1285 Wilderness Curve
INSPECTION RECURD ~ Control Na ~
'CITY. bF EAGAN PERMIT TYPE: fiol!_ li 3 Nri
3830 Pilot Knob Road Permit Number: aw N bif 7
Eagan, Minnesota 55123 Date Issued: e~~'~ (612) 6$1-4675
SITE ADDRESS: 10t. t', rIi itc r. APPLICANT:
1:'N?s WILDERMES`a CUFiVE SVLNQ PKYERSOIif CQpSY ~
wll UfItNFSS pQND5 (612) 884-8144
PERIyl14T P ,YPTYPE: TYPE OF WORK: aLtN
INSPECTION
t'001 1 NFt FRAMiNC
JN'.tst A 1 1 uN t I"A4 .
F tlcE 1'1 ACt:
R[MARkS; PRV 5&1•1 GOMITRACTOR AE=N"l.-RYAN PtBa
Y.
i'
. Y~t! . _ a - . ~ ~ . . _ - - • ~?l -
M?mft Na PsrmR Holder Oete Teleph" #
, S/W
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Impeetlon oaft knp. Commsnto
S ~ ~Jj p
F°°nngs I
Foundation
FramUig
Roofing
Rough Ptb9•
Rwo Htg• 7 'V~L e
Isul.
L--
FimpWm
Finel Htg
Orsat Test ~
Ftnel Plbg. Plbg. inapeaw - NotjfY Plumber
Const. AAeter
Enpl.fPfen
Bldg. FhW y
Dedt Ftg.
Dedc Fnai
Well
Pr. Disp.
s~c~:G~ GsW N~' ~~alf I-
~ ~ 4- •
•
~
C3'? ~.~~cate o~ ~ccu~anc~
~~j o f ~agatt
This Certificate issued pursuant to the requirements of the Uniform Building Code
ceKifying that at the trme of issuance this structure was in compliance with the various
- ordinances of the City regulating building constructiori or use. For the following:
SF DWG 587
use cbassificmon: sldg. Penmit 1Vo.
O-L-Y TYM R-3 M-1 p~ R-1 ~C~ V-N
S PETERSEN C~T 101 PARK VIEW CIR
owott or swimng naa~
Bw~ A~ 1285 WILDERNESS CUR ~~L15, B2, WILDERNESS PONDS
s ri
Date: APRIL 9, 1993
Fowi8officid
~ IU r ~ 114 A CONSPFCUOUS PLACE
S/9 ~ ~o
10 ~ 2 5
ReQUes[ Oate Fire No. Rough-in Inspection
~ ;L Fequired? ? Reatly Now III Notity Inspector
? No 5When Ready?
I CIlcensed contractor ? owner hereby requesi inspection of above elecirical work at:
Job Itlress (SVee[. Box ar Route
Y'lWiP oJ City
83'' es r d
Seclion N. Township Name or No. Range No. Counry
1. 0'7' 1 L9~~j ~CQ r O
Occupam (PRINT) y one No.
.S• P C6 ?r~ a
Power Sup I'rer Adtlress ~
~ C E~6
EiecUical ConVecfor (COmpany Name) ~ nVacfor5 I.icense No. ~
r
Mailing Atltlress ICOmractor or Owner Making Installetion) -
Authodzetl ignaNra IConvacmd r ekln Installa[ Phone Number
V-O/
MINNESOTA SiATE BOAflO OF ELEC'fRIpTY TH1S INSPECiION REQUEST WILL NOi
Gtlgge-Mitlwey 91Gg. - Room 6.193 BE AWEPTED 6Y THE STATE BOARD
1821 Unlverelry Ave.. SI. Paul, MN 55/0i UNLESS PROPEfi INSPECTION FEE IS Phone(612)BGZ-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION °P ~ es.oooo,a~
See ins(mctons for completing this lorm on back oi yellow mpy.
? C~O/9
0 10625 'X" Below Work Covered by This Request ~
ew btld Re`p. • TypeolBuilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Healer Elactric Heating
Apt. Building Dryer Olher (Specify)
Comm./lntlusirial Furnace
Farm Air Conditioner
Olher(specily) nVaclor's Rem ks'. q
or.~~n~o7~'e h owse
Compute lnspection Fee Belaw.'
# Olher Fee A Serv' iranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 00 Amps to IM)umps
Q
Transformers Abav Amps Above Amps f
Si 9lIS Inspecror5 Use Only: ~ 7~7AL
Irri alion Booms [
Special Inspection -
Alarm/Communication THIS INSTALLATION MA ORD E DISCONNECTED IF NOT
Other Fea COMPLETED WITHIN TH .
I, ihe Electrical inspector, hereby Rough-in . Date
certity that the above inspedion has r Date , r/
been made. v
OFFICE USE ONLY F ?
This request void 16 monlhs imm
Address 1285 WILDERNESS CIiRVR Zlp 5512 ~
Lot~15 ~ Blk 2 Sub wTr.DFRNFSS pnNn.c
THESE TI'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: APRIL 9, 1993 Yes No Inspedor:
Final grade (6" from siding)
Permanent steps (gazage) f~
Pertnanent steps (main entry) V
Permanent driveway ?
Permanent gas ?
Sod/Seeded grass ~
TraiUcurb damage
Porch
Basement finish ?
Deck v
Please verify with the builder the temoval of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawp faucet 6efore freeze potential exists.
ContaM engineering division at 6814645 before working in rightof-way or installing underground sprinkler system. ~
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Reauiremenb RemodeVReoair RaquiremeMs '215
• 3 registered site surveys shawing sq. ft. of lot, sq. R. of house; and all roofed areas • 2 topies of plan
(20 % mazimum lot coverage allowed) • 1 set of Energy Calculations for heated additions
• 2 copies of pan showing beam & window sizes; poured found desgn, etc.) • 1 site survey far extanor additions & decks
• 1 set of Energy Calculations • Indicate it home served by sepiic system for additions
• 3 copies of Tree Preservation Plan if lot platted aRer 711193 ~
• Rim Joist DeWJ Optians selecUnn sheet (hldgs with 3 ar less units)
,
DATE VALUATION /
SITE ADDRESS ~ U ~~~~~5 U~- MULTI-FAMILY BLDG _Y _N
TYPE OP WORK ~ FIREPLACE(S) _ 0_ 1_ 2
APPUCANT C.~Yll~ed "tC
STREET ADDRESS 1,1)rVe-rktC'~'-~S C&Ve CITY C_Lvl STATE~IP
TELEPHONE #~~^g~~ PHONE # FAX # qS 2111 4/t`2~
PROPERTYOWNER Poq TELEPHONE#
N
COMPLETE FOR "NEW" RESIDENTIAI BUILDINGS ONLY
Energy Code Category _ MINNESOTA RUL,ES 7670 CA7'EGORY 1 MINNESOTA R ES Z67.2_
reLgy~Code VQbrksheefSu i mitted
(d submission type) • Residentiai Ven6lation Category 1 Worksheet Submitted • N wLBy_--F
• Energy Envelope Calwlations Submined
0 2002 Qiumbing Contractor: Phone # Plumbing system includcs: Water SoCtener Lawn Spnnkler 4N'ater Healer _ No. oE R.I. Baths
No. of 13alhs
Mechanlcaf Conhactor: Phone #
Vlcchanical system includes: Air Conditioning Pee: $70.00
_ Hcat Recovery Sys[em
Sewer/Water Contractor: Phone 1k
I hereby acknowledge that I have read this application, state that the ifn on is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordi Signafure of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated M02
OFFICE USE ONLY
? 01 Foundation ? 07 05-piex ? 13 18-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplece ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi
? 03 Oiof_plex O 09 07-plex ? 17 Garage ? 22 PorchlAddn.(4-sea.) ? 33 Ext.Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 38 MulOi
? 05 03-plex ? 11 70.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 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration 0 37 Demolish (Bldg)` ? 43 Reroof ? 46 Wtndows/Doars
? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning Ciry Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Foatings (new bldg) FinallC.O.
_ Footings (deck) FinallNo C.O.
_ Footings (additioo) _ plumbmg
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Au/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 8 Storage
5&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
ToWI
PERMIT Control No. O Jr O 4
WY6 OF EAGAN `
3830 Pilot Knob Road PERMIT TYPE:. . BuILoiNG
Eagan, Minnesota 55123 Permit Number: 000587
(612) 681-4675 Date Issued: 0 5/ 2 6/ 9 2
SITE ADDRESS:
1285 WIIDERNES5 CURVE
LOT: 15 BLOCK:.2
WILDERNESS POMDS
DESCRIPTION:
. flBuildi:n.g Permit Type SF DWG
Building'iJork Type NEW
r' UBG Qccupdrity R-3 M-1 .
ConsCruction`T.ype V-N
f
Zatting t . _ R-1 , . Bu3lding length . .66 ,
` . Bu3lding Width . . 42...:.
;
r 11~'-
~ fA L 4 ti r~
/ 'til J e~ t..'~ l i ~.,.+y J ~i{ ~L=Qit L,
Y'
REMARKS: C C)~
PRV S& W CONTRACTOR - GEN2-RYAN P186
FEE SUMMARY:
VALUATION $167,000
Base Fee j874.00 PIISCEILANEOUS . $1.610.60
Plan Review $568.10 Total Fee ;3,636.10
Surcharge Z83.50
SAC $700.00
SAC $ 100
SAC Units 1
Suhtotal $2,225.60
CONTRACTOR: - Applicent - ST. LI pyyNER:
SVEMD PETERSON CONST 18846144 000176 S PETERSEN CONST INC
10219 PARK VIEW CIR 10214 PARK VIEW CIR
RIINNEAPOLIS MN 55431 6LOOMINGTON MN 55431
(612) 889-5149 (612)664-5144
I hereby acknowledge Chat i have read this appliaatian and state that ths
intormetivn is rrect and aqree to eomply with all app2ica61e 5tate o# Mn.
SCatutes a» Ckty of Eag.an Ordinancss.
~ ~ -
~/rnd
APPLICANT/PERMITEE SIGNATt1RE I UED Y: IGNA URE
INSPECTION RECORD I C°nt 0504
CITYOFEAGAN PERMITTYPE: euxLoias
3830 Pilot Knob Road Permit Number: 000587
Eagan, Minnesota 55123 Date Issued: 0 5/ 2 6/ 9 2
(612) 681-4675
SITEADDRESS: LaT: is eLocK: 2 APPLICANT:
1285 WILDERNESS CURVE SVEND PETERSON CONST
WILOERNESS PONDS (612) 884-5144
PERMIT SUBTYPE: TYPE OF WORK:
SF DWG NEW
INSPECTION . .A
FOOTINB FRAMING
INSULATION FINAI
FZREPLACE
REMARKS: PRV S 6 W CONTRACTOR - 6EPIZ-RYAN PLBG
F
-
L
PERMIT N CITY OF EAGAN ~ ~ 1992 BUILDING PERMIT APPLICATION
681-4675 YAY 1 8 RECo
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural_& structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date /F~ / Yaluation of rork v r-ro
Si!e Address: ~uh,~e
STREET - SiE / Tenant Name: (commercial only)
Lor ~ aLaK a%C wao.~i~l~~r~N~s'f v.i.o. 0
'PONt~ S
Descri tion of work:
The applicant is: ? Owner ff"Contractor ? Other (Deseri6e)
Name S' l tiz__, _ Phone
Property LAST FIRST
Owner Address
STREET STE f
City State ZiP
Company C~ I-L-?2 sE/? C70 3'6 Phone
r~~e c
Contractor Address /b~i License #/'7d y Exp. 9Y
Ci ty ~L a o~tii?~-i O~? State Zip `--`z` 3/
Company ~ Phone
Architect/
Engineer Name Registration N
Address
City State ZiP
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been appraved.
I hereby acknowledge that I have read this cation and state that the information is
correct and agree to comply with all appl' e State of Minnesata Statutes and City af
Eagan Ordinances.
5ignature of Applicant: ~
~
OFFICE USE ONLY
BUILDING PERMIT TYPE ~
i
O O1 Foundation ? 05 Apt. Bldg ? 09 Basement Finish . 0 13 Comm/Ind New
JR 02 SF Dwg. 006 6arage/Accessory ? 30 Swim Pool ? 14 Cortm/Ind Add
D 03 Two family ? 07 Fireplace ? 11 Res. Add. O 15 Lomm/Ind Rem
L7 04 Mu1ti-fam. T.H. O 08 Deck O 12 Res. Porch ? 16 Public Fac.
? 17 Agricultural
WORK TYPE
31 New ? 33 Alterations ? 35•Move
~ 32 Addition ? 34 Tenant Finish ? 36 Demolish
GENERAL INFORMATION
Const. (Actual) V_N Basement sq. ft. MWCC System
(A1Towable) v- N lst F1. sq. ft. tity Water YE-S_
UBC Occupancy it-3 M-I 2nd F1. sq. ft. PRY Required YiEs _
Zoning 5q. Ft. total Booster Pump
i of Staries Footprint Sq. ft. " Fire Sprinkler
Length ~ On-site well Census Code _745~WF_
Depth 4 Z On-site sewage SAC Code /
APPROVALS
Planning Building Assessments
Engineering Yariance
REQUIRED INSPECTIONS
O Site ? footing ? Framing ? Insulation
0 Wallboard ? Final ? Draintite ? Fireplace
Permit Fee ~/44a vaiuacid,: : r1 QC>D'~
Surcharge f3 ,5a G Ano~GE
Plan Review 54. 6, tc~ 32 Y. 2y.= 7,6 6
Li cense ~ x k4 Z~ (Z~
City SAC Oa,ao 4KK.~
Water Conn. ~ ~ -
Water Meter
Acct. Deposit 71 't 4c 46 = 1134Z,
S/W Permit p;uo BG K 30:= lDg~
S/W Surcharg e ,5'0 ~o X
Treatment P1. 40,0 o Road Unit .3fio.ow II k/a ~ ~~p
Park Ded.
Trails Ded. j~~Dxl, ~q~ y50
Capies Is;r Fioa,¢
Other
Total:
SAC %
5AC Units
eNIZ, Feoor2 k 33
4 xrc~ ~ 1~,~
6S~ 720
4
Cer.`tificate i'or.: ,
•Svexlc} Fet2,rsen Construction
10214 Park ViewCircle N
, Bloomingtun, MN 55431 -
DELIVtlAR H. S'VrH•CAYCZ .
LAND SURV'cYDFS, iNC. `
. PegistereC UnOe/ Lbw9 OI IDB Sfele Ot MlnneSOte
14750 SOUTH ROBERT TRAIL ROSEMOUNT, MINNESOTA 55068 612/423-1769
$URVEYOR'S CERTIFICATE
.
~
R~
Scalec 1 inch = 30 feet
? = Set wood hub
J eDp f1~ .
' 6 ~ 4 L o= Iron pipe monument
Existing spot elevation
Proposed elevation
Proposed garage floor elev. qfoS•~
-Proposed top of block elev_ 94~~ 3
Proposed lowest level elev_ ~57•3
Q ~
9e<. ~
~u ~
x'
.a.~~~^q['/y9~/lrJJ P
13.0}..~'4
~ O. ~J I/6POSf~/ M N
C~ W\ ~~nuSG
a
\ a~a? 3~ ~ ~ g~~ ~ R E'S
DELMAR H.
SCHWANZ
0
. e a_zs°iSOD2_ -8625-
~.v~,-0 If -
yS9•9D „s'`~ ~ ~
Ce..t`vE.
ENGIIUEERIlYG DEPT
Description: ~ ~
Lot 15, Block 2, WILDERNESS PONDS, according to the recorded plat
thereof, Dakota County, Minnesota. Alsu showing the location of a praposed house as staked thereon.
I nereby certify tnat this survey, plan, or report was ' r
prepared by me ar under my direct supervision and
that I am a duly Regis4ered Land Surveyor unCer the laws otthe State ot Minnesota.
Deimar H. Schwanz i~
Dated 05-15-92 Minnesrna Registration No. 8625 'i~
Coo#rastnr S. Petersen Const.lne_ 084-5144
Si#e Addre Lo# 15 Yilderness Ponds
j3e-rek 2
t Total exspased 3ra11 area 2799 0.11 307.85
2 Total raoflCeiling area 1402 4.026 36.452
Total 344.342
Total rall area above floor
A Total rindow area 210 0.32 67.2
B Total Door area 56 0.128 7.168
C Total sliding Glass area 40 0.32 12.8
D Total fireplace area 1$ 0123 2.304
E Total framing area (ar.lO%) 274 0.119 33341
F Tot_ ne# vail area abore floar 1463 0.045 38.335
G Total rim jaist area 233 0.047 10.951
To#alexposed foundatiun area 133
N Total foundation Yindor area 9 0.32 2-88
1 Tot_ net faundation abore grade 224 0.14 '-6
l256_199''
Total
Total exnosed roo#/ceilinu area 1402
J Total skylight area d 0.32 4
K To#_ ronrlceiting framing (1099) 140 0.049 6.86
L Total net insulated roof/eeiling area 1262 0.0193 24.~.~566
Total 31_ 166
. . . . , . _ ....,)11er:.~;~..'N~:.•.
L c T ~ ~ _ CITY OF EAGAN CITY USE ONLY
~0~(JPI IIMBING YERMIT G
SUBD• w~Z-ewv'Yl,[~-~-~ (612) 681-4675 BECEIPT-# ~ ~ZZ
DATE Z
it88IDSNTIAL
PLEASH COMPLETE IIPpER PORTION ONLX FOR SINGLE FAHILY DWELLINGS. AISO, FDR TOWNHOMES AND CONDOS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
TiORK DE5CRIPTION COMPLETE THE FOLIAWING:
NEW CONST X , N0. . FIXTURES EA. TOTAL
REPAIR/ADD ON 15:00
ADD ON _ I SHOWER 3.00 ~
REPAIR WATE& CLOSET 3.00 `O
~ BATfi TUB 3.00
OWNER NAME: ( irn''l (.u IAVATORY 3.00
I KITCHENSINK 3.00 3
SITE ADDRESS: I''UNDRY TRAY 3.00 .3
'Y HOT TUB/SPA 3.00
~ WAT ER hEfaTFs'. 3.00
v3~
FLOOR DRAfN 3.00 . 3"a
ILISTAI3.ER: GENZ-RYAN PL[3MBING GAS PIPING OUT.
~ (MINIMUM - 1) 3.00 3 ~
ADDRESS: 14745 South Robert Trail s~ ROIIGH OPENINGS 1.50 Q
OTHER
WATER SOFTENER 5.00
CITY: Rosemount Zip; 55068 pRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
PHONE 423-1144 w. TORNAROUND 15.00
STATE SURCHARGE .50
SIGNATURE OF PERMITTEE TOTAL: SS3, ~
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BI7ILDINGS. AISD FOR MULTI-FAMILY
SUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION: OWNER NAME:
CONTRACT PRICE:
SITE ADDRESS: 1% OF CONTRACT FEE. .
STATE SURCHARGE - $.50 FOR
TENAN'P NAME: EACH $1,000 OF PERMIT FEE.
SUITE $25.00 MINIMUM FEE.
INSTALLER: CONTRACT pRICE x 1% $
ADDRESS: STATE SURCHARGE $
CITY: ZIP:
TOTAL: $
PHONE f:
FOR: (SIGNATURE)
CITY OF EAGAN
CITY OF EAGAN
L-Z5
~ B a- MEcanxicai, rERMrr REcErnr # ~ b~ 7 Z 2
SUBD. (612) 681-4675 DATE
RESIDENTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMIIY DR'ELLINGS. ALSO, COMPLEl'E FOR
TOR'NHOMES/CONDOS WHEN SEPARATE PERMITS ARE REQUIItED FOR EACH DWELLiNG UNIT.
ORNER: - FEES
SITE ADDRESS: ADD ON/REMODEL (FJIISTING $ 15.00
CONSTRUCI'ION ONLl)
INSTALLER: GENZ-RYAN HEATING FIVAC: 0.100 M BTU
PHONE 423-1144 ADDTI'IONAL 50 M BTU 6.00
ppDggSS; 14745 South Robert Trail GAS OUTLETS - hIWIMUM 1 Q $3 EA. a dv
crry, Rosemount ZIp. 5506II SURCILAItGE: $ .so 11
SIGNATURE: • °
TOTAL: $30 ^
COMMERCIAL
PLFASE COMPLETE THIS PORTION FOR ALL COMMERCIAIJiNDUSTRIAL BUILDING3. ALSO COMPLEI'E FOR
APARTMENT BUILD W GS OR OTHER MITI,TI-FAMILY BUILDINGS WHEN SEPARATE PERhITTS ARE NOT REQUIRED FOR
EACH DWELLING UNTf.
R'ORK DESCRIPI'ION: CONTRACT PRICE FEES
1% OF CONTRACI' FEE.
STATE SURCHARGE IS $.SU FOR EACH
$1,000 OF PERMTI' FEE. $
PROCFSSED PIPING - $25.00 $
MINIMUM FEE • S25.00
OR'NER: TOTAL: $
SITE ADDRFSS:
1'ENANT:
SU11'E
INSTALLER:
ADDRESS:
CTfY: ZIP:
PHONE CITY SIGNATURE
SIGNATURE:
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - -
I For Office Use
Il~
City Ol Enan I Permit#: I
I Permit Fee:
3830 Pilot Knob Road 2
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: U~T~ r1
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: Phone: lOs~' f®~
Resident/ /CaJE'. ~ti.✓
Owner Address /City /Zip:
Applicant is: Owner Contractor
Type of Work , Description of work: oc►~ lX'
Construction Cost: Multi-Family Building: (Yes / No
Company: reIvC el Contact: c ✓C( o~in rl
i Contractor Address: ; a7 e$,/ %✓t City: Hof ~
State: M 1? Zip: 3 7 / Phone: G°
t
License v~o ~91p8~ Lead Certificate
If the project is exempt from lead certification, lease explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Y
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.oopherstateonecall.ora
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 State Building Code must be completed within 180
days of permit issuance.
x Z)qv/ 7,H_"V,-S0tV, x
1/2
Applicant's Printed Name Applicant's Sign
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114650
Date Issued:09/17/2013
Permit Category:ePermit
Site Address: 1285 Wilderness Curve
Lot:015 Block: 002 Addition: Wilderness Ponds
PID:10-84275-02-150
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Eric Brehe
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 -
Rober D Tarbet
1285 Wilderness Curve
Eagan MN 55123
Aspen Contracting/asi
4651 Nicols Rd
Eagan MN 55122
(952) 583-2641
Applicant/Permitee: Signature Issued By: Signature