529 Hawthorne Woods Dr
Use BLUE or BLACK Ink
I For Office Use Z I
Permit#:
City of Ea an ~ 1
Permit Fee: I
3830 Pilot Knob Road 2-i
Eagan MN 55122 Date Received: 1
Phone: (651) 675-5675 I 1
Fax: (651) 675-5694 I Staff: + J "J I
I 1
2012 RESIDENTIAL BUILDING PERMITI APPLICATION
Date: Site Address: S (".y X111 /F1 e 1N'Ue~~^' Unit
Name: ~e Phone:
/0~'7/'~
RESIDENT /
OWNER Address/City/Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: H RY " re~'JF
Construction Cost: / (e Multi-Family Building: (Yes / NoJ )
Company: f) Poo F~T_-,A~ 6- Contact: o e- -777d %w- S
CONTRACTOR Address: 0110 -7h07111- (1 A~,,.C( City: vi J/~
State: / `Al Zip: Phone: (a1g-C910/ ~pg8
License )3(&~qlo Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING ANEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of
the information maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota Stat Building Code must be completed within 180
days of pV7~' x ~Oe &145 x
Appli Vs Printed Name Ap ca 's Signature
Page 1 of 3
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob F3oad ? Permit Number.
Ea an, Minnesota 55122-1897 j'°• :? ?r 1??h
9 ?.? Date Issued: .(612) 681-4675 ' .
?"..1 -A.: iHJl.1L?..1'_.T.:rJ'Ni[
SITE ADDRESS: t c+T1. -i 2 K 1 u c r? ?
II RW i HC1FtNtUitl?)fi? : f}1+
Ilr?r;{!! Il??r'f'ai II??l;f?', Mir
PERMIT SUBTYPE:
itr 1 t
APPLICANT;
TYPE OF WORK:
r,t ??
TtVAt
I
Permit No. Permit Holder Dete Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMINC.,
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
'
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HT(3
ORSAT
?EST
BLOG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG
-
DECK Flr,;;i
-
? ---
? ` ' ? !-/YL _ - - - - - -- --- -
? _11_
?
CITY rJF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
i RECaRn
PERMIT TYPE:
Permit Number: Date Issued: ?
SITE ADDRESS: 4
.,.
i'
? PERMIT SUBTVPE:.
? .
I
(
APPLICANT:
TYPE OF INORK:
INSPECTION
?
r? • „ . .,
? Ff t M'A itt? J'ItV kl NI.KR I'1itMl".;t1N F`I. f+?i
?
?
?sr.
Permit No. Permit Holdar Dete TeleQhone A
SNV
PLUMBING
HVAC
ELECT C 51 ,5 y? adpp
ELECTRIC
Inspection Date Insp. Cpmments
Footings I
FoundaUon
Framing ?a 9,y
Roofing
Rough Pibg. ? ?'? ?
8
Rough Htg.
isui. ? 2 ?? Co i s- - 3 Z
Fireplace
6
Final Htg.
Orsat Test
Final Pibg.
) Plbg. Inspector - Notily Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deok Ftg. ?
Deck Final
Well
Pr. Disp.
y
1-
Wertificate of Ccculpanc?
Ktm 0f cfRgRli r..
MeOarttaeut of $Mi[biag 3"oection
This Certifcate issued pursuar+t to the requirements of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various
ordinances of the Cily riegutating building construcrion or use. For the following:
llse Qusification: Am ac 81dg. Pertnii No. 97761
Om"ncy lype R3 Ml Zaaing Distriat $ I Type Coasi. MN
Owrcrof BuiMing T.TFF_S'TYf.F' FALS TN' Add2ss 148Q T.AKF. PARK !?TR_ F.A('AN
eoilding Addmss 529 HAGIiI-1[7i2N7, ( 9"0D5 T)R7VF. Locality 1,32 R7 _ HASSUYIRNF: LvCYYL4 ?lVn
'1 - _r! Date:
Btrilclirtb
POST IN A CONSPICUOUS PLACE
Address 529 HAWIIHOgNE kY)ODS DRIVE Zip 5512 3
I.ot 32 Blk 2 Sub HnwnioxM WOons ?rm
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECPION.
Date: 1/4/ Yes No Inspector: PAO
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas v'
Sod/Seeded grass
TraiUcurb damage ?
Porch ?
Basement fmish
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 ou4side lawn faucet before freeze potenlial exists.
Contad engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
? _ . PERMIT M057609
CITY OF EAGAN PERMIT TYPE:
3830 Piiot Knob Road B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 027628
(612) 681-4675 Date Issued: 05 /24 /96
SITE ADDRESS:
529 HAWTHORNE WOODS DR
LOT: 32 BLOCK: 2
HA$W7HORNE WOODS 2N0
P.I.N.: 10-32151-320-02
DESCRIPTION:
¢?uildfnPermit Type DECK
?BUilding Work Type NEW
tenegxa Ca.d? ? 434 ALT. RESIDENTIAL
?t
i
, ?--?
?'`. r?cu=
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
Lic. Search Fee
Total Fee
$45.00
$.50
$5.00
$50.50
CONTRACTOR: - Applicant - s-r. LIC.OWNER:
LIFESTYLE HOMES INC 14547$66 0001285 FEIL MARK
1489 LAKE PARK CIR 529 HAWTHORNE WOODS DR
EAGAN MN 55122 EAGAN MN 55122
(612) 454-7866 (612)454-4839
?
I hereby acknowledge that I have read this application and state that the
infcrrma;tiiorf=is ccrrrieC and agrse- to comply with el'I, applinable State o'f Mrt.
5tatutes and City of Ea9an Qrdinances.
?.??.,.. ?
APPLICANT/PEqM E SIGNATURE ISSUED BN S AT
CITY OF EAGAN
???? 3830 PILOT KNOB RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construdion Requirements
RemodeVReoair Reauiremenls
CCi XX2G?.°S' ? ?
? 3 regislered ske survays ? 2 copies of plan
? 2 eopies of plans (includa beam 8 window sizes; poured fnd. das(gn; ete.) ? 2 site eurveys (exterior additions 8 decks)
? i enargy calculations ? 1 energy calculations for heated addilions
? 3 copias of tree preservation plan H lot platted afler 7/1/93
required: _ Ves _ No
DATE: CONSTRUCTION COST:
P\
DESCRIPTION OF. WORK:
STREET ADDRESS: y
a- BLOCK ? SUBD./P.I.D.
LOT ,2
PROPERTY
owNeR
CONTRACTOR
ARCHITECTI
ENGINEER
Name: ?df) Phone #: y
rws. . _. fl 6\ .
Street Address:J-1 I ?-L.?. vT: A A )+U ity6Y14 14 4 1 [^ ?`--' 1?11
City: State: ? Zip:? f?-
Company: ? jj(4/hA_?Xphone #:
Street Address: lwft!a ?L.11 m-License #:?F??I
City:?/aC??'.Q Xl State
Company:
Name:
A4_ Zip:31 o%`--
Phone
Registration
Street Address,
City. State: Zip:
Sewer 8 water licensed plumber: 1"/? . Penalty applies when address change and lot
change are requested once permit is issued. `
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with ail
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
??????ED) ?
OFFICE USE ONLY
iA14V , 5 11?? ?
Certificates of Survey Received _ Yes _ No
------- --,o- _e
Tree Preservation Plan Received _ Yes _ No ?
OFFICE USE ONLY
BUILDING PERMIT TYPE
,. ..? ?
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 5wim Pool
0 03 SF Addition o 08 8-plex ? 13 Garage/Accessory o 20 Public Facility
? 04 SF Porch o 09 12-piex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 _-plex ?v 15 Deck
WOfiK TYPE ...,
?V 31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition •
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. fl.
sq. ft.
Footprint sq. ft.
Building
Engineering
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Variance
?
ev/
?
?-
Permit Fee
Surcharge
Plan Review
License 0
MCNVS SAC
City SAC
Water Conn.', „
Water Meter
Acct. Deposit 'w
SNV Permit ?
11 Surcharge
Treatment PI.#
Road-Unit
Park Ded.
Trails Ded.
Other
Copies
Total
Valuation: $
1r
% SAC
SAC Units
? c;ITI('OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
BUSLDING
022761
12J27/93
SITE ADDRESS:
P.S.N.: 10-32151-320-02
529 HAWTHORNE WO(JIJS OF2
LOTa 32 BLOCK: 2
HAWTHORNE WOODS 2ND
DESCRIPTION:
?
B?,c?,?'?g?permit Tvpe SF pWG
i].d'artlo, WRrk Type
¢u NEW
U•qC 060Up&ri R-8 M-1
Gonstruetion 'Fyrpe V-N
Z o h i n.,g R._.1
BuSld9tar LFngtti 59
Buildinx WitYth 40
$ql:Jelth4 stories, z
?'?g ? ? ????tig
REMARKS
aav
FEE SUMMARY:
5& W pLBR - THOMPSOIV PLBG
8ese Fee
Plan f2aview
5urcharge
SAC
SAC %
SAC Units
5ubtotal
vpLuArzoN
$567.90
$563.66
$82.50
$750,00
100
1
$2,263.05
$165,080
MISCEILANEOUS $,?1e744.50
?.
7nta1 Fee $4,007058
CONTRACTOR: - RPPlir..ant - sl', L1c. OWNER:
LIFESTYLE NQMES INC 14547866 0001288 LIFESTYI.E HOMES SNC
1489 LAKE PRRK CTft 1489 LAKE PARK CIR
EflGAN MN 55122 EAGAM MN 55122
(612) 454-7866 (612)454-7866
I ?
Z hereby aaknaarledgs th,at I h.ave rea€3 this application and staCe that the
informat?o,n 18 c€rrrect ood agree tq ctrmply with all aPp1ioah3.e 5tete o`F Mn.
Statuties and Ca.ty af Eagan brdiilatrces,
L
s? ?`?
?
7 1SSUED
ICAN?f/P MITE?,a^?{yA ?iLLr?
E -- : SI NANRE? ?
REACTIYATE _,
PEW?I;T
21#1 (o?
CITY OF EAGAN 40011- 5.JI At?L;tu v tU
1993 BUILDING PERMIT APPLICATIPNp;r • 5 1993
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 af 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 12 ? 13 ? 93 Yaluation of work
Site Address: 529 HAWTHORNE WOODS DRIVE
STREET SUIiE M
Tenant Name: (commercial only)
IAT 32 BIACK 2 SUBD. HAWTHORNE W00?5 2ND P.I.D. N
Descri tion of work: SINGLE FAMILY DETACHED
The appl i cant i s: ? Owner El Contractor ? Other (Deacribe)
Name FEIL, MARK AND J[JLIE Phone 687-0178
Property LAST FIRST
OWner
Address 3677 ASHBURY ROAD
STREE7 STE N
City EAGAN State MN Zjp 55122
Company LIFESTYLE HOMES. INC. Phone 454-7866
Contractor Address 1489 LAKE PARK CIRCLE License # 401288 EXp, 3/95
City EAGAN State MN Zip 55122
Company LIFESTYLE HOMES. INC. Phone 454-7866
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer 6 water licensed plumber THOMPSON PLUMBING Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
SUfLDfNG PERMIT TIPE • „%
? H? ? ??
? O1 Foundation ? 06 Duplex 0 11 Apt./Lodging 1 Bas errt Fihish,
/ff 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Stim"?'or**-
? 03 Sf Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? ]4 Fireplace ? 19 Comm.JInd. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. 0 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
IJ 31 New ? 33 Alterations 0 35 Tenant Finish ? 37 Demolish
0 32 Addition ? 34 Repair 0 36 Move
GENERAL INFORMATION
Const. (Actual) 1/ Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy 3 2nd F1. sq. ft. PRV Required
Zoning Sq. Ft. total Booster Pump
# of Stories z Foatprint Sq. ft. Fire Sprinkler
Length y On-site well Census Code
Depth On-site sewage SAC Code
APPROVALS
Planning Building Assessments
Engineering Yariance ,
REQUIRED INSPECTIONS
? Si te
? Wallboard
M Footing
,E? Final
,?F Frami ng
? Draintile
a Insulation
O Fireplace
Permit Fee
5urcharge
Plan Review
License
MWCC SAC
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:
Yaluatfm:
6?s•.+ ?r- ?
k?9, S= 288, 7.S
19,S.F 3?` = (o2-11
( TX 5' < <40
/yyoxS % _
Zo,??- l.S= ?o.?.s
?---
?
7%IyBS,?S //??.33?Y
Y," p ss s
?-?----
SAC. %
SAC Units
E" D D
Er a o
0 0
0 H? ?
e- n o
0? D D
il- 0 0
o a? o
0' 0 0
D''0 0
LOT SIIRVEY CHECRLZBT FCx RESIDEHTIAL
BIIILDING
JIPFLICIITIODi
?
PROPERTY LEIiALS
Dat• o! 8urvey: /?
• Reqistered Land Surveyor signature and company
• Building Permit Applicant • Legal description
• AddTess
• North arrow and bar scale
• House type (rambler, walkout, split w/o, split entry,
lookout, etc.)
• Direational drainaqe arrows with slope/qradient t.
• Proposed/existing sewer and vater services
• Street name
• Driveway
13 M'_ D
• Exiatinc
Sewer service
8" D ? • Lot cornezs
ar- II 13 • Top of curb at the driveway
? D ? • Elevations of any existing adjacent homes
Proposea
D' 0 ? • Garage floor
• Fizst floor
E? 0 0 • Lowest exposed elsvation (walkout/window)
0 • prcperty corhers
O? 0 0 • Front nnd rear of home at the foundation
PONDiNa AREAS (if aaaiicable)
D 6l 13 • Easement line
0 0' ? • tawL
D 0 • HwL
0 ?/ 0
D
0 • Pond # designaLion
Q • Emergency Overflew Elevation
DIMENBIONS
? 0 0 • Lot lines
? 0
V D • Right-of-way and etreet width (to back of curb)
0 0 • Proposed home dimensions incYnding any proposed decks,
overhangs greater then 21, porches, etc. (i.e. all
"' structures requizing permanent footings)
0
13 Q • show all ensements of record and any City utilities within
those easements
v0 D • Setbacks of proposed structure and setback of adjacent
- existing homes
00,11
3 • Retaini 'Eift irements, if any
Reviewe / ? A2W97 --
October 1992 ? ?
Cities Dijzital Quality Control
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CITY USE ONLY
PERMITq-77 rS RECEIPTDATE:
RE5IBFJffIAL M£CHANICAL PERMIT APPLICATION
crrYoF- EAEiAv
S$SO PILOT KNOB RD
Ek6M 1NN 55122
651-6$1-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date:
SITE ADDRESS: ?L L:?-a{ c>-rftQ .h Q ,
OWNER NAME: ??t(lQ
TELEPHONE #: i ??4s_(a-?4
(AREA CODE)
INSTALLER NAME:
STREET ADDRESS:
ciTV:
Place a check mark next to the oermit work rvoe
TELEPHONE #:
S51 Z"??
New residential dwelling unit under constructionand not owner/occupied $ 70.00
? Add-on, modification or alteration to existinq dwelling unit ,r $ 50.00
• furnace replacement ?
• air exchanger '
• airconditioner
. other
Nature of work: aloc c ld
32 ?IDU
State Surchar e $ .50
Total $ so ?
Reminder: Call for inspections.
(01z?l U Z- ?L4L(
(AREA CODE)
Updated 1:01
2004 RESIDENTIAL BUII.DING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construdion Reauiremenls RemodeVRenair Reauiremems
3 registered sKe surveys showing sq. R of lot, sq. R af house; and all roofed areas 2 copies of plan
(20°k maximum bt coverage allowed) 7 set of Energy Calalations for heated additions
2 copies of plan showing beam 8 vdndow s¢es; poured found desgn, etc. 1 site survey for additions & dedca
1 set a( Energy Cak,ulations Addition • indica[e if on-site septk sysfem
3 copies of Tree Preservation Plan if bt plafled a8er 711193
Rim Joist Detail Optlons seleclion sheet (bklgs wiN 3 or less unifs
?
i
70
1/ i-7 I
Ge??Q.(,?e.( 3(3I? ?'^?f
?pvueorc?u `o
,_.
Cerf ot SGrvey_Re6d?' ??=?`
Tree'Rres:RJari:ite''cd"'='?-_Y?.?:N ?
Tree PAUuired N
s7,?c
Date Construction Cost dVD
SiteAddress ?,?`) f?u•>?ra?ne= y,
1/am?s 11? UniUSte #
. R ?t ;r-%
Description of Work &SByt,-4- P , ti S ?l
Multi-Family Bldg _ Y? N Fireplace(s) ? 0 2
Property Owner Jm r r- i 1 Telephone #(( 5?-1)41!5? O% s?
Contractor
Address Cit3'
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateaorv 1 _ Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(?I submission type) Submitted Submitted
. Energy Envelope Calcula6ons Submiried
Have you previously constructed a building in Eagan wiih a similar plan?
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Y_ N If so, 25% plan review
Telephone #,(-._)1
i ?
, 1 ,
Telephone #(,? 11
Telephone # j J`1N
I hereby apply for a Residential Building Permit and acknowledge that the inforxnati`on is'crn ptets-1,ankl 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 pernut, 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.
ApplicanYs Printed Name ApplicanYs Signa
Sub Types
? 01 Foundation
O 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
Work Types
OFFICE USE ONLY
? 07 05-plex ? 13 16-plex ? 20 Pool
? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.)
? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 12 12-plex PI6g_Y or_ N ? 25 Miscellaneous
0 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
Valuation / (7 oo
Census Code
SAC Units
# of Units
# of Bidgs
Type of Const
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
_ Foundation
Drain Tile
Roof Ice & Water Final
Framing
Fueplace _ R.I. _ Air Test _ Final
Insulation
W idth
REQUIRED INSPECTIONS
FinallC.O.
X FinaUNo C.O.
Plumbing
_.JY HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests Final
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wall
Approved By: Tz , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit 8 Surcharge
TreaVnent Plant
License Search
Copies
Other
Total
? 30 Accessory Bldg
? 31 EM. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 37 Demolish Building• ? 43 Reroof ? 46 Windows/Doars
•Demolition (Entire Bldg) - Give PCA handout to applicant
Occupancy MCES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
?? ? ?
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
.S Z`J , SZ)
Date I I ? I ? ) q
Site Street Address 5,.3
Unit #
PropertyOwner Y?lul,( Fe-j / Telephone# (6s!
Contrector / ?f? ? ? ?t , l
Address City Telephone # ( )
State Zip
The Applicant is: Owner _ Contractor _Other
Alterations to existing dwelling
24__ Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnarou/n?d (?add $121.00 if a 5/8" meter is required)
Other. _1'ti\z vJ_ _?R Vl ?
- $ 50.00
Water Softener
Water Heater
_ replacement _ additional
$
15.00
Lawn Irrigation System RPZ_ new _ repair _ rebuild $ 30.00
State Surcharge $ 50
? Total $
I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
ApplicanYs Printed Name ApplicanYs Signa re
?
-------Use ----------?
? For Office
City of Ea?an ?I?i4 7M I PePertnrmit itp Fee: r`-' j
= I
? ?. o , ?
3830 Pilot Knob Road
E8g8n MN 55122 j Date Received. ?
Phone: (651) 675-5675 i statt: i
Fax: (651) 675-5694 I
2009 RESIDENTIAL BUILDING PERMIT APPLICATIONG
Date:
Tenant:
Suite #:
ne: 65-t ySF???l7
? Ph
j
l
re
-
Jt
RESIDENT/OWNER u
o
e,e-
- S=
-
,
Name _/V«
?
r!
Address / City / Zip: S
Applicant is: Owner _ Contractor
TYPE OF WORK Description of work:
Construc[ion Cost: Multi-Family 8uilding: (Yes NoIKJ
CONTRACTOR Name: License li
Address:
City: State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILbING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residenfial Ventilanon Calegory 1 Worksheet • New Energy Code Worksheei
Ca[B90fy Submined Submitled
(4 submission type) • Energy Envelope Calculations Submitted
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, da[e and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Confractor: Phone:
NOTE: Plans artd supporting documents that you submit are considered to be public information. Portlons ol
the information may be classifled as non-public il you provide specilic reasons that wou/d permit the City to
conclude thai the are trade secrets.
I hereby acknowledqe that this inlormalion is complete and acarale; ihat the work will be in confortnance with ihe ordinances and codes of the City ot
Eaqan; that I understantl this is not a permit, but only an appLcation tor a permit, and work is not to start withoul a permit; Ihat the work will be in
accordance vnlh ihe approved plan in the case oi work which requires a review and approval ot plans.
X?L E J..! x ?
App1icanYs Printed Wame Ap licant's Sig atiy e
C Page 1 of 3
Site Address:
?? -
3
4.?6
v ?
40 DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage
Single Family Garage Porcif.(4=Se35on)' Exterior Alteration (Single Family)
_ _
_
Multi Deck Porch (ScreenlGaiebo/Pergola) Exterior Alteration (Multi)
_
_ 01 oT _ Plex _
? Lower Level _ Pool _
_ Miscellaneous
_ Accessory Building
WORK TYPES
_ New _ Interior Improvement _ Siding _ Demolish Building'
Addition _ Move Building Reroof _ Demolish Interior
? Alteration _ Fire Repair _
_ Windows _ Demolish Foundatfon
_ Replace Repair Egress Window _ Water Damage
`Demolltion of entire 6uilding -give PCA handout to applicant
„v
Valuation
00 Occupancy JJNC. y MCESSystem
Plan Review Code Edition po ? SAC Units
(25%_ 1000/ Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction ? Width
REQUIRED INSPECTIONS
_ Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water Final
Framing
_ Fireplace: _Rough In _Air Test _Final
7< Insulation
Meter Size:
_ Sheetrock
Final / C.O. Required
>,? Final / No C.O. Required
? HVAC
Other:
Pool: _Footings _Air/Gas Tests _Final
_ Siding: _Stucco Lath _Stone Lath _Brick
W indows
Retaining Wall
Reviewed By: 7?Z? , Building inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
? CEYOWS CERTfFICATE
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PLANNERS / ENGINEERS (SURVEYORS
25r)0 W, C7Y. RD. 42 • HURN;VILLE„btlV. 66?'37 • 612-890•6044:
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SuRVE OR'B ;cERTlFICArE ;
LIFE TYLB I-iUMFS
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NUl'E, NO BPECIFIC SOILS INVH8TI3ATIOIV HA9 BEEN CaMPLEiED
bN'fH18 lOT BY ,IAMGS R, WILL, INC. THE SufTABIUI'Y OF
E016a TD SUPPOftT 7HH 8PECIFIC HOU9E Y1401'04HD IS
NOT THC PlEBpON31 BILI7Y OP JAMEB R. HILL, INC.
NOf'g: lQ,pIryO OIMENSlW9 9MTYN AHE WR HDI'?OriTAI
IVERTICAL IOCATION OP 3TRUCTURE OFHX..9EE
. ARGt17wTUAL PLAN! FOR pUILDIN6 e FouNannoN
OIMEltSqHy,
Z.IE?WED
EAGAN
REVlE?VdED
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"• ' NNtiTES IflOM MONUMENT FOUNq pROPOSED QAiiAdE PLppR - 1541.4. , EET
• X040.0 ENOTE$ E(Ig71Na ELEYATION pI40POSEO IOWE$t FLQOR - 11113.g. ' EET
(000.0) ' EIVOTE$ PROPOSEO ELEVATION PROPOSEp TOP OF BLOCK - 842. 3 EET
'WE H@RE6Y OFtTIPYTO 4IFE9TYI.E FpMHS THAT THIS I$ A 7RUE ANp COIiaECT ?
REpRESENT 110N OP A SURVEY OF THE,BOUNDAHIES pF; .
lal 7. 9100k 0 ,HAWTHpRnEyy00DS tNC ADDIT'ION, ocCOrdlnp 10 the recaqed
plaf ~, Dakoto County, Mtienjr,a!c. - . • .
' I7 00E9 NO pURPORT TO SNOW IMPROYEMENTS OR ENCROACHMEN7S, EXCEPT AS, BHQy4N. AS
BURVEIED ME pq UNDEfi MY DIRECT SUPER"SION TH18 /G+'" DAY OF pEC. , 0117,
N VYSqt 31QNED: JAME5 ILL, INQ. •.
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1 ?4 N'' James R. Hill, inc,
PtANNFERS I ENGINEF-RS / SURVEYrjFiS
-- ., 2600 W. CTY. R0. 44 * BURNSVILLE, MN. 66337 0 812-89Q'60I4
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?1??/?, / ? REQUEST FOR ELECTRICAL INSPECTION
?p? r?7- q C -7 See msW cuons for completing ihis form on back of yellow mpy
IPI G 5.1,TJ 1 "9i" Below Work Covered by This Request
?91(
'0 •EB00001-OB
ao?g7
ew Add Rep Typeol8uilding AppliancesWired EquipmenlWVed
Home Range Temporary Service
x Water Heater Elect nc Heating
uilding Dryer Load Management
t
m./Indusinal Furnace Other (Specify)
Air Condihoner
spec?ry) Contraclor's Remarks
Campute Inspection Fee Below.
# Other Fee # ServiceEntranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 ro WO Amps ?
Transformers A6ove 200 _ Amps Above 100 _ Amps
Sigf15 Inspedor5 Usa Only, {
G? TOTAL ?
Irrigation Booms /
(i? ? ??0
Special Inspection
Alarm/Communicahon THIS INSTALLATION MAY BE ORD ED DI 019NE,CTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTWS. -?
I, the Electrical Inspector, hereby
certify that the above inspection has
been made. Ro.qn-m r
Final
• e. _/? f
Z-?
OFFICE USE ONLV
This requesl vaitl 18 mon[ha Irom
3??25
??
y?
p
157
Request Date
^? p Rre I o. Rough-m Inspection
Raquired' NOTICE vov Musl Call Elecincal Inspecror
IfA Rough-Inlnspecbon
es ? N. Is Reqwretl
I,X licensed contractor ? owner hereby request inspechon of above elechical work at:
Job Atltlress (Street Box or Roule No ) Qry ^.
Sz v ?d,40;-no,eN o?3 :e ?/?e•?,?
Section No. Township Name or No Range No Coun
AKcn1
Occupan[(PFINT) Phone No
?
P%SrYi- t? f c.ncS
Powej?SuOP'iier AdCress
UAKCn'? E /- tc,-,<'ic•l rRk;n??v? i-Vr?j
EiecV I ConVactor (Company Name) Comramors Licenae No
itns" - - . G4z: cne ,c C'/? O 1Y32-
Mailing AtlCress (COnlractor or Owner Meking Installa?ion)
/00. ,7ya??? P « A?«? MN ss12 1/
Autho1? tl Signature onha / ner Making Installabon)
? Phone Number
I. _
-?
MINNESOTA STATE BOAqU OF ELECTRICRY THIS INSPECTION REQUEST WILL NOT
Griggs-Mltlway BIEg. - poom S-173 BE ACCEPTED BV THE STATE BOARD
1821 UniversHy Ave., St. Paul, MN 55104 UNLESS PFOPER INSPECTION FEE IS
Vhone (612) 642-0800 ENCLOSEO
----------------i
For Office Use
n F+i
non Permit
City of EaRd 1 I Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 i Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION c
Date: Site Address: _
Tenant: Suite it. RESIDENT / OWNER Name: 1-6,1~ Phone:
Address / City / Zip: Sl 3
Applicant is: L Owner Contractor
TYPE OF WORK Description of work: 1" 5
Multi-Family Building: (Yes / NO/<J-
Construction Cost: 000
CONTRACTOR Name: License
Address:
City: State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting' documents that you submit are considered to be public information. Portions of
the information may be classified as non-public H you provide specific reasons that would permit the City to
conclude that the are trade secrets.
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 V 4 C x
Applicant's Printed me Applicant's Sig at e
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage
Single Family _ Garage _ Porcfr,(4-Season)' _ Exterior Alteration (Single Family)
_ Multi _ Deck _ Porch (Screen//Gazebo/Pergola) _ Exterior Alteration (Multi)
01 of - Plex 7K Lower Level _ Pool _ Miscellaneous
Accessory Building
WORK TYPES
_ New _ Interior Improvement Siding _ Demolish Building'
_ Addition _ Move Building Reroof _ Demolish Interior
Alteration _ Fire Repair Windows _ Demolish Foundation
Replace _ Repair Egress Window _ Water Damage
'Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation (~~t Occupancy MCES System
Plan Review Code Edition N1a SAC Units
(25%_ 100%-~-() Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction L Width . 1-1
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
')z Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In -Air Test Final Windows
Insulation Retaining Wall
Meter Size:
Reviewed By: I , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge /
Plan Review
l
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA162185
Date Issued:07/01/2020
Permit Category:ePermit
Site Address: 529 Hawthorne Woods Dr
Lot:32 Block: 2 Addition: Hawthorne Woods 2nd
PID:10-32151-02-320
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description: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 Feil
529 Hawthorne Woods Dr
Eagan MN 55123
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA162185
Date Issued:07/01/2020
Permit Category:ePermit
Site Address: 529 Hawthorne Woods Dr
Lot:32 Block: 2 Addition: Hawthorne Woods 2nd
PID:10-32151-02-320
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description: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 Feil
529 Hawthorne Woods Dr
Eagan MN 55123
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature