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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 • . ?" ? ? , ? - t , g. .; , ;: . - . . ' ? . ? ? : ..?.?._ t j. ? . a?A.ri ..??? . . . . . ? ' ?.i ` `. / • ?.? l . . ? Fi . ? ?' 4? ? ? l ..' " ( . ? " . I ^. . •' : ? 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 ' ? . . . , , • . ' ? ? 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 V ,. , . +nP.c;,-. ?. . , , , . . ? . , ?1 , ? „ , -. ,._ - -'-._'_- . . ...?, _ . . , . . . 1;' .. /3/7? . ? .. . .' , ., , j 6 4/ ? ?? ?? ? ::: ?• ' i - r; ? . '. %G?y?_ . . . . : . ?.3G8is? d ?? s ? t , s ?,? 7 _`'"?'°?7; ? . °??-Li?O? /tL ??? ??S?S-?O'do??'.'?,? " - ' , ?. F ? ? • . i . , , • ? . . ? ? ,??, ?? ? X: ? , , .,. , ?l" . ' ? , , ..?n..??w• '?$ L?•T? P ??'1', 1 AW ^t', ' r . ' . ' ?:ie : '?. TA]r...,?.p.?Y'.n • r Y .' . / i .? ' .' . ?C ? 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: ? ? , . ? ? ? •; . . . ?. ' ' . . . , .i -. ? ? . ? ' ? . . . . . . . . . . . .. ' . . .. • ?, ?• ? i , • . , : . ? . ? ? , . ?1.. , , . . ': ? ? . .' . . _ .? ? 1, -? . - . 1 . . .., ? • . . . . ? , ?' , ?., r . , . . .?6, f'- k F-o / 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�