527 Hackmore Dr" .- % .
WtrtifICQte df cCCli.pQ1tC4
Witv of Cfagan
Zoart1 cut ef 138tbaig 3440crtion
This Certifrcate issued pursuant to the requirentents of the Uniform Building Code
certifying tiwt at the time of issuance tkis structure was in compliance w•ith the various
orrliaances of the City regulating building construction or use. For the fo!lowing:
Ux (,'lassifiptian:_ qF_rW Bldg. Pertnit No. 23W -`
Oocupmcy lype R-3!?"1 1 Zoning District R I Type Const. VN
oweer or e+uwiog GHII'IINEY HM ME.AT'fQM wadxesa 4160 i ANiM t.ANE,EAaAN
e?khng aaanms 527 HAb.KHM I7ltIVE t.ocajuy I.2;S3, Atr1T1?t RmF 3Rn
? Z
Dace:
Bmldag
P0.ST IN A CONSPICUOUS PIACE
r = 1
CIYY'OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
1;1?1 f tn}:t t?t'
11.16
Sltl)
I PERMIT SUBTYPE:
TYPE OF WORK:
ra? 1.1
INSPECTION .. .
. ? ? .•
, .sri i 14?s
1 t l•If1i I i ??i? , i re;i?
I ? ?. F;k , ?'11 v
S& W f' LR3 t; i+l ri t i 14 ? t_1 1J AI+t l. k t. '; .}' I E'3 f3
REcoRD
PERMIT TYPE:
Permit Number:
Date Issued:
t< t.? +. t. i.) t
c.a_? t ti,rs
APPLICANT:
? 1?? I• i? ? i????1 ? i., ? I??t
?
?
Permit No. Permit Holder Dete Telephone #
SNV
PLUMBING (p ??o
HVAC
ELECTFi
ELECTRIC
fnspectfon Qete lnsp. Commanta
Footings i
Foundation
7
Framing
Roofing
Rough Plbg.
Rough Htg.
ISUI.
Fireplace
r?-
Final Htg.
Orsat Test s
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
Engr.lPlan
Bidg. Final
Deck Ftg.
Deck Final
wan
Pr. Disp.
pd Z.
r REQUEST FOR ELECTRICAL INSPECTION -.'?a EB-00001-OB
?? q ? See insimaions for completing inis form on back ol yellow copy
3 3 7 1 "X" Below Work Covered by This Request
e Add Rep TypeofBwltlmg AppliancesWrted EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt Bmltling Dryer Load ManagemeM
Comm llndustrial Furnace Other (Specily)
Farm An Conditioner
Omerlspecity, Contracrors Remarks
Compute Inspection Fee 8elow
# Other Fee # Service EntranceSae Fee # Circuits/Feeders Fee
Swimming Pool 0 l0 2?0 Amps 0 ta 100 Amps
Transformer5 Above200 _Amps Above100=Amps
SIgnS , Inspecmr's Use Only ' TO?fA ?tl
Irngation Booms J 6j
Special Inspection
Alarm/Commumcation THIS INSTALLATION MAY B D CQNNECTED IF NOT
Other Fee COMPLETED WITHIN 18 HS.
I, the Electncal Inspector, hereby Roi l
certify thal the above inspection has
been made. F,,,ai
oate
OFFICE USE ONLY
•
This requesl void iB months Irom
,h2l?/? d ?
?S
3 0 ,(.02 3 . ? ;
Repuesl Da
/ ?e
?'?'/7
? Frze No Raugn.ln Inpsect
(VOU muron R irea
sf call inspector en reaxi
Ins ecibn Ofher Than qauqh?ln
qeatly Now ? Will NoOy Inspettar
V Yes ? N. Data Fi
I? hcensed contractor ? owner hereby request inspection ot above electrical work at
ob Atltlress (SireeL Boe or Route No )
va Qry
a ,n
Secuon No Township Name or No- Range No Caunry
Occupam (PRINT) Phone No
Power SuOOlier
?{kfrl
ecflic qdtlress
411 aaoT" 5-F W. ?4rw?r
ElecmcaiConvactor?Gompany Name)
?? +?R- <ec-fr( G Conhactor§ LicensB 146
MaihnG AoCtess ICOnVactor or Owner Making Inslallation)
Jv ?
1 7ba?
, i
Autnonxa0 Signamre COnnaclor ar kmg Ins rvonl Phone NUm ar
/
MINNESOTA ST BOARD OF TF ITV THIS INSPECTION REQOEST WILL NOT
GrlggsMiOwey Bltlg. - Poom 5-1]] BE ACCEPTED BV THE STATE BOARO
1821 Univeraity Ave. St. Peul. MN 551114 UNLESS PROPER INSPEGTION FEE IS
Vhone (612) 692-OBDO ENCLOSEO
Address 527 enQMW DxM Zip 5512 3
r. ,
Lot 2 Blk s Sub a[rnm tuncE 3m
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: /? f Yes No Inspector: ?
Finai grade (6" from siding) //
Peananent steps (garage) Lll
Permanent steps (main entry) LZ
Permanent driveway I/
Permanent gas ?
SodJSeeded grass v
TraiUcurb damage ?
Porch
Basementfinish y5
Deck ?'
Please verify with the builder the removal of roof tesl caps from the plumbing system and the shutoff of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system.
White - City Copy Yellow • Residenl Copy Pink - Contractor Copy ?
PERMIT (??? .zx'?Y
CITY OF EAGAN 60/y?
3830 Pilot Knob Road PERMIT TYPE: g u x L D I N
Eagan, Minnesota 55123 Permit Number: 023368
(612) 687 -4675 Date Issued: 0 q/ 2 g /g q
SITE ADDRESS:
527 HflCKmORE DR
LOTc 2 BLOCK: 3
AUTUMN ftIDGE 3RD
P.I.N.: 10-12302-020-03
DESCRIPTION:
.?
B,u'ildi g'.-Permit Type SF qWG
Buil.ding 46rk Type NEW
UBC OCCUpaftcy", ft-3 M-1
? Construction 1"?p.e V-N
Zoning ?--, R-1
Building Lemgth ? 65
SuAld'zng Witlth 7 41
l?
Bui,lding.stories -'' 2
? J lY'
q..='
i i.i
REMARKS:
? PRV S& W PLBR - MATTHEW DANIELS PLBG
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
sac
sac %
SAC Units
5ubtotal
VALUATION
$881.00
$672.65
$84.50
$800.00
iee
$2,338.15
$169.000
MISCELLANEOU5 $1982$.50
Total Fee $4,166.65
CONTRACTOR: - Applicant - sT. Lzc. OWNER:
WMI7NEY MOMES CREATIONS 14549150 0008344 WMI7NEY HOMES CREATION3
4160 LANTERN LN 4160 LANTERN LN
EAGAN MN 55123 EAGAN MN 55123
(612) 454-9150 (612)454-5332
I hereby acknowledge that t krave read this
rmat c? is correct and agree ta co?nply
Stats,?a?y o'F Eagan prdinances.
?
applicatinn and state that Che
wiGh a•il applicable State of Mn.
ISSUED 34 SI NAT??? _
J
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION , .
681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAI 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 work9ng day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Oate Valuation of work /`3 S f3C? ?
Site Address: --5a7 A aC_?'r?oYp ..j e-
SiREET SUITE X
Tenant Name: (commercial only) _
LOT oz BLOCK --3 SUBD. P.Z.D. #
?
Descri tion of work:
o,tiSZ,
The applicant is: ? Own S Co tractor ? Ot er (Describe)
Name o r, ,- Phone 5Y _ S`3 3 0
Property LAST FIRST
Owner L
?
Address 0 -
.k ?,ti
atiL
? STREET ? STE #
?
City u titi State Zip
Company ? e o e? 0." ? Phone 7?5?? a
Contractor Address ? License # 3`/ Exp.3
City State Zip
Company Phone -S0 7 115 / -/o/ 9
Architect/
Engineer Name Registration #
Address 1-?35` I?1a ' .D. ox IS
City (!??a o? State Zip,=O& 0
Sewer & water licensed plumber a ?...? ? . Processing time for
sewer & water permits is two days nce area has been approved.
lattat tha the information is
I hereby acknow edge tha I ha r ad this
correct and ag ee to compl es ta S atute nd ity
f
Ea9an Ordinanc
Signature of Applicant: ?- ?+
J `?
CIFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging
0 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc.
? 03 SF Addition ? OS 8-Plex ? 13 Garage/Accessory
? 04 SF Porch ? 09 12-Plex 0 14 Fireplace
0 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck
WORK TYPE
El 31 New ? 33 Alterations ? 35 Tenant Finish
? 32 Addition 11 34 Repair ? 36 Move
GENERAL INFORMATION
?
? 16 Base*nt'Fin't°s1P
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
13 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
Const. (Actual) Vni Basement sq. ft. 30y MWCC System 4
(Allowable)
UBC Occupancy
VAI
-.?
lst F1. sq. ft. 13o y
2nd F1. sq. ft. Iz29
City Water
PRV Requlred _
?
Zoning R-/ Sq. Ft. total Booster Pump
d of Stories 2 footprint Sq. ft. Fire Sprinkler
Length
? On-site well Census Code p/
Depth On-site sewage SAC Code p ?
APPROVALS eensus Unit
Planning Building Assessments
Engineering Variance
RECIUIRED INSPECTIONS
? 5ite Footing El Framing _13'Insulation
? Wallboard f?7 Final ? Draintile ? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
5/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
COp12S
Other
Total:
SAC %
SAC Units
vatmc;m: $ ? O?o
/s r
v6 &,2 =
zsSk z _ sl
33G?
)'303,p3x 69= g 9/
ZhN
2x3?/ _
H ?
lz-?o,,. 13 =
? 9 ?9Op
b?
39, /7
17?, 3s
?roLl , '1/
Zn?
Z? Z = `/
Z.rzb ?
'? ?/YJ. /(o £
00v
?yG.61 2,
N
'000
ER ? o r .
C •?
q '
'(OP BL?GIC- ?L., 933.8
P.?ASEM'ENT ?L. 525 ,7
1
a
,y 94c :1
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' r6
'` i;
q??^ ? S 8?• ?Y?Y+1 '-P 5?u ? W
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-43 ? `?+
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a 3. $'a Y)
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S I'T, °
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o' N 89°05'96"E
u? u p ?
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DESCRIp7/oN ?
L07 2?. 6( OCK 3,
AUTUMN R/DG1i `-"-' ?s,?AAV? ?GDD ?, ORTN
3RD ADDJTIOH, ? i ?CALE /"=30'
DAKOtA COUNTiY, ?? o0/' ? ALL BEAR/NG5 ASSLIM$D
MlNNE SOtA ?J r------ 0 DONOTES /R0N MONUMENT
i ?
EAGAI? i ADDRES?S:
?
R E V 1 E W E U SZ7 K 44,V-r,n.oek, De.i?E
BY
? S q?/ I hereby certify that this plan was prepared by me or
?.? / 1'-?? g?r my direct supervision and that I am a duly Registered
Land 5urveyor under the Laws of the State of Minnosota.
Date :Lr,1 G./ f S sl
?'- ?- LeRoy . Bohlen
Registered Land Surveyor No. 10795
,. ,_? .
?
?
f ?
LOT iIIR7yY CliLCI[L2lT FOR RLS2DLlQZ'I1lL
IVZLDtti 2RKIT AFF 2CATi0:L'z'0-00? ?t ? Y?.? ? //?? -? T?
Dat• ei furvoy:
-0?? O
?
O D •
• Aegistered Lnna Burvtyos siqnatnra u?a eompnny
a
3l
i
'
? v
C
nq pezmit 7lpplieant
D
P • ioqal dtscsiption
13 D • 1lddress
0
F
D • North •nov and ber scnle
•
•
D
D • 8ouse type (tambler, valkout, sp21t v/o, split entry,
? lookovt, etc.)
D
D D
? • Di:eetional drainaq• asrows vitb slope/qradient f.
D 0
8?
p 0 •
• Froposed/existinq sevez and vates •ezvices
? Stroet name
F( 0 0 • Drivevay
sLTvas:oNe
i
ti
t
D?D 0
• x
s
nv
Sewez serviee
0 0 • Lot eorners
8^ 0 G
8r0 0 • Top of cuzb at the dziveWey
• ElevntionR of any existinq adjaeent homes
0?D n
" • Preaesee
Cnrage iloos .
c?
n o
V • fir:t :loor
0 0
' • Lovest exposed alevation (valkout/vinLoa)
0?
?0 D • Pzoptrty eorness
II D G • Fzont and tenr of boae at tAe toundstien
poxnrNO AnxIe rit •pp}icasi.l
D ? D Eas:ment line
D
D F? D ;
• ?L
aD poaa f desiqnstien
'
S O E
mezqeney Oveztlov =levation
a:mrilBioNB
8' O O
?0 0
L?D 0
D Q 0
• Lot lines
• Riqht-ot-xsy anE strist v3dtA (to Daek ci en=b)
• pzoposed Dome Qimensions ir+eludinq any p:opoieE doeks,
ovezhnnqs qreetez thna 21. porches, *tc. (i.e. •il
structuzts requirinq perinnnent foetinqte) •
• ShoW all ensements of reeozd •r+a any City utilities vithin
tnose eesements
• Setbaeks of proposee stzveture anQ setbaek ei adjeeent
existinq bomes ,
• Retein n 11 ze izemenLs, if any
Revitweds ? Z
???/??
BENT TREE LANE MH? , STA. -9mFt6'
SEE SHEET 2400 U 6 5' LT.
1
DIP CL 52 g v
TEE
? EL. 937.0
7 E L_ 939.4 1
,- - ,
1 40.4.,
?y
a"-go•??;JD_ , ??--?
- 1
2t29
%MH STA. ^--n-1-29T
?.\1 2 ?-q
, ? -
? O
,
-; 37.5'
8" G'?
- 8 x8 TEE
\ S-Q+30
3 ? INV-918.$
CS-929.3
2, 1
` ?•___?
.. ,
a? 55 •-? ? , , -'?•?? ,? ? a•
7'
30
;
-^ azZ ? :NV-722.3
;
..`--.,...:., r Z ;3
,
?`?tE Cf1`Y fS?'EA`? ?1'bOE??IUOT GUARA?I'EE
? 442FHE; ACCURA4Y OF U'fIUTY LOCATIONS
ELEVATIONS. THIS DATA IS FOR
6NFQRilRAT10N PURPOSES ONLY AND
l/ PERSUNS USIiVG IT SHOULD VERarY THE
IPVFC3RMA7lOP! ON THE SITE.
_ 7 1
1
MN STA.
H A W'MORNE
WOGOS GR!`v'
11 4`? ? ? ?
1 S-0+70
I i N V- 916. 2
? CS-926. i 74•3
72.2.'
4
1.
,
'
'??• ;' ,? r
?
?
s' ? i
_, .
A
`-
'
n"I.6J-0+80
8" ? NV-916.?
- G'J
? CS-9?6.3
? 1
HaCKMORE COUr2T
SEE: RIG?-HT7,
2
BENC;
?NH NorTNwES i o?DRIVE AND 3t-
tl-_`1 =
?NH UcRrHwEST ?.;.
CRIVE ANC CR4M
r. r•.,
r_-
930 G9
3e..... M R?
? B?C. ,I i.50'
? ? ?` •
925.'....
945.:.... .
940 92C,....
... ...
035.:.........
CaUr,,RAiVS'EE . . . : . .
.
'..C:.:52..........
SbR 35 2. 02
? . .?. 9?q?? . . .
' . . . . . . . . . : . . . . . . . . .
. . . . . ?? ?,GCIlRACV OF UTILi`TY Lf3?%??i ?OR
.??Z?° RCF. TIELF.VAl'IOI?S. T?iIS D ?NLY,. A4uD .
• ?:??,p?iRpAOf'J PURPO?ES
0AC
USIING
P.TOSN 0?.'oELD VERi?Y TNE
: ' C??N`C? TG tX. ST'?JB O.4M
', . . . . . . . . . . . . . . . . ?'1'?i • •
?.,:.........
..............:...ggi`
. . .. i
?`--g " PVC SDR:
CONNECT :TO X. STUB :
?VERIFY ELEV. N FIEL:D) :
?
, ? . •
. ......
. . . . . . : .........
?.?. .? .
Ini
C
c?it0 :
CPQ? ,?
?
___ ? ; : •
- -- ?
...... 91.5.:...................
----_ ? ..... , . .
........ .
........o
N
in
cr
........:.... 91.?.:.........:...........
}
!". .
ONE AND TWO FAMILY
?.
ENERGY CALCULAMIONS - AVERAGE "II" COMPUTATION
OWNERt'WHITNEY HOMES/NICHOL SZTE ADDRESS: EAGAN, MN DATE: 3/1/94
C'ONTRACTbR: F.W.P. CALCULATIONS BY: BUEHLER PHONE: 451-1019
Determine working square footage of each that applies.
1, Total exposed wall area .............2882.9,sq. ft. x 0.110 m317.12
2: Total roof/ceiling area ............. 1293 sq. ft. x 0.026 = 33.62
3: Floors over unheated space.... ...... 0 sq. ft. x 0.050 = 0.00
4. Roof/ceiling area (no attic space).. 0 sq. ft. x 0.026 = 0.00
5: Unheated slab on grade .............. 0 sq. ft. x 0.160 = 0.00
6, Heated slab on grade ................ 0 sq. ft. x 0.120 = 0.00
TOTAL WOOD WALL AREA 2756.00
a. Total wall window area........... 259.53
b. Total door area .................. 60.52
c. Total glass door azea............ 72.26
d: Total fireplace wall area........ 102.00
e. Total rim joist area ............. 270.00
f. Total wall fcaming area.......... 199.17
g. Total net wall area above floor.. 1792.52
TOTAL EXPOSED FOUNDATION AREA 126.90
h. Total foundation window area........... 17.57
i. Total net foundation area above grade.. 109.33
j. Total unheated slab on grade area...... 0.00
k, Total heated slab on grade area........ 0.00
Determine "U" value of each wall seqment
a. 259.53 x "t7" 0.360 = 93.43
b. 60.52 x "U" 0.070 = 4.24
c. 72.26 x "U" 0.360 = 26.01
d. 102.00 x "U" = 0.00
e. 270.00 x "U" 0.043 = 11.72
f. 199.17 x "U" 0.106 = 21.12
9. 1792.52 x "U" 0.046 = 83.03
h. 17.57 x "U" - 0.00
i. 109.33 x "U" 0.062 = 6.76
j. 0.00 x "U" = 0.00
k. 0.00 x "U" = 0.00
7 .......................................TOTAL = 246.31
If item #7 is the same as, or less than item #1, you have meet the
intent of SBC 6006(c)2.
NbTE: FOUNDATION WALLS
Full basement (Rambler) entice exterior wall must be not less than
R-5:
Half basement (Split Foyer) entire exterior wall must be not less
than x-10.
?;.
TOTAL ERPOSED ROOF/CEILING AREA 1293
1. Total skjrlight area ....................
M. Total roof/ceiling framinq area........ 129.3
n. Total net insulated roof/ceiling area.. 1163.7
Determine "U" value for each roof/ceiling segment.
1. O XnUn a 0.00
M. 129.3 x"U" 0.028 = 3.68
n. 1163.7 x"u" 0.025 = 29.25
8 .......................................TOta1 = 32.93
If the total of #8 is the same as, or less than #2, you have met
the intent of SBC 6006(c)1.
To utilize the total envelope system method, the values
established by the sum of items #7 and #8 shall not be
qreater than the sum of items #1 and #2.
WALL SECTIONS
"U"@ 1/R
WALL FRAMING AREA CONSTRUCTION R-Value
1. Interior air film 0.68
2. 1/2" Gyp. Bd. 0.45
3. 5-1/2inches s oft wood 6.84
4. 7/16" OSB 0.67
5. Vinyl Siding 0.62
6. Exterior air film 0.17
Total 9.43
"U" Value 0.106
NET WALL AREA ABOVE FLOOR
1. Interior air film 0.68
2. 1/2" Gyp. Bd. 0.45
3. F/G Ins. 19.00
4. 7j16" OSB 0.67
` 5. Vinyl Siding 0.62
6. Exterior air film 0.17
Total 21.59
"U" Value 0.046
RIM JOIST AREA
1. interior air film 0.68
2. F/G Ins. 19.00
3. 1-1/2" softwood 1.89
4. 7/16" OSB 0.67
5. Vinyl Siding 0.62
6. Exterior air film 0.17
Total 23.03
"U" Value 0.043
a. '
"f.
FOUNDATION AREA ABOVE GRADE
1. Interior air film 0.68
2. F/G Insul. 13.00
3. 10" Conc. Blk. 2.33
4.
5.
6. Exterior air film 0.17
Total 16.18
"u" Value 0.062
ROOF/CEILING FRAMING AREA
1. Interior air film 0.61
2. 5/8" Gyp. Bd. 0.56
3. Cord depth 3-1/2" 4.38
9. Insulation 29.00
5. Exterior air film 0.61
Total 35.16
"U" Value 0.028
INSULATED ROOF/CEILING AREA
1. Interior air film 0.61
2. 5/8" Gyp. Bd. 0.56
3. insulation 38.00
4. Exterior air film 0.61
Total
"U" value
39.78
0.025
PLEASE COMPLETE FOR SINGLE FAMII,Y DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE
FIREPLACE INSERT
DATE
HVAC: 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUT'LETS (MINIMUM 1 @ $3.00 EACH)
ADD-ON/REMODEL (sxIS'rIIVG CoNSTRUCI'ioN)
STATE SURCHARGE
TOTAL
FEES
$ 24.00
6.00
?.
$ 20.00
.50
'-
STI'E ADDRESS: 57
OWNER NAME: lrfM4:t72" IWW , TELEPHONE #:
INSTALLERL_,61,(Jax61117,f 9('/1°QZ y`
,
TE: ZIP CODE•
TELEPHONE #:
1994 MECHAHICAL PERMIT (RESIDENTTAL)
CITY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122 '
(612) 681-4675
PLEASE COMPLETE FOR ALL COMAERCLALJINDUSTRLIL BUII.DINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR O'THER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMTI'S ARE NOT REQUIRED FOR EACH DWELLING UNTT.
I?ATE: CL3P7TRAL,'I' P12ICE: $
NEW BUILDING
INTERIOR IlvIPROVEMENT
WORK DESCRIPTION:
FEES
1% OF ,FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF 1:i?;' FEE.
L:: T:.4..4 a n n2 NR..Y.. i
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IMPROVEMENTS oNLl)
INSTALLER:
ADDRESS:
CITY:
TELEPHONE
STATE: ZIP CODE:
SIGNATURE OF PERMITI'EE CITY INSPECTOR
1994 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO; FQR, TOWNF30 `MES :AIVD
CONDOS WHEN PERMTfS ARE REQUIRED FOR EACH UNTf. '
NO. EIXT[JRES EACH TOTAL.
SHOWER 3.00
a `,JVATER (:LOSET 3.0`0
o ?
BAT'H TUB 3.00 ?• c? c? ; ,;
5 LAVATORY 3.00 15. o v.--..
T
- KITCHEN SINK 3.00 3. oo '
? LAUNDRY TRAY 3.00 ? ? -
HOT TUB/SPA 3.00
t WATER HEATER 3.00 ?? - o t?
? FLOOR DRAIN 3.00
? GA5 PIPING OUTLET • mwmum - i 3.00
' ?
ROUGH OPENINGS 1.50
?4 • ? i??
.
WATER SOFTENER 5.00 °
PRIVATE DISP. • naLay. w?. 20.00
U.G. SPRiNKT.FR • nflme unaer co,w. 3.00 '
ALTERATIONS • w ?ting 20:00
WATER TURN AROUND 20.00
STATE SURCHAKGE .SO .
TOTAL: STI'E ADDRESS: rJ ?.^1 1A c? c-k. n.?. t.r
CWINNER NAM''':
«: - -
INSTALI.ER:
ADDRF.SS: [S Z 3 d
CIT'Y: STATE: ZIP CODE: 'S S?b L?
PHONE #: (?OIZ) ? a3- '-?-13U .?#'
SIGNATURE OF P ITPEE -
1994 PLUM$ING PERI4UT (RESIDENTIAL) C1TY OF EAGAN
3830 PILOT KNUB RD
EAGAN MIV 55122 ,
(612) 6814675
PLEASE COMPLET'E FOR ALL COIvIl?1ERCIALJINDUSTf2L4L.BUII.UINGS. AISO'`FQR'MiJLTI-
FAMILY BUILDINGS WI-EN SEP'AR?ATE PERMITS ??RE I+TOT REQUIIiBD.:F"QR. EACH
DWELLING ilIVTT.
_ NEW CONSTRUCTION
ADD ON
_ REPAIR
WORK DESCRIPTIONe
CONTRACT PRICE:
FEE: 1% DF CONTRACl' FE&
STATE SURCAARGE: $.50 FOR EACH $1,000 OF k?:FEE.
MINIMUM FEE° $ 25.00
CONTRACI' pRICE % 1% $
STATESURCHARGE
TOTAL
STfE ADDRESS:
$
$
TENANT NAME: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CI'I'1': $TATE:
PHONE #:
w
ZIP CODE:
FOR:
CITY OF EAGAN APPLICANT
1994 -ALLIMBfiNG P..ERMIT (COMMERCIAL)
CITY.OF :Ei1GAN
3830 1'II:O.T KNOB RD
EAGAIY MN 55122
(612) 681-46Z5
RESIDENTIAL BUII.DING
tr-J$5`? `p Permit Application
City Of Eagau
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
?on
D ___1
NewConsWCtionReaui2menp RemodelRteoairReauiremenb 9tficeUseOnN
3 registered site surveys showing sq. R of lot, sq. R of house; and all roofed areas 2 copies of plan _ Ced of Survay Recd
(20% mauimum bt coveraye allowed) t set of Energy Cakvlabons for heated addi6ons Tree Pres Plan Recd
2 copies of plan showmg beam & window sizes; poured found design, etc. 1 site survey for additions 8 dedca _ Trce Pres Not Reqd
15etofEneyyCalculaUans AddRbn-irMrcateilon,sdesepficsysfem _On-sfteSepticSyslem
3 apies of Tree Preservation Plan'rf bt platted after 711193
Rim Joist Detail Op6ons selection sheet (bldgs wAh 3 or less unAS
I
Date _'L/?/ ?3
Site Address Sj7'l ?66?py6^.P ConsVUCtion Cost 11Q? p
/1r- UniUSte #
Description o[ Work pe-6k
Multi-Fami?y Bldg _ Y ? N Fireplace(s) _ 0_ 1_ 2
Property Owner ri/Il1ln /1Ji Lo L Telephone #(15-l l a a
Contractor
Address ^
State City
Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate¢orv 1 _ Mimiesota Rules 7672
Enercgy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submined
• Energy Envelope Calculadons Submitted
Licensed Piumber Telephone #(
Mechanical Contractor AIPR 0 2 2003 I J Telephone #?
lu u
Sewer/Water Contractor i? <:?z 's Telephone #(
I hereby apply for a Residential Building Permit and acknowledge 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 State of NIN
Statutes; I understand this is not a permit, but only an applicarion 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.
U-,nYt M' c.d )
ApplicanYs Printed Name
&?, A"U??
Aiplicant's Signature
OFF'ICE USE ONLY
Sub Types
? 01 FoundaGon ? 07 OS-ptex ? 13 16-plez ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex 1?3 18 Deck ? 23 Porch (screenlgazebo)
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
r 31 New
? 32 Addition
? 33 Alteration
O 34 Replacement
Valuation DOO
Census Code q 3?
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const V Yl
Footings (new bldg)
Footings (deck)
_ Footings(addiflon)
Foundarion
Drain Tile
Roof Ice & Water Final
_ Framing
_ F'ueplace _ R.I. _ Air Test _ Final
Insulation
Occupancy MClES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
W idth
REQUIREDINSPECTIONS
FinallC.O.
FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Au/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By 2' l , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 38 Multi Misc.
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
`Uemolkion (Entire Bldg) - Give PCA handout to applicant
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ALL BFAR/NGS ASSLIMED
• Dr-NOTES /RON MONUMENT
E F? G A cv ' A4?RE?S:
R E V I E W k U ? 52.7
N A???.r/.,o?.G D2.??/E
BY \ l/l1? ??? I hereby certify that this plan was prepared by me or
r my direct supervision and that I am a duly Registered
Land Surveyor under the Laws of the State of Minnosota.
Date : Zf"I- e. If S ?i? ??.J2?-
LeRoy W. Bohlen
Registered Land Surveyor No. 10795
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 527 Hackmore Dr
Lot: 2 Block: 3 Addition: Autumn Ridge 03rd
PID:10- 12302 - 020 -03
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
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
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
Construction Type:
Occupancy:
Carbon monoxide detectors are required by law in ALL single family homes.
$88.50
$1.50
Total: $90.00
Owner:
Kevin C Nicol
527 Hackmore Dr
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
0801
9001
Issued By: Signature
Building
EA091697
10/20/2009
ePermit
If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
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
�
Use BLUE or BLACK Ink
r-----------------�
i For Office Use �
� � � I
� Permit#: / � � �
�l� 0� �� ��. � .. : � v�, � �� � '
� � �
� Permit Fee: �
3830 Pilot Knob Road � : OC1' � � 2p1't ' � pafe Received: /�-/ -/ +
Eagan MN 55122 � � i
Phone: (651)675-5675 <}{��� "�'"��� i statf: �
Fax: (651)675-5694 __..._._� _____ �-------- �
--------�
2014 RESIDEN�IAL PLUMBING PERMIT APPLICATION
Date: ��-� `-l' � L� Site Address: �l�� �1 �( � � �105"�Q � �
Tenant: '� � � . l� Suite#:
. �
�°�, 1�-! �~ ���?�'' �;
` Name:�� � .i � �.�l "�� Phone:� }���- , , �
�������1����' . �
� }� —
� .. Address/City/Zip:� � 1 L.�'l� , � � ; ���� F
..
,.:<. : _,
�`� �
v Na�: �A�.�,�� l� � Li�ense#: � � �(" l 1�;l.�� �
� � �},�, �
Address: L � � JI� City: �� ; � F
� ���E'���1` ;
� ; , ---� '� ,`� `� t� 4 � �� �
� State:�� ,�Zip: Phone: 3
� ,. � �
� Contact:`��- � EmaiL �
' ��, � _ ��,k„��
� New Re lacement Re air Rebuild Modify Space _Work in RA.W. �
� 7`�t��;'�Q�C�€ ,; — � p — P — — P
� ��
Description of work: �
�� ��
RESIDENTIAL
� A
Water Heater � �
� � �Water Softener �
�awrr trrigation(`RPZ 1_f'i/8) �
������� " Add Plumbing Fixtures�Main/_Lower Level) �
Septic System ;
New Water Turnaround �
� � �� ���� �
' _Abandonment �F.�
��„ _:,�,�:r,�
RESIDENTIAL FEES: ��� ���� �
� $60.Q0 Water Heater, Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge) �
� $60.00 Lawn Irrigation(includes$5.00 minimum State Surcharge)
� $60.00 Add �iumbing F�ctures, Septic 5vst�r�Abandcn����,1Nai�r Tur�aro�rad*(includes�5.00 State Surcharge) �
� "Water Tumaround(add$200.00 if a 5/8"meter is required) ",� � �
� $115.00 Septic SYStem New($10.00 per as built)(includes County fee and$5.00 State Surcharge) C� v �
�� �
�. ..�.��. � _ . �, . � . TOTAL FEES$ ,��.�,��,a,�
�
CALL BEF�RE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against un�erground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. wvvw.aopherstateonecall.ora
I hereby acknowledge that this irrformation 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 rrot to start without a permit; tFxit the work will be in
accordance with the approved plan in the case of work which requires a review and approval of lans.
x � .�. x �
Appli nt's Printed Name Appli ' ignature
������l���� :�� ��^ '� �,` �Y �������Y ���r.;�:
_': _� ..• , : :. , :.: . . .
���nr��t��r��t�+�s �,,;���r����� �����#r�n ,.�..�.,�r T� �:�..,�,�;'�"� ���� ;
���r����ett��� !�#�i�5��, ��itl���� : �f�#�,
.. .$ . _.,..� ..,..,.�.�-�.,.v..�.., .. , _-�---� , , : .� ..; ,
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA140899
Date Issued:01/30/2017
Permit Category:ePermit
Site Address: 527 Hackmore Dr
Lot:2 Block: 3 Addition: Autumn Ridge 3rd
PID:10-12302-03-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Kevin C Nicol
527 Hackmore Dr
Eagan MN 55123
(651) 681-0623
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA144957
Date Issued:08/17/2017
Permit Category:ePermit
Site Address: 527 Hackmore Dr
Lot:2 Block: 3 Addition: Autumn Ridge 3rd
PID:10-12302-03-020
Use:
Description:
Sub Type:Reroof & Windows/Doors
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Windows/Doors: If altering the opening size, a framing inspection is required.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Kevin C Nicol
527 Hackmore Dr
Eagan MN 55123
(651) 681-0623
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
Applicant/Permitee: Signature Issued By: Signature
For Office Use
"%% ° i :1' :::e:
k.„ "-.... -0 _4? EAGAN
.,,,... .4„,.
/vim a,
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinginspections[a�cityofeagan.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 4i.,- : / Site Address: 77k.A4oi7r:'' „�..ri? : Unit#:
f � yy /�
Y Name: /. v r;`.> 1\..> I co [ Phone:
iResident/
I Owner Address/City/Zip: S"Z.7-1 / 4c4,,,,i4 i 2 j2 %
,
I Applicant is: Owner A Contractor
Type of Work Description of work: 7??,,e-, ��r
,/2. A� LC, 'O L'P C?L ��j
l 6 "
Construction Cost .. O o 6 Multi Family Building: (Yes /No )
s
Company r.1()U v JGC Contact: b� c' '_fE? .1- r t,�
Address: 2- ✓ LA_) • i 5--ft,-,.46?;er ie City: e6'Qj'2_ Z..../94e. 1
Contractor �r
State: Vii,- Zip: . � i{ Phone: ( (2 -�Q •mail: y ®F.1 ti eS T.ICC ted ; L
/i Ceiti
License#: RC2 5 7Z. Lead Certificate#: 1
If the project is exempt from lead certification, please explain why:
j
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:
I
I Licensed Plumber: Phone:
i 1
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information may be
classified as non •ublic if ou •rovide s•ecific reasons that would•ermit the Cit to conclude that the are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.com/subscribe.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.gopherstateonecall.orn
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 sta without a permit; i at the work will be in
accordance with the approved plan in the case of work which requires a review and a val of plans.
x ------)1J.4"-)'e --ge,•-liC(hA)IS/C-i X f ---. 7
Applicant's Printed Name Applicant's Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA175311
Date Issued:03/28/2022
Permit Category:ePermit
Site Address: 527 Hackmore Dr
Lot:2 Block: 3 Addition: Autumn Ridge 3rd
PID:10-12302-03-020
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 -
Kevin C & Lori L Nicol
527 Hackmore Dr
Saint Paul MN 55123--304
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-7052
Applicant/Permitee: Signature Issued By: Signature