1671 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
r-----------------1
1 For Office Use
~ Permit I
City of MEE
1 Permit Fee: lid
3830 Pilot Knob Road 1 1
Eagan MN 55122 i Date Received: S t13 _
Phone: (651) 675-5675 staff.
Fax: (651) 675-5694 L
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: I t Site Address: A ` t 1 k4a-
Tenant: L O-R Suite
Name Lj ILK O`-- L LO-QPhone: Q LA o-7) c
Resident/Owner
r- f~ n p 1
Address/ City /Zip: W Q0y!f lC (t
Name: l l ~ )I T ense UV Q e)
Contractor Address: City: 7 l
I State: I Zip: _ Phone:
\ i
i Contact: 1~+ Email:
New VReplacement -Repair _Rebuild -Modify Space Work in R.O.W.
Type of Work
3
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation RPZ PVB) Water Softener
1 Permit Type
Septic System Add Plumbing Fixtures Main Lower Level)
New Water Turnaround
Abandonment _
RESIDENTIAL FEES:
Water Water Softener, or Water Heater and Softener inclu~..~..,~~a na
$60.00 Minimum Heater, (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
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.gopherstate2ne2all.2
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.
/j,
X A i- x
Applicant's Printed Name Applica0' s "nature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA140701
Date Issued:01/17/2017
Permit Category:ePermit
Site Address: 1671 Hickory Hill
Lot:012 Block: 001 Addition: Woodgate 1st
PID:10-84600-01-120
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description: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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Deborah L Bruce
8 Hingham Circle
Mendota Heights MN 55118
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature
, 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 �—