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568 Hackmore Dri. CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: r? r4 1 0 ? .. , I?A(h•h1UttE O AU 111MIN k I Uii4 ?'NC? PERMIT SUBTYPE: , I •,11 riii? 1 1 Nr,s V T NA! .?. oN 1coRD PERMIT TYPE: Permit Number: Date Issued: tt4r11.n1r411 e:r»4. . Ots/t --r/yt; V1z 74 0 L..0 ? - 0 - 0 q , APPLICANT: C. ?tt.ilt'k ? t R ?.; ; ;i i „ E5121 F,4fA--64-49 TYPE OF WORK: tll`.:.l:F? tt`'{ ((iN FunMrNi, i Wi aru ( T N r t r? i r 1c ) ? J Permlt No. Permtt Holder Date Telephone S ELECTRIC PLUMBING HVAC Inspection Date Inap. Comments FOOTINGS •z c uo FOUND FRAMING /L ROOFING ROUGH PLUMBING PLBG AIR TEST ROllGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAI Y BSMT R.I. 85MT FINAL DECK FfG 7' 'S[? ??4L DECK FINAL . ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 ON RECORD PERMIT TYPE: ' Permit Number: Date Issued: SITE ADDRESS: . iie, ri?t ? ?ir•,t? ? i i?s?t PERMIT SUBTYPE: .. TYPE OF WORK: ?- ?: ni Gi . ., . .• X ,. r r APPLICANT: kat??kt r>>; ? ;;a??i•??; i???rf: Nti (tiJ 4 «;ti 01 rtFMltCiKSt SL W V1 fiP T}IOMHSON E't Ht, P1+ Pormk No. Permk Holdar Dats Telephone 0 S/VV PLUMBING c3/ y3 93 C3??'?/? HVAC ELECTRIC ELECTRIC Mspectbn Wb Map. Comments Foocings i Foundat;«? Framing z 93 / S Rookg R«,?? ?s. =ZB? ?S_ ?-` 3?l? ?4 6' Rough Htg. Isul. Fireplace Finai Htg. Orsat Test Final Pbg. Plbg. Inspeclor - Notily Plumber COrist. AAeter EngrJPlen Bidg. Final ?- 2 3? g?j DS Deck Ftg. Deck Fuial wen Pr. Disp- v?D? ?? J ? -? Wertificate af Cccupanc4 6it4 Dt wfiglq[ Tcpart?ccut af Zaitbing aamwdHsn -This Certificate issued pursuant to the requirements of the Uniform Building Code certifying that ar the rime of issWance this srructure was rn conrpliance wilh the various orrtiruueces of the Ciry regulating building corutruction oT use. For the following: SF DWG 20482 use classiscation: sedg. Plenroc No. V-N Occup-y Type A OAEDS ? 'Y40'-O ? Owner of Building Addmas , Building Address ?i? ? AUT RI Dm: JULY 23, 1993 suiia;ng offici POST IN A CONSPICUOUS PLACE AddIeSS 568 HACKMORE DR Zip $512_ I.OI *5 1 Blk 4 $Ull AUTUMN RIDGE 2ND THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION. Date: JULY 23, 1993 Yes No Inspector: S Final grade (6" from siding) Permanent steps (garage) Permanent steps (main entry) Permanent driveway Permanent gas ? Sod/Seeded grass TraiUcurb damage r Porch Basement finish ? Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shutoff of water supply to the outside lawn faucet before freeze poten[ial exists. Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. Whice - City Copy Yellow - Resident Copy Pink - Contractor Copy ? ??191_5_ d .3.4_13 55 REOUEST FOR ELECTRICAL INSPECTION ? See mslmcUOns for compieung Mi3lorm On beck of yellow copy. i"X" B,alow Work Covered by This Request 6TM Ea.oo00 ?.,?.. ew d Rep. TypeolBudding AppliancesWired EquipmentWired ? Home Range Temporary Service Duplez Water Heater Electric Heatmg Apt Budding Dryer Ofhev-(Specity) CommJlndustrial Fumace Farm Air Condi6oner Olher ispenry) Gonvectorh Remarks Compute Inspec[ion Fee Befow: Ncw ; Other Fee # Service Entrance Size Fee # Circuits;Feedars Fee Swimming Pool / 0 to 200 Amps / q, 0U JQ 0 to 100 Amps i- hansformers Above 200 _ Amps Above 700 _ Amps Signs inspemor§ Use oniy TO7pL Irrigation Booms ? Special InspecBOn Aiarm/Communication THIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTH I, the Electncal Inspector, hereby f h h Rouyn.? oet? ?p y? 1 cerh at t e above insPection has y t been made. Final e Dete . ?(--S OFFICE USE 3NLY This repuest voitl 18 months irom d 34655'?/""-' ?- ?? Re4uast Dare . ? ? Fire No. Roug1in InSpaMion Reqmred7 ? Reatly Now t7 WJI Notily Inapector V ? Z? 'Yas ?-, No When Reetly9 ? '/ . IF] licensed contractor i] owner hereby request inspection of above electrical work at; JoE nOtlress (Slreet Box or Route o) ?8 K?j2?,?? Cny iEr9 AN Section No, Township Name or No Range No County OccuDam IPRINT) r r? o v?r?s Phone No. 7,z.3 -- D 0 4- 3 Power Supplier 729 CLcG777JG AtlEress `i`?/"cs?7/N ?7'oiv Elecnsal Comramor iCOmpa^Y Name) Contrecmr§ License No. -?-/'?DDxv rGE'G7w1 C Lv :i Mailin9 Atlaress ICOmranor or Owner Makmg InstalleLOn) O u 6G/ h44-5-i?Da7-M /h/? S_Sl.Sa nutM1Oraetl Signa onlrac?oNOwner M In9 ai j C Phone Num?7er ??G' (OJ?4? MINN OTA STAT 0/ P OF ELECTRICITY THIS INSPECTION REOUEST WILL NOT Griggs-Mitlwa Og - Hoom 5.173 9E ACCEPTEO 9YTNE STATE BOAfiD 1821 Univers y Ave. SL Peul, MN 55106 IINLE55 PROPEfi INSPECTION FEE IS Prone(612)6<Y-0B00 ENCLOSEO IIII?+?IIIII?II III I II II IIII I III IIII 1821 EQ UmersitY Ave., Rm 8-7 8c? Paul P, MN 55104 ??i * 0 2 8 3 4 3 6 4*- phone (612) 642-0800 /p8'(0 ?--?• Home Duplex Apt. Bldg. Orher: ? New Addn Commercial Indusfrial Farm ? Remod Re oir Air Cond. Hfg. Equip. Wmer Htr. Load Mgmt. Other . D er Ran e Elec. Heal Tem . Service "X" above fhe work covered by tbis request Enter remorks m this space and on the back of Ihe white copy only. Calculate Inspection Fee - ihis Inspeclion Request will not 6e accepted without ihe rorrect fee: Olher Fee # $ervice EMrance S¢e Fee # Grcvils/Feeders Fee Mobile Home Park Stall 0 to 200 Amps 0 t s Sireet L}g lTraffic $ig. Above 200 Amps Above 100 Amps TIOnS{otmef/CienefotOr INSPECTOR'S USE ONLY ? T ?- ?j $ign/Outline Ltg. X(mr. Alarm/Remofe Conirol $Wimmin9 POOl I hereb «ni Ihat I ins d fie elechiml in la bt4A erein on tlie daros sh Ini9a}iOn Boom Rcugh-In Dok L_ i( cl ? $pecial Ins edion ? ? p Invesiigafrve Fee Fnol ! Dote Z e. THIS INSTALLATION MAY BE ORDERED ISCONNEC ED IF COMPLETED WITHIN 78 MONTHS. 2 V3-,14 3 6A O9 IC?E U$?ONLY Thrs req?esr roid iB moMhs from validanon dare printed /p?HY Y ? L/ ? PLEASE PRINT OR TYPE 716 k ?? Rovgh- mapedion reqo,red2 [] Vez 0 N. m 0 h h d I en n Olher 7}wn Rovgh-In ? Ready Now 0 Will Coll D k R d e mspecrorw (You m?sr ca en rea y) t a ea y I, Wicensed contrador ? owner hereby requesf inspedion of the a6ove eletlriml work at Jab Pddress (Strao or Rqutq No ) ^ 569 Y k? br Gry Zip Cade ? e , Q 5ecM1On N. Townzhip Name ar N. Range N. Fre No. Counry Occupanl / PMne N. l? v Pawer Supplier Address EleUriml Conhaeor Convocror 6 ce No. Morer Lic Na. (PIoM Eletl. Only) MoiLng Mdress (Com or or Owner Performing Iru?ollano ? /? / // Authanzed ign Conlmcbror Uwner namll non) 1 one o. ??? ? EB- A-10 6/95 TATE COPY-SEEINSTRUCTiON30NBACKOFYELLOWCOPY RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN ?Ga 3830 PILOT KNOB RD, EAGAN MN 55122 ' 651-681-4675 New ConatrucUOn ReauiremeMa RemodeNteoair Reauirements • 3 registered site surveys showing sq ft. of lot sq. ft of house; and all rookd areas • 2 copies of plan (20°b maximum lot coverage allowed) • 1 set of Energy Calwlatians for heatetl additions • 2 capies of plan showing beam 8 window saes; poured found design, etc.) • 1 site survey for exlerior addilions 8 decks • i set of Energy Calculations • Indicate R hane served by septlc system for additiom • 3 copies of Tree Preservation Plan if lot platled aRer 1/1193 • Rim Joist Oetail Opdons seleclion sheet (bidgs vnth 3 or less unifs) DATE ///Y' /O z- VALUATION ! ? ??fl SITE ADDRE55 MULTI-FAMILY BLDG _Y r/N flPE OF APPLICANT STREET ADDRESS %4? t6 ?'- U/GJ [;p TELEPHONE # kl- 115- 7 J`0/0 CELL PHONE # FIREPLACE(S) _ 0 _ 1 _ 2 Z?/+ STATE/O ZI P,S 'b -7 FAX # jo5) - -?s"S - Z 3 "3 ( PROPERTYOWNER gGIVK _b ea TELEPHONE# COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNLSOTA RCILES 7670 CATEGORY 1 _?tt',?7 ?L`?O"PAiRUI.1:??7672 ?Wo?,? qeet Sub ubmitted I n iQle?wEnergy?Code i I P I1 submission type) • Residential Ventilalion Category 1 Worksheet S c (J J1• Energy Envelope Calculations Submitted ?Z' 2 0 0 Z I u Plumbing Contractor. ______ Phone # Plumbing system includcs: _ Water Softener _ Lawn Sprinkler -- rFec: $90.00 _ Water Heater _ No. of R.I. Baths No. of Baths Mechanical Contractor: Mechaniril syslem includes: Sewer/Water Contractor. Air Condilioning Hcat Recovery Systeai Phone # Phone # I hereby acknowledge that I have read ihis application, state that the i'nfpriy with all applicable State of Minnesota Statutes and City of Eagan Or i Signature of AppBcan OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Fec: $70.00 is correqt, and agree to comply Not Required _ Updaled 4/02 OFFICE USE ONLY ? 07 Foundation O 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling O 08 06-plex ? 16 Fireplace O 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex O 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level p 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Yor_ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration O 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement "Demolition (Entire Bldg only) • Give PCA handout to applicant Valuation 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 W idth REQUIRED IN SPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addirion) Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final Pool Ftgs Air/Gas Tests Final _ Framing Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final Windows (new/replacement) _ Insulation _ Retaining Wall Appraved By 8ase Fee Surcharge Plan Review MC/ES SAC ciry sac Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Building Inspector Totai Cities Di it?al Qualitv Control The following image represents the best available image from the originali page. Every effort was made to capture the content from the original page. PERMIT cte od 3 ??y ? CIl"Y OF EAGAN 3' '"?y!3 3830 Pilot Knob Road PERMIT TYPE: Permit Numbec Eagan, Minnesota 55723 Date Issued: ?? ; ,+ ? ? ; ? .3 (612) 681-4675 SITE ADDRESS: ,. ,r,? ,?. t.r:. ,;, 1."01 0 sA, -10 a DESCRIPTION: 8 u1 ldir. g Permii, 1?, p c- 911 .1 1 r1ii':3 '.J6'r! I yp U6C Occt?p?s3=vy•. C:onuctt.4+n Py i,- i ll :J G ! Id i' 3 'i t „ r! ? . ;i . ? _, v=_, . ... ?u? -_?L' '• _. r._ REMARKS: i ; I I rL :,crI [ !,0 he F 1 rc rit% ' FEE SUMMARY: Vr11 :in! i() r! Yli...ta0 0 , . -. ... „o . b1 I'I7.`?L: I I Al'!I OU?? 7 7iii,_, 0 CONTRACTOR: ip;; i. tI ? OWNER: 1467?9t9.;1 1 I-Itlrlh3 VnSf_ 'rIOPir-; T P,Ir (' 0 fiq:; v1it1- C'f nIM1! SSI?Q thLr4 1 ha"':; reraCJ 'i,i1ib lco:.)e,n .ir7cf ?.t,Il:c iii., l t:l'ic, cQr and , , ?-onp' y ?i_.;Cntem Eity nP f?3tj 1, 7 c{t^.c::c o . L ?? fl rw?n ? ?11,kr1 ? d"L?ac?? o' APPLICANT/P RMITEESIGNATURE ? ED V IGNAR?URE - REACTIVATE _ PERMIT"? ' 1.0442. CITY OF EAGAN 1993 BUILDING PERMIT APPLICATION? 681-4675 _ ?3,q1.3.13 gtREM SIN6LE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date 5 / _ ?I / 9? 4aluation of work Site Address: ??-? ?1P STREET SU17E ? Tenant Name: (commercial only) LOT ? BLOCK ? SIIBD. P.I.D. 1t Descri tion of work: The applicant is: 0 Owner 19 Contractor ? Other (o so? be) _::j?q 4' Whone ?s ?"a6S i Name e Property LAST FiRST Owner ??? 4? Address ? ?TREET STE M City State ? /1J Zip Company ?. Phone 4/ - E) (, 12- Contractor A d d r e s s c7a`i ? License #C001?42,<! Exp?`? City fs??C VA- ?I?..? State Zip ?- Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water 1 icensed plumber `??•titi?p ??? '?/u r,?.?i , ?..-4 . Processing time for sewer & water permits is two days once ard7a has been approved. I hereby acknowledge that I have read this application and state that the information is f correct and agree to comply with all applicable State of Minnesota Statutes and City o Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE I I aN O Ol Foundation ? 06 Duplex ? 11 Apt./Lodging,r,,,e R 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 04 5f Porch ? 09 12-Plex ? 14 Fireplace E3 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck WORK TYPE R 31 New ? 33 Alterations ? 35 Tenant Finish ? 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION ,? . _• ? ? 17 Swim Pool ? 18 Comm./Ind: ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 37 Demolish Const. (Actual) V- N Basement sq. ft. MWCC System "la (Allowable) V- N lst F1. sq. ft. City Water Y9.5 UBC Occupancy R•3 M-I 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump d of Stories Footprint Sq, ft. Fire Sprinkler Length On-site well Census Code lai Depth On-site sewage SAC Code ! b/ ? APPROVALS ?, • P.?,fuS uF,. f ? ,_ yy5 1-- Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS 0 Site ? Wallboard ? Footing ? Final ? Framing ? Draintile O Insulation O Fireplace Permit Fee v.imc;on: g DDO - Surcharge } ZND Ft-uoR; Review Plan GA??i ?y 3 28 32- $9 Licen k 0 _ 72? K 6 ~ MWCC SAC 3 ( 3 0 12 n ? = 36 c; ty sac ?y J 21 xu = a y Water Conn. 2?1 n= s ?I -?-'- Water Meter 10 I(, X Sy = Acct. Deposit 6 75 X - 16 = ry S/W Permit ? , ??, S/W Surcharge Z Treatment Pl. 3 X Zg Road Unit y X 21 = gy Park Ded. Trails Ded. CoPies 12KZc 2V Other - - _? Total: ' SAC % lDO Isr R°°n- I o q 3 x ?s _ ??- --- SAC Units /093kp_ S907-7- • / A . ., , LOT BIIROLY CSLCIILIBT r0A kZBIDZlQTII1L ? noprgTx T-VZAL:7- ? pOCVlIEHT 8T 4 8 B',D 0 • Registered iand Burveyor siqriatuz* ana eompany ?Y? ' G • 8uilding Permit 1lpplicant D B ?I • Legal descziption D D? 0 • 1lddress 0 • North arrow and bar scai• • 0' D 0 • House type (ramDier, waikout, spiit v/o, split antry, ? lookout, ttc.) ' D 0 • Disectional draiaage arsows vith slope/qraCient i. D Y p C 0 0 • Propoaed/existinq sewer and vates sarvicas ? ? • Street aame 8' 0 0 • Driveway ntavATZONs D 0'"D • Existinv Sewer service fa" D D • Lot corners D H' 0 • Top of cuzb at the drivevay 0?'0 D • Elevations of any existing adjaeent homes proflosed D' D D • Garage floor V 0 0 • First floor id' D D • Lowest exposed elevation (walkout/virfdow) 0 • Property eorners D/? D • Front and rear of home at the loundation 4Db'DING AREA8 (if anolicabl*) D [r 0 • Easement line _ 0 0' ? • lawL , D 0' D K ? 0 0 • • xwL Pond A dasiqnation D 0 D • Lmerqeacy overflow Elevation L?D 0 • DIMEN620NS ' Lot lines ? 0 0 ? Right-of-way and street vidth (to baok of eurb) ? ? Proposed home dimensions ineluding any proposeC dscks, overhanqs greater Lhan 21, porehes, eLc. (i.*. all ? strueture5 reguirinq permanent footinqs) D D • Show all easements of record aad any City utilities within 1f those ensements 0 D • Setbacks of propoced stzucture and aetback of sdjacent existing homes a a • Retainin re ' aments, if any - Reviewed- ? ame / a e OCteber 1CC'f EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER SITE l?D?DR?SS ?f ._? - / CONTRACTOR ' DATE)-?tz 23PHONE LI? ?jyOY?S ? Determine working square footage of each 1. Total exposed wall area...... -;> -7 5 `'( sq. ft. x ? f I _ 1 30?•@7 `l1. 2. Total roof/ceiling area...... I (,- QY (,c ? sq. ft. x, pD (o = I , LI Total exposed wall area above floor a. Total wall window area ............................... ?17-`f 7 b. Total door area ........................... ........... c. Total sliding glass door area ........................ d. Total fireplace wall area ............................ 5%;--2. e. Total wall framing area (average 10%) ................. ?;I/ ?_, (? f. Total net wall area above floor ....................... 2 2 f O•(.. g. Total rim joist area ................................. Total exposed foundation area I a-qf h. Total foundation window area ............................ / y i. Total net foundation area above grade ................. /( y Determine "U" value of each wall segment. a. , 77,`( J x"U" e3 3 = 4-J`?• ? 7 b. 3"7. 78 X„Uto :• ct-> - -;?-, S3 C. X,U„ a. X1Us, ? e. x"U" ` O'I Ocl f. 1 C? z XTu° B• ?L)`i = Cvya h. X,,," 0 33 X"u" , c3° _ `,( • 33 ?--- 3 ......................................Tota1 (?. / If item 113 is the same as, or less than item #l, you have met the intent of SBC 6006(c)2. Total exposed roof/ceiling area =_ / o 1`7 3. Total skylight area............................ k. Total roof/ceiling framing area (average 10%).. ? u 9C 1. Total net insulated roof/ceiling area.......... Determine "U" value for each roof/ceiling segment. 3. X,tUt, _ k. 1 0 i . (,. 0 X fvll ? ???. , 2.3 - _ X"Uff o 0 23 = ?ZZ .(? r 4 .................................Tota1 = 02 S , a ? If total of Il4 is the same as, or less than 112, you have met the intent of SSC 6006(c)1. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of items 03 and 114 shall not be greater than the sum of items Ill arid #2. 1. ? o a . 4 y + 2. 14 3. 19 0 ?S + 4. ? _? .. _ .. 14. r.Irv nr FAcJAN. CASH:CERr 5 TLF<MINAI... N0. 32 DFlT(:: 09f13/96 72MF: 1.4146:20 TDe NAf11-r, RF_.F4.IRI...SC HOMES S1JC :3c?10 9001 SC,ES HACKi101iE Dfi 137.c 5 21.55 ?t?OJ. 56$ hfACf:nnr,F rn, 4.00 3430 900t 568 HAr.c•;Mnr:E nr; 2.00 Tn+.a7. f:ecE:aipt fimoun+,? 1.43.25 Cfi06289'i' tISF:h .CDa NANCY , : -%t , PERMIT CITY OF L*AGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: 568 WACKMORE DR LOT: 5 BLOCK: R AU7UMN RIDGE 2ND p.I.N.: 10-12301-050-04 PERMIT TYPE: s u zLo i N c PermitNumber. 028422 Date Issued: 0 B J 13 / 9 6 -b DESCRIPTION: (SNCL OECK) guilding,.,Permit Type SF PORCH Suildinc,{-? W'qj? Type NEW Census 6bde°':, 434 ALT. RESIDENTIAL ? a? "". C > _". i?.,: •. : i' S':.; ?i.? :_' k``•u,10°e .... ,:? cy 3"...,,.., ?e.. » REMARKS: FEE SUMMARY: Base Fee Surcharge Subtotal VALUflTION $137.25 $4.00 $141.25 $8,000 CtlPIE5 $Z•0m Total Fee $143.25 CONTRACTOR: - Flpplicant - sT. Lzc.OWNER: REPUBLIC HOMES INC 15466439 0009183 DELEBO MARK 2505 CHEYENNE CIR 568 HACKMORE DR MXNNETONKA MN 55343 EAGAN MN (612) 546-6439 (612)454-6125 I.hereby acknowl.edge that I=have read this appliaetian and qtate that the informat3on is correet and agree to comply with all appl3cable StsCe af Mn. ? Statutes and CiCy of Eagan,Q,rdinances. ? U PLICANT/PERMITEE SIGNATURE SUED B SIGNA -- ----------- CITY OF EAGAN 3830 PILOT KNOB RD - 55122 11b4 996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-46T5 RemodetReoair Reauiremente ,?I 43.z co„w ? 3 regblered stte surveys ? 2 copies of ptan ? 2 wpba of plana (indude beam 6 window aizes; poured ind. deefgn; etc.) ? 2 sNe surveys (exterior addkione d dedcs) * i eyrgy calculetiony ? 1 energy calculations Tor Mated addflions ? 3 wpbs of tree preservaUOn plan H bt pietted sfler 7/1/93 oequircd: _ Yes _ No . DATE: 7/2 s I?fo CONSTRUCTION COST: DESCRIPTION OF WORK: , STREET ADDRESS: ? .? LOT 5 BLOCK SUBD./P.I.D. 2i'c?n-e_ 2 r"'t rq.?h PROPERTY Name:IfflAre L e4L Phone#: -41 S'????a 3- OWNER "°T 1A `"`T 1b+? - t StreetAddress c ,c..0v - e City: ?«,e-v, State: L?v Zip. 57S7ao ?/ ? ? coNTRacTOR Company: E-rD ti? kz F?, v W4 + -?r S 7?tC Phone #: A?0'7f ,??/ 6-b N3q Street Address: CiY License #-62/8 3 da; ., rn P4oti 1C(^ City: State: 64? Zip- 5Y30 ? ARCHfTECT! Company: Phone # ENGINEER Name: Registration # Street Address- City: State: Zip: Sewer 8 water licensed plumber. change are requested once pertnit is issued. Penalry appiies when address change and lot I hereby acknowiedge that 1 have read lhis appiication and state that the information is cortect and agree to comply with ail applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. Signature of Applicant: 4OFFICE USE ONLY RECC OMEDD Certficates of Survey Received ?Yes No .I U 1_ 2 4 11996 Tree Preservation Plan Received _ Yes _ No -----""--"" OFFICE USE ONLY BUILDING PERMIT TYPE ?? ? ''+ , 0 01 Foundation a 06 Duplex o 11 Apt./Lodging o 16 Basement Finish 0 02 SF Dweliing o 07 4-plex ? 12 Multi RepaidRem. ? 17 Swim Pool ?3 SF Addition o OB 8-plex o 13 Garage/Accessory o 20 Public Facility 0 4 SF Porch ? 09 12-plex o 14 Fireplace ? 21 Miscellaneous 0 05 SF Misc. a 10 = plex o 15 Deck WORKTYPE 90'°-CH , 0 31 New n 33 Alterations ? 36 Move ? 32 Addition o 34 Repair o 37 Demolition GENERAL INFORMATION Const (Actual) 4 ?1 Basement sq. ft. MC/WS System V (Ailowable) y4 _ Main level sq. ft. City Water ? UBC Occupancy R-3 j.1 sq. ft. Fire Sprinklered Zoning i?- I sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Oepth Footprint sq. ft. SAC Code nl Census Bldg i Census Unit 0 APPROVALS Planning Building M? Engineering Variance Permit Fee Valuation: $ e? vvo.- Surcharge ? Plan Review ws r?@?? sAC Mcr o = s?P? .-- City SAC Water Conn. Waler Meter Acct. Deposit A? 1? Z- Oo.- S/W Pertnit S/W Surchar9e 7, O 80. - Treatment Pi. Road Unit Park Ded. Trails Ded. Other Copies z . 0D Total: % SAC SAC Unils 1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILDT KNOB RD - 55122 651-881-4675 New ComhucHon ReaulremeMa 6emodel/Reoalr Reaulremenh > 3 regisfered sNe surveys showing :q, ft. of lof, sq. B. of hause 2 copies of plan and pU rooted areas (20% maximum loT eoveraae allowed) 1 set of energy calculaNons IorheaFed addlHom D 2 coptef ot plans (show beam a window shes; poured fnd. des(gn; efc.) 1 sHe survey for extedw addiNons R decks D 1 iN of energy calculaHons D 9 copies ol hee presenalion plan H lot piattad afFer 7/1/93 DATE: 5104191 CONSTRUCTION COST: DESCRIPTION OF WORK: ?'?{"`9Y+? ???K?ni 14M., aaa iiV*Let';r Wl'1NA 1`4vJ S?? ??? STREETADDRESS: S(O% LOT: 5 BLOCK: SUBD./P.I.D.Ik: NITV+?+n PROPERTY OWNER Name: ? eZ6 NIVU Phone #: 4 f? Gla- Last Flrst SfreetAddress: C, G?. Q"r City 105 5.?rl) Ne c?o a5 ? CONTRACTOR ARCHITECT/ ENGINEER Sheet Cfiy State: m „ Zip; SS 7"L3 4pa. ?'654-1540 _ (area code) • S, '? ucense # 9? ?xP• ,?- y p7Gt? ?- State: 7IVi19 _ Zip: Company: _ Name: Telephone N: area code ( ) Sheet Address: RegisfraNon #: City Sewer 3 wafer Iicensed plumber (reauired for new conshueHon onlv): State: PenaMy applies when address ehange and lot change Is requesied once permM is istued. I hereby aeknowledge fhai 1 hove read lhia appllcaNon, state that the State of Minnesota Statutes and CMy of Eagan Ordinances. Signature of Zip: Is corteet, and agree fo comply wR Vil oP abi i I // AIZ OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received - Yes - No - Not Required _- 1f---- --- I ? P4AY 6109'0 J 1I OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace • ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-piex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Rpartments ? 19 Lower Level ? 24 Stortn Damage ? 05 3-plex ? 10 8-piex ? 15 Lodging O 20 Pool O 25 Miscellaneous WORK TYPE ? 31 New ? 35 ? 32 Addition ? 36 4 33 Alteration ? 37 ? 34 Repair ? 38 GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories length Width APPROVALS Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors Demolish Bldg.• ? 41 Wood Stove ? 45 Fire Repair Demolish (Interior) ? 42 Reroof ` Give PCA handout to applicant for demolition permit Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq.ft. Footprint sq. ft. Planning Building Engineering Permit Fee Valuation: Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: SAC Units Census Code SAC Code No. of Units No. of Bldgs MC/ES System City Water Booster Pump PRV Fire Sprinklered Variance °k SAC F,. MECHAMCAL PERMIT (RESIT CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR SINGLE FAMILY DWFId,INGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. A NEW CONSTRUCTION li1J17-V1V A/C; ADD-ON FURNACE DATE F'EES HVAC: 0-100 M BTCJ $ 24,00 ADDITIONAL 50 M BTU (.pp &S OUTLETS (MINIMUM 1 @ $3.00 EACH) 6- DU ADD-ON/REMODEL (ExisTtrrc coNSTuucrtox) $ 15.00 STATE SURCHARGE .50 TOTAL ?=v . irJ SITE .ADDRESS: [„?O / /LfI'/1 f '-Yl & (l J/ l Y ?S OWNER NAME:AI_OL?aS f'!(JMPj TELEPHONE #: 221 '!/D? -q INSTALLER: GENZ-RYAN PLLMING & HEATING C0. ADD :ESS: 14745 South Robert Trail CIT'y; Rosemount STATE: M ZIP CODE: 55068 ^LEPHONE #: (612) 423-1144 C? J PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AI.SO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIltED FOR EACH UNTf. NO. FIXTIJRES EACII ? SHOWER 3.00 3,oc> ? WATER fl-LOSET 3.00 iOo ? BATH TUB 3.00 3 00 00 ,o 0 LAVATORY . ?- KITCHEN SINK 3.00 3.0() LAUNDRY TRAY 3•00 H6T $/sP7k °.J?rA _' LArl i (3o 3.00 U. o0 1 k f Qe. x WATER HEATER 3•00 f FLOOR DRAIN 3•00 3`0O GAS PIPING OUTLET • minimum - t 3•00 3' Uv ? ROUGH OPENINGS 1.50 4. SD WATER SOFTENER 5•00 PRIVATE DISP. • Da1cCry. lia 15.00 U.G. SPRINKLER • eome under consi. 3•00 ALTERATIONS • to otiating 15.00 WATER TURN AROUND 15.00 STATE SURCHARGE .50 TOTAL: cr?) SITE ADDRESS: 5i02 OWNER NAME: -Thc?rneac, ?-?nM es INST ADDRESS• i=?cc?\ '(Yl° -ryw:)M-'r- CITY: Minne?co,nta STATE: 1?llv ZIP CODE: 55 PNONE #: ((PIa) R4L - "7'7 12 U 1993 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PIIAT KNOB RD EAGAN MN 55122 (612) 681.4675 PLEASE COMPLETE FOR ALL CONIMERCIAI.JINDUSTRIAL BUILDINGS. ALSO FOR MULTI- FAMILY BUILDINGS WHEN SEPARATE PERMTTS ARE NOT REQUIRED FOR EACH DWELLING UNTT. _ NEW CONSTRUCi'ION ADD ON REPAIR WORK DESCRIPTION: CONTRACT PRICE: $ FEE: 1% OF CONTRACT FEE. STATE SURCHARGE $.50 FOR EACH $1,000 OF 1!!"IT FE& MINIMUM FEE: $ 25.00 CONTRACf PRICE X 1% $ STATESURCHARGE $ TOTAL $ SI1'E ADDRESS: ... 1'ENANT NAME: STE. # OWNER NAME: INSTALLER: ADDRESS: CI1'Y: PHONE #: STATE: ZIP CODE: FOR: CITY OF EAGAN APPLICANT 1993 PLUMBING PERMTT (COMMIItCIAL) CITY OF EAGAN 3830 PIIAT KNOB RD EAGAN MN 55122 (612) 6814675 I # 1.. 'k P10111EER * 1AN0 SURKYOR3 • 10 PLANNCRS • !Ah 625 Hlghwoy 10 Northeast Bloine. MN 55434 612) 783-1580-Fax 783-1883 Certificate of Survey for: ThOf1'1C1S HOt'T18S, IC1C. House Address: Hackmore Drive. Ea, aq n_MN ? .-- O9 39 5N^ _ f D l h"I ?i'' s. !C52 ? c i ? Z ` r? rn CP a 'R. ?a 6 ? V OR?J,c'NP'Y ` ? ,.? i ?9s3 `b? i'R3 `{WSF. \ Nt P???SERSG g?S?MF\`' G01p4` P.01 t c - ;? 2422 Entcrprise Oriva : Mendotv Hetqnt6, MN 55720 612) 687-1914•FOx 881-9488 ! ? J r \ \1 \ ? \5 1 ? 1 r'?r ? 1 . ?.,? --? v?4K?Lp G°?o Fo-)o?o Fo-)CQ ? A- ?OR ` ?AS ??D-----?r.?----?? 4• PT 120.05 NOTE: CONTRACTOR MUST VERfF'Y ALL DIMEN510NS N 89'41'28" E R 900.0 Denotes Existing Elevatlon pRpppSED MoUSE ELEVA71oN x soo.o Denotes Proposed Elevation '---- ? --- Denotes Drainoge dc Utility Easement Lowest Floor Elevation:_y ? Denotes Drainage Flow Direction - 7op of Block Elevation:__75 -o-- Denotes Monument Gorage Stab Elevotion; -Et-- Denotes Offset Hub Bearings shown are assumed LOT 5, BLOCK 4 AUTUMN RIDGE 2ND ADD. DAKOTA COUNiY. MiNNESOTA I hereby terUfy Ihet thls survey, plan or report wes pr pgred by me pr Un?ier my dirBCt wpervifion end ihat I am duly Reglsterld 6and SVrvEyO? under the laws ot the 5tate of M7nneeota. Dated chis? day of. N1AYRGH' q.p. 19.Z.„ d / Scale:e4 ;^°h=3Q'e?t ?-? $=4?t? EG. NO. 14891 F, : --- ? _. . . :. P.01 , * T * y PIONEER LANO SUq14VOR9 • GNL ? engineering LAfJo PuNNEqS • LANDSCAI ,? * * * i .l . ?-b. Certificate of Survey for: Th om a s H om esI11 C_ House Address: Hackmare DriveL [a, aq n=MN l \\ ?? r "?j'1 i -` - ?g•39 ?`/''? ?=' 9? i !J !!??-8 ? ? ?5? 'N1 `. \ G? N1 1 J '} CP ? a ,p ? O z f'x NtloSF, ?xR 56? P5E-N, G \ ?\ \ N ? 2422 Enfcrpri.e Driva Mendolo Nelghls, MN 55120 (612) 681-1914•Fox 861-9488 625 Hlghwoy 10 Northeast Blaine, MN 55434 (612) 783-1880•fox 783-1863 •.'4. J \J? ?_- '` `•- ?r:ti \ 4~ ? • ? f r^?": ?" -- . .4 i? ?„? ;,.. ,? ?' . L1T • . ORp.r?'Pc?(•?S?(`,Er.l? C . - - - - --~ - f P. R.V. REO E D .., , 120.05 NGiE: CONTRACTOR MiiST VEftIFY ALL C)IMENSIONS h! 89'41'28" E `1' ? d lt. FI v? v v, isw? $P,l, x 900,0 Denotes Existing Elevotlon p120P05ED NOUSE ELEVATION . soo.o Denotes Proposed Elevation Lowest Floor ? Elevation: ---- Denotes Drainage & Utility Easement - Denotes Drainage Flow Oirection . Top of Block Elevation: q56.2(, -o- Denotes Monument Goroqe Slab Elevotion: --E3- penotes Offset Hub Bearings shown are assumed LOT 5, BLOCK 4 AUTUMN _ RIDGE _2ND ADD. DAKOTA COUNTY, MINNESOTA I hertby tertify (hat thlr furvey, plen or raporl wn' ?prppred bY me pr unde, my direct suDe?aLion and (hel I em duly Replstered Land Sorveyor undef the law: ol [he Stala o/ MinneS018. OatBd lhis'???_day ol- M/tiRGH' A.D. 19 ? I ' -?'.?(??. •?? .'11•!____??___ i ??? lln lci°t PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA096069 Date Issued: 09/23/2010 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 568 Hackmore Dr Lot: 5 Block: 4 Addition: Autumn Ridae 02nd PID:10-12301-050-04 Use: Description: Sub Type: e-Reroof Construction Type: Work Type: Replace Description: House & Garage Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector Nva ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee S3K $88.50 0801.4085 Valuation: 3,000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195 Total: $90.00 Contractor: - Applicant - Owner: Gates General Contractors, Inc Mark A Delebo 3 500 Vicksburg Lurie North 568 Haclanore Dr PIN-inouth NIN 55447 Eagan NIN 55123 (763) 550-0043 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 Use BLUE or BLACK Ink r - - - - - - - - - - - - - - - - - I For Office Use I I I I Permit ~y of Eanan Permit Fee: (t~ 3830 Pilot Knob Road Eagan INN 55122 Date Received: ~.(Z I I Phone: (651) 675-5675 j staff: I Fax: (651) 675-5694 L ---I INFLOW & INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: S 1 09 f Z- Site Address: SG% ~Qcky\, jQ Dy Tenant: Suite Name: N'a'1}v Phone: GS)' y S q S RESIDENT / OWNER Address/ City / Zip: flack r►~~ e C4~q~., l~ N s s ]a- Name: License Address: City: CONTRACTOR State: Zip: Phone: Contact: Email: PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK Sump Pump Repair Repair Other: Other: DESCRIPTION Description of work: t.o SyL FEES $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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.goi)herstateonecall.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 re 'ew and approval of plans. X 'vt C LY)" oJeJak x Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground -Rough-In -Final PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA139858 Date Issued:11/14/2016 Permit Category:ePermit Site Address: 568 Hackmore Dr Lot:5 Block: 4 Addition: Autumn Ridge 2nd PID:10-12301-04-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Mark A Delebo 568 Hackmore Dr Eagan MN 55123 (612) 328-0551 Apple Lake Heating & Air Conditioning 207 150th Street West Apple Valley MN 55124 (952) 431-4328 Applicant/Permitee: Signature Issued By: Signature