3758 Brown Bear Tr
INSPECTION RECORD
Cfi-Y OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road ;
Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT: w
Q,4 yi. 'r Y:.a• ! F iii} 'w
}
, r
PERMIT SUBTYPE: TYPE OF WORK: off f r
INSPECTION INSPECTION TYPE DATE INSPTR. DATE INSPTR.
l
Permit No. Permit Holder Date Telephone #
ELECTRIC
PLUMBING or
a~~l
HVAC / 0&6
Inspection ate Insp. Comments
FOOTINGS
FOUND L~
f f
FRAMING
ROOFING
I
ROUGH
PLUMBING L
PLBG
AIR TEST l L
ROUGH
HEATING
GAS SVC
TEST
INSUL/~ll~rf~
GYPBOARD
FIREPLACE I
1
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG t(
SAT
TEST
TEST
BLDG FINAL J- an!
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
a
y (fie #CatC o CC"aw a
(it4 of Waga-n
Tepa~t cut of 'Zoming anbo On
J
This Certificate issued pursuant to the requirements of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following.
SF DWG 31198
Use Classification. Bldg. Permit Na
R-3 U-1 R-1 Vn
j. Occupancy Type Zoning District Type Const. .r
l
Owner of Building MAPLEWOOD DEV & CO T 3030 GRANADA AVE N., OAKDALE MN
r
3758 BROWV BEAR TR L17, B3, BLACKHAWK FOREST ,
Bwldrng Address Loality q.
Date:
,Blinding Off sf~ z
POST IN A CONSPICUOUS PLACE
'i
Address 3758 BROWN BEAR TR Zip 5512?
Lot I1 Blk 3 Sub BLA-MAWK FOREST
THESE ITEMS WERE / RE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: `J Yes No Inspector: T
Final grade (6" from siding)
Permanent steps (garage)'
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
Trail/curb damage
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shutoff of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
CITY OF EAGAN PERMIT
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 / Permit Number: 031190
(612) 681-4675 !l Date Issued: 12/17/97
SITE ADDRESS:
3758 BROWN BEAR TR
LOT: 17 BLOCK: 3
BLACKHAWK FOREST
P.I.N.: 10-14325-170-03
DESCRIPTION:
ilding~,ermit Type SF DWG
Building Wowc,j~ Type NEW
UOC Occupanoy, R-3 U-1
Construction Tye V-N
Z.onir4g a;, ,4 R-1
I~ BuiladingJ Length,-. 64
B>aildin ~Wi tK54
Bvilding tci;rie5` 1
"Sq~hi'e Feet s 2,556
Cei~sLCtle 101 1 - FAM. DETACH
4 ~ V_W 0-
C36 C rL
REMARKS:
PRV S & W PLBR - WOODBURY MECH
FEE SUMMARY:
VALUATION $132,000
Base Fee $1,047.25 MISCELLANEOUS $1,539.50
Plan Review $680.71 Total Fee $4,283.46
Surcharge $66.00
SAC $950.00
SAC % 100
SAC Units 1
Subtotal $2,743.96
CONTRACTOR: - Applicant - ST. LIC OWNER:
MAPLEW00D DEV/CONST INC 17776869 0001011 MAPLEW00D DEV & CONST
3030 GRANADA AVE N A 3030 GRANADA AVE N A
OAKDALE MN 55128 OAKDALE MN 55128
(612) 777-6869 (612)777-6869
i herebyf acknowledge that. hay's t ead'i him( a(5'piig'atibh cladat` th;ert ti's rr,
information is correct:and,,agree to comply with all applicable State of'Mn.
Sta"WM~/ y 'of Eaja-Ord3nahces:.-
L-
W
~~p
E SIGNATURE ISSUE URE M d
5~~ jqo CITY OF EAGAN a
3830 PILOT KNOB RD - 55122 6 1.
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675,~~tl~' I
New Construction Reaulrements RemodetiRmair Reaufrements
♦ 3 registered site surveys ♦ 2 copies of plan
♦ 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ♦ 2 site surveys (exterior additions & decks)
♦ I energy calculations ♦ I energy calculations for heated additions
♦ 3 copies of tree preservation plan Slot platted after 711/93
required: _Yes _ No
DATE: 10/24/97 CONSTRUCTION COST: 640,, Le
DESCRIPTION OF WORK:
13-7SK
STREET ADDRESS: 3r Brown Bear Trail
LOT k~~7 BLOCK 3 SUBD./P.I.D. Blackhawk Forest
PROPERTY Name: same as contractor Phone M
OWNER WT rwsr
Street Address-
City: State: Zip:
CONTRACTOR Company: Maplewood Development & Constructi¢i!t one 777-6869
Street Address: 3030 Granada Ave. N., suite ALicense#:_g93S3
City: Oakdale State: MN- Zip: 55128
ARCHITECTI Company: same as contractor Phone
ENGINEER
Name: Registration
Street Address*
City; State: Zip:
Sewer & water licensed plumber: Woodbury Mechanical Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the ' on is r and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: _
OFFICE USE ONLY
Certificates of Survey Received L, Yes N 2 d W7
Tree Preservation Plan Received Yes _v No jT 1
4~
OFFICE USE ONLY
4t.* ~ ~ 'r A
BUILDING PERMIT TYPE
❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish
02 SF Dwelling ❑ 07 4-piex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool
03 SF Addition ❑ 08 8-piex ❑ 13 Garage/Accessory ❑ 20 Public Facility
❑ 04 SF Porch ❑ 09 12-piex ❑ 14 Fireplace ❑ 21 Miscellaneous
❑ 05 SF Misc. ❑ 10 _-plex ❑ 15 Deck
WORK TYPE
31 New ❑ 33 Alterations ❑ 36 Move
32 Addition ❑ 34 Repair ❑ 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MCNVS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning KT- sq. ft. PRV
# of Stories sq, ft. Booster Pump
Length sq. ft. Census de. 101
Depth tF Footprint sq. ft. SAC Code
2-s
Census Bldg
Census Unit i
APPROVALS
Planning Building Cf Engineering Variance
Permit Fee Valuation: $ 15-2-)000.00
Surcharge
Plan Review
~ryryll~~~~ / \
License ~UW=7Nti'?4ED
MCNVS SAC I (~`d X Imo- 2 ' 3~•Oa
City SAC
Water Conn.
Water Meter S1~1L1~(z'
Acct. I
Deposit
SNV Permit I X I~2h~to. 00
SAN Surcharge
Treatment PI.
Road Unit ~Y+IZI
l (o ' I 204
Trails DDed. M24
Other
Copies
Total: Y
% sac
SAC Units I
i.
612 546 9065
70+ : SCHOELL & MPOSON 612 546 9065 1997,12-17 09:49 #37S P.02/02
SURVEY FOR: MAPLEWOOD DEVELOPMENT 61302-206 532/34
MMM~
(85.85)
Lot 17Blaekloek 3, 9.04KMAyA( FOREST SCNOELL & MAOSON, INC.
aw.son . Mjgk%pq . MWwae
6nc TEPME . DAMMOrM Offift ~
BENC - - dales wMAO SMAMMM SUM I
Tap of iron monument as shown
767os
40 re.crarew w
+a1 say ~eor r_~
Elevation = 857.30 (NGYO-1929) 1
j
J
ADDS=
3758 Brown Bear Trail This droving has been chaeked and
reviewed that 1 day of
E~- 19 ,
sus sw. by .r
eetwnlasr
Q
I hereby certify that
~ under my n and that this survey was
eiA"10101ta°~` a r am o Lleer~an Land Survwyar under the
Q' lows of the State of Minnesota,
Atft Theodore O. Kemna
Date: 16 DEC 1997 License 0❑No. 17005
E,
.jam ~ p'b a
vz~
41 ~,p
Al \ e y /
°s . -Denotes Iron monument.
2. x890.0 - Denotes eamting spot elevation.
0 3. x(890.0) - Denotes proposed spot *Woation.
-Denotes direction of surface drainage.
PV, H LE
5. Proposed garage floor elevation - 857.4 o m a -11 Lam j ti a
LL DROP GARAGE 2 COURSES
^ S. Proposed basement floor elevation - 831.3
S Proposed basement floor elevation - 856.0
7. Proposed bop of foundation elevation - 859.1
30 0 30 60 90 Feet
w
LOT SURVEY CHECKLIST FOR RESIDENTIAL
' BUILDING PERMIT APPLICATION PROPERTY LEGAL:
/_~'S
DATE OF SURVEY: 7
LATEST REVISION:
DOCUMENT STANDARDS
i:~ ❑ • Registered Land Surveyor signature and company
❑ Building Permit Applicant
ffO ❑ • Legal description
❑ • Address
[~~I ❑ • North arrow and scale
❑ ❑ • House type (rambler, walkout, split w/o, split entry, lookout, etc.)
0❑ ❑ • Directional drainage arrows with slope/gradient %
121"~'13 ❑ • Proposed/existing sewer and water services & Invert elevation
qi❑ ❑ Street name
C-'❑ ❑ • Driveway
ELEVATIONS
/ Existina
[Y/ ❑ ❑ • Sewer service (or Proposed)
eT ❑ ❑ • Property comers
❑ ❑ • Top of curb at the driveway
0---~13 ❑ • Elevations of any existing adjacent homes
Proposed
❑ ❑ • Garage floor
[P-~ ❑ ❑ First floor
or' ❑ ❑ Lowest exposed elevation (walkout/window)
❑ • Property comers
[a ❑ ❑ • Front and rear of home at the foundation
PONDING AREA (if applicable)
❑ [2" ❑ • Easement line
❑ R3 ❑ • NWL
❑ er' ❑ • HWL
❑ ❑ Pond # designation
❑ ❑ • Emergency Overflow Elevation
DIMENSIONS
WW❑ 2r • Lot lines/Bearings & dimensions
i ' ❑ ❑ • 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 requiring permanent footings)
0 ❑ ❑ • Show all easements of record and any City utilities within those easements
❑ ❑ • Setbacks of proposed structure and sideyard setback of adjacent existing structures
❑ a,--0- • Retaining wall requirements, if any
Reviewed: Z~z Z 7
Na e ! ate /
Jamiary1996
CRP1019a818L0GPRMr.FM
`If` • EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION - 1 1
OWNER
SITE ADDRESS
CONTRACTOR DATE PHONE
Determine working square footage of each.
1. Total exposed wall area 1f370 sq, ft. X II 2 ,
2. Total roof/ceiling area sq. ft. X , ril.Cv -
A. Total wall window area 14-4-
B. Total door area ~g
C. Total sliding glass door area
D. Total fireplace wall area
E. Total wall framing area (average 10%)........... ) c~f3
F. Total Rim joist area 1
G. Total Net wall area above floor
Total exposed foundation area - ( 4$
H. Total foundation window area !o
1. Total net foundation area above grade........... 14-1-
Determine "U" value of each wall segment.
a. 4 4 _ X "D" b ,57 -
b- 25A X "U" 17 3 CP -A da C., X "U
d. X "U" 7 =
x 4-
e. JJF
X "U., o = 7, 1
SeL. 4
e•_ l v x "a., .04
h• Cr X "D"
t. 142 X "U" a 3 I S• 5
3 ...................................Total 2~- Q
If item #3 is the same as, or less than item #1, you have met the intent of
SBC 6006(c)2.
_ l'
Total exposed roof/ceiling area a ) 33g -
j. Total skylight area
k. Total roof/ceiling framing area (average 10%)...... -1 24.
1. Total net insulated roof/ceiling area ) 2b
Determine "U" value for~^each roof/ceiling segment.
i x "U" 7 sJ
x sun y yZ `Zj. Co
l._ .1 7.,94 X SUN f32Z 2~. 4$
4 Total 3) .1 °
If total of R4 is the same as, or less than /2, you have met the intent of
SBC 6006(c)l.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the
sum of items 13 and 84 shall not be greater than the sum of items tl and i2.
1._ 2aS 7 +2. ~Sj 240,49
3. Zd?, e .+4.-
31 . ► 235,
t3'2t~~g✓ r-v~r,k~,~ ri,~s,~1g '
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) as--
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681.4675
New Construction Reaukemenh Remodel/Repair Requirements
D 3 registered site surveys showing sq. it. of lot, sq. ff. of house 2 copies of plan
and gy roofed areas f20% maximum lot coveroae allowed) 1 set of energy calculations for heated additions
2 copies of plans (show beam i window sixes; poured fnd. design; etc.) I site survey for exterior additions a decks
➢ 1 set of energy calculations
➢ 3 copies of tree preservation plan R [at platted after 711/93
1
DATE: (d Z- / CONSTRUCTION COST. %rdy
DESCRIPTION OF WORK: z~ le etlL 19X~Z
STREET ADDRESS: 7 UI/ A/
LOT: 17 BLOCK: SUBD./P.I.D.
Name: W 4' /4' Phone.#: ~ ✓9
PROPERTY Last First
OWNER
Address:~,~~yWR/~~'/~Fe
Street
City State: Zip: J~1J/ OL
Company gd,40P.0 /,e4-)J A- ,~Lp G Phone
(area code) IVA
CONTRACTOR
Street Address: e u A J' S License # =E-P p00
~~ldS
City I"t/9GS State: Zip;
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
Street Address: Registration
City State: Zip:
Sewer & water licensed plumber (required for new construction only
Penalty applies when address change and lot change Is requested once permit is issued.
I Nereby acknowledge that I have read this application, state that the informal Is correct, and agree to comply with all applfcabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant.
OFFICE USE ONLY Pr-
Certificates of Survey Received Yes No
'v
Tree Preservation Plan Received Yes No Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
❑ 01 Foundation ❑ 06 4-plex ❑ 11 10-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.)
❑ 02 SF Dwelling ❑ 07 5-plex ❑ 12 12-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.
❑ 03 1 of _ plex ❑ 08 6-plex ❑ 13 16-plex ❑ 18 Deck 23 Porch (screened)
❑ 04 2-plex 13 09 7-plex ❑ 14 Apartments [3 19 Lower Level 4 Storm Damage
❑ 05 3-plex ❑ 10 8-plex ❑ 15 Lodging ❑ 20 Pool ❑ 25 Miscellaneous
WORK TYPE
31 New ❑ 35 Tenant Impr ❑ 39 Gas Line Only ❑ 43 Siding/Soffits/Fascia
❑ 32 Addition ❑ 36 Move Bldg. ❑ 40 Gas Insert ❑ 44 Windows/Doors
❑ 33 Alteration ❑ 37 Demolish Bldg.* ❑ 41 Wood Stove ❑ 45 Fire Repair
❑ 34 Repair ❑ 38 Demolish (Interior) ❑ 42 Reroof
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code (J
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs /
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq, ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building _X_L^L Engineering Variance
Permit Fee Valuation: $ , "w)
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies '5n&
Total:
i ,
SAC Units
% SAC
512 S46 9065 1997.12-17 09:49 x376 P•02/02
WLEWOOD DEVELOPMENT 61302-20 532/34
(85.85)
d:
Block 3, BLACKNAWK FOREST 5CNOELL MADSON, INC.
commum 9oa ICU= . emmomcaft sokcO
fop of iron monument as shown 'ow -ZQA MWsW4 sum
Elevation = 857.30 (N vo-1929) Is,» N
sllli-ml ark w ~~1111116
d~ a
3758 Brown Beer Trod This drawing has been aeelred and
reviewed the /Z64 day of
s.rewy saw !L' 19 ,
by
I hereby aertify that W8 Surrey MW
Suewueerew ore =redLUndW fond mq= a nd exit of %vWM the
km* the State of MinSurvOW nesota.
.?Aft
Theodore 0. Kemna
Date: 18 DEC 1997 ucenes No. 17006
J, \
Ste:
1. • Denotes iron monument 2. x890.0 - Denatee gmdvUnq spot devoton. `
3. 090,0) - Denotes Proposed spot elevation.
4.r- - -Denotes direction of surface droinoge• p r
5. Proposed 900" floor elevation - 887.4 a ~ a a
DROP GARAGE 2 COURSES O
6• Proposed boeement floor elevation _ 851.3 G
ProPoeed basement floor elevation . 856.0
7. Proposed top of foundation devotion . 858.1
30 0 30 60 90 Feet
CITY USE ONLY /
~ _
LOT BL RECEIPT E~ q / 22,, ~ 8 (o
SUBD. 4~ RECEIPT DATE: ~1°~/`1
NC37~~( 1998 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN m 55122
2-25`18 (612) 681-4675
Date:
Complete this section only if you are installing 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
• Gas outlets (minimum of one required @ $3.00 ea.) (=va tjAQC-, ~fc p, q, on
• State Surcharge: .50
• TOTAL:
Complete this section only if you are remodeling, adding to, or repairing existing single family dwellings,
townhomes, or condos. Note: Mechanical permit is not required 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 all remodel or add-ons of existing residences $ 20.00
State Surcharge 50
Total: $ 20.50
SITE ADDRESS: _ 3-758 e) nW N 6eA-k 9-.
OWNERNAME: Mf}~nP1)=til06A~q~~ C~2APMt~NT PHONE#: -777- L91.9
INSTALLER NAME: A-POLL,-oI ~TW-6- PHONE '-7-7 0--0G-0 3
STREETADDRESS: e51o N.Abu4 3('6LUD.
CITY: DA-V,6AL6 STATE: MN zip: Ss~ZB
SIG OF P RMITTEE
IS/FORMS BLD/MECH PERMIT (ICES) - 1998
V -4L BL 3 CITY USE ONLY RECEIPT O 7v
SUBD. RECEIPT DATE: 9
1998 PLUl-MING PERMIT (RESIDENTIAL)
CITY OF RAGAN
3830 PILOT KNOB RD
RAGAN, HN 55122
(612) 681-4675
Please complete for: ➢ single family dwellings
townhomes and condos when permits are required for each unit
D backflow preventer for underground sprinkler system
FIXTURES EACH # TOTAL
Shower 3.00 x Z = (a.°°
Water Closet 3.00 x 3 = 9 O°
= G °D
Bath Tub 3.00 x 2-
Lavatory 3.00 x 5'
Kitchen Sink 3.00 x / = 3 g°
Laundry Tray 3.00 x 3,°°
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x t = 3.°`
Floor Drain 3.00 x 3p0
Gas Piping Outlet ' minimum -1 3.00 x = 3
Rough Openings 1.50 x 3 = y.sO
Water Softener ' for dwellings under construction 5.00 x =
Water Softener ' for existing dwelling 20.00 x =
U.G. Sprinkler ' for dwelling under const. 3.00 =
U.G. Sprinkler `forexisting dwelling 20.00 =
Alterations " to existing residence 20.00 =
Water Turn Around 20.00
Private Disposal System ' MPC lie. 75.00 =
(new and refurbished systems)
Private Disposal Systems `Abandonment 20.00 =
STATE SURCHARGE .50
e-fl
TOTAL I hereby acknowledge that I have read this application, state that the inPormatlkin is ckirrect, eiW agree to corripy with all applicable City of Eagan ordmanoea
It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its
normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement.
SITE ADDRESS: -3.~A ~g - eyw vtl 13,ew- Eai I
OWNER NAME: ~GO/e[r/yod ~eyeeejopfwe. I-
F
INSTALLER NAME: Y I dvL ak L/ I'CdWe TELEPHONE* q2--2-"Z32-1
STREET ADDRESS: *Z-I-24h - Z "'~4✓e.
CITY: "/k !ta STATE: ZIP: gs303
SIGNATURE OF PERMITTEE
JS/FORMS BLDG/PLBG PERMIT (RESIDENTIAL) 1998
L gL CITY USE ONLY RECEIPT
SUED. RECEIPT DATE: 9 9
1998 PLUMING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
KAGAN, MN 55122
(612) 681-4675
Please complete for: ➢ single family dwellings
➢ townhomes and condos when permits are required for each unit
backflow preventer for underground sprinkler system
FIXTURES EACH # TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
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 =
Rough Openings 1.50 x =
Water Softener * for dwellings under construction 5.00 X =
Water Softener * for existing dwelling 20.00 x =
U.G. Sprinkler * for dwelling under cont. 3.00. _
SU Snrinkler * for existing dwelling 20.00 _
Alterations * to existing residence 20.00 =
Water Turn Around 20.00 =
Private Disposal System * MPC lic. 75.00 =
(new and refurbished systems)
Private Disposal Systems * Abandonment 20.00 =
RPZ (new installation only) 20.00 =
STATE SURCHARGE .500/l
TOTAL SV
-
I hereby acknowledge that I have read this application, state that the information is tarred, and agree to comply with all applicable City of Eagan ordinances.
It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during Its
normal operational and maintenance activitles to the facilities constructed under this p it within City property/right-of-way/easement.
SITE ADDRESS:
OWNER NAME: V Aye -(t C 2L~ ✓v /
INSTALLER NAME: ~4f~' L) wL TELEPHONE STRERESS: tf
I - L i & c ~C L,
7~D
v
it Lr9
CITY: TATE ZIP:
:
SIGNATURE OF PER~MyITTEE[
CD/PERMIT FORMS/RPLBG PERMIT (RES) -1998 7 ~~T -t~JIY O
F7 90.E
2007 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements RemodeVReoav Requirements office Use only
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and al roofed areas 2 copies of plan showing footings, beams, joists Cad of Survey Recd Y _ N
(20°% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Soils Report - _ Y _ N
1 Soils Report if proposed bulding is to be placed on disturbed soil t site survey for additions & decks Tree Pres Plan Recd _ Y _ N.
2 copies of plan shoving beam & window saes; poured found design, etc. Addition -indcate if on-sde septic system Tree Pres Required . _ Y _ N
I set of Energy Calculations On-site Septic System _Y-_N
3 copies of Tree Preservation Plan Slot platted after 711193
Rim Joist Detail Options selection sheet (buildups with 3 or less units)
Winnegasco mechanical ventilation form
Plans are considered public information unless you state the are trade secret and the reason.
,per eo
Date l 1~ l Construction Cost chi wCl.
Site Address ~ (DU4K y Unit/Ste #
Description of work c'1 - /12,67
Multi-Family Bldg -r' _ Y _ Fireplace(s) _ 0 _ 1 _ 2
Property Owner , C CAjYN' Telephone # (661) !y
~a Y - ?J( k 9'
Contractor
Address o f . City
q Plfl State Zip Telephone # (/t )
_ ~y b _/f[pGC'
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Cade Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Y _ N If yes, date and address of master plan:
Licensed Plumber Telephone )
Mechanical Contractor Telephone )
Sewer/Water Contractor Telephone
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 permit, and work is not to start without a
permit; that the work will be in accordance with the app ved plan in ase of work which requires a review and
approval of plans.
M
Applicants anted Name Applicant Signa
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA112550
Date Issued:08/19/2013
Permit Category:ePermit
Site Address: 3758 Brown Bear Tr
Lot:17 Block: 3 Addition: Blackhawk Forest
PID:10-14325-03-170
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Isaac C Strain
3758 Brown Bear Tr
Eagan MN 55122
Northern Exteriors Minnesota Inc
6677 Timber Ridge Lane South
Cottage Grove MN 55016
(651) 230-5103
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA137483
Date Issued:07/06/2016
Permit Category:ePermit
Site Address: 3758 Brown Bear Tr
Lot:17 Block: 3 Addition: Blackhawk Forest
PID:10-14325-03-170
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (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 -
Isaac C Strain
3758 Brown Bear Tr
Eagan MN 55122
(651) 688-3428
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature