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2084 Kings Rd41,11/P City of Eaaafl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Permit#: �--1, Ca, Permit Fee: 444:1(=V---) Date Received: Staff 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: / Q/tom 5 Site Addressf r 4 Tenant: Suite #: RESIDENT / OWNER P Name: KA 10\0 w \ Phone: U51 ft —9a61 Address / City / Zip: 0,0ste aki n Applicant is: - Owner Contractor TYPE OF WORK 1 Description of work: T O Q/4 � ()C) Construction Cost: i OC) Multi -Family Building: (Yes I No ) CONTRACTOR r r #: �� tow Name: K n„....5License Addre• 3 r LCT S City: W ►$ ss State: /j_[_[ Zig SS J 9 Phone: / 9 �� ` —,S- 'I _ Contact: 111041 h. Email: / ilk`` , 1130, (T"" OE\ -Q.._ COMPLETE In the last 12 months, has Yes 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: :No Licensed Plumber: Phone: Mechanical Contractor: Sewer & Water Contractor.. Phone: Phone: NoTE: Prams and supporting documents that you submit are considered to be public information. Potions atf the information maybe classified as non: public if you provide specific reasons that won t perimit the y 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.orq I hereby acknowledge that this information is complete and accurate; that the work will be . forman Eagan; that I understand this is not a permit, but only an application for a permit, and accordance with the approved plan in the case of work which requires a review and approv Applicant's Printed Name I App is attire ces and codes of the City of it; that the work will be in Page 1 of 2 City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675-5675 www.ci.eagan.mn.us PERMIT City of En Permit Type: Permit Number: Date Issued: Permit Category: Mechanical EA091209 09/18/2009 ePermit Site Address: 2084 Kings Rd Lot: 061 Block: 06 PM:10-81950-061-06 Use: Addition: Vienna Woods Description: Sub Type: e - Furnace Work Type: New Description: Furnace Comments: 3/2/10 Letter & correction notice sent to applicant. Copy of correction notice to inspector. (pf) Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, 952-445-2840 Fee Summary: ME - Permit Fee (Replacements) Surcharge -Fixed $50.00 0801.4088 $0.50 9001.2195 Total: $50.50 Contractor: Apple Lake Heating & Air Conditioning 207 150th Street West Apple Valley MN 55124 (952) 431-4328 - Applicant - Owner: David M Wilson 2084 Kings Rd Eagan MN 55122 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply with all applicable State Applicant/Permitee: Signature Issued By: Signature City of Eagan Eagan, PERMIT City of Eaan Permit Type: Building Permit Number: EA099967 Date Issued: 07/06/2011 Permit Category: ePermit Site Address: 2084 Kings Rd Lot: 061 Block: 06 Addition: Vienna Woods PID: 10-81950-06-061 Use: Description: Sub Type: e-Windows/Doors Work Type: Windows/Doors-New/Replacement Description: House Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: Valuation: 3,000.00 BL - Base Fee $3K $88.50 Surcharge - Based on Valuation $3K $1.50 0801.4085 9001.2195 Total: $90.00 Contractor: Sela Roofing Remodeling 4100 Excelsior Blvd St. Louis Park MN 55416 (612) 823-8046 - Applicant - Owner: David M Wilson 2084 Kings Rd Eagan MN 55122 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. Applicant/Permitee: Signature Issued By: Signature City of Eagan Eagan, PERMIT City of Eaan Permit Type: Permit Number: Date Issued: Permit Category: Building EA100651 08/19/2011 ePermit Site Address: 2084 Kings Rd Lot: 061 Block: 06 PID: 10-81950-06-061 Use: Addition: Vienna Woods Description: Sub Type: Work Type: Description: Census Code: Zoning: Square Feet: e -Siding Siding House & Garage 434 - 0 Construction Type: Occupancy: Comments: When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: Valuation: 3,000.00 BL - Base Fee $3K Surcharge - Based on Valuation $3K $88.50 $1.50 0801.4085 9001.2195 Total: $90.00 Contractor: Sela Roofing Remodeling 4100 Excelsior Blvd St. Louis Park MN 55416 (612) 823-8046 - Applicant - Owner: David M Wilson 2084 Kings Rd Eagan MN 55122 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. Applicant/Permitee: Signature Issued By: Signature SEWER & WATER PERMIT CITY OF EAGAN 3830 Pilot Knob Rd. Eagan, MN 55122-1897 DATE (Q/I/9 D SITE ADDRESS LOT 6 BLOCK 6 SEC/SUB VIENNAWOODS APPLICANT: i 1-. W e✓ ADDRESS. 9 3 6 141 Oh , - -- CITY, STATE C-4-'1 / 0 R0I S a1 A ZIP,5 -/I gyp PHONE: 2084 KINGS RD OFFICE USE ONLY 6/8/90 METER # PERMIT DATE CHIP # PERMIT # 11439 METER SIZE B.P. RECEIPT # C6552 ISSUE DATE B P RECEIPT DATE 2/26/90 XX PRV BOOSTER PUMP PLUMBER. ADDRESS. t CITY, STATE PHONE. PERMIT REQUESTED '/ SEWER WATER TAPS COMM/IND RESIDENTIAL NEW EXISTING Lawn Sprinkler Meters Ah - . - of Domestic Meter C edif LL NOT be • ive to be Installed on Water Line. or Deduct Meters. OWNER: ADDRESS. CITY, STATE ZIP PHONESIGNATURE WHEN METER ISSUED PLEASEALL;R�'�1� 1 0 DIAY OCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM E TOC • PLY WIT AN ORDINANCES SEWER PERMITS, CONTACT ENGINEERING DEPT.