2112 Shale LaneINSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675 ?CCl
SITE ADDRESS: I o I f` '10 ` APPLICANT:
1 r11 . 10 1?1 rif r
11A1 F 1 AN1 i,r.,, t ;? . ; I:"I,
(A DAR 6140W, 4T" 1 61:) 4btl-- 10 to
PERMIT SUBTYPE:
,. , .
TYPE OF WORK:
RFVA111
i < A A&
L
81.11 t It 1 N[i
04/IH/96
ItV MAI?KS a I11 Nq?IW', f1001tti PCA)F 1 Nf, ^:4; P 1 1 1' A`.I f A
Permit No. Permit Holder Date Telephone M
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL FM
BSMT R1
BSMT FINAL
DECK FTG
DECK FINAL
CITY OF EAGAN Remarks * Cedar Grove Acquisition
Addition Lot 10 -Blk 7 Parcel 10 16703 100 07
Owner '` Street 2112 Shade Lane State Eagan. MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWER LATERAL 1972 1,304.00 52.16 25 .88 A006811 - -
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 ........ _- S----- ._-..-...-.__...........
Address (present) .....-----'-'"'`---r------------ ----
Builder ---- / -/ 'g7-... r..--........ _------------------ --
Address ..... .,#.v. °.-_-.iL"'.' {4-r--. '=
DESCRIPTION
N° 1393
Eagan Township
Town Hall
Stories To Be Used For Front Depth Height Est. Cos! Permit Fee Remarks
LOCATION
Street, Road or other Description of Location I Lot I Block I Addition or Tract
ol7
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 BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS.
a
This is to certify, .............has permission to erect a................... .......-------------- .__-upon
the above described premise subject to the provisions of the Building Ordinance for gan wnship adopted April 11,
1955.
...................... ...................(F..!!i.....................I -------- ---------- Per ------- .-._._..-.__--.
Chairman of Tnwn Board 4 t,6 Building Inspector
EAGAN TOWNSHIP
N° 1237
BUILDING PERMIT
Owner-.'.`.
Address (present) .....
---------------------
Builder ...............
Address .............
Eagan Township
Town Hall
Date / ..../.../
.?7/_GV..._
Stories To Be Used For Front Depth Height Est. Cost Permit Fee Remarks
LOCATION
brreer, noaa or omer l escriprr0 or i.ocanon 'or i510CA __ 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 B£KEPT IDN TIDE PREMISE WHILE THE WORK IS IN PROGRESS.
?C
This is to certify, that.:---(11 .._...-(....'0 `" ..... ....:.................has permission to erect a--------- 46..r..4.c?r. r!? __..?..?./.?........ ? upon
the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopte April 11,
1955.
..............
--- ..................... Per ....---........ tc!.........Sl......_...........,.........................__.......
Chairman of Tnwn oard 4 ,g_ Building Inspector
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-16703-100-07
PERMIT
2112 SHALE LANE
LOT: 10 BLOCK: 7
CEDAR GROVE 4TH
c"5 5.y f
PERMIT TYPE: BUILDING
Permit Number: 027312
Date Issued: 04/18/96
DESCRIPTION:
B`uilding,.,Permit Type
Building Work Type
Census Code
, yam
r
REMARKS:
WINDOWS DOORS ROOFING SOFFIT FASCIA
FEE SUMMARY-
VALUATION
SF (MISC.)
REPAIR
434 ALT. RESIDENTIAL
$10,000
Base Fee $162.25
Surcharge $5.00
Total Fee $167.25
CONTRACTOR: - Applicant - ST. LIC.OWNER:
DAHL CONST, BOB 14511010 0002798 DOYLE GAYLE
7473 DICKMAN TR E 2112 SHALE LN
INVER GROVE HTS MN 55076 EAGAN MN
(612) 451-1010 (612)452-7476
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State of Mn.
Statutes. nd City of Eagan Ordinances. }(?J"??' J
APPLICANTlPERMITEE SIGNATURE 'ISSUED B1.r IG QURE
3830 PILOT KNOB RD - 55122
8,, it, t 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) -$
681-4675
New Construction Reouirements
3 registered site surveys
2 copies of plans (include beam & window sizes; poured fnd. design; etc.)
1 energy calculations
3 copies of tree preservation plan if lot platted after 7/1193
required: Yes No
DATE: !?-t W I ?(.0 CC
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT _[D
BLOCK q_
SUBD./P.I.D. #:
COST: / -7 Q /
v
PROPERTY Name: 99 WA F-, v AdLE- Phone #: 45Z- Z4,'(
OWNER •
* ?Z 11w"
aLfz 4iA
/ ?"
Street Address
City: SfA-i.?A-f%j State: Zip:
1
/ AS-' - 1010
CONTRACTOR Company: 24 V ou ?ri11C) aTZIU'TCf A? Phone #:
Street Address: Z473 pl4 i14-rift TIZ . License*
City: Z, State:. ftAJ Zip: SU7
ARCHITECT/ Company: Phone #•
ENGINEER
Name: Registration #
Street Address-
City: State: Zip:
Sewer & water licensed plumber: Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the info rmati co e t and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Remodel/Repair Requirements
? 2 copies of plan
? 2 site surveys (exterior additions & decks)
? 1 energy calculations for heated additions
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No
BUILDING PERMIT TYPE
vrrn.? vac wll? I
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ?
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ?
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ?
? 04 'SF Porch ? 09 `12-plex ? 14 Fireplace ?
? 05 SF Misc. ? 10 - plex ? 15 Deck
WORK TYPE
? 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
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Basement sn'. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building Engineering .
Valuation: $
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Variance
% SAC
SAC Units
/ u CITY USE ONLY
PERMIT #: !16 h " I RECEIPT DATE: 7/ j o -o I
WIDENTIAL MECH NICAL PERMIT APPLICATION
CrrY OF SARAN
3630 PILOT KNOB RD
EAGM MA 551 EE
651-6$1-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: L-2--01
SITE ADDRESS: 1 ?• `Q n n 0 .
OWNER NAME: Ck0.._G qfyd_AS-za? TELEPHONE #: (1 < c(5ot--IY2-Ca
(AREA CODE)
INSTALLER NAME:
STREET ADDRESS:
CITY: )(A C $=
TELEPHONE #:
aZ;a- 3w-oooss
(AREA CODE)
STATE: /1? ZIP: 'G_S?n 9
Ol..we. ..6nn14 .n rt' M.v+ In ?6n n.'.i/ WArle #s A
New residential dwelling unit under constructionand not owner/occupied $ 70.00
Add-on, modification or alteration to existing dwelling unit $ 50.00
• furnace replacement
• air exchanger
• air conditioner
• other
i'1/1`g
Nature of work: A a
v
State Surcharge $ .50
Total $ GD -Yc
Reminder. Call for inspections.
1 n
n{I AUG S 200'
Updated I/01
CITY USE ONLY
PERMIT #:
APPROVED BY:
INSPECTOR
RECEIPT DATE:
COMMERCIAL MECHANICAL PERMIT APPLICATION
CITY OF KAEMN
3$30 PILOT KNOB BD
EA(I N, MN 551 EE
651-681-4675
Please complete for: all commercial industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME: PHONE #:
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #: -
(AREA CODE)
STATE:
WORK TYPE: New construction Install U.G. Tank
- Interior Improvement Remove U.G. Tank
Processed Piping
Specify Nature of Work:
When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and
Plumbing (inspector.
Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater.
Underground tank removal/installation = minimum fee
Contract price: $ x 1%= $ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
SIGNATURE OF PERMITTEE
Updated 1/01
0;z ' /2 Cc,&Cc,
----------------
I For Offic'e:Use
I I
Permit#: f?lcf ? j
'1' Ll I Permit Fee: 2'"0 I
I I
Date Received:
I I
I Staff:
_i
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: '7,01 Site Address: r9014 f?ka,i bl-
Tenant:
Suite #:
RESIDENT I OWNER
-G3y3
Phone:?1Z-z7_1
Name:
/
Address / City / Zip: z b y 7 h4lP Lar
actor
V Contr
Applicant is: - Owner
TYPE OF WORK l
ra
?4j
EG
;t I-LYYLr'J
Description of work:
Z
1
t?
Cost: / 3 7/ S Multi-Family Building: (Yes No Ao?
Construction
CONTRACTOR _
Name: Jr _) aiffu Am, T/,3,4a2j Licensee #: ?f7 t? p p
Address: I z ?d? /(,yj t! o_ -`7 / / ,04
City: rh ina 4-"hd State: Zip:
Phone: lllZ-?7 -?ll?S Contact Person: kcy)i Tll l T'Ll
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
_
Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
(J 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 maybe 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 work will be in
accordance with the approved plan in the case of work which requires a review and approval of pla /j
X l ?V Iti ( l) IJ D X
Applicant's Printed Name i I F Ea t Z??$ Applicant's Si nature Page 1 of 3
Q
DO NOT WRITE BELOW THIS LINE
SUB TYPES
? Foundation ? 05-plex ? 16-plex ? Accessory Building ? Pool
? Single Family ? 06-plex ? Fireplace ? Porch (3-season) ? Ext. Alt. - Multi
? 01 of - Plex ? 07-plex ? Garage ? Porch (4-season) ? Ext. Alt. - SF
? 02-Plex ? 08-plex ? Deck ? Porch (screen/gazebolpergola) ? Multi Misc.
? 03-Plex ? 10-plex ? Lower Level ? Storm Damage
? 04-Plex ? 12-plex ? Miscellaneous
WORK TYPES
? New ? Interior Improvement ? Siding ? Demolish Building'
? Addition ? Move Bui lding ? Reroof ? Demolish Interior
? Alteration ? Fire Repair ? Windows ? Demolish Foundation
? Replacement ? Egress Window ? Water Damage
` Demolition (entire building) - give PCA handout to applicant
DESCRIPTION:
Valuation /
(I?{ o o o
Occupancy
MCES System
Plan Review Code Edition
- SAC Units
(25%100% Zoning z?
- ^+ City Water
Census Code /?? Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Const. tlfl Width
REQUIRED INSPECTIONS
Footings (new bldg) Sheetrock
Footings (dock) Final/C.O.
_ Footings (addition) -,4 Final/No C.O.
. Foundation -
HVAC
Drain Tile Other:
Roof: -Ice & Water -Final Pool: Footings
Air/Gas Tests
Final
Framing -
-
Siding: -Stucco Lath -Stone Lath -Brick
Fireplace:-R.I. _AirTest -Final Windows
Insulation Retaining Wall
Reviewed By: Building Inspector
--------------------------------- - ------ - -------------- - -- - ------- ------- ------- ------- ------------------------------ - -----------------
RESIDENTIAL FEES:
Base Fee
Surcharge
r
Plan Review o
i
MCIES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
Total
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA158698
Date Issued:10/28/2019
Permit Category:ePermit
Site Address: 2112 Shale Lane
Lot:10 Block: 7 Addition: Cedar Grove 4th
PID:10-16703-07-100
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
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: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Brett A Larsen
2112 Shale Lane
Eagan MN 55122
Greenguard Construction Inc
2915 Waters Road, Suite 101
Eagan MN 55121
(651) 289-7000
Applicant/Permitee: Signature Issued By: Signature