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4707 Hazeltine LaneCASH RECEIPT • CITY OF EAGAN - 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 ' _ . ? OATE ? 19 WCErvEo snoM • AMOUNT $ 6 DOLLARS ioo O CASH CQ CHECK FM C 14672 ?t--fty- ovy ?(?`,'?y Yelbvw-Posting Copy 1f'yi1f Pinir--Fila Co?ry ? Thank You BY SEWER & WfATER PERMIT CITY OF EAr3AN 3830 Pilot Knob Rd. ? Eagan, MN 55122-1897 . DATE JiJL 24 ; f9 91 . METER # + PERMIT DATE ',? 712(-•19 1 CHIP # PERMIT # 17.177 METER SIZE B.P. RECEIPT # ISSUE DATE B.P. RECEIPT DATE _ PRV - BOOSTER PUMP SITE ADDRESS ?i7G" 14%2Ci.x7.11:E 1,N LOT 1 BLOCK 1 SECISUB FAT&WA" HILLS 3P1) APPLICANT: ADDRESS: CITY, STATE ZIP PHONE: I PLUMBER: CITY, STATE PHONE: OWNER: - ZIP CITY, STATE $i-AIME MN Zlp 55434 PHONE: 7?6"6000. PERMIT REQUESTED k SEWER -K WATER - TAPS ? - COMM/IND RESIDENTIAL x NEW - EXISTING Lawn Sprinkler Meters are to be Installed Ahead of Domestic Meters on Water Line. Credit WILL NOT be;given for Deduct Meters. 1 aGREE 70 COMPLY WITH CITY OF EAGAN ORDINANCES SIGNATURE WHEN METER ISSUED 454-5220 FOR INSPECTIONS. FOR STORM SEWER 8 WATER PERMIT CITY OF EAGAN 3830 Pilot Knob Rd. Eagan, MN 55122-1897 DRTE JUl. 24, 1991 SITE ADDRESS T"" -, ?' -'7 ' ?-?'• ';E I.i3 LOT ' BLOCK ' SEC/SUB ''AT RiJAY Y.I LLS 3 RD APPLICANT:. ADDRESS: _ CITY, STATE PHONE: _ PLUMBER: _ PRV - BOOSTER PUMP ZIP PLYMOL'TH PLUMBING ENC ADDRESS: ?1290 GACHAPY Lh CITY, STATE KAPLE GKUVE %'Q`7 ZIP `,53b9 PHONE: 493"2474 OWNER: pREFEkRED BUILDEP.S ADDRESS: "741 CEA:TRAL AVE - CITY, STATE BLL:INE N.TI Zip 55434 7 PERMIT REQUESTED x SEWER ^ WATER - TAPS - COMM/IND }- RESIDENTIAL X NEW EXISTING Lawn Sprinkler Meters are to be Installed Ahead of Domestic Meters on Water Line. Credit W1LL NOT be.?given for Deduct Meters. 1 I? • % ,I?AGR COMPLY WITH CITY OF ?EAG OFt I N CES D PHONE: `0b-G000 SIGNATU E WHEN METER ISSUED PCEAg E'ALL01N TW0 WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTtONS. SEWER PERMITS, COMTACT ENGINEERING DEPT. . ? OFFICE USE ONLY ? 2 6/ 91 METER #q4y Yv 7 73 PERMIT DATE '•-7 CHIP # Q, 19`sF PERMIT # 12 177 METER 51ZE B.P. RECEIPT # I- ' )?; ISSUE DATE ? B.P. RECEIPT DATE C-7'2 5 gl FOR STORM CITY OF EAGAN i * 1 194n Q - - 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ` PHONE: 454-8100 BUILDING PERMIT Receipt # r To be used for SF DWC/biAR Est. value $90.000 Date J11L 24 _ ts 91 Site Address 4707 NAZLLTINa LlV LOt i BIOCk' i SeClSub?AIRWAY HILL$ SILD OFFICE USE ONLY Parcel No. occ.pacy A-3-0-1 FEES JL j W Name ?tElY.?tED BUILDEfiS Zoning (qctuaq const - Bldg. Permit 593.00 a Address 8741 CLNTRAL AVE fniwwable) V-M 4s L? City BLAIt?iE Phone 784-6000 ?k of Stories _ Surcharge Plan Review ? 1"•? o Name ? lergth Depih Cit SAC ? ? } , y o¢ ? Address S.F.Tofal - 00 430 ?'ilty Phone S.F. Footprints - SAC,MCWCC Water Co ' 8W.? ? On Site Sewage _ nn F Name on site wan W M 9S•? W 23 AddteSS MWCC System ? ater eter ? ? <W City Phone cirywater ? Aect. Deposit • ? 30*00 ? PRV Fequired _ S1W Permit I hereby acknowlege that I have read this application and state that the information is correct and agr _tp co ly w(th all applicable State ot Minnesota Statutes and C?agan ances. Booster Pump - Sryy Surcharge •50 Treatment PI 276•00 f Signature of Permitee ,` •? ^ ""?- APPROVALS Road Unit 370•00 A Building Permit is issued to: pIYJMMED WILDEM on the express condition that all work shall be done in accordance with all applicable State of Mlnnesota 5tatuies and City ot Eagan Ordinances. Building Official -.?...?._...,.,....._,,...._._?------?_.__... ..a...?...?_..?_.__._., --?.._. Flar'^er Council gidy, pn. Variance ..?_...1,..??.- - - _ - -- Park Ded. Copies TOTAL ? • 3??a•? Psrmfl No. Permft Holder Date Tekphone # WATER r SEWER PLUMBING O APA 7J ' 3"' H.VA.C. ,? r ?1I T 7.T a?? ELECTRIC trtspeetton Oste Insp. Comments Footings i Foundation . Framing Rooting Rough Plbg. Rough Htg. A-L Isul. Fireplace Final Hig_ /ft Orstat Test Final Pibg. Plbg. Inspector - Noti Plumber Const. Meter EngrlPlan 81dg. Final g- 3 B?? ?S Dedt Ftg. Dedc Final wen Pr. Disp. s : ?'? ? . ? • ?,?'` ? f u '? - - • ? r r (gtr#tf irafe of (Oxcupauxy Citp of Cagan Eppmwtnd of lltttbittg i1tfpPttlDtt This Cernfkale issueid pursuant to !he nequinemertls oJSeGion 306 oJlhe Unifonrl Building code cerd?1in8 ihat at the lime of iuuance [hls sirrcccture K+as err camp[iance witli lfre mrious ondinarrces ojthe Ciry regulaAing building cvns[ruction or use. For the jollowbw ux a.ffix8=606 Sy 8 W 6-I-6 !! R Bw r- , xo. 10470 O=VPm7 TYR R1.44 7..i.B D&,;.t R.? Type Camt ? Owov ol Bmldi? Add= =1CENMAT. {1UMIE gu ATW. nuc .t A f,?4 I . e"tdi°6 oe5°W *--- POST IN A CONSPICUOUS PLACE INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: PERMIT SUBTYPE: ia4101.11 I tV TYPE OF 1NORK: t 1 Nl'+t Pertnk No. PertnR Holder Date Telephone i ELECTRIC PLUMBING HVAC Inspectlon Dab Insp. Commants FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST ?? FINAL PLBG FiNAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN 3830 Pilat Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT TYPE: ; t?.i r i t? t a Permit Number: ki :? ?, !, s? yq Date Issued: SITE ADDRESS: 1" I ??r I 144p1Y tl 1 1 1 s{=Ct PERMIT SUBTYPE: 01" "' APPLICANT• ? E,t r?ro . aH I t ?? 1 .' ) ?1?.,• f>ft 'to: TYPE OF WORK: ? ? ?_ Permit No. Permit Holder Da Telephane M ELECTRIC PLUMBING HVAC InapecUon Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PIBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP 80ARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSM7 FINAL DECK FTG 7 ? DECK FINAL 5 - ? DATE! ?26, 1991 RE: 4707 NAZBL'fINE LN (PREFERREO BUILDERS) x Your Sewer & Wjiter Permit for the above property has been completed. It will be held at the Public Works QSrage (3501 Coachman Road) until the meter is picked up. BE SURE TO CALL PUBPC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON. Your Sewer & Water Permit for the above property cannot be completed for the following reasons: - Your Sewer & Water Permit for the above property has been completed, but the meter cannot 6e issued or occupancy allowed until further notice. - COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance. WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC. - REQUIRED BV LAW. CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. Address: 4707 HAZELpjM LRE Lot I Blk I Sec/Sub FAIRWAY HILIS 3RD These items were/were not complete at the time o the final inspection. 8/30 91 Yes No Final grade (6" from siding) -1-1? Permanent steps - garage w? Permanent steps - main entry Permanent driveway ? Permanent gas Sod/seeded grass Trail/curb damage i? Porch Basement finish d?v?^'?;? Deck Please veri£y with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. cocx?EOnxe White - City copy Yellow - Resident copy Pink.- Contractor copy CITY OF EAGAN No _ 19470 3830 Pilot Knob Road, P.O. Box 21-799, Eagan, MN 55721 PHONE:454-8100 ? BUILDING PERMIT /? Receipt # e/ O( 7obeusedfor SF DWG/GAR Est.value $90,000 Date JUL 24 , 1991 Site Address 4707 HAZELTINE LN Lat 1 Block 1 SeGSubFAIRWAY HILLS 3RI Parcel No. I o I Cddress B?i E?T?'honeERS 786-6000 I Name _ Address City _ Name _ Address CITy _ Phone I hereby acknowlege Ihat I have read this ap0cation and slate Ihat the inlortna[ion is conect and a ly ih all applicable State of Minnesola Stawtes and Ci agan ces. SignaNre of Pertnitee / A Builtling Perrnit is:i sued to: P FERRED BUILDERS on the ezpress condition that all work shall be done in accordance with all applicahle State ot Minnesota Statutes aM Cit?y/ of Eagan Ordinances. Building Oflicial ? Phone OFFICE USE ONLY Occupancy R-3 M-1 PEES Zoning R-1 (Actual)Const -Y---N BIdg.Permil 595.00 (Allowable) V-N SurCharge 0 45.0 F ofStories - Lengih Plan Review 3R6 _ 00 Depih 48.1 SAQ Ciry 100.00 S.F. Total - SAC, MCWCC 650.00 S.F. Fo0lpriMS - 660 00 On Site Sewage _ water Conn . On Site Well Water Me1er 95.00 MWCCSyslem X AcccOeposit 30•00 City waler x_ PRV Requiretl - S/W Permil 30.00 Booster Pump - S/W Surcharge 0 .5 Treatment PI ? 276.0 APPROVALS RoadUnit 370.00 Planner - park Ded. Council -- 50 81dg.ON. _ Copies , Variance _ TO7AL 0 3,238,0 OFFlCE USE ONLY This reqvestwid 18 monihs Fom wlidvlion daR prinhd in ihis 6oz. 9// ?III? IIIIIIIIIIf llllliil lllliflllll?-a? ???? 3 '?=?? * 0 4 L Ia L 37 8 t pLEASE PRINT OR TYPE p2D ? RB41es? ? /l /y 9 6 Rougbin inspecHOn requhed? ? Ves N. ?au musl mll Ihe inspecror when readyj Inspeclion Olher Than Ro,gMn: ? ReoJy Nav Will Coll Da1e ReoJy I, ? licansed conhacror x owner hereby request inspecfion of the above elechical work at: Job Address ?SVeet, Ba, w Route Na.) , ti7o N-pze. 14Ln1 Ciry rl Zip Code ssr?3 Seclion No. Tawnship Nama « No. Nange No. Fira No. Cauny DA Ko*a «.,omn Ck?r21eS C Q-rE R PhmeNo(o 12 -6 Sl.l(c,03 Power SoPPl?, s i?n Ko?a ? IEC+?-,c ?ad?, ?f 7 a7 fF42e I--;F?C L n? 5echicd Conrcacbr iCompany Name) Conkocror License No. AAaster Lic No. [Plom EkcL Only) Moiling Address (Conhaclor w Owner Performing Installation) Amhori 5m(Con c1« or Owpq Ped g Ina fion? `? Phone No. (P12 A003 E600001 A-11 8/96 STATE BOAfID COPY - SEE INS7ilUCTONS ON BAGK OF YELLOW COPY REQUEST FOR ELECTRICAL INSPECTION ' ' y' Y16°1J7 8 ?. 1218Univers'ty Ave.rRm. S- 28,ISt Paul, MN 55104 i- ? Phone (612) 642-0800 Home Duplex Apf. Bidg. Other: New Addn Commercial Induskial Farm Remod Re ir Air Cond. Htg. Equip. Water Hh. Load Mgmt. Other: I r D r Range Elec. Heal Temp. Service ? '?p ('r !^ b °X° above !he work covered by fhis request. Enter remarks in /his space and on fhe back oF Ihe whi copy only. Cakulale fnspecfion Fee - 7his lnspection Request will not be occepted wiihouf Ifie corred fee: ? Ofher Fee M Service Entrance Size Fee 8 Circuifs/Feedere' Fee Mobile Home Park Stall 0 ta 200 Amps 0 to 100 Amps Sheet Ltg./Traffic $ig. Above 200 Am s Above 100_Amps Tronsiormer/Generotor INSPECTOH'S USE ONLY ? TOT Sign/Oudine Ltg. Xfmr. G'_ e O Alorm/Remofe Conhol Swimming Pool I here6 ceni lnot I ins ?he dxvicol insmlimion de?ribed heroin on ?he dare. smred IrrigaNon Boom RougMln Data S eciallns ecfion - p p Invesfigalive Fee Z THIS INSTALLAiION MAY BE ORDE NaECTED IF NOT COMPLETED WITHIN 18 MONTHS. RESIDENTIAL ? 5 BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-881-4675 New Construction Reauirements RemodellReoair Reauiremenls • 3 registered sRe surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas • 2 copies of plan (20% maximum lot coverage allovred) . 7 set of Energy Calculatbns for heated additions • 2 copies of plan showing beam & window s¢es; poured found design, etc.) . i site survey for extetlor additions & decks • 1 set of Energy Calculations . Indicate If home served 6y seplic system for additions • 3 copies of Tree Preservation Plan'rf lot platted after 1/1193 • Rim Joist Detail Options seledion shaet (bldgs wiN 3 or less units) DATE S- L?> - C) z- VALUATION ?k UQO ` v, 0-0 SITE ADDRESS "I ! b / aoi,22.(" Lif ) MULTI-FAMILY BLDG _ Y _ N TYPE OF FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT SELA ROOFINCi & REMODEUNr . 4100 E?Ev^Et3i8R Ittr.,. STREET ADDRESS ST• LOUIS PARK, MN 554, ? CITY STATE_ZIP TELEPHONE CELL PHONE # FAX # PROPERTYOWNER \?L-? (???5b?'^) TELEPHONE# --------------------------------- ----------- -------- ----------------- ----°-------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RUI.IS 7672 (J su6mission type) Plumbing Contractor: ___ Plumbing system uicludes: . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Mechanical Contractor: iblechanical system includes: Sewer/Water Contractor: Phone # Tee: $90.00 Pee: $70.00 -----------------------------------------°---------------------------°--------°---°--°--------°-----°-°----------- I hereby acknowledge that I have read this application, state that the inform tion is rr t, and agree to comply with ali applicable State of Minnesota Statutes and City of Eagan Ordins. / ?- SignatureofApplicant ? OFFICE USE ONLY Phone # _ Water Softener Lawn Sprinkler Wa[er Healer No. of R.T. Batlis No. of Baths Phone # Air Conclitioning Heat Recovery System Certificafes of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex O 06 04-plex ? 07 05-plex ? 13 16-plex ? OS 06-plex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 08-plex ? 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 6ct. Alt - Multi ? 33 Ext. Alt- SF 0 36 Multi ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Akeration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demolition (Entire 81dg 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. _ Footings (deck) Final/No C.O. _ Footings (addirion) _ Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tes[s _ Final _ Frazning _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By Building Inspector 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 .,:;.,. r3 n;?Y.W??x-0:?`.yka;Y `r' l:li=? ,. ? ?:"Ei:i^'i r•; ;!r ! ?.If.rt4Y:?? ?::'?.:'??::.?11rFll. ?...?.1?'t.l???'.?•' ? ... ??...p ?. n...`..? .. . ?.. ??Y.: ??.. ,.i,. .. ?r??..?..::i: F's??:...- ?;; i.??r:.i!1r•???;n. ,.«:?,?`$?) , , .., CITY OF EAGAN 3830 Pitot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMITTYPE: suzLozNG Permit Number. 029188 Date Issued: 11 J 0 7/ 9 6 SITE ADDRESS: P.I.N.: 10-25602-010-01 DESCRIPTION: PERMIT 4707 HAZEL7INE LANE LOT: 1 BLOCK: 1 FflIRWAY HILLS 3RfJ ; -- Building-,.,Permit Type $uil;di-ng Glb.rk TYPe Census Code ? : . . . x +N(^f ?l f?? ? . . . .. . . . . ?sR?? l ro. t^t - a , .ti?.? ?-? •`` .`{ ?. i , x {$ REMARKS: FIREPLACE NEW 434 ALT. RESIDENTIAL ? g,r u?, E ? 4 i? ? 1 tl ? . ? l ?} ? ••? . FEE SUMMARY: 6ase Fee Surcharge Total Fee I $25.00 .50 $25.50 CONTRACTOR: - Applicant - ST. LIC OWNER: FZRESIDE CORNER INC 16331042 0001068 CARTER CHARLES 2700 N FATRVIEW AVE 4707 HAZELTINE LN ROSEVILLE MN 55113 EAGAN MN (612) 633-1042 I hereby acknowledqe that I have read thzs app7.ica'tio-n and state that t!he informar3on 3s correFct'ancJ agree to cumply ;vith all appkicable State, of Mr. 5tatutes and City of Eagan Ordinances., L nun R ?a11 rn?f ? APPLICANT/PERMITEE SIGNATURE ISSUED Y: S NATURE CITY OF EAGAN ?j D 19-160 3830 PILOT KNOB RD - 55122 Z?? 1996 FIREPLACE PERMIT APPLICATION 681-4675 DATE: 1\' S ' 9(1D DESCRIPTION OF WORK: X CONSTRUCT NEW FIREPLACE: _ WOOD BURNING _ GAS T _ INSTALL GAS INSERT ONLY IN EXISTING FIREPLACE _ INSTALL GAS LINE ONLY IN EXISTING FIREPLACE OTHER: ROOM TO BE INSTALLED IN: STREET ADDRESS: NC',-7e ?y10 _ .4114 LOT I BLOCK I_ APPLICANT: (circie one only) SLBB.rP.i.B. n: I hereby acknowledge that I have read this application and state that the information i?-correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ,I PROPERTY NamO: l,P Y Y 1'?? Phone #: ?"? 4-14316 OWNER -r? ? FlWi Signature: Street Address: A2>,S -5 ? City: -5- PCW A. State: MrA FIItEPLACE Company: INSTALLER Signature: Street Address: ?_ ol f(] ? n ?P/ &4)e,- City: ??,,p00 State:4mll_ l., GAS LINE Company: INSTALLER ?25 5b Name: Signature: _ Street Address: City: Zip: h h I 0q Phone #: ? License #: M [AM zip: `7h I l,? Phone #: State: OFFICE USE ONLY BUILDING PERMTT TYPE ? 14 Fireplace WORK TYPE ? 31 New ? 33 Altera[ions ? 32 Addition ? 34 Repa'v GENERAi. iiitFORMATIOlY Census Code. SAC Code REMARKC Chimney/flue must be inspected before concealing. ea ? ? ?. .?? 1'.?4F . ? . . .. t. ... . t ? d INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: B U I L D I N G 3830 Pilot Knob Road Permit Number: 025500 Eagan, M innesota 55122-1897 Date Issued: 0 5 J 0 3/ 9 5 (612) 681-4675 SITEADDRESS:P.x.ti.: 1e-256e2-e1e-e1 APPLICANT: Lor: i BLpCK: 1 4707 HAZELTINE LANE ANTONY BRIAN FAIRWAY HZLLS 3Rp (612) 452-5838 PERMIT SUBTYPE: TYPE OF WORK: DECK NEw ?. ? , .. ? .; . r CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMIT TYPE Permit Number: Date Issued: c2?oz0? BUILDIN'G 025500 05/03/95 SITE ADDRESS: 4707 HAZELTINE LANE LOT: 1 BLOCK: 1 FAIRWAY HILLS 3RD P.I.N.a 10-25602-010-01 DESCRIPTION: Biuilding p,ermit Type Buil,d$ng Work?7ype % ?. ? ? ? S. DECK NEW _:'? .. REMARKS: FEE SUMMARY: Base Fee $30.00 COPIES $1.50 Surcharge $.50 Total Fee $32.00 Subtotal $30.50 CONTRACTOR: OWNER: - Applicant - ANTQNY BRIAN 4707 HAZELTINE LN EAGAN MN 55123 (612)452-5838 I hereby acknowl.edge that I have read' thzs information is correct and agree to comply Statutes and City pt Eagan prdi:nances: LAPPLICANTlPERMITEE SIGNATURE appiication and state that th:e wit'h all applicable State ofi Mn. is eo n?s?nFae RE alm'j- J CITY OF EAGAN 4,? 1, 00 3830 PILOT KNOB RD - 55122 moo 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 60-yetlii'`-i 681-4675 New Construction Reauirements RemotleVReoair ReauiremeMs ? 3 registered si[e suneys ? 2 copiea of plan ? 2 copies of plans (inUude beam & window s¢es; poured fnd. design; etc.) ? 2 site surveys (exlerior atlddions & dedcs) ? 1 energy calcufations ? 7 energy calwlations for heaSed additions ? 3 copies of tree proeervation plan iT lot platteC after 7/11/93 requlred: _ Yes No DATE: '7 //Zh) CONSTRUCTION COST: DESCRIPTION OF WORK: nkGk STREETADDRESS: y7D7 LlV LOT BLOCK SUBD./P.I.D. #: ???X<<?/??-??../QQ? ?)!? ? ;'r A l tor A 2 - 5X3 Y y5 PROPERTY otiy n Name: ?- l . , Phone #: OWNER Street Address• (44 ?Z City: ???lb? State: WI r? Zip: 7-52Z- S CONTRACTOR Company: SAyy\ E , Phone #: Street Address: License #, Ciry: State: Zip: ARCHITECT/ Company: Phone #• ENGINEER Name: Registration #, Street Address• City: State: Zip: Sewer 8 water licensed piumber. Penalry applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this applicaGon and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: -OFFICE USE ONLY RECENEL? Certificates of Survey Received _ Yes _ No Apil 14 1995 Tree Preservation Plan Received Yes No --------------- OFFICE USE ONLY I 4 A" BUILDING PERMIT TYPE 0 01 Foundation ? 06 Duplex 0 02 5F Dwelling o 07 4-plex ? 03 SF Addition o 08 8-plex 0 04 SF Porch a 09 12-plex ? 05 SF Misc. 0 10 = plex WORK TYPE q"1 New ? 33 Alterations 0 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning 0 11 Apt./Lodging o 0 12 Mutti Repair/Rem. o 0 13 Garage/Accessory o 0 14 Fireplace o ?15 Deck 0 36 Move 0 37 Demolition 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscelianeous Basement sq. ft. MC/WS System Main level sq. ft. City Water sq. ft. Fire Sprinklered sq. ft. PRV sq. ft. Booster Pump sq. ft. Census Code. 173 Footprint sq. ft. SAC Code _0/1 Census Bldg I Census Unit 0 Building Permit Fee Surcharge Plan Review License MCNUS SAC Ciry SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies .50 Total: _ Engineering Variance Valuation: $ ?ZUO ? °k SAC SAC Units i 1771 14941 rrCUrc.u. R?++a-++,+ , -- • ;.?'I'?F?CATE OF ?RVEY , For:. Ph¢Cerred (ildrt. • M V V V Q ?a ti u , • i? , ja 0 , a ? :W i 0`? ?a .a ? • I Prooosed elrvd6luns: 7op of eloCk = ioz8.z Onrnge F1oor • Ioz•i.e Lowest Floor ¦ iozs.o ts") NB9•i.Y'f/ "E e5ra JO ? ? I e? i ,. ? ? I N 10 ?•?? ? i zl.Z . I NB9°/3'?/ "6" O Denotes 11 foot offset. GD Denotes Droposed elevatian. I" Denotes direction of drainaqe. ? ?. - +? ? p 1 N ? ? ?ao ?Q ? j , ? r r -35• - •? "0 49 ,;?.?: n \ ?? ? ?. ??* • ? Ao Lot 1,' Block t, FAIRWAY HTI.I.S 3Rr) ADOITION, Dakota County, Minnasota. Or7y5r.P8.3r89•2o ? 1lE:l lneh= xO Feet oponotes Iron Bearin s shown ore ossumQd. Job No. 9is3?ws Bk..._Pq._ i hvo0y onfHy that 1his la q trw and ooerect ropnsenfaflon of a surrly of fbe ? G. ?uQ & SQNS, INC. un0arieS of tho obov? dnaibed land enA of iM lecotion of all buildinaf, 1f onY, jnon, and all vhlbN aneroachinMft, it ony, frOm or on soid lend, (ANDSIlRIIMR5 ' E.G. RUD &' SO?NS. INC. 9i6oLwdnptonAnnuaN. l.a rnh .,?a y or..Szk'/K 19PL. Ci4.?s? Qs /,'? i1 Grck Pinx, Mimiesota 56ota by ..6l,/.Gw?? 'Ild.nf.n..,ee .»- MI11n. R.w u? ? I?IN / j' S6?. ? ` ? ?7 P , 1991 BUJING t1,92LICATION CITY OF EAGAN SINGLE FAMILY DWELLINGS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS 1 SET OF ENERGY CALCULATIONS lNLTIPLE DWELLINGS ltill[ I g COMMERCIAL 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL REGISTERED SITE SURVEYS - & STRUCTURAL PLANS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALC[JLATIONS 1 SET OF ENERGY CALCS # OF RENTAL UNITS # OF FOR SALE ANITS PENALTY APPLIES WNEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER M[7ST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLAWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETE?. PERMIT MUST SHOW A LICENSED PLUMBER. c ? To Be Used For: Valuation Date: 7; Site Address ?0 OFFICE USE ONLY Lot I Block ? Parcel Owner Addres City/Zip Code ?l, .. y Phone -?/'QQ0 Contractor ?aY22 p _ Address City/Zip Code ?D' pJ J - occupancy Zoning R -1 Actual Const V'N Allowable V-7J # of stories Length 53 ? Depth S.F. Total Footprint S.F. On site sewage_ On site well MWCC System JZ City water PRV Booster Pump _ FEES Bldg. Permit Jr9S,00 Surcharge N5, ob Plan Review 396,o p SAC, City 1 au.c SAC, MWCC ,Oo Water Conn. rc60,00 Water Meter 95,00 Acct. Deposit 30,0i7 S/w Permit 30.00 S/W Surcharge 050 Treatment P1. ,Oo Road Unit 370, Oo Park Ded. Trail Ded. Copies • ? SUBTOTAL Penalty Lot Change TOTAL Phone APPROVALS Planner a _ Council ? Arch./Engr. y?x'r„2 Bldg. Off. Variance Address City/Zip Code Phone # agrees that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. . , GA r?A G-E ?• G ? Vq L ua-cTOV'q co GJ r--"?=- roqa ?c ls `J6oo - Z?z3?y? 8x? = ?y r--- II??a xiy= 16bbo IS1 Ft,ourL 1?i?r?>>"?? = IMC ? Ilqq x 53= 635. 8 ! $O ? a/2 Ct 0.Ju0- JUL-10-1991 10:41 FROM E.G. RUD & SONS CERTIFICATE 4F SURVEY F01^:. Pi"¢CLrrla OIdrS. ProooseJ elrvdLivns: Top of BlOCk = IozB.z w Gnrage Floor • toz•i.l ? LoW25t F10ot' a IOLS.a (5") V ? NB9•i.?'I/'E ??s u pg?4 B5.70 // ? M . ? ? -- Q r ? Y• i y- . I a I v? IL , I io ?•'-z ? ,a , , ? u v ? ? ? • ? 1 _ I + D ? /¢/.,2d NB9°/3'4/".r O Denotes tT foot offset. Q& Oenotes proposed elevation. or' Denotes direction of drainaqe. 7Q FREFthKtL tlLLR r.uc e f Glt: ?i Ey Easswie.?{' S? ?• ? ?99j E a? ??"r•?\? i `??11 ?.?. /? .4' N n , /,° aw? zje . e rory y "?" ?.d ? ?. I : tt D ' 9 ? O N t? .• 1°?• ' +'? • v 11 : ?o ioys, •---35•-•? +w ?,?.I i•i.??i r??1.:?? , LOt 1. Block 1, FAIRWAY HII.t.S 3Rf1 A06ITION, Dakota County, Minnesota. ,?,_?r755!?ta.7r89•?O? 1LE: l lnch= 22Feat o De?otes Iron Beorir,gs shown ore ossumed. Job Na 91s3.?~s Bk..._Pq _ I hsreEy atrN1y fhaf thia ia q true and cornet roprasentafion ot a survty of th• ??• ?uQ & SQNS? ?NL. undaries W Ihe abore dwaib4A loml and o1 the IocaHOn ot qll buitdinpt, it any, . nwn, and all risibN •ne?oacMnMls, H anY, from or on soid land. CANDSUFNEYORS E. G. RUD 8t $ONS. ING. 9180Lwdnpton Avenue N. lt1 tnie .Ldey ot ? 19&. Circte Rnec, Mirtneaou 56014 r?v ?,?...? er ???,? ?..- Mn,n. e.,. ?- , CITT 0F BOIIDIIG DLPA R'liQNT LITEtIOA-ZIIRLDR'MYGt "U" CMUTATIOM (To Co subaitted dtb pullding pernlt tioa) ne or tao taaily dvelliqg Orner 11 athor 9it• •nensa 4/707 Haa? /, LANL ontraccor paN on• IMfA1 FT. OF IPo9ED YALL ft. above arado ? ?OTAL EYPOSED WA V. • PAQUE MALf. CONSTRUCTION: "U" value x arsa -Sf.r.o!?Ac?._ "U^ •0j17 x 5;1. fC.,?6 ? 5.3? ?U1 .U? Y 5.j . tL. ? (U) D,?M "U^?< s9, IL•(U ) etall reference -r ~UN x sq. ft. ? (U) f.'om G114 cx. "U^?x ao, t(U) ttached sheets U. x aq, ft. ? (U) ~uff If $1. r. ? (V) ?U? Y 5t?. CC. = (U) ^U" x sq. ft. • _ (U) "U" x aq. ft. • ` (U) INDOMS: °U" v}lue x •rea G •ke ! type "U•_J" _x sq. ft.?• a0 (U) "U" x sq. ft. • (U) w ? nUo X !q. rC. ? (U) X sq. fL. ? (U) "U"-"-'X SQ. ft. ? (U) ~ n oU- ][ Sq. ft. ? (U ) i XRS S "U" ValUQ X •['ea ake t LYps L?N ^UM •?% 1[ Sq. 1?L.?? 2•/? (U ) i w i? •U, X 9q. fL. t ? 1U)i w w ? ?. N(fWl[ sq. ft.?? (U)1 s ? •p?- : sq. ft. m U)( , )TAL (U )(A ) VALUES d TA1S 22?z? .Sq. PD ?U 1 IYIDED B7 TOTAL YALL AREA A?. •rv^ z277 . // 7ERAGE "U" or ltsa for 1• family dwellir4a ?29 or less for all Char Duildings , ?T?LC?;':'G' `a yo otail reference gq? f?6. .OZS x sq, (U)( flOS ?U? X sq. rL. • tU?( :tached aheots. •U" : •q, ft. ? (UH ?scriDe openinQe "ll" x llq. ft. m (p)( lII COOt. MUM i 7q. tC. ? M1 ? I?A LM(A) VA LUES 2 G ? LS-?-?-g 4• f t. ( U ) :YIDED BY TOTAL ROOF/ !lT1GV D S CEILING AREA ?-3g ccs. TRAGE •ll" , . for ventilated roota , all other constructlon IP' Z! _ wAL[,S o z(, o ._ ;- - - - ? i ' ? I 7 1 s ? ? 9 10 I / u p is ll'Z i? n . ia 4 r: , --- s = -, --. 77 71 io " 31 32 » 34 ?s Is n n ? O ti 76a ouir, _?- ? e ? e = ; ? 11 I IIIIII II IIIiI ei.osc cor[eLss• r?o[.M.Y.4.. ? ?-?? ^- -- -- i a- - -_ ? ] ? ! . 1 7..2. . . 1 II I-?_-__- 1! ? I? 1 10 17 ??? I I 1 I I III?--I /V? 17I? ------- - - ------- ----- --y -,.- ?- ?- --- _.-.- ?-_ ---- -- ? _-?--- ° __--- ? - - - _- ?-_ _L.. . _ ... .. _ ._ -. 1 ""._. _' . _' _. i. .. . . . ._ . . . .. _ ' _.. 71 )1 ]I )7 - U - ]4 1{ 71 11 11 .. . _._ _ .. .. . .__ ... . _ _. ._ ' ' . 11 O wi.u..a.a. oe.. ov?w owuw v?w wr. __ .'-'- -_... "DEjE?M i N I NLa - W L "U" VALUE e?, ?rcT?nrl - AT RWF, WAILi CtIM, ANp CONG. P)LK. ROOF I CEILING (R) VA?Lr- Q 1W(ERID? A1R FILM O.&I ? 5/8" GYP. ao, .5L ? lNSULAjtoN 38.? O EXjERIOR AlR FILM .lol (STILL) /tz =.oi5 ToTAL CR)= 37,78 WaLL (r?) vAwE ? RrTEK1oV- AIR fILM a(Pa ? lh" UYf'. BD. .45 Qa 3'/2 tNc,uLATtoN 13,00 O sTYRO, s1-tEATxI1444 600 O MA`a')NITE`_ SIDiN(a A& ,(01 ii EX'(ERIDF. AtR FILN1 J-1 U"= I/R=. ToTAL (R)= 20•`17 ? ? 13 m is ? O lzIM INTEI'doti qiR FluM 5 1/7" JNSULAT1oN 2" FtiL RiM ?Ois"f STYRd, SNEA7N?N14 P1AGOrITE SlfllrG E.XT?.rc?ofz AiR FLhl (R) VAIt)c: 0.(08 1`1.m 1.8s (p, o0 S .61 .I-1 n Uu - l /R = .035 1'DTAC. (R) = ZS ?}D fotlODATIoN (u) V??ue (D 1NTEILIOC? Auc Flt1M o.?a ? ? z)i {L" CoN?, ' ?K. ?.28 O ?" ttic,iD INSu" s.gz Q EXjERIoR AIR FllM , l1 ToTaL ? 1 CITY OF EAGAN 3830 PILOT KNOB ROAD EAGA2I, MN 55122 YHONE (612) 454 8100 9G?;'?TGA?.; Mt"M1'xAL,.° FOR CITY USE ONLY PERMIT # RECEIPT #-? / DATE: PLEASE COMPLETE IIPPER YORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. ------------------------ ------------------------------------------ WORK DESCRIPTION FEES NEW CONST _ ADD ON ?!- REPAIR ? OWNER NAME: SITE ADDRESS: LOT:/ BIACK _/ SUBD. INSTALLER: AfiRi J????/ v -IVfi?i17 g,! ?- Co #342.g3Q6 ADDRESS: 700 W LInCI6n n,/ende Minnea • Box 1165 CITY: POIIS, MNZ5U4O-jj65 PHONE # ?ASCQ v- • ?OMMEACTAI:f?NnYTSTA?A?.:; PLEASE COMPLETE THIS PORTION FOR ALL COMII4ERCIAL/INDUSTRIAL BUILDINGS, ......._.._ :............. APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WFiEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: OWNER NAME: SITF ADDR.ESS: LOT: BIACK _ SUBD. INSTALLER: ADDRESS: CITY: ZIP: PHONE FOR: ADD-ON MINIMUM $1500 HVAC 0-100 M BTU 00 ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 OF 1 PER PERMIT SUBTOTAL: $sm_jj, STATE SURCHARGE: .50 TOTAL: $ 1-s;SD ?-_. pF TTEE MjNpl^ FEES 18 OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR EACH $1,000 OF PERMIT FEE. PROCESSED PIPING = $25.00 $25.00 MINIMUM FEE. CONTRACT PRICE x 18 $ STATE SURCHARGE $ TOTAL: (SIGNATURE) CITY OF EAGAN ' CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 FOR CITY USE ONLY PERMIT # RECEIPT # ?CP DATE: S? RE$:IDEN3'Zh,D: PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. ----------------------------------------°------------------------°--°---------- WORK DESCRIPTION NEW CONST ? ADD ON _ REPAIR OWNER NAME: P?EYJM_D 6AjWejZS SITE ADDRESS: 'T Ioi tiv8teVr 1J[=- UJ 2rd LOT:_I BLOCK / SUBD. • v ? INSTALLER: PLXt4Q&MA a L^'t V3 1 COMPLETE THE FOLLOWING: N0. FIXTURES EA. TOTAL ADD-ON MINIMUM 15.00 1 SHOWER 3.00 2 WATER CLOSET 3.00 ? BATH TUB 3.00 25 .CSU 2 LAVATORY 3.00 ?D KITCHEN SINK 3.00 ?_6U ? LAUNDRY TRAY 3.00 3.6T1 HOT TUB/SPA 3.00 1 WATER HEATER 3.00 3.bZJ ? FLOOR DRAIN 3.00 3•U1? GAS PIPING OUT. (MINIMUM - 1) 3.00 I ROUGH OPENINGS 1.50 ? OTHER WATER SOFTENER 5.00 _ PRIVATE DISP. 15.00 _ U.G. SPRINKLER 3.00 SUBTOTAL S ST. SURCHARGE .50 TOTAL: S 3a- ' C? PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: OWNER NAME: SITE ADDRESS:_ LOT: BLOCK , INSTALLER: ADDRESS: CITY: PHONE #: FOR: SUBD. ZIP: FEES 18 OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 18 STATE SURCHARGE TOTAL: $ ( S I GNAT[TRE ) CITY OF EAGAN ADDRESS: 4qZA?) Z4cA-k?" ?-? CITY: MPP(Af CW L ZIP: S?? 1 PHONE #:_ CZTY OF EAGAN 3830 PILOT KfIOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 opommm FOR CITY USE ONLY PERMIT # RECEIPT # /D a? $DATE : ?a PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY ?.:.... ..; .. <.,...... ......... TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNZT. ------------------------ ----------------°--°--------------------' WORK DESCRIPTION FEES NEW CONST ADD ON REPAIR OWNER NAME: SZTE ADDRESS: '170 7 a?aUh?-z-?ILc_ /--,( ? - • I ?I"rJ LOT:I 3LOCK, ? SUBD. Jtnn ?O d- INSTALLER: ? ADDRESS: TWO, INC. ciTY: 9290 ZACHARY LA+fE:N. MAPLE GROVE, MN 55369 PHONE #:_ 493_94]] DWELLINGS fi ADD-ON MINIMUM $15.00 HVAC 0-100 M BTU ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 OF 1 PER PERMI Z SUBTOTAL: $ 10 STATE SURCHARGE: .50 TOTAL : SIGATURE OF PERMITTEE de t/S_s-- ?i#?MMERdIi?J'.f?IS1i1??'RZAX. - PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: OWNER NAME: SITE ADDRESS: LOT: BIACK _ SUBD. INSTALLER: ADDRESS: CITY: ZIP: PHONE #: FOR: CITY OF EAGAN FEES 18 OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR EACH $1,000 OF PERMIT FEE. r&i/CESSnD °iPiNG = $25.00 $25.00 MINIMUM FEE. CONTRACT PRICE x 18 $ STATE SURCHARGE TOTAL: $ (SIGNATURE) PERMIT # IQ? 3,4 RECEIPT DATE: USIDEPTIlkL PLUM$Ift6? PERMiT ALPPLIC!lTION crrY oF EAsm sgso eu.or Kxoa sn Ewsnx, huv 55112 651-8$1-9675 Piease rAmplete for: D single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for irrigation system SITEADDRESS: 1?7,1?) q LAi 23C (fL) OWNERNAME:: Ir-CeE7 /?? b INSTALLER NAME: STREET ADDRESS: CITY: 0'G ??AJ Place a check mark next to the ermit work t e TELEPHONE #: (y cA2 f ,rz?2 C) (AREA CODE) TELEPHONE#: (AREA COOE) STATE: ? A') ZIP: S? New residential dwelling unit under construction and not owner/occupied $ 90.00 ? Add-on, modification or alteration to existin dwelling unit, including: $ 50.00 • abandonment of septic system • new installation/repair/rebuild of RPZ • lawn irrigation system • water turnaround _ I A J ez(c f" S Nature of work: 1/?WI Septic System, new/refurbished - $ 225.00 • includes County & Consulting Inspector fees • requires MPC license State Surcharge $ .50 ??? Total $ Reminder: Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc. I herebyacknowledge that I have read this applicatlon, stale that the inforcnation is covect, and agree to wmplywith all applicable City of Eagan ordinances. It is the applicant's responsibility to notiTy the property owner ihat the City of Eagan assumes no liability for any damages caused by the City during its normal operatlonal and maintenance activities to the facilities constructed under this permit withi ight-oi-way/easement. SIGNATURE OF PERMITTEE Updated 1/07 ? 53a"7 2004 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. IS.S? Date -) I ( a? I tv/ ?1? Site Street Address ?1a-Z-f_L12 ?1 0 Lr? Unit # Property Owner ?\ (,A_C" m ? L_fyz?zYl Telephone # 651 Contractor ILUPAAA Telephone # t ll5)0 'A? Address ? City-1:L A LD?? State_WL Zip The Applicant is: _ Owner ?Contrector _Ofher Aiterations to existing dwelling _Add fiutures to rooms, exciuding water softener and water heater _Septic System Abandonment _Water Turnaround (add $121.00 if a 5/8" meter is required) Other: $ 50.00 Water Softener _ Water Heater 10 replacement _ adtlitional $ 15.00 Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00 StaYe Surcharge $ 50 r al $/ -3. __ I hereby apply for a Residential Plumbing 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 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 approv d.` Applicant's Printed Name AOtkanrs gnature e 7?366,;2 2007 RESIDENTIAL BUILDINC?i PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirements 3 registered site surveys showirg sq. ft of lot, sq. ft. of house; and all roofed areas (20% mazimum lot mverage allowed) 1 Soils Report if pmposed building is to be placed on disWrbed soil 2 copies of plan showing beam & window sizes; poured found design, etc. 7 set of Energy Calculations 3 copies of Tree Preserva6on Plan'rf lot platted after 711193 Rim Joist Defail Options selection sheet (buildings with 3 or less unifs) Minnegasm mechanipl venlilalion form RemodellReoair RenuiremenGs 2 mpies of plan showing foo6rgs, beams, joisfs 1 set of Energy Calalations for heated additions 1 site survey for additions & decks Addition -lndicate if on-sife septic syskm Plans are considered public information unless vou state thev are trade secret and the reason. Date d(o 142 Construction Cost* ,J sqc> ? Site Address ? 7 7 UniUSte # Description of Work Muiti-Family Bldg _ Y?o N Fireplace(s) _ 0 _ 1 _ 2 Property Owner 10t,A_Sor?) Telephone ) -r'/ 9 2- ?_0?7 Contractor 12t)? i Address ''/70 3 City 6?441 State /x ?j Zip _?12-:3_ Telephone # (G/Z ) Ke6_/y>, COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesoh Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . ResidenGal Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submissiontype) Submitted - Su6mitted • Energy Envelope Calculations Submitted In the IasT 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( (??o . e!?b Office Use Onlv Cert MSurveyReo7 _Y _N Soils RepoR _ Y _ N Tree Pres Plan Recd _Y _ N. TreePresR¢quired _Y _N On-site Seplic System _ Y _ N 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 Statutes; I understand thi is not a permit, but only an application for a permit, and work is not to start without a p that the work ' b in accordance with the approved plan in the case of work which requires a review and a rov ofplans. --"k ? ,n D Applicant's Printed Name ? Applicant's Signature DO NOT WRITE BELOW THIS LINE Suh Tvpes ? 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 EM. Alt - Multi ? 03 01 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 (screenlgazebolpergola) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Tvpes ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demalition (EMire Bldg) - Give PCA handout to appliwnt D@SCYiDtiOn: Water Damage _ Yes Valuation Occupancy MCES System Plan Review _ 100% or _ 25% Code Edition Census Code Zoning City Water SAC Units Stories Booster Pump # af Units Sq. Ft. PRV # af Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings(new bldg) Sheetrock _ Footings (deck) FinaUC.O. _ Footings (addition) FinaUNo C.O. _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool Ftgs Air/Gas Tests Final _ Framing Siding Stucco La[h S[one Lath Brick _ Fireplace _ R.I. _ Air _ Test _ Final _ Windows _ Insulation _ Retaining Wall Approved By: , 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 Use BLUE or BLACK Ink - - - - - - - - , For Office Use C it of E t] t]jll I Permit#: Z- I I I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 RDCEIVED I I I Date Received: I Phone: (651) 675-5675 Fax: (651) 675-5694 MAIL U 5 2012 Staff: - - - - - - - - - - - - - J 2044 MECHANICAL PERMIT APPLICATION Date: o?~a~ off- Site Address: V70 7~ Tenant: Suite RESIDENT / OWNER Name: Phone:-/, ;41~> ;2 7i!:P0 -176 Address / City / Zip: CJ011 i -3:1 CONTRACTOR Name: "t? G d 4U License Address: 1490-ar- ( Q~) City: /Cpl _ State: Zip: Phone: Contact: I! ` /'jYpLD/1 Email: TYPE OF WORK New Replacement Additional Alteration Demolition Description of work: NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. PERMIT TYPE RESIDENTIAL COMMERCIAL -4Furnace _ New Construction _ Interior Improvement zAir Conditioner _ Install Piping _ Processed Air Exchanger _ Gas _ Exterior HVAC Unit Heat Pump _ Under / Above ground Tank L_ Install / _ Remove) When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $5 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) J $95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal OR Contract Value $ x1% $55.00 Minimum (includes State Surcharge) Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) TOTAL FEE 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.aopherstateonecall.ora i 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. X. x Applicants Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground Rough In Air Test -Gas Service Test -In-floor Heat -Final _ Exterior HVAC Screening Inspection i PERMIT City of Eagan Permit Type:Building Permit Number:EA151286 Date Issued:08/16/2018 Permit Category:ePermit Site Address: 4707 Hazeltine Lane Lot:1 Block: 1 Addition: Fairway Hills 3rd PID:10-25602-01-010 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 1,500.00 Fee Summary:BL - Base Fee $1500 $62.50 0801.4085 Surcharge - Based on Valuation $1500 $0.75 9001.2195 $63.25 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 - Richard E Munson 4707 Hazeltine Lane Eagan MN 55123 (507) 884-5786 Window Concepts Mn 291 Eva St St Paul MN 55107 (651) 905-0105 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA158075 Date Issued:09/24/2019 Permit Category:ePermit Site Address: 4707 Hazeltine Lane Lot:1 Block: 1 Addition: Fairway Hills 3rd PID:10-25602-01-010 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 E Munson 4707 Hazeltine Lane Eagan MN 55123 (651) 295-6937 Kat Construction Llc 8833 79th St Annandale MN 55302 (320) 266-3455 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA174110 Date Issued:12/27/2021 Permit Category:ePermit Site Address: 4707 Hazeltine Lane Lot:1 Block: 1 Addition: Fairway Hills 3rd PID:10-25602-01-010 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 E & Michelle L Munson 4707 Hazeltine Ln Eagan MN 55123 (651) 295-6937 Minnesota Rusco 5010 Hwy 169 N Brooklyn Park MN 55428 (952) 935-9669 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA177617 Date Issued:07/11/2022 Permit Category:ePermit Site Address: 4707 Hazeltine Lane Lot:1 Block: 1 Addition: Fairway Hills 3rd PID:10-25602-01-010 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 E & Michelle L Munson 4707 Hazeltine Ln Eagan MN 55123 Champion Plumbing Llc 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature