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2023 Shale Lane .; «+? PERMIT # MECHANICAL PERMIT RECEIPT # T' J AN CITY OF EAG 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Ad ress '^ ? ?: '` WOLT r-ANj BLDG. TYPE WORK DESCRIPTION Lot_ Block Sec Su / b Res. New Name Mult Add-on °-' m Address Comm. Repair S City Phone ' Other c Name i FEES RES. HVAC 0-100 M BTU -$24.00 Address ADDITIONAL 50 M BTU - 6.00 p City Phone' (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PEktrA1T) - 1 50 EA TYPE OF WORK . . COMM/IND FEE - 1% OF CONTRACT FEE Forced Air M BTU APT BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU $ MINIMUM RESIDENTIAL FEE - ALL ADD-ON & 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: S / C: ?4GiNIA U 171 E TOTAL: FO , CITY OF EAGAN CITY OF EAGAN Lot t C ICt I f 1 Stree 2023 Shale Lane State Eagan. MN 55122 lei; r)ap. f;f U i ?i6n1 1. err -l - Improvement Date Amount r r Annual Years 1 Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK SEWER LATERAL (,f 1972 1,304.00 , a WATERMAIN * WATER LATERAL 1972 WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: i',tl l ! rtF?i PERMIT SUBTYPE: INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: 1, H ' 8 ? y 11 t ,,, , APPLICANT: TYPE OF WORK: I':1 NA.1l INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR. Itr.l,r, r,: ,7 11??rli RE MARK'.: WINDOW- h `r1. 11.11 N1-i lil A S13' DOOR 4 PermitNo. Permit Holder Date Telephone # S/W PLUMBING HVAC ELECTRIC ELECTRIC Inspection Date Inap. Comments Footings I Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. ?? O /yS Fireplace Final Htg. Orsat Test Final Plbg. Plbg. Inspector- Notify Plumber Const. Meter Engr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. 4 BUILDING PERMIT To be used for ID= CITY OF EAGAN `,t3 19988 J -' ... 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 r Receipt # $1,000 JUM Est. Value Date 19 ss ""M"a "".. Site Ad A CRIT OFFICE USE ONLY Lot Block Sec/Sub. Parcel No. Occupancy FEES MICWL & KAM ILl Zoning $25.00 Name (Actual) Const Bldg. Permit - 3 1 Address (Allowable) ? I S cha e . rg ur o City Phone r of stories Plan Review Length Name SAME Depth SAC, City p u i Address S.F. Total W SAC, MC GC City Phone S.F. Footprints - Water Conn On Site Sewage ¢ v Name On Site Well - Water Meter w W Z Address MWCC System Wz MCI C City Phone City Water Acct. Deposit _ SrW Permit PRV Required - t hereby acknowlege that 1 have read this application and state that the Booster Pump - S/W Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and of Eagan Ordinan s. ? Treatment PI J • J / G Signature of Permitee'? r , ' - APPROVALS Road Unit A Building Permit is issued to: 11111 Planner Park Ded. on the express condition that all work shall be done in accordance with all Council -- applicable State of Minnesota Statu s and City of Eagan Ordin1nances. Bldg, Off. Copies $9.5.50. Building Official ?_- ?t Variance TOTAL Permit No. Permit Holder Date Telephone 8 WATER SEWER PLUMBING H.V.A.C. ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Rooting Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. EAGAN TOWNSHIP' ¢s/ BUILDING PERMIT Owner .1V!a.<C_'C._..C,.4cDD?a.?__ -- ...... Address (present) .-. ?-A,'._- Builder ..................- Address ---- .............. _--........ _. DESCRIPTION N° 9'77 Eagan Township Town Hall 5/7 %4:-, Date ......._........_.....-. stories to B e U se d For Front Depth Height t. Cost Ess Permit Fee Remarks y ? ? ' g t. r Street, Road or other 1)escription of Location Lot Bloc Addition or Tract ---- i . -.{-'7-9 02 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 community. - THIS PERMIT MUST BEqI KE??PT??O%THE PREMISE WHILE THE WORK IS IN PROGRESS, This is to certify, that ._?•e[..db _.has permission to erect a.... 16-......___...---------- ,..------ ---------------- upon the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11, 1955. -.- fr- ..:..... _ Per jC -- ?- Chairman of Town Board - Building Inspector EAGAN TOWNSHIP BUILDING PERMIT ._. Owner ..... . !?. L L- ---...--°- ............................ .................'-----'---. -t...... ....... -.... Address (present) Builder .................................................. ...................... _.......__......_.. Address DESCRIPTION N° 1621 Eagan Township Town Hall Date .1/ai-/G..'...........--'------ Stories To Be Used For Front Depth Heigh! Est. Cost ' Permit Fee Remarks A?`? /D?S?i/ 9 !/So 7, J ed 7?i1Y?G7 4 dC,i?+-fl Q A d LOCATION Street, r[oaa or Omer uescnpzton or i ocanon Loz I ntoca I Raclin or Traci IArI1 I Ct '?/ This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safely, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE KEPT O THE PREMISE WHILE THE WORK IS IN PROGRESS. e e, This is to certify, that.....- .. .h.k-Vii ........ ...... hes permission !o erect a .--.. e:_f-........ upon Ea Township adopted pril 11, the above described premise subject ! he proons of the Building Ordinance r- 1955............. %/ _ ? ?`7`- t -e __ ?? ........ . .. ..°{.......U.'_....---'-............. Per ................. ` """F...._. -°"-""""'.... (/ Chair hof Tow Soaarrd Buildin Inspector CITY OF EA GAN ??p 7988 • 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 D?/ ,., q U ?L? BUILDING PERMIT Receipt p To be used for DECK Est. Value $1,000 Date JUNE 11 19 90 Site Address 2023 SHALE LANE OFFICE USE ONLY Lot 28 Block 1 Sec/Sub. GROVE 4 . Parcel No Occupancy FEES . Z i a Name MICHAEL & KAREN HILLBERG on ng (Actual) Consl Bldg. Permit $25.00 Address SAME (Alowable) Surcharge .50 452-7648 City PIIODB # of Stories th Plan Review Leng - m Name SAME Depth SAC, City o u Address S.F. Total MCWCC SAC < , City Phone S.F. Footprints - e Sit S O Water Conn ewag n e ww Name On Site Well Water Mater E _- Address MWCC System - i D u0 Acct. epos t aw City Phone City Water - i ed PRV R SAN Permit r equ I hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge information is correct and agree to comply with all applicable State of yyy of Eagan Ordinances. Minnesota Statutes an d??? C,,,???( Treatment PI QQ QQQ )JJ Signature of Permitee a;Z e 'p &L APPROVALS Road Unit A Building Permit is issued to: MICHAEL & KAR ILLBER Planner Park Ded. on the express condition that all work shall be done in accordance with all Council -. Copies applicable State of Minnesota Statu s and City of E n rdinances. ? l Bldg, 0". $25.50 -d l Building Official s-u Variance TOTAL PERMIT 2!T?OF EAGAN 0 Pllot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT TYPE: BUILDING Permit Number: 0 2 2 3 9 8 Date Issued: 10/28/93 SITE ADDRESS: P.I.N.: 10-16703-280-01 DESCRIPTION: 2023 SHALE LANE .? ?~ LOT: 28 BLOCK: 1 G 1'? D??I CEDAR GROVE 4TH r Building:Permit Type SF (MISC.) ouilding 4q? k Type REPAIR ar REMARKS WINDOWS & SLIDING GLASS DOOR FEE SUMMARY: VALUATION $2,000 Base Fee $45.00 Surcharge $1.00 Total Fee $46.00 CONTRACTOR: OWNER: - "N HILLBERG 2023 SHALE EAGAN (612)452-7648 licant - MICHAEL LN MN 55122 I hereby acknowledge that I have read this information is correct and agree to comply Statutes and City of Eagan Ordinances. APPLICANT/PERMITEE SIGNATURE application and state that the with all applicable State of Mn. -Auo go-4 I &J ISSUED V: SIj3NATURE4 I REACTIVATE _ PERMIT # %. , CITY OF EAGAN 1993 BUILDING PERMIT APPLICATION ?4? OJ 681-4675 SINGLE 3 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy talcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month. in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date Valuation of work y Site Address: STREET SUITE Tenant Name: (commercial only) LOT BLACK SUBD. P.I.D. N Description of work: S The applicant is: Owner Contractor o Other (Describe). - Phone -fig Name e r Property LAST FIRST Owner l ?" :2 3 S4 a Address 0 STREET STE Y j}? SA 2-Z n Zip S on State Cit L? y aq Company Phone Contractor Address License i Exp. City State Zip Company Phone Name Registration i Engineer r Eng Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is State of Minnesota Statutes and City of li bl h ll i ca e t a app correct and agree to comply w Eagan Ordinances. • Signature of Applicant OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 02 SF Dwg. ? 03 SF Addition ? 04 SF Porch ? 05 SF Misc. ? 06 Duplex ? 07 4-Plex ? 08 B-Plex ? 09 12-Plex ? 10 Multi. Add'l WORK TYPE ? 31 New ? 32 Addition ? 33 Alterations ? 34 Repair ? 11 Apt./Lodging ? 12 Multi. Misc. ? 13 Garage/Accessory ? 14 Fireplace ? 15 Deck ? 35 Tenant Finish ? 36 Move ? 16.8asement Finish ? 17 Swim Pool ? IS Loam./Ind. ? 19 Loam./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 37 Demolish GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning ! of Stories Length Depth APPROVALS Planning Engineering REQUIRED INSPECTIONS ? Site ? Wallboard Basement sq. ft. MWCC System 1st F1. sq. ft. City Water 2nd Fl. sq. ft. PRV Required Sq. Ft. total Booster Pump Footprin t Sq. ft. Fire Sprinkler On-site well Census Code On-site sewage SAC Code Building Assessments Variance ? Footing ? Final ? Framing ? Draintile ? Insulation ? Fireplace Permit Fee x[57 o0 Surcharge /, rice Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pg. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units valuation: $F'''c? 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) -J-1 53I New Construction Reauiremenh CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 D 3 registered site surveys showing sq. ft. of lot, sq. ft, of house and gll roofed areas (20% maximum lot coverage allowed) ? 2 copies of plans (show beam b window sizes; poured Ind. design; etc.) ? 1 set of energy calculations D 3 copies of tree preserv on plan R lot platted after 7/1/93 DATE: g( a 7Q 2 Q / DESCRIPTION OF WORK: /Act", o-1f/? qno?(' / STREET ADDRESS: _Z_ 3 _? 4 /? L /I LOT: ? BLOCK: SUBD./P.I.D. #: Name: 17111-1119 P {'Q A'o tv e I Phone #:6 5' &5K5A 26 tl- 9 PROPERTY Last First OWNER 2 o 7 1 ?1 Street Address: o? -3 ?t ,y City ? a q 1p, *I State: 14 h Zip: S Z Company: Phone #: (area code) CONTRACTOR Street Address: license # Exp. City State: Zip: ARCHITECT/ ENGINEER Company: Name: Telephone #: area code ( ) Streel Address: Registration #: City State: Zip: Sewer & water licensed plumber (reauired for new construction only): Penalty applies when address change and lot change is requested once permit Is Issued. I I hereby acknowledge that I have read this application, slate that the Information is correct, and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. r Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received - Yes - No Remodel/Repair Reaulremenh? U ' 2 copies of plan 1 set of energy calculations for heated additions 1 site survey for exterior addtiions E decks CONSTRUCTION COST: o19 14C2 f QO n?1a 2s o o T 0 Tree Preservation Plan Received Yes No Not Required w 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 CALLS _# 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 IS 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 Site Address Lot a ? Block Parcel/Sub Valuation a0 A3 stiale L.-I. Owner / f'C4.,g/gnAq,e. P,Ae rf1 Jr- Address a0o23 Sh q ?? C??1 City/Zip Code GQq q n Phone ?5-?2 - 7 6 C/o Contractor Address City/Zip Code Phone Arch./Engr. _ Address City/Zip Code Phone # i -' 1990 BUILDING PERMIT APPLICATION CITY OF EAGAN? 14p® JUN 07 Rico Date: OFFICE USE ONLY 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 _ Booster Pump FEES Bldg. Permit e2'b Surcharge SO Plan Review SAC, City SAC, MWCC Water Conn Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Copies SUBTOTAL Penalty TOTAL APPROVALS Planner _ Council / Bldg. Off. $ Variance r I i ? GaQA?E AM ?DN I I I f 52 3 rk ,81 22:1' /'AAACvE I T i 8. S4. /' NFFT lo{ --F-- f- 75, D HOUSE 1 z4' 14 w m SEF JA+txT z of 2 fD,Q J1LOA A00?17oN 0"eWA.Y - e -9:aU" X,y4l.E LANE CQ_T. Z6_ _B1DWK t MAR aROVI NO.q. .ELAN 7.OW#X*4P PA7fQTfI Cdt[d[T.Y. i1 hv;vrMrA. N,v,cr ca?vrnucna l aRC?A4E .4k0i,' ?a+ ;'im,o, /Ara °a _CP. {d E.C_ f/Llii/fEB/f 7°2Z GT ' ^LC'?-:?' v"100 ACOi.7O/? Arl-1'+l10"X w an S?D ? mp :CALF City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 2023 Shale Lane Lot: 28 Block: 1 Addition: Cedar Grove 4th PID:10- 16703 - 280 -01 Use: Description: Sub Type: e- Reroof & Siding Work Type: Reroof & Siding Description: Census Code: 434 - Occupancy: Zoning: Square Feet: 0 Comments: Fee Summary: Valuation: 6,000.00 Contractor: Restoration Resources 6850 Shingle Creek Parkway, #C -175 Brooklyn Center MN 55430 (763) 561 -2698 Reroof: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Siding: When installing ventilated soffit material, remove existing material (ie: debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Paul Hunder BL - Base Fee $6K Surcharge - Based on Valuation $6K Total: I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Construction Type: $132.75 $3.00 $135.75 Owner: Michael 0 Hillberg 2023 Shale Lane Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: 0801 9001 Issued By: Signature Building EA085545 08/25/2008 ePermit City of Eapil 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 IJI ;6O Use BLUE or BLACK Ink r For Office Use Permit #: J� T7J l Permit Fee: 0 Date Receive Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION 6144 5'2-941 Date: k -22-2o1 Site Address: .2 73 Z%4AtEL4,b0 Unit #: RESIDENT / OWNER Name: 'Ai 04 Phone: 1051-4 52 - 74,4 S Address / City / Zip: 20z3 3 �51.-1,&(1 LAtiqE � EAS i t , MtJ 55122_ Applicant is: )e Owner Contractor TYPE OF WORK Description of work: Ee,ces S vulk.atevj Construction Cost: l 519D Multi -Family Building: (Yes / No )) CONTRACTOR Company: 41J Address: 1 State: /ip: -5 License 1.1 L AJ i Cake iy S City: .45r PikuL Pho e: ead Certificate #: If the project is exempt from lead certification,lease explain why: (see Page 3 for additional infor 0 IId/-J- R&1i; -- C7/� L,tcm c 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: Phone: Sewer & Water Contractor: 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 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'sPrinted&v9 Appli ants Sigrlature " Page 1 of 3 DO ®OT4VR I TteELOW THIStINE SUB TYPES Foundation Y Single Family Multi 01 of _ Plex Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall Fireplace Garage Deck Lower Level Interior Improvement Move Building Fire Repair Repair DESCRIPTION Valuation c Plan Review (25% 100%_) Census Code # of Units # of Buildings Type of Construction 513 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final jc Framing Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Fireplace: Rough In Air Test Final Insulation Sheathing Sheetrock Reviewed By: Siding Reroof Windows /Egress Window Water Damage *Demolition of entire building — give PCA handout to applicant / 6071 Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* Demolish Interior Demolish Foundation MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: FInal / C.O. Required inal / No C.O. Required HVAC Gas Service Test Gas Line Air Test Other: Pool: Footings Air/Gas Tests _ Siding: _Stucco Lath _Stone Lath _ Windows Retaining Wall: _ Footings Backfill Radon Control Erosion Control , Building Inspector Final Brick Final RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 delb. C!ty of Ea�all 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use j Permit #: /� / 2- Permit Fee: Date Received: Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: `I !I'l I RESIDENT / OWNER Name: A Agr<1. tti Z l , C Phone:1.06/-b°1)-4'19' 2- Address / City /Zip: 2.0 2 1 -I74 -L._, Li -J Applicant is: '7G Owner ' Contractor TYPE OF WORK D )-/ Description of work: AP -rte "^ Construction Cost: / f?) ©° o M,e-erI s vr. lki Multi -Family Building: (Yes / No )( ) CONTRACTOR Company: e -n6 `, �6(),S,-n. er nslrud iL Contact: %) l Gid n� Address: 22/1 1) o U z=7 G9,v LAICity: -5T• PA -L7 (.-- State: WI IJ Zip: -"/l1 Phone: 1 6-F G'' e)o- 'fyt 94- - 6o0 --z/5-6) IIAii. 11- 0,ta License #: .- Lead Certificate #: N-7.- 3714'2,- O If the project is exempt AO exgggqa from lead ceIiaion, plea explain Y�(see Page 3 for additional information) I L DZei.l 7R,(, -1 iMt_. Ati i 1- /q4.-3 In the last 12 months, Yes No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: 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 Cify;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 s !ans. Exterior work authorized by a building permit issued in accordance with the Minn ' tate Buil ode must by coRrRleted within 180 days of permit issuance. x Y� k' �/ E✓ Y l," �1 �r1 SLrt c�r� Applicant's Printed Name s Signature Page 1 of 3 ,20 41411-c)--0 O WRITE BELOW THIS LINE SUB TYPES ✓ Foundation Single Family Multi 01 of _ Plex Accessory Building WORK TYPES New firAddition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25% 100%fr) Census Code # of Units # of Buildings Type of Construction Fireplace Garage Deck Lower Level Interior Improvement Move Building Fire Repair Repair ocQ 11.71/ REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: 7f Ice & Water arEinal Framing Fireplace: Rough In _Air Test Insulation Sheathing Sheetrock Reviewed By: RESIDENTIAL FEES' Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Pool Miscellaneous Occupancy Code Edition Zoning Stories Square Feet Length Width Final 339� Siding Reroof Windows Egress Window Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building - give PCA handout to applicant AG - -- MCES System v7 SAC Units A- J City Water / Booster Pump 1 ..ei8 PRV /6 Fire Sprinklers l5 Meter Size: Final / C.O. Required - Final / No C.O. Required HVAC Gas Service Test Gas Line Air Test Other: Pool: _Footings Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall: Footings _ Backfill Final Radon Control Erosion Control , Building Inspector qo 0 k sAtefro.v 62 -79ex 3311 /0/2, 6 /6-°* > ���, .1..9 90- lgao ' / y aJ Page 2 of 3 25 09-s 56q -Le /o,2 / 3Ci' EAGAN REV!EW BY: ATE: — /5/X S'441174, Iidproh) 1 D 77.71..,DN(73 -77,,771-10 DIVISION r1/4141 5ws& 1.51 ?oast 610 1 5 gROt-ri. 1 /Ox 138 LA June 11,2012 To: Jeff Wheeler, City of Eagan Inspections From: Karan A Hillberg, homeowner RE: Firing of Jensen & Jensen/Hired Kingsman Construction Hi Jeff, I fired Jensen & Jensen Construction Lic # BC639904,on February 19th of this year. Due to missed deadlines by Nick, his lying and omitting information I needed to know as a homeowner regarding the electric permit I pulled for them (that was to "save me thousands of dollars") and the fact that they scammed me out of more than $40,000, was enough reason for me to hire a truly good construction company. I hired Kingsman construction to complete the addition of a three season porch on my home. Please close out the permit l signed off on for Jensen & Jensen. Kingsman is my only contractor. Please contact me at 952-915-6889 should you have any questions or concerns. Thank you for your time and attention to this matter. Sin Hi .erg 2123 Shale Lane Eagan MN 55122 612-229-7165 cell C!ty of Eagall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use:(*1 10b0C) Permit #: Permit Fee: Date Received: Staff: /� 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 7/ 3/42 Site Address: ? 02 3 $Ae,tite L an Unit #: Name: 1 ��11 / �lj/F'�� Phone: �';PI — 7/6 Address / City / Zip: ?c 3 -SII .J/ L .1 � ge„ , r) y\ Applicant is: Owner ^ Contractor Description of work: Fr n r s t T S ca S:o '0 C Construction Costr 1 Multi -Family Building: (Yes / No ) Company: Address: 21 0to)C,27f)/o6 State: Zip: S5--(42-7 Phone: Contact: (p i P r Z.00—)_43' city: oo Iden 1% /le 76.3 - j55=S((.3 License #: C 3 754 Lead Certificate #: / / /3 T 72O9 3 '""1 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: supporting intocum is that you submit are considered to be public information; nrorma on maybe class►f►ed as nor publi ►f you provide specific reason that would pe ude that they are tradi 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 ermit issuance. Applicant's Printed Nam x Applicant's Signat Page 1 of 3 SUB TYPES Foundation Single Family Multi 01 of Plex Accessory Building WORK TYPES New ,t Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100% ) Census Code #of Units # of Buildings Type of Construction DO NOT WRITE BELOW THIS LINE Fireplace Garage Deck Lower Level .4110. 4,71.0111t ,t Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool _ Interior Improvement Move Building Fire Repair Repair /VIA REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Occupancy Code Edition Zoning Stories Square Feet Length Width Foundation Drain Tile Roof: _Ice & Water Final Framing Fireplace: _Rough In Air Test _Final Insulation Sheathing Sheetrock Reviewed By: RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL go /1//? Siding Reroof Windows Egress Window )2-3 Storm Damage _ Exterior Alteration (Single Family) _ Exterior Alteration (Multi) Miscellaneous _ Demolish Building* _ Demolish Interior Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant ,RG MCES System eta'? SAC Units City Water Booster Pump A yQ PRV 1 /5 1. Fire Sprinklers Meter Size: Final / C.O. Required Final / No C.O. Required HVAC _ Gas Service Test Gas Line Air Test Other: Pool: _Footings _Air/Gas Tests _ Siding: _Stucco Lath _Stone Lath _ Windows Retaining Wall: _ Footings _ Backfill Radon Control Erosion Control , Building Inspector Final Brick Final Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA150336 Date Issued:07/02/2018 Permit Category:ePermit Site Address: 2023 Shale Lane Lot:28 Block: 1 Addition: Cedar Grove 4th PID:10-16703-01-280 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 - Reed Cowan 2023 Shale Lane Eagan MN 55122 (612) 734-7625 Custom Remodelers 474 Apollo Dr Lino Lakes MN 55014 (651) 784-2646 Applicant/Permitee: Signature Issued By: Signature 4 ` Custom 651.784.2646 .cusromremodelersinc CRI Remodelers, Inc. July 18, 2019 To: Eagan Building Department RE: Permit # EAI50336, 2023 Shale Lane Bay Window Installation The shelf for the bay is made from 2x6's and 3/4 inch plywood it is insulated with R19 insulation and is fastened to the sill and the studs of the wall with a ledger loc screws. Bay was placed on the shelf and is supported from cables up top at a 45 degree angle. The brackets for all the cables are fastened into the header above the bay. The bay is also supported by a ledger loc screws going into the jamb of the bay. It is insulated with DAP 812 spray foam; all the proper flashing has been completed. Installer Name: 204,1N Gir., cLe,r Cut_ctot�r 11 ✓ C.k IM 13I (' ) Signed: Date: 7- /8- !4 RE Job#48392-5 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA177734 Date Issued:07/15/2022 Permit Category:ePermit Site Address: 2023 Shale Lane Lot:28 Block: 1 Addition: Cedar Grove 4th PID:10-16703-01-280 Use: Description: Sub Type:Water Softener Work Type:Replace Description: Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 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 - Reed Cowan 2023 Shale Ln Eagan MN 55122 (612) 220-5100 Milbert Company (culligan) 1801 50th St E Inver Grove Heights MN 55077 (651) 451-2241 Applicant/Permitee: Signature Issued By: Signature