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4291 Hawksbury Cir_, _. I '?? CITY bF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: 'Nf+ PERMIT SUBTYPE: ?,_ . 4 APPLICANT: I M ? . . , , 1 •?_ ? . t TYPE OF WORK: t-.I t w INSPECTION .. . .A ? . , t;;?l•:?,.`; ? F'Hi aN REcoRD PERMIT TYPE: Permit Number: Date Issued: t=ll I I It 041/1 :'/'44 :: 1.J 1'4.t:[d -1 Permit No. Permft Holder Date Telephone # SNV PLUMBIfvG HVAC ; ?J g?/-?oav ELECTRIC P ELECTRIC Inspection Date Insp. Comments Footings I i?// ,2/9y Founcation I??(t/?(y ? Framing Roofing Rough Pibg. 7 Rough Htg. I$UI. ? ? - - L - Fireplace Final Htg. Orsat Test Final Plbg. PI g. Inspector - Notrfy umber Const. Meter Engr./Plan Bidg. Final 9 S o.,/ C/ 47l*V. Deck Ftg. Deck Final Well Pr. Disp. I ' / v , 4 1 ,r • :• yF lf ', ?p• _ ? ? WerttfiCRte Df CCCltpaliC4 MM oq cfagan ' ?fltparbxent of $xiiiutg att6pectian Tlus Certificate issued pursuant to the requirements oj ihe Uniform Building Code certifying thal at the time of issriance tius stnecture was ia compliance with the various orrlinances of the City rrgulating building cautruction or use. For the following: use cbmrxatm: SE DG1G sag_ ??;t xo. 23248 OcaPancy 7ype R3M1 Zoning Distrid R i Type Const. 1vm ownff or suilaing JIIM KtFSIE.tIlE HOMES DC wabm 7270 148'LH ST, SAiAM swk%og Aa&m4291 AAW.SM CI= LocWity L3, B2, HAWHMVE 4J170[?S 2NID Dm: suikli otrK;.i P0.ST IN A CONSPICUOI)S PLACE 4*/g?1 ? 15627 REDUEST FOR ELECTRICAL INSPECTION ? See mstmcOQOS for car.zlel?.ting this form an beck oi yellow copy "X" 8elow Work Covered by This Fequest 9-'O?M,%' ?EB-?i°. ew Atld fiep ` Typeof6wltling ApphancesWiretl EqwpmentWiretl Home Range Temporary ServiCe Duplex Water Heater Electric Heating Apt. Building Dryer load Management Comm./Indusinal Furnace Other (SpeCify) Farm Air Condrtioner 00er (syecAy) Cantraotor5 qemarks // ? Compute Inspecfion Fee Below. Iv`?) 6"? ? # Other Fee # Service Entrance Size Fee # Crtcuds/Feeders Fee Swimming Pool ( 0 ta 200 Amps 0 to 100 Amps Transformers Above 200 _ Amps Cove440 _ Amps Signs Inspactor's Use Onry /' ? 7pTAL ? Irngauon Booms / / 1,,, o,J /ao Speciallnspection ? r?V Alarm/Communicatwn \ THIS INSTALLATION MAY BE OR'ERED D NNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTH . ' I, !he Electncal Inspector, here6y certity that the above inspection has been made Ro?yn-?? ? p,nai o ce I?T ? a a?_ p ? OFFICE USE ONp This repuest voitl 18 moNhs irom ? 5s? o °° Repuest oate r g re No- Fough-In InpsMron qeqwretl (YOU must cali mspeclor when ready) Inspedion Olner Tnen Rovgnin ? qeatly Naw? WAI Notity InsOector 1" Yes ? N. Date ReaEy IXlicensed contractor ? owner hereby request inspection of above electncal work at: Job Atlaress (SVaet. Box or Route No I it'loUl Ciry AW Secuon No Township Name or No Range No County Occu0anl(PRINT) POOne No ? - y I, O '1'6/ ? Y ? IV+iO r c N r?? ( ! PowerSu/p?pber ICl9? ?"^? _ Atltlress pGO?(.l Elecincal ConVacto, ICOmOany N&me ? ' Gonvactor5 Lwense No GfJ R? 0l96 Mamng Atltlre s ICAnVacror or Ownar Maving Installalion? aoz? f? 9? ? A& A I/ho?rrzeo SignaWr?e iC•O?nV?ac,onOwner Makm Instailatmnl . Phone NumOer MINNESOiA STATE BOARD OF ELE RICITY THIS INSPECTION REOUEST WILL NOT Griggs-Mitlway BIEg. - Poom 5-173 BE NCCEPTED 9V THE STATE BOARD 1821 Universily Ave., 5t. Paul. MN 55104 LINLESS PROPER INSPECTION FEE IS Phone (612) 602-0800 ENCLOSED Address 4291 HAWKSBURY CIR!7 Zip 5512 3 L.ot 3 Blk 2 Sub t3awnioxM woons zrID THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: Yes No Inspector: Final grade (6" from siding) Permanent steps (garage) Permanent steps (main entry) ? Permanent driveway Permanent gas Sod/Seeded gtass TraiUcurb damage Porch Basement finish Deck Please verify with the builder [he temoval of roof test caps from the plumbing system and the shut-off of water supply [o the outside lawn faucet before freeze potential exis4s. ' Contac[ engincering division at 681-4645 before working in righ[of-way or installing underground sprinkler sys[em. ? White - City Copy Yellow - Residcnt Copy Pink - Contrecror Copy RUr--= °"?.; 01 :23FT9 Ci 15T011 f9ILLbJGFr. P. 2i4 ?. C@,A?TO9d, MILLWOi1K, INC. i qE51DENTIAL . CpMMEHCIAL • INSTITlJT10NAL SERVICE & QUALITY UOR7H 2ND 57REET • NORTH SAINT PAUL, MINNESpTA 55109 (672)770-2356 FAX:770-0439 August 25, 1994 Ms. Pat Schumacher i Jin Koestering M 7270 148th eet Sau, 3e innesota 55378 Pat: Your ternperpd window replaCement i_ cj,- ntly on order with Lincaln ti'indows, but will not be here ir, i,iine .r• your final inspection and This error was made by our purchasing.department and is in no v y the ., fault of Jim Koestering Nomes. Enc[osed you will find a copy of the work order to show the bailding inspecto-. Ovr hope is that the gla5s will b in the r-xt 3 weeks and our service c' tment will instoll as soon a! arrives- I nope the huilding inspector ,_.1 grant a certificate of occupancy based on this information. We at Custom ^iitiwork apologize for our error, and promise prompt attention to this ma-".Yew unce the glass arrives. If the building inspector has a^, us here at 770-2356. :stions at all, please have him cail Sincerely, '1 1 . UudlOlson Sales Representative Custvm Millwork, Inc. DJO:mf i RUS "34 01:24Phl CLISTGPi hIILLldO,-^,K ORIGIVAL , Custom Millwork91nc. 2298 NorYh SeCOnd St, . NOrth St. Paul, MN 55109 f'hone: (612) 770•2356 SOL6 TO 7IM KOESTERIMfi HOMES 7270 148TH STREET SAVAGE MN 55378 - .. aF41P.F0 4291 HflWKSBiJRY CR FAGAN, MN ? F.a/a ** WORK ORDER *+r ORD?R NO' 18?37 1 oF 1 ?P•i 02 s?7 ,0 4 g s?7r. S DAYS ; viA: CM7 ? SFRViCE REFER SVBJECYS; TE?NIS S, CONbITIONS, MtNNESOTA LIEN PIQTICE, CMI PO: FCRMALDEHYpE ri':.PNING, SAG'KSIDE OF IPob'pICE. ? , ROERED e)p SHiPPED UlM ? . :. .UES£RIPSIOni _ ' • : <-: ,. ,-',I ..1, y,r.. '. ,'- .PR(?x ?.., , 7. 3 0 3 EA SP£CIAL QRf7ER 2068 TEMpERED IG W/ INT B6E GRS LoFS QRIG Wq # 12676 NO CHARGE 1 8 1? E„ SHOP SPECIqL CMI LRBGR TO INSTALL NO CHLIRGE u 25, 1444 13:22:37 OT: li Q r"" "?'?'' "SUB TOTAL ? . W f SALE$ ? ?i`,7? ' . . TAX ---? CITY O`F EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: tLINBG`! ? @23248 04/12/94 SITE ADDRESS: 4291 HAWKSBURY CIR 1.0T: 3 BLOCK: 2 NAWTHORNE WOODS 2ND P.I.N.: 10-32151-030-02 DESCRIPTION: SF DWG NEW R-3 M-1 V-N R-1 2 ?A c]! v u Bw3lding'Psrmit Type Building Wo,rk Type ?UBC pccupancy? Construction Type Zonzng ? Building Length > ? Building Width ` Building stories T? - REMARKS: PRV FEE SUMMARY: S & W PLBR - Base Fee Plan Review Surcharge SAC SAC % SAC Units 5ubtotal VALUATION $1,007.00 $654.55 $102.50 $800.00 100 1 $2.564.05 $205,000 70 43 MISCELLANEOUS Total Fee CONTRACTOR: KOESTERING HOMES INC 7270 148TW ST SAVAGE MN (612) 440-9611 - Applicant - ST. LIC . JIM 14409611 0001667 55378 $1,828.50 $4,392.55 OWNER: IM KOESTERING HOMES INC 270 148TH 5T AVAGE MN 55378 612)440-9611 S hereby acknawledge that T have read this infiormation is correct and agree to comply Statutes and City of Eagan Ordinances. - ?r PPL CANTlPERMITEE SIGNATURE applicetion and state that the with all applicable State of Mn. -j ru?n 6.u?. I ISS ED : SI NATURE INSPECTION RECORD CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITEADDRESS: LoT: s BLOCKe 4291 HAWKS6URY CIR HAWTHORNE WQOD5 2N0 PERMIT SUBTYPE: SF DWG PERMITTYPE: euzLoiNs Permit Number: 0 2 3 Z 4 8 Date Issued: 0 4 J 12 / 9 4 2 APPLICANT: KOESTERING HOMES INC, JIM (612) 440-9611 TYPE OF WORK: NEW INSPECTIONTYPE FOOTINGS .. . FOUNDATION .. FRAMING ROOFING INSULA7ION FIREPLACE RQUGH IN PLBG ROUGH 2N HTG FINAL PL66 FINAL REMARKS: PRV F L S & W PLBR - . ? ,. ? ? CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION 681-4675 ? ('U '+. 'i . PR 0 S iaiT..6 ?'??.g?lZ•_ L? ? ... SIN6LE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, i capy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested ance permit is issued. Date Valuation of work ?• oZ OS ?? U _ Site Address: +y2q/ l7-?fv A?Sb L,CCrp- ?e ? STREET SUITE ;7 7enant Name: (commercial only) LOT BLOCK Z SUBD.//_ ? ?P`J P.I.D. # ? r? T?t Descri tion of work: The applicant is: ? Owner Contractor ? Other (Describe) Name !2?inint_ Phone Property LAST FIRST Owner pddress STREET STE # City State Zip ? Company -:J-l m 6::?E5 lcri nvi Phone Contractor Address License #00044 Exp.3--3/- City S?Lqe .17 ? State /21 /? Zip Company 757,7m? Phone Architect/ Engineer Name Registration # Address ' City State Zip Sewer & water licensed plumber Lneqv?,, Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this a lication and state that the information is correct and agree to com?ly wi appl' e State of Minnesota Statutes and City of Eagan Ordinances. `- i Signature of Appli . " ? OFFICE USE ONLY rt , , , BUILDING PERMIT TYPE 4 ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging 'p? lAY ?O'.SSiy 16 Basement Finish IM 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. O II Swim Poo1 El 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory 0 18 Comm./Ind. ? 04 5F Porch ? 09 12-Plex 0 14 Fireplace ? 19 Comm./Ind. Misc. E] 05 SF Misc. ? 10 Mult9. Add'1. ? 15 Deck O 20 Public Facility ? 21 Miscellaneous WORK TYPE 0 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Oemolish ? 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual) /1? Basement sq. ft . ? S MWCC System (Allowable) UBC Occupancy 7? ? / lst F1. sq. ft. 2nd F1 ft pv SS City Water ? PRV R uired . , sq. . ?4a80 eq Zoning ? Sq. Ft. total Booster Pump # of Stories Footprint 5q. f t. fire Sprinkler Length 7 On-site well Census Code se/ Depth ? On-site sewage SAC Code ? Census Bldg APPROVALS Census Unit ? Planning Building Assessments Engineering Variance REGIUIRED IN SPECTIONS ? Site fi3 Fo oting k$ Framing 42 Insulation ? Wallboard 93 fi nal ? Uraintile (B Fireplace Permit Fee veiLmc;m: g ? p.?`aU ? Surcharge Plan Review .Ae License MWCC SAC yV X 76 city sAC Water Conn ?a,sk?l.s = sG . Water Meter 3 krS', y= ?!G Acct. Deposit I K t?;Y = ' 7 s 9 a4' : S/W Permit 6 ?y 5/W 5urcharge Treatment P1. Road Unit d Park Ded. 7rails Ded. 9 ?ADl,a0 Copies Other Total: 3 ? !o K SAC Y SAC Units I ? f ? IAT snvLY CLtCZLIBT !OR SLSIDLIQR'M sais+a=xo LRXIT JLP LZG?TI PRopaRTy ..R.,.: J 2 - ? nate et s ey: -2 DDCOlSLNT RT unAena -Ur- eII 8?0 O D • • Registered Land Surveyor siqnatuss atsQ eompany 8 il 8'O D • u Qinq permit Applieant Leqal deseziption D' D D • 1ledrass HrD D • xorth arrov and ses seais • ?"a 0 • 8ouse type (rambiss, valkonL, split split D • lookont, ete.) Directioaal drainsq* azrovs vith slope/qradient i. ? D • Proposed/axistinQ sawsr and rates aervioas 0 • Strset name D D • Driveway sL?v??s=ops D?O t7?0 D D • t2[3.etin4 sevez serviee • Lot eoznors O? 0 D 8? 8?0 • • Top of eurb at the dzivevay Elevations of any existinq adjaesat homas ?G D • 4reses?d caraqe lloos 0 D • First iloor D"0 D'"D 0 D • Lovest axposed elevation (valkouL/vindov) D?D D' • • property oorners Fzont anQ rsnr of bomt at the ioundation D D ? • p02iDi106 LRLRB /i! ?s?lietbl?l Tassmsnt line . D L! o rT O a • xwz, • a ?d f aesigr?atien iT D fter9eney Overilov =itvstion a=xtxsroNs enuY. Lr?D O • =.ot 213205 B??D D • Riqbt-of-vay and stzest vidth (to baek of curb) ?" D D • proposed Aome dimensions Sneludinq any proposed deeks, overhanqs qreater than =•, poroAes, eLe. (i.e. ali structuzes requisinq permanent Sootinqs) 1?D 0 • Show a11 eesementa of secosQ and any City utiiitiss vitAin tAose aas:ments 8'0 D • Setbaeks of pzoposea structure ar?a setDaek of adjaeeat existing homes, DDOI)- • Retainir,q ll r?quiremaats, ii any Revisved: Y'E?r 3 - :.? c, :u / P , 6 ? I/32 BEND-1 n_D? -cF s*yy `•[J s ? „ • 6 GATE VALVE ? - r ? ` - _ ? ? 13 7 I ? 6i/326END I ?. 12' I I ? ? ? ? ? I 0 9 g CI i Y OF EAGAM DOES f?C?? CU?RANl°E? i hir I 16 TF i E A C C U R A C V O F U T I L I T L O C A T I O f V S F. SEE SHEET N0.9 ANDIO ELEVATIO NS. 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SITE ADoRv-Ss LO 3$? 6, rwo s ODNTRACfORM 1 ic\ 4V ??? (D WTE'T 15 Iq I PF30:E 40 - Determine working square footage o£ each. 1. Total exposed wall area ...... 2 Z L.? sq, ft. X r ) I -1354j4_Z. 2. Total roof/ceiling azea .... sq. ft. R??2? - , Q A. Total wall window area .......................... ? 0 I B. Total door area ................................. C. Total sliding glass door area .................:? D. Total £ireplace wall area ...................... E. Total wall framing azea (average 10e).......__.. F. Total Ria joist area...................... ..• G: Total Net wall area above floor................. ZIZ Total er.posed foundat=on area - ? ?s H: -1'otal foi:ndation window azea .................... I: Total net foundation area above grade._-.........? Determine "O^ value of each rrall segment. a. x «n' ? b. - X `o" C. 4 L X "D^ • d.?_ X ^D^ C. ?,ZZ X *Qn X ^D'. $? I ZA Y °U". < )( 11. `II" i. l(p'? X "U" , Z? ? 4,2 ,?= 2 IZ -- ? ?? 2- e04• ° 14 3 ...................................7bta1 3LI/ I If item 03 is the svnc as, or less than itcm 01, you liave mt thc intent of SDC 6006(c)2. .':• . . Totul exposad rooP/cciling arca aI ? j. 'Potal s}:yliglit arca .................:............. ? k. Total roof/cciling framin9 arca (avcragc 102)...... 1. Total net insulate:d roof/cciling arca .............. Determine "U" value for etch roof/ceilinq segment. C/ X nUu t9- a O . • k.? x l'U" 1. I Vl1 X?Vlf ? DZ14 .'?so2? 4 .....................................TOtd1 4 zII z If total of fl4 is the same as, or less than fl2, you have met the intent o£ SBC 6006 (c)1.' _. . . - • Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of items #3 and 84 shall not be greater than the sum of items #1 and #2.. ? 1. , ? ? ? ? 1 (?r.?.. t Z. 41 40 a IZ. ZD 3.' 7i(Dq,Q.?? +a. 42-1 /1_ wa? ?, PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTT. i/ "dEW CONSTRUCTPON ,Z?/e,?I fo M ADD-ON A/C l) ADD-ON FURNACE FIREPLACE INSERT DATE 6?-d 4 - Ci L/ FEES HVAC: 0-100 M BTU $ 24.00 - ADDITIONAL 50 M BTU 6.00 vAS i'Ji.TT`l.E. (14R:TN.UM is- 33.aD F_ACh7 " ADD-ON/REMODEL (EXISTING CoNS'rRUCI'ION) $ 20.00 STAT'E SURCHARGE .50 TOTAL el7 -fo SITE OWNER TELEPHONE #: INST, a AtR copnmoNiNC co. CITY: °$J'um STATE: ZIP CODE: TELEPHONE #: tfiY1-4QGo ? ._. , ,,.. . ., .. SIGNATURE OF ERMMEWj? 1994 MECHAHICAL PERNIIT (RESIDENTIAI.) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 1994 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PIIAT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETB FOR ALL COMAERCIAL/INDUSTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUII2ED FOR EACH DWELLING UNIT. DATE: NEW BUILDING IN1'ERIOR IMPROVEMENT WORK DESCRIPTION: CONTRACI' PRICE: $ FEES 1% OF MNTMFEE $ PROCESSED PII'ING: MINIMUM F'EE: STATESURCHARGE TOTAL SITE $25.00 $25.00 $.50 FOR EACH $1,000 OF FEE. $ OWNER NAME: TELEPHONE #: TENANT NAME: (nMPROVEMENzs orLY) INSTALLER:__ c ? • • ?; '. , CTTY: TELEPHONE #: STAT'E: ZIP CODE: SIGNATURE OF PERMITTEE CITY INSPEGTOR PLEASE COMPLETE FOR SINGLE FAMTLY UWELLINGS. AISO, FOR TOWNTIO MES AND ------ - ----- CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. 'NO. FIXT[TRES A?CH TQTAL " ? 5I-IOWER 3.00 T WATER CI.OSET 3.00 BATH TUB 3.00 LAVATORY 3.00 KITCHEN SINK 3.00 LAiJNDRY TRAY 3.00 HOT TUB/SPA 3.00 WATER HEATER 3.00 ? FLOOR DR:AIN 3.00 GAS PIPING OUTLET • mi,amum - i 3.00 3 ROUGH OPENINGS 1.50 WATER SOFTENER 5'.00 PRIVAT'E DISP. • oak.cYy. tic. 20.00 U.G. SPRINKLER • bome under co,w. 3:00 ALTERATTONS • to wumg 20.00 WATER TURN AROLTND 20.00 STATE SURCHARGE TOTAL: SIT'E ON:'I`.'ER INST, &41) ? S • ? 0- :5A 5?v OO, CITY: Ap, Gt9'.aAT STATE: /h 2IP CODE: ; vr PHONE #: ( lp/d-) 115 Z- -/SC? 5 9IGNATURE OF-PERl`vfIT-TEE 1994' PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR ALL C0141MERCIAI./INDUSTRIAL `BUILDINGS. eALSQ FOR.'MLJLTI- FAMILY BUIL.DINGS WHEN SEP:4R.ATE PERNITTS ARE: >NOT REQiJIItED FOR BACH DWELLING LTNTT. _ NEW CONSTRUCTION ADD ON REPAL°. WORK DESCRIPTION: CONTRACT PRICE: $ FEE: L% OF CONTRe?CT FEE, STATE SURCHARGE $:50 FOR EACH $1;000 , OF , FEE, DIINIMIIM FEE: S 25.00 ? CONTRACT pRICE If 1% $ STATESURCHARGE $ TOTAL $ k ` SITE ADDRESS: .:. TENANT NAME• STE. # OWNER NAME: INSTAI.LER: ADDRESS: CITY: PHONE #: STASI'E:_ ZIP "GODE: - t? - _ FOR: CITY OF EAGAN APPLICAN1i 1994'RLUMpBING PERNIIT (CUMMERCIAI:) CITYAOF`EAGAN 3830 RII.OT ICNOB `RD EAGAN, MN 55122 (612)G81-4675 7?7 7V 2007RESIDENTIAL BUILDING rExNnT nrrLicaTiorr City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWction Reouirements 3 registered site surveys showing sq. ft. of lot sq. ft. of house; and pll roofed areas (20% maximum lot coveraqe allowed) 1 5oils Reporl if proposed building is to be placed on dislur6ed soil 2 copies of plan shawing 6eam 8 window sizes; poured found design, elc. 1 set of Energy Calculalians 3 wpies of Tree Preservation Plan ff lot plalfed after 711/93 Rim Joisl Delail Options selection sheel (6uildings w(ith 3 or less units) Minnegasco mechanical ventilation form RemodeVReoair Reouiremenfs 2 copies of plan showing faolings, 6eams, jalsis 1 sel of Energy Calculadons far heated additions 1 sile survey for additions & decks Addition - indicate if onsite seplic system 2 0'" [ Office Use Onlv CetlotSurveyRecd _Y _N SoilsRepoA _Y _N Tree Pres Plan Recd _ Y_ N. TreePresRequlred _Y _N On-sileSepGcSyslem _ Y _N Plans are considered public information unless you state they are trade secret and the reason. Date 9 / / z- / o I) Construcfion Cost s/? p 7 _ / Si Add ,? / ` te ress v 2 R 1 aW K h u e Unit/Ste # ? lC Description of Work Re 1,0n-F, Mu?H-Family Bldg _ Y -.? N Fireplace(s) _ 0_ 1 _ Z Pmperty Owner / /G /-P /C ?/`?.N.y Telephone # ( &5-() .?,? ? _ Gyy Z Contractor P) GJYIOC! 4 (e A S Address y?/ l /?? City State lovl-I Zip Telephone # (457) p- l ? CaMPLETE THIS AREA ONLY IF Energy Code Category - Minnesota Rules 7670 CateQOrv 1 • Residential Ventilation Categary 1 Worksheel (J submission type) Submitted • Energy Envelope Calculations Submilled A NEW BUILDING Mixmesota Rules 7672 • New Energy Code Worksheei Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based oh a mpster plan2 _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor I hereby apply for a Residential is comulete and accurai e; 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 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. ? Z /?nPt?o l Applicant's Printed Name AppJ cant's Signature ZIl Telephone #( Telephone #( Telephone # ( ? rd¦.e?a? ? uArN1G.?5?uR.Y CtRGL.? LA 722 a0i APa es 194 iv:ia • -..Nw I do ltw ... ,_ ovv ??? 4 +c„°9i9?Y ° ? 29.5 "? ? tS r _S C:Al'•'e' ' a$a' j. 5' Iz.v ? 1 ?' AA.L FSC-pR1tJLiS A5SLSt+II?D PiZoPos?a ? I e0'rNn'CElp lRa?d MoNuMEniT r ? ? m P,6 ? 1?0?79E o -1 ??l.y. • ? /j"?!b ?R?MP.?\..?, e? UJ ?o ? aas Sq ? ap p ? rz,?? ? ? ?ol . ? S EAGAlv E GI?EE G DEFT. ? ? ? 9 • . ? ? A Q AR P Y &t }AI E fl ' - A ???._. . . ? ? , •l?ls.?t.lTl-Te5t7.K6 Woe?05 ' ? iaD ACp l'?(' 1o1.1y pAlcaa?T'A GouNTY? • ? I ? Mi?*l?SoTA j?11'_??' ? . ? n LL I hereby certify that th3.e swCVey wa8 pa`epax'ed by me or ? under my direot supervision and that I am a du],y Registered ; Land Surveyor under the laws of the State of NLinnesota. Date: 12, /5 ? .? .?c._.k. ' `? ?pY H. ohen ? 42r°-44Registered Land Surveyor No. 10795 IT: F A.y. ian, 44-o - 94014 ;?;97% 04-05-94 04:19PM P001 #23 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA109715 Date Issued:04/01/2013 Permit Category:ePermit Site Address: 4291 Hawksbury Cir Lot:3 Block: 2 Addition: Hawthorne Woods 2nd PID:10-32151-02-030 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. Kris Oien 3670 Dodd Rd Eagan, MN 55123 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Hung T Tran 4291 Hawksbury Cir Eagan MN 55123 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature