1233 Wilderness Park Cir 5/C/ REDUEST FOR ELECTRICAL INSPECTION EBOOOOb08 I
j ? See msimcLOns lor completing ihis forrn'on back Ot yellow ropy 101y.1
I "X" Below Work Covered by This Request
e~mA_ Re"p.I TypeolBwitling Applianceswiretl EquipmemWired
Home Range Temporary Service
Dupiex Water Heater Elednc Heating
Apl Builtlmg Dryer Other (Specdy)
Commllndusirial Fumace
~ Farm Au Conditioner
Other IsVecilyl Gomremors Remer:s, i
I
~
Compute lnspection Fee Below: I
d Other Fee ServiceEniranceSae Fee # CucunslFeeders Fee
Swimming Pool 0 to 200 Amps ~ / 0 ta 100 Amps
Transformers Above 200 _ Amps A P 700 _ Amps
SigOS inspenor's Use oniy , TOTAL
Irngaeon Booms ,;0(" il ~
Special Inspection
AlarmlCommunicaLOn THIS INSTALLATIO BE CONNECTED IF NOT
Other Fee COMPLETED WIT O
I, the Electrical Inspector, hereby Rougmin ~ oa;
ceNfy that the above mspection has F,,,ai oa
been made. --OFFICE USE ONLV This reQUest voia 18 momns Irom
. _ _ _ . -..r..,...
YILUGE OF EAGAN WATER SERVICE PERMIT
.
3795 iibt Kwob Rood PERMIT NO.: 2052
Eoyan, MN 35122 DATE: 9/ 2 0/ 7 fi
Zoning: RI No. of Units: 1
Owner: Sm$nn Pn ersen
Addreas•
s c ress: 1233_ldilderne~s Park Cir le L12 B1 WPk
P um r: .~ro ject PlumbinQ Co.
Meter :A-.Sr 'A 3,140 Connection Charge: 220.00 pd
Size: ~ Account Deposit:
Reader No.: ys / Permit Fee: 10. 00 pd
I eyno to eowqlr with tIN Villov of Eayoe Surcharge: • 50 pd
O?Iin74-~ ~ Misc. Charges: 60.00 pd
Total:
By Date Paid:
Date of Insp.: lnsp.:
YILLAOE OF EAOAN SEWER SERVICE PERMIT
3799 Mlot Kweb Roe/ PERMIT NO.: 2802
Ee4ee, MN 55122 DATE: 9/ 2 0/ 7 6
Zoning: _ - No, of Units: 3-
Owner: SV nn Petersen
Addreas:
Site Address: 1233 Wilderness Park Circle I.12 R1 WP
Plumber: proiect Plumbinq Co
9/15/76 #4116 100.00 pd
I a9rN to eomPly with tlw ViUep ei Eopw Connection Charge: 350.00 p d
0741memcm Account Deposit:
Permft Fee: 10 . 0 0 p d
Surcherge: •50 pd
gy; Misc. Charges:
Date of Insp.: Total:
Insp.: Date PaW:
CITY OF EAGAN Remarks
Additfon LAt 12 Bik ~ Parcel 10 8 2 0 120 1 II
o,,,,,, r?'L 7~-`~1 str~t 1233 Wilderness Park Cr. stete Ea.gan,MN 55123
TJ
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK a(
176,05,. 8,080 20
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATEFi AREA _ rfinjw STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
51DEWALK
STREET LIGHT
WATEH CONN.
9UILDING PER,
SAC Co
PARK 1111.7
Roaeipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fm
FfIJ in numbered spaces 5/C
Type or Print !eglbJy Tot
1. Date 2. Installation Cost
3S ~'k C~' ro L°.
3. Jvb Addresa / <~`nL.ot r~ ~ Blk. % Tract
4. Owner
5. Contractor Phone
6. Address
7, City State Zip
8. Building Type: Residentiai D Commercial ? Institutional ?
9. Work Description: New ? Add ? Alier ? Repair O
10. Oescribe Fuel TYpe
11. No. Eauioment BTU - M. Ea. No. Equiament CFM
Forced Air Air Handling:
Mfg. •
Boilers Mech. Exhaust
Mfg.
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gaa, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
oomply with all ordinances and codes governing this tYpe of work.
Signad : for
Rough Final ~
Inspections: Date Insp. Date 7~~~,, /G _InsP• ~
T'Z
This is your permit when numbered and approved.
ARproved CITY OF EAGAN 464-6100
I SPECTIUN REC4R9
CITY OF EAGAN PERMIT TYPE: ' " '
3830 Pilot Knob Road Permit Number. i4 110
~
Ea9an, Minnesota 55122-1897
Date Issued:
(612) 681-4675 • ~
SITE ADDRESS: E~? r-. t:, 11.1 111 F ~ APPLICANT: '
ir1 ;CPARI( t: (lt P~r1~ i I f! ;'i',~.t,~ f r1 I F•
ri! . . i r4 I,t ; i . ~ .
PEqM1T Su~qTYQE: TYPE OF WORK:
INSPECTION TYPE DA • D•
~
~
~ ~
Permit Hoider Date Telephone M
PLUMBING
HVAC
Inapeetion Dste Insp. Commants
FOOTINGS
FOUND
FRAMING
ROOFING yz ~ ~
ROUGH
PLUM8ING
PLBG
AIR TEST
RQUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
RUSH
MAINS
conioucTwiTr
TEST
HYDFIOSTATIC
TEST Q
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FlNAL
~
I
- -
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
~ 3830 PILOT KNOB RD - 55122
651-681-4675
New Construclion Rwuirements RemodeVReoairReauiraments
• 3 registereA site surveys showing sq. ft. of l04 sq. ft of house, an~ll roofed a2as • 2 co0ies of plan
(20% maximum bt caverage albwed) . t set of Eneigy CakriWtbns for heated addilbns
• 2 copies of plan showug beam 8 windax srzes; poured found desgn, elc ) . 1 site survey for extenor additans & decks
• 1 Set of Energy CalCUlalions • IndxatC rf home SCrvCd by Septlc system for 2ddibons
• 3 copies of Tree PreservaGOn PWn i( bt platted afler 7/1193
• Rim Joist Detail Options selechon sheet (bldgs wiN 3 or less unils)
DATE 10 - L-I -n I YALUAION
JOBSITEADDRESS la~~~dWAer?iP55 }7Grk Gi~~IP
IF MULTI-FAMIIY BUILDING, HOW MANY UNITS?
PROPERTY OWNER C>fe~
TYPE OF WORK I~,orc. FIREPLACE(S) ?O _ 1_ 2
APPUCANT F ` ?t - PHONE# 9SuLy~J'r-_373~
ADDRESS I6~Sn OfbS+er C+• 11or jCe ~ Yl• ZIPCODE .SS_?~
PAGER # CEII PHONE # FAX #
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Categary _ MINNESOTA RUI.LS 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor: Phone N:
Plumbing System Includes: Water Softener Lawn Sprinkler Pee: $90.00
NVatcr Heater No. of R.I. Baths
No. of Baths
Mechanical Contractor: Phone k
Mecf~znical Systcm Includcs: Air Conditioning Pee: $70.00
_ Heat Recovery System
- -
Sewer/Water Contractor: Phondli"
i i
~ • ,
All above information must be submitted prior to processing of application.
f
I hereby acknowledge that I have read this appiication, state that the information is correct, and agre-eto comply
with afl applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of AppUcanf
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1101
OFFICE USE ONLY
? 01 Foundation ? 07 OS•plex 0 13 76-plex ? 20 Pool 0 30 Accessory
~ldga
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace X 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 E#. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multl
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Starm Damage
O 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
32 Addition ? 36 Move Bldg. ? 42 Dertalish (Foundatlon) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• O 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolilion (Entire Bldg only) - Give PCA handout to applieant
Valuation 41 ; a00 Occupancy (l ; _ L/'L MC/ES System
Census Code 4 3~ Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. I -Lj
PRV
Nbr. of Bldgs _L Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings(new bldg) FinaUC.O.
Footings (deck) _y FiuaVNo C.O.
Footings (addirion) _ Plumbing
Foundation HVAC
Drain Tile
Roof Ice & Water Final Other
~ Framing _ Pool _ Ftgs _ A'u/Gas Tests _ Final
F'veplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone
Insulariou _ Windows (new/replacertwnt)
Approved By T2- , Building Inspector
Base Fee 3- 5~" NSt*J
Surcharge
Plan Review
MCIES SAC
City SAC
Water Supply & Storage
S&W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
~~~~~s /ao~~!
Fequest Date, Fire No. Rouph-in Inspettion NOTICE: You Must Call Electncal Inspeclor
Reqmretl'+ II A PougM1-In Inspedron
/I ?Yas ~~41fto IsPeQwretl.
I
~I licensed contractor ? owner hereby request mspeCtion of above electrical work at
i
Job Atldress (Snee6 Bax or Route No ) ~I City-
~2
Section No Tavnship Name or N. Range No, C ut~
(i (PRINT) one No.
Power Supplier ` Atldress
IC
Etecvical Contrecmr ~C ~ma) ~ I ConlraMorS L~cense No.
me?~c~ ~e ~c , cr Ao
atling Address (COntroctor or Orvner Making Inslallatmn) ~
\
1
Auih z ignaW~ (Contracton glnstallation) PhoneNUmber
NESOTFO OF ELECT TY THIS INSPECTION REOUEST WILI NOT
Grlggs-MlRoom 5-19 8E ACCEPTED BV THE STATE BOARD
1821 UnivPeul, M 106 UNLESS PROPER INSPECTION FEE IS
Vhone(6 Ba1-0B00 I ENCLOSED.
- neWUesi run nLtGIFi1, INSPEGTION ` ~EB-00001-/
i S e i sl qio lor comple~ing Ihis lorm~on back ol yellow copy, pS
~ 'Be/ow Work Covered by This Request
M 20268 ~9 ~ ~ °
i Add"f!p. T ofBdtlin AppliancesWuad EquipmentWiretl
Home Range Temporary Service
Duplex Water Heater Electric HeaM1ng
Apt. Building Dryer Load Mana ement
Comm./Industrial Fumace i Other (Specdy)
Farm Air Condrtioner
OtM1er (spenty) Conlrador§ Pemarks:l I lyC
Compute Inspection Fee Below: Ccpa...i, r" Ma4il
# Other Fee # ServiceEniranceSrze Fee # CircuRS/Featlere Fee
Swimming Pool 0[0 200 Amps 0 to 700 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
SigflS Inspectorb U. Ony TOTAL
Irriga6on Booms ~Q • 'S`~
Special Inspection
Alarm/Communication THIS INSTALLI TION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the ElecUical InspecloC hereby Rouqn,n I Date
certify that the above inspection has F~~ai i ome•
been made. „
OFFICE USE ONLY
This reduest voitl 18 monihs imm
i ~
CITY of EAGAN 4067
BUILDING PERMIT
....5:.....~G4..~f"S.AN......r.ePAr..S.7.~.....1l.c...... 3795 Pilo! Knob Road
Ownei ~ Eagan, Minneaola 55124
Addsea (Presenf) ~!.7~L.....~I.lf7..~:~.I.•`....f..t'f../..~,~.~$.......5..-.5.~/3 ~J 454-8100
Bulldar .......................s a7./.Yl.K................................................... > / ~
Addreai ~ Deto l..~..2.~(l
~
DEBCAIPTION
Btoriec To Be Uaed For Fron! Deplh Heigh! Eai. Cos! Permi! Fee Aomarlcs
/6
gc ~ 8 ~5~ ~oa • 333 LOCATION
Sireal, Aoad or oiher Daseripfion oI Locelfon I I Lo1 Bloek Addillon or Trsc!
This permii does not aulhorize the use oi elreefs, roads, ellaps or cidewallu nor does if give the oanor or his agen!
the riqht to ereale any sifuation which is a nuisence or which presents e hasard !o the heallh, safelp, eoaveaienp and
general welfare !o anyone in the communily. . ~
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WOAK IS IN PROGRESS.
i
ihis is !o eerlify. haepermiaston !o erec! a..~~,~ . ....._upoa
the above described premise subjeci Yo the provisions af all applicable Ordinanees for !he Ci2~Eagan.
..,1.`!.!.....L......~...~.1..z2
Pr ..~~.l........~~...................
.
Mayor Suildinp Iaspxlo
r-
,
CS`i'Y CF E9GAN
37.05 Pilot Kno3 P.oad
Eagan, Nlinnescta 55122
PERi~'fIT N0. : 805
The City of Eagan hereby grants'Ito Genz-RVan Plumbinv &
Heatinq Znc. o£ ~ Rosemount, MN 55068
a HEATING Permit for: (Owner) Svend Petersen '
at 123,8 Wilderness Par1S pirsuant to application dated _ 9/16/76
Fee Paid: $20.00 dated this 24 day of September , 19_ 76
.50 s/c ~
i
Building Insp°ctor
Nechanic[Ll Permits: ,
Bid Total:
' / o ~s~a So iC)o
II
~
727
I
Project Plumbing Co.
~ 9743 Hur.ibold tAve. So.
I
PLUMBING $venn Petersen Const.
Frk Cizcle
123 & 1235 4lilderness 76
$40.00 20 September 76
1.00 s/c
I
I ~
,irr.10 2d Carlson I
Wildernesa Run Road
~ ~ '-ag<' L, Mi nn . Bk : 2 9/153
.
DELMAR H. SCHWANZ lANDSUWVEYUA
Feps\m~C UnG.r L.~t of Tne ISi.:. of Mmneeob 11515 SOUTM ROBENT TRAII P.O. BO% M ROSEMOUNT, MINNESOTA 55088 PMONE 012 423-1789
I
, SURVEYOR'S CERT,IFICATE .
~
r
~ 7500
'
N 88 ° 30'44 " W
h o 'o
. 1~ a
LOT 12
+ ~ .
"T z o
So iou anovo leo,; a r- I 7 R~
I 10 i ~ HOVS,E
1 incn = 47 !'eet
<o..
o Denc*.es irori mor.. o
/ O . .GGR%. If
\I~ Q
30.0
` 1-t:,~-.Drainage
LY m u tillty
~
R-j68;~5 ` ~S`~~• -
, 0
~
I
:tereby cert,lfy that thits is a true and correct representation of
a survey oP the boundari~:s ..nf : "
Lot 12, II1ock 1, WILDrRNESS ?ARK ADDZTION, accurding to the
recorded plat thereoF, Dakota County, Minnesota.
It also shops the location of a proposed ou11d1nF. As surveyed by me ~
this 19th day oP Auguat, 197t,. I ~ O
~ ~
I ,
I •d,wrvFSOTA REG[S RATIO4 N0.8675 /
I I I ~ f
PERMIT
CITY OF EAGAN
83C4 WifotKnobRoad PERMITTYPE: aurLorNe
~ agan, Minnesota 55122-1897 Permit Number: 0 3 3 3 6 0
(612) 681-4675 Date Issued: 0 9~ 2 2/ 9 8
SITEADDRESS: 1233 WILDERNESS PARK CIR
LOT: 12 BLOCK: 1
WILDERNESS PARK
P.I.N.: 10-84250-120-01
DESCRIPTION: R E R O O F
Building Permit Type STORM DAMAGE
Building Work Type REPAIR
.Census Code 434 ALT. RESIDENTIRL
~
, . ' . . . _ . , ' .
. i `
REMARKS: i I
FEE SUMMARY:
I
NrA`fIN~TAq~56CIATES _ pPP 114691212 0009228 OJONES WNER: GREG
26386 HIGHVIEW AVE 1233 WILDERNESS PARK CIR
FARMINGTON MN 55024 EAGAN MN 55122
(612) 892-0454 (651)
I hereby acknowledge that I have read 'this application and state that the
information is correct and agree to co'mply with all applicable State of Mn.
SCatutes and City of Eagan Ordinances.
L J
APPLICAN7/PERMITEE SIGNATURE UED BV: SIGNAT E
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
~ 3830 PIT.OT KNOB RD - 55122
3 c) e81-4675 Naw Construetion Re uirements RemodeUReoair Reauirements
? 3 registered site surveys • 2 copies af plan
• 2 copies of plans (incluCe beam 8 window saes; poure0 fnd. design; etc.) ? 2 site surveys (exteriar additians 8 decks)
? 1 energy wiculationa ? 7 energy calculations for heated additinns
? 3 copies of !ree preservation plan d lot platted after 777193
reqwred _ Yes _ No 00
DATE: - CONSTRUCTION COST;
DESCRIP N OF WORK: ~ D7/YI
~
S EET ADDRESS: ! L _
LOT: BLOCK: SUBD./P.I.D. n'v~a AJ-) ~
Name: Phone
PROPERTY Laz irst
OWNER p y ~ \
Street Address: aJ/ ~ ~lijL~/
Ciry State: f~I/ V/ Zip:
Company:&/! Ar-) lt-/Lcl:/ e • 1c~1~v~iwjl
CONTRACTOR / /
Street Ass: ~~Dla License #
City ddrg ~ State: ~V Zip:
ARCHITECT/
ENGINEER Company: Phone
Name: Registration
Street Address:
C iry State: Zip:
Sewer 8 water licensed plumber (new construction only): Penalty applies when address chanc
and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application and state that the info ation is ce and agree to compty with all appiicat
Siate of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applica :
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
.
BUlLD1NG PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging 0 16 Basement Finish
O 02 SF Dweliing ? 07 4-piex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 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
? 31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
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 Valuation: $
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Pertnit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
1:2 3.,7 ,eA...
MASTER CARD
LOCATION
OWNER
STRUCTURE AND
LAND USED AS
Issued To
Permit No. Issued Coniractor Owner
BUILDING
PLUMBING 1? 0/ -2U-'~
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING ,
GAS INSTALLING
SANITARY SEWER •
OTHER
OTHER
Approved
Items (Initial) Date Remarks Distance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL DEPTH
HEATING OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD .
PLUMBING
WELL
I
SANITARY SEWER
~ Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONIY IN EVENT OF OBSERVED VIOlATI0N5
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE ? NON-COMPLIANCE. BUILDER DOES NOT
OBSERVED. INTEND TO COMPLY.
~ ACCEPTABLE SUBSTITUTIONS OR ~
DEVIATIONS. COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
? REINSPECTION REQUIRED DATE OF REINSPERION
REINSPECTION REVEALED
CERTI FICATI ON - I cettify that I heve carefully inspected the abwe in which I have no interest present or prospective, and thet I have raported herein
all significant conditions oLServed to 6e at variance with ordinances of the Town of Eagan, apprwed plans and specifications, and any specific require-
ments for off-site imprwements relating to the property inspected.
F-I ALL IMPROVEMENTS AGCEPTABLY COMPLETED
BUILDING INSPECiOR DATE
COMMENTS:
23
Attn: ~
• Arnold Carlson
1255 Wilderness Run Road
F-1gt*%, t+li. nn . Bk : 19/153
_ DELMAR H. SCHWANZ LAND SUR V EYOF
ReqUlcreO Vnoar Lawt ol Tne Stale of Mmnesota 14515 SOUTH ROBERT TRAII P.O. BOX M ROSEMOUNT, MINNESOTA 55088 PMONE 812 423-1788
, SURVEYOF'S CERTIFICATE .
~
\ L I~.)
7s. oo '
I N 88 °30'44 "W
h O' io
lb
- O
yp° / LOT 12
I L 0--. .~;7o
30 VROPOSID/ o r-
a = r-~
10 o HOUS~E
n i
I ~
1 inch = 40 f'eet
0 ~
o Denotes irvn mon. :
a
-~w
N I I o I
a ~ GAR /
1 /
oo : J, z<.o .
1-7- llrainage ~ - ~
m utility
~
l11 0'o' esmt. ~ oa3~Q0
u~ ,o - L ,6 .
o ~ ~L R'
L_10~a3 ` ~~r,•
i ° k
I ~f,1` jC)1 ,
1 ~
I
_T hereUy cer•tify that thta .Ls a true and correct representation oP
a survey of the Uoundarles of: I -
Lot 12, B2ock 1, WILDF.RMESS PARK ADDITTON, according to the
recorded plat thereof, Dakota Coyinty, Minnesota.
It also ahows the locatlon of a proposed buildlnF. As surveyed by me ~
thls 79th day ot August, 197c,. O
,
'1 nNFSrITa qEG15'YRA7I(1~1 NO 8625 ~
• \
Date:
BUILDII7G PERMIT P.PPLICATIOI4
LOT __Zg BIACIC ADDITI
~
PARCEL & SiCTIODI PNtdBER IF UB]PLATTED -
ADDRF.SS OL' PP.RCEL I.~ /./~~-~~•r.n.~',%Li /~iti/-~ P/2~'~[v ,
AOi1TIdG_~--aCCUPIiPJCY W 'e;~t5~
E;TILIATED COS^1
Ow.dER S PF7-Eh' Sf`A/ C9 U/f/S't- (?O TELEPHONE v0.
zunxESS -//70 / u/ /'1 PG s• 5 S 4~ 3~
CONTRACTOR 5.. (fc7 ?'~LEPxorE rto.
AnoREss ~ 7 o i Gv o T= 5-~- /Ll f'L s_ f'y i•vr~. y 5~f 3 7
iiotes Include site plan, building plans, and elergy calcul ' ns vJith this
application ~
S' ed
OPFICE iTSE
VALUATIOII
SAC ~ ys~ Da
ATER co.~vEcTxoea ~
ra
kJATER !4ETER ~ I..~ • 0c)
BUILDING PER1,1IT FEE
~
SURCHA.RGE FEE 3 -PLAtI CfiECK FEE
PAFtiC DEDICATIOId FEE
OTHER -
TOTAL* ~ /
I V '
APPROVALS: ~
ASSESSMEiVT CLERK_4~~BUILDING DEPT. POLICE DEPT.
WATER & SETJER DEPT. FIItE DEPT. PARR DEPT.
~
MECHANICAL (RESIDENTIAL) 12p ~
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX 4 651-675-5694
Please complete for. Smgle Family Dwellings
Townhomes and Condos when permi[s are required for each unit
Date
Site Address ~rlr.`js pQY c-;-r- Unit #
Property Owner VTL[~ ~ V LJ..~.i..~, U~'CS Telephone )
u
Contractor Wohlers Southside Htg. & Air, Inc.
I 6950 W. 146' St., #106
Street Address _ Apple Valley, MN 55124 Cjty
(952) 431-7099
State Telephone # ( )
The Applicant is _ Owner ~ Contractor Other
Add-on, modification or alteration to existing dwelling unit $ 30.00
furnace replacement
air exchanger
~ air conditioner
other
State Surcharge $ .50
C,I ~
` ~II11
Total
SCP 0 8
i
I herehy apply for a Residen[ial Mechanical Permit and acknowledge that the iafol tion-is-complete=and•accu~'rate; 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
pemut, but only an application for a permit, and work is not to start without a pernvt that the work will be in accordance with [he
approved plan in the case of work wtrich requires a review and approval of plans.
UD~1@5 QCAr~,t.v (.jj_~,,~
Applicant's Printed Name Applicant's Signature
MECHANICAL (COMMERCIAL)
Permit Application
City OfEagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Plcasc complete 1'or commercial/industrial buildings
multi-family buildings when separate permits are not required Por each dwciling unit
Date
Site Address Uni[ #
Tenant Name (if applicable) Previous Tenant Name
Proper[y Owner Telephone # ( )
Contractor
Street Address City
S[ate Zip Telephone # ( )
The Applicant is _ Owner _ Contractor _ Other
Work Type
New construction Underground Tank _Install _Remove
Interior Improvement Call for inspection during installationlremoval of tank
Processed Piping
Nature of Work:
Permit Fee 550.50 Dlinimum Pec (includes Stntc Surcharge)
Contract Value $ x I% Permit Fee
• If permit fee is $1,000 or less, add $.50 ~ $ State Surcharge
If permit fee is over $1,000, add $.50 per
$1,000 Permit Fee
$ Total Fee
1 hereby apply for a Commercial Mechanical Permit and acknowledge that the information is compie[e and accurate; [hat the work
will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes: that I understand ihis is
not a permi[, but only an applica[ion for a permi[, and work is not to start withou[ a permi[; that the work will be in accordance wuh
the approved plan in [he case of work which requires a review and approval of plans.
Applicant's Printed Name Applican['s Signa[ure
Approved By: , Inspec[or Date:
VJL,LAGL OF EAGAN WATER SERVICE PERMIT
3495 Pilot -Knob Rood PERMIT NO.: 2052
liglim,M14 55122 DATE: 9/20/7G
Zon g: RI No. of Units: 1
Owner: Rvmnn Petersen
Address:
Site Address: 1233 Wilderness Park Circle L12 B1 Wn'k
Plumber: If r o j e c t 1 u b i n g Cc.
Meter No.: Connection Charge: 220 P d
Size: Account Deposit:
Reader No.: Permit Fee: 10 . 00 pd
1 agree to comply with the Village of Eagan Surcharge: .50 Pd
Ordinances. Misc. Charges: 60.00 p d
Total:
By � Date Paid:
Date of Insp.: o > Insp.:
VILLAGE BF EAGAN SEWER SERVICE PERMIT
3795 Pilot Knob Road
PERMIT NO.: 2: „"
Eagan, MN 55122 DATE: / ' r , I
Zoning: & T No. of Units: 1
Owner: Sv ?rin n Petersen .
Address:
Site Address:
1233 Wilderness Park Circle L12 131 WP
Plumber: r r k ct, ',)1 dm I,, in g r t., .
9115/76 (4116 1nO.0O pd
I agree to comply with the Village of Eagan Connection Charge: 351 P
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
B Misc. Charges:
Date of Insp.: i Total: R'
Insp. _
f i Date Paid:
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA124165
Date Issued:06/24/2014
Permit Category:ePermit
Site Address: 1233 Wilderness Park Cir
Lot:012 Block: 001 Addition: Wilderness Park
PID:10-84250-01-120
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Scott Lofgren
5708 Upper 147th St W #102
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
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 -
Gregory L Jones
1233 Wilderness Park Cir
Eagan MN 55123
Lofgren Heating & Air
5708 Upper 147th St W
Suite 102
Apple Valley MN 55124
(952) 431-5811
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA124392
Date Issued:06/30/2014
Permit Category:ePermit
Site Address: 1233 Wilderness Park Cir
Lot:012 Block: 001 Addition: Wilderness Park
PID:10-84250-01-120
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 .
Michael Schrader
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 -
Gregory L Jones
1233 Wilderness Park Cir
Eagan MN 55123
(763) 444-1373
All Season Remodeling & Exteriors LLC
17344 Puma Street NW
Anoka MN 55303
(763) 444-1373
Applicant/Permitee: Signature Issued By: Signature