2096 Shale LaneCITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
2046 SHA1 E
CEDAR GROVE 41H
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
?- Date Issued:
Control No. ` r' (
-t- t . 1, f-r
Bull It INO
0014'18
A9/10/92
LOT s 6 BLOCK > / APPLICANT:
LANE AMf: RICAN RE11ODELING INC
(fill?) b63--0020
PERMIT SV?TYPE: TYPE OF WORK:
( ??c.. t ALTERAt'10N
DESCRIPTION SOFFIT & FASCIA
Pa.. It Pfc. Permit Hokter Dab Tahphona R
SJW
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Do" Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
laul.
Fireplace
Final Htg.
Oreat Test
Final Ptbg. Ptbg. Inspector - Notify Plumber
Const. Meter
EngdPlan Q
T'
Bldg. Final
Dedc Fig.
Deck Final
Well
Pr. Oisp.
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-189
(612) 681-4675
SITE ADDRESS: i !
.11111 1 A h
PERMIT SUBTYPE:
INSPECTION RECORD
PERMIT TYPE:
Permit Number;
7 Date Issued:
6 N 101, K : APPLICANT:
TYPE OF WORK:
. 1. 1
rail Ij
ilAVAQ /MI111k0014
INSPECTION DATE INSPTR. INSPECTION DATE INSPTR.
RFMARVS'i P1_ AN RfV1 Wf.1) BY 871 1 ADAM-,
`;F PARA Tf- Pf RM 1 1 RE IJU I RI 11 1 11!< ANY PIAINH I
n ? r is ° +
n ?.
Permit Holder Date Telephone #
PLUMBING
HVAC
Inspection Date Insp.. Comments
FOOTINGS 9p G (
/?"
FOUND
FRAMING ?aCJ?19?! K/G?
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL /
<
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG c?
FINAL HTG
ORSAT
TEST
BLDG FINAL ^? oy
//
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN Remarks * Cedar Grove Acquisition
Addition CEDAR GROVE #4 Lot 6 Blk 7 Parcel 10 16703 060 07
Owner S/Y1ia0, 141 1 Al Street 2096 Shale Lame 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
WATERMAI N
* WATER LATERAL 1972
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
?r
EAGAN TOWNSHIP
BUILDING PERMIT
,
Owner ....... ° /.&" M1 .-....f!------ . ... . ........... .
Address (present) a g ( ---•:'° " .. .. .. .....................
Builder ..............??C.[.e.:fr..... ------------------------------------------------ ------
Address
N° 1293
Eagan Township
Town Hall
Date ...............................................
'Stories To Be Used For Front Depth Heigh! Est. Cost Permit Fee Remarks
LOCATION
Street, Road or other Description of Location Lot Block I Addition or Tract
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 PT ON THE PREMISE WHILE THE WORK IS IN PROGRESS.
This is to certify, that...... ?.... rte ..........................has permission to erect a........ ... .....-."-. . - .................upon
the above described premise subject to the provisions of the Building Ordinance for E n TowAhip adopted April 11,
1955. /
............................ ........-????V---`-?1..' ......-.. Per ........ ............. aZ(7..u......?s ..... ...". _.8?..
Chairman of Tnwn Board /J Building Inspector
City of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651)675.5694
Date:
Tenant:
-----------------
I For-QHlcelJSe I
j Permit #: 96-3 1? j
Permit Fee:
Date Received:
Suite #:
1 8 2008
RESIDENT / OWNER ti Phone. ` -1
Name: Wk k ? T
?
`
J I
Address / City / Zip: ?N
Applicant is: - Owner Contractor
TYPE OF WORK Description of wor :
1'NL -?
QQ
Construction Cost U 10_? Multi-Family Building: (Yes-/ No )
CONTRACTOR License #:
Name:
`
Address: J
,,
?&
S
EA K*
fate: Zip:
City:
-
c
5S
t
t P
1 M ! ?
Ph
,
on
ac
one:
erson: _
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
submission type) • Energy Envelope Calculations Submitted
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 non-pWic if you provide specific reasons that wouid 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 work will be in
accordance with the approved plan in the case of work which requires a review and appTa(al of plans.
x I ) Q,na l x ?I t W ll tL
Appl cant's Printed Name Applicant's Signature
Page 1 of 3
VA, wivd Amk i?o ?0 aa??
2008 RESIDENTIAL BUILDING PERMIT APPLIC
WO
2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone #E 651-675-5675
Please complete for: single family dwellings & townhomes/condos when permits are required for each unit
Date
Site Address C=,Aj95.2 l y ;2 Unit #
Property Owner a [,;7 ?_`? ? f7 Telephone#(6SI)
Contractor (6?„ /r/eJ?(p
J //?!
Street Address y City awl4e Va /4=
State _h3 ?\ Zip Telephone # ( ,SS) X34 S e3,2?,
Bond #: Expires:
The Applicant is Owner / 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
Total
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 plant, ,
\
Applicant's Pn ted Name Ap cant's Signature
APR 1 12005
2005 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
Street Address City
State \
ip Telephone # ( )
Bond # F
es:
The Applicant is Owner Contractor Other
Work Type
New Construction - Underground Tank Install -Remove "see below
Interior Improvement - Install Piping _ Proc sed -Gas
Nature of Work:
"When installing/removing underground tank, call for inspection by Fire M hal and Plumbing Inspector
Permit Fees: $70.50 Underground tank installation/removal
$50.50 Minimum (includes State Surcharge)
or
Contract Value $ x 1% Permit Fee
• If permit fee is $1,000 or less, add $50 $ State Surcharge
If ermit fee is over $1,000, add $.50 for
every $1,000 yermitfee $ Total Fee
r nereoy apply ror 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 Datc:
Cities Digital Quality Control
The following image represents the best
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Every effort was made to capture the content
from the original page.
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LOT NAME SIZE
BLOCK ADDRESS VALUE
ADD-N. AREA TYPE
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CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
2096 SHALE LANE
LOT: 6 BLOCK: 7
CEDAR GROVE 4TH
BUILDING
001428
09/10/92
DESCRIPTION:
i
i
Li I
SOFFIT & FASCIA
=Building Permit Type SF (MISC.)
Building-Work Type ALTERATION
r
REMARKS:
C 09-0 7Y2-
FEE SUMMARY:
VALUATION
Base Fee
Surcharge
Total Fee
$72.00
$2.50
$74.50
$5,000
CONTRACTOR: - Applicant - ST. LI OWNER:
AMERICAN REMODELING INC 15530020 000240 SCHMIDT SHARON
3700 ANNAPOLIS LN 2096 SHALE LN
PLYMOUTH MN 55447 EAGAN MN 55122
(612) 553-0020 (612)454-7028
I hereby acknowledge that I have read this
information is correct and agree to comply
Statutes and City of Eagan Ordinances.
L_
APPU /PERMITEE SIGNATURE
application and state that the
with all applicable State of Mn.
I. Control No. 1041
D of, 4 p
IS U D B : SI AT UR 'k
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
2096 SHALE
CEDAR GROVE 4TH
INSPECTION RECORD Control " 1041
PERMIT TYPE: BUILDING
Permit Number: 001428
Date Issued: 09/10/92
LOT: 6 BLOCK: 7 APPLICANT:
LANE AMERICAN REMODELING INC
(612) 553-0020
PERMIT SUBTYPE: TYPE OF WORK:
SF (MISC.) ALTERATION
DESCRIPTION SOFFIT & FASCIA
PERMIT #
REACTIVATE' _
iftl
CITY OF EAGAN
1992 BUILDING PERMIT
681-4675
APPLICATION .40
MN CONTRACTORS
LIC. # 2408
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, l set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chap a is requested once Permit is issued.
Date Valuation of work DD
Site Address:_ ?091n ?[?t?? oyl
STREET SUITE R
Tenant Name: (commercial only)
LOT l° BLOCK SUBD. / l
f l,I kCG F.I.D. M
mar/
Description of work: ?DW?? QiJL'?! ClC i7 Q? cam„ ,
The applicant is: O Ow er tractor Other (Describe)
Nam ?/X . Phone
'?.?Sl
Property
Owner LAST fIRST
2091
?-XlC
a
-.
Address .
STREET STE ! ..
?-
City State 1'161? Zip
Company e d Phone ?
C?010 .;?0
Contractor /?
Address L°- License # Exp.
City ®zrl`C State Z3pr?7
Company / Phone
Architect/
Engineer Name Registration #
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
correct and agree to comply
h all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Z
/
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation
? 02 SF Dwg.
? 03 SF Addition
? 04 SF Porch
? 05 SF Misc.
WORK TYPE
? 31 New
? 32 Addition
? 06 Duplex
? 07 4-Plex
? 08 a-flex
? 09 12-Plex
? 10 Multi. Add'1.
? 33 Alterations
Repair
? 11 Apt./Lodging ? 16 Basement Finish
? 12 Multi. Misc. ? 17 Swim Pool
? 13 Garage/Accessory ? 18 Comm./Ind.
? 14 Fireplace ? 19 Comm./Ind. Misc.
? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
? 35 Tenant Finish
? 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
3 of Stories
Length
Depth
APPROVALS
Planning
Engineering
REQUIRED INSPECTIONS
? Site
? Wallboard
Basement sq. ft.
1st F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
? Footing
? Final
? Framing
? Draintile
? 37 Demolish
MWCC System
City Water
PRY Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Assessments
? Insulation
? Fireplace
Permit Fee OD
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
SAC Units
velutim: $
STATE OF MINNESOTA
DEPARTMENT OF COMMERCE
133 East Seventh St
St. Paul, MN 55101
(612) 296-6319
BUILDING CONTRACTOR
ID#0002406
REMODELER
CORPORATION
Issued: 01/13/92 Expires: 03/31/93
BERNARD M LANE
STATE OF MN DEPT. OF COMMERCE
133 East Seventh St , ::, p??xr.?
St. Paul, MN 55101 '
(612) 296-6319,,
BUILDING CDNTRACTOR ;:is.:?;:'
ID#0002406
REMODELER
CORPORATION
Issued: 01/13/92-03/31/93
BERNARD M LANE
AMERICAN RMDLG INC AMERICAN RMDLG INC
8585 NORTH STEMMONS 8585 NORTH STEMMONS
FREEWAY FREEWAY
DALLAS TX 75247-0000 DALLAS TX 75247-0000
CM M5A]
CITY OF EAGAN
CASHIER- S TERMINAL NO: 889
DATE- 09/25/98 TIME,., 15-16-59
ID-
NAME. SUTTER BROTHERS CONSTRUCTION
3210 9001 2096 SHALE LANE 556.75
3422 9001 2096 SHALE LANE 361.89
2155 9001 2096 SHALE LANE 24.00
s
Total Receipt Amount: 942.64
CRO97740
USER ID: NANCY
PERMIT
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, „Minneslta 55122-1897
(612) 681-4675
PERMIT TYPE: BUILDING
Permit Number: 033441
Date Issued: 09/24/98
SITE ADDRESS:
P.I.N.: 10-16703-060-07
2096 SHALE LANE
LOT: 6 BLOCK: 7
CEDAR GROVE 4TH
DESCRIPTION: GARAGE/MUDROOM/PORCH
Bu f?'ing,Permit Type SF ADDITION
Br'ilding "Wo,rk Type NEW
0,ensus 'Code'- 434 ALT. RESIDENTIAL
>E
,rl
t
y U ? 1
A I REM#PN:REVIEWED BY BILL ADAMS.
SEPARATE PERMIT REQUIRED FOR ANY PLUMBING WORK.
CALL 445-2840 REGARDING ELECTRICAL PERMIT AND INSPECTIONS.
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
Total Fee
VALUATION
$556.75
$361.89
$24.00
$942.64
$48,000
Sl>"P7E17"'i'pP)R,T) - App1i19873079 5135LiC OSCHMIDT WNER BILL
8280 EAGLE CREST DR 2096 SHALE LANE
€AGAN MN 55122 EAGAN MN 55122
(651) 987-3079 (651)454-7028
I hereby acknowledge that I have read this application and state that the
information is correct and agree to 'comply,wiCh all applicable State of 'Mn.
Statutes and City of Eagan Ordinances.
'L_
APPLICANT/PERMITEE SIGNATURE SUED BY. SIG ATURE PK-
119 8 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PMOT KNOB RD - 55122
?`3t 1 681-4675 vl ?{ a. I
New construction Requirements Remodel/Repair Requirements Qt - a - `
? 3 registered site surveys • =2 copies of plan
? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? ?2 site surveys (exterior additions & decks)
? 1 energy calculations ? .1 energy calculations for heated additions
? 3 copies of tree preservation plan if lot platted after 7/1193
required: _Yes _ No
DATE: ?Af IF? CONSTRUCTION COST; p YX 004• °Q
DESCRIPTIO F WORK: AArtf" f ?rg9MA6G LI 701V l?irl? 01jo ky', 4-'e PRa
STR TT ADDRESS: 209(Y SHALE 4AA)IE
LOT: C9 BLOCK: _ 7 SUBD./P.I.D. #: ?i 0/72Se7 o[se?n --OEOh+cl,Ete?e `f
Name: S H_M)DT 6I L f- ?/IhRvN Phone YS-q-70 28
PROPERTY Last First
OWNER
Street Address: ?(-P Sf fil C GAAX
City f A&4,V State: Af Zip: SS/
Company: ?YyF_A BRo7ffEkS (,yt7-RuG77a? Phone #: ?P-T0V 9
CONTRACTOR U `` //??
Street Address: 9. 80 GlG4EC.CEST JCIVC License # S /3
C.4-V State: t/ Zip:
City kA-
ARCHITECT/
ENGINEER
Company:.
Street
City
Sewer 8 water licensed plumber (new construction only):
and lot change is requested once permit is issued.
Penalty applies when address than
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicat
State of Minnesota Statutes and City of Eagan Ordinances. `/
r
n
Signature of Applicant:
OFFICE USE ONLY fC? I1
Certificates of Survey Received Yes ?NoF _2*
Tree Preservation Plan Received Yes No Not Req fired
Phone #:
Registration #:
State: Zip:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
03 SF Addition ? 08 8-plex X 13 Garage/Accessory ? 20 Public Facility
04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
I' 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
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:
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Building Engineering Variance
Valuation: $
O
% SAC
SAC Units
`ERSEN
GROUP` "NANCY SWANSON
COMMERCIAL
COMMERCIAL SALES REPRESENTATIVE
TEL.: 612-288-9910
FAx: 612-288-9926
INTERNATIONAL MARKET SQUARE
DATE: JOB:
W i
'? I b
,.Z?'lO. I?EROE0.'i I.(9
- Dcoicr A,)a 16'-pigoe-
bwef.E fl/v +XI ?' Lf,NAT&D??
fain ?twr 6vAC,t babe
z,
c
0
r*,
w
5
r,
ANDERSENS WINDOWS & PATIO DOORS FOR COMMERCIAL & INSTITUTIONAL USE
?-- ?xY [?Acy?
CITY USE ONLY L J BL RECEIPT#: 9913T
SUBD. / RECEIPT DATE: IS IF t- Yxoye- 1998 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT IINOH RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
D townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
--- -- -- ------------- --------------------
FIXTURES ----------------
EACH ----- ---
# TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping Outlet ' minimum -1 3.00 x =
Rough Openings 1.50 x =
Water Softener ' for dwellings under construction 5.00 x =
Water Softener ' for existing dwelling 20.00 x =
U.G. Sprinkler ' for dwelling under const. 3.00 =
U.G. Sprinkler ' for existing dwelling 20.00 =
Alterations ' to existing residence 20.00 = z l
Water Turn Around 20.00 =
Private Disposal System ' MPC lic. 75.00 =
(new and refurbished systems)
Private Disposal Systems' Abandonment 20.00 =
RPZ (new installation only) 20.00 =
STATE SURCHARGE .50
TOTAL
---- ------------------------ ----- ------------------------------------------------------------------------------------------ ------------------
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances.
It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its
normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement.
SITE ADDRESS: 2 0 94, ?Nf7zC Z A/?&
OWNER NAME: 1n14L 1)9 //&-N J/GN/YI i Z? 7
INSTALLER NAME: A/141 //a N-, S? V rr / nT TELEPHONE #: 41L<Z- 70 .7-)P
STREET ADDRESS: O ?S Az A?/F'
CITY: 9G? y STATE: r? ZIP: SS/2s
SIGNATURE OF PERMITTEE
CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1998
0 %
CLAIM VOUCHER - REFUND REQUEST
CITY OF EAGAN
CLAIMANT WEN2E1 NEATING & AIR CONDITIONING-_-_-_
ADDRESS_1g55 Si&1LNEE ROAD -_-
-EAGAN. MN 55122
Location
2046 SHALE LANE
_L6.Z_B7, CEDAR GROVE #4 ?_-
Receipt No./Date 14649-02/23/44
Reason for Refund PERMIT NOT RE UIRE----D FOR BASEMENT FINISH DUCTWORK
- 4------------- ----
Type of Refund Electrical Permit 3211-4220 $_---
Plumbing Permit 3212-4220
Mechanical Permit 3213-9220 $ 20.00
Surcharge 2155-9220
Water Connection Permit 3713-9220 $
Sever Connection Permit 3743-9220 $
Account Deposit 2252-9220
Utility Account over-payment 2250-9220
Other: ---------- 5---_
S
TOTAL $ 20.00
I declare under penalties of law that this account, claim or demand
is just and that no part of it has been paid.
- =----------- 8124-
y
?-
c=i GNATURE ^a ?fc' DATE
16
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NEW CONSTRUCTION
ADD-ON A/C 611aGF'??OSK
ADD-ON FURNACE
FIREPLACE INSERT
DATE X/ / 99,
FEES
HVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM I @ $3.00 EACH)
ADD-ON/REMODEL (EXISTING CONSTRUCTION) $ 20.00
STATE SURCHARGE .50
TOTAL Z o. Sa
SITE ADDRESS: .? o9cf J1141;2-5- ?46(102__.
OWNER NAME: _%/iil?i TELEPHONE #: `?SY7e9Z8
INSTALLER: !'.!f?_; ey 6 Z ,'1c .
ADDRESS: 19.-5- X4 - w.401-r olza.
CITY: STATE: ? ZIP CODE:
TELEPHONE #:_ _ 4%r2- - -zz 6?fi-t_
N U O ERMITTEE
1994 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
1"4 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMMERCIALANDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
DATE:
CONTRACT PRICE:
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
I% OF CWPI FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF PERIti2IT FEE.
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IMPROVEMENTS ONLY)
INST.
ADDRESS:
CITY
STATE: ZIP CODE:
TELEPHONE #:
SIGNATURE OF PERMITTEE CITY INSPECTOR
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA121388
Date Issued:03/28/2014
Permit Category:ePermit
Site Address: 2096 Shale Lane
Lot:6 Block: 7 Addition: Cedar Grove 4th
PID:10-16703-07-060
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 by law in ALL single family homes .
Amy Jilk
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 -
William A Schmidt
2096 Shale Lane
Eagan MN 55122
Lindus Construction
879 Hwy 63
Baldwin WI 54002
(715) 684-4647
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA129101
Date Issued:01/08/2015
Permit Category:ePermit
Site Address: 2096 Shale Lane
Lot:6 Block: 7 Addition: Cedar Grove 4th
PID:10-16703-07-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Tony Boerner
2090 County Road 42 W
Burnsville, MN 55337
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 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 -
William A Schmidt
2096 Shale Lane
Eagan MN 55122
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA141198
Date Issued:02/27/2017
Permit Category:ePermit
Site Address: 2096 Shale Lane
Lot:6 Block: 7 Addition: Cedar Grove 4th
PID:10-16703-07-060
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 -
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: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
William Tste A Schmidt
2096 Shale Lane
Eagan MN 55122
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:Building
Permit Number:EA155258
Date Issued:05/06/2019
Permit Category:ePermit
Site Address: 2096 Shale Lane
Lot:6 Block: 7 Addition: Cedar Grove 4th
PID:10-16703-07-060
Use:
Description:
Sub Type:Fireplace
Work Type:Free-standing Stove (new)
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
William Tste A Schmidt
2096 Shale Lane
Eagan MN 55122
Glowing Hearth And Home Llc
100 Eldorado Dr.
Jordan MN 55352
(952) 492-9276
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA159863
Date Issued:01/23/2020
Permit Category:ePermit
Site Address: 2096 Shale Lane
Lot:6 Block: 7 Addition: Cedar Grove 4th
PID:10-16703-07-060
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.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
William Tste A Schmidt
2096 Shale Lane
Eagan MN 55122
(651) 454-7028
Lofgren Heating & Air
5708 Upper 147th St W
Suite 106
Apple Valley MN 55124
(952) 431-5811
Applicant/Permitee: Signature Issued By: Signature