2074 Shale Lane•
i
Date:
City o(EaQau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
} 2611
2011 RESIDENTIAL PLUM
Site Address:
Tenan
RESIDENT I OWNER
CONTRACTOR
Use BLUE or BLACK Ink
1
Permit#: /0057/0
Permit Fee:
Date Received:
Staff:
ING PERMIT APPLICATION
Suite #:
Name: Act -Jut -cot #3 (4 Jr` �t s Phone: — s3'1745;P'
Address / City / Zip: ied-i %24 u
Name:.MILBERT COMPANY INC.dba CULLIGAN WATER
Address: 1801 50TH ST EAST City INVER GROVE HGTS
State: MN Zip: 55.077 Phone: 651 :45.1.-2241
Contact BILL.MILBERT Email:
TYPE OF WORK
PERMIT TYPE
New Replacement _ Repair Rebuild Modify Space _ Work ira.R.O.W.
Description of ork:..
RESIDENTIAL
Water Heater
Lawn Irrigation L_ RPZ / _ PVB)
Septic System
New
Abandonment
‘IteWater Softener
Add Plumbing Fixtures ( , Main / Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heaterend Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes 55.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add 51€6.00 if a 518' meter is required)
5105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
$95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) ''4-- I1
TOTAL FEES $ 0 V +v`�
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.aooherstateonecaliora
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 perk; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
/
(1„e,, /
x vitt Ilii t 61,t/4,eII--
Applicant's Printed Name
x
Applicant's Signat
CITY OF EAGAN
3795 Pilot Knob Road Eason, MN 55122
PHONE: 454-8100
7545
BUILDING PERMIT
$4, fj(; ,, , Receipt #
To be used for Addn.
Site Address 7 4 F h a l e
Lot i Block -r- Sec/Subs"
Parcel #
0: Name Tim Doherty
2074 Shel e )' n
z Address
0
city '10 ^rt Phone
Name
u0 a Address
~ City Phone
UW
Name
WW
F -z
Address
I hereby acknowledge that I have read this of
the information is correct and agree to corn
State of Minnesota Statutes and City of Eaj
Signature of Permittee
A Building Permit is issued to:
all work shall be done in accordance with all
Building Official
Erect ? Occupancy 1
Alter Q Zoning j
Repair ? Fire Zone
Enlarge ? Type of Const. '
Move ? # Stories
Demolish ? Front Z ft.
Grade ? Depth 24 ft.
Anorovals Fees
r,_.._ September 27
rtion and state that
with all applicable
State of
Assessment Permit j• • ='?' _
Water & Sew. Surcharge 2 • }c.
Police Plan check
Fire SAC
Eng. Water Conn. _
Planner Water Meter
Council K-2•:7 7
Bldg. Off.
;
APC Total
'
PC r
r -*-7q
on the express condition that
as=to Statutes and City of Eagan Ordinances.
N2 4496
Permit # Date Issued pem"t"
Plumbing
Mechanical
INSPECTIONS DATE INSP. Rough-In pinpl
Footings Date Insp. Dote Insp.
Foundation Plumbing
Frame/ins. Mechanical
Final Z- Z,-f
Remarks.
CITY OF EAGAN
8795 Pilat Knob Road Eagan, MN 55122 N2 5172
PHONE: 454-5100
BUILDING PERMIT !1
Site Address 4 ;zt ! e XY?
Lot 10- Block Sec/Sub. '-'C--Iar (,rove #4
Parcel *
ne Name U;LJULy n. L.AR',.i.L.;;r
Z Address2074 Shale Lam
r-arr A q A_=tZ A 1
Name L.-M
0
uU Address
1327,36
Receipt *
Erect [ Occupancy
Alter ? Zoning 1
Repair ? Fire Zone
Enlarge ? Type of Const.
Move ? * Stories
Demolish ? Front ft.
Grade ? Depth ft.
Annravets Fees
Assessment Permit • 2tj
!ln
?
Water & Sew. Surcharge
'
Police Plan check
Fire SAC
Eng. Water Conn.
Planner Water Meter
Council
Bldg
Off
.
.
APC
Total 10.011
on the express condition that
Minnesota Statutes and City of Eagan Ordinances.
I hereby acknowledge that I have read this
the information is correct and agree to c
State of Minnesota Statutes and City of
Signature of Permittee
A Building Permit is issued to:
all work shall be done in accordance with
Building Official
Penalt # Date Ime/ Penelttee
Plumbing
Mechanical
INSPECTIONS DATE INSP.
Rough-In
Final
Footings Date Insp. Date Insp.
Foundation _ Plumbing
Frame/ins. Mechanical
Final
Remarks: c?
CITY OFEAGAN Remarks* Cedar Grove Aactuisition
Addition CEDAR GROVE #4 Lot- 1 Blk 7 Parcel
Owner r' Street 2074 Shale Lana 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
HOUSE HEATING TEST RECORD
ADDRESS <P D -74 Sh a I2 LP, E 4 4 h 5 Sl a aZ
APT. LOCI R IY
OCCUPANT 16c k ?D gwh K i.5 OWNER k4P_0 gr,t i h u t S
HEAT LOSS DATE HTG. INST.
SOLD BY HOME ENERGY CENTER INSTALLED BY HOME ENERGY CENTER
Electrical Work By HARRISON ELECTRIC Gas Line By
TYPE OF HEAT GA -FA X HW- STEAM -SPACE HTR. UNIT HTR. OTHER
Model _
Serial .
INPUT
THERMOSTAT
Valve
Limit
Limit Setting _
Fan Setting
Pilot Type _
Pilot Make
Pilot Model
Pilot Timing
L.W. Cut Off _
Pressure
Input CFH
Stack Temp.
Heat Plug
Percent C02
Percent 02_
Percent CO.
MAKE OF BURNER _
Model
Max. BTU Rating _
MAKE OF FURNACE
Model
Vent Size
KIND OF LINER_
Draft Hood
Filters Size
Chimney Location
Chimney Constructic
Smoke Bomb
Door Pressure-
Date Tested_
Company Testing
Name of Tester_
SIZE NONE
Regulator
Number
Inside Outside
Wiring
Test Tag
Lighting
Form 235
I - DESCRIPTION
1,062
Eagan Township
Town Hall
Date -142- r.k.s---------------------
5torier' To Be Used For Front Depth Heigh! Est. Cost ' Permit as Remarks
LOCATION
I- Street, Road or other Description of Location Lo! Block Addition or Tract
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 BEEP[T) OIIJ THE PEMISE. WHILE THE WORK IS IN PROGRESS. ,
This is to l-. ....... - ?..__-------------has permission to erect a... y......_..... ............... .._ ` ..........upon
the above described premise subject to the
I provisions of the Building Ordinance for Eagan Toy
wnship ado ted April 11.
1955. i
.........- .............. ----... Per _..... _...-..Y --------
..... .
.....
Chairman _
Chairman of Tnwn Board Building Inspector
if t12
VA'(LAICE
0177 OF SAGA ?'
3795 PILOT MOB ROAD
EL4M, M1,47ESOTA 55122
Attest:_
lerk
The Council of The City of Eagan hereby grants a variance
pursuant to application of -Timothy R. Doherty a o 7 -/ aZ16
dated July 7, 1977 for the following purpose Variance of
24? from street setback regulation. Approved Conditional on drive
entrance of South side of Garage. -L 65-Z ?7
Date approved: August 2, 1977 Fees Paid: $50.00
By: _ J-
ayor
P"k? ('0
VARLU71CE
CITY OF EAGA"
379$ PILOT K'OB ROAD
EAGAN. MI 'ITESO'TA 55122
The Council of The City of Eagan hereby grants a variance
pursuant to application of Timothy R. Doherty, 2074 Shale Lane
d02d JAY 7. 1977 or the following purpose 24' variance
from street setback regulation for attached garage at 2074 Shale Lane,
subject to drive extending South and curving to Sandstone.
Date approved: 8-2-77 ees Paid: $50.00
By: c;
Mayor
Attest: ?
? Clark
CITY OF EAGAN
:;. 3795 Pilot Knob Road Eagan, MN 55122 N2 4496
PHONE: 454-8100
BUILDING PERMIT APPLICATION $4
600 Receipt # 7549
,
.
To be used for Garage Addn. Date September 27, 19 77
Site Address 2074 Shale Erect ? Occupancy 1
Lot I B lack_ 7 Sec/Sub. CCTV. Alter IJK Zoning R1
Parcel # Repair ? Fire Zone 3 _
Enlarge ? Type of Const. V
W Name Tim Doherty Move ? # Stories
3 Address 2074 Sh41e Ln Demolish ? Front 24 ft.
city Phone Grade ? Depth 24 ft.
s N Same Approvols _ Fees
p ame _
H
OU Address
.,
Name _
Address
I hereby acknowledge that 1 have read this application and state that
the information is correct and agree to comply with all applicable
State of Minnesota Statutes and City gf,Eogon Ordinances.
Assessment _
Water 8 Sew.
Police
Fire Eng.
Planner
Council
Bldg. Off. _
APC
Permit 18. Vu _
Surcharge 2.50
Plan check
SAC
Water Conn.
Water Meter
Total 20.50
Signature of Perm"ttea
A Building Permit is issued to on the express condition that
all work shall be done in occoorAnce withis le State of Min eso/ta Statutes and City of Eagan Ordinances.
Building Official
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122
PHONE: 454-8100
BUILDING PERMIT APPLICATION Receipt #
T. M and Fe. FireplaCe Est- Value 1 .25.$6 Date
Site Address cY i4 z>115"M I Nfte
Lot 10- Block 7 Sec/Sub. Cedar GrOVe #4
Parcel #
W Name Timthy R. Doherty
Address2074 Shale Lane
c Eacian 454-5541
p Name _
r
U? Address
r r:...
Name _
Address
I hereby acknowledge that 1 have read this
the information is correct and agree t
State of Minnesota S. es a City,os
Signature of PermIlt ca4
A Building Permit is issued
all work shall be done in q
N? 5172
Erect @ Occupancy R3
Alter ? Zoning Rl
air
Re ? Fire Zone
p
Enlarge ? Type of Const.
Move ? # Stories
Demolish ? Front ft.
Grade ? Depth ft.
A.. ht Fees
Assessment _
Water & Sew.
Police
-
Fire
Eng.
Planner
Council _
and state that
iall?plicable Bldg. Off. -
APC
Permit 7.UU
Surcharge 1.00
Plan check
SAC
Water Conn.
Water Meter
Total 10.00
on the express condition that
Minnesota Statutes and City of Eagan Ordinances.
Building Official
PARdANCE /17' L/
CTPY OF EAGA,t
3795 PILOT KROB ROAD
EAGAV, MIetNTESOTA 55122
The Council of The City of Eagan hereby grants a variance
pursuant to application of Timothy R. Doherty . 2Q74 Shale Lane
dated July 7, 1977 for the following purpose 24' variance
from street setback regulation for attached garage at 2074 Shale Lane
subject to drive extending South and curving to Sandstone.
Date approved: 8-2-77 Fees Paid: $50.00
mayor
Attest: C! U
_T Clark
y EAGAN TOWNSHIP
BUILDING PERMIT
Owner ------ -..[i+-a. ................ ------
Address (present) A,0-7.91 ...... ...... :/-
Address
DESCRIPTION
N° 2995
Eagan Township
Town Hall
Dale .`.5.,_2- 7-
.................................
Stories To Be Used For Font Depth Height Est. Cost Permit Fee Remarks
V LOCATION
Street. Road or other Description of Location I Lo! I Block I Addition or Tract
W
This permit does not authorise 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. safety. convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE KEPT N THE PREMISE WHILE THE WORK: IS IN PROGRESS
This is to certify, that ? .............._....
y. .......-....°----------------has permission to erect a---•------ .............°......°_................_...-upon
the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11.
1955.
vw...,,,.
........................- -/----'
"'....:............................p.........
.....:..................
.......... Per --------------......
Chairman %f Town Hoard Building Inspector ?i
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan (, g (y, 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. single family dwellings & townhomes/condos when permits are required for each unit
Date /D
/ O /M
n
Site Address ao74 5hu 1 e Lo Unit #
Property Owner A Cbm? 9 u, I T l V h5 Telephone # (6S I ) 415 14 • 069
Contractor HOME ENERGY CENTER
1 5200 25TH AVE. N #128
Street Address PLYMOUTH, MN 55441 City
State Zip Telephone # ( -)(p'3) 4-1(o • 16t q O
Bond M Expires:
The Applicant is Owner A Contractor Other
Add-on or alteration to existing dwelling unit $ 30.00
furnace -Additional Replacement
air exchanger
air conditioner -New -Replacement
other
State Surcharge $ .50
l?J r $ ?JO
`JO
Total .
OCT 0 2004 D
I hereby apply for a Residential Mechanical Permit and acknowledge that information is complete d accurate; that the work will
be in conformance with the ordinances and codes of the City of Eagan anthe.' ; 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.
Lisp, UxA
Applicant's Prin d Name Applicant's Signa
2004 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
Date / /
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor -, "'r. v-
tF
Street Address ry
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 of Work:
**When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector
Permit Fees: $7050 Underground tank installation/removal
$5050 Minimum (includes State Surcharge)
or
Contract Value $ x 1% _ $ Permit Fee
• If permit fee is $1,000 or less, add $.50 =1 $ State Surcharge
If permit fee is over $1,000, add $.50 for
every $1,000 permit fee $ Total Fee
I hereby apply 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 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
Approved By: , Inspector Date:
DATE
BUILDING PERMIT APPLICATION
include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations.
To be used for X ?f
Site Address : ;z 079
Lot Block Sec./Sub.
1 7 (Pear jr'e're I
Owner
Address -4
Contractor
Address
Arch./Eng.
Address
Valuation 401po ?
Parcel Number
Telephone
Telephone
Telephone
OFFICE USE
Erect
Alter
Repair
Enlarge
Move
Demolish
Grade
OFFICE USE
Date of Approval & Initial
Assessment
Water/Sewer
Police
Fire
Eng.
Planner _
council
Bldg. Off. _Z
A.P.C. 7---29-,77
Occupancy
Zoning
Fire Zone
Type of Const.
# of stories
Front ?
Depth a
FEES
OCR
Permit
Surcharge a
Plan Check
SAC
Water Conn.
Water Meter
TOTAL '_
DATE z/- 2q-79
BUILDING PERMIT APPLICATION
Include ? sets of plants, I site plan w/elevations and 1 set of energy calcuations.
To be used for h4ep f,*R,r Valuation 10 13 x7. ®(e
Site Address: 2 0:2 4 S` G I r
Lot Block Sec./ ub.
owner L V-rf4-?
Address A014 Y#04 LE AANO
Parcel Number
Telephone 415"o
Contractor Telephone
Address
Arch/Eng. Telephone
Address
/ OFFICE CSE ONLY
Erect Occupancy
Alter Zoning
Repair Fire Zone
Enlarge Type of Const.
MI
ove # of Stories
Demolish Front
Grade Depth
Date of Aoproval and Initial
Assessment
Water/Sewer
Police
Fire
Engineer
Planner
Council
Jtdg. Of r.
A.P.C.
Fees
Permit _
Surcharge
Plan Check
SAC
Water Connection
Water Yeter
TOTAL
1?? 7
?dfr
F ?L
W
0O)
SF}+4LE L AOE
MASTER CARD
0
OWNER
STRUCTURE
LAND USED
Permit
No.
Issued Issued To
Contractor Owner
BUILDING ,?g9 s- 3 ?s.73
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Items Approved
(Initial)
Date Remarks
Distance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING 4- - ?, TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
L
t ?
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
IZED AND DESCRIBED AS FOLLOWS:
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL. -
? REINSPECTION REQUIRED
REINSPECTION REVEALED
DATE OF REINSPECTION
CERTI FI CATION -I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR
DATE
qjw s.
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA132343
Date Issued:08/10/2015
Permit Category:ePermit
Site Address: 2074 Shale Lane
Lot:1 Block: 7 Addition: Cedar Grove 4th
PID:10-16703-07-010
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Richard G Bulthuis
2074 Shale Lane
Eagan MN 55122
(651) 402-2921
Custom Remodelers
474 Apollo Dr
Lino Lakes MN 55014
(651) 784-2646
Applicant/Permitee: Signature Issued By: Signature