499 Chapel CtPERMIT
City of Eagan Permit Type:Building
Permit Number:EA112302
Date Issued:08/07/2013
Permit Category:ePermit
Site Address: 499 Chapel Ct
Lot:16 Block: 1 Addition: Cherrywood Knoll
PID:10-17050-01-160
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Susan K Lauermann
499 Chapel Ct
Eagan MN 55121--236
(651) 324-1588
Gene's of Apple Valley Inc
17660 Kettering Tr
Lakeville MN 55044
(952) 892-0060
Applicant/Permitee: Signature Issued By: Signature
:
a----t w??-l 2 G S?
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New ConatrucHon Reaulremenh
Name: Phone #:
LCSf FiBf
i.3-7
.9 - S-C) d
% 3 registered site wrveys showing sq. ft. ol iot aq. H. ol house 4 coples of plan
and Qil rootetl areas (20% mmclmum lot covemae allowedl 1 set of energy calcWaHOna for heated adtliMOna
> 2 copies ol plans (show beam & window sizea; poured (ntl. dealgn; etc.) 1 site survey tor aztedor addlMons & decka
> 1 set ol energy cawlanons
> 3 coples of tree preservatlon plan if lot PlaRed aNer 7/ 1/93
DATE: a1 itp IaoOD I v irtCONSiRUCT10N COST:
DESCRIPTION OF WORK: &r19?Q, "mi?\l Ftovr)e--.) If mulH-famity bldg., how many units?
STREETADDRESS: -4Gq C"GpeA
LOT: I Lp_ BLOCK: I_ SUBD./P.I.D. #: C.YXY'YqW DoC1 Kno I 1
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Sheet
City
Stafe:
c='-k"
Remodel/Reoalr RernilremeMs
?
Zip:
company: Anclersor? 'F-am "1., xlc?mP c? rnone a: ci 52 4? o - 4 r?o e,
(area code)
SfreetAddress:llolP,lo YY\o.in fat)e. License11aOO4 Ettp.g3IJa6oI
Clfy q-or La1Ce_ Sfate: -YYIt'A Lp: 5t) 31a
Company: Name:
Telephone #: (
Sfreet
City
Regisfraflon #:
State: ZIp:
Sewedwater licensed plumber (if installina seweNwater): Pfo?ie #:
I hereby acknowledge that I have reod ihis applicafbn, sfate Nwt the infortnafion is cortecfL and agree to comply wNh atl applicable Stafe
of Minnesota Statutea and CNy of Eagan Ordfnances.
Slgnalure of
Certificates of Survey Received LM Yes
Tree Preservation Plan Received _ Yes
OFFICE USE ONLY RECE???D
- No AUG 2 4 2000
_ No ?lot Require ?
BY:----
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 OS-plex
0 02 SF Dwelling ? OS 06-plex
? 03 01 of _ plex ? 09 07-plex
? 04 02-plex ? 10 08-plex
? OS 03-plex ? 11 10-plex
? 06 04-plex ? 12 12-plex
WORK TYPE
p 31 New
? 32 Addition
? 33 Alteration
? 34 Repair
OFFICE USE ONLY
• ?
O 13 16-plex ? 21 Porch (3-sea.) ? 37 Ext Alt - Mutti
? 17 Garage O 22 Poroh/Addn. (4-sea.) ? 33 Ext. AR - SF
? 18 Deck ? 23 Poreh (screened) ? 36 Mum
? 19 Lower Level [1 24 Stortn Damage
Plbg _Yor_N ? 25 Mfscellaneous
? 20 Pool ? 30 Accessory BkJg.
? 36 Move Bldg. O 43 Reroof
? 37 Demolish (Bldg)* ? 44 Siding
? 38 Demolish (Interior) ? 45 Fire Repair
? 42 Demoiish (Foundation) ? 46 Windows/Doors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code D ?
No. of Units
No. of Buildings _L
Const. (Actual) 5-- v
(Allowable) J ?1J
UBC Occupancy ?
Zoning
# of Stories a2 sq. ft.
Length ? sq.ft.
Width (? n Footprint sq. ft.
Basement sq. ft. /4'f.2- Census Code
Maip level sq. ft. iq s!D MC/ES System
a1'?4ew/sq. ft. r4?y Ciry Water
G ar sq. ft. 4 3 f? Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning _
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SNV Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Building UK Engineering Variance
Valuation: $ I S'7 pvo ?
?
Q SM. i
76 O,pu?'
796- =-o
g?yXSS/- ?
Ga.ra ? e- ?03896 fr /a, so?. m=
.5U a--1. 3 `]
azO 78
G Q/
SAC Units
% SAC
Ventiiation Measurement Documentation
Bldg Address: 499 Chapel Court Date:
City: Eagen Zip Code: 55123
Completed By: Nicole L. Meyer Co. Name: Anderson Famity Homes
Path 0, Aggregate Altemative
Ventilation: Measured PerFortnance
People Ventilation Supplemental Ventilation Total Ventilation
Minimums ? 75 109 184
Measured Measured
People ??8?ed Intake Exhaust Supplemental Designed Intake Exhaust
HRV or ERV 1 172 cfm. HRV or ERV 1 17 cfm.
Master 8athroom 80 cim. Master Bathroom 0 cfm.
1st FI Bathroom 0 cim. 1st FI Bathroom 80 cfm.
2nd FI Bathroom 0 cfm. 2nd FI Bathroom 80 cfm.
People: 252 cim. Supplemental: 177 cim.
Note; Air flow for balanced ventilation systems must be balanced within ten pereent.
Total Designed Ventilation: 429 cfm. Total Measured Ventilation (people + supplemental):
Compliance 3tatemeM: Installed veMilation system is in comptlance wHh the MN Energy Code mM slzed to provlde the deslgn alr flow.
ApplkanR (prlM name) Signature Date Phone number
Aggregate Make-Up Air Altemative and Ventilation Documentation
(Can be Used as a Supplement to Permit Application)
Bidg Address: 499 Chapel Court Date: 8/16/00
City: Eagen Zip Code: 55123
Completed By: Nicole L. Meyer Co. Name: Anderson Family Homes
Path 0, Aggregate Alternative exnaust Devices cFM
Space Heater: Sealed Combustion Clothes Dryer 175
Water Heater: Not Applicable Kitchen Exhaust 0
Gas Hearth: Sealed Combustion Master Bathroom 80
Solid Fuel Hearth: None 1st FI Bathroom 80
CO Alarm: Not Required 2nd FI Bathroom 80
Make-Up Alr Requ irements Central Vacuum None
Exhaust Devices Dryer Kitchen Largest
Other Total
Exhaust Capacity I 175 0 0 175
I
Distribution I CFM
PassivelnfiHrafion I 175
Passive Opening(s) I Rigid Flex Direct
?
Powered Make-Up
I
I
?
I
Ventilation ? Minimum Required
Sq. Ft. Bedrms ; Total Ventilation People Ventilation Supplemental Ventilation
3676 4 i 184 75 109
?
I
People ? Supplemental
HRV or ERV 1 ? 172 cfm. HRV or ERV 1 17 cfm.
1
Master Bathroom ? 80 cfm. Master Bathroom 0 cfm.
1st FI Bathroom ? 0 cfm. 1st FI Bathroom 80 cfm.
2nd FI Bathroom ? 0 cfm. 2nd FI Bathroom 80 cfm.
oit
I
. • ' LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
? PROPERTYLEGAL: LT 16 e/nPu/l/IX?? &/-L^
n DATE OF SURVEY:
H ?
W LATEST REVISION:
(X
o DOCUMENTSTANDARDS
O
O
ry ? • Registered Land Surveyor signature and company
?y ? • Building Permit Applicant
? Legal descriptlan
R/? ? : Address
¢?p ? North artow and scale
? ?.
? ? House type (rembler, walkout, split w/o, sp6t entry, lookout, etc.)
? • DirecSonal drainage arrows with slope/gradieM %
a?,el ? • Proposed/existing sewer and water services & invert elevation
?? ? Street name
5 ? ? Driveway
? • Lot Square Footage
? ? • Lot Coverage
ELEVATIONS
ExisOna
p ? Sewer service (or Proposed)
m??' ? ? Property comers
d?,e • Top of curb at the driveway
0 m/,? • Elevalions of any exassting adjacent homes
u?? Adequate footing depth of structures due to adjacent utility Venches
Prooosed
?
? - Garagefloor
o . Firstfloor
y ? . Lowest euposed elevation (walkouVwindow)
? ? • Properly comers
0 ? • Front and rear of home at ihe foundation
? PONDING AREA (if apdicade)
? ? • Easement line
o p? o • NWL
? ?? • FIV1lL
? /? • Pond # designation
? ?' ? • Emergency Overflow Elevation
DIMENSIONS
? • Lot Iines/Bearings & dimensions
y? o • 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 shuctures requiring permanent footings)
?? • Show a0 easements of record and any City utilities within those easements
?? '6 • Setbacks of proposed structure and sideyard setbac of adjacent exdsting strudures
o u/ o • Retaining wall requirements, 'rf any
Reviewed:
011241d ?
/ Date
Mareh t99e
CRAIG/B1LO0PRMT.FM
* PIONEER
* ang n-i?
* * *
*
Certificate of Survey for:
L07 AREA =12,053 SQ. F7.
HOUSE AREA =2082 SQ. FT.
COVERAGE =17.3 %
HIOUSE T1PE=2 STORY LOOKOUT
2I
2422 Enterprise Drive
Mendota Heights, MN 55120
(651) 681-1914 FAX:681-9488
625 Highway 10 N.E.
Blaine, MN 55434
(612) 783-1880 FAX:783-1883
ANDERSON FAMILY HOMES
499 CHAPEL COURT, EAGAN
BENCH MARK
TOP OF PIPE
i ELEV.=879.35
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ELEV.=883.95 r; KqGA,W F•WGINFE$IIVG DEPT.
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NOTE: PROPOSEO GRAOES SHOVM PER GRAOING PLAN BY: ME7R0 ?
--
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LOWEST FLOOR ELEVATION:
NDTE: BUILDINC OIMENSIONS SHOWN ARE FOft HOR120NTAL AND VERTICAL LOCATION TOP OF BLOCK ELEVA110N: ¢' z
OF STRUCTURES ONLY. SEE ARCHITECTUAL PLANS FOR BUILDING AND
FouNOnnoN oin+ENSioNS. GARAGE SLAB ELEVATION:
NOIE: NO SPECYFlC SOILS INVESTIGA710N HA$ BEEN COMPLETED ON THIS LOT BY h1E
E
TOB @ LOOKOUT ELEVA710N: 877-7
SURVEYOR. ME SUITABWTY OF SOILS TO SUPPORT THE SPEQFlC MOUS
PROPOSEO IS NOT THE RESPONSIBILITY OF THE SURVEYOR.
NOTE; THIS CERTIFICATE DOES NOT PURPORT i0 SHOW EASEMENT$ OTHER THAN X 000.00 DENOTES EXISTING ELEVATION
Ri05E SHOWN ON iHE RECOROEO PLAT. ( 000.00 ) DENOTES PROPOSED ELEVATION
DENOTES DRAINAGE ANO VTL17Y EASENENT
NOIE: CONTRACiOR MUST VERIFV ORIbEWAV DESIGN. DENOTES DRAINAGE ROW DIRECPON
NO1E: BEARINGS SHOKN ARE BASED ON AN ASSUMEO OATUM ? - DENOTES AIONUMENT
---o -- DENOTES OFFSET HUB
WE HEREBY CERTIFY TO ANDERSON FAMILY HOMES THAT THIS IS A TRUE AND CORRECT REPRESENTA710N OF A
SURVEY OF THE BOUNDARIES OF: LOT 16, BLOCK 1, CHERRYWOOD KNOLL
DAKOTA COUNTY, MINNESOTA
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR
UNDER MY DIRECT SUPERVISION THIS 10TH DAY OF AUGUST, 2000. "
SI ED: PIONEER ENGI EE G, P.A.
SCALE : 1 INCH = 30 FEEiT J ey' ?
900fi ohn C. Larson, L.S. Reg. No. 19828
RESIDENTIAL BUILDING
Permit ApplicaUon
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
?70.00
New Construction Reauiremen6 RemodeVFieoair Reauiremenfs Ofice Use Onlv
3 registe2d site surveys showing sq. ft. of lot sq. ft. of house; anG all roofed areas 2 copies of plan Cert of Survey Recd
(20% rreximum lot coverage allowed) 1 set of Energy CalalaUons for heatad additions Tree Pres Plan Reed
2 copies of plan showiig beam & window sizes; poured found design, etc. 1 site survey for addiGOns 8 decks Tree Pres Not Reqd
1 sat of Energy Calculations Addition - indicate Nonsite septic system _ On-site Septic Syslem
3 copies of Tree Preservation Plan if lof platted afler 711193
Rim Joist Dehail Options seledion sheel (hldgs with 3 or less uniis
Date 4:;4 ConstruMion Cost
-
Si[e Address yaft c #,4 ?
UniUSte #
Description of Work _lye b eG L'`
Multi-Family Bldg _ Y_ N F7replace(s) _ 0 _ 1 _ 2
Pro
ert
Owner g l G ??? 4 T
h
)61`q / I6
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k
p
y one
e
ep
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Contractor A*/v,b lyv* K isSe/1(C e y b e Giz-
Address /?j y s ??Y /?
/ 3 City ?e/r f+ 0 T,-:9"
State _MH/ Zip Telephone # ((qS( ) L?S 7 - 5 -2-2/
COMPLETE TNIS AREA ONLY IF
A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
#?? ? ?? Q3
I hereby apply for a Residential Building Permit and aclrnowledge that the information is complete and accurate;
that the work will be in confortnance 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 applicarion 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.
b4/q CfJl2 US U b cwr,
Applicant's Printed Name ApplicanYs Signature
OFFICE USE ONLY ?
Sub Types f 1?
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBldg
? 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 OS-plex X 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_v or _ N ? 25 Miscellaneous
Work Types
? 31 New 13 35' Int Improvement 0 38 Demolish (Interior) `? 44 . Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish.(Foundation), O. 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/DOOrs
? 34 ReplaCement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation 2-? Occupancy -3 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 ? W idth • ''"
REQUIRED INSPECTIONS •
Footings(new bldg) FinaVC.O.
LO Footings (deck) ?O FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other
? Roof _ Ice & Water _ F inal _ Pool _ Ftgs _ Air/Gas Tests _ Final
Framing Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ _
Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
aRea -12,053 sa. s l:
.E AREA -2082 SQ. fT.
,4ACE -i 7.3 R
.E TYIIEaT. STORY LOOKUUi BENCH MARK
TqP OF PIP
. , ELEV.-879.3?
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El.Ev.=883.95
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ostu cMEs sHavav PErt cnAdnc run er, ueRta
wC OAA[N4UN5 SHONN AfE FOR HURIZONTAC AMI V[411CAL IOCATION
IRUCTUpES ONLT. SCS A5tt9iECNti VLANS F7R &GIOWG rN0
DATIOH pMENWNg_
?eane sai.s INAsncnnar HAs eeen eaaPLeTEn aN Mis Lor er nE
[rvn. nHe swrAOlurr or soVLs ro smvwvr rNe saecwc nase
oko is t+ot nHE rresronsren.irr oF THr surtVevon.
LERfIF1CAlE ppE$ pOf PUAaOpf i0 SMOW EA'.iEMfNTS OTUER THAN
! 3FWM1/ On1 nK RECORO(O YLAT,
IACIOfi INSr wRICY OqiwwAY DE9GN.
Nc5 SMOM/ ARF, BASE6 QV J.N A55{)NED OATVN
3Y CERTII"Y .TO ANpfRSON FAMILY WOMES Thlqi THIS I5 A
W THE 90UNOARiES PF: ,
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P&QPOSE'D.HOUSE ELEVATtON
LOwfSi FLtlOR ELEVAitOM;. ?_
YOP OF BLOCK ELEVAiION: Z?r4-4-
GARAGE SlAB EIFYATiON: 973-Y
TOB 0 LOOKOUT E4EVATION:,? 7_
X 000.00 OFNO%'S f,wSTNC ELEVAIION
( 000.00 ) uFTFOlES PROPOSEO EINAtItlN
DENOIES OFWNALE ANO Vi141iY FASCNCNi
- OENCIES DRFINAOE fLOW OtltfC(ION
--h- pEN07ES MOMJAIEFIT
-c-- pfNOTES OFFSET NU8
TRUE AND CORR£CT REPRESENTATIpN OF A
61 BLOCK 1, CHERR'YWOOD KNOLL
:OUNTY, MINN£SOiA 40T PURPORi i0 SHOW 11APROVEAIf.NTS OR ENCHROACHMENI'S, EXCEPT AS SHOVM, AS SURVEYEO BY M6 pR
f OIRECi SUPEF2VISION ??>jw (ww+wjw_?tn 0 •
?OC" 0 ? ??00
1 INCH = 30 FEEr1??3a ??bdfi1??6?1??FREry?61???qj,
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4 CITY USE ONLY
I`p BL
SUeD. C?
RECEIPT #:
RECEIPT DATE:
PERMIT# 1, ?i (O
2000 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PIIqT IaiOB RD
EAGAN, MN 55122
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backFlow preventer for underground sprinkler system
FIX771RE5
EACH #
TOTAL
Alterations to existing dwelling - minimum fee
Describe: $ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet * minimum -1 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tra 3.00 x = $
Lavato 3.00 x = $
Septic System new/refurbished • requires MPC 1{c. 75.00 X = $
Septic System abandonment 30.00 x = $
RPZ new installationlrepaiNrebuild 30.00 X = $
Rough o ening 1.50 x = $
Shower 3.00 x = $
Underground sprinkler rf dwelling is under construcfion 3.00 x = $
Underground sprinkler if existing dweniny 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener if dwelling under eonstruction 5.00 x = $
Water softener if existing dwelling 30.00 x = $
Waterturnaround 30.00 x $
State Surchar e .50 --> -> ---> $ .50
TOt81 -> S
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
----------------------------------------------------------------------------------------------------• -------------•-°------------------
I hereby adcnowledge that I have read this application, state that the intortnation (s co-rted, and agree to comply with all applicable City of Eagan ordinances.
It is the applicanYs responsibility to notify the property owner that the Ciry of Eagan assumes no liability for any damages wused by the City during its -
normal operational and maintenance activities to the facilities constructed under this permit within Ciry property/right-of-wayleasement.
SITE ADDRESS: L1179 Cjn,,q /k-j
OWNER NAME: :
INSTALLER NAME:
STREET ADDRESS:
? TELEPHONE #:
(ARE+ cooe)
? TELEPHONE C1G?? y/ -7 (-5u
(AREA CODE)
GY
ciTV:
Cfl'Y USE ONLY
I r [LOT 4 BL J_ PERMIT #:
SUBD. l.'IIPTfV VYOOd YIQI I RECEIPT #:
-7-
RECEIPT DATE:
2000 MECi3ANICAL PERMIT (fiESIDENTIAL)
crrY oe EAsax
S$SO PILOT KNOB RD
£A6AN MN 55122
651-6$1-4675
Date: d? ?
Complete this section on if you are installing HVAC in a single-family dwelling, townhome or condo under
construction and not owner/occunied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @$3.00 ea.)
State Surcharge
Total
$ 30.00
6.00
1 o1?j
?u
5G ,
Complete this section an if you are reinodelinF, adding to, or mplacinQ an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or replacement.
New _ Replacement
_ Furnace
Air exchanger
Other
Air conditioning
Other
Fee $ 30.00
State Surchazge .50
Total $ 30.50
Rerninder.• Call jor final inspection. ?
SITE ADDFESS: ? ` ? ?? ?'` y) Q- ? ?.
. I-,
OWNER NPME: A-n U??S G,'L l? v', PHONE #: cl-
CODE) t A ? ? }
INSTALLER NAME: ? lR?/'U ? ? - ??`1 L. PHONE #:
(AREA CODE)
STREET ADDRESS: ?
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Z
STAT'E: OVv ZIP: S `? 3-ja
Cr['Y: 4 f ' N cl -
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SIGNATURE OF PERMITTEE
Address 4 q 9 c x APF L La-KEG-t- Zip 5512 1
I*F 'A` 16 Blk i SUb CHERRYY700D KNOLL
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: ZtOq • D' Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Petmanent driveway
Permanent gas
Sod/Seeded grass
Trail/curb damage ?
Porch 7 1
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 po[ential exists.
Contac[ engineering division at 6814645 before working in right-of-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
Ad* Yess A e,a .cxntRPE 1.a1kE
4.'{?1.hs ? 16 Blk I.
THESE ITEMS WERE / WERE Nf
Zip 5512 i
Sub CHERRY4300D KidOLL
COMPLET'E AT TfE TIME OF THE FINAL INSPECTION.
Date: 12„ , . Q r Yes No Inspector: ?
Final ade•(6" from siding) ? ?
Permanent steps (gatage) . ?
Permanent steps (main entry) ?
Perntanent driveway
Permanent gas ?
Sod/Seeded grass
TraiUcurb damage ?
Porch ?
Basement 5nish ? ?
Deck
Pleue verify with t6e builder the removal of [oof test caps from the plumbing system and the shuboff of water supply to
the ou[side lawn faucet before freeze potential exisis.
ContaM engineering division at 681-4645 before working in rightof-way or insfalling underground sprinkler system. ?
. . . .. . White - City -CoPY Yellow - Residenl Copy .. ... Pink • Contractor Copy. .
. ? ? •
Site address: 7` / ( ( ii7?'? / ( ' Lot Z6 Block ? Su6d. -
On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air
tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that thefollowing information be
submitted prior to issuance of a Certificate of Occupancy.
- This structure: is constmcted to meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
_ This shucture: will be constructed to meet more restric6ve requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTINGTYPE
Water Heater ? ? ? 161
Fumace •
/L
? YYl 1? e?'
?
???
Dryer
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
Cf,M's VENTED
res No
Kitchen kitchen AIA
Bathroom 1
8athroom 2
Bathroom 3
BatBroom 4
Other
FIREPLACE S
LOCATION
GAS
WOOD
MANUFACTURER
MODEL
8TU'S VENTING
DIRECT ATMO&
deA, n-Gld L f3
?
MAKE•UP AIR MODEL TYPE CFM's
K II /2 J`"O ? i ,
I here6y acknowledge that the above informa6on is cortect and agree to wmply with the' Minnesota Energy Code and City of a an /V
requirements.
Sign ure Date
Rnderam ?n?rr?il i CompanyName
' This form is the responsibility of the General Contractor.
Reliabuilders
4,11'' City of Eatall RMp�` 10
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
952-226-5514 p.1
Use BLUE or BLACK Ink
For Office Use
Permit#: /I �Lp
Permit Fee:
Date Received:
Staff: ► / 1
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 5/1 5/ 13 Site Address: Li `1 1 C k v- e 1 C k unit #:
/
1 Phone:S t-?� Y-15 fid` I
Name: S-%Sor. L U✓rl✓\Sd„r t
Resident/
Owner
Type of Work
Address / City f Zip: 11 C1 �) C- 4r' e I c �-
Applicant is: Owner >( Contractor
Description of work i _ k o c�
Construction Cost:
Multi -Family Budding: (Yes ; No )
L
if the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
Contractor
Company: tr e .- e i o 'r f� a 1TI
Address: 7 �6U le F-1 r �5 I dct,/ City: t- t,ke.44 (le
A\ (
State: , Zip: ,S - O `( � Phone: (i g - (c) d 5- C
Contact: - C..5 o., Alk < G 1 e l s
License #: B L S/0 c Lead Certificate #:
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:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
Phone:
CALL BEFORE YOU DIG. Call Gopher State One Call at (6511454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.QootmerstateonecalLorq
I hereby acknowledge That this information is complete and accurate; that the work will be in conformance with the ordinanoes 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 MI 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 or permit issuance.
x kso, tit Ghe 1f x CIW &
Applicant's Printed Name Appli 'ant's Signature
Page 1of3