4812 Slater Ct . ..
, -:.. ,,
` Ct7Y 8� „
3830 Pi1��i��� ����- . _
� ,.,,,. :
!E � "
,
P.-U.Box 217� � s ,5�1��
� ��.�_�ta� �'��.: �s�� �
C
, � �Otfillg;� � °�.�,'. � . � � �'+��� �,� r.
Owner, X���` ��t��BR N�bf Ur►lts; �
;
Addres3: ` <_ , ;
� /�,e�; �4�I2 �1��� ^�surt Z.7 ��, �
W+,+mber. ���� �3cie� �.�u��iz� ��t� i� �' d$ �
Meter No:
� Stze: C�tion Ch,m�; '�"i� +��� 3;
Re°d�r IV�,-. '4'coa+nt Depoadt:_�Y�.t3��ct
��•a�ta ' PYir+rtit Fe�e: tt�.(��
;. p�a��ene�,°01b�lr wt�'e�R+C�r�f e�, �,�� .-�.,`�..-------�-�-�....____,' :
AAtat. Ctr�r�es; — I5b {}� �p �
BY TwCd:
, �ta af:Ir►sp,; �� PttFtl: ,
�.: -'
, :;
_ � ���`� '��� - �
C1TY 0�E�CaAtw1 ' . ��7 hK�:. ' � . , �
3�Rilot K(i�ctis Ro�d .'�.,�' `�._ ;
��P.t�.Sc�c 2'�#� � �'�E: � ` � � ;
Eg�n,t1AN �"121 �,of thats: � �
Zor�i�+D: > '; "�
Ownec
_ �
/�ss: � r . ,
S�te ��� �.t?A.�d��, ,
Wumber: "��Uu+��i'�'�"'� ����,.,���
t e��ru ta oo�OM'�'- �,�t �� �
Os�M� pae�+�i" F�s: .�.�.�^^^�."""'`' y;
Su�: ,--•�-----'
�. Misc. t:t+o� '.
By Tat�i.
E1ate of {e+sp.: pr�e Paiej: ' c
t+�sp.:
}
�_ ;
���. ,� � �
..,
���` ;��
,Fj.
�� :,, ,,.
� ` � * r
rt. � � � tz�'�;a �
i'"c' r�,=�.�:
k�i
��
��.a
¢,�.._�..:
-
..t.�' .<.2 , ,
� �,. .:t CITY OF EAGAN ���� �+����
�-p �� �� � a 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH�NEt 454-8100 i . `
BUILDING PERMIT Receipt# ` ` � ' ' ''
To be used for S�° �3r3€.x�G.�lR Est.Value ���+��� Date ��'������' �� ,19 ��
Site Address -- ���-� SLATER �T Erect � Occupancy R�
Lot 7 Block x Sec�Sub. �I•����I�� ����model ❑ Zoning �� '
Parcel Na Repair ❑ Type ofConst. �
Addition ❑ No.Stories
W Name H(�I�f�: �:�aTA�`�S IiSTG Move ❑ Length �'?
3 Address �`��'� �' B[.1.tZP`1SVII+TiF. PK61Y Demolish ❑ Depth '�o
Int.Impr. ❑ Sq.Ft.
° City �'�'��+�+�hone ���""�S'�6 mstall ❑
a� ' Approvals Fees
o Name ��''�' ��� ��
�� Address Assessment Permit �` ��$'��
'' City ,._„., Phon�., Water&Sew. Surcharge ��•'�d
�� Police Plan Review ���'��
�W Name Fire SAG �7�'��
_� Address �'��•��
� Eng. Water Conn.
<W City Phone Planner Water Meter ��'��
Council RoadUnit �g�'�Q
I hereby acknowledge that l have read this application and state that the B�d9 Off. � �� � Tr.Pl. ��S•��
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances. - APC ParkS
"° � Var. Date Copies
Signature of Permittee ` '" `"�-' TOtaF "e . •�a
A Building Permit is issued ta ����° '�''������`�' �k�� on the express condition that
all work shall be done in accordance with all appli�able St�te of Minne�o,t�St,atutes and City of Eagan Ordinances.
Building Official l', p' � ,,�. ,�c;�,- r �
' �„
� � o v n a � � � g a � �o � T T T g m m x �
� ,� m m w a � 3 a o 0 o m o 0 o M o ,� � �
v, = x �' ? m °' °= v � m m = 3 � = � w � � a s�3
�^ � r o r � x d s s � g a > > » o , Q f
M '� 3 �e � � Q ro A 2 y m m m. m� m� o A ei C7� m
Ip o� �C m � � — — 7
�y � � 1 \ \ O "=-� O ':. e-'�` `.� �
� � ,. � v � �
V '�. � � � � � .`, '° L..� t;� � � O
d`. �. .� z W
.,4 r} � o `
�.,_ �. ��..,; . �
, � "'' t�:; a G
� � � ��
_ � .,,.
7 f�,r. �
�, M � ��
R
�'�l 9� ��� t 'U d v
S F
` � 1` � }. ' 3
� � � � �, _
� � � � �
��� �� �
� � °
� �
�- 3 �
.�. �j. \
� r.�.�:. ��` .. � o �
6 A � `:;y:" �� \ � V 1
N �
;� a 1 �, �`' o
� � fl r,� �
�� W
;° �
, �A� t�,� o
� r, ' 7
Y A
V
,. ;M .. _, `��'.;"'L`.�' i}'�.',"y';r^,:``"s "-'.'"��" � �.�" �», n-r;�,.. a. ,
.. F<:
„� e PERMIT# ���"�I'�/? . .
, PLUMBING PERMIT RECEIPT# `����^ �
CITY OF;EAGAN
3830 PILOT KNOB ROAD,EAGAN,MN 55121 DATE: `9���. - =' v'
CONTRACT PRICE: PHONE:454-8100 .�
Site Address `'� `'� } - '� BLDG.TYPE WORK DESCRIPTION
Lot �/� Block �Sec/Sub �
:F.�.� ..e ' � , _ ��4> Res. New �
� Name ` t=� ' z.�`�`'' ug; ``�.° ` Mult Add-on
� Address��� f - t{" �`� {-�-�"� �` ' � Comm. Repair
c City c ,f�.�`.<< �ci^ Phone } Y�� �`��-�� Other
_ ,
;
NO. FIXTURES OTAL
� ,�`��`-i.�_�� '- ,(_r�.t�<� : �-�-rL�� , � , . �_
Name �_Water Closet-$3.00 �
3 Addr2ss °� �- `� ''�< ;�r K� �t . Bath Tubs-$3.00 . `- C
p _ :Git�,�.f;'<..� _ : �.�.�..e..C.l;: Phone � ��.� _ . �j� {.�vatory;$3.00 . . � _:.
� ' Shower-$3.00 ��, � C
FEES --L—Kitchen Sink-$3.00 -��� �-
COMM/IND FEE- 1%OF CONTRACT FEE Urinal/Bidet-$3.00
MINIM�IM—RESIDENTIAL FEE -$10.00 �undry Tray-$3.00 -�- � -
MINIMUM—COMM/IND FEE _ 20,0p Floor Drains-$1.50 ��`� �-
STATE SURCHARGE PER PERMIT .50 Water Heater-$1.50 �-�='��
(ADD$.50 S/C IF PERMIT PRICE GOES Whiripool-$3.00
�-Gas Piping Outlets-$1.50 '-� �-
BEYOND$1,000.00) Softener-$5.00
Well-$10.00
; Private Disp.-$10.00
- � _.� C� �f._._,'�.r;� �Rough Openings-$1.50 ,:..a�.
SIGNATURE OF PERMITTEE FEE: --��•�� -
STATE S/C: . S i
FOR:CITY OF EAGAN GRAND TOTAL: ��� ` � ��
;�.- �-;��
! ' PERMIT# "
' • MECH/kNI�AL PERMIT RECEIPT# ' � ,�
CITY OF EAGAN r
3830 PILOT KNOB ROAD,EAGAN,MN 55121 DATE: r-�•s�- �y � 7,'�y�°
CONTRACT PRICE: PHONE:454-8100
Site Address � �f �` '����'� BLDG.TYPE WORK DESCRIPTION
Lot�_Block �Sec/Sub
c •,� $ �. � ��,,.
' Res. � New
� Name r:�� �- `'�'�--
�� Muli Add-on
m Address `'t1'�j `'�i�f� ������� �-✓ ,
.. -��-=—��'' r,. .,.� � Comm. Repair
c City �,�t�i�+ ��f1 l��� Phone �C-' -
- Other
Name ���t `` � �'- t r f��� FEES
, , y
c Address ' z '-�' ��!� � f f!�5 '' �" RES.HVAC 0-100 M BTU -$24.00 '
3 , , „ . _
p Ciry �-'ti���N����-� '� Phone`` {-� �-�-��' ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
ADDITIONAL 6 M BTU - faA6-�-�r
TYPE OF WORK ...� �sJ , GAS OUTLETS - � 1.50,EA:
Forced Air ��% M BTU '� COMM/IND FEE- 1a/o OF CONTRACT FEE
Boiler M BTU MINIMUM—RESIDENTIAL FEE - 10.00
Unit Heater M BTU MINIMUM—COMM/IND FEE - 20.00
Air Cond. M BTU � STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD$.50 S/C IF PERMIT PRICE GOES
� ` BEYOND$1,000.00)
Gas Piping Outlets# � r
Other �
�� �� �
FEE: �,5. °'.. i' ,,� % �.`(,c.�[-�'
}� SIG ATU E OF PERMIT�'
S/C: `
r '
TOTAL: ��>� � � � � �
FOR:CITY OF EAGAN
CITY OF EAGAN
� ' 3830 Pilot Knob Raad, R.O. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT Receipt#
To be used for - Est.Value Date ' ,19
Site Address OFFICE USE ONLY
Lot Block Sec/Sub. , On Site Sewage Occupancy
MWCC System Zoning
Parcel No.
On Site Well (Actual)Const
¢ Name �"���� � City Water (Allowable)
W PRV Required #of Stories
� Address ' '" � �
� City Phone Booster Pump Length
Depth
°C Name � S.F.Total
. o
o Q Address Footprint S.F.
U
� City Phone APPROVALS FEES
F� En r/Assess. Permit
.
W W Name 9 '
_� Address Planner Surcharge '
QW City Phone Council Plan Review
Bldg.Off. SAC,City
I hereby acknowledge that I have read this application and state that the Variance SAC,MWCC
information is correct and agree to comply with all applicable State of Water Conn.
Minnesota Statutes and City of Eagan Ordinances. Water Meter
Signature of Permittee Road Unit
A Building Permit is issued to: Treatment P1
on the express condition that all work shall be done in accordance with all Parks
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official TOTAL _
v � v v � n W � � � � � � � � � � � � � m x v
� m` ,,m m � m a > > � c o 0 0 � °c o °o v ° m < c
p = � � � w cQ m w � — � � ° 3 � .. .. � � � D� 3
� � -n O �t � 2 w 3 � ' � m � co � � � (�
�° w � � � �',� � � m � � `° f° o f� (� � � co
— — . cn �
�`� m 3
�
Z
� 9 0
m
3
�
x
0
a
m
n
0
3
3
�D v
w �
�
�
A
v
�
0
0
�
#
� , �. ...v . � � � � ;
C!�'Y @��EI46i4AI � ��t� `
�l'hispe � W�t�ds .� ,� � ��
adtlition r i�'i �,ot 7 �t��,.,„.—� �,�.,�.�.,,e,�.
�.a.,„ ., , .. ,.
���fi s��t �i6�,'� �1����r� ����� ,��� � - �
u._
Irriprflvement t)st� A►�ssurwt ASnn� �r'�t., :rv�, t3�L�-:
STREETSURF. -. � . ,� �, �� �
,:�a j , ;�E1.
STREET RESTOR. -�, -
faRADINIG " �`
, £ .
,� -
. r
� �- � �� .,�, z_� �� � - .r
, u
, .
� SAN�SEWTRUNK ��� • ��� � `- � :' �, � � F �-� " ���
�
SEWEFi LATERAL L �
� `WATE[�?filFA1N � � � � � ��� � � � ` ' .
. n„
�-
- ... , _ .-
���� {!VA'fER�LATER.AL �� _ �� ' , �.� ° � . �> �
- �� � , ,; �.. `. � � _ :,m, . .
tfltAT�R A#3EA •
� STORtt�l�SEW TR�K� � � �� � t
STORM SfVd�AT , >
,
,
,. : � . , ., ,
� �L1RB$t GUTTER - _ � �
51[3EWALK �.;; , =F
_ ,��.
STREET LIGHT ` ' �
.
� � ; �. � �:
� � , �;. x .
�"
� . ��
' .,
��ft�ATER CONN. � , °; � .: •; , � -
a , , ,, .�.
� �. � ��
, ,.z� ._ �
. �UILDING PER.
SAG � � -
PREtK �
.. �
, �
, � r
�. ; .� 4 ...,�� � , � ��� �":
r
�. �.. � _' ., s'- _ » , - , afi,'+ . .F:' < < � '�
e . � � ' . �� S . �-.
� . . . . , :: , : .
.. , . . yy,.. `n n.. .., . f"<'�:;i�'3
_�- 3.
,� � CASH RECEIPT
� CITY OF EAGAN
p 1 3830 PILOT KNOB ROAD
EAGAN,MINNESOTA 55122
,, DATE 19 ,
RECEIVED . . � � .
IFROM � .. �.� ., ,.,<__. •
. � .�s"'�� . .
AMOUNT � (
�,� �
� � &� � DOLLARS .
foo
❑ CASH �,�.-CHECK
.. FOR . 'm� t " `. �, � .' " .
�
� � � • � ,
� . �� � . � ' . .:..� r .
. FUNb:.`.� �� � CODE � AMOUNT�� �
Thank You
B�:
� ,.,
`'� 7 y' :� �
White—Payers CoPY
Yeliow—Posting Copy
Pink—File CoPY
BLDG. PERMYT N0. ���_� _
,�. C-lJcx���;
� � .
01=3210 .lBl�g�Permit . �� �`-ci
01=3422 Plan Check
01-3445 ' Surch./Adm. 7�
Q1-3446 SAC/Adm. �
01-2155 Surcharge
17-3860 Road Unit D L'-v
20-2275 SAC � u
20-3865 Water Conn. ��v� ``�
20-3868 Water Trmt. � -r,�
20-3716 Water Meter � �S �
20-2252 Acct. Dep. _-_!�
20-3713 Water Permit
20-3743 Sewer Permit '
79-386b Sewer Conn. IG--U ��'
11-3855 Park Ded.
�
TOTAL c�� p c
• � CASH RECEIPT •
. � CITY OF EAGAN
' 3830 PILOT KNOB ROAD
EAGAN,MINN OTA 55122 �
p T '. �O 19
REGEI V ED
RROM � � °...
AMOUN $ y ;j I�
fJ J f]
& DOLLARS
�oo
❑ CASH CHECK
FOR
(�-�--�� ,
'��� �... .� .
�
�/f/-��// _....
( �/ �
FUND GODE AMOUNT -
� v�
/o ''��/
!
G
/ / 1'
�
U �-- r' � � �/�c)
�� � � ��
Thank You ���� c���
BY
N� 67022' ` -
White—Payers Copy
Yeilow—Posting Copy
Pink—File CopY
This request void �/�/��- �G cl�,��G
18 months Trom
� .l-,.3�.7 �- � ;�'/ L�.,�' z�'f�c y�, �!U� '��a'f•G G�
Request Date �� Fire No. Rough-in pection
� Required?� �Ready Naw Will Notify Inspec-
�` es �{Va tor When Ready
Licensed Eiectrical Contractor I fiereby request inspestion of'above
❑Owner electrical work insialled at:
Street Add s, eox or No. Ci�
�'�/� e���� ,��
eciion o. Township Nart�e or iVo. Range No. County
Occupa t (PRINTi Phone,N�.
Power Supplier `����� Address
Elect�'r I ractor 1Gomp Name) i Contractor's Cicense No.
r
� c3�
d (Cont ctor or Owner Ma ing nstailation)
� � ����� .
Authorize ignature tGontract r/Owner Making Installation! Phorte Number
� �� � �
MINNES07A STATE BOARD OF EiECTRIGITY THlS INSPECTIQN REQUEST WILL NOT
Grigga-Midway Bldg.-Room N-197 BE ACGEPTED BY TffE STATE BpARD
182T Universitv Ave..3t. Paul, MN 55TQ4 UNIESS PRpPfR INSPECTION Fff 15
Phone i612)6s12-0800 ; ENCIOSED.
. � � . . � . � n. f . 1.
. . . .. . . . . .. . 1 . _
. . . .� . . . . . .. � . . .. . . .. . . . .' �: � �. . .
-. . . .. . ._... . _ _. . � � _ . � . . .. . �,`�: .
. � . _ � � . �� . � � - .
. . . � . . . �1i
. � '�..' .'��: . . .+. ...:, � . � . . .
� ..�� M; . � . v ..�. - .
. . . ..: . . _.
.
� � F 1 ..� .. . .. . .:. . . a i.- .
. . � : . � �'�. , '''.:.�. : � . . . � . � � . s �.'. . �
. . � � .+ � : �. . . . ...._s � i .. � ` . . ..�
//l/y7 REQUEST FOR ELECTRICAL INSPECTlON_y � es o/000�/os
�See instructions far completins this forlfror�back of yeltow copy. �`��"�'60
'"'X"" Below Work'Covered by Thrs RequesF ��L'°'D
Add Sep• TYpe of Bt�ildin�g ApPiisncea Wired Equipmeni{Afired
Home Range :Temporary Servree
DuplHx Water Heater Lightiii,y fixtures
Apt: Building Dryer Etectrie He�tir�
CommereiaJ-6ldg. Furnace Sito Unloader
Indusiriai Blcig. Air Conditioner Bulk Milk Tank
Farm' Otn�:r ve�� y Otner Isne��fy)
t .r; �eci y ther <Other
ampute lnspe�icon Fee $elow '
lt' Fee ServiceEr�ranceSize' tt pee Fee¢ers/Subfgede�s # Fes Circuits
U to:200 Am s 0 to � Am s ' � to 30 Am s `
Above 200_qmpy 31 ta 400 Amps '�' 31 ta t�0 A
Swipimin Pool Above 1�?_Amps Above 10Q_Am�s
" TraFlStormers rri` tFon Booms = 'Partiakr'Other Fee
err,�rk� Signs Special Inspection g j �� TUT kEE
�� ��
Rough-in { Date ! �,the cat
� j -. 7.,f ,_Inspector, hereby.
� � �`� .certify t�hat the above
Fin�l � �)te�� inspection has been
„�"� ? made.
This request void 18 mOnths trom
_ �, ,
, ..
, .
� , ;., _ ,
�
- : � . = ., , : �
__
� : .. - t.,-;: • :..
, �_,
� _
'�o � .
� . .
,
��� ;� � ���E � t � ���
. �� •
�e�,�.,� ,�;.,��. .�x -,�
CITY OF EAGAN t�'p
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 �v— . ���O�
PHONE:454-8100 /�,����
BlJ'ILDING PERMIT Receipt# ��Y
To be used for SF DWG/GAR Est.Value $7 6,0 0 0 Date SEPTEMBER 3 0 y 9 8 6
SiteAddress 4812 SLATER CT Erect L� Occupancy R3
�ot � Block 1 Sec�Sub. WHISPERING WOOD$temodel ❑ zoning P1�
Parcel No. Repair ❑ Type of Const.���}
Addition ❑ No.Stories
¢ Name HOME ESTATES INC Move ❑ Length ��
Z 2 0 0 4 W BURNSVILLE PKWY Demo►ish ❑ Depth �o
3 Address Int.Impr. ❑ Sq.Ft
° City B'VILLF'phone 435-6556 �nsta�� ❑
o Name SAME Approvals Fees
�� Address Assessment Permit $ 3 61.0 0
� City Phone Water&Sew. Surcharge 3 8.0 0
�� Police PlanReview 180.50
�W rvame Fire SAC 5 7 5.0 0
=Z Address Eng. Water Conn. 5 0 0.0 0
�
a W city Pnone Planner Water Meter 63.50
Council Road Unit 290.00
I hereby acknowledge that I have read this application and state thatthe B�dg.Off. 9/3 0/8 6 Tr.PI. 15 6.�l�
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of E an Ordinan s. APC ParkS ,
Var.Date Copies�
Signature of Permittee TOtal 2����
A Building Permit is issued to: HOM STATES INC on the express condition that
all work shall be done in accordance with all a p' bl S te of inn S atutes and City ot Eagan Ordinances.
Building Official
�
CITY OF EAGAN N° 'I 5 2 4 �
; ' ' ' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 � �� / „�
BUILDING PERMIT Receipt# lSl
To be used for DECK Est.Value $1,000 Date JliNE 23 ,1 g 88
Site Address 4812 SLATER CT OFFICE USf ONLY
7 1 WHISPERING WOODS On Site Sewage Occupancy
Lot Block Sec/Sub.
MWCC System Zoning
Parcel No. On Site Weli (Actuaq Const
a� Name M�RTIN & JULIE ERIGSON City Water (Allowable)
z Address 4812 SLATER CT PRV Required #of Stories
� City �AG� PhOne 890-Q870 Booster Pump Length
Depth
¢ Name SAME S.F.Total
, o
�Q Address Footprint S.F.
� City Phone APPROVALS FEES
~� Engr./Assess. Permit 2�+•00
�W Name
_� Addr'eSS Planner Surcharge •50
Q W City Phone Council Plan Review
Bldg.Off. SAC,City
I hereby acknowledge that I have read this application artd state that the Variance SAC,MWCC
information is correct and agree to comply with all applicable State of Water Conn.
Minnesota Statutes and City of an Ordinar�s. �J Water Meter
d /
Signature of Permittee G,ciL4..( '�'( �[.�G..�Q'�, Road Unit
A Building Permit is issue to: M�RTIN OR J[iLIE ERIGSON Treatment P1
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and Gity of Eagan Ordinances. Parks
TOTAL Z�F.50
Building Official —
,
_
E
` � � j
�
1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL CONTRACTORS 1�4UST BE LICENSED MITH THE CITY OF EAGAN
INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
r 1 S�FT OF�RGY CALCULATIONS
.Q�av �'_'_ q �
To Be Used For: Valuation: Date:
Site Address: �g�2 ��jrT'� ��'� OFFICE USE ONLY
Lot: � Block � Sect/Sub W�� (.��et � Occupancy 3 �
� Remodel Zoning �
Parcel �� Repair Type of Const �
� °� Enlarge �� of Stories
Owner �,� ��=��� 1',.�5 Move Length
, . ` (� Demolish Depth ,��
Address o��V � �v► 1 fl C��� Grade Sq Ft
C i t y/Z i p Co d e �u:CZruSv �� .� �'1 W ------------------------ ---------
Phone �� ���, gPPROVALS
Contractor �,p,�,�y�- �.S �.bo�,� Assessments Permit
, Water/Sewer Surcharge
Addres
s
Police Plan Review 'SD
Fire SAC ��"
City/Zip Code Engr Water Conn ��
Planner Water Meter G . Q
Phone Council Road Unit
Bldg Off Parks _!c�
Arch./Engr. APC Treatment Pl I
Variance �/
Add re s s TOTAL .i��O'T `
City/Zip Code
Phone ��
7 �� ��
.
�=•,
�t.4 Zrs� �1��o � S`b � ri�l��� _
�
-t,� �c 2''S = 5Z a � ►2 � 6'3� �, _ .
�.
���
7�'��;� , C�
�
�
_T
,
_ ; ,
�' ; t,`
�- , `'�'
•.� t,�
�`� � ��. '
� � ,�'� i= •��' " ��'
�� � � �� �0
J ,.; ,y� �,
� � � � ��
. . �' �� �
. �� ;;�� _ ,�,u .
� �,�
- . ,; �� �°' ��
, �`� �
� ,���� �� �`_ �sy
�ar � �, ,� �
.i ��J �c°��; ta" `�✓ �
s
�
�„��ji � �,u S;9�s, g . ��
�t 6A �
Y,1� + v'� �„`9��,� . ;' . �
.c'',�y;� �j`� ' '�� �
9 � , , � �Y�, �,;'�"
_ ��,�o ��,� ,,o ;
. 5��� ,,� ge` ,a �9„
s� __ ,�a 9:�; '`�; � y,.
9� , o o= � o yo �- ,
,�:r�.s� y��� Z ��� !` � ti�� ` � r ?s-�� �v ,
�
G+ � � ,�
O � � � 0` � .�o�� s + �� ��',b
�vt I�n , ,� , \��� ! r� s� � ,
�� ,z `�.� �,� s _�', ��\,o r� 9�1,0��► ,
� h• y �t� / �, 9 qo.v �.
� � � �/ � �/ �� /�o �XES i 9�'O
,Ny o, ! , y<< �0-° J�' ' � f �� �I 9�s,d ,
��, � /� � �
1 ,,O ��/��•� / �
"16
�, � �0
�i
1 � �,� �- ,�,� �
/ � � � � � � ..
l }; � ' � ^� �/ �` . .
v G/ /
�..,� �O 1 ,�'o�� �`�'���1 � •'�
-�.`� �'� ��"��� /4���h I
ao� \ ;. J ` � \o r�.�'
.
�
� � � �
.
5
l .
�
�1 � _
�r'�yK 9��� yL - -.���� ""'�—P'�P��G(U -
` q�� ��
0 33 00 �,�,y� 9S�.o W''f� '7� �►4ot.tL. �
�V 83 03,��,,���• �,� y 1N�11SA6�tt�►�. v►toc��� .
D�d�r�» __toV�y� __:_._-- _
_ t�n�M��S c�+rA . _ -- _
NaCL'fN_ __: _
,SGA�I.�_ t u : 3 0`
� RE�21�tt�, p�t�n,�D ,
n D�faaY� �Q.eµ nno�aUM��T
I hereby certify that this survey was prepared by me or
under my direct supervision and that I am a duly Registerec�
Land Surveyor under the laws of the State of Minnesota. �
D a�e:�4•/ � l�1�l� .� , , ,�-� .-�.•�'"�____
LeRoy H Bohlen
Registered Land Surveyor No. 10795
: �..,.�a . _ __ � _____
__ _..�.... .�... ..�....„,6 _ _ ___.
' �,~� � � EXTERIOR I,NVELOPE AVERAGE "U" COMYUTATION �
(To be submittc�d with buildinc� permit application) 1
One or two family dwelling � Owner J�,��}.a 7�/2- �'/��,
All other
Site Address �$"/'L �i,�f�. G��c�"
Contractar ��J�(/�' f S ��?��`�,� .� ,� ' c Date� �� Phone �%�S�` �i S.Sr�
LINEAL FT. OF
EXPOSED WALL + + + + + + + + above grade = lin. ft.
TOTAL EXPOSED WALL AREA
OPAQUE WALL COIvsiRUCTION: "U" value x area '
5,���� � �L,4'..� ��U�� �a� x sq. ft. /��, � = i6 . a�7' (v) GA>
�t�c� �_.�At.C.__ ��U�� 64 x sq. ft. r�/3? �= �0�- ��/ (U) (A)
Detail reference G�.l.r� la_i"�� "U" ��?_x sq. ft. �3� . ,�j = �''j s� (U) dA)
from ;- p���'� � ��U" 0�9 x sq. ft. %.,<;,/, Z = �. I fU3f �`�)
attached s�ieets � "U" x sq. ft. _ (U) �A)
��U�� x sq. ft. _ (U) (A)
,�U�� x sq. ft. _ (u) (A)
WINDOWS: "U"' value x area d
Make & type C- a o c1 ��U". SS- x sq. ft. /.`i.3.��i= $�.a0 (U) (A)
" " � ; �, \,d-� ,�U�� �s` x sq. ft. (L„ I i = �_..�� (U) (A)
�� �� ��U,� x sq. ft. _ (U) (A)
�� �� . ��U�� x sq. ft. _ (U) (A)
DOORS: "U" value x area
Make & type ��_ ��U,� ,-��7. x sq. ft. r�,?"? = `�,�� (U) (A)
�� �� 5C -r C o�, (5' ��U�� ,.,�_X S�I. ft: ?�, o� _ ,a (U) (A)
�� �� ,�U��� x sq. ft. _ (U) (A)
„ „ S a1b�—Sq. ft. / , � (v , (U) (A)
TOTAL (U) {A) VALUES - , (�� AVG. "
DIVIDED BY TOTAL WAL REA ���'7.
.17 Avg. "b° Value, 5tate de
1tOOF/CEILING: /
TnTAI, ARI•:1�: / c=� ,
Uetail retei en�� - — `-- —____ . _ � �� �� � '
�..".Q.�� ll .Oa$� x sg. ft. I � •� �� (U) (A)
from �c�r�tQ "U" .e�� x sq. £t. S�� '" � `'// (U) (A)
attached sheets. "U" x sq, ft.^ _ (U) CA)
Describe openings "U" x sq, ft. _ (U) (A)
in roof „��� x sq. ft. _ (U) (A)
ToTAr�s / ��� sq. ft. 3�7.-7 (u: (�,)
TOTAL (U) (A) VALUES =
�J AVG. ,� ��
DIVIDED BY TOTAL ROOF/ ��� f�' � � I
CEILING AREA Avg, "U" V , tate Code, Vented
. Value, State Code, tJnvented
ti:�..:::ES�TA c::1EFtGY C�i�. ��IAXIriUM THIS BUILDING ESTIMATED
BTU LOSS THIS BUILDING BTU LOSS
SQ. FT. OPAQUE WALL @.17 = '
SQ. FT. CEILING @.OS =
SQ. FT. UNVENT CLG. @.10 =
TOTAL BTU LOSSIHR:ISQ• FT./ . . , __ , . .
DEGREE OF TEMP DIFFERENTIAL = .
----_ ._-------_ _ _ _. _.___ __ _ ___ _
_. _. .___ ._ ,. _ __ � , �
- - -- <�•
• � .
WRLL SECTIONS ��U° = 1 2
R
NOTE: Use 10� of opaque wall area for
frame construction Construction R-Value R-Value
. "�/' O
1 1. Interior air film 0.68 0.68
- -- --�2� 2. ✓J,�� �`i� f�a _, i!�'..
� • � 3. �sinches soft wood �,g�g'
. �__.-O
4• '�,.'� r3,�tr;� �-2�Z..
--.-� 5• f'1�!o4-5a.�zTf 5��''�S',z, � - $L
RASIC ___ __� 6. Exterior �ir film 0.17 0.17
ti";ALL - Total �p.�5
__Q
��U�� = l = ���' ,U�� _ 1 _
1'��•:ra —
FIG. #1 TOPL"IEPJ OF 1. Interior air film � Q.68 ' 0.68
FRAM� V'1ALL 2. / :, �; �!j �
3. ��,n S wL._ �'/ ,L J y�,�,
-' 4• '/L" 13�N-T+�-� /-zz-
I S. iNA.ic�.:y��-� ,. 82.
FIG. # 2 -� 6. Exterior air film 0,17 0.17
Total z�2 78
�
; � ��U�� = 1 _ �y3,�U�� _ 1 =
.?�,7�' ,
� r-.� 1. Interiar air film 0.68 0.68,.
_ ----- � 2. S'J/z �` ;Tn�swi..A-TZ.r�.� �y Gc+
sill sealer i �. /�Ci" �!�_r�._ Jbis7` i-y�
' �� -- 3� 4• '/�; �� C-S, (t-Q;t�; /-�2
YeripheraZ � , —� 5• 1'►���7"T� . �'L
Floor '�all � 6: Exterior air film 0.17 p,�7
. � Total 3, 7�
Q..q. .�,` �•� nUn _ l - 0�.t nun _ 1 _
:r 'O � � �zrn °
.o'.
, , —{� 1. Interior air film 0.68 0.68
� o . : �. ^.
. � ____.._..�:____� ?. .__.�� _^����_L.4rtr_�___,._.�•ea
i�,�,�r�n��n�r i�,N . , ��, ,3. _.
�rtAL�L ° .� .�o ''a 4. `i.>ti/CR� l�C.L(:� 'o�.��
.�D •� o '��RA��E.i , 6. Exterior air film 0.17
�b� ��. � o.i�
��� �"� Total /'i.,.�
��U�� = 1 =.0�:.`) ��U�� _ 1 -
SLAB ON GRADE ��3
� � . � . . . . .i , ,N- ' �• . � . " . 'J • . . . G.
'D �?!^ �}� ' ' .� , • � . • Ca. ' . .'� • . �
� a � ,� � . �_e, , G�,qo - ;� ! _ a . '� : • ' . .
Z a � � �t .� . t l l - = i� E �--�=�►1 - � . � - .
o . . . � �_.4l_ I . : : . . � - . - -.
�, � � .� ° i i 1 = I(I � �' � . :
. � � � , , - � Q . � . .
FIG. � 3 � `� . . - •
_y,
a • ,
, .o ;
�� ' ' NOTE: Indicate type, "R" value, depth and I
� � G ' ' � ' �� placement of insulation.
• `� G ' . _ , o , • o
� . . .�
v _ � _ ....� _- _ ____�w ...__..,..._...._.�e,�
q . -
3
ROOF/CEILING ��U�� _ 1
� ,
Construction R-Value R-Value
, . ,._.
3 1. Interior air film 0.61 0.61
^ 2- I�2 ��" � [�� �s
3• TWSi.LL.�}''t'Tv�Y /2.`7,�f'•, � �,c�7
4. Exterior air film (still) ' 0.61 0.61 '
v�NT . :39., �7
Total
� 2
,�U,� = Z - ,��^" �,U„ = 1 -
- ---.�, -
� ._. ,
a�v7
Heat Flow Up
Vented
� 1. Interior air film 0.61 0.61
# 5 ,��
FIG. 1 2. �/� " �'��S��rz� �j_ .'f�
� `t' 3. Cord Depth .Z�(� � 35�"
4
FIG. # lf>C_._ ---) 3 4. 1�1ISw�-�TT��N �,.?� �9��+lJ
5. Exterior air film (still) 0.61 0.61
- � 'rotal 3�',G1.
2 1 1
� 1 „U„ _ _ .,e° "u�, _ _
3�.�L —�
l. Interior air film 0.61 0.61
� r 2� .
S 3.
�J � 4. Exterior air film (still) 0.61 0.61
. ._ _ . - _ . .. .. . .. ..... .. . .. .. . .. . .. .. , .
. . Total
�� 2 3 4 ,,�„ � 1 _ „�„ = � _
Heat Flow Up Vented
FIG. # � �
3 ¢ 5 � `�� ` �,
.; , .,:
:_-
. , l. Inside air film 0.61 0.6T
� ' , �� f'. � .,�' 2.
�-` , ., 3.
'� �
�
� 4.
��;, 1 2 5. Outside air film 0.17 0.17
. Total ,
NON VF,NT� �
1 1 �
��U�� _ _ ��U�� _ _
Heat: .
F1ow Up
FIG. # 8 NOTE: Use additional sheets if more space is
needed for details and calculations.
�.�w� a .,�,�,..t,.��,� ..�.... -�,�.. s .
,r..........�......�..,.. _
�
., . -
� ` _. _.._
4
Energy Use Form
Date
Estimate No. Customer
,.. .
�tv,
A method to figure "U" values for walls and ceilings to conform with State of Minr►esota
new code "Energy Conservation in New Buildings, Additions and Remodeled Elements o€
Buildings". This code to be effective January 30, 1976.
Window Areas, Door Lite Insulated Glass Area, Special Insulated Glass Areas
NOTE: Unit Quantity=Nua►ber of units in group Sg1=1, mu11=2, etc.
� UNIT TY SO FT/UNIT TOTAL SQ FT
Q DESCRIPTION �—. -
� � � — -- � o�
_.L. � �•� ��'�`��
� � � -y �, z� =' 2
� y S/ — �,03 3�,
� a w�S �- �,e3 �.��
,� ' c.,>? s-� � �'�dy
/ / ,��-- _..-�----- S� 020,/�
� v � ----�--
� -
TOT�AL,�WINDOW SQUA�EET I S3��y
U Rated @
Entry Doors
Doors With Insulated Glass �'igure G1ass Area With Windows
Entry Units With side Lites List Side Lite Only Separately-Double Door Equals 2 x Single
DESCRIPTTON UNIT TY S4 FT/UNIT TOTAL SQ FT
�� .2 �' y � - � �� �a
,'
�% � CD,,.�.� / _
�7-.-�--=7 7
TOTAL DOOR SQUARE FEET ? �,��
� Door ,�U�� Rating
Side Lites
. . _
?QTY DESCRIPTION SQ FT/UNIT TOTAL S FT
'
- ��/�
_.,�.
� Side Lite "U"
- Rated
TOTAL SQUARE FEET C��� f ' >—.�
Patio Doors
QTY DESCRIPTION UNI7M' Q� SQ FT/UNIT TOTAL SQ FT
-_i�,.:-
— TO3'_'.'� PATIO DOOR SQUARE FEET
- ----- __ "IJ" Rateci �_.
r _.....� �.d... . �,�..�
� �
___ _ ._ _
: � . �.__ . ...._-�
�
. _ I 5
. • .
WALL AND CEILING AREA COMPUTATIONS
�
i , i
i '�
� To Figure Stud Wall Area
Standard stud wall incl, plate= �,o�' sq, ft,/lin. ft, x �lin. ft. wa11=��,��sq. ft. wall
Knee stud wall incl, plates= y, 3�sq, ft./lin, ft. x �$.S].in, ft, wa11= ��7��g, ft. •wall
Other stud wall incl. plates= sq. ft./lin. ft. x lin. ft. wa11= sq, ft, wall
Other stud wall incl, plates= sq, ft./lin, ft, x lin. ft. wa11- sq, ft. wall
TOTAL ,�.1.�.�._
�
Stud And Plate Area
Total sq, ft, stud wall area includin knee wall. area = L� sq. ft. ` `"
10� total ;stud wall area = _�c�c•i sq. ft. stud and plate. This percent allowed by state.
Rim Joist
Lin. ft, rim joist /�x .� sq, ft./lin. £t, rim joist = /3G,3 sq. ft. rim joist
Lin. �t, rim joist x sq, ft./lin, ft, rim joist = sq. ft. rim joist
Lin, ft. rim joist x sq, ft./lin. ft. rim, joist = sq, ft. rim joist
Exposed Basement Block
Inches above grade �� x ,0833 x /�3 Iin. ft. wa11
�_ _ �r,�sq. ft, block
Inches above grade x .0833 x lin, ft, wa11 = �Sj sq, ft. block
Inches above grade x .0833 x lin, ft, wall = sq, ft. block
Inches above grade x .0833 x 1in. ft, wall '= sq, ft. block
Inches above qrade x .0833 x lin. ft. wa11: = sq, ft. block
Inches above grade x .0833 x lin, ft. wall = sq, ft. block
Inches above qrade x .0833 x lin. ft, wa11 = - sq, ft. block
/0�/,2a
Net Wall Areas --`-"""
ibtal stud wall area /�'ll�� Basement block area
Less windows /s;,���` Plus area well
Less doors �'7,-)'� Less windaws
Less patio doors l� Less doors
Less stud and plate _� �, L�ess firepiac�:
Less f��-e�lace `������ �� �, , { � TOTAL BASEMENT BLOCK AREA ��?�f, 2 J
TOTAL ��� -`��_
Ceiling<Joist or Cord
Number of cords or joists / x � length = 3(��� total lin, ft, x .125 = �.$isq, ft.
Number of cords or joists ---� x � length = ��.p total lin, ft. x .125 = .S�° sq. ft.
Number of cords or joists x length = total lin. ft, x .125 = sq. ft.
s���
Ceiling Area
Ceiling width x ceiling length = �'a 7� sq. ft. ceiling
Ceiling width � x ceiling length = sq. ft, ceiling ,
Sq, ft. ceiling (c1�� less sq, ft. cord Sd'��S = �225.$�sq, ft, insulated ceiling
Sq. ft, ceilirig less sq, ft, cord = sq, ft, insulated ceiling
FIREPLACE �•
Opening width x opening height = sq, ft, fireplace
. _._._ _-----------..._,�.,.
�, �,� �h,��R��� � �x����� � �..�x �W �._� r � ��5�'k5�;�, ����^ _, �"�.`�".',�'���..'.,, �� �� � .:
� �r;'
*� a ,
#% � ,'t{t,: b �- YY���: .;��'+ ���r,�.,..��*. '��'
x " �
�
�:� � - � �. � �� .a
� .
r ��
- Y�.-,.�r„ �
' ��'� � �
.,.,���,k ,� �-�' � - ' _
�: � , � -.. �� 'a . . . .._
a
:, `h, L g�''�'����, � �T�'t�� .�. � _ _
a
ar q'�,�"�'' -�' '�i��s� '���4
3<s� � � �
a
9��w
';4
2� y� � �� ..;; .
%4 �p5"r`:a.0
9:"
�F �
���a.
F��
X3+ 1 �
�� � �
��'t x^ 5� x {�F aa�.i.
.r�r..�. N� �.j' d"
' .' �. '. . .w". .el
�, *}
�� � �
��� � . � �� �
. �, � '��.�x�`
.r ,� � � 1� ,�.
� �. r':� �ax 7�
�, �'' ' ` "� f fi�.." .ry'r'
��. r � �p��' ,�� "�
?
,�r a�,�r�4� E
,. , ; , rA ��
,
, - t ' 4 �
.
a z'f ,� : . _z r .� ...- ��at�; 'a �r -
<
;.
�.., u, a:�+
. '+
3..w�����.� �: i � - ,. �'r� ��k�
i.. r.
z ,x
,
� . ,�. :..�e ;, ;
...;
� .�t. .
�q�x_� � ., , �. '- �
�' �.x ' .'�.
✓.N
��, �.,r � ,.
� r�
i
��-, � � � ��ar y;s� .
r ��i�q d. ��:��� � i"����x
}°'3 *
'i, v� �� ts^.�a �.�
������� � ' .
.f'� �i'";, � rs�� '° M-
� ��`� � a.,"1 �� ����,'L. :v�.�::. _�„`_.-.
}`�*��:`�' ,"
fi�
�� `�� e . .�,� `� � �� �
� � � �'�M1.
b� :�h t$ b'"� '�'.
'�' � ;�` .x �� ?
«�kr ft;,� ya' � ��Fa�}
{� ' 1;,...- xk
1V,.'`�+�' �:� wh
� ' �s� � {�- 2� � g"� �%
�.� - � i , t � ��'-
X; ,
'�L �
rtl � x
''S.c �u' �� �'F �i_e.
�,���ia" �;r �'.� p ' �' �Fr
��1�h� � �.- '� ��;` -t,
�� ,a^� „� _ �
b�;
�y T a£ t 7�
'f" �," 4' Y�.
v# ± �t �
.�e�.�.�'�+`i;< ' "�+?
'�s�``�r?i�S�� b 7�f �s
� i �n
�av�.- {�'er 3 ,( �:,:�
$ ���Y'$��r� `� ?.r��' �.-
,�1`- K 'S� ' ' '� �£"� . y � -
#ih
7� �' . .: �.:��� ° � . .
�, � . Q a.' .��. ,
�.�� � :.:- .. �- _�,: "� . - -
,. , ....;- . . .. . " �..
� „ ,•, X
� � � .� { - qj..'
A' - S''
��rE�`�3it '��� t>e'�� �a .�*`�
. �� ,,. �
�, ��;
�� r X� �,� � �'
�s � �,. ��,��; �� . ��;,
� �' � �^
„��' �� ��'.
��� �f ��
� � � , � 3�� �� .
�
�:�r ._�,-; f '��y.���r ��' �
..+,�,.�3' x'� .`"� `` 4 Y�.�.��`���..e.��.,
�� . �
r�'" t e ;
�rt,a°� .r�k'�J *�" �� �° £
�'r� �:•F a eA.. _� `#` '��;,;
,,„
� z �
'�, � �'" �t t�a ,#'°' ��s ,
���'����� �� ,
M1� � � n K
� �� x �
�';S��� � �"' * �h x, a��
rS%5���� �' � i fi.C' Ya^. �..�
��� � � t �� �k ���ti
e� ,t7 `� ��,. '"� �* 'E '� � ' .i"
i 'f`Y-�y l r3� x� ��'` �
������ ������ ����
F Y ,�. 'F
4�y '�'�"r , }�r& -. �� �y� j�_`•
�+�'� � � s ,� �.` �* �� x E
� z s �y�-
a� � �- , i }�� � �� � E..
���� � .. �x �_._
?.°s{` k. Y�'i' S� h_� k `� 1
.
� � �_ �� � .EY � ���
� , ' ; � . r� .,
�
4"
.�.,. ' Ye . �.� u,,� ., r� ,, ... . ,: ., . „�
LL _z .... .' t. �'^. . .:n't . . �.. -tr
'��� ��'�- ' ��;� � � �E�
��, $.
� � � ��� � ��. �_�'� �°�
, . �,��,� � � �
�� �� � � � � � �;� �
,� k ,« �� �+�� -w �
� � � ` � � � � ���� �.
. ,. � �
�� �,. ,.. :_ ..' Yr�a =', .. `, 3 `'�, ` a �.� �3'' ,; , �#r�'p,
,r le.� . �.*�s �, � � _
��,. � '� �`xt r,�,�,�.�,+��"y� a �' y
� � z� � �� � � � �£� �� `.
� - t �§ € -z -.,,,. �� +�'"�, �_
; ;
� i r S 3 �� ta �,n
�' f� � �r
,Y 4 ��< '����..,,�����
R ,� � ,. ' , , ��. a.
r _ , . , �.. i-. ' , r.
_�'�' ' .v- .. , _ �" . . .. �,°°&+. il ��}��
'y�, _� �'r .°i } � y�x '� - f rtd"L .�,y 's 3��E�<
ef 1ii ,�S�y.� S x f � Y
Q � d` W 5 1`
� � � 4
�" �'� azg }4 �. f,;�' � " � f x
`����� r,g �v,� y� � 4
t ;
#���. $� � '� ` � si �:
"�- 4�` �� 'r` 3^� ' ' Ks.
2 �� r
�Y �� <�+ '�s r 1� s
�
� f�k+� f
�� ,,.5. �E:fi� ,�-G`
�� l �` ��� �',N c`nr�' Rr
t �,� g� a` ��- $ �X� � �� � ��.
¢ � � ���
��P�-� �.s 's�. +� {�- � �,�..; ��'���� �4 ;;..-
�
� 4 � k� �~k�f Y
� 1'�} g�.if•. +f � �M1 �" y '�A�
N� 'h� F�� S �'xv Y ,' � +`� '
�„a I� ,�`�' "� � '� �`
� r '� � ``ex a
, F . � "
� > �
F� ' �;,� � o ,� �� �`, �'s
�'` "`� 4,:� P.,F i �.$ p°
�� � � � � � " C�j �+h
y� 4. � 37 ���
�
��'� �� ����,Ea,�i a ���y ��
�
#� d..,��� pk, ��� �E
y'�"p'y 3�`" .�..' �` '3 �
S s � � � � ��
���,^� '��,�� s �' 'A
��� �� � � � � �.
E k
3 ���ht� 3�; �
§� .� � } � ..: �Y�
9�s��" � ��y' � . � . �_ � ` "
���� � � _ s;
� ��� � '
� r`
�� � �:.�� 1.�m� �4` �N� }` i'.
� 1�'dx���� �,�t, t�:
� � #� �t
k �� �
� � T� �
��
� F� � i.. *° s
�� �,� � � �'S W+ ���_
� � 1�i"�i f r. .k-� ^:,�F M,.
F
� � i
!"a � � y�� � f+ - f � h
� y� � : �` . .,�-� � i
,� � .i. u <,� �- 'c.�., '.b t - 4: Se�:
� �� �
� � �
L � 1 ' �
�} � � S
�y aa ����� ,,� ' � �y-= �t ' � �';�
� : � .
t . � .r .
_
��rR I� .�_ ¢ �..
� ,�', 'F3 � 'k
�`g�� ' Y.T.
y"k f „`?
� � $ ' .`�'
�
g S;
� ,
}�� . .: �7 4 �n' �
� �,
�� t" ae
� �� 'tM1 £ �
� ��+ k �,J.
✓
� � �
� a ,"� �
.. �
� � �
. . : , � �:. � .
.
�� • _
� k 4 , .._ .. . , ,_a
� 3 *�
� �
;- F .
� ��
� �
.
>
:
r -'. . . � �,.. ,, i
w
a: .r� . � . , . .. �.i . '��.
.� . , . ' . . : v. .. , , �
_ _
; ' . . / .� _� �. 7 ',",/ _• ;"'' <C..r' •!� ,��' ��•
�\/ I�
,� �,�► .:�� �Qr ,,
� .�o ,; .� ,�,�. .
. . . .Ff` Q � . . .
. . �. � : � � . � �� •�� � � .
t�" ,�,�' �
�;� ;y � � �` �� ,h
v �� �
�. Oa� ���'� � ��
iG / h , . ' Q` �
�E,utii91S',r �•
� ����a, G�+.�y-�p.V . � �%
�- r �/ M
st 1 �� *�1 �' �• �
•t9�1�, �� � , ,y• ���,•:'"
../'..� Q� O' i ��',' �✓o �i .
b•y�3 �� �;` � Sr �
'���� �9�t• � �� 9 .
�s`� o � �' o ��'�� �
�r...t� 99��%'�? . � ti 'y�� � �'?S�\ � ,
�►'�► �r_ � �p
� �p�'
o U � N P � •yo`�- � ���Ir�" '� � i �
�ut 1°1 Y ss ,� �� �i Sj�sl\ , ,
t'� 1~`��h,47''�. �j� � �y�p �F. �\� � / �.o
� /,� ,p � � ��u�. � 9
' `���j' � "� � �, � � y /�4� .7l� � io ��.�� 9 Ls�•
" i � '1'�� N J �., ` '� ,� � � ,
'.� °
' �' ` 1 I p �4 � Q /
,c, i� P.��,� ,
�'; � � ^� � � P,�' i
. �; •;� � ���'��: �. �'' � ,�
�..
�1 —o ,� .
f vcr 1 _ �'S. ns ,�.?� PROPo��y�hh
��''� °o N \` �' 't?�.��.j \,ry"' ,
� , j ��y�
. �
1 �
i
� � �/k�Q-�P't'10�
�.�����-� ��;,3 �
���, 9;�;.� �'-- _ �,,�/o ,_ �� .
1 �'�' G�,'1 ygf.•p L+,T `l� (�r4�Q�L1�.► �
lV� 33 �o , c,� `?$�'�
' �°o�,�r••�.� Wu►St��Ntwa. w000�=
Qatic.�s�rA . c.a►V�t�-y�
ti N���►.1�ESd't'A
NottTH
l 4�At,� 1"= 3 0, •
;
�- �A,R1u�•�L p�Ut�D ,
;
n ID�l��'�� 1�►N� M�RN►►t?ME�tT'
�
� I hereby c�rtify that this survey was prepared by me or
under'my direct supervision and that I am a duly Registered
Land Surveyor under the laws of the State ,of Minnesota. �
Dat e:1�x•..�...�f�-!� • -► :, L� ,,�..�-�--�-
e oy H 8ohlen
Registered Land Surveyor No. 10�95
,
;
�
f
• ,' • ' • f �M i • w 1 ' I# � �}P �t•
, r
_ ;� .�. � . . ,�� , �, , R' i • • :
�
•i � • • �/QQ s� �
4'
- CZTY (7F EAGAIV f -• '
APPLICATION FOR PII2MIT SEWER AAID/OR WATII2 CONNECTION
�� P s Pr�.nt
1) PROPII2TY ADDRFSS:
I,FJGAL DE.SC�2IPTION: ' G(� GC/
(Lot Block Subdivisio or T Parcel I.D. �r)
IF EXISTING STRL'CI'tJRE, DATE QF QRIGINAL BLILDII� PERMIT IS�t'A1�CE:
�Manth Year}
PRESENT ZONTNG/PROPOSID USE: R-1. SINGI,E FAM3LY
R-2 DiJPLEX (Twc� LnitS)
R-3 TOWNHC}L'SE (Three + Ln�.ts) { Units)
R-4 APAR'T�lEi�FI'/Ct3NDC7MINIL'M = { Lnits)
C'.C�SERCIAL/RETAILjOFFICE
II�IDL'STRIAL
zt�TZZ�:�rzor�/r�v�.�H.a�r '
,_, , _���.�,..�. . ...__.._.�,.._�.. ;LL�� .
2� . >. l:tYe7 , /�
N�ME: ���
ADDRESS: �`f,
CITY, STATE, ZIP: . . a
PHONE: ���- �_�'�
3) • r a�• � � Far City L'se;
N�' Plumbers Licens�
ADDRESS: - �v
CI'I'�, STATE, ZIP: � �tive
� � u�S �S' CT �pired
PHONE: - � TER LIt�NSE #����--�-��� ' Q Not Reeorc
Staf� In'"�it al
4) • •, � i�•
N�ME: �'�
ADDRFSS: . � .
CITY, STATE, ZIP: n , c��
PHONE: , �S- �--
S) F , - .�. : �• �,
CONNECTION TO CITY SEWER C�1IVECTI{3N TC? CITY WATER
D OTHE�2 (Plea�: Describe)
6} �� �T• •.�
❑ PLF��SE HOLD APPROVID PERMIT FQR�PI�K-L'P BY ON� OF ABE7V� `
PI,EASE MAIL AF'PRt�VED F�IIT T� I,� 3, 4, A�dVE
(C cie ane)
7) Qr,* ' ' � r` f'� °Z� `��
y
� . .. . � . . . .. . . . .. � . . .. . _ '� f . .
F 0 R C I T Y U S E O N L Y ..
' ,
PE2MIT " ISSUED ,
C-���� -� . -
� _
: F��S: � ��' Cj b S�'.':LD n���'ITi /Ttij('T'.`*'�^ r't��ir"4' C7 "�' _
• :�. \ �r+:.L... JVa.�...c1...GCa
� $ /O'• �� W�TE� PERP'[IT (Zi1Ci,uDE SliRCHA�GE}
$_ � � S� � WATER ��lETER/COPPE:2HORN/OUTSI'JE READER
$ WAT�R TAP (INCLUDE CORpOr�ATION STOP)
$ S::vER T.�P
S /�, � '����_:•T =��s�: - _ ��
^ �� ,. .. ..
$ �J�' �U� ACCOliNT D�:PC�SIT - t•IP,T�R
Y �D-O, v � wac
$ 57 S � cr Z� sp c
$ T?�liNK WATE� ASS�SS:��.�T
, $ TRlii•1K Sr.�vER �SS�SS��i��iT
$ Lr�TE?�L BE�IEFIT/T:?U`1K S�:•iLR
_ $ L�1T�.Rr�.L BENEFITJTRU��K j4AT�R
S I�Zo ' U D � WATER TREATMENT PLANT SURCHARGE
$ OTHER: �
-$ TOT�L
$ �t� , 5'D A��lOLTtiT P�ID/REC°IPT � � �v `f /�,,3
�/�� �-�o � �.-
DOES UTILITY CONNECTION REQUIRE EXC�VATION IN PUBLIC RIGHT OF WAY?
�� YES IF YES, "THEN e� "PERMIT FOR T�lORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
� NO ENGINEERING DIVTSION. LIST AS A CONDI-
TIGN:
SUBJECT TO THF FOI•L�SdING CONDITTONS: �
APPROVED BY; '� � . . .
- TS�LE: _
DATF: ._._,! a Z,.,��'� _
� _
� .
�F ,
c�t� o� e�ae�c�n �
3830 PILOT KNOB ROAD.P.O.BOX 21199' • • . BEA B�OM9UIST
EAGAN,MINNESOTA 55121 nnav«
PHONE:(612)454-8100 THOMAS EGaN
JAMES A SMITH
JERRY THOMAS '
DATE:M�Y 1, �-986 THEODORE WACHTER
. . . � CCUnC�I MemD�s
' � � THCMAS NEDGES
' City Aamin:rtata
. EUGENE VAN OVERBEKE
SPECIAI. ASSESStifENT SF.ARCH CitY Cl2rk
DAKOTA COUNTY`ABSTRACT � RE� Whispering Woods
1'Z50 HWY 55, P O BOX 456'; Lot � Block 1
IiASTIN6S MN 55033 - -
- ' 4812 Slaters court
Enclosed herein is the search which you requested made on the above described propertv.
1986
Kind of Improvement yPa_...-; Beginning Original Aruount Balance Due I n s t a 1 r
Street Surf . 10 1981 $657 . 79 $328 . 90 $97 .3
San Sew Trunk 15 1982 179 . 39 131 . 55 23 . 4
Sewer Lateral 10 1981 463 . 23 231 . 62 68 . 5
Watermain 5 1984 87 . 97 35 . 19 22 . 8
Water Area 15 1982 179 . 39 131 . 55 23 . 4
I further certify that according to the records of said office, the following improve-
ments are contemplated or pending after having been approved and are now in the process
- of planning or completion.
� Kind of Improvement Approximate Date of Completion Anproximate Cost
NONE
WAIVER: . _
- Iveither the .^.ity of Eagan nor its employees guarantees the accuracy of the above infor--
- mation which was requested by the nerson or persons indicated. Nor does the City or its
employees assume any liability for the correctness thereof. In consideration for the
� supplying of the indicated information in the above form and for all other consideratio
of any nature whatsoever, any claim against the City or its employees rising therefrom
is hereby expressly waived. Levied assessments to be paid to the CITY OF EAGAN,
3830 Rilot Knob Road, P. 0. Box 21199, Eagan, MN 55121. '
.Very truly yours, � �
%��� '' '
SPECIAL ASSESSMEN DIVISION �
. THE CONE OAK TREE...THE SYMBOL OF STRENGTN AND GROWTH IN OUR COMMUNITY �
�
city oF ��c��n
3830 PILOT KNOB ROAD.P.O.BOX 21199 BEA BLOM9UIST
EAGAN,MINNESOTA 55121 MO�'Of
PHONE;(612)454-8100 THOMAS EC�fW
JAMES A SMITH
VIC ELLISON
THEODORE WACHTER
Special Assessment Search �°�"�''"'�"''�`S
THOMAS HEDGES
City Adminisirator
EUGENE VAN OVERBEKE
Date s December 10, 1986 c�c��k
Reques ted by: Re. ��:�`� ,.p .
. ���.
�°�'�. = �t �t�'�.��t
1250 HWY 55, P 0 BOX 456
�iASTINGS MN 55033
On the attached form is the City's response to your search request
on the identified property. The information includes the 'original
amount of the assessments and the payoff amounts of the assessments
on the parcel. In addition, pendin9 assessments are included for
improvement projects that have been ordered to be installed by the
City Council as they may affect this parcel.
The City's policy is to levy assessments based upon the current
zoning or existing use of the parcel (whichever is higher) as
reflected in the above assessments. If, and when, the parcel is
rezoned or developed to a higher use, a condition of development
approval will require that this parcel assume any additional
assessment obligations that have not been previously paid for
existing public improvements. The City Engineering Division can
provide further clarification of this policy if you desire.
WAIVBR/DISCLAIMSRs
Neither the City of Eagan nor its employees guarantees the accuracy
or completeness of the information provided which was requested by
the person or persons indicated. Nor does the City or its employees
assume any liability for the correctness thereof. In consideration
of receiving and using information on the attached form and for all
other consideration of any nature whatsoever, any claim against the
City or its employees rising therefrom is hereby expressly denied.
Pending assessments cannot be paid until levied. Levied assessments
can be paid to the CITY OF EAGAN.
Very truly yours,
/�i�`y� � .
SPECIAL ASSESSMENTS
Attachment
THE LONE OAK TREE.. .THE SYMBOL OF STRENGTH AND GROWfH IN OUR COMMUNIN
i: �� . . . . . . . .
. � . , . : . . . � . � . . . ' . . '.
� . . � . . . . . . - . . . . .
. . . . � . . . . � � . . �
� � � � � . � . . I
. . . � � � . . � � . . . . . � . . � ��. � ' � � . . �
.... ... ... ...,.. ... _. ._ . .. .., .. . ..., .. . . . � . . . .
� :�:: :.:. , . . .
.... ... ... ..
� , �•:i•-i1�'�(�::r?i-•sl_ 7 ._V��`•� .(�L�l� . �C:'t:!? , .t t._t�` ..:"i :_� � � . . . � .
��F='z=.'i.. .i-if._ 1::1,_ ..rk:`. �1�"iF"I`•.I.f,.`
... ....:... .. . ..�;..,,..,,...t::;c::�.. . .,..,^; ;._,�..,, .. .. �, , tr. .,E;
:�,i:::�.i_.l.'i-�i!_. r•i c:,•::,t.-...,...�(�f L:�l`.i"1 •_, •-:�t:.i i r.{..:I-•i :..r la l'I I 1 t=�i; }
� �.�....,,._��.;..,.,,. . �. . � . .. . � _�� .... . :..., :_.;:�_r�_n� ...�. � __.._ C �,�.. • ! �� ' ���. � �.
{='r:t.:i- ..... , `t .,. �� �.1� 1��rlJty i'ca 1.1r•�� .r_ ., _.. .����I:-;t7 51 �C�,.�-�L. Lt��l:ii.�__..._.._..._
. . .. � : . . . . � .. � . ,.:- `:'` . � '":�t.....��._ ...�;__C�._.;�l,� .
. � .. . r . � � . . . � .- . . .
l�, . ...... ....:: . ...._ �'�������
.;....�.,.;`.,_,,..,....,._;;�•,.....r:�1: �� ��/ v�;�-sy Ll�dv���J--w� 1
. :::. ._.... ... :::•_:•:::•c•::_......_._....:. f._.-....�.._......... v( .. ...�_.........:::..:::::::•::::-::.-c c::c::::::::_�:•:c::.^ ._•___.....__.. ...,_. �� . . ..
.., . ,, ..,._; _...,...,� ,._ . ... _ � .. ..
, :. j;. ., � , �... � i r I .r-i,_,�.., '� '.;�, '`�:;.., .y..,- �:�. ri ....f.,._ .��'�t::• ::.M�.�'_:...:::......:..�..
.:. r; rr: 7 1;t=i1��E: r 'iT�i-�r._ i�y1`di`aa1~'iY.il`d„ {�'r•�Vt
... , r��� i• t-a:.a:��a;._i�1,_���1+ 1 �._ ,� . ,. i"II''1L°I`d'r
. .. .. .. ....... ._ ,;Ya: . .. ��. .. .
,_., , .. , _
� ,�,_,.....,.
. . t�� 7
. � , . �:• ,:;'u tl;:"�:� • L f`•i= � r ., ';
.,i 1..���_�...�..:.�..i� .!� 1"•.1.:;Z'. ! � � . i:}�_+ .L t_). . ... .. .�. �:::Y . !�� !-r ./�7' .L L:7.t ..}i: �
. :.� .:.c:...�:; .... . ,� _ ...,_ � .� � � � _y ., . . � .
. .., . _ ._, ..;
.. . . .� : -� .
.l�_+�_l,..!.�:°� � �;: b � :. 1� ,� . . �{_] 4) � i �:)(1,:. :.�..�, . 4. _. . . . 1'.i , L r
! �!. .! r._�-y� .. s_ .L _ i:. , _ . ''t(_1�.::�,� ... •:�xu' �, m J:'c_ � 7�
� ,�....... . ......� �.... ...i i� �'11.... � . .. . . . .. . «; � .. ��.�... �1 .. ... . .
. � a � � . .� : . . H y
t i t!r^i_J r :-�� ts���......c:...1`��1� . ?ti l .L:�.1 �;j u i_i i f r„ � �1 !�7�R ...�"}� 1. 1 ., tS!:] .1�..���`V,. t`a I . .
. �..+
� .. ...,;., : i:::i:'� � ��..�.. ...,`x:•.d . . .� ..�,. _. �..y .. . .i ::�.r .. . � . .
;.. . ..� _. _. . . .
. . y ;�..: . . .. . �,;
. ....�
.:llt.��:�5 ::_� )�d; ri .,: .e...,. t-.�.z .�...! ,:a„tii_):t,. J 1' �'u •_� : .e 1 � '�c�-� .2�); n c:tf'
. ..,.... . ,,.,..,_,_.;,.. ;� ._: ..:..� �::. . _ ..._ ...
� . ,' ..,.��5 �Y I°i� �.::t X�r�(-t.'��.� 'i.,�� 1 "{1„�1�.1.�,. � ;-i'+ N �.:y =_ 4 . .
, ;: •:: : .; .�
. •.
. .�,i._S i 3 t:! 'ti::. �. {:. .... .L _ .. _ .. . f� . ! � �. � .L ! � C7..t. �
.�`..>.!a..',".i.:.r� ;"�:�?i��l�„ 1=.:.t.: . � � � : ���l�+ .t:'.'i � . „ C.;!,J'.:; ..•'ti:_'}c�.> >'•F�� � �� �.1(..y� � �.��..� �"''i;'!_..1..'�'�,'r.
.:-.� . �.., .w,.: „ ..y.:; :.. . ,. ,.,_r. .i.� ��... � � � .r�_r . .. � c�..,. .�c::• � � c: . ..�. .
,.. ., ...�..._
':_':�?:T�':ti.,,y..r: .. �._/ ! .: . . . , :. f � • � � :..J L�l�T• .
•.':
,.�..JI�� � r.:ir� r r r.:i{.:. .r. .:. ,..!i..�% w / . .f.,..�•_�p t:.�...i •..+.::.
. . ,.�.... ,_ _
. ... y.. . ��, .r � - ,-� ;7,-;y
� T:¢;a;;a;•:4 s..�+:. ! �'�( '") Y��`P•i f:� Li � 1,j�.t.. !",_!.t � .. .....a_ ..... � .. . . . . . .
� ,.. �,. ,. � ,..., .. � � . . ... . � � . . � � � . �
. .
� :..�,..... . ... .. ._...
� ..... . . _.
i' f li+:.. .�_y . . � .... : • y ... .. ' .
�_. : ._�i.l�.::i°.. i' !�il' tt7. lJI'.: i.. / .1'i`+:_":"i..cs: �'.. f^ti' t�l�i}
�:::�: ::. �- .? ...�i' . .�_ .I-:_.
�R� ��� �:���
RESIDENTIAL BUILDING
Permit Application �,�
�`� a � 2.._ City Of Eagan 2�l�
3830 PilotKnob Road,Eagan Mn 55122 � v'
�'� �AR 2 4' ��T'd Telephone#651-675-5675 FAX#651-675-5674
New Construction Reauirements RemodeVReaair Reauirements Ufflce Use Only
3 registered site surveys showing sq.ft.of lot,sq.ft.of house;and all roofed areas 2 copies of plan CeR of Survey Reai
(20°k maximum lot coverage allowed) 1 set of Energy Ca�ulafions for heated addidons Tree Pres Pian Recd
2 copies of plan showing beam&window sizes;poured found design,etc. 1 site suroey for additions 8�decks Tree Pres NotReqd
1 set of Energy Ca�ulations Ad�iition-indicate iionsite septic system _On-site Septic System
3 copies of Tree Preservation Plan if lot platted after 7/1193
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date�/ o`�� 1o20b.3 Construction Cost �� a�d ' v�
Site Address -��/� �la /e� C.'p(,�,/f Unit/Ste #
�./j.n�. �
Description of Work �i�i`n G�. , / �: KJ i/�,�OGCk
Property Owner �GL/�-%n �- �U �i�' C�i G�E;S�✓,� Telephone#�� ) gQl� -(� 7l1
Contractor �i np�0� � ��� �brY1 t ��'1,0
Address �7d d ' 9'� l P �1.�0 • City r� �Cc,l,�
State M,�, Zip� `�7'�_ Telephone#(�QJ��) g �- �87Q
COMPLETE THIS AREA ONLY IF CONSTRUCTIN6 A NEW BUILDING
— Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy Code Category Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet
(�I submission type) � Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Pl�mber �y Telephone #( )
�, �
Mechanical Contractor � � ��� Telephone #( )
M
Sewer/Water Contractor Telephone #( )
ey
{
I hereby apply for a Residential Building Permit and acknowledge that the informatian 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 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.
��dd�t �n Se�ra
Applicant's Printed Name Applicant' ignature
� t
2004 RESIDENTIAL BITII�DII�TG PERMIT APPLICATI4I�T
City Of Eagan
3830 Pilat Knob Road,E�g�a lYIl�T 55122 , ` `� `�? 0 • ��
,�'� � (�� Telephone#631-675-5675 FAX#651-675-5694
New ConsUuction Reauirement� Rerrro�UReqair Reaui�r m� �'`:
3 registered site suNeys showing sq.ft.of lot,sq.ft.of house;and aA roo�d areas 2 copks of�lan "'��� �'''��
20°�maximum lot covera e ailowed 1 set o#E f'
� 9 ) �8Y Ca�CUlations for heal�I acklititms ,`'
2 c�pies of plan showing beam&window sizes;pourecl found design;etc. 1 site survey for additions 8 decks `
1 set af Energy Calculations Additron-u►alicate if ar�site septic system
3 copies of Tree Presenration Plan if lot piatted after 7/1/93`
Rim Joist Detail Options selection sheet(bldgs with 3 or�ss units
Date 2 / �J / C)�' Construction Cost ��a'� �
Site Address ��!�Z `�,�'l.��C`� C.�' Unit/Ste #
�
..�
Description of Work ,�� 5��2L, �'�! �/Jj��-l
Multi-Family Bldg Y _ N Fireplace(s) 0 ,�� ,_ 2
Property Owner ,�L.(L E l�'f� 'L�'Q.((.�5 ON Telephone#(� )t�� � bl�7U
. . � . � .. '..�•. . .. F � � :
� �`� '�����
Contractor l � iK.'�1��, �
Address ���7 �, �`1 ��� City , �1�n�h t,/!L G(,,S
State 1� Zip 35��7 Telephone#(���-) ll'�J "�''��"�f
�
,
•
C�MPLETE THIS ARE�► QNLY IF CC�1'�TRUCT1Nt$i A N�W BUf�.QING
Energy Code Category — Minnesota Rules 767U Category 1 _ �ii lnesota Rules 7672'
• Residendal Ye�tifatie�n�at�gory 1 Worksheet • New Energy Code Worksheet
(�1 submission type) Submitted Submitted"
. Energy Envelope Catculations Submitted
Have you previously constructed a building in Eagan with a sirnilar plan� _Y _N If so, 25°� plan review
fee applies.
Licensed Plumber Telephone #( )
Mechanical Contractor Telephone #( � �`.� `�
Sewer/Water Contractor Telephone #f ) 1' �, �.�04
;, �
I hereby apply for a Residential Building Permit and acknowledge that the informatian T�� p.ete aticl accurate;
that the work will be in confarrnance with the ordinances and cades e�f the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, d wark is not to start without a
permit; that the work will be in accordance with the approved p in e case o ark which requires a review and
approval of plans. .
` _ � � ° _
Applicant's Prin d Narne Applican s Signature
41111)
City of Eau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Date 44,,t ,.
6
Use BLUE or BLACK Inkik)
•
For Office Use
/ 7�
Permit #: / .)
Permit Fee:
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address: 4% ?-V c_t
Resident/
Owner
Name:
Address / City /Zip: iM2, colt CCY
n
Applicant is: )( Owner Contractor
Description of work7 i t `
Type of Work 4 Z J
Contractor
Construction Cost:
Company:
Address:
Unit #:
Phone:1012.- l6 -2)5D
6114 va;it
Multi -Family Building: (Yes / No
Contact:
City:
Email:
State: Zip:
License #:
Phone:
Lead Certificate #:
If the project is exempt from lead certification, please explain why:
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:
Fire Suppression Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Cali 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.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(O It x
App !cant's Printed Name Ap !cant's Signature
Phone:
Page 1 of 3
' 1 1-0/LC .
l DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
/ Single Family
/_ Multi
01 of _ Plex
Fireplace_ Porch (3 -Season) Exterior Alteration (Single Family)
Garage Porch (4 -Season)_ Exterior Alteration (Multi)
Deck_ Porch (Screen/Gazebo/Pergola) _ Miscellaneous
Lower Level Pool Accessory Building
WORK TYPES
New _ Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows _ Demolish Foundation
IA Replace_ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation J5a�, Occupancy ,..-1-7.e.-- , MCES System
Plan Review Code Edition ,4'u 20}S SAC Units
(25%_ 100% 10) Zoning )2 — l City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Suppression Required
Type of Construction V% Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) )D Final / No C.O. Required
Foundation HVAC Gas Service Test Gas Line Air Test
Roof: _Ice & Water _Final Pool: _Footings _Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace: _Rough In _Air Test _Final Siding: _Stucco Lath Stone Lath _Brick
Insulation Windows
Sheathing Retaining Wall: _ Footings Backfill Final
Sheetrock Radon Control
Fire Walls Fire Suppression: _Rough In _Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: / 0 /?i; kI I / , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA161035
Date Issued:04/30/2020
Permit Category:ePermit
Site Address: 4812 Slater Ct
Lot:007 Block: 001 Addition: Whispering Woods
PID:10-83950-01-070
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Joni Everman
4812 Slater Ct
Eagan MN 55122
(612) 865-5350
Hoffman Refrigeration & Heating
5660 Memorial Ave N, Suite 2
Stillwater MN 55082
(651) 439-5770
Applicant/Permitee: Signature Issued By: Signature