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3169 Doneene Lane 05/31/2011 TUE 13:48 FAX 763 473 8565 Sabre Plumbing & Heating 0002/002 ) fl'yl('(A Use BLUE or BLACK Ink FofOffiee.U e--- nn I i I Permit I ! City of I EaEd ~`4® I ~ I 3830 Pilot Knob Road Permit Fee: I Eagan MN 55122 f ` I 1 Dale Received: S`31-/I 1 ! Phone: (651) 675-5675 C()is_ taFax: (651) 675-5694 I _ ft 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: I Site Address: t,Jf ~~r)p 1- Tenant: Suite RESIDENT / OWNER Name: ~;nl Phone: Address / City ! Zip: , tbq Ut' '~l uA n -e- CONTRACTOR Name: 1 License Address: ! i' % City: -PI ~4 V11 1 1 State: d Zip: 66IL Ll Phone: I~; Contact. rV1 Cd'1 Email TYPE OF WORK New - Replacement Re air Rebuild Modify Space Work in R.O.W. Description of work: j- r- &2 PERMIT TYPE RESIDENTIAL Water Heater - Water Softener r \ Add Plumbing Fixtures Main 14 Lower Level) Lawn Irrigation RPZ ! T, PVB) Septic System Water Turnaround New - Abandonment RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *VtlaterTurnaround (add $166.00 if a 5/8" meter is required) $105.00 Septic System New ($10:00 per as built) (includes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEES 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.gopherstgteonecali.org 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, x yo -e X Applicants Printed Name Applicant's Signature FOROFFJCE USE Reviewed By: Date: Required Inspections: -Under Qrqund -Rough-ln Air Test, Gas Test -Final 3169 and 3173 DONNENE LANE CERTIFICATE OF SURVEY For- SCHAFER BROTHERS CONSTRUCTION. INC. PROPERTY DESCRIPTION: Lots 5 and 6, Block 1, SCHWANZ ADDITION, Dakota County, Minnesota. We hereby certify that this is a true and correct survey of the above described property and that it was performed by me or under my direct supervision and that I am a duly Licensed Surveyor under the laws of the State of Minnesota. That this survey does not purport to show all improvements, easements or encroachments, to the property except as shown thereon. Signed this 23rd day of March 2005. James R. Hill, Inc., ED 1 By i'N 1 By-. Date -3/;>>8/n.5 Gary , n esoto L.S. No. 11529 EAGAN ENGWEERING DEPT. Not S. 1. Building dimensions shown are for p Denotes set spike horizontal & vertical placement of structure o Denotes set iron monument only. See architectural plans for building x927 6 Denotes found iron monument Denotes existing elevation & foundation dimensions. (930.0) Denotes proposed elevation 2. No specific soils investigation has been drainage Denotes completed on this lot b,y James R. Hill, Inc. TC Denotes op of curb top a The suitability of soils to support the specific TNH- S.W. Quad. Pilot Knob house proposed is not the responsibility of Bench Mork: 908.67 _ and Jurdy Road James R. Hill, Inc. or the surveyor. Proposed Garage Floor= 902.2 3. No specific title search for existence or non- Proposed Garage Top of Block= 902.6 existence of recorded or un-recorded easements Proposed House Top of Block= 902.6 has been conducted by the surveyor as a part Proposed Lowest Floor= 894.6 of this survey. Only easements per the recorded plat are shown. 4. Proposed grades shown were token from the grading &/or development plan prepared by Bearings are on assumed datum JAMES R. HILL, INC. Scale: 1'=39 2 W W p a O O A En 0 W° Hill Inc James R C) A N 0 CD 0 r(?n m w <?O D m 0 ` , . , O n o o ao m Z PLANNERS / ENGINEERS / SURVEYORS Ln m ° N o o ^ 2500 W. Cu.. ft 42, snE 120. DA=& WIN 55337 y ra 0 ME (952 90-6014 FAX: (9M)B90-6244 • ?ft LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION ) I + F ?IoG S?G' ?v1 fJ 14 s PROP , ERTY LEGAL: DATE OF SURVEY: i LATEST REVISION: 3IZ3I?5 m c m L U p Z a DOCUMENT STANDARDS ?y ? ? • Registered Land Surveyor signature and company ?g ? ? Building Permit Applicant ,43 ? 0 • Legal description 2 ? ? • Address ,'ff ? ? • North arrow and scale 3 ? ? • House type (rambler, walkout, split w/o, split entry, lookout, etc.) g ? ? • Directional drainage arrows with slope/gradient % A3 ? ? • Proposed/existing sewer and water services & invert elevation g ? 'Tf r ? ? ? • • Street name Driveway (grade & width - in RAN and back of curb, 22' max.) g ? ? • Lot Square Footage ? ? • Lot Coverage ELEVATIONS Existing AT ? ? • Property corners ,Ej. ? ? • Top of curb at the driveway and property line extensions c? ? / • Elevations of any existing adjacent homes - 51.nw Elu- of 4 7 1644S /1o for fer ? 12 ? ? • Adequate footing depth of structures due to adjacent utility trendies ? ;d ? • Waterways (pond, stream, etc.) Proposed ? ? • Garage floor ,pJ ? ? • Basement floor B' ? ? • Lowest exposed elevation (walkout/window) .Er ? ? • Property corners X ? ? • Front and rear of home at the foundation PONDING AREA (if applicable) ? ,a ? • Easement line ? z ? • NWL ? .d ? • HWL ? .ej ? • Pond # designation ? Z ? • Emergency Overflow Elevation ? ? • Pond/Wetland buffer delineation Y CN) • Shoreland Zoning Overlay District Y • Conservation Easements DIMENSIONS ? ? • Lot lines/Bearings & dimensions ?g ? ? ? ? • • Right-of-way and street width (to back of curb) osed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. Pro ,g p (i.e. all structures requiring permanent footings) g ? ? Show all easements of record and any City utilities within those easements , z ? ? . Setbacks of proposed structure and sideyard setback of adjacent existing structures ' z ? ? Retaining wall requirements: ' Date 3 o '?^ Reviewed By: , " G: /FORMS/Bu ilding Permit Application Rev. 11-26-04 Permit Number REScheck Compliance Certificate Checked By/Date 2000 Minnesota Energy Code REScheck Software Version 3.5 Release le Data filename: C:\Program Files\Check\REScheck4SCHAFER - 04-0202A4.rck PROJECT TITLE: 04-0202A4 ? , -- 3 fl n t°_?YI e- Gage! COUNTY: Dakota STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 07/29/04 PROJECT DESCRIPTION: SCHAFER TWIN PROJECT NOTES: RES CHECK IS CALCULATED FOR ONE SIDE ONLY COMPLIANCE: Passes Maximum UA = 391 Your Home UA = 387 1.0% Better Than Code (UA) Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor LTA Ceiling 1: Flat Ceiling or Scissor Truss 1347 44.0 0.0 36 Wall l: Rim 176 10.0 2.0 36 Wall 2: Wood Frame, 16" o.c. 1546 19.0 10 70 Window 1: Above-Grade:Vinyl Frame:Double Pane with Low-E 173 0.310 54 Door 1: Solid 38 0.350 13 Door 2: Glass 84 0.370 31 Basement Wall 1: Solid Concrete or Masonry 581 5.0 0.0 45 Wall height: 8.3' Depth below grade: 8.0' Insulation depth: 8.3' Basement Wall 2: Solid Concrete or Masonry 70 5.0 0.0 8 Wall height: 3.5' Depth below grade: 3.0' Insulation depth: 3.5' Floor 1: Slab-On-Grade:Heated 126 5.0 94 Insulation depth: 3.5' Furnace 1: Forced Hot Air, 90 AFUE Proposed and Maximum U-Factor Averages Proposed Maximum Average U-Factor Allowed U-Factor Above-Grade Windows and Glass Doors 0.330 0.370 Includes Foundation Windows > 5.6 ft2 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the - building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2000 Minnesota Energy Code requirements in REScheck Version 3.5 Release 1 e (formerly MECcheck) and to comply with the mandatory requirements listed in the REScheck Inspec heckh' J Builder/Designer/v 4` Date 1 (?[ 10-5 REScheck Inspection Checklist 2000 Minnesota Energy Code REScheck Software Version 3.5 Release 1 e DATE: 07/29104 PROJECT TITLE: 04-0202A4 PLAN REVIEW AND INSPECTION ISSUES This fist of items may be helpful for Plan Reviewers and Building Inspectors to use as a guide for enforcing the Minnesota Energy Code. The items apply to Group R, Division 3 Occupancies, one- and two-family residential dwellings. The items marked with * apply only to detached one- and two-family residential dwellings. PLAN REVIEW ISSUES FOUNDATION INSPECTION [ ] foundation wall insulation R-5 minimum [ ] foundation insulation extends from top of wall down to top of the footing [ ] exterior foundation insulation is covered by a protective coating finish CONCRETE SLAB OR UNDER-SLAB INSPECTION [ ] slab on grade perimeter insulation R-5 minimum [ ] slab insulation extends from top of slab to design frost line or top of footing [ ] floors over unheated space R-30 minimum WINDOWS / DOORS / SKYLIGHTS [ ] average U-value is 0.37 maximum for windows and glass doors (excludes foundation windows) [ ] window U-values consistent with building plan and REScheck Certificate [ ] window and door areas consistent with building plan and REScheck Certificate MECHANICAL VENTILATION ISSUES [ ] residential mechanical ventilation system provides adequate ventilation per code requirements* [ ] furnace efficiency is consistent with REScheck Certificate or building plan [ ] protection against excessive depressurization is installed per code requirements* ENVELOPE INSULATION FOR PLAN REVIEW [ ] interior basement insulation R-5 minimum (if no exterior insulation) [ ] ceilings with attics R-38 min=mum or consistent with building plan and REScheck Certificate [ ] wall framing and insulation level is consistent with building design and REScheck Certificate INSPECTION ISSUES CONCEALED INSULATION Framing and Sheathing [ ] wind wash barrier installed at attic edge [ ] exterior wail comers framed so that insulation can be installed after exterior sheathing is installed [ ] intersections of interior partition walls and exterior walls framed so that insulation can be installed between the partition and exterior sheathing after exterior sheathing is installed [ ] gaps between framing less than one-half inch are eliminated by securing framing together or are insulated at the time of assembly * [ J all penetrations between conditioned and unconditioned spaces made prior to framing inspection are sealed Interior Air Barrier [ j all fire stops are air sealed [ j pipes, ducts, wires, equipment and flues and chimneys through the interior air barrier are sealed [ ] a sealed continuous interior air barrier is installed on the warm side of the building envelope at ceilings, walls, and floor rim joist areas * [ ] air barrier behind tub and shower is sealed and protected [ ) recessed light fixtures are sealed Envelope Insulation [ ] basement insulation R-5 minimum ( ] wind wash barrier on wall separating house and garage is sealed [ ] loose fill insulation is prevented from entering the eaves [ ] insulation on skylight shafts and walls exposed in attics is supported on the unconditioned side Attic Insulation [ ] attic access panel insulated to R-38 for ceiling panel and R-19 for wall panel [ ] attic card attached to framing near access opening [ ] notification of attic R-value and date of installation posted near building permit inspection card This is a summary only. Other requirements may apply. See the Minnesota Energy Code. Questions? Call the Department of Public Service Information Center at 651-296-5175 or 1-800- 657-3710. ?_b -i- ? (-S 1 j5P 2005 RESIDENTIAL BUILDING PERMIT APPLICATIO?$ d City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 ? Telephone 051-675-5675 FAX 9 651-675-5694 ? 1 151 1D??l(?rJ [7ff a t e 917!12 New Construction Requirements Remodel/Repair Requirements !£_-- 3 registered site surveys showing sq. ft. of tot, sq. fl. of house; and all roofed areas 2 copies of plan Ced of Survey Retd N (2D% maximum lot coverage allowed) t set of Energy Calculations far heated additions Tree PresPlea Recd 2 copies of plan showing beam & window sizes; poured found design, etc. I site survey for additions & decks Tree Pras Ragwrad T Y l set of Energy Calculations Addition - indicate if on-site septic system on-511es hc5ystem.. ...:Y - 3 copies of Tree Preservation Plan if lot platted after 71V93 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Date 3 7 9 / Site Address { 1 q L l 05 1 Construction Cost 2 (DO O O n e.en e l 5 ?n Unit/Ste # 5 [3 1 Schlinzc?nx Add Description of Work n 2 W cC) n !5-f r u c++ an Multi-Family Bldg - N Y ) Fireplace(s) ? o _ 1 _ 2 r Property Owner S c kctTt,,F' " ) 8 r c- s. f) 5f I ()C Telephone # (?51 Contractor Sc Address yG f-1`1 State 1 r 1 Y T SLY 0 b I U ro ' Co' ` ' t - { nG ' q Gt , l QA City () er Grroy?e 1416. Zip .SSQ`J 7 Telephone # () 450 ` (0 -f 9-7 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 4 Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category I Worksheet New Energy Code Worksheet submission type) Submitted Submitted • Energy Envelope Calculations Submitted i Have you previously constructed a building in Eagan with a similar plan? >-<-' Y - N If so, 25% plan review fee applies. Licensed Plumber Wen 7,e 1 P l a rn b- ; rra Mechanical Contractor ro-f:P H ? `^ ' I 9 Sewer/Water Contractor s'tl e?n -,- l P I u m bi na Telephone #(0) y5- 155 Telephone #(?51) qa3-38Qa Telephone # LIAR 0 9 20 I hereby apply for a Residential Building Permit and acknowledge that the inform on is complete and a urate; 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%" xir hout 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. ?v? sci Ilg L Sc.b,g?¢r' Applicant's Printed Name Q1: Applicant's Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 -Porch (3-sea.) ? 31 Ext. Alt- Multi 70 03 01 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. ? 05 03-ptex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Yor_N ? 25 Miscellaneous Work Types '¢I 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 aldg) - Give PCA handout to applicant Valuation Occupancy 2-3 _ MCES System Census Code D U ( Zoning ?-y City Water 2 E SAC Units i Stories / Booster Pump # of Units 0 Sq. Ft. PRV # of Bldgs D ? Length Fire Sprinklered L Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) FirtaUC.O. Footings (deck) Final/No C.O. Footings (addition) _ Plumbing iy Foundation _ HVAC Drain Tile Other Ice & Water Roof Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ _ Siding _ Stucco - Stone -Brick _ Fireplace _ RI. _AirTest - Final _ Windows Insulation _ Retaining Wall Approved By: /r , B uilding Inspector Base Fee Surcharge Plan Review.' MC/ES SAC SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ,5 ?? 1 a urlenf iln-7 _ -57 --? U;1 P.-,7;5 I+e'D 3? emg4j 75? 59•r-f. 6, /S aG -;Ir 3F70•pa /'5;7- 13 C s, & • a.- 737 fp - o 0 o? =`9672?•? 6s1?zo 9 ct 55&- i?. Decr- -F1.,)'I r--EE ?113,975:??' Address: 3169 Doneene Lane Zip: 55121 Lot: 5 Block:I Subdivision: Schwan TILE FOLLOWING ITEMS WEREIWERE NOT COMPLETE AT FINAL INSPECTION ON , 1' ob Yes No Comments Final grade - 6" from siding Permanent steps - garage Permanent steps - main entry Permanent driveway ? Permanent gas Retaining Wall or 3:1 Max Slope Sod/Seeded lawn Trail/curb damage Porch Lower level finish Deck Fireplace • Verify with your builder that roof test caps from the plumbing system have been removed. • Turn off water supply to the outside lawn faucets before freeze potential exists. • Call the City's Engineering Department at 651-675-5646 prior to working in right-of-way or installing irrigation system. I n V BUILDING INSPECTOR: y ?I? t' N CG'- CONTRACTOR: Schafer Brothers Construction 9470 Abigail Court Inver Grove Heights, MN 55077 c 3169 and 3173 DOWNE LANE CERTIFICATE OF SURVEY For, SCHAFER BROTHERS CONSTRUCTION, INC. A 11r\ITI/1 ICI -?vvIIIVIVn Z NOW N00006'13"E N00006'13"E 46.00 Q'87.8) 46.00 889.0 n 866.3 (886.5) )DRAINAGE & UTILIT -, 1 i I m BASEMENT PER PLA .' n PILOT ,LOT 6 r5 3 m 893. - 1 12 n N12 It II _a12 15.00 F 00 - 0.00 DECK ( ?? I (894.1) DECK O C DECK (891.0) rn 36.0 36.0 OR OMME o r I ? \ \ 0 a ' 0 99<S4 ?[G7G0 ( I°D PROPOSED PROPOSED I PROPOSED\ H OUSE LO I I n HOUSE HOUSE \n I M (WAG) M I M (WAD) \ rn M n\ (WHO) C: M 4 ..T M \M M \I I M r? \ I I J I I - _ ? p O m i A A K 1 V I i 1 3 00 I it 3 1 9 . \ O (901/-9) m GAR. GAR,a6 (9$1.9) 10.0 (898.8) GAR. 00 I ? I I I O \ 20.33 7n -1 0 00 ^ (901.9 (901.9) M? 10 (897.4) BENCH MARK 1 rn 15.00 < r , BENCH MARK TOP OF SPIKE 5 I'y' 00 PROPOSED ppRIEWAY 00 >I TOP OF SPIKE+ V ELEV =900 25 . . I 9 - a 6 SERV. ELEV.=897.43 SERV. w k a?SE 0 M - I TC 898.5 ? I N D QN E EN E ' I ' 0M O I o cio oa ° ) I N LAN E _ IN I ~' ' ? M^? 1U\1 [ w rr?, o? O? L S 'JOA N f_ !1 I L_ a0 \ I V N ? , Op N I I I I .. \ L_ L_ N LOT 5 AREA=8188 SO. FT. ? LOT 5 COVERAGE AREA- I \ I 1840 SO. FTOR 22.4 % DRAINAGE & UTILITY: 1 LOT 5 SAN. SERV. ELEV.=889.0 EASEMENT PER PLAT ? I N LOT 6 AREA=8188 SQ. FT. LOT 6 COVERAGE AREA= WEST LINE OF BLOCK 1, 1820 SOFT. OR 22.2 X SCHWANZ ADDITION LOT 6 SAN. SERV. ELEV.=889.0 - m m A -A m - ? RICHT OF ACCESS 46.00 46.00 N00006'1 YE N00006'13"E COUNTY OF DTO THE AKOTA PER PLAT Ln O EXISTING SIDEWALK C.S.A.H. NO. 31 IL_V I r\IV\/L. I\\,Jt I SCAN o 19? ED R a Scale: 1"=30' Page 2 of 2 James R. Hill, Inc. 3169 and 3173 DONNENE LANE C ERTIFIC ATE OF SURVEY 1 For: SCHAFER BROTHERS CONSTRUCTION, INC. r- r- r- F)r- C`C L_ I I I \ L_.? ?+ A r\r\ITI(\NI r\ULJI I ?vI v^ Z I 1 ommak N00006'13"E N00006'13"E _ (889.8) - 46.00 (887.8) 46.00 (ss7.3) 889.0-" ,886.3 (886.5) 19 _ (DRAINAGE & UTILITY ', } ` ? rASEMENT PER PLA N I iLOT E LOT 61 893. x 2 N 15.00 <' ? N O? g 4Qa? tm 0.60 DECK (894.1) \ (894.1) DECK O.I DECK (891.0) \ 5 ? g?dU (???C?i?? 3610 360 0I ° j ^ I \ N I r) CC co P I ROPOSED PROPOSED I I PROPOSED\ \ I HOUSE HOUSE HOUSE M O\) C \ 00 I n T (a L U I I M uj _ Z U) \ A / A N I -r I It _ LO 'n M of ° - °N ai 10 V r\ ?\I v I 0 mI IO v ock 1 3 11.3 0 a 61 (9a01.9)I i- `10.0 (898.8) GAR.\ d R. GA R., 0 i ((901 9) j GA O \ 20.33 0 00 10 0 ^ ff (897.4) (901.9) (901.9) n ? I °' I BENCH MARK TOP Of SPIKE ` 15.00 ` a' 1 1 a°'° BENCH MARK 1 5 25 w ELEV =900 I PROPOSED RDRIVEWAY >I TOP OF SPIKE • ° . . I W b 906 S ELEV.=897.43 _ M _ M o TC 898.5 1 DQNEENE o ? LANE I\ /A Tr- N E:) o ( I \I Vr-\ I L g oaa ' O D N N ^TL)r-r-T `? ?? oo LL \ i _ " I I\ I LOT 5 AREA-8188 SQ. FT. N N C'i \ I C? LOT 5 COVERAGE AREA= ` I 1840 LOT SS . FTOR 22ELEV =889 0 I DRAINAGE & UTILITY _% N . . LOT 6 AREA 8188 SQ FT EASEMENT PER PLAT ; . . 1 LOT 6 COVER RAGE AREA= WEST LINE OF BLOCK 1, 1820 SOFT. OR 22.2 X SCHWANZ ADDITION LOT 6 SAN. SERV. ELEV.=889.0 46.00 46.00 ?- RIGHT OF ACCESS N00006'1 YE N00°06'13"E COUNTY of DAKOTA PER PLAT ^ N ^ EXISTING SIDEWALK C. S. A. H. N0. 31 - -III /\T It N I rN L)/\ A r\ 0 EFT o 0 Scale: 1"=30' Page 2 of 2 James R. Hill, Inc. Use BLUE or BLACK Ink r I For Office Use / City of EI I Permit Fee: Permit Fee: I i I 3830 Pilot Knob Road Eagan MN 55122 I Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 L Staff: 2/010 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: -r -O No Site Address: C /u Tenant: Suite RESIDENT/ OWNER Name: 7Cf d'U d` 'A y ~Q ~/L Phone: Address / City / Zip: 69 ~Unif co C f CONTRACTOR Name: t2~ ~iY(5 License g'y()Ll Address: 1-/!%d1 City: sli, State: IIJ A) Zip:$ Phone: , C G /76)0 C0k7j Contact: <~S e ~C~~'1f7JGl ? Email: Ci < Ca /-'-7 TYPE OF WORK _ New _ Replacement _ Repair _ Rebuild _ Modify Space Work in R.O.W. Description of work: cu Pn v- f PERMIT TYPE RESIDENTIAL Water Softener Water Heater Lawn Irrigation RPZ PVB) Add Plumbing Fixtures Main Lower Level) Septic System Water Turnaround _ New Abandonment RESIDENTIAL FEES; $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) *Water Turnaround (add $166.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ 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.goi3herstateoneGall.org 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. x "~7rke --5-6~i~saw ...-al( Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test _Gas Test Final May, 16. 2011 11:05AM gonyea company i nc No, 472$ P. 2 Use BLUE or BLACK Ink G~ I j Permit I City of Way Permit Fee,. I 3830 Pilot Knob Road 4(D01 Eagan MN 55122 Date Received; I I Phone: {651) 675-5675 ~ I Staff: l Fax: (651) 675-5694 a 1,0d I 4 2011 RESIDENTIAL. BU LDING PERMIT APPLICATION L Date., May site Address: 4ane Unit : / Name /'(CCI^tJ ~"'tlG~_ Y ! ' _ Phone 65 RESIDENT I N OWNER Address I City/ Zip: to n Applicant is: Owner _X Contractor T-f rl f TYPE OF WORK Description of work: ►'►?P~+'►1 - Construction Cost: 6 • co Multi-Family Building: (Yes~LNo Company: %1 e- Contact: CONTRACTOR Address: (QQ ~15bh rfG,~- City: l e e~~ _ _ Phone: state: Zip: 153-10 110 License Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING ANEW BUILDING In the last 12 months,, has the City of Eagan issued a permit for s 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: + tyarJl' ul her; slid, d to" udlic neat a ti,y'y'Fortion bf'i; 1s mft CAD af13 e 1 H, NOTE:'Pl~r~ `:and'.suppdr*d r0ciiriift 0 the' lhforrnatio~l:ttt j✓'be . At 1~l d asliidn=~ir; Ala y1 yda p► i~rt~b,`spe~i i~'r i 5oti ';that tNOi ld p r It the'Clty t4 f Cr rats. ttclube tli Nr :ar6;~rade'S~c r CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 46 hours before you intend to dig to receive locates of underground utilities, www.gopherstateonecall.ora 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 applicatlon for a permit, and work is not to start without a permit; that the work will be In aecvrdenea with the approved plan In the case of work which requires a review and approval of plans. x_ tan x .d~ Applicants Printed Name Applicant's Signature Page I of 3 uU NU I YVKI I t tftLUW THIS LINE r SUBTYPES 3169 _ Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage Single Family - Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) _ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) i Exterior Alteration (Multi) 01 of _ Plex Lower Level _ Pool _ Miscellaneous Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation - Replace - Repair _ Egress Window Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation' t ► Occupancy MCES System At" Plan Review Code Edition.1 SAC Units 100% (25%_- Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other Roof: -Ice & Water -Final Pool:. Footings Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath _Brick Fireplace: Rough In Air Test Final Windows Insulation Retaining Wall: - Footings _ Backfill _ Final Meter Size: Radon Control Erosion Control Reviewed By: . Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge STEW Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 2