4504 Hay Lake Rd S•.. , CITY OF EAGAN t?e p
?3830,Pilot Knob Road, P.O. Bax 21-198, Eagan, MN 55121 `??. 12441
PHONE: 454-8100
BUILDING PERMIT ? Receipt #
To be uaed for -`?F DWG/GAR Est Value $63,000
SiteAddress 4504 So iiAY LAKE RD Erect 13 Occupancy R3
Lot 17 Block a Sec/Sub. OV'ERHILL FAM Remodel ? Zoning i'D
Parcel No. 2ND ADD Repair ? Type of Const. v*a
Addition ? Mo. Stories
ac Name
GRI?,3D OARS DEVEL CO
?
titove
0
Length 46
i
1$t?l 5U[4Y.ISL CT Demolish ? Depth 4.4
o Address
City f;A
GAiV phone 452-8934 Int Impr.
Install ?
? Sq. Ft
cc
z
Ut
?
?
Name 5ame
Address
Phone
Assessment
Water 8 Sew.
Police
Fire
Eng.
Planner
Council
statethatthe gld Off. $/11/$f
able State of 9'
APC
Var. Date
EV'T."t, Co
i' o
e of Minnesota Statutes and City of Eagai
Permit 2 • 00
Surcharge i•?
Ptan Review-161. u O
SAC 575.00
Water Conn. 500• 00
Water Meter 63 • 50
Road Unit 290.00
Tr. PI. 156 . QO {
Parks ?
Copie
Total ' ? . t'tJ
Ordinances.
condition that
Building
Permlt No. Permit Holder Date Talephane k
Plumbin9 U
H.V.A.C. CC
Eleddc C i-13 s
Softe,e.
Inspsctlon Date Insp. Comments
Footinqs 1
Faotinge 11
Foundatlon
Framing Q q-Y(p ?
RooNn9
Rouyh Plbp.
Rouqh Nty. ? ff 9-eJ
lnsul.
Fkeplace
Flnal Hty.
Flnsl Piby.
Bldg. Finll ' . K
Cert.Occ.
Deck Fty.
Deck Frmy. .
WNI
Pr. Dfsp.
PERMIT #
' PLUMBING PERMIT RECEIPT #
GTY OF EAGAN
- 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
Site Address H " L)
Lot 1 '1 Block
? Name
? Address
c City' ?
L Name
3 Address
i a City
• L't kc c.t BIOG. TIPE ?WORIC DESCRIRTfON
Sec/Sub0 ?...c.?l..Z ,(? ?', ` , I Res. ? New X
v Mult Add-on
Comm. Repair
one Other
rI
-' ? Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMi1M - RESIDENTIAL FEE - $10.00
MIIVIMUM - COMMIIND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
?'-SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
NO. FO(TURES
Water Closet - $3.00 TOTA
S 4" ?
? Beth Tubs -$3.00
?-
Lavatory - $3.00
? Shower - $3.00
? Kitchen Sink - $3.00
Urinal/Bidet - $3.00
T-
Laundry Tray - $3.00 T- `
l
Floor Drains - $1.50
=
Water Heater - $1.50
Whirlpool - $3.00
?-Gas Piping Outlets - $1.50
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
-
--
7
Rough Openings - $1.50 -
FEE
STATE S/C: ' 's-
GRAND TOTAL:. -
. • , . • - `': j" PERMIT# / w (p y
MECHANICAL PERMIT
RECEIPT #
- " CITY OF EAGAN -
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE
Site Address, '
Lot 1 f Block
m Name
3 Addre
c City _
? Name
c Addre
O CitY -
TYPE OF WORK
Forced Air Pj M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping Outlets #
Other
FEE
S/C:
TOTAL•
BLDG. TYPE WQRK DESCRIPTION
; w
Res. New ?-
Mutt Add-on
Comm. Repair
Other
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 - 1 % 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)
1(1 L k ?
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
INSPE
GITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
? SITE ADDRESS: ' ? t4 ' "
i;A'/ ( Ak' f P1A .
rAkM :?ratl
PERMIT SUBTYPE:
TYPE OF WORK:
I 1 f : IP CP T I Off
i I ; ..11411l t tJ
f' 1 N !i t
i yi
wr W
cri A, r??:,?r:t?
. , _ .. ..
.. ..
?I
L - - - - - - - - - - - - - - - - --. J
?
O
;C4RD
PERMIT TYPE:
Permit Number:
Date Issued:
IH +/
11"
1 /°' ' ` APPLICANT:
isi Ct 1
c?,t>> ri';1-2 Fwt
Permlt No. Pemiit Molder Data Telaphone #
ELECTRIC
PLUMBING
HVAC
Inspectfon 06to Insp. CommeMs
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL I'
GYP BOARD I
i
FIREPLACE
FIFEPLACE
AIR TEST
FINAL PLBG
FINAI HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
?_
CITY OF EAGAN WATER SERVICE PERMR
3830 Pilot Knob Road
P. O. Box 21199
PERMiT NO.: 7.?
Eagan; MN 55121
DATE:
. ?
Zoninp: No. of Units:
Owner:
/Sddross:
$iT! /1dd?lBS: - fNeZ'17il1 j'a <T 11
Plumber.
-
AAeter No.. Comection Charpe: - . ,
Sise: Aroount Deposit: ' .
Reoder No.: Pervnit Fee:
I e?O
!!M comVffi wuh !Iw C1ef of la9ow
Surthorge:
Ordiwwam Misc. Charpes:
By
Dote of Insp.:
TOtOI:
Dote Poid:
Lr
TY OF EAGAM sEYM SER1/ICE PERMR
30 Pilot Knob Rosd
0. Box 21199 PERMIT NO.: ,
gao, MN 55121 DATE:
ninp: No. of Units:
Nddress:
h eePlr wilY !w CM1 of impa
of I r?ap.:
Connection Charsla:
llooount Deposit: - - - -
Permit Fee: Surcho?pt:
Misc. CJ+oroas:
Tota(:
Dats Paid:
ClTY OF EAGAN W?T? SERVICE PERMIT
3830 Pilot?::nob Rosd .,
P. O?*x 21199 PERMIT NO.: - ,
Eagan, MN 55121 DATE: '
ZO?ing' ' No, of Units:
Ownlr: ` r "'-riC. OF 1:::
Addroas:
Ssre Address: ? ;>ad LI7 r3 :?verhil?
.S " ?
rr No.: 42
w te oow?Py ?11? fl?e Ciey of ?;
' jE?,E4H? r? ?
? y a,?
aore Po?a:
of Insp.: Inep.:
/o - J - 86
CITY OF EAGAN
3830 Pilot Knob Road
P. O. Box 21199
Eaw. MN 55121
Zoninp;
OwrKr:
Address:
Site Address: ?
Plumber.
I - 9 n0 to eMply ?rtlh tlN Ciry' of yp,m
OralMnas.
By
Dote of Insp.:
SEINER SERVECE PERMIT
m
PERMIT NO.:
DATE:
No, of Units:
Conntction Chorpe:
Accourrt Qaposit: -
Parmit Fea:
Surchorpe;
Misc, phnros; `
Totol;
Daft ibld:
This repuest void %5zw 96 /
18 nqn[hs from .
4 3`0 4 5 L I17, (?i 3 ?ec -ovev-h, t!
Heq te Fire No. Pouph-in Inspection
Req red? ?Heady Nnw?W?ll Nntify,
Z71 Inspec-
? ? ?'es ?NO [or When fteatly
Licensed ElecincaV ConVactar I heraby repuest ina0ection of above
? Owner electrical work installed al'
Straet Address. 8 x or R e No. Y
?
?O
ecLO. o. Township Neme ar No. ange No. Cowrty
uant IPPIN I Pho e Nc.
S a- ?
Su plier ? Address
(
Ele Vical Conira
or omDa Name)
? Coniractor's License No.
°
G?
MailinB Address ICon ractor or Owner Making Instailati nl
? (3
Authoriz "i0n
amre (C btr?ctor/O M:rking Installationl P ne umber
I
?r
MINNESOTA STATE BOAflD OF ELECTRIQTY THIS INSPECTION flEQUEST WILL.NOT
Grigga-Midway Bldg. - Roam N•791 BE ACCEPTED BY THE STATE BOARD
UNLESS PROPEH INSPECTION FEE IS
1821 Universitv A?e.. St. Paul, MN 55104 '
Phona 1612) 297-2111 ENCLOSEO.
REQUEST FOR ELECTRICAL INSPECTION EB-00001-04
?-
1 See instructions for comoletin9 this larm on back ot Vallow copy.
1?? l I
r ai n as "X" Below Work Covered by 7his Request
I
Mwv?AndI 8eo.1 TVPe of Builtling ?AOOiiancen Wiretl ' Equiument WeA
Home Ranye Temporary Servicire
Bulk Mi
p Fee ServiceEntrenceSi:e H Fee Feedere/5ubfeeders N Fee Ctrcuits
0 to 200 qm 5 0 to 30 Am s 0 tn 30 Ani
Above 200 qmps 31 to 100 Amps 31 to 700 A s
Swinvning Pool Above 100-Am s Above 100_Am s
dransformers Irrigation 3ooms Partial•"Other Fee
I I_ISigns I I ISpecial lnspection ?S ?
(?_V TOTAL F,EE?1
NertNrks
TO j , /f) ??
I <'L iC
floueh-in ie
?
?? I.the Elactricel
17 Inspectoq ?ereby
- certify thet tha above
Final peetion hes baen
r
Thb1epuestvoltll8montlrefrom `? -' ""/w?j'??11
3830Pilot Knob Roadi P.O. Box 2G-A1 9, Eagan, MN 55121'v o 12441
PHONE: 454-8700 I-a?g
BUILDING PEHMIT
Receipt #
iobeusedfor SF DWG/GAR EstValue $63,000 Date AUGUST 12 1g 86
SiteAddress 4504 50 HAY LAKE RD Erect IN Occupancy R3
Lot 17 Block 3 Sec/Sub. OVERHILL FARM Remodel ? Zoning PD
Parcel No. ZND ADD Repair ?
? Type of Const. I'LF}
W Name GRAND OAKS DEVEL CO
; Address 1881 SONRISE CT
° cily EAGAN phone 452-8934
o Name SdIRe
$ a Address
? Ciry Phone
?a
w W Name
?
u,, Address
iz
W City Phone
I hereby acknowledge that I have read this appl ication and state that the
information is correct and agree to comply with all applicable State of
Minnesota Statutes and Ciry of Eag O dinances.
Signature ol Permittee
A Buildin9 Permit is issued to: RAND O S DEV CO
allwork shall be done in accordance with all a pli le State of Mimreaal
Building Official
Addaion
Move ? No. Stones
Len9th 46
Demolish ? Depth aR
int. Impr. ? Sq. Ft.
Install ?
Aoorovals Fees
Assessment
Water & Sew.
Police
Fire -
Planner
Council
eidg.On. $/11/86
Date
Permit $ 322.00
Surcharge 31.50
Plan Review 161.00
SAC 575.00
Water Conn. 5 0 0. 0 0
Water Meter 63 . 50
RoadUnit 290.00
Tr. PI. 156.00
Copie 2 , 099. 00
Total
on the express condition that
Statutes and Ciry of Eagan Ordinances.
'?"-CITY OF EAGAN
3830 ?ilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT Cvz444
PERMITTYPE: euxLoiNG
Permit Number: 031022
Date Issued: 10 j 2 7/ 9 7
SITE ADDRESS:
4504 HAY LAKE RD S
LOT: 17 BLOCK: 3
OVERHTLL FARM 2ND
P.Z.N.: 19-56151-170-03
N:
, (6AS INSERT)
B'uilding•,Permit Type FIREPLACE
Building Woxk Type NEW
>
; Census Cod;e
A. ?_ .. ? F;; • *
.
REMARKS:
434 NLT. RESTDENTIAL
P
FEE SUMMARY:
Base Fee $50.00
Surcherge $.50
7ota1 Fee $50.50
CONTRACTOR: - Applicant - sT. I.IC OWNER:
FIRESIDE CORNER'SMC 16332561 2009091 EBERT RUTH
2790 N FAIRVIEW AVE 4504 HAV LAKE RD S
ROSEVILLE MN 55113-0847 EAGAN MN 55123
(612) 633-2561 (512)681-1896
I hereby acknowledge that I heve reatl this application and state that the
information is corxect and agxee to comply;witM all app1,icahle State of Mn. ;
? &tatwCSS and?City-of Eagan Ofdinances.,I_
APPLICANTrPERMITEE SIGNATURE
.
ie
?ISSUED B : SATLFRE k
CITY OF EAGAN
? 1997 FIREPLACE PIERNIIT APPLICATION
3 1 v 681-4675
DATE: ? PERMIT FEE: $50.50
DESCRIPTION OF WORK: ? CONSTRUCT EM FIREPLACE _ ALTERATIONS TO EXISTTNG
? INSTALL GAS INSERT ONLY
_ INSTALL GAS LINE ONLY
OTHER:
STREET ADDRESS: - 4'5704' S , 6 y LJ41<-A
LOT ? BLOCK ? SUBD./P.I.D. #:
APPLICANT: (circle one only) OWNER CONTRACTOR
I hereby acknowledge that I have read this application and state that the information is coaect and agree to comply with
al] applicable State of Minnesota Statutes and City of Eagan Ordinances.
PROPERTY Name: Phone #:
OWNER
Signature:
Street Address:
City: ?(,?1? ,State:
FIItEPLACE Company:
INSTALLER
5o --Cli -k/ 91--
ciry:?2,?SV/c?c..? sta&:
GAS LINE Company:
INSTALLER
Name: _
Signature:
Street Ad<
City: -
Zip:
Phone #:
License #: 2-22 1909 ?/
ziP: J3??
Phone #:
State:
Zip:
NI A J
'?
OFFICE USE ONLY
BUILDWG PERMIT TYPE
0 14 Fireplaze
WORK TYPE
0 31 New ? 33 Alterations
0 32 Addition ? 34 Repair
GENERAL INFORMATION
Census Code. 434
SAC Code O]
REMARKS
Chimney/flue must be inspected before conceafing.
jl?- ? 05
.`
r?c:pii o-O
ClTY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
NnT5': PAYMRNr OF k'EE AT TIME OF
APPLICATION DOES Wr CONSTITUTE
APPROVAL OF PERNIIT.
INSPF,(TION OF SEWE12 ANID/OR WA'IER
ItSSTAI3JATI0N5 WIIS. NOT BE SCHED--
IIIED UNTIL PERMIT AAS Sffi]
APPROVID.
. . " 1?}R4]fllll?F;}][9?Xif'RAiFI[F]fFiifFlfFifi?fif]fA
P ease Print
1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
IF EXQSTING STRCCICRE, DP,TE OF ORIGINAL BL'I7,DING PERMLT ISSL'ANCE: . -
i
(Nbn ear}
1'RESENP ZONING/PROPOSID IISE:
COf1MERCIAL/RE1'AIL/0FFICE
Q It,IDCSTRIAL
Q ZNSTITi'TIONAL/GOVII2TAENT
? R-1 SINGLE FAMILY
? R-2 DL'PLEX (4tao Units)
? R-3 'lUPINhiOT-ISE (Three + Units ) ( Dnits )
R-4 APaRTM=/cormorurnum (. Units)
2) ?
NAME:
ADDRESS:
CITY, STAT'E, ZIP:
PHONE:
--lp9
3) u c a•
NAME:
_ ADDRFSS:
i CITY. STATE, ZIP:
MASTER LICgISE# p?1C17 1yj' (p
4) e.a •?,? ...?,ia'.?
NAME:
ADDRFSS:
CITY. STATE, ZIP:
PAONE:
Plumbers License:
Active
Expired
Not recorded
'st-aTF
.5) i? v .. ? a: • a• , : a : o.a :r?. x:
? CONNECPION T0 CITY S (:ONNIDCTION TD CITY WATE4 OTFIEE2 '. .
6) ? «• o r ? PLEASE HOLD APPRpVID PEEtMIT FOR PICK-CTP BY ONE OF AB09E
PI.EASE MAIL APPROVED PERh1LT TO 1. 2, (p 4. IBOVE
}.? ? n ?, • , (Circle one)
7)
ac .
i _-
FOR CBTY IJSE OIVLV
PERMIT # ISSL'ED
Pd w/Bldg. Permit
S
$
$ $ c
s /S'r o
$ /S "n a
$ 5DC>-oU
S S7S, Ob
$
$
S
}.
FEES: -
S AO,-,5-Z) SEWER,PERMIT (INCLLDE SL'RCHARGE)
$WATER.PERMIT (INCLLDE SL'RCHARGE) ..
$ WATER METER/COPPERHORN/OC'TSIDE READER
$ WATER TAP (INCLODE CORPORATION STOP)
$ SEWER TAP
$ ACCOUNT DEPOSIT - SEWER
$ ACCOL'NT DEPOSIT - WATER
$ WAC
S SAC
$ TRUNK WATER ASSESSMENT
$ TRf!NK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRC'NK SEWER
$ $ LATERAL BENEFIT/TRL'NK WATER
$ ?`J In Dci $ WATER TREATMENT PLANT SURCHARGE
$ $ OTAER:
$ v• 5z $ a TOTAL
- ?5-5- 7,P - ??037
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PL'BLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN POBLIC
Q ROADWAY" MUST BE ISSOED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CO[VDITIONS:
APPROVF.D SY:
TITLE:
DATE: _ Z//6 ,(
Y'
f
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
A?- 30 PILOT KNOB RD • 55122 -?
? 651-681 •4875
h
New CanahucNan ReaWremenh RemodeVReoatr Recuiremen
.1
V
> 3 regtslered sIte surveys shawing sq. N, ot bf, aq. H, of Fwuse
and all roofetl areos (TO% maxlmum bf eoveraae alloweN
> 2 coplea of plama (show beam & window sizes; poured hfd. deaign; etcJ
> 1 sei of anargy calculaHona
> J coples Of free preaervaHOn Plan H lot plaftd after 7/1 /93
DATE:
DESCRIPTION OF WORK: O'9CS;,4 fT0vne
STREET ADDRESS:
. /7.!> /.! LR
LOT: BIOCK: ? SUBD./P.I.D.
i
v vvti
PROPERTY
OWNER
Name: elr¢ 6? Pnone u: 6 SI - 6?/ -/c?96
Los, cirsr
? -
City _ .??di6e0? Sfafe: MW up: ?
Sheet Address: 5';l Y -s
Company: Phone #: L< 1-2- 0'7 - "! Od f
(area code)
COMRACTOR ?J
Sheet Addresa'r?? ?//`P Licerue Ho2oe6?/i?9 7 Exp.2,6!?4L
cnr wfh"? cbll%? srafe: InIv up: SS"33 7
ARCHITECT/
ENGINEER Company: Name:
Telephone #: ( )
Sheet Address: Regisfralion M:
Clfy
2 copies of plan
1 se1 of energy calcWaHOns for heated addtlons
1 aite survay br exteda adtliNOns & tlecks
v
CON5fRUCT10N COST:
State:
Sewer/water licensed plumber fff installina sewedwaterl: Phone #:
Zip:
I hereby aclcnowledqe that I hwe read lhic appiication, atate thaf Ihe infortnation is cortect, and agree to comply wNh all applicable State
of Minnesota Stafutes and CHy of Eagan Ordinances.
, Y
Signafure of Applicant ?
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No '
Tree Preservatlon Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation O 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 08 06-plex ? 17 Garage O 22 Porch/Addn. (4-sea.)
? 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened)
? 04 02-piex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
? 05 03-plex ? 11 10-plex Plbg _Yor_N ? 25 Miscellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 ' Accessory Bidg.
WORK TYPE
? 31 New ? 36 Move Bldg. ? 43 Reroof
? 32 AddiGon ? 37 Demolish (Bldg)' ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (FoundaUon) ? 46 Windows/Doors
• 6ive PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code
No. of Units
No. of Buildings
Const. (Actual)
(Ailowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Capies
Total: 1 ?I l ."?1 Is-
sq. ft.
sq. ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
_ Engineering Variance
Valuation: $
? 31 Ext. Alt - Mutti
0 33 Ext. AR - SF
? 36 MuRi
SAC Units
% SAC
a'
• 7986 BDILDIAG PfiAMIT APPLICATIOH - CITY OF SAGAN
NOTS: 9I.I. COATRACTOHS HOST SE LIC6eiSED fiITH THE CITY OF EAGAN
SINGLE F6MLY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
MUI.TIPLS DiiELLIl7GS - R&SIDSNTIAL RENTAL ilNITS FOR SALS DNITS
INCLIIDE 2 SETS OF PLANS, CERTIFICATS OF SQR06Y - CHECg WITH BLDG. DSPT.,
1 SET OF ENERGY CALCULATIONS
CONMRCIAY.
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE HOND
To Be Used For: Valuation: Date:
Site Address ?C?'I S. OFFICE DSE ONLY
Lot L7 Bloek -?3 Erect X Occupancy
-
? Remodel
? Zoning A99
Parcel/Sub Repair Type of Const g?/
? Addition # of Stories
Owner Move Length
4/z7;-
Demolish J
Depth
Address -
Int.Impr. _ Sq Ft
Install
City/Zip Code
Phone
Contraetor
Address
City/Zip Code
Phone ?{Sa- J'93
Arch./Engr.
Address
City/Zip Code
Phone OF
APPR009IS FEES
Assessments Permit 3,z 2
Water/Sewer Surcharge
Police Plan Review
Fire
SAC ?
Engr Water Conn
Planner Water Meter ?
Council Road Unit 2170
"
Bldg Off .., Treatment P1 f6
APC Parks
Varianee Copies
TOTAL 26
NOTE: ADDRESS6S FOR CORNfiR LOTS - CDNTRACTOR/HOHEOfiNER MIIST DESIGNATS ilHICH 9DDRESS
IS DSSIRED. NO CHANGSS iIILL BE ALLOTd6D ONCE BOILDING PEAMIT IS ISSIIED.
, .
• "? >; ?? :.
, EXTERIDR ENVELOPE AVCRAGE U COMPUTA7TDN
GRAND OAk:5 DEVELOPMENT COh7PRNY `, ?
MODEL Q', • A`FEA U. U X AREA
.
REOUIRED
1, 70TAL WALL AREA 1800 X.il k?9'
;. TOTAL ROOFAREA 1196 X.026 Ll..)096
ACHIEVED
AF:EA U U X AREi1
A. WINDOW AREA 186.66 . .5 9 '•=. -1
B. DOOR AREA 39.5 .077 7.0646
C. SI.IUE GLASS AREA 13.44 .43 6•i?517
D. FI REPLACE Ar1EA 0 v o
F. WP.LL FRAME AREA 180 .041 -.:>U
F. NFT WALL AF2L=A 1164.1 .049
L'. RlM JOIST AREA 214.52 .0436 S.21I072
H. FOUND WINDDW AREA U C)
1. FOUND AEOVE GRADE 96.48 .135 13.024E3
3, TOTAL-WALL AREA 1800 ?•5o'-16
J. SKYLITE 0 0 C)
IC. R00F FkAME 119.6 .032 3•Q=72
L. NE7 RDOF AREA 1076.4 .025 26.41
4. 7DTAl. FtDOF AREA 1146 ?•7_172
SUM 1.+2. ,. 096
SUM 3. +4. ?;?239E1
S URVEY 0 R' S C E R T I F I C A T E GRAND OAKS DEVELOPMEN'f CU. ?
52?? N 0001'23"W
68.73 N04.10
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T- DENOTES PROPOSED SURFACE DRAINAGE
SCALE: 1
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= FEET
O
• DENOTES
DENOTES IRON MONUMEN7 SET
IRON MONUMENT FOUND PROPOSEU GARAGE FLOOR = 953.3
5
950 FEET
fEET
.X000.0 DENOTES EXISTING ELEVATION PROPOSED IOWEST
PROPOSEd TOP OF FLOOR
BLOCK '
=
=9S'3•-7 FEET
(000.0) DENOTES PROPOSED ELEVATION
I NEREBY CERTIFY TO GRAND OAKS DEVELOPMEN7 C0. THAT THI3 IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE I30UNUARIES OF:
Lot 17, Block 3, OVERHILL FARM SECOND ADDI7ION, according to the
recorded plat thereof, Dakota County, Minnesota. (THIS LEGAL
DESCRIPTION WILL BECOME VALID UPON FILING THE PLAT OF OUERHILL
FARM SECOND ADDITION.)
AfJD OF 71IE LOCIITION OF A PROP05ED 6UILDING. IT DOES NOT PURPORT TO SIIOW IMPROVEMEN7S.
OR ENCROACHMEN7S, IF ANY, THEREUN. A5 SURVEYED BY ME, OR UNDER h1Y UIRECT SUPERVISION,
TI1IS 11 DAY OF jI]jy , 1986,
NOTE: GRADES SHOWN WERE TAKEN FROM
THE GRADING PLAN FOR OVERHIIL FARD1
SECOND ADDITION, PREPARED_ BY MINNE50TA
VALLEY SURVEYORS INC., LAST DA7E0
MARCH 28, 1986.
hAOJECT N0.
86809
FILE NO.
' FOLDER
BOOK / PAGE
SIGNED: JAME R. HILL, INC. ?
? c?
[3Y:
HAROLb C. PETERSON, LAND SURVEYOR
PIINNESOTA LICENSE N0: 12294
JAMES R. HILL, INC.
Planners / Engineers / Surveyors
8200 Humboldt Avenue South
81oo1nington, Mn. 65431 812-884-3029
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA127214
Date Issued:09/24/2014
Permit Category:ePermit
Site Address: 4504 Hay Lake Rd S
Lot:17 Block: 3 Addition: Overhill Farm 2nd
PID:10-56151-03-170
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and house wrap and leave on site.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Ruth A Ebert
4504 Hay Lake Rd S
Eagan MN 55123
(651) 815-3630
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA131030
Date Issued:05/28/2015
Permit Category:ePermit
Site Address: 4504 Hay Lake Rd S
Lot:17 Block: 3 Addition: Overhill Farm 2nd
PID:10-56151-03-170
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Ruth A Ebert
4504 Hay Lake Rd S
Eagan MN 55123
Minnesota Exteriors
8600 Jefferson Hwy
Osseo MN 55369
(763) 391-5514
Applicant/Permitee: Signature Issued By: Signature
'. Use BLUE or BLACK Ink
r__--,___„—_ --,
� FOf OffIC6�189 ' --- �
• : � Pertnit#: � l�� �U �
Clty of Ea aIl , .. � �
� . i Partnit Fee: dS I
3830 Pilot Knob Road � I
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I i
Fax: (651)675-5694 I Staff: �
I �
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ��� Site Address: ��CU ,��t � �'-l� �0�� Unit#:
Name: �LC ��'? �� �'� � '���'�i�o 7J�
Phone:!�o S 1
Address/City/Zip: ���G�� �D� Fr'"�� ��E f� �d�L�� ���'��
Applicant is: Owner ,,,,�Contractor
Description of work: �l� ��-� �LZ-t�9-�}� �j r
Construction Cost: ��Z ��•� Multi-Family Building: (Yes /No
.� / �
Company.��N ���'�-arase �1aa✓' 'co�te�:��5����
� Address:„�(.�� ��Sl�t� �d� N' . � City: ��'a/��S
State��Zip: 7�� Phone� 2 7' mail:
uce�s•#:�o ��oC�82— �eaa certrflcate#: /%2`= 7 2. �7�— I
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
��a l.��.�
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the City of Eagan(ssued a partnit for a slmliar plan based on a master plan?
�Yes _No If yes,date and address of master plan:
Ucensed Plumber. Phone:
Mechanical Contractor: Phone:
Sewer 8�Water Contractor: • Phone:
CALL BEFORE YOU DIG. Call Gopher 3tata One Cali at(651j 454-0002 for protection against underground ut(lity damage. Call 48 hours
before you Intand to dip to reCefve bcates of underground utlitties. www.couherstateonecall.oro ...
I hereby acknowledge that this information is complete and accurate;that the work will be ln conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an,appiicatlon for a petmit, and work Is not to start without a permit; that the work will be in
accordance with the approved pian in the casa of work whlch requires a review and approval of plans.
Exterior work authorized by a building pennit Issued In accordance with the Minnesota State Building Code must be ompleted within 180
days of permit issuance. . :,
. � . .
X / �l / _ X., � \
ApplicanYs rinted Name AppiicanYs Signature �
� Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA133427
Date Issued:10/13/2015
Permit Category:ePermit
Site Address: 4504 Hay Lake Rd S
Lot:17 Block: 3 Addition: Overhill Farm 2nd
PID:10-56151-03-170
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & 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 -
Ruth A Ebert
4504 Hay Lake Rd S
Eagan MN 55123
(651) 815-3630
Holmin Heating & Cooling Llc
3432 Denmark Avenue, #228
Eagan MN 55123
(651) 405-3853
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r For Office Use
j
i*
Pe /�City of Eaaall Permit Fee: .7,2- ` �'y,
3830 Pilot Knob Road r`�C
Eagan MN 55122 RECEIVED Date Received:
Phone: (651)675-5675 1 /
buildinginspections@cityofeagan.com Staff: '
JUL 151017
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
i (,_.� 1 �9
Date: �-� ` Site Address F "�� YV� k-e- 6. Unit#
( Phone:
Name. iJ 1,�� �._
i Resident/
P--- ,
Owner Address/City/Zip: yS `-4-,,\(1(i ; _ �'J
,_ t,
Applicant is: Owner Contractor
i
i —
t Description of work: �ecr.�
., Type of Work i
,
Construction Cost tom-=- Multi Family Building (Yes /No )
( se,7
i Company: \��"�C' u , iej/7./(`�' e- I r le .4-t�-Contact: JGC �G2C_� �a
Contractor >
Address:(----:.,Lf-7K6 /be , f Trot 1t'I City: , '"C./4.4
f State: Y-l� Zip: 15,- ..-----)12..7 Phone: 6(C_re, -Lr email: c,e.,��te (�zK\itti.- ,L-
€ lel �6P C� J r
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:
Sewer&Water Contractor: Phone:
Fire Suppression 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 conclude that they
are trade secrets. _ __ _ _ _ _ _
You may subscribe�to receive an electronic notification from the City of proposed ordinances by signing up for an email update on
the City's website at www.cityofeagan.com/subscribe.
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.•o•herstateonecall.ors — )
I here,y a knowledge that this information is complete and accurate; that the work ill be in c nformance he ordinan«-s . d codes of he City of
Eaga ; th t I understand this is not a permit, but only an application for a perm., and wor is o start wit out a pe j;it; -t the we k will be in
acco dan with the approved plan in the case of work which requires a review an% approval pl ns.
B
iLikx i - , \ x
Ap, lica'nt's Printed Nam•
e tkpplicant's Signature
-.JUS 1 ,�cc--k 'rte(e`Q.0-. Page 1 of 3
Lk-6g 14444 KK DO NOT WRITE BELOW THIS LINE /WV-5- 6
SUB TYPES
Foundation _ Fireplace Porch (3-Season) Exterior Alteration (Single Family)
Single Family Garage Porch (4-Season) Exterior Alteration (Multi)
Multi ?c' Deck Porch (Screen/Gazebo/Pergola) Miscellaneous
01 of_Plex Lower Level Pool Accessory Building
WORK TYPES
C New Interior Improvement Siding Demolish Building*
Addition Move Building Reroof Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
Replace Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION
Valuation 34S-0 •— Occupancy \ MCES System
Plan Review Code Edition Aln 2.fl I S SAC Units
(25%_ 100% Zoning 1 City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction U 3 Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
?0 Footings (Deck) Final/C.O. Required
Footings (Addition) ,r Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice &Water _Final Pool: _Footings _Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace: Rough In _Air Test Final Siding: _Stucco Lath _Stone Lath _Brick EFIS
Insulation Windows
Sheathing Retaining Wall: _ Footings_ Backfill Final
Sheetrock Radon Control
Fire Walls Fire Suppression: _Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: --/—`01/1 n!eE-1 , Building Inspector
RESIDENTIAL FEES
Base Fee t ? X/3 b
aeC. (c—
Surcharge ` .4 .Sly r
Plan Review .-�� C`` ? eS �j'�
MCES SAC
City SAC
Utility Connection Charge `' /S . b S f *
S&W Permit& Surcharge z 3 n ,cf
Treatment Plant
Copies
TOTAL
Page 2 of 3
SURVEYOR 'S CERTIFICATE GRAND OAKS DEVELOPMENT CO.
68.73
ftmlboormapir
,Q
�,� \''::'::1-‘--------;2°,414t
9 2
DRAINAGE & UTILITY S ( i----.3::14 -
15 EASEMENT PER PLAT i 1
LOT 56q 14/4 q (it4S6- ViCi- ... e
Nt 17
co
1.
•` \s y !,
Gt--..2..f.:11_3___ 651 _ )3 1 I Pr `--'
C) ;, 42.0 x17.54
1 -. +,/PROPOSED IJ •
I = to HOUSE !
m N / ti r w
24.0 I (Nr-)
10 j(35l, 4.0 m
(\, 1
0) i o GAR„� vt. !
CO)::4 20.64 1 N N 1-"-
(n +~ _' 1. " - - 22.0 21.50 ry�M� (.)
9, 5�.b • ' —4
„low ir
-o _ 41 II,' J
67C '
1
pp 11 5'
0
61 2
R= 4876.9
LAKE ROAD
--------
--- DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE: I INCH = 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 90.3 FEET
.X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = 950,5 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 9572'2 FEET
I HEREBY CERTIFY TO GRAND OAKS DEVELOPMENT CO. THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 17, Block 3, OVERHILL FARM SECOND ADDITION, according to the
recorded plat thereof, Dakota County, Minnesota. (THIS LEGAL
DESCRIPTION WILL BECOME VALID UPON FILING THE PLAT OF OVERHILL
FARM SECOND ADDITION.)
AND OF THE LOCATION OF A PROPOSED BUILDING. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS .
OR ENCROACHMENTS, IF ANY, THEREON. AS SURVEYED BY ME, OR UNDER MY DIRECT SUPERVISION,
THIS 11 DAY OF lily , 198 6
- — SIGNED: JAME R. HILL, INC.
NOTE: GRADES SHOWN WERE TAKEN FROM /
THE GRADING PLAN FOR OVERHILL FARM '
SECOND ADDITION, PREPARED BY MINNESOTA ✓ %' , 4/6
1}9',72.-----
VALLEY SURVEYORS INC. , LAST DATED BY:
MARCH 28, 1986. HAROLD C. PETERSON, LAND SURVEYOR
MINNESOTA LICENSE NO. 12294
ORo.JECT NO. BOOK / PACEJAMES R. HILL, INC.
86809 •
Planners / Engineers / Surveyors
FILE NO. 8200 Humboldt Avenue South
FOLDER Blootnington, Mn. 65,431 812-884-3029