1303 Interlachen Dr ,.
Use BLUE or BLACK Ink
, � ._ / �-----------------
� ,�� I����� 1 �� � For Office Use ��
� /' iG�cI �D � ' �.� �1 � ��l
• � � � ��� �S�'(O —� fl - � � j Perm it#: � �
�l� ���'t� t�I�� �a�-��� �- �`� � ����
� � E / p� �/ � Permit Fee:� �S�� �
3830 Pilot Knob Road � � D '��• ��7 � (�' �i I
Ea gan MN 55122 � ' � Date Received: D'''��` � � I
Phone: (651)675-5675 I I
Fax:(651)675-5694 `;� 1 Staff: � 1
w
(_ � � I I
� � . .
� � �-t� �.����g'
�—___��_��_______J.
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ��' � Site Address: 0 3 �1�� ��� Unit#:
,:
Name: ���� Phone:
R�S�CI���/ a � � �. -�
��g�- Address/City/Zip: .
��� ���
�� Applicant is: Owner N Contractor � �-
a'C� , ry �
� Description of work: /UC�J S%N bL-E` �i4�rr/Z t��
Typ+e c��Wt�r��
�.: Construction Cost: �l�� Of� Multi-Family Building:(Yes /No�)
� �.,
�� �� t Company: �_�(�7T�X� Contact:�1��� ��12�
.�
� ����..,: .
; �� Address: �t7�"S�t� � �bi''r r'�i3,P �(l Y f City: ��fJ� ��f�
� - ��
�� ��
�� State:�Zip:�Phone:�'I,�Z'q�S�-�gb�Email: b� ��fcv1'����'��/`j�l -
�.
�
.:
� � ' '; ' License#:___��- GZ ,�t�2 �� Lead Certificate#:
If the project is exempt from lead certification, please explain why:
AV��, C�-on s�;�v ul�,J
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 72 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
/� '�
Yes �No If yes,date and address of master plan: �'I/�-�� �ZS � ��� �����
Licensed Plumber: %��1��! Phone: �� `� " y� � ���� �
Mechanical Contractor: `1�J�'� Phone: 7� 3 - `�� 3 '-y�7
Sewer 8 Water Contractor:__ S�� r ���lJ� � Phone: l 5� "�� 7 � �� � �
Fire Suppression Contractor: ���� Phone:
N�7T`E.I�la�r���r�a1 s��a .; r�� ` . e��#h�ya�u s�rt��i��rr������t�r�f`��.I�����i������rarr �?��►�r�����
` �tr��trmari����nr�y be��,�i�ie������rtpu,��'tc.►��.prc�urde���+c�frc rr�sor�s��t r�uld����C��jr��
.
..::.. . ..��. ,,,.:.���`��t., �t��'t� ��.�r' �'�ts. �
�+��: ,.. �.. ..
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. o herstateonecall.or
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 withir
days of permit issuance.
X L I.V� t�L� X �
ApplicanYs Printed Name ApplicanYs ignature
�
/-���������D O�RITE BELOW THIS LINE �jv��j�
. .
SUB TYPES
_ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
�Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
_ 01 of_Plex _ 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
_ Replace _ Repair _ Egress Window _ Water Damage
_ Retaining Wal) *Demolition of entire building—give PCA handout to applicant
DESCRIPTION
Valuation � Occupancy f� MCES System
Plan Review Code Edition ���M, < SAC Units
(25%_100%�) Zoning � City Water
Census Code Stories ` Booster Pump
#of Units Square Feet PRV
#of Buildings Length �„(,f� Fire Suppression Required
�
Type of Construction Width �1
tF
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
Roof:_Ice&Water _Final Pool: _Footings Air/Gas Tests _Finaf
� Framing Drain Tile �-
�Fireplace:�Rough In �Air Test�Fin�� Siding: Stucco Lat 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
�- Other:
Reviewed By: ----� •�' ' Building Inspector
RESIDENTIAL FEES �,�� ����--�r �� � ;` ��� ��� < � �� �
Base Fee � �
Surcharge ����� f"" ��`� � '"f "/ („ ,�� ;��° ".�� ;-���� �,�-��t
,� w �� F.
Plan Review �.
t � � � ;��;�n:. � �� � � ..
MCES SAC 1 � , ���� �� � � � -� - �
� -
CitySAC � . �. {. � ��'. ; �a'�
Utility Connection Charge ✓ ��.��' � � ^� �� �� � �°`��� � �
�
� x ��� �
S8�W Permit&Surcharge
Treatment Plant � a�;E��`°'� g �' ;�� �'` '� � '�> � !"� �./�
b � � �. .� �
� " .
Copies �. �.����
TOTAL ,� ,., �'{� -�-�
l�` (� �'' � �`�' � � ,v�C��
��,,��� � �_- � Pa 2� V �
� � . � ���
� �
/`�����"
New Construction Energy Code Compliance Certificate �.�•]�[� �(`
Date Certif'reate Posted .��_�� � �.
Per R401.3 Building Certificate.A building certificate shall be posted on or in the electrical distribution paneL
8/28/15
Mailing Address of the Dwelling or Dwelling Unit
1303 Interlachen Drive
Name o(Residential Condractor MN Liceau Number
DRHorton BC605657
Commun:ty p�o�p �
Eagan 5306
HERMAL ENVELOPE RADON SYSTEM
o Type:Check All That Apply X Passive(No Fan)
N Li
''�' „ �' A�ive(#�`rtle�un;�rt3�nr�meteror'
� P T
w '� � � � a° �, ', �r�h�rsys�m rt��itvrfngde�3icej, '
� � � � � �j � b � Location(or future Location)of Fan:
� T
> o z N N ° o, w K �
Insulation Location � •:. w =° =° v O � W
�s o � � � � � :o :o
E-� � z w w w° w � � oG Other Please Describe Here
Belrrw�n#ire Siab ', }(
Foundation Wall(Sides) R-15 X R-10 F�cterior,RS Interior
n�datlQn W�#I(Fronk and B�clt) ��'�� ' � R-�tU�ter�r
Rim Joist(Foundation) R-20 X Interior
ltim doi�t{i"�tuor-�) f�-2� ' �
�
wau R-21 X
+�eiiin`,ttxx ' :. R-�� . '', �C'
�. _ _.. . � ._.
Ceiling,vaulted R-49 X
Bay Windvws c►r cant�eVered`�r�as �_� : �`
Bonus room over garage R-32 X X
Describe athcr in��te+��as
Buildin Envelope air Ti htness: Duct s tem air ti htness:
Windows B Doors Hearing or Cooling Ducis Ovtside Conditioned Spoces
Average U-Factor(excludes skylights and one door)U: 0.31 Not applicable,all ducts located in conditioned space
Solar Heat Gain Coefficient(SHGC): 0.28 -8 R-value
MECHANICAL SYSTEMS Make-up Air Selecta Type
Appliances Heating System Domestic Water Heater Cooling System X Not required per mech.code '
�ue#'�'. ��:� �k����,�..���''., . �����. �`�'�.��� _-_..,. Passive ��I
Manutacturer CARRIER AOSmith CARRIER Powered
Interlocked with e�chaust device.
1k�o��t ' �S��AtI6t��17' GP�t.-5U �A1�t�fA{}� .: , Describe:
Input in 60000 Capacity in 50 Output in 2,5 Other,describe:
Rating or Size BTUS: Gallons: Tons:
��'AFUE cx' �l�of� S�S�R�'� ���.�- -; Location of duct or system:
ffiCIC11Gy HsPF°fa EER
� HEAT LOSS HEAT 6AIN COOLING LOAD
SIDENTIAL LOAD CALC 47,589 19,347 25,707
Cfin's
roun uc
Mechcnical Venfilation System "metal duct
Describe any addirional or combined heating or cooling systems if installed:(e.g.two fiunaces or air Combustion Air Select a Type
ource heat pump with gas back-up fiuuace Not required per mech.code
Select Type X Passive
Heat Recover Ventilator(HRV) Capacity in cfins: Low: High: Other,describe:
Energy Recover Venrilator(ERV)Capacity in cfins: Low: 50%88 High: 90%=158 Location of duct or system:
Balanced Ventilation Capcity in CFMS: fUPflaC2 POOI'Ti
L.ocarions ofFans,describe: Cfin's
Capacity continuous ventilation rate in cfrns: 7$ 4 "round duct OR
Total ventilation(intermittent+continuous)rate in cfms: 155 "metal duct
1303 /nterlachen Drive Eagan SOUTH
HVAC Load Calculations
for
DR Horton
Lakeville, MN
Prepared By:
Michael Hoium
Sabre Plumbing&Heating
15535 Medina Road
Plymouth, MN 55447
763-473-2267
Friday,August 28,2015
Rhvac is an ACCA approved Manual J and Manual D computer program.
Calculations are performed per ACCA Manual J 8th Edition, Version 2, and ACCA Manual D.
' ��iden��1�� �ght�er���ti1lA���sads � \` ��%� it� � In�.
� ' hi�&I���f�n9 � �� � � '� ��nt�z���r� �t!"Ci-1
:. -
�
�, : .
��!SiU . �7: � ........: . .���,. ' .a� ,. a`: � ��„ ��:P �2`.
Pr�'ect f�7e c�rt
. .._ , ._
, q� _, �
���.1;�.. � '� �� /� : � ��- c./f : �,�,,'�,9 X -__,a; ;�'-, _ _r
' ,.,�zi.< � �..��::5a �:, dC' -� ,. :-' � .,-
_
2.. �:^�::. x3a3`
. � v.-.,: ..,, -�z..,. ,, . . ......�',, ,:; ,e . „ .� .,.
Project Title: 1303 Interlachen Drive Eagan SOUTH
Designed By: Michael Hoium
Project Date: Friday,August 28, 2015
Client Name: DR Horton
Client City: Lakeville, MN
Company Name: Sabre Plumbing &Heating
Company Representative: Michael Hoium
Company Address: 15535 Medina Road
Company City: Plymouth, MN 55447
Company Phone: 763-473-2267
Company Fax: 763-473-8565
� � �k=u.�,��, s �
,,,, „_._�� : �. ,e
Reference City: Minneapolis, Minnesota
Building Orientation: Front door faces South
Daily Temperature Range: Medium
Latitude: 44 Degrees
Elevation: 834 ft.
Altitude Factor: 0.970
Outdoor Outdoor Outdoor Indoor Indoor Grains
�Bulb Wet Bulb Rel.Hum Rel.Hum Dry Bulb Difference
Winter: -15 -12.38 n/a 30% 72 29.40
Summer: 88 73 50% 50% 72 42
�:,�
f�_ e.�;�
�,.:. �..,.�? �.
Total Building Supply CFM: 857 CFM Per Square ft.: r 0.234
Square ft. of Room Area: 3,668 Square ft. Per Ton: 1,712
Volume(ft3)of Cond. Space: 31,192
, s,�
` �° f� ��
r F r �,'�-- I
Total Heating Required Including\Ventilation Air: � 47,589 Btuh 47.589 MBH I
Total Sensible Gain: 19,347 Btuh 75 % �
Total Latent Gain: 6,360 Btuh 25 %
Total Cooling Required Including Ventilation Air: 25,707 Btuh 2.14 Tons(Based On Sensible+ Latent)
� F ` 4,, ;�
�,.
Rhvac is an ACCA approved Manual J and Manual D computer program.
Calculations are perFormed per ACCA Manual J 8th Edition, Version 2, and ACCA Manual D.
All computed results are estimates as building use and weather may vary.
Be sure to select a unit that meets both sensible and latent loads according to the manufacturer's performance data at
your design conditions.
M:\Sales and Estimating\Heat Calcs\DRH\1303 Interlachen Dr Eagan SOUTH.rh9 Friday,August 28, 2015, 9:10 AM
Ftl� , �` ��er�#tai+�� c�n�t+� A�C � "� sz�-'~ ��r � � �e c
S�bce�u�ty, ���f►r� � ,� ��`�� � � ,�� ~ ti�er�a ` t�rr�s ���TF�:
��
�
� �,
F�� !7i � � � � ; �'. a�`� ��� y ;3 �� \:� � `�`�`
a_.... �,x i,, , ;... ` �
� ,�� < ,, .
'
...., ...,, ;. �
Lc��d Pre�rieuu;R� cart :
1 Net ft.�� ; Sen� Lat Net Sen Ht� CI� Act Duct
Scope � Ton /Ton� Area Gain; Gain Gain Loss CFM CFM CFM Size
Building ; 2.14 1,712 ', 3,668 I 19,347 6,360' 25,707' 47,589 560' 857': 857 I
System 1 . . . 2.14 1,712' 3,668 19,347 6,360' 25,707 47,589 560': 85? 857 10x16
Ventilation . . . 1,059 4,259! 5,318 5,757, ..
Humidification _ __ , 5,309
Zone 1 . . . . . .. . 3,668 . 18,288 2,101 + 20,389 36,524 560, . 857 857 1dx16
1-Basement 1,820' 3,872 0= 3,872 16,954 2601 181 181 2-6
2-Main Floor i 1,848 14,416 2,101 16,517 19,570 300' 675 675 . 7-6
M:\Sales and Estimating\Heat Calcs\DRH\1303 Interlachen Dr Eagan SOUTH.rh9 Friday, August 28, 2015, 9:10 AM
RM���-�'2es�den � HK��1� � E!€#e �; It�
�,,�„�� , �,�
Sabre F�l�tr��€�� .:. � ; '` . , �''� � : ,� �� ���g�r���!"t#�
'o� �. ,� �° ` .,� � ��� �� ����_ � e 4:
TQt,�I°Buildi:n 5u►r�m� Lc�ads
� � y������ ,y� , � li s, � �.�, h �.
\ ,_t � k �3, ., _ � � �3 �� E�,1�.
i w:J/,, v� �G Ol 5 �, b•, �� k .
.��, '��" _,� �;�� :� `�:: tlA � � � �ia�����.
DRH LowEE 2929: Glazing-DRH Windows, u-vatue 029, 40 1,009 0 1,270 � 1,270
SHGC 0.29
DRH LowEE 3228: Glazing-DRH Windows, u-value 0.32, 258 7,189 0 4,223 4,223
SHGC 0.28
DRH LowEE 2924: Glazing-DRH Windows, u-value 0.29, 10 252 0 271 271
SHGC 0.24
DRH LowEE 3029: Glazing-DRH Windows, u-value 0.3, 40 1,044 0 1,276 1,276
SHGC 0.29
DRH Door 31 UF: Door-DRH Exterior poor-.31 U Factor, 40 1,078 0 334 334
.23 SHGC
DRH-R15 8ft: Wall-Basement, Custom, DRH-8"poured 645.3 3,312 0 441 441
concre#e wall, R-15 board insulation to footing, no
interior finish, 8'floor depth
DRH-R15 4ft: Wall-Basement, Custom, DRH-8"poured 120 616 0 82 82
concrete wall, R-15 board insulation to footing, no
interior finish, 4'floor depth
12F-Osw: Wall-Frame, R-21 insulation in 2 x 6 stud 1890 10,687 0 2,003 2,003
cavity, no board insulation, siding finish,wood studs
DRH-R10 8ft: Wall-Basement, Custom, DRH-8"poured 360 1,848 0 246 246
concrete wall, R-10 board insulation to footing, no
interior finish, 8'floor depth
RJ 20 Spray Foam: Wall-Frame, Custom, Rim Joist R-20 348.5 1,516 0 478 478
Closed Cell Spray Foam
R49 16B-49: Roof/Ceiling-UnderAtticwith Insulation on 1848 3,698 0 2,168 2,168
Attic Floor(also use for Knee Walls and Partition
Ceilings), Custom, R-49 Blown Insulation, No
Radiant Barrier, Vented Attic,Asphalt Shingles
21A-20: Floor-Basement, Concrete slab, any thickness, 2 1820 4,275 0 0 0
or more feet below grade, no insulation below floor,
_anx floor_cover, shortest side._of floor.slab_is_20'wide
_ ......... - __......_
Subtotals for structure: 36,524 0 12,792 12,792
People: 6 1,200 1,380 2,580
Equipment: 901 4,116 5,017
Lighting: 0 0 0
Ductwork: 0 0 0 0
Infiltration:Winter CFM: 0, Summer CFM: 0 0 0 0 0
Ventilation: Winter CFM: 155, Summer CFM: 155 5,757 4,259 1,059 5,318
Humidification(Winter) 14 48_gal/daY�___ _...----_ _.. _. 5,.309
- - _ _ __0 _.... __ 0
Total Building Load Totals: 47,589 6,360 19,347 25,707
`� �%i?�� , �� , r
Total Building Supply CFM: 857 CFM Per Square ft.: 0.234 \
Square ft. of Room Area: 3,668 Square ft. Per Ton: 1,712
Volume(ft3)of Cond. Space: 31,192
��- a � �;: '�\� €
Total Heating Required Including Ventilation Air: � 47,589 Btuh 47.589 MBH
Total Sensible Gain: 19,347 Btuh 75 %
Total Latent Gain: 6,360 Btuh 25 %
Total Cooling Required Including Ventilation Air: 25,707 Btuh 2.14 Tons(Based On Sensible+ Latent)
�� � �:. � n. �_
�,,., w �.:: a ��� ;��' ��,;a � az,�. � .� ��,,.. � ��
, ><. � F . , ..�a. :x• u ;z ,,,, -_:..,:t ,..r..,,,,, .
.._. ., ...a.... .-.
Rhvac is an ACCA approved Manual J and Manual D computer program.
Calculations are performed per ACCA Manual J 8th Edition, Version 2, and ACCA Manual D.
All computed results are estimates as building use and weather may vary.
Be sure to select a unit that meets both sensible and latent loads according to the manufacturer's performance data at
your design conditions.
M:\Sales and Estimating\Heat Calcs\DRH\1303 Interlachen Dr Eagan SOUTH.rh9 Friday, August 28, 2015, 9:10 AM
Siteaddress 1303 Interlachen Drive,Eagan MN Date $/2$/15
`°�`�"°` Sabre Plumbing & Heating `°BY`ea Michael H
Section A
Ventilation Quantity
(Determine quantity by using Table R403.5.2 or Equation 11-1)
Square feet�Co�ditioned area including 3668 Total required ventilation 155
Basement—finished or unfinished)
4 Continuous ventilation 7�
Number of bedrooms �
Directions-Determine fhe total and continuous ventilation rate by either using Ta61e R403.5.2 or equation 11-1.
The toble and equotion are below
Table R403.5.2
Total and Continuous Ventilation Rates in cfm
Number of Bedrooms
1 2 3 4 5 6
Conditioned space(in Total/ Total/ Total/ Total/ Total/ Total/
1000-1500 60/40 75/40 90/45 105/53 120/60 135/68
1501-2000 70/40 85/43 100/50 115/58 130/65 145/73
2001-2500 80/40 95/48 110/55 125/63 140/70 155/78
2501-3000 90/45 105/53 120/60 135/68 150/75 165/83
3001-3500 100/50 115/58 130/65 1 3 160/80 175/88
3501-4000 110/55 125/63 140/70 155/78 170/85 185/93
4001-4500 120/60 135/68 150/75 165 83 180/90 195/98
4501-5000 130/65 145/73 160/80 175/88 190/95 205/103
5001-5500 140/70 155/78 170/85 185/93 200/100 215/108
5501-6000 150/75 165/83 180/90 195/98 210/105 225/113
Equation 11-1
(0.02 x square feet of conditioned space)+[15 x(number of bedrooms+1))=Total ventilation rate(cfm)
Total ventilation—The mechanical ventilation system shall provide sufficient outdoor air to equal the total ventilation rate
average,for each one-hour period according to the above table or equation.For heat recovery ventilators(HRV)and energy
recovery ventilators(ERV)the average hourly ventilation capacity must be determined in consideration of any reduction of
exhaust or out outdoor air intake,or both,for defrost or other equipment cycling.
Continuous ventilation-A minimum of SO percent of the total ventilation rate,but not less than 40 cfm,shall be provided,
on a continuous rate average for each one-hour period.The portion of the mechanical ventilation system intended to be
continuous may have automatic cycling controls providing the average flow rate for each hour is met.
Section B
Ventilation Method
(Choose either balanced or exhaust only)
� Balanced,HRV(Heat Recovery Ventilator)or ERV(Energy Recovery ❑ Exhaust only
Ventilator)—cfm of unit in low must not exceed continuous Continuous fan rating in cfm
ventilation ratin b more tha�100%.
Low cfm: �� High cfm: ^C O Continuous fan rating in cfm(capacity must not exceed
1 JO continuous ventilation rating by more than 100%)
Directions-Choose the method oj ventilaLian,balanced or exhaust onty.Balanced ventilotion sysiems ore typically HRV or fR V's.
Enter the low and high cfm amounts.Low cfm air flow must be equal to or greater Yhan the required continuous ventilation rate and
less than 100%greater ihon the continuous rate.(For instance,if the/ow cJm is 40 cfm,the ventilatian fan must not exteed 80 cfm.J
AutomaYic controls may allow the use of a larger fan that is operoted o percenfaqe of eoch hour.
Section C
Ventilation Fan Schedule
Descri tion LoCation Continuous Intermittent
Diredions-The ventilotion fon schedule should describe what the fan is for,the location,cfm,and whether it is used for continuous
or intermittent ventilation.The jan that is chose for continuaus ventilation must be equal fo or greater than the low cfm air rating
ond less than 100%greater than the continuous rafe.(For instance,ij the low cfm is 40 cfm,the continuous ventilation fan musf not
exceed 80 cjm.J Aufomatic controls may allow fhe use of a larger fan that is operated a percentage of each hour.
Sedion D
Ventilation Controls
(Describe operation and control of the continuous and intermittent ventilation)
ERV has wall control-set to 50%=88 CFM
ERV has wall conVol-set to 90%=158 CFM
Directions-Describe Yhe operation of the ventilotian system.There should be odequote detail for plan reviewers and inspectors to verify design ond
installation compliance.Related irades also need adequafe detail for placement of controls and proper operation of the building ventilation.If exhoust jans
are used for building ventilation,describe the operotion and location of any controls,indicators and legends.ljan ERV ar HRV is to be instolled,describe how
if will be instolled.!j it will be connected and interjaced with the air handling equipment,please describe such connections as detailed in tNe manufactures'
installation instrudions.If the installation instrudions require or recommend the equipment ta be interlocked with the air hondting equipment for proper
operation,such interconnection shall be made and described.
Diredions-In order to determine the makeup air,Table 501.4.1 must be filled out(see below).for most new installations,calumn A will be appropriate,however,if
atmospherically vented appliances or solid fuel appliances are installed,use the appropriate column. Please note,if the makeup air quantity is negative,no additiooal makeup air
will be required for ventilation,if the value is positive refer to Table 501.4.2 and size the opening.Transfer the cfm,size of opening and type(round,rectangular,flex or rigid)to
the last line of section D.
Table 501.4.1
PROCEDURE TO DETERMINE MAKEUP AIR QUANITY FOR EXHAUST EQUIPMENT IN DWELLINGS
(Additional combustion air will be required for combustion appliances,see KAIR method for calculations
One or multiple power One or muRiple fan- One atmospherically vent Multiple atmospherical-
vent or direct vent ap-pliances assisted appliances and power gas or oil appliance or one solid ly vented gas or oil appliances
or no combus-tion appliances ve�t or dired vent appliances fuel appliance or solid fuel appliances
Calumn D
Column A Column B Column C
1� 0.15 0.09 0.06 0.03
a�pressurefactor �
(cfm/s�
b)conditioned floor area(sf)(including 3668
unfinished basements)
Estimated House Infiltretion(cfm):[la 550
x 1b]
2.Exhaust Capacity
a)continuous exhaustronly ventilation system E RV=O
(cfm);(not applicable to ba-lanced ventilation
systems such as HRV)
b)clothes dryer(cfm) 135 135 135 135
c)80Y of largest exhaust rating(cfm);
Kitchen hood typically `Z40
(not applicable if recirculati�g system or if
powered makeup air is electrically interlocked
d)80%ofnextlargestexhaustrating NOt
(cfm);bath fan typicalty
Applicable
(not applicable if recirculating system or if
powered makeup air is electrically interlocked
Total Exhaust Capacity(cfm);
[2a+2b+2c+2d] 375
3.Makeup Air Quantity(cfm) 375 �
a)total exhaust capacity(from above)
b)estimated house infiltration�from 55�
above)
Makeup Air Quantity�cfm);
[3a-3b] -175
(if value is negative,no makeup air is needed)
4.FormakeupAirOpening5izing,refer NOT REQ��
to Table 501.4.2
A.Use this column if there are other than fan-assisted or atmospherically vented gas or oil appliance or if there are no combustion appliances.(Power vent and direct vent
appliances may be used.)
B.Use this column if there is one fan-assisted appliance per venting system.(Appliances other than atmospherically vented appliances may also be included.)
C.Use this column if there is one atmospherically vented(other than fan-assisted)gas or oil appliance per venting system or one solid fuel appliance.
D.Use this column if there are multiple atmospherically vented gas or oil appliances using a common vent or if there are atmospherically vented gas or oil appliances and solid
fule appliances. �
Table 501.4.2
Makeup Air Opening Sizing Table for New and Existing Dwelling Units
One or multiple power One or multiple fan- O�e atmospherically vented Multiple atmospherically Duct di-
vent,direct vent ap- assisted appliances and gas or oil ap- vented gas or oil ap- ameter
pliances,or no combus- power vent or direct vent pliance or one solid fuel pliances or solid fuel
tion appliances appliances Column 8 appliance appiiances
Passiveopening 1-36 1-22 1-15 1-9 3
Passiveopening 37-66 23-41 16-28 SO-17 4
Passive opening 67—109 42—66 29—46 18—28 S
Passive opening 110-163 67—S00 47—69 29—42 6
Passiveo enin 164-232 101-143 70-99 43-61 7
Passiveo enin 233-317 144-195 100-135 62-83 8
Passiveopening 318-419 196-258 136-179 84-110 9
w motorized dam er
Passiveopening 420-539 259-332 180-230 111-142 10
w motorized dam er
Passiveopening 540-679 333-419 231-290 143-179 11
w/motorized damper
Powered makeup air >679 >419 >290 >179 NA
Notes:
A.An equivalent length of 100 feet of round smooth metal duct is assumed.Subtrad 40 feet for the exterior hood and ten feet for each 90-degree elbow to
determine the remaining length of straight duct allowable.
B.If flexible duct is used,increase the duct diameter by one inch.Flexible duct shall be stretched with minimal sags.Compressed duct shall not be accepted.
C.Barometric dampers are prohibited in passive makeup air openings when any atmospherically vented appliance is installed.
D.Powered makeup air shall be electrically interlocked with the largest exhaust system.
Combustion air
Not required per mechanical code(No atmospheric or power vented appliances)
� Passive(see IFGC Appendix E,Warksheet E-1) Size and type 3"RI Id,4��Flex
Other,describe:
Explanation-If no atmospheric or power vented appliances are installed,check the appropriate box,not required.If a power vented
or atmospherically vented appliance installed,use IFGC Appendix E,Worksheet E-1(see below).Please enter size and type.Combustion
air vent supplies must communicate with the appliance or appliances that require the combustion air.
Section f calculations follow on the next 2 pages.
Directions-The Minnesota Fuel Gas Code method to calculate to size of a required combustion air opening,is called the Known Air
Infiltration Rate Method.For new construction,4b of step 4 is required to be filled out.
IFGC Appendix E,Worksheet E-1
Residential Combustion Air Calculation Method
(for Furnace,Boiler,and/or Water Heater in the Same Space)
Step 1:Complete vented combustion appliance information.
Furnace/Boiler: 60000
raft Hood �an Assisted �irect Vent Input: Btu/hr or Power Vent
water Heater: 40000
raft Hood �Fan Assisted �irect Vent Input: Btu/hr or Power Vent
Step 2:Calculate the volume of the Combustion Appliance Space(CAS)containing combustion appliances. 2�6�
The CAS includes all spaces connected to one another by code compliant openings. CAS volume: fta
LxWxH 10 L 27 W 8�H
Step 3:Determine Air Changes per Hour(ACH)1
Default ACH values have been incorporated into Table E-1 for use with Method 4b(KAIR Method).If the year of construction or ACH is not known,use
method 4a�Standard Method�.
Step 4:Determine Required Volume for Combustion Air.(DO NOT COUNT DIRECT VENT APPLIANCES)
4a.5tandard Method
Total Btu/hr input of all combustion appliances Input: Btu/hr
Use Standard Method column in Table E-1 to find Total Required TRV: ft3
Volume(TRV)
If CAS Volume(from Step 2)is grea ter than TRV then no outdoor openings are needed.
If CAS Volume(from Step 2)i s less ih an TRV then go to STEP 5.
4b.Known Air Infiltration Rate(KAIR)Method(DO NOT COUNT DIRECT VENT APPLIANCES)
Total Btu/hr input of all fan-assisted and power vent appliances Input: 400�� Btu/hr
Use Fan-Assisted Appliances column in Table E-1 to find RVFA: 3000 ft3
Required Volume Fan Assisted(RVFA)
Total Btu/hr input of all Natural draft appliances Input: � Btu/hr
Use Natural draft Appliances column in Table E-1 to find RVNFA: O fts
Required Volume Natural draft appliances(RVNDA) �
Total Re uired Volume TRV =RVFA+RVNDA TRV= �OOO + � _ �+000 TRV fta I
Step 5:Calculate the ratio of available interior volume to the total required volume.
Ratio=CAS Volume(from Step 2)di vided by TRV(from Step 4a or Step 4b)
Ratio= 2160 � 3000 = 0.72
Step 6:Calculate Reduction Fador(RF�.
RF=lminus Ratio RF=1- 0.�� = 0.��+
Step 7:Calculate single outdoor opening as if al�combustion air is from outside. 40000
Total Btu/hr input of all Combustion Appliances in the same CAS Input: Btu/hr
(EXCEPT DIRECT VENT)
Combustion Air Opening Area(CAOA):
Total Btu/hr d i vid ed by 3000 Btu/hr per inz CAOA= 40000 /3000 Btu/hr per inz= ��.�� inz
Step 8:Calculate Minimum CAOA.
Minimum CAOA=CAOA multiplied by RF Minimum CAOA= I 3.33 X 0.28 = 3.73 inz
Step 9:Calculate Combustion Air Opening Diameter(CAOD)
CAOD=1.13 m ultiplied by t he sq u a re root of Minimum CAOA CAOD=1.13 V Minimum CAOA= 2'1� in.diameter go up one inch in size
if using flex duct
1 If desired,ACH can be determined using ASHRAE calculation or blower door test.Follow procedures in Section
G304.
IFGC Appendix E,Table E-1
Residential Combustion air(Required Interior Volume Based on Input Rating of Appliance)
Input Rating Standard Method Known Air Infiltration Rate(KAIR)Method(cu ft)
(Btu/hr) Fan Assisted or Power Vent Natural Draft
1994 to present Pre-1994 1994 to present Pre-1994
5 000 250 375 188 525 263
10 000 500 750 375 1 050 525
15 000 750 1 125 563 1575 788
20 000 1000 1500 750 2 100 1050
25 000 1250 1875 938 2 625 1313
30 000 1 S00 2 250 1 125 3 150 1575
35 000 1750 2 625 1313 3 675 1838
40 000 2 000 3 000 1500 4 200 2 100
45�0 2 250 3 375 1 688 4 725 2 363
50 000 2 500 3 750 1675 5 250 2 625
55 000 2 750 4 125 2 063 5 775 2 888
60 000 3 000 4 500 2 250 6 300 3 150
65 000 3 250 4 875 2 438 6 825 3 413
70 000 3 500 5 250 2 625 7 350 3 675
75 000 3 750 5 625 2 813 7 875 3 938
80 000 4 000 6 000 3 000 8 400 4 200
85 000 4 250 6 375 3 188 8 925 4 463
90 000 4 S00 6 750 3 375 9 450 4 725
95 000 4�50 7 125 3 563 9 975 4 988
100 000 5 000 7 5� 3 750 10 500 5 250
105 000 S 250 7 875 3 938 11025 S 513
110 000 5 500 8 250 4125 11550 5 775
115 000 5 750 8.625 4 313 12 075 6 038
120 000 6 000 9 000 4 S00 12 600 6 300
125 000 6 250 9 375 4 688 13 125 6 563
130 000 6 S00 9 750 4 875 13 650 6 825
135 000 6 750 10 125 5 063 14175 7 O88
140 000 7 000 10 S00 5 250 14 700 7 350
145 000 7 250 10 875 5 438 15 225 7 613
150 000 7 500 11 250 5 625 15 750 7 875
155 000 7 750 11625 S 813 16 275 8 138
160 000 8 000 12 000 6 000 16 800 8 400
165 000 8 250 12 375 6 188 17 325 8 663
ll0 000 8 S00 12 750 6 375 17 850 8 925
175 000 8 750 13 125 6 563 18 375 9 188
180 000 9 000 13 500 6 750 18 900 9 450
185 000 9 250 13 875 6 938 19 425 9 713
190 000 9 S00 14 250 7 125 19 950 9 975
195 000 9 750 14 625 7 313 20 475 10 238
200 000 10 000 15�0 7 500 21000 10 500
205 000 10 250 15 375 7 688 21525 10 783
210 000 10 500 15 750 7 875 22 OSO 11025
215 000 10 750 16 125 8 063 22 575 11 288
220 000 11000 16 500 8 250 23 100 il 550
225 000 11250 16 875 8 438 23 625 11813
230 000 11 S00 17 250 8 625 24 150 12 075
1.The 1994 date refers to dwellings constructed under the 1994 Minnesota Energy Code.The default KAIR used in this section of the table is
0.20 ACH.
2.This sedion of the table is to be used for dwellings co�structed prior to 1994.The default KAIR used in this sedion of the table is 0.40 ACH.
� ' LOT SURVEY CHECKLIST FOR RESIDENTIAL ��� -�-j��
BUILDING PERMIT APPLICATION
PROPERTY LEGAL: Z � • ° a' �r� '
✓ DATE OF SURVEY: �
LATEST REVISION:
_ � �Gyr� ��`l�� 1 F�r�"�c:-�- ���
�
� �
�
�
�
a �
O z Q DOCUMENT STANDARDS
�" ❑ ❑ • Registered Land Surveyor signature and company
� ❑ ❑ • Building Permit Applicant
� ❑ ❑ . • Legal description
� p ❑ • Rddress
� p ❑ • No�th arrow and scale
�( ❑ ❑ • House type(rambler,walkout,split w/o,split entry, lookout,etc.)
� p ❑ • Directional drainage arrows with slope/gradient%
� p ❑ • Propased/existing sewer and water services& invert elevation
' �' ❑ 0 • Street name
,� ❑ 0 • Driveway(grade&width-in R/W and back of curb, 22' max.)
�P1 0 ❑ • Lot Square Footage
�- ❑ p • Lot Coverage
ELEVATIONS
Existin
�' ❑ ❑ • Property comers
� ❑ p � Top of curb at the driveway and property line extensions
� p ❑ • Elevations of any existing adjacent homes
� ❑ ❑ • Adequate footing depth of structures due to adjacent utility trenches
� p ❑ • Waterways(pond, stream, etc.)
Proposed �
�' ❑ 0 • Garage floor
L� 0 ❑ • Basement floor ,
�- ❑ ❑ • Lowest exposed elevation(walkoutlwindow)
� ❑ ❑ • Property corners
�' 0 ❑ • Front and rear of home at the foundation
PQNDING AREA(if applicable)
p � ❑ • Easement line
p � ❑ • NWL
❑ � 0 • HWL
❑ �f p + Pond#designation
❑ �d 0 • Emergency Overflow Elevation ;
❑ � p • Pond/Wetland buffer delineation
Y Q • Shoreland Zoning Overlay District
Y � • Conservation Easements
DIMENSIONS
f� ❑ 0 • Lot IinesBearings&dimensions
�X ❑ p • Right-of-way and street width(ta back of curb)
� ❑ ❑ • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent footings)
�'' ❑ p • Show all easements of record and any City utilities within those easements
�( ❑ p • Setbacks of proposed structure a ' yard setback of adjacent exisfing structures
� ❑ 0 • Retaining wall requirements:
Reviewed By. Date
G:/FORMSBuilding PermifApplication Rev.11=26-04
rtzg-ose tass) �xv� �os-ose (zss) ��NOHa � �
. •o}osauuly� '�(}una� o}o�{�ra 'N01110Qd c c M Q 4,
L££S5 NW 3llYrSN21fi8 , �' (A W Z � Q
bZl 311f1S 'Z4 OVON AlNf10� 1S3M 006Z 02�� Hldd b'1QN`dQ £ ���18 '� �p�1 O� ,� �'.°' _1,v
sao��nans / sa�wpr� / sa�N�na r,aas�xknr - �rr katbro�r xrr � � � � ��� . �o W Q r
�:�u i � � sa�� �a� � � � � W �� �"' � "' W
I II.N �I r �n�ns �o ����� � � �� � a �
� -� �
t� � � N N � f0
�' 3
E„ � � Q oa � �
�
�� o � o � n � � ` v s m
N N
ar u �a � � � r° 3 a 3 � aQ.i
� �c o3 `oa�i �� � � `o � X
m o �' s �' `- °1 `" Q �" a�'i a a�
� � u .«- � v w. � a� �. -�' � o-,�
� o �
��\ 'w °�' � c � � u tO '� �Q °�° ` � cn �" °1
c � �o o y � � a� m ,� v 4 m „ a
� v °0 -o a v a � n-a u et o � .,,,, c�.� cs o
c.°� � � °„' � .'� � y,-a `�° � o r+ �' � v ,� ca
� m tC 'O� Q! � t... �X .tl 4! OD J N �� �a y,,, C.J � L
+' to � p.++ O C! 'O 'D p� J O vf�� O a-+
� O � O O � Q � V � ri u O 0�0 3 � � Q
� a.+ !`� .� V O. � � � � CC a ^ Q � M P� h h� M e-i t' 1�.7 a s�.�
4'�
z � p v� C �-- O � y � sn "� � m � oC oC oC O O � � � � �
� S -� � W � � ltt ti'1 V1 V1 ti,. N O. 3 y
O � �-` � � o � � � � � 'G � vi Q0000 o �. � � � �
�- � '� •� � �' n � a�i a�i a m Q � ° � � .-� .-i r+ .-i � $ o o ,� :.c u
0 � o v � .� _ � y � N *' �- � � �s � � ro �' ro
� c u � � a � •X �a +� a, � �o ° �t O 6Q� � ro � � o
Z Q c � � � o ,� '-° v � awv . c > +`� F- `'° � a' Q n' `_° h�- c o
� � a, 3 ,r � ° oos � 3 .. a °' ° vu`ti " �,+� c� c�
� M � ,� � V d0� �„`~' ,� N � Q Z .`^ N '�'' �.�I. M��OQ v � t O � � v�i �
F- �- ao c `^ � '^ s� �- '�' as cu Q L m � �s Cn � � cv rn LL � +, �, y � cn
� ¢ ,� ° '^ °' � :n �a � �.� a'vri� > v Z V u u u F- '^ � c c � �i
� n- "' � oa c � '`^ °,�' °' c � m � °„' � � p _J � � � .cm Q Z
� � �� � .n � >- •o L c.+� af0+ �� a'�� u � ° F– o � � Ca.) u V @ N � y T �
W Y 0 . N � C N vf ,u,, y ++ "a N L C � � � � C 'Q '- p V O .0 • O N �p � O
0 a i Q = ro o � � � � cu � ao a w a� ^'� �a > "- o � c„ tn +� � � °' o a.
o m �° � o ;,� " v 4= '° � -o � m a � ui SC ` m m � '1 m m � � .c
}' m ��" m c c � c a"i �Y Q $ n a o� c R z Q s -'� `o ° o o � ,� p '� �� � °�' � _
I'� Y ~ 's= "C V C1 a� � 4t Z 'O a�.+. y� W O Q' �. O � s.. � u1 � d �n
W o ��� ;; afOi �� ,_'-, � o = � o c � � a? 4 L � �0 = ° � 'j- E- � LL V C7 ro UJ T'�'' .� a�i .-� Y .
� m c mm � =az � . z � oa -rssnl7 �na �„a � O � a°'o � v � °n' a�'i � � �y ° ° 3 a �
p m to CY LL'
� o m W o � m o 0 o Q � o 'i � � a � � °
� � .-� .-i ni e+ri' d� �ri � r: oo m I- u„ l? C7 x ...a = -, � D Cn , � _ ._ � v� �
A ---�_ ���r V
,� w ---_��' N3 �
N
z � � -�' "------`��ry�""� '� a � � � o
¢ z ..� +!� �-------�-_._"���1�� � � � s �
z � ¢ �} � o� ���� �S4LQS� «o��csQ�=o — ---� _ � �� � �
c E .. > _
� o � ; ,,£ �� � Qo'o�9=� � Q � � � � � �
� o -� v -�
� E� w .d,l}�� ° .Ltio LO-=C7 � r� � c .� � � ao N
�'"t�SOi � �rj �C�'� .,,-��,L�$i-�j:, �1L�hSQC i .a3£`954�..,._.`__'."" _..i.-` n".a c a. � � n..
.� W "� � �' � � 'n2i3s � " \ '�.S��C.��"" � � � �° a° v a
� O � +� � ��/ ih, �8�b , � � �
� ' `~! 8'9SOt a a�i a a�i a v v
� —Z--- o000000
W � a 'S!- � � � �� ::.:...... ..
fa C3. E�-y � � .. 06°t6'26',�:..�'� 6 •
„_, r/� � ... `'..`,�" --._ rn T o � � t8'9S0 t�� c c c c c c c
? w ,� ��al � o � .. r„} cc'�"' 8 �� oor.� 0000
� ,.� z �v � °i t e'"a ��sso� � w I ,.- ��'�so�-n.�-r�
� z w � N Q d„ ; � �'�� ' 1Mb F'090[' �, ,• -4�3Ntds �� dal
+� � � o o Q-= z��.--� �c'9sot)�nvM^��M3^►�1� '; 1�' '- --z•$soa�w H�►v�a � o
a�- , _ � � � �sodo � r: r � £ s�rra "
� � o o•�z v� 2Jr,} , '�1so�
„�.f} / u� � ���SSQI. t3� a +� � o , J.M�/ o� o
^ ^ 4 � � ;, �F•��� � ti {i$�o�) � ;� � -0 4 0 . .� � �
q �, � � ; ; ; ,,���.�.�,�Z.ozq o ,
'C M 1 i ,� ,�'' ,;,/�` �,,,,�,�'o� i �- , � "��(}d
d'` ��Y�r� �i �`Jb' ''� {�� � �
`�� f �`° ��u-Ni�o � �,,-'' % �Jb� o ^ '
rn o Q� .,,/� ���sv o,� a? c.�
� ` ; ��a Z�il� `� ,-'�,f j,.�`��,�' Q'j �� '� 3�b�jt��
� `+ r� ��r,`; q3S�p��� � ' C�C7. w x " �
,
Q 0 � '� w� , �,,,-'�.-�r,. � �,' �,,,_ ;, '`��� �
^ O ° � ;` � �` ; -' ,`1 n��?b� ''� 4 - -'�` '
o�' p� �� y ;�.` , M-a'SI �,,� M} N j� t,t,� GlnO�lbM) �
a � `... / `U" -.._ , "?ha3Q a� 0,,�'��� I pj
/ " � . „ ,�'- , Cp �'°£sat
^. � : � L`z� st� • ai p•� s�."
�� �� N�ia aN�a�a��t �"*'�-�_b'oso� aria
., .
�7� ot Qdd �o-re .�o a�a-: (t•oso�so� ` <' � s�zsoc .u�a �e
�� t7-
a� � �;-�...L �-s�ot ,�y7d o � � � Q �
� ��, �,-' � �y � l� � � � t�
o � �_�_'l��� ��Q� �/�j��3��N�W��otx 'w: C� � � � � N
1 a�� 1 �:O�aZQ��,�1 •.�t,Z�,o �bN�y�Q�„ � r � 1'� � � �
��. � �C� + Z�'`�-.. � .� �
a � `'�.. S w
o ,,,�,�
� � "J.... � ' � � �
.s �C�(�� .� � �� �� z � �� q
� t. , � ',.► � � w d
� � U
r Q �
OF � �js �. � � �,►
�' ��',� �0�� M` n ,- >.
,�� � °6C' °�oJ! // � �
� Y.. � �
� `�— �, � Q l(,i
a, � � � s�� �, � �
��, � � �so� m� c� qC
4J = �+ �c�� �(� J �
� : V
4'� � � t� 1�
� �� � � � `J ���
� • `- �!,� `�- � '> � U
.� •� r
� ;� � �� � ��,�� Z
,� �`� °C "�� z��
� � � V~Q�
�
M /
City of Eau
Address: 1303 Interlachen Dr
Permit #: 132935
The following items were / were not completed at the Final Inspection on: cr /
Final grade - 6" from siding
Permanent steps — Garage
Permanent steps — Main Entry
Permanent Driveway
Permanent Gas
Retaining Wall or 3:1 Max Slope
Sod / Seeded Lawn
Trail / Curb Damage
Irci 7Jr20 S�eDep
Porch
I/ -
Rete_ f z t—
Lower Level Finish
Deck
U12 ez pq_ckt-
Fireplace
v L o
• Verify with your builder that roof test caps from the plumbing system have been removed.
• Turn off water supply to the outside lawn faucets before freeze potential exists.
• Call the Engineering Department at (651) 675-5646 prior to working in the right-of-way or installing an
irrigation system.
Building Inspector:
13s. 04 044(Y4
G:\Building Inspections\FORMS\Checklists
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA136441
Date Issued:05/12/2016
Permit Category:ePermit
Site Address: 1303 Interlachen Dr
Lot:2 Block: 3 Addition: Dakota Path 3rd
PID:10-19542-03-020
Use:
Description:
Sub Type:Residential
Work Type:Underground Sprinkler System
Description:PVB
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - RPZ/PVB/Lawn Irrigation $59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Dr Horton Inc Minnesota
20860 Kenbridge Ct Ste 100
Lakeville MN 55044
Sabre Plumbing Heating & A/c Inc
15535 Medina Road
Plymouth MN 55447
(763) 473-2267
Applicant/Permitee: Signature Issued By: Signature
�` Are e CJS-- ( 4`�l/"'v Use BLUE or BLACK Ink
V 1
For Office Us1
City of Eapll . 4L C())7\44
3830 Pilot Knob Road SSV' -tS
Eagan MN 55122
Phone: (651) 675-5675 Ira 7,0$
Fax: (651) 675-5694
Permit
t #:
Permit Fee:
Date Received:
Staff:
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Site Address: 1 (Th \ fl ,.I(Chei)�r.Eo,o,Am,rnNI 55 1'
Tenant:
Suite #:
RESIDENTIAL FEES:
Name: ID 1. l 1O'(*OyTh Phone: p 2- JO C,- I bA
Address / City / Zip:
Name: Milbert Company Inc dba Culligan Water WC6413 76
License #:
Address: 1.801 50th St East
City: Inver Grove Hgts.
State: Mn Zip: 55077 Phone: 651-451-2241
Contact: William R Milbert
Email:
New Replacement Repair Rebuild _ Modify Space Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation (_ RPZ / PVB)
Septic System
New
Abandonment
XWater Softener
Add Plumbing Fixtures L Main / Lower Level)
Water Turnaround
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) / //��
TOTAL FEES $ (0V , Q O
CALL BEFORE YOU DIG. Call Gopher State One Call at (661) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecali.oru
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 ich requires a review and appro I of plans.
i"kVt
x
Applicant's Printed Name
Applicant's Signature
a