3766 Brown Bear TrINSPECTIQN RECORD
CITY OF EAGAN RERMIT TYPE:
38?0 Pilot Knob Road Permit Number:
?agan, Minnesota 55122-1897 Date Issued: .
(651) 681-4675
SITE ADDRESS: APPLICANT:
PERNIIT SUBTYPE:
TYPE OF 1NORK:
INSPECTION
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3zlo Permit Holder Date Telephone #
SEWER/
WATER
PLUMBING
HVAC p •7??p(1lj6e2
inspection Date Insp. Comments
FOOTINGS ?L/3
! ? ..
FOUND
FRAMING
dot (
( 4?J
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
<z i
GYP BOARD
FIREPLACE
FIREPLACE
AIRTEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLdG FINAL
DOMESTIC
METER
IRRIGATION
METER '
FLUSH
MAINS
caMaucrivirr
7E5T
HYDRdSTATIG
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
ni
?
f r tt ix issrs{?•li, i-ti : .t,i ? I:
(fer#ifiCate of Cecupancv
Kit4 of Cfagan
?e?rartraeut v? ?xitbing ?n???ectian ':.??j ?`{?
This Certificate issued pursuant to the requirements, vJE tiee Uniform Building Code
certifying that at the time of issuanee tfus structure was in compliance wirh the varrous
orriinances of the City regulating building co?srtruction or use. For the following:
Uu Qassificacion: SF'+ jLC SMg. Parmit No. 34M2
Type R3 7aning
Address
Address 3766 rsxcxatv EEAx LRAu, Zip 5512 3
I.ot i= Blk 'I Sub n.nnmar.nr :nuFCr
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECITON.
Date: Yes No Inspector: ?
Final gta e(6 from siding)
Permanent steps (garage)
Pecmanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
TraiUcurb damage
Porch
Basement Snish •
Deck
Please verify with the builder the removal of toof test caps from the plumbing system and the shutoff of water supply to
the ouuide lawn faucet before freeze potential exists.
ConMad engineering division at 681-4645 before working in rightof-way or instalGng underground spriakler system.
White - City Copy Yellow - Residenl Copy Pink - ConVactot Copy w
PERMIT
CITY OF EAGAN
3830 Pjlot Knob Road
'Eagan, Minnesota 55122-1897
(651)6814675
PERMIT TYPE:
Permit Number: B U I L D I N G
Date Issued: 0 3 4 0 8 2
.17.124 /98
SITE ADDRESS:
P.I.N.: 10-14325-150-03
3766 BROWN BEAh l"fi
LOT: 15 BLUCK: 3
BIflCKFIAWK FOREST
DESCRIPTION:
Bu: dinq"P?rmit 'iypF
Bpilding Wo'?k Tvpe
kY6C pcCUpancv \
Construction TY01Z o n i n q ??,---?
8uildinq Lenqth ?
8uildinq Widr,h
eulidin4 stnries?
fW-w.5 COde _
SF pWG
NFW
R-3
5N
R-1
72
32
`L
101 1 - FAM. DETACH
r-
v'_l??
REMARKS:
PLAN ftEVIEWED BY CRAIG NOVAI:7YK.
9& W PLl.IM6ER iS VALLEY pLUMBTNG PHOIVE ik492-2121.
FEE SUMMARY:
Base Fee
Plan Review
Surcharqe
SAC
SAC %
SAC Units
Subtotal
vALuArrori
$1,127.25
$732.71
$74.00
$1.000.00
1.0@
1
$2,933.96
$145.0(A0
MISC. FEES .50
1'ota7 Fee $4,526.46
CONTRACTOR: - Applicant: - 5r. L]:C. OWNER:
HOMES BY ChIASE 18955337 0001619 HOhIES BY CNASE
166^q E CLIFF ftCJ 1668 CL.TFF RO E
BURdSVSLI.E MN 55337 BURNSVILLE mN 55337
(612) 895--5337 (612)895-5337
F
I
T hereby acknowledge that I have read Y.hks So[rliCation and state that the
information is correct and aqree to comply with all applicable State oY Mn.
StaY.wtes and City of Eaqan.Ordir•ianr,es.
'APPLICANT11PERVITTEff S ATURE C,4SUED BY: SIGNATURE%
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
, - , CI1'Y OF EAC}AN
?? ?1 3830 PII.OT KNOS RD - 55122 ?-t• y, S-a ?? f
-7 681-4675
New Construdion Reauirements RemodeVReoair Requirements CA?
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plans (inGUde beam 8 window sizes; poured (ntl. design: etc.) • 2 site surveys (extarior addiUOns 8 dedcs)
? 1 energy calwlations ? 1 energy plculations far heated addkions'
? 3 copies of tree Dreservation plan N lot plalted after 711J93
required: _Yes _ No
DATE: CONSTRUCTION COST; f??? ?Ov
DESCRIPTION OF WORK:
STREET ADDRESS: `??? ,GJ ?l?GLo ?. i?2?Nx( ?i
LOT: ? BLOCK: ? SUBD.IP.I.D. #: 4?4??/??
Name:???iaa VVr-- Phone
PROPERi'Y Leat- Fi*st
OWNER
Street Address: i/
City State: ? Zip:
Company: _ Phone #: O /? 7 .? 2 ; 7
CONTRACTOR
Sveet Address: License #
City
State:
ARCHITECT/
ENGINEER Company: 117
Nacne: -- ,_
Street Address:
Ciry
State:
Sewer 8 water licensed plumber (new construction only): ?/???-+? /a'?lf? ???,r •
and lot change is requested once permit is issued.
C?
Penalty applies when address chang
2-1
I hereby acknowledge that I have read this application and state that the inTurtnation is correct and agree to comply with all applicabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicank
OFFICE USE ONLY
Certificates of Survey Received Z"?Yes _ No
Tree Preservation Plan Received - Yes _ZNo _
Zip:
Phone #:
Registration #: _
Zip:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwelling O 07 4-plex
? 03 SF Addition O 08 8-plex
? 04 SF Porch 0 09 12-plex
O 05 SF Misc. ? 10 = plex
WORK TYPE
? 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
? 11 Apt./Lodging ?
? 12 Multi RepaidRem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
? 15 Deck
O 36 Move
? 37 Demolition
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Misceilaneous
S-tj Basement sq. ft.
e7- Main level s
ft 20
o
/z MC/WS System
q.
.,
540 L.? sq- ft. .
6/ City Water
Fire Sprinklered
sq. ft. G42- PRV
S4• ff• Booster Pump
sq. ft. Census Code. .o
Footprint sq. ft. SAC Code D
Census Bldg /
Census Unit /
Building ? Engineering Variance
valuation: $ 7 /V
70
Planning
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pi.
Park Ded.
Trails Ded.
Other
Copies
Total:
°k SAC
SAC Units
/203XS"? ?
98/ X
1Pb75°==
u/!r07 Q .?..?.`.
52 °17?_°?
/ / D 7Z '?
.?
** *
* PIONEBA
* eng
* * *
*
Certificate of Survey for:
LAND VLFNNERS• UNDSCAPE MCNiTECTS 625 Highwoy 10 N.E.
Blaine, MN 55434
(612) 783-1880 FAX:783-1883
HOMES BY CHASE
3766 BROWN BEAR TRAIL
30
n
3
0
N
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?
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BR? ZRPA' 85:
0
e
o INV
sr
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,
? ?s3
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? BENCH MARK ?
? TOP OF PIPE ?e?
ELEV.=859.25
14
2422 Enterprise Drive
Mendota Heights, MN 55120
(612) 681-1914 FAX:681-9488
? ?
!r9
o ,a
%\3.y?? ' BENCH MARK
85 S'7 TOP OF PIPE
ELEV.=857.88
2q ?4 i?
s`? D•1?
858.9 16
858. ? y? SF?c
J. ? 858.5 859.0
Al
?
7 ?
Xasa.s
b•
?ooJ oo /
> 858.8 ?g5q.o? ?
--?85 .7
6 15
. /
?
\ \86:0\
?.
h?o r'
868.5
?A 9
T1':
NOTE: PROPOSED GRADES SHONN PER GRADING PLAN BY: SCHORLL k MADSON PROPOSE D HOUSE EL EVATION
NOTE: BUILOING DIMENSIONS SHOWN ARE F?t HORIZON7AL AnM `?R7ICAL LOCATION LOWEST FLOOR ELEVATION: SZ.
OF STRUCNRES ONLY. SEE ARCHITECTUAL PLANS FOR WILDING AND
nna+ oIMensIor+s
.
rauNO TOP OF BLOCK ELEVA710N:
NOIE: NO SPECIflC SqLS INVES71CA710N HAS BEEN C04PLETED ON 1MI5 LOT BY THE
ARAGE SLAB
ELEVATION:
SURVEYOR. THE SUITABIUTY OF SOILS TO SUPPOR7 THE SPEqFIC HOUSE G
PROPOSED IS NO7 iHE RESPONSIBIUiY OF THE SURVEYOR.
NOIE: TMIS CER7IFlCATE DOES NOT PURPORT TO SHOw pASEMENiS OTHER THAN % 000.00 DEN07E5 ExISnNC ELEVqnON
THOSE SHONN ON THE RECORDED PLAT. ( 000.00 ) DENOTES PROPOSEO ELEVA710N
DENOTES DRAINAGE ANU VTLITY EASEMENT
NOTE: CONTRACTOR MUST VERIFY ORIVEWAV DE4GN. - DENOlES DRAINAGE FLOW DIRECTION
NOTE: BEARINGS SHOWN ARE BpSED ON M7 ASSUMED UAIUM t OENOTES MONUMENT '
B DENOTES OFFSET HUB
WE HEREBY CERTIFY TO HOMES 8Y CHASE THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A
SURVEY OF THE BOUNDARIES OF:
LOT 15, BLOCK 3, BLACKHAWK FOREST
DAKOTA COUNTY, MINNESOTA
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR
UNDER MY DIRECT SUPERVISION THIS T DAY OF NOy.. 1998.
? U[ 5-? A ?(- 10 79y? SIG D: EER ENGINE ING, ?.A.
SCALE : 1 INCH = 30 FEET
BY: L
58 98540.00 SWK n C. Larson, L.S. Reg. No. 19828
17V
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LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMITqpPLICATION
PROPERTYLEGAL:
DATE OF SURVEY: ?
LATEST REVISION:
DOCUMENT STANDARDS
• Registered Land Surveyor signature and company
• Building PermitApplicant
• Legal description
• Address
• North arrow and scale
• House type (rembler, walkout, split w/o, split entry, lookout, etc.)
• Directional drainage arrows with slope/gradient %
• Proposed/exassting sewer and water services & invert elevation
• Street name
• Driveway
ELEVATIONS
r ?
y 0
?? ?
0% ?
• Sewer service (or Proposed)
• Properly comers
• Top of curb at the drnreway
• Elevations of any existing adjacent homes
CQ O •
D?p ? •
[3??0 ? •
g?j? ? .
6 0 0 •
?
? o-'O
? 0-` ?
? cr' ?
? [I"?
?/o ?
Ci/' ? ?
H ? ?
C] 'o ?
C? ? ?
? el-?
.
.
.
Prooosed
Garage floor
First floor
Lowest exposed elevation (walkout/window)
Property corners
Front and rear of home at the foundation
PONDING AREA fif apolicablel
Easement line
NWL
HWL
Pond # designation
Emergency Overflow Elevation
DIMENSIONS
Lot Iines/Bearings 8 dimensions
Right-of-way and street width (to back of curb)
Proposed home dimensions including any proposed decks, overhangs greater than 2',
porches, etc. (.e. all structures requidng permanent footings)
Show all easements of record and any City utilfies within those easements
Setbacks of proposed structure and sideyard setback of adjacent ebsting structures
Retaining wall
Reviewed:
January 1996
CRAIG19Bflf8LDGPRMr FM
I . 1& 2 Family Residential "Cookbook" Methoa
.
SI'fE ADDRE55
-
Gty ?
Y
776,? ?
BUILDER
,r3 Y Date
Minimum Criteria:
Rim Joisc R-19 insulation Foundaton wndows: Insulated glass. 12" air space, uood ar vinyl 6amc
FnM„ d?rt- 1?/? inch solid wood with stotm or better
STEP 1 Window & DoorArea
Total Window 8t Door Area in Sq. Feet
WINDOWS (including fouadation windows):
Dimensions Qnty. Area
X .
?
x (v. U
° x c:+
.? X
1?7 °' x
x
3 ° X ° ? . 0
` x
c?x
x u
x
DOORS_
3
b x
x
Total Area of
Window & Doors
Total Wall Area in Sq. FL
Wall Total Perimeter Height Area
?
175Y
Total Area
.,r.,,5n B
STEP 2 Calcnlate atea as a percent of wall
Box A(window & door area) divided by Boz B(total
wall area) times 100 equals [he window and door area
as a percent of wall area (Boz G).
BozA ?la07 ff!N
z 100 BoxB fl7G?/,.3
STEP 3 Design Features
ASSEMBLY OPT'IOV
FxaME wALL:
STANDARD FRAbtIIQG ?
ADVANCED FRAMING
cnvrryr uNstnAnorr R- q'
SHFATENG: L.ESS THAN R-5 ?
R-S OR DSORE
WBJDOWS (except foundation windows):
U-FACTOR
From the table, determine the maY;mum percent window
& door area for the design options selected and enter the
value in boz D below:
Boz C must be less than or equal to Box D
F. The building must not exceed the maximum wuidow and door area as a
percentage of overall exposed wall area listed below for the combination
of framing technique, R-value of insulaHon within the insulated cavity,
sheathing R-value, and window U-factor. Other components must meet
the requirements of this subpart.
MAxMLTM WINDOW AND DOOR A1tEA
AS A PQtCENT OF OVERALL EXPOSED WALL
Cavity
Window
STANDARD : . . ._. R 13 ' • ' ; , 2R-7 .. ., 13.4% .. -17.8% 21.30/ o 24.3%
STANDARD R-15 2R-5 129% .
17.1% 20.1% 23.4°0
STANi3ARD,',.:-"
, -'--,R-18?'. .`:-
<
< <R-S _.,11.1%` ` ;16.0%-
' 1&8% 22
09'0
STANDARD .
.._, ? ?. .
__.?
R-18 ....
2It-5
13.5%? ,
_
?? 18.6% ;
21.8% .
25.3°0
ADVA.NCED R=18..:', ,. - <R-5.. il.l% 17.1% ?. ' 20.1% 23.4%
ADVANCED R-18 2R-5 13.5% 19.29'0 22.5% 26.1°0
STANDARD <R-5. ,>: "• ` . µs.:ll_8%-` ' `° 17.U°lo' . 19.9% 23.1%
STANDARD R-21 2R-5 14.0% 19.3% 22.5% 26.1%
ADVANCED R-21 <R 5 " 18.19'0 21.20/a 24.6%
ADVANCED R-21 2R-5 14.0% 19.9% 23.2qo 26.9%
Subp. 3. Performance criteria. The combined thermal transmittance (Uo)
factors for walls, roof/ceilings, and floors over unheated spaces must be less than or
equal to:
A. 0.110 Btu/h ftz °F for walls;
B. 0.026 Btu/h ft2 °F for roof/ceilings; and
C 0.04 Btu/h ft2 °F for floors.
STAT AUTH: MS § 216C.19
HIST: 18 SR 2361
7670.0480 Repealed, 28 SR 2361
/
Minn. Ru1es Chapter 7670 26 Jwie 1994
F u'?671? 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
Now ConShucMon ReauiremeMs ??r /7Lh?- 1?507 RemodeUReoair Reaidremenis
Pi '
S registoretl slfe surveys ahowing cq. It. of lot, aq. ft. of house
and ? rooted areas t2096 moximum lot covemae allowedf ?" ??' ? O
2 copies ol plans (stww beam & window sizes; pouretl fnd. tleslgn; etc.)
t aet m energy cmculations
S coples of hee preservatfon pian il bi plaNed aRer 7(1/93
DATE:
2 cople8 of PIUn
t sef of energy CalCUtaNOns for heated adtllHOna
t sNe survay lor extedor aqdifions & decks
CONSTRUCTION COST:
DESCRIPTION OF WORK: /V X/'Y rZfAnD DBC..I" It mulN-famfly bidg., how many units?
STREET ADDRESS: 37G4 "O&wBEQ.C J72A/L
LOT: A-5_ BLOCK: J SUBD./P.I.D. N: Blrckhawk Fnrect
PROPERTY
OWNER
CONiRACTOR
ARCHITECT/
ENGINEER
Name: G01Y6 yoiY6AI1516 Phone t: l S/• l8G • 7.?SCS
Lasf Firat
Sheet Address: 3 7G G?/?/JIrY R6•4! TX.4/C
cny E??4N srate: np: SS/1?.7
Company: Pnone a: 7G3. 7Ld •:fnlO
(area code)
Sheet Address: .? S/G d/ F?S ST Llcense # 9608G880 V. 3 3/ .?do!
CNy /,SANT/ state: /`94 Zip: 5.S6 S1D
Company: Name:
Telephone #: (
Sheet Address: ReglshaNon #:
citY
State:
Sewerfwater licensed plumber (ff instaliirw sewerlwater): Phone #:
Zip:
I hsreby acknowledge fhaf I have read this applicaNOn, stote Mat Me fnformation Is correct, and agree to cwmpy wNh atl applieable Ske
of Minneaota Statutes and CNy of Eagan Ordinances.
Sfgnolure of Applicant:
OFFICE USE ONLY
Certificates of Survey Received Yes _ No JUL I 0
Tree Preservation Plan Received _ Yes _ No ?Not Requi2d A
$ bU.w0
C41Ied 7/Itla
Rw
r -,
OFFICE USE ONLY
BUILDING PERMIT 5UBTYPE5
O Ot Foundation O 07 05-piex
? 02 SF Dwelling ? OS 06-plex
0 03 01 of _ plex O 09 07-plex
O 04 02-plex ? 10 OB-Plex
O 05 03-plex p 17 10-plex
O 06 04-Plex ? 12 12-plex
WORK TYPE
M 31 New
[3 32 Addition
O 33 Alteration
O 34 Repair
O 13 16-plex
0 17 Garage
Eff 18 Deck
? 19 Lower Level
Plbg _Y or _ N
? 20 Pool
p 21 Poroh (3sea.)
O 22 PoreNAddn. (4sea.)
O 23 Porch (screened)
? 24 Storm Damage
p 25 Miscetlaneous
0 30 Accessory Bldg.
O 36 Move Bldg. O 43 Reroof
E3 37 Oernolish (Bldg)' ? 44 Siding
? 38 Demolish (Interror) E3 45 Fire Repair
O 42 Demolish (Foundation) [3 46 WindowslDoors
` Giye PCA handout ta applicant for demolftlon permit
GENERAL INFORMATION
SAC Code 0/
No. of Units O
No. of Buildings
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq.ft.
MISCELLANEOUS INSPECTIONS
O Stucco/Stone
APPROVALS
sq.ft.
sq. ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Planning Building -4L Engineering Variance
Permit Fee Valuation:
Surcharge
Plan Review
License
MC/ES SAC
City SAC Water Conn.
Water Meter
Acct. Deposit
S/W Permit
5/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
? 31 Ext Att - Muw
? 33 Ext. Alt - SF
? 36 Multi
?
SAC Units
% SAC
0
Gt.
m
?
0
m
?
cn
?
a
¢
?
a
?
0
0
0
0
N
I
CD
I
r
¢
?
aauSMrm er HM WM,?, INL
N
?
S E
SITE PLAN
c1'A! F• 1' = N
YffiM $ FWVMI UlL'i : Cl6TIM NAhE
3`16b BRM BEAR TRAL : STWEf
EA6AM, I4l 5fi'122 : QIY
65I686-780 : FIOFE PtCiE
t61W-8671 : WOM PNX
14' X 44' TREAIED [m( : CUWTR'.CTQ! TYPE
EIAPI FU : PRDECT MM"
OY[I IYtlO : 11f11WN Ol
5r}pp : UATf
-A1 - ?
?
MA1 BEM TW
V ' CTI'Y USE ONLY
LOT _/,f_ BL ? RECEIPT it:
SUBA RECEIPT DATE: ??i'?•? f /
1998 MEcxMccAL PERMrr tREsinErrriAw
crrY oF r.Aem
S$SO PILOT KRO$ RD
EAHAN MIY 551 YP
Date: 1 d``? '? g (618) 6$1,4678
Complete this section onlv if you are instailing HVAC in single family, townhomes or condos under
construction and not owner /occupied '
• HVAC: 0-100 M B T U $ 24.00
ADDITIONAL 50 M BTU 6.00
• Gas outlets ( minimum of one required @$3.00 ea.) G,w
• State Surcharge: .50
• TOTAL: 3(o - So
Complete this section onlv if you aze remodeling, adding to, or repairing existing single family dwellings,
townhomes, or condos. Note: Mechanical permit is not reauire d for alteration/add-on to ductwork in
existing residential units; but is required for the following:
_ Install furnace _ Install air conditioning
_ Install air exchanger, i.e. Vanee system, etc. _ Other
Minimum fee applies to sii remadei or add-ons of eatis:ing residences v 23.00
State Surcharge .50
Total: $ 20.50
SITE ADDRESS:
OWNER NAME: VAA?-?
INSTALLER NAME:
STREET ADDRESS:
CITY:
/
ATE: ?j ZIP:
SIGNATURE OF PERMITTEE
PHONE#:
PHO?NEf#:
JS/FORMS BLD/MECH PERhIIT (RES) - 1999
? n
L? BL ? CITY USE ONLY ?CEIPT#: ?f??5d
SUBD. ? ?, L ItA,j RECEIPT DATE:
1998 PLUI+BING PERMIT (RESIDENTIAL)
CITx OF &AGAH
3830 PIIAT FINOB RD
EAGAN, 2M1 55122
(612) 681-4675
Please complete for: ? single famity dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinklersystem
FIXTURES EACH # TOTAL
Shower 3.00 x
Water Closet 3.00 x
Bath Tub 3.00 x I._
Lavatory 3.00 x 3 = ?
Kitchen Sink 3.00 x
Laundry Tray 3.00 x
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x
Floor Drain 3.00 x
Gas Piping Outlet ' minimum - t 3.00 x I_
Rough Openings 1.50 x =
Water Softener ' for dwellings under construc[ion 5.00 x =
Water Sottener ' for existing dwelling 20.00 x =
U.G. Sprinklef ' for dwelling under const. 3.00 =
U.G. Sprinkler ' forexisting dwelling 20.00 =
Alterations ' to existing residence 20.00 =
Water Tum Around 20.00 =
Private Disposal System • MPC iic. 75.00 =
(new and refurbished systems)
Private Disposal Systems ' Abandonment 20.00 =
_op, .50
STATE SURCHARGE ,
TOTAL `v""`
'zo? •Sv
-------------------------------------------------------....------•-• •------•------
I hereby ecknaxAedge that 1 have read this application, state that the iMormaHon is conect, and agree compty with all epplica6le Cily of Eagan ordinances.
It ia the applicanPs responsibility to notify the property owner that the CKy of Eagan assumes no liability for any demages caused by the Ciry during its
normal operedonal and maintenance activBies W Ne facilities construd der this pertnk within City property/right-of-way/easement.
SITE ADDRESS: '? V`+' ? f u c? ? ?&/-
OWNER NAME:
INSTALLER NAME: V -, TELEPHONE #:
STREET ADDRESS: O4 U ? ? ? ?. ?? ? ?
CITY: 7 d f_J A' STATE: ZIP: SS 3 T ?
SIGNATURE OF PERMITTEE
JSlFORMS BLDGJPLBG PERMIT (RESIDENTIAL) 1998
n
- - - - - - - - - - - - - - - - -
~or 01
lice Use
City of EPermit
U JUN 2 2 2009 I
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff:
2009 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: O Site Address: 5 / bG t 'Own B'ecLr
Tenant: Suite
RESIDENT/OWNER Name: O oct h f h Phone: (oF5I 7 2--50
Address / City / Zip: ~J l.t,~ 7 Cc ~1 5 S ( 22
CONTRACTOR Name: License O ~ / L y Pitt
Gbomplon
Address: 65 3864340
City: 3670 OW At 0100 State: Zip:
Phone: Contact Person: LS lJ
TYPE OF WORK -New _/Replacement _Repair Rebuild CC,^ Modify Space _ Work in R.O.W.
3o
Description of work: Lt)
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
RPZ PVB) _ Main _ Lower Level)
Septic System Water Turnaround
_ New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
*Water Turnaround (add $165.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
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 C2- -0-uor x~
Applicant's Printed N e Applicant's a ure FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-in Air Test Gas Test Final
39 c^~ 5
Use BLUE or BLACK Ink
r
For Office Use j~
I V~~ I
non
City of Ea~tl Permit#: I Permit Fee: LOG 1
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
I
Fax: (651) 675-5694 I Staff: I
I
/ 2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
6//C - J `
i Name: aJ c. r"b D f} Phone:
Resident/
Owner Address / City I Zip: ,3 t~ ,d
Applicant is: 4 Owner Contractor
Type of Work ' Description of work: pT 9
Construction Cost. Building: (Yes / No
Company: /2 e' 11Contact: x /
Address: Cit : ~~j ~ C.G(/`
~ Contractor ~State: Zip: V~S11/d Phone: Zy- -.7
i
License #:,6CZ9,13 j~ 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 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.
- - - - - -
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.org
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 issua/n~c//e.
x bnA/t'_1 / L xk4~:O1
Applicant's Printed Name Applicant's Sign ure
Page 1 of 3
Jan 30 14 12:01 p
AA Garage Door
651-702-0838
p.1
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. lwrw.aooherstateonecall.ora
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.
xDeboioM I�'JaC
Applicant's Printed Namg
t) �i�
jij,Jii
Applicant's Signature
Page 1 of 3
Use BLUE or BLACK Ink
For Office Use %� �,�/'�[I
Permit#: 1City
of EaaR�p.a�
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122
Date Received:
Phone: (651) 675-5675
Staff:
Fax: (651) 675-5694
2014 RESIDENTIAL
Date: 30 /14 Site Address: 31/ (.(',LP
L
BUILDING PERMIT APPLICATION
3r&oi bear -rrL Unit #:
!
Resident/
Phone:
jL fi 1 L ( s i hi 0 CO/:�-R 07' 3VGC
Name:. -
II �r (til, 1
Address / City /Zip: .37 t12 urr I "1�r Yl tf ar l'r`
a"9i2t1 , 1t 5 J
/
Applicant is: Owner�_Contractor
i Type of Work
Description of work I pi QC'e_.r p (i c+1 i1) QV1 i�Ad ad I�Glr ci alf
Construction Cost $ 800. 0d) Multi -Family Building: (Yes / No )
Ii
Contractor
)
Company: :
f
� 71&C(c No{ Contact: .I
/eh J v y asciL A '
Address: t 01 C`�T/c f L/ City: l� � 4a I -NI&
State: f4I - Zip: '5) + Phone. l E,���� rgl. 7l1)?r
License #: Lead Certificate #: LS - I Lf 7g -q;
i
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
i
s
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
i
( In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
i
r
If yes, date and address of master plan:
_Yes _No
Licensed Plumber: Phone:
x.
Mechanical Contractor: Phone:
t
Sewer & Water Contractor:
Phone:
NOTE: Plans and supporting documents thf t you submit are considered to be public information. Portions of
i the information maybe classified as non-public if you provide specific reasons that would permit the City to
concl�de that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. lwrw.aooherstateonecall.ora
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.
xDeboioM I�'JaC
Applicant's Printed Namg
t) �i�
jij,Jii
Applicant's Signature
Page 1 of 3
r ' Use BLUE or BLACK Ink
r—————————————————�
I For Office Use �
' � Permit#: � � ��� ����
Clty of ���a� �� ; . ;
Permit Fee: �+
3830 Pilot Knob Road I /� `�/S �
Eagan MN 55122 -- � Date Received: �-� �
Phone: (651)675-5675 I I
Fax: (651)675-5694 ��y��. .� �� �,,, I Staff: I
� --------� I
2015 RE � '��
SIDENTIAL BUILDING PER��IIT APPLICATION �,�
Date: �m �S Site Address: ��'�� �Y'1 ��C' �� \ �� Unit#: ��
� : �� �: �� , Name: �ct�r�,`��� ���vY10,�'l �' �� 1 Z� ZO°�3�10�
�� Phone:
���i{��:�
�"����11�C't��`� Address/City/Zip: ���� �-�`L�-�,�`Y�� _�c�+�( < < � � ��1(,�.Y'1 Y/'��
e� SSI 2-"�
;�, �: Applicant is: wner Contractor
.'•>i�o a:�:
���
� ����� Descriptionofwork: �e�P��cR.. "�t�.--�- �-�-"�'<� d�+C� � �i�-�i�Cv'f � i`{-�
� �'� � Q\�`� = C�2 u� i'�� c�.ea�!T�-��R�i
���, ,�� a�„ Construction Cost:Qw��l 1 a c� Multi-Family Building: (Yes I No�
� �
����`,°� ������� ����,
a; � ��� Com an : Contact:
�\ � ����� p Y -
� ' � �
� �,�r��,���� Address: _City:
���a` `' a
���\ � � � State: Zip: Phone: Email:
� � ��
�� ��. I
,, ��, 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 b;ased on a master plan?
Yes No If yes, date and address of master p n:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
� N� F���€�s�r��I� p ���ng��� �r��tt��t�rc�c���r , r�" ,srd'�r� � ���r ���far � tfc�n ���,��� ��f`
��`;�e���rm �n►»�y b� ssrfi�d �r��' � ��Ef yo�r�rrc� "��p��fic re �� ��v`ct�rld p��r�� ��rty tt�
�. .
� � ���� ��ac ��
�`�`' �' a.. :.�.. .,... �. . ...��.. " � �f#�.. ,,, �., s'��'��` '�' .����54C � �...
: ,
�; �
�
�, . „ „
�..,'....
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. o herstateonecall.or
9 p 9
I hereby acknowledge that this information is complete and accurate;that the work will be in coinformance 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 i:s 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 pdans.
Exterior work authorized by a building permit issued in accordance with the Min St��te Building Code must be completed within 180
days of permit issuance. ,�
x �.�P � ��r�-�r� x �
ApplicanYs Printed Name Applicant';>Signature
Page 1 of 3
c�/
,
� DO NOT WRITE BELOW THIS L.INE �� C�L�J� /
SUB TYPES Z�(_p C�p �1��`�h ���� ��
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
_ 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 f� Occupancy �� MCES System ""'
Plan Review � Code Edition !"� SAC Units �—.
0 0
(25/o_ 100/o_) Zoning �--! City Water —^
Census Code $L{ Stories �—' Booster Pump �
#of Units � Square Feet �"" PRV ._...
#of Buildings 1 Length ` Fire Suppression Required --
Type of Construction � Width --
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) �L Final/No C:.O. Required
Foundation HVAC Gas Service Test Gas Line Air Test
Roof:_Ice &Water _Final Pool:_Fc�otings _Air/Gas Tests _Final
� Framing Drain Tile
Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick
Insulation � Windows
Sheathing Retaining WaIL•_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire SupprE:ssion:_Rough In_Final
Braced Walls Erosion Control
,/�l Other:
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee �'f °�
Surcharge ,
Plan Review ',33,,,��.--
MCES SAC
City SAC
Utility Connection Charge
S8�W Permit 8�Surcharge
Treatment Plant
Copies /Q� " �
TOTAL
Page 2 of 3
For Office UsseeI
„, ® ,�® Permit#: / / � �
.., EAGAN
Permit Fee:
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff:
buildinginspections(a�cityofeagan.com L
2018 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: --S-a A-- \ 'il Site Address: —8'cb F' ) L`--( T r
Tenant: Suite#:
Name: �� Phone:
lac$ - r
{ent/ Witerl;
' Address/City/Zip:
'44. w
4. 4 ,
Name: License#:
4# ,7t
Contractor v
Address: City:
;- State: Zip: Phone:
�urn Contact: Email:
„;n New Replacement —Repair Rebuild —Modify Space Work in R.O.W.
4 Type adf Work ---
— —
– '---) .7L-4
- .� �= �
Description of work:
4 } m � RESIDENTIAL
; Water Heater
44.4 .4Water Softener
t t Lawn Irrigation(—RPZ/—PVB)
rmitType ,
,,. x Septic System Add Plumbing Fixtures( Main/—Lower Level)
4
' Water Turnaround
;. New
,,$,, , Abandonment
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 System Abandonment, Water Turnaround*(includes State Surcharge)
*Water Turnaround(add$280.00 if a 3/4"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$
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.00pherstateonecall.orq
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.citvofeagan.com/subscribe.
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
Ea•.•• 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
a Gordan.-(1 the approved 'an in the case of work which requires a review and approval of plans.
x �,_'Si , - kfO,� x ir\ 1,
Applicant's Printed Name Applicant's Signature
Ol F'FICE Woe u Reviewed B9,1:7.5;,,, , rat ' 44:tea
Requiredle : w yeder Ground ; Rd :6p-In Air, e :.1..F. =s Test �e Fin *xx
,Meter Related Items � ,
11llerize� x � actio ReedManometer r f � .; Y:.
till
For Office Use
tt i i s pa Permit#: ( 176 /1
y► •�',, ,„, E AGA N
Permit Fee: // 6-
/ /�
RELIEVED Date Received:
�,
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX: (651)675-5694 Staff: ; ie
buildinginspections(c�cityofeagan.com ��� 1 8 LU18 L
2018� RESIDENTIAL BUILDING PERMIT APPLICATION
Q-� y
Date: .3- 1 0 Site Address: Unit#:
.1 Name: pack'(\ () k c Pin 0 rTh Phone: (D 14 -ca.-.4.-3 N5
Resident/ 3 =�-
Owner Address/City/Zip: tom, R{ C
i '',7---T.--
t
Applicant is: Owner Contractor
Description of work .'hr.s.SL � 1^l_ SAti ,,e,24 ki-E
Type of Work ).
v+ Construction Cost: '"x t 0(:)r) 1v O c2.,t, Multi-Family Building:(Yes /N
{
n 5i Company: 52 \. Contact:
Contractor
Address: _
x
,,-;.x'': ' State: Zip: Phone: Email:
License#: 0 Lead Certificate#: Ai t —
If the project is exempt from lead certification, please explain why:
. \Jr-- 1c c X14
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a imilar plan based on a ma plan?
Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contra Phone:
Fire Suppression Contractor: Phone:
NOTE:Plans and supporting documents that you s bmit areco#sidered to be , 8">.•rtio»s,of the inforMation may be '
classified as non-public if you provide specific reas ns that:vould permit, - f. . to a .4,.$..$®., 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.citvofeagan.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 appro al of plans. ti
x ...---''' Y\. -1 ' x - A
Applicant's Printed Name Applicant's Signature
DO NOT WRITE BELOW THIS LINE — — 22 (23 `�' /q 7e' 5
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 �L 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 tt
Valuation q Occupancy ,4,�L/V MCES System
Plan Review Code Edition v,j1 I "--- SAC Units
(25%_100%"*) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction v-19, 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 X HVAC_Gas Service Test Gas Line Air Test
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
`c 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: i._ , Building Inspector
RESIDENTIAL FEES (IBase Fee ��/ ficiA��
Surcharge _
Plan Review 709 0 420 - 7 /, vtrd
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA162482
Date Issued:07/15/2020
Permit Category:ePermit
Site Address: 3766 Brown Bear Tr
Lot:15 Block: 3 Addition: Blackhawk Forest
PID:10-14325-03-150
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Daniel Simon
3766 Brown Bear Tr
Eagan MN 55122
Applicant/Permitee: Signature Issued By: Signature