1364 Lakeside Dr. ? CITY OF EAGAN
, 8795 Pilot Knob Rood Eogen, MN 55122 N2 5525
PHONE: 454-8100
. .
BUILDING PERMIT Receipt #
To be uted for Est. Value Dote ? 19
Sita Address Erect 0 Occupancy
Lot Block Sec/Sub. Alter ? Zoning
Parcel # Repoir p Firo Zone
Enlarge ? Type of Const.
e
o Name Move ? # Stnries
W
? Address Demollsh ? Front ft.
Grode ? Depth ft.
Cit Phone
?
O Nome Apprevals Fees
Zu
s Address
I
r..,.
Nome
Address
Water & Sew.
Police
Fire
Eng.
Plonner
Council
Permit
Surcharge
Plan theck
SAC
Water Conn.
Water Meter
I hereby acknowledge that I hcve read this cpplication cnd state that Bldg. Off.
the infortnution is correct and agree to comply with all applicoble aPC Total
State of Minnesota Stntutes and City of Eaqan ardinances.
Signoture of Permittee
A Building Permit is issued to: on the express tondition thot
oll work sholl be done in accardance with all applicable State of Minnesoto Stututes cnd City of Eagan Ordirwnces.
Building Officiol
??nnM # pah lnwd ?u?rMtN
Plumbing r
Mechonical
? ?oti o a ? o
T 4( lo-z -? 5,1 Fe?
INSPECTIONS DATE INSP• Rouph-In Final
Footings Dote Inap. Date Irop.
Foundation Plumbi ?
Frome/ins. Mechoni
Final
. `
Remorks: /x,
CITY OF EAGAN
3795 Pilot Knob Road
+ Eagcn, Minnesota 65122
Phene: 454-8100
Dnte: ? . ?
Site Address:
Lot
1364 Lakeei(le Drfve
Block Sub/Sec. ??? ' A?T ].st
,
Na
Receipt No.:
$ingle I
Residential
Multi Res., Comm./Ind. I
??' `::` .
Name ' New/Alter
/Re
air P
.
p
3 Address - ' !?C`C
Cost of Instoilotion
O
jt ? ', ?,.. l ?;•
City ' Phone: ' .
Permit Fee '
Name Surchorge
g.
Address
?
City _ Phone: Totol
L
This Permit is issued on the express condition thot all work sholl be done in occordnnte with all applicable Stote of
Minnesota $tututes und City of Eogan Ordinonces.
PERMIT
Building Offlciol
. CITY OF EAGAN
3795 Pilot Knob Read
Eogan, Minnesota 55122
Phone: 454-8100
I
i'LU-MBINr= PERMIT
Date:
1/3/80
Site Address: 1364 Lake°ide ITriVe
Lot Block ? Sub/Sec. _ Che"r 18t
No. 15 `?'7
1.7343
Receipt No.:
Single
Residential -`
Multi Res., Comm./Ind. I
r'rogZ I.C?iT.1e^ L'!C .
Nome New /Alter
/Repair
.
Address ?x 1211
Cost of Instollotion
?
BllIT18VlliE,
City Phone: Permit Fee
PrOJeCt PluLtblTg
Name SurtFwrge
?
,
r
?
ll 3 xu7T?UOld?i AvP.. 5Q .
?
Address
e
0
'
City Phone: Totol
This Permit is issued on the express condition thot oll work sholl be done in accordonce with all opplicoble $tote of
Minnesoto Statutes and City of Eogan Ordinances.
Buiiding Official
CITY OF EAGAN
AdditionCHES M
OwneGKe?
lst ADDITION
streec 136M Lakeside Drive
,-j: ?- - -
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 Z
• SEWER LATERAL
*
WATERMAIN
* WATER LATERAL 1977
* WATER AREA 1977
* STORM SEW TRK 1977
* 570RM SEW LAT 1977
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN, 270.00 16992 11/4/79
BUILDING PEFi.
n
11
SAC Z . O if it
PARK S25.00 if it
CITY OF EA6AN
3795 Piiot Knob Road
Ecgan, MN 55122
Zoning:
Qwner- -
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
Address:
5ite Address:
Plumber:
Meter No.:
Si7o•
Reader No.:
1 agree to eompfy with fha City oF Eagan
Ordinanees.
By
Connection Charge:
ACtount Deposit: _
Permit Fee:
Surcharge:
Misc. Charges: -
Total:
Dote Paid:
Dote of Insp.: Insp,;
'
CITY OF EAGAN SEWER SERVICE PERMIT
3795 Pilot Kneb Rood PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner:
Address:
Site Address:
Plumber:
1 agiee +o eomplr with ths City of Eagan Cannection Chorge:
Ordinances. Account Deposit:
By
Date of Insp.:
Insa.:- ---
Permit Fee: ?
Surcharge:
Misc. Chorges:
Total:
Dote Paid:
? p ?
g EW?AN 1 site plan w/eleva 'ons &
?II;PER4rr APPLICATIOrI - 1 set of energy calculations.
5/A.L[E' FAA?f.
i 5?f? oa+?
D
t
b He used For N
7 D OS E valuat
on a
e
.
site Aaaress: /?d 4/ 44KKs/ 9 ? I?4 oFFIcE usE ONLY
Lot S sloCx 3 sec./sub.
- Erect /< occupancy ?P 3
Alt.er Zoning
Parcel #• ?? /7 4? 4,_?7-0 03 gepair Fire Zore 3
r UL'
' Enlarge 4ype of Const. r/
Oaner: G?QOa
Z?f ? Mf}N ?
l -
Move # Stories
Pddress: Demolish Front G? ft.
? Grade DePth ft.
? City/Zip Code: /J11iPit15v/LLj? . lL1A1. 65
0_)
Phone #: 415.11 - ?i ? ?? el.5-q-aV APPROVALS FEES
Contractor: SLI/Ne-
Address:
City/Zip Code:
Phone #:
arcn./Eng.:
Adaress: rA-GAN
City/Zip Code:
Phone #:
Assessments . ' _`1/3/,,QPernit I v-
Water/Sewer Surchar4e
Police P1an Check?
Fire ? -
gzq, Water Conn.
Planner Water Meter ?
Council 12oad Unit
Bldg. Off.
11PC
TU`PAL
, ?
_ -7
r / 8C d
S?
s?l??
cirr oF ea"N
? 3795 Pilet Keo6 Rood Hagan, MN S5122
4
rHONe: asa-eioo
BUILDING PERMIT APPLICATION Receipt #
&
m
ve
000
N? 5525
/LI A?.2-
Erect ? Occupancy nj
Alter ? Zoning Rl
Repair ? Fire Zone III
Eniarga ? Type of Const. V
Move ? # Srories
Demolish ? Front 62 k.
Grade ? Depth 46 fr.
Aoorovals Fees
lot ' Block
parcel # 10-17100-050-03
?K INome
Z PO Box 1211
; Address
o r;, Burnsville 452-3979/454-2815
0
ZV
U?
Name _
Addre54
Yw lName Terry Morse
_5 I Address
i"Z' CIN Eag? Phone
I hereby acknowledge that 1 h ad this opplicotion and state that
the information is mrrec nd agre to comply with alI upplicable
State of Minnesota Sta tes and ' of, Ea9ov0ndinances.
Signa[ure of Permitted11 A Building Permit is issued to: --? -G-rO:
all work shall be done in acmrd dc ith I
Buildfrg Official ec-
Water & Sew.
PoHce -
Fire
Eng.
Planner -
Council _
Bldg. Off. -
APC
Permit 140. ;?V
Surcharge 27 • 00
Plan check 73 • 2
yqC 525.00
Water Conn.270.00
Water Meter 60.00
Rd.Unit 75.00
Totol 1,176.75
• on the expres mndition that
Minnesota Statutes and City of Eagon Ordirronces.
Minnesota State Board of Electricity
1954 !I-ni'versity Ave., St. Paul, Minn. 55104-Phone 645-7703
` R'EQUEST FOR ELECTRICAL INSPECTIO ?
CHECK'BELOW WORK COVERED BY THIS REQUEST ? S
/ 789G
230b,"
Type ot Building New Add. Rep. Check Appliancas W'ved oi Check Equipment Wired Fm
Home ? ? Range ? Temporary Wiring ?
Duplex ? ? ? Water Heatec ? Lighting Fixtures ?
Apt. Bldg. ? ? ? Dryer ? Electric Heating ?
Commeicial Bldg. ? ? ? Fumace ? Silo Unloader ?
Industrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ?
List List )
Othsr
?
?
? p
Hehets? p
y
Heie 5f
COMPUTE INSPECTION FEE BELOW
Service Entrence Size: # Fee Fceders&.Subfeedeis: u Fee C'vcuits: Ig 't # Fce
to 100 Am s. 0 to 30 Am ies 0 to 30 Am eies
101 to 200 Am s. 31 to 100 Am res 31 to 100 Am res
Above 200 Amps. Above 100 Amps. Above 100 Amps.
7ransformers RemoteConttolCire. Partial or other fee
5' ns S ecial lns ection M"vtimum tee $
Remazks TOTALFE
I, the Electrical Inspector, hereby certi i t th Uc e igspection has been ad ??- kQ
(Rough-in) ?, ) Date -Zp (Final) Date ? ti
This request void 18 months from o
This request void 18 months from
/ 7 gp 710
Date of this Request 2 - ?? - S?G , S 2 3 0 4 0
I, as ;KLicensed Electrical Contractor 0 Owner do he b request inspection of the above electri•
cal wiring installed at: ?3 ?y?7? IIap
Street Address or Route No. `f.? ?? 5,?: CitJ?=
Section _ Township ` Range County
Whioh is occupied by 4612 S 2 d"L-P ly adL7b? _
Is a}oughin inspection required on this job? No ? Yes 13Y Ready Now O Will Ca?
Power Supplier ga K , 15-! e C • Address
Electrical Contractor-/61/'? 1<< /f?(? r?7l4-r. ---.v4C''Contractor's License'No3!73
(COmpany Name)_ /?
Mailing Address ?' /..y'? ? ? f, 7? /?? .v7ei b[?`? °`7',
Authorized
Phone No'? 3? >/
?? /,? ?
? n? (} ? 0?,???? ? Q??'{?f/ This inspection request will not he accepted by the
[;.,? ??- Ej SWte Board unleu proper inspection fee is enclosed.
/? q /? REQUEST FOR ELECTRICAL INSPECTION y-„ EB-00001-03
T?- 7J[ 1' Seu instructiuns for comPIeUn9 thiz form on hnck of "?
V L 1 Vellow caPY. '`
"'X"" Sefow-W'brk Cavered by 7his Request ??'L -1
ew Add HeO. Type of Building Appliflnces Wrted Equipment Wiretl
Home Ran,ye Temporary Service
Dupfex Water Heater Ligh[inq Fixtures
Apt. Building ryer Electnc Heatin
Commercial Bidg. Ftimaca Silo Unloade,
Industnal BIAg Air Condrtioncr Bulk Milk T2nk
Farm Umri Pecifv other ISOeciM
thiar ISyor,ify Othor pther
I,OfAn(/IB N7SE7P.CIlO/i fP8 C@lOW
# Fen ServiceEntrance5ize q Fwn Fnedere/Subteatlars # Few Cvcni1e
I I I? ?? ? to zuu qmps ? ? ?.s i to i uu qmps ? ? ? si to I uU Amps I CL4 ? ? ? Above 200 qmos Ahove 700 Amos /L Ahnvo 100 Amos
Tia
?? sn ?? Speual Inspectwn g??•? TOTAL F(/O
Rertia rks
?
Rou9?*in Oatv
I, the Elechical
s? Inspector, hereby
if
N
final
Date cert
y
at ihe above
pecbo
ins
n has bexn
J
!0"?' l(?
?? maAe.
This reques[ voitl "
18 mnnths honi
Thiti reyuetit vosd /[i[ `-?
16 months trom
'T 7.8214
Li 63 ? GI'l?5 /tiir.? r( s±-
.
/6,00
? -z c( ?( I
Faquest Date Fire No. flouph-in InsVeGron
Recp ireJ?
eady N?iw ? WiII Notity Innper
Q?j 1,f ?Ves o tar When ReadV
censed Electnwl Cunlr,ctor I hereh
y request insVecfion of ebove
Dwner eleUncal work installed aL
Stoeet L.AdresPs, Boz r Rojrte o./ Crt
ectiwn o. inwnshi p ame nr No. Rnnyo No. County
Occup.mt IP I ^' Phnne No.
Power $upVlim I , Atldress
Electn,, tractor ompany ? f/
?-? C/om?rdrtor'sL7icense No.
-
Mailing? Add s( onVactor Ownr,r Ma in
Ul:? e Insta la n)
?l.u3JIJ ,
e?, SS'3
Author¢ed Si Iure 1
?t ontracto Own r kmy Instal lationl
a ? Phone. Nu1''b?er7 ??0
MINNESOTA STATE 90AFO OF ELECTRICITV . TMIS INSPECTION REQUEST WILL NOT
Griggs-Midwav Bldg. - floom N-191 BE ACCEPTED BV THE STATE BOAftD
1821 ll UNLESS PROPER INSPECTION FEE IS
nivarsitY Ave.. St. Paul, MN 55104
on....e 1w111 oa7_1111 ENCLOSEO.
REOUEST FOR ELECTRICAL INSPECTION ,
aW, MN 55104
21 Un ersih' Ave
IIII I II II IlIIII I I? 1 ar
s 0 2 3 1 7 6 1 " Phone (612) 642-0800 ??
8 Rll/I?'77.[ ?+?
Home Duplea Apf. Bldg. Other. New Addn
Commerciol Indushial Farm Remod Re air
Air Cond. Hig Equip. Water Htr. Load Mgmf Other:
D er Ron e Elec. Heat Tem . Service
"X' above the work covemd 6y this request. Enfer remarks in fhis space ond on the back of the white mpy on(y.
Calculafe Inspechon Fee - This Inspedion Requesf will not be attepfed without the correct fee:
OHier Fee 8 $ervice Enhance 5'¢e Fee # Grwils/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Streei Ltg./lmffic Sig. Above 200 Amps Above 100 Amps
TronsformedGenera}or IN3PECTOR'SUSEONLV TOTAL ?
Sign/Ou}line Lfg. Xfmr.
Alarm/Remofe Conhol
$Wimming Pool I hereb cam thal l ins ecMd Me elecfiml insMllobon descnbed herain on Me daros ekkd
Irriga}ion Baom Rough-In Dak
$peciol Inspedion
Investigafive Fee -7
k ^ -1 /
THIS INSTALIATION MAY BE ORDERED DISCONNEC MO H N 18 MONTHS.
2 31 ? 1 V ?
? OFFl E IISE NLY This reqaest wid 18 manihs lrom volidanon dare pnnred In this box
i???.s
?
PLEASE PRINT OR TYPE
Reqowl re ? Rovghnn tnspeaion reqoirtd2 ? Yes No Impecnon Oiher Than Ro gh-In: Reody Naw ? Will Coil
/1 1Ye? m?.
<o?? *?,?>P?„???,?d,,
I, licensed conhador ? owner hereby reques} inspedion oi ihe above eledrical work af:
Job Pddrev (SVeet, BaF,y r RoWe No )
? C Ciry
'/1
?6 Zip Code
S3/
.
..3 /..4 ? si G • L /f .
a 3
Sution No. Townshi0 Nome or No Range No. Fim No. Counq
Occ M
6?z ,? Phone N .
'? 5S7
Powar Supplier Pddreza
Eleclnm 5onhador (Comporry Name) , Comraaor Lkense No.
' Momr 4c N. (Plant EIM Only)
/ h!!? C_
AD1d7 z
MaiLrg raa (Con rarOrmerPadormnglnsmllalion)
/ Y • ? /71 ??
/? ? ?IJ lCJ
Autho gnatu Perloimieg Installohon)
or Phone No V? ?
w
EB-001&If-10 6/95 STATEBOARD COPY-SEEINSTRUCTIONSONBACKOFYELIOWCOPY
sdS/R r
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construclion Reuulramenis
. 3 registered sile surveys showing sq. fl. of lot, sq. ft. of house; and all roofed areas
(20%mauimum lof coverage allowed)
. 2 copies of plan shaxing beam & window s¢as; poured found design, etc.)
• 7 set of Energy Calwlations
• 3 copies of Tree Preservatan Plan if lot plaflad afler 711/93
. Rim Joist Defail Options seledion sheet (61dgs wilh 3 or less units)
DATE ?? ?c,2 (? ` Q _?r'
SITE ADDRESS
TYPE OF WO
STREET ADDRESS lSo2 S- C'? /-4?0 I.?i CITY
TELEPHONE #qSo?ELL PHONE #
PROPERTY
FIREPLACE(S) _ 0 _ 1 _ 2
/S7 C;?J-
ZIP ,5533 -7
FAX #
TELEPHONE# 6S-1" 7-,y `t' S-
---------------°------------------------------------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RUI.ES 7670 CA'PECORY 1
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: __
Plumbing system includes:
Mechanical Contractor:
Mechanical system includcs:
Sewer/Water Contractor:
_ Air Conditioiung
Heal Recovery System
Phone #
Fee: $70.00
Phone #
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all appjic-¢ble State of Minnesota Statutes and City of Eagan Ordinances.
j? ?/ Slgnature of Ii gpt
Y17 `
OFFICE USE ONLY
Water Softener
Waler Hcatcr
No. oT Baths
RamodallReoair Reauiremenls
• 2 copies of plan
• 1 set of Energy Calculalions for heated addiM1Ons
• 7 site survey for extarior additions & decks
. Indicale'rf home sened 6y septic system tor additions
_ PIlOIIC #
Lawn Sprinkler
No. of R.I. 13aths
MULTI-FAMILYBLDG _Y _N
VALUATION 4 7. 27 / ' O"
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updated 4l02
Tee: $90.00
:v- . _v F': z•.
,:. . :• Lr i?-^.=n
'?:fn?viilc, ;?l: 55337
DELMAR H. SCHWANZ
LANOSUpVEVOR
peqitHntl VntlGr Lawf o1 Th<Stdb ol MinnOfOb
7978- 168TM STREET W. - BO% M ROSEMOUNT, MINNESOTA 66068
SURVEVOR'S CERTIFICATE
?
o?? L
cr.
?yt.43
1 .
? U/?`?1
?f- '8.17 _
1 1 \ \ I I
?L pKpl??-t-? ?E N
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M
r?
i
/07
gn,l8
Fll:2
PNONE 612 423-1788
I
I
I \
%J?'
T heseby certi4'y thFt thio L: a tru^ ancl carr•?:t rearec(:t ?.? 'of a aurvn.y o: Qhe boundariea of tho f.bllix•finr dcr.crsb:::; C^_•?
of land:
I.ot 5, filock 3, CHaS b1FlR FZRST A`-DI`I1L7i°',
Cnunty, h:innoaotD..
AI.so aho:;lnG tha tocation of a propnccd houso as uC k;rl *_1,• r~
Dccuriocr 4, 1:'73
/ i
M1+INNESOTA REGISTRATION ND 8075
?-?-? (
/ 7100 -OSD-ct3
CITY USE ONLY
L _ _ BL ?_ RECEIPT #: 5027Z
? DATE: 1 9 Aff
SUBD. ?
1995 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
/?a9?99' ?oZU ? 3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dweliings
? townhomes and condos when permits are required for each unit
New construction ? Add-on furnace
-?---
Add-on air conditioning Add-on airexchanger, i.e. Vanee system, etc.
?
Date:
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL
SITE ADDRESS: 4 La Ce.S 6t?-- •
OWNER NAME: Lrze,_ CeI b(_a J _ PHONE #: Z/54- S?ld
INSTALLER NAME: Ae?? ")('j , cl"(` ?C'
STREET ADDRESS: ?? (2??? ll)
CITY: !Z--c 'C0' Q?L_ STATE: ZiP:
PHONE
?^• ??.w..wr^•` / ? A• ??(??? ?'yf?? ' ti?" ,1 S ?F
?1\L V?LI\IYII / ?
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA137797
Date Issued:07/22/2016
Permit Category:ePermit
Site Address: 1364 Lakeside Dr
Lot:5 Block: 3 Addition: Ches Mar 1st
PID:10-17100-03-050
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 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 -
Christopher D Colburn
1364 Lakeside Dr
Eagan MN 55123
Lofgren Heating & Air
5708 Upper 147th St W
Suite 106
Apple Valley MN 55124
(952) 431-5811
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA150955
Date Issued:07/31/2018
Permit Category:ePermit
Site Address: 1364 Lakeside Dr
Lot:5 Block: 3 Addition: Ches Mar 1st
PID:10-17100-03-050
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Christopher D Colburn
1364 Lakeside Dr
Eagan MN 55123
(651) 395-1826
Window Concepts Mn
291 Eva St
St Paul MN 55107
(651) 905-0105
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA151144
Date Issued:08/10/2018
Permit Category:ePermit
Site Address: 1364 Lakeside Dr
Lot:5 Block: 3 Addition: Ches Mar 1st
PID:10-17100-03-050
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Christopher D Colburn
1364 Lakeside Dr
Eagan MN 55123
Fireside Hearth & Home
2700 Fairview Ave N
Roseville MN 55113
(651) 633-2561
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA173088
Date Issued:10/27/2021
Permit Category:ePermit
Site Address: 1364 Lakeside Dr
Lot:5 Block: 3 Addition: Ches Mar 1st
PID:10-17100-03-050
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
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 -
James A & Suzanne Barghini
1364 Lakeside Dr
Eagan MN 55123
Intelligent Design Corp
10907 93rd Ave N
Maple Grove MN 55369
(763) 315-0745
Applicant/Permitee: Signature Issued By: Signature