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1665 Hickory HillCITY OF EAGAN Remarks Addition Wood ate lst Addition Lot g Rik 1 ParCel 10 84600 090 Ol owner screet 1665 Hickory Hill State Eagan, MN 55123 ' Improvement Date Amount Annual Years Payment Receipt Oate STREET SURF. 9 STREET RESTOR, pavin 1976 $410.12 $136. 71 3 PAID GRADING PAVING ¢ 3 974 $115.45 $23 . 09 5 PAID SAN SEW TRUNK q 1974 $93.54 $6. 24 15 PAID *SEWER LATERAL 1975 15 WATERMAIN * WATER LATERAL 1975 15 *WATER AREA 1975 15 *STORM SEW VOWLAT ,'jq 975 $1505.70 $100.38 15 PAID * STORM SEW LATtI']C 1975 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $130.00 12129 11-12-/4 BUILDING PER, SaC 9773 12-31-73 PARK CITY OF EAGAN Remarks Addition Woodqate lst Addition Lot 10 Rlk 1 Parcel 10 84600 100 Ol OwnerU'I.??? s. ?.itm. I.C., rt street 1667 Hickorv Hill state Eagan, MN 55123 Improvement Data Amount Annual Years Payment Receipt Date STREET SURF, STREET RESTOR, pavin 1976 $410.12 $136. 71 3 PAID GRADING PAVING 1974 $115.45 23.09 PAID SAN SEW TRUNK 1974 $93.54 $6. 24 15 PAID *SEWERLATERAL 1975 15 WATERMAIN * WATER LATERAL 1975 15 * WATER AREA 1975 15 *STORM 5EW 9'fFK LAT A7 1975 $1505. 70 $100. 38 15 PAID * STORM SEW LATtrk 1975 CURB & GUTTER 51DEWALK STREET LIGHT WATER CONN. $130. 00 12.1.29 -12-74 BUILDING PER. sac 375.00 9773 12-31-73 PARK I CITY OF EAGAN Addition WoodQate lst Addition Loc 11 eik 1 Parcel 10 84600 110 01 Owner u?`' ?''•`-'''??`' Street 1669 HiCkory Hill State Eagan, MN 55123 Improvement ae Amount Annual Years - Payment Receipt Date STREET SURF. STREET RESTOR. pAVING $410.12 $136. 71 3 PAID GRADING PAVING 3 ] $115.45 $23.09 5 PA ID SAN SEW TRUNK y $93 . 54 $6. 24 15 PAID *SEWER LATERAL 15 WATERMAIN ' *WATER LATERAL 1975 15 *WATER AREA 1975 15 *ST4RM 5EW T"LAT ;Ly1 1975 $1505.70 $100. 38 15 PAID * STORM 5EW LATtrk 1975 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $130. 00 12129 11-19-74 BUILDING PER. s,ac 37 .0 9773 12-31-73 PARK ? C1TY OF EAGAN Remarks Additiaf Wood ate lst Addition Lot 12 Rik 1 Par?l 10 84600 120 Ol owner?d(1ts:t_:, street-1671 Hickory Hill State Eaqan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. , j09 1976 $410.12 $136.71 PAID STREET RESTOR.paving 1974 $115.45 $23.09 5 PAID GRADING SAN SEW TRUNK ?( 1974 $93. 54 $6.24 15 PAID * SEWER LATERAL 1975 15 WATERMAIN * WATER LATERAL 1975 * WATER AREA 1975 15 * STORM SEW ?Flif T 014)1 1975 $1505.70 $100. 38 15 PAID STORM SEW LATtY' CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 130.00 12129 11-12-74 BUILOING PER. sac 9773 12- - PARK cinr oF EAGAN 3795 Pilot Knob Raod Eagan, MN 55122 N2 5412 PHONE: 454-8100 BUILDING PERMIT Receipt # To bs ased for Est. Volue Date 19 Site Address , . Erect p Octuponcy Lot Block Sec/Sub. Alter p Zonlnp Pomel # Repoir ? F(re Zone E rfle ? Type of Const. Name ove ? # Stories W 3 Addreu Demolish ? Front ft. , Ciri Phorie Grade ? Depth ft. p Name Addra Nome _ Address Fces Assessment - Water & Sew. Pol ite Fire Eng. Planner Council Permft " Surcharge ' Plcn check 5AC Water Conn. Water Meter I hereby acknowledge thot I have reod this opplication ond state that gldg, dff. the informotion is correct and agree to comply with all opplicoble 5tote of Minnesota Stntutes and City of Eagon Ordinonces. APC Total Signature of PeRnittee A Building Permit is issued to: on the express condition that oll work shnll be done in accordance with oll applitable State of Minnesoto Stotutes and City of Eagon Ordinances 8uilding Officiol PernM # psN Iwwd ?«tMtM Plumbing Mechanical INSPECTIONS DATE INSP. Raqh-In Finol Footings Dote Irsp. Date Insp. Foundation Plumbing Frame/ins. Mechonicol Finol - 1 7 Remarks: ....,.?..--? . . , .. .n r.. .a . ..?.....?a?-+? PERMIT # MECHANICAL PERMIT RECEIPT # ?J ?I ? -vil CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE COMTRACT PRICE: PHONE : 454-8700 Y? Site Addrgss BLDG. TYPE WORK DESCRIPTION ? Lot Block Sec/Sub Res. ? New ? Muft Add-on ? 1 Name ? ?" ? f?S4 ??1? t s ' ? Comm. Repair .: Address ..y t..++.? .E a f ..3 c Cit Ph Other y one FEES Name 00 HVAC 0-100 M BTU -$24 RES . . c Address ADDITIONAL 50 M BTU - 6.00 p Cit Phane •7- (RES. HVAC INCLUDES A/C ON NEW y CONSTRUCTION) 50 EA GAS OUTLETS (MINIMUM - 1 PER PEkilAln - 1 . . TYPE OF WORK COMM/IND FEE - 196 OF CONTRACT FEE Forced Air M BTU APT. BLDGS. - COMM. RATE APPUES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8 Unit Heater M BTU ? REMOQELS - 12.0& Air Cond. M BTU ' r. .00 MINIMUM COMMERCIAL FEE _ 20.00 ' ?"' ? V CF - STATE SURCHARGE PER PERMIT .50 ent M ? (AdD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # BEYOND $1,000) Other FEE , .?.. S/C: p? E S TOTAL: ? ? • r?' m ! FO : CITY OF EAGAN RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 New Canstructfon Reauiremenh • 3 registered sAa surveys showing sq. fl. of lot, sq. 8. of house; and all roofed areas (20% maximum lol coverage aliowed) . 2 copies af plan showing beam & windaw sizes; paured fouM dasign, atc.) • 1 set of Energy Caiculations • 3 copies of Tree Preservatian Plan it lol platted after 711193 • Rim Joisl Det2il Optlax selekion sheet (bldgs with 3 or less units) DATE _?l 1 S JOB SITE IF MULTI-FAMILY BUILDING, HOW PROPERTY OWN TYPE OF WORK APPLICANT ? ADDRESS / l 7 PAGER # a n) c FIREPLACE(S) _ 0 ?O 1 _ 2 _ PHONE# 9?5,-'?"9?5 ZIP CODE ?S3 3 7 Fax # 2L? -"s = 7 NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category (check one) Plumbing Contractor. _ Plumbing 5ystem Includes: Mechanical Contractor: Mechanical System Includes: Sewer/Water Contractor: _ Air Conditioning _ Heat Recovery System All above information must be submitted prior to processing of applica6on. I hereby acknowledge that I have read this appiication, state that the with all applicable State of Minnesota Statutes and City of Eagan Ors Signature of Applfcant _ MINNESOTA RULES 7670 CATEGORY 1 - Residential VenHiation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted _ MINNESOTA RULES 7672 - New Energy Code Warksheet Submitted Phone #: _ Water Softener _ Lawn Sprinkler _ Water Heater _ No. of R.I. Baths _ No. oF Baths !.Y /?/'I iJ RemodellReoair ReauiremeMs • 2 mpies of plan • 1 set of Energy Calculatlons far heated addNons • 1 site survey forexterioradditions 8 decks • Indicate if home served by septic system fir addNons VALUATION ?2, vo .1. _ i? _ ?., . Phone # Phone Fee: $90.00 Fee: $70.00 correct, and agree to Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 1/01 CELL PHONE # OFFICE USE ONLY 0 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex O 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage O 06 04-plex ? 72 12-plex Plbg_Y or_ N O 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 ? 48 Windows/Doors ? 34 Replacement "Demolition (EnUre Bldg only) - Give PCA handout to applicant Vatuation Occupancy MClES 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 INSPECTIONS Footings(new bldg) Footings (deck) Footings (addition) Foundation Drain Tile Roof Ice & Water Final Other Framing _ Pool _ Ftgs _ Air/Gas Tes[s _ Final Fueplace _ R.I. - Air Test _ Final _ Siding Stucco Stone Insulation _ Windows (new/replacement) Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit 8 Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total FinaVC.O. _ FinallNo C.O. _ Plumbing HVAC Building Inspector EAGAN TOWNSHIP BUILDING PERMIT ? ,. Ownar ... Addrass (Presan ----- fQ ?-'__.... .. . • -?iP-a??vl"C+??_, Builder ........,... Address ...... N° 3191 Eagan Township Town Hall ne:e _.. /??_'J/=7'9 --..._.. DESCHIPTION Storiasl ?( Used For FroaS 7i / e ? ? Deplh Heaghi Est. Cos1 ? ? Permif Fae I S .n-c Rems:ks /Hr. ?N 7. I?fN-K. b j psU, V r ? LOCATION " a; 5lreey Road or /(,?s /4L3 -4/ i.d9a? 1 ? or 1'his pesmit does aot aul2w!'ise 2he6Gse of sfreels, roeds, alleys or sidewalks nor does it give the owner or his ageni the sig6tfo creaYe any sifuation which is a auisance or which presenfs a hasard !o the heellh, safety, conveaience and general welfare !o anpone ia fhe communilp. TfiIS PERMIT MUST T I EMISE WHILE THE WORK IS IN PAOG*R SS. ?. / This is !o eerlifY. !ha . .LCa.J.C ..... ....._?. .-?u..R?--------_--has permission !o erect a._(..?_L(?1.... .:x,k?c?tuk:?.?.?pon the above described pre i6B B j !o ! provisiona ot the 8uilding Oxdinance for Eagan Township adopled April 11, 1955. /??? / ......---.... ......_.._ ..........-- "" "..... ?.?a..C?i.......?_ Pea :._,,.. . .... Chai an of T?noard \ Suilding I ec2or l \ ciTr oF eacaN 5795 Pilet Knob Rood Eagan, MN $5122 N2 54 12 ? -i+HONEi 4548700 BU ILDING PERMIT APPLICATION Receipt # To be uwd for FireplaCe Est. Value 1,400. Date 9-13 1979 Site nadmss 1665 Hickory Hill Drive Erect ? Octupancy Lot 9 Block 1 Sec/Sub. Woodqdte 1 Alter ? Zoning parcel # l ORdfifl0 090 Ol Repair ? Fire Zone Enlarge p Type of Const. rc Name -' • YJQv{o ? # Srories ; Address 1665 Hickory Hill Demolish ? Front ft. o C, EdCJai1 55122 Phone /Lf3 Grade ? Depth fr. ? Name POY'?'S Brick Wark Approvaia Fees Zu ?1nE*?Od DYlV2 Address Assessment Permit ' 8? F . Apple Valley ???4 432-5342 Weter & Sew. 1.00 Surcharge ? h k Police Plan c ec G? ?w Name Fire SAC Address Eng. Water Conn. CI Phone Planner WaterMefer Council I hereby ockrawledge that I hove read this application and stote that the information is correct ond agree to comply with all applicoble State of Minnesota $tatutes and City of Eogon Ordinances. Signoture of Permittee A Building Permit is issued to: $hOY'ty'5 BY1C7S- Yk cll work shall be done in nccord th oll applic " ate of Mti Buildirg Official ? j? Bldg. Off. APC Totul 10.00 ? on the express cond(tion that and Clty of Eagan Ordirwnces. crrY oF EAGM0VS4p-- Tp Be Used Ebr Site Address: BUILDING P ' APPLICATION Valuation Iqt __7_ Block L_ Sec./Sub.y?? Parcel #: /a ? 9 6 o o 0 96 O/ Oaner: Address: ./ d4 s- 'Al,?,{?A At City/Zip Oode: Z-- Phone #: / Contractor: Address: 2 T s ?cqrrJeorl t9if City/Zip Code: a ?????a? Phone #: ?6f2 Ax+ah./E.zg. : Address: Include 2 sets of plans, v 1 site plan w/elevations & 1 set of energy calculations- Date r OFFICE USE dDLY Erect ? occuparicY Alter Zoning Repair Fire Zone ErLLarge _ 7.ype of Const. Move # Stories Demolish Front ft. Grade Depth ft. APPROVAiS FEES Assessments Water/Sewer Police Fire En4 • Planner Council Bldg. Off. 9-/3 7 y__ ' APC Perntit ? '_..a Surcharge f - Plan Check SAC Water Conn. water meter Road Unit City/Zip Code: - Phone # : 9-/- / wood5afe VILLAUE QF r:AGA1V 3795 Pilot Knob ttoad Eagan, IvIinnesota 55122 PERMIT N0, 511 The Village of Eagan hereby grants to Geo. Sedawick Heatina & A/C Co of 1001 xenia Ave. So.. tapls. 55416 a ur Amrrac. Permit for: (Ovmer) ptew I3orizon Nomes aTf15T _67-6q-71 fii kotv Hill I Parsuant to application dated 4/29/74 Fee Pai.d: sro. oo dated this 23 day of rfay , 19 74 2.00 s/c Building Inspector Niechanical Permits: Bid Total: ? 9- /-? ?oGdy??e CITY OF EAGAN 3795 Pil.ot Knob Road Eagan, Ninneaota 55122 PEFNdT NOa: 461 i'Yie City of Eagan hereby grants to Geo. Sedgwick Heating & A/C Co. of 1001 %ania Ave. So., Mpls. 55416 a Permit for• (Owner) mm - gpiison Homes 1650-32-5I-56 81Ckosp Lene 6 6 67-66-68 . '"'- -c - at girtkr?ty il> >usnt to applicatibn dated 2 1 1 i: ??c- Fee Tnid: 160.00 dated thia 19 daY of F ab 4.00 S/c , , • `_?.? Building Inspector Pdechanical Permits: Bi.^. Total; . = CITY OF EAGAN i 3795 Pilot Knob Road "" ?i ` , • Eagan, D7innesota 55122 Gvr ?, ? PERP,ST NO.: 4-12 The City of Eagan hereby g:ants to '7'homPsor Plvmhin^, Co. of 12201 Minaetor_ka R1vR. a P7?T+r.MpI*iG Permit for: (Owner) Mew Horizan [ o*,n?n •- WboQ!*ate Addn. 1 at see attached lisY pursuant to application dated 4/19/71 Fee Faid: $1,Q60.00 dated this 211r`! da.y of P.pri.l ? 19 7,1 4Q.00 s/c Building Inspector Mechanical Permits: Bid iotal: HOUSE HEATING TEST RECORD f/ D-21109 ADDRE55 16?65 Aslrory fli11 APT.-FLOOR CITY SUBURB Eagan OCCUPAN7 Dwight P Bjoberg OWNER yes HEAT LO55 DATE HTG. INST. ? ji $OLD BY Elechicai Work By TYPE OF HEAT INSTALLED BY Sedgwick fteatin8 Ges Line By it 11 GA FA g_HW STEAM-SPACE HTR. _UNIT HTR. _OTHER GAS DESIGN CONVERSION MAKE WillinmSnn MAKE OF BURNER Model 177 7-0]-5 Model Saial 74009845 Maa. BTU Rating- INPUT 7S.OO0BtV.jh7 MAKE OF FURNACE CONTROLS THERMOSTAT em2F+n Heat Plug Valve M H VSOOc Limit Robe§aw BFLr-75D Limit Sstting 200 f Fan Selfin9 90 f 1,7,0-f Piler Type _ Pilof Moke _ Pilot Model _ Pilot Timing L.W. Cut Off Model Vsnt Size 4•• KIND OF LINER Ali+m SIZE6" NONE Draft Hood vQrtira7 Reguloror Filtsrs Size 16x25 Number ? Chimney Location Inside ype Outaide Chimney Consiruction metj1L hagtna Smoke Bomb Draft Wirin9 - Teat Tag Door Pressurs Lighting Insi. Proasure 4.4 11 uc PereenTC02 7 0T Do}e Tested 411917??'--? S. HRICArGONIPIU?PV) - Inpuf CFFI ].$ Percent 0 Z $?]x Company Tesfing $fack Temp. 520 f percenf CO()-()()X- Name of Tester A Form 235 HOUSE HEATING TEST RECORD ADDRE55 11687 Hickoay Hill ppT. FLOOR OCCUPANT JOhII A. M111¢T OWNER YQa HEAT LOSS DATE HTG. INST. GAS CO. METER BADGE SOLD BY INSTALLED 8Y QdgW1Ck HTg. ? Eleetrieal Work By Gas Lins By TYPE OF HEAT GA -FA X HW -STEAM _SPACE HTR. UNIT HTR. -OTHER GAS DESIGN MAKE n`illiamenn MAKE OF BURNER_ Model 1117-07-5 Model Seriol 7412347 Max. BTU Rating- INPUT 75,000 Bf:11 HI'. MAKE OF FURNACE CONTROLS THERMOSTAT Cm 260 Heat Plug Valve M.H. VSOOc Limit RoLahaw RF'L 750II Limit Setting 200of Fon Serring 90°f & 120°£ Pilot Type Pilot Make Pilor Model Modal Vent Size q'n KIND OF LINER Allllri. SIZE s" NONE Draft Hood vPrt16B1 Regulaior filters Size 16" S*5n Numbsr i Chimney Lo<ation Inside Ye2 Outside Chimney Construction Metalbeate $moke Bomb Pilot Timing 57 Seconde Draft L.W. Cut Off Door Pressure 4,8"W•C. percen}C02 7'90 DataTested - InputCFH 74 Parcent 02 8•7 CompanyTesting Stack Temp. '480of Percent CO 0'o Nama of Tester . CITY suaurteEagan CONVERSION Wirin9 - Te:t Tag Form 235 HOUSE HEATING TEST RECORD D-21109 ADDRE55 1669 Hickory Hill AP7. FLOOR CITY SUBURBEagap OCCUPANT or on ara a OWNER QB HEAT LO55 DATE HTG. INST. ge gwle g. SOLD 8Y INSTALLED BY Eleehical Work By Gos Line By TYPE OF HEAT GA -FA HW STEAM -SPACE HTR. -UNIT HTR. -OTHER GAS DESIGN MAKE Williams4n MAKE OF BURNER_ / Modal 1117-07-5 Model Ssrial 7412295 Max. BTU Rating - INPUT 75,000 Bt11 MAKE OF FURNACE Model CONTROLS THERMOSTAT r'm 260 Heat Plug Vent Size 4tl Valve M.H. VBOOC KIND OF LINER Alnm , SIZE r+1' NONE Limit Robahaw RFL 75 011 Drafr Hoad Var+ Anal Regularor Limit Sstting 200of Filters Size 16" v961' Number 3. Fan Setting 90 f& 120°f Chimney Location Inside Yee Outside Pilat Type Couple Chimney Construcfi on Metalbeatoa Pilot Make Pilot Model Smoke Bomb Wiring Piloi Timing 51 Seconda pra{t OK Tsat Tag Yee L.W. Cut Off Door Pressure Li9hting Inat. yPB Pressure 4,6}"WCPercantCO 7• DateTeated 1/16 ?75 TCFN I Z Percent O 7 5 8 7 Com Tesiin an C S BI'1 }lt LO. rryu - Z - W 6 p y g k Te $t 5 O f PercenT CO Nama of Tes}ar ? ?? `?<< oe mp. _ Form 235 CONVERSION HOUSE HEATING TEST RECORD ADDRE55 .1671 H1QkOX'y H311 ppT. FLOOft OCCUPANT Rxdge B. RCddiCk OWNER HEAT LOSS DATE HTG. INST. SOLD BY Eleefrieal Work By TYPE OF HEAT GA - FA n HW -STEAM D-21109 el - C17Y SUBURB EaLal1 )AS CO. METER BADGE iY INSTALLED 8Y Sedgwick Hte_ - Gas Line By SPACE HTR. _ GAS DESIGN MAKE Wi111amSOR MAKE OF BURNER_ Mode1 1117-07.5 Model $a1el 7410012 Max. BTU RaTing_ INPUT 750000 B MAKE OF FURNACE CONTROLS THERMOSTAT Cm 9R(1 Heat Plug YaHe ? A V800C ?;m?r ? ? Robahaw R1?L 750n Limit SeHing 200 f Fan Serr'ng 90 f& 120 f Pilot Type ?'+Olipl@ Pilof Make Pilor Modal Pi{ot Timing 58 Seconds L.W. Cut Off _ Pressure 4•7"WC• ParcentC02 7.90 InputCFH 74 Percanf OZ Rr7 ? ek Temp. 5?5Oof perceni Cp m 235 V Modsl Vent Size 4" K1ND OF LINER - AlUM• SIZE 6„ NONE Draft Hood vC2't7.C81 Regularor Filters Size lg g25 Num6er 1 Chimney Location Insida YeS Outsida Chimney CansTruction Metaibestos Smoke 8omb Draft - Door Prassui Wiring Test ' p Lighting InsT. Date Tesfed 11; Z7t74 _ Company Tesfing ra-M • Name oi Tester , ? •1L'?.?r ?.?+' n h UNIT HTR. -OTHER CONVERSION 71(0 5Z K ,(i ReQUest Date Fre N. h-in Inspecbon qwretl? ?Ready Now ? WAI Nottty Inspectar ? Yes No When Ready9 I$icensed contractor !] owner hereby request inspechon of above electrical work at: Jo0 AOtlress (Street eox oJr R/oure N?o j) ? I r Ciryy C<f !9''L !TlCl?r„" /77 Section No Township Name or No. Range No Counry_? ?? /J F? Occupan ?PRINT) Phone No y vrssr 95?-' Power Supplier Address ?. ?3oU Elecincal Comhactor (Company Namet j C4/ S ?ig /f-r?5 ??e Contraqa§ LneOSe No 2' 03 Mailmg AeOress IGOnVacror or Owner aWng Installauon? Yss3 u i4r? d LI, Aum SiSnawre C racoor/O e Phone Number ss?--ur? ?( MINNESOTA STATE BOFqD Di ELECTRICITY THIS INSPECTION REOUEST WILL NOT GNggs-MlOwey Bltlg. - qoom S-173 BE ACGEPTED 8V THE STATE BOARD 1821 pniversity Ave, 51 Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Vhone(612) 642-0800 ENCLOSED 911019y REQUEST FOR ELECTRICAL INSPECTION ?orm OnbsciF ofyellow <opy. II, See insVUCtions for comple0ng thi °`"`•°? ? ? ea-ooom.ory /071 0 K+2 4 3 4 5 . T R " " ? 64 "? p Below Work Covered by his equest X •?• ew Adtl Re . TypeoiBalding ApplianCesWired EqwpmeniWired Home Fiange Temporary Serwce Duplex Water Heater Electric Heating Apt Building Dryer Other-(Specify) Comm /Industnal Furnace Farm Air CondiOOner Oti (syacdy) Contrector5 Remarks Compute Inspechon Fee Below: n " cP,4 C t A. V4 QC / Ilep AO # Other Fee # ServweEmranceSae Fee # Crtcmts/Feedars Fee Swimming Pool 0 to 200 Amps 1 3 0[0 100 Amps (ZpG hansfoimers Above 200 _ Amps Above..laq,_ Amps Signs mspeao.§ use anry ' NTAL Irrigation Booms ?J' /I ? S• J V Special Inspection Alarm/Communication THIS INSTALLATION MAY BE OROERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, ihe Electrical Inspector, hereby Aougn-in ? oa?e certify that the above inspection has been made. Fnal Da -??--- OFFICE USE JNLY This request wid 18 months fmm ?P YS J .6 9 70 lo e Request Dale Fre No ? ough-m Inspectory pepu?reG? / ReaOy Now ? Will NoMy Inspector ?? ? ?/ G Ves V No en He WhaCy9 Ipefriaensed contractor ? owner hereby request mspection of above electrical work at. Jab Atltlress (StreeL Box ar ROUte No 1 Qty C,C? Se lion No Towns?ip Name or No qenge Na. Caunry A/ 7;74- Occupant(PFINT) Phone No Pawer Supplier AQdress Elecmcal Gonlractor (COmpany Name) o Conlrail License No ? c ao stallalion) Z 1 qnaldo ,10wner Inslallatio ) P ne um?er 6d?GZ?L MINNESOTA STATE 60M1AO Di ELECTRICITY ? THIS INSPECTION REOUEST WILL NOT Gngpa-MlOway BIEg. - Hoom 5-173 BE ACCEPiED BV THE STATE 90ARD 1821 Univerfity Ave„ SL Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS VKone (612) 662-0600 ENCLOSED ?/,•s/9? J:69870 REQUEST FOR ELECTRICAL INSPECTION W See msimclions lor completing this lorm on back of yellav copy "X" BelowbVork'CDvered byThis Request ?F6?e?"t? E8-000p1.08 ??? ? ?.,?.. ew 90tl. p L TypeoiBwlding ApphancesWired EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt Bwlding Dryer Other (Specity) Comm /Indusirial Furnace Farm Air CondRioner Other (speciy) Con[ractor5 Remarks Compute Inspechon Fee 8elow- > . Otner Fee # Service EntranceSize Fee N CrtcunslFeeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformars Above 200 _ Amps A ve 100 _ Amps Sgns InspectarSUSeOnly TOTAL Irriga6on Booms / J ? ?6 Special Inspection Alarm/Communicanon THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby certrfy that the a6ove inspechon has been made Rough-m F,mai ? oeie oa /a OFFICE USE'JNLY Ths request vaitl 18 months irom 2 5 3- 688 ? OFF1C/EEE???-UllSE ONL...Y This reqoest void 18 manihs fmm vaLdation date prinicd in Ih?/? ? ???/`/ ? f Mwv dfl PLEASE PRINT OR TYPE p• ? ?J ?O?O Reqeesl D.I. C? Rmgh-in insp«4on reqmred2 ? Yes Inepetlion Olher Than Rough-In: Ready Now 0 Will Call ? ?- /*- / (You most mll tha inspacrorwhen ready) Dme Ready I, ,R licensed contmcfor El owner hereby request inspedion of ihe a6ove eledrical wark at- lob PGdmss (Street, 8ox, or Roule No ) ?/ ?/? ? Gry ' 2p Code C .c /7vt-C 2 ae'L Ce e S/ Setlion Na. Township ame or No. Range N. fire N. County OccuPanl Phane Na & ( - Y/O PowerSovvLer Pddrezs ElMnwl Conhocror (Com ny Nome) ConVanor Lcense N. Momr Lic No. ?Planl Eled. Only) / MatLngPdd (ComrodororO?merPeAoeminglnslallalion) ?, ' 12 n - ? YY/ ? 2 c ? / Ihonzed5i rwwn Co croror0 dormin Insbll uon PhoneNo. EB-OOOOlA-10 6/95 STATEBOMDCO SEEINSTPUCTIONSONBACKOFYELLOWCOPV IIII II ?GII Y? REQUEST FOR ELECTRICAL INSPECTION? I I Minnesota State Board of Electricity 1001 1821 University Ave., R???128, $? aul, MN 55104 Phone (612) 642-08W ??y Hnme Duplex Apt rJtht+f' New Addn Commernol Indushwl Farm Remod Re oir Air Cond. Hig. Equip Water Hir. Laod Mgmf. Other: D er Ran e Elec Heaf Tem . Service 'R" above fhe work mvered by fhis request En>er remdrks mthis space and on the back of the white copy only. ?O. Gi r-.CJL Ntt C £ Calmlate Inspection Fee - This Inspedion Requesf wdl not be accepfed without the mrrecf lee- Olher Fee # Service Enirance $ize Fee # Circuih/Feeders Fee Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps Sheet Lig./Traffic $ig. Above 200 Amps Above 100 Amps TransformerjGenerator INSPECTOR'S USE ONLY TD;:? ?.r? _TU $ign/OuHine Lfg. Xfmr. N _ O Alarm/Remote Control O-" Swimming Pool i hem mm ?har I m: fie ela?r? I ??:blloeo? de:?db d h?r?? o? M? daro::wkd Irrigation Boom Raagh-In Daie S ecial Ins edion p p F l D. Imestigative Fee rna % THIS INSTALLATION MAY BE ORUERED DISCONN TED IF NOT COMPLEfED WITHIN 18 MO S. ,._ ,. --?-- ? „ . _ -- -?--- T, ? ? o vILLaoe o: ?snaar 9 ;W?1 ? 795 Pibt Knbb Read Eey-,MN 55122 Zoning: 4 - Owner: WOOdqBt@ New Address: ' Site Add 66 67 -7 ' ' II11 Q - ? , . Plumber SOn P7mewi ? . Meter No.: ' Size: , Reader No,: ? uBree M canyly wkh H V ? ???? ?,? ?. ?•? ' ? ? ' ?# r - Ordfnenaes. M"o.of gag= $Y DateofIne . p.: F - ? . -._ -----_--- , . _-""'--- Ynap.: - ?????? y ? . ; i G? ? •?: °" - ?i _:/.?1 ?-?z- iG , Permit *70. 44? - a/2AJ74 Cove?? fol lowinn linits ane nomcs: ? M 1f.29 ,1-532, 153F, 1640, iFnn, 1E5n, 1654, 1658, 1Fti2, LCGE, 1C7n, 167" , 1r7?, 1F°2, ;r,QF, Iror, 1?'2, 1FU4, 169E,, lf9°, 17M tvalnut Lane and ].F35, 7655, 1FF7, t_r,FO, I r.73, 1F77, LFa7, 1tiR5, 1f-89, 1693, lE°', I7nl ctialnut Lane 1F31-?0-27-25 Hickory Hill, 76FE-6p0HjcY,ory Eill & F67=F.5 Nick?.r? Lane, 156i,F7-F,o-71 Hirkory ITill, 1.hF37r1--59-57 !iickory fiill, 1Fn1.=83=85=.g'7 ui.cirorv llill plus las*_ eleven (71) townhouse buildinqs - dn not have correct house nur.ihors as vet. ? RESIDENTIAL BUILDINC PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 Naw Conatructian ReouiremaMs • 3 registered site surveys shovnng sq. ft. of lot, sq. ft. af house, and all roofed areas (20°k mazimum lot core2ge allowed) • 2 wpies of plan showing heam 8 vnndax sizes, poured found desgn, etc.) • 1 set of Energy Cakulations • 3 copies of Tree Preserva6on Plan A lot platted afler 711N3 • Rim Joist OetaB OpUons seledion sheel (bidgs wilh 3 or less uni45) DATE 1G- 9-c`5'2_ RemodeVReoair Reuuiremnts g Li . 2 copies of plan . 1 set of Erergy CalculaCrons (or heated addilions • 1 sitesurveyforezterwraddi6ons&decks . Indicate if home sarved by septic syslem (or additians VALUATION SITE ADDRESS 4?MULTI-FAMILY BLDG _Y XN TYPE OF WORK FIREPLACE(S) JV0 _ 1_ 2 APPLICANT Restoration STREET ADDRESS 2489 RiCe St Suite 70 CITY Roseville STATE_MN ZIP 55113 TELEPHONE # 651-734-9433 CELL PHONE # PROPERTY FAX # fi51-dR3-11719 TELEPHONE# `,oS L LV?:& COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESO'1'A RULFS 7670 CA'I'EGORY 1 MINNESOTA RULFS 7672 (4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calwlatlons Submitted Plumbing Contractor: _____ Plumbing system indudcs: Mechanical Contractor: Ytcchanical system includcs: Sewer/Water Conhactor: Water Softener Water Heater No. of Baths _ Phone # Lawn Sprinkler No. of R.I. Baths Air Conditioning Heat Rccovcry 5ystem I hereby acknowledge thai I have read This application, siate that the with all opplicable State of Minnesota Statutes and City of Eagan Orc Signature of OFFICE USE ONLY Phone # Phone # Fee: $70.00 Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Fee: $90.00 to comply_ Updated 4102 OFFICE USE ONLY O 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex ? 07 DS-plax ? 13 78-plex O 08 06-plex ? 18 Fireplace ? 09 07-plex ? 17 Garage O 10 08-plex ? 18 Deck ? 11 10-plex ? 19 Lower Level ? 12 12-piex Plbg_Y or_ N ? 20 Pool ? ? 21 Porch(3-seaJ O ? 22 Porch/Addn.(4-sea.) 0 ? 23 Porch (screened) ? ? 24 Storm Damage ? 25 Miscellaneous 30 Accessory Bldg 31 Ext. Alt - Multi 33 Ext. Att - SF 36 Multi ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding 0 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) 0' 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof Q, 46 WindowslDoors ? 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 Sprinkl,ered Type of Const W idth REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) FinaUNo C.O. _ Footings(addirion) _ Plumbing Faundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ Siding Stucco Stone _ F'aeplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By , Building Inspector 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 RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knoh Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New CansWCtion Reouirements RemodeVFteoair RenuiremeMS Office Uu Oniv 3 registered site surveys showing sq, 8. oF lot, sq. ft. W house; and all roofed areas 2 copies af plan Cerl of Survey Recd (20°k maximum lot coveraqe allaved) . 7 set of Energy Calalations for heated addNonS Trae Pres Plan Rerd 2 copies of plan showing beam R window sizes, poured fowM design, etc. 1 site survey for addiGnns 8 decks Tres Pras Not Reqd 1 set of Energy Calculations Addfiion - irMkate ifonsRe sepNc sysfem _ On-site Septic System 3 mpies of Tree Preservation Plan if lot platted after 717/93 Rim Joist Detail Opfions selection sheet (bldgs with 3 or less units Date d_-'?' ! Construction Cost 2a?U ' ?,-4- Site Address `l Unit/Ste # Description of Work Multi-Family Bldg ? Y _ N Fi ce(s) _ 0_ 1 _ 2 Property Owner Telephone #( 651) loBS' C`k??o Contractor 'ATc??{''(?7?,? ?n. Address 4c) City State Zip k Telephone # ( v5 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category Minnesota Rules 7670 Cateeorv 1 • Residential Ventilation Category 11 (J submission type) Submitted . • Energy Envelope CalculatiQns-Subi G???7 \ Licensed Plumber Mechanical Contractor Sewer/Water Contractor Minnesota Rules 7672 • New Energy Code Worksheet Submitted #( #( ) Telephone # ( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work wiil be in accordance with the approved plan in the case of work which requires a review and approval of plans. ApplicanYs Printed Name A 1' anYs Signature I ? 2C0 ? \, U o ? L Te?e. OFFICE USE ONLY Sub Types ? Ot Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwalling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demalish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. , ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Remof ? 46 WindowslDoors 0 34 ReplaCemeni 'Damolltlon (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MClES 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 INSPECTIONS Foorings(new bldg) FinallC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addition) _ p]umbing _ Founda6on 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 (newheplacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector RESIDENTIAL ??\ BUILDING PERMIT APPLICATION dTY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4875 New Construction Reauirements . 3 regis[ered site surveys showing sq. ft. of lot, sq ft of house; and all roofed areas (20%maximum lot coverage allowed) • 2 copies nf plan shawing heam 6 window sizes; pou2d found design, etc.) • 1 set of Energy Calculahons • 3 copies of Tree Preservation Plan'rf lot plaHed aRer 717193 • Rim Joist Detad Optbns selection sheel (bidgs with 3 or less units) DATE j C:?-- ID- Cp2 SITE ADDRESS TYPE OF APPLICANT MULTI-FAMILY BL?DnG _Y ?N _ FIREPLACE(S) ` _ 1 _ 2 STREET ADDRESS 2489 Rice St_.SiutP.M CITY-ROSWiUp STATEMAJZIP55113_ TELEPHONE # 651-7344433- CELL PHONE # FAX # 651 4Q3421.4? PROPERiYOWNER__C?1?xz.hC`Q,.??p?? TELEPHONE# COMPLETE FOR "NEW° RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RUI1;S 7672 (4 submission lype) . Residential Venfilation Category 1 Worksheet Su6mitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbtng Conhactor: _____ Plumbing system includes: Mechanical Contractor: Mechanical system includes: Sewer/Water Contractor: _ Air Conditioning _ Heat Recovery System Phone # Phone # Fee: $90.00 Fee: $70.00 I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinprrsp;. e::F? Signature of OFFICE USE ONLY Water Softener Water Heater No. of Baths Phone # I,awn Sprinkler No. of R.I. Baths ?"y .-1? RemodellReoair Reouiremeirts • 2 copies of plan • t set of Errergy CalculaGore for heated additwns • lsitesurveyforectenoradditions&decks • Indicate "rf home served by septic system for additians VALUATION MO 293e.a4 Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 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 Ext. Alt - Multi ? 03 01 of _ plex ? 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 ? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demalish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. 0 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windows/DOOrs ? 34 Replacement "Demolition (Entire Bidg 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 INSPECTIONS _ Footings(new bldg) _ FinaUC.O. _ Footings (deck) _ FinaUNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ Siding Stuwo Stone ; _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply 8 Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total Building Inspector / ct 3 7y RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 New Construction Reouirements • 3 registered site surveys shorriig sq, ft, o(lof, sq. fl. oi house, and all roofed areas (20%masimum lol coverage allowed) • 2 coples af plan showing beam 8 window sizes; poured found design, etc.) . 1 set of Energy Calculations • 3 capies af Tree Preservation Plan'rf lot platted afler 711/93 • Rim Joist OatalOptions selectlon sheet (bldgs wilh 3 or less units) DATE 312-2I62- JOB SITE ADDRESS IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER ?V\k6 A TYPE OP WORK 7? o:c?VaC?YIG RemodellReoair ReauiremaMs • 2 copies of plan • 1 set o( Energy Calculations for heated additrorts • 1 sllesurveyforenlenoradditions6decks . Indirate if home served by septic system for addAions VALUATION $ \ u (13) bY. Ca?acvn . mUU SS t2Z. u\kG 0 G\OUVS FIREPLACE(S) _ 0_ 1_ 2 APPLICANT \)U? V\C:UU S\AU1?'h PHONE# ADDRESS _Q)? - ZIPCODE SSI2:2, PAGER # CELL PHONE # FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category (check one) Plumbing Contractor: _ Plumbing System Includes: Mechanical Contractor: _ Mechanical Systein Includes: Sewer/Water Conhactor: All above information must be submitted prior to processing of application. Phone # Phone # I hereby acknowledge that I have read this application, state that the information Aances. ? with all applicable State of Minnesota Statutes and City of Eagan Ord Signature of Appllcant _ MINNESOTA RULES 7670 CATEGORY 1 - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted _ MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Phone #: _ Water Softcner I.awn Sprinkler _ Water HeaLer No. of R.I. Baths iVo. of Baths Air Conditioning Heat Recovery Systecn Fee: $90.00 Fee: $70.00 MAR 2 1 2002 L? rrect, and agree to , rGy--- Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 2002 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plsx ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 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 Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ?' 46 WindowslDoors ? 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 W idth REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings(deck) FinaUNo C.O. _ Footings (addition) _ Plumbing _ Foundarion HVAC _ Drain Tile Other Roof _ Ice & W ater _ Final Pool _ Ftgs _ Air/Gas Tests Final _ Framing _ _ Siding Stucw Stone _ _ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By Base Fee Surcharge Plan Review MC/ES SAC ciry sac Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other ToWI Building Inspector 84600 WOODGATE 16251 10 84600 250 01 1627/ 26001 1629/ 27001 1631 28001 16331 10 84600 21001 1635/ 22001 1637/ 23001 1639 24001 1642/ 10 84600 030 02 1644/ 040 02 1646/ 01002 1648 020 02 1643/ 10 84600 17001 1645/ 18001 1647/ 19001 1649 20001 1650/ 10 84600 050 02 1652/ 060 02 1654/ 070 02 1656 080 02 1657! 10 54600 13001 1659/ 14001 1661/ 15001 1663 16001 1658/ 1084600 090 02 1660/ 100 02 1662/ 110 02 1664 120 02 1665/ 10 84600 09001 1667/ 10001 1669/ 11001 1671 120 01 1666/ 10 84600 130 02 1668 140 02 HICKORY HILL (4-plex) (4-plex) (4-plex) (4-plex) (4-plex) (4-plex) (4-plex) (4-plex) (1 /2 of 4-plex/oYher 1/2 on Hickory Ln) 1 (PAGE 1 OF 4) MASTER CARD iek. I Permit No. Issued To ? Issued Contractor Owner BUILDING r + I PLUMBING _ ? l CESSPOOL - SEPTIC TANK ? I WELL ELECTRICAL ? HEATING GAS INSTALLING SANITARY SEWER OTHER OTHER I I}ems Approved (Initial) Date Remarks ' Distance From Well PUOTING SEPTIC FOUNDATION CESSPOOI FRAMING TILE FIELD fT FINAL ELECTRICAL HEATING DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD i PLUMBING r ? WELL SANITARY SEWER Violations Noted on 8ack COMMENTS: STRUCTURE V LAND USED AS F? ae ? COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN @VEN7 OF OBSERVED VIOLATIONS PERMIT NO. CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE OBSERVED. ? ACCEPTABLE SU&STITUTIONS OR DEVIATIONS. DATE OF INSPECTION ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZED AND DESCRIBED ? REINSPECTION REqUIRED REI NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. ? COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. DATE OF REINSPECTION CERTI FICATI ON - I certify that I have carefully inspected the above in which I have no interest present or prospective, and thet 1 have raported harein all significant conditions observed to be at variance wiih ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to che property inspected. 1-1 ALL IMPROVEMENT5 ACCEPTABLY COMPLETED B111LDING INSPECTOR DATE CITY USE ONLY L ? BL ?_ RECEIPT SUBD. DATE: 1996 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55722 (612) 681-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit Mew ronstrurtion ?l??mac2 ?G CQi ? - , Add-an air conditioning Add-on air exchanger, i.e. Vanee system, etc. Date: 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 1 required @$3.00 each) ? State Surcharge .50 TOTAL SITE ADDRESS: OWNER NAME: PHONE #: INSTALLER NAME: STREET ADDRESS: CITY: MVJ`7 STATE:? ZIP: PHONE #: ( W/ ) E ? [ l? ? • u?J ? VUJ?1 PERMITTEE CITY USE ONLY L BL SUBD. RECEIPT #: DATE: 1996 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 Mq# required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION DESCRIPTION OF WORK: INTERIOR IMPROVEMENT FEES: .$25.00 minimum fee 4.C 1% of contract price, whichever is greater. • Processed piping - $25.00 • State surcharge of $.50 per $1,000 of oermit fee due on all permits. CONTRACT PRICE x 1 % PROCESSED PIPING STATE SURCHARGE TOTAL SlTE ADDP,ESS: OWNER NAME: TENANT NAME: (iMPROVenneNrs oNLr) INSTALLER:. ADDRESS: _ CITY: PHONE #: SIGNATURE TELEPHONE #: SIGNATURE OF PERMITTEE STATE: ' ZIP:. CiTY INSPECTOR CTTY OF .F..AGAN L'ASH.[E:Ft: JS C'Ef:MINAI_ NCI: 71t3 DAT£a 07/16/99 TSNiIt?.? 10-54•.13 IAo NFt?E? AiiDEI) VALUE f'X'fER[ORS, INC. 3210 9001 1657 HICKORY HI 139,i?5 2i.55 9001 1657 IiTC:F:OhY hIT 3.50 321.0 9001 1663 HSCf;pRY HI 1.:39.25 2155 3001. i.665 H]:CK[:1FfY HL 3.50 321.0 9001 1708 N.T.(:F(ORY I-II '1.33.?_S ^ci.,'i,`"i 9007. 1708 HICF.[)RY H:[ :3.50 :ic^..J.0 9001 1724 I-iTChQRY H.T. 13r).?S 21.55 3001 1724 H.T.C:4:ORJ hII 3,50 32a0 `_=?(](]i. 1641 HICItURY LA 139.25 2155 9001. l649. 1'l]:C;I<hRY L.A 3.50 CR1.13489 ** CUNI'INUG USE:F: :CLie JAN W% CON'Y:I:NUE 3(yFXCXC9it?k?K?F1k?M?k?>XW>X?'C1KYF?X1$ 'M?ktFMYF>R?XN:$tMM? 'MXokM>%'M C(']M):NUE CITV flF EAGATd C;A:iFICEF;: 1S TF'F.MINAI_ NU: i"18 DAIF; 07/16/79 TIi1f:? 0e54u1.4 ID- NAt4Ea AL1LtED VALUF: E:X'f1=.Fi:[UIf,S"7 inr.. :)i?LO 9001 1676 HZCFCQhY LA 09.25 2155 9001 1576 HICI:bfiY LA 9.50 Tota7. Recei.pt AmourNi;. 856.50 cFMa89 I1SL.fi IDe JAN ?k ? K>X ? ?K Xc 7 k ? yF 'M>X ? ?>k %? yF ? k k o%? M>k 'M ? >X>%>k>% %?>X ?X Y,C YF Y? ?X Yr: k ? ?X ?k \ •i yya ksuiLuInc, NtKnni I wNNLIcN I wN tKESiUENt'iAI ?t^ cn-? CITY OF EAGAN ?? b? 3830 PILOT KNOB RD - 55122 851-681-4675 New Conshuction Reaulremems Remodel/Renalr ReauMemenh D 3 regMered ske surveys showing sq. H. ot bt, sq. R. W house 2 coples of plan and p! roofed areaa (2046 maximum lol coveraae a0owed) 1 uf of enmgy cakulafions for heatetl addiNons D 2 coplea of planr (show beom a window elzer, poured tnd. deeign; Hc.) 1 fke survey lor exferior addHlons a decW D 1 set of energy calculaNons > 3 copiea of free preservatlon plan M bt plaMed aller 7/1 /99 ? l fl ll V Dare: -] - I S - ?/9j DESCRIPTION OF STREET ADDRESS: '*b7 IOT: ? BLOCK: , ^?r `?4? S? Name: U.? A--e 44r4Le-0cO-"S f??N Phone #: S PROPERTY L FIrt1 OWNER . Sireet Address: CZ City C44- State: Zip: SS/ 2Z Company: rhone #: ? l=4 53 -9? ?-2 (area code) CONTRACTOR Street Address: 4(-7 Sl:inaO License #?E!?-[? Exp. V52?- ciy ?s f' P?-Pl sto+e: ?r..? ziP: S S ARCHITECT/ ENGINEER Telephone M: area code ( Name: SheeT Address: Regishation #: City Stafe: Zip: Sewer S waler Iicensed plumber (reaulred }w new conahuctlon onlv): Penaly applies when addreu change and lot change Is requested once permff is Issued. 1 hereby acknowledge thal l hwe read 1hb applkation, sfate 1haF the iMormatlo la o cf, d a ree fo comply wNh aN appdcabl Stafe of Minnesote StofvFes and CHy M Eagan OMlnances. Slgncture o} Applicanh • OFFICE USE ONLY ' Certificates of Survey Received _ Yes _ No ? r ?? ' I 5 IS99 j i?Tree Preservation Plan Received _ Yes _ No _ Not Repuired J I L I,? I ! ?--- _- _f C1TY USE ONLY PERMIT #: 4411 RECEIPT DATE: 1?3f U) MIDEPTIA1.14IECHi4NICAI. PFItMiT APPLICATION crrYoggwsm 3930 Pu.OT Kxos Rn E?snx Mx ssr zs 651-681-4675 Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit Date: SITEADDRESS: OWNER NAME: (1r iC4. ?ZA !J TELEPHONE #: (AREA i.ODE) INSTALLERNAME: V)UQnw 1\ TELEPHONE#: q Sa- ?-9 (AREA CODE) STREET ADDRESS: 1 g.kO CSLQ AU- S- CITY: S0_0 C&Ce Q__ STATE: LA-0 ZIP: SS3-7?- Plaee a eheck mark neYt to the nermit wark tvoe New residential dwelling unit under constructionand not owner/occupied $ 70.00 Add-on, modification or alteration to existina dwelling unit $ 50.00 • furnace rep acemen • air exc ang av c4nditicrffi c1r • other n .Qikrp ?.?5/?.cz,?- Nature of work: 4 .2 , ? State Surchar e $ .50 Total $ Reminder: Ca[l for inspections. : ? x L k - i6Q::: ? ? SIGNA E OF PERMITTEE Updated I/Ol (" USE ONLY PERMIT #: _ APPROVED BY: INSPECTOR FtECEio i ? COMMERCIAL M£CiiAMCi4I. PEiiM1T APPLICATION CITYoF EAs14N S$SO PILOT KNOB fZD F-+tGtlv.Mv 55122 651-6$1-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: SITE ADDRESS: OWNER NAME: PHONE #: TENANT NAME (IMPROVEMENTS ONLY): (AREA CODE) WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: ADDRESS: CITY: WORK TYPE: New conshuction _ InteriorImprovement _ Processed Piping Specify Nature of Work PHONE#: - (AREA CODE) STATE: ZIP: _ Install U.G. Tank Remove U.G. Tank When insta!ling/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and Plumbing Iinspector. Fees: 1% oFcontract price OR $50.00 minimum fee, wluchever is greater. Underground tank removaUinstallation = minimum fee Contract price: $ x 1%_$ (Base Fee) State surcharge calculate at $.50 For each $1,000 Base Fee TOTAL g SIGNATURE OF PERMITTEE Updated 1/Ol ' For Office Use I ing Permit City of EaRd~ I u I Permit Fee. 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 Staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: X /J/C Tenant: Suite RESIDENT / OWNER Name: Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: / C tf-1- t F _ CC E Construction Cost: 2 0, 0 a C. Multi-Family Building: (Yes - / No CONTRACTOR Name: C License 9j2 l Address: C 1 i/f / 'T 0 G X g 6 /V i`) Zip: J`'~-3 3 City: State: Phone: 5 r ~O 7J Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted submission type) • Energy Envelope Calculations Submitted 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. 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. x L4 SGT I'LL K ! % r_ t ,y 1 X / ; Applicant's Printed Name Appli ant's Sign re Page 1 of 3 VILLAGE OF EAGAN SEWER SERVICE PERMIT 3795 P11ot Knob Road PERMIT NO.: 2197 Eagan, MN 55122 DATE: 4/26/74 Zening: PL?l3 No. of Units: Owner: WOOdq :L(,: Next HOrizon Mattis Address: Site Address: 1665- 67 -69 -71 Hickory Hill Plumber: ThOWSOf ?IUMbinq Co. agree to comply with the Village of Eagan Connection Charge 12/31 Ordinances. Account Deposit: 7 Permit Fee: 10.00 pd Surcharge: .50 P By: Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: , EAGANr For Office Use !w % * s •�r Permit#: e... «tea Permit Fee: I EC .CeivE Date Received: �,7—7 3830 PILOT KNOB ROAD EAGAN, MN 55122-1810 yr (651)675-5675 I TDD: (651)454-8535 I FAX: (651)6 69A., Staff: _1�� buildinginspectionsCaacityofeaoan.com Hl'R ' 7 2019 2019 RESIDENTIAL B�• _ - _- - - MIT APPLICATION Date: 1 ( 7-- l 7 Site Address: /(JG1� `�Cv ��f I �nC�r Unit#: . WOO d Oti t 1Me A--ss c. ' O 57 - u5Y-7 ci Name. 0��t/� d a ►� Phone: ` 3 Y Residents / 71 `c k.(7 it 11 o r rFa9 a 3T5 I oZ o� OWner Address/City/Zip: y Applicant is: Owner X,Contractor j Description of work: ' `e C Qr ( Q ar' O' I "f and c 'vialace Type of Work f tJ� Construction Cost: ` /010 Multi-Family Building: (Yes A I No ) Company: Bd I"!'tol n rt D`0 Iiiflf [0n fl`&c9 tact: Ste Vt. £crr►1 Cid id Contractor Address: / 7 5 73 FOX ear0 C ty �a/�-►-1. r,5 71711 State:(1 Zip: 5304 ( Phone: 't6/(k-519-0,360 ail: License#: A C /7006c( Lead Certificate#: If the project is exempt from lead certification, please explain why: No fOG '1 -fr _ R H poo r.,, ,y 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: Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Pardons 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. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. 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. 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.aooherstateonecall.orq 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 approve of ens. x Sferec'I AO/'rioihvl x –�-} `"tel Applicant's Printed Name Applicant's Signat re �— PERMIT City of Eagan Permit Type:Building Permit Number:EA161066 Date Issued:05/04/2020 Permit Category:ePermit Site Address: 1665 Hickory Hill Lot:009 Block: 001 Addition: Woodgate 1st PID:10-84600-01-090 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 - Peggy Hohag 1665 Hickory Hill Eagan MN 55122 (612) 968-2087 Crew2 Inc 2650 Minnehaha Ave Suite 100 Minneapolis MN 55406 (612) 276-1680 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA169814 Date Issued:06/10/2021 Permit Category:ePermit Site Address: 1665 Hickory Hill Lot:009 Block: 001 Addition: Woodgate 1st PID:10-84600-01-090 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 - Peggy Hohag % Jack Hohag 9110 Brandywine Rd Corcoran MN 55340 Minneapolis St. Paul Plumbing Heating Air 640 Grand Ave St. Paul MN 55105 (651) 228-9200 Applicant/Permitee: Signature Issued By: Signature