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521 Hackmore Ct
Tr Use BLUE or BLACK Ink ( r For Office UUsee~ Cit of EaRd Per mit#: I L~ ~y I I Permit Fee: ✓V 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Z/ b//ireg lo&a C~a~,efi Unit Name: 4+,Ie kyle,A Phone: ~s/r6p3°I~/1~ RESIDENT / ,l OWNER Address / City / Zip: 44 5Z/ 6t ham G~ Applicant is: Owner Contractor ®t TYPE OF WORK Description of work: > Construction Cost: 7000 Multi-Family Building: (Yes / No ) Company: Wee,/, Contact: Sw &a CONTRACTOR Address: .61 C,l~S~~,[[c A11- City: 6 State: Lr /V Zip: .5 SAD 76 Phone: License Zo S V 3 ~;>7y Lead Certificate M 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 classified as non-public if you provide specific reasons that would permit the City to i conclude that the are trade secrets. B 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 fora 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 13,11 Applicant's Printed Name Applicant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation - Fireplace - Porch (3-Season) Storm Damage 7-2, ingle Family _ Garage _ Porch (4-Season) - Exterior Alteration (Single Family) ulti Deck Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi) - 01 of _ Plex Lower Level _ Pool _ Miscellaneous Accessory Building WORK TYPES New _ Interior Improvement _ Siding - Demolish Building* _ Addition _ Move Building _ Reroof _ Demolish Interior Alteration Fire Repair Windows Demolish Foundation - Replace - Repair Egress Window Water Damage Retaining Wall *Demolition of entire bull ing - give PCA handout to applicant DESCRIPTION Valuation Occupancy MCES System Plan Review Code Edition SAC Units (25%100% ) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC _ Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: Footings _ Backfill _ Final Sheathing Radon Control Sheetrock / Erosion Control 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 Page 2 of 3 , /0 0 5858 Blackshire Path Krech Exteriors Inver Grove Heights, MN 55076 ❑ Main: 651-688-6368 Fax: 651-994-1388 Siding Roofing Windows Gutters www.krechexteriors.com "We've got you covered" MN LIC# 20583274 PROPOSAL SUBMITTED TO HOME PHONE # ' c f }}fir DATE,, t tit i ) atii 1 rs7:' ~I 1 STREET 4 ,k tV, "HONE # FAX # ' CITY, STATE and ZIP CODE EMAIL SALESPER N + P.O.# CELL PHONE fI 1 ~ V l AUTHORIZATION FOR CHANGE SPECIFICATIONS I hereby authorize and assume responsibility for the following changes and/or additions to my original contract of services: Description / Details: I I 3 1-J I i r e' I I I ~ I i I f TOTAL ADDITIONAL CHARGES $ , due and payable by homeowner in full upon signing of change order. Method of Payment: Cash ❑ Check ❑ Visa ❑ MC ❑ Credit Card # Expiration Date: Approved and Accepted ~f i' } t F X i "ly Date: 4 Customer's Signature INSPECTION RECORD ? CITY OF EAGAN PERMIT TYPE: I 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: Ilii?.h hlt+12L l, i 0 vi- I,, I?1tJi?'•+ ! !119f1 i, I 0!,1 F1f1 ',A66-if!-99 y PERMIT SUBTYPE: F I f toi f TYPE OF WORK: M_W f irj i",t Pam?ft No. Permit Flolder Date Talephona M ELECTRIC PLUMBING HVAC Inspectlon Date Insp. Commants FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ONSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL OECK FfG DECK FINAL ? INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 1:" f 1 '' 1 "'l ? 3830 Pilot Knob Road Permit Number: 0.' Fi ?• t`' - ? Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 i SITE ADDRESS: ` 1?•` 101'' iaa,:,c?Q l0 r: ttt nCK l liAC! MURt tfIpIN f11Cl6L :34tD PERMIT SUBTYPE: i t r• ? r; i r.i I :Fh! t`, FI F RAM 1 Ni, RCIi1{,If I H 1 1 Ei4: t:t MA(:K.`„ ';1 !"AkATf I'f V b!{ 1' , APPLICANT: i'W,110 ! E• 1:' ? t? N 3?- ?!? ? fi TYPE OF WORK: I N',tll f1 f 1 MI f lNAI Rt:U??rfct IF i (IR ANY k l FGTFti'[:AI UR V1 [IMNIN[; 1.?t3R1 • -------- - --- -- -- - - ------------- ?i Permk No. Permk Holder Date Tetephone # ELECTRIC °?'? PLUMBING ?('04 ? HVAC Inapection Date Insp. Commenta FOOTINGS FOUND FRAMING p N{O ROOFING ROUGH PLUMBING ? -72-qG Ik? PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL O _ 2 Z -1., 0 j wad - GYPBOARD FlREPLACE FIREPLACE AIR TEST • FINAL PLBG FINAL HTG ORSAT TEST BLOG FINAL ? BSMT R.I. I BSMT FINAL DECK FTG DECK FINAL ? • ?r ?t`•+? Wertificate vf cccuvanc? mt? nf Cfaga? ?fttuf ? ?affbins 3*40lecdan This Certificate issued pursuant to the requirements of the Unrform Burldrng Code certifyiRg that at the tinre of issuance this structure was in compliance with the various ordinances of the City regulating building constructron or use. For the following: Ux Qusificnion: SF rW Bldg. Pertnit No. 2M Ooaipaocy Type RU/r1 1 Zoning Disuia RI Typc Cons[. kM Owner af Building HYrItn OaM DC pdArm qW WAMSM DR, w. EACM &clding Addrecs 521 EIAC7QH1rE M1RT i / Bm{cbn8 mcla Lodity 1.2,?.i1., AiTiTMN RTiYY?.' 3gp Date: POST IN A CONSPICUOUS PLACE . 'CITIf' OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: PERMIT SUBTYPE: ON RECORD PERMIT TYPE: Permit Number: Date Issued: rci, I E it I rlii N. _'ti41il Nl/I0 ;`r4 APPLICANT: ;, . TYPE OF WORK: INSPECTION ? ? .. . ? . ,. . DA 1 N f 1 1 ` '.;rtltf `, F'f '.: FtEUfl l pf t #W 1 I1N'1 Rf1i: T[1it -'hi APt i'I !IMH t N+. -1 [L PermR No. Permit Holder Date Telephone M S/1N PLUMBING O HVAC ELECTRI ? 0 9 ?8a O° ELECTRIC Inspectbn Date Insp. Comments Footings I r/ Foundation !) r Framing ! f ? RooNng Rough Pibg. Rough Ht9. 3 lsul. Flreplace Final Ht9_ -Z7-? Orsat Test Final Plhg. Plbg. Inspector - Notity Plumber Const. Meter EngrJPian Bldg. Final U 7 Deck Ftg. Deck Final Well Pr. Disp. 3 -9 ? ?1 `-?--?-- .- RESIDENTIAL BUILDING PERMIT APPLICATION '-t 55122 (' C) v SU (a V 3830 PILfOT KNOB RDN 651-681-4675 New Construction Reauirements RemodellRepair Reauiremenls • 3 registered site surveys showing sq. fl. of lot, sq. ft, of house; and all roofed areas • 2 mpies of plan (20°h maximum lot coverage allowed) • 1 set of Energy Calcula6ons for heated additions . 2 copies of plan showing beam & window sizes, poured found design, etc.) • 1 site survey for extenor additions & decks • 1 set oi Energy Calculations • Indicate if home served by sepGc system for additions . 3 copies of Tree Preservation Plan iF lot platted afler711193 . Rim Joist Detail Options selecUOn sheet (bldgs with 3 or less units) DATE ?? VALUATION (EXCLUDING LAND) 9'?'C)60- ? /?_r JOBSITEADDRESS}?QCk{'tf/?'L C?T• If MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNEROMIJI-c?lKtk LtY'a YY?E vFWCRK c?n?,Jn, lj r?AS r?!`Y`/?r? l??nY`?,(? r/<?C ri??7o( ('lfiS FIRFP!ACE(S) _0 ?_2 _3 APPLICANT ??p Si'? ADDRESS .3R PAGER # v???"Y1_P_r?PHONE# ?? ?? NLli` [I /3 13W"f1S(?AtO? ?? ZIP CODE h ?33 Z CELL PHONE # FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RUI.ES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted _ MINNESOTA RUI.ES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor: Phone #: Plumbing Systcm Includes: _ Watcr Soflener _ Lawu Sprinkler Fec: $90.00 WaLer Healer No. of R.I. Badis - No. of Badts tj P ' ???? ^ ? ` 4 Mechanical Contractor: / (PG?1 ?r Sl P Phone # / P S/ C lz Mcc6anical Systcm Includes: Air Condition' ig Fcc: 7.00 ,.....?-- _ Heat Rccovery System Sewer/Water Contractor: Phone # All above information must be submitted prior to processing of application. 19v _.?-- I hereby acknowledge ihat I have read this application, state that th ' rmation is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Or " nces Slgnature of Applica f ` -) L7v_ti4a Al? Certificates of Survey Received _ Tree Preservation PlanlTe-ceived _ Not Required Updated 1101 OFFICE USE ONLY ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 ' Porch (3-sea.) ? 31 EM. Alt - Multi ? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bidg)* ? 43 Reroof ? 48 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuaion Occupancy MC/ES System ; ;F••;^-ug Cnd? - ?G.)Iny^ - Ciiy 1r'vat8i SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const W idth REQUIRED INSPECTIONS _ Footings(new bldg) _ FinaUC.O. _ Footings (deck) _ PinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Roof Ice& W ater Final Other _ Framing _ Pool _ Ftgs _ Air/Gas Tests Final _ Fireplace _ R.I. _ Air Test _ Final _ Siding Stuceo Stone _ Insulation _ Wmdows (new/replacement) Approved By °asc Fc.. Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total . Building Inspector Address 521 xnaWRE G= Zip 5512 3 I I,ot 2 Blk i Sub aImM 2IDCE 3tD THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION. Date: Yes No Inspector: Final grade (6" from siding) Permanent steps (garage) ? Permanent steps (main entry) v Permanent driveway ? Permanent gas v Sod/Seeded gtass TraiUcurb damage Porch ? Basement finish v Deck Please vcrify with the builder the removal of roof tcst caps from the plumbing system and [he shutoff of water supply to the outsidc lawn faucet befote freeze potential exists. Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ? White - City Copy Yellow - Resident Copy Pink - Contractor Copy REQUEST FOR ELECTRICAL INSPECTION JI- See in5hv Wns for ccwpletmg this form on back of yellow copy ? 214?2 7 "X" Below Work Covered by This Request ??• Ee-ooooi-oe ew dd Rap. . TypeofBuilding AppliancesWrtetl EquipmeniWired Home Range 7emporary Service Duplex Water Heater Eiectnc Heallng Apt Bwltlmg Dryer Load Management Comm.llndustfial FUrnace Other (Specity) Farm Air Condnioner Othar (specity) Comradot5 Remarks Compufe Inspection Fee Below: # Other Fee # ServiceEntranceSlze Fea # Cncuits/Feeders Fae Swimming Pool 0 to 200 Amps a 0 0 io _IVVAmps Transformers Above 200 _ Amps Above - Amps p SIgnS Inspeclor5 Use Only. ? TAL Irrigation Booms gZ' Special Inspecnon Alarm/Communication THIS INSTALLATION MAY BE ORDERED ISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 M HS. ? I, the Electrical Inspector, hereby pougn,o certifythatiheaboveinspectionhas been made. ( Date ? ??j? J a OFFICE USE ONLY ? This request voitl 18 manths from ,.•. i r? ?, M 214 2 Request Date fire No Rau9h-in Inspection NOTICE: You Must Call Elecmcal Inspector Reqmretl? If A Rwgh-In Inspectlan ? Ves ? No Is Reqwretl I 0 licensed contractor ? owner hereby request inspection of above electrical work at: Job Address (Sireet, Box or Route No ) ? r s '3 Ciry 7o?? a / 44 Secuon No Township Name or No 1 Range No Counry l.?-- Occupant(PRINn ? Phone o. y??f Power Supplie / r ? {(? O • Address Eledncal Contrector (Company,Ndme} ..v Contracjor5 ucepg?,Go. Maihng Atltlress (COnireclo`r o?r O/? oE4 MaWng Inslallabon) ??±1;?'LL ;?° 47?:" P5":b T??v.L . r'V3 ??LVSI?J! Authorize0 Sg ur (COnhactodOwner Makmg Instalianon) Phone ryu?npa??? ??YY MINNESOTp STATE BOAFO OF ELECTPICITY GrlggrMitlway Bltlg. - Foom 5473 1821 Universny Ave., SC Peul, MN 55106 Phone(812)662-0800 THIS MSPECTION REQUEST WIIL NOT BE ACCEPTED BYTHE STATE BOARD UNLESS PROPERINSPECTION FEEIS ENGLOSED. ? ivtl ay&e- i C5 6 71914, .?/ ? ? ;-?,? .?, 3? ?Q'd `v Repuest Dete . Fna No Rough-In inps puired s eclion Other Than Rovgb.ln ' (VOUmusicall ns rwhenreatly) 'Eff R¢adyNOw ? WiIINONyI^s0edor ? Ves No Date ReaEy licensed coniractoi r] owner hereby request inspectwn of above electncal work at: ... Job Aetlress (Sireat Box or Route No ? ? Qty ? S ? ?•?9-c ?-ax•- ? ?- SecOOn No Township Name or No. Range No. Counry Occupant(PRMT) i Phone N. -o "-_'/ /L` 4LI Power Sup06er P. :E- .00' Adtlress Electnc31 ConVatlm ICOmpa'?Nam ?'N ^ Oqi FpANf\G. V Contreclor's L?epse N^??^ WV:K MaaingAtltlresslConlracm, orOwn r Installauoni ?P? •. 12803 FLORIDA ??' VALLEY pAfd 55124 Futnonzea Sig ature mracror?Owner hfa«rng instanaUon) anone Num ber p' ?? / f J? f i MINNESOTA STATE 60AR0 OF ELECTRICITY ? Griggs-Mitlway Bldg - Poom 3413 1821 Ilniverslty Ave., SL PeW. MN 55104 Phone (612) 642-0800 _ THIS INSPEQION REOVESi WILL NOT BE ACCEPTED BV THE STATE BOARO UNLESS PROPER INSPEGTION FEE IS ENClOSEO REQUEST FOR ELECTRICAL INSPECTION ? V??19 See instmctmns for compleling Mis form on back ot yellow copy "X" Belaw W'orlt Covered by This Request ?BM?? EB-00001-0e ew Acd Rep TypeofBwlding AppliancesWiretl EquipmentWired Home Range Temporary Service Duplex Waier Heater Electric Heating Apt. 8wltling Oryer Load ManagemeM Comm,9ndustnal Fumace Other (Specity) Farm Air COnditioner Other(syecityl ConVactors RemarksCompufe Inspechon Fee Below`? # Other Fee # ServiceEntranceSZe Fee # Crtcuits/Feeders Fee Swimmmg Pool 0 to 200 Amps 0 to i00 Amps Transformers A6ove 200 _ Amps -- Above 100 _ Amps SignS inspetror's Use Only TOTAL Irriqatwn Booms Speciallnspectwn Alarm/Communication THIS INSTALLATION MAV BE RED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspecror, hereby certiry that the above inspection has been made Ro.9n-m F,nai oaie pa?e OFFICE USE ONLY This request voitl 18 monlhs irom 315 -716 FI] ?FFI E USE ONLY This reqoesf vaid 16 monlFs from vahdovan date pnnled in Mis b PLEASE PRINT OFi TVPE Ice, Reqaml Do?e 1 2 1 ?2 Rough-in inspedion reqwred? es ? No Y h Inspecnan Other Than Rough-In eody Now ? Will Call D t R d 6, . ne mzpetlor w en readyl ;oo musl mll o e ea y Ijrlicensed mn}mdor ? owner hereby request inspedion of ihe above eledrical work ot Jab Address (SVeef, B ar Roote N. S? ? G-lc ?E'E C-7= ew Zip Code Senian No Tawnship Name or N. Range No Fire N. ` Counry ?i / ? ?A I?oTTq Occuppant / /? / L"'??L?i1r?c7C?VlI?t/S7?'1`?" rUN Phone NQo/ (J?! ` loys?. Power Sopplier Address Elennml Comronor (Compa?y Nomej ?E-?flC-?:' ' CGEcTeic.. Conlrotlor license No Moskr Lic Na (Planr Eletl Only) Madcnaadd,a..(com??.a.o.me, Pertoi,nein.mii i /.). yo ?f? ? • ? ?°- . Insmllonan) Authonzed Sigrwt?re ICon ctaA171 s??-,? Phone N. E0-OOOOlA-10 6/95 STATEBOARDCOPY-SEEINSTRUCTIONSONBACKOFYELLOWCOPY ?I I II II I I III III?I III II II I?II ? II I?? REOUEST FOR ELECTRICAL INSPECTIO Minnesota State Board W Electricity ? '? ? * 0 3 i, 5 7 1 6 1 * Phone (812)5842-0800 Su1, MN 55104 `??' Home Duplex Apt Bidg. Other. New Addn Commercial Indusfrial Farm Remod Re mr Air Cond. Hfg. Equip. Wa}er Htr Load Mgmt. Other: D er Ran e Elec. Heat Tem . Service obove the work mvered by tbis request. Enter remarks in this space and on fhe bock o1 the white copy only. Calculate Inspechon Fee - This Inspection Request wdl not be occepted wlthout Ihe mrrect fee: ONier Fce # Service Entrance Sae Fee # Circvih/Feeders Fee Mobile Home Park Stall 0 to 200 Amps 3 Amps 010100 Street Lfg./Trallic Sig. Above 200 Amps Above 700 Amps Transformer/Generator INSPECTOH'SUSEONLY TOTA}y SQ $ign/Outline Ltg. Xfmr. , ??U ? Alarm/Remofe Conhol Swimmmg Pool I hercb wm Ihat I ms d the dMnml insmllanon desrnbed herein on Me daks ?lotdd Irrigahon Boom Ro.gh-In Dok Special Inspedion Investigafive Fee THIS INSTALLATION MAY BE OHDERED UISCONNECTED IF NOT COMPLETED WITHIN 78 MONTHS. i • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted NewConatruction Reouiremenh . 3 regislered site surveys showing sq. ft of lol, sq. ft. of house; and all iaofied areas (20% mazimum lol coverage allowatl) . 2 copies of plan shovring beam & vnndow sizes; poured found design, elc.) • 1 set af Energy Calalations . 3 copies of Tree Preservalion Plan if lot Datted after 7/1193 • Rim Joist DelaJ Optbns selecUon sheet (bldgs wdh 3 or less units) DATE SITE ADDRESS TYPE OF WORI ?ULTI-fAMILY BLDG _Y _N FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT Cedar Valley Exterbrs, lnc. STREETADDRESS CoonRapids MN 55433 CITY STATE_ZIP TELEPHONE #fI? l-SSIa? ICELL PHONE # FAX PROPERTYOWNER 1(?.A.?.?`ld C??3.-?-Y?CI TELEPHONE#(ObI"??.v?J? I"l I? COMPLETE THIS SECTION FOR "NEW° RESIDENTIAL BUILDINGS ONLY Energy Code Category _ yIINNF,SOTA RULFS 7670 CATEGORY 1 _ MINNCSOT:1 RliLES 7672 (J suhmission type) Plumbing Contractor: ___ Plumbing system includes: Mechanical Confractor: Mechanical system includes: Sewer/Water Conhactor. _ Air Conditioning Heat Recovery Systcm Phone Phone # Fee: $90.00 olTP? oT? ----------°-------------------------------°-°-----------°---•----------------°------°-------------------•-------°-- I hereby acknowledge ihaT I have read ihis application, state that the inf otion is correct, and agree to comply with all applicable StaTe of MinnesoTa Statutes and City of Eagan Ordi a ces. Signafure of Applicant OFFICE USE ONLY Phone # RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EACAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681•4675 _ Water Softener _ Water Hcater _ No. of Baths I '-1 ii ,---l ? RemodaVReoair Reauirements . 2 copies ol plan • i set ot Eneyy CalculaNans for heated addi6ons . 1 sile survey for exterinr addi6ons & decks • Indicate if home served by sepfic system for additions VALUATION (9412 • New Energy Code Worksheet Submitted _ Iawn Sprinkler No. of R.I. Baths Certificates of Survey Received - Tree Preservation Plan Received - Not Required _ Updated 4/02 OFFICE USE ONLY ? Ot Foundatlon ? 07 05-plex ? 13 16-plex ? 20 Pool O 30 Accessory Bidg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 6ct. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? OS 03-plex ? 11 10-plex ? 19 Lower Level 0 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement "Demolition (Entire Bidg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED IN SPECTIONS _ Foorings(new bldg) FinaUC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addition) Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ F inal Pool Ftgs Air/Gas Tests Final _ Framing _ Siding Srucco Srone _ Fireplace _ R.I. _ Air Test _ Final Windows (new/replacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Building Inspector crrv nF FnrAN CAFiNTE'Ra S iF..kMSNAI_ M[7; 67 DA'rl.: 06/04/9i' IIFSE: 14:57:17 1D: NAMF: EARTFtFN AR7S LFlNLiS(:61!'FS 300 9001 `;?i I-lAC:Y.MC]RF IiR Sq.OCJ ?_ii`; 9001 i?_i. HM1aCl;1'fORF: I1F: 0.50 :3430 9001 521 I-IACt.Mt]hE DFi 0.50 7ot a:t herei.pt Art?ount ; 5000 CF'I774964 UEiI:'fi :(t7: P!ANCY ? CITYOF EAGAN PERMIT 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.I<N.: 10-12302-020-01 621 HACKMGRk CT LO7: 2 6LOCK: 1 Al1TUMN RI[7GG' 3ftG PERMIT TYPE: B u z Lo Z Nc Permit Number. 030142 Date Issued: 06/ P 3/ 9 7 DESCRIPTION: &15i1dlnPermit Type DEGK k Type iuild3n4 W6,11 NEW _ 434 ALT. RE,SIDEPITSFlL ti ? ? . , ?9`? k? ? ali y ..?`??•-• ?n `Pe el ??'f.?.r \ i fq°''- ...E uj tw .'i'c .-........ Li C,:.,I REMARKS: FEE SUMMARY: Base Fee $50.00 COPIES (2) ?•S8 Surcharge $.50 7otal Fee ;51.08 S«bt'otal $541.58 CONTRACTOR: - applicanc - sT. Lsc. OWNER: EARTI-IEN ARTS LANDSCAPES 18662599 2007046` KUKURA DAVE ?500 14TH AVE 5 521 HACI<tA0{2E CT FICHFIE'LD MN 55423 EFsGAN MP! (612) 666-2599 (612)663-1918 I . „ I tieraby acknowiedye tk+at I'have read Cktis inFormatfrtn is oorv?ect- a•nd ?9rse tn ramply SCatitas apd City a# Eagan Qrdinancas. ? ,.._. "? APPLICA PERMITEE SIGNATURE aPplieatiesn arrd state that l:hts ° w?,?}h ,a],a. apglSoabIe State nf Mrt. ISSU D BY: IGNATU , 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) oro - - arr oF eacaN ? 3830 PILOT KNOB RD - 55122 _ $81-4675 New Conafruction ReauiremerHS RemodeUReoeir ReaufremeMS . ? 3 registered aite aurveys ? 2 eopies M plen ? 2 oopies M pWna (Indude beam 8 wiMow sixea: poured fi0. deagn; etc.) ? 2 site wneys (eMarior Bddidons & tladca) ? 1 energy calaledons ? 1 energy ealaletlona tor heated adtlitlons • 3 copiea M tree preeervation plsn 'rf lot platted after 7/1/93 required: _Yes _ No ? ? DATE: ?Q? CONSTRUCTION COST: DESCRIPTION OF WORK: -?-?? STREETADDRESS: _ ?ZI I.daC?Ctnnu u ?. Q?t ? LOT °'? BLOCK ? SUBDIP.I.D. o"? I PROPERTY Name: LuV, , R A 4„ln, u i?4 Phone #: AW3`1cl IP OWNER . ,,,,, ,.„ ?.. Street Address: k rnO-, U n.Q. City: ac4r,J1 State: ??V jj2 Zip: CONTRACTOR Company: F'G LLt?u A5 LfatnS(AWL Phone #: Street Address: License #:r?,Lom.f.1_ City: State: w1..?> Zip:x?l ARCHITECT/ Company: Phone #: ENGINEER Name: Registration #: Street Address: City: State: Zip: Sewer & water licensed plumber (new construction only): . Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the information is wrrect and agree to comply with all applicable State of Minnesota Statutes and City of Eastan Ordinances. OFFICE USE ONLY Certificates of Survey Received Tree Preservation Plan Received Signature of Applicant: _ Yes _ No _ Yes _ No T'C?---Z'L(' RECEIVED iViAY 2 `? 1997 BY: - Not Required OFFICE USE ONLY ., BUILDING PERMIT TYPE ? 01 Foundation a 06 Duplex 0 02 SF Dwelling ? 07 4-plex ? 03 SF Addition o 08 &plex ? 04 SF Porch ? 09 12-plex 0 05 SF Misc. ? 10 = plex WORK TYPE 0 31 New ? 33 Afterations ? 32 Addition o 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS - s 0 11 Apt./Lodging ? 0 12 Multi Repair/Rem. ? ? 13 Garage/Accessory o 0 14 Firepiace o 0 15 Deck 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous 0 36 Move ? 37 Demolition Basement sq. ft. MC/WS System Main level sq. ft. City Water sq. ft. Fire Sprinklered sq. ft. PRV sq. ft. Booster Pump sq. ft. Census Code. Footprint sq. ft. SAC Code Census Bidg Census Unit Pianning Building Engineering Variance Permit Fee Surcharge Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: Valuation: $ % SAC SAC Units . , PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT-ryPE: gUrLoTNc Eagan, Minnesota 55123 Permit Number: 022806 (612) 681-4675 Date Issued: 01 J 10 / 9 4 SITE ADDRESS: DESCRIPTION: 521 HflCKMORE CT LOTe 2 BLOCK: 1 AUTUMN RSDGE 3RD 84ilding'--Permit Type SF DWG 'Building W?d,rk T,ype NEW "UBC Occupancy?R-3 M-1 ? Construction TyjSe VN ZQninq --? R-1 Buiiding Length ` ? f3uilding Width ? 70 45 L;?F i {J !? Li oY. REMARKS: PRV REQUIRED FEE SUMMARY 8ase Fee Pl.an Review Surcharge SAC SAC ? SAC Units 5ubtotal S&W CONiRACiOR - STAR PLUMBTNG VALIJATION $863.50 $561.28 $82.00 $800.00 100 $2,306.78 $164e0@0 MSSC FEES _., $1.828.50 Total Fee $4,135.25 CONTRACTOR: - Flpplicant - sT. Lzc. OWNER: HUTTNER CONST, WILLTAM 14523085 0001653 HUTTNER CONST WM 960 WATERFORD DR W 960 WATERFORp DR W EAGAN MN 55123 EA6AN MN 55123 (612) 723-4161 (612)452-3058 i hereby acknowledge that I have read this informetion is correct and ag,ree to comply StatuZes and City ofi Eagan Ordinances. L -- APPLICANT/PERMITEE SIGNATURE applir.etian and state that the with all appliceble Stat2 of Mn. J ,-?Mg ?- ISSUED BV: SICa ATURE REALTIVATE CITY OF EAGAN FERMIT't 19r-},'rBUILDING PERMITAPPLICATIQN 1983 194 681-4675 I SINGLE Q MULTI-fAMILY 2 setts of plans, 3 registered site surveys, i copy of energy C8IC5. COMMERCIAL 2 sets of architectural 5 structural plaas, I set of specifiations. 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but oot picked up by last working day of month- 3) lot change 1s requested once permit d h or ange in which request is made, 2) address is c is issued. Date / L / 34 /3 Yaluation of work Site Address: 5,L 4f?kfna 1U, CT LiNEET iUITE Y Tenant Name: (commercial only) IAT ? 82ACK ? SUBD. ?' J'?-'- ? P.I.D. M ' ' , I lGL'+l Descri tion of work: The applicant is: ? Owner Lontractor [3 Other (Describe) Name Phone Property L•ST FIRST Owner Address SiREET LTE / C;ty State ZiP &2J- Phone ?s13v?? Company license i/94 3 ExP• 7 A' Contractor , Address City E?f? State Zip Company _ Phone ArChitBCt/ Name Registration # Engineer Address City State ZiP Sewer & water 1lcensed plumber Processing time for sewer 5 water permits is two days once area has b en approved. I hereby acknowledge that I have read this ap lication and state that the information is ?e S ate of Minnesota Statutes and City of licab ll a ith l , pp a y w correct and a9ree to comp Eagan Ordinances. `J ?? - Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT 31fPE O 01 Foundation ? 06 Duplex 0 11 Apt./Lodging -0 02 SF Dwg. ? 07 4-Plex ? 12 Nulti. Misc. O 03 5F Addition 0 08 8-Plex ? 13 Garage/Accessory E3 04 SF Porch ? 09 12-Plex ? 14 Fireplace O 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck WORK TYPE ,,0 31 New ? 33 Alterations 0 35 Tenant finish O 32 Addition ? 34 Repair O 36 Move GENERAL INFORMATION Const. (Actual) (Allowabte) UBC bccupancy Zoning / of Stories Length Depth APPROVALS Planning Engineering ?1.o/ Basement sq. ft. ?_?/? lst F1. sq. ft. •-K-/ 2nd Fl. sq. ft. ? Sq. Ft. total Footprint Sq. ft. ? On-site well Oo-site sewage Bui•lding - Variance REOUIRED INSPECTIONS ? Site ? Ytallboard I?rfooting .0- Final O 16 Basement Finish 0 11 Swim Pool 0 18 Comm./Ind. ? 19 Coron./Ind. Misc. ? 20 Publit facility 0 21 Miscellaneous p 37 Demolish 1302 MWCC System ? 7309 City Mater 1?yz PRV Required v_ Booster Pump fire Sprinkler Census Code _77277 SAC Code vi I Assessments ? I?k Praming ? Draintile a Insulation 13 Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/M Permit 5/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. m es er Tota1: Y.t,.t;o,: s l? y ?o i SO,r/?' - 7Sa 39, 6?F- l! 3 9 5; 3 k P : 3 y, vo 21 -3 1 30v,? ?k0?- )L? 2n? 3 xz1 ? G?z :r- /I 5y- ?4r• zz 3A- 3z,s? 'I2o,zf Z D. 3, f- Z= %ee om-/6 eG'Z %. 3 iAC % SAC Units LOT BIIRPEY C8ECICLZBT FOa RESIDENTIAL ? SIIILDI3iG pBRMIT IIPPLIC!?TIO g$OpERTY I.EQALs ?? J ? Date ot Burvept DOCIIMENT ST7INDARDB / 0",D ? • Reqistered Land Surveyor siqnature and company @?,! 0 • Suilding Permit 1?pplicant ' 8;,,? ?0 • Leqal description ¦"i? 0 • 1?ddresa Q 0 - North arrow and bar acale EYO 0 • Houce type (ramblar, walkout, aplit v/o, split entry, -/ lookout, etc.) ID' 0 0 • Directional drainnge arrows with slope/grsdient i. E?iD 0 • Proposed/axistinq savar and water services 8?'? 0 • Street name D? O D • Driveway 13 2/ ?I0 • Sewer service • Lot corners l P D • Top of curb at the drivewey 0 • Elevations of any existing adjacent homes 0 • progoseQ Gnrage floor a • First floor F D • Lowest expoced elevatioa (walkout/window) D • Property corners D • Front and rear of home at the foundation BONDING f?REAS (if applicablel D D • Ensement litfe D ? 0 • HWL D ?/? • Pond f designation D 0 0 • Emergancy overtlow Eievation DIlSENBI0278 8? D 0 • Lot lines ?-/0 0 • Riqht-of-way and street width (to back of curb) ?` G 0 • Froposed home dimensions includinq aay proposed •aecks, overhnngs qzeater thnn 21, porches, etc. (i.e. all structures requiriag permanent lootings) 0' D D • Show all easements of =eeord and eny City utiliLies within -/ those easements II G 0 • Setbacks of proposed sLructuze and setback of adjacent existing homes 10 D 0 • Retaini 11 r irements, if any Reviawed:? I TI 9?? DCtObez 1992 r TO EE SU°`1ITiED WITit BUILDINC PiPJfIT AI'PLIC,ITION 0!':; ER: SZTE ADDR£55: M:TEP.IOR };,yVF.LOPE AVERACP_ "U" C(1.`iPUTATION A1' c ? T CANTRAGTOR: ?yc?.^ 6?-S/l DATE: L39-13 P210NE: `fS Z -7n? Determine vorking equare footage of each 1. Total exposed wall area......... /y2`( aq.ft. z •OZ-6 ? 37ioZ 2. Total roof/ceiling area......... 4171)? sq.ft. x ??? 3.• Total exposed wall area calculations: Totul exposed wall area above floor a. Total vall vindou•area .............................. 3/Z b:" iotal door area .....................................39 c. Total sliding glass door area ....................... 8CJ d. Total fireplace vall area........................... - e. Total caall framing area (average 107.) ............... f: Total net wall area above floor ..................... j5(06' g. Total rin joist area ................................ 2 Yeef Total expoaed foundation area - ./ 7 De 8• b. C. d. termine "U" value of each wall segment '}II ry I ?' /• L?r / Z ,,? x 1 lU . 38 X 0 p X .,v„ yN o -- X lfUlt ---- . ' - • e. 7S<, x iun f. 3 yo ?' X "Ull g. z y?' X „u„ x fovl$ t. / 7& Xlv- ,1 G . l7, ? h. r 1?? 3. • TOTAL \l .. w , ?' j Z h. Total foundation vindoW area........................ i. Tor.al net foundation area above grade ............... 120 ,D7 ? d -1 ,n`f If item 03 is the same ae, ar less than item 01, you havc mct [he intcnt of snc 6006(c)2. ' . ,' 4. 7otai ca?osed roof/cc111ns calculatlons: Total e>cposed roof/ceilizg area - ) 7zy/ J. Total skyliEh[ area ............•........... ......... ` k. To[al rooE/ceiling framing area(averap,e 107.)......... / 1. Total net insulated roof/ceiling area ................. /? 8 2. Detemine "D" value for each roof/ceiling segment `?- ---- _.? j- . X clIIll ? , o,,... _ k. l? z x„U„ Z. 4. ';TOTAL ? Z p r I O If total of 04 is the sarae as, or- lecs Chan f2, you have net the intcnt of SBC' 6006 (c)1. Alternate Building Envelope Aesign ''??.',, . ' .. . . •: . To utilize the total envelope system method, the values establislied by " the sum of itecis 03 and 04 shall not be greater than the sum of items fll and 02. 1. + 2. - 3. + 4. ? C E R T I F I C A T I 0 2i I hereby certify tliat I have calculated the "[J" factors and R values herein and that the building hero described meeta oi exceeds the State of Hinnesota Energy Conservation Act. 0 ?- / (Signa[ure), iz-2a-b . (Aate) ' . • , _ CT7Y ClF 'L"AGAN (;AGiIIIE:Ei" S T'1=hMT.NAL Nile 32 DATEr, 0803/96 7.T.ME : 09:5035 IV. NAME: I_INDA F: I:.UKl.1Frl 3210 9001 Sf?i HACF:i1f1F'F X1R 50.00 2j 55 3001 :21 HACF:MLlf1F DR n.:,n Tni;a1 heceip+, Amaurtii;. 50.50 CRObc?875 I.ISF...Ii :f.De NANCY \f ? CITY OF EAGAN PERMIT 3830 Pilot Kno6 Road PERMIT TYPE: e uILo s N G Eagan, Minnesota 55122-1897 Permit Number: 028515 (612) 681-4675 Date Issued: 0 8(13 J 9 6 SITE ADDRESS: 521 HACKMORE CT L07: 2 BLOCK: 1 AUTUMN RIpGE 3RD P.T.N.: 10-12302-020-01 DESCRIPTION: .?.. Bui3d3ng_Permit Type ?BUildivrg 14o k Type ' -Census Code fi. ? ? _ . . r. . BASEMENT FINISH AL7ERATION 434 ALT. RESIDENTIAL Ci 1... \i......it?e .i :}1 •I? jir 'AE 2 %? REMARKS: SEPARATE PERMITS REQUIRED FOR ANY ELECTRICAL OR PLUMBING WORK FEE SUMMARY: Base Fee $50.00 Surcharge $.50 Total Fee $50.50 CONTRACTOR: OWNER: - Appzicant - KUKURA DAVID 521 HACKMORE CT EA6AN MN (612)653-1918 ? I hereby acknowledge that I ha0eread Chis applicat?ion"and state that the information.iscorrect and,a?ree tt? camply, withall applica67e Stat.e•of Mn. Statute& and City'o'f Ea9a.n Ordinances. ? . APLIC N /PE ITEESIGNATURE ?? ?.?? ?Z I ?r( I? Y. SIG ATUR CITY OF EAGAN u ? 3830 PILOT KNOB RD - 55122 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Construdlon Reauirements Remodel/Reoair Reauirements ? 3 registered s0e aurveys ? 2 copies of plan ? 2 copies of plans (include beam 8 window sizes; poured tnd. deslgn; etc.) ? 2 site surveys (exlerior addRions 8 decks) ? 1 energy calculalione ? 1 energy calalations for heated addilions ? 3copies of tree presarvation plan H lot platted afier 7I1193 requfred: _ Yes _ No DATE: 7-3o-cfh CONSTRUCTIONCOSTA ??oco DESCRIPTION OF WORK: 15"S-26S"E^S7 E19"kStF STREET ADDRESS: SZN LOT ? BLOCK SUBD./P.I.D. #: ??.-?y,? PROPER7Y Name: KUVvp?A, 'VNNI\O Phone #: (75-?>- Nak 3 owNeR u.. ,M,_ Street Address- eOG'R\- - City: State: \-\P Zip: CONTRACTOR Company: Phone #: 5treet Address: License #: City; State: Zip: ARCHITECT! Company: Phone #: ENGINEER Name: Registration 50 , j O 04'ela- 1` 7 Street Address• City: State: Zip: Sewer & water licensed plumber: change are requested once permit is issued. Penalry applies when address change and lot I hereby acknowledge that 1 have read this application and state that the information is correct and agree to comply with all applicable State oi Minnesota Statutes and Ciry of Eagan Ordinances. , Signature of Applicant: OFFICE USE ONLY Ir[?' M[?? Certificates of Survey Received _ Yes No AUG p 219g5 Tree Preservation Pian Received - Yes _ No --------------- OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex ? 04 SF Porch o 09 12-plex 0 05 SF Misc. ? 10 = plex WORK TYPE ? 31 New ar'33 Alterations 0 32 Addition ? 34 Repair GENERAL INFORMATION ? 11 Apt./Lodging o' 16 Basement Finish ? 12 Multi Repair/Rem. ? 17 Swim Pool ? 13 Garage/Accessory ? 20 Public Facility ? 14 Fireplace ? 21 Miscellaneous ? 15 Deck ? 36 Move ? 37 Demolition Const. (Actual) VN Basement sq. ft. MC/WS System 'l? (Aliowable) vg_ Main level sq. fl. City Water ? UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code, y34 Depth Footprint sq. ft. SAC Code v i Census Bldg ? Census Unit U APPROVALS Planning Building 4479- Engineering Variance Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S!W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: Valuation: $ 7- v_- ? 3cY i? = 3?? 47 x 17?` GyI.S16 A s-z?787.Sa % SAC SAC Units CITY USE ONLY L _ L BL ? ? RECEIPT #: ?c2"9 gl SUBD. DATE: 8 (, 4 1996 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? singie family dwellings ? townhomes and condos whe;n permits are required for each unit EJXTURES EACF1 ?Q. IQTAL Shower 3.00 x = Water Closet 3.00 x 1 = Bath Tub 3.00 x _I_ _ Lavatory 3.00 x _j_ _ Kitchen Sink 3.00 :c = Laundry Tray 3.00 :c = Hot Tub/Spa 3.00 :c = Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet " minimum -1 3.00 :t = Rough Openings 1.50 x = Water Softener 5.00 :c = Private Disposal * Dakota cty. license 65.00 = (new and refurbished systems) U.G. Spfinkler ' home under const. 3.00 = -?,?? Alterations ' to existing 20.00 = CYU ' Water Tum Around 20.00 STATE SURCHARGE .50 ?n TOTAL ?1L? SITE ADDRESS: OWNER NAME: INSTALLERNAME: -170,,_. r'lLc._rmn 7 4-1 c,-, 1-?'l c - STREETADDRE5S:1??? EL ???A ioq C-)"- S?, -_- CITY: ?i 1- h?. ? /,--j STATE: Yn k-?- ZIP: ?- PHONE #: (Za (a) Ss'l?l; -.3? ; 7 OFFICE USE ONLY L T Bl _ RECEIPT #: SUBD. 1996 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55722 (612) 681-4675 Please complete for: ? all commerciaVindushial buildings. w mufti-family buildings when separate permits are pgs required for each dweliing unit. DATE: WORK TYPE: NENI CONSTRUCTION DESCRIPTION OF WORK: CONTRACT PRICE: ADD ON REPAIR IS WATER METER REQUIRED7 _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING: WATER FLOW: GPM. ARE FLUSHOMETER:i TO BE INSTALLED? YES NO. FAILURE TO PROVIDE THIS INFORMATION WILL RESULI' IN A DELAY OF METER ISSUANCE. WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM7 YES NO. IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINY:LER PERMiT. FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per $1,000 of Rertnit fee due on all permits. CONTRACT PRICE x 1% STATE SURCHARGE TOTAL S:TEADDP.ES3 TENANT NAME: OWNER NAME: INSTALLER: _ ADORESS: _ cirr: PHONE #: SIGNATURE: OFFICE USE ONLY METER SIZE: DATE: STE. # STATE: ZIP: APPLICANT _ INSPECTOR: 7ae7$q 2006 RESIDENTIAL PLUMBING PERnniT aPPUCaTioN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dweilings. Date -9 1 ?.L 1 Site Street Address Property Owner1 z / C-1 Contracti Address The Applicant is: _ Owner Septic System _ New _ oi#erations to existing dwelling X'Contractor ? efurbished Subm one # V.5? Y3 S -78W State/VA)- Zip -?r-S73 _Other sets of plans and MPC license Per as-built Add plumbing fixtures. This fee includes installation of a water softener and/or water heater at the same time. !f you are installing onl a wafer softener and/or water heater, do not complete this section, move to the next section and check the appliance(s) you are instalhng. _Septic System Abandonment Water Turnaround (add $130.00 if a 5/8" meter is required) Other'. _ Water Softener new Lawn Irrigation ^RPZ State Surcharge v Water Heater replacement PVB _new _repair _rebuild s County fee $ 100.00 $ 10.00 $ 50.00 $ 15.00 $ 30.00 $ 5D Total I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate that the work will be in conformance wiih the ordinances and codes of the City of Eagan and the piumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accorda ce with the approved p an in the event a plan is required to eviewed 7andproved. Ap lic nYs Printed Name Appi cai Ys Signature l.5,s-o Unit # g?? Telephone # J?,S/ ) G'r,3' Z PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA097319 Date Issued: 12/08/2010 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 521 Hackmore Ct Lot: 2 Block: I Addition: Autumn Ridae 03rd PID:10-12302-020-01 Use: Description: Sub Type: e-Windows iDoors Construction Type: Work Type: Windows Doors-New ; Replacement Description: House Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openin,s, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee S3K $88.50 0801.4085 Valuation: 9.690.00 Surcharge - Based on Valuation S3K $1.50 9001.2195 Total: $90.00 Contractor: - Applicant - Owner: hrech Exteriors Inc David J hukura 5866 Blackshire Path 521 Haclanore Ct Inver Grove Heights NIN 55076 Eagan NIN 55123 (61)688-6368 I hereby aeknowledae 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 Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA100181 Date Issued: 07/20/2011 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 521 Hackmore Ct Lot: 2 Block: I Addition: Autumn Ridae 03rd PID: 10-12302-01-020 Use: Description: Sub Type: e-Siding & Windows Doors Construction Type: Work Type: Siding & Windows doors Description: House & Garage Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: When installing ventilated soffit material. remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Improvements to the home require smoke detectors in all bedrooms. If altering window openin,s, call for framing Fee Summary: BL - Base Fee S6K $132.75 0801.4085 Valuation: 44.850.00 Surcharge - Based on Valuation S6K $3.00 9001.2195 Total: $135.75 Contractor: - Applicant - Owner: hrech Exteriors Inc David J hukura 5866 Blackshire Path 521 Haclanore Ct Inver Grove Heights NIN 55076 Eagan NIN 55123 (61)688-6368 I hereby aeknowledae 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 Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA118990 Date Issued:11/13/2013 Permit Category:ePermit Site Address: 521 Hackmore Ct Lot:2 Block: 1 Addition: Autumn Ridge 3rd PID:10-12302-01-020 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . 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 - David J Kukura 521 Hackmore Ct Eagan MN 55123 Krech Exteriors Inc 5866 Blackshire Path Inver Grove Heights MN 55076 (651) 688-6368 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA121429 Date Issued:04/01/2014 Permit Category:ePermit Site Address: 521 Hackmore Ct Lot:2 Block: 1 Addition: Autumn Ridge 3rd PID:10-12302-01-020 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Kenny Henage 640 Grand Avenue Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 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 - David J Kukura 521 Hackmore Ct Eagan MN 55123 (651) 290-1997 St Paul Plumbing & Heating 640 Grand Ave St. Paul MN 55105 (651) 228-9200 Applicant/Permitee: Signature Issued By: Signature 411,11 City of Eau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 MAR 3 01016 r Use BLUE or BLACK Ink For Office Use Permit #: am G� 1 Permit Fee: • C�� 1 Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 3-32-02o/ Site Address: / Unit #: es. t Name:&dkA e. u r^ Phone: ,24,2-a),2-65427 Address / City/ Zip: 4502/ i // .. --r �' % p�/Y1� /�%► MA/ J Applicant is: Owner Contractor i 7 , ype tWork Description of work: r//liYf// W4 / ey Call ' Ypy p91'gc (ice®P) j Construction Cost: 50 gq,5700 Multi -Family Building: Yes / No 171 P Company: ac f1 , CLVS5,1 Contact: `i Address: /g/ / 11/17/ t€P7 2 - City: 4t7k— V 6' » State: Mill Zip: Phone mail: 7 rDy7 L/ .6Wt.) License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: In the last 12 months, Yes No 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? If yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Fire Suppression Contractor: Phone: Phone: Phone: Phone: upporting en 4 at you �c n rnfo y la s n . bl i ' i " e x t re rad rets, 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. A.Ac Kizie /42c.C-� SUB TYPES Foundation ?e-- Single Family Multi 01 of Plex DO NOT WRITE BELOW THIS LINE Fireplace Garage Deck Lower Level WORK TYPES _ New Interior Improvement Addition Move Building Alteration_ Fire Repair Replace Repair Retaining Wall DESCRIPTION Valuation 4" 2,Oo©, Plan Review (25%_ 100% )4 ) Census Code # of Units # of Buildings Type of Construction V3 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Roof: Ice & Water Final y Framing Fireplace: _Rough In Air Test Insulation Sheathing Sheetrock Fire Walls Braced Walls Shower Pan Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Siding Reroof Windows Egress Window Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Accessory Building Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building - give PCA handout to applicant Occupancy .J12 4— 1 MCES System Code Edition m n 2-0 S'r SAC Units Zoning R - 1 City Water Stories Booster Pump Square Feet PRV Length Fire Suppression Required Width Final 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: TO fl"t K11 it , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL k4, A- J t r4'A b )7 vv d-rx Page 2 of 3 1 For Office Use , City of Eapli Permit#: 7k c)--0 0 Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: 4-16 Phone: (651) 675-5675 Staff Fax: (651)675-5694 AP4 2017 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: t7 Site Address' - - • old It - • - . • - Tenant: Suite#: 1 ph cHQ Irtitiodemitiiiiiiiiio Name, Aancia,, 771:4 one. Address/City I ZipMatti "M\[ 19- 3 Name: _Li • - License#: PNI , • Address: lb Ok- ( - City; C State. Zip. Phone. • Contact: '\-0 Email pn()(11) AielL 1111k A 0,,P\ 4,4:sib New Replacement Repair Rebuild Modify Space Work in R.O.W. ' - Description of work: a . 6 . , Olt :4:*34411Z2-1101... RESIDENTIAL Water Heater ---w,VAVA' acMat:rw Water Softener Lawn Irrigation( RPZ PVB) • • Add Plumbing Fixtures( Main/ , Lower Level) • Septic System New Water Turnaround 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 System Abandonment,Water Turnaround*(includes State Surcharge) *Water Turnaround(add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ ,Lpo m 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,copherstateonecall.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 ap. .v, .4 plans, d Ath ts Applicant's Printed Name ppiicant*s Signature FbOFICE USE Reviewed • 0,014*Stie011„ -bit, PERMIT City of Eagan Permit Type:Building Permit Number:EA143943 Date Issued:07/05/2017 Permit Category:ePermit Site Address: 521 Hackmore Ct Lot:2 Block: 1 Addition: Autumn Ridge 3rd PID:10-12302-01-020 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Michael B Golembiesky 521 Hackmore Ct Eagan MN 55123 (815) 520-6971 Mc Exteriors Inc 274 New Brighton Rd St Paul MN 55112 (612) 221-0084 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA160380 Date Issued:03/05/2020 Permit Category:ePermit Site Address: 521 Hackmore Ct Lot:2 Block: 1 Addition: Autumn Ridge 3rd PID:10-12302-01-020 Use: Description: Sub Type:Fireplace Work Type:Gas Insert Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 - Michael B Golembiesky 521 Hackmore Ct Eagan MN 55123 Fireside Hearth & Home 2700 Fairview Ave N Roseville MN 55113 (651) 633-2561 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA174969 Date Issued:03/03/2022 Permit Category:ePermit Site Address: 521 Hackmore Ct Lot:2 Block: 1 Addition: Autumn Ridge 3rd PID:10-12302-01-020 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 - Michael B & Christine M Golembiesky 521 Hackmore Ct Eagan MN 55123 Pella Northland 15300 25th Ave N #100 Plymouth MN 55447 (763) 745-1400 Applicant/Permitee: Signature Issued By: Signature