4019 River Valley Way ��/����1 -- `� � ��. ��7
�-���� - /f�'a� � �' Use BLUE or BLACK Ink
�-----------------
L / /�a `� � � For Office Use i
� � /;�:��5� _� ,
C�b Ol �� 11 F< '��V��/ � / I Permit#: ���c�/ j
Y � � � Pennit Fee: f � `�' 7 �
3830 Pilot Knob Road Q I I
Eagan MN 55122 ��� O u ���� � Date Received: (�` ����
Phone:(651)675-5675 � �
Fax:(651)67 -5694 I Staff: I
�Ois- (� /����C7� I----------------�
2015 RESIDENTIAL BUILDING PERMIT APPLI TI N
o_'��i� � ,�lr�► " ��t'Q�, �.��►,� {�.
Date• � Site Address• 1u �� V W� ��� � Unif#• �
� ^ �Name: Q.I�[� �Y1�-E � ��(.,t'IC�. "-Phoa�:v��c��!
Residen�/ �j� � e �n
Owner Address/City I Zip: � �J'� ��/ � � �
Applicant is: Owner �Contractor ,� ��� �
Descriptionofwork: � � �l � ��tC�� ��
Type of Work . � � �
Construction Cost:` ��� ��� MulEi-Family Building: (Yes�/No_)
Company: � �!"t�l"��U't�lt '1l' ✓G�,�' �""' 'E2Sntact:_� ,�
Contractor � Address:�� ��°� C;fy. �'',c�'l'�/� l r c,tn f�� ,
State:l � I�ipt�� hone�:�`"��'"� `"�EmaiN �%�J W ' (�QY
License#:_ �(i����� Lead Certificate#:
If the project is exem t from lead certification, please explain wh :
� �u.u( ��� s ,�y�. 9
�.
COMP ETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In fhe 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��" l,��r`c V� � �\�� �V�/
- Y
Licensed Plumber: �� /(� �����'� � � Phone: �c�-�
Mechanical Contractor: '� � •Phone:� l�� ��'Y��-I'
Sewer&Water Contractor: �1 !� C.� � 1 h e•_�����}�� ��
Fire Suppression Contractor: � �./� » ��U`1� n� "" / 10����� Q
NOTE:Plans and supporting tlocuments that you submit are considered to be public informafion. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to. ' I
: conclude that#hey are trade secrets.: '
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of undecground utilities. www.aopherstateonecall.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 wifhout 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 S� , x �� .
ApplicanYs Printed Name ApplicanYs Signature
Page 1 of 3
� � ->
���' i -�. �'��� C� o��� � �
� � � d �, W�TE BELOW THIS L[NE ��
_ � C, l
SUB TYPES
_ Foundation _ Firepiace _ Porch(3-Season) _ Exterior Atteration(Single Family)
_ Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
Multi Deck Porch(ScreenlGazebo/Pergola) Miscellaneous
�j 01 of�Piex _ 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 Wall *Demolition of entire bullding—give PCA handout to applicant
DESCRIPTION
Valuation � �� Occupancy � 'L—'','—� MCES System
Plan Review Code Edition � �,� SAC Units
(25%�100%� Zoning �_ City Water
Census Code � Stories Booster Pump
#of Units Square Feet PRV
#of Buildings � length �p! Fire Suppression Required
Type of Construction �/'� Width �
_"T�'—
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 _Final ,
� Framing Drain Tile
� Fireplace:�Rough In �Air Test �Final Siding:_Stucco Lath ff Stone Lat _Brick
�, Insulation Windows
�C Sheathing Retaining Wall:_Footings_Backfill_Final
� Sheetrock � Radon Control
� Fire Walls Fire Suppression:_Rough In_Final
�C Braced Walls � Erosion Control
Other:
Reviewed By:_ � � , Building Inspector
RESIDENTIAL FEES ��������� ����Q����.��t,,� (�„�t,�`��`�
Base Fee
/ ! `J /
Surcharge ��..�,,.-,�,�,r; �'`��,,, .�l '7�:1 ��� ���l o��
Plan Review r�-�� y- (� /�,
MCESSAC ��. � � ,+' !` / �J���= �``�� ��� � �,�
City SAC ��!` � ���� � ��� �� °� � /���d � / �
Utility Connection Charge � �
S&W Permit&Surcharge °�' � �
�� �� ��� � �� � ��
Treatment Plant �4 � ._.._----''`�'
Copies � �� ��J�l��
TOTAL
�
Page 2 of 3
� �����
New Construction Energy Code Compliance Certificate
Per R401.3 Certificate.A building certificate shall be posted on o�in the e/ectrica!distribution panel. Date CertifiCate Posted
COPY OF THIS DOCCUMENT WILL BE POSTED ON THE PLENTUM OF FURNACE 10/7/2015
Mailing Address of the Dwelling or Dwelling Unit: City:
4019 River Valle Way Eagan �
Name of Residential Contractor: MN License Number
RYLAND HOMES BC035443
THERMAL ENVELOPE RADON CONTROL SYSTEM
Type:Check All That Apply X Passive(No Fan)
Activ�{Witfi fan antl monometer
o �, orvthersystem monitoring
� � deviGe)
a �,
� a� � Location(or future location)of Fan:
.p T
i @ i° � N �, _ � a a� If fan is required;Attic
o u '� -' U � o -o �
c� �- ° f6 'o U -4 a� �
3 Q m m d � -o c
� � Q � a
� C � N N � O_ LL O
Insulation Location � � Z � � v O @ w N
`° o o' °' E E
�6 3 C N N N �O �6
� � C
F°- � z ii� � �° �i � � � Other Please Describe Here
Below Entire 51ab X
FOundatiOn Wall R-15 X R4022.8,Exception;a.R-10-by plan
Perimeterof Slab pn Grade x -
Rim Joist(1st Floor) R-20 X
Rim Joist(2nd Floor+) R 2o x
W811 R-21 X
Ceiling,flatl R-49 X '
Ceiling,vaulted R-a9 x
Bay Windows or cantileuered<areas R 3o x
i
I Floors over unconditioned area R-38 X
I Descnbe other insulated areas
Building envelope air tightness: Duct system air tightness:
Windows&Doors Heating or Cooling Ducts Outside Conditioned Spaces
Average U-Factor(excludes skylights and one door)U: 0.29 X Not applicable,all ducts located in conditioned space
Solar Heat Gain Coefficient(SHGC): 0.32 R-value
MECHANICAL SYSTEMS Make-up Air Select a Type
Appliances Heating System Domestic Water Cooling System
Heater X Not required per mech.code
Fue�Type NATURAL ELECTRIC ELECTRIC Passive
IManufacturer LENNOX RHEEM LENNOX Powered
i Interbcked with exhaust device.
Mode� ML193UH045XP P'ROE502RH91 13ACXN018 oescribe:
Input in 44000 Capacity in 50 Output 1 5 Other,d2scribe:
Rating of Siz2 BTUS: Gallons: in Tons:
AFUE or g3 SEER ' 13 LOCBtiOn Of duCt Or SySt2�Yt:
Efficiency o
Residential Load Heating Loss Heating Gain Cooling Load ERV installed on furnace
� Calculation 39466 15887 18383 crm�s
"round duct OR
MECHANICAL VENTILATION SYSTEM "metal duct
Describe any additional or combined heating or cooling systems if installed:(e.g.two furnaces or air Combustion Air Select a Type
source heat pump with gas back-up furnace):
X Not required per mech.code
Select Type Passive
Heat Recover Ventilator(HRV) Capacity in cfms: Low: High: Other,describe:
Energy Recover Ventilator(ERV)Capacity in cfms: Low: 50 High: 140 Location of duct or system:
Balanced Ventilation capacity in cfms M@Cha111Ca1 fOOI71
Location of fan(s),describe: Cfm's
Capacity continuous ventilation rate in cfms: 6" "round duct OR
Total ventilation(intermittent+continuous)rate in cfms: "metal duct
%���� 1
P1�01eCt SUCr911'lal``, J°b'
� �N��C��4'��s0�� J 3 Date: 2015
Enf�re 1-�ouse ay:
Elar�der tViechanical fnc Pian: FREMONT
700 VaEley Industrial Circle South,Shakopee, MN 55379 Phone:852-445•4692 Fax:952-496-2092
8 ' 0 0
For: Ryland Homes
�iotes:
� - o e �
Weather: Minneapo[is-St Paul lnt'I Arp, MN, US
Winter �esign Conditions Summer Design Gonditions
Outside db -95 °F Outsicfe db gg °F
Inside db 70 �F Inside db 7Z °F
Design TD 85 °F Design 7D 'f6 °F
Qaily range M
Relative humidity 50 %
Mois#ure difference 38 gr/lb
Heating Summary Sensible Gooling Equipment Load Sizing
Structure 35603 Btuh Structure 15165 Btuh
Ducts 0 Btuh Ducts 0 Btuh
Central vent (85 ctm) 3863 Btuh Central vent (85 cfm) 723 Btuh
Humidificatian Q Btuh Blower 0 Btuh
�'�p��g 0 Btuh
Equipment load 39466 Btuh Use manufacturer's data y
Rate/swing multiplier 1.Q0
itlfiifi�'ation Equipment sensibfe load 15887 Btuh
Method Simplified Latent Cooling Equipment Load Sizing
Canstruction quality 7fght
Firepiaces 0 Structure 143'[ Btuh
Ducts 0 Bfuh
Heating Goaling Cenfral vent (85 cfm) 1065 Btuh
Ar�a (ftz} 2252 2252 Equipment latent load - 2495 Btuh
Vofume(ft3} 18928 18928
Air changes/hour 0.15 0.08 Equipment total load 18383 Btuh
Equiv.AVF (cfm) 47 25 Req. tatal capacity at 0.86 SHR 9.5 ton
Heating Equipmen� Summary Cooling Equipmenfi Summary
Make Lennox Make Lennox
Trada MERIT 90 Trade MERIT
Madel ML193UH045XP24B-� Cond 13ACXN018-230-*"
AHRI ref 4792'i30 Coil C33-25*++TpR
AHRI ref 76'172�49
Efficiency 93AFUE Efificiency 19.0 EER, 13 SEER
Heating input 44000 MBtuh Sensibfe cooling 'i5228 Btuh
Heating output 41000 Btuh �.atent cooling 3572 Btuh
Temperafure nse 61 °F' Taial cooling 18800 Btuh
Actual air fiow 627 cfm Actual air flow 627 cfm
Air flow factor Q�18 cfrr�/Btuh Air flow factor 0.04'f cfmBtuh
Static pressure 0 in H20 Sfafic pressure 0 in H20
Space thermostat Load sensible heat ratio 0.88
8oldlitalic values have been manually overridden
Calculations approved by ACCA to meet all requirements of Manual J 8th Ed.
2015-Jun-24 0'7;14:i5
^+- �1fV!'Cg{1tS�3�° Right-Suite�Universal 2012 12.i.06 RSU13410 Page 1
�� ...ardfDesktoplHeat[.osses 20131Ryland Fremoni.rup Calc=MJ8 Front Qoor faces: N
- ' ' LOT SURVEY CHECKLIST FOR RESIDENTIAL / � �� ��
BUILDING PERMIT APPLICATION �
PROPERiY LEGAL: ���."/C� ��c• +I.� �-�v'�'f'� ��11��� �St d`7!� -
DATE QF SURVEY: � ��II��
LATEST REVISION: In�����
d
a�
c
R
t
V
�
O z ¢ DOCUMENT STANDARDS
� p ❑ • Registered Land Surveyor signature and company
� ❑ p • Building Permit Applicant
�j p ❑ • Legal description
� p ❑ • Address
� ❑ ❑ • North arrow and scale
� ❑ ❑ • House type(rambler,walkout,split w/o,split entry, lookout,etc.)
� ❑ ❑ • Directional drainage arrows with slope/gradient% r
❑ � • Propased/existing sewer and water servicQs&invert elevation—��jpy�//1�• t� L����•
•� ❑ ❑ • Street name
� ❑ 0 • Driveway(grade&width-in R/W and back of curb,22' max.)
p �J ❑ • Lot Square Footage
p �' ❑ • Lot Coverage
ELEVATIONS
Existin4
� ❑ p • Property corners
� ❑ ❑ • 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
❑ � 0 • Waterways(pond, stream, etc.)
Proposed t
,� ❑ ❑ • Garage floor
❑ �` 0 • Basement floor ,
� p ❑ • Lowest exposed elevation(walkout/window)
�� ❑ A' • Property corners
❑ �' • Fronty an_ d rear of home at the foundation
PONDING AREA(if applicable)
❑ � ❑ • Easement line
❑ � ❑ • NWL
� ,�( 0 • HWL
p ,0 ❑ • Pond#designation
❑ ,� p • Emergency Overflow Elevation ;
❑ ,� ❑ • Pond/VVetland buffer delineation
y t� • Shoreland Zoning Overlay District
Y � • Conservation Easements
DIMENSIONS
� ❑ 0 • Lot IinesBearings&dimensions
��� ❑ � • Right-of-way and street width{to back of curb) S�p�/ �q''d`� ��/'e.�.'�.,1.
0 � • Proposed home dimensions including any propossd decks, overhangs greater than 2',porches, efc.�/t4�/��,�r�..t'
(i.e. all structures requiring permanent fo ' S$�,J h�� � f S'7�flb�p
� ❑ �' • Show all easements of record and an ity utilities ithin those easements s�✓ ,���r�
❑ fJ7' ❑ • Setbacks of proposed structure and sideyar set ack of adjacent existing structures
�'1I p ❑ • Retain,ing wall requirements:
Reviewed By: Date Z7 `
G:/FORMSBuilding PermitApplication Rev.11-26-04 ����6���
. .
Located in the NE 1/4 of
N
Certificate of Survey for. /����� Sec. 19, Twp. 27, Rge. 23 `
3:1 M�lmum S�oP� RYLAND HOMES -
a� ��a�ai�ing Wali W�1
B� Req�u�red � House Address:
4011 - 4019 River Valley Way, Eagan, MN
i House Model:
,� Fremont E, Pinehurst E, Newport F, Ontario H, Fremont F
/ � ��� /
�� � � ��
/ � � � � �
� � �
/ `
/ ���/ sMH azs.a
� i �� �
�
� ��\ �\� ��o�
/ /y� s�\ Szs.B 10' OFFSET
/ �. �� i BENCHMARK
/ /�\ G��O� �� 826.1 �/ i'— TOP OF SPIKE
� // 9,pF y �\ /� � EL = 829.34
/ � I
\\\\ ///\.�1 �\\ \\\\ \ 'i� � � $ 1I �
�� /� �,��v I � ���,. �/ �� 826.3 /� �, x 829.6 /�/ �
�i\ ,� V J `� ri (� � \7c R a2s.a 's� ._--05 L7
� /
\� /� ��� v\`��d� \ ��1 ��\ 100�� 29.3 0�-�/// ��
� \� /� �� i�\ � 826.6 � +0$'1 p\ ;9�9 q�'�� /' �+,
\\ \ j� / � \ ,.� 0�°,�.�,��' � cP�� l���� pFa'r
��\ / �\ � � s sf�� .�,LO 6, �1V�'o �j ��"�0���s ,`"�
\ 9���� � '�'�S� 19 0,�� � �?������// •S�o. � �,
'AF�, + O� �O �'19�0 �.}�°+ �Q,(� O
� � 6``st"O '1. •�S S B � /
�c�0 � 827.2 +'� 0 �•s �' °o � � s.�°L � �/
ASC�\ \� n, 6or�� �� ��,� a'� �•o � ( �0 `///
� 60�0 , !. ,�,s `/
\ G., r > j,,/ ��/ �
\ `J A^
� � / \ w�V� 6,,s o i �,� �6 `' 827.3
� \� 827.3 ` �0 +�°o ��4�� �y� Q
\�\ / �,S 7,�' �� �Q � _` � � �, � 9/ 827_3___\ /
\ N ,�
� � 827.6 � R��' eo'��0 `n, ` t�. �`� i�'�O� � 0
827.6 \ / �o N `L+ �go� V` ,-'�� ' GP�tPG� 828.0 � 1 0 $,L�. /'�
�� O � �' �( �� 826.6 �
TC �O �
5 �
'.A� g2g 5��. �o+�g1 \ 6'� � � �btig 9 � \ 27.s �! /
� 827.8 c� + \n �on OrR 1 �
/ / �6,s�, M �' g, � Q S�.eQ�ao� %�� PG�c, G6 6 �jpr � //
°f �° CO °` ° ' °� O� G� � 'L �, /�
827.8 / /�� /� ssro 'o�� k�` 'S� i�� F P , �O`'O /
(� G 0 G pQ �P � � 826.7
���F.�P�� / Pr>F.����e," .{�Ec1� � s��,6 O 69� s� Q O � V a R $,L0�0c�- O � Q�\�1°�° /��\ TC
��"� / \�y 4' ��\828.4 �.h�,� � 1 � Q ?� p GF, �oo+� � O r'��� � //�� 1 10' OFFSET
O J�\� � 25.4 O�\\ �106�s� ^ � � � 0 Gp.�tP �`6��,� ��\ � \ �826.9 \�\`— BOPCOF SP KE
/\�p-�'F,�,�g$/ ��,9� �s ooi k1s� `( � A 5 e�• 9 `µ 'o��ti'1$ �.1,Q yF,O \\J /y k// 7� ��� EL = 827.29
O�P �/ � �0��9�cPr, t� V 6`l'$.�i ' G5 �Q���lF''y°1° ��� ����I // �?,
�� 82 . �9� p ;:�V� PG�c• G6}0 0 ��ORx,'1' / � �\ /7 �
� ��-- �' Gp,fi �'O I� � � ��\ J� �/ \�
/ �p �' \ � / 827.5\ 7 ?
10' OFFSET j x 830.3 O � ,y�j, �O � J .(� TC �� / `9,
BENCHMARK i 832.0 r,�o+ �o;,- �9 t�G�µ oQ��Py / �/ �\ ��m ` �
TOP OF SPIKE —'� +� � � S O `�c., a. � QEz��.9e�e \� � � p�,, �
EL = 829.26 /� � "6`�,°s- `S Rp.GF' 16+6 OO ��'`\ r'� ORx,`�' �� �\J � /� �� \ � �
�� u'� o GP �,'L' Fj v� � � � ��,'/� �
,~j i � � \
�-� 7���•� s � `�� �o cs d�0,s1'QpS�° �� sz�.s�� ��X�,o s"\ �
�v- o � \ TC � �' n �
/� x 830�37,,� �i9i� G4°6�l�l G� �� \ \e�R\�9�0 /// '7/9�i�0�' o \� \� /� \
!y ,6+ $ \ �J / �`� �'� � � �
�o �9�'0 > Ec�'I \� ��\i \�aza.� �!r i` \ �s �� � �\ /
� 830. ��O. ~j ,y'LQ c�F,O �/\ j� �/ J�� \ �� / \
��J -' ,,-� �o azs. QR°�.�-�^Io �i� � ���;�� n J �,� �
. 0 2 p� e�• � \ � i � �, �.�, � \
�� �� x 829.8 , � � /\ J �\ �'' � F,p�`��' /
/ 9: 829.2 � � �-7 I ��� q1
10' OFFSET � 0�' /� / �J (,� .���.� / \
BENCHMARK / 828•5 /�il J /
TOP OF SPIKE —� � /� �� TC /��C��� r \ �P��
EL = 829.97 / \ //� �� �/v�\\J �\ JRP��PG \
\\� / / 828.8 //`�B� \ �' O �
"� Denotes Existing Hydrant �� � i� 9'�F�,� /
� � i s �
� Denotes Existing Electric Box '���9° � �
� Denotes Existing Television Box `� �,s 5"'M\\ �
� Denotes Existinq Telephone Box ��� /�. � � LEGAL DESCRIPTION:
� Denotes Existing Light Pole `'s°�' �� � Lots 6, 7, 8, 9 and 10, Block 1, CEDAR GROVE
So Denotes Existing Service �`� \` TOWNHOMES 1ST ADDITION, Dakota County, Minnesota
o Denotes Existing Curb Stop `
x 000.o Denotes Existing Elevation � LOtS 9 and 10
a X soo.o Denotes Proposed Elevotion By PROPOSED BUILDING ELEVATIONS
� — Denotes Direction of Drainage �
- - Denotes Drainage & Utility Easement �� --� "'' Lowest Floor Elevatfon: 830.1
Z (per recorded plat) EpGAI� ENG EERING UF.1'T; Top of Foundatfon Elevation: 833.3
a
�— Denotes Iron Monument Garage Slob Elevation (at door): $29.4
o NOTES:
Beorings shown C1re assumed LOtS 6, 7, and 8 1. Proposed buiiding site grading is in accordance with the
o cRaPHic sca�E PROPOSED BUILDING ELEVATIONS grading plans prepared by Alliont Engineering, Inc.,
� 0 15 30 60 last revised 7/28/15.
N Lowest Floor Elevatlon: $29•6 2. Contractor must verify sewer depth.
c rOp of Foundotion Elevotion: $32•$ 3. Driveways shown are for graphic purposes only. Final driveway
� Garoge Slab Elevatton (at door): 828•9 design and location to be determined by owner/builder.
(IN FEET� 4. All building foundation dimensions shown on this survey
� (11x17 sheet� include exterior foundation insulation widths, if applicable.
Refer to final building plans for foundation details.
1038 5711.002 BJS R and Job No. 35050010221 - 35050010225
� I hereby certify to Ryland Homes that this survey, plan or report was prepared by me or under my direct supervision
� Carison and that I am a duly licensed land surveyor under the laws of the State of Minnesota.
o � Dated this 29th day of September, 2015.
� McCain Signed: rls n Mc I c.
v ENVIRONMENTAL=ENGINEERING^SURVEYING
� 3890 Pheasant Ridge Drive NE, BY •
� Suite 100, Blaine, MN 55449 Revised: City Comments 10/26/15 Thomos R. Bolluff, L.S. Reg. No. 40361
d Phone: 763-489-7900 Fax: 763-489-7959 Revised: Client Comments 10/6/15 Peter J. Blomquist, L.S. Reg. No. 51676
>
�
s
use I or k*
ckdFor ONIMUM
of I Fee: 1 �
PIM Knob Road I
I
W 5rlri s l7a�s Reosiaad I
Phorm(W1)67SMM �
Fmc(451)675MM 2016
FEB �U --
2616 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION
D.ta: i— zs–ho sm Address• `' p 1 j -Rites VAuo WRY f i:T3�6
Taus suft m
Phom
taddress t cny t z� �s 1� �iJ�A(�iZA M �R.
i'i01
pr, AfF'iQAdRL� SPRthktER 5YST ?
Desm"m of waft o > l
wow
1"tEti�E >tf�t�i21;S5totJ �viGES e:
` ur.
, Itl tdI Cf r .cFiilZ
r
: .15 36 PMtone: � 3'Z-77
a ' ni
Contmt Sa
FM PERMR TYPE VK=TYPE
S�� (#Of ht�dsZ} A New —Ad on
Fme Ptxnp —Standpipe — —Remodel
—_Cxt+er: Owe:
DESCRIPTION OF WORK: —Commwdef )(-ResiderM
FEES
X1.00 Petit Fee Nk*num Conttsct Value S x Al
Surcharge=Corit M Vakre x$0.0005 =$ PenTdt Fee
If the project valtudon is over$1 million,plesse caw forSuncfmW =$ surdame
$100.00 ReskWnW New(inductee State Sum} =$- TOTAL FEE
3W Fire Motor-$2W= =$ Fire MOW
=& OQ TOTAL FEE
2 complete sots of dnwkw anw spoemcadons,cart sheets on mateclak and comPmuft to be 109d
I hereby apply for a Fins SuppMOaion Syli@M pemait and admoaledge drat the in[on swon is aarapkft mm accurate.SW the work will be in
cm*mmmm wilt the ondr wxm ayxt codes of the fey of Eagan and vAh the harrrraeata 8uldi V44re Codes;f d I undarstarrd We is not a perms but
only an appiieawon for a pwmii,and wok is not to start wilin t a penrr'tR Met Yte work will be In accmbncs wwh xre aWumd Plan in 80 case of work
which requires a nmm and approval of plow.
x 6A Wq5K x 444M
App's Pi kited Mom akpleft"
REQUIRED ifi r ��1'iONS
r.
�staticvk
df Issuance
h4 a
VV
Plk
r-
3, t .
Permit Rev a
. 1".
4*'
C!ty of EaRan
Address: 4019 River Valley Way
Permit #: 133681
The following items were / were not completed at the Final Inspection on: 6 ' 3v 1 4o
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
d, c
Porch
Lower Level Finish
/7 a 3ft�,l/toe r,•_
Deck
Fireplace
• 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:
/ ° o^ //nt• lel y1,9
G:\Building Inspections\FORMS\Checklists
Use BLUE or BLACK Ink
411' CityFor Offce Use
a Permitiof Eaali ti;a
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received: 1.10-4{-/
Phone: (651) 675-5675 Staff:
Fax: (651 - 94 L .,
1;
2017 SIDENTIAL PLUMBING PERMIT APPLICATION
Date: ��F. - Site Address: 4D` \CI 1_` ` ' - •4 " � ��
Nv ► , I I- I
Tenant: {X16 i 4 ' Suite#:
r
sok k ;£
�'I Name: � Phocol n
'',""4.'-' de` ® W
���` �---v:-..:,,�� �������` Address/City/Zip: t�I 1
. 2, , Name: t U 1k\\( .9"(/-1 oA. �1L/ �A A (.� .� License#: WC
3 { Ill..../1 fid' �► . cris—�-' yn Cord
�� *�`-,--40 4.4'�T� �� Address: Cit Li L �i
® tract•
% , , Y State: r) t Zip: el) Phone:
", ,1 `* meek F.
.4:6-t t' £.' ,�''? Contact:Lt 1•Pv IT\(' Email: L.A.�, 4 Q ad kc.��-�
'` ` New Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
* Description of work:
° _ ,,. .44 x-Zt�' RESIDENTIAL
x�
Water Heater
':, Water Softener
l4w '':::;:•;'A!', Lawn Irrigation( RPZ/_PVB)
L , # •! Add Plumbing Fixtures( Main/_Lower Level)
' '', _ ; Septic System
ti * _New Water Turnaround
`-'141-,-'T4- , ` *`, Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60,00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
*Water Turnaround(add$280.00 if a 3/4"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge)
TOTAL FEES$
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.00pherstateonecall.orct
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 e case work which equires a review and approval of pllla�nss�.
it
-.
Applicants PrtinteedrNaamerr ` Applicant's Signature
l �0 '/I't :+-'''4 ' �< yu.: �a �' ,,moi tY'" , 17.:4 , ' `
r!,O 'PF, C z S 4;:. s,. € • _ ' , s. ,:-...-`3`fi` x '" '',� ,. `�,..^r , w..
r ^a , f baa r
� +5#t�. �' zy y, 3" S « �. �=r t .�'k # 3' � �: !E.s, v':c 1- t x � t ,, , '.
�r,� r ,�^' 7 � 6. my � 14;;;;,4:4114140:! � xa a',
'' .eq red s• t •n ? t °IJtem *r"4,'::'70e d n ;; 'i k a
�'''' ; ,J 3 r z 2.'4 ? �.,*,41 `' ' '` �,'; ] z , , y,. + €' r r:
x � 2 a ���AK rt Hi = , ''''''' ''' '''',..%,:"?'
-t►a,er Related,tem0,2'4 eterr Size �'°• ad.Q R a4° , ;M n r e ;',--',',.A. �, , ,° . ° , f ; �'.