632 Hackmore DrGASFi RECEIPT ? r
CITY OF EAGAN , .
3830 PIIOT KNOB ROAD
EAGAN, MINNESOTA 55122
a?TE JI, ='? 1) +a ; I
ALouKr
a oouaas
?
? cA.sr+ Q aHEcK
sr ?l.. .
--?
a
(; 13629 Thank You
,,...,
BUILDING PERMIT
:ITY OF EAGAN -?3
ad, P.O. Box 21-199, Eagan, MN 55121 ""
PHONE: 454-8100
Receipt #
To be used for SF ow'i/w Est. Value$ 131,000
Site Address 632 HACKmoRE DR
Lot 3 Block _5 Sec/Sub. AIRUlQJ itIDGE
Parcel No.
W Name _
3 Address _
0 CItY "I
a Name SAME
Address
? City Phone
Name _
Address
i hereby acknowlege that I have
information is correct and agree
MinneSOta Stalutes and City of E?
Signature of Permitee _i,,
is issued to:
Phone
this application and state that the
>mply with all applicable State of
)rdinances.
I WINDWW CO tNC
iall be done in accordance with all
Building Official ?
OFFIC E USE ONLY
Occupancy R--3 -K--l FE ES
Zoning a?l
(Actual) Canst Y N Bldg. Permil T?¦?
(Allowabie) Surcharge 6s. ?
# of Stories
Length 54' Pian Review 46¦?
33, 1oc
?
Depth SAC, Cily ,
S.F. Total - SAC, MCWCC 630•00
S.F. Foolprints _
On Site Sewage _ Water Conn 660,
00
On Sile well water Meter 95.00
MWCC System x ?
?
Water
City ? t. Deposit
Acc •
PRV Required ? S/W Permit 30,
Booster Pump - SNV Surcharge 0
Treatment PI 276•?
APPROVALS Road Unit 370•?
Planner - Park Ded.
Council --
gla9 afi _ Copies
Variance - TOTAL 31,511.
?
- Permit No. Permk Hoider Date Telephone N
WATER
SEWtR.
PUu*NC 1414 7o 4P3-.3 3v
H.V.A.C.
ELECTRIC
InspecNon Date Insp. Comments
Footings I ?
Founda6on
Framing 6 ? s
Aoofing
Rough Plbg.
Rough Htg.
lsul.
Fireplaoe
Final Htg.
Orstat Test
Final Plbg. 1 Plbg. Inspector - Nofdy Plumber
Const. Meter
EngrJPlan
Bldg. Final ?- 2? 5._ ?
Dedc Ftg. 2 7
Dedc Final ?
Well
Pr. Disp.
"4-?
? FiE:
?
DATE: MAY 30, 1991
632 HAClQNORE DR (THE iRNDW00D CO INC)
Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
•;•? i???
(grx#tfira#e of (Orrupau.ry
Cirp of tagan
llrpwcriartt# of WuOing 3wPrtim
This Certifuaate issued pursuarrl !o the reqrdremenLs of Section 306 of the Uniform Building
Code ceWfiing tJrar at Ihe time af issuernce lfus snclure wrrs in compFicurce with the various
ordinuncses of lhe Ciry regufaAing buifding oonsiruction or use For the following:
t.a.,a.c. _SF 17G1G7AAR Bae- %mi IMm 19064
OO°°P-c7''IYK R3/ml Zodwg pyuia Ri TypcCoM VN
POST IN A COtJSPlCUOUS PLACE
CITY OF E:'lGAN METER #??T a7 ?L' PERMIT DATE S% 30 /G I
3830 Pilot Knob Rd. CHip # () 2 2 D _ 3 S! U PERMIT # 12008
Eagan, MN 55122-1897
METER SIZE B.P. RECEIPT # ? 1?'
DATE i•.AY 16 t 19?,1 ISSUE DATE ,7•- ?-,?? ? B.P. RECEIPT DATE
F• PRV _ BOOSTER PUMP
SITE ADDRESS 632 HACi:M0i:E DR PERMIT REQUESTED
LOT 3 BLOCK 5 SECiSU6 AUTUMr, RILGh
x SEWER WATER _ TAPS
APPUCANT:.
ADDRESS: _
CITY, STATE
PHONE:
ZIP
PLUMBER: MATTHEW LIArIEI.S INC
ADDRESS: 15185 CAROUSEJ. WAY
CITY, STATE RUSEMOUfyT MA' ZIP 5506c
PHONE: 42 3-3 73 ()
COMM/IND _t RESIDENTIAL
Y NEW _ EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line. .k;
C16tlit WILL NC)T be given fqr.t3educt Meters. ?-
?
--
I AGREE TO CGIMPLY WITH CITY OF
EAGAN ORDINJINCES G
G? Gr- ?'c0qwtot, ?
SIGNATURE HEN METERISSUED
ILL 454-5220 FOR INSPECTIOiaS. FOR STORM ;
SE'!lER &?111ATER PERMIT
T
E
N OFFICE USE ONLY
CI
Y OF
9GA METER # PERMIT DATE
3830 Pildl Knob Rd.
Eag2,f?, MN 55122-1897 CHIP # PERMIT # i1C?8
METER SIZE B.P. RECEIPT # ? 2302'.
AY 16
'
1991 ISSUE DATE B.P. RECEIPT DATE
?
:
DATE
X PRV - BOOSTER PUMP
SITE ADDRESS 632 HAC'14ORE DR PERMIT REOUESTED
LOT 3 BLOCK `' SEC/SUB AUTi;i;,;
x SEWER ,• WATER TAf
APPLICANT:
ADDRESS:
CITY, STATE ZIP
PHONE:
PLUMBER: ?1AT'rHEW L?? I'? I?.:LS : tC
AQDRESS: 1518_6i CAi:GL-S?I. WAY
CITY, STATE n.18F.F0UN?' r"J ZIP 51•0b8
PHONE: 4; 3--3730
OWNER: TtiFS WINUWGUD CG INC
ZIP 55l 2j>
- COMMIIND RESIDEN
X NEW EXISTING
Lawn Sprinkler Meters are to be Inst
Ahead of Domestic Meters on Water I
Ccedit WILL NOT be given for Decluct Me
? i
A ?f !/?. ._" .... _.
I AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES
;>"1--u&Q` SIGNATURE WHEN METER ISSUED
ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTfUNS. FOR STORM
PERMITS, CONTACT ENGINEERING DEPT.
?: :' a,, .. • , . ?k'?? :_n?. '???'. F?.. ?:?,??i??a.,
OWNER: THE WINDWOOD CO INC
ADDRESS: P 0 BOX 24329
CITY, STATE APYLi VA.LLE`! 4!i4 ZIP 55124
i
i PHdNE
CITY OF EAGAN N2 19064
. 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUI CDING PERMIT Receipt # 0 - 17?? L %
To be used for SF DWG/CAR Est. Value $131, 000 Date MAY 16 , ? g4L
Site Address 632 HACKMORE DR
Lat 3 Block 5 SeGSub. AUTUMN RIDGE OFFICE USE oNLY
PafCel No. Occupancy R-3-H-_1 FEES
R
1
2oning -
w Name THE WINDWOOD CO INC (ACtuat) Consl ?!-N Bmg
Permit 748.00
? Address P 0 BOX 24329 (allowable) V-N .
65
50
e City APPLE VALLEY Phone 891-4605 x oi siones Surcharge .
54' Plan Review 486 . 00
Length
o Name S? Deplh 55' snc
cn
o
100.0
,
y
'? Address S.F.Tolal -
650
00
snc.MCwcc .
F C.ISY PhOf1B S F. Foolprinls -
C
W
t 660. 00
On Ste Sawage er
a
onn
u?
ww
Name
On Sile Well
-
W
l
M
0
95
0
i? Address n+wcc system X a
er
eter .
d W Clty PhOnO City Water X Acct. Deposit 30.00
X 30
0
D
PRV Required S/W Permit .
I hereby acknowlege that I have read Ihis applicaiion nd state at Ihe eooster Pump -
0
SM/ Surcnarge .5
inlormation is correcl and agre o comply wilh all plicabl late ot
Minnesota StaWtes and City ot ag n Ordinan ?
n
Treatmenl PI 276.0
SignaNre of Pefmrtee - r APPROVALS Road Unit 370_ nn
A Building Permit is issued to: THE WI D OOD CO INC PlannB1 - Park Ded.
on the express condition that all work shall be d ne m accordance with all CouncA
applicable State of Minn
esota St
a
tutes and City
of Eagan Ortlinances. Bldg. Off. _ ?Pies
?
.
p
? /
BwldingOtficial { I1.a1/? 11.01f? ? m/I
I ? ? \ Variance - 70TAL 3.$11.00
i9 a0a5
p 7 7 51 T--- ? 4ff00
ReQ est Dale Fire No Rough-in Inspection
Reqwretl?
? Reatly Now 3 YIIRJOtity Inspector
' • ?S E No When Reatly'+
iP*10censed coMrector D owne r hereby request inspection of a6ove electrical work at.
Jao aress Streec 6ox or o e Na i Cny
1
5ion No ow pip Name or No Range No Coumy
Occu0anl PRINT) P?o
? N D
Powe?5u0Pli i Ari
EIBGtnc IrdOtoI,mpany,Na Cop((acto lLca a?
0
MaTn Atl ess ICO r ctoro er Maki Installafion)
Authonze ignature rConn onOwn r Meking Installauoni
_? Phone mber
5d3
MINNESOTA STATf BOAflD OF ELECiRICITV THIS INSPECTION fiE0UE5T WILL NOT
Griggs-MiEway BIOg - Room S173 BE ACCEPTED 8Y THE STATE BOARD
1821 Unrversity Ave, St. Paul. MN 55100 _ UNLESS PROPER INSPECTION FEE IS
Fhone (61I) 602-OBOU EN0.05E0
/ ?QUE ?T FOR ELECTRICAL INSPECTION ea.ooom-oa
7//9/ See mstructions (or mmpleung Ous torm on back ol yellow copy ?'?"?- ?OaOa S
11 775 1 "X" Below Work Covered by This Request ''<,?•??
ew Atltl Rep. TypeoiBwlding AppliancesWired EqmpmeniWved
Home Range Temporary Service
Duplex W er Heater Electnc Heating
Apt Bulldmg ryer Other (Speclty)
Comm /Indushial Furnace
Farm Air ContlRioner
OtM1er(syeoty) Conlractors FemaBs
Compufe Inspecnon Fee Below
# Other Fee C Sermce EntranceSrze o k CircmiSiFeeders Fee
Swimmmg Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps 100 _ Amps
Signs Inspecmr§ Use Only. TO L ?
irngation Booms ? •
Special Inspection
AlarmiCommumcahon THIS INSTALLATION MAY BE OROERED ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 78 HS. 14 t
I, the Electncal Inspector, hereby Rough-in re? d
a
certity that ihe above inspection has
been made. pinai ?e
.-
OFFICE 115E JNLV
This request void 18 months Irom
Address: 632 HAaMBE DRIVE Lot 3 Blk 5 Sec/Sub ALT1'" R=
These items were/were not complete at the time of the final inspection.
t : 7/26/91
Yes
No .,
,a. Tnsppctor,
Final grade (6" from siding) 1Z
Permanent steps - garaga
Permanent steps - main entry LI/
Permanent driveway t/
Permanent gas ?
Sod/seeded grass
Trail/curb damage ?
Porch
Basement finish
Deck
Please varify vith the builder the ramoval of roof test caps from the plvmting
system and the shut-off of water supply to the outside lawn faucet before
freeze potential exists.
?
arnvmnn?
White - City copy Yellow - Resident copy Pink - Contractor copy
_ _ ?-
,_2_ RESIDENTIAL ?
??J??J BUILDING PERMIT APPLICATION
CITY OF EAGAN
? J 3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
New Construction RenutremeMs
• 3 registered sile surveys showing sq. fl. ot lot, sq. N. of howe; and all rooled areas
(20°k maximum lot coverage allovred)
. 2 copies of plan showing beam & window s¢es; poured found design, etc.)
• i set of Energy Calculahons
. 3 wpies of Trea Preservation Plan if lot platted after 7/1193
. Rim Joist Detail OpM1ons seleUlon sheet (61dgs wAh 3 or less units)
DATE CD -btC- Oc
RemodellReoair Reauirements
• 2 copies of plan
• t set of Energy Calculatians for heated additions
• 1 sAe survey for exienor additions & decks
• Indirale'rfhameservedbysepticsystemforadditions
VALUATION a I i 64(O-11
SITEADDRE35 oL 3a )1 rlt^Mpt -blt ; a_ MULTI-FAMILYBLDG _Y _N
TYPE OF WORICRnpaS,A?,(,p? ?';?n FIREPLACE(S) _ 0_ 1_ 2
W S% 'Mn1f ?
APPLICANT
STREET ADDRESS
TELEPHONE #
I PELLA WINDOWS & ?OORS
15300-25TH AVE. N. STE. #100
1 PLYMOUTH, MN 55447
763-745-1400
! LICENSCE #120I65884
STATE ? ZIP
I FAX #
?
PROPERTYOWNER^?]G.itv? TELEPHONE#LOSI•cj'9g.a419
COMPLETE FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNES01'A RLJLES 7670 CAT'EGORY 1 MINNESOTA RULES 7672
(d submission type) . Residential Ventila0on Category t Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Su6mitted
Plumbing Contractor: Phone # __
Plumbing syslem includcs: Water Softener _ Lawn Sprinkler ree: $90.00
Water Heater No. of R.I. Baths
No. of Baths
Mechanical Contractor: Phone #
Mcchanical syslem includes: Air Conditioning _-_F-cea- $70-00_ --
Heat Recovcry Systcm
li 1?- Jn?n.,? I
Sewer/Water Contractor. Phone # L J - ?'I
I hereby acknowledge that i have read this application, state that the information is corr eBt? ?nd agree to com ?
with all applicable State of Minnesota Statutes and City of Eagan O nances.
Signature W Applicant ak(A ?
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
z -
OFFICE USE ONLY
? 01 Foundation ? 07 05-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 01of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 Ext.Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
C] 32 Addition 0 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
p 33 Alteration ?,37 Demolish (Bldg)* ? 43 Reroof ? 46' Windows/Doors
? 34 Replacement "Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/rmS System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprinklered
Type of Const Width
• REQIJIRED INSPECTION5
„
_ Footings(new bldg) FinaUC.O.
_ Foorings(deck) FinallNo C.O.
_ Foohngs (addition) _ Plumbvtg
_ Foundafion HVAC
_ Drain Tile Other
Roof _ Ice & W ater , Final _ Pool
Ftgs _ Air/Gas Tests _ Final
_ Framing _
Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ _
Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S8W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building InspecYor
Wd9E: l '8 'unp aWil pania0 aa
PeJIa Windaws & Doors - Twin Giries, Inc. 15300 ZSTH AVE. N. STE. #100
PLYMOUTH, MN 55447
763l745-1400
?
June 8, 2001
City of Eagan
3836 Pilot Knob Road
Eagan, MN 55122
Dear Jan:
Elder Jones Corporation is authorized to pull building peimits for Peila Windows &
Doors -'Itwin Ciries, Inc. Please allow their representative to provide that service for us
in Eagan. Ttus suthorization shall be valid until such time as the division manager
expressly revokes it, in writing to the City.
I request that this authorization be accepted expeditiously, so as to not delay the
processing of our building permits any furthec Please call me if there are any questions,
I can be contacted at 763-745-1432.
Your immediate attention to this matter is appreciated.
cerely, ?
._.,, SWARILM
Bryan May Replacement Sales Manager cc_ Kaza -EldcrJones """ - "
Denna Krafty - Replacement Sales Process Coordinator
Windows, Doors,
& Skylights
VJATS 1-800-462-5359
FAX 763/745-1401
7nnft evrTrn r,irur TuJ hIar esI 7ra vv.r ir'cT ru.r Tnionion
CITY OF EACAN
3830 YILOT KNOB ROAD
F.ACAN, 1^': :5122
PHONf:: (612) 454-8100
S'L'fJl{BING P$RMIT
SOk CITY USE ORLY
PERMIT # 1'1`120
RECEIPT it /O t?J'r _
DATE: im/ $ B/
RESIDENTIAL:
PLEASE COMPLETE
UPPER PORTION
ONLY
FOR !
SINCLE FAMILY DWELLINGS
TOWNAOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
---------------------
WORK DESCRIPTION
NEW CONST _-/_
ADD ON ?
REPAIR
OWNER NnME: W01L(001 7/UYY1G5
SITE ADDRESS: ? 3-? ?fl?v/?L
LOT:3,.,-7 HLOCK s SUSD. ,?(,,JZ/rYll'J G/CCC3C_,
INSTALLCR; ///G.,?'1l?fCfl.ti !J 1t?S _L?'/L. `
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMl7M 15.00
03 SHOWER 3.00 ?
3 WATER CLOSET 3.00 7a)
L BATH TUB 3.00 a6D
,_?F LAVATORY 3.00 9.0
? KITCHEN SINK 3.00
L LAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
? WATER NEATER 3.00 3u7
? FLOOR DRAIN 3.00
GAS PIPING OUT. L (MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50 _
` OTHER - --
WATER SOFTENER 5.00 _
? PRIVATE DISP. 15.00 `
U.G. SPRINKLER 3.00 _
SUBTOTAL
ST. SURGHARGE
Toxnt.:
S Ua w
? .50
$ q-;), --p
COeU;ERCIAL/INDUSTRIALi PLEASE GOMPLETE TNIS PORTION FOR ALL GOMMERCIAL/INDUSTRIAL SUILDINGS AND
MIILTI-FAMILY BUILDINGS 41HEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
-------------
CONTR.ACT FRICE:
OWNER NAt7E:
SITE ADDRESS:
LOT: BLOCK SUED
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
CITY OF EAGAN
ZIP:
FEES
18 OF CON1'Rf+CT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MSNIMUM FEE.
CONTRACT PRICE x 18 $_
STATE SURCNARGE $_
TOTAL: $
(SIGNATURE)
ADDRESS: JS??S 1//,`9,I 6011I/
CITY: ZIP:
CITY OF EAGAN
3830 PILOT KA20B ROAD
EAGAN, !IN 55122
PHONE: (612) 454-8100
"'PW
FOR CITY IISE ONLY
PERMIT # ?
RECEIPT 8DATE:
PLEASE COMPLETE DPPER PORTION ONLY FOR SINGLE 7
?• ....:,::.........:.
TOWNHOMES/CONDOS WNEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST _
ADD ON _
REPAIR _
OWNER NAME: IA?I/YI?;LG(171J1/,?
SITE ADDRESS: }? ? `"?CO3oz G?l`6T-
LOT: ? BLOCK .? SUBD. ??t?-'=•_:-._
INSTALLER 4??9 !.L A 1'( ?6 `3y U1
ADDRESS:I. ?. ?
CITY: ZIP:
PHONE #: `7?t 5-7_5',
FEES
DWELLINGS &
ADD-ON MINIMUM $15.00
HVAC 0-100 M BTU 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
?j?G
SUBTOTAL: $ "`
STATE SURCHARGE: .50
TOTAL:
SIGNATURE OF PERMITTEE
p4)NR4?[tG?A?STSTKIA'L;? PLEASE COMPLETE THIS PORTION FOR ALL C0MMERCIALJINDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
-------------
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BIACK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE
FOR:
CITY OF EAGAN
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE a $.50 FOR
EACH $1,000 OF PERMIT FEE.
?ROCESSED PIFZNG = $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1&
STATE SURCHARGE
TOTAL:
$
(SIGNATURE)
U4 )
PERMIT # CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION APR 0 RFrn /
681-4675
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
af month in which re uest is made or lot chan e is re uested once ermit is issued.
Date y/ 2 / 9 2- Valuation of work
Site Location: 632 Ha'--k,•.ose Drive
STREET STE Y
Tenant Name: F? rrY Gtq r-Vyur
-?
LOT 3 BLOCK ? S118D. AU `U mY1 I> I dge P.I.D. A
Descri tion of work: D e? k
The applicant is: Cd"Owner El Contractor ? Other (Describe)
Name Garfinar gacr4 Pha ne G$8 - Z'-119 e„y
Property LAST fIRST 'z-r- yX-7 a,yl
Owner pddress 6-3 2 jjackm,5rn Dr;ve-
STREET STE A
City F_a aV? State M? Z;p 551IZ3
Company Phone
Co ntractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved. ,
I hereby acknowledge that I have read this application and state that th e information is
correct and agree to comply with all applicable State of Minnesota Statu tes and City of
Eagan Ordinances.
Signature of Appl icant: •,?{ Y/2??y
?
OFFICE USE ONLY BUILDING PERMIT TYPE
? 01 Foundation
? 02 SF Dwg.
? 03 Two family
? 04 Multi-fam. T.H.
? 05 Apt. Bldg.
WORK TYPE
J3r31 New
? 32 Addition
? 33 Alterations
? O6 Garage/Accessory
? 07 Flreplace
0 08 Deck
? 09 Basement Finish
? 10 Swfim Pool
? 34 Remodel
? 35 Repair
13 36 Tenant Finish
? 11 Res. Add./Parch
? 12 Comm./Ind. New
O 13 Comm./Ind. Add
O 14 Comm./Ind. Rem
O 15 Public Fac.
? 37 Move
? 38 Demolish
? 99 Undefined
GENERAL INFORMATION
Occupancy
Zoning
Const. (Actual)
(Allowable)
# of Stories
Length a
Depth I*Y
APPROVALS
P7artning
Engineering
REQUIRED INSPECTIONS
? Site
? Wallboard
Basement sq. ft.
ist F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint 5q. ft.
On-site well
On-site sewage
Building
Variance
Eg Footing
J4 final
? Framing
? Draintile
?
? Insulation
? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC 5AC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
G 1 vewet;on: s
? 16 Agricultural
? 17 Building Move
? 18 Demolition
? 20 Miscellaneous
MWCC System
City Water
PRY Required
Booster Pump
Fire 5prinkler
Census Code
SAC Code
Assessments
SAC %
SAC Units
--?.....-..,.?.
t ;t
o • :x
748•U0F
65•50+
486•U0+
2, 211•50F
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'
f 1GRI(TrAPOICATION
1991 BUI ?CITY OF EAGAN
SINGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCUTATIONS
MULTIPLE DWELLINGS
. :„
COMMERCIAL
2 SETS OF PLANS 2 SETS OF ARCNITECTURAL
REGISTERED SITE SURVEYS - & STRUCTURAL PIANS
(CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, SUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTDR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALIAWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MtIST SHOW A LICENSED PLUMBER.
To Be Used For: SincTle Family DetaVkb(gation: ?9`;7M Date: 5/10/97
Site Address 632 Haclmtore Drive
Lot 3 Block 5
Parcel/Sub Autumn Ridqe
Owner The windwood Canpanv. Inc.
Addresspp gax 24329
City/Zip Code Apple Valley, MN 55124
Phone 891-4605
Contractor The Windwood Canpany, Inc
Address PO Box 24329
City/Zip Code Apple Valley, MN 55124
Phone 891-4605
Arch./Engr.
Address
City/Zip Code
31 v., ? OFFICE USE ONLY
Occupancy [Z-31+1-(
Zoning f1-f
Actual Const V•N
Allowable - -?
tt of stories
-
-
Length S?
Depth S`I%L?
S.F. Total
Footprint S.F
FEES
ld
P
i r?
qB
O
g.
erm
t
B ,
p
l
Surcharge 6?,
Plan Review 86,00
SAC, City 100,00
sAC, tswcc 5'D,00
Water Conn. 1010?
Water Meter ,00
Acct. Deposit 3 D.Oo
5/w Permit 0 1 00
S/W Surcharge , 5)
Treatment P1. r) .0?
Road Unit IfI0100
Park Ded.
Trail Ded.
Copies
SUSTOTAL
Penalty
Lot Change
TOTAL . ? I. .
On site sewage_
On site well _
MWCC System ?
City water ?
PRV t/
Booster Pump _
APPROVALS
Planner _
Council
Bldg. Off.
Variance
Phone #
--? agrees that all work shall be done in accordance with
(Signa e of Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
?
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31 j2 X ?2 y ,: ?1$'6
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acroim n=ma
raaeaoas amocnaa vAs.vs hmeszMZXs .
Th;s Aqreament, made and entered into the /L? daY
os isso, br ana becvaen the crrx oF racnri, s
funicipality of the SLela of Minnesota, (hereinaiter ealled the
?
r
City), and the Owner and the Oeveloper ideatified herein.
Tha term •Developar^ as usad herein refers to: AUTOlQ1 RZOGE
LIMITgp pAR7TiERSHIP, a Hinnesata limited partnerahip, e/o JAltES
pgpffi,ppxgNT C014PAt7Y vhose address is 7808 Creekridge Circle, Suite
310, Bloominqton, Minnesota 55435.
TAa tarm "OVner" as usad herain refers to: AVTUlII7 1tZDGE LZlSZTED
p7utTN8RSHIP, a Minnesota limited partnership, c/o JAtSES DEVELOPMENT
COMPAti1[ whose address is 7808 Creekridge Circle, Suite 310,
8laoaincjton, ISinnesota 55435 and RUTH CON1tAD whose addsess is 5015 -
35th Avenue South, Apartment 215, Mlnneapolis, Minnesota 55417. . .tiAg,REAg, the Developer Eas applied to the City for approval of
the plat or subdivision knwm as AUTU4II1 RIDGE, loeated within the
City; and
NHERFA3, the pvner and peveloper aqree to notily the Proposed
potantial buyers of all lots vithin A9TUlW AIDCE that Lots 1-7, Bloek
1, Lots 1-8, Block 2. Lots 1-9, Slock 3, Lots 1-17. Block 4 and Lots
1-5, Block 5, are in a hiqh vater pressure zone and a pressure
reducinq valve shall be installed in each home belov the alevation ot
966 feat. All eosts shall be the responsibility of the Ovner and
Developer and shall be installed to prevent damaqe due to hiqh vater
psessure.
??'?:A
?
?
NOi?, TIMUPORE, the City, Oimer and peveloper aqree as follovs:
1. 8ecozdina. This aqreement shall 6e recorded vith the Dakota
County Reeorder ao as to provide notice to the owners of Lots 1-7,
Block 1, Lots 1-8, Block 2, Lots 1-9, Slock 7, Lots 1-17, Block 4,
and Lots 1-5, Slock S. The Ovner Bhall provide and exeeute any and
all doeuments aecassary to implement the racording of this aqreement.
2• NQLic@• The reoording of this document shall constitute notice
to all ovners and future ormers of property in ttfe AtJTOlW RZDGE
subdivision that Lots 1-7, Block 1, Lote 1-8, Block 2, Lota 1-9,
Block 7, Lots 1-17, Block 4 and Lots 1-5, Block S are in a hiqh vater
pressure zone and that a pressure reducing valve shall be installed
in eacA home belov the elevation of 966 feet. All coets shail ba the
respoasibility of the Owner and Developer and shall be instailed to
prevent damaqe due Lo high vater pressure.
3. validitv. If any portion, saction, subseetion, sentence,
clause, paraqraph ar phrase of this aqreement is for any reason held
to be invalid, such decision shall not affect the validity o1 tlie
remaininq portion ot this Contrect.
d. Bindinv aareement. The parties mutually recoqaize and aqree
that all terms and conditions of this recordable agreement shall run
rith the land herein dascribed and shall be bindinq upon the Aeirs,
suceesaors, administrators and assigns of the ovners and developers
refereneed in this Contraet.
1? r
IN ttITNESS WHEEOF, ve have hereunto set our hands.
CITY OP
ApT(Jl4i gIpGE LIISZTED YAR'Pl1ERSHIP,
a tiinnesota limited partnership,
!Thftas By: JAMES DEVELAPMENT COMPANY,
A. an a Iiinnesota Corporation
ts: MAYo= Its: General Pa=tner
tut . J. VanOVerbeke y: lffmffi Date fi4f
Its: ity Clerk Its.
gY; Date
Its•
?
RTftH CONRAD at
DEVEIAPER:
ADTDt47 RIDGE LIMITED PARTNERSHIP,
a Minnesota limited parinership,
8y: J71ME5 DEVFS.OP![ENT COMPIINY,
a Minnesota Corporation
Its: General Partner
?'?" /??
g?.: Date N
ItB:
.p
..
-,.,. !
/
?
gy. Date
Its•
ST11TE OF lIINNESOTA
ss.
COUNTY OF D1IKOTA )
Oil this Z2?& day of e-z . 1990, b4lole me a Notary
Public within end for eaid Coun , personally appeared THOMAS A. EGAN
and E. J. VanOVERBEKE to me %rsonally knovn, uho 6eing eaeh by me
duly svorn, each did say that they are respectively the ltayor and
Clark of tha city ot 8aqan, the municipality named in the toregoing
inctrumant, and that the seal ailixed on behalf of said municipality
by authority of its City Council and eaid Mayor and Clerk
acknovledqed said inetrumant to be the iree aet and deed of caid
municipality.
?„
gt_?? ? anr n:?:?rcE?m¢w?r? N tar PuDlic
1 CCUNTY
` WDAKOTA t?mR:?,? uo r?n e i?
ST11TE OF MINNHSCTA )
) ss.
COD27''Y OF Wv? ) ?
On Lhis ? day of . 1990, bafore me a Notary
Public ri in. __LIIndor sasd Caunty, personally
appsa=ed ?.DSZfJiI ?I to me
parsonall knovn, vho beirnq each 6y me duly s n„ e? ch ' say that
tt?ey are respectively the 3?%L---
dw of JAISES DLVEI.OPMENT C019YAt7Y, a
Minnssota aorpozation, qeneral partner of AUTUl4r RIDGE LIMZTED
p11R17iSt5ft a Minnesota limited partnership, to me persona2ly knovn,
vho be me duly snorn, did say that Lhey are
the Si _ ani of the
corporation and limited partnership namcd in the fozeqoinq
instrumanC, and that the seal afiixed to said instrument vas signed
? d l? on _ f of saidx c?orporation and limited partneYShip and
-- = acknovledqafl
said instrument to be tAe free act and deed of said corporation and
13sited partnership.
L .
Notazy Pul? ic
11??I? A?OOOp¦
•? A?4. l7?91
? _ :.,.; .. .
?- ? ?t._ .._ ._. . . . .
. .
: ?ro,Z ,I:AJ;}:i
r•,,,,.?:
STATE OF )
F ss.
CODNTY OF 1
On tday of ?Irj , 1990, betore me a NctarY
Public withia and for eaid County, ersonaily appeared RtITf[ CONRAD to
•a personally known to be the person deseribed in and vho executed
the loreqoing iastrument aad acknowledqed that she exeeuted the same
as her lrae aet and deed.
T
1•10 -,.?,.:,? ?r?nr? E .
Notary lic
MIt? 4 ?.?oW
71PPROVBD AS TO FORM:
1lttorne ( O Z
tod: -
APPROVED 11S TO CONTBtiT:
iiFw ?Fli4G£f'h.?
Public Works partment
Dated: 8^ 7- 9 0
THIS INSTRIIlMNT WAS DRAPTID BY:
SBVBtSON, WILCGX i SHEI.DON, P.A.
600 Nidvay National Bank Sldq.
7300 West 147th sereet
]?pple valley, !rtt 55124
(612) 432-3136
IIGD
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122 ? `--? , ? ?
Telephoue # 651-675-5675 FAX # 651-675-5694
New ConsWdion Reauiremenis RemodeliReoair Reouirements Office Use OnN
3 regmtered sde surveys showirg sq. ft o( lot sq. ft of house; and a11 roofed areas 2 mpies of plan Cert of Survey Rectl
(20% maeimum bt coverage allowed) 7 set of Energy CalculaGons for heated add'N'ons Tree Pres Plan Recd
2 copies of plan showing heam & window sizes; poured found design, etc. 1 sKe survey for additlons & decks Tree Pres Not Reqd
t set of Eneyy Calwlations Addifian - ind'icafe i/onsde sep6c system _ On-site Septlc SysRm
3 copies of Trea Preservation Plan if lot platted after 711193
Rim Joisl Defail OpUons selection sheet (bldgs with 3 or less units
Date y l?? 1?3 Construction Cost
SiteAddress C-?L /?<<_/G ir,o?C. 12e. UniUSte #
Description of Work f
Multi-Family Bldg _ YN Fireplace(s) _ 0_ 1 _ 2
Property Owner 7
Telephone # (f'?
Contractor ?v?+ '/ ?? ?f ^ ?'?j'1 ?L' / 1? c .
Address %l//j ?</p.x?' e . /.1
State ?'? . City
Zip ?// Telephone #
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category t Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
. Energy Envelope Calculadons Suhmitted
Licensed Plumber
Telephone #(
Mechanical Contractor
Sewer/Water Contractor
Tele one # ( ) -I
Teleph1one #? ? I
? . 4 J 1
By_'--=--_I
I hereby apply for a Residential Building Permit and acknowledge that the m ormation is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of 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.
? ?--?
c?--
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
Sub Types
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool O 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - MuIG
? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg, ? 42 Demolish (Foundadon) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to appliwnt
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 Width
REQUIRED I NSPECTIONS
_ Footings(new bldg) FinaVC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundarion HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tesu _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/reptacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review -
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
i
W/NOWDDD 9044E5
-"V3540. o/
CONSUI.TI146 6NO NfffiS
PLRNNERS anJ tRfVU l?11RVEYURS BK /SB
P6 38
1 IV C.
STflEET, flUHN5VILLE, MINNE&OTA 6636i P11 43Z'3UUU
Certificate ofi Survey
Legal Description : Lo7 3, Bl17CK 5", AUTUMiI/ R/pGE,
DAKOTA COUNTY, M/A111-1E507,9.
Cy3`f"' S? DENOT[S EXISTIfJG CLEVATION
(936.5) DENOTES PFtOPOSED ELEVAi-ION
? INDICATES DIR[CTION OF SURFACE DRAINAGE
936.83 = FINISHED GARAGE FLOOR ELEVATION
2?• 3' = BASEMENT FLOOR ELEVATION
938-50 = TOP OF BLCCK ELEVA'i-IUN
6CALE z 1' e 30'
DRA/NA6E AkO
UT/U7Y EASEMEN'T
/
&37. 6)
?---, N 83°S
,937. 6 ? S 39 "/iY
?
7??5 a0 =34 5I
? il?X N w? $ 937 b ?
4
o ro
J t ?? ?93¢?? ?
5l 64,e,q?c i
2¢ q?
9A?.3/ V1? ? ? r93¢? ~
NU
/3B. 77
N ?eSO'36 ?/Y
L?
-30' FKJ'NT 8U11-01iVG
56- 764 CK z /NE
'j1 ;
i?932. 9'?
?O?
?/0 ? 0
N?M
?? e.¢? no N V 01
TY31 g f ? ? ? ??i
iryl
Im?:
?
?
{ hataby certlly Iliat this la e trua und correct repiasantalion o( n trncl o( Innd as ehown
and deactlbed h.rson. As piopnted by tne on lli{s ?Z! day ol L??I1y - '1991 ,
(-?j_
,
• • ? •
• ?NA
flOB? CoNfUI. INO 6N0INEElis
C7j?YgaEIING PLflNr?Eas a,id LANP dunvevons
Pt?
N
COMPANY, INC.
? ?IUUU LAST 1481h 6TREET, dUFlN6YILLE, MINNE801A 6639i
W/NDWO4D HOMES
?3590. o/
?BK /SB
P6 ?
PH 432''JOUD
Certificate ofi 5urvey
Legal Description : coT s, e?ocK s, AUTUM/? R/OGE,
DAKOTA COUNTY, M/NNESOTA.
(93,f5 ) DENOTCS EXISTING ELEVATION
(936.5) DENOTES PROPOSED ELEVA-I'ION
? INDICATES DIR[CTION OF SURFACE DRAINAGE
936-83 = FINISHED GARAGE FLOpR EIEVATION
93O• 33 = BASEMENT FLaOR ELEVATION
938•5-o = TOP OF BLOCK ELEVATION
SCALE c 1' - 30'
DRA/NA6E ANp
UT/UTy E4SENJEN7'
F,eoAvr BviLoi,vG
SETBACK L/NE
/
937'.G? N83°S `
3¢
935,0 8 ? ?_ i932.9?
3 ?
k4-)
f /0
? ry?m
O? \ m 8 W N - -- ?
/ _
p
O b :P34_6,
?-13 ?u
•
s
? ?--2¢ o'
(9*,') ?•?64.Sj \ c736s? ? ?
N
J'
?
\A?
° ?12tLY 0,00
.
G? (?,4jo F?? ' 7 `?.?..?
?
l heraby certl(y lhnl lhia ia a lrue and correcl representaUon ol n trnul of land us ehown
and deactlbed hossao. As psepated by. me on llds'1,Q!! Jay ol A/tAY ,19g(„ .
??1 A 13600
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117454
Date Issued:10/18/2013
Permit Category:ePermit
Site Address: 632 Hackmore Dr
Lot:3 Block: 5 Addition: Autumn Ridge
PID:10-12300-05-030
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
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 by law in ALL single family homes .
Doug Andrys
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 -
Joseph W Netland Lover
632 Hackmore Dr
Eagan MN 55123
(651) 395-9659
Andrys Home Improvement Inc
2420 Brinkhaus St
Chaska MN 55318
(952) 212-4663
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA146698
Date Issued:11/08/2017
Permit Category:ePermit
Site Address: 632 Hackmore Dr
Lot:3 Block: 5 Addition: Autumn Ridge
PID:10-12300-05-030
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
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Joseph W Netland Lover
632 Hackmore Dr
Eagan MN 55123
(651) 283-5221
Nmc Exteriors & Remodeling
14276 23rd Ave N
Plymouth MN 55447
(763) 684-1662
Applicant/Permitee: Signature Issued By: Signature
f 11
r For Office Use c 311q-1 vi
VIJ
�I,� rr rr E AGA t..� :::: ee
#: 7
� r
U1 01g 0
WO
:
X-7
Date Received: 3- 7.
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinginspections@cityofeagan.com J
2019 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#: pp
Name:• J#Yll1 A dr Tee ,$)6,-1-41,6- Cv et- Phone: GP / �J• .Si'ZZ
Resident/ (p3 2 /-1.4C- ,12PQ ))/2J be eet 4' f't�,V S c/Z.
Q1Nn8r : Address/City/Zip:
Applicant is: Owner Contractor
Description of work: 1 /L!it) , 11GQ //) a- 112
Type of Work
Construction Cost: Multi-Family Building: (Yes /No
/ .�
Company: �� t17a�e 63‘4. -?-1-!-Z-4t/e5}/ Contact: �t`''41--19 Alt/
Contractor Address: `7'/7 .-TC/4064 Pr - 1 yd s" City: !'/J
State: L'Zip: Sr/2- Phone:4/Z. f 9% " mail: /IX /1MA7l'1 Q, 1�.Wit?
License#: 5 Lead Certificate#: 4--I— 3OS 8 --/Z. " 6)05-1/7
If the project is exempt from lead certification, please explain why:
5/1//4 /,e-/ )6?1/
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:
Fire Suppression Contractor: Phone:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information may be
classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.com/subscribe.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.ciopherstateonecall.orq
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 7 141/ i x �/
Applicant's Printed Name Applicant' •nature
DO NOT WRITE BELOW THIS LINE --,f Ift4da togc �02 a / c-/Z(-/S
SUB TYPES
Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
4\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*
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 / 40 Occupancy __ MCES System
,N
Plan Review Code Edition 0! ( 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 _ Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings (Deck) Final I C.O. Required
Footings (Addition) Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood
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
Insulation Ni., 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: II-l. , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge . 1
Plan Review '' Y' , (Ar I,
MCES SAC ,� ) V
- n' X' (:-/f
City SAC te '0' ,
Utility Connection Charge
S&W Permit&Surcharge1 /
Treatment Plant U /i'� �4 ?O l./s CO 0 0
Radio Meter Read `�
co
_,
Copies I
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA155606
Date Issued:05/23/2019
Permit Category:ePermit
Site Address: 632 Hackmore Dr
Lot:3 Block: 5 Addition: Autumn Ridge
PID:10-12300-05-030
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Fixtures
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 (miscellaneous)$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 -
Joseph W Netland Lover
632 Hackmore Dr
Eagan MN 55123
(612) 750-9968
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature