3959 Clippers Rd
PERMIT
City of Eagan Permit Type: Plumbing
Eagan. Permit Number: EA092697
Date Issued: 02/01/2010
OR Permit Category: ePermit
41~ it~ of E3
E
Site Address: 3959 Clippers Rd
Lot: 18 Block: 2 Addition: Sherwood Downs
PID:10-67670-180-02
Use:
Description:
Sub Type: e - Water Heater
Work Type: New
Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Kris Oien
3670 Dodd Rd
Eagan, mn 55123
Fee Summary: PL - Permit Fee (WS &or WH) $50.00 0801.4087
Valuation: 200.00 Surcharge-Fixed $0.50 9001.2195
Total: $50.50
Contractor: - Applicant - Owner:
Champion Plumbing Timothy R Fredbo
3670 Dodd Rd., =100 399 Clippers Rd
Eagan MN 55123 Eagan MN 55122
(651) 365-1340
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and Cite of Eagan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
^ ! INSPECTIaN RECaRD ?ntrol No.- 0 7 0 3?
CIT1( OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number. •?s"?'
Eagan, Minnesota 55123 Date Issued: •?' ? z'? ?`i `(612) 681-4675
SITE ADDRESS: LoT t 18 Rt r,CI?: 2 APPLICANT:
3969 CLIPpER9 ItU MILlEIt NOIiES JOSfpM
SHf'RWt#qU UONMS (611) 454-4663
PERMT ?,qPTYPE: TYPE OF WORK: NEW
ss.
77W_
kPMARK`+T kkCETP'f t '3%iW pIHR - akN7--HYAN
Pwnk No. PertnK HoIdK 0o% Tbieplwte t
SJVH
PLUM8ING
HVAC
ELECTRI
EIECTRIC
k+spectfoe Ddte Insp. Comments
Fodings I T?P/, oL !J,e
Foun4atbn
Frarttinq
Rooflng
R9Ugh PIbg' ?Zli /
! V / Y
Rough Htg-
??
l?l •'1+
Flreplace ap '? ?ji)
rY
Fnal Flly.
OrsBt Test
F?nal Pbg. Pfbg. Inspector -Nofin? ?mber
Const Meter
EngrJPian
Bldp. Final
Deck Ftg-
Deck FmW "'0111S?? ?
wen
Pr. Diap.
/??2 ?
« ? v
Me, 'V
k ' 'catc vf cccupanc?
?? ? ???
mail" -"dim
7his Certifteate issued pursuant to the requerements of the Uniforrn Building Code
certifying that at the time of issuortce this structure was in compdiance with the various
ondinances of the City ngerlating building coRStructron ar use. For the following:
Usc 02saiCxa2ion: SF DWG Bldg. Ptrmit No. ?
O-MP-Cy TYM aoe r?.? ? °?` kifft,
or.er of soil? Ad?ese rxmum
3 LIS, +
BoddbW naa?m Lowur
10/IS/42
awe:
smMwoMc.i
POST IN A CONSPICUOUS PLACE
•AtidYess: 9 Lot 1$ Blk 2 Sec/Sub?? ?S
These items were/were not complete at the time of Che final inspection.
]0 !5 92 Yes No
Final grade (6" from siding) ?
Permanent steps - garage ?
Permanent steps - msin entry L",
Permanent driveway ?
Permanent gas ?
Sod/seeded grass l?
Trail/curb damage J/
Porch
Basement finish
Deck ?
Please verify with the builder the removal of roof test caps from the plumbing
system and tha ahut-off of vater supply to the outside lawn faucet before
freeze potential exists. r?
,?_,4,
xrnaEO wu
White - City copy Yellow - Resident copy Pink - Contractor copy
i i
D ,--:r y S_ //o 71 [Z?,
'
14 166 Td
Requas[ Dale Fra Na
a?? y 29, 1992 Rough-in Inspec[ion
Fequire ,?.I
? ReatlY Now Mvrnl NoLty Inspecta
s C No When Reatly?
IL_?.Ftensed contractor ? owner hereby request mspection of above electrical work at:
Job Aaaress (Slreet Box or Route No ) ciry
3959 Uiploe2h i2d. Eayan
Section No Township Name or No Range No Counry
t7¢kota
OccuOant (PRINT)
oe ?li?kea Komee
o? W
Etr
454-4663
Power Supplier
[7¢kot¢ EQect2ic Aaaress z? ,p R. S. W?
fu2m?Ryton ,(?N 55024
Elec'ncai Conhactor(COmpany Name,
GonVaotor's L¢ense N.
Pltidkartd EQ Lat.tLc 04 1610
Maibng qtltlress IGOnlractor of Owner Makrng Inslsllalion)
97854-d uP,ee Gl? L¢k e2jieQe,/'1N. 55044
Aulnori a S?9naN Comra oOwnar Meking Ins?allation7
Pnone Number
- 1 s9z-1444
ntaViaelalttlUaHUUF qICITY
Griggs-Mitlway Bitlg - qoom S4
1821 Umversity Ave, 5t Paul, MN 55106
Vhane (612) 642-0111
THIS INSPECTION REOUEST WILL NOT
BE ACGEPTED BV THE STBTE BOARD
UNLESS PROPER INSPECTIDN FEE IS
ENCLOSED
L)
J I
REQUEST FOR ELECTRICAL WSPECTION
J 4 916 6' See ins[mclans for completing this iorm on beck oi yellow copy
X" Below Work Covered by This Request 73 7 7
FewrAtld ReP F Tvoeofauinr? _
Heater
Comm /Indi
Farm
]therfspecfy)
Compute Inspechon Fee Below:
Other Fee
Swimming Pool
eooms
_1OtherFee ?-
I, the Electncal Inspector, hereby
certify that the above inspection has
been made
iFFICE USE JNLY
his request voitl 18 months fmm
ServiceEntrance5ize Fee
!0 200 Amos i1
Use
Other (Specity)
Cvcuns/Feeders Fee
10 100 Amps 7!
? JQ0 - Amps
y
TOT
AL
1
p
0i?.5U
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
COMPLETED WITHIN 76 MOnfrwc
I
PERMIT
CITY OF eAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
3959 CLIPPER3 RD
LOT: 18 BLOCK: 2
SHERWOOD DOWNS
BUILDING
09@902
06/24/92
SITE ADDRESS:
DESCRIPTION:
-8uilifi.ng Permit Type
Building,Work Type
UBC Occupancy
Construction Type
Zaning ?
Building Length %
Building Width
44
42
- ?,
REMARKS:
RECEIPT N
S&W PLBR a 6ENZ-RYAN
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC $
SAC Units
Subtotal
VALUATZON
PERMIT TYPE:
Permit Number.
Datelssued:
SF DWG
NEW
R-3 M-1
VN
R-1
$131,000
$748.00
$486.20
$65.50
$700.00
100
1
$1.999.70
MI9C FEES $1,610.50
Total Fee $3,610.20
CONTRACTOR: - Rppilcanc - 51. Lil;OWNER:
MILLER HOMES JOSEPH 14544663 0002431 MILLER HOMES JOE
16133 CEDAR AVE S 16133 CEDAR AVE S
FARMINGTON MN 55024 FARP9INGTON MN 55024
(612) 454-4663 (512)454-4663
I hereby acknowledge that Z have read this application and state Chat the
information is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
?
fPull f{ ei ? I i,.t(
ISSUEL) .??T?'T-
Control No. 0703
G
FERMIT M
RE"ACTIVATE'_
?
CITY OF EAGAN I '_5 6/ d
1992 BUILDING PERMIT APPLICATION COQ ?' *
681-4675 ' J U N 1 8 RECD
SINGLE MULTI-FAMILY 2 ts of plan , 3 r istered site surveys?opy of energy
~-? alcs. -
COMMERCIAL 2 sets of architectural 6 structural plans, 1 set af
specificatiohs, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of mon h 1n which re uest is made or lot chan e is re uested once ermit is issued.
Dat 02 Yaluation af work 10c?? O? o
Site Address: J??J 9 QWAg?
`?C GQ
STREET SUITE w
Tenant Name: (commercial only)
IAT I BLOCR ? SUBD. P.I.D. N
Descri tion of work:
The applicant is: O Owner 4Contractor ? Other (Describe)
Name Phone
Property 1A51 FIRST
Owner
qddress
STREE7 STE R
City State Zip
Company Phone
Contractor Address 18133CEDARAYE.SQ License # Exp.
City 1f0002431 State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
AU/I Sewer 6 water licensed plumber Processing time for
sewer 8 water permits is two days once rea ha been appraved.
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.
Signature of Applicant: L2__j
OFFICE USE ONLY
BUILDING PERMIT TYPE
O 01 Foundation
,9 02 SF Dwg.
? 03 Sf Addition
? 04 SF Porch
? 05 SF Misc.
? Ob Duplex
? 07 4-Ptex
11 OS 8-Plex
? 09 12-Plex
? 10 Multi. Add'1
? 11 Apt./Lodging
? 12 Multi. Misc.
? 13 Garage/Accessory
? 14 Fireplace
? 15 Deck
• • 1 R
? 16 Basement Finish
? 17 Swim Poal
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
O 20 Public Facility
0 21 Miscellaneous
WORK TYPE
,W31 New
? 32 Addition
? 33 Alterations
O_ 34 Repair
? 35 Tenant Finish
? 36 Move
? 37 Demolish
GENERAL INFORMATION
Const. (Actual) V-rI Basement sq. ft. MWCC System E s.
(Allowable)
UBC Occupancy N
.3 lst F1. sq. ft.
2nd F1
ft City Water kQp
Zoning
R=r? . sq.
.
Sq. Ft. total PRY Required
Booster PumP
# of Stories
- footprint Sq. ft. Fire Sprinkler
Length
Depth ? On-site well
On-sit Census Code /01
e sewage SAC Code p?
APPROVALS
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
? Site ? Footing O Framing O Insulation
? Wallboard ? Final 0 Draintile ? Fireplace
Permit Fee
Surcharge Yaluetion: R ISI 0?..?' .,... :i
1
Plan
view .., . ,
a; z2X22 ;7 44 94 K I(e= 9q4 H
License
Mwcc snc RSMT: aa - rt6o
City SAC
Mater Conn. '
I y K 7?,;30S
Water Meter
Acct. Deposit y- 8
S/N Permit
S/N Surcharge
1ST F-LovtZ
/ozo 'Of
Treatment P1.
Road Unit 8?T =. tiozo
Park Ded.
Trails Ded
.
a% ?
=
r4
Coies aX 8? ? .
To?al : 55(? 5 Ly .
SAC % ? ao
SA ZNa :r(_,o,?L
S I
C Units
-?-
C? 7 Q ?
1? S 3' r
?i3Q?szg
# izi/4
Owner
~ Stte Address
Contrattor
Bui.lding Classification: Type Al (Single Family 6 Duplex)
NOTE: Complete pages 3 and 4 first. (Other)
GENERAL INFORMATION
- N 0
1. Buildfng Perimeter?WQEL t.
2. Wall height (ground to eave) ? ft. ,
. 2
3. 1. x 2. (above) gross wall area :"TK'?? ? ft.
Phone
Type A2(Residential)
? 0 stortes or less
(Over 3 stories)
4. Building dimensions (L) X(W) ' IZ?.?aI ft.2 roof S floor area
5. Square foot area of rim joist - Floor joist size (2 x 10 ) Iq? X Perimeter = Rim joist area = ??!? ft2
12 14+
6
in. U factor I4) ?? ?-+
Perimeter
7. To[al door's perime[er ft.
?
8. Windows: Manufacturer State approved
U factor .
TYPE SIZE AREA (Ft.2)
N EACH
..M,..;;0
.; r-
9. Total ft.Z Glass 1
t.
NUMBER OF TOTAL FEET 2
UNITS
10. Fireplace area; Width X helght = X = Ft.2
11. Exposed foundation: Hei ht X Perimeter X '1`7 9 w. 4J Ft.2
LOMPLETION OF THIS FORM IS REQUIRED FOR ALL E CONSTRUCT ON, MAJOR REMODELING AND BUILDINGS BEI
MOVED WHERE ENERGY, OTHER THAN THE MINIMAL CODE ALLOWANCE, IS USED.
MINNESOTA STATE ENERGY CODE CALCULATIONS ?/1?_r?,•?
BASED ON CHAPTER S OF THE
MODEL ENERGY CODE - 1983 EDITION
. Adoption Effective I/l/84
Phone Date
Ddors - Area
Thickness
Type of Construction
Manufacturer
oT Ie. 'BLocK 2
I
1,2.'- Framing area = 10Y of gross wall area.
13. Gross wall area ?? ?;, I-1 7
41?fl... l;-,
ft.Z
U windows = o3 La U x A= l?iCn1
U rim joist =041_ U x A= "4 1?v
U doorarea= I ?4 U xA=
u f?0*8"e, ?4 ? u X a= 3•? ??
U foundation = 1 (r' U x A= 71 3 3
U framing area = 0" U x A= ZJ' ?7 1
U wall = iO??JU x A= r?!L yI
ZG?? n
I
' (136 ) TOTAL . . • . • • • • • . U x A
Windo•rr area A o?-4, `5 ft.2
Rim joist area A q. J?' 7i ft.2
?1.c? 2
Door area A'-1 i,v ft.
area A 04,0 fc.2
?.
Exposed foundation A ? ?• ??' ft.2
Framing area A Zq?( ft.2
Net wall area A I 1 74 iZ7 ft.
a
14. Gross wall area z 0.11 (A-1 single family & duplex = allowable U x A/Code
(13. above) • ,
15
x 0.23 (A-2 other residential)
x .23 (Other buildings)
x .23 (Over 3 stories)
BTUH Must be larger thar
A x U Code. uF. 13B above
(.or the same as)
Ceiling framing area (Af) equals 10% of ceng area
15A. Gross ceiling area =(L) x(W
158 Joist area (Af) =
15C. Net ceiling area
U ceiling x A c _
U f rami ng x A f=
15D. TOTAL U x A....,
ft.2
lOa ceiling area = I Z 3 r U ft.2
(Ac) (15A - 158) = ft.2
?
X ? ??J = Z '? J
X
16. Geiling area (15A) x 0.026 (A-1 single `amily & duplex - code allowable U x A,
x 0.033 (9-2 other residential)
x 0.06 (other)
i0Z BaUH Must be larger than 15D (above)
q05q) I z- 5 1 x lJ (code)= JZ?O? F (or the same as)
NOTE: Use U and A values obtained from pages 1, 3 and 4.
CERTIFICATION: I hereby certify that I have calculated the "U" factors and "R" values
herein and that the buflding here described meets or exceeds the State of Mfnnesota
Energy Conservation Act. te
gnature
0
?.
;'r/, v3X l?'?+ ?? ,??. s'?' ?Js,J?"? ? ? Z=/?
I ? 1 1 V I? !
zO?
? = I11z? X II = I Z3
_
.
,; pX
,
?. ?oXcao =
Jl??y I:?
= I lcv,o
UXlo _ TOX4 = ?10
I!?
wl5c.,
i.
;
?
---. „
I'
i.?
- ??l;
WALL '
SECTION
. ?'
STUD
SECTION
SECTLQN.
R1M
JO15T
IntetLor aall
u vHLUt LNLLULUIluNS
R YALUE U VALUE
Inaide att film .68
Intetior vall .47 (Uall) U ? 1
R =
Insulatlon 101'0
i ?
O
2
7
Shea[hing 4'00 .
• '
•(
01
Stding .
Outstde alr film .17
R TOTAL Z 3D?j
Inside air film ' .68
Interior wall •4,/
.,? stud R= AIN 0,5 (Framing) U? R .
Shea[hing
d
Si
ing
?
Outside
air film 17
R 20TAL ? D 1 52 3>
Inside air film R= .68
Insulatlon (Well ? U d R a
iing ^ .
Exterlor wall co
Exterior air film R e.17
R ?OTAL
lnterlor atr film R= .68
Insulatlon I 1'Or-> I
l-? inch soft wood R??B? (Rim U,??I
Shea[hing
Extetior wall covering
Exterior air film R= ,17 •
R TOTAL z 1?` 1p
Lnterior ai: film R= .68
? Lnsulatlon 11'0
I Foufidation
? -- E:cterior air film R= •17
a roraL 3
\
-Exoosed 91uck
.\ .. ??
3.
?
(Fdn.) U = ? =
,070
,-_
. , CEILING WITH VENTED ATTIC SPACE ABOVE
R `lALUE V UE
• • • FRAMING CEILING
0.61 Air Film 0.61 Insulation ?'T
Joist
fl tv___ Ceiling
0,61 Air Film 0.61
4zI 1 (D Total R 45.797
1
, O'L'7;7 U = a ? Oz'L
FLAT ROOF OR CATHEORAL CEILIN6
R Va ue R `JAIUE
FRAFIING CEIUNG-
0.61 Inside air film 0.61
Ceiling
Joist (stu
Insulation
Air space
Roof decking
Insulation
euilt-up raof
0
17 Outside air fil m 0.17
,
1ota1 R
-
R - U
4indow infiltration .5 cfm/lineal foot of crack
2esidential door infiltration 0.5 cfm/square foot or door and minimum code requirement .
•lon-residential door infiltration 11.0 cfm/lineal foot of crack
)b 12" concrete block no insulation = .47 R 2•1
)b 12" concrete block insulated cores = .26 R 3.8
)y 12" liglitheight block =
' .32 R 3.1
)b 12" cores =
lightv,eight block insulated .12 R 8.3
J single glass = 1.13; with storm taindow .54
1 double glass = .55
J triple glass = .41
all exterior walls and ceilings must have a vapor barrier (0.10 perm max.).
;apor barrier must be on the inside (heated side) of Viall.
rapor barriers of the polyethelene thin film have no R value.
4.
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
L City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 __QW?- vvw??
Telephone # 651-675-5675 FAX # 651-675-5694 i ?.-? -? - cJ ?
New ConsWCtion Reauirements RemodeUReoair Reauirements OIFice Use OnN
3 registered site suneys showing sq. R. of lot, sq. ft. of house; and all roofed areas 2 copies of plan CeA of Survey Recd _Y _ N
(20°h maximum lot coverage allawed) 1 sel ot Energy Calcula6ons for heated addilions Tree Pres Plan Recd _ Y_ N.
2 wpies of plan showing 6eam 8 window sizes; poured tound design, etc. 7 site survey (or addihons & decks Tree Pres Required _Y _ N
7 set of Energy Calculations Addifion - inMicate if arsRe septic system On-site Septic System _ Y_ N
3 copies of Tree PreservaUon Plan'rf lot platted atter 711193
Rim Joist Detail Op4ons selection shcet (61dgs wM 3 or less uniLs
Date /! / /??/ ol/ Construction Cost
?
Site Address `3959 C`i?2s? ?'AW, /rIN 57;7Zy UniUSte k
Description of Work / %MSf/ hV%/x'/V! ( (.?x}LK ocrr?
Multi-Family Bldg _ Y Zc N Fireplace(s) _ 0V/ 1 _ 2
?- /? ?
Property Owner 1?? ?F- L/Sfj
Telephone #( 65/)4Yl - l '77/
W ? i - Z9 -?Ft9c7
Contractor
Address N0 Y
State 'p le e # ( )
Y
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Catesorv 1
(J su6mission type) • Residential Ventilation Category 1 Worksheet
Submitted
• Energy Envelope Calculafions Submitted
Have you previously constructed a building in Eagan with a similar plan?
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
A NEW BUILDING
Minnesota Rules 7672
. New Energy Code Worksheet
Submitted
Y_ N If so, 25% plan review
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to s[art 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.
? fic.?vgo ?
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex )k 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex 1
Plbg_Y or _ N ? 25. Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
1121 ? 33 Altera6on ? 37 Demolish Building' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement 'Demolition (Entire Bldg) - G ive PCA handout to applicant
Valuation r- zg 0 Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bidgs Length Fire Sprinklered
Type of Const ? Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
X Framing
? Fueplace y R.I. -K Air Test )t Final
Insulation
REQUIRED INSPECTIONS
FinaUC.O.
? FinaVNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests Final
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wall
Approved By: TZ/ , Building Inspector
Base Fee
Surcharge
Plan Review
nncres sa,c
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
L? ??
;? c? 0 z7
?
--
I' /tL%?c. T /1,1P
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
?? 3830 PILOT KNOB ROAD, EAGAN MN 55122 ?? ??
651-675-5675
Please complete for modifications to existing residential dwellings.
Date // 1 /? 1 oc/
sitestreet,4ddress 393'9
unit#
Property Owner Am Telephone #(67v?) 6YI-17 7)
Contractor ?-
Address
City Telephone # ( )
State
Zip
The Applicant is: Owner _ Contractor _Other
Alterations to existing dwelling
?dd fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_ Water Turnaround (add $121.00 if a 5l8" meter is required)
Other: $ 50.00
Water Softener
_ replacement _ Water Heater
additional $ 15.00
Lawn Irrigation System RP2_ new _ repair _rebuild $ 30.00
State Surcharge $ 50
Total $
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the ev?ent a Ian is requi to be reviewed and approved.
ApplicanYs Printed Name Applicant's Signature
PERMIT N
REAC?IVATE--K
? -?
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
681-4675 •
SEP 0 1 _REC^
SINGlE?B MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural 8 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 or lot chan e is re uested once ermit is issued.
Date S__ / -6-a [ ? Valuation of work ?1?/ir
Site Address:_ ,-1 q`, ?I ?Li6,Q? G? 0?-
STREET L) SUITE N
Tenant Name: (commercial only)
IAT BIACR ? SUBD. P.Z.D. k
Descri tion of work: e. ?a .t,vv,.-?t
The applicant is: ? Owner 63, Contractor ? Othe (oeseribe?? ??'HA ?cALpe?tJT
Name Phone
Property «:T F1RSi
Owner
Address
STREET STE !
City State Zip
Company Phone
10E ILLE HOM S
Contractor Address 18133 CEDAR AVE. S0. Litense 1/ • Exp.
FARMINGTON, 02
City N0002431 State Zip
Company Phone
ArchitecU
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber . Processing time far
sewer & water permits is two days once area has been approve .
1 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.
Signature of Applicant:
OFFICE U5E ONLY
BUILDING PERMIT TYPE
O 01 Foundation
? 02 SF Dwg.
? 03 SF Addition
? 04 SF Porch
? 05 SF Misc.
WORK TYPE
31 New
32 Addition
? 06 Duplex
? 07 4-Plex
? 08 8-Plex
? 09 12-Plex
O 10 Multi. Add'1
O 33 Alterations
11 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
#? of Stories .
Length
Depth ?
APPROVALS
Planning
Engineering
REDUIRED INSPECTIONS
t ?
y ? 18 Comm./Ind.
f•
.
- O 16 Basement Finish
? 17 Swim Pool
? 19 Comm./Ind. Misc.
? 20 Public Facility
O 21 Miscellaneous
? 11 Apt.{Lodging
O 12 Multi. Misc.
? 13 Garage/Accessor
? 14 Fireplace
g 15 Deck
? 35 Tenant finish
? 36 Move
Basement sq. ft.
lst Fl. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Variance
? 37 Demolish
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code ?
SAC Code
Assessments
? Site 1?1 Footing , O Framing ? Insulation
? Mallboard y Final O Draintile ? Fireplace
Permit Fee N ? Valumtim: $ ?-- '
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Mater Meter ,
Acct. Deposit
S/W Permit
S/W Surcharge .
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies ?
Other
Total:
SAC %
SAC Units
A
Certificate ofi Survey for: JOSepII M. Miller Construction CO.
House Address: 3959 Clippers Road. Eagan. MN
" Model Name: Custom CLIPPERS ROAD i
-------------------------?
5 00'33'08" W 4"P AN, I
? -- \ 90 ?S
O
0
02
---- 75.00 3 3
ee?
___ 0
___ f 9
fl
N -- i W
? I DRIVEWAY I >
20 p
.0 22.34 - - ?- - - --8- ? 51.00 Q
0
o 2.0 CANT
+
^m +
N GARACE ' 074.33
rri
I 75
7.33
.?
6.0 _ J N
o I
+
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o PROPOSEV HOUSE 4 ?'
i
? ? Q
W 12 COURSE BASEMENT I O
I oc 2.a WALKOUT
'S I
? O 5.0?
- ? 38.00
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rn II 10
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N II 00
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B s .
S 3??2 EF?GAN EN
s?3 8i
olp,
. 900.0 Denotes
. eoa.o Denotes
-- Denotes
Denotes
-o-- Denotes
.-e- Denotes
Existing Elevation ?Y
Proposed Elevation
Drainage & Utility Easement
Drainage Flow Direction
Monument
Offset Hub Bearings shown ore
LOT 18, BLOCK 2
DAKOTA COUNTY, MINNESOTA
Z
?
T3G DEPi
L est Floor Elevatfon:882.45
Top o lock Elevation:890.56
Garage Slab Elevation:890.23
assumed
SHERWOOD DOWNS
.
L A gL CITY OF EAGAN
?? PLUMBING PERMIT
SUBD _ mrrL, (612) 681-4675
&ESZDENTIAL
PLEASfi COMPLETE IIPPER PORTION ONLY FOR SINGLE FAHILY DWELLINGS
WfiEN PERMITS ARE REQUIRED FDR EACH UNIT.
---------------------------------------
WORK DESCRIPTION
NEW CONST ?X
ADD ON _
REPAIR _
pWr7ER NAME; JOE MILLER CONSTRUCTION C0. INC.
SITE ADDRESS: /CA'-a-ci'
INSTALLER: GENZ-RYAN PLUMBING
ADDRESS: 14745 South Robert Trail
CITY: Rosemount Zip; 55068
CITY USE ONLY
RECEIPT #
DATE 77/ a' 9_f'L_
rl
AISO, FOR TOWNHORES AND CONDOS
COMPLETE THE FOLIAWING:
N0. . FIXTURES EA. TOTAL
REPAIR/ADD ON 15.00
SHOWER 3.00 ?
? WATER CIASET 3.00
BATfi T[JB 3.00
? IAVATORY 3.00 /]-Z
? KITCHEN SINK 3.00 ?
? IAUNDRY TRAY 3.00 ?
AOT TUB/SPA 3.00
/ WATER HEATER 3.00 ?
? F7ACc? DRAZN 3.00 .3 ?
? GAS PIPZNG OUT.
(MINIMUM - 1)
3.00 ?
E
? ROUGH OPENINGS 1.50 0
_ OTHER
WATER SOFTENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
W. TURNAROUND 15.00
STATE SURCHARGE .50
TOTAL: S SD tJD
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR AIS, COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED F(1R EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS:
TENANT NAME:
ISUITE
INSTALLER:
ADDRESS:
CITY:
PHONE
FOR:
ZIP:
CONTRACT PRZCE:
1% OF CONTRACT FEE. .
STATE SURCHARGE - $.50 FOR
EACR $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL:
$
(SIGNATURE)
CITY OF EAGAN
PHONE #: 423-1144
„
L? B a MECHANICAL PERMIT
SUBD. ,=?4r.r? (612) 681-4675
RESIDENTIAL
xEECEirr # /0 73>?-
DATE
PLEASE COMPLEI'E UPPER PORTION ONLY FOR 3INGLE FAMIIY DR'ELLINGS. ALSO, COMPLETE FOR
TOR'NHOMES/CONDOS R'HEN SEPARATE PIItMT15 ARE REQUIRED FOR EACH DWELLING UNTT.
OWNER: FEES
STfE AD RESS:
31?$ ADD ON/REMODEL (MSTING
CONSTRUCI'ION ONM $ 15.00
WSTALLE1t. GENZ-RYAN HEATING HVAC: 9-100 M BTU 24.00
PHONE #: 423-1144 ADDTl'IONAL 50 M BTU 6.00
ADDRFSS: 14745 South Robert Trail
r GAS OU7T.EfS - MINIMITM 1@ $3 EA. a ?VIV
I1'1'.
F Rosemount ZIP: 55068 SURCHARG& $ .50
I GNATURE:
S ?• ???' . TOTAL: $ 3 d ro
COMMERCIAL
PLEASE COMPLEfE THIS PORTION FOR ALL COMMERCIAIIiNDUSTRIAI. BUILDINGS. AISO COMPLEfE FOR
APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WIiEN SEPARATE PERMTTS ARE NOT REQUIRED FOR
EACH DWELLING UNI'I'.
WORK DFSCRIPT70N: CONTRACf PRICE
146 OF CONTRACT FEE. FEES
STATE SURCAARGE IS $.SO FOR EACH
$1,000 OF PERMTI' FEE.
$
PROCFSSED PIPING • $25.00
ivIIlvairilTR3 PEE - $25.00
$
OR'NER: TOTAL: $
STI'E ADDRFSS:
1'ENANT: ,..
UTI'E #: •
.:. _.
,..,,. ..
INSTALLER: , ..: _ .. .
ADDRESS: ,
CI1'P: ZIP:
PHONE #: [CrrYSIGNATURF_
SIGNATURE.
*
y* PIONEEA „
_r_'_' -__r___"
* engmeermg LAND
* * * *
Certificate of Survey for:
5 • CIML ENGINEERS
House Address: 3959 Clippers Road, Eagan, MN
" Model Name: Custom CLIPPERS ROAD j
---------------- ----i
S 00'33'08" W 4 "i" ?
gQ 2SO ?
- - - - 75.00
?9
eeze °
- - - - - -
-
?
?
4
? ?
I DRIVFWAY I
669.9
I 20 Q ?
.0 22.34 __-?_- _?
1 51.00
p 2.0 CANT
o
,^o ? - o14.J3
GARAGE ' e I
25
N
^' 7.33 I
:
J a
6.0
I
r
~ _
n ?
o PROPOSEO HDUSE h i I
w I -12 COURSF. BASEMCNi -' I
I o .0 WALKOUT
1e 2.0
I
N ? D
I
?-? 39-00 I- 50.95 _ _
?
N Q
? 10 CANT N 0033'08° E
Bet.9 ppn
?
?
?
N J
l
o
o i i
U)
I J
I
?
?
?
?
?
?
\
12
? ?sY3 87
02,,
EAC"
'LANNF.RS • LANOSCAPE ARQIITECTS 625 Highway 10 Northeost
Blaine, MN 55434 ?
1(612) 783-1880•Foz 783-1883
Joseph M. Miller Construction Co.
: 900.0 Denotes Existing Elevation ?Y
x 9mDo Denotes Proposed Elevation
-- Denotes Drainage & Utility Easement
Denotes Drainoge Flow Direction
-o-- Denotes Monument
-e Denotes Offset Hub Bearings shown are
LOT 18, BLOCK 2
DAKOTA COUNTY, MINNESOTA
2422 Enterprise Drive
Mendota Heights, MN 55120
;612) 661-1914•Fax 681-9488
LLJ
/
?
?
?
?
?
LL]
C)
50
?
Q7 LC)
rn
N rn
co
Z
\ D
°'-
?
EE IA1G DEPi'
L est Floor Elevation:882.45
Top o lock Elevation:890.56
Garage Slab Elevation:890.23
assumed
SHERWOOD DOWNS
I hereby certily that this survey, plan or report was prepared by m`e or under my direct sup rvision and fhat 1 am duly Reghtered Land Sarveyor
under the laws of the State of Minnesota. Dated this day ol °? NF A.O. 79 ? Z ,
Scale: 11nch=30Te_et / 4R? 9 /?0?
O5. AEG. NO. 14891
I or_Office Use -ry I
j Permit ~Ck O`
11
ty of Eap
I I
3830 Pilot Knob Road Permit Fee:
Eagan MN 55122 I Date Received: y`
Phone: (651) 675-5675 I 1
Fax: (651) 675-5694 1 Staff-
12010
ESIDENTIAL BUILDING PERMIT APPLICATION
Date: a o_ / Site Address: 37-3? ec
Tenant: Suite
RESIDENT / OWNER Name: S/- Phone:
Address / City / Zip:
Applicant is: -Z Owner Contractor
TYPE OF WORK Description of work: Cen //AW444-, Qr/
Construction Cost: Multi-Family Building: (Yes / No )
CONTRACTOR Name: _ J fU7 1G 11f. 1,G~ License ~0 3 0C: ? y
Address:..
17 / SS 7~~
City: State: Zip: M410
Phone: (®S~ ° c~-~C37Yf Contact Person: 1 a Se-D 14Ce,-,-
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
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
accords h the approved plan in the case of work which requires a review and approval of plans.
x x /ao S
is Prin ame App icant's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation - Fireplace - Porch (3-Season) _ Storm Damage
- Single Family - Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
- Multi - Deck - Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
- 01 of _ Plex - Lower Level - Pool _ Miscellaneous
- Accessory Building
WORK TYPES
New - Interior Improvement Siding _ Demolish Building*
Addition -Move Building Reroof _
D
_ emolish Interior
- Alteration - Fire Repair Windows _ Demolish Foundation
Replace - Repair
- _ Egress Window Water Damage
Retaining Wall *Demolition of entire building - give P CA handout to applicant
DESCRIPTION SrD< d
Valuation Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_ 100%-) Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
Framing Siding: Stucco Lath Stone Lath -Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall
Meter Size: Erosion Control
Reviewed By: , 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
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA109890
Date Issued:04/12/2013
Permit Category:ePermit
Site Address: 3959 Clippers Rd
Lot:18 Block: 2 Addition: Sherwood Downs
PID:10-67670-02-180
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Janel Behrends
122 West 3rd S
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
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 -
Timothy R Fredbo
3959 Clippers Rd
Eagan MN 55122
Haley Comfort Systems
122 West 3rd St
Hastings MN 55033
(651) 437-0338
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA152798
Date Issued:11/01/2018
Permit Category:ePermit
Site Address: 3959 Clippers Rd
Lot:18 Block: 2 Addition: Sherwood Downs
PID:10-67670-02-180
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
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: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 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 -
Timothy R Fredbo
3959 Clippers Rd
Eagan MN 55122
(651) 470-8346
Justkyle
3966 Riverton Ave
Eagan MN 55122
(651) 230-6016
Applicant/Permitee: Signature Issued By: Signature