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3940 Donegal WayWertif cote of ccc"ancv Witig of Cf agan Mou rtratnt of 8xitbing 3x0ection 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 cunifixMiann_ SF DWG Bidg. Permit No. 31733 O-P-cy Type R3 U 1 Zoning Dit+tr R 1 Type ConsI.N OW= of Bviwwng R A KOT fCHES Address 7644 1281H ST W, AME G&UEYC Buiwing Address 3440 DONEGAL WAY locality L21 B2 FAM % Date: POST IN A CONSPICUOUS PLACE INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: t t. n `ret; 3830 Pilot Knob Road Permit Number: ? Eagan, Minnesota 55122-1897 Date Issue (612) 681-4675 SITE ADDRESS: iJA v PERMIT SUBTYPE: APPLICANT: TYPE OF WOR INSPECTION TYPE DATE INSPTR INSPECTION TYPE . WENARKSs 5 1? W PI III, WFN7rt PLAN Rr-Vit1AV1) P'; NItF RAPC s Permit No. Permit Holder Date Tialephone M ELECTRIC PLUMBI HVAC C oZ -??S Inspection Date Inap. -j Comments u FOOTINGS Y/` /1195, l FOUND FRAMING q1j' /4g ROOFING ROUGH PLUMBING PLBG AIR TEST K lC C9 - - G?vl ROUGH HEATING GAS SVC TEST O I? e, ?ya?rLZt} o??,?J V ^/ INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PL.BG FINAL HTG /2 JQ 1 ORSAT TEST BLDG FINAL w?? BSMT R.I. BSMT FINAL DECK FTG DECK FINAL r __ I Addfe,4'* . Zip 55123_ Lot 21 Blk 2 Sub MURPHY FAR 4 THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: 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 V Deck t/ I 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 CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERMIT PERMIT TYPE: BUILDING Permit Number: 031733 Date Issued: 04/16/98 3940 DONEGAL WAY LOT: 21 BLOCK: 2 MURPHY FARM P.I.N.: 10-49500-210-02 DESCRIPTION: Bu' 11 h#U Permit Type =Building'Wprk Type USC Occupano Construction Type Zoning *1 Building Length Building Width :. 8uiiding,°Storie5 Square Y9 Fe`t SF DWG NEW R-3 U-1 V-N R-1 63 50. 2 2,106 101 1 - FAM. DETACH E: 4 nw Ac f I -?F;f } 17}E?'1 I} y? REMARKS: S & W PLBR - WENZEL PLAN REVIEWED BY MIKE BARCK FEE SUMMARY: VALUATION Base Fee Plan Review Surcharge SAC SAC % Il SAC Units Subtotal $1,272.25 $826.96 $88.50 $1,000.00 100 1 $3,187.71 $177,000 MISCELLANEOUS $1,592.50 Total Fee $4,780.21 CONTRACTOR: KOT HOMES, R A 7694 128TH APPLE VALLEY (612) 687-9513 - Applicant - ST. LI 16879513 000150 ST W MN 55124 L_ R A KOT HOMES INC 7694 128TH ST W APPLE VALLEY MN 55124 (612)687-9513 I hereby acknowledge that I have read this application and state that the information is correct and agree tojcp[4plygwi_" all app1i;cablp state,of .M In Statutes and City of Eagan 'Ordihan6es. APPLICANT/PERMITE-E 5 ATUR N a RJ1? Ill ISSUE Y:S NA RE .. i i tl I i 9 Y r i)I,i - ,•, I , d , , it '. in rl. ? ! ? I •. ?i??PMINW NQ Y38 i` S 04/17/90 TMEn 005M, ?draPRiir a ri I:C)7 HOMI S !NC; t 0256 AM AWO DONERAL WA 4,780.21, I: lI 81 ice.! I. .[=1' JPV L I i ,. .p J it .• I., Ili :I• ? •n•I.., g0a6T 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 Remodel/Repair Requirements 2 copies of plan ........................ .. nl Cerf oFSurueyRecd ' (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres P(a Recd Y _N, _ 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Requued in tid st O d S S ,,.; Y -PN _Y N I set of Energy Calculations Addition - indicate if on-site septic system s rts e ep : y ,_ ; 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Date (V / Site Address / 0 -7 L? U Con e a w Construction Cost 1go ? Unit/Ste # r 10? Description of Work T r ?aC7,- _ _ Y N Multi-Family Bldg Fireplace(s) 0 - 1 _ 2 Property Owner p n ,n rCCG?4! IJr?1'1Chett - p Telephone #(6.51 (0/ ?L1 Contractor ((?? ?? ?1 to t I?f71e( %CCI/?1 N ??f?Yl C0h' 1 CY Cf (j), S . . 34)c_ Address State 5 ag?) ? IL 010 (-( 0i R(:C M Al - * 100 Zip 55-3 5 7 City ?[ f YI?VI f?i° Telephone # (ice) 70;7, Egs9 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category I _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted . Energy Envelope Calculations Submitted in the fast 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? - Y - N If yes, date and address of master plan: 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 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 ? 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-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Yor_ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? .38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System Plan Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump ; # of Units Sq. Ft. PRV # 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 -Brick _ Fireplace - R.I. _ Air Test _ Final _ Windows Insulation _ 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 3998 BUILDING New Construction Requirements PERMIT APPLICATION (RESIDENTIAL) Ll CITY OF EAGAN / 3830 PD.OT KNOB RD - 55122 @ ?-? 681-4675 Remodel/Repair Requirements ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (include beam & window sizes; poured find. design; eta) ? 2 site surveys (exterior additions & decks) ? 1 energy calculations ? 1 energy calculations for heated additions ? 3 copies of tree preservation plan N lot platted after 711/93 required: _Yes _ No DATE: 44 1 IT7 n CONSTRUCTION COST; 2 S; a 0 0 DESCRIPTION OF WORK: 2es ide" aJ STREET ADDRESS: 3 9 `}-0- - 'j)o vt e? wa LOT: BLOCK: y SUBD./P.I.D. #: vMv h.? FaN Name: ?< p? ?C • / ] , Phone #: L g 7 9 ?? 3 PROPERTY Last First OWNER ST- Street Address: ? `' Z W F1 1 . l City reQ !/JIJ) , V a State: M N Zip: .-s/ Z Company: c- Phone #: 9 7- 9 J-?3 CONTRACTOR Street Address: y ) Z ?'^ S / KJ - ,License City 1jh (,- t/A ? State: A) Zip: S,-rl ARCHITECT( ENGINEER Company: ?)_. • L- S tq t.? Phone #: 6.87 .-g 5/ 3 Registration #: Street City State: Zip: I,v?t sitI Ae-?? Sewer & water licensed plumber (new construction only): malty and lot change is requested once permit is issued. applies when address chang I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant OFFICE USE Certificates of Survey Received Yes No Tree Preservation Plan Received - Yes - No ? Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex 1:(-02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-plex ? 05 SF Misc. ? 10 _-plex WORK TYPE k31 New ? 33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning ? 11 Apt./Lodging ? 16 Basement Finish ? 12 Mufti Repair/Rem. ? 17 Swim Pool ? 13 Garage/Accessory ? 20 Public Facility ? 14 Fireplace ? 21 Miscellaneous ? 15 Deck ? 36 Move ? 37 Demolition \/;,j Basement sq. ft. 13 3i MC/INS System i Jd Main level sq. ft. i 338 City Water 2 3 U-1 2 .a sq. ft. c l 3d Fire Sprinklered T CU,.e r sq. ft. '+e•5 PRV Z ?L sq. ft. Booster Pump L Z ' 8' sq. ft. Census Code. r e - ! Footprint sq. ft. '2,1 0G SAC Code + Census Bldg + Census Unit Building --? Engineering Permit Fee Valuation Surcharge , Plan Review -`" License ?8 Y 32. 2. s MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit + S/W Permit = z, .u S/W Surcharge Treatment Pl. Park Ded. ?- Trails Ded. - ti, a Other S 1 kC Units 33 u'z2 Variance $ 1-7,7 e)c)CQ. - 12- 7 S . S- + T2,- S?7.S r$ 2d cbe.S + 1?7. sq = -720 225, I -S -/, 5 rt A 5'/ r -77(- y2- 7 (? a rh 9 +lo 7?, z ? S, x l74 + Scav, ; LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION PROPERTY LEGAL: ( ? Lazy®? _ T DATE OF SURVEY: /?c1 _ LATEST REVISION: DOCUMENT STANDARDS °z t? ? ? • Registered Land Surveyor signature and company a-'? ? • Building Permit Applicant M ' ? • Legal description / a ? ? • Address o ? North arrow and scale 0 0 ? • House type (rambler, walkout, split w/o, split entry, lookout, etc.) r?? ? Directional drainage arrows with slope/gradient % ? [-' ? • Proposed/existing sewer and water services & invert elevation ca-? ? ? • Street name q-- ? ? • Driveway ELEVATIONS Existina ? 0?' ? • Sewer service (or Proposed) 0/ ? ? ? ? • Property corners f i T b t th d c cur op o a e r veway [?? ? Elevations of any existing adjacent homes Proposed El' ? ? Garage floor Er' ? ? First floor ? ? • Lowest exposed elevation (walkouttyAndow) ? ? Property corners ? ? • Front and rear of home at the foundation PONDING AREA (if applicable) ? 12 ? Easement line ? i1T, ? • NWL ? Q/ ? • HWL ? ? ? • Pond # designation ? ??'? • Emergency Overflow Elevation DIMENSIONS ? ? • Lot lines/Bearings & dimensions >0-'? ? • Right-of-way and street width (to back of curb) 0'0 ? • Proposed home dimensions including any proposed decks, overhangs greater than 7, porches, etc. (.e. all structures requiring permanent footings) Z'o ? Show all easements of record and any City utilities within those easements P?-- • Setbacks of proposed structure and sideyard setback of adjacent existing structures 13 ? Retaining wall requirements, if any Reviewed: Names /Da January 1996 CRAIG79adUMPRMr. FM EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION OWNER MIKE $ PATTY I3LANCIIETTE PLAN NO. 9-0908-7 SITE ADDRESS LOT 21, RLK. 2, MURPHY FARM CONTRAC'T'OR: R.A. KOT HOMES,TNC DATE 03/24/98 PHONE 687-9513 DETERMIME WORKING SQUARE FOOTAGE 3620.24 1. Total- exposed wall area 3665.8 sq.ft. x .11 403.238 2. Total. roof./ceiling area 1258 sq.ft x .025 32.708 3. Total floor cant. area 0 sq.ft. x 0.05 0 (over, unheated enclosed areas) 4. 'T'otal floor cant. area 2 sq.ft. x 0.025 0.05 (over unheated exposed areas) 5. Total. exposed wall area above the floor.. 3300.24 a. 'T`otal wall. window area...........`......... 355.88 b. Total door_ area ........................... 55.6278 c. Total sliding glass door area ............. 80.04 d. Total fireplace area ...................... 0 e. 'T'otal wall framing area (ave. 10%)........ 330.024 f. 'Dotal net wall area above the floor....... 2478.668 g. Total. rim joist area ...................... 320 TOTAL EXPOSED FOUNDATION AREA ................ 45.56 h. Total foundation window area .............. 0 i.. Total net foundation area ................. 45.56 Deter.mi.ne "U" value of each wall segment. a. 355.88 x "U" 0.41 145.9108 b. 55.6278 x "U" 0.06 = 3.337668 c. 80.04 x "U" 0.33 26.4132 d. 0 x "U" 0 = 0 e. 330.024 x "U" 0.097752 = 32.26041 f. 24'78.668 x "U" 0.044843 111.151 g. 320 x "U" 0.042123 = 13.47936 h. 0 x "U" 0.41 = 0 i. 45.56 x "U" 0.076161 = 3.469916 6 .....................................Total 336.0224 If item #6 is the same as or less than item #1 you have met the current energy codes. 2 MCAR 1.16008 A AND O. TOTAT, EXPOSED ROOF/CEILING AREA j. Total skyl_ighL area ....................... k. Total flat roof./ceiLing framing area...... 1.. Total neL flat. roof /ceiLing ar.ea.......... Determine "U" value for each roof/clg j. 0 x "till 0 = k. 125.8 x "0" 0.025549 1. 1132.2 x "U" 0.021801 = 1258 0 125.8 1132.2 segment 0 3.214103 24.6828 7 ...................................Total 27.8969 If item #7 is the same as or less than item #2 you have met the energy code. 2 MCAR 1.16008 A AND 0. TOTAL FLOOR CANT. AREA (enclosed). 0 o. Total floor cant. framing area (ave. 10%). 0 p. Total net insulated floor/cant. area...... 0 Dete.rmi.ne "U" value for each floor/cant. segment. o. 0 x "U" 0.047192 = 0 P. 0 x "U" 0.021622 = 0 8 ...................................Total 0 If item #8 is the same as or less than item #3 you have met the energy code. 2 MCAR 1.16008 A AND O. TOTAL FLOOR/CANT. AREA (exposed) 2 q. Total floor/cant. framing area (ave. 10%). 0.2 r. Total net insulated floor./cant. area...... 1.8 Determine "U" value for each floor/cant. segment. q. 0.2 x "U" 0.039793 = 0.007959 r. 1.8 x "U" 0.019924 = 0.035864 9 .............:.....................Total 0.043822 If item #9 is the same as or less than item #4 you have met the energy code. 2 MCAR 1.16008 A AND O. I HERESY CERTIFY THAT I HAVE CALCULATED THE "U" FACTORS AND "R" VALUES HEREIN AND THAT THE BU (DING HERDESCRIBED MEETS OR 1lCEEDS THE STATE OF MINNESOTA ENERG CONSER A I N ACT. / (signature) /9 99A 7da-°?? DETERMINE "U" VALUES" THRU STUD WITH SIDING & S.R. Interior Air...... 0.68 Sheet Rock........ 0.45 Thermo-Break...... 0 Stud .............. 6.93 Shthng(Bracerite). 1.22 Siding............ 0.78 Exterior Air...... 0.17 Total "R" Value... ......... 10.23 1/R = ''U'' Value ... ......... 0.097752 THRU INSULATION WITH SIDING & S.R. Interior Air...... 0.68 Sheet Rock........ 0.45 Thermo-Break...... 0 Insulation........ 19 Shthng(Bracerite). 1.22 Siding............ 0.78 Exterior Air...... 0.17 Total "R" Value............ 22.3 1/R = "U" Value ............ 0.044843 THRU CEILING MEMBER Interior Air...... 0.68 Sheet Rock........ 0.56 Ceiling Member.... 4.35 Insulation........ 32.92 Still Air......... 0.61 Total "R" Value............ 39.14 1/R = "U" Value ............ 0.025549 THRU CEILING INSULATION Interior Air...... 0.68 Sheet Rock........ 0.58 Insulation........ 44 Still Air......... 0.61 Total "R" Value............ 45.87 1/R = "U" Value ............ 0.021801 i THRU CONCRETE BLOCK Interior Ai.r...... conc. Blk......... Insulation........ Sheet Rk. (opt.). Exterior Air...... 0.68 1.28 11 0 (Add 0.45 0.17 Total "R" Value............ 13.13 1/R = "U" ..................0.076161 THRU RIM JOIST Interior Air...... Insulation........ Rim Joist......... Shthng(Bracerite). Siding............ Exterior Air...... 0.68 19 1.89 1.22 0.78 0.17 Total "R" Value............ 23.74 1/R = "U" ................ 0.042123 U" value for wi.ndow........ U" value for doors......... U" value for Patio Drs..... THRU CANT. @ MEMBER (enclosed) Interior air...... 0.68 Finish Flooring... 1.23 Shthng(Bracerite). 1.22 Plywood........... 0.93 Joist(W/2x4 Furr). 15.94 Sheet Rock........ 0.58 Still Air......... 0.61 0.41 0.06 0.33 't'otal "R" Value............ 21.19 1/R = "U" ..0.047192 THRU CANT. @ INSULATION (enclosed) Interior Air...... Finish Flooring... Shthng(Bracerite). Plywood........... Insulation........ Sheet Rock........ Still Air......... 0.68 1.23 1.22 0.93 41 0.58 0.61 Total "R" Value............ 46.25 1/R = "U" ..................0.021622 THRU CANT. @ MEMBER (exposed) (Assumes 2x10 Joists) Interior Air...... 0.68 Finish Flooring... 1.23 Underlayment...... 0 Plywood........... 0.93 Joist(W/2x4 Furr). 15.94 Shthng(3/4" RMAX). 5.4 Soffit............ 0.78 Exterior Air...... 0.17 Total "R" Value...... ...... 25.13 1/R = "U" ............ ......0.039793 THRU CANT. @ INSULATION (exposed) (Assumes 200 Joists) Interior Air...... 0.68 Finish Flooring... 1.23 Underlayment...... 0 Plywood........... 0.93 Insulation........ 41 Shthng(3/4" RMAX). 5.4 Soffit............ 0.78 Exterior Ai.r...... 0.17 Total "R" Value............ 50.19 1/R = "U" ..................0.019924 ANSWER THESE QUESTIONS ABOUT THE STRUCTURE. (in the case of windows and doors, round up to next foot.) 1. WHAT IS THE TOTAL LIN. FT. OF SECOND FLOOR RIM JOIST?...... 156 2. WHAT IS T HE TOTAL LIN. FT. OF FIRST FLOOR RIM JOIST?........ 164 3. HOW MANY LIN. FT. OF 1ST. FL. RIM HAS PARTIAL W/O BELOW?... 56 4. HOW MANY LIN. FT. OF 1ST. FL. RIM HAS FULL W/O BELOW?...... 40 5. WHAT IS THE TOTAL INSULATED CEILING SQ. FOOTAGE?........... 1258 6. HOW MANY PANES OF WINDOW GLASS ARE THERE? .................. 39 6A. HOW MANY 2' HIGH? ..............INCL'S TRANSOMS... 5 6B. HOW MANY 3' HIGH? ................................ 0 6C. HOW MANY 4' HIGH? ................................ 17 6D. HOW MANY 5' HIGH? ................................ 16 6E. HOW MANY 6'OR MORE HIGH? ......................... 1 7. HOW MANY 3FT. EXTERIOR DOORS ARE THERE? .................... 1 8. HOW MANY 218" EXTERIOR DOORS ARE THERE? .................... 2 9. HOW MANY SL. GLASS DRS. OR ATRIUM DRS. ARE THERE AT: 2 9A. 5'0" ............................................. 0 9B. 6'0" ............................................. 2 9C. 7'0" ............................................. 0 9D. 8'0" ............................................. 0 9E. 9'0" ............................................. 0 10. WHAT IS THE SQ. FOOTAGE OF SKYLIGHTS? ...................... 0 11. WHAT IS THE 1ST FL. SQ. FOOTAGE? .......................... 1256 12. WHAT IS THE SECOND FLOOR SQ. FOOTAGE? ...................... 1181 13. WHAT IS THE 1ST FLOOR CEILING HGT.? ........................ 8.17 14. WHAT IS THE 2ND FLOOR CEILING HGT.? ........................ 8.17 15. WHAT IS THE TOTAL ENCLOSED CANT. SQ.FT ..................... 0 16. WHAT IS THE TOTAL EXPOSED CANT. SQ.FT ...................... 2 17. WHAT IS THE TOTAL FOUNDATION WINDOW AREA ................... 0 ? CITY USE ONLY p p L c7V BL -I- RECEIPT #: S QJ' y RECEIPT DATE: 1998 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, III 55122 (612) 681-6675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH # TOTAL Shower 3.00 x .3.00 Water Closet 3.00 x .3 = w Bath Tub 3.00 x 12.? = 6.00 Lavatory 3.00 x .S' _ 16-.04 Kitchen Sink 3.00 x 30D Laundry Tray 3.00 x 3 cb Hot Tub/Spa 3.00 x = Water Heater 3.00 x -L = 3-60 Floor Drain 3.00 x 3.00 Gas Piping Outlet * minimum - t 3.00 x = 3-016 Rough Openings 1.50 x 3 = Water Softener * for dwellings under construction 5.00 x = Water Softener * for existing dwelling 20.00 x = U.G. Sprinkler * for dwelling under const. 3.00 = U.G. Sprinkler * for existing dwelling 20.00 = Alterations * to existing residence 20.00 = Water Turn Around 20.00 = Private Disposal System * MPC lic. 75.00 = (new and refurbished systems) Private Disposal Systems * Abandonment 20.00 = STATE SURCHARGE .50 TOTAL 5&-Q(_ - - ----------- ----reatl ------- ------------ - - ------ --- ----- - ------ ----------------------------- I hereby acknowledge at -I have this application, stale that the informatioc is - correct, - and - agree - to - compy - with all applicable City of Eagan ordinances. th It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement. SITE ADDRESS: ) v r OWNER NAME: INSTALLER NAME: iftd.,? [u' r»3d/ ???. TELEPHONE#: 5?3-3i,,q0 STREET ADDRESS: CITY: Jy .. of r STATEN ZIP: 33-01F SIGNATURE OF JS/FORMS BLDG/PLBG PERMIT (RESIDENTIAL) 1998 CITY USE ONLY LOT C-V BL RECEIPT #: SU RECEIPT DATE: 1998 MECHANICAL, PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN NN 55122 p (612) 681-4675 a / / o Date: Complete this section only if you are installing HVAC in single family, townhomes or condos under construction and not owner /occupied • -HVAC: 0-100 M B T U $ 24.00 ADDITIONAL 50 M BTU 6.00 i • Gas outlets (minimum of one required @ $3.00 ea.) 600 • State Surcharge: .50 • TOTAL: '?P<-1521) Complete this section only if you are remodeling, adding to, or repairing existing single family dwellings, townhomes, or condos. Note: Mechanical permit is not required for alteration/add-on to ductwork in existing residential units; but is required for the following: Install furnace Install air exchanger, i.e. Vanee system, etc. Minimum fee applies to all remodel or add-ons of existing residences State Surcharge SITE ADDRESS: Install air conditioning Other $ 20.00 .50 Total: $ 20.50 OWNER NAME: 9 Itr e9 / PHONE #: lPS ry- 9513. INSTALLER NAME: STREET ADDRESS: CITY: PHONE #: D 9 V-496&1! ISIFORMS BLDIMECH PERMIT (RES) - 1998 S ST : 1 NATURE OFPERMITTEE CITY USE ONLY L BL SUED. RECEIPT #: RECEIPT DATE: 1998 MECHANICAL PERMIT (COB CITY OF EAGAN 3830 PILOT XNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for. all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: 1% of contract price OR $25.00 minimum fee, whichever is greater. Processed piping - $25.00 CONTRACT PRICE x 1% PROCESSED PIPING PERMIT FEE STATESURCHARGE TOTAL --------------------------- SITE ADDRESS: ($.50 per $1,000 of permit fee due on all permits.) OWNER NAME: TENANT NAME (IMPROVEMENTS ONLY): INSTALLER: PHONE #: ADDRESS: PHONE #: CITY: SIGNATURE OF PERMITTEE STATE: ZIP: CITY INSPECTOR _ 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) .a CITY OF EAGAN 3830 PILOT KNOB RD - 55122 `-? 651-681-4675 pp??')}? .(? ?,V 2 New _l enh erher -?J a J C` Construction Reauhem Remodel/Reoair Rea D 3 registered she surveys showing sq. ff. of lot, sq. ff. of house and all roofed areas (20% maximum lot coverage allowed) 2 copies of plans (show beam a window sizes: poured fnd. design: etc.) D 1 set of energy calculations D 9 copies of tree preservation plan ti M platted offer 7/1/93 DATE: r- !f!'1- e9 I 2 copies of plan 1 set of energy calculations for heated additions 1 site survey for exterior additions a decks CONSTRUCTION COST: 9 ago Ga DESCRIPTION OF WORK: bti.GSC A iii// r 1ox-1 /JDM/' G a Ids y STREET ADDRESS: 39,(o LOT: BLOCK: SUED./P.I.D. #: PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER tf ?S?- 60 ??yZ- Name: ?SLRNG//,NTfii Vf Pn7rY Phone #: Last First Street Address:. 39yO 12011l146:4L W-4/ City l??l GA t4 Stale: Zip: SSA/Z y- e??? Companytil/iz J- T? oa?L Cm t Phone #: dry!- (area code) 3 Street Address: 1r6 3 L ?9 A,4 on/ ,gvrl y' License # Exp. city 1AM-4 ?i2odfs ?i?`/G rS State: Zip: Company Name: Telephone #: area code ( ) Street Address: Registration #: City State: Sewer a water licensed plumber (required for new construction only : Penalty applies when address change and lot change Is requested once permit is Issued. Zip: I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ??--? OFFICE USE ONLY A4y 9?tMs+'fu?.?y Certificates of Survey Received Tree Preservation Plan Received Yes No Yes No Not Required V OFFICE USE ONLY BUILDING PERMIT TYPE w + J. ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex kg? 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE ? 31 New ? 35 ? 32 Addition ? 36 ? 33 Alteration ? 37 ? 34 Repair ? 38 GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair Demolish (Interior) ? 42 Reroof * Give PCA handout to applicant for demolition permit Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Planning Building Permit Fee &0 Surcharge .5a Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit SAN Permit S1W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: o'0 SAC Units % SAC Census Code SAC Code No. of Units O No. of Bldgs a MC/ES System City Water Booster Pump PRV Fire Sprinkiered Engineering Variance Valuation: $ a 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN y p 9y 3830 PILOT KNOB RD - 55122 851.8814875 Now Construction Realremerds a,& i Cv 1&-OU W-GO CQlle? ??13?0? n 3 registered site surveys showing sq. iL of lot, sq. ff. Of house 2 copies of plan and gp roofed areas (=maximum lot coveraae aliowetll 1 set of energy calculations for heated additions D 2 copies of plans (show beam & window sizes; poured Ind design; etc.) 1 site survey for exterior additions & decks 1 set of energy calculations D 3 copies of tree preservation plan If lot platted after 7/1 /93 DATE: 7 ?Z l e9--ern CONSTRUCTION COST: t Yy. co DESCRIPTION OF WORK: STREET ADDRESS: g LOT: BLOCK: SUBD./P.I.D. is 1 U Name: 0 &,11 Z,2? P 77 ti Phone PROPERTY Lost First OWNER Street Address, City C? /?1I State: Zip: Company: 2 soil l O F? Phone 2 (area code) CONTRACTOR 7&L Street License Address:????rl? >? City State: ZIP: ARCHITECT/ ENGINEER Company Name: Telephone ft: ( ) Street Address: Registration: city State: Zip: Sewerfwater licensed plumber (if Installing sewerhrateA: Phone tk I hereby acknowledge that I have read this application, state that the information is correct, and agree to comp C/ ail applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _)Yes No ) .)Um T Tree Preservation Plan Received Yes No Not Required 'A6 OFFICE USE ONLY BUILDING PERMIT SUBTYPES ? 01 Foundation ? 07 05-ptex ? 02 SF Dwelling ? 08 06-plex ? 03 01 of _ plex ? 09 07-plex ? 04 02-plex ? 10 08-piex ? 05 03-pfex ? 11 10-plex ? 06 04-plex ? 12 12-plex WORK TYPE .'Zr 31 New ? 32 Addition ? 33 Alteration ? 34 Repair ? 13 16-plex ? ? 17 Garage ? ,)<J 18 Deck ? ? 19 Lower Level ? 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. ? 36 Move Bldg. ? 43 Reroof ? 37 Demolish (Bldg)* ? 44 Siding ? 38 Demolish (Interior) ? 45 Fire Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors * Give PCA handout to applicant for demolition permit GENERAL INFORMATION SAC Code 01 No. of Units 0 No. of Buildings _ I Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. MISCELLANEOUS INSPECTIONS ? Stucco/Stone APPROVALS Planning Building Engineering sq. ft. sq, ft. Footprint sq. ft. Census Code MC/ES System City W ater Booster Pump PRV Fire Sprinklered Variance r-. ? 31 Ext. Alt - Multi ? 33 Ext. Aft - SF ? 36 Mufti Permit Fee I4a . s a Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Park Ded. Trails Ded. Other Copies Total: -, 60.50 Valuation: $ SAC Units % SAC CITY OF EAGAN PERMIT 3830 PILOT KNOB RD EABAN, NN 55122 651-621-4617 WCH: 825 S-4 tX-s m4f-T 7?575m 80952340$21 REF: C " 14 5 lD Pe?E: VISA TR PPE: PIJWASE ii J: 37431 DATE: M 24, 99 14:17:31 TOTAL $60,59 ICCT: 4152 431W9U EXP: 6143 AF: T10? Kl: RA'y-hC;m O REhvw? CAQii E1`EP, NY'$HiVIRSES RECEIPT OF M ET?AC-ES iH 11E MTV If THE TUN 011:1 r-1 ArTEE TO DqO%l T"E icSli ; `cT F;. TH cY T11 r ;ut _iT it ,,H T E IS%U. T R-R :u'iR5 VISA IT „ n;r'}ai': '':•';Vil{',ihd la !.I ?i....?.1;..? i'r .:,.. ..?..1 .`i).:1(.. i. ..:,f:3^i.0 NINE .f;flt.. •.r.. ;1:1 z0 D ' :.d... alA Ed1 .f,i{) u °i(7 'r1:> . ,...._.3:1.171: 1 * * AIONI *e on Certificate of Survey for: NOTE: CONTRACTOR TO VERIFY SEWER SERVICE INVERT ELEV. PRIOR TO CONST. INV. NOT AVAIL. FROM CITY SER VICE. BppEpNpCH MARK ELEV? 909 26.E v/ Qf TA b ?' ry M JI Q 1908,1 I • I 10 ? ? 10 '- - 0 7 u 909.0 39 2$ 100' 3) 48'w 21 $F/ 9+ M / o ?a I Mal tV i? w W 1 2.670' d1a Wr go 7.1 904 6dw 13, 3 - I I . Z21 ? N I ? ? I ) I 910_4^-?+,,.-.- 1 i?1...1 10 BENCH MARK TOP OF PIPE 22 ELEV.=911.67 f NO'E: PROPOSED GRAPES SHOWN I'ER 0RF.044O PLAN BY: BRW NOTE: BUILDING OIMENSICNS SMOVM ARE FOR MORQON'fAL AND VERTICAL LOCATION EIF STRUCTURES ONLY, SEE ARCHIIEOTUAL FLA45 FOR BULDiNO AND FOUNDATION DIMENSIONS. 401E. NO SPECIFIC SOILS 'NVESTICATION HAS BFEN C?MPLETED ON THIS LOT BY THE SURVEYOR. THE SUITMU1Y OF SOILS 10 SUPP'IRT THE SPECIFIC HOUSE PROPOSED IS NOT THE RESPONSINRITY 01 THC SOR`/EYOR. 907.0 R99.5 ? 129.80 ; o) PROPOSEO HOUSE ELEVATION, LOMST FLOOR ELEVATION: 123•y TOP OF BLOCK CLEVATION: 113-3 GARAGE SLAB ELEVATION: g111W 401!. 'HIS CERTInCATE DOES NOT PURPORT TO SHOW EASEVENTS OTHER IMAM A DOD 00 DENOTES EIISTMC ELEV„ION TIIOSE SHOWM ON THE RECORDED PLAT. ( MO N 1 DF.NO?ES FROPOSCO ELEvANUn ROTE CONTRACTOR MUST V[R'FY DRIVEWAY DESIGN. PEN07CS ORANAOE AND UTILITY EAS_MENI DENOTES ORAINACE FLOW UINECfiON NO/E DEARINOS MOWN ARE RASED ON AN ASSUMED DATUM -0- DENOTES EION'J¢F.NI --g- DENOTES OFFSET HVe WE HEREBY CERTIFY TU R.A. KOT THAT THIS IS A TRUE AND CORRECT REPRESE?i;, 1019•. Q.?? SURVEY OF 1HE BOUNOARIES OF: ii'a?700A LOT 21, BLOCK 2, MURPHY FARM b. '...,4EWED DAKOTA COUNTY. MINNESOTA 77; % IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACFItAENT" gROEYED-BY ME OR UNDER MY DIRECT SUPERVISION THIS RO DAY OF PA CH, 1991,:-I. - .? "CALE : T INCH - 30 FEET UILD fi 97500.02 SINK John C. LDrson, L. $, Reg. NO. 1982,5- 1 0 , d FIANWITS• R.A. KOT 3940 DONEGAL WAY / 904.' i 2422 Enterp•;se Drive Mendota Heights, MN 55120 (812) 881-1914 FAX:881-9488 625 Highway 10 N.E.?x Bovine. MN 55434 (812) 783-1880 FAX:783-1883 fall F.E.G. INV.a89i1.0 •? 19 --- Q1 S /vi / l--1 f / I 2.0 I I 9097 o> off, •9 n_ Y` am Q• ? \ O \ 1 898.8 7.9 s 110 I 3, 7,? 55 q ?? I I E4 908.2 I 909.7 j? 9:15.0 i 0/30, 3 cT l 908 7 x 1 // IN I * * ** * PIONamp en _ -_ _ IAHp wA?(.ntc . nIAL EMN(EPt _ 1 nQer ng LANG 4.NrxPS. [AID}f,AP[ PPCNII[C4 or * * * 2422 Enterp,;Se Dnve Mendoto heights, MN 55170 (612) 681-1914 FAX:681-9488 675 Highway 10 N.E. Blaine, MN 55,134 (612) 783-1880 FAX: 783-1883 C;ertifiCote of survey for: R.A. KOT 3940 DONEGAL WAY NOTE: CONTRACTOR TO VERIFY SEWER SERVICE INVERT ELEV. PRIOR TO CONST. INV. NOT AVAIL. FROM CITY SER VICE BENCH MARK TOP OF Pip[ FLEV 909.26 C? Q ?~ /909.1 J r fJ T X 10 f L 904.9 ?r fab F.E.S. INV.=899.0-/' 1905.6 If 19 / 2.00 I JO 9097 18.C'QQQ o> 'a / Wd 1n 3 na 2,00 5 an `.1 6/? 0 909.0 39.3 q.3- 2 rA"") S89432A49"W BENCH MARK TOP OF PIPE ELEV.=911.67-'.-2- 2 017 f-ROPOSeD GRADES SHORN PEA .Rr.O';JD PLAN eY: EIRW TO'E' RU^_OINC OIMENSICNS SHOWN ARE roe HORcoN'FAL AND VERTICAL OVNOATCON DR!ENSIONS. E ARCHITE-rTL L FLA45 FOR SUko,NO AN UCA 11014 O,F. NO SPECIFIC 50x5 NYFSIICA DON HAS eF(N SURVEYOR THE SUIV,e1in CWPLETED ON THIS toy By THE Y PROF OF SOILS 10 SUPP-Al THE SPECIFIC H OSEO IS Nct ME FESPrNSMITY O. T`+E S;)RbEYOR. OUSE D„•+ ,WS CERTRCATE n105L sN DOES NOT PURPORT TO SHOW FASEMENTS THAN OMN oN THE RECOROrO PLAr OTHER 898.8 W N 899.5 A a PROPO 0 HO S F FVA*I,;, LOWEST FLOOR ELEVATION- !72-Lo- TOP OF BLOCK LLEVATION; Iti --- GARAGE SLAB ELEVATION: ITf CONTRAC 70R MUST x 000.00 DENOTES EEISD110 E:EW 9pN VCR," pR1y(WAr DESIGN. (DOD OO) OFNOTES PROPOSED ELEVAPON "E O[AIRNCS GOWH AR( eA SfO ON AN ASSUMED LA1VN _ DENOTES D.MAINAOE 4140 UTI ITY K ""-+•- DEN,JTES ORAINACE FLOW DIRECTION, A'EN, C HEREBY CER 11?Y fU R A K --?- RENO'ES NO.v7,1EnT IQVc/ OF 7H DT 'HA7 ?HIS IS A TRU - - OENorES OFFSET HU9 E BOUNDARIES OF: E ANp CORRECT REPRESEIIfigA'IOfP pp?,g )T 21, BLOCK 2, MURPHY FARM C" N61"P9?Etl? rank KOTA COUNTY, MINNESOTA a 6 Ill lp?y DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACF?AENT ??EE Y )Er7 My DIRECT SuPER14SP?N THIS RO DAY OF M CH, Y ME OR ALE 1 INCH L` I i --- 30 FFET /2';P- el"a LIJILD Wit EGOrW0 4NC;JEc INr,.1 p.A D7500.02 SWK To ._[ John C. Lmson, L.S..Reg. ICI 8;R r \ >azl?,/ Ito 5604 J4l', 908.2 8 I 909.7 i? 9;13.01 I e? Y d $a° /30.33 ??m $ AEI I i 1908 ?.,7 /&l,/ 21 gal / x b FCL zO&I 12.00 W?I 14.6Zy?l ! W 1 ?al m I t"I 910.4 I h to 907.0 129.60 * * * 41 * picklo12R UND WRV4YORf . nvL [NGINI * I?n? nCer ng LAND -uH.cRA• unrscAPE AAc Certificate of Survey for: _R.A. KOT 3940 DONE GAI. WAY NOTE: CONTRACTOR TO VERIFY SEWER / SERVICE INVERT ELEV. PRIOR / TO CONST. j 0049 i i 2422 EnterpT se Drive Merdata Heights, MN 55120 (812) 881-1914 FAX:881-9488 625 Highway 10 N.E. Blaine, MN 55434 (812) 783-1880 FAX:783-1883 ?QU F.E.S, INV.=898.0• INV. NOT AVAIL. FROM CITY SERVICE. ' \\ BENCH MARK TOP OF PIPE ELEV =909.26 ' / / I 10 007 /? 735s43gT'^ 908.2 909.7 _ Il.n 905 z .0 hry 1908 7 C0/ I ?1 /-. ' Y ^' I I c 2.1111 21 > e? 0. / ? nn ?a Q 30 909 7 ?i o N ?r< r o 18 CO 11 .00 wl '908.1 wa ,n/? 1907.1904,64=L rf a? 9 iv ,?? 13.3 Ri i aLGy{? o- 2.00 f2I 10 1 `.,,_ao l I ??? iTW i I p I I ! ? so nn/" 9104 909.0 _ 10 Dnn 7? _In_ r "I'l? S8932'48"W BENCH MARK 70P OF PIP= ELEV.=91T,g7-- _ IIa v7 5-' 907-0 129.60 22 r;01E: CIROPOSEO GRADES SHOWN PEN GRAO'NG PLAN BY: BRIN NOTE: SUILOINC DIMENSICNS SHOWN ARE FOR HORVON'TAL ANC VERTICAL LOCATION OF STRUCTURES ONLY. SEC ARCHITE'?TUAL PLANS FOR BU'-IDINO AND FOUNDATION NwENSIONS. NOTE: NO SPECIFIC SOILS INVESTIGATION HAS BEEN C IVPLETEO ON THIS LOT BY THE SURVEYOR. THE SUITABILITY OF SOILS TO SUPPORT THE SPECIFIC HOUSE j. PROPOSED IS NCT ME FESPCNSIBRJTY O` THE SURVEYOR. 898.8 ` got.°J 2 A7A W N in 10 P) PROPOSED HOUSE FLFVATIQ LOWEST FLOOR ELEVATION! 125 TOP OF BLOCK ELEVA7ION:1 GARAGE SLAB ELEVATION: 1T 4171: THIS CERTINCATE DOES NOT PURPORT TO SHOW EASEMENTS OTHER THAN x 000,00 DENOTES EzIST"IG ELEVATION THOSE SHO" 0"1 THE RECORDED PLAT. ( 00000 ) DENOTES PROPOSED ELEVATION NO1F CONTRACTOR MUST VERIFY DRIVEWAY OESIGN. - - - DENOTES ORA'NAGE AHD UTILITY EASSNENT DENOTES DRAINAGE FLOW DIRECTION NCIi BEARINGS SHOWN ARE RASED ON AN ASSUMED DATUN -1- DENOTES MONUNENT -$- DENOTES OFFSET HUD ? WE HEREBY CERTIFY TO R.A. KOT THAI THIS IS A TRUE AND CORRECT REPRESEN ? Fr,TI ? A SURVEY OF THE BOUNDARIES OF: tt rLrsvU LOT 21, BLOCK 2, MURPHY FARM 1 d D U U OAKOTA COUNTY, MINNESOTA ,T DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACOiNT-&-E-%6 / Y ME OR UNDER MY DIRECT SUPERVISION TWS RO DAY OF M CH, 199&jC C 1E???c /,Y f BUILD 5?`1 ?- E ICr9I?HLAtl HtNG.1 P. A. SCALE 1 INCH 30 FEET 72r 7l 97S00.07 SWV John C. Larson, L5. Reg. DIO. 1982A 10 *li 41!lb° City of Eaaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: 11 ccl 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: J (C ?:113 Site Address: Name: ' ` Ocn(eOte i/kc Unit#: L vire CZNIC) 2Cl e Phone: Address / City / Zip: 3C/ VC) d e---3 c€L " Applicant is: Owner X Contractor Description of work: f - rd5 One— cooed 5(J1 Le &) Construction Cost: P/)0010 Multi -Family Building: (Yes / Nox ) Company: Ceace( C u siorn 8G1 (10.6,6- �en�fy "ss/ / ZhC Contact: „cy rg P_G�S City: agetn'`-s1,1' le Address: 1 JO ` )i -&-`L k- Y q State: 'v Zip: 5-52D6 Phone: 7501-'d-6 d -✓`S License #: /66. % / � ' 3 Lead Certificate #: If the project is exempt from lead certification,tiplease 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: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public` information P.orttons of the information "may be classified as non-public if you provide specific reasons that would permit the City,i conclude that they are trade Secrets. ``"` _a. . 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.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. 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. drge 7adzYte Applicant's Printed Name x Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA176649 Date Issued:05/25/2022 Permit Category:ePermit Site Address: 3940 Donegal Way Lot:21 Block: 2 Addition: Murphy Farm PID:10-49500-02-210 Use: Description: Sub Type:Water Heater Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$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 - Michael D & Patricia Blanchette 3940 Donegal Way Eagan MN 55122--470 Applicant/Permitee: Signature Issued By: Signature