753 Hay Lake Rd N
PERMIT
City of Eagan Permit Type: Building
Eagan. Permit Number: EA095622
Date Issued: 08/25/2010
OR Permit Category: ePermit
41~ it~ of E3
E
Site Address: 753 Hay Lake Rd N
Lot: 19 Block: I Addition: Fawn Ridae 2nd
PID:10-25801-190-01
Use:
Description:
Sub Type: e-Windows iDoors Construction Type:
Work Type: Windows Doors-New ; Replacement
Description: House
Census Code: 434- Occupancy :
Zonin,:
Square Feet: 0
Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee S3K $88.50 0801.4085
Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195
Total: $90.00
Contractor: - Applicant - Owner:
Renewal Andersen Thomas LoNve
1920 County Road C West 753 Hai Lake Rd N
Roseville NIN 55113 Eagan NIN 55123
(61)264-4777
I hereby aeknowledae 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 Cite of Eagan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
BtDG. PERMIT N0.
01-3210
01-3422
01-3445
01-3446
01-2155
17-3860
20-2275
zo-3s65
20-3868
20-3716
20-2252
20-3713
20-3743
79-3866
11-3855
?
?
Vel
?.?
Ll?i?? 1 G1L/{1L . /
Plan Check ?
Surch./Adm. "
SAC/Adm.
Surcharge
Road Unit -? ?
SAC -.?.
?
Water Conn. '
Water Trmt. Water Meter
T
Acct. Dep. ?
Water Permit ?
Sewer Permit
Sewer Conn.
Park Ded.
TOTAL
--?,
• CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, M I N N ESOTA 55122
.
DATE
RECEIVED , FROM
A M 0 U`JY ' .• $
"1 l
[-] CASH [3 CHECK
DOLLARS
foo
A
FOR .- I . ? " L-C., d , ! . 5
BY ?
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
Thank You
•• f• ,:_ ?' CITY OF EAGAN ?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121E ??- l 3 2 4 8
PHONE: 454-8100
BUILDING PERMIT Receipt#
To be used tor 5F DWG/GAR Est value $105,000 pete F EBR UAI2Y 20 , 198 7
Site Address 753 fJ0 HAY LAKE !2li Erect t] Occupancy R3
Lot 19 Block 1 Sec/sub. FRWN RIDGE 2ND Remodel ? Zoning R 1
Parcel No. Repair ? Type ot Const V
Addition ? No. Stories
W ?
Name KEYLAT?D IIOi .E
S
Move ?
Length 48
3 14450 HURNSV
Add ILLE FKWY Demolish ? Depth 39
° ress
city B' VILLEphone 8
94-2636 Int Impr. ?
Install ? Sq. Ft.
= o Name SAM Approvals Fe
?°, ¢ Address Assessment Permit ?
City Phone Water 8 Sew. Surcharge
Police Plan Review ??? • ??
? W Name H?+L(2(lIST Fire SAC 625.00
? a Address Eng. Water Conn. 52 S. 00
<W City BLl'1GT"d Phone 831-1875 67.00
Planner Water Meter
Council Road Unit 305. 04
I hereby acknowledge that I have read th is application and state that the gldg. Off. Tr. PI. 180.00
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagrn OrdinWrqes. APC Parks
I Var. Date Copie
lly?
Signature oi Permittee ? fQ -- $. 2 5'
532
'- Total ?
'
A Building Permit is issued to: KEYLAND HOMES on the express condition that ?
all work shall be done in accordance with all applicable State of Minnesota Statutes and City ot Eagan Ordinances. ?
Building Official - i
,. PermB No. PomM HoldK Dab TeIsphaN N
PlumbMg
H.K11.C.
Eleetric
SOIIenN
Inspeellon Oate Imp. Commmnb
Footlnqsl
Footinqs II
Foundation
Framiny ? 7 ?.?.
Fiooflny
Rough Piby. 4/ zJ3-? /.j J.1
Rough Hfp. T/,7/77
Insul. G g 7 C-?'
FNeplace
FMaI Htq. -
Flnal Plby.
Bldp. Final
Cert.Occ. .?11 7 ?•
Dsek Fty.
Detk Frm9.
Well
Pr. Dfap.
PLUMBING PERMIT
CITY OF EAGAN
` 3830 PILOT KNOB ROAD, EAGAN, MN 55122
Site Address -
Lot
Sec/Sub
? Name
? Address
H
c Ciry Phone rS 9s?-Z7;' j
Name ?
? Address ?' - o ?
O City 'Z?? ;+,e c _ Phone fz2 -{?( y?
FEES
COMMIIND FEE - 1% OF CONTRACT FEE
APt BLDGS - COMM RATE APPUES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.OQ
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
? • ?? l ,?^ '? ?'C( ?.?
PERMIT # -? % 7 2.-
RECEIPT tt ???? 22-
a4r?: 3/ b/ d 7
BLDG. TYPE WORK DESCRIPTION ?
Res. New
Mult. . Add-on ?
Comm. Repair ?
Other ?
RES. PLBG. ONLY - COMPLETE THE FOLLOWING: ?
NO. FIXTURES OTAL .
Water Closet - $3.00 - °"o +
Bath Tubs - $3.00 3 •ew-) . 4
i
? Lavatory - $3.00
vo
_?.
?
--J_Shower - $3.00 ,? • ?v ?
_?__Kitchen Sink - $3.00 3 G V !
?
Urinal/ Bidet - 53.00
I Laundry Tray - $3.00 • ?'' ?
I Floor Dralns - $1.50 7 V ?
?-Water Heater - St 50
Whirlpool - $3.00
_I Gas Piping Outlets - $1.50
,
(MINIMUM - 1 PER PERMIT) ?
Softener - $5.00
well - $10A0 •?
Private Disp. - S10.00 ;J
? Rough Openings - $1.50
I
'?sVe SIGNATURE OF PERMITTEE FEE: -3•
STATE S/C:
FOR: CITY OF EAGAN GRAND TOTAL• ??• S?
,
CONTRACT
Site Address
Lot
m Name
? Addre
c Ciry i
? Name
3 Addre
o citv !
.,?.. ,.
, PERMIT #
MECHANIGAL PERMIT RECEIPT #
CITY OF EAGAN ,
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: -
'RICE 0 U PHANE: 454-8100
?
? " "' BLDG. TYPE
Block Se?/Sub
Res, -<.
N\v o
M ult
1,4") i "".ltj t h-A
o P ?-.o. ? Comm.
Phone pther
WORK DESCRIPTION
New
Add-on
Repair
TYPE OF WORK
Forced Air
Boiler
Unft Heater
Air Cond.
venr.
Gas Piping Outlets #
Other
/ 20 MBTU
M BTU
M BTU
M BTU
CFM
/
FEE
S/C:
TOTAL:
FOR: CITY OF EAGAN
A
1
. ?:' 11
FEES ?
RES. HVAC 0-100 M BTU -$24.00 ?
ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - 6.00
GAS OUTLETS - 1.50 EA.
COMM/IND FEE - 196 OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - 10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
`'.- %•,? , r ? . ? "r,
(Itr#ifiratt of (Orxu?anry
Citp of (fagan
mppaY't1'[PnY of vlttlblltg 3wptttOt[
This Cerlificate issued pursuant to the requiremenu of Section 306 of the Uniform Building
Code certrfying that at the time of essuance this structure was in compliance with the various
ordinances of tlre City regulating buildrng construcdon or use. Far the following.•
1: !?:-:;t
use QaWfintion DwGIGAR ' Bldg. Rmrit No.
?
Oocop-YTyPe Tdnmg District . Type Cona. OwoerdBwldiog -• ``:ti: 1V?•?": Addren Ii????..i_':_.
Builmng Addrem ?1 tY i!',r•i:V T'-i.ra.
Dik:
Bwldiug Oicial
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN • Permlt No: 8523 pete: 3-6-87
3830 Pilot K-iob Road Meter No: -9 7r Z, ;G 6- 7 Size: =r?'a
P.O. 8oz 211 ni Reader No: D_.g1? D ? I-
Eagan, MN 55121 Date: ?' 81
Ownee
Site Address: V)j ivo.
Plumber, n C Ziec
Conn. Chg: 525. UO c?? ?R'Li"'
Acct Dep: i289a ig?lA
Permit Fee: -t,??NF - Utlil I
Surcharge: • -? 'n
Tr. Plant
Meter. - 7 n n-i
CITY OF EAGAN .v, Permit Na-
3630 PilofKnob Road Meter No: -
P.O. Box 21199 Reader No:.
Eagan, MN 55121
":L-vlatid ':oraas
.,...__.. ,
Site
with the City oi Ea9an
Date: ?
Size:
Date:
Conn. Cag: 525• ?,P,? Zoning:
Acct Dep: •0 No. of Units: `
Permit Fee: 10. Ot?p??
Surcharge: • 50n(? I agree to comply with the Clty of Esgan
Tr. Plant 1 ?'' • lu, 0 PL Ordlnances.
Meter r. 7 a0*1d
CITY OF EAGAN 4 SEWER SERVICE
3830 Pllot i:nob Road ,
P.O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zonina: Ri No. of Units: ?
.? _33 -8 i ;*,,:jC);}
to compFy wfth ft City of Ea9an
Insp.:
P.oad L19 B1 Fawn RidQe LI
8523
Connection Charge:
Account Deposit: _
Permit Fee:
Surcharge:
Misc. Charges: -
Total:
Date Paid:
flapd
CITY OF EAGAN ?
13248
N
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55721
-
BUILDING PERMIT - PHONE:454-8100 ReceiptxjcplQ? -
Tobeusedfor SF DWG/GAR EstValue $105,000 pate FEBRUARY 20 19 87
SiteAddress 753 NO HAY LAKE RD Erect occupancy R3
Lot 19 1 FAWN RIDGE 2ND
Block Sec/Sub. Remodel ? Zaning Rl
Pa
rCel No Repair ? Type of Const. V
.
Addition ? No. Stories
a KEYLAND HOMES
Name Move ? Len9th 4$
-
=
3
nddress 14450 BURNSVILLE PKWY iQ
Demolish ? DepM
I
t
l
? S
FC
° City B' VILLEphone 894-2636 n
.
mpr.
q.
Install ?
o Name SAME ApProvals Fees
Address ASSeSSment Permit $ 518. $ 0
? Ciry Phone Water&Sew. Surcharge 52.50
= Police Plan Review 259.25
F Name HALLOUIST Fire SAC 625 00
¢ z address Eng. Water Conn.525.00
aw C;ryBLMGTN phone 831-1875 Planner WaterMeter67,00
Council
Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Off.
information is correct and ree to comply with all applicable State of
Minnesota Statutes and ot Ea i n Or 'n es. APC
?? Var. Date
Signature of Permittee
Road Unit 305. 00
Tr.PI. 180-00
Parks
Copies
Total $2,532.25
A Building Permit is issued to: KEYLAND HOMES on the express condition ihat
all work shall be done in accordance with all applicable Stat Minnesota Sta?tes and oi Eagan Ordinances.
Building Ofticial
'D
REQUEST FOR ELECTRICAL INSPECTION ' E?B-00001-0C5
? See ina<ructions br complatinp this torm on beck of vellow copY. 7 /11?../
r 7!j 1 " X"' Below Work Covered by 7his Request ?
V AAd ReD.? 7voe al Builtlina Aoolionewe Wb.tl Eouiumenl Wired I
Bulk Milk
p ee Se"iceEntrence5ize k Fee Feaders?Sublaetlers k Fee Circuits
2,OD U to 200 qm s 0 to 30 qm s •Z" 0 tn 30 Am s
Above 200 qm ps 31 to 100 Amps `pa 31 io 100 A s
Swimmin Paol qbove 100_A2s ? Above 100_Am s
Transiormers Irrigation Booms Partial-'Other Fee
iSigns Speciallnspection
Nemerks ? ,,S 6 TOTAL F
l7_0
'(/' )
) JT f 1. Me Elechicel
Insaector. hereby
Final D5
?(? certify that the above
irupeetion hes been
0 metle.
mia ropuesc voie
? r 21 ?4 , ?. l /
ReqKest pale.?
?, ?
/? Fr e No. Roueh-in Inspeafion
Requiretl? ?11
?Reatly Now ' ob y,InsVec-1
.Z.f d9 ?r1Nn ror When Peady 1
ULicenseG ElacvItEal Comrnctor I hereby reouest ioapaction ot above
? Ow^er eleclrieel work installed at:
Sireet Atldress. Box or Route No. Cily
s 3 % Z. ? le" ?
ecuon o. Tow
?i
or No. Range o---- CouJy /
/
?? ?
%
` L
Occupant IPftI Phone No.
Power Supolier 7 ?! Address
Elect ical C h actor (Company Na /?- Comraclor's License o.
` G ?
.riiLr G
,,?c?
MailinB Atldress fCOnnacmr or Owner Making Insta{ tion)
AuMorized ignature ( nh tor Owner M e ?nstallatio Phone Numbar
MINNESOT/[ STATE iARO OF ELEGTNICITY THIS YNSPECTION REQUEST WILL NOT
6rippa•Mitlwey Bldg. - Boom N-781 BE ACCEPTED BY THE STA'fE BOAXD
1821 Un{veraitv Ava.. St. Poul, MN 65104 UNLESS PROPER INSPECTION FEE IS
Phene(61218b2-090D ENCLOSEO.
2 c'5 /? -
.3
1
1986 BIIILDIeiG PEl@IIT APPLICATION - CITY OF E6G9N
BOiS: ALL CAATRACTOBS MOSY BE LICSBSBD iiITH THE CITY OF EAGAN
3IAGLE FAlffI.Y DjiE[.LINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SIIRVEY, t SET OF ENERGY CALCULATIONS
MOLTIPLfi DWffi.LIPGS - HESIDSNTIAL RENT9L DNITS F08 S6LS ONITS
INCLUDE 2 SETS OE PLANS, CEATIFICATE OF SQRVEY - CHECB iIITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
INCLUDE 2 SETS OF ARCHITECTURAL
1 SET OF SPECIFICATIONS AND 1
ENERGY CALCULATIONS,
$29OOQ LANASCAPE BOND
To Be Used For:
S1te Address
& STRUCTURAL PLANS,
SET OF
/
Lot -Lf Block /
Parcel/Sub
Owner
i
Address / V V- S D
City/Zip Code Al--?e.e&
Phone
--?
Contractor ?-?
9ddress
City/Zip Code
Phone
Arch./Engr. p????-??` ?
Address
City/Zip Code ?
Phone #
1D5,ooo
Date: ?- -// 'e/
Ereet ? Occupancy P, 3
Remodel 2oning K-I
Repair _ Type of Const SZ
Addition # of Stories
Move Length 45
_
Demolish _ Depth '511_
dnt.Impr. Sq Ft
Install
APPROVAL4 FESS
?
51B
-
Assessments Permit ,
Water/Sewer Sureharge -?
Police Plan Reviex Sq,zs
Fire SAC 25?
Engr Water Conn S 25•
Planner Water Meter b-l•
Couneil Road Unit -;XJ S•
Bldg Off Treatment Pl I g0,
APC Parks
Varianee Copies
mrAL s-
NOTE: ADDRESSSS FOR CORNER LOTS - CONTRACTOR/HOlfEOSRiER IiOST DESIGNATB WHICH 9DDRESS
IS DSSZRSD. NO CH9NGfiS WII.L BE ALLOW6D ONCE BOILDING PERMIY IS ISSQED.
2?'i ?C ZCq = ? Z 8 X ? - ef Z 2 Z4 ' ? ' , < •• ' t
,
?: .
Zo x f z= Z4o x 4 4= foS?o '
20 ?C Z? - S Q o x 1 Z ?(,--p 4-ed
(o x (o - (cx?) X b = 800
28 ?2? _ -7z6 x 44 ° 3203 2
216 o x¢4 ? f 2 3 2C-)
,
,
f044r6
°l"Es
FaosE
ENGINEEAING .
COMPANY, INC.
1000 EAST 1461h STREET,
CONSUlTINO ENOINEEBS PtANNEI?S udd t11HD iURVEYOfIS
BuRNSVILLE, YINHESOiA 53337 PH 432'5000
CerIX i}'i ccz? Suy-v-e y
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? 92i._o ; DE/v7?TES EX/ST/NG
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(9Zi? ) dENOTES PROf'OSEo
EGEYAT/ON
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--?' /NO/CATES D/RECTjON OF
SURFACE OR.4/NAGE
f/N/SNED G.9Rfr6E FGOOR
EG ErA T/ON= 9Z/,33
I hereby aertify that this ie s true
laod as showm'and deecribed hereon..
`E8P-+J+4RM • 19 87 • ?nle7 Rev;kd - Fl;rped Povse.
\ .
\
eao??sg?,5' '0.°
0
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i ?
\A
p 7? -?-r V.
?
c9?ip4 da?3oo bK
l. p.9 9g Zz ? ? ?}
R J,¢' \; NpR
and eorrect rapreeentation of a tract of
As praparad by me on thia isf nl day ot
' ? '?'?••"¢ Hina.
? -
R.a. xo. i46'gr
-
EXTERIOR ENVELOPF IIUERAGE
"II" COMPI17l17TON 33(flg " " ? ? z????
, . --- . .. . .
. . .
?
.. ?S Y ?
?
OWNE R• K
0-(Lk4-JC;> NoMES nnTr:
4-2z-8C
- - -- - -
- ,°.
SITE ADDRESS: PNONE:
,, at
CONT RACTOR:
, Determine working square footage of each
,.
{ 1? y
1. Total exposed wall area..... Z38OO sq. ft, x.11
2. Total roof/ce119ng area..... sq, ft, x.026 =' ZS? Z
Total exposed wall area above floor= _ Z3So
a. Total wall window area.. ................. ..................... I`F9.?O
b. 7ota1 door area.............................. .....................
38
c. Total sl9ding glass door area ............... ...................... o
d. Total fireplace wall area ................... ........ ......... '....
-
e. Total walt framing area (average lOw) ....... ..................... Z 3
f. Total rim jaist area......................... ..................... 1
g. net wall area above floor ................ ..................... ? 1
h. wall area above floor ................ .....................
i. wall area a6ove floor ................ .....................
j. frame wall area at founclation ...................................
Total exposed foundation area= II ZD
k. Total faundation window area ....................... O.5
1. Total net foundation area above grade .............. .S
Determine "u" value of each wall segment
(e.g. window, door, eacfi separate wall section)
a. I`}`?•Co x "u" ,'?S = SZ,?
b. 38 x „uli
c. 9o x „u„ ?35' = 14
d. ' X "U"
e. Z3S X tfuil .nl = Z1A
x llu„ .b?1 = 5,(0
x -,u-, r11
h. X "U" _
1. X "U" _
3. X "u" _.
k. )0.5 x „u„ ,56' = 1`7
1. II09.,5 X „u,.?o-cA_
3 . ........ .......................rotal = Z?-,3
I
- - - - - - -------------
.;-
If item 03 15 the' sa
as, or less than ite
N1, you have met;the
intent of SBC.6006 (
'?
t M'( •
r Envelope Average "ll" CompUt•al•iwi
Total exposed roof/ceiling area
m. Total skyli.ght area ............................
n. Total roof/ceiling framing area (averaye 10%)...
o. Total net insulated roof/ccilinq area........... ?
Determine "U" value for eacli rooffcciling seqment
M.
X "U"
n. q'1 X nLt`
o. ? I X.oZ 1 ?,?#L
9 ........................... 7bta1 = ??.1 Z
If total of N4 is the same as, or less than R2, you have met the intent of
SbC 6066 (c) 1. -
Alternate Buildin Envelope Design .
2b utilize the total envelope'system method, the values established by the sum of
i.tems #3 and #4 sha11 not be greater Lhan the sum of items i11 and #2.
1. z(DI ,B -+ 2. Z?45- Z = Z5 -7
3. _ Z-025 + 4. 1?,1Z = Z?`t
PLAki 41:
,
0 LimEAL
?LOG fC ; 140
?
,
PULLI ? ?4v
F u Ll_ 2_ ; J4o
T71P...EPLAc.E ;
TZ1M: 140
t3LocK.'? 14fl
Pul.lr I ; 14-0
Fu LL Z I )4o
F
. p, ' ,.
TZiM ; 140
F7, E.x.posEp WAL L
SK.t-?OSED WA Ll,.
)( , S = 1) Zb
X S -
K 8 =
X g- t 1 Zo
k ? = IIZa
?C =
? 1 = 1 4a
TD"fA L. = Z38o
?SQ,Ft. ?K?oS?D GEI L1UC? ? (D8
¦ w Dx/s
Z - L43Co
t? -zq-4o
? - ?zc,a
I - z4z?}
3 -Z?(oo
AR.EA
1? s D ooQS r?
i z 3° -z.o
u° ZS -IS
s Sto
5
? ?f4Tl0 D26, ?C
4
3a (."- ?v
??9 t? . M}35M4 U6+5 6
4-Zlx,4 -10.5
. 5Cr.7•, 0 145
uf npa,mr? w.,Al l nreii Car
cc,nl ru ct iu n . '
> >c --• , •
? -
? •
Fiu. ti Tc,i'VIF:SJ OF
• FIWiE IJAt.t.
? ..,...JI..._._... . ' .
ric. 02
---?--^?
. .,. .....
t'<m• .triic:t;c,u , 1;-V.,lu.:
l. d??lt'L;?,?._.1?.?..1_i,?a: --••-.. ._0_??t'!
?'• .
Yz"
?--??.n.
,?` 45
--
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-
:-
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?rz ?„??i???._ _??.? ?. ,.•.; _.-?
- ? --
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4. xG?L..ytlT.(?. . ._.. . _2,d1.
?i . ,?f.l ?.? la Q/ ..... . . . _ .. . .. . _ •.?YZ.
G. F.>:lcriur alr (ilin ?• i1.I'1
_.._ _. ___._ ..__ .... . .. . ....__ ..... .........
.0°i
UL
l. TnCrrlne ti.t' :1)c?
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2 .
?. ?'i
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... ..- --........ __ ...^....`?}5
..... _.._..__.._.._
a.
5. _?i]di?_....-. - -. .. . _. _ _._._.. . .....coZ.
G. ExLi_rio1 air iiL.i _'_^r1.17
U=
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. p . ?tianpc
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CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
PATS: PAYMENS' OF kY-M AT TIME OF
aPPLxcATIoN DoFS rAm COrsizTUTE
APPROVAL OF PERNIIT.
irSrncizoN oF sDM Arm/ox ckWM
IWTM.ramTONS WII.L MT SE SQIID-
ULID UNPII. PERMIT HAS BEEN
APPR(n7ID.
xxx---xx x-----,.x -
P ease Print
? ? 1) PROPERTY ADDRESS: D
LEGAL DESCRIPTION: /, p?' `a,_," , "-
tLOt/t3lock/SUbdivision or Tax Parcel qD
IE' E7QSTING STRCLZtJRE, DATE OF ORIGINAL BC'ILDING PERMIT ZSS['ANCE: ??% 9'7
? (Mon Year?-
PRFSIIW ZONING/PROPOSID I!SE:
q c0K1fEaciaz/P!ErauL/0FF1cE
? IDIDCSTRIAL
? INSTITS:TIONAL/GOVF,RNhg,'NT
? R-1 SINGLE FAMILY
? R-2 ?LPLF':{ (7t,vv Units)
? R-3 ZOWNiOUSE (Three + Units) ( Units)
R-4 APARTMENP/CODIDOMLNIDM ( Units)
2)
ADDRESS:
CITY, STATE, ZIP:_
PxoNE:_
• 3) NAME• For City Ose ..
_ DC Plumbers License:
aDDxPSS: c/z 9-7:7 2?-> i' yv ?- Active
i CITY. STATE. ZIP: f?cpired
-- Z D r b fAti /yi A./ev ? 5? S y Not recorded
PHONE:_ ?9Y-a77 S-? MASTER LICENSE# 3t-&Tf =nitial
41 KckikuVc1.o i7i i iw
f1AME:
. ADDRFSS:
QTY. STATE, ZIP:
PHONE:
-5) n ?n • ? a• • ?• : ? • a? - ??
? CONNEC.TION 1C) CITY SEWII2 ?-. CONNEC'TION TC) CITY WATER ? OT[IER '
6) ?? • • i- ? PLFASE HOLD APPROVED PERMIT FC)R PICK-OP BY ONE OF ABOVE
? PLF.ASE MAIL APPROVID PERMIT 1O lr 2. Q 4. AHOVE
C) ,; , (Circle one)
?
I -Ozez? 3' g?
FOR CITY USE ONLY
PERMIT # ISSUED
Fj-- Z 3
Pd w/Bldg. Permit FEES: ?
$ $ ?("JV SEWER PERMIT (INCLUDE SORCHARGE)
$ $__ WATER PERMIT (INCLUDE SDRCHARGE)
$ $ WATER METER/COPPERHORN/OCTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ ?S ' D C7 ACCODNT DEPOSZT - SEWER
$ $ ACCOLNT DEPOSIT - WATER
$ .22 WAC
2- $ SAC
$ $ TRLNK WATER ASSESSMENT
$ $ TRONK SEWER ASSESSMENT
$ $ ` LATERAL BENEFIT/TRC'NK SEWER
$ $ LATERAL BENEFIT/TRLNK WATER
$ $ WATER TREATMENT PLANT SLRC
HARGE
$ $ OTHER:
$_I3cr-o $ ?d /C%? TOTAL
_ ?'D 70 ? Z 7L
RECEIPT RECEIPT
DOES UTILITY CONNEC TION REQUIRE EXCA VATION IN PUBLIC RIGHT OF WAY?
F-1 YES IF YES, THEN A" PERMIT FOR WORK WITHIN POSLIC
Q
NO ROADWAY" MUST BE
DIVISION
LIS ISSUED BY THE ENGINEERING
.
T AS A CONDITION.
SLBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE :
?
*?*******?**************************?**
CITY OF EAGAN
CASHIER: JS TERMINAL NO: 719
DATE: 08/09/00 TIME: 14:23:26
ID: •
NAME: AZTEC ROOFING AND CONSTRUCTION
3210 9001 753 HAY LAKE RD 125.25
2155 9001 753 HAY LAKE RD 3.00
Total Receipt Amount: 128.25
CR135614
USER ID: JAN
********?******************************
?2 ` ? ? 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
cirr oF eacaN
3830 PILOT KNOB RD - 55122
851•881-4675
New ConshucMOn ReouiremeMa . RemodeUReoalr Reaulremen??
> 3 reglstered Ate Surveys 3Iwwing sq. tl. of lot, sq. fl. 01 house
and 21 rOOled areas (20% ma)lmum lof coveraae aliowetn
> 2 coples ol plans (show beam 8 wlnUOw sizes; poured Ind. design; etcJ
> 1 set G energy calculaHona
> J coples of hee preservallon plan if lot plaltetl atter 7/I/93
DATE: 0 I 9 10,1)
DESCRIP'f10N OF WORK:
STREET ADDRESS:
LOT: ?J-
75 3 nfv.e?
2 copies M plan
1 set of energy cdci6aNOns tw healed additlons
1 site survey tor axtedor addiHons 8 tlecb
CONSfRUCTION COST: -6?
G.LLKE ZPq-G
BLOCK: j SUBQ./P.I.D. #:
!l2nl -'95-1 z3
PROPERIY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: ?40cJJc ?YYL- Phone Jf: la SJ ? 6?? - 7l?G
Laat _ Flnf
753 Ifo?f?- 44+j LakC PJ-
Cly " ,M') I State: rnN ZiP:
SheAt
5S/23
company: `f7?r"?`zl ar,one a: 6 /Z S °!S?' Oa v,,
(orea code)
SheetAddress: Sr* 3
City llE- State: m n1
Company: Name:
Telephone ff: ( )
Sheet Address: Reglshatlon #:
CNy
State:
Sewer/water licensed plumber ((f ipstallina sewer/waterl: Phone #:
ZIP:
1 hereby ackrawledge lhaf I have read this applkafbn, sDote ihollhe Infortnatbn is cortecl, and agree fo comply wfth all appAcable State
of Minnesota Stalufes and Ciy of Eagan Ordinances.
Signafure of Applieant
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
ucense # ;zc 1'39' 10 ExP.
Zip: -G ,i ?3 7'
auG - s
Tree Preservation Plan Received _ Yes - No _. Not Required
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 08 06-piex ? 17 Garage ? 22 PorchlAddn. (4-sea.)
? 03 07 of _ plez ? 09 07-plex ? 18 Deck ? 23 Porch (screened)
? 04 02-plex ? 10 OS-plex ? 19 Lower Level ? 24 Storm Damage
? 05 03-plex ? 17 10-plex PI6g _V or_ N ? 25 Miscellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bldg.
WORK TYPE
? 31 Ext. Alt - Muni
p 33 Ext. Att - SF
? 36 MuRi
? 31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)' ? 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.
No. of lJnits Length Sq• ff•
No. of Buiidings Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. MC/ES System
UBC Occupancy sq. ft. City Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS ,
? Stucco/Stone
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation:
Surcharge
Plan Review
License
MC/ES SAC
City SAG
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S1W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
_::t og?9
2005 RESIDENTIAL BUII.DING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
-4 Ta , FO
New Consiruc6on Reauirements . RemodeVReoair Reauiremenis Office UseOrilv
3 regislered site surveys showing sq. R. of lol, sq. N- of house; and ?II roofed areas 2 copies of plan celi of $ury¢Y Read .? Y? N
?
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated edditions TteePres P16nEFecd _ 3" _N.
2 copies of pian showing beam 8 window sizes; poured faund design, etc. 1 sAe survey for additions & decks Yoes Pres {?equrced ,,,;Y ?. ?1
isetofEnergyCaiculafions Add'Rion - indicaferfonsitesepficsysfem Drnae$6ptiC?stem
3 copies o( Tree Preservation Plan if lof pla8ed after 71753
Rim Joist Detail Options seledion shcet (buildings with 3 or less units)
Date ?a ' I G? ' ,.,?' ,C.,on?st1rucfion Cost O? . OS-
SiteAddress La-;11? Cx.?efl UniU$te #
: ?? •
Description of Work 753
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2
Property Owner Telephone # 0 0
Cantractor RENEWAL BY ANDERSEN
1920 COiJNTY RD. "C" W.
Address ROSEVILLE, MN 55113 City
State 651-264-4777 Telep6one # ( )
LICENSE #20130983
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Mimiesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J su6mission type) Submitted Submitted
• Energy Envelope Calculations Submitted
In the IasT 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan8
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is compiete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
per it; that the work will be in accordance with the approved plan in the case of work which requires a review and
ap val of plans. T, r
' L 1 200' Applicant's Printed Name Applicant's Signature I?? I
?7
- -- _?
• OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01of_plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn.(4sea.) ? 33 Ext.Alt - SF
? 04 02-plex ? 10 OB-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 72-plex PI6g_Yor_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement `DemolRion (Entire BIdg) - Give PCA handout to applicant
Valuation
Plan Review
Census Code
SAC Units
# of Units
# of Bidgs
Type of Const
100% or
25%
_ Footings(new bldg)
_ Footings (deck)
_ Footings(addipon)
Foundauon
Drain TIle
Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
Occupancy
Zoning
Stories
Sq. Ft.
Length
Width
MCES System
City Wffier
Booster Pump
PRV
Fire Sprinklered
REQUII2ED INSPECTIONS
_ FinaVC.O.
_ FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests Final
_ Siding _ Srucco _ Stone _ Brick
_ Windows
_ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
..v,.,a.sv•.s. xuv as.o? rnd. (OJ U(1'44dU IV?.IYI:IPdf? F#1°9Nf/fS24+72S1Y
re ?.?
funn t mol
- City af Bm?gan :
3836 Pilcrt gAOb Road • '
Pagan, MN 55•122 -?
. To Whom It May Cmoerxi: IIder Jones is authoit?.?d ta p,a18uilding pftnits forRrmwaF tfy Andaisea,_ ptcase alIow
Eidcr 7ones to p?+oridc this servicc for us in Eagaa, TIutt
. date bcyond 616101; untii a$*Rawal bp muhorizatifen is valid fvr any W tha City AudGrsen msnagar ?1y revoIms it tn wiictng
_
Er?cqnest this autIio?izaHatt bc aGCCptec?-?p?@onsly, ss to ttot deIa m the .
cvnhactccl ?anita any furtfiar. Elcasc cx?Il mc if thccc ac?c an y P??tig'vf
r at 763-Sfl2-¢?(}6_ .. Y??ss[ona.. I i?u? ixi
Yonr lmmqdiatc attcntion to tIiis matter i4 eIL?marna a .,.
slxi&m?y>
ynnortd"R &Rm
ostallation 1vFanager
Renowal by Andascn CarPorativn
.,; t
WUu
C'r.: Kfrrn-Ffrie?Snne? . , .
QH D. ?? ' .
RBCEIVBd TiQIE jlifl. I- m7pm
-N15r3
2006 REStDENTIAL PLUMBING PERMiT aPPUCarioN
CITY OF EAGAN
3830 PfLOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
96,6P
Date _7 I _aK l b ?
Site Street qddress 753 Lr-?cP QcQ /V Unit #
Property Owner ScUke:?- L ou;? Telephone #(6S1 )/r8,6- 21?4
Contractor__f 'Ay ?A L, Telephone# {?SI) 7Ui I
Address_??1.Sd City State/uA.1 Zip
The Applicant is: _ Owner ? Contractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.?D
Afterations to existing dweliing $ 50.00 ?
_ Add plumbing fixtures. This fee includes installation of a water softener andlor water
heater at the same time. !f you are installing on(v a wafer softener and/or wafer
heater, do not complete this section; move to the next section and check the
appliance(s) you are insialling.
_Septic System Abandonment
? _ Water Turnaround (add $130.00 if a 5/8" meter is required)
Other:
_ Water Softener ? Water Heater $ 15.00
` new ? replacement
Lawn irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State 5urcharge $ 50
i
Total g
r nereoy appiy ror a rtesiaential rlumbing Pertnit and acknowledge that the information is complete and accurate; that the
work wiil be in conformance with the ordinances and codes of the Cify of Eagan and the plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in
accordance with the approved plan in the event a plan is required to be reviewed and approved.
?
Applicant's Printed Name ApplicanYs Signature
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA088705
Eagan, MN 55122 . Date Issued: 04/13/2009
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 753 Hay Lake Rd N
Lot: 19 Block: 1 Addition: Fawn Ridge 2nd
PID 10-25801-190-01
Use
Description:
Sub Type: e-Windows/Doors Construction Type:
Work Type: Windows/Doors-New/Replacement
Description: House
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: huprovements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Renewal Andersen Thomas Lowe
1920 County Road C West 753 Hay Lake Rd N
Roseville MN 55113 Eagan MN 55123
(651) 264-4777
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.
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
j -
For Office Use j
Permit # / i -70
1
My of Eajan ( t
I Permit Fee. I
3830 Pilot Knob Road I I
Eagan MN 55122 t Date Received: t
Phone: (651) 675-5675 I Staff:
Fax: (651) 675-5694 t
INFLOW & INFILTRATION PERMIT APPLICATION
A- Plumbing / Sewer & Water
Date: Site Address: / :5 3 Ai,,A k N A y l„_c ke /P 0 0, .
Tenant: Suite M
s
$ Name: 7) N r,z Ln -o-e- Phone: (,p a 3 8 7 - ► ?
RESIDENT / OWNER
Address / City ! Zip: 5 3 Na t j 1^ U-t )Fv
Name: 1A ess )a +n License
a
CONTRACTOR Address: P U, v x of a I i city: I -Lq"..
:
State: tea' Zip: S it Phone: G91- 6 3 1- 8 2 5 2
t
Contact: LYl ~ ~VA .('c L i I Email: _ r-, i It C-) AC SS la n pit.- r• b 1 r c v r•.
PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope)
TYPE OF WORK Sump Pump Repair Repair
Other. Other.
3 r Description of work: ) D en I L i ,1a
DESCRIPTION
FEES
$60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ 0, 0 o
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit III repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.citvofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call
48 hours before you intend to dig to receive locates of underground utilities. www -gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and
codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans.
'
Applicant's Printed Name Applicant's Signature"
FOR OFFICE USE Reviewed By: Date:
Required Inspections: .._._.Under Ground -Rough-!n Fina!
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA116144
Date Issued:10/03/2013
Permit Category:ePermit
Site Address: 753 Hay Lake Rd N
Lot:19 Block: 1 Addition: Fawn Ridge 2nd
PID:10-25801-01-190
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required 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 -
Janet L Lowe
753 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:EA143137
Date Issued:06/05/2017
Permit Category:ePermit
Site Address: 753 Hay Lake Rd N
Lot:19 Block: 1 Addition: Fawn Ridge 2nd
PID:10-25801-01-190
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Janet L Lowe
753 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
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA152456
Date Issued:10/16/2018
Permit Category:ePermit
Site Address: 753 Hay Lake Rd N
Lot:19 Block: 1 Addition: Fawn Ridge 2nd
PID:10-25801-01-190
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 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 -
Janet L Lowe
753 Hay Lake Rd N
Eagan MN 55123
(651) 387-8197
Shelter Construction LLC
7040 Lakeland Ave N
Brooklyn Park MN 55428
(612) 849-8082
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA163486
Date Issued:09/02/2020
Permit Category:ePermit
Site Address: 753 Hay Lake Rd N
Lot:19 Block: 1 Addition: Fawn Ridge 2nd
PID:10-25801-01-190
Use:
Description:
Sub Type:Windows/Doors
Work Type:Overhead Garage Door
Description:
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, 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: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 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 -
Janet L Lowe
753 Hay Lake Rd N
Eagan MN 55123
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA164969
Date Issued:10/13/2020
Permit Category:ePermit
Site Address: 753 Hay Lake Rd N
Lot:19 Block: 1 Addition: Fawn Ridge 2nd
PID:10-25801-01-190
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
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 -
Janet Lou Lowe
753 Hay Lake Rd N
Eagan MN 55123
Haley Comfort Systems
3708 Broadway Ave N
Rochester MN 55906
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature