4509 Alicia Dr? 2000 BUILDiNG PERMIT APPLICATIOH (RESIDEIVTIAL)
` CITY OR lAGAN _
' 3830 PILOT KNOB RD • 33122 01-4 0•??
? .
0 ?- ? 651-681-4675
3- a-?-0?
> 3 nglOorec, dte mmoys diovWft'sa. K a M. sq tt. ot house 2 copie= a pla+
and gl roaea aroa: tM mmumnm Ia crn?araas a?owea) 1 setof energy cdculations tor heaied aadMoxm
D' 2 oopies of plans (stiow beam & window sins; pourod bnd. dosign; etc.) 1 tita w'vay tor oxietlot addiiim 8 dockt
? 1 sat a arw?Qy caculaitons
> 3 oopies ot tree presorvaMdl plan H IW Pkoed anar 7!1/43
DATE: CONSTRUCTION C05T: / Z- 3'? Z 7
DESGRIPTION OF WORK: ? C `
S'tREfT ADDRESS:
LOT: BLOCK: f SUBD./P.I.D. #: 7?,?„?????? ?d 5-?-
? ?(?.a;?-9 rn ?r ?? -er-- ? rrns ? _ co w-?
Nome• k z C Phone #: v t12- z
PROPERTY tcnt Firsf
OWNER
Sheet Addross'
City A?0/ 8? Stctte: az Z-,::r- Zip;
?- -- g-- 2 ?-PZ
. Compcny; Rnone #• ?2
: (area Code) .
'CONTRACTOR
Sireet Address: License # E?.
Cify State: 2ip:
??
ARCHiTECT/ ®r
ENGII+dEER Compony: -CJ Name: ?(? •? ?
? w Telepftone C ( 6?1) ?,l? ,(-? --?=-2-
r Sheet Aclcresa: Regstrotior? C
City Stcte: Z1p:
61Ck,ja - ?'S ?-a--'
_ ?( U ,, ? ? 0- l .,
Sewer/water licensed plumtaer (if insts8irw sewerlwaterl: Phone #:
! hereby acknowledqe that 1 hove reW this opplication, atcte thaF ihe inforrr?afion ? t?rreCt, and t? oq CtppRt?le S'i?
af Mknesota S#?futes and City of Et?an Ordinances.
Siqnature of Applicxmt
S ?.?(\r C
?
V?: -N-- OFfICE USE ONLY
Certificates of Survey Received es -?Q;]EJ"
MAR 3
Tree Preservation Plan Received Yes No ?ot Required
? `?/
OFFICE USE ONLY a
. . _ . . . . . . . . .. . .. . ..: . r _.i ,;.* . . ..
BUILDING PERMIT SUBTYPES
O 01 Faundation ? 07 05-plex ? 13 96-plex 0 21 Porch (3-sea.) 0 31 Ext. AIt - MuYd >
;E?'02 SF Dweiling ? 08 06-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) 0<33 Ejct. Atf- SF
p 03 01 of _ plex ? 09 07-piex 0 18 Deck 0 23 Porch (screened) 0 36 Mufti
? 04 02-ptex O 10 08-plex ? 19 toHrer Levei D 24 Storm Damage
p 05 03-p18X 0 11 10-pleX Plbg _Y or _ N'? 25 MiSC8118neouS
p 06 04-piex O 12 12-plex O 20 Poai 0 30 Accessory Bldg.
WgORK TYPE
;W" 31 New ? 36 Move Sidg. ? 43 Reroof
0 32 Addition ? 37 Demo(ish (Bidg)* C! 44 Siding
0 33 Alteration ? 38 Demolish (Interior) 13 45 Fire Repair
O 34 Repair 0 42 Demoiish (Foundatian) 13 46 WindowslDoors
* Give PCA handout to appiicant for demaiition permit
' GENERAL iNFORMATION
SAC Code ? # of Stories 2 sq. ft.
No. of Units 1 Length -20 sq. ft.
No. af Buildings
L Width 3 Footprint sq. ft.
?
Const. (Actual)
?- Basement s4. ft. i Z7?!
? Census Code l G I
(Allowabie) Main level sq. ft. i Z 7-u MClES System
UBC Occupancy .,,.--?_ It sq. ft. City Water
Zoning sq. ft. ??Sr Baaster. Pwmp
PRV ?
Fire Sprinktered
MISCELLANEOUS INSPEG7I4NS
O Stucco/Stone .
APPROVAL3
Planning Building Engineering Variance
Permit Fee
l S $? '2D(?
Valuation: $
Surcharge =
Plan Review ?1
L/Lf.%,t,I 1Z?y a-IS ^ t
= /k,1tp
License t
MCiES SAC
City SAC
Water Conn. vlir- S Sr? G
Water
A
e# ?-? $- 7 2 Y Y 16 = 11 `?l 8"
cxt. De
?sit
S/W Permit
SIW Surcharge
Tceatment Pt.
Park L1ed.
Traiis Ded.
Other
Copfes
Totat: so A o_gS
SAC Units
% SAC
03/10/00 FRI 15:43 FAX 6124920694 LAMPERT APPLE4'ALLEY
0001
L'an?
pert Yards Inc.
Lumber & Buil d ing Materiais
FAX
Apple Yalley
14555 Galaxie Ave
Appte Vailey, MN S5124
Phone: (biZ) 432-0600
Faax: (612) 432-0694
I To: ( Frazn: I
f Coinpany= ( Fax: #
Nuinber of Pages Including Cover
0 Urgent O Far Revievv CD Please Reply
E) I'lease Camment EJ FYI
Comment:
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Oallfl/Od FRI 15:44 FAX 6124320694 LAMPERT APPLEVALLE4' Z003
I C ??) ?-1?VI 4 k
` 1.9E MfCROLLAMOLVL HEADERS AND BEANIS
LOAD TABLES (PLF): RQQF (SNUW LQAD AREA 115%)
' Totai Load 450
8T!
1223
1638
5
g ??1A4 8tIW? ?3S - .. " "'
ii?.ErK*o. aeadf?§ 1.91s 2.015.0 z.en.o 3.7/9.4 4.7111.e
??aaF :• ?
tal L
o
?d
, 24I 544 1008 1335 1661
??_
? q ?
jy
rF
{ (
y
Yvl?QynlD•n UGOY
n-
. _. e? -- '? _?
v . ..
,
tu
d?h?:E?u11iPL?2aM8 1_513.5 1.5/3.6 2.7/6.7 3.518_9 4.41111
148 325 841 1126 1389
--
--
--
°?«. <
,.513:s
,.Sfas
z.
a.are.s
e.zr,o:s
? 1016 fLoB¢ .° 91 205 863 973 1193
'
wa (CesilOn i3240 ' ' •• -- 647
?
'?,?* n??i0!!nr Beat?re?p 1,513-5 1.5I3.5 23153 .318-4 4_1N0.3
Tsn.t4toodd 59 135 815 fDaS
H(}W TO USE TNtS TABLE:
2523 3049 1,} Dgtertnir/6 the 10t81 load ? th8 bectm ar
-- -- hE3der in pounds per li??e?l ioot {pl}.
5.8/14.5 7.QJi7.5 ??r SPAN a s
an tt?at me?ts or
2
) Loc
t
p
:
a
e
2nos 23e4 exceeds tE?e requirec! beam or heeslet spen
5.3l13.4 6:e118.0 (Cen28i-10-CCl11@C d# b68(N1Q).
1660 1957 3.) Scart irom lefk to 60t Wrhn itte SPAN row
uriW you fuW a ceil where the ?naxunum TOTAI
5.112.7 6.0s5:o LOAQ meets or exceeds ttve tec}uired load. Fcr
1417 1659 Sbffor d08C1tOR 4YIf8(Id. !!SB 1hC U240 Y81ttBS.
4.9f121 S.7114.3 4.) T18 dt116+flSitN15 of ft bee'lflt flre 5t10Wf! St t1@
t23fi 1439 ?P OI ?18 COIUtri?t Qf 1?18 6?G?Cd ?.
fi 5 if ftK? actar.fari tu?am ic trx+ rionn nr N+n TuGn
??- 4 A'?r?z.
Z'1?11* ?
NorEs
.
1. MAXIMUM WALL LENGTH WITH A MATERIALS
CONTROL JOINT 50'-0". CONCRETE, 3000 PSI e 28 DAYS
2. PRIOR TO BACKFILLING, FND WALLS AGGREGATEs FTG - 1Ve" MAX
MI1ST BE LATERALLY SUPPOtTED BY WALLS - 3/{" MAX
FLDOR GEINSTRUCTION AT BOTH TQP & REINFORCING : ASTM A615 GRADE 40
BOTTOM OR BY ADEQUATE TEMP. BRACING. : ASTM A615 GRADE 60
3. SPECIAL REVIEW REQUIRED FOR BACK 100 V. GRANULAR - GROUP I
WALLS HIGHER THAN 9 FT. FILL: EQUIVALENT FLUID PRESSURE
4. WALLS WITH EQUAL BACK F2LL ON (Yeq ) = 35 PCF
BOTH SIDES REQUIRE NO REINFORCING GRANULAR & LIGHTCI.AY - GROUP II
EXCEPT DOWELS, FOR WALLS LENGTHS EQUIVALENT FLUID PRESSURE
LESS THAN 30' LONG AND HORiZ. (Yeq ) = 45 PCF
REINFORCING & DOWELS ONLY FOR HEAVYCLAY - GROUP III
WALLS LONGER THAN 30'. EQUIVALENT FI,UID PRESSURE
5, A MIN OF (2) IIQ° 0 x 8"A.B.W/<i) NUT (Yeq ) = 65 PCF
& WASHER OR SIMPSON MA6 ANCHOR GRDUPS BASED ON CODE, SEE SHT. S-5
EACH PLATE. ONE WITHIN 12"EA. END.
6. FND DRAIN TILE MUST COMPLY W/ UBC
APPENDIX 1824.3 &1824.4 OR APP' D EQUAL
7. INSTALL A SIMPSON A34 BETWEEN SILL V
& RIM JOIST 2 RLL A.B. LOCATIDNS, --" --
SLDPE -? $?? •
`
<req>=35 PCF (req)=45 PCF Creq>-65 AWAY
PCF GRADE
FROM FDN.
, ?
VERT.
STEEL
C4> # 4
,
HORIZ, BARS ( SEE
e e e ON TIES SCHEDULE )
#4 x 2'-0" D?WEL ' ?
'
@ 6' -
D.C.
o
R
t
m
SIMPSON A34 SIMPSON A34 SIMPS?N A34
H
ANCHOR W/4 ANC
OR W/4 ANCHOR W/4 .•
8d NAILS EA. 8d NAILS EA. 8d NAIL,S EA ,
LEG N.S. OR LEG N.S. & LEG N.S. & TYP. PCF 1?/z °? 2" CLR
F.S. OF JDIST F.S. OF JOIST F.S. OF JOIST
2 16" O.C. e 16" O.C. 2 16" ?,C. 65 PCF 31/z FLOOR
ONLY ? , SLAB
.
H = 9'-0" HIGH WALL . . . . .
? . 0 4 . . .
<IN) 8 8 10 DRAIN?
10 TILE . . . . ° .
35 65 35 FTG <MIN>
x 16"
65 8"
<PC) FTG
SIZE
BASED ON
V 352 652 352 652 SOIL CONDITIONS 2
(PLF) EA. SITE BY DTHERS.
V R STL NON 801@ NONE ONE
V 60
@ NONE
? W A L L S E C T I ON
.
STL. NON 2 ?QP
1/2°.A,B. 40 24 40 24 NQTE HIGHER STRENGTH
SPAC.(IN) CONC REQ'D FOR N0 REINP.
40 24 40
6 24
IN)
SPAC
GOPHER STATE CONCRETE, INC CO98100?
? J. H. Dahlmeier 9' HIGH
9110 GRAND AVE. S, W+?WN BY Engineering Inc. S- 2
BLOOMINGTON, MN 55420 JHD
c??cKm ey 2434 Commerce Bouievard 612-472-4746 11/30/98
P h o n e: (612) 8 8 8- 9 3 3 0 JHD Mounfl, MN 55364 Fax 612-472-4761
'ENERGY GODE WORKSHEET FOR l& 2 FAMILY DWELLINGS ?-
SIT.B ADDRESS GITY
COMPLET£D HY: G PIIONE # AATE
9'i72LDING CLASSIFICATION: ? categoty l(etandard ) oz category 2(muet itncluda vcntilation)
HINYMUM CRITERIA
FoundaCion Insulation-R10 Ptalle & Wittdowa Roof Attic Inaulation:
(See table on reverse side
Slab on Grade Insulation-R10 for allowable pe rcencages) R44-With Attic No:Eteel
Floor over unheated spaces-R24 R38-With Attic Raised Iieel
Foundation Windows 1/2" R38 & R5-So1id RaEte'rs
ineulated Glass.
-Wood or Vinyl Frame
STSP 1 Window & Door Area • STSP 2 Calculate area aa a percent of wall
A. Total Window & Door 7area in Sq. Feet
WINDOWS (TnclUding Foundatio n Windows):
WINDOW MANUFACTURL NAMS:??V &- C. FLOm Step 1 divide box A{Fiindow & Duor
y Axea) by box _B (totai wali ax•ea) Cime: 100
_
WZNDOW MAN'LTFACTURE TYPE ? ?? equals the window and door area as a
_ Parcenc oE wali arEa (box C) .
WINDOW MANIIFACTtTRS II FACTOR: ?
?
i
R. O. ¢uantity
i sq.EC_Area X 100 = C=
EOX A
Bc;c E?
?
? ?
oits
Dimens ?
?
?
1 (
1 " ?t:L
? X h
J
L
Z
STEP 3 Daaign Featureu
l'o '.DKX L v1 ' ?Q ASSEh18LY
? rX
-4
FRAMZttG TYPE;
_ X ? STAt1DARD FRAMING ?ctuds 1611 o. c."
? h X ?h ADVAIICED FkAMING stUds 29 11 o. c.
?- N X CFVITY INSULATTON F7;- ?
I
K X 4 1
cA
? -O
Ll SFtBATHTtTG TYPS:
_
r ?
LESS THAN < R-5
a 2 R-5 > OR MoRE
X U-FACTOR
DOORS: From the Gable, (reverse side) determine the
maximum percznt window & door area for the
al
i
2
c
t
ue
v
ons se
e
ted and enter the
deaign ope
? in Box D below isased on the window mfg. U-
factor:
X ik D
'I'uCal Area oE A?4'??qg..ft. -
Windows & iSoors ?
B. ToCal Wall Area in Sq. Ft. The t value Erom the Gable in Box D'shaii be
eqtial ta or greater ttian the t in Box C
Wall Total Height Area
Perimeter
2 kb
.
Et
?c
B
O?
Totdl Area oE W8118 ?.
=
l
' ONE- & TWO-FAMILY RESIDEIV'ITAL BUTLDING PRESCRIPTTVE (CCJOK-BOOIC)
A.PPROACH
MAXIMUM WINDOW AND DOOR AREA AS A PERCENT QF OVERALL WALL
AREA
From Minn. Rules part 7670.0475, subpart 2, item F
Cavi Exterior Window U-Factor
Framin Insulation Sheathin 0.49 0.36 0.31 0.27
STANDARD R-13 > R- 7 13:4°l0 17.8% 21.3% 24.3%
STANDARD R-13 > R- 5 12.4°!a 16.4°fo 19.7% 22.5%
STANDARD R-15 > R- 5 12.9% 17.1% 20.1%o 23.4%
STANDARD R-18 -19 < R- 5 12.1°l0 16.0% 18.8% 22.0°fo
STANDARD R-18 -19 > R- 5 14.0% 18.6%0 21.8% 25.3%
ADVANCED ` R-18 -19 < R- 5 12.9°!a 17.1% 20.1% 23.4°!a
ADVANCED R-18 -19 > n- 5 14:5% 29.2% 22.5% 26.1%
STANDARD R-21 < R- 5 12.8°l0 17.0% 19.9% 23.1°la
STANDARD R-21 > R- 5 14.5% 19.3% 22.5% 26.1°l0
ADVANCED R-21 < R- 5 13.6°l0 1$.1% 21.2°10 24.6°10
ADVANCED R-21 > R- 5 15.0°Jo ` 19.9% 23.2% 26.9%
Additional calculated values
STANDARD R-17 < R- 5 11.9% 15.7% 18:4°Jo 21.5%
STANDARD R-17 > R- 5 13.$%0 18.4% 21.5% 25.0%
ADVANCED R-I7 < R- 5 12.6% 16.8%0 19.6% " 22.9%
ADVANCED R-17 > R- 5 14.3% 19.0°l0 22.2°l0 25.7%
?
Notes:
Window area equals rough opening minus installation clearances.
Window U-factor must be determined by either the National Fenestration Rating
Council standard 100-91, or ASHRAE 1993 Handbook of FundamentaIs, Chapter 27,
Table 5.
.
.
.
r°
3
J
. , . LOT SURVEY CHECKUST FOR RESIDENTIAL
• BUIl.01NG PERMIT APPUCATION
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Mar+ch 19M
car?ocPRNrt.FM
DATE OF SURVEY: ? -'
tATEST REVtSiON:
D4CUMENT STANOARDS
• Registered Land Sucveyor signature and company
• Building PemTit AppNcant
• Legaidescrip6on
• Address
• NaRh arrow and scale
• House type (ramtler, rroalkaut, spkt wlo, sp?t entry, ioakout, etc.)
P
• Directional drainage arraws witfi stope/grddient %
• Propowd/etisting sewer artd w^ater senrices & imert elevaGon
• Street narne
• priueway
• Lot Square Footage
• l.ot Coverage
ELEVATIdNS
Existing
• Sewer senRice (or Proposed)
• Prop" corners
• Tap of curb at the driveway
• Elevations of any ebsting adjacent hames
AdequaEe footing depth af structures due W adjacent utiNty trenChes
Pro
• Garage flaor
• First floar
• LOwest exposed elevation (welkouttwindonr)
• Properly comers '
• Frorrt and rear of home at the foundation
PONDING AREA (d aaa"bia)
• Easement fine
• NWL.
• HWl
• Pand # designation
• Emergency OveAlow Ele+va'tion
DtMENSiONS
• Lot knesBearings & chmensions
• Right-of-way and street width (to back of curb)
• Proposed home chmensans indudin9 any proposQd decks, ovethangs greatet 3han 2', porches,'ertc.
(i.e. aI atructures requidng permenent footngs)
•' Show ad easements of record and any City utilities within thase easemer?ts
• Setbacks of proposed structure and sideyard setback af adjacent existing structures
• Retaining waN requiremettts, if any
?
Reviewed:
Name ! Oate
? CtTY USE ONLY
LOT ` BL I FERMIT #:
susD. REcEIPr
?
RECEIPT DATE: 3 3p -Q 0 `
2000 rXcWM=c? PZRMiT (RZssnZrrrM)
. c=Tr oF EArM
3830 PILQT KNOB RD
RAGAti M 55122
3 65I-681-4675
Date:
?
Complete this section glly if yau are installing HVAC in a single famiiy dwetling, townhome or condo ;under
construction and not awner/occunied. ?
• HVAC: 0.100 M B T U . . $ 30.00
ADDITIONAL SO M BTU : 6.00
• Gas outlets (minimum of one required Q$3.00 ea.) ?•co
State Surchazge .50
. Total $
Complete this section onlv if yow are remodeling, adding to, ar repairins an eacisting single-family dwelling,
townhome, or condo. Please indicate if it is a new item, atteration, or repair.
New Alteration Repair , Other
Furnace Air conditianing
Air exchanger Other
Fee $ 30.00
State Surcharge .50
Totai $ 30.50
Reminder: Call for inspections
SITE ADDRESS:
OWNER NAME: ?? °I- ? ?D?? • PHONE ?_-
, .
INSTALLER NAME: 1/Y, ( t? 3 d ?,?.., A p p[e Ualicy C5J2JPHONE #: ( )
LOFGR?N (A"ACODE)
STREET ADDRESS:
ea tng i
CIT'Y: 20108 Catgary Tr. STATE: zip:
?
. . ?3???j . . .
. . ? . . ?. . . ? ? . . . . . ? ?
. ?., NATURE ERM TTEE
?
. . . . . ? . , y ?.. . . . . . . . . . .
i
. . . . . . . . . .
? . . ? . . ? . ? . . . ? . . . . ?
` GITY USE ONLY
L $L PERMiT *
SUBD. RECElPT#:
APPROVED BY: ,1NSPECTOR RECEIPT DATE:
2000 bOCFtANICAL PXRMIT (COOMCIAL)
C*TY OF EAGAN
3$30 P2L4T RNBB RD
, ZAGM, 'NK 55122' -
651-681-4675
Please cOrnpiete for ali commeraairmdustriat buildings
muiti-family buiidings when separafe permits are ?ri retauired for each dnreliing unit
DA 'IE:
WORK TYPE; New construction Install U.G. Tank
Inttriar Imgrovement Remove U.G. Tank
Processed Piping
When installing/removtng ernderground tank, call 651-681-4675 for inspection by fire marshal and
plumbing inspector.
Description of work:
Fees: 1°!0 of contract price OR $30.00 minlmum fee, whichever is greater.
' Undergraund tank removaUinstallation - minimum fee
Contract price: $ x 1°fe =$ (Base Fee)
State surchazge calculate at 5.50 for each $1,000 Base:Fee
TOTAL $
- -- - -- - --------
SITE AUbRESS:
' OWNER NAME: PHONE #: -
(a"a? coDE)
TENANT NAME (R"ROVEMENTS'ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
AI?DRESS: ` PHOI3E #: . - '
(AREA GDDE)
CITY: STATE: Z[P:
SIGNATURE OF PBRMITTEE
Address 4 5 0 9 A 1 i c i a D r i v e Zip 5512_3
Lot 1 Blk 1 Sub Southern Lakes West
THESE TTEMS 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
Trait/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 af 681-4645 before working in tight-of-way or installing undecground sprinkler system. ?
White - City Copy Ye11ow - Resident Copy Pink - Contractor Copy
7? x s 30W: ?, .. y+r? `a . . ?.%'ey?c• ?r4. Y e.?? #•y ?w«?sk q.R s?i'¢?x:?" ? ¢. ? `? :?`??< >-,'„'?'?'M d? , ? ?i?'?'??
VtTY YSE QNLy I.' . .
t
L? aL aEcEiPrt
SUBD. V" RECEIPT DATE'
,PERM17 #
2040 PLLTM$ING FERMIT (RLSIDENTIAL)
CITY OE EAC,AN
3830 PILOT YIN{)B RD
LAGAN. MN 55122
651-681-4675
Pisase complete far. ? singte farnily dwellings
? townhomes and eondos when permits are required`for each unit
? backflaw prevertter far undecground sprinkler sysfiem
czv,nio ee VAt'"il !f TdTAL
Alterations to exisdng dwelling - minimum fee
Describe: $ 30.00
Bath tub $ 3.00 x $ ' --
Fioor drain 3.00 x ti
Gas piping outlet ' minimum - 1 3.00 x 1 = $ -
Hot #ub/spa 3.00 x = $
Kitchen sink 3.04 x = $ --
Laundry tra 3.00 x I - $ 3,-
Lavata 3.00 x Z. _ $
Septic System naw/refurbist?ea * reputre,c MPC ttc. 75:00 ` x $
Septic System atianaonment 30.00 x - $
RPZ new'rnstatiationtrepaidrebuild 30.00 x = $
Rou h o enin 1.50 x 3 $ ?•
Shower 3.00 x 1 $ 3=
Under round sprinkler if dwelling is under canstruction 3.00 x = $
Und@f fOUC1d S(1nk1@I' if exis#ing dwelling 30.00 ` X - $
Water ctoset 3:00 x 7. _ $
Water heater 3.00 x 1 = $ 3
Water softener if dwelling under construction 5.00 x = $
Water softener It exisang aweirng 30.00 x $
Vitater turnaround 30.00 x = $
State Surchar e .50 ->
E $
TOtal -> ->
Reminder: Call for inspections of alterations, i.e. water tteaters, water so#teners, etc. `
----------------------- ------- ------- ------=---------------- ------------------------------------------------------------=--------- ------
I hereby aGcnowledge that 1 have re?i this appiication, st?te ?a# the +nforrnation is correct, and agr? to't?mply w?tti a? appli+cable G?j/ of E??n and'm?n+?s•
It is the applicanYs responsibility to notiry the property owner that the Gity of Eagan assumes no liability for any damages caused by the City during its
normai operationai and maintenance activities to the faciiities constructed under this permit within Gity propertylright-af way/easement.
SITE ADDRESS: Ir
OWNER NAME: TELEPHONE #:
(AREA CODE)
?
INSTALtERNAME: G?"???C/ I? A TELEPHONE#: L0 1 Z" '/ (-/ -1"-f0
(P+REA GODE}
STREET ADDRESS:
CITY: ty- STATE: ZiP: 2--
;
SIG TU E C??.l' ?MITTEE ?? ,,
,.. ,ayf
A.
..,. i Fy '.f? { a ?
?Y ? ,' . '. ,?' `?D r ?j r ri a f ??: .`"?'C 'F $?? ? ?` ? t
. . . . .
• 3 MgMered site sunreys afiotwNi9 sq. it of tot sq ft, of hmm wt# d toobd area ` y
*
(2{196 rrazinu?tt bt COrerage aNbwed) '. 1 sd 4f Erietgy fi,atculaC?ni tr hegotl sMft
• 2 copies of plartshovving beam 8 window sizes; poucecl Eocmd.design, etr.:y . t ske survey for txterior add't? & decics
• 1 set of Eneqy Gaicu;a6atis
• 3 cwpies of Tree PreServation Rlan N lotplatfsd after 711193
• Rim Joist Detaii Options selection sheet (bidgs with 3 a im mis)
. ?
i
D
TE 4za
P
N
l
_
A VALUAT (excLuDiNG uANO)
IO
,;JB SITE ADDRESS
IF MULTI-FAMItY BUILDING, HOW MANY UNITS?
PR4PERTY OWNER 465 f {
TYPE OF WORK G FIREPLACE(S) _.0 _,_:1 -2 ._3
APPLICANT c- ' .. Z?? Lr ? 577649 PHONE #
AQDRESS 2 3 3 ZIPCODE
PAGER # CELL PHONE # lo /L - _4Z 8 - Z Tg<L fAX # ; 95_2 - 4'G / - 4fL7
NE1V RESIDENTiAI BUILDfNG fJNLY -Filt: OUi' COMPLETELY
Energy Code Category MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residentia! Ventilation Ca#egory 1 Warksheet Submitted
Energy Envetope Catcutations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Woeksheet Submitted
Plumbing Contractor. : Phone #:
Plumbing System Includes: ?Watex Softener Lawn Sprinkler Fee: $94.00
Water Heater No. of R.I. Baths
?
No. of $aths
Mechanicai Controctor: Phone #
111echanical Systena Includes: Air Conditioning Fee: $74.00
- - Heat Recovery System
Sewer/Water Contractcr: Phone #
All above information must be submitted'priar #o processing af appiication.
1 hereby acknowiedge that i have reod this application, state that the information is correct, and a?'e comply with ,
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
,
Signature of Applicant
Gertificates of Survey Received Tree Presenration Plan Received Not Required '
Updated tro1
I
? ??'hua?'?` , ...t4Fe • M'....:iG{i`?MM, a.ly! ,)af?,7'?'l4MI?lav
. , :
} 'tiis 'i.7{ 77' h'
4
-
,
77
. 0
03-oBX
4.7 oi? 11 1 V-pleX C3 10 Low i.exGi 0
2
..
0 06 04=plex `Ct 12 12-ptex PUVY or ? N 0 25 N{iscellan+eous
? 31 New E3 35 int impravement 0 38 =Demofish (tnteriar) O 44 Sitiing
E3 - 32 Addition ? 36 Move Bfdg. 0 : 42 C?emotish (Foundation) 0 45 Fire Repair
0 33 Alteration D 37 Demotish {BWg}# ; O 43 Reroof O 46 WindowslDoors
? 34 Replacement *13emaitcon (Entire sieg only) - Give PCA handout to appi€cant
Valuatian Occupancy MC/ES 5ystem
Census Code Zoning City Water
SAC Units Stories Boaster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. afBldgs length Fire Sprinktefed
TYPe of Const Width
REQUIRED IIVSPECTIONS
Footings (new bldg) FinaUC.O.
_ FnotinQS (deek) _ FinaUNo C.O.
Footings (addition) Ftur44ing
Foundarion
? HVAC
Drain Tile
Roof
Ice & Water _ Final ` Other -
?
Framing ,_ Pool _ Ftgs _ Air/Gas Tests -Final
Fireplace _ R.I. Air Test Einal Siding S#ueco Stone
-
Insulation - .rt Windows (new/replacement)
Approved By
, , Suitding Inspector
- ------ --- ---
Base Fee ----- ---- -- -- - - - - - - -
Surcharge
Pian Review
MC/ES SAC
I
.
city sac
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
MecManical Permit
License Search
Copies
4ther
Total
LT ,?
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-u??p,??? d - '' 1h.' ?
?-BF'R
su ?
? ? c) -roa4ue, l? 8? ° S?,` 5 t ., ? ` op 1206
AooRF55PF?.c??y: F?.FJ?=??3? ,? 3(:?,-- `'ua tiJr ????,-???r4
4509 A-ockq lp
ldA
A0 1 ?
a 22.33 `?'_ _ ? I
? 3p oA i N
,3$ / 9 4j.?$ _ o
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w ri 39 ,b NA` rrA 2'7?
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d,. _ '----- t - --?- Q ? ,
? .u,?.u? ?
27,30 36.9'7 ? 12 .C?Ga ? ?? $2,?,?
-Top 1-kvG, P
v)FqFE ???=94t,?5 '`?? ?',= q4t.8s /
Q?,-rea$w7m
A ?..,l ; I ? L E. rr-p Cu,Q?
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C dp 0aa
1?SJ?- `33b.`? ?t.C??.=??j?•?? -9?',{??7
CS. = 94(),9 Bearings are assumed
13?17 ?,o?•?P?+ r?,.,?,
?L-p?kY-% ?pPP,- ?&?(o dq?, Subject to easements of record fi any
U
13.9 '10 C09 M . 0 Denates set or iound iran pipe monuments
Denotee set woad hub and tack
Proposed garags floor elevation
T&4.0 Denotes existing elevation
?`-i"?. ? ?'ouup?RT?D1J
Proposed top of b*Sdc elevation Denates propased finish grade elevati.an
('1 Denotes direction of surtace drainage
Proposed lowest floor ?levation
. ,•
o I ? ti Ls Opi K)40o t 1r-_p W17
D1?--r
?
9.? hereby certify that this is a true and correct representation of a survey of the boundaries
_ n;:
R DR-Kb"i'P
of Lot Block l. ,SOUT1-AEM County, Minnesota ae an file and of record
in the Ottice of the County Recorder 1n and tor safd 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.
rn r
na tea :?? ,
?
§; ,_.?... 3t ?? ? v . E
F\% ? . ? . ?. . . . - .. . . . / . . .
Allan R. Nastings -
?i, • ` . --... Minnesate Registratian No. 17009
212 First Avenue E. •
Suite No. C
?r
Shakopee, biinnesota 55379
. Phone 612 445 4029
? ? ? F,???(J" JV'
i
. f . . . - . :: .. ... . ..:.: . . . . . .
tity oF engan
eArRIC:w E. AvUAnA
Mati-or :
('.-1[.'L BAKKEN
PEccYC.axtsON ,IUIy 23, 2002
C?i?;DEE F[ELDS
N[EC; TILLEY
?
Council viembrrs SUBURBAN EXTERIORS ,
?
; 7466 W ASHINGTON AVE S
THOVt-\s HEncFS EDEN PRAIRIE MN 55344
CicyAdmini$cracor ' RE: BUILDING PERIYYIT APPLICATION FC?,. .?? ,.TO WHOM iT MAY CONCERN:
' ,Mun;ciPat center: This letter will verify our conversatian earlier today that Building Perrnit #51312 issued
3830 Pilot tcnob Road ' to Suburban Exteriors on June 7, 2002 for 4530 Greenleaf Dr E. has been chan?ed to
esga„, N[:v 55122-1897 4509 Alicia Drive. A revised copy of this permit noting the address change, as wett as
Pt,one: 651.681.4600 ; Your check for Alicia Drive, is included with this tetter. The check originatiy submitted
for Greenleaf Drive will cover this adciress change.
Fax: 65 t .G81.4612
TnD: 651.454.8535 ? If you have any questions, please feel free to give me a call af 651-681-4695.`
; Sincerely,
Maintenance Facility:
3501 Coachman Point
?
Eag,an> MN 55122 i illee?,,.n
Office Supervisor
Phonr: 65 t.t31.4300
Fax: 65I.681.4360 cc: Dale Schoeppner, Chief Building Offieial
TDD: 651.454.3535
www.ciryofetgan.com
j
;
"['HE Lt)NEl)AK C'KEE r
['hr symlx,l ot,aen?,nh
:tncl gruwth in uur ;
,
cumtnunitY
itESIDIENTIAL
BUtLDING PERMIT APPLtCAT10H
cnY oF EacM
830 PILOT KN08 R0, EAGAN MN 55122
851-881-48T5
?qw Goristr?tbn Re,quiremsn? t R}r,?eUR?cak RIqu?ner
• 3 registered site surveys shor?g sq. ft. se; and ?ll raofed areas • 2 copies of p?n
{20% ma?cimum bt cx?verage ahowed} J ". 1 set of Ensrgy Galculatio
• 2 cmpies of ptan show?g beam & windod design, etc.) ?;,, _ f: ___ 1_ • t s?e survey for exteri?x
. 1 set of Energy Caiculations 7 wt4??W?!?'v Indiqte if hane se
\7/1/93
• 3 topies of Tree Preservation Plan rf bt n ? ,
. Rim J?t Deheff O?s selection sheet s ?
.+ i??r
DATE __-_- VALUATION
SITE ADDRESS
TYPE OF WORK
o .
..-- ?
.
APPLICANT
STREEt A?DRESS L{,.?Cc 511 A Cf1( iC??'r't i7t.? st-'`ATE 1r'?/?-?IJp
TELEPHONE # 42-'?ZCELI PH4NE # FAX #
l
PROPERTY OWNER K i' Gt, (.t,2 2 TELEPH4NE #? f Z'?c??- f Z Z/?
?
,
---------------- m_-.m ??w??.??????? ?r--r--.-?rrr---- .?, .? . -.? - r.?-r-?r-- -.n.?-----w?--. .
. ? . ? . . . . . . . .
CC?MPLETE TMIS SECTION F4R N?W" RESt?ENT1AL BUtLDINGS QNLY
Energy Code Category MINNESOTA RU 670 CA'T'EGORY 1 MINNESOTA RULES 7672
(1 submission rype) . Residentiai Ven6lati Gategory 1 Workshest Submitte?i + New Energy Code WoAksheet Submitted
• Energy Envelope C lations Submitted ?, .
. . ? ? . . . .. .. . `ti . .. . . . .
. . . . . ? . . . . . ?.,. : . . . .. .. : . ..
PIU('r?k?Ing CQtltraCbr: PtlOni #
Plumbing system inciudes: Water Softener ? Lawn SpriWer Fee: $90.04
? Water Heater ? No, of RI.'?aths
No. of Baths
Mechanical Gontrccbr. F'hone #
------
Mechanical system includes: ? Air Conditioning
Heat Recovery System
0 6 20a2
--
SowerlWafer Contract/,,t ` Phone #
;
----- --------------------- ------ ---------- - ----- --- ----- ---- - --- °=",?-,,.r...........:...---
I hereby acknowiedge ave read this ap piication, state that the information is c4nect, and agree tQ comply
with ali appiicoble Sto nesota Statutes and City of Eaga r r es
Signature of Applica
OFFICE USE ONLY
Certifrcatss of Survey Received _ Tree Preservation Plan Received _ Not Required
Updated 4/Q2
?
rW
,
.
I-i
FS for heated eWrtions
dibons & decks
septic system r add?
?
MULTI-FAMILY BLDG _ Y ?SN
, FtREPLACE(5) `_ p ._. i _ 2
S ? 31 Z RES1DENTIAL 5,/ 2
BUtLDING PERMIT APPLICATION
CITY OF EAGAN
Q.p 3$30 PILOT KNOB RD, EAGAN MN $5122
• 651-681-4675 , .
? .? 714 t z,?? . 4skj^
&vda_4
New Construction Reauiremems . m +
• 3 registered site surveys showing sq. . of lot, aq. ft. of house; and Ai roofed areas-•? ,_. • 2 copies of plan ' 6
(20% maximum bt coverage aliowed) 1??tio • 1 set of Energy Ga?ulations far heated addftk?ns
• 2 copies of plan showing beam & window sizes; poured found design, etc.) ?+ a? °• 1 site survey for exterior addRions & decks
• 1 set of Energy Ca?ulatbns ???? ? • lndicate ff homessrved by septk system for addkions
• 3 copies of Tree Preservation Plan if bt platted after 711 /93 `
• Rim Jo?t Detail Options selectbn shee# (bkJgs wfth 3 or less units) b4,e,? -7?3'?? ,
DATE VALUATION
SITE ADDRESS Jbr- f 7,,?, MULTI-FAMILY BLDG _ Y ? N
TYPE OF WORK Pp,P=,jf- FIREPLACE(S) _, 0_ 1_ 2
APPLICANT ? s7ujue?'_',?
STREET ADDRESS ccs CITYz-,d,?-??., STATE ? 21P ?b?.?
TELEPHONE # 9.0881-V32 CELL H4NE # fAX #°9 <2 g 1t r^W6 IJ '
,
PROPERTI(OWNER JL.4 TELEPHONE#
---------------------------------------------------------------------------------------------=-
COMPLETE THIS SECTION FOR -NEW,, RESIDENTIAL BUILDINGS ONLY
Energy Code Category T MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672 '
(4 submission type) • Residential Ventilatian Category 1 Worksheet Submitted ' • Nsw Energy Code Warksheet Submitted
• Energy Envelope' Calculations 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 ?
_ Heat Recovery System
D-
Sewer/water Contractor: Phone # 2 2 2002
-------------------------------------------------------------------------------------------- ----------------- ------- --
t hereby acknowledge that I have read this application, state that the information is c e#, a r+ee tt5" o piy
with all applicable State of Minnesota Statutes and City of Eagan Ordin es.
Signature ot Applica t ? `??
.........?........................................?
. ---................... --............ ....... ---........
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received Not Required _
"
uadated 4/02
OFFICE USE ONLY
O 01 Foundation ? 07 05-plex 0 13 16-piex 0 20 Pool Ck 30 AccessoryBidg
? 02 SF Dwelling 0 08 06-plex O 16 Fireplace M 21 Porch (3-sea.) '13 31 Ext. AIt - Multi `
13. 03 01 of _ plex 13 09 07-plex ? 17 Garage ? 22 porch/Addn: (4-sea.) ? 33 Ext. Att - SF
0 04 02-plex 13 10 08-piex ' ? 18 Deck 0 23 Porch (screened) ? 36 Multi
? 05 03-plex 0 11 10-plex ? 19 Lower Level ? 24 Storm Damage
13 06 04-plex ? 12 12-piex PIbg__Y or,__ N 13 25 Miscelianeous
O 31 New ? 35 Int Improvement 0 38 Demolish (Inte(ior) E3 44 Siding
0 32 Addition ? 36 Move Bldg. 0 42 Demolish (Foundation) ? 45 ' Fire Repair -'
13 33 Alteration ? 37 Demolish (Bidg)" ? 43 Reroof 0 46 Wintlaws/Doors
? 34 Replacement *Demolition (Errtire B idg anly) - 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 Bidgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) _ Fina1/C.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 Stucco Stone
Fireplace _ R.I. Air Test Final Windowa (new/replacernent) '
_ Insulation Retaining Wa11
------- - ------------------------
-
-
-
-
--
- Approved By:
-------------------------- - ------------- , Building Inspector
----- - --------
-
-
--
-
Base Fee ---- - --- --
------
- - ---------------- ---- - --- - --
Surcharge
Plan Review
MC/ES SAC .
City SAC
Water SuPplY & Storage
S&VN Permit & Surcharge
Treatment Plant
Plumbing Permif
Mechanical Permit
License Search
Capies
Other
Total
;Sou?evard Trge Planting Permit Procedure - Part III
. Example: Marshall's Ash 1.5" dia.
N.
A-m
2. "
3. ? s .,
._?
F 5.
http://www.ci.eagan.mn.us/Farestry/plant_pemut3.htm
?p c1? Gu{?
11), g K
p'
J
Diagram:
Please attach a rough diagram of your lot and the right-of-way area showing'the locatioi
structures, buildings, driveway, street edge or curb, and location of tree(s) to be plan
' 1 of 2
8/26l2002 9:57 AM
.. ?
Boulevard Tree Planting Pem-ut Procedure - Part III, Agreement
FOR CITY USE:
http://www.ci.eagan.mn.us/Forestry/plant_pernut3a.hhn
Property I.D. # Lot Block
Subdivision
Application Record
Reviewed bY:
Engineering Date
,
Reviewed by:
City
i,- 3-02
Date
1 of 2 8/26l2002 9:57 AM
/ r
13
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. .. . . . .. . . . . . ? ? .. ( 1? . ? ? . . . .
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4509 Alicia Dr
Lot: 1 Block: 1 Addition: Southern Lakes West
PID:10- 71300 - 010 -01
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
Construction Type:
Occupancy:
$88.50
$1.50
$90.00
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Owner:
Mark Harrington
4509 Alicia Dr
Inver Grove Heights MN 55077
0801
9001
Issued By: Signature
Building
EA087215
10/31/2008
ePermit
If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not
acceptable in lieu of inspections.
Permit expired without required inspections. 5/4/2009 CE
- Applicant -
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply
of Minnesota Statutes and City of Eagan Ordinances.
h all applicable State
� }
Use BLUE or BLACK Ink
r �r----------------�
` I For Office Use �
� ����� �G�:
� �.� � Permit#: �
City of Ea�a� g �
,�` ' .:.�%�ld��� �����
• I Permit Fee: f
3830 Pilot Knob Road Q(N"nQn��'Y� RECEIVED � f � �-'"
Eagan MN 55122 \ � � Date Received: '�� ��
Phone:(651)675-5675 I I
Fax:(651)675-5694 QCT 0 6 1��5 I Staff: I
I I
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: (7� ��dols Site Address: �I SOq A-I�u�. l��tv�c. t= .� Unit#: "-
��`�.� ��{
�.
��� Name:�M_p,rk I�arr�1�,� loS�^ c�/(v ' ��� Phone:_�%� �j� � �� �
.-, _ � /
� � ��l�'1 dk- u�6�F�
�"r ��� ; Address/City/Zip: y S O 1: ' �r;�+c. �i. „
� � �
h�= Applicant is: X Owner Contractor
�f
� Description ofwork: ��ar.c,a� Adldc�,on �S.�.� = rorr.t�han =Fnw..',r►.►q= RooCw,
� Vllo� `
�`_ � Construction Cost: � S,Ot�d Multi-Family Building:(Yes /No )
�
� Company: Contact:
� #
�� r; ' Address City:
f w 01". ..
�:;; ,�
`,�: State: Zip: Phone: Email:
�: x��,«, � ' License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
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:
� � lans�na1�u. a` r�g�loC�m�n� o �k�r� � �i li��' ' � a� �y ' �'�
#t�����a��atiaw� ��cla�� ��s nc����� � �nav�"d����� � x�: a# ��;� �#��e ��;
�; � �.�; ��� � �"�
n , y � � ;y ,� .�
7 � x t�.. ��� . - v. �.. �. h 'rcon���`��e�t�� �,.� ar?e>tratlQ se�� # � �� :;�� , _
Wx, .*�. . . �.an. � .. _ ��. x•
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utiliry 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 conformance 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 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 ermit issuance.
x
Applic t' rinted N Applicant's Signature
Page 1 of 3
�
'���� ��� ��`/� ���r DO NOT WRITE BELOW THIS LINE r-���'r�� �
SUB TYPES
_ Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration(Single Family)
— Single Family — Garage — Porch (4-Season) — Exterior Alteration(Multi) •
Multi Deck Porch(Screen/Gazebo/Pergola) Miscellaneous
01 of_Plex Lower Level Pool Accessory Building
WORK TYPES
_ New _ Interior Improvement _ Siding _ Demolish Building*
_ 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 r �
Valuation �� � ��'�;,� Occupancy � �,, � MCES System
Plan Review � Code Edition � �t�������� i �� SAC Units
(25%_100%�) Zoning � City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
� Footings (Addition) � Final/No C.O. Required •
� Foundation HVAC_Gas Service Test Gas Line Air Test
Roof: _Ice &Water _Final Pool: _Footings Air/Gas Tests _Final
� Framing Drain Tile
Fireplace: _Rough In _Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick
� Insulation Windows '
Sheathing Retaining Wall:_Footings_Backfill_Final
� Sheetrock Radon Control
Fire Walls Fire Suppression: _Rough In_Final
Braced Walls Erosion Control
Other:
� ��, � � ,
Reviewed By: � , Building Inspector .. ._ .'�'" --y��`�y���r E=+�
z
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC � ,,
�City SAC � � ��� �� � l / �� �/.,�' �
Utility Connection Charge T
S8�W Permit&Surcharge •
Treatment Plant
Copies
TOTAL
Page 2 of 3
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�"��-.-_._ � ;_X hereby certify that thia is a true and correht representati,on of a aurvey of the bounclaries
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� Yv�'�1S �,� ����x ot Lat �, Block 1, ,��U'Tl-�E'�V �-�.�`tK�,rj 1Y1ir„��" Caunty,. Minns�ota ar an tilw and o! rscord
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-� �f� in the Ottice ot the County Recorder in and for aaid Couaty� also shorving the proposwd lbcatian
e.(..r. � � � . � . . . . - . .
r�� . . � . . . � . .. . � . . . . . . . � . .
of a houae as staked thereon. •
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�,.,� �� � � That I am a duly Registered Land 8urveyor under the Le►wa oi the 3tate o! Minneaota.
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� ng t�a: ��I A�t`.��� �A�ZOp(� f
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Allan R. Hastings -
r!t, - .-... Minnesota Registration No. 170tf9
� � .':- _3_-�-' .D._�:_ , 2�.a �irst Avenue E: �
-� . ';:F;, ,,,�; '*.f}_._... Suite No. C
. � ... : . . . .
, 5hakopee, l[innesot� 55379
Phone 61� 445 4U27
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