712 Hay Lake Rd N,-
BLDG.. PE,RIIIT N0.
-7 1 .. ,Jia
01-3210 BYdg.Jier'mit,
?.
01-3422 Plan Check
01-3445 Surch. /Adtrtt?Ae
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
? CASH RECEIPT - ?.
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, PJrNNESOTA 55122
. ^
DATE
19
/
RECEIVED
FROM
AMOUNT ? I
?
ec ooLLwwa
ioo
? CASH ? CHECK
FUND COP6 AMOUNT
Thank You
BY
?
' White-Payers CoPY
Yellow-Posting Copy
Pink-File CopY
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: `-" ""' "'l
3830 Pilot Knob Road Permit Number: I`' H
i,? ; ; •?? j?? .t
Eagan, Minnesota 55123 Date Issued: ?
(612) 681-4675
SITE ADDRESS: , ; , APPLICANT:
3 ri ra?? Ii.
PERMIT SUBTYPE:
,? q
TYPE OF WORK:
III • , 1: i t tii-,
n r Li
i1NI 1 r,?., 1,?' iiErk)
II I „i I "I,
I jf nrt i N1,
I I, r? .101 A i i'IN I I I I NnI
Permit No. PermR Holder Date Telephone N
S/VN
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Commants
Footings I
Foundation
Framing k5" 93 ?
??
Roofing
Rough Plbg.
Rough Htg.
l5ul.
Fireplace
Flnal Htg.
Orsat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bidg. Final
Deck Ftg.
Deck Final
weli
Pr. Disp.
PERMIT # h _Z
• ' ' . PLtSMBING PERMIT
CITY OF EAGAN RECEIPT #
3830 PILOT KN08 ROAD, EAGAN, MN 55122 DA7E:
CT PRICE: PHONE: 454-8100
Site Address ^J
Lot I, Block ? Sec/Sub
1 F.
? Name
g Address i
I
c City j . ._ ?i - Phone u -•
? Name
3 Address
p City Phone 'i'-L, .. ? y :
` FEES
COMM/IND FEE - 196 OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE S CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.OU
MINIMUM - COMM/IND FEE - $2U_00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PEfiMIT PRICE GOE5
BEYDND $1,000.00)
I
RE
F PE
T
S
GNATU
O
RMIT
EE
FOR: CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
R s. New
ult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAI
I_Water Closet - $3.00 $
I Bath Tubs - $3.00
_-4-Lavatory - $3.00 '-<
Shower - $3.00
I_Kitchen Sink - $3.00
Urinal/Bidet - $3.00
I Laundry Tray - $3.00
F4oor Orains - $1.50 '-
?Water Heater - $1.50 -
Whirlpool - $3.00
i_Gas Piping Outlets - $1-50 '
(MINIMUM - 1 PER PERMin
Softener - $5.00 `
Well - $10.00
Private Disp. - $10.00
S_Rough Openings - $1.50 v '
FEE:
STATE S/C: ' )?
??
. ; . ,
"- Ttrtt#ira#t uf (Orrupttrtry
titp of eagan
Eppartinpttt pf llt'db* 3uptYlDii
This Cerlifrcate issued pursuant to the requiremeRts of Section 306 of the Unijorm Building
Code certijying thut at the time of issuance this structure was in compliance with the various
ordinances of !he City regulaAing building constrrrction or use. For ihe following:
ux cbn&=tk, _V eldg. Permit No. 13535
ooc"w°`r Trv° zonine DWW .. Tyye coust. a
POST IN A CONSPICUOUS PLACE
Uate:
PERMIT ii
PLUMBING PERMIT
CITY OF EAGAN
3830 PILQT KNOB ROAD, EAGAN, MN 55122
Site
? Name _
? Address
c Ciry ?
Phone
v
_ Name _
3 Address
O CitY -?
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
{ADD $.50 S/C IF PERMIT PRICE GOES
RECEIPT k
DATE: -
BLDG. TYP,,,E WORK DESCRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - S3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
{MINIMUM - 1 PER PERMin -
? Softener - $5.00 -
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
FOR: CITY OF EAGAN
_ . 1
TOTAL: `?
CITY OF EAGAN 3535
? 13830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
1 PHONE• 454-8100
BUILDING,,PENMIT Receipt #
To be used for Est. Value Date f`? 1 .19
Site
b HAY 1.AKE
Lot Block Sec/Sub.
Parcel No. `
m Name 3 Address
° City Phone `
,o Name
? 3 Address
P Gity Phone
Address
City _
Phone
I hereby acknowledge that I have read this application and state
that the informatfon is conect and agree to comply with all applicable
State of Minneaota Statutes and City of Eagan Ordinances
Signature of Permittee
A Building Permit is Issued to: all work shall be done in accordance with all apalicable State of I
OFFICE USE ONLY
On Site 5ewage ? Occupancy '
MWCC System _ Zoning ?
On Site Well Type of Const T_
Ciry Water _ (Actual) ?
(Allowable) u
# of Stories
Length
Depth
S.F. Total •
Footprint S.F.
APPROVALS FEES
Assessments Permit ` J
Water/Sewer _ Surcharge
Police _ Pian Review 5
Fire _ SAC, City , u
Engr. _ SAC, MWCC
Planner _ Water Conn. -? ,
Council _ Water Meter J
Bidg. Off. _ Road Unit
APC _ Treatment P7
Variance _ Parks
Coples
roraL
on the express condition thet
nnesota Statutes and City of Eagan Ordinancea
Building
Psrmit No. Psrmit Holder Date Tslephono 7t
Plumbing rr9,
' r -
H.v.ac. G
Electric Ll?
Softener
Inspsction Datg Insp. Comments
Footings I , ?L ?
Footings II
Foundation
Framing -11-r7 6;_
Roofing
Rough Plbg r-647
Rough Htg.
ig?i. ss?
Flreplace
Final Htg. Z ?Q
Final Plbg. ? 7 6_
Bldg. Final ?/irsr,?Lt?Jj
Cert.OCC.
Temp. LP
Deck Ftg.
Deck Frmg
We
r
fl
Site
? rvame _
? Address
c City _L_
Name _
Address
TYPE OF WORK
Forced Air
t Hester
Cond.
Gas Piping Outlets #
Other
MECHANICAL PERMIT RECEIPT # 7 L
CITY OF EAGAN
7
• 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE
. 00 PHONE: 454-8100
Sec/Sub BLDG. TYPE WORK DESCRIPTION
? New X
Res.
Mult Add-on
? Comm. Repair
Phone -
- ??
?
FEES
RES
HVAC 0
00 M
TU
2
.
-1
4.00
B
-$
r ADOITIONAL 50 M BTU - 6.00
? one?? - (RES. HVAC INCLUDES A/C ON NEW
- - _
CaNSTRUCTION)
GA5 OUTLETS
MIN
M
M
(
I
U
- 1 PER PERMIn - 1.50 EA,
COMM/IND FEE - 1% OF CONTRACT FEE
a-7-M BTU .O APT. BLDGS. - COMM. RATE APPLJES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
M BTU MINIMUM RESIDENTIAL FEE - ALL AOD-ON 8
M BTU REMODELS - 12.00
M BTU $ MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
CFM
(ADD $.50 S/C IF PERMIT PRICE GOES
? • 6 BEYOND $1,000) ,
FEE • S ? ?
SlC: SIGNATURE OF: RMITTEE
TOTAL:
FOR: CITY OF EAGAN
; CITY OF EAGAN Permit No: Date:
3830 Pilot KAob lroad Meter No: Size:
P.O. Box 21199 Reader No: Date:
Eagan, MN 55121
Conn. Chg:
Acct Dep: 525•00Ad
15. OOpe
Permit Fee: I0• OOpd
Surcharge:
Tr.Plant • SQpd
•?() p 0,
Meter. 67
c •
'
: ? I?f?'
?
ial
Misc.:
q
Zoning: _
No. of Units:
I agree to comply with ihe City of Eagan
Ordinances.
ey
WATER SERVICE PERMIT
cinr oF eaGAN - SEWER SERViCE PERMIT
3830 Pflot Knob Road
P.O.'Box 21159 PERMIT NO.: '' F'
Eagan, MN 55121 DATE: ?
Zoning: Rl No. of Units:
Owner. Grand Oaks
Address:
Site Address: , 7_1' _ ='q• _"ia . Lake F°ad L6 B2 Qverhill. Farrn II
I ayree to comply w(th 1hs City ol Eagan Connection Charge: S? 5_ M)ud_
1'
Ordinances. -
Account Deposit:
Permit Fee: ? ? - ???--
SurCharge:
BY
Misc. Charges: Penal t3? ' ` an"d-
Date of insp.: Total:
Insp.: Date Paid:
lot Knob Rosd
K 21199
MN 55121 '
to comply wRh the CRcgOAW -
of Insp.:
k
No. oi Units:
Eic, ioo.ooPa
•
Surcharge:
Misc. Charges: --4
Total: '
Date Paid:
CITY OF FAGAN Permit No: , ? 2? Date: 5-• I' -?" 7
3.* IFNlot Knob Fload Meter No: 395 ?6 LrY Size: 5 8" Ro`A
P.O. Box 21199 Reader No: 0 3P 91197- Date:
Eagan, MN 55121
Owner.`? ' I Oaks
Site Address:-71y__.,? .?_: r•T T
Conn. Chg: 525. tlp .-1I'll'" 1tg?i?q?ir.. P1
Acct Dep: 15. ;? ??, , . 1?T?`y btif ??rnt : ?-
Permit Fee:
Surcharge: I?tee`to comply with the Ctty o1 Eagan
Ts. P4ant ,, '
Ordlnances.
Meter. ? 7 ?
_ ?-
Misc:
Y
WATER SERVICE PER
RESIDENTIAL
f BUILDINC PERMIT APPLICATION ?
CITY OF EAGAN I I?'? S
3830 PILOT KNOB RD - 55122
651-681-4675
NawConsbucGon Reouiremenfs
• 3 registered site wrveys showirg sq. R of bt, sq. fl of house; endZll roofed ereas
(ZO% maximum bt coverage albwed)
. 2 apies of plan showing beam 8 wiiMOw sizes; Poured (oun0 design, etc.)
. 1 set of Energy Cakulations
. 3 mpies of T2e P2servation Plan rf bt platled afler 7H193
. Run Joist Detail Optrons selsctlon sheet (bldgs wIM 3 w less units)
DATE
O
JOB SITE ADDRESS 7Z
IF MULTI-FAMILY BUILDING, HOW MANY
PROPERTY OWNER C Gt
TYPE OF
APPLICANT
ADDRESS
PAGER #
- POO 'F
_ FIREPLACE(S) _ 0 _ 1 _ 2
PHONE#
r-dG/'i IIPCODE 5535.?
CELL PHONE # ^Al?= FAX #
11,03
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Category
(check one)
Plumbing Contractor. _
Plumbing System Includes:
Mechanical Contractor: _
Mechanical System Includes:
Sewer/Water CoMractor.
Phone #
Phone #
Fee: $90.00
' Fee: $70.00
PJI above information must be submitted prior to processing of application.
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 Ordin nces.
Signafure of Applicant
_ MINNESOTA RULES 7670 CATEGORY 1
- Residential Ventllation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Phone #:
_ Water Softener _ Iawn Spruikler
_ Water Heater _ No. of R.I. Baths
_ No. of Baths
CA-)
_ Air Conditioning
_ Heat Recovery System
RemodellReoairReauiremeMs
. 2 copies of plan
. 7 set ot Energy Calailations lar heated addiGOns
• 1 ske survey for exlerior edditiore & decks
. Indcate if iwme served by seDtlc syslem iw additions
VALUA(ION `' 7 SDU
Certificates of Survey Received _ Tree Preservation Pian Received _ Not Required _
Updatea t/01
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
0 04 02-plex
? OS 03-plex
? 06 D4-plex
? 37 New
? 32 Addition
? 33 Alteration
? 34 Reptacement
Valuation
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
O 24 Stortn Damage
? 25 Miscellaneous
13 30 Accessary Bldg
? 31 EM. Alt - Multi
? 33 Ext. Alt - SF
? 36 Mulfi
O 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
O 37 Demolish (Bldg)• O 43 Reroof ? 46 WindowslDOOrs
'Demolition (Entire Bldg only) • Glve PCA handout to applicant
Occupanc.y MC/ES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
- Width
REQUIRED INSPECTIONS
Footings (new bldg)
Footings(deck)
Footings(addition)
Foundation
Drain Tile
Roof _ Ice & Water _ Final _ Other
FranunB _ Pool _ Ftgs _ Air/Gas Tests _ Final
Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone
Insulatlon _ Windows (new/replacement)
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Suppiy & Storage
S8W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
? 07 OS-plex O 13 16-plex
? 08 06-plex ? 16 Fireplace
O 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Oeck
? 11 10-plex ? 19 LowerLevel
? 12 12-plex Pibg_Y or_ N
Fina]/C.O.
FinallNo C.O.
_ Plumbing
HVAC
Building Inspector
I
• CASH RECEIPT •
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MIN OTA 55122
, I]ATE 19 ?
o
dZ
AMOUNT $
& DOLLARE
00
? CASH El K
7/d ?o >'Z74g 1?r
FUNO COOE pMOVNT
a/
d
Thank You
N° 73419
White-Peyers Copy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN (v° 13 5 3 5
3830 Pflot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING_ PEFiMIT PH ON E: 454-8100 Receipt •-7?? a 7
To be used for SF DWG/GAR Est. Value $66,000 Date MAY 1 ,1987
SiteAddress 712 NO HAY LAKE RD
Lot 6 Block 2 SeGSub. OVERHILL FARM 2N]
Parcel No,
a Name GRAND OAKS DEVEL CO
= Address 4521 SO NAY LAKE RD
? Ciry EAGAN Phone 452-8934
, o Name 5AME
?< Address
? City Phone
a
w w
Name _
I hereby acknowledge that I have reatl this application and state
thattheinformationiscorrectandagreetq complywithallaDPlicabla
StetC of Minne8ota Statutesand Cit?ANEaoen Ordinances
Signature of
A Building Permit is issued ta ' ??vu uaxca uev ?u
all work shall be done in accordance with all applicn e of
Building Otticial
OFFICE USE ONLY
OnSiteSewage Occupancy R3
MWCCSystem X Zoning R7
On Site Well Type of Const
Ciry Water X (AChaq V
(Allowable) y
# ofStofies -
'
44
Length
Depth 4$
S.F. Total
Faotprint S.F.
APPROVALS FEES
$ 384.50
Assessments Permit 3T
--0O
WateUSewer _ Suroharge .
Police _ PlanReview zo2 ?5
Fire _ SAG City i(1f1 _ flp
Engc _ SAC. MWCC 59 S_ flp
Planner _ WaterConn. S95 np
Council _ WaterMeter ?7 nQ
Bldg Off. _ RoaC Unit „n 5 n0
APC _ TreatmentPl QC) ?p
Variance _ Parks
Copies
TOTAL A7T-4 11-75
on the express condition that
nryqsota Statutes and City of Eagan Ordinance&
r
Y -
n ? NL
?'e" °
?
?.S'u
ilequBSt Date - Fri, Pough-in Inspaction
I Fequire0? D Reatly Now Will Notity Inspector
Ves ? No han Faatly?
Iklicensed contractor ? owner heraby request inspection of above electrical work at:
Job AOtlress (Slre¢t Box or Rou)No Ciy,
L
.
t
Seclion No. Township Name orN . Renge No. County
Occup IIPRI i Phone No. .
n
?
Pc er Sup01 ? ' Atltlress
Eiecmcal ConVactor (COmp am CoMractor's Llce o.
Mailing Adoress ICOnKacw or Owner Maki In all5liory
?/?
IAmnonzea . a re i nv mrOwne Making Instaii
l I ppp
Pnon um //??
v Y
MINNESOTA STATE BOAZ OF ELECTRICITV
Gri9ga-Midway 91dg. - Poom 5473
1821 Univerpiry Ave.. SL Paul. MN 55104
Vhone (612) 602-0800
---
THIS INSPECTION REOl1E5T WILL NOT
BE ACCEPTEO 6Y THE STATE BOARD
UNLESS PROPEF INSPECTION FEE IS
ENCLOSED.
REOUEST FOR ELiCTRICAL INSPECTION esoooo.oa
l ? See inshuctiore tor complating ihis form on back of yellow copY?
=??a5?s
1R9 711 'X" B&w Work Covered by This Request ??
e Atld Rep. Type of Building AppliencesWired EquipmentWirad
Home Range Tempaary Service
Duple. Water Heater Elactric Heating
Apt. Building Dryer Other(Specify)
Comm.Antlustrial Furnace
Farm Air Condition r
OAer (syecily) ComracMs Remark . .
Compute Inspecfion Fee 6elow: / `" ?G `
# Olher Fee # Service Enirance5ize Pee # Cimuits/Feetlers ' Fee
Swimming Pool 0 to 200 Amps 0 to 700 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
Signs Inspector's use only: 70TAL /
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY ORD E?DI$CONNECTED IF NOT
Other Fee COMPLETED WITHIN 1 THfll
. ?
I, the Electrical Inspector, hereby
certity ihat ihe above in5pection has
been made. Rocynm ?
/ 4 oeie/y 2,
7 / <
aie
OFiICE USE'JNLV
This requesi void 18 momns trom ,
REQUEST FOR ELECTRICAL INSPECTION ea-ooooi-os
Ii, See instruetions for comDleting this torm an back ol Vellow copV.
?.3?3 1 "X" Below Work Covered by lhis Request
And xeo. Tvoe of euneing Aooiiancea wiroa eauiu.,e.i Wi.en
Home Range Temporary Service
Duplex Water Heater Lightfny Fixtures
Apt. Building Dryer Electrlc Heatin
Commercial Bldg. Fumace Silo Unloader
Industrial BIAg. Air Conditioner Bulk Milk Tank
Farm omr. oaci v (suc, I rv)
I 1.1UCGIIV Otr1Gf nlhL,
ompuie lnspection Fee Below
p Fee Service Entranee5ize M1 Fee Feaders/5ub(eeders k Fex Circuits
Z,[I(J 0 to 200 qmps 0[0 30 qm s 39CO 0 to 30 Am s
A6ove 200 qin ps 37 to 100 qmps 31 to 100 Am s
Swimming Pool A6ove 100_Amps Ahove 100_Amps
Transrormers Irngation Boorns ,.$O Partia6Other fee
SignS Specialin5pection -^
T
emarks
OTAL Ft?
1Llw eUy
Nough-in D.te I, tha Elactrieal
Inspactor, hereby
cartity thxt the above
Final Dat inspection hes been
mede.
" 68
t0isrepunlvolElBmontirelrom ?
This request void&/?y ?J` f//9 /
78 manths (rom X?
D 3 2 31
Raques49ate . Fire No. Rouph-In InsUecI ion
2^
S- V"&? Required? OFeaAy Nuw ill Nutity Inspec.
??,r Wh
R
Yes ?NO ¢n
?
eady
Lice.ns¢d Elecvical Con[ractor 1 hereby request inspection of above
Owner electrical work installed et
Street Address, Box ar Route No.
7l z /U &
r City
g
;i an
ection o. Township Nam r No. Range No. County
Occvpant(PRINT)
1 ? Phone No.
-
C.7/ r 4q VS Z - &-
7 3
Power $upplier
c)ZM? ,OZ6? Atltlress
Electrical Con[ractor (Company Name)
19 Cnntr.ecmr's License No.
'
J
S -
D?-1I ykS
Mailing AJress lContractor or Owner Makinq I
-- n iailationl
2
c) N
w i
4,75
r2
Signat e ation) Phone Nomber
Z2 kCio-6 3 4, y
MINNESOTA STATE BOAqD OF EIECTNICITY THIS INSVECTION REQUEST WILL NOT
Griggs-Midwey 91dg. - Poom N-191 BE ACCEPTED BY THE STATE BOAND
1827 UnivarsitvAVe.. St. Paul, MN 55104 UNLESS PflOPEN INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
,5/j&REQUEST FOR ELECTRICAL INSPECTION ee ooom-0?
C ? See instmctbns fw completing this form on back oi yellow cropy. C J G$/
? 9?1 9 2 5 X" Below Work Covered by This Request
ew ep. TypeofBuiltling ApplianrasWirad EquipmentWired
Home Range 7emporary Service
Duplex Water Heater . Electric Heating
Apl. Building Dryer Olher (Specity)
Comm./Industrial Furnace
Fartn Air Conditioner
Other (specity) Conhectak merks:
Compufe Inspection Fee Befow:
# Other Fee # SarviceEnVanceSize Fee # CimuRsiFeetlers Fee
Swimming Pool 0 to 200 Amps o to 100 Amps
TransFOrmers Above 200 _ Amps 00 Amps
Signs InspectorB Use Onry: 7p7pL ?
Irrigation Booms
Special Inspection
Alarm/Communication
Other Fee - ?
I, the Electrical Inspector, hereby
certify that the above inspection has
been made. Aough-in ?. oa?e^ ?
OFFICE USE ONIV
This reQUesl vaid 18 months trom ''- ---
_. . ???
5?/? 89 C !9 &11
f? 9 9 2 5 ? ? ?
%
Request Dale _ Flre No. qagh-in Inspection
Required?
? ReaGy Now
? Will Nolly Inspeclor
? lP ? Yes ? No Whm ReaOy?
1 1-1 licensed contractor )(owner hereby request inspection of above electrical work at:
Jab AEdress (Street, Box or Route No.1 Ciry .i
Cl ? OL ?
Secdon No. Township Name or No. Fange No. Cou
OcwpaM (PflIIJn
c a,, ),e Phoi» No.
F??
?'3(0 8?
Power ppLe?r/
?
C I
4 AGdreas
PG
r
C
A.a .
Eleancal Comrador (COmparry
01 ContractorB License No.
Mailirg Atltlre s(COntrador w Qmer Meking Inatalla n)
Authonzetl gneture niraclor/Ovmer Making Install Phone Number
MINNESOTA ATE BOARD OF EL qICRV THIS INSPECTION REQUEST WILL NOT
Grigg&A1Wway eltlg. - Room &1 BE ACCEPTED BV 7HE STATE BOARD
1821 Unlversky Ave., St. Paul, MN 55106 UNLESS PROPER INSPECTION FEE IS
Phone (612) 6,12-0800 ENCLOSED.
ntQUEST FOR ELECTRICAL INSPECTION EB-OUW1.04
? 1 See instrvctions tor c(mpletinp this torm on Deek of yellow ?oP?. 00a0? 9?
' 15289 . X" Below Work Covered by 7his Request
0.dtl Bep. TyDe of BuiitlinB Apolinnms Wired Equiun+eni Wired
Home Range Temporary Service
Duplex Water Heater Lightinp Fixtures
Apt. Building Dryer EleCtric Heatin
Commercial Bldy. Furnace Silo Unloade.r,
Industrial Bldg. qir Conditioner Bulk Milk Tank
Farm Otnrr oeai v Otnnr ISnwciiy)
[ er Sueufy ther 01h,r
LulljNUie 111suecuwi ree ueinw
k Fea Sarvice EnL0nce5ize b Fee Fextlers?5ubleetlars a Few Circuits
0 to 200 qm s 0 to 30 qm s 0 tn 30 Am s
Above 200 qmps. 3t to 700 Amps 31 to 100 A
$wimming Pool Above 700_Am s Above 100_Amps
Transiormers Irn tion &?orc,s I Partia Fee
Signs ? SUeciallnspection
S
S
Memarks ` - I
irJif71? 1 * RCfJVYIiOYIY Z/ T ?jcE
Nou6h-in - ' Da?e
/
7.. 1. t
al
/ insoe.io., ne.eny
Final ? artily tAat the above
'b insaection has been
mede.
Tnb reQuest vo1018 montM irom
Tnis rauest „ola
78 mon[hs from
C 15289r ;. ?
f ?- 7
rO i-e , /? i irn-,n
Requpst ete `
?J ?? ?
? F re No. Rough-in Inspec[ion
eq ired?
?Ready Nuw Wili No1ify, Inspec-
Wh
R
? ?N
es or
en
eatlv
Licansed ElecVical Conhactor i hareb rey queat inspection of abova
? Owner elechical work instelled at:
Street Atltlress, 8ox or Route N. .
l CilyF
a
1 an
I
.
eclion o. Township Name or No. anBe o. Counly Gfq
A
Occu?n? PRINTI
-- 1 Phone N
8? -836 ?
Power swone. Address
Elecvical ConUactor (Company? e)
G, e Contr,?ac?ols Ly?ense N7
' <i:. ?; 3
Mailin?AdJress ( ont a<tor or Owner Maki B I st
? Ilation) ^^
i J
?
9 s J
?
AWh etl Sign wre (Cont ctor O ner Makin Installaiionl P one NumD r
52-? 53g
MINNESOTA STATE BOAPO OF ELECTflICIiY I THIS INSPECTION PEQUEST WILL NOT
Grip9e-MiAweY 910g. - Noom N-197 BE ACCEPTEO 6V THE STATE BOAflD
1821 Universitv Aye., S<. Faul, MN 55104 UNLESS PPOVEH INSPECTION FEE IS
PA- 16121 297-2111 ENCLOSED.
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: BuzLozNG
3830 Pilot Knob Road Permit Number: 021598
Eagan, Minnesota 55123 Date Issued: 07 / 29 / 93
(612) 681-4675
SITEADDRESS: Lo`r: e BLOCK: 2 APPLICANT:
712 HAY LAKE Rp N RHEIN CONST C0, RANDY
OVERHILL FARM 2N0 (612) 461-3336
PERMI PoU?BTYPE: TYPE OF WORK: NEw
pESCRIPTION (INCL 6'x 12' DECK)
INSPECTION
I,FOOTZNG D. .
FRAMING ,.
'INSULATION FINAL
?
- ? _ _ ?
CITI'( OFEAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
- (INGL 6'x 12' DECK)
ldiriT Permit Type SF PORCW
ldirrg,W'qrk Type MEW
DcGUpai?Z7?1-1 R-3
BUILDTNG
021596
07J29/93
SITE ADDRESS:
P.I.N.: 10-56151-060-02
PERMIT
712 HAY LAKE RO N
LO7: 6 BLOCK: 2
OVERHILI FARM 2Np
DESCRIPTION:
$uitding L?engt#a"(
Bu3lding 4Jidth
r. I
ft U j`
12
16
?-?;??
?n - ??
, ???
REMARKS:
FEE SUMMARY:
Base Fee
Surcharge
7ota1 Fee
VALUATION
PERMIT TYPE
Permit Number:
Date Issued:
$10,000
$117.00
$5.60
$122.00
CONTRACTOR: -
RHEIN CONST C0, RANOY
8600 237TW ST E
LAKEVILIE MN
(612) 461-3336
Appiicent - sr. Lzc. OWNER:
14613336 0003311 BAILEY ED
712 HAY LAKE RD N
55044 EAGAN MN 55122
(612)688-8368
I heraby aclsnowladge that 2 hawe raasf thiz appXication and state t?hat the ?
infarmation is caCrect and agre.e trt comply wi'th a13: appl;icoble Stat€; of Mn.
Statutes and City o'f Eagan Ordin:anaes,
L
_ c
APPLICANT/P MIT SIGNATURE ISSUED B. SIIVATUR
REACTIYATE ?(?'(?:22, ??/ED CITY OF EAG14N
PERMII` 1593 BUILDING PERMIT
iff L APPLICATION ? I 2 Z. DO
1993 681-4675
.?
C!i ,??f I, ri
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month•
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date qlq / zZ /93_ Valuation of work AB(9tJda-
5ite Address: 7/L /v a 4?2y LA-Kr_ ??.
STREEi SUITE /
Tenant Name: (commercial only)
IAT (i ? SLOCK Z SIISD. P.I.D. M
Descri tion of work: f?6l2Cb}-
The applicant is: ? Owner Contractor ? Other (Descri6e)
Name 13A4 L£? P16 Phone ?3C.9
Property LAST F1R5T
Owner pddress 7/2- L A-k-f eij,
STREET . STE / -
City State AA tl . Zip.5?42
Company N-N b'1£1£iA) dnlstnwG76A3 C,?, Phone 4% 3334
Contractor Address F60 D 237'?-cS} -?, License # 11 Exp. (4
City l,?i?-?--?- State 01/V, Zip ?m ¢-4-
Company Phone
Architect/
Engineer Name Registration
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this applicatio and state that the information is
correct and agree to comp 1 applicable St e of nnesota Statutes and City of
Eagan Ordinances.
i
f
Signature of Applican't--_
?
OFFICE USE ONLY
,
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging O 6? Base iifei?t%Ffinish
O 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. 13 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 18 Comn./Ind.
eg 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
,
O 05 SF Misc. 0 10 Multi. Add'1. 0 15 Deck ? 20 Public fatility
0 21 Miscellaneous
WORK TYPE
31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
32 Addition O 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC 6ccupancy IL 2nd F1. sq. ft. PRY Required
Zoning Sq. Ft. total Booster Pump
#? of Stories Footprint Sq. ft. Fire Sprinkler
Length I 2. On-site well Census Code ?
Depth On-site sewage SAC Code
?
APPROVALS o
Planning Building Assessments
Engineering Variance
REGIUIRED IN . ,
SPECTIONS A t-Sa C XDZ,?
'
? Site Footing ? Framing ?Insulation
O Wallboard ?Final ? Draintile ? fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
5/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
Il 2, ° °
S.oo ?°?- 6 alwcion:
=
25_D_?_
?9i 86 y0
.r----?----
?6
SAC %
SAC Units
?? ( F-Y O R' S C E R T I F 1 C A T E aRnrio nnrs nEVELnaMEnr co .
M NOR?TH HAY LAKE ---
ROqp
? o
S 83°26' 14.99
44"E??
`_ ' .. 96.46 R_
1944.29 d=2050133"
0
,.o s
? ^ -- m ;. ,: 0 9Y7,n)
N ? l O .r -
5 ^ nl ?. . •.y -?
' 22.0 ?
' / 39.35 ?-
?` W g ? N GAR./N ?
4.0
0 0/ ? c
?
PRHOUSEO h ?
Z ?
?-- ?
40.0 ?
29.34
.
_ J tc) ?-- ? a
W '?T
\
1
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30
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Y 1
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LOT 6 0?
vi m
5 (D (D
I ORAiWAG£ B UTIL/r? 10 ?
? ?JfASE:1l£N7' PfR p?Ar ?
L
N ?_
?
' 93.01 S 83°37'22" E
(9s).o)
-?-
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?
30
SIIEET 2 UF 2 SfIEETS
PflOJECT NO. BOOK / PAGE
87275
FILE NO,
FOLQER
_ N
?
?
O
?
JAMES R. HILL, INC.
Planners / Engineers / 5urveyors
8200 Humholdt Avonue South
Biootnington, Mn. 55431 812-884-3029
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*RYPE: PAYMETTP OF FM AT 17ME OF
APPLICATION DOES NOT OONSPIITJPE
APPROVAL OF PERNIIT.
Tt,tSaEr'r'rON OF SEWM ADID/Ot FTATII2
. II1S'1'Ai7ATTQN$ wnZ NW $$ $?ED-
ULID UMII. PF.RNIIT AAS BEM
APPROVID.
`* ?TX'** **t* *'R **X'# Rf Yt1YiRltYYtfFrt* *'k't*'Rilr
P ease Print)
? 1). PROPERTY ADDRESS:
LEGAL DESCRIPTION: •-
IF EXISTING 51RCCiVRE, DATE OF ORIGINAL BL?ILDING PERMIT ISSL'ANCE:
i
PRESENf 7ANING/pROPOSID LSE: (Abn Year
q corNERcIAL/xErazLioFFic:e
Q IbIDL'SIRIAI,
n INSTI'ILPfIONAL/GpVII2NMEN'p
El-R-1 SINGLE FAMILY '
Q R-2 DC'PLEX (Tao Units)
? R-3 7MM0USE (Three + Units) ( C?nits)
p R-4 ApARTHWp/CONIDOMINIUM ( Units )
2) ?
N11ME: ?I?4N7' D?k/?CSAwDREss:_
CITY. STATE, ZIP:
PxorE:- 4/ 5'2, P93
• 3) • u ?: ?• - NAME.- V?4-L.1--?-' y ?_.•-. : For City Lse .
, Plumbers License:
AnDxFSS:_ l9 i o C2?Xe? A-N - .?ctive
2
CITY. STATE. ZIP:_ c7d'L?? Av?/ -S 3 S U ? Not recorded
? P xorE:_ y da a ? a/ rAsTER LIcINSE# .21
st?tial
4)
•. • i?•
NAME:
ADDRESS:
CITY. STATE, ZIP:
PHONE:
.5) u v ? ? r: •?• :? • y? .
B?corn?crzorr To ciTc sEwEa o-EersWrioN Tv ciTr suaTER p oTHEa_.
6) ° •' ? -K--PLFASE FiOLD ApPROVID PERMIT FOR PICK-UP BY ONE OF AHOVE
C3 PLEASE MAIL APPROVID PEEIMZT TO 1, 2, 3, 4, ABOVE
(Circle one) ,/ l'
7) r ru•• "7`-
Q ?-Xi3t r4it/ `
FOR CITY USE ONLY
PERMIT # ISSL'ED
?17z7
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLUDE SURCHARGE)
$ $ WATER PERMIT (INCLDDE SL'RCHARGE)
$ $ WATER METER/COPPERHORN/OC'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ACCOUNT DEPOSIT - SEWER
$ $ ACCOL'NT DEPOSIT - WATER
$ $ WAC
S G• 7_ SD Z? $ SAC
$ $ TR['NK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRL'NK SEWER
$ $ LATERA L BENEFIT/TRL'NK WATER
n•?' L)
`$ I $
9 WATER TREATMENT PLANT SURCHARGE
$ $ [/, C OTHER: ???LCI
$ $ TOTAL .?.eiA ?i?F_c•t_, ? ?}' (/ ? /
1V 7)
s-
^ _
(
7 3 ? z 7
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q
ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A COIVDITION.
SLBJECT TO THE FOLLOWING CO[VDITIONS:
APPROVED BY:
TITLE:
DATE : S/?-E/f 7
U•*
3N4•SU+
? 33•00+
? 792•?7v
? ? b25•DU+
525•U0+
?
67•00+
` 305•OU+
? 180•OUY
' 2+511•'15k
? ?? f3.s3S ? . .
[V'D 0,1987 BOILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLQDE 2 SEfS OF PLANS, 3 CERTIFICASES OF SUSOEY, 1 SET OF ENERGY CALCQLARIOHS
NOTE: ADDRESSES FOR COHNER LOTS - CONTRACTOR/HOMEORNER MIIST DESIGAATB WHICH ADDRESS
IS DFSIRED. NO CHANGES WILL BE ALLOWED ONCE BDILDING PERMIT IS ISSOTsD.
MITLTIPLfi DiiEI,LINGS - RFSIDENTIAL RfiNTAL IRVITS FOR S6LE D$ITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SIIRVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
C0+MRCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: S rt- Valuation: ?'000 Date: -'?- -3. O ^C1 -I
Site Address L (o R Z
Lot _ Block-71o? A,1• ? C?s.?ta-fCt
Parcel/Sub
Owner )
G??
Address
City/Zip Code
Phone
Contractor ???b rA-AS
Address
City/Zip Code
Phone 7 $^2. ??j ? ?
Arch./Engr.
Address
City/Zip Code
Phone Ik
OFFICE USE ONLY
>
On Site Sewage_ Occupancy
MWCC System Zoning ?1
On Site Well Type of Const
City Water ? (Actual) ]Z
(Allowable) ?
dl of Stories
Length ?
Depth ?
S.F. Total
Footprint S.F.
APPROVALS FEESS
Assessments Permit -389'?
Water/Sewer Sureharge 3-2>.
Police Plan Review tLU ,u
Fire SAC, City Oc).
Engr SAC, MWCC 525
Planner Water Conn 525-
Couneil Water Meter b'7.
Bldg Off Road Unit 30 5.
APC Treatment Pl ? gp.
Variance Parks
Copies
TOT6L ??
SURVEYOR'S CERTIFICATE GRFlND OAKS UEVELOPMENT C0.
-4- DENOTES PROPOSED SURFACE DRAINAGf_
O DENOTES IRON MONUMENT SET SCALE: 1 INCfI = 30 FEET
• DENOTES IRON MONUMENT fOUND PROPOSED GARAGE FLOOR = 95a o FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = 92?7 2 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BI.OCK =?? FEET
I HEREBY CERTIFY TO GRAND OAKS DEVELOPMENT C0. THAT TIiIS I5 A TRUE AND CORRECT
REPRESENTATION OF A SURVEY DF THE DOUNDARIES OF:
Lot 6, Block ?, OUERIIILL FFIRP1 SECOPID AGt',ITION, accordina to the
recorded plat thereof, Dakota County, P1innesota.
AND OF THE LOCATION OF A PROPOSED 6UILDING. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS,
OR ENCROACIIMENTS, IF ANY, THEREON. AS SURVEYED BY ME, OR UNDER P9Y DIRECT SUPERVISION,
THIS DAY OF , 1987.
S1GPlEU: JAMES R. HILL, INC.
dy: / J/.vL'(-j':?f_ ?...?•, l A?3'J?al,e11lel\?
n OLD C. PETERSON, L,4ND SURVEYOR
SHEET 1 OF 2 SHEETS PiINNESOTA LICENSE N0. 12294
PROJECY NO. BOOK / PAGE JpMES R. HILL, INC.
87 275
Ptanners / Engineers / Survey,ors
FILE NO.
8200 Humboldt Avenue South
FOL,DER Bbomington,Mn. 55431 612-e84-3029
SURVEYOR'S CERTIFICATE
0
M
S 83? que
n`
i
i
i -
.?
L J
,
- J
GR/?PID OFlKS DEVELOPP9EfIT C0.
NOR?TH HAY LAKE R qp
99_ i
' z"(3.46 R=1944.29
o d=2050'3310
? n W 3
N 51?
?)97,7i;
? 22,0
0
N GAR.?Lf) p L`7?
22.o a.?
0 0?
?Y N PROPOSEO ?
Z HOUSE ri
26.51 N
o,..?
Ip
345
?
0
M
? M
?
M
N
2
( vN
lc?
co
` 40.0
h (, ni tarl -? l -L 29.3"
LOT 6
5
? ORAIryqG£ B U77LlT? '?y
? ??£ASfMENlP£lPPLA7' y
S N `L?
' 93.01 S 83° 3 27 2" E--
(9sl.o)I
`
I
SHEET 2 OF 2 SHEETS
PROJECT NO.
87275
FII.E NO.
FOLDER
,
,
- 30
3p
a
?
X
Q
J
Q?
I°
OD -
N
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?
30
BOOK / PAGE JAMES R. HILL, INC.
Planners / Engineers / Surveyors
8200 Humboldi Avenue Sauth
Biootnington, Mn. 55431 612-884-3029
.
°EX'TERIOR ENVEIOPE AVERAbE U COMpUT ATTON
GRAND DAKS DEVELOPME NT COMPANY '•
MODEL Q AFEA U. U % AREA
ti .
kECIUIFED '
1. T07FlL WALL AREA 1800 X .11 199
;. 70TAL ROOF AREA 1146 X. 026 31.096
ACHIEVED
AREA U U X AREA
A. W I IVDOW AREA 186.66 .5 9?? •7'
B. D60R AREA 1-19. 8 .077 3. 0 646
C. SLIilE GLASS AREA 13.44 .40 6.4512
D. FIREPLACE AREA 4 0 o
F. WALL FRAME AREA 1 E30 .041
•.??
F. NET WALL AREA 1164.1 .049
G. RIM JOIST AREA 119.52 .0436 5.211072
H. PCUND WINDOW AREA ? 0 u
1. FOUND AEOVE GRADE 96.48 .135 13.0249
;i. TOTAL WALL AREA 1800 105.5026
J. SKYLITE ' d 0
I'. ROOF FRAME 119.6 .032 3.9272
L. NET ROOF AREA 3076.4 .025 26.91
4. 1"OTAL ROOF AREA 1146 Z,0•7372
SUM 1. +2. 229. 09h
5UM 3.+4. 216.2390
,,
***************************************
CITY OF EAGAN
CASHIER: JS TERMINAL NO: 785
DATE: 08/17/00 TIME: 07:05:17
ID: #
NAME: RANDY RHEIN CONSTRUCTION CO
3210 9001 712 HAY LK RD N 83.25
2155 9001 712 HAY LK RD N 1.50
Total Receipt Amount: 84.75
CR136017
USER ID: JAN
Z q 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
I
3830 PILOT KNOB RD - 55122
851-881-4875
New ConthucMOn Reaulremenh - Bemodel/Reoait Reaulrem6el€
> J reyiiltered tlte wrveya ahowiny aq. (L of lol, sq. lt. of house
and gl rooled areaa fT0% mmdmum bt croveiaae allowetlf
? 2 caplea W plmns (ahow beam 8 wlntlow alzes; poured tntl. deslpn; etc.)
> 1 aet o1 enerpy caleutatlona
n 7 capiea ol preservatbn plan if lol plaHed after 7/1 /9J
DATE: a / ? 4?- / cg?
DESCRIPTION OF WORK:
STREET ADDRESS;
LOT: ?9
lZ
2 copias ot pian
1 set ol energy calcWafions tor heated additlona
1 aNe survey ror axtedor addlNOna & decks
CONSTRUCTION C05i:
f-
aKo o?
BLOCK: D SUBD./P.I.D. N:1 VII2h-lq;, I I F& r V?, ?
Name: 6,0'(I.PL. 4 Phone /: Gs`? / r
PROPERTY tast Flrst
OWNER
Street
CIN E694 104'1/1 I - - - State: V44,,4 Zip: ?5/ 2' 3
? ?.
'333 4-
Company:
.
(area code)
CONTRACTOR
streer aactress: 4SCsco ucer,se # ?L ( Paca.3 3 < ? t
Cliy ?-6E1 I?'"Z u tl?.? state: ZiP;
ARCHITECT/
ENGINEER Company: Name:
Telephone #: (
Sheet Address: Regishaflon III:
Cify
Sfate:
Sewerfwater licensed plumber (if instailina sewerfwatarl: Phone #:
Zip:
I hereby acknowledpe Mwt I have read ihis appgCaHon, afate thaf ihe InfortnaNon is cortect, and agroe to comply wHh 09 appAoable S1ate
of Minnesota Stalutes and City of Eagan Ordinances. ?
/
Signalure of Applicani?- -
OFFICE USE ONLY
Certiflcates of Survey Received _
Tree Preservation Plan Received _
Yes _ No
Yes _ No
REcEj?D
AUG 16 2000
Not Required
BY:
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundatlan 0 07 05-plex ? 13 16plex
?
21
Porch (3-sea.) ? 31 Ext Alt - Multi
? 42 SF Dweiling ? OS 06-ptex ? 17 Garage O 22 PorchlAddn. (4-sea.) ? 33 F_xt. AR - SF
plex ?
? 03 01 of 09 07-plex ? 18 Deck ? 23 Porch (screened) D 36 Muki
_
? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
? 05 03-plex ? 11 10-plex aitg Y or_ N ? 25 Miscellaneous
? 06 04-plex O 12 12-plex ? 20 Pool ? 30 Accessory Bk19•
WORK TYPE
? 31 New ? 36 Move Bidg. ? 43 Reroof
? 32 Addition ? 37 Demotish (Bldg)" O 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code # of Stories sq• ft•
of Units
No Length sq. ft.
.
No. of Buildings Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. MC/ES System
UBC Occupency sq. ft. City Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS IN5PECTIONS
? Stucco/Stone
APPROVALS
Planning Building
Engineering
Variance
Permit Fee
Surcharge
Plan Review
License
MClES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SNU Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation:
SAC Units
% SAC
PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required for each unit
4/S SD
Date -?z_ 63
SiteAddress ']la'( e- Unit#
Property Owner /?PC L/ 13Q,/p,y Telephone # V/.V
Contractor oo/'Ql/7
Add
/
'?/
e
°W City
/
ress /Y/
L
1
State Zip ? Telephone # (? ) L//, ?9 -Wlf
The Applicant is _ Owner Contractor _ Other
Septic System New _ Refurbished Submi t 2 sets of plans and MPC license $ 100.00
Includes County fee. Additional consultant fees may apply.
Alterations To Existing Dwelliog Unit, Including $ 50.00
_ Adding fxtures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water turnaround (+ 5/8" meter if needed -$121.D0)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
h
t
W
f
V W
er
ater so
tener
ater
ea $ 15.00
additio
l
ment
l
Yre
p
_
na
ace
State Surcharge ? JUL ], 52003 $ 50
rocai I
3y_ ?
? .- -- -
$
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that 1 understand this is not a
permit, but only an application for a permit, and work is not ro 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.
SczJ7L ??Crl?el'9' ?/?P ?6 /??"
ApplicanYs Printed Nam Appl' t's Signature
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: singie family dwellings & townhomes/condos when peanits are required for each uni[
Date
SiteAddress *VI Unit#
Property Owner KW w Telephone # ( )
GM2
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Oa
Contractor
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State r ? ?V 1 Zip ? Telephone #
Bond #: Expires: 6 ?
The Appiicant is _ Owner ? Contracror _ Other
Add-on or alteration to existing dwelling unit $ 30.00
? furnace _Additional ? Replacement
air exchanger
? air conditioner _New k7 R eplacement
other
State Surcharge $ 50
'?
?
$
Total ?
•
I hereby apply for a Residential 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; 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
app ved pl?n in the case of work which requires a review and approval
?VlY?1?i?i ?rt 1?S
Applicant's Printed Name
2004 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: commerciaUindustrial buildings
multi-family buildings when separate permits aze not required for each dwelling uni[
Date
Site Street Address Unit #
Tenant Name (if applicable) Previaus Tenant Name
Property Owner Telephone # ( )
Cantractor
Street Address City
State Zip Telephone # ( )
Band #: Expires:
The Applicant is _ Owner _ Conuactor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove "see below
Interior Improvement _ Install Piping _ Processed _Gas
Nature of Work:
"When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing lnspector
PYI't111C FCCS: 570:50 Clnderground [ank installfltiunlremova!
550.50 Minimum (includes Sta[e Surcharge)
or
Contract Value $ x 1% _ $ Permit Fee
• IF ep rmit fee is $1,000 or less, add $.50 => $ State Surcharge
If ermit fee is over $1,000, add $.50 For
every $1,000 aermit fee $ Total Fee
[ 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; that [ 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.
ApplicanYs Printed Name
ApplicanTs Signature
Approved By: , Inspector
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 712 Hay Lake Rd N
Lot: 6 Block: 2 Addition: Overhill Farm 2nd
PID:10- 56151- 060 -02
Use:
Description:
Sub Type:
Work Type:
Description:
Census Code:
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Pella Windows & Doors Turnkey Sales
15300 25th Ave N #100
Plymouth MN 55447
(763) 745 -1400
e- Windows/Doors
Windows/Doors-New/Replacement
House
434-
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
Construction Type:
Occupancy:
Carbon monoxide detectors are required by law in ALL single family homes.
$88.50
$1.50
Total: $90.00
Owner:
Edwin 0 Bailey
712 Hay Lake Rd N
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
0801
9001
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
Building
EA089103
05/11/2009
ePermit
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114272
Date Issued:09/12/2013
Permit Category:ePermit
Site Address: 712 Hay Lake Rd N
Lot:6 Block: 2 Addition: Overhill Farm 2nd
PID:10-56151-02-060
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Amanda Hanson
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 -
Edwin O Bailey
712 Hay Lake Rd N
Eagan MN 55123
(651) 688-8368
Snap Construction
8200 Humboldt Ave S
Bloomington MN 55431
(612) 360-1033
Applicant/Permitee: Signature Issued By: Signature
'111`
City of Eaaau
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
3 Site Address: A. i 6c C / Unit #:
Name:
J
/764/f 1.r /ef Phone: -&r
36
Address / City / Zip: 7/( /769/=-4
Applicant is: Owner Contractor
Description of work: f + 4ce ___% dyf
Construction Cost: 000
Multi -Family Building: (Yes /
License #: /.3C 6 3'd2'/
Lead Certificate #: //e3
2
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
Mechanical Contractor:
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 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.
3a/%%G 7l9,04
Applicant's Printed Name
icant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA127303
Date Issued:09/26/2014
Permit Category:ePermit
Site Address: 712 Hay Lake Rd N
Lot:6 Block: 2 Addition: Overhill Farm 2nd
PID:10-56151-02-060
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Edwin O Bailey
712 Hay Lake Rd N
Eagan MN 55123
(651) 688-8368
Pella Northland
15300 25th Ave N #100
Plymouth MN 55447
(763) 355-1300
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA159548
Date Issued:12/30/2019
Permit Category:ePermit
Site Address: 712 Hay Lake Rd N
Lot:6 Block: 2 Addition: Overhill Farm 2nd
PID:10-56151-02-060
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.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
Edwin O Bailey
712 Hay Lake Rd N
Eagan MN 55123
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA173858
Date Issued:12/08/2021
Permit Category:ePermit
Site Address: 712 Hay Lake Rd N
Lot:6 Block: 2 Addition: Overhill Farm 2nd
PID:10-56151-02-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Nancy A Bailey
712 Hay Lake Rd N
Eagan MN 55123
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature