2084 Shale Lane1N SFEU ION KEUOK1)
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS:
IIAN tikkivi 14
s 1, orK : APPLICANT:
PERMIT SUBTYPE:
TYPE OF WORK:
I.ilii I?IMt?
ffri 1 i R /c,
7
I
Permit Holder Date Telephone M
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING 6
?
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN 8 r 6r1
?'
5795 Pilot Knob Rood Eagan, MH 5'5122
PHONE: 454-8100
BUILDING PERMIT PE-ROOF HOUSE Receipt s
To be wed for & ADD r,=GE Est. Value ',6,000 Date Octorer 11 19 S3
Site Address Shale ne Erect ? Occupancy R-3
7
Lot Block Sec/Sub. Cedar Grove 4th
Alter
Zoning
1-3-16703-030-07
l
P Repair ? Fire Zone _,
#
arce
Enlarge ? Type of Const.
of Kirk Fox
Name Move ? # Storie
i 2034 Shale Lane
Address Demolish ?
` Length 14
- -
r++. L:aPan 55122 pk y 454--_
5926 Grade ? Depth Sq. Ft.
g .vso ?cau ?. a?ua?.
Name ?U.
i? 5353 Wayzata Blvd.
oU Address
"j r;#- Mpls. 5511 346-3335
ok-
Name _
Address
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.
Signature of Permittee t --
A Building Permit is issued to,
all work shall be done in accordance with all applicable State,yof Mic
Building Official
Assessment _
Water & Sew.
Police
Fire
Erg.
Planner
Council
Bldg. Off. _
APC
Fees
Permit " - J. U0
Surcharge
Plan check
SAC
Water Conn.
Water Meter
Road Unit
$59 . 50
Total
on the express condition thoi
and City of Eagan Ordinances.
Permit No. Permit Holder Misc. Permit No. Holder
mc?
Plumbing
H.V.A.C.
Well
Water
Disp.
Sewer
Electric
Inspection Date Insp. Other
Footings
Foundation
Framing
Rough Pibg.
Rough HVA
Insulation
Final Plbg.
Final HVAC
Final
Water Describe Location:
Well '
Sewer
Pr. Disp.
CITY OF EAGAN
97" Pilot Knob Rood Leven, MN 66122 N4 5958
PHOHLs 464-6100
BUILDING PERMIT Receipt # ?J
r
Tw L. -A 9. I--rr ,-`;,-?? Fet V. h . 3-/ r?n• Dnte 1 i-? 19 4
Site A?dress ?',- S11`' i3@ r`?
r
Erect
R
r
[] T
Occupancy
Lot Block Sec/Sub.
{ Alter
??? ? Zoning
Parcel # Repair ? Fire Zone
??
Enlarge ? Type of Const.
ce r
Name 1 .? r
Move
?
# Stories
Z
3
Address
Demolish
?
Front ft.
"?, Vin 5
D . ' ' Grade fl Death ft.
't- . ;-Is?rnr Approvals
Name
p
01 Address Assessment -
uF r lir f "'r. Water & Sew.
city Phone
W Police
Name Fi
12uj re
x? Address Eng.
Cez
<11
City Phone Planner
I hereby acknowledge that I have read this application and state that Bldg. Off,
the information is correct and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan C?-+ ^^^-?? APC -
Signature of Permittee
A Building Permit is issued to:
all work shall be done in accordance with all-oppl
Building Official
Permit
Surcharge
Plan check
SAC
Water Conn.
Water Meter
I Total
on the express condition that
hate of Minnesota Statutes and City of Eagan Ordinances.
Permit # Deft Issued Permittee
Plumbing
Mechanical
INSPECTIONS DATE INSP. Rough -in Final
Footings Z _ Date Insp. Date Insp.
Foundotion Plumbing
Frame/ins. Mechanical
Final
Remarks:
UITY OF EAGAN Remarks-* Cedar Grove Acanisition
Addition CE IDAR MOVE!! 114- Lot 3 Rik 7 Parcel 10 16703 030 07
Owner i` I L,L ' Street 2084 Shale Lane state_F+agan, 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
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
?? BUILDING PERMIT
Owner _--d4-11??it.-":.,5 '-.--L?!r.-.... .............`-
Address (present) ...0.:......!6..:...;7...w^L_____.___.._......
Builder ...._ ..----------------------------- .... ..._.......... .__.------------ ........ _.....
Address ---'_.--d---------------------------- ------------------------- -------------- -
DESCRIPTION
,(.L LLB-t._•c.CE'c-, /S, ?s-r
LOCATION
N° 127'7
Eagan Township
Town Hall
Date
Street, Road or other Description of L Lot Block Addition or Tract
.3 6C,-' 7 Cc?.. -L --
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, safety, convenience and
general welfare to anyone in the community. -
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS.
This is to certify, .fhaf..mss- ........ has permission to erect a...7 et9- ..... ..`S._..`..s :.`?. ??..._.y.._:._upon
the above described premise subject to the provisions of the Building Ordinance for Eagad 'Township adopted'April 11.
1955. -
lLrf ems': c'f'...1..
LZt ._.. . ?CE < .....
Per ?Y--_.._.._.......__......_...
Chairman of Town Board. Building Inspec.tor.
4
CITY OF EAGAN Np 856rr
3795 Pilot Knob Road Eagan, MN $5122
PHONEt 454.8100
BUILDING PERMIT RE
R
F
Receipt # j ?
-
OO
HOUSE
To be need far & ADD GARAGE Est. Value $6,000 Date October 11 1983_
Site Address 2084 Shale Lane Erect g$ Occupancy
R-3
Lot 3 Block 7 Sec/Sub. Cedar Grove 4th Alter XX Zoning R-1
Parcel # 10-16703-030-07 Repair ? Fire Zone NA
l
E T
f C V
n
arge ? ype o
onst.
W
w Name Kirk Fox Move ? # Stories
z Address 2084 Shale Lane Demolish ? Length 24
C; Eagan 55122 Phone 454-5926 Grade ? Depth-2-2-Sq. Ft.
0
Name WBstern Const. Co.
Approvals
Fees
:jr
Address 5353 Wayzata Blvd.
"i- r i,- Mpls. 55116 p4 nnn 546-3385
Name _
Address
I hereby acknowledge that 1 hove 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.
Building Official Assessment _
Signature of Permittee
western ons ruc ion
A Building Permit Is issued to:
all work shall be done in accordance with all appli e 5 to f
Water & Sew.
Police
Fire
Eng.
Planner -
Council _
Bldg. Off. _
APC
Permit 7v.Du
Surcharge 3.00
Plan check
SAC
Water Conn.
Water Meter
Road Unit
Total 59.50
_ on the express condition that
and City of Eagan Ordinances.
CITY OF EAGAN Include 2 sets of plans,
r 1 site plan w/elevations &
`???oV ??OOJS BUILDING PERMIT APPLICATION 1 set of energy calculations.
To Be Used For G Q ?a n valuation d ! Date
Site Address OFFICE USE ONLY
Lot 3 Block -7 Sec. /Sub. CEda(`Qinn?F Erect ?C Occupancy
Parcel #: Q) - (LO-103 - 030 -0-1 Alter ? Zoning
Repair Fire Zone
Owner: ?CiJIL ? d? Enlarge _ Type of Const.
Move # Stories
Address: ` ` /6 La k C Demolish _ Front 2'( ft.
City/Zip Code: q g q Grade Depth 2 Z ft.
Phone #: 41.5 y/- Sgt (-
Contractor: W P S P? ?d l
Address: .r.3 ?? (.?q L 4 ? ??
City/Zip Code: r1l
Phone #: 1 ?i G- 3 3 S
Arch./Eng.:
Address:
City/Zip Code:
Phone #:
4-AO; ?
APPROVALS FEES
Assessments Permit 5&, la o
?9ater/Sewer Surcharge 2 •e-) p
Police Plan Check
Fire SAC
Eng. Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off.
APC
TOTAL i 5q ' 57b
CITY OF EAGAN
` - 3795 Pilot Knob Read Fagan, MN 55112 N2 5958
r PHONE: 454-8100
ZP?
BUILDING PERMIT APPLICATION Receipt #
Tu be used for Fireplace Est. Value 1, 550. Date 117? U_
Site Address 2084 Shale Lane Erect ® Occupancy I
Lot 3 Block 7 Sec/Sub. Cedar Gro ve 4 Alter ? Zoning Rl
Parcel # Repair ? Fire Zone
Enlarge ? Type of Const. V
w Name Kirk & Paula FOX More ? # Stories
z 2084 Shale Lane
Address
Demolish [3
Front ft.
O Fagan
454-5926 Grade ?
D
epth it.
Phone
city
.._-L_Y... ee.,......,..-, Aeeroreh Pees
o Nome
OU Addre
Nome
1 hereby acknowledge that I
the information is correct a
State of Minnesota Statutes
Signature of Permittee -1
A Building permit is issued tr
all work shall be done in a
Building Official
this application and state that
to comply with vii applicable
of/Eogan Orcirrronres,
of
Assessment _
Water & Sew.
Police
Fire Eng.
Planner -
Council
Bldg. Off.
APG
Permit ?"•"" _
Surcharge 1.00
Plan check
SAC
Water Conn.
Water Meter
Total 11.00
on the express condition that
Statutes and City of Eagan Ordinances.
------------------
ForOffice Usep ?? ?Jp
j permit #: o?3 0 j
/?S 7S
Permit Fee:
c
? Date Received: j
1 I
I Staff: I
I
2008
Date: VIVOK
Tenant:
RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address: 3OQ V Gl L7/Y7G? LCt N P
Suite #:
RESIDENT / OWNER Name: VkS f Phone: 7 7f
Address / City / Zip: 54 1L An e ?40 55> a t`
Applicant is: _?(_Owner Contractor
TYPE OF WORK Description of wo srdr G d re - / ??
Construction Cos I 1 120 Multi-Family Building: (Yes No
CONTRACTOR Name: -cm C ?0? 5 f ?y? 11 girl License °?flL}(/ 8? y
t7
Address: 7la`! pl,c,070,ld 67 C9d+"
e
city: &L fin(/) State: 1 O/v Zip:
Phone: l?y Contact Person: CND/ L' ?'f'Yll?l?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7672
_ Minnesota Rules 7670 Category 1
_
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(J submission type) • Energy Envelope Calculations Submitted
In the Iasi 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.infarrnation may be classified as. non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
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 wo will be in
accordance with the approved plan in the case of work which requires a review and approval of pla
x ?I an e( gumme ? x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-16703-030-07
PERMIT
2084 SHALE LANE
LOT: 3 BLOCK: 7
CEDAR GROVE #4
PERMIT TYPE: BUILDING
Permit Number: 0 3 2 9 5 3
Date Issued: 08/18/98
DESCRIPTION: RERDDF PORCH/STORM
Bu ld ng?PerIn it Type STORM DAMAGE
Building Work Type REPAIR
C=ensus Code434 ALT. RESIDENTIAL
f
j'
t
t I ,t-REMARKS
FEE SUMMARY:
ITE'NNSS'"52 WR*S CARPENTRY 18905074 20072521 OWNER: KIRK
14709 BURNSVILLE PKWY W 2084 SHALE LANE
BURNSVILLE MN 55306 EAGAN MN 55122
(612) 890-5074 (651)454-5926
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 Mn.
Statutes and City of Eagan Ordinances.
APPLICANT/PERMITEE SIGNATURE
I SUED BY. SIGNATURE
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122 ?/
681-4675 s- R _ 9 sS
New Construction Requirements Remodel/Repair Requirements
# 3 registered site surveys
# 2 copies of plans (include beam & window saes; poured fnd. design; etc.)
# 1 energy calculations
# 3 copies of tree preservation plan if lot platted after 7/1/93
required: _Yes _ No
DATE: '9 - 18 - '? $
# 2 copies of plan
# 2 site surveys (exterior additions & decks)
# 1 energy calculations for heated additions
CONSTRUCTION COST; 9-I 0 0 0
DESCRIPTION OF WORK: re-ro e1_T or ck c1 2 m apti 'M s-L-o r car
STREET ADDRESS: 2 0 Cr 1-1 S k (c L" nn1
LOT: 3 BLOCK: SUBD./P.I.D. #: 4 1, `?Q\?_
s?{ ' S I Z 6
Name: -q ox ?-: y k Phone #: L4
PROPERTY Last First
OWNER ff
Street Address: -2- 0 g y S 11 7 f e L N
City E State: /9 /L Zip: S$ 1 2 2
Company: of n n: S S .'v e r s C a ra e ti_ +T Phone pp#:g D- S D 7 Y
CONTRACTOR L?"? J 3 t
StreetAddrress: 11470 4 LV. I?e ?1?w? SS License # 'Z 0 0 7 2 5' 2 I
City 1J u r s,'/ 1 State: /4,4- Zip: S-S 3 0 6
ARCHITECT/
ENGINEER Company: Phone #:
Registration #:
Street
City State:
Sewer 8 water licensed plumber (new construction only):
and lot change is requested once permit is issued.
Zip:
Penalty applies when address chang
I hereby acknowledge that I have read this application and state that the infortnatior is correct and re to comply with all applicabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes No
Tree Preservation Plan Received _ Yes - No - Not Required
v'
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 _-plex
OFFICE USE ONLY
? 11 Apt./Lodging ?
? 12 Multi Repair/Rem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
? 15 Deck
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
? 36 Move
? 37 Demolition
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bldg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MC/WS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
% SAC
SAC Units
Cities Digital Quality Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
I
5353 Wayazata Boulevard
Minneapolis, Minnesota 55416
546.3365
jcM m tT
CITY ?- "
ADDRESS 1/ ?• -?
NAME C c y
TELEPHONE / . L'' WORK
DA
GARAGE SIZE ?' X X -APRON
DRIVEWAY SIZE
WIRE MESH '/2"=RODS_CONDUITPIPE
OVERHEAD DOOR SIZE L / OFFSET
PERMIT OBTAINED BY SERVICE DOOR LOCATION '
SALESMAN BLOCK SIZE & LOCATION
CEMENT MAN
OLD GARAGE REMOVED B
OLD CEMENT REMOVED BY.
WATERPROOF
BACKFILL
EXCAVATION BY
GRADE FLAT- I DROP OFF
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DATE 1 Z-al ')k
BUILDING PERMIT APPLICATION
Include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calcuations.
To be used for )I'- LFTC? Valuation
Site Address:
Lot Block 7 Sec./Sub. Parcel Number
Owner t?f L (?L ?OX Telephone T 2
?j
Address
Contractor Telephone
Address
Arch/Eng. Telephone
Address
OFFICE USE ONLY
Erect Occupancy
Alter Zoning
Repair Fire Zone
Enlarge Type a
Move
Demolish
Grade
Date of Approval and Initial
Assessment
Water/Sewer
Police
Fire
Engineer
Planner
Council
Bldg. Of Q
A.P.C.
# of S
Front
Depth
Fees tom-
Permit /U
Surcharge
Plan Check
SAC
Water Connection
Water Meter
TOTAL
Citi of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Date:
Tenant:
r
Use BLUE or BLACK Ink
For Office Use p�
Permit #: I I 107
Permit Fee:
Date Received:
Staff:
L
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
Site Address: nyvL ' 1.
Resident/Owner
Contractor
Type of Work
Suite #:
Name: \ Phone: [6 51 `t l DiTh
Address /City /Zip: � � __.._.
le. YUMA
Name, �./16'� V\1 S-�---�DA-X-C17 License #:
Llc'1 e
Address: __J`C `-t0 City: l.'C t IUi
State: \ Zip:5\-1 PhoneTA
Contact: Email:
New >c Replacement _ Repair _ Rebuild _ Modify Space Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation (_ RPZ / _ PVB)
Septic System
New
AbandonmentVAIOMM,
Water Softener
_Add Plumbing Fixtures ( Main /
Water Turnaround
Lower Level)
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) � w
TOTAL FEES $ l: D
CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454-0002 for protection against underground utility damage.
CaII 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.
x
\;r- 7)01cvb\a/ -.
Applicant's Printed Name
Aicant's Signature
FOR OFFICE USE
Required Inspections: Under Ground __Rough -In ,_Air Test Gas Test _Final
Reviewed By: Date: