3586 Birchpond RdINSULATION INSPECTION CHECKLIST FOR RESIDENTIAL
BUILDING PERMITS
PROPERTY LEGAL: -107- 16 0 loc- (< 'pl-
PROPERTY ADDRESS: ?F?c, 2 .` I'"c. In ?z? ay? RpCz,j
INSPECTOR: /_/ep 1.)
INSPECTION DATE: (p
d o a
? Z Z SITE GRADING
?? ? All slopes 3:1 or flatter?
K ? 0 Slopes steeper than 3:1 require retaining wall. Are retaining walis present?
??? Does grading conform to As-Built Grading Plan (+/- 1 foot approximately)?
?? f'? Does perimeter grading tie in well with adjacent properties/undisturbed land?
??? Is there proper grading and/or drainage around Lookout or Egress Windows?
EROSION CONTROL
??? Is Silt Fence (or approved equal) installed and in good working order?
[a" ?? Is Sod/Fiber Blanket installed behind curb?
??? Is the Rock Construction Entrance/Driveway installed and in good working order (proper
type/size of aggregate, clean-not covered with soil, etc.)?
?? ? Is temporary vegetative cover§pn ulch present?
?" ?? Is permanent vegetative cover ni/ r w/o mulch present?
ircle one)
CITY EASEMENTS AND UTILITIES
? ? ? Are all easements clear-no part of any build ing/deck/porch/retain ing wall/etc.
encroaching in easement?
?? ? Are catch basins present within the property or in the street in front of the property, if so
are they clean, do they have the proper erosion control in and/or around them?
??Does the property have an Emergency Over Flow (EOF)? This can be found on the
Certificate of Survey. If so, is it present and has it been graded properly?
MISCELLANEOUS ITEMS
???'" Is there tracking present on Public Right-of-WayJStreet from construction site?
C? ?? Is the driveway at the proper width at ROW line? (22 ft. max.)(Curb stop is at ROW line)
?? ? Is the site clean, no trash and/or construction debris lying around?
?? ? Was the proper type of building constructed according to the approved grading plans?
(LO, WO, FB, R, etc.)
Address: 3586 BIRCHPOND R.D Zip: 55122 Permit: 77951
THE FOLLOWING ITEMS WERE/WERE NOT COMPLETE AT FINAL INSPECTION ON : (I ZS 0-7
Yes No Comments
Final grade - 6" from siding VI"
Permanent steps - garage V
Permanent steps - main entry ?
Permanent drivewa
Permanent as V/
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 the City's Engineering Department at 651-675-5646 prior to working in right-of-way or installing
irrigation system.
? BUILDING INSPECTOR: ljo
GBldg Insp/Forms/2007/Checklists
Site address: ,?u Lot Block r?-
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.
_ 7his structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
? This structure: witl be constructed to meet more restrictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER
iter Heater ? /;
?`? i1 ?? •?
'nace
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,ef x
EXHAUST SYSTEM I LOCATlON
bamroom i
Bathroom 2
Bathroom 3
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TYPE
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MODEL
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MODEL
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LOCATION GAS WOOD MANUFACTURER MODEL
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STU'S VEN7ING TYPE
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CFM'S VEIVTED
YES NO
..a L%
BTU'S DIRECT ATMOS
?Y'
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 Ciry of Eagan
requirements.
n
Signature
Date
?CompanyName L?c??;
* This form is the responsibiliry of the General Contractor.
??
952 555 5';5L= I ine 1 ESARDFR M[-i;iiA
Llatu° 9/12/2006 ?evision C6ate: 9112/2006
Site Information
Address 1; 3586 Birchpond Rd
Address 2;
City: Eagan ?ounty: Dakota
A2pi€catlort lnforrnation
Busine5s Narr?e: C-iartder Mechanicai lnc.
t;ontact Pe; smn: Todd
01:1,5 56 p0£.1 :i.2006
IV ..p.w ConstrUcLion
Project #:
Lot: Blark:
Subdiwision:
MI"3 CCtntf'actof Li^en5£ #;
Office Ph: 952-445-4692 Fax: 952-445-7487 Cell Ph:
Add?e?S 1: 591 Citakyon dr;ve
City: Shakc?ppe State; iVlinrtasota Zip Code; 55379
House Detaiys
Square FeeT, 5257 sq, ft. Avg. Ceiiing Ht: 9 ft. Number af Bedrtauma: 4
VentilaYior? - BaIarrced
l"otal Ventilatiorr Capac;.ty : 207 cfm.
11IIfnIP1'1Gl73 CantInU0U5 VefltilatlOtl .75cfm,
IraterrnitPent Venti4ation: 1 32 cfrn.
Cobustian Lk,p LnSe
Water Heater. F'ower Ven2 lnput BTUs; 75,000 lr7dependently Vented
Furn-acelBoiler; Direct Vent/Seaied Combust;on Input BT€Js: 90,000 Indeper?dentiy U'entet;
{)tl'1ef t:oC11bu5tif9/i 6pOSatiCe3
Gas Firad Direct Vent Firepiace(s): Yes Gas Fired Pawer Vent Fsreplace(s): No
Gas Fired Natu,ai Dra#t Firep!acp(s)': No Soigd Fue1 Appiiance(5): No
ExhaLis4 EQ6i1pYtlellt
ContinuoEas Exhaust Ventilation .?apacfty (c€m). NA Clothes Dryer (cfm): 135
Exhaust Fan Rat?ng (c#m): 640
Make-Up Air
No Make-l3p Rir RequiYed by Code
Combustian Air
Round Rigid Required: 5 iriCheS of Ir'os«?ated Fiex: 6 iiiches
1 ?'Z
Applicant Name (print): Signature/date:
,??::?
Code Cfficia9 (pr4nt):.._._.
1_6 2004 Cenl:c;cPoir?t l:riergy AirEneg,ic;,u. 2004 Meehanicai Code. Guidelines. Page 1
?'?, ? 795 / `1, o`.,
? 2006 RESIDENTIAL BUILDING PERMIT APPLICATION 61., -? -7953 y?,511
. City Of Eagan -77ys_c/ ' ?K,so
3830 Pilot Knab Road, Eagan MN 55122 ?
Telephone # 651-675-5675 FAX # 651-675-5694 , ' ? ? 7` ??
?f-t .M&ss?
"
New Construcfion Reauirements (?iz- ?qr? RemodellReaair Reauirements Office Use Oniv
i 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and ell roofed areas 2 copies of plan showing footings, beams, joists Cett of Sutvey Recd V_ '_ N
`0% maximum l
ot coverage dIlowed) ? n n,? (? et of Energy Calculations for heated additions Tree Pres Plan Recd ° N
pies of plan showing beam & window sizes; poure found d si n,efc:=?=? ite suroey for addftions & decTree Prns Required _ Y_ N
t of Energy Calculations L. dition - indicate if on-s?Te sepGc system On-site Sepbc System _ Y_ N
+Se
?-i, 3'copies of Tree PreservaGon Plan if lot piatted after ll
R i m J oisi D e f a i l O p t i o n s s e l e c t i o n s h e e t ( b u i l d i n g s w i t h l esg ') .-
?Alinnegasco mechanical ventilation form ?- ~q
Date Construction Cost
Site Address ,..5 S
Unit/Ste #
? 0 0 !-1
Description of Work
Mutti-Family Bldg _ Y? N Fireplace(s) _ 0 _X 1 _ 2
Property Owner ' Telephone # ( , )
Contractor
Address ??-?...•. ..1--? 1? t
9a.
` c;?. ro 0 v"'Z ? Cify W4
State Zip ' Telephone #
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUiLDING
x 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
!n tv/ t months, has the City of Eagan issued a permit for a similar plan I?ased on a master plan? ?07
N If yes, date and address of master plan: ? Of'? r Licensed Plumbern61-- r 1?1?.,c.:lls 11 .?,. Telephone #(AS;4 ?1?1? ?? ?/??1 ?•..
Mechanical Confractor ?=--?fr .? o_?? ? 1`?;?{_????..,.? . ?..?. ? Telephone # (,7?;d.j rv'L"- `/Z_
? ?-
Sewer/Water Contractor a??? 41 ev,? P-)Telephone # q l
?
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
DO NOT WRITE BELOW THIS LINE
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Sub Tvpes '
? 01 Foundation ? 07 05-plex ? 13 16-plex 0 20 Pool ? 30 Accessory Bidg
? 02 SF Dweiling ? 08 06-plex ? 16 Fireplace ? 21 Pocch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of,_ plex ? 09 07-piex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Ait - SF
O 04 02-plex ? 10 08-plex 0 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-piex ? 11 10-plex ? 19 Lower Leve! O 24 Storm Damage
O 06 04-plex ? 12 12-plex ? 25,, , Miscellaneous
Work T es
31 New ? 35 Int Improvement ? 38 Demolish Interior 0= 44 Siding
O 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Buildi ng* O 43 Reroof , 0, 4a ,Window5/Doors
? 34 ReptaCement •Demolition (Enti re Bldg) - Give PCA handout to applicant
Description: Water Damage Yes
0 -> ' t
Valuation
14 42
Occupancy
-
em
MCES Sys
Plan Review 100% or -X- 25%
Census Code ?'34 Zoning City Water
SAC Units C? ( Stories Booster Pump
# of Units ? Sq. Ft. PRV
# of Bldgs Length ? Fire Sprinklered
Type of Const 1/ (t') Width
12EQUIRED INSPECTIONS
Footings (new bldg) Sheetrock
_ Foatings (deck) ? FinaUC.O.
Footings (addition) FinallNo C .O.
?C Foundation _ HVAC
Drain Tile Other
Roof Ice & Water Final Pool Ftgs Air/Gas Tests Final
? Framing _ Siding _ Stucco Lath _ Stone Lath _B rick
Fireplace _X R.I. -)( Air Test 4 Final Windows
? Insulation _ Retaining Wall
Approved By: _ ZI , ! , Building Inspecfor
?------------------
Base Fee ---------_-_- - _---- --------- ----------------- -
Surcharge
Plan Review
4 '' 1>t
A
MC/ES SAC
City SAC
Utility Connection Charge
GA
S&W Permit & Surcharge '
Treatment Plant ,
i:w
License Search x
Copies
Other
?
Total
f1A`'i'-1E1-v'.001? 15; i,-_z, L_Bz_: SPLES & ?-DESIGt•J 952t,760312
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Pi°Co?eGt "Fft1e: El Ker'Itt7r? "B" Cottagt?
R6pc7xl DatS: 11 ?49186
Data ailersa;'r?e: G?1CRG?'b?!'?T?ACIT•-1'?,?C6nCOn18-?C:'P=-?1d??.N1??9N?1lKF:N7?,"?-c.??%?{
Fner9Y Coda. 2000 M9rtneserta ErrevgY Ccicie
1-6caiiorf; Hennepln GauMtY, IN66atn?soth
Gannkrue1c,ra T}pa: Sl3tigle F5n111y
t;Ea7ing Area F'arcentago' 16%
Coftsf'CiJCtlCS(S Site: O4Vn8riAge"1£: DeSIgt7ar/CoritraGkor:
3586 Eirehprand Poad W6nnar Family Cr4 9uSiders
545 Indian Sviound Ea9t
E3gsr„ MN 55122 Nlayzata, lVitv 55341
955;'.'-249.4500
EM=
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Geiiing 1; rlat Ceiling or 5cissor Tn.rse: 2C20 44.0 (7.0 55
VWali 1;Wood Frarria, 24" 4?.c.' 167 0,0 6.5 22
4NaS12; YdcrQd Frorr,e, '16" 0 c.; 198 19.0 0.0 1Vinr.lo,v t:Above-Grade:'rLOtio F;ama;DGuNO Pa7e Wtp k.ow«E:; 44 13
NJiaiI 3, W4cI4 C'rarne, 24" 9.P.: 165 20 6,5 22
Vvait ?! -Wac?! firactia, 16" o,c;.: 140 I3.a 0,0 11
WaH 5: lNcrau Fraroe, 16"" o.Q; '2464 15.te V7 11?2
4`J:ncimw 2: Abovs-Grade'sN'ood Frame;DoubCe P ane vrAth i- avu-r? 463 0240 ? 157
Draor 9. Saiici? aS O.w7i '
I
'NaI! 61 Wnod Frerrie: 16" o.c.? 1535 15.0 01 W ndaw 3; Abdva-Grade;'No?,d Frame:DsrublGi Parc; wiih Lap?v-R: 182 i.?.3a0 82
8aseinent WmS 1: S;;;d ?4gr?eretQ or D??asor,ry- 92? ?.?J ?a.t3 1 i5
? i?'2
Baseinent W&'?! ti ?' 5?rli?i C,?nereta c?r P?1a?sCrnry?? 992?D 0.0 5 0 ? 3
Flc?or 1, A,II-Wacr.f Jaistl7russ_flvi:rfJci?csn?+?"•'It?ner? :spaca?. ?39 `?`?0 "?t°
r=1 oar :'.; All-4'Vcand Joistl+rusS'C7var d:;uksido A:r: S? 24,0 2
Fursiacn 1: Fercec! Fut A;r. 90 ArUE ?
t^ornptiarrca Statemen°; 1'1,4 pmpased Jesigr, des;,ribed hwe !t, o.,mmistenf av:th the bLii1iiM-- plalssW 5pe6fir:a4.-.?c;c?
r,ak-,ulatians sabnItCCCi wi41r) kho parrnri applPCatlor' The proposad bta'i=daria has been dewigned M rne9r thG 2000 Minr+e ta EnengY
Cnda req;imments ii7 RE5ahenkYsrsiun ,3:''." qnd tc camply w;ltr Che maridatory reyuo°4rxior,ts iistad 1n tne RESchec^ insppction
Cn6ckli? ? ? ,,
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TLTNaL F'. 01
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? City lnspecfian Dept. Capy
City Forester Copy
Applicant/Builder Copy
__ - - -- - - - -= - -- -
?' - - - -
Development
Lot Number _ & Block Number ?i
Add.ress ???O A) /?? R 10
Bui{cier fiZI/C16f7-?U E&C71. ) A-)-f 1
Phone Number:'??
Contact: ap0 `MeAl? A-
Tree Protection Requirements:
x Tree Protection Fencing Installed On Site
Oak Tree Pruning (Immedi-ately seal wounds during April 1 to July 31)
Therapeu#ic Pruning Required
Refaining Walt To Be Installed
Other:
Replacement Trees:
?
Attachments:
?
Additional Notes:
Not Required f ?
As Folfows: 1'0411Z
Yes
No
EAGAN FCkRESTRY DIVIStON
H:\ghove\2006file\treepres\Tree Preservafion Plan Summary-2006
PtEV1EWED
BY A- L
Qa-rE
(BUILDER, PLEASE READ ATTACHMENTS)
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DENOTES
OEXISTING TREE SAVE
-TP- 1REE PRESERVATfON FENCE
PER TREE PRESERVATION PLAN
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DRAINAGE & UTILITY ---,-. 1 '
EASEMENT PER PLAT?__ ? i ?10
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Tree Preservation plon Pre House Pra osed Post House
TERRA GLENN Development Construction Tree Preservation Construction
LOT 16, BLOCK 2, Const, s-Built Post House Const As-Built
POINT N0.
ELEV.
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3613 852.2 OAK 18" X X X
3614 853.3 ACKBERR 10" X X X
3615 839.6 OAK 11 21" X X X
3617 850.5 ACKBERR 11" X X X
3616 850.3 OAK 19" X X X
3619 848.0 OAK 10" X x X
3620 850.1 OAK 16" X X X
3621 853.5 OAK 7" X X X
3622 852.3 OAK 9" X X X
3623 850.9 OAK 6p X X X
3624 849.9 ACKBERR 10" X X X
3625 846.9 OAK 7" X X X
3626 846.2 OAK 111D" X X X
3627 848.1 OAK 16" X X X
3628 851.4 OAK 19" X X X
3629 851,8 OAK 13" X X X
3630 854.5 OAK 12" X X X
3631 853.0 OAK 8" X X X
3632 853.0 OAK 12" X X X
3633 852.9 ACKBERR 7° X X X
3634 852.0 OAK 14" X X X
3635 851.5 OAK 17" X X X
3636 850.8 CHERRY 17" X X X
3637 850.3 ACKBERR 11" X X X
.6 OAiC tf" X X
? X X X
3663 847.5 ASH 15" X X X
3664 847.4 CHERRY 13" X X X
3665 848.2 OAK 9" X X X
3666 647.6 OAK 10" X X X
3667 847.5 OAK 10" X X X
3668 847.5 OAK 16" X X X
3669 848.1 ACKBERR 10" X X X
3670 847.6 OAK 15° X X X
3671 847.6 OAK 9" X X X
3672 850.3 OAK 15" X X X
3673 848.2 OAK 12" X X X
Preliminary Tree Certification
During a site visit September 15, 2006, all significant trees designated to be saved on the
Tree Preservation Plan prepared by James R. Hill, Inc., were present and in good heaith, ezcept
os nated in the table above.
i The house has been staked. Tree fence will need to be placed outside the dripline of all signifcant
? trees to be ved. F rading and construction should not have a negative effeci on these trees.
?
?- gy, e: ? P? By. Date:
' . Gary ,' esota L.S. No. 11529 Signature of Owner
Scale: 1"=40' Page 1 of 1
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DRAWN BY
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DATE
09/13/06
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BOOK/PAGE
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CONIROL N0.
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261317.dwg
PROJECT N0.
261317
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DRAWER
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LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTY LEGAL: ?A I?i ?IM I? Z-T2rrtt Cat k,,, 'i fidC7
DATE OF SURVEY:
LATEST REVISION:
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O z Q DOCUMENT STANDARDS
0 ? • Registered Land Surveyor signature and company
? ? • Building Permit Applicant
,B D D • Legal description
? ? 0 • Address .
0 ? • 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
-A D ? • Driveway (grade & width - in R/W and back of curb, 22' max.)
Ff El ? • Lot Square Footage
X 0 ? • Lot Coverage
ELEVATIONS
Existin
,? ? ? • Property corners
? ? ? • Top of curb at the driveway and property line extensions
? ? ? • Elevations of any existing adjacent homes
,,? ? Q • Adequate footing depth of structures due to adjacent utility trenches
? 0 • Waterways (pond, stream, etc.)
Proposed
fz ? ? • Garage floor
,? D El • Basement floor
,a ? ? • Lowesf exposed efevation (walkouUwindow)
? ? ? . Property corners
? ? ? • Front and rear of home af the foundation
PONDING AREA (if applicable)
? R1' 0 • Easement line
? ,0 ? • NWL
? 'Pr ? • HWL
? ;a ? • Pond # designation
? E1 0 • Emergency Overflow Elevation
? 16 ? • Pond/Wetland buffer delineation
Y • Shoreland Zoning Overlay District
Y • Conservation Easements
DIMENSIONS
,? ? 0
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• Lot fines/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 s' yar setback of adjacent existing structures
• Retaining wall requirements: a
Reviewed By:,
G:lFORMS/Building Permit Application Rev. 11-26-04
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DRAINAGE & UTILI7Y ---, 1
EASEMENT PER PLAT_ 10
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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
laws of the State of Mi nnesota. That this survey does not purport to
show all impronements, easements or encroachments, to the property
except as shown thereon.
Signed this ? day of 2006?, / --1 James R. H?, It1C,
OteS:
1, Building dimensions shown are for
horizontal & verticai placement of structure
only. See architectural plans for buiiding
& foundation dimensions.
2. No specific soils investigation has been
completed on this lot by James R. Hill, Inc.
The suitability af soils to support 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
has been conducted by the surveyor as a part
of this survey. Only easements per the recorded
plat are shown.
4. Proposed grades shown were taken from
the grading &/or deve4opment plan prepared by
JAMES R. NILL, INC.
LOT 16 = 39,779 SQ. FT.
PROPOSED HOUSE=2,632 SQ.FT
OR 6.62% OF LOT AREA
DRIVEWAY= 899 SQ.FT.
A
Denotes
set spike
o Denotes set iron monument
• Denotes found iron monument
x927.6 Denotes existing elevation
(930.0) Denotes proposed elevation
Denotes proposed drainage
TC Denotes top of curb
Bench Mark: 853.03 - TNH-lot 17 Biock 1 CP#1
Proposed Garage Floor= 851.9
Proposed Gorage Top of Block= 852.3
Proposed House Top of Block= 853.0
Proposed Lowest Floor= 844.3
Proposed Top of Block
0 Look-out Wndow= 847.5
Bearings are on assumed datum
Scale: 1'=40'
SAN. SERVICE INVERT
ELEV.= 839.6
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DATE
os/13/os
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corrrna No.
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261317.dwg
PROJECT N0.
261317
FlLE N0.
DRAWER
SHEET 1 OF 1
P.R.V. ????U`.- ZDH ?:'??s'???? CERTIFICATE OF SURV?$???
cw Retaining vuWI wO s
, ? Requ'md ? Far: LUNDGREN BROS.
?
C""' :00 PROPERTY DESCRIPTION: Lot 16, Block 2, TERRA GLENN ADDITI4N
Dakota County, Minnesota.
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INSULATIOfV iNSPECTIOtV CHECKLIST FOR RESIDEIVTIAL
BUILDING PERMITS
PROPERTY LEGAL:
,
-11
, _.
PROPERTY ADDRESS: ???6- ZVr'???,pOAd ? -
INSPECTOR: -2rm .uzt-
INSPECTION DATE:
cy, o
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SITE GRADING
? ? ? AIf slopes 3:1 or flatter?
? ? ? Siopes steeper than 3:1 require refaining waif. Are retaining walls present?
? ? ? Does grading conform to As-Bui(t Grading Plan (+I- 1 foot approximately)?
J? ? ? Does perimeter grading tie in well with adjacent pro perties/u ndistu rbed land?
?d ? ? Is there proper grading and/or drainage around Lookout or Egress Windows?
EROSION CONTROL
??l? ?? Is Silt Fence (or approved equal) installed and in good working order?
`..1
d? ? !s Sod/Fiber Blanket installed behind curb?
?? ? Is the Rock Construction Entrance/Driveway instailed and in good working order (proper
type/size of aggregate, clean-not covered with soil, etc.)?
(/?7 ,J? ? Is temporary vegetative cover w/ mulch present?
U
?? ? Is permanent vegetative cover w/ or w/o mulch present?
(circle one)
CITY EASEMENTS AND UTILITIES
?? ? Are all easements clear-no part of any building/deck/porch/retaining walUetc.
encroaching in easement?
?'Z ? Are catch basins present within the property or in the street in front of the property, if so
are they clean, do they have the proper erosion control in and/or around them?
? 0 ? Does the property have an Emergency Over Flow (EOF)? This can be found on the
Certificate of Survey. !f so, is it present and has it been graded properly?
MISCELLANEOUS ITEIVlS
0 j? ? , Is there tracking present on Public Right-of-Way/Street from construction site?
?? ? Is the driveway at the proper width at ROW line? (22 ft. max.)(Curb stop is at ROW line)
JZf ?? Is the site clean, no trash and/or construction debris lying around?
?? ? Was the proper type af building constructed according to the approved grading plans?
(L ,,, WO, FB, R, etc.)
FOR ALL lTEMS REQU{RING ADDITIONAL FOLLOW-UP:
NAME OF PERSON CONTACTED FOR FOLLOW-UP:
COMPANY NAME:
COMPANY ADDRESS:
COMPANY TELEPHONE NUMBER:
DATE CONTACTED:
DATE OF FOLLOW-UP 1NSPECTiON:
INSPECTOR:
COMMENTS:
G:/FormsIINSULATION INSPECTION CHECKLIS7 FOR RESIDENTtAL.doc Revised 2-06
City 0f Eanon
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
?-----------------
? EorO#fice,Use I
j Permit #: 3 j
? Permit Fee:
? Date Received: ??? ? a? j
I
1 ' l
I Staff: I
?- - - - - - - `- -J
2008 RESIDENTIAL BUtLDING PERMIT APPLfCAT10N
Date: r 1 ?? `?'Cs
Site Address: ' ''J
Tenant: Suite #:
RESIDENT / OWNER Name: Phone:
Address / City / Zip: ?-l€
Applicant is: Owner ? Contractor
TYPE OF WORK Description of work:
Construction Cost ` Multi-Family Building: (Yes / No L?,,
CONTRACTOR
License #
Name.
Address. `:;; < ?? N ? . .?
City: ve& t.`e , '`w',r" ?- State: Zip;
-- : ? ..?-_--
Phone: ?P Person:
COMPLETE THIS AREA OPfLY IF CONSTRUCTING A WEW BUiLDlNG
T Minnesata Rules 7670 Categorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category i War4csheet ?• New Energy Code Worksheet
Category Submitted Submitted
Submission type) • Energy Envebpe 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 !f yes, date and address of master pian:
Licensed Plumber: Phone:
Mechanicaf Gontractor; Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that yau submit are considered to be public lnforma#ion. Portions of
the infarmation msy be classif'?ed as noR pabllc if yau pravide specific reasons Ehat wouJd permtt fhe City to
canclude that the are lrade secrets
1 hereby acknowiedge that this information is complete and accurate; ihat the work will be in conformance with the ordinances and codes of the City of
Eagan; that 1 understand this is not a permit, but onty 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 wark which requires a review and approval of plans.
F ??d 1' /?? ? .... / ?d I d.7 /9 ? 1y?. ')T? ?.?r?"' '- ? ..
X X Applicant's Printed Name yAppli 1 nYs Signatune
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
?
SUB TYPES
? Foundation ? 05-plex ? 16-piex ? Accessvry Building ? Pool
0 Single Family ? 06-plex Cl Fireplace ? Porcfi (3-season) ? Ext. Ait. - Multi
? 01 of - Piex ? 07-plex ? Gerage ? Porch (4season) ? Ext. Alt. - SF
? 02-Plex ? 08-plex Deck ? Porch (screenlgazebo/pergola) ? Multi Misc.
? 03-Plex ? 10-ptex ? Lower Leve{ ? Storm Damage
? 04PIex ? 12-plex ? Miscellarmous
WORK TYPES
? New ? Interior Improvement ? Siding ? Demolish Building*
? Additlon ? Move Building D Reroof ? Demolish Interior
? A{teration ? Fire Repair 0 Windows ? Demolish Foundation
? Replacement ? Egress Window ? Water Damage
" Demolition (entire building) - give PCA handout to appiicartit
DESCRIPTION:
Valuation
Plan Review
(25% 100% _?i_)
Census Code
# of Units
# of Buildings
Occupancy V _" ; f I
Code Edition
Zaning
Stories
Square Feet
Length
Type of Const. Width
REGIUIRED INSPECTIONS
Fcotings (new bldg)
? Footings (deck)
Footings (addition)
Foundation
Drain Tile
Roof: _Ice & Water _Final
y., Framing
J-t Fireplace:_R.I. Air Test _Final
Insulation
Sheetrock
Final/C.O.
_5C FinaUNo C.O.
HVAC
Other:
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Pool: ___,Footings Air/Gas Tests --Final
Siding: Stucco Lath Stone Lath JBr9ck
Windows
Retaining Waff
Reviewed By: -? I " , Buiiding Inspector
RES/DENTIAL FEES:
Base Fee
Surcharge
Plan Revlew
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Piant
Copies
Total
Page 2 af 3
NEW 14' X 22' DECK
3586 BIRCH P4ND RD
OWNERS- TODD & CAMILLE WHITE
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Use BLUE or BLACK Ink
r----------------i
I For Office Use �
I �
� � Permit#: �� I
City of ���a�� � _ �
� ,
I Permit Fee: �
3830 Pilot Knob Road j �
Eagan MN 55122 � Date Received: �
Phone: (651) 675-5675 � �
� Staff: �
Fax: (651) 675-5694 �_________________I
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 1 ��i ( � Site Address: ����� �I f Gh j�c�r�d� �
Tenant: Suite#:
� ��r�� n
������ "��
Name: Phone:
�
.zw�����#/�w1��P. �
�£ � ��. Address/City/Zip:
s�� .3. _
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������ ��� ����¢�: Name: G �ec�sroh /���...t�I�g } H2�,'�-1 n� License#:
�
�� x���� ' � � i
�OntractOT���M Address Tl�L{ .C�c,��21� ��— �� City: �t`•��G�e��
���� �� : h„ c, / Zip: ��c�S �CrJ Phone: �(��v�'4'c7 7— ��g�
� �. � State: v�
� ���;:
�����' �����--� Email:
��µ�.,. Contact:
� �.
������� � €� }�� � � — — — — —
�� `�`�� �l�New Replacement Repair Rebuild Modify Space Work in R.O.W.
� ����`���Df WOr ���
F��� �
��� � :�������" � r��� Description of work: p6�c,., �r c� r�s.�
��u
� � .. . :�� x�% RESIDENTIAL
�
,���
��� :
� ��#�� Water Heater
������x �" Water Softener
Lawn Irrigation(_RPZ/_PVB)
#�e�m�#�'fyp�
��� Septic System �Add Plumbing Fixtures�Main/ l'�" Lower Level)
`� Water Tumaround
�� � ## � —
�~ ������ New
;��
`�"������ F� Abandonment
� nn.�.�. ��
RESIDENTIAL FEES:
$60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic Svstem Abandonment, Water Turnaround"(inctudes State Surcharge)
''Water Turnaround(add$210.00 if a 5/8"meter is required)
$115.00 SeptiC Svstem New(includes County fee and State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.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.
x v�l�� f�(��%zc��l� _.
ApplicanYs Printed Name ApplicanYs Signature
� �� ��. ��� � � :: �
FOR 0�����USE� ���� ���� � ���� eviewed By �� � � � Q�#e��.
. �� ��� � � � �'�� � � �
�� �� � a����
��� �.
�# ; � �� . �� ���,
����r�tl Ins�xe��ons y �'��:. Ur�der Gr�ur��i �������� � ;¢��r�es� � �� e� � � Fi �
���� s:,. � � �� .v� �� �* � .
�t. v� ��.:-�, . M� � ��� f� �� s� + �� ������ - � �� „�-� "�"� �.� ��
c'�'�
��I�����elated���e�s. Me�er Size . Fn� � R�tia�� ����.r .r��„:��ar��rraet€��� St��ff x�r .� �x ��� � g
r.¢wx.m� �•:n ���: ww�.� t r.., n � �. ..i. . �r
Use BLUE or BLACK Ink
r----------------i I�;.
` I For Office Use n,/���,��
. i �� `��'i /�!
City of ����� , Permit#: �� ,��
�
� Permit Fee: ���� ��
3830 Pilot Knob Road
I
Eagan MN 55122 ' ". ' ' � Date Received: ��Y�� I
Phone: (651)675-5675 � I I
Fax: (651)675-5694 I Staff: I
. I I
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: �/>��r Site Address: �S�'d ���['tQ�'J!� �� Unit#:
� �
� �� Name: '��� ! /��,�C�i lit-i.'r Wh"1�% Phone:
�� � � � u Address/Ci /Zi � i�j,Q��F�� �)
����� o�nr��� � � �Y p� ?�.5�
�n � � . ��
`�� �r y�.; Applicant is: Owner �Lontractor
��x r °_�
�� �`� �" �" Description of work:��(�r���1✓(.�� �a-�'t��-
7jrp�of Wc�r�C�
����3
{ � Construction Cost: �„`���� Multi-Family Building:(Yes /No.��
�,�
� � � ������ Company:��_ "0� ' �" "DG3({��➢�n!]Contact:��`-b� .�,�'L1�"�v nl A� �
�� �' � �
#������' � ' ' Address: ��` I��3,� 1�s� City: C:ff�t��S�
���aC�t�
����� ��
x��F{� „� � p.� �� G� r w t��
� = State:�Zi 1 Phone: `�SZ 3 1�'`�(++(o��mail: 1 i3�� rh�5���si �7 �
�m� �� F'
t,��� � ,�.: License#:�f� (0��'�7�S� Lead Certificate#:
If the project is exempt from lead certification, please explain why:
t��.5� w 1+3 �i�i ul' l��l'r� f.�%�DH= p,A-�
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 8�Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOT�;f'/ans and��i� � $s���i�r►enfs# ,�u� �: #� , ir'��tl� '������� a�
#he infort�tronf may�r�� �ssifed a� � } �1ic�fytau pro���le specific-�easc�r�s�`ha��"i�t��� ��iit�ti��= " ��:z
t
�����"x £ �:,= �������,; � at:the are�raale,secrsts°. � >#� ` t ,�������,�� s� w
,
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.aopherstateonecall.orp
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.
X �f D� ��'d-���� X
Applicant's Printed Name Applica Signature
Page 1 of 3
� �
.��� � DO NOT WRITE BELOW THIS LINE ���� ��
SUB 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 y(� Lower Level _ Pool _ Accessory Building
��
WORK TYPES
_ New � Interior Improvement _ Siding _ Demolish Building*
_ Addition _ Move Building _ Reroof _ Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
_ Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall "'Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation �/ 7D ��b' _�� Occupancy �C' � MCES System
Plan Review Code Edition �'ln ?�� ,� SAC Units
(25%_100%lA ) Zoning i�� City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction �( � Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) `� Final/No C.O. Required
Foundation � HVAC_Gas Service Test Gas Line Air Test
Roof: _Ice &Water _Final Pool: _Footings Air/Gas Tests _Final
�° Framing Drain Tile
Fireplace:_Rough In _Air Test _Final Siding: _Stucco Lath Stone Lath _Brick
� Insulation Windows
Sheathing Retaining Wall: _Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: _Rough In_Final
Braced Walls Erosion Control
Other:
Reviewed By: %�YN lYI iKl ..,/,}- , Building Inspector
RESIDENTIAL FEES
Base Fee v�� � � '�� : '� � �� � a �. ��
Surcharge �` � � �� °
Plan Review
MCES SAC l�(�%� �t�S h e' S���g e- S�� s�• /�%
c�ty sac
Utility Connection Charge
SS�W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA142605
Date Issued:05/10/2017
Permit Category:ePermit
Site Address: 3586 Birchpond Rd
Lot:16 Block: 2 Addition: Terra Glenn
PID:10-75400-02-160
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Todd R White
3586 Birchpond Rd
Eagan MN 55122
Sela Roofing Remodeling
4100 Excelsior Blvd
St. Louis Park MN 55416
(612) 823-8046
Applicant/Permitee: Signature Issued By: Signature