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4510 Alicia Dr ?? 9 14 41 1 ? tAti?+t 609? ri f7ega?ara • 3 registered site surveys'showing eq. R. of lot, sq, ft. of hem; srtd ell roofed areas (20% maxkn s lot coverage allowed) • 1 set of Energy Calculations for heated additions • 2 copes of plan showing beam & window sizes; poured found design, etc.) • 1 site survey for exterior additions & decks • 1 set of Energy Calculations • Indicate if home served by septic system for additions • 3 copies of Tree Preservation Plan if lot platted after 7/1/93 • Rim Joist Detail options selection sheet (bldgs with 3 or less units) DATE VALUATION 3 yob JOB SITE ADDRESS IF MULTI-FAMILY BUILDING HOW MANY UNITS? PROPERTY OWNER ' t'ke( S S c I/ L TYPE OF WORK JJ FIREPLACE(S) _ 0 1 2 APPLICANT PHONE# 6(2 ?2 fi - 2 ADDRESS ZIP CODE PAGER # CELL PHONE # FAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category MINNESOTA RULES 7670 CATEGORY (check one) Residential ventilation Category I Worksheet Su - Energy Envelope Calculations Submitted MINNESOTA RULES 7672 New Energy Code Worksheet Submitted By Plumbing Contractor. Phone #: Plumbing System Includes: Water Softener Lawn Sprinkler Fee: $90.00 Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor Phone # Mechanical System Includes: Air Conditioning Fee: $70.00 Heat Recovery System 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 corre , a agree to comply with all applicable State of Minnesota Statutes and City of Eagan Or ances. Signature of Applicant Certificates of Survey Received Tree Preservation Pla eeeived Not Required Updated 1/01 s "?ry!p',7iT'r?y' M'i_ Ae'1719 'ri /W.f?Y i"tf?' 77 ' y y j ? o 0 04 02-p ex o 10 08-plex 9-010, Deck t 23 P 6%h (s ned) 0 38 Multi 0 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage O 06 04-plex 0 12 12-plex Pibg_,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 0 33 Alteration 0 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation(, Occupancy MC/ES System Census Code Zoning City Water Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) - Final/C.O. 9 Footings (deck) _eV Final/No C,O. r Footings (addition) Plumbing Foundation HVAC Drain Tile Roof Ice & Water F inal _ Other Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final Fireplace - R.I. Air Test - Final _ Siding _ Stucco _ Stone _ Insulation Windows (new/replacement) - - - ---- - -- - ------- Approved By , Building Inspector Base Fee - - - Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total ARK U RW..Y Foi'; qLW% q42 ,5 , ?0 ND 1 ?c?usf `D NUkc?3 •L r? ' map tam `ToP N e' © F G t E ;' lz -- ° C5 ' E. 1 0 4 9 ?° x .3) _ ???d to± f ? E0 ( i , I tM ? LIP r 1 1 r7' ` °i 934 .0 j 24.0 .? Q Cf @ I t.z ?AA t Z. 10 -5 *63 IDt co Hue> .4? \ 4. C>e-' °00 GQD = q??o,4} 8? ?7 t ?{? d,? ` 'Tap \U1g Sup (- ?V LOT 42;CDC, Sutt..01k1c AREA = 2 9 .'lBearings are assumed ?,I°1 ,•? IYC b4E ; I.R W ? 0 - fir ?? fc, Subject to easements,of recor i -•any Itatl,zq'o Q Denotes set or found iron pipe monuments 93°).0 loo Denotes set wsead hub and tack -!? Proposed garage,,,floo, r elevation 'Te4o Denotes existing elevation q4 Proposed top of Meek elevation 84O Denotes proposed finish grade elevation Denotes direction of surface drainage • Proposed lowest floor elevation ?O'TP. ' O' "CtTLF OPwto0 FUR?JtsHFFO I hereby certify that this is a true and correct representation of a survey of the boundaries of Lot Block 1 , SOUTItER14 KY'E? art O1'tTh County, Minnesota as on file and of record in the Office of the County Recorder in and for said County, also showing the proposed location of a house as staked thereon. That I am a duly Registered Land Surveyor under the Laws of the State of Minnesota. Hated: dwa"N lkutu'b: Uo I C&qt Allan R. Hastings Minnesota Registration No. 17009 212 First Avenue E. Suite No. C W .. y ,...,? -Shakopee) Minnesota 55379 Phone 612 445 4027 • 57 Site Address 4510 Alicia Drive Lot 6 Block I Subdivision Southern Lakes West Permit # EA XXXXXX This structure is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670. X This structure wilt be constructed to meet more restrictive requirements of Chapter 7672, or 7674. Path I Appliance Gas Electric Manufacturer Model BTU's Venting Type Water Heater Yes Marathon MR #105-245 15,358 Not applicable Furnace Yes Carrier 58 MVP 080 or = 80,000 sealed con*ustkm, d t vent Dryer ? ? 2 ? ? To be purchased & tnstatled by homed er Exhaust System Location Type Model CFM's Vented Yes No Kitchen Kitchen mkroty? Amana MVH25o WAS or = 250 Yes Bathroom # 1 Main floor bath Ceiling Broan # 688 or = 50 X Bathroom # 2 2°d Floor Main Bath Ceiien Broan # 688 or = 50 X Bathroom # 3 Master bath Ceiling Broan # 688 or = 50 X Bathroom # 4 Other Fireplace (s Location Gas Wood Manufacturer Model BTU's Sealed Direct Atmos Family room Yes Heat N Glo 6000 TR or = 30,000 Yes Make-up air Model Type CFWs Summer Aire Pro Ventor SH125 or HRV 125-180 hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and the City of Eagan requirements. Signature Company Name M. R. Hebert & Associates Inc. License # 5700 due Rdpgtferusnts F ` t ?., i., Ft' • 3 registered site surveys showing sq. ft. of lot, sq. it of house; and ail roofed areas • 2 copies of 0 01 rr?, (20% maximum lot coverage allowed) • 1 set of Energy °Calcutations for hated add9irtt ? V . • 2 copies of plan showing team & window sizes; poured found design, etc.) • 1 site survey for exterior additions & decks • 1 set of Energy Calculations • 3 copies of Tree Preservation Plan if lot platted after 7/1193 Cqlled 311/,J • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) 'Q>< DATE VALUATION (EXCLUDING LAND) JOB SITE ADDRESS S / O / u c ?zr c.? s _ IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNERfr ? .2. /T/ ` sc c_ 7Z -c' i (PE OF WORK 3 F 2 FIREPLACE(S) _0 APPLICANT V, F c S cs c.. PHONE # 3Z E ADDRESS 2 3 3 oc? I-'-6c--rX1n1r dz- % -mac ZIP CODE S' 9 2- `?? p 7 PAGER # CELL PHONE # FAX # NEW RESIDENTIAL BUILDING ONLY FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted NESOTA RULES 7672 New Energy Code Worksheet Submitted Plumbing Contractor: Plumbing System Includes: Water Softener Lawn Sprinkler Fee: $90.00 Water Heater _ No. of R.I. Baths No. of Baths r Mechanical Contractor: Phone # a 1 _ Mechanical System Includes: ditionng Fee: $70.00 Heat Recovery System Sewer/Water Contractor: r-- Phone # jW4 `I All above information must be submitted prior to processing of application. tC I hereby acknowledge that I have read this application, state that the information is co t, d a g co p?'y with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant Certificates of Survey Received Tree Preservation Plan Received L) Not Required Updated 1/01 {-.,M ".. - - ,. r' of _ ptex' rl do 701-0ex : y?r ??r'ts:;ni'ii? ¢? /`-f4 }4._°'{ r- • r-r _ '. u?`'.• rt ?,,s ' ;' CI ' ? ' +q . ; 1 r+1 . Cl 04 02-plex 0 10 08-plex ?' 1$ f k 0 23 Porch ( eened) Cl 36 05 03-plex 13 11 10-plex ? 19 Lower Level ? 24 Storm Damage 0 06 04-plex ? 12 12-plex Plbg_Y or _,_ N ? 25 Miscellaneous K 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. 0 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 70, ow Occupancy '# MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs __ Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS X 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 Air/Gas Tests Pool Ftgs Final _ _ Fireplace J( R.I. 4 Air Test Final Siding Stucco _ Stone Insulation Windows (new/replacement) -------------------------------------------- Approved By -------------- ---- --- - Building Inspector - ------------------ ------- Base Fee ---------- - --- - -- - - ----- - --------------------- ---- - -- - - Surcharge -o Y, 0 Plan Review MC/ES SAC ?i City SAC Water Supply & Storage S&W Permit & Surcharge ? Treatment Plant I Plumbing Permit ?~~~ Mechanical Permit License Search C pi es o Other Total 2001 Building Permit Application (Residential) Date March 10"'. 2001 Construction cost 5 129,470 Description of work Single Family Dwelling Street Address 4510 Alicia Drive Lot 6 Block I Subdivision! PID. # Southern Lakes West Property Owner Name M. R. Hebert & Associates Inc. contact Mark Hebert Phone # 952.461-4195 mobile 612-328-2592 Fax 952-461-4197 E-mail mr hebertAmsn.com Street address 23300 Grandview Trail City Lakeville. State Minnesota Zip 55044 Contractor Company M. R. Hebert & Associates Inc. Phone 952-461-4195 Contractor M.R. Hebert & Associates Inc. Phone 952-461«4195 Street address 23300 Grandview Trail license # 5700 Zio 55044 Architect! Engineer Corry Planco Name Torn Korb Phone # 651-452-0724 Street Address 3435 Washington Or City Eagan, State Minnesota Zip 55122 -8939? Sewer ! Water contractor licensed Plumber Clearwater Plumbing (612) Heating & Air Conditioning Contractor Lofaren Heating & Air 651-460-8313 I hereby admowledge that I have read this application, that the info is correct, and agree tP comply with all applicable state of Minnesota Statutes Ciity of Eagan nances. Signature of applicant . E ._MNcheck COMPLIANCE REPORT Minnesota Energy Code Permit # 1 MNcheck Software Version 3.0 1 Checked by/Date 1 COUNTY: Dakota 1 STATE: Minnesota ZONE: 2 . OO +TSTRUCTION TYPE : Single Family DATE: 3-8-2001 .PROJECT INFORMATION: 4510 Alicia Drive Lot 6 southern Lakes West CORNY INFORMATION: MR Hebert & Associates Inc. _,'IANCE: PASSES Required UA = 635 Your Home = 450 29.1% Better Than Code Area or Cavity Cont. Glazing/Door Perimeter. ------------- -- - R-Value R-Value U-Value --- - ----- UA - - - -------------------- CEILINGS ------- 1592 -------- ------- ----- 44.0 0.0 ---- 43 WALLS: Wood Frame, 16" O.C. 2883 19.0 0.0 170 WALLS: Wood Frame, 16" O.C. 290 0.0 8.0 34 BSMT: Conc. 9.0' ht/8.0' bg/9.0' insul 1303 12.0 0.0 73 GLAZING: Windows or Doors, Above Grade 261 .0.350 91 DOORS 10$ 0.350 38 FLOORS: Over Unconditioned Space 30 30.0 0.0 1 HVAC EQUIPMENT: Furnace, 94.0 AFUE -------------------------------------- ------- ----------------------------- ----- COMPLIANCE STATEMENT: The proposed building deli described here is consistent with the building plans, s ificati , and other calculations submitted with the permit applicatio The pr zed building has been designed to meet the requi is the Minn sota Energy Code. Builder/Design Date Aggregate Make-Up Air Alternative and Ventilation Documentation (Can be Used as a Supplement to Permit Application) i Bldg Address: 4510 Alicia Drive Date: 3/10 2001 City: Eagan Zip Code: 55077 Completed By: MRH Co. Name: M. R. Hebert & Associates Inc. Path t1, Aggregat e Alternative Exhaust Devices CFM Space Heater: Sealed Combustion Clothes Dryer 150 Water Heater: Sealed Combustion Kitchen Exhaust 250 Gas Hearth: Sealed Combustion Master Bathroom 50 Solid Fuel Hearth: None 2nd Fl Bathroom 50 CO Alarm: Not Required 1st Fl Bathroom 50 Make-Up AIr Central Vacuum None Exhaust Devices Dryer Kitchen Largest other Total Exhaust Capacity 150 250 50 450 Distribution CFM Passive Infiltration 425 Passive Opening(s) Rigid Flex Direct 25 3 4 2 Powered Make-Up 0 Ventilation Minimum Required Sq. Ft. Bedrms Total Ventilation People Ventilation Supplemental Ventilation 3998 4 200 75 125 People installed ventilation in e>s of the required minimum people is deducted from the required minimum supplemental. This is based on the Energy Code definition of Supplemental = Total minus People. People Supplemental HRV or ERV 1 183 cfm. HRV or ERV 1 0 cfm. Master Bathroom 0 cfm. Master Bathroom 5a cfm. People: 183 cfm. Supplemental: 50 cf'm. Total: 233 cfm. Ventilation Measurement Documentation V B1d Address: 4510 Alicia Drive Date: Ci : Eagan Zip Code: 55077 Completed By: MRH Co. Name: M. R. Hebert & Associates Inc. Path 0, Aggregate Alternative Ventilation: Measured Performance People ventilation Supplemental Ventilation Total Ventilation Minimums ---> 75 125 200 Measured Measured People Designed Intake Exhaust Supplemental Designed Intake Exhaust HRV or ERV 1 183 cfm. HRV or ERV 1 0 cfm. Master Bathroom 0 cfm. Master Bathroom 50 cfm. People: 183 Cfm. Supplemental: 50 cfm Note: Air flow for balanced ventilation systems must be balanced within ten percent. Total Designed Ventilation: 233 cfm. Total Measured Ventilation (people + supplemental): Compliance Statement: Installed ventilation system is in compliance with the MN Energy Code and sized to provide the design air flow. Applicant (print name) Signature Date Phone number Window and Door Schedule 4510 Alicia Drive, Lot Lot 6 4510 Alicia Drive Lot 6 block I Type Count Series Size Location Width Height Sq " U-Value Windows A 5 201s1 Sox4o Basement, study 60 48 14400 B 2 201 2ox50 fixed breakfast 24 60 2880 C 1 201 sl 9ox50 familyroom 108 60 6480 D 1 701 20x44 1-1 casement right, grids Laundry 25 49 1225 E 1 201 5ox5o grids, transom Dining,bed 60 72 4320 F 1 0 G 1 201 sI 4ox4o Kitchen 48 48 2304 H 0 1 0 J 1 20191 4ox4o master bath 48 48 2304 K 1 201 sI 5ox50 grids Front bedroom 60 60 3600 L 0 M 0 N 0 0 0 Total Sq. In. 37513 Total Sq. Ft. 260.5069 Doors AA 1 3101 Patio with transome right op breakfast 72 80 5760 BB 1 3101 SGD right operate basement 72 80 5760 CC 1 30910 front door transome & side light 69.25 100.25 6942.313 DD I 2-8x6x8 a 10, hinge right hinge left closer 65/8" jamb 34.25 82.5 2825.625 Total Sq. In. 15527.94 Low E, Argon Total Sq. Ft. 107.8329 18 White vinyl Jamb 6 112 pine Inc. Hebert Associates 23300 Grandview Trail, Lakeville, Mn Office 952-461-4195 Mobile 612-328-2592 Hayfield Window Et Door Product Performance Chart l}J -., nr ni r Praduct Infiltr3tion Sofar Gain Co Haat efficient Visible light Trinsmissiin Product * 4 0.02 Z5 per z9 54 -..55 .6ia : 32 i 31 .30 52 .5tt .28 29 .31 .30 .52 .50 - 10 .29 0.02 7.5 psf 29 31 1 30 .52 .50 - rr - _1•.x.'1; Y"r j,. oy . \ Slider 49 .49 S.H. 0.06 Sit 3.0 pd 20 .54 .55 .56 .56 34 .35 S1;der 0.03 Slider 5.25 psi .30 1 .30 .51 = .49 tewri .30 .31 30 30 .51 AS : . 4 0 - - pa€ 51 5t 53 29 .30 .29 .29 .50 .97 49 3 0 02 0 psf 6 77 .55 .59 61. 62 . . . 32 :33 31 .37 .53 _54 = 5 :29 .31 -32 .53 54 IT, CUHNEH; 651 633 8884; Jan•29•01 9:58AM; Page 2/2 n.nM, cT L?ij cmHcm 0 November 17, 2000 No one builds a better fire Bruce Nelson Senior Engineer Energy Division 121 7 Place East St. Paul., MN 55101-2145 RE: Sealed combustion certification Dear Mr. Nelson: This letter certifies that the Heat-N•Glo direct vent fireplace models fisted below have been tested and meet the criteria. of the 2000 Minnesota Energy Code, Chapter 7672.0900, Subpart 8.A. (9) "Sealed combustion appliance". The units, when installed to manufacturer's instructions, will function and draft properly at negative pressure of 50 Pascals. 6000TRB 7000XLS 6000XLS8 PIER TRC 7000TR SL-350DVT Underwriters Laboratories,.Inc, administered these tests and results are on file. Please contact me if you have any questions. Sincerely, Marc Fuller Agency Compliance%Reliability Manager Ph. (952) 985-6572 Fax (952) 985-6772 Page (651) 908-0060 HEAT.N.GLO a division of Hearth Te hnologics•20802 Kensington Bivd.«Lakcviitc MN 55044 LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION PRO PERTY LEGAL: G a?" ?0 8?e? l S'd u #r n Gs t?GS L?eS DATE OF SURVEY: 1 LATEST REVISION: ° f?- DOCUMENT STANDARDS o [y ? ? • Registered Land Surveyor signature and company U/ 0 ? • Building Permit Applicant 0 • Legal description q/ ? ? • Address 0 ? • North arrow and scale W/ ? 0 • House type (rambler, walkout, split w/o, split entry, lookout, etc.) i' ? 0 • Directional drainage arrows with slope/gradient % [9K ? ? • Proposed/existing sewer and water services & invert elevation ? ? • Street name 0 ? • Driveway L F S 0 0 • ot quare ootage L C (13 ? ? • ot overage ELEVATIONS Existing 0 0 • Sewer service (or Proposed) C7", 0 ? • Property comers C/ 0 0 • Top of curb at the driveway ig/ ?/ 0 • Elevations of any existing adjacent homes Ad f f i h t ilit h c 0 W ? • es equate oot ng dept o structures due to adja en ut y trenc Proposed / P/ 0 ? • Garage floor d 0 / ? • First floor L / i do 9 ,o 0 • owest exposed elevation (walkout w n w) i 0 ? • Property comers ? ? • Front and rear of home at the foundation PONDING AREA (if applicable) 0 13 ? • Easement line ? ? • NWL 0 [D' ? • HWL ? f /? • Pond # designation ? [P/ 0 • Emergency Overflow Elevation DIMENSIONS / ? ? • Lot lines/Bearings & dimensions ? 0 • Right-of-way and street width to back of curb) ( ' ? ? • , porches, etc. Proposed home dimensions including any proposed decks, overhangs greater than 2 (i.e. all structures requiring permanent footings) 0 0 • Show all easements of record and any City utilities within those easements ftY ?/ El • Setbacks of proposed structure and sideyard setback of adjacent existing structures U • Retaining wall requirements, if any Reviewed: t 'f 3. O Na e / Date March 1999 CRAK''IRI flc PRMT FM. M&R 1 `.R 45U RVEY Fqij; C ?.-9az,5 Aope S Pr-p- 01'.4 1- 417 10 ?. v R42.t ?! ,, `` tVO : tL oc"N'sE AD tt?uti3Ei ?' p' " ?bP \4uF6 P 1 ) ?- 3 N & ?,-q33 ai E ,. 40,8 939-ta f?'' v? Yr GD o c7 130.(09 / -t- --? - -i 10 1 10 ' I r- qfo$ { LU q43, +1.+ti30Pr h u t.? 34 Denotes direction of surface drainage Z2Q it .q 1 9a4 t MAD 4 934 Ifi-JA '9 00 J I 24.0 f1j ?r Q V) 4?0 tt .... _. Icy J ? at tot ss-T-Or'?),5? ,, E a Ug D4 'To ? uP? 37. ? cr Leo = q ` XJL_T eBrA) C?5_j -1-69 ?kLAJ2> LOT key 00c, t.. Bearings are...assumed.. 611?%>TV_ SEW ER,A U) I\ WP- Pig LINOS Subject to easements of record if any 1 ) ac o 0 Denotes set or found iron pipe monuments t1 ?'r?. ' i?JO1•? {?} Denotes set wood 'hub and tack °' Proposed garage floor elevation 'TB4o Denotes existing elevation Proposed top of bloek elevation ?q q Denotes proposed finish-grade elevation Proposed lowest floor elevation A?Q?: 'I?o ?T?-r?? (?pl??o? FuR??sHFC? J nh Ja Q I hereby certify that this is a true and correct representation of a survey of the boundaries of Lot 1 Block 'I SO tT&ERA LKKES R-r ?AKtiTc County. Minnesota as on file and of record in the Office of'the County Recorder in-and for said County, also showing the proposed location of a house as staked thereon. That I am a duly Registered Land Surveyor under the Laws of the State of Minnesota. Dated: REu rcb, mR '?, 2c?a Allan R. Hastings Minnesota Registration No, 17009 212 First Avenue E. Suite No. C Shakopee, Minnesota 55379 Phone 612 445 4027 Address 4 5 1 0 A l i c i a Dr Zip 5512 Lot 6 Blk 1 Sub Southern Lakes West THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: 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 remo4al 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 RESIDENTIAL p / BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Reauirements RemodeUReoair Reagirements • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan (20% maximum lot coverage allowed) • 1 set of Energy calculations for heated additions • 2 copies of plan showing beam & window sizes; poured found design, etc.) e 1 site survey for exterior additions & decks 019. • 1 set of Energy Calculations • Indicate if home served by septic system for additions • 3 copies of Tree Preservation Plan if lot platted after 711/93 • Rim Joist Detai Options selection sheet (bldgs with 3 or less units) i ZOO Z VALUATION Vil 72gs DATE Ab I., u S ' SITE ADDRESS 45-1 ® !' Yt-1 c.J v L -"'e-- MULTI-FAMILY BLDG Y N TYPE OF WORK --Q co r- FIREPLACE(S) 0 1 - 2 APPLICANT AZ1-ti3i? Ltn/SoN STREET ADDRESS 4-SID / t t i`, 0 w? CITY STATE tM''-ZIP L-1--0-7-7 TELEPHONE # 12--L S -OOn CELL PHONE # FAX # PROPERTY OWNER hPill't L4-i(1-1S° TELEPHONE # 6QS -4,S -OC)S'Y COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MIN St4 y?o rk bmitted ('I submission type) • Residential Ventilation Category I Worksheet Submitted • t n rn) • Energy Envelope Calculations Submitted u AUG 0 5 2002 Plumbing Contractor: Phone # _ Plumbing system includes: Water Softener Lawn Sprinkler QY Water Heater _ No. of R.I. Baths No. of Baths Mechanical Contractor. Phone Mechanical system includes: Air Conditioning Fee: $70.00 Heat Recovery System Sewer/Water Contractor. Phone # I hereby acknowledge that I have read this application, state that the information is co t, 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 Tree Preservation Plan Received Not Required - Updated 4/02 PLUMBING (RESIDENTIAL) Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Please complete for: Single Family Dwellings Townhomes and Condos when permits are required for each unit Date / 02 / 0 Site Address 1 {s / O 1 t C -l CA? ' c e Unit # Property Owner Telephone # ( ) Co tractor city _ rT Address IS aqqp State Zip ?-- Telephone #s-, t e' •?" 7 The Applicant is Owner Contractor Other 5 o b C©n rAG* C Septic System New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00 Includes County fee. Additional consultant fees may apply. Alterations To Existing Dwelling Unit, Including Adding fixtures to lower levels or room additions, excluding water softener and water heater $ 50.00 Abandonment of septic system Water turnaround (+ 5/8" meter if needed - $121.00) tt_ Other: of 51 r\ 0, L0.J &U in4 ?J RPZ - new installation _ repair - rebuild $ 30.00 Lawn irrigation system Water softener Water heater $ 15.00 replacement _ additional State Surcharge $ .50 Total $ _ D c I hereby apply for a Residential Plumbing Permit and acknowledge that the tnrormanon is complete aria accuratie; iuaL UIC WU11 Will be in conformance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; 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. Applicant's Printed Name Applicant's Signature boo(, 0 RESIDENTIAL BUILDING Permit Application ?G, 06 City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 CZ" 1,fc Telephone # 651-675-5675 FAX # 651-675-5694 77- /' New Construction Requirements Remodel/Repair Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan - Cart of Survey Recd (20% maximum lot coverage allowed) I set of Energy Calculations for heated additions - Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. I site survey for additions & decks -Tree Pres Not Reqd 1 set of Energy Calculations Addition - indicate if on-site septic system _ On-site Septic System 3 copies of Tree Preservation Plan if lot platted after 7/1/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units 12 Datef? /_ / 20 d Site Address 4 S? a Construction Cost $ a 09ct c f )/e f v Unit/Ste # Description of Work ; ?,d3 0- , 5 Multi-Family Bldg _ Y - N Fireplace(s) _ 0 _4--T 2 Property Owner 6--m 5 a a / Telephone # (fir 2) 3 Z. F- 2 S P 2 Contractor *?66d9e_ r Address State 2. 3 3 ®y '?--.0 AAJ di 7iZA7 ` Zip T' S'o `1S City Telephone # (,?Y2.) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code Category Residential Ventilation Category 1 he-t_.__ • New Energy Code Worksheet (1 submission type) Submitted Submitted • Energy Envelope Calculations Sub i( it n r `7 1 r.?ftl ?, . ,!1)?? V3 f k nsed Plumber Telephon (?/} Y 7 7 Mechanical Contractor Sewer/Water Contractor Qlephone (tct`) `Y_c -13/ 3 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 a permit, and work is not t start without a permit; that the work will be in accordance with the approved plan in the case of w which re 'res a review and approval of plans. Applicant's Printed Name 1icant's Signature I. OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 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 (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex 19 Lower Level d 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg Y or N ? 25 Miscellaneous Work Types ? 31 New 3 35 Int Improvement ? 38 Demolish (Interior) 0 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair 1 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof O 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Valuation t _ Occupancy R - MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units 0 Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) _ Final./C.O. Footings (deck) Final/No C.O. - Footings (addition) Plumbing Foundation HVAC Drain Tile Other Roof - Ice & Water _ Pool Ftgs Air/Gas Tests - Final Final Framing _/ - _ Siding Stucco - Stone n l Fireplace 1s- R.I. L Ai r Test aceme t) Final - Windows (new/rep Insulation _ Retaining Wall ----- -------- ---------- Approved By 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