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4722 Hazeltine Lane? IN5PECTION RECORD I Control No. 0559 CITY OF EAGAN PERMIT TYPE: M'a i{ E' j"a 3830 Pilot Knob Road Permit Number: 00069?' Eagan, Minnesota 55123 Date Issued: 66 f•2 / 9' (612) 681-4675 SITEADDRESS: 1.011 2 BLOcK: 1 APRLICANT: 4172 NAdE'LT INE LAltE KRAIt";E 4REQ FAiRWAY Hlll$ 9Rp (612) 462--834:.' PERM?T PUB.TYPE: TYPE OF WORK: pEW DFSCRIPTICIN SCR. FaRGH RN DECK '? Yd"„ Ow . _ '?r ? , . J lFFNIARK!3s FtECFiPT t Bllll.[I SCRt`FNtU PflRCN i31M EXIST:iNG DECk Permk No. Ponnk Hokier Date Teleprione * S/W PLUMBING HVAC ELECTRtC ELECTRIC inepeclion Dafe Insp. CommeMa Foptings 1 Foundation Framing Roofing Raugh PI6g. Rough Htg. laul. Freplflce Final Htg. Orsai Test Final Plbg. Plbg. Irispector - Notify Plumber Cons4. Meter Engr./Ptan 8ldg. Final Deck Ftg. Deck Final J We?I Pc Disp. CASH REGEIPT . CITY OF EAGAN 3830 PILOT KNQB ROAO EAGAN, MINNESOTA 55122 DATE - _ __ ___ • 19 ? f RECErvEO FROM AMOUNT S & DQLLARS ,ao ? CASH ?T CHECK BY ? C a 16444 Whi,e-Payon ? ?`r Yellrnr-PosHrg Copy ? Pink-FileCOpy Thank You SEWEli & WATER PERMIT CITY OF EAGAN 3830 Pilat Knob Rd. Eagan, MN 55 1 22-1 897 . ' . DATE DEC 9. 1491 METER # OFFICE USE ONLY CHIP # METER SIZE ISSUE DATE SITE ADDRESS 4722 HA2ELTINE LN LOT 2 BLOCK 2 SEC/SUB FAIRWAY HILLS 3RD I APPLICANT: I CITY, STATE PHONE: , PLUMBER: R C PLUMBIIIG ADDRESS: 5910 CHESTEx AVE CITY, STATE NaRTHFIELI} Mt+1 Zlp 55057 PHONE: 461-2096 OWNER: SONS CONSTRUCTIaN ADDRESS: 4600 FAIRi,IAY HILLS DR CITY, STATE EAGAN MN ZIP PHONE: 452-5355 ZIP PERMIT DATE t2/09/91 I PERMIT # 12425 B.P. RECEIPT # `• I {? ? ?Z B.P. RECEIPT DATE 12f 09/9l PRV X 6005TER PUMP I PERMIT REQUESTED X SEWER X WATER - TAPS : _ COMM/IND X RESIDENTIAL X NEW _ EXISTING Lawn Sprinkler Meters are to be Installed ? Ahead of Domestic Meters on Water Line. 1Credit WILL NOT be given for Deduct Meters. ? _ .. J I AGREE TO COMPLY WITH CITY OF ? EAGAN ORDINANCES a SIGNATURE WHEN METER ISSUED PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR SEWER PERMITS, CONTACT ENGINEERING DEPT. SEWER & WATER PERMIT CITY OF EkGAN 3830 Pilot Knob Rd. Eagan, MN 55122-1897 ' DATE DEC 9, 1991 OFFiCE USE ONLY METER # .1?4 PERMIT DATE 12/09/91 CHIP # D?ln O 9? II- PERMIT # 12425 METER SIZE ? ?-Al uS B.P. RECEIPT # 0 16 ? ISSUE DATE L-E'2.Z B.P. RECEIPT DATE 12 09 91 - PRV X BOOSTER PUMP SITE ADDRESS 4722 HAZELTINE LN LOT 2 BLOCK 2 SEC/SUB FAIRWAY HILLS 3RD APPLICANT: ADDRESS:_ CITY. STATE PHONE: ZIP PLUMBER: R C PLUMBING ADDRESS: 5910 CHESTER AVE CITY, STATE NORTHFIELD MN Zip 55057 PHONE: 461-2096 OWNER: SONS CONSTRUCTION ADDRESS: 4600 FAIRWAY HILLS DR PERMIT REQUESTED X SEWER X WATER - TAPS - COMM/IND X ?RES X NEW - EXISTING Lawn 5prinkler Meters are to be Installed Ahead of Domestic Meters on Water Line. Credit WILL NOT be given for Deduct Meters. I AGR TO COMPLY WITH CITY OF EA ORD ANCE,S c . v K•? CITY, STATE EAGAN MN Zlp PHONE: 452-5355 S NAT R EN O ER 664 PLEKS? aLLOW TWO WORKING ?AYS ?bR PROCE5?ING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEEFiING DEPT. ,/; ..,? uEM 05118/92 -,?ip?115B 452-8342 CITY OF EAGAN , 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 LJO ?9 9 14 (; PHONE: 681-4675 BUILDING PERMIT ' Receipt ? -' To be used for 5?DWa/G/?R Est Value $i b1.OW pate ti$C 9 , 19 91 Site Address 4722 UZELTINE LA , 2 2 FATRYAY HILL5 3RD OFFICE USE ONLY Lot Block Sec/Sub. Fees Parcel No. °cc"Pa"cy R-3 M=1 183 00 R-1 Bkig. Pertnlt • zoning SONS CORST?iIlCTION N2fTle (Actual) Const Surohar e 70.50 ? Addrm 4600 PAIBidAY UILIS DQ (Albwable) V? g i-w Review Wq.op C"?,h? ??M 7jp A' of Stories - 1? Lkww O Lenglh Pf?p(16 457-5355 Depih 31L, SAC, Cily 100.00 a: Name SAME S.F. Total - SAC, MCWCC 650•00 0 S.F. Footprints p'ddress Sit O S = Water Conn Q?•? n ewage e Ciiy ZP On Site well water Meter 95.00 Phme MWCC Syslem x Acct De osit ?.? City Water x . p Lbeme # 30'00 PRV Required S/W Permit I hereby acknowlege that I have read this application and state that the Booster Pump S/yy Surcharge '50 inlormafion is correct and agree to comply with all applicable State of M S 2T? ? innesota tatutes and City of Eagan Ordinances. Treatment PI ? Signature of Permitee ? r:^ APPflOVAIS Road Unit 370•00 A Building Permit is issued to: SOliS CONSTRUC'I'ION Plan^ef - Park Ded. on the express condition that all work shall be done in accordance with all Council -- applicable State of Minnesota Statutes and City of Eagan Ordinances. g?, pff. _ Copies V ri n e 3. STa?? Building Official ? - e a c - TOTAL PermK No. Permit Fiolder Date Tekphone # %W o? Of d / 9 ? Pu)MSir,G i/3 9? ?/;?09G HvAC - ELEc,Ri Td YG ELEcTRic awpecn«, o,ne insp. comaw,a Foofings I "211UIJ-l Foundati«, ?3 i uJ Framing Fioofing R-Vh Plbg. "kC A1 Rough Htg. ? t.??_ • I5ul. I'f-Z ? a FrepLaoe Final Htg. Orsat Test Final PI6g. Plbg. Inspector - Notily Plumber Const. Meter EngrlPlan Bldg. Fmal oeck Ftg. Sr4 9z Dedc Rnal wai Pr. Disp. I v'?,,C{TY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: ? .?rI 1 rNC: i.AMr i r1 1 i. l-! ?? ?' ,! 1 E l I•. t!t h PERMIT;SV.BTYPE: ?qi?I :141ati-. ? APPLICANT: ;, .. ( ?-`? 1 1 It9.', I °+6+?1 TYPE OF WORK: t'l i .. i i 1 i i'i.l AI It FiAI ][!PF IrrVI A ( f r- A1:) () V 0 r)1 F: fiM i tJii st f 1 }yI, iAN F?EV1f=6J[•I1 I{'J 411 ! AfIpIM`.. :tii. t 44 f.? ,'8 :10 y<r I i A U rrsrar; iI r r l L I t rrDl•, ? ? .._..r 3ay?7 Permit Holder Date Telephone # PLUMBING H VAC Inspection Data Insp. Comments 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 DOMESTIC AAETER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDFOSTATIC TEST BSMT R.I. BSMT FiNAL DECK FTG (J DECK FINAL .?., _ . ?, . . ? ? x v.krr#tf rra#t o# (Orrupauzy Citp of Cagan iorparwuv# n# Wwwag itcvertinn This CertiJuxrte issued pursuanl to the requiremenls of Se+ction 306 of the Uniform Building Code aertiflM8lhat at the lime of i.rsuance lJris a7ructure wru in rninpliairce with the viarious ordinmrces af the [}[y regulaiing building cont?Gruction or use Foor tJre jollowiag.? u. a.r..c. -SF 17WG/GAR eue. eawk rrm 1946 o-m,,Xr ry* R3/M 1 Zming o&r;a ri Tyrxcom VN POST IN A CONSPIWOUS PLACE i?/?17/F/ J (18661 REQUEST FOR ELECTRICAL INSPECTION ? See instmctions (or completing tbis form on back of yellow copy. "X" Below Work Covered by This Request EB-00001-08 ?. . ew Add Rep. TypeofBUilding AppliancesWired EquipmeniWired Home Range Temporary Service Duplex Water Heater Eleciric Heating Apt Building Dryer Other (Specity) Comm./Industrial X Furnace Farm }{ Air Conditioner Other (specily) Contractor's Femarks: Compute Inspection Fee Below: # . Other Fee # ServiceEnirance5ize Fee # Cirouits/Feeders Fee Swimming Pool 0 to 200 Amps ta 100 Amps Transtormers Above 200 _ Amps e 100 _ Amps SIgfIS Inspector's Use Only: /1 i 7pTAL ' Irrigation Booms .O $ 6 5. 5 0 Special Inspection ? AfarmlCommunication DISCONNECTED IF NOT THIS INSTALLATION p6l 1 Other Fee , : COMPLETED WITFIIA 18 MO I, the Electrical Inspector, hereby if R°°9n-in L oate f 7 p, 1 ot cert y ihat the above inspection has been made. Final oate OFFICE IISE JNLY ThiS lBquBSt vp? 18 TOItlh6 flOT ?6' 5,c-z6 s J 0 66 ? ? Request Date Fira No. Rough-in I io 12 / 2 3/ g 1 RequircH? ? HeaOy Now io Will Notity Inspector Yes p No When Featly9 IU licensed conhactor ? owner hereby request inspection of above electrical work at: Joo Aaaress (SimeL Bav ar Route No-) Ciry 4722 Hazeltine Way Eagan n No. Name or No. Rarge No. Courily ! ? Dakota Occopant (PRMT) Pliorie No. Sons Construction Co. 452-5355 Pawer Supplier qdtlr¢;,s Dakota Electric 4300 220 St. W., Farmington Elecmcal Comracror (Company Name) ConVaclaS License No. Joos Electric Co. AM01895 Maiiing Atlaress ICoMranor or pwner.Maxing Installationl 2104 Great Oaks Drive, Burnsville, MN 55337 Aurtrorizetl SignaWre ICon[raclonOwner Makin stall ion? Phomre NumGer - -- ?'431-4755 MINNESOTq STATE BOAHD OF ELECTqICyi Y / C Griggs-Mltlway BWg. - Xoom S179 1821 Univeraity Ave., 51. Paul, MN 55104 Glw. (612) 642-0600 • THIS INSPECTION REOUEST WILL NOT BE ACCEPTEO BY THE $TATE BOAPD UNLESS PROPEF INSPECTION FEE IS ENCLOSEO , DATE: DEC 9, 1991 RE: 4722 HAZELTINE LN (SONS CONST) X Your Sewer & Water Permit for the a6ove property has been completed. It wilt be held at the Public Works GarBge (3501 Coachman Road) until the meter is picked up. BE SURE TO CALL PUBLIC 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 be 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 BY LAW. CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. Address: 4722 HAZE[,rIIM IANE I,ot 2 Blk 2 Sec/Sub FARIWAY HI7S.5 3RD These items were/were not complete at the time of the final inspection. at : 2/14/92 Yes No Tnsppcfnr- Final gradt (6" from siding) ? Permanent steps - garage Permanent steps - main entry L/ Permanent driveway ? Permanent gas Sod/seeded grass p? Trail/curb damage t? Porch L/ Basement finish ? Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of vater supply to the outside lavn faucet before freeze potential exists. 101?j ?a .ECmmwnn White - City copy Yellow - Resident copy Pink.- Contractor copy • CITY OF EAGAN ???? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 f1O ? 9946 PHONE: 681•4675 ? u ' /6 ,r/t/{/ BUILDING PERMIT Receipt # ? ' y To6eusedfor SF DWG/GAR Est.Value $141,000 Date DEC 9 , 1 Sile Address 4722 HAZELTINE LN Lot Z Block 2 Sec/Su6FAIRWAY HILLS 3Rl Parcel No. N2me SONS CONSTRUCTION z Address 4600 FAIRWAY HILLS DR ? Cily EAGAN Zp Phone 452-5355 2 O ?Q U Nazne _ Address City _ Phone _ ? Zp I hereby acknowlege that I have read this application and state ihat the iniormation is correct and agree to comply with all applica6le Stale oi Minnesola StaNtes and Cily of Ea49n Ordi pnes Signature of Permitee A euilding Permit is issued to: SONS CONSTRUCTION on the ezpress condition ihat all work shall be done in accordance with all applicable State of Minnesota StaWtes and City ot Eagan Ordinances. Building Oflicial OFFICE USE ONLV FEES occupancy R-3 M=1 783 00 Zoning $=1 Bldg. Permil . (Actual) ConSt V=N Surchar9e 70.50 (Allowable) V=N Plan Review . 509.00. # ol Slories - Length 5?5-' Licensa ' Deplh 3B I SAQ City 100- nn S.F. Tolai - SAC, MCWCC fi So _ nn S.F. Faotprinis - C 660.00 On Site Sewage - Water onn On 5ite Wel1 - Waler Me1ar 95.00 MwCC System X 30. 00 Ciry Water -X- acct. oeposit PRVRequired SN/Permil 30.00 Booster Pump X S/VJ Surcharge • 50 7reatment PI 276.00 APPROVALS RoadUnit 370.00 Planrier - park Ded. Council - BIdg.Olf. _ Copies Variante - TOTAL 3.574.00 (?? 6q(. 2005 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. X/N- P-- Date HOFFMAN, MELISSA 4722 HAZELTINE LANE Site Street Address Ufllt # EAGAN, MN 55123 (651) 681-1461 Property Owner ielephone # ( ) NORBLOM PLUMBING CO . contractor Telephone #( ) Address City State Zip MINNEAPOLIS, M N ?5540? The A licant is: O ? _ pp wner ontrac or Other Alterations to existing dwelling $ 50.00 _ Add plumbing fixtures (excludes water softener and/or water heaterv-complete next section if installing these appliances). _Septic System Abandonment ' _ Water Turnaround (add $125.00. if a 5/8" meter is required) _Other. _ Water Softener X Water Heater $ 15.00 _ new ? replacement. _ Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 SWte Surcharge $ ,50 Total $ IS. SO 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 approved. _Je4 K)orblam ApplicanYs Printed Name Ap ia s ignature IlJ ?i ?? ?? L i11 MAR 0 2 2005 ? L? ?o -j -)-, RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55722 651-681-4675 New Constructlon Heoulrements . 3 registeretl site surveys showing sq. h. of (at, sq.1t. ol house; anditl,t roofed areas (20% maximum bt coverage allowed) • 2 coples of plan showing beam & window sizes; pouretl founC Oesign, etc.) • 1 set of Energy CekwlatWns • 3 copies of Tree Preservation Plsn tl hi plattetl aflar 7/1/93 • Run JoW Detail Optbns selection sheet (bbgs wim 3 or less untts) DATE r) ^ ? - O ?)? BemodeNieoe'u Requlrements • 2 cop'res of plan . 7 sel W Energy Cakulaibns for heatetl additbns • t slle survey for e#erior add'Abns & tlecks . InGicate'rf home servad by septic system tor addffions VALUATION SITE ADDRESS -0-191a' kP__ii-,i_Q-- ? MULTI-FAMILY BLD6 _ Y )(- N TYPE OF WORK ?.SL? M- FIREPLACE(S) _ 0_ 1_ 2 APPLICANT k 54kA_e:, STREETADDRESSB a6 C'l U-rrnwa.-I C) 1 CITYEckkcyw-- STA*AK) ZIP TELEPHONE #GS I qJD 193?CELL PHONE # ? FAX 'f ?oSI ?LI> 2L U0 PROPERTYOWNER Q_)*'1061V? TELEPHONE#05 ( 9ct4 (DcrgL? ----------------- ------------------------------------------------------------------------- COMPLETE THIS SECTION FOR %%NEWa RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672 submission type) • Rasidentiai Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Su6mitted Plumbing Conhactor: Plumbing system includes Mechanical Contractor: Mechanical system includes: Sewer/iNater Contractor. _ Air Conditioning _ Heat Recovery System Phone # Phone # --- ° ----------° ------------- • -----°---°° °.- °-----° ---------------° -------------° I hereby acknowledge ihat I have read this applicaTion, state that ihe information is with all applicable State of Mlnnesota Statutes and City of EpgqK_0t?linances. / Signalure of OFFICE USE ONLY _ Water Softener _ Water Heater _ No. of Baths Phone # Lawn Sprinkler No. of R.I. Baths Fee: $90.00 Fee: $70.00 and agree to comply Certificates of Survey Received _ Tree Preservation Plan Received _ Nod-Mq uired -- Updated 4/02 OFFICE USE ONLY O 01 Foundation O 07 OSplex 0 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Owelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) 0 31 Ext. AI[- Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext. AR - Sf ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (SCreened) ? 36 MuIG ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Stortn Damage ? 06 04plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair O 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Wlndows/Doors ? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout W applicant Valuation Occupancy MCIES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bidgs Length Fire Sprinklered Type of Const W idth REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tesu _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final _ Windows (newheplacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storege S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Building Inspector INSPECTION RECORD CITY OF EAGAN PERMiT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITEADDRESS: LoT: 2 eLoCK: 2 APPLICANT: 9722 NAZELTINE LAIiE KRAUSE FAIRWAY HILLS 3R0 (612) 462-8342 PERMIT SUBTYPE: SF PORCk TYPE OF WORK: DESCRIPTION Control No. 0559 BUILDING 000692 06J02/92 6REG ItlEW SCR. PORCH ON DECK :`._.:,RE.MARKS: RECEIPT N BUIID SCREENED PORCN ON EXISTIM6 DECK PERMIT C°nt °"°. 0559 ? CITYOF EAGAN 3830 Pilot Knob Road PERMIT TYPE:.. euiLoYNG Eagan, Minnesota 55123 Permit Number: 090692 (612) 681-4675 Date Issued: 0 6/ 0 2/ 9 2 SITE ADDRESS: 4722 HAZELTIPIE LANE LOT: 2 BIOCK: 2 FAIRWAY HILLS 3RD DESCRIPTION: SCR. PORCH OM DECK Building Permit Type SF PORCH ... Building`Work 7ype NEW Building Length ,11 Building Width.\ 14 ? ,? {??'i'? ?i?J(? ?i, v'.-- i_i ... _ %, _.. REMARKS: L u 1l1 I L;' RECEIPT M BUILD SCREENED PORCH ON EXISTING DECK FEE SUMMARY VALUATION .. ;q,900 8ase Fee $63.00 Surcharge E2.80 Total Fee =66.00 CONTRACTOR: OWNER: - ApRlicant - KRAUSE GREG 4722 HA2ELTINE LANE EAGAN P1N (612)952-8342 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 Mn. statutes and City of Eagan Ordinartces. L ? s,il I r1t.N T/PE MF? ITE SI RE ISSUE81'. SIGN ATURE glAPPL14CA' PEwMIT r CITY OF EAGAN 1992 BUILDING PERMtT APPLICATION 681-0675 ? 6 s-0-o e?? ZG' SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2•sets of architectural.3 structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which re uest is made r lot chan e is re uested ance ermit is issued. Date ? / aQ! / y,-?- Valuation of work Site Address: SiREET STE i Tenant Name: (commercial onty) D7 a? BLOCK Descri tion of work:6C?Y'eein ;r,c 'a J e, The applicant is: Owner ? Contractor ? Other (Deseribe) Name Q7 f-Bo, Phone ''??o? R3?-Z Property LAST FIRST Owner Address ?a? 4?/)e_ ?n . STREET ' STE A . City State {Y11'? Zip _e???loa Company Phone COntI'8Ct0r Address License # Exp. City. State Zip Company Phone Architect/ Engineer Name Registration # Address City 5tate Zip Sewer & water licensed plumber . Processing time for sewer & water permits is two days once area has been approved. 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 Minnesot'a Statutes and City of Eagan Ordinances. ?-? Signature of Applicant: ! L-le ?J V OFFICE U5E ONLY BUILDING PERMIT TYPE ? Ol Foundation ? 05 Apt. Bldg O 09 Basement Finish ? 13 CottenJInd Hew ? 02 SF Owg. ? 06 Garage/Accessory ? 10 Swim Pool ? 14 Comm/Ind Add 0 03 Two family ? 07 Fireplace ? 11 Res. Add. ? 15 Coam/Ind Rem ? 04 Multi-fam. T.H. ? 08 Deck 0 1 Res Porch 0 16 Public Fac. . ? 11 Agricultural WORK TYPE e31 New ? 33 Alterations ? 35 Move ? 32 Addition ? 34 Tenant Finish ? 36 Demolish GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System 4Gr (Allowable) lst F1. sq. ft. City Water UBC Occupancy 7Z?K7 2nd F1. sq. ft. PRY Required Zuning Sq. Ft. total Booster Pump t of Stories Footprint Sq. ft. ' FSre Sprinkler Length li- On-site well Census Code 934I Depth t4, On-site sewage SAC Code APPROVALS . Planning Building 2 ?, 11z Assessments Engineering Yariance REOUIRED {NSPECT{ONSgu1c.p S?n?n`?eca-( oH ?Exds?Jt?6 ??? ? Site ? Footing ;0L Framing ? Insulation ? Yallboard P4Final ? Draintile ? Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City 5AC Mater Conn. Water Meter Acct. Deposit 5/W Permit S/W Surcharge Treatment Pl. Road llnit Park Ded. Trails Ded. Copies Other Total: (j,j. o eD valutim: s v ? . 2.00 !1 xly? 15y? SAC % SpC Units CITY OF EACAN CASH7:ERz S TERMINA!_ M0: 795 DFll'E? 0E3/26/3£3 rInr_: 15e43se7 zD . NIAME: SAU...Y A HOEVEN 3210 3001 4722 FfAlEL..TINE 40.25 205 3001 47c^2 NAZF.I_T'INE O.E,O Tota1 Receirr, Amount: 40.135 Cfi09f:,696 USER IDa M1lANCY FERMIT CITY OF EAGAN 3830 Pilot Knob Road ? Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: i P.I.N.: 19-25602-020-02j PERMIT TYPE: Permit Number: Date Issued: 4722 HAZELTSNE LANE LOT: Z BLOCK: 2 FAIRWAY HIL45 3RD DESCRIPTION: REPLACE & Bu,kr1¢1nq:,-,Permit Type Build'ing W'ork Type `G'et5sus C'ode ` , ? ..?;. AOD ROOF SF PORCH ALTERATION. 434 flLT. RESIpEN7IAl BUILDING 032997 08/26/9$ t ? . .... ?=? . _ . REM?W REVIEWED BY BILL RDAM5. CALL 445-2840 REGARDING ELECTRICAL PERMITS AND INSPECTIONS. FEESUMMARY: vaLuArzoN $1,20e Base Fee $40.25 Surcharge ? $.60 Total Fee $40.85 CONTRACTOR: OWNER: - Rppilcant - HOEVEN DAVID 9722 HA2ELTINE LANE EpGAN MN 55123 (651)405-1904 Y hersby acknpuledge that I have read Chis applicaCion and stats thafi the infiormation is correct and agree to comply with all applicable State of Mn_ Statutet. and Citq af Eaga'n fIrdfnances. APP I ANT/PERMITEE SIGNATURE SUEO BY. SIGN? " (_)S ?1998 BiTXZDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAC}AN ? - / 3830 PII.OT KNOB RD - 65122 681-4675 New Construetion Reauiremenls RemodeVReoair Reauirements ?) ?y_? `j •?? " 1 ? 3 registered site surveys 4 2 copies af plans (inUude beam 8 wirMow sizes; poured fnd. tlesign; etc.) 1 1 energy plculations • 3 copies of tree Dreservation plan if lot platted aRer 7/9/93 requireA: _ Yes _ No DATE: rDJ(d _ IVO 1%70 DE 7CRII ION OFWORK: 19C9, FP 'F C. DDRESS: ???? 1JCl Z Q? Vl ? 2 copies of plan ? 2 site surveys (eMerior add'Rions & decks) • 1 energy calwlations for heate0 adtlRions CONSTRUCTION COST; 1t em LOT: _ ?_ BLOCK: ??_ SUBD./P.I.D. ?(3 %Y/,r 1(;r U !77 //j -,?? Name: HOG V eDa ?/lC] •' ?? ll(iJ Phone #: q6S-l/ D'7 PROPERTY Lssc ? Firsc oWNER Street Address: y-7a,,) I-kze%?n,e L n - City State: Zip: 55IQ3 Company: e)Gl.?1?._p Phone #: CONIRACTOR Street Address: License # City State: Zip: ARCHITECT/ ENGINEER Company: Phone #; Natne: Registration #: Street Address: City State: Zip: Sewer & water licensed plumber (new construction only): and lot change is requested once permit is issued. I hereby acknowledge that I have read this applipBon and sfate that the Siate of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Penalty applies when address chang is correct and agree to compty wRh all applicabi &': i Tree Preservation Plan Received _ Yes - No _ Not OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dweliing ? 07 4-plex ? 03 5F Addition ? 08 8-plex 14 04 SF Porch ? 09 12-piex ? 05 SF Misc. ? 10 _-plex WORK TYPE ? 31 New Z_ 33 Alterations O 32 Addition ? 34 Repair GENERAL INFORMATION ? 11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? ? 15 Deck ? 36 Move ? 37 Demolition Const. (Actual) Basement sq. ft. (Allowable) Main level sq. ft. UBC Occupancy sq. ft. Zoning gq. ft. # of Stories sq. ft. Length sq. ft. Depth Footprint sq. ft. APPROVALS Planning Building JLL 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Misceilaneous MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Engineering Variance ? ? Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: Valuation: $ 4200 % SAC SAC Units CONSUlTINO fNOINEERS ?`?v'L'? ?v.??•???° ?a • 49/ _Q.Q? PIONNEHS ond LpNO 3UflVEYOflf ?'3876 ENGlNEERING BK. ?66 . 3s XX COMPRNY, INC. ? 1000 EAST 1461A S7ftEET, BURNSVILLE, MlNNESQTA 56337 PM ?32'3000 , CERTIFICATE OF SURVEY Legal Description: ?arz ,azoc.,e z FA1RW9Y 1114tS 320 _ADDiTioN, O4&07-W COU.t/TY /Yl/NNESOT/f. (L3,,?_) DENOTES EXISTING ELEVA7{ON pENOTES PROPOSED ELEVATION INDICATES DIRECTION OF SURFACE DRAINAG 1o3a, 33 = FINISHED GARAGE FLOOR ELEVATION . ozs. = BASEMENT FLOOFi EIEVATION • -- 1033. bb n TOP OF FOUNDATION ELEVATION scnLe : r • sW I 9a.oo ?ozi s0 z ¢ a u] '. Z N ? ID ? I ? /? ?L,-? ?,l?? L_ ? IL,0 .T\2- ?11 I \ ? o ° ? ? t-- ` I D I ? 10 i ...,? ? s ao 1 PRo posED HouSe ? ifr4R46E M ? r „ ?- o b. 4RRoOi 70.00 ?- ? HP?ZELTINE ??iy IP ?vrck wl ?fGI ??Cle2 ? ? , °? ? Po?ch Cdee,?-? r?ll 6? •- ?0,33 ,?,t-, d`ru,?, ?ra?.?? I he7ceby certiPy that this is a true and correot repreaentation oP,u?tra? land as ahown and deaoribad hereon. As prepaYAd by me this ?_ dc /1f0YFiifQ?P , 19,91 Minn. Reg. No. 136G. • CIO jp"O , ? DRAINABE AND UT/L/TY EASEMENT ? O n ? \I ?v N?B 6tEV. 30 f7,' fROrVT BU/GO/M6 i=jo33.a5ETdAC.e L/NE Q6 I s ? o LA1VE, - ------------------------------------------------------- -? ----.------ --^----,_....___._., , u•a ??. ? 78s•oo+ `?o•?o? ? ?? 3 • u ;? ?2, 211•50+ 51 514•J:1-? 7r33•u0; `lJ•!5UF 503•U0+ 2,211•50: 3; 574•00-l 1991 BUIIDIAG?? APPLICATION SINGLE FAMILY DWELLINGS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS 1 SET OF ENERGY CALCULATIONS CITY OF HAGAN It[TLTIPLE DSJELLINGS 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 CALCUTATIONS 1 SET OF ENERGY CALCS _# OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY IAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADORESSES FOR CORNER IATS - CONTRACTOR/HDMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING 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 Be Used For: ,.r -e Valuation: ? Date: //- 2- ' - // Site Address q'7 aa NAze L714-le tA) Lot 2, alock 1- Parcel/sub r'-A//Lw4'1 ALL, 3 f Owner ? f Address A-L6 bIL- City/Zip Code e4 i .y rJ Phone S3!'r Contractor Scp, J J'T Address -146G City/Zip Code 'f? Phone y S 2- $? S S? Arch./Engr. Le c- Address yG G G FA/{LL,it?/ y,4ZI City/Zip Code OFFICE USE ONLY l °ll,ono- Occupancy R-3 M -I Zoning K' I Actual Const V-N Allowable V-N # of stories Length 4-50 Depth 3$.UD S.F. Total Footprint S.F. On site sewage_ On site well MWCC System k7 City water Z PRV Booster Pump APPROOALS _ Planner Council Bldg. Off. (! "?-Z S/OS Variance FEES Bldg. Permit V53,00 Surcharge O SD Plan Review J 509,0 SAC, City /oD,O? SAC, MWCC b'St)•vJ Water Conn. k6 0 10 0 Water Meter 95,00 Acct. Deposit 30,a0 S/w Permit 3 a,vo S/W Surcharge _ so Treatment P1. qb po Road Unit 3 F) O,ms) Park Ded. Trail Ded. Copies SIIBTOTAL Penalty Lot Change TOTAL Phone # 'y 5-.? - S? SY Se e• T c d Contr._1?• ? /j/n??. "-? agrees that all work shall be done in accordance with (Sign t e of Contractor) all applicable State of Minnesota Statutes and City of Eagan Ordinances. _ . . vALT4 I mol ?aszA(zg-. 7y k Zz?l2; Syb ?C 15 ?`?/oJ ASN?T, . 3z x Za? $?` ?3Klc??. 13u ? ?- l?Z6X 1436(4 1'lu`'S'e- _ I5T g?m-r ??oz G Xs3 = 5eq 3 r7 B t, wv Fwo? Iq?2K /206 k53= 63,91q- I ya,r76o mw? ly)/OoJr A.. , CONSUITING EN31N8ENi PINNNlBf cnd LANO fYflVBYORf NGINEEtiING COMPAN4, INC• ? 1000 fASY 148M STREET, 9WtNSV1LLE, MtNNESQTA 55737 ?yG?t/J Go.?/? •?? ?... . . ?-.. ?3876 • ?? ?• ? PN 43Za3000 CERTIFICATE OF SURVEY Legal Description: /-orz &ocx z FA1Rj' /via?s 32D ADD1;r1oN 0•4.C?9T.4 COU.t/TY ryli.t/NFSOr?F (Lsi,?_) DENOTES EXISTING ELEVATION ,. DENOTES PROPOSED ELEVATfON r- INDICATES DIRECTION OF SURFACE DfiA1NAG /033.33 ? FINfSHED GARAGE FLOOR ELEVATION oz . 62 = BASEMENT FLOOR ELEVATION • ,- 1033. bb = TOP OF FOUNDATION ELEVA710N SCALE : 1" ? 30' . . . Im? yl z d a w' z r.a N' Q x L / 89° 90.00 ?A2). 5?+ . I i? } ? L.D.T\Z I I \ I. ? ?. h •--- -- ,3,?, - ? ?o o: E $ $ I ?o'3a j•j /9.0o E ?I 22.50?? PRoPoBE? ? I ? I 8. Hcru.? ,64946a.&:I R ? r-- - a? !0 h ?`I ? cR ? aol fl % \?R;E'_ B9°/3'¢/jE HAZELTINE 44f97-4, 1??- 3) R . '' By Date -- OOST PUMP EAW^A1tiT EIVC?';NEERING DEcT I hexeby asrtify that! h? s a true and correct raprasentation oE,a trac land as shown and dascribed hsraon. Ae prepared by ms thie /87°`? dt /lIDY?! p - i 19q/' Minn. Iteg. NO. /.iba (2,1440.?q , p9A/n1A6E AND uTiurY =4sE41&vr 'q?. o? . 0 `v NU6 6fBv sjosH.87 30 f'T. fRONT Bv11D1N6 SETB9CK L/NE . $ M . .. ......_..,.,.? . . ? .?.r s.. ----------------------------'----"--""-'--"'-'-'-"-'-'-""'-"------ ""-: '--'-""""'-" I EXTSRIOR.BNYEI:OPH HNHBGY CODB CO6IPIITATION i90RKSHB8T 'ib Determine Ompliarice aith the Minnesota Fhergy Oode (Sectim 502 of the Statie Amendea 1983 Model EercAr Code) Project Title Kralpe [IWe. -k'ImTs variatiai Sit2 Add!!89 4722 Hazettine Lare I. EXPOSED WALL CALCIILA7ION8 ABR °EJ" VAIi1E ARF91 X "IJ" A. Opaqt]e S+Ta]l • 1. Masonry/Concrebe ' a, x • b. x ? c. x ? 2. Fourxiatim Wa W)ove-Grade) a. (cZ . 25 x .01 = .11 b. x ¦ 3. %bod Frmoe WaU a. Imlated Atea 15 tfi x?_ ? 103.44 b. Frdming Area (Ave. 158 at 16" x) 401.1 x Ao ? 4e .'i 1 C. FLemlflg Aies (AVe. 10$ dt 24" OC) Y a 4. Perioherai Floar Edge/Rim Joist a. 220•O x _ .04 b. x ? B. Glazing 1. Windaas a.??Uf1?_E ilcjwl4a LO1.J E? 31a5 x.38 ' 136•l b. 6" Dl 65F-, ?i? 40 x . A-'i a t A. 0 2. Doors x ? C. Doors 1. wbod d. SOliCI ?12.[??S'f TSM ? - ? Y •O(D ? 1 • Z b. With Stacm X ° 2. Metal x ' 3. Overhead x s 4. OthEI ? X s D. 'POTAL WAIL ARFA, sq. ft ..................... ZJIlB E. TOML of At?'A x"U" ......................... .......................... 250.Q'° II. SOOF/CEILIN(3 CALCULATIONS A. iaoof/bel3,ing Dsulated Area J?14- i.0 : .DL • ? B. Roof/Ceiling Framirg (Ane. 158 at 16' oc) x ¦ C. Roof/teilirg Framing (Ave. 106 at 24" oc) 11q,A: x .BZ ¦ 3,5a D. Skylight 7c • E. TOTAL RooF/CEu.nG P,xEk eq. ft .............. t 9 F. moMw CF rM xT• .................................................. 35 • 87 m. svu.DnNa sxvsr.ora xEQuMENOrrs TWy AMA ngUnM `Q` ALLOWABLB (Fnam I.D & II.L+) (From V.) • (Acen % "[J") A. Exposed W.1: 2119) x, .1 I ¦ •? 8 8. Roof/Ceilirg: ?94 x ,'nz.co C: TD'ML }YLLl1fME HUIIDIING IIVVII,OPE ('lbtal of A i$ above)... 34-5 • l02 IV. ACTQAL SIIILDINti BNYBLOPB ACTUAL (Area x "U") A. Exposed Wall (From I.E) 56 «.O, B. Roof/Ceilirg (PYam II.F) ??• a' C. z+omp,t ac.'EMr. avannaG ERvgM ('roral of A& B) ............ 33 •(Neets eode nqutrwnu tt las tJa iII.c) V. REQUIItSD "0" YALQE$ p?LI3 I?+'?CEII.ING Detacriea orn ard two family dwellings .71 .026 * Miti Family Residential euiidiriJa .238 .033 (3 staries a lesa in heigdt) * All Other Oast=uction 7)pea (3 s0ories ar 1ea8) .238 .06 + all Other Constructian Types (More than 3 staies) .28 .06 • Based an 8007 AeatiA9 deYm d4Ys (Pp1s/St. ftni) Adtust mO• va1ues aceordieqly for otAer laeasian i hereby certify that i have oapleEed the above in?ODastian end :l?at dt oanplies with tht Minnesota Stabe EnPxgy/ \ _ ri BCSD 3-89 cr-snT/6574 _ C:L7Y f:?F I:AI;;AN f'ta;aN7:Fli: ,la i"L-"fiMINAI N(]e_ 692 UA'TE:: 09/1.0!99 Tlhf[:; 10::1.1.; ;3 iD: NAHL:, f'INI_EY ANLI 5ClN5 ;iiW 9001 472i3 HAZELTINF.. 139.25 ?_1'0`SS E)0(11 4722 IiATE1...TINI': 3.50 To+,a1 Iteceip+, Amouni;:' 142.75 CFi:i.1::7>063 ' USE:fi .T.Li: :7APd 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) ? CITY OF EAGAN ? 3830 PILOT KNOB RD - 55122 651-681-4675 New Consfruetton ReauhemeMS Remodel/Reoalr Reaulremenh ? 3 regiafered sMe surveys showing sq. ft ol lot, sq, fl. of house ond atl wofed areas (40% maximum bt covemae allowed) ? 4 coples of plans (ahow beam R wMdow skes; poured (nd. design; etc.) ? 1 sei of energy colculations D 9 cop of iree presenatfon plan H IM plaMed aker 7/1 /93 DATE: Uzkedn ?O DESCRIPTIO F WORK? /jA , ±JU ' 9 1 copies W plan 1 set of energy cakulatfons tor heofed addBloro 1 sBe survay for exterior addiFions d decks CONSTRUCTION COST: 4 D ? STREETADDRESS: '-`-'I z,/ ?-?g- f Z" 4 LOT: I BLOCK: a SUBD./P.I.D. #: Name• ? ne PROPERTY OWNER Sheet Address. /•-? ? City State: Zip: Company: ?? . Phone #k? ?? s f ?- (3tea code) CONTRACTOR /h? ? • ? Sheet Address: SLicense # Exp. City ???Q? State: Zip: !??()/ ARCHITECT/ ENGINEER Company: Name: Telephone #: area code ( ) SheeR Cffy State: Sewer i water Iicensed plumber (reavired for new conshuefbn onlv): _ ? PenaNy applies when address change and lot change is requested onee I hereby acknowledge thaf 1 have read this applicaNon, stale that Ihe Sfate of Minnesotn Statutes and Cify o1 Eagan Ordinances. Slgnature of OFFICE U5E Certificates of Survey Received _ Yes _ No Regisfrafion #: _ Iip: luued. s correct, and oaree, Tree Preservation Plan Received - Yes - No - Not Required OFFICE USE ONLY . . ?, BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling O 07 5-plex ? 12 12-plex ? 17 Garage ? 22 PorchlAddn. (4-sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex 0 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex O 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? OS 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE ? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 SidinglSoffits/Fascia ? 32 Addition ? 36 Move Bidg. ? 40 Gas Insert ? 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair ? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof * Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning Basement sq. ft. Main level sq. ft. sq.ft. sq, ft. sq.ft. sq. ft. Footprint sq. ft. Building Census Code SAC Code No. of Units No. of Bldgs MC/ES 5ystem City Water Booster Pump PRV Fire Sprinklered Engineering Variance Permit Fee Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: Valuation: SAC Units °!o SAC PERMIT #?0440 ?? . cirir oF eaGaN 1992 BUILDING PERMIT APPLICATION 681-4675 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 capy of energy calcs. COMMERCIAL 2 sets of architectural.& structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies when typinq of permit is requested, but not picked up by last working day of month in which re uest is made o lot chxn e is re uested once ermit is issued. Date J' //'/ /q'_7' Valuation of work # UCW Site Address: tllZa 1{a5P1)4KP Z"e 94ar 4,# 4-0 .Q/or/e.2 At<&1e"Ali;{s 3o.4' STREET STE # Tenant Name: (commercial only) Lar ?Z I eLac 3E wso. ?.. I.D. v.r Descri tion of work: The applicant is: Owner ? Contractor ? Other (uescrine) Name nY&tSe- ?7P'Ca Phone Property LAST FI a T OW?,er Address L17aa C Id- ?XP1-bilQ ZAx-'e_ STREEi STE N City State ? Zip S-51i 3 Company Phone Contractor Address License # Exp. City State Zip Company , Phone Acchitect/ Engineer Name Registration #_ Address City State Zip Sewer & water licensed plumber . Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all a 'cable 5 ate of Minnesota Statutes and City of Eagan Ordinances. f? Signature of Applicant: OFFICE USE ONLY BUlLDING PERMIT TYPE p OI Foundation ? 05 Apt. Bldg ? 09 Basement Finish ? 02 SF Owg. ? 06 Garage/Accessory O 10 Swim Pool ? 03 Two family ? 07 Fireplace O 11 Res. Add. 0 04 Multi-fam. T.H. 0_08 Deck ? 12 Res. Porch WORK TYPE ? 31 New ? 33 Alterations ? 35 Move ? 32 Addition ? 34 Tenant Finish ? 36 Demolish . ,,.. ? 13 Comm/I?Neww y ? 14 Comm/Ind Add ? 15 Comm/Ind Rem ? lfi Public Fac. ? 17 Agricultural GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (A1Towable) lst F1. sq. ft. Lity Water UBC Occupancy rz -? 2nd F1. sq. ft. PRV Reqaired Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. ll Fire Sprinkler sus Code ? Length a', On-site we Cen Oepth 14 On-site sewage SAC Code APPROVALS ? $ - ?' Planning Building Lis 9?D5 Assessments Engineering Variance REqUIRED INSPECTIONS ? ? Site Footi ng ? Framing ? Insulation ? Wallboard ? Final ? Draintile ? Fireplace Permit Fee reiuocton: $ Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit 5/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % I SAC Units A0 t3E CpNSULTINO EN41NEEfli PLBNHEBS ond LpND fUpYEYOAS CNGINEEAING ' COMPANY, lNC. ? 1000 EAS7 1161b STREET, BURNSVILLE, MINNESQ7A 56337 -*3d7b. 0/ BK. /6B ?W. 35 aH 4ax-aooo CERTIFICATE OF SURVEY Legai Description: Lorz glulc,e Z FA/Rl?/9)' f1it.?S 32D '9aD17zorV OAKo7'.4 GOLiNT1? ?'1/NNE?'U7sf (L3i,,?_) qENOTES EXISTING ELEVATIpN DENOTES PROPOSED ELEVA710N INDICATES DIRECTION OF SURFACE DRAINAG /033.33 = FIN{SHED GARAGE FLOOR ELEVATION ozs. - BASEMENT FLOOR EI.EVATfON - ? /03-3-66 a TOP OF FOUNDATION ELEVA710N SCALE : 1" - 30' nol Ipl .v z d wa w ? \ Z,r °o N y ? x D' u (Ioz7. a) 99° 13 4?027S'J ,r/nZ6_?? 90.00 ?_027 5? 4) ? 10 j ? L,OT?? I ? I ? 1 I ? (?028. )GWruwr i%o28^,' wavonw' I •-__ riozs.s?. ?3•?' I ? PRoPosED i zz.so hauW 169R4W ?30.50 3 t--' o 10 09A1N46E AND uTicirY g54seM61v7' 0? . ?. ?1 ? O ? ` h I fl ?v Q I L2.5o 03'.33 N/03.9 87 10 ?03/. o_ . ? . jas3o) oN ? 4i °p ?0•?! - I` 1 i1'PZ?i.A IIi'YI !' ?az96?'+ loi9?? 30 fT. FR4N7 9U1GO1N6 . 5ETP9CK L/NE 0 M i hereAy certify that this ia a true and correat repreaentation oP,cs tra? land as ahown and desoribed heraon. As prepar4d by me this /B7°? d? 191/. ' ? Minn. Reg. No. /36c- .. .,-. „_.,_...._, _« , .. ------------------ - ------------------------------------- ---- -----------------•--- ••--• I CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 --------------- ----- -----+-----------------------------°-°-----• WORK DESCRIPTION NEW CONST ? ADD ON _ REPAIR _ OWNER NAME: SITE ADDRESS: ?'Y! LOT:' _ BIACK SUBD. j INSTALLER: GQNZ-RYAN PLUMBING & HEATING COMPANY ADDRESS: 14745 South Robert Trail CITY: Rosemount ZIP: 55068 PHONE tt: 423-1144 DWELLINGS 6 ADD-ON MINIMUM 15.00 HVAC 0-100 M STU 24.00 ` ADDITIONAL 50 M BTiI 6.00 GAS OUTLETS - MINIMUM ? OF 1 PER PERMIT SUBTOTAL: $ n7 7, ?? STATE SURCNARGE: .50 TOTAL: $ 42 7•5-6 SIGNATURE OF ERMI EE C42II4ERCIALjZND?$TItT?T,,; 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: BLOCK SUBD. INSTALLER: ADDRESS: CITY: ZIP: PHONE #: FOR: FOR CITY USE ONLY PERMIT # RECEIPT # DATE: ? a- PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE ] TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. FEES 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 FOR CITY USE ONLY _ 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # ? PHONE: (612) 454-6100 RECEIPT # /O ............. ??±iG?? DATE: / PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQIIIRE D FOR EACH UNIT. ------------ ------- ----- ------------------------ -------------------------- WORK DESCRIPTION ---- --- COMPLETE THE FOLLOWING: N0. FIXTURES EA. TOTAL NEW CONST x ADD-ON MINIMUM 15.00 ADD ON I SHOWER 3.00 3- REPAIR ? WATER CLOSET 3.00 9- - - a BATH TUB 3.00 6 - ? 1AVATORY 3.00 1?2_ - OWNER NAME: Sons Constiuction I KITCHEN SINK 3.00 -7- - ? LAUNDRY TRAY 3.00 -3 - "- SITE ADDRESS: 4722 Hazeltine Lane HOT TiIB/SPA 3.00 WATER HEATER 3.00 -3. - LOT:Q?l BIACK ? SUBD. IJtX.r?L .3 ? FIAOR DRAIN 3.00 3- - GAS PIPING OUT. INSTALLER: R C Plusbing 1 I (MINIMUM - 1) 3.00 , 3 3 ROUGH OPENINGS 1.50 ?•-7? ADDRESS: 5910 Cheater Ave _ OTHER WATER SOFTENER 5.00 CITY: Northfield ZIp; 55057 _ PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 rxorrE u: 461-2096 SUBTOTAL ST. SURCHARGE $ .50 SIGNAT E OF PERMITTEE / e-b TOTAL: $ PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUZLDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: OWNER NAME: SITE ADDRESS: LOT: BLOCK _ SUBD. INSTALLER: ADDRESS: CITY: ZIP: PHONE #: FOR: FEES 1% OF CONTRACT FEE. STATE SURCHARGE a $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE CONTRACT PRICE x 18 STATE SURCHARGE $ TOTAL: $ (SIGNATURE) CITY OF EAGAN -• 2004 RESIDENTIAL BUILDING PERMIT APPLICATION ? City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWction Reauiremenls RemodeVReoair RenuiremenGs 3 registered site surveys showirg sq. ft of lot, sq. R W house; and all roofed areas 2 copies of plan (20% maximum lot coverage allowed) 1 set of Energy Calculafions for heated addilions 2 api:s of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks 1 set of Energy Cakulations AddNon - indicate Monsite sep6c system 3 copies of Tree Preservation Plan K lot plalled a$er 711/93 / -i ?` Rim Joist Detail Options selectlon sheet (bWgs with 3 or less unlls aZ? ? 5eoo?'_ _ CerEofSanej!3tecd : Y " 'N TtEBP,re?SPirqRecd _Y _N TY'E?'Epi85R?ired N iSrc,s}?Sep6cSystem la0..V -e- . Date 5 / c7tq / aZ/ ConstrucdonCostylvrr, Site Address 417 2 Q Unit/Ste # Description of Work ?-?'/ `?' ( ?L? Multi-Family Bldg _ Yte' N Fireplace(s) _ 0 ? 1 _ 2 Property Owner /0!!?/ /tLfil;'?t'"- Telephone #( GS/ Ss4' S Contractor Address State City Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CC Energy Code Category - Minnesota Rules 7670 Cateeorv 1 (J submisslon type) • Residential VenWation Category 1' Submitted • Energy Envelope Calculations Sub Have you previously constructed a building in Eagan fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor A NEW BUILDING Minnesota Rules 7672 • New Energy Code Worksheet Submitted Y_ N If so, 25% plan review #( #( ) Telephone # ( I hereby apply for a Residen6al 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 this is not a permit, but only an application for a pernut, and work is not to start without a perxnit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. /?.?•-?- ApplicanYs Printed Name Ap ic Ys Si ature OFFICE USE ONLY Sub Types /li'y?,£ 5/L6yw/i7 ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 03 Ot of _ plex ? 09 07-plex ? 17 Garege ? 22 Porch/Addn. (4-sea.) ? 04 02-plex ? 10 OS-plex ? 18 Deck O 23 Porch (screen/gazebo) ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex PIb9-Yor_ N ? 25 Miscellaneous Work Types ? 31 New )11( 32 Addition ? 33 Alteration ? 34 Replacement _./-"w ? Valuation Census Code OS SAC Units - # of Units ? # of Bidgs J Type of Const '-' .. ? :. ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Ait - SF ? 36 Multi Misc. ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 36 Move Building ? 42 Demolish Foundalion ? 45 Fire Repair ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Ooors 'Demolition (Entire Bldg) - Give PCA handout to appliwnt MCES System - City Water - Booster Pump PRV ? Fire Sprinklered - _ Footings (new bldg) _ Footings (deck) _ Footings (addition) Foundation Drain Tile Roof Ice & Water Final _ Framing _ Fireplace _ R.I. _ Air Test _ Final _ Insularion Approved By: REQUIRED INSPECTIONS F»vc.o. FinaUNo C.O. _ Plumbing HVAC Other ? Pool _ Ftgs _ Air/Gas Tes[s ?Final _ Siding _ Stucco _ Stone _ Bric _ Windows _ Retaining Wall Building Inspector Occupancy Zoning R-I Stories '- Sq. Ft. ?/OoZ Length Width Av.?w?ia??ec. Base Fee v Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge 5&W Permit & Surcharge Treatment Plant License Search Copies Other Total .., POOL PERMIT - APPLICATION SUBMITTAL REQUIREMENTS ? ? GENERAL INFORMATION V ?C QZa O d ? ? Applicant - name, address, phone & fax numbers, signature ? ? Properiy owner name ? ? Legal description and address of property j? ? ? North arrow scale (1" = 30' or 40') and date -? ? ? , Location and name of all streets adjacent to property ,2f ? ? Site Plan drawn to scale showing location of house, pool and other existing or pmposed structnres ,a ? ? Directional drainage arrows (existing and proposed) ELEVATIONS Existina ? ? Houss corners ,e( ? ? Property comers ?? On property lines at point of ineasured dimension to pool (see below) ?? ? If applicable, gound elevation at each end of retaining walts and at wali's greatest height Proposed ??I O Finished pool deck comers ?? ? Top of retaining walls (if any) and at each different elevation (if it changes) ? .PJ ? Pool bottom (or max. depth) Existina ,0 ? ? All property/lot lines Proposed ? ? ? Pool ? ?0 ? Pool plus integrated deck/patio ,Ja ?? Shortest distance from outside edge of pool deck to lot lines and house Reviewed: Date c:rrecw.ia zoozmooi pea„ic cneckiist CONxUITIHCi (NGINEERi ,,,.r pLpµryEBS ond IHND 3UflYEYORf G1NEE(i1NG COMPANYy INC. 1000 EAS7 1461h STftEE7, BUHNSVIILE, MINNESQTA 56337 PRopoSED ' 8 HouSE jt ? 3Z,oo ? I -ao , a (?033.?) m Qo88.? CERTIFICATE OF SURVEY Legal Descriptiort: 1-o7-Z .a«c,e z FA1R1N4 Y 1-1149 3l2D ADD/T/ON ,QA,('o?'.4 co?,v? iYIiNNESP7"/f (?o3i,?=) DENOTES EXISTING ELEVA710N DEN07ES PROPOSED ELEVA710N INDICATES /03 3 ? FINISHED GARAGE'FO RAINAG LOOR ELEVATION azs. = BASEMEN7 FLOOR ELEVATION - ? 1033. bb = TOP OF FOUNDATION ELEVATION zAQA,r,4 6CALB:1'•70' ?§ L_ 7.1) ?B9°/3'fF/"E (loz7.? -?o I 9a.oo ? z Q a w' z ? Dog ? N Q x ? ? 0 h I I i ir ? I LOT\Z 1) ? •--- ? I lo - - ? -? . d w ? S C1 oe \ p pQ ?r 70. c.v ? I N 89° /3'4i'iE o 0 ?..-. ? HpOZEa.TINE I.p1NEE, M „ loi9 6$Go3o;.7?' ?? ?Z', • J ?YzGt r,Ljl ll rer(Qc2 ? anR , f-'6jj (Jec,?) to,(l 3033 .Pl-. 4z?,-. ?-9" t lk"e z hezeby certiPy that this is ;a'trua and correat represantation oP,a tra? land as shown and deaoribed 11erAon. As pYepaTSd by ms tltie NoY??P , 19ql. - Minn. Reg. No. 136& , __. ? .,_ , .. . ?)?/,.V? l.??Y ? '? ? 9K. /66 y,rr. 3.5, pH 432'3000 ,r pRAI/VR6E AND 071L/TY EASEMENT OF- Y\ o. ? o `v ? N?6 6cC?. ? 30F7.' FRaN7 BU/Lp/NG SE7-94C.< G/NE I m ? I'll Q? CpNSUlTIN6 ENOINEEfiS Pl11NHEB5 nad IflHD 3UflVEYOlIf GINFEtiING COMnANY, lNC. 1000 EAST 1161h 57ftEE7, (ioz7. z) A/ ?cZ6-tp ? 90.00 CERTIFICATE OF SURVEY Legai Description: .? 6CALH : 1' - 30' ? ¢ a Zar Y ADD/ (L3,,,?=) DENOTES EXISTING ELEVATIQN (1033, o ) DENOTES PROPOSED ELEYATION INDICATES INISHED GARAGE'F?LOOR ELEVA IONRAINAG /03? 33 ^ F ozs. 64 = BASEMEN7 FLOOR ELEVATION • 1033. bb = TOP OF FOUNDATION ELEVATION ?.i v,r ?..-, ? .. • „ _ 8K. /66 ?W. 35 BURNSVILLE, MtNNESQTA 56387 . PH 432'5000 ? REVd BY?? 0275) I N?????????' ?%027 5' ?? 4n -= lo W ? I ? I ...__ I? I z PW4 ?' a ? o? N y Q x -? r d? IO I ? y n 9 Qo33.o? m -' •- ? ? m i 00 70• i A/69°/3'¢/" l E ? v. ao ? ?? 2z sa PRoPoSED HOU,SE 16494? ? ? HAZELTIN E LA Z9 f?,Qo29 6?? 3 N ? fu.n? ?" ?.?????? ? k. V ]ti".La',GATi' EN(xI[ti.EERING T?EP3° .-DRA1NA6E AND UT/L/TY E4SEM6i17' P o. ? J o. ?v 8 ? Nve ?r?? 30f 7.' FRONT 944/1 O/N6 . _ ?SETQAGK L/NE /?0.3? 3) ?porih W? (I c? heve, f a)zj(deck) t"All d,-Lti?, , ??-I ?`1??? /?' R,. 1 . . ? = hereby cerrify that this is a"trde and correot repreeentatiion Ao praparnd by ma tliie land as ahown and d?9?d herAOn. il/oYF.?f Minn. Reg, of. %,tza. /d_ aL No. /.364- PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA085589 Eagan, MN 55122 . Date Issued: 08/26/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4722 Hazeltine Lane Lot: 2 Block: 2 Addition: Fairway Hills 3rd PID 10-25602-020-02 Use Description: Sub Type: e-Reroof Construction Type: Work Type: Repair Description: House Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not acceptable in lieu of inspections. Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 3,000.00 Total: $90.00 Contractor: -Applicant - Owner: Abelard Construction Anthony Hoffman 6200 Shingle Creek Parkway, #545 4722 Hazeltine Lane Brooklyn Center MN 55430 Eagan MN 55123 (763) 503-6610 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. Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA087367 Eagan, MN 55122 . Date Issued: 11/12/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 4722 Hazeltine Lane Lot: 2 Block: 2 Addition: Fairway Hills 3rd PID 10-25602-020-02 Use Description: Sub Type: e-Siding Construction Type: Work Type: Siding Description: House & Garage Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: When installing ventilated soffit material, remove existing soffit material (i.e. debris that could block vent openings) and take steps to ensure maximum ventilation into attic space. Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 3,000.00 Total: $90.00 Contractor: -Applicant - Owner: Abelard Construction Anthony Hoffman 6200 Shingle Creek Parkway, #545 4722 Hazeltine Lane Brooklyn Center MN 55430 Eagan MN 55123 (763) 503-6610 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. Applicant/Permitee: Signature Issued By: Signature i Use BLUE or BLACK Ink ' I For Office Use v City of EaRd~ , Permit#: , ~37/-CC) Permit Fee. _ 3830 Pilot Knob Road Eagan MN 55122 Date Received: ' l Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Unit M L111) Date:,-`) l " 6 _ 1 / Site Address: ~7 2Z /7,1Z~C~I /yC Name: /TJlt~d/~~ Phone(,~~.2 7 v~vZ- ~~L,,7 RESIDENT / OWNER Address / City / Zip: 22- Z a_1 C6644si &J -TV &3 Applicant is: Owner Contractor TYPE OF WORK Description ofwork: OC.~ /'Lo Phot-, Construction CoisCrk„2 ~b0 Multi-Family Building: (Yes / No ) Company: Contact: CONTRACTOR Address: City: State: Zip: Phone: ! License Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to i a conclude that tW heir are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. X/ Applicant's Printed Name A li 's gnature Page 1 of 3 - DO 0411R TIIELINI SUB TYPES Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage Single Family Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) Multi Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) _ 01 of Plex _ Lower Level _ Pool Miscellaneous Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Wo Occupancy MCES System Plan Review Code Edition t°1 r. SAC Units (25%,100%) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In Air Test -Final Windows Insulation Retaining Wall: _ Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review V- L/ MCES SAC 01 City SAC Utility Connection Charge dd S&W Permit & Surcharge B Treatment Plant Copies (NVS boa( Std, 06T TOTAL Wo so 17-`1 m Y Is- - 12~~00~ i Page 2 of 3 f 2A4- a co LANH~Rx ai l LRND SfUjivivoils *,-7876. o! ENGINEERING aK. /d V COMPRNY INC. 1000 EASY 1461h STREET, BURNSVILLE, MINNESOTA 96337 PH 432-3000 CERTIFICATE OF SURVEY Mega{ Description: /-a7-azo ZwRw4Y ytu,s 3.20 v DENOTES EXISTING ELEVATION RENOTEES ELEVATION INDIOAT D R CT 4 OF SURFACE DRAINAG ~03~33 - FINISHED GARAGE FLOOR ELEVATION Az-5- BASEMENT FLOOR ELEVATION - /0-3-3-66 TOP OF FOUNDATION ELEVATION SCALE . 1' , 30' 3p co L. (/az7. 2-) B9° !3'4/'' 1A DRAINAF E AND UT/L/TY F#5eA46A1r 44 OT ?0 t oxa. oo 1 Fu $ " 4 N PROPOSED 2a.5o 3a 5o ti l Zz. So yea Ara ~'D f 7 iRDA/T BU/L4/NE t,~e;Wr. K G/NE 0 , (Jo33a~ Qoa~p~ a ► o~ k T off, .00[ Al 8 13'4-1 I HAZEL TINE LANI51 r6iqlaee -y &C~1Fhe. I hereby certify that this is a true and correct representation of,a tra, land as shown and described hereon. As prepared by me this _/B a~ 19 -2L- - Minn. Reg. No. /-U& Use BLUE or BLACK Ink For Office Use I • ~~3 i City Qf E~~~31 I Permit ~ ~ I Permit Fee: I 3830 Pilot Knob Road I Eagan MN 55122 1 Date Received: ~3 Phone: 651 675-5675 ( ) I Staff: Fax: (651) 675-5694 L________________~ 2013 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: " at ~.c'~ J Site Address:~~i~ 1 ' a l Tenant: Suite Resident/Owner Name: Phone: f0~~ Address / City / Zip: a j~3 Name: Wenzel-Plymouth Plumbing, LLC License#: 061555 Contractor Address: 1710 Alexander Road City: Eagan State: MN Zip: 55121 Phone: 651-452-1565 Contact: Carl Michels Email: cmichels@wppmn.com Type of Work - New _ Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W. Description of work: Demo Pressure Booster RESIDENTIAL Water Heater Lawn Irrigation RPZ / _ PVB) Water Softener Permit Type Add Plumbing Fixtures Main / _ Lower Level) Septic System New Water Turnaround X Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $5.00 State Surcharge) *Water Turnaround (add $200.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ N/A 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.gor)herstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and oGdes 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 pl x Carl Michels x Applicant's Printed Name A ant's gnature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final PERMIT City of Eagan Permit Type:Building Permit Number:EA157770 Date Issued:09/06/2019 Permit Category:ePermit Site Address: 4722 Hazeltine Lane Lot:2 Block: 2 Addition: Fairway Hills 3rd PID:10-25602-02-020 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 - Anthony L Hoffman 4722 Hazeltine Lane Eagan MN 55123 (612) 462-8927 Window World Twin Cities 2106 11th Ave E N St. Paul MN 55109 (651) 770-5570 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA158298 Date Issued:10/08/2019 Permit Category:ePermit Site Address: 4722 Hazeltine Lane Lot:2 Block: 2 Addition: Fairway Hills 3rd PID:10-25602-02-020 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. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - Anthony L Hoffman 4722 Hazeltine Lane Eagan MN 55123 Kb Service Company 430 E. County Rd. D Little Canada MN 55117 (651) 748-4933 Applicant/Permitee: Signature Issued By: Signature