541 Hawthorne Woods Dr
Use BLUE or BLACK Ink
For Office Use
I I
,i
--I"
City of Ea 110n Permit C--->
~ ti~ I I
b I Permit Fee: Q~
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
1 2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:3t41- 0-5- QQ
Tenant: /(g,2--'~ 1\i` t Suite
RESIDENT/ OWNER Name: ri ~ r> L? lD ~ Phone:Z2j-7- 4k_'E"4~606_
Address/ City/ Zip; W,}~~i,l,~,€J
Applicant is: Owner Contractor
TYPE OF WORK Description of work: POO P
Construction Cost: -40001-90 Building: (Yes / No C/)
CONTRACTOR Namel.,15k&i I ®k_c License ~9_31.1?lu 15-)
Address I- t I II~ 33'x/ City: _4&4&2
State Zip: 0 _3 Phone:'
Contact:/1.44 Email:
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:
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 the 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.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 wor i not to start .thout a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approva f ins.
x P, ~ x
Applicant's Prin d Name pplican s ignature
Page 1 of 3
:? -- .
. CITY OF EAGAN
` 3830 Pilot Knob Road
Eagan, blinnesota 55122-1897
(612) 681-4675
rION RECORD
PERMIT TYPE:
Permit Number: '
Date Issued:
SITE ADDRESS:
; la4_!1 NO1NEi
P. l - N, t ltb 7 7.Fi 1 °:'4*1 -Hi'
101 s ?? SC014 ;k
tiaMAMtr"c t??ncan?t ???c •- w0011f., :•ari
PERMIT SUBTYPE:
?
0' " '3 Hro ME s
461.11) 6E36-..94W
TYPE OF WORK:
I
INSPECTION D. . D•
1 E4.,
OrMakKS: S&u 4,1 E04Ht RI,- M .0
? ?`
• PermR Na. Permit Holder Oata Talephone #
ELECTRIC
?
PLUMBING ,SO
HVAC ? AP /O 9'J
Inspection te Insp. Comm ents
FOOTINGS ?
? ? ?? - L (F
FOUND
l
FRAMING Jv'/ cv f ? ' I7- ? L? f J ,
ROOFING
rrr?r VAft S
ROUGH
PLUMBING
" -/j 97
PLBG
AIR TEST
-
ROUGH
NEATING
l(7 9?
?! L? e 1l ?
rf
t'?f,?,.e
GAS SVC
TEST d 0,"-- /"N SS -*s ,jJ '
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBCi
4J??
FINAL HTC,
AA9
ORSAT
TEST $--ol- 1-97 .
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
G t`
?
rY ~-4
%CL'tiJiCQte 0f CCCIIpa1iC?
%itV af Cfagatt
MCO«ct exr of lax?? anoecnon
This Cenificate issued pursuanl to the mquirements of the Unifor?n Buildin$ Code
certrfying that a1 the time of issuance this structurr was in campliance with the various
ordirtances of tlu Ciry regulating buelding construrtion or use. For the following:
use c,m;rwmion: SF I7WG aag. ecmit No. 29q33
o-P-Cy Type 831I1 I zoning pania Ri Type Consi. VN
ownffor euileina J S M4E,S nadn=437 I BEBT LRFE LN, F.AC'-0
awwi.g Aaa. 541 HAWUCM WM I?2IVk .. li-Y 12q, B2, HAiiTDUM 4A"IODS 2rID
Dw:
e?? ? offk?
POST IN A CONSPtCUOIJS PLACE
- ? CITY ? OF EAGAN -
681-4675
DEPT. OF BUILDING INSPECTIONS
Correction Notice
I have inspected this structure and these ?
premises and have found the following ?
violations of city codes: ?
577/P R" ?D 9d t-Ort9 /??.ITaJ?Uwrrul /,v-
Whoe"n corrections have been made, pleasej%AT`
aII 681-4675 for inspection.
,? n cw Tf?s ?
41/9?7
Date
Inspector C+ty of Eagan • ?
?
DO NOT REMOVE T IS TAG ?
? p? OFFICE USE ONLY This requesi void 18 monlhs hwn " n rin in Pois 6ox
7 ??
II IIIIIIIII IIII IIIIIIIIII I II III IIIIII?yBa,?`?°?- oR
TYPE
Raqueu Dule Rough.n mspecnon requiredR [TI., ? N. Inspecoon Other Thon RwgMn: 0 Ready N OgYill Catl
(Yao most mll the Impeclor when rcvdy1 Oak d
I, Elficensed conhacror ? owner hereby request inspeclion of ihe above elechi w ?
Jo6 Addreu JSneef, Box, w RoNe N. I
5 t??1Q ?.JW ? Ci1y /?p
? 4/? :/fWh p oda
55
Secbon W Tovmship Nome or No. Range N. Fire No. Cainly
5 K" ,-
Occuponl
75 Phone/ N
o
Power Supplier Pddress
?lec T,- ,- y3oo O S C-? gr , S`?C?o2
Elechical Conrcocmr ?COmpony Nome)
C`•? Z ?ec r,' ' Conhocpror Lcense No
?/T ?077 ?0 5 Moster Uc. a(Plonl Elect Only?
Moiltng Address (Conkacror or Owner Pedorming InsmlhM1Onl
? .• l? ST "
95-
Authorized Signy?ure (Conh ? Periormi?g Insrallonon?
//? -,_ %p?a No
EB000i 1 8/96 g7pM gppRU COM - SEE INSiRUC710N5 ON BACK OF VELLOW COPY
4 6 6 =307
? REQUEST FOR ELECTRICAL INSPECTION 7'1
_
Minnesota State Board of Electncity
1821 Uoiversity Ave, Rm. S-128, St. Paul, MN 55704
Phone (612) 642-0800 .
Home Duplex Apt.6ldg. Cfiher. ' New 1 JO Addn
Commercial Indusirial Form Remod Re air
Air Cond. Hig E ui Water Htr. Load Mgmf Other.
Dryer Range Elx. Heat Tem . Senice
"X" obove the work covered 6y ihis request. Enier remarks in this spoce ond on yj?j ock oiffie wFite copy only.
(X
r??.
Calculate Inspecfion Fee - This Inspecfion Request will nof be oecepted without !he mrrecl fee:
Other Fee # Service Entrance Size Fee M Circuifs/Feedere Pee
Mo6ile Home Park $tall 0 to 200 Amps ? 0 fo 100 Amp
Sireet lig./Traffic Si . Above 20Amps Above 100_Amps
Tronsformer/Genemtor INSPECTOp'S USE DNLY TOTAL
Sign/Oudine Lfg. Xfmr. . 5?
Alorm/Remafe Conhol 7
$wimming Pool
I here cem that I'
cal i Ilaeon de herein on 16 dares M "
Irriga}ion 8oom R?W Date y? ?-
ection
S
eciallns ? ?
p
p
Invesfigafive Fee
?
Fn
al
?o
O y
THIS INRTALLATInN MAV RF [] Rf]FRFf1 I'11SC(1NlJFCTFf] IP NAT COMPLETEn WITMIN 1A MONTHS.
i:? .-?- •',:,j._..?.v,.:-^-,.. -n,,,r..?,.,?..?..--.vu?--.-,,.,..?..T 17,-.^.G4^. ..? ,- . - ,. ...e ....- .?.""
Adciiess SAi nnIaTxnuNr c;nOM Dtrrvr• Zip 5512
L.ot _ zc) Blk 2 Sub xnwTHoFNs WODDS zrrn
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: Yes No Inspector.
Final grade (6" from siding) i,' ?
Permanent steps (garage) ?
Permanent steps (main entry) t -z
Permanent driveway V'
Permanent gas
Sod/Seeded gtass ?
TraiUcurb damage
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shuaoff of water supply to
the oufside lawn faucet before freeze potential exis4s.
Con[ac[ engineering division at 681-4645 before working in righbof-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Con[racror Copy
su e?=B
xew Recs,pt # /
I?mei? nsae 9 ?
7A?ztj9 Order Far Payment
s,G=/e?
Date 9)9 2 Request for Inspection Number on this job ICQ- 3a'7
Date Filed S 97
ElecUical InstaUer r 1 License 1+10. Gqo.27 63
(3wnd/(?ccupaet 'S ?_}?,.._e3'
Job Address ?H 1?r+? City 4?fJe,
Additional Rough-in inspection was reqwred.
?A shortage of fees on the above job.
____Reinspection Fee.
A Copy of this order must be returned with payment to the;
Eagan Municipal Cerner
3830 Pilot Knob Road
Egan, MN. 55122
PSone: 681-4600
T__
Please retum Yhis wiih a check ia Yhe amcawrt of $ O t' payable to the CiYY of E$an.
The abovt nrder must fie eamplied vvith bY {date3 UR2 22
Elechicai Inspector Chris Brinkhaus, 1026 Oak Rd., Shakopee, Mn 55379 (612)1969615
t ? RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
NewConsWctian Reauirements
• 3 registe2d site wrveys showing sq. fl. of bt, sq. R. of house; and II roofed areas
(20°/a maximum lot coveiage allowed)
• 2 copies of plan showing beam & wiMow sizes; poured found design, etc.)
• 1 sef of Ercergy Calculations
• 3 copies of Tree Preservatlan Plan if lot platted after 711193
• Rim Joist Detail Options selection sheet (bidgs with 3 ar less unils)
RemodellReoair Reauirements
• 2 coples af plan
• 1 set of Energy Calculations br healed additions
• 1 site survey for ezterior additbns & decks
• Indicate if home served by septic system kr additions
DATE T//
.
VALUATION
SITEADDRESS 14t.k (%iJ:?U'O.,-, GVbO?S MULTI-FAMILYBLDG _Y )(N
TYPE OF WORK S Gc e_c r. P? r C.l--'1- }? 2.L\C, FIREPLACE(S) _ 0_ 1_ 2
APPLICANT Pe r+r d 6 r r r hc, C o v?c:. -E.
STREET ADDRESS Z2 GC, Q 1 Pck " n, ?? I?u t CITY fn? k-v5+ev STATE MVZIP g S'L>??3?
CELL PHONE #_? 76 6 Y,9'0 9 Z FAX #
PROPERTYOWNER_4-o hn 4- S 1n"r} ,rbr. e, -t- v r,n I gE_TELEPHONE#
_"' _""""""_' _ __"_' ----------------------°"_""""--------_"---------"""'_""_'
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULFS 7670 CATEGORY 1 MINNES d?R ??fl
(4 submission Type) • Residential Ventilation Category 1 Worksheet Submitted • New Energ sleVSM92ed I
• Energy Envelope Calculatlons Submifled ITl By 510
Plumbing Contractor: Phone #
Plumbing system includes: _ Water Soflener _ Lawn Sprinkler Fee: $90.00
_ Water Heater _ No. of R.I. Baths
_ No. of Baths
Mechanical Confractor: Phone #
Mechanical system includes: Air Conclitioning Fee: $70.00
Heat Recovery Syslem
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.
Signature of Applicant ?,O vK7'Q
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 31 New
IX 32 Addition
? 33 Alteretion
? 34 Replacement
? 20 Pool
? 21 Porch (3-sea.)
? 22 PorchlAddn. (4-sea.)
K 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
?• ?
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 6ct. Alt - SF
? 36 Multi
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDOOrs
*Uemolition (Entire Bldg only) - Give PCA handout to applicant
Valuation
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const VAI
Occupancy 11- Idel MC/ES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
W idth
REQUIRED INSPECTIONS
Foorings (new bldg) FinaUC.O.
Footings (deck) X FinallNo C.O.
? Footings (addition) _ P1uxnUing
Founda6on HVAC
Drain Tile pther
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
? Framing Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _
_ Final _ Windows (newheplacement)
_ InsulaNon _ Retainwg Wall
Approved By-x2--,,Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
? 07 OSplex ? 73 18-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex x 18 Deck
? 11 10-plex ? 19 LowerLevel
? 12 12-plex Plbg_Y or_ N
6CA4%" ?7)-,o
0 *k
%
?l ??a
CITY i]F EAGAN
CASHSEk: S TERMINAL N0: 53
LA7Er. 05/12/3' l'IMF:: 15:22:32
TD:
NAME: JS HOMES INC
2256 3001 541 HWTHRk WDS 496E,8.46
10,al Rereipt Amollnt: 47F668.46
' CROi3E,23
USFk IIt: NANCV
* PERMI?'
X' CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: a u z La z Ns
Eagan, Minnesota 55122-1897 Permit Number: 029933
(612) 681-4675 Date Issued: 05/17 f g 7
SITE ADDRESS:
P.I.N.: 70-32151-290-02
541 HAWTHORNE WOODS DR
LOT: 29 BIOCK: 2
HAWTFIOftNE WOODS 2ND
DESCRIPTION:
7,?dP e r m i t T y p e S F L?W G
?,U3:,?:)OR T'k Type NEW
?
Wa° ElR'C' ?00- R-3 U-1
C-ci'n! S't'r:U t?'t,.i? e V N
..
-'°; R-1
7k
?5 U;?eYdt bst?'1`?ii'g?}?;?'.. 70
42
ses a - FAm. aE T A C H
eq
?u'?"? 3 ???
?m? ?
REMARKS:
s&w piumBeR - r7 w
FEE SUMMARY:
VaLuA-rzoN
Sase Fee
Plan RevSew
Swrcharge
5/iC
SAC %
SAC Unitis
Subtotal
$1,267.25
$823.71
$88.00
$950.90
100
1
$3,128<9S
$176,000
MISC FEES --____..t1, 53,9.50
7ota1 Fee $4.663.46
CONTRACTOR: - Appiicant - sT. LIc.OWNER:
k S HOhIES 16869092 0004849 J S NOMES
371 BEN7 7REE l.N 9371 BF_PRT TREE LANE
FlGAN MN 65123 EAGAN MN 55123
612) 686--9092 (612)686-9092
S Nterel3y ??krt????tSg? th:?€? ? ?Jr???.ree
r?.0.
'5tatuta?s 4?r`aS 6? 4°?nA?e
?, . ?,
_ . . ... ?r ?w:. .._
PLICAN /PEti EE SIGNATl1RE
?. .. a. .. , . g F?
_? E 2 t Y ?
14 -tw-.?'r'v?'F?' ?fi?'t'?i S?.?"J? "?'t'Ko ? .
d _ ?St
"?4'??;td°?
I? UED B ? SIGNATUR ?
? 1997 BUILDING PERMITAPPLICATION (RESIDENTIAL)?7`¢
r CITY OF EAGAN ?„ pp n
3830 PILOT KNOB RD - 55122 ""-'?"?-e.?.
681-4675 S?
New Construction Reauirements genodeVReoeir ReauiremeMS ?
• 3 registered site surveys 4, pcoPies pf Plan
• 2 coples oF plans (inGude beam & wirMOw sizes; poured fid. design; eta) ? 2 alta surveys (e#erior edditions & dedcs)
? t energy alwlations ? 1 energy cetculations tor heated addkions
? 8 copies M tree preservation plan M lot pletted after 711/93
ieQuired: _ Yes No ?
DATE: ?/? V ? CONSTRUCTION COST: ?/ 5 ? `?J
(
DESCRIPTION OF WORK: s,
STREET ADDRESS: ? ? I ?!/h`'?J ?'?`? ??z'?' S ?n
LOT ? BLOCK L SUBD./P.I.D. #: ?d' °2 /1"eK 27-'
PROPERTY Name: Phone e? D G- 16,
? Z
OWNER M., ..,
Street Address:
City: State: Zip:
CONTRACTOR Company: ?-S W,.6'? Phone #: ? 1? - v° e2
Street Address: License #:
City: 12State:,14fi`-, Zip: SJ Y 23
ARCHITECT! Company: ??e9,?"'`- ? Phone #:
ENGINEER
Name: Registration #:
Street Address:
City: State: Zip:
Sewer & water licensed plumber (new construction onty): Penalty applies when address change
and lot change are requested once permit is issued. '
I hereby acknowledge that I have read this applip4on and state that the information is correct and agree to comply with all applicable
State of Minnesota Statutes and Ciry of Eagan Ordinances.
Signature of Applicant: ?--- ?
OFFICE USE ONLY R7APR CEIVED
Certificates of Survey Received _ Yes ZNO 2 2 1997
Tree Preservation Plan Received Yes No ?t Required B--------"
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex o 11 Apt./Lodging ? 16 Basement Finish
izf' 02 SF Dwelling ? 07 4-plex o 12 Multi RepaidRem. 0 17 Swim Pool
? 03 SF Addition o 08 8-plex n 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. 0 10 = piex ? 15 Deck
WORK TYPE
n' 31 New ? 33 Alterations o 36 Move
a 32 Addition o 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
\,/ 4 Basement sq. ft. MCIWS System _T
J rl Main level sq. ft. City Water
R-3, J-i sq. ft. Fire Sprinklered
R- r sq. ft. PRV
z sq. ft. Booster Pump
-70 ' sq. ft. Census Code. ? o
k z' Footprint sq. ft. SAC Code 01
Census Bidg i
Census Unit i
, Building ?VG Engineering Variance
Pertnit Fee Valuation:
Surcharge ?-?--?--
Plan Review ao K Z-
License kg K 15. `7
MCNUS SAC y. -7 x 3,1
C.Ity S/4Ci Z 3 x Z
Water Conn. 3 Y? 3
Water Meter si
Acct. Deposit
SNV Pertnit Sa^?°-
S/W Surcharge
Treatment PI. "-
Road Unit
Park Ded. Z'? y
Trails Ded. z-
vtv
Other °-
?---
Copies ?. o. 3? v 3 z.
-2v . 3 7 r z
Total:
% SAC
SAC Units
$ t 'r (? , 000, -
4v
7 sz.Z
3L$, ?
V(o
?
---
?a?s.$
I a`S.8 @'4 sv:
? z `5. 8
v
?z
??-
8.8 ?:6 sy=
?s4•y
4U.7
"7oo
r$ ? 9 87. -
(- g, 353. z
?'-
?+?5?
' LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATIO
G?
PROPERTY LEGAL: ?^
? DATE OF SURVEY:
LATEST REVISION: ?
a DOCUMENTSTANDARDS
/
?? ? • Registered Land Surveyor signature and company
a? ? • Building Permit Appl(carrt
? • Legal description
??
? 13 • Address
?
"
6
JC7 0 • North arrow and scale
? ? • House type (rambler, walkout, split w/o, split entry, lookout, etc.)
? • Directional drainage arrows with slope/gradient %
13 0 • Proposed/ebstng sewer and water services & invert elevatlon
w'o ? • SVeet name
e-'o ? . Driveway
ELEVATIONS
Existina
Er- 11 ? • Sewer service (or Proposed)
? 13 ? • Properry comers
e` ? ? • Top of curb at fhe dfireway
'd 13 o • Elevations of any epsting adjacent homes
Prooosed
cv?o o • Garage floor
CC3'o ? • First floor
ff' o o • Lawest exposed elevation (walkout/window)
11 • Properly corners
? • Front and rear of home at the foundation
PONDING AREA fif aoolicable)
? 4? ? • Easement line
? [3'' ? • NWL
? L?? ? • HWL
? cr' ? • Pond # designation
o [I"[] • Emergency OveAlow Elevation
Q--13 o • Lot IinesBearings 8 dimensions
a? ? ? • Right-of-way and street width (to back of cur6)
ff, ? ? • Proposed home dimensions inciuding any praposed decks, overhangs greater than 2',
porches, etc. (.e. all structures requiring permanent footings)
Ly" ? ? • Show all easemeMs of record and any City utilides within those easements
C3' ? ? • Setbacks of proposed structure and sideyard seffiack of adjacent exasstihng structures
o cr' ? • Retaining wall requiremen if any
Reviewed: /
January 1996
CRAIG7 BBBIBLDGFRMT.FM
Cities Digital
( Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
EXTERI4R ENVELOPE AVERAGE "U" COMPUTATION
OwMER: -7 .S' ?-/ u„?
St7E ADDRE55: I .5 4'I 0Y?n'c' ?-
CONTRAC70R: DATE: PkONE:
DETERMINE WORKING SQUARE FOOTaGE OF EACH;
1. TOTAL EXPOSED WALL AR£A,,,,,,,, ,2 9-? 4 sq ft x"U" ,l? •;?Ii. ?
2. TOTAL R06F/CEILING AREA,,,,,,,, 1466 Sq fC x"U" ?(}r;L (o r`?L?,ily
3. TOTAL EXPOSED 1JALL AREA CALCUtATiONS:
Total exposed wal)
aree above fToor,,,,,,,, ? 834 sq ft
kt)
a) Total wall windaw area:
l>?t'S'.ar!r g18zCd...... Sq fL X nUn 4J
q
.
?.
An?A:.eYD?? glazed..... Sq f! % ??Uii O 1(
::
6) Total door area ,,,,,,,,, sq ft x"U" I?
c) Total s1lding plass cloor aree:
glazed,..... c7 sq ft x ??U" 110
.
glazed...,..
sq rt x "U"
s
dy Total fireplace wali area Z?i/P, sq ft x"U"
r
e) Total wati framing area I
(Average iDq)........... sq fL x"U" 0 ?2 • 2:3 .24
f) Total net watl area above
floor (Insulated)....... 'zG]S sq ft x"U" .04 !
g) Total rim )oist area.... .. _ ?,5 9 sq ft x"lJ" c%O
Total foundatlon
area (Exposed),........ _ ;`{ J sq ft
h) Total foundatlon
window area............. -- sq ft x"U" ??G'? !•?:-?? a -
t) Total net foundatlon
df83 above grade,...,.. Sq ft X??U"
3• TOTAL a) thru t} .,L?I?'.l>SS
tf item N3 is the same as, or less than ftem F1, you have met the intent of
2 b:CAR 1.16008 A end G.
Page 1
.
ities
igital Qualitv Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
, 4• 707AL EXPO5ED ROOF/CEILING CALCULqTI0N5:
' 7ota1 exposed
' roof/celling area..,,.,., l4 LG sq ft
J) Total slcyllqht area..... .. LJ sq ft x"U" ?? a C7
-,--?....? -
k) Total roof/cetltnq Praming
area (Averaqe f119),..., r4? .ty sq ft x"U" u%I
?
t) Tota1 net Insulated
roof/ceiTinq area....... _ r?;2 L sq ft x"U"
4' T07AL J) thru }) .??0•?(??
tf total of #4 is the same as, or less than N2, you have met the intent of
2 MCAR 1,16008 :4 er.d 0.
ALTERNATE BUILDING ENVELOPE bESIGM
To utlllze the total envelope system method, the values estabiished by the sum
of items #3 and H4 sha1T not be greater than the sum of items N1 and 02.
+ 2. m
3• + 4. e
C E R T I F I C A T 10 N
! hereby certify that I have calculated the "U" factors and "R"
values herein and that the buildlnq here •lescrtbed meets or exceeds the State
of Minnesota Eneray Conservation Act.
/l,'
Syat Ye
(oace)
PasP 2 '
3 ?
CITY OF EAGAN
CASHIERr t5 TERMINAL NQ: 760
?ATE: 12/14/99 TIMF: 13:21:03
ID :
NAME: L. FATRICIO CO&O5
3210 3001 541 HAWTNOfiPlE W 60vOd
2155 3001. 541 HAWTHOFNE W 0.50
Tor,al Receip+, Amoijnt: 60.50
Cfi I2 l2 i 4
IJSER [D: JAN
?C?XXc*?#X??k%?%??XY??k?k?F?k***%KX??k*?k ??X?t?k?k ?#%? ?K?X ?k??X#**
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
'
3830 PILOT KN B RDN 55122 ?(00 •`? v
851-681-4675 ?
New Conshu[fton Reaulrements Remodel/Reoatr ReaulremeMs
? 3 registered sRe surveys showing sq, tt. of lot, iq. H. ol house 2 copies of plan
and gll roofed areas (20% maximum lot coveraae allcwed) 1 eet of energy calculations for heated addBlons
D 2 coptes ot plans (show Ceam R wlndow sIzer, poured tnd. design; efc.) 1 site survey lor exfedor addRlons 3 decks
? 1 set W energy calculations
> 3 coptes M hee presenafbn plan 8101 plafFed aHer 7/1/93
DATE: f PZ f
?? .
DESCRIPTION OF WORK:
CONSTRUCTION COST: ? % or ovv
STREEfADDRESS: S`EI qcjcJv".? t?le l-UOVdS 0rl'Y'P-
LOT: 2 'f BLOCK: _ ` SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: C060S 1-0.UYC7 Phone#: L65O 'q56-v547
tast Ftrsf
SfreetAddress: .2} 1 quw`F'UYY1B WoPl Dr•
City ?e CtVl StaFe: MNJ Zip: 5J i 2,3
Company: At?.A- . Phone #:
(area code)
Sheet
City
Stafe:
Company:- /S (IA • Name:
Telephone #: area code (
Stree? Address: Registration #:
City
Sewer & water licensed plumber (reautred for new construction onivl:
State:
Planalfy applies when pddress change and lof change is requested once permN is issued.
Zip:
Zip:
I hereby acknowledge that 1 have read this applicaHon, state that the informatlon Is correct, ond agree to comply wHh all applicabl
State of Minnesota Statutes and Cly W Eagan Ordinances.
l?
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes
No
Tree Preservatlon Plan Received - Yes - No
_ Not Required ?
License # Exp.
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.
? 03 plex
1 of ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 _
2-plex ? 09 7-plex ? 14 Apartments 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only 0 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
,lRr' 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
* Give PCA handout to applicant for demolition permit
GENERAL INFOR MATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building L6
Engineering
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
U3N
G?
?
Permit Fee 60, S O
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI:
Park Ded.
Trails Ded.
Other
Copies
rotai: 60 . 5 a
Valuation: $ 1 U1 OC/U, °°
r'
SAC Units
°k SAC
CITY USE ONLY
r. 1).
L a 9 sL
sueo. (s \-..i'n cn vu_ ? G"cL?3
RECEIPT #: I ? U -?) (,?
RECEIPT DATE: ? -)- - I U
PERMIT # 39 01 L
1999 PLUM$INS PERMIT (RESIDENTIAI.)
crrY oF EALsax
3830 Paor Kivos sn
EAsM, Mrr ssY Es
(651)6$1-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES
EACH #
TOTAL
Bath tub $ 3.60 x = $
Floor drain 3.00 x - $
G8S I If1 OUtlet ' minimum - 1 3.00 x ? $
Hot tub/s a 3.00 x = $
Kitchen sink 3.00 x = $
Laund tra 3.00 x = $
Lavato 3.00 x - $
Minimum fee alterations to existin dwellin 30.00 x = $ ? _U
Private Dis osal S stem new/refurbished ' re uires MPC iic. 75.00 x - $
Private Dis osal S stem abandonment 30.00 x - $
RPZ new installation/re air 30.00 x = $
Rou h o enin 1.50 x - $
Shower 3.00 x - $
Under round s rinkler if dwellin is under construction 100 x = $
Under round s rinkler if existin dwellin 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water Softener if dwellin under construction 5.00 X = $
Water softener if existin dwellin 30_00 x = $
Water turnaround 30.00 x ---- _ $
State Surchar e .50 --> ---> ----> $ .50
TOtal --? --> ---? ----> $ `30 ,
Reminder: CaH for inspections of alterations, i.e. water heaters, water softeners, etc.
---------------- -----------------------------....-------------------------------------------- •--------•---------•----•--•------------------
I hereby adcnowledge that I have read this appliration, state that the infortnation is cwract, and agree ta comply with all applicable City of Eagan ordinances.
It is the applicanPs responsibility to notity the property owner that the City of Eagan assumes no liability for any damages caused by the Ciry during its
nortnal operational and maintenance activiGes to the facilifies constructed undet this permit within Ciry praperty/right-of-way/easement.
SITE ADDRESS:
1"1 l.l cS 51
OWNER NAME: QAT I21 G C7 Go gc75 TELEPHONE #:
(AREA CODE) .
INSTALLER NAME: OWNCYL TELEPHONE #:
(AREA CODE)
STREET ApDRESS:
CITY: STATE: ZIP:
? -.
--- --. ?
SIGNATURE FJERMITTEE
V/.
L ? a BL J, --- CITY USE ONLY RECEIPT#: 751;240
SUB . ? G!/O,64 O? ?v RECEIPT DATE: 6110/p 2
7997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: . single family dwellings
. townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES EACH NO. TOTAL
Shower 3.00 x 10
d
WaterCioset 3.00 x Cf,ov
Bath Tub 3.00 x j 21 o O
lavatory 3.00 x ,O
Kitchen Sink 3.00 x = :; o n
Laundry Tray 3.00 x
J
7,0
Hot Tub/5pa 3.00 x =
Water Heater 3.00 x 3eOo
Floor Drain 3.00 x 4, a v
Gas Piping Outlet * minimum -1 • 3.00 x
J
4910
Rough Openings 1.50 x 3 = ?Q
Water Softener ' for dwellings under construction 5.00 x =
Water Softener ` far existing dwelling 20.00 x =
U.G. Sprinkler "fordwelling undercoqst 3.00
= 3! Di?
U.G. Spflnkler ' for existing dwelling 20.00 =
Alterations- _--' to existing residence 20.00 =
WaEer'furn Around 20.00 =
Private Disposal System ` oek cry rc. 75.00 =
(new and refur6ished systems)
Private Disposal Systems"nbandonment 20.00 =
5TATE SURCHARGE .50
TOTAL ?
s??v
I hereby adcnowledge that I have read this applicaHon, stete that Me Inkrtnation is coiract, and egree to compry wkh all applicable Ciry
of Eagen ordinanoes. Il is the applicarrt's tesponsibility M notify the property owner that the City of Eagan assumes no liabil@y for any
dameges caused by the Cily during ita nortnal operational and maiMerrence acWkies to fhe facitities conshucfed untler fhis pertnk within
City property/rigMcf-wey/easemeM. 4'ell
SITE ADDRESS: 6? /-L/ I,c _40 GYS f?d??
OWNER NAME:
INSTALLERNAME: TELEPHONE#: 4_9`6 -62} D
STREETADDRESS: s/7v 4l.70 <i /T/,?y/ Y/
CITY: I lsc/? ? STATE: ZIP:
SIGNATURE OF PERMITTEE
? CITY USE ONLY
LOT CZ ? BL ?- xECEUPra: 75/OCo
SUBD? RECEIPT DATE:
1997 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
Date:
Complete this section only if you are installing HVAC in sin¢le familv, townhome, or condos that are
under construction and are not owner /occupied.
• HVAC: 0-100 M B T U --? $ 24.00
ADDITIONAL 50 M BTU YPAB
• Gas outlets (minimum of one required @$3.00 ea.) 3,00
• State Surcharge: .50
• TOTAL:
770
Complete this section onlv if vou are remodelin¢, addin¢ to, or repairing ezisting single familv
dwellings, townhomes, or condos.
_ Add-on furnace _ Add on air conditioning
_ Add-on air exchanger, i.e. Vanee system, etc. _ Other
Minimum fee applies to all remodel or add-ons of existing residences $ 20.00
State Surchazge .50
Total: $ 20.50
srTE nnvREss:
OWNER NAME: TS /Ta,22ES PHONE #: 4?
INSTALLERNAME: _'0?4uTi..a/? PHONE#:
STREETADDRESS:
CITY: %r / ?d?G ?t•'qif?5 STATE:&AI ZIP: _"007
SWWWRE OF PERMITTEE
.I
CITY USE ONLY
L BL
SUBD.
RECEIPT #:
RECEIPT DATE:
1997 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612)687r4675
Please complete for: ? all commerciaUindustrial buildings.
? multi-famiy buildings when separate pertnits are not required for each dwelling
unk.
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: ?$25.00 minimum fee or 1% of contract price, whichever is greater.
? Processed piping - $25.00
? State surcharge of $.50 per $1,000 of eo rmit fee due on all permits.
CONTRACT PRICE x 1 %
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS
OWNER NAME: TELEPHONE #:
TENANT NAME: (innPROVEnnEnrrs oNLv)
INSTALLER:
ADDRESS: ?
CITY: STATE: ZfP:
PHONE #:
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
aa
CITY USE ONLY
L 8L a2
SUso.???a?%
RECEIPT #:
gro (e k? g'
RECEIPT DATE: Q111 / 9
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3630 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-1675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES EACH N P. TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Sath Tu6 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/5pa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping OuUet ' minimum - 1 3.00 x =
Rough Openings 1.50 x =
Water Softener ' for dwellings under wnshudion 5.00 x =
Water Softener ' for existing dwelling 20.00 x _
U.G.Sprinkler "tardwellingunderconst. 3.00
U.G. Sprinkler ' for existing dwelling 20.00 =
Alterations ' to existing residence 20.00 =
Water Turn Around 20.00 =
Private Disposal System ' Dak Cty Ilc. 75.00 =
(new and returbished systems)
Private Disposal Systems " AhandonmeM 20.00 =
STATE SURCHARGE .50 n
?
?a
TOTAL
I herehy adcnowledge that I have reatl this application, state that the iMOrmation is correct, and agree W comply wiN all eppliceble Ciry
of Eagan ordinances, it is the applicaM's responsibility to notify the property owner that the City of Eagan assumes no liability for any
damages caused by the Cily during ifs fromrel operational and mainlenance activities to the facilRies mnsWaed under this pertnit wkhin
City praperty/rightwf-way/easement.
SITE AODRESS: W?_k? U V N e- W Q CXX S `'(, C- ct4 apl
aWNERNAME: ?"? VV) 0`Y)
INSTALLER NAME: ow?i -e r TELEPHONE #: yS (o -DSL/ ?
STREET ADDRESS:
cirr:
i?-»-y7 T C,
4fi
STATE: ZIP:
C(/1/UUri?? d'
SIGNATURE OF PERMITTEE
Extabllshed in 1982
LOT SURVEYS COMPANY, IMC.
LAND SURVEYORS
RECISTER$D UNDER THIC LA118 OF 9TATE OP 111NNESOTA
7e01 7Jrd Meow North e1Q-600-3099
l'ox No, 6a0-368E
J S HOMES
HlapSapolls, Mlnoowot, 661$B
*ururgnrs (grr#ifiratr
Property located in Section
25, Township 27, Range 23,
Dakota County, Minnesota
Property address- 541 Havrthorne Woods Drive
NIf?E::Sanitary sewer invert elevation= 890.7
i
?I0
?
?
s"v a ;r
?
`
?3b
eq}b .
s ?
?. ?
<
ZN
?
V11 /
?Jt l ?,3 ??P 33
Jt r ? '?
A
M\
?
sn
? Lot 29, Block 2, HAWTHDRNE NOCDS 2ND ADDITION
?
s;,ti?.2av ?;
Propossd butldinq Inlormollon rrwal bs chscked wllh approved buildinp
plon bGlore dwcorollon ond conslrucllon. '
Tha ordy eosemenls shown ore from plab of racord w InIormoUon
provided by cllenl.
Wa bereby eeN{ly thol %hb Is a Iroa orM corracl represeninlivn ol
a wrvey ol tM boundatlss ol Ih* obova descrlbed luid ond lhe
locallon al all Auhdinps md vinible, oncrDOChmanle, If any, from or on
fold lond.
Surcveyed br uf Ihls 18th doy of _April 19-27
•'.riiVt?} nf;i .i'.
?
?
Q-rV s-t-97 sign.a
Rev 4-22-qn CtKwM. F. F"d'r.°^, rn'
?O\9,;L _gq33 ?D i
.n ?
?
?
?
? 01.6
,
1 9 R
)
O_ o
IV
z \?9?
, y?
` 9•\ v?
6? ? \
?
INVOICE N0... 462sfi
,
F.B.N0. 766-G2
SCALE: 1 30'
0 o.twt.. ra, u«r,m«,t
U pwmlot Wood flub So1
fa eMCOralion oriy
x000.0 Uwioleo Erbtkq EMvallon
arwtes Ptoposed EMvallon
Uwwloo Svloco Drainoqe
q04'-' Prcposed Top of Bbck
6l03' , !''fopo.ed CQape Fbor
? 6•1" Proposod Lowool Fbor
Type of Bu1Wkp
rvtL tripsEMEr.r, u1AL,lLo,n-
?
?Q
,
\.
b9 y.f?jr ?
,??; a
'!Z?,,o ?OS
q9?v-
L-
\ ? ?• ?a ??' ?
eab.e '? ? ? ? 15
p
Establlshed in 1982
LOT SURVEYS COMPANY, INC..
LAND SURVEYORS
REGI3TER$D UNDER TH6 LAlIB OF 9TATE OF 1dINNE90TA
7601 '/3rd Mmuo North !la-6E0-9099
rat No. 600-96EE
YlnoNpolL, ltlnnewlo 664$0
??urur?ar?c (?er#iftcttir
J S HOMES
Property located in Section 25, Township 27, Range 23,
Dakota County, Minnesota
Property address- 541 Hawthorne Moods Drive
NIfTE:=Sanitary sewer imert elevation= 890.7
?
yA s
?A
Pk
?
? ? ra
• o\ ?S ,? b9?' A4 0/
`l ? ???"`?",? ? •?,4??Q? py /'?
?
? p D
Ac
3,?6 ? s ?,w •
•3'
60 26 C?
89b.b Wk
9b6 ?
INVOICE N0. aemr, .I
F.8.N0. 766-02
SCALE: 1 " = 30'
o DMwIeo kon NuMrmat
n p«,ot.. wooa K,n s.t
for excorallon My
x000.0 Uenoles Edeikq Ebvallon
Ed Dwwlon PropoNd ENvallon
Derwlee Surfoce Oralnops
q04.1- rropo..e rop ol Bbck
qo31 propoted Carop. Fbor
89 6,1, r,opo,.a Lo,...t Fwa
Type a( Buhdlnp
ru1.L 8AsEF4E", WAt,tc.v,m
?
X
A
,
? -?
? 93
.?
Lot 29, Block 2, NA4fTHORNE NOG05 2ND ADDITION
L L
E;A!k_"u?, -E?Ni',r'Tt4'E.:RINti T?F.1'T,
Propossd Iwlldiny Informolion rtwsl be chscksd wilh approved buildinp
plon belorv dreovollon and conslruction. '
The only awemenb shown ars hom pbte of recard or inlormalion
provided by ctlml.
Ws hersby carllfy thol lhls ls p lrue ond correcl feprevenlolioa ol
o rurwy of lhe boundaris• of Ihe obova dasmlbad Imd ond lhe ,
loCOllon o( uA 6u0dinqs ond vlslble. ancrpocMnenle, If any, Irom or on yr._.
sald land. e-cv Sipnrd ai(-VAJ-A?
s-1-9'?
Surveysd by ua \hh l8th doy ot Aoril 19-U- Rev 4-22-9'7 ChwNs F. Mderson, Mm. R?q. No.21763
: _ ..:_ _ ___ ----- -- - -_ ------------------- - - ---- ------ -- - -- -------- - - -- -_ _
MATCN UNE- CONTINUEO SBW 2Ml
sewaao sewa+az
ro SHEET W. 9 •,v;M4!'
4 U ? •IB??wJQ? ? a56.w 1] ? n18B 15G-C9
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' 46W2f12 034"34 2 ? 35 37 NYOF4NT
36 B£NCXMARN: UNDEF CITY CONiR4CT CONCURHENT WITN
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? \ ]1'..46 M.N.2 38 iTq ]2HC CONfIRM IOCATION 6 ELEVATI6N.
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7YPICAI. SERYICE
f T?e -- I I ? SEWER-4' P.V.G SOR 2C
J i I WATER - I' TYPE K COPPEA
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AT NORTH ENTRANCE TO PINEt'A700 EIEMENTARI' SCHWL,
NE OUAO. ELEVATIDN • 932.7T .
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Use BLUE or BLACK Ink
r---__._____--_-__-
I For Office Use
Permit 1 V
City of Ea~ai~
I Permit Fee: V~ I
3830 Pilot Knob Road I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: _Tott- 64- (A,MQL_ Phone:
Resident/
Owner Address/ City /Zip:/ i_t i~✓Ow~
Applicant is: Owner Contractor
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Type of Work Description of work: A. enr_e. _ ~
Construction Cost: Multi-Family Building: (Yes /No Company: Grp K 1~`=- r Contact:—
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Address: City: t J a
Contractor
State: zip: Phone: G 17- - b 0 2
License ® 6 ,:~,6 y t3 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?
i _Yes No if yes, date and address of master plan:
{ Licensed Plumber: Phone:
f 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 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 State Building Code must be completed within 180
days of permit issuance. I~
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Applicant's Printed Name Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA124722
Date Issued:07/09/2014
Permit Category:ePermit
Site Address: 541 Hawthorne Woods Dr
Lot:29 Block: 2 Addition: Hawthorne Woods 2nd
PID:10-32151-02-290
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Tony Boerner
2090 County Road 42 W
Burnsville, MN 55337
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 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 -
Thomas F Stumpf
541 Hawthorne Woods Dr
Eagan MN 55123
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA154652
Date Issued:04/05/2019
Permit Category:ePermit
Site Address: 541 Hawthorne Woods Dr
Lot:29 Block: 2 Addition: Hawthorne Woods 2nd
PID:10-32151-02-290
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: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Thomas F Stumpf Tstes
541 Hawthorne Woods Dr
Eagan MN 55123
Clear Choice Restoration
2722 Hwy. 694, Suite 100
St. Paul MN 55112
(612) 259-7177
Applicant/Permitee: Signature Issued By: Signature