4152 Countryview DrINSPECTION RECURD C°ntr°l "°. 0015
CITY OF EAGAN PERMIT TYPE: nIf i?I'f I "N
3830 Pilot Knob Road Perrnit Number: 000001
Eagan, Minnesota 55123 Date Issued: 0311Z/ g2
(612) 681-4675
SITE ADDRESS: I u F 3 6 $1 flc9 :.3 APPLICANT:
41r;1 cou"rl;•rvtEN AR Ev?t??. .,irpc? +? NEs rr+G
Cb!UNTRY HOl I ?IW ?i1Q (61x)Z496-Z]4H
PERMIT SUBTYPE:
-ir E,t,ii
TYPE OF WORK:
IN ri4
INSPECTION
Ati I I t?ii, .
'ftAll?Nf? ..
N?yu1 p! taw rNA?
IWV['t At f i
'•: ? < t ; +k,,,? - F s ;r ? ? f ??r ,
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`
- `? • 1'l r ? tni ;? 47
- ? ,? ??.?-+,ti?, _ #- - ? ?
?l ?
=-
_..?j
?
3
`- -- - ------------- 14
5
- ----------__.___...__._.__._ _??
Permft No. PormR Holder Dge Telephons N
sm '
PLUMBING 3-,3W
HVAC ?' - l?,e?3-•S77S]
ELECTRIC
ELECTRIC
Inspeetion ate Insp. comments
F°°fi"9s I 3?a ?y? uJ ?
Foundalion
FmmirV y ? 9z N
Roofing
RouO Plbg.
Rwo HW. ?
FirWtace r4W`/. z2? ?s psr ??
Flrtel Htg.
? i
Orsat Test
Flnal Pfbg. ,.?,(t? ul/,
A/A7 Plbg. Inspector - NotNy Plumber
Const. Meter
EngrJPian
Bldg. Flnal
Dedc Ftg.
Dedc Final 7,..0
w?l
c:o i-+.s?- vc.PC
s
??
Pr. Disp.
?6`0 I
/ ' ?d
?I./,?
? , • , GITY OF EACAN '
3810 PIIAT KNOB 1t0AD
? FACAN, t^: 55222
PHONE; (612) 454-8100
? PLUM BING PEItHIZ'
?..:.:; : .......:.:..:.::;..: . .::: ,,...:;.v
FOR CITY USE ONLY
PERMZT 0
RECEIPT N ? S?-
DATE :
`
.. ,. .?
?.lDENTYI?:, PLEASE COHPLETE UPPER PORTION ONLY
.;«;, ....
......... :..:,a...::.:? . FOR SINGLE FAMILY AWELLI NCS &
.
.
TOVNHOMES/CONDOS fiHEN PER?IITS ARE REQUIRED FOa EACH UNIT.
------------------------ --------------------------------------------- ------ ------
WORK DESCRIPTION COMPLETE THE FOLLOSJING:
NQ, FIXTURES EA. TOTAL
NEw coNST ? ADD-aN MiNiMUM 15.00
ADD ON ? StIOWER 3.00 3•°c)
REPAIR a- WATER CLOSET 3.00 ?.0 ?
? BAT1I -TUB 3.00 (• o0
\
?-S
w
evk
S?1?
E
N
l
r `?
T? LAVATORY
KITCHEN SINK 3.00
00
3
3?- °J
q
OWN
R
N
E:
-
-- .
T
IAUNDRY TRAY
3.00
3:0 a
S 1TE ADDRESS : 4 1 SA' U i AA-! \ I?, HOT TUB/SPA 3.00
?? ?
?/? _
L
WATER HEATER
3.00 o 0
3
° v
LdT: ? BLOCK .3 SUBD a 7 F1AOR DFtAIN 3.00 •
CAS PIPING OUT.
Matthew Daniels
INSTALLER: ? (MINIMUH - 1) 3.00
ROUGH OPENINGS 1.50
15185 Carousel Way
ADDRESS: _
_ OTNER
WATER SOFTENER 5.00
CITY• ?s??t 2ip; 55068 pRIVATE DISP. 15.00 . '
U.G. SPRINKLER 3.00 #; ' 423-3734
;2 -7 '
. ' SUnTOTAL S
CJLs- )y ST. SURCHARCE .50
SICNA URE OF PERMITTEE a-? .?--U
TOTAL: ?
COt'fl1ERCIAL/"INDIJSTRZAU PLEASE COHPLETE THIS PORTION FOR ALL COMHERCIAL/INDUSTRIAL BUILDINCS AND
MULTI-FAHILY BUZLDINCS W![EN SEPARATE PER}SITS ARE NOT AEQUIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE:
01,TNER NAME:
SITE ADDRESS:
LOT: BLOCK SUO-D.
INSTALLER:
ADDRESS
CITY: ZIP:
PNONE #;
FEES
1% OF CONTRACT FEE. '
STATE SURC}iARGE - $.50 FaR
EACH $1.000 OF PERMIT FEE.
$25.00 HINIMUM FEE.
CONTRACT PRICE x 1= $ -
STATE SURCHARGE, $
TOTAL:
(SICNATURE)
FOR:
C I 1'Y 6f. EACAN
, ? ,
a-
DATE: MAR 16 1992
RE: 4152.COUNTRYVIEW DR (EVERLASTING HOMES INC)
X Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed untfl further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- RE(iUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
V!71 Building Inspections Depi.
__
SEWER & WATER PERMIT OFFICE USE ONLY p3 / 13 /92
CI'TY OF EAGAN METER # Q PERMITDATE 39
3830 Pilot Knob Rd. - CH?P # PERMIT #
Eagan, MN 55122-1897 5 B_P. RECEIPT # C 017741
METER SIZE
ISSUE OATE i Z B.P. RECEIPT DATE 03 /12/92
DATE ?? 13 1992 X PRV _.BOOSTERPUMP
4152 COUNTRYVIEW DR PERMIT REGIUESTED
SITE ADDRESS COUNTRY HOLLOW 2ND
LOT 6 BLOCK 3 SEC/SUB X SEWER X WATER - TAPS
APPUCANT:.
ADDRESS:_
CITY, STATE
PHONE: _
COMMrIND x RE5IDENTIAL
ZIP x NEW - EXISTING
? PLUMBER: MATTliEW DANIELS INC
15185 CAROUSEL WAY
ADDRESS: ROSEMOUNT MN ZIp 55068
CITY, STATE
423-3730
PHONE:
?
EVERLASTING HQMES INC
OWNER: P 0 BOX 914
ADDRESS: BURNSVILLE MN Zlp 55337
STATE
CITY
, 435-2148
DurIAIF•
PROCESSING. CALL
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
COMPLY WITH CITY OF
METER ISSUED
FOR INSPECTIONS. FOR
SEWER PERMITS, CONTACT
RFCORD OF COl?PLAINT
Date
Complaint taken by 0 m
Type of buflding
Name
Addres
L,egal description -
Phone number f Lb - bq3 r
Complaint ?
Action taken
Comments
.......?.. Signamre
GAS WORK ORDER
1072 Payne Ave. cq?ml DARD
St 51/772-2449101 ATING0
& AIR COMDITIONING
LAST
410 W. Lake St.
Minneapolis, MN 55408
612/824-2656
A Blue Do ; Service Co. EQUIPMENT INFORMATION
jC`??? FIRST ADDRESS `f t 5 Z 60C/n7-v y l/,. e?v
?
cirY ziP i Z 3
HM PH 6-?!- WK)P-li 1c-
TECH DATE
,
TYPE
MAKE ? ??' 091
MODEL 3,?'3 ??
SERIAL3 7q 9/4 / ,3 `
INPUT ff,cC/VI
r" ORSAT TEST RECORD
C02 % METERED INPUT Cfh CHIMNEY TYPE DUPr - T'
02 g °k LIMIT SETTING 17 ° FLUE SIZE If1.
0 % PILOT OUTAGE?n ?,ir./, -i j sec CONNECTOR SIZE in.
NET STACK TEMP 3 6O ° TOTAL CHIMNEY INPUT I3 b CIUG btUh
..?*1 15 0X -
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-687-4675
New ConsW etion Reauirementt
• 3 registered site surveys showing sq. ft. af lot, aq. fL ot house; end all roofed areas
(20% mazimum lot cmerage allowed)
• 2 copies of plan showing beam & window sizes; poured found design, atc.)
• 1 set of Energy Calculations
• 3 copies of Tree Preserva6on Plan if lot platted after 711193
• Rim Jaist Detail Op6ons selecGan sheet (bldgs wAh 3 or less units)
DATE y' 16 " 0 02
SITE ADDRESS 415-a- Co u n17Yty Ul EM/ h2 _ MULTI-FAMILY BLDG _ Y -XN
TYPE OF WORK_ FtNi5 N B R Sr M-e Nr- FIREPLACE(S) ?C 0 _ 1_ 2
APPUCANT j r ep MY N"
STREETADDRESS q 1 S2 CoLA? 9 7-9-y JI EuJ 0iL CI'ry EEr& A-n/ STATE MA/ZIP 23
TELEPHONE#L?-1-6f8-166YCELLPHONE# 6tz-q78-Zylb FAX#
PROPERTYOWNER ?'AYN/LF TELEPHONE# ????6P$'[66?/
?s.?i- cr2-1,78-ZM16
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RUI.CS 7670 CATEGORY 1 MINNESO"CA RULES 7672
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
. Energy Envelope Calcula6ons Submitted
Plumbing Contractor: __
Plumbing system includes:
Mechanical Contractor:
Mechanical system includcs:
Sewer/Water Contractor.
Water Softcner
Water Hcater
No. of Baths
Air Conditioning
Heat Recovery Systcm
Phone #
Fee: $90.00
?
i
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 Ordinancej.j j
Signature of Applicant
OFFICE USE ONLY
VALUATION
RemodellReoair Reauirements
. 2 copies af plan
• 1 set of Energy Calwlations for heated addilions
• isitesurveyforexterbradditions&decks
• Indicate if home served by septic system for add'N'ons
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
Phone
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-piex ? 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 (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Yor_ N ? 25 Miscellaneous
? 31 New Az__99 ? Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
?< 33 Alteratlon ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement "Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation ot , Ova Occupancy R-3 MGES System
Census Code Zoning _ City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const v W idth
REQUIRED INSPECTIONS
Foorings(new bldg) FinaUC.O.
_
_ Footings (deck) 71: FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation }v HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tesu _ Final
? Framing _ Siding Stucco Stone
Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
? Insulation _ Retaining Wall
Approved By iin , Building Inspector
-?
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
W ater Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
113, 75
RESIDENTIAL
y3 BUILDING PERMIT APPLICATION
EAGAN
PILOT KNOB RD,EAGAN MN 55122 <( J•???
? 651-681-4875
NewConaWCtbn Naaulrements pemadeVReoeir Heouiremente
• 3 regWered sfte surveys ftwing sq. R of ht, 5q. it. of house; and all roofetl areas • 2 copies of plan
(200k ma)imum bt coverage albwed) • 1 set of Energy Calculations loi heateG addiUOns
• 2 copies of plan showing 6eam & wintlow sizes; poured fourM Aesign, etc.) . 1 Site survey for exlerior additions & decks
• 7 set of Energy CaWlatbns • Indicate 8 home served by septic syslem fw addttbns
• 3 coDlas of Tree Preservatbn Plan if lot platled aNer 7/1/93
• Rim Joist Detail Options seled'an sheat (bldgs with 3 or less unAS)
DATE (p I l2- LC) z_. VA4UATION , tI qOO, 00
SITE ADDRESS MULTI-FAMILY BLDG _ Y VN
n ?
TYPE OF
FIREPLACE(S) _ 0 _ 1 _ 2
9 t,g
APPLICANT LJ ec.AN&,in: (
STREETADDRESS -7 Me.nFV,.;.l A-rM, /U CIN 14r STATE_O ZIPM?3
TELEPHONE # (n'S(-439 -'I340CELL PHONE #
FAX# 6 Sf-351 - 291 (a
PROPERTY OWNER -? e?? /1?v???e.• TELEPHONE # (a51- lodf9- 4,61W
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RT_iLES 7670 CATEGORY 1 MINNESOTA RULES 7672
(d aubmission type) • Residantial Venfilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
PlumbMg ConfraCtor. ___
Plumbing system includes:
Mechankal Conhactor:
Mechanical system includes:
Sewer/Wafer Conhactor:
Water Softener
Water Heater
_ No. of Baths
_ Air Conditioning
_ Heat Recovery System
Phone #
Phone #
Fee: $90.00
Fee: $70.00
---------°----
I hereby acknowledge that f have read this applicatlon, state ihat the information is correct, and agree to comply
with all appllcable State of Minnesoto Statutes and City of Eagan Ordinances,
Signafure ofApplicant Ahz_L--
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
_ Phone #
Iawn Sprinkler
No. of R.I. Baths
Updated 4102
. e . _ . } ?. ?
` (Irx#ifirate of (Orrupanry-
A • , Citp of (eagan ;.
MPpt?hIYri1 of gitIIDUm jwPdlDlt
? This CertlJfcale issued pursuant 1o the requiremenu ojSection 306 ojthe Unrjomr Bullding
? Code cemljying rhat af Me time oji.ssuance this suuclure kas in rnmplianct wlth 1ke warious
ortinancev oJthe GYty regula6ng building construcNon or use For rhe jolJowing.
? U,, SF I7eG/GAR m4 n?t Nm 07 ' o,MW„-Y Tppe R3/M1 ,mba DWM RI _ .ry?cMI VN
o? otei.u?KEVM.ASrIIVG IiM INC. Ad. P.O: &pC 914, &]I@1SYILSS;
? 152 CWNMNIW DHIVE 9 B3„MW1ItY HXdIOW ?Nm
aw s/zi/vz
,-
._;
1 . - POST IN A CANSPoCUOU8 PtACE:; .
i ?
Addzess: '4152 CAi1NTRYVIEW DRIVE Lot( Blk 3 Sec/Subr,pUNTRy Hplj,pW 2Np
These items were/were not complete at the time of the final inspection.
Date: 5I21/92 Yes No
Final grade (6" from siding) ?
Permanent steps - gatage ?
Permanent steps - main entry
Permanent driveway ?
Permanent gas
Sod/seeded grass
Trail/curb damage ?
Porch (Z
Basement finish
Deck
Pleasa verify vith tha huilder tha ramoval of roof test caps from the plumbing
system and tha shut-off of water supply to the outside lawn faucet before
freeze potential esists. ?
, ana.o?.
White - City copy Yellow - Residentcopy Pink.- Contractor copy
PERMIT ? Control No. 0015
CITY Or EA-02AN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
'PERMIT TYPE:
Permit Number.
Date Issued:
BUILDING
000007
03/12/92
SITE ADDRESS:
4152 COUNTRYVIEW DR
LOT: 6 BLOCK: 3
COUN7RY HOLLOW 2N0
DESCRIPTION:
Building Permit Type
euilding Work Type
UBC Occupancy
Construction Type
Zoning
Building Length
Building Width
SF DW6
NEW
R-3 M-1
V-N
R-1
42
48
REMARKS:
? -t? 'C bm`{ j
FEE SUMMARY:
VALUATION
Base fee
Plan Review
Surcharge
SAC
SAC 8
SAC Units
Subtotal
$581.00
$377.65
$43.50
$700.00
100
1
$1,702.15
$87,000
S & W PERMIT
S & W SURCHARGE
ACCOUNT DEPOSIT
LICEN3E SEARCH
MISCELLANEOUS
COPIES
Total Fee
$30.00
$.50
$3@.@0
$5.00
$1,550.00
$1.00
$3,318.65
CONTRACTOR: - Applicant - S7. I. OWNER:
EVERLASTINfs HOMES INC 14352148 00030 4 EVERLAS7INC, HOMES INC
P 0 BOX 914 P 0 BOX 914
BURNSVILLE MN 55337 BURNSVILLE MN 55337
(612) 435-2148 (612)435-2148
I heraby acknowledge that I have read this applioation and state that the
information is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
?
I
c /-L --_ zl gz, 6---- 4a R D,l? I rn
APPLICANT/PEflMITEE SIGNATIJRE 1rSIGNAT?
cirY oF Eac,aN
1992 BUILDING PERMIT APPLICATION
681-4675 4AR p 6 p
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made ar lot chan e is re uested once ermit is issued.
Date _ / SD- Valuation af work f22?3 r??
Site Location: L-IAIAXiIixoAx
STREET STE Y
Tenant Name: Z_
LOT ? BLOCK 3 SUBD. 7 //6 "dj p, I . D. #
Descri tion of work:
The applicant is: ? Owner ? Contractor ? Other (Describe)
Name ?4,
t' /'_"- ,`G/_ Phone
Property b
LasT FIRST
OWner
pddress
STREET STE If
City State 2ip
Company .Z,vC _ Phone ?/3S-,-9/Yec-
Contractor Address '0 O, Q6 k 'l'7 ?V License #
City l'7 ?In. ?.C u, .1 /5i' State ti1 Zip SS .?,P 2
Company Phone
Architect/
Engineer Name Registration #
Address
City State 2ip
Sewer & water licensed plumber f ' . Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Si
t
f
l
?
?
gna
ure o
App
icant:
e
#
BUILDING PERMIT TYPE
? 01 Foundation
fl3?02 Single Family
? 03 Two-family
? 04 Multi-fam. T.H.
? 05 Apt. Bldg.
WORK TYPE
d90 New
? 91 Addition
? 92 Alterations
OFFICE USE ONLY
? 06 Garage/Accessory
? 07 Fireplace
? 08 Deck
? 09 Basement Finish
? 10 Swim Pool
? 93 Remodel
? 94 Repair
? 95 Tenant Finish
GENERAL INFORMATION
Occupancy
Zoning
Const. (Actual
(Allowable;
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REGIUIRED INSPECTIONS
?TSite
? Wallboard
Building
Variance
ET Footing
"P Final
A Framing
O Draintile
,0- Insulation
O Fireplace
Permit Fee 591
Surcharge
Plan Review ,
License
MWCC SAC 700
City SAC ioo
Water Conn. ?7s
Water Meter
Road Unit 3 go
Treatment-Pl., 3pB
R63d-tlM
w 3 n .
PgTk-B2?f: ?Svpr"• _ Sp
T••"r •-r''s-?oea':ACcfi
Copies ?.mo
Other
?
Total: 3 3 f?. ?-a
SAC %
SAC Units
Valuatim: s U' /
?owe1 <<vel3
3 $ G'7 = 9 95, NG
/yl, 3G
v?r ?e?r?S
y6
,?
?z? z zY
S,?rz / 2
G?Y
Assessments
1?912/,ea
ks-3
kl6 ?
,PSG 3. z
?'?? 396/y
? 11 Res. Add./Porch
? 12 Comn./Ind. New
? 13 Comm./Ind. Add
? 14 Comm./Ind. Rem
? 15 Public Fac.
O 96 Move
? 97 Demolish
? 99 Undefined
--@asemen t sq. ft.
? vff?.
1 sq. ft.
nd F
. sq. ft.
? Sq. Ft. total
Footpri nt Sq. ft.
On-site well
On-site sewage
ti
Vi
J .
4
O 16 Agricultural
? 17 Building Move
? 18 Demolition
? 20 Miscellaneous
MWCC System
//67 City Water
PRV Requ9red ?
Booster Pump
Fire Sprinkter
Census Code ??
SAC Code 0 /
MAR-02-1992 16:00 FROM TO 16124320475 P.01
« • ONS AND TWO PA!lILY
ENERGY CALCULATIONS - AVSRAC*E "U" COMPUTATIOH
LoT(-, 5L?43 mnw
ATE:
Z
3/2/92
01iN 8R: BARTp$ SITE ADDRBSS:"hu?l?/a
?bS
t iw
,?
EN PHONE: 451-1419
R
CONTitACTOR: EVBRLASTIHG CALCUL.ATIONS BY
netermine merking square footage of each that applies.
1. Total expased wali area .............2521.7 sq. ft. x 0.110
x 0
026
ft s277.39
= 30.68
2.. Total roof/ceiling area ............. 1180 sg.
0 .
.
x 0.050
ft - 0.00
3. sq.
Floors over unheatad space..........
0 s .
x 0.026
ft s 0.00
a. q.
Raaf/ceiling atea (no attic_sgace)..
0 s .
x 0.150
ft - 0.00
5. q,
Vnhsated slab ou qrade ..............
0 a .
x 0.120
ft - 0.00
5. q.
gtate8 slsb on grade ................ .
TOTAL w00D 9YAI,L AREA 2384.50
a Total wall window area........... 185.00
.
b. Total door atea•••••••••••••I •••. 35
33
c. Total glass door area............ .
d. Total firepldce wall area........ 127
$?
g. Total xim joist area ............. :
igg,05
F. Total wall framinq area..........
46
1791
q. Total net aall area ahove floor.. .
TOTAL SRPa3ED F'OUNDATION ARffiA 137.27
h 'rotal foundation window area........... 14.93
.
f Total net 4oundation area abave grade.. 122.84
.
J. Total unheated slab on gzade area...... p;
k.
Total
heated slab on grada area........ oo
Deteraiine *U" value of each wall seqment
a. 185,00 x "U" 0.360 = 66.60
35
3
b 47.82 x ^u^ 0.070 = .
.
C 33.35 x "U" 0.360 ? 12.01
.
a_ 0.00 x °U" ? 55
5
e. 127.$2 x "?3" 0.043 - .
£. 199.05 x "U" 0.106 - $?-98
1791.46 X "U"
" 0.045 ? 00
0
h. 14.43 x "U _ ,
59
7
i 122.84 x "U° Q•Q62 ` .
.
0.00
x
"u°
' 0.00
g, 0.00 x "U" a
L a 0.00
19.18
7 ............ ........................... TOPA
If item t7 is the eame as, or less than item p1, you ha e me the
intent of 8HC 6006(c)2•
NOTE: FDUNDATION 4IALL5
Fuil basem4nt (Rambler) entire exterior wall must be not less than
R-5.
galf hasement (Split Payer) entire exterior wa2l must be not less
than R-10.
-- =--- - - - - - - - - - - - - - - - - - - - - - ----
MRR=02-1992 16:01 FROM TD 16124320475 P.62
?
TOTAL LXPQSSL? ROOF/CEILING ARBA 1180
1. Total skylight area... .
m. Total roof/Cailfng fsaming?area..????•118
n. Total net insulated roof/ceiling area.. 1062
Determine °-U" value for each roof/ceiling seqment.
I- 0 x°U" = 0.00
a• 118 x°U° 0.028 = 3.36
n. 1062 x"U" 4.025 = 26,70
5 .......................................Tatal - 30•05' >
If the total oE #8 is the same as, or less than #2, you,have me£-
the intent of SBC 6006(c)1. -- -
To utilize the total envelope system method, the valaes
e6tahlished by the sum of items #7 and #8 shall not be
qreater than the sum pf items #1 and #a.
ieIALL SBCTIONB
"U°a Z/R
WALL FRA!lYNG ARSA CdAigTgUCTiON R-Vaiue
1. intetior air film 0.68
2- 1/2" Gyp. scl. 0.45
3. 5-1/21nches sqft vrood 6.84
4. 7/16" OSB 0.67
5. Vinyi Sidinq 0.62
6. Exterior air film 0,17
Total 9.43
"U" Value 0,106
N8T WALL ARSA ABOVE E'LOUR
1. interior air fiim 0.68
2. 1/2" Gyp. Bd. 0.45
3. F/G zns. 19.00
4. 7/16" ass 0.67
5. Vinyl Sidinq 0.62
6. Exterior air film 0.17
Tatal 21.59
nUn vdlilB 0.046
RIM 30IST ARBA
1. Zaterior air fflm 0,68
2. F/G Ins. 19.00
3. 1-1/2" softmaad 1.89
4. 7/16" pSH 0.57
5. Vfnyl Siding 0,62
6. Exteri.or afr film 0.17
Total 23.03
"U" Value 0.043
--------------------------------------- --
MRR=02-1992 16:02 FROM TO 161243^c0475 P.03
FOUNDATION ARSA ABOVS GRADE
1. Intexior air film 0.68
2. r/G xnsul. 13.00
3. 101 Conc. Blk . 2.33
4.
5. -
6. Exterfor air film 0.17
Total
"U" Value
ApOF/CfiILING FAANIING AABA
l. Interior air film 0.51
2. 5/6" Gyp. Hd. 0.56
3. Cord depth 3-1/2" 4.38
4. iasnlation 29.00
5. Sxtesior air film 0.61
Total
^U" value
TN$ULATSD R
1.
a.
3.
4.
DOF/CBILING ARSA
intetior air film 0.61
5/8" Gyp. Sd. 0.56
Insulation 38.00
Sxterfor air film 0.61
Total
"u" Vaiue
16.18
0.062
35.16
0.428
39.78
0_025
TOTAL P.03
CIT'Y OF EAGAN
L-L- B 3 MECHANICAL PERMTT RECIIP'P #?? 5 07 ?
SUBD. (612) 681-4675 DATE 3 a? -
RESIDE1V17AL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, COMPLEI'E FOR
TOWNHOMFS/CONDOS R'HEN SEPARATE PERMTfS ARE REQUIRED FOR EACH DWELI.IIVG UNTT.
ORTTER: "XS
SITE AD RFSS: ADD ON/REMODEL (ERIST'IIdG S 15.00
?? CONSTRUCfION ONLM
HVAC: 0-100 M BTU 24.00
IADDTI'IONAL 50 M BTU 6.00
ADDRBSS: ! Ik67 /A Y711 / Ct I I11,.J GAS OUTLETS - MIHIMUM 1@ $3 EA.
I CI1'Y: W SURCHARGE $ .50 I
11 TOTAL:
SIGNATUV& /i nl n:
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAIJINDUSTRIAI. BUILDINGS. AL50 COMPLEfE FOR
APARTMENT BUILDINGS OR OTIIER MULTI-FAMILY BUILDINGS R'HEN SEPARATE PERhII1S ARE NOT REQUIRED FOR
EACH DWELLING UNIT.
WORK DESCRIPTION: II CONTRACT PRICE: IFEES
196 OF CONTRACT FEE. I
STATE SURCAARGE IS $•SU FOR EACH I
$1,000 OF PERMTl' FEE.
PROCFSSED PIPING ;525•00 r'
Ia
hiINIMUM FEE - $25.00
F
OWNER:
SITE ADDRFSS:
1'ENANT:
SUITE #:
INSTALLER:
ADDRFSS:
CTiT:
PHONE #:
SIGNATURE:
TOTAL: I $
ZIP:
CITY SIGNATURE.
. ? ?
J/07,9'-/ ;? -,4-
16505/_& ra3 ?
- ?,. /0so2 0%
arId- ??58400
Request Date Fire
7? ough-in Inspection
equlretl?
? Reatly Now ?Will Notity Inspector
y?_? es ? No When Peatly?
IRI licensed contractor ? owner hereby reque5t inspection of above electrical work at:
Job Atldress (SVeet. Box or Roule Na.? -
S
/ P City
?Gi cfl/f
?
, w
Secl on No. Townshi0 Name or No. Range No. COuny
0, /
?? _'
Occupam (PRINT)
Cvcr a, s?is? o?t(es' Phone Na.
Power Supplier Pdtlress
Elechical Con racror (GO ny Namel ConVaqorS License No. "' 3
Mailing qtltlress (ConVac[or or Owner Making Instal Lon) /.? Dd2 Fi';?rrc?r- Z&4? fjui-A s
Aulhorizetl S?gnat I nVac IhJwme' 71 1 Ilation) Phone Numbe,
nrvcsoiw VTqiE BOAFO OF ELECTRICITY/ THIS INSPECTIDN FEQUEST WILL NOT
Griggs-Miaway Bltlg. - qoom 5-173
BE ACCEPTED
1821 UNVetnity Ave., 51. Paul, MN 55100 9V THE STATE BOARD
UNLE55 PROP
Phone(614) 6C2-0800 ER INSPECTION FEE IS
ENCLOSEO.
.
3 a,,?i C??, REQUEST FOR ELECTRICAL INSPECTION
/ t`? a
Es,ooomae ?
?
q See nsvuctions br completing this lorm on Dack ol yellow copy.
? ?
\
?I
a`
"X" Belaw Work Covered bv This Reauest
J 1 ? O?
ew Atltl Rep. TypeolBUilding AppliancesWired EpuipmeniWiretl
Home Range Temporary Service
Duplex Water Heater Electric Heating
ApL Building Oryer Other (Specify)
Commlindustrial Furnace
Farm Air Contlitioner
Olher(syecily) Convactor's Remarks'
Compute Inspectian Fee Below:
M Other Fee # ServiceEntranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 ro 26B-Amps /$?0 g° v 0 to i00 Amps
Transformers Above 200 _ Amps Ab _ Amps
Signs Inspector's Use Only. OTAL ?/
Irrigation Booms
•
S
i
l v
pec
a
Inspection
Alarm/COmmunication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fea COMPLETED WITHIN 18 S. r
I, the Electrical Inspector, hereby
certiTy that the above inspection has
been made. Rougn-in a ?
oa?e
OFFICE USE ONIY
This request voitl 18 months Imm
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
. r • CITY OF EACAN -
? 3830 PILOT KNOB RD - 55122
651-681-4675
New ConsWCtlon ReauiremeMs RemodeUReoafr ReautremeMs
? 3 regktered ske turvays ehowinp sq. %o11ot, sq. R of house 2 copks of plan
and II roofed arees (20% ma:imum lot rnveraae albwed) 7 set ol energy alculatioos kr heated addilionw
D 2 copies of plans (sAow beam 6 windaw aizes; poured ind. deaign; atc.) 7 ake cuney Por axterfor aAdilfons & decke
? 7eetofenergyukuladons
D 3 wpiea of hae precervetion plan M lot pWtted aRer 711193
DATE: 7"%=7 CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREETADDRESS: Y,/ -5 ? CvvivT,eY !?//=w lJi?rdiz
LOT: ? BLOCK: ? SUBDJP.I.D. #: C G Y'?Y H o( l ? w ar?
Name: , t 11>,2/.f,< //YLG.1 Phone i: Z d?- ? y'7
PROPERTY Ust Firt
OWNER
StreetAddress: I// iaw J.711 'vff
Qity (S/aGnN State: Zip:
' /(jj;J?/?NJ I?GC
Company:%?1z l?rCG?i Dc-3"? <e . /i,c Phone#: 52-
(area eode)
CONTRACTOR
Street Address: / 7 J ?
,p G, z
12 License #rVY?7---.Exp. "
City/NG?.??tG.eo.i/c State: Zjp;3:a
ARCHRECT/
ENGINEER Company: Name:
Telephone #: ( )
Street Address: Registratlon
City State: Zip:
i
Sawer & watar licensed piumber Inew consWCtion onlvl: Talephone
? Penally appiies when addreas change and lot ehange la requeeffid onu permk is bsued.
I hereby aeknowletlge tliat I have iead this applkaUon, sfate that the infortnation is eorrect, and agree to comply wNh en applicabk State of Minnesota StadAes and CR
of Eagan Ordinancea. ?-?
i '
Signature ofAppllcant:?
CeRificates of Survey Received
Tree Preservation Plan Received
OFFICE USE ONLY
Yes _ No
Yes _ No _ Not Required
L BL (3 CITY USE ONLY
suBO. ?'Cunfrv ynlloW 2n
RECEIPT#: ? 3 qV37
RECEIPTDATE: 7- 1 'OC)
PERMR# ?II7{- /
2000 PLUMBING PERMIT (RES2DENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, bII7 55122
651-681-4675
Please complete for. ? single family dwellings
? townhomes and wndos when permits are required for each unit
? badcflow preventer for underground sprinkler system
FIXTURES
EACH #
TOTAI
Alterations to existing dwelling - minimum fee
Describe: $ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas pipin ouUet ` minimum -1 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tra 3.00 x = $
Lavato 3.00 x = $
Septic System new/returtisned * requfres MPC lic. 75.00 x = $
Septic System abandonment 30.00 x = $
RPZ new installatioNrepaidrebuild 30.00 X = $
Rough o ening 1.50 x = $
Shower 3.00 x = $
UndergfOUnd Spflnkl@f ff dwelling is undar wnstrudion 3.00 X = $
Underground sprinkler if exisBng dwelling 30.00 x = $
Water closet 3.00 x = $
Waterheater 3.00 x $ S. 00
Water softener if dwelling under construction 5.00 x = $
Water softener 'rfexisting dwelling 30.00 x = $
Watertumaround 30.00 x $
State Surchar e 50 -> -> -> $ .50
Tot81 -> 3 0 . s
Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc.
-------------------------•-------------•------------•------------- --•-----------------------' -------------------------------------
I hereby adcnowledge that I have read this appliption, state that the infortnation is corred, and agree to compty wdh all epplicable Ciry of Eagan ardinances.
R is the applicanPs responsibility to notify the proparty owner that the City of Eagan assumes no Iiability Tor any damages raused by the City during ks
normal operetional and maintenance adivitiea to the fecilitles constructed under this pertnit within City property/right-of-wayleasement.
SITE ADDRESS: %/.SccZ
T
OWNER NAME:: TELEPHONE#: o?? d'od'af' .lo V37
(AREA CODE) . .
INSTALLER NAME: flfk .i Q/ZSOr? TELEPHONE 9.s'C9 9a0 . a(?, gU
(AREA CODE)
STREETADDRESS: y/?o2 ?un?ry N ar
CITY: d&yg? ?L1 ^/Oc?/,S /"a.ik STATE: ?N ZIP: `rSS?a?
SIGNATURE OF PERMiTfEE
CITY USE ONLY
LOT `P BL J pERMIT#: /a('% I[
SUBD. Ct>U/I?YU I IOII?? ??? RECE[PT k: I'59 /1?-s
RECEIPT DATE: ? - ?J - CJo
2000 MECHANICAL PERMIT (RESIDENTIAL)
CITY.OF EAGAN
3830 PIIAT HI70H RD
EAGAN bRI 55122
1 ?
Date: 651-681-4675
?
Complete this section onfv if you aze installing HVAC in a single family dwelling, townhome or condo under
construction and not owner/occuoied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @$3.00 ea.)
$ 30.00
6.00
State Surchazge .50
Total $
Complete this section oniv if you are remodeline, addine to, or repairine an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
_ New _ Alteration ? Repair _ Other
? Furnace _ Air conditioning
_ Airexchanger _ Other
Fee $ 30.00
State Surchazge __ -------'`
Total $ 3030
Reminder: Call jor inspections
S[TEADDRESS: JCtill 1
OWNERNAME: 6Gf M /? I cY PHONE #:
(AREA CODE)
INSTALLERNAME: PHONE#:
?? i (AREA CODE)
SIREET ADDRESS: ?APCMM
raw.....
CITY:
L-o4 (-c, 13?,3
Co?4?.? I?o/1 o.d2u
Or
TMOVaS EWN
3630 PIIOT KNOB ROAD Maya
MINNESOTA 5 5122-169 7
EAGAN
,
DHONE: (612) 454-5100 DAVID K. GUSTAFSON
FAX: (612) 454-8363 PAMELA AACCREA
TIM DAWIENTY
THEODORE WACFRER
CWncil Members
T1iOnM5 HEDGES
City Administrator
October 29, 1990 EUGENE VAN OVERBEKE
- Cily Clerk
WARREN ISRAELSON
PROGRESS COMPANIES INC
14300 NICOLLET
SUITE 235
BURNSVILLE MN 55337
Re: Hold on Buildinq Permits
Dear Warren:
The City of Eagan has put a temporary hold on building permits for
Lot 4, Block 5, Country Hollow Addition and also Lots 1-10, Block
3, Country Hollow 2nd Addition.
The pond lying east of Lot 4& 5, Block 5, needs excavation work
at the pipe outlet area where sand has accumulated due to upstream
erosion. This work can best be accomplished by access of Lot 4,
Block 5.
Lots 1-10, Block 3, Country Hollow 2nd Addition, are on hold
because of the lack of final restoration work in conjunction with
the retaining wall construction. These lots will remain on hold
till this work gets completed to the satisfaction of the City of
Eagan Engineering Department.
We hope this work will get completed as soon as possible.
If you have any questions pertaining to these items, please call
me at 454-8100. Thank you.
Sincerely, cc: Mike Foertsch, Assistant City
Engineer
Craig Knudsen, Engineering Tech
Steve Hanson, Assistant Building
Official
Stan Lexvold
Senior Engineering Tech/Construction
SL/jj
THE LONE OAK TREE...?HE SYMBOL OF STRENGTH AND GROWfH IN OUR COMMUNIiY
Equal Opportunify/Attirmative Acfion Employer
954870
,
, COUNTRY HOLLON 88COND ADDITION
FRE88IIRE REDIICING VALVE AGRS8M82
This agreement, made and entered into the day
of a?,!?-45L , 1990, by and between the CZTY OF EAGAN, a
i
municipaYity of the State of Minnesota, (hereinafter called the
City), and the owner and Developer identified herein.
:he terms "Developer" and "Owner" as used herein refer to:
PROGRE55 LAND COMPANY, INC. whose address is 14300 Nicollet Court,
Suite 235, Surnsville, Minnesota 55337.
WHEREAS, the Developer has applied to the city for approval of
the plat or subdivision known as COUNTRY HOLLOW SECOND ADDITION,
located within the City; and
r
WHEREAS, the Owner and Developer agree to notify the proposed
potential buyers of all lots within COUNTRY HOLLOW SECOND ADDITION
that Lots 1-4, Block 1, Lots 1-17, Block 2 and Lots 1-10, Block 3 are
in a high water pressure zone and a pressure reducing valve shall be
installed in each home below the elevation of 875 feet. All costs
shall be the responsibility of the Buyer and shall be installed to
prevent damage due to high water pressure.
NOW, THEREFORE, the City, Owner and Developer agree as follows:
i. Recordina. This aqreement shall be recorded with the Dakota
County. Recorder so as to provide notice to the owners of Lots 1-4,
Block 1, Lots 1-17, Block 2, and Lots 1-50, Block 3. The Owner shall
provide and execute any and all documents necessary to implement the
recording of this agreement.
,
2. Notice. The recording of this document shall constitute notice
to all owners and future owners of property in the COUNTRY HOLLOW
SECOND ADDITION subdivision that Lots 1-4, Block 1, Lots 1-17, Block
2, and Lots 1-10, Block 3 are in a high water pressure zone and that
a pressure reducing valve shall be installed in each home below the
elevation of 875 feet. All costs shall be the responsibility of the
Buyer and shall be installed to prevent the damage due to high water
pressure.
3. Validitv. If any portion, section, subsection, sentence,
clause, paragraph or phrase of this agreement is for any reason held
to be invalid, such decision shall not affect the validity of the
remaining portion of this Contract.
4. Bindiny Aareement. The parties mutually recognize and agree
that all terms and conditions of this recordable agreement shall run
with the land herein described and shall be binding upon the heirs,
successors, administrators and assigns of the owners and developers
referenced in this Contract.
IN WITNESS WHEREOF, we have hereunto set our hands.
r
r.'
CITY OF
(Date: ' ' w
,W. Thcbmas A. 'E4att _//
Its: Mayor ??
?A \??AALLU_
Attest: W. J. VanOVerbeke
Its: erk
OWNER AND DEVELOPi.R:
PROGRESS LAND COMPANY, INC.
c?
ay:
Zts: PP.cJiDE,vr
Bv.
Its°
STATE OF MINNESOTA
COUNTY OF DAKOTA
ss.
On this pL/ S% day of 1990, before me a Notary
Public within and for said County/J personally appeared THOMAS A. EGAN
and E. J. VanOVERBEKE to me p6rsonally known, who being each by me
duly sworn, each did say that they are respectively the Mayor and
Clerk of the City of Eagan, the municipality named in the foregoing
instrument, and that the seal affixed on behalf of said municipality
by authority of ?ts City Council ar.3 said Mayor and Clerk
acknowledged said instrument to be the free act and deed of said
municipality.
y •...r,.?.,rrrr..a......e:.. ? / %?? .
,• :kNl; ? q / .
f ` . l V;:' _. . ? j • , // .
? . . . ^ - /.1 "? =I:.'p , y'? ,?A! li L': .??E-L•???',z???'? q
Not,? Rublic
, .. ....... ...R ? ?:
STATE OF MINNESOTA.)
) ss.
COUNTY OF Itr ?'-'? )
On this day of '--' , 1990, before me a Notary
Public within and for said County, personally
appeared t.. r; ;;. r 1-:A 7i!' -erxd- to me
persona 1 ]c?, own, 'who being ?aG? by me duly s?orn, ea?s?s did say that
they--=?eres}9ee#?i}6 the I ? L?.? d; i ? t
a"d of the corporation named in the
foregoing instrument, - `h_< _«__._, -_ ___d ___.._..__ is
, and that said instrument was
signed wnd--&ee+etl on behalf of said corpora zon,k?3? authority of its
Board of Directors and said rcS d c-*z l"
?- acknowledged said instrument to be the
free act and deed of the corporation.
Notary Pub• ic
APPROVED AS TO FORM:
?
Public Wo s Department
Dated: A???a
THIS INSTRUMENT WAS DRAFTED BY:
SEVERSON, WILCOX & SHELDON, P.A.
600 Midway National Bank Bldg.
7300 West 147th 5treet
Apple Valley, MN 55124
(612) 432-3136
MGD
oloL -6-95l /F..h
APPROVED AS TO CONTENT:
?.,
Please cumplete:f9r.
2007 RESIDENTIAL MECHANICAL rERMIT arrLicaTioN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone #i 551-675-5675
single family dwellings & townhomes/condos when permits are required for each unit
07
SiteAddress "'T /5z Countru vi o,w I)ei vb Unit#
y%qq7 _O 11?
Pro
er[
Owner 1 ? 11 hc
/ Fov., T
l
h
#
p
y
.
e
ep
one
( (
Coutractor H/ £ 67` lj
Street Address ?p 3?5 CAnCJI i(JI . 5il, 6 City E'd cn rQl r/e/
State Zip 55O Telephone # (?) ?'] ??f "r ? 2-11
Bond #: -ALL _ 5C011U15 Ex
ires: Y 0/
p
The Applicant is _ Owner X Contractor _ Other
Fire repair (replace bumed out appliances, duc[work, etc.) $ 90.00
This fee applies when extensive mechanical repairs are made to a building.
Add-on or alteration to existing dwelling unit $ 50.00
fumace _Additional _Replacement _ New
air exchanger
X air conditioner
heat pump
other
State Surcharge $ •50
Total N $ 50 , 50
MAY 2 1 2007
1 hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will
be in conformance wi[h the ordinances and codes of the City of Eagan and with the Mechanical Cod ; understand this is not a
permit, but only an application for a permit, and work is not [o start without a permit; that [he w rk wi in acco an ith the
approved plan in [he case f work which requires a review and approval of plans.
re rn?. hurc,hill '
Applicant's Pr ted Name Ap lic t's Signatur
M 32 -rb4 -
,. ? • RTjF/CATE Qyr .
????? -Z69 ,gS N ??r ,?ZO .
?
? ?. Z .
:991
i 1.67 _ o $ ?,,.•`..,;? NI
020.00
SCAII
gLt, ? P2DPc?? '; !a. esZZ,O ; . ,
?o r
823' ?
I ? /? 10i? I
N I II ,
?N
- ?'-
N
? ? :D
N ?o
N
A /? ? . .
I I Scale; 1il _
? ... . .?;. r• 300
•R.V. REQUtRED ? I NE??I??:,?
?
ry
SL ? D.ate
c? '- -` "- - -JS EAGAN E;iVGINEr d
'??•- ? ??_ v RI:VG
[:
? ?D p
.? ?? 55?g'E ?13,9d
- `i?
'EBY CEi97lFY 7i/AT TN/S S(,1qVFY f'CAN N?D?J?P?
°19EPAREO BY ME AN UNAEN MY ???T ?""--- CR-? N
?T ! AM A?Y a'A?'T sYA9Eqyi?, Lo t 6, B 1 o ck 3
??E' LANS pe ny? A ? LAND II/NNEb?qqiDTA ?MW COUNTRY F;OLLOiY '
. . Aakpta .
C"nty, D4innesota
Plat bearinFs shown
? ? 8140 ° Denotes iron nonument
2?
(Existin$,! , Pronosed
?
brondt an9j?aa?jn
210S woodi trail9 a "urv,aying
burn,vjlla, minna,oto 55337_..
(?1?) 435-??9fr6 ,
?' . a..,a
?
W?
?
'Y
0
i L
ty1,K
;y O
M {4
2
9v
1 Gy ??'
1 F?a
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f 0
??v8?3iN
?
? ?. _...
1J'+'i
S 89° 23'yl'E ? gy10
I12.00 za.(.v cl a ?
u
I
iowi d
?
L
U V-9,A?r
, 3
1
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14.0
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? ?y, 83Ctti N
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5
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' ` m <
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:> I
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1N2.00
S 89°23`?/!"E
'Cop ?,L.c?1L EL..
?AhC-MEN't' E L. DESCR rPrioN
LOr b, SL oCK 3,
COUNTRY HOLLOW
Sc COi'V'D ?'1T/VIT?ON,
DR kOTA COLlNTY..
M 1NNE SOrA
$33.0
,l.? ?? y, ?, p?q,
?.' S`4 :dcXl@ £.i'?1..'8rA4Tu%?AlAI''6Li
NoRTH
5CALE J"=30'
A1.L 8E49iN65 ASSUMfip
o pFNOrES /RoN MONL/MENT
?r, ??
I hereby certify that this survey was prepared by me or
under my direct supervision and that I am a duly Registered
Land Surveyor under the laws of the State of Minnesota.
Date
LeRoy H..iBohlen
Registered Land Surveyor No. 10795
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA129190
Date Issued:01/20/2015
Permit Category:ePermit
Site Address: 4152 Countryview Dr
Lot:6 Block: 3 Addition: Country Hollow 2nd
PID:10-18276-03-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Applicant: Troy Good
3670 Dodd Rd
Eagan, MN 55123
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Kenneth R Adam
4152 Countryview Dr
Eagan MN 55123
(757) 288-2880
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
02/24/2015 16:28 952-935-9544 MN RUSCO P�GE 02105
, �
�-----�--___,...,..,._----
� ��� �
i „o, , , ... ;.,,.,W i
C�t of �apa� ; Pe�,��:�_���.�q� ;
� a � Permit Fee: � V �
3830 Pi�ot Knob Road � �';
�agan MN 55122 � �ac�Rocaivea: �`�� �-''�
PhOne: (651) 675-5675 I I
Fax: (B51)675-5694 ' � StafF: I
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2009 RESIDENTIAL BUILDING PERMMT APPLICATION
Date: �� �'�� ,_„_SitA Address• / ��� C:r✓'L�/��/'�y VI� VC ���a� :J'�`s
i
Tenant• �` � g����;
RESIDENT/OWNER Name: �'�/�N� /"{ v�i v I PhOne: � 2�� 2
Address/Clly/Zip: "T��� ���� ���Yi� �G) V�
Appllcant is: „�Owner �Contractor
tYPE OF WORK pescription ofwork: /'�i!'i ���wL- ���• ��M��� ��C
.
Construction Cost: � _ Muitl-Famlly 8ullding: (Yes_/No/� )
CONTRACTOR Name: �.SS 0� Su, L'D T J.�Liconse#:��,,�/�
Address: ��J U � 7�r� �
City: State:_T Zip:� � ,�
Phone:� 'q3�_`�L�C�.C.�,,,,Contact Porson:„�__,:�� �0�
COMPLETE TWIS AREA ONLY IF CONSTRUCTING A NEW BUII.OINC�
� Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy Code • Resldentlal Ventllatlon CatOgory 1 Worksheot • New Energy Code Worksheet
Category Submitlad Submittad
(�submission type) • Ene�gy En�elope Calculations Submltted
In the 18st 12 months,has tha City of Eagan Issuad a pertrdt for a slmllar plan based on a master plan?
_Yes _No If yes,date and address of master pl�n:
Licensed Plumb�r: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
,�a , ' , .s. �'. ��'�+j'�'�IP�9' ' q� �. � , , �''J'y'��, .�/�" �
1 (�%�,�,, � � � ( �.. ����� y TJ) G� t (���i ��, �� �y►/� r�y�/�'���
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"6 a ; `i, il I B "� ���I 1�.��:;;.
I hareby acknow�dge th9t this infomtation is complete and accurato;that the work wltl be in confortnance with the ordinanCes and codes of the City of
Eagan;that I underst�nd thls Is not a parmit,but only an appfication for a permlt,and work Is �ot to shrt wlthout a p9rmit; that the work will Be in
accordance wlth the approved plan In tho ca�a of worK wnicn raquires s review and approval of pl2ns,
X IC�-,� � 1/'a I�� X �-i Uv I�,.
Applocant's Printed ame Applicant's Signature
Page 1 of 3
02/24/2015 16:28 952-935-9544 MN RUSCO P�GE 03/05
. L/��,--�� �a�,�Z ��c-�-� �!� �
, � � I�-��
DO NOT WRITE BELOW TNIS LINE /
SUB TYPES
_ Foundation ^ Fireplaca _ Porch(3-Sea�on) _ storm Damage
� SPngle Family _ C�araga � Porch(4�S0ason) ^ �xterior Aiteration(Singfe Famlly)
^ Multi � Deck _ Porch(ScrQ�n/GazebolPergol�} _ Exterlor Alteration(Multi) •
_ 01 oF_PIQx _ Lowar Level � Pool _ MlsceUaneous
_ Accossory Bullding
WORK TYPES
_ NaW ^ Interior Imprrnrement _ Siding _ Damolish Buliding*
_ Addltlon _ Move Bullding � Reroof _ Demollsh lnterior
�, Alteration _ Fire Repair � Wfndows ^ Demolish Foundation
_ Replace _ Repair _ Egrass Window � water Damage
� Retalning Wall "Dcmolltlon of entire building—give PCA handout to appllcant
DESCRIPTION
Valuatlon �f�Z°•o� Occupancy .J--�-1 MCES System
Plan Revlew Code Edition yr1M Zo�S'� SAC Units
(25%_100%�,) 2ani�g �?-1_ City Water
Census Code Stories Sooster Pump
#of Units Square Feet PRV �
#of Buildings Length Fire Sp�inklers
Type of Construction �____. Wldth
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings(Deck) Final/C.O.Required
Footings (Addltlon) � F1na11 No C.O.Requfred
Foundation HVAC
Drain 7ile Other:
Roof:�Ice &Water �Final Pool:_Footings _AirlGas Tests _Final
_� Framing Siding:,�Stucco l.ath wStone Lath �Brick
Fireplace:�,Rough In ____Air Test �Final Windvws
� Insulation Retaining Wall
Meter Size: �rosion Control
Revlewed By:,,��_°1N_l___l�]LI%��� � ,,Building Inspector
RESIDBNTIAL FEES
Base Fee g� �)C � � ���^ '�'� 79'�r •
Surcharge
Plan RQVi@w
MCES SAC
City SAC
Utility Connection Charge
SRW Permit&Su�charge
7reatment Plant
Coples
TOTAL
Page 2 of 3
Use BLUE or BLACK Ink
---------,
� For O�ce Use �
I �
Cl� Ol L� �� � Permit#:_ I���5� iC�
y � �
� Permit Fee: �
3830 Pilot Knob Road j i
Eagan MN 55122 I Date Received: �
Phone: (651)675-5675 � i
� Staff:
Fax: (651)675-5694 . , i______ _ _ �!
� ------
,:;,: .� r ,. ;
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION ���'"`�t �'��•
'/ ,�/ % /�� ��s�rLoc2 C'l�cK
Date: �7`-" Site Address: `'f"�� C..-d)CG�Z � V� �� �
Tenant: Suite#:
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�; � '` Name: � �����/�/`t'
�,��f��l�C�-��'f�. Phone:
� / 1/ �� ,
��.`� � � `: Address/City/Zip: `T��J f ti-l� 'r, ����
` � � � Name:�//��'' ���J� /���� License#:
"� � � � r ;�' z
� ' Address: ��`T� 0 ��City: �_ (`,,"�IC�D(��.
�����C'�O��
�� r�/ o� �
"' �. ` ° State:_�Zip: ��J" ���� Phone: /CJ � � c:/��--- ��
,�
k ��' {e , 'z {,a'v�' � ,��� � .
6 '� "Y� a
�`= ,` x ,_��4 ,� Contact: �'1 GS Email: � �� � � �`�00• �
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��p������� ; _New ��. Replacement _Repair _Rebuild _Modify Space Work in R.O.W.
a —
�u�'t �'— p x � /� � .
=��� � ` � �.'°�, �'! Description of work: «'
���i � � 'r� �,�� � T RESIDENTIAL
}����� _, ����=� Water Heater
��}.. ' � ` � Water Softener �
��"`��= C � k r
� Lawn Irrigation(_RPZ/_PVB)
, ������������� � �Add Plumbing Fixtures(�ain/_Lower Levei)
5 e,� `�,� ;��� Septic System
� ��� Water Turnaround �
� �� �� p �,�_ � New
$ ��� —
.��"-; � � :r� Abandonment �
RESIDENTIAL FEES: �'�r
$60.00 Water Heater,Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge)
$60.00 Lawn Irrigation(includes$5:00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic Svstem Abandonment, Water Turnaround"(includes$5.00 State Surcharge)
'Water Turnaround(add$200.00 if a 5/8"meter is required)
$115.00 Septic System New($10.00 per as built)(includes County fee and $5.00 State Surcharge)
TOTAL FEES$ . P
CALL BEFORE YOU DIG. Call Gopher State One Call at(657)454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.qoqherstateonecall.orca
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 ermit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approv o plans.
X� �6 '�� � '� X ` ����►.��
Applicant's Printed Name Applica�t's Signature
, ,.
� �
��� ,��.,y �g �� o- �„ w�h �` -v ��e� i i k � y : � � i ' ��,��y � �g '��r-�,,,r �� a ��" �i '� '�� �'��
. '-�,� ,��, _a`��� ��� ��— ��Y � �� �� ������r�����i � �� r uU' �� �� !� :� �2���� `,��� _ �`ar f� .
p: i� . 4 � � "�� `�` ;�-. � ` � �r ��k� � � -w�'�w �e� � ti si� N ui E � � �
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA131269
Date Issued:06/11/2015
Permit Category:ePermit
Site Address: 4152 Countryview Dr
Lot:6 Block: 3 Addition: Country Hollow 2nd
PID:10-18276-03-060
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Kenneth R Adam
4152 Countryview Dr
Eagan MN 55123
(651) 200-3150
Window World Aka Probuilt America
2211 11th Ave E, #130
N St. Paul MN 55109
(651) 770-5570
Applicant/Permitee: Signature Issued By: Signature
K_
...�` "
Use BLUE or BLACK Ink
---------,
� For Office Use I
� 2� I
� I � �.Nl�� ' I �
Clty of �a�a� ; Permit#: �
��o �
� Permit Fee: I
3830 Pilot Knob Road �� 3� - ;,�_q�°� � i
Eagan MN 55122
��'�- � �-�': +:�.i.J I Date Received:�� � � �
Phone: (651)675-5675 � � i
i i ''' 1 �+^a � Staff: .
Fax: (651)675-568�1 ��-w � t 2�iJ I � �
���������������� J
� 2015 RESIDENTIAL PLUMBING PERMIT APPLICATION �
�/� � �„� _
Date:�r�� ���. Site Address:��',-'�t '�"" �;� , �� ���
Tenant: � Suite#: �
�� ��;� � . , ,.
�� � Name: ���1, Phone:
�ResidentlOwne ���'�""
� ���� ����� �--- -�. �- /�
;� ��� Address/City/Zip� � � 1�-�'� �+�'� ��
;`� W. .�, �_..- �
� �� rvame: M�bert Corr�pany Inc dba Culligan Water License#: WC6 13 76
�� ���
�� '�`� Add�ess. �1801 50�' St East Inver Grove Hgts.
� Contrac���,
c�ry:
k � 55077 651-451-224�
� �-�" State: � Zip: Phone:
��'���
�� Contact: W1Illari1 R M11beTt Email:
� � �>�,
;� ,
�� ���ype �f��`�.Q_� ��� �New _Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
� . •,
` Description of work:
,�
� .., p,� . � .
RESIDENTIAL
� 45 ��=� �
`� � Water Heater
' � �,Water Softener
Lawn Irrigation(_RPZ/_PVB)
�� �I�ermit�T�p ���
�-'fi Septic System Add Plumbing Fixtures�Main/_Lower Level)
� ��` ��� New WaterTurnaround � �
f xW'9.1- �... . � . . . . _
� Abandonment
RESIDENTIAL FEES:
'$60.00 Water Heater,Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge)
$60.00 Lawn Irrigation(includes$5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Turnaround*(includes$5.0o State Sur�harge)
"'Water Tumaround(add$200.00 if a 5/8"meter is required)
$115.00 SeptiC Svstem New($10.00 per as 6uilt)(includes County fee and$5.00 State Surcharge) 6 D O
TOTAL FEES$
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.gopherstateonecall.or4
' 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, buf only an application for a permit, and work is not to start with ut a permit; that the work will be in
} accordance with the approved plan in the case of work which reguires a review and approval of plans. .
x_�IJ,%/,��� I1�1,(�a, /rT.L �._ x '
Appiic Y r nte�Name T- App icanYs Signature
,�� , _ , � ..: . . _ ,
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� �FO O'FF �_�!l.S�� �; � � ; ,�t. � -�� = ..
�Re uired Ins,p�. ti ,s� " e;f., � , : g., �
�� .
;�Meter Related f > : e.e Si ,_ _ . _ , �