1642 Hickory LaneDate:
r City of Eaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
R-
-
JUN 142012
Use BLUE or BLACK Ink
For Office Use �
Permit #:
/o9%
Permit Fee. iii-/L7I7L 5s
Date Received: ._t �/ ' /).
Staff:
Y v "
2012 RESIDENTIAL BUILDING PERMIT APPLICATIONCA" h6
ES
I
/ LL11 r
i -t c o r LA,JE Unit #: C9�
Site Address:
RESIDENOWNER I
Name: Wc20() C9 0 +-t° / CaAlG o? /IMie 'o'Phonevi (5! 373 /3
Address /City /Zip: `o 42_V /�' l ` g ,4 4' 1S c of /4 /e 1:07 L
Applicant is: Owner Contractor
TYPE OF +WORK
Description of work: e C+ (c
Construction Cost: 2500 Multi -Family Building: (Yes / No )
CONTRACTOR
Company: L 1 /CT' -1 C) Q `7 Contact: L.. A!ey /1‘. Te Ural
Addres: OCO 5 L7hPI dVrVe City: Pv /v-/ L4 ice
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NA%Cif --326CState: / Pi Zip:ZSs 3 71- Phone: t/ �
License #: J3) C. IDS'/ 11 Lead Certificate #: / l A- T 1/ ; /t
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
gni/71p77g
In the last 12 months,
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 _No
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents: that you submit ar+e considers d t be #t% Information. Portions of
the information maybe classified as nonpublic if you ufd perrrrtt !fie City fo
conclude drat they are bade 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.00pherstateonecall.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 L/-tozi PcTev1
Applicant's Printed Name
x
App nt's Si tune
Page 1 of 3
761/.2 ii,ckoty zcoc
SUB TYPES
Foundation
_ Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
DO NOT WRITE BELOW THIS LINE
_ Fireplace
Garage
Deck
Lower Level
_ Interior Improvement
j` Addition_ Move Building
Alteration Fire Repair
Replace _ Repair
_ Retaining Wall
DESCRIPTION 3ekt7
Valuation -i fa`
Plan Review
(25%_ 100% irr
Census Code 1139
# of Units
# of Buildings
Type of Construction
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
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
Sheathipg
Sheetrock
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
_ 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
s
s1 esgo
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 Cont
, Building Inspector
TOTAL
Final
Brick
Final
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64`,
02,vison
Page 2 of 3
1
BY:
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EAGAN
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INSPECTIONS DIVISION%
EAGAN
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POTIONS DIVISION
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City of Ea�RII
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEIVED
APR ? 5 2016
r
Use BLUE or BLACK Ink
For Office Use
Permit #: �
Permit Fee: // •/
Date Received: 7 £c) fI y;"
Staff:
2016 RESIDENTIAL
'BUILDING PERMIT APPLICATION
Date: 7 "2 -1 (0 Site Address: /c f J2 ekoei Lr� ��f�d, Unit #:
Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
Description of work: 1 t47 C,e Frvn 4" .S
Construction Cost: 50° Multi -Family Building: (Yes / No )
Company: L '1 C LG
Address: y®ao CJ/0A Ato .i
61/2
Contact: /'l f1 l.� < 11 /- 735-//6.r
City: /Llr /5
State:/'ttJ Zip: 55-1/ 07 Phone:Grp -0024(Email:
License #: (3G 70c.f& 72 Lead Certificate #.
If the project is exempt from lead certification, please explain why:
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:
Mechanical Contractor:
Phone:
Phone:
Sewer & Water Contractor: Phone:
Fire Suppression Contractor: Phone:
Plans and supporting documents that yousubmitare' onsidered to �e publi of ,
ormatiornY nay be classified as non nlablic f ou et pec iic r s rns khat woui
rncluale that they°are trade secr
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.
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 (t%ha4 1 tlfr`z—
Applicant's Printed Name
x
A r. licant s Signature
Page 1 of 3
J'/2- 14'.'Yoe11 GDO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100%
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
Lower Level
/-36. 7
— Porch (3 -Season) _ Exterior Alteration (Single Family)
Porch (4 -Season) .4.-' Exterior Alteration (Multi)
Porch (ScreenlGazelio%Pergola) _ Miscellaneous
Pool r; -, . Accessory Building
Interior Improvement
Move Building
Fire Repair
Repair
434
1
1
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: Ice & Water _Final
Framing 30 Minutes 1 Hour
Fireplace: _Rough In Air Test
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Shower Pan
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Final
Siding
Reroof
Windows
Egress Window
_ Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
MCES System
149c SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
7) 0
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Pool: _Footings _Air/Gas Tests _Final
Drain Tile
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Fire Suppression: _Rough In _Final
Erosion Control
Other:
Reviewed By: , Building Inspector
RESIDENTIAL FEES "
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
ff-
3 2s
Page 2 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA157104
Date Issued:08/05/2019
Permit Category:ePermit
Site Address: 1642 Hickory Lane
Lot:026 Block: 003 Addition: Woodgate 1st
PID:10-84600-03-260
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$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 -
Audrey M Moore
1642 Hickory Lane
Eagan MN 55122
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA165134
Date Issued:10/19/2020
Permit Category:ePermit
Site Address: 1642 Hickory Lane
Lot:026 Block: 003 Addition: Woodgate 1st
PID:10-84600-03-260
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Audrey M Moore
1642 Hickory Ln
Eagan MN 55122--253
Haley Comfort Systems
3708 Broadway Ave N
Rochester MN 55906
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature