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1517 Deerwood Bend Use BLUE or BLACK Ink For Office Use Permit City of EaRd~ J I Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION~lS Date: Site Address: Unit !c5-! 9 Name: wvoD~': D~ .4 JJ_C. Phone: CG ia~ 3a 9 -17,~~ RESIDENT / OWNER Address / City / Zip: /34A,14 Applicant is: Owner 0/Contractor TYPE OF WORK Description of work: 1~~-4001C ✓~oD~' Construction Cost: `V 3R, op a Multi-Family Building: (Yes /No ) Company: ULe /16S'ia2~1-7t J 4-i461L,4Contact: TIVneiZ, t7,44EZ Address: -73 9dx-®-71' City: CONTRACTOR `t c..er State: 47,-L/ Zip: -r-J`e y Phone: 3'7e' •FOO O License 2 0 63 3 7 ;X 3 Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 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: I 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. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 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'f "? j 1 `^ ? ?. +. *r 'r.??' ?? 1 ? ?T ?f.•?rr .Fj: t?? ?r-?•? . .I'Y?T ?•^?jf", l'.r?° . a7?'? . ? .,A? 1? ? ` . d ? j •?'.} ? ?? ? ? ?` ?:f /?'" Y J ?'' , 'e t.-f?_'?'?? t,y'y ?J #. .:ir3'y?`;?r 'T1.S?"7e'?. .•?,~?y.. {r?? ? ?r?,,.,t•?.R. ? ,??' ' "? ° ?'. ?. ?( :A+? ; O , Y_ ..?`!.? ??-?1w ?`?°t+y? ?F` ?? ? • ? &P ?- ?c??:-..? Y- o ? 'ib '?:q?? .. bc. '.. • I ? ? r.. .,r , . . . r'?, . ? _ . .. •i• ' ? R? i ? 11 - l pp - lni t?n ? RESIDENTIAL BUILDING Permit Application w _ , -e I (y0LI City Of Eagan Pf 3830 Pilot Knob Road, Eagan Mn 55122 (gi (p? Telephone # 651-675-5675 FAX # 651-675-5694 New ConstrucGon Reouiremen5 RemodeVReoair Reauireme?ts 3 registered site surveys shaving sq. ft. of lot, sq. fi. of house; and all roofed areas 2 wpies of plan (20% mazimum lat coverage allowed) i setof Energy Calculations for heated addilions 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks i sel of Energy Calculations Addition - indicate tlarsite septic system 3 copies of Tree Preservation Plan if lot platted aiter 711193 Rim Joist Detail Options seleclion sheet (bldgs wBh 3 or less units §5sti4.a I ? ?Q.,,Sb ? 50 Use Onl ert of Survey Recd Tree Pres Plan Recd X Tree Pres N Re d _ naite Septic System Date { I I I /O'? Construcdon Cost 1701 bLD Si[eAddress UniUSte # Description of Work I`Rw Multi-Family Bldg -4 Y _ N Fireplace(s) _ 0 _ 1 _ 2 Yroperty Owner M. W . ?,]Ur `???Vl Telephone # (?Z ) <YIZ Contractor ?' W' ?JVYVYIS?V? Address n6r7jaw'Llr City LAy .Ll/ll hti State MA Zip 55014Telephone # T?Z-) 4M" !710 COMPLETE TIi1S AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 (J submission type) • Residential Ventilation Category 1 Worksheet • New Enargy Code Worksheet Submitted Submitted • Energy Envelope Ca_IculaGansSu6mittetl Licensed Plumber A ?elephone # j )2-4 Mechanical Contractor JTelephone #((p51)??PI3"?P?7iZ SewedWaterContractor lephone#([QQO "?7?1S?PS ?D cl-c-L. 1?w. 't /?- 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 StaYutes; 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. mrn Applicant's Pr ted Name Applicant's ?$ gnature U :I OFFICE USE ONLY Suh Types , • r ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of 'plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc. ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y Or_ N ? 25 Miscellaneous Work Types ?l- 31 New ? 35 Int Improvement ? 38 Demolish (Inlerior) ? 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 (EMire Bldg) - Give PCA handout to applicant Valuation ?1?/ 000 Occupancy MC/ES System Census Code 1) / - Zoning City Water SAC Units 0/ Stories ? Booster Pump Nbr. of Units ? Sq. Ft. ? PRV ' Nbr. of Bldgs / -- Length ? Fire Sprinklered Type of Const Width ? REQUIRED INSPECTIONS Footings (new bldg) ? FinaUC.O. _ Footings (deck) FinaUNo C.O. Footings (addirion) plumbing ?C Foundation HVAC _ DrainTile Other ro?N, {. RooF Ice & Water Rinal Pool Ftgs Au/Gas Tests Final Franung Fire l ? R I - Ai T Siding Stucc Stone _ ? p ace * . . ? r I l est ?, - Final Windows (new rep acement) nsu ation ? Retaining Wall Approved By 7- G, , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S8W Permit & Surcharge Treatment Plant License Search Copies Other Total (3#-sC- 1 sc? 3 X 0' 65X Sy _ 19q x s`V = ? ?? G ? ? 21S /Z 2s v v ? 171,96 9-` , MNCheck COMPLIANCE REPORT Minnesota Energy Code MNCheck Software Version 3.0 Permit # Checked by/Date COUNTY: Dakota STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 9-3-2003 DATE OF PLANS: 09/09/03 PROSECT INFORMATION: Lot 9 Woodstone Eagan, MN COMPANY INFORMATION: MW Johnson Construction Inc. 17645 Juniper Path #100 Lake,vi].le, MN 55044 ?- COMPLIANCE: PASSES Required UA = 624 Your Home = 547 12.3% Better Than Code Area or Cavity Cont. Glazing/DOOr Perimeter R-Value R-Value U-Value UA ------------------------------ - - ---- ------ ---------- ------- - ---------------- CEILINGS 1503 44.0/ 0.0 41 WALLS: Wood Frame, 16" O.C. 3294 `T5 0 2.0 184 BSMT: Conc. 4.0' ht/4.0' bg/4.0' insul 152 10.0 0.0 10 BSMT: Conc. 8.01 ht/4.01 bg/4.01 insul 816 10.0 0.0 130 GLAZING: Windows or poors, Above Grade 324 0.480 156 DOORS FLOORS O U di i 38 0.350 13 : ver ncon t oned Space 320 30.0 0.0 11 FLOORS: Over Outside Air 50 / l 30.a/ 0.0 2 HVAC EQUIPMENT: Furnace, 90.0 AFUE ------------------------------------ - ---- - ---------------------- - --------- - COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit appltion. The proposed building has been designed to meet t requ' ements of the Minnesota Energy Code. Builder/Designe r/ Date O? '? U Job Site Address: "CATEG4RY 1" ALTERNATE FOR ONE & TWO FAMILY DWELLINGS INSTRUCTION5: TNis alternative may be used for one- and two-Family dwellings 6uilt to meet the Category 1 requirements of Minnesota Rules, Chapter 7670. Complete Parts A, B, and C. Cleazly mazk plans with: insulation R-values; window and skylight U- va(ues; size and type of equipmcnt; equipment controls; and location of vapor retarder and windwash bazriers. More detailed information can be found in the Minnesota Energy Code summary sheets available from the Minnesota Deparhnent of Commerce. Part A. BUILDING ENVELOPE }?r ;" , %'?'?" ?,i? Performance (attach U-value calw(ations) 70` Systeme Malysis method (athech analysis) "Cookbook" Worksheet INSTRUCTIONS Step L Check item(s) thaz design meets on Minimum Requirements list ro the right. Must meet all items to use "Cookhook" option. Step 2. Indicate proposed wall type on ta61e below. Step 3. Indicate Window U-value and source. Step 4. Verify total window (including area of all foundation windows) and door azea is equal or less than allowable percentage. g?; ? ??t,? ?'MIDII14i?REQTY?L''14?SIN?.? -- ? ?.- ? Ceiling Insulation: Minimum R-38 with 7%a" energy heel; or Minimum A-04 with low truss heel; or Muvmum R-38 with R-5 sheathin when no attic. ? Entry Doors: Marz. U-value of 030 or 1'/1' solid wood with s[onn ? Rim 7oist Insulation: Minimum R-19 - ? Floors over uncondiflaned s aces: Minimum R-24 ? Foundation Insulation: Minimum R-10 ? Foundation windows: %x" insulated lass, wood or vin 1 frame MlNNESOTA ENERGY CODE - WHrcH RucES Ma r I Use ? Part'B. DE?RESSURIZATION PROTECTION Check option used: Fuel burning equipment (complete schedules below) ? No fuel burning equipment INSTRIICTIDNS Step 1. Complete the Combusdon Equtpment Schedule below. Only equipment with a Y(Yes) may be selected under the "Category 1" alternate. Step 2. Complete Exhaust/Make-up Air Schedule on the right if direct or power vented or solid fuel ahnospheric vent space heating equipment is BGlBOSOd. Statemeot of Comp?iance: The proposed building design represented in [hese documents is consistent with the building plans, specifications, and o[her calcularions submitt d?w th th perm -application. The proposed building has been designed to meet the re irements of he Minnesota Energy Code ? - l ? D G? ?/?Z -?S?/Z-/??aCS Applicant (print name) i re Dat Telephone number Part Ca. VENTILATION (Submit Part C2 upon completion of system veritication}) x -------------------------------------------------- Job Site Address: Pertnit Number Applicant (print name) Signatuce Date Telephone number Part Ci. VENTILATION Compliance Stateroent: Installed ventilarion system is in compliance with MN Energy Code and is sized to provide the design atir flow. LOT SURVEY CHECKLIST FOR RESIOENTIAL BUILDING PERMIT APPLICATION PROPERTY LEGAL: NloGlC II fjClaBc(S? ?e ?w?r? ?H?S DATE OF 5URVEY: 1- 9- 4 3 LATEST REVISION: !?-- Zrp - D 3 Ya oz 15? ? g? ? ? $ ? ?' ? IR ? & o ? ? m ? c A r U `v ? a ? c ? ? ? ? 4WY ? ? ? ? DOCUMENT STANDARDS • Registered Land Surveyor signature and company • BuildingPertnitApplicant • Legal description • Address • North arrow and scale . House type (rambler, walkout, split w/o, split entry, lookout, etc.) t,-Directional.drainage•arrowswith slope/gradient %-(n me stie?:vd+? . Proposed/existing sewer and water services & inveR elevatan • Street name . Driveway • Lot Square Footage . Lot Coverage ELEVATIONS Existin ? ? ? '?. ? +io+ Pr ? ? 0 4p ? ? x ? gil?t? • Sewer service (or Proposed) .?.P.roperty-comers (ns'o,.?:.e -ac ?Q=rn?:ss r'y9)' . Top of curb at the driveway and property line extensions •.-Elevationsofarryexisting.adjacent.homes-(Go?`&-fc S?>'• Adequate footing depth of structures due to adjacent utility Venches • ,.Waterways.(pond; stream, etc.),. , Prooosed 0 ? ? • Garage floor a d ? • Basementfloor ? d ? • Lowest exposed elevation (waikouUwindow) ? ? 0?- • PropeAy comers- ?a l(-+utSSr'n ? -- ? ? 0 ? • Front and rear of home at the foun ation PONDING AREA (iFaoplicable) ? ?, ? • Easemynt fine ? ? ?8?•?__TNWL_C5-?m«"j-- ? ? ?._-----•-HWL-(-SL+ow?--. ? ? ? • Pond # designation )C?R.#?•---•-EmergencyOverflow•Elevation..(S.l.,mw)_*,' ? ? )( ? • PondlWetland buffer delineation DIMENSIONS ? 00 • Lot Iines/8earings 8 dimensions ??? • Right-of-way and street width (to 6ack of curh) ?? ? • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. all structures requiring permanent footings) j% ?? . Show all easements of record and any City utilides within ihose easements /'e / ? w* •_$ethacks.of proposed.sWCWre.and•sideyard selback of adj8cent°ezisting'sttuctures?3?' o?? ) ID' 0 ? . Retaining wall requirements, iT any S 2P % Reviewed: Name Date G:/FORMS/Building PermitApplicatlon CE'RTIFICA TE OF SUR VEY Fo? M. W. JOHNSON CONSTR UCTION 3:1 A1iaArraxn SEoRss Or Retaining yl+a11 NII BB RBcciUIfOd DRAINAGE AND UTIUTY EASEMENT OVER ALL OF LOT 35 35 NWL = 868.0 HWL = 871.0 E.O.F. = 873.0 SiLr F.f? ry ? r ?W \ m 4? s ? ocsp ° v??OF9ktl S 8 ? VACANT \ aas=\? .\11 ?836 "nsr HousE ?e>a/ ° a 5•< \ h B?N s9°p? ejs,s ?X ? ry NOTE: ALL HOUSE DIMENSIONS ARE TO OUTSIDE FOUNDATION ??4?f? ?HENE? 2SS? 90-11 6 -y*?e.OZ ?+'; ?.e:'?' .'1• ?'' :='y',: I? t; ,?.VG D}?s?. P .ao:,.:.. e 33 a 'YS ?Op N ??Q ? ?qRqCf ? o ?V ) j> &3 h? ry yk e>g+s ?m vi -Z200 g ? y N 2p ?• ? . 'zr> BYIy. 31.83 ?"' ?ieez m? O? ?q j2^ m ?.?• w ?S m ? i ° ` 00• ? / lZ 17 m^J ? ? ? ?}4?• ? ? M ?BB A ? t O ?a/ ?N?? q 63? ^ UPP ' Y O b a ?4m\ ? ?2'??z?9 ?:•^ 2S5p o? "Y ? GAR4Cf ? N ? N tr?ak o ti? V s9oo2'3Z" F LOT 9 1519 OEERWOOD BEND PROPOSED GARAGE FLDOR ELEV: 883.8 PROPOSED TOP OF BLOCK ELEV: 884.1 PROPOSEO BASEMENT FLOOR ELEV =876.1 LOT 10 1517 DEERWOOD BEND PROPOSED GARAGE FLOOR ELEV: 883.8 PROPOSED TOP OF BLOCK ELEV =884.1 PROPOSED BASEMENT FLOOR ELEV =876.1 6039``?LDTSEOAAREA 1783 OS ?. F T. .. HSE AREA = 1783 SQ. FT. 4 SEWER SVC LOT 9= 872.7 (PER PLAN) SEWER SVC LOT 10 = 873.3 (PER PLAN) BENCHMARK - TNH WEST END STONEWOOD LANE = 888.36 SEP 26 REC'D PROPERTY DESCRIPTION: DENOTES PROPOSEO DRAINAGE DIRECTII LOTS 9& 10, BLOCK 1, WOODSTONE TOWNHOMES, OOOXO DENOTES PROPOSED ELEVATION CITY OF EAGAN. DAKOTA COUNTY, MINNESOTA. OOOXO DENOTES EXISTING ELEVATION ? DENOTES HUB SET • DENOTES FOUND IRON PIPE MONUMENT * DENOTES SERVICE LOCATION I HEREBY CERTIFY THAT THIS SURVEY WAS PREPARED BY ME OR UNDER MY DIRECT SUPERVISION AND 7HAT I AM A DULY REGISITERED LAND Bohlen SURVEYOR UNDER THE LAWS OF THE STATE OF MINNESOTA. Surveying & Engineering 31462 Foliage Avenue <735 123rd Street W. DATE• 9--?3 Northfield, MN 55057 suite 200 Savage, MN 55378 J REVISED 9-23-03 LEROY H. BO LEN, LAND SURVEYOR phane: (507) 645-?768 B F Phone: (952) 895-9212 REVISED 9-25-03 MINNESOTA LICENSE NO. 10795 Fau: (507) sas-nss Foz: (952) 895-9259 M9-1081-03s 1" = 30' Site address: IS 11 K Inf A'? Lot _ Biock _ Subd. 46'ftM-2 - On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air tightness, and ventilation, was adopted. As a resuit, the City of Eagan is requiring that the following information be submitted prior to issuance of a Certificate of Occupancy. _ This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670 OR _ This shucture: will be consWCted to meet more restrictive requirements of Chapters 7672 or 7674 APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTINGTYPE waterHeater ,D SrAA,^ rPSt+ 56 2-7 0 E 0#q) UC, Fumace ? ?.c n GS" YYt 6- d -1 o GbU Dryer EXHAUST SYSTEM LOCATION TYPE MODEL CFM's VENTED YES ao Kitchen kitchen Bathroom 1 MQ-"rt 6 Bathroom 2 N 0 Bafhroom 3 d Bathroom 4 Other FIREPLACE S LOCATION GAS WOOD MANl1FACTl1RER MOOEL BTU'S VENTING OIRECT AiMOS 1 1 ? , i.s-Gco MAf(E-UP AIR MODEI TYPE CFM's iw So (?e no /sv I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan requirements. 2410? Si n lure Date _Lss,.? CompanyName ' This form is the responsibility of the General Contractor. Address: 1517 Deerwood Bend Zip: 55122 Lot: 10 Block: 1 Subdivision: Woodstone Townhomes THE FOLLOWING ITEMS WERF,/WERE NOT COMPLETE AT FINAL INSYECTION ON Z- // - p Ii/ ....r 8 /,( JOf. Yes No Comments Final grade - 6" from siding Permanent steps - gara e Permanent steps - main entry u?A Permanent driveway x Permanent as Sod/Seeded lawn TraiUcurb damage S' ?W c,?U =tiy Porch Lower level finish Deck Fir lace • V erify with your builder Wat roof test caps from the plumbing system have been removed. • Tutn offwater supply to @ie outside lawn faucets before freeze potenrial exists, • C all the City's Engineering Department at 651-675-5646 prior to working in right-of-way or installing _ vrigation system. ? BUILDING INSPF,CTOR: ` CONTRACTOR: MW Johnson Construction 17645 Juniper Path N100 T1111-1 Lakeville MN 55044 City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: / Date Received: L9 W .. ' Staff: 2013 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 6/4/13 Site Address: 1517 Deerwood Bend Tenant: Suite #: Name: Ross Wolff Phone: 952-237-3974 Address / City / Zip: 1517 Deerwood Bend, Eagan, MN 55122 Name: K&S Heating, A/C & Plbg. LLC License #: 5 9 6 2 0 PM Address: 4205 Hwy 14W City: Rochester State: MN Zip: 55901 Phone: 507-282-4328 Contact: Heidi Brown Email: Hbrown@ksheating. corn New XX Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W. Description of work: RESIDENTIAL XX Water Heater Lawn Irrigation ( RPZ / _ PVB) Septic System New Abandonment Water Softener Add Plumbing Fixtures ( Main / _ Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $60.00 Lawn Irrigation (includes $5.00 State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $200.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) TOTAL FEES $ 60 . 00 CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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. xRandall A Holtan Applicants Printed Name x Applicants ignature Use BLUE or BLACK Ink r I I For Office Use Permit #A City of Ea Permit Fee. `l 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: ; Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: / Unit Name: Phone: Resident/ Owner Address/ City/ Zip: -.5 / 7 a!~~-- -f ~•?(~E "~f~ Applicant is: Owner -Contractor Type of Work Description of work: & &4 ,/}n -C Construction Cost: $20o o Multi-Family Building: (Yes / No ) r Company: . derma a '4d 5contact: Contractor Address: ~~O 69C~S6Ur'~ L~ City: ~lf,~c1 F State:/W_ Zip: ~~~'1 7 Phone: 7 C~0 License Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 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 they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of per it issuance. X x Appl' ant's Printed Name ~4pplica s > ure Page 1 of 3 City of Evan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: I ;aG`f Permit Fee: Date Received: Staff: 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: Resident/ Resident/ Owner % ®/. �/� SGYI p�l Name: it° (%C( / --5'3'_ #04- Phone: 6'57- 775-7-F5'5.— .`�T�)f'� l Address / City / Zip: M77-6767 / t..JlXd _,_rq' 4-S722- -'22Applicant Applicantis: Owner 4� Contractor Type of Work Description ofwork: JQ/>tiQl tif' �� /'a' ` R9/ � Construction Cosi' /, 000 Multi -Family Buildi : (Yes / No ) Contractor Company: . S ( y L G < 'l ", (.ntact: -.c-0 Niat'C Address: 3 VI GkAL),re1 /i�.c+t,44� k y PitirlOtAll J �L/ i State: ,/( Zip: , c� Phone: J(� ST D 7YAIR. License #: '.90 (1/7f3 Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) In the last 12 months, Yes No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: 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 they are trade secrets, CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 days of permit issuance. Appli ant's Printed Name x I' 1 Alikallb a ure Page 1 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA168550 Date Issued:04/26/2021 Permit Category:ePermit Site Address: 1517 Deerwood Bend Lot:10 Block: 1 Addition: Woodstone Townhomes PID:10-84900-01-100 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 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 - Ross L Walhof 1517 Deerwood Bnd Eagan MN 55122 (952) 737-7674 Home Energy Center 2415 Annapolis Lane N #170 Plymouth MN 55441 (763) 476-1990 Applicant/Permitee: Signature Issued By: Signature