501 Chapel Ct 'Permit #
'Job Address
'Heating Contractor I✓!S.
'Testers/Signature
Pounds
Date Ji nee pLessure
"Gas Line
Pressurized
Inspected
E!EBEQBMANCF
'Percent CO(9~p ~ 'percent CO
Q
"Percent Op (0, 0 'Stack Temp.
Final Inspection Date
co
On Apffi 15, 2000 the Mlnnesota Energy Code, Category 180ding Requirements for insulation protection, air
tightness, and ventilation, was adopted, As a result, the City of Eagan is requiring that the following information be
submitted prior to issuance of a Certlftate of Occupancy.
This structure: Is constructed to meet minimum requirements of the Mn Energy Cade, Chapter 7670
OR
This clrucluro: will be cans W cted to meet more restrictive requirements of Chapters 7672 or 7674
i- +
APPLIANCER MODEL BTU'S VENTING TYPE
Plater HealeTI}~.J poO h
I L
Furnace 4~T V~
r,,9 o u} rr
- VENTED
~(HAtli ST SYSTEM LOCATION TYPE MODEL CFM's rea No
KnGren kitchen Ow.L
6a;hracrTi 'I
a+u f~(QDR AsIC
e3thra~m 2
1`7eo rl Sin x
I fia~hrc;m 3
A+' ~ ddM rl
6alhra0r. 4
C±tcr
VENTING
FIREPLACE'S LOCATION GAS WOOD MANUFACTURER MODEL BTU'S DIRECT ATMas
, A,d Rwa _ LeA)A)v /Neat 3530 al o00
MAKE-UP AIR MODEL TYP CFM's
,t1 FRS A,+.~
I horoby acknowfodga that the ahovc information is correct and agree to comply With the Minnesota Energy Code and City of Eagan
rcqu!rements.
rZ ~io.r
Si0"at r Dat . -
Company Name
Tnls form Is the responsiblllly of the General Contractor.
Address 5 0 1 Chapel C t Zip 5512
Lot 17 Blk 1 Sub Cherrvwood Knoll
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: 8-. Yes No Inspector:
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 shut-off 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
Site address: S I Cl,~ro Lot I Block Subd.(1Trrjw0dk6 t n"JLL_
On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air
tightness, and ventilation, was adapted. As a result, the City of Eagan is requiring that the following information be
submitted prior to issuance of a Certificate of Occupancy.
I This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
- This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE
Water Heater x (,INYroaW A) L40000 pfrs.CT- PUc-
'ZSoaa ~+D QUc
Furnace 15-: AJNbx G -z(,,
Dryer twuICNOwt1 wNun~drv~ t4 "`max`
VENTED
EXHAUST SYSTEM LOCATION TYPE MODEL CFM's YES NO
Kitchen kitchen x
Bathroom 1 '12. 6 Agli 5-M 50
Bathroom 2 wry, rLR- S 7L 50
Bathroom 3 5~-D rjU
Bathroom 4
Other
VENTING
FIREPLACES LCCATION GAS WOOD MANUFACTURER MODEL BTU'S DIRECT ATMOS
~Ri1t! Nd ~IOCJ X
MAKE-UP AIR MODEL TYPE CF9OS
`ass F►ss~ Hr~u"~u~T pL50 ~v n fNrr6✓SfldN E}rf1 ZIXOGFr r
I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan
requirements.
I G`f D Z R~~ NZ L Za/oL
Signa> r { Date
Company Name
' This form is the responsibility of the General Contractor.
45, lqs ~i
RESIDENTIAL
Ch~,vey~W~ rVI ( BUILDING PERMIT APPLICATIOWP#N-"5/ O 1J0-50
CITY OF EAGAN PP Oz/0s(.0l
3830 PILOT KNOB RD - 55122
651-681-4675
51 Ss-y,
s
New Construction Requirements V~' ~1,~.L'-- RemodellReoair Requirement
• 3 registered site surveys showing sq. ft. of lot, sq. fL of house; and all roofedd ail • 2 copies of plan n
(20% maximum lot coverage allowed) rJ 1 W 3~ 1 set of Energy Calculatons for heated additions
• 2 copies of plan showing beam 8 window sizes; poured found design, etc.) ~j 1 site survey for exterior additions & decks „nn
1 set of Energy Calculations V~
• 3 copies of Tree Preservation Plan if lot platted after 711193
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE I zl ZS~f d' VALUATION (EXCLUDING LAND) Zo 000
JOB SITE ADDRESS So ~ C ~r~J4l C7'
IF MULTI-FAMILY BUILDING, HOW MA'N'Y UNITS?
PROPERTY OWNER V A14c_ / X46 m4 s
TYPE OF WORK Nev') SZL- ~A»irLY FIREPLACE(S) _0 1 _2 _3
APPLICANT 5A4vn'F-, PHONE # 01-'154 - 5 330
ADDRESS X1,3 0 FLAc~4AwIL Aa k lIL4 E ZIP CODE 5--;) ~
PAGER # CELL PHONE # Tab SW ?T• (oI? - 3(03 AXF # (oS~-t (S~ -~9 5~
2(15
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category V;dNNESOTA RULES 7670 CATEGORY I
(check one) Residential Ventilation Category 1 Worksheet Submitted
d Energy Envelope Calculations Submitted
I
_ MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Plumbing Contractor: SCo W/lR G~ PL~emBJ~C- Phone (P5 C- 4SD - (01(05
Plumbing System Includes: _ Water Softener Lawn Sprinkler Fee: $90.00
Water Heater No. of R.I. Baths
No. of Baths
eLj
Mechanical Contractor: ~ 01✓1N5 Phone # L05[ ` 23 - S °7 S?
Meclumiatl System Includes: ] Air Conditioning Fee: 570.00
Heat Recovery System x~kNsoa
Sewer/Wafer Contractor. 5co S wfl~~11°tt u 1 '5YCA
()#MlPhone #
i i
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 Ordinances.
1 n
Signature of Applicant
Certificates of Survey Received Tree Preservation Plan Received _ Not Required _
NO 5t NrF(C-Aril-' -t h~~ S up aced 1i01
OFFICE USE ONLY
❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg
X02 SF Dwelling ❑ 08 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 Ext. Alt - SF
❑ 04 02-plex ❑ 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 Plbg_Y or- N ❑ 25 Miscellaneous
31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding
❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair
❑ 33 Alteration ❑ 37 Demolish (Bldg)' ❑ 43 Reroof ❑ 46 Windows/Doors
❑ 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation -53, o o0 Occupancy MC/ES System
Census Code O ~ Zoning City Water
SAC Units o Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length t~ Fire Sprinklered
Type of Const V Width '
REQUIRED INSPECTIONS
Footings (new bldg) Final/C.O.
Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation _ HVAC
_ Drain Tile
Roof ~ Ice & Water Final _ Other
Framing _ Pool _ Ftgs _ Air/Gas Tests -Final
y( Fireplace -J~ R.I. XAir Test X Final Siding Stucco _ Stone
X Insulation _ Windows (new/replacement)
Approved By Building Inspector
Base Fee
Surcharge i3/TS~ ! 7 ~itlnrf
Plan Review X I S:, - 12- YO
MC/ES SAC / tQ
City SAC /`iqw C£Lf U b n f
Water Supply & Storage
S&W Permit & Surcharge J"
Treatment Plant V pr% L-£U£
Plumbing Permit 107V prx oU ~ a ( ~~O
Mechanical Permit
License Search
Copies 6 Yo Pd r `~G
Other
Total / S~Z 7
I
MNcheck COMPLIANCE REPORT I
Minnesota Energy Code Permit #
MNcheck Software Version 3.0
I
Checked by/Date
I
COUNTY: Dakota
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Family
DATE: 12-28-2001
DATE OF PLANS: 12/28/01
TITLE: Eagan Model
PROJECT INFORMATION:
501 Chapel Court
Eagan, MN
COMPANY INFORMATION:
Variety Homes, Inc.
4130 Blackhawk Rd. # 114
Eagan, MN 55122
COMPLIANCE: PASSES
Required UA = 602
Your Home = 446
25.9°% Better Than Code
Area or Cavity Cont. Glazing/Door
Perimeter R-Value R-Value U-Value
CEILINGS 1240 44.0 0.0
WALLS: Wood Frame, 16" O.C. 3177 19.0 0.0 1
BSMT: Conc. 8.0' ht/7.5' bg/8.0' insul 1008 10.0 0.0
GLAZING: Windows or Doors, Above Grade 387 0.350 1
GLAZING: Windows or Doors, Above Grade 40 0.350
DOORS 38 0.350
HVAC EQUIPMENT: Furnace, 92.0 AFUE
COMPLIANCE STATEMENT: The proposed building design described here is
consistent with tTII&-building plans, specifications, and other calculations
submitted with th permi plication. The proposed building has been
designed to meet r.qu ments of he Minnesota Energy Code.
~ J f
Builder/-".,,,,"- Date
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTYLEGAL: t a t 17 l31acJK l C-IGr:rn wdu~ Kti~
DATE OF SURVEY:
LATEST REVISION: / D
m
or
c
m
i DOCUMENT STANDARDS
O z
❑ • Registered Land Surveyor signature and company
Q/ ❑ ❑ • Building Permit Applicant
C~ ❑ ❑ • Legal description
[~j❑ ❑ • Address
d ❑ ❑ • North arrow and scale
GJ~ ❑ ❑ • House type (rambler, walkout, split w/o, split entry, lookout, etc.)
U/ ❑ ❑ • Directional drainage arrows with slope/gradient %
d ❑ ❑ • Proposed/existing sewer and water services & invert elevation
d ❑ ❑ • Street name
19/0 ❑ • Driveway
D' ❑ ❑ • Lot Square Footage
E(/ ❑ ❑ • Lot Coverage
Ct ❑ ❑ • Benchmark
ELEVATIONS
/ Existing
W o ❑ • Sewer service (or Proposed)
¢V CI ❑ • Property comers
LV ❑ ❑ • Top of curb at the driveway and property line extensions
UK ❑ ❑ • Elevations of any existing adjacent homes
❑ t/ ❑ • Adequate footing depth of structures due to adjacent utility trenches
❑ ❑ • Waterways (pond, stream, etc.)
Proposed
P/ ❑ ❑ • Garage floor
I9' ❑ ❑ • First floor
U/❑ ❑ • Lowest exposed elevation (waikout/window)
IV ❑ ❑ • Property comers
❑ ❑ • Front and rear of home at the foundation
PONDING AREA (If applicable)
❑ I9/ ❑ • Easement line
❑ a/ ❑ . NWL
❑ @-, ❑ • HWL
❑ IR/❑ • Pond # designation
❑ ❑ • Emergency Overflow Elevation
DIMENSIONS
~;r ❑ ❑ • Lot IinesBearings & dimensions
W ❑ ❑ • Right-of-way and street width (to back of curb)
r~ ❑ ❑ • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent footings)
ff/ ❑ ❑ • Show all easements of record and any City utilities within those easements
If ❑ ❑ • Setbacks of proposed structure and sideyard setback of adjacent existing structures
6/D ❑ • Retaining wall requirements, N any
Reviewed:
Name / Date
CERTIFICATE OF SURVEY V1 0-87- 01
for
VARIETY HOMES ulAly U 0 ntt; D
I ~ ~ I
I I~~
~
~`9712
0. t.98 25.00 .a]3 ;i
67
0 -7
90'00'00" E _ 1/1,*,
io F-,
4E7~ 97
26.00 O qI 3 0 T.00 (D V)
2.00 SJO
W Gor slab m 3 O
7/,Y3~ o Top74,S n.67 81 h m
,t I l 61ks7ka3
°0.
~ ~ JJJGGG I
a~
20).oo
U 10 '~j 0,
3.foH Ln x,33
25.00
2 4
N 9D'00'00" E
I I
lo, ST LT f~NGe
I I
~5~8;9t4,
F' 03z S
Lo 1
Scale: 1" = 30' _ TO -Chapel Court
DESCRIPTION
I hereby certify that this survey, plan, or
report was prepared by me or under my direct Lot Lot 1 177, , Block 1, CHERRYWOOD KNOLL
supervision and that I am a duly Registered Dakota County, Minnesota
Lond Surveyor under the Lows of the State
of Minnes' c. Plat bearings shown
o Denotes iron monument
Date' 1 GC. `200) Reg. No. 8140 Existing j Proposed
P- C; V 3 Oz
BRANDT ENGINEERING & SURVEYING
14041 Burnhaven Drive, Suite 114
Burnsville, MN 55337
(952) 435-1966 V10-87-01
PERMIT
City of Eagan Permit Type: Mechanical
Permit Number: EA104846
~it~ Date Issued: 06/13/2012
of On Permit Category: ePermit
Site Address: 501 Chapel Ct
Lot: 17 Block: 1 Addition: Cherrywood Knoll
PID: 10-17050-01-170
Use:
Description:
Sub Type: e - Air Conditioner
Work Type: New
Description: Air Conditioner
Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952)
445-2840
Scott Lofgren
5708 Upper 147th St W #102
Fee Summary: ME - Permit Fee (Replacements) $55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
Total: $60.00
Contractor: - Applicant Owner:
Lofgren Heating & Air Robert M Galezewski
5708 Upper 147th St W 501 Chapel Ct
Suite 102 Eagan MN 55121
Apple Valley MN 55124
952 431-5811
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.
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
-For --Offi-o Use ~
I f
j Permit / V 7 j
City of Eapn Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 I Date Received: j
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 staff:
J
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
.-t
Date: )a Site Address: Unit
Name: &a e.-zeLam' Phone:
RESIDENT / t~
OWNER Address / City I Zip: L C k~ peu 1 C o o v" 1
Applicant is: Owner + Contractor
TYPE OF WORK Description of work: `Feck'r CJf f O'V'N ~ Re r4o f 1"t OAJi e * C'`0'f"~ q e
~ tJ
Construction Cost '1 .7 Multi-Family Building: (Yes No V_J
C
Company: A 6yy e6ocxr~ 1'tC3cCm fS I Atoo `T'1CContact: 'Ocyy' e
CONTRACTOR Address: o 71o l M ~ 6Y tii<Ave iv city: C-t'•
State: M A. Zip: SsO'7 3 Phone: GS i X32 o6 o
License Pbc'A -1 LH : Lead Certificate 1 11 S
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
o f t !'bo r b t 41 ~ao S I t; Arse Teel- o f eN r w1 i- * A O w f vt ~ G' c (mil I
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 the 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.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and odes 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.
xTAVi~ 1."?'r Sto; 5 ! x
Applicant's Printed Name Applicant's Signature
Page 1 of 3