507 Chapel Ct1z+ ao bIbck I ..?- ?
Cher :y,??c ?( ICino1 I ES DENTIAL ???`l85'-{ I
BUILDING PERMIT APPLICATION MP yFsya
Irl ?7;1'_
'7d ,50 '
CITY OF EAGAN
rt, y85?13 90, so
3830 PILOT KNOB RD - 55122 p
651-681•4675 ?
New ConstrucGon Reauiremenb RemodellRauair Reauirements
• 3 registered site surveys showing sq. R. of lot, sq. R. of house; and all roofed areas 7p 0 • 2 coPies of plan
(20% manimum lot coverage allowed) . 1 set of Emyy Calculations for heated addilions ?,?j (SS
• 2 copies of plan showing beam & window s¢es; poured found design, etc.) 64;L 1 site survey for exterior additions & decks 1
• 1 set of Energy Calculations
• 3 cropies of Tree Preservalion Plan if lot platted after 711/93
• Rim Joisl Detail Optbns selection sheet (bidgs wilh 3 or less units)
DATE 11.1 a°I I o, VALUATION (EXCLUDING LAND)
JOB SITE ADDRESS SOT CX?a.?e_1 _?t?.
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER &ndersori Fa,nMLJR ttom,y,-c
TYPE OF WO
APPLICANT
tEPLACE(S) _0 11 _2 _3
PHONE#
ADDRESS I(o18 "11? I?J.J t?l F oc'r'rl-?- b T F21o , ( 4.1GE, ZIPCODE 653?0
PAGER #
CELLPHONE# f la•1?,(p9 -13a--4 FAX#
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category ? MINNESOTA RLTLES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNFSOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor: learW0t.r F?U,mlo Phone #: ?15a-y?T- a?l3b
Plumbing System Includes: Water Soften r Lawn Sprinkler Fee: $90.00
1 Water Hcater L No. oC R.I. Baths
a No. of Badis
MechanicalContractor: Nlo-ro ?r Phone# a5a-Ny?-Bta?l
Mcchanical System Includes: Air Conditioning Fee: $70.00
Heat Recovcry System
Sewer/WaterContractor. Cl?nr-L,:?r.Ac.r i' UmbA rtQ. Phone# ?f??-LI?I-1-6Q3D
All above information must be submitted prior to processing of application. ? C?? a-Qcf?
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply wi{hl
all applicable State of Minnesota Statutes and City of Eagan Ordinances. r_> /--\ '
Signature of Applicant
Certificates of Survey Received Tree Preservation Plan Received Not Required _
7 P?.Q? (?Q??2 1L Updated 1/01
?ln-I ?t' ?
.L?
OFFICE USE ONLY
? 01 Foundation
X 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 OS-plex ? 18 Oeck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or_ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn.(4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
r
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 E>ct. Alt - SF
? 36 Multi
X 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 B idg only) - Give PCA handout to applicant
r..? Qu
Valuation / I? "
Occupancy n
/C ? ?- ,?/-./ MC/ES System
Census Code Zoning City Water
SAC Units O ? Stories Booster Pump
Nbr. of Units I Sq. Ft. `1- PRV
Nbr. of Bldgs ? Length SO ! d?? Fire Sprinklered
Type of Const V-N W idth 70 ?-O
x F REQUIRED INSPECTIONS
ootings (new bldg) ? C.O.
FinaU
_ Footings(deck) FinaUNo C.O.
Footings (addition) Plumbing
X Founda[ion HVAC
Drain Tile _
Roof X Ice & Water ? Final _ Offier
Framing
X Pool Ftgs Air/Gas Tests Final
Fireplace X R.I. X Au Tes[ 2( Final _ Siding Stucco Stone
Z( Insulation _ Windows (new/replacement)
Approved By
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
L.L.
1s) 2
IST f c-c-c./L
1 S 124X
sT&O P
380 x
3a = =
`Z N 17 r"t-C,G/L
6- /+ 21a-?
7 L6 ?7f X 16
Building Inspector
? I Yd
f /616
l?(? Z?
RESIDENTIAL
` BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
New Construction Reauirements
• 3 registered sile surveys showing sq. N. of IoL sq. ft. of house; and ?il roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing 6eam & window sues; poured found design, etc.)
• 7 set of Enerqy Calculatbns
• 3 copies of Tree Preservation Plan if lot platted after 711l93
. Rim Joist Delail OpGons seledion sheet (bidgs with 3 or less unils)
DATE
SITE ADD
TYPE OF
,ULTI-FAMILY BLDG _Y ?
FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT__QNSK,S IlP[ LC,
STREETADDRESS ?IIS ?kfh,??Pw) Rkid• CITY . - c,wl STATEA - ZIP U7
TELEPHONE # AQ - yS - W06 CELL PHONE # 6Sl' - IL17cf FAX # - yS3-6961
PROPERTY OWNER P?. I n? ?G ?u nac4 TELEPHONE #/aSI -'y=- 9723?
COMPLETE FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNE50TA RiJLLS 7670 CA'PEGORY 1 MINNCSO"1'A ItULES 7672
(J suhmission type) . Residential Ventilation Category t Worksheet Submitted • New Energy Code Worksheet SubmiUed
• Energy Envelope Calculations Su6mitted
Plumbing Conhactor:
PlutnUing system includcs:
Mechanical Contractor:
Mechuiical syslem includcs:
Sewer/Water Contractor:
_ Air Conditioning
_ HeaC Rccovcry Systcm
Phone #
Phone #
Fee: $90.00
Tee: $70.00
4}?? ?
I hereby acknowledge that I have read this application, state that the information is correct; a?cug
with all opplicable State of Minnesota Statutes and City of Eagan Ordin ?
Slgnature of Applicant ?
----------------° "°----°------------------°--°-°--'--- ---------°---°°'------------__.....
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Wa[er Softener
Water Heater
No. of Badis
-'S N-?b.c)b
RemodellReoair Reouirements
• 2 copies of plan
• 1 set af Energy CaICWaUons for heated additions
. 1 site survey for extenor additions & decks
• Indicate if home served by septic system for additions
VALUATION tS5? ?
Phone #
Lawn Sprinkler
No. of R.I. Baths
,o)
?'I ?f
`,
Updated 4/02
****
tificate of Survey for:
LOT AREA = 28,116 sq. ft.
HOUSE AREA = 2,200 sq, ft.
SERVICE INV.=857.1
9? 21
(x $ ?o) ,
C? 840)
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LOWEST FLOOR ELEVATION:
TOP OF BLOCK EIEVATION:
GARAGE SLAB ELEVATION:
TOB 0 LOOKOUT ELEVATI01
% 000.00 DENOTES E%ISTING ELEVAIION
( 000.00 ) DENOTES PROPOSEO ElEVA710N
DENOTES ORAINACE AND UiILITY EASEMENi
- DENOTES ORAINAGE ROW OIRECIION
• DENOTES AIONUMENT
-9- DENOTES OFFSEi HUB
3 ?
? I
B??ENppi MpM?pgN 862.(
ELEV B57.19.
NOTE: PROPOSEO GRAOES SMONN PEft GRADING PLAN 8Y: METRO HUU?)t
NOIE: BUIl01NG DIA/ENSIONS SHOWN ARE FOR MORIZONTAL ANU VERTICAL IOCAT10N
OF SiRUCTURES ONLY. SEE ARCMITECiUAL PLANS FOR BUILUING ANO
FOUNDATION OUAENSIONS.
NOTE: NO SPECIFlC SOILS INYES11GA110N HAS BEEN COMPLEIED ON 7HI5 l0! BY TH as7.{
SURVEYOR. 111E SUITABILITY OF SOILS TO SUPPORT THE SPEdflC MOUSE
PROPOSED IS NOT ME RESPON5181LITY OF ME SVRVEYOR.
NOIE: TNIS CERTflCAiE OOES NOT PIIRPORi i0 SMOW EASEMENTS OTHER THAN (fm-6
THOSE SHOWN ON 1HE RECOP.DEO P!AT. _ 85E
NOIE: CON7RACTOR MUSi WRIFY ORIVEWAV OESIGN,
NOTE: 9EARINGS SHaNTI ARE BASED ON AN ASSUMED OATUM
WE HEREBY CERTIFY TO ANDERSON FAMILY HOMES, INC.
THIS IS A TRUE AND CORRECT REPRESENTATION OF A
SURVEY OF THE BOUNDARIES OF:
LOT 20, BLOCK 1, CHERRYWOOD
DAKOTA COUNTY, MINNESOTA
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7P WAY 5•00 ?`B7?ENpOI MN
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IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR
UNDER MY DIRECT SUPERVISION THIS 26TH DAY OF NOVEMBER, 2007.
'R6VtS EO: (2I2'1Iol SIG D: PIONE ENGIN ERIN , P.A
SCALE : 1 INCH = 40 FEET a??°`? RAS' S?+•?'°'ck5
f Q??'4?nt..c Wa?? BY: JlA `
1-61 100247.02 NJL Pef 0,4?( ???'? •?R'>-'. ??,?p( Dan . Westergren Reg. No. 19790
• 2422 Enterprisc Drive
Mendota Heights, MN 55120
amw?s 1(651) 681-1914 FAX:681-9488
)scuf rnuahcrs 1625 Highway 10 N.E.
Bloine, MN 55474
(612) 783-1880 FAX:783-1883
ANDERSON FAMILY HOMES, INC.
507 CHAPEL COURT EAGAN, MINNESOTA
(Bn• 4'p2aw
Al
1
20
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TO:
FROM:
DATE:
SUBJECT:
MEMO
city of eagan
SUE SHERIDAN, ACCOUNTANT I
DALE SCHOEPPNER, CHIEF BUILDING OFFICIAL
JLTLY 25, 2002
ESCROW TO BE REFUNDED
Please refund the $2,000 escrow (CR #25800 dated 4/29/02) to Anderson Family Homes for 507
Chapel Coitft. The retaining wall has been completed and verified on July 23, 2002.
If you have any questions, please give me a call. Thanks.
ChiefBuilding Official
DS/j s
Siteaddress: "JU u? f L6-.,,14- Lot 1?, Block ? Subd. C.Au+-a (.ja-,' A;-?•
On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air
tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be
submitted prior to issuance of a Certificate of Occupancy.
This sVucture: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
_ This sWcture: will be cons±nucted to meet more restrictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTINGTYPE
Water Heater C, e, 00 q ? C 4-??
Furnace 58 mx -!Zx) lZaoW tJC..
Dryer l? L(O. -? Z-) 'LZ-G0( ZLaJ
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
YeS No
Kitchen kitchen
Bathroom 1
Bathroom 2 (00
Bathroom 3
Bathroom 4
Other
FIREPLACE S
LOCATION
GAS
WOOD
MANUFACTURER
MODEL
8TU'S VENTING
DIRECT A7M05
( EC- Gw -sG -750 - ?
MAKE•UP AIR MODEL TYPE CFM's
14 zv Ge-L *u. d Z.so ff rw. I (- u
I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan
requirements. 6?- AA--r z.3 7? z
Sign re Date ?
Company Name
` This fortn is the responsibility of the General Contractor.
:
MNcheck COMPLIANCE REPORT
Minnesota Energy Code
MNCheck Software Version 3.0
Permit #
Checked by/Date
COUNTY: Dakota
STATE: Minnesota
ZONE: 2
CONSTROCTION TYPE: Single Family
DATE: 11-28-2001
DATE OF PLANS: 11/28/01
TITLE: Ralph & Janel Lavansky
PROJECT ZNFOR`^ATION:
507 Chapel Lane
Eagen MN 55057
COMPANY INFORMATION:
Anderson Family Homes
16186 Main Avenue South East
Prior Lake MN 55372
COMPLIANCE: PASSES
Required UA = 593
Your Home = 923
28.7$ Better Than Code
Area or Cavity Cont. Glazing/DOOr
Perimeter
-------------------------
-- R-Valu e R-Value U-Va1ue UA
-
--- -------
CEILINGS: Raised Truss 1376 --------
38.0 ----------
0.0 ------------ -----
34
WALLS: Wood Frame, 16" O.C. 3188 19.0 2.0 179
BSMT: Conc. 9.0' ht/9.0' bg/9.0' insul 729 10.0 0.0 90
SSMT: Conc. 4.0' ht/4.0' bg/4.0' insul 172 10.0 0.0 12
GLAZING: Windows or poors, Above Grade 369 0.350 129
DOORS 84 0.350 29
FLOORS: Over Uaconditioned Space 14 30.0 0.0 0
FLOORS: Over Outside Air 15 30.0 0.0 0
HVAC EQUIPMENT: Furnace, 92.0 AFOE
--------------
COMPLIANCE STATEMENT: The nroposed building --------
design ----------
described --- --
here is ----
consistent with the building plans, specific ations, and other calculations
submitted with the permit application. The proposed building has been
designed to meet the requirements of the Min r.esota Energy Code.
Builder/Designer '7(??& (_Ol?!// _ Date // O
LOT SURVEY CHECKIIST FOR RESIDENTIAL
• BUILDING PERMR APPLICATION
PROPERTY LEGAL: L- of -2D G K I i.,,.,.%
DATE OF SURVEY: //' :Z.!-o/
i
LATEST REVISION: /-2. - 27' d i
m
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v DOCUMENTSTANDARDS
v
O 'z 'a
Fd"/ ?? • Registered Land Surveyor sgnature and wmpany
? o • Building PermitApplicant
? ? • Legal description
Fe/ ? ? • Address
p/ ?
V ? ?
? • North arrow and scale
H
bl
t
li
/
i
k
• ouse type (ram
er, walkou
, sp
t w
o, spl
t entry, bo
out, etc.)
04"11 ? • Directional drainage arrows witli sbpe/grddient %
Ci/ ? ? • Proposedlepsting sewer and water services 8 invert elevation
fY ? ? • Street name
[q/ ? ? • Driveway
e/ ? ? . Lot Square Footage
C7l? ? ? • l.ot Coverage
LY ? ? • Benchmark
ELEVATIONS
Existin
d ? ? • Sewer service (or Proposed)
GI/a ? • Property comers
[,y ?? • Top of curb at the driveway and property fine extensions
[VO ? • Elevations of any existing adjacent homes
? q/?? • Adequate footing depth of structures due to adjacent utility trenches
? d ? • Watervvays (pond, stream, etc.)
Prooosed
Fa/? ? • Garage floor
Gd? ? ? • First ibor
q? ? D • Lowest exposed elevatron (walkout/window)
4-/ ? ? • Property comers
yy 0? • Front and rear of home at the foundatlon
PONDING AREA fif aoolicablel
? ?
C( • Easement line
? /
R ? • NWL
? G? ? • HWL
? d ? • Pond # designation
? g/? • Emergency Overibw Elevation
DIMENSIONS
Pr ?? • Lot IineslBearings 8 dimensions
¢, ?? • Rightof-way and sVeet width (to back of curb)
[a? ?? • Proposed home dimensions including any proposed decks, ovefiangs greaterthan 2', porches, etc.
/ (i.e. all sWctures requiring pertnanent fiotings)
d 00 • Show all easements of record and any City util8ies within those easements
? • Setbacks of proposed sWcture and sideyard setback of adjacent existing structures
L9 ? 0 • Retaining wall requirements, if any
Reviewed:
?. .__....._._.?__?.._.....__,
,
4t
WIONEER
* BHg 1'f68P
?[ * * *
Certificate of Survey for:
. ?
?-
_. _. ?A . ?..
LOT AREA = 28,116 sq, ft.
HOUSE AREA = 2,200 sq. ft.
SERVICE INV.=857.1
2422 Enterprise Orive
Mendota Heights, MN 55120
(651) 681-1914 FAX:681-9488
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OP SED OU E V ON 3
LOWEST FLOOR ELEVATION: '?'O ?
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TOP OF BLOCK ELEVATION:
• j?
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GARAGE SLAB ELEVATION: Oo
TOB @ LOOKOUT ELEVATION: g?2?Z 0`
2a
X 000.00 DENOTES Ex15TING ELEVAiION b_ ?
( 000.00 ) DENOTES PROPOSEO ELEVATON
--- DENOTES DRAINAGE AND UTILITY EASEMENT BENa1 NMIt gby,(
' DENOTES DRAINAGE FIOW DIRECiION
• DENOTES MONUMENT ?
-9- DENOlES OFFSET HUB
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NOTE: PROPOSED GftA0E5 SHOWN PER CRADING PLAN BY: ME7R0 HOUSE ; 8 (??
NOiE: BUILOING OIMENSIONS SMOWN ARE FOR HORIZONTAL AND VERTICAL LOCATION
? 0
OF S7RUCTURES ONLY. SEE ARCHITECIUAL PLANS FOR BUILDING ANO I
Q
FOUNOATION UIMENSIONS.
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NOTE: NO SPECIFlC SOILS INVESTIGA710N HAS BEEN COMPLEIED ON THIS LOT 6Y iHE e57,4. a5a" .ag
SURVEYOR. TME SUILABIIJTY OF SOILS TO SUPPORT THE SPECIFIC HOUSE
PROPOSED IS NOT 1HE RESPONSIBILITY OF i}iE SURVEYOR.
/
NOTE: THIS CERTIFlCAIE DOES NOT PURPORT TO SHOW EASEMENT$ OTHER THAN (?7) o
mose sr.oaw oN me Rece.=,oeo P! P.7. 858.
NOIE: CONTRACTOR MUSi VERIFY DRIVEWAV DESIGN.
NOIE: BEARINGS SHONN ARE BASED ON AN ASSUMED DAiUM 1. r ? °J1'' 860.3 _t
WE HEREBY CERTIFY TO ANDERSON FAMILY HOMES, INC. THAT_ /? '
THIS IS A TRUE AND CORRECT REPRESENTATION OF A CHAP??3}?OURT
SURVEY 4F THE BOUNDARIES OF: ?
LOT 20, BLOCK 1, CHERRYWaOD KNOLLN89'52104"E
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OAKOTA COUNTY, MINNESOTA
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMEN7S, EXCEPT AS SHOWN, AS SURVEYED BY ME OR
UNDER MY DIRECT SUPERVISION THIS 26TH DAY OF NOVEMBER, 2001.
lzEV G-o: IZI2?Io? SI ;jPIAO'NtESCALE : 1 INCH = 40 FEET ?? l..fa?? B) 100247.02 NJl Per C'4`r "?''?' PR"`' I?2,'?eergren Reg. No. 19790
Ho s?s . nHL cnpratns
?ms. iurosc? M+X hcn
625 Highway 10 N.E.
Blaine, MN 55434
(612) 783-1880 FAX:783-1883
?4NDERSON FAMILY HOMES, INC.
507 CHAPEL COURT EAGAN, MINNESOTA
?- N70.
« n 34,o2yW
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Address 50r/ ChGlpe I Ci_ Zip 5512 ?
iAc C2 C) Bik ? sUb CHerrvwooti Kn011
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPEGTION.
Date: Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
TraiUcurb damage
Porch
Basement finish
Deck
Please verify wilh the builder the rcmoval of roof 4est caps from the plumbing system end the shut-off of water supply lo
t6e outside lawn faucet before freeze potential exists.
Contaci engineering division at 681-4645 before working in righ[-of•way o[ installing underground sprinkler system. ?
White - Ciry Copy Yellow - Resident Capy Pink - Contrector Copy
'Pormi1?
'JObMEIbs .7G'7 Cy/r01tT' f
•Heefirg f,.? METRO AIR
•Testen/SynaWre /` ?-'? ??
Pourtls
- Date T_me Vree _sme
•ce urb
Prevu.izey
InspecleA
PERFORMANCETEST
'PercenlC 3 / ?% G "
?4 'Percent CO _ L> yG
'Percem OZ •Stach Temp. ?•?
Finallnspactpn Da1e
-1N5-7c)
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Ot Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694 <are qI ?. .
`??
•-_?
New Conslmdion Reauirements RemodeUReoair Reauiremenis Office#15s'Oniv
3 registered site surveys showing sq. N. of lot, sq. fl. of house; and all roofed areas 2 copies of plan Ciik of SurveY Recd ?_ Y_N
(20%maximum lot coverege allowed) 1 set of Energy Calculations for healed additbns TteeAreg Pten ftectl '_Y _N.
2 copies of plan showing beam 8 window sizes; poured found design, etc. 1 site survep for additions & decks Tree PresRepUrcCd 'Y N
iselofEnergyCalculations Addition - iMicateifon-sitesepticsystem OrtsiteSgpticSyslem Y _,;N
3 copies o( Tree Preservation Plan if lot platled affer 711193
Rim Joist Detail Options selection sheet (buildings with 3or less units)
Date Q9 / 0 n / 6-5'
Site Address c?? ? CHfiP S-C Construction Cost? ?? v
. C004-T Unit/Ste #
Z
Descriptionof Work ?,/J/,Cl Pf loP/e-f
Multi-Family Bldg _ Y?,/ N Fireplace(s) _ 0X 1 _ 2
Property Owner kAhP?j u -, Ti4A/`"GC? ?,JjZ&I SKY Telephone # ( i6SI ) LfJS- 3 77S
Contractor S e t ?
Address Sh7 Ch a?Ie (
Stxte (\N.ti) /
?A o-?!'`f CiTy T' ,4rs n
Zip 5-41LI Telephane #(U51)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Mimiesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissionfype) SubmiNed Submitted
• Energy Envelope Calculations Submitted
In ihe last 12 monihs, has the City of Eagan issued a permit for a similar plan based on a master planZ
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Conhactor
Telephone #(
Telephone # (
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in wnformance 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 pernut, 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.
? lo? La?u nr ?? '.%fl,v'?C- Lr?v?4n;'SKY
Applicant's Printed Name
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi
? 03 01of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 Ext.Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex `$[ 19 Lower Levei ? 24 Storm Damage
? 06 04-plex ? 12 12-plex PI6g_Yor_ 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
? 33 Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolkion (Entire Bldg) -Give PCA handout to applicant
p
Valuation cgc v Occupancy MCES System
Plan Review 100% or 25%
Census Code
SAC Units
# of Units
# of Bldgs
Type of Const ?
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
_ Foundation
Drain Tile
Roof Ice & Water Final
Framing -
_ Fireplace _ R.I. _ AirTes[ _ Final
•[ Insulation
T
REQUIRED INSPECTIONS
Final/C.O.
Z?< FinallNo C.O.
Plumbing
?r HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tes[s Final
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wall
Approved By: Building Inspector
Base Fee
Surcharge
Plan Review
MClES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
???"
? 2 ?`11
2006 RESIDENTIAL PLUMBING PERnniTaPPLicaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dweliings.
IT 5-6, 50
Date t 13 1 d ?
Site Street Address _5-0? 'Q U! C?6z a n 6YJ 5-17 L- Unit #
Property Owner fCI'0-164- V- VftA)f[_ ?. 4f/jR'lU SK_ Telephone #((?pSl )iM--3 77ef
Contractor Telephone # ( )
Address City State Zip
The Applicant is: ?,AOwner _ Contractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Alteretions to existing dwelling $ 50.00
? Add plumbing fixtures. This fee includes installation of a wa ter softener and/or water
heater at the same time. !f you are installing on7 a water sokener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
?
_ Water Tumaround (add $130.00 if a 5/8" meter is required) I
other: .?Sentie? II N FFD p 3 2000 ? ? I
Water Softener Water Heater ?By = $ 15.00
_ new _ replacement
Lawn irrigation _RPZ _PVB _new _ repair _rebuild $ 30.00
State Surcharge $ SD
Total $ 50.50
I 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 req to be reviewed and approved.
?I?1rirEc? LA't/?-A15Y?Y 7 ApplicanPs Printed Name App' anPs Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA142521
Date Issued:05/08/2017
Permit Category:ePermit
Site Address: 507 Chapel Ct
Lot:20 Block: 1 Addition: Cherrywood Knoll
PID:10-17050-01-200
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
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 -
Ralph P Lavansky
507 Chapel Ct
Eagan MN 55122
(952) 894-0005 X5151
Burnsville Heating & Air Conditioning
3451 West Burnsville Parkway, Ste. 120
Burnsville MN 55337
(952) 894-0005
Applicant/Permitee: Signature Issued By: Signature