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904 Lakewood Hills Rd NCITY OF EAGAN Remarks Addition Lakewood Hills Lot 19 sik 1 Parcel 10 44350 190 00 „xj?g. owner?6- street `946" No. Lakewood H311s Rd'state Eagan, MN 55123 tmprovement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK SEWER LATERAL WATERMAIN - WATER LATERAL WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. sac $375.00 9187 10-11-73 PARK c= c^ EAcaN 3?"i Pi.7.ot Knob Foad EaG-M, N;inr.Leaota 55122 T?.e City oi Eagan herehy grs.n ts to rGo ? PEPlilIT IVTO.:____ {q_ of 1001 !larie Ave. 30. , 30. St. Paul. P4Q 55072 J. Haxaann, X. stroaky, J. Dacaqar, C. Irish, =_ iTZ" PMR _ Permitsfor: (Owner) p, Gaueman. B. MOrcan, lnd M. Her ? 4270 Stir-='r. 7223rL +?^---, • e?i er.? . ? ui ?».• --??=?s?a od ? ?- ? rt to applic ation da ced 5/5%16 _ Fce P^._j.da _---$35.00 dzted this ?.. 25 day of Play ?. ??_ 76,.i 3,50 sJc ? i . Iiui_d.ing.T_n;:p?,c "tjr = Ferr°its: t;iu Totcut • i ? ' . , ? T i 4E)-c1tv oF 3830 PILOT KNOB ROAD, P.O. BOX 21199 EAGAN, MINNESOTA 55121 PHONE: (612) 454-8100 April 28, 1987 MR. LARRY GliTHRIE 904 LAKEWOOD HILLS DR EAGAN, MN 55123 TO WHOM IT MAY CONCERN: 8EA BLOM9UIST Mayor THOMPS EGAN JAMES A. SMRH VIC ELLiSON 7HEODORE WACHTER Coundl Members THOMAS HEDGES CNy Adminishator EUGENE VAN OVERBEKE aN awk The original building permit for construction of the above referenced property was issued October 11, 1983. Construction of this residence began with a footing inspection on November 14, 1973 and continued inspections of the home and private disposal system were made through February 1984. At that time, this re.sidence was constructed according to City and State building codes. Sincerely, Doug Reid /L-?--i t?- ? Chief Building Official DR/is THE LONE OAK TREE. ..THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNIN ? ? M? 1 ? ? •J ? ?- Olt \ 1 U 4 I S Z --k 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. *100.5o Date1/ ! //-/ I G S }J. site street Address . i9?°?%? ?y Unit # 14 Z Property Owner /7 Telephone # ( ,?d4?5 Contractor Telephone # (21v ) NIa'.X19 Address Gz7 11 :wll 4g74 , N-uJ City 1VALV•zV1 State %d4 Zip !56464 The Applicant is: -z?, Owner _ Contractor _Other Alterations to existing dwelling $ 50.00 _ Add plumbing fixtures. This fee includes putting in a water softener and/or water heater at the same time. !f You are installinp only a water softener and/or water heater, do not complete this section. Move to the next section and check-th-e appliance(s) you are installing. ?.7', i; , _Septic System Abandonment _WaterTurnaround (add $125.00 if a 5/8" meter is required - Other: -? R 30-:4-c? 10105 Water Softener Water Heater $ 15.00 _ new _ replacement Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ •50 Total $? I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accor d the approved plan in ? the eve?,is r?i?e be reviewed and 2bk ?' /IV a Applicant's Printed Name re Qov , ° - CASS COUNTY ENVIRONMENTAL SERVICES ` TRENCH DESIGN SHEET APPLICANT NA t U h? - TOWNSHIP FIRE#_ ?' p ? Lct -tJ?oe PERMIT# m' DATE DESIGNER NA E Z;E 6?zif S-ZA CERTIFICATION # 12100 SIGNATURE: let? DATE: Im - 1'l- D 5 SITE EVALUATION # WATER USE APPLIANCES (CHECK ALL THAT APPLY) CLOTHES WASHER_ WATER SOFTf?ER_ DISHWASHER_ WHIRLPOOL_ HUMIDIFIER_ / NUMBER OF BEDROOMS 3 TYPE: I?II_ GARBAGE DISPOSAL:YES_NOK AIR TEST: YES_ NO_ WELL: DEEP (50'+)Zt SHALLOW _ SETBACKS: TANK DRAINFIELD SEWER LINE FLOW A. ESTIMATED A-S-b GPD OR MEASURED GPD B.SEPTIC TANK VOLUME 164C -EauS i ,/JfOGALLONS C. PUMP TANK VOLUME GALLONS SOILS D. DEPTH TO RESTRICTING LAYER S?-fFEET E. MAXIMUM SYSTEM DEPTH (D-3) 2 FT OR ELEV. F. PERCOLATION RATE MPI G. SOIL SIZING FACTOR 1,tcj SQ FT/GPD TRENCH BOTTOM AREA H. 6 IN. OF ROCK OR GRAVELLESS:A x G= x= SQ.FT. 1. 12 IN. OF ROCK: A xG x 0.8= x = SQ.FT J. 18 IN. OF ROCK: A x G x 0.66= x = SQ.FT K. 24 IN. OF ROCK: A x G x 0.6 ?x. (p =45 i_SQ.FT BED BOTTOM AREA (6 OR 12 INCHES OF ROCK) L. SEEPAGE BEDS: 1.5 x A x G= 1.5 x x = SQ. FT. M. PRESSURE BEDS: A x G= x = SQ. FT. ROCK VOLUME IN CU FT 7 CU FT. N. ROCK DEPTH 2+0.5FT.x(H,I,J,K)45= lll ROCK VOLUME IN CU YDS ROCK WEIGHT O. N. Il2'7 =27= A-2 CU YDS P.O.x1.4=5$-?L TONS SYSTEM LENGTH Q. BOTTOM AREA (H-K) AS-L = TRENCH WIDTH?_= I? LINEAL FT LAWN AREA R. SELECT TRENCH SPACING, CENTER TO CENTER= ? FT. S. MULTIPLY TRENCH SPACING BY LINEAL FEET R_?_xQ lL,& _1152> SQ FT OF LAWN AREA ESD APPROVAL: TE: COMMENTS: CHECK OFF LIST--HAVE ALL OF THE FaLLOWING BEEN DRAWN ON THE MAP?? SHOW EXISTING OR PROPOSED--? WATEK WELLS WITHIN 100 FT OF TREATMENT AREAS ? PRESSURE WATER LINES WITHIN 10 FT OF TREATMENT AREAS ? STRUCTURES ? LOT IMPROVEMEf,JTS ? ALL SOIL TREATMENT AREAS REQUIRED SET BACKS-? STRUCTURES ? PROPERTY LINES ? OHWL ? HORIZONTAL AND VERTICAL REFERENCE ? POINT OF SOIL BORINGS ? DIRECTION OF SLOPE ? LOT EASEMENTS ? ALL LOT DIMENSIONS ? DISTUR2ED/ COMPACTED AREAS ? ACCESS ROUTE FOR TANK MAINTEN NCE ? SITE PROTECTION-LFTHE AND R16BION E'?JERY 15 FT COMMENTS: I? ? : DESIGNER SIGNATURE: .44r'1 DATE 1-^)I-D S LICENSE # ? Z& FIELD EVALUATION SHEET Preliminary Evaluation Date _ 10-05-05 Field Evaluation Date 10-05-05 Property Owner S7EVE pNp DEBBY NEINE Phor?e X Address X Clty, Stdte, Zip X Legal Desc x PIN # X Sec X Twp X Rng X, Township X Fire # Lake/River_ Lake Ciass ,_ OiWI _ ft Description of Saii Treatment Area #1 Area # 2 Reference BM fit Disturbed Areas Yes No X Yes _ No N Reference BM Description Compacted Areas Yes No X Yes _ No X Flooding Yes No X Yes _ No XX Run on Potential Yes No N Yes _ No X S10pe % 4 4 Direcdon of Slope N TQ,S N TO S Landscape Pqsition OPEN OPEN Vegetation Types ?w ED5 WEDS Depth (ft) to Standing w0ter ar mottied soii--Boring ,11 5+ 3A) SxA 21 5+ ZA) 2xA Bottom elevation- first trench or bottom of rock bed i) 3' R 21 3' ft Sail sizing factor i] 1.67 2) 1.67 Construction Related Tssues Site Evaluator license # Evaluator Signature Telephone System approved by Lug Review Date Comment Soil Boring Logs on Reverse Side This form prodaced by Septlc System DesFqner, copyright 2000 - 2002 MC SoRware Stephen Heine 904 Lakewood Hills Rd. Eagan, Mn. 55123-1912 - SOIL BORINGS FOR BOTH PROPOSED AND ALTERNATE SITES ? 1(BROP03M) 30IL3 DATA 2(PROPQSED) SOTL9 DATA . D8PTH TEXTURE MANSELL AEPTH TEXTURE MUNSEI,L (INCHES) COLOR (INCHES) COLOR 0-10 TaPSOIL lOYR 2/2 0-12 TOPSOIL lOYR 2f2 11-30 I,pAM 10YR 5/4 13-32 IAAM IOYR 5/6 31-60 SANDY I,OAM IOYR 6/6 33-60 SANDY LOAM IOYR 6/e 1(ALTERl3ATE) SOILS DATA 2{AT,T&RNA'1'ffi) SOILS AATA DEPTH TEXTURE MUNSELL DEPTH TEXTURE MIJNSELI, (INCHES) COLOR (INCHES) COLOR 0-14 TOPSCII, IOYR 2/2 0-11 TOPSOTL lOYR 2/2 15-33 LUAM IOYR 5/4 12-31 I+OADi lOYR 5/8 _...T-. 34-60 SANDY LOAM IOYR 6/6 13-60 SANDY LdAM IOYR 6/8 ADDITIONAL SdIL BORINGS MAY BE REQUSRED This form produced from Septic System Designer, Copyright 2000-2002 MC Software JOB # .PEKC6LA • DA Company Name_[,? License Number_! Percolation Test Performed by?-QJX?6 GJ1 ll???? __ ___ ?Atl Homeowner Name__ Address 904- ?l?`?cl.±.???J__ t/lC.CJS UAwL---?A!? ,? Test Hole Diameter of hole _ _inches Location Method of scratching sidewall Depth at bottom of hole ? _inches Depth of gravel at bpttom inches Date presoak started Starting atG]' AM ! PM Depth of initial water filling `24 above hole bottom Method used to maintain 12" of water depth in hole for 4 hours t? ?° Date presoak ended i__ Ending at ?? __AM /6m v? Date perc readings conducted ?_ Starting at J_? _AM /- r Maximum depth a6ove hole bottom during test _ 2 inches Surface elevation (in reference to benchmark): Directions: Enter elapsed time and drop in waterlevel and the rest will be calculafed * 3 consecutive percolation rates must be within 10% or less of each other I hereby certify that I have completed this work in accordance with all applicable ordinances, rules and laws (date) (signature) _________(license - PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA153761 Date Issued:01/22/2019 Permit Category:ePermit Site Address: 904 Lakewood Hills Rd N Lot:19 Block: 0 Addition: Lakewood Hills PID:10-44350-00-190 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). 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 - Matthew Gmach 904 Lakewood Hills Rd N Eagan MN 55123 (612) 834-0681 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA161375 Date Issued:05/20/2020 Permit Category:ePermit Site Address: 904 Lakewood Hills Rd N Lot:19 Block: 0 Addition: Lakewood Hills PID:10-44350-00-190 Use: Description: Sub Type:Fireplace Work Type:Gas Fireplace (new) Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 - Matthew Gmach 904 Lakewood Hills Rd N Eagan MN 55123 (952) 513-7706 Glowing Hearth And Home Llc 100 Eldorado Dr. Jordan MN 55352 (952) 492-9276 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA178744 Date Issued:08/31/2022 Permit Category:ePermit Site Address: 904 Lakewood Hills Rd N Lot:19 Block: 0 Addition: Lakewood Hills PID:10-44350-00-190 Use: Description: Sub Type:Fireplace Work Type:Gas Fireplace (new) Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 Total: This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after started. 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 - Matthew & Jessica L Gmach 904 Lakewood Hills Rd Eagan MN 55123 Glowing Hearth And Home Llc 100 Eldorado Dr. Jordan MN 55352 (952) 492-9276 Applicant/Permitee: Signature Issued By: Signature