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1625 Hickory Lanevut v eaaax SEWER SERVICE PERMIT 3795 rawt,;Znob Rood PERMIT NO.: 27n4 Eagan, MN 6:.'22 DATE: 4/26/74 Zoning: Pt1D No. of UnSte: Owner: Woodaate, N ew florizon Homes Address: Site Addrese: 1625-27-29-31 Hickory Lane Plum6er: Thompson Plumbin4 Co. I aqrse fe eemply wkh eM Village oF Eeqan Connection Ordinanws. By: Date of Inap.: Insp.: - Account Deposit: 1- Permit Fee: 10.00 pd Surchazge: .50 Pd Misc. Chazgee: Total: Date Paid: ? ... LJ. ?n. VILLAGE OF EAGpN WATER SERVICE PERMIT 3795 Pilot Knob Road 1449 PF:R:NI7' NO . __ Eagan. MN 55122 4 26 74 --? -?- - / DATF.: ? Lnninq PUD -- -- - - - --- ?-- -- - - - - - Nu. ot' Units? ---- Uwncr? _ Woodgate, New- Hori - zon Homes ? - -- - A[ ( YCSs - - - - ------__- ? -- - - -- - sue addrv„ 62 -27- 29-31 Hicko?r I.ane - - -- 19uu1b?.r yson -- ---------- ---- Pltsnbinq_ Co.- - - --- M,?ner No ---------- --?- --?- Cannec?tion Char ?o K?+`T ?'??: -- Accnunt Urpisit? He.ider Nu - - Pennit Fee -- - -lO.Ob pd - -- ? - 1 ogree to comply with the Villoge o/ Eogon SurvhxrKr __ __ • 50 Pd __' ? Ordinonces. y Misi ChdrKen'2 !t-.0 '? ?? ? • ..__ U ---?- I)'ncol l:iap _ dn?a?V atr Paid _ ? /C.3: - ??? ?a b? o ? - ? G•st 8y ? ? ? ? ?io F n ';lL ? J , I ldooaqa.Te Isfi CITY of EAGAN 33 u N°- 3401 BUILDING PERMIT 3795 Pilo! Kaob Road Owasx "?'- ..:........ ........ .... ........ ......... ............. . .... .... .... ..... ? . ?n ' ......... Eagaa Miuaesota 55322 01 d-- v ) l:'•-•-•...e?C'r.-?7.J .S'?'-?'-? Address (Praseni) --1 ...............?........ O . ......r.............. . ? 454•8100 .:..:. .. auilae: .. ................'?4.. ................... :. Address ..... DESCAIPTION a.:. .... g.- ............. Storiecl To Be Used Fos Fron! Daplh Ha h! Esl. Cost orml! Fea Remaska ?-? ???" I LOCATIOH 'Al-% Y 05 ° ? ........................ -....- G'.Y--'...?...._....... -.... Po, ................... ....O .................... ....... .-.................... Ma or Huildlnp Impeefos p This permii does noi aufharisa the use of siree2c, roads, alleps or sidewalks nor doas St pi?e !he ownes or L4 syeut the xighi to create any sifuation which is a nuisanca os which prosents a hasazd !o the heallh, sa[elp, eonvenbnee sad qeaeral welfare to anyone in !he communiip. THIS PEAMIT MUST BE KEPT ON THE PAEMISE WHILE THE WORK 23 IN PROGRESS. This is So ceriify, fhat.?titt..?!'_.. i:.. ...??! .has parmisafoa !o axoe! a....!z<<' .?. ....c? ...................... _qpee ihe above described premise subject t6 ihe pxovisions of all applicahle Ordinances for !he Cilp of Eagan HOUSE HEATING TEST RECORD D21066 ) J5/?? -0 2!_ ADDRESS 1625 Hickory Lane ApT. - FLOOR CITY SUBURB Eagan OCCUPANT Roaer P, B&Elieri OWNER Ye9 HEAT LOSS- SOLD BY DATE HTG. INST. GAS C0. METER BADGE ed ick Ht INSTALLED BY ? g• n n Elechical Work By _ TYPE OF HEAT GA Gaa Line 6y FA X HW -STEAM SPACE HTR. -UNIT HTR. -OTHER CaAS DESIGN MAKE Williamnnn MAKE OF BURNER Model 1717.-07 F Model CONVERSION Serial 7421176 Mo:. BTU Rating- INPUT 7.r;,nnn R+.in 'Air, MAKE OF FURNACE CONTROLS THERMOSTAT Cm 280 Heat Plug Volve M,H? VROOn Limir Robshaw RFL 750n Limit Sstting 200of Fan Setrinq 90of & 120of Pilot Type Conple Pilot Maks Pilot Model Model Venf Size 4° KIND OF LINER Alum. SIZE s" NONE Draft Haod Vertical Regularor Filters Size ls° X 25" Number 1 Chimney Lowfion Inside yQA Outside Chimney Construcfion Metalbestoa $moke Bomb Wiring Pilot Timing Fil Rar.nnr3y Draft nx Tese Ta9- L.W. Cut Off Door Pressura Lighting Inst. Pressure 4.2"W.C, percentCOZ 7•0% Date Tested 10/23474 Input CFH 74 Porcenf 02?Company Tasting ? Staek Temp. 550of percent CO 0_6 Iz Name oF Tester ? ? f Form 235 HOUSE HEATING TEST RECORD D-21066 le?? . • ?3a O Z ADDRE55 1627 Hirkn y Tana pp7,_FLOOR CITY SUBURB Fa$an , OCCUPANT Fx'ed J_ Selapack OWNER S'Pa HEAT LO55 DATE HTG. INST. GAS CO METER BADGE N SOLD BY Elechical Work By TYPE OF HEAT GA INSTALLED BY .SadoGgirtk Htg Gas Line By Ir ft FA X_HW STEAM _SPACE HTR. -UNIT HTR. OTHER GAS DESIGN MAKE William9oII MAKE OF BURNER_ Model 1117-07-5 Model Serial 7421175 Max. BTU Roting- INPUT 75,000 Bt AT. MAKE OF FURNACE CONTROLS THERMOSTAT CIS 260 Hear Piug ya[,,, M.A. V800c Limit Robehaw RPl, 7 On Limit Setting 200of Fan Setting 90of & 120of Pilor Type Couple Pilot Make Model CONVERSION Vent Size 4" KIND OF LINER Alu m. SIZE R" NONE Drak Hood UeT firAl Regulator Filters Size 18" X 2511 Numbar ? Chimney Location Insida YPA OuTSide Chimnay Construction Mef.a7be9tng Pilot Model Smoke Bomb Wiring Pilot Timing 56 +SQCORClB pra(t OK 7esT 7a9 Y06 L.W. Cut Off Door Pressure Lighting Inst. YQ¢ Pressure 4.$"W.C. pereentCO ?-° Dnte Tssfed 10f23/74 2 input CFH 74 Percent OZ-. R-?7% q_ Company Testing Stack Tamp. SOOof percene CO 0•0"N Name of Tester ?" Form 235 HOUSE HEATING TEST RECORD ADDRESS 1629 HickoY'v Lane APT.-FLOOR OCCUPANT xaren J. KI'uckmAn OWNER HEAT LOS$ SOLD BY Elecfrical Work By TYPE OF HEAT GA Model GAS DESIGN MAKE WilliaffieOn MAKE OF Model 1117-07-5 Model - se.iel 7421180 Max. BTU INPUT 752000 B'Eti MAKE OF CONTROLS THERMOSTATCm 260 Heat Plug y,lv, M.H. V800c Limit RobBhaw RFL 750t1 Limit Setting 200°f Fan Setting 90 f& 120 f Pilot Type C+Ollp].@ Pilot Make BURNER ? ?'?d --D 2 ? CITY SUBURB T''AgAn CON V E RSION Rating - FURNACE Vent Size 4e1 . KIND OF LINER A>»m. SIZE s„ NONE Drak Hood VQTt'iQal Regulator Filters Size 16„ x 25" Number 1 Chimney Location Inside Yea Outside Chimney ConsTrucfion Metalbestoe Pilot Modal Smoke Bomb Wiring - Pilot Timing 61 Seconds pra(t OK Test Tag_ L.W. Cut Off Door Pressure Lighting Inst. Pressure 4,4"W,C, percentC02 7.0%_ Date Tested 10I5t74 Input CFH 75 percent O2 Cumpany Teseing C? Staek Temp. 5SO F percenf CO o Name of Tesfer ? DATE HTG. INST. GAS C0. METER BADGE # INSTALLED BY SedgwiCk Htg_ Gas Line By it n _FA X HW STEAM-SPACEHTR.-UNITHTR._OTHER Form 235 ?7 HOUSE HEATING TEST RECORD ADDRESS 1631 HiCkOry LaCle APT.-FLOOR OCCUPANT F'x'ancie J. Peterson OWNER HEAT LO55- SOLD BY Elactrical Work By _ TYPE OF HEAT GA PA X HW STEAM SPACE HTR. - UNIT HTR, -OTHER GAS DESIGN MAKE Wllliam8ori MAKE OF BURNER CONVERSION Model 111 /--V 1 -0 Model $arial 7421177 Max. BTU Rating- INPUT 75,000 Btll $T. MAKE OF FURNACE CONTROLS THERMOSTAT Cm 260 Heat Plug Valve M-H- vBOOC Limit Rob8haw RFI, 750a Limit Setting 200 f Fan Settinq 900f & 120 f Pilot Type Couple Pilot Make Model 4" Vent Siza KIND OF LINER Alum• SIZE 6" NONE Drah Hood Vertieal Reguloror Filrors Size 18" g Q'S" Number 1 Chimney Location Inside Ye8 Outside Chimney Consiruefion Metalbeetoa Pilm Model Smoke Bomb Wiring Pilot Timing 80 SeCOIId6 D ft OK Test ' L.W. Cut Off ra . -a - Door Pressure Lighting Insf. Prossure 4,5"W2C, per<en1C02 7•ON Date Tested?125 ' 174 InputCFH 74 Pereent 0 R_% Company Testing Z Coponisvon n..?..?. Smok Temp. 510of Percant CO 0•00% Name of Testar ? DATE HTG. INST CITY SUBURB ?gan GAS C0. METER BADGE N INSTALLED BY SCdgwlCk }g (?aas Lins By n- 11 i Form 235 0I7f Or^ F.ACaN 3797 : ilot I'u.ob P.oad Eagan, I••tinne3ota 55122 PERY1ILT NO.: r?r The City of Eaoan hereby grants to G., gedyw4ck HS«•,_ r00 of yoci xami, A%re c.. n+.,i Q 55416 a HEAT2IIG Permit for: (0•„mer) New florizon - Woodgate and Smith-Berens 625 26-29-31 HICkory IWne and a 1473 Highview ? pursuant to application dated 7/10/74 Fee Pai.d; x3fSx8 100.0rtated this 31 day of July ? ?9 74 2.50 s/c Building Inspector 14echanical Permitsc Bid Total: ? CI'I'f ^v}+' i1^,rATT 10 9,9e e, Od 3311 oa 3795 piJ.ot I;r_ob Hr,ad Eo; "'_, Mi:::7e:>ota. 5j1.22 (.t>UGC??4f? F3r,"19:' !VT'J.: 35 Tne City of la,lgan hereby greirts to _ Cmmners Soft Water Co. ef 3801 California St. N.E. a w8ter Softener p-0-;,;it for: (Gwner)__^ Verse Webber a;_1627 Hickory Iane pllrsuant to application dated 5/11/76 _ Pee ?'ttid; $5•00 dated this lZ day of maY . 1g 76 - -?TC • ------ k?uilding In3peotor Nachanical_ Permats: Eici Total; I CITY OF EAGAN Remarks I Addition Woodgate lst Addition Lot 34 Rik 2 Parcel 10 84600 340 02 Owrter n"`? st,eet 1625 Hickory Lane scate Eagan, MN 55122 ? Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. pq STREET RESTOR. pAVING 1976 $410.12 $136.71 3 PAID GRADING PAVING Ab?p 1974 $115.45 $23.09 5 PAID SAN SEW TRUNK AW 1974 $93.54 $6.24 15 PAID _ * SEWERLATERAL 1975 15 WATERMAIN * WATERLATERAL 1975 15 * WATER AREA 1975 15 * STORM SEW TRK ? STORMSEW LAT a 1975 $1505.70 $100.38 15 PAID CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $130.00 11730 9-23-74 BUILDING PER. sAC $400.00 11730 9-23-74 CITY OF EAGAN Remarks Additio Woodctate lst Addition Lot 33 slk 2 Parcel 10 84600 330 OZ Owrfer'1'! E, i?,? ?l iaJfJ(J-? [ /-( Street 1627 Hickory Lane State Eactan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. 3?'j9 1976 $410.12 $136. 71 3 PAID GRADING PAVING 1974 $115.45 $23.09 S PAID SAN SEW TRUNK A%jj 1974 $93 . 54 $6. 24 15 PAID * SEWERLATERAL 1975 15 WATERMAIN * WATER LATERAL 1975 15 * WATER AREA 1975 15 * STORM SEW TRK * STORM SEW LAT 1975 $1505.70 $100.38 15 PAID CURB & GUTTER SIDEWALK STREET LIGHT WATERCONfV. $130.00 11730 9-23-74 BUILDING PER, sAC $400.00 11730 - - PARK CITY OF EAGAN Remarks addition Woodgate lst Addition Lot 36 Rik 2 pa{cet 10 84600 360 02 Street 1629 Hickory Ln. 5tate Eacran, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, o95TREETRESTOR.pAVING 1976 410.12 $136.71 3 PAID GRADING PAi7ING 1974 115.45 23.09 5 PAID SAN SEW TRUNK 1974 93.54 $6. 24 15 PAID * SEWERLATERAL 1975 15 WATERMAIN * WATERLATERAL 1975 15 * WATER AREA 1975 15 * STORM SEW TRK 1975 * STORMSEWLAT a 1975 $1505.70 $100.38 15 PAID CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $130.00 11730 9-23-74 SUILDING PER. SAC 400.00 11730 9-23-74 PARK CITY OF EAGAN Remarks Addition WOOd ate st Addition Lot 35 Rik 2 Parcel 10 84600 350 02 owmer sueet 1631 Hickory Ln. State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. ? STREET RESTOR. pAVING 1974 $115.45 $23.09 5 PAID GRADING PAVING 1-301 1976 $410.12 $136.71 3 PAID SAN SEW TRUNK a r 1974 $93 . 54 $6. 24 15 PAID ie SEWERLATERAL 1975 15 WATERMAIN * WATERLATERAL 1975 15 * WATER AREA 1975 15 +t STORM SEW TRK * STORMSEW LAT c? 1975 $1505.70 $100.38 15 PAID CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $130.00 11730 9-23-74 PER. sAC $400.00 30 9-23-74 PARK DRrr,E"y q -t L(Oaq r', qo i (6 q v ?'? ;n.? rq h?Px1?C u,Ms? vu ? °? s ? G ? Z ? In, (-}tc?Cc:P`? V1Nf 4 d carz(s ri v I C? ??l WALNOi L,4NE \,.JOO O e1C\-C. ??JIUO'1 RESIDEPITIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 NewCOnstructbn peaulremenb • 3 registered site surveys showing sq. tt. of bt, sq. fl. of house; and 1 rooted arees (20°k miuamum bt coverage albwed) . 2 copies of plan dwwhg beam & window sizes; poured found design, etc.) • 1 set of Enargy Celculethns • 3 coples of Tree Preservatbn Plen d bt plettetl after 717/93 • Rim Joist Oetail Optbna selecllon sheei (bldgs wNh 3 or less uniGS) DATE RemodeUHeoair ReauiremeMs . 2 coples of plan • 1 set of Energy Cakuletions for heatetl addabns • lsilesurveyforex[erloraddAions&decks • Iridicale X home served by septic syslem for addttbns VALUATION SITE ADDRESS <<°a ? ?n.lA'C-N? L/l/. MULTI-FAMILY BLDGxY _ N NPE OF WORK kil-I3U iL O E-l(57"1%UC L7EGK FIREPLACE(S) _ 0_ 1 _ 2 APPLICANT .5cor`( C427f=(L STREETADDRESS `n1`1 14A(221,4)pnJ 12D- CIN "GT?, STATE ?'!NZIP 25L2 TELEPHONE # R.'xi -I Ila-l CELL PHONE # y5? _ PkOPERTYOWNER MONI CA kqp_i5 MUFLLE(Z TELEPHONE# ---& ----------------------------- ----°-------°----- COMPLETE THIS SECTION FOR "NEW" Energy Coile Category _ MIIVNESOTA RULES 7670 CA' ? (J su6mission type) . Residential Venfilation Cater' ^ . Enargy Envelape Calcu? L/ Plumbing Contiactor: _ Plumbing system includes: Mechanlcal Conhactor: Mechanical system includes: Sewer/Water Conhacfor: ? -----°----° °-------------°---------- NTIAL BUILDINGS ONLY MINNESOTA RULES 7672 ?\ • New Energy Cotle Worksheet Submitted # v FAX # Water Si. : Sprinkler _ Water Hea,, ? ?b of R.I. Baths _ No. of Baths\ / ? Phone # _ Air Conditioning _ Heat Recovery System Fee: $90.00 --°---------------------------------------------------------°-----------------°------ -------------- -------- --- ----- I hereby acknowledge that I have read this application, state that the information i mply wlth all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature ofApplicaM ?e OFFICE USE ONLY Certificates of Survey Received ? Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY 0 01 Foundation ? 07 05-piex ? 13 16-plex ? 20 Pool ? 30 Accassory Bldg O 02 SF Dwelling O 08 06-plex O 16 Fireplace ? 21 Poroh (3-sea.) ? 31 Ext. All - Multi 0 03 01 of _ plex O 09 07-plex O 17 Garage ? 22 PorchlAddn. (4,sea.) ? 33 Ext. Alt - SF 0 04 02-plex ? 10 08-plex X 18 Deck 0 23 Poroh (screened) ? 36 Multi ? OS 03-plex O 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 08 04-plex O 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Mave Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair ? 33 Akeration d 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doore A 34 Replacement *Demolilfon (Entire Bldg only) - Give PCA handout to applicaM Valuatton Occupancy MGES 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 1/0 Width REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. ? Footings (deck) ??.y? ' " ?j?l ? FinaUNo C.O. _ Footings (additio j ? l _ Plumbing _ Foundahon HVAC i Drain Tile Other Roof _ Ice& Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing - Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final ? Windows (new/replacement) _ Insulation ? Retaining Wall Approved By ? z- , Building Inspector Base Fee Suroharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total /7jLNL6re'2 vL,-0 0 ?`a Ovo Y10- MECHANICAL (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete for: Single Family Dwellings Townhomes and Condos when permits aze required for each uriit $3 a -SZ) Date Site Address `? L„ • GUnit t! e Property Owner p Telephone #WSl ) y?? `?/ g Contractor tied1z9k StreetAddress y131 nl? J 4!-l f'le maAv? 1ckL3i City ?•cLO,n..vN State Kn, Zip Telephone# (IaSI') ST?f' 7SlO The Applicant is _ Owner ? Contractor _ Other Add-on, modificafiou or alteration to eaisdng dwelting unit $ 30.00 T fumace replacemeM air exchanger air conditioner other °,. :a Su.-cha: ge l i $ .50 Tota1 1 ?Y:3 ? P a ?'•*to APFi 0 I hereby apply for a Residentaal Mechanical Pernrit and acknowledge that ttte info?s- e e an accurate; that the work will be in conformance with the oxdinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a perxnit, 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 appioved plan in the case of work which requues a xeview and approval of plan!-. K'A e,i cs - ?l I Applicant's Printed Name Apptitm4 liature MECHANICAL (COMMERCIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete for: commerciaUindustrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date Site Address Unit 4 Tenant Name (if applicable) Previous Tenant Name Property Owuer Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) The Applicant is ? Owner _ Conhactor _ Other Work Type _ Newconstruction UndergroundTank _Install _Remove _ Interior Improvement Call for inspection during instailation/removal of tank Processed Piping Nature ofWork: Permit Fee $50.50 Mdnimum Fee (mcludes State Surcharge) Conh-actValue $ x 1% _ $ Per.citFee • If pernut fee is $1,000 or less, add $.50 => $ State Surcharge If permit fee is over $1,000, add $.50 per $1,000 Permit Fee $ To[al Fee 1 here6y apply for a Commercial Mechanical Pernut and acknowledge that [he infortnation is complete and accurate; that the work will be in conformance wrtL the ordinances and codes of the City of Eagan and with The Mechanical Codes; that I understand this is not a pernvt, but only an application for a pemut, and work is not to start without a pertnit; that the work will he in accordance with the approved plan in We case of work which requires a review and approval of plans. Applicant's Printed Name ApplicanPs Signature Approved BY: , Inspector Date: 7co9( 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Kuob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX 4 651-675-5694 New Construction Reauirements RemodeVRevairReowrements Office Use Oniv 3 registered si[e surveys showing sq ft. of lot, sq. ft. of house; and all mofed areas 2 copies of plan CeA of Survey Recd Y N (20°k maximum lot coverege allowed) 1 set of Eneqy Calculations for heated additions Tree Pres Plan Recd _Y _ N_ 2 copies of plan showing beam & window s¢es; poured found design, etc. 1 site survey for addNOns & decks Tree Pres Required _ Y _ N isetofEnefgyCalculations Addffion - irMkafellonsitesepNcsystem On-sNeSepticSystem _Y _N 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Optrons selection sheet (buildings w@h 3 or less units) Date -0_ Constructi an Cost Site Address n' (f ( t? UnitlSte it Description ot Work c"" ? CAVVJ Multi-Family Bld g ? Y _ N Fireplace(s) _ 0 _ 1 _ 2 PropeHy Owner ; ??Telephone # ( + ) ???? Contractor Address - ?//7;77 ? 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 Venttlation Category 1 Worksheet • New Energy Code Worksheet (4 submissiontype) SubmRted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. 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 City of Eagan and the State of MN 5tatutes; 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 p,lan in the case of work which re uires a review and approv ofplans. r`!? i] I ??pr7/ ? N I'JI ir ApplicanYs Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool O 30 Accessory Bldg ? 02 SF Dwelling ? DS 06-plex ? 18 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. AR- Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. All - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 38 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 Demolish Interior ? • 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair 0 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement •Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC lJnits Stories Booster Pump # of Units Sq. Ft. PRV # 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 Tesu Final _ Framing _ Siding _ Stucco _ Stone _ Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows _ Insulazion _ Retaining Wall Approved By: Base Fee Surcharge Plan Review MCfES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector NOU-28-2006 07:15 From: IC'oI? J O.? znofi RF.SII)ENTTAL BUILDING PF,RMIT APPLICATION City Qf Esgan 3830 Pilot Knnb Rnad, Eagan MN $5122 '1'etcp6one # 651475.5675 FAX # 651-675-5694 Hew Carwmictlon Reaulremenp '" • 3 regidered slle survepS showlny sQ 2 of lot s9 R of haise, nM 4 roofed nratu 2 aWee d0an ahaAi4 faotings, benrm, pots (2096maumumlotcovmapemawed) I m olfTerorCekude6msfmheeteoedemom xree`.ka 1 Sc?t e M Enefq?y CB?Onwirig tulatlons m 9- wirwWw sizes, pouran (ouM dedpn, ew. 'Addsita tlon "NrScefa ? 6sedads PVe spfsm ? 3 copre6 Df Tre9 PrBSenatlon pmn N lot piartad aflor 7t1FJ3 R1mJplitp9qll0ptlm 6B4etlon6h9pt (6u0ding6xHhJorlessunlR) Minntgasco mechanieal ventllauon fortn Datc Con51*uctfonCast Site Address z UCi75te # _ Descrippon of Work Multi-Pumily BWg _ Y_ IV Firepluce(x) _ 0 _ 1 _ 2 I PrnpertyOwaer??? ? ...,. 31 c Tdephonell(p?? ) ?'7???'S3 ! ? Coniractor Addreaa --ZQ 7DehhQ& R4- City? z1(AP[??% ?? _ P Sfate ? ' Zip : rp 411f Telephane # 04lj' ) C? COMPLETE TH1S AREJ? ONLY IF CON$TRUCTING A DIIENII BUILDING Energy Code Category - Minnesotn Rules 7670 Cateaorv 1 _ Minnesata Ru[es 7672 (J su4misaton tyPw) 'Resitlantlal VenWalion Category 1 Waksheal • NeW 6nergy CGds WpAcfhplt Submitta0 3u6m3ttad • Energy Envelopa Calculatlans Submlrted In iho last 12 monihs. has ihc Cify oi Eagan issucd a pormiT for a simflar plqn based on a master planZ _ Y _ N If yes, dnfA ond adciress of master p3an: Licensed Plumber MeChanical Canfractor Sawer/Water Contractor _. _ Telephone # ( Telephone #( ) 1 hereby apply for a Residential Building Permit nnd acknowledge that th0 information that the wotk will 6c in conformuncc with the orciinances and codes of the City o t Statutes; I understand this is not a pcrmit, bul only nn application for permit, and permit; that the work will be in accordanee with the approved plan ' e of w approval of pfans. ?c:'L To:651 675 5694 P.2/3 Telephone N ( is complctc and accurate; gan and the State of I+h?v k is not to start withauc a uch requires a review and L Applicant's Printed Name Applicaiit's'Signature 1,I010-28-2006 07:15 From: 16? ba.6 To:651 675 5694 P.3'3 zoos RESIDENTIAL PLUMBING peannir aPPLtcATioN CITY OF EpGAN 3830 PILOT KNOB ROAD, EAGAM MN 55722 551-675•5875 Please complete for modifications to existing resitlential dwellings. Dat e SlteStreetAddress ? `c-.? Unlt#__ Property Ownec-),,"L 4-4 ,?-IN n.71 ? Telephane Telephone # VL3) Addresa ' le22 /-?? ??r ;4-oe jV Cii Stata "'J, ziF The Applicant Is; _ Owner Gontrectar _Othor _ Septlc Systam _ New _ Refurb shed Su6mit 2 sets of plans and MPC IlCense IncVudes County 4ee S 100.00 Peras-buin $ 10.00 Alteratfons to existing dwelling $ 50.00 ; _ Add plumbing fixtures. This fee indudes installation af e water soflener anivw water heater at the same time t/ you are installing ( a watar soRener and/or watar heater, do not complete this section, move to the next section and check the appliance(s) you ere installing -SeptEC System Abandonment Water Tcurnaround (add $130_00 if a 5/8" meter is required) I J? -Other: Water SaHenar _ Water Heater $ 15.00 _ new _ replacement _ Lawn IrHgatlon _RPZ _PVg _new _repalr ,rebuild $ 30.00 State Surcharge $ .50 Total i nereoy appry ror a rzesufen2iai Pwmbfng Nermit antl ackrawledge that the information is comDlete and accurate; that thA work wiu be in conformance with the ordinances and codes of the City of Eagan and the plumbing Codes; that I understand this is not a pem+it, but only an applir,ation for a ped (wark is not to steR wiMout a permit and work will be in accordance Nn e approved pl2n in the event a plan Is req 1qb eviewed and approved. App icsnt's Printed Name /AOplicant's Signa ure ? L C" 5?5'Oq DEC-13-2006 15:10 From: s - jjubt*lee TM HOME SOLUTIONS I I To:651 675 5694 P.1?2 .jl'1bflFle Hpme .SQ1IIt.10i1S Phone: (651) 645-5040 Fax: (651) 64564495 700 Prior AvC. N 5t. Paul, MN 55104 www.JubileeHome.com To: -/- lFrom: L?-i'???C?. ??t.ct??? Cc: Re: (?-Si 2 ? ? k Fax: &5-P & 75.---5-L.471- k nate: /T% )cey Pagcs (including covcr): '?--- DEC-13-2006 15:10 From: ., • i V j fj T T 7W T'de FIaPge BCitln whicta attad,ss to 16re a watertaght sesl on 1 Pac.ta"r tub or sm For fleld 'siS18tIaYo?, P a tqG.yw: 1, G6eata b,pb fonge RewEOVe Adheslve tm ftwgo to tub flartge DlagmIdt 1. Lflea uP adhesNm wltle the bp m YCItlBI eXGe&S $99g fl811 !see fJlagrerid 2) &D I fla?h vft hotto?re oF ° S08116iBl the void bet+w XKR ft tub wlth eMar ?1'brl? IRRIlr?ppE @ayy?. SOIfd $W7f8C8 CAtlR? w7d Shwma... s an RBS the itangp, of tFre tLib to provide I sides of any uk adge, tolfow the direcWns and apply tite ahawn In 3 bottom aR the m of the tub Range, tlff !lO1LOft1 t dle tlange sats ttub flangu< an the tle flange dUCone cautfc_ ?- °---'°. ? 4 . Dragram q 17Fa?rr?m ? Ta:651 675 5694 P.2'2 ^.C7RP9RAM UP FiCE. 325 ConhMn$al SIvQ. Et4z1aa9d, C1klsrhem*71013-:i tti t 46!5f3aD$tlE9 Perca75i318-67b; ollF .M %WC 1.i1!!0- 2Q9-r" i WWW. jeiFu?Gow. ?tAIV?? Ap 9?ly 5 0ta'dd O€ s:.leaa' t[?IOcnrae caBtlk ,•"` ? ?? ??? ???? ?----------------- ?Foi CS*e t'Jsg r ? Q L ? j Permit #: ? Permit Fee: I ? ? Date Received: ? I Staff: I I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: /0' °2?Og Site Address: / Go2S? 02 ? ' ? ? ? 3 1 f?i?l<oz ? ?iLL Tenant: Suite #: RESIDENT/OWNER Name: W40L?. Gri-'T? /,0/4 Phone: Address / City / Zip: Applicant is: _ Owner -X- Contractor TYPE OF WORK Description of work: T-eA-401=i- +-2 f'P-a0F Construction Cost: ?:3, 00 d Multi-Family Building: (Yes _/ No CONTRACTOR Name: e`?' S?00 Fi a) C License #: 7cZ ? N Address: ? ???U I - ?1? !7 c kOG k P-L City: 8l)IZ /vS ?/ LCF State: Zip: Phone: &.2 - a I/ - 7 ? ?5- Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheel • New Energy Code Worksheet Category Submitted Submitted (4 submission type) • Energy Envelope Calculations Su6mitted 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 tre public informaflon. Portions'of the in/ormation may be classified as non-public i/ you provide specific reasons that would permit the City to conclude that the 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 ihe City of Eagan; that I understand this is not a permit, but only an applica[ion for a pertnit, and work is not to start withoul a permit that the work will be in accordance with the approved plan in ihe case of work which requires a review and approval of plans. XMIK4 9-To2l(-s7-eak-)/6 X ?44 ApplicanYs Printed Name Applic nYs Sfgn pre Page 1 of 3 ~r For Office Use I • Permit C~ . City of Ea Rd~ I Permit Fee: Z6_1 3830 Pilot Knob Road I _ I Eagan MN 55122 Date Received: G' Phone: 651 675-5675 Fax: (651) 675-5694 I Staff: I I I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: li - I-/~CIC/`-j Tenant: r" L' t=tea: yI i ✓ / Suite RESIDENT / OWNER Name: Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: / C i Construction Cost: Multi-Family Building: (Yes ) / No CONTRACTOR Name: License ~ Address: / / ✓ / /C )/f / 'T /f~ jC ✓~~J/ \ n City: ' k r,% t ' 1 L L State: /11 Zip: -D Phone: e,2 Contact Person: ~ C 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 the 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 f plan j i jL X ~j(-if' 1~ C ✓~..5C-11 (C'S % 44 A2 x Applicant's Printed Name Applicant's Signa re Page 1 of 3 Use BLUE or BLACK Ink r For Office Use non ; Permit #:`'7 O j City of Ea , i Permit Fee: 3830 Pilot Knob Road V l~jco I Date Received: I l an MN 55122 S Ea9 2 8 Phone: (651) 675-5675 I I Fax: (651) 675-5694 Staff: (~~Trd 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Unit M " Date: q-,29-,261t Site Address: % v 14 &,y L a Name: Phone: RESIDENT / ' OWNER Address / City / Zip: 16 3 `C Applicant is: Owner Contractor ~r2-d n~ ~r3Q,., I i s /vl A l~ TYPE OF WORK Description of work: l 5 j e , i i Construction Cost: Jnq_;~A?Ulti-Family Building: (Yes / No ) Company: ontact:.10vL LiL >7 CONTRACTOR Address: / Cr 0 4 Fes, -4-cx,-(4 Our- Ld City: Prn ©1JL,,,n;T' State: o A) Zip: ~Cj5e51 $ Phone: L; e ( L 95d - L41,7- 62-.3 3 i License Lead Certificate #:Le.t If the oje t is ex mp fro .lead certification, pl ase xplain why: (see Page fnr additional information) + a[ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.popherstateonecall.orp I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x JI0 kin E,naL h x Applicant's Printed me Appli nt's Signatur Page 1 of 3 NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) Multi Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of Plex _ Lower Level _ Pool Miscellaneous Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Alteration Fire Repair Windows Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Gk~v Occupancy MCES System Plan Review Code Edition SAC Units - (25%_ 100%-Z) Zoning- City Water - Census Code ~T Stories - Booster Pump # of Units Square Feet PRV # of Buildings - Length- Fire Sprinklers Type of Construction- Width j- REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC _ Gas Service Test Gas Line Air Test Drain Tile Other: Roof: Ice & Water -Final Pool: -Footings -Air/Gas Tests Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: _ Footings _ Backfill Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector Y) n 1 r" RESIDENTIAL FEES Qa /--,w- Base Fee :23 Surcharge Plan Review 4/7 MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 rJ6 11119 41' N 49. 40,5 /V' 9p 33, Nsg T ~ V ~ i4~~ bti~! ~ ~ City of EaQali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 RECEIVED APR 152016 r Use BLUE or BLACK Ink For Office Use I 7S7 0‘ Permit #: 1,6 Permit Fee: / gK - Date Received: Staff: 661 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 19(© Site Address: /49.25- HICk £ 4 fon Unit #: Res# Name: Phone: Address / City / Zip: Applicant is: Owner Contractor Type of w Description of work: �p,4 re g -vii 4- s4 Construction Cost: .2I 5-0°Multi-Family Building: (Yes / No ) gi C Ot Company: 6''(- i St./.4,‘ L CC Contact: /14, /' G✓ I lle,--- L %e_ 7,30"//%S Address: VOX) C// vApp.--5 City: /1- `r /s State: /Ai") Zip: 5-5qa7 Phone:6r} o2 V/ - 002f Email: License #: (3G --/Owe 72 Lead Certificate #: If the project is exempt from lead certification, please explain why: JD In the last 12 months, Yes No COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? If yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Fire Suppression Contractor: Phone: Phone: Phone: t Phone: TE Plans awe a upporting documerntstha ®' sub pit are on ' e ered to be publi infi tion i ortio Sof a informationinay be classified as non- ns that t+voul rmit the C CALL BEFORE YOU DIG. Call Gopher State One CaII 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.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. xii(444 4 tQd(C- Applicant's Printed Name x A. icant s Signature Page 1 of 3 /6 SUB TYPES Foundation Single Family 12 L7 (/1. DO NOT WRITE BELOW THIS LINE Fireplace Garage Multi Deck 01 of _ Plex Lower Level WORK TYPES New Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25% 100% Census Code # of Units # of Buildings Type of Construction 3 / Porch (3 -Season) Exterior Alteration (Single Family) Porch (4 -Season) y' Exterior Alteration (Multi) Porch (Screen/Gazebo/Pergola) Miscellaneous Pool Accessory Building Interior Improvement Move Building Fire Repair Repair L.✓3y 1 1 _4/3 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Roof: Ice & Water _Final Framing 30 Minutes 1 Hour Fireplace: Rough In Air Test Insulation Sheathing Sheetrock Fire Walls Braced Walls Shower Pan Reviewed By: Occupancy Code Edition Zoning Stories Square Feet Length Width Final Siding Reroof Windows Egress Window _ Demolish Building* _ Demolish Interior Demolish Foundation Water Damage *Demolition of entire building - give PCA handout to applicant X2c,- toic MCES System SAC Units City Water Booster Pump PRV Fire Suppression Required Meter Size: Final / C.O. Required Final / No C.O. Required HVAC _ Gas Service Test Gas Line Air Test Pool: _Footings Air/Gas Tests Final Drain Tile Siding: Stucco Lath Stone Lath _Brick Windows Retaining Wall: _ Footings Backfill Final Radon Control Fire Suppression: _Rough In Final Erosion Control Other: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Alco .1J -5i Page 2 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA174014 Date Issued:12/17/2021 Permit Category:ePermit Site Address: 1625 Hickory Lane Lot:034 Block: 002 Addition: Woodgate 1st PID:10-84600-02-340 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Jennifer L Myers 1625 Hickory Ln Eagan MN 55122--252 Bonfe's Plumbing & Heating 455 Hardman Ave South St. Paul MN 55075 (651) 228-7140 Applicant/Permitee: Signature Issued By: Signature