4016 Cedar Grove LaneCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4016 Cedar Grove Lane
Lot: 1 Block: 03 Addition: Nicols Ridge 2nd
PID:10- 50901- 010 -03
Use:
Description:
Sub Type:
Work Type:
Description:
Meter Size Meter Type
Comments:
Fee Summary:
Valuation: 100.00
Contractor:
Bob Sable Services
5242 Quebec Ave N
New Hope MN 55428
(612) 534 -6526
e - Water Softener
New
Water Softener
Bob Sable
5242Quebec Ave N.
New Hope, Mn 55428
PL - Permit Fee (WS & /or WH)
Surcharge -Fixed
Total:
Manufacturer
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Serial Number Remote Number
Owner:
Cheri Long
4016 Cedar Grove Lane
Eagan MN 55122
$50.00 0801.4087
$0.50 9001.2195
$50.50
Issued By: Signature
Plumbing
EA083314
06/02/2008
ePermit
Line Size
3n" 94? J?.? N P-,:?3552- #y,gsr.qY
a006 RESIDENTIALBUILDINGs MP :73 sSW 4-0.56
City Of Eagan 012 .9y
3830 Pilot Knob Road, Eagan MN 55122 .Gnl
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCfion Reauiremenis
3 registered sde surveys showing sq. ft of IoL sq, ft of house; and all roofed arees
(20% maximum lot coverage allowed)
2 copies of plan showing beam & window sizes; poured fouM design, etc.
1 set of Energy Calculations
3 copies of Tree PreservaYion Plan rf bt platted after 717193
Rim Joisl Defail Options selection sheet (buildings wAh 3 or less units)
Minnegasco mechanical ventilation form
RemodeVReoair Reauirements
2 copies of plan showirg footings, heams, joists
1 set ot Enegy CalculaUons tor heated additions
1 sile survey for addi6ons 8 decks
Addfiion • indicate 8onsite sepNc system
q-3 S S S fx * 1089 q5
t7fi,,,,;l7sebo .,,'`?,3r„:':.?u,?
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Tffe?.reSN
?4? ;qr ;Fi-s
MAY 6 2006
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Site Address o I n
t te
M?. i le' 9.e.1
Description of Work / ve- tj ?? ?S??u Lf`??s"\
Multi-Family Bldg /Y Y_ N Fireplace(s) _ 0 ? 1E' 2
PropertyOwner +^Lr'Ivla? Cd,-N Telephone#((?/ ) 2 99 - 3 '113
Contractor Sq l""t ?
I
Address <3- '7 y i e v? tvi6U'i Cl E95"+"
City
" A.l? C
State rA /V Zip :553ctf Telephoce#(bs'/) Z ?-.3 ar-/.7
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
submissiontype) Submitted Submitted
. Energy Envelope Calculations Submitted
In the lasi 12 months, has ihe City of Eagan issued a permit for a similar plan based on a masterp lan? 3,p?
? Y _ N If yes, date and address of master plan: d? JOa C`eC?az? ?s a,? ? 1'?? ?
Licensed Plumber ?12
Mechanical Contractor vi Z- P`
Sewer/Water Contractor !t'f Ku s1 5 e
hereby apply for a Residen6al Building Pernut
Telephone # ( 9S2) 76 ? ? (000
Telephone #(qs,?-) U7 _/40 p
[? fC?lephone #((,5/) z??-' - 03 ? (
II11
a'r 1 6 d"6 v
aclaiow e ge 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 wark which requires a review and
approval of plans. MAY 16 2006
ApplicanYs Printed Name A 'cant's Signature
DO NOT WRITE BELOW THIS LINE
Sub Tvpes
? 01 Foundation ? 07 05-plex ? 73 16-plex ? 20 Pool ? 30 Accessory Bldg
V60 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
V 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 6ct. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screeNg azebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10.plex ? 19 Lower Level ? 24 Storm Damage
? 06 04plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
Od' 31 New O 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demoiish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement `Demolitlon (EMire Bldg) - Give PCA handout to applicant
Description: Water Damage _ Yes
Valuation 99,6g3 Occupancy l23, U MCES System ?4 c 5
Plan Review 100% or ?25%
Census Code _! 01? Zoning p D City Water eS
5AC Units I Stories ;21 Booster Pump -
# of Units / Sq. Ft. 95? PRV " i e5
# of Bldgs / Length 3;97 Fire Sprinklered ?7 0
Type of Const Width v .6
? REQUIRED INSPECTIONS
Footings (new bldg) Sheetrock
_ Footings(deck) FinaUC.O.
Footings (addition) FinaUNo C.O.
? Foundation HVAC
Drain Tile
/ Roof _kl Ice & Water
? / Other
Final _ Pool Ftgs Air/Gas Tests Final
Framing Siding _ Stucco Lath Stone Lath Brick
,Z Fueplace ? R.I. ?Air Test ? Final Windows
? Insulation Retaining Wall
Approved By: lhke L. , Buiiding 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
La?? L-evel T-,,,?;5tied
h n un?;'nesk?q
MA-?rJFlaoY ?in?Sl.er?
u? [evei
G-w?9 e-
tJecL
aas
640
a?, ?9a
aar?o-
$ qq, (aa3
kck.,;, ley At6d,,?
IBMCAaCk C01IPLIAMCE REPOAT
Minnesota Energy toee
NNMeek SefTrrare Yersion 3.0
COUNTY: Nepnepin
S"!'pTE; Mfnnesota
ZONE: 2
CpiSTHUCTION T'PE: Single FanilY
WITE: 6•74.2p6S
DATE OF PLANS: 9-8-04
PR0.IECT INFORMATYUH:
Su4ris Collection
Nicols Rfdge
Eapan
CONPNiY IlIFOMUITION:
{.ennar Corp.
iWTES:
? McKinley un3.t (4S")
CONPLIANCE: PRSSES
Hequirea UH = 604
Your None = 400
93.8*4 Beccer Than CoOe
I (
i I
? Permit N ?
I I
? Checked by/Uate ?
prea or CaviLy Corrt. WaYing/OOar
Perfaieiar q•value R•Valua U-Yalue Ua
----------------------------- ..-------'----'--•--......
CEILINGS 962 98.0 0.0 ,.---
29
AuLLS: Wood Frame, tH' O.C. 3252 19.0 2.0 182
GLAZING: W7lndoKS Or poors, Abova Graqe 258 0.350 90
OOORS 42 0.330 15
FLOORS: Over Uneondfsi.ened 3paee 414 30.0 0.0 14
StAN FLOORS: YnNeated, 72_0• inaui. 116 70.0 70
HVAC EQUIPMENT: furnacE, 9C.0 AFUE
'---------
----------••_'---'---`--•---....-'-------------.-....._.__...---
COtB+LIANGE STATEMEN7: 7ne proposmd Duildlnp desiyn qeseribed here is ----
eonsiscent w1iA tha puildinq p7.ans, spaoifications, and other, caleulatians
su6sitted wieA the peno;t applfeation. The proposed buildinp has been
desioned to aect the requirenents of the Minnesota Enerpy Code_
Builder/Designer_ Dats
.
? LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTY LEGAL: ?s I? 3? 4 NoCk 3, IV j?-'nIS Ri ,?
DATE OF SURVEY:
LATEST REVISION:
d
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a
DOCUMENT STANDARDS
'x ? ? . Registered Land Surveyor signature and company
-
,2' ? ? • Building Permit Applicant
.? 0 ? • Legal description
?r - ? ? . Address
'0 ? p • NoAh arrow and scale
_,jel ? ? • House type (rambler, walkout, split wlo, split entry, lookout, etc.)
e ? ? • Directional drainage arrows with slope/gradient %
1-21 ? ? • Proposed/existing sewer and water services & inveR elevation
,g- ? ? • Street name
'g' ? ? . Driveway (grade & width - in R!W and back of curb, 22' max.)
? ifJ ? • Lot Square Footage
? ,B' ? • Lot Coverege
hd
ELEVATIONS
Existinq
? ? • Property comers
„H' ? ? • Top of curb at the driveway and property line extensions
p' ? ? • Elevations of any existing adjacent homes
.a' ? 0 • Adequate footing depth of strudures due to adjacent utility trenches
Jd' 0 0 • Waterways (pond, stream, etc.)
Prooosed
? ? • Garage floor
,0' ? 0 • Basement floor
? ? • Lowest exposed elevation (walkouUwindow)
? ,0' ? . Property comers
'z ? ? • Front and rear of home at the foundation
PONDING AREA (if applicable)
? ? • Easement line
? ? ? . NWL
? f} ? • HWL
? ? ? • Pond # designation
? p ? . Emergency Overflow Elevation
? Z ? • PondlWetland buffer delineation
y ? . Shoreland Zoning Overlay District
Y N • Conservation Easements
DIMEPISIONS
X ? ? . Lot lines/Bearings & dimensions
,H" ? 0 • Right-of-way and street width (to back of curb)
,6 ? ? • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc
(i.e, all structures requiring permanent footings)
•e( ? ? • Show all easements of record and any City utilities within those easements
g ? ? • Setbacks of proposed structure and ideyard setback of adjacent existing structures
'
z ? ? • Retaining wall requirements:
Date S Z¢ 6
LL
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ev
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y:
G: lFORMS/Bu ilding Permit Application Rev. 11-26-04
'- Surveyor's Certificate
SURVEY FOR :Lennar
DESCRIBED AS :Lot5 1,2,3, and 4, Block 3, NICOLS RIDGE 2ND ADDITION, City of Ea
County, Minnesota and reserving easements of record.
G°oG°?o?Io [MCQQM?G°
oa
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Proposed
Home
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ol? 17 00-.9e
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Praposed
Homa
Tob=
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^y \\? oo 7S ia? N ? ao o°??\ r?
\? 8 61 844.4 rv°/ 838.0
? i
?
? 535.0
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3:9 Mum Slops3 ovrcor a
Of ir. ..;..'i51f1 Dralnoge & UtiiHty Easement ?
(? {'9EC?WfBCB over all ot Outlo[ A ?
\
\
\
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PROP05ED ELEVATIONS
}
Top of Foundation = 841.5
Garage Floor = 838,2 =
Basement Flocr = 838.3
Aprox. Sewer Service = 827.5 827.3 826.4`.B
Proposed Elev. -
Existing Elev. _
Drainage Directions =
Denotes Offsat Stnka
SCALE: 7 inch a SO feet
! HEDLUND
PLANNlNG 6NGlN86RlNC SURVEYlNC
2005 Pin Ook Orive
Eagan, MN 55122
Phone: (657) 405-6600
Fax: (651) 405-6606
'i" / ."?,
Cala9e
D. LINDZ;REN, IA SURVEYOR
ITA UCENSE NU R 14376
J08 N0:
OSR-498
BOOK:
Niclos Ridge
?
BENCHMARK,
TNH@Ce arva e r. edor Grove Prkwy
t,= EI=821.26
MIN. SETBACK REQUIREMENTS
Front - House Side -
Rear - Garage Side-
I HEREBY CERIIFY IHAT 1HI5 IS A TRUE AND CORRECT REPRESENTATION
OF THE BOUNDARIES OF 7HE ABOVE DESCRIBED PROPERN AS SURVEYED
BY ME OR UNDER MY OIRECT SUPERVISION ANO DOES NOT PURPORT 70
SHOW IMPROVEMEN75 OR EN{{??GROACHMENTS, EXCEPT SHOWN.
DA7E .! !/_1/ +? . ??
??1" ?.? ? ??--? ? 2,...A BP
' a0o(o RESIDENTIALBUILDINGrt ?
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Nevr ConsWCtlon Reaui2ments
3 registered s@e surveys sAowing sq, ft nf lot, sq. R of house; and all roofad areas
(20% maximum lot coverage allaved)
2 copies of plan showing beam & window sizes; poured found design, etc.
1 setof Energy Calculations
3 copies of Tree Preservation Plan if lot platted after 711/93
Rim JoistDetail Options selection sheet (buiWingswith 3 or less units)
Minnegasco mechanipl venUlation fortn
RemodeUReoair Reauirements
2 copies of plan showing footirgs, beams, joisls
1 set of Energy CalculaUons for heated addNOns
1 sRe survey for additions 8 decks
AddiNon - irMicffie HonsBe septic system
?
'54i„? --? 355q 9#10
?35SL ?y,??N.19
9a•so
?-3SS ? ?o sa
$y,R gs. )9
t}ffie`e`1.T's*?lhlv
?arfi6$?ti?V?? d ?.
7'iee?,2sPlsn??s ,: ? d`?
S !?f
Date / _??/ ?06
Site Address p 1 ?t IS3
Construction Cost 1
(Q dcir6-rbYe- L-G1 ''J 4;,? U¢iUSte #
e- !ti-ete-(
DescriptionutWork /)c Li `o
Multi-Family Bldg X y_ N Fireplace(s) _ 0 ? 164Ch 2
Property Owner r1 " CC` /' Pc, r' ct?l dv? Telephone #( 6g7 ) z b") - ??`f3
Contractor S°i r4 -e-
Address '-?7 L" i a v? t^'i0 U'1 Cl 'FqsCity b? ?k
State 1? /U Zip 5S a'ql Telephone #(6S/ ) Z A4 C ,
h- S d V 3
COMPLETE THIS AREA ONLY IF COHOTRRO A W BUILDING
- Minnesota Rules 7670 Cateeorv 1 D G? ? esota Rules 7672
Energy Code Category . Residential Ventilation Category t W he?(f?Y 16 2006 . New Energy Code Worksheet
(J submission type) Submitted Submitted
. Energy Envelope Calculations Submitted
In the last 12 monihs, has the City of Eagan issued a permit for a similar plan based on a masterp lan? I j? a 3,?•.f
? Y _ N If yes, tlate and address of master plan: oZ IOO C'e d ?? ?? ::%? ?-(h?? ,Licensed Plumber ?e ?IZ
Mechanical Contractor 2 ?
Telephone #( 9s2) ? 6?- 000
Telephone#(qs.L) 7b7 `11`600
Sewer/Water Contractor Ar K-Q ?,? S e L? e /- Telephone # ( (,Sf ) 21,16 - 639 1
?
I hereby apply for a Residential Building Perxnit 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.
0-c\(' e v\' ZP'n')6lr D---Q"`? ,,?MAY Y 6 2006
Applicant's Printed Name icant's Si e
DO NOT WRITE BELOW THIS LINE
Sub Tvaes
pO7 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
L?/ 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Ait - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch(Addn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screeNgazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storrn Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
W kT
es
31 ? 35 lnt Improvement ? 38 Demolish Interior ? 44 Siding
New
CI 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolitlon (EnUre Bldg) - Give PCA handout to applicant
DeSCfiption: Water Damage _ Yes
Valuation Ll?j 227 Occupancy ?t4_ MCES System Ll -e- S
Plan Review 100% or ?25%
`
Census Code !oa Zoning F, f)_ City Water
SAC Units ! Stories 9 Booster Pump
# of Units ( Sq. Ft. RO "7 PRV
?
# of Bldgs / Length 3e I Fire Sprinklered
Type of Const -73 Width a G,
REQUIRED INSPECTIONS
? Footings(new bldg) / Sheetrock
^ Footings (deck) ? FinallC.O.
Footings (addition) _ FinaUNo C.O.
,Z Foundation _ HVAC
Drain Tile Other
Roof ? Ice & Water ?Final _ Pool Ftgs Air/Gas Tests Final
? Framing
- Fi
l
? R
? Siding _ Stucco Lath _ Stone Lath _Brick
?F
rep
ace
.L
Air
_-L, Test
inal Windows
? Insulation _ Retaining Wall
Approved By: ?? kt LO,c e-- , Building Inspector
Base Fee - -- -------------- ?o we.rY l..r?v? ? F"Vt is {.c cQ ? I a )?fs0 ---
Surcharge iL un?_''iµisked 5$5
PlanReview Ma;N Ploor -Fin?s?e? 1E8,9?8
MC/ES SAC Ut-jnar ??? ? ? ? 19()
ciry sac
li
C
GaxQ9e ?0
Uti
ty
onnection Charge a,ooa
S&W Permit & Surcharge
TreatmentPlant
License Search
Copies
otner
Total
IlNeheck C0MPLYAtiCE REnOn7
Nfnneaota Enerpy Code
mucheck SoftwarB version 8.0
CDUN7Y: Hennepin
STA7E: Minnesota
ZOtdF: 2
CONSTNUCTION TYPE: 3ingle Fanily
OATE: 6-11-2005
DATE OF PLANS: 9-6-04
PFOUECT INiORYA7Idi:
Suaafi Collection
Nicols Aidge
Eagen
CQMPANV INFORNATION:
Lennar Corp.
? NOTES:
Ruahmore Unit (4190)
COMPLIANCE: PASSES
Npuired tla = 587
YOUr NomE - 369
37.14 Betier Thsa tpde
r i
i i
? Pel'm3t # ?
I 1
? CheCked by/17ata ?
1 1
Area or tavity Cenl. Glsiing/floor
PerLoeser R-Yalue R,Va1ua U-Value uA
---------------------- •----..---------- --•--------------------------- ------- ---
CEILINGS 962 38.0 0.0 29
MALt,S_ 1VaoA Fra", 16' O.C. 9208 79_0 2.0 150
GLA2ING: Windows or Ooors, Abova 4raae 178 0.350 62
OOORS 42 0.350 t5
FLOOR3: Wor Uncanditioncp &paee 417 30.0 0.0 14
SCAB PlCORS: Unheated, 72.00 inaul. tta 70.0 Bg
HVwG EQl)IpMEw7; Furnace, 50.0 AFUE
...
-------------------------••- ^ --------- .....................................
COMPLIANCE STATEMENT: The propo8ea buiidinQ deslqn OeseriEed here is
oonsistent with cAe buildipg plans, speciffoations, and other ea].tulations
subeiittad Mith the pera3t apPlieatipn. Tha propoaetl building has been
designe6 to weee rhe requiraeenta pf the Minnesota Enerpy Code.
BuilGar/Desipne? pate
Ya
Oz
_Fr o
,2' 0
.? ?
? 0
? ?
-8' ?
.9' ?
? 0
? ?F1
? ,9'
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDWG PERMfT APPLICATION
PROPERTYLEGAL: l-6TS I,C' 5 A 'i- 1SIoCl4 '6 ! lUj??
DATE OF SURVEY:
LATEST REVISION:
d
m
c
m
t
U
?
a DOCUMENT STANDARDS
? • Registered Land Surveyor signature and company
? . Building Permit Applicant
? • Legal description
? • Address
? . North arrow and scale
? • House type (rambler, walkout, split w/o, split entry, lookout, etc.)
? • Directional drainage arrows with slope/gradient %
? . Proposedlexisting sewer and water services & invert elevation
? • Street name
? • Driveway (grade 8 width - in RNV and back of curb, 22' max.)
? . Lot Square Footage
? • Lot Coverage
ELEVATIONS
ro
Existin
? ?' ? • Property corners
,0' ?? . Top of curb at the driveway and property line extensions
J2, ?? • Elevations of any existing adjacent homes
.g ?? • Adequate footing depth of structures due to adjacent utility trenches
,B' ? ? . Watenvays (pond, stream, etc.)
Proposed
0 0 ? • Garage floor
p' ? ? • Basemen[ floor
? ? . Lowest euposed elevation (waikouUwindow)
? .0' 0 • Property corners
,,z ? ? • Front and rear of home at the foundation
PONDING AREA (if applicable)
p ? • Easement line
? ?X ? • NWL
? f? ? • HWL
? ? ? • Pond # designation
? ? ? • Emergency Overflow Elevation
p PJ ? . Pond/Wetland buffer delineation
Y ? • Shoreland Zoning Overlay District
Y ?l • Conservation Easements
DIMEhfSIONS
? ? ? • Lot Iines/Bearings & dimensions
,Er ? ? • Right-of-way and street width (to back of curb)
,B ? ? • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent footings)
,Ct ? ? • Show all easements of record and any City utilities within those easements
,25 ? ? • Setbacks of proposed structure and ideyard setback of adjacent existing structures
,eI p ? • Retaining wall requirements:
G
f Date 4124
??
??L v?vzi?U
Reviewed By: b
G:/FORMS/Building Permit Application Rev. 11-26-04
? Surveyor's Certificate
SURVEY FOR :l-ennar
DESCRIBED AS :Lot5 1,2,3, and 4, Block 3, NICOLS RIDGE 2ND ADDITION, City of Ea
County, Minnesota and reserving easements of record.
poG°o?In G°C?Q[?aC?CD „
?,RAIL
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lo+
Ra0° ?" RO '
EDAR ? ?-
C
.,
oa??}?dd
QL?Jh1i?'? ? f?u?5 SC? f i y?0 36. ? f
Proposed 837 + f
Home i 5?p +
Tob= 38. oo*S h ??
i .-. _ . ... ...
,. j Cp?a
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a hN " Gora9e ?.g ' •f
p) pr
Z ?s;?No.p C?r?9e
39.4 ?/ 25.9g a//c r w? Aoyey 4
o??m t? p 35Pew
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\ 84 .2i ry' `P . 76,0?
\ o
? 842.5? o "ecAr \ ry `"
?m N?p o aa .
9:9 PAaxim-*t*JF
p
Of "lr.:'.3if51ng
lv??t,'' i`c"USr@d
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876. 836.
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0
0 38. 377 ° 3 . ?0.66
838.D
G?rO9e S. s + p
401
6 ?D
ToWry Poaed ?N •
`?Spcw °me ? ?
2$ 98
n, Dakota
i
J
Praposed
Home
Tob=
00'7Jr di942.0 ec
\
8 B40
6;,
\ 838.0
\ 844.4
\ + I?ul
838.0 m
\
\
\
\
OUTLOT A
?o?? Droinoge & U}illity Ease \ `
ment
i 'U over olI of Outlot A
?
\
\
?
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v
?
?
C?
?
PROPOSED ELEVATIONS - ' ?
BENCHMARK,
Top of Foundation - 841.5 = TNH@Ce arva e r. edar Grove Prkwy
Garage Floor - g38,2 " - EI=821.26
Basement Floor = 838.3 ? Aprox. Sewer Service = 827.5 827.3 826.4'826:8:.. - .-
Propo§ed Elev. -0 Existing Elev. -
Drainage Directions =
Denotes Offset 5toke = • SCALE: 1 inon = ao faat
MIN. SETBACK REQUIREMENTS
Front - House Side -
Rear - Garage Side-
JOB N0:
HEDLUND I HEREBY CERTIFY THAT THIS IS A?RUE AND CORRECT REPRESENTATION 05R-496
OF THE BOUNDARIES OF THE ABOVE DESCRIBED PROPERTY AS SURVEYED
BY ME OR UNOER MY DIftEC7 SUPERVISION AND DOES NOT PURPOR7 TO BOOK: PAGE:
PL9NNlNG 6NGlN66RlNC SURV6'YINC SHOW IMPROVEMENTS OR ENCRDACHMENTS, E%CEPT SHOWN.
20°9Qn,l MN?551?22e OATE jzJ /a? v' CAD FILE:
Phone: (651) 405-6600 F E D. LIND REN, lA SURVEYOR
fox: (651) 405-6606 INNESOTA LICENSE NU R 14376 Niclos Ridge
S!? 00Y, g51. 9 y
u
d2ESIDENTIALBUILDINGs "° ' qo. S a
(City Of Eagan Nt 1° ?"3 SO 2 ?. S?
3830 Pilot Kaob Road, Eagan MN 55122 ?S, 0( 2_ Ry
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction ReQuiremenis RemodeVReoair Reauiremenfs
3 registered sHe surveys showing sq. iL of lot, sq. H. of house; and all roofed areas 2 copies of plan showing footings, 6eams, joists
(20°,6 rtaximum bt coverage albwed) 1 set of Energy Calculations for heated additbns
2 copies of plan shaving beam & window sizes; poured found design, etc. 1 sile suney for additions & decks
1 set of Energy Calculations AtldRion • iMicate+I ar-site septic sysfem
3 mples of Tree Preservafion Plan'rf bt platted aher 711193 7
Rim Joist Detail Op6ons selection sheet (huildings witli 3 or less unifs) S?} •_ '?-?5 ?> R# ? 0 8 9`!S
Minnegasco mechanipl ven8lalion form
C}Ifice:Use-0'n .
Qn-s?e:SeRticSYSistn:'? `m=..:=?: ?:N
IMAT
1 oos ,? ? S 1. y(? o
Date / //
T O 20 / Construction Cost
Unit/Ste #
,e ?G r l? 4e
Site Address
??I C ' ? e
) n
t
sfir(
Description o[ Work '
,
`c
Multi-Faroily Bldg X Y_ N Fireplace(s) _ 0 el" 1(F'k h 2
PropertyOwner ?-?nnu,- Cerpoi-cd/dr% Telephone#(65(
Contractor -e'
Address ?+ Q vN Pvl 0 u-+ C? eq.S"i" City ?•? h U,'?
State IM /J
Zip !5339 J Telephooe #((0S/ ) 2 Ge?ai:Suiwe3';R'ec"d_=2?? "'3j?=,? F1
11- fa y3
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residantial Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
. Energy Envelope Calculations Submitted
In ihe last 12 months, has the City of Eagan issued a permit for a similar plan based on a master planB
? Y _ N If yes, date and address of aster plan: o? IOO e
ra ra r?T'CSITf?
Licensed Plumber ? (f qZ - ?
Mechanical Contractor Vi 2- ?:?G3uvu ? pTqy 16 2006
Sewer/Water Contractor Ar YZ ? cuie T
#(9s2) 767- (coo
Telephone #(qsJq 76 `7 f t 00 O
Telephone#(65!) 2416 - 63 9 1
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 pemut, 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.
aj,- ?? 1---- Hpy 16 2096
Applicant's Printed Name A licant's Signature
DO NOT WRITE BELOW THIS LINE
?
Sub Tvpes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
3? 02 SF Dwelling ? OS OCrplex ? 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 ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04plex ? 12 12-plex ? 25 Miscellaneous
Work Tvues
V 31 New ? 35 Int Improvement ? 38 Demolish Interior O 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
DesGrtptlon: Water Damage _ Yes
Valuation Occupancy -? L_ MCES System Tg_. S
Plan Review 100% or ?25%
Census Code Zoning ir?)_ City Water _l?_ ?
SAC Units / Stories ? Booster Pump -- '
# of Units / Sq. Ft 95? PRV ?.a
# of Bldgs ! Length ?g Fire Sprinklered ?
Type of Const __2i Width .26
REQUIRED INSPECTIONS
? Footings(new bldg) ? Sheetrock
_ Footings(deck) ? FinaUC.O.
Footings (addition) FinaUNo C.O.
? Foundation HVAC
Drain Tile Other
? Roof - Ice & Water ? Final _ Pool Ftgs Air/Gas Tests Final
Framing
?
/ Siding _ Stucco Lath Stone Lath Brick
? Fireplace ? R.I.
Au T est -?
Final Windows
? Insulation _ Retaining Wall
Approved By: Eke L.
---- , Building Inspector
BaseFee
?^-- ---- -? Lovuer \-'eve1 inisked A?d ?a 125--
Surcharge
I< <` AK?n,sl,d
69 0
Plan Review Z S ? R??
?n 0°r ? I YI ? S hel? 1
MC/ES SAC r Cev?1 i`
cicy sac
'
Utility Connection Char9e '
a9e' 2 o?
S&W Permit & Surcharge ,
Treatrnent Piant !
License Search
Copies
O
h ?
nq
1 V IC k_,h ie
t
er
Total
wieAsck COWIIANCE REPOHT
Minnesota Energy Gode
6acneek SoTtware version 9.0
CWNTY: Hennepin
STATE: Minnesota
ZME: 2
COtiSTRIRTYON TYPE: Sl.ngle Faaily
OATE: 5-74-2005
pnTE OF PIANS: 9-8-04
PpOJEC7 tNFCAMhTION:
Suerft Colleetion
Nicols Nidge
Eapan
CONPaNY INFORNATION:
lennar Corp.
lp7ES:
xcKinley unit (4s")
CONPIIANCE: Ph$SES
pequirea UA = 604
Your Nome = 400
33.8k Betser Than Code
i i
i ?
? Pernit N ?
I I
I 1
? Chaeked bylAaTe ?
I I
Area ar Caviiy Corri, Glsxingl0oor
Perimeter R•Value R•Value U-Value Un
.......................... '................................................ .---
CEILINGS 862 98.0 0.0 29
AU?I,LS: Wood Fraaer. 16' D.C. 9252 19.0 2.0 1$2
Gt.AZINO: Windows or Daors, pbove Gratla 258 0.350 90
nooRS aa 0.350 15
fL00R5: Over UnCOndi'[iAneO Space 414 30.0 0,0 14
S1AB Pl00RS: UnNeatsd, 72.0' inSUl. 116 70.0 70
NVAC EQUIPMEN7: FurnaCe, 90.0 AFUE
'----'----_-•"••" ...._---'------.._..'-'-'---'----'-'--'-' ...................
COYPLIAUGE STATEMElIT: Tne proposod pu11A3n4 dsbiqn peacribea here is
eonsisceni with Yh@ puildin9 plans, apeeiTications, and otfier esleulasians
subnitted with tAe penmix application. The proposed buildinq has been
desioned to aeet the requirements of the Minneaoia Enerqy Code_
Builder/Oesipner Daie
SEP 4 2 1005
f
? LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTY LEGAL: 3z 4- BkCI4 3,?liC+c?IS Ri Qa
DATE OF SURVEY:
LATEST REVISION:
m
rn
c
m
t
U
a
o z ?
a
DoCUMENT STANDARDS
_,2- ? ? • Registered Land Surveyor signature and company
k{' ? ? . Building Permit Applicant
,? ? ? • Legal description
?- ? ? • Address
?g ? ? • North arrow and scale
,21 0 0 • House type (rambler, walkout, split wlo, split entry, lookout, etc.)
e ? ? . Diredional drainage arrows with slope/gradient %
Ig- ? ? • Proposedlexisting sewer and water services 8 invert elevation
?- ?
? ?
? .
• Street name
Driveway (grade & width - in R/W and back of curb, 22' max.)
? iPJ 0 • Lot Square Footage
? ,g ? • Lot Coverage
rld
ELEVATIONS
Existin
? x ? . Property corners
,0' 0? • Top of curb at the driveway and property line extensions
j21 ?? • Elevations of any existing adjacent homes
?g ?? • Adequate footing depth of structures due to adjacent utility trenches
? ? • Waterways (pond, stream, etc.)
Proposed
? ? • Garage floor
? ? ? . Basement floor
0 0 ? • Lowest exposed elevation (walkouUwindow)
? ,g' ? • Property comers
?z ? ? • Front and rear of home at the foundation
PONDING AREA (if applicabie)
? ,9 ? • Easement line
? ? ? • NWL
0 f1 ? • HWL
? ? ? • Pond # designation
? JU ? • Emergency Overflow Elevation
? d 0 • Pond/Wetland buffer delineation
Y ?'k) • Shoreland Zoning Overlay District
Y Vj • Conservation Easements
DIMENSIONS
? ? ? • Lot lines/Bearings & dimensions
,4T
? ?
? ?
? •
. Right-of-way and street width ([o back of curb)
Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requi(ng permanent footings)
.C( ? ? • Show all easements of record and any City utilities within those easements
'z ? ? • Setbacks of proposed strudure and ideyard setback of adjacent existing structures
,P] ? ? • Retaining wall requirements:
? Date ,S 21'4
Cl
i
d B
,v.??z
y: -
ewe
Rev
G:lFORMSlBuilding Permit Application Rev. 11-26-04
Surveyor's Certificate
SURVEY FOR :Lennar
DESCRIBED AS :Lots 1,2,3, and 4, Block 3, NICOLS RIDGE 2ND ADDITION, City of Eagan, Dakota
- County, Minnesota and reserving easements of record.
U`o?a1J4 ?1?LIll?D
5"n rcoR
O?DA
?
f
CEDAR
s ?
ac??s??ad RQOqoa .*,+,r - ?,, i ; \x
{t
?
5?Amgzr4 on
36
?
Prapwed ?1,
? ,
h
37
Home C
T
6= . q?p S
• tf 1t ??
a
(8425 , ? 36,
j p? o
r° /?
017 36, i? 836.
.
0
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33
B ^ 7J
?:
c/
\ ,? , 6
38.1
?
8
p
? ?
9e p 6. .
B
Corp9e . 6
? r P?opo ?3
0 ?.
0 38.1 37.
Z. Q
839.4 ,js? ??c p
orp9e
r
d/I Taw'PaBe
?Sg ? . 2p,s6
? d
8
35nc HOjne .
2
w d?l
p?o
S6 y C
9e C
840. Q
T
Po
De
a0 3spc NO
4 a16 ?O
? B4 .2f
\ c
@
p f w d
11
N 26,0Q /Y prp M
joWnPoeey N. .S
\ \ 842.5? 8 ' p Oeck • 35Pcw °'?e
d/l y'
q?
n \ N70o 94 . O
842
0 rv
00'
Ck ?
!
? C
\
\ .
75. ?
p
)
40
\
86j 844.4
\
rv/ 838.0
\ 638.0
? IMUYPI $IOP$9 \
or Re watI vvIe
B'8 R6quj OUTLOT A
Dralnoge & Utiility Easem
?
? ent
over oll oi Outlot A ?
\
\
PROPOSED ELEVATIONS \
Top of Foundation = 841.5
Garage Floor - 83$.2
Basement Floor = 838.3
Aprox. Sewer Service = 827.5 827.3
Proposed Elev. = U
Existing Elev. _
Drainage Directions
Denotes Offset Stake = .
BLV.Y' - z U
_ ..,,f},£ rv .Y
SCALE: 1 inch - 30 feet
Front - House Side -
Rear - Garage Side-
JOB N0:
I HEREBY CFRTIFY THAT THIS IS A iRUE AND CORRECT REPRESENTATION 05R-496
H DLUND OF THE BOUNDARIES OF 7FIE ABOVE DESCRIBED VROPERTY AS SURVEYED
E
BY ME Oft UNDER MY DIRECT SUPERVISION AND DOES NOT PURPORT TO BOOK: PAGE:
PGANNINC 6NGlN66RlNC SURVEYINC SHDW IMPROVEMENTS OR ENCROACHIAENTS, EXCEPT SHOWN.
2005 Pin Oak Drive •
Eagon, MN 55122 DATE ?/??,5 G.J. CAD FILE:
Phone: (651) 405-6600 Vrru D. LIND REN, LA SURVEYOR
Fox: (651) 405-8606 INNESOTA LICENSE NU R 14375 Niclos Ridge
Proposed
Home
Tob= C?40_3 ?
?
?
?
BENCHMARK,
_._: J'NH@Ce ?rvo e r. edar Grove Prkwy
EI=821.26
MIN. SETBACK REQUIREMENTS
?-?e 2,..d\
aDd ? RESID NTIALBUILDINGs
" City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX 9 651-675-5694
New ConsWCtion Reaui2ments
3 iegishved site surveys showing sq. ft of lot, sq. ft ot house; and all roofed areas
(20% maximum lot coverage allaved)
2 oopies of plan sYrowing beam & window slzes; poured fouM design, etc.
1 setof Energy Calculations
3 copies of Tree P2servaUon Plan 'rf lot platted after 711/93
Rim Joist Detail Optlons selection sheet (buildings wiUi 3 or less unlGs)
Minnegasco mechaninl ven6laGon form
6? ?-3S? `1
M?° ?-`3S?Io
RemadeVReoair Reauirements
2 copies of plan showing footirigs, 6eams, joisLs
1 set M EneTgy Catcufatlons for heated addNonx
1 site survey for additions 8 decks
Addfi'on - inrc!kate Non-sde sepNc system
s?-?=?35?? ?#?ogqy5
; lephone # ( 9S2)
lephone #
Date /MY
Site Address 16 2006
'Y O , Construction Cost S8 i? y?
`?-?e C4R r l9' (bYe- ?-G ''1 2 UniUSte #
GC.S e 2c?
Description of Work ./ 1O eLi `c '?s--f-1 CL LZ`eb°'\
Multi-Family Bldg X Y_ N Fireplace(s) _ 0 ? 1 2
PropertyOwner ? Lr1viQ i" CC'/Pc'rcdld? Telephone#((n
Contractor
Address ?'1 d Eo5 t City
State Zip '53 Z Cl I Telephooe # (65h a4 C\
- 3d-/ 3
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
. Energy Envelope Calculations Submitted
In the?st 12 months, has the City of Eagan issued a permit for a similar plan based on o moster plon?
_ Y N If yes, date and address of master plan: d IOa ('e d??
{q
Licensed Piumber &e Z -
Mechanical Contractor Pi 2? ? V
rsZuos
Sewer/Water Contractor 4J e'?
4PV, SSl.9 q
9o.so
?0.50
?S,at2. qy
-
offi111ce??e3f)iilv
CErf,?b?:?itiveV?ec?`'.s,!'s,.?;+-?
T2ei§es.?a?' ? TrY:?
TtEe?rES-?? ?'{ ? "=?`aa?
h ? rry.??,
='? n •'5$
Y??.i?_E'?4?1B,I11Skr:? °,'_..
767- /coo
76-7 -rooa
Telephone#((,5t) 2 416 - 03 9 1
I hereby apply for a Residential Building Pernut 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
3tatutes; I understand this is not a pernut, 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. ?--
O-c? c' e v\? W1AY 16 2006
Applicant's Printed Name A icanYs Signature
DO NOT WRITE BELOW THIS LINE
'
Sub Tvpes
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBldg
I9' 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
Q 05 03-plex ? 11 10-plex ? 19 Lower Level O 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Wnrk Tvees
C9' 31 New ? 35 Int Improvement ? 38 Demolish Interiar ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 WindowslDoors
? 34 R2placement 'Demolition (Entire Bldg) - Give PCA handout to applicant
DesCriptiOfl: Water Damage _ Yes
Valuation OM617 3 Occupancy MCES System Ne-s
Plan Review 100% or 0"?25%
Census Code ! 01?, Zoning ?D City Water ?e S
SAC Units / Stories ? Booster Pump ?
# of Units ? Sq. Ft. PRV
# of Bldgs ? Length 3 gv Fire Sprinklered ?
Type of Const Width a6 ?
REQUIRED INSPECTIONS
? Footings (new bldg) ? Sheetrock
_ Footings (deck) ? FinaUC.O.
Footings (addition) FinaUNo C.O.
r? Foundation HVAC
Drain Tile Other
_
Roof ? Ice & Water L?Final _ Pool Ftgs A'u/Gas Tests Final
? Framing Siding _ Stucco Lath _ Stone Lath _Brick
? Fueplace _ R.I. _ Air Test _ Final Windows
? Insulation _
_ Retaining Wa11
Approved By: Building Inspector
Base Fee /
Surchar9e
?i l5?
U,y??,wrskcI
Plan Review a5 'e 41
I?-? I 9a
MC/ES SAC ? ?a5we? r
C;tY SAC A? , ( ac ?qa
Utility Connection Charge ?I ?pO?r
S8W Permit & Surcharge ? .200
TreatrnentPlant Q? ?73
License Search
Copies .02ir /?
l?As c R7 A C
Other
Total
r
IWeheek CWIPLIANCE REPONT
Minnesota Enerpy CoQe
mWCheck Softaare version 3.0
CpUNTY; NEnnepin
STA7E: Minnesota
ZONE: 2
CONSTRUC7ION IYPE: Single farily
OATE: 6-14-2005
DATE CK PL.ANS: 9-6-Oa
PROJECY TW4XMATION:
Suwis Golleetion
qiCels RSdpB
EaqBn
COdPAM' INfOR?NTION:
Lannar Corp.
NOnS:
? CascaOe Unit (45s)
COMPLWICE: Pn5SE5
Baquired UA = BDa
Yaur Nore - 400
33.8+k Better Than Code
I t
I I
? Permit N ?
i I
I I
? Checked trylDate ?
I I
,vea or Caviiy Cant. Glazinglnoor
Parimater R-Yalue R-Value U-Value UA
"""'---"'-""""' •""----' -"""""""""'--' ... ..
CEILINGS 962 98.0 0.0 ........ "-'- "---
29
WALLS: wood Frase, 16' O.C. 3252 19.0 2.0 182
GLnZImG: Windows er poors, Above GradE 256 0.350 90
DODRS 42 0.350 75
FWORS: Over Uncontlitioned 3paos 414 30.0 0.0 14
SLAB FLA083: Unhea[ed, 72.9' 3o3u1. Y18 70.0 70
XvAC EOUIPNENT: fumdCe, 90.0 AFUE
-------------------- ----------------------------- ...""'..
.'----- ^----
--'
•
-
CqMPLIANCE STATEMEN7; rMe proposed bui7,0i,np peaign descrlDed Dere ia -
eonsistent wltu tne buildiep plans, speeiffeasions, and otiror ealculations
aubmittetl with ehe perwit appliCasion. The proposed bui.lGfhp has bean
deeigneE io osat the nquimrenCS of tl+e Yinnesota EnsrpY Code.
Buiider/Designer Date
,
m
?
c
R
L
U
Y a v
oz a
fd' 0 ?
? o ?
.a' ? ?
? o ?
,H ? ?
'z ? ?
e o ?
'B' ? ?
.0' ? ?
,6' ? ?
? iC1 ?
? ,0 ?
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTY LEGAL: I--OTS
DATE OF SURVEY:
LATEST REVISION:
DOCUMENT STANDARDS
• Registered Land Surveyor signature and company
• Building Permit Applicant
• Legal description
• Address
• North arrow and scale
. House rype (rambler, walkout, split w/o, split entry, lookout, etc.)
• Diredional drainage arrows with slope/gradient %
• Proposed/existing sewer and water services & invert elevation
. Street name
• Driveway (grade 8 width - in RlUV and back of curb, 22' max.)
• Lot Square Footage
• Lot Coverage
ELEVATIONS
Existin
? '6' ? • Properiy corners
g ? ? . Top of curb at the driveway and property line extensions
.2 ? ? • Elevations of any existing adjacent homes
-0 ? 0 • Adequate footing depth of structures due to adjacent utility trenches
,?d' ? ? • Waterways (pond, stream, etc.)
Prooosed
,g' ? ? • Garage floor
?z ? ? • Basementfloor
,Z ? ? • Lowest exposed elevation (walkout/window)
? ,0' ? • Property comers
?,P1 ? ? • Front and rear of home at the foundation
PONDING AREA (if applicable)
? ,p' ? • Easement line
? ?k ? • NWL
? f7 ? • HWL
? ? ? • Pond # designation
0 ? ? • Emergency Overflow Elevation
? .? 13 • PondNVetland buffer delineation
Y U . Shoreland Zoning OveAay District
Y N • Conservation Easements
DIMErISIONS
? ? ? . Lot Iines/Bearings & dimensions
? p ? • Right-of-way and street width (to back of curb)
'H ? ? • Proposed home dimensions inciuding any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent footings)
,[i ? ? • Show all easements of record and any City utilities within those easements
0 ? 0 • Setbacks of proposed structure and ideyard se[back of adjacent existing structures
? ? ? • Retaining wall requirements: %
ADate Z¢ 6
i
d B
R
ev
ewe
y:
G'lFORMSBui lding Permit Application Rev. 11-26-04
`Surveyor's Certificate
SURVEY FOR :Lennar
DESCRIBED AS :Lots 1,2,3, and 4, Block 3, NICOLS RIDGE 2ND ADDITION, City of Eagan, Dakota
County, Minnesota and reserving easements of record.
M)orRlwD 1LfC--1)d1E(2Ud1I?1ED
r?
r°
° TAIL ? '??
k _`) pVE R
f'
a ??+ ?
l ?p0 ljR
AR f` ?
CE? f
..._....._._ (. . .?.
,. ...f_?._.?....? ;? ??
?....?__..-_.;, ...__ , .., ? .._...w,?.?..? . .r
Proposed
Home
Tob= C?42.5 ?
\
\
\
\
3:1 ?b MImun
OC
I$a riuyuired
ERo??0M.
P 02 509)
?
?
4J
°u0 -.O ?- 203 B ,•'v F?`? E< . 4 ?i Proposed
,4/ •65 3 38.1 °? 78 P `?Ti. Home
40 i Tob=
0)
?O MN C??Q9e
? pr 3 0 38.1 37.7 /
? TOw "t)DOsed Cor O/
_ `?SpeHarhe P o4e ?p,66 m/ ?p
?.
639A ? 25,gg aA 3 wolo°,sed q p.D
?'? •
Goro
SPCw °me . 9e 6 O
o' ?n ecq q d/j ?'ro
`?/ 840. ? o0 0 26??? h8ed 401 CO
84 .2? ?PCW Ome T P d? oPO
z6Op ow^ r aed rv
,M
842.5? o oepl, •- ?Sge ?? O? r
? N7Qo 4. ? pe ?3 oh „?..1
00,75?842.0 rv ? ° ? ? 7p. D? ?
\\ 8 ` 640 a?/ B3 0
? 67 844.4
\ j
? 839.0
\
\
SlOpe$ ?
?
ourcor a ?
??l vvilA Drainage & Utillity Easement ?
aver oll af Outlot q ?
\
\ \ ?
PROPOSED ELEVATIONS -- ?
rz°;i?•' BENCHMARK,
Top of Foundation = 841.5 ;'=.TNH@Ce arva e r. edar Grove Prkwy
Garage Floor = 838.2 ' D = Ei=821.26
Basement Floor = 838.3 ` ' s;? .• :;,,,
Aprox. Sewer Service =827,5 827.3 826.4'-826.8
Proposed Elev. -(=D
Existing Elev.
`; :,, s•?'.,;.
Oroinage Directions
Denotes Offset Stake =. SCAIE: 1 inch = ao taat
MIN. SETBACK REQUIREMENTS
Front - House 5ide -
Rear - Garage Side-
JOB N0:
HEDLUND I HEREBY CERTIFY THAT THIS IS A TRUE AND CORREC7 REPRESENTATON 05R-498
OF THE BOUNDARIES OF THE ABOVE DESCRIBED PROPERTY AS SURVEYED
BY ME OR UNDER MY DIRECT SUPERVISION AND DOES NO7 PURPORT TO BDDK: PAGE:
PLANNING 6NGlNBdRING SURV6YINC SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT A SHOWN.
2005 Pin Ook Orive l1
Eagan, MN 55122 DATE jV/-a/j25 • CAD FILE:
Phone: (651) 405-6600 F E D. LIND REN, LA04 SURVEYOR Niclos Rid
Fax: (651) 405-6606 INNESOTA LICENSE NU R 14376 9e
No. 3rz vez
Sltaad?: ??{'? Ce?a? l?.ro?rC ?cjhe Ld ? 81ook?
suba AJO 3 ?Ajq r-?q?
On AprN 15, 2000 fhe Minnesota Energy Code, Category i BuNding Requirements for insufatlon prufsctlon, air
SghUiess, and ventilation, was adopted. As a resuk, the Cily of Eagan is requiring that the following informdtion be
submitted priorto issuance of a Certificate of Oceupancy,
? TMs ehuchua igca,saucted to met mMimwn reqiinanenls at tlm Mn Errergy Cada, CAoper 7670
OR
_ Thia shucAea ?Jp.¢gconeln?ted ? n+eetmo?e restric6?s ieq?encents of CPiaptero i872 ar 7fi14
AiPIJFNCE GAS EI.EC MANUFACTURER mOOEI BTUS VEkTlMG7YPE
WarerHeater Gtm G `hpoO Y
Fumace ? a0o AB5
°"°' cm, OWSR 8 " w
EXHAUSTSIiSTEM
LOCA110N
TYPE
M06EL
CFM's VENIED
vm No
Kw+en kimhen O N Co
Botluoom 1 " Oay% (o 3C X
80vown2 X
Betlmom 3 ?j OC/w {,?jCOGd? (10 X
aa'"°°"' 4 3.a 1:000 •?, PANFVI j V Q Z 1 100 x
Other Qr+,V?e' (o -i'o X
FIREPIACE LocanoN ens wooa MANUFACtuaea rom grn oMGT nM
x (!!?i K
a? *S?-
Sign re
L e.r,nAc
Owww Nam
CE c "v d 2006
pate
nt
0 This fonn 13 fhe responsib(Illy of fhe General CcMreeWr.
I hereby ecluwwledo fhat the abwe in}armeUan is oorrect and agree fo wmply wlth tha Minnasota Energy Cads and Cly of Eapen
mwwdnwa
N0.372 902
Site '(0 '0 C e? a f (?ro ir c?c? vt e(,ot ?$Iock ?
Suat llle(.0OS ?4j0'? . a--KCL
On AprN 15, 2000 (he MiMesota Energy Code, Category I Buitding Requirements tor insulation protectlon, air
tighlness, and ventilation, was adopted. As a resuN, fhe City ot Eagan is requiring fhat the tnllowing informetian be
submitted priorto issuance ot a Cenificate of Occupancy.
? TNs sdushum is constructed M meet fiUimtsn reqhmentc o} tlho Mn Fnergy Cads, Chapter 7670
Ok
, T#ia stuchae: W[kconBVxted biheatmae res0ictlve reqllfeltWs od Chaptts 7872 Dr 7676
APWJANGE GA6 ELEC MANUFACTGRER MODEC BN3 WNTINfit1'PE
waterHeater GCm p 19QO'? G5 P0,rY
Fumaoo ? Lamicr 58mc [?o0- mD 1T65
Dryer • ??JM1 Q •• W
EXNAUSTSli8TEN1 LOCA110N TYPE ?Y?DEL CF141's ? ?NO
Kibifen kihhen d N^
Bstluoom 1 ^41% (.c... 00,4%
6ausoam 2
X
Betlmom 3 ?j ?/.w- ?c'OGh ?o X
SalMoom4 3er? F ara C. V( V 1610 3 ?Q X
O"r OwAc??' (p '?(? X
FIREPLAC LOCATION GqS yy0pp MpNUFACTURER MODFI 97U'S CnEet " ATA90s
X (?tk X
I herebY acknowledge fhal Ihe abova in£armation is canect and agree En comply wlth !he MinnesMa Energy Code and City oi Eagan
tawnxrfm"
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Sign
LG+A(?AC
Crnpany Name
Lcc G Q 20
pate
?f
4 Tfda fonn Is the respondbiliry W ft General Cartrsctpr.
12/07/2006 12?04 FAH 6512893240 NICOLS RIDGE CONSTRUCTIO > EAGAN, CITV OF 16002/002
?
161?,_.. NO.372 D82
, (9 L
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r - ,?13 ??q?, '
Slteadq?eec: `?OLcl ??a l?ro?? 1-.c3nc t.flt 3 81aok - subRi e?+(•ar--^-
pn AprN 15, 2DOQ the Niinqesota Ensrgy Cade, Category f 8uiidinq Requtrameala for Insulatlon profectlon, air
GgMrresa, and ven61a6cn, was adopfad. As a result, the qty of Esgan Is raqwkiag that ihe fallawing informaUan be
submitted prior to is5uance of a CeAlficate of Qccupancy.
??Ns e?uc?m: ?S ca+aauo?ae to ?t n?r,tmum ?ux.i,enm or U» #? 6?gy cads. cnap?r rem
Odt
? 7Ma BUucOmr: ?g c?nqn+oted bn?ttrqre rae0l?re mq?n d C??ap0ery 7972 ar 767t
APPUANCE GAB Et1C hfANUFACTU NWEL 9TtP3 YtNT7NGIYPE I
wamrH.ats? tCm o `kbO`3 65 Vs'
F""ac° `e r SrnC - ouA f} S
EXH
AU97SYffTEM LOCAl10H TYPE ?QEL CFM's y?VENTED
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-to x
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Betlanom 3 "?j ?/ t'CGro.v1 (9-74 7
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I hwaby ac;knotMatlps that Ilw abon intcrtnutlon Is camel end agree do oompiy wlth fha Minrftola Errergy CadO and Gty of Eepan
IWAIP"M
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ME? C) 4. 2005
Pate °
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• 7hls Taim la fhe reapotielpillty of ft tienerd Corqrecfpr.
6512893240
12/07/2006 72 04 FAX 6512E93246 NICOLS RIDGE CONSTRUCTIO 4 EAGAN, CITY OF ? 007/002
? t A-1 )ti'l I??. C- I N0.3?2 fioz
r
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SJta adrkeee: `{O ??- ? p? a r (..t,n t Lqt ? 91aak Su6d AC01)
On Aprll 15, 2000 ft Aqinnesota Enerqy C.nde, Cafegory I 9uNdinp RBquiraments ior Insuladon pmtactlon, afr
tightness, and venblatian, wae adapEed. As a reauN, the Cily of Eagan is requKfng that ihe fallpwing iMormatian te
ssthmiftd prlorto issuance of a Cwtifica4e of Occupancy.
2< 'rHa smxdaa 13oor?mt?d to rneet mnimum MeAmnenh dft Mn Fnwgy cade, C?ow 7e70
OR
? TNaehuakrt??caf+?n?eEedbltrostRare?trk?eroqWrenleratsdChapbas7872or767i
MWJANCE GAB B.EC RIpNWA R MODEI 9TIF8 VENTfNCtTYPp
wamrHa.ter tEm G 14o«7 85
Fumwo '? r 8(?+C
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ot-ss e ? ?
E%IU1UeT SYSTEM LOGA'RDM TYPE MCpEI C5A!'s r?s?Na I
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Be4?Oam 9 '3ee1 01, co 7C
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?ther C?7? (o o X
fIRE e LOGAT?ON $ WOOP MANUFACTURkR MGGEL gTU'S DRRECi A7AIOb
x ? X
GKp? *SA-
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n L.t,wwi'
OarnpsWMams
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Oots ...
ti t
• Thia form 13 the roapwtalDlllqr of Me CdOnere! CWtredot`.
I nermy eckna,n.ap fti u+e ebove jr+farmatwn 18 aorrect ana e0ree to oomp+y Wr? Ihw r?n?eeota enargy Codo and ay a Eegen
?a.
r
2007 RESIDENTIAL PLUMBING PeRMir aPPUCaTioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existin residential dwellin s.
?
oate0 q / ! ` / )--0, o ?
Site Street Address 10 1Q Unit #
Owner 20?6 C-
hone # (6S 1) 3 3 Z y??3
Pro
? Tele
ert
p
p
y
.
U?
b?
? "?6
Q! N
Telephone #(
Contractor
q
Address v'ai a' 7 Z lSt v?( ?; i-tf/t ? City State /yJ h Zip 53
The Applicant is: _ Owner 8 Occupant _ Licensed Plum6ing Contractor (%(1 (J
Septic System _ New
Refurbished Submit 2 sets of plans and MPC license Includes County fee
_ $ 100.00
Per as-built $ 10.00
Fire Repair (replace burned out fixtures, etc.) $ 90.00
This fee a lies when extensive lumbin re airs are made to a buildin .
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures to main level lower level. This fee includes
installation of a water softener and/or water heater at the same time. !f you are
insialling onlv a water softener and/or water heaier, do not complete this section;
move to the next section and place a checkmark next to the appliance(s) you are
installing
_Septic System Abandonment
_Water Turnaround (add $136.00 if a 5/8" meter is required)
Other:
? Water Softe 'r' _ Water Heater $ 15.00
' new _ replacement
Lawn Irrigation _RPZ _PVB _new _repair _re6uild $ 30.00
State Surcharge $ 50
Tatal $ 5? v
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
accord ce) with the apP roved pla?sn?in the event a plan is require o be eviewed an approved.
Applicant's Printed Name ApplicanYs Signature
?1(,qi
2007 RESIDENTiAL MECHANICAL rERMiT APrLicaTion
C:ity ()f Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone t# 651-675-9575
Please complete Por. single family dwellings & Wwnhomes/cooAus when permiLS are ceyuired ioc e'act arrit
6z?. 6in:)
Date 0 5 I 0 7/ 2007
Site Address 4018 CEDAR GROVE LN Unit #
NropertyUwner ROBZIRPER Telephone#( )651-332-1225
Contractor GENZ-RYAN (STEPHANIE)
StreetAddress 2200 W HWY 13 City BURNSVILLE
gtate MN Zip 55337 Telephoncll ( ) 952-767-1845
Bood #: 929298827 Expires: 8114107
The Applican[ is _ Owner X Contracror _ Other
Firc repair (replace burned out sppliances, ductwork, etc.) $ 90.00
This fee applies when extensive mechanical repairs are made to a building
Add-on or alteration to existing dwelling unit S 50.00
furnace _Additional _Replacement _ New
eir exchanger
air condidoner
p
heat pum/
? other
State Surcharge D ? ((?[VWED $ .50
? ??• ?
Total
I here6y apply for a Residential Mechuucal Permit and acknowledge that the information is c:omplete and uceura[e; [hat the work will
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; 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 oFplans. ???
cS?e?l?aoi?e, ?' .?" a,,, e
Applic t's Printed Name Applic 's Signature
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - -
I For Office Use1 I
Permit
City of Ea
Rd~
Permit Fee: aC~ -
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: Q
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date Site Address: L 1-✓i~v'+u Unit#:
Name: & I ' G+!~ L rS =`kC.~ I,( 0_11. I ~ P I ( - e
Phone:
Resident/ / y t , 4 >
Owner Address / City / Zip: 1 ~C) `t a C. P C?t i p t"(? I iLV ~_o 14'e--1-1 t zz / `e L
Applicant is: Owner Contractor
t f r r' / d
Type of Work Description of work: t?wVIOC
t L'
Construction Cost: Multi-Family Building: (Yes / No )
e•
s t
: Z
Company: h( PE's to i'rifI c, 1 C ruu J Contact: L I ~ & S e~ P ~
jj / 4 {
Contractor Address: k3 AC el' E'-1 City:
State: I Zip: - Phone: y `70 C e
License ' t Lead Certificate 4~C6 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE. Plans and supporting documents that you submit 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.
X i-C1 v' x e~&`G-L11/ LA' /
Applicant's Printed Name Applicant's Signat 'eA
Page 1 of 3
Use BLUE or BLACK ink
------------------.
� For 4ffice Use, �
. � � ����� 1
Clty of �a�a� I Permit#. �
� Permit Fee: �,�g.� �
3830 Pilot Knob Road
Eagan MN 55122 j Oate Received: �
I
Phone:(651?675-5675 � I
Fax:(651)675�5694 I Statt: I
I �
L������������..����J
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: _ �1 r"7•���� Site Address: "' (3 '" 0 '�'�y°' �Unit�:
Name: Phone:
ReS�d@11t1
�nrner add�ss i city i z�P:
Applicant is: Owner Contractor
Type!�f WC�NC Description of work:��iC�i�l1n ��r-ti1(�,�, t���
Constnaction Cost: Multi-Famity Building: (Yes�i No_}
Company: 6 � � Con�t ct:_1�1e�r1�, t101�.,1���"'O?i�5
Ck'1tl#i'�CtOC, Address: �I��J�J ��1��"��" �� c�ry: l_bY^���
state:J�LJ zip: ��J3� Phone: �Dl`c�.����5^���mail:
' License#: Lead Gerti�cate#:
If the project is exempt from lead certification, please explain why: {see Page 3 for additional information)
COMPLETE THIS AREA UNLY IF CONSTRUCTING A NEW BUILDING
fn the last 12 months,has the Ciry of Eagan issued a�rmit 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 8�Water Contractor: Phone:
NQTE;Pfans and suppori�ng dv�umen#s th�t}rou submif��ccrnsTdered tc�be pu�rlic i�ftr�ma�vn. ;l�i�rt��ns of !
the inf+ormafion�y b�c�a�si�ed as na�n publlc if you proaiat�sp�ific r�as�ns?�h�f wdulql P�e�»i��he CrYy to
cor�c/r�de thaf ftt� ar�er trade s�t�t's.
CALL BEFORE YOU DIG. Cail Gopher S#ate One Call at(651)454-0002 for protection against underground utility damage. CaN 48 hours
before you intend to dig to receive locates of underground utilities, www.popherstateonecall.oro
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
accardance 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 i80
days of permit issuance.
e
0
X . a�-�ti t�;a�-��y�,, X�� L.
Applicant's Printed Name Applicant's Signature
Page 1 of 3
f
I.
•
r For Office U Sit°
Permita: .3.?
EAGA
*....c., Permit Fee: DI 1 °I'
:::R
(651)675-5675ITDD:(65 )454-855IFAX: (651)67 3
8y
2019 RESIDENTIAL BUILDI MIT APPLICATION
Date: 06/19/19 Site Address: 4016 - 4022 Cedar Grove Lane Unit#:
Nicols Ridge Summit Homes7 � �� ��� 9` �
Name: 9 Phone:
Resident/ 7100 Northland Circle, Suite 300, Brooklyn Park, MN 55428 i
Owner Address/City/Zip:
Applicant is: Owner i Contractor
—
replace entry stair treads and risers, install bracing for treads
Description of work:
Type of Work I
g
Construction Cost 1 V00.00 Multi Family Building:(Yes /No ) l
Keran Home Services, LLC Tim Keran i
Company: Contact
Address: 265 Fillmore Ave E city: St Paul f
Contractor I
MN . 55107 651-334-68f� : timkeran hotmail.com I
State: Zip. Phone: Email.
CR593945 i
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
2006 construction
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: /
i
Mechanical Contractor: Phone:
I
r,
Sewer&Water Contractor: Phone: I
l
Fire Suppression Contractor. Phone:
NOTE Plans and supporting documents that you submit are considered to be public Information. Portions of the information maybe
classified as nonpublic If yoo,erovide specific reasons that consthermit the Cit to conclude that tha are trade secrets. _ _ _
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at
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.
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.
I hereby acknowledge that this information is complete and accurate;that the work wi. .-- in conf. an 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 :nd work is of , s • without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and :pproval s :-:,, '
/xTim Keran x
Applicant's Printed Name / • , 'sl"' Signa
DO N'OT WRITE BELOW THIS LINE N '7' o �D ` 1-(6)� /' ` `,3
'
SUB TYPES C da ( G r!'v.._L'•'(
Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
_ Single Family _ Garage T Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
Y01 of"f`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
RetainingWall
*Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation t 00/a Occupancy MCES System
Plan Review Code Edition V f SAC Units
(25%_1 00% ) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of ConstructionWidth
REQUIRED INSPECTIONS yr—)
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) <}' Final/No C.O.Required
Foundation Foundation Before Backfill HVAC—Service Test Gas Line Air Test_Hood
Roof:_Ice&Water _Final Pool:_Footings Air/Gas Tests Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In Air Test Final Siding:_Stucco Lath Stone Lath _Brick_EFIS
Insulation Windows
—
Sheathing Retaining Wall: Footings_Backfill_Final
—
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
—
Braced Walls Erosion Control
Shower Pan —
Other:
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base FeeOPV
SurchargeM V�'l l✓ I-rL- i, 'ti .-
Plan Review /y / '�
MCES SAC ( J 664
116)
City SAC N I
Utility Connection Charge
0(*.ji" i. (// 0 0
S&W Permit&Surcharge a s
4 (Treatment Plant ( r ‘../ j i 1
Radio Meter Read
Copies
TOTAL
Page 2 of 3