Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
1652 Hickory Lane
r Use BLUE or BLACK Ink r--- For Office Ussee Permit 1 736W j City of Ea ~a~ Permit Fee: 3830 Pilot Knob Road I I Date Received: I I Eagan MN 55122 VAY 9 Phone: (651) 675-5675 Staff: Fax: (651) 675-5694 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit M w Name: Phone: RESIDENT I el OWNER Address /City /Zip: r Applicant is: Owner J_\ Contractor i TYPE OF WORK Description of work: lko4ee-w , 11-~0 T© t,,;? hah se Construction Cost: ® 00 Multi-Family Building: (Yes _Ip4- / No ) Company:h^ .S ~6/bg " S. r r_0/10"r ont ct: e_-6k,'5 t ~ ,4 e,; Address: i4A517 r4/1 e;0- L..L0 Aa city: S by i-r imi& te CONTRACTOR State:/ Zip: Phone: qsz 3 62 6623 License #:M /V Z p !p 3 s2Og Lead Certificate F- J "00 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 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 the 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.gol)herstateonecall.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. Z2 Applicant's Printed Name Applican s Signature Page 1 of 3 6 ACT n C'` (Q ~Q DO NOT WRITE BEL THIS LIIV€~ 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* X, Addition - Move Building - Reroof _ Demolish Interior T 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 Occupancy MCES System Plan Review Code Edition AAA SAC Units (25%100%) Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width 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 4 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 RESIDENTIAL FEES Base Fee Surcharge Plan Review VVVv MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 ~\YJ r O~ NON INN lzz~: lzs 00, 2z r r l"n { s'' 34 4'?).6 VILLAGE OF EAGAN WATER SERViC48PERMIT , 3795 Pilot Nnob Road PERMIT NO.: --- Eagan,MN 55122 ---------- UA"TE. _ 4?2r2/74 ---- - - ?-- -- - - - No, af Units -- --- -- --- ?-?- -- --- Zmmng* PU? (7wncr . 1400d4Jdte. NeMi. HOL.IZQI1 ?141RQ?-- -. ---?-- --- - -- - sucnddret 1652 54-55-58 Hisk4xY_5an0_.,_---------- ?'/, . Plumbrr PSOn P111IRbi?19_CO-- \1r ter N --------`- - - -= Connection Char -- -- ----- - n ? Sii.e? Account Deposit - ----? - -- -- - ? Yermu Fer. . .__70.00 pd - R?•ader Nn ? _ -- - - .50 - Pa --_ 1 a9ree to comDly with fFe ViIlage ol EoqM SurCharKe. ---- Ordinnnces. Mii,c Charges: "-??C?d?--- -- -- - I otxl Ry t/'?` Ua[e Paid' Il.nrpilnnp ± ? 7 ?f71 U' r ? vu'A89- oc EkBaN SEWER SERVICE PERMIT 3795PilofKnobRoad PERMITNO.: 2204 Eagan. MH 55112 DATE: 4/26/74 Zoning: PUD No. of Units: Owner: Woodqate New AOrlZOn FIOmeS _ Address: Site Address: 1652-54-56-59 H6ckory 7ane Plumber: Thomnson Plumbing Co. _ 1 ograa ro comDl1 with fhe Villoge of Eagan Ordinancea. By: Date of Insp.: ]nsp.: - Connection Chazge/ E-•tc Account Deposit: --In .-.Gu-p-ff - Permit Fee: P Surcharge: Misc. Charges: Total: - Date Paid: Woodqa'1"e Isfi CITY of EAGAN BUILDING PERMIT Owne: .....'.."`.'??!r ..... .............. \.... ?-,..?? ? , .:................. .... ............... ... Address (precent) ..l.......7:?"1,?:?-'_""??°-"??^? ? '7?,.?-,??J-.-rT?'•--+[-? SS3 5<3 Builder .......----.............. ............................. Addren ..... DESCRIPTIOlQ ... ty' No 3785 Pilo! Rnob Road Eagaa. Mionesola 55152 454•B100 LX 3401 aw ...q..-?3.:.7.? Stories' To Be Uasd For Fron! Deplh Hs h! Esl. Coa! ermt! Fea Aomot /i ? },- 179 ?s/h/ LOCATION Slreal, Road or oihar Defcriptioa oI Localtoa I Lo! Block Addition os TrW I ? Z t ? This pecmit does not aulhorize the use ol slreata, roada, alleys or sidewalb aot doaa it glv* !he owner o= hIt syent the righ! !o create anp siluation which is a nuisanee or which presenls a haard !o the heelth, tetslp, eoavsobaee ead general welfare !o anpone in the eommunify. THIS PERMIT MUST SE KEPT ON THE PAEMISE WHILE THE WORK IS IN_ PROGAESS. .y?-. This is !o cesiify, lhai.?--_ .--_.haspermissioa !o szecf ... ................... ................... _ . upon the above described premise subjecY the pxovisions of all applicable Ordinances for the Cilp of Eagae. ?-`?C!.'__G?,?-n.._/ ............................ Per .l?"""" ......... .............. . ."----_'....-'•'----........:............... .. ................................... Mayor Bulldinq Impelos oe HOUSE HEATING TEST RECORD D-21372 aDDRess 1852 Hickory La, ppT.-PLOOR CiTY SUBUR6Eag111 OCCUPANT NOrie nwuco NCW Hoz'].ZOIIe HEAT LO55 SOLD BY Elschicol Work By _ TYPE OF HEAT GA DATE HTG. INSt INSTALLED BY SedgwiCk Htg, u n Gas Lins By FA "=HW -STEAM -SPACE HTR. UNIT HTR. -OTHER / GAS DESIGN MAKE WilliBmgotl MAKE OF BURNER _ Modal 1117-07-5 Model : Sawia1 7437109 Max. BTU Rating- INPUT 75,000 Btn MAKE OP FURNACE CONTROLS Pu9 THERMOSTAT Cm M,H , 260 HQatV8UOC Valve Limit Robehaw RFL 750n Limit Setting 200 f Fan Setr'ny 90°f & 120af Ptlof lype Cauple Pilot Make Model CONVERSION 4° Vent Size KIND OF LINER Aluo1, SIZE 611 NONE Drok Hood VCI't>C8l Regularor Filters Size 1611 8 25" Numbsr 1 Chimney Location Insids Ye8 Outside Chimnay Construcfion Metalheatoa Pilot Modsl $moke Bomb Wiring Pilot Timing 53 Seconda pra{t 0K Test Tag YQ$ L.W. Cut Off Door Pressure Lighfing InsT. Yee Pressure 4•9"w•C• percentCO 7•`5% Dote Tssted 1211174 f CFH I 74 2?8' Psrcent 0 Com Testin an Co b t' n S ecial ' ea npu ?_ ? p y g ? Smck Temp. 490 f pertent CO ?•??? Name ef Testsr yrJc?r-? L d. Form 235 ` J ? .\ , ' ??\ ., ;S?f ' GC `i b? ?.';?? ? ' ?.'. ? ?,.??:_? . ,c??. .. _. ?.. ,. ? A { ?? ? :u L'u c. ? . ,. „ ?.? , •?,?? 9 ': r ?? ?, . ,. , ? ?;;,-w, . ? ? . . ? 4? ;?_?. ' ?'' ` = :? ..?? ? ?(?y7S ? w _ •?A ? ?J ? .?.`.,n? .. ?j 4 G 1 li . " ?" ' • ., w d . 1? _,'? . .. _ . J "v'. - '" _ ' HOUSE HEATING TEST RECORD D-21372 ADDRESS '`1654 Hicknry i,ane APT.-FLOOR GTY SUBURBEagan OCCUPANT nene OWNER New HoriLoAe HEAT LOSS - SOLD BY DATE HTG. INST GAS C0. METER BADGE .? INSTALLED 8Y Sedewick Heatiaa Gas Line 8y M ft Elechical Work By _ TYPE OF HEAT GA FA X_HW -STEAM -SPACE HTR. GAS eOTl ESIGN William MAKE 11 7- MAKE OF BURNER Model Model UNIT HTR. -OTHER CONVERSIDN Ssrial Max. BTU Raring flE - INPUT 5a n r' MAKE OF FURNACE Model Cm260 CONTROLS THERMOSTAT .??HCatPlug Valvs ? Limit b8h8w FL 75 Limit Setting 200 f Fan Sotting 90 f 120 f Pilot Type C017A10 Pilot Make Pilot Model 4" Venf Size 151. KIND OF LINER 8°m SIZE NONE Drok Hood verica Regularor Filters Size 16825 Number 1 Chimney Location Inside 9e8 Outside Chimnay Conseruefion met81 ).1B$t08 Smoke Bomb Pilot Timing 44 aeC• Draft L.W. Cut Off Door Pressure Wiring .Tesf Tap 9ea _Lighting Inst. Ye8 Prossure 4 5„we PereenTC02 70% Daro Testsd 12/11474 Input CFH 'T.$_? -Pereent OZ Company Tasting $tack Temp. 47(1 f Percent CO Nome of Teatar ? Form 235 ' HOUSE HEATING TEST RECORD D-20944 ADDRESS •1654 Hickory La, APT OCCUPANT 1vo' HEAT LO55 _ SOLD BY Elechical Work By TYPE OF HEAT Model GAS DESIGN MAKE Wi1lia,ie90A MAKE OF BURNER _ Model 1117-07-5 Model se,;,l . 7346692 Max. BTU Rating - INPUT 75,000 Btu Hr, MAKE OF FURN,4CE CONTROLS THERMOSTAT r'm 260 Heat Plug Val.e M.H. V800c L;m;t Robehaw RFL 750n Limit SeMing 2000f F,,, S,f,;,,y 90°f & 120 f Pilot Type Pllot Make Pilat Model Ysnt Size 4" KIND OF LINER &lum. SIZE 6" NONE Draft Hood UQrt1C81 Regularor Filters Size 16" g25" Number 1 Chimney LocuTion Insida Ye9 Outaide Chimney Consttucti on Metalbe8'EOS Smake Bom6 Pilot Timing 49 Secouda pra(t L.W. Cut Off Dow Pressure 4•611W-C• pareentC02 7'0% Input CFH 74 Percent OZ 8.7% $tack Temp. 3900f percenT CO 0•6 Form 235 DATE HTG. INST, GA _ FA X HW STEAM -SPACE HTR. UNIT HTR. OTHER GAS C0. METER BADGE ?iCk Htg, INSTALLED BY ? 5 n n Gaa Line By Oote NFLDIO;R CITY SusUrta Egan OWNER ew orizOpB Wiring Tosr Tag Yes Pressure / Lighting Inst. Ye8 Tssted 7! 11174 Company Tesiing Comb t'on S ec'lties Name of Teseer CONVERSION HOUSE HEATING TEST RECORD D-21372????IAj /"?iJ3 ADDRESS 1656 Hickory LaIIe ? APT. -FLDOR CITY SUBURB Eagan OCCUPANT none HEAT LOSS SOLD 8Y Eleehical Work By _ TYPE OF HEAT GA OWNER New Aorizon9 DATE HTG. INST. GAS C0. METER BADGE INSTALLED BY edgwick Heating Gns Lina By - FA X HW -STEAM SPACE HTR. -UNIT HTR. -OTHER GAS DESIGN MAKE Williamnon MAKE OF BURNER_ Model 1117-07 5 Model Ssrial 7430968 Max. BTU Raring _ INPUT 7Ra0001flt ' r MAKE OF FURNACE Model CONTROLS THERMOSTAT cm-960 Haot Plug Vsnt Size 4„ Valve M_$,_ VROOn KIND OF LINER 81Am 51ZE NONE Limit Rnhehaw R,FL 750 Droft Hood 4Qrt1C81 Regulator Limit Setting `Ln,1? Filters Sise 16a25 Number 1 Fan $attin9 9/)o f 12(l?f Chimney Location Inside ?e8 Outside Pilot Type _ Pllot Make _ Pilot Model _ Pilot Timing L.W. Cut Off Qiimnay Canstru<Tion metel bestoa Smoke Bomb Wiring DraFt Ok Test Tag Ye8 Door Pressure Lighting Inst. 3'Qa Prossure 4-5 "wC 7-0% PsresntC0 DateTested 12j11ft4 Inpuf CFH 74 2 PercenT 0 MR-7.9 Company Testing t?e Smck Temp. 470of ,y peresrQ Name of Testar -?? v CONVERSION Form 235 HOUSE HEATING TEST RECORD D-20944 ADDRESS • ` 1656 HickorV La, ' APT.-FLOOR CITY SUBURB Eagan OCCUPANT??? HEAT LO55 _ SOLD BY DATE HTG. INST. OWNER New HOrizOna GAS C0. METER BADGE # INSTALLED BY Sedgiyiek Htg. Ga L' B tt n Electrical Work By TYPE OF HEAT s me y GA _ FA X_HW _STEAM -SPACE HTR. UNIT HTR. -OTHER GAS DESIGN MAKE William8an MAKE OF BURNER_ Model 1117-07-5 Model 5,,;,i 7340800 Mo:. BTU Ratiny- INPUT 75,000 B'E11 $t', MAKE OF FURNACE CONTROLS THERMOSTAT Cm 260 Heat Plug Yalve M,A, V$00C Limit Robehaw RF7, 750n Limit Setting 20oof p,,, Sett;,,9 90°£ & 120 f Pilot Type CoUDlB Pilot A1ake Model CON V E R51 ON Vent Size 4" KIND OF LINER Alnm. SIZE 8° NONE DraR Hood VQrt1C81 Regularor Filters Size 18" X 251' Mumber 1 Chimney Location Insida Yee Outaide Chimney Construction Metalbestos Pilot Model Smoke Bomb Wiring Pilot Timing 52 Seconda pra{} OK Test Tog Ye8 L.W. Cut Of4 Doer Prassure Lighting Inst. Ye8 Pressure 'g+75w•C • Percant CO Y ,0% Daro Tested 7.110`74 InputCFH 75 Percent O 2 $...?1? Company Testing Stack Temp. 3700f percen} CO Name o{ Tastar ? •?+? Fwm 235 y HOUSE HEATING TEST RECORD D-21372 ADDRESS 1658 HiCkOry L8T1¢. Ea en None APT. New Horieons'TM SUBUke g OCCUPANT OWNER HEAT LOSS DATE HTG. INST. SOLD BY Eletxical Work By TYPE OF HEAT i GA _ FA X HW INSTALLED BY Sedgwick Htg,. Gas Line By If 11 STEAM -SPACE HTR.- GAS DESIGN MAKE Willi8maon MAKE OF BURNER_ Model 1117-07-5 Model Sxial 7430974 Max. BTU Rating- INPUT 75.000 BtiyfHT_ MAKE OF FURNACE Model CONTROLS THERMOSTAT Cfe 260 Heat Plug Vent Size 41t Valre 1ui A_ VRO(lr KIND OF LINER A117 m SIZE F° NONE Limlf Rnhshaw RFIk 7 ,50n DrohHood Vax` f.inal Regularor Limit Setting 200of Filters Size 151 u`J5" Number L. Fan $et}{ny 9(1of .6 12(lof Chimney Lacation Insida S'aA Outside Pilof Type Coun] e Chimne Constrottion Matglhoa+na y Pilot Make Piloe Modal Smoke Bom6 Wiring Pilot Timing 53 Seconda Druft nu Test Tag S:£R L W Cut Off Door Press re Yea Li Inst htin . . _ u g . g Prossure 4.5"w.C, par<entCO? 7•0% Date Tested 12.t 11t74 Input CFH 7 4Percenf 02 g 7 Company Testing C t? S lti Stack Temp. 4 Peresnf GO 000 Name of Tesbr Form 235 UNIT HTR. _OTHER CONVERSION /y- 3-/ to,G - 72ie City of Sagan hereby grants to PERMST NO.; ?8, cz7°t oF Eaa;;u 3795 PilOt I{nob P.cad Eagan, D2innasota 55122 °f -1003-Senia nve Se , Up.1a 554316 ?REaTlx. Permit for: (Owr.er) New Horizo - Wood ate 1724 & 1710 Walnut Circle, 1660-62-54-66 HicY,ory I,ane. 165 54-56?58 Aickory at Ta*+a 1, pursuant to application dated 9/25, 9/6, 9/18/74 s2oo.00 dated this PFZChanical Permits: Bi"' Total: 19 74 q i9- 3-/ e5tfQ CITY OF EAG.!1N 3795 Pil.ot Knob Road Ragan, Dtinne;,ota 55122 PERNIIT NO,; 461 The City of Eagan hereby grants to Geo. Sedgwick Heatinq 6 A/C Co. of 1001 Xeala Ave. So., Mpls. 55416 a Permit for: (Oumer) mr HOrison Hmes 1650 54-55 6lokory Iane & 1665-67-66-68 at' ??wkozy qill , purauant to applicatibn dated 2 1, 4? y?? Pee Paid: 160.D0 dated this 19 day of 1'abrRUSY '?4 4. OO aIC J.,.i Suilding Inspector P%;echanical Permits: Bi3 Total: 3?? a 38355 , 00 A ? ? l Requast Dale S/ ? • Fira No. R -in Inapechon qqqyi?p ?/ ? Reedy Now/Jqrr?ll Nouty Inspaclw V W'hen Read ? ? ? Vas N. y 1 p licensed contractor owner hereby request inspection ot above electrical work at: .be Mareas (st , Box or W No.) ciry Co5 ?c r $eCtron No Township Name or No. R¢nge No Coumy Otcu nt (PRIM) i L ? ('/ N Phona No. 87- g? '7?- ( onni e E .? Power Supplrer P4tlress Eiectrcai ConVadw (COmpany Name) Comraaor5 Lkanse No 0me.own['r Maibrp AEtl s(COnVactor or Owner Meking Installa(an) OvC.? Au nzed signatura (COnVactor/Owrier Making Installanon) PFwne NumOer NINNESOT115TqTE BONHD OF ELECTRICT' THIS INSPECTION RfiOUEST WILL NOT Grlpps-MlEway BIOy. - Room S113 BE ACCEPTED BY iHE STATE BOARD 18Y1 UnNerNty Ave., St Poul, NN 55104 UNLESS PROPER INSPECTION FEE IS PInM (812) 642-0800 ENGLOSED. 1s/y/ H,3U 55 REOUEST FOR ELECTRICAL INSPECTION W See instmctions for comDleting Ihis form on back ol yellow copy i.V'Se/ow Work Covered by This Request E8-00001 8 ew Atld Rey TypeolBwltling AppliancesWired EquipmentWired Home Range Temporery Service Duplez Water Heater Eleclric Hea6ng Apt. Building Dryer OMer (Specity) Comm./lndustnal ' Furnace Farm Av Condilioner Olher (specTy) Contractorn§ ReI'Am??arks?G M4iA ?fL4?CEY Compute Inspection Fee Below: li? # Other Fee # SernceEmranceSize Fee # Circurts/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 700 Amps Transformers Above 200 _ Amps A6ove 700 _ Amps SIJnS Inspector§ Vse Only TOTAL .SD Irrigation Booms A, 5 Spedal inspection / f Alartn/COmmunication THIS INSTALLATION MAY BE 0 CONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rougn-m oeie certity that the above inspection has been made. Final ' Deta OFFlCE USE ONLY Thm repue4l wi0 18 momhs Irom CITY OF EAGAN Remarks Addition Woo-Igate lst Addition Lot 19 Rik 3 Parcel 10 84600 190 03 Owner•?lp(t Street_1ti52 H,ir-knr? 7.n State Eaqan, NLN 55122 ? Improvement Date Amount Annual Years Payment Receipt Oate STREET SURF. STREET RESTOR. pAVING 1976 410.12 $136. 71 3 PAID GRADING PAVING 1974 115.45 $23.09 5 PAID SAN SEW TRUNK a, 1974 $93.54 $6.24 15 PAID * SEWERLATERAL 1975 15 WATERMAIN * WATERLATERAL 1975 15 * WATER AREA 1975 15 * STORM SEW TRK * STORM SEW LAT aq 1975 $1505.70 $100. 38 15 PAID CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. $130.00 11730 9-23-74 BUILDING PER. sa,c $400.00 11730 9-23-74 PARK CITY OF EAGAN , Remarks Add;t;an Wood ate lst Addition Loc 20 Blk 3 Parcel 10 84600 200 03 Owner v Street 1654 Hicltory Ln. State Ea an, MN 55122 1fz ?A ?)Q `, i? "' ?; Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, 3oqSTREET RESTOR. pAVING 1976 410.12 136.71 3 PAID GRADING PAVING 1974 $115.45 $23.09 5 PATD SAN SEW TRUNK a, 1974 $93. 54 $6. 24 15 PAID * SEWERLATERAL 1975 15 WATERMAIN * WATER LATERAL 1975 15 * WATER AREA 1975 15 * S70RM SEW TRK * STORMSEWLAT 1975 $1505.70 $100.38 15 PAID CURB & GUTTER SIDEWALK S7REET LIGHT WATER CONN. $130.00 11730 9-23- BUILDING PER. sAC $400.00 11730 9-23- 4 PARK CITY OF EAGAN Remarks _ Addition Woodaate lst Addition Lot 17 aik 3 Owner '°"' Street 105b HICKOL'y l,Il. _ Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 3?)%STREET RESTOP'PAVING 410.12 136.71 3 PAID GRADING 115.45 23.09 5 PAID SAN SEW TRUNK ? 1974 93. 54 6.24 15 PAID * SEWER LATERAL 1975 15 WATERMAIN * WATERLATERAL 1975 15 * WATER AREA 1975 15 x STORM SEW TRK * STORMSEW LAT a9 1975 $1505.70 $100.38 1$ PAID CURB & GUTTER SIDEWALK STREET LIGHT WATERCONN. $130.00 11730 9-23-74 BUILDING PER. s,ac 400.00 11730 9-23-74 PARK CITY OF EAGAN Remarks Addition Wczod ate ZSt A$d1ti0II Lot 18 81ic 3 Parcel 10 84600 180 03 Owner Street-1658 Hickory Ln . state_ Eaqan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREETRESTOR.pAVING 1976 1 $410.12 $136.71 3 PAID GRADING - PAVING 33 1974 $115.45 $23.09 5 PAID SAN SEW TRUNK 1974 $93. 54 $6. 24 15 PAID I * SEWERLATERAL 1975 15 WATERMAIN * WATER LATERAL 1975 15 * WATER AREA 1975 15 ? STORM SEW 7RK 1975 * STORM SEW LAT ac?? 1975 $1505.70 $100.38 15 PAID CURB & GUT7ER SIDEWALK ? STREET LIGHT WATERCONN. 130.00 11730 9-23-74 13UILDING PER. sAC 11730 9-23-74 PARK CITY USE ONLY L BL /+? «?- SUBO. ?- ? Please complete for: 1999 PLuMSiNfi PE{MIT (RES1DENTIAL) CIT'Y Of f-4fiikN 3$30 fILOT KNOB RD Ens,41v, tYN 55122 (651)6$I-4675 ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinklersystem FIXTlIRES ? EACH !f TOTAL Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas i in outlet ' minimum - 1 3.00 X = $ Hot tub/s a 3.00 x = $ Kitchen sink 3.00 x = $ Laundr tra 3.00 x = $ Lavato 3.00 x = $ Minimum fee alterations to existin dwellin 30.00 x = $ Private Dis osal S stem new/refurbished * re uires MPC iic. 75.00 x = $ Private Dis osal S stem abandonment 30.00 x = $ RPZ new installation/re air 30.00 x = $ Rou h o enin 1.50 x - $ Shower 3.00 x = $ Under round s rinkler if dwellin is under construction 3.00 x = $ Under round s rinkler if existin dwellin 30.00 x = $ Water cl et 3.00 x = $ Water h er 3.00 x $ -? -Watgr-softener if dwellin under construction 5.00 x = $ Water softener if existin dwellin 30.00 x = $ Water turnaround 30.00 x ---- = $ State Surchar e 50 --> ----> ----> $ 50 Total --> --> ----> ----> $ -:?o. S-D Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. -------- --------------------------------•----------- • ---------------------------------------------- -- --------------------------- -- -- - -- ---- I hereby acknowledge that I have read this applicatioo, state that the iofortnation is cortect, and agree to comply with all aDPlicable City of Eagan ordinances. It is the applicanYs responsibility to nohfy the property owner that the City of Eagan assumes no liability for any damages raused by the Ciry during its normal operetional and maiNenance activities to the facililies consVUCted under this permit within City property/right-of-way/easement. SITE ADDRESS: v OWNERNAME:: TELEPHONE#: loS YJ`z. /ZZ3 (ARE) INSTALLERNAME: TELEPHONE#: lel?S-S/ oSSS- STREETADDRESS: (AREA CODE) v*? CITY: STATE: ZIP: RECEIPT#: Z? iGa RECEIPT DATE: PERMIT # J UL --- ' SI NATURE OFQER ITTEE xcl 1/6 00-170-6,? L, ry BL 3- CITY USE ONLY SUBD. RECEIPT #: ? -? DATE: 1995 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612)681-4675 Please complete for: ? singie family dwellings ? townhomes and condos when permits are required for each unit New construction 114- Add-on furnace nuu-vi oii Cv^d::iGi ii^L'j ?-.LjE?'C^ 27r °XC!:E^^y°.', l.g. \janna Sk•SfEm, Qtf'. Date: // fEES ? Minimum Fee: Add-on/Remodel (existing residence o $ 20.00 ? HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ? Gas Outlets (minimum of 1 required @$3.D0 each) ? State Surcharge TOTAL .50 SITE ADDRESS:.??? LA) z ? * 0 -r?9'L??, ?' ?yo° OWNER PHONE #: 0? INSTALLER NAME: 4ZIlzC STREET ADDRESS: /,/ Z:L-? CITY: i_2ffi2L2 PHONE #: { ) !?jro7- ???v? CITY USE ONLY L _ BL _ RECEiPT #: SUBD. DATE: 1995 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ? all commercial/industrial buildings. ? multi-family buildings when separate permits are = required for each dwelling unit. DATF- WORK TYPE: CnN-rRnr.T pRirE; _ NEW CONSTRUCTION DESCRIPTION OF WORK: INTERIOR IMPROVEMENT FEES: ?$25.00 minimum fee 2[ 1% of contract price, whichever is greater. • Processed piping - $25.00 • State surcharge of $.50 per $1,000 of permit fee due on all permits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL viTi ADvAEvv. OWNER NAME: TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS: _ CITY: PHONE #: TELEPHONE #: STATE: ZIP: SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR 73 93/ 3D- szD 2006 RESIDENTIAL MECHANICAL rERMrr aPPLic,aTroN City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. single family dweilings & townhomes+condos when permits are required for each unit i ? Date ?2_ Sk Add e ress / Unit # Prnpaty Owner Telephone #6?/ Cm Lofgren Htg & A/C 5708 Upper 147th St W#102 - s Apple Valley, NIN 55124 c;ty Zip Telephone # (7D? Fiond if• Expires: T6r. Applicant is _ Owner ? Contractor _ Other _ Add-on or slteretion to e:isting dwelling unit $ 30.00 fumace _Additional Replacement _ Nex . air exchanger airconditioner , heat pump other Stade Surcharge $ 50 Tot?? $3 ? I hereby apply for a Residential Mechanical Permit and acknowledge that the information is com be in conformancc with the ordinences and codes of the City of Eagan and with the Mechanical permit, but only an application for a pettnit, and work is not to start without ermit; that the approved plan in the case ofgork hich requires a review and approval of plefisf. 1 ApplicanYs Printed 1 lame plicants Si na accurate; tlial the work will at I underst-and this is not a I be iD accorclance dvith the ------ --------i i ??? ? ? ???' f I ? Pertnit#: ` I w I I Permit Fee: I ? Date Received. ? I I ? I Staff: ? I ----_- 2009 RESIDENTIAL BUILDING PERMIT APPLICATION y-/3 - 0/ Site Address: ?-?-- Date: _?- Suite #: Tenant: 2- S'T-E^_? 08 P-K ( Phone: e: K? S RESIDENT / OWNER Eddress/CitY/ZiP: Applicant is: _ Owner _?4 Contractor ~?.,?_a D Il- `? TYPE OF WORK Description of work: po 7 ? Construction Cost: ( ^?'? I?OD1flNC? 1'c? CONTRACTOR Name: \ n -,eod i- Multi-Family Building: (Yes >0_ / No ? License #: 9,2 / q Address: n Staie: Zip: c?ry: D?J Q r?X ?1 L ?? ,??/ Phone: / ?2'25 / /' VLZContad Person: /,` -/ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7672 Minnesota Ruies 7670 Cateaorv 1 -, New Energy Code Worksheet Energy Code • Residential Ventilation Category 1 Worksheet Submitted Cat¢gory Submitted . Energy Envelope Calculatwns Submitted (4 submission type) 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: - - Phone: Licensed Plumber: Phone: Mechanical Contrector: Phone: Sewer & Water Contractor: NOTE: Plans, a,nd su portin documents, thaf yoa submit are considgred to be public,information. Portions of , 11 A g co . _ the information may be classified a ncfuderthat the a,e trade ecfrets. asons thatawoufd permit the City to, that accurate, I e this applicat on fortaepermit,Nand work sfnot to st rttwtthout a pe mit; that thewo ihwilCbe In con Eagan;Ythat ?Io nlderstatndtthis is notnatpermitc buplonlyete accordance with the approved plan in the case of woAc which reqwres a review and approAa? f ps.^ ?^ n 'A' 1n /? // '77T? Xl 1?[.(-,-1?'L lJJ02?-> '.r,.216 q pli anYsSign/ re ApplicanYs Printed Name Page 1 of ? For Office Uses T l Permit City of Eantin 3 Permit Fee: (i - 3830 Pilot Knob Road Eagan MN 55122 Date Received: i 71 I I Phone: (651) 675-5675 I /?<^y I Fax: (651) 675-5694 staff: 2009 RESIDENTIAL BUILDING PERMIT APPLICATION ,ter ~-R Date: 7 ( ° Site Address: / h" Ir Tenant: Suite RESIDENT / OWNER Name: 5c, r I ? Phone: 617 Address/ City/ Zip: Ll,'rkara c L-weiti, j Applicant is: Owner Contractor TYPE OF WORK Description of work: a'Ti r 7 , 1^ rC? =1' C X CCU r~ t!1c, Construction Cost: Multi-Family Building: (Yes / No ) CONTRACTOR Name: S ~ License S Address: City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted (4 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 appro al of plans. n rio 1 Applicant's Print N e A plicant's Signa ~e Page 1 of 3 r - - - - - - - - - - - - - - - - I For Office Us 1E ~ Permit I 't rc r City of Ea a~ I Permit Fee: 3830 Pilot Knob Road I Eagan MN 55122 Date Received: j Phone (651) 675-5675 I Fax: (651) 675-5694 I Staff: L -----------------I 2009 MECHANICAL PERMIT APPLICATION Date: Site Address: ✓ ^ Tenant: Suite Name: Me, ^C 5 Phone: RESIDENT /OWNER Address/ City / Zip: CONTRACTOR Name: License Address: City: State: Zip: Phone: Contact Person: TYPE OF WORK New Replacement Additional Alteration Demolition Description of work:U NOTE: Both roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector or one of the Planners for information on permitted screening methods. PERMIT TYPE RESIDENTIAL COMMERCIAL Furnace New Construction Interior Improvement Air Conditioner Install Piping Processed _ Air Exchanger Gas Exterior HVAC Unit _ Heat Pump _ Under / Above ground Tank Install / _ Remove) When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ TOTALFEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ X1% $50.50 Minimum (includes State Surcharge) = $ Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. If Permit Fee is > $1,000, surcharge increases by $.50 for each = $ State Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). $ TOTALFEE 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 i t e case of work which requires a review and approval of plans. Applicant's Printe N me Applicant's Sig tur FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground _ Rough In Air Test -Gas Service Test In-floor Heat -Final Exterior HVAC Screening Inspection b)m/,71L/ (9k,4A,)14 0 Use BLUE or BLACK Ink rs:, For Office Use lio q3;1, Un Permit City I of ~~a Permit Fee % cam' ` -7C J 3830 Pilot Knob Road Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 Fax: (651) 675-5694 staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Ir Ic o p y L. /yz Tenant: (F02F_r-L a.5 !L 6 4-7- 7TX fS 'T//', Suite RESIDENT / OWNER Name: Phone: Address / City/ Zip` Applicant is: Owner Contractor TYPE OF WORK Description of work: fkk OFF 4,ef -k0 i_ ArsO b0/A')C' 16.!5 ~(o~ O Construction Cost: Z1,171 ~ b Multi-Family Building: (Yes )S_ / No CONTRACTOR Name: C ,d- Z- k oo i-t A-'C, License ~12/7 Address: / VIL')l / % t ~&-4 Jeff City: ROR NSal LC'E State: ✓ l zip: -5-5-3 3 / Phone: Contact: Email 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 the 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.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. x Alofh'-AiL kjdkILS7-R,4ot b Applicant's Printed Name Appli ant's lgn re ;Page 1 of 2 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA126807 Date Issued:09/10/2014 Permit Category:ePermit Site Address: 1652 Hickory Hill Lot:006 Block: 002 Addition: Woodgate 1st PID:10-84600-02-060 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Troy Good 3670 Dodd Rd Eagan, MN 55123 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Robert Golling 1652 Hickory Hill Eagan MN 55123 (651) 456-5433 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature