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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 •' r ? ? ? 9[ ,VCINIAp.r SBWIfDt ? , BJ9.P /SBIYl+T9 i ? 'iOPwfel.KJ AMT s?.?l?. `?N(5 6"-1/I6BEN0 a9.v90' 8XA8 65M y?%' I 99Y.i INPLACE M4NN0.E NO IW TO BE INSTALLED ' 46W2f12 034"34 2 ? 35 37 NYOF4NT 36 B£NCXMARN: UNDEF CITY CONiR4CT CONCURHENT WITN SC4Lf iN iEET TOP NUT Of B16Ar? $3 \?'SOWOM3.} ? I EIEY.?BIRIJ Dli(LEY FOaD 1993 CONSTPUCTION 6rf? ? \ ]1'..46 M.N.2 38 iTq ]2HC CONfIRM IOCATION 6 ELEVATI6N. SBWNOI ?B6lB I SIIPQC2B1 JBW0-93 r30;rl2' ' •ae'.w?6' 32 HYDRANT \ J s' 3251 L.no' wo ,R,?' ' selo 6?%6'TEE 4I0 B.v? SBw0r37 31 39 14e:.367 3Yn Lr. ?1 '^ II I BB)B 4p• 1 ?? -6° \. ?. \ ASb? HYORANT I II II 4 sew?w? A?_ ? ? /? li 6*X6"TEE rypWTiqRNE VqOpS DFIVE VI 32,52.09 B90 ) 33 aO MH 4i 40.0 ' ?so' i r' i o E co. no Ho. w P.oT.23.11 8 44.0' N.O /? ? /I 6"-I/I6BEND rsd r ? ?A y ? V ri I r ? I 29 ? n J Z M.H.3 an.o vo'c zs.se . no' 310' M.O92.0 MH.5 s'muc.swcwux 9 10 no' 6" r [3,flTPOC.200 1 A.3 . ? v I Q I ? ? B 6'-I/I60EN0 SBW0.39 ' 360? ? 6 L u O 836?,wI6' II \ ? />0 58WOI9B SB9T W w36ls?3, 8302 IS ? ? W 1 ? y O 7 s06.v]B 8397 $BWffY9 430' 86I3 s40.13 I m ' . . . , I sexr+m e414 12 > ? / .-? • 6 16:wIB' ? ? •-. ?? 9f5 BTJ.) ? I? ? I • ? ??? ^ ?// SBWNBt ? SeWlrll 6"UIPSTBW -q W T80? 4D.wOB' aM?MSB? ____ BYCITY-REAqVE T ? T y 5 BB0.0 W6B FWG 9E iEN 1 r y „o B \ ?? PER 1 NO28: 6LL SCV? IIm tY2s SMPICFS TO !L PSIQIDm +31 SOW3 P93' 4 / i u• o• IXgma ? LINE rM CIn S,ANDAIM oMM fiw wo.ea unum s rrv p P? M'S 300 Y0 730. wnn Stior N.S.o.) se 1 \ e6?.?lY ` - iPOM D?jlEr m, O LOCAiIW13 NOSS ?I OVfSIDB R/W L a ?? SIDdAfi. {1 3 BBAJ M]AD I° A ?) ???? CLEARMa ? ilE lWTI016 OF E%[STU6 LIUFWAd1D VtA31IF5 enE 9DMN IN 9n NPRLpiM B52o 9WU JHL4 T£ EWICT WCAt[a? 1 ? \ L_J I I v o . 1'E E%GVAit?4 CWiM[IOM oE?f Vr?"+ ESvt?G V?TILIT?IES? m??I ? ?SI?dNEE05BY?MIS F I FDA Rl LU1E 8 ?S ^ i? • ? Lp{pTE pryp ppESEpy( pHY ND ALL L1aEACROAn VTR[TIES. 7YPICAI. SERYICE f T?e -- I I ? SEWER-4' P.V.G SOR 2C J i I WATER - I' TYPE K COPPEA BM? HAWTHORNE WOODS D R I VE BENCMMARK. NP M/T HTOAMT Np?Tl1 SIDE HACKMORE AT NORTH ENTRANCE TO PINEt'A700 EIEMENTARI' SCHWL, NE OUAO. ELEVATIDN • 932.7T . MN.I 5 MH.I 4 - I RE90i? ' 900 H96.0 __ FEB9E? ' . _. ? ¢ 1('^:'? S.`i "' ..' r ',.a?• ' 890 uTji..{6I `` J, aweres?eg?amE « M.H. 3 " . ?.iN3. ' 170LF.-e'PV.CrSOR33 . 880 ' 32BX 1 l ... . . _ . . /?•' y? - ! -373 ?-± YiIV'?LVVa?jji3i M.H :6\17?T S ONTHr:-SITE. ? - ' M.H. I i h 330 7.02 x ° 486LF.-8'PV.C.-SDR 35 - .7?^8'.G o m ` ! 20L.F.-e'DI.P-CL52-728h ? N0. i<i IUNDEF Grtv . fANiFACT: o . . • ?. •• T.5 MRl ? i 850 CWEF-._. SDR 35-364X s-W4? W 3.39 M4iry ? ? ? , ? 1 - 4wae le"rrcp? . 52 a ? m ? . . .. . 830 268L.F.-8"PV.C.-SOR 35-796 73 21 22 " . -5 ?`?,?,•,J ? ' _ ? ?_ ?C1?•9?RL.?p%19YUT? , 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 I Type of Work Description of work: A. enr_e. _ ~ Construction Cost: Multi-Family Building: (Yes /No Company: Grp K 1~`=- r Contact:— _ , ~.,1x I 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~ x ~A \r, x V✓t3~--~ _ 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