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1633 Hickory Lane?- CITY OF EAGAN Remarks Additio Wood ate lst Addition Lot 30 Bik 2 Parcel 10 84600 300 02 16 ? Owner ,4 t . ` k Street 1633 Hickory Lane 5tate Eacian, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. q STREET RESTOR. GRADING SAN SEW TRUNK #41 1974 93. 54 6.24 15 PAID * SEWER LATERAL 1975 15 WATERMAIN * WATER LATERAL 1 ?5 15 ,r WATER AREA 15 * STORM SEW TRK 1975 * STORMSEWLAT 1975 $1505.70 $100.3$ 15 PAID CURB & GUTTEFi SIDEWALK STREET LIGHT WATER CONN. $130.00 11730 9-23-74 BUILDING PER. sAC 400.00 11730 9-23-74 PARK CITY OF EAGAN Remarks Addition Woodqate lst Addition Lot 29 B1k 2 Parcel 10 84600 290 02 Owner.?',?n ?'=- Street 1635 HiCkory Ln. State Ea an, MI3 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SUR F. STREET RESTOR.pAVING 1976 $410.12 $136.71 3 PAID GRADING PAVING A 1974 $115.45 $23.09 5 PAID SAN SEW TRUNK 1974 $93.54 $6.24 15 PAID * SEWERLATERAL 1975 15 WATERMAIN * WATER LATERAL 1975 15 * WATER AREA 1975 1S ,t STORM SEW TRK * STORMSEWLAT Asl 1975 $1505.70 $100.38 15 PAID CURB & GUTTER 510EWALK STREET LIGHT WATER CONN. $130.00 11730 - - BUILOING PER. sAC $400.00 11 30 9-23-74 PARK CITY OF EAGAN Remarks AdditionWO d ate lst dition Lot 31 sik 2 Parcel 10 84600 310 02 Owner °"`?Street 1639 Ni clrnry T..71'1P State Eaqan_' MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR.pAVING 1976 $410. 12 $136.71 3 PAID GRADIPVG PAVING 3 3 1974 115.4 3. PA SAN SEW TRUNK 41 1974 $93. 54 6. 24 1 PAID * SEINER LATERAL 1975 1 WATERMAIN * WATER LATERAL 1975 WATER AREA 1975 * STpRM SEW TRK * STORM SEW LAT 1 $1505.70 . 38 CURB & GUTTER SIDEWALK STREET LIGHT 1 WATER CONN. $130.00 11730 9-23-74 BUILDING PER. saC 11730 9-23-74 PARK CITY OF EAGAN Remarks a.ddirior, Woodcrate lst Addition Loc 32 aik 2 Parcel 10 84600 320 02 Owner. streec 1637 Hickory Ln. State Eagan, MN 55122 J?r?r ?,r"!. ?. 1[ ?T 1 T[!.Z"Yl GC. Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. ? STREET RESTOR.pAVING 1976 $410.12 $136.71 3 PAID GRADING PAVING 1974 $115.45 $23.09 5 PAID SAN SEW TRUNK Ay 1974 $93 . 54 $6 , 24 15 PAID * SEWERLATERAL 1975 15 WATERMAIN * WATERLATERAL 1975 15 * WATER AREA 1975 15 * STORM SEW TRK * STORMSEWLAT 1975 $1505.70 $100.38 15 PAID CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 130.00 11730 9-23-74 BUILDING PER. sac 11730 9-23-74 PARK _ --? cirr oF EAw?N 3795 PIlet Kno6 Rood Eagen, MN 55142 PHONEs 454-6100 BUILDING PERMIT Receipt ? . . , ;:'Ir::: i?I'?'.?.I:? - •- . ;: 17 .'? FFBRUrtR?' 2 _ 89 SJte /lddress t v D:j rltt.nvtcs 14hr ii_. Lot Block ? Sec/Sub. ''700I)Gj'%TT; ADD . Parcal ?t 10-9,1600-310--02 oc Name z A lE??_7 T11Li\Q!,.V Ty `Yi? 9 I?fESS .. . - .. ,-,... , ..?__ 454-5649 °C Ncme ur1;_1kj ip T- 94 & I?VY. 115) ?? Address 1- ri*„ I`r?? 7 ?!S a?,.,.,. `_ ? 7-'? 9 0 G Neme _ Addresa I I hereby otknowledge fhat I have reod this applitotion ond stote that the informafion is Correct ond agree fo wmply with all applicable Stote of Minnesota Stotutes and City of Eagon Ordirances. Erecf ? Alter ? Repoir Enlo?Qs O Move ? Demolish ? Grode fl Assessment - Wcter 8 Sew. Police Firo Enp. Planner Council Bfdg. Off. _ /?PC Fees Permit '" ? `" ?' • 5urchorge Plon check SAC Water Conn. Woter Meter Road Unit Totol '? 131.U ? Siflnoture of Pertniftee I A 8uilding Permit is Issued to: on tha expross tondiNon Ihnt all work sholl be done in accordonCe with ell oppliooble Stote of Minnesoto $tatutes ond City of Eo9on Ordinances. Occupancy -.' .? Zoning _ Ff re Zone V Type of Const. # Stories Le n gth_ Sq. Ft. Buildinq Official Psrmit No. Psrmit Holdar Misc. Permit No. Holder Plumbing ! H.V.A.C. , Well Watsr Disp. Sovrsr Electric 0 I Inspeccion Date insp. Other Faotinyt ' Foundation Framinp Rouqh PIb4. . 9•? Rouph HVA Inwlation Final Plbp, Final HVAC Final Water Describe Location: Y,rau ? ? i 4 ? 3l ? • s.w.. Pr. Diap. - CITY OF EAGAN ' 3830 Pilot Knob Rosd, P.O. Box 21-199, Eagen, MN 55121 N? 8$2 j PFIONE: 454-8100 BUILDING PERMIT Receipt Te be w"d ier F I RE DM fA (1, F; Est. Voiue ?'? ? • Date I'r ?? RUARX 17 19 84 1635 HICYORY LA:ar Site Address Erect ? ?-1 Occuponcy -? Lot 2 () Biock 2 SeclSub. WOOd GAi'E I\DF) - After ? Zoning t23 ParcelNo. 10-'r`1600-290'"02 Repair [1 FireZone Enlarfle p Type of Const. V oc Neme J?.:•1:?S O' M?.11RA Move 0 .# Stories Z Address 2 234 C LE-1F.K ST . ? pemolish p Length 'J/?? City `UR'1SV?LT,Fphone s9Q-020g Grade ? Depth Sq. Ft. oc o CU S'i OT `?; ; 001 DES IG`I Name Approvals Fees u? Address 550F' -'111'>> AVF'.? Sn Assessment Permit r- Clty rf biS - Phone 72 ?5? Cf Water & Sew. Surcharge ?_ " N Police Plan check a e ?W Ftre SAC ?,-? A?? Enp. Wuter Conn. ?W City Phone Planner Water Meter Councll Road Unit 1 hereby ackrawledge thot I have read this eppiication and stote thot gicig pff. 2 117/; ? the information is correct and agree to comply with oll applicubla r ? State of Minnesoto Stotutes end City of Eogon Ordinnnces. APC Totol Siflnoturo of Permittee /1 Bullding Pe?mit Is issued to: on tha exprcss condition thm all work sholl be done in ecpordance with a!I applicable Stote of Minnesoto Stotutes and City of Eayan Ordinances. Buildirq Official - Permit No. Permit Holdsr Misc. Permit No. Holder Plumbing H.V.A.C. w.u Wster Dup. S?wer Electric Inapeetion Date Insp. Other Footingt Foundation Fnmiep RouYh Plbp. - ? - Rouqh HVAC Inwlation Final Plb¢ Find HVAC Find Watsr Dasaibe Location: n YYell Sewsr ?? ? Pr. D'ap. . MPERMIT # MECHANICAL PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ounuF• daa_21nn ? Name m Address c City Phc ? Name c Address p City ' Phone. TYPE OF WORK Forced Air M BTU Boiler M BTU Unit Heater M BTU Air Cond. M BTU Vent. CFM Gas Piping Outlets # Other FEE: S/C: TOTAL: BLDG TYPE WORK DESCRIPTI ON . ? New Res. , Mult Add-on Comm. Repair - Other FEES HVAC 0-100 M BTU RES -$24 00 . . ADDITIONAL 50 M BTU - 6.00 (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PEkMIn - 1 50 EA . . COMM/IND FEE - 1% OF CONTRACT FEE APT BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLJES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & REMODELS MINIMUM COMMERCIAL FEE - 12.00 - 20.00 STATE SURCHARGE PER PERMIT - .50 R (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000) JI FOR: CITY OF EAGAN y!s-/?' ? x*tJ' Receipt ? 1. Date ._:i -a i 3. Job Address 4. Owner UMBING PERMIT Permit No. J ' ITY OF EAGAN ? -- Fee in numbered spaces S/C ' =- •J pe or Print Jegib/y Tot. Installation Cost ' _ Lot - ?_ Blk. .,?- Tract 5. Contractor, -i ' <. . ,i .: ' -r.t Phone ? 6. Address 1 7. City State Zip ' - 8. Building Type: Residential 0 Commercial ? Institutional ? 9. Work Description: New ? Add O Alter ? Repair Q 10. Describe I 11. No. Fixtures Water Closet No. Fixtures Cesspool /D rainfield Bath tubs Septic Tank Lavatory Softner 5hower Well ? Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : ? for Ro h Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 -? Receipt PLUMBING PERMIT Permit No. I CITY OF EAGAN Fee FiII in numbered spaces S/C Type or Prini legibly Tot. ?1. Date 2. Installation Cost ? 'I 3. Job Address ,k? i` s`+? / ?: • Lot '.( Blk. -y Tract 4. Owner 7 i' 5. Contractor Phone r, _ ;•? -?,T_ 6. Address c- _ 7. City State I ? Zip 8. Building Type: Residential ? Cammercial ? Institutional ? 9. Work Description: New ? Add ? I 10. Describe 11. Alter ? Repair ? _ , , •; No. Fixtures Water Closet No. Fixtures CesspoollDrainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 PLUMBING PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 CONTRACT PRICE Site Address 1 Jr `r._L,; ? i - , i Lot Block ?'- Sec ? Name a? ? Address c City Phone ., Name _ 3 Address p City _ ? COMM/IND FEE - 1% OF CONTRACT FEE TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAI FEE - $12.00 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES FOR: CITY OF EAGAN PERMIT # RECEIPT # '2' ? - DATE: /-9`- 9d BLDG. TYPE WORK QESCRIPTION Res. r New Mult. Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL Water Closet - $3.00 S Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater - $t 50 Whiripool - $3.00 Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIT) Softener - $5.00 Wefl - 510.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE: STATE S/C: GRAND TOTAL 30 - 3 \ VIILAGE OF EAGAN WATER SERYICE PERMIT __ __ .... 3795 Pilot Knob Rood f'ERMIT NO 144 . 3 Ea9an,MN 55132 UATE: 4/26. ?74 - l.onuiK PUn No. o! Unt[s: <)wr,er. ? woodqate, New Horizon Homes Addretis - ?- ---- -----??-?- -----?--?------? .erpson Site Addreu35-37-39 HickOty-I?dnC Plurnber P1Ulub1T1CJ CO. - ._- Me[er No Connecttou CharKe - -? Svr Account Depoait - 10. _ 00 pd Re.tdrr No Permu Fee' 50- pd- - 1 agree ro comvll' with ehe Village o4 Eogan Surcharqe _ - -- --?- -- , Ordinances Misc CharEv".=PIP6 '-?--G?--- --? ?/ ? Hv llatc P:ud. Uateuflnsp Insp.: v- ? J9.? - - - - -- -- -.? -- - e..-7.? o -4 y a .--? ? ' YIU.A6F?F EACAN WATER SERVICE PERMIT 3795 iilot Knob Rood PF.RMIT NO.: -1443 Eogon,MN 55124 Dp7E: ._ 4/26/74 "l.unmg: _. PUD Nu. ot' lhiils: - woodgate, New Ownrr: Horizon Homes _ Add«.s,: 4y-?/ -.??t- site Address:1633-?35-37-39 }licko Lane Plumber: 'rnompson Plumbin9 Co. Meter No.: ConnecUUn Charge: Size: - Account Deposit: 30.00 pd Reader No.: Pennit Fee: .50pd- I aqraa to eomply rkh fM Villogo _ ef Eagan SurLharKe: Ordinanea,. Misc. Charqes: Total: gy llate Paid: Date of lnsp.: lnsp.: YILUIOF OF EA011N SEWER SERVICE PERMIT 3795 P'!a! Kna:: Rood PERMIT NO.: 2203 Eayan, MN 35122 DATE: 9/26/74 Zaning: nnn No. of Unlte: OwneC WonAnara ? T IPw HOL120T1 HOmeS Address: Slte Addrees:..1.6a;-1S-'47- 39 Hickory Tane Plumbec: Thnmpaon P hinci Co. 1 eprn ro eomply wifh fhs, Villaye ol Eagan Connecttan Charge/' •+M? ?3L• Ordleoneas. Account Depoeit: Permit Fee: 10.00 pd Surchazge: • 50 pd By; Mfec. Chargee: Date of Insp.: Total: Inep.: Date Pald: CITY OF EAGAN 3830 Pilot Kno6 Road, P.O. ?7 Box 27•199, Eagan, MN 55121 jr ? 8827 ?r L PHONE : 454-8100 ?J DING BU PERMIT Receipt # t- Te M uwd }er r'IRE DAMAGE Est. Volue $5,200. pate FEBRUARY 17 lq 84 Site Address 1635 HICKORY LANE Erect ? Occupancy R 3 Lot 29 Biock Z Sec/Sub. WOODGATE A DI] _ Alter ? Zoning R3 ParcelNa. 10-$4600-290-02 Repoir ? Fire Zone N/A E l t V T f C n nrge ? ype o ons . ac Name SAMES O'MEARA Move ? # Stories Z nddress 2254 CLARK ST Demolish p Length N A City BURNSVILLEphone 890-(19(18 Grade ? Depth Sq Ft.- , CUSTOM WOOD DESIGN AVProrals Fees o Name ?? qddress SSpR - 4RRT1 AVF cn r Citv MPT.G- Phone 722-0594 Name _ Address CitV - Phone I hereby acknowledga that I hove read rhis opplicorion ond stare that the informotion is correct ond ogree to comply with oll opplicoble Stote of Minnewta $tatutes and City of Eagon Ordinances. Assessment Water & Sew. Police Fire Eng. Plonner Council BIdg.Off. 2 17 $e APC Permit ?)o • j? Surchorge 3.00 Plan check SAC Woter Conn. Water Meter Road Unit TotaS? ?? Signature of Permittee I on tho ex ress tondition thm A 8uildin9 Pem+it Is issued fo: T? WOOD p oll work shall be done in c rdance wrt II icabla State o4 Minnesoto Statutes and City of Eogan Ordinances. Building Officiot ?? / CITY OF EAGAN Include 2 sets of plaris, ffa 1 Certificate of Survey & BUILDING PERMIT APPLICATION 1 set c£ energy calculations. i p!l Zb Be Used For? Vf,, Valuation Date ? Site Pddress ? S LX)_ GOGAi? Lot ? Block D 2 Sec./Sub.W <IDp. Parcel #: ld -SsL6 UD ?9a -az Oaner: o llme?--4ZN adaress: 7 ZS? l'CA2? ?C-?? City/Zip Code: Phone #: ?0??Oy --</4 ,) Contractor: fi?U(jo Qe Pcldress: Gj D?. jD City/Zip Code: ??l s Phone # : 7?' ? Arch./Eng.: Address : City/Zip Code: Phone #: OPFICE USE ONLY Erect Occupancy Alter Zoninq Repair X_ Fire Zone Enlarge _ Type of Const. Nbve # StAries Deimlish Front ft Grade Depth ft. APPROV11T.5 FEES Assessments Permit ,?(o -S 0 [9ater/Sewer Surcharge ? ,p C7 Police Plan Check Fire SAC Eng lanner Council Bldg. Off. -APC Water Conn. Water Meter Rc>ad Unit ?raL , % + J O CITY OF EAGAN Np g?91 3795 Pibf KnoE Roed Eegan, MN SSIZ! VHONFs 431-8100 L! ? BUILDING PERMIT Receipt # Te M wed for FIRE REPAIR Esr. Value $ 17,000. DOfe FEBRUARY 2 Iy 84 Site Address 1639 HICKORY LANE Erect ? OccuPOncy R3 Lot 31 el«k Z Sec/Sub.WOODGATE ADD. Alter ? Zoning R3 parcel # 10-84600-310-02 Repalr M Fire Zom N/A c Nome DENNIS PETERSON z Addm# 1639 HICKORY LANE ? c. EAGAN Pham 454-5649 o Nome DACO IN C. o? Address I-94 & HWY. 36 "? Cit ROGERS Dhone 497-3900 Name FW i? Address Enlarge ? Type of Const. V Move ? # Stories Demolish ? Length_ Grade p Depth Sq. Ft.- Approvals Foes Assessment - Woter & Sew. Police - Fire Eng. Vlonner _ Council _ 1 hereby ackrrowled9e that I have read rhis opplicotion ond stote that BId9. Off. fhe intormation is correct and ogree to comply with oll opplicable AP? _ State of Minnewta Statutes and Ciry of Eagan Ordinonces. Sipnature of Pertnittea Permit J 1LL.7U Surchorge $.5? Plan check SAC Water Conn. Woter Meter Rood Unit Total $ 131.00 A 8uilding Permit Is issued ro: DACO 1N?C ?. on the express tordition ihm all work sholl be done in a r a e ith oll ?`,p{?ywbJe Stote of Minnesota $fatutes and City of Eagen Ordinances. 9u71dfn9 Of/icial v ? e CITY OF EAGAN BUILDING PERNQT APPLICATION 7b Be Used For Fivo ? mv/" Valuation / 7rQOd} °?"" site Pddress: 163 HWc at'/ Lq Lot -Y f Block ? Sec./Sub.F4?1??q,i?-_?td?l._Erect P?i #: ?b -9?{6 D o- 3/0 - o z- ?? Repair ? Owner: e.IRPt s0v1. ??e - Move Ptldress: .? 14ac'qo rt+y L Ct, Danolish _ r Grade City/Zip Code: WN P- '7 9?/ Include 2 sets of plans, 1 site plan w/elevations & 1 set of_ erx>_rTI cal.culations. Date '' ?V-aCf OFFICE USE ONLY Occupancy ,3 2oning 3 Fire Zone Zype of Const. # Stories Fmnt ft. Depth ft. Phone #: 6v 3 APPROVALS FEES Contractc Address: City/Zip Phone #: Arch. /EIZy. . Address: City/Zip Code: Assesss[ients Water/Sewer ?olice ? ire Eng. Planner Council Bldg. Off. APC Pattnit Surcharge $ ? Plan Check SAC Water Conn. Water Meter Road Unit Phone #: TCT%L 1 Tb llJoodc?a.Te Isfi -? CITY of EAGAN 36 BUILDING PERMIT Owne: ...`..'..... .:.` 8'.....?...??.`.?.?...._/......, Address fpresenll .......7:1u:-?-.-Y.r-Lr-•-•?+?? Builder _ ...........? Addraa ._ . .._._ ........................................................................ DESCRIPTION .. LIX N2 3401 3795 Pilo! Kaob Road Eagaa, Minaesola 55124 454-8300 Dele .... g..- : 7?L Siorieai To Se Uasd For I Fsoni Deplh H h s ! Eel. Coit ormi! Foe Remarb // ?ti.--•,_ /a-..?..4.,t."F? - ? - - -- ?/? 3s s, LOCATION oZ / 3 9 ^5 ° ?......... ?------ ---- ............... Per !.................................. ?"`vLi a? v? ............. . ........................... Mayor /3 Buildiap Impoctos .a This pexmii does noi auihorize the uce of sixeels, zoadc, alleps or sidewalks nor doas It ghe the owms or Lb ey*ef the right to areate any situaiion which is a nuisance or which presenls a hasard fo the heelffi, safelp, eoavealenee and genaral walfare to anyone in the communify. THIS PERMIT MUST SE KEP`TI ON THE PREMISE WHILE THE WORK IS IX PAOGRE`1SS. ' This ia !o aerSify, thal._...has parmisaion !o erecf a....?z.---....? ....................... upoa the above described premise subjeai ' ? ?ihe provisions of all applieable Ordinanaes for the Ciip of Eagan. 3/- a Z,6,) 6 z CITY OF EAGAN 3795 Pilot Rnob Road Eagan, Minnesota 55122 PERMIT'NO.: 561 The City of Eaga.n hereby grants to Geo• Sedgwick Heating 6 A/C a; 1001 tenia Ave. So., Mpls. 55416 a HEATING Permit.for: (Gwr.er) T1ew Hozizon Homea - Woodgate at1633-35-37?„39? 8lckory ?iDursuant to application dated 7/29/74 Fee Puid: 560,9Q... 2.00 s/c dated this fl..? day of nyquat , 197a • Buildin; Inspector Mac._a::ical Permits: L'?d TDtal: i HOUSE HEATING TEST RECORD D-21274 ADDRE55 a_ 1633 Hickory La, Eagan Frank L Blankkle APT. FeooR ci7Y SueuRa OCCU'PANT y ? OWNER HEAT LO55 DATE HTG. INST. Z})($'C0. METER SOLD BY INSTALLED BY Electrical Work By - TYPE OF HEAT GA Gas Line 8y BADGE QdgSV1Ck H{,$''. ii 1 FA A HW _STEAM -SPACE HTR. _UNIT HTR. OTHER GAS DESIGN MAKE W7.11i8m90ri MAKEOF BURNER_ Model 1117-07-5 Model 5«iei 7421224 Ma:. BTU Ro+iny- INPUT 75,000 BtuAIr. MAKE OF FURNACE CONTROLS THERMOSTAT Cm 260 Heat Plu 9 Valve 800c H. V limit Robahaw RFL 750n Limit Setting 2000f Fan Setrin9 900f & 1200f Pilof Type Couple Pilor Make Model 4" Vent Size KIND OF LINER Alum, SIZE 8" NONE Drah Hood Verticel Regulamr Filters Size 1611 x2511 Numberl Chimney Location Inside YQ8 Outsida Chimney Construction Metalbe8t08 Pilot Model $moke Bomb Wiring Pilot Timing 85 Seconds DrafT OK Test Tag YQ9 e9 L.W. Cut Off Door Pressure Lighfing Inst. Prossure 4,61W.C. PereentCOZ 7.0% Dote Te:tsd 10j29J74 Input CFH 74-Percent 02 8.7% Company Testing ?!O b 6't10C1 5 0fil'tL @8 Stack Temp. `5`50 ? pereent CO 0' -O-OV Name of Tester Form 235 CONVERSION ADDRESS 1635 Hic oCCUeaN t ? None HOUSE HEATING TEST RECORD D-21274???y,? Lane APT. _N.FLOQR CITY SUBURBEaban H HEA7 LO55 DATE HTG. INST. SOLD BY Eleetrieal Work By TYPE OF HEAT GA _ FA X HW OWNER ew or12olla 3A5 CO, METER BADGE ?y1C g, INSTALLED 6Y Gas Line By STEAM SPACE HTR. UNIT HTR. _OTHER GAS DESIGN MAKE WilliamsoA MAKE OF BURNER_ Model 1117-07-5 Model Sariol 7421226 Max. BTU RoTing- INPUT 75,000 Btu r, MAKE OF FURNACE Modsl CONTROLS THERMOSTAT e'm 260 Heat Plu g Vent Size `?91 VO1Ve ? M.H, V800C KIND OF LINER AlLim, SIZE 6„ NONE Limit Robahaw RPL 750t7 praft Hood VCTt7.CR1 Regularor Limit Sstting 200Of Filters Siza 16" R 25n Numberl Fon Setting 90 f& 120°f Chimney Location Inside Ye9 Outside Pilot Type Pilot Make . Pilot Model Chimney Construction Metalbestoa Smoke Bomb Pilot Timing 51 Seconde praft L.W. Cui Of4 Door Presaure 4• 3"W.'• percen} CO2 7.0% Date Tesfed - Input CFH 75 Perceni OZ $' 7 Company Testing Stock Temp. 5400f PercenT CO ?•?? Name oF Tester _ CONVERSION Wirin9 _ Test Tag @B Lightiny InsT. Form 235 REQUEST FOR ELECTRICAL INSPECTION k'M Ee-ouooi_a ' See insituctnons for completing this form on back of yellow copy. : ? X" Be/ow Work Covered by This Request r y? ex EquiumeN Wired ectric al I,OmAUIC InSpECLlol7 h8C lfB/0W _ ,rtJ II Fee ServweEniranceSiza q Fee Feeders/SUbfaeders Pbe_, Circuits 0 to 200 Am s? 0 to 30 Am s 0 to 30 Am s Above 200 qmps 31 to 100 Amps t 37 to 700 Am Swimnun Pool Above 100-Amps Abave 100_Am s Transiormers Irrigation Boorcis i Partial- Other fee ?L I Signs ? I ISpecial Inspection ?5 RerrNrks .2,3TOTA EE? . - , . !, i i. ma eiar.'tcai Inspectoq heraby -- Y cartify thet the above Final inspectmn has baen TI6IepuB81 v0id Thps requast void L-`. ou ??• Q Q 18 rtwnths from ? A 19 4 n 1L3 j e't f? o ooL e k 44ol . q'd W Rnquest Oate Fim No. Roueh-in , per,bon ? L? ^ Required? Ready NuwkW? Noufy.InsDec- p<-- P- WYes ?NO I?>rllWhen Reatly ? L.censed Electncal Cuntrac[or I hereby reuuest inspection oi ebova ? Dwner electncal work installad aY Street Addross, Boa or Houte No. btv 3 ?a rY•r? ecuon o. Townshi0 Name or Nn. Range No. Counl OccupaM (PqINT) Phone No. ?f97- 3 ? t_ts, Power SupDlier Address Ele,ctnc?ontractor IComDanv N&me) ? Contrato License%. Mailing Jres ICon[ar Oe InstailatioN Col 17 ga r ??i?tr{ .-1 Au nze Signa re IContra or wner Making Instalintion) Phone Nwnber , z MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION HEQUEST WILL NOT Griggs-Midwey Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOABD 55104 UNLE55 PNOPEN INSPECTION FEE IS 1821 University Ave., St. Paul. MN ENCLOSED. Phone I6121 297-2111 Thisrequestvoid 1/qO'1 18 mon[hs from ?? A 1 1r,1 7Ll q R a, W o 4 A4,..& GZ ?e( . 2 0, cra Reques4?iate ?A ? fire No. RouPh-?n InspecUOn Requmedt pec- OReady NuW?ll Nouly In Tb Wh R ? .a ?NO r Y Qn ead '9,Licenssd Elecfcal ConVactot I heraby request mspection of ebova ? Owner-, elachical work inslallad ar Sveet Address, 9on or R u[e No ? Ciri ecLOn o. Township Name or No. Nanpe No. Count OccuOant IPflINT Phone No. Power uppl er Atldress Electncal Contractor ICOmp?ny Name) ? ?L • L C??nhactor's License No. - Mading Address (COnvactor or O„er Making Instailatwn) i'1 ? ? La N " Aut rized Sign w.(Co t ctodOwner king Installation) Phone Numbor MINNESOTq STATE BOAND OF ELECT0.ICITY _ V THIS INSPECTION NEaUEST WILL NOT C/iees•Midway eldB. - Room N•181 9E ACCEPTED BY THE STATE BOARD 1827 UniversitY Ava., St. Paul, MN 55104 UNLESS PHOPER INSPECTION FEE IS Phnnw 16121297-2111 ENCLOSEn. `' 0'L'? REQUEST FOR ELECTRICAL INSPECTION r. °,L ?? ' See insiructions tor complefin9 this form on back oi yellow copy. ?(?t ? ! ?1 2 "X" Below Work Covered by 7his Request HewlAdtll Reo!I Tvna of Builtlim I Aooliancas Wirotl 1 En.ipmant Wired I ec[nc He.iti Air on q Fae Service EntrencBSize p Fee Fexders/5ubfeaders b Fex Cucu,ts ? to 200 qm s 0 to 30 Am s 0 m 30 Am s Above 200 qmpy 31 to 100 Amps 31 to 100 Am • Swimming Poal Above 100_Am s Above 100_Am s Transiormers Irrigation Booms 0 Partial-'Other e Signs SUeciallnspection $ TAL PEE the Elactrical spector, he,eby Jtrty that the above spection has bee. 70,74? 2007 RESIDENTIAL BUILDING rERmiT ArPLICnTioN City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone 9 651-675-5675 FAX # 651-675-5694 NewCansWCfion Reauirements 3 registered site surveys showing sq ft. of lot, sq fL of house; and all roofed areas (20%maximum lot coverage albwed) 1 Soils Report d proposed building is fo be placed on distuNed soil 2 copies of plan showing beam & window sizes; poured found desi9n, etc. 1 set of Ener9y Calculafions 3 copies of Tree Preserva6on Plan A Iot platted after 711193 Rim Joist Detail Opdons selecfion sheet (buildings with 3 or less uni[s) Minneoasco mechanical ventilaGon form ?2'5y 7s RemodeVReoair Reauirements 0f6ce Use OnN 2 copies of plan showing loohngs, beams, joists CeA uf Suive( Ftecd 'I' `Y "_ N isetdEnergyCalalatiansforheatedaddiEons SoilsRepM_ -__ 7 site survey for addi6ons & decks Tiee Pas Plan Recd' qddihon. indreatei(arsitesep6csysfem Tree"Pre's'Requi[ed ? r,' '_Y,`_N On-sile Sepfic System', -, _ _Y._ N "- /3?0?7 ? / Construction Cost /5'DDD / Date - Site Address 16,33 UniUSte # ? Description of Work 1 `c61e Orr ?y?? Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 2 Property Owner V3OOt?G 1£ 14 0-4 Telephone #( ) ?4 z- r < r ? ? 1 Contractor /C/I/0/ fN/?/'TC dd /? OCC3 E City /JtJQ;JSU/L?-? ress A ' Zip 53 Telephone #(!S?) g q/ YD 1IS State / ? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7672 Minneso[a Rules 7670 Cate2orv 1 - , New Energy Code Worksheet Energy Code Category . Residenlial Ventilation Category 1 Worksheet (V submission type) Submitted Submiried • Energy Envelope Calculations Submitted In ihe lasi 12 monihs, 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 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 staR 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. Applicant's Printed Name A plica= i ?ture DO NOT WRITE BELOW THIS LINE Sub Tvues ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi ? 03 01 of _ plex ? 09 07-plex ? 17Garage ? 22 Porch/Addn. (4-sea.) ? 33 E#. Alt - SF ? 04 02-plex ? 70 OS-plex ? 78 Deck ? 23 Porch (screenlgaze6olpergola) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Tvpes ? 31 New ? 35 Int Improvemenl ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 WindowslDoors ? 34 ReplaCement 'Demolidon (Entire Bldg ) - Give PCA handaut to applicant D85CfiptiOft: WaterDamage _ Yes Valuation Occupancy MCES System Plan Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Canst Width REQUIRED INSPECTIONS _ Footings (new bldg) _ Sheetrock _ Footings(deck) _ FinaVC.O. _ Footings (addi[ion) _ Final/No C.O. Foundation HVAC Drain Tile Other Roof Ice & Wa[er F inal Pool Ftgs AidGas Tests Finai _ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick Fireplace R.I. Air Test Final _ Windows _ _ _ _ Insulation _ _ Retaining Wall Approved By: , Buiiding Inspedor Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total oD 2007 RESIDENTIAL PLUMBING PeRmiT APPUCarioN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date! /lp l? / Site Street Address ? Unit # ? ? Property OwnerD2 6`1C11/1?Y (/?Z Telephone # (??/) 1?9"Z?/oZ ? Contractor ??j?G1/?j/? /Telephone # (?SZ ) ?O -, 3 TT `? Address / ?Z?L' Lf??/!?c /?lC'?. Citv State ??/ Zip ? The Appiicant is: _ Owner ?Contractor _Other Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Fire Repair (replace burned out fixtures, etc.) - $ 90.00 Alterations to existing dwelling $ 50.00 _ Add plumbing fixtures. This fee includes installation of a water softener and/or wa{er heater at the same time. !f you are installing on/v a water softener and/or water heafer, do not complete this section; move fo the next section and check the appliance(s) you are installing. _Septic System Abandonment _ Water Turnaround (add $136.00 if a 5/8" meter is required) Other: Water Softener ? Water Heater $ 15.00 _ new _ replacement Lawn Irrigatian _RPZ _PVB _new _repair _rebuild $ 30.00 / State Surcharge c ? LP - $ .50 ? ? k j 1, 1 1 j 0 (Vuf Total $/6-.?p I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete antl accurate; tnac tne work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work wiil be in aqcordance with the approved plan in the event a plan is repu'yed to be reviewed And approved. Onnlir?n}'c Prin4oii Alomc ' An.1lin?ni'c Cl...+n-.. l 12940 " 4illk City of EapIl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ------------------ I FbrjQ??e?Use ? I I j Pertnit #: ? ? I '1 I 7D ? C I Permit Fee: C/ I I I I Date Recelved: ? I ? 1 Staff: ? I ? -----------------? 2008 RESIDENTIAL BUILDING PERMIT APPLICATION ;, N/ Gr< V2`i 1-( 1 ti Date:16'oZ4 "Dq SiteAddress: / &J-7 Tenant: Suite RESIDENTIOWNER Name: -rJ?tvt+a/K r-Eit.2/APL Phone:GS?/ Address/City/Zip: iif/L,eowY/Y/L?17A Applicant is_ Owner ? Contractor TYPE OF WORK Description of work: -TQcw u^ p ? Construction Cosl: ?q?g-??, Multi-Family Building: (Yes ! No _) CONTRACTOR Name: A E5?10 TIVC Licenseu: 2c(6.q 3 2 3 Address. ,?%p J14DICL6F( C state:/L1I I zip: .r;'S.3 ?i7 ZNSU(b R ,` ciry: uB Phone: ?' ) ;k_'7O7' _IS / Contact Person: AYU ?y 151C (NC PI COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateporv 1 Minnesota Rules 7672 EnOrgy COde . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet C8t@gOfy Submitted Su6mitted (V 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 supporling documents that you submit are considered.to•be putilic inform'afion..'Portiohs of ' the information may be classified as non-public it you provide specific reasons that would perniit. jiie'Cify to ' s: conclude that the are trade sedret I hereby acknowledge that this information is complete antl accurate; ihat ihe work will be in confortnance with the ordinances and codes of the Ciry of Eaqan; that I unders[and Ihis is not a permit, but only an application for a permit, and work is not lo start without a permit; that the work will be in acwrdance vnffi [he approved plan in [he case ot work which requires a rewew and approval of plans. ? X +'1/1fk6?4G ?4, ?jCGt-!?C X ApplicanYs Printed Name A canY S42r e Pa ge 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES ? Foundation ? Single Family ? 01 of _ Plex ? 02-Plex ? 03-Plex ? 04-Plex WORK TYPES ? New ? Addition ? Alteration ? Replacement DESCRIPTION: Valuation Plan Review (25 % _ 100 % Census Code _ # of Units # of Buildings Type of Const. ? 05-plex ? 16-plex ? Accessory Building ? Pool ? 06-plex ? Fireplace O Porch (3-season) ? Ext. Alt. - Multi ? 07-plex ? Garage ? Porch(4-season) ? Ext.Alt.-SF ? 08-plex ? Deck ? Porch (screen/gazebo/pergola) ? Multi Misc. ? 10-plex ? Lower Level ? Storm Damage El 12'PleX ? Miscellaneous ? Interior Improvement ? Siding ? Demolish Building' ? Move Building ? Reroof ? Demolish Interior ? Fire Repair ? Windows ? Demolish Foundation ? Egress Window ? Water Damage Demolition (entire building) - give PCA handout to applicant _ Occupancy MCES System _ Code Edition , SAC Units Zoning City Water _ Stories Booster Pump _ Square Feet PRV _ Length Fire Sprinklers Width REQUIRED INSPEGI'dONS _ Footings (new bldg) Footings (deck) " Footings (addition) Foundation Drein Tile Roof: Ice & Water Final Framing Fireplace:_R.I. _qir Test _Final Insulation Reviewed By: Sheetrock FinallC.O. FnallNaC.O. HVAC Other: Pool:_Footings _AidGasTests Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wali Building Inspector RES/DENTIAL FEES: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utilify Connection Charge S&W Permit & Surcharge Treatment Plant Copies Totai Page 2 of 3 12939 --------- ? ?or;,ONiee?llse --------- ? j Pertnit #: O? ? S I ? Permit Fee: I I ? Date Received: ? ? I ? I Staff: ? I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: lb "0?? ?Di Site Address: ( & Tl 5- H / G. /G0 /L `? f'7 ( LL ? Tenant: Suite #: RESIDENT / OWNER Name:`„7Afr R/ /}M (n4 ( G6(- Phone: ?sr-l- ?1 ??"7z 6!J Address / City / Zip: l(v 3fr//??f//LL FP-, 9F*&-f7k-1- MW 5-57z'Z - Applicant is: _ Owner _4n Contracror TYPE OF WORK Description of work: ? Q? a?K' rP?Sb Construction Cost: Multi-FamilY Buildin9: (Yes / No CONTRACTOR Name: ?? z&C License #: 2e21 / R3 R 3 Address: o21?60 J!CDiGL6FL ?Q7 ?/ (i (D City: !'7 U?/?/ ? U( InL C State: /YA I Zip: ?S .3 3 7 Phone: Contact Person: f'Ti17 p x STC (IVC P? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . Residential Venulation Category 7 Worksheet • New Energy Code Worksheet CBtegOPy Submittetl Submitted (4 Submisslon type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan 6ased on a master plan? _Yes _NO tl yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: _ Phone: NOTE: Plans and supporting documents thaf you submif are consldered to be public intormation: 'Portions'•bf the information may 6e classified as non-public if you provide specific reasons'that would permit {he'Eify to conclude thaf the are trade,secref"s: ?a -,i?='-? I hereby acknowledge thal ihis informalion is complete and acwrate; that the work will be in confortnance with the ordinances and codes oi the Gity ot Eagan; that I understand this is noi a permit, but only an application tor a permit, and work is not to stan without a permit; that ihe work will be in accordance with ihe approvetl plan in the case of work which requires a review and approval of plans. X M A P-, k Ar, a?4-.V, 0 X ??-- ApplicanYs Printed Name A canY Sign ure Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES ? Foundation ? Single Family ? 01 of_ Plex ? 02-Plex ? 03-Plex ? 04-Plex WORK TYPES ? New ? Addition ? Alteration ? Replacement Valuation Plan Review (25%_ 100% Census Code # of Units # of Buildings Type of Const. ? 05-plex ? 16-plex ? Accessory Building ? Pool ? 06-plex ? Fireplace ? Porch (3-season) ? Ext. Alt. - Multi ? 07-plex ? Garage ? Porch (4-season) ? Ext. Alt. - SF ? 08-plex ? Deck ? Porch (screeN9azebo/pergola) ? Multi Misc. O 10-plex ? Lower Level ? Storm Damage ? 12-plex ? Miscellaneous ? Interior Improvement ? Siding ? Demolish Building' ? Move Butlding ? Reroof ? Demolish Interior ? Fire Repair ? Windows ? Demolish Foundation ? Egress Window ? Water Damage ' Demolition (entire building) - give PCA handout to applicaM _ Occupancy MCES System _ Code Edition SAC Units Zoning City Water _ Stories Booster Pump _ Square Feet PRV _ Length Fire Sprinklers Width REQUIRED INSPECTIONS Footings (new bldg) Footings (deck) " Footings (addition) , Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace:_R.I. _Air Test _Final Insulation Reviewed By: Sheetrock, Final/C.O. FinaUNo.C.O.' HVAC Other: Pool:_Footings _Air/GasTests Final Siding: _Stucco Lath _Stone Lath _Brick Windows Retaining Wali Building Inspector RESIDENTIAL FEES: Base Fee Surcharge Plan Review MClES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Totai Page 2 of 3 12938 City of Eap 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 -----,w-ol -----------; j Pertnit #: I ? C? ? ? PermitFee: /a C/? ?% ? I ? I ? Date Received: I ? i ? I Staff: ? I -________________? 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 16 SiteAddress: a Zi7 N(C?GcS/Lt" H/LL TIT- Tenant: Suite #: RESIDENT / OWNER Name: 4;;>, D `.? ??/c4 Pnone: ??- pVS' - vf40 ?- Address / City / Zip: /G ?7 fl / c.-t- D OZ- ?A6? 1 Appiicant is: Owner ? Contractor 6 ? ? TYPE OF WORK work: 9? fZBL1 C Descnpno Construction Cost+? I.oo Multi-Family Building: (Yes -)?,-/ No CONTRACTOR Name:A Q? Z/UC License#:?j/n9333 Address: L C State: /LI ?1I Zip: US V L L R , City: U Z/ Phone: ?--707' /S / Contact Person: AYU ?.7 y iS TC 1Nt IZ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Energy Code . Residential Vemilation Category 7 Worksheet • New Energy Code Worksheet Cai090ry Submitted Submitted (q submission type) • Energy Envelope Calculations Submitted In the last 72 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 thaf yau submif are considered.totbe,public information.:'Portions=of • the information may 6e classified as non-public if you provide specific, reasons'fliaf would permihf6e`City to conclude that the are trade sebrefs. .; `'' I hereby acknowledge that ihis intormanon is complete and accurate; ihat the work will be in conformance with the ordinances and codes ot the Ciry ot Eagan; that I understand Ihis is not a permit, bul only an application for a permit, and work is not lo start without a permit; Ihal the work will be in accordance wrth the approved plan m the case of work which reqmres a rewew and approval of plans. xM A E? k .4 ? ?E a-o, C- x ? ?L4i---- Applicant's Printed Name A canY Sign ure Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES ? Foundation ? Single Family ? 01 of _ Plex ? 02-Plex ? 03-Plex ? 04-Plex WORK TYPES ? New ? Addition ? Alteration ? Replacement ? 05-plex ? 16-plex ? Accessory Building ? 06-plex ? Fireplace ? Porch (3-season) ? 07-plex ? Garage ? porch(4-season) ? 08-plEx ? Deck O Porch (screeNgazeho/pergola) ? 10-plex ? Lower Level ? Storm Damage ? 12-plex ? Miscellaneous ? Interior Improvement ? Move Building ? Fire Repair DESCRIPTION: Valuatian Plan Review (25°!0100% Census Code Type of Const. Occupancy # of Units # of Buildings Cade Edition Zoning Stories Square Feef Length Width REQUIRED INSPEGIJONS Footings (new bldg) Footings(deck) - " Footings (addition) , Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace:_R.I. _Air Test _Final Insulation Reviewed By: RESIDENTIAL FEES: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total ? Pool ? Ext. Alt. - Multi ? Ext. Alt. - SF O Multi Misc. ? Siding ? Demolish Building' ? Reroof ? Demolish Interior ? Windows ? Demolish Foundation ? Egress Window ? Water Damage " Demolition (entire building) - give PCA handout to applicant Sheetrock, Final/C.O. Final/No',C.O. HVAC MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Pool:_Footings Air/GasTests Final Siding:_Stucco Lath _Stone Lath _Brick Windows Retaining Wall Building Inspector Page 2 of 3 12937 `101? City of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675•5675 Fax: (651) 675-5694 ----------------; FF' ? SrpO[8c?e?iJse ? Q-7/ I j Permit #: i ? 0 ? i Permit Fee: ? I I ? Date Received: I ? I ? I Staff: ? I---------------- 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ? ?? ?k-M Site Address: / 6-3 f N fe_/402 `C (Lr lLL Vgw_? Tenant: Suite #: RESIDENT / OWNER Name: ?.T_h'wr GL 4:9 /r t *fit d"'?j Phone: lo Address / City 1 Zip: /b 5S H/c-KA2YNlLC- 124.f JA4 AJ?? Applicantis: _Owner _?,_ Contractor TYPE OF WORK Desceripn o7wor : ???C9 r-- kConstruction Cost: . OL, Multi-Family Building: (Yes / No ? CONTRACTOR Name: A T&C License #: 9 3 R? Address: oZ?ICaD S?CDICL.4L ?U7 ?/ 0 a City: State:IY -1I Zip: .> 5,337 Phone: L J;?_?70• !S / Contact Person: AYU 0 x STC I NC 12, COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Energy Code . Residential Ventdation Category 1 Worksheet • New Energy Code Worksheet Category Su6mitted Submitted (4 SubmiSSion type) • Energy Envelope Calculalions Submitted In the lasi 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. P.,ortions of the intormation may be classified as non-public if you provide specifia reasons that would permif?the'GifyRo ' s:_ conclude that the are trade secret I hereby acknowledge that this iMormatlon is complete and accurate; that the work will be in conformance with the ordinances and cotles ot the cny or Eagan; that I understand this is not a perrnit, but only an application tor a permit, and work is no[ to starl without a permit; that Ihe work will 6e in accordance wrth the approved plan in [he case of work which requires a review antl approval of plans. X 04 i4P-, k Ar, C X ApplicanYs Printed Name A canY Sign ure Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES ? Foundation ? Single Family ? 01 of _ Plex ? 02-Plex ? 03-Plex ? 04PIex WORK TYPES ? New ? Addition ? Alteration ? Replacement DESCRIPTION: Valuation Plan Review (25 % __ 100% Census Code _ # of Units _ # of 6uildings Type of Const. ? 05-plex ? 16-plex ? Accessory Building ? pppi ? 06-plex ? Fireplace ? Porch(3-season) ? Ext.Alt.-Multi ? 07-plex ? Garage ? Porch (4-season) 0 Ext. Alt. - SF ? 08-plex ? Deck ? Porch (screen/gazebo/pergola) ? Multi Misc. ? 10-plex ? Lower Level ? Storm Damage ? 12-plex ? Miscellaneous ? Interior Improvement ? Siding ? Oemolish Building' ? Move Building ? Reroof ? Demoiish Interior ? Fire Repair ? Windows ? Demolish Foundation ? Egress Window ? Water Damage ' Demolition (entire building) - give PCA handout ro applicant _ Occupancy MCES System _ Code Edition , SAC Units Zoning City Water _ Stories Booster Pump _ Square Feet PRV _ Length Fire Sprinklers Width REQUIREDINSPEGTlONS Footings (new bldg) Footings (deck) Footings (addition) , Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace:_R.I. _AirTest _Final Insulation Reviewed By: Sheetrock, FinaI/C.O. Final/No,C.O. HVAC Other: Pool:_FOOtings _Air/GasTests Final Siding:_Stucco Lath _Stone Lath _Brick Windows Retaining Wall Building Inspector RESIDENTIAL FEES: Base Fee Surcharge Pian Review MClES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total Page 2 of 3 III y Use BLUE or BLACK Ink a j City of Eayn- ; Permit#: » Permit Fee: 3830 Pilot Knob Road 1 I Eagan MN 55122 1 Date Received: //-l> Phone: (651) 675-5675 I Fax: (651) 675-5694 j Staff. i ------------------J nn 2/011 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: _1 V - a5 / Site Address, 3 r~ u 16N Tenant: bvv4 Suite RESIDENT / OWNER Name: ' Phone: ~g Address I City; Zip: CONTRACTOR Name: MILBERT COMPANY INC.dba CULLIGAN WA Address: 1801 50TH ST EAST city INVER GROVE HGTS State: MN zip; 55.077 Phone: 651 '.451-2241 Contact: BILL. MILBERT t . Email: TYPE OF WORK _ New replacement _Repair -Rebuild _ Modify Space _ Work in,R.O.W. Descri tion of ork• PERMIT TYPE RE$IDENT/AL Water Heater ater Softener Lawn Irrigation RPZ I _ PVB) Add Plumbing Fixtures L_ Main Lower Level) Septic System Water Turnaround -New Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (includes $5.00 state Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $166.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEES $ CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Cali 48 hours before you intend to dig to receive locates of underground utilities., www.oooherstateonecall.ora 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 sta without a permit; that the work will be In accordance with the approved plan in th ase of work which requires a.review and approva of plans. x x Applicant's Printed Na a Applic is Signature FOR OFFICE USE rt.'Revlewed By r +Reyulred Inspect)©ns;; Under Ground ._f ough-In A~r;Te q -M.0 Test4 _a Final ; f ; y; ; PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA176351 Date Issued:05/12/2022 Permit Category:ePermit Site Address: 1633 Hickory Lane Lot:030 Block: 002 Addition: Woodgate 1st PID:10-84600-02-300 Use: Description: Sub Type:Water Heater 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 - Christina Joelle Groshek 1633 Hickory Lane Eagan MN 55122 Adam's On Time Plumbing & Water Heaters Llc 13791 Jonquil Lane N Dayton MN 55327 (612) 205-6060 Applicant/Permitee: Signature Issued By: Signature