702 Hay Lake Ct?
' CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
INSPECTION RECORD Control No. 0 8-8 5
PERMIT TYPE: "11t IA11"a
Permit Number: 00.1166
Date Issued: 01/3019Z
SITE ADDRESS. I n T: 6
= 0.' NA1f L A#cE G1
p A T R T i;.h r
r- ?-._ -
PERMIT ?j?)TYPp-:
APPLICANT:
Hu1"1NER CoNbF3eUc7 io14 WM
11612j) 7r:3-4161
TYPE OF WORK: NEu
RaNAr.r.?., pRv s z WCONittAC11?R •- 51Att ptne
'
PsMR No. PermH Hoklw Date TilepAone #
S/1N
PLUM8IN(3
HVAC
ELECTRlC ? 1471 y??'? ?
ELECTRIC
Inspectlon Dste hmp. Comments
Pootinp I
F"dafi0n S/ ? iL'C B?
Frarrdnp
QL Q aln? / S'.y?c?1r?
nG
BoDfi
Rough Plby. ,.(/.??, f}SS
?,lL
Rowh HtB'
16uL
?,?
v-- VFF-e?` ??', ?,7:? 7?
Rrkal Mo. o.? ?Z D S
Orsat Test
Final Plbg.
.? Plbp- h?speCtOr- Noltty Wmber
Const. hAeter
EngrJPlan
8ldg. Flnal
Deck Fte.
Oeck Rrtial
wou
Pr. Diep.
G
'? - ?L_?r •,.i
t?,`?tificate vf cccupanc?
Mm of ftean
TqM1 ing Iii of sawaing 3*60ted"
This Certificate issyed pursuant to tht requir+emerets of the Uniforin Building Code
cerlifyiag drat at dee 1vw of issuwrce r?iis structure was in cartpliance with the various
ordinances of dee City regulating building construction or use. For the following:
SF DWG 1166
Use Qamdkation: Bldg. Permit No.
Occupancy Type R-3
WM M-1 zomim Didrid
UTTNER CONST R-1 ry? ? V-N
960 WATERFORD DR W
Owner o(Budding Addmu
BtnWing Addrcas Q HAY LAKE CT L, H1 , PATRICK
Lnntity
OCT 22
1992
,
Doe:
BMKM 6ffMW
POSf IN A CONSPICUOUS PLACE
06?595
REDUEST FOR ELECTRICAL INSPECTION
? Sea insimdions far completing ims form on beck of yellow coOY
X" 3eloc3 Work Covered by This Request
ee-ooaai-oe
€ /D S'l/j-
'?. aa..
e Atltl Rep. TypeoiBUilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplez Water Heater Elactric Heating
Apt Bmldmg Dryer Other (Specify)
CommJlndustrial I FUmace
Farm Air Conditioner
Olher(specdy) Coniractor's Remarks
Compute lnspection Fee Below
# Other Fee # ServiceEniranceSize Fee # Circuits/Feetlers Fee
Swimming Pool 0 to 200 Amps o to ioo Amps
Transformers Above200_Amps nAmps
Signs mspectors Use oniy: TOTAL 7 ?O
IrngaaonBOOms
Special Inspection
Alarm/Communicahon THIS INSTALLATION MAV 8E ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MQ?ITHS,4
I, the Electrical Inspector, hereby Rouqn-in oaie {Q, l_ Y
(
certify that the above inspection has
been made. Final oate
OFFICE USE ONLV
TM1is requesl voitl 18 moniM1S irom
06595
i o ? ??5 /?l
Repu st Date Flre No Rough-in Inspecem
R tl9 ?
? Raetly Now1[lyMf Notiry Inspeaor
es _ No ' ?een Reatly?
I"? ? ensed conhactor ? owner hereby request inspection of above elecuical work at:
Jo Aaaress (SireeL Bov or Route No.1 Ciry?
? d
Section No Townshi0 ame or o Rang¢ No County/?
v
Occupanl INT) ' Phone No
? d-il.. e
Power Supplier Atltlresg
/
Elec[ncal GonVactor (COmpany Nema) Gontreo???
DALE FRANKE ELEC, INC ?
MaiLng Aatlress iGOnvactor or pwner Making Installation?
12803 FLORiDA LANE ?PLE VALyEy MN 55124
ontrattonOwnar Makmg Installation,
NmM1m11etl Sig ure PM1one Nyr??e??Q,
a1
?? '
)
? n ?? `Z _ ? VJ
MINNESOFL51?B9?TY THIS INSPECTION FEQUEST WILL NOT
Griggs-MlEway Bltlg - Foom 5473 BE NGCEPiED Bv THE STATE BOARD
1821 Umversny Ave, SI. Paul. MN $5109 UNLESS PROPER INSPECTION FEE IS
Phone(612) 6/3-0800 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION F°. 7"`?rA ?ooooyoj
? See insimceons lor complenng this lorm on Oack of yellow copy.
d 0.9 8 4 7 'X" Be/ow Work Covered by This Request
ew Sldd Rep. Typeof8uitding AppliancesWued EquipmenlWired
Home Range 7emporary Service
Duplex Water Heeter Electric Heatinq
Apt. Building Dryer Other-(Specify)
Comm /Industrial Fumace
Farm Air Conditioner
Otner(syecdy) Conhacmr5 Ramarks
Compute fnspection Fee Below:
# Other Fee # ServiceEntrenceSaa Fee # CircuitslFeeders Fee
Swimmmg Pool 0 t0 200 Amps O to 100 Amps
Transiormers Above 200 _ Amps Above 100 _ Amps
Si Jn5 Inspecror5 Use Only, 7pTAL /.?
_
trngahon 8ooms 6
T i
?
Special Inspection ,
Alarm/Communication THIS INSTALLATION MAV BE OR CONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspecbr, hereby
cenifythattheaboveinspectionhas
been made. Rougn-in
F,nai oete
oaie
?
OFFICE USE ONLV •
This request voitl 18 months Irom
47 7/,0 -/-/
9 8
?
?
Re ujfst ate
+
(^?
I
r Fre No. Rougn-in Inspecuon
Feqwredi
? Reetly Now WAI Nobty NspeCtor
1
pf? '7? No WhenRee0y9
I:1 licensed contractor rJ owner hereby request inspection of above electrical work at
Job Atltlress IStreet x or Route No ? Ciry
Section No TownsNp Name or No Renge No Couniy
Occupant(PRINT) Pnone No
5
ES 3
Power SuOPlrer Atltlress
Elecn¢al Comracror (Company Nema) Con
or5 L
icense No
Vact
/i
.O LC?? n
M
?
C?nC.l? ?i
Mahng Aadress (COnlractor or Owner Makjng Installalion;
NNhonzetl Si ? e ICO on ner ing Installauonl Phane Number
/
-3
MINNESOOlARTATE BOAPD OF ELECTHIqTY THIS INSPECTION FEOUEST WILL NOT
Griqgs-Mltlway BIEg. - poom &173 BE ACCEPTEO BV THE $TATE 90ARD
1821 UNVerslly Ave.. St Pcul. MN 55704 UNLESS PROPER INSPECTION FEE IS
itlone(6i2) 642-0800 ENCLOSED.
Address: 702 HAY LAKE CT LotS Blk 1 Sec/Sub PATRICK
These items were/wera not complete at the time of the final inspection.
Date: OCT 22 1992 Yes No
Tnspprtnr-
Final grade (6" from siding) tle Cn Ze
Pexmanent steps - garage ?
Permanent steps - main entxy ?
Permanent dtiveway
Permanent gas ?
Sod/seeded grass ?
Trail/curb damage
Porch y?
Basement finish ?
Deck
Please verify with the builder the removal of roof test caps from the plumbing
system and the shut-off of water supply to the outside lawn faucet before
freeze potential exists. ?
maueoarex
Whita - City copy Yellow - Resident copy Pink - Contractor copy
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
J 651-681-4675
NawConstructlonReouUemame RemodeVlieDalr eauhemeMe
• 3 registeretl sile surveys showUg sq• fl. of bt, sq. tt. ol house; antl Ag roofed areas • 2 copias of plan
(20% marinum bt coverage 8lbwetl? . 1 set ot Energy Calculatbns lor heatetl add@rons
• 2 ooples of plan showing beam & wintlow s¢es; poured tound desgn, etc.) • 1 sNe sunrey for extetlor addttbns & decks
• 1 set of Energy Calculetions • Indicate tl home servetl by septic system for additbns
• 3 ooples of Tree Preservation Plan'rf bt platted aker 7/1/93
• Rim ,bis[ Detail Optbns selec[lon sheet (hMgs w8h 3 or less units)
DATE
SITE ADQ
NPE OF
AULTI-PAMILY BLDG _ Y D<N
FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT l?Cma Yk?YLrio l- ?cC1?xQ ?QNt11C'St S? LLK' ,
STREETADDRESS I?DI- 6Yi dQ1v SrQ?? ClNvaur??f L i STATE(yY4 ZIP?5S?L-l
TELEPHONE#(If?Q-1`?S?JAOCELLPHONEI FAX#CEDD') LA5?
PROPERTYOWNER JVYkkAS ?Y?(lfX?¢?o? ?11?4'lSCSr? TELEPHONE#
COMPLETE THIS SECTION FOR -NEWff RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7610 CATEGORY 1 MINNESOTA RULES 7672
(4 submission type) • Residential Ventilation Category 1 Worksheat Submitted • New Energy Code Worksheet Submittad
• Energy Envelope Calculations Submitted
Plumbing Contractor: Phone #
Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee:_$i90.00
Water Heater No. of R.I. Biths nn j q"'?
_
No. of Baths
L
Mechanical Contractor. Phone # -
Mechanical system includes: _ Air Conditioning Fee: $70.00
_ Heat Recovery System
Sewer/Water Contractor: Phone #
----------°--------------------°-°-----°---------°---------°.-.._---------------------------------------------°°--
I hereby acknowledge that I have read ihis application, state that ihe information is correct, and agree to comply
with all applicable STate of Minnesota Statutes and Cfty of Eagan Ordlnances.
Slgnature of Applicant
. . . ...... . ............ . . . ... . . . OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
9'5??
VALUATION Dbo
?
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex O 20 Pool ? 30 Accessory Bidg
O 02 SF Dwelling ? 08 06-plex ? 16 Fireplace O 21 Porch (3sea.) ? 31 Ext. Alt - Mulli
O 03 01 of _ plex ? 09 07-plex ? 17 Garege ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
O 04 02-plex O 10 08-plex ? 18 Deck O 23 Porch (screened) ? 36 Multi
? OS 03-plex 13 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex O 12 12-plex PIbg-Yor_ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reraof ? 46 WindowslDoors
? 34 Replacement 'Demolition (Entire Bidg only) - Giva PCA hanlout to applicaM
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbmg
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
Ciry SAC
W ater Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Pertnit
License Search
Copies
Other
Total
Building Inspector
PERMIT
CrTY dF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
Control No. vfa g85
PERMIT TYPE:
Permit Number:
Datelssued:
BUILDING
001166
@7/30/92
SITE ADDRESS:
,,'Building Permit Type
, SF DWG
8u31ding,Work 7ype NEW
UBC Ocaupaircy R-3 M-1
Construction°"fype V-N
Toning , R-1
8uilding Length . 67
BuildirSg W3dth 37
94iltl?irug eCories =^' 2
_
?
t e
DESCRIPTION:
REMARKS:
PRV
FEE SUMMARY:
702 HAV LAKE CT
LOT: 5 BLOCK: 1
PATRICK
.- 3x
?
S & W CONTRACTOR
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Subtatal
' 7
STAR PLBG
VALUATZQN $147,000
$504.00 MTSCELLANEOUS
$522.60 Total Fee
$73.50
$700.60
100
$2,1@0.10
$1.610.50
$3,710.60
CONTRACTOR: - Applicant - ST. LICp?yNER:
HUTTNER CONSTRUCTION WM 14523088 0001653 WILLIAM HUT7NER CONST
960 WATERFORD DR W 960 WATERFORO OR W
EA6AN MN 55123 EAGAN MN 55129
(612) 723-4161 (612)452-3088
I hereby acknouledge thaC I have read thic app]..icatiori and stat•e tkrat the
informatian is aprrect and agree ta comply with all app,licable State af Mn.
Statutes and City of Eagan prdin•ances.
L
L
' APPLICANT/PERMITEE SIGNATURE ISSUED V: SI UFE
FERMIT #
REACTIiIATE '
I I LL
CITY OF EAGAN $5' ? 10.0
1992 BUILDING PERMIT APPLICATION
681-4675
W` 2 ! IIGLU'
SINGLE 6 MULTI-FAMILY 2 sets of pl'ans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest i s made or lot chan e is re uested once ermit is issued.
Date -7 / zj / ?Z- _ Yaluation of work
Site Address:
STR T SUIiE M
Tenant Name: (commercial on ly)
LOT r_ BIACR SUBD. P.I.D. # ,
Descri tion of work:
The applicant is: ? Owner Contractor ? Other (Deseribe)
Name Phone
Property LAST FIRST
Owner
qddress
STREET STE M
City State Zip
Company Y'Ln'' Phone VS2- -3off1
Contractor Address ?I a-f0r 1 o-4d( 'gr 9) License #/CO Exp. 3?
City 5tate ??t Zip
Company Phone
ArchitecU
Engineer Name Registration #
Address
City State Zip
Sewer 6 water licensed plumber S7'_?,-r p& u i . Processing time for
sewer 5 water permits is two days once area has been a proved.
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 innesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex 11 11 Apt./Lodging
IK 02 SF Dwg. 0 07 4-Plex O 12 Multi. Misc.
? 03 5F Addition ? 08 8-Plex ? 13 Garage/Accessory
? 04 SF Porch ? 09 12-Plex ? 14 Flreplace
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck
WORK TYPE
J4 31 New ? 33 Alterations O 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
?., ?• ? ..
El 16faserygnLFinish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. M1sc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
Const. (Actual) Basement sq. ft. / MWCC System ?
(Allowable) lst Fl. sq. ft. City Water
UBC Occupancy Al? 2nd F1. sq. ft. ieog PRV Required
Zoning Sq. Ft. total Booster Pump
A of Stories z Footprint Sq. ft. Fire Sprinkler
Length On-site well Census Code 7a7
Depth 3 7 On-site sewage SAC Code o/
APPROVALS
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
? Site El Footing ,p Framing El Insulation
? Wallboard JD Final ? Draintile ? Fireplace
Permit Fee
Surchar
e vetuacim: g Ddo
R
?
/
-?
g ,,.
?
/
c t
Plan Review 2P. ,,l-.?3 m
JZy .
License ,
MWCC SAC 23gL
City SAC
Nater Conn. 3 Z
(p?0
Nater Meter
Acct. Deposit
S/W Permit
S
W 2Z?LA,./?? ?iScy
/
Surcharge 24 ?
Treatment P1.
Road Park Oedt 3 ?,?,
S3?/zy
O
lG/??
°O
Trails Ded.
Copies
Other
Total:
SAC %
SAC Units
•---- -- ---• -- -? -- ----- -- ----._----- ..
,., TO EE SlJ94ITTcD LlItil IIUILDIf1C PiiUiIT AI'PLTC,1TI09
" M:TErIOR FNVF.LOPE AVERACE "U" CO:q'UTATION "
Ot'NER:
53TP ADDRESS: OZ- Z
CANTRACTOR: 0 pl- 14 DATE:
4 <Zrjl P}IONE•
• 7?L -?o
_
Determine vorking aquare footage of each
1. Total exposed wall area......... eq.ft. x ° b
2. Total roof/ceiling area......... ?z 3.0 sq.ft. x -OL?
3., Total exposed wall area calculations: .
Yotnl exposed wall area above floor
a. Total wall vindoW area ............................
b:' Total door area ..............••'................... 39
e. Total sliding glass door area ..................... ffO_
d. Total firep.lace e+all area ........................... --
e. Total wall framing area (average I07.) ...............
f: Total net wa11 area above floor ..................... Z57
S. Total rin joist area ................................ Z
Total exposed foundation area m 13 O
h. Total foundation vindov area ........................ -
i. Total net foundation area above grade ............... 1.30
Dete=mine "u" value of each wall segment
8. z6 Y x „U„ /0 8, z
. b. ; ? x „u,. >>.?g
. C. Fo x „U„
d. ? X fluff
. B• _3? ?o x tsUlI io/
. f. Zj %( x P,U„ , oK
X „ull , a q _ , 7h
. h -- x „u„
-
t. 130 x lou„ 13,0
3. • rorAt. ?•'•. . 31y.7y
,
If item 03 is [he same as, or less than item 01, you hnve mct the intenc of
SBC 6006(c)2. '
.i? .
4.' Total exposed roof/cciling calcula[Sons:
?
Total e;cposed roof/ceiling area n )230
J. Total skylight area ................................... ?
k. Total roof/ceiling framing area (averay,e 107.)......... /L3
1. Total net insulated roof/ceiling area ................. I/0 7
Detemine "II" value for each roof/ceiling segment
X .1V
-- ?
R„U„
R„U„
4. ToTAL
If total of C4 is t}ie sarae as, or- less than G2, you have n e intcn[
of SBC 6006(c)1.
Plternate Building Envelope Design
`'?t.'. ... . . : . .
To utilize the total envelope system method, the values establislied by the sum of iteas 03 and 04 shall not be greater than [he sum of items 41
and 02.
1. + 2. ?
3. - + 4. -
:
C E R T I F I C A T I O N
I herehy certify that I have calculated the "U" factozs and R values
herein and that the building heres described meete or exceeds the State of
Hinnesota Energy Conservation Act.
• • l-?G?) j??.E?Bta C ,??`v ?
(Signature).
• ?? ??? ??
. (Aate) '
'??:.
jlc lU;'of ol-?qu^ waI1 azca, for
'rainc con::tructiun
x - -j??J
? Const?zuctionF`
? . x,,;•, 1;. t2or air film
2. ,M'•'. W HQK't`...:..
3; i.nchessoftwnnd - .3
H AZ ...d. . 2.0
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BASIC`? 6:, 'Exterio=<nir`IA?filmL:.
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,.:Il :??? ??r` ; y' .- ',`' .. ,•. ' ' f;' '.,z" +
?r','?? 1 s.,-}.,,ir..k'-'? 1 ..v??^:`:M• :?a.?,-'tx :?:=::,.
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6. Er.terior air £ilm 0.17
I . . TbtSl
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1. Interior air film 0.68
\ 2. 11'45 , ?? T7KCrJ? 7,SD
y? • 3. 12" BCOliK
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UFcR TII. NANCV
? ? . 1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
' CITY OF EAGAN
3830 PILOT KNOB RD - 55122 o? J v
---7 ( 651-681-4675 C
New Confhudlon Reauhements Remodel/Reoair ReaulremeMS "
? 3 reghtered sRe surveys showing sq. tt. of loi, aq. H. ol house 2 coples of plan
and gq rooled areas (2046 maximum lof coveraae allowed) 1 seT of energy calculations For heafed addBlons
? 2 coples of plans (show beam 6 wlndow sizes; poured tnd. design; etc.) 1 s8e survey for exterbr adtlNfons a decb
? 7 set ol energy calculations
s 3 copies oF free presenafton pfan M lot plaMed after 711193
DATE: CO Z? r!?j CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS: _q N
LOT: ? BLOCK: I SUBDJP.I.D. #: ??-?x `t C 7C /
600Ae1c'C/j2'33Cr S? (o?)
Name: LA?/n ly>?'e4A itl Phone #•
PROPERTY L°st Ftrst
OWNER -702 /-{L} C./?/?.??
Street Address: y
City 6_4 ? State: ?AJ Zip: v.51 Zz-
Company: Phone S:
(area code)
CONTRACTOR S?-?
Sheet A ress: License # Exp•
ARCHITECT/
ENGINEER
City _
Company:,
ielephone #: area code ( )
Street
C'iiy
Sewer 8 water licensed plumber (reautred for new conshuctlon onN1:
State: Iip:
Name:
RegishaHon #:
State:
PenaNy appltes when address change cnd lot change is requested once permB Is issued.
Zip:
i I hereby acknowledge that I have reod this applicaflon, state that the iMormation is cortecf, and agree to compiy wHh all applicabi
State of Minnesota Statutes and City of Eagan Ordinances.
Certificates of Survey Received ?! Yes
Signature of Appilcant:
__----. -" , .. , •
( t-- -
?1 ?;? ?C;• - -- - '
OFFICE USE ONLY
No
Ii ...mv I `.
Tree Preservation Plan Received - Yes - No - Not Required
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 p 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of
plex ? 08 6-p{ex ? 13 16-plex JN?, 18 Deck ? 23 Porch (screened)
? 04 _
2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? OS 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
31
,6 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
\
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg." ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
' Give PCA handaut to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Census Code
SAG Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
?
?
-?-
APPROVALS
Planning
Building a
Engineering
Variance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNV Permit
S!W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $ 1,206)
t
SAC Units
% SAC
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
' 3830 PILOT KNOB RD - 55122
659-681-4675
Conahuclion ReauGemeMs
? 3 regfrtered sMe surveys showing sq. R. of lot, sq. fl. of house
and gLi roo(ed areas (20% maximum lot eoveraae allowed)
D 2 copies of plans (show beam R window sizes; poured fnd. dealgn; ete,)
? 1 set oF energy calculations
D 3 coples of hee preservation plan H IM plalFed afler 7/1 /93
DATE: 'S/a
DESCRIPTION
STREET ADDRESS: W
- al?
LOT: BLOCK:
Remodel/Reoair ReaulremeMs
2 copies oF plan
1 set of energy calculafions for heated addNions
1 aMe survey for exterior addlNons 8 decks
CONSTRUCTION COST:
f SUBD./P.I.D. #:
PROPERTY Last Ftrst
OWNER
Sfreet Address:
Ci1y
ComE
CONTRACTOR
Sheet
Ci1y
ARCHITECT/
ENGINEER Company: ?
Telephone #: area code (
Sheet
City
Sewer & water licensed plumbei
Penaly applles when address c
1 hereby acknowledge that I h
State of Minnesota StotuFes a
Phone #:
State:'! J? Zip: T-3 0-??
Phone #: 6 ?,f 3 7w%
(area code)
License 8
State:
Zip: S s°zZ
h ge and lot change is requested once permB is Issued.
e read fhis appiication, state that the IntormaHon is conecf, and agree to
City of Eagcn Ordinances.
with all applicabl
Signafure of ApplicaM:
_ .?
OFFICE USE ONLY -
Certificates of Survey Received _ Yes _ No iuAY 2
Tree Preservation Plan Received _ Yes _ No _ Not Required . 4 _
i
...
L
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 1 of _ plex ? 08 6-plex ? 13 16-plex )3? 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 ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bidg.* ? 41 Wood 5tove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
' Give PCA handout to applicant for demolition permit
GENERAL INFOR MATION
Const. (Actual) 5- -1 Basement sq. ft. • CensusCode 434
(Allowable) in? Main level sq. ft. SAC Code o l
UBC Occupancy R- -3 sq. ft. No. of Units
Zoning 2• t sq. ft. No. of Bldgs o
# of Stories - sq. ft. MC/ES System
Length - sq. ft. City Water
Width ? Footprint sq. ft. Booster Pump
PRV
Fire Sprinkiered
APPROVALS
Planning Bu ilding -&,ffW- ,--,ZEngineering Variance
Permit Fee Valuation: $
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
Total:
SAC Units
% SAC
L_--?_ eL CITY OF EAGAN
PLUMBING PERMIT
SUBD.I?a/'?.L?GaC./2 (612) 681-4675
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
CITY USE ONLY
RECEIPT IO
DATE .3 2-
ALSO, FOR TOWNHOMES AND CONDOS
WORK DESCRIPTION
NEW CONST xx
ADD ON
REPAIR _
OWNER NAME: (__??_SAn?cAN...e,-.
SITE ADDRESS: U'4' ?'-
INSTALLER
MATTFII3+i DANIEI.S, INC.
ADDRESS: 15185 CAEZOOSII, WAY
CITY:
Im6IId0UNP ZIP: 55068
COMPLETE THE FOLIAWING;
N0. FIXTURES EA. TOTAL
REPAIR/ADD ON 15.00
SHOWER 3.00
3 WATER CIASET 3.00
? BATH TUB 3.00
? IAVATORY 3.00 7
a v
1 KITCHEN SINK 3.00
I LAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
( WATER HEATER 3.00 s• ? °
? FLOOR DRAIN 3.00 3• c 0
GAS PIPING OUT.
f (MINIMi1M - 1) 3.00 ?- 00
.3 ROUGH OPENINGS 1.50 ck . S L
_ OTHER
WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
_ W. TURNAROUND 15.00
STATE SURCHARGE .50
TOTAL: S 44 bU
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS: _
TENANT NAME: _
SUITE #:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
CITY OF EAGAN
CONTRACT PRICE:
1% OF CONTRACT FEE. .
STATE SURCHARGE - $.SO FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1%
$
STATE SURCHARGE $
TOTAL:
$
(SIGNATURE)
YHONE #: 423-3730 '1
- CITY OF EAGAN
L Jr B/ MECHANICAL PERMIT RECEIPT # J57m
SUBD. (612) 681-4675 DATE - - - a
RESIDENTIAL
PLFASE COMPLEl'E UPPER PORTION ONLY FOR SINGLE FAMII,Y DWELLiNGS. AiSO, COMPLEfE FOR
TOWNHOMFS/CONDOS WHEN SEPARATE PF,RMITS ARE REQUIRED FOR EACH DWELIdNG UNIT.
OWNER: ,/?^ ? LtIoel C' ADD-ON A/C ADD-ON FURNACE ?
SITE ADDRFSS:
' D' L (1 ADD ON/REMODEL (E7IISTING
CONSfRUCfION ONLI) $ 15.00
INSTALLIIt: C? ?O I' S' f?T ?N HVAC: 0-100 M BTU 24.00
PHONE ADDITIONAL 50 M BTU 6.00
ADDRFSS: 3:,2_ T 1 J ST GAS OUTLEI'S - MINIMUM 1@ $3 EA. _ 00
CTIY: ifo5e_ ?-bU.c. ZIP: 5?'"062C SURCHARGE: $ .SU
SIGNATIJRE: ? TOTAL: $,f6
NO PERMIT REQUIRED FOR DUCTWORK ONLY!
COMMERCIAL
PLEASE COMPLEI'E THIS PORTION FOR ALL COMMERCIAIJINDUSTRIAL BUILDINGS. ALSO COMPLETE FOR
APARTNfENT BUILDINGS OR 01'FiER MULTI-FAMILY BUII.DINGS R'fEN SEPARATE PERMIT3 ARE NOT REQUIRED FOR
EACH DWELLING UNIT.
WORK DESCRIPTION: , CONTRAGT PRICE:
196 OF CONTRACT FEE. FEES
STATE SURCHARGE IS $.SO FOR EACH
$1,000 OF PERMTT FEE.
$
PROCFSSED PIPING - $25.00 '
MINIMUM FEE - $25.00
$
OWNER: TOTAL: $
SITE ADDRFSS:
1'ENANT:
SUITE
INSTALLER:
ADDRESS:
CI1'P: ZIP:
PHONE #: CI1'P SIGNATURE:
SIGNATURE:
CITY OF EAGAN
3830 PILOT KNOS ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
:.:: >...,. :..
FOR CITY DSE ONLY
PERMIT #
RECEIPT # G
DATE:
??DE?1'?Ii,: PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY
......
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH IINIT.
-------------------
WORK DESCftIPTION
NEW CONST
ADD ON ?
REPAIR _
OWNER NAME: -:s??5 LU?/15UY!
SITE ADDRESS: C?T
LOT: 5 nLucx L sonu.(? Qa?i?,c?f? _
INSTALLER: ?Fk? YC?'R`C1AX^?' ?C?lX7lltiX?'
ADDRESS: ?LlU&(Z ksPI1 ?d.
CITY: I?.?C:An ZIP:
PHONE #: 'k? -
DWELLINGS &
FEES
ADD-ON MINIMUM
HVAC 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS - MINIMUM
OF 1 PER PERMIT
$15.00
24.00
6.00
3.00
SUBTOTAL: $ ?In- 010
STATE SURCHARGE: .50
a ? ? R
aa. 'K
SIGNA kE OF PERMITTEE' PLEASE COMPLETE THIS PORTION FOR ALL COhAfERCIAL/INDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLSNG UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BIACK _ SUBD.
INSTALLER:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
:KiJl:i.SSEL :1Y111G - a25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
ADDRESS: STATE SURCHARGE $
CITY: ZIP:
TOTAL: $
PHONE #:
(SIGNATURE)
FOR:
CITY OF EAGAN
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please comple[e for. smgle family dwellings & townhomeslcondos when permits are required for each umt
Date (.0 / ?° / t
Site Address 102 ? 6U ? a Unit #
Property Owner _? ?jh(,nSp/? Telephone # ( (0 ? ) yS"y S
- 1? (o
Contractor
410 WE3T l.AKE g`f`AS? '
Street Address City
6124M4'26H
State Zip Telephone # ( )
Bond #: Expires:
The Applican[ is _ Owner X Contractor _ Other
Add-on or alteration to eaisting dwelling unit $ 30.00
furnace _Additional _Replacement
air exchanger
? airconditioner _New iC Replacement
r
other ?
State Surcharge $ .50
04
JUL
Total i jh $
B
I hereby apply for a Residential Mechanical Permit aud acknowledge that the inFormation is complete and accurate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; erstand this is not a
perxnit, but only an application for a pernilt, and work ' not to sYart withou[ a t; that the work ill a cordance with the
appxoved lan in the case of work h requires a revie and approval of plan .
Applic nt's Printed Name App icanYs Signature
2004 COMMERCIAL MECHANICAL PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone #t 651-675-5675
Please complete for. commerciaUindustrial6uildings
multi-family buildings when separate pertnits are not required for each dwelling unit
Date
Site Street Address Uni[ #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor ,
Street Address City
. ?
State Zip Telephone # ( )
Bond #: Expires:
The Applicant is _ Owner _ Con[ractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove *"see be(ow
Interior Improvement _ Install Piping _ Processed _Gas
Nature of Work
*'When installing/removing underground tank, call for /nspecfion by Fire Marshal and Plumbing Inspector
P¢1'mit F¢eS: $70.50 Underground [flnk mstallahon/removal
$50.50 Minemum (mcludes Sta[e Surcharge)
or
ContractValue $ x 1% _ $ PermitFee
• If ermit fee is $1,000 ar less, add $.50 => $ State Surchazge
If ae rmit fee is over $1,000, add $.50 for
every $1,000 pCrmit fee $ Total Fee
I hereby apply for a Commercial Mechanical 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 with the Mechanical Codes; tha[ I understand this is
not a permit, but only an application for a permit, and work is not to start wi2hout 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.
Applicant's Printed Name
Appiicant's Signature
Approved By: , Inspector
TRf-LAND C0.
L? SURVEYING
?
SERVICES .
SITE PLAN FoR : HUTTNER CONST.
LEGAL DES?CRIPTION: Lor 5,BLOCK_/ , PA?R1CK ./?DpITION
ACCORDING TO THE RECORDED PLAT
S2 ?Q$ THEREOF DAKOTA COUNTY, MINNESOTA
?"rADDRESS: 702 H,4Y LAKE COURT
?
51
1
I?s r,
I 4?? g
?
? HAY LAKE COURT
a
•`?`•`? 'P? .?
?a' ?S? 1SS,ep -s
9
?y1tIVEW1lY_
? .
i @,34 -? ?t'k?rT? '?te N.b ?c ? i? ra?. cnc.
e
9z%-Y7
m
? ? O? so 9?q No?¢: l1..ti ro i. r.c. c•u. ,
LOT 5 ? LOT 4 _
bD
SCALE;I",50'
N
o a h O?
V /??e / ?Q ,op ry0
?
RE ?
o o .?;
M
;?. ?,.?._..
:?:;?;????I? FNG21-NEERlNG I)E:.?"1
51.50
S 0°12'50"E
LEGEND INVERT ELEVATION AT SERVIGE EkTENSION='
o DENOTES IRON MONUMENT PROPOSED GARAGE FLOOR ELEVATION= q? .9
o DEN07ES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION = 4 $o
?"?j I2q,Y-L
93o DENOTES EXISTING SPOT P_F,3QP,p B/1SEMENT FLOA_R_ . _`?POSE Cq2?DENOTES PE?E ATI ONPOT ?e(,'??TW?iEOU ? REs,d9
6? ?
?- DENOTES DRAINAGE DIRECTION NOTE VERIFY ALL FLOOR HEI6HTS WITH
FINAL HOUSE PLANS
I hxebjr certify thot this survey,plan or
rsport wos preporsd by ms or under my
diroct supervision and ihat I am a duly
Reqistered Land Surveyor under the
Laws o} tAe Stote of Minnesoto.
Bradley . Swenson, Mn. Re9. No. 15235
Datt 1 7/7 _rAz -
E?NS?
?
°TRI-LAND C0.
SURVEYING
SERVICES .
S I T E PLAN FoR : HUTTNER CONS
LEGAL DES?CRIPTION:
2 eA? t
4 'r~ .
r-
I 1
?g31rS p
?
ti
M
bD
?
e
?
co
U)
LEGEND
o DENOTES IRON MONUMENT
a DENOTES WOOD HUB SET
y:?o DENOTES EXISTING SPOT
ELE VATION
C92)DENOTES PROPOSED SPOT
ELEVATION
? DENOTES DRAINAGE DIRECTION
SCALE;I"=50'
.
.
? ?? ,...- . _. _.
.
.?. . .....__._ . 71 zF'/y ?
INVERT ELEVATION AT SERVICE EXTENSION=
PROPOSED GARAGE FLOOR ELEVATION = 9z
PROPOSED FIRST FLOOR ELEVATION = ?
...PROP_.QS?E(D BASEMENT FLOOR - 3?
7r ?Lq,YL
NOTE = VERIFY ALL FLOOR HEIGNTS WITH
FINAL HOUSE PLANS
I hareby certify ihat thls a1XV0y,plan or
rsport was prepared by me or under my
direct superwafon and tAaT I om a duly
Reqistered Lond Surveror unde? fhe
Lnws of tAe State oi Minnesota.
Hf?Y LAKE COURT
1vrio?`?o'F.
,?F??',?
/
?m
Ditk
1 LOT 5
1 ?
/ p?? e?
51.50
S 0°12'JO"E
LOT 4 ?
ry0?
? (p? u?Me F1.b ?o ? ie hc. c?t.
ot_
Y ?O
1 u) 924rY7
p? Ivod¢: 1?./0 1 o m i. r.c . w?.
N
LoT 5, BLOCK I_ , PATRICK QDDITION
ACCORDING TO THE RECORDED PLAT
THEREOF COUNTY, MINNESOTA
ADDRESS: 702 H/!Y AKF COURT
Brad- I- eVSw*nson,AMn. Req. No. 15235
Date 1 71zs192--
?
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 702 Hay Lake Ct
Lot: 5 Block: 1 Addition: Patrick
PID:10- 56790- 050 -01
Use:
Description:
Sub Type:
Work Type:
Description:
Meter Size Meter Type
Comments:
Fee Summary:
e - Water Heater
Replace
Water Heater
Permit expired without required inspections. 4/20/2009 CE
Cherie Pung
1424 3rd St N
Contractor:
McGuire & Sons Plumbing & Heating
1424 N 3rd St.
Minneapolis MN 55411
(612) 604 -4285 X61
Total:
Manufacturer
PL - Permit Fee (WS & /or WH)
Surcharge -Fixed
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Serial Number Remote Number
$50.50
Owner:
Margaret J Evenson
702 Hay Lake Ct
Eagan MN 55123
$50.00 0801.4087
$0.50 9001.2195
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Plumbing
EA087035
10/22/2008
ePermit
Line Size
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA116898
Date Issued:10/14/2013
Permit Category:ePermit
Site Address: 702 Hay Lake Ct
Lot:5 Block: 1 Addition: Patrick
PID:10-56790-01-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
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.
Josh Mcguire
1424 3rd St N
Minneapolis, MN 55411
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 -
Margaret J Evenson
702 Hay Lake Ct
Eagan MN 55123
Benjamin Franklin Plumbing
1424 N 3rd St.
Minneapolis MN 55411
(612) 604-4285 X61
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA120403
Date Issued:02/07/2014
Permit Category:ePermit
Site Address: 702 Hay Lake Ct
Lot:5 Block: 1 Addition: Patrick
PID:10-56790-01-050
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Margaret J Evenson
702 Hay Lake Ct
Eagan MN 55123
(612) 723-6345
Gates General Contractors, Inc
3500 Vicksburg Lane North, Suite 400-351
Plymouth MN 55447
(763) 550-0043
Applicant/Permitee: Signature Issued By: Signature
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA136712
Date Issued:05/25/2016
Permit Category:ePermit
Site Address: 702 Hay Lake Ct
Lot:5 Block: 1 Addition: Patrick
PID:10-56790-01-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
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 -
Margaret J Evenson
702 Hay Lake Ct
Eagan MN 55123
(651) 454-5136
Blue Ox Heating & Air Llc
5720 International Pkwy
New Hope MN 55428
(612) 238-9709
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA144056
Date Issued:07/11/2017
Permit Category:ePermit
Site Address: 702 Hay Lake Ct
Lot:5 Block: 1 Addition: Patrick
PID:10-56790-01-050
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and house wrap and leave on site.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Margaret J Evenson
702 Hay Lake Ct
Eagan MN 55123
(651) 492-3498
Legacy Restoration Llc
14000 25th Ave N
Suite 110
Plymouth MN 55447
(763) 354-7660
Applicant/Permitee: Signature Issued By: Signature