4574 Hay Lake Rd SCASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
RECEI V HO
19
AMOUNT $ I
ae DOLLARg
+oe
? CASH ? CHECK
r.•cr' . ?'.-,• G ???!o,o /=•?'
FUND CODE pMOUNT
Thank You
BY
?
YVhite-Payers Copy
Yellow-Posting Copy
Pink-File Copy
CITY OF EAGAN Remarks
Addition OVERHILL FARM 1ST ADDN Lot 7 B1 1 Pe?cei
OwnerCkKvl\ -Pvn ?Inr . 4574 S. Hay La ke oa?
Q Street State _
1,046 nJ,+x.nh Qd 97cl, sr
Improvement Date Annual Years Payment Receipt Date
STREET SURF. Z. 1981 15.54 20 264.12 C0081.rJ8 7-20-83
STREET RESTOR. q 2053.34 C00$741 ?.11-14-83
GRADING 1985 ? 1120.16 C009394 9-10-84
SAN SEW TRUNK 515 1981 3;5;q2R ? 17.96 305.40 C008158 7-20-83
AFJy-*SEWER LATERAL & WSC L ? 1985 4332.80 C009399 9-10-84
iIZSAN SLN TRK LAT BEN 1984 z35.60 15.71 1 8-2-83
WATER LATERAL 5 ? 198
62
.
146. 56
C008158
7-20-83
WATEFi AREA 1981 3$9. 17.96
STORM SEW TRK "61 19$/t ,1+5,2.z4 30.15 15 452.24 C008310 8-2-83
STORM SEW LAT -3 1?h
.2?j
S.I?Z
15
$1.24
C0083I0
8-2-53
?y SS L& Services I985
11
1149.69
C009399
9-10-84
CURB & GUTTER g?'y ? g
SIDEWALK
STREET LIGHT
250.00 3521 3
WATER CONN. SO.OO
BUILDING PER,
SAC
PARK
r
Receipt PLUMBING PERMIT Permit No. -
CITY OF EAGAN Fee
Fill in numbered spaces S/C •'?'
Type or Print legib/y Tot. `?-
1. Date /??-?-i 2. Installation Cost
MS7`+ ..Jo. ::CICI 'JVi' I ?
3. Job Address T ak, .oL,i Lot 7 Blk. 1 Tract t'o r 4
4. Owner Vi`r8nt Broa.
5. Contractor "`arque Plumbing Phone '' Z6-S7G?
6. Address _.1? 7 • ar. _a.e?? 'i. ,_ . :^,
7. City ;=>ti'1' State -Zip
8. Building Type: Residential G] Commercial O Institutional 0
9. Work Description: New f] Add ? Alter ? Repair ?
1 10. Descri be
11.
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outtets
12. I hereby certify that the above information is true and correct, and I agree to
wmply 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 454-5100
Raoeipt.'? MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fee.
? FiII in numbered spacas S/C
Type or Prfnt /egib/y ,
Tot.
1. Date 2. Installation Cost
? 3. Job Address Lnt7 Blk. ? Tract
4. Owner ? _ .
5. Contractor . ? Phone q ', 31F,7 7
-,-,?
6. Address 7. City State • Zip
8. Building Type: Residential El Commercial ? Institutional ?
9. Work Description: New O Add O Alter O Repair ?
10. Describe Fuel Type
11.
e
No. Eauioment BTU - M. Ea.
Forced Air No. Equipment CFM
Ai
H
dli
Mfg. r
an
ng:
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 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
Permit No. Permit Hotder Misc. Permit No. Holdar
Plumbing S l,?'?j \ ?Q r ?( `, [p 2`$ 3
H.V.A.C.
9
Wall
w?e.?
D'ap.
Sewer
Electric I,t?p"2lZb ?DCk 'S E?f.t• S- `?
Intpeccion Date Insp. Other
Footings 1
Foundation ?l
Freminp ?
Rouyh Plby.
Rough HVA
Inwlation
Finsl Plbp.
Final HVAC
Finei ' 6 J€3
Water Dftaibe Locstion:
Well ?
Sovwr
Pr. Dbp.
. pF EAGAN
f 95 'ilot Knob Rood
oyon, MN 55122
onf np:
wner. ' ddress:
te Address: '
lumber
some M aomply wlf6 tle, CiFr oF Eogan
rdiuanoss.
i
ote of Irup.:
sp.:
iTY OF EAGAN
5-PS Pil-* Knob Roed
lgon, MN 55122
oniny: -
-
wner, - - r.,-1 12
ddress:
te /lddress: ,I? ? T
umber:
eter No.: ?
ze:
wder No.:
ig?ee te eanply wleh the Ciry of Eagan
+dlnancaa.
ite of I nsp.:
PERMIT NO.:
DATE:
No. of Units:
on Frr.
Connectlon Choroe:
Acoount Deposit: _
Permff Fee:
Surcharpe:
Misc. Chorqes: _
Totol:
Dote Poid:
F.JS (1A ..
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
. Na. of Units:
Connection Charqe:
Account Deposit: _
Permit Fee:
Surchnrge:
Mfsc. CF,orges: -
Total:
Dcte Paid:
CITY OF EAGAN
BUILDING PERMIT APPLICATION
.1-I-C /
Include 2 sets of plans,
1 site plan w/el.evations &
1 set of eriexgy calculations.
?- ? ?T-
'lb Be used Ebr .sl hr?r /?., valuation l0 X Q&) Date
Site Pddress: 1{5']
Int ? Block Sec./Sub. OJerH r 9frrt J-??rect ?`
Parcel #: (6 SColSO C?76 O? ??
Repair
Owner: Enlarge -
Move
Address: yl71/ iTahn Aoar/ ?trm? ?/2 Demlish
City/Zip Code: 5 5 1?2? Grade -
OFFICE USE ONLY
Occupancy 3
Zoning /
Fire Zone _
'iype of Const.
# Stories -T
Front < ft.
DeAth tSYI ft.
Phone #: f5 5`/ APPROUAIS FEFS
Contractor: uIV?4N? BroS. LOnS,
Pddress: ) tf,O lo? ?"ST. f1Y1 i
CitY/Zip Cocle: ajI/-CY.9Y,)?& W1 SSo:7.S_
Phone
Arch./Ehg.:
Address: guYhS I!l 6lf
City/Zip Code:
Phone #:
Assessments
Water/Sewer
Police
Fire
En9 •
Planner
Council
Bldg. Of£.XtZ-n'
APC
Permit _3o`IS ?
Surcharge 3a
Plan Check / l 2 ?79
SAC u`?6 ?-
Water Conn. ?-
Water Meter?
Rnad Unit ? sp
R?'I41L ? ` U ? ' ? S ?
0
_ s?
?3
C?rrtifirtttr of (?9rru?ttnr?
Citp of eagan
39rpttrtmrnf nf Builbing 3nsprdimt
Tbif Certificatr iraurd purtrrant ro the requirrmrntt of Section 306 of the Uniform Building
Codc artifring tbat ut tfx timt of irraana thir nnuture wat in romplinnrr with tbe variout
ordiru+nrrt of the City ngulating building connrrution or utt. For the follaving:
cl?a„ SF DWG/GAR eideN,,,,;,NO. 7910
0.PaYTYPe R3 7YPComwcYOn V FlroLOn NA 2omiyDimict RI
o,,,,,,fa„udft Michael Krehs .?d,n4174 Rahn Rd., 1112, Eagan
Road By,
June 16, 1983
VIVANT BROS. CONST.
.a., ,. . ?..??„?,. .?.<.
CITY OF EAGAN ?J91O
3795 Pllef Knob Read Ea9sn, MN SS121 l?l ?T .?
PHONF: 454•8100
BUILDING PERMIT ReceiPt #
Te !a wed 4er SF DWG/QAR Est. Volue $64,000 Date April 8 83
1q
Site Address 4574 So. Hay Lake Road
Lot 7 BI«k 1 Sec/Sub. Overhill Farm ist
parcel # 10 56150 070 Ol
w IName Michael Krebs
z Addrem 4174'Rahn Road, Aptf^Ok12
o Name Vivant Bros. Construction
iu Addresa 2420 lOSth St. East
? ,.,,,, IGH 55075 451-3483
Nume _
Address
I hereby ocknowledge ahot I have read this appiication ond sfote thaf
fhe information Is torrect ond agree fo comply with ell applicoble
Slate of Minnesoto Stotutes ond City of Eogon Ordinonces.
Erect g][ Occupancy R-3
Alter ? Zoning R-1
Repoir ? Fire Zone NA
Enlorge ? Type of Const. V
Move ? # Stories
Demolish ? Length46
Grade ? Depth 50 Sq. Ft.-
Approvab Feet
Assessment -
Woter & $ew.
Police -
Fire
Enp.
Planner _
Council _
Bldg. Off. _
APC
Signature of Permittea -
nstruction
A Bullding Permit is iuued to: vant ro s . o
all work sholi 6e done in accordance with all ,a(pp?licob?le? Stote of innewt,
Buildirq Officiol Xe_z ?
Permit 32s.00
Surcharge 32.00
Plan check 162.50
snt 525.00
Water Conn.450. 00
Woter Meter 60.00
Road Unit 250.00
Toral $1804.50
on the express condition thao
Stotutes and Ciry oi Eagan Ordinances.
This reqvest void
18 month5 irom
W 071704
L-I i6?i o I ( 3S9 ?(
?0.rwl ( S?' ?aZ ? ta O
Req
uest Date Fire No. Roueh-in Inspeaion
flequ
iretl7
? Nuw
Q Will Notify bisPec-
o
S
- ? 3 Z] Yes ?NO tor When Ready
[6?1-icensed Electriwl ConVaCtor I hereby raquest inspaction oi abova
? Owner electrical work instelled ar
Street ? A / d tl r a s s , Box or Route Na C i[y
eclion o. Township Name or No. Rangc No. County?
OccvpantlPfllNT
?
??l/??C?`J? Phone No.
Power Supplier Atltlress
Electricai Conha to. (Compan
y
N
ame)
Con ctor's License
No.
` /
J
?
?X? • K ?
??G7
Mailing Addre ICoMractor or Owner Mnkinu lnstallationl
-
-
A Z)
Authorized SiBnature ( ntr mr/Ownor MakinB InsWllation) Phone Numbe
r
O4E , ?-
?? ? U / 7
MINNESOTA STA BOARD OF ELEC CITY THIS INSPECTION flEQUEST WIIL NOT
Grie9s-Midwey A. - Aoom N-191 gE ACCEPTED BY THE STATE eOAHD
1821 University Ava.. St. Paul, MN 56104 UNLESS PROPEN INSPECTION FEE IS
o?.....e iat1i 1471111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION EB-00001-04
'Seeinsvuetions for comoleting this form on back of yellow copy.
BeTow Work Covered by 7his Request
ev4 Addl ReP. Type ol Builtlin0 APPIianCes WirOd Equipment Wired
Home Fange 7emporary Service
Duplex Water Heater Lightiny Fixtures
Apt. Building Dryer Electric Heatin
Cominercial Bldg. Fumace Silo Unluader
Industrial Bldg. Air Conditiaier Bulk Milk Tank
Farm otne, oeciN Oiner rsucaitvl
t er uecity ther Othir
Compute lnspectron Fee Below
N Fea Se?viceEntrancaSize p Fee Feeders/Subtanders N Fex Circuits
. D 0 to 200 qm s 0 to 30 qm s O 0 to 30 Am . O
Above 200 qinps 31 to 100 Amps / o0 31 to 100 Am s
Swimming Pool Above 100-Ainps Above 100_Am s
Transformers Irrigation Boonis PartiaL'Other Fee
Signs Specialinspection
flemarks
5,0 TOTAI,-FEI?--?,
Rough-in Oate V
(I, tha ElacVicel
Inspector,hereby
certify that the nbove
Final r D;ne '.spection hes been
,reee.
Thlereauastvoitll8monthsimm ? r 4.4
RESIDENTIAL
BUILDING PERMlT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
NewConstruction Reauirements
• 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas
(200/6 marJmumlot coveraqe allowed)
. 2 copies of plen showing beam & windmv sizes; poured found design, etc.)
• i set of Energy Calculations
. 3 copies of Tree Preservation Plan ii bt platted after 7/1193
• Rim Joist Detail OpBons selection sheet (61dgs with 3 or less units)
DATE C' 3- a -z-
SITE ADDRESS
TYPE OF WO
LTI-FAMILY BLDG _Y _N
FIREPLACE(S) _ 0 _ 1 _ 2
SEIA ROOFING & REMODELING
APPUCANT 4100 EXCEI,SIOR fsLVD
5T. LOUIS PARK, MN 5541!'
STREETADDRESS IB#B0B1850 CITY STATE_ZIP
TELEPHONE #CeI.Z-4cZ??? CELL PHONE #
FAX #
PROPERTYOWNER TELEPHONE# ?Slo- d t??
-------------------------------------------°--------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUlLDlNGS ONLY
Energy Code Category _ MINNESOTA RLJL,ES 7670 CA'1'liGORY 1
(4 submission type) . Residential Ventilation Category 1 Worksheet Su6mitted
• Energy Envelope Calculations Sudmitted
Plumbing Contractor: ____
Plumbing system includes:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Contractor:
Phone #
Phone #
I hereby acknowledge that I have read this application, state that the information is
with all applicable State of Minnesota Statutes and City of Eagan Ordjnances.
Signature of Applicant
Fee: $90.00
Fee: $70.00
---------°----..__..._
and agree to comply
OFFICE USE ONLY
Phone #
_ Water Softener _ Lawn 3prinkler
Watcr Heater _ No. of R.I. Baths
No. of Baths
Air Condilioning
Heat Rccovery System
/ a?
C? ? ,.
RemodeUReoair ReauiremeMs
• 2 copies of plan
• 1 set of Energy Calculations for heated additions
. 1 sile survey for extenor additions 8 decks
• Indicate'rfhomeservedbysepticsystemforadditions
VALUATION t SS7(, C c E0
Certificates of Survey Received _ Tree Preservation Plan Received ? Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplaoe ? 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 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
O 32 Addition ? 36 Move Bldg. ? 42 Oemolish (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 Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footsngs (deck) _ FinallNo C.O.
_ Footings (addition) _ Plum6ing
Foundation HVAC
Drain Tile Ofher
Roof _ Ice & Water _ Final _ 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
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
IVANT
ROTHERS
L(
Gene Vivant
VIVANT BROTHERS CONSTftUCTION (612) 451-348'
2420 East 105th Street
- Inver Grove Heights, Minnesota 55075 Ranald Vivan
(612) 432•604'
Lor -7 BIK I
O(J-Ar ?-k 11( Fryr"S Iir141
f)4k.7rt 'VA1?V
k'63?J )?Jke
?)JQ k ;
?
?
I
i
I I
?
0
Q
?
T
- qIjj?- 1)
a ,
? ? GRrA,}e
7 1%^tl?'.'?
?',°
? 4•Lr)
i
-- - ---- -- -' I
I I
,
??-
- Pf ?pbsuQ
?
30 /
?1?? J ? IQ ?L c '?'?d
_f
?
q
? M
0, o
,•-+?T'Y71LU?J ?vriv ..w... . ._-_ ,-...-.,.._ ,
ir-?""' . . .:- .' . .. ' . .' . _._•._ r:......1:...:-•. •: ..
EXTERIQR ENVELOPE kVERAGE "U" COMPl7TATI0N
. . ;. . -#?' q 36 Z C.: !•
ONNER
SITE ADDRE55
LONTRACTOR 13 e„ru? m q UATE IQ=`?.? PNaNE ? .
. `• V? v A uT - , , , . .
Determine working square footage of each. Total exposed wall area .....
7-o53.LoaL s9• ft. x
2, Total roafJceiling area .... 1120 sq. ft.' x .04 °?5•?
Total exposed wall area above floor
........ 13g.l.o -
.
.. a. Total wa11 window area ...............:..:
b. Total door area .... ............................ 4.?
F c. Total sliding glass'door area .................... . .
d: Total fireplace wa71 area........... . '...... ?-,Z
e. Total wa17 framing area (averagelCA)............ I
f. Total net wall area above floor .................
g. Total rim joist area ..................... .
Total exposed foundation area = (, ?
h. Total foundation windort area ....................: ?
{, Toa1 net foundation area above grade ...........
Deternin° "!1" value of each wall segment.
a. 193 Le xalu,t 55 _- ?o?•"f
b. 3 8 x„u,i ,?3 = S•28
c. g „Wl
a. X „u„ ? _
-
J -
-
x?????_ bqlo =
e. 1 S L ty?7!
f. 1379.1 1a x`lull .ny3 ° 59.3
,
? .6
W 9 X J,u„
9-
= Io•4?
4 h. - X 'lUll ?
,iun
' 8
?
.
. ZO 51, ?AS...,Total
3 ..................... ... . .
- If item n3 is the same as, or less than item fl, you have met the intent
of 56C 6005(c)2.
. • - . , ?
. f
, r,. . - • . . . .. . . . . . , . ' . . , ?
_f - •
,
Tota3 exposed roofJceiiing area
_ - :
:. ,
Total 9ross roofJceiling area
, . . -
• _ :3: Tota1 skylight area .................. •
.. '. k. Total roaf/ceiling framing area ...... ....
? 1.- Total net insulated roof/ceiling area.."..... t?IS•Z -. '
? - . .. , _ . . . .. ,
' . .. - Determine "l1" vatue for each roof/ceiling segment. '
' --- ,..... . ?... ... X liu" . ? ._..._ .
F
?
?
F
?
(
?
?
?
.. k. I 1Z, 43 . RPull .035 = 3•4q .
1. 161 J.Z _ A PUn
- 4......... .......1?.L ?..........7ota1 ° EM
If tota] of 14 is the same as, or less than #2, you have met the intent nf
SBC 6006(C)i.. _ .. . , : - ' .
To utiltzed the total enveTape system method, the vatues.estabTished by the
sum of items 93 and #4 shall not be greater Yhan the sum of iteRS #l and #2.
. 1? . _
, : . . 3._
` 24ATERIAL5
?
_ &xterior Air 5lding Dlaterial
Sheathing
TnBalation -
SheetroCk
Interiox Aix
Stude
Rim
conc. Blks.
+ 2,
+ 4.
Thertn. $tsis$ance "R"
.y3
Z•dGV
?.57
]• ?8
? -? .
**?*?*****?****??*?*?*****************?
CITY OF EAGAN
CASHIER: JS TERMINAL NO: 010
DATE: 08/25/00 TIME: 14:20:44
ID:
NAME: BURNSVILLE HEATING & AIR
3213 9001 4574 S ITY LK RD , 30.00
2155 9001 4574 S ITY LK RD 0.50
Total Receipt Amount: 30.50
CR136510
USER ID: JAN
LOT I BL I
PERMIT #:
SUBD._ OlyTh4« Farm I`S- RECEIPT #:
RECEIPT DATE:
8000 MECfANICAL PERMM1T (fiESID£1VTIAL)
CTl'Y OF EA6AN
5$30 f ILOT KN08 RD
$AfiAN b1N 55122
g a3--? ssi-s$r-asas
Date:
Complete this section onlv if you are installing HVAC in a single-family dwelling, townhome or condo under
construction and not owner/occupied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @$3.00 ea.)
$ 30.00
6.00
State Surchazge .50
Total $
Complete this section only if you are remodelinp, adding ta, or reDlacing an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or replacement.
New L,?Replacement
Fumace
_ Air exchanger
Reminder.• Call for final inspection.
SITE ADDRESS:
OWNER NAME:
INSTALLER
STREET ADDRESS:
$ 30.00
a
$ 30.50
PHONE #: 0671 - LI S-70- n IL4?
(AREA CODE)
PHONE #: '!?'( Sa - gCl LI'UC.0?S_
(, (AREA CODE)
CITY: ??GI,ChQ, STATE:OA)_ ZIP:?ail7X
RLsCEA V P?1J'
NLIG x`? 'OOq sG OFPE 4i EE
BY:
CITY USE ONLY
_ Other
? Air conditioning
Other
Fee
State Surcharge
Total
L BL
SUBD.
APPROVED BY:
INSPECTOR
PERM IT #:
RECEIPT#:
RECEIPT DATE:
2000 bi£Ci1b4NICAL PFRM1T (COhIMEitCIAcL)
CITY Of £A&AN
3$30 PILOT KN08 RD
EAfl,elN.1NN 55122
651-6$1-4675
Please complete for: all commercial/industrial buildings
multi-family bLiildings when separate permits are not required for each dwelling unit
DATE:
WORK TYPE: New consWction Install U.G. Tank
_ Interior Improvement _ Remove U.G. Tank
_ Processed Piping
When installing/removing underground tank, ca11 651-681-4675 for inspectian by fre marshal and
pfunebing iirspector.
Description of work:
Fees: 1% of conhact price OR $30.00 minimum fee, whichever is greater.
Underground tank removaVinstalla[ion = minimum fee
Contract pnca: $ x 1%= $ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
SIT'E ADDRESS:
OWNER NAME: PHONE #:
(AREA CODE)
TENANT? NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
CITY:
CITY USE ONLY
4
PHONE#: -
(AREACODE)
STATE:
SIGNATURE OF PERMITTEE
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA112735
Date Issued:08/22/2013
Permit Category:ePermit
Site Address: 4574 Hay Lake Rd S
Lot:7 Block: 1 Addition: Overhill Farm 1st
PID:10-56150-01-070
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Pat Addy
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 -
Rashal L Peterson
4574 Hay Lake Rd S
Eagan MN 55123
Greenguard Construction Inc
2915 Waters Road, Suite 101
Eagan MN 55121
(651) 289-7000
Applicant/Permitee: Signature Issued By: Signature