4017 Camberwell Dr N.• '?• ?
of 1C?rrupariry
Citp ot (Eagan
?irpormumt n# IuOintg Jtt"prtirnt
This Certtffnate issued pursuant 1o the requuenrents of Secllon 306 of the Uniform Bulldixg
Code cem; jyrng that a1 rhe lune of rssuance this sductune mvs in compliance witli tlu wariacs
ordinmtces of Ihe Clty regulating building construction ar use For the following:
UX Cb=irKlf= SF M/GA-R M4 PtnWc No. 20177
., _ - .. .,.? ._ PD l ?-- ^--? VN
...:., ?
awxr ot ma;og A4d=
B ELL DR N l.awliry L22, $2, HIIdS OF STCIl?SRID(?. 3RD
isld"cg Addreae ; •'
6/22, 92
PdST IN A CONSPICUOUS PLACE
?rr??
- , . . ?+? • - : ??, ?
. ,
• ? ?> ? ? ;, CITY OF EAGAN
?-. 3830 Pilof Knob Road, P.O. Box 21-199, Eagan, MN
55121
U4-
' PHONE: 681-46 75
BUILDING PERMIT
Receipt # ?
t
? To be used for w? DW/(;Aft' Est. Value $145,011W
Date
MAR
4
Site Address ???? ????????L DR IN ?
LLS QF
?
2'2
2
OFFIGE USE DNLY ;
81ock
SeciSub:
tot
?
- Fet:s
57R
Parcel No. STQNEBRI?'E occupancy R-3 M"1
Bld
P
k
???:??
Zoning PD ??. g.
ertn
N8fY12 ?ENTEX ?OMES (Actual) Const V-N Surcharge 72.50
I W Address 4929 BAKER (Allowable) V'N Plan Review 5}&+05 . ;?
?
Cj{y '?I NNE'??1?G14 ? ?jp $5311'? # ot Stories
?lf??'
Ucense
?,C?[9 '
Lengtn
Phone 640-72b0 (IdE3,tf) Depth 381. SAC,City 100•04 '-?
Name SA,E S.F. Toial - SAC, MCWCC 700•00 ?
' ?
?
Addrm S.F. Foatprints
OnSiteSewage
_
WaterConn
675*00
(;fty Zip on Site Well Water Meter 95?. *?
?
? MWCG System ? 30.()0
Q ?
lOtlB
0?1 333
Cily Water x
- Acct. Deposil
?? ? ? ?
VCenSB # PRV Required _ SM! Permit
I hereby acknowlege that 1 h?w e?sar?? thi ?ipplication and state that the
?
' Boostar Pump - 5/W Surcharge 150
information is correct and agkeY'to;co
? with all applicable State of
I
`
r
?
3?.?
Minnesota Statutes anc# ? it 4
r
iipances.
g h O
? Treatment PI ?
? ,.?
?
Signature ofPermitee
?
APPROYALS
Road Unit
380r00
t?
CENTEX HWZS Plann6r - '4
A Building P9rmit i5 is§ued lo: il
C park Oed. 'I
on the express condition that all work shall 6e done in accordance with all
a
licable Stata ol Min
ota Statute
and Cit
of Ea
an Q
es
di ounc
COP1OS ??
. ?
pp
.
nes
s
y
g
r
nano Bldg. Off. _
?
9uilding Qificial '
Varianre
-
TOTAL 3y7(?4.175
Permit No. Permit Hoider date Telephone #
PLUMBING
HVAC
Ce-
ELECTFkIC ?3958.
ELEc-rRic AI'78
-47 tnspection Date Insp. CommeMs
Footings I
Foundation
Framing 2
Raofing
Rough Pibg- 1y-/n ??
Rough Htg.
IsuL
Fireplace
Final Htg.
Orsat Test
Final Plbg_ - ?
? ?} • ??
Plbg. Inspector- NoliFy Plumber
Consk, Meter
Engr,lPlan
8idg. Final
Deck Ftg.
DeCk Final
Welt
Pr. Disp.
SEWER & WATER PERMiT
CITY OF EAGAN *3830 Pilot Knob Rd.
Eagan, MN 55122=1897
DATE ?R 4• 1942
! OFF CE USE ONLY
METI.R # q?" -? PERMIT DATE 03/05/92
CHIR # ? 6 5qq PEfiMIT # 12592
ME7ER StZE 5?? iU- B.P. RECEIPT #
lSSUE DATE -V?E /q ?, B-P- REGEIPT pATE
PRV - BOOSTER PUMP
SITE ADDRESS ' 4017 CAMBERWELL DR N
LOT 2213LOCK 2 SEC/SUB HYLLS OF STONEBRIbGE 3RD
APPLICANT:
ADDRESS: _
CITY, STATE
PHONE: -
PERMIT REaUESTEQ
X SEWER X WATER - TAPS
COMM/INQ
X NEW
x RESIDENTIAL
EXISTING
Lawn S rinkler Meter are to be Installed
sters on Water Line.
PLUMBER: PLYMOUTH PLBG I?IC Ahe f f
ADDRESS: 9290 ZACHARY LN Cre it I e en for Deduct Meters.
CITY, STATE ?1PLE GROVE MN ZIP 55369
-
PHONE: 493-2474 ? ?
I GREE TO COMPLY WITH CITY QF
OWNER: CENTEX H4MES EAGAN ORaINANCES
ADDRESS: 4929 BAKER
CITY, STATE MINNETONKA MN Z1P 55345
PN NlE: 540-72 0(REYD) SIGNATUR HEN METER ISSUED
,?
PL A ?ALL 1 O WORKING DAYS FOR" PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT. Ap
,,;.,. ..' • i r :. r ... . ".. 4,:'`
.. .. . .
. .. . . . . :'X•,.t.?(' l. . ' C.: _
. . ,£" i., ?F?u
. 9
.
1
.
SEWER & WATER PERMiT, OFFICE USE ONl.Y .
CITYO,F ERQAN A"?y METER # .? PERt+AIT DATE 03fo5I g2
3830 Pilot Knob Rdo " 1.2592
Eagan, MN 55122? 189f CHiP # i'ERMIT #
METER SIZE B.P. RECEIPT #
1???
?? ? ISSUE DATE B.P. RECEIPT DATE
,
?AT?
RRV - BOOSTER PUMP
SITEADDRESS" '4017 CAMBERWELL DR N Pt:;imtl"REQUESTED
LOT 22 BLOCK 2 SEC/SUB Hfi.LS OF STUPdEBRI1JGE 3RI? "
K SEWER X WATER - TAPS ?
APPLICANT:
- COMM!{Nb X RESIDENTIAL =
ADDRESS:
GITY, STATE ZIP X NEW EXISTtNG `
PHONE:
Lawn Sprinkler tJl2ter are to be fnstafled
PLlJMBER: PLYMOUTH PLBG INC Ahead?f a s?c ,?ters on Water Line. ?
Q
ADDRESS: ???o ZACHARY LN b? Ven for Deduct Meters. ;.
Cr4?41 ?
STATE MAP[.,E GRd)1lE Mt+]
CITY ZIP 55369
,
493--24-74 ? -- ? -
- ? ;
PHONE: -
1 GREE TO CE3lVSPLY W{T4i CSTY OF ;
OWNER: CEEiTEX H4MES EAGAN tJRDdl?ANCES t
AQDFiESS: 4929 BAKER i
STATE H'XNNET'ONKA MN ZIP 55345
CfTY,
PHONE: 640-7260 (IZL-iD) SIGNATURIEWHEfW METER 155UEd
PLEASE ALLOW 7W0 WORKING DAYS FOR PROCES5ING. CALL 454-5220 FOR IINSF'ECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERiNG DEpT.
CITY OF EAGAN M0201 7 7
3830 Pilot Knob Road, P.O. Box 21-199, Eagan; MN 55721 -
PHONE: 681 •4675 l01F'
BUILDING PERMIT ' Receipt # 0 ?? ` 7
Tobeusedfor SF DWG/GAR Est.Value $145,000 Date MAR 4 , is9?
Site Address 4017 CAMBERWELL DR N
Lot ZZ Block 2 Sec/Sub. HILLS OF
Parcel No. STONEBRIDGE 3R1
Name CENTEX HOMES
? p,dd? 4929 BAKER
? Cjty MINNETDNKA MN ZjP
cc Name SAME
? Address
p? citY ZP
? Phone
License # 0001333
I here6y acknowlege t t ha e r ihi plication and state that the
information is corcecl a to I with all applicable State of
Minnewta StaWtes en Rya E g? Or i ances.
Signatme of Permitee
A Building Permit is is ued to: f'RNTFX N(1MF.S
on tha express conditi n that all work shall be tlone in accortlance with all
applicable State ol Minnesota Statutes antl City of Eagan Ortlmances.
BuildingOtticial-'?WR1
OFFICE USE ONI:Y
FEES
Oaupancy R-3 I1-1
Zoning PD ?l
?9' P? 797.00
(ACtuap Consl NL?T` Surdwga 72.50
(anowable) V=N
Plan Revev 518.05
F ol $lories
Lerglh 66' Loanse 5 _ nn
Depth 38' SAG City 100.00
S.F.7ofal - SAC,MCWCC 700.00
S.F. Faolprinis _
On Sne Sewage _ water Conn 675.00
On Ste well water Meter 95.00
MWCC Sysrem X 30.00
X /+ccc Daposil
Ciry Water 30.00
PFV Required s(W Pamii
Booster Pump - S/VJ Suroharge • 50
Treatmem PI 300.00
APPROVALS Raad Unil 380.00
Planner - Park Ded.
Counal -- 1
0?
BIdg.0f1. _ Copies .
Variance - TO7AL 3 ,704.05
Addzess' 4017 CAteE%QZ DRIVE NLot Zz Blk 2 Sec/SubHILLS pg sTONEBRTDM gTtp
These items wgre/were not complete at the time of the final inspection.
Date: 6 22 92 Yas No ? Tnqpertor,
Final grade (6" from siding)
Permanent steps - garage
Permanent steps - main entry
Permanent driveway
Parmanent gas
Sod/seeded grass L?
Trail/curb damage ?
Porch
Basement finish
Deck
Pleasa verify vith the builder the ramoval of roof test caps from the plumbing
system and the shut-off of water supply to the outsida Lawn faucet before
freeze potential axists. ?
.a?neowa
White - City copy Yellow - Resident copy Pink - Contractor copy
DATE: MAR 5, 1992
RE: 4017 CAMBERWELL DR N(CENTEX HOMES)
X Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
- Your Sewer & Water Permit (or the above property cannot be completed for the following
reasons:
Your Sewer 8 Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) 6efore issuance.
WARNING: BEFORE pIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIpED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATEH TURN ON POLICY.
Secretary, Building Inspections Dep[.
I?r B a? ?
HOU
E ATING TEST RECORD
??7 r/
Jr?WL(
el/N"
`
ADORESS i ApT.-FLOOR dTYSUBURB
OCCUPANT OWNER
HEAT LOSS OATE HTG. INST.
SOLD BY INSTALLED BY
Elscfrical Werk &. Got Lino B
y
TYPE OF HEAT GA _ FA HW _STE AM -SPACE HTR. -UNIT N .-OTHER
GAS DESiGN CONVERSION
MAKE ??' I MAKE OF BURNER
/
Moda /!Vig 17 Model
Sxial 2 =5-3 I Mex. BTU Ratinq 1• 0
a?• ?
INPUT
MAKE OF FURNACE ?
'± ?-
Mod•I ? ".S-+<Fl
?
/ CONTROLS
TNERMO$.TAj Msat Pl Vent Siz• ?? ?
up
Volva 1??? KIND OF L R ' SIZE NONE
Limit 2. 1 f f Drafr Heo Rapulo
LimiT SaMinq Zq o Filtms Si:e ber
Fan Setting ? g Chimney Loeafioo In da Outaids
Pilot Type G vDyl/ L ?imnsy Construcfion ?
OS ?i
Pilot Make
Pilot Model $moke B 6 Wiring
Pilm Timing SCc Draft ?? Tssf Tap
L.W. Cut Off r poor Prosawe Liphtiny Inat.
?rj?
Pressuro < <'? ?• Pereant G Y' "Dab Tesfsd
Input CFM Parcent, 0 ?ompeny Tasting
Stack Tsmp. Psreant CO ? tio Nams of Tssfer
F«m 235
1?5
? ,?4 I8 5 9
opl=p / 07 J 3%
ReQuest Date rrms No gh-m Inspeclion
i u? Ready NOw RWIII Noh(y Inspector
4-1-92 Ves C No When fiaatly?
I[X hcensed contractor ? owner hereby request mspection of above electrical work at
Job Mtlress (Slrcel Box or Rou[e No ) Ciry
4017 Camberwell Ea9an
4cl ion Nn Townslip Name or No Renge No LouMy
/
OccupantlPRlNp Phone W.
Centex HOmes
Power Supplier AAtlress
Dakota Electric
Elecincal CoMractor (COmpany Name) Contrector5 Ucensa No
Tkazer Electric, Inc. CA 01110
MaiOng Atltlress IConVatlor or Owner Making Installatwnj
8383 S se Road N.E. Minnea lis P'IIM 55432
Authometl Sgnature IConVact uOwner Making InstallaUOn1
' Pnone Nomoer
6 wai-4k-
1 784-3729
MINNESOTA STATE BORHD OF EIECTRIGITY THIS INSPECTIDN qEOUEST WILL NOT
Grlggs-Mitlwey BIOg. - qoom S113 BE ACCEPTED BYTHE STATE BOARD
1821 Univeniry Ave., SL Paul, MN 55104 UNLESS PROPEP INSPECTION FEE IS
Fhone (612) &124800 ENCLOSED
REOUEST FOR ELECTRICAL INSPECTION °°•e?'t EB-000-01-0e
, ?_ 4785 g See nslruceons !or complehng Nis form on back of yellow mpy. &_.
? ???/7`?
'X" Below Work Covered 6y This Request
ew Add Rep: ,- 7ypeolBuilding AppliancesWired EqmDmen[Wired
7( Home Fange Temporary Service
Duplex Water Heater Electnc Heating
Apt. Building Dryer O[her (Specity)
Comm./Industrial Fumace
Farm Air Conditioner
pher (speciy) Conirector's RemaAS:
Compute Inspection Fee Below:
?t ' 01her Fee # Service EntrenceSize Fee # Circuils/FeedeB fee
Swimming Pool 0 to 200 Amps o to 100 Amps
Transformers Above 200 _ Amps 100 _ Amps
Signs Inspector§ use Ony. _/ TOTAL
Irrigation Booms °JO? $86.50
Speciallnspection ??
nlarm/Communication THIS INSTALLATYON MAY BE ORDERED DISCONNECTED IF NOT
• Other Fee COMPLETED WITHIN 78 M HS.
I, the Electrical Inspector, hereby
cemfy that the above inspection has
been made. R°"yh-'" oate
!o
oata
?
^
OFFICE USE DNLY
This repuest wiG 18 months irom
y
- cS/a& 5a- /0.3077.3
J 3 9 8 2 0ao °°
Requesl Oete Fne No
?'`?p RougRm Inapection
e wretl?
G No
? ReadY No. ill Nahly InSpecip
hen ReaEY'
I licensed contractor p owner hereby request inspeclion of above elechical work at:
Jo0 Atltlress L(S/ir^eel. Box or Rouce
'N/ Cily //?°?
V N-J
Seclion No Townsm0 Name or No Range No CouMy
OccupantlPRl Phone No.
Power Supplier
I I7 Appress
Elech,cal Conva o(COmpany N CqnVacrorS L¢dnu N0.
MMan tl ss 1 Vaclor or aking Installalion?
?'E.X9/ ?
hothorixetl S ure COnVaclonOwner Making Installai
'zz Plqne Number
MINNESOTA STATE BOARD OF ELECTAICITY TMIS INSPECTION REOUEST WILL NOT
Grlgga-Mitlway BWg. - floom S173 BE ACGEPTED BYTHE STATE BOARD
1821 University Ave., SC Paul. MN 55104 UNLE55 PROPER INSPECTION FEE IS
Phone(61Y)802-0BDO ENCLOSED
3?? qa,
- REQUEST FOR ELECTRICAL INSPECTION
? See inshuctions br compleung this brm on Dack ai yeilow copg °?^"=? eeaoooi oe
?''
J 9?82 'X
" Below Work Covered by This Request
ew Add Rep. Typeofeuilding AppliancesWired EquipmeniWired
Home Range Temporary Service
Duplex Water Heater Electric HeaNnq
Apt. Buildmq Dryer O[her (Speci}y)
Comm./Industrial Furnace
Farm Air Conditioner
Other syeciy) Conlraclw5 Fem9rks
Compute Inspec6on Fee Belaw:
#' Olher Fee # ServlceEntranceSize Fee # Ciromis/Feeders Fee
Swimming Paol 0 to 200 Amps a to 700 Amps
Transformers Above 200 _ Amps Abo Amps
Signs inspector5useonry
?yr TAL ?
Irn9ation Booms ?
OD
Special Inspeceon
Alarm/Communication TNIS INSTALLATION MAY 6E OR ISCONNECTED IF NOT
Other Fee COMPIETED WITHIN 78 MONTHS.
I, the Electrical Inspector, hereby
i Rough-in oata
cert
ty ihat the above inspection has
been made. Finai ? oa?e 'y
OFFICE USE ONIY
TTis r¢quest wM IB monfis Imm
RESIDENTIAL
7 BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
NewConcWdion ReauiremeMs
• 3 registered site surveys showing sq. ft of lot, sq. ft. of lause; and all roofed areas
(20°k maximum lol coverage allawed)
• 2 copies of plan showing 6eam & window s¢es; poured found design, etc.)
• 1 set of Energy Calculalions
• 3 copies of Tree Preservation Plan H lot platted after 111193
. Rim Joisl Delail OpBons seledion sheet (bldgs wiUi 3 or less units)
I D__F5_- a?
RemodeVRaoair Reauirements
• 2 copies of plan
. 1 setof Energy Calculatbns Mr heated addiUons
• i sile survey tor exlenor additiorts & decks
. Indicate A home sened by septic system for additwns
DATE (D I 2:S I CS1- VALUATION
s8co. e?>
SITE ADDRESS 410j1 Cc1b ?1911 GAf Ole I V MULTI-FAMILY BLDG _Y \/N
TYPE OF WORK9-25'1121°' FIREPLACE(S) _ 0_ 1_ 2
APPLICANT
1
STREET ADDRESS 5'0
TELEPHONE # ?'/sL -`f69- 7J1? CELL PHONE #
PROPERTYOWNER SAmer TELEPHONE#
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNFSOTA R171,ES 7670 CATEGORY 1 MINNNS01'A RUI.ES 7672
(J submission type) . Residential Ventilaflon Category 7 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Su6mitted
Plumbing Contractor: ____
P1umUing syslem uicludes:
Mechanical Contractor:
Mechanical systcm includes:
Sewer/Water Contractor:
Air Conditioning
Heat Recovcry Systcm
I hereby acknowledge that I have read this application, state that
with all applicable State of Minnesota Statutes and City of Eagan
Signature of Applicant
Fee: $90.00
; CCT 2 4 2002 ?'?
is
agree to comply
OFFICE USE ONLY
_ Watsr Softener
_ Water Heatcr
No. of Baths
Phonc #
_ Lawn Sprinkler
_ No. of R.I.13aths
CITY ?i`4- STATE /k,- ZIP r5Z'4CK
F,vc # 957- - y69 V 7 z r
Phone #
Phone #
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
L OU BL - 0L ' CITY OF EAGAN
0 r/ PLUMBING PERMIT
SUSD.?? 1 (612) 681-4675
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS
WHEN PERMITS ARE REQlIIRED FOR EACH UNIT.
---------------°_--____T -__-----°----------°°----
WORK DESCRIPTION I
NEW CONST ?
ADD ON _
REPAIR _
OWNER NAME:
SITE ADDRESS: --5/'eqI/;7
INSTALLER:
ADDRESS: 7'Z`-S v9-o • ?? ???
CITY: ??? -;? . zIP: S"&UG 8
PHONE jj: '6Z-6 -
SIGNATURE OF PERMITTEE
NO
1
?
?
/
1
3
CITY USE ONLY
?$n 3a
RfiCEIPT # Eo
DATE 3- 30-4 2
AL50, FOR TOWNHOMES AND CONDOS
COMPLETE THE FOLLOWING:
FIXTURES EA.
REPAIR/ADD ON 15.00
SHOWER 3.00
WATER CIASET 3.00
BATH TUB 3.00
IAVATORY 3.00
KITCNEN SINK 3.00
TAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
WATER HEATER 3.00
FLOOR DRAIN 3.00
GAS PIPING OUT.
(MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50
OTHER
WATER SOFfENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKI.ER 3.00
W. TURNAROUND 15.00
STATE SURCHt1RGE .50
TOTAL
o?
p
lacs0
D
?
s 8
300
TOTAL: S 0 ?
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS:
TENANT NAME: _
SUITE #:
INSTALLER:
ADDRESS:
CITY:
PHONE $:
FOR:
CITY OF EAGAN
CONTRACT PRICE:
1% OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1% $
STATE SURCHARGE $
TOTAL:
$
(SIGNATURE)
CTTY OF EAGAN
L o202 B11- v MECHANICAL PERMIT
SUBD. ?J' (612) 6814675
RECEIPT # /0 5 SL/-f
DATE
y RESIDENTWL
-?-?a
PLEASE COMPLETE UPPER PORITON ONLY FOR SINGLE FAMIIY DWELLINGS. ALSO, COMPLEfE FOR
TOWNHOMFS/CONDOS WHEN SEPARATE PERMITS ARE REQUIRED FOR EACH DR'ELLING UNTf.
OR'NER: &02?1C 1 Weff? FEES
STPE ADDRESS: J
6 Q ?
I ADD ONJREMODEL (EXISTIIVG
CONSTRUCI'ION ONLI) $ 15.00
?
HVAC: 0.100 M BTU 24.00 ,-?
INSTALLER: ADDITIONAL 50 M BTO 6.00 /
ADDRESS: GA§-OL i I.Et3 - Mi1vIMiTii 1@ $3 •C? ?
CI7'Y: SURCHARGE $ -50
SIGNATURE: L TOTAL: $ ?
/
COMMERCIAL
PLEASE COMPLETE THIS PORTiON FOR ALL COMMERCIAIIINDUSTRIAL BUILDINGS. ALSO COMPLEfE FOR
APARTMENT BUILDINGS OR OTHER MULTI•FAMILY BUILDINGS R'HEN SEPARATE PERMITS ARE NOT REQUIRED FOR
EACH DR'ELLING UNTl'.
WORK DFSCRIPTION:
CONTRACf PRICE I FEES
1'k OF CONTRACf FEE ?
STATE SURCHARGE IS $.50 FOR EACH s
$1,000 OF PERMIT FEE.
PROCESSED PIPING - $25•00 r
MINIMUM FEE - $23.00
la
, cirr oF eac,aN
? 1992 BUILDING PERMIT APPLICATION
681-4675
SINGLE ff MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of manth in which re uest is made or lot chan e is re uested once ermit is issued.
Date .3 / Z / 9z Yaluation of xark
Site Location:
STREET STE f ?
? - U
Tenant Name•
LOT 2-
I
BLOCK ?
SUBD.? L? °
ta
P.I.D. #
Descri tion of work: 5. ? Al.
The applicant is: PKOwner Contractor ? Other co
Name Ew T?X PE1D Phone
Property usT FIRST VDlLEP6,2
Owner JOAP e2? ???
Address
STREET , STE Y
AN Zi
St
t
i
P
e
a
C
ty
Company Phone
Contractor Address License # DDO/33?3
City State Zip '
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days nce area has been approved.
I hereby acknowledge that I have r thi a pli i and state that the information is
app i 1 S e of Minnesota Statutes and City of
correct and agree to comply with
!
Eagan Ordinances.
Signature of Applicant:
BUILDING PERMIT TYPE
O 01 foundation
? 02 Single Family
? 03 Two-family
? 04 Multi-fam. T.H.
? 05 Apt. Bldg.
WORK TYPE
)E(90 New
? 91 Addition
? 92 Alterations
OFFICE USE ONLY
? 06 Garage/Accessory
? 07 Fireplace
? 08 Deck
? 09 Basement Finish
? 10 Swim Pool
? 93 Remodel
? 94 Repair
? 95 Tenant Finish
GENERAL INFORMATIDN
Occupancy R 3 M-)
Zoning
Const. (Actual) v _ N
(A1Towable) v _ N
# of Stories
Length ?
Depth ?g
APPROVALS
? 11 Res. Add./Porch
? 12 Comm./Ind. New
? 13 Comm./Ind. Add
? 14 Comm./Ind. Rem
13 15 Public Fac.
? 96 Move
O 97 Demolish
? 99 Undefined
Basement sq. ft.
lst F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Planning Building 3:3L ns
Engineering Variance
REGIUIRED INSPECTIONS
? Site ? Footing ? Framing
O Wallboard ? Final ? Draintile
Permit Fee '7`j7.oo
Surcharge 72,50
Plan Review 516. 05
License
riwCC SAC '260, o0
City SAC 100.00
Water Conn. bqs, o0
Water Meter 95,00
Road Unit 390,C) 0
Treatment Pl. 3 0 0, uo
RD3&-Uflit'14ct.T De.p. 30 , u a
P3PIt-9Cd.5*w Pw.c6 3n, o0
Tr3iJs--?.stm s/c s-o
Copi es 1.00
Other
Total:
SAC %
SAC Units
veiuatid,: $ l y S0 ovo -
BASi<- rADpZ = 114 I1 ZS--I
I XD`?CR?Qs61PGMt4bl'c.x/s = - 2,<- go
---
/qg,?31/
. ?
'7J7•U0?
72 •>Qh
5l0•0J?
1•00?
? li>'>•?o?
? 3>7?J.•p`"-
737-00t
7z • so+
518•u5?
2315,p+
1•00r
>>704•Oix
? 16 Agricultural
0 17 Building Move
O 18 Demolition
? 20 Miscellaneous
MWCC System YEs
City Water e-S
PRV Required
Booster Pump
Fire Sprinkler
Census Code to+
SAC Code 0(
Assessments
? Insulation
? Fireplace
L_ -#- 2i4o
? ** ** ?
* PIONEER LANowe..crom•CIVILENGINEERS
* engineering.. LANOPLANNEAS- LAND".CI1PE11RCHITEfi3
*?**
Certificote of Survey for: CeClteX ___I11_COf?701'C]t2Cj
2422 Enterprise Drfve
Mendota HeigMs, MN 55120
(612) 681-1914
Model Name: 2190 ?
CAMBRIDGE DR1V? N, - _ -
699.80 S 1203608 E K
- - -- - - - l p ? 05'S9 327?
5-91 - - ?
?K
?.•
? K 22.?i?
b 1 o w 1POe.5i
O
p 10p W
sed
1
? lae? 4.oeo
w
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tp0,? J ?
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,
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? INA E ?Ill?ttt K
,. ntm \
y oHn _.?a ?i?
SXV°t'. S 08q616' E
• 900.0 Denotes Existing Elevation PRUPOSED_HOUSE ELEVATION.
oo. o Denotes Proposed Elevation Lowest Floor Elevation:896.35
- Denotes Droinage & Utility Easement Top of Block Elevation:904.46
- Denotes Drainage Fiow Direction - - --
-O- Denotes Monument Garage Slab Elevation:904.13
-? Denotes Offset Hub Bearings shown are assumed
LOT 22, BLOCK_2 _H_ILLS OF_STONEBRIDGE_
DAKOTA COUNTY, MINNESOTA _3 R D__. A D D I TI O N
1 her'by eertlly Ihet this turvey, plen or report was prepared 6y me er under my direr,t supervisloa end lhet I em duly Registrred lend Surveyor
under rhe Inws nf Ihe 51a1e nl Minneaote. Dated thls ZCrP day of TL?R?? A.b. 19?-.
i ?
SCdle. 11nch_4 feet ? r?L'
?.. {tORFP?B. 1 ?nEG.N0.14l91
P05] 91336.10
ti
rlAnnin!] Cw,siqn Irc.
i.._.11 Flitthvi?ty .ti) H.C.
?riri 55'152
i ic-_'`.?ir"i 9,^!1
C;{?i•IPi. i`•!U.
t"innasota Stata Energy Code Ca1cu3ations
Nased cn Chauter 5 u^ tl;e Model Energy CocJc
1?83 Ed i t:on - t:dop'L-ad 1 i 1 i 84
'-i-nn_•r: I"4LEL. 42190 CC1MP1. tJO:
:_.(t<: QddrPs•_.= LoT 2Z1 Soc-k -7- 1? H jus oi ?aen Ab-p'N .
L::t:':ractorn CEP!?r_;; iQ! ;;='S Phor.e:
,.;c!u. C1K50; H!. A1 for S.'tng1N F'ami?y;nuple;:
R2, residential <. 3 stories
Qver _ staries
Other
GGPdC=RAi_ .i.h•1FJ'iMATIOr.t
clcate: The s:=ction designations :"Section F5", "Section P" etc.) ar-e sor
cor:ver.ience in calculaticns onl;. and are nrrt related frcm onp =et of
cal::t.tlatzcn= belca: tc the r:e>:t.
1. r<1rJg, Wal :s F'e:^tiweter >: Wali neights, = Area
g.-aund to eave
3ection r-`i . _:. 10.4 = 223. ;
3c.'C i' 2 GPi B . ], 7f3 .13. Ji:S - 2526. 8J
se[I:ion r
5wr t i an' 6. 'J i> = C?
Gross Wall Area 2755.68
2. Builditrg di.rnensians Fioar or
Ceiliny
Length >: 4lidth = Area
Sectir.,n r-: . 10.t3 2 = 21.6
9ection ts ; 13 < = 26
5EC_tiun C. 1?.8 32 = 67,3.6
SLCy LT o() D i Lt 31 ? 681
Tota2 rloor or ceiliny area = 1363.2
_. Fiim Joist Fer'imeter = 158
rloor joist 2 6y f8", 16", 12" or 16">): 10
Rim Joist flrea = 131.E.666
4. Loors
Area: 43.8 Thiclcness (:inr_hes): Cl
Perimeter ('fPf3t):
Type of coris.ruction:
Z. Toc,al donr's perimel-cr: 0
. . 'vJi. n(inwf>
:':ail'.:i ;Ci.ll:'?I^;
::.lUcl??2 lll[71^O'ied:
Bsrir. urdIT
UOiJE:LE lillfJCI5
i•,CJ',i_Nt;7QF
T,fpe
s. F'ario Doar:
V. iatrium:
1. - FAi^p!..7'_._ drF l
l.ocai Sy Fi. _
i:l. E>;posed Foundation
Flei ght area p:
Sq F± area A =
F_::posecf Foundation
hlei ght area P:
Sq Ft area R =
?
1<.
Grcass w311 area
rai. izus
4Ji ndow area
Patio door area
Atriuin area
Fim ioist area
Door area
Fireplace area
E>:pnsed Found.
? Eraning area
cqual s
Srq•. IICk
11 i ciL' tvi . ).47
`fES
Flet?i•`':'_ ., Lc:riUi_li . iJumbcr - 'T'utn?
:?nch??=1 ;Ir,che3 , of r-.i'Iss SGEt
Un i. + 5
14 27 4 10.5
28 11-L 4 12.44
is 20 4 8.39
i? 20 4 t._•. 33
22 ?l 8 31.11
2_ 29 4 17.11
28 24 17-0. J 7
2 12.44
?4 36 4 2<l
iJ 15
i
3.13
V U O Cl
u o 0 u
0 C) o
?. Windoai r_,lass area fSqFCi = 263.62
1-l2ight .. Length ., tJumt+er = Total
ifeecJ (Feet) units SyFt
0 0 U U
6.8 2.8 2 ?S.U(3
Q HL-iqh't: 0
i)
r
C+.6: Pe rimeter area A:' 154
143.18
0 Ferimeter area P: O
0
SyFt U factor U>: A
2755.68
263.62 0.47 123.9
v 4 0
38.08 0_ 4 7 17.9
131.66666667 0.035 4.61
43.8 0.14 6,13
C) O p
103.10 4.14 14.45
• 275.568 0.069 19.01
1 Q99. ?v?7:J==
0. iL_7 irc, .iR
i'ot:?lc= ;?,t• ??ro?=_ wall _re•; _:'r?.:?:'i
_ Frc::ninii area is ]!Ji o+ Urr=_s aiall area
13. Gross sca11 area .. fact Qr oe1o+,: = IS .. Fl per c_oc1N
Fact:r.r iv ,il far A-1 sinyle +arnilr & dup].e;;
.2= Eor A-2 and other re>id2ntial
.23 ?or c•ther bt.i:lding=
• 23 Fcr over ._ stcries
; accar is: =:.11 -
BTUH = 30_:. 1240 IHIJST NE : OR
lCalLl.lle1'f.m(J clb(JVV
tA. l,ross ceiJ:I r;; are? = 1"b.T.7
15, Cr.=iT.irrrj franilfig ar ea ...% uF ce+,ting .xrea) = 1W.:r:
IS- Jcsis!_ Firea ?lU'f, oi cei!inq area5 = 136_32
17. 1•Jet ceiliny area ! Gro5== ceil. arca -:loist area7 = !226.88
18. U ceiling: 0.021 .. NL-t r_oil. area =25,76448
J.`i', 1! sraminge .y.024 r. Joist cire-A = 3.27268
20- Total af item 18 s: item iy = 2",.03636
21. Gross ceiling area r. factor below = U r. A per codP
Frctor i=_ .026 for A-I single family .'_< Cuple>:
.033 fvr A-2 and other residpntial
.06 for othar bui:lditigs
FdCtUl^ ? 5: 0..1<<u
-- -
PTUH = ?
:
?3
+3432 MUST EE r t7R = -_?~ '
29
?
03616
.
. .
?
(calculated abov __-_--
U YALUC CAi,CUGATIONS
2 X G/ HIGH `R" SHEATHING
Inside air film
InCetior wall
Insulation
Sheattun9
Siding
Outside aic PiLu
R 1OTAL
Inside air film
interior vall
Stud - 6 '
Sheathi[tig
Siding
Out-side air film
R 1DrAL
R YAL[A:
U VALUF.
(Wall) U = 1 =
K
_037
WALL
JEMK\
Sl[ID
SL•GTION
[tiM
JOIST
.G8
.45
19.00
6.0
.G7
.17
26.97
.GO .
.45
6.50: (Framing) U = 1 =
6_a R
.67 .069
.17 .
1447
Interior air film -60
Insulation 19.00-
1= inch 3oft voa] 1.II0 (Itiw JoisLj U= 1=
Sheatiuay • • 6.0 N
Exterior wall oovering -67 .035
ExCerior air'L•ilm .17 _
R TOPAG 28.4
EDN.
interioc aic film
,
Insul.atior? . Eoundation (12 ' Block)
Exterioc air Eilm
R 1OrAL
_68
5.00 ,
1.28 (Fmadati(xi) U = 1
.17 K
7.13 .14
;.
•CEILING WTl'fI VIIJM A'1TIC SPACE ABOVE
' R YALUE R YALUE
FRAMING CEILING
0.61 Ait Film 0.61
36.00 Insulation 44.00
4.38 Soist
.56 Ceiling .56
0.61 Air Film , 0.61
41.55 1bta1 R 45.78
.024 U = R .021
CATHEDRAL CEILZNG
R VALUE
FRAMIIVG
R YALUE
CEILM
0.61 Inside air film 0.61
.56 Ceiling .56
14.375 Joist(Spacer) -
- Insulation 33.85
- Ai.s' Space .50
.67 Roof dec.ki?l9 _61
_06 Felt .06
.94 ShuMle .94
0.17 Outaide air film 0.17 .
16.88 1bta1 R 36-86
.059 R = D .027
windov i.nfiltration .5 cfm/li*+ml foot of ccack
Residential dooc infiltration 0.5 cfm/g;oure foot or door and m;n;m•,m oode requirement
Non-residential door infiltration 11.0 cfm/lineal foot of crack
tb 12" concrete black rto insulatian =.781 R 1.28
double glass = .52
triple glass = .31
All exterior valls and ceilirgs n.st have a vapor bacrier (0.10) perm max.).
vapor bacrier must be on the inside (neated side) of rall.
Yapor bariers of the polyethelene thin fiLo have no R value.
RESIDENTIAL
BUILDING PERMIT APPLICATION
? CITY OF EAGAN
3830 PILOT KNOB RD - 55722
? • "I J??"1 651-681-4675 670"00
l-
Naw Construction Reauiremants RemodeVReoair ReaWremeMs
• 3 regislered sile surveys showing sq. R ot lot, sq. fl. of house: and all roofed areas • 2 co ies M lan A,
(20% maximum lot coveiage allowed) . 1 setot Energy Cakulations for heated additions ? al ?? '? r v I
• 2 capies of plan showing beam 8 window s¢es; paured found design, etc.) • 1 sRe survey for ezterior additions & decks
• i set o( Energy Calculetiore • Indicate H Irome served by sepdc system kr addiUoris
• 3 copies of Tree Presenatbn Plan'rf lat platled after 711193
• Rim Joisl Defail Optbns selectan sheet (bldgs wilh 3 or less units)
DATE "ab -QI n VALUATION
JOB SITE ADDRESS `-lO R OGLWI OOiI L(Je C( c N
IF MULTI•FAMILY BUILDING, HOW MANY UNITfS?
PROPERTY OWNER {? Q- ?C' ? G1 1 l.l
TYPE OF REPLACE(S) _ 0_ 1Z2
APPLICA PHONE# CaS?I -CP&9UQ 001
ADDRESS SWmc_ el&o CllOv? ZIPCODE --I'3
PAGER # CELL PHONE # r01 a-QqQ- 90 9'0 FAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
MINNFSOTA RULFS 7672
New Energy Code Worksheet Submitted
Plumbing Contractor. _
Plumbing System Includes:
Mechanicai Conhactor: _
Mechanical System Includes:
Sewer/Water Confractor.
_ Air Conditioning
_ Heat Recovery System
All above information must be submitted prfor to processing of application.
Fee: $90.00
Fee: $70.00
?P? ? 0 lJ ?
I hereby acknowledge that I have read ihis application, state that the informatio? is correct, and agree to comply
with all applicable Siate of Minnesota Statutes and City of Eagan Ordinances.
Signafure of Applitant
Certificates of Survey Received _ Tree Preservation Ptan Received _ Not Required _
Updated 1I01
_ Water Softener _
? Water Heater ^
_ No. of Baths
Phone #:
Lawn Sprinkler
No. of R.I. Baths
Phone #
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 , 01 of _ plex
O 04 02-plex
? 05 03-plex
O 06 04-plex
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 OS-plex kb 18 Deck
? 11 10.plex ? 19 Lower Level
? 12 12-plex Plbg_Y or _ N
? 20 Poal
? 21 Porch (3-sea.)
? 22 Porch/Addn.(4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
i4ill
? 30 Accessory Bldg
? 31 Ext. Alt • Multi
O 33 Ect. Alt - SF
? 36 Multi
? 31 New O 35 Int Improvement ? 38 Oemolish (Interior) ? 44 Siding
O 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
? 33 Alteration O 37 Demolish (Bldg)• ? 43 Reroof O 46 Windows/Doors
? 34 Replacement 'Demolitlon (Entire Bldg only) - Give PCA handout to applicant
Valuation -240O ` Occupancy i1?3 MC/ES System
Census Code X/? Zoning ? City Water
SAC Units C#--/ Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs ( Length Fire Sprinklered
-?
-
Type of Const W idth
Footings (new bldg)
?'J Footings(deck)
_ Footings(addirion)
Foundation
Drain Tile
Roof Ice & Water Final
_ Framing- -
_ Fireplace _ R.I. _ Air Test _ Final
Insularion
Other
Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
Windows (new/replacement)
Approved By t(X , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S8W Permit 8 Suroherge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
REQUIRED INSPECTIONS
FinallC.O.
eL) FioaUNo C.O.
_ Plumbing
HVAC
* ?*4,
*PIONEER
? eiigineering..
* *?
?
fEr15
2422 Entorprise Drive
Mendola I leiglils, MN 55120
(612) 681.1914
Certificate or survey for: Centex,_ Incorporated
Modei Nome: 2190
CAMBRIDGE
111ND SVN VEYOR! • CIVII ENGIN[EIfS
--_`?-
• 900.o benotes Existing Elevation
• 9oa_3j Denotes Proposed Elevatton
--- Denotes Drainage dc Utility Easement
--- Denotes Drainage Flow Dfrection
-o- Denotes Monument
r
5 1236o8 E x 5
I , 110.97
5 0g"p5'16' E
PROPOSED HOUSE EIEVATION
Lowest Floor Elevation:896.35
Top of Block Elevation:904.46
Garage Slob Elevation:904.13
-R- Denotes Offset Hub Bearings shown are assumed
LOT 22, BLOCK__.2.___. _HIL_LS _OF_ STONEBR.i_DGE_
DAKOTA COUNIY, MINNESOTA 3 RD A D D I TI 0 N
1 hrreby tErlily Ihet thh turvey, plen ar reporl wns prrpeip(l by mu ar undcr my dlirr.t sapneivision snd thel 1 em dvly Regktpred LenA Swveyoy
undor ihe Mws nl Ibe Slate of MlnnesMo. Datcd tlds? 6? d»v al F?1SFV?ICY A.D. 19 J.Z_ .
S L Q I e. 1 Inch 'O(eeii
L
i ?
? f(<,
^AI?? B.5 KI . .,nE(3. NO. 14E71
K
pR1VE
-- R ? 05'58 32•
fl(1S' 91136.10
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• a?.aj Denotes Praposed Elevation �.owest Fioo� El�evotion:896.35
Deno#es Drainage dc Utitity Ec�seme�t � �� '
--� Denotes Dratnage Flvw Direction �ap of Block Elevation:904.4fi
--o— Denotes Monurnent Gnrage Slab El�vatton:904.13
—�— Denotes Offset Hub 8eorings shown ore vssumed
L�T. 22, BLOCK ._ _2---_ .NILL� ._C�F_---STONEBRID�E_
bAK�TA COUNTY, MiIyNFSOTA ��� ,q p��T10�
1 fitreby cerlify ihat this swvey,plert or te{iort wea prey�e��d!+y md or u+�der my dtrrr.t s�n►er+vialon snd thal 1 am du�y R�gytrreil'�e�n!ServeYo+
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