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4112 Skylark LaneCity 737 C.) 67 u21 76 -d C r ICC re_ Ofiiaall�/ 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 12 For Office Use q_,7. Permit #: Permit Fee: Date Received: Staff: 2009 MECHANICAL PERMIT APPLICATION Date:S 11 _ 6 ( Site Address: I --f H ( 2... Tenant: rbc\lc:ri \< 16,(l� Suite #: RESIDENT / OWNER I hereby acknowledge this that Name: fl r -v ti C9 i i c;, -J Phone: Se 7 -Lt S) "7 LC g �/ Address / City / Zip: Lt H 2 `> ,/._, k. r kc_ V c -., ,_c)c,---) CONTRACTOR e0tial Me Name: CSI. icense #: cn Address: A.it� IOi1ditit0?1eting s 1815 -East 41st Stroet City: Minneapolis, MN 55407 State: Zip: (61724-1899 Phone: Contact Person: TYPE OF WORK New N6, Replacement Additional Alteration Demolition Description of work: NOTE: Both roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector or one of the Planners for information on permitted screening methods. PERMIT TYPE RESIDENTIAL Furnace COMMERCIAL New Construction Interior Improvement _ Install Piping Processed Air Conditioner Air Exchanger — Gas Exterior HVAC Unit Heat Pump _ Under / Above ground Tank ( Install / Remove) Other **When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) out appliances, ductwork, etc.) (includes $.50 State Surcharge) C $ SS's TOTAL FEE $90.50 Fire repair (replace burned COMMERCIAL FEES: $70.50 Underground tank installation/removal $50.50 Minimum (includes OR State Surcharge) surcharge is $.50. increases by $.50 for each Permit Fee requires a $1.00 surcharge). Contract Value $ x 1% _ $ Permit Fee - If Permit Fee is less than $1,000, = $ State Surcharge - If Permit Fee is > $1,000, surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 • • $ TOTAL FEE mformahon is complete and accurate; that the work will be in conforr I understand this is not a permit, but only an application for a permit, and work is not to start without plan in the case of work which requires a review and approval of plans. r\,e •c Applicant's Printed Name x ce with the or�1inahces and permit; that thk w¢rk wit es of the City of Eagan; that rdance with the approved Applicant's Signalfure FOR OFFICE USE Reviewed By: Date: Required Inspections: _Under Ground Rough In _Air Test _Gas Service Test _In -floor Heat _Final _ Exterior HVAC Screening Inspection CllyofEaaii 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit #: 0'1/ Pemrit Fee: .9 —" Co Date Received: Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION C' Date: /%' 2010 site Address: 'Wo®—q//r S,C'y/aa,i- L4 4t: lGl c, `S" Tenant: Aleocd»-tar / i % ity ET , •"�6��' , X14' 53/2 Z Suite #: /l RESIDENT / OWNER Name: /7<.4Pa�44./. r G.sssen et -",,,,Y Phone: 9952 ;7i 3 .r '/ 2 7 Address / City / Zip: S.' 3 r 4, fy 41-174 P /&b...aj,,, /2V.eem ,&i.'ow aj.5N-3VY ,...Ar Applicant is: Owner )( Contractor TYPE OF WORK Description of work: A.. ¢ ae.e//.r«...er+e 40 oke st 6.1.14, z-1«ee .44.4-., -'-r ' Awavt 4* Construction Cost s/3, c od> Multi -Family Building: (Yes / No ) CONTRACTOR Name: A/jS`r 0, 4,4.1rt.,c ki,,,e-r ,e416, .--1 7" License #: 20.g3/.5-7.5"- 0.g3/$7Address: Address:57'V3— ,.27 /Sf.."41c/ --Cif City 715,m/«c ,e .4 State: /Ix, Zip: 53-3S% Phone: /75-2, ?+'Z. 795'Y Contact 371.50,4/ /i f 4 Email: J .4.,54:1 ,,r& • /_sf ,,-.. 6. COMPLETE In the last 12 months, has Yes No 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: Licensed Plumber. Phone: Mechanical Contractor Phone: Sewer & Water Contractor. Phone: NOTE; Plans and supporting documents that you submit are considered to be public inn. ',Portions of the information may be classified as nonrpubllc if you provide specific reasons that would pt the City to conclude that they we trade SW s CALL BEFORE YOU DIG. CaII 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.ciopherstateonecall.oro 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 walk is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which regtrres a review and approval of plans. x A,N 4 +Ct41'V7 Applicant's Printed Name 1 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Single Family 4 Multi 01 of _ Plex Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall Fireplace Garage Deck Lower Level Porch (3 -Season) _ Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool DESCRIPTION Valuation Plan Review (25%_ 100%) Census Code # of Units # of Buildings Type of Construction _ Interior Improvement Move Building Fire Repair Repair tr` 6°0 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Additio )„, Foundation 61, Drain Tile Roof: _Ice & Water _Final Framing Fireplace: _Rough In Air Test _Final Insulation Meter Size: t*5 Occupancy Code Edition Zoning Stories Square Feet Length Width Reviewed By: 'I 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 )e. Final / No C.O. Required HVAC Other: Pool: _Footings Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Erosion Control L(Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL tvot Page 2 of 2 Fwm:ALLSTAR CONSTRUCTION 19529427464 CityofEa�ali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-56. Ug 10/14/2010 14:16 #165 P.002/025 oz Use BLUE or BLACK Ink Permit #: 9 a5 co Permit Fee: � I tP=' . S% Date Received: St 2010 UILDING PERMIT APPLICATION Sky L a..k L.+.•��- Date: /®/1 `jf ZQ/0 Site Address: 'coo, 5r/02, '/vr/, y/06 , 51/o d 1 Y//s wiz, W/y Yir/, y//a Tenant Name: 04,...../04i4,44. 1,�6 //a,4 (Tenant is: New / Existing) Suite #: Former Tenant: a PROPERTY OWNER Name: 447440,..k4,44. /1,•12A, / ea 6..Kr&.'r0�0..-7 Phone: (,rt) is3- 192? Address / City 1 Zip: 6 y3 b' e/ 4 at /t/4 ,7 ,.., A,e,... . A 3 yy Applicant is: Owner Contractor / . TYPE OF WORK Description of work: • L / .J tz -:— ri-, r Construction Cost: i / 5/Y1 3114 '7? CONTRACTOR Name- • _.,,f v... ea..:�........f License #: tOI 3/5-76-- /5-75Address: Address:S/YS" L,�dts44e,..“- J, !w,%/e City: //94.0/ ,77i. State: ,a/ Zip: 5-5.75-", Phone: (ffZ) 92 —9 Y4-7 Contact: efw//A- 95-) 4/t4",‘ (—Email: Gtr/4-.-CP z/' ice-. AZ_ ARCHITECT / ENGINEER Name: Registration #: Address: City: State: Zip: Phone: Contact Person: Email: Licensed plumber installing new sewer/water service: .Phone #: OTL"- j1/]'lan+s an ►y up o! g� p encs th�rynr]o/�F. r if ► } Su ,1ypc!nfo tion.} } ,92‘ �c 4nformatio I ay be cl l M �9 -pub/�X �K � k cif reasons th � Ik�C F9 [- ...rA , rYP7s,it0x :` un.. 0x/,h. f4n''i,`t rV ,:.k.mk, ,. 0: O. of ✓ F 3 t a 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.aooherstateonecali.oro 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 accordancencwith the approved plan in the case of work whichrequiresayevi�w and approval of plans. x G cL /Zi+. AG,4iOt0. x de -- Applicant's Printed Name Applicant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Single Family Multi 01 of _ Plex Accessory Building WORK TYPES New Addition l ( Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25% )( 100% ) Census Code # of Units # of Buildings Type of Construction Fireplace Garage Deck Lower Level Porch (3 -Season) Porch (4 -Season) Storm Damage _ Exterior Alteration (Single Family) Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi) Pool Interior Improvement Move Building Fire Repair Repair REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: -C Ice & Water A Final Framing Fireplace: _Rough In _Air Test Insulation Meter Size: Occupancy Code Edition Zoning Stories Square Feet Length Width Final Reviewed By: C� Siding Reroof Windows Miscellaneous h71-3-00-7,--5 60 6TYL, IL-e-rizovf,aze Demolish Building" Demolish Interior Demolish Foundation Egress Window _ Water Damage `Demolition of entire building - give PCA handout to applicant pi 912,2"0U7 MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required ?C Final / No C.O. Required HVAC 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 Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL - • n 0-0- Page 2 of 2 EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DtTE:_ $4i/72 NUMBER Q)7 OWNER: Huesi� t1117apdal«. 1 PLUMBERwcierks Trenching Industrial Address TYPE OF PIPE DESCRIPTION OF: BUILDING Commercial Residential Ct Iron Multiple Dwelling No. of units XS; Location. of Connection:: 10 Connectioncharge Permit Fee 10.00 E'd '/4/72 Pd W47/4 Street Repairs Total Inspected by: Date Remarks: By Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulation of Eagan Township, Dakota County,, Minnesota' By Ta3+sc±c�t 'Pran4ing Please notify when ready for inspection and connection and before any portion of the work is covered. 1110, Fram:ALLSTAR CONSTRUCTION 19529427464 10/18/2012 16:34 #614 P.001/010 • City of Eaaao 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 207 Use BLUE or BLACK Ink For Office Use % Permit #: ,hi %7 3 Permit Fee: /It r q1 % Date Received: /�! / 7✓! Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION 19 Date: d 17/ a Site Address: oa o 0 via P HI; i t U ; unit #: Name: /ri.e.La' j/ L ieh/p G/O �, t,(PA, /,v,r��,4 / j Phone: 0_57 \ 2..C3-.7 9 rf Address / City / Zip: la c/.3ff 1j, ,d,4„,-/- ./ e,k.t..14 --et/e, ,.e. -4..„;:,L, Jit. // 5-s'3 f° V Applicant is: _ Owner X Contractor i p_ RESIDENT./ OWNER Description ofwork: / GG ..- o /p /r,&71; ramp.- fC� , J I t $l©I. ,., J J Construction Cost: 4t G 0, fit; '4. . Multi -Family Building: (Yes / No ) Company: Qi/si-a.-Civari-c7SD,- /144 „�mg.o.7 Z. ' Contact: 4/4,4ites r, CONTRACTOR Address: S% �� .ik dr/ _ ir'ze./ Sp 1e /6�i City: /.Jei.�L_ State:lar4Ar' Zip. c---3 ` Phone: 9r2- - 272-- 7V.5 -Y" License #: G' 6'3/576- Lead Certificate #: /47^_ !o'6 r— If the project is exempt from lead certification, please explain why: see Page 3 for a-/dditional informattin) 1.1-1 iq 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 documents.that you submit are considered to be public information• Portrons.of the information,ay be classified,as non public if you provide specific reasons that would permit the City to conclude that the 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.000herstateonecall.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. 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 GL �%/[ �� / Div,. // X ad! App icant's Sign ture Applicant's Printed Name Page 1 of 3 • 1 I L LAKt& DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Fireplace Single Family Garage Multi frL:..i/5(,(;Iji Deck `01 of _ Plex _ Lower Level Accessory Building WORK TYPES New Addition Alteration tenor ImpFovem nt _ Siding _ Demolish Budding* Move Building_ Reroof _ Demolish Interior Fire Repair_ Windows _ Demolish Foundation Replace Repair _ Egress Window_ Water Damage Retaining Wall Porch (3 -Season) _ Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool /(277-3 9 Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous DESCRIPTION Valuation Plan Review (25%_ 100% /�, ) Census Code 1 # of Units # of Buildings Type of Construction (121)./IC-2,2- 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 �.l Framing--- Vt.0o','3- L!,Lki Fireplace: _Rough In Air Test _Final Insulation Sheathing Sheetrock Reviewed By: *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 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 5 of -A p-rtr3 Page 2 of 3 From:ALLSTAR CONSTRUCTION 19529427464 09/30/2013 15:19 #670 P.002/016 4too( ' toa. 410k1 41b(ot 41ot, 4-110 Abh, 41i2,41t4, 41v(01411% 71'. City of Etat 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ) Use BLUE or BLACK Ink .. For Office Use Permit #: Date Received: Staff: V xl 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date:? 1'\ h ` – 30 I3 Site Address: - I 1 DO SK I��k Ln • — tb .) � Unit #: Name: M{tQcIVv\i,qti k Rice, c/o : (lab() C_pa. Phone: Resident/ .Owner Address / City / Zip: tPtM Gill We ?(, Wrt43 Bith I?Y01irM N 3yj Applicant is: Owner Contractor Description of work: "MY off OtI d Ye ropf- awlSiding Construction Cost: s31 p% •1°1 `! Multi -Family Building: (Yes Ai No Company: PrIgtaY (OrdMChon Maffi nt,LtLContact: l Ne, AialSifaci Address: ?H' diVI f t ia) Stet -tic ItZ City: 1\A(1►pI 1)160 State: MN Zip: 55359 Phone: ✓2' 2' 1L4L--1 License #: EC.1931515 Lead Certificate #: N t'IT' 2D1 tD' I- 0 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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 documents that you submit are considered to be public information. Portions of the information may be classed as non-public if you provide specific reasons that would permit the City to conclude that the 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.gooherstateonecall.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. Exterior work authorized by a building permit issued in accordance with the Minneso • State Build' 4 Code must be comp) =d within 180 days of permit issuance. uoe 0M -ea d Applicant's anted Name is Signat re Page 1 of 3 City of Eagan PERMIT 411' CityofEaan Permit Type: Mechanical Permit Number: EA134721 Date Issued: 01/19/2016 Permit Category: ePermit Site Address: 4112 Skylark Lane Lot: 047 Block: 03 Addition: Hillandale 1st PID: 10-32950-03-047 Use: Description: Sub Type: Residential Work Type: Replace Description: Furnace 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 Total: $60.00 Contractor: Genz Ryan Plumbing & Heating 2200 West Highway 13 Burnsville MN 55337 (952) 767-1000 - Applicant - Owner: Aaron Ostler 4112 Skylark Lane Eagan MN 55122 (651) 955-9831 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 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675-5675 www.ci.eagan.mn.us PERMIT 40o City of Eaaan Permit Type: Building Permit Number: EA134930 Date Issued: 02/03/2016 Site Address: 4112 Skylark Lane Lot: 047 Block: 03 Addition: Hillandale 1st PID: 10-32950-03-047 Use: Description: Sub Type: Single Fam Work Type: Day Care Inspection Description: Adult Foster Care Census Code: Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: Residential Transitions: 612-227-9014 Fee Summary: Day Care Inspection $50.00 1221.4216 Total: $50.00 Contractor: Owner: Aaron Ostler 4112 Skylark Lane Eagan MN 55122 - Applicant - 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