524 Hackmore Ct
PERMIT
City of Eagan Permit Type: Building
Eaaan. Permit Number: EA098441
Date Issued: 04/04/2011
OR Permit Category: ePermit
41 it~ of E3
E
Site Address: 524 Hackmore Ct
Lot: 6 Block: I Addition: Autumn Ridae 03rd
PID: 10-12302-060-01
Use:
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434- Occupancy :
Zonin,:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector Nva ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee S3K $88.50 0801.4085
Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195
Total: $90.00
Contractor: - Applicant - Owner:
Associated Construction Services Inc Fade N Prouh
1990 ONven Avenue 524 Haclunore Ct
Hastings NIN 55033 Eagan NIN 55123--306
(651) 755-4166
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 Eaaan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
PERMIT
City of Eagan Permit Type: Mechanical
Eaaan. Permit Number: EA098067
Date Issued: 02/23/2011
OR Permit Category: ePermit
40~ it~ of E3
E
Site Address: 524 Hackmore Ct
Lot: 6 Block: I Addition: Autumn Ridae 03rd
PID: 10-12302-060-01
Use:
Description:
Sub Type: e - Furnace
Work Type: New
Description: Furnace
Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson. State Electrical Inspector.
952-445-2840
Janet Mason
122 West - 3rd St
Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
Total: $».00
Contractor: - Applicant - Owner:
Haley Comfort Systems Fare N Prouls
122 West 3rd St 524 Haclunore Ct
Hastings NIN 55033 Eagan NIN 55123--306
(651) 437-0338
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 Cite of Eaaan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
CITY OF EAGAN
° 3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE: ' " li I' iNti
Permit Number: ? '' ? r• 0'4
Date Issued: ? / o / I `' `?
? SITE ADDRESS:
, i i I 1. i I?I I? i' I
? I IIIrIRt li 1111iF iiili
PERMIT SUBTYPE:
1111.1 1 wFt-,
APPLICANT:
liii ?;,?; ? i ??i? . ? . ? ? ? ? ? 1 ??I•
1 6. 1 ,'1 410.1
TYPE OF WORK:
I i Nr?E
Parmk No. Pormh Holder Date Telaphone Y
ELECTRIC
PLUMBING
HVAC
Inspectfon Datr Insp. Commanb
FOOTINGS
FOUND
f?
FFiAMING
ROOFING
ROU(3H
PLUMBING
(51VL,
PLBG
AIR TEST ?
•
1
ROUGH
HEATING ^ ? ' ?
GAS SVC
TEST
'70y
(i p
? '3£?L I?
M?QLw
INSUL
GYP BOARD
FlREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FlNAL
DECK FfG
DECK FINAL
r1j",
?
Wertificate vf cccupanc?
CV1t4 of Cfagan
TcVwrtaceat of lexitbntg 3nOcrtion
This Certifecate issued pursuant to the requirentents of !he Uniform Building Code
certifying that ot the tinre of issuance this structure was in compliance with the various
ortfinnnces of the City regulating buildrng corrstruction or use. For the following:
ux clamifcatim- SF DWG
O-W-r TYvr R3/M I zo4ing astrioi -
Owner o( Suildina DiYM OAM HM IW
sdiw;.g Aaa. 524 HAQQ'M- rJOURT
K?4
Bu1lding OffmaI
swg. Nr,,;t rvo. 23317
R I Type ca,st. Vn
Ad&xssP.O. B(VC 7I+0045, APPIE VALtliY
[,ootity Ib, Bl, AUILM RIDGE 3RD
DatG:
POST IN A CONSPICUOUS PLACE
`C1TY•OF EAGAN
3$30 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS: , ol
' 1 lii,# ! FtIrFrF
t?ll { iljyhl r, ! Iliil !I; f1
PERMIT SUBTYPE:
INSPECTION
;CORD
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
TYPE OF WORK:
f II(aMA',
4
N iJ
f.Otl I 4
d?'.t i 1 r
N9/14J'+9
INSPECTION .• • .A
t; ?k
Irii.It AI 14ItJ t!; i t.I A, I
!'0f11,lt i N 1'f 1;f- 'tl II t
I A 1-4 nl f'l ftl, . ? i 0111
I ; Il:11tKS
IF
L__.=..
Up1Vl'lJAY E N(KANI f MUSr Hf! r,li"i f t !t Ht'fUiti i U C.AN f+F [S?:1ff !s
i'HV 14 111 f11t 1140141"-,M4 1't tif; -1
J
rrr
PermR No. Permk Holder Date Telephone #1
S/W
PLUMBING /(? ? (?3d •?''/
HVAC ( jSt?-?{p
ELECTRIC •-
ELECTRIC
Inapection Dste Inap. Comments
Footings I
7?7
Foundation
Framing
Roofing
Rough Plbg. 3/ 9'y
Rough Htg.
lstil.
Fireplace ?
Finel Htg.
Orsat Test
Final Plbg. -"4"
G? Plbg. Inspector- NoUfy Plumber
Const. Meter
Engr./Plan
Bldg. Final 7 /!
Deck Ftg.
Deck Final
Well
Pr. Disp.
r G r
? ? ?? ;?? ?...? ? -? ??• ?
REQUEST FOR ELECTRICAL INSPECTION
? See msbuchons for compleonq [his fortn on back ot yellow copy.
IPI Z1626 X" Belodv Work Covered by This Request
EB-00001.08
??? af139 a
ew Add Rep. TypeoiBUilding / ApphancesWrted EquipmentWired
Home Range Temporary Service
Duplex Water Heater Elecaic Heatmg
Apt. Bwlding Oryer Loatl Management
Comm./lndustrial ? Furnace Other (Specity)
Farm Air Conditioner
Olher (specify) 06olractor's Ramarkg
Compute lnspection Fee Below
# Dther Fee # ServiceEnbancaSrze Fee # Qrcuits/Feeders Fee
Swimming Pool 0 to Cj0 Amps ao to 100 Amps (.?O
Transformers Above 200 _ Amps / A6ove V - Amps ?-
Slgns Inspedor§ Use Only TOTAL
Irrigation Booms
Special Inspecnon ?
Alarm/COmmunication THIS WSTALLATION MAY BE RED DISCONNECTED IF NOT
O[her Fee COMPLETEU WITHIN tMMON ?
I, the Electrical Inspector, hereby Rough-in v? oate
certifythattheaboveinspechonhas
been made. Flnel ( Date e.
?f
OFFICE USE ONLY
This requast wiC 18 months imm
M1?3/ q y $ p7 -
? 21626
d°6 e? azzL., ill 3114` ak3g0
Request Date Fire o RouBh-in Inspeclion NOTICE: You Musl Call Eledncal Inspeclor
eq red? It A Rough-In Inspection
es ? No Is Requvetl.
10 licensed coniractor ? owner hereby request inspection of above electncal work at:
Job Atldress `Streep/ B'ox or RauleNo
-?"G6?{?LC,i= U
Ci
b
o1?
Sec[ion o Township Name or No flange No. Cou
Occupa (PR Nn PMne No
Power Suppber Address
Elecfncal COonAtra kprypgp C'NC -
1. 1't{Hrv Conlraclor5 Liceqnsep No i,
?
MeJu?q Atl.re?(??n}?ipqg(?rygBrJ?Ael?c?isWllation)
a u r?v???ur•.??ro?.. ?PLE VMIEYl?U agi"
Aulhorrzetl Sign(aW'r CoMrador/(pJy?ner Making Installation)
\ !Y/?-f'
, w'? ?1?? -
Phone MupOer
,'WIWPI
MINNESOTA STATEBOARD OF ELECVTPICITV THIS INSPECTION REOUEST WILL NOT
Grigga-Mstlwey Bldg. - Poom S-173 BE ACCEPTED BVTHE STATE 80ARD
1821 Universily Ave., SL Peul, MN 55106 UNLE55 PROPER INSPECYION fEE IS
Phone(612)Ba2-0800 , ENCLOSED
Address 524 HAMUttE = Zip 5512 3
Lot- , 6_ Blk i Sub atrnm xmcE 3Rn
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date:7// y Yes No Inspector:
Final grade (6" from siding) bl-
Permanent steps (garage) v
Pemianent steps (main entry)
Permanent driveway ?
Permanent gas
Sod/Seeded grass ?
TraiUcurb damage
Porch V
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and ihe shuboff of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. ?
White - City Copy Yellow - Residcnt Copy Pink - Contractor Copy
?a?/?,/ REQUEST FOR ELECTRICAL INSPECTION
j ? See instmceons lor compienng thps form on back ot yellow copy
4 8 8 9 5 - x" Below Work Covered by This Request
y ee-ooom-oe
";?;??-
? ,MS bkv
e" Atld Rtp. TypeoBudding ApphancesWired EquipmentWiretl
Home Range Temporery Service
Dupiex Water Heater EleCtric Heating
Apt. Burlding Dryer Load Manegement
Comm./Indusfrial Furnace Other (Specify)
Farm Air Conditioner
Olher (syecilyl Cqmrador9 Remarks ` _ ^ ^
VP ,r
Compute Inspection Fee Below:
# Other Fee # ServiceEmrance5ize Fea # Gmwts/Feetlers Fee
Swtmming Pool 0 to 200 Amps 0 fo 100 Amps
Transformers Above 200 _ Amps Abova-700 _ Amps
Signs . insPecmrs use onry: T ?
Irn9ation 8ooms ?o
bz?
Special Inspecfion L
niarmiCOmmunication THIS INSTALLATION MAY BE ORDER IF NOT
CONNECTED
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electncal Inspecror, hereby RO°9n.in oa+e
certiry that the above inspection has
been made. F,,,ai ) Date ? I .
OFFlCE USE ONLY
This request vort 18 momhs hom
4 s 8 ? ? ?r- ?`ao°?
Reque9l Data
, l
? ? q y Fre No Rough.ln Inps 'on epuned
(YOU must cell inspector when reaEy)
? Ves ? No Insoeciron Olher Tnen Rough-In
? qeeEy Now ? Will Notdy InspeMr
OeteReaE
licensed contractor ] owner hereby request inspection of above electrical work at:
Job Aaoress ISVeeI Bok r oute No ) ? Qty ?
Section No Townsbip Nama or No Range No CoiWqe
?
, OC
Occ nt IPRINT? , ???,
1 • Phone No ? _ ? ? ? ?
Power SupPlrer Gress
Elecmc Camractor IGOmpany Na eI Comractors L¢ense No
GJA
M?ing Atltlress IComractor oyq.vner Making Installation) ?
y5 q
A iie0 Sgnature (Com m'Owne Making Insialla on,
? 6 ?)a one Number
C4 3
MINN SO A STATE BOAND OF ELECTRI Y THIS INSPECTION REOUEST WILI NOT
Grigga-MlCway 81Eg. - Room 5"3 ? 8E AGGEPTED BV THE STATE BOARD
10Y1 Universrty Ave., 51. Paul. MN 55100 UNLESS PROPER INSPECTION FEE IS
Vlwna(61P) 60P-0800 ENCLOSED
05i16%2007 10:12 EAGqN ENG+COM DEV 3 96519051?45
aor RESIDENTIAL BUTLDY'_?1G.rEMr aprLIcaTtorr
ctey or?agan
3830 Pilot Knob Road, Eagan MAT 55122
Telephone 4 651-675-5675 FAX 0 651-675-5694
Nnw Gns7udan Re¢uvemend
3 r0g4swW silB suNeys Showing sq. ft of bC sq, f[ of house, an0 dl iaofetl aiees
(T6%muimu.n Iot covereg9 allawetl)
1 Sals Rapat It propos2tl LmTdlng 4 t00e placaq p1 d'ftrhed sail
2 mpie+ ol pdan ehaving Cepm 8 wlMGNShes; peuretl fauM deslgn, elc.
t sot ol EreigY CelwmUais
i cOples of Sree PrBaervatmn Plan d lal plal[ed after 7l1193
.aim Jog Dete7 Optiore selaton sheel (oui1E'p V nM 3 ar iess unlsi
Wmnagasco rtetlhaniml umUlation lann
RemcdCURaRR r Reoalremenla
2 mpbs of aian showing foobngs, heam. jasfs
7 set of Energy Cakuiadons ta heamd additlons
t sile wrvm Mr addpbns & decVs
Addklon -lMicele Aon-aAe seWk ayatem
N0.361 002
?/6-o 0
arce u:a On
Certot6wwsyRaD _Y _N
Se1s Repart _Y _N
Tree Pres Plan Recd _Y _N.
TreePres AepuYed ,r _N
On-slle5lpAc5ystem _Y -N
are
untess
Date /0 / 'S ! 07 Consruetion Cosf 43 d fl 0.
Si[eAddress 40.Gk muc3ra. L'7 TJn5tl5te 1i
Tksortptiop of Work RR-?-t?t2.. 4,-
Multi-Family Aldg _ i' _ N
Freplaee(s) _ o ? 1 _ 2
IUd
Property Owner PJ-O vj?c Telephone l 6R )-aD l
L
Window Concepts of MN, Inc.
Cautnclor 990 Lone Oak Road Suite 114 ?
Addres: Eagan, Minnesota 55121 1 Cjty
Toll Free 1-888-712-1733
State _ License # 20163493 >? I ? Telephuoe N(? )
www. win -
THIS ARE/A OMLY IF GpNSTRUCTING A NEW BUILDING
- Minnesot2 Rides 7676 Cateeorv 7 Mmnesota Rules 7672
Ene1y/ Gpde GdtCgOry . Raslaenfial 1/entilation Category 1 Workahaet • New Energy Catle WcrksheeE
[dsuCmissiantypo) Suhmlttetl SuhmltteC
• Energy Envaiope Calcula0ons Submitted
In tne last 12 months, has the City of Eogan issued a permit fa a sindorplan based an a moster plan?
_ Y _ N If yes, date and address of mflster plarc
Ucensed Flumber i? r Telephone #I )
Mechanicol Cantroctar _ InSi n?FT} Teiephone #? )
Sewer/Woter Coniractor
for a
Telephona #( J (
?
that the information is comolete and mccurati
,
rhat d1e work will be in conformance with the ordinances and codes of the City of Eagan und the State of MN
Statu'es; T undexstand this is not a pecruit, but ou[y an applicatson for a permit, and work is not to start without a
penn'.E; that the work will be in accordance wit$ che approved p[an iu the case of work which requires a review and
aPproval of plan9.
&??? A?t?
? f f??,?l? "?,
App cl ant's Printed Name Applicant's Signature
?CI?'Y O? EAGAN
830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
PERMIT y - i ? -qy
PERMITTYPE: BuzLorNG
Permit Number: 023317
DaTe Issued: 0 4/ 1 A/ 9 4
524 HACKMDRE CT
LOT: 6 BLOCK: 1
AUTUmN RIDGE 3RD
DESCRIPTION:
r ,
Building Permit Type SF DWG
Building Wo,rk Type NEW
UBC Occupancy" R-3 M-1
' Constructi.on Type V-N
?Zoning R-1
Building Length ? 58
Building Width ? 38
Building etories ` 2
Li':
? l
REMARKS:
ORIVEWAY ENTRANCE MUST 8E CONCRETE BEFORE C 0 CAN BE ISSUED
PRV S& W PLBR - THOMP50N PLBC --
FEE SUMMARY:
VALUATION $132,000
Base Fee
Plan Review
Surcharge
sac
SAC %
SAC Units
Subtotal
$751.50
$488.48
$66.00
$80@.00
100
1
$2,105.98
MISCEI.LANEOUS $1,828.50
Total Fee $3,934.48
CONTRACTOR: - Applicant - sT. LIC. QWNER:
OASE HOMES, TWOMAS 18945954 0001434 HOMAS OASE HOMES TNC
P 0 BOX 240095 P 0 BOX 240995
APPLE VALLEY MN 55124 APPLE VALLEY MN 55124
(612) 894-5954 (612)683-9253
I hereby acknowledge thet I have read this
infiormation is correct and agree to comply
Statutes and City of Eagan Ordinences.
L
?
APPLICANTlP GNATU J4.efe
application and state that the
with all appliceble State of Mn.
?nria R,uat? 1 ?I.?l
ISSUED B'YTSI NATUF
' CITY OF EAGAN
' 1994 BUILDING PERMIT APPLICATION
/
681-4675 /
. r
r??:,?•. ?:_ 33 J
,11?,?r1 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date ApIrt Valuation of work ? 134;z UC)
Site Address: K ti'nu2,e
STREET SUITE #
Tenant Name: (comrtiercial only)
LOT 1O BIACK SUBD.
/'?I.ITI.I Fvl ??l
Descri tion of work:
The appl i cant i s: ? Owner Contractor ? Other (Describe)
Name L"n?x le s Phone
Property LAST FiRST ?
Owner 1?
'e
Address
STREET ? STE #
City State ZiP
?r>>f?Y'-? Phone (o$3-?a-?-3
Company bi4-c,,-_
'1
? / tT+va 1 (? 01*n ?P S
3 2
Li cense # /?3 Exp
9 S
Contractor .
_
Address ?oU a-?r pt?
City _? da ?A l!e???_ State /t) Zip /1
Company Phone
Architect/
Engineer Name Registration #
Address
City State ZiP
Sewer & water licensed plumber . ? i.c . Processing time for
sewer & water permits is two days once ar a has been approved.
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.
Signature of Applicant:
B
UILDING PERMIT TYP
E OFFICE USE ONLY ' .
? fN
? ,x
?
*
?
?
r __..,..
.,.,,.•
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
% 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessary ? 18 Comm./Ind.
? 04 SF Porch O 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 5f Misc. ? 10 Multi. Add'l. ? 15 Deck ? 20 Publtc Facility
? 21 Miscellaneous
WORK TYPE
lp 31 New ? 33 Alterations 0 35 Tenant Finish ? 37 Demolish
? 32 Addition O 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable) Basement sq. ft
lst F1
s
ft . ?
. MWCC System ?
Cit
W
.
q.
. 1611 ? y
ater
UBC Occupancy .R ?• M.(
Zoning (? 2nd F1. sq. ft.
S ? PRY Required
I
# of Stories a q. Ft. total
Footprint Sq. ft. Booster Pump
Fire Sprinkler
Length ;? 6
Depth : On-site well Census Code
3 ? On-site sewage SAC Code ?L
APPROVALS Census Bldg
Census Unit
Plann9ng Building Assessments
Engineering Variance
REGIUIRED INSPECTIONS
? Site ? Footing ? Framing ? Insulation
? Wallboard ? Final ? Draintile RI Fireplace
Permit fee
S
h veiuresson: g /3 41 ovo
urc
arge
Plan Review
License 7J
MWCC SAC Z6 ,Y sF,r 2 ,1 F
City 5AC / (o X ;a = 3,2 0
Water Conn.
Water Meter 7,1(3 i.2
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
1 ? - 870
Road Unit 5.4
Park Ded. ? ? 7ff
Trails Ded.
Copies
Other
Total : a y, Sx .)u x S g,?)
SAC % zx ? = f,6
SAC uni ts 6???? = P6 9,6
LOT SmtPLY CELCILLI6T fOR RLBIDLT7TZAL
LRtSIT 71FFLICATIO ?
? lOZLDI71/"
?
ROPLRTY bLG11L•t
Z Y
? ?7 /
Dat• et tnzvept ?
nOCVmNT RT ttna
?O O • Registered I,snd 8urveyez siqnntuz* wnd eompaay
L1? 0 0 • 8uildinq Permft 1lpplieant '
$? 0 D • Leqal deseription
D D • 1ledress
0 0 • North azrow and bar scale
•
•
C O • House type (tambler, ralkout, split M/o, split
r lookout, etc.)
II D D • Dizeetionnl drs3nsqs arrows rith slope/qzadiRnt !.
H? D 0 • 8roposed/existinq sewer aad water •ezvicet
8?'?0 0 • Street name
I? D 0 • Dzivevay
tLL711T20NB
lxistine
fl D 0 • bewez •erviee
0, D 0 • Lot corness
Lr D 0 • Top of curb at the driveaay
b 0 0 • Elevetions oi any txisting ndjaeent homee
proeesed
Dr'*?D D • Garage llooz D''D 0 • Fizat floor
LY 0 0 • Lovest exposed elevation (ws2kout/vindov)
Q? 0 D • Fzoperty cozners
p? D 0 • Frcat end zeez ef Aom* at the founastion
pONDINO ARE718 (it aaipl,itable)
13 a ?Da 0 ?Lement 1ir+e
0 d • xwi.
0 0 • Pond I designation
G O'0 • L7eezpency overi3ov Ll:vetion
airnxe=o?vs
lntry,
? 0
? 0 • I?ot lines
0
0
VD 0
0 • Riqht-of-vsy anQ striitt widtA (to Dack of enrb)
• FzoposeE bome dimerssions inclualnq any proposed -aeeks,
overhnnqs qreater than 21, porches, stc. (i.e. all
/ struetuzes requiring peneanent iootinqs) •
D 0 O • 6naw all eesementa of zecord and any City utilities vithin
those easements
Q? D 0 • Setbaeks of propoaee strueture nnd setbeek of edjacent
existing hoa,es ,
D 0 • Retaininq w quizements, if any
Revieved: ?S
Nn e / Date_
V1CES SNALL 9E 1 PEK i TrL
4LL SERVICES 15' INTO THE I.OTS.
3EWER SERMCE E
S CIP
,? 26 UNLESS MAINLINE ?I ?
'.TAiL
? E pR1VE SNAL.L BE 3' CUTSIDE THE ?DE
p,LL pT1-IER CURB S70PS AND CLEANQUTS
QN TME a/w ur+E.
- CONNECT TO
EX{STtNG STUB
2.
Ta;r GI'i Y OF E AN DOES N0 "Gi
THE ACCUR QF UTILIT L
AKD'OR ELOWOIVS. THIS AT,
'N[--OR!="ATIOPd PURPOSES
?':?RSG;!S UCIIUG I?T?SHOULD UE
?O?`,? ON T'jC'J: vITt.
W
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Q
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CS- 92E
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HACKMCRE DR1VE EX-,ENp g- W. !?, jFROM TEE ----
cffaFT 260' TO PROFERTY UNE. r -, r
MAINTA{N 7.5' MIN. COVER,} .
PLUG END.
L
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F"
iach GRAPHIC SCALE iN F'EET CO Ul-? 1 a 50 feet HAcKMORE . . . . . . . . . . . ...
.....................:.........:. . • . . ... .. _..: ??.v?.
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: : . . , THE CITY 0 EAG N DOES iVOT GUARAiUTEE
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EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER p PCa`c l X'
SITE ADDRESS
CONTRACTOR 7?? ,p S DATE /( ?!-? PHONE 6S 'Fo)?3
?tr?o1?C3`(
Determine working square footage of each
1. Total exposed wall area...... o1.?S5 sq. ft. x.(( ° I'?S?ySf
2. Total roof/ceiling area...... 1 S y,5 sq. ft. x,p,?6 = I ?/d f'7 I
Total exposed wall area above floor
a. Total wall window area ...............................
.?
b. Total door area ..........................:............_?s . 53?
c. Total sliding glass door area ......................... d. Total fireplace wall area ............................
e. Total wall framing area (average 10%) .................
f. Total net wall area above floor ...................... .1fl,ycr,y
g. Total rim joist area ................................ / &4
Total exposed foundation area _Vk •
h. Total foundation window area ....................:.....
i. Total net foundation area above grade .................
Determine "U" value of each wall segment.
a. / S.Z . .2 I x"U?? ? ;L I = 3 ( • `?' ?,
b._ x"v° ? 067 = 3.os
C. 2- Z X„U„ ,a5- = B. L)?
a. X"u" ,038 = 1•71
e. 7tnIIn . 07 I = ? ?O < !.'Z
f. ig???.`t i X"U" ?038 = 7o.a?'
g. !(og X"U'1
h. xnU°
i. Xllv„
3 ......................................Tota1 ?
If item l13 is the same as, or less than item 411, you have met the intent
of SBC 6006(c)2.
Total exposed roof/ceiling area = LS--yS--
j. Total skylight area ..............
k. Total roof/ceiling framing area (average 10Y,)..
1. Total net insulated roof/ceiling area.......... J?S-y 5--
Determine "U" value for each roof/ceiling segment.
3-
x"U"
k. XnUa _
1. /S y5 eU"_ ?va( = 3?.YS
4 .................................Tota1 = 3 Z. -C 5
If total of 4k4 is the same as, or less than I12, you have met the intent of
513C 6006(c)1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the
sum of items (l3 and /14 shall not be greater than the sum of items lll arid 112.
1. -27_ O,S + 2. `Y L . / 7 _ 'Z Z Z
+ 4. 7j
.
??
? CITY OF EAGAN PERMIT
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
c? ?-.?? I.?'
PERMITTYPE: BurLorNG
PermitNumber: 025609
Date Issued: 0 6/ 0 7/ 9 5
SITE ADDRESS:
524 HACKMORE CT
LOT: 6 BLOCK: 1
AUTUMN RTOGE 3RD
DESCRIPTION:
r
Building.?Permit Type DECK
rBuilding Wor,k Type NEW
.?
?
, -,?•k ; ., :i,,'y,;• '_.?. ?<;t
REMARKS:
FEE SUMMARY:
Base Fes
Surcharge
Lic. Search
Subtotal
$30.00
$.50
Fee $5.00
$35.50
COPY $.50
TotaJ, Fee $36.00
CONTRACTOR: - flpplicant - sT. Lzc OWNER:
HUTTNER CONST, WILLIAM 14523088 0001653 WM HUTTNER CONST
960 WATERFORD DR W 960 WATERFORD DR W
EAGAN MN 55123 EAGAN MN 55123
(612) 723-4161 (612)452-3088
?
I hereby aeknowledge that I have read this applicetibn and"state that the
information is correct and agres to comply with all applicable State ofi Mn,
Statutes and City of Eagan Ordinances. `
APPLICANT/PERMITEE SIGNATURE
?.1 m.
ISSUE SIG TURE
CITY OF EAGAN ?
a 5 b? ? 1995 BUILDING PERMIT APPLBICATION (RESIDENTIAL) 43?'
/`? . r, ,. ,r^
681-4675 '
?
w
New Constructien Reauirements Remodel/Renair Requirements
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plans (include beam 6 window saes; poured fitl. design; etc.) ? 2 site suneys (ezterlor additions & dedcs)
? 1 energy calwlatiom ? 1 energy calculations tor heated addRfons
? 3 copies of tree preservatbn plan M lot platted after 711/93
requircd: Ye6 _ No
DATE: CONSTRUCTION COST:
DESCRIPTION OF WORK: lJE
STREET ADDRESS: ' s2 `LOT _t/,? - BLOCK ?
SUBD.iP.I.D. #:
PROPERTY Name: ?TLP31(,?' L111/b Phone #:
OWNER •w"
Street Address•
City: State: Zip:
CONTRACTOR Company: P h o n e #: 44 z-
Street Address: Y/!i C!/?????-(J Uf 6? License
City: State: /Mk Zip.
ARCHITECTI Company: Phone #ENGINEER
Name: Registration #Street Address-
City: State: Zip:
Sewer & water licensed plumber: rY/ . Penalty applies when address change and lot
change are requested once permit is iss d.
I hereby acknowledge that 1 have read this application and state that the infortnatlon is corcect nd agree to compty with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: _
OFFICE USE ONLY
Certificates of Survey Received
_ Yes _ No
Tree Preservation Plan Received Yes No
G? E C l-
MAY 15 19aF
---------------
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex
a 02 SF Dwelling ? 07 4-plex
0 03 SF Addition o OS 8-plex
? 04 SF Porch o 09 12-plex
? 05 SF Misc. ? 10 _ plex
WORK TYPE
?-31 New o 33 ARerations
0 32 Addition ? 34 Repair
GENERAL INFORMATION
0 11 Apt./Lodging ?
0 12 Multi Repair/Rem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
,"5 Deck
? 36 Move
? 37 Demolition
Const. (Actual) Basement sq. ft.
(Allowable) Main level sq. ft.
UBC Or,cupancy sq. ft.
Zoning sq. ft.
# of Stories sq. ft.
Length sq. ft.
Depth Footprint sq. ft.
APPROVALS
Planning Building
Engineering
Variance
y3y
?
0
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
CRy SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SNV Surcharge
Treatmerrt PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies . SD
Total:
?
Valuation: $ /Z?O
I • n
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bidg
Census Unit
% SAC
SAC Units
1994 MECHAHICAL PERMIT (RESIDENTIAL)
6 CITY OF EAGAN
? 6 3830 PILOT KNOB RD
? EAGAN MN 55122
1xa?v? ` (612) 6814675
0
PLEASE COMPLETE FOR SINGLE FAMII,Y DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTI'S ARE REQUIltED FOR EACH UNTT.
NEW CONSTRUCTION
X ADD-ON A/C
ADD-ON FURNACE
FIREPLACE INSERT
DATE
FEES
HVAC: 0.100 M BTU $ 24.00
ADDTTIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1@ 53.00 EACH)
ADD-ON/REMODEL (MsTttvG coNSTxUCTtOrr) $ 20.00
STATE SURCHARGE
TOTAL
SITB
.50
o'?b • 50
OWNER NAME: oc,S ?i ,/L% TELEPHONE #:
INST
c?
Z/i -
CITY: 167;1_f' Uv STATE: ZIP CODE: ?J?SC 7
TELEPHONE #: 1-IS?? ?IID?I??_
SIG14ATURE OF PERMTI'TEE
q-,?5=9?/ dJ?
PLEASE COMPLETE FOR ALL CONIlMERCIAL/INDUSTRIAL BUII.DINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUII.DINGS WHEN SEPARATE
PERMITS ARE NOT REQUII2ED FOR EACH DWELLING UNIT.
DATE:
NEW BUII.DING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
CONTI2ACI' PRICE: $
1% OF ???FEE
R:O?'z::S:
PROCESSED PIPING:
MINIMUM FEE:
STATESURCHqRGE
TOTAL
FEES
$
$25.00
$25.00
$.50 FOR EACH $1,000 OF FEE,
$
SITE ADDRFSS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IMpROVEMENI'S oNL1)
INSTALLER:
ADDRESS:
CTfI':
TELEPHONE #:
STATE: ZIP CODE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
1994 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
?
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNI-IOMES AND
CONDOS WHEN PERMTTS ARE REQUIRED FOR EACH UNTT.
STATE SURCHARGE
TOTAL:
NO. FIXTCiRES
I SHOWER
? WA'TER CLOSET
BATH TUB
? LAVATORY
HITCHEN SINK
' i ....,.Tr,r,v = ev Loo,S},?o,"'?
HOT TUB/SPA
= WATER HEATER
FLOOR DRAIN
? GAS PIPING OUTLET • minimum - t
? ROUGH OPENINGS
WATER SOfiTENER
PF2IVATE DISP. • Dak.Cry.lic.
U.G. SPRINKLER • home under const.
ALTERATIONS - lo existinS
WATER TURN AROUND
EACH TUTAL
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
1.50
5.00
20.00
3.00
20.00
20.00
6 <Ql?.
?,z?o
.50
SITE ADDRESS: J'c-AL/
OWNER NAME: -P10man1 I41mud
PHONE #: (, ia ) 9?'a- `7`71 `7
?! ),t m? ?Ll/ritP.2JZ _
SIGNATURE OF PEF2MI:TTEE
1994 PLUMBING PERMTf (RESIDENTIAL)
CITY O.F EAGAN .
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
CITY: A.4,nvr?Cti? STATE: M? ZIP CODE• -5?-?
V
PLEASE COMPLETE FOR ALL COMIVIERCIAL/INDL'JSTRIAL BUILDINGS. ALSO FOR IGIULTI-
FAMILY BUILDINGS WHEN SEPARATE PERM'ITS 'ARE NOT REQi7IRED FOR EACH
DWELLING UNTT.
_ NEW CONSTRUCTION
ADD ON
_ REPAIR
WORK DESCRIPTION:
CONTRACT PItICE: $
rrc: i% oF corrrxncr FEE.
STATC SURCHARGE: $.50 FOR EACH $1;000 OFf" FEE.
DtINIAtUA1 FEE: $ 25.00
CONTRACT PRICE X 1% $
STATE SURCHARGE $
TOTAL S
SITE ADDRESS:
TENANT NAME: - - STE. #
OWNER NAME:
INSTALLER:
ADDRESS: • - • - • •• •
CITY:
PAONE #:
; STATE: ` - ZIP CODE:
FOR:
CITY OF EAGAN AP-PLICANT
1994 PLUMBING PERMIT` (COMMERCIAL)
CFI'Y OF EAGAN
3830"PILOT KNOB, RD
EAGAN'MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUII2ED FOR EACH UNTT.
? NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE
FIREPLACE I ERT
DATE FEES
HVAC: 0-100 M BTU 24.00
ADDITIONAL 50 M BTU .00
GAS OUTLETS (MINIMUM 1 @ $3.00 EACH)
ADD-ON/REMODEL (ExisTING CoNSTRUCt'ioN) $ 20.00
STATE SURCHARGE .50
TOTAL
3 SG
o -
SITE ADDRESS:
OWNER
TRi.F.PHONE #: he3 - 9 2S3
VALLEY HEATING & AIR
CITY: STATE: ZIP CODE:
TELEPHONE #:
AZJLZL?
IGNATURE OF PERMITTEE
i"a MEcHarnc.a,i, rExMrr (REsIDErTInr.)
CTfY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 651-4675
PLEASE COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTfER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMTTS ARE NOT REQUIltED FOR EACH DWELLING UNIT.
DATE:
CONTRACT PRICE:
NEW BUILDING
INfiERIOR R4PROVEMENT
WORK DESCRII'TION:
FEES
1% OF WNTERAFEE
PROCFSSED PIPING: $25.00
IvIINIMUM FEE: $25.00
STAT'E SURCHARGE $.50 FOR EACH $1,000 OF FEE.
TOTAL $
STI'E ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IINPROVEMENTS ONLI)
INSTALLER:
ADDRESS:
C1T1': STATE: ZIP CODE:
TELEPHONE #:
SIGNATURE OF PERMITTEE CTI'Y INSPEGTOR
1994 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 651-4675
?.??J ?
,. ?
? o0
U-4c_?
2007RESIDENTIAL BUILDING rERMiT arrLicnTroN
City Of Eagan
3830 Pilot Knob Road, Eagan iVIN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Cons[mcUOn Reauirements
3 regis[ered site surveys showirig sq H of lot, sq. ft of house; and all roofetl areas
(20%maximum lotcoeerage ailowed)
1 Sals Report rf proposed building is fo be placed on disNrbed soil
2 copies of plan showing beam & vnndow sizes; poured found design, etc.
1 set of Ener9y Calcula6ons
3 copies of Tree Preservabon Plan if IU platted aRer 771793
Rim Jast Detail Ophons selection sheet (buildingswith 3 orless umts)
Minnegasco mechanical venfdation fortn
RemodellReoair Reamrements
2 copies of plan showing footings, beams, joists
1 sel of Energy Calculahons for healed addAions
1 site survey for additions 8 decks
Adddion - ind'rate if on-sife septic system
,6 ` c, o
cikc__c?_
Olfice UseDnN
CenofSurveyRec_Y _N
So,ilsitepat:.„
Tre`eFies Pan Recd-- a;'YN.
Tree'6esR,e9uiiCd,-::'-
On-siteSeptic5yslem,-. i^Y;;_N
I
?
?2 i???.?
Date 6?7 f 10J / oZ.?'? ? Construction Cost '
Site Address Unit/Ste #
i
i
tion of Work
scri
D
e
p
i?
Multi-Ramily Bldg _ Y_ N Fireplace(s) _ 0 Z
Owner T `^'-1 'Pr Q L,A Telephone # ( G5-1) '7
Pro
ert
p
y
I
Window Concepts of MN, Inc.
p
contraccor 990 Lone Oak Road Suite 114
51` ?? o
ls
pddress Eagan, Minnesota 55121 City
License # 20163493 Telephone # ( ) ?
state
_
www.windowconceptsmn.com
?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilallon Category 1 Worksheet • New Energy Code Works
(v suSrissian :ype) Submi[ted Submitted
. Energy Envelope Calculalions Submiited
In ihe last 12 months, has ihe CiTy of Eagan issued a permit for a simiiar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber Telephone #( J
Mechanical Contractor Telephone # ( )
Sewer/WaterContractor Telephone#( ?
-'I hereby apply for a Residential Building Permit and ackiiowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the Siate of MN
Statutes; I understand this is not a permit, but only an application for a pennit, and work is not to stait without a
permit; that the work will be in accordance with the approved plan in the case of work which requires alreview and
approval of plans. ?e
ea-rb l m a n &__?/ ?r`""? i
(?
ApplicanPs Printed Name Applicant's Signature
Lv a.v a .....?....?.....? .. ?___.. _'"'_
Sub Tvaes
? 01 Foundation
?
07
05-plex
?
13
16-plex
?
20
Pool ?
30
Accessory Bldg
? 02 SF Dwelling ? O8 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext Alt -Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. AR - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo/pergola) ? 36 Multi Misc
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvnes
? 31 New ? 35
? 32 Addition ? 36
? 33 Alteration ? 37
? 34 Replacement
- DBSCrIDYiOII:- WaterDamage`Yes
Valuation
Plan Review
Census Code
SAC Units
# of Units
# of Bldgs
Type of Const
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Width
Foo[ings (new bldg)
Footings (deck)
Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
Framing
_ Fireplace _ R.L _ Air Test _ Final
lnsulation
Approved By:
REQUII2ED INSPECTIONS
Sheetrock Final/C.O.
Final/No C.O.
HVAC
Other
Pool Ftgs Air/Gas Tests Final
Siding _ Stucco Lath _ Stone La[h _E
W indows
Retaining Wall
Building Inspecfor
Base Fee
Surcharge
Plan Review
MGES SAC
City SAC
Utiliry Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Int Improvement ? 38 Demolish Interior ? 44 Siding ?
Move Building ? 42 Demolish Foundation ? 45 Fire Re air,
Demolish Building' ? 43 Reroof `rvl 46 Windows! i ors
*Demoii[ion (Entire Bldg) - Giva PCA handout to applicant
Occupancy MCES System
100% Or 25%
Use BLUE or BLACK Ink
For Office Use
2- o 12 q
Ea~ I Permit#:
City of Ea
I Permit Fee: 6 00
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:1
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: 24 I
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: l432s-~
Tenant: Suite
RESIDENT/ OWNER Name: ~s Phone:
Address / City / Zip: 4ec Y~-
Applicant is: Owner X Contractor
TYPE OF WORK Description of work: r. y e-) F~(
Construction Cost: a2 J Multi-Family Building: (Yes / No )
CONTRACTOR
Name:. 311,,%L S ~ ~~<<~ ;vGt Q rj License SA31179
Address:O
City: State: Zip:
Phone: ~j.2''Ufl rCJ O Contact Person: --FZ)-<e ,dh YZ(l
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
conclude that the are trade 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.gopherstateonecall.org
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 CC-M ~)5c x
Applicant's Printed Name Applica 's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type: Building
Eagan. Permit Number: EA095296
Date Issued: 08/05/2010
OR Permit Category: ePermit
41~ it~ of E3
E
Site Address: 524 Hackmore Ct
Lot: 6 Block: I Addition: Autumn Ridae 03rd
PID:10-12302-060-01
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: 3,000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195
Total: $90.00
Contractor: - Applicant - Owner:
Sears Home Improvement Products Fade N Prouh
2700 Winter Street NE, Suite 1 524 Haclunore Ct
Minneapolis NIN 55413 Eagan MN 55123--306
(763) 537-774
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
n
Use BLUE or BLACK Ink
I For Office U/se~) I
I Permit
City of Eap I Permit Fee: `f -7-
3830 Pilot Knob Road I
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675
x % t I Staff:
Fax: (651) 675-5694 _ I I
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Z~ /`7 .&I-se ~-c COQ Unit
Name: E/-PV1 G 4^w. ~ f e- I' Olt ✓f<X Phone: '6
RESIDENT /
OWNER Address/ City / Zip:._ q--f- Q -r Siff
Applicant is: Owner X- Contractor r
Description of work: rPw.d~
TYPE OF WORK
Construction Cost-Of-7 Multi-Family Building: (Yes / No 1!)
Company: k 1 Cam//OX4W Contact: T,@ A A4eVk-t -
CONTRACTOR Address: ob t f C~44ill 4f*- City: '-PAW'6-mod'
State: A10-- Zip: SIG Phone: GT-1 5T/-! 2.7 C,4
License VC ~Lo x13 z- Lead Certificate /,-'-'4T- 2.95-r 1
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
IbL
/97J? A111'r /'V /95i~
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
conclude that the are trade 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. _.nrvtr :Fstateonera!l orc~
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 issuan .
~f l&4,1 x
x e /1 et/.
Applicants Printed Name Appli s ignature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace _ Porch (3-Season) T Storm Damage
Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
Multi _ 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 building - give PCA handout to applicant
DESCRIPTION
Valuation 3c~~ Occupancy I R G 2 MCES System
Plan Review Code Edition X Ag7 SAC Units
(25%_ 100%_k~ Zoning IZ -1 City Water
Census Code N 3 4 Stories Booster Pump
# of Units / Square Feet PRV
# of Buildings i 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 -A4- 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
01
RESIDENTIAL FEES
Base Fee 6=
Surcharge
Plan Review rj T3
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
Use BLUE or BLACK Ink
r
For Office Use
I I
Ann Permit v 1
oc,
City of EaEd
I Permit Fee: I
3830 Pilot Knob Road I
Eagan MN 55122 I Date Received: 2
Phone: (651) 675-5675 I I
Staff:
Fax: (651) 675-5694 L
2012 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: Z H ~t C k lam-, / t c- Tenant: Suite
RESIDENT / OWNER Name: c~~G C lG !~-f Phone:
Address / City / Zip: ' ~l G6~r y c
Name: _r-;,ex pet °u~ pl ter,~~ 1Z~ License
CONTRACTOR Address: Z ° Z ~GK s s r¢ v City: Z<-- k -t-~,' t lc
State: _4' Zip: 5-5 Phone: Z 7,-,/ 7 2_
Contact: ter- Email: -F--~Cy 4, /6,
TYPE OF WORK - New - Replacement _ Repair Rebuild _ Modify Space - Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation RPZ PVB)
PERMIT TYPE Add Plumbing Fixtures Main Lower Level)
Septic System
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (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 $189.00 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.gopherstateonecall.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.
x Cr 1f'- e-, 1~ G ~7~ x zl:f ~
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final