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4374 Bent Tree Lane
Use BLUE or BLACK Ink tt Ea j Permit#: Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 j Date Received: _ I j Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: 2010 RESIDENTIAL 22BU~ILDING PERMIT APPLICATION ~ -1 Dater/.7 f Site Address: ! ✓ 1 I l ) °2 3 Tenant: LCOn rid ~l6Z.ri9r~ Suite M RESIDENT / OWNER Name: /."In ,n L-Xl ~A- Phone: Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: '~Oe Multi-Family Building: (Yes No CONTRACTOR Name: 061 !9 /lall Al License* Z ,0'3 3 Address: ~s 3 /~FXeef )jr!-e City: /-e T State: e!~~11 ll zip: L Phone: g-3-~' ~~f ,!a Contact: ~~ia'i ;n C Email: i76'pll 60,%- 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'Te considered to be,pubAc:information. Portions of; the information may be classified as non-public if you provide specific reasons that tveotrt p,4tmitih,i~trYy conclude that the are trade secrets. CALL BEFORE YOU DIG. Cali Gopher State One Call at (651) 45440002 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 codes of the City of Eagan; that I nd rstand this is not a permit, but only an application for a permit, and work is not to s without a permit; that the work will be in accordance h a ved plan in the case Tfrk which requires a review and approval of xpli n e s at Page 1 of 2 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan o ..2 r 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Reauirements Office se Only 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and ali roofed areas 2 copies of plan Cert of Surrey Recd Y _ N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd Y N. 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required ` _Y, N 1 set of Energy Calculations Addition - indicate if on-site septic system On-slte Septic System Y N 3 copies of Tree Preservation Plan if lot platted after 7/1/93 C, Rim Joist Detail Options selection sheet (buildings with 3 or less units) ~Y Date a,57 l Z9 l 2L~0 Construction Cost Site Address ~/3 74 e~ 7< 71/_e ° G. Unit/Ste # ,C~ Description of Work /All S 4re-S >v Alt, -7' Multi-Family Bldg - Y 2, N Fireplace(s) L~ 0 - 1 - 2 Property Owner ~~t'~tJ~/~ ~ra' G 1'-'(A AJ Telephone # t)s y432 Contractor Address City State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (q submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Telephone # ( ) Mechanical Contractor Telephone # Sewer/Water Contractor Telephone # ( ) I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for 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 AV "n 005 E3 y - OFFICE USE ONLY Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling 13 08 06-Plex 13 16 Fireplace 13 21 Porch (3-sea.) E3 31 Ext. Alt - Multi ❑ 03 01 of_ Plex E3 09 07-Plex 13 17 Garage 13 22 Porch/Addn. (4-sea.) El 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 1' 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbc4~Y or _ N ❑ 25 Miscellaneous Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair 1 33 Alteration ❑ 37 Demolish Building* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant i Valuation U V Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const V 12) Width REQUIRED INSPECTIONS Footings (new bldg) _ Final/C.O. Footings (deck) Final/No C.O. Footings (addition)_ Plumbing _ Foundation ;-7_ HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests -Final Framing _ Siding Stucco -Stone -Brick Fireplace _ R.I. _ Air Test _ Final _ Windows Insulation _ Retaining Wall Approved By: 17 , 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 qo gg 2005 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date-5- / / C) Site Street Address 7 % Unit # Property Owner Telephone # (6q) Contractor I vc Telephone # (612) Address ijmsx- City State Zip 11 The Applicant is: Owner Contractor -Other Alterations to existing dwelling $ 50.00 Add plumbing fixtures. This fee includes putting in a water softener and/or water heater at the same time. If you are installing only a water softener an 7-7-77- heater, do not complete this section. Move to the next section and helk xh~e' 71 appliance(s) ou are installing. = 2005 S L eptic System Abandonment Water Turnaround (add $125.00~if a 5/8" meter is required) Other: ~`flVL i' CQyj! ~ - b4 ~ _ _ Water Softener _ Water Heater $ 15.00 new _ replacement Lawn Irrigation _RPZ _PV13 new -repair -rebuild $ 30.00 State Surcharge $ .50 Total $ So * J 0 1 hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. &-Yz~er/ A(~ Applicant's Printed Name Applicant's Signature C? 6 17`4 N 19 0 8 'Request ate Fire No. Rough-In Inpsectio equ d Inspection Other Th n Rough-In (Vou must call inspector when ready) ❑ Ready Now Will Notify Inspector Yes ❑ No Date Ready ` I f~7ficensed contractor D owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No. City Section No. Township Name or No. Range No. Count Occupant (PRINT) Phone No. 170 pany Na Contractor's jcense No. J(igna Address { CC 300 .f V or or Owner Making Installatio ! C'k ntra r Making In Ila n ) Phone Number _ MINNE OTA STATE BOARD O LECTRICITY THIS INSPECTION REQUEST WILL N Griggs-Midway Bldg. - Ro S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. ul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED, REQUEST FOR ELECTRICAL INSPECTION EB.00001-08 /e 4 ~ ► See instructions for completing this form on back of yellow copy. N . 9 8 8 ~ X' Below Work Covered by This Request ° New Add Rep. TypeofBuilding Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contractor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps AWR Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only: Irrigation Booms ' 1v C' Speciallnspection et ! Alarm/Communication THIS INSTALLATION," D REb DIS NNECTED IF T Other Fee COMPLETED WIT141044 MO I, the Electrical Inspector, hereby Rough-in Date` rJ 4%`_' certify that the above inspection has Final Date been made.. OFFICE USE ONLY This request void 18 months from Keidf irate of cccupa cC WR4 of Wagan Meparbueut of >xitbittg tt~~ectiott This Certificate issued pursuant to the requirements of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following; use classification: S DW Bldg. Permit No. 23508 Occup"CYTYK RA/Ml Zoning District RI Type Const. VN Owner of Building J_S 1JUVES Address 600 H&MI EE DRIVE, _EM N Building Address 4374, FM TIME L.4_1UI+. Locality L7, B2,~41MM RIDM 3RD Daze: Building Olficia~l POST IN A CONSPICUOUS PLACE Address 4374 BENT TREE I-4E Zip 5512 3 , . I Lot 7 Blk 2 Sub AUR Ml RIDGE 3RD THESE ITEMS RE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: Q Yes No Inspector: Final grade 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 PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55123 Permit Number: 0 2 3 5 0 8 (612) 681-4675 Date Issued: 05/11/94 SITE ADDRESS: 4374 BENT TREE LANE LOT: 7 BLOCK: 2 AUTUMN RIDGE 3RD P . I . N 10--12302-070--02 DESCRIPTION: Building Permit Type SF DWG Building Work Type NEW UBC Occupancy R-3 M-1 Construction Type V-N Zoning R-1 Building Length 59 Building Width 52 Building stories 2 REMARKS: PRV S & W PLBR - MCDEREN PLBG FEE SUMMARY: VALUATION $171,000 Base Fee $888.00 MISCELLANEOUS $19828.50 `P $ Plan Review $577.20 COPY .50 Surcharge $85.50 Total Fee $4,184.70 SAC $800.00 SAC % 100 SAC Units 1 Lic. Search Fee 5.00 Subtotal $2,355.70 CONTRACTOR: - Applicant - ST. LIC. OWNER: J S HOMES 16869092 0004849 J S HOMES P 0 BOX 39652 600 HACKMORE DR EDINA MN 55439 EAGAN MN 55123 (612) 686-9092 (612)686-8092 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Mn. Statutes and City of Eagan Ordinances. APPLI NT/PERMITEE SIGNATURE ~ ISSUED B : SIGNATURE! 'SAN 1994 BUILDING- PERMIT APPLICATION 8814818 t4AY 0`3 1994 0i 14,1410 4.n~ rrr r+r------- SINGLE & MULTI-FAMILY 2 sets of 'plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy talcs. Penalty applies: 1) when ermit is typed, but not picked up by last working day of month ,.in ich.request is made, address is changed or 3) lot chance is requested-once permit pate 1 Valuation of rnrrk' Site Address;-~ c~ STftET SUITS Tenant Name:. (c rcial only WT, Z B SCI MD. P.I.D.,tv 2649 i t on of X9 k: The applicant is: D Owner t9' Contractor 0 tither (D"triW Nam Phone :Propody LAST itR$ t C rn r Address STl T - 8TE # City State Zip Company phone r_ #AW .~11tracWr Address i xp.. City state zip Company Phone Arehiti tl In : r dame ,Registration # Address City Stat+ Zip Sewer & water licensed plumber .-409t7l~ Processing time for sewer &.water permits.is two days once area has been approved. I hereby acknowledge that I have read this a plication and state that the information is correct and agree to comply with all applica a State of Minnesota Statutes and City of 'G Fagan Ordinances. Signature of Applicant: F OFFICE USE ONLY ` P s BUILDING PERMIT TYPE C1 01 Foundation ❑ 06 Duplex ❑ 11 Apt./lodging ❑ 16 Basement Finish 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi.-Misc. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-Plex ❑ 13 Garage/Accessory ❑ 18 Comm./Ind. ❑ 04 SF Porch ❑ 09 12-P1 ex ❑ 14 Fireplace ❑ 19 Conn./Ind. Misc. 13 05 SF Misc. ❑ 10 Multi. Add11. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE 0 31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish C.! 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) k) Basement sq. ft. HWCC System -LIE (Allowable) 1st Fl. sq. ft. City Water UBC Occupancy _e~ 2nd Fl. sq. ft. PRV Required Zoning Sq. Ft. total Booster P # of Stories Footprint Sq. ft, Fire Sprinkler Length On-site well Census Code Depth On-site sewage SAC Code Census Bldg APPROVALS Census Unit Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑.Site to Footing I~rFraming Insulation ❑ Wallboard I Final ❑ Draintile Fireplace Permit Fee y8tun;o: $ / 2 Surcharge Plan Review 1 License a s r 9110 Yj k 15' = 64 6 MWCC SAC a 64!- City SAC YY k tS f~I~,U l 3 X ie 15` Water Conn. 'k /a b Water Meter 1 66 6 X S ~j3i Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. ~y n, 3 a 7 ? Z Road Unit I k ZO x t~~ Park Ded. ~o '4( s` rs, 7.4 2- U'j Trails Ded. /0-? r46 Copies Other 0 2 Total: SAC % SAC Units ' * * * M2422 endota the ghts,DMN 55120 * PIONEER LAND SURVEYORS • CIVIL ENGINEERS (612) 681-1914 FAX-681-9488 * engineering LAND PLANNERS. LANDSCAPE ARCHITECTS 625 Highway 10 N.E. * * * Blaine, MN 55434 (612) 783-1880 FAX:783-1883 Certificate of Survey for: J.S. HOMES 4374 BENT TREE LANE BENT TREE LANE LO In SER V ICE N.., 948:4..... 947.0 al yN INU=9353 TV. PED.-___ 948.8 c I n t 9442 ELEC. PED. TELE. PED.___ 85.00 S22 26 57 W x 4. - TV. PED. " T21:~711 cq I~-.5BENCH MARK g 0 }TOP OF HUB N ELEV. =949.34_ PROPOSED O M --BENCH MARK ~l v I DRIVE WAY M ,-7.7 TOP OF HUB M I 83 (G4cl 9) 948.6 ' - 946.6 ELEV..=946.63 N _ 32 O 95 . Ix ~ O 12.0 0150.0 I I O Z W o x; 8 0 GAZ%~j OD 1 I M N 27.0 rro to 0 11.5 a o ti W ti (D 0 v i (Q N 9479 0 6 0 Z ,n /d N 46.9 U) 0 POSE v 'n / ;i xx $ 0 HOUSE 0 8.2 W M_ OD M n~ N 0 I ' 3 2.5 v k 94 4.58 949.4 '94 x II 945,4 (,f,50. 6) 943.2 N 1 `Q 94X.1 942.7 00 LO Ak-#U 7 9el DRAINAGE a UTILITY 5 f~ EASEMENT PER PLAT- EAGAN WE R 6; D , 948.9 Ln 94 85.35 1.0 (q4 f9 0~) S 17019'-36'W ELF PROPOSED GRADES SHOWN PER GRADING PLAN BY: PIONEER ENG. NOTE: BUILDING DIMENSIONS SHOWN ARE FOR HORIZONTAL AND VERTICAL LOCATION OF STRUCTURES ONLY. SEE ARCHITECTUAL PLANS FOR BUILDING AND FOUNDATION DIMENSIONS. NOTE: CONTRACTOR MUST VERIFY DRIVEWAY DESIGN. THIS CERTIFICATE DOES NOT PURPORT TO SHOW EASEMENTS. OTHER THAN THOSE SHOWN ON THE RECORDED PLAT. NOTE: NO SPECIFIC SOILS INVESTIGATION HAS BEEN COMPLETED ON THIS LOT BY THE SURVEYOR. THE SUITABILITY OF SOILS TO SUPPORT THE BEARINGS SHOWN ARE ASSUMED SPECIFIC HOUSE PROPOSED IS NOT THE RESPONSIBILITY OF THE SURVEYOR. PROPOSED HOUSE ELEVATION x ooo.oo Denotes Existing Elevation ( ooo.oo j Denotes Proposed Elevation Lowest Floor Elevation: 31L - - - Denotes Drainage & Utility Easement Denotes Drainage Flow Direction Top of Block Elevation: C/Sl.?i Denotes Monument Denotes Offset Hub Garage Slab Elevation: q50• Z LOT 7 , BLOCK 2 AUTUMN RIDGE 3RD ADDITION DAKOTA COUNTY, MINNESOTA We hereby certify that this survey, plan or report was prepared by me or under my direct supervision of I am duly registerd L1V&Su r under the laws of the State of Minnesota. Dated this 13TH. day of APRIL A.D. 19 VIED: ONEER ENG EERING, Scale: 1 inch = ,30 feet ,lotTn C. Larson, L.S. Reg. No. 19828 930 9 322 5. 01 ~b LOT SURVEY CHECKLIST FOR RESIDENTIAL w W N BUILDING PERMIT APPLICATION m a J ¢ PROPERTY LEGAL: W ~7 Z- ol,-.. a m W < r Date of Survey: z I DOCUMENT STANDARDS 8""'Q 0 Registered Land Surveyor signature and company V 0 Building Permit Applicant 0 Legal description b-"0 ❑ Address 9--'0 0 North arrow and pia scale 0~ ❑ ❑ House type (rambler, walkout, split w/o, split entry, lookout, etc.) 0~ ❑ ❑ Directional drainage arrows with slope/gradient Q--"0 ❑ Proposed/existing sewer and water services 9~D ❑ Street name 0 ❑ Driveway ELEVATIONS Existing 0~ ❑ 0 Sewer service 0~ ❑ 0 Lot corners CPO 0 ❑ Top of curb at the driveway Q -"*'*11 0 Elevations of any existing adjacent homes Proposed 01 ❑ 0 Garage floor El's ❑ ❑ First floor ❑ ❑ Lowest exposed elevation (walkout/window) ❑ , ❑ 0 Property corners V ❑ 0 Front and rear of home at the foundation PONDING AREAS (if applicable) ❑ r,[] Easement line ❑ NWL ❑ 0' ❑ HWL ❑ Pond # designation ❑ Emergency Overflow Elevation DIMENSIONS 13"'0 0 Lot lines 0~❑ 0 Right-of-way and street width (to back of curb) 2---11 0 Proposed home dimensions including any proposed decks, overhangs greater than 21, porches, etc. (i.e. all structures requiring permanent footings) @" ❑ ❑ Show all easements of record and any City utilities within those easements 0 ❑ Setbacks of proposed structure and setback of adjacent @-'11 existing homes ❑ Retaining w requi ents, if any Reviewed: Nam / to October 1992 S-0+22 INV-935.6 a CS-9 46. ) ` S-2+00 C CS-950.3 S-0+35 c i REMOVE PLUG 1 INV-928.0 & CONNECT TO CS-938.5 EXISTING STUB S~--O-+. i S-1+15 H YD ' INV-935.3 YD CS. 93~ , CS-945.8 $ 13'-6" IP CL 52 „ 8u E ' S-1+90 GR 6E 00.00 INV-939.4 7 g CS-949.9 INSTALL WATER e SERVIC ONLY f CS- 9 .6 >J * EXISTING SANITAR SERVICE C ` L~iGAIan DOES NO" U' ~ A t ~ ACCURACY OF UTILITY I_ CATI01 zs so ioo -LEVATION ' THIS DA TI I0 CR PURPOSES', ` C1Nf-3 IT ` H!-" RAPWC SCALE IN FEET 1 inch - 50 feet BENT TREE •EXIST1NG GROUN© f . . m K~- 8 •BLD. 1.1.00' +A H PE 937;45* . 7 E3LD• . 11.100': PRI`~POSED GRAaE • • : . . • . • . - . • . . . • . . . . . . . • . • • : • • • • . . . . • . • • • : . • • • • : • • . •.r''r ST1NG* S.TxJB : : Opp . . ~8•.~ 2........... 7.5' MIN. . 20r. • , a7 ITI iiiiiiiij 4 r a • • Y • _ v . . . . . t6- ,cO . . . . . . . . . . . . . . : 7 ? Z............... . • ~ N y EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER: /Z 'Gf' - L vT SITE ADDRESS: CONTRACTOR: ~ c DATE : -S 12174' PHONE : Y4 20P/z;,, DETERMINE WORKING SQUARE FOOTAGE OF EACH: I. TOTAL EXPOSED WALL AREA, , , , , , , , 2 ~a 7 sq f t x "U" 2. TOTAL ROOF/CEILING AREA.,,,,,,, sq ft x "U" 6r~o 4~•g~ 3. TOTAL EXPOSED WALL AREA CALCULATIONS: Total exposed wall area above floor,,,,,,,, v~ (Ct sq ft t a) Total wall Window area: samko Low iE Ovp,.Potrglazed...... .RO S. $3 sq ft x "U" 22- s • Low rri. ovA.-&#d glazed...... ~ i. sq ft x "U" X47 ° (4-s b) Total door area S$ d 6 sq ft x "U" r c) Total sliding glass door area: glazed...... sq ft x "U" glazed...... sq ft x "U" d) Total fireplace wail area - sq ft x "U" e) Total wall framing area o~~ 9• sq ft x "U'l , O$~., _ ,02 (Average 1090 f) Total net wall area above _ •O floor (Insulated) sq ft x "U" -0(41 g) Total rim joist area...... Q sq ft x 7-5 -7 Total foundation area (Exposed) h~Zq ,33 sq ft h) Total foundation window area..........:, sq ft x "U" <6 1) Total net foundation area above grade L 2R . sq ft x "U" `tib S = $ILI I _ TOTAL a) thru 1) _ 6g 3. If Item #3 is the same as, or less than Item hl, you have met the Intent of 2 MCAR 1.16008 A and G. Page 1 4. TOTAL EXPOSED ROOF/CEILING CALCULATIONS: " Total exposed roof/ceiling area........ sq ft sq ftx"U" J) Total skylight area.....,. k) Total roof/ceillnq framing c/ area (Average 109;) , sq ft x "U" 40-Z-1 1) Total net insulated roof/cei 1 inq area....... ' 1.55, Z sq ft x p2 4. TOTAL J) thru 1) 'If total of 04 is the same as, or less than 92, you have met the intent of 2 MCAR 1.16008 A and 0. I ALTERNATE BUILDING ENVELOPE DESIGN To utilize the total envelope system method, the values established by the sum of items #3 and #4 shall not be greater than the sum of items #1 and 92. 1. + 2. + 4. r I C E R T I F I C A T 1 0 N 1 hereby certify that I have calculated the "U" factors and "R" values herein and that the building here :lescribed meets or exceeds the State of Minnesota Energy Conservation Act. 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ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. _:;?n NEW CONSTRUCTION ADD-ON A/C ADD-ON FURNACE FIREPLACE INSERT DATE ,,12 7 FEES H VAC: 0-100 M BTU $ 24.00 . ADDITIONAL 50 M BTU 6.00 GAS OUTLETS (MINIMUM 1 @ $3.00 EACH) 22 B ADD-ON/REMODEL (EXISTING CONSTRUCTION) $ 20.00 STATE SURCHARGE .50 TOTAL SITE ADDRESS: y y 7' OWNER NAME:` --i- S TELEPHONE INSTALLER: ADDRESS'-- r Z z 3~ CITY: STATEN ZIP CODE: cs 33 TELEPHONE SIGNATURE 0 F PERMITTEE i<- ::::.:::::.:::::.R~ottn .t~'F-r :`c , ,e:...•::,a h'Cx:., nv yT...,,:::.~::::...:::..:: •:.:.;;•w}}: •:r::.; .r:}r»}r:.::.}:{.,.}:?.:?<•r:.:•:,}}:•}:•:•}}}:•r . : • . p~ ,2; c. 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'~T .n4 t.: ~3} ::::i•:t::3}\4:::i•:ti:ti}:;}:ti;:ii::::;~i'}:::iii::i::?iv4:::::;:;:: Y.~B .fix......... v ...•.Fh..v 1 ?.A:v. r{vvti:.v.:}}}:pih J~Q...:....... F.:....:.:.......v .....i ....vvvv.:v.:v::v:. ....v..........:, vi•:::,, r i4v::2}}':.. . v..... r....:. rw:.4 u' •~::i';;{vv,~A ti:'?{-.,:v v:v.v.:v:.}::•}}.{. ' ++Y:•:i; ,...v v .v. x. • v. w; ••::r:{•:?Siy,.}}}}:•:::}}ii}r:•i;•}}}>}}}:}ri}}}i1:{}i :::::::::::::................v x..... r....:3'fh....:....:xah r.:.::•}:5::{r,.Sr: S}:•::•}}i}:.:v}.::{w.w:::::; }:•}}}:v1:•:•::::. ~...::.,+:.v::>..~~:ti:•}}x:^:•:~.v. }}:•}r}}}}:G:........,.. : nw:::...v:::x.4:n:...vr.x...}:....rr..........:............................•........... 1994 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. - - - - DATE: CONTRACT PRICE: $ NEW BUILDING INTERIOR IMPROVEMENT WORK DESCRIPTION: FEES I% OF 'FEE $ PROCESSED PIPING: $25.00 MINIMUM FEE: $25.00 STATE SURCHARGE $.50 FOR EACH $1,000 OF FEE. TOTAL $ SITE ADDRESS: OWNER NAME: TELEPHONE TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE SIGNATURE OF PERMITTEE CITY INSPECTOR f RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ,j 651-681-4675v Now Construction Rmukements Remod r Reaybremerrts • 3 registered site surveys showing sq. ft of lot, sq. ft of horse: and at roofed areas • 2 copies of plan (20% maximum lot coverage allowed) . 1 set of Energy Calcul ions for heated addibo ts 2 copies of plan stowing beam & window sizes: poured found design, etc.) . 1 site surrey for exterior additions & decks • 1 set of Energy Calcuiadons • 3 copies of Tree Preservation Plan if lot platted after 7/1/93 • Rim Joist Detail options selection sheet (bdgs with 3 or less units) DATE - ?J VALUATION (EXCLUDING LAND)i ob JOB SITE ADDRESS ~13 Z _,,$j,d2t- 77 Sc IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER 1,:° C-=4Q yes 1V TYPE OF WORK FIREPLACE(S) _-,,,0 ,.1 _.,.2 -3 APPLICANT Alsd br-,P E y~50W C91157- C&C" PHONE # 9, a fif"54 ADDRESS I LE AYe 0642 PA f_~1Up,"/ 6ZL-c ZIP CODE PAGER # CELL PHONE # FAX # ?24-~-. ' E~Srl NIEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category MINNESOTA RULES 7670 CATEGORY I (check one) - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted MINNESOTA RULES 7672 New Energy Code Worksheet Submitted 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 # Vj U, C' 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, d agree to comply wi all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant Certificates of Survey Received Tree Preservation Plan Received Not Required Updated 1/01 i OFFICE USE ONLY ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessary ;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 (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 i Valuation 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 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 Fireplace , R.I. -Air Test -Final _ Siding _ Stucco _ Stone Insulation Windows (new/replacement) Approved By , Building Inspector ~ w 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 N CITY USE ONLY L / BL ~ RECEIPT SUBD. az~-24"" DATE: 1996 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ► single family dwellings ► townhomes and condos when permits pare required for each unit FIXTURES EACH TOTAL Shower 3.00 x Water Closet 3.00 x Bath Tub 3.00 x Lavatory 3.00 x Kitchen Sink 3.00 Laundry Tray 3.00 Hot Tub/Spa 3.00 Water Heater 3.00 x Floor Drain 3.00 x Gas Piping Outlet * minimum -1 3.00 x Rough Openings 1.50 x Water Softener 5.00 x _ Private Disposal " Dakota Cty. license 65.00 = (new and refurbished systems) U.G. Sprinkler * home under const. 3.00 = Alterations " to existing 20.00 = Water Turn Around 20.00 STATE SURCHARGE .50 TOTAL SITE ADDRESS: OWNER NAME: INSTALLER NAME: STREET ADDRESS: DBA VEwco/APPUANCE INSTALLERS 2g = MN 55458 I,AStJNEAFJQLIS, CITY: ST TE: ZIP: PHONE ( ) NORBLOM PLUMBING CO. t)BA 1iEt4TCO/APPLIANCE INSTALLERS RE OF PERMITI EF (612) 827-4033 29MIN05 S AMN 55408 H OFFICE USE ONLY L BL RECEIPT SUBD. DATE: 1996 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ► all commercial/industrial buildings. ► multi-family buildings when separate permits are not required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR DESCRIPTION OF WORK: IS WATER METER REQUIRED? - YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING: WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED? YES _ NO. FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE. WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? YES _ NO. IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT. FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per $1,000 of ermit fee due on all permits. CONTRACT PRICE x 1% STATE SURCHARGE TOTAL SITE ADDRESS: TENANT NAME: STE. # OWNER NAME: INSTALLER: ADDRESS: CITY: STATE: ZIP: PHONE SIGNATURE: APPLICANT OFFICE USE ONLY METER SIZE: DATE: INSPECTOR: 1994 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. NO. FIXTURES EACH TOTAL SHOWER 3.00 3 WATER CLOSET 3.00 9 .71- BATH TUB 3.00 G _ ? LAVATORY 3.00~t i KITCHEN SINK 3.00 _ LAUNDRY TRAY 3.00 15 HOT TUB/SPA 3.00 WATER HEATER 3.00 3 FLOOR DRAIN 3.00 .3 GAS PIPING OUTLET • minimum - 1 3.00 13 ROUGH OPENINGS 1.50'. 5`0 WATER SOFTENER 5.00 PRIVATE DISP. • Dak.cty. lic. 20.00 U.G. SPRINKLER -home under cont. 3.00 ALTERATIONS - to existing 20.00 WATER TURN AROUND 20.00 yG . s o STATE SURCHARGE .50 TOTAL: y`7 , o a . SITE ADDRESS:- K? OWNER NAME:- mod- S a s INSTALLER: ee-'e 4 .J ADDRESS: CITY: STATE: ZIP CODE: _ 3_3 3 PHONE ( ) S 4_1 4M~ATURE PERMITI'EE L> ::.:.i'r~:v,::w::::??:{:i;}i•.?wii:{.....+::v.,•::.•::::;{•:{p:j'i':n}w:::::t::ni•:.::~:::::::.~::..i'.~w:.::4i•::::::::::.i•:x{•:rii::?:.}•::.:i:?::y:nii::.:.y:nii>v:~:;v:::::}.isnw::i:^::>i~:: r^:iti:::::4::~:i:'.':i'i'iy:::':ii::::' ..::::.t:ti<ii:;(:in iris :;isiiiiiYi:{:iii:i:i::Y:ii;{:iji ?}:iii::::::}iii::;:::iii:::iLiii :iiji i::i::'v - •i?iii:•iii:•i/^:•:?.:.i•iiiiiSi:4:iii4:.i^:•i i i....... .'i:vj4 i't{i is ?iii:i~? `i::iii:i:{:;?ii~+isi:: iiiiiii'iiii :i:: ::::ti;::': iiij:`'iii{ii::::,>.::iiiii::ii: it iii:?(:i is^iiii. {v iii ir:`niiii:<?iii: iiiiiiS:•,};:: :..............i: `j: :i3:.. : ri.:?.:i;yi':;?:;:ii:::>r i>::•:ifi:i:iiiii:;i iii`' . ..::.'+i:. is ........:ii i.....::i::i: i.... 1994 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI- FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. NEW CONSTRUCTION ADD ON REPAIR WORK DESCRIPTION: CONTRACT PRICE: $ FEE: 1% OF CONTRACT FEE. STATE SURCHARGE: $.50 FOR EACH $1,000 OF FEE. MINIMUM FEE: $ 25.00 CONTRACT PRICE X 1% $ STATE SURCHARGE $ TOTAL $ SITE ADDRESS: TENANT NAME: STE. # OWNER NAME: INSTALLER: ADDRESS: CITY: STATE: ZIP CODE: PHONE FOR: CITY OF EAGAN APPLICANT INSPECTION RECORD OF E LAN M TYPE: fl IJ 11- 0 1146 M law PRO Knob Road NOR Number -mow Eagan, Minnesota 55123 Date Issued: 05 /f 1 /44 (612)681-4675 W ",WRESS: h APPLICANT. Aft v t1mo C4 10fif, 3kil 1 { x' A xrY b ,4 WIT SUBTYPE: TYPE OF WORK: Ow R A M I H pl.l0f-If "U 1. A T LO N pt.Hii # 001#Pf 114 i1fu 1 l Ms ! 1*I 1: ti V NA1 - m NO. PWMlt f,o. m now Temohm" # v {afT} 'F ELECM# Dift aw. cow FodAnp i ,f~?d FatwaRfipn FMft 'Age pAto Pft. N tom, f. FWSPWe fP- F t3~. OMM T"t Final P". Pfg. inspector - Noiity Pi-ibw Cava. Meter i Bklg. FinalOje tlg. Deck FMW WON Pr. Di". , Ahab ±:ia;tz PERMIT City of Eagan Permit Type:Building Permit Number:EA115754 Date Issued:09/30/2013 Permit Category:ePermit Site Address: 4374 Bent Tree Lane Lot:7 Block: 2 Addition: Autumn Ridge 3rd PID:10-12302-02-070 Use: Description: Sub Type:Reroof & Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Valuation: 8,000.00 Fee Summary:BL - Base Fee $8K $162.25 0801.4085 Surcharge - Based on Valuation $8K $4.00 9001.2195 $166.25 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Leonid Glozman 4374 Bent Tree Lane Eagan MN 55123 Purpose Driven Restoration Llc 325 Main St NW Elk River MN 55330 (763) 633-4737 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA172995 Date Issued:10/25/2021 Permit Category:ePermit Site Address: 4374 Bent Tree Lane Lot:7 Block: 2 Addition: Autumn Ridge 3rd PID:10-12302-02-070 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 210-0754. 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 - Leonid & Yelena Glozman 4374 Bent Tree Ln Saint Paul MN 55123--305 (651) 206-3551 North State Mechanical 1444 14th Street W Hastings MN 55033 (612) 207-0345 Applicant/Permitee: Signature Issued By: Signature