4522 Hay Lake Rd S
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,..r I r UF EAGAN Remarks
Addition OVERHILL FARM IST ADDN Lot 1 Rlk 1 Paroal 10-56150-01
Owner Street 4522 S. Hay Lake Road State
%
Improuement Date Amount Annual Years Payment Receipt Date
STREET SURF. 198I 310.74 15.54 20 a 1?. (P d o ?I 3
a.
/ 3/84
STREET
RESTOR. ?/? ? T ./ &V // 3 -;-
GRADING 883 1985 6 3 1, SS eO / -3,a-
n 1
1 54 lo - 43,Z
-515 SAN SEW TRUNK 19$1 1
35 17. .' 20
EWERLATERAL
T`SAN SEW TRK LAT SAN 1964 221.48 1.77 15 17'7. .1o C'o / 3 112
?
WATERMAIN
WATER LATERAL 573 jQ$j 172.42 5.62 20 O C 11„3 //.3 ?{e
WATER AREA 1981 359 . 28 17.96 20 1 Lrv /i 3?
11
STORMSEWTRK 'TI`I 1984 .1 28. 1 -gi-lo - /•3 L!,q /I ?02 ? .3 (??o
STORM SEW LAT -?rk ?13 1984. 76.37 5.09 15 6/• /d o3?. /
CURB & GU7TER
SIDEWALK
STREET LIGHT
WATER CONN, 500.00 " "
BUIIDING PER.
SAC
PRRK
CASH R EC E I PT
? •
CITY -OF EAGAN
P. O. BOX 21-199 J
EAGAN, MINNESOTA 55121 ;
DATE
AMOUNT $ < , I< /
. Q DOLL.ARS
I oo
F] CASH ? CHECK
rOR ' ,?
i. ? , .. , . . ' ? •
FUND CODE AMOUNT
i
?. i
Thank You
BY i.•. °, l
`1 C:•
White-Payers Copy .?
Yellow-Postinp Copy,
Pink-File Copy
? -
6UILDING 'ERMIT
Site Address
Lot ' Black Sec/Sub.
Parcel No.
Nerhe
Address • " ', iJ
l?
Citv Phone
Phone
Phone
1 hercby ackrawledye thot I hew reod this applicotion and stote that
tht intormction is tonect oe+d ogree to comply with oll cpplicoble
Stcb of Minnesoto Statutas and City of Euqon Ordinonces.
CITY OF EAGAN
3830 Pilot Kno6 Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Receipt
'10351
Erect L„J Ocwpancy
Remodel ? Zoning
Repair ? Type of Const.
Addition ? No. Storiea
Move ? Langth
Demolish ? Depth
lnt. Impr. ? Sq, Ft.
Install ?
Approraf@ feq
Assessment
Water & Sew.
Pol ite
Fire
Eno.
Plonrer
Council
Bldg. Off.
APC
V D
Permit -
Surcharge
Plan Review
SAC
Water Conn.
Water Meter
Road Unit
T?. PI. -
ar. ete I Copies
Siqnatun of Permiftae , .
Total
/l Bulldinq Permit is issutd to: on the exprcss condition that
al( work sholl be dorw in accordonte with all applimble State of Minnesoto Srotutes ar+d City o1 Eopon Ordinonces.
Pxmit No. PKmk Holder Dsft Teiophonis *
PlumbinO Y U
N.VA',c.
Ebetrie ?? ?/ 1 V. J / ?? CJZJ
Softww
Infpeetion pate Insp. Othw
Footingsl G . w
Footings 11
Foundatlon L
Framiny
RooHnq
Rough Plbg.
Rouyh Htp.
i
Insul. ?
Firoplacs
Finsl Htg.
Flnal Plbp.
Final i3 "A /S /l? ?? ?v? ? crJ ? CL 16 ?? 7-5k
Csrt/Occ.
Water Dewibo Locotion
Wdl
Sswer
Pr..Dlsp.
Receipt PLUMBING PERMIT Permit No.
? - CITY OF EAGAN
? F«
Fill in numbersed;paces S/C
TYpe or Print legibly Tot.
1. Date 2. Installation Cost '
3. Job Address Lot?Blk. ? Tract 1109wer4r1lFr,
• / ??
4. Owner
5.
6. Address . iA .
7. City State Zip
8. Building Type: Residential O Commercial ? Institutional O
9. Work Description: New Cl Add O Alter O Repair ?
10. Describe
11.
No. Fixtures
Water Closet No. Fixtures
fi
C
l/D
i
ld
Bath tubs esspoo
ra
n
e
Se
ti
k
T
Lavatory p
c
an
S
ft
e
+
Shower o
n
r
Well
L Kitchen Sink
Urinal/Bidet Othe
Laundry Tray r
? Floor Drains
arinking Ftn.
Slop Sink
Gas Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : ` , ;
for
Rough F inal
Inspections: Date Insp. Date tnap.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Reciipt
CITY
Parmit No.
Fas
S/C ?
?
Tot
„?-
1. Date 2. Installation Cast ?
3. Job Addreas. Lot Blk. ? Tract q
fk
4. OIMI@?
• . ?. ?. ., . . ".: . I ? ? i'.( • /- . .. , 5. Contractor Phone
s. Address COOn Rapids BIvd.
7. CitY ot ; State , . . Zip -
8. Building Type: Residential 0' Commercial [3 Institutional ?
9. Work Deacription: New EY Add ? Alter ? Repair 0
10. Desari6e Fuel Type
11.
No• Equioment BTU • M. Ea.
Forced Air ? '' ' No. Equiament CFM
Air Handlin
:
Mfg. i ^ f g
Boilers
Mfg. Mech. Exhaust
'
Unit Heater ! d'f! : un :_r1 ;' '?
Mfg. ! f Qther
t Air Cond.
Mfg.
Gas, Piping Outlets
I
I'
12. I herebY certify that the above inform4iodis true and correct, and I agree to
comply with all ordinances and codes Oqveming this type of work.
i
Signed: -?f6rInspections: Date Insp._
7his is your permit when numbered
Approved
Final
Date Insp.
CITY OF EAGAN 454-8100
55433
ga ;
CITY OF EAGAN SEWU SERVKE PERMR
3830 Pilot Knob Road
P. O. Box 21199 _
PERMIT NO.: -
Eagan, MN 55121 D/17E: -
Zoninp: -'• No. of Units: 1
Owner. C;;•aalei;?'-?cs?i:? `< "'° -
Add.ess:
Site /lddross: ? ? :io ?IFiv
Plumber: - - -
100.00 pd
L 1 pne to eeapy wi1b 1M Cley ef tyo. Conn.cHon C}wW: 425.00 pd
OrdiuoeeN. ACtouM Deposit:
Penrdt Fes: -
Surcharpe:
By
Dote of Insp.:
CITY OF EAGAN
3830 Pilot Knob Rwd
P. O. Box 21199
Eagan, MN 55121
Misc. Chorpes:
Totcl:
Dote Poid: -
WATER SERVICE PERMIT
PERMIT NO.:
D/1TE:
Zoninp: No. of Units: 1
Owner:
Address: -
Sih Addrcss:
Plumber: _
Mete? No.: _
Siu:
Reader No.: .
1 qrw te oovuply wMh IIw Ciy ef Emps
OrriwseaM.
p-
Connedion Chorqa: "t
Account Deposit:
Permit Fee:
Surchorge:
Miac. Chorpes: 12. 70 Totol:
Dcte Poid:
Date of Insp.:
CITY OF EAGAN
3830 Pilat Kno6 Road, P.O. Box 27-199, Eagan, MN 55121
' PHONE:4548100
BUILDING PERMIT Receipr
SiMAddress 4522 SO HAY LAKE RD
Lo: 1 Bixk 1 ?ec/sub. OVERHILL FARM
Parcel No. 1ST ADDITION
W N8111e OVERHILL PROPERTIES INC
? Address 3106 PILOT KNOB RD
City EAGAN phone 435-2005
ya
ZO
s?
N_ 10351
Erect 9 Occupancy R-i
Remodel ? 2oninq Rl
Repair ? Type of Const. V
AddNion ? No. Storias
Move ? Lengtn 54
Demalish ? Depth 37
Int Impr. ? Sq, ft.
Ina[all ?
Avvo.als Ftas
Name P1l.P1VLLLLV/ll .?iPlri &- tiJJUC
Address 430 INDUSTRIAL BLVD Assessment
c;tv MPLS Phone 378-3981 worer3 Sew.
Name
Address
City Phone
I hercby ockrwwladge tMtp have reod rhis application und stote thot
Nq inlormntion is correct? ond ogree to comply with oll upplicoble
Stata of Minnemta Smtu?f? nd Ci?,y of E an Ordinances.
Slpnoturc of Permittee ?
A Bullding Permit is issued M: `?a`'`•"'?'-'.
oll work shall be dona in occordanCe with oll
Bulldirg pfficial
Poliu
Fire
En0•
Plannar
Council
Bldg. Off. 5
APC
Var. Date
Permit 328.00
surcnarga 32.50
PlanReview 164.00
SAC S2S.OO
Water Conn. 500.00
water nnater 63.00
RoedUnit 280.0?
29 85 Tr,PI. 132.04
Perks
I Coplea ?
Tofal $2.024.54
_ on tha ezpress Condifion Ihot
ond City o£ Eopon Ordinancas.
5?3 `iSl
B 41030
REQUEST FOR ELECTRICAL INSPECTION EB'(t1
, See insbuctions for completing [his torm on back af Vellow copy.
"X" Below Work
Request I-) ,
5 -SS`
NwrAAddl Reo.1 Tvoe oi BuilAinn 1 AooliaMes WirW 1 Epuipment Wired , I
ex . 1 I Water
Mi
p Fea ServiceEntrenceSize k Fee Feeders/SuAfeeders i3 Fee Circuits
0 to 200 qm 5 0 to 30 Am s ? ?? 0 to 30 Am s
A6ove 200 qmps 37 to 100 Amps 37 to 100 Allt,
-Swinming Pool Above 100-Am s Above 100_AmFs
Trensformers rrigation 0ooaf, Partial%Other Fee
Hemarks - Y ' . `
?'itJ ?rrt ?,- ? i7 ?
flouBh-in r. Da^/te 1. t" clsital
? (.j ??? I?spector, hereby
cenity tlat xhe above
Final / D/ate ' p¢?<ion has been
?de.
Thia requestvoiC
This reques[ void 5`3 c) S '
1R-6c i.nm _
7-?3-a-
?j?1?'ri
Re ui?¢ci?•U??••?•• R adY Now Q Will NotiH. InsOec-
7?c?+1 ,?Yes ?NO [or When fleatlY
JLJ`6lcensecLElechical Conhactor ' 1 h¢reby reuuest insOacKOn ot above .
? Owner elaetrical work ivstslled at
Street Address, eoz or Route No.
S'. .
4- Citv -
14? 9i4
ectmn o. TownshiD N e or N. ftanAe No. Count' / /
? ?j71
Occupnnt(PPINT). Phone Nn.
?l ? ?
?`
l? "? ?7.._?c?,.
'??
5
?„v
?
; ?:s <o?• .
?
Power Supplier ' Address
Ele t'cal Conhactor (COmpanV Namel . ' s Lcense No.
Conaacmr'
? f 4f ; 1?: ?_ • iG/C. !
?L??-? f:? D?'?.,._
lgialt e P.ddress (Contracmr or Owner MakinB Instailation)
G 5/y? G(;?.y?,,.?"
ctodOwner Making InsWlla[ionl
Auffi ize?d $i9nafu ?Contra Phone Nwnber
?
MINNESOTA STATE 80AR0 OF ELECTRiCITY iHIS 1NSPECTION REQUEST WILL NOT
Griggs-Mitlway Bldg. - Room NA91. BEACCEPTED BV THE STAiE BOARD
1821 University Ave., St Paul. MN 55106 UNLESS PROPER INSPECTION FEE IS
Pn...o 16121297.2111 . ENCLOSED.
CITY OF EAGAN WATER SERVICE PERMIT
3830 Pilot Knob Road 6337
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: 6-27-85
2oning: Rl No. of Units: i -
pwner; McMullen(Moselle & assoc
Address:
Site Address: 42 ZZ `o x<
Plumber. Lakes' e 7
Meter No.:
Stu:
Reader No.:
I agre? w eomyy whli eha Ciy
OfAIM110w
?
Date of 1 ?
,
Connectia+Charye: _$00.00 pd
qccounr Depostr. 15.00 pd
Pervnit fee: 10.00 pd
Surchorge: .50 Pd
Misc. Chorpes: i't .00 -d
Totol: 63 nn ..a m « r
Dote paid:
KIP? 4- q 8'67 ,6,6
RESIDENTIAL
' - BUILDING PERMIT APPLICATION \
? CJ
CITY OF EAGAN ?? 0
3830 PILOT KNOB RD, EAGAN MPI 55122
651-681-4675
New Canstruction Reauirements
• 3 registered site surveys showing sq. ft. of lot, aq, ft. ol house; and II roofed a2as
(20% maz'cnum lot coverage allowed)
. 2 copies of plan showing beam & window s¢es; poured found design, etc.)
• 1 set of Eneigy Calculations
• 3 copies of Tree Preservafion Plan if lot platted after 7l1193
. Rim Joisl Detail Options seledion sheet (61dgs with 3 or less units)
DATE 51z2?/-O 0
SITE ADC
TYPE OF
iULTI-FAMILY BLDG _ Y XN
FIREPLACE(S) X 0 _ 1 _ 2
APPLICANT ?' 117`ll ? f
STREETADDRESS ?iCXtC'I CITY??nLSTATEI7WZIP S5I
TELEPHONE # 51`9 y-ACt CELL PHONE # FAX # -
PROPERTYOWNER-CITT"liE' °tBrff-& I_JeLfC) TELEPHONE#LCSI-qSq-C9 '7
-----------------------------------------------------------------------------------°----------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category MINNESOTA RLJLES 7670 CATEGORY 1 p?y{ ?672
(d submission type) • Residential Ventilation Calegory 1 Worksheet Submitted ?4eet Submitted
• Energy Envelope Calculations Su6mitted ?
MAY 242
Plumbing Contractor. Phone
--------- ------? -
Plumbing system includes: Water Softener Iawn Spri 0.00
Water Heater No. of R.I. Baths
No. of Baths
Mechanical Conhactor:
Mechaiucal system includes:
Sewer/Water Contractor:
Air Condidoning
Heat Recovery System
Phone #
Fee: $70.00
Phone #
----------------------------------°-----------------------------------°--°----------°-----°--------°-----°-°------
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Or I'nances.
Signature of Applicant ?%JYYLtC
OFFICE USE ONLY
?
RemodeUReoair Reauirements
• 2 copies of plan
• t set of Energy Calculations for healed additions
• 1 sAe survey for exlerior additions & decks J
• Indicate rf home served by seplic system faraddNions
VALUATION
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required
Updated 4102
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex O 17 Garage
? 10 08-plex X 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn.(4-sea.)
? 23 Porch(screened)
? 24 Storm Damage
? 25 Miscellaneous
.? ,..
? 30 Accessory Bldg
? 31 Ext. AIt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
,X 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation 4,2V Occupancy 'R -3 MC/ES System
Census Code yl Zoning A -/ City Water
SAC Units ` Stories ` Booster Pump
Nbr. of Units - Sq. Ft. Il ? PRV
Nbr. of Bldgs ` Length ? Fire Sprinklered
?
Type of Const ? Width ?
REQUIRED INSPECTIONS
Footings(new 61dg) FinaUC.O.
? Footings (deck) j? FinaUNo C.O.
_ Footings (addition) _ plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Au/Gas Tests _ Final
_ Framing _ Siding Smcco Srone
_ Fireplace _ R.I. _ Air Teat _ Final _ 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
Cities Digital Qualitv Control
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Al-L BEJSRING'i Ad'sU'AFD
o pENOTEb tRo1s MofJUMENT
v
I hereby certify that this survey was prepared by me or
under my direct supervision and that I am a duly Registered
Land Surveyor under the laws of the State of Minnesota.
NoRT N
?,GALE 1=30'
1
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LICENSED MITH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OE SURVEY
1 SET OF ENERGY CALCULATIONS
TO B2 USE(] For: cF TT, rnn?ct lyCVr???lOtl: Date: Ma?z 74 ? 1925
={ssa,?- sd,.
Site Address: xav Lake itoad OFFICE USE ONLY
?Overhill Farm
Lot: 1 Slock 1 Sect/Sub First Add.Erect y. Occupancy (?-3
Remodel _ Zoning
Parcel Ik Repair Type of Const 11:
Enlarge li of Stories
Owner pverhill Prooerties Inc. Move _ Length
Demolish Depth
Address 3106 Pilot Knob Road Grade Sq Ft
City/Zip Code Eaqan, MN 55127:
Phone 435 -2005 APPROVALS
Contraetor McMullen/Moselle & Assoc. Assessments Permit
Water/Sewer Surcharge
Address 430 industrial alvd, In°' Police Plan Review
Fire SAC
City/Zip Code Mpls., MN 55413 Engr Water Conn
Planner Water Meter
Phone 378-3981 Council Road lJnit
Bldg Off Parks
Arch./Engr, APC Treatment P1
Variance
Address
City/Zip Code
TOTAL
32. 5°
525 ?
Soo-?
280. "'
t'32 . 00
42?f°.. c?11
Phone II
3?x 2?? ? 08 ? 5¢ - 53352
1 x t3 ` i3 ? 4?"" S33
I2c? x 4 ?.
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MIN t-l ESoT4
I hereby certify that this survey was prepared by me or
under my direct supervision and that I am a duly Registered
Land Surveyor under the laws of the State of Minnesota.
Date: /vqy L rz-,,- f f???
L oy . Bnhlen
? Registered Land Surveyor No. 10795
.
041fJER
EXTERIOR ENVELOPE At1EP,AGE "U" COi1PUTA7I0N
SITE ADDRESS
CONTRACTOR fftMuU.ty,J `M?CLC DATE 21??,5 PHONE
Determine working square footage of each.
l. Total exposed wall area ...... 1?16 sq. fit. x .II
2. Total.roof/ceiling area ..... 1134, sq. ft. x.P9.az6= 2q,q?
Total exposed wall area above floor =
a. Total wall window area .................... ....... 109.61.
b. Total door area........................... ....... qZ,pp
_ c. Total sliding glass door area ............ ....... _ 34,3
d. Total fireplace wal.] zrea.........:....... ....... 0
e. Total wall framing arez (average 30%)_..:. ....... 150,00
f. Total net wall area above floor .......... ........ l003
b3
g: Total rim joist area ...................... ,
.......
Total eznosed foundation area'= 57,b?
h. Total
foundation rrindow area .............. ;
.......
i. 7oal net foundatron area abcve grade ..... .......
Deternine "U" value cf each wall segment.
a. 101),b6 x;,U" .51 ' = S5, 3
b_ 4z? X ,luii .61 = 1.?a. .
. . C: 3437 . -X „Ui,
- d. ? X .stuil?_
e. ISO-OD X 1.u11 .12 = ?B.CD
f. lC?3Fx3 X "U" -40,15
X „U11
oGA?
= 3.s?
h. X „Ull ?ry _ = rPl
x .,u„
3 ..................................... Totai - ?iaS.G? I
If item a3 is the same as, or less than item 11, yoii have met the inient
of SBC 6006(c)2.
3-
k.
1.
Total exposed roofJceiling area =
Total skylight area..._.•••-••• -•-••••-•••••••'-S-
Total roof/ceiling•framing area (zverage lOX).._
Total net insulated roof/ceiling area...........
Determine "U" value for each roof/ceiling segment.
?•
X "U" -
k. 1?3 X „u„ oz = zz?
7: 1021 x zo M,-
,
4 ..................................7ota1 = ? .
ir total of r4 is the same as, or less than =2, you have met the intent of
S5C 6306(c)]. c
Alternate Suilding Envelope Design
io uti;ize the total envelope system r=_thod; the valu°s estahlished by the
su7-1 os itwns ;3 and '4 shall not be greater than the sum of itens Tl and
' 1. 16IPbS'' _+ 2. 1a6,L3
3. ??i•°I? -r 4.
T
WALL CONSTRUCTION
?
?
?
?
a • ??
d ? .•????
-1111=
_?11l
V
Construction Fig. # !
R-Valve
AIR Flt-tn
'
2. tiJ ' c.,HEET ROCK ?
3. ?'li' SoF7L..?ooD
, 4. zs/xz Z.bro
, FiR. 1 6• ex7- AtR.Gi?-M .1?
TOTAL "R" ?41
--1Z- "U"
Construction Fig. # Z
1. 1?. A1? FILM _ -?
2. !Iz SNEET QOr? - - ?_ ..
3.
4. zsAz 'ButvT-urre_. . _ 2•0?
. S. :SIDIUC ' , -?'7
Fiq. 2 6. EX7: AtR-FII-M. . .'? 7
TOTAL "R" . Z3. -D 3
ifUn p4 nIIn
Construction Fig. ,4` 3 •
1. 1NT• AIV_ F1LP'1 -68
2. ?,FG IuSU?• - ??
- 3.
' -- . . 4.; Z5 3Z' B01?T-RITE . . 'Z.O(? .
'
-61 .
71 g. 3 - 6. cXr. Ai?_ Ftt-M -17
TOTAL "R" Z4.46
nUn _ 1 = :O? -nUe
Construction Fig.
Fig. 4
1. lut• AtR Ftt-t? . to8
2. IZ° (3w(?K 1-2-8
- 3. gIGiD 11VuL• ?. 02>
= 4. C-Kr AiR Fi1.J?1 _f?
5.
s.
TOTAL "R" -
nUn nUn
?c Uae this dimension when basament wSndoRS ere below gnade wlth areaRells
.,
- -
?
.
VENT
1
FiR. 5
,fUll _ 1?
Conatruction Fig. J? 5
. ' R-Valve
i . Al B_(?s,+?- _ .-68
2. PLnv? l?ro_ adc? 3. 5?, DRw w4 :•S/
4. (Nr Au- Fic?m _ ,hv
5.
6. .
. TOTAL "R" 4sc)
flUti _ 1 . .OZ"U,l .
Construction Fig. # -/0
1 . .M ? .
2. '/z" kFflfi"LI [Z __3Y?
3. mn%4 i,?5tn? 36 _
4. S
Ay
-
5. -_ro?p'i r? G1 f b7?
6.
' - TOTAL "R" ? 42,3L
nUn - 1 - _e17 nIIrt
Construction Fig.
1.
2.
3. '
4.
5.
6. -
TOTAL "R"
?
uUn
nUn
Construction Fig.
1.
2.
3.
4.
5.
6.
TOTAL "R"
nUu
Fiq. 6
?. `
C
2/84
d '
%
CITY OF EAGAN
APPLICATIODI FOR PERMIT
• SEWER AND/OR WATER CONNECTIODT
(PLEASE PPINT)
1) PROPERT-V ADDRESS:
r_Fryar. DESCRIPTzcv:
(IOt/Block/Subdivisicn or Tax Parcel I. . Nlunber)
; I"r E:;ZS"^':G ST"-S'CP':2E, OAT:.' 0F OiZTG^IAI, u,II.DP:G PEF:,:IT ISSur\C.:
PPE=i'?' ]..^„7rF:/Pe`,OPOSED C`S: ? R-1 SLNGLE r^FMSLY
C] R-2 PUPI.??" (2SG0 UIVITS)
? =2-3 ZC7.v1iLHCxrGE (?'I??= + L=TS) ( Wi Zmc)
? P,4 A^rAR`r:'1Eti'T/CC2DCi,SI1rJM ( UVITSi
p C94.MERCLAI./REPAIWOFFICE
Q L\'DL'ST2irlL
Q 1 N STI';C,T20N AL/GGVEE? 2,1-'\7
2) AppLic= h (PLEASE PRINi)
NPr?,': f1 PL M ?.r
aDDREss:
crrY, sTATE, zIP: n'?rv 553
PHONE: 72- - -
3) P?mER PLEASE PRIN7) FOR CITY USE ONLY
NAME• /
-
ADDRESS_ PLUMBERS bItEHSE:
Activ
CITY, STATE, ZIP: Ez 'red
MA6j?R
PHOiVE: pLUMBER LICENSE #6G,?3?7/?'J If_pecoed
'
a tnitia
q) pCC[7?pNP/C7,;,NtE2 NANIE: IYLtASt PNiNrj
"?
ADDRESS: y?Cj
CTTY, STA'IE, ZIP:
PHOrE: ? - ,.27G 7
5) INDIG'1TE S9HZCH PERNLTT IS BEING REQCTESTED:
CONDIF.CrION 'M CITY SEYIER
CONNDCPICN 20 CITY ATATE.4
? ?'ITEit (PLEASE DESCRIBE)
6) ILMI= C,+'E:
? PI.EASE F?OII] APPRWID PERMiT FOR PICF-UP BY ONE OF 11BCJVE
C] PLFASE N*AIL APPROVEp PERb1IT TJ 11 Z?! 3, 4 ABOVE
(Circfe one)
7) SIG.`?eT?,'IL'RE: ??'" r?g ,L U? DATE:
??e a?ai?fs.,v ? ar a?se:a:a ??s nro:asa+r sr s s?s? :r a a? ?at..a7ny+?y? ? ? wa ? aa?sa:? ?
FOR C I TY U S E ON;,Y '
PERMIT " ISSUED
FEEs : g_ jG?.S v
$
$
$
S
$_
$
$
S
$
$
$
SE:^iER °ERMrT (I?ICL-==- SUP.CR?RGE)
WATER PEtZtz4ZT (SNCiJDE SliRC:?ARGE)
WATER METER/COPPE4HORN/OUTSIDE READER
WATER TAP (INCLUDE CORPORATION STOP)
SE;vEF TAP
?r-Di;::'?' ..?:GS7_ -
ACCOU:IT DFPpSIT - UlAT£R
WAC
SP.C
TRliVK SVATER ASSESSMENT
TRliJIK SESJER ASSESShIEDiT
LATERAL BENEFIT/TRUNK SE;IER
LATERAL BENEFIT/TRUNK WATER
OTAER '
S
TOTAL
Ah10II_VT PAID/RECEIPT # S 31c%..'?
DOES UTZLITY CONNECTZON REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A "PERMIT FOR 'r]ORK WITHIN
PUBL7C ROAnWAY" MUST gF, ISSUFO RY THE
NO ENGINEERING DIVASION. LIST AS A CONDI-
TION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DAT_° :
MassW ESwmma o"a
C,2 D
p3 ) Z,1
H T LOSS ALCULATION °TEMP. DIFF.
L
Cuttomw Nsme ----- -- I TYVe Comtruitwn
city windo
ws
Drlw Name . Wallt -
SaMt -------- Ceilieq
City -- Floor
.I&)? Room I LmgtA ,3 $ Wi
Windows and Doors-Croekaoe md Ar"
Na W'4r?
n p?n? MIqF?
OI p?M Ne. 01 ? UM11 M1.
L b OI CIItI Aw
. 11.
a m o
COSf. 8tu
IntiItra?ion 0 q7i aY O
G b:s .$ D o
Exp. wall
Net eMp. wall ?Q
Int. wall ?
Ceiling
Floor
Stam Snh
Im.
Im.
1,.,RoomlLvnyth // Wi
and Doors-Gackao and Arr
NO. wb?A
n/ M M?yM
M M MO. CI
LH LInN11t
Of NKY A?M
N. H.
L 3 _ 1 _
CWf. BW
Infiltntion 37
Gi.a 92 3
-
Exp. wall a
Ne/ exp. wall
Int. wNl
Ceiling
F loor
Total Btu. 117 750 II Toul Btu.
f FI.? T Roomltmpth Width /o? Heqht R ? FI.? oom?L h Width 1-?-? FNipht
Windowsind Duas-Crsckag? and ArN Windows and Doors-Gaduos snd Ar? I
No W'dtn Nppnl
b ?M YI ?M No. W
L?1?? LMwI R.
O?CHL? MM
?p.l?.
3
IE
E Cosf. Btu
In(iltntion S'
Gh+• 3
Eap. wall q
Neh exP. wall D
Im. wall
Ceilmg
F lonr
No. wwm
OI ?M w4n?
1 M Ne. oe
L? X uamool re.
Of PKb Awi'?.
.
1. Caf. Btu
Infihwtan
Gim
C
-
-
Exp.wsll
Not axa. we1l ?
Int. wall
Ceiling t4
14
14
'd
Floor
Total Btu. _ ? I) Total Btu. .? (O fl
?FI.I Room I langth )o Width ?? H?pht FI.? Room?Lm h 1 WidM
" WmMws anA paors-Gacluue and Ar? Witdows md Doors-Gaek and ArM V
M.. Wn11n w,?l NO, e1
'Lo
n, I?.M nl MM L~1 N.
M Lr? A,M.
p. 1\
Ol
?
bi
Caf. Btu
Intiltrahon
G?ass
-
Ema. waU
NN ntP. w+II (e
Int. wall
Ceihrg b 3 (.l7
ilorr
To41 Bw. I dJ / ?"
un. ??mn W4? `o. W of h.
.
0.
?
-!- -
Co?t. Btu
Inliltntwn
GI.. ? a
Exp. wau
Not nco. watl 6
Int. wsll
Gilirq
Fbor
Total Btu. I ? ?nlY a
HEAT LOSS CALCULATION
cuaom. wm.
CitY --
DNNr Name
Stnet
ci:v -
Room I Lenpth 1_-'; Width I'7 M.ietir
` W in0ows and Door s-Gackaga and Ar q
Ho wp?n
M OIN nnpn?
OI p?M wo. of ? Linw11L
L IN. ? 01 fOCY Aw
M. M.
CoN. Btu
Inhltration .2
G isss
EKp. wall- 0 b
Net exp. wall 6
Int. wall •
Ceilinq
Fbor
Total Bfu. 1 '7A A
F1.I nN'fn.. Rooml LarqtA 11) widm 7 Heinh[ R
W indows i gd Door s-Gsd up mdAr o?
N. w.a,"
al eM
01 M we e,
l U LUtfwtu,.
Y/ CIKk we..
M. t1.
?
o
J
7
/- 73
Corf. Btu
Infiltration
Glae
Erp. wall
Nci exp. wall 33 ?O
In1. wall
Ca16M 1 O
7 oZ l A
Floor
Tetal Btu. 15a a'_j
F 1.) Room I Lerqth Mlidth Meiaht
WiMnws snd poors-Gackape srd ArM
NI WM?1M?M?
n? ?yM n1 M?e MO.01
L? ?N L?1r?1H.
N NK? A1M
?0. N.
CoN. Btu
Inf iltrat1on
Glxs
Exa. wiill
NM exp. wall
Int, wall
Ceilug
Flax
iopl Btu. I
° TEMP. DIFF.
TYw Comtraetion
Wirdows
Walis
Ceilinp
Flow
Lwnth WNth FNidN
Windows and Doors-Gadcap and Ara
Ne. w1Ofh
OI N ChH M. If.
z
CoN. 8tu
Intiltntion
G laa
Exp. wall
Ne1 exp. wall ,. ?
Int. wall
Flow - Tota1 Btu. ??_.;.z I
FI.I ReemlAlfbth/"'? M ieht
Windows and D or rGac d
Na. of yn? p.
w ke?' . ArM
ft,
Cnf. Btu
Infihrstion
c? 6 -o
Exp. wsll '0
Not exp. waII
int, wall
Ceiling
Floor
Total Btu. I
FI.I Logth Width Height
Windowt md Doas-Cndume ard Arm
N/1. WMfI?
01 N 11?j?ilt
OI M I/O.O/
L P LMY??1.
OI IIK? ??N
A. M.
{/". ow
Inliltratwn
Glan
Eap. wall
No exp. will
Int. will
Ceilirq
Floor
Tobl Btu. I
Stam Sath
IrN.
2006 RESIDENTIAL MECHANICAL PEI2NIIT APPLICATION
City Of Eagan
3830 Pilot Knoh Road, Eagan MN 55122
Telephone # 651-675-5675
Pleese complete for. single fzmily dwellings & townhomeslcondos when permits?aze.required for each unit ? Date l.F? / ? ? /? . . .. . . .
Site Address Unit #
Property Owner Telephone # ( )
Coutractor CTLnz Pl/ I o.n
Street Addressc;)C ? •
State
Bond #:Q?% ?WV/'
Zip
Ezpires: ? City
Tetephune #
The Applicant is _ Owner . /\ Contractor _ Other
Add-on or alteration to eaisting dwel4ng unit $ 30.00..
furnace _Additional
? air exchanger ? Replacem ent ? New
air conditioner
heat pump
other
State Surcharge $ .50
Total $ :3?
I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will
be in conformance with the ordinances and codes of the Ciry of Eagan and with [he Mechanical Codes; that I understand this is not a
permit, but on4y an appiication for a permit; and work is not to start without a pettnit; that the work will be in accordance with the
approved lan m the case of work which requires a review and approval of pl s. , R ,
?r`n erlvi I ?? ? 2r?
Applicant's Pnnted ame Ap cant's Signature
1-12 q,;Zy 2006 RESIDENTIAL BUILDING rExMiT arrLicaTioN
l/ 3- 715?
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construdion ReQUirements
3 registe2d sde surveys showing sq. R of 1ot, sq. R of house; and all roofed areas
(20Yo maximum lol coverage allowed)
2 copies of plan shoWing beam 6 window s¢es; poured found design, etc.
1 set ot Energy CalculaGons
3 copies of Trce Preservation Pmn'rf lot plalted after 711193
Rim Joist Delail Optlons selection sheet (buildings wifh 3 or less un'AS)
Minnegasco mechanipi ventilation fortn
RemodeVReoairReouirements Dffic°eUseOnlv _
? 2 copies of plan shaving footings, beams, joists Cerf ofSurveyAec? L,
Y. _1V
1 setof Energy Calculations for heated add'N'ons Tree'PresiblanRecc?.
isitesurveyforaddNons&decks TreGFtQSRe?uirad? ";Y.?,N
Add'rfion - indicafeifon-sifesepticsystem On-Sep9c'Sysiem „=Y _N
Q/i P,( ,,-.4 i.r I! g
Date u?
Canstruction Cost L(-X2
Site Address UniUSte #
DescriptionofWork Miavf' d; F'
? i??, c,,kaf,r Pcn'lo (t1Pl,) hPArrxtYY`,
,
Multi-Famity Bldg ,
_ Y_ N ?
Fireplace(s) _ 0 _ 1 _ 2
?
Property Owner 6f
?5 S u,r+?o
Telephone # ((?j f ) Ll,) (v q(CQ
Contractor _?Aq v i (.)
Address aI?0 c) KY?YIYiCk O C?trf, City ??-Ak-e?;114
State fr) i'0 Zip j ? Telephone #( ?}v?) ?j q
COMPLETE THIS AREA ONLY IF
A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 esota Rules 7672
Energy Code Category , Residendal Vendlation Category 1 Wor9csheet e?r?y?ode Worksheel
(J submission type) Submitted u itt?$ 0
. Energy Envelope Calculations Su6mitted
JUA' PeD
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master p a? 2 ZQQs D
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanicai Contractor
Sewer/Water Contractor
Telephone #(
Telephone # ( )
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statufes; I understand this is not a permit, but only an apptication far a permit, xnd 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
DO NOT WRITE BELOW THIS LINE
Sub Tvpes
? 01 Foundation ? 07 OS-plex
? 02 SF Dwelling ? OS 06•plex
? 03 Ot of _ plex ? 09 07-plex
? 04 02-plex ? 10 08-plex
? 05 03-plex ? 11 10-plex
? 06 04-plex ? 12 12-plex
? 13 16-plex
? 16 Fireplace
? 17 Garage
? 18 Deck
? 19 LowerLevel
? 20 Pool
O 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screen/gazebo)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - MuIG
? 33 Ext. Alt - SF
? 36 Multi Misc.
Work Tvpes
p 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Additbn ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
33 Altera6on ? 37 Demolish Building* ? 43 Reroof ? 46 WindowslDoors
(O 34 Replacement •Demolition (Entire Bldg) - Give PCA handout to applicant
DCSCI'iption: WaterDamage_Yes
Valuation ?_, G a6 . b o
Plan Review 100% or 25%
Census Code
SAC Units
# of Units
# of Bidgs
Type of Const ?/ (g
Occupancy ?2 - `?- MCES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Width
, Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
_ FoundaHon
Drain Tile
Roof Ice & Water Final
- ? Framing
Fueplace _ R.I. _ Air Test _ Final
L10 Insulation ,
?
Approved By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
5&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
REQUIREDINSPECTIONS
_ Sheeuock
FinallC.O.
>o FinaUNo C.O.
HVAC
Other
_ Pool Ftgs Air/Gas Tests Final
_ Siding _ Stucco Lath _ Stone Lath _Brick
_ Windows
_ Retaining Wall
Inspector
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA120049
Date Issued:01/13/2014
Permit Category:ePermit
Site Address: 4522 Hay Lake Rd S
Lot:1 Block: 1 Addition: Overhill Farm 1st
PID:10-56150-01-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Renae Frienwald
2200 Hwy 13 W
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Bess Y Hwang
4522 Hay Lake Rd S
Eagan MN 55123
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA144977
Date Issued:08/17/2017
Permit Category:ePermit
Site Address: 4522 Hay Lake Rd S
Lot:1 Block: 1 Addition: Overhill Farm 1st
PID:10-56150-01-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Bess Y Hwang
4522 Hay Lake Rd S
Eagan MN 55123
Genz Ryan Plumbing & Heating
2200 West Highway 13
Burnsville MN 55337
(952) 767-1000
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r �
For Office Use
Permit#:
City of Eapll Permit Fee: /O
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651)675-5675
buildinginspections(a�cityofeagan.com Staff:
2017 RESIDENTIAL BUILDING PERMIT//�� APPLICATION
/'1 Site Address:I ( ) u-y (__G�� I�tJ Se
Date: ✓� Unit#:
,.I
f� s 65 / 3F-3 L3
✓ Name: 4� [.a GA- vn Phone:
Resident/
Owner ". Address/City/Zip: 5 �-C 1 L GCc. a,) � G d° s/
Applicant is: Owner k- Contractor
Description of work: fl" . e-&VV1 evx.
Type of Work :xx q J
Construction Cost: /(3 -�- Multi-Family Building:(Yes /No eke. )
Company: C`Pr 3\c�/ C—^1 `r t� f ca x.43 Contact: ✓ a H C�"
J
Contractor
Address: (7�' S ` Q City:
.y. . State:1V 1 f� Zip:.'53i !-" Phone:6 / fir '5 7 mail: ,r'') k rdL e 6 5.9icy ,.,-1/4
License#: ? )f".>14ei`f Lead Certificate#:
If the project is exempt from lead certification, please explain why:
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:
NOTA Plans and supporting documentsf at you submit are considered to be public in rmatt on. Portions of the
"info imation may be classified as on b if" you provide specific reasons thatwouldpermit he City to conclude that Cham
are trade secrets. 4v4
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.comisubscribe.
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.qopherstateonecall.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 tart without permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of
�n (�/�� t
x /1 l4 I X ( r ) x
Applicant's Printed Name Applicant's Signature
Page 1 of 3