1577 Rustic Hills DrCity of Eagan
Eagan,
PERMIT
City of Eaan
Permit Type: Building
Permit Number: EA095680
Date Issued: 08/30/2010
Permit Category: ePermit
Site Address: 1577 Rustic Hills Dr
Lot: 2 Block: 0 Addition: Rustic Hills
PID: 10-65000-020-00
Use:
Description:
Sub Type: e-Windows/Doors
Work Type: Windows/Doors-New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Construction Type:
Occupancy:
Comments:
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary:
Valuation: 3,000.00
BL - Base Fee $3K
$88.50
Surcharge - Based on Valuation $3K $1.50
0801.4085
9001.2195
Total: $90.00
Contractor:
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
- Applicant -
Owner:
Kenneth P Schoenike
1577 Rustic Hills Dr
Eagan MN 55121
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.
Applicant/Permitee: Signature
Issued By: Signature
INSPECTION RECORD
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS: L OT i W &LOCK t 0
%71 RtlSTIC HTL L% OR
RU91 TC MI l.S
PERMIT ?,"RTYPE:
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
?.CHt)k'kIXkE.
?Y73
TYPE OF WORK:
Control No. ?8
( Nt/iL01Nfi
R?1aF?7
KENNETH
M
INSPECTION TYPE
I ?i+i t (Nfi .DATE INSPTR. INSPECTION TYPE
F f? vlitY NA DATE INSPTR.
IN SOLAIION FINAL
FIR!<'Pt ACE
RFofAft K 10E't;l Ip1 4
S&U PLOR -
Permit No. Permit Holder Date Telephone #
S/W
PLUMBING
HVAC
ELECTRIC 5
ELECTRIC
Inspection
Dale Insp. Com Ms
Footings I pp
/1t?4
Foundation ll 2
Framing
Roofing
Rough Plbg.
93 ?s(
?i 6'"
- z - ?r l
Rough Htg. 3, l? S?g A3 41,C,
Isul. /(?ile2/t?S f Sz?p uss *uy
Fireplace Y
Final Htg. f1 ly# -r
Orsat Teat
Final Plbg. Y ?.
7` Plbg. Inspector - Notify Plumber
Cont. Meter
EngrJPlan
81dg. Final ?? tv1 - ' ?&
Deck Fig. p Q
?/ 6 T 3 O? ! /? ?7 [u -
Deck Final
Well
!
Pr. Disp. y?
C,
niaP
UAP
7
r?
9
[-ertificate of CccupancV
CM4 oq Wagan
zoartac»t of 13ai[bing an#Pection
This Certificate issued pursuant to the requirements of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
use clamrecatio t, SF M Bldg. Permit No. 1057
Occupancy TYW I31M I Zoning District R I Type Const. VK
o.wr of Building SOMENIM ! RMsPWM Address 391515 ___176'iS?D S1, MMS
Building Ad&= 1577 I UMr. RM S nRTVE Miry T_9. BO M=C ATT T S
Dare:
Bttimng Official
POST IN A CONSPICUOUS PLACE
i ,
CITY OF EAGAN Remarks yI7r
Addition RUSTIC HILLS ADDITION Lot 2 Blk D Parcel
Owner u? L((, Street 1577 Rustic Hills Drive State
Lil-' dV?1? for 'r Litt ( (/q ? a`i 1 (. .
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. V-3 i 98o 18ss.41 185-54 10
STREET RESTOR.
GRADING
SAN SEW TRUNK 1968 45.85 1.53 30
AGEWER LATERAL
WATERMAIN
WATER LATERAL 1391 1972 170.98 8.55 20
WATER AREA
_j 17 1977 79.55 5.30 15
• water IntAral 1980
-
STORM SEW TRK 1979 332.28 33.23 10
*STORM SEW LAT 1980
*Service 8
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
Address 1577 RJSric HnLS DRIVE Zip 5512 2
Lot , 2
Blk D
Sub RDsTIC HTf.i.s
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: ?/S g
4.1 ? Y
No
Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass V" o
Trail/curb damage
Porch
Basement finish
Deck
l y
?
s? i w wd ? ?-
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
O?2 -
om
88 /
K
c??
t
-
_4A ad.,
Request Data
/77a Fire No. Hough-in Inspection
q, ad?
[J Raetly Now A{'?Jillen Nohty React
1
\When flea
-
es r No /
' .,
ukicensed contractor D owner hereby request inspection of above electrical work at:
Job Address (Street. Boa or Route No.) 4 City
!4S? 7 r fi; ue ; AA J
Section No. Township Name ar No. Rang. No. Co
Occupant(PRINT)
w,-ae-fA So- No e A%jke Phone No.
Power Supplier Atltlress /L'4? 0!{t
N
S?
?
r / c
t+ /
AU.diL ei ? 44 AI
ORY
Etectncal Gomractor (Company Name) Connector; License No.
Mailing Atlbress (Contractor or Owner Making Installation)
z' ? l
sT/7J/°L
SS4'QE;
/7J
..? < <
.c
?
,1, .
Authorize0 Si naN `ICO tattoo net akin Installation) Phone Number .
/ .,Q
MINNESOTA STATE BOARD ECTRICITY `- THIS INSPECTION REQUEST WILL NOT
Griggs-MlHway 8". - Ro S-1T3 BE ACCEPTED BY THE STATE BOARD
1041 Univinnil Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phu. (014) 04]-0000 ENCLOSED.
a 9? REQUEST FOR ELECTRICAL INSPECTION EB-00001-08 mo see instructions fp. wmpletiif¢ this form on hack of yellow copy.
28288 "X" Below Work Covered by This Request
K
New Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service 4.
Duplex Water Heater Electric Heating
Apt. Building Dryer Other-(Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) Contractor's Remarks:
101A e tiew hbus2.
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Abov O Amps
Signs mspector5 Use Only:
? TOTAL
Irrigation Booms k
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN ONT
1, the Electrical Inspector, hereby Rough-m Deto p
O
certify that the above inspection has
been made. Final oat
OFFICE USE ONLY • -
This request void Is months from
CITY OF 'EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
Control No. 0865
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDING
001057
07/24/92
SITE ADDRESS:
1577 RUSTIC HILLS DR
LOT: 2 BLOCK: 0
RUSTIC HILLS
DESCRIPTION:
;Building Permit Type SF DWG
Building',Work Type NEW
UBC Occupancy R-3 M-1
Construction``Type VN
Zoning R-1
Building Length 43
Building Width 64
REMARKS:
RECEIPT # 0 ()QM$? S&W PLBR
FEE SUMMARY-
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Subtotal
VALUATION
$751.50
$488.48
$66.00
$700.00
100
1
$2,005.98
$132,000
MISC FEES $1,610.50
Total Fee $3,616.48
CONTRACTOR:
OWNER:
SCHOENIKE
3915 E
MINNEAPOLIS
(612)724-4065
Applicant -
KENNETH
43RD ST
MN 55406
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 Mn.
Statutes and City of Eagan Ordinances.
rL_wx.titnl. zvt?? ?7?- -
APPLICANT/PERMITEE SIGNATURE ISSUE BY: SIGV E
INSPECTION RECORD Control No. 0865
CITY OFEAGAN PERMIT TYPE: BUILDING
3830 Pilot Knob Road Permit Number: 001057
Eagan, Minnesota 55123 Date Issued: 07/24 /92
(612) 681-4675
SITE ADDRESS: LOT: 2 BLOCK: 0 APPLICANT:
1577 RUSTIC HILLS DR SCHOENIKE KENNETH
RUSTIC HILLS (612) 724-4065
PERMIT SUBTYPE:
SF DWG
TYPE OF WORK:
NEW
INSPECTION TYPE
FOOTING DDATE INSPTR. INSPECTION TYPE
FRAMING DATE INSPTR.
INSULATION FINAL
FIREPLACE
REMARKS: RECEIPT # S&W PLBR =
PERMIT
REACTIVATE
CITY OF EAGAN '0?3 L / 6, q rJ
1992 BUILDING PERMIT APPLICATION
681-0675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, I copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, I set of
specifications, I copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re guest is made or lot Chan a is Et quested once permit is issued.
L
Date J U 1 / 10 / I`19
Valuation of work
?
l
?
1
??
?S77 ?uS?fC ?tr??S t, VL°
Site Add
res
s:
STREET SUITE ,F
Tenant Name: (commercial only)
LOT Z BLOCK SUDR
1 P.I.D. A
ust;c
f
Description of work: J
The applicant is: -M Owner ? Contractor ? Other (Describe)
Name Sc otfq Se- KeAgel Phone -? l yv?S
Property LIST FIRST
Owner Address t-,-?
STREET STE A
? ot5
M
ad
`
n
City
State f
Zip S
Company Q4, kg d' Phone
Contractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area as been approved.
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.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation
02 SF Dwg.
? 03 SF Addition
? 04 SF Porch
? 05 SF Misc.
WORK TYPE
? 06 Duplex
? 07 4-Plex
? 08 8-Plex
? 09 12-Plex
? 10 Multi. Add'].
? 11 Apt./Lodging
? 12 Multi. Misc.
? 13 Garage/Accessory
? 14 Fireplace
? 15 Deck
? 16 Basement Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
® 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const..(Actual) 2Y Basement sq. ft . /SYG.3 2 MWCC System Ile
(Allowable) Vlt? Ist F1. sq. ft. 1-87P-,,?9 City Water ?-
UBC Occupancy 3 /fi-/
- 2nd Fl. sq. ft. PRV Required
Zoning
#
f St / Sq. Ft. total Booster Pum p
o
ories Footprint Sq. f t. Fire Sprink ler
Length On-site well Census Code /
Depth y33 On-site sewage SAC Code
APPROVALS
Planning Building Assessments
Engineering Variance
REQUIRED IN SPECTION S
? Si" ? Footing ? Framing ? Insulation
? Way d ? Final ? Draintile ? Fireplace
Per ,•'ee
Sul iarge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
SAC Units
lOo65'o ii
5X /&>
veluetim: $ 13 Z DOO
T:4, ?dC' H
SY4, 3)
t
?X `/,S = SP, S
189?,8?-rs3
'2 7,4
y
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER: Ken and Rita Schoenike
SITE ADDRESS: 1577 Rustic Hills Drive, Eagan, Minnesota
CONTRACTOR: DATE: May 12, 1992 PHONE:
DETERMINE WORKING SQUARE FOOTAGE OF EACH:
1. TOTAL EXPOSED WALL AREA,,, 2
f
097 "U"
1 231
,,, ,
sq
t x
.
2. TOTAL ROOF/CEILING AREA,,,,..... 1,951 sq ft x "U" • a a?°. 51
3. TOTAL EXPOSED WALL AREA CALCULATIONS:
Total exposed wall
area above floor,,,,,,,, 1,710 sq ft
t
a) Total wall window area:
glazed,,,,,, Casement = 151 sq ft x "U" .35 53
glazed,,,,,, Decorative = 55 sq ft x "U" .32 18
b) Total door area,,,,,,,,. 18 sq ft x "U" .13 2
C)
Total sliding glass door 20
area: .26 5
glazed...... 40 sq ft x "U" .31 . 12
glazed...... sq ft x "U"
d) Total fireplace wall area same as std. sq ft x "U" ---
c) Total wall framing area
(Average 10.t)........... 155 (A)
sq
ft x
"U"
.089
14
f) Total net wall area above
floor (Insulated)....... 1,391 (B) sq ft x "U" .043 . 60
g) Total rim joist area...... 202 (C)sq ft x "U" .04 • 8
3
Total foundation
area (Exposed).......... 185 sq ft
h) Total foundation
window area........... 41
sq ft z "U"
I) Total net foundation 144:
area above grade........
Dl = 63 sq ft
D' = 81 sq ft x "U"
.35
.47
.19
TOTAL a) thru 1).
If Item A'3 Is the same as, or less than item /I, you have met the Intent of
2 KCAR 1.16008 A and 0.
14
30
15
231
Page 1
4. TOTAL EXPOSED ROOF/CEILIIIG CALCULATIONS:
Total exposed
roof/cellinq area........ 196/1.727 sq ft
1) Total skyllaht area....... - - sq ft x "U" '
Q Total roof/cellinq framing
area (aLveraoe-4)..... 8 / - so ft x "U" .072 1 Ua
4% sloped roof 176 @ .032 6 Ua
1) Total net Insulated and 1727 @ t, ,022 .38 Us
roof/ceiling area....... sq f
t x U
4. TOTAL j) thru 1) 45
If total of !4 Is the same as', or less than B2, you have met the Intent of
2 MCARZ 1.16008 A and 0.
ALTERNATE BUILDING ENVELOPE DESIGN
To utilize the total envelope system method, the values established by the sum
of items 93 and N4 shall not be greater than the sum of items fll and 12.
1. + 2.
3. + 4.
C E R T I F I C A T I O N
I hereby certify that I have calculated the "U" factors and "R"
values herein and that the building here described meets or exceeds the State
of Minnesota Eneray Conservation Act.
Slgna;ure ??IL
MW [A. Mt
(Date)
Page 2
HSTRUCTION
AMING SECTION:
Interior air film
Gyp. Bd. 1/2"
Inches soft
A
R VALUE
6R
TOTAL R -11.23
U - 1/R .089
B
r.r
D1 &
WALL SECTION (INSULATED)
-11 Interior air ...
-{2 Gyp. Bd.
-?3 Batt Insulation"
-14
d•il•.JnJ.
RIM JOIST SECTION:
1
Interior air f
'2
f--( 4
5
FOUNDATION INSULATION REQUIRED:
Min. R-5 on entire wall OR
Min. R-10 down to frost depth
FOUNDATION SECTION: D1
1 Interior air f
2 Block
3
4 Exterl-orb
(6
D2 Dl D2
m Tnt. air film - n• 0.
Block 1.28 1.28
Siding -- 1,00
m Ext. air film n.17 0.17
Sheathing -- 2.06
TOTAL R - 2.13 15.19
U . I/R . 0.47 0.19
SLAB ON GRADE
•'d, v'.G 1 l' /l••.
Heated Slabs:
Minimum R = 8.5
q; ..4. Unheated Slabs:
Minimum R = 6.2
o 4 w a¢ I
4 4 G :D
•;4. 4 Q 4• • Q.?••.
Page 3
U - 1/R - .043
U . 1/R - .040
CONSTRUCTION R VALUC
CEILING. SECTION (INSULATED):
1 Interior air film n.hl
2 ,""n. Bd. 1/2" 0.45
3 Insulation 12 Cellulose 44.00
4 Exterior air film (still) n.tt
TOTAL R - 4 .
U - 1/R - 0.022
CEILING FRAMING SECTION:
1 Interior air O lm n_hl
2
3
4 Interior air film still ().AI
5 inches soft wood
TOTAL R -
U- 1/R-
u
CEILING SECTION (INSULATED):
I- Interior air film 0.61
2 [ lm Rrl 0.45
3 Insulation 30.00
4 Exterior air film still n.t;1
TOTAL R -
U - 1/R -0.032
VENTED
CEILINr, FRAMING SECTION:
1• Interior air film o.Al
2
3
4 Exterior air film still n.61
S Inches Soft wood 12.6
TOTAL R - 13.82
U - 1/R . 0.072.
N/A
I Inside
2
3
4
S Outside air film n•17
TOTAL R -
U - I/R - __
Page 4
film n.A
Certificate For:
Ken Schoenike
3915.Eas't 43rd Street
Minneapolis, MN ••55406
DELMAR H. SCHWANZ
LAND RURVIIYORS, 1110.
R"WV" Undo, LM. M 7M SIM of MinnNeN
14150 SOUTH ROBERT TRAIL ROSEMOUNT. MINNESOTA S500
SURVEYOR'S CERTIFICATE
9?? Z
0
LOT 11 1
4
m .tot 39
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41
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'116.5
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-199.SI
--ore-«
790, 4
- JO
0
7-/G
N
St4//251750
Scale: 1 inch = 30 feet
o = Set wood hub
a = Iron pipe monument
x = Existing spot elevation
Q = Proposed elevation
I•DSWFi Proposed garage floor elev. 798.6
Tod
W Proposed top of block elev. '2yB.9
V1 I Proposed lowest level elev. 79,,03.
? NI
7
h
ii
f
h
l
35
f
BM: Top
m o e
man
o eet east
Z of east
lin e of Lot 2 = 800.92
yjoL.9 ?
? ? W /l 1 7
iFDv•'15g
'K kw
1184
PEVIEWED
BY S
OAT 13
By
Dace
EAGAIV ENGINEERING DEPT
S 8q -47 -S-7 F-
?o I iL
790•
$i 794.38 7`71.9L
RU5TIC _ HILL-3 Dp-I\)
Description:
Lot 2, Block 1, RUSTIC HILLS ADDITION, according to the recorded plat
thereof, Dakota County, Minnesota.
Also showing the location of a
1 hereby certify that this survey, plan, or report was
prepared by me or under my direct supervision and
that 1 em a duly Registered Land Surveyor under
the laws of the State of Minnesota.
Dated 07-06-92
as staked thereon.
DELMAR H. =
SCHWANZ E
- 8625 - f elmer H. Schwan
,Z Mlnneeets Rsol"on No. MS
O?
1993 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NEW CONSTRUCTION
_ ADD-ON A/C
ADD-ON FURNACE
DATE I -d I-q3
FEES
HVAC: 0-100 M BTU $ 24.00
GAS OUTLETS (MINIMUM 1 @ 53.00 EACH) Ce Ia.Oa
STATE SURCHARGE .50
36.?
TOTAL
SITE ADDRESS: I s-7 7 R q S-(c 4, Its Dr-
OWNER NAME: k'e"'A S C6 eLA t Kr- TELEPHONE #: 72 ! Y6 6;
INSTALLER: KeNN°e4-K SC ?ta??ti?°
ADDRESS:N ?Ct
CITY: ' IN STATE: Mn ZIP CODE:
TELEPHONE #: 72 I yo.6s-
SIGNATURE OF PERMITTEE
1993 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN.
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMMERCIALJINDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
DATE: CONTRACT PRICE: $
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1% OF RPNTRACT FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF ItitI FEE.
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:
CITY
STA
ZIP CODE:
TELEPHONE #
SIGNATURE OF PERMITTEE CITY INSPECTOR
L. c T 2--
10--x,'000-020-00 AND 1_- ._' _ - J
Ruz:tic Hills Limited Partnership
1565 Rustic Hills Dr.
Eagan,MN 55121
June 27, 1991
City of Eagan
Mr. Gene VanOverbeke
3830 Pilot Knob Road
Eagan,MN 551.21
Dear Mr. VanOverbeke,
RE; PROJECT 543R, SKYLINE ROAD OBJECTION TO
$1,059.98
We object to this road assessment since the
been assessed for road, curb and gutter when
that affects these lots. We believe the two
pay the cost of the roads that are connected to
,-arid not connected to these lots.
SPECIAL ASSESSMENT
lots have already
the road was built
developers should
their development
Please be notified that this Partnership objects wholeheartedly
and will further object to this assessment of $1,059.98 against
each of the above mentioned lots.
Yours truly,
%eA??
Warren M Anderson
general partner
Rustic Hills Limited Partnership
L ? BL D CITY OF EAGAN
PLUMBING PERMIT
SUBD. (612) 681-4675
RESIDENTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST
ADD ON
REPAIR _
OWNER NAME: KP?I Sr-hor,nikse-
SITE ADDRESS: 101r] Uric . IA.] QV•
INSTALLER: VnMf
!Qa???a.• ('piCR
ADDRESS:lSCi)l 1?01IL11TY''?7 ica, ZIKL -tCA,
CITY: ? ? iftyr?kA,6'?i9a.ZIP: Sffi5 S
PHONE
OF
TOTAL: S zl 7,nn
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS:
TENANT NAME:
SUITE #:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
ZIP:
CONTRACT PRICE:
1% OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL:
(SIGNATURE)
CITY USE ONLY
RECEIPT # O to S
DATE t3 /S? 90
ALSO, FOR TOWNHOMES AND CONDOS
COMPLETE THE FOLLOWING:
NO. FIXTURES EA. TOTAL
REPAIR/ADD ON 15.00
SHOWER 3.00
WATER CLOSET 3.00 ?e o0
BATH TUB 3.00 3
LAVATORY 3.00 t
KITCHEN SINK 3.00
I LAUNDRY TRAY 3.00 3,ta?
_ HOT TUB/SPA 3.00
WATER HEATER 3.00 5,rn
FLOOR DRAIN 3.00 3.00
GAS PIPING OUT.
f (MINIMUM - 1) 3.00 3,-Q,
ROUGH OPENINGS 1.50 1.5
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_ WATER SOFTEAR 5.00
PRIVATE DISP. 15.00
_ U.G. SPRINKLER 3.00
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CITY OF FAGAN
4Pil'
City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: toe -03
Permit Fee:
Date Received:
Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
Name:
K t& e -k& 3CIA 1:Z
Address/City/Zip: (S7 % RLSt1C
Applicant is: Owner Contractor
Description of work:
Construction Cost:
[:epk ce
Phone: 5( (�'i Ci 9 7C.
c:urcidcj e Door
(3o6 .c)b
Company:
Multi -Family Building: (Yes / No X )
Contact:
Address: City:
State: Zip: Phone:
License #: Lead Certificate #:
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:
Phone:
Phone:
Mechanical Contractor:
Sewer & Water Contractor:
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.qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and 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 Kee (4( 0 ev1t Ke
Applicant's Printed Name
x
Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA161137
Date Issued:05/07/2020
Permit Category:ePermit
Site Address: 1577 Rustic Hills Dr
Lot:2 Block: 0 Addition: Rustic Hills
PID:10-65000-00-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Kenneth P Schoenike
1577 Rustic Hills Dr
Eagan MN 55121
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature