4731 Hazeltine LaneCITY OF EAGAN '
681-4675
a
DEPT. aF BUILDING INSPECTIQNS
Correction Notic7e";
I have inspected this structure and these
? premises and have found the following
vialations of city codes:
/s R'E2P '/) ias IL>E
?7?'?2 CrL I? s s
When corrections have been made, please _
call 681-4675 for inspection.
T
Date ? 31 {?AfV !L "471A/
Inspector City of Eagan
DO NOT REMOVE THIS TAG
S??rC43s
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
I SITE ADDRESS: ? I
? , . ? ?i1?: C 1 a fMf
!? 1 RWRY tf 1 1 i?, ?ii!)
' PERMIT SUBTYPE:
i ANF
APPLICANT:
? ?. ? .' ? ?,tt t ?. •t'?.
TYPE OF WORK:
ftuI ( 11 1 a,
0 ;>44 6 ,1 1
INSPECTION
. . , ,. .. .
, . DA
I KN : ?F f>AkAfF F'f KMT 1', AI?F kt'+J1111•1 11 fil?: AMl' i`1 H?? ?IR E:1.1•A Iklt(:Al LJMIM
?
..
3
I
__J
Permft No. Pertnit Holder Data Telephone S
ELECTRIC
PLUM81N0
HVAC
Inapectlon Dete Insp. Camments
FOOTINGS
FOUND
FRAMING (L I
7 ? 3? f Q
7
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL / ??}?
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBCi
FINAL HTG
ORSAT
TEST
BLDG FINAL
t 'A 'D,ti- ecows,
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
KlAk I
' w!
0 CASH RECEIPT
CITY 4F EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
-, i
DATE
•
` ? .
_T..
r?c.?rveo .
?
AMOUNT
& DOLLAFiS
100
D CASH ? CHECK
FM
?- ? ? ?, ? }-? • ? ?Y . ? ( ,?.? .
! . _.. CJ
av c--1--f ,`'? c
C 1 4298 ,?,?a? ?
Y?? ?„ ?
Rnk-Fiia copy
Thank You ,
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-4837 ,
• '
?
DATE -lUL :. 2991 • f '
METER #
OFFICE
Y _...,0/°!
CHIP #
METER SIZE
ISSUE DATE
? ..
PERMIT DATE
PERMIT # } 7143
B.P. RECEIPT # C1429?
B.P. RECEIPT DATE
PUMP
SITEADDRESS
LOT 7 BLOCK '- SEC/SUB FAZRWAY HIi.I.S 3RD
APPUCANT:.
ADDRESS: _
CITY, STATE
PHONE: _
ZIP
PLUMBER: j?'fAR PLUMBIt1G
ADDRESS; 1O18 HDUND $PRIHC:S TaRk
CITY, STATE BUDOEYNGTOPi t;N ZIp 55420
PHONE: 884-4149
OWNER: Vj_?LIAM NUTTt3EZ CUNSTEJC'1I0N
ADDRESS: 964 IdATLRFORD D_2 Fi
CITY, STATE
PHONE LAGAV MN Zip 55122
452-3bH8 OB 723-4I61
PERMIT REGIUESTED
i SEWER A WATER - TAPS
- COMM/IND ? RESIDENTIAL '
- NEW - EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
p .a, 77
,
I AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUEO
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALI 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
?
SEWER & WATER PERMIT CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE
OFFICE U
METER # Lly!l ?C -? 7' -2-
CHIP#11, ?7 9' 1 (1 a
METER SIZE,571,9
ISSUE DATE
_ PRV
SITE ADDRESS L'; -'iE LN
LOT BLOCK ? SEC/SUB rAI.RWAI IIILLS 3kD'i `.
APPIICANT:
ADDRESS:_
CITY, STATE
PHONE: _
ONLY ?/10/91
PERMIT DATE
PERMIT # 12143
B:P. RECEIPT# ?242G8
: B.P. RECEIPT DATE 7 /2 / ? i
BOOSTER PUMP ..Iiy,LcceCQ S-zS)
PERMIT REQUESTED
'X SEWER WATER - TAPS
- COMMIIND ? RESIDENTIAL
x NEW
EXISTING
Lawn Sprinkler Meters are to be Installed
PLUMBER: :1`[A!? ?'LUMBING Ahead of Domestic Meters on Water Line.
ADDRESS: i01II HOUNll SPc:INGS Credit WILL NOT be givert for' peduCt Meters.
CITY, STATE BLOUMLNGTOtti thid ZIP ` %`;?11 •: ?' ?' -?
PHONE :?84-4149
OWNER: WjLLIA'i HUTTNER COh; T,:u:, ; i:`i:
ADDRESS: WATEkFORU GR 'vJ
CITY, STATE ZIP 5'? 1? 4
PHONE:
ZIP
I AGREE TO COMPLY WITH CITY OF
EA ORDINA?CE
.. /?i?t-` ??
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TVYO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT. ???v^''-•Q°'
, s CITY OF EAGAN
? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 ?
? BUILDING PERMIT Receipt #
' a1
To be used for $lP U(',?? Est. Value $140 ,000 Date -n1i- Z , 19lL- d
Site Address 473Y HAT.BLTZM L1i
Lot _7 Block _I Sec/Sub.
-
OFFICE USE ONLY
Parcel No. occupancy ? 3 -*-I FEES
zoninq
W Name WI?.?.I? ?'?+1EA ('?$'j'Q?."jIQX (Actuaq Const ? Bldg
Permit ?s?
AddfBSS 960 WA?RFORD aR W (Allowable) .
70
?
0 City EAGM Phone 452-305 # ot stories
-
,
Surchar
ge
Plan Review S07- ?
o Name AIM Length
oepth 33' tm
m
sAC
al
Z _
,
y
? Address S.F. Total
-
'
s
City Phone
S.F. Footprints
- sAC, Mcwcc 650-00
00 1
660
t
C
W
On Site 5ewage _ .
a
er
onn
A
W W Name On Site Well ??
W
M
?w
x?
Address
MWCC System -
? ater
eter ?
<W
City PhOne
City Water
X ?.QQ
Acct. Deposit
?
?
PRV Required SlW Permit
•
I hereby acknowlege that I have read this application and state that the
infortnation is conect and agree to comply with;?ll ap'?icable State of
MinnesoW Statutes and City of Eagan Ordinance 7°?
`
j Booster Pump x SNV Surcharge
?
Treaiment PI 276•
! ,
,? "_??
S' nature of Permitee Y
? APPROYALS
Road Unit 370.00 •?
A Building Permit is issued to: WIZ.IM ?R COWT
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Slatutes and City of Eagan Ordmances.
Building Official Planner
Council
gld9 pff.
Variance _
_
- Park ped.?
?
Copies ?
?
TOTAI 3,568.50
Pe?mk No. PertnH Holder Date Telephone #
WALER
SEWER
PLUMBING
H.VAC. ?' E? ?.? / 7rS'i o?
ELECTRIC
Inspsclion Date Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Plbg.
j ?
Rough Htg.
Isul. g 1?
F?replace p i? 91
Final Htg.
Orsf2t Test ,
Final Plbg. Plbg. Inspector - Notify Plumber
Gonst. Meter
EngrJPlan
Bldg. Final q Jg (,{J - .
Dedc Ftg.
Oedc Final
Well
Pr. Disp.
% ? r .4;
i?
?erttfira#t uf (Orcupattxy
Citp of (Eagan
ilppwhnm af luilding jhwrrtimt
T74ir Cerafraate Pssued pursrrairt w the r+equWmm&of SecAiox 306 ajllte Unijorm Bailding
Code oertilyin8 lhal at [he tinre ojissuantr lkisstrucurre was in ca?pliaace wilh the viarious
ardiircnctir ojthe CitY m8u1a1ing buildin8 canstruaion or use. For rhe foffowing.
.\
use a„isa,ti„ SF DWG/GAR Mk Pa N,, 19359
Bwlft A4d= 4731 HAZELTINE LN L-ak L7, B1, FAIRiTAY HILLS 3RD
,
! (utl 60i ?..i '?_? DUC SEP 19, 1991
Buaft'
POST IN A GONSPICUOUS PLACE
DATE: 7/10/91
RE 4731 HAZSLTINE LANE, L7, B1, FAI&WAY H1LIS 3RD
gg F
- YouMSewer & Water Permit for the above property has been completed. It will be held at the
PuWi¢ Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
'6ALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
- Your Sewer & Water Permit for the above property cannot be completed tor 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, GALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
Address: 4731 HAZELTINE LN Lot 7 Hlk 1 Sec/Sub FAIRWAY KILLS 3RD
These items were/wete not complete at the time of the final inspection.
- Yes No (?/,AT
Final grade (6" frvm siding)
Permanent steps - garage ?
Permanent steps - main entry
Permanent driveway
Permanent gas ?
Sod/seeded gtass L?
Trail/cur6 damage
Porch ?
Basement finish
Deck ?
Please verify with the builder the removal of roof test caps from the plvmbing
system and the shut-off af water supply to the outside lawn faucat before
freeze potential exists. ?
??mEOaffa
White - City copy Yellow - Resident copy Pink - Contractor copy
BUILDING PERMIT..
To be used for SF Di
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8700
Est.Value $140,000
Site Address 4731 HAZELTINE LN
Lot 7 Block 1 Sec/Sub. FAIRWAY HILLS 3R
Parcel No.
w Name WILLIAM HUTTNER CONSTRUCTION
3 Address 960 WATERFORD DR W
? Cit EAGAN
Y Phone 452-3088
Nt ..
Receipt # (2_ 1 y -,)LqC,
Date JUL 2 1991
OPFICE USE ONLV
Occupancy R-3 M_t
Zoning R-1
(ACtual) Consl Bld9. Permit
(anowabie) V-N Surcharge
o Name SAME I
$? Address
City Phone
W w Name
??-Address
<W CitY Phone _
I hereby acknowlege ihat I have read this application and state thal Ihe
informalion is correct and aqree to comply with II ap icable Stale of
Minnesota StaWtes and City of Ea Ordinance
Signature oi Permitee ? ?. ?
? rJ
n euilding Permit is issued to: WILLIAM HUTTNER CONST
on the express condition that all work shall be done in accordance with all
applicable State of MOnesota Statutes and City of Eagan Ordinances.
Building Olticial
A o151ones
Leriqm 86'
oeum 33'
S.F. Total -
S.F. Footprint5 -
On Sita Sewage _
On Site Well
MWCC Syslem X
City Water X
PRV Requiretl
Booster Pump X
APPROVALS
Planner
Council
Bldg. Off.
Variance
Plan Review
FEES
780.00
70.00
so7_nn
snc, ciy 1100_ nn
SAC,MCWCC 650.00
0
Water Conn 660.0
WaterMeter 95.00
Aca. oeposit 30.09
S/W Permit 30.00
0
S/W Surchar9e .5
0
Treatment PI 276.0
0
Road Unit 370.0
Park Dad.
Copies
TOTAL 3.568.5^
?/?? REOUEST POR ELECTRICAL INSPECTION
? Sae insVUCtions for completing this brm on back oi yellow capy.
?
144 8 8 X" Below Work Fovered by This Request
a
p? E600001-OB
e iAdtl Rep. Typeof8uilding ApOliancesWiretl EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Oryer OUier (Specify)
Comm./Industrial ' FUrnace
Farm Air Conditioner
Other(specity) Coniractor§ Remarks:
Compute Inspectian Fee Below:
# Other Fee # ServiceEntranceSize Fe # Circuits/Feedere Fee
Swimming Pool ? 0 to 00 Amps ? 0 to 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
Slgns Inspectm5 use Onry: TOTAL ? v
Irrigation Booms Sr ' ? . ?
Special Inspection
Alarm/Communication - THIS INSTALLATION MAV DEORDERED ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 1 HS. (
I, the Electrical Inspector, hereby
ceniy that the above inspection has
been made. Rou9n-in ? ca ?7 g/
Finai Date `
d?"9
OFFICE USE ONLY Tnrs repuest wiC 18 monms from
748 • ? ???°
Request Oate Fire Pb: -' Rd0 -in I spection
qeGU + .
? Aeatly NowNOtiy Inspector
84 0 No Wheh Reatly?
I A ensad contractor ? owner hereby request inspection of above electrical work ai:
Jo0 Atlarass (St2et, Box or Rouie Na] Ciry
417 3/ A ii..'r
Section No. iownahip Narne Or No. Range No. Counry
Occupanl PRINT)
i Phone No.
Power /$y?lier? Adtlress /
r?
f?/ ! 7 ?'
ElMric nVactor (COmpany Name) ? ? CaMt r§ License No,
Yer
ai in9 Atlaress ICOntractor or Owner Making Installetion)
`
4
3 'r-
A hor etl ' aWre (COnbacrorlOwner Making Installation) Phone Num
Oer ?
/
?
i
e
MINNESOTA STATE BO/.flD OF ELECTRICITY - T THIS INSPECTION flEOUE$T WILL t NOT
GriygoNlEway BIEg. - Noom &173 BE ACCEPTED BV THE STATE BOARO
1821 Unlverslty Ave., SI. Poul, MN 55100 UNLESS PROPER INSPECTION FEE IS
Plwire (BIY) 64241800 ENCLOSED.
315 - 6 7 5 R / OFFICE?USE N/LY/ This reqoesl.oid IB monlhs (rom mlidafion dak pnnkd m fhIs box
? ._. . / ?
CT?--+
I ? r? ?
D
PLEASE PRINT OR TYPE I. " ?
Requeai/po Rou9h-in inapection mquiredY ,?'Ya InspecHon Olher Thon Rouqh-In: Reody N. ? Will Call
?7 (Youmosrwlliheinspenorwhenreody) DaieReadr:
licensed <ontrador ? owner hereby request inspecfion of ihe above eledriml work ah
Job Admss (SVeel, Bw, or koa Na.)
???
L L Ciry
G? Zip Code
ti -
z..? fW
Sedion No- Tomuhip Name or No. Ronge Na. Fire No. Caunry
JA XO-h+
Oaupont /
?.R EWDD? ?ONS ?UCTion? Phone No.
grl?/' G`IS?-
Power Sopviher Pddress
Elecfical Conhactur (Company Nome) Canhador Gcrose No. Master lic. Nn ?Plant Elee. Only)
METTLER ELECTRIC CAO 1223 AMO 2589
Mailioa Pddr.u (canimao, o, ownar PeAorming Insionanan)
1240 46th ve. N E., Mpls. MN 55421
AuPoOnzad SipnoNn (ConMacror r P In Phane Na.
Mi el . ettle? 574-9744
EB-00OOlA-10 6195 STATEBOAflDCOPY-SEEINSTpVCTION50NBACKOFYELLOWCOPY
REDUEST FOR ELECTRICAL INSPECTION 7? ? U
?? ?? ?I I?? I I I ?I I? I I? I II 8,21 Une Ssiry AvearRrof SI'ctricSt. Paul, MN 55104 ?j
?t 0 3 1? 5 6 7 5 9* pnane (siz) 642-0800 rd'?''
Home Duplez Apt. Bldg. Other: New Addn
Commercial Industria) Farm Remod Re ir
Air Cond. Hfg. Equip. Water Htr. Load Mgmf. Other.
D er Ran e Elec. Heat Tem . Service
'k' above ffie work covered by this requesf. Enter remarks in this space ond on the ba<k oi fhe white mpy only.
psem&v? F?;cy hdm
Colculate Inspection Fee - 7his Inspecfion Requesl will not be accepted wifhout the rorreci fee:
Olher Fee # $ervice Enhana Size Fee # Circuih/Feeders F.
Mobile Home Park $tall 0 to 200 Amps 0 to 100 Amps
Sfreet Lig./rmffic Sig. Above 200 Amps Above 100 Amps
Transiormer/Generator INSPECTON'SUSEONIY d TOTAL SO
Sign/Oufline Lig. Xfmr. LL'-F7
j0/ JC??O
? ??
Alarm/Remo}e Confrol r,,,
?
`?'?.1??
?
$wimming Pool C'el 'i'
.
I hereb ceni ihot I ine ed the el tion de:cnbed herein on ihe dares
Irrigofion Boom Roogh-In
Special Inspedion
Investigofive fee oaie
THIS INSTALLATION MAY 8E ORDERED DISCONNECTED IF NOT COMPLETEO WITHIN 78 ONTHS.
r ° x
k ;..y ,._e • .:'' ? i.xs '? e .
•, E s.&Y R
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R•?7?'?°F5" ??i'?'??Y?f?`?Y?S^??? "M?'?n?,9(i iK7?'1e ?Y,i$!?F.}XY?f ,"
' na -1 ?.J?• . _
c ._-
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
51TE ADDRESS:
PERMIT
PERMIT TYPE
Permit Number:
Date Issued:
4731 HAZEL7INE LANE
LOT: 7 6LOCK: 1
FflIRWAY HIIIS 3RD
P.I.N.: 10-25602-070-01
DESCRIPTION:
?r ?.; .., .,
g
41
ermit Type
?,rk 7ype
4•a
BASEMENT FINISH
ALTERA7ION
434 AIT.. RESIpENTIAL
e
? ? 03,'€? m. a.?p ?
§?xk ??' ?g. ?u r $?'a??wiati" ?t?` ??y ?
REMARKS:
SEPARATE PERMITS ARE REQUIRED FOR RNY PLBG OR ElEC7RTCAL WORK
FEE SUMMARY:
Base Fee $50<00
Surcharge .50
Total Fee $50.50-
BUILDING
@29621
03/26/97
CQNTRACTOR: - Applicant - ST. LIC OWNER:
LAKEWOOD CONST 18816452 200377541 HAUSER 70M
401 LAYMAN LN 4731 HAZELTINE LANE
BLODMINGTON MN 65420 EAGAN MN 56123
(612) 881-6452 (612)686-6241
]G hereby adkriowle'dqe that_t1 h.-rk0 ,Tat1 th'1`? aa;CA?ah art ?a?e a7:'tha
infarmatian is, cprrot an,0 agr?4itdE bl?
5T.atLiGes and-C?.??r ?Qrdiz??r??es, LA
:
? (rSSrrEDB'C.sn1Uh ?
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) $?? 'o
CITY OF EAGAN a//99 Crdh-&(__
3830 PILOT KNOB RD - 65122 ?
681-4675
NewConsWCtionReauirements RemodeVRenairReouirements
? 3 registered site surveys ? 2 copies of plan
• 2 wDies of plans (Indude beam & window sizes; pound fnd. design; eta) ? 2 stte suneys (exterior atlakions fl dedcs)
? 1 energy calculations ? 1 energy calalationa tor heated additions
? 3 copies of tree preservation plan H lot platted aRer 711/93
required: _Yes _ No DATE: 3-i'fS -°( 7 CONSTRUCTION COST:?
DESCRIPTION OF WORK: 3A?f?,'AAT T i?,' lS i'A
STREET ADDRESS:
LOT I BLOCK
7
? SUBD./P.I.D. #:
Ze-,L
E
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: k1 Nv S cr, -TG (1-I Phone #:
Street Address: y?
City: ??CoAN State: M? Zip: ?5 42-3 ^
Company: ??e?D G8?`'`STR?+? TLO'v Phone #: xx 1-??S Z
Street Address: *)l 'h`fo-'vk,/ License #:-Z-?,? ? ?7 -7 s?
City:13L&;,t'tl?+?-vp State: ?VN Zip: 7 5 9Z d
Company:
Name:
Phone #:
Registration #:
Street Address:
City:
Sewer & water licensed plumber (new consVuction only):
and lot change are requested once permit is issued.
Zip:
Penairy applies when address change
I hereby acknowledge that I have read this appliption and state that the informaGon is correct and agree to comply with all applicable
State of Minnesota Statutes and Ciry of Eagan Ordinances. -- } ?)
, Signature of Applicant:
/
OFFICE USE ONLY 71MAR CEIVED
Certificates of Survey Received _ Yes _ No 1$ 1997
State:
Tree Preservation Plan Received _ Yes - No _ Not Require Hy; /?
OFFICE USE ONLY "• '_.
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex o 11 Apt./Lodging ,ff'?16 Basement Finish ?
? 02 SF Dwelling ? 07 4-plex ? 12 MuRi RepaidRem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
•
? 04 SF Porch o 09 12-plex o 14 Fireplace o 21 Miscellaneous
? 05 SF Misc. ? 10 _ plex o 15 Deck ,
WORK TYPE
n 31 New X' 33 Alterations o 36 Move
? 32 Addition o 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actuai) Basement sq. ft. MC/WS System ?
(Allowable) Main level sq. ft. City Water i
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories ? sq. ft. Booster Pump
Length sq. ft. Census Code. y34
Depth - Footprint sq. ft. SAC Code 01
, .; Census Bldg i
Census Unit D
APPROVALS
Planning Building /10 Engineering Variance
Permit Fee
Surcharge
Pian Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S!W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
% SAC
SAC Units
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD - 55122 ?q
(651) 681-4675 I
New Construction Reauirements RemodeVReoair Reauirements
? 3 registered sde surveys
? 2 wpies of plans (include beam 8 window sizes; poured fid. design; etc.)
• 1 energy calculations
? 3 copies of tree presarva8an plan it lot platted after 7/1/93
required: _Yes _ No
DATE:
DESCRIPTION OF WORK: 19
STREET ADDRESS: 4?J 1
? 2 copies of plan
• 1 site surveys (exterior additions & decks)
? 1 energy calculations Por heated additions
CONSTRUCTION COST:
CRV4 P? ?
?
S85-7 -t?-
LOT: ? BLOCK: ? SUBD./P.I.D. #: ? WO, ?,- ?N I \S 3rt)
PROPERTY
OWNER
Name: Phone #: lOSL
? Last First .
Street Address:
City State: ? av Z,P: 'Za3
Phone t/: ?OC?7 ' :B(!A G
CONTRACTOR
ARCHITECT/
ENGINEER
SELA ROOFINQ & REMODELING, INC.
Street Address: 4100 Fxt^.Fi gloR BEdB
ST. LOUIS PARK, MN 55416
City ID #nnM05p State:
Street
City
Sewer 8 water licensed plumber (new construction only): _
change and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application, state that the
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No
Zip:
Phone #:
Registration #: _
State: Zip:
. Penalty applies when address
nform ' n s correct, n gree to comply with ail applicable
I?
,I
_ Not Required
License # 1?Exp.
OFFICE USE ONLY
BUIIDING PERMIT TYPE
? 01 Fbundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
13 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
O 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 _-plex ? 15 Deck
WORK TYPE
? 31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Ailowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SM/ Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Tbtal:
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Valuation:
Census Code
SAC Code
Census Units
Census Bldg
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
% SAC
SAC Units
CI1'Y OF F.ACAN
3$30 YILOT KNOB KOAD
F.ACA:1, 55122
PEiONh (612) 454-8100
1'L(JMBING P?RHIT
,,. .
r ?
RESID?RTIALfi PLEASE COMPLETE UPPER POR3ION ONLY FOR SINGLE FAMZLY DWELLINGS 6
TOWNIlOMES/CONDOS
--------- W1iEN YERMITS ARE REQUIRED FOR EACH UNIT. -----
----- ° -------
WORK DESCRIFTION - ----- ---------------------- --- ----------------------
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
NEW COfdST ADD-ON MINIMUM 15.00
ADD ON _ 2 SHOWER 3.00 6100
REPAIR WATER CLOSET 3.00 °7•60
BATH'TUB 3.00 3.u?
LAVATORY
OWNER NAME: Lc 3.00 31A
/ / IAUNDRY TRAY 3.00 3:40
// /
SITE ADDRESS: 77J?1 /-/-q2 rhjyjt, lly1G HOT TUB/SPA 3.00
WATER
R
LOT:BLOCR L SUBU . ?l{2(J UV f//I`S FLOOR DRAIN 3.00 3.rz?
GAS PIPING OUT.
If:STALLLR: (MINIMUM - 1) 3.00 310
ROUGII OPENINGS
.50
1
ADDRESS: ?SI?S CrQYC?LSfi ? ?idbl/ _ OTHER
WATER
ER
5.00
CITY:_/(,roSGi'Y?7(?/77 ZIP: PRIVATE DISP 15.00 . '
U.G. SPRINKLER 3.00
Fk10NE r, : Yd5 :? /? ys?
n/? SU6TOTAL $ ?
' sE'J ?Y v ?L,; ST. SURCHARCE .50 '
SIGNATURE OF HRMITTEE TOTAL: 4
s '
COi4fERCIALJINDL'STRIAL[` PLEASE COMPLETE Tk1I5 PORTION FOR ALL COM2MERCIAL/IND[7STRIAL BUILDINGS AND
MULTI-FAMILY BUILDINCS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNI3.
------------
CONTRACT PRICE
OWNGR CIM1E:
SITE ADDRGSS:
LOT: BLOCK SUO-D.
INSTALLEA: ADDRESS:
CITY: ZIP:
PIIONE #:
FOR:
GI1'Y OF EAGAN
rOR CITY USE UNLY
PERMIT #
RECEIPT # ???•-
DATE: ?J
FEES
19 OF C0:ITRACT FEE.
,STATE SURGHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
GONTRACT PRICE x 18 $ .'
STATE SURGHARGE $ TOTAL: $
(SIGNATURE)
I
CITY OF EAGAN
, . ? 3830 PIIAT KNOB ROAD
EAGAN, MN 55122
PHONE (612) 454 8100
".G49rt.A..L;;YFR3SI:?;
FOR CITY USE ONLY
PERMIT #
RECEIPT # ' I `I 1 a2
DATE: 9
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY
T051NHOMES/CONDOS WHEN PERMITS ARE REQUI?tED FOR EACH UNIT.
----- -------------------
WORK DESCRIPTION
NEW WNST ?
ADD ON _
REPAIR
OWNER NAME:
SITE ADDRESS:
LOT:I BLOCK ? SUBD.
INSTALLER: 1_.?NK hAJ54.
Z ?
ADDRESS: ?? N)'41'j CITY: ??_? ZIP:
PHONE
FEES
DWELLINGS &
ADD-ON MINIMUM $15.00
HVAC 0-100 M BTU 24.0
ADDITIONAL SO M BTU 6._0
GAS OUTLETS - MINIMUM 3
OF 1 PER PERMIT
?
SUBTOTAL: $ ?7=
STATE SURCHARGE: .50
? T L:
SIGNATURE OF PERMITTEE
Cb?1ERCTAL{?7#iTSTRTAT.;;; PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDIISTRIAL BUILDINGS,
..
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
-------------
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
IAT: BIACK SUBD.
INSTALLER:
ADDRESS•
CITY: ZIP;
PHONE
FOR:
FEES
18 DF 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
:
1991 BUI 19p3ri211ICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
HULTZPLE DWELLINGS
COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 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 LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSIIED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO_GHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS SEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For:
Site Address
Lot -7 Block ?
iluation: /yJ/vvJ ? Date:
CQ. OFFICE USE ONLY
? P?
Parcel/Sub 'af 1- 4U (/ J ?
Owner
Address
City/Zip Code
Phone
Contractor W t-- (7k,??1e/l- asl,
Address % IOZ) W3lzW6rd hr, W,
City/Zip Code S3-12 Z
Phone #5-L°368`S 72,3-M((
Arch./Engr.
Address
City/Zip Code
Phone #
Occupancy
Zoning Q -1
Actual Const V-N
Allowable V-N
# of stories
Length
Depth 33
S.F. Total
Footprint S.F.
On site sewage_
On site well
MWCC System ?
City water v
PRV ?
Booster Pump
APPROVALS
Ylanner
Council
Bldg. Off.
Variance
FEES
Bldg. Permit 780,DJ
Surcharge ?0,00
Plan Review [)9,Oo
SAC, City /O.DO_
SAC, MWCC 56 O•on
Water Conn. O. aa
Water Meter 9LTI DO
Acct. Deposit 30.00
SJw Permit 30,170
S/W Surcharge •$a
Treatment Pl. e?'76,00
Road Unit 3r]O,OJ
Park Ded.
Trail Ded.
Copies
SUBTOTAL
Penalty
Lot Change
, TOTAL 1'?
411!!- agrees that all work shall be done in accordance with
(Signature of Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
r_
?r 4%0 „qo 0 w
vA
?-
(rR?A GE'
...-?..?
I2xzo = Z?Iv
22x2o= y4o
C?So X J5- lo?zo?
?.-s--?--7-?
3tiaX,3 r 390
'? 31t I'? ? 29 9
?
_.-
89 Xi4=
' 71?8
Z.
?
?I55 x 53 = yoo?S
u ? ?--v
?KZy= ;(4
2 X7=
2 l? la = 1 '2'
r?
lyqy 153= r7 01
I 3 ? ?W3
a
METRO • 1875 PLAZA OR
SURVEYORS surrE Zoo
INC. _ • EA GAN, MAL 5S/22
Certificate of Survey for? (612)452-785p
HUTTNER CONSTRUCTION
LEGAL "DESCRIATION; LOT-Z,BLOCKI, FAIRWAY HILLS 3RD ADD
ACCORDING TO THE RECORDED PLAT
THEREOF DAKOTA COUNTY,MINNESOTA
.
HAZELTINE LANE
5
6
?p3D 1031 ?
N 89° 13' 41" ?E 103.3
?
Io31 -
'R-?-------- ----
?A I ? N • ?r?
5
vr
io 3? D33 ??o?s°) '" Ic
?- 7v.L7 N
?CF,cT 0) n a 3.l.7 . 1?.?7
o
- M ?pJ7w I ? ss.a
M I M%.O . . ., .. .. . . ...
?
O
r'v 3
N sE
?-- iD
--? o
0
Z
a,
I ro33=. (ioas-) `
41= 17.9 10' S5 .. a
L 29,99lo'sz ?- +^
/4)Cj
00
N
? LOT 7900`,0 4
CA
? '
?
G /
51 O?P?
L BB _
S 89° 29' 42., W?
16.48 '
B008T ' pp_JMp
. RQUoRiEED _
o DENOTES IRON MONIJMENT
a DENOTES W000 NUB SET
/033? DENOTES EXISTIMG SPOT
ELE VAT.IO,N
pEKOTES PROPOSEO SPOT
ELEVATION
? DENOTES DRAINACwE CIRECTION
eovi--er OlAAJ
1 hwow certify that ihls surveY,plon or
roDat ra ProPnna py ms or under my
direct supervision and Ma? I om a duly
Repistered Land Swv*ra undK fM
Lawa of tM StWs of Muw?411wt9
EA:aAN ENGTYZ
DEPT;:
f'?'Z.oPcSED 4 LELiF.t.. SPi- r-r -Alo uJRtXouT
INVERT EI.EVATION AT SERVICE ExTENSION¦
PROPOSED GARAGE FLOOR ELEVATIOM• o,5
PROPOSED FIRST FLOOR ELEVATION •?D3G L
PROPOSED 9ASEMENT FLOOR
ELEVATION
NOTE' VERIFY ALL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
Bf001?y J•???iw?,?lAl???'l ea N0. 15233
Dott ' / ,6 ?T
. ?j
?
r .
t.
(Fo:a Dcvcloped by thc Sta:c of :Sinnesota Cocc i>ivlsio:i)
TO EE SU3.`SIiTLD LiITfi IIUILDI;:C PEPJMIT APPLICATI09
M,tiER:
S£TE ADDRESS:
F.XTEF.IOR FNVF.LOPE AVERAGE "U" C(1:fPUTATION
I T/ ltc
CONTRACfOR: L it- //ct ( l KQr &Cf% DATE: 47-Z ?-/ ? PIIONE: 7 SZ ?o??
Determine vorking aquare footage of each
1. Total exposed wall area......... 26 (0 7 _ 69•ft. x.??
2. Total roofJceiling area......... ? 7 6 2- 6q.ft. x•?Z 6° 3.53
3.• Total exposed crall area calculations:
Total exposed wall area above f3oor ? L s0 7
a. Total wall tvindow' area ............. lFq
b:' Total door azea ................................... S
c. Total sliding glass door area .......................
d. Tota2 fireplace wa21 area ..........................: -
e. Total uall framino area (average I07.) ............... Z a
f: Total net wall area above floor ................... l 33
g. Total rin joist area ................................ /`10
Total exposed foundation area
h. Sotal £oundation window area .......................•
i. Total aet foundation area above grade ............... / 0
Determine "U" value of each wall segment
8. ? 0 7 Xlopse 7 S
b. s? X „U„ , ?
C. A tlU\I AS? ? 2. Z, O
a • ?-r y IIt?11
A u
. e. G 5 O' X"U"
f. I g33 x "u"
. s- x $lv.f
x "u"
i. /lo Q x °Un
3. '
.07 _ I7, 5
73,3Z
TOTAL . . ? ?Z1. 53
?'.
If item 03 is the same as, or less than item 01, you have mct [he intent of
SSC 6006(c)2. •
Total ex,osed roof/eeiling calculations:
_ Total e:cposed roof/ceiling area n
-?--
J. Total skylight azea ...................................
...__?
k. Total roof/ceiling framing area (average 107.)......
1. Total net insulated roof/ceiling area .................
Deteznine "U" value for each roof/ceiling segment
1-• X nIIn
k. ?( 0 RolUll r CQ ?,- ' c-??.l?o
?. J33y- x,.U„
4. ' 'TOTAL r °
?
Zf total of b4 is the same as, or. less than C2, you have net the intcnt
of SBC 6006(c)1.
Alternate Building Envelope Design
'?i.'.. - ' .. : . . .
To utilize the total envelope system method, the values establfslied by '-
the sam of itens #3 and 04 sha11 not be greater than the sum of items 41
and 02.
1. + 2. '
3. + 4. 041
C E R T I F I C A T I 0 N
I hereby certify that I have calculated the "U" factars and R values
fierein and that the huilding hera described meeta o= exceeds the State of
Minnesota Energy Conservation Act.
? (Signature).
. (Date) '
,`
lvA1.L
j^c ]U': of oj-,ayur ,rall a:ez for
:r.umc conu:tructiun
SIt1 (SeAL.
a-iPSr:r.:l
DOtiilATIC.I
S1?.I.I:
F?2T`1:E Y:T.LL
Constztictinrt R-ValuC
L
1. Intcr5or aiz film 0.66
2• I?n _ ._ .. .
3, ? ?' inches sofr t:?nnd -! -
5. <: '' ' i•
6. Exterior air film = 0.17
Total
?-'J _ . i,.. ..l . , ?' ' •
1. Intcrior air £ilr.i 0.6£4
-
2. ,. _. ,. ,
3.
9.
?
5. -
Tr
?
6. Eaterior air filn 0.].7
lbtal I,q(
? . 1 .
1. Tnterior ei.r filni 0.68
2. ?
3.
4. n.. - - . _ - . .
S• G ' % -
6. Er.terior air i-ilm 0.17
4bta1 "
1.
2.
3.
4.
5.
G.
Interior air film 0.68
. 7 ? -. : . . . . . - , ,
Exterinr air film 0.17
'Potal
SI,AB O;d GF?,ll'i
= IG. #3
?L 4 • •o , 0 1?
. u - , ' ?i •
i , . . . ?
P . ' •J • . b '
. e • r . ` `
?? nPF-?:? • ?, ? ;a ?? . y , . ?
? ??? ' ? ?6 ?. •
ir?? . • • .
- ?c : . . . . _ / ? ?
i?i •• • . • ift '
FIG. ea r?? ?` ??' '•, o` ?= i'r
NOTC: Yndica[r, eync, "P." valun, dc:nth and
. placenent of insulation. .
i - .
?
F001'/CEILI1:G
Cnnetr.uction R-ValiiC
r, .
3
VIItT
4--nW1--{z?
Vi.;ICEd I w I:C.ZC SIUt.•
u P
F7G. fi5
1 I;eat flocl vp
; vented
1. Interior ai.r fils 0.61
2. 4?? - -
4. Txtcrior nir fili't (st:ill) 0-G
- 'tocal
' i
?? .?;;, •
. a? . ,
,
1, film
InLcrior air 0.61
2.
3.
9. Er.teriur air film still 0. 1
. Total _ °;`
i .
:... '..
,
1. Snsic7c air fi].m 0.61
2.
's.
9.
5. Outside air film 0.17
Total
Nntc: Us:c additional ::hects if morc: --F+ac:c i:
needcd for details aud calculations•
.
. Hent
' , flov up F.r.r,. p7
*dtV oF eagnn
nioMnsFCnla
Moyvr
September 2,1994
Mr. AI Herrnann
AI Hermann Construction
535 Stone Road
Mendota Fieights, MN 55120
Re: Lots,6 and 7 Block 1 Fairway 1-lills 3rd Addition and
Lot 4, Block 1 Fairway Hills 4th Addition
Dear /11:
PAiRIC1A hWADA
SIIAWN HUI,IIER
SAIJDRA A. MASIN
iHEODORE WACI1iER
Councii 1•dembers
1HOMA5 FIEDGES
f.11y ntlminisholoi
E. J. VAN OVERBEKE
CIW Gerk
Please be aware that Bill f luttner has completed the drainage swale in order to resolve the
drainage problem for the above mentioned properties. I did inspect the work upon
completion and shortly alter a signi(icant rain and found the corrective aciion to work quiie
well.
Please contact me at 681-4616 if you have any questions.
5incerel
r(?"aig Kru?dsen
Engineering Technician
cc Bill Huttner
eng/bermann.hr
MUNICIPAI CENTER
3830 f'IIOI KNOP ROAD
EAGAN.M1NIiF501A 551221807
PHONE: (612) 6814600
FA%: (612) 661-4612
iDD: (612) 454 8535
7HE lO1JE OAK 1REE
IIIE SVMBOL OF SIRENC-TH AIJD GROWTFI IP1 OUR COMMUPIITV
Eqvot OpporlunltylAlfhmotNe Acllon Employer
MAINTENANCE iACILITY
3501 COACH1dA1J f'OPJI
EAGAN, MIUPlESOIA 55177
FHONE: (612) 601 4300
fAX' (612) 681 436C)
1OD: (612) 454 -0535
JUL-11-2012(WEO) 07:50 P.001/001
Use BLUE or BLACK Ink
-
For Office Use,
City of Eap Parnit ft: Permit Fee:
3830 Pilot Knob Load I
Eagan MN 55122 j Date Receivod:
Phone: (651) 675-5675. I l
Fax: (651) 675-5694 Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: 7e'/ A-, r_ r?/n'r jp -i . 6A404. 1%7N i Unit
IIII ( p I I (~I ~
m Amo-io-,r Phone:
~ 1&I~ II ~ RII I~I. IV'u ~i NI i Name: -rc-
' Ill~l~...lr I (I II
Address / City / zip: t. r rt lrt . c
I!I N : N k I4I 1 I~~I ~II~, it , I : Applicant Is: Owner X Contractor
AWF N X504 71V
fl I'IIIII li~l ~Yllll I , ~I~I,L~ I~I,illl II pGon of work: i »l
Descri~ ( ~~.cc < r . ~ ~ 's ~
' , I'I I pJFI I
: _I r , G. h abr. u t k ~~rt ryn .l r r'Q1Q Ce. tt Ss "k
I. I yyI p IIry II I r - C h, ~e
1111 ~I' I!Idllki~ Ywf~~l~.~•I I I" Y~kl I Construction Cost: SU -00 Multi-Family Building: (Yes / No X c
I? f 1 I ~i I Company: Contact: ` rrnc8
k~~ III I~ ~I:
I. p+ t Ilf Address: I y 0 / r I r 4, ca c) `i City: tN'yt SV 1,P
I ~ ~P u~ gu^q ail. ~ ~II I~ ' state: Alw zip: S I `r Phone: ?:572- Sc"E 4c e9
~I . I k I I I ~
PyC ~_I'I -t
' ~!IM 9 License
1911 II I, (II I~ 1
If I S , il^I I 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 pennit.for% similar plan based on a master plan?
Yes _No If yes, date and address t'm2slor plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
,
4 , .
I ~'e!"~I'I I`IIIN'~AI Ild !IS I"'"I IIIII II:,"'`+•/~~I"~II ,I.I M/,~~/}~.I~~~' .I~WII/y~ IIM~S'/rYe.:,... r
N at/a~ a(fOn''o~k 'I
IIiI~ -~''1.-IIIII. III I" I'l lit .il llgl•lo~n tg ll".'I'~IIIIII' I•InIiIII.:I111 J:In.,111'I r~`I 7lflrilill^II e'll[I' 11• Y,I'ilUl~nil'III.IIIIN'll'•,1Cl ~r~ly~'y~~~I
IIJI~III~r I;i 1~ .I'll
I1` I r p I I, p cll hl b.ipq,p,n" I' qP III ` I"I Ib III
CCl> I I~e3sQ~jl ; ft ~Perin/glt ~clyltdq~Ip•III
Y I ' ~ I I . IIIII r , )I ~!I L~ ~Ildl . II~Jir . I L In L li. tnRlgl I'I;llr i . ~I il$r}I:IIIIII~Ih Y el ~I II' n 11 0 ~
I I ~ Ill 1111 ~J r 111 i. I 1d
illy, II IIUU9 1~ 19'u I ,l , I' I', ril • L I I'lifll l '1.1h91,111 sl.l'
II~I~I IL,lclllr,1,lll! ,l••Lll•II ~ttudelit~iar,~tker .6r.e,ltrade.s®t*relll~l~hl,d~lul...ll,tat.la'I,~..L,I,,Il.ll.1.1..llllplillllil~al.li,llarl•dul,ill.,.'I,..~~,I,I:IL,.llllll~~lcllll
i I
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 4544002 for protection against underground utility damage. Call 48 hours
before you intend to dig to rocalve locales of underground utilllles. www.aophorslateonecall.om
I hereby acknowledge that this Information Is complete and accurate; that the work will ba In conformance with the ordinances and codes of the City of
Eagan: that 1 understand this Is not a permit, but only an application for a permit, and work Is not to start without a pormlt; lhot the work will be in
accordance with the approved plan in the case of work which roqulms a review and approval of plans.
Exterior work authorized by a building permit issued In accordance with the Minnesota State Building Coda must be completed within 180
days of permit Issuanco.
x Ze"C'
Applicant's Printed Name Applicant's Si ure /
Page 1 of 3
Use BLUE or BLACK Ink
• _ r
For All Office Use I
City of EaEct n j Permit#: I Per mit Fee: V
3830 Pilot Knob Road
Eagan MN 55122 ;`r I Date Received: I
Phone: (651) 675-5675 r I I
Fax: (651) 675-5694 Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit M
Name: -F o M mtsl1$ Phone: (0-5-/- & gff • 6la( 8
RESIDENT / L1731 J /
OWNER Address / City / Zip: T 7 tLZE' Ott ite, a oqeGl ~an , M 5a~
Applicant is: Owner Contractor
TYPE OF WORK Description of work: ~3,;~ j J\J!~ F:o U!N SW, M (N~ t
Construction Cost: ~~R,00 U Multi-Family Building: (Yes / No )
Company: _ LAA (-k DfwL7(J Cb1-C VL O Contact:
Address: 1 ~ 0, i'0)c / City: L_4 4C Ut </~P
CONTRACTOR t ~
~~f yGt Phone: 'r/'to/~- 9 ?0C)
State: dN Zip: '
License Lead Certificate _W CoAk"4 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
conclude that they 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 Build' Code must be completed within 180
days of permit issuance.
x 1 lJo r x G
Applicant's Printed Name Applicant' ignature
Page 1 of 3
-7 6 DSO NOT WRITE BELOW THIS LINE 106 6 ~
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 `Nf, 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 O p Occupancy /L MCES, System
Plan Review Code Edition 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
I T9
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: y1Footings -Air/Gas Tests Final
Framing -C" Siding("_Stucco Lhth -Stone Lath -Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall: _ Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: fL , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge P09 lj
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
l
POOL PERMIT - APPLICATION SUBMITTAL REQUIREMENTS
Address: 4--)3l Lze.t-f ;t n e- Lo,,e-
Applicant Name: W 04 ~3n S
N
GENERAL INFORMATION
o 'z
Ja( ❑ ❑ Applicant name and contact information
)d ❑ ❑ Property owner name
.,Z ❑ ❑ Address of property
,Fe' ❑ ❑ North arrow, scale (1" = 30' or 40')
,,af ❑ ❑ Site Plan, drawn to scale showing location of house, pool, and other existing or proposed
structures, including retaining walls and fences.
fd~ ❑ ❑ Location and name of all streets adjacent to property
❑ ❑ Directional drainage arrows (existing and proposed)
ELEVATIONS
Existing
f~ ❑ ❑ House corners
f~ ❑ ❑ Property corners
❑ ❑ If applicable, ground elevation at each end of retaining walls and at wall's greatest height
Proposed
❑ ❑ Finished pool deck corners
❑ ❑ Top of proposed retaining walls (if any) and at each different elevation (if it changes)
.~X ❑ ❑ Pool bottom (or max. depth)
DIMENSIONS
Existing
❑ ❑ All property/lot lines
Jd' ❑ ❑ All Easements on the property
Proposed
❑ ❑ Pool
~I ❑ ❑ Pool plus integrated deck/patio
,21 ❑ ❑ Shortest distance from outside edge of pool deck to lot lines and house
/->x.
Reviewed:
Name Date
N
G:FORMS/Pool Permit Checklist/02-13-07
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SURVEYORS SUITE 200
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INC' Certificate of SurveY fors 'J2J452-71950
HUTTNER CONSTRUCTION
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ACCORDING TO THE RECORDED PLAT
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INVERT EI.EYATION AT SERVICE EXTENSiOAIes
o DENOTES IRON MONUMENT PROPOSEO GARAGE FLOOR ELEVATION
a DENOTES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION ■ ~D_ 3,..,.,..
DENOTES EXISTING SPOT PROPOSED BASEMENT FLOOR
/~33 ELE V#%TIQN ELEVATION
~1p34") DENOTES PROPOSED SPOT
ELEVATION NOTE VERIFY ALL FLOOR HEIGHTS WITH
DENOTES ORAtNAGE p1RECT1 ON FINAL HOUSE PLANS
ieEv r ~ E.D la/2fs'J9! - .t1F..kJ I-~ou5~. PG4-,c-1 _
I hsrew certify flat this survey, plan or
report ras prepared by me or wrMr any
direct supervision and that I am o dull Bradley J. Mo. Roo. Na. 1w
Re9istsred Land Svrvoyor wow the
~ Date
Laws of the Stale of Minnesota. IN
f
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA160957
Date Issued:04/24/2020
Permit Category:ePermit
Site Address: 4731 Hazeltine Lane
Lot:7 Block: 1 Addition: Fairway Hills 3rd
PID:10-25602-01-070
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Includes Skylight
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).
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 -
Tom W Ammons
4731 Hazeltine Lane
Eagan MN 55123
(612) 237-8876
Kat Construction Llc
8833 79th St
Annandale MN 55302
(320) 266-3455
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA165504
Date Issued:11/04/2020
Permit Category:ePermit
Site Address: 4731 Hazeltine Lane
Lot:7 Block: 1 Addition: Fairway Hills 3rd
PID:10-25602-01-070
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
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 -
Tom W & Anne C Ammons
4731 Hazeltine Ln
Saint Paul MN 55123--217
(612) 237-8876
River Valley Rpz Llc
1623 210th St E
Farmington MN 55204
(515) 210-2094
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA174699
Date Issued:02/14/2022
Permit Category:ePermit
Site Address: 4731 Hazeltine Lane
Lot:7 Block: 1 Addition: Fairway Hills 3rd
PID:10-25602-01-070
Use:
Description:
Sub Type:Water Softener
Work Type:New
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 -
Tom W & Anne C Ammons
4731 Hazeltine Ln
Saint Paul MN 55123--217
(612) 237-8876
Wix Plumbing Llc
178 Summit Point DDR
Hastings MN 55033
(651) 438-0006
Applicant/Permitee: Signature Issued By: Signature