3565 Birchpond Rd20A RESIDENTIAL BUILDING PERMIT APPLICATION ??•~Ia?-G ?
City Of Eagan ') P •. ?a 4q ?
3830 Pilot Knob Road, Eagan MN 55122 `
T I h 44 651 675 5675 FAX 4:1 651-675-5694 51D ' y1DqqLf
e ep one - -
j(* / o26 aa -
uirements
New Construciion Re Remodel/Reoair Requirements
q Y ?1
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Gert At S..?ey Recei
(20% maximum lot coverage allowed) t 1 set of Energy Calculations for heated additions Tree Pres Pfan Recd Y N;
Y. N
2 copies of plan showing beam & window sizes; poured found design, etP 1 site suroey for additions & decks 7ree Pres Requitsd
1 set of Energy Calculations Addition - indicafe if on-site sepfic system Qn-site:SsRltic System r Y <N`:
3 copies of Tree Preservation Plan if lot platted aHer 7/1/93 - `"1
Rim Joist Detail Options seleclion sheei (buildings with 3 or iess units)
D ate Construction Cost
Site Address S,;S Ltl 5 ti ' H f%(
Unit/Ste #
I h.; b ? o A C) ?
LA Tt_v Y '
Description of Work .'4S E--/-
Multi-Family Bldg _ YQ N Fireplace(s) _ 0 2
Property Owner Telephone # ( )
Contraetor Li,? ?}DGtzet_) b(Lns
Address Lt%C)1,41J L/r o L4 0 1) ?i City j/tjj4 y2-t?Tf?
State M IQ Zip 55 Telephone # (952) 0.? 9
.-"
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
? Minnesota Rules 7670 Categorv 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
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _?O N If yes, date and address of master plan:
Licensed Plumber Telephone #oSZ) 144 S-LIOZ
Mechanical Contractor Telephone #(??SL) `??9 Z
SeweriWater Contractor PLU?r? kA)i4)6= Teiephone #(J54
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. n \\n vi,,
v
Applicant's Printed Name
? 06
Applicant's Signature rL6
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
A 02 SF Dwelling 0 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 Plbg_Y or - N ? 25 Miscellaneous
Work Types
x 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 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 Bidg) - Give PCA handout to applicant
Valuation ? ? L? Occupancy MCES System ?
Plan Review 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) ? FinaUC.O.
_ Footings (deck) _ Final/No C.O.
Footings (addition) _ Plumbing
? Foundation _ HVAC
Drain Tile Other
? Roof ? Ice & Water
Framin ? Final = Pool = Ftgs _ Air/Gas Tests Final
Stucco Stone Brick
Sidin
g g
? Fireplace ?- R.I. *Air Test ? Final Windows
Insulation =
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
%79,1? " 6
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a?eCct % ???? ??oi-11
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Development ?u? ? 2,?7 (? ? (sl`? l `°
Lot Number t? Block Number . /
Address
Builder ?,°r/70176)?r
Phone Number:
Contact: J6HlJ
Tree Protection Requirements:
Tree Protection Fencing Installed On Site
Oak Tree Pruning (Immediately seal wounds during April 1 to July 31)
Therapeutic Pruning Required
Retaining Wall To Be Installed
Other:
Replacement Trees:
Not Required
As Follows: j? LTC5C3
Attachments:
Yes
.._...?.,.?.
No EAGAN FOR;ESTR Dl11'iSI
C}N
Additional Notes: REV????
By aaTE
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H:\ghove\2005fi1e11reepres\Tree Preservafion Plan Summary-2005
(BUILDER, PLEASE READ ATTACHMENTS)
? 1 1 It
3565 BIRCHPOND ROAD
CERTIFICATE OF SURVEY
For: LUNDGREN BROS.
LOT 14, BLOCK 1
? B I RCHPOND ROAD ;-
--?? - - R=972 .50 - - ---?
A=06 °29,45„
-" ? 4,"YD*_ 10 . 26
SERV.
T. V.°
? -? ---
? PROPOSED ?
I DRIVEWAY
I
V 20.83 ? 4.83 STOOP "? ?
cv,2.o? - si o?ol I
W 5.83 "'
? GA?G? ? t?qNT.33 13.31
O
PROPOSED
I 20.02 ? HOUSE
I/lT' -1 y o (FULL)
/C"4.' LVI ? ZI 4
19.52 I
? I n i? n N iT 1i.oN ?
vn?ni v i N °•
I
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N ?
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.96ba 3.9 TP
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0 12'0/ EGRES CY) I ?
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LMT 14 ?I
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? 94.22 N10035'53"E
DENOTES
0 EXISIING TREE SAVE ni iTI n-r n
VV IL_VI U
?EXISTING TREE REMOVABLE
?EXISTING TREE CUSTOM
-TP- 1REE PRESERVATION FENCE
PER 1REE PRESERVA710N PLAN
W
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_ TMu So3Zel1 coucct
t061 «? New•.o+?cg
J
TERRA GLEN
Tree Preservation plan
Pre House Proposed Post House
Development Construction Tree Preservation Constructio
Const. As-B uilt Post House Const. As-Built
POINT N0.
ELEV.
TYPE
DIA w
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? PZ: --
w w
? w
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w w
?
11 X X X
3991 847.6 7 X X
3992 4 Y X X
1 X X X
9 X X
4820 4 8 X X X
4821 848.3 Y 7 X X X
1 X X X
4848 852.7 OAK 8 X X X
Preliminary Tree Certification
During a site visit on February 2, 2006 all significant trees designated to be saved on the
"--- ?, Tree Preservation Plan prepared by James R. Hill, Inc., were present and in good health, ezcept
as noted in the table above.
The house hos been staked. Tree fence will need to be placed outside the dripline of all significant
trees to be saved. Fufure grading and construction should not have a negative effect on these trees.
J
/
? Dafe: 46 46 BY
, Minnesota L.S. No. 11529 Signature of Owner
Date:
Scale: i"=30' Page i of 1 James R. Hill, Inc.
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DRAWN BY
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DATE
2 /1/06
REVISIONS
BOOK/PAGE
NONE
CONTROL N0.
2»s2
CAD FlLE
261027.dwg
PROJECT N0.
261027
FlLE N0.
DRAWER
SHEET 1 OF 1
L
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?
LOT SURVEY CHECKLIST FOR RESIDENTlAL
BUILDING PERMIT APPLICATION
PROP
??????.?1?1'...,C. k-,14
ERTY LEGAL: ?
DATE OF SURVEY: z./(oIOL
?
LATEST REVISION:
d
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s
U
Ya
O Z V
a
DOCUIVIENT STANDARDS
0 ? • Registered Land Surveyor signature and company
? ? • Building Permit Applicant
? ? ? • Legal description
? ? • Address
? ? ? • North arrow and scale
0 ? • House type (rambler, walkaut, split w/o, split entry, lookout, etc.)
? ? . Directional drainage arrows with slope/gradient %
? 0 • Proposedlexisting 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 ? ? • Property corners
?? • Top of curb at the driveway and property tine extensions
? ? • Elevations of any existing adjacent homes
,' ?? • Adequate footing depth of structures due to adjacent utility trenches
? f'rl ? • Waterways (pond, stream, etc.)
Proposed
?1 ? ? • Garage floor
'0 ? ? • Basement floor
p 0 ? • Lowest exposed elevation (walkout/window)
,0 ? ? • Property corners
y ? ? • Front and rear of home at the foundation '
PONDING AREA (if applicable)
? / ? . Easement line
? 'z ? • NWL
? Id ? • HWL
? ? 0 • Pond # designation
? ? ? • Emergency Overflow Elevation
? jd 0 • Pond/V1letiand buffer delineation
Y . Shoreland Zoning Overlay District
Y ? • Conservation Easements
DIMENSIONS
,y3 ? ? • Lot lines/Bearings & dimensions
y7'' ? ? • Right-of-way and street width (to back of curb)
'z ? ? • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent footings)
y?' ? ? • Show all easements of record and any City utilities within those easements
z ? ? • Setbacks of proposed structure and si r setback of adjacent existing structures
/
'Wr ? ? • Retaining waN requirements:
Reviewed By; Date
G:/FO RMS/Bui lding Permit Application Rev. 11-26-04
. elk 1. ' 1
CERTIFICATE OF SURVEY .
IEWED P.R.V. R??? ? ?I???D ?
For: LUNDGREN BROS.
EAGA.N ENG???? DEff. pROv??? ??DMAINTAIN • Lot 14, Block 1, TERRA GLENN
gm?
I?v?.ETpxo?rEcmIo?vuh?c[t, PROPERTY DESCRIPTION. "
FINAL TLiRF iS ESTABLISHED ?
ADDITION, Dakota County, Minnesota. ?
'/? ?
b
W
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? B I RCHPOND ROAD ? ??
We hereby certify that this is a true and correct survey of the above E ?g?
o
R=972.50 N described property and that it was performed by me or under my ?
_----N??c??
? D Q 6029'45 " direct supervision and that I am a duly Licensed Surveyor under the
? , T C 847.1 T C 846. 0 8 4
_r' TC 846.8 laws of the State of Minnesota. That this survey does not purpor t to
show all improvements, easements or encroachments, to the property
-? (847.3 ) 48.? 847. 7 ? 8 6.3 except as shown thereon.
141. r.u ?E?F. Signed this ? day of .?? , 2006. James R. HIII, I?1C.,
,? ? ? o
ai 5 PROPOSED ° ? 0
BENCH MARK N ? DRIVEWAY ? I BENCH MARK
TOP OF SPIKE
ELEV.=848.31 847.5 (849•3) 847.5 I ?. TOP OF SPIKE Z,
w z
CUT=7.01 TO TOP ? 2083 , o i 4-83STOOP?i °O ELEV.=847.46 Bqj '
T ??20'96I ? CUT=6J 6 TO TOP J?
OF LOWEST FLOOR ? N 12 ? -- s ?,
1 M I ? OF LOWEST FLOOR .Gary n, Min ta L.S. No. 11529 ay
W ? ?? / / /. 5.83 s
0 - 11.33 m 3
O •I N GARAGE ? ?qN 13.31 I ? W Notes. ??W?
in 1. Building dimensions shown are for p Denotes set spike 0 -°
/ ?--
? 20 . 0 2 ? P HOp ? E D ,? ? ?? horizontal & vertical placement o f structure 0 Denotes set iron monument U Q
? ? T N? 847.7 q,a (FULL) O • Denotes found iron monument
? nT ? r o n l Y. S e e a r c h i t e c t u r a l p l a n s f o r b u i l d i n g x927.6 Deno tes exis tin e leva tion d' a o-
?_v ? •? 00 o?g 52 ao? ?--v 1 1`-? & foundation dimensions. (930.0) Denotes proposed elevation V? mo
n r? n n i T p 0 t l I I Z? ? ??.o" • j847.9 It r- ? i n /-\ n N 1 T ---- D e n o t e s r e a r o f b u i l d i n g p a d
v n.?n i v III N? N o°$?849 3) 847J ? 18.55 ln ? v n ?n i v I 2. No specifc soils investigation has been _ p oQ
Denotes pro osed draina9e
0? 847.3 sb? s? s47.s+?.?i-? .to o ? completed on this lot by James R. Hill, Inc. TC _ Denotes top of curb ?
?? . 847_3 12•0' $ 7•7 _ _ _ _ EGRESS • p?p Denotes
? The suitability of soils to support the specific - rear of Building Pad V
,., _ ? ..
? ??e#- house proposed is not the responsibility of per grading plan
DRAVIM BY
BenCh Mark: 849.36 -TNH-Lots 13 & 14, Block 1
d- ?. ??CE ? James R. Hill, Inc. or the surveyor. MAL
? I (84 'AT» 3. No specific title search for existence or non- 84.9,6 DAIE
Proposed Garage Floor=
LOT 14 , ezistence of recorded or un-recorded easements Proposed Garoge Top of Block= 850.0 2/1/06
I has been conducted by the surveyor as a part Proposed House Top of Block= 850.0 REVISIONS
of this survey. Only easements per the recorded Proposed Lowest Floor= 841.3
EAGAN 5I DRAINAGE & UTILITY plat are shown. Proposed Top of Block
EASEMENT PER PLAT ot Egress Window= 844.5
REVIEW 5 4. Proposed grades shown were taken from
? 854.0
13 Ythe grading &/or development plan prepared by
BOOK/PAGE
; /
94.22 N10°35'S3°° 856.0 JAMES R. HILL, iNC. Bearings are on assumed datum NONE
?' - E - ? 855.9) --- ----__ _, Scale: 1°=30' co 2rno? No.
?` • _:?___-_.?'?.?..
??__....,-nTr,?IONS d#VIS1ON? CAD FlLE
LOT 1= 14,785 SQ. FT.
T n 261027.dwg
v v I L .v i v PROPOSED HOUSE = 2845 SQ. FT. SAN. SERVICE INVERT pROJECT N0.
3:1 M-aximum Slopes OR 19.24% OF LOT AREA ELEV.=836.0 261027
z
or _;a°r;ng WaIl Wjl) DRIVEWAY = 120 SQ. FT. FlLE N0.
DRAwER
Ba Iioquii'8d ?
SHEET 1 OF 1
I-
REScheck Compliance Certificate
Peii-nit Num'ber
Checked By/Date
2000 Minnesota Energy Code
REScheck So$ware Version 3.6 Release 2
Data filename: G:iCAD\New Statldard\Traditional\Remington\C\l ll4-TG-RemC\Peimit.rck
PROJECT TITLE: Remington "C" Inventory Home
COLTNTY: Dakota
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Family
WINDOW / WALL RATIO: 0.16
DAT E: 02/06/06
PROJECT DESCRIPTTON:
3565 Birchpond Road
T elra Gl enzl
DESIGNER/CONTRACTOR:
Lundgren
545 Indian Mound E.
Wayzata, MN 55391
PROJECT NOTES:
9 ft. Foundation
Std. and Oversized Window wells
[ncludes New Standard Features
COMPLIANCE: Passes
Maxirnum UA = 722
You1- Home UA = 691
4,3%;,o Better Than Code (UA)
Gross Glazing
Area or Cavity Cont. or poor
Periineter R-Value R-Va1ue -Factor UA
Ceiling 1: Flat CeiIing or Scissor Truss 2398 44.0 0.0 65
Wall 1: Wood Frame, 16" o.c. 81 19.0 0.0 3
Window 1: Above-Grade:Wood Frame:Double Pane with Low-E 33 0.330 11
WaII 2: Wood Frame, 16" o.c. 176 „1311, 0.0 14
Wali 3: Wood Fiame, 16" o.c. 1730 19.0 0.0 80
Window 2: Above-Grade:Wood Frame:Double Pane with Low-E 294 0.330 97
Door 1: Solid 38 0.067 3
?
?
?
•
Door 2. Glass 48 0.330 16
Wall 4: Wood Frame, 16" o.c. 1994 19.0 0.0 94
Window 3: Above-Grade:Wood Frame:Double Pane with Low-E 316 0.330 104
Wall S: Wood Frame, 2" 210 0.0 12.0 21
Wall 6: Wood Frame, 24" o.c.
-------- 236 0.0 12.0 24
.
Basement Wall 1: Solid Concrete ar Masonry 1734 0.0 5.0 139
Wall height: 9.0'
Depth below grade: 8.5'
insulation depth: 9.0'
Baseinent Wall 2: Solid Concrete or Masonry 52 0,0 5.0 6
W all height: 3. 5'
Depth below giade: 3.0'
Insulation depth: 3.5'
Floor 2: All-Wood Joist/Truss:Over Outside Air 75 3Y 3.0? 0.0 2
Floor 3: All-Wood Joi st/T russ: Over Unconditioned Space 401 33.0 0.0 12
I,uinace 1: Forced Hot Air, 90 AFLTE
i?roposed and Maximum U-Factor Averages
Proposed Maximum
Average U-Factor Allowed U-Factor
Above-Grade Windows and Glass Doors 0.330 0.370
Tncludes Foundation Windows > 5.6 ft2
f~loors OverUnconditioned Space 0.030 0.033
COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans,
specifications, and other ca(culations submitted wifh the permit application. The proposed bui(ding has been designed to
meet the 2000 Milinesota Energy Code requi,rements in REScdaeck Version 3.6 Release 2(farmerly MECcheck) and to
(.oinply with the tnandatory requireinents listed in the RESchecli Inspection Checklist.
f3uilder-/Designer V??'? Date 'Z- o _
02-10-06; 9:39 ;ELANDER MECHANICaL
Date: 218/2006 Revision Date: 2/10/2006
Site Information
Address 1: 3565 Birchpond Road
Address 2:
City: Eagan County:
Application Information
Business Name: Elander Mechanical Inc.
Corltact Person: Todd
New Construction
;612 445 7487 # 1/ 1
Project #;
Lot: a'?t" Block: ?
?
Subdivision:
MN Contractor License #:
OffiCe Ph: 952-445-4692 Fax: 952-445-7487 Cell Ph:
Address 1: 591 Citation Drive
City: Shakopee State: Nlinnesota Zip Code: 55379
House Details
Square Feet: 5655 sq. ft. Avg. Ceiling Ht: 9 ft, Number of Bedrooms: 4
Ventilation : Balanced
Tota! Ventilation Capacity : 223 cfm.
Minimum Continuous Ventilation :75cfm.
Intermittent Ventilation: 148 cfm.
Combustion Appliance
Water Heater: Power Vent Input BTUs: 75,000 Independently Vented
Furnace/Boiler: Direct Vent/Sealed Combustiort Input BTUs: 100,000 Independently Vented
Other Combustion Appliances
Gas Fired Direct Vent Fireplace(s): Yes Gas Fired Power Vent Fireplace(s): No
Gas Fired Naturaf Draft Fireplace(S): No Solid Fuef Appfiance(s): No
Exhaust Equipment
Continuous Exhaust Ventilation Capacity (c#m): NA Clothes Dryer (cfm): 135
Exhaust Fan Rating (cfm): 300
Make-Up Air
No Make-Up Air Reauired bv Code
Combustion Air
Round Ri?id Required: 5 inches or lnsulated Flex: 6 inches
l?
n s Applicant Name (print): ; '?,/'..?- Wf?-+-?6? A Signature/Date:;??U;???u??,c,?C,?? O
Code Offiicial (print):
5ignature/Date:
(D 2004 CcntcrPoiril Gnergy Minnegasco. 2004 Meclianical Codc Guidclincs, I'aoe !
v *
Address: 3565 Birchpond Rd Permit: 72491
Lot: 140 Block: 01 Subdivision: Terra Glenn
THE FOLLOWING ITEMS WERE/WERE NOT COMPLETE AT FINAL INSPECTION ON
Zip: 55122
ekilm
Yes No Comments
Final grade - 6" from siding "
Permanent steps - aarage
Permanent steps - main entry
Permanent driveway
Permanent gas
Retaining Wall or 3:1 Max Slope
Sod/Seeded lawn
Trail/curb damage
Parch
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 C'?ty's Engineering Department at 651-675-5646 prior to working in right-of-way or installing
irrigarion system.
? BUILDING INSPECTOR: ? ?
_ 0 `w
Site address: j4J fl-? Lot JS ?} Slock ? Subd. f?l'c?
On April 15, 2000 the Minnesota Energy Code, Category I Buitding 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 Cotle, 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
-r'tI
F
4C? t) v 0-
JI'V i
Furnace A V ' 62 Q I ?- .
1? c? Q ?
Dryer
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
YES No
Kitchen kitchen
Bathroom 1
C ? X
Bathroom 2 -
? 4 ?y
"-?o
?
Bathroom 3 ? ? ?' ?
Bathroom 4
,qn.?
- d4
Other
FIREPLACE S
LOCATION
GAS
WOOD
MANUFACTURER
MODEL
BTU'S VENTING
DIRECT ATMOS
?C)(i
MAKE-UP AIR MODEL TYPE CFM's
M,?r
s-rluf c
P
j c
I hereby acknowledge that the above information is correct antl agree to comply with the Minnesota Energy Code and City of Eagan
requirements.
42u?L?? ?? ? (ff
3ignature
?-/ r>._0 (c
Date
Company Name
* This form is the responsibility of the General Contractor.
Use BLUE or BLACK Ink
For Office UseL/5®/
City of EaRali Permit#.
1 C�
Permit Fee:
/(1
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651)675-5675
buildinginspections(a�cityofeagan.com Staff:
•
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
Name: 1 " V� J Z J P t,u L 6 - Phone:
1 Resident/ et
Owner Address/City/Zip: S` C� r>, t2c �n QVC G'`C (C" l ( (f�
I Applicant is: Owner Contractor
Type
ye of ork Description of work: - ) -
Construction Cost:
, Multi-Family Building: (Yes /No )
Company: /�v A(e.. 6f7Yr C; fid Contact: 4 c
� Contractor
Address: 0 6 c ñ-2iCity:
State:/(ti Zip: 6(6) I Phone: �^ Email:
g
@ License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
•
..
.............
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
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:
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 conclude that they
are trade secrets
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on
the City's website at www.cityofeagan.com/subscribe.
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.
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 he roved plan in the case ofwbrk which requires a review and approval of plans.
Applicant's rinted Name Applicant's Sig -ture
Page 1 of 3
• r For Office Use ///�
I G f q
,% ��� Permit#: /���b`77 .E AGA N
I
Permit Fee: ry W,
� f C//
j! ` Date Received: Dg-
3830
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 1 Staff:
buildinginspectionst cityofeagan.com ,
2019 RESIDENTIAL BUILDING—PERMIT APPLICATION
Date: Site Address: tt // Unit#:
Name:Da� IC 1 g sb Ory Phone: 6 ( ,7.017- 7---S-Alll .
Resident/ / I/ n n
Owner Address/City/Zip: 7 J�� (5 1 ird../ 21- � /— j
hcant is: Owner Contractor (��-1 /1
�p � ���L ICb�I�� ,^ rr, ✓ted �F� � �
Type of Work
Description of work: r 1 V)!S 4 rod w� / h 1 D W i°i(i /P-!'d T 7�✓ �/(�Q y k-6'Ivy)
Construction Cost: a't'O Multi-Family Building:(Yes /No )
Company: Contact:
Contractor Address: City:
State: Zip: Phone: Email:
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
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:
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 conclude that they are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeauan.com/subscribe.
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.
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 ap oval of plans.
x -DGS,le. k 1119 s � �aiv
�'f
Applicant's Printed Name J Applicant's Signature
I'�
DO NOT WRITE BELOW THIS LINE --e. 6\p_U2 jj F /. / R'vgs
SUBTYPES
Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
_)( Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
Multi — Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
— 01 of_Plex _ Lower Level _ Pool _ Accessory Building
WORK TYPES
New — Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
1, Alteration _ Fire Repair _ Windows _ Demolish Foundation
I _ Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION 0 0
Valuation ( (9 Occupancy MCES System
Plan Review Code Edition 1� , •�j ( '' SAC Units
(25%_100% ) Zoning /� City Water
Census Code Stories J/ Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction (/IS Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) )( Final/No C.O. Required
Foundation Foundation Before Backfill /` HVAC_Service Test Gas Line Air Test_Hood
Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests _Final
�( Framing 30 Minutes 1 Hour Drain Tile
'�+ Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: II' , Buildin 1 pect r
RESIDENTIAL FEES r%4,
Base Fee t1(6. 5 ('tore
Surcharge VAP/11
J np
Plan Reviewi/9v1
6/ife
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge 0 f 0 ,/�}
Treatment Plant 6 / (/'
Radio Meter Read r
Copies
TOTAL
Page 2 of 3
C3.�
For Office Use
r , Permit#: /S / 6/
E
AGA N
• Permit Fee: 7.6
RECEIVER Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-
pc+buildinginspections(a)citvofeagan.comDEC 17 2019 S�'f
2019 RESIDENTIAL BUILDI" MIT APPLICATION
Date: (21 ( 7 IA°(9 Site Address: 3,5-6, J 13) Unit#:
Name: DG (e-- S 6 V✓i Phone: Eos r C aZ 4
Resident/
Owner Address/City/Zip: 5-6 S T�1 V �-.PcJIA. di i2 J.
Applicant is: V Owner Contractor Pb i /9 ( /&fJ1
1
Type Work Description of work: 'EA-se M ''UT"EF/h1 I S � C
+ '&63 1 1 U(y,C OM
Construction Cost: 4. I 2., 00O Multi-Family Building:(Yes /No / )
Company: Contact:
Contractor Address: City:
State: Zip: Phone: Email:
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
f3,u/4;i' /4 d G
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
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:
Fire Suppression Contractor. Phone:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the Information maybe
classified as non-public If you provide specific reasons that would permit the City to conclude that they are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeauan.com/subscribe.
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.
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.gopherstateonecall.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 am.
Ua Ie K It 6srmu Y �� �� vt . /-
Applicant's Printed Name Applicant's Signature
1 __ __-_-,- ___6- ei p_ctrii A A'd• /._.,- )& / -___
DO NOT WRITE BELOW THIS LINE
UB TYPES
Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
_ Single Family _ Garage _ Porch(4-Season) Exterior Alteration(Multi)
_ Multi Deck — Porch(Screen/Gazebo/Pergola) Miscellaneous
01 of_Plex ,z Lower Level _ Pool — Accessory Building
WORK TYPES .
_ New _ Interior Improvement —
Siding _ Demolish Building*
Addition _ Move Building ' _ Reroof _ Demolish Interior
ir 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 G'ee Occupancy /2c1 MCES System
Plan Review Code Edition // SAC Units
(25% 100%_) Zoning P D City Water
Census Code 1/311 Stories — Booster Pump —
#of Units a Square Feet — PRV _
#of Buildings a Length -- Fire Suppression Required
Type of Construction 7,8 Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Final I C.O. Required
Footings(Addition) Final I No C.O. Required
Foundation Foundation Before Backfill HVAC Service Test Gas Line Air Test_Hood
Roof:_Ice VicIater _Final Pool:_Footings _Air/Gas Tests Final
At Framing 30 Minutes 1 Hour Drain Tile
Fireplace: Rough In Air Test Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: Rough In_Final
Braced Walls Erosion Control
Shower Pan ? Other:
Reviewed By: ,� °� ,Building Inspector
RESIDENTIAL S 9 `
3e-0,67 1'// O'
Base Fee 31 9 t--
Surcharge
Plan Review i
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Radio Meter Read
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA160728
Date Issued:04/08/2020
Permit Category:ePermit
Site Address: 3565 Birchpond Rd
Lot:14 Block: 1 Addition: Terra Glenn
PID:10-75400-01-140
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Basement Fixtures
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Dale Kingsbury
3565 Birchpond Rd
Eagan MN 55122
Patricki Plumbing Llc
14179 67th Cir NE
Elk River MN 55330
(612) 490-5263
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA164913
Date Issued:10/12/2020
Permit Category:ePermit
Site Address: 3565 Birchpond Rd
Lot:14 Block: 1 Addition: Terra Glenn
PID:10-75400-01-140
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Dale Kingsbury
3565 Birchpond Rd
Eagan MN 55122
(651) 592-5204
Water Heaters Now Inc
23310 Canby Ave
Faribault MN 55021
(952) 688-2222
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA172393
Date Issued:09/28/2021
Permit Category:ePermit
Site Address: 3565 Birchpond Rd
Lot:14 Block: 1 Addition: Terra Glenn
PID:10-75400-01-140
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Dale Kingsbury
3565 Birchpond Rd
Eagan MN 55122
(651) 592-5204
Apple Lake Heating & Air Conditioning
207 150th Street West
Apple Valley MN 55124
(952) 431-4328
Applicant/Permitee: Signature Issued By: Signature