3613 Ashbury RdCITY OF EAGAN Permit No: Date:
3830 Pilot Knob Road Meter No: e::f? ? 71 0 6 Size: lgIr
P.O. Bbx 21199 Reader No: Date:
Eaqan, MN 55121
Owner.
Site Address: .? 1'
..
Conn. Chg: 550.00.,
Acct Dep: 15. Permit Fee: 1 (". 0 OP`'
Surcharge: • SGpd Tr. Plant
Meter.
Misc.: BY
Benson
b
with the City of Eagan
WATER SERVICE
CITY OF EAGAN Permit No:_
383Q Pllot Knob Road Meter No: _
P.O. Box 21199 Reader No:
Eagan, MN 55121 •
Site
955?
Date:
Size:
Date:
Conn. Chg: r , • `?CP?
Acct Dep:
Permit Fee:
Surcharge: • ??`^''
Tr. Plant { , 0 0 n
Meter. -'
Misc.: Zoning:
No. of Units: ?
I agree to comply with ths Clty of Eagan
Ordinances.
sy
WATER SERVICE PERMIT
•' 3;j 7 07
CITY OF EAGAN Permit No:
3836Pilot ICPOb Road B/p No: -;`
P.b. Box 21199
Eagan, MN 55121 ?
?ei2ron Tiomes
Owner. t. _ _
Date: 10_r••?
Date: 4- T
- ?
Site Address: ? M*ieTw Plumber: , . - P._g . C .
MWCC
550.OOnd
li,n . U910
City Chg;
.
Acct Dep: ? fi
Permit Fee: ?
Surcharge: t '
Zoning•
No. of Units:
I agree to comply with the City of Eagan
Ordinances.
By
SEWER SERVICE PERMIT
CITY OF EAGAN
- ' 3830 Pilot Knob Road, P.O. Box 21-198, Eagan, MN 55121
PH ON E: 454•8100
BUILDING PERMIT Aeceipt #
To be used for Est. Value Date
Site Address
Lot Block Sec/Sub. ' Parcel No.
City
Name
? 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.
Signature of Permittee -
A Building Permit is issued to:
on the exprese cond ition that all work shal I be done in accordance with all
appficable 5tate of Minnesota Statutes and City of Eagan Ordinances.
Building Official
a A '!
19
On 3Re Seweqe Occupancy
MWC:C System Zoning
on site well (Actual) conat
CIry Water (Allowable)
PRV Required # of Stories
Booster Pump Length
Depth
S.F. Total
FootpHnt S.F.
APPROVALS FEES
Engr./Assess. Permit
Planner Surcharge
Council Plan Review
81dg. Off. SAC. City
Variance SAC, MWCC
Weter Conn.
Water Meter
Road Unit
Treatment P1
Parks
TOTAL
Psrmit No. Permit Holder Dste Tslaphone
Plumbing C????V/?
H V.A.C. 7 d ,- c..
Electric 9
° Cc- .?7 ?1 ?1
Softener
Inapaction Date Insp. COmmBnts
Footings I ? J
Footings II
Foundation ?
Framing ?-
Roofing
Rough Plbg.
Rough Htg.
lsul.
Fireplace
Final Htg.
Final Plbg. _ • . j?
Bldg. Final
Cert.Occ. j? ?
Temp. LP
Deck Ftg_
Deck Final
Well
Pr. Disp.
. . ? ,. *s . _
PERMIT #
? • ' ' , MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KN08 RaAD, EAGAN, MN $5122 DATE:
CONTRACT PRICE pHON 454-8100
Site Address
Lot Blocl?
-3 Sec/S
ub BLpG. TYPE WORK D,E/S? IPTION
?
r Res.
New ?
? Mult Add-on
? Name
Comm. Repair
e? Address
Other
c City Phone
FEES
? Name RES
HVAC 0-100 M BTU
$ 24
00
? .
- .
c Address ADDITIONAL 50 M BTU - 6.00
O City Phone - (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS
MINIMUM
1 PER PERMi 1
5
A
-
n -
( .
.
0 E
TYPE OF WORK COMM/IND FEE - 1°r6 OF CONTRACT FEE _
Forced Air ? M BTU C? APT. BLDGS. - COMM. RATE APPLIES
Boiler
M BTU TOWNHOU5E & CONDOS - RES. RATE APPUES
M
IM
M RES
DENT
L FEE
DD
O
IN
U
I
IA
- ALL A
-
N &
Unit Heater - M BTU REMODELS - 12.00
Air Cond M BTU $ MINIMUM COMMERCIAL FEE - 20.00
Vent.
CFM STATE SURCHARGE PER PERMIT -
(ADD $.50 SiC IF PERMIT PRICE GOES .50
Gas Piping Outlets # BEY91d0 $1,000)
Other
FEE:
S/C: SIG ATURE OF PERMITTEE i
? TOTAL• c`
' FOR: CITY OF EAGAN
PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
Site
Lot.
m Name i?lrrr 'l' ;
? Address i? ? •• • r
c Ciry ? Phone
.. Name
3 Address I
p Ciry Phone 'S-
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BLDG. TYPE WORK DESCRIPTION
Res. ` New '
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00 ?
Lavatory - $3.00 ?._
-1_Shower - $3.00 r:
i_Kitchen Sink - $3.60 }
Urinal/Bidet - $3.00
?Laundry Tray - $3.00
?Floor Drains - $1.50
?Water Heater - $1.50
Whirlpool - $3.00
=Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
' Rough Openings - $1.50
SIGNATURE OF PERMITTEE FEE:
STATE S/C:
FOR: CITY OF EAGAN GRAND TOTAL:
PERMIT #
RECEIPT #
DATE: -
To
Site AddrQss
Lot ?? Block
Parcel No.
. . . . '.t. . .:'L.! - . ? ??,1. ?[t?. . ... . . . '_ .-, .. . ? _ . ..
CITY OF EAGAN 1$024
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PNONE: 454-8100 • .; ? '?
T ' cReceipt #
K Est. Value $i fow Date Jun 14 , 19 "
? •0111021uv D(1
W Name viPW"'T 4XMb-MW
o Address
City. Phone --_
Q o aAwauaa aAnrr. a?vna aAw s aw.
Name S i "KNICY T
Address
? City ST pAUL Phone
Name _
Address
Phone
I hereby acknowlege 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.
?.
Signature of Permitee
ST[tAIGNT WOE CC3NST
A Building Permit is issued to:
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
: ?, ..
8uilding Otficial ?
Occupancy; - FEES
7oning
23.00
(Actual) Consl - Bldg• Permit
(Allowable) .50
- Surcharge
k of Stories
IAIM
Plan Review
a?
Length
?
Depth SAC, City
S.F. Total -
S.F. Footprints - SAC, MCWCC
On Site Sewage _ Water Conn
On Site Well - Water Meter
MWCC System _
Aca
- DePosit
_
Ciiy Water
PRV fiequired _ S/1N Permit
Booster Pump - S/W SurCharge
Treatmenl PI
APPROVALS Road Unil
Planner - park Oed.
Council
81dg.Off. _ Copies ?.
Variance - TOTAL ?
Pe?mit No. Permit Holder Date Telephone #
WATER
SEWER
PLUMBING
H.V.A.C.
ELECTRIC
kmspection Date Insp. Comments
Footings I
Foundation
Fr2rrling
Roofing
Rou9h Plb9.
Rough Htg.
Isul.
Fireplace
Fnal Htg.
Final Plbg.
Const. Meter P1bg. Inspector - Notify Plumber
EngrlPlan
Bldg. Foal
Dock Fig. L ?
Deck Final C
Well
Pr. Disp.
J
Cgtx#i#irafe nf COrrupttnry
Citp of (Eagan
Eppa1'tmPllt Df Wdh)itl0 inNpPttiDlt
77ris Cerrificate issued pcersuant to the requirementr of Section 306 of the Uniform Building
Code certifytng that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating buiTding conrtructron or use. For the following:
?? 1
u? c?e?suon ., ` GAR eiag. etrrnic No. 14762
?
oocu?,?y Tya R.
mi CN Ho8' wrw, Addreas P:CiX '=.= ? , I?rk'L?L.T E
Owner of 6uildieg
ariiaing naam 3613 ASi-IIiUKY Ro,%r? 1.0cality L24, L3, i3I.A[MMY, Gi -1-Y -V-
-? ?
nate:
Bw7ding Official .
POST IN A CONSPICUOUS PLACE
CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
nMouNT $
i
.
?
& DOLLARS
100
? CASH [4.CHECK
FCA -d
? .
FUND OBJECT AMOUNT
M I s1 l
L ?
L 1 ??d
Thank You
BY
i? V V V tJ : White--PaYem CoPY
, Yelbw--PosNng CopY
Plnk-File Copy
` BLDG.
. _,_
01-3210
?
01-3422
Od-3445
01-3446
01-2155
167'-3860
20-2275
ZO-3865
20-3868
20-3716
PERMIT _NO.
A
Bldg. Perm
Plan Check
Surch./Adm
SAC/Adm.
Surcharge
Road Unit
SAC
Water Conn
Water Trmt
Water Mete
20-2252 Acct. Dep.
20-3713 Water Perm
20-3743 Sewer Peru
79-3866 Sewer Conn
A?g-3855 Park Ded.
TOTAL
CITY QF EAGAN
3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121
PHON E: 454-8100
BUILDtNG PERMIT Receipt #
To be used for -;7! :.AR Est. Value $130 ,(iU4 Date
SiteAddress A13 AStiBURY kD
Lot ?k Block 3 Sec/Sub. BI.ACMiiif GLEl1 2
Parcel No
e rvame ...?......, .....? ..,...,...s.,..?
= Address 1147C 451
° City LAICEYtLLE Phone 469-2306
?oName_
.
? Q Address
? City _
1- ¢
VW -
Name
Address
v
Q W
City Phone
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 Stattites and City of Eagan Ordinances.
Signature of Permittee
A 8uilding Permit is issued to: EEHSUN NCtME 8t ILDERS
on the express condition that allwork shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
19 i:..
OFFICE USE ONLY
S?n Slte Sewage Qccupancy K- 3
MWCC Syatem x Zoning fi-I
On Site Well (ACtual) Const V--N
City Water X (Allowable) Y-i,l
PRV Required X # of 5tories
Booster Pump Length 69' --b"
Depth 391-6t,
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit 672.00
Planner Surcharge 65.00
Council Plan Review .136. QQ
BIdg.OM. SAC,City 1LiU-O()
Variance SAC, MWCC S5Q-OCf
Water Conn. 5.50..00
Water Meter bl _ ll[?
RoadUnit 325•00
Treatment P1 20d_rn
Parks
569.00
2
TOTAL ,
.
•? CASH RECEIPT
. CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
?
?
AECErVED FrRM
JAMOUNT
& DOLLARS
,oo
? CASH Cl CHECK
FOR .. 1 (
t
i
. . - I.. ? \
FUND OBJECT AMOUNT
Thank You
8Y
VYhite-Payers CopY
Yellow--POSting Copy
Plnk-File Copy
RESIDENTIAL
z#:- y5515 BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651•681-4675
New Consiruction Reauiremenls
• 3 registered site surveys showing sq. fl. of lot sq. ft of house; and all roofed areas
(20°6 maximum lot cove2ge allowed)
• 2 wpies of plan showing beam & window sizes; poured found design, etc.)
• 1 set of Energy Calculations
• 3 copies of Tree PreservaUon Plan if lot piatted atter 7J1193
. Rim Joist Detail Optlons selec0on sheet (bldgs with 3 or less units)
DATE d
JOB SITE ADDR SS_
IF MULTI-FAMILY BUIL
PROPERTY OWNER_
TYPE OF WORK -11
APPLICANT `r
ADDRESS 9P,'
PAGER #
CELL PHONE #
FAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
i Energy Code Category _ MINNESOTA RULES 7670 CATEGOR
(check one) - Residential Ventilation Category 1 Workshee
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
I - New Energy Code Worksheet Submitted
Plumbing Contractor:
Plumbing System Includes:
Wa[er SoFtener
_ Water Heater
No. oF 13aths
Phone #:
Lawn Sprinkler
N0, of R.I. Baths
Mechanical Contractor. Lj P(S?-l??j(?P ?T/"'l h?e # `9??
?-?
??Icchcmical 5ystem Includes: Air Condit? ning Pce: $70.00
Hc.ic Rccovcry System
j Sewer/Water Contractor:
Phone #
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with
all applicable State of Minnesota Statutes and City of Eagan Ordinanc ?
Slgnalure of Appllcanf
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
$ 70Z0
s---:.:,) I -C) 1
RemodeVReoair Requirements
• 2 copies of pian
• 1 set of Energy CalculaGons for heated additions
. 7 site survey for exrenor addifions & OeCks
(2I VALUATION (EXCLUDING LAND) $?OO(`)
??1 ? ,?sl hur r? ?r?
HOW MANX UNITS?
0
EPLACE(S) _0 ? _2 _3
PHONE # k?`-?1?? ?75?i4
ZIPCODE s33
Updated 1101
rce: $90.00
This reqces? voitl J/8''Y
18 imnths (rom ? ?? r c3 `
E 6 3 3 5 ?9-3 ,.'?. % ;:gyz? 12 r o
Hepuest Date Fire No. FooPh-In InsVer.tion
RequireA?
?fleady Now M.JiII Nntity InsDec-
n
?-1?-L j- pg ?Yes ?No [or When fleady
[25 Licensed Electrical Canractm 1 hereby repuest insoaction of ebova
? Owner electrical work instellad aL t
Sveet Address, Baz or Route No. Citv
3613 ASHBURY ROAD EAGAN
ection o. Township Name or No. Range No. County
DAKOTA
Occuuant (PPINT)
BENSON HOME BLDRS. Phone No.
469-2306
Power SupOlier
DAKOTA ELECTRIC Atldress
FARMINGTON
ElecVical ConVnr.tor ICompanv Name) Convactor's Liwnse No.
MCNAMARA ELECTRIC, INC #A=042608
Mailinq AtlJress ICOntractor or Owner Makinu Installationl
P.O. BOX 422, ROSEMOUNT, MN 55068
Authoriz SiB???ure ICOntr ctor/Owner aking Installationl Phone Number
423-5505
Os? v
MINNHSOTA SiATE BOAND Oi ELECTPICITY ? THIS INSPEC710N HEQUEST WILL NOT
BE AC
Grigga-Midway Bldg. - Room N•191 CEPTED BY THE STATE BOAND
1021 Universilv Ava.. St. Peul, MN 55104 UNLESS PNOPEN INSPECTION FEE IS
v?....o ia171 wn?.nnnn ENCLOSED.
J/& /W REQUEST FOR ELECTRICAL INSPECTlON (e;s-ooooi-os
? Sae inshoctions for xompleting this form on beck oi vellow copn
V
E ° 6 335 "X" Be/ow Work Covered by 7his Request
Ad ReO. Typn oi Builtling Appliancea Wired Equiuman[ Wired
Home Range Temporary Service
Duplex Water Heater Liyhtlny Fixtures
Apt. Building Dryer Electric. HeaLn
Commercial Bldy. Fumace Silo Unloader
InAustrial Bldg. Air Conditioner Bulk Milk Tank
Farm Otner ae6 v -i??e? 15nocitvl
ther uccify ihcr Othur
ompute lnspection Fee Below
p Fee SarviceEntranceSize 4 Fae Faxders/Sublexders q Fxe Circuits
0 ro 200 qm 5 0 to 30 qm 5 0 to 30 Am>s
Ahove 200 qmpsj 31 to 100 qinps 1 10 . 31 to 100 Am s
Swimming Pool Above 100 -Amps Above 100_AmU`%
Transtormer5 Irrigation Boonis PartfalOther Fee
Signs Specialinspection S
ror e
Aamarks 6 7?
?
fh181BQUB5I V014 18
This request void
78 months twm °J` J O
E fi32 G
-?A;' c??b'J
/ J I `JZ/(q
? -- --._ - .- ..???,._... ..,........„
?^7'8 $ Re9mreA! ?fl Y Now WiU otifV.InsPer
r]Yes XNo lor When Reatlv
? Lii,ensed Electrical Convactor I hereby repuestinsoectioq otebova
? Owner elaetrical work installed et\
Street AAdress, Box or Route No. . City
3613 ASHBURY EAGAN .
ection o.
Townshio Name or No.
Range No.
Cou
------------
DAKOTA
Occupent (PRINT) Phone No.
BENSON HOME BLD 469-2306
Powee Supplier Address
DAKOTA ELECTRIC FARMINGTON
Electrical Contraclor (Company Name) Cnnttactor's License No.
MCNAMARA ELECTRIC?INC• #AO-42608 _
Mailine AdJress (Comracmr or Owner Making Inswllanon)
P.O, BOX 4221ROSEMOUNT,MN 55068
Authori Sig a[ur 1 nnactor e Maki B Inslallationl Phone Number
'?.
_- e.?
423-5505
MINNESDTA STATE BOAFO OF ELECTPICITY (/ THIS INSPECTION HEQUEST WILL NOT
C+uiggs• g. - Hoom N•191 gE ACCEPTED BY THE STATE BOAflD
Midwav Bld
1821 Universitv Ava.. SL Pxul, MN 515104 UNLESS PROVER INSPECTION FEE IS
ENCLOSED.
Phone (612) 642-0800
REQUEST FOR ELECTRICAL INSPECTION /e?}Js-ooooi-oeJ
1 See insfructians for Somoleting this fwm on baek o/ yellow copy. L
? 6329 "1(" 8elow Work Cavered by 7hrs Request
b.dJ NBP ?Type oABuildinp Appliantea riiroC EpuiVment Wired
Home Range Ternporary Service
DuplHx Water Heater Liyhtiny Fixtures
Apt Building Oryer Electric Heatin
Commercial Bldy. Fumace Silu Unloader
Industrial Bldy. Air Conditioner BWk Milk Tenk
Farm tner Spnu V Othqr Isnor_riVl
[ 9! VCC1(v QthC! ?1?IpI
Compute lnspection Fee Below
p Fee ServiceEnfra?ceSize H Fee Feaders/SuEteeders b Fert Circoits
/. d U to 200 qmps 0 to 30 Am s 0 tn 30 An! s
/above 200 qmps 31 ta 700 Amps 31 to 100 Am s
Swimming Pool Above 700-Amps Above 100_Am s
Trensformers Irnyation Booms Partial.'Other Fee
L? ISigns ? I ISUecialinspection ?512 5?IT0 ?g;O
Aem?rks 7 v
' CITY OF EAGAN (vo 14 7 6 2
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100
BUILDING PERMIT Receipt #
To be used for SF/GAR Est. Value $130, 000 Date APR T I ,19-&$_
Site Address 3613 ASHBURY RD OFFICE USE ONLY
Lot 24 Block 3 Sec/Sub
BLACKHAWK GLEN Z Site Sewage _
?n Occupancy R-3
. WCC
System X 2oning R-1
Parcel No.
V-N
On Site Wall (ACtual) Const
a Name BENSON HOME BUILDERS Cirywater X (Allowabie) V-N
W
z
Address BOX 451 PRV Required X # of Stories
Q
City LAKEVILLE phone 469-2306 BoosterPUmp - Length 69'-6"
oevtn
o Name SAME s.F.7otai
,
?a AddreSS FootpriniS.F.
? City phone pppROVALS FEES
ww Name Engr./ASSess. Permit 672.00
l Planner SurCharge 65.00
i
s? Address
Council
PlanReview
?3?2..QQ
aw City Phone
BIdg.Off. SAQ City _LQQ._Q.Q
1 hereby acknowletlge that I have read this application and state that the Variance SAC, MWCC 550._00
information is correct and agree to comply with all applicable State of WaterConn. _550_00
Minnesota Sta[utes and Ci o?E? An Ordinances.
WaterMeter
_61_.,00-
Signature of Permil[ee
Roatl Unit
325.00
A Building Permit is issued to: BENSON H E S_7?DER5 TrealmeM Pi -zG4.,.p0.
on the express condition that all work shall be done in accordance with all
Parks
applicable State ot Minnesota Statutes and Ciry of Eagan Ordinances. 2?869.00
Building Ofiicial?.m.??F,A,I,(?,, ? 111 I, TOTAL
, - ?-
1988 BUILDING PERMIT APPLICATION - CTTY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OE ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WFIICH ADDRE3S
IS DESIRED. NO CHANGES WILL HE ALLOWED ONCE BUILDING P£RMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF UNITS
INCLUllE 2 SET$.OF PLANS,_ CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,-
1 SET OE ENERGY CALCULATIONS
COhAERCIAL
INCLUDE 2 SETS OF ARCHIT&CTURAL & STRUCTURAL PLANS, '
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
. , - ?
To Be Used For: ?7 ? e,?,?? Valuation. ? Date:
Site Address
Lot Block ? -
0
Parcel/Sub ?? ? 44cl?,A&,lc vf_u 2'?14
owner l I I NP KF,\- ( 'JbS
Address V[ lJ' ? ? f-i4 by fip,,). 14h
.rF
City!Zip Code e U,p?
Phone (L?Z,.` ( U /
Contractor v?5t?h ,`?DY?n ? 16f d?S•
Address
City/Zip Code ??ljCe(J(LL•e" i/Isj.
Phone 7O - Z. 17 6(?
Arch./Engr. Le
Address
City/Zip Code `
Phone #
OFFICE USE ONLY
? f 3d oao'
I On site sewage Oceupancy R? 3
MWCC,system ? Zoning
On site well Actual Const V-N
City water ? Allowable
I PRV required ? # of stories
4 Booster,Pump _ Length_ (? -6
P Depth 39- to',
? S.F. Total
Footprint S.F.
APPROVALS FEES
Engr/Assess Permit Z.oo
Planner Surcharge 65,Oo
Council Plan Review 3 36,oa
Bldg. Off. SAC, City /ao,ov
Variance SAC, MWCC .SSa,oa
Water Conn SSO, po
Water Meter ' ,ov
Road Unit 3 zsoa
Treatment P1 20 ,00
Parks
Copies
TOTAL
... --VA?WT-170N
11 x z 2 :: zux
ZI x zy =`i
74G K'y= Ioy?IV
GSm?'
S?'/z w y _ ? 21
3'7/2'4Z = '45-0
/171 Xr3=1S 223
!sr F'??_
?-
-f3"srn-r = 117 r
I K/o = lo
.;z x?=-!J-
I 195 X49= S?ss-S
Z?N b?bn
= O?d
ZYX30
2 x?2 = ZN
iz
2XL
97G?? y9= y?
?27/q6
l2xI u = 168 x 15 = 25'??
r2°??i6G
;o' Feour aN?o?N
$ETg!C L LINE
DRAri.IAhC
c SZ8.7S
6[FN LVO
L6}-t?, bI k 3
Dlackhawk ?len
\
1nd
C1t1eS D1a1
ity Control
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from the original page.
" '%.?> . '_ _- • EXTERIOR ENVFLOPE AVERAGF "lJ" COMPUTATiON ..
1'QUNPk?,:*- r G^c>? r- OS
I S 17£ RDDRESS: ?T d(
? s ? . .
COPtTRACTO
.. R:
.- -? . DAT[: PHONE:
DETERMINE b10RKINf SO.UARE FOOTAGE OF EACH:
1. IOTAL EXPOSED UALL AREA, ,,,,, ;, 3aa ln sy f t x "U" I, ? I 3S`?•F?
`
2. 70TAL ROOF/CEILINC AREA...... 3L.!
. f „
' , O'11 x
rI
.
? sq
t x U
i rXlO
p?/:7
a
3• TOTAL EXPOSEU iJALL AREA CALCU TATIONS:
• Total exposed wall
afee above fioor [
3
?
?
,,,,,, ,,
p
p
?-7j s9 ft
a) Total wall wlndow area:
4lazed..... . sg ft x .U,?
: qlazed...... sq ft x "U"
b) Total doot area ,,,,,.., yQ r sq ft x"U"
c)_;.Total sl?dlog glass door arca:
6?5 glazed...... JP1 _ sq ft x??U" I1??
glazed...... sq ft x "U"
d) Total ftreplace wall area f "
"
,. sq
t
- x
U
e) Total wa)1 frnming area
Ihverage 10g,..........
_ 3aa5q ft
x???l"
f) TotaY het wa11 area ahove
floor (Insuiated)....... sq ft x (67
g) Total rim Joist arca...... .. sq ft x"U"
Totel foundation
area (Exposed).......... 3S sq ft
h) Total foundatton
window area .............
. ?•s sq ft
x -,U?-
?Jrjr I _ ^
?
,
1) Total net foundatlon
area above grade......,
sq ft
x"U"
,
TOTAL a) thru I) 0?•37
if ltem #j fs the same as, or le
2 PICAR 1.16008 A and 0. ss than item NI, you h ave me ; the intent of
?
Page 1
4. TOTA! EXPQSED ROOF/CEIU Nf CALCULATIONS:
, ToYal exposed
..:roof/ceillng area..... ... sq ft
J).•..7oYai skyllaht area....... sq ft x"U" °
k) Total roof/cell(nq framinq
9
=
(A
;
'
"
"
5?7
,),,,,,
area
veraae 10
; , sq f
t U
x
1) 'Total net Insulated
roof/ceilfnq area....... n?
•0 sq ft ?v
x"U" ? I'
T
4. TOTAL j) thru 1) .?
If-total of 84 Is the same as, or less than N2, you have met the intent of
2 AfCAR 1.16008 A and 0.
?
ALTERt1AT[ eUILDIfIC, FtIVELOPE (IESIf,N
e
To utlllze the total envelope system method, the values es[ablished by the sum
of liems F3 and 94 shal) not be greater than the sum of items Nl and N2.
1. + 2.
3. +
L E R T I F I C. A T I_ 0 f7
? 1 hereby certify tha[ I have calculated the "U" factors and "R"
values hereln.and that the huildinq here described meets or exceeds [he State
of Mlnnesota;Enerpy Conservation Act.
?
i
. _ ._ . :a....
?
Siqnature
(Date) ?
Page 2
- .....??..: ? ?,
GUIDELINE TO (R) F/ICTORS FROM ASHRAE MANUAL
Of TY PICALLY USED PRODUCTS
. !'
AIR.FILMS SH[11THING 1BI
Interior Air Film (Walls)
Extertor Air Film (Walls) 0.68
0
1 3/4" Wood Subfloor or Sheathing
" 0.94
( .
7 112
Plywood Sheathing
a
? 0.62
Exterior Air Film
Vented Ceiling;
Interior Air Film (Non V
t
d 0.61 Gypsun,
or
PlasterrBoard 3/8" 0.32
en
e
)
Exterior Air Film (Non Uented) 0.61 Gypsum or Plaster Board 112" 0.45
0.17 Gypsum or Plaster Board 5/8" 0.56
1 Plywood 3/8" 0.47
BLOWIN Plywood 112" 0.62
Plywood 3/4" 0.93
Approx. 3" 9
00 Sheathing, Reg, Density 112" 1.32
Appt'ox. 4 112" .
13
00 Sheathing, Reg. Density 25/32" 2.06
ApprOx. 6.1/4" .
19
00 Nail-6ase Sheathing 112" 1.14
Approx. 7 1/4" .
24
00
Approx. 14" .
30
00
Approx. 18" .
40.00 ROOFS
Atl oth8r insulation materials must
6e verified (R Factor) Built-up Roofs
Asbestos-Cement Shingles 0.33
0.21
Asphalt Roll Roofing 0.13
• Asph;alt Shingles 0.44
INSU?LqTIpN
Insulation: 2-2 3/4" fiberglass i
7
00
SIDING
Insulation: 3 112" F16erglass
Insulation: 6" Fiberglass ,
77,00
nluminum Siding
0.61
Insulation: 3 5/8" Fiberglass 19.00
13
00 ??uminum with 6acker 1.II2
Insulation: 9" Fiberglass .
3? ??? Aluminum with Dacker R Foiled 2.96
Insulation: 12" Fiberglass 38
00 1/2 x II Lap Siding (Wood) O.II1
Insulation: 8" Cellulose .
00
29 7/16 x 12 Hardboard Siding 0.67
Insulation: 10" Cellulose '
00
37 nsbestos Sidinc?s 1/4 Lapped 0.21
Insulation: 12" Cellulose '
44.00 Stucco (Drown and Finish Coat) ----
Insutation: 1 112" Thermax 12
00
Insulation: 2" Thermax .
16
00
. OOORS (U)
WOODS 1 3/4" Solid Care Door .46
Fir, Pine & Similar Soft Woods w/Storm, Wood
w/Storm, F1etal .31
.26
1 112" 1,89 Pease Steel Door Insl/N/GL 7.45R .13
2 112" 3.12 Slidin9 Glass Door, Wood .65
3 1/2" 4.35 Metal .72
5 1/2" 6.87
CONCRETE BLOCK wiNOOws
8" Concrete Block (S & G Reg.) 1
11 All Windows
(Filled with Vermiculite) .
7
93 (w/Storms 1" to 4" Space) .56
12" Concrete Block (S & 6 Reg.) .
1
28 Removal Dou61e Glazing (RDG) .55
(Filled with Vermiculite) ,
3
15 Thermo or Welded 3/16" Air Space .69
S" Light Weight .
2
18 1/4" Air Space .65
(Filled with Vermiculite) ,
5
03 1/2" Air Space .58
12" 4ight Weight .
2
48 (Other windows specifically tested
(Filled wlth Vermiculite) .
5.82 can use better ratings)
Page 5
., ? .,
' .?....
.-_. ?. .
i ,..
`^M
„ n
DPlSTRUC,T 10t1
RANING SECTION:
1 In[erfor air
Z t0
3 fnche
4 S
5 masd
F Exterior air
14ALL SECTIOt! (INSULATED)
-I
,) Inter(or air film
3
1,
S
R VALUE
0.69
n,f,R
Exterlor air film 0.17
RIM J015T SF.CTIQ11:
--(1
?
P' p ' ? 4
• ` r a
e ... ,
•p'??.
.?Ia ;Q
p' '? ' A-
;Q:o:.-
... at?f..,?„4
3
q
>
6
U= A-17
FOUNDATION INSULATIOtI REQUIRED:
Min. R-5 on entire wall OR U °I/R
Min. R-10 down to frost depth
FOUNDATI01! SECTION:
1 ntcrior air f11m 0,F8
4 Fxterior air film
?i
? TOTAL R
U= f/Rs.?B
SU1R ON f RADE
1? \:4 4•`?v'.' a°a•`a 711b/
G• i7 /? /1
? . • ;Ileated Slabs:
., ,.
? ?•. QMinimum R= 8.5
Unheated Slabs:
"`" ?• 4'? • ; Minimum R = 6.2
;i ,a;a4Q.b • :a, 4;4`: n.?
° ;-4'?. 4•. .a•q I
,
?
? ? ?: ? • ? ._ ' n' •d?,??
'
L
`
. ? " ?
,
4
,'
? •
. ,
4? '.4
?.
..?
?
??
. q' ,
?
- •
' cf 1
i .. •
?• ' ?
.
a ?9•
q
'
?
4
,
d
?
.
n
Page 3
U° I/R°CR
, ? 4?..?....
.?_ .
• ? `.. -.
CONSTRUCTION " ft VAI UC
CEILINf, SECTtQtJ (INSULATED): •
I lnter or aIr fflm
2
3 d?.
4 fxterlor a1r f11m still) r)./1
TOTAL R = ,jB:
U - 1/R =.Qp- .
f.EILINf fRAMINf, SECTION:
1 Interlor ir film ?.Fl
2
3 - ,.p0
h In[ r vr air f11m still O. 1
2,?'
inches sof[ woa?
TOTAL R =?,/7,
U = 1/R =.0&5'
i
!1 1
'
CEILItlC SEf,T10t7 (ItlSULATED):
1' In[erior air film (1.61
2
3
4 Fxterior air film stil) O..I
TOTAL R =
U= 1/R=
C[ILING FRAMIPIf, SEf.T10t1:
1 Interior air film O.F1
z
3
4 Fxterfor air film stfll ?. I
i inches Soft wood
TOTAL R =
U= 1/R=
1 Insicfe afr film n.F1
2
3
ti
S Ou[side air film n•17
TOTAL R =
U= 1/R°
Page 4
?rVENTED
$3?..V
APFLICATION FOR PERMIT
SEWER AND/OR WATER GONNECTION
*NOTE: PAYtg27P OF FEB AT TIME OF ^ .'R
? APPLICATION WFS N;lf CON- ?
i Sl'IN1E APPRQJAL OF PIItPIIT. ?
r
INSPF7CfION OF SEWFTl AHI7/OR WATIIZ *
*
* It1STALIATI0N5 WIIL NOT BE cCMn*?D
'y I7Kf'ZL PIItFIIT EDS gEFS] ppPROVID. :
citv }f f!!Yf 1?}11?+R44tti4if}i##f #R1ef f HR}ff w
oF ecagan
(PLEASE PRINT
1) PROPII2TY ADDRFSS:
T•FY:AT• DE.SQ2IPTIONI . . . . . . . . . . . , V . . . . . . . . . .
Lot B oc Sub vision or Tax Parcel ID )
IF EXISTING STRL'CPORE, DATE OF ORIGINAL BLILDING PII2MIT ISSLANCE:
Mont Year
PRESENT ZONING/PROPOSID DSE:
Q CONA7ERCIAL/RETAIL/OFFICE
Q IPIDOSTRIAL
a : INSTITUTIONAL/GOVERPAIENT
2) ? NAME:
ADDRFSS:
1 { R-1 SINGLE FAMILY
R-2 DUPLEX ('iWO Lnits)
Q R-3 TOWDIIi0U5E (Three + Driits) ( Units)
Q R-4 APARTMENT/CONDOMINIUM ( Units)
czTY, STATE, zzr: & -6Sb(l'[
PHONE: 49 - ?iD6 .
3) ' i: ?• NAME: _LuA77?I&ei-1 QRnI/4G5 .1.n1 c?
ADDRESS:
CITY, STATE, ZIP:
PHONE: ?2-3'3 7.10 MASTER LICENSE # 3d?
?-( Active
I-i Expired
I_1 Not recorded
Sta?Initial
4) 11150 _ : e . i?l
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
5) + ' • ? ' •?+? • o ? ?!e ,
? CONNECTION Tb CITY SEWER MCONNECTION TO CITY WATER O OTHER
6)
3X9 lRd'
*????:W?*????«***********?********?**** *? ***?s***?**??********?+********,?******?*********+*?+**?*x
* THE GOLD COPY OF THE PIItNIIT WILL BE SENP Dg2fX.TLY TO PUBI,IC WORKS TO FACILITATE MEM PICK-UP. *
,*t PLEASE ALIAW 7w0 WORIQNG DAYS FloR PROCFSSING. SOMFANE FROM TfiE CITY WII,L coNl'ACT ]C(XJ IF Mm *
* ARE ANY PROSLENL4. ?
FOR :CITY USE 4NLY
--, :
PERMIT # ISSUED '
Pd w/Bldg. Permit FEES:
$ $ lC; S z SEWER PERMIT (INCLUDE SURCHARGE)
$ $ WATER PERMIT (SNCLUDE SC'RCHARGE)
$ $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ $ ?S •L'C? ACCOUNT DEPOSIT - SEWER
$ $ ?S^O!% ACCOUNT DEPOSIT - WATER
$ .?S D • D L? $ WAC
S. ?? ?, d d $ SAc
? $ TRUNK WATER ASSESSMENT
$ $ TRGNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRONK SEWER
$ $ LATERAL BENEFIT/TRi)NK WATER
$ $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ $ f? TOTAL
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQDIRE EXCA VATION IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A" PERMIT FOR WORK WITHIN PUBLIC
ROADWAY" MUST BE ISSCED BY THE ENGINEERING
Q
NO
DIVISION. LIST
AS A CONDITION.
SDBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE:
' CITY OF EAGAN ?0 ? $O24
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127
PHONE: 454-8100
BUILDING PERMIT Receipt # l" g ( I
To be used for DECK Est. Value $1,000 Date JUNE 19 , 1990
Site Address 3613 ASHBURY RD
Lot 24 81ock 3 SeGSub$LACKHAWK GLEN 21
Parcel No.
w Name VINCENT GOSSMAN I
o Address 3613 ASHBURY RD
Citv EAGAN Phone 456-8238
" Name STRAIGHT EDGE CONSTRIICTION
?? Address 868 STICKNEY ST
U¢
? City ST PAtIL Phone 290-0451
r
ww Name
NMI Address
<w City Phone
I hereby acknowlege ihat I have read this application and slate Ihat the
information is correct and agree b wmply with all applicable State of
Minnesota StatNes and City I Eagan Ordinances.
SignaNre of Permitee
A euilding Permit is iss; to: STRA GHT EDGE CONST
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City ol Eagan Ortlinances.
Buildinq Official
OFFICE USE ONLV
Occupancy -
Zoning -
(AaNaq Const -
(Albwable) -
x of stories -
length 177}a(L
Depih 8' oCtO$onal
S.F. ToWI -
S.F. FoolpriMS _
On Site Sewage -
On Site Wall -
MWCCSystem -
City Water _
PRV Required _
Booster Pump -
APPROVALS
Planner -
Coundl _
Bldg. Ofl. -
Variance -
FEES
Bldg. Permil 2$.00
Surcharge .50
Plan Review
SAC, City
SAC, MCWCC ?
Water Conn
Water Meter
Accl. Deposil
S/W Permil
S/W Surcharge
Treatmenl PI
Road Unit
Park Ded.
Copies 1.00
TOTAL Z6.50
:? r
- ? •
U
SINGLE FAMILY DWELLINGS
1/2 SETS OF PLANS
S REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCULATIONS
? ? • f
014 ?
1990 SIIILDING PERMIT APPLICATION ?
CITY OF EAGAN
?
MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PI.ANS
REGISTERED SITE SURVEYS -
(CHECK WITH BLDG. DEPT.)
1 SET OF ENERGY CALCULATIONS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
2 SETS OF ARCHITECTURAL
& STRUCTURAL PLANS
1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER M[JST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS EEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: Ik L k Valuat ion: ??o (o? Date :
V?41 Site Address .?6/3 OFFICE USE ONLY
Lot AC{ Block 3 FEES
Occupancy
AGkNAWk CSL6N 201--? ADD!o
bBt
P
l
S Zoning
o
?S
m
-
arce
/
u Actual Const ,
o
B1dg. Per
it
7
x Owner VI,(/Cj?:UT ?in C S NI iCl t/ Allowable
# of stories Surcharge Sb
Plan Review
Length 12 x I/o SAC, City
Address 4')tl4,C Depth g' oe-Tcvorw LSAC, MWCC
S.F. Total Water Conn
City/Zip Code F46/4?j 5-g, 1,2 ?:L Footprint S.F. Water Meter
Acct. Deposit
Phone W -•-J,7,3j On site sewage_ S/W Permit
On site well 5/W Surcharge
X Contractor myy7, FaCii MWCC System _ Treatment Pl.
City water Road Unit
Address „Q]'IC!'.'/? 61 PRV Park Ded.
_
Booster Pump Copies 1.00
City/Zip Code Si P14UA /'t A.) 7 SUBTOTAL
APPROVAI.S Penalty
Phone ia) Planner TOTAL
Council
Arch./Engr. Bldg. Off. (($
Variance
Address
City/Zip Code
Phone #
UIILIiY EASEMEN) PEfl
?OOG NO 622))0
SB9°3T'29"E
ASHBURY
- - ll ? ?- a'I9°2/'on•
U;
u?
I--
r?
_ . _.... _._...?._M
N
M
0
O
% \\
\ 19
3
y
?
N??e3333^?
2p4 06
L, L. 1 r i-i V v I\ J L L I b
/1 r) r? 1-i- i /\ 1
IJi /- iLL) i iII, IJ
`
?3 9 97 RESIDENTIAL -1 5i
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
651•681-4675
New Conalruction Reauiremenq
• 9 registered site surveys showirg sq. ft, of lol, sq. R. of Aouse; and all roofed areas
(20% maximum lot coveiage albwed)
• 2 copies of pian sMwing 6eam 8 vnndow s¢es; poured Found design, etc.)
• 1 sel of Eneqy Calculatians
• 3 copies of Tree Preservalion Plan it lol platted aNer 7l1193
• Rim Joist Delail OpUOns selecfbn sheet (bidgs with 3 or less unAs)
DATE $- a - a it
SITE ADDRES
TYPE OF WO
iULTI-FAMILYBLDG _Y _N
PIREPIACE(S) _ 0 _ 1 _ 2
APPLICANT ?L
STREETADDRESS CITY WS\ `AU
TELEPHONE # (oSIASN(o CELL PHONE #
ATE ? ?'1NZIP SSL ?
PROPERTYOWNER jN")QK TELEPHONE#
.................................. ------'---------------------'-------------------------------'
COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ ?IINNliS01'A RliLES 7670 G\"CEGORl' 1 MINVESO'1:\ RL;LL:S 7672
(d submission type) . ResidenGal VenGlation Category 7 Worksheet Su6mitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Coniractor: _
Plumbing system includes:
Mechanical Contractor:
Mechaiiical sys[em includes:
Sewer/Water Conhactor:
Phone #
Fee: $70.00
---------------------------------------•---°---...----------...._..-------•-----------•-°----------------°-----------..
I hereby acknowledge that I have read this application, state that th i ormation is correct, and agree to compiy
with all applicable State of Minnesota Statutes and City of Eaga=??% Sig
nature of AppUcanf
OFFICE USE ONLY
_ Water Softener
Water Heater
No. of Baths
Remodel/Renair Reuuiremenh
• 2 :opies of plan
• lseto(EnergyCalculaGonsforheatedadditions
. 1 vte survey for extenor additions 8 decks
. InUicate il home sened by septit system for additions
VALUATION aa, 1'?a. ?
ra?nn s1. ? r?? 2 S90.00
?Ic?, of B'a? ? 2 002
Air Conditioning
Hcat Rccovcn' Systcm
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updaled 4102
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex 0 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex 0 17 Garege ? 22 Porch/Addn. (4-sea.) ? 33 Ext. AIt - SF
? 04 02•plex p 10 08-plex ? 18 Deck ? 23 Porch(screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex PI6g_Y or _ N ? 25 Miscellaneous
? 31 New O 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
O 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entira Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of 81dgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Smcco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ [nsulanon _ Retaining Wall
Approved By
Base Fee
Surcharge
Ptan Review
MCJES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
2004 RESIDENTIAL BUII.DING PERMIT APPLICATION Q4k 1.,?
City Of Eagan ??
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
NewCorstructlonReauiremenis RemodeVRepairReoui2menls
3 mgisteied site surveys shaving sq. ft of bt, sq. ft of house; and all roofed areas 2 copies o( plan ?fk?afi "?y et?? (20% maximum lot coverage albwed) i set of Energy CalculaUons for
heated addNons Tree Pre?n Recd* ?.'Y t?
2 copies of plan shawing beam 8 windax s¢w; poured found design, etc. 1 sAe survey for additions & decks Tree P2s#?eqWred'? •Y iN
7 set of Energy Ca?ula6ons Addftion - iiMicate Hrn-s8e septic system S?6 Al?6€ 6y3.(4Ln ?-,`_.' Y A
3 copes of Tree Preservation Plan'rf bt pWtted after 711l93
Rim Joist Defail Options selectlon sheet (bldgs with 3 or less unils
Date O? /_L9,_1 661
Site Address 3
NGb?
Construction Cost
Unit/Ste #
Description of Work r 2.
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 2
Property Owner (1) inCr,J Telephone #(G S I) G S?5- Cl z S I
Contractor
Address py,J &RA. /Z,-
State
Zip SS( Ik City? A
Telephone#(657 ) S-.Z Y
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventllation Category 1 Wwksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previousiy constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Telephone #(
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Teiephone #(
I hereby apply for a Residential Building Pernut and acknowledge that the informati Y' ate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans. ?-.AA ? n
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
)( 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 6ct. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screeNgazebo) ? 36 MuIG Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building O 42 Demolish Foundation X 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 WindowslDoors
? 34 ReplaCement •Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation 3 Occupancy 23 MCES System
Census Code . 434 Zoning ?• ? City Water
SAC Units ? e) ? Stories Booster Pump
# of Units o Sq. Ft. PRV
# of Bldgs ? Length Fire Sprinklered
Type of Const 1?? S Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addilion)
Foundation
Drain Tile
Roof Ice & Water Final
? Framiug -
Fireplace R.I. Air Test Final
? Insulation
REQUIRED INSPECTIONS
FinaVC.O.
? FinaUNo C.O.
_ Plumbing
HVAC
Other
Pool _ Ftgs _ Air/Gas Tests Final
? Siding _ Smcco _ Stone _ Brick
Windows
_ Retaining Wall
Approved By: NOJI"{&? , Building Inspector
__-----
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? -d 0
1 Od.?S
? For;OiYice us'e --------- -
? Permit#: / j
I Pertnit Fee:
I I
? Date Received: ?
I I
I Staff: I
I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: -L - -.? ' a6?.
Tenant:
Site Address:
Y
Suite #:
RESIDENT / OWNER Name: V\ CL Phone: ?•$?' ?
Address/City/Zip:?b?3 *IS?r-..,
Applicant is: _ Owner ?C Contractor
TYPE OF WORK Description of work,-O,yLk-ta? r--? 1 y t,4 lw1
Construction Cost: Multi-Family Building: (Yes _/ No 3L
CONTRACTOR Name: Y ?+ License#:
Address: D? ? J
City:? State: Zip:
Ph
?? D?
? ?a
one:
, Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Cdt@9ory Submitted Submitted
(q submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a pertnit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: phone:
MechanicalContractor. Phone:
Sewer 8 Water Contractor: Phone:
NOTE: Plans and supporting documents that you submif are considered to be publrc information. Portions of
fhe information may be classified as non-public!if you provid@ speciFc reasons that would permit t6e City to;-
` conclude that the are tra`de secrets.' ?11 fl
I hereby acknowledge that this information is complete and accurate; that the work will be in confortnance with the ordinances and codes of the Ciry of
Eagan; that 1 understand this is not a permit, but only an application for a permR, and rk i not to start without a permR; that the work will be in
accorclance with the approved plan in the case of work which requires a review and ap f p s.
X 34?? %- - .&eL x
Applicant Printed Nam ApplicanYs Signature
Page 1 of 3
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA150940
Date Issued:07/31/2018
Permit Category:ePermit
Site Address: 3613 Ashbury Rd
Lot:24 Block: 3 Addition: Blackhawk Glen 2nd
PID:10-14351-03-240
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Shannon Smith
3613 Ashbury Rd
Eagan MN 55122
(612) 221-1496
Bonfe's Plumbing & Heating
455 Hardman Ave
South St. Paul MN 55075
(651) 228-7140
Applicant/Permitee: Signature Issued By: Signature
. s*-
aile-r
�
For Office Use ill
tier •
.. D.----
'4,+ i •�• Permit#: /'//
E AA N E /g 7. O
or luto Permit Fee:
I � � � Date Received: '/31/1
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 AUG 1 1 207
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff:
buildinginsoections ancitvofeagan.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
Name: S h Q n 0r) Sryl;I-in Phone:
Resident/ ,f
Owner Address/City/Zip: 3(.1 3 Jl,ju r,1 'tri _......... 1J
Applicant is: Owner )(Contractor
/
Type of Work Description of work: peCK
•
Construction Cost: IA 00 Multi-Family Building:(Yes_/No )
Company: (,fy22iv 001Stl'uc ar LL e Contact (—akt, TGrrIth
Contractor Address: I' 1 O S D 51 E # (.. City: -riuttc 4, if_c'9kits-
State: MO Zip: 5So77 Phone: ' 1 Zy$cJf3Z Email: ev2.7:r'►Zee- 64/put?' ,co.—' .
License#: (3C 67C$y2- Lead Certificate#:
If the project is exempt from lead certification, please explain why:
5 u i H-in 19'og
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information may be
classified as non-•ublic If ou •rovide �•-cific reasons that would•<rmlt the Cit to conclude that they are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.cityofeagan.comFsubscrlbe.
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.aopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in cormance 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 of to start without a permit;that the work will be in
accordance with the approved plan in the case of work which requires a review and ap•royal of, -
Applicant's Printed Name Applic 's Signature
L.
3((3 s6 bOr rc(1 S <4(9. DO NOT WRIT BELOW THIS LINE
SUB TYPES
_ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
Multi ID Deck Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex Lower Level _ Pool _ Accessory Building
WORK TYPES
rNew Interior Improvement _ Siding — Demolish Building*
C 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 1 y3 51)' — Occupancy .2C-/ MCES System
Plan Review Code Edition/I9/7a Zoic SAC Units
(25%_ 100%y)) Zoning I-t City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings u Length Fire Suppression Required
Type of Construction IJI Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
--
ro Footings(Deck) Final I C.O. Required
Footings (Addition) ?Q Final I No C.O. Required
Foundation Foundation Before Backfill 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
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: 'TOW ,1Ciyg , Building Inspector
RESIDENTIAL FEES e e[L is,' 6 /gyp r 2- z- 51. 7-77
Base Fee �/ /`- / �
Surcharge P /1 1/ $7,/ `R 5 c? 'S9.
Plan Review
MCES SAC
city SAC
29 it •"4"--
Utility
P?-Utility Connection Charge £it9 1ST
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
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Receipt:#571055 3269140
EASE Return to: $46.00 IIII�P I till IOI itI IU. III 1111111
DOUGHERTY MOLENDA
14985 GLAZIER AVENUE Recorded on:91612018 12:06 PM
STE 525 By CZP Dept
APPLE VALLEY MN 55124
Office of the County Recorder
Dakota County,Minnesota
Joel T.Beckman,County Recorder
TEMPORARY CONSTRUCTION EASEMENT
This easement,made this 1 day ofAAS?_ ,2018,between Shannon Smith,
k\ property owner Lot 24, Block 3 Blackhawk Glen)2nd Addition (hereinafter referred to as
"Landowner"),and the City of Eagan,a Minnesota municipal corporation,organized under the laws
of the State of Minnesota(hereinafter referred to as the"City").
WITNESSETH:
That the Landowner, in consideration of the sum of One Dollar($1.00)and other good and
valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does hereby
grant and convey unto the City, its successors and assigns, a temporary construction easement for
site grading and excavation purposes over and across the following described premises, situated
within County,Minnesota,to-wit:
Together with a temporary easement for construction purposes, over, under and across that
part of said Lot 24,described as follows:
Beginning at the northeast corner of said Lot 24; thence on an assumed
bearing of South 00 degrees 12 minutes 55 seconds East along the east line
of said Lot 24, a distance of 32.97 feet; thence North 70 degrees 19
minutes 47 seconds West, a distance of 42.42 feet; thence South 19
degrees 40 minutes 13 seconds West, a distance of 20.00 feet; thence
South 70 degrees 19 minutes 47 seconds East to said east line; thence
northerly along said east line to the point of beginning.
Said temporary easement shall expire August 1,2019.
The grant of the foregoing temporary construction easement for site grading and excavation
purposes includes the right of the City, its contractors, agents and servants to enter upon the
premises at all reasonable times to construct, reconstruct and inspect site grading and the further
right to remove brush, undergrowth and other obstructions. After completion of such construction,
maintenance,repair or removal,the City shall restore the premises to the condition in which it was
found prior to the commencement of such actions, save only for the necessary removal of brush,
undergrowth and other obstructions, subject only to permanent easement alterations.
The Landowner, their heirs and assigns, does covenant with the City, its successors and
assigns, that it is the owner of the premises aforesaid and has good right to grant and convey the
easement herein to the City.
IN TESTIMONY WHEREOF, the Landowner has caused this easement to be executed as
of the day and year first above written.
f
STATE OF MINNESOTA)
)ss.
COUNTY OF'bc.i1�-aka. )
The foregoing instrument was acknowledged before me this 3t day of
iU. , ,2018,by '\(\0nm)n creq'Sti, .
rNYRMJCINNESO? {` V(ALLZL/A t
Notary ublic
APPROVED AS TO FORM:
City Attorney's Office
Dated: 1f/"10'
APPROVED AS TO CONTENT:
.-PLA--- ri
Public Works Department/
Dated: B-31— /6
THIS INSTRUMENT WAS DRAFTED BY:
DOUGHERTY,MOLENDA, SOLFEST,
HILLS&BAUER P.A.
14985 Glazier Avenue,Suite 525
Apple Vallley, MN 55124
(952)432-3136
Easement No. 1345/206-40076
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Receipt:#571055 3269139
ReSnto. II 11111 III I 1 II 111111111 III
5 GDOUGHRTY MOLENU Recorded on:9161201812:06 PM
14985 GLAZIER AVENUE
STE 525 By:CZP,Deputy
APPLE VALLEY MN 55124
Office of the County Recorder
Dakota County,Minnesota
Joel T.Beckman,County Recorder
DRAINAGE AND UTILITY EASEMENT
This Drainage and Utility Easement is made this 3 _day of et
2018, by and between Shannon Smith, property owner of Lot 24, Block 3 Blackfawk Glen 2nd
Addition (hereinafter referred to as "Landowner"), and the City of Eagan, a municipal corporation,
organized under the laws of the State of Minnesota(hereinafter referred to as"City").
WITNES SETH:
That the Landowner, in consideration of the sum of One Dollar ($1.00) and other good
and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does
hereby grant and convey unto the City, its successors and assigns, a permanent drainage and
utility easement over, across and under the South Quarter of the Southeast Quarter of the
Southwest Quarter of Section 16, Township 27 North, Range 23 West, situated within Dakota
County,Minnesota,to-wit:
hA perpetual easement for drainage and utility purposes over, under and across that
part of Lot 24, Block 3, BLACKHAWK GLEN 2ND ADDITION, according to
the recorded plat thereof,Dakota County,Minnesota,described as follows:
Beginning at the northeast corner of said Lot 24; thence on an assumed
bearing of South 00 degrees 12 minutes 55 seconds East along the east
line of said Lot 24, a distance of 32.97 feet; thence North 70 degrees 19
minutes 47 seconds West, a distance of 42.42 feet; thence North 19
degrees 40 minutes 13 seconds East to the northerly line of said Lot 24;
thence easterly along said northerly line to the point of beginning.
(hereinafter the"Easement Area")
See also Exhibit"A"attached hereto and incorporated herein.
The grant of the foregoing permanent easement for drainage and utility purposes includes
the right of the City, its contractors, agents and servants to enter upon the premises at all
reasonable times to construct, reconstruct, inspect, repair and maintain pipes, lift station pumps,
conduits and mains. After completion of such construction, maintenance, repair or removal, the
City shall restore the premises to the condition in which it was found prior to the commencement
of such actions, save only for the necessary removal of potential moveable obstructions.
And the Landowner, its successors and assigns, does covenant with the City, its
successors and assigns, that it is the Landowner of the premises aforesaid and has good right to
grant and convey the easement herein to the City.
IN TESTIMONY WHEREOF, the Landowner has caused this easement to be executed
as of the day and year first above written.
Ldf IL7'(//g)-
STAFF,
OF MINNESOTA)
)ss.
COUNTY OF DAKOTA)
The foregoing instrument was acknowledged before me this 3 day of
F\ , 2018, by Shannon Smith, property owner of Lot 24, Block 3 Blackhawk
Glen rd Addition.
MICKI LARAE WELCHER
".._ NOTARY PUBLIC-MINNESOTA
�� t My Commission Expires Jen.31,2020 Notary Public
APPROVED AS TO FORM:
City Attorney's Office
Dated: VW/7
APPROVED AS TO CONTENT:
1/17
Public Works Departme
Dated: 8-3l- fe
{
THIS INSTRUMENT WAS DRAFTED BY:
ik
DOUGHERTY,MOLENDA, SOLFEST,
HILLS &BAUER P.A.
14985 Glazier Avenue, Suite 525
Apple Valley,MN 55124
(952)432-3136
(RBB: 206-4768/Easement No. 13 42)
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