1304 Wilderness Lane
CASH RECEIPT ~ , • s~4~,
CITY OF EAGAN 3836 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
RlCEC'SED
FROM -
~ AMOUNT $ I
~ DOLLAR$
oo
~ CASH ~ CHECK
FOR ~
. i FUND CODE AMOUNT
~ I 1
L
I
ThankYou
8Y
6 7 White-PeY@ri CoPY
Yellow-Postiny Copy
Pink-File Copy
BLDG. PERMIT N0.
01-3210 Bldg. Permit
01-3422 Plan Check -
% 01-3445 Surch./Adm.
01-3446 SAC/Adm.
,
01-2155 Surcharge -
17-3860 Road Unit -
20-2275 SAC
20-3$65 Water Conn. -
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
17-1-3855 Park Ded.
TOTAL
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 '
,
PHON E: 454-8100 .
BUILDING PERMIT Receipt ~
To be used for SF DWU/GAR Est. Value k)'' Date ~~~~~~,Y Q ,19 8~
SdteAddress 1 i04 WILr)f:RINEs5 LAur-, OFFICE USE ONLY
Lot Z` 81ock ~ Sec/Sub. ~ILI):.li'~',~5 #~~iD5 OnSiteSewage Occupancy ~
- MWCC System Zoning
ParGel No. On Site Weil Type of Conffi
City Water x (Actuaf)
c Name I.L~Yl~ tiJf~LL: u ASSt3t;. , 1t~C. (Allowable) n-
~k o( Stories _
= Address il',ij~' QENi~fQ(;i~ AV£`:l-F
Length 7 B. u(i
a City ,.t ° Lc; VALI.F ~hone '*~2-t7?? Deptn 33.33'
S.F. Totel
, o Name' SANE Footprint SF.
~ ` Address APPROVALS FEES
~ CityPhone Assessments _ Permit 7'=~ °1 1
WaterySewer 5urcharge + ~ • J
W W ~T~~% • Police _ Plan Review 3 t, 3_ uc
~ Name
W ~
= Z Address Fire _ SAC, City Engr. _ SAC, Mwcc 7'j u-
¢Z City Bl_'RNSVIL[,E, phone 432°3it('tJ Planner - WaterConn. 5-1 ~•v~f
~
W
Council Water Meter • V~
I hereby acknowledge that I have read this applfcatfon and state Bldg. Off. _ Road Unit 357
thattheinformationiscorrectandagreetoCOmplywithallappliCable APC - TreatmentPl LU (iu
State of Minnesota Statutes and City of Eagan Ordinances. Variance _ Parks
Copies
Signature of Permittee - roTAL
LL~±~•~.; , , i:;,I:
A 8uilding Permit is issued to: on the express condition that
all work shall be done in accordance with all applicable State oi Minnesota Statutes and City of Eagan Ordinances.
Building Official ' '
CASH RECEIPT, CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNE50TA 55122
DATE 19
RECGIVED '1 , I I
FqOM
AMOUNT $ ; I
,
8 DOLLARf
oo
? CASH ~ CHECK
roa ~
FUNO CODE AMOUNT
' Thank You
BY
White-PeYer3 CoPY
Yellow-Postinp CoPY
Pink-File Copy
~ . • ~ ~
, . . . , CITY OF EAGAN
3830 Pllot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH O N E: 454-8100
BUILDING PERMIT Receipt~t
To be used for Est Value Date ,19
Site Address OFFICE USE ONLY
On Site Sewege _ OCCUpancy
Lot BloCk S8C/Sub. MWCC System _ Zoning
PerCel No. On Site Welt _ Type of Const
City Water _ (Actuaq
a Neme (Allowable)
W * of Stories
3 Address Length
~ City Phone ' Depth
S.F. Total
, p NBme Footprint S.F.
0 ~ Addreas APPROVALS FEES
Ic City PhOne Assessments _ Permit
Water/Sewer Surcharge
W W Meme Police _ Plan Review
FW
U~ AddreSS Fire = SAC, Cfty
Engr. SAC, MWCC
c= City PhOne Planner _ Water Conn.
tW
Council _ Weter Meter
I hereby acknowledge that I have read this application and state Bldg. OH. _ Road Unit
that the information is correct and agree to comply with all applicable APC - Treatment P1
State of Minnesota Statutes and City of Eagen Ordinances. Variance _ Parka
Capiea
Signature of Permittee TOTAL
A Building Permit is issued to: on the express condition that
all work shall be done in aocordance with all applicable State of Minnesota Statutes and City of Eagan Ordinancea
Buildinp Official
Permlt No. Pe?mlt Holder D+eto Tolephono ~
Plumbing 3 6 , 7,S F
. '
H.V.A.C. Electric
Softener
Inspection Date Insp. Commonts
Footings I
Footings II
Foundation
Framing 3 ~
Roofing
Rough Plbg.
Rough Htg.
Isul. y~
Fireplace
Final Htg.
Finel Plbg.
Bldg. Final
Cert. Occ.
Temp. LP /yE S~J-y/ Co .~rt~-r.~ Cow2
Deck Ftg.
-
Deck Frmg.
Weil -G ~ .A~~?r %.-va-L
Pr. Disp.
Nc,
/ 3- ~
. ^ ' . ~ . , . . , _ •N : ~ ~ • 1 . . . .4 ` tr.~~+M
~
. , v
(gertifirafr uf Orrupaury
Citp of (Eagan
'Ervarttnrnf of liuilaing jns.pertintt
This Certifrcare issued pursuant ta the requiriementr of Section 306 of the Unifor?n Building
Code certifying that at the dme nf issuance this structure was in conrpliance wrth the various
ordinances of the Cr1y regulating building eonsrnection or use. For the fallowrng.•
Uae Claai6ation SF DIC/GAR mdg. %rmit No. )458I
Oavpancy Type R3 ldoing [listrict Rl Type Comt. ~
~~4 Bdding IIUYI) I-i1IIJiE & AS.90C. Addrem 14530 PMlOCK AVE, APPLE VAILFU
awlaing aaarm 1344 WIIiERm.S.S iAm Loality L 10, 82, WIIERESS PCMng 24~ w,e: MAYM 9, 1989
auadi g OfficialF,
POST IN A CONSPICUOUS PLACE ~
~
1 . - -
PERMIT # l
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN - ~ Y
3830 PILOT KNOB ROAD, EACAN, MN 55122 DATE:
CONTRACT PRICE PHONE: 454-8100
Site Address 7ZI-14 77 ~ ~ ~ 2 7 ~ BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/Sub
Res. New
~ Name`~y'~ Mult Add-on
.T ~ J,/ Comm. Repair
~o Addr
c Ciry f~-' " "Phone Other
FEES
~ Name RES. HVAC 0-100 M BTU - $24.00
c Addre~s~`~S ADDITIONAL 50 M BTU - 6.00
p City Phone Z~e -~3 (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PEkMIn - 1.50 EA.
TYPE OF WORK , COMM/IND FEE - 19'o OF CONTRACT FEE
Forced Air ~ M BTU b~j APT. BLDGS. - COMM. RATE APPLIES
d: TOWNHOUSE & CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU REMODELS - 12.00
Air Cond. M BTU $ MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent. CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # BEYOND $1,000)
Other
FEE:
S/C: SIGNATURE OF PER ITTEE
TOTAL•
FOR: CITY OF EAGAN
PERMIT ti ~ '
. ' PLUMBING PERMIT RECEIPT #
CITY OF EAGAN , -
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address ~ ~ • ~ ~ ` 'f ' BLDG. TYPE WOFiK DESCRtPTION
Lot Bloek See/9 b~ Res. New
. ~ 2 u=-- ~ ? Mult. Add-on
~ Name ~ ' • ~ ~ ~ + Comm. Repair
R Address Other
c City Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
- ND. FIXTURES TOTAL
Name r -1 _ Water Closet -$3.0o $
Bath Tubs - $3.00
3 Address Lavatory - $3.00
p City Phone TShower - $3.00
' Kitchen Sink - $3.00
FEES Urinal/Bidet - 53.00
COMM/IND FEE - 1°rb OF CONTRACT FEE ~ Laundry Tray -$3.00
APT. BLDGS - COMM RATE APPLIES ' Floor Drains -$1.50
/ Water Heater - $1 50 -
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00 Whirlpool - $3.00
MINIMUM - COMM/IND FEE -$20.00 ~ Gas Piping Outlets -$1.50
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT)
(ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00
BEYOND $1,000.00) Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
SIGNATUAE"OF PERMITTEE FEE:
STATE S/C: --7 ~
FOR CITY OF EAGAN GRAND TOTAL: ~
~
Q ~
7-0 5 ~ ~~'Y
1 ~f •^t o ~~'c "
~~DS- 3 ~~-r_
s~--7
Pvr-,Ars 4N' 1414W s•~J~vG-
A c. -
Permit No: Date: '
CITY OF EAGAN Date: 9630 pilot Knob RDad,, B/P No: '
P.O. Boz 2t499 Eagan, MN 55121
Owner. _ , der~es s T. : "11
Site Address: '
Plumber:
Zoning'
MWCC:
No. of Units:
City Chg: ,
Acct Dep: . 1 agfee to comply with the City ot Eagan
Permit Fee: Ordinances.
Surcharge: B
Misc.: y
SEWER SERVICE PERMIT
CITY OF EAGAN Permit Na. Date:
3 7 " d~ 3830 PI{ot Knob Raad Meter No:a O Size:
P.O. Sox 21199 Reader Na. Date: 3'«~p
Esgan, MN 55121
Owner. Tlovd 'jelle ; 11ssoc
SiteAddress: 1 w4 ;tiilderne s Ln 1.10 P' ~ il:lcrre~~ ;
Plumber
Conn. Chg:
Acct Dep: Us:
C~' of
Permit Fee:
Surcharge: IELLPHONE ' Li~~.? tb'~" with the Clty ol Eagan
Tr. Plant ~t J, Tln[GUrI M c m w .
Meter.
Misc.: BY
WATER SERViCE PERMIT
~
Date: -'-12-88
C?T1f O~ EAGAN Permit Na.
3830 PNot Kndb Road B/P No: ' Date: -
P.O. Box 21199
Eagan, MM 55121
t_"SSUC
Owner. i S.. . i _ . _ : .
Site Address:
Plumber. •,1 likilgint
-
r'•'~ ' in call lo I util~t?es .
nnwcc: Rico. .
of Unit~:,
City Chg:
AccK. Dep: v g~v omPly with the Ch9 01 Eagan
.
Permit Feef~ncoc
Surcharge: Misc.: By , . . _
SEWER SERYICE PERMIT ~
- -
_ . • g;z, A '_-12-t~R
CITY OF EAGAR, Permit No: Date: -
3830 Pllot Knob Road Meter No: Size: -
P.O.,jBox 21199 Reader Na. Date:
Eagan, MN 55121
Owner. ~.lovd i:'elle '1.ssc~c
h"ildierness 1n 3 1' C"' Ivil'orres- ronc4<.
Site Address:
Plumbe~
~
Conn. Chg: Zoning: ~
Acct Dep: No. of Units:
Permit Fee: Surcharge: 1 agree to comply wifh ths City of Eagan
Tr. Plant Ordinances.
-
Meter.
Misc.: BY
WATER SERVICE PERMIT
CITY OF EAGAN N~ 14 5 81
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE: 454-8100 Receipt # ~ r`, /01
Tobeusedfor SF DWG/6AR Est.Value $147,000 Date FEBRUARY 2 ,1988
Site Address 1304 WILDERNESS LANE OFFICE USE ONLY
Lot 10 Block Z Sec/Sub.WILDERNESS PONDS OnSiteSewaee Occupancy R-3
MWCC System X Zoning R-1
Parcel Na On Sitewell _ Type of Conat
City Water X_ (ACtuaq Vn
a Name LLOYD HJELLE & ASSOC., INC. PRV X (Aliowable) Vn
w - # of Stories
z Address 14530 PENNOCK AVENUE Leng[n TG-.Uo~
° City APPLE VALLE}Shone 432-1737 Deptn 33_ 39 -
SF. Total
, o Name SAME Footprint S.F.
~a Address APPROVALS FEES ?
~ City Phone qssessments _ Permit 726.00
Weter/Sewer Surcharge 73.50 "
ww Name PROBE ENG. Police _ Plan Review 363-D_-'
!_i- Add ress Fire - SAC, City 100 _ O(1
cl En r SAC. MWCC 550.00
'W City BURNSVILLE phone 432-3000 Plenner _ waterConn. 550_00
Council _ WaterMeter 67_00
I hereby acknowledge that I have read this epplication and state BIdg.Off. _ Road Unit 375 _(1f1
thettheinformationiscovectandagreetacomptywithallaOD~icable APC - TreatmentPt 704_00
State of Minnesota Statutes City oi Eagan Ordinancea Variance _ Parks
~n n Copies
Signature of Permittee TO7AL 2, 93875-0-
A Building Permit is issued to: LLOYD HJELLE on the express condition that
all work shall be done in accordance h all applicable State of Minnesate Statutes and City oT Eagan Ordinances
Building Official a2z(4 /
This repues, void p/~~
18 months trom tl
~ 624 6~.« ~
Heqvesi Dat@ Fire No. RouAh-in InsVer.tion
^ Re~quy'ed7 ~qeady Nuw Niil Nnlify Inspec
_ 0
a ~'es ?NO ~or When Readv
Licensed Elecvical Contrector I hereby reqoest inspection of ebova
El Ownef eleclrical work installad aL
Street Address B~ox~ ~or Routa No. City
l v~G Gv~ lT~ ~
emion o. Township Name or No. Range No. County
OccuVAm (PqINT) Phone No.
P. pplier ~ Addmss
El~ectri~cal/Convactor (ComoanY Namei / Conhactor"s License No.
Mailmp Atldress (Convaclor or Owner Makina ~nsrailation)
Z
A re [ra t/ er Ma - g stallation) Phnne Number
6?~ r ~s
MINNESOTA STATE BDA OF ELECTflICITV THIS INSPECTION qEQUEST WILL NOT
Grigga-Midway Bltlg. - oom N-191 BE ACGEPTED BY THE STqTE BOAHD
1821 Universitv Ave., S[. Pnul, MN 55104 UNLESS PPOPEN INSPECTION FEE IS
Phone(612) 642-0800 ENCLOSED.
REQUEST FON ELECTRICAL INSPECTION ee-onaooi-os
624 ~ See instructions for complating lhis form on beCk of Vellow copY.
D 3 6 "x" Below Work Covered by lhis Request
Navy Adtl Fep. Type ol Builtling Appliancea WireE Equiumen1 Wired
Home Range Temporary Service
Duplea Water Heater Liyhtlny Fixtures
Apt. Building Dryer Elearic HeaUn
Commercial Bldg. Fumace Silo Unlonder
Industnal 81dg. Air Conditioner Bulk Milk Tenk
Farm om.+. oea v emn, ~snredrv~
t r SVecify Other Cliher
ompute /nspeciion Fee Belaw
q Fee ServiceEntrenceSixe tt Fee faxde~s~Subfeede~s tt Fee Clrcu'ns
to 200 qm s 0 to 30 qm s Z 0 to 30 An s
A6ove 200 qmps 31 to 100 Amps 31 ro 100 qm s
Swimming Pool Above 100_Amps Above 100_Amps
Transtormers Irrigation Booms Partial-"Oth r Fee
Signs Special Inspecti,pn L{
Aertyrks $ TO7 F
1
flou9h-in ~he E tric
, +°V~ / ~ ~ IpsDeCtor, herBby
rtify that tpa above
Final inspection has baen
Mis reQueel voltl 18 monlhs Irom
' . F'OR CITY USE ONLY "
PERMIT # ISSUED
Pd w/Bldg. Permit FEES:
$ $ /p SEWER PERMIT (INCLODE SURCHARGE)
$ WATER PERMIT (INCLUDE SORCHARGE)
$ Cn 7• O~ $ WATER METER/COPPERHORN/OLTSIDE READER
$ $ WATER TAP (INCLLDE CORPORATIO[V STOP)
$ S SEWER TAP
$ ACCOUNT DEPOSIT - SEWER
$ ACCOLNT DEPOSIT - WATER
$ WAC
$ SAC
$ $ TRONK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRLNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ ~°.U $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ O6 s J I. Ov TOTAL
~
a, ~0,~ / ! D
RECEIPT RECEIPT# -
DOES UTILITY CO[VNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
F--j YES IF YES, THEN A"PERMIT FOR WORK WITHIN PLBLIC
ROADWAY" MUST BE ISSUED BY THE ENGINEERING
~[VO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
~ DATE: -
M .
. , .
, .
" • A P F L 1 C~A T IO N F O R P E R M IT :NM= PAYM27r OF FEE AT 'F[ME OF ;
APPLICATIOH OOESS P70P CON- .*k
SI'IN1E APPROVN. OF PIIiPIIlC. i
C~. SEW ER AND/OR WATER CONNECTIQN ; Im°EMaN oF MER nca/OR vn+Tm
r ; xtasrnLUTzas wua. Nar ae scmW.tn ~
. ; ormu. rFanuT xAS amu n2rxovID. ;
1}t~##44l1tY4*ttlYii#tfif#lkMffiRtI#t~i
~
Citv OF CC1gC8Pf
PLEASE PRINT
1) PROPII2TY ADDRFSS:
LEGAL DFSCRIPTIONI.
Lot oc S ivision or Tax Parcel ID
IF EXISTING STRLV'iY1RE, DATE OF ORIGINAL BUILDING PERNLiT ISSL~ANCE:
Mont Year
PRESENf ZONING/PROPOSID LSE:
Q,COhPvMCIAL/RETAIL/OFFICE m R-1 SINGLE FAMILY
Q INDL'STRIAL El R-2 DDPLEX ('14ro L~nits)
a;INSTITCiTIONAL/GOVERNMENT ~ R-3 7'OWNiOLSE (Three.+, Units) ( Lnits)
Q R-4 APARTMENT/COAIDOMINIUM ( C~nits)
.
2) NAME:
ADDRFSS: . .
CITY. STATE, ZIP:
PHONE:
For City Use
3) ' :2• Pliunbers License:
ADDRESS: Active
Expired
CITY, STATE, ZIP: . Not recorded
PHONE: MASTEE2 LICENSE Sta In~fitia~
e • a•
4)
NAN1E:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
5) ~ • a ~u ~e
~ CONNECTION TO CITY SEWER a CONNECTION TO CITY WATER ~ OTMR
6) "n
~*****~*~,r«***,r*******~***~~**+*:~**+********~*+*,~***,r*~~*~**~~****,r*~~~**:r*************x**~~*~*~~**~
* 74IE GOLD COPY OF THE pERNffT WILS, BE SENP DIRECPLY To PCTBLIC FARKS ZU FACZLITATE MEPER PICK-UP. w
~ PLEASE ALLpW nVO WURKING DAYS FOR PROCESSING. SOMEONE FROM TfM CITY WILL CONPACf YO[J IF Z41ERE x
* ARE ANY PROSLF.M1S. *
a
~
. ~
. 1
J
F O R C I T Y U S E O N L Y
PERtitIT ° ISSUED
~
F°L'S: $ S°:^:Eo oERMri (I`IC:.::D: SliPC?U?RGE)
$ WATER PERAIIT (INCLUDE SURCHARGE)
$ WATER METER/COPPERHORN/OUTSIDE READER
$ L4aTEP. TAP (INCiUDE CORPORATION S-IOP)
$ SEWE4 Tan
$ ACCOUNT DEPOSZT - SEi•7ER
$ ACCOUNT DEPOSIT - WATER
$ WAC
$ sac
$ TBUNK WAT°R ASSESSi4ENT
$ TRliNK SEWER ASS£SSMENT
$ LATE°.AL BENEFIT/TRUNK SEWER
$ LATERAL BE*:EFIT/TRUNK WATER
$ - OTAER
$ TOTAL
$ AMOUNT PAID/RECEIPT #
DOES UTILiTY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGriT Of WAY?
0 YES IF YES, THEN A"PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGZNEERING DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO TIIE FOLLO'.4ING CONDITIONS:
APPROVED BY:
TZTLE:
DaTE:
~
. ~
- ~
~ ?
~ . I
2/84
% CITY OF EAGAN
~ APPLICATION FOR PERitiIIT _
SEWER AND/OR WATER CONNECTION
, (PLEASE PRINT)
i) PRoPERTY AnDxESS: cV LQU F),Yu SS XQ.YL.L.
r.Fr=,r, DESCu_tirzcN: 13LL7- GULCLlF~QMI-IJC'-,
(Iot/Block/Subdivision or Tax Parcel I.D. NLunber)
ir ~tI G S`I'.RGCT~'RE, DaT G_' CRIGii:AL :~iILCZ".G F~':aSm rcSU?~G:
i 5 0 R-1 M;GLE FaY1ILY . - ,
R-2 CUPLE.Y Mti'p L7i7ITS)
? R-3 TG4MGY'SE (TERF" + UNZ;S) ( Wi I'"S)
? R-a APpRUrc-;m/CCjNID(~~= IL~1 ( Wi ITSi
? COL~,.'RCLAL/RETAI7,/OFFICE
? LML'STRIAL
? INSTITUTIO~I.AL/Gp-v'E.RDA=
2) APPLIC!V'P (PIiASE PRIHT)
IIOYD HJELLE & ASSOCTRTES INC.
ADDRESS: 14530 Pennock Ave.
CITY, STA'I'E, ZIP: Apple Ualley Mn. 55124
PHO-NE: 4 3 2- 4-4-3~ 1231
j) pLu,ffiER (PLEASE PRINi) FOR CITY USE ONLY
NAME: S}an Ol mhin
PLU!!BERS LICE4SE:
ADDRESS: 1018 Mound Sprinqs Ter. Q pctive
CITY, STATE, ZIP: Bloomington, Mn. 55420 0 Ezpired
A~iE Q Not of Aecord
PHOLNE: 884-4149 PLUMBER LICENSE H 3329M
arr initia
4) pCC2,'PF1NT/(7,7N&R I 1~ q(PLEASE PRI
NA[+IE: ~IS.JY n /`CI~1f, " Cn' //l_tC
ADDRESS: 145~ 1--~~1,uffr 'AVE -
CITY, STATE, ZIP: APPE LM[E~
5) INDICATE WHICH PEP,hiIT IS BEII'~.G REQUEST'"D:
E] CO.1,'NECI'ION TO CITY SEF7ER
~ CO:IIv'DCTICN 'IO CZTY [qP,TER
? dI'I'.ER (PLEASE DESGRIDE)
6) u:piG;::: 0:E:
? PL°?SE EOID r1PPROVFD PERtiLLT FOR PICi:-UP BY ONE OF ABWE
°L~15E %VPUJL APP:2M'r.~ PERtiLiT TU 1. 2, , 4 AHWE
' (Circle ane)
7) SIazATCRE:
Dr1T'E:
- •
~ - f~15•25 ,V
Cj,~ t-~000 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
~S crrr or eacair \
3830 PILOT KNOB RD • 55122
~ 9 14 651-881-4674
\V ~
\
> s reo.rowa are wNer d+owft sq fL a bt w. fL a na,w s cocie+ a wcn
and go rooled areat C,Nx maximum lot coveroae allowedl 1 s9t a anergy calcuhHOm for twaled addMOra
D 2 coples of Wans (thow baen & wintlow tizeA Pa+red Ind deftM etc.) 1 Wa wrveY tor axteAa addlMaM 3 dacb
D 1 wt d awrpy tdcWatloru •
D 3 caDies d tree prowrvallon plm M Id plaMatl adar 7/1/93
DATE: I~ I'7 I G d CONSTRUCTION COST: I oi ~ 6 rJ ~9
DESCRIPTION OF WORK: JPL.~ i^.t ~oI Y2 - fooF L, n c/ sz- cr.i+o.l ,_g~,ua ,qP _
sMErnoDREss: 130U GJ,`lArties5 Ln 4v4H 5-5123
~
Lor. i~ BLocL' a susD./P.I.c.
Name: r.lri'ck 6~o~'Ll Phonet: 6.5/--1/.~~/Sq Z/
PROPERTY tatt RM
OWNER
street Addresa: 130 -J/ 4e- 5~S
cny 4 Q4 L~, srm.:-np:.55ia3
company:~l(' UgPa ~P~ TAbE!'ljc5~ Phonee: bla- dffS- l/1/9
(area code)
COMRACTOR
street nddress: /L15 ucenae: o/ v>,U6E,cP.
City ~U11?,5(// fIe- Sfofe: Az/!O ZIp: ~'S337
ARCHITECT/
ENGINEER Company: Name:
Telephone 41: ( )
Sheet Addresa: Reglahallon It:
CNy te: Lp:
Sewerlwater lieeneed plumber (H Installina aewarlwaterl: Plwna M. I hereby acknowledpe lhat I have read Mds aPPRkaNon, dafe thaf Mo IMortnalion b oarecf, and aWea b comply wilh aB appec" Stale
of Minrseaota Stahitea and CNy of Eapan OrdinanCea.
Siynalure of AppNcaM:-
A - -
OFFICE USE ONLY
Certiflcates of Survey Received _ Yes _ No
Tree PreservaUon Plan Received _ Yes _ No _ Nnt Required
,
OFFlCE USE ONLY
BUILDING PERMIT SUBTYPES
O 01 Foundatfon p 07 05-plex O 13 16-plex p 21 Poroh (3-sea.) p 31 Ext Alt - Multl
O 02 SF DwelUng O. 08 06-plex O 17 Garage O 22 Porch/Addn. (4-sea.) O 33 Ext Alt - SF
0 03 01 of plex 0 09 07-plex O 18 Dedc O 23 Poroh (screened) O 38 Mufti
O 04 02-plex p 10 08-plex p 19 Lower level O 24 Storm Damage
E3 OS U3-plex E3 .11 10-plex PIDp Y w_ N O 25 Miscellaneous
O 06 04plex O 12 12-plex O 20 Pool O' 30 Accessory Bldg. WORK TYPE
0 31 New 0 36 Move Bldg. 0 43 Reroof
0 32 Addition O 37 Demolish (Bldg)• p 44 Siding
O 33 Alteratian O 38 Demolish (Interior) I] 45 Fire Repair
0 34 Repair p 42 Demolish (Foundation) O 46 Windows/Doors
' Give PCA handout to applicark for demolitlon permit
GENERAL INFORMATION
SAC Code # of Stories gq, g.
No. of Units Length Sq, ff.
No. of Buildings Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main levei sq. ft. MC/ES System
UBC Occupancy sq, ft. City Water
Zoning sq, ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
13 Stucco/Stone
APPROVALS
Planning Building Engineering Variance
Permit Fee C~- ` Vafuation: $
Surcharge ~ . S
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge +
Treatment Pi.
Park Ded. ,
Trails Ded.
Other Copies
TotaL• aC) O- 7
. SAC Units
% SAC
CITY UF EAGAN
CA4;HIEft: lg YEFiMINAl_ N0: o01
DA'TE; 01/25/00 TIMF_: lc'':c^_5:31
ID:
KIAi4Ea MIU4IEST' t:EIIAk TIMBEfiOpF GC)
3210 9001. 709 SUMMER L(•1Nh_ 139.25
2155 9001 709 SIJMt'iFfi LAhIW 3.50
32 10 9001 1304 W:f.l..LiF:N55 L 1.95aE5
eis., 3001 1304 147:LLIftNSS L 5.50
s
.
Tata1 Feceip+, Amount : 343.50
Cf? 1226 J. U
USFfi TD: JAN
.
lloyd Hjelle
O. A 5 5 O C I A T E S
QCINCORPORATED
Uoyd D. Hjefle & Associates, Inc.
14530 Pennock Avenue
Apple Valley, Minnesota 55124
(612) 432-1737
FEBRIJARY 2, 1988
TO WH0M IT MAY CONCERN:
RE: LOT 10, BLOCK 2, WILDERNESS PONDS
THE REAR CORNER OF GARAGE IS SET INTO A HILL WHICH WILL REqUIRE
11 COURSES OF 6" BLOCK. R SHELF IS PRESENTLY CIJT INTO THE HILL
WHICH OBUIOUSLY WILL RECEIUE A 4f RETRINING WALL TO DIRECT
DRAINNGE TO THE SIDE OF GARAGE.
SINCERELY
v LLD HJEL t
, Total exposed roof/ceiling area = I37-1
'Total gross roof/ceiling area = I 3 Z( ,
. j. Total skylight area .
k. Total roof/ceiling framing area
1. Total net insulated roof/ceiling area....... y~,q
Detenn3ne "U" value for eactt roof/ceiling segment.
. j. X uVo
k. ? 32.. I xllut, I?
1 . ~ 188,q x iluli
a 13Z.1.............. -rotal
If total of #4 is tfie same as, or less t3ian #2, you have rtiet the intent of
SBC 6006(c)1,
To utiTized ttie total envelope system method, t}ie values established by the
sum of items N3 and N4 shall not be greater tlian the sum of itens #1 and #2.
1. . + Z. _
3. + 4. _
MATERIALS Ttierm, Resistance "R'I
' Ezterior Air .1ri
Siding Material .45
Sheathing ZIOIo
Insulation 19_
Sheetrock 145
Interior Air ' .(05
Studa Le, 57
Rim. I • F~B
Conc. Blks. 1, 2q
' . ' .
PN1LL`,IPS PLAN SL'HVn:t ~ • ucnvwc
. 7831.w. Us1n Sveat - . - • .
- ,.Appled'"•71ey,MN 65124
EXTERIOR ENVELOPE AVERAGE "Il" COMPl1TATI0N 041NER
~oND
SITE ADDRE55 w~L~cRa1~e~-E
CONTRACTOR DATE PHONE
Determine working square footage of each.
1. Total exposed wall area 2Zq sq, ft. x •1 D Z
2. Total roof/ceiling area sq. ft. x •021,= I '14, h _J
Total exposed waTl area ahove floor
a. Total wal] window area I q~{
6. Total door area '
Ci4_
c. Tatal sliding giass door area ~
d. Total fireplace wall area.....................
e. Total wall framing area (average 10%).......... 2-13.4
f. Total net wall area above floor =-1
g. Tatal rim joist area I
Total exposed foundation area = Ip ,Zq
h. TotaT foundation window area........,,,,,,,,,,,,,,
i. Toal net foundation area abvve grade ,Z
Determine "U" value of each wall segment. a igg X ljuii
b. 5 4 xliuli
c._RE? g --U„ Llq_
d. Cf~_ xOull
e•- x"U„ , 09b = ZD~4
f. Zn,lo x lluit ,04 = Z,S
9-_ `lny^ g lluli t 0 - la I L
h. - X Putl _ _
. IOS.Z~{- X "U" ,ORL = ,8
3 .....................~?9Q,ZI..... Total
If item #3 is the same as, ar less than item #7, you have met the intent
of SBC 6006(c)2.
v -
- _ _ . a ~1s:8: i <.ip':..,1 yr:ce£:;'i`~-
- ' ~ v~ GMtlt M~bs I
PI LOYD C pIRHHE flS and6lAH0 S,
11NYEYOflS
GiNEEA1NG t??~t.o? COMPRNY, INC.
~ 1000 EAST 1462k STAEE7, 4pNNSVILLE, YIHHESOta 55337 PH 432-3000
'
Cer~?~'i cci~e RS'urZre c., ~
~
. ~
~~al d2Wcr~4-2ian- Lp-r 10.BCDCK 2. WILDERIVESS POND, i'
~ DAKOTA COUMY . M{NNESOTA . fl
~
.
~
~ (426.3~ (927,41) ~
WILDERNESS 1-ANE
c93s-i._ ~ DENoTF-s FxisnNc ELEvAnoN
,
~ EAST (932.0.0 ) DENMS PROMSED -,ELEVA'nON
- L=sz.V R=3025.08 G=1~900" : ,2g
9
3T,1WDICATES :DIRECTION ,OF
(9218) ~ T
suttF4CE DwUNAGE ~
(~3o.4) FlNISHED GisRAGE FLOOR ;
„9z ,SL33 0 (932.33 ~ 932.33 ~
' 13.93 013.5 ELEVATION a
c. . o o IZO ° 1633 1l _ f
vltovosp Pms; M I' . 30 FRONT SuILD1NG
Houss N ~ ~ 8ET8ACK LINE .
~ ~ o ~ 46.0 9.77
30.0 N
, • e~'~? _ ~ao (990.1) N32~ tri CC ~
~ Z
LOT 10 - . _
; .
; 5L
L-_~^.--~ DRAINAGE AND t!I'fuTY i
~
~93q'
~P3) ~ E+43EMENr
.
~
.
1 ~0
N~,~/i ~ - ~~5 ,,:~sca~•`
` ~ • ~ . ~ ~~i~~ ' . . ~-r ~ i a ~ a ~~t .f
~ .
° I her*by cartify that this ia a~LZ'+e and carrect repraaentatiaa of a tract of ~
lind sho+m"and'.aaacribed hnrnon.-, Ae prapsred by 1ne an thfr - 'f d !Yi~ar ~
f!k
.,e . . ' . ~ . -I .y,
. . . 3;~,1L R tl.. ~ .
_ - . ~~~~/11JIn• ~~~r PQr`~r
~1:+. . _ . . . . . . , , . _ ie'
vALua-rIoN
GARAGE
24x 18= 432
I 2 1C 23 = a'l (o
~oBXlz= gy9~
SEMEN7'
~O)( 30 = 900
3X13= 39
1 x 14= 14
1 laX 19 = 297
~ XiL4 - 1 ~V, _
351 x iN 184i4
1-
IsT Fcoo~_
BS«T ~ ~35 i
~~9 = 14
136~ X yy = 6e0 60
ZA1D ~~OOR .
ZZA 32= 'lD4
ZXIi= 22
15
I X6 = ~
2oXt6=5zo
~oK~ = `
~ 335 XyU= 5894 0
~4GZla
. ~ ~~s81
' 1988 HUILDING PERMIT APPLICATION - CITY OF EAGAN "
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECB WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
CONIMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For: R~~~ Jt~N 2'~ ~f
i Valuation: ~ Date:
Site Address /.30 OFFICE USE ONLY
Lot L Block z _ 5 On site sewage Occupancy {Z- 3
MWCC system Zoning ~ - ~
Parcel/Sub = On site well Actual Const V- N
City water Allowable V-/9
Owner l( C l~T) t-[wa pRV required 4k of stories
Booster Pump _ nh 76.OD'
Address De
Q) pth
3~•33
S.F. Total
City/Zip Code Footprint S.F.
Phone 43Z- 1~3~1 APPROVALS FEES
Contractor a ' I Engr/Assess Permit W("00
Planner Surcharge 713150
Address Council Plan Review ,363.0
p
Bldg. Off. 2 Z SAC, City /00 , 00
City/Zip Code ~ U~ Variance SAC, MWCC 55 O, o0
Water Conn b50. DU
Phone Water Meter Gr7,~00
M~ Road Unit 3Z51pa
Arch./Engr.T~~(,t(86Q/kn Treatment Pl O(/,OJ
/4.S36~b~~ILY.~ UE Parks
Address ~ IL~.C,w` Copies
V. SS IZL4 ~ TOTAL a S$ SO
City/Zip Code T~)ppSV
Phone al 43z/zo4ei
-r
OFFICE USE ONLY
Sub Types '
? 01 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 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OB-plex O 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plez ? 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 Building* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement `Demolition (Entire Bldg) - Give PCA handout W applicant
Valuation Occupancy MCES System
Plan Review 100% or 25%
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaVC.O.
_ Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tesu Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
5&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
~I I l q .~3v.oo
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
' City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauiremenls RemodellFieoalr Renuirements OKce Use Oniv
3 registered sfle surveys shmving sq. tt. of lot, sq. k. o( Frouu; and all roofed areas 2 wpies of plan CeR of Survey Recd _ Y_ N
(20Na maximum lot caverage allowed) 1 set of Energy Calculatans for healed additions Tree Pres Plan Recd _ Y_ N.
2 copies of plan showing beam & window s¢es; poured found design, etc. 1 site survey for edditions & decks Tree Pres Required . Y N
1 set of Energy Calculations Add'rtion - indicate tl on-sde sepGc system On-site Septic Syslem _ Y_ N
3 copies of Tree Preservation Plan if lot platled afler 717193
Rim Joist Defail Options seledion sheet (bWdings wilh 3 or less unifs)
Date /0 l /Z l QJ~ Constrvction Cost
Site Address /30 Y b(JCC'AS". 5 L/'JUniUSte #
E
Description of Work k%J5 MZ(~ 64,
iti 5L,,1'L/
Multi-Family Bldg _ YK, N Fireplace(s) _ 0K 1 _ 2
PropertyOwner [Wt--~~ayo 11,q Telephone#(tn,r) 4W
Cootractor ~Qe J L- vL 14`IJ
Address ~•~1(;ejCiI H,-)Ajj V~,.7'ra /J City ? 4V4U
State V'^^~ Zip %37b Telephone#(&CO) SVl-301
n.
~'S111;
COMPLETE THIS AREA ONLY IF CONSTRUCTIN& A, NEW BG7ILDIN~G:',
11J ,
- Minnesota Rules 7670 Cateeorv 1 C~ Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Eriefg_ yCode Worksheet
(J submission rype) Submitted
Submitted
• Energy Envelope Calculations Submiried In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master planZ
_ Y _ N If yes, date and address of master plan:
Licensed Plumber Telephone )
Mechanical Contractor Telephone )
Sewer/WpterContractor Telephone#( J
I 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 perm' , and work is not to start without a
permit; that the work will be in accordance with the approved pl in the case f work which requires a review and
approval of plans.
kH 0
Applicant's rinted Name Ap icant's Signa e
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA113112
Date Issued:08/29/2013
Permit Category:ePermit
Site Address: 1304 Wilderness Lane
Lot:010 Block: 002 Addition: Wilderness Ponds
PID:10-84275-02-100
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.
Crystal Cochran
7588 Washington Ave S
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 -
Fredric Groth
1304 Wilderness Lane
Eagan MN 55123
Pronto Heating & Air Conditioning
7588 Washington Avenue South
Eden Prairie MN 55344
(952) 835-7777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118345
Date Issued:10/31/2013
Permit Category:ePermit
Site Address: 1304 Wilderness Lane
Lot:010 Block: 002 Addition: Wilderness Ponds
PID:10-84275-02-100
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 .
Lisa Nyberg
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 -
Fredric Groth
1304 Wilderness Lane
Eagan MN 55123
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA123331
Date Issued:06/04/2014
Permit Category:ePermit
Site Address: 1304 Wilderness Lane
Lot:010 Block: 002 Addition: Wilderness Ponds
PID:10-84275-02-100
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 or installing Bay or Bow
windows, 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 -
Fredric Groth
1304 Wilderness Lane
Eagan MN 55123
(651) 454-3844
Pella Northland
15300 25th Ave N #100
Plymouth MN 55447
(763) 355-1300
Applicant/Permitee: Signature Issued By: Signature