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4305 Orion LaneINSPECTION REC4RD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: E uN t AW I.J! L 1?1 kFdf '.'? 11ltltK r-'ND PERMIT SUBTYPE: APPLICANT: t,,. TYPE OF WORK: u i I n/allqR 17C"P A t V { kri0 f I NF 1 . ' .. .. ? . `r 14 Permit No, Permit Hoider Date Telephone # ELECTRIC PLUMBING HVAC Inspection Deta Insp. Comments FOOTI NGS FOUND FRAMING ROOFING RpUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLQG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OP EAGAN '? 3795 Pilot Knob Road Eogan, MN 55122 N2 4485 PHONE: 4548100 i ? BUILDING PERMIT ReceiPt # i . - To be und for DaYe , 19 Site Address Erect Occupancy Lot Block Sec/Sub. - ''`'nS5 Alter ? Zoning Parcel # Repair ? Fire Zone _ Enlarge ? Type of Const. Nome Move ? #f` Stories ? W Z 3 Address Demolish ? Front - ft. 0 Ci Phone Grade ? Depth ft. ? 0 Name Approvals Fees Uo < Address ? fith ?', t ? F r?... . eL___ FS?t? 5 i?i..': Ncme _ f4ddress I hereby ocknowledge thot I have read this opplicotion and state that the information is correct ond ogree to comply with all applicable $tate of Minnesota Statutes and Ciry of Eagon Ordinonces. $ignature of Permittee , A Building Permit is issued to: -- " all work shnll be done in accordonce with all applicable Stote of Mii Building Officiol Assessment _ Woter & Sew. Police Fire Plonner _ Council _ Bld9. Off. aPC - Permit ' I. ki", - Surcharge Plan check SAC Wuter Conn. _ Water Meter ? Totol 7 9. 50 on the express condition thot Statufes ond City of Eason Ordinonces. ? hes?M # Dah tawd hewNlM Plumbing Mechanicol INSPECTIONS DATE INSP. Rough-in Fined Footings ? Date Inap. Dote Inw. Foundation Plumbing -?) Frame/ins. Mechanical Final Remarks: CITY OF EAGAN 3795 Pifot Knob Rood Eagan, MinnesoM 55122 Phone: 454-8100 PERMI7 Date: =>eptember 27, 1977 4305 Site Address: Lot Slxk Sub/5ec. Nome ?°nd PPtersen ti ' -:]- ; Address ' O ??ty ?sZoor.?ington phane: P1;.i:;-d.,iraq r `eatinq Address ? 745 SO. RObert 'Ira31 e 0 v ?e?sc?,,,o;ant City Phone: This Permit is issued on the express condition that oll work shnfl be Minnesota Statutes ond City of 5agan Ordinances. No. _ Receipt No.: ' Single I Residential Multi Res., Comm./Ind. I New/Alter./Repoir Cost of Installation Permit Fee Surcharge Total ` ` . done in accordance with all applicoble StaYe of Building Official CITY OF EAGAN ' 3795 Pilot Knob Road • • .•• Ecgan, Minnesota 55122 Phone: 454-8100 ?- PERMIT Date: ' Site Address: . OP . Lot Black Sub/Sec. w Pk ` Name ¦ ; Address O City Phone: ' - - / - V Name , . ,,l ,,:;, :i.: ' . - -ati;,<. Tr1r• ? No. !f' Reteipt No.: 5ingle Residential Multi Res., Comm./Ind. I New/Alter./Repoir Cost of Installqtion Permit Fee Surchorge " ; I Address e V .?,'.,. r.- City Phone: Totol This Permit is issued on the express condition that all work sholl be done in accordance with all applicabie State of Minnesota Statutes and City of Evgan Ordinances. Offlciol CASH RECEIPT . CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN. MINNE50TA 55122 DATE RECEIV ED 19 AMOUNT ? I & DOLLARS ' oo Ej GASH F? GHECK FUND I COOE I AMOUNT Q _. B Y , . _ J NUMERICAL FILE COPY CITY OF EAGAN Remarks /7T Additio WILDERNESS PARK 2nd Addi ti on Lot 1 Blk 1 ? Parcel 10 84251 010 01 owner ?.? ?`?(?k r, _ sveet 4305 Orion Lane State_Eagan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK AQ-1 107.95 A00529S 2-9-7 SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA j'] 624,19 62.42 9-13-78 STORM SEW TRK 1979 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 06 BUILDING PER. At F- SAC 117-5-, PO 9-11-77 PARK CITY OF EAGAN SEWER SERVICE PERMIT 3795 Pllot Knob Rood PERMIT NO.: - Eagon, MN 55122 DATE: Zortinp: No. of Units: Qwner: Address: Site Address: ' L) 5 rn- ?z ?.?= ?•t -. Plumber: I agree fo eomply wifh fhe City of Eogon Ordinances. By Oate of Insp.: Insp.:_ CITY OF EAGAN 3795 Pilot Kno6 Roed Eagan, MN 65122 Zoning: , ??.00 Cannection Charge: Account Deposit: Permit Fee: - ' i Surchurge: - - Misc. Chorges: - Total: - Dote Paid: WATER SERVICE PERMIT PERMIT NO.: DATE: ' No. of UniYs: No.: Connection Charge: r'' Account Deposit: No.: - Permit Fee; to comDN wiffi !he Ciry of Eegon Surcharge: 1C°?• Misc. Chorges: Totol: - Dote Raid: cITr oF eacnN 3795 Pilot Knob Rood Eagan, MN 55122 Nn 4485 PHONE: 454-8100 BUILDING PERMIT APPLICATION 5 0 Receipt # 7403 $7 ,0 0. ro be used for Sing. Fam Dwlg, d Garg. Date Se ptember 13, , lq 7) Site Address 4305 Orion Ln _ Erecr PS Occupancy I Lot-1 Block 1 5ec/Su6. Wildemess PSrk qlter ? Zoning _ Rl II Repair ? Fire Zone 3 _ Porcel # Enlarge ? Type of Const. V s Name St8n1eV O1SOA Move ? # Stories Z 3 Address Demolish ? Front 62 ft. ? City Phone Gmde ? Depfh 52 ft. p Name ••° ""` •• oV Address 4701 W 0 h St u? r:«.. Mols oti- 884-5144 Name _ Address I hereby acknowledge thot I have 9ead t s application and the information is correct and a re o e6m allState of Minnesota Statutes and y4y of E an r}gd( Of?ermitYetr--? Signature A Building Permit is issued to: all work sholl be done in acco Fees Assessment - Water & Sew. Police _ Fire Eng. Planner - Council _ Bldg. Off. _ APC Permit 1//.UU _ Surcharge 37250 Plan theck sAC 475.00 0 Woter Conn. 230.0 WaterMeter 60.00 Toral 979.50 on the express condition thot $tatutes and City of Eagon Ordinances. Building Ofticicl This request vaid 18 months from W o7 7s/ Da? of t$is'i2equest 10 -(,Q-?? P 14 808 I, as 09 Iacenscd Electrical Contractor ? Owner, do hexeby request inspection of the above electri- cal wiring installed at: Street Address or Route No. 445z City rv 3`ection TownsMp Range County OD Which is occupied.by .)Q??CV 7-'2-CC"6-3J L?'72A.Uz.c.tC,(! t.o-iaJ (Name of Oc<u0anq Is a roughin inspection required on this job? No ? Yes M Ready Now ? Will Catl {$I PowerSupplier ZI"o-ta„ &e? QAa? ddress8a! 3/2J • A-'e.ne-c"f?c Electrical Contractor Contractor's License No 3 3d'S (Co fran Name) / -ik ?iE • ?tlo JC6-?( fi ?,Qcra-ywc,?a.e9 t-x . 551/.?,O Mailing Address Yo Z o 9, 4 (EleGtrital ContlaGtor of Ownel Making Thl nstallatlon) AuthorizedSignatureKe.ri Soren5a,1 PhoneNo.S'S?-4{'4ZC (Etectrical Contractor or Owner Making This Installatlon) STAU BOaRD COPY Minnesota State Board of Electricity 11109,ar'University Ave., St. Paul, Minn. 55104-Phone 645-7703 REQUEST FOR ELECTRICAL INSPECTION CHh iC.SF-kOW WORK COVERED BY THIS REQUEST 14808 Type of Building New Add. Rep. Chetk Appliances W¢ed For Chec& uipment Wirod Foc Home ? ? Range Temporary Wving 11 Duplex ? ? ? Watec Heatet ? Lighting Fixturea 11 Apt. Bldg. ? ? ? Dryer ? Elecuic Heating ? Commercial Bidg. ? ? ? Fumace B? Silo Unloadei ? Industriai Bldg. ? 0 ? A'v Conditioner - ? Bulk Milk Tank ? Fazm ? ? g? List L ist Other _ ? ?•• °? p Heiel$f p Heie13? COMPUTE INSPECTION FEE BELOW Semice Ennvwe Size: # Fce Feedecs!&Su bfeedera• Fee Cucuits: ? Fee 0 to 100 Am . 0 to 30 Am re ? 0 to 30 Am eres 101 to 200 Amps. 31 to 100 Ampere'?` ?? / 31 to 100 Am eces Abave 200 Amps. Above 100 ?..Amps`. :? ° Above lOD Am s. Transformers Remote ntrolC'ua Pactialorotherfee Signs Spec' tn cKup Minimum fee $5.00 Remazks TOTAL FEE I, the Electrical Inspector, hereby certif t at the ?bo4?e ihspec n has been made. ?_ oG (Rough-in) I ., Date , u --r (Final) IN Date This request void 18 months from ' ? ,... v 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephoue # 651-675-5675 Please camplete foe. single family dwellings & townhomes/condos when permits are required for cach unit Date SiteAddress y209r 64? o%.v ?V,,,._J Unit# V Property Owner ?? ,?p?, ) .?? ??i.?„ /,,,? P.,• Telephone #( 6S/ ) y? ?- 937? Contractor Q ? ? yy? ` ??oa ? ? ?° 2 Street Address yl3 / .f ,.,Q ? - •/%r+c..u« ,. tY `? -6^ State -)17NJ Zip SS/],Z Telephone# (6S/ ) 89y l,pu Bond #: Expires: The Applicant is _ Owner _.k' Contractor _ Other Add-on o alteration existing dwelling unit $ 30.00 ? f l Additi ent R l urnace ona _ _ ep acem ' air exchanger airconditioner _New _Replacement other State Surcharge $ .50 Total $ 26 '5-0 I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; 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 ? etz.. TA () l•=1'Z 1 _ , /?zc.?• Applicant's Printed Name Applicant's ` ignature - ? 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City OfEagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. commerciai/industrial buildings . multi-family buildings when separate permi[s are not mquired for each dwelling unit •' . . % Date Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone H ( ) Contractor h Street Address City State Zip Telephone # ( '' ) Bond #: Expires: The Applicant is _ Owner _ Contractor _ Other Work Type _ New Construction _ Underground Tank _ Install _Remove'*see below _ Interior Improvement _ Install Piping _ Processed _Gas Nature ofWork: •*When installing/removing underground tank, call for inspection by Fire Marshal and Plumbinq Inspector P¢I'mif F¢¢S: $70.50 Underground tank instullatioNremoval $50.50 Mittrmum (incluJes Sla[e Surcharge) : or Contract Value $ x 1% _ $ Permit Fee • If ep rmit fee is $1,000 or less, add $.50 => $ State Surcharge If eo rmit Fee is over $1,000, add $.50 for every $1,000 ermit fee $ Totai Fee 1 hereby appty for a Commercial Mechanical 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 with the Mechanical Codes; that [ 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 ofwork which requires a review and approval ofplans. ApplicanYs Printed Name ApplicanYs Signature Approved By: , Inspector /D gya,5l o?? f ? DATE ? /? ~ ? •? BUILDING PERMST APPLICATION Include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations. To be used Eor t 5ite Ad ess: Lot ? Block Sec./Sub. Adcl2ess cValuation ?7foo2 = ?305 .,.,,pQIDn ,.. Owner,-?YT?1/u'? ?Y a C? G S v n? Parcel Nwnber ZI/L /?EfPN?sS P?` ?K /'0L n? Telephone Contractor , Y/?,vj ?E%t-RS&?n/ (701?5&' Addresa ?120 i iz/ iY Pc s', 7 Arch./Eng. Address 1 ? / Telephone PA "" Telephone DFFICB USE ErecL Alter Repair Enlarqe Mve rienolish Grade OFFICE USE Mte of ApProval & Initial Assessment }-%3 - 77 - ? ? Ftater/Sewer. Police Fire Eng. Planner Oouncil Bldq. ofP. A.P.C. FEES s? Perait Surcharge Plan Check SAC 475 ?2d GTdtez Conn. 411?0. i')n t•Iater Meter (c/InL' .?- TOTAL Occupancy 2oning Fire Zone 3 Type of Const. ? # of Stories Front Oepth ? L? Certificate for: 719venO Peterson 4701 tdest- ll Ah St. Bloomin.gton, P^inn. 55437 ? DELMAR H. SCHWANZ LANDSUpVEYOR Registerap VnGer Laws o( The S[ale ol MiOnesota 14515 SOVTH ROBERT TRAIL P.O. BOX M ROSEMOUNT, MINNESOTA 55088 SURVEYOR'S CERTIFICATE r ?! I Bk. 23/12j'?q`b PHONE 612 423•1769 O ?og0 99.00 N89°55'43E N63A59 30 ? io I N ? 3 35.0 m -00 LOT I ° o o - o Z 025.6T ?A r' I SCALF: i Sizcn -- 4) f'c?et z ? o / ?j 33 ? 0 m O o PRO?SEO/ M o p HoUs/-? Drainagu o? t - ?' & atilityl . ' 32.0 O . E?/ilit d 130.00 N89°55'43"E I 30 hereby Certify that thio irt a true and corPC= +. repreG3nt;ition oi Lot 1, Dlock 1, LdIE,DERNFS5 PAI-'.K SFl;OND A)DTTI?)A: Dakota Coant?i, ?•tinneaota. Plat not yet recoraed Alao ctzowin; the 2ocation of a proposed hou.ce atakc;d thercon. Ao surveyed by me this lOth day of Auguot, 1;77. MINNESOTA REGISTR/YfION NO 8625 ?;•r:;<\t.x,::;r: k:k:1(YF?:ht:?'!Y,cxy;??k:i<,?(?f,.?.W?<X>X7X:;'ik.:F'M?'.%n;t?a;.?tY(.:?F:1?)::?( C1T4 OG Et°d'Aiv i.';ARh!.i:ER° 5 ..f.I:iiNiLi\1AL. NO2 2!50 L'FT.?:: 1GJOr}/`;t,:, _f(.Mf:.; 0r1904 1D ;: ryt,M=::: aoiaN :i ,-uHr=i._r:; :...,i.(l 9001 r i I..F1 , ,i:=. A:i(1'.5 Cil;,:i.•.JA. N?_ ,.. r4„M, - f • l_??. 'I,„"i[) c"':;... ?)f;Ci:!. :.2n.°:, C;,t].Ot? Am+:,::. I 7:`'1;;9.1. I:'{e[`21P'r `i1'nrHl'fli:... +6•0; s%i:1.1656i_'.Ci . US!?'rt iDc i,±„,ivCY CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMITTYPE: euxLozNs Permit Number: 0 2 9 0 0 7 Date Issued: 19 / 0 7 J 9 6 SITE ADDRESS: P.I.N.: 10-84251-010-01 DESCRIPTION: SF (MISC.) REPAIR 434 ALT. RESZDENTIAL _ V. ¢`? s' S ? 4+? ? ? ?y?', ??' ? G L? ? Z ? ? !"E'(.e ? ? 1 Y•: 4305 ORION LANE LOT: 1 BLOCK: 1 WILpERNESS PARK 2ND (ROOFING) B[i=1ldii5`q Permit Type ,Buil:ding, WiRIk 7ype w?Cens:us G;ode • 'd t` ' Y?? G? #+.n'? . ? REN9ARKS FEE $UMMARY: VALUATION $3,080 Base Fee $74.75 Surcharge $1.50 Total Fee $76.25 CONTRACTOR: - Applicant - ST. LIC OWNER: CEN'fURY ROOFING 18692767 2003417 MCKENNA GARY 6336 LYNDALE AVE S 4305 ORION LN RIC{iFIELD MN 55423 EAGAN MN (612) 869-2767 (612)686-9031 ? I hereby acknowledge that I have rea-d th3,s, application and state that the ? ihto?^matYon-3s correet ani7 a:gt^ee tcs comply.with a11 applicab1Q State of Mn. Statutes and City of Eagan Qrdinances. rt m 1-1161. APPLICAN7 ERMIGNATURE -?? ? SIG?AT? ? ????- £ I CITY OF EAGAN ? 3830 PILOT KNOB RD - 55122 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-d675 RemodeVRegair Reauirements ? 3 registered afte surveys ? 2 copies of plans (inWude beam 8 windav sizes; poured tnd. design; elc.) ? 1 energy calculations ? 3 coples of tree preservation plan H lot platled aRer 7H193 required: `Yes _ No DATE: Id -' ? - ?6 CC DESCRIPTION OF WORK: Jlk ?. STREET ADDRESS: LOT BLOCK ?? -'L'J PROPERTY owNeR CONTRACTOR ARCHITECT/ EhGfNEER D44!? /6/U SUBD./P.I.D. #: CosT: 4aq3a ° ? Name: ? C ?PAv-UA? ?t h ?? Phone #: "-' rwe Street Address: uf U-'v 44"t? City: State: Zip: Company: PnJ % Phone #: V6 7 Street Address: rv ? license City: State: zV?Q Zip: Company: Name: _ Street Adi Ciry: _ $ "I? •h'? ? 2 copies of plan ? 2 site surveys (exterior addBions d decks) ? 1 energy calculations for heated addilions Phone #: Registration State: Sewer 8 water licensed plumber: change are requested once permit is issued. Zip: Penalty applies when address change and lot I herehy acknowledge that I have read this appfication and state that the information is correct and agree to comply with all applicable SWte of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: > r 4? r OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received Yes No OFFICE USE ONLY BUILDING PERMIT TYPE ? M%' F !.'sA Y?.. 4 ,"g, w ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish 0 02 SF Dweiling o 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool ? 03 SF Addition ? OS 8-plex ? 13 Garage/Accessory o 20 Public Facility 0 04 SF Porch o 09 12-plex ? 14 Fireplace ? 21 Miscellaneous a 05 SF Misc. ? 10 _ plex o 15 Deck WORK TYPE n 31 New ? 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories length Depth APPROVALS Planning Permit Fee Surcharge Plan Review License MCNVS 5AC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SNV Surcharge Treatment PI. Road Unit Park Ded, Trails Ded. Other Copies Total: _ Basement sq. ft. MCNVS System _ Main level sq. ft. City Water _ sq. ft. Fire Sprinkfered _ sq. ft. PRV _ sq. ft. Booster Pump _ sq. ft. Census Code. _ Footprint sq. ft. SAC Code Census Bldg Census Unit Building Engineering Variance Valuation: $ °k SAC SAC Units - CITY USE ONLY J LOT ? BL ? q RECEIPT #: SUBD. L(JA.OlX./(/NX.Oi1J C)?oRECEIPT DATE: 1997 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PII,OT KNOB RD EAGAN MN 55122 Date: (612) 681-4675 Complete this section onlv if vou are installins! HVAC in single familv, townhome, or condos that are under construction and are not owner /occupied. + HVAC: 0••100 M B T ti $ 24.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets ( minimum of one required @$3.00 ea.) • State Surcharge: .50 • TOTAL: Complete this section onlv if vou are remodeling, addine to, or repairiae eaistine sinfEle familv dwellings, townhomes, or condos. _LZAdd-on furnace _ Add on air conditioning _ Add-on air exchanger, i.e. Vanee system, etc. _ Other Minimum fee applies to all remodel or add-ons of existing residences $ 20.00 State Surcharge 50 Total: 20.50 siTEnnnREss: ?l.38 ?r Q00/0 612?/ OWNER NAME: (O #F(/ 111d'C/1110/U PHONE #: INSTALLERNAME: A11111e PHONE #: STREE CITY: )0 cm use oNLv L BL SUBD. RECEIPT#: RECEIPT DATE: 1997 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612)681r4675 Please complete for. DATE: COiV i RACT FRICc: WORK TYPE: _ NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: > $25.00 minimum fee pr 1°k of contract price, whichever is greater. w Processed piping - $25.00 ? State surcharge of $.50 per $1,000 of pgMd fee due on all pertnits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL SITE ADDRESS: OWNER NAME: TELEPHONE #: TENANT NAME: (IMPROVEAAENTS ONL`n INSTALLER: ADDRESS: CITY: STATE: ZIP: PHONE #: SIGNATURE: SIGNATURE OF PERMITTEE ? all commerciaUndustrial buiidings. . multi--family buiidings when separate pemdts are nM required tor each dwelling unit. CITY INSPECTOR -? Use BLUE or BLACK Ink I For office Use of ; Permit Ny f Eap I as i Permit Fee: 3830 Pilot Knob (toad Sagan MN 55122 Date Received: Phone: (651) 675-5675 I i Fax: (651) 675-5694 1 Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: unit s: E Name: - tD a- K 5 l,~a KC e is kita ane: G 71 Resident/ f Owner Address / City / Zip: d n I C). L A". -t Applicant Is: Owner contractor Type of Work Description of work: K-C ®o ° ,14o i -P Construction Cost: Mufti-Family Building: (Yes ! No Company: 1AR0 U 1510" 4- - Contact: 122:f Contractor Address: ~XAJM'r+y~_S: wg, _ City: 15' A r State: h-UN_ Zip: 47, 0-/ , '3 Phone: 1 ' <13" i-x - 7 License Q L 2 !6'1 Lead Certificate M If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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 nonpublic if you provide specific masons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 4644043 for protection against underground utility damage. Can 48 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.ora 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 riot 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 M accordance with the Minnesota state Building Code must be completed within 184 days of permit issuance. x m -t I f p-.t4~e -t x Applicant's Printed Name Applicants Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA133029 Date Issued:09/17/2015 Permit Category:ePermit Site Address: 4305 Orion Lane Lot:001 Block: 001 Addition: Wilderness Park 2nd PID:10-84251-01-010 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 - John Schaffenberger 4305 Orion Lane Eagan MN 55123 (651) 456-9378 Window Store Home Improvements 2924 Anthony Lane #115 St Anthony MN 55418 (612) 353-5780 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink � r----------------- I For Office Use � I � Q � � Clt Of �� Il ; Permit#: I � 1/ I /,,, G� � J b � Permit Fee: �✓� � 3830 Pilot Knob Road � I Eagan MN 55122 � Date Received: j Phone: (651)675-5675 � � Fa�c: (651) 675-5694 I Staff: I �-----------------� . 2015 RESIDEIVTIAL PLUMBING PERMIT APPLICATION �ate: �l ��-- 1 � s�te aadress:_ C(�d 5 (�d-r�� L�,G� � `� �ar��, 1�,2�� 6`�1�� , `,� /� �('�-_ Tenant: ��,�1 �, �c-/At^,,� �7'G��G� �U ' ��GC.G2�1't'��t.�'U—c�l2..U'^ �/ Suite#: Name: ��i,G�. C� + � /�G�-.r `��-�"l �'I� �c��-��ti_��'`'�+�-�.e�'_ #tesid�ntlt�wner Phone:_t s7 ys� � �-�7S1 Address/City/Zip:__�� nt�(c� ��-�. `� ��c�'-t Gt� ��v J s ��,..� �f / < Name: �'h,v�E� � �(�l�r ,FJ�`G�.� License#: COttti'�CtOY Address: City: j��G'�- �'"`�s State: G�� Zip: Phone: Contact: Email: T�/�e 0�1NOt'k —New �Replacement _Repair _Rebuild _Modify Space _Work in R.O.W. � < < � . Description of work: tt-e. ��'- �-�E'c��lC:- ��r � c�S G�t�,`ff'c�'��'�E'l�' > RESIDENTIAL �Water Heater � Water Softener Lawn Irrigation(_RPZ/_PVB) ��pe Add Plumbing Fixtures�Main/ Lower Level) Septic System — New Water Tumaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment, Water Turnaround'`(includes State Surcharge) "'Water Turnaround(add$210.00 if a 5/8"meter is required) $115.00 Septic Svstem New(includes County fee and State Surcharge) / � L�t% TOTAL FEES$ �`� � CALL BEFORE YOU DIG. Call Gopher State One Call at(651)4540002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. � x C��-�t`�� -�i�c.`��i�i'J`c�" X .��'��L.., ��'-� ' Applicant's Printed Name Applicant's Signature FOR OFflCE USE' Reviewed By: Date: Required lnspections: Under Ground Rough-In Air Tes#" Gas Test �inal Meter Relafed Items. ` Meter Size Radio Read Manometer Staff: PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA140852 Date Issued:01/26/2017 Permit Category:ePermit Site Address: 4305 Orion Lane Lot:001 Block: 001 Addition: Wilderness Park 2nd PID:10-84251-01-010 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace 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 - John Schaffenberger 4305 Orion Lane Eagan MN 55123 Dean's Professional Plumbing 7400 Kirkwood Court N Maple Grove MN 55369 (763) 428-1321 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA143427 Date Issued:06/15/2017 Permit Category:ePermit Site Address: 4305 Orion Lane Lot:001 Block: 001 Addition: Wilderness Park 2nd PID:10-84251-01-010 Use: Description: Sub Type:Residential Work Type:Replace Description: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 - John Schaffenberger 4305 Orion Lane Eagan MN 55123 (651) 456-9378 Dean's Professional Plumbing 7400 Kirkwood Court N Maple Grove MN 55369 (763) 428-1321 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA158214 Date Issued:10/01/2019 Permit Category:ePermit Site Address: 4305 Orion Lane Lot:001 Block: 001 Addition: Wilderness Park 2nd PID:10-84251-01-010 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door 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 Fee Summary:BL - Base Fee $1500 $62.50 0801.4085 Surcharge - Based on Valuation $1500 $0.75 9001.2195 $63.25 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 - John Schaffenberger 4305 Orion Lane Eagan MN 55123 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA174447 Date Issued:01/27/2022 Permit Category:ePermit Site Address: 4305 Orion Lane Lot:001 Block: 001 Addition: Wilderness Park 2nd PID:10-84251-01-010 Use: Description: Sub Type:Furnace Work Type:Replace Description: Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 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 - John & Kathy Schaffenberger 4305 Orion Ln Eagan MN 55123--185 (651) 456-9378 Controlled Air 21210 Eaton Ave Farmington MN 55024 (651) 460-6022 X253 Applicant/Permitee: Signature Issued By: Signature