749 Hay Lake Rd NBLAG. PERMIT N0.
.. t
01-3210 Bldg.. . PeXmi
01-3422 Pla$ 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 Permi
20-3743 Sewer Permi
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
CASH RECEIPT
? C1TY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
?
DATEt-? 19!
w
RECEIVED
FROM ?
AMOUN7
& DOLLARE
too
E]CASH Q CHECK
FOR
,
. ? . . l.. .. Jf?? /?
FUND CODE qMOUNT
Thank You
BY j _
7 4 g ?. .?
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
.
E5 ATE 19
Receiveo ' - '-' -
FROM
AMOUNT $ I
& ooLLwws
,oo
EICASH n GHECK
ft
White-PaVers Copy
Yellow-Posting Copy
Pink-File Copy
Thank You
BY
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PECTI4N RECQRD
PERMIT TYPE:
Permit Number:
Date Issued:
n1.1E t 0 r NN
A:"i l h!,
aA/i8J93
? SITE ADDRESS. ' r " : t o ;• "0"'G1 H H 1
' ?)y N11Y
,t?}hl It I l???f 'Pfi'?
PERMIT SUBTYPE:
' ?;i.,- ?
I I At;l1 3 W
l "r : :1 0
? q}. F f44! M
APPLICANT:
rlI Ft f 0 1,t t+ i f hi I'! I, I1
@! ! h FZ
[ t. i:' l H40
TYPE OF WORK:
W i.?
I ! YJAI
Pertnit Na Pormit Holder Date Telephone k
ELECTRIC
PLUMBING
HVAC
Inapection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFWG
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE 14
FIREPLACE
AIR TEST
FI(VAL PLBG
FINAL HTG
pRSAT
TEST
BLDG FINAL
BSMT R.I.
6SMT FINAL
DECK FTG
DECK FINAL
OF EAGAN
EM 3830 Pilot Knob Rcad, P.O. Box 21-199, Eagan, MN 55121
PHON E: 454•8100
PERMIT Receipt #
Est. Value ' Date
Site Address
Lot Block Sec/S u b. Z iy D
Parcel No.
Phone 1_ _
Phone
I hereby acknowledge that I have read this applicatfon and state
that the information is correct end agree to comply with all applicable
State of Minneaota Statutea and City of Eagan Ordinances.
Signature of Permittee
OFFIC E USE ONLY
On Site 3ewaye Occupancy
MWCC System _ Zoninq
On Site Well Type of Conet
City Water _ (Actuaq
(Alloweble)
# of Stor{es
Lenyth
th
D
ep
S.F. Total
Footprint S.F.
APPROVALS
Aasessment8
Weter/Sewer
Police
Fire
Engr.
Planner
Council
Bidg. Off.
APC
Variance
FEES
_ Plen Review
_ SAC, City
_ SAC, MWCC
_ Water Conn.
_ Water Meter
_ Road Unit
Treatmerrt P1
TOTAL
A Building Permit is issued to: on the express condition thet
all work shall be done in accordance with all applicable State of Mfnnesota Statutea and City of Eagan Ordinencea
Building Official
Permit No. Psrmit Holder Date TNephone x
Plpmbing a -. ,•
,
H.v.ac. ?- ;7?
Electric
Softener
Inspectlon Data Insp. Commants
Footings I %
Footings II
Foundation
Framing ; c ?•
Roofing
Rough Plbg.
Rough Htg,
lsul.
Fireplace
Final Htg. - ?
Final Plbg.
Bldg. Final
Cert Oca ?J
Temp. LP
Deck Ftg.
Deck Frmg. X/?
Well
Pr. Disp.
a 'a'
(Ur#ifira#P of (Orrupanry
titp of (Cagan
Er}artitcpnf nf Iiuilbing JmWrriim
This Certiftcate issued pursuant to the requiremenu of Section 306 of the Uniform Building
Code cenifying thar at rhe rirne of issuance this structure was in compliance with the various
nrdinances of the Crty regulating building consrruction or use. For the following.•
use Cksdfimtioa S" DWG/GAR Bids. K=k Nm 13367
t? v
Oxupancy Type , Zoomg Distrut . Type CaM
ovfm.aeuddn :,,}•??`P.i? CGP:;?"i -- Add"•+w66 td:.Duw'UOU DR/ i? GAN
?;^
?,?? ??ty
',?.??, B1, rAWN t?TDCr 2i?iD
au:
etiaaing offikiil
POST IN A CONSPICUOUS PLACE
I CONTRACT PRICE:
PERMIT #
PLUMBING PERMIT RECEIPT # '71E 7F
CITY OF EAGAN .,
3830 PILOT KNOB ROAD, EAGAN, MN 55122 OATE: 7
PHONE: 454-8100
SiteAddress
loi.- - ? Block ' Sec/Sub
-. . . ;
a Namel-.?
?
? Address
-
c Ciry Phone
?a"
?
?
Name
c Address
O Ciry Ph.one .,
FEES
COMM/IND FEE - 196 OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMMfIND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
t i ?
-i
SIGNATURE,Of PERMITTEE i
BLOG. TYPE WORK DESCRIPTION
Res. ? New ??
Mult. Add-on
cGomm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
-' ? Water Closet - $3.00 $
'
?Bath Tubs - $3.00 7 `
= Lavatory - $3.00
Shower - $3.00
Kirchen Sink - $3.00 ? -
Urinal/Bidet - $3.00
1-Laundry Tray - $3.00
?Floor Drains - $1.50 ? . ? v
Water Heater - 51 .50
Whirlpool - $3.00
=Gas Piping Outlets - $1.50 1 (MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
-Private Disp. - $10.00
Rough Openings - $1.50 -
FEE: ? a
STATE S/C: ?
I FOR: CITY OF EAGAN GRAND TOTAL• -2(-'
G • ?
a», 7777
?
MECHANICAL PERMIT RECEIPT # °LE
CITY OF EAGAN
PILOT KNOB ROAD, EAGAN, MN 55122 DATE: april 3 ,?. 9 C,
i -, Name _..,.,.,o uon?; n„ ?, n
Address 13075 Pioneer Tr
? c City Lden Prairle phone
Name Corporate
Address 4466 Wedge
City Eagan
, TYPE OF WORK
Forced Air Lr,irlox 75,000 M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent ; brith irins CFM
Gas Piping Outlets # Fltrn<<- VIll f
FEE
S/C:
TOTAL:
FEES ?
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00 ?
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION) ?
GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA.
COMM/IND FEE - ta/o OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTCAL FEE - ALL ADD-ON 8
REMODELS - 12.00 ?
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50 -?
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYONO $1,000) i
L5.S / , j /
? .:.i.f,?/ r 1
• 5 SIGNATURE OF PERMITTEE
)ti n
BLDG.TYPE
Res. x
Other
WORK DESCRIPTION
New x
Add-on
Repair
FOR: CITY OF EAGAN I
CITY OF EAGAN SEWER SERVICE PERMIT j
3830 Pilot Knob Road ,)719
P.O. &Ix 21199 PERMIT NO.:
Eagan, MN 551i 1 DATE:
Zoning: ? No. of Units: '
Owner. Corporate Const. j
Addresc ;
51te
Plun
I agree to comply with the Clty of Eayan
Ordlnances.
?. BY
Date of Insp.:
'-1sp.:
fOF EAGAN
I Pilot Knob Road
Bo* 21199 .,
on, MN 55121
Const.
Date: 3-2 6 _ ,. 7
Size:
Date:
nn. Chg: 525. t]0pd , ?
ct. Dep: 15. OoTiii
rmit Fee: =0. OOpC
rcharge: _ . SOvd
Plant 1S0,00pd
Aer. 67 GlQpg
2oning: _
No. of Units:
I agree to comply with the City oi Eeyan
Ordinances.
WATER SERVICE PERMIT
GITY OF EA(3AN Permit No: 8579 oatg 32.
38 S 7 a s L 7 size:
3830 Pllot Kncb Road Meter No:
P.O. Bo.x ^.119fi Reader No: DRAI 73y/ D Date: I/-/ 3-F.7- ?
Eagan, MN 55121
' Owner.
ite Address: H3v Laice '-oad L? (! 71 * avi
tumber ??avmoud ?'= . iiae - ?lu- -
,.? __ 5? 5 nn„? V? A ,..,, .... __ • ,
Connection Charge: 525 . OOpd ?
Account Deposit: 15. 001>C1
Permit Fee: 10. OOpd {
Surcharge: • ?opd Misc. Charges
Total:
Permit No: $579
Meter No: _
Reader No:
-CITY OF EAGAN N° 13 3 6 7
3830 Pilot Knob Road, P.O. Box 21•199, Eagan, MN 55121
?
BUILDING PERMIT PHONE:454-St00 Receipt #e)1-71
7obeusedfor SF DWG/GAR Est.Value $69,000 Date P'1ARCH 20 ,19 $7
Site Address
Lot 20 E
Parcel No
749 NO HAY LARE RD
1 Sec/Sub.FAWN RIDGE 2ND
? Name CORPORATE CONSTRUCTION INC
= Address 66 WEDGWOOD DR
? City EAGAN phone 454-0644
p Name SAME
?Q Addiess
? City Phone
Uy?j
W
w Name
F
xz. Address
aw Ciry Phone
OFFICE USE ONLY
OnSiteSewaga Occupancy
MWCC System Zoning
On Site Well 7ype of Const
City Water X (ACluap
(Allowable)
# of Stori85
Length
Depth
S.F. Total
Footprint S.F.
APPROVALS
Assessments
Wa[er/Sewer
Police
Fire
Engr.
Planner
Council
1 hereby acknowledge that I have read this application and state Bldg. Off.
thattheinformationiacorrectendagreetocompiywithallaDPlicable I APC
State of Minnesota Statutes gpC)C? o?,Eagan Ordinances. Variance
? L ?Pl
Signature of Permittee J? /C,
A Building Permit is issued to: CORPORATE CONSTR[7CTION
all work shall be done in accordance with all applicableJ$tate of Minne;alta Statute
FEE$
_ Permit
_ Surcharge
_ Plan Review
_ SAC,Ciry
_ SAC, MWCC
_ WaterConn.
_ Water Meter
_ Rofld Uni[
_ Trea[ment P7
_ Parks
Copies
TOTAL
R3
-R1-
V
-v
40
48-
395.OC
34.5C
197-SC
?OE
59S OC
f,7-pC
-If1S OQ
7Rn 0c
?00
COon the express condition that
and Ciry of Eegan Ordinancea
Building Official
Thi9 'tlQU05IVOid ?///
C??95014
. . ?? .. - •ic ??. u"
, ? Reqmretl. [DNeady Now [] Wi II Nutitv InsPec-
? 13Yes ?NO tar When Neatly
LLKicensetl Elecvical Contractor ' I hereb
y.ra0uest insoection of above
? Owner alactrical work installatl et:
SVeet Atldr s Boz or o le No. ? Cit? ?^?
?/
ection o. Township Name or o. ange No. County
?
Oc - nt (PPZ Phone No.?
? S
T
Power Supplier Adtlress
d '
Eleclrical ConVacmr (CompanV Neme) ontractor' License No.
3 9
Mailina 4ddress ICOntracmr or Ownar Making Instailationl
uthonz iena ure n ac ner Makine Installationl Phone Number
14540 PENIVOCK LANE '
VWEP&ESMIE1BId1TbDF F11Fd1?A?GJL/1 G'! THIS INSPECTION NEQUEST WILL NOT
Gripga-Midwav Bldy. - Room,Fl•187 - BE ACCEPTED BY THE STATE 60APD
IlNLE55 PPOPER INSPECTION FEE IS
1837 Univsrsitv Avs.. 3t Peul. MN 66100
PMne (6121 862-0900 ENCLOSED.
KEQUEST FOR ELECTRICAL INSPECTION ea-ooooi-os
/ -' °/0/ / See instructiona br completi
riy this form on beek ot yeliow copv.
/1 "X" Below Wark Covered by This Request ,
^ qsn') c}
d Nep.1- Type ol Building Appliuncea Wired Equipment Wired L4 -1_ --1--14ome i- Range Temporarv Service
A Ir
ce
N Fas Serviee EntranCeSize p Fee Feeders/5ubleeders +# Fee Ciecuits
• 0 to200Am s 0 to30Am s .01 0 tn30Am
A6ove 200 qmps 37 to 100 Amps 31 to 100 Amps
Swinvnin Pool Above 700-Am s Above 700-Am '
Transfortners Irrigation Boorcis Partial."Other Fee
ial Inspection
1, the EleclrieSf-
Inspector, hereby
cerliiy thal the abpva
inaoection has been
458-580 5].
R Y ISt1Q-7
REQUEST FOR ELECTRICAL INSPECTION
Minnesota State Board of Electrir,iry
1821 University Ave., Rm. 5-128, 5. Paul, MN 55104 ?
Phone (612) 64z-o8oo?9 rJ
Home Du`lexv Apt. Bld . bther New Addn
Commerciol Indushiol Farm Remod Re air
Air Cond. Htg. Equip. Wofer Htr. Load mf.
I
Olher:
Dryer Ronge Elec. Heot Temp. Service
"X" obove f6e work covered 6y rhis request. Enter remorks in rhis space and on fhe back oi the white ropy only.
ki V u lM?tl?.? +A-LP
Vw'l-/-
t! Calculofe Inspeclion Fee - This fnspecfion Requesl will not be accepted without the correcf Fee:
Other Fee # Scrvice Entrance Size Fee il Cirtuils/Feeders Fee
Mobile Home Park Stall 0 fo 200 Amps 0 t0 100 Amps
Street Lig./Tmffic Sig. Above 200_Amps ^ ve 100-Am s
Tmnsformer/Generafor INSPECTOR'S USE ONLY s, TOTAL
$ign/Oulline Lfg. Xfmr. ?? 20 .50
Alorm/Remofe Control
Swimming Pool i
i
I herecerti IhatJ'ins e elxtriml InsmlloHan dexribed heretn on Ihe da?s siored
Irrigofion Boom Rougkln ' Dme
S
eciallns
ection
p
p
Inves}igative Fee Firol
-
THIS INSTALLATION MAY BE ORDERED DISCONN €Q IF NO OMPLETED WITHI 18 MO H5.
^• // ??/C ? OFFlCE USE ONLY This request void 18 months $an vay ??k? ?d in this 6ox.
'Y 7
? ,/??A ?QNd
)1;1.0?'P• ?n ? Oo
I IIII II I llifilili'll 11111111111111111111111111 I III?o?O? ??? Jlu/1AG / oc U//
* 0 4 5 8 5 8 0 8* PLEASE PRINT OR TYPE a&-)
Request Da1e
y_i?_q--? Roughin insp«tion ,equiredR ? Yes No
(ya?mus?cailIheinspecrorwhenreody)
I Inspenian Olher TMn RougMn: ? Ready Now Wtll Call
DateReady
licensed coniractor ? owner hereby request inspecfion of fhe above electrical work at:
Job Address ISneet Bm Rou?e Na.)
? L?q N.1 Ua,V? 2oad Ciy
?a Zlp Code
Sxnon No. Townahip Name or N. Range No. fire No. Cwnry? {
??L?
Occrupont ,
r Phone No.
gqD-r)jEg
Power Sopplier Address
Elecniml Connacbr (Cwnpany Name
l l`?n EI c?- Co ns?. C? . Con or Lioanse No
-oo qo Masier Lic Na. (%om Elect Onlyl
Moiling Address I ?? ?'?r Pghr ing I?bll ?
2? ?c,- ee?- N 55107
Authorired Si narore jConn r or Owne, Pe,hrming anion) Ph. Na.
Zz? z$ 33
E6,WtA-1hK6 n 1n STA7E BOAflVCAPY - SEE INSTNUCT10N5 ON BpCK OF VELLOW COPY
U ?r 6
0 RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Conekuctkn ReauhameMe
• 3 rBglsterBd Sile SUrveyS Showing Sq. tt. of bt, Sq. it.01 house; and gll r00iBd areas
(20°/> maunum bt cove2ge albwed)
• 2 copias ol plan snowhg beam & window saes; pouretl found design, eta)
• 1 set of Energy Cakulatbns
• 3 copies ol Tree Presenatbn Plan If bt platled etter 711199
• RimJOistoetail OptbnsseWctbnsheet(bklgswim3oriessunis)
DATE Z7 IZ ° ?2`
SITE ADDRESS C? Y I N `
TYPE OF WORK I-Cu? ' o
APPLICANT
v_u.g
4 5,eTv P ?d.? sT
MULTI-FAMILY BLDG _ Y _ N
_ FIREPLACE(S) _ 0 _ 1 _ 2
STREET ADDRESS 10`4
?-
TELEPHONE #?? S Yol 2 CELL PHONE #
PROPERTYOWNER
6 r c- ?.e.? S r>-7
TELEPHONE #
-----------------------------°-----------------------°-----------------------------
COMPLETE THIS SECTION FOR °NEW,, RESIDENTIAL BUiLDINGS ONLY
Energy Code Category/ ;/ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672
(4 submiesion typ,e?J.%''? . Residential Ventilation Category 1 Worksheet Submitted • New Energy Coda Worksheet Su6mitted
?
• Energy Envelope Calculations Submitted
1,10
Plumbing Contractor:
Plumbing system includes:
Mechanical Conhacfor.
Mechanical system includes:
Sewer/Water Conhactor.
_ Water Softener _
_ Water Heater _
No. of Baths
Air Conditioning
Heat Recovery System
!.? 0i'-?-4 STATV1"( ZIP
FAX #
Phone #
Lawn Sprinkler
No. of R.I. Baths
Phone #
Phone #
Fee: $90.00
Fee: $70.00
--------------------°-----°---°-----------------------°----------°------------
I hereby acknowledge That I have read this applicaTion, state that the inf rmation is correct, a d,
with all applicable State of Minnesota Statutes and City of Eagan Or i nces. I
Signature of Applicanf
-----_----__._______------------------ ---- ___--?'rc?s ??,.
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
modeUHeueirReauhemeMS 03. 3- 75-
• 2 copiesof plan
• lsetofEnergyCebulationstorheatedatleiCnns
• 1 3ite survey for edenor addmons 8 tlecks
• Intlicate il hane served by septb system for atldRbns
rd
VALUATION ?1` b 0
to comply
Updatad 4/02
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex O 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Mufti
? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) O 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) O 38 Mufti
? 05 03-plex ? 11 10-plex O 19 Lower Level ? 24 Stortn Damage
? 06 04-plex ? 12 12-plex Plbg_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 AHeration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 WindowslDoors
? 34 Replacemant •Demolition (Entire Bldg only) - Gfve PCA handout to appliwnt
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 Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ Final/C.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumhing
Foundation HVAC
Drain Tite 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 _ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
5&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical PeRnit
License Search
Copies
Other
ToWI
r. .
:?
CtTY'?]i?.EP?? :
TER2'iTk?A1.. N7* ° 94 '
, ; < <
zn .
?1E?1`1?'Y _ .1`!Y'{.°:6Tr?i°'Cf?`ti?_???'
r
HAE L,k Sc :n13
1
2_'i? `?s3?J,'1 i'?.9 ?iA`?•Lt:'?,, `+ ? C.Sq
.
; ,. .
„ . .z . - . , . . ', . .
k . .
?.
fi
Nk,tS!' _ . , ? .. . ., . ..
?'o.,r???G+kWxix
.$,•a7X?Xm
%,? ts SX;:t>`a46'dY Y;°J:tYt.?.
?
_
, .,-
. ,'.
----?CITI? OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT
PERMITTYPE: eurLozrvG
Permit Number: @ 2 9 7 6 6
Date Issued: 0 4 J 18 J 9 7
749 HAY LAKE RD N
LOT: 20 BLOCK: 1
FflWN RSDGE 2ND
P.Z.N.: 10-25801-200-01
DESCRIPTION:
iuildinj,Permit Type
_i=Buil-ding ?bd'aar,c?Type
" Census Gode' ?.._,
?.
. . . . .. ?^"9T\
y
1?i'. . ? . . . .. . . . . ??%
\ 5??
?\• ? v?r?
i
?
REMARKS:
FIREPLACE
NEW
434 ALT. RESIDEN7IAL
? .-'• ? 'l " ? ? ? r ?
FEE SUMMARY:
Base Fee $50.00
Surcharge $.58
Total Fee $50.50
CONTRACTOR: _ Applicant - sT. t,zc.OWNER:
H?AT-N-GLO FIREPLACES 18900758 0002960 RANK S7EVE
3850 W HWY 13 749 HflY LAKE RD N
BURNSVILLE MN 55337 EAGAN MN 55123
(612) 890-0758 (612)686-6259
T hereby acknowletlqe that I have read_ this.application and state that xhe
informaCion :is correct dnd agree to comply with all applicable Stdte of Mrv.
StatuCes andCityvf 6agan Ardi:nances. -`-
? . . _ ? _ . ' . .._ . ?
APPLICANT/PERMITEE SIGNATURE
ISSUED B?: GNATURE
CITYOFEAGAN L16'd
830 PILOT KNOB RD - SS122
0: 0765 1997 FII2EPLACE PERNIIT APPLICATTON
??? 681-4675
DATE: 4 /PERMIT FEE: $50.50
??o S
DESCRIPTION OF WORK: L-0 CONSTRUCT NM FIILEPLACE _ ALTERATIONS TO EXISTING
OTFER:
STREET ADDRESS: 1
LOT 90 BLOCK
APPLICANT: (circle one only)
_ INSTALL GAS INSERT ONLY
_ INSTALL GAS LINE ONLY
? SUBD./P.I.D. #: 't
OWNER CONTRACTOR
a14 °
-- 1
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
PROPERTY
OWNER
Name: cS l L?? Phone #: 4$ 6- b z S? /
Signature:
FII2EPLACE
INSTALLER
GAS LWE
INSTALLER
Street Address: ! L-
City: ?A 4??AoV State:
N
StrcefAddress?58Z-d
CitjZ deL"\1 l L-?-? State: ?
Company:
Name: _
Signature:
Street Add
City: -
zip: /' Z
'67S
one #;890
/
License #: Z ob 70 91
Zip:
Phone #:
State:
Zip:
,_ .
OFFICE USE ONLY
BUILDING PERNIIT TYPE
? 14 Fireplace
W ORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Census Code.
SAC Code
REMARKS
Chimney/flue must be inspected before concealing.
1987 BQILDING PERI?IIIY 6PPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
IRCLQDE 2 SEfS OF PLANS, 3 CSRTIFICATSS OF S[TRVEY, 1 SST OF ENERGY CALCQLATION3
- r
NOTE: ADDRESSES FOR CORNfiR LOTS - CONYRACTOR/HOMEOTiiNfiR MDST DESIGHAYB AHICH ADDRESS
IS DFSIRED. ND CHANG&S WILL SB ALLOWED ONCS BQILDING PERNIIT IS ISSDSD.
MULTIPLE DWELLINGS - RBSIDENTIAL RBNTAL iTAITS FOR SALS UHITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SOBVEY - CHECB TdITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCI9I.
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFIC9TION5 AND 1 SET OF
ENERGY CALCULATIONS, ?
$2,000 LANDSCAPE BOND
To Be Used For: NCw Valuation: p+,000 Date: T-1 &-d7
Site Address 24c? L . uAY l aee (2)
Lot Zo Block ?
Parcel/Sub ?„?,,,,,,, ??d9. 2,"•? Ad?
Owner l..p'PO.cf(r ?p1?s?,'ry?i
Address l.irC3ty/Zip Code 4n557-123
Phone CSK 06Yy
Contractor S-dKlP -
Address
City/Zip Cade
Phone
Arch./Engr.
Address
City/Zip Code
Phone B
On Site Sewage`
MWCC System N"?
On Site Well
City Water ?
APPROVALS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
' Council
Bldg Off
APC
Variance
Oceupancy ?•3 '
Zoning
Type of Const
(Actual) ?
(Allowable)
# of Stories
Length 40
Depth
S.F. Total
Footprint S.F.
FSFS
Permit
?
Surcharge 4-
Plan Review
_$D
197
SAC, City ?po.
SAC, MWCC S2_5_
Water Conn GZS
Water Meter (fl?.
Road Unit 30 5.
Treatment Pl
Parks
Copies
TOTAL ?
?-3 } `? "o
v?-7 (o
(2x12 ? ??I4 x 4-4 ? C?23cn
2Dx22"
(; 3 x 4? ? z'7 ? 2
,44o x ? Z = J28 ?
?
r
.
r g ?`? ?
•
SURVEYDF?'S?? CERTIFICATE CORPORATE CONSTRUCTION
• ?
?? •
' C8l'6do•6.0.62 N64°24'IS"E?• 9?? ) , "•
. / n xi. ? . ..
J 1
i
' dDAAfNA6E A U77LlTY ? ? . [AS6M6NT r6R PLAT, 6 \? . .
W I
g LOT 201 in
(7)1 N 11
4-
r-
- N 13R9 40.0
i'- N P Houe E? N ?
? w/ A
•? ? Ma IA m,p?
? a g mGAP-/*M W \
,• / ?yno? ? ? ? m ..
• ?.G .
20.0
. ? ?, ?
cd
2
70.76 :•' R•580.00 ?
6.00? ? p.6°59'23p
N N 6403510011 E
ORTHHAY?. LAKE.:. RO ?-?,
DENOTES PROPOSED SURFACE DRAINAGE SCALE; 1 INCH ? 30 FEET
• O DENOTES INON MONUMEN7 SET
• DENOTES IRON MONUMENT FOUND PROPOSED GIIRAGE fL00R - 92'L-16 FEET
%000.0 DENOTES EXISTING ELEVA710N PROPOSED LOWEST FLOOR ¦ 919•5 FEET (000.0) DENOTES PROPOSED ELEVA710N Pti0PD5EU TDP. OF BLOCK ¦ 927-•'1 FEET,
1 HEREBY CERTIFY TO CORPORATE CONSTRUCTION TNAT TH15 15 A TRUE AND CORIiECT
REPRESENTATIUN OF A Sl1RVEY OF THE 60UNDARIES OF: '
Lot 20, Block 1; fAWN RIDGE 2ND ADDITION, accordi,ng to.the • •
recorded plat thereof, Dakota County, Minnesota.
AtID OF THE LOCATION OP A PROPOSED BUILDING. IT DOES NOT PURPOAT TO 51f04f 1FiPROVEMENTS
ON ENCROACHMENTS, iF ANY, THEREON. AS SURVEYED 8Y ME, OR UNUER MY DIRECT SUPERV1510N,
TfllS 2bTH OAY OF Jar4uAa.y , 1987. '
PROPOSED ELEVATIONS SNOWN ARE AS SIGNED: JAMES R. HILL, 1NC.
TAKEN FROM THE GRADING,DRAINAGE:;• •
ANO EROSION CONTROL PLAN FOR FAWN
RIDGE 2ND ADDITION PREPARED BY G?
PR08E ENGINEERING COMPANY, 1NC. BY:
LAST DATED 8-21-86. NAROLD C. PETER50N, LAIIU SURYEYOR
M1NI8ESOTA LICENSE W. 12294 . •
PAOJECT N0, soo?c ? PnGE JAMES R. HILL, INC.
87039
planners / Enginesrs / Surveyors
FILE NO. ' 8200 Humboidl Avenu• 6oulh
.
FOLDER • ,e?oominDlon; Mn. 66431 012-0e4-3029
. . ' MltltlhJVlw oI
- BeSED ov r,HA TER OF T
MODEL ERGY CODE - DITLOK_-_
Adoptlun Eff*c[lv• l!i/ 4
.
)wner Phone
;1tt address
:ontrLCtOr :NIC?c.? .?hOne
su11d1ng Classlficatlon: Type At (51n_gle fa:nily 3 Ouplex) ?/ Type A2 (Residentiat?
(3 stoHes or ess
(Other)
3EHERAL INFDRlWTION
(Over 1 staries)
1. 8u11ding Perimeter \ tk (o ft.
LZy?; ?'?
?'. Wail height (grounC to eave) ft.
2
3. i. x 2. (aDove) gross ti+all 4rga 4,052L4 ft. }\q??.
I . Building dimensions (L) 4o x(W) z(o •? Z3 ? ft.2 roof S floor area
: S. SQuare fcot area of rim joist - Floor joist size (2 x to? )
to? x Ferimeter • Rim o st area ? zO.o ft2
1f-
6 . Doors - Area `t .
Th1c r?ess ?3Iq"? n. actor
Typt of Costruct oi n 4 r\ -rerimetv 1ce• 3z ? 15.4F,- fL.
ManufatWrer??
? 7. Total door's perimeter ? z. z tb ft J
8. Wlndows: Menufacturer ??•-C' o? State approved
U factor
TYPE SIZE AR:A (f:.2) 4ri1M8ER Of TOTAI fEET Z
Cft C..
.
?.
cqCH UNITS
?.4r, lo (,4.
vk . ? Z
?c??so ? ? s9 S_?iQ
So3(, 2 _ l? 59
5040__ ? 14.-1 4 q4.7?2?_
.. g. Total ft.Z Glass ? 5 `;6a a k
106 fireplece area: W dth x heiaht ¦ {? z__? FL•Z
1Exposed founda N on: Helqht x Perimeter Ft.Z
:)MPLETION OF THIS FORM 1S REQUIRED FOR ALL NEY COfISTRUCTION. MAJOR REMOOELING ANO,BUIlOi.'1G5 BEING
13VED 4?HERE ENER6Y, OTHER THAY TFIE MINIP4'1l COOE AILONANCE, IS USED.
?iny airar • tO? ot ??ts Mrlti ?rra. :.. ,: a ?Y:
?
2 j
_
;ross wll ara Zo G-, 4 - f*•• `?
Nindow area A ft.Z 1: velndows • a '? !1 x A ¦?,,?,q0 =i
?• Rfii joist erN A ? O ft.2 U rim joist ? . CD-A, U x A ¦__„
, . ,
poor area A .,
ft.?
7
door area ¦ ,, ???
U x
A
'c
, Ftreplace arN A
? 2
f:.
U _
rireplace U x
a
•_?
Exposed Toundation A -7 ¢, f!.' 0 foundation ¦ ..\\ U x A •
min
ar
a A
f O ( 2
ft
- U franing area •
O`i U x A •
g
..,
.
_
ra
fl
-?t
J=
Net watl area a 14 5a.. !? ?,`t•
i
'J wa 11 = „ [-j-?{ ? U x A • ?O ? 50
f
(>?o -:;-..L . . . . . . . . . . U x
;
C
Gross wail area x 0.11 (A-1 single famil.y S du;:>x • allowable UA A/Code
(13. above)
' x 0.23 (A-2 other resiCentia'.;
• x .23 !0[her building:`
.c ^8 (Ovet• i stor;-)
.? . _
?
TUH Must be larger than ?
A ?O x t! Ccde. .- `?, -- 138 above.
--r--
Caiting fraAtng area (Af) aquals 10= nf c_;1;n, ;rea ? or the same as) -
?1..; 6ross ceiling area ? (L) C) x(W) ft.2
Joist erw (Af), • 10'; csiling area ft.2.
Ne: ceilino are: (Ac) (15A - 156) -?k Q fL.2
il ceiling :c A c¦ 'Z x_k Q?i?;, ' ?•'? _ ?`I
U framing z A f¦ _ O 4 x_???.?
0. TOTAL U z A ....................................... ?-T
i.etlin9 srea (15A) x 0.026 {A-1 single `amily S duplex - code allowable U x A
T? .
x 0.033 (A-2 other res'ida.^.tial)
• x O.C6 (other)
• BTUH Must be larger than 150 (aCa've)
q(I5.1) x?ftodeL pZ(o ?F (or the same as)
_ Z) ?.. oQ)
NOTE: Use U and a values oDtained f••om nps 1, 3 and 4.
,
.
.
?.,
..
.i
-
1\... . ... . ?...
, • ?u
SYCTIQM
i
sTLID
sccria+
' 2ND uALI
SLGii'?K
?a
,
! .; . -
RlM
JOIST
,r
,
r?
?a
,r•', .
s?•.
?.. __.?.r_..
?'.
?.;
.1..} J
4
?bi [`
1:?4
' I }. ?'
I
`?!
? r ]! ;`
? l
-77
Intartoe wil
• .
4?
? ?
? • I • rv
6`• F K!nsuia[lvn oo i
??nthini
I...S1.s
i
t c?-r, 0 4'?:
rJutsldv- air Ellm .17 ? t
3 T07AL N
lnalde air f ila
?
lnt.:toc +si1 •4? ':.?
' ?/" ? scud R? ? (Framing) U ? ? • ;.? '
I ?q I ?hea[hing Z.ole 1i.
Sldfns
^. ,Il OutsiC• air illn
.17
? . . ??
• ?'? :.. .'?? •
J , .
m -OTAL ? O . ? Q ':%?
Insltle air C:lM R• .68
InterLor vail
,i
inoutactcn 1C}.op (uall3 . • ??':": f;?:'I
Shaathtng
Exterlor vA11 :overing
?
Extretor air t11m n ..1%
s toTeL 2'303
z
;
, .?
ln[rriur air film ?! .63
:r.suln'.lon ?61.00
1? ir,th Su[r vuuJ R>1.88 (RiA1
U •.?!''...-'.`?,a
\
YOISL);
IL. '?
C' 3/`4 S
Sheac?Yhg O`
4
7/?u L''nteror wall cuvr.rina, •?O?
lih
Esteclor air illm Rs :I7
? ?
.
' 0 4
? a mrAL '
?4 4(e
. :
?: ?
.
I
? lnt?.rtor air iiln
R• .68 G
lnsula:lor. -?.00
I ??Y Cer«a?, FounJatiun Z•lo (Fdn.) U •??
.
b xtector air ftln a`,7
QN.
I <
F TOTAL
5.
I I f:cpoaed 31ucK ,?
r--? •
rroCe
.
?
,y ?P?{?'n ay,. r???•i?y y?y'?.St.?? y.??/?. ?,? e? - c -ll
a ?
• }4?1?'??li h?I???? ??t :?5..1'? t i ??? ...>? ? :? :
AP
A4r'iitm 0161
. ?
3\ .15 insulation 44 . o
• . ?, ?} . 3 ?,
011
?.
3-7 .93
,oz(-4
Joist
s
Y `.
Ceiliny
Air F11m 0.61 ?
rotat a
V
F!.4T aoOF oa carHEDwAl. CEiLt,+G
---FTaTue ? R YaI.UE
FR,;MING CEILIriG
I td i fi 0.61 ,.
ns e a r 1?m
Ceiiing 1
Joist (stud
Insulatton
dir SpaCR
Roof de:kinq
Insulation
Buttt-uv roof
Outsidt a1.r t.iiw p
TotaT R
I
o " V
pdow 1nf11tratic-i 5 tfai/tineal foot of crack
;1QRn t1a1 door, inNltration 0.5 cfm/sQuare fao: or dcor and mininur code requlremcnt
e-res identiai door infiltration 11.0 cfr/lineal foot of crack
;
,. 12" conri•ett block no tnsu9ation - .4I R 2.1 r
i 12" concrete block lnsulated cOrts =.26 R 3.8
12" light.KipA? black - •.32 R 3.1 . ..;
12" 11ght?etght blxk Wsutated cores ?.12 Q 9.3
,
tiayle gtasi ? 1:13: wlth storirn windox .54 . ? z
?`?doubl? ?lass •..56 . ''i
1, tripl• q1as; • .81
311 euterior vells and ceilings must have a vapor barrier (C.10 perm glax.).
:#por barrier aKest be on tht 4nslde (heeted side) of Nall.
44por barrters of.tht polyethelenQ thfn film have na R valuc.
;.. ;.?
• a. .
?
!f .
CITY OF EAGAN
APPLICATION FOR PERMIT
=R AND/OR WATER CONNECTION
!J, CN1LI •_ . '?
1) PROPERTY ADDRESS: --I l? ct T
LEGAL DESCRIPTION:
ase
:*TOTF: PAYMH NC OF FFE AT TIME OF
't ArrtscATIorr noFS Nom CONsriTurE
F APPROVAL OF PEEU+IIT.
` rNSPncizotv oF sEWEz ArID/ox MOM
; TTISTAT.TATTOIIS WIIS. NC7P BE SCFED-
: = I]NTIL PII2NIIT HAS BEEP]
: APPRdVID.
(Lot/Block/Subdivision or Tax Parcel ID )
IF EXISTING STRCt.ZURE, DATE OF ORIGINAL BC'ILDING PERMIT ISS['ANCE: .
Year
PRFSENP ZpNIi?/PROPOSID LSE: (Nbn
C] CONP7ERCIAL/RETAIL/OFFICE
r7 IAIDL?STRIAL
n INSTI'I[."fIONAL/GpVERNMEN'P
NrR-1 SINGLE FAMILY
Q R-2 DLPLEX (7tao Onits)
CD R-3 TOWNFiOUSE (Three + Units) ( Dnits)
Fl R-4 APARTT'hNP/COAIDON1iNI(.T1 ( Units )
2)
N71ME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
3) ' c ?'• NAME:
ADDRESS:
CZTY, STATE, ZIP:
PHONE:
MASTER LICENSE#
41
s• M?
NAME:
ADDRESS:
CITSt, STATE, ZIP:
PHONE:
Plisnbers License:
Active
F?cpired
Not recorded
StaFf-Initial
5) ? r a• • ?• : ? • ?? - a??
UrC(&NE(.TSON ZU CITY SEWII2 M??.`tION TC) CITY WATER ? OTHER_
6) ?? • • i- ? pLEASE HOLD APPROVID pERMIT FY)R PICK-PP BY ONE OF AHOVE
PLEASE MAIL APPROVID PERMIT TO 11 2(?. ABOVE
n n (Circle one)
?
FOR CITY USE ONLY
PERMIT # ISSDED
Pd w/Bldg. Permit FEES:
$ s /4 • '? C?
$ $ /o - ??
0?
SEWER PERMIT (INCLUDE SURCHARGE)
WATER PERMIT (INCLUDE SL'RCHARGE)
$ /r; 7, Ga-D $ WATER METER/COPPERHORN/OC'TSIDE READER
$ S WATER TAP ( I[VCLUDE CORPORATION STOP )
$ $ SEWER TAP
$ I.SI$ ACCOLNT DEPOSIT - SEWER
$ $ ACCOUNT DEPOSIT - WATER
$ J Z? l? $ WAC
S 6 $ sAc
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRDNK SEWER
$ $ LATERAL BENEFIT/TRLNK WATER
$ / O D' C? C7 $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$c? -71 / I d' $ TOTAL
' Cqo2 7, o v " /A ?
RECEIPT RECEIPT ,
DOES.DTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC'RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PDBLIC
Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
I
DATE: ?Z(p ?? 7
1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTR9CTOR/$OMEOWNER M[IST DESIGNATE WHICH ADDRESS
IS DESIAED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF UNIT3
INCLUDE 2 SETS OF PLANS, CEATIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCOLATIONS
COMA'fERCIAL
?
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTUR L PLANS, ?-
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used ror: Valuation: Date:
Site Address -(qq-A)
Lot 2D Block
Parcel/Sub
Owner m rr
Address
City/Zip Code 1a3
--
Phone (V 69D/- (?SOa,
Contraetor
Address
City/Zip Code Soapa,ve -TSU 7 5-
Phone
Arch./Engr.
Address
City/Zip Code
Phone It
3- 01C-7? - U 3
OFFZCE USE ONLY
00 J °-°
I
On site sewage _ Oceupancy
MWCC system Zaning
On site well Actual Const
City water _ Allowable
PRV required l6 of stories
Booster Pump ` Length
Depth
S.F. Total
Footprint S.F.
IlAPPROVALS FEES
Engr/Assess . Permit
Planner Surcharge ,
Council Plan Review
Bldg. Off. 4)Z57-3/ZZ SAC , City
Variance - SAC, MWCC ..
Water Conn
Water Meter
Road Unit
Treatment P1
Parks
Copies
I _ TOTAL . ?,$"
Midwest Remodeling
& CONSTRUCTION COMPANY
Customer `
Address
City
Phone: (Hm.)a/ . 4z?.
, ,
Salesman,
'?) „) 2,r SS/?
14
, kl- W2-- (W k.) ?
'Y2 c- _ Q -:Z , ri .c ?
DIAGRAM
-?-- ---
;
,
? ? t
•
. _ _
_
- --, ?
, ,
- - _-
, , r
, --
- !
-- , '
- _ _
-
? -?- --?_. _
? ----! ? ---? . -
--- ? ----.
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114056
Date Issued:09/10/2013
Permit Category:ePermit
Site Address: 749 Hay Lake Rd N
Lot:20 Block: 1 Addition: Fawn Ridge 2nd
PID:10-25801-01-200
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 .
Eva Lewis
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 -
Li Eau Ly
749 Hay Lake Rd N
Eagan MN 55123
Purpose Driven Restoration LLC
325 Main St NW
Elk River MN 55330
(763) 633-4737
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA129927
Date Issued:03/24/2015
Permit Category:ePermit
Site Address: 749 Hay Lake Rd N
Lot:20 Block: 1 Addition: Fawn Ridge 2nd
PID:10-25801-01-200
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Applicant: Troy Good
3670 Dodd Rd
Eagan, MN 55123
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 -
Li Eau Ly
749 Hay Lake Rd N
Eagan MN 55123
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
For Office Use L�
°� �° :::e:
[,, E AG A N
,„
.....0
1 0.5'
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinclinspectionsCa?cityofeactan.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
j Name: '"1:y `� c( t. L1 "4 Phone: ifs L _� i_1s 6 7
Resident! /`
1 Owner ; Address/City/Zip: ) i-i ) A/ /f �L 6Z r., R tt'c G,1'(11,,,L, MN S' 1 z3
U
F Applicant is: ✓Owner Contractor
Type of Work Description of work: (� G'( Iii -
tr
Construction Cost: Multi-Family Building: (Yes /No )
,
Company: Contact:
Contractor
Address: City:
State: Zip: Phone: Email:
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
I
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:
iSewer&Water Contractor: Phone:
• Fire Suppression Contractor: Phone:
NOTE:Plans and su••pporting documents that you submit are considered to be public information. Portions of the information maybe j
classified as non-•ublic if ou •rovide s•ecific reasons that would •ermit the Ci to conclude that the are trade secrets. I
websiteou at subscribe
to receive
cei a an electronic
notificationn from Ci._. .. osedmm n up f . :: ll.:; p a eo _._. ..:i..
the City of proposed ordinances by signing for an email update on the City's
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.
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.aooherstateonecall.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.
� '
XV —Tr et.44- t. L l 2/ x 'll t
Applicant's Printed Name Applicant's Signattfex
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA169369
Date Issued:05/24/2021
Permit Category:ePermit
Site Address: 749 Hay Lake Rd N
Lot:20 Block: 1 Addition: Fawn Ridge 2nd
PID:10-25801-01-200
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Li Eau Ly
749 Hay Lake Rd N
Eagan MN 55123
(917) 691-2866
Home Depot Usa Dba The Home Depot
2455 Paces Ferry Rd
Atlanta GA 30339
(763) 852-1044
Applicant/Permitee: Signature Issued By: Signature
Nov 21, 2021
Re: Permit # EA169369
To Whom It May Concern:
Please be advised that the permit obtained for 749 North Hay Lake Rd for Windows is
to be canceled. The homeowner has withdrawn their contract with our company. I
certify that no work has been done at this address by Home Depot USA, Inc and we
would like to cancel out the permit that has been submitted.
If you have any further questions, please feel free to contact Phuong Huynh via email at
phuonghuynh@gopermits.org.
Thank you,