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4350 Bent Tree LaneCITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: PERMIT C `) ` --3 PERMIT TYPE: BUILDING Permit Number: 024197 Date Issued: 07/20/94 4350 BENT TREE LANE LOT: 1 BLOCK: 2 AUTUMN RIDGE 3RD P.I.N.: 10-12302-010-02 Ili DESCRIPTION: Building Permit Type DECK Building Work Type NEW REMARKS: FEE SUMMARY Base Fee $30.00 Surcharge .50 Total Fee $30.50 CONTRACTOR: OWNER: -- Applicant - SIMPLOT TIM 4350 BENT TREE LN EAGAN MN 55123 (612)686-4952 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Mn. Statutes and City of Eagan Ordinances. U APPLICAN /PER ITEE SIGNATURE SS ME: D Bvj SIG TURF Il SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site su-rveys., 1 copy of energy" caics. COMMERCIAL 2 sets of architectural 4 structural plans, 1 set of specifications, 1 copy of,energy caics. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. &ate Valuation of work Site Address: STR ET ' SUITE :Tenant Name: (commercial only) LOT BLOCK ' SURD. Ld" P.I.D. Description of work: The applicant is: ner ? Contractor ? Other (Describe). Name Phone iffl A 1A Property '7__j . LAST FIRST Owner tS!t Address STREET STE # City State z 4 25- r Company Phone Contractor Address License Ep. City State Zip Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber . Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes andCity of Eagan Ordinances. ,Signature of Applicant: V OFFICE USE ONL''. Ift BUILDING PERM TYPE' 0 01 Foundation ? 06 Duplex C3 11 Apt./Lodging 0 16 Basement Finish C 02, SF Dog. 0 07 4-Flex 0.12 Multi. Misc. 0 17 Swim Pool ;(3 03 SF Addition 0 ,08 8-Plex 013 Garage/Accessory Crl 1$ ca". /Ind. 0 04 SF Porch 13 09 12-Flex 0 14 fireplace 0 19 Comm./Ind. Misc. 0-05 SF Misc. 0 10 Multi. Addl. 10 15 Dock, 0 20 Public facility, C~! 21 Miscellaneous WORK " 31. New. 0 33, Alterations C3 35r Tenant Finish, 0 37 Derool i sh t3. 32 Addition 0 34 Repair, 00 36 M e GENERAL : R TION Const. (Actual) (Allowable) Basement sq4 ft 1 t Fl ft . : CC System W t Cit s . sq. . er a y UBC Occupancy 2nd Fl. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft.. Fire Sprinkler Length On-site-well Census Code Depth .On-site sewage ' .SAC Code APPROVALS Census, Bld Census Unit . Planning"` Building Assessments ' _ Engineering Variance REQUIRED INSPECTIONS 0 site Footing 0 Framing Q Insulation 0 Wallboard Final 0 Draintile, E3 Fireplace MFR 18 '94 13:17 TO 4560051 FROM PROBE ENGINEERING T-866 P.02 _{ CONSULTING ENd NEEflS `,- DONALD tlOllA a!/46 g jT AO BE PLANNERS and LAND UAVEYOAS r {f 6Z 33, 0 ENGINEERING 8K. 209 COMPANY INC. PC?. /9 1000 CAST 1461h STREET, BURNSVILLE, MINNESOTA 55337 PN 432-3000 CERTIFICATE OF SURVEY Legal Description: o LO p,4DD?T/ac/ z? cnu?v ,, ?v?sor C3a=) DENOTES EXISTING ELEVATION (938a ) DENOTES PROPOSED ELEVATION ...----- INDICATES DIRECTION OF SURFACE DRAINAGE 8.33 = FINISHED GARAGE FLOOR ELEVATION 9Z = BASEMENT FLOOR ELEVATION 938,(06 = TOP OF FOUNDATION ELEVATION SCALE : V- 30' 'ENQIMf/CK : 71Vf/ AT LorS / z, gar. Z E[.-1/. 93,7,4G 3O FT: FRONT BUILDING 5Ei Aek. LINE PR4N,ji^E ANO v77L/7Y E4SEMENT- 8E NT TREE I hereby certify that this is a true and correct representation of a tract of land as shown and described hereon. As prepared by me this /8 day of MARCU 1994 . Minn. Reg. No. 60 X935 0l ? Wertificate of cccuvanc4 Wit*j of Wagan ¶e4artment of 3nitbing an#4iection 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: SF 13 Bldg. Permit No. 23155 Occupancy Type R3/M I Zoning District R I Type Const. VP1 Owner of Building DONALD L .X SM S T19Caddress46PARK R MM DR, EALAN Building Address 4350 BENT TREE LANE Locality L i B2, ALTIIMI RflXm 3RD Date: /.` Building (Jificial POST IN A CONSPICUOUS PLACE Address 4350 Barr TREE LANE Zip 5512 3 Lot, 1 Blk 2 Sub AURM RIDGE 3RD THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: CP $? q Yes No Inspector: Final grade (6" from siding) Permanent steps (garage) Permanent steps (main entry) Permanent driveway Permanent gas Sod/Seeded grass Trail/curb damage Porch Basement finish Deck V/ 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 l 3 do 2 (? 90 ? Request Date >?"} ) ire Rough-In Inpsection Re 'red (You st call inspector when ready) Inspection Other Than ough-In 1:1 Ready Now Will Notify inspector Yes ? No Date Ready ,A licensed contractor 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. County Occup t (PRINT) K_ j Phone No. Power Supplier Address Electrical Contractor (Company Name) Contractor's License No. f^ , Mailing Address (Contractor or Owner Making Installation) Authored ;igw,tr iture (Contractor/Owner Maki InstallatOn) Phone Number MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. f I? REQUEST FOR ELECTRICAL INSPECTION ? See instructions for completing this form on back of yellow copy. N 0 9 9 G 1 "X" 8elow Work Covered by This Request es': EB-00001-08 ew Add Rep. Type of Building 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 w .e 0 to 100 Amps C t Transformers Above 200 Amps Above Amps Signs Inspector's Use Only: TOTAL Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED D1$ CONNECTED IF NOT Other Fee ' COMPLETED WITHIN 18 M S. ' I, the Electrical Inspector, hereby h tif Rough-in "),7? y t cer at the above inspection has been made, Final Date l1 OFFICE USE ONLY This request void 18 months from CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: DESCRIPTION: REMARKS: PERMIT PERMIT TYPE: Permit Number: Date Issued: 4350 BENT TREE LANE LOT: 1 BLOCK: 2 AUTUMN RIDGE 3RD Building Permit Type Building Work Type UBC Occupancy Construction Type Zoning Building Length Building Width Building stories PRV S & W PLBR - OLBERG FEE SUMMARY: Base Fee Plan Review Surcharge SAC SAC % SAC Units Subtotal VALUATION $793.50 $515.78 $72.00 $800.00 100 1 $2,181.28 SF DWG NEW R-3 M--1 V-N R-1 2 $144,000 56 36 8UILDIN 023155 03/28/94 MISCELLANEOUS Total Fee 1 828.50 $4,009.78 CONTRACTOR: - Applicant - ST. LIC. OWNER: JOHNSON HOMES INC, DONALD 14560034 0001603 DONALD L JOHNSON HOMES INC 4639 PARK RIDGE DR 4639 PARK RIDGE DR EAGAN MN 55123 EAGAN MN 55123 (612) 456-0034 (612)456-0034 I hereby acknowledge that I have read this application and tate that the information is correct and agree to comply with al_i applicable State of Mn. Statutes and City of Eagan Ordinances. L_ :'2 Ly APPLICANT/PERMITEE SIGNATURE ISSUED B SIG ATURE / o CITY OF EAGAN --------' -_ 1994 BUILDING PERMIT PP AT" C0h CE 681-4675 t4,? 1 1 94 2S Oq oab- 8 q, 0 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, I copy of energy calcs. COMMERCIAL 2 sets of architectural structural plans, I set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit G is issued. Date / / Valuation of work © . Site Address: 3 S? )68xt- STREET SUITE Tenant Name: (commercial only) LOT I. BLOCK JSUM). 1Pm.D. tlescri tion of work: ) L.c..L) e_rX<2 L?A The applicant is: 0 Owner Contractor 0 Other coeacr be3 Name Phone Property ,LAST T1RST Owner Address STREET $TS City State Zip Company Phone DV3 Contractor Address License X03 _ Exp. city State Zip Company Phone Architect) # Engineer Name Registration Address city State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once are as been approve . 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. Signature of Applicant: Perri Peer. arsc# $ Surcharge Ptsn Review Rs•t, ??- 3Z t, license P?WC SAC S k 13. ? . r 9?: 2z . S.r zz. 3 = 5n ?, 7s City- SAC Mater Conn. ©S Water Meter 2C ?? /fi Acct. Deposit t $f Permit S/W Surcharge T reatment PI. ' Unit Road ak7?? $3Z Park ?.----". 1 L13 3:s- 0 'Trails tedw Copies *51f L G2zbg other SAC % SAC Units 4 r MAR 23 '94 08:02 TO 612 681 4612 FROM PROBE ENSINEERING SPROGG `PL N SRS nd?LAAND s?Unv(YOns P NGINEERING COMPANY, INC. --a 1000 EAST 146th STREET, BURNSVILLE, MINNESOTA 56337 T-878 P.02 Doiv io j% AV X6233, 0 / BK. 209 Pp./8 PI1 432 - 3000 CERTIFICATE OF SURVEY Legal Description: Lo / A" 2. DENOTES EXISTING ELEVATION (938.0 ) DENOTES PROPOSED ELEVATION -• INDICATES DIRECTION OF SURFACE DRAINAGE 9• 33 = FINISHED GARAGE FLOOR ELEVATION 121, = BASEMENT FLOOR ELEVATION _9384 = TOP OF FOUNDATION ELEVATION SCALE : 1• - 30' Vc//MAQK . 7A-111 AT 40r-'5 /QLA^K Z BLEU = 939.4to APD/ es. : 43-So SEA-1T TREE LA,. E :935 J N89°o5 9. e 1 ?. 20 FT FRONT 8UWLD1N6 90o a SETBACIG LINE ---? ?R?y 6AR. FLR. (,2,34.70, - --?? $ ?G--- -- _ It SENT L.°89.77 ? i2n xz ?-- . Im X9=33 $ , 938. o X36 PORC14 GAPE 1 31,67 s.Co PROPoc?cD How IS HOUSE N .00 1 ? o \ ? (93?0? f\938.O? 0941A d4 a Aso UrlL/TY E4SEN1ENT- ??? ///// t/ / L -U--???". L / /O 140.8'3 72. /3 (937-4) a,zrs? 33, /7,0 /70 EAGAN Elk TN E V{1E. D DA12 3 l DEPT. I hereby certify that this is a true and correct representation of a tract of lan?c?, as shown and described hereon. As prepared by me this day of MAP.a/ , 19 94 fi5 3-Z2.-R4 : c,7y KEva Ia4 e ?'*l2iJ M1 l1ou4E /&Ak 6ePW465, Am AMr E% , 4P1 alate?rw,o Minn. Reg. No. 6/ 085 =?50 612 432 3723 03-23-94 07:59AM PO`0 LOT IIIRVZy CBZCZLIBT FOR RZSIDZNTZAL BIIILDXN PERMIT 1PPLICATZ PROPERTY LReaL = Date of •urv y: £ DOCIIMENT 6T1NDA?tnA -ir- g- D''0 D D Registered Land Surveyor signature and company 0 D Building Permit Applicant D Legal description Address Id' D m 0 D D North arrow and bar-scale House type (rambler, walkout, split W/o, split entry, D 0 lookout, etc.) D'D 0 Directional drainage arrows with slope/gradient %. D'D 0 Proposed/existing sever and water services Street name 0 Driveway ZLEVATTONB 0 P13 ZxiZtizq Sewer service Lot corners D? 0 0 Top of curb at the driveway D/0 0 Elevations of any existing adjacent homes D Pro Garage. floor DEG 0 D' First floor D 0 Lowest exposed elevation (walkout/window) B 0 0 0 0 Property corners F ront and rear of bon* at the foundation PONDING AREAS of aDwlicablel D 0' D Easement line 0 m' D 0 D D NWL HWL 0 D Pond $ designation D D Emergency Overflow Elevation 0 0 DIliENBIO! S Lot lines 0 0 Right-of-way and street width (to back of curb) 0 D Proposed home dimensions including any proposed -decks, overhangs greater than 2', porches, etc. (i.e. all "' structures requiring permanent footings) d M D Show all easements of record and any City utilities within 0 0 those easements b Set acks of proposed structure and setback of adjacent existing homes D 0 R t i i e a n ng w mental if any Reviewed: T 19V October 1992 -35 28.0 38.5 HYD 13'--6" 8"x6" GR. Ey INV-924.7 CS-935.2 f S-0+78 \ INV-925.3 CS-935.8 )IP CL 52 :E 000.00 8•-11 l p4 BEND S-0+77 INV-923.8 8"GV CS-934.3 8"x8"TEE-7 ,, 2 ( > 3 . oN S--0+72 w W INV-923.5 cs-93.0 Q w '•= \-B"-90* BEN 7 6 k ? + c" E C ;N Dc. ' THE ACCURACY OF UTILITY LOCATIONS AND/OR TREEELEVATIOi S, THIS D "JT IS FOR INFORMATION PURPOSES (O.LY AN Z PERSONS USING IT SHOULD F fi ?Y THE INFORMATION ON THE SITE . . . . . . . • . . . . . . . . 3 f . . . . . . • . . . . . . : • . 1 j - : : : i - ?* :Kl1K .'RE:939.7>Q..:`... i•..:. •.....•.....; • .................•...... N RIDGE, 3RD+ gpD't1C PRO,?EC? AUT Donald L. Johnson Homes, Inc. Endrgy Code Worksheet Simplot, Tim & Jill Address - 4350 Bent Tree Lane Contractor - Donald L. Johnson Homes, Inc. Lic #1603 4639 Park Ridge Drive Eagan, Minnesota 55123, Phone 456-0034 Building Classification: Type A (Single Family & Duplex) General Information: 1. Building Perimeter - See Worksheet 2. Wall Height - See Worksheet 3. Gross Wall Area 2256.82 4. Square Foot Roof Area 1182.00 5. Square Foot of Rim Joist 124.00 6. Doors - Area 34.20 U Factor 14 &.47 7. Total Door's Perimeter 8. Windows - See Worksheet Crestline Insulated Casements 9. Total Square Foot Glass 176.85 10. Fireplace Area -0- Clearance 11. Exposed Foundation .67* 161 83.08 12. Framing Area = 10% Of Gross Wall Area U Factor 13. Gross Wall Area 2256.82 Window Area 176.85 0.36 63.67 Rim Joist Area 124.00 0.04 5.08 Door Area 34.20 0.14 4.79 Other Door Area 0.00 0.47 0.00 Exposed Foundation 83.08 0.14 11.63 Framing Area 225.68 0.10 21.44 Net Wall Area 1613.01 0.04 69.36 175.97 14. Gross Wall Area 2256.82 0.11 248.25 15. Gross Ceiling Area 1182.00 Joist Area 118.20 Net Ceiling Area 1063.80 U Ceiling 1063.80 0.02 25.53 U Framing 118.20 0.02 2.72 28.25 16. Ceiling Area 1182.00 0.03 30.73 21-Mar-94 Page 1 Donald L. Johnson Homes, Inc. Energy Code Worksheet Simplot, Tim & Jill Address - 4350 Bent Tree Lane Contractor - Donald L. Johnson Homes, Inc. Lic #1603 4639 Park Ridge Drive Eagan, Minnesota 55123, Phone 456-0034 Worksheet 26+48*8.33 616.42 26+48+14+32*13.67 1640.40 2256.82 Roof 1182.00 Windows 2636 3*5.01 15.03 3 2040 2*2.18 4.36 2 2640 5*8.36 50.00 5 3040 1 *11.65 11.65 1 2050 10*3.37 33.70 10 1636 2* 1.83 3.66 2 2036 0*2.18 0.00 2650 7*8.35 58.45 7 176.85 30.00 Doors atrium 34.20 1 6'0 Patio 0.00 34.20 I hereb 'fy that I have completed the above information OMVT jene t co lies with the Minnesota State Energy Code. . J ohnson ate 21-Mar-94 Page 1 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. ---------------------------------------------------------------------------------------------------------------------------------------- NEW CONSTRUCTION ADD-ON A/C ADD-ON FURNACE FIREPLACE INSERT DATE ?-O ? HVAC: 0-100 M BTU ADDITIONAL 50 M BTU GAS OUTLETS (MINIMUM 1 @ $3.00 EACH) ADD-ON/REMODEL (EXISTING CONSTRUCTION) STATE SURCHARGE TOTAL SITE ADDRESS: OWNER INSTALLER: ADDRESS: (1 ? A rne,s q JAIL d- CITYYI? V i L I,? STATE: ZIP CODE?33 7 TELEPHONE FEES $ 24.00t,-" 6.00 3, O0 $ 20.00 .50 5D jl-r TELEPHONE #:b 1994 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 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 1%OFi 01.. CT FEE $ PROCESSED PIPING: $25.00 MINIMUM FEE: $25.00 STATE SURCHARGE $.50 FOR EACH $1,000 OF ?Rga FEE. TOTAL $ SITE ADDRESS: OWNER NAME: TELEPHONE #: TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE #: SIGNATURE OF PERMITTEE CITY INSPECTOR 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 . 0 0 ! WATER CLOSET 3.00 9 . b 0 BATH TUB 3.00 0 0 LAVATORY 3.00 1 z.. 00 KITCHEN SINK 3.00 3 . e o LAUNDRY TRAY 3.00 HOT TUB/SPA 3.00 WATER HEATER 3.00 a a FLOOR DRAIN 3.00 3 , oc> GAS PIPING OUTLET $ minimum - 1 3.00 3 . 0 0 ROUGH OPENINGS 1.50 c-f • D -4_ WATER SOFTENER 5.00 PRIVATE DISP. - Dak.Cty. lic. 20.00 U.G. SPRINKLER $ home under const. 3.00 ALTERATIONS • to existing 20.00 WATER TURN AROUND 20.00 STATE SURCHARGE TOTAL: .50 H-). oy SITE ADDRESS: Ll 3 !D OWNER NAME: INSTALLER: A- is - ?-\ S ADDRESS: CITY: S-? __ -- ---?" STATE: (A ZIP CODE: 4& PHONE #: (to rZ) `l Z - 31 30 SIGNATURE 1994 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 . _,.. 1994 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 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 lE'II`F FEE. ....................: MINIAIUM 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 *0011 S37 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 Now Construction Requirements • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) • 2 copies of plan showing been & window sizes; poured found design, etc.) • 1 set of Energy Calculations • 3 copies of Tree Preservation Plan if lot platted after 7iit93 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE ' U SITE ADDRESS TYPE OF WORI ULTI-FAMILY BLDG _ Y N FIREPLACE(S) - 0 _ 1 - 2 APPLICANT Cedar Valley F-xhdm. Inc. 20 Zilla Street CITY STATE ZIP STREET ADDRESS 99 Geen Rapids, MN 55a3 ?I ?OJ ?I55-53' 1O TELEPHONE 3CELL PHONE # FAX # PROPERTY OWNER. S? .S°ZSYI TELEPHONE #( rf)) - (A I -G 8) COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672 (d submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Plumbing system includes: Mechanical Contractor: Mechanical system includes Sewer/Water Contractor: Water Softener Water Heater No. of Baths Air Conditioning Heat Recovery System Phone # Lawn Sprinkler No. of R.I. Baths Phone # Phone # Fee: $90.00 Fee: $70.00 I hereby acknowledge that I have read this application, state tha t e informati is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eaga rdinances.( . . _ n Signature of Applicant OFFICE USE ONLY Certificates of Survey Received - Tree Preservation Plan Received - Not RemodellRenair Requirements • 2 copies of plan • 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks • Indicate if home served by septic system for additions VALUATION 0 ?002 4/02 OFFICE USE ONLY ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex O 07 05-plex ? 13 16-plex ? 08 06-plex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 08-plex ? 18 Deck ? 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 ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi ? 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 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 Other Roof - Ice & Water Final Pool _ Ftgs _ Air/Gas Tests -Final Framing - Siding Stucco _ Stone _ Fireplace _ R.I. -Air Test -Final Windows (new/replacement) Insulation Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total C / w L 7 S-_7 CD 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) 2 copies of plan showing beam & window sizes; poured found design, etc. 1 set of Energy Calculations 3 copies of Tree Preservation Plan if lot platted after 7/1/93 Rim Joist Detail Options selection sheet (buildings with 3 or less units) fif Al' ?"7 a4apj Remodel/Repair Requirements Office Use Only 2 copies of plan Cent of Survey Recd Y 1 set of Energy Calculations for heated additions Tree Pres Plan Recd - Y 1 site survey for additions & decks Tree Pres Required _ Y Addition - indicate if on-site septic system On-site Septic System -Y N N N N Date Construction Cost Site Address Lf 3 'O gQ ri € JAI Unit/Ste # Description of Work SCE-> 71 ,l?orG Multi-Family Bldg - Y N Fireplace(s) J 0 2 Property Owner Telephone #(Z,,5_1) 60/ 9M) Contractor -- /r7/ YG h'?? Address /QO ? vLoO« ?/ //1/LL?/ S _ S fi ?ctt city $ - ST A State h7 / J Zip ? SO 7 ' (6 j/) 5 S ?/ Jd ? ? Telephone # COMPLETE THIS AREA ONLY IF CONSTRUCT NEW ILDING Minnesota Rules 7670 Category 1 -.Y --_j f -.e innesota xutes Jo i/- Energy Code Category Residential Ventilation Category 1 Worksheet rgy Code Worksheet (4 submission type) Submitted Submit ed • 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 Mechanical Contractor Sewer/Water Contractor 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 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 w Sub Types OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 04 02-plex ? 10 08-plex ? 18 Deck 23 Porch (screen/gazebo) ? 05 03-plex ? 11 1 0-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or - N ? 25 Miscellaneous Work Types ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi Misc. ? 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 *Demolition (Entire Bldg) - Give PCA handout to applicant Valuation 0 4,7 V Census Code SAC Units # of Units # of Bldgs Type of Const Footings (new bldg) Footings (deck) Footings (addition) _ Foundation Drain Tile Roof _ Ice & Water _ Final Framing Fireplace _ R.I. - Air Test - Final Insulation Zoning Stories Sq. Ft. Length Width Occupancy W, 3 - Ulf, MCES System City Water Booster Pump PRV Fire Sprinklered REQUIRED INSPECTIONS Final/C.O. Final/No C.O. Plumbing HVAC Other Pool _ Ftgs _ Air/Gas Tests - Final Siding - Stucco - Stone - Brick Windows Retaining Wall Approved By: , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total 3o f L i . ?4o:8i 7Z. /3 (990,8') N8 /6 45" ki 7• pr L i 94 13:17 TO 4560951 A CONSULTING ENG NEERS his:, DO/I/ALO v'//4 ?! 'ROBE PLANNERS and LAND tURVEYORS _ 6233.0 ENGINEERING Ny BK. Zo9 COMPANY INC. PQ. iB 1000 EAST 146Ih STREET, BURNSVILLE, MINNESOTA 55337 PH 432-3000 CERTIFICATE OF SURVEY Legal Description: 074 a /We: 3RDi49/77a 1 DENOTES EXISTING ELEVATION ( 938.0) DENOTES PROPOSED ELEVATION ?..---- INDICATES DIRECTION OF SURFACE DRAINAGE 938.33 = FINISHED GARAGE FLOOR ELEVATION 929,66 = BASEMENT FLOOR ELEVATION 13606 = TOP OF FOUNDATION ELEVATION SCALE : t' - 30' 96t/Cf1M,q / : TN// AT L075 'Zit Z ELEt/•= 939,440 X935 oi' BENT o I 034,70`, N89°O5'w 9.99 L30 FT. FRONT BUILDING 6E n3ACk LINE ?35b? ?935,5? WIZ 2933 GARa6e-I 8.00 1 J TREE .4ME- g 36 ? R. B,o) 936.0 _ bRc}? X936. i 3l,6- ROM D %.j e44) 3 O l N 48.00 CAD \ A M U 33,2 J^V ; 4 A D.0WIl cE AND 5 / U7"/L/n' EASEMENT /O O I hereby certify that this is a true and correct representation of a tract of land as shown and described hereon. As prepared by me this day of MAWU Minn. Reg. No. I PE1c1dZN7R'EC0RD WYOF EACAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: 0 ' 4 t € 'I Eagan, Minnesota 55123 Date Issued: F (612) 681-4675 iim ADDRESS: APPLICANT: 435E fit.fdf ff,f,f= iAHf ## LOT ;# AUTUMN t x Lift t kf t; f. " } ': t3+ I' ,a PERMIT SUBTYPE: TYPE OF WORK: t?1 frft 1411 I o o T s t f' i NAI Pwni Wo. fit Hold!! Dole TOMOWA SW PLUMBM HVAC' E ACTM Owfoobaft Ode Foundation Fm*q Rod" Rough PPIbg- Rough Htg. M ul. Fireplace Rned Htg. Or" Test Feed Ptb . Plbg. Inspector - Notify Plumber Corot. meter EngrJP%n tom. Feral Dells Fig. „ ,G.4 ' 1 aV "' "- Deck FMS ?{.,. f ,+.? ` ?'" r •- WON fs'1 ?7l / ??r Pr. Dep. ¢ +Ddrr?V o- RA#41N1 ff€i} 4.1 N0 OD t IN P1.86 1( #1€i! N 141 INAI.° P1,06 U )NA fMIAf f >,,, PRV .14 P1 8 nt (U I . 'f a. ,. PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA131133 Date Issued:06/03/2015 Permit Category:ePermit Site Address: 4350 Bent Tree Lane Lot:1 Block: 2 Addition: Autumn Ridge 3rd PID:10-12302-02-010 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)$55.00 0801.4088 Surcharge-Fixed $5.00 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 - Norbert F Winter Iii 4350 Bent Tree Lane Eagan MN 55123 (651) 699-1818 Wenzel Heating & Air Conditioning 4145 Old Sibley Memorial Hwy Eagan MN 55122 (651) 894-9898 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA131140 Date Issued:06/03/2015 Permit Category:ePermit Site Address: 4350 Bent Tree Lane Lot:1 Block: 2 Addition: Autumn Ridge 3rd PID:10-12302-02-010 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Norbert F Winter Iii 4350 Bent Tree Lane Eagan MN 55123 (651) 336-8516 Wenzel Heating & Air Conditioning 4145 Old Sibley Memorial Hwy Eagan MN 55122 (651) 894-9898 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink For Office Use LO-(iTi City of Eaaall :::e: I V 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651)675-5675 Fax: (651)675-5694 Staff: -2017 RESIDENTIAL BUILDING PERMIT APPLICATION �'/ Date: �'(� 7-17 Site Address: 11550 13 �' -'`"/� Unit#: Name: AV, ,,�j 11 r Phone: Resident/ _ Owner ' Address/City/Zip: 11350 1 �r L , F / 5.5 ) 2.3 Applicant is: Owner )(Contractor Description of work: P,,r ot, P Type of Work Construction Cost: q.,042'7 Multi-Family Building:(Yes /No ) All � 1 Company: Al 5 C�s,St��c t ,i �t57 4 ,'c) Contact: r r . Contractor Address: 'ct l L.i�,icd/n �r City: z'6 State:/1/V Zip: 155/f3 6, Phone: 7(,3-67v 621rj Email: 7ar(Grye_'IIs/r7'`0t14,y C(. License#: &jCb 10 352- Lead Certificate#: a'VJ 7r-161 5s-- 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: 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. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 permit issuance. of x -4,()'\ 1 x Applicant's Princey61/2(k1 ame Applicant's Si re Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA153079 Date Issued:11/20/2018 Permit Category:ePermit Site Address: 4350 Bent Tree Lane Lot:1 Block: 2 Addition: Autumn Ridge 3rd PID:10-12302-02-010 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Norbert F Winter Iii 4350 Bent Tree Lane Eagan MN 55123 Allstar Construction Residential Llc 4934 Lincoln Dr Edina MN 55436 (952) 698-3200 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA161121 Date Issued:05/06/2020 Permit Category:ePermit Site Address: 4350 Bent Tree Lane Lot:1 Block: 2 Addition: Autumn Ridge 3rd PID:10-12302-02-010 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - Norbert F Winter Iii 4350 Bent Tree Lane Eagan MN 55123 (651) 289-7499 Homeworks Services Co Dba Homeworks Plumbing Htg 1230 Eagan Industrial Rd, Suite 117 Eagan MN 55121 (612) 400-9020 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA176668 Date Issued:05/25/2022 Permit Category:ePermit Site Address: 4350 Bent Tree Lane Lot:1 Block: 2 Addition: Autumn Ridge 3rd PID:10-12302-02-010 Use: Description: Sub Type:Fixtures Work Type:Replace Description:Kitchen Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. All tiled shower bases require a water test. Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087 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 - Norbert F Iii Winter 4350 Bent Tree Ln Eagan MN 55123 Spiess Plumbing Inc 493 Bear Avenue South Vadnais Heights MN 55127 (651) 248-3853 Applicant/Permitee: Signature Issued By: Signature