1673 Hickory HillCITY OF EAGAN Remarks
Addition - WOOd at2 lst Addition Lot 5 Blk 1 Parcel ZO 84600 050 Ol
Owner_ C741 (??l GyY.?/1- Street 1673 HiCkox'v Hlll State Eagdn, D'Ild 55123
?
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.pavin 1974 $115.45 $23.09 5 PAID
GRADING
PAVING 1976 $410.12 $136.71 3 PAID
SAN SEW TRUNK 1974 $93. 54 $6.24 15 PAID
*SEWERIATERAL 1975 15
WATERMAIN
* WATER LATERAL 1975 15
* WATER AREA 1975 15
* STORM SEW iRRK L/?T ,Zyj 1975 $1505.70 $100.38 15
* STORM SEW LAT 975
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATERCONN. $130.00 11222 - '
BUILDING PER.
sAC 9773 12-31-73
PAR K
CITY OF EAGQN Remarks
Addition ood ate lst Addition Lot 6 Rik 1 Par?l 10 84600 0]c[)- O/
Owner treet 1675 HiCkory H].11 State Eagan, NIN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.pdVlilg 1976 $410.12 $136.71 3 PAID
GRADING
PAVI!VG ;, 1974 $115.45-
.
SAN SEW TRUNK aq 9.54 6. 24 15 PAID
* SEWER LATERAL 197-9 5
WATERMAIN
* WATER LATERAL 1975 15 I
* WATER AREA 15
,t STORM SEW i4MG LhT a 1975 1505. 70 100.38 15 PAID
* STORM SEW LAT 1975
CURB & GUTTER
SIDEWALK
STREET LIGHT
wATER CONN. $130.00 11222 7-29-74
BUILDING PER.
sAC 5.00 9773 12-31-73
PAR K
CITY OF EAGAN Remarks
Addition Woodgate lst Addition 1 10 8460
. Lot Blk Parcel
Owner r ifl. Street 1677 ui rknry Hi 1 1 State Eagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
pj STREET RESTOR.paving 1976 $410.12 $136.71
GRADING
PAVING 253 1974 $115.45 $23.09
SAN SEW TRUNK Z 1974 $93.54 •
*SEWERLATERAL 1975
WATERMAIN
*WATERLATERAL 1975 15
WATER AREA 15
STORM SEW T-1314E (,A'r' Zm 1505.70 $100. 38 15 PAID
* STORM 5EW LAT trk 1975
CURB & GUTTER
SIDEWALK
STREET LIGHT ?
WATER CONN. $130.00 11222 /-29-74
9UILOING PER.
SAC $375.00 12-31-73 '
PARK
.., r C7F EAGAN Remarks
Addition "Wflod ate lst Addition Lot 8 Rik 1 Parcel 10 84600 080 Ol
Owner r-'' ?- Street -1679 Hickorv Hill State Eagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SUR F.
?0 STREET RESTOR. Paying 76 410.12 136.71 3 PAID
? GRADING
74 115.45 23.09 5 PAID
SAN SEW TRUNK 1974 93.54 6.24 15 PAID
I *SEWERLATERAL 1970 15
I
WATERMAIN
* WATER LATERAL 1975 15
* WATER ARER 1975 15
,tSTORM SEWif44 LhT .tR 1975 $1505. 70 $100. 38 15 PAID
x STORM SEW LAT trk 1975
CURB & GUTTER
SIdEWALK
STREET LIGHT
k
WATER CONN, 0. 00 11222 7-29-74
BUILDING PER.
sac '$'3
5.0 0 9773 12-31-73
PARK
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT
Te 6e awd fer F'IRE REi AIR Est. volue
SiteAddress 1675 HICKORY HII,L DR.
Lot aiock 1 se,isub. 1"70ODGATE
Parcel No. 10-84600-060-01
$10,000
W Name PAUL GROSS
? Address 112 ISRESTWQOI? DR.
city FURI'1SVILLI:phone 435-6013
oc
zo Name _
?? Address
?- CitV -
Name _
Address
City -
. Lv v .
Phone
I hereby ncknowledge that I hove read this applicotion ond stote that
the iniormetion is correct and agree To tomply with ull opplicoble
Stote of Minnesoto Stotutes and City of Eogan Ordinonces.
Permit `
Surtharge -"
Plan check
SAC
Wcter Conn.
Woter Meter
Rood Unit
Totol ?
Slpnature of Permittee I
C?'_PF.'?•,_
A 8uilding Permit Is issued to: on the express condition thnt
oll work shull be done in; acoordonCe witQ oll, appFiaoble State of Minneaota Statutes ond City of Eagan Ordinances.
8uildinp Official
N? 8g1J_l
Receipt # ^?
„ . I' F B RUA.RY 8 . „ . .
Erect ?
Alter ?
Repair ?J
EnlarQs ?
lvlove ?
Demolish ?
Grode f?
Auessment _
Water & Sew.
Police
Firo
Eny.
Planner
Council
Bldg. Off. -
NPC
Occupancy
zoning r ?
Fire Zone
Type of Const. V Il
# Stories
Len gth
Depth Sq. Ft.
Fees
Psrmit No. Permit Holdsr Misc. Permit No. Holder
umbing
[
H.
V.A.C.
Well
ter
D isp.
Sewer
elserie LA)bS 06 &-)I0,fAf4 El?
Inspection Date Insp. Other
Footinpt
Foundation
Framinq
Rouyh Plbp.
Rouyh HVA
Inwlation
Final Plbp.
Final HVAC
Final
watsr Dascribe Location:
5ewsr
Pr, Dhp.
V CITY OF EAGAN ; . l
3795 Pilet Knob Reed Eagen, MN SSIZ'! PHONEs 454-8100
BUILDING PERMIT Receipt #
To ba wed fer Est. Volue '''1 ?? r??' ^; • Dote
S)te Addr
Lot
Parcel #
Block l Sec/Sub. vrM'vylE A.DD.
10-3•?G??-!}30-?11
oc Name ""-•- ----?______
z ,?d,?? 1679 I?CF
ORY T;IIsL FtT;.
$` Name ?_,?.:.,?..,?..... , .?........? .
zF 9621 l?'ITi. P??:. :?0.
?? Address ^
?- r.., i'"o?.,,..? '??'.A-??7t?J_
Name
I hereby acknowledge that I have read this applicotion and state that
the information is correct and ogree to Comply with oll appliCOble
State of Minnesoto Statutes and City of Eogon Ordinances.
$'75f}
34
Erect 0 Occupancy
Alter ? Zoniny
Repolr Z`] Fire Zone
Enlarye ? Type of Const.
Move p # Stories
Demolish ? Length
Grode 1-1 Depth Sa. Ft.
Assessment
Water & Sew.
Pol ice
Fire
Enfl•
Planner
Council
Bldp. Off.?
APC
Pertnit
Surchar9e _
Plan check _
S^C
Water Conn.
Woter Meter
Rood Unit _
Totol 7
Sipnoturo of Pem+ittee I
L. . . . . . . . . . . .L
A Building Pertnif is Issued ro: on the exprcss condition Ihnt
oll work shall be done in osaordorxe with oll opplicable State of Minnesotc Statutes ond City of Eoqan Ordinances.
BWldinp Official ? '?'
.;r
Permit No. Permit Holder Misc. Permit No. Holder
Plumbing
H.V.A.C.
w.n
Water
D"isp.
Savuer
Electric
Inspection Data Insp. Other
Footingt
Foundation
Freminp
Rouph Plbp.
Rouph HVAC
Inwlation
Final Pllsg.
Final HVAC
Final 3 f
Wabr Dascribe Locatiom
YYell
Sawsr
Pr. Diap.
CITY OF EAGAN
3795 Pilot Knob Roaid
Eagae, Minnesota 55122
Phone: 454-8I00
FT,•-liIER SOFTHI4'FR _ pERMIT
? _ove???ex 14, Z"
Date:
Site Address: 167 3 Fiz?.'kor5?
Lot Block 5ub/Sec. _
I Name
.
; Address '{'i3
O
City "a`?ar Phone:
/? ell&od oso D 1
No. I,: `
Receipt No.: h?
Single
Residentiul
Multi Res., Comm./Ind. ?
New/Alter./Repuir j?-
Cost of Installation
Permit Fee 5.00
'??Nome Y.si-?,:_.?? ;.n. •- ~t:?.a.:.?.:,:-. ISurcharge ` 5r1
I
I I Address 1001 t`?arie Avenue
e
V
Icity `?? . t.' ?•? 1 • _ Phone: Total S . 15- 1)
This Permit is issued on the express condition that all work sholl be done in accordance with all applicable State of
Minn Statutes and City of Eagan Ordinances.
Buildin9 Officiol
• .
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.
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nLu?oe ov Enoar WATER SERVICE PERMIT
' . ,
. . . 3793 iilor Knob Roed p,EgMIT NO.: ' 1408 . ' . . ? ,
' . . Eagon.MN 85172 D?YA1'E: " Z&7274 _- ?'
Zoning
pgp
' ?y . , . . .
_
_----------;`:_ IYO. of Units: 4 Oillt
141
. . . Uwnri•: ...M4M -HOS'1TAR
Addrese:
Site Addrnsr.. 75-
j
77-
79 gi Ors Hill
?
?
?
?
Plumber:
I?
C4
?-P11?b1IIQ
Mete.r No.: --------- Gonnectloa Charge: S 0.0 5
size: _ Accouut DFPowt- ` '
.'? • t
? . . ?
. Reader No.: Pe:mft Fee: ` ' L°• W P° ? ' ? ? V '
?
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. , , • . ' ? ? aBrMI fo tOmply wifh fM Yllloy. p? Ep0yq g???8a??f ? ' "?°. I '- r , . , r . ? d
? O.di • !. ?,
ti:z -?
B Toul:
V714?.?
Y . ? Date PaSA
.
.; ,
. . . :
Date of Inap.: i
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?l" . ' ? , , ..?n..??w• '?$ L?•T? P ??'1', 1 AW ^t', ' r . ' . ' ?:ie : '?. TA]r...,?.p.?Y'.n
•
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a
vlwmi oR uau? " SEWER SERYICE PERMl7' ; •
9riS Nb? Knw6 Reer PERMIT NO.: 2161
Eoyon. MN 55122 DA7E: 2/27
?
, Zaning: PUD Na af fJMa: ? 4 an t
' - Owner:Woodddit e - Nev HUi:=
Addrese:
167
3
, site eddree
n: 75-77-79 BiakoaY eill, .. . '" .. ;;
?
?
?
Plumber:
11/21/73.. i
. ' ? ' . . 1 oqm ro ""tMr wftb *A vp," of
t,v,. Conosctim C?50b. 00 po l47t -
ordl
no?
Ao=W DeposI4 , , . .,.
. ..
?
• ' ??
? Pvmh Fe?.00 pd' .
? gurchiarge, .50 bsd? .. , ? IV
er: `
Mlu CDu+aes:
i
Date of Inap.: Taaf: . . . . . ? . . ' . ' . . ? . -
.. Inep •
-- ? ---., . . ,
DetePaw:
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CITY OF FFIGAN
BUILDING PERNIIT APPLICATION
'Ib Be Used For I'1R7o jc'u?iA-i C?_ Valuation 1C FOC^ Date
Site Pddress: IiG15 4kc,y_?e.,j
Lot ? Block ) Sec. /Sub .L" "o-? 3 a
Parcel #: / J' gqfD O O • CJIa l> "(7 /
Oaner •
Address: 112 Ka2???h1eh,? 1?2.
City/ZipCode: '?N U\P- N+.,r,..i 5
Phone #: 4?- c-?CiZ3 ?
Contractor: Lc;s.n?4z\ N ;
Address:
City/Zip Coc1e:
Phone #:
Arch./Eng.:
Pddress:
City/Zip Cocie: _
Phone #:
Include 2 sets of plans,
1 Certificate of Survey &
1 set oF enerTj calculations.
OFFICE USE ONLY
J
Erect Occupancy _
Alter Zoning
Repair >e Fire Zone
_
Enlarge _ Type of Const. `
Move # Stories
Detmlish Front ft.
Grade Depth fte
APPR?TALS FEES
Assessaents
Water/Sewer
Police
Fire
Eng.
Planner
Council
Bldg. O
P,PC
Petinit
Surcharge
Plan Check ry{p?
SAC
water Conn.
Water Meter
Road Unit
?
TC/PAL
CITY OF EAGAN
'
-
y
3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121
.
ND 8gO1
PHONE: 454-8100
BUILDING PERMIT Receipt #
Te 6e uwd fe. FIRE REPAIR W. Volue $10,000 pO}e FEBRUARY 8 ?q 84
Sitenddress 1675 HICKORY HILL DR. E??? ? ??upancy R3
Lot 6- 81 ock_1?Sec/Su6. WOODGATE ADD Alter ? Zoning R3
ParcelNo. 1 0-84600-060-01 Repoir ? FireZone N/A
E
l Vn
T
f C
n
arge ? ype o
onst.
w Name pAIIT GROSS Move ? # Stories
z Address 112 KRESTWOOD DR. Demolish ? Length_
City B TRN7,FPhone 415-601 3 Gmde ? Depth Sq. Ft-
p OMPANY AvOrovals Fees
o Name GIERTSEN C
iu
Address 5147 WINNE'L'"KA AVE. NO.
? City NEW HOPE phone 535-3212
ww Name o77- I.797
f
x? Address
<W City Phone
I hereby acknowledge ihat I hove reud this applicarion and state that
fhe information iz correct and agree fo comply wlth all opplicable
Stote of Minrresoto Statutes and Ciry of Eaqan Ordvwnces.
Slpnoture of Permittea _
A Building Permil Is issued ta:
all work shcll be done A-32cv
Assessment _
Woter 8 Sew.
Police -
FIIB
Eng.
Fionner _
Council -
Bidg. Off. _
APC
Permit a o V.j v
$urcharge 5.00
Plan check
SAC
Water Conn.
Woter Meter
Road Unit
Total 85.50
GIER'ISN COMPANY on the exprev condition thn+
: yfgk al{.,eppLicable State of Minnewta Statutes and City o4 Eagan Ordirwnces.
Building Offlcioi
CITY OF EAGAN NO 8756
9795 Pitat Kno! Rmd Eagan, MN 55122
PHOHE: 454-9100 ?
/,/
BUILDING PERMIT ReceiPt # ?
S?'
Te M wed for F'IRE DAMAGE Est. Value $10,000. Dare JMRZRY 9 _, 19 84
Site Address 1679 HIQ{ORY HII,L RD. Erect ? Occupancy
Lot 8 B lock 1 $ec/Sub. WOODGATE D--.) Alter ? Zoniny
10-84600-080-O1 Repoir g? Fire Zom
parcel #
Enlarge ? Type of Const.
c Nome ?T ?BU$Q?I
Move ? # Stories
; Address 1679 HTCKORY HTT.T. RD. Demolish ? Length _
b ci E AGAN phom 729-6235 Grade ? Depth Sq. Ft.-
L?j? LvIK]? ApDrornb Faes
o Nome
?u Address 9621 lOTH. AVE..NO.
l- ,-,... PLYMOUTH ?___ 544-8761
Name _
Addren
I here6y ocknowledge that I have read this applicatian ond state that
the intormntion is correcf ond agree to comply with all applicable
State of Minnesota Stotutes and City of Eogon Ordinances.
Assessment
Water d Sew.
Police
Fire
Enp.
Plonner
Council
eta9. ort. 1/9/84
APC
Permit ov.?v
SurcFar9e 5•00
Plan check
SAC
Water Conn.
Water Meter
Road Unit
Total
Signoture of Pertniftee I
A Bullding Permit Is issued to; L??$`1''? ?ST. on the e:preu condition Ifini
pll work sholl be done in ascprdonce wuQWLnpplicable Stote of Minnesoto $fatutes ond City of Eoqon Ordinonces.
Building Offltial
, y/L,,:1
u? . ?
Zb Be Used For
Site Address:z
CITY OF EAGAN Include 2 sets of plans,
1 site plan w/elevations &
i?• iZ ?,,,?,DING PERMIT APPLICATION 1 set ofre?rclY cal.culations.
f?l• `?? I /
Valuation Date
%Lz ?Vl?? _ OFFICE USE'/ONII.Y
Lot i"BlocJc ? Sec./Sub. '"' °°',
Parcel #: 00 -?(/ Go'+ ' d 9?0 - 0/
OWilex:
Pddress:
City/Zip Code:
Phone #:
Contractc
Address:
City/Zip Code:
Phone #:
Arch./hlig.: _
P3dress:
City/Zip Code:
Phone #:
Erect Occupancy
Alter Zoning
Repair-= Fire Zone
Ehlarge _ 7.ype of Const.
Move # Stories
Demolish Front ft.
Grade Depth _ ft.
APPF20UALS F'EES -
Assessments ?
Pexmit ?--
Water/S2wer Surcharge
Polioe Plan Check
Fire SAC
Enq, Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off. / ? -
APC
.,
.
.y .
EAGAN TOWNSHIP
BUILDING PERMIT
Ownex ".'....
Address (preseni) ?`? "
...........................-`°-°-...----..
Huilder
Addreas
DESCAIPTION
N°
.
Eagan Towaship
Town Hali
E.1
31'75
Da}e _"??" .. /- 7.?
6fories To Be Used Fos Fron! Depih Heigh! Esi. Cos! Permif Fee Aemarlcs
?. _t7_V:,_ls-??:o
LOCATION 3x 9% C-0
Sireel, Road or oiher Descriptiox oi Localion I Lo! Block Atld9tion or Traet
1
)6 j.1_ S-A-fiS - k 7 - 7 -t- 77- '79-
This permit does noi au2horize the use of sizeels, roads, alleys or sidewalka nor doas it give the owner or his agent
the righi !o areate anp siiuation whieh is a nuisance or which presenfs e hazard Yo the heallh, safety, eonveaience and
general weltare fo anyone in the commvaiSp.
THIS PEAMIT MUST BE KEPT ON THE PAEMISE WHILE THE WORK IS IN PROGAESS.
_/..............."'._.............""'_ " u oA
This is !o eerlifp. 2ha!".71,` ... .............hasParmassion Yo ereat a_. 2,..... (. p
the above deseribed psemise subjeef !o ffieprovisions of the Building Ordinance fos Eagaa Township adopled April 11,
1955.
?I? ?.C. ?.--
....-.- ....... ...............? . . . . . . . ---?.... Per ..........................................°---°--.-.----....... ?
. .. . ... ...----.............°............
Chairman of' nwn Soard .- Building Inspeetos
I m ?i?v..?
? ? ?A iDoo o-to o i
bD0C6'TJCL' _
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT NO.: 430
The City of Eagan hereby grants to T,a„ipann Plnmhin4 ro.
Minnetonka,
of l77ni M{TnPi-f1TYA Rlvc3,_ MinnPaota rM41
a Permit far: (Owner) wAM rreriren rremna
1?33-35-37-39, 1643a45-47049, 1650-52-54-56, 1642-44-46-48, 1658-60-62-64, tuld
a167.3_+6_7:7_7e ei_,.,,.... v+,• Pursuant to application dated _9f97/74
Fee Paid: $480 00 dated this 77*.b day of pa}?_ w??? , 19 7d.
12.00 s/c
Building Inspector
Mechanical Permits:
Bid Tota1:
,..
f-/J/
wo cdgct fe
VILLAGE QF LAGAN
3795 Pilot Knob ttoad
Eagan, Minnesota 55122
PERMIIT N0. 497
a1' h?:rF: ? &t 1673+73-5
Fee Pai?Y '',
oP..'. 1001 Xeaia Ave. So.
The Village o£ Eagan hereby grants to sedawick Heating
rc? PexmttPYors '(Oianer) n't?is4
?,y?.? .
7;y2jinickory gi,ll , pursuanb to application
-' SS0.00 dated thia 13 dar oY Ad
4.00 e/c ?
Nlechanical Permits:
Bid Total:
3
HOUSE HEATING TEST RECORD
1673 Hickory Hill
ADDRESS APT. -FLOOR
OCCUPANT Romeo D. Cruz E Yea
HEAT LOSS -
SOLD BY
Elecfrical Work By
TYPE OF HEAT
Gas Lina 6y
GA _ FA g HW -STEAM -SPACE HTR. -UNIT HTR. -OTHER
? GAS DESIGN
MAKE WilliamaoL MAKE OF BURNER_
Model 1117-07'5 Model
' Swiai 7412337 Max. BTU Rating -
INPUT 751000 BtII Hk, MAKE OF FURNACE
Model
CONTROLS
THERMOSTAT Cm 260 Hear Plu
Valve M.H. V?OOc
Limit Robshaw RFL 750n
Limit Sening 200of
Fan setting 900f & 120 f
Pilot Type
Pilot Make
CITY SUBURBEagan
CONVERSION
Vent Size
KIND OF LINER AlID9, SIZE 8" NONE
Drok Hood Vertical Reguloror
Filtera Size 16" x 25 Number
Chimney Lotation Inside Yee Outsids
Chimney Construction Metalbeetoe
Pilot Model $moke Bomb Wiring
Pilot Timing 64 SQC00d8 Draft Ox Test Tog Yes
L.W. Cut Of4 ?/ Door Pressure .? Lighting Inst. Ye8
Prossure 4.38?w.C. Percent COZ 7."/' Dare Tssrod 1/ `8'?5
Inpuf CFH 7?Percent 02 $•7 Company Testing CS, ' ht Co
Stack Temp. 49O f patcenf CD .0 Name of Tsster
DATE HTG. INST.
OWN R
INSTALLED BY Sedgwi6k Htg,
1 it
Fwm 235
HOUSE HEATING TEST RECORD D-21101
ADDRE55 1675 HiCkOx'y Hill APT.-FLOOR CITY SUBURB E8gan
OCCUPANT Mickael Wm, LogBri - OWNER Yee
HEAT LOSS DATE HTG. INST.
SOLD BY
Electrical Work By
TYPE OF HEAT GA _ PA X HW _STEAM
-GAS C0. METER BADGEed 1Ck Ht
-INSTALLED BY ? ? g•
-Gas Line By u n
SPACE HTR. -UNIT HTR. -OTHER
GAS DESIGN
MAKE Willi8m80n MAKE OF BURNER_
Medel 1117-07-5 µ,del
saial 7412348 Mo:. BTU Rating-
INPUT 75,000 Btll -Hx'. Mp,KE OF FURNACE
CONTROLS
THERMOSTAT ? g260 Hear PIugOOC
Valve YtS
Limit Robshaw RFI, 750II
Limit Setting 200 f
Fon Serting 900f &120 f
Pilo} TYpe Conple
Pilot Make
Model
Vent Size 4"
KIND OF LINER Alllm, SIZE 6" NONE
Drah Hood vertlC$1 Regularor
Filters Size 1811 R 2511 'Number 1
Chimney Location Inside YeS Outside
Chimney Constmctien Metalbeetos
Pilot Model Smoke Bomb Wiring
Pilot Timing 64 Seconds praFt QK Test Tog YeB
L.W. Cut Off Door Pressure Lighting Insi. YQ8
Pressure 4.4"W,C, pe,.ntC02 7-0%DateTested-I.4s./75
Input CFH 74 Percent OZ Company Testing ?
Stack Tamp. 540af Percent CO 0• 0? Name o( Tsster -? -""'? -°E?
CONVERSION
Form 235
HOUSE HEATING TEST RECORD
ADDRESS 1877 H1CkOTy Hlll ppT. -FLOOR CITY SUBURB Eflga?
OCCUPANT Rufael C. Naquiat OWNER YQe
HEAT LO55
SOLD BY
Elecirical Work By _
TYPE OF HEAT GA
Gas Line By
FA 'Y HW -STEAM -SPACE HTR. _
GAS DESIGN
MAKE willlam80ri MAKE OF BURNER
M d I 1117-07? I
UNIT HTR. -OTHER
CON V E R51 ON
o e Mode
s«iol 7412396 Maz. BTU Rating-
INPUT 75.000 Bt , MAKE OF FURNACE
Model
CONTROLS
THERMOSTAT CRt 260 Heat Plu Vent Size 4"
Valve M.H. OOC KIND OF LINER Alllm. SIZE 611 NONE
Limit RobehaW RFL 750C1 Draff Hood Vertical Regularor
Limit SsMing 200 f Filterz Size 16" % 25" Number 1
Fan Sefting 90of & 120of Chimney Lacation Inside Yea Outaide
Pilot Type Couple Chimney Construcfi on Metalbestoa
Pilot Make
Pilot Model $moke Bomb Wiring
Pilot Timing 43 Seconde Draft OK Tezt Tag YQ8
L.W. Cut Off Door Pressure Lighting Inst. YQe
Pressure 4,8°W.C. ParcentCO 715% Date Tested 10j29174
InputCFH 75 Percent 02 7•$ Company Testing COmk7 t10C1 S BCi Ztl@9
Siack Temp. `520of percant CO Name of Tesfer -? ?
DATE HTG. INST
GAS C0. METER BADGE
INSTALLED BY edgwick Htg•
u I
Form 235
HOUSE HEATING TEST RECORD D-21109 ?=S-/
1679 Hickory Hill Esgan
ADDRESS APT.-FLOOR CITY SUBURB
OCCUPANT Rev, Wi11i81llE7 R, Farmer OWNER Ye9
HEATlOSS DATE HTG. INST. GAS CO, METER BADGE
SOLD BY INSTALLED BY Sedgvtick H g.
u n
Elechieol Work By Gas Line By
TYPE OF HEAT GA _ FA X HW STEAM -SPACE HTR. -UNIT HTR. -OTHER
GAS DESIGN
MAKE Williameon MAKEOF BURNER_
Model 1117-07-5 Model
7412324
Serial Maz. 8TU Rating-
INPUT 75,000 BtII HI'. MqKE OF FURNACE
Model
CONTROLS
THERMOSTAT Cm 260 HeO} PI Vent Size 4??
ya1Ve M.H, ?kOOC KIND OF LINER Alum. SIZE NONE
Limit Robahaw RFL 75011 Droft Hood veTt1C81 Regularor
Limif SeNin9 2000f Filters Size 16 " a 2511 Num6er
Fon Setting 900f Sa 1200f Chimney Location Inside Yes Outside
t T
Pil L'OUpZC Construcii
Chimna on Metalbeetos
ype
o y
Pilot Make
Pilot Model Smoke Bomb Wiring
Pilot Timing 59 S2C011d8 Draft QK Test Tag Ye9
L.W. Cut Off Door Pressure Lighting Inst. Yes
Prossure 4,6"w•C'• perceniC02 7` DateTested -
InputCFH 74 Percent OZ.? ?mpany Testing
SMCk Temp. 5600f ercent CO -" -' Name oi Tesror _
Form 235
CONVERSION
This request voitl y /15-1 Z,
18 rHonths from
W 050683 L l., e 1, WooP 6qTF AOn -20 •4m
Fequest Date Fue No.
?? Rouyh-,n InspecLOn
Re4wred>
[]fleatly Nuw Q Will Nolity, Inspec-
-?
? ?Yns ?NO Iur When Ready
?Licensed Elecvical Contracror I hereby requast insunction ot ebove
? Owner electncal work instelled at:
SVeet Address, Box or Route Nn. Crty "
? C?
1G EA64N
ecuon a. o. a
Townsh?p Name or Nn9e No. Caanty
?
Occupdnt(PPINT) Phone No.
G«-,e.r??-•? c?.
Power Supuher AdAress
Electncal Cnnlractor IComp.iny Namel Contractor's Lic(inse No.
SPF?c?`? EL?R?G CO C?'d8r.5'
Mailing AdJress (Comraclor or Owner Makina InstellaLOn)
N f?/?l.1JS?? .4!!241I4r- !? LO.?'zS?/?Y? ?Sc3c3 ?
Authonzed Signat e(Conv ctor/Owner nB Installatron) Phon umber
- y``r6-1?1
MINNESOTp STATE 90AflD OF ELECTHICITY THIS INSPECTION PEQUEST WILL NOT
Grigga-Midwey BIdO. - Noom N-181 BE ACCEPTED eY THE STqTE BOAND
UNLESS PflOPEH INSPECTION FEE IS
7821 Universitv Ave., S[. Peul, MN 55104
o-.. ia», no, i'l• ENCLOSED.
7 ?#REQUEST FOR ELECTRICAL INSPECTION ? EB-00001-04
, See inatructions for comoletin9 this form on back of yellow coOV. /
'IX Be??W?rkCo?red by This Request
aaa neo. 7ype of euimna Avvliancxs Wired Enuuumeric wi.ed
Home Ratige Temporary Service
Duplez Water Heater Liyhhny Fixtmes
Apt. Bwldinq Dryer Electric Heaun
Cominercial Bldy. Fumace Silo Unloader
Industnal Bldg. Av Condivoner Bulk Milk Tank
Farm Ner Specrty Other ISUCr,ifyl
[ P.f SGCCI Y' O1hp! Ot'1(+.t
Compute /nspectron Fee Below
p Fee ServmeEntranceSae # Fuo Fexders/Subfeeders N Foe Circurts
0 to 200, Am s 0 to 30 Am s 0 tn 30 Amo
Above 200 qinps 31 Co 100 Amps 31 to 700 A y
Swimming Pool Above 100_Am y Above 100_Am s
Transiormers Irngation eooms Partial%Other Fee
Signs )bX Specialinspection g
Remarks TOTA EE '
/1
?-
flough-in // ,• ( D_.YJe,?
?r theElachwnl
Inspector, hereby
certify tMt the above
F?nal inspection hes been
3 mede.
Tliis reauest void 18 moMhs fmm
This requesl vofd ? `? ?kt(
18 months fmm A 36179 R.sc , e?. ?.Jeolqq.?lt 14dd. ?lf ? 5S
Request ate
n Fve. No. Rnugh-in Insvecuon
Hequirad? " ?
?Ready N(w?WtITNOtify Insoer
(_ 1 Vos ?N. [or When qeatly
igLLicensed Elecvical ConUactor I hereby raquest inspection of above
?/Jv+ner elac[rmal wotk mstallatl ai
Sv et Address, Boz or Route No.
W" wttit-S R-0A o Gty
`pAC7RO
ecuon o. Townshi Namo or No. Ranye. No. County
DpAwaTq
OccupnntlPplNT)
ti-1NOSiPan ?Or?aGRO?a?le,?+ Phone No.
Power Supplier
N
• Atltlress
Ele
tncal Conhactor (COmpany Name) ConVactor's License No.
L
?
u? (:11QRu- 35Sz,5-
Madmg AdJress (Contractor or Owner Making Instailauonl
lqt? (, Cu?- Kr%
Au ori d Si atur IContractodOwner Making Installation) Phone Number
? ,Y`'i, -5305'
MINNE90Tq STqTE BOARD OF ELECTHICITY THIS INSPECTION REQUEST WILL NOT
GrigBe-Midway Blda. - Aoom N-781 BE ACCEPTEO BY THE STqTE BOAFD
1821 Universi[Y Ave., St Peul, MN 65104 UNLESS PHOPEN INSPECTION FEE IS
PA..no 16121297-2111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ? EB-00001-0d
? SBB inStfuCfionS for complB<in9 lhi5 tofm on back Of YellOw cOpy. ?/
A "X" Below Work Covered by This Request
t1Ad Hfo.# Tvoe of emltlma? AaPliances WireA Equipmem Wired I
ex
ectrlc
? Commercial Bldy. Fumace J?lo Unloader
Industnal Bldq. Air Conditioner Buik Milk Teni<
# Fee ServiceEnVenceSi¢e b Fee Feeders/5ubfnetlers N Fee Cvcuits
0 to 200 qm s 0 co 30 qm )s 0 to 30 Am s
Above 200 qm s 31 to 100 qinps 31 to 100 qm s
Swimmmg Poal Above 100-Am s Above 100_Amps
Transtormers Irngation Booms I SIL1 . Partial,'0 ee
eigns ?PeciaiinspecUOn S?
Remarks T EEE
?iR'" n n., J r , ?
nougn.in ?.11r?'E?nioe?
4i4 Inspector, hereby
certify thnt the abova
Final ?`? ! ,inspection has been
• ??? made. ?
ttlw repueat voitl
,.?
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pibt Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWctlon Requiremenis RemotlellReoair Reauiremenls
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 wpies o( plan
(20%maximum lotcoverage allowed) 7 set of Energy Calculations for healed additions
2 copies of plan showing beam 8 window sizes; poured found design, etc. 7 si[e survey for addNOns & decks
1 sel of Energy Calculations AddRion - indicafe if on-s8e sepfic system
3 copies of Trea Preservation Plan if lot platted after 7/1/93
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
office Use On?
CeAOfSurveyReod _Y _N
Tree Pres Plan Recd _ Y_ N
Tree Pres Reqd _ Y_ N
Onsile Septic System _ Y_ N
Date 03 ConstructionCost
Site Address ? ? ? 3 ?-?? G ? iz.•, ljr ( ? 4m? UniUSte #
Description of Work ! up-W n,-Oc 6c - Tvt S44 it [DA--40 DcxJ2
Multi-Family Bldg ? Y _ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner K-0 hi n e?£ Telephone #4yt)&O $-awfo
Contractor 4 M1 I Cu.. s?. ,?,?
Address yo yo w/ 3 -7City .Sf}v.4.f £
State yN i.,0? Zip , 3'7 s Telephoce #( J?rp) 88,3- C7 0?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate¢orv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissionrype) Su6mitted Submittad
. Energy Envelope Calculations Su6mitted
Have you previously constructed a bu
fee applies. ? ?
lDl
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
2 2003
Telephone #(
Telephone #(
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 will be in accordance with the approved plan in the case of work which requires a review and
approva] ofplans.
ApplicanYs Printed Name
a similar plan? _ Y _ N If so, 25% plan review
Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 OS-plex A 18 Deck ? 23 Porch(screen/gazebo)
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New
x 32 Addition
? 33 Alteration
? 34 Replacement
Valuation ?
Census Code G! 3Y
SAC Units -
Nbr. of Units -
Nbr. of Bldgs ?
Type of Const ?
Foorings(new bldg)
? Footings(deck)
_ Footings (addition)
Foundarion
Drain Tile
Roof Ice & Water Final
? Framing
Fireplace R.I. Air Test Final
Insulation
-------------
Occupancy 'PI`3
Zoning Pn
Stories
Sq. Ft. -1 .?-
Length
Width /zl
MC/ES System -
City Water -
Booster Pump ?
PRV -
Fire Sprinklered
REQUIRED INSPECTIONS
FinaUC.O.
A4 FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
Siding Stucco Stone
? Windows(new/replacement)/9AI;v.i/L
_ Retaining Wall
Approved By
Base Fee ?
Surcharge f) l?
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
rotal
?.
? 30 Accessory Bldg
x 31 Ext. Alt - Multi
? 33 EM. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)• ? 43 Reroof k 46 Windows/Doors
'Demolition (Entire BIdg) - Give PCA handout to applicant ?Z602.
Building Inspector
. • U)9a?4 ? AA?R
?
? Y
?
QK
?
?
i
b
?
<
v4
c,.
?,6
?A ,c"k J?
?
h
?
\?\
JONNNY CAKE RIDGE RD
v39pla 3Ntlo ANNHOf
84600 WOODGATE
84601 WOODGATE 2ND
HICKORY HILL (PAGE 2 OF 4)
16731 8 600 050 01 (4-plex)
1 7=-=06t3701? _=-- ----
1677/ 07001
1679 08001
1681/ 10 84600 01001 (4-plex)
1683/ 02001
1685/ 03001
1687 040 01
1688/ 10 84600 01003 (1/2 of 4-plex - other 1/2 on Hickory Lane)
1690 020 03
1700/ 10 84601 150 02 (4-plex)
1702/ 160 02
1704/ 140 02
1706 130 02
1701/ 10 84601 02001 (4-plex)
1703/ 01001
1705/ 03001
1707 04001
1708/ 10 84601 110 02 (4-plex)
1710/ 120 02
1712/ 100 02
1714 09002
1709/ 10 84601 06001 (4-plex)
1711/ 05001
1713/ 07001
1715 08001
1716/ 10 84601 070 02 (4-plex)
1718/ 080 02
1720/ 06002
1722 05002
2
?
? 3?
ib
PERMIT #: 5(a
CITY USE ONLY
RECEIPT DATE:
EOOE iiESIDENTIAL MECHtNICAI. i'£gMIT ?PPLICATION
crrY oe EaeAx
S$SO PILOT KFOB RD
HABAN EtN 55122
851-8$1-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: 1 l- Cn ' 02-
SITE ADDRESS: I ?03 W (• ko r y 176114_1&
OWNERNAME: n*v 4 IF ?n6 inetk-rL., TELEPHONE#: (as-I-6BV- a3?P
INSTALLER NAME: TELEPHONE #: !2'. -d/J 4'? Y3?ci?
STREET ADDRESS:
CITY: ?p[QGrL,r?. STATE: 1-1ko ziP: SSI a3
Place a check mark next to the permk work type
Add-on, modification or alteration to existinq dwelling unit $ 30.00
rnace replacement
• air exchanger
• air conditione
• o er
Natureof work: 4?4n ec1x_ oc 14.e.
I
State Surchar e I $ 50
111i '+I;v u u I
T
t
i u U
S ? . ?O
o
a
I
SIGNATURE OF PERMITTEE
voz
CITY USE ONLY
PERMIT #:
APPROVED BY:
INSPECTOR
RECEIPT DATE:
2002 COMMERCLftL MECHlkA1CAI. PERMIT APPL1CPcT10N
CITY OF KAHtkN
3$30 PILOT KNOS iW
EAsAiv, Mv 55122
651-8$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):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
STREET ADDRESS:
CITY:
TELEPHONE #:
STATE: ZIP:
WORK Tl'PE: New construction Install U.G. Tank
_ Interior Improvement Remove U. G. Tank
_ Processed Piping
SpecifyNature of Work
When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and
Plumbing inspector.
Fees: 1% oFcontract price OR $50.00 minimum fee, whichever is greater.
Underground tank removalhnstallation = minimum fee
Contractprice: $ xl%=$ (BaseFee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
SIGNA'I'I1RE OF PERMITTEE
Updated 1/02
,
TION
OWNER
MASTER CARj)-,,
toq;?r6- 7• ?ek I
_ _ a „r--
STRUCTURE AND oe
LAND USED AS Y644t/
Permit
No. I
Issued Issued To
Contractor Owner
BUILDING
PLUMBING 2/71-I
i ?Z? I
CESSPOOL - SEP71C TANK
V'JELL
ELECTRICAL
H EATI NG
GAS INSTALLING
SANITARY SEWER
OTHER
i
OTHER I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FGOTING SEPTIC
FOUNDATION ')? CESSPOOL
FRAMING 11 /7. 7J° TILE FIELD FT.
FINAL
ELECTRICAL
NEATING
' DEPiH
OF WELL
GA$ WSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER ?
Violations Noted
on Back
COMMENTS:
'...
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF
CONDI710N5 OF CONSiRUCTfON A7 THIS INSPECTION
? NO EVIDENCE OF NON-COMPLIANCE
OBSERVEO.
NON•COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIA710N5.
? NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
-? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? REINSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CERTI FICATION - I certify that I have carefully inspected the a6ova in which I have no interest present or prospecxive, and that I have reported herein
all significant condicions observed to be at variance with ortlinances of the Town ot Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
? ALL IMPROVEMENiS ACCEPTABLY COMPLETED
euILOING I
DATE
CITY USE ONLY ?
LOT O BL I RECEIPT t1: %95
a
SUBD. (pO64c.ytYiLR.J I? RECEIPT DATE:
-? ?
1998 MECHAIVICAL P£itMIT (RUIDEP'flAI)
crrY oF £asav
3830 PILOT KA08 $D
f.A6AP !![i 851 EE
neee: ll-- I S'-95'i'' c61EJ 681-4675
Complete this section onlv if you are installing HVAC in single family, townhomes or condos under
construction and not owner /occupied '
? HVAC: 0-100 M B T U $ 24.00
ADDITIONAL 50 M BTU 6.00
• Gas ouUets (minimum of one required @$3.00 ea.)
• State Surcharge: .50
• TOTAL:
Complete this section onlv if you are remodeling, adding to, or repairing existing single family dwellings,
townhomes, or condos. Note: Mechanical permit is not requued for alteration/add-on to ductwork in
existing residential units; but is required for the following:
x Install fumace _ Install air conditioning
_ Install air exchanger, i.e. Vanee system, etc. _ Other
Ivlinunum i4e appiies to ali remode,i or n;:d-ans a; existing res:de:aces $ 20.00
State Surchazge 50
Total: 20.50
siTE .4nnREss: /(o ? 9 I41Gkof ? /???? ?'i •
OWNER NAME: liscn i, v P n pHONEM ysa - 99161
INSTALLERNAME: I-Alk4vs Jo utk i-e !7 ty PHONE #: ?{ f• 709- 9p,
STREETADDRESS: I7 73R - d'"pnY10[ k ,?
?,
CITY: ?61A,W , STATE: /?W-_ zip: .55"/a y
16?/ k&W1v.= -
SIGNATUM OF PERMITTEE
lS/FORMS BLD/MECH PERMIT (RES) • 1998
L BL
SUBD.
CITY USE ONLY
APPROVED BY:
RECEIPT #:
RECEIPT DATE:
1998 M£Cf1ANICAL P£it41IT (CObIMEfiCIRL)
C1TY OF EALfiAN
3$30 PILOT KNOB !tD
£AfiA1V, b[N 5518E
(61$)681-4675
Please complete for. all commerciaUindustrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE: CONTRACT PRICE:
WORK T'YPE: _ NE"VV CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: 1% of contract price OR $25.00 minimum fee, whichever is greater.
Processed piping - $25.00
CONTRACT PRICE x 1%
PROCESSED PIPING
PERMIT FEE
STATESURCHARGE
TOTAL
SITE ADDRESS:
($.50 per $1,000 of ermit fee due on all permits.)
OWNER NAME:
PHONE #:
TENANr NAME (IlvIPROVEMENTS oNL1):
INSTALLER:
ADDRESS: PHONE #:
CITY:
STATE:
ZIP:
SIGNATURE OF PERMITTEE
PERMIT #
RECEIPT DATE: / -? -C I
? US1DEPTLkL PLUM$INfl PEIMTf A"LICATlON
crrY oF EA(IJAx
saso Pnor Kxos Etn
St46AN. bllY 55122
651-8$1-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for irrigatlon system
SITEADDRESS: +brl AIGJ(zpq W)u, VZ
ArP7
f'?"
OWNER NAME: :NA)FETZ dtETAf`AQDCL- TELEPHONE #: w T
(AREA CUDE)
INSTALLER NAME:
STREET ADDRESS:
CITY:
Place a check mark next to the permit work type
STATE:
ZIP:
New residential dwelling unit under construction and not owner/occupied $ 90.00
Add-on, modification or alteration to existina dwelling unit, including: $ 50.00
f • abandonment of septic system
?; • new installation/repair/rebuild of RPZ
• lawn irrigation system
• water turnaround
Nature of work: z0bac WIN-117?- ?+?W?_
Septic System, new/refurbished - $ 225.00
• includes County & Consulting Inspector fees
• requires MPC license
State Surcharge $ .50
'11? L ! Luul I?I
u
l
so.sc)
Tota
I- $
?
Reminder. Be sure to schedule inspections of atterations, i.e. water heatensrwater,'softeners, etc.
I hereby acknowledge ihat I have read this applicatioa, state that the information is correcl, and agree to complywith all applipble Cityof Eagan ordinancas. It
is the applicant's responsibiliry to notify the property owner that the City of Eagan assumes no liability tar any damages caused by [he City during its normal
opera6onal and maintenance activities to the facilities consWCted under lhis permit wifhin City pro /nght-of-wayleasement.
SI A RE OF PER ITTEE
Updated 1101
Gine?C(1MC TELEPHONE#: R5?
p,..
2th Avenue South (.vREAcooe)
RESIDENTIAL BUII,DING
Permit Application
City Of Eagan "3
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX 9 651-675-5694
NewConsWCtlonReauiremenfs RemodeVRenairReouirements Office UseOnlv
3 registered si[e surveys shaving sq. ft. of lot, sq, ft. of Muse; and all roofed areas 2 mpies oF plan _ CeA of Survey Reod
(20% maximum lot coverage allowed) 1 sel of Energy Calculations for heated addiGOns Tree Pres Plan Recd
2 copies of plan showing 6eam & window,sizes; poured found design, etc. 7 site survey for additions & decks Tree Pres Not Reqd
isetofEnergyCalcuWtions Addifion - iMicatedon-sdesepticsysfem _On-siteSepUcSystem
3 copies of Tree Preservation Plan i( lot Faried after 7l1193
Rim Joist Detail Opllons selec4on sheet (bldgs wAh 3 or less units
Date _? / ?/ Q? Construction Cost
SiteAddress I-)2j v,c?7- Unit/Ste #
E??P?-9c? p2 SUPp02? aSTJ ?.?a?+y ?Z,?
Description af Wark _!L?`?i.?
J7) I s Y-S 4.0i rss !7//,L?.?d-L
,
Multi-Family Bldg Y_ N Firepiace(s) ?_ 1 _ 2
Property Owner Telephone # (45X3/) ?'p,5"Zlv?d-yC
Contractor ??"Z ?
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheel
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # ( )
Telephone #
Telephone ---
n.
APR 1 5 2^?" ?
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 th State of MN
44:?R-wu2k is no o start without a
Statutes; I understand this is not a perntit, but only an application for a penAB
permit; that the work wi11 be in accordance with the approved plan in the case of work which requires a review and
approval ofplans.
s,;?4?r2A .?_ REd2.ey,r??w
ApplicanYs Frinted Naxrie
ApplicanYs Signature lel
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplaca ? 21 Porch (3-sea.)
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex X 18 Deck ? 23 Porch (screen/gazebo)
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_YOr_ N ? 25 Miscellaneous
Work Types
? 31 New
? 32 Addition
X_ 33 Alteration
? 34 Replacement
Valuation sOp ?
Census Code
SAC Units " 6 ^
Nbr. of Units ?
Nbr. of Bldgs f
Type of Const V • /V
_t-'Footings (new bldg)
` Footings (deck)
^ Footings (addiflon)
_ Foundation
_ Drain Tile
Roof Ice & Water Final
_ Framing
_ Fueplace _ R.I. _ Air Test _ Final
Insulation
Occupancy X. 3
Zoning
Stories
Sq. Ft.
Length
W idth _
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
REQUIRED INSPECTIONS
FinaUC.O.
? Final/No C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement) '
_ Retatning Wall
Approved By Fr--N , Building Inspector
Base Fee
Surcharge
Plan Review
MG/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
.?
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Oemolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)* ? 43 Reroaf ? 46 Windows/Doors
'Demolition (Entire Bldg) • Give PCA handout to applicant
4
84600 WOODGATE
HICKORY HILL
1625/ 10 84600 25001 (4-plex)
1627/ 26001
1629/ 27001
1631 28001
1633/ 10 84600 21001 (4-plex)
1635/ 220 01
1637/ 23001
1639 24001
1642/ 1084600 030 02 (4-plex)
1644/ 040 02
1646/ 01002
1648 020 02
1643/ 10 84600 17001 (4-plex)
1645/ 18001
1647/ 19001
1649 20001
1650/ 10 84600 05002 (4-plex)
1652/ 060 02
1654/ 070 02
1656 080 02
1657/ 10 84600 13001 (4-plex)
1659/ 14001
1661/ 15001
1663 16001
1658/ 10 84600 090 02 (4-plex)
1660/ 100 02
1662/ 110 02
1664 120 02
1665/ 10 84600 09001 (4-plex)
1667/ 10001
1669/ 11001
1671 12001
1666/ 10 84600 130 02 (1/2 of 4-plex/other 1/2 on Hickory Ln)
1668 140 02
(PAGE 1 OF 4)
1
?4? ;?ci4
Zoos RESIDENTIAL MECHANICAL rEiuvtiT nrrLicnTiorr
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes/condos when permits are required for each unit
?
36,
Date-4 // t)
Site Address I U0 qH I U? Unit #
Property Owner hTEPt??? r.I.l F ?Qt Telephone #(?5 'yz;?
r
Contractor HALEY COMFORT SYSTEMS,INC.
StreetAddress _ 122 4TH ST W _ Cyh, HASTINGS _
State _ MN Zip 55033 _ Telephone # 851.437.0338 _
---
Bond #:_ MN22041 -- -
Expires: -
---
9/3/2006
------ -- -
The Applicant is _ Owner ? Contractor _ Other
Add-on or atteration to existing dwelling unit $ 30.00
furnace _Additional _ Replacement ` New
air exchanger
X air conditioner
heat pump
other
State Surcharge .50
Total
I hereby apply for a Residential Mechanical Permi[ 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 with the Mechanical Codes; tha[ I understand this is not a
permit, but only an application for a permit, and work is not to start without a permiC at the w?rk wil! ' accordance with the
approved plan in the case of work which requires a review and apprcval of planp`.
Applicant's Printed TQame L-Ilrppl'c 's i atur ?
7'?vg-
2007 "SIDENTIAL BUILDINGPERMIT APPLICATION
City Of Eagan
3830 Pilot Kno6 Road, Eagau MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWc6on Reouirements
3 registered site surveys showirg sq. ft. of l04 sq. R of house; and all roofed areas
(20 % ma)dmum lot coverege allowed)
1 Soils Report if proposed buiiding is ia 6e placed on disturbed soil
2 copies ot plan showiig beam & window sizes; poured found desgn, etc.
i set of Energy Calcula6ons
3 copies of Tree Preservation Plan rf bt platted after 7l7793
Rim Joist Delail OPtions selectlon sheei (buildings wilh 3 or less units)
Minneaasco mechanical venLlation form
'q Z 7, 76 -
RemodellReoair ReamremeMS Office Use OnN
2copieso(planshowingloohngs,beams,joists Ceitai5urveyRecd _Y _ N
i set of Energy Calwlahons for heated additions SoilsReporl .„- -.
i site survey for additions & decks Tree Pres Plan RBCd =Y =?
Addi6on - indcafe ff on-siie sep6c system ??? Sep6c System -_Y" _ N
-? 1/3 / 0 r? Construction Cost 1,100o
Date
16,72 A ,
/ // UnibSte #
Site Address
'0 5 4, ?
tion of Work 0 r!-
scri
D 7-
p
e
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 2
? ? `?
Property Owner V?-i 0[91?G 7_-`c
140A
? Telephone # ( )
C Z_ Pm r l /-?
C
Contractor
s /??n4 ?hF/TC
Add /?
/Gc?cl< p
l?? City lJtJkNSU/LL?
res
' Zip 235 3 Telephone #(IS?) SL1 - Vd 15
State /
l h?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7672
- Minnesota Rules 7670 Cate-orV 1 , New Ener Code Worksheet
Energy Code Category . Residential Ventilation Catego7l Worksheet 9Y
(d submission type) Submitled Submitted
• Energy Envelope Calcula6ons Submilted
In ihe last 12 months, has ihe City of Eagan issued a permiT for a similar plan based on a master plan?
Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone #(
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 Ciry of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a pennit, and work is not to start without a
perniit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
c1it1eL L Q- ?CS•7'?e?n?J
Applicant's Printed Name 4Apli,canfs ig tuurree
DO NOT WRITE BELOW THIS LINE
Sub TVpes
? Ot 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. Ait - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea ) ? 33 Ext. Ak - SF
? 04 02-plex ? 70 08-plex ? 18 Deck ? 23 Porch (screeNgaze6o/pergola) ? 36 Multi Misc.
? OS 03-piex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plez ? 25 Miscellaneous
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 AlteraUon ? 37 Demolish Building' ? 43 Reroof ? 46 Wndows/Doors
? 34 Replacement `Demolition (En[ire Bldg) • Give PCA handout to applicant
DCSCfiptl011: WaterDamage_ Yes
Valuation Occupancy MCES System
Plan Review 100% or 25%
`
Census Code Zoning Gity Water
SAC Unlts Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIItED INSPECTIONS
_ Footings (new bldg) _ Sheetrock
_ Footings (deck) _ Final/C.O.
_ Footings (addition) _ Final/No C.O.
Foundation HVAC
Drain Tile Other
Roof Ice & Water Final Pool F[gs Air/G as Tests Final
_ Framing _ Siding _ S[ucco La[h _ Stone Lath _Brick
Air Test _ Final _
Fireplace
A.I. Windows
_
_
_
Insulation Rehaining Wall
AQproved By:
Base Fee
Surcharge
Plan Review
MCiES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building lnspectar
City of Eagan
Cash Receipt
Receipt Date 8/16/2008
Receipt Number 192888
1675 HICKORY HILL DR
DAYCARE INSPECTION
1221.9216 50.00
DAYCARE INSPECTION
Total Receipt Amount 50.00
121197 7:19:19
1
r For Office Use
•fs :::t:,
I -ceive Date Received: ,��
3830 PILOT KNOB ROAD EAGAN, MN 55122-1810 d►
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)6 6gq� Staff:
buildinginspectionsta�citvofeagan.com M11R 1 7 2019
2019 RESIDENTIAL V. _ • MIT APPLICATION
J /e77Y/e79
7
Date: l / . 4 7 Site Address: /‘73 Ft( ci r M/ I/
Wood ci lb 'le Assoc' vol 657 — V51-7 �'
Name. 9 e 0�� of Phone. 3 Y
Resident/ /6 71 iv`C ACU/` `11 /9 r Ea9 c .57.5-
OWR®r Address/City/Zip:
Applicant is: Owner X Contractor
Type of Work
Description of work: ' `� ""Q( I j2ar o 1 `I— 0.ry d I*/, /ac(J
Construction Cost: /ao Multi-Family Building: (Yes X /No )
Company: dI"h►Rnn i r0ens [CniraJ'np
Contact: Sfkrre AG rviq,til
Address: / 7 5-73 f'X 6i?ro C City: �al✓`'i hIrti5
Contractor l _
State: N Zip: 550d-LILI Phone: �b�� S9 9_ Email:
License#: A 17 00 b 1 Lead Certificate#:
If the project is exempt from lead certification, please explain why:
/\10 fiGt ct ; v-NuO P•ply
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. Portions of the information may be
classified as non filc`ifyou provide specificreasons 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.aoaherstateonecall.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 ans.
x 51-tired UQr1110141
Applicant's Printed Name Applicant's Signat re Z�