644 Hackmore Dr? - 11?1J1
Cll"'f OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 5;123
(612) 681-4675 ` ? •
SITE ADDRESS:
, ,. . ..,.,. . ,
PERMIT SUBTYPE: -
N
PERMIT TYPE:
Permit Number:
Date Issued:
- 1 .
APPLICANT:
??! •+? . c+0;
.?? TYPE OF WORK:
E
-- ;
Itli l I tl 1 W?i
l+)Hl?,bt i
INSPECTION DA • DA
I rr?,
11rt44 ti r+r, 1? : I? r t- v I I . I #
F-I R `! o & W i'I f'i17 I) 1 M1=C11
F
L
?-1
Psm?ft No. Pa.mn Mo1d K o.a TeWpnoae r
S/W
PLUMBING
HVAC
ELECTRIC.
ELECTRIC '
Inspectfon Doft Insp. Comme nts
Foot;ngs I 6S ? o be 61 V P ?
F«,ncfanon
Freming
Roofing
R-0 Pbg. - _ ?? . ? n /<? Z- Z C 3 G 4/,
R°,* "'e. -? _
lsui. '''IS4-j
Fi?epiace
Fnal Htg.
orsat Test
Final Plbg- i Plbg. Inspec4or - Notity Plumber
Const. Meter
F_ngrJPlan
sldg. Final S- 2 5? 3
Deck Ftg.
Deck Final
Well
Pr. Disp.
? •
?
' ?< ?
Keftificate af cccupanc4
Mt4 Qf wagan
TeVartmcnt oF Auilbfng 3a##atirx
This Certrficate issued pursuant to the requirements of the Uniform Building Code
certifying that at the tipw of issuance this structure was in compliance with the various
? orrlinances of tlte City regulating buelding construction or use. For tlee, f'ollawing:
use clas5ificsuon: SF DWGIGAbt awg. Pftmw ro. 1967 Zonin ??- Occupancy lype KEY LAN H Sg Disvict 7}?g,C?,
OwnerofBuildi? Addrest UKl'IDtll •? B?VZ?++ 644 ? t 92, - I Building Address Locality
Date: MAY 25, 1993
Buildi ial
POST IN A CONSPICUOUS PLACE
3 ? ?
Feduast Date" '-
?,? /`? /??
? F re No. Rough-in Inspedron
Feqwre 7
- es G No
? Reaoy Now AI Notily Inspecror
When Ready'
I,?, "'licensed contractor p owner hereby request inspection of above electrical work ar
Job ACtlres IStreet. Box or ROUIa No I
Gc QA-rnUi...e n
,V..c
Section No Tawnship Name or No Fange No Cou
Occu a PRINT)
i Phone No
Power pber Adtlress ? .
Elecmc nVacror COmpeny Nem ? ConVaqtor? Lmense N
e71
Matling Aatlress IC nVador or Owner Makmg InstallaLOn)
/ ?
/
NutOOnze 9gnewre ICOnUaclovOwner Making Installauonl p Phone Number
MINNESOTA STATE BOAPU OF ELECTRICITV ? THIS MSPECTION REOUEST WILL NOT
Griggs-Midway Bltlq - Room S-113 BE ACCEPTEO BV THE STATE BOARD
1821 UnlveraMy Ava., SI Peul. MN 55104 ONlESS PROPER INSPECTION FEE IS
Plwne (812) 642-0800 ENCLOSED
A" ???, a
REQUEST FOR ELECTRICAL INSPECTION
? -
? See instmctmns br compleMg Nis form on back ol yellow mpy Ya{
'
?? 'i 7,5? 0 "X" Be/ow Work Covered by This Request ??•?`•i
ew Aatl Rep. h TypeofBUilding AppliancesWired EquipmenlWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
ApL Building Dryer Other-(Speaty)
Comm.llntlustnal Fumace
Farm Air Conditioner
OIM1er(syeafy) ConlradOr§Pematks'
Compute Inspecfion Fee Selow:
# Other Fee # SerwcaEniranceSrze Fee # Circutls/Feeders Fee
Swimmmg Pool O to 200 Amps 0 l0 100 Amps
Transformer5 Above 200 _ AmpS Above 100 _ Amps
SigpS Inspector5 Use Only 7OjpL ?
?
Irrigaiion Booms ,Q - ?D
Special Inspedion
AlarmlCommunication THIS INSTALLATION MAY RDERED 91SCONNECTED IF NOT
Other Fee ? COMPLETED WITHIN 7 NS. r
I, the Electrical Inspector, hereby
certify ihat the above inspection has
been made. Rouyn-io ., .
F,,,ai f , ? y-,3
oa?e
?-
OFFICE USE ONLY
Tnis request witl iB monIDS irom
AddIOSS _ 644 HACKMORE DR ZlP $$12_
I:ot' , T. Blk 2 Sub IIAWTHORNE WOODS
THESE iEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'[ON.
Date: MAY 25, 1993 Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
Trail/curb damage
Porch
Basement finish ?
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in rightro&way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Conttactor Copy
PLiJMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone 4 651-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dwellings
Townhomes and Condos when pernrits are required for each unit
s ,s-s-42)
Date 1:1?_ /?? /t/i 3
5ite Address Zyl/ fWM "rZ? 12?-JUff Unit #
Property Owner 11?lr e1467 ?? Telephone #
Contractor ?J 12
?/,; ? Address -?f--?7'[LT? City CU?'/?1
State Zip Telephone #
The Applicant is _ Owner ? Contractor _ Other
Septic System New Refurbished Submit 2 sefs of plans and MPC license $ 100.00
InGudes County fee. Additional eonsultant fees may apply.
A?terations To Existing Dwelling Unit, Including $ 50.00
_ Adding fiMures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water turnaround (+ 5/8" meter if needed -$121.00)
Other:
RPZ new installation _ repair rebuild -
- - - ??,1 $ 30.00
_ Lawn irrigation system
?
1
?
?1?
-, onn? ?
1
'
?? ,? ? ?.. J
?„ ?• ?
_ Water softener ? Water heater
$ 15.00
replacement _ additional
r`C
$ .50
State Surcharge
$ ? J ?Yo
Total
I hereby apply for a Residential Plumbing Pemvt and acknowledge that the information is complete and accurate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand this is not a
permit, but only an application for a permit, and work is not to start without a pernut; that the work will be in accordance with the
approved plan m the case of work wluch requires a review and approval of plans.
?i.
Atm V n I r?e C ? kVLU'
Applicant's Printed Name . Ap? canYs Sigiature
J
New Constructton Reauiremants
• 3 regislered site surveys shovring sq. ft. of bt, sq. ft. of house; and all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing beam 8 windaw sizes; poured found design, etc.)
• 1 set of Energy Calculations
• 3 copies o(Tree Preservalion Plan if lot platted aNer711193
• Rim Joist Detail Optiors selection sheet (61dgs wilh 3 ar leu unils)
DATE I D -?,.3 D" O?
SITE ADDRESS
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
/-57. L` -s
RemodeUReoair Reauiraments
. 2 wpies af plan
. 1 sel of Energy Calcidations for healed additians
• 1 site survey lor eztenor addifions & decks
• Indicale rfhome served by seDlic system foraddilians
VALUATION -Z?D r)
LTI-FAMILY BLDG _ Y _ N
V?)Y
? ?
TYPEOfWORK? eak 4 R.eyco-?- hAUSek"ucke? ?jQYa5f FIREPLACE(S) _0 _ 1_2
APPLICANT SELP,AOOFING&REMQDELING,IN(`.
STREETADDRESS BT.LOUISPARK,MN 55416 CITY STATE_ZIP
TELEPHONE #?la?ta3--k04?CELL PHONE # FAX #
PROPERTY OWNER 11,14 TELEPHONE # (?oSI - "I b M '°I i?J
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MIVNESOTA RliLE.S 7670 CATtiGORY 1 MINVESOTA RliLES 7672
(J submission lype) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations SubmiKed
Plumbing CoMractor: Phone #
PlumUing system includes: _ Water Softener _ La?m Sprinkl ? r??Fee: r$90 00
Water Heater No. of R.I. Ba _ l?? No. of Baths Q CT 3 0 1C?7
Mechanical Contractor. Phonel#
Mech.uiical systeiti includes: _ Air Conditioning L' T'ee?- 4-70: 0
_ Hcat Recovery System
Sewer/Water Contractor: Phone #
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ^
7-?
Signatureo(Applicant S1
--------- ___------------------ ---------- ___..-------- -°-------------_..------------------------------
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updaled 4/02
OFFICE USE ONLY
O 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
O 04 02-plex
? OS 03-piex
? 06 04-plex
0 07 05-plex O 13 16-piex
O OS 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
O 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or_ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
O 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move 81dg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement •Demalition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. nf Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings(new bldg) FinaUC.O.
_ Footings (deck) FinallNo C.O.
, , . _ Footings (addition) plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final Pool Ftgs Air/Gas Tests Final
_ Framing Siding Stucco Stone
_ Fueplace _ R.I. _ Air Test _
_ Final Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MGES SAC
City SAC
Water Supply 8 Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
P.1.11., 10-321SO-010-02
PERMIT
PERMITTYPE: BuJ.i.a1N6
Permit Number. 0 07 9 6 7
Date Issued: 01/06/ 9 3
e4i! FIArKMORE P.Ia
0e01 BLOcn e 0002
FInwI-HoftrdF i,anons is r
DESCRIPTION:
Buildiny Permit lype
Bi.iSld,ing Wnrl-: T;•pF
UFiC Occupancy
GqnsCruction fiypF
2oning ?
6uild.i.nq Length
buildiriy Width
SF DWG
fJ F 6d
R-3 M-9
V-N
R-7.
611
5¢
REMARKS:
RFCE7PT #
Pl;b' S F.• W PLBR - U C MECH
FEE SUMMARY:
Vr" i.uA rJ. oN
Revir4e
i;e
3RC
SRf' Uni_ts
Siab tntI
1r„
w
Y v,
.{
!
$t,1 00
t76U 4?0
7 47 47
?
.? 1
_. .
?a u
l ?3
11;11zo0eN
rdrnus
To[al I-e•r-• 3
I CONTRACTOR: f?E?F>> > ?? ?? ?- - sf- 1-z(-OWNER:
I<I:), L`ifJCi tIUPl;=S (89?IZb?G 0 0 0 L553 n=Y LiiND HOMES
14450 tiUf'MSVIILLF PK6JY l41I'y0 BUf2N51/J:ILE PKWY
hUIdN:') V 11_LL IIN 5;i3i B URNSVSLI.t Y4N 55337
(61:) £;9?-26"36 (612)594--2636
S herpby acknowledge that I' have read this applicati.on and state that The
inturmation is rprrect and aqi-ee r,o comp.l.y with all appli,cabie Stote o"f Mne
Statutes ancJ City o'f Eayari qrcl.iriances.
? -
i LI?PiA El l-?
APPLI N/PER IGNAT RE SUED BIY. IGNAT R
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: L Ej r e e0 H t a i. o r r; a 000 APPLICANT:
sa -a fincr;moRr nR l?Llv [Riva woMFs
I;1;W'I`I{ORNE WOODS 15T (612) N912F::6
PERMIT SUBTYPE:
St owr,
TYPE OF WORK:
N c Ui
Pu??niP?G
6".r.A 42;
INSPECTION
FourI'niG D, .
r?iaaht.- nc, .,
L??:;Ul !?7 LON FTNA(.
PJW.p CE
r-
?
I'RV 6 t, i.J Pi.FR - Ci r. ML (I li
r I
PERMIT #?
IqLfl
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
681-4675
rn {1>r1 19 - 3f? s?,'G ?.J?oa?
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural_8 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 lot chan e is re uested once ermit is issued.
Uate b_ /S_Z_ /q ?Z- Valuation of work j310 ----
Site Address:?4 iAA' AY?1r0R?- 'Df?+i vr-
STREET STE IN
Tenant Name: (commercial only)
LOT ? BLOCK -2- SUBD. AA4-a"6R41E ?L10DS P.I.D. ?
l?"l: l?
Descri tion of work:
The applicant is: ? Owner )ky Contractor ? Other com«;ne>
Name Phone
Property LAST FIRST
Owner qddress
STREET gTE x
City State ZiP
Company IrIEy L.A41D ?,n meS Phone F'fl?"'7.L?3Lv
Contractor Address ti44G L3uR"SUILL?. License # 1'55`5 Exp.
City 99L)Ras%JIL.L.E State P'lt4• Zip 55110737
Company ? Phone
Architect/
Engineer Name Registration #
Address
City State ZjP
Sewer & water licensed plumber ?G• MEc.AAWtrnral.-.. . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the informatinn is
of
d Cit
t
St
t
y
es an
u
a
correct and agree to comply with all applicable State of Minnesota
Eagan Ordinances.
Signature of Applicant: ? ??? •'?? IZ12z?9Z
, . OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 05 Apt. Bldg ? 09 Basement Finish
0?02 SF Dwg. ? 06 Garage/Accessory ? 10 Swim Pool
? 03 Two family ? 07 Fireplace ? 11 Res. Add.
? 04 Multi-fam. T.H. ? 08 Deck ? 12 Res. Porch
WORK TYPE
* 31 New ? 33 Alterations ? 35-Move
? 32 Addition ? 34 Tenant Finish E3 36 Demolish
GENERAL INFORMATION
Const. (Actual) V- N Basement sq. ft.
(Allowable) v-N lst fl. sq. ft.
UBC Occupancy -g 3 M_l 2nd F1. sq. ft.
Zoning R_1 Sq. Ft. total
# of Stories Footprint Sq. ft,.
Length ? On-site well
Depth ? On-site sewage
APPROVALS
Planning Buildin
Engineering Variance
REQUIRED INSPECTIONS
? Site
? Wallboard
? Footing
? Final
? Framing
? Draintile
? Insulation
ElFireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Mater Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC % I0o
`'.AC Units I
v.tuecim: s 1221000 - • .
?ryAR46?? 3Zw6=51??/6r B??Z
26= ?6 2Lf x rs = 9?360
IS? ?
ZYX2(p_ (oZ4
2 x ?diz: I?
-
2?= 6'7z
ay
.
x
(09j96p
?r?+H wrwr
nKG,
.
-
zoo c Xo T
'
` ZN? ?i.? S
a9
)t2y a69W
? kla?_ .`1N 0
7/ o x 53 = 39,63
.?
,
.,
? 13 Cofim/Ind New
? 14 Comm/Ind Add
? 15 Comm/Ind Rem
? 16 Public Fac.
? 17 Agricultural
MWCC System Es
City Water
PRY Required ?
Booster Pump
Fire Sprinkler
Census Code
SAC Code o?
Assessments
? . LOT BIIRVEY C8EC3CLI8T !OR REBIDSNTIAL
? SIIILDING PFR!!iT l1PPLIC7ITI
? 4ROPERTY LGALt
Date of Surveys 7 ?
CIIMENT sTANnaRna
B' 0 0 • Reqistered Land Surveyor signature and company
C? 0 0 • Building permit Applicant
tY0 0 • Leqal description
Vqr 0 • Address
[-'1^p 0 • North arrow and bar scale ? U 0 • House type (rambler, walkout, aplit v/o, split antry,
lookout, etc.)
0?b 0 • Directional drainage arrows svith alope/gradient 4.
D Q'0 • Proposed/existinq sewer and vater services
6?'?0 0 • Street name
H" ? 0 • Driveway
ELEVATIONS
Esiatina
D D'-? • Sewer service
0' 0 D • Lot corners
? 0 0 : Top of curb at the driveway
0 ? Elevations of any existing a8jacent homes
Proooaed
HI0 0 • Garage floor
tY 0 0 • First floor
0-0 0 • Lowest exposed elevation (walkout/window)
0, 0 ? • Property corners
V0 0 • Front and rear of home at the foundation
PONDING AREAS (if aoDlicable)
U 01? 0 • Easement line
D Ci' ? • NwL
O 0' 0 • xwL
? 5"0 • Pond # designation
D 5,0 • Emerqency Overflow Elevation
DIMENSIONB '
D 13 • Lot lfnes
0 • Right-of-way and street width (to back of curb)
0 • Proposed home dlmensions including any proposed dacks,
overhangs qrester than 21, porches, etc. (i.e. all
structures requiring permanent footinqs)
0 • Show all easements of record and any City utilities within
those easements
9--0 0 • Setbacks of proposed st cture and setback of adjacent
existing home
?['1'--D • Retainirng,-+affS equi ents, if any
October 1992
nnTr : ?Z " ZZ ^ aZ.
owN?k • _ _
? PNO"IE: O I??Z?o 3?o
S?7E ADCkE SS: ilp?}?
11 PLA1ap "
PLPN s5eJc::?
CONT RACTOR :
' De:ernine working square foo tage of each
3Q• •
.
goq
ll area
'Z ft, x 11 = 2(A •
1. Total _
... _
..
_
exposed wa
2. Total roof/ceiling area..... IA(n P> s9• ft. x 026
Tctal exposed wall area above.floo r=
a. Total wall windotia area .......................... ...:.............
............. I? --
b. Total door arez ...........................:..... ....
...... q 0
c. Total sliding glass door area ................... ........... -
d. Totzl fireplace rrall area .......................
...
lOA) .................
.................
?
•'
e. Total ........
wall framing area (average
• ....... ?
X. Total .........
rim joist area ..... .............. .......... .
1'74g7
net wall area above floor ............... ... ....................
......
h. . wall area a6ove rloor ............... .... .......... ,..
i. ? wall area a6ove floor, ..............:... .................. .
.
J'• frzme wall area at zo?:.*idation ................. ................... '.
Total exposed foundation area=
..............
w area
d
i .... -
k Total .....
n
o
foundation w '
. ea above grade ..........
i .... 3
7 .
1. Total on ar
net foundat
Determine "u" value of each wall segment . ..
' (e.g, window, door, each separate wail section)
qtb ?
? x „?„ 42,
?4
. .
b.r 1_2X „V,
C. X l,u„
• 4?
1'l ,2
• d. X ituti
e. g „uii
• O4
X -ituil = ? .?lo '
w
9. 17422 X „u„ fo4 = ?°(.°lz ?
h. X ltui,
__._-?- •
. ? X IIUTI _
X uUn --- If item 43 is the s
„
X „? =
-'- as, or less than it
k. ---- zl, you have met tf:
? ?Q
X"U" = S•??? intent of SBG 6006
_
Total = N 7 • 301
'
-
3 . ... .............................. ,..
Y. 'IUI/+L Gn.i....v .................' ?.""_ """___
?..' • ToEal exposed
?'. •• roof/ceiling area........ t
sq
ft
Total skyliaht arez.......
? ? sq ft x"U"
°
?
.
k) Total roof/ceilinq framing
I4( _
5q
ft x'"U" ' 4?. °?? s
area (Averaae tnz)...... o :
1) Total net insulated `?ZZ ft x"U" '(?'L °
roof/ceilinq area.......
sq •
? TOTAL j) th ru 1)
If total o` 54 is the same as, or less. than N2, you have met the intent df
. ? mG.7 1.16005 s ar2 0. •
• ALTERt1ATE BU I LD I PIG EPIVELOPE DcS I GN To utilize the total erivelope system method, the values establ-ished by the sum
of itens .13 2nd =4 shall not be nrez[er than the sum of items 91 and 92.
l. C??•?? + 2.
. 3. . J 9-7.3 q + 4. 2? •q4 = 2.
?Y fiCatnC CG1''stYUGf inn
4A LL
E=G- *-
pR4h1E h'nLt
ZG. -4a
CONSTRUCTIOTL-- FRAMLNG
1. INTERIOR AIR FIIM 0.68
2. 172-7 GYPBD .4
3. 5 1 2 SOFT WOOD 6.87
4. '25T3'?S`HEA
5. SID-TK9 .8
6. ?TER'i0R AIR FILM 0.17
R= .8
U= .09
NET
1. INTERIOR AIR FZLM 0.68
2. :"li 2 GYPBD .45
3. i
4. 2 32 SHEATh'ING 2.06
5. ' SIDING .6?
6. _ OR AIR FILM 0.-17
U= .04
- G)
1.
INi'ERIOR 1IR FILM -
0.68
--- QI 2. 6 INSUL. 1.00
3.
4, 1 JO
25/32 G
2.06
? 5. SIDING .6
6. EXTERIOR AIR FILM 0.17.
o O
! U= .04
a p ,?
V
I _ ?
???w o?'
6 A
? ` O BLOCK
?-?- ? `
tp?. •q` t l`i? 1. WTERTOR AIR FII3d 0.68
I
,
E 2. _
?
?
I-r.• ? =
3.
ST1'RO
5.00
? 4. PROTECTIVE BARRIETt
5.
6. FILM
TOTAL R= 7.13
U= .14
? SLAB ON GRADE o _ .•. . ?? ? ? "Y.
8
.
? `= d ? '
•? `
J I I
?E u ? ? ?
? ? I!t =
.
n .
-
? ?
t' P
' ?. s4
?•43 i
?
I?
?
`,• s? fJ? rt? tlr ? i r? ?
1 r ,
NdiE: INDICATE TYPE, n
Rn VAi1JE. D£P'iH Atd1
? ?
F ?
? i PLACII?Nf OF II?ISULATTON.
a
c
7 ? _ ? ?,
.' ' . , . , • ?? CONSTROCTION ' R-VAIJ.JE
? • - L. .
1- INTERIOR AIR FTiM nra
2. 5/8" GYP BD SR
3. IDISULATION cc. nn
' 4. EXTERIOR ATR FTT M ?,? 0.-61
45.80
.02
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1, INTERIOR AIR FILM
2. "
3, iSULATION 38.35
4, R AZR FILM 0.61
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COeiSTRUCTION
], INSlDE AIR FILM
2.
3.
4.
IDE AIR FILM 0.17
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1 INSIDE AIR FILM • 0.61
2.
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NOTE: USE PDDTTIONAL SHEEfS IF Mn SPACF IS
NEIDED FOR DETAILS PND CAEC(JiATIOPiS •
CTTY OF EAGAN CITY USE ONLY
L/ B MECHANICAL PIIiM1T RECEIPT #1 en?
(612) 681-4675 DATE /?
RESIDIIVT7AL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMII Y DWELIdNGS. AL40, COMPLEI'E FOR
TORNHOMES/CONDOS WHEN SEPARATE PERhIIT3 ARE REQUIRID FOR EACH DWELLING UNIT.
OWNER: ADD-ON A/C ADD-ON FURNACE ?
STl'E ADDRFS :
q ADD ON/REMODEL (EXISTING
CONSTRUCI'ION ONLI) $ 15.00
INSTALLER HVAC: 0.100 M B1'U 24.00
PHONE #: ADDTfIONAL 50 M BTU 6.00
ADDRFSS: Q???Qeev--2• l'?.:s .?. GAS OUIZETS - MINIMUM 1@ $:; ?-o?
CTI1': ZIP•.,,5,.5„3 7 SURCAARGE $ .50
SIGNATURE: TOTAL: $ ,3b,Sa
NO PE?tMIT REQUIRED FOR DUCTWORK ONLY!
COMMERCIAL
PLEASE COMPLETE TFIIS PORTION FOR ALL COMMERCIAI/INDIISTRIAL BUILDING5. ALSO COMPLEl'E FOR
APARTMENT BUILDINGS OR OTHER MULTI-FAhIII Y BUII.DINGS R'HEN SEPARATE PERMTTS ARE NOT REQUIRED FOR
EACH DWELLING UNI1'.
WORK DESCRIPTION: CONTRACT PRICE
196 OF CONTRACT FEE. FEES
STATE SURCHARGE IS $.50 FOR EACH
$1,000 OF PERMTf FEE.
$
PROCFSSID PIPING - S25.00
MINIMUM FEE - 525.00
$
OR'NER: TOTAL: $
STI'E ADDRESS:
TENANf:
SLTITE #:
INSTALLER:
ADDRFSS: _
CITY: ZIP:
PHONE #: CiTY SIGNATURE:
SIGNATURE.
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIltED FOR EACH UNTf.
NO. FIXTURES
SHOWER
? WATER CLOSET
BATH TUB
LAVATORY
I KITCHEN SINK
-? LAUNDRY TRAY
HOT TUB/SPA
-? WATER HEATER
1 FLOOR DRAIN
GAS PIPING OVTLET • minimum -
-3 ROUGH OPENINGS
WATER SOFTENER
PRIVATE DISP. • Dek.ccr. tio.
U.G. SPRINKLER • nome uneer const.
ALTERATIONS • to atisting
WATER TURN AROUND
STATE SURCHARGE
TOTAL:
EACH TOTAL
3.00
3.00
3.00 3 D°
3.00
3.00 ?W
3.00 ? . w
3.0 ?`r
3.00
3.00
1.50 -:56
5.00
15.00
3.00
15.00
15.00
.50
?
SITE ADDRESS: (D`?q ?re- -
OWNER NAME: U''v-\6
INSTALLER: pC '?? ? ('?1n?..?LCG \
ADDRESS: D?l\ 1..D ? L c??lk
CITY: STATE: ZIP CODE:
PHONE #: (f.E\a)
l ?
SIGNATURE OF PERMITTEE
1993 PLUMBING PERNIIT (RESIDEIVTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-
FAMILY BUILDINGS WHEN SEPARATE PERMIT'S ARE NOT REQUIRED FOR EACH
DWEL.LING UNIT.
_ NEW CONSTRUCTION
ADD ON
_ REPAIR
WORK DESCRIPTION:
CONTRACT PRICE:
FEE: 1% OF CONTRACI' FEE.
STATE SURCIIARGE: $•50 FOR EACH $1,000 OF ?RM FEE
MINIMUM FEE $ 25.00
CONTRACT pRICE X 1%
STATE SURCHARGE
TOTAL
SI1'E ADDRESS:
$
$
$
TENANT NAME: STE. #
OWNER NA11ZE:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
STATE:
ZIP CODE:
FOR:
CITY OF EAGAN APPLICANT
1993 PLUMBING PERMIT (COD'IMERCIAL)
CITY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 681-4675
1993 MECHANICAL PF.RNIIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTT.
NEW CONSTRUGTION
? ADD-ON A/C
RDD-ON FCTRNACE
DATE
May 12, 1993
HVAC: 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS (MINIMUM 1 @ $3.00 EACH)
ADD-ON/REMODEL (Ex]STING CoNSTaUCrloN)
STATE SURCHARGE
TOTAL
FEES
$ 24.00 0
6.00
$ 15.OOx
.50
$16.J`0
SIT'E ADDRESS: 649 Hackmore Drive
OWNER NAME: Dan cork TELEpHONE #:
INSTALLER• xleve xeating & Air Conditioning, znc.
454-9461
ADDRESS: 13075 Pioneer Trail
CI,I,Y. Eden Prairie STATE: MN ZIP CODE: 55347
TELEPHONE #: 941-421i 'q / S 3 ?
wl?)rjld?
SIG TURE OF PERMITTEE
1993 MECHANICAL PERMIT (CODMIEItCIAL)
CITY OF EAGAN
3830 PII.07C KNOB RD
EAGAN 11-IIV 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMIv1ERCIAUWDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUII.DINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUIRED FOR EACH L)WELLING UNTf.
DATE:
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
COIv tT2AC'i- t RICE: $
FEES
1% OF qpN? FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF PA?I,T FEE.
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IMPROVEMEN75 ONLl)
INSTALLER:
ADDRESS:
CTTY
TELEPHONE #:
STATE: ZIP CODE:
SIGNATURE OF PERMITTEE CTTY INSPECTOR
PLEASE COMPLETE FOR SINGLE FAMII.Y DWELLINGS. AISO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTT.
NEW CONSTRUCTION
ADD-ON A/C
fvuD-Giv FUFcNtii,E
DATE G- ! a -R 3
FEES
HVAC: 0-100 M BTU $ 24•00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1 C 53.00 EACH)
ADD-ON/REMODEL (ExisTtNG coNSraucTloN) raftv"° $ 15.00
STATE SURCHARGE .50
TOTAL
? y 711Y43 SITE ADDRESS: G /f
OWNER hAME: oz //-- TELEPHONE #: 445zl-
INSTALLER: ? b4125 A,n,o li' 4-n1 c ?= ?` ?R./l t c t
ADDRESS: OI a F ?S -cd?
CITY: 02 9 1_ s STATE: 6701 ZIP CODE: '5v'`rl
TELEPHONE #: 7 a,a -O /5/
1993 MECHANICAL PERMTI' (RESIDENTIAL)
CITY OF EAGAN
3830 PII,OT KNOB RD
EAGAN MN 55122
(612) 6814675
?m:u?:•::..: ::.;• . .
D
PB
PLEASE COMPLETE FOR ALL COMNMERCL4LJINDUSTRIAL BUII.DINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMII.Y BUII.DINGS WHEN SEPARATE
PERMTI'S ARE NOT REQUIRED FOR EACH DWELLING UNTT.
DATE: ._._,: ___:_ CONTRACT PRICE: $
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1% OF CONTRACF FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF PgR? FEE.
TOTAL $
Si i E rwLkESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:
CTl"Y:
TELEPHONE #:
STATE: ZIP CODE:
SIGNATURE OF PERMITT'EE CITY INSPECTOR
1993 MECHATiICAI, pF.RMTi' (CONIlI4ERCIAL)
CITY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 6814675
RES[DENTIAL BUILDING _70 rd
bO C? Permit Applicatioo
City Of Eagau
3830 Pilot Knob Road, Eagan Mn 55122
Tetephooe # 651-675-5675 FAX # 651-675-5694 -7/11
New ConsWCtion Reauirements RemodeNieoairReaui2menis Ofice Use Onlv
3 registe2d site surveys 5howng sq. R of lot, sq. R. of house; and all roofed areas 2 copies of plan _ Cert of Survey Recd
(20% msnmum lot coverage albwed) 1 set of Ernrgy Calalations far heated additions Tree Pres Plan ReW
2 copies of pWn showing beam & window sizes; poured found design, etc. 1 sde survey for add'Nons & decks Tree Pres Not Reqd
t set ot Energy Calculations Adddion - irtdicafe d on-sde sepfic system _ On-site Sep6c System
3 copies of Tree Presenation Plan rf lot platted atter 711193
Rim Jaist Defail Options selecAOn sheet (bldgs with 3 or less unifs
?i
Date Construction Cast d ooo
'
r?
Site Address ?-79 Ndc.u mary- b rO se Unit/Ste #
1rlN.
GI
?IN(5
Description of Work dr'Y
?b"YhQ?tf- Sh2e?aL &wof Cz(?```v
r? yh .
Multi-Family Bldg _ Y?N Fireplace(s) 0 _ 1 _ 2
O Telephone # (iS
Property
wner
Contractor
Address ?`?.. itY ?
Sta[e /n Zi Teleph a -
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Catecorv 1 _ Minnesota Rules 7672
Energy Code Category . ResidenGal Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 su6mission type) Submitted Submitted
• Energy Envelope Calculations 5ubmitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
- Telephone # (
Telephone # (
iU? U 3 ? 'J
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of NIlV
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 icP quires a review and
proval of plans.
ApplicanYs Printed Name Applitn s Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 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 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex X 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 (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bldg) - G ive PCA handout to applicant
V
i 0 9 L ?
a
uation ( Occupancy
- MCIES 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)
_ Foorings(deck)
_ Footings(addition)
_ Foundation
Drain Tile
Roof Ice & Water Final
? Framing
Fireplace _ R.I. A'u Test Final
? Insulation
REQUIRED INSPECTIONS
FinaUC.O.
? FinaUNo C.O.
Plumbing
?C HVAC
O[her
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By T Z , Building Inspector
Base Fee
Surcharge
Plan Review MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit 8 Surcharge
Treatment Plant
License Search
Copies
Other
Total
L,Z.? 44
?` ?c9?
644 HACKMORE DRivF
;?nn
SUR1i•EYOR'S CERTIFICATE
93?
in?1 g1tODNC. ' a I 7
--
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/f?
BENCH MARK ?
TOPOFPIPE
= 933.T0 -
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. ?
9
( ?)
t? 1 1
A y t
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U . ?
--
I
I
KEYLAND HOMES
QRI VE
831.7
?
?
BENCH Nt4RK
PROPdSED / TOPOFPIPE
DRIVEWAY N ? z932.82
(A4Q3) 26.32
,-
o/ G
' (? 3s 1) a 11 Z3.G? M
? PfiQP,QBED
Fivusn
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41
?
i ?
P hJq? ?
/v
r?
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?J
y322x vav I
2 935. ? 93g t 932.6
c?
R I LOT I ?
'
r1) ??
s?. ??AL,-? a ? Z1?C?IRT??RIIdG I
< : . 9"?r+?a Ar DEFT
: .
n
4l5.46
?- NJ9°?hs"w
nG°3owo G°3E(MMLl= 11Q)
N07E: BULDiNO DIMfNSI0N3 SMOWN ARE iCR HDRQOHTAL '
8 VIIIITICAL LOCATION OR STRUCTYIIE ONL1: SEE •
ARWITEL7UAL RANS FOR BUILpING 6 FOUNDATI(xl NOTEv HO SPOCFIC SoILS INYES7GpTI0N NAS BEEN'COMPLETEO
DIMENSpNS, ON TMIS L07 BY TTiE SURVEYOR, TFE SUITMILITY Of
SOILS TO SUPPORT TME SPECIFIC HOUDE rq010![D IS
+ DENOTES PROPOSED SURFACE DRAINAGE NoT THE RESPONSIBILITY OF THE SURVEYOR. '
O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 9Y4•G FEE7
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 92g, 3 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK-JJL.4 FEET
WE HEREBY CERTIFY TO KEYLAND HOMES THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot !, Block 2, NAWTHORNE WOODS IST ADDITION, accordinp to the recarded
plrn thereof, Dakota County, Minnesota
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 17TH DAY OF DEC. , 1992.
PROPOSfD ORADHS SHOWN WEqE
TpAjKEN lIIOM 7NE ORA?INO S
?Ci?ANKR0 "ASlOC.'°N€', .
LA3T DATED 8-23-92.
0 m
? m m ?
? N 7
C
? O N Z ? y ? m x
_ ?
O
m
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'<
R. HILL, INC.
X,,X? e-
JOHN C. LARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 79828
James R. Hill, inc.
PLANNERS / ENGINEERS / SURVEYORS
2500 W. CTY. RD. 42 a BURNSVILLE, MN. 56337 0 612-880-6044
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA139200
Date Issued:10/13/2016
Permit Category:ePermit
Site Address: 644 Hackmore Dr
Lot:1 Block: 2 Addition: Hawthorne Woods 1st
PID:10-32150-02-010
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 -
Jeanette Y Lasley
644 Hackmore Dr
Eagan MN 55123
Lofgren Heating & Air
5708 Upper 147th St W
Suite 106
Apple Valley MN 55124
(952) 431-5811
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA165302
Date Issued:10/27/2020
Permit Category:ePermit
Site Address: 644 Hackmore Dr
Lot:1 Block: 2 Addition: Hawthorne Woods 1st
PID:10-32150-02-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Miguel Cervantes
644 Hackmore Dr
Eagan MN 55123
(651) 234-9969
Milbert Company (culligan)
1801 50th St E
Inver Grove Heights MN 55077
(651) 451-2241
Applicant/Permitee: Signature Issued By: Signature