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1654 Hickory LaneCity of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675-5675 www.ci.eagan.mn.us PERMIT City of En Permit Type: Permit Number: Date Issued: Permit Category: Mechanical EA075124 09/14/2006 ePermit Site Address: 1654 Hickory Lane Lot: 020 Block: 003 Addition: Woodgate 1st PID:10-84600-200-03 Use: Description: Sub Type: e - Furnace Work Type: Replacement Description: Furnace Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, 952-445-2840Lisa Lyons 122 W 3rd S t Hastings, MN 55033 651-437-0338 llyons@haleycomfort.com Fee Summary: Surcharge -Fixed ME - Permit Fee (Replacements) $0.50 9001.2195 $30.00 0801.4088 Total: $30.50 Contractor: Haley Comfort Systems 122 West 3rd St Hastings MN 55033 (651) 437-0338 - Applicant - Owner: Norman J Williams 1654 Hickory Lane Eagan MN 55122 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Applicant/Permitee: Signature Issued By: Signature VILLAGE of EAGAN WATER SERVICE PERMIT 372PMat Knob Road. PERMIT NO.: 3448 EEgaa,MN 55122 DATE: 4/26/74 Zoning: PUD No. of Units• Owner: Wbodgate, New Horizon 8 Address: Site Address .6S2-•54-56-5$ Hickory Lane Plumber Thompson Plumbing Co. Meter No.: Connection Charge: Size: Account Deposit: Reader No.: Permit Fee. pd I agree to comply with the Village of Eagan Surcharge. • 5© pd Ordinances. Misc. Charges- Total. By Date Paid. Date of Insp.: Insp • VILLAGE OF EAGAN SEWER SERVICE PERMIT 3795 Pilot Knob Rood PERMIT NO.: 2208 Ea4an, MN 55122 DATE• 4/26/74 Zoning: PUD No. of Units: Owner: WOodgate, New Horizon Homes Address • 1652-54-56-58 HHckOrY Lane Site Address Plumber. Thompson Pluanbing Co. 1 agree to comply with the Village of Eagan Connection Charge. Ordinances. Account Deposit: 10.00 pd Permit Fee: Surcharge: By: Misc. Charges• Date of Insp.: Total. Insp.: Date Paid. City of Eagall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 RECEIVED APR 151016 r Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Ne. 6 Date Received: IY' ?'5 1, Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date:"II-23-'10 Site Address: / if ✓ Y 11(G%f y L'J q�c� n Unit #: Name: Phone: Address / City / Zip: Applicant is: Owner Contractor Description of work: Izei ce tern 4' S Construction Cost.2, 5-4;C:` Multi -Family Building: (Yes / No ) /1,41///1=-4_(Pim Company: '' `( St./4p, I. C.- Contact: /4i t 1,41///1=-4_�- if/770-11.6r Address: 100 67/0- Abe' 5 city: /t-lr b State:/AP Zip: S -Y.%47 Phone:6r}2'£1-O'2gEmail: License #: (3G 70447 72 Lead Certificate #---/-- Z- /' CP If the project is exempt from lead certification, please explain why: /2/5 7- A- &b PA -0/ TM ..g4 -71&/Z COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: Fire Suppression Contractor: Phone: 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.gooherstateonecall.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 f1(cha4 64)/(Ve"- Applicant's Printed Name x A. • Iicant s Signature Page 1 of 3 /6 s / ; SUB TYPES Foundation Single Family Multi 01 of _ Plex WORK TYPES New _ Interior Improvement 4_r{ / DO NOT WRITE BELOW THIS LINE Fireplace Garage Deck Lower Level Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100% Census Code # of Units # of Buildings Type of Construction Move Building Fire Repair Repair 1 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Roof: Ice & Water _Final Framing 30 Minutes 1 Hour Fireplace: Rough In _Air Test Insulation Sheathing Sheetrock Fire Walls Braced Walls Shower Pan Reviewed By: Porch (3 -Season) Exterior Alteration (Single Family) Porch (4 -Season) , .4-." Exterior Alteration (Multi) Porch (Screen/Gazebo/Pergola) Miscellaneous Pool �:.; Accessory Building Occupancy Code Edition Zoning Stories Square Feet Length Width Final Siding Reroof Windows Egress Window Demolish Building* _ Demolish Interior Demolish Foundation Water Damage *Demolition of entire building - give PCA handout to applicant X14.- / MCES System ) i SAC Units City Water Booster Pump PRV Fire Suppression Required Meter Size: Final / C.O. Required Final / No C.O. Required HVAC Gas Service Test Gas Line Air Test Pool: _Footings Air/Gas Tests _Final Drain Tile Siding: Stucco Lath _Stone Lath Brick Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Fire Suppression: _Rough In _Final Erosion Control Other: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL AJY Page 2 of 3