4155 Lantern LaneINSPECTION RECORD
? CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
c,
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT: I
, r-.M 1 f,.w i r.Nf?
PERMIT SUBTYPE: TYPE OF WORK:
Permit Holder Date Telephone #
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TES7
HVDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN
3830 Pilot Knob Rd.
P.O. BoX 21199
Eagan, MN 55121
?.
SITE ADDRESS ?-`---
LOT -6LOCK ' SEC/SUB U:.L-r? t-Y c?' -
APPLIC.ANT:
CITY, STATE •? ??` ?' ZIP `- `f l 5
PHOW: PLUMBER: --
ADDRESS:
CITY, STATE "s = •. - ZIP "-=w°
PHONE: ;_ +
OWNER: ' .1 ;, ?? ?14P_4--i,.-,f K I ?-? I r-
PERMIT REQUESTED
-SEWER '=d7ATER _ TAPS
/
_ COMM/IND
?NEW
RESIDENTIAL
EXISTING
I AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES:
I,"ti i . M!"l • -,.
ADDRESS: SURE EN METER ISSU?
CITY, STATE ZIp
PHONE:
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEW ERMIT C TACT
ENGINEERING DEPT. ; ? -
OFFICE USE ONLY
PERMITDATE .`i!Y,I; ?3.
WATER PERMIT # t??2 SEWER PERMIT #
B.P. RECEIPT #L 7425
Fit/iDEH # B.P. RECEIPT DATE 6 I 2'69
METER SIZE J
ISSUE DATE ?-? /_q' d 'x PRV _ BOOSTER PUMP
SEWER & WATER PERMIT
GTY OF EAGAN
3830 Pilot Knob Rd.
P.O. Box 21199
Eagan, MN 55121
OFFICE USE ONLY
PERMITDATE WATER PERMIT # I_ _?- SEWER PERMIT #
METER # B.P. flECEIPT # :°42`-
READER # B.P. RECEIPT DATE
METER SIZE
ISSUE DATE i? PRV - BOOSTER PUMP
SITEADDRESS -7lSS L?1/1e1'?1
LOT '71LJBLOCK -SEGSUB
APPLICANT: c
ADDRESS:
CITY, STATE ZIP - "
PHON€:
?
PLUMBER:
ADDRESS:
.
CITY, STATE ZIP • -? ?
PHONE:
OWNER: '
ADDRESS:_
CITY, STATE
PHONE: -
ZIP
PERMIT REQUESTED
_SEWER '-117ATER -TAPS
_ COMM/IND
_ NEW
RESIDENTIAL
EXISTING
I AGREE TO COMPLY WRH CITY OF
EAGAN ORDINANCES:
?
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMITS, CONTACT
ENGINEERING DEPT.
yy ?
- S ,T . . .. .Y.
. PLUMBING PERMIT
CITY OF EAGAN
CONTRICCT 3830 PILOT KNOB ROAD, EAGAN. MN 55122
PRICE PHONE 4548100
Site
Lot.
? Name
? Addre
c Clt)C ?
? 4...?
? Addressik!f
49 ;.,/q.Aj ;tXk
? City E9 4AN
FEES
COMM./IND. FEE - 7% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDO - RES. R,4TE APLLIES
MINIMUM - RESIDENTIAL FEE $12.00
MINIMUM - COMM.IND./FEE $20.00
STATE SURCHARGE PER PERMIT .50
(ADD $.50 S!C PER EACH $1,000 OF PERMIT FEE)
Res. ._.?_
Mult.
Comm.
Other
For Office Use Onty
PERMIT # '7
RECEIPT #
WORK DESCRIPTION
New
Add-on
Repair
RES. PLBG. ONLY • COMPLETE T
NO. FIXTURES
_ Water Closet - $3.00
Bath Tubs - $3.00
_ Lavatory - $3.00
_ Shower - $3.00
Kitchen Sink - $3.00
_ Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
_ Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIn
Softener - $5.00
_ Well - $10.00
Private Disp. -$10.00
_ Rough Openings - $1.50
PERMIT FEE:
$
? I STATES S/C:
CITY OF EAGAN GRAND TOTAL: • S ?
. . . . ,
. : ..R
... (. . -
i
/N
PERMIT #
7V
MECHANI CAL PERMIT RECEIPT N _
?
CITY OF EAGAN `?.;%
I
,
I 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: -
i
F
Offi
U
O
I CONTRACT PRICE: PHONE : 454-8100 n
y:
or
ce
se
? Site Address gILpG, TypE WORK DESCRIPTION ?
I Lot Block - Sec/Sub
? '
New ?
Res
.
Name Mult Add-on
?v
Address
" ? Comm. Repair
o?
c
City
Phone her
Ot
?
Name FEES
HVAC 0-100 M BTU - E24
00
RES
.
.
c Address ADDITIONAL 50 M BTU - 6.00
O City ? Phone (RES. HVAC INCLUDES A/C ON NEW
TR
CTION
CONS
)
U
50 EA
GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1
.
TYPE OF WORK COMM/IND FEE - 19io OF CONTRACT FEE
- COMM
RATE APPLIES
APT
BLDGS
Forced Air M BTU .
.
.
TOWNHOUSE & CONDOS - RES. RATE APPUES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent. CFM ? (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # BEYOND $1,000)
Other $
FEE:
SIGNATURE OF PERMITTEE
S/C:
TOTAL: FOR: CITY OF EAGAN
CONTRACT
PRICE
Site A?s
Lot
? Name _
? Address
"c City _
` Name-
? Address
? CRy -
PLUMBING PERMIT FRECE.IPT CITY OF EAGAN 3830 PILOT KNOB ROAD,
EAGAN, MN 55122 PHONE 4548100 Phona
Phone
FEES
COMM.AND. FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APLLIES
MINIMUM - RESIDENTIAL FEE $12.00
MINIMUM - COMM.IND./FEE $20.00
STATE SURCHARGE PER PERMIT .50
(ADD $.50 S/C PER EACH $1,000 OF PERMIT FEE)
Res. ? New `
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOILOWING:
NO. FIXTURES T L?O
?•S Water Closet - $3.00 $
? Bath Tubs - $3.00 '
Lavatory - $3.00 f
_ Shower - $3.00
_ Kitchen Sink - $3.00
? UrinaUBidet - $3.00 ---???
?- Laundry Tray - $3.00
?- Floor Drains - $1.50 • ?
?- Water Heater - $1.50
Whirlpool - $3.00
?- Gas Piping Outlets - $1.50
(MINIMUM -1 PER PERMIn
Softener - $5.00
Well - $10.00
Private Disp. -$10.00
_ Rough Openings - $1.50
PERNqT FEE:
STATES S/C:
GRAND TOTAL:
.?
v?, 6 c
fA e t r
Tprtifiratp uf COrruvttnry
titp of eagan
DPpartmPltY IIf B1ttidtItQ ltISpP2'ttDIt
This Certifcate issued pursuant to the requirementr of Section 306 of the Unijorm Building
Code cerdfying that at the time oJissuance this structure was in compliance with the various
ordtnances of !he City regulating bui(dfng construction or use. For the followeng:
Ux CLsdfication -?-?- DWICAR BWg. Rrmit No. 16612
oaup.ocy Type ?Z3/M I zooNg oiuria R 1 Tya const. VN
Owner of BuiWiDESIGN &Addras 3786 WDUME M. F.AGAN
ew'U naa? 6155-14NiEM IANE Lowit,L24, B3, OOU1KtY HOLiAW
I i
Dea: SFPI?TiRF?'R 97_ 19R9
BidWing?OffbtZif?-
POST IN A CONSPICUOUS PLACE
BUtLDING PERMIT
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
ed for ?°+F DNGIG:Ai: Est. Value
Receipt #
$1132,000 Date JtLhi' i2 , 19r?
Site Address 415 ; LAWCL'FM LN
Lot ' 4' elock 3 Sec/Sub. CUiiMY F!t?1.LOil
Parcel No.
W Name ??'i:?ili9Fi2Y liBSIG'1 & 1WII.D
a Address 37st', ,'TKLTf?ES DR
City #:k,`:^A:' Phone 681-9230
, o Name
z?
oU g Address
Q
? City Phone
U¢
WW Name
H
X ; Address
a W City Phone
I hereby acknowlege that I have read this application and state that the
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permitee
'. A Building Permtt is issued to: 'W'i`rr(;Sk,L"KY
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Siatutes and City of Eagan Ordinances.
OFFICE USE ONLY
Occupancy FEES
Zoning
v-?
752.00
(Actuaq Const Bldg. Permit
(Atlowable)
Surcharge ?b•?
# of stories
640
Plan Review
376.00
Length
Depth SAGCity 100•00
S.F.To[al - SAC,MCWCC 373•00
S.F. Footprints - R. ? . • ?
On Site Sewage _ Water Conn
On Site Well Water Meter yU •00
MWCCSystem ? ?
Ciry Water ?`?' Acct.Deposit •
PRV Required 3'^ S%W Permif 20.00
BoosterPump - S?WSurcharge 1•00
228•00
TreatmantPl
APPROVALS RoadUnit 341?.OC1
Planner
il
C - park Ded.
ounc
&dg. OH Copies
'f ? Cr t.n
Building Oflicial I Variance - TOTAL " `
Permit No. PermR Holder Dete Telephone #
WATER
SEWER
PLUMBING
H.V.A.C.
?I?•?J'? ?
?- ??!?/Y,L, y
7??3 O CJ'
ELECTRIC /D
Inapection Date Insp. Comments
Footings I
Foundation
Framing • /c?/_ _?'
Roofing
Rough Plbg.
Rough Htg.
IsuL 7 ?l
Fireplace D ?
Final Htg.
Final PI6g. ?
Const. Meter Plbg. Inspector - Notify Plumber
Engr.IPlan
81d9. Final 7 8$ ?
Deck Ftg.
Deck Final
Well
Pr. Disp.
? CITY OF E?
\ 3830 Pilot Knob Road, P.O. Box
" PHONE: 454•
BUIlDIN6 PERMIT
To be used for BASEWNT pINISH Est. value $1' S00
Site A ress 4155 I.AN?SRN tli
Lot ?? Block SeGSub. COUMgY ROLLOW
Parcel No.
w Name DAVIU [ICIN
0 Address RN LN
City EAGAN Phone
Name "
Address RIDCEWOOD DR
City UGAN Phone -1773
Name -
Address
I hereby acknowlege that 1 have read this
information is correct and3pG?
ree to compilyw
Minnesota StaWles and Ci(y,ot Eapan prdiFlanLc
? '`r+-Q.
Signature of Permitee
?B Di
A Building Permit is issued to:
on the express condition that all work shall be c
applicable State of Minnesota Statutes and City
Building Official '
Phone -
i and state that the
applicable State of
accordance with all
"
i9, tagan, MN 55121 18762
f?`? {J
' Receipt
„_,_ MAR S .,, 9l i
OFFICE USE ONLY
Occupancy - FEES
Zoning - 35.00
(Actuap Consl - Bldg. Permit
(Allowable) - Surcharge 10W
# or stories _
Length _ Plan Review
Oeplh - SAC. City
S.F. Total - SAG MCWCC
S.F. Footprints -
On Site Sewage _ Water Conn
On Site Well - Water Meter
MWCC System -
Acct. Deposit
Ciry Water _
PRV Required - S/W Permit
Boosrer Pump - SNJ Surcharge
Treatment PI
APPROVALS Road Unit
Planner , - park Ded.
Council
BIdg.Off. -
_ Copies .50
?
Variance
- TOTAI •
I I vermn No. I Permit Holder I Date I Tebphone fi I
sewea
PLUMBINCa
H.V.A.C.
ELECTRIC
I Mapactfon Date I Insp. I Comments I
Final
CITY OF EAGAN rT? 16612
° 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 ?
BUILDWG PERMIT Receipt # 0-
7o be used for SF DWG/GAR Est. Vawe $132, 000 Date JUNE 12 , 1989
Site Address 4155 LANTERN LN
Lot 24 Block 3 SeGSub. COUNTRY HOLLOW
Parcel No.
W Name MONTGOMERY DESIGN & BUILD
; Address 3786 WINDTREE DR
° city EAGAN Phone 681-9230
o Name SAME
Z
$a Address
¢ City Phone
?
Q
ww
Name
FW
?z
Address
,
a
w City Phone
I hereby acknowlege that I have read this application and state that the
inlormation is correct and agree to comply with all applicable State of
Minnesota Statutes and ity ot Eagan Ordinances.
Signature ot Permitee
A Building Permit is issued to: R DE N
on the express condition that all work shall be done in accordance with all
applicable Siate of Minnesota Statutes and City of Eagan Ordinances.
Building OHicial
OFFICE USE ONLY
Occupancy R-3 M-1 FEES
Zoning R=1
(Actual) Const V-N Bldg. Permit 752. ?0
(Allowable) V=N Surcharge 66.00
# of Stories -
v
L
Plan Review
376, ?D
Length i.
Depth SAC,City 100.00
S.F. raai - 5ac, McwCC 575.00
S.F. FootpriMS -
On Site Sewage ? Water Conn 580.00
On Site Well - Water Meler 90. 00
MWCC System xx
}(x Acct.Deposit 30_n0
cuY water
PRV Required XX SIW Permit 20. 00
Booster Pump - SiW Surcharge 1.00
Treatment PI 228.00
APPROVALS RoadUnit 340-n0
Planner Park Ded.
Council _
BIdg.Off. _ Copies
Variance , TOTAL 3,158.00
CITY OF EAGAN NO ? 8762
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 ,y' 2
BUILDING PERMIT Receipt #
To be u"sed tor BASEMENT FINISH Est. value $1, 500 Date MAR 5 19 91
Site Address 4155 LANTERN LN ?
Lot 24 81ock 3 Sec/Sub.
Parcel No.
W Name DAVID KIGIN ?
; Address 4155 LANTER ?
0 City EAGAN Phone
,o Name BOB DEVANY
Address 3772 RIDGEWOOD DR ?
V4 I
? City EAGAN Phone 691-1p-3--
wu W Name
?=. Address ?
?
a W City Phone ?
I hereby acknowlege that I have read this application and state that the
information is correct and agree to comp1?'Ai t! all applicabl, e State of
Minnesota Statutes and C'y Ea an Ordl ances
Signature ol Permitee
A Building Permit is issued to: BOB DEV
on Ihe express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and Ciry of Eagan Ordinances.
Building Official - 18ma A?J1J.14Ly'
OFFICE USE ONLY
Occupancy _ FEES
Zoning _
(AcWat) Const - 81dg. Permit 35.00
(Allowable) - Surcharge 1.00
# ot Stories -
Lengih _ Plan Review
Depth - SAC, City
S.F. Total _
SAC,MCWCC
S.F. Footprints _
On Site Sewage _ Water Conn
On Site Well - Water Meter
MWCC System _
Acct. Deposit
City Waler _
PRV Required _ S/W Permit
Boosler Pump - SIW Surcharge
Treatment PI
APPROVALS Road Unit
Planner - park Ded.
Council -- 50
BIdg.O1L _ Copies .
Variance - TOTAL 36.50
7 REQUEST FOR ELECTRICAL INSPdCTtON ??'" ee-oaoo,-oa
? See instmctions tor completing ihis form on back of yml low cnpy.
¢
3/ /91
"X"Below Work Covered by This Aequest
G? 31619 ? ??
ew A6d Rei Typeof8uilding AppliancesWired EquipmentWired
Home Range I Temporary Service
Duplex Water Heater Eleciric Hea[ing
Apt Building Dryer Other (Specify)
Comm./lndustrial ' Fumace
Farm Air Conditioner
Olher (specify) Caniractor5 Reni
Compute Mspection Fee Below: r/i) /sV LCLti
,C L,P? ('c-7L
# Other Fee # Service EntranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 ta 700 Amps
Transformers Above 200 _ Amps A 0 Amps
SIg11S Inspedor's Use Only: \ TOTAL
IrrigationBooms L
Special Inspection
Alarm/Communication THIS INSTALLATION MA`I I 8E O ISCONNECTED IF NOT
Other Fee ,5 COMPLETED WITHIN 18 THS. (
I, the Electrical Inspector, hereby Rougnan
a+e ?
certify that the above inspection has
been made. F;nai oace
OFFICE USE ONLV
This request void 18 months from
`J/ /
a // l. / ? f C;4 /S[pC
oO
619
3 ,?P
Fequest Date
3 6- Fire No ugh ? Inspection
e uire ?
9
'?Ready Now LTWiII Notity Inspecror
Wh
R
d
?
s G No en
y
ea
I gjicensed contractor ? owner hereby request inspection of aboye electrical work ah
I
Job Address (Street, Boz or Route No)
L
L Ciry
7
r
y, 5-s
?4 vi,-z e? F=
A?, Al-,
Section No. Township Name or No. Vlange No. Coun
"D
4??1 ?
Occupant(PRINT) ,J Phone No.
I? ?<?' , v-\
Power SupplierPAtlr¢ss
C?
??J?4 ?T?
L?c, I f-.e Vyl-t 'llIvTC?
Elecirical Contra?°'? ompany Name) Contrflctor§ License No.
'T"'14 a45,9-7
Mailing Adtlress (COntraClor pr OW r Making InStallati0n)
lqlo ov? e?;TO ? ? 55?zz
Authorized Signat fConiradorlpwner ki g Installation) Phone Number
? 1a83-0; 3 Z
MINNESOTA STATE BDApD OF ELECTRICITY THIS iNSPECTION REQUEST WIIL NOT
Gdggs-MWway BIOg. - Room &173 BE ACCEPTED eY THE STATE BOARD
1821 Univmalty Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Plrone (612) 842-0800 ENCLOSED.
?i MEQUEST FOR ELECTRICAL INSPECTION . eeooooi-m
? See instruciions for completing this form on back?of yelbw copy.
X" Below Work Covered I by This Request
ew d Rep. Type of Building AppliancesWired EquipmentWired
Home Range ? Temporary Service
Duplex Water Heater ? Electric Heating
Apt. Building Dryer ? Other (Specify)
Comm./Industrial Furnace ?
Fartn Air Conditioner ?
Other (specity) Contractor's Remarks: I
Compute lnspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps ? 0 to 100 Amps
Transformers Above 200 _ Amps ? Above 100 _ Amps
SIgf15 Inspector's Use Onty: TOTA
Irrigation Booms ?
..-?-
Special Inspection 6 ?
Alarm/Communication
Other Fee y (j
I, the Electrical Inspector, hereby
certify that the above inspection has
been made. Rough-in
Final te
i ?
a
OFFICE USE ONLY
This request witl 18 monihs Imm I
i? 2 b b b 4Zc?z - 6-?./ °ti
Request Date
6 Fire . Rough-' 1 spe ion
RBQ
Ready Now ?V?
?e?or
?R
D Yes ? No en
eadY
Klicensed contractor ? owner hereby request inspection of above electrical work at:
Job Address (Street, Bmc or Ro No.) city
15'S , rra 21" ?
Section No. Township Name or No. Range No. Counry ^/-
?/? ?
Occupam (P INT Phone No.
Power Supplie . ?J
?
AddreiK
eP?L'GG-C? /
ElectriCa
tfactor (COmpany Name Contractor§ License No.
?
Maillrg Add ss (COntrecWr or Owner M'al mg Installation/) Q n
? ?J C
Author¢ed ' aNre (Conir ctorl er Making Installatio frone Number
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bidg. - Room S173 BE ACCEPTEO BY THE STATE BOARD
1821 Universfty Ave., St. Peul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
PERMIT
CITY OF EAGAN BUZL??N?
3830 Pilot Knob Road PERMIT TYPE:
Eagan, MinneSOta 55122-1897 Permit Number: 032433
(612) 681-4675 Date Issued: 07/0 7/9 8
SITE ADDRESS:
4155 LANTERN LANE
LOT: 24 BLOCK: 3
COUNTRY HOLLOW
P.Y.N.: 10-18275-240-03
DESCRIPTION:
ltlTh=g Permit Type
lciing'R'ldork Type
sus Gdd
STORM DAMAGE
REPAIR
434 ALT. RESIDEIVTTAL
? a
? 'U, ? s
s.+
? PM.
A"i I
REMARKS:
FEE SUMMARY:
CONTRACTOR: - Applicant - sT. ?.zc OWNER:
METRO BLDG CO 15360277 9005944 KIGIN DAVE
473$ 42ND AVE N 4155 LANTERN LANE
PIINNEAPOLIS MN 55422 EAGAN MN 55123
(612) 536-0277 (612)683-0749
= Iher`eby a`ckrrcrwJ.edge =that I: have read tFiis apPJ:'icat`ibrrPand` state thaty; th"e' .
inforrration 3scorract and o9ree t6--camply Wa,th a1? ,appal3.?able? Sta'te af Pin
r. .
atute"s '?Ytrl • ?i?tY. of' ,Eag??n €trci3'na'nce's
APPLICANT/PERMITEE SIGNATURE I SUED BY: IGNATl1RE
BUILDING PERMIT APPLICATION (RESIDENTIAL)
32qli CITY OF EAGAN
3830 PII.OT KNOB RD - 55122 L?
681-4675 CJ??
New ConstNC[ion Requfrcmenta RemweVRepair Requinments
? 3 rogistered site surveys
? 2 copies of pians (inGude beam & window s¢es; poured fid, design; etc.)
? 1 energy calwlations
? 3 copies of tree preservation plan if lot platted aRer 7/1/93
required: _ Yes _ No
DATE:
d?
DESCRIPTION OF WORK:
STREET ADDRESS: 4
LOT: BLOCK:
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
7r
? SUBD./P.I.D. #:
? 2 copies of ptan
? 2 site auneys (exterior addftions 8 dedcs)
? 1 energy calwlations for heated additions
D{ ?? 64"'
CONSTRUCTION COST; Z
O 1-) /) d?
Name:?? Cp { /C/ Phone #: ee6d
Last Fiist
Street Address:
Ciry State: Zip:
City
,y/s Y,
anyY/???? ? Phone L? 2- 7 ?
Addressr'? ?4e /t/ `3 License #
State: ? rv Zip:
Company:
Name:
Phone #:
Registration #:
Street Address:
City State:
Sewer 8 water licensed plumber (new construction only):
and lot change is requested once permit is issued.
I hereby acknowledge that I heve read this apptication and state that the i ion is correct
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applican
OFFICE USE ONLY (
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
Zip:
Penalty applies when address chang
to comply with all applicabl
SINGLE FAMILY DWELLINGS
1969 BUILDIAG PERMTT APPLICATION
CTTY OF EAGAN
LLIN
ILWE I
COMMERCIAL
2 3ETS OF Y[.ANS 2 SEfS OF PI.1NS 2 SETS OF ARCHI?ECTURAL
3 REGISTERED SI'P6 SURV8Y3 REGISTBRED SITE 3QRVEYS - 6 STBaCT[IRiL PLANS
1 SET OF ENERGY CgI.CS. (GHECB WITH BLDG DIQ. ) 1 SET OF $PECIPICATIONS
1 3Sr OF ENERGY CALCS. 1 SET OF ENERGY CN.CS.
IiULTIYLE DWELLINGS AEHT9L MZgS 70 SALE UdTTS # OF uAITS
1i0TBa ADDRESSE3 FOA CORNER LOTS - CONTAACTDR/HMOWAEH !lQST DESIGNlITE iiHICH 1DDRESB
IS DFSIRED. 80 CHAHGFS WILL HE j.I.I.E3Ti£B WiCE 9UILDIHG PERMIT I3 2330ED..
SEWER & iiATSA PEIMI? FEES i1oD ACCOONT DEP03IT FEES i1ILL BB IIICLDDED iiITS THE HOILDIN(3
PERMIT FEE. PROGFSSING TIME FOA 3EWER AND W9TER PERMIT3 I3 TWO DAYS ONCE A PERMIT HAS
BEEN COMPLETED IRDICgTIAG A I.ICEN3ED PLtIMER.
PENALTY APPLIES WfEAit PER@fYT YS HOT PAID FOR YAl SAA4E MONTH IT Y5 REQUESTED.
= LOT C9ANGE IS REQDESTED ONCE PERMIT IS %5517ED.
To Be Uaed For: 5? Yaluation: 1:3 zo 000' Date:
Site Address ?{I ? 5 La,tey,n La,v? OFFICE OSS
Lot CN Block ? Occupancy P1-3 M-!
' I r I Zoning R- I
Parcel/Sub rtp,(,h, Actual Const V-N
T Allowable V-N
Owner # of stories
Length
Address
City/Zip Code
Phone
Contraetor Ohcmk-r?e`-I
Address $" (P (,t) ; rd +?e-w-
City/Zip Code 1M N
Phone 'I to 2- -'b 6
Arch./Engr.
Address
City/Zip Code
Phone #
Depth
S.F. Total
Footprint S.F.
On site sewage
Qn aite well
MMC Sy9tem ?
City vater ?
PRV required _
Booster Pump _
APPROOAL3
Planner
Couneil
Bldg. Dff. nZwq
Varianee
JuN o s 1989
Bldg. Permit '!S L . Uv
Surcharge I00
Plan Review ,Qa
SAC O City 1 OO, DC)
SACO MWCC ?15 5,00
Water Conn 001OJ
iiater Meter lb,oo
Acet. Deposit z).00
S/W Permit 01 00
S/ii 3uraharge 1,00
Treatment Pl. Z29,00
Road Unit qo,p,
Park Ded.
Copies
SIIBTCYTAL
Penaity
TOTAL 17? S F
v??W
A . ...
f_"XTERIOf"i LhJVLLOF'L AVEFiAGE "U" f'O1IF'U7ATTCjhI
i"IC71\i"fGOhll:.l`;Y i?E_SZGN v< E:sIJTL..C7 CC?
11350 (-;l_Bl-1'w'P,F? F'ATF-1
T N'JE:f; UI=iL7VE t-IF I f.aHTS5 h1N 55(:,-,7r-,"
h'1Q1f)EL F::iGIR! CCJF'F'i.-R I`1TI`,) f-11=iE=.A l.J UX FiRLA
FiEG!I 1 T kFD
1 o Tnt"AL WAL!_. ARE°fa 2549 0 1. i. ^?iV
};OQI'=' A R E:F? 11 =4 o 0:'£; "2, 9
AC:F-IIrVED
f`i WI hII?OW AFtEF3 )c' ° - - 69
B DOCiR AREA 40 5
C St._ID7:FdG G_..f413S AF'EFi ?:'Z 24
D f-' 7 f;GF''LF-1CE AhEA a4
o2
11
E. WF`il_L_ FFiFlh'!E AFiEFl ,..54. 9 .(,)95 24
F NLT Ia1HL_L F-1(;'EA 1919.1 o i a.Tp 73
Cry 1=;IM ,ICIIST AF;EF, 336 „0436 15
I-i F70LJI`aD W]: ItIDC?W fiREA i r
I FCUND ABOVE GF,ADE 94 .069 6
_ a TCt'7'AL W?1LL r?REA ?'.^E?
J ::al;Yl_ITE ib .5 S
i:: r;nOF F f<AMF=: 11."%e 4 ° i) :2 4
L 1'.11=T riD01= ]AfiEii 1020e6a a0227 `,_'=;
4„ T(_iTf1I_. R00f-` rJ;EFi =i'':,
SUM f.:IF ia+2? 310
5UM DF "_';. 1-4.
SU_RV.EY
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0 DENOTES IRON MONUMENT FOUND
X000.0 DEMOTES EXISTINQ ELEVATIQN
(OOp.Q) DENOTES PROPOSED ELE1/ATION
EAtxAN E1VGIaVEEF.I
Rova R 1E Q u Qr?E 10
SCALE: 1 INCH =- 3o FEET
PFiOPOSED QARACiE .PLOOR - B z+, s FEBT
PRONOSED LOWEST FLOOR - gig.,; FEET
PROPOSED TOP OF BLOCK•- az?,7 PEET
WE HEREBYCERTIFYTO Mo?s-[GOME'RY t?CStGN 7NAT THIS IS A 1'RUE AND CORRECT
REPRESEN7ATION OF A SURVEY OF THE BOUNDARIES OF:
Lof:zy . Sbak '3: , OOU?VT'RY • HOLL,OW, • _? ; , ; ;' aecording to the rocardad
piat ti?.sreof. , DokotoCounty;z?Mtnneiota:?:. . . •
• (T DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHpWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVI510N THIS 2.?4p DAY OF JuNE ,1884•
` J? L, INC.
`...; NRO ,P08E0, OWADEB SFIOWId WlP2H TAKEN SfC?NED:
« `MROht'" ORAqINOgDRAINAOlE & 6lqSlON ?
; CmMwt.`^AK r?oa couKrmr rooLLaw,
BY: PRov1081) rr ?+RMaaa ENa.,, wc.
HAROLD C. LAND SURVEYt?R
LA?T °iDATZD t-iT-o7 PE7ERSQN;
MWNESOTA LICENSE NUMBER 12284
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James R. HiLil, inc.
PLANNERS / ENGINEERS ! SURVEYORS
$401 JAMES AVE."S. • BLQOMINOTON, MN. 56431 • 812-884-3D29
. ' •?.
R'S CERTIFiC/o1TE
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CZTY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
18 OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE $
ER$5????;:;; PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
.;: :: . . . _ . ,: . ,. .. ::, . .? ?,...:: ,,,,.
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
------------------------ --------------------------------------------------------
WORK DESCRIPTION ? COMPLETE THE FOLLOWING•
NEW CONST
ADD ON ?
REPAIR
OWNER NAME:
SITE ADDRESS:
r
LOT:4? BLOCK ? SUBD. Mj=
INSTALLER: ??E-?c- ?/? iv- F? %iv e
ADDRESS:
CITY: 1 i/-? ?'? ZIP:
-?
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00 Y_
_ SHOWER 3.00
_ WATER CLOSET 3.00 ?
= BATH TUB 3.00 ?
LAVATORY 3.00
KITCHEN SINK 3.00
LAUNDRY TRAY 3.00
_ HOT TUB/SPA 3.00
WATER HEATER 3.00
_ FLOOR DRAIN 3.04
GAS PIPING OUT.
_(MINIMUM - 1) 3,00
ROUGH OPENINGS 1.50
_ OTHER
WATER SOFTENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
f S Ufi
SUBTOTAL $
ST. SURCHARGE .50
TOTAL: $ l L SZJ
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: FEES
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FOR:
TOTAL:
FOR CITY USE ONLY
PERMIT #
RECEIPT # C11915
DATE: 3 9
$
( S IGNAT[7RE )
CITY OF EAGAN
SIGNATURE OF PERMITTEE
1991 BUILDING PERMIT APPLICATION
? ib
?IOF?
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT I5 ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: 1?SValuation: -
Site Address IISS I-4x1kR^/ I-A
Lot 9-1 Block ° _
Parcel/Sub I A 01,YIx114 d&t
f Owner ?/4oep Kc?g( `?
Address
City/Zip Code Z45q-?
Phone
x Contractor 90b
` ? 3?7a rD,e??D Q
Address
City/Zip Code c '94'4-xJ
Phone / 77 3
Arch./Engr.
Address
City/Zip Code
Phone #
(Signature of Contractor)
Date: ? 141! 1
OFFICE USE ONLY
FEES
3 ? 0 '
Occupancy . Bldg. Permit
Zoning Surcharge 00
Actual Const Plan Review
Allowable SAC, City
# of stories SAC, MWCC
Length Water Conn.
Depth Water Meter
S.F. Total Acct. Deposit
Footprint S.F. S/w Permit
S/W Surcharge
On site sewage_ Treatment P1.
On site well Road Unit
MWCC System Park Ded.
City water Trail Ded.
PRV _ Copies if-122
Sooster Pwnp _
SUBTOTAL
APPROVALS Penalty
Planner Lot Change
Council TOTAL 36 •.R?
Bldg. Off.
Variance
agrees that all work shall be done in accordance with
all applicable State of MinnesotafStatutes and City of Eagan Ordinances.
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'? - DENOTES PAOPOSED SURFACE DRAINAC3E
0 DENOTES IRON MONUMENT SET
• DENOTES IRON MONUMENT FOUND
X000.0 DENOTES EXISTINCi ELEVATION
(000.0) DENOTES PROPOSED ELEVATION
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P.R.V. REQUI'RED
SCAlE:1iNCN " 3o FEET
PiiOPOSED QARAQE FLOOR - g zi, 5 FEET
PROPOSED LOWEST FLOOR - 8i8.s FEET
PROpOSEO TOP OF BLOCK -- 15ZI, 7 FEET
WE HEREBY CERTIFY TO r?owZGOMe'RY t)-r&StGN THAT TN1S IS A 7RUE AND CORRECT
REPRESEN7AT10N OF A SURVEY OF THE BOUNDARIES OF:
Lot ?zy , 91pek '3: . QOUN'T'RY HOI.I.OW, t•; awording to the recordsd
plat'thonot? . Dokota County?'a Mtnniiotc:.:.. .
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS QR ENCROACNMENTS, EXCEPT AS SHOWN. AS
. SURVE'iLcb 8Y ME OR UNDER MY DIREGT SUPERVISION THIS 2NU DAY OF JU,NE' ,1M,
' Si(3NED: JA L, INC.
i?ROPGBEO.ORADBS $HOWN W[R6 7AK@N
` FlIOM IW ORADINOtDRMNAOR w ElqlIION l..
`CQNKl10l.''*MN MOR CWNTRY FIOLLOW, BY:
' PROVIQRD bY PRooqEsa eNO.,, wc,
LAfT DATLO 9-I7-AT HAROLD C. PETERSQN; LAND SURVEYOR
'MINNESOTA UCENSE NUMBER 12204
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James R. Hill, inc.
PLANNERS I ENGINEERS / SURVEYORS
8401 JAMES AVE°S. • B600MINOTON, MN. 56431 • 812-884-3028
DAILY INSPECTION
COYY.
NO.
iROJECT
NO.
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617
REPORT oATe J5- !b-'7U `4'
CaL'?. v\. +'t v "oflok/
wp4^fCy? T 4fQdJ So+ti
OWNER fi- out" e55 Cow\Qv11l,'
SAN iWR
p,- r? - ??
INSPECTON
NEPORT TO Tow? Colbe{d- ? Mi k? Foer?sek
Gra'? L?c.rSor? 8?
CONTRACTOR New L?FG 1.??A SCO? Dc nd1
P?,Aq ?R'y?"? A[Eii 1 ` WORK B -O? AM 2=O'DAbSNEETNO_?a:TORMSWR fOREMAN ?VIV\ Hvlb'?? SMIFT ? PM 6=00Ph?
--.V ?TREET Thkrs FRIOAy
IOCATION ON WEATHER
F
4 TEYPERATURE
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FRQM Tp ,
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CONDITIONS
PAY QUANTITIES: HOwse-
PAY CUT
D14METER,TYPE • CLASS OF PIPE LAID / Z7 ? ?pz3?
?
Ex'e.vo.?Q? Dra;v?.o.,Ge, Swo?l? alo++o,_
Ad.aed -?-? l'? i h backUar? o!r b 3.0? ? .
? c,a-va-l-e ra' ? Swa alo,n N?? 5?de o?so„?°;+re ?d1??4erti /?E
ct, 4-kQ11 - YCf I?0.Cc?- 5-Oa' • STA. TO 5TA•
TYVE i NUYBER OF STHUCTURE WORKED ON (IF COMPLETE, S O STATE 1: I L157 YISC. PAY ITEMS A OUANTI11E5 FOR TNIS DAY :
EXCESS
MaNMOIE MANMOLE GTMER
EXCE55
MANMOLE MANHOLE OTMER I
.
EOUIPMENT ? TYPE 8 NOUPS WORKED I
l1'5e? ?o Gk?-
Qw{ 4 TYCxck 4o
•?.-___ 5 ?XGeS$
BEDDING CLA55 DOY-? AWAV
! TYGE OF BACKFILL
GEWATERING
IiNE L GRADE BY:
METHOD
LASEN ? OTHER ?
gTp, TO STA.
UNDEHGNOl1ND UTIlIT1ES ENCOIINTERED: NOl'?P/
BATTER BOARDS ?
CLASS OF SOIL AT 1NVERT
TESTS CONDUCTED ANO TMEIR OUTCOME:
e.
OEYIATIONS OR CNARGE FROM PU1N5 AND SPECIFICATIONS :
se-F- c? ro.?es o?- swa 1? a- ?-ke ?ew 5wa (es c-?+ i?
surve 5-Fake?
UNUSUAL CONDITtONS:
REMANKS VROiERTY DAMAGE, ACCIDENTS, DELAYS, DEFECTIYE WORK, ETC. I n
/ A. r . t i - ' " '- - c w . •. w? r? . A X1l? -n C1?
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? PROPERTY DATA SYSTEM • •• 3••• W
• OWNER NAME AND ADDRESS INQUIRY :CURR 302 :
. PROPERTY ID :NEXT :
: 10-18275-230-03 A;;;;;;;;;2
• OWNER .
• LAST NAME FIRST M CORP TAXPAY ADDR .
: Owner: PRICE JOHN M N Y N .
: Addrl: 4159 LANTERN LN Addr2: EAGAN MN 55123 .
. Addr3: Addr4: .
: Owner: PRICE JUDITH A N Y N .
: Addrl: 4159 LANTERN LN Addr2: EAGAN MN 55123 .
. Addr3: Addr4: .
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.Type PID: press ENTER; or F1, F21 F51 F8
•• PROPERTY DATA SYSTEM • • •• 3• W
• OWNER NAME AND ADDRESS INQUIRY :CURR 302 :
. PROPERTY ID LO+ 2,,4 B I K 3 : NEXT :
: 10-18275-240-03 Co??+r Hrv ? A;;;p;;;i;2
• Y OWNER .
. LAST NAME FIRST M CORP TAXPAY ADDR .
: Owner: KIGIN DAVID W N Y N .
: Addrl: 4155 LANTERN LN Addr2: EAGAN MN 55123 .
. Addr3: Addr4: .
: Owner: KIGIN JENNIFER O N Y N .
: Addrl: 4155 LANTERN LN Addr2: EAGAN MN 55123 .
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. owner: Oak Co
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA107960
Date Issued:11/07/2012
Permit Category:ePermit
Site Address: 4155 Lantern Lane
Lot:24 Block: 3 Addition: Country Hollow
PID:10-18275-03-240
Use:
Description:
Sub Type:e - Water Heater
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Kris Oien
3670 Dodd Rd
Eagan, mn 55123
651-365-1340
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
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 -
Scott F Rutz
4155 Lantern Lane
Eagan MN 55123--161
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature