738 Hay Lake Rd NCASH RECEIPT
' 'CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
oare ? ts_
wecerveo ? ?.. .
FROM
AMOUNT $ I
6 DOLLARf
?eo
._ . „
1Nhite-Payers Copy
Yellow-Potting Copy
Pink-File CopY
Thank You
BLDG.- PERMIT NO.
--. r j -o ! •. , _
01-3210 B1dg.;Permit
01-3422 Plan Check
01-3445 Surch./Adm.
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 ,
r,....
O
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
4 , SITE ADDRESS:
';; , i AF ; +? i
PERMIT SUBTYPE:
,:+? I f il f N?i
PERMIT TYPE:
Permit Number:
Date Issued:
-? ?s? ??? ? . ? APPUCANT:
M
? ?, i . ? a?,. ??.s.???
TYPE OF WORK: (i< W
INSPECTION .A . ..
?
?
Permlt No. Permtt Molder Date Telsphone N
ELECTRIC
PLUMBING
HVAC
Inspeetlon date Insp. Commenb
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FlFEPLACE
AIR TEST
FINAL PLBG
FlNAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAI
DECK FT(3 0? •?
?
DECK FINAL
?.-,si
CITY OF EAGAN Remarks
Addition FAWN RIDGE ADDITION Lot 4 eik 5 Parcel 10 9Sunn nan 05
Owner screet 73.8 No HaTiake RQacL_ State Eagan, MN 55123
Improvement pate Amount Annual Years Payment Receipt Date
STREET SUFtF. 1981 229 . 35 - 11.47 20
STREET RESTOR. ' 1984 499.46 ? 49.95 10
GRADING 1981 61.26- 4.08 15
SAN SEW TRUfVK ,5 1981 205.44, 10.27 20
' SEWERLATERAL 5 7 7 19$1 33.07- 1.65
Se e 1981 23.57- 1.18 20
WATERMAIN
WATERLATERAL 57 19$1 43.67, 2,18 20
WATER AREA ? 1981 205.44 - 10.27 20
Water La ral ? 1981 27.68- 1.3$
sroRnn sEw TRK 1985 557. 79-" 37.19 15
' STORMSE LA - ' 1984 222.51? 22.25 10
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PAR K
?.-
. .. r 'y . . . ... - .... .. . .r . _.. , . ....
CITY OF EAGAN
? 3830 pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE 454-8100
BUILDING PERMIT Receiot#-?
Site Address 136 NU HAY LAKE RD Erect 99
Lot-4 Block --5-_Sec/Sub. i'AWN WIDGE Remodel ?
Parcel No. Repair ?
Addition ?
m VALLEY INVESTr1ENTS CO Move ?
i Name Demolish ?
3 Address 3770 5a LEXINGTOId (nt. rmpr?
° City EAGAN phone 454-5191 Install ?
12681
Length 52
Depth d (1
Sq. Ft.
Assessment
Water & Sew.
Potice
Fire
Planner
Var. Date
INVESTMENTS CO
all applicable
Permit ~ '''' ` • v"
Surcharge 34 ' O`)
Plan Review55 `'
Water Meter "'' • -' W
Road Unit --2-5y.-Cju
Tr. P I. 1 S o. Ci U
Parks
Copies
Total ' • u ?'
Permft No. PermN Floldw Data TNephone N
PlumWng
H.V.A: C.
Elodric c 3 ?8 ? ?P , ?? ? 6 c? J
$afte,w
Inspection Date Insp• CommeMs
FooNngs I
Footfngs 11
Foundatbn
Framiny ?
RooHnq
Rouyh Piby.
Rouyh Hty.
Insul.
Fireplace
Final Htg.
Final P
1b
Bldg. F
Cert. O + ?
Deck F
Deck Frmy.
We11
Pr. Disp.
CITY OF EAGAN WATER SERVICE PERM14
3830 Pilot Knob Rosd
P. O. Box 21199 PERMIT NO.: ,
Eagan, rIN 55121 DATE: ?
Zonirg: . No, of Units:
Owrwr: - t ?
/lddresa:
Site /Wdrcss:
?UMbC?? l3??rci 1 ?ll°7h:?.-^-,"
Metar No.. 3 074 Cho?ne:
Siu: IQ 1
ttl
Reader No.: 6 '
?T?
?,.
11
I
-
I .,?..,o ?.?,, ,.? o. _Q? ti 0
_
Q v ?-
/ ?r
Dote Poid:
Inap..
/ z - a(/- 8(0
CITY OF EAGAM WATER SERVICE PERM ff
3830 Pilat Kno6 Rosd
P. O. Box 21199 PERMIT NO.:
Esgan, MN 55127 DATE: , ` ' . .
ZoninD: _ No. of Unlts: -
Owner. - - '
Add?ess:
SIM Addr+ess: ' . _ , :•
Piumbsr.
Meter No.: Connection Charge:
Stze: Axount Deposit: -
Reoder No.:
Permit Fee: , .
I prM h a=npFy wilM !w Cilq ef Egyan Surchorge: .
OrJtmneN. Mist. Charpes:
Totol: r
BY Dote Pcid:
Date of Insp.: Intp.:
N eonWY wNb tw Ciyr of Eo/as
SEWER SBVlCE PERMR
PERMIT NO.:
D/1T'E: .
_ No. of Units: -
Conrnctton Charqe:
Account Deposit: _
Parmk Fes:
Surchorpe:
Misc. Chorpes: _
Totai:
Dote Poid:
CITY OF EAGAN N°_ 12681
3830 Pilot Kno6 Road, P.O. Box 21-199, Eagan, MN 55127
? ,(Jo
BUILDING PERMIT PHONE: 454-8100 rteceiptp6?
To be used for SF DWG/GAR Est. value $ 68 ,000 Date SEPTEMBER 26 1g 86
SiteAddress 738 NO HAY LAKE RD Erect m Occupancy R3
Lot 4 Block 5 Sec/Sub. FAWN RIDGE Remodel ? Zoning PD
Parcel No. Repair ? Type of Const. yn
Addition ? No. Stories
Name VALLEY INVESTMENTS CO naove ? Len9th S?
?
o
Address 3770 SO LEXINGTON Demolish
I
I ?
? Depth -----------
S
Ft
city EAGAN phone 454-5191 nt
mpr.
Install
? q.
.
i o Name_
0
u ? Address
? City _
ra
Fw Name-
_z
? a Address
z
a W Ciry -
SAMF
Phone
Phone
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 a i? of Eagan Ordinances.
Signature of Permitte ? -^
A Building Permit is is ed '. VALLEY INVESTMENTS CO
all work shall be done in accortlance with all applicable Sjfte of Minn sota
Building Ofiicial
Assessment
Water & Sew.
Police
Fire
Planner
Council
eldg. On. 9/23/86
Var. Date
Permit $ 337.00
Surcharge ?Y•vv
Plan Review 168. 50
SAC 575.00
Water Conn. 5 0 0. 0 0
WaterMeter 63.50
RoadUnit 290.00
Tr. PI. 156.00
Copies
r,.1 2.124.00
on the express condition that
and City of Eagan Ordinances.
4?
RESIDEWTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Reauirements
• 3 registered si[e surveys shaxing sq. ft of lol, sq. @. of tause; and all roofed areas
(20%macimum lot coverage alimred)
. 2 copies of plan showing beam & window sizes; poured found design, etc.)
• 1 set of Energy Calculations
. 3 copies of Tree Preservation Plan if lot pla@ed aRer 7!7193
• Rim Joist Detail Options seledion sheet (bldgs w0h 3 or less unils)
DATE P9 ` CCS - OZ
SITE ADDRESS 73g _ k)' 14 olly lAuC ~J
TYPE OF
APPLICANT
RemodellReoair ReauiremeMs
• 2 capies of plan
• 1 set of Energy Calculations for heated addNOns
• i site survey for ezterior additions & decks
• Indicate if hame served hy septic system for addAions
"3,UU0.??
VALUATION Vy,-75
??
STREET ADDRESS qo tJ I ???I?' C'n yy?cl?a,C?? CITY4,??- i' v,.,IrSTATEZIP 5;?
TELEPHONE # ? CELL PHONE # 411Z' ?'16 VS FAX #
?j(
PROPERTYOWNER ????-otadp vt TELEPHONE# ?5l t(SZ ?l ??
------------------------------------------------------- -................................
---°--
COMPLETE TH15 SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULLS 7670 CATEGORY I
(d submission type) . ResidenGal Ventilation Category 1 Worksheet Submitted w e tN?
• Energy Envelope Calculations Submitted JUN
? 1 0 ?Qp?
Plumbing Contractor: __
Plumbing system includes:
Mechanical Contractor:
Mechaziical system includes:
Sewer/Water Contractor.
_ Waler Softener _
_ Water Heater _
No. oP liaths
Air Conditionuig
Heat Rccovery System
---------•------------°----------------------°°------------°•-------
I hereby acknowledge that I have read this application, state that 1
with all applicable State of Minnesota Statutes and Ciry of Eagayf
Signafure of
Phone #
OFFICE USE ONLY
Phone #
Lawn Sprinkrer
No. of R.I. Baths
Phone #
MULTI-FAMILY BLDG?- Y /NI
_ FIREPLACE(S) _`?0 _ 1 _ 2
Fee: $70.00
-----------°---------°--------
correct, and agree to comply
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
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garege
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 PorchlAddn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 6ct. Alt - SF
? 36 Multi
? 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 Reroof ? 46 Windows/DOOrs
? 34 Replacement "Uemolition (Entire Bldg only) • Give PCA handout to applicant
Valuation Occupancy MClES 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 Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundarion HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final , _ Windows (new/replacement)
_ Insulation _ Retain'utg Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechan'rcal Permit
License Search -
Copies
Other
Tntal
Building Inspector
INSPECTION RECUKll
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
. . .. - - ,,
SITE ADDRESS: LOi: q a Lo c K: 5 APPLICANT:
736 1qflY LAKE RD N BUCNf+IAYEl7 RUI"H
FAWN RIDGE (612) 952-9329
PERMIT SUBTYPE: TYPE OF WORK:
DtCK NEW
? .... . ... . . . .. .... _.
?. . . _ ...... ..... . ..
BUILDINC
026644
10/27/95
_. .. ._ . . ... _. _ ... .,_ _. ._ . ._. . . _. . . ?
. ... .. _. _ __ _. . _ _. . . ?_ ? . .? . . . .._. . . _ . _ ?
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
P.:L. N. : 1.43-25800-040--05
DESCRIPTION:
B
PERMIT TYPE
Permit Number:
Date Issued:
738 FIAY LAKE fil] N
LO7? A L?LQCK; 5
FAWN RIDGE
PERMIT
Permit T,ype UECK
4o,rk 7ype PIEW
,
x":?"???{gg???` f1%
?? e+? vA 3y.1? ? 6j a?l?'nrv4'? fih 4i?"' 4?? e?u?8? Rrv 9?
?- i??are
cR,w1 q
6UTLDIMG
026644
i0/z-r{9s
REMARKS:
FEE SUMMARY:
Bas- Fee
Surcharge
Subtol'al
CONTRACTOR:
$30.00 coFZEs
$ ..50 TVtal FP.E.
$:a0.54
$sz.mcn
OWNER: - APPxicant -
PUCMMAYEft RUTH
738 HAY L.AKE ftD hl
EA(iflN MN 55123
(512)452--5329
CITY OF EAGAN
119VI,
3830 PILOT KNOB RD - 55122
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681 -4675
? 3 iegistered si0e surveys ? 2 eopies of plan
? 2 eopiea of plans (indude beam & window saes; poured fid. design; etc.) ? 2 site surveys (exterbr atlditions 8 decks)
? 1 energy cakuladons ? 1 energy calcuWtions for heatetl addkbns
? 9 cDpks M tree pressnetion plan if lot plened aRer 7/1N3
mqulred: _ Yes _ No
DATE: 10- I fT ' 9 S CONSTRUCTION COST: O50,° o
DESCRIPTION OF WORK: a d d de ck to P e a r o-F h a u 5 e.
STREET ADDRESS: 739 I4A,y 1- 4 k e R d-
LOT ? BLOCK ? SUBD./P.I.D. #:
PROPERTY Name:_, i chvwni?ar- Phone #: 3 Z 9
OwNER * rMer
Street Address. 73,9 Oby lcr ke R?.
City: ? a s a o State: M n 2ip; S SI'.3
CONTRACTOR Company: S am e, Phone
Street Address:
License #•
Ciry: State: Zip•
ARCHITECT/ Company: SQ ^'+ e-
ENGINEER
Name:
Phone #•
Registration #•
Street Address-
ciry:
Sewer & water licensed plumber.
change are requested once pertnit is issued.
State:
Zip:
Penalty applies when address change and lot
I hereby acknowledge that I have read this application and state that the infortnation is correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No , 0 C T z 3 1995
Tree Preservation Pian Received Yes No
? F
BUILDING PERMIT TYPE
0 01 Foundation o 06 Duplex
? 02 SF Dwelling o 07 4-plex
0 03 SF Addition o 08 8-plex
0 04 SF Porch o 09 12-plex
0 05 SF Misc. 0 10 = plex
WORK TYPE
,,-?31 New o 33 Alterations
0 32 Addition o 34 Repair
GENERAL INFORMATION
Const. (Actuai)
(Allowabie)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
OFFICE USE ONLY
0 11 Apt./Lodging o
0 12 Multi RepaidRem. o
0 13 Garage/Accessory o
? 14 Fireplace a
,O? 15 Deck
0 36 Move
0 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Planning Building
Engineering
Variance
3y
o/
D
Permit Fee Valuation: $ /Z00 ?
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter ,
Acct. Deposit
S!W Permit
S/W Surcharge
Treatment PL
Road Unit
Park Ded.
Treils Ded. Other
Copies
Total:
% sAc
SAC Units
.. .. M, .? +?4
1^ r
!
.ih. +w f?Mn
-i • 'M ? r JI? .
Y? p
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MCMIS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
L Ml ?
xb'
?
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1986 BIIILDIAG PENlIIT 9PPLICATION - CITY OF EAG96
AOTE: ALL CONTRACfOE5 MOST BB LICfiASED iiITH THE CITY OF EAGAN
SIBGLS FAlIILY DAELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 7 SET OF ENERGY CALCULATIONS
MQLTIPLS DiiELLINGS - RffiIDENTI9L RENTAL pHITS FOE SALB QNITS
INCLUDE 2 SETS OF PLANS, CEBTIFICATS OF 3DRVSY - CHECg (iITH BLDG. DSPT.,
1 SET OF BNERGY CALCIILATIONS
COMAfERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCIILATIOMS,
$2,000 LANDSCAPE HOND
To Be Used For: LJ Valuation: Date: q'ZZ'??'Q
Site Address I ? AteL
Lot ? Block Parcel/Sub Eau,
Owner U?f?7iVl? WJCLif,}? t'
Address ? 770 C>
City/Zip Code Je?-i;vw SS;L 3
Phone "-f 49-4( - S/ c/ /
Contractor ?(?J-L[-?(/ ?.t/(?,ES?.r?i??
.
Address -3 776 City/Zip Code C:?o46,4-A) Phone
Areh./Engr.
Address
City/Zip Code
Phone 4
Erect
Remodel _
Repair
Addition
Move _
Demolish _
Int.Impr. _
Install
Oceupancy 3
Zoning
Type of Const
# of Stories
Length
Depth O
Sq Ft
APPROVAIS FSfiS
Assessments Permit 337
Water/Sewer Sureharge s"
Police Plan Review / 5
Fire SAC $7,r
Engr Water Conn
Planner Water Meter 3.
Council Road Unit ?
Bldg Off Treatment Pl ?
APC Parks
Variance Copies
TOTAL ?
.1
NOTS: ADDRESSSS FOR CORNER LOTS - CONTRACTOR/HOMEOWNE@ MDST DESIGNATS WHICH ADDRESS
IS DESIHED, NO CHANGFS SiILL BE ALLOWED ONCE BOILDIIJG PERMIT ZS ISSOED.
/
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co: ";d (..0 _ ?•
17 u co = %tiZ
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k tz -s A3z
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k 5as 5440 S$p
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ENG?NE?i?ING
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SCALE' : l,• - 30,
(o947. o)
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I heraby eart3fy that this ia a and c?21,:rct raprsentatiort of t triet of
lind a: ahcsrn' and deac^ibed heraca.. Aa praparad by 1ne on this 18W day of
A->&,Ya- , 1994 . • •
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rine work? 17 n
Deten
.1 4r•- X
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' ; Mowpl exposed wa11'area ..•..,
,:, ; ft..x '• .05
sq. ,
? ,.
i roof r/ceil;n9
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................... ?tt
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. ? door area ............... .. ?l ? laS5dG01" dYy?d. •.... t.? . . •
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2/84
CITY OF EAGAN
APPLICATZ0N FOR PER'4IT
SEPIER AND/OR WATER CONNECTIODI
(PLEASE PRINT)
1) P'.?OPETY?'!' ACDRE55: I
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` ACDRESS: (c crA' 7`/y1) tr /P 6?L /fb
CI?"_'. Si.',TE, ZIP: -4N?Q''<-
= PF.OZE: .
3) PLL;M-? lP??„Sc i'@iYT) FOR CITY USE OHLY
T
PDC?ESS: ? PUJP.9ERS LICE4SE:
. ??J/f/•c? ie 7if'L Cj Acti?e
CIT'_'. .STA'."E, ZIP: 1(c? /S?'•ff! Ah-? 3"S'67J-` ? Expired
. PHOVE:
PLUMBER LICFfISE N Q Not of Record
' arr ;ntc=
g) a=„PFNT/C*.-;N?ER 1YLLASt ?et;?t)
N7%ME: ? l?i ??%A?. ?
ADDRESS:
CTT'!. STT,TE, ZIP: £19 ey -? ,
Pi-;o>E: /r
5) INDIGXE :VHICH PERi•lIT ZS BEItiL; REC[JFS'I'LD;
?CC.`,'?1EC.TI0?1 'It? CITY SE?iEEt
FCO:.'NECPIC:1 'IO CITY LJATL?2
? Oii'ER (PLG,SE DFSCP.ZEE)
D) 11vUlllii:: ll:,[.:
7) SIC7,TCRF.:
? PM7,SE f?OID APPRWFD PERMST FOR PICl:-GP BY CNE OF AF(.Z/E
?. °7-= =+S :•*,aIL APPROIID PE°:•lIT 'PJ 1.6 3, 4AW4'E
I
DAT°:
?
2F R E?SMIYA ? il? Q l?:O?c'? ! S I'R A i?? i 1? i ii ?:i a! 1!!l.sl?',Fl? fA f? 1t! i s?y
F O R C I T Y U S E O V L Y
PE?'`?i'^ °- ISSUED
rr"-$: $
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$°.9G.°, nr?).1T'= ?I?1C:T."?^ n or_'?^r^
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(I`:CiuDE :uRCHycZGc'.i
$ G 3• 5?= waTEa yETER/COPFERHORN/OL'TS_J° REe:DER
$ WATE3 TAP (INC:,UD° CORPORATIO?I STOP)
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$
$ /? • ?,_z? acccU:.T D.-PeszT - c-:aTEz
S ,j'?OO ' CJ-C LdHC
s ..`J 7 S?' G+-z3 gAC
$ T3u`:ri aSSESS:,-.Im
$ ?.:: S::, ..
TR"' _ _B "SSES,.?:,E?;T
+S L.,T::.yi, S:J:vEr'ZT/T_?li`IK SEI•;ER
$ L.=;: EZyL nLVLL IT/TRU:iK ;'IAT°_R
$ ? WATER TREATMENT PLANT SIIRCHARGE
$ OTHER:
$ TOT ;L
'`' A11OUNT Pn1J/?.'?..._....i?T n V CC ?2- l
DOES UTILITY CON:]ECTION REQUIRE EXCAV,ITION I:7 PUBLIC RIGHT OF WAy?
L YES IF YES, TH EN ".y "PERMIT FOR IWOR?i WITHIN
PUBLIC ROA D:vAY" MUST BE ISSliED BY THE
I? NO ENGINEERID7G DIVISION. LIST AS A CONDI-
TION.
SUEJEC'1' TO THE FOLLOS4ING CONDITIONS: •
APPP,OVED BY:
TI:Lc: •
DAT_° : -7
4101'
City of btu
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*: 113D-3-7
D3-7
Date Received: -4* 3
Permit Fes:
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address: 73g N• f1AY L A JI C izD Unit #:
Resident/
Owner
Type of Work
Contractor
J
Name:
M; A7 /Vo R S TA i)
Address / City / Zip: 73t /V • IM y LA gb- Pip
Phone: 6/2-5"/g- i7c j
Applicant is:
Contractor
Description of work:
Construction Cost
/ Pe 206,-(
9J,oa, od
Multi -Family Building: (Yes / No X )
l�hf ^CEO )$M6 —� 7
( Company: // �P�Pov�'n�tSvTS Contact: S/t%�HL�'•v L yDti�'
Address: �/o f/ ,0/4/2,8k00/- CIJd / City: 6/q GAec./
State: l"' Zip: S..0 / 2'2- Phone: to SJR 152 - 7 e'/
License #: fie 43.0/44 Lead certificate #: NST - 574.310 /
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:
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
t'e mat tltf are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. wnNw.00pherstgteonecalt.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ondinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and wok 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 S r r: 8 -'Idi Code must be m within 180
days of permit issuance. Pfd
x S
7.41:2F%r v L
Applicant's Printed Name
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA156359
Date Issued:06/26/2019
Permit Category:ePermit
Site Address: 738 Hay Lake Rd N
Lot:4 Block: 5 Addition: Fawn Ridge
PID:10-25800-05-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Kevin Plummer
738 Hay Lake Rd N
Eagan MN 55123
(612) 387-3916
Mcquillan Brothers Plumbing & Heating Co
1711 East Highway 36
St. Paul MN 55109
(651) 292-0124
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA157155
Date Issued:08/07/2019
Permit Category:ePermit
Site Address: 738 Hay Lake Rd N
Lot:4 Block: 5 Addition: Fawn Ridge
PID:10-25800-05-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard 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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Kevin Plummer
738 Hay Lake Rd N
Eagan MN 55123
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA173776
Date Issued:12/02/2021
Permit Category:ePermit
Site Address: 738 Hay Lake Rd N
Lot:4 Block: 5 Addition: Fawn Ridge
PID:10-25800-05-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
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 -
Matthew Russell & Amy A Nicol
738 Hay Lake Rd N
Eagan MN 55123
(715) 563-3675
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature