4513 Hay Lake Rd SBLDG. PERWIT N0.
01-3210 erm
01-3422' ?Plan Check
01-3445 5urch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
11-3855 Park Ded.
f I
TOTAL
CASH RECEIPT
CITY • QF "EAGAN
DA3830TE PILOT KNOB ROAD
. ,
. ' ,
RECCIVED
/ROM
?
AMOUNT $ - 1 I
EAGAN; AAINNESOTA 55122
? 19
?-?
? CASH ? CHECK
00
DOLLARS
ROFF _
I C
Thank You
BY t
?
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
11 - • -,&
fgtrfiftratt nf (Orruvanry
titp of (tagan
arparfmrnf n# luflbfing 3tcapitrftnrc
This Cenificate issued pursuant to the requiremenu of Sectron 306 of the Uniform BuildJng
Cod'e cenifyrng that at the tinre of issuance this structure was in compliance with !ke various
ordinances of the City regulatirrg building construction or use. For the following:
Ux Clasifintion ??/(-4 ? ' BldS. RKmit No. --
O-pory Typc R3 Z?miog piaujcl Type Coost_ `.
Owuer af Bmlding Addrns ?C ? ?• '
RL.
BIY?lOg F?L?QiC65 . . . . LOCalI[S' nnp
•
D90C:
Bwlding Officiel
POST IN A CONSPICUOUS PLACE
•` ' • 3830 Pilot Knob R d! P.O. Bo 2G-Ai e, Eagan, MN 55121 N Q 13253
BUILDING PIERMIT PHONE 454-8100 Receipt# ---
r i
Site Address `
Lot-3_ Block
Parcel No.
0
z
3
0
" Demolish
- Int, Impr.
. Instali
Depth
Sq. Ft
?
o Name Su"i£
0 ? Addres9
~ City Phone
OAKS DEVEL CO
Phone
information is correct and
Minnesota 5tatutes and C
Signature of Permittee-
A Building Permit is issued to:
all work shall be done in acco
Building Official
read this application and state thatthe
to comply with all applicable State of
with
DEVEL
Assessment Permit `' ' • •• • ? ?
Water & Sew. Surcharge 46. SO
Police Plan Review 139.50
Fire SAC 625.00
Eng. Water Conn. 525. 0 0
Planner Water Meter 67.00
Councii Road Unit 305.00
Bldg. Off. Tr. PI. 1$0.00
APC Parks
Var. Date Copies 0
r-•-, ? .
on the express condition that
City of Eagan Ordinances.
Permft No. PermN Holder Daio TNephone M
Plumbiny ? 7
H.Y.A.C. ?? 75 7 -~ CC1.LL. . ' ? J /71?%'
Electric a 'g r
Sokener -
InspecNon Dsts laep. CommHtb
Foodnysl
Footinys 11
Foundatbn
n
Fnmlny
Roollnp
Rouyh Plbp.
Rouyh Htq.
Inoul.
Flreplsce
Flnal Hty. Z
Flnal Plby.
Bldp. FMaI
CM. Occ.
DoWtg.
Dec Frmy.
WNI
Pr. Dbp.
VJ
• . .' G PUIMNIING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121
Site Address _ 'I ? t ` > H - , L?,,
Lot 3 Block a Sec/Sub
m Name v4
? Address ? • ? ` -
c City S ? Name
3 Address p City Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - a10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
FOR: CITY OF EAGAN
PERMIT #
RECEIPT # DATE - I
BIDG. TYPE WORK DESCRIPTION ?
I
Res. ? New
M uit Add-on
Comm. Repair I
Other
NO. FIXTURES TOTAL ?
a Water Closet - $3.00 s ? 'I
I Bath Tubs - $3.00 a Lavatory - $3.00 ? i
' Shower - $3.00 I
' Kitchen Sink - $3.04 ?
Unnal/Bidet - $3.00 i
k_Laundry Tray - $3.00 I
Floor Drains - $1.50
E Water Heater - $1.50 I
Whirlpool - $3.00
1 Gas Piping Outlets - $1.50 ?
Softener - $5.00 I
Well - $10.00 I
Private Disp. - $10.00
? Rough Openings - $1.50
FEE ' I
srarE src: I
GRAND TOTAL• `
? . , r cnrvn ? » ? ? ? ?r
• . • MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE : 1 1..._ ? 1 J f j? , 1,
T PRICE; PHONE: 454-8100
Site Address y •" i : ' _ }?
Y Lot - Block 34
I m Name _
' -b Address
c City _
? Name
3 Addre
0 City
-
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent.
Gas Piping Outlets #
Other
BLDG.TfPE WORK DESCRIPTION
?R,,e? . New ?
?A"ult Add-on
Comm. ? Repair '
Other - FEES
RES. HVAC 0-100"M BTU - $24.00
ADDITIONAL 50 M'BTU - 6.00
- - ? Phone (RES. HVAC INCLUDES A/C ON NEW ?
CONSTRUCTION)
_ G#S OUTLETS (MINIMUM - 1 PER PERMIT). - 1.50 EA,
C(?JMM/IND FEE - 1ft OF CONTRACT FEE ?- _ _ ___ -?++-:••
M BTU ??I •?' APT BLDGS. - COMM. RATE APPLIES
M BTU TOWNHOUSE 8 CONOOS - RES. RATE APPLJES
MINIMUM RESIDENTIAL FEE - AlL ADD-ON &
M BTU REMODELS - 12.00
M BTU MINIMUM COMMERCIAL FEE - 20.00
? STATE SURCHARGE PER PERMIT - .50
CFM
?- _ (ADO $.50 S/C IF PERMIT PRICE GOES
1 • ` ? BEYOND $1,000)
-•..
FEE:
S/C: SiGNA?iURE OF P RMI7TEE
TOTAL• ? • ?
FOR: CITY OF EAGAN
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road e.:
P.O. Box 21199 PERMIT NO.:
Eaqan, MN 55121 DATE: '- 74--" '
? 2oning: - 1 No. of Units:
? Owner. rr?t:i Gaks -
? 1 agree to oomply wUh fhe Clty of Eagan Connection Charge: S? 5- O??T-
Ordinances. Account Deposit:
Permit Fee:
Surcharge:
By Misc. Charges:
Date of Insp.: Total:
L I nsp
?4 74
ITY OF EAGAN Permit N2-24-E7 '
o: Date: ?
830 Pilot Knob Road Meter No: Size: ?
O. Box 21199 Reader No: Date:
agan, MN 55121
wner. "rund ('akz 3
iteAddress:`'' So. . ay Lar`?. `?°^u '.'? 22 Overhi Farm II ?
Conn. Chg: 1- ; ,Ot)j,c, Zoning: kl
Acct Dep: ,5•00Pd No. of Units: ?
Permit Fee: 1J.'JOpd
Surchar9a ' 5 00d I agree !o comply wiM the CRy af Eagan
Tr. Plant I?' l•??? `' `^ Ordinances.
Meter. F'' ;)() „ :
Misc.: gy
WATER SERVICE PERMIT
CITY OF EAGAN Permit Na 3," Date:
3830 Pilot KnoS Road Meter No: 376,65q?! F Size: !Q1 "Ro-c ?C
P.O. Boz 21199 Reader No: 0 ro T41 QY.$? Date: -7 - a - ? 7
Eagan, MN 55121
Owner.
Site Address: '= 5 So. 13ay :.akE F'.oad 1.3 A2 Uverhill Farr•: i?
g. ?, ? .i i eS t,
. Ch 5? . 'IV r°??
DeP: 1r tri ? t? ?.
t Fee: t A???
iarge: r-n ?grdl?'to omp1Y with the City of Eagan
int D Ordinances.
By??k-?
WATER SERVICE PERMIT
- - -- ?
CITY OF EAGAN
N°
13253
3830 Pilof Knob Road, P.O. Box 21-199, Eagan, nnN 55121
PHONE: 454-8100
BUILDING PERMIT Receiptq :74> ?y7
7obeusedfor SF DWG/GAR Est.Value $93,000 Date F EBRUARY 2 3 ,19 87
SiteAddress 4513 SO HAY LAKE RD Erect Cy Occupancy R3
Lot 3 Block 2 Sec/Sub. OVERHILL FARM 21510nodel ? Zaning Rl
Repair ?
Parcel No Type ol Consc Ij
.
Addition ? No. Stories
c GRAND OAKS DEVEL CO Move ?
Name Length 52
i
4521 SO HAY LAKE RD Demolish ? Depth dr
o Address Int Impr. ?
EAGAN
452-8934 Sq. Ft.
phone
City
Insta11 ?
. o Name SAME APProvals Fees _
z
$ c Address
s
? City Phone
a
F w Name
ox ? Address
z
a w Ciry Phone
Iherebyacknowledgetha have read thisapplication and state thatthe
iMormation is correct and ree o comply with all applicable State of
Minnesota Statutes and C7iry a . Or ances.
Signature of Permittee"'*
A Building Permit is issued to: RAND OA DEVEL CO
all work shall be done in accordance with all applicable te 6 Minneso
Building Official ?? -
Assessment _
Water S Sew.
Police -
Fire
Eng.
Planner_
Council _
Bldg. Off.-
APC
Var. Date-
Permit
Surcharge 46.50
Plan Review 239. 50
SAC 625.00
Water Conn. 525.00
Water Meter 67 . 00
Road Unit 305.00
Tr. PI. 80.00
Copies___??
0
on the express condition that
Ciry of Eagan Ordinances.
c7"
REQUEST FOR ELECTRICAL INSPECTION jIft rEys?ooooi-os
' See instructiona tor eompleting this form on back of vallow copv- lic-Ij 7
o=
C ?? 12q "XC" Below Work Covered by 7his Request
ACd 'BeO: 7Yae of Building AOVliantea Wirod Equipment Wi.ed
Home Range Temporary Service
Duplex Water Heater Lightin,y Fixtures
Apt. 8uilding Dryer Electric Heatin
Commercial Bldg. Fumace Silo Unloader
InduStrial BIAg. Air Conditioner Bulk Milk Tdnk
Falm thNr pect v ther ISn?rifyl
i.r Ueci y Ot er Other Compute Inspectron fee Below
M Fee ServiceEmranca5iza tl Fae Feetlers/5ubfeeders N Fea Grcu:ts
-- U to Z00 qm s 0 to 30 qm s 0 co 30 Am s
Above 20 _qmpy 37 to 100 Amps 31 to 100 A s
Swimming Poot Above 100_Am s Above 700_Am
Transtormers Irn acion Booms -?"n Partial.'Olher e
Signs Special Inspection $2Z
/}? OT
emarks ? ? f /f•
" A EE T/
flouph-in ?ate ?, the Electrical
r Insoeclor, he,aby
Final Date eertify that the abova
spection has been
• ri j.z--3'?' ea. '
Tla roqueat volC 18 montlia from
? nonths frl L J?
92
? ??cr1:00
?_2 I•••? ••?• I Re?ppu?iredi•• ?4•,??? I0lieadv Nuwl NofitY InsPec"I
y,?.?es N. or Whan Ready
eS,?kensed Electrical ConVaclor i hereby reQUest inspection ot above
? Owner elactrical work insfelietl et
Street Addres5. Box or Route City
ecuon o. Township Name or No. Range o. Cowiry
Occ nt INTI
??'-r?'L??
5m Phon No.
Powe upplie
J Address
Ele ical Conuac[or ICOmpany Namel
7C ??' Convacmr'S License No.
01 rVT-
Maiii BAddrIConv ctor or Owner Makine Ins[ailati
l ? /?? z,/ ??
AuMorized ' na e(C nh cmr/?Dne 1,?st3llationl P??ber ?y??• _
MINNESOTA STATE BOARD OF ELECTqICiTY THIS INSPECTION NEQUEST WILL NOT
Gripgs•MiAweY Blda. - Mom N-791 BE ACCEPTED BY THE STATE BOAND
1821 Universitv Ave.. St. Feul. MN 66704 UNLESS PROPER INSPECTION FEE IS
Phone I612) 642-0800 ENCLOSED. ,
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
?-?
Date G/ I rC ?T I?
Site Street Address Unit #
9?13
Property Owner Telephone # ( )
Contractor Rm(hl GI C.j Telephone # (;?3 ) 7P(? 7;7 7
Address & City 3(zr'A, -Q- StateAA-1 Zip S5`?
The Applicant is: _ Owner _216ontractor _Other
Alterations to existing dwelling $ 50.00
_ Add piumbing fixtures (excludes water softener and/or water heater--complete next
section if installing these appliances).
_Septic System Abandonment
_ Water Turnaround (add $125.00 if a 51.8" metiBr is required) 1 ('?
Other: U-2 ?1 ??'T? ?DCcJ?fo F[k.u+, ? '??nQ"1 -2 "ly' _e
Water Softener _ Water Heater $ 15.00
_ new _ replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge .--1 ? n $ 50
Total ?? MAR ? 4 2005 g J, ?
I hereby apply for a Residential Plumbing Permit and al&nawJedge-1#?et?ihformation is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City 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.
ApplicanYs Printed Name Applicant gn ture
RESIDENTIAL
' - BUILDING PERMIT APPLICA710N
CITY OF EAGAN
3830 PILOT KNOB RD, Fr4CAN MN 55122
C? 659-681-4675
NewConatrucNonReauirements RemodeURawirReaulrements
. 3 registered site surveys showirg Sq. fl. of lot, gq. fl. of house; and all raofed areas • 2 coDies ot plan
(20% maximum bt coverage albwed) . 1 setof Energy Calculations far heated additions
• 2 copies of plan showing beam 8 window s¢es; poured found design, etc.) • 1 sRe survey far e#erior addftinns & decks
. 1 set of Energy CalcWatlons . inclicate it trome served by sepd"e system for additlans
• 3 wpies of Tree Presenation Plan'rf bt plffited atler 711193
. Rim Joist Oetail Optlons selection sheel (61dgs wiU 3 ar les& unRs)
DATE R - N -02 VALUAiION I'I 9 c6a-? 9?-
SITE ADDRESS 4SI?f ???A (0 • S- MULTI-FAMILY BLDG _ Y gL_N
TYPE OF WORK Wt (\Ib 0S FIREPLACE(S) _ 0_ 1_ 2
APPLICANT WjW •
STREEiADDftESS Q94"I W1{Ak,;t RVL' S6UA CITY?r&1kK(2- SiATE mO ZIPnJ?,F?f37
TELEPHONE CELL PHONE # fAX #Q?? ?Y?"O
PROPERTYOWNER LEIrY'U AvVndvn iELEPHONE#452A iq_y
-----------------------------------------------------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNE50'I'A RULPS 7670 CATGGORY 1 MINNI:SOTA RUI.I?5 7672
(4 submission type) • Residential Ventilation Category 1 Workshee[ Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: Phone #
Plumbing system includes: Water SoFtener _ Lawn Sprinkler
Water Heater _ No. of R.I. Baths
No. oF Baths
Mechanical Conhactor:
bicctilnical systcm inciudes:
Sewer/Water Controctor.
Phone #
Phone #
Fee: $90.00
? ?1
------°----------------------------------°---------------°------------°--°------°---- ;"rl---------•--------- -
-= ;
I hereby acknowledge that I have read this appiication, state that the information is corVect, and_agree to1compiy
with all applicable State of Minnesota Statutes and City of Eagan[ ?Or`""dinances`? ? 1„I
Signature of Applica? F" u- '"? ??
OrPICI: USF. ONLY
_ Air Condi6oning
Heat Recovery System
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONIY
? 01 Foundation ? 07 05-plex O 13 16-plex ? 20 Paol ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 76 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 lower Level ? 24 Stortn Damage
? 06 04-plex ? 12 12-ptex Pliog_Y or _ 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 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Baoster Pump
Nbr. of Units Sq. Ft. PRV
Nbr, of Bldgs Length Fire Sprinklered
Type of Const Width
REQUiRED INSPECTIONS
_ Footings (new bldg) _ FinaVC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
RooF _ Ice & W ater _ Final _ Pool _ F[gs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MClES SAC
Ciry sAC
Water Supply & Storage
S&W Permit ffi Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
RESIDENTIAL
BUILDING PERMIT APPLICATION
GTY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651•681-4675
NewConstruction Reauiremanta
• 3 registerea site surveys showing sq. ft. cf !ct. sq. fl, of house; and all roofed areas
(20% maximum lot coaeraqe allowed)
• 2 copies of plan showinq 6eam d window sizes: poured found desgn, etc.)
• 1 sel of Eneryy Calcula[ions
• 3 copies of Tree Preservation °Ian if lot plaRed aRer; I1193
. Rim Joist Detail Optians selection sheet (hidqs with 3 or less units)
DAiE %- 3 ` 0
_ Watcr Soltcner
Water Heater
No. of Bat}is
SITE ADDRESS J 5Z 3 50 t'I A`I 4,AY. P ir? MULTI-FAMILY BIDG _ Y N
TYPE OF WORK4WMMMW*r f P S I c` FIREPLACE(S) _ 0_ 1_ 2
APPLICANT D E' ?e.rE?JQG i ?G
STREET ADDRESS 15a-3 C/ Ai? pn7(; S Tl'Ne- CITY tr ill STATEA-9A)ZIP,F?.?2-
TELEPHONE # y5a-1?1/7 -756& PHONE # (o?a-??TS -9-lif3-I FAX #`rsa - 7_tfG. -Lt77
PROPERTYOWNERL,6 Y'ry 1-/c/rlvdelO TELEPHONE
C (r, . t? J
COMPLETE FOR "NEW° RESIDENTIAL BUILDINGS ONLY ? StP 03 2002
Energy Code Category _ MINNESO'l':\ RUL1:S 7670 CA"I'EGORY 1
su6mission type) . Residential Ventilation Category 1 Worksheet Submitted • New Ener9y Code Worksheet Su6mitted
. Energy Envelope Calculations Submitted
Plumbing Coniractor:
Plumbing system includcs:
Mechanicol Contractor:
N[cchanical svslcm includrs
Sewer/Water Contractor:
Phone #
Phone #
Fee: $90.00
['ce: :s70.00
I hereby acknowledge that I have read this application, siate that the information is correct, and agree to comply
with all applicoble State of Minnesota Statutes and City of Eagan Ordinances.
SignatureofApplicant?/' t ?
OFFICE USE ONLY
i? ? . 7 s
RemodellReuair Reauirements
• 2 copies of plan
• 1 set of Eneryy Calculatbns for healed atlaitions
• 1 site survey for exterior additions 8 decks
. Indicate if hame served by septic system `or additions
VALUATION ?00
Pt10RL' #
Laavn Sprinkler
No. oF R.I. Baths
Air Condiuoning
-- E-Icat Rccovcry S}stcrn
Certificates oF Survey Received - Tree Preservation Pian Received _ Not Required _
Updated ai02
OFFICE USE ONLY
? 01 Foundation ? 07 OSplex ? 13 18-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Owelling ? 08 06-plex O 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Muld
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex PIbg_Y or _ N O 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition 0 36 Move Btdg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Damolitlon (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stocies Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaVC.O.
_ Footings (deck) FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation
? HVAC
Drain Tile Other
Roof _ Ice & Water _ F inal _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ _
Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
W ater Supply 8 Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Building Inspector
Total
S p a 9'5- RESIDENTIAL
BUILDING PERMIT APPLICATION
CfTY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
851-681-4875
New Conatructlon qeoulremenffi
• 3 rBgiStOrBtl s%e suNBys ShOwing Sq. fl. al lot, Sq. il. Of h0use; and aII ro0fed ar02s
(20% maximum rot caverage alrowed)
• 2 coples of plan showing Eeam 8 window sizes; paured found design, eta)
• isetofEnergyCakulatbns
• 3 coples of Tree Preservatbn Plan 8 bt plattetl atter 7l1193
• Rim JoW Deleil Options selection sheel (bldgs wiCi 3 or less unAS)
DATE
Remotle4Reoair ReauhemeMe
. 2 copies Of plan
• 1SetOtEnergyCelculation5brheatedaddflbnS
• 1 silesurveyforexlerloraddttion5&decks
• Indicale d home servetl by septic system for addiflbns
VALUATION 0 °7rDOTI 00
SITE ADDRESS ?fK{? )2d S MULTI-FAMILY BIDG _ Y XN
TYPE OP WORK ?e 5ti? L-e no F FIREPLACE(S) ZC 0_ 1_ 2
APPLICANT L-/k r
STREET ADDRESS -
TELEPHONE #
PROPERTY
t4V i ?
CELL PHONE # _
?!a-r97 ?f%v STATELf4?N11P ?S/Z3
FAX #
TELEPHONE#
----------------------- J------------ m -------------------- m ----------------------r-------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNFSOTA RULFS 7672
submission type) . Residential Ventilation Category 1 Worksheet Submittetl • New Energy Code Worksheat Submitted
. Energy Envelope Calcula8ons Submitted
Plumbing Confractor: ___ Phone #
Plumbing system includes: _ Water Softener _ Iawn Sprinkler
_ Water Heater _ No. of R.I. Baths
_ No. of Baths
Mechanical Contmctor: Phone #
Mechanical system includes: _ Air Conditioning
_ Heat Recovery System
Fee: $90.00
Fee: $70.00
SewerlWater Contractor: Phone #
-------------------------------------°-----°----------------°°°-----^----------°°----------
I hereby acknowledge that I have read this application, staTe ihat ihe inform tion is correct
with all appllcable State of Mfnnesota Statutes and City of Eagan Ordina
Signature of Applican
---°-----°-'-----°-------------------------------_._---"'---------'---'--..._........
OFFICE USE ONLY
agree to comply
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4I02
OFFICE USE ONLY
? 01 Foundation ? 07 OS-plex O 13 16plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3sea.) ? 37 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex 0 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ex[. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Poroh (screened) ? 36 Multl
? 05 03-plex ? 11 10-plex 0 19 Lower Level ? 24 Storm Damage
? 06 04plex ? 72 12-plex Pibg_Yor_ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repalr
? 33 Alteratan ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement "Demolitian (Entire Bldg only) - Give PCA handout to applicanf
Valuation Occupancy MC1ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinkleretl
Type of Const Width
REQUIRED INSPECTIONS
_ Footings(new bldg) _ FinaUC.O.
_ Footinge (deck) _ FinaVNO C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
Drain Tile Othar
Roof _ Ice & Water i Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Smne
_ Fueplace _ R.I. _ Air Test _ Fina1 _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
MeChanical Permit
License Search
Copies
Other
Building Inspector
Total
? a CITY USE ONLY
L ?i Bl
suso.
i
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Please cortlpiate for.
I
i
2000 PLUI+BINC, PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT IINOS RD
EAGAN, MIlI 55122
651-681-6675
RECEIPT#: /?) Z, I0 /
RECEIPT DATE: d' I' O 0
PERMIT# -3 1 S1-( S
? single family dwellings
? townhoines and condos when permits are required for each unit
? backflow preventer for underground aprinklersystem
FIXTURES '
EACH //
TOTAL
i
Alterations to existing dwelling - minimum fee
Describe:?
$ 30.00
Bath tuh $ 3.00 x = $
Floordrairti 3.00 x = $
Gas pipin . outlet ' minimum -1 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sirjk 3.00 x = $
Laund tr 3.00 x = $
Lavato 3.00 x = $
Se tic S stem new/returbisned • requlres MPC Ilc. 75.00 X. = $
SB tIC S S Eril abandonment 30.00 x = $
RP2 i new Installationlrepairlrebuild 30.00 x = $
Rou h o enin 1.50 x = $
Shower i 3.00 x = $
Under rou d sprinkler If dwelling is under construction 3.00 X = $
Under rou d s rinkler B axisting dwelling 30.00 x = $
Water closet 3.00 x = $
Water heaCer 3.00 x = $ 3-00
Water softener If dwemnB under conauucnon 5.00 x = $
Water softener If exlsting dwelling 30.00 x = $
Water tumaround 30.00 x $
State Surcfiar e .50 -> -> -> $ .50
rotal ! _> ->
Remfnde?: CaII for Enspectipns of aateralior.s, i.e. water heaters, water scfteners, etc.
- - - _...••••-•••-------------------•-------••-••••-••------------------
I heroby adcnpwledge that.l have read Mls apPlication, state thet tAe inkmiatlon is corted, and eprea to mmply with all applicabla Cily o} Eagan ordinances.
N'is the appliCant's respansibility to notify the property owner that the CIry ot Eagan assumea no Ifability for any damages caused by the Ciry during its
normal operajional and malntenance actiyities to the fadlltles constructed under thia permit within City property/right-of-way/easement.
51TE ADDf?ESS: HvwoeN, LARAY
4513 HAY LAKE ROAD SOUTH ?
OWNER Ni4ME: : EAGAN, MN 55123
. (651) 452-5418
INSTALLER NAME:
STREET
cirv:
TELEPHONE #:
(AREA CODE) '
TELEPHONE#: ?lZ 27' `'b3?
, IL-- (AREA CODE)
P 5 o
PERMITTEE
o•*
479•o0+
46•5U+
239•7U+
625•OU+
\ 525•OU+
67•00+
305•OU+
i80•00+
2, q6'7•0U *
rh0?`
7987 BIIILDIAG PEAMIY APPLICATIOH - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLDDE 2 SETS OF PLANS, 3 CERTIFICA2ES OF SORVEY, 1 SST OF ENERGY CALCOLATIONS
HOTE: 9DDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MQST DESIGHAYE WHICH ADDRfiSS
IS DESIRED. NO CHANGfiS WILL BE ALLOWED ONCE BQILDING PERMIT 25 ISSQPsD.
MIJLTIPLE DHELLINGS - RFSIDENYIAL
INCLUDE 2 SETS OF PLANS, CEA
1 SET OF ENERGY CALCULATIONS
RENTAL OPITS FOR SALE iJNITS
OF SORVEY - CHECS iiITH BLDG. DEPT.,
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
B
T
U
d F
'9-3
Q00 2o
o
e
se
or: Valuat ion:
, Date: 0
Site Address OFFICE USfi ONLY
Lot ??1 Block -2 Site Sewage Occupancy
_
MWCC System ? Zoning
Parcel/Sub ? On Site Well Type of Const
, City Water ? (Actual)
Owner (Allowable)
dd of Stories
Address ' Length 5Z
Depth 4(0
City/Zip Code S.F. Total
Footprint S.F.
Phone APPROVAI.S FEFS
Contraetor Assessments Permit 47'7,
- `
` Water/Sewer Surcharge
5 ?
Address
t Police Plan Review 23R?
Fire SAC, City
City/Zip
Code Engr SAC, MWCC 52
: Planner Water Conn 5Z5
Phone s?_E5 3? Couneil Water Meter 67,
Bldg Off Road Unit 305.
Arch./Engr. APC Treatment P1 IgOr
Variance Parks
Address Copies
TOTAL
City/Zip Code
Phone ll
?( ?? f.
. ?. .
,. ., ..?, ,
g?cl 4° 112
?
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SUR
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OR'S CERTIFICATE
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pROJECT N0.
87091
BOOK / PAf3E
SIGNED: R HILL, INC.
BY:
IAROLD C. PETERSUN, LAPID SURVEYOR
PIINNESOTA LICENSE N0: 12294
JAMES R. HILL, INC.
Planners / Engineers / Surveyors
FILE NO.
FOLDER
8200 Humboldt Avenue South
Blootnington, Mn. 55431 812-884-3029
+- DENOTES PROPOSED SURFACE DRAINAGE
O pENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = q 5S'.3 FEET
.X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = 5 2. S FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK =? S 5,? FEET
I FIEREBY CERTIFY TO GRAND OAKS DEVELOPMENT C0. TNAT THIS I5 A TRUE AND CORRECT
REPRESENTATION Of A SURVEY OF THE BOUNUARIES OF:
X50?".
GRAND OAKS DEVELOPMENT C0.
? N
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33 00 \ riL
- •n 1
?KD
- 5515-5-5 V ?
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Lot 3, [ilock 2, OVERHILL FARM SECOND ADDITION, according to the
recorded plat thereof, Dakota County, P1innesota.
AND OF TIIE LOC.ATION OF A PROPOSEO RUiLDING. fT DOES NOT PURPORT TO SIIOW IMPROVEMENTS.
OR ENCROACfIMENTS, IF ANY, TIIEREON. AS SURVEYED BY ME, OR UNDER P1Y DIRECT SUPERVISION,
TIIIS Iq1j1 DAY OF Feg¢vc,eH, 1981.
PdOTE: PROPOSED GRADES SHOVIN WERE
TAKEN FROM THE GRADING PLAN FOR
OVERHILL F{1RM SECOPID ADDITION,
PREPARED BY MINPIESOTA VALLEY
SURUEYORS INC., LAST DATED 3-28-36.
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CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
-------------
P ease Print
1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
IF E7QSTING STRCCZS.'RE, DATE OF ORIGINAL Bi!ZLDING PERMIT ZSSC'ANCE: ."
i
(Nbn Year)PRESENf 7ANING/pROPOSID C?SE:
?E
0 CO??'ACIAL/f2E,TAIL/OFFICE
Q IbIDC'3TRLAI,
n INSTII[)TIONAL/GOVEt2bID7ENT
_LD-R-?SINGLE FAMILY
r-I R-2 DuPLEX (TWo Onits)
R-3 ZOWNiO0SE (Three + Units) ( Lfiits).
? R-4 APARZT1ENT/CONID0MINIUM ( Units)
2) NAME:
ADDRFSS:
CITY, STATE, ZIP:
PxorE:
• 3) • u ?: a• ?ME•-v ,!? For City Use .
Plisnbers License:
AnDxPSS: /,? /b ? ed
i CITY, STATE, ZIP:_ Not recorded
PHONE: ?/.;t- 4 MASTII2 LICIIVSE# ?/U 7•-/j/( J S?=Elal
4)
•.« • • ? i?•
tuAME:
ADDRESS:
CITY. STATE, 2IP:
PHONE:
5) ? v, ? a: • ?• : ai • a? • ??
Q-emmcPION 70 CITSC SE4JER M-QBRWTION 1U CITY WATII2 OTHER '. .
6) ? •'- • r ? PLEASE HOLD APPROyID PII211IT EY)R PICK-[7P BY ONE OF AHOVE -_.' -- -
?SE MAIL APPROVID PERMIT TO 1. 2, c 4. ABOVE .
(Circle one)
7) d-7
*AT6: PAYME6TP' OF FEE AT TIME OF
APPLICATION mES Wr CXXZMTM
APPROVAL OF PERMIIT.
itvsrncriota oF sEwat Arro/Ot WATEz
INS'LA7T.ATTON$ WIId.. NO'P SE $CHED-•
UI,ID UNTII, PIItMIT.HAS BFF,N
APPR(]VID.
FOR CITY USE ONLY. , - PERMIT # ISSCED
Pd w/Bldg. Permit FEES:
$ IC S--b $ SEWER PERMIT (INCLODE SORCHARGE)
$ $ WATER PERMIT (INCLUDE SCRCHARGE )
$ $ WATER METER/COPPERHORN/OCTSIDE READER
$ $ WATER TAP (INCLODE CORPORATION STOP)
$ $ SEWER TAP
$ /,? • ?' U $ ACCOUNT DEPOSIT - SEWER
$ $ ACCOUNT DEPOSIT - WATER
S J?? ? - LrL? $ WAC
$ SAC
$ $ TRI)NK WATER ASSESSMENT
$ $ TRL'NK SEWER ASSESSMENT
$ $ ` LATERAL BENEFIT/TRONK SEWER
$ $ LATERAL BENEFIT/TRLNK WATER
$ $ WATER TREATMENT PLANT SDRCHARGE
$ $ OTHER:
$ ?`? ?` ?•? $ TOTA
L
RECEIPT RECEIPT
DOES UTILITY CONNE CTION REQUIRE EXCAVATION IN PC'BLIC RIGHT OF WAY?
Q YES IF YES, THEN A" PERMIT FOR WORK SVITHIN PDBLIC
ROADWAY" MOST BE ISSUED BY THE E[VGINEERING
Q
NO DIVISION. LIST AS A CONDITION.
SDBJECT TO THE FOL LOWING CONDITIONS:
APPROVED BY: Ne_ Cc,C?- ' 41-7
TITLE:
DATE:
T
(o7q(j 2-1 'drf ( 3,-7 5
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan (0-M N"J"
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction ReauiremenGS RemodeUReoair Reauirements Office Use Onlv
3 regislered site surveys showing sq. ft, of lot, sq. ft. oi house; and all roofed areas 2 copies of plan Ced of Survey ReaJ _ Y _ N
(20% msximum lot coverage allowed) 7 sei W Eneqy Calculations kr heated addRions Tree Pres Plan Recd _ Y _ N.
2 copies of plan showing beam & window sizes; poured (ound design, etc. 1 site survey for additions & decks Tree Pres Required _ Y _ N
isetofEnergyCalculaGons AddPo'on - indkafeBOn-sifesepticsystem On-sifeSeplicSystem _ Y _N
3 copies of Tree P2servation Plan if lot platted after 111193
Rim Joist Dehail Oplions selection sheet (buildings w(ith 3 or less unRs)
Date
5ite Address 45) 3 H!!., "?Le ?-?• Construction Cost ? 3f ACQO
?oJf-l-? Uoit/Ste # `
Description of Work
Multi-Family Bldg _ Y? N Fireplace(s) ? 0 _ 1 _ 2
Property Owner L-e,,, Telephone tt ( (9SI )°l o S'- _V75-y
Contractor
Address
StBte /11nJ' , City 'RmVViSeu
Zip 5-S'3p3 Telephone #(6 i2.) 34.? -'-/S 3$
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Enecgy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submissiontype) Submitted Submitted
. Energy Envelope Calculations Su6mitted
Have you previously constructed a building in Eagan with a similar plan?
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone #(
Telephone #(
N If so, 25% plan review
I hereby apply for a Residential Building Permit and acknowledge that the informat?@? rate;
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
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.
S?o!•1-W ic?S?
Applicant's Printed Name plicant's Signature
OFFICE U5E ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04: 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex O 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06: 04-plex ? 12 12-plex Plbg_Y or _ 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
7 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors
? 34-ReplaCement 'Demolition (Entire Bldg) -Give PCA handout to applicant .
Valuation Occupancy MCES System
Census Code ? Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof [ce & Water Final
? Framing
Fireplace _ R.I. _ Air Test _ Final
Y Insula[ion
T
Approved By:
REQUIRED INSPECTIONS
Final/C.O.
? FinaUNo C.O.
_ Plumbing
HVAC
Other
Pool _ Ftgs _ AidGas Tests
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wall
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
?.? (rY10 i?lO h?.?
?
L>
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4513 Hay Lake Rd S
Lot: 3 Block: 2 Addition: Overhill Farm 2nd
PID:10- 56151- 030 -02
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 2,000.00
Contractor:
Home Depot at Home Services, The
5169 Winnetka Avenue North
New Hope MN 55428
(763) 367 -9740
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
Surcharge - Based on Valuation $2K
BL - Base Fee $2K
- Applicant -
Construction Type:
Occupancy:
Permit Type:
Permit Number:
Date Issued:
Permit Category:
If altering the opening size, a framing inspection is required. Smoke detec tors are required in all sleeping rooms prior to
final inspection. When wall studs or ceiling joists are exposed, hard -wired detectors are required Bat tery operated types
are acceptable if the wall/ceiling finish (i.e. sheetroc k) has to be removed to install a smoke detector. Kara Benson 1120
Eas t 80th Street, Ste. #211 Bloomington, MN 55420 952- 345 -6047 tims @elderjon es.com
$1.00
$69.00
$70.00
Owner:
Laura F Johnson Gil
4513 Hay Lake Rd S
Eagan MN 55123
9001
0801
Issued By: Signature
Building
EA073521
05/26/2006
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply with all applicable State
S '0 6~ -315
Use BLUE or BLACK Ink
I For Office Use I
j Permit
City of EaEd I 3
Pennit Fee: U5
3830 Pilot Knob Road I 1
Eagan MN 55122 Date Received:
Phone: (651)676-5675
1
Fax: (651) 675-5694 1 Staff: I
I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:
010) 13 Site Address: I C~3 Unit
i Name: Phoneg3f-3),?- - ~qI
Resident/ E
r Owner ( Address / City / Zip:
1 f
j Applicant is: Owner Contractor
-ac
I Description of work:Qn r
Type of Work ;
Construction Cost: 6,~ . Multi-Family Building: (Yes Nb;i~
I Company: 41 Contact: I G(,,
t, i
( Address: 1 1 o``~dyt d-l 1V City:
Contractor
` State: (M
IN Zip: SJ Qaa Phone: ~15I - 0 29 " ~~'j - (3-
! License ~ l Lead Certificate #:N)4I - nss5~) -
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
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 ora
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed. within 180
days of permit issuance.
x
Applicant's Printed Name Applicants Signature
Page 1 of 3