1718 Hickory Hill
- - - - - - - - - - - - - - - - -
f rN I For Office Use I
G' l r~ j
;:::e:
City of Eaaall el 3830 Pilot Knob Road / - -3
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 72c -09 Site Address: / / (P + 1/ 12 - % C C2 ,/}/LL
Tenant: 12-ho KAT-su-541 SO G AAA Suite
RESIDENT I OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: 7E/44 OFF tP-E-k-90F
Construction Cost: 0 Multi-Family Building: (Yes / No
CONTRACTOR Name: C R og F f r-3( License 2c_
Address: ~ r € OC_{C K L
City: /J Oe A-)5 i/ I L- State: ciA) Zip: 3 J ?
Phone: S~ °e?/I - YO73 Contact Person: /at`j f~ ~1~
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.
N
x IL L /J S` ti= I~ X
Applicant's Printed Name Appli ant's Sin ure
Page 1 of 3
VILLAGE OF EAGAN WATER SERVICE PERMIT
3Tl95.Rilot.Knob Road PERMIT NO.: 1639
Eagan, MN 55122 DATE: 11/15/74
Zoning: t'iAt No. of Units:
Owner: New Horizon Sons8 agate 11
Address:
Site Address: 1716 --18 -20-22 Hickory Hill
Plumber: peon Plumbing Co.
Meter No.: Connection Charge:*d'd'.�>
Size: Account Deposit:
r Reader No.: Permit Fee: 10 pd
1 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 SEWER SERVICE PERMIT
3795 PilotdCnob Road PERMIT NO.: 2399
Eagan, MN 55122 DATE: 11/15/74
Zoning: PPD " • No. of Units:
Owner: stew Rnr3 von Homan itoodgatn II
Address:
Site Address: 2716-1R-20-22 Hickory Hill
Plumber: Epson Plumbing CO.
I agree to comply with the Village of Eagan Connection Charge: /1: e it 1
Ordinances. Account Deposit:
Permit Fee: 10 -PD Pd
Surcharge: • 50 Pd
By: Misc. Charges:
Date of Insp.• Total:
Insp.: Date Paid:
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA146440
Date Issued:10/25/2017
Permit Category:ePermit
Site Address: 1718 Hickory Hill
Lot:008 Block: 002 Addition: Woodgate 2nd
PID:10-84601-02-080
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: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Derrick M Elsmore
1718 Hickory Hill
Eagan MN 55122
Window Store Home Improvements
2924 Anthony Lane #115
St Anthony MN 55418
(612) 353-5780
Applicant/Permitee: Signature Issued By: Signature
r For Office Use
41
At
ØL :
Permit ata
�' Date Received: ,7-7
3830 PILOT KNOB ROAD EAGAN, MN 55122-1810 V W/
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)6Staff:
buildinginsaectionse.cityofeagan.com M I 1 7 2019
2019 RESIDENTIAL ig - _- MIT APPLICATION
Date: ( 17- 17 Site Address: /7/b Ft; a r j7L1// 7-nc/, �7/c lUnrt#:OI / . cam_
Wod d ct h�i N1 eC. t 57 - S '-7 ?
Name: 9 e 0 Vol►+�'`I t/� d of Ol� Phone: 6 Y 3 Y
Resident/owne /6 7� `C icor` r Ea! 11 0 y .55 1 EZ.01_6),r Address/City/Zip: H
Applicant is: Owner X Contractor
Type of Work
Description of work: W Q� l 'Q ar p c h b / '6�'1 4c e
Construction Cost: / 0 Mufti-Family Building: (Yes /No—�
Company: 66'rhiR Cotact: S� Vt. Sof-Pm a.t
ContractorAddress: / 7 S73 F0 X ear° CI- City: aarA'"• hi "mac
State:M N Zip: 3d l Y 9r /01 -sq g,x,368*
pp :1 O` Pone: Email:
License#: p' ` ?0 0 Ch1 Lead Certificate#:
If the project is exempt from lead certification, please explain why: n
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:Piens andsupporting documents that you submit are considered to be public ice. Porus of the Information may be
classified as non Nc If you proms specific reasons that would pe +f the City to conclude drat they are bade Mets.
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.aoaherstateonecall.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 ans.
x Spare vi .UOrrioohv(
Applicant's Printed Name Applicant's Signat re Z�