1667 Hickory Hill
' For Office Use I
ing Permit
City of EaRd~ I
u I Permit Fee.
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: X /J/C
Tenant: Suite
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: / C tf-1- t F _ CC E
Construction Cost: 2 0, 0 a C. Multi-Family Building: (Yes - / No
CONTRACTOR Name: C License 9j2 l
Address: C 1 i/f / 'T 0 G X g 6
/V i`) Zip: J`'~-3 3
City: State:
Phone: 5 r ~O 7J Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
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 classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
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 L4 SGT I'LL K ! % r_ t ,y 1 X / ;
Applicant's Printed Name Appli ant's Sign re
Page 1 of 3
VIL4AGE OF EAGAN WATER SERVICE PERMIT
3795 Knob Road PERMIT NO.: 1437
Eaie, MN 55122 DATE: 4/26/74
'ioning: PUD No. of Units:
Owner: Woodgnte,New Horizon
Address:
Site Addres1,665 -67— $9-71 Hickory Hill
Plumber: ThOmPsOn Plumbing CO.
Meter No.• Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee: 10.00 pd
I agree to comply with the Village of Eagan Surcharge: .50 pd
Ordinances. Misc. Charges:
Total:
By Date Paid:
Date of Insp.:
Insp.:
VILLAGE OF EAGAN
3795 Ptiot Knob Road SEWER SERVICE PERMIT
Eogmn, MN 55122 PERMIT NO.: _ 7 ?
Zaning: PM DATE: +L/ 6174
No. of Units:
Owner: 4 -, HOrist i
Address:
Site Address: 665-67-69-71 Bioko gill
Plumber: p co.
I agree to comply with the Village of Eagan Connection Char ge pd 12/31
Ordinances.
Account Deposit: 7
Permit Fee: 10.00 pd
By: Surcharge: .50 pd
y:
Date of Ins Misc. Charges•
Insp.:
p. Total:
Date Paid:
Use BLUE or BLACK Ink
--------------,
---- --_._ `—:.__.__.-�----- _
� For Office Use I
-- _-_-- ..___ —�-�j— ,
Cit� of���an �
__
� Pertmt#: 1 � �
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3830 Pilot Knob Road � Permit Fee: �
Eagan MN 55122 I �
Phone:(651)675-5675 � Date Received: `� �� �
Fax:(651j 675-5694 MAY 15 2015 � � j
� Staff:_ �
�����������������J
20'15 MECHANICAL PERAAIT APPLICATION
❑ Please submit two(2)sets of plans with all commercial applications.
`_ �,�_�0,���� �1�
Date• �` �-�t - Site Address• l,('
��.�.
Tenant: � Suite#:
Name: , 1 tM^^- �>C� �r�rlt� Phone: 19���"j�J' �I��"�'
Resident/Owner —o �, �� � ����2
Address/City/Zip: ��Z� I G
Name: MINNEAPOLIS-ST.PAUL PLUMBING,HEATING&AIR License#: MB003372
� � i
� � �� Address: 640 GRAND AVE. Clty: ST.PAUL I
Contractor
State: MN Zip; 55105-3402 p�e: 651-228-9200
Contact: L��x��� K, Vo aV;,"-- Email: PERMITS@MSPPLUMBINGHEATINGAIR.COM
_New �Replacement _Additional _Afteratlon Demolitian
Type of Work Description of work: Q° C. w v G1�'J�� �i�'�-�rJ �� '
�
NOTE:Roof mounted and ground mounted mechanical equipment is required to be screened by City ;
Code. Piease contact the Mechanicai In�pector for information on permitted scr�eNng metlwds. j
�
RESIDENT/AL COMMERCIAL �
_Fumace New Construction _Interior Improvement
P@ftllit Typ@ �ar Condition�r _Install piping _Processed E
_Air F�cchanger �s Exterfor HVAC U►�t
_Heat Pump Under/Above ground Tank (_Instalt/_Remove)
Other
RE�lDENTIAL F�E�
$60.00 nimum Add or alteration to an existing unit(includes$5.Q0 State Surcharge) h
$100.00 Residential New(includes$5.00 State Surc�rge} _$ �v�p TOTAL FEE
COMMERCIAL FEES Contract Value$ x.01
$55.00 Permit Fee Minimum
$70.00 Underground tank lnstallation/removai =$ Permit Fee
*If contract value is LESS than$1 d,010,Surcharge=$5.00 =g Surcharge*
*'`if contract value is GREATER than$10,010,Surcharge=Contrac.t Value x$0.0005
""*if the project valuation is over$1 million,please call for Surcharge =� TOTAL FEE �
I hereby acknowledge that this information is complete and accurate;that the wak wfll be in confortnance ' ordinances��codes of the City of
Eagan;that I understand this is not a permit,but anly an appiication�r a permit,and is rmt to start wit a perm}t;that tl�e wnrk will be�accordance
with the approved plan in th�case of wvork which requires a revi�w and approval of plans. ;
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ApplicanYs PNnted Name nYs Si at
FOR OFFICE USE
I
Required Inspections: :Revlewed By: Date: `.,
_Underground _Rough ln _Air Test _Gas Senrice Test _In fioor Heat _F�al _HVAC Screening �
Use BLUE or BLACK Ink
� For Office Use I
' �� � ��� ��
I Permit#:
�1�� Q� �� �� � � . C�G�
� Permit Fee: ��J
3830 Pilot Knob Road � �
Eagan MN 55122 i i
Date Received:
Phone: (651) 675-5675 � i
I Staff:
Fax: (651) 675-5694 L________________�
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: `75""��-1� Site Address: � �t� / `� �� J`°✓~9 l7•t/ �tc
Tenant: Suite#:
�',"�6 '� 'i = � ii
��, ���C�1N���" :' Name: �i Nri �l�7,: 1 �P � / Phone: ��I - rS��,��y �"7�
;i � ��i,'G :�i ' � - �'�'���� _ . �
�� �F , ��� Address/City/Zip: "�vZ2✓�" ��ti w�Py C� �� � c�n n: � j ZZ..
;Ni� �' ���'� � Name: j,�L/ravv� �t?v5 S�p �li`�h �'v �,�< License#: ���j����
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- � � �� ��= Address:_ 5 5�f� /9����`�Pv' C.'�-<:1�, Cit ��� ��K�
�'QI`�"�G�i�' i" � Y�
� ',�`'��I � ° �3�' ���� State: d°YI n- Zip: S S lO 5 Phone: �i�. - '�(�`� �- � � 5 C`j
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; `�I� ' -� � ,��� Contact �i,`/ ;;� �re��r��d�� Email: , � Yf'n��k/C`��v�t vn��s��r� lf�� b C"�
� iq., i��� _ ,i
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'� �,� � �,����, _"` _New _Replacement ��Repair� _Rebuild _Modify Space _Work in R.O.W.
. �.
�jr �,�, ��i�� �
=�
��� _ � Description of work:
� �° � "� ' = RESIDENTIAL - �
�� � �;, �
� ��� �
� �G �°
������ - �Water Heater
� ti ; Water Softener � �
— , Lawn Irrigation(_RPZ/_PVB)
�� �t ���� - Add Plumbing Fi�dures �Main/_Lower Level)
� y � Septic System
� � �� ����, New Water Turnaround
�� , �° - —
c�� ,,, =,i��� _� Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Turnaround*(includes State Surcharge)
'tWater Turnaround(add $210.00 if a 5/8"meter is required)
$115.00 SeptiC SVstem New(includes County fee and State Surcharge) `�-`
TOTAL FEES$ �v�
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.qopherstateonecall.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.
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ApplicanYs Printed Name ApplicanYs Signatu e
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, EAGANr For Office Use !w
% * s •�r Permit#:
e... «tea
Permit Fee:
I
EC
.CeivE Date Received: �,7—7
3830 PILOT KNOB ROAD EAGAN, MN 55122-1810 yr
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)6 69A., Staff: _1��
buildinginspectionsCaacityofeaoan.com Hl'R ' 7 2019
2019 RESIDENTIAL B�• _ - _- - - MIT APPLICATION
Date: 1 ( 7-- l 7 Site Address: /(JG1� `�Cv ��f I �nC�r Unit#:
. WOO d Oti t 1Me A--ss c. ' O 57 - u5Y-7 ci
Name. 0��t/� d a ►� Phone: ` 3 Y
Residents / 71 `c k.(7 it 11 o r rFa9 a 3T5 I oZ o�
OWner Address/City/Zip: y
Applicant is: Owner X,Contractor j
Description of work: ' `e C Qr ( Q ar' O' I "f and c 'vialace
Type of Work f tJ�
Construction Cost: ` /010 Multi-Family Building: (Yes A I No )
Company: Bd I"!'tol n rt D`0 Iiiflf [0n fl`&c9 tact: Ste Vt. £crr►1 Cid id
Contractor Address: / 7 5 73 FOX ear0 C ty �a/�-►-1. r,5
71711
State:(1 Zip: 5304 ( Phone: 't6/(k-519-0,360 ail:
License#: A C /7006c( Lead Certificate#:
If the project is exempt from lead certification, please explain why:
No fOG '1 -fr _ R H poo r.,,
,y
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:
Fire Suppression Contractor: Phone:
NOTE:Plans and supporting documents that you submit are considered to be public information. Pardons of the information may be
classified as non—Public If you provide specific reasons that would permit the City to conclude that they are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaaan.com/subscribe.
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.
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.aooherstateonecall.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 approve of ens.
x Sferec'I AO/'rioihvl x –�-}
`"tel
Applicant's Printed Name Applicant's Signat re �—
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA166165
Date Issued:12/16/2020
Permit Category:ePermit
Site Address: 1667 Hickory Hill
Lot:010 Block: 001 Addition: Woodgate 1st
PID:10-84600-01-100
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
James L Schaffert
% Nancy K Schaffert
2225 James Ct
Eagan MN 55122
(651) 335-2235
Dan Koch Construction Llc
12900 16th Ave S
Burnsville MN 55337
(612) 481-9213
Applicant/Permitee: Signature Issued By: Signature