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2019 Shale LaneCITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT To be used for : T TASC IA Est. Value $3,000 Site Address 114.19 SHAD LN Lot 27 Block 1 Sec/Sub. CEPAx GROVE 4TH Parcel No. W Name CORD' BARUN 3 Address 2019 SHALE LN ° City "GAN Phone 452-0426 o Name AMRL+ INC ZOV Address 3700 ANNAPO LIS LN 0°-` CitV PLYHOUTH Phone 553-0020 Name Address 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 Permit is issued to: ^^? + 1944- on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official % Its 1X- a? :` 16323 Receipt # DateAPR 20 1989 OFFICE USE ONLY Occupancy FEES Zoning (Actual) Const Bldg. Permit 54+0t: (Allowable) Surcharge 1.50 # of Stories Length 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 Water PRV Required S/W Permit Booster Pump S,,W Surcharge Treatment PI APPROVALS Road Unit Planner Park Ded. Council Bldg. Off. Copies 55 St Variance - TOTAL Permit No. Permit Holder Date Telephone # WATER SEWER PLUMBING H.V,A.C. ELECTRIC Inspection Date Insp. Comments Footings l Foundation Framing Roofing Rough Plbg. Rough Htg. [Sul. Fireplace Final Htg. Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final I. Deck Ftg. Deck Final Well Pr. Oisp. CITY OF EAGAN Remarks * Cedar Grove Acquisition Addition CEDAR GROVE #4 Lot 27 Blk 1 Patce4 10 16703 270 01 Owner Street 2019 Shale Lane State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK * SEWER LATERAL 1972 1,304.00 52.16 25 Paid WATERMAIN * WATER LATERAL 1972 WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK EAGAN TOWNSHIP N° 920 BUILDING -PERMIT Owner .__L..?- ?- "-r"J'r_ ------ &I--. - -gan Township Address Town. Hall Builder ...__- ......... ' .44. U-l"A------------------- ...... . Address .:..-. _ ..-,te ............... ......... ......................... --......... ----- ----- - -------_ .......... DESCRIPTION - Stories To Be Used For Front Depth Height Est. Cost Permit Fee Remarks LOCATION Street, Road or other Description of Location ..f?? of Block _ Addition or Tract 3 / This permit does not authorize the use of streets, roads, alleys or sidewalks nor does if give the owner or his. agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the communify. THIS PERMIT MUST BE K?EP?T ON /THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that?g5-4.4-ccC? r.&2_-. -x...__...._. has permission- 20 erect, aL ?_:.; `". -_ `'J_-,..upon the above described premise subject to the provisions of the Building Ordinance for Eagan ownship adopted April 11, 1955. ....:...........-.......^lC!?ci?..`..Y..'............ Per ..._-.-.. g2-?_- . Chairman of Town_oald Suildin Ins ector CITY OF EAGAN N9 16323 • '? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 ?- C LG C BUILDING PERMIT Receipt # COVER $3 000 To be used for SOFFIT FASCIA Est. Value Date APR 20 1989 Site Address 2019 SHALE LN OFFICE USE ONLY Lot 27 Block I Sec/Sub. CEDAR 6ROVR 4TH Parcel No. Occupancy FEES Zoning M Name CORY BARUM (Actual) Const Bldg. Permit 54.00 3 Address 2019 SHALE LN (Allowable) 1.50 h S ° City EAGAN Phone 452-0426 # of Stories urc arge - Plan Review Length o Name AMRE. INC Depth SAC City uQ Address 3700 ANNAPOLIS LN S.F.Total , - SAC, MCWCC City PLYMOUTH Phone 553-0020 S.F. Footprints Water Conn On Site Sewage ww Name On Site Well Water Meter w x? Address Mwccsystem - o° Acct Deposit aw City Phone City Water S1W Permit PRV Required I hereby acknowlege that 1 have read this applicalion and state that the Booster Pump S1W Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan O limnC $ § / Treatment PI / / ,?-( ? l lv I? APPROVALS Signature of Permitee Road Unit A Building Permit is issued to: Planner Park Ded. on the express condition that all work shall be done in accordance with all Council - applicable State of Minnesota Statutes and C Eagan Ordinances. iity of Bldg. OH. Copies J ° Building Official 11(tt,T .Vj (?. I t11./1 Variance TOTAL 55.50 gUDO '11' k otEatan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-W6 Fax: (651) 675-UN J ?50aS ---------------^I I r i Point ?'ry0/???-i//1??o1 Penk Fee: 1 I 1 ? Date Received: I ? I I I 1 stafF. i -------------- 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date D-? D site Address: f9 I °l Sk9L° l? t n P suite # Tenant: I a =moo - 3?as a ' AT121cK Phone: (D RESIDENT I OWNER Name: Address 1 City i Zip: App MA is: _ Owner Contractor TYPE OF WORK Description of wodc :L f2 OFF f ? a3 Construction Cost: qd , aU Multi•Family Building: (Yes_/ NoK CONTRACTOR License Address: - f r r MY: Flllt? ? Staw:fy\w_Zip: S5082 Phone: lr?1 y %?-Contact Person: ICt?(?PYI COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Min to Rules 7670 CatooorY_1 _ MinnPents? Rules 7672 Energy Code • Residential Ventilation.Categofy h worksheet • New Energy Cade woAnheet Category Submitted submitted (4 submission type) • EneW Ernvelope CakWadoes Submitted In the last 12 months, has the City of Eagan Issued a Permit for a Similar Plan based on a master PBan? _Yes _No it yes, date and address of master plan: Licensed Plumber: Photo: Mechanical Contractor. Phone: sewer & Water Contractor 11.. i hereby sciuwwiedge that tide Imomlation is completeand acourara; that the work wig be in comormanGB with the ordinances and Codes r# Ste MY of aVan; that I undmsland this is not a pornIt but only an application for a Pem+a, arld work is not to:siart without a permit; Shat Oro work wE be in aocordartce wM the approved plan in the one of work which requires a review and Wpr?oval of plane. . VY\ x C??1MLlC xU'\ Applicant's Printed Nance Applicant's Signature Page 1 of 3 ,;x'y.wM CITY OF I:'AGAN t APHIEW 39 TEi.E2filNAL P•`0a 690 DATEn 0"/23!99 'iTME: 09:09YEL3 1;; P-'AiME.. MERRTI_!: Ni: C. JE:f:'SEN 9210 9001 200 `--.iHrJ...,: LA i25 "(Tli R05,9001 200 AHWE L?,,' 3.01 CR;.i.":'3 9 USE? ID: JAN 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651.681-4675 New Construction Reaulrements Remodel/Repair Reaulrements D 3 registered site surveys showing sq. R, of lot, sq. it. of house 2 copies of plan and all roofed areas (20% maximum lot coverage allowed) 1 set of energy calculations for heated additions D 2 copies of plans (show beam & window sizes; poured fnd. design; etc.) 1 site survey for exterior additions S. decks ? 1 set of energy calculations D 3 copies of tree preservation plan R lot plaited after 7/1193 DATE: C/,9 CONSTRUCTION COST: na DESCRIPTION OF WORK: T'c4Q ,SFr - 1eE12001C:!' STREET ADDRESS: 1240/ pZla/e LOT. _a BLOCK: SUBD./P.I.D. #: (Air nv'6 PROPERTY OWNER Name: Gro& JDer1 h l s q*, Phone Last First Sheet Address: 00I61 3ho)6 W. City 4K--1 State:Zip:7 7 7 CONTRACTOR Street City ARCHITECT/ ENGINEER Comp Telephone #: area code ( ) Phone #: (area code) License # State: Zip: Name: Streei Address: Registration #: City State: Sewer L water licensed plumber (required for new construction only Penalty applies when address change and lot change Is requested once permit Is Issued. Zip: 1 hereby acknowledge that I have read this application, state that the Information Is correct, and agr to comply with all applcabt State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: / OFFICE USE ONLY Certificates of Survey Received Yes No SEP 2 2 is Tree Preservation Plan Received _ Yes _ No _ Not Required 0 OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-pfex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-pfex ? 12 12-pfex ? 17 Garage ? 22 Porch/Addn. (4-sea. ? 03 1 of _ pfex ? 08 6-pfex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-pfex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-pfex ? 10 8-pfex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE ? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair ? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof * Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning Basement sq. ft. Main level sq. ft. sq, ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Engineering Census Code SAC Code No. of Units No. of Bldgs MC/ES System City Water Booster Pump PRV Fire Sprinklered Variance Permit Fee Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Park Ded. Trails Ded. Other Copies Total: Valuation: $ i SAC Units % SAC 1989 BUILDING PERMIT APPLICATION - CITY OF EAGAN 41.3 SINGLE FAMILY DWELLINGS 1 (*.3 INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS 0 OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS /0 94 To Be Used For: cG? //61?0//CL Valuation: Date: Site Address Lot Z? Block Parcel/Sub CeT)Ak CsR.OU79 L41rH Owner Su L D Address /L wle- City/Zip Co11de?? G Q 2/ /c. /'?' z Phone Y?Z ' ®YC?C?v Contractor ?2 Q?u? Address (Z i ?D0 yzlt City/Zip Code Phone c-?.o ee'zo Arch./Engr. Address City/Zip Code Phone S 3ooc- Occupancy Zoning Actual Const Allowable # of stories Length Depth S.F. Total Footprint S.F. On site sewage On site well MWCC System _ City water PRV required Booster Pump APPROVALS Planner Council Bldg. Off. Variance Council USE FEES Bldg. Permit 541, 00 Surcharge J,a Plan Review SAC, City SAC, MWCC Water Conn Water Meter Acet. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Copies TOTAL d 702ro NOTE: Sewer & Water Permit fees and account deposit fees will be included in the building permit fee. Processing time for sewer and water permits is two days once a licensed plumber has applied for a permit at City Hall. City of EaQall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit Fee: Date Received: ?r- ov Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: / r// —70 Site Address: 00/% �Lw /t /» � � �.� ss --41? Tenant: RI k Suite #: J RESIDENT / OWNER Name: Pei. /-61‘ 'C k A k, Ns Address/City/Zip: 020/9 sL<-1e Applicant is: / ` Owner Contractor Phone: Zr7/i2 *90- 3`// 5 IA) FSA"/ M Al 5— /.2-. TYPE OF WORK Description of work: Construction Cost: Multi -Family Building: (Yes / No ) CONTRACTOR Name: License #: Address: City: State: Zip: Phone: Contact: Email: 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: OTE: Plans and supporting documents that you submit are considered to be public information. Portions of e information maybe classified as non -...public, if you provide specific reasons that would permit the City to. conclude that they;are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www. gopherstateonecall.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. Applicant's Printed Name Applicant's Signature Page 1 of 2 Use BLUE or BLACK Ink/� h r For Office Use �i Permit#. `1 City Of l Eaaall Permit Fee: 2A 2 13--?.2-(? 3830 Pilot Knob Road ,` ;; �I Eagan MN 55122 Date Received: ' 11 '11 Phone: (651)675-5675 Fax: (651)675-5694 Staff: 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: % APO,/ Site Address: a o\ci 'Hit\t...C_ LAP-) Unit#: IName ' '�Q.-1<V`J IMC'.S ,.,.l.C.. a mx Phone: Co'5k .33 -13x51 Resident/ Owner I Address/City/Zip: ki, f::::. swx-ixiI 0,,A.0^LE. E.9,4.21:kt•J M.k3 551-'a _ ; Applicant is: Owner X. Contractor __ Type of Work Description of work: 11•V�CkkTc,..A) tgSNIIV ..t \ Pi't&.S IIN1, RED L. L k EL k YP tt.�1 a a op' w6 o LnwE _LE TE.L. r:.l�+►bfl - �m.,� _ y Ny N1 Construction Cost: `aC)0 t OOU Multi Family Building: (Yes /No X ) I Company: t\1Gr1kE. . C4m,1 E.L. tO*J Contact: `M1 ,ja, 1..A____ ,,,tlt._ Contractor I Address: -c v c�`L� t%A 1' tOfJ 0.---T. City: . L�kt—E %EMI._ State: I'\ Zip: $bW3 Phone:L5 k ^a`1 a•'w i 7mail: W‘Uty C� ate(03t�01 h1L-1 CC License#: dC..��0 Ci an Lead Certificate#: O P�V- V t'1\ac...--s-‘ If the project is exempt from lead certification, please explain why: \Z-.' 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? 1, Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they ere trade secrets , CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. Applicant's Printed Name Applic nt's Signat (Y/39/e..r."------ Page 1 of 3 DO NOT WRITE BELOW THIS LINE / jl SUB TYPES .20/y S/t u - 4/4 Foundation Fireplace _ Porch(3-Season) Exterior Alteration (Single Family) Single Family Garage Porch (4-Season) Exterior Alteration (Multi) Multi Deck Porch (Screen/Gazebo/Pergola) Miscellaneous 01 of Plex Lower Level Pool Accessory Building WORK TYPES New Interior Improvement Siding Demolish Building* Addition Move Building Reroof — Demolish Interior Alteration Fire Repair Windows Demolish Foundation Replace Repair Egress Window Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation I 000 Occupancy ovi,,it MCES System Plan Review Code Edition 1) Is7 SAC Units (25%_ 100% ) ) Zoning /i2 _ City Water Census Code . • Stories �_ `�� Booster Pump #of Units Square Feet ' PRV #of Buildings Length Fire Suppression Required Type of Construction 1005Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings(Deck) ' Final/ C.O. Required Footings (Addition) X Final I No C.O. Required Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Roof: Ice &Water _Final Pool:_Footings _Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace: _Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall: _Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression: Rough In_Final Braced Walls Erosion Control O Shower Pan Other: (7 Reviewed By: 2' , Building Inspector RESIDENTIAL FEES Base Fee 14 '</ ! + r 1 J" Surcharge ik_4,1-1.41- 1 l Plan Review 14 1 riv " MCES SAC 't { City SAC (3 t ' r f Utility Connection Charge S&W Permit&Surcharge elF , Treatment 1 i a1 i € f /— Copies s-�°- TOTAL - } f Page2of3 Use BLUE or BLACK Ink ,- For Office Use 1 /AII \N. City of Eaaall :::: / �j 0,. (/�v 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 Staff: Fax: (651) 675-5694 L. 17 RESIDENTIAL�jPLUMBIN PERMIT APPLICATION Date: 7 Site Address: 2C/ i/e ,1 4) Tenant: Suite#: Resident/OwnerName: �' ,cif/ Phone: t Address/City/Zip: li Name: / jr'�'( _ YEA- � � ceut';e#: ContractorAddressL59 ' C P City: 1 ��u� , State: / Zip: Pho -• .�75 AOa Contact �lil� A /� ,_ l.�� P.P/PGS ' (l l L�'.v7 Erna' Type of Work —New ,— Replacement °�Repair build _Modify Space _Work in R.O.W. Description of work r '>'�L(� 21cc RESIDENTIAL v --,. , . .) i 0 6-- ,/-71.6 d'1,7-.._./)`'1 . 4 , Water Heater Water Softener 1 Lawn Irrigation ( RPZ/_PVB) rn Rerl Type 1 Septic System Add Plumbing Fixtures( Main/_Lower Level) I I Water Turnaround _New Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) 1 $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround*(includes State Surcharge) *Water Turnaround (add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowle' a 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 un rstand this i not a permit, but only an application for a permit, and work is n• • start without a permit; that the work will be in accordance wi the ap. .�v-: an in the case • work which requi es a review and approval of is_ iA x Appli, s - ` Appl- s Sig,.::flt.� FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In AirTest Gas Test ' Final Meter Related Items: Meter Size Radio Read Manometer Staff