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1362 Wilderness Run Dr � Use BLUE or BLACK Ink �----------------- � For Office Use � �� 6�E1.�� j Permit#: � �� j y � � � � � � �� Permit Fee: � � � 3830 Pilot Knob Road �� '��'�� Eagan MN 55122 j Date Received: j Phone:(651)675-5675 I I Fax:(651)675-5694 I Staff: I � � --------� �-------- ��`� r� � 2014 RESIDENTIAL BUILDING PERMIT APPLICATION o`,� � Date: ��— / Site Address:` �� 1/�` �� • �"`��'`� Unit#: r='� �ttt ) Name. �� - Phone��—��C.-'�� '�Resident/ ':_ Owner Address/City/Zip: � � � � ��"'�� ' Applicant is: Owner Contractor Description of work: �;C�� P"��r�C''J l� ` Type of Work . � Construction Cost: �� Multi-Family Building: (Yes /No ) Company: Contact: Contractor Address: City: ` " State: Zip: Phone: Email: License#: Lead Certificate#: If the project is exempt from lead certification, please expiain why: (see Page 3 for additional information) j�'1� 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 documenfs that you.submit,are consideredto be public informat�on Port�ans'of the information maybe c/assi�ed as non bublic if you provitle speci�c reasons that would per'm�t the,Cci�ji fo °. � � � ' �' �� conclutle:tliat�the��"are tratle secrets.:�� ` ` �� CALL BEFORE YOU DIG. Call Gopher State One Cail 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.qopherstateonecall.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 ns. Ext ior work authorized by a building permit issued in accordance with the Minneso Sta e Buil g Code�ust be completed within 180 da f permit issuan� v � � x t/ � � x Applicant's Printed Name Appli ant's Signature Page 1 of 3 [3�2- i��s� �-��, ��- • DO NOT WRITE BELOW THIS LINE I��3� SUB TYPES _ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) _ Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) _ Multi Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous _ 01 of_Plex �, Lower Level _ Pool _ Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior �Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Damage Retaining Wall "'Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation � Occupancy �� MCES System Plan Review Code Edition SAC Units (25%_100%�` ) Zoning �(�s City Water Census Co de � S tories �� Boos ter Pump #of Units Square Feet PRV #of Buildings Length Fire Sprinklers Type of Construction � Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) Final/No C.O. Required Foundation � HVAC_Gas Service Test Gas Line Air Test Roof: _Ice &Water _Final Pool:_Footings _Air/Gas Tests _Final � Framing Drain Tile Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick � Insulation � Windows �.;J,�'.ti¢� �,�t�,1�1 Sheathing Retaining all:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Erosion Control Braced Walls Other: �} „ Reviewed By: � ��{ , Building Inspector I I RESIDENTIAL FEES �'' �"" �: � I �,� �� v Base Fee � �� 'I Surcharge �� "� � � �,�,.,,(YV �� Plan Review � ��`� MCySSAC � � � i� � �� Cit SAC � � Utility Connection Charge ��...�� S&W Permit 8 Surcharge Treatment Plant � � �-� �-�"' � � � � Copies � TOTAL Page 2 of 3 ` CITY OF EAGAN Remarks t 1 Parcel 10 84350 051 01 Addition Wilderness Run lst A ddition Lot 5 Blk pwner a Street 1362 Wilderness Run Dr. state Eagan, MN 55121 L. Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 41Z 1973 $175.00 $8. 75 20 PAID SEWER LATERAL WATERMAIN WATER LATERAL WATER AREA STORM SEW TRK 1981 3•1$. 00 15 212.00 2 -18-8I STORM SEW LAT CURB & GUTTER SIDEWALK STFiEET LIGHT 1981 107.94 21.59 $ ' SEW CONN 1973 $240.00 48.00 5 PAID WATER CONN. 1972 $280.00 5289 - 1-19-72 BUILDING PER. SAC PAR K INSPECTIUN RECORD ' CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: ! t?( ; `,1 til.i,t'F . l i1FPFl1 RIFM f1R PERMIT SUBTYPE: TYPE OF WORK: INSPECTION . I I ~ ~ I ~ ~ ~J Portnk No. Pormit Holdw Dab Telephone • ELECTRIC PLUMBING HVAC kapwtlon Dah knp. Comnmnts FOOTINGS FOUND I FRAMING ROOFING ROUGH PLUMBING PIBG AIR TEST ROUGH HEATING GAS 5VC TEST INSUL GYP BOARD I FIHEPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG I ORSAT ~ TEST BLDG FlNAL I I BSMT R.I. I BSMT FINAI { DECK FfG DECK FlNAL I I I 1 ~47262 SYO °o Repuesl Date Fire No Rough-in Inspecvon '/J/ q Reqmretl~ ? Reatly Naw ~ WtlI NoLty lnspecror -J - / ~p - ? Yes No When ReaGy' I licensed coniractor O owner hereby request inspection of above electrical work at: Job AtlOress ISlreet. Bor or Route No ~ Ciry s? ~/G!~ 2..1f 5 4.,,J Se<imn No TownSM1ip Name w No Fange No. Counry U OcNOant (PRINT) Phone Na Z o.P- .Q- E2 6~7- 9~9 ~ Power Supolier Atltlress P ~-Ku t'~G8 c G Elecmcal Gomracror IGOmOany Name) Contractar5 License No ~z 9,e- o~/~ -3 Mailing Atltlress (ConVaclor ar Owner Making Instailaimn) l~ '9G E E Awhoraee SignaNre (GOntractorrp.vner Making Installation) PM1One Number ~V0 3 srS ` MINNESOTA STATE BORRD OF ELECTRICIT THIS INSPECTION REOIlEST WILL NOT GrlgypMlEwey BIEg. - Room S413 BE ACCEPtED BV THE STATE BOARD 1821 Universlty Ava. St. Paul, MN 55104 UNLESS PROPER iNSPECTION FEE IS V1ane(612)602-0800 ENCLOSED REQUEST FOR ELECTRICAL INSPECTION Idi":E8-00001-08 firO ? Se inslmcRore br complet~ng Ihis forrn on back ot yellow copy /oO$~IQ 4 7 2 6 2~ 3ft" Below Work Covered by This Request Il II t `l ew Add Rep.' ' TypeofBmlding AppliancesWued EqmpmentWrted Home Range Temporary Service Duplex Water Healer Electric Healing ~ Apt. BwlOing Dryer Other (Specity) Comm /Industnal ' Fumace Farm Au Gond~tioner Olher (specily) Contractor5 Remark§cLG[° b 50 ~oll/ Compute Inspection Fee Below: ccJ / 2P . # Other Fee # Service Enirance Size Fee # CircmtsiFeeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transtormers Above 200 _ Amps A 100 _ Amps S19n5 Inspector5 Usa Only TOTAL ~ Irngation Booms Special Inspecuon )5 v Alarm/CommunicaLOn THIS INSTALLATION MAY 8E ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 16 MONTHS. I, the Electncal Inspector, hereby Rl oare cenity Ihat the above inspecllon has Rrai o~ - been made OFFICE USE ONLY This requesl witl 18 months lrom CITY ofEAGAN N'°- 3226 BUILDING PERMIT -~y~ ' 3795 Pilok Knob Road Ownes ...........1 Eegan. Minnesola 55122 Addresa (Presan!) 454-8100 Builder Date 3........ . Addreas DESCRIPTION Biories To Be Uaed For Fronf Dapih Heighf Eel. Cos! Permii Fee Aemarlcs S U LOCATION 177at' a..p,~ d 5lreei, Road or other Deseripfion oi Loaaiion I Lo! Bloclc AddilSon oz Tree! This permit does noi au2horize the use of slreels, roads, alleys or eidewalka nor does it qive the ownsi or hia egent the righf io ereale any situafioa which is e auisence or which presents e he:ard !o the heallh, safelp, eonvsnlenee aad general welfare fo anpone in the communiiy. THIS PERMIT MUST BE KEPTP ~N T~H~E~ P~REMISE WHILE THE WOAK IS IN PROGRESS. Thts is !o ceziify, lhat..... 7!.................................. has permissioa !o arect a..... `;:.`.°.".'.'.:::.`.,`E:.`: ~.,_~pee ~ the above described premise subjeci to the provisions of all applicable Ordinances for the Cilp o Eegan. U..L`.'.-`P"~`. Per Mayor Buildinq ~peclos • EAGAN TOWNSHIP BUILDING PERMIT N? 2640 Ownex Eagen Townehip Address (Presen! Town Hall Builder IJ-Xf.crsr......1-....'.....----................................. r -7 p p J' ~dr' / 2_ Addreis . DE5CRIPTION 7orles To Be Used For ron! Depth HaightEat. Cos! Permi! Fee Aemarke ~ LOCATION 8iseet. Road or olher Dascripflon ot Loealion I La!- oe Add[!!on or Trac! 13oC2 N/t fdip? Kel" A.n 12r This permii does aot aulhori:e the use of slreefe, zoads, alleys or nidewelks nor doee !t give the ownes or h!e agen! the righf !o creale any eifualion which is a nuisance or which pzesenSa a hazerd !o the heallh, eefety, aonvenience and general weltaxe !o anyone in the eommuniip. THIS PEAMIT MUST BE EPT ON THE BREMISE WHILE THE WORK IS IN PROGA SS. This is fo eerlifY. !hal.u &r....^^:r:.^-""~................ haspermission !o ereat a..... ..-'-'~.~.~'1.^..`..' upon . _ the ebove deacribed psemisebjec! !o the pxovisions of the Building Ordinence for Eag Townshi adopled Ayril 11, 1955. ,p . - Per /?-`~~c~ ,^l~-~ . . : Cheirmen f Tnwn Board ~ Huilding Inspecio-rz" /O ~'¢35v G5% U/ TOWN OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 PERMIT N0. 783 The Board of Supervisors hereby grants to J. F. FARIIELL & SON of 990 W. rlontana Avo:wa, St. Paul 55117 a PLUML'II.G Permit for: (Owner) Tilaen Canstxvction Co. 1362 W3ldernesa Run Ih•ive~~-j$3; I'38~ at ec 1-3<J.1 n.,,,,wytli-, Eagan j5123 , pursuant to application dated 3;'9/72 Fee Paid: _$80.04 Dated this 9th day of _V1,-yr , 1972, 3'.00 c/c Building Inspector 3 , • w w ,Ru„ Isi , . . . µ ~ . ar. , , e- T04)N OF EAGAN :,795 Pilot Rnob Road Eagan, Minnesota 55122 PERMIT N0, 189 The Board of Supervisors hereby grants to. Neil &U ba*d Heating & pty_Rr.++rii}irmino r_-of 99 NO- '+nlliW:AY@.. St._ Dnnl ~,S1Q~y --4- - a ucam=yC_ Permit for: (Owner) TLaen Conetx'uGtim Co. at 1383, 1397 & 1391 Amarylis & 0Wildqrlp%%1%tFJqt 1}MLY*plication dated Fee Paid; IL - $80.00 Dated this »th day of _ginru , 197_Z. 2.00 8/C Building Inspectar RESIDENTIAL ~ (7D~ BUILDING PERMITAPPLICATION _ CITY OF EAGAN ~ 3830 PILOT KNOB RD, EAGAN MN 55122 ~ , 651-681-4675 l \ New Conswctbn Reauiremente RemotleVReoair Hequlrementa • 3 regislered We survays showing sq. tl. of bt sq. tt. ol house; and II roofe0 areas • 2 copies of plan (200/6 maximumlotcoveragealbwed) • 15etotEnergyCalculatbnslorheatetlaUd'Aions • 2 copiesof plan showing Deam & window saes; poured fountl design, etc.) • 1 sAe survey lor ezlerior atlddans & Uecks • 1 set ot Energy Calculatqns • Indicate N home served by septic system lor add'Abns • 3 copies ot Tree PreseNatbn Plan'rf bt platted atter 7!1/93 • Rim Joist Detall Options selection sheet (bltlgs wfth 3 or less unAS) DATE O2 VALUATION D0~ SITE ADDRESS I3~nZ lAA1.DELtnIE55 2vN. ?2. MULTI-FAMILY BLDG _Y "?N NPE OF WORK '2E 26o F - FIREPLACE(S) _ 0 2 APPLICANT T l1 6 GHU3A C U. STREET ADDRESS 1~97_7la VG2~.1 orj sT- NLJ CITY L--GK- fZi v-E/Z STATE M-~j ZIP SS7 3Z5 TELEPHONE # 763 -Y4/ -4 4 RXELL PHONE # z Y2 FAX # ~f SS3 S PROPERNOWNERMRRY T3uGK~_C`e 1) AA2K- SZA~'M°~? TELEPHONE# 6s~'~~E-7$83 COMPLETE THIS SECTION FOR ^NEW,, RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672 (4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Conhactor: Phone # Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00 _ Water Heater _ No. of R.I. Baths _ No. of Baths Mechanical Conhactor: Phone # Mechanical system includes: _ Air Conditioning Fee: $70.00 _ Heat Recovery System 1-~' Sewer/Water Conhactor: Phone # JUN I hereby acknowledge ihat I have read this application, state that The infor atlon is cor c, and agree to comply_ with all applicable State of Minnesota Statutes and City of Eagan Ordinas. /Il ~ Signature of Applicant ~~~yL~-~ OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ? 01 Foundation ? 07 OS-plex ? 13 16plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06plex ? 16 Fireplace ? 21 Porch (&sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 72 12-plex Pibg_Yor_N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndalion) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MClES 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 W idth REQUIRED INSPECTIONS _ Footings(new bldg) _ FinaUC.O. _ Footings (deck) _ FinaVNo C.O. _ Pootings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Wa[er _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC W ater Supply & Storage S8W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total ~ - . • ' MASTER CARD LOCATION AIPA OWNER 0~~-T?. L y STRUCTURE AND J LAND USED AS /j/ I Issued To Permit No Issued Contracfor Owner BUILDING PLUMBING CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER 07HER OTHER Approved Ifems (Initial) Dafe Remarks Disfance From Well FGOTING SEPTIC FOUNDATION CESSPOOL FRAMING FINAL ELECTRICAL DEPTH HE,4TING OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOI DRAINFIELD PLUMBING WELL SANITARY SEWER Violations Noted on Back COMMENTS: COMPLIANCE INSPECTION REPORTS f0 BE USED ONIY IN EYENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE ? NON-COMPIIANCE. BUILDER DOES NOT OBSERVED. INTEND TO COMPLY. ~ ACCEPTABLE SUBSTITUTION$ OR ? DEVIATiONS. COMPLE710N OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ? NON-COMPLIANCE. BUILDER WILI COMPLY WITHOUi DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: ? REINSPECTION REQUIRED DATE OF RfINSPECTION REINSPECTION REVEALED CEflTI FICATION -1 certify that I hwe carefully inspected the abwe in which I have no interest present or prospective, and that I have reponed herein all significant condilions observed to 6e at variance with ordinances of the Town of Eagan, approved plans and speciticetions, and any specific require- ments for off-site improvements relating to the property inspected. ? ALL IMPROVEMENTS ACCEPTABIY COMPLETED BUILDING INSPECTOR DATE COMMENTS: sa . . i . , ....,.....~.Z.~,b. . ,I . 'i ~ - - 7T.:ri.y.~~~~~,t-------------------- ~ - - /~./.~Z-I G~LpGRi?dJI /cd.V__~IG/l~- ~ Cia J H.c%-ii//~i.J:/_,---- I ~ - " ~ (,v " ~ - - ~ ~ . _ - - i i- ; i - - - - - - - ' - ' - - - - , ~ ~ y .P~>.o~.?ae_ _ . ~ i ~ ; ' RY _ A . ~ - - - ' - - . ~ J ~ 1 . ~ 1 I 22' "ij 1 ~ A/oeox.2o ~t ' ' , i I ( O~ b - - 0 ( 4 - - ~ - e i ~ - - - - - - - i~ ~ ~ ~ - - - - - - f•='-=. - - - - ~ - ~ - , . . - - ..y-Z1~------ i - -f..---------- ; ~ ~ ,o_Er~~ AkOOE~TY LNE ~ ~ i I I + ~ro ~ I'I OU S E I ~ I I , Ca L~ ; tq e6 . ~innMER a , ~np~eTV G . I Lor S BLack I ' Rc-~)aE-P,T T%LSEN'5{ ~ ~ ~ rr~oNr_~a~aFrzrY..__LiNE ~ PLO1 iLAN ~ MASTER CARD • LOCATION b"d2?YI CSS y0_,~o~~ ' S- 1 - 41A OWNER r~ w1.i Qr G'recG STRUCTURE AND ~ LAND USED AS Issued To Permif No. Issued Con}ractor Owner BUILDING 76 L/11 ~/p_ • I/ ,'J P x PLUMBING CESSPOOL - SEPTIC TANK WELI ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER OTHER OTHER • APProved Items (Inifial) Date Remarks Distanre From Well FGOTING 3-9-~ SEPTIC FOUNDATION 3 _9 • ~j/ CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTRICAL q HE4TING DEPTH y-~- 7 OF WELL GA$ INSTALLATION SEPTIC TANK CESSPOOL DRAINFIEID PLUMBING -~Y aJ.7 WELL ' SANITARY SEWER - h-13 • Violations Noted on Back COMMENTS: . COMPLIANCE INSPECTION REPOftTS TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS , • 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. O ACCEPTABLE SUBSTITUTIONS OR D DEVIATIONS. COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYEO BY CONDITIONS BEYOND CONTROL. ~ NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZFD AND DESCRIBED AS FOLLOWS: ? REIhSPECTION REQUIRED DATE OF REINSPECTION • REINSPECTION REVEALED CERTI FICATION - I certify that I ha+e carefully inspected the above in which I have no interes[ present or prospective, and that I hava reported herein all sienificant conditipns observed to 6e at variance with ordinences of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site imprwements relating to the property inspected. ? AlL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR DATE COMMENTS: • q&.~'~p sa PERMIT , CITY OF EAGAN K 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Oman, Minnesota 55122-1897 Permit Number: 03.1182 (612) 681-4675 Date Issued: 11 / 2 8/ 9 7 SITE ADDRESS: 1362 WILDERNES3 RUN DR LOT: 51 BLOCK: 1 WILDERNESS RUN 1ST P.I.N.: 10-84350-051-01 DESCRIPTION: (GAS IN3ERT) BuJ,lding'-P,ermit Type PIREPLACE Building Wdrk Type NEW Census Code 434 ALT. RESIDENTIAI 0,:-;-~~t%- , REMARKS: FEE SUMMARY: Base Fee $50.00 Surcharge $.50 Total Fee $50.50 ~ ~ / CONTRACTOR: _ ,qpplicant - ST. LIC OWNER: FIRESIDE CORNER'INC 16332561 2009091 RAYMOND MARK 2700 N FHIRVIEW AVE 1362 WILDERNESS RUN DR ROSEVILLE MN 55113-0847 EAGAN MN 55122 (612) 633-2561 (612)686-7883 I hereby acknowledge tFrat I have read this application and state that the information is correct and agree to comply with all applicable Stete of Mn. L Statutes and City of Eagan Ordinances. ~ APPLICANT/PERMITEE SIGNATURE ISSUDI A,1: SI oA U~ I ~ ~ • '~~II 11~ I . I k~~X%~~k7aXCX~X~1kX~~XfX~k~~kX~M~CX~X~~X%~X~~C~C~%XCX~X~~X~kX~X~X~X~~X~kX~ CITY OF EAGAh CASH7:Efi: AfG TERMINAL rl0: 577 IiOTE: 11/28/97 TIME; 13:45:31 I : 10 R'FME: ALLIEP FIRESIDE INC 32 i0 3001 1362 WIL_IiCRNESS 50.00 Q55 9001 1362 WILDERNESS 0.50 ~ . To+,al Receipf, Amoun+,; 50.50 , CF083510 USER ID; MAkLYNN f zt~~C~c%c~kXc%cXc~~C~t~#%~~k~k~k~k~kX~XcXt~CXc~c~C~c~X~YXc~C~~c~cXc%c~C~t 1~ ~ i1vAr, i 1 'IGY~.II;J ~.rl JiV.. . 6i N•a' 0. C 1 '•~M I 'i I ~ii t . ~ i l ~ t~ ~ • •~ii • i,, f i ~~.i ~ i ~~n~ , ~ i. ~ .il i . ,ii ~~i~ I ~~nlli~ ~ J~~ A t ~ i ~f4 1. •t.l t, I4 i. ~ I ' . • ~ LI' , 1 . . ~ ~ . 1~ ~..i~ • . ,~n I ' 1 I • ~ CI'CY OF EAGAN 3830 PILOT KNOB RD - 55122 ~ fi O~ O 1997 FIREPLACE PERMIT APPLICATION ~ 681-4675 DA'I'E: ~ ~ - 2 C~dS PERMIT FEE: $50.50 / IJS ~YL'~ DESCRIPTION OF WORK: _ STRUCT bMW FIREPLACE ALTERATIONS TO EXIS7'ING INSTALL GAS INS _ INSTALL GAS LINE ONLY OTFER: STREET ADDRESS: t r3C~ Z W L~.C~c..sQ tJ ~ S ~Y~= LOT ~ BLOCK SUBD./P.I.D. I APPLICANT: (circle one only) OWNER CONTRACTO I hereby acknowledge that I have read this application and state that the information is coaect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. -~fark, 6B6 - PROPERTY Name: C) Phone 798 3 OWNER n~ Signahue: Street Address: \Aj k 0 1` 3(95 j J/6 City: ~ 4~ N State: Zip: / 2 z" Al...~lL-~P '~'cYLsc~/0~ 633 -Z 15-° 1 FIREPLACE Company: 1 P e~'L Phone 89 0- 0 7 INSTAI.LER ~ ' nature: ----PS eet ddress:,-3s~'o - W N~13 License ~oo po 9 G~ A Ciry~~•~Lc~S J GLf...~f state: zip:.~".5~3 3,~ GAS LINE Company: Phone INSTALLER Name: ~ Signature: Street Address: ~ • City: State: Zip: .w;+. wa,.. ~ 4, ~ OFFICE USE ONLY BUILDWG PERhIIT TYPE ? 14 Fireplace WORK TYPE ? 31 New o 33 Alterations 0 32 Addition ? 34 Repair GENERAL INFORMATION Census Code. 434 SAC Code O1 REMARKS Chimney/flue must be inspected before concealing. ~v ~ w < EAGFN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PER141T FOR WATER SERVICE CONNECTION Date: U March 23, 1972 Number: 792 Billing Name:Tilsen Construction Co. Site Address; 1362 Wilderness Run Drive Owner: Greg Simmer Billing Address same Plumber• Luecken Excavating Location of Connection Meter Size Connectioa Chg. 200.00 pd 1/19/72 ' 335469 Meter No ?1982514 Permit Fee 10:00 !~19/72 ~ Meter ReadingO00 Meter Dep. 0~ 19/72 s/c Meter Sealed: Yea_ Add'1 Chg. NO Total Chg. Inspected by Date Building is a: Remarka: Residence xx }LJ.~~ t3ultiple Iio, Units ~i; j'~ ~ I; ' ?~.iae ~ Commercfal Industrial By: Other Chief Inspector In consideration of the isaue and delivery to me of the above permit, I hereby agree to do the proposed work in accorda e with the rules and regalatioas of Fagan Township, Dakota Count , Mi ~esota. Luecken bccavating Please notify the above office when ready for inspection and connection. s- ~ - ~ r EAGEa 110WNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: March 23v 1972 NUMBER 954 Tilsen Const. fnr OWNEK: Greg Sinmier Addrees 1362 Wilderness Run Drive PLUUPIIBER Luecken Excavating Z'ypE OF PIPE Heavy Cast Iron DESCRIPTION OF BUI7D ING Industrial Comaercial Residential Multiple Dwelling No, of uniCs xx Location of Connections: Connection Charge -0- Permit Fee 10.00 pd 4/19/72 s/c Street Repairs Total Inspected by: Date Remarks• By Chief Inspector In conaideration of the issue and delivery to me of the above permit, I hereby agree to do tfie proposed work in accordance with the rules and regulations of Eagan Tocinship, Dakota County innesota BY _ C Luecken Fxcavating Please notify when ready for inspection and connection and before any portion of the work is covered. , REQUEST FOR UTILITY IMPROVEMENTS I/We hereby requeat of the Board of Supervisors, Eagan Township, Minnesota, utility improvemente on and over praperty owned by me/us as follows: (Mention type of improvement, e.g, water, sanitary sewer, etc,) san3tary sewer connection - $240.00 The IocaCion of said utility improvements shall be generally as follows: Lot 5 Block 1- Wilderness Run No. m(Parcel C3893) I/We hereby waive notice of any and all hearings necessary for the installation of said improvementa and further consent to any assessments neceasarily levied by the Township of Eagan for such improvementa. 114Te furthez agree to grant to the Township of Eagan any easements neces- sary for the installation of such improvements. It is further understood that this requesC shall be reviewed by the Board of Supervisors of Sagan Township or its agent and I/we will be given reasonable notice as to whether this requeat is possible under present utility planning as to timing, location, etc, Dated: GYtc~.T. S Requeat accepted by _ ~u . ~-~*~l? Date Eagan Township Request referred to Town Engineer: Date Copies: 1. Township 2. Town Engineer 3. Applicant 5~-- . BEr1 BLOMOUIST ~ iHOMA$ HEDGES MNYOR CITV POMINISiRAiOF THOMAS EWN CITY OF EAGAN ALVCE BOLNE MARN PNRRANiO CI1Y CLERN JAMES A. SMIiN THEODOREwACHiER gµ~ 3796 PILOT KNOB ROAD , cOUNcarnErneEr+s - EAGAN, MINNESOTA - 95122 ~ ~~C+ PMONE 464-l100 ~ July 22, 1980 _ _ i>-~'' . Q . / Mr. Terry Stover 1362 Wilderness Run Drive ..i c,. _ aga , , 55'T23~ Re: Payment for Claim on Damages Caused by the High Water Level of West Thomas Lake Dear Mr. Stover: In official action that was taken by the Eagan City Council at a special meeting held on Thursday, Iuly 17, 1980, it was agreed upon the recom- mendation of the Public Works Chairman, City Councilmember Mark Par- ranto, to make payment in the amount of $1,769 to you, for damages to your property that resulted from excess water overflow from West Thomas Lake. The City of Eagan has since constructed a storm sewer trunk main which connects Thomas Lake with Blackhawk Lake which will now control the water level of East and West Thomas Lake. Enclosed is a check in the amount of $1,769. Also enclosed is a release which was prepared by the City Attorney for your signature. The release is a focm of an agreement between you, as a property owner, and the City of Eagan stating that you will now release the City of Eagan from any liabilities, obligations, or claims regarding the damage to the property as payment has been made to repair the damages caused by the rise of Thomas Lake. Please sign the celease and return a copy to the City in the enclosed envelope. On behalf oF the City of Eagan, we are certainly sorry for the incon- venience the high water caused you and your family during the past years. If you have any questions regarding the action taken by the City Council, please feel free to contact me at any time. Sincerely, i~fv~~ kqa_~ Thomas L. Hedges City Administrator TLH/hnd Encls. cc: Tom Colbert, Director of Public Works TNE LONE OAK TREE THE SYMBOL OF STRENGTH AND GROWTN IN OUR COMMUNITY. R E L E A S E' I KNOW ALI: MEN BY THESE PRESENT, that */e, the undersigned, D4r. Terry Stover of ~ 1362 Wilderness Run Drive ~ for and in consideration of the sum of One Thousand Seven Hundred and Sixty Nine 1,769.00 ) Dollars, the receipt of which is hereby acknowledged, do release and forever discharge fhe Crty of Eagan from all liabilities, obligations, claims or charges arising out of and pursuant to that certain claim on damaqes caused to the aforementioned property, by the high water level of West Thomas Lake. IN WITNESS WHEREOF, we have hereunto set our hand(s) and seal(s) this day of 19 O^u . WITNESS: STATE OF I~~ ) COUNTY OF ss. On this ~ day of 19 0~ , before me personally appeared IfSAN known to me to be th person(s) named in and who execut d the above Release and acknowledged that executed same as free act and deed. G~ THIS INSTRUMENT DRAFTED BY: Paul H. Hauge & Associates, P.A otary Public 3908 Sibley Memorial Highway ~ py~~g„pp~~ Eagan, MN 55122 y res (612) 454-4224 E DAK OTA COUNTY 5.MyCommiseionExpirWMer.JO.t982 Cities Di it~ al 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. -_--.--r. z ~ THIS INSTRUMENT, WHEN SiGNEO . ~ BV THE TREASURER, SHALL BE- . - ' ~ , • : CITY OF EAGAN conne A CHECK PAVABLE TO THE , , ' F ~ 3795 PILOT KNOB ROAD ORDER OF THE PAVEE NAME~ FOR ' O~ O J~/ EAGAN,MINNESOTA55122 THEAMOUNTSTATE~. • ~ MID AMERICA NAT'L BANK ~ 75-14 , ' ~ - , • Eegan, Minnesote 960 . I^ 3.#~ R A;; •.a • ~ 17 (9•~~tfx~f~~:'4^;~~ . ~ . ~ . ~ ~ CHECK NO. PAV TO THE ORDEN OF OATE CHECK AMOUNT r 1 July 24, 1980 ~ 11769,00 ' TERRY STOVBR O F . ; ~ ~:'(/.Pi,iPR...`.:/?fi-('~,.E~('~•. : , L TOG~ RER i:0960 I L. 29 0: 10 2 21" . ' ' DETACHBEFOREDfPQSITING REMITTANCEADVICE =526-00-257Payment ' :.;.DESCRIPTION•F,'~3':•::'1~UGflOSS•AMO UNT:' I -DEDUCTIONS'~$,NET.AMOUNT"y'j< . on damages caused by the high water level 1769,00 Thomas Lake . . ~ 1 , , ~ ~ ~ ~ , Q„N~j` s`y~'` J4 ' . . . . *F,.. ' ~Yy~~.{S,' , . : . . . ~ , . . . . . . , . y.~.pJ-.~;,,~lv . . ~ . ' • ~ ~.;.~.,.:i:~'t..A•; • t..,•. ' CITY OF EAGAN * 3795 PI107 KNOB ROAD *EAGA}l,M1NhESOTA55122 • RESIDENTIAL BUILDINC PERMIT APPLICATION CITY OF EAGAN t~ ~ I 3830 PILOT KNOB RD EAGAN MN 55122 / Q.C) ~ 651-681-4675 New ConsUUCtion Reauirements RemodellReoair Reauirements • 3 registered site surveys showing sq. ft. of bt, sq. N. of house; and all roofed areas • 2 copies of plan (20°h ma<imum lot coverage allowed) . 1 set of Energy Calculations for healed additions • 2 copies of plan showing 6eam & window s¢es; poured found desgn, etc.) . 1 site survey forextenor additions & decks • 1 sel of Energy Calculations . Indicate if home served by septic system for additlore • 3 copies of Tree Preservation Plan if lot platted aker 71M3 • Rim Joist Detail Options seledion sheet (bldgs with 3 or less unds) DATE " l II "l ID ~ VALUATION ~ ,fo n. ~ SITE ADDRESS I~l.(~Z VV t ~[_iC,i'Y`~-SS EiY1 ~py- _MULTI-FAMILY BLDG _Y '-/N YYPE OF WORK I Q3 FIREPLACE(S) _ 0 -1_ 2 t- ru.ft r~ APPLICANT & STREETADDRESS ~ W. U~~J CITY j II~STATER~ZIP TELEPHONE # CELL PHONE # FAX # PROPERTYOWNER61,4~mc-Ytd TELEPHONE# 0Io7-ID,Yo17S3~ COMPLETE FOR NNEW" RESIDENTIAL BUILDINGS OIN~L'YI2 _r~_ r I I 2 l I~nV CGO ~ a ~nn~ III Energy Code Category MINNlSO'1'A I2ULES 7(i70 CATEGOItY 1 MINN~CSOTA RULF,S ~7fi72 ~ (4 submission lype) • Residential Ventilation Category 1 Worksheet Submitted • Newl Energy Code Worksheet~S~mitted • Energy Envelope Calculations Submitted BY_-- Plumbing Contractor. Phonc # Plumhing syslcm includes: Water SoPlcncr Lawn Sprinkler Fce: $90.00 Water Heater No. of R.I. Baths No. of BaQis Mechanical Contractor. ~ai~ A'e- lk RQ v, Phone # ~ I VU v Mect~vnical system iiiclttdes: Air Condilioning Fec: $70.00 Hcal Rccovcry Systcm Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan rdi ances. Signature of Applican OFFICE USE O LY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY ? 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 EM. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demalish (Interior) ? 44 Siding O 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant ~aluation 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 W idth REQUIRED INSPECTIONS _ Footings(new bldg) _ FinaUC.O. _ Fooangs(deck) _ FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacemen[) Insulation _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MCIES SAC City SAC Water Supply & Storage S8W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total BEA BLOMWIST THOMAS NEDGES MAVOR LIlV AOMINISiRPiOA THOMAS Efi1N ALYCE 80LKE MARK PFRMNiO CITY OF EAGAN GiY CLERN JAMES A SMIiH THEODORE WACMTER 370E PILOT KNOB ROAO courvcarneMaeas EAGAN. MINNESOTA ne~zt . PMONE 454-8100 June 11, 1980 l }w`t~ 4~..Mr. Jack Osten . 4454 Ches Mar Circle Eagan, MN 55123 Re: Proposed Storm Sewer Assessments - W 220' of Lot 5 Block 1 Wilderness Run lst & Outlot A Ches Mar lst Dear Mr. Osten: In official action that was taken by the Eagan City Council at a regular meeting held on Tuesday, June 3, 1980, the proposed storm sewer assess- ments on the above referenced two lots forming the peninsula in Thomas Lake were formally abated. in other words, the storm sewer assessments will be eliminated by absorbing the amount of the assessments into the trunk area storm sewer fund. As the official representative of the Wilderness Run Park Association, please notify families affected by this action so they are aware that there will be no obligation by the association for the storm sewer improvement to those two lots. If you have any questions regarding the action that was taken by the Eagan City Council, please feel free to contact Mr. Tom_ Colbert, Director of Public Works, or myself at any time. Sincerely, Thomas L. Hedges ~ City Administrator TLH/hnd cc: Tom Colbect, Director of Public, Works Bob Peterson THE LONE OAK TREE THE SYMBOI OF STRENGTH AND GROWTH IN OUR COMMUNITV. w> i I F,,or`,Offce Use Clty of Eapn j Permit# I ~ I Permit Fee: I 3830 Pilot Knob Road ~ Eagan MN 55122 ~ Date Received Phone: (651) 675-5675 j Staff ~ I Fax: (651) 675-5694 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Oate: 01 Site Address: 1 f6- 2 GLOesS 10-ii IJ 60- Tenant• ,4-u Xf /t suite RESIDENTlOWNER Name. ML ~ Phone: Address/City/Zip~ ~ te2 rK 1-t~ I>- 2 Applicant is: Owner _ Contractor TYPE OF WORK Description of work. • Construction Cost: Multi-Family Building: (Yes No CONTRACTOR Name: License Address: City: State: ZipPhone. Contact Person. COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Ene1'gy Code . Residential Venhlation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted '(4 5ubmission type) • Energy Envelope Calculations Submitted In the last 72 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 8 Water Contractor: Phone: NOTE: Plans and supporfing documents that you submitare considered to,be public intormation. Portions of . the informafion may be classified as non-public if you provide specific reasons that would permit the City to conclude that fhe are trade secrets: I hereby acknowledge that this information is complete and accurate; that the work will be in co o ance with the ordinances and codes of the Crty of Eagan, that I understand this is not a permit, but only an apphcation for a permit, and work ' n t to staR wdh ut a permR, ihat the work will be in accorda with the approved plan in the case of work which requires a review and approval o pla s. ~ x i'uL x ApplicanYs Printed Name Appl'canYs Signature Page 1 of 3 PROPOSAL -:GREENSIDE, INC. Proposal No. ~ 941 Beacon Lane sneet No. 1*1e Yafley, MN 55124 _.432-6524 aat° Propocal Submitted To Work To Be Performed At Name Street Street City State City Date of Plans State Architect Telephone Number We hereby propose to furnish the materials and perform the labor necessary for the completion of S;t> C-2 i" i n/ , - All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantial workmanlike manner for the sum of ooners c$ 174 9• with payments to be made as follows: ~ Any altaration or deviation from above spec'rfications involvinp Respectfully submitt/i~~~'~~ " erctre costs, will be executed only upon written orclers, and will becflme en extra cherge over end above the estimate. All agreements cantingent upon strikes, axiderrts or delays beyond Per our oontrol. Owner to carry fire, tornedo and other necesaary inwrance upon above work. Workmen's Compensation and Note - This proposal may be withdrawn Public Liability Inwrance on a6ova work to be taken out by by us if not accepted within days ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signeture Date 5ignature TOPS FORM NO. 3750 LITMO (N U.S.A. Paul's Plumbing&Heating 507-645-7109 p.1 Use BLUE or BL.ACK Ink -- ------------, � For Offiee Use � � I �l� 757 � Clty af Ea��Il 1 Permit#: , � � _ , � Pertnil Fee: � � I 3830 Pilot Knob Road � I Eagan�IAN 55122 ; Date Received: � Phone: (651)675-5675 I statf: I Fax: (651)675-5694 L--�----------' 2014 RESIDENTlAL PLUMBING ERMIT APPLICATION Date: '- LI Site Address: / 3 �l/r�� 5S � Tenant: 0�� Suite t�• 1 E [�^ .` ` � � ' � Name: 1'Lw � [�L �:l�l� Phone: � � ResidentlOwner � � � � Address!Ciiy 1 Zip: 1 ' � 1 1 � ..��._ , � y � �\ . C, � �. � y Name: QS� cense�1: � Address: 7 1 n � City: ' IS � tll Contractor � State:�_Zip: 5 �.v�� Phane: � '��S'-7�D j �e� ' - ` 1 � �. i/. a Contact: � Email: � S�'� CL.Z��S � C/�.( �Yl� �.�..�.�..,�.�.,..�__..._� ,; 4 `� New Replacemeni Repair Rebuild �Modify Space _Work in R.O.W. ! M Type of Wo�k `� — — .� a :' ; � � �: Description of work: '^��.�i RESIDENTIAL. ` ` C ; i § ` Water Heater ` ,r ? t Water Softener 3 � Lawrt lmgation(!RPZ!_PVB) � 5 Perntit Type � �Add Plumbing Fixtures(_ilAain 1.�lower Level) ; Septic System � � �E ; _New � Water Tumaround h k �' � � i � � Abandonment 4 RESIDENTIAL FEES: � $60.00 Water Heater,Water Sof#ener, or Water Heater and Softener(i cludes$5.flo State Suroharge) � y � =60.00 Lawn Imgation (includes$5.00 minimum State Surcharge) � � $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water T maround'(includes$5.00 State Surc�arge) � � `Water Tuma�ound(add $200.00 if a 518"meter is�equired) ; �, �115.00 SeptiC SYstem New($10.00 per as built) (indudes County fee and 5.00 State Surcharge) � �� TOTAL FEES S � CALL BEFORE YOU DIG. Call Gopher State One Calf at(651)454-0 02 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilitie . w�vw.QOpherstaseonecall.orq I hereby acknowledge that this information is complete and accurate:that the work will e in confortnance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a perrnit, an work is not to start with'out a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and app val of plans. / � � / -- x �s� C'� x � Applicant's Printed Nam Ap lic s ignature FOR OFFICE USE Revlewed By: Oate: Required tnspections� U�der Ground Rough-In Air 7est Gas Test Final Meter Rstated Items: Meter Size Radio Read taff: PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA157662 Date Issued:09/03/2019 Permit Category:ePermit Site Address: 1362 Wilderness Run Dr Lot:000 Block: 001 Addition: Wilderness Run 1st PID:10-84350-01-051 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Thomas J Flaherty 1362 Wilderness Run Dr Eagan MN 55123 (612) 232-9001 K & S Heating, A/c & Plumbing Llc 4205 West Hwy 14 Rochester MN 55901 (507) 282-4328 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA166073 Date Issued:12/09/2020 Permit Category:ePermit Site Address: 1362 Wilderness Run Dr Lot:000 Block: 001 Addition: Wilderness Run 1st PID:10-84350-01-051 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 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 - Thomas J & Kristen M Flaherty 1362 Wilderness Run Dr Eagan MN 55123 (612) 232-9001 Apple Lake Heating & Air Conditioning 207 150th Street West Apple Valley MN 55124 (952) 431-4328 Applicant/Permitee: Signature Issued By: Signature