (Caniranor or Owner Making Installation) #* ? / Authonz¢ Signature (Contractor/Owner Making Insta lation) Phon Number ?yo -y g b a MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUES7 WILL NOT Griggs-Mitlway Bldg. - Foom S173 ? BE ACCEPTED BYTHE STATE BOARD 1877 UniversiTy Are., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone(812)6a2-0B00 ` 'e ENCLOSED. p ? nGV?q?11rVn CLG1,IIlIVML ur.?rvn . ? •- 'VQ, co•vv?vi-oo ? P/Y '/ ? Sea inshuclinns Mr comoletino ihis form on baCk of Vellow CoOV. /? C 7 J 0 X" Below Work Covered by This Request N ? j? 638S ew 'Add R?io TypeofBuilding AppliancesWired EquipmeMWired Home Range Temporary Service Duplex Water Heater Eleciric Heating Apt. Building Dryer Other (Specify) CommJlndustrial Furnace Farm Air Conditioner Olher Ispecifyj Coniractor's Remarks: Compute Inspection Fee Below: # ', Other Fee # ServiceEntrenceSize Fee # Circuits/Feeders Fee Swimming Pool 0 to 2D0 Amps 0 to 100 Amps Transtormers Above 200 _ Amps Above 100 _ Amps Signs Inspecror's use Only: TOThk Irrigation Booms ? Special Inspection Alarm/COmmunication THIS INSTALLATION MAY BE ORDERE DISCONNECTED IF NOT Other Fee COMPLETED WITHIN MTRNTH f I, the Electrical Inspector, hereby Rough-in oete certify that the above inspection has been made. F?„ai r Date OFFICE USE ONLY . This request void 18 months Irom Addr(jis: 4126 LAN= T•ANE Lot 12 Blk 4 Sec/Sub rpVENTRy pASg M These items were/were not complete at the time of the final inspection. Date: 5/26/92 Yes No Final grade (6" from siding) Permanent steps - garage Permanent steps - main entry Permanent driveway Permanent gas Sod/seeded grass tr Trail/curb damage ? Porch Basement finish Deck PLease verify vith the builder the removal of roof test caps from the plumbing system and the shut-off of vater supply to the outside lawn faucet before freeze potential exists. ? xcrciEOwven White - City copy Yellow - Resident copy Pink - Contractor copy DATE: MAR 25, 1992 RE: 4126 LANTERN LN (MITTELSTAEDT BROS) It Your Sewer & Water Permit for the above property has been completed. It will be held at the Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON. Your Sewer & Water Permit for the above property cannot be completed for the following reasons: _ Your Sewer & Water Permit tor the above property has been completed, but the meter cannot be issued or occupancy allowed until further notice. _ COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hail. Meter size must be confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance. WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC. - REQUIRED BY LAW. CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. 2006 RESIDENTIAL MECHANICAL rERMiT aPPLicATioN CiTy Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when pernuts aze required for each unit 3(?,,,5z) 'vsi`Sai Date 6 Site Address Unit # Property Owner Telephone # ( ) , _J? (Z Contractor - Street Address ?'2 I c LYL City ? State Zip SS?7Z Telephone# Bond #• ires: x; 3/ 6, Ex p The Applicant is _ Owner Contractor Other Add-on or alteration to eaisting dwelling unit $ 30.00 furnace _Additional _ Replacement _ New air excha nger air conditioner heat pump other State Surcharge $ .50 Total $ I hereby apply for a Residenrial Mechanical Permit and aclrnowledge 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 with the Mechanical Codes; that I understand this is not a pernut, but only an application far a perxnit, and work is not to start without a pernut; that the work will be in accordance with the appr ed pl?y in the case of work which requires a review and approval of plans. ? ,?4C At4?r?401-1 Applicant's Printed Name Applicant's Signature 2004 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 ?o 00 New Construction Requirements RemodeVReoair Reauiremenls 3 registered sife surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan GertoFSeaueyRecd (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions T[eePres A01h Recd Y ?. N 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for addflions & decks 3reePres,#, qqired N N 1 sel of Energy Calculations Addition - indicate itoo-site septic system 9?st18 Sepitc8?s?em :?: _?' _ N 3 copies of Tree Preservation Plan if lot platled after 711193 Rim Joisi Detail Options selection sheet (bldgs with 3 or less units Date 6l I L2- / 0 ? Construction Cost #??,OzpoT Site Address Unit/5te # ? Description of Work /,j5/ //ct (3r75 Multi-Family Sldg _ Y kN Fireplace(s) _ 0 2 Property Owner Telephone #(?`?O? ? r = Contractor l ? ?J/L Address city ? A State Zip 7??3 7 Telephone 07a ?a2 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category 0 Residential Ventilation Category 1 Worksheet • New Energy Code Worksheef (dsubmissiontype) Submitted Submitted . Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( ) _ Telephone #( ?_ Telephone #( 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 Statutes; I understand this is not a permit, but only an application for a permit, and wark is not to start without a permit; that the work will be in accordance with the approved plan i the se f which requires a review and approval of plans. j C ? % Applicant's Printed Name Applica t's Signature ??? RESIDENTIAL 29 Z9 BUILDING PERMIT APPLICATION 1- CITY OF EAGAN 3830 PILOT KNOB RD, EACAN MN 55122 651-681-4675 New Canstruction Reauirements Remodel/Reoair ReQUirements • 3 registered site surveys showing sq. rt or lot, sq. ft. of house; and all mofea areas • 2 copies of plan (209'o mazimum lot coverage allowed) • 1 set ot Energy Calculations for heated additions • 2 copies of plan showing heam & window ;izes; poured found design, etc.) • 1 sile survey for exlenor additions & decks • 1 set of Energy Calculations • Indicate if home served by septic system /or addi6ons • 3 copies of Tree Preservatfon Plan if lot plaRed after 711193 • Rim Joist Detail Options selection sheet (bicgs with J or less units) _S DATE 11 I S/ 0Z VALUATION ? 2._76, o O SITE ADDRESS ?I2(e L-An'teer% Ln MULTI-FAMILY BLDG _ Y _ N TYPE OF WORK FIREPLACE(S) _ 0_ 1_ 2 APPIICANT Wea.,^? STREET ADDRESS S(647 ?k&?,a?e,J /'tl&. ?. CITY STATE lI ZIP 550k'Z- TELEPHONE # (a51-y39-?{32D CEII PHONE # FAX # (v51-35)-20?_ I?IO PROPFRTYOWNER D0.!'VLiL j- C4ora.. t'e.I-e,rSQ-v? TELEPHONE# (05HAI-0 COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ %[[N\ES0"1'.\ RI;I.t:S 7670 C:\"I'I;GORY 1 MIVNF.SO'I':1 RliLI:S 7672 (4submission type) • Residential Ventilation Category 1 Worksheet SuCmitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: _____ Plumbing systein includes: Mechanical Contractor: _ N[cch.uiicA svslcm includr;: Air Conditioning Fee: $90.00 r•ee: Hcat Rccovcr}' Systcnt Sewer/Water Contractor. Phone # r g ?c^? ? il ?i ., F. . . Li' t MLi I hereby acknowledge that I have read this application, state that the information is cqrrect, and OnfPeY#o?-?mp?Y with all applicabte State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant OFFICE USE OvLY Water Soltcncr Watcr Heater No. oF Baths Phonc # I,acm Sprin(:ler ti' o. oE' R.I. Baths Phone # CertiFicates of Survey Received Tree Preservation Plan Received _ Not Required _ - Updated 4/02 RESIDENTIAL r BUILDINC PERMIT APPLICATION J ? CITY OF EACAN 3830 PILOT KNOB RD, EACAN MN 55922 651-687-4675 NewConetruction Reauirementa RemodellReoair Reauirements • 3 registered sde surveys showing sq. ft. oi lot sq, fl. af house; and all roofed areas • 2 copies of plan (20°k maximum bt coverage allowed) . 1 set of Energy Calculations for heated additions • 2 copies of plan shaxing beam & window s¢es; poured Found design, etc.) . 1 site survey for exlenor additions & decks • 1 sel of Energy CalculaGons . Indicate if home seNed by septic system for additions • 3 copies of Tree Preservation Plan i( IM plaUed after 711193 • Rim Joist Detad Options selection sheet (bldgs with 3 or less unifs) DATF 9 VALUATION ??OO SITEADDRESS y P-0 "n-6.rn L.n. MULTI-FAMILYBLDG Y N TYPE OF WORK 3 Season iROoW1 FIREPLACE(S) X 0_ 1_ 2 APPUCANT STREET ADDRESS TELEPHONE #9s2-qNl -?73- ?, CELL PHONE # PROPERTY OWNER _I?Arki I&_ PC44rSPn TELEPHONE #651 -6451-pi 710 COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 A (q submission type) • Residential Ventilation Category 1 Worksheet Submitted • • Energy Envelope Calculations Submitted Plumbing Contractor: Plumbing system includes: Mechanical Contractor: Mechanical system includes: Sewer/Water Contractor: ? Water Softener _ _ Water Heater ? No. of Baths Air Conditioning Heat Recovery System Phone # TA RULES 7672 gy Code Worksheet,Siu`ff , sr. ..? D ? ,?? ?nn? •?? i FPP' ,U90.00 _ Fee: $70.00 I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with ail applicable State of Minnesota Statutes and City of Eagan Ordina ces. Signature of Applicant OFFICE USE ONLY 0 r(Y _ Phone # Iawn Sprinkler No. of R.I. Baths Phone # ' -A(-i° r STATE Mr1-ZIP `S 3:7,2 ov? FAX # Certificates of 5urvey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY ? 20 Pool 1" 21 Porch (3-sea.) / ? 22 Porch(Addn. (4-sea.) ? 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous . ? Ot Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? OS 03-plex ? 06 04-plex ? 31 New ? 32 Addition • ? 33 Alteration ? 34 Repiacement ? ? 30 Accessory Bldg 0 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation at? ? Occupancy MC/ES System _ Census Code Il 3 471- Zoning City Water _ 5AC Units Stories Booster Pump _ Nbr. of Units Sq. Ft. PRV _ Nbr. of 81dgs Length ? Fire Sprinklered _ Type of Const V10 Width ? REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. Footings (deck) $! FinaUNo C.O. Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final Pool _ Ftgs _ Air/Gas Tests _ Fina] _y Framing _ Siding Stucco Stone Fireplace _ R.I. _ Air Test _ Final _ W indows (newlreplacement) ? Insulation _ Retaining Wall P,pproved By D Z. , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC Ci1y SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanicat Permit License Search Copies Other Total ? 07 05-plex ? 13 16-plex ? 08 06-plex ? 16 Fireplace ? 09 07-plex 13 17 Garage ? 10 08-plex ? 18 Deck 0 11 10-plex ? 19 Lower Level ? 12 12-plex Plbg_Y or _ N Q : 7! ? 1/o ? . 4MVEYOR'S CERYIFICATE J,_„-?~?9 2 0.6 azs 9: d ?N azs e . ?. r 2 35 • ?d_..?"' , BEMCM NARK ?,. roa oF PIPE i Lev.. 029.4> --?-r _ M1TT[LS7AEDT BROS. CONST"RUCTION R?DGE `_---,? OAO, ? , '---?-.. ? 29.4 eee.a ?. 94,01 L =40°1p??1??RxJ? 824,5 4. p7 ` S? , ? e f 8R9? J 5 a 6 q ? ' I sti 23.00 •' 34.33 -- -- -=- --- - -- 1 M5. M 20,'S3 - 31 13 ?N ? tOi PROFGSED ; GAR. :v ci H O U$E A2Za ? O i 6.0 ' N 8'J ? S. S Q"? ' t` ? B:s. = 34.0 wi ?.- 25.33 ? ?-c-829.9 ----?830.8 • (- e3z.o c?? --, - 3? G ? ? s 4?f ? l O I B[Zt / Q 0 ' C7 ? fi -- (0 i?? / co / BE N qRK TOP Opt pIPE FIFV_rab1.1S z IL - ? i - t I ` I ?~1 t - I cG F tr:???,hjt I L OT I? I b' , ?------,---?- 'k" b / tr onrE_ e2 r ? tp 1p? ? . ! ?LO???g?p l I INCH = 30 hEET ? - ? V? James R. Hill, I f 1C. PLANNERS i ENGINEERS / SUAVEYORS 2 500 W. CTY. RD, 42 0 BURNSVILCE, MN. 55337 • 612-$90-5044 NOMENOMMOUN? ` 12- BL T cirr use oNLY suso. C eh S S :4RECEIPT #: RECEIPT DATE: 11- ltv? _ PERMIT # 7 7 2000 PLUMING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 ?t 651-661-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH # TOTAL Alterations to existing dwelling - minimum fee Describe: "L?^ Lcvd $ 30.00 Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Ges piping outlet ' minimum -1 3.00 X = $ Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x = $ Laundry tray 3.00 x = $ Lavatory 3.00 x = $ Septic System new/refurbished ' requires MPC Ile. 75.00 X = $ Septic System abandonment 30.00 x = $ RPZ new installation/repairlrebuild 30.00 x = $ Rough opening 1.50 x = $ Shower 3.00 x = $ Underground sprinkler if dwelling is under construction 3.00 X = $ Under round sprinkler if existing dweiling 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water softener If dwelling under construction 5.00 x = $ Water softener if existing dwelling 30.00 X = $ Water turnaround 30.00 x $ State Surcharge .50 --> -> -> $ .50 Total --> --> ----> ---> $ Reminder: Calt for inspections of alterations, i.e. water heaters, water softeners, etc. ------------------------------------------------------------------- -------------------------------------------------------------------- I hereby adcnowledge that I have read this applicaGon, state that the infortnation is conect, and agree to wmpiy with all applicable City of Eagan ardinances. It is the applicanYs responsibility to notify the property owner that the City of Eagan assumes no liability for any damages ceused by the City during its normal operational and maintenance activities to the facilities constructed under this pertnit within City propeRy/right-of-wayJeasement. SITEADDRESS: G ZC(.h-:(-tri-i GdrM - OWNER NAME: :?l r V?! ?rit'Gv'.S u't TELEPHONE #: / s l ltfl` bI 29 (AREA CODE) INSTALLER NAME: TELEPHONE #: (AREA CODE) STREET ADDRESS: CITY: STATE: ZIP: SIGNATUR OF PERMITTEE 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 'r C1U ? 3 reglatered site wneys ahowlnp sq, fL of loi, aq. R. of house and go rooled areas (2096 ma)dmum lot coveraae ailowed) D 2 coplea of plans (ahow beam & wh?dow sizes; poured fnd. design; etcJ n 1 set of energy calculaflons ? 3 coptes of tree preaeroation plan if Iot platted after 7/1/93 DATE: LIZLIOO RemodeVReoalrReaulremenh l,ralIcj 1I`19-0 ?ppies Ot plan ? 't'SoPOtstsergy cSlculaNons for heated addlfions fl-fy) i alte wney for extedor addiHons & decks CONSTRUCTION COST: DESCRIPTION OF WORK: Idwcr L?vt? ?; v?.iS STREET ADDRESS: YI.,2 4 LQ,rt-?u^N Ll.L LOT: ? BLOCK: SUBD./P.I.D. #: -L l.? yc L OVPI??f's 2hcl Name: /'64-Gv`Se-A IL Phone Po?? Lasf Fi?? ??ti ? ? y g 5S'? Sheet Address: yiaL laxfcy . ?in e- City ?6ui6Cvt state: ztp: • Company: one #: (area code) CONTRAGTOR Sheet Address: License Y Exp. C11y _State: Zip: ARCHITECT/ ENGINEER Company:_ Telephone #: Sheet Addre: Cify Name; Regisha8on 0: Sewedwater licensed plumber (if installina sawerMraterl: Phone #: Zip: I hereby acknowledge that I huve read this application, stafe thaF 1he Infortnafion is cortect, ond agree to comply with all appncable StaFe of Minnesoto Staiutes and CiFy of Eagan Ordinances. Signature of Applicanh - OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Required AtQ(/ n 2Q0o _?,/? OFFICE USE ONLY BUILDING PERMIT SUBTYPES ? 01 Foundation O 07 05-piex ? 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext. Alt - Muw ? 02 SF Dweliing ? OS 06-plex 0 17 Garage 0 22 Porch/Addn. (4-sea.) ? 33 Ext. Ait - SF ? 03 01 of_ plex ? 09 07-plex ?,8 Deck ? 23 Porch (screened) 0 36 MuRi ? 04 02-plex ? 10 OS-plex ? 19 Lower vel o ? 24 Storm Damage ? 05 03-plex ? 11 r _ N 10-plex Plbg v ? 25 Miscellaneous ? 06 04-piex ? 12 12-plex ? 20 Pool ? 30 Accessory Bidg. WORK TYPE ? 31 New O 36 Move Bidg. ? 43 Reroof ?2 Addition ? 37 Demolish (Bldg)' ? 44 Siding ? 33 Alteration 0 38 Demolish (Interior) ? 45 Fire Repair ? 34 Repair O 42 Demolish (Foundation) ? 46 Windows/Doors " Give PCA handout to applicant for demolition permlt GENERAL INFORMATI ON SAC Code # of Stories Sq• n. No. of Units 0 Length sq. ft. _ No. of Buildings ? Width Footprint sq. ft. Const. (Actual) vAv Basement sq. ft. Census Code t/3y (Allowable) vn/ Main level sq. ft. MC/ES System UBC Occupancy &- I sq. ft. City Water Zoning sq. ft. Booster Pump PRV Fire Sprinklered MISCELLANEOUS INSPECTIONS ? Stucco/Stone APPROVALS Planning Building IS& Engineering Variance Permit Fee Valuation: $ I)2ov Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SNV Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: SAC Units % SAC INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3630 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITEADDRESS: LOT: 12 BLOCK: 4 APPLICANT: 4126 LANTERN LANE ARNETT STEVEN COVENTRY PASS 2ND (612) 973-0906 PERMIT SUBTYPE: DECK TYPE OF WORK: NEW BUILDING 021725 08/20/93 INSPECTION D. . .A FOOTING FINAL ? cITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT ? C4"° PERMIT TYPE: Permit Numlier: Date Issued: BUZLDIMG 021725 08/20/93 SITE ADDRESS: P.I.N.: 10-18401-120-04 4126 LANTERN LANE LOTs 12 BLOCK: 4 GQVENTRY PASS 2ND DESCRIPTION: ermit Type DECK @,rk Type NEW 13 14 R"-, ? i ?? y ??'? ? '"x REMARKS: FEE SUMMARY Base Fee 5urchargs Subtotal CONTRACTOR: $25.@0 1.50 $25.50 r I horeby soknaw3ed-ge: that I ?hav Informativn is :ccsrrect.an 1 4 ag.we stottate.? ?h4I C,i'ty of Eagari Ordi APPLICANT/PERMITEE SIGNATURE CQPY $.50 Total Fee $26.00 OWNER: - Applicant - ARNE7T 57EVEN 4126 LANTERN LANE EAGAN MN (612)973-0306 ISSUED BSIRNATUR' ? ,n. ? ? ? ? x REACTIVATE PERK?V# ? . ') 172)" r) CITY OF EAGAN 1993 BUILDING PERMtT 681-4675 APPLICATIO? o-o C;? - 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: 1) when permit is typed, but not picked up by last working day of month. in which request is made, 2) address is changed or 3) lot change is requested once permit F is issued. Date /?/19 Yal uati on of work '`?9M /A¢tA!1?W Site Address: ??? `?f2?""?? ?- STREET SU1TE y ? Tenant Name: (commercial only) LOT ? BIACK ? SUBD. ?..I D. * Descri tion of work: ?-2 6 The applicant is: X Owner [3 Contractor ? Other (Descri6e) 3-03010 Name , P,vT) Phone ptda E(nE??roF_?33 Property LAST FIRST Owner Address nter'1) G'1 STREET STE 0 City State l?(1J Zip 5?12-3 Company Su h,.P. Phone Contractor Address License # Exp. City State Zip Company Phone Architect/ Engtneer 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 wit 11 applic ble Stat of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: J OFFICE USE ONLY BUILDING PERMIT TYPE O 01 Foundation ? 02 SF Dwg. O 03 SF Addition ? 04 SF Porch ? 05 SF Misc. ? 06 Duplex ? 07 4-Plex ? 08 8-Plex ? 09 12-Plex ? 10 Multi. Add'1. WORK TYPE ? 31 New 32 Addition O 33 Alterations O 34 Repair 0 11 Apt./Lodging O 12 Multi. Misc. ? 13 Garage /Acce s sory ? 14 Fireplace pl? 15 Deck ? 35 Tenant Finish 0 36 Move , .__. .. ? 16 Basement Finish ? 17 Swim Pool O 18 Comn./Ind. O 19 Comm./Ind. Misc. O 20 Public Facility O 21 Miscellaneous ? 37 Demolish GENERAL INFORMATION Const. (Actual) 'i Basement sq. ft. MWCC System (Allowable) lst F1. sq. ft. City Mater UBC Occupancy R. 3 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code L/.;?!? Depth On-site sewage SAC Code ?- APPRO\'ALS o Planning Building Assessments Engineering Variance REOUIRED INSPECTION S ' ? Site Footing ? Framing O Insulation [3 Wallboard ? Final O Draintile ? Fireplace Permi t Fee ZS . v J 1 veLuae;a,: $ Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit 5/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies .? Other Total: SAC % SAC Units INSPECTION RECORD Control No. 0092 CITYOFEAGAN PERMITTYPE: BUILDING 3830 Pilot Knob Road Permit Number: 000093 Eagan, Minnesota 55123 -- Date Issued: 03 /24 /92 (612) 681-4675 SITE ADDRESS: Lo T: 12 4126 LpN7ERN LpNE ?`GOV,ENTRY PAS5 2ND PERMIT SUBTYPE: sF owG s Loc K: a APPLICANT: MITTEL5TAEDT BROTHER3 (612) 456-9125 TYPE OF WORK: NEW INSPECTION SITE DA . FOOTING D• FRAMING INSULATION WALLBOARD FINAL FIREPLACE F L PERMIT ` -CITY OF EAGAN 3830 Pilof Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: PERMIT TYPE: Permit Number: Date Issued: 4126 LANTERN LANE' LOT: 12 BLOCK: 4 COVENTRY PASS 2ND DESCRIPTION: Buildfng Permit Type Building Work Type UBC Occupan?cy,, Constructa,on Ty'pe Zoning - Building Lengttt Building Width ? ? .. .. 3F DWG NEW R-3 M-1 VN R-1 60 26 , - ` X BUILDING 000093 03/24/92 REMARKS: ?0) ??4 ? ?^ V FEE SUMMARY: Base Fee Plan Review Surcharge SAC SAC % SAC Units Subtotal VALUATION $716.50 $465.73 $61.00 $700.00 100 1 $1.943.23 $122,00@ MI3C FEE3 $1,610.50 7ota1 Fee $3,553.73 CONTRACTOR: - applicent - sT. LIWNER: MITTELSTAEDT BROTHERS 14569125 0003 43 MITTELSTAEDT BROS CONST 785 SUN5ET DR 785 3UNSET DR EAGAN MN 55123 EAGAN MN 55123 (612) 456-9125 (612)456-9125 I hereby acknawlsdge that I have read this ap,plzcati.an and state that the information is correct and agree to comply with all applicable State of Mn. Statutes and City af Eagan Ordinance,s. ? APPLICANTlPER EE SIGNATURE ISSUED BY IGNATURE Control No. 0092 OFFICE USE ONLY BUILDING PERMIT TYPE O 01 foundation p 02 Single Family D 03 Two-family ? 04 Multi-fam. T.N. ? 05 Apt. Bldg. ? 06 Garage/Accessory 0 07 Fireplace ? OS Deck D 09 Basement Finish ? 10 Swim Pool O 11 Res. Add./Porch ? 12 Cortnn._/Ind. New ? 13 Comm./Ind. Add O 14 Gomm./Ind. Rem. ? 15 Public Fac. WORK TYPE 19 90 New ? 91 Addition O 92 Alterations ? 93 Remodel O 94 Repair ? 95 Tenant Finish GENERAL INFORMATION ? 96 Move ? 97 Demolish O 99 Undefined ? 16 Agricultural ? 17 Biiilding Move ? 18 Demolition ? 20 Miscellaneous Occupancy V3 / Basement sq. ft. /00 y MWCC System Zoning (Actual) Const lst F1. sq. ft. d F1 2 ft GG City Water uired PRV Re . n . sq. . B q (Allowable) Sq. Ft. total Booster Pump # of Stories 2 Footprint Sq. ft. Fire Sprinkler Length 7_6 On-site well Census Code Depth 2 61, 3 On-site sewage SAC Code APPROVALS Planning Building Assessments Engineering Variance AEQUIRED INSPECTIONS Ig Site 13 Footing L1 Nallboard 0 final [,YI Framing ? Draintile ? ? oL ,0 lnsutation L7 Fireplace Permit Fee So v?tuae;«,: : I Z? Surcharge Plan Review 73 license -2 Q,? yb ? 800 CWty SAC 200 3,- 3 y =/D ? Water Conn. !n 25- ' 3,t 3 y =?_ Water Meter qs Acct. Deposit 30 9 v (o?Z?,p S/W Permit 30 ? S W Surcharge Treatment Pl ?? . - Z h ? Road Unit 390 Park Ded. Trails Ded. _ ?/?$5"Z Copies y - ? Other Total: ?QV zzz.r/G ? `V? SAC 96 SAC Units .. l CITY OF EAGAN 1992 BUILDING PERMIT APPLICATION 681 -4675 , A i? 'e q RECD 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 typing of permit is requested, but not picked up by last working day of month in which re uest is made ar lot chan e is re uested once ermit is issued. Date 3/ Val uat i on of work Site location: 41a4o 1gAx7e,z.?J Ll?vs STREET STE # Tenant Name: LOT ? BLOCK ?f SECT/SUBD. Czv ywg.Wj? P.I.D. # Descri tion of work: G , t ` Fevw, The appl i cant i s: ? Owner Contractor ? Other (Oescri6e) Name Phone Property LAST FIRST Owner Address STREET STE N City State Zip Company X, 2-I"56-6 /gzeft 4ey.L?- Phone Contractor Address `79'-5 Sr?s?? ,dr??.d? " License # CV,034,? 3 City State Zip 55??14; Company _ Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber AIG {r?.&az.z,4A6&i ? } . 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 all applicable State of Minnesota Statutes and City of Eagan Ordinances. 5ignature of Applicant: _ _, r • ? BUILDING PERMIT TYPE 0 01 Residential ? 02 R. Garages 0 03 Two-family 0 04 Townhouses 0 05 Multi. Dwellings WORK TYPE OFFICE USE ONLY 0 06 Commercial 0 07 Industrial 0 08 Public Works 0 09 Utility 0 10 School 0 90 New 0 93 Remodel 0 91 Addition 0 94 Repair 0 92 Alterations 0 95 Tenant Finish TYPE OF STRUCTURE 0 101-01/20 1 Family Res. 0 102-03/22 1 Family attached ? 103-02/21 2 Family (duplex) ? 104-10/23 3 & 4 Family 0 105-10/23 5 or more Family 0 213-30 Hotel/Motel 0 214-30 Other Shelter/Board 0 318-30 Amusement/Rec. 0 319-30 Place of Worship 0 320-40 Industrial 0 321-30 Non-Res. Pk. fiar. 0 322-30 Service Station 0 323-30 Hosp./Institution GENERAL INFORMATION Length Occupancy Depth Zoning Sq. Ft. Const. (Actual) On-site sewage (Allowable) On-site well # of Stories APPROVALS Planning Building _ Engineering Variance _ REQUIRED INSPECTIONS ? Site ? Footing O Wallboard ? Final [ . ,_ 0 11 Other Structure 0 12 Demolish 0 13 Fireplace 0 99 Undefined 0 96 Move 0 99 Undefined 0 324-30 Office/8ank 0 325-30 Utilities ? 326-30 Schools/Ed. 0 327-30 Retail/Rest./Whse. 0 328-30 Other Nonres./Sheds 0 329 Non bldg. Structure 0 434 Alt./Add. Residential 0 437 Alt./Add. Non res. 0 438 Alt./Add. Res. 6arage 0 645-50 Deno 1-Fam. 0 646-50 Demo 2-Fam. 13 647-50 0emo 3& 4 Fam. 0 648-50 Dana 5 or more 0 649-50 Demo Other MWCC System City Water PRV Required Booster Pump Sprinklers Assessments ? Framing ? Insulation ? Draintile ? Fireplace sac catcutas;«,s: Description SAC X , % SAC Units :.. . z _ i?'ri? ?? ?.? .i??? ?_• __L..fIIiL?? ?• IIILL l?t? iL?_ I_?_1.:. L? L 11 r1iJl i-I_? i .titJRVE,YOR'S CERTlFICATE MITTELSTAEQT sROS coNsTRucTIorv f,l'`?8Y 0 6 __? NSd6V o? ?35, _..? f-R-I D--G E -?_----R o? _ p ? 94.01 0=40°IO'31ps ?_. ? r 6? 8?9a1 m cr 5? 1 a o % S N ? 8EliCN MpRK ro a of 54.33 „15 • M 2033 3" P?ve -, ?.00 . , . : f LEV.. OY6.17 (0 Nj ? ? PROF'GSEiJ ; GAR. N HousE ' a eas.s o? zzs to G 6.0 ? ¦ .t 340' ---------'---25.33__ at7. ? 7 .? R ?SO.Y 832.6 /?1? '?'_ EYL.? 0l/ 5 jr W?r 0 o 0 J CD f? f o `?. ? . 632, Ir Q) / eeNCH MaRK TCP OF PIPE ELEV•6E1.73 f L,? ? m ? 1 EAGAN LOT !2 I I ? ?\ y R £V ,E W E a ---?°- LA_ mG BY___....?.5 ? DarE ,. .+ Ar? ' ? v . !' } Y+ ?? ?.Y a? ?- u?? ,s..?__ ?•G, _`----?---._ g , t 6 ? ? 1 y i INCH?30 1=EET ? -- - i?Sa 1? l? o U o O3 ECQ)Lfl!1 James R. Hill, inc. PLANNERS / ENGINEERS / SURVEY4R5 2500 W. CTY. RD. 42 • BURNSVILLE, MN. 55337 • 612-880-5044 CITY OF EAGAN 11k ? L 12.1 bq, N46ry CITY OF LAKEVILLE BUILDZNG INSPECTION DEPARTMENT 20195 HOLYOKE AVENUE, P.O. BOX 957 LAKEVILLE, MINNESOTA 55044 612-469-4431 U.1 E SGaf'r This form is only applicable to detached one-and-two family dwellinqs. The requirements herein are based on amended Section 502.2.1.7 in lieu of the criteria specified in Sections 502.2.1.1, .2 and .3. Building Address: 412, (,,_ (_/470-1E2U) Lnr- Contractor or owner: emeIIt "R" Values Area (sq ft) % of Ext.Walls Ceilings Design?Required 38 Walls* (exterior) Design 2LRequired 21 2 37& (without foundation) Floors* Design_34 Required 20 (overheated spaces) Windows** Design_!L?lRequired 2 Foundation Walls Design13i,Required 5 (when insulating full depth of foundation wall) Design_Required 10 (when insulating only to frost depth & footings extend below) Slab-on-grade Design`?=? Required 8.83 floors -Doors Design ry Required 3 Footnotes• * For the insulated cavity of opaque walls, floors, and rim joists. ** Maximum window area must not exceed 12 percent of the area of exterior walls, not including foundation walls. CERTIFICATION I hereby certify that I have completed the above information and that it complies with le Minnesota State Energy Code. Signature Date: . ? - CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 FOR CITY USE ONLY PERMIT # RECEIPT # DATE : It,?S;???';f`;?3> PLEASE COMPLETE >:.:: ?,...::<:. .:.....:: .......? UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS 5 . TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FO& EACH UNIT. ------------------------ WORK DESCRIPTION ----- --------------------- ---- --------------------- COMPLETE THE FOLLOWING; ------ N0. FIXTURES EA. TOTAL NEW CONST ADD-ON MINIMUM 15.00 ADD ON / SHOWER 3.00 REPAIR ? WATER CLOSET 3.00 ? / BATH TUB 3.00 3 ' LAVATORY 3.00 OWNER NAME: l KITCHEN SINK 3.00 3' LAUNDRY TRAY 3.00 ?r SITE ADDRESS: HOT TUB/SPA 3.00 ,,_,,s,f? n ?` ? ' ?' / WATER HEATER 3.00 ? LOT: BLOCK SUBD. `-'?- " ? FLOOR DRAIN 3.00 T= GAS PIPING DUT. INSTALLER: (MINIMUM - 1) 3.00 ? ? O '`??' ? ROUGH OPENINGS 1.50 ADDRESS: OTHER ? r WATER SOFTENER 5.00 ? ZIP: CITY: z- PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 SUBTOTAL $ q???o ST. SURCHP.RGE .50 TOTAL: $ ?7_(X, PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. __- -----°-------------------------°-----°_ CONTRACT PRICE: dWNER NAME: SITE ADDRESS: LOT: BLOCK SUBD. INSTALLER: ADDRESS: CITY: ZIP: PHONE #: FEES 18 OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 18 $ STATE SURCHARGE TOTAL: $ ( S IGNAT[JRE) FOR: CITY OF EAGAN ? CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 FOR CITY USE ONLY PERMIT # RECEIPT # D DATE: PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & _.:. . . _. . ....,:::::. TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. ------------------------ ---------------------------------- -----------------°---- WORK DESCRIPTION FEES NEW CONST v ADD-ON MINIMUM $15 00 ADD ON REPAIR OWNER NAME :& 1 fe ( S T-GL'2-?? SITE ADDRESS: 4/eI1-nG LOT: W, BLOCK __!?4 SUBD. ?DIIe-,1 ?QSS a?d INSTALLER: RiirncVlllp Heatin$ S4-A?C, Inc 12481 Rhode Island Ave. So. ADDRESS: SaVage, MN 5-5-,,'?7$ 4-1-2-2 894-0005 CITY: ZIP: -___--- PHONE # HVAC 0-100 M BTU 4.Z ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM OF 1 PER PERMIT SUBTOTAL: STATE SURCHARGE: TOTAL: $??U Ft'?GNA E OF PERMITTEE/? ^V-S uP-'Vl ? `? i -Ce-4-1 , ra-,-j,e.. ?01+II?EItC?AT,f?tb'EJST?L?AT.;; PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, APARTMENT SUILDINGS, AND MULTI-FAMILY BUILDINGS WEIEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING IINZT. -------------------------------------------- _^..___ _----------____?_____------- CONTRACT PRICE: OWNER NAME: SITE ADDRESS: LOT: SLOCK SUBD. INSTALLER; ADDRESS: CITY: ZIP: PHONE #: FOR: FEES 18 OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR EACH $1,000 OF PERMIT FEE. PROCESSED PIPING = $25.00 $25.00 MINIMUM FEE. CONTRACT PRICE x 18 $ STATE SURCHARGE $ TOTAL: $ (SIGNATURE) CZTY 4F EAGAN PERMIT City of Eagan Permit Type: Building Permit Number: EA105263 Date Issued: 0710512012 itj of 0n Permit Category: ePermit R Site Address: 4126 Lantern Lane Lot: 12 Block: 4 Addition: Coventry Pass 2nd PID: 10-18401-04-120 Use: Description: Sub Type: e-Fireplace Construction Type: Work Type: Gas Fireplace (new) Description: Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: Improvements to the home may require smoke detectors in all bedrooms. Chimney /flue must be inspected prior to concealing. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Valuation: Surcharge - Based on Valuation $3K $1.50 9001.2195 3,000.00 Total: $90.00 Contractor: - Applicant - Owner: Hearth and Home Technologies Daryle L Petersen 2700 N. Fairview Ave 4126 Lantern Lane Roseville MN 55113 Eagan MN 55123 (651) 638-3309 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. Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink r For Office Use I Permit 7 r I (Ion City of Ea I I Permit Fee. zz- 7 I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: I Fax: (651) 675-5694 I I Staff: Phone: (651) 675-5675 2012 RESIDENTIAL BUILDING PERMIT APPLICATION C ~t,,c. 1ti Date: Site Address: Unit Name: LasW c& Phone: Q 470 RESIDENT/ OWNER Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: id 1 pp 1$00 ' Multi-Family Building: (Yes / No ) Company: A4.vrif /cv►idR+~nw`~••aC yliC Contact: F."' (LT- f~it2.~C„~Cct CONTRACTOR Address: Yk -7 G n me~S J e City: -CA y~I~~1sG State: MPQ Zip: $7S$%47.A{ Phone: 112 to IL License Lead Certificate (02,6(®3 If the project is exempt from lead certification, lease explain why: (see Page 3 for additional informa I f-4,, wig. ur c~ s t ~ 4 ke LC-4t- c S 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 Building Code must be completed within 180 days of permit issuance. X J4XA R.T' 00 EQr~.t-lam #Wr x Applicant's Printed Name Applicant% Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE 1 1d7U; SUBTYPES I-llz4o L.;-~ _ Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) _ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) _ 01 of Plex Lower Level Pool _ Miscellaneous Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* _ Addition _ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair xe Windows _ Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation QZI Occupancy MCES System Plan Review , Code Edition 477 SAC Units (25% . 100% ~ Zoning - City Water Census Code lyN Stories Booster Pump # of Units Square Feet PRV # of Buildings l Length - Fire Sprinklers Type of Construction- Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC _ Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In Air Test -Final Windows Insulation Retaining Wall: _ Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee 3 Surcharge Plan Review IV 7 MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA160085 Date Issued:02/12/2020 Permit Category:ePermit Site Address: 4126 Lantern Lane Lot:12 Block: 4 Addition: Coventry Pass 2nd PID:10-18401-04-120 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 - Daryle L Petersen 4126 Lantern Lane Eagan MN 55123 (612) 670-1029 Apex Energy Solutions 9655 Newton Ave S Bloomington MN 55431 (651) 688-2739 Applicant/Permitee: Signature Issued By: Signature