671 Crimson Leaf Tr•? • " •
W""J[CQ.te nf cCClivRnC? -
6it) vf Cfagan
l n
?Tiiis Certificate issued pursuant 1o the reqreirements of the Uniforrre Building Code
certifying that at 1he lime of issuarrce this structure was in cornpliance wirh the various
ardinances of tiee City negulatireg building consrrucrion or use. For the fo!lowing:
Use Qassification: SF IW, BWg. Permit No. 25814
oomqa-Y T%Pe R-01I 7noing Disoia _ RType Cons[. ini
Owner d BuildinglKE7N1F''.Y .MATTfrI.R_TI?^, Ad?c?l. IfiC1 T?778tN T sA1G' FN`?N
euilding Addtess 67 I r-RIMM iFAF ATT. Locatiry
i j
Building OfftcialI ? POST IN A CONSPICUOUS PLACE
. .. Il
' eiT?r oF EaGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
.,,
, I I I I
I I(MN ft t Dld 1 f!I
4 PERMIT SUBTYPE:
?
O
PERMIT TYPE: : ' ` 11,I)I"
Permit Number: ' ? 8i 4
Date Issued: %' f `q"
""" APPLICANT:
(f, I .' ) WA '+ 1 `,N
TYPE OF WORK:
ra 1 i i
,
INSPECTION .. . .A
. .?, .
; 1?• r: l t? ,:'r?ll I
I ?iftt ', i'ftV .:. 41 i' I Icl; niA i i tIF i-J ItliN i I I'< f'I
Permit No. Pertnlt Holder Dete Telephone t
ELECTRIC 90 ov
PLUMB ya
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND ?D Q
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
Z - 7 7 S' ` ?
GAS SVC
TEST
/
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG - ?
ORSAT
TEST
BLDG FINAL /G;??,?, D?
7 IyZ?
BSMT R.l.
BSMT FINAL
DECK FTO
OECK FINAL
fa? _ J
REQUEST FOR ELECTRICAL INSPECTION ? ee-0 q001-09
See instmclions for completing Ihis torm on 6ack of yellow mpy. ??? ??•
?
Befow Wor`? Covered by This Aequest ?.,„?, Q
Ne
Ad 0 Ic? P
Type of 8uilding ^
Appliances Wired .
Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
CommJlndustrial Fumace Other (5pecify)
Farm Air Conditioner
Dlher [speolfy) ConGarAor's Remarks'.
Compute Mspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 1 0 to 700 Amps S-
Transformers A6ove 200-Amps 100 -Amps
Signs Inspecror's use only: TOqTAL sp
Irrigation Booms (0.
Special Ins ection Xr- GCJ
Alarm/Communication THIS INSTALLATION MAV D DISCONNECTEO IF NOT
Other Fee
I, the Electrical Inspector, hereby COMPLETED WITHIN 18 MO S.
R°°yn-In °ate - S
certify that the above inspection has
been made. Finai
/ oa? ?
OFFICE USE ONLY
This reques[ void 18 months imm '
L
????95 48901f
0 2. 101 0 ?o ?
-
Fequefl 15ate
?
z Fire No. Ro gh-n Inspettion Requlretl In peG'mn Other Than Roughln
(VOU musl call lnspeotor when ready) ? fieatly Now ? WIII Ne17y Inspector
Yes o Date Reatly ??'?
_OYE ?
request inspection of abov electri o k t:
IATlicensed contractor ? owner hereb
4
Job Atltlress (Streetaox or aoute nlo)
/ Ci
ci Q?
! ?id45?%i i?Gt c?
7
Sec?ion Na Tawnship Name or No nge No, unty
Oxupanl(PRINT)
?tlh ' ` 5 Phone Na.
'Y -,S3
Power Supplier
17. R o Atldress
e('
ElacYrical Conhacbr (Company Name)
"
' Contractor's License No-
(fe/
A, tr z-
Iefc?nc c? CA
Mailing Address (COnlraclor or Owner M'ng Installa0on)
1 0? 'fs
Authorixetl Slgnature (Contrncror/ ner M king I lallafio Phone N ?er
MINNESOTA STAT OARO OF EL HI
GriggsMitlway BI g. - Room 5428 -
1
111
I
I
I
I
I
I
I
I THIS MSPECTION REQUEST WILL NOT
BE ACCEPTED BY THE STATE BOARO
I
1921 Universlty Ave., St Paul, MN 55104 UNLFSS PRDPER INSPEGTION FEE IS
PM1One16121642-OB00 . .., . ENCLOSEO.
Address 671 C2n43orr r.EAF rRnu, Zip 5512_3_
Lbt ,• .6 Blk 1 Sub t?mrt? uir? ani
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: f D a C? Yes No Inspector. ?
Final grade (6" from siding) V"
Permanent steps (garage)
Pennanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
TraiUcurb damage
Porch
Basement finish
Deck
Please verffy with the builder the removal of roof test raps from the plum6ing system and the shut-off of water supply to
the outside lawn faucel before freeze po[ential exists.
Contact engineering division at 681-4645 before working in righaof-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contraaor Copy @
? Clo YoOF EAGAN
' Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT TYPE:
Permit Number:
Date Issued:
PERMIT
671 CRIMSON IEflF TR
LO7: 6 BLOCK: 7
AUTUMN RIOGE 4TH
P.I.N.; 10-12303-660-01
DESCRIPTION:
ermit 7ype
b;rk Type
2onf.nq
Builtlin'g
e fl g'kh
3; d ttk
1} rk k i9y g
?z s
?x ]S F oy
2f^
REMARKS:
PRV
FEE SUMMARY:
SF pWG
NEW
R-3 U-1
V-N
p
n-1
72
50
1
2,684
yt`
}y ?§Y
Z
S& W PLBR - MA7THEW DANIELS PLBG
VALUATION
Base Fee
Plan Review
Surcharge
SAC
SRC &
SAC Units
Lic. Search Fee
Subtotal
$2,588.54
n_d !sF>rvaC @? .c"?°bra ¢.?y ?? {? ?
a.rw. 4 it eaw M nA. kt ??a ?
$167,000
BurLozrvs
025814
06/15J95
MISCELLANEOUS $1,892.50
Total Fee $4,481.04
CONTRACTOR: - Applicant - sr. LIC. OWNER:
WHITNEY HOMES CREATIONS 14549150 0008344 WHITNEY HDME CREATIOMS TNC
4160 LAN7ERN LN 4160 LANTERN LN
EAGAN MN 55123 EA6AN MN 55123
(612) 454-9156 (612)454-5332
herehy. aeknowledge thit:1 F?aue- read tfi3s °apPji'cat?.are•dnd' t#?at ??ae in 0 rrna ion is correct' anCf agMee R?,y ua'tM q? ?`?pplic.?aCz3e.$#p?ta 'SSf Msr
r
k ?n <C?.ty o- Eagani arc?i°nanc&ss ?
A .. _ . __ , ? .. .__
$1,222_25
$427.79
$83.50
$850.00
109
1
$5.00
?A???OJI?.z?? ??
APPLICANT/PERMITEE SI TU E IS ED B:51 ATUR
CITY OF EAGAN
? 3830 PILOT KNOB RD - 55122
1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construdion Reauirements RemodeURecair Reauiremenls
? 3 registered site surveys ? 2 oopies of plan
? 2 cropies oi plans (inGude beam & window sizes; pourod fid. destgn; etc.) ? 2 site surveys (extarior add'N'ons 8 dedcs)
? t energy celwlations ? 7 energy calculations far heeted addifions
? 3 copies of tree preservation pl n ff lot platted aRer 7!1/93
required: _ Yes , No
DATE:
DESCRIPTION OF WORK: ?
STRE ADDRESS: ?
LO? BLOCK SUBD
PROPERTY Name: K? h
OWNER
CONSTRUCTIC
1„_2 c? r
./P.I.D. #: lkkh
?
` c
L
d-O
%i k
r) 3
L- Phone #: a - S 3 (3) <,?
FlN6T
Street
City:
CoN7tuCroR Company.? ?
Street Address: ?
,L
State:
Zip:
Phone #: 5? ?' 6 3 3 a
License #- ?
zip Ia-3
?honeMSo7-/,/$I- ip r9
ARCHfTECT/ Company:
ENGINEER
Name:
Street Address.f \ -
Sewer & water licensed plumber: ?-I 2vQ Ll ?L` S 1?-
change are requested once permit is i sued.
1 hereby acknowledge that I have read this application and state that the i
applicable State of Minnesota StaWtes and City of Eagan Ordinances. I
Signature of App, cant:
OFFICE USE ONLY
Certifiqtes of Survey Received Yes No
Tree Preservation Plan Received Yes ? No
Registration #•
8tate: Zip: <??? L?4> b
Penalty applies when address change and lot
is cx9trect and ag(e)p to
J u11 a a 1ss5
BUILDING PERMIT TYPE
OFFICE USE ONLY
? 01 Foundation o 06 Duplex ? 11 Apt.lLodging ? 16 Basement Finish
-A:r--02 SF Dweiling o 07 4-piex ? 12 Multi RepaidRem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
0 05 SF Misc. 0 10 = plex o 15 Deck
WORK TYPE
New ? 33 Alterations ? 36 Move
0 32 Addition ? 34 Repair o 37 Demotition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of 5tories
Length
Depth
APPROVALS
Ptanning
$-N Basement sq. ft. 9 9 MCNVS 5ystem oL
// Main level sq. ft. /, stos
? City Water OC
-3 u-/ gq, ft. Fire Sprinklered
12- J sq. ft. PRV Yts
03s-z- sq. ft. Booster Pump
/,s sq. ft. Census Code.
So Footprint sq. ft. v SAC Code
Census Bldg /
Census Unit /
?
Building
Engineering
Variance
Pertnit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SNV Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total: .
Cq.ar
Valuafion: $ 167, °oO
*Arx GL'C?
2,(07 x 37 ? 9?7
Z x s ' /(c
z x S'7. i?? // y
z/?gF 65_s = /, `?gZ
Y n 3s.r = ?ss
6 z /a ?.?--
? q?s'KS5'=
13s?»r•
I =?G?.+.. -- ??96f
Lzna?
?f?°, ? L.f
Z 3 x 7??. 6-7 ? 7zb
,43?zO ?7-
'73rx
/o SAC ?
SAC Units
_? ff
ll, 7 b°
?
v' ? ca
?
.
lr'? ? •
D? ? 0 •
L] t7 ? ?
ca" n r? •
.
I7 ? P3 •
EAT *'7RVEY CRECRL'ST EOR Sd.ES?DrNTIAL
SIII'LDING RFRMST APPLZ
RAOPERT_Y _7r.r_ar„
WCT7MEN'!' 19,ThumAm
Date of 8urvmy:
Registered Land Surveyor siqnature aand company
Building ??ermit Apnlfcant
1.eQa1 d?-scribtion
l%?dy«:s.:s ?
Wor;:h arrow and 3sarscal.e
1KouWa type (rambler, walkout, cplit Ta/o, sp13t
1aoScout, e~c. )
nirectlanal drainage arrows wi.th slope/grad.+'.ent ?.
Propot?;ed/ex? ^tinq sewer and water service ,
street as3me
Y)c3vt;uray
M?ZIM,
4.'xt st •im
?? 0 • Sewes serviee
1?"' ? ? • Lot coW-ners
L'r?J ? • Top of eurb at the driveway
'a' t7 17 • E1evations oi any existing adjacent homes
? ? ? • Garaae floos
i?' D !7 • First floos
LY D fj • I,owest esr.posed elevation (walkout/window)
? r? » Property corners
fJ
0 l? • Front and rear of home at the foundation
gQ.`,1DT_WG AREA9- (_if 9??., abi
? . 0? I] • Easement line
n e? n • xWz
n ry? n - xwL
0 LI??LI • Pond #? designation
0 R t2 - L?nergency overPlow ElQvata.on
entry,
T n _xs,?Rg
??" 1] D • Lot
L?' ? D • niqht-c*-way and strQet width (to back of rLrb)
? D 0 - P-onosed hemr-: d3m?na' ons .<.ncluc:ing ar.y f1i oi?poBed decks,
overhangs grea•te•_r v.ha7 21, pozches, F:tc.
LtTuctures .requiring permanent footings)
?? D • 5how all easc_..?ntr of rccerd. erd any City i±±±l '±ies within
those ?=asemenr>a
D? • Setbacks af proposed atructure and ve:thack of 8djacent
existinc* homes
a n? • Retaining 11 reguiremen*_s, i* any
Revlewed: ?
Oetober 1992
W:e l.re ! vOIC GA17791tl DOGJ NOTUVf?.fiAi i 1?•-
1°;;:_ F:CCJRACY OF UTIUTY LMA11CJNti
r l.:? :'•:L? ? ELEVATIONS. THIS DATA 15 ?0FI
J•:;:t3AT(OIU P?JRPOSES OitlLY ;^?i?'t7
I S& W I f51
2 S a W?.i`2_ UoOI(VG IT SHOU(D VERIFY' ";j7:
C.S. - 943.5 C.S.
2 ENV - 934.5 - S4p-3- 942.7 ON'fHE SIT
I 1 E?`l
? INV - 933.7 7 5' A
5 f 15'
rrIl ?-
f D.I.P CL 52
HYDRANT J ? I I I? I
eND FI_EV. 94a 90 EXIST. 6'x 6" 7EE ? I
TrVFf. EL. 945.98 L-L J
EXISL 6"PLUG? T--,1
7
-xw
1 77'
? 1 I g q-4 ? I -•?- - - ,/- ._ _ _ ? _. 1
7.0=` 6,+??-----
t >
? _ r33.G' \EX. B' SAN SWR ?----`-
?-`--_
? 784 exisr. EE.RP 2138
5O
.?SAN MN U
EX.21 S'7d cµ?
' ExRST-k;,tca - ? _ - - _ _ - ?-r SEE RP 2140 U
2+!99
A. ? 1229.`\-iGi.? ? ?GVi& BOX
u . I I;? - I I
t3 5 1 6 L?
38- 1
s&wi+4s ? 0+50 3.2 saw C.S. - 943.5 ??" L ,.
i.2 !NV- 934.5 C.S. - 942-8.942.6 L - - - ? ' -
fNV - 933.7
\
944.24
MH RE -944-6&
I BLD. 1690-
, I0.87'
94237
RE 942.28-
BLD 16#?
10.22'
PROPOSEO GRADE
_' - --- _ ? -
- - - - - - - - - - - - -
7.5' MiN.
COVER
---RE?VE PLUG 2EX. 12 R.C.P
.? - CONNECT TO EX
r'QIP. ?
Ex d'p.lP
611 D.I.P CL 52 I II
L?----;---
_t
2' - 8 PVC SDf4 35a
?g? ? L- -- - _
0. 41 % EX. 8" PVC
CORE DRILL EX MH. --J
IN5TALL WATER TIGHT
SEAL. BREAK OUT BENCH
AND REFORM FOR NEW
1NVERT.
to
(V
I?0) . IZ
. . _ . .c<?'.. d3acS N01 CaUi4,;; ..
CY OF UTILITY LOCA"i IQ?J--
r?E.El:",I'IONS. THIS DATA
PURPOSES ONLY
?^=? ?=E:`:?4 UCIE1G IT SHOULD VERI; `.
'=?-:0,????:', i t01V ON THE SITE.
ONE AND TWO FAMILY
ENERGY CALCULATIONS - AVERAGE "U" COMPUTATION
OWNER: SITE ADDRESS: DATE:
CONTRACTOR: WHITNEY CALCULATIONS BY: JSA PHONE: 451 -1019
Determine working square footage of each that applies
1. Total exposed Wall area ............. 2677 sq. ft. x 0.710 = 294.47
2. Total roof/ceiling area ............. 2040 sq. ft. x 0.026 = 53.04
3. Floors over unheated space.......... sq, ft. x 0.050 = 0.00
4. Roof/ceiling area (no attic space).. sq. ft. x 0.026 = 0.00
5. Unheated slab on grade .............. sq. ft. x 0.160 = 0.00
6. Heated slab on grade ................ sq. ft, x 0.120 = 0.00
TOTAL WOOD WALL AREA 2535.00
a. Total wall window area........... 352.00
b. Total door area .................. 56.00
c. Total glass door area............ 74.00
d. Total fireplace wall area........ 0.00
e. Total rim joist area ............. 216.00
f. Total wall framing area.......... 183.70
g. Total net wall area above floor.. 1653.30
TOTAL EXPOSED FOUNDATION AREA 142.00
h. Total foundation window area...........
i. Total net foundation area above grade.. 142.00
j. Total unheated slab on grade area......
k. Total heated slab on grade area........
Determine "U" value of each wall segment
a. 352.00 x"U" 0.360 = 126.72
b. 56.00 x"U" 0.070 = 3.92
c. 74.00 x"U" 0.360 = 26.64
d. 0.00 x "U" = 0.00
e. 216.00 x"U" 0.043 = 9.38
f. 183.70 x"U" 0.106 = 19.48
9. 1653.30 x"U" 0.046 = 76.58
h. 0.00 x "U" = 0.00
i. 142.00 x"U" 0.062 = 8.78
j. 0.00 x "U" = 0.00
k. 0.00 x "U" = 0.00
7
TOTAL = 271.49
If item #7 is the same as, or less than item #1, you have meet the
intent of SSC 6006(c)2.
NOTE: FOUNDATION WALLS
Full basement (Rambler) entire exterior wall must be not less than
R-S.
Half basement (Split Foyer) entire exterior wall must be not less
than R-10.
` r
" .
TOTAL EXPOSED ROOF/CEILING AREA 2040
1. Total skylight area ....................
m. Total roof/ceiling framing area..,,,... 204
n. Total net insulated roof/ceiling area.. 1836
Determine "U" value for each roof/ceiling segment.
1. 0 x"U" = 0.00
M. 204 x"U" 0.028 = 5.80
n. 1836 x"U" 0.025 = 46.15
5 ....................................... Total = 51.96
If the total of #S is the same as, or less than #2, you have met
the intent of SBC 6006(c)1.
To utilize the total envelope system method, the values
established by the sum of items #7 and #8 shall not 6e
greater than the sum of items #1 and #2.
? - CITY USE ONLY
L BL -j RECEIPT #:
SUBD. -j( /-).uA/? DATE: y ?
1995 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55722
(612) 681 -L675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FlXTlJRES EACH NO. TOTAL
Shower 3.00 x 2 = u ?Do
Water Closet 3.00 x ?
Bath Tub 3.00 x =
Lavatory 3.00 x 15 , ?
Kitchen Sink 3.00 x 1 = 3- DD
Laundry Tray 3.00 x 1
Not Tub/Spa 3.00 x 1 =?
Water Heater 3.00 x 1 = ?;,lp
Floor Drain 3.00 x 1 = "00
Gas Piping Outlet * minimum -1 3.00 x 3- 03
Rough Openings 1.50 x =
Water Softener 5.00 x =
Private Disposal * Dakota cty. iicense 20.00 =
U.G. Sprinkler * home under const. 3.00 =
Alterations ' to existing 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .50
1 f?'il?L 49
SITE ADDRESS: tD11 Uwy1SOf1 Lf(1? rTV .
OWNER
INSTALLER NAM
STREET
CITY: %Su%\U?k STATE:W_ ZIP: o U
PHONE #: (??2 ) ?13" -mm Ulgvv? F ?'LM p2L ?
?
L CP B CITY USE ONLY RECEIPT # T '/?
?L / ?//,,
Sii 9S
SUBD. DATE:
1995 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
New construction Add-on furnace
rldd-on air condiiioning Add-on air exchanyer, i.e. Vanee system, etc.
Date: -ma c;( l? `?2 ?
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL
C a, I
SITE ADDRESS: [v
OWNER NAME: 5 - ;
INSTALLER NAME. ' 2
STREETADDRESS:
CITY:
PHONE #: 016?)
PHONE
ZIP: --
?
PLEASE BE ADVISED THAT T}{EHE IS A FEE SHORTAGE ON T}E ABOYE
II.ECTRICAL INSTALLATION IN THE A![OUHT OF $ c7f c-c/
SHORTACE lSIST BE PAID WHITHIN 14 DAYS.
REMARIiS !
cc)
, 31 to 100 amo, circuits=
0 to 100 amo service=
? 101 to 200 amo. service=
r GC?
TOTAL FEE AUE=
s
RETURN A COPY OF THIS FQRM WITH REMITTArCE.
PERMIIfI /,,J ??l /D /
ORIG. RECEIPTII 4l?P Ae?r?P
RECEIPT DATE d -15;?
?C?
?o(S? ((-) j .- -$ 1??O.od
2007 RESIDENTIAL BUILDING rERMIT nrrLicaTTON
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 ? ? i?
Telephone # 651-675-5675 FAX # 651-675-5694 C, 12H ?
New CoreWCGOn Reouiremenls RemodeVReoair Reouirements OKce Use Onlv
3 regislered site surveys shovAnq sq. tt. of IM, sq. ft. of house; and all roofed areas 2 ropies oi plan showing footings, 6eams, joisis Cert ot Survey, Recd' .. _ Y'. _ N
- (20%maximum lot coveroge allowed) 1 set of Energy Calwlations fa heated atlditions Sals Report _ Y_ N
1 Soils Repod A proposeU building is to be placed on disluNed sql 1 sHe survey for additions 8 decks Tree Pres Plan Recd _ Y _ N,
2 copies of plan shovnng beam & vrindwr saes; poured found design, etc. AddiB'on -iMicafe rf on-site septic sysfem Tree Pres Required Y'_ N
1 set of Energy Calculations On-sile SepGC System Y:_ N
3 copies W Tree Preservation Plan'rf lot platteE after 717193
Rim Jast De4ti Optlans selection sheet (buJdngs wilh 3 ot less units)
Minnegasco metlianical ventilation Ponn
Plans are considered ublic information uniess ou state the are trade secret and the reason.
Date / / 7 / ( 27 ?
Construction Cost ?1-0ODD
Site Address ? u r+ 2Orls w g-G 7?& UniUSte #
3
Description of Work O0Gg /Q" P t2! %!ov I
?
I
Mul[i-FamJy Bldg _ Y[r N Fireplace(s) 0 2
'
Property Owner Ayu,v ,y-?f?-/L l 9
? FfEQ/ Y%7 Telephone # ?.5? ) ?/SoZ -1 ?'JvZS? '.
Contractor /6m`s A4'*'e ?EO. ai.e i?Tin, 'vo )
nadress /OD?7 (.v? ?/?_?UU?
?R dr -
I
cicy ?i9-ef?vs?
State Zip S5/;X3 Telephone#(65!). 31,7-'ar37
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Resitlential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submiried - Submitted
. Energy Envelope Calculations Submitletl
In the last 12 monihs, 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 Contracior
Sewer/Water Coniractor
I hereby apply for a
Telephone #(
Telephone #(
Telephone #(
and acknowledge that
is complete and accurat
e;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State ot 1v1N
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.
//M &,-JD ?
Applicant's Printed Name Applicant's Signature
?.
DO NOT WRTTE BELOW THIS LINE
Sub Tvqes
O 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Eut. 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 IW 18 Deck ? 23 Porch (screenlgaiebo/pergola) ? 36 Multi Misc.
13 05 03-plez ? 11 10-plex ? 19 Lower Level ? 24 Stortn Damage -
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous -
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration .0.. 37. _ Demolish Building• ? 43 Reroof ? 46 Wndows/Doors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
DBSCrIpti0I1: WaterDamage_Yes
Valuation UvO. p'D Plan Review 100%or 25%
Census Code ?
SAC Units
# of Units
# of Bldgs
Type of Const
Occupancy .Sf2 C ? MCES System
Zoning City Water
Stories ' ' - - - -- Booster Pump
Sq. Ft. PRV
Length ? y Fire Sprinklered
Width - °`-2 a
REQUII2ED INSPECTIONS
Footings (new bldg)
p Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Fina(
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
_ Insulation
_ Sheetrock
FinaUC.O.
ZO Final/No C.O.
HVAC
Other
_ Pool Ftgs Air/Gas Tests Fina]
_ Siding _ Stucco Lath _ Stone Lath _Brick
Windows
_ 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
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I hereby certify that this survey was prepared by me or
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Land Surveyor iznder the laws o£ the State of Minnesota.
LeRoy . Boh1en
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Rev, 6- 9-Ya? Registered Land Surveyor I4o. 10795
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2 hereby certify that this survey was prepared by me or
under my direct supervision and that I am a du].y Registered
Land SurvQyor under the laws of the State of Minnesota. 2c--4 , co - tn - 9s LeRoy X. Bahlen
Rev. ?• 9-Ya" Registered Land Survefor i4o. 10795
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2012-06-0511:29 » 651975 5694 P 1(2
Use BLUE or BLACK Ink
For otpce Uss /
~ Permit t!: CO~~ I
City of Wan
® I
I Permit Fee: cen,
3$30 Pilot Knob Road t
Eagan MN $5122 i Data Received: ~ 121
Phone: (661) 675.5675 t I
Fax: (651) 676-604 t Staff:
L------------------ 1
2012 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date' l 1 Site Address' U I~~('l (Y1 ~U.)'1 yt Tr
Tenant: Suits
Name:
-_.._..r,. , A Phone:
Address / q/ zip:
fe : Namme: License #:-b 10~
3
e
Addre88 S. 1 Chy:
State: . Zlp: Phone: --tolea Kk
Coned: PmaiC
- Replacement
'i New Repair Rebuild _ Modify Space Work in R.O.W,
Oetcri on of work: of n
lv'' irr ~rM
RESIDENTIAL "J
. . Water Heater
x: Water Softener
Lawn Irrigation C_ RPZ / PVS)
Septic Stem Add Plumbing FL U M Main I ~ Lower Level)
Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$60.00 M Water Heater, Water Softener. or Water Heater 80,E Softener (Includes $5.oo state Surcharge)
$80.00 Lawn Irrigation (includes $5.00 State Surcharge)
$80.00 Add Plumbing Fixtures, $enllc Svstem Abandonment, Water Turnaround' (includes $5.00 State Surcharge)
*WaW Turnaround (add $169.00 if a 5/9" meter is required)
$105.00 i&5yatIM New (S1o_oo per as bulQ) (Wudes County tee and $3.00 Stete Surcharge)
TOTAL FEES S
CALL BEFORE YOU DIG. Cell &*her State One Call at (661) 454-0002 for protection against underground utility damage.
Call 46 hours before you Intend to dug to recelve locates of underground WOliea. L
I hereby aolmoMeope that eft Information is complete and aeeunmte; that the work VAR be In conformance with the ordinances and codes of the City of
--c""-:-fbaf I I t.oNy.aa..applin6on roc a.pwet t-be-ir►-- -
aorord Wfh the approved plan in the case of work Alch requires a rWew and appr mral of pans.
Applicant's Printed Name Applice i 8196 r
/:;r-:s•:; 1, • ;r
FOR'QPIE / ♦ r: . "rI r ll~ a l r r 1 / 1 4 ..~,1 r ; , • ^;1 •,Y
qow it
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zAf2-04.9016:10 6519755694 /
Pae~ t
Use BLUE or BLACK Ink
_ --------------
� For Office Use j
1"�t (� n j Permit#: �,��7�� I
11 b� U�����il i °� I
3830 Pilot Knob Road � PermEt Fee: d i �
Eagan MN 55122 � �
Phone:(65'!)675-5675 l Date Rec�ived: I
Fax: (651)675-5694 � �
� Staff: �
. . � . . ��.������������'��J .
. . « . � � . � . � � � «.. � � � . ,
2014 MECHANICAL PERMIT APPLICATI'ON
❑ Please submit two(2) sets of plans with all commercial applications. -
Date: l��l-��1 s�te add�ess:_ �l2� � ���.S v`l'�, �.,lLO�.� �Y�G,i � ,
Tenant: Suite#:
� � - ° (1 ,�,n
Name: �U11'�� 'd'_t G�1r 1 1[ '�Y'�� 1}'� Phone: ��- �(��7
..
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�,.; �. ;, °,': -1, : Address/City/Zip� h �� �2
� �� � �
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_
t <... �k�3,� � �� �� .. Name: License#:
� � �� Address: ��� `'������L�d�$� �.r���'s��� ����a Ci
�r+C1t�#1"�C�#�' '
� �� � � �, � � '�'C&�� ��,a��� ��� �.
�� � �� ����-��: State: Zip• �i' ��6�tsa`c�-�ra� ���
�� �� � e .
�� � � � Contact: �51-�34��r�1�
�. `�� .. z,.,� �-�°� -�
�
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�� �� �� ,�� �, �
� � �� New �Replacement Additional Alteration DemoliUon
�
�� : � �� � ���
,�fiyp����►It�"�C�� ; Description of work: v` �i�- j�- �
�w �,, ��
� _ ��� �� �,�` � i��'C� ��'f m�!�in ed,�ncl�r��idr�ou�#+�tr���ar�t�i����pr��`'�s:��re���#t��������r��t�r�
�-.: � ��� : � �`�:�i�d�,.���se°�ant��.t#�e��Ch�k1l�c�l��sp��c�rf�r�i� ���or#�� �i��cr������r���c��'�..� ,
. . - �, . . : .,. �
, << . �
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� . � . . . ... . .. . . . . . . ��. ..: . .
f� � a �� RESIDENTIAL COMMERC�.4L
� `� � ��.� �� '�„_ �Fumace New Construction Interior Im rovemenf
� � — _ P
� ��������p�� � ; �Air Conditioner _Install Piping : _Processed :
� � _Air Exchan er _Gas _Exterior HVAC Unit ;
� 9
� �� �� _Heat Pump _Under/Above ground Tank (_Install/_Remove) �
�... � � ��. Other �
RESIDENTIAL FEES � �
$60.00 Minimum Add or alteration to an existing unit(includes$5.00 State Surcharge)
$100.00 Resitlential New(includes$5.00 State Surcharge) _$ (,Q O.(�Q TOTAL FEE
COMMERCIAL FEES
Contract Value$ x.01 �
$55.00 Permit Fee Minimum
� � � � � � �
$70.00 Underground tank installation/removal =$ Permit Fee
"'If contract value is LESS than$10,010,Surcharge=$5.00 �
""If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 $ Surcharge*
"""If the project valuation is over$1 million, please call for Surcharge - -
_$ TOTAL FEE
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and'codesbf the City of
Eagan;that l 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.
c
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1 1 D X� �
Applicant's Pri ted Name App' s Signat r
��������'��� N' 4 �7
�
;�. .,; ; �: ,, ;
R�qu�rec�Inspec'�ions�`. � �
Revrewed�y ,i � �Aat� r
� � ,� : : , �
: �.Iridergro���.�� F�c�ugh�n .. � A�r�e�t Gas;Ser�r�ce��st � ;:: ��-�(��,�3e��_. ,�ia'tal.� �,�����t'�e�r����.U�,;:" ,
4111)01.
City of Eqpt
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
a 26 216
Use BLUE or BLACK Ink
For Office //Use t `°-;
Permit #: /I
Permit Fee: / c:2.6 9
Date Received:
Staff:
J
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7/25/2016 Site Address: 671 Crimson Leaf Trail Unit #:
Name: Cari and Lynn Meredith Phone: 651-452-1925
Address / City / zip: 671 Crimson Leaf Trail
Applicant is: Owner 1 Contractor
Description of work:
Master bath remodel
Construction Cost:
$23,000
Multi -Family Building: (Yes / No ✓ )
Company: Sicora IncContact: Britt Hanson
Address: 5601 West Lake StreetCity. St. Louis Park
state: MN zip: 55416
Phone: 952-929-0098 Email: bhanson@sicora.com
License #: BC253425Lead Certificate #: NAT 26298-2
If the project is exempt from lead certification, please explain why:
home built in 1995
fA
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
Fire Suppression Contractor: Phone:
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.00pherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
N
days of permit issuance.
(..(asIN
Applicant's Printed Name
nt's Signature
Page 1 of 3
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
0J � ,?//2O NOT ITE BELOW THIS LINE
DESCRIPTION
Valuation
Plan Review
(25%_ 100% )
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
Lower Level
Interior Improvement
Move Building
Fire Repair
Repair
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: _Ice & Water _Final
Framing 30 Minutes 1 Hour
Fireplace: _Rough In Air Test _Final
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
I.,
Shower Pan
Reviewed By:
Siding
Reroof
Windows
Egress Window
E79z/
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
_ Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
w
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Pool: _Footings _Air/Gas Tests _Final
Drain Tile
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings _ Backfill Final
Radon Control
Fire Suppression: _Rough In _Final
Erosion Control
Other:
, Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
Aug 0516 10:02a Paladin Plumbing
411011 CityofEaaafl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
7635153818
L
p.1
Use BLUE or BLACK Ink
For Office Use
Permit #: 5�
Permit Fee:
Date Received:
Staff:
2016 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Cr-./ �C� �---
Site Address: C.11 Citl S6 LCt.('l-
Tenant:
Resident/Owner
Contractor
Type of Work
1
J
Name:
Address / City / Zip:
Name: Pt l�'� YI-UFh1iY1er License #: 4i6 L_L ()O
Suite #:
Phone:
Address:
City: h `. 1 -'ml t" i
State: H 1 `k Zip: .5.-3
Contact: 1.-'t
_ New Replacement
Description of work: t�e.io
Permit Type
RESIDENTIAL
Water Heater
Lawn Irrigation (_ RPZ / PVB)
Septic System
New
Abandonment
Phone:
Email:
' 6.3 -LL 5- 4,n
Repair Rebuild . Modify Space _ Work in R.O.W.
ns\ -Lk � ne ,; ,�bl 5t-ivi :c� ,'fb t -e-:
Water Softener
Add Plumbing Fixtures ( Main /_ Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge}
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes State Surcharge)
*Water Turnaround (add $280.00 if a 3/4" meter is required)
$115.00 Septic System New (includes County fee and State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend lo dig to receive locates of underground utilities. www.00nherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
xi nisE1J .;
Applicant's Printed Name
(1 -t
Applicant's Signature
FOR OFFICE USE
Required Inspections: Under Ground Rough -In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read
Reviewed By:
Date:
Manometer Staff:
rs
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA143991
Date Issued:07/07/2017
Permit Category:ePermit
Site Address: 671 Crimson Leaf Tr
Lot:6 Block: 1 Addition: Autumn Ridge 4th
PID:10-12303-01-060
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Lynn M Meredith
671 Crimson Leaf Tr
Eagan MN 55123
Giertsen Company
8385 10th Ave N
Golden Valley MN 55427
(763) 546-1300
Applicant/Permitee: Signature Issued By: Signature