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3561 Birchpond Rd RP -114 `t24 (0 100, L-I 6 2006 RESIDENTIAL BUILDING PERMIT APPLICATION pp -1y-12.15 q0.50 City Of Eagan M4l -14-12L.', -10 , 3830 Pilot Knob Road, Eagan MN 55122 74-12 -1 Telephone # 651-675-5675 FAX # 651-675-5694 La?Cat .`4. New Construction Reouirements Remodel/Repair Reouirements Office Use Only 3 registered site surreys showing sq. ft. of lot, sq, ft. of house; and all roofed yeas / 2 copies of plan showing footings, beams, joists Ced of Survey Recd --Y - N., - (200 maximum lot coverage allowed) t set of Energy Calculations for heated additions Tree Pres Plan Recd N 2 copies of plan showing . beam & wi ow sizes Poured found des!9n, etc. 1 site survey for additions & decks Tree Pres Required N 1 set of Energy Calculations Addition - indicate ff on-site septic system On-site Septic System _Y _N 3 copies of Tree Preservation Plan if lot platted after 7!1193" l Z Ran Joist Detail Options selection sheet (buildings with 3 or less units) V t{- ~/~7L Minnegasco mechanical ventilation form ~~11410 601V14 Date '7 ate (o n Construction Cost -3 Site Address to f i t jc t✓~,Oc/0p 90'.9-D Unit/Ste # Description of Work .505,E) Multi-Family Bldg Y N Fireplace(s) _ 0 V 1 _ 2 Property Owner Telephone # ( ) Contractor L-. CA ft Cg 8P - r )S - Address A-) p~H7 ~(SUI~f) City u~j~~fI1 State Zip s 3~Lj Telephone # (957.,Z) L173 - 09 q-:;S COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING ~ Minnesota Rules 7670 Category! 1 _ Minnesota Rules 7672 Energy Code Category Residential Ventilation Category 1 Worksheet New E y 4W D (4 submission type) Submitted Submi - • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Y X N If yes, date and address of master plan: „ Licensed Plumber ELA1JL7;~X GiAI IJ Gr<1 L Telephone # 052) 4y5`L1 &qZ Mechanical Contractor i LA0 A61L 14F( C94 1\)IC.A`. Telephone # 6,52) ~ ~5'?(oq2 Sewer/Water Contractor T -Li2 fIt~,yr P) / Ki G Telephone # 44 " ~y 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. i' i7n~ l~f}~A ~11 LL E f©r Applicant's Printed Name A plicant's Signature DO NOT WRITE BELOW THIS LINE Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of_ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12; .12-plex ❑ 25 Miscellaneous 412rk Types 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior Q 44 Siding ❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish Building* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Description: Water Damage Yes Valuation A(000 Occupancy d23- l MCES System Plan Review X- 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) _ Sheetrock --F Footings (deck) Final/C.O. _ Footings (addition) - Final/No C.O. Foundation _ HVAC _ Drain Tile Other Roof _ Ice & Water Final Pool Ftgs _ Air/Gas Tests Final Framing Siding _ Stucco Lath Stone Lath Brick Fireplace R.I. LAir Test *Final _ Windows Insulation Retaining Wall Approved By: Building Inspector Base Fee Surcharge `s 9 Plan Review MC/ES SAC L City SAC `-y Utility Connection Charge J, JL, S&W Permit & Surcharge Treatment Plant`'' License Search 7 Copies L /t Other ~ Total Permit Number REScheck Compliance Certificate Checked By/Date 2000 Minnesota Energy Code REScheck So$ware Version 3.6 Release 2 Data filename: G:\CAD\EI\TRADIT~I\Hampton\XF-CRAM\HAMPTO-I\FULLAN-I.RCK PROJECT TITLE: Hampton "F" Cra$sman COUNTY: Dakota STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family WINDOW / WALL RATIO: 0.12 DATE: 07/26/06 DATE OF PLANS: 07-06-06 PROJECT DESCRIPTION: Inventory Home 3561 Birchpond Road Terra Glenn Eagan, MN 55122 DESIGNER/CONTRACTOR: Lennar 545 Indian Mound E. Wayzata, MN 55391 PROJECT NOTES: Full Lower Level 9 poured foundation COMPLIANCE: Passes Maximum UA = 682 Your Home UA = 601 11.9% Better Than Code (UA) Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1: Flat Ceiling or Scissor Truss 2228 44.0 0.0 60 Wall 1 (egress): Wood Frame, 16" o.c. 82 19.0 0.0 3 Window 1: Above-Grade: Wood Frame:Double Pane with Low-E 36 0.330 12 Wall 2 (rim): Wood Frame, 24" o.c. 198 0.0 12.0 20 Wall 3 (main): Wood Frame, 16" o.c. 1878 19.0 0.0 92 Window 2: Above-Grade: Wood Frame:Double Pane with Low-E 254 0.330 84 Door 2: Solid 69 0.067 5 Wall 4 (rim): Wood Frame, 24" o.c. 200 0.0 12.0 20 Wall 5: Wood Frame, 16" o.c. 1749 19.0 0.0 92 Window 3: Above-Grade:Wood Frame:Double Pane with Low-E 198 0.330 65 Basement Wall 1 (full): Solid Concrete or Masonry 1647 0.0 5.0 132 Wall height: 9.0' Depth below grade: 8.5' Insulation depth: 9.0' Basement Wall 2 (egress): Solid Concrete or Masonry 52 0.0 5.0 6 Wall height: 3.5' Depth below grade: 3.0' Insulation depth: 3.5' Floor 1: All-Wood Joist/Truss:Over Outside Air 62 24.0 0.0 2 Floor 2: All-Wood Joist/T russ: Over Unconditioned Space 336 44.0 0.0 8 Furnace 1: Forced Hot Air, 90 AFUE Proposed and Maximum U-Factor Averages Proposed Maximum Average U-Factor Allowed U-Factor Above-Grade Windows and Glass Doors 0.330 0.370 Includes Foundation Windows > 5.6 $2 Floors Over Unconditioned Space 0.023 0.033 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2000 Minnesota Energy Code requirements in REScheck Version 3.6 Release 2 (formerly MECcheck) and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Builder/Designer Date 7'Z6 p I I 952 555 5555 Line 1 ELANDER MECHA 10:53:37 a.m. 07-26-2006 1 /1 Date: 7/26/2006 Revision Date: 7/26/2006 New Construction Site Information Address 1: 3561 Birchpond Road Project Address 2: Lot:/3 Block: / City: Eagan County: Subdivision: Application Information Business Name: Elander Mechanical Inc. MN Contractor License Contact Person: Todd Office Ph: 952-445-4692 Fax: 952-445-7487 Cell Ph: Address 1: 591 Citation Drive City: Shakopee State: Minnesota Zip Code: 55379 House Details Square Feet: 5551 sq. ft. Avg. Ceiling Ht: 9 ft. Number of Bedrooms: 4 Ventilation : Balanced Total Ventilation Capacity : 219 cfm. Minimum Continuous Ventilation :75cfm. Intermittent Ventilation: 144 cfm. Combustion Appliance Water Heater: Power Vent Input BTUs: 75,000 Independently Vented Furnace/Boiler: Direct Vent/Sealed Combustion Input BTUs: 90,000 Independently Vented Other Combustion Appliances Gas Fired Direct Vent Fireplace(s): Yes Gas Fired Power Vent Fireplace(s): No Gas Fired Natural Draft Fireplace(s): No Solid Fuel Appliance(s): No Exhaust Equipment Continuous Exhaust Ventilation Capacity (cfm): NA Clothes Dryer (cfm): 135 Exhaust Fan Rating (cfm): 640 Make-Up Air No Make-Up Air Required by Code Combustion Air Round Rigid Required: 5 inches or Insulated Flex: 6 inches Applicant Name (print):JSW=64v,,A )JLL6F620 Signature/Date.. ~ ~~G Cn Code Official (print): Signature/Date: 0 2004 CenterPoint Energy Minnegasco. 2004 Mechanical Code Guidelines. Page 1 LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILD) IING -PERMIT APPLICATION / PROPERTY LEGAL: 1 1~ K I 1 fz ~P.~yl ri0,d~~T~ ~Y1 DATE OF SURVEY: 7/ZOO LATEST REVISION: d a~ ea U o z` < DOCUMENT STANDARDS '0' 0 ❑ • Registered Land Surveyor signature and company ❑ 0 • Building Permit Applicant ❑ 0 • Legal description ❑ 0 • Address ~rY ❑ ❑ • North arrow and scale ~H ❑ 0 • House type (rambler, walkout, split w/o, split entry, lookout, etc.) 'z 0 ❑ • Directional drainage arrows with slope/gradient % 0 0 • Proposed/existing sewer and water services & invert elevation ,Pl 0 ❑ • Street name ~Y ❑ 0 • Driveway (grade & width - in R/W and back of curb, 22' max.) ❑ ❑ • Lot Square Footage 0 D • Lot Coverage ELEVATIONS Existing X ❑ ❑ • Property corners ❑ ❑ • Top of curb at the driveway and property line extensions ,P1 ❑ 0 • Elevations of any existing adjacent homes 0 0 • Adequate footing depth of structures due to adjacent utility trenches 0 ,!7 0 • Waterways (pond, stream, etc.) Proposed f~ 0 0 • Garage floor Ja ❑ ❑ • Basement floor 1a 0 ❑ • Lowest exposed elevation (walkout/window) 0 ❑ • Property corners 0 ❑ • Front and rear of home at the foundation PONDING AREA if applicable ( ) ❑ i1 D • Easement line 0 X 0 • NWL ❑ X 0 • HWL D 0 • Pond # designation ❑ 0 • Emergency Overflow Elevation ❑ 'z Pond/Wetland buffer delineation Y • Shoreland Zoning Overlay District Y Conservation Easements DIMENSIONS D 0 Lot lines/Bearings & dimensions ❑ ❑ Right-of-way and street width (to back of curb) 0 ❑ Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. all structures requiring permanent footings) ❑ 0 Show all easements of record and any City utilities within those easements ,z ❑ 0 Setbacks of proposed structure and ' ey rd setback of adjacent existing structures 0 ❑ Retaining wall requirements: / Reviewed By ` Date G:/FORMS/Building Permit Application Rev. 11-26-04 3561 BIRCHPOND ROAD r Maximum I u aWW Q.R.V. CERTIFICATE OF SURVEY REQUIRE D Be Required $ - - L For: LUNDGREN BROS. Ilan 2 7 RIOT R I ..o. ac = J b NI PROPERTY DESCRIPTION: Lot 13, Block 1, TERRA GLENN rQ~ rIOVNTtt , . BIRCHPOND ROAD , fNALT 1S_--= J Ham- J R-972.50 11~ TEA S,'0 CCD _ ADDITION, Dakota County, Minnesota. CIE UJI N ILL 40 = 6°29'45" r~ :-1: !o W 1D ~ 1'6 I 8 2 TC 4 rTC 847.1 (~-~=--cc co L. 848.51 0.26 HYD. N N`- We hereby certify that this is a true and correct survey of the above g (848.5 0 847.3) described property and that it was performed by me or under my z a W `2Z BENCH MARK direct supervision and that I am a duly Licensed Surveyor under the I - - - - ` TOP OF SPIKE laws of the State of Minnesota. That this survey does not purport to BENCH MARK ' ~0 PROPOSED m ELEV.=848.39 show all improvements, easements or encroachments, to the property N CUT=4.69 TO TOP 1 TOP OF SPIKE I DRIVEWAY OF LOWEST FLOOR except as shown thereon. ELEV.=850.50 I o 5.00-1850.0 (851.0) _ -22.85 CUT=6.80 TO TOP _ a _ _ _ _ 00 849.2 Signed this 4W'0' day of C 2006. James R. Hill, Inc., OF LOWEST FLOOR I 20.33 12.33 849.8 _ I I 00 ` (851,7) i.. / 851.3 I ~ GARAGE ~11s7o -'24.65 M I of m STODP _ rn 849.2 o O GARAGE N d o X4.65 CC) d- By. wZ EXISTING ~t I 33 16,02 CANTS.- EXISTING, J. Gar yon, nnesoto L.S. No. 11529 rsi HOUSE L6 850.8 PROPOSED 8.1 HOUSE ¢ Z (FULL) I 4a2 HOUSE W (FULL)/ ' o (FULL) EGRESS 1 N es. 04 U O A Denotes set spike 851.1 15.9( I w o 0 17.0 1 00 o 0'o 22.0 N 199 14- 0 Denotes set iron monument Y ANT 1. Building dimensions shown are for 00< 86~ _.5 .7 1396 5 N Q 00 0 Denotes found iron monument 1! o LL1 850 - ~851 _ 0) . CN horizontal & vertical placement of structure x927.6 jO C6 14- d Denotes existing elevation U M . LO T- X It only. See architectural plans for building (930.0) Denotes proposed elevation SH Mo NT- ---(s505) 00 - Denotes proposed drainage & foundation dimensions. F-o U) TC Denotes top of curb o° 000 I 1 nT 2. No specific soils investigation has been - - - - Denotes rear of Building Pad 'a I nT o-t LOT 13 L_v 1 t- completed on this lot by James R. Hill, Inc. per grading plan U L_v I I Co I The suitability of soils to support the specific DRAWN BY LL Z '\1 DRAINAGE & UTILITY i sTa { e house proposed is not the responsibility of MAL EASEMENT PER PLATIMETERJN NUM I-1 I 849.36 _TNH-Lots 13 & 14, Block i James R. Hill, Inc. or the surveyor. Bench Mark: DATE 5 L - ' o to / 3. No specific title search for existence or non- 7/13/06 4- o / (854 5) existence of recorded or un-recorded easements Proposed Garage Floor- $51.3 REVISIONS LO - co has been conducted by the surveyor as a part Proposed Garage Top of Block= 851.7 (861.2) '55"W of this survey. Only easements per the recorded Proposed House Top of Block= 852.4 3 N05-54 Proposed Lowest Floor= 843.7 94.2 plat are shown. Proposed Top of Block n' 1 n~ r` 4. Proposed grades shown were taken from p v v I L_v I V at Egress Window= 846.9 BOOK/PAGE the grading &/or development plan prepared by NONE 41 JAMES R. HILL, INC. Bearings are on assumed datum CONTROL NO. MWEDD. 21192 Scale: 1"=30' CAD FILE By LOT 13 = 14,810 SQ. FT. 261255 z SAN. SERVICE INVERT PROJECT NO. Date PROPOSED HOUSE = 2,685 SQ. FT. EAGAN F,NGINEERLNG DEPT. OR 18.13 % OF LOT AREA ELEV.=836.0 261255 FILE NO. DRIVEWAY = 863 SQ. FT. DRAWER li SHEET 1 OF 1 i Address: 3561 Birchpond Rd Zip: 55122 Permit: 74724y THE FOLLOWING ITEMS WERE/WERE NOT COMPLETE AT FINAL INSPECTION ON : V Yes No Comments Final grade - 6" from siding" . Permanent steps - garage Permanent steps - main entry Permanent driveway Permanent as Retaining Wall or 3:1 Max Sloe X 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 the City's Engineering Department at 651-675-5646 prior to working in right-of-way or installing irrigation system. y BUILDING INSPECTOR: r ~ G Site address: ~O1 i f~ PcSry EPA D Lot J ~ Block l Subd. t j" a/" f-Z~,LEt,_~/tiJ On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be submitted prior to issuance of a Certificate of Occupancy. This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670 OR This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674 APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE Water Heater U <; P•S o 'LZ Furnace Dryer } PJ?" V { v 12-0 ,000 V L, t > 1 ~-J (.P Z b o Low OW -n C_ --rA c_ VENTED EXHAUST SYSTEM LOCATION TYPE MODEL CFM's YES No Kitchen kitchen Bathroom 1 5,7 k Bathroom 2 - - -M 5D /X Bathroom 3 Bathroom 4 Other 7tG /1) l`j f 0 0 VENTING FIREPLACES LOCATION GAS WOOD MANUFACTURER MODEL BTU'S DIRECT ATMOS MAKE-UP AIR MODEL TYPE CFM's I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan requirements. r ate -0 Signature Date 6-f Company Name * This form is the responsibility of the General Contractor. 7 ~ For Office Use I j Permit City of Eakin I / ~a I Permit Fee. / I 3830 Pilot Knob Road Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 1 1 Fax: (651) 675-5694 i staff: 4.----------.-.-------- 2o09 RESIDENTIAL BUILDING PERMIT APPLICATION ? .r Date :trr~, Site Address:Fs let Tenant:_ Suite 9: n~ RESIDENT/OWNER Name: Phone: Address / City / Zip: I s / ~;1/r"r° rig Applicant is: 2~_ Owner Contractor TYPE OF WORK Description of work: !~1"~°/r~ Construction Cost:_' Multi-Family Building: (Yes / No CONTRACTOR Name: ~i4/ / I_icen, s Address: City: - State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. 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 pennit, 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 appr I of plans. x X, Applicant's Pri ted Name Applicant's Si at W E Page 1 of 3 W AUG 0 1 2009 DO DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation i Fireplace Porch (3-Season) _ Storm Damage _ Single Family _ Garage _ Porch (4-Season) Exterior Alteration (Single Family) _ Multi Deck _ Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi) 01 of _ P1ex i Lower Level _ Pool _ Miscellaneous _ 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 building - give PCA handout to applicant DESCRIPTION Valuation i 410 0 Occupancy 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 Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: -ice & Water Final Pool: -Footings Air/Gas Tests iFinal Framing Siding: -Stucco Lath -Stone Lath Brick Fireplace: -Rough In Air Test -Final Windows Insulation Retaining Wall Meter Size: Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 r - i«~u«aaosssa~.atu t«af xur:aa~rrsmaarurisawuerwmwa~s~ur acw.oaf.:Bat a:cw;ama'.:au~e:cwwravg+w.Gr...i.iaowu..mr :;:~r..:~fsw~; ...w:aacn~.ya.uc..c•..:vw :~s~..::mf~uerc',twwE:...::a3w:«das.uvuc ~z:::acasc».:: .c...fa. -ar.«.uv:~:cazsa:;s.:: rcwawa:~1 Q W r- I~~ d _ mcr-0W _ ~11 G"1 r rnm -u n 0 16.00 1.50 ~ ~ ~ 00 7 1 1 . LA -Tj -1 m 27.5N86°00'25"E I 00 ;a -u W r- 00 148.51 (849.3) - 29.77 U' (849.8) - - 55.40 - - N W 1 p 854.8 ~ I oo w I ° 0 10 m o 00 29.83 1 00 n~ (D 0 m D ICI EGRESS.-P, Co D\W o ~x I D o f 12.0 i°v x ~ < 1 00 n m c~ 23.48 \D \1w.0 cn mo I ra P iv oc©' U) 7.4 - (r1 I m P? N \ W Iv o - z I c ® Co ool o\ L- 8.2 _a NCO O r a x ° CJ U' D ?.o noo J I or NNI 1 w ~c00 11.0 00I N r I~ E~ ~I ~4\ m~\ 19.0 r I{ t_ _ 0 ~Ln Cn I I Cn -rPnU1 z b) 1 o 1 m 1 31.31 W® rl ' I 849.2 co ~I 1 F;zl vl N IN to 160 853.2 8 8. ~J I -+X r ® a 00 0 55.40 29.77 - 00 v0 0. ~0 849.0 (848.0) / 1 4 -;u 29 50y'E S IA(A o co on Cn mr -i Om 849.1 a N min a~ D O~:<O= w ~ a7 s r0~fM _ ~zx o -r 27.5-- f --27.5---•, _ c: O&i r-w- BOO 11.5. 16.00 16 11• \ 00 5 I I C- 0 CD L,4 C& nx• N C _ o- T CD p -n N 1 Y (D (D N < p -I m o o ti CD o `n c ° cn c' CD O O U! 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PLANNERS / ENGINEERS / SURVEYORS SURVEYORS D cn Fn D Z of 00 LOT 13, BLOCK 1, TERRA GLEN 2500 W. M RD. 42, SunE 120, Bm%wv, MN 55337 ~I 0 O m N ADDITION, DAKOTA COUNTY, MN PHONE: (952)890-6044 FAX: (952)890-6244 woivmsta~~ara,xayriuafnf~a,afacmawawfcm ®emezsoraamcnsscsa.avr~s.ea.c:m..w.srm.s:.c..~»~...,e~...r....»......c•.:~,.w~.,..•r..e.,.....,::.~.:...,.. - Use BLUE or BLACK Ink r For Office Use I 4*. City of Eagan Permit:e: L:4 Permit 1 a 3830 Pilot Knob Road ((( Eagan MN 55122 Date Received: Phone: (651)675-5675 Fax: (651)675-5694 Staff: 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: Name JDfriUS61- Aili x--IA L � l dhoue� Phone:�.,�. ..M..N.��..m...,n. .�., _.. Resident/ y p: 3 16 ( n rRCh pe,-9 R 10 1 f4 361)u ikf i- - C-/a a Owner Address/Cit /Zi § P Applicant is: Owner Contractor I Description of work: �e — ii-UF' Type of Work Construction Cost: 2 Z' OZ`57 Z' Multi-Family Building: (Yes /No ) I Company: -4/1/)4 4-414' 600 4 V/2 y(ri U Contact: � P-. L 6 ben; tc_ p Y; 1 Contractor Address: )d C Q.)6 S i 14 ��Z City: ` '���Cq2 J State:;91 X'Zip: 0r44 11 Phone: 6 (2-211-612-- 2-2 1 1-6rE a I: a 4 s to i-`_ Cir 11�6* tie'. License#: 1 C G b t 2 / Lead Certificate#: If the project is exempt from lead certification, please explain why: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 6 In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? i Yes No If yes,date and address of master plan: Licensed Plumber: Phone: 1 Mechanical Contractor: Phone: i Sewer&Water Contractor: Phone: I I Fire Suppression Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to 1 _, conclude thalpm 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 underground utilities. www.qopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. p fi________ ......„________,,- x 4 LE14 \ hp, C- o U.-t ei C� L_ x Applicant's Printed Name Applicant's Signature Page 1 of 3