1375 Lakeside DrCITY OF EAGAN Remarks
Addition I N Lot 4 Blk
Owner 4 . 41 'f street 1375 Lakeside Drive
G II
040
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 281.61 14.08 20
47-1
* SEWERLATERAL 1977 4634.33 308.96 15 ?a - s•77
* qervice u 197
WATERMAIN
* WATER LATERAL 1977
* WATER AREA 1977
* STORM SEW TRK 1977
* STORM SEW LAT 1977
CURB 8i GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
VILLADE OF EACAN WATER SERVICE PERMIT
3795 Pilof Kn4. Road PERMIT NO.: 2061
Eogon,MN 55122 DATE: 10/18/75
Zoning: RI No.ot'Units: 1
Owner: n s t. Inc.
Address: ? ? I A/1 777lt?S /
Siie Address: 1375 Lak eside Dr.
vlumber. Same - Weierke 6 Mound
Meter No.: ?X vS ?y iy0 f Connection Chuge: 220. 00 qd
S e:. - Account Deposi[ :
-3
fte. er Na.: ?'?'S' ?/ $ Permit Fee: 10.00 pd
I a o omplr with the Villoge ef Eayon Surchazge:
c • SO pd
rdinan
eT.:;' n Misa Charges: 60.00 pd
? Total 11.30 pd
R
hJ ? ?'k^"4--.Bare Paid:
Date of Insp.: ]nsp.:
YILLAGE Oi F.AORN SEWER SERVICE PERMIT
3795PilotKnobRaad PERMITNO.: RRRg 2811
Eagan, MN 55142 DATE: 1 0/ 18 7 6
Zoning: RI Na. of Units: 1
Owner:
Address:
Si[eAddress: 1 '175 t.,kasi de nr. L•4 B1 Ches Mar lst
Plumber: Same - WPier ke k Piound
9/24/76 #:1490 1 00.00 pd
1 ograa ro comply wifh fha Vilkya of Eagon Connection Chazge: 3 5 0. 0 0 p d
Ordimncea. Account Deposit:
Permit Fee: 10.00 pd
Surchazge: • 50 pd
8y: Misa Charges:
Uate of Insp.: Total:
Insp.: Dace Paid:
' CITY of EAGAN
BUILDING PERMIT
Develo ers .
Owaee ........... Constru
..................L'................................., c .. t ... i ... o ... n ...... I ... n ... c ..
....
. Chase Rd.
Address (preceni) ....4515 ... O.ak .
................................."......................
Butlder ..............Sx'1761P . ..............
Addresa
L?
.. i.
N2 4089
3795 Pilo! Kaob Road
Eagaa, MinaesoSa 55122
454-810D
Dsls ...9/,24/7.6 ....................
SSOrias To Se Used Fos Froni DepYh Helgh! Eet. Cosf Permi! Fse Remerkm
135.5
S/F ?wlq & Gar 72' 35' 48,000 24.0 s/c
Ad
This permit does ao2 aulhorise the use of slxeela, roads, alleys or sidewalks aor doas it give the owne: or his agsn!
the righ! !o ereate anp siluation whtah is a auisaace os which preseais a hasard !o the hea]!h, satelq, coavenSenes aad
general welfare !o anyone in the communily.
THIS PERMIT MUST BE KEPT ON THE PAEMISE WHILE THE WOAK IS IN PROGAESB.
Thia ia fo certify, thal..... Dav. - »---- Go-n-s.t....... nc ...............haspermiseion !o ereet a...S/..k?...Av?l.9.._F....?a=................ _upon
the above desc 'bed premi ?u6"ecf lo the provisioas of all applica
........ .. ble for the Ciip of-Ea
T
....?._.?...`.?.- .......... ............... pBr ........ ... ... ........... .. .........
. . ... ..... .._......... ..........
. .... ................?- -•-- ... or SuildinQ InsPeetos
CTTY OF EAGAN
3795'Pilot Knob Road
Eaten, Minneaota 55122
? m?-
PE2iMIT N0. : B 3 0
i'he City of Eagan hereby grants to Home Heatina E Air Cond. Ca.
_ °f -4QQ? Dominick Dr Minnetonka 55343
Burton Const.1 Aevelopers C.Inc.,
a aoemrNr_ PeY'mit fOr: (Owner"a$ pnharf i( ?wenay?.
at i596-MeEas-Ehg_ROad, 1375 Lakeside Dr.,
_ - , pursuant to application dated 11
Fee Paid: _ 060. Aa _ dat«d .this ,d day Ofx?++?e+??e?
1.50 e/c '
Building Inspector
Mechan$cal Permits:
Bid Total:
JL?
CITY OF EAGPN
3795 Pil.ot ?r.r.ob Road
Eagan, :+Iinnesota 55122
4-/
GdLkILT"Jaj??
PER4vffT NO.: 750
The City of Eagan hereby grants to Mound Plumbina Oo.__ _
of 6029 Evernreen Rd. Mound 55364
8 P7.OtMING Permit for: (Owner) Develouera Construction
at 1375 rakeside Drive , pursuant to application dated 11/10/76
Foe Paid: 520.00 dated this 10 day of November ? 19 76 .
.50 s/c
Building Inspector
Mechanical Permits:
Bid Total:
0- ?? 7 6 2 0 ?a???? r???
?
/ ? ?°
Requ st Dale I ? Fve Na ough-In tfwn Re uued
(YOU ^specto? ?w ?en raetly) Ins eclion Olher Tha Fough-In
Reatly Now ?JAI NdRy Inspeclor
°
ASI No Oate Reatl r
co"W
I licensed contractor ?owner hereby request inspection of above ele r,a c u /
Job Atldress Va?oRONe yp ? ?e?
L / Gry
Sectmn No Township Name or No RanBe No Cou y
c
Occupan
/Igo l(PRINT)
c. -e e cero
Phona No?? CyC G
? .?
Power SuppLer / Atltlress ?
ElecMC I ConV ctor (Company Name) Contractor's Llcense No
33
/
Mai mg Atltlress (COnVaclor or Ownar/r?y ng IJ?stalla?ion)
/O? ?/e
?G
G
l
rn
Authonzetl Signature onVacror/Owner Makin nsl letion) Phone Number
MINNESOTA STATE BOAHD OP ELECTRICITY I I THIS INSPECTION REOUEST WILL NOT
5t ?. Pau15MN 55106 I
1821
6
? II ? ? I I II ?I II II ? I UN ESS PROPER NSP CTIONFOEERS
P
1
642?0800
?ooe
?
?
ENCIOSED
es.o
oooi-os
L ?3 - 7`? ;Z- REQUEST FOR ELECTRICAL INSPECTION VL.11A
? Sae instmcnons br compleling this rorm an back of yellow copy. "X" Be/ow Work Covered by This Request 1<18d(p (p
Ne Add Rep. Type of 8uilding s Wired Eqwpment Wired
Home Range Temporary Service
Duplex Water Heater Electnc Heating
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (5 ecif
Farm Av Conditioner
OUer (specRy) Conttattai e Remerks
7yb s?.??a?
Compute Inspecfion Fee Below:
# Other Fee # Servica Entrance Size Fee tf Circwts/Feeders Fee
Swimming Pool / 0 to 200 Amps 0 to 100 Amps
Transformers Above 200_Amps Above 100 _Pmps
SI OS Inspecmrs Use only TOTAL
Irrigation Booms ' G /pj ,_SU
S ecial Ins ectwn v
AlarmlCOmmunication THIS INSTALLATION M Y BE ORDERE ISCO BOT
Other Fee COMPLETED WITHIN 18 THS--? ?
I, the Electncal Inspector, hereby
if
h
i
i R°uyn,n oata
ced
y that t
e above
nspect
on has
been made.
F?nei !F
/
Date ??a_
OFFICE USE ONLY
This request void 18 moMhs tmm
************************??***?****?***CITY OF EAGAN
CASHIER: JS TERMINAL NO: 665
DATE: 09/06/CQ TIME: 15:01:37
ID:
NAME: SELA ROQFING & REMODELING
3210 9001 1375 LAKESD DR 167.2.
2155 9001 1375 LAKESD DR 4.5
Total Receipt Amount: 171.7,
CR137120
USER ID: JAN
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) ?
CITY OF EACAN
3830 PILOT KNOB RD - 55122 171 ( J?
851-881-4875
> a royxerea dre wryeys snownrro ua. n. a bt, w. n. a nane z couie: a alan
ana gl roofed aeas canx mmamun, iot covemae wwwem 1 se? or energy cacwanorn r« ?bated addmons
D 2 eoPies ol plara (thow bearn & window tlzes: Paured fnd deqyrr etc.) 1 sMe wrvey /or axleAa addidona a daeks
? 1 aef o/ enerpy cadeulaMOna
D J Copies OI he9 preservoMon plaf M bt plpMed afier 7/1/93
DATE: _ ( -•G " ejL* CONSTRUCTION COST: ? ?• m ?
DESCRIPTION OF WORK: TZ0.YoO KeIm`t "e- Fro?+.+ Rr@ is A?F4Qhtal ?Qr??! G
STREET ADDRESS: '1375- L R KC S i['.lG I?f i vL.
1nd ?
LOT: BLOCK: SUBD./P.I.D. t: I ?ILl r
Na,,,,e: Gv;on m;ehdlt- Phone#: 645-1"4S7-0620
vROrExrr LCISI flrst
OWNER StmefA?rew 1371' LqKe5edC Dn-pc
cxr f?yar1 srote: 1ft 5-Slx3
Ccmpony, SELA ROOFING & REMODELING, INC. Phone 0: Vdk 5-93' ?fd y?
(area code)
6T. LOUIS PA$K, MN 55416 i"4yt A
CONiRACTOR
3heet Address: ID #0003060 LlCense Y L0 $_ O Exp 'Aa0 f
Cty
State:
21p:
ARCHITECT/
ENGINEER Company: Name:
Telephone A: (
Sheef Address: RegisfroHon M:
Gy I State: Z1P:
Sewedwater licensed plumbeP (if installino sawer/waterl: Phone #:
I hereby acknowledqe Ihat I have read lhis applkatbn, sfate that the Wortrwlion Is carect? , to comply wHh aG aPP6cable State
of Minnesota SfWufes and Clly oi Eapan OMinances.
Sipnalure of AppficanY.
OFFICE USE ONLY ` ."' `4J'R?i D
?.
Certfiqtes of Survey Received _ Yes _ No StN s' 2000
Tree Preservation Plan Received _ Yes _ No _ Not Required ?
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex ? 13 16plex 0 21 Porch (3-sea.)
0 02 SF Dwelling ? OS 06-plex ? 17 Garage 0 22 Porch/Addn. (4-sea.)
O 03 07 of _ plex O 09 07-plex O 18 Deck O 23 Porch (screened)
O 04 02-plex O 10 OB-plex 0 19 Lower Level O 24 Storm Damage
? 05 03plex ? 71 10-plex Plbg, Yor_N 0 25 Miscellaneous
O 06 04-plex O 12 12-plex 0 20 Pool O 30 Accessory Bldg.
WORK TYPE
O 31 New O 36 Move Bldg. ? 43 Reroof
? 32 Addition p- 37 ' Demolish (Bldg)' ' O 44 Siding `
O 33 Alteration O 38 Demolish (Interior) O 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) O 46 WindowsJDoors
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code # of Stories sq• ft•
No. of Units Length sq. ft.
No. of Buildings Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Aliowable) Main level sq. fi. . MC/ES System
UBC Occupancy sq. ft. City Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INS PECTIONS
O Stucco/Stone
APPROVALS .
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn. r•
.
Water Meter
Acct. Deposit .
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
? 31 Ext Alt - MuW
? 33 Ext. Alt - SF
0 36 Mufti
SAC Units
% SAC
w
LpT BIACK
ADDITIObT
PARCL''L & SECTION PNP•1IISR IE' UYTPLATTED
ADDRF.SS OF FAZCEL
•
70id2TiG OCCUPANCYa a `! l/?t75g? ?.
T-r? .?
ErjTIt]ATED COST 4S,660,09
TNC.• TELEPHONE iVO. y?-?/ooy
--------r 1
ADDRE:SS ?/ ? i$ OA K CkA 4&, R.?
S Z- I O?
COLJTRACTOR ?? ?_al apr_} Can. iTri.M.c.?? a w. ZNL TEUPHONE L10. 41
ADDRESS S,&M L d? ?4 ? V V?? -
s
Ydote? Include site plan, building plans, and ener alculations wiL
application
Signed .
USE
VALUI1TIOtd
SAC
YFATER COidNECTIOTI
k7ATER METER (v0 . ?
A) r.37J
SUSLDING PERMIT FEE J
SURCHARGE F8E
?
a'L
PLAt] CFECK FEE
PAFtR DEDICATIOTd FEE
OTfOR
TOTAL* '
APPROVALS :
ASSESSME:VT CLERKO?BUIL?IPIG D POLICE DEPT. O
6I7iER & SE4IER DEPT. FIRE Dh'PT. PARK DEPT.
?
Date: Se a?.Z3f?g'Ib
BUILDIP7G PERMIT P.,PPLYCATION
.iLtI?`.?'v
Dev,eloper3 L'onctructton, Inc.
44,1 Gak Cha:se L3ne ?
r:agan, P9lrine3nta 55123
\
DELMAR H. SCHWANZ
lANOSURVEYOR
Rlqistlrla UnOei Law1 ot TM1e Stat< U1 Minnefotd
14515 SOUTM ROBERT TRAIL P.O. BO% M ROSEMOUNT, MINNESOTA 55068
9k.19/150-1'i1
PHONE 812 423-1789
RVEVOR'S CERTIFICATE
9S•0
t? 3
,o
D m
I Q o
? o
%
.?o
„
o = T?oi?
50 ° ' ?f,crly EA
eN ? /
1
10
INN
,4 Z' ?
Q ' . za.? T j4
S
`\ `.? io' urp?fv /
n?l ?G
? ??q0VIIP ,
'i
?
L? I hereby certi:y titiat th.Lsis a trae and
c,)rrect repreFentation of a surve:r of
I.ot 4, kilock 1 of tne plat of t'AF
AiRST ADL`ITION, as on file and :)f record
!n the off'ice oC the County Recorder, Uakota
County, MinnesoY.a.
Also showing the location of a propcsed t:ou-e and garage aa etakPd thcrepn.
Septemlier 2', 1`i7u ?
Q>
Mi1vNE4UTA flEGIST- )N NO 8625
` MASTER CARD
LOCATION 1375 LAKESIDE DRIVE L4 B1 Ches Mar Estates lst Addn.
OWNER Developers CO1]StxUCtiOn Inc.
STRUCTURE AND 5/F Dwlg & GdY
IAND USED AS
Permit
No.
Issued Issued To
Coniractor Owner
BUILDING 4089 9/24/76 Dea. Const. Inc. same
PLUM6ING
CESSPOOL - SEPTIC TANK
r- ?sa?rv
WELL
ELKTRiCAL
HEATING S3? ?/??yC??
q L? Qp•
GAS INSTALLING
SANITARY SEWER
OTHER ),(
6/ '
OTHER
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTInIG
FOUNDATION ? SEPTIC
CESSPOOL
FRAMING ?3•' TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WEII
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFlEID
PLUMBWG
WELL /(_ ? ?_ )
s_?.L. /_.6
SANITARY SEWER
J
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENGE OF NON-COMPLIANCE
OBSERVED.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
I7EMIZED
AS FOLLOWS:
11 NON-COMPLIANCE. 6UILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION Of CERTAIN IMPROVEMENTS
WILL BE DELAYED 8Y CONDITlONS BfYOND
CONTROL.
? REInSPECTION REQUIRED
REINSPECTION REVEALED
DATE OF REINSPECTION
CE RTI FICATION - I certify that I have caretully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions abserved to be at variance with ordinances of the Town ot Eagan, approved plans and specifica[ions, and any specific require-
ments for off-site imprwements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
DATE
COMMENTS:
? 23
/ L41 gL ? CITY USE ONLY RECEIPT#: 7259.?-'
SU80. CUt, I? RECEIPT DATE:
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(672) 6814675
Please complete for: w single family dwellings
? townhomes and condos when permits are required for each unit
. backflow preventer for underground sprinkler system
FIXTURES EACH TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping Outlet ' minimum - 1 3.00 x =
Rough Openings 1.50 x =
Water Softener ' for dwellings under construc[ion 5.00 x =
Water Softener " for existing dwelling 20.00 x =
U.G.SOrinklP.f `forAwellino Underconst.
' 3.00 = ' o
U.G. SprinklBr
tar existing dwelling 20.00
Alterations ' to existing resiilence 20.00 =
Water Tum Around 20.00 =
Private Disposal System ` Dak Cty lie. 75.00 =
(new and refurbished systems)
Private Disposal Systems' nbandonment 20.00 =
STATE SURCHARGE .50
s°
TOTAL C>X ?
I hereby acknowledge Nat I have read this applicetion, sfete that the infortnation is corted, end agree to comply with all applicable City
of Eagan ordinances. k is Ne applipnYS responsibility to notify tha property owner that the City of Eagan assumes no liability for any
damages caused by the Cily during its nortnai operetional and maintenance aGivRies to the fediitles construded under this pertnit within
City property/right-of-wayleasement.
r _
SITE ADDRESS: /3-75 A4 a,6 04
OWNER NAME:
INSTALLERNAME: _ TEL PHONE#:
STREET A/DDR_? ?
CITY: ( O STATE: ^4 . ZIP: ?GJ ???
SIGNATUR OF PERMITTEE
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
,$ 11 3, 7S`
caxkl-4 4.-
New Construction Reauirements RemodeUReoairReaui2ments Office Use Onlv
3 registered site surveys showing sq. fl. of lot, sq. ft. of house; and all roofed areas 2 wpies of plan Cert of Survey Recd
(20% ireximum lotcoverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan ReW
2 copies ot plan showng beam & wiMow sizes; poured found desgn, etc. 1 srte survey for addNOns 8 decks Tree Pres Not Reqd
lsetofEne(gyCalculatlons AddRion-indicafeifon-s'desepticsystem _Oo-siteSeptlcSystem
3 copies ot Tree Preserv2tion Plan if lot platted after 7/1193
Rim Joisl Defail Options selection sheet (bklgs wBh 3 or less units
Date ? /27/ 03 Conshuction Cost
Site Address )-31,q Y e S i d`p Unit/Ste #
Description of Work )i? SeU f!'JY! su n roorb
Multi-Family Bldg _ Y? N F7replace(s) Y . 0 _ 1 _ 2
Property Owner yl Telephone #(4?? ) Lek7' d(? 20
Contractor t--2?2 Eyt e/TJ S-./ Y'E'S
Address l?e 1, C?, City Li ?Vs2
State Zip S.Sy/ 2. Telephone #(6S4
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
. Energy Envelope Calculations SubmiUe
rrt? Licensed Plumber ` ? `i Telephone #( )
2 q 200 U
Mechanical Contractor 3
MA? Telephone # ( )
Sewer/WaterContractor 4 V14' , l 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
5tatutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval lans. /of ? ? o \,? Y\1 C\Vj
Applicant's Printed Name Applicant's Signa e
OFFICE USE ONLY
Sub Types
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace 'K 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screeNgazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bldg) - Gi ve PCA handout to applicant
Valuation Fav
Census Code
SAC Units
Nbr. of Units -'
Nbr. of Bldgs
Type of Const ?
_ Footings (new bldg)
Footings (deck)
? Footings(addirion)
Foundation
Drain Tile
Roof Ice & Water Final
Framing
_ Fueplace _ R.I. _ Air Test _ Final
Insularion
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
occupancy A
Zoning /`-!
Stories ?
Sq. Ft. ?
Length %D
Width
/ ?-
MC1ES System
CityWater -
Booster Pump -
PRV --
Fire Sprinkiered -"
REQUIRED INSPECTIONS
FinaUC.O.
? FinallNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ AidGas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By
?7 ----
/dZ&4 PC' *: yF-rw
Building Inspector
s r'znst:^?r.t!o;., 'c.
t ?
a 9k.19%15^,-1
DEIMAR H. SCHWANZ
LANpSOAVFVOR
k<q,sterea Unaer Lawi of fne SfeV of M-oeaob
14515 SOUTH ROBERT TRAII P.O. BOX M qOSEMOUNT, MINNESOTA 55068 PHONE 812 423-1769
- RVEYOH'SCERTIFICATE
950
? 3
1 .o =m
? N
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,
_ o - I,eon/
L
10
s
f O0
? pko?0 4 Zn
J ?1
V ? 1 ??', Ib
jftcff?
? 95,
? oy'6;o D
QKEy?D?
Lr' I:ir.reby --er` i:'y tilat t; isle a trae and
c:^rect rompr?sentatiun of a s1^ve,y nf
iat 4, Flock i o° tne plat of rtl;:; YAF
FTftET ADl'ITI?iN, as on flie and :)f record
ici tcie ot't',ce of' the Cowity Fecorder, DakoLa
Cuunty, Mlnr.esota.
Alsu showinr, the :ccatior, of a Gropcsed a::d nar:k?e a9 fiC3iCP.B thereon.
Septem?er 1', 197i;
?
MiNNESOTA REGIST?I*'tON NO 8625
r? 22006 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55I22 '
Tetephone # 651-675-5675 FAX 4 651-675-5694
New Cons[mction Requirements
3 registered site surveys showing sq. ft. ot lot, sq. h. of hovse; and all roofed areas
(20% maximum loi coverage allowed)
2 copies of plan showing beam & window sizes; poured found design, etc.
1 set of Energy Calculations
3 copies oi Tree Preservafion Plan'rf lot platted after 711193
Rim Joist Detail Options selection sheet (buildings wilh 3 or less units)
Minnegasco mechanical ventilation form
Remodel62eoair Reauirements
2 copies of plan showing footings, beams, joists
1 set of Enefgy Calculations for heated addifions
1 si[e survey foradd'Aions & decks
Add'dion -'rndicate i( on-sde septic sysfem
? -n v-b
Of6ce Use Onlv
CedofSurveyRerA _Y _N
Tree Pres Pian Recd _ Y_ N,
Tree Pres Required _ Y_ N
On-site Septic 5ysfem _ Y_ N
Date 5 Construction Cost
Site Address ?),L N , Unit/Ste ti
Description af Work
Multi-Family Bldg _ Y K N
Fireplace(s) _ 0 2
Property Owner Telephone # (G l) ) ?'? ? ???' 1 `?
Fireside Hearth $ Home
Contraccor 14399 Huntingtan Avenue
naaress Savage, MN 55378
State 952J36.7761
License#20512060
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City r ta,, _
_ Telephone # ( Y
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv I _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) , Submitted Submiried
. Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone # (
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the infonnation is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Bagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a pern, it, and work is not to start without a
permit; that the work will be in accordance with the app ed pl the c 3e of work which requires a review and
approval of plans.
ApplicanYs Pnnted Name App icant's Signatur
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA122359
Date Issued:05/06/2014
Permit Category:ePermit
Site Address: 1375 Lakeside Dr
Lot:4 Block: 1 Addition: Ches Mar 1st
PID:10-17100-01-040
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 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 -
Michelle A Guion
1375 Lakeside Dr
Eagan MN 55123
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA162862
Date Issued:08/03/2020
Permit Category:ePermit
Site Address: 1375 Lakeside Dr
Lot:4 Block: 1 Addition: Ches Mar 1st
PID:10-17100-01-040
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Michelle A Guion
1375 Lakeside Dr
Eagan MN 55123
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature