4542 Hay Lake Rd SCITY OF EAGAN Remarks •
,4ddition OVERHILL FARM 1ST ADDN Lot 3 Rik 1 Parce
wner?'). Street 4542 S. Hay Lake Road State
g3.qg- iq6m-5+:w hcbU?,d.,L-i nrr,
Improvement Date Amount Annual Years Payment Receipi Date
STREETSURF, 47- 1981 310.74 15.54 20 264.1 A012015 3-17-83
RESTOR. 1954 2128.26 425.65 S 2128.26 C008733 11-9-83
GRADING 1985 919-20 5 d
?DO oZd D P flr-
?
5AN SEW TRUNK
-? ?75
1981
35?
20
30 .40
5
A01201
-1 -8
?;-iLSEWERLATERAL & W2t 1985 360Q.55 ]2];1 IaOQ- ? e9D v2 O ? e2
SAN SEW TRK LAT BEN 198l? 241?.19 16.28 15 244.19 C008341 8-4-83
WA7ERMAIN
WATER LATERAL 5,73 1981 172.42 8.fi2 20 146.56 A01201 -1 ?
WATER AREA 5-76 1981 359.28 17.96 ZQ Q.40 ff n
STORM SEW TRK ? 1984 468.74 31.25 15 468.74 C008341 8-4-83
STORMSEW LAT- 3 1984 84.20 5.61 15 84.20 " "
* x
CURB & GUTTER
SIOEWALK
STREET LIGHT
ROAD IT 240.00 32341 10-7-82
WATER CONN. 420.00 it it
BUILDING PEFi.
SAC 525.00
n
?t
PARK
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
oare 19
AMpUNT $ I
DOLLARS
+oo
E] CASH E] CHECK
FOR i
White-Payers CoDV
Yellow-Posting Copy
Pink-File Copy
Thank You
(?:>? BY f
Receipt 3` t't MECHANICAL PERMIT Permit No. 5
-`'--?
_ CITY OF EAGAN
r Fee - -
FiII in numbered spaces S/C
Type or Print legib/y Tot.
,
1. Date??.?-? 7-? 2. Installation Cost
S c F'
3. Job Address YLot ? Blk. ? Tract ?}
4. Owner CD i
5. Contractor `' Phone 1 -?7
? ?. ? ?: .
6. Address ?, ? / j'7 /
,
7. City _' : : ?% ? , . 1 r > State Zip --
8. BuildingType: ResidentialA Commercial ? Institutional O
9. Work Deseription: NewA Add O Alter ? Repair ?
1 10. Describe
? 11•
Ty pe
No, E,guipment BTU - M. Ea.
Forced Air (00-100C:> No. Eauipment CFM
A
Mfg. C? E ir Handling:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg, Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances andccodes governing this type of work,
Signed : ,?? _ '?_ -• ', ? ? F,;,t
,._ . ?-
for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Racaipt
PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fes
Fill in numbered spaces S/C • '
Type or Print legibly Tot
1, Date ?` 2. Installation Cost
3. Job Address Lot ; Blk. ? Tract ;. •
4. Owner vi ? 0
5. Contractor Phone
6, Address
7. City State i • Zip
8. Building Type: Residential I? Commercial ? Institutional ?
9. Work Description: New C? Add O Alter ? Repair ?
10. Describe
11.
No.
? Fixtures
Water Closet No. Fixtures
Cess
ool/Orainfield
? Bath tubs p
Septic Tank
_L Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Oth
;
Laundry Tray er
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I 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 Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
cirr oF EAG?N
. p 3796 Ppef Kwob Road Eogon, MN 35122 ; {
PHOMEs 454.8100
BU1LDiNG PERMIT R ?iFn #
Tro be aed fer Est. Value Date , 19
Site Addrcss Erect Q Occuponcy
Lot Blotk Sec/Sub. Alter ? Zonirq
parcel # Repafr ? Firo Zone
Enlarqa ? Type of Const.
W N? Move ? # Stories
; llddress Demolish ? Length
b rct. T Grcde r1 Depth Sa. Ft.
Nnme WTICr
Ncme
1 hereby acknowledge thot I hove read this opplicotion ond state that
the inlormation is wrrect and agree to comply with all applicoble
Stute of Minnesoto Stotutes ond City of Eogon Ordinonces.
Sipnoture of Permittee
A Building Permit fs issued to:
all work sholl be done in aocordance with all appliooble StaDe ?
Buildirg Officiot
1lssessment
Water 8 Sew.
Police
Fire
Erq.
Plonner
Council
Bldp. Off.
APC
Permit
Surcharge
Plon check
SAC
Water Conn.
Water Merer
Road Unit
Totol
on the exprcss condition thm
Stotutes ond City of Eogan Ordinonces.
Psrmit No. Permit Holdar Misc. Permit No. Holdar
P?umwn9 307-1 t?wPt€ r ?a-z7-??
H.V.A.C. ?as3
W.ll
Watsr
Disp.
Sevwr
ENetric 7 ( g ?pc,? ?5 ?ECr J ( ?
Inspection Date Insp. Other
Footingt (}/y ?
Foundation
Framing
Rouph Plbp.
Rouph HVAC A??
fzy
Inwletion
Final Plba
Final HVAC
Final /? `
Wabr Doscribe Location:
YVell
r ?•
Sevwr ?
Pr. Disp. i . ?
CITY OF EAGAN ???7
- 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUtLDING PERMIT PHONE: 454-8100
Receipt # ' k
Site Address U? A HAY iArp gD
Lot A- Block I_ Sec/Sub. IMaKiLL FARl1
Parcel No. _
W Name ROBEt't ? .I08NSON
; Address 042 S HAY I.AKB RD
0 City- tAf:AN Phone 454-0585
,o Name
zr
00g Address
? City Phone
Phone
I hereby acknowlege that I have read
information is correct and ,agree to c
Minnesola Statutes and Cjry" of Ea n I
11
Signature of Permie L '
A Building Permiris issued to:
on the express condilion thal alI work s
Rion and state that the
all applicable State of
e in accordance wilh all
Eagan Ordinances.
OFFICE USE ONLY
Occupancy - FEES
2oning _
IActuaq Const - Bidg. Permit
(Albwable) - Surcharge .50
+Y oi Stories -
Length _ Plan Review
Oeplh _ SAC, City
S.F. Total - SAC, nncwcc
S.F. Footprints -
On Site Sewage _ Water Conn
On Site Well - Water Meter
MWCC System _
City Water _ Acct. Deposit
PRV Required _ S/W Permit
Boaster Pump - S/yy Surcharge
Treatmenl PI
APPROVALS Road Unit
Planner
Co
ncil - Park Ded.
u
BIdg.Off. _ Copies
Varfance - TOTAL ZS• 50
Pe?mN No. Permit Holder Date Tekphone #
WATER
SEWER
PLUMBING
H.V.A.C. '
ELECTRIC
Inapection Date Insp. Comments
Foolings I
Foundation .
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Qrstat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. AAeter
EnyrJPlan
Blda. Final
Dedc Ftg.
Qedc Fnal
weu
Pr. Disp.
CIT1f OF EA6AM WATER SERVICE PERMIT
3795 Pilot Knob Rood PERMIT Nd.:
Eogon, 14N 55122.. DATE:
Zaning; : No. of Units:
Owner:
Address: _ .• . .. ?-., _ -
5ite Address:
Plumber: ,
Meter No.: Connection Charge:
Size: Account Qeposit:
Reader No.: Permit Fee:
1 ogrea M aomplY wiHi 16s Cify of Eagan Surcharge: -.--
Ordinonas. Misc. Charges:
Total:
By pote Paid:
Dote of Insp.: Insp.:
?,3?-- - - .
CITY OF EAGAN SEVNER SERVICE PERMIT
3795 Pilof Knob Road PERMIT NO.:
Eagon, MN 55124 DATE:
Zoninfl: No. of Units:
Owner.
Address: _
Site Address:
r Tnc.
Plumber:
. ?. ? ,. 1 agroe M oompir with the Clty of Eagan Connection Charge:
Ordinanees. Atcount Deposit:
Permit Fee:
Surcharge:
7.' gy Misc. Chorges:
Date of Insp.: Total:
ll-2? L3, 6?1 ovEr?n.i(? 33235
This recaest yoid `?
;Z t bC)
18monthsSr^m 7
Date of this Request C' - ;P Z- Fire No. it 17 418
I, as 53-Licensed Electrical Contractor El Owner, do hereby request inspection of the above electri-
cal wiring instaped at: ?
Street Address or Route No. 'S?S SraZ `?m.?,? Ime ?& City 'a?
Section Township
Which is occupied by
Is a roughin inspection required on this job? No ?
Range County
Yes J?i- Ready Now ? Will CaII4KJ
PowerSupplier A/Fc/cf_ Address
I
Electrical Contractor ??? 5[`C'' Contractor's License No. _
(Comoanv Namal . .
Mailing Address
Authorized
or
or
Ss 30 3
STA`?? ????? ???? ??, TM1is inspection request will not be accepted by ffie (? State Baard unless proper inspection.fee is enclased.
. uvama maan waru ui nec[nci[y
Griggs Midway Bldg. - Room N191
siry Ave., St. Paul. Minn. 55104 - Phone 297-2111
?/ QUEST FOR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REOUEST
EH-00001-02
33z3S
T 17418
Type of Building New Add. Rep. Check Applinnces W'ved For Check Fquipment Wited For
Home ? ? ? Range ? Temporary Wiring ?
Duplex ? ? ? Wate[ Hexter ? Lighting FUCWres ?
Apt. Bldg. ? ? ? Dryer ? F.lectric Hea[ing ?
Commercial Bldg. ? ? ? Fumace ? Silo Unloader ?
Industrial Bldg. ? ? ? Ait Conditioner ? Bulk Milk Tank ?
Fazm List List )
Other
?
?
? o
Heheis? o
}
Herels)
COMPUTE INSPECTION FEE BELOW :2,1e.e-4-
Service Entrance Size: # Fee EeedersBSubfeeden: # Fee Circuits: # Fce
0 to 100 Am s. 0 m 30 Am etes 0 to 30 Am res ctl U
101 to 200 Amps. 31 to ]00 Amperes 31 to 100 Am eres
Above 200 Amps. Above 100 Amps. A6ove I OQ_Amps.
Transformers Remote Control Circ. Partial or other fee 5 • 5
Si ns Specia] Inspection Minimum fee $5.00
Remarks
TOTAL FEE
., ine niecmcw mspecwr, nereoy cernt M ttle 7
o e lRSpecLOn has beenmade.??l??
(RouSh-in) Date ??z?
(Final) ? Date
This request void •
18 monlhs from
-'ti `1'2v-a -9? 6;(" ????-? /-"& CITY OF FAGAN Include 2 sets of plans,
W'-"Za, 1 site plan w/elevations &
BIJILDING PERNffT P,PPLICATION 1 set of energy calculations.
7b Be Used Ebr ? Dw ?,?a c-' Valuation ?.615, ?
Date /0 -?-? Z
site
Adaressq5q Z So. tk-fx ok Lak? R.?a-c? ?zce uss oNLY
Lot 3- Block l Sec./Sub.bv?Ail( Fmr"'< <Ercct ? Occupancy 3
Parcel #: 1 C) S(o l SL 030 o , Alter zoning /?1' /(P J
O,.mer:
GFvtc Vi Ja r4 Repair
Enlarge Fire Zone `
Type of Const.
Address: :?? a0 (DS L!2,- S?aS-?- M°ve # Stories
City/zip Code: ?n V£ r G (-,U E (-(-?-s , SSo7S
Phone #: q5 1- 3 4 873
Contractor: C) Lv ?L ? f
Address:
City/Zip Code:
Phone #:
Arch./Eng.: q?>? i'?li ? S?lQ /L .SE h`u i'C ?
Acidress: 000 f? l y(o - S-}-,, Su i-,+- (a O
City/Zip Code: Su.rtisVL'( L 5533-7
Phone #: 43 Z- Zo
Iemlish Fxont (o fto
Grade Depth L?`O ft.
APPROVALS F EES
Assessments Permit
?aater/Sewer Surcharge
Police Plan Check
Fire SAC
Erg. Water Conn.
Planner Water Meter
-tlQ
/60
Council Road unit &%Yo-
Bldg. Off. JfJ _ 7 ?
APC
IV rAo ? ???T
TOTAL ?
74
?Qoc edv??S
?21
(g.ertifirtttr nf (Orrupttnry
Citp of eagan
Erpbrtmcnt nf Nuilbing 3nsprr2iun
Tbit Cc+tift[qtt 17J#[1I purraant to tbt nquirerrsaur of Sertion 306 o f the Unifmm Building
Code urtifying that at the time of ittuarat tbir rtrutture wat in tomPliantt with the variour
ordinanret of the C#y ngslating 6pilding ronnruttian ar usr. Far the f olloudng:
U.Ck.dfiutlm SF DWG/GAR 7560
BId4MemtitNO. J i
(?I.ftYD'W R3 T7ACov4ucuao V Fn7.e NA ZoeiNDirt?l (PD) R1
a„?awom,a Gene Vivant 2420 lOSth St. E., Inver GY, s.
Md?,Aft= 4542 So. Hav Lake h Lot 3,Block 1,Overhill Farnr ,
?j Road lst ia
"d'?n? ? March 2. 1983 ;??
.a.. 1. . .?.W. .wa
,..A.
CITY Of EAGAN
9793 Pilot Knob Raad Eagen, MN SS12! NO 7560
PHONF: 454-8700 -
BUILDING PERMIT - Receipt # '?>'o
Te ba wed Fae SF D4H',IGAR Est. Volue $65r000 pOte OCtAbPS 7 , 19 82
Site Address 4542 So. 1{9y Lake Fodd Erect 3 Occupancy R-3
Lot 3 Block 1 $ec/Sub. OveIh311 F8rm 18t Alter ? Zoning (PD) R-l
porcel # 10 56150 030 02 Repair ? Flre Zone NA
V
Enlorge ? Type of Const.
W Na? GEne Vivant Move ? # Srories
z Address 2420 105th 3t., Si= East pemolish ? Length 46
p In ver G=ove q,one 451-3483 Grade ?. Depth 50 Sq. F[.-
ec Aovrovals Feea
o Nome _
?
?? Address
f ?:...
Name _
Addreu
1 hereby acknowledge chot I have read this opplicotion and stote thaf
fhe inlormotion is torrect ond ogree to wmply with oll opplicoble
Stofe of Minnewta Statutes and Cify of Eogan Ordirwnces.
Signoture of Pertnittcro
A Building Pertnit is issued to: Gam
ali work sholl be done in accordance with oll
Buildirg Officiol
Assessment Permit ?eo.vv
Water & Sew. Surcharge 32.50
Police Plon check164.00
Fire SAC 525.00
Eng. Wafer Conrf320.00
Plonner WarerMeter60.00
Council Rood Unit Z40.00
Off
BId9
.
.
APC
Taol $1769.50.
on the expreu condition thni
Statutes ond City of Eagan Ordinantes.
CITY OF EAGAN Np 19707 .
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100
` /?,,_I'?;?
-
BUILDING PERMIT . Receipt # ?; '?
wi
To be used for FIREPLACE EsL Value Date 19
Site Address 4542 5 HAY LAKE RD
Lot 3 Block 1 SeGSub. OVERHILL FARM OFFICE USE ONLY
P81'C21 N0. OccuDancy - FEES
2oning -
W Name ROBERT T JOHNSON (ACtual) Const _ Bldg. Permit 25.00
; Address 4542 S FIAY LAKE RD (Allowable) -
50
° Sumharge .
Cjty EAGAN PhOng 454-0585 No(Srories _
Plan Review
Length _
o Name Sp'ME Depth SAC
Cit
i
?¢
Address
S.F.TOtal -
,
y
-
SAC,MCWCC
? CIty Phone S.F. Footprinis _
H'ater Conn
On Site Sewage _
` Name on sae wen
M
W
ti
?
AddfB55
MWCC Syslem aler
eter
-
-
aW
City Phone City Waler ?cl. Deposit
-
PRV Required _ S/W Permit
I hereby acknowl
tha ave rea Booster Pump - ShV Surcharge
intormation is wree to
A
Minnesota Statutef Ea Treatment PI
SignaWre of PermV ?- APPROyALs Road Unit
A Building Permit is issued to: RO T T.TOHNSON Plenner - park Oed.
on the express condilion thal all work shall be done in accordance with all Council -
applicable State of Minnesota Stalute
s antl City of Eagan Ordinances. gla9, pff, _ Copies
1
Building Ofticial Afwjq ?tlA. i rn Variance - TOTAI '15. 50
a - ? ?' RESIDENTIAL
BUILDING PERMIT APPLICATION
CITIf OF EAOAN r,P 1.1
a, . tf w r i _ , ,Rs ?, 3830 _PILOT KNOB RD, PAGAN MN 55122 851 '1
881-4675 '? " '' .
, iA t F.
NewConeuuctionBeauheme"ra . . , rl, .. ,. N?bnodeNleoehRea?irem „ ...
• 3 registared sAe wrvey's slwwhg sq. ft of lat aQ ft"ot house and gll roofetl areas . 7caPles M plen `" " . ?,.
(244$l1187N7tllttlbl[OV9!@8B8fbWBd) f :.• .' 1 ':=pt:pj 1:0 fJf:EI1Bfgy C81CIIIBti0f13(OfhB&fBddddilqfl6
. 2coplesofplenshowbgbeam&wlndowshexpouredlaunddeslgn,.etc.j?? . isttewrveytprexterbradditions_&decks 1 sel 01 Energy CaICuletions InGiCete tl home served b '. ?. .
• 9 coptes ol Tree Preservetian Plan Y bt piatted atter 711/93 YSaNk; sYStem ior addttbns
• Rhn ,bisl Deta00ptqns selectbn aheel (bldgs wiM.9 or less unes) ,., .
_.... :. _„ . _ - , ,_ ,....: ...
.. ,_ .. . . _ . s.,.:r..:.' . . ...
.. , . .... .. ,. '? .: '.: '- ?,
,i•, r . ,::,:
DATE VALUATIO,N
SITE ADDRESS MULTI-FAMILY BLDG _ Y I/ N
-
NPE OP WORK
FIREPLACE(S) _ 0 _ 1 _:2,,: .
APPLICANT
STREET ADDRESS 9 706 / 3 ' )Ie
TELEPHONE # '7E3 CELL PHONE #
,1,71 STATEAmt/ ZIRe?50/
FAX # _
PROPERTYOWNER Kck- TELEPHONE# ?I-9?
--------------------------- ---------------------°-------------------°------------------------
COMPLETE THIS SECTION FOR «NEW" RESIDENTfAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULFS 7670 CATEGORY 1 MINNFSOTA RLILFS 7672
(J submission type) `. Residen4al' Vantilation Category t WoACSheet Submitted • New Energy Code Worksheef Submitted
• Energy Envelope ?Calculations Submitted ' - Plumbing Confracfor. Phone #
Plumbing system includes: _., _, Water Softener Iawn Spruikler
_ Water Heater _ No. of R.I. Baths
_ No. of Baths
Mechanical ConNacfor.
Mechanical system includes:
Sewer/Water Conhactor.
_ Air Condirioning
_ Heat Recovery System
Fee; $90.00,
Phone #
Fee: $70.00
Phone #
I hereby acknowtedge that I have read this application, state that the informatton is corcect, and agree to comply
wim all applicable State of MinnesoTa Statutes and City of Eagan Ord(nances.
Signature of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received - Not Required _
1991 BIIJINGT9APICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS M[TLTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRIICTURAL PLP,NS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 5ET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
?# OF FQR SALE UNITS
PENALTY APPLIES WEiEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED IIP BY IAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER HUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE SUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Se Used For69-' Valuation: :
Site Address S. gqy 404,r
Lot ? Block _L
Parcel/Sub
owner'?P06E/LT T4
?EJf1/v5dr?
Address
City/Zip Code C-,4 L7 4 k-P .?rX1`? 3
Phone ?4S y-- 0 S-k5
Contractor Sr-5-L /-
Address
City/2ip Code
Phone
Arch./Engr. _
Address
City/Zip Code
;hone
e ater L'
. ?l ?
.
Contractor)
Date: 2 ' z '-? - 'g, "-
OFFICE USE OIQLY
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
On s3te sewage_
On site well _
MWCC System _
City water `
PRV _
Booster Pump _
APYROVALS
Planner
Council
Bldg. Off.
Variance
FEES 00
Bldg. Permit c?Jr "'-
Surcharge -15ro--
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Acct. Deposit
S/w Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trail Ded.
Copies
SIIBTOTAL
Penalty
Lot Change
TOTAL J- SD
agrees that all woYk shall be done in accordance with
sll applicable State of Minnesota Statutes and City of Eagan Ordinances.
13, i?
1-d ) 3
Nk, I
?
;
^(A pe'r?neYS
,-?-- --'--_?_...----- ? ?---- ?' ----
,_-? ,
? I
?
"` ! 1?' -- ya `-
?t ; - i ?--
?I
?
?
.,
,
pP,
I ,
W
0
;
---`--
J3 °--
. C,vp,,13 ,1 eJ•
I,.
i
?
a
?
v-4 J
??° _
Total exposed wall area above floor = 186$
,. a. 7ota1 wa11 window area .................:........ 193 .i.fl
b. Total door area .... ............................
c. Totat sliding glass'door area ................... ?
d: Tota1 fireplace wall area ........ .. ....."...... -
e. Total wa17 framing area (averagelQA)............. ! .2
f. Total net wall area above flaor ................ I •
g. Total rim jaist area ............................
Total exposed foundation area
h. Total Foundation window area.....................
i. Toal net fioundation area above grade ............ ?
Qetermine "U" value af each wa'!i segment.
a. t93.La X „U„ _?5 = toio,
b. ? B X „U.t
c. L{%4 x lluit
d. X IbUlk _ --
e. td x
` iiul. .D9? = 1y?71
f.
x „u,t .n4S = 59.3
9. 148 X ltuil •b'?1 = Lo.4lo
h. - X „ull -.-
;. 9?,?08 x l,u„ •?It?4 = '15• 8I
s . ... . ...:...... .... ZO 53: I.oB.. ..rotai = Z ,
If item n3 is the same as, or less than item rl, you have m°t the intent
of 56C 6005(c)2.
x„uff b3 _ = 7504
4...... ....... ..........Total ' 31„3.i.J
. .....
.. _ . . • . -
`If totaT of #4 is the same as, or less than #2, you have met the intent of
$3C,G006(c)1.._ _ _ . .. . : _ .:
f To utitized the total envelope system method, the values-established 6y the
sum of items #3 and #4 shalt not be greater than the sum of itens 81 and #2.
c . _. . . _
? _ , • -
? i. _ .. +
? 3. + 4, _
? - _ - - t
? • --
? t?fATERIA2,5? Therrn. Eesistance
G ' Ezteriar Air
; Siding lfaterial . V S
? Sheathing Z•OCo
? Znsulation - I?_
ShaetxoCk •4
? Interior &ir .fo8
' 5tuds 4,59 .
R4m ). SB
; Conc. Blks.
1.28
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, '� Use BLUE or BLACK{nk
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� For Office Use i
� j Permit#.��`���� �
�1ty of�a��Il .�� � . /� �8 �
3830 Pilot Knob Road �� '�` ` ', r��; i Permit Fee: . �K'• i
Ea an MN 55122 � �
9 l,U ;. ,� 1,ry Y � Date Received: � � � �
Phone:(651)675-5675 �.f� : � � �+,� � �
Fax:(651)675-5694 � Staff: �
�-------- -------�
2014 RESIDENTIAL BUILDING PERMIT APPLICATION :
� �3�
Date:��'�-��/y Site Address: Z SQ .C' O unit#: �
Name: {��t Gpf � GI��L1 �LNYIr'��i�� Phone: `S/'S9 Z- �Z y j
R�siden�i ' ,
(�/�tg� Address/City/Zip: �A�'1�
Applicant is: Owner � Contractor
Descriptionofwork:��A� LOI�'�,(�- '�K�a/ �i✓Y ✓/��f� �G��` N' �GXc�M"
fiype of Wark � � ' '�'�r � F�i !e�
Construction Cost: Multi-Family Building: (Yes /No
Company:PV�11.r1/Yls �I�cS�J�v� � Oi✓7 l���Contact: Y�I SO^/
; C011tr�+ctQF Address: �-� ��L� ,',��� � t'� City: �/� �✓%� N �,�
state;/Y�Y z►P: S�o 7 Phone: (�� yas,�38.�ma�i:
License#: C.� b Lead Certificate#:_��/� �"7'f�G� �- /
If the project is exempt from lead certification, please explain why: (see Page 3 for additianal 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,dafe and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer�Water Contractor. Phone:
�TE.P/ans a»d srrp�a�rdr►g�ocurrte�ts tha�t you s�bmr`t.ar�e e+�r�sitl�er�:t�fie pubtic Fnfotr»�on. t�ar�ns taf
the ittform8#io»m�y be ctassffred as r1c�l��ub�lc nf you provftle�pe�ii�C r�ea�t�res�ra�t�roukt p�rrrti�fhe�fty�r,'
conctvd�fh�t the are#�ate secr�ts�
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. wuvw popherstateonecali 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 Buildi�g Code must be completed within 180
days of permit issuance.
x �J A' S�/✓ W�l—�i � �1�Gt✓l
Applican!'s Printed Name ic nt's Sig re
Page 1 of 3
��-.�,1 v�+��°
w ���� �� � �
, � . . ����a�
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Firepiace _ Porch(3Season) _ Exterior Alteration(Single Family)
�C Single Family _ Garage � Porch(4-Season) _ ExteriorAlteration(Multi)
_ Muiti � Deck _ Porch(ScreeNGazebo/Pergola) _ Miscellaneous
_ 01 of_Plex _ Lower Level _ Pool _ Accessory Building
WORK TYPES
_ New ^ Interior improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Irrterior
� Alteratian _ Fire Repair _ wndows _ Demolish Foundation
_ Repiace r Repair _ Egress Window _ Water Damage
_ Retetining W81) *Demolltion of entire building—give PCA handout to applicant
DESCRIPTION
Valuation Occupancy ���2 MCES System
Plan Review Code Edition 2.t�U�7 iM5�j�. SAC Units
(25%_ 100%� Zoning �'� City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
�f of Buildings Length Fire Sprinklers
Type of Construction �' i'� Width
REQUIRED INSPECTIONS
Footings(New Buitding) Meter Size:
� Footings(Deck) � �n r��n Final/C.O. Required
Footings(Addition) � Finai/No C.O. Required
Foundation HVAC Gas Service Test Gas Line Air Test
Roof:_Ice&Water _Final Pool:_Footings _AirlGas Tests �,Finai
� Framing Drain Tile
Firepiace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfili_Finai
Sheetrock Radon Control
Fire Walis Erosion Controi
Braced Wails Other:
Reviewed By: � f�- , Building Inspector
RESIDENTIAL FEES
Base Fee "� .��C,� � �61�\�'� � ���
Surcharge i�nc��� �to � �-� = 3ZC3
Plan Review ��-�`ti�,�� �l-�� �
MCES SAC �� p�'�°
City SAC �/ i �- — � �{,�� '
Utility Connection Charge
)� l
S8W Permit&Surcharge ,
Treatment Piant '
Copies
TOTAL
Page 2 of 3
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA176869
Date Issued:06/06/2022
Permit Category:ePermit
Site Address: 4542 Hay Lake Rd S
Lot:3 Block: 1 Addition: Overhill Farm 1st
PID:10-56150-01-030
Use:
Description:
Sub Type:Water Softener
Work Type:Replace
Description:
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Richard M & Cindy K Schreiber
4542 Hay Lake Rd S
Eagan MN 55123--303
Tony's Appliance Inc.
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature