The URL can be used to link to this page

532 Hackmore DrINSPECTION RECORD ' CITY OF EAGAN ? PERMIT TYPE: 3830 Pilot Knob Road ' PeRnit Number: Eagan, Minnesota 55123 Date Issued: (612?681-4675 SITE ADDRESS: ,„l i, i,,, r , APPUCANT: ?'? i1I11 t Pll?f?1 11i hf f? 1 I I? I!Si ?I ? f?Et(1C??1?}j'.. PERMIT SUBTYPE: ? TYPE OF WORK: wi I + INSPECTION DA ? . .• ?? ??1 • I ????,i . i ?? i I , i? i . ; ,:?!??is I r? I i ! ?, ? : . .,??i?il ! r•? !! I ?? IYRI l/"?l VkV IF- ? Permlt No. Permk Holder Date Telephone # SNV PLUMBING HVAC ELECTRIC ELECTRIC Inspectbn Date Insp. Comments Footings I 71f? Founda,ion /v 2 3 5 Framing ( Roofing Rough Plbg. ' U Rough Htg. I , II 7.5 7? I5ul. -zz 93 Fireplace /- j t Final Htg. ?a orsat rest i r i, Finetl Plbg. vo Plbg. Inspector - NWify Plumber Const. Meter EngrJPian eidg. Final No CO unless dri r Dedc Ftg. ( DeCk Final Weil Pr. Disp. "V1.., A / Address 532 HAGm7RE DRTVE Zip 5512 3 I.ot 7 Blk 1 Sub ntmM xIDGE 3RD THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date:B Yes No Inspector: Final grade 6" from siding) Permanent steps (garage) Permanent steps (main entry) IIZ Permanent driveway Permanent gas Sod/Seeded grass ? TraiUcurb damage ? Porch Basement finish ? Deck ? Please verify with the builder the removal of roof test caps from the plumbing system and the shuhoff of water supply lo the ou4side lawn faucet before freeze potential exists. Contad engineering division at 681-4645 before working in rightro£-way or installing underground sprinkler system. ? White - City Copy Yellow - Resident Copy Pink - Contractor Copy _ . . , . 1 11 apil /--1 . /-? w v wh - - ? 7- Agz s?1.?8 °v Re0 st Date Fire No Rough?in Inspection Fepmretl? , O Ae9tly NowWill i I J _K y ryp ?. Wh n Eyl _l I licensed contractor ? owner hereby request!insegclion-of aboelactrical wor I lob Atltlress ISVeet Box ar Route No ) Qry 3 o b?. Secuon No ' Township Name or No Range No Counry Ocwpant IPRINT) I ?G JA,?O7 Phone No f • ? Power Suopli¢r AYfipi? l?-G. j qtltlress /.u 0 i/? Eiecrncal ConvactorlConDany Name) Gonnector5 Lwense No ,E vZ7 ,USo d1?ca'.G ?. ? oo(Q oZ.9 Mailing qtltlra55 iGonVactor or Owner Makmg Instellation? Ac?, ?iozl.4?? ?i'I1"•?.??".? Aumon etl Sgnature iCOnvaaoreOwner Meking Insianation) A ? I Pnone Numoer yyo-Y?6o , MINNESOTA STATE BOAflO OF ELECTRICITY THIS INSPECTION REOUEST WtLL NOT Grigge-Mltlwey BIEg. - Room 5-173 8E AGCEPTED BV THE STATE BOARD 1821 UmveraBy Ave., S6 Geul. MN 55100 UNLESS PROPER INSPECTION fEE IS Phone(614)642-OB00 ENCLOSEO REQUEST FOR ELECTRICAL INSPECTION a?l'`•°j? eaooom-oe^ 11 ? Sae in?tmatons iK rompleeng 1MS lorm an back o1 yeitow copy I? 71 9 1 n "X" Below Work Covered bv This Reauest / QA % 7 e Atld ? Rey, ??.. TypeolBudding - -- -- ApphancesWiretl -?•. ?- EquipmentWired Home Range Temporary Service ? Dupiex Water Heater Electnc Heating Apt Bmidmg Dryer Other (Specify) Comm.Anduslriai Fumace Farm Av Conditioner I I Otharlsyeafyl Lontractor's Remerks, Compufe Inspechon Fee Below # I Other Fee # ServiceEntrane9Siz8 , Fee # Circmt5/FeBders Fee Swr"ming Pool 0 to 200 Amps ? B 0 to 700 Amps Trensformers Above 200 _ Amps Above 700 _ Amps SignS Inspector's Usa Only: y TOTAL irriganon Booms ? ?, ? a C? Special Inspechon ? a(? a 1 AiarmlCommunicanon ? .?/ THIS INSTALLATION MAY BE ORBER?D DISCONNECTED IF NOT Other Fee COMPLETED WITMIN 18 M S. I, the Electncal Inspector, herehy i Rough-in f e/`l? ceri iy that the above inspection has been made. Final ? oete OFFICE USE ONLY TM1Is r¢quBSt witl 18 months hom I A,CPTY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-12302-070-01 PERMIT Ct Iti e3s ? PERMIT TYPE: Permit Number: Datelssued: 532 HACKMORE DR LOT: 7 BLOCK: 1 AUTUMN RID6E 3RD UILDIN6 022337 10/26J93 DESCRIPTION: r ~.? B,uildin'g:,Permit Type SF DW6 Building Wo,rk Type NEW "-'UBC Occupancy\, R3 M-1 1) Construction Type VN Zoning R-1 ? Building Length ) 59 i Building Width 52 `.?-- ? 0? REMARKS: 5&W CONTRACTQR - KLUVER MECHANICAL FEE SUMMARY: Base Fee Plan Review Surcharge SAC SAC 8 SAC Units Subtotal CONTRACTOR:- ' MITTELSTAEOT BROTHERS 785 SUNSET OR EAGAN MN (612) 456-9125 VALUATION $755.00 $490.75 $66.50 $750.00 100 $2,062.25 PRV $133,000 MISC FEES Tntal Fee pplicant - ST. Lic 14569125 0003443 55123 $1.744.50 $3,806.75 OWNER: MITTELSTAED7 BROS 785 SUNSET DR EAGAN MN (612)456-9125 55123 I hereby acknowledge that I heve read this applicetion and state that the information is correct and agree to comply with all applicable State of Mn. Statutes and City of Eagan Ordinances. ? f " 7 APPLICANT/PE ITE IGNATURE .n ISSUED B': 51 NATUR REACTIVATE GI I Y Vt EALiA1V PERMIT N° rO'C ? ?D3 BUILDING PERMIT APPLICATION T 15 19 93 681-0675 ? o;?2 -a?7 ewk4? ) 01z? ?3? SINGLE 8 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. ? Yaluation of work ? ? ?9 Date iD ite Address: 5 _3:) NAne/.NfJJlF A/LivE STREET SUITE M Tenant Name: (commercial only) IAT -*_ BLOCK ? snsa. 4ruP ?,c? P.I.D. M Descri tion of work: ,rze'z_E The applicant is: ? Owner EY-Contractor ? Other (Deceribe) Name Phone Property LAST FIRST Owner Address STREET SiE M City State ZiP Company &,? Phone Contractor Address 7je6 JJ/G License # 3V4(3 Exp.5?,Y'4_ City State llol_ Zip Company Phone Architect/ Engtneer Name Registration A` Address City State ZiP Sewer & water licensed plumber &Lu?6:?'Z' Processing time for sewer & water permits is two days once area 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: ? ? OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging JZ 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 04 SF Porch ? 09 12-Plex O 14 fireplace O 05 SF Misc. ? 10 Multi. Add'1. O 15 Deck WORK TYPE 9 31 New ? 33 Alterations ? 35 Tenant Finish ? 32 Addition ? 34 Repair O 36 Move GENERAL iNFORMATION ? 16 Basement Finish ? 17 Swim Pool O 18 Comm./Ind. ? 19 Comm./Ind. Misc, ? 20 Public facility O 21 Miscellaneous ? 37 Demolish Const. (Actual) V- N Basement sq. ft. NWCC System rS (Allowable) V-N lst F1. sq. ft. City Mater YC5 UBC bccupancy .3 M_I 2nd F1. sq. ft. PRV Required Zoning 9-1 Sq. Ft. total Booster Pump B of Stories - - - Footprint Sq. ft. Fire Sprinkler Length 97 7 5 On-site well Census Code ? Depth 52• On-site sewage SAC Code z+r APPROVALS Tr Planning Building Assessments Engineering Yariance REGIUIRED IN SPECTION S ? Site ? Footing ? framing O Insul ation ? Wallbuard ? final ? Draintile ? Fireplace Permit Fee Surcharge Plan Review License MWCC SAL City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Lopies Other Total: sac x loo SAC Units vatLotim: G ARAGE', gsWT I 'Llrkav= S_ 133. 0aa ^ 30 x 22 :, 66 0 Z ?loz ? x 63YX/6=: /o?14y x is_ ?&w ?t Yh A? w t?y S,, b Y o !k il: ll P7 3) )to'y? 39u-7 tj T;s`aMT= 517(0 I!2xi? _ /? 2riL4= W? Le4 :12i ? . T SURVEYQR'S CERTIFiCA7`f MITTLESTAEDT ? N L.IJ?. ?n !7 M f? ? j ? 30 P a????' 1?t1 <, ? ? ? ? 4..f' ._S80° 10' 48" E ?° m1?lc /ys?o ., j y., 111.-r in ?>13 p ?o •- r?e? Q '? O ?? 2 ?6.75 ' 44, 2 ,3 ???? •\ 1 ? °vN 10 0 y gtl' ? ? o ? 4.33 M ? 3 O ? '? ' ? 1 $ i tl Ot h?' ? ^p ?v i I? ~ r? rt! ?' ? ? `?? ` H ?_.??2•8@ ~ ^ .? ? ?`?4..fls`rrlg O 'm qZ•Op ???` ?,g ? 1v 1 ?$ . ?3 O ?qr IF+A?'sART ]EN ?•???_? , MEMG BDMvr NOTE: 9V4(?Irv0 61M?1j3tONS $HdWN ARg FbR Fqqt7ANTAl,rypTE: NO SPEGFIC SOILS •INV£STrA71pN HA3 BEEN GOMPLETEp B VERTtcal. LOCATtON OF STRUCTURE ONLY. $EE ON TH1S LOT BY THE SURVEYOR. 7YE SUITABILITY. OF QRb11TECTUaL PtANS FOR BUILDIN6 & FOUNOA710N ' SOILS TO SUPPOR7 7HE SPECifIC HWSE PRpPQSED IS 61MENSiON5. DENOTES PROPOSEO SURFACE DRAINAGE NOT THE RESPONSI61LI7Y Of T4iE SURVEYOR O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET * DEiVOTES 1RON MONUMENT FOl11VD PROPOSED GARAGE FIOOR -??6• 3 FEET X000.0 DENGTES EXISTING ELEVATiON PROPOSED LOWEST F100R -- `>rB-tc. FEET (000.0) DENOTES PROPOSED ELEVATION PKiOPOSEb 70P OF BLOCK -- y3lv.7 FEET ?i ? ? ,r??o-??i?p? 'U WE HEREBY CERTIFY TO MITTLESTAEDT I?. M t& '- REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lo1 7, Block I, AU7UMN RIDGE.,?Rb ADDiTtON, according To ihe recorded ploi thereof, pakotq County, Mlnnesota, IT DOES NOT PURPORT TO SHOW IMPROVEMENTS Oft ENCROACHMENTS, EXGEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUP VISlON THIS 1; TH OAY OF OCT 11993. ZJA'A. HI?L, INC. ? PROPOSED GFiqDES SMUWN WEfYE SIG D: TAKEN FROM THE Or1+ElAPMEN7 PLAN FDR AUSUMN RIDOE PRE- (' ' PAREO 8Y piONEER EN6. LAST B ? • DA'1'ED B- 22-90. JOHN C. LARSON, LAND SURVEYOR MINNESOTA LICEIVSE NUMBER 78828 m m Np ?, o °)ames R. Hill inc. a ?` _ dm p ?m c'? °° ax ? ? n Wo ? a C ? ? o z ? o i - ? ()L, ? ' rr i W p PLANNERS / ENGINEERS / SURVEYORS a m ? ? v? • 2600 W. CTY. RD. 42 • BURNSVILLE, MN. 55337 + 612-890-6044 0 • ?. . w W m ? ¢ < a m C3'" 0 ? • 0? ? ? • 6?' ? 0 • ? C? 0 • 0^' ? ? • 0?? ? • 6?* ? ? ' • Er ? o • 0 0 : ? LOT SIIRVEY CHECRLIST FOR RESIDENTIAL BIIILDING PERMIT APPLICATION PROPERTY LEGAL• DOCIIMENT STANDARDS Registered Land Surveyor signature and company Building Permit Applicant ' Legal description Address North arrow and bar scale House type (rambler, walkout, split w/o, split lookout, etc.) Directional drainage arrows with slope/gradient t. Proposed/existing sewer and water services Street name Driveway ELEVATIONS Existinv 0 8? ? • Sewer service 2? ? 0 • Lot corners B? 0 13 • Top of curb at the driveway 0 6'? ? • Elevations of any existing adjacent homes ProDOSed C? ? ? • Garage floor ? ? • First floor tr/ ? ? • Lowest exposed elevation (walkout/window) P,--C7 ? • Property corners ?? 0 • Front and rear of home at the foundation PONDING AREAS (if aDVlicable) i] ? • Easement line ? ?CJ ? • NwL 0 C',Cl • HwL 0 H? ? • Pond # designation ? 0 • Emergency Overflow Elevation entry, ?? ? • Lot lines ?? ? • Right-of-way and street width (to back of curb) ?? 0 • Proposed home dimensions including any proposed decks, overhangs greater than 21, porches, etc. (i.e. all f- structures requiring permanent footings) U? ? • Show all easements of record and any City utilities within / those easements ? p ? • Setbacks of proposed structure and setback of adjacent existing homes ? ?• Retainin e rements, if any Reviewed• e? ? za ?-? -7 N me / ate October 1992 Date of Survey: /111?4Z; rNE Lffv(cF, r.c-n CITY OF LAKEVILLE BUILDING INSPECTION DEPARTMENT 20195 HOLYOKE AVENUE, P.O. BOX 957 LAKEVILLE, MINNESOTA 55044 612-469-4431 This form is only applicable to detached one-and-two family dwellings. The :{7requiraments herein are based on amended Section 502.2.1.7 in lieu of the :criteria specified in Sections 502.2.1.1, .2 and .3. Huildinq Address: Contractor or Owner: "R" Values Ceilinqs Design+Required 3$ Walls* (exterior), Floors* (overheated spaces) "Windows*+ Foundation Walls Design-URequired 2,Q Design3e Required 20 Area fsa ft) % of Ext.Walls 9 X; "? 3 (without foundation) Design -I'7Required _I Desiqnllit-Required 5 (when insulating full depth of foundation wall) Design_Required I& " (when insulating only to frost depth & footings extend bqlow) Slab-on-qrade Designg.3 Required 8.83 floors Doors DesiqnJV Required 3 Footnotes- For the insulated cavity of opaque walls, floors, and rim joists. ** Maximum window area must not exceed 12 percent of the area of exterior walls, not including foundation walls. CERTIFICATION I hereby certify that I have completed the above information and that it complies with the Minnesota State Energy Code. Siqnature Date: CITY USE ONLY ? ',S D L BL ? RECEIPT#: F? ? a5?4 SUBD. yLyC? ? RECEIPT DATE: 1998 PLUNMING PERMIT (RESIDENTIAL) CITY OF EAGAN 3630 PILOT KNOB RD EAGAN, MAI 55122 (612) 681-4675 Please complete for: X? single family dwellings ? townhomes and condos when permits are required for each unit x? backflow preventer for underground sprinkier system FIXTURES EACH # TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot TublSpa 3.00 x = Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet "minimum- t 3.00 x = Rough Openings 1.50 x = Water Softener * for dwellings under construdion 5.00 x = Water Softener ' for existing dwelling 20.00 x = U.G.Sprinkler 'fordwellingunderconst. 3.00 = U.G.Sprinkler 'forexistingdwelling ?/c2c(.LU,ry G???0.00 AltEfetiOnS 'to existing residence 20.00 = Water Turn Around 20.00 = Private Disposal System * MPC lic. 75.00 = (new and refurbished systems) Private Disposal Systems' Abandonment 20.00 = RPZ (new installation only) 20.00 = STATE SURCHARGE .50 TOTAL ?n ?5D -------------------- ----------------------------------------------------------------------------------------------------------------- I hereby adcnowledge that I have read this application, state that the infortnation is corted, and agree to wmply with ell applicable Ciry of Eagan ordirances. It is the applicanYs responsibility to notify the property awner that the City of Eagan assumes no liability for any damages causad by the City during its normal operetional and maintenance adivities to the facilkies constructed under this permd wi[hin City propertylright-of-way/easement. SITE ADDRESS: 53? T?`?C????-?+,0 ? `??? , o-4 ? . OWNER NAME: INSTALLER NAME: TELEPHONE#: 4?, /,2 - 753`3S??P?/ STREET ADDRESS: L<? 49-6C-? /",CF) . CITY: STATE: ?2G • ZI P: s-?O J I ?ebcv 71?5-/ ?+ D? ? PU'a 9?a5/( "aA- SIGNATUREO PERMITTEE CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1998 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTT. ------------ NO. F[X1'URES E&C-H / SHOWER 3•00 3 WATER CLOSET 3•00 i BATH TUB 3.00 L LAVATORY 3•00 _ ? KITCHEN SINK 3•00 i LAUNDRY TRAY 3•00 / HOT TUB/SPA 3•00 / WATER HEATER 3•00 / FLOOR DRAIN 3•00 / GAS PIPING OLTTLET • minimum • 1 3.00 ---- ROUGH OPENINGS 1.50 WATER SOFTENER 5•00 PRIVATE DISP. • DakCty. Iic. 15.00 U.G. SPRINKLER • Eome under mnat. 3•00 ALTERATIONS ' io atisting 15•00 WATER TURN AROUND 15.00 STATE SURCHARGE T/lT 1 ? STTE OWI? INST ? ? . q .50 9. S/) ADDRESS: CITY: ' ? y/' 6`^,? - STATE:ZIP CODE: PHONE #: (( /,:)) e-Y%'S -3 / ,1? SI TURE OF RMITTEE 1993 PLUMBING PERMTf (RESIDENTIAL) CTIY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681.4675 1993 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PII.OT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR ALL COMMgRCIAIANDUSTRIAL BUILDINGS. ALSO FOR MULTI- FAMILY BUP.JINGS WHEN SEPARATE PERMTTS ARE NOT REQUIRED FOR EACH DWELLING Ui::T. _ NEW CONSTRUCTION ADD ON _ REPAIR WORK DESCRIPT'iON: CONTRACT PRICE: $ FEE: 1% OF CONTRACf FEE. STATE SURCHARGE $.50 FOR EACH $1,000 OF PERMiT FEE MINIMUM FEE $ 25.00 ° ..." . CONTRACT PRICE X 1% STATESURCHARGE TOTAL SITE ADDRESS: $ $ TENANT NAD1E: STE. # OWri'ER NAME: INSTALLER: ADDRESS: CITY: PHONE #: STATE: ZIP CODE: FOR: CITY OF EAGAN APpLICANT / 'o ?.s< PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMIT'S ARE REQUIRED FOR EACH UNTT. ? NEW CONSTRUCfION ADD-ON A/C ADB-O::' F`JitNACE DATE I ZZZA-3 FEES HVAC: 0-100 M BTU ADDITIONAL 50 M BTU GAS OUTLETS (MINIMU1 C$3.po EACH) ADD-OIv'/REMODEL (EXISTING CONSTRUCTION) STATE SURCHARGE TOTAL S1TE ADDRESS 24:00 C? ? $ 15.00 .50 c Q, OWNER NAME:? i 7.??5 fEcedCt?? TELEPHONE #: INST. ADDRESS: 12481 Rhode Island Ave. So. CI.I.Y: , 894•0005 STATE: ZIP CODE: TELEPHONE #: A A? S ATU OF PERMITTEE 1993 MECHANICAL PERMIT (RESIDENTIAL) CIT1' OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 a 4L - B D; PLEASE COMPLETE FOR ALL COMvIERCIALJINDUSTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTf-IER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMTTS ARE NOT REQUIRED FOR EACH DWELLING UNTT. DATE: NEW BxJI?.D.T.NC- INTERIOR IMPROVEMENT WORK DESCRIPTION: CUNTRACT PRICE: $_n_.., FEES 1% OF CONTRACT FEE $ PROCESSED PIPING: $25.00 MINIMUM FEE: $25.00 STATE SURCHARGE $.50 FOR EACH $1,000 OF PERIGITF FEE. TOTAL $ STI'E AllDRESS: OWNER NAME: TELEPHONE #: TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS: CITY: TELEPHONE STATE: ZIP CODE: SIGNATURE OF PERMI77EE CITY INSPECI'OR 1993 MECHANICAL pERMIT (COMMERCIAL) CITY OF EAGAN 3830 PIIAT KNOB RD EAGAN MN 55122 (612) 6814675 Use BLUE or BLACK Ink µ r i for Office Use Permit City of Ea I Cam, I d Ed I Permit Fee: I 3830 Pilot Knob Road I OCT 02 Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I I Fax: (651) 675-5694 1 Staff: - - - - - - - - - - - - - - 9z 2009 RESIDENTIAL BUILDING PERMIT APPLICATION 0411 C( J /0 0 Date: i V y 4 _Site Address: 532 H m(a1 ng, 06 U e Tenant: iV {'i r ~J Suite M RESIDENT I OWNER Name: &rll'*) C yam' 718A) Phone: qD /l % ~ L ` 6` Address / City / Zip: 53 2 ))h-CA A4,a? e ~rYV Ci Applicant is: Owner A Contractor TYPE OF WORK / a Description of work: / 6/1 ' 'f~, d~ Construction Cost: A~, 6(go Multi-Family Building: (Yes / No CONTRACTOR Name: G r}Vs°ib GO/t43,b'LG /0?%) ljOt1 License f Address: y 71/rli~tr ~IrP~ S, City: Goft#s e 6 roves State: A/k) Zip: z~(V 6 Phone: 913 / Contact Person: G Y,,~tJl /U 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 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. xy~ye~1'~a/ x Applicant's Printed Name Applicant's Signature Page 1 of 3 ~Si4~~~2GClz , ` DO NOT WRITE BELOW THIS LINE all . o SUB TYPES Foundation _ Fireplace _ Porch (3-Season) _ 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 c.~.U Occupancy &A-1 MCES System Plan Review Code Edition j~j 1y SAC Units (25%_ 100%4) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) _7y Final / No C.O. Required Foundation HVAC 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 Meter Size: Radon Control Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review,. MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 O N ' NN 301t"t1 48 41, Are 1 j.at3 Of o~ 1w I .p Avt o, L~~ tn~. ova _ ►s.7~. ' x e W4) V; f it i +i: (t? rn y p x a Al,. r 40 to Zat '30# oriv NOTE: @VR.DII.to DIMENSIONS SHOWN ARC FbR I*R ALWOTEt NO SPEDIFIC SOILS -INVESTGA-nON HAS BEEN COMPLETED 6 VERTICAL LOCATION OF STRUCTURE ONLY. StE ° ON THIS LOT BY THE SURVEYOR. THE SUITABtIlTY- OF DIMENSIONS. fUaL PLANS FOR BUILOINSi Q FOUAIRATION ' SOILS TO SUPPORT THE SPECIFIC HOUSE PROPOSED IS y+ DENOTES PROPOSED SURFACE DRAINAGE NOT THE RESPONSIBILITY OF THE SURVEYOR O DENOTES IRON MONUMENT SET SCALE: 1 INCH y- SO FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - `P-2Ca.5 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR 9Z6.O FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK `34,,7 PEET WE HEREBY CERTIFY TO MITTLESTAEDT THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIE$ OF: Lot 7 , Block I , AUTUMN RIQGE. .J~RD ADDiTION, OGCording to the recorded plat thereof, Dakota County, MlnnSsoto. IT- DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUP VISION THIS II TH DAY OF OCT 11893. SI6 J R. HILL, INC. PROP031:0 GRADES SHOWN WERE TARN FROM THE DEVELOPMENT PARED BYAP ONiE (ER NSLAST DATED 22-90 B JOHN C. LARSON, LAND SURVEYOR MINNESOTA LICENSE NUMBER 18828 r-4 REScheck Software Version 4.2.2 Compliance Certificate Project Title: ADDITION Energy Code. 2000 Minnesota Energy Cade Location: Dakota County, Minnesota Construction Type, Single Fangly Glazing Area Percentage: 30% Ctimaie Zone: 2 Construction Site: Cwner/Agent: Designer/Contractor: MICHAEL & KARIN CIERZAN 532 HACWORE DR EAGAN, MN 55123 Compliance: 4.Wo Better Than Code Maximum UA: 81 Your UA: 77 Assembly or R-Value R-Value or Door Perimeter U-Factor Ceiling 1: Flat Ceiling or Scissor 1 runs 304 38.0 0.0 9 Vial 1: Wood Frame, 16" o.c. 439 19.0 0.0 18 Window 1: Above-Grade.-Wood Frame:Doubie Pane wish Low-E 132 0.320 42 Floor 1: ,Alt-Wood Joist/Truss:Over Outside Air 297 38.0 0.0 B Furnace 1: Forced Hot Air 94 AFUE Comp/fance Statement The proposed building design described here is consistent with the building plans, specirrcadons, and other calculations submitted vrtth the permit application. The proposed twiding has been designed to meet the 2000 lAnnesota Energy Code requirements in RESciteck Version 4.2.2 and to comply with the mandatory requirements listed in the REScheak Inspection ChecdsL 4yyj IrN ~I S Name - Title gnature Date Project Tide: ADDiTION~._ ~ Report Idate: 10106J09 Data -filename.- Unt83ed.rck pace 1 of 1 Z-d 9VZ£-£6b-L99 daoC) uoi;}ona1suoo;s9ua3 e-?£: L L 60 90 100? Use BLUE or BLACK Ink r--------- For office Use City of E ~ Permit ap I I Permit Fee: a 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: y Site Address: ✓//~"`/v0U Tenant: Suite M RESIDENT/ OWNER Name: Z &V Phone: Address / City / Zip: Applicant is: Owner T Contractor TYPE OF WORK Description of work: owl p~1/~/~ ~ Construction Cost: <JMulti-Family Building: (Yes /No X^ 1 CONTRACTOR Name: ~b 60,t* C to eVr License 201-16511- 19 Address: 7 7l City: G'O ~S~ C9 y(~1i`~i State: R Zip: b2~L Al Phone: Contact Person: &A, /--e Jy eC G1,v 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 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 worts 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 E?, VX )el, 3 GrU J X Applicant's Printed Name Applicant's Signature Page 1 of 3 C~ - - - - - - - - - - - - - - - - - For )ffi i_(1~ Permit / V_ City of EaV I Permit Fee: ~ I 3830 Pilot Knob Road I i Eagan MN 55122 I Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 Staff: j 2008 MECHANICAL PERMIT APPLICATION Date: ,~o~ 9 09 Site Address: I°1A b (l 'b o__ Tenant: Suite RESIDENT / OWNER Name: +f~~ Phone: (95- C086- Address / City / Zip: S~fJM y1 CONTRACTOR Name: License Address: 18550 County Rd. 81 Maple Grove, MN 55369-9231 _ (763) 428-3677 State: Zip: Phone: Contact Person: TYPE OF WORK New )t Replacement Additional Alteration Demolition Description of work: 4 NOTE: Both roof mounted and ground mounted rechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector or one of the Planners for information on permitted screening .methods., PERMIT TYPE RESIDENTIAL COMMERCIAL Furnace New Construction Interior Improvement Air Conditioner Install Piping Processed Air Exchanger Gas Exterior HVAC Unit * HVAC units must be screened Heat Pump Under /Above ground Tank Install / _ Remove) Other When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x1% $50.50 Minimum (includes State Surcharge) Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. If Permit Fee is > $1,000, surcharge increases by $.50 for each State Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). $ TOTAL FEE 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 theeccase of work which requires a review and approval of plans. x \ vim, , Applicant's Printed Name Applicant's Si r FOR OFFICE USE Reviewed By: Date: Required Inspections: Under G~r~und Ro!!iuh In Air Test GJ ; Ser is Test In-IILv)r Heat Final PERMIT City of Eagan Permit Type:Building Permit Number:EA110299 Date Issued:05/02/2013 Permit Category:ePermit Site Address: 532 Hackmore Dr Lot:7 Block: 1 Addition: Autumn Ridge 3rd PID:10-12302-01-070 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Karin B Cierzan 532 Hackmore Dr Eagan MN 55123--304 Property Claim Solutions LLC 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature A CARBON MONOXIDE ALAr uS1 BE INSTALLED IN ALL NEW SINGLE FAMILY AND MULTI FAMILY DWELLING UNITS. VAFF RRIER laiST 6-Sfl.ED GNI TOE WARM SVE OF ALL WALLS ANC ATTIC CriNG. ALL EXTERIOR WALL OPENINGS FOUR FEET OR GREATER IN WIDTH SHALL BE SQUASH BLOCKED SMOKE DETECTORS ARE REQUIRED ON EVERY LEVEL OF THE HOUSE .AAISS2. IN EVERY SLEEPING ROOM AND IN EVERY HALLWAY LEADING TO A SLEEPING ROOM 11.11•10.011.110.111101.114......4.1118.6101.1.0....*** 3°Yel2r 1-P ev, 5 111•7i)iii 4.° ( 3 7- h/.13-iook,s. Po 0 rt $ 541 Pg. nfir 177 tr- .D! NG INSPECTIONS DIVISION qi636 jet 1b' Use BLUE or BLACK Ink r————————————————-+ K I For Office Use I . I � �� I Permit#: l�d O �� I Permit Fee: l G�3� I 3830 Pilot Knob Road RECEIVED I I Eagan MN 55122 � Dat�•Received � Phone: (651)675-5675 ,JUN Z �i ZO�4 � � � Fax: (651)675-5694 I Staff: I I � � ----------��G---�.�,�`� 2014 RESIDENTIAL BUILDING PERMIT APPLICATION � J�� `��C�' � � �� 7�1� .2s�� 't� Date: � �� ^` � Site Address: � \ /��`'�- �',G� Unit#: Name:��Jl .�l� � �iZ�-� Phone:(p�� .7 Residentl �g Owner Address/City/Zip: (.t�� .� � Applicant is: �Owner Contractor ` ° ' ��r z° T @ Of WOI'k'' Description of work:_�a�� ' Yp '' Construction Cost: Mufti-Family Building: (Yes /No� ': Company: ' Contact: r C017tYaCt01"' Address: City: State: Zip: Phone: EmaiL License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) �l«use �v�s .��tl� ,��.t�r 15 ? �'6 ��q�� 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`Cbntractor: Phone: NOTE:Plans and supporting documents tl�at you submit are canside�et�l to be pubfic information. `Portions of the information maybe classified as non-public if you pro�ide speeific reasons that would permit the City to - conclude fhat the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protectior�against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.ora 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 ermi issuance. n ��.. F f.... , X � rlff""�� X . � . Applican 's rinted Name Applican 's Signature Page 1 of 3 �� i l�c�r-��r e �r / DO NOT WRITE BELOW THIS LINE '� C�`�� :. , SUB TYPES Foundation Fireplace Porch (3-Season) _ Exterior Alteration (Single Family) Single Family Garage Porch(4-Season) _ Exterior Alteration (Multi) _ Multi � Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous _ 01 of_Plex _ Lower Level _ Pool _ Accessory Building WORK TYPES New = _ Interior Improvement _ Siding _ Demolish Building* • � A�ddition > � _ 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 ,,�/G�1 r Occupancy Z','�C-L MCES System -" Plan Review Code Edition � SAC Units ^ (25%_ 100%� Zoning �-'� City Water "" Census Code ��k Stories Booster Pump ---- #of Units � Square Feet �y PRV -^ #of Buildings Length /G Fire Sprinklers — Type of Construction � Width /K REQUIRED INSPECTIONS Footings (New Building) Meter Size: � Footings (Deck) Final/C.O. Required Footings (Addition) � Final/ No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Roof: _Ice &Water _Final Pool: _Footings _Air/Gas Tests _Final � Framing Drain Tile Fireplace: _Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick Insulation Windows Sheathing Retaining Wall: _Footings_Backfill_Final Sheetrock Radon Control Fire Walls Erosion Control Braced Walls _�.---- Other: Reviewed By: , Building Inspector RESIDENTIAL FEES ��u� �G��Q lb`"� �3GU Base Fee ��3 -- � Surcharge Plan Review �i7� MCES SAC City SAC Utility Connection Charge S8�W Permit& Surcharge Treatment Plant Copies TOTAL Page 2 of 3 " T � ��RVEY� �� GE��`�� MITTLESTAEDT � �� _. � t.lJ?. � .. m !! m h M ��i L � ��l. Li„��'' ,.-�iDf.74 ,� �, cr. / �' - 48 � -� , �. � �� + $ ° Io` �t � � �� N��4 � . ... �I �� :�'13�O$ � f8.75�,.' � #� �'�.Q�I`��n 'p� �7' {p� '� � t �� +��.; �r' ., � ��"�� # � �'� t 'o� � 4•33 '`"'t, �..,� �� fih � � 1 �y�_ �Q �-- _..._ �G ""yl� 's� � � r � c� ti � � � �0` o, l `-� , � ��4 �'�` � _._w._.4 �._ �+.1 C � �` ' o,. -. �, ��.�.,w, � �r �� !�" h co �,� ° • , �� r � � ` _ . . ,,,.�. � v� �w � � �"'-- ��a, ._.._ _ �� M � � o � � � r _.___ /y� .�a _...._v � � �� _ � _._-- �� ~Q} � � � � � ,� �� Q � / �„ `V . ° � ' O � � , H ��sJ � � .� I . G_� /"� � _ � o w ,,, '--�-r�, �.g$ � � � � -.-..1� �� .. �. f � � •► ��- �4, .� � � 1 o�i fm t ' `, � ��- r i �,,,f � !c� 4�� '�'�,��`� � '� ... _^ � $ t� S � � � � _ � r4o �� , �, �� `'��,�., -.�� , � E _. � D x � � �. ��. � �� -,d�i .�Z�► ' � �� _ _ �� ;��._�i�,/i� � . �� f��a�� . �� NOTE: �V�►.QsNO OIM�t�t3tON3 SHOWt�i AR� F�bR HpptZaAt'CAt_,�pT�+ NO S7�CF�C SU1LS •INY�S3�+ATIQN! HAS g�N COMYL�T�{1 � YER7lCAL LOGATEaN a� 5TRl1GTURE 4Nk'f. �� ON �'HtS LOT 8Y THE SURV�YOR. TNE SWTA�iS.lTY. �F QRCfiIT�CfUA�. PLANS FOR BUILDINi3 Er FOUJ�pA710N ` SOILS TO StJPPOR'� YHE Sf'ECift� HO(1SE P�tppQ$�p IS pIM�NS10N5. �� DEN4TES PROPOSED SURFAC� DRAINAGE Hor THE ��s�aHSiei�.t�rY 0� THE su�vEYO�. O OEtV4TES IROt�i MQtVUME�iT 5ET SGALE: 1 INCH �- �O F��T • DEiVE37ES 1RON MONtJMENT FOUiVD PR�POSED GAR�GE FLOOR —�'��•� ��7 X000.0 DEMGTES EXIS7ING ELE1/ATlQN PROPOS�D k.OYV�ST F�.04R �9�'c1-c"c- F�ET (000.0) D�NOTES PROPOSED ELEVATIOiV Pf�bPdS�D 7dP O� gLC3C#t--y�.�fo.7 �E�1' WE HER�BY C�RTlFY TQ MITTLESTAEDT uT'�bil�t� �i � ` t�i��tp��L* REPR�SENTATION OF A SURVEY QF THE BOUNDARIE$ OF� Lot 7 , 8locic I , AUTUMN RIDGE.,�1�b �DDiTtON, accordEng to rt�e recorcied plat thereaf, Qakotq Caunty , Mtrtnesa4a. � � IT DOES NOT PURP4RT TO SMOW 1MPROVEMENTS dR E�iGROACHMENTS, EXGEPT AS SH�WN. RS SURVEYED BY M!� OR UIVDER MY DIREGT SU� VtSfdl�f 1'HIS I; TH DAY i7F aCT , 18g3, 51G D: .!A R. HILL, INC. PROPOS�O 6qqQE5 StiUWN W�F(E 1'AKEN FROM THE O�VEWpM$tJ1' PLAN Fpli AUTUt�AN RlDOE PR�- e' ' PARED 9Y PIONE�R El�36. LA81' � . DA'I'�D B^ 22-90 JOHN C. LARS4N, LAND SURV�YOR MINNESOTA �kC�NS� NUMBER �8826 �� >� _ � N Go : ►�� Q f ■ , �. �� ! . � dm � mt�o 'NV`�� ° av � � �� r �� a � o rn � �> � c�ao � � o � l�LAN�IER� / ENGIt�lEERS ! �URV�Y{�R� ,� � � z � c� `� � W � � m v►• 2�OQ W. CTY. RO. 42 • SLIflNSV1LLE, MN. $5337 * $12-$8�-6Q44 PERMIT City of Eagan Permit Type:Building Permit Number:EA139879 Date Issued:11/14/2016 Permit Category:ePermit Site Address: 532 Hackmore Dr Lot:7 Block: 1 Addition: Autumn Ridge 3rd PID:10-12302-01-070 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Karin B Cierzan 532 Hackmore Dr Eagan MN 55123--304 (612) 834-4161 Kat Construction Llc 8833 79th St Annandale MN 55302 (320) 266-3455 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA177616 Date Issued:07/11/2022 Permit Category:ePermit Site Address: 532 Hackmore Dr Lot:7 Block: 1 Addition: Autumn Ridge 3rd PID:10-12302-01-070 Use: Description: Sub Type:Reroof & Siding 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. We encourage you to retain an electronic copy of photos until the project passes a final inspection. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to Valuation: 10,000.00 Fee Summary:BL - Base Fee $10K $191.75 0801.4085 Surcharge - Based on Valuation $10K $5.00 9001.2195 $196.75 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 - Karin B Cierzan 532 Hackmore Dr Saint Paul MN 55123--304 Ashco Exteriors Inc 11164 Zealand Ave N Champlin MN 55316 (763) 225-8333 Applicant/Permitee: Signature Issued By: Signature