1440 Hemlock CirCITY OF EAGAN Remarks
Lot 1 1 sik 3 Parcel 10 24bdO 110
Street
22
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SANSEW TRUNK 1 61.25 C009998 1-1?-85
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA
STORMSEW TRK 1983 403.96 26.93 323.17 C009998 1-10-85
STORM SEW LAT _
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 280.00 3810 7'9-71
BUILDING PER. 2 Q
SAC 240.00 7254 - -
PARK
7 INSPECTION RECORD
CITY OF EAGAN PERfIAIT TYPE:
, 3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date issued:
(612) 681-4675
SITE ADDRESS:
, . ,?1 ML?1C?: r cl?
I ' 'lt=NtiRFE N !'AF'k
PERMIT SUBTYPE:
11 WA, CIK• APPLICANT:
l A - I .' 1 4 (.i
TYPE OF WORK:
?', , ,i : ; F.lf-)
II /96
R t: I'A I R
(PAr 10.0o01k)
a IanI
?
? - - - - - - - - - - - - - - - - - - - - - - - - - - -
Pertnit No. Permit Holder Date Telephone 0
ELECTRIC
PLUMBING
HVAC
Inspection Date 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
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
.. ,. ,
/i 3 (?-•i •
TOWN OF EAGAT3
3795 Pilot ;Cnob Road
Eagan, iIinnesota 55121
PERMIT N0.
The Board of Supervisors hereby grants to,g, r_ ,^.=,,-rPt i n r,.+,
Of nc?(; V_Ct'E,- Pnnl FF717
8 wi ?r-cr/Permit f/or: (Owner) Tilsen Constructian Co.
. / ?h' c? y ? ?n ?G n .y
at .,_?,__ ?7,,.,.e, r„,,,,, 5512? , pursuant to application dated
7 /10 171
Fee Paid: cqn _nn Dated this ,^,day of 3y) 5, , 197 ,
.50 S/C
Building Inspector
//-2 C5, r
T047N OF EAGAN
3795 Pilot Knob Roar.l
Eagan, Minnesota 55122
PERMIT N0. . 136
The Board of Supervisors hereby grants to Ne31 & Hubbard Seat3ng
& Air Cond. of 99 No. Snelling, 3t. Pavlo I+AT. 55104
a Heating Permit for: (Owner) Tilson Construetion
at 1$40 Hemloek , pursuant Co application dated
Auguet 16, 1971
Fee Paid; , 20.00 Dated this 17 day of AuguSt , 1971
.
-50 3 0
Building Inspector
CITY USE ONLY
PERMIT #: `( 1 T,3 ( RECEIPT DATE:
??? RESIDENTIAl. MEL`$LAMCiA. ? ??PLIC,ATIOR
CITY OF SRHAR
. . 5880 PQ.OT 1{AOB RD `'' ? `? 1,
???ss12E , D ?? C: I.;
651-681-4675 " APR 01 , jU02 L
?hJ
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: ? - a's v?
SITEADDRESS: I`?yU ??fYIICS ? L c Ll°u
OWNERNAME: C??"1C? TELEPHONE#: COc?J-y5,??-LD?QC(
?
INSTALLER NAME:
STREET ADDRESS:
CITY:
T. fNIC:
Place a check mark next to the permit work type
ZIP:
? Add-on, modification or alteration to existina dwelling unit $ 30.00
• fumace replacement
• air exchanger
• air conditioner
• other
Nature of work:
State Surchar e $ .50
Total $
IL" m1?1?' t "0 J" -) ?-
SIGNA OF PERMITTEE
' - _ . -- ----"c#:
Wo}ilers Southside Htg. & Air., Inc.
6950 W. 146h St., #106
Apple Valley, MN 55124 -
(952) 431-7099
t/oz
CITY USE ONLY
PERMIT #:
APPROVED BY:
INSPECTOR
RECEIPT DATE:
8008 COMMEftCLAL ME CHAftICA1. PERM1T AFPLICATION
CITY OP EAfiAA
3$30 PILOT I{ftOB RD
ElGkA, b!N 551 EE
651-6$1-4675
Please complete for: all commerciaVindustriai buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME: PHONE #:
TENANT NAME (IMPROVEMENTS ONLl):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
STREET ADDRESSe
CITY:
TELEPHONE #:
STATE: ZIP:
WORK T1'PE: New conshuction Install U.G. Tank
_ Interior IWrovement _ Remove U.G. Tank
_ Processed Piping
SpecifyNature of Work:
When installiag/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and
Plumbing inspector.
Fees: 1% of conhact price OR $50.00 minimum fee, whichever is greater.
Underground tank removaUinstallatian = minimum fee
Contract price; $ x I%= $ (Base Fee)
Shte surcharge - calculate at $.50 for each $1,000 Base Fee
TOTAL ?
$
SIGNATURE OF PERMITTEE
Updated 1/02
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675 (t
New ConlrucMon Reauiremenb
• 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas
(20% maximum lot coverage allowed)
. 2 copies of plan showing beam & window s¢es; poured found design, etc,)
• i set of Eneyy Calculations
. 3 copies of Tree Preservation Plan if lot patted after 7l1193
• Rim Joist Detail Options seledion sheet (61dgs wiN 3 or less units)
DATE
JOB SITE
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY
RemodellReoair Raouirements
• 2 copies of plan
• 1 set of Energy Calculations for healed addilions
• 7 sile survey for exterior additions & decks
. Indicale'rf home served by sepfic system for addilions
S O?
VALUATION
TYPE OF WORK 6992 [? "A?Z?-
APPLICANT
ADDRESS
PAGER #
PHONE#
ZIP CODE
CELL PHONE # - ?i/2'?'ZY.GOG0 FAX #
NtIV RESIDENTIAL BUILDING ONLY - FILL OUT CO
Energy Code Category MINNESOTA RUI.ES 7670 CATEGOR J?p? 2 7 2002
(check one) - Residential Ventilation Category t Worksheet mi e
- Enargy Envelope Calculations Submitted sA)
_ MINNESOTA RULES 7672 By
- New Energy Code Worksheet Su6mitted
Plumbing Contractor. Phone #:
Plumbing System Includes: _ Water Softcncr _ Lawn Sprinkler Fee: $90.00
_ Water Heater _ No. of R.I. Baths
No. of Baths
Mechanical Conhactor:
Mechanical System Includes:
Sewer/Water Contractor:
Air C;onditioning
Heat Rccovery System
FIREPLACE(S) _ 0 _ 1 ` 2
Phone #
Phone #
Pee: $70.00
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that th 'r?(orm ' n is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan rdi b
Signature of Applican
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 2002
^'!' s'/_ j 0 esT
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Eut. Alt - Multi
? 03 01 of _ piex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch(screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? OB 04-plex ? 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
? 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED WSPECTIONS
_ Footings (new bldg) Final/C.O.
_ Footings (deck) FinallNo C.O.
_ Footings (addiUon) _ Plumbing
_ Foundarion HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool
Ftgs
Air/Gas Tests Final
_ Framing _
_
Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ _
Final _ Windows (new/replacexnent)
_ Insula[ion _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S8W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
(Y !'tr. F:(di:;6:?'2
,{1..1i_.. ?."•./OE;:`?'?r, 'T.I.'J'_a ''.f;:i.'e?r:i
!Tln
EL..I1G.R-'.1!'NE.''; CNC
,. ca_(? `)JI::1:1. .'•.440 Fil_f?i_f I!_i< f'i 6??.,;=,_
(:r..
113ii::`_? .i`??,. ?ltll"i?.•?',,
_ . PERMIT
CITY OF EAGAN
3830 Pibt Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 029193
(612) 681-4675 Date Issued: jI -1-8 / 0 8/ 9 6
SITE ADDRESS:
1440 11EMLOCK CIR
LOT: 11 BLOCK: 3
EVERGREEN PARK
P.I.N.: 10-24880-110-03
DESCRIPTION:
(PATIO DOOR)
wuilding,Permit Type SF (MISC.)
6t]iI[ling tWbrk Type REPAIR
Cens;us Code ° 434 ALT. RESIDENTIAL
T?1
,
\
•-?
#":,i:?
? ' . ?' F
r Jr°
?
y
c ,.
t ? E• r l?r ?f lk I.
Th. ...e .. P2 '..sa -c_.. ..t ?..._.- 3 ?''*...?..d. ?
REMARKS:
FEE SUMMARY:
VALUATItlN $2,000
8ase Fee $62.25
Surcharge $1.00
Total Fee $63.25
f
?
CONTRACTOR: - Applicant - sT. LIC OWNER:
RENEWAL BY ANDERSEN 14307255 2004063{ ZELLEN CINDY
1700 BWERKLE 1440 HEMLOCK CIR
WHITE BEAR LAKE MN 55110 EAGAN MN 55122
(612) 430-7255 (612)452-6799
I here6y aaknowle,dge thdt.. S hav?e rea=d thisaRplioation an.d sCate that theinformation is correct and agree to comply with all applicable State of Mn.
Statutes and City':of Eagan 0rdinances.
?flru? R?, r?.l y1l ?
APPLICANT/PERMITEE SIGNATURE ITSSUED-H?': S N U E
- I
?
` CITY OF EAGAN ??? ?
3830 PILOT KNOB RD - 55722
1896 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New ConeWCtion Reaulrements RamodaLReoair Reavirement=
? 3 reglatered sRe surveys ? 2 copies ot plan
? 2 copies of plans pnelude beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (ezterior add8ions 6 dedcs)
* t energy calculatlona ? 1 energy calculalfons for heated additioos
? 3 copke M hee preservetion plan H IM platted aHer 7/7/83
required: Ves _ No '
DATE: I y'19(' CONSTRUCTION COST: vJ
DESCRIPTION OF WORK:
$TREET ADDRESS:
LOT BLOCK eo?GC? ? Pa.f+o doo.
?`?`fU 17evn I oc (? i o-r l
SUBD./P.I.D. #: ;? h??c w%??n e?orsf'L4 o,peK^ L
-
PROPERTY Name: Phone#: ?s3-67?g
OWNER '/
StreetAddress ?`ryv 77c `?"°
Pgg /oclc 6'ro
(? _
City; E-7a State: ?N Zip: ?S/ /C?:;-
CoNTRACTOR Company: Rehw .,a! &c(e•se., Phone #: 'Y30 -2ass-1
Street Address: 170U ?u?rkl? License #' a0CV063-0
City: wAife. a.- La.ke.. State: MitJ Zip- '0710
ARCHITECTI Company: 1VIA- Phone #:
ENGINEER
Name: Registration #-
Street Address,
City: State: Zip:
Sewer & water licensed plumber:
change are requested once permit is issued.
Penalty applies when address change and lot
I hereby acknowledge that I have read this application and state that the informatlon 's correct and agree to comply with all
appflpble State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservatfon Plan Received _ Yes _ No
OFFICE USE ONLY
BUILDING PERMIT TYPE
•&
..? ??.?
0 01 Foundation ? 06 Duplex o 11 Apt./Lodging ? 16 Basement Finish
0 02 SF Dwelling ? 07 4-plex o 12 Multi RepaidRem. ? 17 Swim Pool
0 03 SF Addition a 08 8-plex o 13 Garage/Accessory o 20 Public Facility
? 04 SF Porch o 09 12-piex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. 0 10 = plex o 15 Deck
WORK TYPE
? 31 New ? 33 Alterations ? 36 Move
0 32 Addition ? 34 Repair o 37 Demolition
GENERAL IHFaRMAT?flN
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
?
Planning _
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
Gity SAC
Water Conn.
Water Meter
Acct. Deposit
5NV Pertnit
SNV Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Buiiding
Engineering
Valuation: $
MCIWS System
City Water
Fire Sprinkiered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Variance
% SAC
SAC Unfts
L'/ BL ? CITY USE ONLY RECEIPT #:??jDS'?
L
SUBD. .?.Y? DATE: 3Y' FS
1995 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dweilings
? townhomes and condos when permfts are required for each unit
_ New construction ? Add-on fumace
_ Add-on air conditioning Add-on airexchanger, i.e. Vanee system, etc.
Date: 3 - /7 - 9,5E
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 7 required @$3.00 each)
? State Surcharge .50
TOTAL ?0 • -?D
SITE ADDRESS: ?yy? ,¢.??2,?hGK ? l!^ •
OWNER NAME: ?. lll al, Z-e `le/? _ PHONE #: 799
INSTALLER NAME: ?L?z
STREET ADDRESS: '7623Q - C-0 ? ys eA
CITY: &f.C/ STATE: ?1I ?I ZIP ?l°?"? -
PHONE #: n
?? ? awa _
CITY USE ONLY
L BL
SUBD.
1995 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? all commercial/industrial buildings.
? multi-family buildings when separate permits are = required
for each dwelling unit.
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION
DESCRIPTION OF WORK:
RECEIPT #:
DATE:
INTERIOR IMPROVEMENT
FEES: - $25.00 minimum fee QC 1% of contract price, whichever is greater.
• Processed piping - $25.00
• State surcharge of $.50 per $1,000 of oermit fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER: .
ADDRESS:_
CI7Y:
TELEPNONE #:
STATE: ZIP:
PHONE #:
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
4
EAGFN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERTUT FOR SJATER SGRVICE CONNSCTION
Date: Suly 9, 1971 Number: 676 11-3 (51F•
Billing Name: Tilsen Construction Co. Site Address: 1440 Hemlock
Owner•
Plumber: Luecken Excavating Co.
Billing rkidress
Meter Size--'?W Connection Ghg.28o.oo od 7/9/71
Meter Permit Fee io.oo Pa 7/27/71
No,?isc9?ao
Meter Reading MeCer Dep. •50 pd7 ffl7 1 s/c?
Meter Sealed: Yes Add'1 Chg.
NO ITotal Chg.
Building is a:
Residence xxxx
Multiple go,
Connercial
Iadustrial
Other
Inspected by
Date
Remarks;
$25.00 RE-INSPEC71LIfJ F?E FpR
IMPROPERCY !NSaA? L€D iNE7ERS.
By:
Chief Inspector
In consideration of the issue aad delivery to me of the above permit, I
herehy agree to do tYm proposed work in accord e ith the rules and
regulations of Eagan Township, Dakota Count , P4iran ot:a.,
e
Ludcken Excavating Co.
Please notify the above office when ready for inspection and connection.
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE• July 9. 1971
OWNER: Tilsen Construction Co.
PLUMBER Luecken Excavating Co,
NUMBER 834
Address 1440 Hemlock 11-3 C,P
TYPE OF PIPE Cast Iron
DESCRIPTION OF BUILUING
Industriall Commerciall Reaidential I Multiple Dwelling I No, of uniCs
Location of Connections:
Connection Charge '0"
Permit Fee 10.00 pd 7/27/71
.50pd72771sc
Street Repairs
Total
Inspected by:
DaCe
Remarks•
Bv
Chief Inspector
In consideration of the issue aud deliverq to me of the above pernait, I
hereby agree Co do the proposed work in accordance with the rules and
regulationa of Eagaa 1bc•mship, Dakota County sota
BY ?
Luecken Excavating Co.
Pleaee notify when ready for inspection and connection aad before any portion
of the work is covered.
0
._-
EAGAN TOWNSHIP
BUILDING PERMIT lq? 2507
Ownex ....... J.4_.'t ------.................................................... Ea9an Township
Address (Presenf) ""----?!-`-?-_`.... 11$.7£Y-`.'.`...?..?............................... Town Hall
Su;,der .... . .....-.-.-.............................................................................
Addrest Dale .................:....
........... ........................................ -..........................................
DESCAIPTION
Bloriea To Se Used For Froni Depih Heigh! I Esf, Cact lm'l Fee Aamarka
r
• d
%w? LOCATION ?
or
s ast{ o, I /! I 3 I
This permiY doea ao2 eulhorise the use of slreels, roads, alleys or eidewalks nor does it give the owner or hfa agan!
the righ! !o create aay situalion which is a nuisance or whieh presents a hazard !o the health, aafelp, convenience and
generel welfare !o anyone in the eommuniip.
THI$ PERMIT MUST SE ?g/EPT ON TH£ PREMISE WHILE THE WORK IS IN PROG ESS.
This ia fo aeslify. !hal.....r-r.-.-_Cc!.?Y....?....?.`------------- hes pasmissioa !o erect a ... ........ .....?l.._.... ?. ..._upon
the abova deseri6ed psemise subjeet fo the provisions of the Sullding Ordinance fos Eag Townshi adopted Apsil 11.
1955. ?/pn
'-"..... ................. ........"_"'."--'-4---"1__`:.'.`.':...-`.^-----. Per ---- '•-_-......,.....?f.`?r':.._"_I3-..'.<?_? a-?.-""•"'_"...-"""
Chairman of Tnwn Board ? ? Huildin Iae eclos
MASTER CAR,D
•
/ y yo i/- -
OWNER ;2 SAir d/
STRUCTURE ANO
LAND USED AS
Permit
No.
Issued Issued To
ContraCtor Owner
BUILDING zS v '? •] (? ? '?/ _I
?-?? ?/ .?.?
• L
PLl1MBING fy? ?
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING ?
GAS INSTALLING
SANITARY SEWER ?
OTHER
OTHER I
•
•
Items Appraved
(Initiel)
Date Remarks
Distance From Well
1=00TI NG .? SEPTIC
FOUNDATION
FRaMING eV_
12 CESSPOOL
TILE FIELD FT.
FINAL
ELECTRICAL _
HEA7ING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CFSSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER O,
_ •
- -
_7 _-?
Violations Noted
on Back
COMMENTS:
,
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
r 1
U
PERMIT NO.
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVED.
1:1 ACCEPTABLE SU85TITUTIONS OR
DEVIATIONS.
DATE OF INSPECTIQN
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENT$
WILL BE DELAYED BY CONDITIONS BEYOND CONTROL,
AND DESCRIBED AS FOLLOWS:
? REIhSPECTION REQUIRED DATE OF REINSPECTION •
REINSPECTION REVEALED
CERTI FICATION -1 certify that I have carefully inspected the above in which I have no interest preunt or prospective, and that I have reported herein
all significant conditions oLserved to be ai variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating m the property inspected.
? ALL IMPROVEMENTS ACCEPTABLY COMPLETED
owre
•
9
Qp??. ..
PERMIT # ? I ?T RECEIPT DATE:
8008 RES1DEPTIlkL PLITM$INfi PERMiT APPLICATION
crrY o? KAGM
3830 eu.or xiroa gn
HAaeAA, MA 55122
651-6$1-4676
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irtigation system
SITEADDRESS: IyilO G?e,-i XpG,/c L-N
OWNERNAME:: _C-10W/4 ZG11Pe7 TELEPHONE#:
(AREA CODE)
INSTALLER NAME: L4,&I/i I?-P Pl u-r TELEPHONE #: S.a' ' 89,9- -OBG 2
STREET ADDRESS: / 7 712 410 „/o? (! y-' ?- (AREA CODE)
CITY: [-q kPVi11-e I STATE: 44, !2 ziP: ssay?)
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consult2nt fees may apply
• MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water turnaround - existing dwelling unit (+ 5/8" meter'rf needed -$118)
Other:
_ RPZ: new installation/repair/rebuild $ 30.00
_ lawn irrigation system
Replacement/additional: _ watersoftener 14 waterheater $ 15.00
State Surcharge $ .50
TOtal $ . Sd
1 hereby acknowledge that I have read this applicatlon, state that the iniormalion is correct, and agree to complywith all applicable Cityof Eagan ordinances. It
is the appllcanYS responsibiliry to notiry the property owner that the City of Eagan assumes no liabiliry for any damages ca ed by the Cily during its nortnal
operational and maintenance aclivities lo the facilities consWCted under fhis permit withi Ity p drty/p t-o way( -.
/
SIG A URE OF PERMITTEE 1l02
Use BLUE or BLACK Ink
I For Office Use
I I
Permit 7e j
City of EaRd Permit Fee: ' l
3830 Pilot Knob Road
Eagan MN 55122 RECEIVED Date Received:
Phone: (651) 675-5675 X012 j staff:
Fax: (651) 675-5694 AQ~ 1 I
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: V A94- 42- Site Address: )'4'7D I cl/Uck r~ a6LL' Unit
Name: CJ qw-r Phone:
RESIDENT /
OWNER Address/ City/ Zip:
Applicant is: Owner Contractor
~j
Description of work: Q✓L'Z 1L
TYPE OF WORK
Construction Cost: / Multi-Family Building: (Yes / No )
Company: 1 I b%1 L~ t l~ Contact:
CONTRACTOR Address: 6316 1~-4-rrn l G LLLc! City: ~1 -1/'~
State: /n/7 Zip: Phone: GI
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
AW al 0 &#W4
$g 1T
1 t 11-7
/r
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:
Mec4anical 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 the 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.aopherstateonecall.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 " 0112?l x
App i nt' nted Name Appli an s Signature
Page 1 of 3
Cl"~'DO NOT WRITE BELOW THIS LINE
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 OccupancyG MCES System
Plan Review Code Edition Gam? SAC Units
(25% 100% Z) Zoning - ! City Water
Census Code 4341 Stories Booster Pump
# of Units _ Square Feet PRV
# of Buildings Length 3 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 M ` .Other:,,
Roof: -Ice & Water -Final Pool Footings Air/Gas Tests _Firi.If `
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
~i
RESIDENTIAL FE VS ~ ~►~L,G~ ~ 9~
Base Fee 73
Surcharge
Plan Review y 7
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
r
~f
. ~ 1
Tti
b :
N 1194 3
1 00
0 _900
0
m~ 155o29
ra
!IT ' V
0
P4 I
oop"m
ML
k
9 29
- _F
N 89043'W
-AMWI
000
Use BLUE or BLACK Ink
For Office Use
41b~ j Permit
City of Eap
( Permit Fee: I
3830 Pilot Knob Road
Eagan MN 55122 j Date Received: j
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 8h S (i '1 Site Address: A'V 0 k>1e k. 10144 Ct^1' Unit
?Name: Ju~C~ 1Ce~~~ Phone: 0/
s Resident/
Owner A Address / City / Zip: ~f,~/B/'G~~w- 1~. ~s<►-.L rte' e y y..` 3 Z
's
Applicant is: Owner Contractor
Q _....._._o~_,...
Description of work:
Type of Work
Construction Cost: Multi-Family Building: (Yes /No
)
Company: ('ez7~a f ~1N va4A Contact: y^ Y'..~~,(frsd-z
s
Contractor Address: 20 fir ~v s e City: C a ~V 6GG~
State: Zip: S 6-0 2dq Phone: Q~L 2 2-~ ~U~ 7
s
K License J3 t!1 yZ 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
conclude that their are trade secrets
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-=2 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.oro
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.
1
x S.1((, ea"Ad S* r,_P_ x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA140761
Date Issued:01/19/2017
Permit Category:ePermit
Site Address: 1440 Hemlock Cir
Lot:11 Block: 3 Addition: Evergreen Park
PID:10-24880-03-110
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
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: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Joshua D Mckoskey
1440 Hemlock Cir
Eagan MN 55122
(612) 234-5447
Custom Remodelers
474 Apollo Dr
Lino Lakes MN 55014
(651) 784-2646
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA146766
Date Issued:11/13/2017
Permit Category:ePermit
Site Address: 1440 Hemlock Cir
Lot:11 Block: 3 Addition: Evergreen Park
PID:10-24880-03-110
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: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Joshua D Mckoskey
1440 Hemlock Cir
Eagan MN 55122
(612) 234-5447
Custom Remodelers
474 Apollo Dr
Lino Lakes MN 55014
(651) 784-2646
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA160986
Date Issued:04/28/2020
Permit Category:ePermit
Site Address: 1440 Hemlock Cir
Lot:11 Block: 3 Addition: Evergreen Park
PID:10-24880-03-110
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Joshua D Mckoskey
1440 Hemlock Cir
Eagan MN 55122
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA161391
Date Issued:05/21/2020
Permit Category:ePermit
Site Address: 1440 Hemlock Cir
Lot:11 Block: 3 Addition: Evergreen Park
PID:10-24880-03-110
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 -
Joshua D Mckoskey
1440 Hemlock Cir
Eagan MN 55122
(612) 234-5447
Custom Remodelers
474 Apollo Dr
Lino Lakes MN 55014
(651) 784-2646
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA163427
Date Issued:08/31/2020
Permit Category:ePermit
Site Address: 1440 Hemlock Cir
Lot:11 Block: 3 Addition: Evergreen Park
PID:10-24880-03-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
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 -
Joshua D Mckoskey
1440 Hemlock Cir
Eagan MN 55122
Lasalle Heating & Air
901 Crystal Lake Road West
Burnsville MN 55306
(952) 435-3633
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA166125
Date Issued:12/14/2020
Permit Category:ePermit
Site Address: 1440 Hemlock Cir
Lot:11 Block: 3 Addition: Evergreen Park
PID:10-24880-03-110
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 -
Timothy P Horn
1440 Hemlock Cir
Eagan MN 55122
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA170499
Date Issued:07/06/2021
Permit Category:ePermit
Site Address: 1440 Hemlock Cir
Lot:11 Block: 3 Addition: Evergreen Park
PID:10-24880-03-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Timothy P Horn
1440 Hemlock Cir
Eagan MN 55122
Gv Heating & Air Inc
5182 West Broadway
Crystal MN 55429
(763) 535-2000
Applicant/Permitee: Signature Issued By: Signature