4676 Bristol BlvdCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4676 Bristol Blvd
Lot: 7 Block: 3 Addition: Weston Hills
PID:10- 83750- 070 -03
Use:
Description:
Sub Type: e - Fumace & Air Conditioner
Work Type: New
Description: Fumace & Air Conditioner
Comments: Questions regarding electrical perm
952- 445 -2840.
Fee Summary:
Contractor:
Sedgwick Heating & Air
8910 Wentworth Ave S
Minneapolis MN 55420
(952) 881 -7739
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
equirements should be directed to Mark Anderson, State Electrical Inspector,
$50.00 0801.4088
Owner:
Bruce 1 Bartlett
4676 Bristol Blvd
Eagan MN 55123
$50.50
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$0.50 9001.2195
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Mechanical
EA083339
06/03/2008
ePermit
; \ ? .•
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
PERMIT SUBTYPE:
PERMIT TYPE:
Permit Number:
Date Issued:
TYPE OF WORK:
?4I ;I
INSPECTION ¦ • D
I?id141',?t? , ...•? ..
i
?.. . , . ..I? .
f?'??? ? . j- ti.i p Ila?R I k.ip,t I F:1' ?•E.€i6 ?
?,? ??
-
_ . -. ?,..?:.. . .... _.-,__
?i. @?'r?u??
_ ?
Permit No. Permit Holder Date Telephone #
S/W
PLUMBING
HVAC
ELECTR
ELECTRIC
Inspection Date Insp. Comments
Footings I
`t
Foundatian -AO,
Framing
Roofing
Rough Plbg.
%
Rough Htg.
l ?
Gv
I5ul.
Freplace
Final Htg_
(
Orsat Test e?
Final Plbg. s-Z ? c?1i ? Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bidg. Final
f
Deck Ftg.
Deck Final
Well
Pr. Disp.
.? ,?,
?
Wertifica#e nf cccupanc4
iKtm of Ragan
zoartmenr o? 13miibing 3a'Spectiun
This Certifecate issued pur.suant to the requirements of the Uniform Building Code
Certifying that as the time of issaeanCe this strueturn was in Compliance with the various
ordinances of the City regulating buidding constrttctlon or use. For the following:
Use Clatsification:,p,F n.V"' 6ldg. Permit No. _ ZZS51
TYPe'COnst. VN ?
Ooaqancy Type R3MI_ Zoning Distria R I
Owoer of Bailding JIM BY rNA.ST+'. Acldness75fY1 TJ MY ED 42, B!Vm M_ ?" •a:
,/
BuildSng Addness!ORTSM. ?jj M&]gp l'°Wity
Date:
POST IN A CONSPfCUOUS PLACE
RESIDENTIAL
• `? BUILDING PERMIT APPLICATION
CtTY dF EAGAN
3830 PILOT KNOB RD - 55122
651•881•4675
New Construetbn Reauiremenls
• 3 registered site smveys showing sq. R of bL sq. ft M house; and all rocfed areas
(2096 maeimum bt coveiage allowed)
. 2 copies of plan slaWng peam 8 window sizes: poured }ounC design, etc.)
• 1sHO(EnergyCala;auons
• 3 copies of Tree Preservation Plan i( lot platted aRer 711193
• Run Joist Detail Opbons selec6on sheet (bldgs wilh 3 a less unhs)
DATE
.,JB SITE ADDRESS_ `'f G-7 G /?'??'i ? `?a
IF MULTI-fAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER L, c/'! ?. 4 rJr'u.G
TYPE OF WORK p + _?
APPLICANT
ADDRESS
PAGER #
FIREPLACE(S) _!?O _1 _2 _3
_PHONE#?Sa--jr84--G !or,,
ZIPCODE -'S"q
_ FAx # 9sa-?g y - 9 Cps-;Z.
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLET
Energy Code Category MINNFSOTA RUL.ES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submi
- Energy Envelope Caiculations Submitted o
_ MINNESOTA RULES 7672 ey\? /
- New Energy Code Worksheet Submitted
Plumbing Contractor. _
Plumbing S}'stem Includes:
Mechanical Conhactor. _
blechanical S}•stem Includes:
Sewer/Water Contractor:
Phone #
Phone #
Fee: $70.00
All above infortnation must be submitted prior to processing of appliration.
I hereby acknowledge that I have read this application, state that the
all applicable State of Minnesota Statutes and City of Eagan Ordinai
Signature of Appiicant
Certificates of Survey Received _ Tree Preservation Pian
4 iqz-15
oulua
RemodellReoairReoutrements
• 2copleso(plan
. 1 set ot Enagy Cakulatiore for heated aditions
• 1 site survey fa ezterior additlons 8 decks
VALUATION (EXCLUDING LAND)
4 a r 1-1 e
CELL PHONE #
_ VVater Softener _
, Water Heater _
_ No. of Baths
Phone #:
Iawn Sprinkler Fee: $90.00
No. of R.I. Baths
_ Air Conditioning
Heat Recovery System
is correct, and agree to comply with
_ Not Required _
Updated 1/01
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
0 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 31New
32 Addition
? 33 Alteration
O 34 Replacement
? 20 Pool
? 21 Porch (3-sea.)
27 22 PorchlAddn. (4-sea.)
1
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
, ,
? 30 Accessory Bldg
? 31 Eut. Alt - Multi
? 33 Ext. Alt - SF
O 36 Multi
? 35 Int Improvement ? 38 Demolish (Interior) O 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
O 37 Demolish (81dg)' O 43 Reroof ? 46 WindowslDoors
'Demolition (Entire Bidg only) - Give PCA handout to applicant
Valuation ?7 4p0 O pancy
? l
Census Code Zoning
SAC Units O? Stories
Nbr. of Units Sq. Ft.
Nbr. of Bldgs ( Length
Type of Const ? Width
? Footings (new bldg)
_ Footings (deck)
Footings(addition)
? Foundation
?j Drain Tile
Roof Ice & Water Fina]
? Framing
Fireplace _ R.I. _ Air Test _ Final
?i Insulation
/C --3 MC/ES System
City Watei
Booster Pump
PRV
Fire Sprinklered
-?
REQUIRED INSPECTIONS
FinallC.O.
_1? FinaUNo C.O.
_ Plumbing
_ HVAC
Other
_ Pool _ Ftgs _ A'u/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
Approved By?14 , Building Inspector
Base Fee
Surcharge
Plan Review "
MGES SAC
City SAC
Water Supply & Storage
S&W Permit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
? 07 05-plex O 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex 0 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 LowerLevel
? 12 12-plex Plbg_Y or _ N
- ,a?xs?-
Address 4676 s_SmL aWtEvnxo Zip 5512 3
Lot 7 Blk 3 Sub wESPON Hli.i.s
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: 515 Yes No' Inspector:
Final grade (6" from siding) ?
Permanent steps (gazage)
Petmanent steps (main entry)
Permanent driveway
Petmanent gas
Sod/Seeded grass
TraiUcurb damage ?
Porch j?
Basement finish ?
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply ro
the ouuide lawn faucet before freeze potential exists.
Contaa engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. ?
Whiu - City Copy Yellow - Resident Copy Pink - Contractor Copy
?-
,? ?
Request Dale
/? /
3 Fre Na FlougRi Inspection
Requi ? NOTICE: You Must Call Eieqncal Inspecmr
If A Rough-In Inspec?an
"L ?/ es ? No Is Reqwretl
I licensed contractor El owner hereby request inspection of above electrical work at:
Job Atldress (Street, Box ar Roufe No.) Cdy
?/l? 7-Z' .?.'Sto-e v
Section No. Tovmship Neme or No. Range No Counry
Occupent (PRINT)
4 Phone hlo.
3 7
o rLi e5
1
PowerSuppher
%X PdEress
Electricel Contractor (Compairy Nem
' Conlractor5 Ucense No
/-
? e 60 -
Mai ing Atltlress IContracWr or Owner Making Installa?wn)
' '
S l
S3*,j 6
Authonzetl S tur ContraclodOwrierMabrg Ingallalion) Phone Numbe
= \
?fJ
MINNESOTA STATE 80AFD OF ELECTRICITV THIS INSPECTION REQUEST WILL NOT
GrIpgs-Mitlway Bldg. - poom S173 BE ACCEPTED BV THE STATE BOARD
182f Unlvorslry Ave, SL Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone(81Y)69R-0B00 ENCLOSEO
& /p,/ REQUEST FOR ELECTRICAL INSPECTION
?q C??`p• /? ? So sWC?ons for completing this brm on Oack ol yelbw copy
l?U O 7'-F'S "X" Below Work Covered by This Request
` ? EB-00001-OB
0??8'
.?.
e Adtl Rep' TypeoiBUilding AppliancesWired EquipmentWired
Home Range Temporery Service
Duplez Water Hea[er Elactnc Heating
Apt. Buildmg Dryer Load Management
Comm./Industrial -Furnace Otner (Speary)
Farm Air Condi6oner
Other (specAy) CorHrac[or5 Ramaiics
Compute Inspection Fee Below:
# Other Fee '# ServiceEnlranceSiza Fee # CimwtsiFeeders Fee
Swimming Pool 0 to 200 Amps / ?l 0 to 1 Amps s
Transtormers Above 200 _ Amps 100? Amps
Signs Inspenor5 Use Only
? DU TA
L
Irrigation Booms ?
? ?
p J •?
Special Inspection
Alarm/Communication THIS INSTALLATION M BE ORDE ISCONNECTED IF NOT
Other Fee COMPLETED WITHI ON
I, the Electrical Inspector, hereby Rough-in oa? ^ Y
? ?
certify that the above inspection has
been made. F,,,? oate
OFFICE USE ONLY ?
Thie mque51 v0id 18 monMos Irom
-. •
EXTERIOR ENVELUPE ENEItGY CODE COMPUTAITON WORKSHEF
To Detecmine Compliance wich use Ivinna°ta Energy Code
(5 'on 502 of the State Amended 89 Model Eaergy Code)
Projecc Tide ?
T671o B?v c
Site Addr•ess
I. EXPOSED WALL CALCfJI.PiTIONS AREA "U^ VALUE
A. Opaque Wall
1. MasomY/Concrete
x
a. X
b. X
C.
Foundation Wall (Above Grade)
2
. a
a•
b. x
3. Wood Frame Wall Z7 f) a
a. Insuiated Area
b. Framing Area (Ave. 15% at 16" oc) -
X
G Framing pxea (Ave. 109'o at 24' oc) _ x
4. Peripheral Floor Edge/Rim 7oist ? x
?
b. %
B. Glazing
1. Windows ? x
a.
b. g
----
2. Doors x
C. Doors
1. wooa X
a. Solid g
b. With storm door x
2_ Metal x
3. Overhead X
4. Oraec
D. TOTAL WALL AREA, sq.fc......... -......_._....? a3 I
E. TOTAL OF AREA x"U"...._ ..............._.__._......_......._.....__.......?.
AREA x °U"
?
-7 9
?a =
,73
? -
II. ROOF/CEII.IIVG CALCiJfA1TONS
A. Roof/Ce7ing Insulated Area ._.L[, '!'-- x
B. Roof/Ceiling Frsming (Ave. 15% at 16" oc) x ?
C. Roof/CeRing Framing (Ave. 10% at 24" oc) /,;L
x
D. Skylighc
E. TOTAL ROOF/CEII..IIdG AREA sq-ft-....•..-•.--.---- /a2a._
F. TOTAL OF AREA x'iJ".»___......_._......_._.._............_...._..._»_......._........ .
?"-?
a2. ?,?
3,//
. ` M. BUFLDING ENVELOPE REQUIItEMENTS
TOTAL ARFA REQUIRED "U"
(From LD. & II.E) (Fram V.)
A. Exposed Wall: .23 z , Ir =
B. Roof/Cei7usg: x , pgG =
C. TOTAL ALLOWABLE BUII.DING ENVELOPE (Total of A& B above)._..._......:..
IV. ACTIJAL BUII.DING ENVELOPE
ROOF/CEII.ING
.Q26
.026
.06
.06
ACPUAL
(Area x "LJ")
A. Fxposed wa(L (From LE.)
B. Roof/Cei1'ng (From II.F)
C. TOTAL ACTUAL BUII.DING ENVELOPE (Total of A& B)......... ................._........
•(Meets code requirrmaus if less dran IIZC)
V. REQiJIItED "U" VALUES
WALIS
Detached one and tMo -fm?7y dwellings .11
' Multi Family Residential Btu'idings
(3 stories or less in heaght) .238
° All Other construction Types (3 stories or Iess) .238
' All Other Construction Types (More than 3 stories) 28
'Based on 8007 heatin8 degree days (Mph? /St Pau!)
Adjust "U" Yalues accondingly for other locations
I hereby certify that I hav_e
ALLOWABLE
(Are- J, el .
T
ag.
/ 3.0?
3,71
the above information and that ic complies with the Minnesota State Energy Codi
BCSD 4-93
CC/SM/6574
?
?iw
?
?
:
;;±:i7G Sc=TIOH:
w'AL! SE:-fGtl (iNSi!Li.Ts:)
y
! • ?'
=
e. •,
• ', •
1 • .:. .
. j?p^C
Rf!', JOtST 5"cETICti:
:i
7
U a 1/R = l ? 0?9
FOEINDAZiQN 28SEJ"iIQf! kE;L:'ED:
Min. R-5 on entire NEli QR
M;n. R-10 dowrt to fresZ deptfi
U = 11R g
E
i-A,X ': G 6
_. -., .
FOINQA?IOi: SEGTICN:
-?1 Int±rior atr film 4.E8
..,
;=• cx,e-icr air filn 0.17
?E
TOi.lL R =
St:3 GY GR.;D'c
/ A
i ?? ?' „ •
F:ea *.ed SIab s:
Mi nica^R=8.5
Unhe=_ ! 51ats:
?o Miri=,. R = E.2
?•?'?? •???? X" 4.
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? ? .. < . `-A•- '
..
• •
G
1 .
; • t4
- `,Q'.-
.
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q ? . •,.e
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'
•
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1
•
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.
: X. . PaB= 4
L, a 1%'. ° I/D
u - ilR
a?
f °
?
?
c:]l.t:Ir. SEc71r,ri (PIsULAr_D)
=
1 In[e-ior air fil.^ :
B _. 2
a (o ?-
4 Exterier air Eiir.. (s:ill) C-
11:TnL !Z a •? •
U ?O25
c=_t! tnr, P:,;r,tNr, 5?_Ttcv:
j ITttHrIC" dt! rIlL Q.Si
3 ?-
4 Irteericr air rilr.. (s:ili) C.3
5 t)_ 'nches se'; weer' N.35'
70 , aL a - Y/,-5
u - I /a - .e..?-;k-
cm
vENTED
C°_ILING SECTtQr1 (IHSJLP.T'cD):
1' Interior air fiim 0.61
Z .
' 3 '
4 Exteriar air rilm (s:iil) 07I
TOTAL R
V
e_iuHr FRarti"r, sEt-110ti:
1• (n[erior air film 0.61
2
3
4 Exterior air ilm (stilil 0.61
? S Incies seft wcod
TOTAL P.
U= 1/R=
?
1
2
3
4
S
Instde alr film 0•61
Outside air filr.. Q•ti7
T?ITAL R =
U
Eagz 5
....._._ . _?- --.. .
;EYOR'S CERTIFICATE 7'3
.`?.II0MGS BY CI-iASE
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? NO BVECIFlC 9TlE INVRSTIOATION HIlB B!!N COMPLC7lU
?
OH TM18 LOT 9V dAMPS R' FIILL, ING. TH! BUITACIUTY OP (
SOIL9 T0 BUPVORT THH BPECIPIO NOU9E PROPO9E019
NOT TMt. RR.APONSI9ILITY al' JAMlb 11. HILL, INC•
-w DENOTES PROP03ED SURPACE URAINA(;E
p DENOTES IRON MONUMENT 3E1'
• DENOTESIRON MONUMENTFUUNU
X000.0 DENOTES EXISTINO ELEVA'IIVN
(OUD.O) DENOTES PROPO5E0 EIEVATION
5
?/ 30
0
\ gB a ?
EAGAN
DEPT.
SCALE: 1 INCH - 30 fFEEt
EET
pROPOSED OAFAOE FLOOR - ?I`// 0 PROPOSED LbWEST FLOOR - 9-'H. ft FBET
PROPOSED TOP OF 6lOCK -4' FEET
WE HEHEBY CERTIFV TO HdME9 SY CHABB THAT THI5 IS A 7RUE AND CORRECT
REPRESBNTATION OF A SUHVEY OF THE BOUNDARIFS OF:
;Lot 7, blook 0, Wg670N MILL9o 8ooording lo the reoo?dsd pl?t the?eol,
}
Opkota County, Mlnnosotb
HPORT TO BHOW IMPROYEMENTS UH ENCRO
IT DOE5 N07 PU A; H DAY OFE'-T'?""'Aw- ??10 9??
SURVEYED 6Y? ME OR UNUER MY DIRECT &UPERVISION THIS Iz_
81pNED: JAMES R. ILI, INC.
NOTH: BVILDINO G+MF:NSIUNB SHOWN ARE . ?
fOR HOPIZOMAL 0 ?T[AL LAC•
AiION OF 9Tf1UCTVRE ONLY. 9E! AIiCHItECfUAI ?>N9??I?INO BY'RYR?WARRl3, DSURVEYQR
9 FOUNb4T10N OIMENSION9. pA
MINNESOTA UCENSENUMBER 10943
James R. Hill, inc.
PLANNERS / ENGINEERS I SURVE`(ORS
2500 W CTY. Rb. 42 • BUANSVIILE, MN. 66337 • 612-8906044
x CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
P.T.N.: 10-83750-070-03
DESCRIPTION:
PERMIT
PERMIT TYPE
Permit Number:
Date Issued:
4676 BRISTQL BLVD
LOT: 7 8L(JCKa 3
WESTON HILLS
Bilding?-Zermit Type 5F DWG
I8uilding W?.r_k 7y,pe NEW
UBC Occupancy? R-3 M-1
Con5tru?c'tion Ty.-? V--N
Z o n. i n g `--? R-1
Building Length ? 70
Building Width ?
?..
_
- 30
. ?
?.
\
Ll? f?y?y
Xy
BUILDING
022851
01/19(99
???? ?? ?aopan
REMARKS:
PRV
FEE SUMMARY:
S& W PLBR - VALLEY PLBG
VALUATION
Base Fee
Plan Review
Surcharge
SAC
SAC t
SAC Units
5ubtotal
$755.00
$490.75
$66.50
$800.00
100
$2,112.25
$193,0@@
MSSCELLflNE0U5 $1,828.50
Total Fee ?$3,940.75
CONTRACTOR: - Applicant - sr. Lzc. OWNER: ,
HOMES BY CHASE 15955337 0001619 HOMES BY CHASE
2500 W COUNTY ROAD 42 260 2500 W COUNTY RDAD 42
BURNSVILLE MN 55337 BURNSVILLE MN 55337
(612) 895-5337 (612)895-5337
I here6y acknowledge khat S have read,this applicatiq;n and state thet the
information is correct and agree to comply with ill dpplicable State of Mn:
Stetutes end City of Eagan Or'dinances. .
L
?-
?i'`?'?iC_ 1h.?
APPLICA ERMITEE SIGNATUHE SSUED Y 5 NATURE (k-
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: B U I L D I N G
3830 Pilot Knob Road Permit Number: 022851
Eagan, Minnesota 55123 Date Issued: 01 / 19 / 9 4
(612) 681-4675
SITE ADDRESS: i. o T: 7 B L 0 C K: 3 APPLICANT:
4676 BRISTOL BLVD HQMES BY CHASE
WES70N HILLS (612) 895-5337
PERMIT SUBTYPE:
SF DWG
TYPE OF WORK:
NEW
?
INSPECTION
FOOTINGS .. •
FOUNOATIpN .A
FRAMING ROOFING
IN5ULATTON FIREPLACE
ROUGH IN PL66 ROUGH IN HTG
FINAL PI.BG FTNAL
REMARKS: PRV
F- -
S& W PLBR - VALLEY PLBG
ii
t
-7
REACTIVATE CIIY OF EAGAN
L01 P5RMI7 t WBUILDING PERMIT
94
I'JAN 14 1994 681-4675
APPLICATION ?_? M0,15
C.ridBll I ' 0
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
' calcs.
COMMERCIAL 2 sets of architectural 8 structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty appties: 1) when permit is typed, but not picked up by last working day of month-
in which request is made, 2) address is changed or 3) lot change is requested ooce permit
is issued.
Date _? // 3/ Yaluation of work ?0j;& 7Oo
e/ 1?5ZvcLI
Site Address: !5;16 7?O y,2SiS?/574
SiREET SIJITE /
Tenant Name: (commercial only)
IAT ? BIACK 2 SIIBD. P.I.D. N '
Descri tion of work:
The applicant is: Own r ontractor ? Other (Deseribe)
Phone 1?S-S 337
Name ?
_
Property A T FIRST
Owner Address ? t'0 ?? &V _ c x?, ?al yY 2?o o --
^
STREET STE /
City State l'[, ZiP 3 ;
Company Phone
Contractor Address License # Exp.
City State Zip
Company Phone
ArchitecU
Engineer Name / --? Reaistration #
Address
City State ZiP
Sewer & water licensed plumber . Processing time for
sewer & water permits is two day once afta s been approv d.
I hereby acknowledge that I have read this app1lcation and state that the information is
correct and agree to comply wi 1 applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: ?J
OFFICE USE ONLY
BUILDING PERMIT TYPE
O 01 Foundation
p 02 Sf Dwg.
? 03 SF Addition
? 04 SF Porch
13 OS SF Misc.
WORK TYPE
? 06 Duplex
? 07 4-Plex
E3 08 8-P1ex
? 09 12-Plex
? 10 Multi. Add'1.
? 11 Apt./Lodging
0 12 Multi. Misc.
? 13 Garage/Accessory
0 14 Fireplace
? 15 Deck
?! wy?
1? Al
17 16 Basemf'Finish
O 17 Swim Pool
O 18 Comn./Ind.
O 19 Comm./Ind. Misc.
O 20 Public Facility
? 21 Misce7laneous
JR 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft . ??19 MWCL System X
(Allowable)
l1BC Occupancy ?
-s- lst F1. sq. ft.
2nd Fl
s
ft ho e City Mater ?
PRV Re
uired
. _? ,
q.
. q
Zoning - Sq. Ft. total Booster Pump
#? of Stories 2 Footprint Sq. ft. Fire 5prinkler
Length ? On-site well Census Code i/
Depth 30,33 On-site sewage SAC Code ?
APPROVALS
/
Planning Building Assessments
Engineering Variance
REQUIRED IN SPECTIONS '
? Site 12 Footing jD- Framing U Insulation
? Wallboard 0 Fi nal ? Draintile 0 Fireplace
Permit Fee
Surcharge
Plan Review
License
wwcc sac
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
v.tusc;ac g 13 3 DO d
Qs? t-? lst ?-
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5- 3?352
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SAC %
SAC Units
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S?JR?VEYUR'S CERTIFICATE
IIOME5 BY CHASE
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NdTE t NO SPHCIFIC 801L8 INVHS7IU,
ON THI3 LOT BY JAMC9 R. HII
SOIL9 TD BUPf'ORT THH 9PE
N07 THE RE3PON91AlLITY C
-.w------ bENOTES PROF
O DENOTE3IRON
0 pENOTE5IRON
X000.0 DENOTES EXISI
(000.0) PEhlOTES PROf
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: EAGAN
REVI€WED
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tON HAB BHEN CAMPLE'I'ED
t INC, THE BUITABtLtTY OP ?_n1o
FIO HDUBfi PROP09EP IS r
JAMES 11, HILI., INC, ,
3Eb SUFiPACE URAINAGE
IONUMENT 3E1'
IONUMENT FUUNb
IQ ELEVA'Ilt]N
?SEP EL.EVATION
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EAGAN
I rb .? (J? 11"
DEP1:
SCALE:tiNCN = 36 FEE7
PROPOSED OARAOE FI.OOR m cV-'// fq FFEET
EET
PROP03ED LbWEST FLOOR -- £?
PROPO5ED TC1P dF BLOCK =9'Y;2 q FEET
WE HEREBY CERTIFY TO I HOM49 SY CHA88 THAT THIS 15 A 7RUE ANO CORRECT
REPR@SBNTATION OF Pi SUaVEY OF THE BOUNDARIES OF:
;Got 7, Blook 3, W88TON HIi.LI, mooording Io tha reooirdsd plet thareol,
Dekoia County, Minngsots, '
DAY OF ? E uvqiz`( HOg N. ?'? S
SURVEYE? YpME ORRUNU Fi M bIR CT Q 5UP8RV 310N TH 5 ENCROACHMENTS,
NOTE: 9VILDING CxMENSIVNS SHOWN ARE
FOR HOpIZONfAI Q VOYr-AL LOC-
A710N OR 97FlUC7URE ONLY. 86H
ARCHITECrVAI. PlAN9 FVR BUILDINO
9 FOUNCATION DIMENSIQNS.
31QNED: JAMES R. ILL, INC.
BY: _ ??.,..
QARY R, WARRI3, LA d SURVsYOR
MINNE80TA UGEN5E NUMBEp 10943
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James R. Hill, inc.
F'LANNERS / ENGINEERS I SURVE1(ORS
2600 W. CTY. RD. 42 , BURNSVILLE, MN, 56337 o 812•090•0044
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LOT iIIROEY CBLCI?LIST ?OS ItE6ZDENTI7IL
SDI;
YROPERTY I.LQAL=
• aate ot snrvap:
D4CIIlSENT BT711QDARDB
• Reqisteree Land survayor siqrsatuso aad eampany
• Suildinq Permit 1?pplicant , '
• Legal description
• )?ddrass
• North arrow and bar scaie • 8ouse type (ramblar, ralkout, sp13t .v/o, split sntry,
lookout, etc.)
• Direetional dzaiaeqe arrows with slopa/qradisnt s.
• Proposed/axistinq sever and vater services
• Street nnme
• Driveway
• Sewer servica
,0 • Lot oorners
D13 0 • Top oi curb ai the driveway
D • Elevations of any existing adjacent homes
D
• pronosed
Garage floor
? 0 [3 • FYrst lloor
6' 0 D • Lowest expoced elevation (walkout/vindow)
0 0 • Property corners
? 0 • Front and senr of home at the loundation
Z4NDINC 11RE718 (if apolieable)
D 0?G • Easemeat line
D 8" D • NwL D 0-?.0 • awt.
0 8?"?0 • Pond 0 desiqrration
D 8' O • Emerqeney Overflow Elevatioa
??C1 ? • Loi iines 6 J 0 • Siqht-of-way and street xidth (to bsck of euzb)
8" ? D • Proposed bome dimensions including any proposed •deoks,
overhangs qrenter than 200 porchas, etc. (i.e. ail
structures requiring permanent footiags)
? D 0 • ShoW all ensements of record and any City utilitiea within
thoce •asements ? 0 0 • Setbecks of proposed ructure ana setback oi adjacent
•xisting h
JK'D • Aetaini em?ntc, if any
Reviewed:
?- ? ----?-_- ---- ,?-_..? _ ?
Octobar 2992
UlIII6lI: ??,? r L? ti
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S I I C, nuU!+[5Ss • . . . . . ,
cunInncron: unrE: ? rnonE:
bETEnHIUE• uoni;tnn sQunnE rooinr, E o F Eneii: „ . : . ; . ?
.
i.. iornL ExrosEO unLL nnEn,,,e2lsti rt x "u"
M
7.. ioinL nuor/cEil.1116 nntn........? s,, rc x ?,u,l?' OaS ? losy`•?'G
,
3. TarnL ExrosF.n
unLL nnen cnLcuLnrinnsr
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Total oxposeJ wall ' . •? ,
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oren above flvor.,......
sq ft . ,
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e) Total vral l r+lnJow ereal
? gtazad...... %2A sq rt x ??U"
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rylazed?r???? sq r t x IlUll ?
b) L?'? 's(I
iocnl tioor areo • rc x flute•
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c1 lotn) slldln{I cllass'door'areaf•?. . ? ,? • ' .? .? . • •
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glozed....... sq ft x "U,.,
qlazed.*.so, ?t x nun . „ .
d) lotal flreplace woll eren _ •' ?j ' _sil ft x "U"
e) Total ta?ll fr??ning area
-
(nvcr,t
Rc io.) ........... .2(Q?_ sq
rc
x
"U?? ? tl?
' f) Totnl riet wul) orea ebova '
flaor sq ft x "U"
g) 7otal rim Jolst.erea,,,... sq ft x "U'!
Totnl foundatlon '
arca (ExposeJ)..,,,,,,. sq .ft . . .
h) 1'atnl found?tlon
s ry
%alnJorr aren .............
f t
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Total net founclatlon" '? '
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orca above.ryr
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sq
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? , TOTAL a) thru 1) °
If•Item /+i Is the samc as.• or lass than Item pl, yov hove met the hltent of
S.H.C. Sectlon 6006 (c) 2.
' rorni. Cxrusi_u nuor/cliit.tnu r,nicuLnrions:
'lotnl r.xpvsed ' ' •
ft •
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J) . lotal slcyl lpl?t. areo.'?..... () sq
-
ft x
"U" ??
" • • ? , ?';!,.i ,
'?
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k) lotal roof/cclllnq framliin ;., .. . •
, . .
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• arca (Averape 10%),,.... / Sq (t x ?
"U" ?
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I) lota) net lnsulateJ ••• ?
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.
. ?oof/cclllnq nrea..?...??? sry ft x "U"
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tntal•of Nh Is the same as, or le9s thnn 02, ytlu have ntet the Intent of
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t.C. Sectian GGpG (c) 1. ',
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• AL7E1111A7E IlVILI)1116 EIIVELOhE IiCSlt;11 • .
n llzc Lho totol envelope systeM melhod,,the volues,estob1151reJ by the swn.f Ilcuis p3 anJ nil shnl) not bc ryreatar thqn the sum of Items 91 and p2.
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3. ` + 11!.
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r.Entir.ir.nTinn ' .
I here6y certlfy*tliot ( have calculuted the "U" factors ond "It"
V:IIUCS hereln mtd lllot the bul1dinn here descrihnd meets or exceeds tl+e Stnte
of I{Irmesota Encrny f.onservatlon Act. ?
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• , . {'• i Siqnoture .
11
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTTS ARE REQUIRED FOR EACH UNTT.
NO. FIXTURES EACH TOTAL
` sxOAhTR 3.00 3-
.S_ WATER CLOSET 3.00 a ?
i_ BATH TUB 3.00 (r
3 LAVATORY 3.00 5-
I KITCHEN SINK 3.00 3 -
LAUNDRY TRAY 3.00 3-
_ HOT TUB/SPA 3.00
T
WATER HEATER 3.00 3:.
FLOOR DRAIN 3.00
? GAS PIPING OUTLET • minimum - t 3.00
2? ROUGH OPENINGS 1.50
WATER SOFTENER 5.00
PRIVATE DISP. - nekc,y, rc. 20.00
U.G. SPRINKLER • hame under ronst. 3.00
ALTERATIONS • to oticting 20.00
WATER TURN AROUND 20.00
STATESURCHARGE
TOTAL:
.50
4-1 -
SITE ADDRESS: ? G-? G IJ p; s ? 0 1 (?\,/j
OWNER NAME: Cl,as c
INSTALLER: U AII? PI? ?
ADDRESS:_filU C i2cc lL
CITY: c? fa ? ST?.TE: rn- ZIP CODE: '5??
PHONE #: ( )
Cj\-,&? k k-l
SIGNATURE OF PERMITTEE
1994 PLUMBING PERMTT (RESIDENTTAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
?
c =
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
?NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE
FIREPLACE INSERT
DATE ;?- - q ' \
HVAC: 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS (MINIMUM 1 @ $3.00 EACH)
ADD-ON/REMODEL (EXISTING cONST[tucrION)
STATE SURCHARGE
TOTAL
SITE ADD]
OWNER N
INSTALLE
FEES
$ 24.00
6.00
3.0?
$ 20.00
.50
a ?. So
TELEPHONE #: cs -5 ?37
AllllKr:JJ: \ ? V? \,_,-4 I t? l) I C'J N u
CITY: OS er_r? STATE: I", (1 Irl ZIP CODE:
TELE?HONE #: ? ? `?('".C?c? ?-
1994 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
04/08/1994 10:20 612-861-6809
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RUSSELL L. BRANDT
R I{? 9600 UPTON fiOAD
L BLOOMINGTON, MINN. 55431
612-881•6808
April 8, 1994
Nr. Ron Chase
Homea by Chase
2500 W. County Rd. 42 N260
Burneville, MN 55337
Be: Chaee Residence
4676 Briatol Blvd.
Eagan, MN
Dear Mr. Chase,
KUDJCLL L nrtr+ivaii
A /?' N.?, ??1 /JZ'
V
GIY0.•STRUCTURAL ENGINEERING
?'/?X 89 S- a 59 0
At your requesl: I visil:eci subject premises. You are concerned
about the basement £outidation. I am to analyze the basement
foundation wall t.o dr.Lermine how much, if any, verti.cal
reinfoi•cement ia required. My comment•s are limlLed to this
matter. I visit.ed Lhe siLe apri3 5, 1994. Sketch 415-1 is
attached.
DESCRIPTION
Thie 2 atory residence is under construction. It is of wood
Prame. Siding is bein$ installed. No gYPsum board has been
inetalled. Basement walls are of concrete block. Basement floor
is NOT in place. Furnace is temporarily suspended from first
floor Joists.
OASERVATIONS
You sa.id that the weather turned coid during the conatruction of
the basement walls, thaL frost heave was first noticed Nhen
inetalling roof trussea, and that some basement wa12s cracked.
It appeared to me that the basement Walls cracked at varioue
locationa, and that crucks wei•e repaired. T saw evidence oP some
cutting in t1ie mortHr jointa in the front well, and of repairs to
the exterior of the re.ar wall. Backfill had been removed prior
to my visiL. Alao, I notir.ed some hairline cracks in the front
wall.
Rear• basement wal] appeared to be slightly bowed inwardly neur
the xindow. Basement walls are 11 or 12 courses high
sccamodating n sunken living room. 5oii on site nppeared to be
moatly eandy c:lay and/or sandy, silt.
DISCUSSION
You said your concrete roan would arrive the sfternoon of my visit
and fill cores as necessary. I analyzed the xall shown on Lhe
aLtached sketch 415-1. You provided I.he dimensiona. IIockfill
BRANDT letter to CiiASE - April 8, 1994 page 2
material shall be sand and/or gravel. Vertical reinforcing eteel
is required.
The amount of vertical steel required is 1#5 vertical 0 3'-0" an
center and loc;ated 4 inches from the inside face of wall. See
sketch 915-1. Corea containing reiriforcing steel to be filled
solid with 3,000 p.s.i. concrete. You said the wall presently
contains 2 p4 bars vertical @ 6'-0" on cetiter, and located at
mid-thicknexs of thn wall. The 2#4 0 mid-thickrieas are
equivaletit to 1 Y5 as indicat.ed sbove.
The hairli.ne cracks in the front wxll ara neither unususl nor
unsightly.
I presume you wil.l provide an adeyuate drain Cile syatem at the
faotings.
CONCLUSION
It ia my opinion that vertical reinfoi•cemriet ia required in
basement wa11s, ttiat ttie spacing oP Chis reinfore;ement ehall be
3'-0" o.<:., and that the reinforcement ahall be elther 1#5
vertical 4" fr•om inaide fnce or 'l #14 vertical 6" from inside
face.
Thsnk you for allowing me Lo aerve you st thie time. If I can be
of Yurttier service t,n you, Please call me.
Vecy truly yours,
Russell L. Uraiidt, P.R.
Consulti.ng 6ngineer
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4-8-94 ;4p 415-1
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
(o?C? 3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
oate ' / ' S , v U
Site Street Address yt'71. bR iSTa L bL ? J Unit #
PropertyOwner 6Ru?cE 6 R7LEEr' Telephone# (?0?1? Qqy.._ w9c3
Terry Overacker Plbg Inc
1630 County Hwy 10
Contractor
Spring Lake Park, MN 55432 Telephone #( )
Address (763) 572-8880 State Zip
The Applicant is: _ Owner iC Contrector _Other
Alterations to existing dwelling $' 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required)
Other:
Water Softener ? Water Heater $ 15.00
?C replacement _ additional
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ .50
?
4A %iq p
$ I'5.?
Total 4
I hereby apply for a Residential Plumbing Permit and a?kn edg_ that the information is complete
and accurate; that the work will be in conformance with the or ances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
?Ea,a.y OJF2.MC?E2 ? d?.?/
Applicant's Printed Name ApplicanY Signature
i
Fir:--Off ice Use
My of Eaau Permit 1 / `7 O
Il
3830 Pilot Knob Road Permit Fee:
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I
Fax: (651) 675-5694 Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: U 0 Site Address: Z/6 2("Z, i cj' £ 2d
Tenant:
Suite
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work:
Construction Cost: d 66 Multi-Family Building: (Yes / No
CONTRACTOR Name: LefO(?~ ~1Ci /O G L License C)0(0,
3 n
Address: 17I SS
City: L Z-6f0 State: _A/1) Zip: Lb 'OD
Phone: 77S 7V Contact Person: g S~L~ f C
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
tJ 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 they 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 permit, but only an application for a permit, and work is to start without a permit; that the work will be in
accord,wrap with the approved plan in the case of work which requires a review and approval of ns
x x
Ap ant's Printed Name Ap Ii s Si ture
Page 1 of 3
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Use BLUE or BLACK Ink
r----------------'�
I For Office Use �
� � Permit#: �� �`�' �� �
City of ����I1 ; . a�- �
Permit Fee:
3830 Pilot Knob Road � � j�� �
Eagan MN 55122 � Date Received: � �
Phone: (657)675-5675 I I
Fax: (651)675-5694 I Staff: I
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ��— /O^�`� Site Address:�(�Jlp i��)S.i�L �1!J� . Unit#:
�
Name: ��(iGF ��(�!�f:' Phone: �2, � ZU7—'7>��
Resldentf � � p
� , Q�y�jp�� �� Address/City/Zip: ��7G� �/L,/1 T[. />l vD
o � ��.:� ������M� _
�,��� � Applicant is: Owner Contractor
�. �
' ' Description ofwork:��,2�.�_�' / /2P,S1��
Type of Wark
� ' � Construction Cost:� � Muiti-Family Building: (Yes /No�
�_�-
Company: ��J11 ar.»� �-D►�IS'T ,�itJ�. Contact: ��
C011tN'aCtOC Address: �703 /�lZt Yia L ,�1�. city: Cfld„�tn�.
�
° � ; State: m�,l Zip: .�'IL,3 Phone:�/Z 31�1 /�12P. Email:
�, �
' License#: L�-- /3�(yh Lead Certificate#:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
� NOTE Plans and supporting alocuments tha�you sclbmit are eonside'reaf tc�be public information. Partions of :
the rnforr"rraf�dn may be�lass��e'al as non,pu�ilic;�f you:provid�sp�c�ficw r�asoris_°tha't would pe�rm�t.tl�e Cfty to '
�� 'concrude�t�r�#�the �are�tr�de 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.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.
Exteriorwork authorized by a building permit issued in accordance with the Minnesota State Building Co e must be completed within 180
days of permit issuance.
�
x /(� eG %�/v1L.d/
Applicant's Printed Name ApplicanYs Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA154417
Date Issued:03/20/2019
Permit Category:ePermit
Site Address: 4676 Bristol Blvd
Lot:007 Block: 003 Addition: Weston Hills
PID:10-83750-03-070
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Bruce J Bartlett
4676 Bristol Blvd
Eagan MN 55123
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
r For Office Use,
., ;; %; Permits: I 10 193
, EAGAN
•.... ....,
Permit Fee: 1 3 J �?
....--.4„... Date Received: S-/-3. �'i
3830 PILOT KNOB ROAD I EAGAN.MN 55122-1810 IlEC EN j
(651)675-56751 TDD:(651)45445351 FAX:(651)675-5694 staff;
buildinoinspectionsCi!citvofeaoan.com MAY J
13 2020
�j 2020 RESIDENTIALBUILi ' ERMI APPLICATION
0
Date: ` /13 Site Address: (-1671, (&rIJ J 15) '/ Unit*:
Name: 4/-/-01q FCl,11c Phone: 1.017-207- 73V3
Resident/ L
Owner Address/City/Zip: 1-)10 7 I, 73v1,ch I /Poi
Applicant is: Owner XContractor
7 e of Work. Description of work: ' DrrG%f? T%
YPConstruction Cost: 5050° Multi-Family Building:(Yes /No )
Company:J'i i 71C,✓/ j/('�,V C O74W Contact:f(-�/4y diad fah
Contractor Address: (5A 3 7 L4/(r/i'rrd (h City: evr. &/
Staten Zip:S3-yi4 Phone7/o3:637 1/4"f Email:/ 0u" G41:4A�iJ✓( r'/dam,
Ucense#: BCO01S2 Z Lead Certificate ii:JM Z/y. 3
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:
Ucensed 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 notMcation from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaaan.comisubscribe.
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. Cell Gopher State One Call at(851)454-0002 for protection against underground utility damage. Call 48 hours before you
Intend to dig to receive locates of underground utilities. www.000herslateonecail.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 ap plan in the case of work which requires a review and approval of plans.
x )Ap ilea es ranted Name Ap. Ivan s/.na ure
f I6I s�3
Db NOT WRITE BELOW THIS LINE Ll VJ(e i S \ -I v c/
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) Lt Miscellaneous
01 of_Plex _ 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 X Repair _ Egress Window ^ Water Damage
—
Retaining Wall *Demolition of entire building—give PCA handout to applicant
—
DESCRIPTION
Valuation 3 2i_�_b'ad Occupancy' I MCES System
Plan Review Code Edition20t#A$NRC SAC Units
(25%_100%_J Zoning 12' I City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction V d Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O.Required
Footings(Addition) k 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: f�� ,Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Radio Meter Read
Copies
TOTAL
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