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565 Hackmore Dr
Use SLUT: or BLACK Ink I------- r ' ! For Office Us ! ! 1 Permit City of E aEdf € PermitFee: 2 3830 Pilot Knob Road t ~ Eagan [VIN 5512 Date Received: ! Phone: (651) 675-5675 I ~ Fa: (61) 675-5694 Staff: ! 2 1 1 PI V PERMIT APPLICATION 77 ll Date: ...site Address: c'~ Tenant: } suite RESIDENT / OWNER Name: luc, Phone: Address/ City I Zip: S~ ! C4G +r c ,l CONTRACTOR Name: r "o License/#: Address: 0 / r t f~, City: J-/., / r p State. + Zip: Phone: ContactG Email: TYPE OF WORT( l ew _ Replacement Repair _ Rebuild Modify Space Work in R.O.W. Description of work: PERMIT TYPE RESIDE ! IAL _ (water Heater Water Softener Lawn Irrigation RPZ ! PifB) - Add Plumbing Fixtures Main i ~ Lower Level) Septic Systerrr Water Turnaround New ~ Abandcnanent RESIDE'PITtAL FEES. $55.06 Minimum Water Heater, Water Softener, or Water Neater and Softener (includes $5.00 State Surcharge) $35.00 Lawn irrigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Tu around* (includes $5.00 State Surcharge) "Water Turnaround (add s l ea co if a 5l8" rneter is required) $105.00 Septic System New ($10.00 per as built) (snc(udes County fee and $5.00 State Surcharge) r $95,00 Fire Repair (replace burned out appliances, ductwork, etc) (includes $5 00 Stale Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 4 pro-.,, gainst underground utility damage. Gal! 48 hours be ore you iiccmi to dig to receive locates of underground utilities. hereby ackno aft _ - ' is w. 0 ~s d cmkas of t^a City of Eagem- Utzt d -'i for e 1 z t a a juit 4 a...<:.: ! be in • ~a"G'd3f£;'~3f3'~.,.'bd.~;$i`~ Bc+„f~~ -~C..r.,?%.Y. :-C~-- =t£:." fE~~it~SarE?L~isi.'3RG~"eis of- ; U` : l"f" I t y / FOPI O r lCF 114.°x'"_ pevi p E _:3. f}}$s..Cf c rte" s, PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA098521 Date Issued: 04/08/2011 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 565 Hackmore Dr Lot: 2 Block: 2 Addition: Autumn Ridae 02nd PID: 10-12301-02-020 Use: Description: Sub Type: e-Windows iDoors Construction Type: Work Type: Windows Doors-New ; Replacement Description: House Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee S3K $88.50 0801.4085 Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195 Total: $90.00 Contractor: - Applicant - Owner: Home Depot At Home Services Douglas Vanwatennulen 656 Nlendelssolm Ave. N 565 Haclanore Dr Golden Valley NIN 55427 Eagan NIN 55123 (763) 42-8826 I hereby aeknowledae that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature ? CITY OF EAGAN PERMIT TYPE: +; ?? i i ?' i?f; 3830 Pilot Knob Road Permit Number: Eagan, Minhesota 55122-1897 Date Issued: (612) 681-4675 I i te }.? 1:• ?; SITE ADDRESS: 54i i 0 ,' 6) APPLICANT: . 1i;;? r ?i??? ? I.?Iz t?s , i??, ;•, I t i i? i4 F? ,: ? ?? ?? ? .i'd ? I i? !. 1 ? .' I I 1•) PERMIT SUBTYPE: TYPE OF WORK: 'f 1.+i',? F'11ttt4 i IiJ1..Z (,l.j i) Ft?n t 1 N14 1 1 1 1 ; nhl:I Nr F 1 NAi Itf MANK S ASf PRFIATt Wi R MJ I i`•.: V F"tl1rl{r#'f7 f tJC3 ANY 1 i t V f R 1 CA ! Wt3}rY ? ?5 -- - - - - - - - - - - - - - -- -- - - -- - - -- -- - -- - - - Permit No. Permit Holder Date Telephone # ELECTRIC W PLUMBINCa HVAC Inspection Data Insp. Commenis FOOTINGS FOUND FRAMING 7 l? G?+ ? ?f?Q CJ ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOAfiD FIREPLACE ? FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL 4/wg /IL- BSMT R.I. BSMT FINAL OECK FTG / DECK FIN;-L I CITV OF EAGAN 3830 Pilot Knab Road Eagan, Minnesota 55123 (612) 681-4675 INSPECTIUN RECORD PERMIT TYPE: Permit Number: Date issued: Control No. 0698 H??tI1??MM SITE ADDRESS: 1,01, z T, E,0, HACKMORk nR nutuMN 141001E 2MO PERMIT SUBTYPE: `, f IJtd[, APPLICANT: MCDONAl.D r..oW?-t IMr. (6tz) 680--1*61 TYPE OF WORK: NF'W INSPECTION ( r3?3 i I. MEi .A . f?ItAMII+??i . tN 7U! A f'I+:sµ PINAk. P'CFPE'{'! Ar t ? lit MAKF'`; ! f)pV S4 W C[!MTliAl:1'OFt -STAIR PLN9 ?--?---- ----- ' ----------- _?___ ? PermR No. Permit Holder Dale Telephone # SIW PLUMBING HVAC ELECTRIC ELECTRIC Inspeetion Date Insp. Commerita Fowings I -?% ?9 .t. ?..1fU Foundation Framing Roofing Rough Plbn. r Rough Hlg. Isul. OC? Fireplace O / d ?/3/ [,? Final Htg. Qrsat Test Final Plbg. Za !Z Flbg. InsPector- Nodiy Plumber Consi. Meler EngrJPlan Bidg. Final ?-23-Z Dedc Flg, Dack Flnal wen Pr- D+sp. 5+ y • C # F: ir fEtr#ifiratir uf (Orrupanry Citp of olagan 19r;ttrbnenx nf IiuilbiM Jnapertinn This Certiftcate i.ssued pursuant tn the requiremenu of Section 306 ojthe Unifornr Building Code certifying that at tJre time of issuance thrs strucuere wes in compliance with the various ordinances of the Ciry regulaling building eonstruction or use. For the jollowing: ux ctass;rcaria, ". Fbmiii rva. 870 o-„a.ncr rype R3/M 1 Zo,,;ng Dkrirt R I rype COOSL VN 0wrerdB.ldinMR1fNAT7) !TXqI' TA1' pddrcss 1212 Bi711?RTi7. $pY RpI B'VIII?' euud;ng Aaa?565 HA[3MM DRIVE I.2, ffi. AUILMd RIIIC•E ?NID ? ql.3/42 /BUTM OTA§ff POST IN A CONSPICUOUS PLACE Y Address: 565 HA„r[MRE DRIVE Lot 2 Blk 2 Sec/Sub ALTI" R= 2Np MOM These items wera/were not complete at the time of the final inspection. Date : 9/23 92 Yes No ° Tnspprrnr- Final grade (6" from siding) Permanent steps - garage Permanent steps - main entry Permanant driveway Permanent gas Sod/seeded?grass ? Trail/curb damage Porch Basement flnish Deck Please verify with the builder tha removal of roo£ tast caps frora tha plumbing system and tha shut-off of vatar supply to the outside lavn faucet befoxe freeze potential exiats. -0a KcmEOwu White - City copy Yellow - Resident copy Pink - Contractor copy Ab? Clty 0f EaiaIl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax:(651) 675•5694 _________I ? For Office Use ? Permit#: Y"`J.Ja? 1 j ? Permit Fee: ? I i ? Date Received: i ? ? Staff: ? `-----------------I 2008 MECHANICAL PERMIT APPLICATION Date: S'?I z_aC.?LiO SiteAddress: Tenant: DGu. UG KJ ? G`Ct? rMn ?n? e n? Suite #: RESIDENT / OWNER Name: T,.,. c 1. i u CA e rmv.lf s.. Phone: Address I City / Zip: Sn ? (f, .Q ? CONTRACTOR Name: )0i` t D f - 4,- & f9 License #: Address: 16s-R41 .?,!z A!'oo? C?- City: Yp`i o i' L,? /72AJ ` State: /?A-1 Zip: Phone:';??-IJLJ7 7517? ContactPerson: ?L?°c?.v? fJl`Crr+X? TYPE OF WORK - New %?-, Replacement _ Additional _ Alteration _ Demolition Description of work; NOTE: Both roof mounted and ground mounted mechanical equipment is required !o be screened by City Code. Please contact the Mechanical lnspector or one of the Planners for information on ermitted screenin methods. RESlDENTIAL COMMERCIAL PERMIT TYPE Interior Improvement New Construction yFurnace _ _ _ ? Air Conditioner _ Install Piping - Processed EMerior HVAC Unit G85 _ Air Exchanger _ _ ' HVAC units must be screened _ Heat Pump Under / Above ground Tank ? Install ! Remove) Other " When inst211ing/removing tank(s), call for inspection by Fire - Marshal and Plumbin Ins ector RESIDENTlAL 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) $ TOTALFEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x 1% $50.50 Minimum (includes State Surcharge) _ $ Permit Fee - If Permit Fee is less than $1,000, surcharge is $.SD. - If Perrnit 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). $ TOTALFEE I hereby acknowledge that this information is complete and accurate; that the work will be in confo e with the ordinances and codes of the City of Eagan; that I understand ihis is not a pertnil, but only an application for a pertnit, and xrork is not to start wit ut a p rtnit; that the work vrill be in accortlance with the approved plan in the case of work which requires a rewew and approval of plans x 1J Eo-,\ l-Gn oK -?- ApplicanYs Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough In Air Test Gas Service Test In-floor Heat Final ' `7 2-C ? RESIDENTIAL BUIIJDING Permit Application City Of Eagan 3830 Pilot Kno6 Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 0 P7a.eo c.a." 3/q 10? New ConsWdion Reauiremenis RemotleVReoair Reouirements OKce Use Onlv 3 regisle2d sde surveys showing sq. N. of lot, sq. fl. of house; and all roofed areas 2 copies of plan Cert of Survey Recd (20% maximum lot coverage allowed) t se( of Energy Calculations for healed addNOns Tree Pres Plan Recd 2 copies of plan showing beam 8 window sizes; poured found design, etc. 1 site survey for addi6ons & decks Tree Pres Not Reqd lsetofEnergyCalculations Addifton - indkatei(on-sifesepficsystem _ Oo-siteSep6cSyslem 3 copies of Tree Preservatlon Plan rf bt platted aNer 7A193 Rim Joist Detail Optlons seledion sheet (61dgs with 3 or less units Date (i /Q b / Construction Cost Site Address Stp ? ?C Lzk,,G-r" c? 1 J'( i 11-C/ Unit/Ste # . Description of Work " `-A? SI-a-droCC d-CX S ev Vx CGh ,? _)1 Multi-Family Bldg _ h N Fireplace(s) A 0 _ 1 _ 2 Property Owner An r? 4, I)?, c V`".h ??•?.19?. Telephone #((o SI) &?_P '33 LIv Contractor 7__?3 1E-- ( a ( S naaress a8q ( o f c)q. hCr~F- ? c?t, 5?, v-ps ?0.,--e State /`4 r? Zip !S'Q'77 Telephone #( b5?!) J"S a-l l?tk_ COMPLETE THIS AREA ONLY IF Energy Code Category - Minnesota Rules 7670 Cateeorv 1 • Residential Ventilation Category 1 Worksheet (J submission type) Submitted • Energy Envelope Calculations Submitted Licensed Plumber Mechanical Contractor Sewer/Water Contractor A NEW BUILDING Minnesota Rules 7672 . New Energy Code Worksheet Submitted Telephone # ( Telephone #( .? 1- , i•. ,. I hereby apply for a Residential Building Permit and aclrnowledge that the inf@rtnation is co?nplete d accurate; that the work will be in conformance with the ordinances and codes of the C4"??'=Eagan ate of MN Statutes; 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. Applicant's Printed Name Appl' 's Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 EM. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex OK 19 Lower Level ? 24 Storm Damage ? 06 04-plex O 12 12-p10x P16g_Y or _ N ? 25 Miscellaneous Work Types ? 31 New m, 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ?P- 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement 'Uemolition (Entire Blde) - Give PCA handout to applicant Valuation Z, a?Ca ? Occupancy ? MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width _ Footings (new bldg) _ Footings (deck) _ Footings (addirion) _ Foundation Drain Tile Roof Ice & Water Final Framing _ Fireplace _ R.I. _ Air Test Final Insulation REQUIRED INSPECTIONS FinaUC.O. ? FinaUNo C.O. Plumbing ? HVAC Other _ Pool _ Ftgs _ Air/Gas Tests _ _ Siding Stucco Stone _ Windows (new/replacement) _ Retaining Wall Approved By 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 ? D W &ck L mV e- 1 ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-12301-020-02 PERMIT PERMIT TYPE: Permit Number: Date Issued: 565 HACKMORE OR IOT: 2 BLOCKe 2 AUTUMN RIDGE 2N0 . BUILDING 027880 06/17/96 DESCRIPTION: (INCL DECK) Ruilding--?Permit Type SF PORCH ?'Buildihg Werk Type NEW Gensus,Gode "z 434 ALT. RE3IDENTIAL . i ? \ ..,j a?.:::a??:;'i:;'?•t_s??'w^e?;?? ? REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK FEE SUMMARY: VALUATTON ease Fee Plan Review Surcharge Total Fee $187.25 $93.62 $6.00 $286.67 $12,000 CONTRACTOR: - Applicant - 57. I.IC.OWNER: WEIS, JOE 15521114 2002216 VANWATERMULEN DOUG 2846 104TH CT E 565 HACKMORE DR INVER GROVE HTS MN 55077 EAGFN MN (612) 552-1114 (612)686-6246 T hereby aeknQaledge thatI haae read this''appl3aation and state that the information is correct and agree to comply with_all a-pplicabla State af Mn. ? StaCutes and City of Eagan Ordfnances. - ? q PPLICANT/PERMITEE SIGNATURE ISSUED BY SIGN TURE' Lc' c ,;.i . iq 490 CITY OF EAGAN 3830 PILOT KNOB RD - 55122 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) ss1-as7s ? 3 registered ske surveys ? 2 copies ot plans (include beam 8 window sizes; poured fnd. design; ele.) ? 7 energy plculations ? 3 copies of tree preservetion plan N lol pleNed after 7l1193 required: _ Yes ? jNo DATE: 4 - - ` U/ CC DESCRIPTION OF WORK: STREET ADDRESS: LOT _2__ BLOCK ?- SUBD./P.I.D. #: RemodeUReoair Reauirements COST: ? 2 copies ot plan ? 2 site surveys (exterior addftions & decks) ? i energy eaiculations tor heated additions 000 PROPERTY OWNER CONTRACTOR ARCHiTECTI ENGINEER Name: L/ouS Ve..r?I ?i fIRBl Street Address• 57G15 /-j City: cz State: Company: oS (?t S #: Z_-7RCo - 103`7 t.'J Zip: Phone #: !3Sa l /l271 Street Address: lv`t + C rtELicense ; City: :1? 1± State: r-,, Company: Phone #:. Name: 5treet Address: City: Zip: 95-197 Registration #: State: ZiP: Sewer & 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 informaHon is crorrect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ? Signature of Applicant: Ci? OFFICE USE ONLY Certificates of Survey Received _ Yes _ No RECEWED Tree Preservation Plan Received _ Yes _ No JUN 05 qSM ? ------ - --- --- OFFICE USE ONLY BUILDING PERMIT TYPE 0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 0 02 SF Dwelling ? 07 4-plex o 12 Multi Repair/Rem. ? 0 03 SF Addition ? OS 8-plex ? 13 Garage/Accessory ? ?04 SF Porch ? 09 12-plex o 14 Fireplace ? ? 05 SF Misc. ? 10 = plex ?-15 Deck w, WORK TYPE 0 31 New o 33 Alterations ? 36 Move 2 Addition o 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Planning Building Permit Fee 1-43: 7. ZS Surcharge /? - o? Plan Review 4 s. &.'L License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SNV Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: Z 8&• f3 7 % SAC SAC Units , . A? i 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscelfaneous MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. 2?75 -T SAC Code 0/? Census Bldg / Census Unit d _ Engineering Variance Valuation: $ ?Z, DOV ? r Le? , /'C/o Y c :A ? CfTY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT ? PEFiMIT TYPE: Permit Number: Date Issued: BUILDING 000870 06/24/92 SITE ADDRESS: 565 HACKPIORE OR LOT: 2 BLOCK: 2 AUTUPIN RIDGE 2ND DESCRIPTION: ' `BU3lding Permit Type SF DWG / Buildiog?Work Type NEW UBC Occupancy R-3 M-1 Construction Type V-N 2oning R-1 Building length -; 88 Building Width ? 31 . „, •` _ dJ L.4 J REMARKS: t?-CC)jq•570 PRV S 6 W CONTRACTOR - STAR PL86 FEE SUMMARY: VALUATION Base Fee Plan Review 8urcharge SAC SAC % SAC Units Subtotal $786.50 $511.23 $71.00 $700.06 1@0 1 $2,068.73 ;142.000 MISCELLANEOUS E1,610.60 Total Fee $3,679.23 CONTRACTOR: - Applicant - S7. LICOWNER: MCDONALD CONST INC 16887061 0002376 PICDONALD CONST INC 1212 BLUEBILL BAY RD 1212 BLUEBILL BAY RD BURNSVILLE MN 55937 BURNSVILLE MN 55337 (612) 688-7061 (612)688-7061 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 Mn. Statutes and City of Eagan Ordinances. Control No. 0698 _? ? ?? ?.. ISSUE ?ft o,.1 ? rn r? /`2 PPLICAN /PE MITESIG URE ' B SIGNA URE PtRMiT4 cirY oF EAcaN tio 1992 BUILDING PERMIT APPLICATION 1Ay 1° Reco 681-4635 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which re uest is made or 1ot chan e is re uested once ermit is issued. Date -S / / 9 / 9 2-- Yaluation of work !!f (,?xa4-?444 ?o Site Address: h1??1 ?ackm6re IDr.r ?a?a,n„ /vtN SS123 '? ?? S? STREET STE t Tenant Name• LoT Z eLaK °Z wao• P.I.D. f Descri tion of work: The applicant is: ? Owner 0 Contractor O Other (oesoribe) Name Phone Property IAST FIRST Owner Address STREET ' STE / City 5tate Zip Company IYlcAane,lA Con-*ru.c-(,:o„ , i,% c- , Phone (o?g-7oG I C011t1'8Ct0r Address l"2-1'?- b3Gue'61 Q flau kA• License A00023?G Exp. City ?u?nsvk Re State Mtj Zip S-S a 37 Company Phone Architect/ Engineer Name Registration N Address City State Zip Se:rer & water licensed plumber t?lk.,r-6"r.5 . Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this a,Yication and state that th e information.is correct and agree to comply with all pli e State,of?linnesota Statu tes and City of Eagan Ordinances. ? ? O ?- Signature of Applicant: ? / v BUILDING PERMIT TYPE ? 01 Foundatfon ? OS Apt. Bldg ? 09 Basement Finish 12(02 Sf Dwg. ? O6 Garage/Accessory p 10 Swim Pool ? 03 Two family ? 07 Fireplace ? 11 Res. Add./Porch ? 04 Mutti-fam. T.H. ? 08 Deck ? 12 Comn./Ind. WORK TYPE _ V?31 New ? 34 Repair ? 37 Demolish ? 32 Addttion ? 35 Tenant Finish ? 99 Undefined 0 33 Alterations ? 36 Move - GENERAL INFORMATION ? ??, ? ' ? 13 Giib? Fac. C].14.Agricultural ? 15 Miscellaneous Canst. (Actual) v-tJ Basement sq. ft. MWCL System YEs (Allowable) V- N lst F1. sq. ft. City Water -? t16C Occupancy -3 M-1 2nd Fl. sq. ft. PRV Required Zoning ra -i Sq. Ft. total Booster Pump # of Stories - - Footprint Sq. ft. Fire Sprinkler Length ?' On-site well Census Code Depth 31-' On-site sewage SAC Code ? APPROVALS Planning Building Assessments Engineering Variance REGIUIRED INSPECTIONS O Site ? Wallboard Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/M Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % / 00 SAC Units ? ? Footing ? Final ? Framing ? Draintile 98G .50 vatu.c;d,: :? y? (Do o^ '7!o u GRIQA6e; v?2X.32 = 70y 700,o2 8801 (Z$o X /&r /O 9 , S. o o gS 1rtT ?, 3o,oa ' - ? ? ' ?o.v0 .74y.2H s S'rl6 . 1 ? .s-rs g?C/as gG 30n•ao o8? b?2 X15= ?b ? 3 $O, o0 ? __, /ywU ;K63 = '7 6,6132- ?.?- -?? f??IFil??rs??7> 4R?? -c.n?n,7' !/K/r3= 19 8 K2o - 3`??On ZN p FC+ooC 7 4, Sus3= Yoy3?j - r ? Insulation ? Fireplace j ,i , :. 10-- .)?/ISciI I MINNH??A STATE ENFRGY CODE CAL.COTTONS BASED ON CNAPTER 5 DF THE'qw ' MODEL ENERGy,CODB - 1983 EDITION (? ( Adoption Effective stte 2. 7 Building Classification: Type A1 (Single Family & Duplex) Type A2 (Residential, 3 stories or lesa) (OVer 3 stories) (Other) HOTE: Comnlete pages 3 and 4 first. •NE A . rNFO MATTON 1. Building Perimeter ? 11 2. Wall height (ground to eave) ft. 3. 1. X 2. (above) qross wall arealo-I I20 sq.ft. 4. Buildinq dimensions (L) "" X(W) =?41(40sq.ft.roof & floor atea 5. Sq. foot area of rim joist F,1g?t? jo ize (2 X y0 [V Xlt? Q?q.ft. 6. Doors - AreaI ? 4?? ?4- iZ , Thickness in U. factor?1 Type of Construction Perimeter ft. Manufacturer 7. Total door's perimeter ft. 8. Windows: U factoi approved TYPE SI2E AREA (Sq.Ft.) • NUMBER OF TOTAL EACH UNITS SQ FEET 'N 9. Total sq. ft. Glase !Z*601 0 .? 10. Fireplace area: Width X Height = X = sq.ft. 11. Exposed foundation: Heiqht X PerimeterflU I Xisq.ft. COMPLETION OF THI3 FORM I3 REQUIRED FOR ALL NEW CONSTRUCTION, MAJOR REMODELING AND BUILDINGS BEING MOVED WNERE ENERGYO OTHER TNAN THE MINIMAL CODE ALLOWANCE, I5 USED. -1- .,12. praming area = lo$ ofogross wall area. • 2 /f /1 13: Gross wall area ? li!?? sq.ft. Windaw area A 1 o sq.ft. U windows Rim joist area Id Gey,ft. U rim joist=jA:2df Door area A 414q sq.ft. U door area= l``T Other doors area A?165g.ft. U otlter doors= I UXA = UxA = _ UxA - . UxA = Exposed fndn A L4?1 w sq.ft. U foundation=10UxA = Framinq area Aj7-4:,j?.-u9.ft. U framinq area=UxA = Net wall area AL~?L1-6q.ft. U wall= l06I'/ UxA = (13B) TOTAL . . . . . . . . . 14. Gross wall area x 0.11 (A-1 single family & duplex) = al (13. above) 1 l x 0.23 (A-2 other residential) x .23 (other buildings) x .28 (Over 3 stories) _BTUH must be larger than or same U Code 1? 1 %(JL ?t °F. as 138 above 15. Ceiling framing area (Af) equals 10$ of ceilinq area 15A. Gross ceiling area =(L) ?- x(W) _ sq.ft. 158. Joist area (Af) = 10$ ceilinq area sq.ft. 15C. Net ceilinq area (A C) (15A -? 15B)''?-_,,//???4 sq.ft. Vi ceiling X AC a ?F??Li/r-?-/iXa ?3 I U framinq x Af =x \az ._. 1 _ 15D. TOTAL U X A ......................... 16. Cellinq area (15A) x 0.026 (A-1 6lhqle fSY?& duplex) = allowable UxA/Code x 0.033 (A-2 other residential) x 0.06 (other) 'larger than or same A(15A)`?-C ? 1?x U Code t 6 G? ? _? 3 F. TUH must as be 15D sbove NOTE: Use U and A values obtained from paqes 1, 3 and 4. sERTIFICATZON: I hereby cartify that I have calculated the "U't factors and "R" values herein and that the buildinq here described meeta or exceeds the State of Minnesota Energy Conservation Act. Date Siqnature -2- --- v? ?Ptx:?aJ? t 1l? ? 9??x .?_ I??o 2??, d ?-- -t ? ? ? ?-- ? 4Q49 ?? ?? 1 ?k? ? ? Fionear Eneinaerins 6815488 P.02 * PIONC-ER LANO SURWVORS • CML ? +ea'?gincerrn? (.ANO PLANhEaS . Luao`sC-AF 2422 Enterprise Drive Mendota He}ghts, MN 55120 612) 681-1914•Fax 691-9486 625 Hlghway 10 Northeast Blaine, MN 55434 672) 783--1850•Fax 783-1883 Gertlficote of 5urvey for: MCDOt'iQICJ Construction. II'1C. House Address: Hackmore Drive. Eagan. MN Model Name: 92-278 54.3'- , ? ? ?. O / \ uj N ? dQ +97,? • rr ? ? \ y. 0 ?s ? 3r?061. 'Orprr. ? ? ? Uh ? ip?'Py¢?" ? ?N N QaW IO fo '??°?? ti? ?•/ ? \ ?\ J / f d 00 ? 0) I ? Z, 00 00 r• `L 1 _? -' •- O O !? i C952j ? ? ? ? J ? . YO''G? ? . 900.0 DEnotes Existing Elevation ` .0 oo.D Danotea Proposed Elevatfan - Denotes Drainage & Utility Easement Denotas Drainoge Fiow Direction --0-- Denotes Monument -$- Denotes Offset Hub Bearings shown LOT 2 , BLOCK 2 / ? DEPT ?A • ?-- - =, ?? ??ELEVA?,? '-Lowest Floor Elevafion:947.43 Top of B1ock Elevation:955.53 Garage Slab Elevation:954.53 are assumad DAKOTA COUlJTY, AIINNESOTA I heru6y csrtify chat thiF iurveV, pien or report waa preparad by rpe or under my direct sup rv19i0n end that j sm duly Regisi8red Lend Surveyor under ihe !aws oi Ma Stota o1 Minnaiata. Dated thts ^p day of +?) u e A.G. 19. I a S c a I e: 21n--3 0 teet ? , • / ,?;? ?-. • ? r. f , f •` ? kbB6RT S'IItIC ?:..5. REG. NO. 14891 !698 92232500 165 tn aa..ir?? n '7 S N ? -, C o ?IOIVEER * engi?n e HRCKMOnr ?.. ... nrK! 2 Pionvor Envineerin• ? I.AND SUFVEYOpS - CML CNCRIClR9 WND MANhCRS .LANDSCAf'E ARtllITEI 2422 Enterprlse Dri.ro Mendeta Neiqhts. MN 55120 612) 661-1914•Fox 687-9488 625 Hlghway 10 Nor{heast Blaine, MN 55434 612) 783-1860•Fax 783-1883 Certificote of Survey far: McDonald Construction IC1C House..:Address: Hackmore Drive Eagan MN Mode1 Name: 92-278 54. ; r, 1 \ ,, r ? \ • N N ? r-; \ ^ q ? ? \ M -? o ? ? / 6519468 P.02 . ??°"? ti??? ,?s s ! ?`'p \Ot°sr, ? <N v ?pPt P {i5 ? . ti k 4?.,7, R° v ? ?'1 ?i 3\ M `/M a9 h o r? ? ? ? a,?. ?y ti u n1 4g1;' vy, ? \ti.\\ ?k? h,ykry ?a1 ',k0 "AP? \ ?9 ? ?? O? / ,? ? Jo 000 I \ .?j??, i J • ? I ? ? 00 00 m I Y ? / ? i R7 9522::. r , i / n ?. ? ? . ? 4;/^ ? ? i . soo.o Denotes Existi.ng ElevatlOn • sEs> Denotes Proposed Elevatlon - Denotes Drafnage & Utflity Eosement Denotes Drainage Flow Directlon -o- Denotes Monument -a Denotes Offse{ Hub Bearlngs shown LOT 2 , BLOCK 2, .SAGArJ Y?G NFE ..iNG DEYT s??? ???????EO ?e? `"Cowest Floor Elevation:947.43 Top of Block Elevation:955.53 Garage Slob Elevation: 954.53 are tlssumed OAKOTA COUNTY. MINNESOTA I hprYby Certiiy thal thit surv4y, plan or nport wea prepand bY rqe Or undEr my direct sup rvlsion and that 1 am duly Registor¢d Lend Svrveyor under ibe !iwa ot the 6tata af Mlnnewta. Datatl chis It-D daV of -4u u e A.D. 10, X •? Scale: 1nL-3 0lo d ?`., r=?r. OCSi NIl 45 REG.N0.168Y1 98 92232500 PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA103391 Date Issued: 03/22/2012 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 565 Hackmore Dr Lot: 2 Block: 2 Addition: Autumn Ridae 02nd PID: 10-12301-02-020 Use: Description: Sub Type: e-Reroof Construction Type: Work Type: Replace Description: House & Garage Census Code: 434- Occupancy-: Zonin,: Square Feet: 0 Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector Nva ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee S4K $103.25 0801.4085 Valuation: 4.000.00 Surcharge - Based on Valuation S4K $2.00 9001.2195 Total: $105.25 Contractor: - Applicant - Owner: Property- Claim Solutions LLC Douglas Vanwatei7nulen 4655 Nicols Rd Suite 202 565 Haclanore Dr Eagan NIN 55122 Eagan MN 55123 (61)994-2028 I hereby aeknowledae that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA138827 Date Issued:09/21/2016 Permit Category:ePermit Site Address: 565 Hackmore Dr Lot:2 Block: 2 Addition: Autumn Ridge 2nd PID:10-12301-02-020 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 - Douglas Vanwatermulen 565 Hackmore Dr Eagan MN 55123 (651) 688-3340 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink For Office Use C, City of Eap,au PetTnitf: RECEIVED Permit Feo: S 3830 Pilot Knob Road /7 Eagan MN 55122 FEB 0 62017 Dale Received: Phone:(661)676.6676 Fax:(651)676-6634 Stat "ci J br\ 2017 RESIDENTIAL BUILDING PERMIT APPLICATION , 11 02/06/2017 565 Hackmore Dr Date: site Address: Unit#: fri Y;;,` Name: Doug & Ann VanWatermule Phone: 651.688-3340 o Address/City/Zip: 565 Hackmore Dr, Eagan, MN 55123 "r ;I: Applicant is: Owner X Contractor ` ` , ' ' 2 Bath Remods See Site Plan For Details' N Description of work: Construction Cost 7500 Multi-Family Building: (Yes_/No � Great Lakes Window & Siding Derek company: Contact: `'"+`�`'` 14690 Galaxie Ave A le Valley �� 1 Address: city: PP ontraator,' + , � , State: Zip: 55124 phone: 952-891-3400 Email: MN derek.glwsco@gmail.corn „ �• ; atones a: BC060427Lead Certificate a: NAT-23297-2 If the project is exempt from lead certification, please explain why: 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 8 Water Contractor: Phone: Fire Suppression Contractor. Phone: NOTE:Plans and supporting documents that you submit are considered to be information. Portions of the information May be classified as nonpublic if you provide specific reasons s that would Perotit the•City to: ;,....,. .:conttude:Jbatthe ,Are, des fits .., CALL BEFORE YOU DIG. Call Gopher State One Call al(631)464.0002 for protection against underground utility damage. Coll 48 hours before you Intend to dig to receive locates of underground utilitieswww cooherstatennernll rfp I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances end codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work Is not to start without a permit;that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit Issued In accordance with the Minnesota State Building Code must be completed within 180 days of permit Issuance. Br�,cji— x Appllca a Printed Name Applicant' re Page 1 of 3 9/I'd i769SSL91S9:01 0S2t71682S6 00SM1S:W08d 62:ST LTO2-9-63d ---)DO NOT WRITE BELOW THIS LINE I l cl1 CI SUB TYPES Foundation ` Fireplace — Porch(3•Seaeon) _ Exterior Alteration(Single Family) 4 Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) Multi Deck — Porch(Screen/GazebolPergola) _ Miscellaneous _ 01 of_Flex — Lower Level _ Pool _ Accessory Building WORK TYPES _ New _ interior improvement — Siding _ Demolish Building' _ Addition _ Move Building _ Reroof — Demolish Interior lot Alteration ` Fire Repair _ Windows _ Demolish Foundation Replace _ Repair — Egress Window _ Water Damage — Retaining Wall 'Demolition of entire building—give PCA handout to applicant DESCRIPTION0 Valuation f Occupancy MCES System Plan Review Code Edition ,; - fr" SAC Units (25% 100%, ) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction (6 Width REQUIRED INSPECTIONS Footings(New Building) Meter Size; — Footings(Deck) Final/C.O.Required Footings(Addition) >c Final/No C.O.Required Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Roof: ice&Water Final Pool: Footings Air/Gas Tests _Final Framing^30 Minutes__,__1 Hour Drain Tile Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath Stone Lath Brick_EFIS XInsulation Windows Sheathing Retaining Wall: Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In Final Braced Walls Erosion Control Shower Pan Other; Reviewed By: , Building inspector RESIDENTIAL FEES Base Fee Surcharge _ / I Plan Review A, MCES SAC 2 /. Oil i°` City SAC �._. r t 0 10> t Utility Connection Charge S&W Permit&Surcharge /0 ql X 20 -r D Treatment Plant ! U Copies 1LP 0 4a TOTAL 51 ya ttoVZof3 9/2'd b69SSL9TS9:01 @S2t I682S6 O0SM19:WO8d 0t7:SZ Lt02-9-83d Use BLUE or BLACK Ink 1 For Office Use41!illibb / (, Permit#: / �/ /a Cit of Eatau Permit Fee: 0 ' 176 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651)675-5675 Staff Fax: (651)675-5694 2017 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: g131,1 Site Address: 5-405-- Hac4/'h0Ye _AV!.✓e Tenant: Suite#: Resident/OwnO3tr' Name: Vail Vt/a4ev�w(-e... Phone: Address/City/Zip: 66.5- ��� DK' ✓� Name: Com!hes es f �tYVI.b t✓� °f )+&I Z./1/.License#: t'C Cp�-3�j(o Address: 7Ff 7 a St- t& I Contractor State: /lid zip: 5SUPhone: (Ds--1 -7q. (,'L(7 Contact: Email: CCAVOI(C/17e.s/ii14Iflhi/)r COM �.ype � � _New X Replacement Repair Rebuild Modify Space _Work in R.O.W. place ohawet% valve. . / /zeh v- Vci/vim. Description of work: 4 /200 a 0 ✓a /C,C t°_ RESIDENTIAL Water Heater Lawn Irrigation( RPZ/ PVB) Water Softener permit Type Add Plumbing Fixtures( Main/_Lower Level) Septic System New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge) $60.001awn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) *Water Turnaround(add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x e(Aro I Coprad x Applicant's Printed Name Applicants Signature FOR'©FFICE USE . Reviewed By Required inspections: _ tinder Ground Rough-in Air st G _F al Meter Related:Items:. Meter Size Radio Read , Manometer` . . i Staff. PERMIT City of Eagan Permit Type:Building Permit Number:EA148418 Date Issued:03/27/2018 Permit Category:ePermit Site Address: 565 Hackmore Dr Lot:2 Block: 2 Addition: Autumn Ridge 2nd PID:10-12301-02-020 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) 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. 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 - Douglas Vanwatermulen 565 Hackmore Dr Eagan MN 55123 Polar Builders Inc 1103 West Burnsville Parkway Suite 110 Burnsville MN 55337 (612) 432-1597 Applicant/Permitee: Signature Issued By: Signature