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4198 Countryside Dr. , . ,r .: «. . ? . •4 BUILDING PERMIT To be used for Sr 1 . _. t: -- . . .?.,,,;c•,. .,,:w,,w^. . . .. .. . r . . . .., .. . . ' ,.?.p?:;? ,? . CITY OF EAGAN ? 6? 0 ? 3830 Pilot'Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 ? v?Cz- Receipt # C 2957 Site Address 41111`6 UUUW[$TS? Lot I Block 1 Sec/Sub. Parcel No. W Name JOSEPli M MII.U ? Address 18133 CEDAR Ai O _. pAtrbTfliMVlv Name SANZ City Name _ Address Phone Occupancy ° 2oning (Actuaq Const IAllowable) # of Stories Length Depth S.F. Total S.F. Footprints On Site Sewage On Site Weil MWCC System City Water PRV Required I hereby acknowlege that I have read this application and state that the Booster Pump inlormation is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permitee APPRDVALS A euilding Permit is issued to: JO$EPIi !! MILLEjt CONST Planner on the express condition that all work shall be done in accordance with all Council applicable State oi Minnesota Statutes and City of Eagan Ordinances. gldj, pry. Building Official ' j Variance Phone V-11 .. . ?. _? V ? Bidg. Permit 636.00 - Surcharge 49•50 52' Plan Review 316,00 $41 sac, City 100000 - SAC, MCWCC 575'00 WaterConn 580•00 ?- Water Meter 40•00 xx AcCt. Deposit 30' 00 -jx SNY Permit 20'00 - SrWSurcharge 1*0D Treatment PI 228'00 ? Road Unit 340•oo - Park Ded. Copies 967.50 2 - TOTAL , PermH No. Permk Holder Date Telephone # WATER ? ? 7 O SEWER PIUMBING C/ ? O/A H.V.A.C. ELECTRIC Inspection Date insp. Comments Foo6ngs I (414 Foundation Framing ?jy tS Rooling Rough Plbg. Rough Htg. Isul. Firepiace f ???•? #1 Fnal Hlg. Final PIb9 40• 47..ti-. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan C r- ? C l 81dg. Final Deck Ftg. Oeck Final Well Pr. Disp. ja ! Q % ', CONTRACT PRICE: Site Address Lot Block ? m Name ? Address ' c City ?- ' Ph ? Name c Address p City Ph TYPE OF WORK Forced Air Boiler Unit Heater Air Cond. Vent Gas Piping Outlets # Other MECHANICAL PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN PHONE: 454.8100 M BTU M BTU M BTU ? M BTU CFM FEE: S/C: TOTAL: # '# DATE: For Office Use - BLDG. TYPE WORK DESCRIPTION , r , ?• Res. New M ult. Add-on Comm. Repair ,. Other FEES ; 00 t HVAC 0-100 M BTU -$24 RES . . ADDITIONAL 50 M BTU - 6.00 ? (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) 50 EA GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1 . . COMM/IND FEE - 1°r6 OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPUES TOWNHOUSE & CONDOS - RES. RATE APPl1ES MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8 REMODELS - 12.00 MINIMUM COMMERCIAL FEE - 20.00 ? STATE SURCHARGE PER PERMIT - .50 ADD $ 50 S/C IF PERMIT PRICE GOES . ( BEYOND $1,000) ? ? r; ? • i. - ' • - • " SIGNATURE OF PERMITTEE ' FOR: CITY OF EAGAN ? _ .... . . . .,;.?.,.,.:,.??,_ ? ? Site Addrsss ` / ? ? ?°L"?r •? ? "' '? Lot ? Block / SeedSub ' Name <- ? o? Addre?s c City Phone -? < Name 'C.-F c Add3kssTr -s p Phon4;!?E a!UU FEES COMM/IND FEE - 1% OF CONTRACT FEE APT. BL.DGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RA7E APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM - COMMlIND FEE - $20.Q0 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND.$?1,000.00) f' . ' 51GNATURE OF PERMITTEE I OF BLDG. TYPE WORK DESCRIFTION Res. ' New - Mult. Add-on Comm. Repair Other ? RES. PLBG. ONLY - COMPLETE THE FOLLOWING: Nl?. FIXTURES ? TOTA! "'`- Water Closet - $3.00 _ ?_ S 7 Bath Tubs - $3 00 . Lavatory - $3.00 ?Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - $3.00 --i-- ? Laundry Tray - $3.00 =Floor Drains - $1.50 ? Water Heater - $1.50 Whiripool - $3.00 = Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMin Softener - $5.00 Well - $10.00 Private Disp. - $10.00 ?- O $ 50 Rough penings - 1. FEE: STATE S/C: '.. GRAND TOTAL: - ? E ?.. 'ER & WATER PERMIT OF EAGAN Pilot Knob Rd. ?. Box 21199 `.t ?n, MN 55121 , STATE AIC• ?-? I - PERMIT DATE 7 120/''q WATER PERMIT #10564 SEWER PERMIT # METER ? 70o. B.P. RECEIPT # ; 2957 I R# 9? pd ?'? Y D B.P. RECEIPT DATE 7 j 141 ti9 METER SIZE ?$ Roclf I S S U E D A T E IQ? - 1-7-,0 )'==? P R V _ B O O S T E R P U M P ? y PERMIT REQUESTED _C/SUB ''t?- 'J , ? C2 A-EWER __?'WATER _ TAPS ' ' - COMM/IND /-RESIDENTIAL ZIP?V -k-NEW _ EXISTING Z?- ??J? r I AGREE TO COMPLY WITH CITY OF " ZiP EAGAN ORDiNANCES: ? OWNER: ADDRESS: SIG TURE WHEN TER ISSUED CITY, STATE ZIp PHONE: ? PIEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. .,_ _ . . . ` Address: 4198 ?YSIDE DRIVE Lot 1 Blk ] Sec/Sub COUNM HOLUpW These items were/were not complete at the time of the inal inspe ion. DATE: JANtIARY 10, 1991 Yes No INSPEC ? Final grade (6" from siding) Permanent steps - garage Permanent steps - main entry Permanent driveway Permanent gas Sod/seeded grass Trail/curb damage Porch Basement finish Deck Please verify with the builder the removal of roof test caps from the plwnbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. White - City copy Yellow - Resident copy Pink - Contractor copy • - • . , ? ?Ross ?XP?s? ` / !•5 X C34+34+4?0?-9?0? 'r ??7?r?4? ??. .- •?71? C34t34+?t?, ="-Iol.Zo f?? ? T . . - ... . , 83 1,1 C34f3¢-f?v?-4?? _ . 13Z.go ? wldwws Ilnx3(o = 4-.0 x 4=- Ilo. o0 ZOX3lo = 5, v ;e, (v -= 30.00 24 x3(v =?v.o X?}- = Z4. o0 2¢)48 )c Cv = ? 9S.ao ZvX4,o _ 0-7 go ..?:...., •a• :.? ? . ,.?_..,?y!¢A:?O ? _ . . . ., l. ?? . 3' ST?• wf 5L. _ . 2S,vo ' . Z? 57L? 5E? = Z?•t?0 (v ° PA r/o = oo . ' ?f •DO ? . 1?6T &Xpe,S w,gL?' ? Z?Zo•oo , G?S? ?'o?c , 107. z o ?475. ga , i, 1?pw ? 144, So . . . 00 V 184. zo . . . ? , , ..?.... _ . . . .. • YAZE ?* = 1n 69 8 x8 - ?4 RESIDENTIAL ' BUILDING PERMIT APPLICATION 3830 PILIOT KNOB RD - 55122 1/0,o0 651-681-4675 ?J 2 NewConstructionReauirements RemodellReoairReauiremenfs Call? / ?/ " ? • 3 registered site surveys showing sq. ft. of lol, sq. ft. of house; and all roafed areas • 2 copies of plan ? (20% mazimum lol wverage allowed) . t set of Energy Calculatiore for heffied additions • 2 copies of plan showing 6eam &window saes; pou2d found design, etc.) . 1 site survey forexlenoraddNons & decks • 1 set of Energy Calculatbre . Indicate'rf lwme served by septic system for additiore • 3 copies of Tree Preservatbn Plan H lot platted after 7l1193 • Rim Joist Detaa Optiore selection sheel (61dgs with 3 or less units) DATE VALUATION JOB SITE ADDRESS ???GD?a?-/,eSSa e ??? IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER??.P TYPE OF WORK?o%tCi4c? FIREPLACE(S) _ 0_ 1_ 2 Y?6-l ?S 7 APPLICANT PHONE# 65il- ADDRESS ZIPCODES PAGER # # 7 rI FAX # NE1V RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category MINNESOTA RULES 7670 CATEGOR (?? (check one) - Residential Ventilation Category 1 Worksheet ?tt?tl - Energy Envelope Calculations Submitted D _ MINNESOTA RULES 7672 1 A New Energy Code Worksheet Submitted Plumbing Contractor. _ Plumbing SysCem Includes: Mechanical Contractor: Mechanical System Includes: Sewer/Water Contractor. Water Softener Water Heater No. of Balhs Air Conditioning Heat Recovery System Phone # Phone # Fce: $70.00 All a6ove information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordi nces. Signature of Applicanf, Certifcates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 1/01 Phone #: Lawn Sprinkler Tee: $90.00 No. of R.I. Baths OFFICE U5E ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace O 21 Porch (3-sea.) ? 03 01 of _ plex 13 09 07-plex O 17 Garage ? 22 PorchlAddn. (4-sea.) ? 04 02-plex ? 10 08-plex f?18 Deck 13 23 Porch (screened) ? 05 03-plex ? 11 10-plex ? 19 Lower l.evel ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 32 Addition ? 33 Alteretion ? 34 Replacement ?g.. ? 30 Accessory Bldg ? 31 Eut. Alt- Multi ? 33 6d. Alt - SF ? 36 Multi ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding O 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair 0 37 Demolish (Bldg)" ? 43 Raraof ? 46 Windows/Doors *Demolltion (Entire Bldg only) - Give PCA handout to applicant Valuation o?OOp ?O`-61 Census Code Y C/ SAC Units Nbr. of Units ? Nbr. of Bldgs Type of Const Occupancy /?_z MC/ES System Zoning /V ? City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered W idth REQUIRED INSPECTIONS Footings (new bldg) ?_b Footings (deck) FinaUNo C.O. _ Footings (addirion) Plumbing Foundation Drain Tile Roof Ice & Water Final Other _ Framing _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Swne _ Insularion _ Windows (new/replacement) Appraved By ?6 , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total FinaUC.O. ? HVAC I 57 "' RESIDENTIAL BUILDING PERMIT APPLICATION ? CITY OF EAGAN ? ?j (D ??? 3830 PILOT KNOB RD, EAGAN MN 55122 851-881-4875 New Conatructlon Beaulrements pemoEeVFlanelr Bequlrements • 3 repisleretl stte wrieys showing sq. tt. of ht, sq.1t. W house; antl AD roofed areas . 2 copies of plan ' (20%meximumbtcoveregealbwed) • lsetofEnargyCakulatansforheatedaaaAbns • 2 copies of plan shaxing beam 8 winCOw sizes; poured found UesIgn, etc.) . 1 sAe survey for exterior add'Abns & decks . 1 set of Energy Calalatlons • Indicate If home servetl by septic system Inr atld'Abns • 3 capias of Tree Preservetbn Plen tl lot platted afler 7/1193 • Rim ,bisl Defall Optbns selectlon sheet (bidgs wiN 3 or less unMS) DATE 2k A7 VALUATION-700 SITE ADDRESS 1796 Co.,.,.,I„ , s;&, 112. MULTI-FAMILY BLDG _ Y K N TYPE OF WORK Raroo.?' FIREPLACE(S) _ 0_ 1_ 2 APPLICANT A teipwz or -rqc ?'rtw,«r X,,. STREETADDRESS 11041 /oa*l fibE ,dW NJ CITYNIapc? G?r? STATE / u ZIP 5r?r6 P TELEPHONE # 763- ?.?3aa y CELL PHONE # 61d- vS?6-6uP0 FAX #?E?-`t?- ys? PROPERTY OWNER 61o,V Fars? _TR TELEPHONE # 3223 ------° °-----------------------------------°--------------------------------------------°-- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RiJI,ES 7670 CATEGORY 1 M (d submission type) • Residentiai Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Conhactor: Phone # i Plumbing system includes: _ Water Softener _ Iawn Sprinkler Water Heater _ No. of RI. Baths No. of Baths Mechanlcal Conhactor: Mechanical system includes: Sewer/Wafer Contractor: - Air Conditionin° _ Heak Recovery System Phone # Phone q MAY 2 1 2002 Fee: $70.00 --------------------------------°---------•^------------------------------------°----------------------------°----°--- I hereby aCknowledge that I have read this application, state that The information is correct, and agree to comply with all applicable STate of Minnesota Stcrfutes and City of Eagan Ordinances. SignalureofApplicant QLL a<a.??,?seFTrfg ---°-°---°° --......... _......... ..-°......... _.__ OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4l02 . 1989 BSTILDIBG PENMiIT APPLICATION ' CTTY OF EbGAN 11??0( 3INGLE FAMILY DiIELLINGS 2 3ET3 OF PLANS 3 RE6ISTEltED SITE SOR9EY3 1 SET OP ENEAGY CALCS. !lULTIPLE DIiELLINGS AENTAL UNITS COlBiERCIAL 2 SETS OF ARCHTfECl'URAL & STHOCTORIL PLANS 1 SET OF SPECIFIC9TIONS 1 SET OF 88EAG1 CALC3. FOH SALE DRTT3 / OF QNITS 60TEt LDDRF53FS P06 CORNER LOT3 - CONY'RACTOR/HOMEOWNEA !lOST DE4IGN9TE iiHICB iDDAFSS IS DFSIRED. AO CAdAGES AII.L BE ILLOWED ONCE BDILDII9f3 PERlSIT 13 ISSOED.. SEWER 6 W9TER PfilH+II'£ FEES lND ACCOONT DEP0.RIT lEFS iiILL Sfi INCLDDED iiITH THE HUILDING PERMIT FEE. PROCESSING TIME FOR SEViEA !HD W9TER PE9MIi3 I3 Ti10 DAYS ONCE A PERMTT HA3 BEEA COMPLETED INDICATIHG A LICENSED PLDMBEA. PENALTY IPPLIE.% 61HENs PERMIT IS NOT PAID FOR IP1 S9ME MOPTTH IT IS REQIIESTED. LOT CHANGE I3 REQUESTED 0@ICE PERMIT IS ISSUED. To Be llsed For: Site Address Z/ lIIILTIPLE DIiELLINGS 2 3ETS OF PL9A3 AEGISTfiRED 3ITE SDA9ET3 - (CflECb YITH BLDG DI9.) f SBt OF EAEAGY CALC3. Valuatio?t??7,=? Date: Lot I Block Parcel/SubL?f2L? Owner 6ddress City/Zip Code Phone Contractor AddI'eS9 . ( ?9 oo0? ? .?r.,? ,,.?o ,...,.. Occupaney R_3 M_i FEES Zoning V ,-N, Aetual Const Bldg. Permit 636.ao Allowable Sureharge y9.50 # of stories Plan Revierr ,Da Length 5L' SAC, City 100.00 Depth SAC, MWCC 5'7 .oo S.F. Total Water Conn SRa, a? Footprint S.F. ilater Meter qo,oo On slte aexage ? On site xell ? MWCC System ? Cit water v /Im . v ..- City/Zip Code -=/??? iPPA0V9LS Phone Planner Couneil Arch./Engr. Bldg. Off. Yariance Address City/Zip Code Acet. Deposit D w S/Yi Permit d['+.00 S/il Sureharge 1,00 Treatment P1. a ,a Road Unit 4o 40 Park Ded. Lvn Copies SQBTOTAL Penalty SOTAL ? tKt7/Z ? ? 0 / so Phone 9 , CITY OF EAGAN N2 16801 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-6100 ' BUILDING PERMIT Receipt # C 2957 - To be used for SF DWG/GAR Est. Value $99,000 Date J1fi Y] 4 , 19$9 C Site Address 4198 COUNTRYSIDE DR ? Lot -L Block ?L Sec/Sub. COUNTRY HOLLOW Parcel No. w Name JOSEPH M MILLER CONSTRUCTION 3 Address 18133 CEDAR AVE S ° City FARMINGTON phone 431-2001 E o Name _ $: Address ? CIIy _ Phone ?W Name ?gAddress aw City Phone I hereby acknowlege thall have read Ihis applicafion and state thatthe intormation is correct and agree to comply with all applicable State of Minnesota Slatutes and City of Eagan Ordinances. SignaWre of Permitee A Building Permit is issued to: JOSEPH M MILLER CONST on the ezpre55 Condition that ali work 5hall be done in accordance with all applicable State of Minnesota StaWtes and City of Eagan Ortlinances. Builtling OHicial u'?..v Cy • Y`: ,p OFFICE USE ONLV Oaupancy R-3 -M--J FEES Zaning V-N (ACtual) Const V-N Bldg. Parmit 636.00 (Allowable) - Surcharge 0 49.5 +v ol Stories - 318 00 Lenglh 52' Plan Review . Depih 54? SAGCity 100•0? S.F.TOtal - SAC.MCWCC 575.0 O ? S.F. Footprinis - 580 00 On Site Sewage _ Water Conn . On Site Well . Water Meter 0 90.0 Mwcc sy:tam YX Acct. Deposil 0 30.0 Ciry Water X PRV Required xx S/W Permit 20.0? Booster Pump - SM/ Surcharge 1.0 ? Treatment PI 0 228.0 APPflOYALS qoad Unit 340 _ 00 Planner - park Ded. Council -. BIOgAfl. _ Copies Variance - TO7AL 2.967.50 % I (gtx#ifirafr of """rrupanry Citp of Cagan / lot'mu1Mtt of Ww"M jt16}iPttittt[ This Certifiaale i.xrued pursuartt mlhe requ'vemenu ojSectioa 306 ojfhe UniJorni Building Code ceRifldn8 tlwl at the time ojrssuance rhis sfruclure Kas u compl'wnce with the varrous ordinanoer ojthe Cyry regula6ng buildLig oonarnruion or use For rhe follawing: v,eclik'al Crr na^_9r.eR ew8.w?nw. IhAfll Oon"„W7ra R'i/MI zmivs pko;a VN ryacMm V'T p„W,fg„lfiv '9'iQr.R7 M_ 1f1T71R Add? IAI'1-4 (7tf1AR AVR C, FA*MGIdN POST W A CONSPICUOUS PUCE , ulrx vr' BUILDIHa llEPAf2'PHliNT q . kXTERIOR ENVELOPE AVERA(lE IIUII C0I4PUTATION . 4 (To be suhmStted with building permit application) One or mwo Family Dwelling Owner All Other Contractor );e?{ ?jLLE? `01yS? LINEAL FEET OF ?? !f ' EXPOSED Yl1tLL ?` ?E . tt-.0DIZK qE? f t. Site Addraes LDT ?. 6LocK I _ ? Date Phone above grade = 2 5ZO•00 ? 'TOTAL EXPOSED VYALL AREA SQ. FT. OPAQuE WALL CONSTRUCTIONs "Ull Value x Area Detaii FR,40)E itull .043 X •se,. reference 01M& t -itUll ' 0740 x SR• from ?IN? lipll x SQ. npo x SQ, attached iipn x SQ, sheete npn x SQ. FT. I •LO. 77, (7(U)(A) FT. Jo7!7-p= 0.19 (U) (A) FT. 132.So= S•i l SU) (A) FT. (U)(1t) FT. - (U)(A) FT. _ (U) (A) WINDOWSS "Ull Value x Area Plalce & Type eSIJI'r 'lUll • Q'$ x SQ. FT. HQ-.$O= ?09,SO (U)(p) " 't liUll x Sq . FT. _ (U)(A) u n uQu x , 5Q. FT. - (U)(A) " ° IIUII x SQ. FT. - (U)(A) DOORS: "II" Value x Area Ilalce & Type _?-l(LM16Lr "U" .14' X SQ. ii u -?nn ,Q7 x BQ. n n upu x SQ. n u _ nUu x SQ. ToTnz,s 23ZO.00 s@, At/ERADE "Ull TOTAL (ll)(A) VALUE5 ' J?jCd S? _ AIVIDED BY TOTAL 1'iALL AREA Z320iOD AVEIZAOE "U ,115 lesa for 1&2 family dwellings ROOF/CEILIN(I s TOTAL AREA: Z(p0T FT. 9,0V _ (O, BCP (U) (A) FT. 4zioa (U)(A) F'T. - , (U) (A) FT. - (U)(A) r•T. I88•Slo (u) (a) Detail reference IIUII-- pOLt x SQ. FT. Ju00 = 2(0+ ?ll)(A) from ilUto x Sq. FT. ? (U) (A) attached sheete, lollto x SQ. FT. - (U)(A) Describe openinga IIUII x SQ. FT. - (U)(A) in roof. 'IUII x SQ. FT. - (U)(A) TOTAL (U)(A) YALUES DIVIDED BY 21o?ti,CO 7O-r4? ??tl N•ft x&"'-ff0`U(A) ? TOTAL ROOF/CEILIN(1 AREA I2?00 •d?j AVERA(lE VOUI? ,025 or ventilated roofa. - , SJ?/?'y 9..3.? ?s P 212 72 ,c/ / .?? z? Request Date Fire No. . Ro ? n Inspedion ' 7_'Z 8_$(? R ir d4 ? Reatly Pbw Will Notity Inspedor ?es ? No ?en Ready? I licensed contractor ? owner hereby request inspection of above electrical work at: Jab Mtlress (Sheep Box or Route NoJ City 4198 Countryside Drive Eagan Section No. Township Name or No. qange No. Counry Dakota Occupant (PRINT) Phorre No. Joe Miller Construction Co. 431-2001 PawerSupplier Address Dakota Electric Farmin ton, MN 55024 Elecincal Conhapor (COmpany Name) Comractor§ Lkense Na. Alidland Electric Inc. 041610 Mailing AEdress (COmractor or pwner Making Installation) 14055 Grand Ave So, Suite E, Burnsville, MN 55337 AWM1?' Conlraclor/Ower Makirg Ins Ilati 7 hone Number 7 892-6688 MINNESOTA STATE BOAqO OF ELECTRICITV ?THIS INSPECTION REQUEST WILL NOT Grtgga-Midway Bltlg. - qpum 5173 BE ACCEPTED BY THE ST.4TE BOARD 1821 Univerelty Ave., St. Peul, b1N 55101 UNLESS PqOPER INSPECTION FEE IS PhoM(812)642-0Bp0 ENCLOSED. g///ryn, _ REQUEST FOR ELECTRICAL INSPECTION ee-ooool-o7 ? d 7 lir See insVUCtions !ar mmplefirg ihis tortn on beck of yellow copy. ~• ??i3/)J r? n. 2 1 C 7 L 'J(° Below Work Cavered bv This RmuP.ct ew Adtl Rep. - TypeofBUiltling - AppliancesWired - --i EquipmenlWired Home Range Temporary Service Duplex Water Heater Electric Heating Ap[. Building ?ryer Other (Specity) Comm./Indus[rial Purnace Farm Air Contli[ioner Ol?er (spec?y) Contrac[or9 Ramarks: Compute lnspectian Fee Befow: # Other Fee # ServiceEntrance 5ize Fee # Cirai[s/Feeders Fee Swimming Pool Transformers D to 200 Amps A6ove 200 _ Amps to 700 Amps A?Inve-794_ Amps Signs Inspecrorg Use only: - TOTAL Irrigation 8ooms Special Inspec[ion ? S AlarmlCommunication O[her Fee I, the Electrical Inspector, hereby certify that the above inspection has ' been made. RO°9n-'n ? Date ? Final ? ? ? [OFi.FICE USE ONLY reques[ wid 18 months fmm -' ? 'Determining "Ull valuee at Roofs Wall, Rimt And Conc. I3loclc RooF/CEII,INa R VAI.UE I.) Interior Air N'i1m 0,61 2.) 5/81, aYP. ad. .56 . 3.) Ineulation 41" 00 4.1 . 5.) Exterior dir Film .61 (STILL) 'lull _ ,/n, , oz! ToTni. (R)= g-,5-,7g ..-r-- , .?--- _ WALL 6.) Interior Air Film 7.) P ayn. sa. 8.) Insulation '9.) .??rca=Ptrr 10.) hiaeonita Siding 11.) Extarior Air Film R VALUE 0.68 .ii5 19?ov .61. .17 n1ln = ll?='-. ' ? ? TOT1lL (R)= RIIt 12.) Interior Air Film 13.) Insulation 111,) 211 Fir Rim Joiat 15. ) .Pvlt-r? rr7'F 16.) Ffasonite 5iding 17.) Exterior Air Film [t VAI,UE 0.68 19,00 1.88 ? 67 .17 upn = 1/R= TOTAL (A)= .._.t._ T FOUIIDATION R VAI,U 180 Interior Air Film 0.68 i9.) zo.? K-!1 yTKW!'eA //O° 21.) 12't Concre ta Bloclc 1.28 22.) 23.) Exterior nir Fxiro .17 nUn = ,/R= , p7(D TQTRL (H)= / M32-- t95-89 , . =- LD I ? Q? ? ? ? ? N q p ! / X ,.; f ra..' ...• K7 ? _ !:!. I ? •?:: •, ; F ? CERT/f/CATE OF srnVEr 14z , o 0 ? 26,00 -y- 1 L'4f1.1 ? Q 6 00 ? -? .? a s IA 10 I \ I ? Aa? ( 26`00/?'" vi I?? N. d q? ? io - o o 30 ?-_- 142,2 S N g6°ss'33°?' 5cale: .? N ? < 1 49' , DESCRIPTION / NEREBY C£RT/f Y TNAT TH/S SGPVEY, R.AN 044 Rf/'A4T Ws15 PR£PAR£O BY ME OR UNDEH MY D/RECr SwERV/S/OW ANO TNAT I AM A DULY Rf'G/STER£O LAND SURVEI'C)YP UNAER TN£ LAWS Of' THE STAr£ AF M/NN£SOrA. o.+rE ,yEr. nro 8140 Lot 1, Block 1, COUNTRY.IIOLLOW Dakota County, Minnesota Plat bearings shown o Denotes iron monument, l? Denetes right-ef-access ClExist ng, Proposed r brondt anginaaring 11 iurvayln- 2705 woodt trail burn.rvilla, minnarote 55337 (VIZ) 4351966 M3a -i9s-B4 M3 2- l95 -a9 CERT/F/CATE / L??r 1!??? 3 o ( ?? / U ? ? Q I ?i??? ry a f H? ?i V N p - o C% 2 3o f I 142.2 S JV g6°SS'33??1' Scale: 1" = 30' "RE L?Evv ? p By Da n EAGA1V EIVGIPI ERI DESCRIPTION Lot 1, Block 1, COUNTRY HOLLOl4 Dakota County, Minnesota / N£R£BY Cf/9T/FY THAT tH/S SU4VFY ftAN OR RfP0Y9T Wi1S PREPARED BY M£ ON UHDER MY D/NECT SwERV/S/QM ANO THAr! AM A AULY REG/ST£RED LAND S(/RYEYqq uroaER rHf cAWs oF rHE sr.er€ cF Mea,vt-sora. OATE S'_?s RtG M0. 8140 Plat bearings shown o Denotes iron monument 0 Denotes right-of-access _ ?Exist n, Proposed P.R.V. REQMOG°3E10 brondt anglnaaring P. rurvaying 2705 uroodi trAil burniuilla, minnarota 55337 (bIR) 435 -I966 of ArvvEr vi ' 142.0 0 rtQon- o_ _ T i?"?) N .?d 26.00 ry I ? ld 1 ? U I ` I c? Q? ? N !. 4 8 .ai I -..7 _ L--J z ? v - - /113z -195-$9 Use BLUE or BLACK Ink r For Office Use Permit City of Ea ~,"`n I Permit Fee: J 05-~ 3830 Pilot Knob Road I c~ t~' I Eagan MN 55122 Date Received: ! e 13 Phone: (651) 675-5675 I 2 1 Fax: (651) 675-5694 1 Staff: I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit lys Y Name: G Cep ter. Phone: 05_1-ti 56- Resident/ c(l4uti < Owner Address/ City /Zip: 's I a. Applicant is: Owner Contractor Description of work: CCI_. 1, c r z, >v~' O c~J~ ~y,cr/r_w_.•~Gs Type of Work Construction Cost: 1 ~~UUZ}. Multi-Family Building: (Yes / No Company: V-r J o4 +i-_ F ~ ~ Contact: Js4u :~~Yr.v" Contractor Address: I L) c ( (00 Yom. Iq city: ~lJ~ V ✓°-K State: *1-1 44 Zip: Phone: G l '`cr d L License (3C3 I oC7 0 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 A NEW BUILDING I 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 submi_t 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 i 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.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. x l 1AgL6 11[e- en_% App icant's Printed Name Applicant's Signature Page 1 of 3