1243 Wilderness Park Cir
CITY OF EAGAN WATER SERVICE PERMIT
3795 Pilcwt Knob Road PERMIT NO.:
Eogen, MN 55122 DATE:
Zoning: ? No. of Un(ts: ~
Owner: qven E'~ter, a~r~
Address: -
i
l~d'i *+?iir~c•.rr~~,., ",x-'c "1-rci.,, ; P . ~c
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reoder No.: Permit Fee:
I egree to eomply wlth the Citr of Eegon Surcharge:
Ordinonces. Misc. Charges:
Total: -
gy _ Dote Paid:
Dote of Insp.: Insp.:
SEWER SERVICE PERMIT
CITY OF EAGAN
$795 Pilot Knob Roud PERMIT NO.:
Eayo,;, MN 55122 DATE:
No. of Units: ~
Zoning: ,
Owner:
Address: tz-;- CAr. 7.7 rl
~i'! -7err..c<<~~
' Site Address: ^
Plumber: ~ rC~, 7~1 S~ci
e
1 ogree to eomplY witl+ the City of Eo9o Connection Charge:
Ordinanca=. NccouM Deposit: -
Permit Fee:
Surchorge:
By Misc. Churges: Date of Insp.: Total:
I nsp.: Dute Poid:
cirr oF EAcAN
3795 Pilor Knob Raed Eagen, MN 55122 N2 4206
PHONE: 454-8100
BUILDING PERMIT Receipt #
- !'an
To be ussd fw ~ Dute 19 '
'%4? C: i 1 derne s • r. Erect ~ Occuponcy
Site Address
Lot 7 Block ~ $ec/Sub. ` Jerness :'nrb: Alter ? Zoning _
Parcel # _ Repair ? Fire Zone
Enlorge ? Type of Const. 5
m Name ;'~i1cl !'e t t: r. Se~n Move ? # Stories
7
; Address Demolish p Front ~ ft.
b
Ci 4E y Phone ~'j ~44 Grode 0 Depth it.
-
lx Na~ Approvals Fees
o
o~ Address Asseument Permit _
Ci Phone Water & Sew. Surcharge ;6.0L}
Polite Plan chetk
U~
FZ Name Fire SAC 47 i- ilCl
Address- Eng. Woter Conn.-22Q..~h~
a W Ci Phone Plonner W ; ater Meter
Counci I l~C?--~.~L~ x'
I hereby acknowledge thot I hove reod this opplication and stote that gldg. Off.
the information is correct and agree to comply with oll applicable
State of Minnesota Stotutes and City of Eagan Ordinonces. APC Total Z~~~• 4i~ _
Signature of Permittee
A Building Permit is issued to: on the express condition that
oll work shall be done in accordonce with all.applicoble Stote of Minnesota Statutes and Ciry of Easan Ordinoncss.
Building Officiol
r
r~llM~ # ah ~N~ rMwMfM
Piumbirw .4-f~6'77
Med,anicol X yY 0-~ ~
INSPECTIONlS DATE iNSP.
Rouph-In Fr+d
Footinps Dah IrnP. Dofe Imp.
Foundotian ~ Plumbt?q `.fS=)) f -1v - J'
Frome/ins. AAechaniwl
- Finol 1404 /s -10 - 7'\
~
Rema?ks:
~ CASH RECEIPT ~
.
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
RLCt1 VKD
, RltOM
AMOUNT $ I
!k DOLLARS
10e
? CASH ? CNECK
I . rOR
F1JNG CODI AMOUNT
I
~
I
I
aa BY
oll, ~095
NUMERICAL FILE COPY
CITY OF EAGAN Remarks
Additton wil Lot 7 Blk ~ Parcel 10 M250 070 L01
Owner Street 1 State FaganMN 55123
-ILL
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 176,05. 8.80 20
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AflEA
STORM SEW TRK 98
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATERCONN, 220.00 05095 -19-77
BUILDING PER,
sAC 475.00 05095 1-19-77
PARK
1_ _7
Hi I I
_ INSPECTIQN RECORD ~
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
M . r
SITE ADDRESS: } ; APPLICANT:
!.'~t tJll ill FiFlf:~`~ 1'f11:f ~.1{? t If.! .~I~i ! I~~ Ni h lPJ~
Ill I IiF I'pJi , f'IIRI
PERMIT SUBTYPE: TYPE OF WORK:
ii~ ~r li` i ~ i~ra ~ ,,r:, {l~.i : ~ ~~fl! ,
I
DA • D•
II
I
i
I
i
~
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L~ J
~
I Permk No. Permk Holdsr Dab Talephone R
ELECTRIC
PLUMBING
HVAC
InipscUon Dete Insp. Commenb
II FOO7INGS
' FOUND
FRAMING
ROOFINd
HOUGH
PLUMBING
' PLBG
~ AIR TEST
I RouGH
i HEAT)NG
I C3AS SYC
TEST
INSUL _
GYP BOARD
FIREPLACE
~
FIREPLACE
3 /Q f'f
L(~~
AIR TEST
I FINAL PLBG
FlNAL HTG
I ORSAT
TEST
j BLDG FINAL
I BSMT R.I.
~
BSMT FlNAL
' DECK FT(3
~
I DECK FINAL
~
I
~
cirr oF Er?Gi?N 'J
3795 PiIM Knob Road Eogae, MN 55122 N! 4206
` PHONE: 454-8100
BUILDING PERMIT APPLICATION 569000 Rec@;pr
To be e.W h. Sing. Fam W/ Garg. ,~OGv- Jan. 19, 19 77
Site Address1243 Wildemess Park Cr. ~ Ercct p occuPancy
Lot 7 Blxk 1 Sec/Sub. Wilderness Park Alrer ? Zoning
Parcel # Repair ? Fire Zone _
Enlorge ? Type of Const. 5
]cd]Name Svend Petersen Move # Sro?tes
ress 4701 W, 110th St. Demolish ? Front ft.
MV1• s Phone 884- 5144 Grade ? Depth 34 ff.
~ Apprwols Fees
p Name
Assessment Permit 1(~,Q5n
v~ Address S~e Water & Sew. Surchorge ?$,00
Cit P~~
Police Plan check
W
Nome Fire SAC -47 5..On
Address Eng. Water Conn. Z?C1.00
~ W Ci phone Plonner Woter Meter
CouMtl Park 120. 0
I hereby acknowledge thot I have read t' tion stote that Bldy. Off.
the information is correct and ogre ply i oll opplitoble APC Total 1052.5~
State of Minnesota Statutes and inonces.
$ignature of Permittee
A Building Permit is issued to: on the express condition that
nll work sholl '8one ac rdo wi te of Minnesota Statutes and Gty of Eagan Ordinances. I
Buildinp Official
0
2004 RESiDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
(o ~ Gl ~.f.--1 3830 Pilot Knob Road, Eagan MN 55122
~ Telephone # 651-675-5675 FAX 4 651-675-5694
CaQ-Qs~~"a"(
New ConsWdion ReauiremenLS RemodeUFteoair Reauirements Office llse OnN
3 registered site surveys shrnrirg sq. fL o11ot sq. ft ot house; and all roofed areas 2 copies of plan Cerl of Survey Reod _Y _ N
(20%maximum lot cove2ge allowed) 1 set of Energy Calculations for heated addAions Jree P2s Plan Recd _Y _N
2 copies of plan showing beam & window sizes; poured found desgn, etc. i site survey for additions 8 decks ITree Pres Required,_ _.Y. =N
lseto(EnergyCalculations Add'dion - irrdicafedonsitesepticsystem OnsiteSeptlcS~em __Y'_N
3 copies of Tree Preservalbn PWn M bt platted after 771/93
Rim Jast Detad Options selecGm sheet (bldgs wiN 3 or less unfls
Date ~Z / / ConstrGvct(on
SiteAddress /0' NeSS b69Y'fi GtH °L Unit/Ste #
Description of Work
Multi-Family Bldg _ Y~N Fireplace(s) _ 0 _ 1 )(2
Property Owner t iYf G l~'G/l G[ C Telephone #(6/2-)
Contractor /V CJ
Address Z~ /7('J/!/lGL~C - City
State Zip 7 5r.3~-J Telephone k(94-~Lio
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Iviinnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy Code Category . Residentlal VenGlation Category 1 Worksheet • New Energy Code Worksheel
(4 submissiontype) Submitted Submitted
• Energy Envelope Calculalions Submitted
Have you previously constructed a building in Eagan with a similar plan2 _ Y !bN If so, 25% plan review
fee applies.
Licensed Plumber Telephone )
Mechanical Contractor n Telephone #
Sewer/WaterContractor Telephone#( ~
Fiv 1~~n
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accwate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; 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 whic~h requires a review and
approval of plans.
ApplicanYs Printed Name ApplicanYs Signature
OFFICE USE ONLY `
Sub Types
O Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
~ 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage O 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck O 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 70-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex 0 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation <45 Fire Repair
? 33 Alteration ? 37 Demolish Buiiding' ? 43 Reroof ? 46 Windows/Doors
? 34 RBplacement 'Demolition (Endre Bldg) - Give PCA handout to applicant
Valuation O 4 rJ Occupancy ~e~MCLS System
Census Code Zoning ~ City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const ~tj Width
REQUIRED INSPECTIONS
_ Footings (new bldg) Z( FinaVC.O.
_ Footings (deck) _ FinalMo C.O.
_ Footings (addition) _ Plumbing
Foundation HV AC
Drain Tile O[her
Roof _ Ice & Water _ Final _ Pool Ftgs _ AidGas Tests Final
~ Framing Siding _ Stucco _ S[one _ Brick
Fireplace R.I. AirTest Final ~ Windows
Insulation _ Retaining Wall
Approved By: , Building Inspector
-
Base Fee I U~
Surcharge Sa•ov
Plan Review
MC/ES SAC ~~/~ff1n
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
7otal I U f ~J
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
(osqls~ CITY OF EAGAN J U
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date -I 1 iq ! O 7
Site Street Address I a y A9 R-f- C~ Itt, t't, Unit #
PropertyOwner G-(Zw~.fcl. Telephone# ( )
Contractor S`Cfc~^~~~1,aSS ~LIj '"^%ITelephone#(41VI 30-01Ld
Address 11L E$b ST $4- E ( 0~ City (14ASIcA State MN Zip .SS 3/(
The Applicant is: _ Owner tX Contractor _Other
Alterations to existing dwelling $ 50.00
X Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment D ~
_Water Turnaround (add $121.0 'f a 5/8" meter is required) ,JUL 1 6 Z0 4
Other.
ey------'""="
Water Softener _ Water Heater $ 15.00
_ replacement _ additional
_ Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00 ii
State Surcharge $ 50
Total
I hereby apply for a Residential Plumbing 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 the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
J. r-.I f- ~ A
LV(rcf/.~1
ApplicanYs Printed Name ApplicanYs Sigsn,ature
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION ~~~~Cfc( 7~02. /0
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. smgle family dwellings & townhomes/condos when permi[s are required for each unrt
Date ol
SiteAddress 1,7 Bmv- Unit#
T/,Y~
Property Owner 1-e,~ Telephone # ( )
Contractor F- qTI1JL+ '~p Cfl-61,1PZ4 1 WN)
S[reet Address 550~-~ g'Q. L~ City HAF,$ (:~;fLCV.B,
State Zip ~3&7 Telephone #
Bond Expires:
The Applicant is _ Owner ~Con[ractor _ Other
Add-on or alteration to existing dwelling unit JUL 0 1 2004 $ 30.00
~ furnace _Additional _/Replacement
air exchanger By
airconditioner _New _Replacement
other %~(.IGTWO~tK- 12~1J1510(,D"f
State Surcharge $ 50
Total $
I hereby apply for a Residential Mechanical Perntit and acknowledge that the information is complete and accurate; that the work will
he m 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 tha work wil] be in accordance with the
approved plan in the case of work which requires a review and approval of pla~nj ~
d1I&S P;C1igL~al.i- t~-'ti ~
Applicant's Printed Name Applicant's Signature
2004 COMMERCIAL MECHANICAL PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone N 651-675-5675
Please wmplete for. commerciaVindustrial buildings
muiti-famity buildings when separare pertnits are not requirod for each dwelting unii
Date
Site Street Address Unit N
Tenant Name (i(applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Stree[ Address Cjty
State Zip Telephone # ( )
Bood 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:
*`VYhen installing/removing underground tank, call for inspecfion by Fire Marshal and Plumbing lnspector
P¢rflllt F¢¢S: 570.50 Underground lank installa[ion/removel
550.50 Minimum (includes Statc Su¢harge)
or
Contract Value $ x I% _ $ Permit Fee
• If ep rmi[ fee is $1,000 or less, add $.50 a $ State Surcharge
If pe rmit fee is over $1,000, add $.50 for
every $1,000 ep rmit 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 wnformance with the ordinances and codes of the City of Eagan and with [he Mechanical Codes; tha[ I understand this is
not a permit, but only an application for a permit, and work is not m start without a permir, that the work will be in accordance with
the approved plan in the case of work which requires a review and approval of plans.
Applican['s Printed Name Applican['s Signature
Approved By: , Inspec[or Date:
RESIDENTIAL BUILDING
~ Permit Application
City Of Eagan 0-70. 7,5
3830 Pilot Knob Road, Eagan MN 55122 ~Uj/~
Telephone # 651-675-5675 FAX # 651-675-5694 r~'~d a/
New ConsWCUon ReawremenCS RemodeVReoair Reouirements ORce Use Onlv
3 registered site surveys shaxing sq. ft. of lot, sq. N. of house; and all rvofed areas 2 copies ol plan Cert of Survey Recd _ Y_ N
(20% maximum lot coverage allowed) 1 set of Energy Calculabons for heated addi6ons Tree Pres Plan Recd Y N
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for addilions & decks Tree Pres Reqd Y N
1 setofEner9yCalalalions Adddion - indicatedon-sdesepUCSystem On-siteSeplicSyslem _ Y _N
3 copies ot Tree Preservatlon Plan if lot platted afler 711193
Rim Joist Detail Optrons selection sheet (bidgs with 3 or less uniLs
~
Date n Construction Cost
Site Address cjlideYrwe-ss ~'~~if4 ///c / UniUSte #
Description of Work e 4Q6,qCC, /Y! Cr.t/l
,
Multi-Family Bldg _ Y x N Fireplace(s) _ 0 _ 1 _ 2
Property Owner c//M 204,dIY> S Telephone #(~j% )~,5~ sa~ °j
Contractor
Address / 57 • City UJ~57TY~---
State /577/l) Zip SS O~ Telephone
&fi/ i a -V
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheel • New Energy Code Worksheet
(Jsu6missiontype) Submitted Submitted
• Energy Envelope Calculatlons Submitted
Have you previously constructed a building in Eagan with a similar planZ _ Y _ N If so, 25% plan review
fee applies.
~
_---~p ~ -
Licensed Plumber Telephone ~
Mechanical Contractor f~~lI nIII SEP Za~~ I~ i) Telephone ~
Sewer/Water Contractor luu I Telephone # ( )
Bv -
[ hereby apply for a Residential Building 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 the State oF MN
Statutes; 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 wo which requires a review and
approval of plans.
zap
Applicant's Pried Name ~ Applicant's Signa e
OFFICE USE ONLY ~
Sub Types `
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30. Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Ait - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Exl. Alt - SF
? 04 02-plex ? 10 OS-plex 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex 0 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_v or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition O 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bidg)' ? 43 Reroof ? 46 Windows/Doors
34 ReplaCement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation (9 ZIP ~ Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
Footings (new bldg) FinaUC.O.
Footings (deck) Y FinaVNo C.O.
_ Footings (addirion) Plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ AirTest _ Final _ Windows(new/replacement)
_ Insulation _ Retaining Wall
Approved By -z , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S8W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
~ . o r : . ,
~ erson
~ 2at 110th Street
.,mington, Minneaota 66437 ~
. 2"1:5C-51
DELMAR H. SCHWANZ
LAND SVRVEVOR
R"isbratl UnCer L&ws o1 Tne SUta o1 Mmneso4
74515 SOUTM ROBERT TRAII P.O. BOX M ROSEMOUNT, MINNESOTA 55088 VHONE 812 423-1788
SUHVEYOR'S CEHTIFICATE
hi3
,fo
9a ~ ~ I
~ 34
(~<%~L?~ ~ ~ vr9~~`~v ~ ~
0 o h(~r7r1~'` I v°~° b`.u
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~ CA/1j 70 n/ ANE
I hereby certlfy that this is a true and correct repreaentatlo::
oP a aurvey of the bourtdaries of the following deacrlbed trsct
of land;
Lot 7, Block 1 of the recorded plat of WILDERNFSS pAF,K
ADDZTION, City of Eagan, Dakota Coanty, Minnesota. ~
Also showing the locatlon of a proposed houae and garage as staked ~
thereon, C~ .
Janaary 14, 1977
~ d
, . . .__.~,_~~1~`f1• % 1 C-l.~/fr J. ;^_,f
r c_~
, ' - - MINNESOTA REGISTRATION N0.8675 ~
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COP1:2;..:e.I:iOR ~ TELEPF:OPi,: YdO.
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Y2ot:- Iuc1»,r~: plana hA'1j.B:ng p2ar.s, and energy calcul-,4`lo~~ith this
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CertiFicate For: ,
Swen Peteraon 4701. Yieyt 110th Street •
Bioomington, Minnesota 66437 22:50-51
DELMAR H. SCHWANZ
t LANOSUAVEVOR
Reqiiteratl UnCer Laws of Tpe State OI Mmnesotd ,
14575 SOUTM ROBERT TRAIL P.O. BOX M ROSEMOUNT, MINNESOTA 55088 PNONE 812 423-1788
I
SURVEYOR'S CERTIFICATE
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T hereby certify that thla is a true and correct representation
af a survey of the boundaries of the following described tract
of land;
Lot 7, B1ock 1 of the recorded plat of WILI3ERNESS PARK ~
ADDITION, City of F.agan, Dakota County, Mlnneaota.
~
Also ahowtng the location of a proposed houae and garage aa ataked C~
thereon. ~
V '
January 14, 1977
fr~
i A. 1.•1
, MINNESOTA REGISTRATION NO 8625
~ CI7;(OF EAGAN PERMIT
~3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 030573
(612) 681-4675 Date Issued: 0 8/ 0 6/ 9 7
SITE ADDRESS:
1243 WILDERNESS PARK CIR
LOT: 7 BLOCK: 1
WILDERNESS PARK
P.I.N.: 10-84250-070-01
DESCRIPTION:
' (GAS INSERT ONLY) .
Buildinq Permit Type FIREPLACE
Building Work Type NEW
Census Code 434 ALT. RESIDENTIAL
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REMARKS:
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
CONTRACTOR: - Applicant - ST. LIC OWNER:
FIRESIDE CORNER INC 16332561 2009091 EREHUL JIM
2700 N FAIRVIEW AVE 1243 WILDERNESS PARK CIR
R105EVILLE MN 55113-0847 EAGAN MN 55123
(612) 633-2561 (612)454-5293
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable 3tate ofi Mn.
~ Statutes and City of Eagan Ordinances. ~
APPLICANTlPERMITEE SIGNATURE ISSU D BT. S ATUFi
CITY OF EAGAN
~ 11 3530 PILOT KPIOB RD - 55122 0 O•~ O
1997 FIREPLACE PERMIT APPLICATION
681-4675
~
DATE: ~ PERMIT FEE: 50
DESCRIPTION OF WORK: CONSTRUCT NEW FIREPLACE ALTERATIONS TO EXISTING
~O 1NSTALL GAS INSERT ONLY
_ INSTALL GAS LINE ONLY
OTfER:
STREET ADDRESS: / Z+3 w t ~ ~YC At(,f~S 9 A>2.IL C~ i 2
LOT BLOCK SUBD.IP.I.D.
APPLICANT: (circle one only) OWNER CONTRACTOR
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.
PROPERTY Name: ~~Q ~ ji ~ Phone
OWNER
Signature:
Street Address: 12-¢3 W l L-D Mid L'~-5
City: Z-A (vA!°V State: ~ Zip: s-S~l Z
A G
FIREPLACE `J`~(
Company: Phone
INSTALLER
Signature•
Street Address:,~~ZT W~~-'y~ l.~ License #2110d
Cityc ~Q \Z t-) S'\/ 1 L,1,C State: i Zip: -5:S'-337
GAS LINE Company: Phone
INSTALLER
Name:
Signature:
Street Address•
RECEIVED
City: State: Zip:
~ •'j ;V 1iy1
BY:~
c
. } a "y
• . a.
L~
1
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 14 F'veplace
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repa'v
GENERAL INFORMATlON
Census Code. 434
SAC Code 01
REMARKS
Chimney/flue must be inspected before concealing.
l L~ W I~~I r
For-t-ceUse
~ Eaan F:: :
Permit Fee.
3830 Pilot Knob Road Eagan MN 55122 Date Received:
Phone: (651) 675-5675 i 7l t
Fax: (651) 675-5694 Staff:
L---------------- -
2009 MECHANICAL PERMIT APPLICATION
Date: Site Address: I ` x -t ) 1 \ ( ( ¼ f "Cb ( 1 0- \ ' u
Tenant• Suite
ii Y-,
RESIDENT1 OWNER Name: ~1 C V\ _ C 'l Yl `,,etc' Phone: ? C%i L)5Zl
Address I City I Zip: I t C\ . c t lN'; t L@ 1 r ` Le
CONTRACTOR Name: C° f1 L - 1UGL t'1 License b4Ci P
Address: 1,a
City: ` A Y- I`l l F~ State tYlf\1 Zip: 55 3 3 3
Phone: GF 5 . 1 , I O y L Contact Person: o'(\~ e.
TYPE OF WORK New ,Replacement Additional Alteration Demolition
Description of work:
NOTE: Both roof mounted and ground mounted mechanical equipment is required to
be screened by City Code. Please contact the Mechanical Inspector or one of the
Planners for Information on permitted screening methods.
PERMIT TYPE RESIDENTIAL COMMERCIAL
Furnace New Construction _ Interior improvement
Air Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump Under! Above ground Tank I_ Install/_ Remove)
When installing/removing tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
R 1 NTIAL FEES:
$50.50 inimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$ . 0 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1%
$50.50 Minimum (includes State Surcharge)
$ Permit Fee
- If Permit Egg Is less than $1,000, surcharge is $.50.
- If rmt Egg Is > $1,000, surcharge Increases by $.50 for each = $ State Surcharge
$1,000 Permit Fee (i.e. a $1,00142,000 Permit Fee requires a $1.00 surcharge).
TOTAL FEE
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 permlt; 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 i i L- Applicant's Printed Name ph nt's Signature
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: Under Ground Rough In Air Test ,_Gas Service Test -in-floor Heat -Final
Exterior HVAC Screening Inspection
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA111341
Date Issued:06/19/2013
Permit Category:ePermit
Site Address: 1243 Wilderness Park Cir
Lot:007 Block: 001 Addition: Wilderness Park
PID:10-84250-01-070
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
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, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Nanette L Dahms
1243 Wilderness Park Cir
Eagan MN 55123
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
For Office Use { I
-Z
Permit
City of Ea Rdflo
R -
Permit Fee:
3830 Pilot Knob Road I / I
Eagan MN 55122 Date Received: '
Phone: (651) 675-5675 I i J
Fax: (651) 675-5694 I Staff:
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: Phone:
Resident/ n
Owner Address/ City/ Zip: G, L( S
Applicant is: Owner contractor
Type of Work Description of work: ~A~L Ut
Construction Cost: e Multi-Family Building: (Yes No L_~
Company: 64,,) Contact: I ± a i m A
Contractor Address: 'C ity:
State:_ Zip: 17 Phone: !;~a
License ( Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
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-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
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.gopherstateonecall.org
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.
Exterior work authorized by a building permit issued in accordance with the Minnesota S e Building Code must be completed within 180
days of permit issuance.
X
IW6;~n~ A
Applicant's Printed Name Applican 's Signature
Page 1 of 3