523 Hackmore Dr.?
(NJ-ertiiica#e of cccupanc?
??m of
zqartmeur o? Vai[bnig 3xiopccrion
This Certificate issued pursuant to the requiremenis of the Uniform Suilding Code
certifyireg that a1 the time o}essuance this structure was in compliarece with the variaus
ordinances af 1he City regulating building canstructeon or use. For the folloFVing:
Use Ciassification: V DX Bld?nnit No. _224 U--:?
pccupancY'Iype RI&() Zoning Dimict Type Const.
Owner of Building Adttress 14450 R? IU RWr$ IVUL&
Bui6diog Address 523- _.D-R7T1Q Locality y.;B3--AIMM-RcMCE 3RD
, i
09,402,194
Buildi;g Official ` ..
POST IN A CONSPICUOUS PLAGE ,???
, .
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
i ? IIMM !r I(??it tkU
PERMIT SUBTYPE:
APPLICANT:
1. , ,.+ ,1 ,
1 to i ,'. } rl'44 .'+,
TYPE OF WORK:
e//9*?9
L/P , ?ccs -?s3a 7
INSPECTION .. . .•
i i
? r!
I I ' ;irlki, 1. t {'I
j'coRn
PERMIT TYPE:
Permit Number:
Date Issued:
1' i tiH - fl C!q f c: ?1
INSPECTIQN
I1-
Permit No. Permft Holder Date Te{ephone #
S/1N
PLUMBING
HVAC
ELECTRIC,
EIECTRIC
Inspection Date Insp. Comments
Footings I
Foundation z Z ? ? jv Sr 3" Q
Framing I ? `1
Roating
Rough Pibg. 7' J
/ n J .It ?j
Rough Htg.
Isul. Q
?replace I -
Fnel Htg. !? ?f--'l?/J
r !l,fY
Orsat Tesl
Fnal Plbg. _?,? • ,f./,t Plbg. Inspector - Notfly Plumber
Const. Meter
Engr./Plan
Bldg. Final
GO 1
Deck Ftg.
DeCk Final
Well
Pr. pisp.
-P I
a-.? %Yl 73 ,W /.
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
? 14 i? ?I ., Li
I PERMIT SUBTYPE:
lillI lNli'.
f NA?
PERMIT TYPE: " " I t f' I Nii
Permit Number: r? •'','? tv'
Date Issued: ?' ?.?' i b j:) `;
APPLICANT:
t Ett ?,?
' r??,?? ?.??, F? s?:,?.
TYPE OF WQRK:
'-- .?. ..
i'{, hM I PJ1I
F
?
? ?
Permit No. Permtt Holds? Date Telephone !
ELECTRIC
PLUMBING
HVAC
Inspwtfon Date Inap. Commenb
FOOTINOS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FlNAL HTG
ORSAT
TEST
BLDG FINAL ?G• ? ?
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAI
9 o2y ?j? REQUEST FOR ELECTRICAL INSPECTION °""?"4 Ee-00001-09
?' ^
032256 ? Sea ingmclions tor complabng thle form on back of yellav cropy. ??`,- ?° ??f.r+
"X" Below Work Covered by This Request ?•1j ?.
Ne Add Rep. Type of Bullding Appliances Wired Equipment Wired
Home Range Temporary Service
Du lex Water Heater Electric Heatin
Apt. Building Dryer Load Management
Comm./Industrial Fumace Other (S ecify)
Farm Air Conditioner
Other (specily) Contracror's Remerks
Compute Inspectian Fee Below: OFF pep'tic-
# Other Fee # Service Entrence Size Fee # Circuits/Feeders Fae
5wimming Pool 0 to 200 Amps 0 to 100 Am s
Transformers Abave 200_Amps . A6ove 100 -Amps
Si ItS inspector's Uee Oniy. TOTAL
Irrigation 8ooms ? -OC ;tCF* rD
S ecial Ins ection
Alarm/Communication THIS INSTALLATION MAY BE ORDEHED DISCONNECTED IF NOT
Other Fee SJ COMPLETED WITNIN 78 MONTHS.
I, the Electrical Inspector, hereby
cedify that the above inspection has
been made. Rough-In
F;nai oare
ce
OFFICE USE ONLV ?
Thls requeat wid 18 months Irom
?093?2 5 6 ? j?55?
~
Requsal Date
Ffre No
a_? n
? Roughdn Inspedion R u e
(YOU must cali Inspedor when reetly)
? Yea 0 No Inepectlon OtharThen Roughdn
qeaGy Now ? Wiil Notlty InspMOr
? Reatl
I'0 licensed contractor ? owner hereby request inspection ot above electricel work at
Job Atltlress (Slreet, 6oa or Route No ) CITy
3 rw Y. ??s-&Zn
Sectlon No Township Nams or No Renge No. Counry
K
Occupent(PRINT) Phone No.
h 1
PowerSuppheTr
? b Atltlress
Electncal Convactor(COmpany Name) Contraclofs Lkense No.
y
Mailing AGtlress ( retlor or Owner Making Installatbn)
? ? -5S
Author SignaNre (COntrac Owner M Indallalion) ? Phone Number
MINNESOTA STATE BOAR CTRICITY THIS INSPECTION REQUEST WILL NOT
Grlgga-Mltlway Bltlg. - Roo •1P8 BE ACCEPTED 8V THE STATE BOAFD
1821 Unlverelty Ave., SI. Paul, MN 55101 UNLESS PROPER INSPECTIDN FEE IS
Phone (812) 6024M O?b p?/ll - J ENCLOSED
J-lo -Y /1?07<a
m 71 33
8 4 -?
?
"-rl
cxitk5 °o
Request Date
re No.
Fl
Rough-in Inspe ion
'
NOTICE:
You Musl Call Electncal Inspecror
?
?^
_ RequireE II A Rough-In Inspeclion
..J es ? N. Is Reqwretl
I.er-ricensed coniractor ? owner hereby request inspection of above electrical work at:
Job AdOress (Street, 6ox ar Route No Qty
?
Sechon No.
Township Neme or o
Renge No
Coun 61
Occupen? ? IMj
1L Phone I'JO.
Power her Adtlress ?
?l
EI¢clnual Contrador (COmpany Nflme) r Contr r5 License No,
DO
MaNng Address (Conh clor or Owner Makmg Inslall on)
Ci?
? /
AuthorizSignature (ConVaclorl wner Making Installation
- 14- Phorie Number
is, - 3 T ?
NNESOTA STATE eOApD OF EIECTpICITV THIS INSPECTION REQUEST WILL NOT
lggsMiEway Bltlg. - Room S7]3 9E ACCEPTED BYTHE STFTE BOARD
1821 Unlverolty Ave., SL Paul, MN 55100 UNLESS PFOPER MSPEGTION FEE IS
Pnone (612) 642-0800 ENCLOSED
,_? - y r L REQUEST FOR ELECTRICAL INSPECTION
p? T pp ? See jpsWCkons br cumpleting ihis (orm on back of yellow copy
lol .
713 O?F `X" Be/ow Work Covered by This Request
EB-00001-08
i
e Add Rep. Typeofeuildmg ApphancesWired EquipmeniWired
Home Range Temporary Service
Duplex Water Heater Electric Heann
Apt Bwlding Dryer Load Managemem
Comm./Industrial Fumace Other (Specry)
Farm Air Conditioner
Olher (spaoiy) CanVactor's Remarks
Compute Inspecaon Fee Below:
# Other Fee # ServiceEn[ranceSize Fee # Cimwls/Feeders Fee
Swimming Pool 0 ro 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
S19p5 Inspectar5 Use Only 'r(J TOTAL
Irrigation Booms ? '?
Special Inspection
Alarm/CommunicaLon THIS INSTALLATION BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electncal Inspecror, hereby Rough--m J
certifythattheaboveinspectionhas
6een made. J
F,,,ai
OFFICE USE ONLY
This request voitl 18 months Imm
0- 9?
046
a
40
Requesl a[e I??
?? Fve o Rough-In InspocLOn Requiretl ns ectmn Other Than RougM1-In
(VOU m call mspector when reatly ? qeatly Now ?WAI Nolity Inspector
es ? N. Dete Read
I? licensed cornractor Tyewner hereby request inspection of above elechical work at:
Job Atltlress (Slreel, Bo or aute Na j Gty
u?o?3 ?ekml r'.
Seclmn No Township Name or No, Range N. County
Occ RINT,
l?n
elij Phone Na
Power Suppher Atltlress
Eleqr¢ 1 Controctor (COmOany Name) Contrectors Lmanse No
OVh eo w n P.r
Me01ng Atldress (Conhaclor or Owner Making Instellation)
0Lj V
Fuihonzed g Wre onlraclorlOwn r Makmg Iretalletwn) . Phone Number
MINNE50 A STATE BOAflO OF ELECTHICITY
I THIS INSPEGTION FEOUEST WILL NOT
4011 - Eway Bltlg. - Foom 5120 II I I II I I I I I I BE ACCEPTED 8Y THE STATE BOAPD
182 University Ave., SI. Paul, MN 55104 ? UNLESS PROPER INSPECTION FEE IS
Phoire (6141642-0800 ? ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION Vrg?%- ee-oroooi-o/g
OV Y/ ? Sea instructions for complenng ihis form on back oi yellow copy ? ?'yJ ?LG
8/?/g5' "X" eeJOw Work Covered by This Request ?
Ne A d Rep. Type of Builtling Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (Speci )
Farm Air Conditioner
Olher (spenty) Conrcacmr's
Compute lnspection Fee Below:
# Other Fee # Service Entrence Size Fee k Circuils/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Am s
Transformers Above 200_Amps Above 100 -Amps
S19nS tnspectar's Use only ToTL S,F-
Irrigation Booms
Special Ins ection
AlarmlCommunication THIS INSTALLATION MAY ORDE DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 1 ON
I, the Electrical Inspector, hereby
dd
h
h
b R°uyn-in ? oaee
ce
y t
ai t
e a
ove inspection has
been made
OFFlCE USE ONLY
This request wid 18 monfis !mm
Address 523 HACKM3PE n?uvE Zip 5512 3
I.ot " 1 Blk 3 Sub AUIiIlmr BmGE 3RD ?
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: 02/02194 Yes No Inspector: 4-IJ49
Final grade (6" from siding)
Petmanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas ?
Sod/Seeded grass ?
TraiUcurb damage d
Porch
Basement finish
Deck v
Please verify with the builder the temoval of roof test caps from the plumbing system and Ihe shut-off of water supply [o
the outside lawn faucet before freeze potential exists.
Contact engineering division a[ 681-4645 before working in rightof-way or installing underground sprinlcler system.
White - City Copy Yellow - Resident Copy Pink - Contracar Copy ?
PERMIT
-?i CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
ck.004
PERMITTYPE: suzLozNG
Permit Number: 0 2 5 9 3 7
Date Issued: 0 6/ 3 0 J 9 5
SITE ADDRESS:
523 HACKMORE DR
LOT: 1 BLOCK: 3
AUTUMN RIDGE 3RD
P.I.N.: 10-12302-010-03
DESCRIPTION:
? (SCREENEO)
8"uildin6_Permit Type SF PORCH
?uil.ding WQ.rk Type NEW
...
?
f,
M
f{:w, .._, ... -.. __ . .
REMARKS:
A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK
FEE SUMMARY:
VALUA7ION
Base Fee
Surcharge
Total Fee
$99.75
$2.50
$102.25
CONTRACTOR:
$5,000
OWNER: - Applicant -
BIALKE JOHN
523 HRCKMORE DR
EAGAN MN 55123
(612)725-5352
I hereby acknowledge that I have read this
information is correct and agree to compiy
Statutes and City o'f Eagan Ordinances.
L
P?"&tAo
APPLICANTlPEFMITEE SIGNATURE
application end state that the
with all applicable State of Mn.
ts ? {(?l saru?l Ifl?
93 CITY OF EAGAN
14-f 3830 PILOT KNOB RD - 55122
1995 BUILDING PERMIT APPUCATION (RESIDENTIAL)
681 -4675
New Conshudion Reauirements RemodeVReoair Renuirements
? 3 repistered 6ke surveys ? 2 copies of plan
? 2 copiea of plens (indutle 6eam & window sizea; poured fid. tlesign; etc.) ? 2 site surveys (exterior addiGona & dedcs)
? 1 energy cakuletions ? 1 energy celalatlons for heated additiona
? 3 copies of tree prossrvaticn plan H IM platted after 7H/93
roquued: _ Yea _ No
DATE: 14 Zurn.L aS CONSTRUCTION COST: Q5oo MrL LAbor O
DESCRIPTION OF WORK: eo nSk Of 14+ X 1'L' $ cre.t^ ?d r eh Qlka"} io n
STREET ADDRESS: S 23 \? o.dL.rv."psti. Dr
LOT ? BLOCK 3 SUBD./P.I.D.#:
-las•sasz w)
PROPERTY Name: 2) t o.\kc. Phone #: (Ogi - q5d 9 Lt.%)
OYYNER ""*
Street Address- 5n
City: State: M^ Zip: 55 ? 23
coNTR?C7oR Company: N o+u. Phone #:
Street Address: License #•
City: State: Zip•
ARCHITECT! Company: So* Phone #- 6t1 -*0
ENGINEER ? , -
Name: w11c.? J o?"+^ Registration M-6 I5qA
Street Address !C ?vv%wa., -
Ciry: State: Zip:
Sewer 8 water licensed plumber: . 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 correct and agree to comply with ail
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: OFFICE USE ONLY
Certificates of Survey Received
_ Yes _ No
JuN 28 1995
Tree Preservation Plan Received - Yes - No I --------------'
OFFICE USE ONLY
BUILDING PERMIT TYPE
:
. , r .?
?
0 01 Foundation o 06 Duplex o 11 Apt./Lodging ? 16 Basement Finish
0 02 SF Dwelling ? 07 4-plex o 12 Mufti RepaidRem. 0 17 Swim Pool
0 03
%:?04 SF Addition o
S OS &plex ? 13 Garage/Accessory o 20 Public Facility
,E F Porch o 09 12-plex o 14 Fireplace o 21 Miscellaneous
n 05 SF Misc. ? 10 = plex o 15 Deck
WORK TYPE
n 31 New o 33 Afterations o 36 Move
da"132 Addition o 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of 5tories
Length
Depth
APPROVALS
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq.ft.
Planning Building
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census UnR
Engineering Variance
y?y
o/
?
O
Permit Fee
Suroharge
Plan Review
License
MC/WS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Pertnit
SMJ Surcharge
TreatmeM PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
TotaL•
?
Valuation: $ S ,,od ?
lZ x/Y
% SAC
SAC Units
? CITI( OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(672) 681-4675
SITE ADDRESS:
P.I.N.: 10-12302-010-03
DESCRIPTION:
h
\
C)?'
PERMIT
PERMITTYPE: BuzLozNG
PermitNumber. 022492
Date Issued: 11 / 10 / 9 3
523 HACKMORE DR
LOT: 1 BLOCK: 3
AUTUMN RIDGE 3RD
B.u3ldin'q?_ Permit Type SF DWG
Building tJork Type NEW
'UBC Occupancy,. R-3 M-1
?Construction Tyve V-N
Zoning ? R-1
j
Building Length 7 58
Building Width 42
\ 1
,r'
?? ?
`-"-•
?
O?
(
REMARKS:
PRV
FEE SUMMARY:
S& W PLBR - D C MECH
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Subtotal
CONTRACTOR: - Applicant - sT. Lzc OWNER:
KEY LAND HOME3 18942636 0001553 KEY LAND HOMES
14450 BURNSVILLE PKWY 14450 BURN5VILLE PKWY
BURNSVILIE MN 55337 BURNSVILLE MN 55306
(612) 894-2636 (612)894-2636
I hereby acknowledge that I,have read this applicatian and staCe thrgt Ehe
infiormation is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
L 40
??? ! -
/ / Ir
LIC N R TEE SI ATURE
VALUATSON
$793.50
$515.78
$72.0@
$750.00
100
$2,131.28
$144,000
MISCELLANEOUS $1,749.50
Total Fee $3,875.78
- ?
I :SIGNATURE
?
REACTIVATE _
PEFMIT B? -
CITY OF EAGAN
1993 BUILDING PERMIT
681-4675
APPUCATION 4J1q"I' .'I`
(r,!' ?,1!-i
SINGLE & MUL L-.FAMILY__ ? set of plans, 3 registered site surveys, 1 copy of energy
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: i) 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 1IDLi Valuation af work 10564fp
Site Address: 6Z?7 ?144-?iMoe.F- PZ1Ua
STREET SUITE N
Tenant Name: (commercial only)
IAT BIACIC ? SUSD & P. I. D. M
)T J
Descri tion of work: QEw 5t+1 c.c' 4:?Rm iL ??? 4om
The applicant is: ? Owner Contractor 1:1 Other (Deseribe)
Name Phone
Property LAST F1R5T
Owner
Address
STREET STE #
City State Zip
Companyi?EY LA1.1 rM- Phone 81'?-Z40z71o
Contractor Address 144$0 gUQAS0L-l-?- rV-V7U/R. License # 1"?3 Exp.3-?i1-
City gxUP+li?--uju-E- State mq-. Zip S530 Co
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer 6 water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this a plication and state that the information is
correct and agree to comply ith 11 applica le tate of Minnesota Statutes and City of
w
Eagan Ordinances.
C
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation
0 02 SF Dwg.
El 03 SF Addition
0 04 SF Porch
? 05 SF Misc.
? 06 Duplex
? 07 4-Plex
? 08 8-Piex
? 09 12-Plex
? 10 Multi. Add'1.
'w'4 : a M " ",? •"3
? 11 Apt./Lodging .?,.!&'1P`teaeenV'finish
0 12 Multi. Misc. ?'17 Swim Pool
? 13 Garage/Accessory ? 18 Comm./Ind.
? 14 fireplace ? 19 Comm./Ind. Misc.
? 15 Deck ? 20 Public facility
O 21 Miscellaneous
WORK TYPE
'?K 31 New
? 32 Addition
? 33 Alterations
? 34 Repair
? 35 Tenant Finish ? 37 Demolish
? 36 Move
GENERAL INFORMATION
Const. (Actual) V-N Basement sq. ft. MWCC System yt?$
(Allowable) V-N lst F1. sq. ft. City Water YES
UBC Occupancy R.3 M?I 2nd F1. sq. ft. PR4 Required yav
Zoning R_i Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length ,5g On-site well Census Code )0/
Depth y 2• On-site sewage SAC.Code o/
?
APPROVALS /
Planning Building Assessments
Engineering Variance
REGIUIRED IN SPECTION S
0 Site 0 Footing ? Framing ? Insulation
? Wallboard ? Final ? Draintile ? Fireplace
Permit fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC % / DD
SAC Units -T-
veturee;m: S 14 4-I ,Q`X7'"
GA„! ZSSx30 ? ?Yc7
zX/0= ?20? 22Xlyr 308
?_ Zsa X y ? 2
14 K22
(p ,? 13'/2 % fs I
zgxzs= ?Sw 1y3, 6Ns
zx?y ° ??2 r
k?4S?.t5' I?,17?
.BSmT ?) 45'
x a= s ,..--.
I
?,2x,Z= ??3 ?2"23 ? -
I 1???
1926i93 06:54 e?
, .
3862-A
? e
SURVEYOR'S CERTiFl?AVE KEYI.AND HOMES
i1ACK" Q? DR VE
247 .
BP7.2
I ? 4- 6°4+i?1 0311
'11=9090000?? Ra445.T9 . g?
F2¦20.00
a,.s?
31.42 5878 -.
1
? ? • ?Q ' g ;?(9zg.3)
? ? - -- -?`-I
?WMAAK ? -- ? r
aEV.. Pas.ss PROPOeeo ? s ?K
oaiyBwAr .?
t?v:-a?'aa9
W l92.z) 928.2 f93o.0
> 30 20. ? 10.0• t-V
r 0 n ? . .,
_? ? I 929.! ?? ??1?•? QAR. ?
3 0 ?-i---- ;928.3 (430.0) 9YB.4 ??, ?
W
,.,
?.
c' z 1 L4T
" o?
? I I ?--
M
= DRAM 6. V7iU T ?
30 Y? EOS?? PER ?.,:Z?_ S ?
10 85.41 N 14°3??
•9
n
I :/ I ppr
INOTE? NO SPECFIG SOILS •INVESTIGLTION MAS BFFN COMPLETEO iNG E "NDMT.
ON• THIS LOT BY TME SURVErOR. Tt£ SNTlA9ILlTY dF
SOIIS TO SUPFORT TME 3PECIFIC HWSE 4DH0130SEO 18 NOTE: BUILDING DIMFJi510N5 SHOWN ARE WR NDRIZONTLl1
rlO7 THE RESpON3181LI7Y OF THE $URVEYOFI. _ 9 VF7tY1CAL IOCATION OF $TRUCTUpE OHLT. SEE '
+- DENOTES PROPOSED SURFACE DRAINAGEJ ^?'TecruaL Puws ? euiLoiNG 9 FOUNOATILN.
DIMENSIONS.
O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET
0 DENOTES IRUN MONUMENT FOUND PROPOSED GARn{ ':- FLOOR = 930.3 fEEf
X000.0 DENOTES EXISTING ELEVATION PROPOSED Lr: °LOOR - yzz. 6 FEET
(000.0) DENOTES PFiOPOSED ELEVATION Po???jo ?E '?,?? ?J ?nFE?
U ? LJ
WE HEREBY CERTIFY TO KEYLAND HOMFS THAT 7N!5 t5 A TRUE AND CORREC7
REPRESENTATION OF A SURVEY OF THE BOUNbAFiIES OF:
Lot I, Block 3, AUTUMN RiDGE 3RDp4I31'rION; according,l.o u'a ;r.-. ,sat thereof, Dakota
County, Mlnnesota,
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXGEPT AS SHOWN. AS
SURVEYED BY ME UH UNDER MY DIRECT SUP VISION SHIS 6TM DAY OF OCTOBER , 1993.
PROPOSED ORADES SHOWN WERE SI(iN : J M R. HIIL, INC.
TAxEN FAOM THfi DEYfiIAPMENT
PLAN FoR AU7UMN R10OE PiSE- <
p?? eY?IONFER EH6. LA9T 8,
?a
Z 2 -
JOHN C. LARSON, LAND SURVEYOR
N?INNESOTA LICENSE NUMBER 19828
m James R. Hil1, inc.
5 ' ? PLANNERS / ENGINEERS l SURVEYORS
FzO,n O a
W ?m
m .y
2500 W. CTY. RD. F. 42 • BURNSYILLE, MN. 55337 • 812-890-8044
Z<
LOT BDRVEY CSECRI.IBT FOR RESIDENTZAL
I ° SIIILDIHG PERMIT 71PPLICATION
S2 ? PROPERTY I.EGAL: ?
` m Date of 8urvey:
? DOCIIMENT BTANDARDB
?? ? • Registered Land surveyor signature and company
H` D D • Building Permit Applicant '
-0` 0 0 • Legal description
8---0 ? • Address
@' ? 0 • North arrow and bar ecale
L? 0? • House type (rambler, walkout, split w/o, eplit entry,
lookout, etc.)
0-10 0 • Directional drainage arrows with slope/grndient $.
0 C?I''? • Proposed/existing sewer and vater services
6??D ? • Street name
Ef0 0 • Driveway
BLEVATIONS
Existina
D ff'?0 • Sewer service
0? 0 ? • Lot corners
• Top of curb at the driveway
? Q-10 • Elevations of any existing adjacent homes
Prooose8
? p ? • Garage floor
0 • First floor
Q? ? 0 • Lowest exposed elevation (walkout/window)
• Property corners
• Front and rear of home at the foundation
PONDING AREAS (if a,pplicable)
D ? 0 • Easement line
D e' 0 • tawL
? ? ? • xwL
p ??CJ • Pond # designation
p L'T ? • Emergency Overflow Elevation
DIMEN6ION6
0'0 0 • Lot lines
P?'-
0 • Right-of-way and street width (to back of curb)
Q-?p p - Proposed home dimensions including any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
structures requiring permanent footings)
? • Show all easements of record and any City utilities within
those easements
?p ? • Setbacks of proposed structure and setback of adjacent
? existing ho
Dzr 0 • Retain. rqo!drements, if any
Reviewed:
OCtober 1992
QNNER;
nnrr
S?TE ADDRESS:SZ--j' tY64n/f1OZE PZUE-_ • Ph:ONE: 7(p25 (-
COYTRAC?OR: /??u1.?"?T7 ?70.•,•%-•?_ _ PLAN R ? 7COCp?
Determine work9ng square foota9e of each
1. Total exposed wa"l area..... ? sq. ft. x .11 /fE?
2. Total roof/ceiling area..... sq, ft. x.026 = ??,F6
Total exposed wall area above_floor= 4L_4?
z. Total wzll window area ...........................................
b.' Total door area ...................................................
c. Total sliding glass door• area ....................................
d. Total fireplace wall area ........................................
e. Total wall framing area (average 10%) ...........................:.
f. Total rim joist area ....................... .:............ ........
g, net wall area above floor .............. :......................
h. wall area a6ove rioor .....................................
i. . wall area above floor ............. ........................
' . rrzme wall area at io?ndat_on ...................................
?
Total exposed toundation area= 71?
/3 S
?
0
7 ?L>
?
k. Total foundation window area.......................
l. Total net?'roundation arza above grade .............. /9Ir
Oetermine "u" value of each wall segment
(e.g. window, (loor, each separate wail section)
X'lu,l 7 = 3, r-.?-
b. 3? x „ui,
C. o x
d. - Y. U..
x U.,
,
T. ?qq X „u „
9. i??ro X „u„
h. X ilu„ _
x u?? _
i.
• j, X"U" ° Ip item ;3 is t?
? X"U" , O = as, or less thar.
?• F1, you have me_
X„U„- ,/ _ intent of SBC cC
L?-
3 . .................................Total = ??a Ti •
4. TOTAL EXPOSED RQOF/CEILING CALCULATIOtIS:
, ... .
. Total exPosed
roof/ceilinq area........ ?[? O 5q ft
: j) Tocal skylioht area....... "-' sq f[ x"U" --- ` -?-
k) Tocal roof/ceilinq framing /
area (AveraQe 105?)..... sq ft x"U" OZq 1GAL-1=
1) Total net insulated ??! f
roof/cei 1 inq area.......1 ??/ JI19 sq ft x"U" ?vZ6 •i'? Gyz,ri i•'?
i
L TOTAL j) thru t)
1` total o` -`4 is the same as, or less than r2, you have met ihe intent o`
2MC: Z 1. 16005 _4 ar.d 0.
ALTERt;ATE 6U I LD fNG ENVELOPE DES I CN
To ucilize the total envetope system method, the values established by the sun
of itens =3 and ?4 shall not be oreater than the sum of items fll and °2.
t. ?'v?•?? r 2.
?f •?j. tf - sJ<j ? i?./J
-^ J +
? li?' J::i ?I. ? +_
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTTS ARE REQUIl2ED FOR EACH UNTT.
NO. FIXT[JRES EACH TOT?
? SHOWER 3•00
'
00
3 -?
7?
WATER CLOSET •
_
BATH TLTB 3.00 (o UU
?
LAVATORY 3•00 ?? - 6m
KITCHEN SINK 3•00 ? ° °a
I LAUNDRY TRAY 3.00 ?, uv
HOT TUB/SPA 3•00
L WATER HEATER 3.00 3 • ?
_
? FLOOR DRAIN 3•00 - •???
GAS PIPING OUTLET • minimum - t
1 3•00 3? C/Z)
_
3 ROUGH OPENINGS 1.50
_
WATER SOFTENER 5•00
PRIVATE DISP. • Dak.Cty. lic. 15.00
U.G. SPRINKLER • nome uneer const. 3.00
ALTERATIONS • to austing 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE .50
x
??
TOTAL: •
SITE ADDRESS: dk-41&? -P-' '
OWNER
INSTALLER: ? v ?.?M('.hAzc MO -
ADDRESS:
CITY: ? STATE: ZIP CODES 3 7F
PHONE #:
?-??-
SIGNATURE OF PERMITTEE
1993 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD
EAGAN MN 55122
(612) 681-4675
1993 PLUMBING PERMIT (CONIlIZERCIAL)
CITY OF EAGAN
3830 PII,OT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMAERCIALJINDUSTRIAL BUILDINGS. ALSO FOR MULTI-
FAMILY BUILDINGS WHEN SEPARATE PERMTTS ARE NOT REQUIltED FOR EACH
DWELLING UNTT.
_ NEW CONSTRUC710N
ADD ON
REPAIR
WORK DESCRIPTION:
CONTRAGT PRICE:
FEE: 1% OF WNTRACT FEE.
STATE SURCHARGE: $.50 FOR EACH $1,000 OF "R]i3£T FEE
MINIMUM FEE: $ 25.00 "
CONTRACT PRICE X 1%
STATE SURCHARGE
TOTAL
SITE ADDRESS:
$
$
TENANT NA117E: S1'E. #
OWNER NAME:
W STALLER:
ADDRESS:
CITY:
PHONE #:
CITY OF EAGAN
STATE:
ZIP CODE:
APPLICANT
LOT t BLOCK ? SUBD. rZ;d- R. ??c( A-??
RECEIPT t! C K O& DATE
1994 CITY OF EAGAN
IRRIGATION PERMIT (FOR BACKFLOW PREVENTER)
COMMERCIAL IIVSTALLATIONS - FORM MUST BE COMPLETED BY LICENSED PLUMBER
Date: Commercial GPM
Residential (boulevards) GPM ?t_
Ezisting residential
Area/address to be irrigated: Sa3 A01r-6"'`°+-e bc ,\-e-
Installer: `-50he? IT ?ic?lke Owner 4 Plumber 0
3treet address: Sa3
City, state & zip code: ?Q.a.-. Mt.E Phone !/: Co$1 -5Slo`l'
owner Name: Sa y-?"c
Street address:
City, state & zip code: SA?P Phone #: Sam.Q
Irrigation contractor, if different than installer.
Telephone !f:
I hereby acknowledge that I have read this application, state that the information is conect, and agree to
comply with all applicable City of Eagan ordinances.
I w " 0-2
Sign re Title
If construction activity occurs in public easement or City right-of-way, signature of property owner is required.
The properiy owner agrees to hold hartnless the City of Eagan for any damages caused by the City during its
norma] operational and maintenance activities to the facilities constructed under this permit within Ciry
:ope ry Ow:er Date
pproved b Date:
PRV Yes ? No
New service ? Yes a'No Meter Size & Cost
Fees due: Calculated by:
z -3 7s ;?
PLEASE COMPLETE FOR SINGLE FAMII.Y DWELLINGS. AISO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
? NEW CONSTRUGTION
_ ADD-ON A/C
ADD-ON FURNACE
DATE ll1l0/93
ES
NVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1@$3.00 EACH) 9. Lv
ADD-ON/REMODEL (EXISTING CONS7RUCf10N) $ 15.00
STATE SURCHARGE .50
TOTAL 733. o
SITE ADDRESS: Jof J l?-d-L-/C/yL?cx.?
OWNER NAME: ? TELEPHONE #: 9 Z
INSTALLER: •
CITY: STATE: 772? • ZIP CODE: S-S3 7?--?
TELEPHONE #:
SIGNATURE OF PER EE
1993 MECHAMCAI, PERMIT (RESIDEIVT'IAI,)
CITY OF EAGAN
3830 PILOT KNOB RD
FAGAN MN 55122
(612) 6814675
"i. ,
??:. . ... .. _ ._...
1993 MECHANICAL PERMTf (COMMEItCIAL)
C1T'Y OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COD9vIERCL4UINDUSTRIAL BUII.DINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMII,Y BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNTf.
DATE:
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
1% OF GONTRACT FEE
PROCESSED PIPING:
MINIMUM FEE:
STATE SURCHARGE
TOTAL
SITE F,BDRESS:
FEES
$25.00
$25.00
CONTRACT PRICE: $
$.50 FOR EACH $1,000 OF FERMT£ FEE.
$
OWIv'ER NAME: TELEPHONE #:
TENANT NAME: (IMPROVEMENTS ONLl)
INSTALLER:
ADDRESS:
CTl'Y:
TELEPHONE #:
STATE: ZIP CODE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 523 Hackmore Dr
Lot: 1 Block: 3 Addition: Autumn Ridge 03rd
PID:10- 12302 - 010 -03
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspec
acceptable in lieu of inspections.
Fee Summary:
Valuation: 3,000.00
Contractor:
Property Claim Solutions LLC
4655 Nicols Rd, Suite 202
Eagan MN 55122
(651) 994 -2028
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Construction Type:
Occupancy:
on prior to final, you must meet inspector with ladder and flat bar. Pictures are not
Owner:
Dana E Schlitter
523 Hackmore Dr
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
$90.00
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Building
EA087077
10/24/2008
ePermit
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 523 Hackmore Dr
Lot: 1 Block: 3 Addition: Autumn Ridge 03rd
PID:10- 12302 - 010 -03
Use:
Description:
Sub Type: e- Siding
Work Type: Siding
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Property Claim Solutions LLC
4655 Nicols Rd, Suite 202
Eagan MN 55122
(651) 994 -2028
Applicant/Permitee: Signature
PERMIT
City of Eaan
Construction Type:
Occupancy:
Carbon monoxide detectors are required by law in ALL single family homes.
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total: $90.00
- Applicant -
Owner:
Dana E Schlitter
523 Hackmore Dr
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
Issued By: Signature
Building
EA088573
03/27/2009
ePermit
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.
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply with all applicable State
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA177438
Date Issued:06/30/2022
Permit Category:ePermit
Site Address: 523 Hackmore Dr
Lot:1 Block: 3 Addition: Autumn Ridge 3rd
PID:10-12302-03-010
Use:
Description:
Sub Type:Air Conditioner
Work Type:Replace
Description:
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Shawn Buermann
523 Hackmore Dr
Eagan MN 55123
Metro Heating & Cooling
1220 Cope Ave E
St. Paul MN 55109
(651) 294-7798
Applicant/Permitee: Signature Issued By: Signature