925 Cliff RdAddress 925 Cliff Road
Zip 5512 '
IAt 3 Blk I Su6 Acorn Pond Addition
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPEGTION.
Date: Yes No Inspector: L
Final grade (6" from siding)
Permanent steps (gazage) x
Permanent steps (main entry)
Permanent driveway X
Permanent gas X
Sod/Seeded grass ?i
TraiUcurb damage
Porch
Basement finish ?
Deck ?i
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply ro
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 6efore working in right-of-way or installing underground sprinlclec system. ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
L -71D BL 1 CITY USE ONLY
^ ^
SU80. (Al C-CJ 5r Y-?'
RECEIPT e: 7
RECEIPT DATE: 67110 U
PERMIT # I O G Sl
GWV P4VDiDl1\e Tili?iRl• \umENTIAL)
4ffi OF '{:A6M
3$30 PILOT KNOB RD
EA6AN, bIN 551E2
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
nvri ioec FACH
#
TOTAL
Alterations to existing dwelling - minimum fee
Describe: $ 30.00
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
G85 i in OutlBt " minimum • 1 3.00 x = $
Hot tubls a 3.00 x = $
Kitchen sink 3.00 x = $
Laund tra 3.00 x = $
Lavato 3.00 x = $
S0 tiC S tem newlrefur6lshed ' re uires MPC Iic. 75.00 X = $ ?
SE tic S stem abandonment 30.00 X = $
RPZ new installatioNrepair/rebuild 30.00 X = $ ?
Rou h o enin 1.50 x = $
Shower 3.00 x = $
Under round s rinkler if dwelling is under construchon 3.00 x = $
Under round s rinkler ifexistin dwelling 30.00 x = $
Watercloset 3.00 x = $ ?
Water heater 3.00 x = $
Water softener If dwelling under tonstruetlon 5.00 x = $
Water softener if existin dwemn 30.00 x = $
Water turnaround 30.00 x --- _ ?
State Surchar e .50 --> ---? --' $
Total -' --' ----> ._?
n i $
r l
Reminder: Call for inspections of alterations, i.e. water heaters,ater safteners, etc. ?
----------- -------------
--"------------------- -----...- ---------------------••---------••---------•---------•-----------------
I here-by acknowledge-tt?at I have-read- -this application, state that ttie informatlon is correct, and agree to comply with all applica6le City of Eagan - ord - inances.
I[ is Ne applicanPs responsibtlity to noUy the properry awner that lhe City of Eagan assumes no liabiliry for any damages caused by the Gry dunng its nortnal
operatlonal antl maintenance actiwties to Ihe facilities constructed under this pertnit wifhin City propertylright-of-way/easement.
SITE ADDRESS:
TELEPHONE #: I? ^ / f/ -?D 77
OWNER NAME: : LL?le_
(AREA COOE)
INSTALLERNAME: TELEPHONE#:
(AREA COOE)
STREET ADDRESS: ?17?? ??- 4V -
CITY: STATE: 1-;-707 ? ZIP: ?3a??•
-?'
SIGNATURE OF PERMITTEE
,. ON-SITE SEWAGE TREATMENT SYSTEM - INSPECTTONREPORT
nffl;cam ana Permit a: C'har /eS RZ'hczrol zor• nau otIrivocuon: S-.7-6o
!
inspecteaby: DirK d6uSc $*41'4VV 47nsPecfi0r. PawdID; /6-l6at50-630-0
Munic;paurirrownship: 61v 6F C040-&l sice naarm: Qi:?s c/ rf' ,Pe"id.
_._. ,.,
gOUsE srr,? A" soms : : ;;: . .... . <
?# Soil Borings U(1 elC 7.? to ResUiction House Type: Q II III
(?)
?# Perc Test Gatbage Disposal: Yes / Na
Type: atawmg Bedroac w,aw,.w
/G??nverage r«c xate # orBedrooros
/.67
cn _ ncttprance Rate -
("v FtJgd) ? 11 Potential Bedrooms
Resecve Area: '&/ No -
-:.-::. :- : ? _.. . .... . -
... . . 'r:'?.'?`???:?.•.? ..'?:.;?'s:'??.,.-,?_?.•r"?,?TI?"??iAA,?''':?`?+r''WL'I?'1?AIY,A17i ?ris.,,'r?';?a':--:..;.:;:r:'i..?[-r':;:.;;s.;?.;::_':?:.••,,,.;.(,,;,-:.
2 Number of Septic Tanlcs
2- ?? ?tY (i.ooo $ Min.)
Pro-fab Tank Model: CYed / No
1,-'Outlet Baffie (37%of mW liquid
depth. 6,• abave liquid wdiux)
L,-'Outlet a min. 3" below inlet
tl?[izoutal Dimension (s4^ mio.)
?Tank is level
_k:f-'Inlet Baffie (e^ ndww sywa-i^
above idd aown)
?Inspecfion Pipes (4^ .W.)
?Manhole (2a^ mia)
Pumping tank Yesdi5-1)
?Liquid Depth (so° min.) ?Watertight Construction
.. . . . .. . :: :..: . .. .
_,,.,... .
,....
..., ,. .. . .
...,,,,_ •
. .. , .
: : . . .:. : : :::.r . :.. •;<;
?Property Lines (10')
?WCll (73')
Nb` Yct DI'''tl".
? $w?d?agg f107
1,-'Recmation & Tributary (73•)
V Buried Water Ptessure Pipes
(10')
k"All otLecs except Rec. & Trib.
(iso')
,_ . _..,. _.
..
. ;.:. ,
t/suudings c20•>
Large 1Yees (io•)
?PropenyLines(io.) -
1-?x«reauoa & Tnlmtary c,s,)
Well (so• m iaa•)
*ar- yC,f Dr??w,
L?-?Au offim ««pc xec. & Trin.
(,so•)
l/ Buried Water Pressure Lines
(lo')
, .. .
,. ..
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s. : : . ,.,
_J:?4ate[tight Construction
_Zinlet Inverts (I" .bore ouuee
imat)
?PB C011IICCIlOR
?pe to Drop Box (unpafaarea)
!"et InveIts (4^ ebove H?)
1'1 Box is I.evel
Distdbution: 4? Pressure
`7 Number of I,aterals
'ROCk j.1LdCi PIj1E (6"-24')
Lateral Lengths (100, m.x.)
R[ICk OVC[ PIPC (2')
Total Trench Depth
9QPL Tatal Sq. Ft. Trench Area
Site Drawing:
D12AINnELD .:.
C04n
i. . .
.?• Trench Widths (ia•mirL - sc•,
mnc)
Rock is Cwered (wim wata
raoa.m.w,a)
G r?" I2tCCd1 S118CIilg (7' on aNu
Plvkffcd)
p vQ2 7 sottom of Trench to water
iode, Table or Bedrack
N
'f
O
?/?Siope arP;pe
? - ? 'Ll over I.ate[als (6" mio.. 36"
max)
Size af Washed Rock (3ia^ w
2W)
L}. o
I??oY ?Ajd?
Q Scc?LP-
SOMrI.
? = feet
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Designer: &1Z?L p(/bu) cZ G. C.#? 1"7 7d? Approved: es No
Installer: ZCI'/Q,v?e( 5eea1-o2 d- t.Je,4-r_? - c,l'L Signature: ?e
...,..? !?-,a -oa
'I9.ur14 `4';z`,IlNfi
YewConaWetion RetuimmeMs
P3.-APPL1CATFOFi ixiiSIDENTIAiJ
CITY GliP EAGAN
3Me :'PILOT KNOB RD - 55122
651-881-4675 ? ? ?-1 ? • ?S
tl a U
allReuair Rsaulrenrft
9 3 te?aterat slte survsys sMwinp s9,1L of b; sl. R of house R?wpi?a u? ;!a?e
and all roofad areas (20% mazimum lot coverege ailowed) 1 set of onergy cakuladone for heated adtlilions
? 2 copies of plaro (show beam & window sixes; poured tnd. desigu; ek.) 7 clle survey for axterior addltbns b dacks
D 1?n:ofanergycalculationa
D 3 co;4es of fres srvaUon pHn M bt plaUed after 7H183
?g^n
DATE: CONSTRUCTION COST:
OESCRIPTIONOFWORK: Nra.?t co.3r?"n2ucyt,,,, - l^-AM% L?r
STREEf ADDRESS: 4 Z S GL t F r 0-m m?,
LOT: 3_ BLOCK: l SUBO.fP.I.D.#: Acu*.j
I'
PROPERTY
OWNER
C9NTRACTOR
ARCHITECTI
ENGINEER
I
Name: 2n in s-3 -T Sv »-L.n..-n 2 u ut[
Last Fl'st
City a'"3UAus..r I u.`. State:
Company: 111cwqrW t-+c
(&iz)
Phone#: 89 1- C 0 l 9
Zip:
Phone M: (!I2. - R 37- 4o Q'7
(area code)
StrestAddress: 1AgAS =llovwoeo e-ir Lieense# LTZ.G Exp. 3.31.00
city State: An-j • zip: 5 5 3 A4
Company: SAMNL. AS A%av` Name:
Talephona p: ( )
• Street Address: Registration #:
City 9tate: _ Zip: _
c- S?
st--e w?
Sev/er3waterlicensedplumberlnewcanaWctiononMl: Lod,?a-ae Telephona#: 615I -t131 - 9la5
Pet1aNy epplies when address change and lot change Is requested once permit k issued.
1 hereby aeknowledge tlwt I have read tlUs epplkaHon, sfate that the Infomudon ia co ree to om p II applG ble State o'nnesota Statutea and Cit
• A
of Ekgan Ordinances. TW'A"
Signature of ApplicaM: ?
OFFICE USE ONLY
Certificates of Survey Received --?WYes , No
?. G
Tree Preservation Plan Received 7s?)1'es _ No _ Not Required ?
OFFICE USE ONLY
:
BUILDING PERMIT TYPE ,
? 01
Foundation
?
06
4-plex
?
11 10-plex
?
16
Fireplace
?
21 .
Porch (3-sea.)
)( 02 SF Dwelling ? 07 5-plex 0 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.
? 03 1 of _ plex p 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 5torm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
)K 31 raew ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Sidi ng/SofFds/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Daors ;
? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of 5tories
Length
Width
APPROVALS
Planning
? Basement sq. ft. ?? Census Code /o/
y/ Mti! Main level sq. ft. SAC Code
? sq. ft. ?? No. of Units
sq. ft. No. of Bldgs
sq. ft. MC/ES System
sq. ft. City Water
Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
r,
Building ? +1'/Z7 Engineering Variance
Permit Fee
Surcharge
Plan Review
License
_A4C1ES-SAG-
-Water-Cn°n.
? Watei-hAeter
AGd--Dapos#-
-sw+FReFm?c
saAl-Surcbarge
Park Ded.
Trails Ded.
Other
Copies
Total:
?a °! C, , i,?- Valuation: $ `' oa
-?`Zb C)
371 70r'
?
..._--
?
-;) -?) 1Z?- .(? I-S,-
SAC Units
°k 5AC
, . LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUIIDING PERMITAPPLICATION
? PROPERTY LEGAL Lcss .3 'V?a'e / AG?,'Z"? Tv.?LJ
' h DATE OF SURVEY:
H
? LATEST REVISION: ? -- ?7 --L?20
w
?
a DOCUMENTSTANDARDS
0
? a
g-
? .
Registered Land Surveyor signature and company
m/? ? • BuildingPermitApplicant
OV ? ? • Legal description
v? ? • Address
V? ? • North arrow and scale
ea/ ? ? • Hause type (rambler, walkout, split w/o, split enUy, lookout, etc.)
?o • DirecOOnal dreinage arrows with slopeJgradient %
? • Proposed/ebs4ng sewer and water services 8 invert elevation
yY ? ? • Street name
2, ? ? • Driveway
u' ? ? • Lot Square Footage
ar'/ ? ? • Lot Coverege
ELEVATIONS
? Existln
o m' ? . Sewer service (or Proposed)
U_?o }? • Property corners
??? • Top of curb at the driveway
0 m?,? • Elevations of any exdsting adjacent homes
? m/ ? Adequate footing depth of sbuctures due to adjacent utility trenches
Prooosed
kl? ? • Garagefloor
? ? ? • First floor
? a ? ? Lowest exposed elevation (walkouUwindow)
o Property camers
vcl ? • Front and rear of home at the foundation
0/? ?
g/? ?
iil/? ?
cp?o ,o
? o/ ?
o ?
?/? ?
ar' ? ?
kl? ?
m/??
?
m/ ?
PONDING AREA (if aodicade)
• Easement Iine
• NWL
• HWL
• Pond # designaton
- Emergency Overflaw Elevation
DIMENSIONS
• Lot lineslBearings 8 dimensions
• Righ4of-way and street widCi (to back of curC)
• Proposed home dimensions indudng any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all atructures requiring permanentfootings)
• Show all easemenis ot record and any City uUlities within those eaaements
• Setbacks of proposed structure and sideyard aetback of adjacent exassGng strudures
• Retaining wall req '---__t . __..
Reviewed:
March 19W
CRAqRLDGPRMfFM
18:54 FtI 8517957321 B. Brorrn lih oo?
CE735-73z?
?EI ICcar.ATInrv RacraRT
?78E IiE50URCE MNAGE,HENT ,DOESrY'T' CQST....r7' PAY,9
7anuary 21, 2000
CHARI_ES COOMBS
(612) 937-9077
SUIIy TESTING FOlt THE DESIGN OF SIEPTiG SYSTrMS
LACATICJN: Lnt 3, Black 1, Acarn Pond, Eagan; Dakata County
925 CliffRoad
USE DF BU7i,DINCr: 4 bedroom single•familYbvwe
Twp shallow soil horings were doae on this lot soma time in the last year,
showing it to be a buiidable lot. A test area was set up recently and soii pprings were
begua Between that time and now, the ground has ftozea and percoTation tests couid not
be dAne.
My intent is to do new soil6orings and percolation tests in tfie spring when the
ground thaws. From lookiag at the resalts of racent borings, at least part of the test area
will be ahle to use in ground trenches. The secondary site anay need to be a mound or at
grade system.
I have hegua a sewage treatinent worksheet and am showiug the proposed ta,nk
size and estimateci flqw, .
Trenches will be designed to be at least 20' from the house and 10' fxom lot lines.
The well w911 need to }se at the onnncite side nf che hnuse ai lea.gt 50' frnm amr part trf tfiis
system_ The weIl should not be driiled unril the exact drainfield lacation is established.
The pand is reported to be at least 75' from any oart af the system.
'f'Itjg design will he prepared in accordance with Charner 7080 and T)akota Caunty
ruIes.
**The test area must be roped off and prokected from compaction by construcrian
traffic. If tbe test ares Hecomes compacted, a new area may need to he tested.
b ,4444?'
BARRX BR4wN
LICENSE # 1 772
pFr,rcTm e T'inrr sk al I;
01i22/00 SAT 18:55 FAX 6517957321 B. Brown
1NDIV1DtJAL SEWAGE TIZEATMENT SXSTEM WOR3C5HEET
FLow
A. Esrimated (c&0 gpd
measured x 1.5, gpd
SEPTIC TANK VOLUiviE
e, ivcu 9'1400 a uo?
aa
SQILS (Site evaluation data)
C. Depth ta restricting layer =4d&ftVAaL-T Feet ;"/dr
D. Maxi.mum depth of system C- 3 ft ;a feet
E. Texhue Percolation rate ytPI
F. 55F -sqEt/gpd
G. Slope _°/a
'ITiENCf; BOTFOM AREA
H. For trenches with 6 iitches of rock 6elow the pipe:
AxFo- x- =_sqftof6ottomazea
1. Fvt lrenches witkt 12 inches of rock below the pipe!
AxFx0.8=____xT„x9.6=_,,sqftofbatlomarea
J. For trenches with I8 inChes of roc?c below the pipe:
A x F x 0.66 =_ x,,,_ x 0.66 =_ sq ft of bottom azea
K. For ttenches with 24 inches of rock be4ow #he pipe:
AxFx0.6=_x__x0.6=- sqftof6ottomarea
BED BO'ITOM A.REA
L. For seepage 6eds with 6 oi 12 ncnes of xock below the pipe;
1SxAxF=1Sx_x-=_sqftofbottomarea
ROCIC VOLUME IN CU FC .
M. Rpck depth below dutribution pipe plus 0,5 foot times bottom area:
„ M rRoctc depth + 6 inches x Area (H,I,J,[.,KY
(- +0_Sft)x_=_cuft
xocx v4tvNta tN Cu YDs
N. Volume in cu h divided hv 27
M+27=cuycfs_+27= cuyds
ROCK WEIGHT
q. Cubic yazds tiatea 1.4 = tons
Nx1.4=tons- zl.4tons
SYSTEM LENGTH
P. SeleCt trench width = (t
Q. Divide bottom area by trench widtlt: (H, I, J, or K) = P=
iineal feet
lineal feet
Ql. Graveiless Design
A x F+( 3 tor 10" pipe, 2 for 8" pipe, width of the Chaatbet )
feet
LAWN AREA
R. Select trench spacing, center to center =„feet
S. Multiply trench izpacing by lineai feet R x Q= sq Et of lawn acea
- x , _ - sq ft
LAYdEJ'I' (Use other side)
1_ Seleet an apprapriate scale; one square = feet. •
2. 5how pertinent property boundazies, right-of-way, easements.
3. 5how locadon of house, garage, driveway, and all other
- @tooa
&umauA 5cwa¢e Flows m Gallens per tlay j
I
N
um6er fTypel fTtpelf ITypelII I Ttx
o
scloorra i ; I ry '
3 ' 700 I 2+5
3 I 450 300 IHO
218
f ft '
a 600 375
7
45 o
?
256 Y,h„a
50
0
6
fi ? 9m i SES 294
In
332 I
T}SS l. i
7 f l?SD I EOp Pp !
?ar
8 ' 1200 1 675 .tp9 _
i¢
5?. mnna r???s???
??y??a ?a???,..
Mumlarn! 4iniiewpbVeM UWd?+ad+,r-p w??hJum?wx
9?+1?wnu C?n yv0lt?Jtlpad 41LianJe
7 ur les :91 1111 UM
1
3 M? 3(Ipp IS110 JAXI
S:r6 ilpp 7730 YIIXI
t.x.rY :u7n kluo . +Har?
Soi1 Charaeterisii4s and Requircd Aress
far5ewa eTxatment
percoluion Ramin Square
Minutes per lneh Seil Festuee ka per gallon
tMPI1 pcr dar
Poswihan0.1 • co,neSara -
0.l to 5 Sand . 0183
0.1 la 5 Fne SenO •• 1.67
610 15 SaAdr Laam 1.27
161030 Laaro 1,67
31 te AS Sat Laam 2.00
461c,60 CYar I,pam -^p '
5ltwsrWanfiO'•• qav .--
• Soil wo eouu ror sevlge o-eaurcian-
USe SVvAmf (Of I'dPIdlV penryWbf650115_
•' Soil itfMe 90%or ritmt of fine wid
" plu:vcrynne sula.
•' •Sai3 wifA ieo [pgh a areuuge of clay far
insulladon o[ an ingrunnd.tton6utl sysam.
6 inehes= p% Reduction*
12 inehes= 20% Reduciian
1B inches_ 34% Rednction
24 inches= 40% Reductiext
* siziseg for graveIless trench I
abric
t Cover
t. Pipe
Rock
1/2"
4? ?
'4?
Cb
co
x
?o
' agpi] nµ???. ?y ^
??*90N
? ?i? ely
?
? ? J?? 1 . • ?! ? y ?? ? % r ?' V'? H
*?1 ..n `?tt?![?? ; ? w ?? E.
'°??? -.?•' y ? ?`"'.L'-"';:` 4 ? ?
r? f p ? ?4?
? ,L
tiys
? ? a- ? +?, . ?'??;,{_ _,? •? '
ak.xj
41
?,?,`?`'"`_??,???? 'x
t0 { a
- =-?---_._._.1? T •?-'?? ?.-?" N ?' -?_?_. _... Mo.
p_,____ - %t
v ?`--Pasable Retoining wall ----------------------
`--Pcsable ------ --------
tnvy be needeC in tltis area.
PROPQSE?ve nranrS' I?olES•' e
W ar &oar ? 9e4.4 vNoMs ro GcFwr twwcoPE com
cVAOr Ftoa? = se.J-7 oss. MrvoIEs PrtGPvsErt fcfvArrovs
towsr FtooR ;eTS s 023_0 1,FM4TES EXISANG EtEVA WWWS
GRAPHIC SCAC,E •? NavQnrs nWenav af- oRAuV,4eE
A+CYD WRnCAt DAIr/AIN
HA'lSf & GAR. = 23B.1 6 S F.
[aF S1,ZF = 87,25a.9 SF,
x
$
?
?
Y.?
?
0
?
( Dl l86E )
1 iaoh e 30 R
MNcheck COMPLIANCE REPORT Minnesota Energy Code
MNcheck S'oftware Version 2.0
Minnesota Department of Public Service
1-612-296-5175 1-500-657-3710
COUNTY: Dakota
STATB: Minnesota
ZONE: 2
CONSTRUCTION TYPE:
DATE: 1-21-2000
DATE OF PLANS:
TITLE:
COMPLIANCE: PASSES
Required UA = 438
Your Home = 372
Single Family
Permit #
Checked by/Date
Area or Insul Sheath Glazing/Door
Perimeter R-Value R-Value U-Value UA
----------------------------------
CEILI43G5 -----------
429 --------
38.0 --------
0.6 ------------- -----
13
CEILINGS: Raised Truss 2533 44.0 0.6 33
WALLS: Wood Frame, 16" O.C. 2898 19.0 1.2 155
GLAZING: Windows or poors 329 0.290 95
DOORS 160 0.330 53
DOORS 38 0.350 13
FLOORS: Over Outside Air 23 30.0 1
BSMT: 8.2' ht/7.5' bg/8.2' insul.
---------------------------------- 166
----------- 10.0
--------
--------
------------- 9
-----
COMPLIANCE STATEMENT: The proposed building design represented in these
documents is consistent with the building plans, specifications, and other
calculations submitted wit the permit application. The proposed building
has been designed touwe? th requi?"ments of the Minnesota Energy Code.
Builder/Designer c?Li %/J Date .1a.... 24 , zaoo
' NEW HOME FIELD INSPECTION
- ENERGY CHECKLIST
PAGE 2
MINIMUM REQUIREMENTS
( CATEC'OKY 21
INSULATION:
[ ] Vapor barrier installed
[ ] Interior foundation wall:
( ) Vapor barrier installed
( ? Insulation installed: R-_
( ) Moisture barrier installed
[ ] Attic insulation installed:
R-
[] Attic card posted with proof of
hags installed
[ ] Floor insalation instal2ed:
fib-
[ ; Nal? ilTs^,.latsm i:mstalred:
( )R-19 ( )R-21 ( ) R-
WI1?T"i 7d'Ti SF'i RARti=3':
[] Wind wash barrier installed at
attic edge
[ ] Overhangs (cantilevered floors
and bay windows)have wind wash
barriers
QPTIONAL
('CATEC'a1ZY 11
[ ] All exterior joints in
building envelope sealed
MECHANICAL:
[ ] Ducts running outside conditioned
space sealed and insulated
with minimum of R-8
[] Returns in same space as furnace
sealed
[ ] Ducts in unheated spaces
[] Water heater has pipe insulation
or heat traps installed
[ ] E'urnace AFUE :
[ ] Central Air SEER:
( ] Residential mechanical
ventilation system
installed (Mandatory if one
or more item in this column
is checked)
----NOTES TO FIELD (Building Department Use Only) -------------------------
NEW HOME FIELD INSPECTION
- ENERGY CHECKLIST
MINIMUM REQIIIREMENT$
(cxTEGUxY- zT
QPTIQNAL
r)'
FOUNDATION:
[ ] Exterior foundation wall
insulation installed:
R-
[ ] Slab-on-grade insulation
installed: R-
[] Ducts in slabs have R-5
insulation bottom and sides
PENETRATIONS:
[ ] Win@ow and @oor frames sealed
() Framed wa7.l openings into attic
sealed
[ pOther joints in wa23 sea3ed
[ ] Dropped ceiling air-blocked
[ ] Foundation zirri joist sealed
airtight
[ ] Upper story band jo35ts
sealeci aastight
[] Ceiling poly sealed to top
of interior partition walls
[ 7 Plumbing penetrations sealed
[ ] Exterior walls behind tub
and shower sealed
[ ] Plumbing vent stack sealed
[] Chimney flues sealed at ceiling
[] Perimeters of all grills and
registers sealed to vapor
barrier
[ ] Electrical service sealed
[ ] Recessed light fixtures sealed
[ ] Wire penetrations into attic
sealed
[ ] Telephone, cable TV
penetrations sealed
[] Fans sealed where vapor barrier
penetrated
[ ] Electrical boxes sealed to
vapor barrier
[ ] Fan housings air sealed
. • S T? t6,
\
.'a . os ?:vqus vall asra fer
Lr..:nc cu::r.:ruc:ion
Yaqn Tco
Conscrucrinn R-valu¢
ia z
1. Interior aiz film
2. YZ' eew ea.? o ws
3. s%i i.nchcs soft w.+oC d?bB
4.
5. ?/4' 2.•n...seo S•o..as 0.44
6. Extcrior eiz film ? 0,17
1bta1 1p.]4
•v?3 -
S
+ us 0.o44
cca
1?n? i
r
Q = .to qa7.
1.
Interim
2.
3.
4.
S.
6. Exteria;
mcPOS.o rr,.¢, .,.r, - Fw MWr r
Intarior air film 0.68
i2' e+..? ?.?? 1 ZS
y ¦ 0. 04? -
?+1 bA+u? S Snicco u= O.oqfo
' Vt+ 11!
1. xntrrior air film
0.6B
2• SI! * os .r ?Je.a.wT. ?a 11• OO
3. tY:- So,. r -.w.o e.es
4. y2' -J a MQQI^? f Atw -aC 1 22.
5. 3/a' 0..q9
6. Exterior air film 0.17
7otct 23•d,
u =o.oas
l.
2.
].
4.
r
?•
G.
.
ZG. 13
a. - • ?
. ? ?
•p ?u• . -/' ?, ,,,`? .
c.*uoe
Fic, ra
Extorior air film 0.17
'POSal
u•o.VZ4
. . . • • `
? ?? x • ' • ? ' '•t` '
?r?? . • ' .. ,
/f/
it?
= k •? ? • ' ' _ ??r
rr? a? • o =
?c X
(l! /,r .? l!! _. ?i? _
Indtcate tyoo, "*^ valu:, denth and
Placaosac of inaulatian.
NO'fL• a
Pagn :e•e
Constrvcrion Ii-Va]uo
ana/v+.w. e lo,S
1. 7nie.-ior air film 0 f8
2. Yi cv4
3. S' " f.nch.cs soit w'+od ?.ae
4. _SA' a..? erra ' a SL
5.
G. Exterioz air lilm r 0,17
1bta1 d,74
Y1f.1l.,
• 101i ' .
l. Zntcrior air f31m 0 6U
3. fi4x? a+s ? e..ta
d' "'? M1? O •56
5.
6. r:.terior air tilm p,?7
Total 20.64
.i• e.a48 ,
VMrLe"n.+s.
1. Sntesior air film 0.68
2. A' :.... ?e...? a wA
].
<.
5. '
6. Extarinr air film 0,17
'1btLl j.40
Y a 0.417
apoor?s srwL ftvl - W? ..-%?
1. Zntorior air film O.GB
,? ,..
2. 7.
]. ,...• , 6.00
4. _L. ?.. .s 1. 2A
r
J•
G. Exterior air °i:m 0.17
Total
.Js a• 043
! G*EFOr
!J
. . ?
.
. u . ? ?? •
. . ` `. .
'' -
P . ' -/ • . ? '
. . , • • ?
• ??
'"' ,/!/? . . •'` .
i ?
I(I ? • , . . , _ ?? ?
FIG. 04 ? k .• • . ? ? /?/
!fl d, • C,
> ` /?/ •
1i( "_ ir? E. _
roo'1'.:: Indleat• tyva, '?`^ valus, deneh and
. rilaecnsnt of inaulatiai.
?•? •?. eS• rl.aqca vall a:ea ior
:Z:,1ar GVIf.'.tZt10L10O
Paqa ?hrae
AOOF/CESLI:iG
«a e 9 07,
Conatrvction R-Valum
PuiT
. ? i 1 2 '
Vsnc_d 5nat flow
? up
F:G. ".5 '
l. Interior air film 0.61
2. _ r/a' e.o c,n? p S.
3. 4.50" O?*? ?•???o„t??? AA.00
4. Extcrior nir tila fsta111 .a
Tosal ?E.7b
ti T o.oilp
Q - SO - SI.76/ v_ a.0l 93
u.a c I o?L
1. Intezior air film 0.6I
2• S/e' m.o aae a. S6
3• _g%z' s.Rr r..w b•aE
4. L•xtersoz 31??1 6 Stli1)
• TOtIIl
4 av?. ?+saaws .+? s?.ao
ss. vr.
.? ` o•v2D
2• so - A I. J= o, 02Ao
O.Gl
1. Insi.dx air film
2.
3.
4.
• S. Ouiside a ir film 0.17
ToGal
MoCC: Vnc a3ditional shcets i: more spa;c i:
neecicd foz dr.tails and caleulaCions.
1 I?aat flov up ' ,. venced
.? iW?/?V!',!?]E'] • ?
. Hnac ?
flov up '
PT.r.. 47 • • ,
?:.
',
/ • ?.l? '. '?' ''•''??i•..
. • ?. ?
• . . •. } ? 1 • ?
-. - ; _-
.
ov?a?w..cs e ?o?
' '• =`=c ' cc= "-= o.bl
=. 3 . ..? . 0.93
3. 9 " sarr .veee f1.88
air fLlm stL1L. 0 3I
. S. i5 :.?.a 3¢s p.56
ia sq
u = o. 061
_e±v.?u?!?u3, 0- 4a7. '
ii
' • ?;i
•/i
. . ? . w n A ?..i. .? ^.
. ??? . . . .. ??/ t.:l•..1
' • :? ' t:?`??:i.?
. .,; .
-- •^ '?' ----
' ? ..•
...... _ ?. ? '
i ?
.. 2ntQrsor at.r ?cl.w
? • a EM.t ..?S?L?'S r--?
;. Exeertier wir ?i i+ S??il ,
YO ?KrC • '• •r_ ?
0. bi
0.99
30• 00
_O. bl
o.Sb
u= 0.031
.-m
' - - --'_•----_- - - ? - . .
=• ='= - -- ?- =. _. •--
- .e? ..???"'''?' ' . ' - '_. • .
: `. Ci .? . . .. . ..
?Vi5 c6P y
41k.
(SEE ATTACHMENTS)
Development ICrCO ro,\ -?10\116 ?
Lot Number
Address
Builder
Bloek Number
Ct z.S;, C lA 'R. Z
GU, Z
cv,, ,? C wtc; 61z-a3l-9o'1
Tree Protection Reauirements:
Tree Fencing
Oak Tree Pruning (Seal wounds during April 15 to July 1)
Therepeutic Pruning
Retaining Wall
Other:
Reolacement Trees:
? Not Required
As Follows:
Attachments:
Yes
No
Additional Notes:
? ?Uv
o?
??a
suso.? IT'c-, i?Y ? 1" 6 VI d
CITY USE ONLY RECEIP7 #: Id 5 S 1 I
RECEIPT DATE:
PERMIT# qC E-; I'uJ
2000 PLt7NBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 BiLOT IINOS RD
EAGAN, D47 55122
651-681-4675
Piease complete for: ? single family dwellings
D townhomes and condos when permits are required for each unit
D back8ow preventer for underground sprinkler system
FIXTURES
EACH f/
TOTAL
Alterations to existing dwelling - minimum fee
Describe:
J $ 30.00
Bath tub
'? ?? $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet " minimum - i 3.00 x = $
Hot tub/spa 3.00 x = $ ,CD
Kitchen sink 3.00 x = $ ,pQ
Laund tray 3.00 x = $$. C)o
Lavato 3.00 x = $ ,pp
Septic System newlrefurbished ' requires MPC lic. 75.00 x = $
Septic S stem abandonment 30.00 X = $
RPZ new installetioNrepair/rebuild 30.00 x = $
Rough openin 1.50 x = $
Shower 3.00 x = $
Under round sprinkler if dwelling is under construction 3.00 x = $
Undergroundsprinkler rfexistingdwelling 30.00 x = $
Water closet 3.00 x = $ tD.OD
Water heater 3.00 x $ CO
Water softener if dwelling under construction 5.00 x = $
Water softener If existlng dwelling 30.00 x = $
Water tumaround 30.00 x - _ $
State Surcharge .50
Total -> -> -> -> S
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
--------------------------------------- -------------------•----- - -------------•--------------------------------------
I hereby acknawledge that I have read Miis application, a?te that the infortnetion is correct, and agree to mmply wMh all applica6le City of Eagan ordinanoes.
It is the applicant's rosponsibility to not'rfy the property owner that the City of Eagan assumes no liability for any damages pused by the Ciry during Ils
normal operetianal and maintenance ec[ivkies to the facilities consUucted under this permk within City property/righFOf-way/easement.
SITE ADDRESS:
OWNER NAME: : ZYIU& a-S, TELEPHONE #: W&
(AREA CODE)
INSTALLER NAME: !?Inx-s UuS nUYYI6n TELEPHONE#: QFJZ 4-10-I2-0$
STREET ADDRESS: ? ZOc) LDtQ- LuC1.y K-oU (AREA CODE)
CITY: CxCe-IS?Qr S ATE: MN ZIP: 5s33l
SIGNATURE O PERMITTEE
CITY USE ONLY
LOT -3 n BL _?____ PERMIT #: " (0 ? ? /
SUBD. ErLU Y?1 I'o n DI RECEIPT #: I d W??
RECEIPT DATE: l` c7 I- OC)
2000 MECHANICAL PERMIT (RESIDENTIAL)
Dste: 31 ? -d DD
Complete this section onlv if you are installing HVAC in a single faznily 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.)
CITY OF EAGAN
3830 PIIAT IQ10B RD
EAGAN MN 55122
651-681-6675
State Surchazge
Total
$ 30.00
---6-00-
?p ?
.50
$?o1SG
Complete this section onlv if you are remodeline, addin?to, or reairin an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
_ New _ Alteration
_ Air exchanger
Fumace
Repair _ Other
_ Air conditioning
Other
Fee $ 30.00
State Surcharge .50
Total $ 30.50
Reminder: Call for inspections
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME:
STREET ADDRESS:
CITY:
PHONE tl:
(AREA CODE)
rxorrEa: 7 6 J
(AREA COOE)
r
STATE? ? ZIP: 3s 9
SIGNATURE OF PERMITTEE
5qRESIDENTIAL
- BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55722 -%. j 1v
651-681-4675
New ConsW ction Reauirements
. 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all mofed areas
(20% maximum lot coverage allowed)
• 2 copies ot plan showiig 6eam & window sizes; poured found design, etc.)
• 7 set of Energy Calculatiore
• 3 copies of Tree Preurvation Plan H IM platted after 7l1193
• Rim Joist Detail Ophons seledlon sheet (bldgs wilh 3 or less uniGS)
DATE 8'_ '8- 200Z
RemodellReoafr Recuirements
• 2 copies of plan
• 1 set of Energy Calculahons far healed addi0ons
. 1 site survey (or exterior additiore & decks
• Indicate'rf home served by septic systam (w additions
VALUATION
SITE ADDRESS q? 5 ?1 ?? h p MULTI-FAMILY BLDG _ Y _ N
TYPE OF WORK FIREPLACE(S) _ 0_ 1_ 2
APPLICANT
STREET ADDRESS ? f '?'?' ?"? CITY,
TELEPHONE #V?? ???S81 CELL PHONE #G S? ?(O 3?
m ziP ?-s123
FAX #
PROPERTY OWNER ZM A"\ 2' ?`? TELEPHONE #?f I `Z 7U ?'2 (q?
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CA'I'EGORY I MINNESOTA Ri7I.ES 7672
(4 suhmission type) . Residential Venfilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calcula6ons Submitted
Plum6ing Contractor: __
Plumbing system includes:
Mechanical Contractor:
Mcchaiucal system includes:
SewerJW oter Contractor:
_, Air Contiilioning
_ Heat Recovery System
i hereby acknowledge that I have read this application, state that the
with all applicable State of Minnesota Statutes and City of Eagan Orc
Signature of Applicant
OFFICE USE ONLY
Fee: $70.00
N ? ? n I'I ?
? UG p g?ODZ r?
n is correct, and a?ee to comply
Certificates of Survey Received - Tree Preservation Plan Received ` Not Required _
_ Water Softencr
_ Water Heater
_ No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
Phone #
Fee: $90.00
Updated 4l02
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 af _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
Q 09 07-plex ? 17 Garege
? 10 08-plex 47 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex PI6g_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 PorchlAddn.(4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Att - Multi
O 33 Ext. Alt - SF
? 36 Multi
JI 31 New ? 35 Int Improvament ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) • Give PCA handout to applicant
Valuation 2, Ov i) Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED IN5PECTIONS
_ Footings (new bldg) FinaUC.O.
,)a Foodngs(deck) ? FinaUNo C.O.
_ Footings (addition) _ P]umyjng
_ Foundarion HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By //' l . Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City 5AC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
V
?4(?
Jha@a9 ??tt
?c x
'?1 w
s CV o
p?r6
?
x
10Z g$
V?
,
.
UtilitY
/ a 2% grade x
Maintain terline of swole, x e? ?.
Bj 8 ? 6
? along cen I , 59„ W ? s
° N 6004. '? °°X .,-
?? 271.20 --
?
X _
?•l
? j
?f
25.0 6 ao
?O$ W 27.33
?
w
?
?
J
LQ
' h3?1
+? r O
? O I
ApVI
D ?d
c ° 1
?
B.p? 1! •
= - =--
X `X
41?j? ?js x
1 ? --•. o: 'Pdl `?'>3
x x sy. -
O
O
lt
r $??$ ?,?, .93 ? ?y
? ? --------- " '?l?' °? x 3
, i -?? ? ---- ?
X ' S
? x
x X
x?s
d
?;:IX Rs'?lp ?qsA
R
t In'!: L'L-g
a-D
s" 1 ? °v
k? \ 88 -•."' 28.33
? ? +
" a
?DAA
?.,
9
10 'o N
Z'05
N
A
rcetaining wo11 to be ---
constructed in this area
not within the easement.
Extend Concre#e Block to-__,
match grade in this area.
(No Retaining Wall Here) *
,
? '0
---__"'_""-_
___'-_--
-- to be
Retoini7g wull Drainage
- ----"---
constructed in this areq "-----
not within the easement.
PROPOSED ELEVA TIONS• ' -
TOP OF 6LOCK FOR HOlJS£= 8817 (lpcrs.)
TOP OF BLOCK FOR GARq GE= 884.4
GARAGE FLOOR = 883. 7
LOWEST FLOOR =875.5
NOTES.•
f
IM '\OENOTES 10 OFFSET ENt?EZOPE CORNER
?, DENOTES PROPOSED E'LEVAT/ONS
x 1023.0 DENOTES EX1571NG EL£V,477p/yS.
.? DENOTES DIR£CTION OF DRA/NAGE.
NGVD IgRJJCAL DATUMN
NOUS£ & GAR, = 2583.6 S F.
LOT 5/ZE = 87,250.9 SF.
DESCR/F
SCC1l@ 1
O De on i
l hereby C
dire sup
af th Stc
/, , -
612 891 7588
JUN. -09' OOIFRI I l,i:,i?
D.aKOT.d CO E:V4 b1CT
TEl 6(?-891-"58B
?_Q?, ?
P. 00l
Municipal Plotice of Well Permit Applicatian
Dakota County Environmental Management Depaj7ment
Water and Land Management Section
14955 Galaxie Avenue West
Apple Valley, MN 55124
Tel (612) 891-7011 Fax (612) 891-7031
DATE: Iune 9,2000
TO: Tom CoI6ertlWayne Schwanz - EM
FROVi: Water and Land Management
RE' Well Permit #: 00-639431
Municipality: Eagan
Fax #: (651) 681-4E94
Wel1 Type: Domestic
Environmental Specialist: Olsen
The Water and Land Msuiagement Section of the Dakota County Environmental Management Department
bas receivcd the following permit applicadon for the well described. !f you r:qu've further review of the
application or if you have any questions or concems about it, eontact the Emrironmental Specialist Iisted
above or our ofFice at (612) 891-7011. If there is no response from your office within 24 HOURS (axcluding
weekends and holidays), we wiil assume that you have no objections to the issiiance of the pennit. Please
note thaC perniit issuance is always conditioned on Lhe permit app(icant's observ.ince of and compliance with
all app]itable state, eounty, and municiyal laws and codes.
Well Contractor: Ingleside Engineering
Date application received: June S, 2000
AntieipatedDrillingDate: Time:
Mticipated Grouting D¢te: Time:
Property Owner: Charles Ricliard [nc
Well Owner: Charles Richard Inc
WELL T.OCATION:
PLS Coordinaies: 1/4, ne 114,
Street address: 925 Cliff Rd
PIN Number: 10-10250-030-01
WELI. INFORiYIATION:
Diametec 4
Casing depth: 190
Total depth: 200
Siatic Water Ltvel:
Aquifer:
ne 114, nw 114, Sec 26, Town 027, Renge! 23
COMMENTS:
Dakota County Real Estate Inquiry
Dakota County Real Estate Inquiry
Data Updated 5175100
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Legend
Real.Estate Parcels
ED Paroels
EM Common Ownership
IRWater
M R1UU, Easemem
?Oeddcated R1W
10-10250-030-01
2.00
177707077 - ?'B
Page 1 of 1
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House #:1__._____...... ..._... ?...x 1
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This apQlicahort was devetopetl by the GIS unit of the Dakota County Survey and Land Information
Department in cooperation with Assessing Services and Treasurer - Audilor Departments
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9 - (No Retaining Wall Here) ' ` T
Scale 1 30 • • c ~ Drawn B ~ MH Book: P+ XX Disc: XXX Job No.: DENOTES 10 OFFSEI' EN~ELOPE CORNER y X X X 43 ~ No.: 439-00`2h '
1023.0 DENOTES PROPOSED ELE~ATIONS. , O 0 Denote,a Iron Set • Denotes Iron Found Bearin s Ch
PROPO g ~ own are on an assumed datum. SED ELEI/A TIONS DENOTES x 1023.0 EXISTING ELEI!ATIONS I datum.
TOP OF - l hereb r' BLOCK FOR HOUSE- 883.7 (1:2crs.~ y ce t~fy that t,h~s plan, surve. or report : was prepared by me or under m _ ~ DENOTES D/RECTION OF ORAlNAGE. y ~~~G ~
TOP OF BLOCK FOR GARAGE- 884.4 . direc super~ision and that l am a duly f?eqistered Land Surve or under t~he lpws [tVEMG & ENGINFERI'NG
GARAGE FLDOR = 883. 7 , NG'l/D l/ERTICAL DA TUMN _ of th Stat Min s Doted this ~nd da of ~ ~ 2000. ~~4UNTY R~AD D
LOWEST FLOOR =875 5 HOUSE & GAR. - 2583 6 S F ~ y ~ LOT S/ZE = 87250.9 SF. L~'~• E r I N~.~ 1' A ~ 1 , NE50TA 56ll7
` License Na' T~. (6~ 7~66-0llZ FAX 7~66-06iZZ F~IAIIr surv
. 2 F1MAIIf survey@metrols.com
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA130272
Date Issued:04/15/2015
Permit Category:ePermit
Site Address: 925 Cliff Rd
Lot:003 Block: 001 Addition: Acorn Pond
PID:10-10250-01-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
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: Jamie Rippel
12850 Chestnut Blvd
Shakopee, MN 55379
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 -
Vladislav Gokhberg
925 Cliff Rd
Eagan MN 55123
(651) 994-1333
Appliance Connections Inc
12850 Chestnut Blvd
Shakopee MN 55379
(952) 445-4803
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA168443
Date Issued:04/21/2021
Permit Category:ePermit
Site Address: 925 Cliff Rd
Lot:003 Block: 001 Addition: Acorn Pond
PID:10-10250-01-030
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
*Roof permits issued between December and March will be inspected in the spring.
Valuation: 10,000.00
Fee Summary:BL - Base Fee $10K $191.75 0801.4085
Surcharge - Based on Valuation $10K $5.00 9001.2195
$196.75 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 -
Mark Gordon Uyeyama
925 Cliff Rd
Eagan MN 55123
(952) 454-4945
Bella Remodeling & Roofing
7675 W Highway 13
Savage MN 55378
(612) 760-0949
Applicant/Permitee: Signature Issued By: Signature