3521 Birchpond Rd& cl??? .
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
11??o _ 60
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7 / ,!?' / 0s
Date
_
Site Street Address `Yw J, Unit #
Property Owner L Telephone # ( )
Contractor Telephone #
Address ?- e City, ,L-?, State 1'&, , ZipS??
The Applicant is: _ Owner Contractor _Other
Alterations to existing dwelling $ 50.00
Add plumbing fixtures. This fee includes putting in a water softener and/or water
heater at the same time. lf vou are installincl onl a water softener and/or water
heater, do not complete this section. Move to the next section and check the
appliance(s) you are installing.
-Septic System Abandonment
_Water Turnaround (add $125.00 if a 5/8" meter is required)
Other:
Water Softener Water Heater $ 15.00
_ new ? replacement
Lawn Irrigation _RPZ ^PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
r
Total $?
I hereby apply for a Residential Plumbing Permit and
and accurate; that the work will be in conformance
Eagan and the plumbing codes; that I understand this
permit, work is not to start without a permit and work
the event a plan is required to be reviewed and appr e
IzLat,d) i?d' e?"" ?
acknowledge that the information is complete
with the ordinances and codes of the City of
is not a permit, but only an application for a
will b,,*,.i_n aq6o,,iance with the approved plan in
Applicant's Printed Name Ap0jidXn05Signature
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
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New Construction Reauirements RemodellRe air Re uirements 0ft0se'4nlv
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and aU roofed areas V2 copies of plan Gel of SanueyReotl .? Y,?,,,: N
(20% maximum !ot coverage allowed) 1 set of Energy Calculations for heated additions 7r?Ptes PIan,Recd „Y N;
2 copies o.f plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Ptes RBguired` .? Y.,^ tV
1 set of Energy Calculations Addkion - indicate if on-sife septic system (?n-site Sep6c System _:-Y N.
3 copies of Tree Preservation Plan if lot piatted after 711193
Rim Joist Detail Options selection sheet (buildings with 3 or less units)
Date 6_5 Construction Cost
Site Address j?{{vo/1.?D
? Unit/Ste #
r
Description of Work 6-DGU6?/Z- LE " j:?;J_ 1cfIA-51-S-14
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Mulfi-Family Bidg
Y ?C N Fireplaee(s) ? 0 _ 1
-
_
- f?,
Property Owner Telephone # ( `-
Contractor Z14 /'? 662?. (Z&) _!?7-/WGTI M
Address 5q5,:&),nl,y70 PIGY,(,t)Z) ?:.,? City rA yZ zy-
State Zip Telephone # (%JZ,}?{'?-??
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
?O Minnesota Rules 7670 CategorLl Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(q submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan w'th a similar plan? Y? N If so, 25% plan review
fee applies. ?1c L-.,?.1?:?-°-?.__?f?:,.?t-1?-.?__r?...
Licensed Plumber ?ND?!'c. l??Cfl?4iVJG,q ?- Telephone # 06-4 41y5" e14.
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.....,.,_....._ ..................._._........_.._......?._.,......._.._.,_?..._._?.__ - .?._.__._____.____?.._._.._...__.._..____--__.__.___._._.__._?.._._____...__._....
?
Mechanical Contractor A&Lff?4AYC4A(- Telephone # WZ) 4qS' q( ,a 97
S "
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans. D/oZE C-7" j5_2 )_;?y9
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Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation
? 02 SF Dwelling
? 01 01 of _ plex
C] 04 02-plex
0 05 03-plex
? 06 04-plex
Work Types
? 31 New
0 32' Addition
)51 33 Alteration
? 34 Replacement
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 37 Demolish Building" 0 43 Reroof ? 46 Windows/Doors
*Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation l9 4g"'o
Census Code
SAC Units
# of Uriits
# of Blclgs
Type of Const
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
_ Foundation
Drain Tile
Roof Ice & Water
? Framing
Occupancy
Zoning
Stories
Sq. Ft.
Length
Width
Final
Fireplace _ R.I. _ Air Test _ Final
?C Insulation
MCES System
City Water
Booster Pump
PRV
Fire Sprinklered
REQUIRED INSPECTIONS
Final(C.O.
FinaUNo C.O.
Plumbing
_X HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests Final
_ Siding ^ Stucco - Stone _ Brick
Windows
_ Retaining Wall
Approved By: Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 07 05-plex ? 13 16-plex ? 20 Pool
? 08 06-plex O 16 Fireplace ? 21 Porch (3-sea.)
0 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
Cl 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
0 11 10-plex ,W, 19 Lower Level ? 24 Storm Damage
0 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
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?C---e ? ? cL 2? `"1 '' ? v, V? 2004 RESIDENTIAL BUILDING PERMIT APPLICA? ?N ? ? ? O?, , ??Z?
?
t City Of Eagan ?? ?`I ? p?? ?
Date
Site Address 35? a 7
t 810CCWP0iVD Constiustisn Cost :3
aJ!?'Tj Unit/Ste #
Description of Work 5r
Multi-Family Bldg _ Y X N Fireplace(s) _ 0 Y 1 - 2
Property Owner Telephone # ( )
Contractor ,V hG--&C 0 U" Sa C dNS7eUGy/eA-2
Address q55-
State A) C. (i(,14 yZ14 Z`,f. .gJ L U D Cit3' ?0L.Y,7 9-r;'?r4
Zip c71 Telephone #(g?Z) 4.7 - 6 Z 9.--
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
X- Minnesota Rules 7670 Cate2orv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(q submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y A? N If so, 25% plan review
fee applies.
Licensed Plumber cz?c, /VIE?{?,4?CJ/c 74 L Telephone #(??) ??5'?
Mechanical Contractor ELflA.J-m4?t&('/G R L Telephone # ( ?,2) Sewer/1Nater Contractor Telephone #( fiL;;aA
I hereby apply for a Residential Building Permit and acknowledge that the inform is?c?mpl't6
that the work will be in conformance with the ordinances and codes of the City fgan and the Stat
Statutes; I understand this is not a permit, but only an application for a pernut, an
permit; that the work will be in accordance with the approved plan in the case of work which requi
approv
6wa4 al of plans.
U?UEF-e RD
Applicant's Printed Name App icant's Signature
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and
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2004 RESIDENTIAL BUILDING PERMIT APPLICATION
, City Of Eagan
' 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements RemodellReuair Reauirements ?f#ite
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan bf?un?y
(20°Jo maximum lot coverage allowed) 1 set of Energy Calculations for heated additions 1Y? PrS P? Aacd`
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks 'FrGr?? R,8qtti , itd ?y ??+7
1 set of Energy Calculations Addition - indicate if on-site septic system Qr?-site?epfic.'ht ? Y?N
3 copies of Tree Preseroation Plan if lot platted after 711193
Rim Joist Detail Options selection sheet (bidgs with 3 or less units
Date / / Construction Cost
Site Address Unit/Ste #
Description of Work '-
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner Telephone # ( )
Contractor
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y ! N If so, 25% pian review
fee applies.
Licensed Plumber
Telephone # (
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation
)K 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-piex
? 06 04-plex
? 07 05-plex ? 13 16-plex ? 20 Pool
? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? 11 10-plex ? 19 Lower Level 0 24 Storm Damage
? 12 12-plex Plbg_Y or_ N? 25 Miscellaneous
Work Types
K 31 New ? 35
?
? 32 Addition ? 36
? 33 Alteration ? 37
C] 34 Replacement
Valuation
Census Code _0_
SAC Units t? (
# of Units ?
# of Bldgs /
Type of Const ?
V ?
?
30 .
Accessory Bldg
? 31 Ext. Alt - Muiti
? 33 Ext. Alt - SF
? 36 Multi Misc.
fnt Improvement 0 38 Demolish Interior ? 44 Siding
Move Building ? 42 Demolish Foundation ? 45 Fire Repair
Demolish Building'` ? 43 Reroof 0 46 Windows/Doors
*Demolition (Entire Bldg) - Give PCA handout to applicant
Occupancy - ? MCES System
Zoning City Water
Stories Booster Pump
Sq. Ft. 1-4 qri PRV C rA
Length ? Fire Sprinklered
Width (
? Footings (new bldg)
_ Footings (deck)
Footings (addition)
7? Foundation
Drain Tile
? Roof Ica & Water Fina]
? Framing? `
Fireplace )(- R.I. $e Air Test X Final
? Insulation
REQUIRED INSPECTIONS
? Final/C.O.
_ Final/No C.O.
_ Plumbing
, HVAC
Other
_ Pool Ftgs Air as Tests Final
_ Siding _ Stucco Ston ` Brick
Windows
_ Retaining Wall
Approved By: Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
city sac
Utility eonnection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
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2 ??? D ??
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2004 RESIDENTIAL BUILDING PERMIT APPLICA ?N `
- C-,'`-I (.1 4 v go
? City Of Eagan
s 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements k5timmodeVRenair Reauirements
3 registered site surveys showing sq. ft. of tot, sq. ft. of house; and ail raofed areas 2 copies of plan
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks
1 set of Energy CaUlations Addition - indicate if on-site septic system
3 copies of Tree Preservation Plan if lot platted after 7l1/93
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date - la! 1 -7 !
Site Address 35-2- O7 Constr`uctiun Cost
Unit/Ste # /
Description of Work
Multi-Family Bldg _
Y X N
Fireplace(s) _ 0 Y 1 _ 2
Property Owner Telephone # ( )
Contractor ? G 1V h G2c IJ U6L DS, C 0N57P-Uc71 6/l?
,
Address 93 v`-
State Ad A) C, (/(JA yZ- ,¢ 7-A A ,L V 7) City /.A-Ti9
Zip ?J?3 9l Telephone #(9,52) 47 -5 - 6 Z 7,_
COMPLETE TNIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
rQ- Minnesota Rules 7670 Cateorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventifation Category 1 Worksheet • New Energy Code Worksheet
(4 submission rype) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? ^ Y -,t' N If so, 25% plan review
fee applies.
Licensed Plumber EL-4-JI) E?C' 14ELfh4,c) /c 4 1- Telephone #OsL)
Mechanica{ Contractor c
LAA)W W, ?_ Telephone # ( ?SZ)?'j?bS °' ? ?Z
Sewer/Water Contractor Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the inform is?`c?m?pl?t6
that the work will be in conformance with the ordinances and codes of the City Eagan and the Stat
Statutes; I understand this is not a permit, but only an application for a permit, an permit; that the work will be in accordance with the approved plan in the case of work which ?requi
approval of plans. Q?v2&, p`'?.? /4
6k&q?V4 UJiuElcre Ri 6&j., 3,
Applicant's Printed Name App icant's Signature
MN
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and
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MECcheck Compliance Report
1999 Minnesota Energy Code
MECcheck Software Version 3.2 Release 1
TITLE; Kenton "B" Model Home
COIJNTY: Dakota
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYFE: Single Family
DATE: 12/13/04
DATE OF PLANS: Dec. 13, 2004
PROJECT INFORMATION:
3521 Birchpond Road
Eagan, MN 55122
Terra Glen
COMPANY INFORMATION:
Lundgren Bros. Construction, Inc.
545 Indian Mound East
Wayzata, MN 55391
COMPLIANCE: Passes
Maximum UA = 662
Your Home = 639
3.5% Better Than Code
Permit Number
Checked By/Date
Gross Glazing
Area or Cavity Cont. or poor
Perimeter R-Value R-Value U-Factor UA
Ceiling 1: Flat Ceiling or Scissor Truss 1893 44.0 0.0 51
Wall 1: Wood Frame, 24" o.c. 201 OA 12.0 21
Wa112: Wood Frame, 16" o.c. 87 19.0 0.0 3
Window 1: Above Grade, Wood Frame, Double Pane with Low-E 38 0340 13
Wa113: Wood Frame, 24" o.c. 170 0.0 12.0 17
Wall 4: Wood Frame, 16" o.c. 107 13.0 0.0 5
Window 2: Above Grade, Wood Frame, Double Pane with Low-E 48 0.340 16
Wall 5: Wood Frame, 16" o.c. 2117 19.0 0.0 99
Window 3: Above Grade, Wood Frame, Double Pane with Low-E 396 0340 135
Door 1: Solid 45 0.067 3
Wa116: Wood Frame, 16" o.c. 1392 19.0 0.0 71
Window 4: Above Grade, Wood Frame, Double Pane with Low-E 191 0340 65
Basement Wall 1:
Solid Concrete ar Masonry, 9.0' ht/8.5' bg/9.0' insul 1695 0.0 5.0 136
Floor 1: All-Wood JoistlTruss, Over Unconditioned Space 114 33.0 0.0 3
Floor 2: All-Wood Joist/Truss, Over Outside Air 44 33.0 0.0 1
Furnace 1: Forced Hot Air, 90 AFUE
Proposed and Maximum U-Factor Averages
JVV
Proposed Maximum
Average U-Factor Allowed U-Factor
Above-Grade Windows and Glass Doors 0340 0.370
Includes Foundation Windows > 5.6 ft2
Floors Over Unconditioned Space 0.030 0.033
COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans,
specifications, and other calculations submitted with the permit appiication. The proposed building has been
designed to meet the 1999 Minnesota Energy Code requirements in MECcheck Version 3.2 Release 1.
Builder/Designer"??,?_? y ? Date y
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LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
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` PROPERTY LEGAL: Bl0e-K 1, TQ-ffa I4.r?n
DATE OF SURVEY: IZI1S10'4
LATEST REVISION:
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DOCUMENT 5TANDARDS
. Registered Land Surveyor signature and company
• Building Permit Applicant
. Legal description
. Address
• North arrow and scale
. House type (rambler, walkout, split w/o, split entry, lookout, etc.)
. Directional drainage arrows with slope/gradient %
• Proposed/existing sewer and water services & invert elevation
. Street name
. Driveway (grade & width - in R/W and back of curb, 22' max.)
• Lot Square Footage
• Lot Coverage
ELEVATIONS
Existin
'z ? 0 • Sewer service (or Proposed)
„H ? ? • Property corners
00 0 • Top of curb at the driveway and property line extensions
?„B 0 • Elevations of any existing adjacent homes
..2?0 • Adequate footing depth of structures due to adjacent utility trenches
? .0 ? • Waterways (pond, stream, etc.)
Proposed
? ? ? • Garage floor
0 • Basement floor
.,? ? ? • Lowest exposed elevation (walkouUwindow)
?' ? ? • Property corners
? ? • Front and rear of home at the foundation
PONDING AREA (if applicable)
? ? • Easement line
? ?.1 ? • NWL
? ? • HWL
? tR ? • Pond # designation
? ? ? • Emergency Overflow Elevation
p p? ? • Pond/Wetland buffer delineation
Y ? . Shoreland Zoning Overlay District
DIMENSIONS
? p ? . Lot lines/Bearings & dimensions
? ? • Right-of-way and street width (to back of curb)
? ? ? . Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent footings)
? ? ? • Show all easements of record and any City utilities within those easements
? ? ? • Setbacks of proposed structure and sideyard setback of adjacent existing structures
,,Z ? ? • Retaining wall requirements:
: Date /Z
Reviewed B
y
G: /FO RMS/Bu ilding Permit Application Rev. 11-26-04
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3521 BIRCHPOND ROAD
CERTIFICATE OF SURVEY
For: LUNDGREN BROS.
?
PROPERTY DESCRIPTION: Lot 3, Block 1, TERRA GLENN
ADDITION, Dakota County, Minnesota.
We hereby certify that this is a true and correct survey of the above
described property and that it was performed by me or under my
direct supervision and that I am a duly Licensed Surveyor under the
la ws of the State of Minnesota. That this survey does not purport to
show all improvements, easements or encroachments, to the property
except as shown thereon.
Signed this ? day of 2004. James R. Hill, Inc.,
By.
1. Buiiding dimensions shown are for
horizontal & vertical placement of structure
only. See orchifectural plans for building
& foundation dimensions.
2. No specific soils investigafion hos been
completed on this lot by Jomes R. Hill, Inc.
The suitability of soils to supporl the specific
house proposed is not the responsibility of
James R. Hill, Inc. or the surveyor.
3. No specific title search for ezistence or non-
ezistence of recorded or un-recorded easements
hos been conducted by the surveyor os a part
of this survey. Only easements per the recorded
plot ore shown.
4. Proposed grodes shown were taken irom
the grading &/or development plon prepared by
JAMES R. HILL, INC.
PROPOSED HOUSE = 2,546 SQ. FT
OR 16.17 % OF LOT AREA
DRIVEWAY = 902 SQ. FT.
LOT 3= 15,741 SQ. FT.
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Notes: o cr
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p Denotes set spike ^
0
p Oenofes set iron monument .
.
• Denotes found iron monumen t ? o
x927.6 Denotes ezisiing elevation V mo
(930.0) Denotes proposed elevotion rk
---- Denotes reqr of building pod P.o
Denotes proposed droinage oQ
TC Denotes top of curb J
v
rk: $59.30 -JRH CP #1259
h M
B DRAYVN BY
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enc
862.1 MJH
Proposed Garage Floor=
Proposed Garoge Top of Block= g62.5
DATE
Proposed House Top of Block= 863.2 11/22/04
Proposed Lawest Floor= 854.5 R VISIONS
Proposed Top of Block ot Deep Wndow= 857.7 12 13 Oa ,
Bearings are on assumed datum BOOK/PAGE
NONE
Scale: 1a=30' CONTROL N0.
- 21192
SAN. SERVICE INVERT CAD FlLE
241225.dwg
ELEV.=846.0 PROJECT N0.
241225
FlLE N0.
DRAWER
SHEET 1 OF 1
Site address; at11? ?-J? Lot
? _ -a Block? Subd.??%??C???',??
On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protect'ton, air
tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be
submitted prior ta issuance of a Certificate of Occupancy.
_ This structure: is constructed to meet minimum requirements of the Mn Energy Cotle, Chapter 7670
d` _ OR
This structure: will be constructed to meet more restrictive requirements oi Chapters 7672 or 7674
APPLIANCE
Water Neater GAS ELEC MANUFACTURER MODEL BTU`S VENTING TYPE
2-?? ` ? E S ? ? 4br o?1 U ?
Furnace „
Dryer 350 MA- & otµo
l2a; 0 00
EXHAUST SYSTEM
Kitchen LOCATlON
kitchen TYPE
MODEL
CFM's VENT
vES No
Bathraom 1
Bathraom 2 p
~0
?
Sathroom 3
Bathroom 4
? F M ?
sQ ?°
>6
Other -1 ? ?..2- s-O 2)
, lob
FIREPLACE S LOCATION GAS WOOD MANUFACTURER MODEL BTU'S DtRE TENTI A MOS
? FA fL ab,y`1 i"7 G.. oOU 7C
MAKE-UP AIR MODEL TYPE CFM's
e:N ?
?" Gc e ?'!?
L?4 fvC F
I hareby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Cotle and Ciry of Fagan
requirements.
?
?
Signature ,7
1A 1 y--a?
Date
Company Name
" This form is the responsibility of the General Contractor.
Address: 3521 Birchpond Rd Zip: 55122
Lot: 3 Block: 1 Subdivision: Terra Glenn
?
THE FOLLOWING ITEMS WERE/WERE NOT COMPLETE AT FINAL INSPECTION ON C)/
Yes No Comments
Final rade - 6" from siding
Permanent steps - garage
Permanent ste s- main ent
Permanent driveway
Permanent as
Retaining Wall or 3:1 Max Slope >
Sod/Seeded lawn
Trail/curb damage
Porch
Lower level finish
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 trP Cily's Enginee-ring DPpartment at 651-675-5646 prior to working lin right-of-ivay or instaIling
inigation system.
e?
? BUILDING INSPECTOR:
CONTRACTOR:
Lundgren Brothers Construction
935 E. Wayzata Blvd
Wayzata MN 55391
:?-Z) GSI
2005 RESIDENTIAL MECHANICAL PERMIT Ai''I'LICA;TICIN
City C1f Eagan
3830 Pilvt I£nob Road, Eagan MN 55122
Telephane # 651-675-5675
Please camplete for: single family dweltings & tovtmhomeslcondos when permits are required for each unit
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State )W N ZiA ,5-53,7 ? Telephone # ?z-
Bond #• Expires:
The Applicant is Owner ? Contractor Other
Add-og or alteration to existing dweHing nnit S 30.00
furnace _Additional ,,,_Replacement
air exchanger
air cQndi#ioner New -Replacement
? other c,s
State Surcharge $ •50
Total ? 30, so
I hereby apply for a Residential Mechanical Permit and acknowleclge that the inforrnation is complete artd accurate; ttist tle work will
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Cc}des, $9 1 unclers#and thls is not a
permit, but only an application for a permit, and work is not to staartt without a permit; t the wcark vvi}l be in aeccrdance fivith the
appraved plan in the case of work which requires a review and approval of plans.
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Applicant's Printed Name Applicant's Signa.ture .
aeos comMERcUL MEcsANIcAL r??MIT APPaJcATION
City Of Eagaa
3830 Pilo# Knob Roa, Eagaa MN 55122 `
Telephone # 651-675-5675
ftaw armpletc fpr iaVinttustrial bnildinp
multi-fami2y bculdmgs wbm separate permits ara W required far csch dwelling writ
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'F+ruast Name (if applleabk) P?'evio?? T??tt I?? ,
Property Olvner Tclophou # { }
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Hond #: Expires:
T'be Appkant iS Chmer CQniractor {?ther
Worc 1`yle
Pdew Gar+stnaction Underground Tank InsW -Remove'"`a" below
tnferior Irnpravement InstaH Piping _ Processed _Gas
Na#ure of Work:
"When PrtsWOn ovfng undorground tanty by 'Mm At*ft*0 :&4P"lxrmbift+inqmftr ;
catl far' kropoct9on
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Pernaiit Ffts: S74M Undaronnd Umk Watlatr;Untemval
S50.30 (inaludes Stme $umbage)
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eor,tracc vaiue $ x 1% s $ Pennit Fee
• If ggtnit fee is S1,000 or less, add $.SQ ? $ Staft Sumharp'
If ?e is ovtr $1,iMa, add S.SQ for
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every $I
000 ne tr ni_t fee $ 'T'otal Fee
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> I herebY aPply fQr a Cammercial Machar+ical Pmmit and acknowledie-thst the infunrativn is complote and accuratc; that the work
will be in conformance with the ordinances and co+des af the Ciry af Eagan and with the MeebuicW Co€les; titai I underitaW this is
not a permit, but only an appliecattian for a permit, and work is not to start rwviithvut a perrmit; iha# tlte work wiU be in woordance with
#kxa a,gpraved ptan in thecase of work vYhich requires a review and approval of plans.
ApPlicant's Prh?ted i+tatne , ' Applicwt's Signatura
Approved By: Inspector IIate:
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA106869
Date Issued:09/13/2012
Permit Category:ePermit
Site Address: 3521 Birchpond Rd
Lot:3 Block: 1 Addition: Terra Glenn
PID:10-75400-01-030
Use:
Description:
Sub Type:e-Reroof
Work Type:Replace
Description:House
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
JEANNIE DUBRAY
3521 Birchpond Rd
Eagan MN 55122
Legacy Restoration LLC
10650 Cty Rd 81, Unit 101
Maple Grove MN 55369
(763) 354-7660
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA131377
Date Issued:06/17/2015
Permit Category:ePermit
Site Address: 3521 Birchpond Rd
Lot:3 Block: 1 Addition: Terra Glenn
PID:10-75400-01-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Jeannie Dubray
3521 Birchpond Rd
Eagan MN 55122
Sedgwick Heating & Air Conditioning
1408 Northland Drive, Suite 310
Mendota Heights MN 55120
(952) 881-9000
Applicant/Permitee: Signature Issued By: Signature