1763 Walnut LaneCity of Eaaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
MAY 2 4 2011
a`
cep;-es
r
Use BLUE or BLACK Ink
Permit #: q 9 0
-76.71
Permit Fee:
Date Received:
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION Crit
Date: VA ay Li Site Address: 11 (03 to•J e n ' Law— Unit #:
RESIDENT I
OWNER
Name: C..p7.1 ATCI'r . Phone: ti251 -a..53 -8 3% 4
q
Address / City / Zip: 116 W Eztn Qin mA) 551
6 S ein ik 1..0..Y...
Applicant is: t/ Owner Contractor
TYPE OF WORK
Description of work: 1�e.telace.. PVs )'I2q1s eg,n &e.V---
Construction Cost: Q ? k to OD Multi -Family Building: (Yes / No /)
CONTRACTOR
Company: Contact:
Address: City:
State: Zip: Phone:
License #: Lead Certificate #:
If the project is exempt
4tC-kt', ab(
from lead certification, please explain why: (see Page 3 for additional information)
-0Q-c1/•,-.
In the last 12 months,
No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
_Yes
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information Portions of
the information maybe 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.
Applicant's Printed Name
x
Applicant's 't ature
Page 1 of 3
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
Addition
Alteration
/Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% ✓)
Census Code
# of Units
# of Buildings
Type of Construction
A-11A6c inn t
DO NOT WRITE BELOW THIS LINE
Fireplace
Garage
Porch (3 -Season)
Porch (4 -Season)
Deck XIV, Porch (Screen/Gazebo/Pergola)
Lower L I'i Pool
Interior Improvement
Move Building
Fire Repair
Repair
st 341
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water Final
Framing
Fireplace: _Rough In _Air Test _Final
Insulation
Sheathing
Sheetrock
Reviewed By:
Siding
Reroof
Windows
Egress Window
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Other:
Pool: Footings Air/Gas Tests Final
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Erosion Control
Building Inspector
RESIDENTIAL FEES V
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
City of Eaaan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Date:
r
Use BLUE or BLACK Ink
Permit #: q
Permit Fee: 4,2e 3 V
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
17103 (kJ kx-14.7?
Tenant:
Site Address:
Suite #:
RESIDENT / OWNER
Name: Phone:
Address I City I Zip: /.73 °lc /tut Zia, 6 ,
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: I'.t1/97-e- /2 L 4Y-0/4 C -4: -
4Construction
Construction Cost: 600 Multi -Family Building: (Yes I No )
CONTRACTOR
r , aG2G-
Name: a / , o * ,r % �! License #:
Address: P1t //!.''a P _ City: ,V1q/) /%/���(/
//'��
State: ell Zip: 55337 Phone: (!/fd" �p, `&i'U2/I�j
Contact: Email: ,&a l g hd�J%UJI , 0/1'i
COMPLETE
In the last 12 months, has
. If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
_Yes _No
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 maybe classified as non-public if you provide specific reasons that would permit the City to.:
conclude thatthey 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.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 of plans.
x N\IO e SYvi I� ct
Applicant's Printed Name
pplicant s Si
ature
Page 1 of 2
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
Accessory Building
Fireplace
Garage
Deck
Lower Level
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
WORK TYPES
New Interior Improvement
Addition Move Building
Alteration Fire Repair
Replace Repair
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100%)
Census Code
# of Units
# of Buildings
Type of Construction
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Drain Tile
Roof: Ice & Water Final
//Framing
Fireplace: Rough In Air Test Final
l/fnsulation
Meter Size:
Reviewed By: / Y I L_
Siding
Reroof
Windows
Egress Window
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Sheetrock
Final / C.O. Required
�inal / No C.O. Required
HVAC
Other: V(3cL - --
Pool: _Footings _Air/Gas Tests
Siding: Stucco Lath Stone Lath _
Windows
Retaining Wall: _ Footings _ Backfill
Radon Control
Erosion Control
Building Inspector
Final
Brick
Final
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 2
YILLAGE OF EAGAN WATER SERVICE PERMIT
379: Pilet Xwob Rood PERMIT NO.: 1711
Eagon,MN 55122 DATE: 4/9/75
Zoning: PUD No. of Units:
Owner: New HOrizon Homes - Wood ate II
naare88: 15"- -j-
Site Address: 1763 Walnut I,ane
Plumber: ThomPson Plumbing Co.
~iG[eter No.%-A!6~ /4 7_-7- Connection Charge140.00 pd
Sizer,,~ Account Depoeit:
Reader No.: A TGZ ~ Permit Fee: 10.00 ppdpd
1 eomolp witfi tM Villaye of Eogon Surcharge: '0~p
p4a. Misc. Charges: 0' D
~f Total:
gy 4~. - W~~---~ Date Paid:
Date of lnsp,: lnsp.:
wLuaE oF EAwN SEWER SERVICE PERMIT
3795 Ilbt Kwob Aeed PERMIT NO.: 2471
Eepan, MN 55122 DATE: 419/75
Zoning: x'LIl1 No. of Units:
Owner: ~w Hc~ri~An Ho*~~ Ldoodgat II
Addrese:
Site Address: 1'161 ttalnilt t ane
Plumber: Thomnson Plumhing r'o
425.00 pd
I oqne M eernPir with tIN Yills,e of Ea4on Connection CharBe:
prdinonqm Account Deposit:
Permit Fee: 10. 00 ~ pd
Surcharge: •50 od Pd
By: Misc. Charges:
Date of Insp.: Totv:
lnsp.: Date Pdd:
INSPECTION RECORD
CITY OF EAGAN PERMITTYPE:
3830 Pilot Knob Road Permit Number: •~t
Eagan, Minnesota 55123 Date issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
~ . I li11 rdtl t i ANf {t{'k I tii
` PERMIT,SUBTYPE: TYPE OF WORK:
!
INSPECTION . .A
f f ?d ~1 {
~
f - ~
L.~ ~
1
wm,n No. a.rmn Hoids. o.c. T.kpnon. r I
srw I
PLUMBING I
I
HVAC I
ELECTRIC I
I
ELECTRIC I
knpoctlon Daes Insp. Commenh I
Footirgs I I
I I
I Foundation
Freming
i
Roofinp //v/l s ~
R°uyh Plbg_ aAO'"
( Rou9h M9
Isul.
Fireplece
Fnel Hty.
I Orsat Test
Finel Plbg. Plbp. Inspector - Notily Plumber
I ConBt. Meter
I EnpclPlen
I
&dy. Flnal I
I Dok FV I
I DeCk Finel I
I Weli I
I ~
I Pr. Disp. il
I
~
CITY OF EAGAN Remarks
Addition w00 ate 21~ Lot alk 4 Parcel 1 150 04
Owner Street, 1763 Walxlut, Lai18 State EaganaMN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. , 33 12711 2 1
STREET RESTOR. ~5 s 1976 10Paid
GRADING
SAN SEW TRUNK aql 1974 11 2 1 p'
• . 37.d.
*SEWER LATERAL ~13 1976 8 1 1022.90 3 PiCI
WATERMAIN
-XLVATER LATERAL 4 ~ ~j
ATER AREA
~STORM SEW TRK ~ b
,~STORM SEW LAT ~
CURB & GUTTER
SIDEWALK
STREET IIGHT
I
WATER CONN. 140,00 1 O L-2-75
BUILDING PER. 1 O
s,ac 425.00 13094 -2-7 ~
PARK
t/
CITY of EAGAN N~ 3537
BUILDING PERMIT
~ 3795 Pilo! Knob Road
.
(7r" . . .
Own~e .~t:t/ . Eegan. Minaesole 55122
'~+'-~~1"~"J
Addreu (Presen!) 454-8100
.
Bulldee L/ 75~.
Datt .......T...~
Addrou
DESCRIPTION
Blories To Ss Usod Fos Fron! Depth Heigh! Eef. Ca! P~rmt! F~a Romarks
83s ~ I s0'
LOCATION
Strsef, Aoad or ofher Description oi Loealion ~-Lo! Block Add!llon or Tred
.37'-- /Y-I~-
ii^f ~
Thia psrmii doea eot auShorize the vea oi ctraele, rosde, elleya or etdewellcs nor does it gi?e the ownor os hL apon!
the righ! !o oreale enp situaiion which is a nuisenee or which presenis a heserd !o the hssllh, sstefp, oonveaienn aad
gsneral welSare !o enyone in the community.
THIS PERMIT MUST SE KEPT ON THE PAEMISE WHILE THE WORK I$ IN PROGAESS.
This ie !o eertifp. 1hel....7.~! .r..:............... hae permiseton !o sraet e...L/............... _upon
the above described premise subjee! !o the p ovisions of all applicable Ordinaneea for the Ciiy~egen.
r
` ....lY w-f Per
Mayor ~B Bvlldinp Imptelos A3
• " - GJG..~'
CITY OF EAGrN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT NO.: 648
The City of Eagan hereby grants to Geo. Sedqwick Heatinq
of 1001 Xenia Ave. S.
a _ HEATIPIG Permit for: (Owtler) Ttew Y.orizon IIoodgate
at 1763 Wa nLt Lane , pursuant to application dated 3/5/75
Fee Pairl: $20.00 dated this 13 day of Mar. , 19 75_
.50 s/c
Bu.ilding In3pector
Mcchanical Pcrmits:
Bici Total:
w~
czT^t oF E,.r,nra
3795 Pilot Knob Road
Eagan, Blinnesota 55122
PERMIT NO.. Gs,4
_ The City of Eagan hereby grants to Thompson plombing Co.
Slvd., Ninnetonka
a PlG71GIt%G PBrmit for: (Owner) Nei•? FlXizot - Woodgate II
1755, 1753, 1760, 1762, 1759 lfir_kory Hill and 1755, 1757, 1759, 761,~ 5,1
ath 1765 Walnut Lane ! , pursuant to application dated 4/1,15
Fee Paid: S72 ().00 dated this °th day of T^r.il ~ 19 75
i.'p s/c
Building Inspector
D7echanical Permits:
Aid Total:
PERMIT cUoW
~ CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55123 Permit Number: 0 2 4 3 3 4
(612) 681-4675 Date Issued: @ g/e g/g q
SITE ADDRESS:
1763 WALNUT LANE
LOT: 15 BLOCK: 4
WOODGATE 2ND
P.I.N.: 10-84601-150-04
DESCRIPTION:
~y REROOF S~= ~mIS~
B1'uilding1`Permit Type MrGSFI i AhFn's-
tsuilding Wo•r_k Type REPAZR
1o O
REMARKS:
FEE SUMMARY:
VALUATION $2,200
Base Fee $54.00
Surcharge $1.10
Total Fee $55.10
CONTRACTOR: - qpplicant - sT. LrC. OWNER:
B& K ENTERPRISES 18616809 0008890 BULTEMA CORY
7601 MORGAN AVE 1763 WALNUT LN
RICHFIELD MN 55423 EAGAN MN 55122
(612) 861-6809 (612)452-3417
I hereby acknowledge that I have read this application and state that the
infiormation is correct and agree to comply with all applicable 5tate of Mn.
L Statutes and City of Eagan Ordinances. J
%
APPLICANT ERMIT IG AT RE - ISSUED °IGNATUiiE
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: B U I L O I N G
3830 Pilot Knob Road Permit Number: 024334
Eagan, MinneSOta 55123 Date Issued: 0 8/ 0 9/ 9 4
(612) 681-4675
SITEADDRESS: Lor: is BLOCK: q APPLICANT:
1763 WALNUT LANE B& K ENTERPRISES
WOODGATE 2ND (612) 861-6809
PERMIT SUBTYPE: TYPE OF WORK:
MISCELLANEOUS REPAIR
DESCRIPTION REROOF
iNSPECTION . .
FRAMING ROOFING '
FINAL
F ~
L _ ~
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
a y 3 3~ 681-4675
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: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued. i
Date L' Valuation of work
Site Address: i 7l -5 z,(M/~/~ ) ~4 /
STREET SUITE M
Tenant Name: (commercial only)
LOT BLOCK ~ SUBD. `yJ 0"7" Z ~EKTP. #
Descri tion of work: e-
The applicant is: ? Owner Contractor ? Other coeser;be>
N a m e ziii /jrP r'L Phone 17~2'3.`7
Property LAST FIRST
Owner Address ~24-,3 A)
STREET STE #
City State -.22ZA) Zip
Company Phone
~ 9~
COI1tY8CtOr Address '7~'~/ ~v RU2 License #~Q_ Exp. L
City ~~i/Zl ~
/d' State ~~9%U~ Zip
Architect/ Company Phone
Engineer Name Registration #
Address '
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
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 M'nnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: a~///'~y~
PLUMBING (RESIDENTIAL) ~ I S• ~
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required for each unit
Date3 1 29 /03
Site Address j I lA~ VV (L l''YUAJr 1sN Unit #
Property Owner I1t+XA~ Telephone #(rpS l) 4S2--,:3*( 7
Contrac[or X, 10 . 1' /p iilND'? K~
Address A, bbbb k~ City F--~t GC(iVLi
State _hA Zip 2SS[E~~ Telephone # 6~;I)3~s- 13 4-0
The Applicant is _ Owner ~ Contractor _ Other
Septic System New Refurbished Submit 2 sets of plans and MPC license $ 100.00
InGudes Counry fee. Additional consultant fees may apply.
Alterations To Existing Dwelling Uni[, Including $ 50.00
_ Adding fixtures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water turnaround 5/8" meter if needed -$121.00)
Other.
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
~ n (a fl 1~1 ~7.
_ water softener X Water heater APR 0 3 2003 $ 15.00
v ~U
~ replacement _ additional
State Surcharge $ 50
Total $
I hereby apply for a Residen[ial Plumbing Perntit 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 with [he Plumbing Codes; [hat I understand this is not a
permit, but only an application for a permit, and work is not to s[art without a permit; [hat the work will be iu accordance with the
approved plan in [he case of work which requires a review and approval of pla . ,
L9Sc~ 1i10 Wq,~1 ~j, V~eA A~~OU4.
Applicant's Printed Name i(pplicanYs Signature
~ ~~k{ 5~ 50
Cpe__
2006 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single famity dwellings & townhomes/condos when permits aze required for each unit
Date_~,__ / 2-"l / U,
Site Address `-7 Le-5 L-1-)C1 I Y1l.Lfi LX-) Unit #
Property Owner L-T On r ~ VUL I +-rT0., Telephone # (LaS)
Contractor Wohlers Southside Htg. & Air, Inc.
6950 W. 146th St., #106
Street Address Apple Valley, MN 55124 City
(952) 431-7099
State Telephone # ( )
Bond#: RLTLQ542987 Expires: U8-
The Applicant is _ Owner X Contractor _ Other
Add-on or altera[ion to exis[ing dwelling unit $ 30.00
fumace _Additional 14Replacement New
air exchanger Qw E D
airconditioner ~IUn1I
heat pump u u J U L 0 3 2006
other
State Surcharge $ .50
Tota I
I hereby apply for a Residential Mechanical 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 wi[h the Mechanical Codes; that I understand this is not a
permit, but only an application for a permit, and work is not to start wi[hout 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.
~L/L---
Applicant's Printed Name Applicant's Signature.
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 1763 Walnut Lane
Lot: 015 Block: 004 Addition: Woodgate 2nd
PID:10- 84601 - 150 -04
Use:
Description:
Sub Type: e- Reroof, Siding & Windows/Doors
Work Type: Reroof, Siding, Windows /doors
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 9,000.00
Contractor:
Window World AKA Probuilt America
2211 1lth Ave E, #130
N St. Paul MN 55109
(651) 770-5570
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $9K
Surcharge - Based on Valuation $9K
- Applicant -
Construction Type:
Occupancy:
$177.00
$4.50
$181.50
Owner:
Cory J Bultema
1763 Walnut Lane
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
0801
9001
Issued By: Signature
Building
EA091752
10/26/2009
ePermit
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.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA178096
Date Issued:08/01/2022
Permit Category:ePermit
Site Address: 1763 Walnut Lane
Lot:015 Block: 004 Addition: Woodgate 2nd
PID:10-84601-04-150
Use:
Description:
Sub Type:Fixtures
Work Type:Alteration
Description:Multiple
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
All tiled shower bases require a water test.
Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087
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 -
Cory J & Connie F Bultema
1763 Walnut Ln
Saint Paul MN 55122--244
Johnson Plumbing & Heating Co
11350 Albavar Path
Inver Grove Heights MN 55077
(612) 243-3965
Applicant/Permitee: Signature Issued By: Signature