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1266 Deerwood DrAddiCSS 1266 DEEkWGOD llBIVn Zlp $$12 3 L.ot ' Blk Sub GOETZ IST THESE iTEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'fON. Date: Yes No Inspector: ? Final grade (6" from siding) k Permanent steps (garage) )c Permanent steps (main entry) Permanent driveway Permanent gas Sod/Seeded grass X/ TraiJ/curb damage Porc6 Basement finish Deck Please verify with the builder the removal of roof test pps from the plumbing system and Ihe shut-off of water supply W the outside lawn faucet before freeze potential exists. Confact engineering division at 6814645 before working in rightof-way or installing uaderground sprinkler system. ? White - City Copy Yellow - Resident Copy Pink - Contractor Copy . 0 ?, : aap N Z Q , q W B z W ~ < U ? = 6 a w ¢ Q y g a O W ? J W c ~ ¢ U' m O ¢ x O N 9i i ? 7 N ?E i-f 865.1 867.0 CURB 8 8 DEERWO D DRIVE S?evi?CS ? ? 192.27 S89043'16"E Q"??' B4 .9 33.00 . eao. METLANO \ ?y ? ANO \ UTILITY ? Q) 8 .4 O g EASEMENTS I?w m ~/ n Z I? P ? 850.2 / ? ? A?E OB51.4 y ??3•53'3 O 4g 00 LO rl ? e».2 '? . °o 876.8 881. 29 9 - ? 15.00 _ 2DQ0 1 I ? 22 M 67 861.0 1 22 874•0 GARAGE Z + 880.288 •2 + ? • ? \\\ . 877. B a ? ? I \ a PROPOSED HOUSE 1 + ? 880.0 i O } 863.8 I 885,1 . N ? ? 87 C? .3? 00 p ?15 34 ' - y 20.00 ? . b?........... . . ? { 1gg .6a 872.0 877.8 sn, N?5• 21' ?B? ? ' . Properi.y nPSCripti-on= ?I ' Ivt 1. Siock 1. c30ETZFiRST ADDTT j County, MinnPanta, t Also showin4 tte locatjoai of a p 1 Uiereon• . Qoserl 4az'age floor elev. J7;?6 0 posed tqi.: of blorx elev. ?76.3 posed laWe st level elev. 876.8 Q ? AR+GE 877.8 20.00 g 7Qeity DescriptiOII: t 1, Biock 1, (OEPLFIRST AMPPION. Dakota yity, Mi nrwenha . 3o showing the location af a pmposed bouse ?LBm. i ? i 0 Z ? Z ? EC. aM N I . cV ? s: G_i J CO .o . go; o $ t : t ? °sao ov?€ o J f o ' S Q y .. 2, o - $ a ? o a, $ E o ? e e ? ? $ a_ ? o s o i 4 , 2000 BUILDINC PERMIT APPLICATION (RESIDENTIAL) ? CITY OF EACAN 3830 PILOT KNOB RD - 55122 % S 1 ??? 9?- ? ? 651-881-4875 ?1. /aeoair Reauiramenb IJew con:mucnon Reoulre tI? menfs ? I?+ ?,o > 3 regbtered qfe wrveY= OmMng aq. fl. of lot. aq. R. of house and go rooled areas (211'4 mmdmum bf coveroae allow" n 2 coples ol ptans (ahow beam 8 wlndow slzea; poured fnd. deslgn; etcJ D t sel ol energy catculaNoru D 3 coples ol hee prefervalion plan N lol platled aHer 7/1 /9J DAiE: DESCRIPTION OF WORK: ' '?V ?`? dcld? STREETADDRESS: /-?2/4 j?°`? ? LOT: f BLOCK: 2 coplas of Dlan 1 aet of energy catculaNons lor heated addlNOna 1 Qfe Eurvey (or extedor addlMOna & tlecks CONSTRUCTION COST: PROPERTY OWNER G.? Name: latf Flrai G _ C) 3 o -?)- o 0 PhoneM: ??S-G Z50/' Cly Stdfe: ZIP: Sheet SUBD./P.I.D. #: ie #: (area code) COIYTRACTOR ARCHITECT/ ENGINEER IPZ Telephone i: ) Sheet Cly Sewedwater licensed plumber ? Ucense # Exp. Zip: Name: / ?1?? /?{ •? '? Regishaflon A: State: Zip: Z 1 (??j -?- S'}- i Slo 5 Phone : do I hereby acknowledge Ihaf I have read lhis appllcaHon, afate fhaf Ihe of MlnnesoM Staiutes and Cily of Eagan Ordinancea Signature of Applieant aNon is , cnd agree to comply-?p'aU appAcable State OFFICE USE ONL ?YCPS Pres I tr G1+ oK p Certifcates of Survey Received ? Yes _ No ' MAR 2 2 Tree Preservation Plan Received ? Yes _ No _ Not Required ? CHy Sfatl? OFFICE USE ONLY BUILDING PERMIT SUBTYPES ? st Exc ntc - nnulfi O 33 Ext. Aft - SF ? 36 Mu1N ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.) K 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 Poroh/Addn. (4-sea.) ? 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened) O 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage ? OS 03-plex ? 11 10-plex Plbg _Y ot _ N ? 25 Miscellaneous ? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bldg. WORK TYPE K 31 New ? 36 Move Bldg. O 43 Reroof ? 32 Addition ? 37 Demolish (Bldg)• ? 44 Siding ? 33 Aiteration ? 38 Demoiish (Interior) ? 45 Fire Repair ? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors ' Give PCA handout to applicant for demolition permit GENERAL INFORMATION SAC Code # of Stories d. sq. ft. No. of Units Length ? sq. ft. No. of Buiidings Width Footprint sq. ft. Const. (Actual) ?J Basement sq. ft. Census Code (Aliowable) T Main level sq. ft. MC/ES System UBC Occupancy 2 1%) 0_ sq. ft. City Water Zoning >(6<dhAWsq. ft. Booster Pump PRV Fire Sprinklered )-4- MISCELLAN J?S !Ng IONS K ucco/Stone /)j??, y APPROVALS Planning Building ? fb7,? Engineering Variance Permit Fee Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit SNV Permit S/W Surcharge Treatment Pi. Park Ded. Trails Ded. Other Copies Total: valuation: $ r b t?17 /q A JW d-d".`? &fmet 1,7 osr s? = q z,o?0 13311,r 7)-/ d 3? ?1 v 1? '? ?" ??/ 3 yO _ ?l? 3sf sc?aS.aS SAC Units % SAC . ENERGY CODE WORKSHEET FOR 1& 2 FAMILY DWELLINGS SITE AOURESS ' aT?' COMPLE7ED BY: PHONE f DATE ? BUIIDING CLASSIFICATION: O category 1(must Include supplimenml ventllanon) or category 2(3pndard) MINIMUM CR1TE W A ' 'ounAaGon InsulaUOnR10 Walia 3 Wnaows Root Attic Insulation ! 3lab on G2de Insolatlon-R10 (See table on reverse sbe'or allow2ble R44-WM Attic No Heei percenlages) =1ow over unheatetl spaces-R24 R9&WiN ANC Raised Heel °oundaoon Wndows 12" insulateG Glass. R98 & RSSoIiA.RaRers -WOW W Nn Frame STEP f Wlndow L DoorArea SiEP 3 Calculate area bs a percent o( wall - k 7olal Window & Doa Area in Sp. Feel WINDOWS (IntlWing Foundafion WnCOws): If) I G A? V MNDOW MANUFACTURE NAME: U C. From Step 1 divide box A(Window.& Door Area) by box 8 NINOOW MANUFACTURE TYPE??? ' ITotal Wall Area) times 100 equals C(the window and door area i percent to wall area ) MNOOW MANUFACTURE V FACTOR t Nea R DimenSi nCrt SG ?2 U Q ? 3ox A?+ Box B?"??' X 1CO = C=?Y. . ? ? . or?S ua y li5rl X 1-5N "? O? ? S7EP7 Assembty Oesign Features 1 „ x ? N FRAMING TYPE: X I , I, I ? STANCARO FRAMING 4-siucs 16' o.c. `10VAtiC`cC) FfL1MING sNCS ?s' 20. ^ X ? I;\ WALLCA'dIT/INSUTATfCN R x?' 1-x " I1"') 5 SHEATHING TYPE: R Value 11i1 1 ? o T ? tFSS n+av < R-s R-5 > CR MORE STEP l O X ? 5 From the table, (reverse side) determine the maximum percent window 8 door area for the design options selected and enter O ? X f D the °/. value on D below based on the window mfg. U•factor. ? D= % 2 ,vmean a Ooa Area ?dfAL Aa L aq:R J -' 3. Taca+ wau aeea in SQ. Ft The °/. value from the table on D shail be equal to or greater than the°/.inC Watl Total PeametH pai9ht FVea ? ,O 1 II i 8,83 ? Ta 1? B+ s4fL I ONE' & TWO-FAMII.Y RFSIDFNTIAL BUTI.DING PRESCRIPTIVE (COOK-SOOIn APPROACH MAXIMUM WINDOW AND DOOR AREA AS A PERCENT OF OVERALL WALL AREA From Minn Rules part 7670.0475 subpart 2, item F Cavit Exterior Window U-Factor Framin Insulation Sheathin 0.49 6.36 0.31 0.27 STANDARD R-13 > R- 7 13.4% 17.8% 21.3% 24.3% STANDARD R-13 > R- 5 12.4°/u 16.4% 19.7% 22.5% STANDARD R-15 > R- 5 12.9°/a 17.1°/a 20.1°/a 23.4% STANDARD R-18-19 < R- 5 12.1% 16.0% 18.8% 22.0% STANDARD R-18-19 > R- 5 14.0% 18.60/6 21.5% 25.3% ADVANCED R-18-19 < R- 5 12.9% 17.1°/a 20.1°/a 23.4% ADVANCED R48-19 > R- 5 14.5% 19.2% 22.5% 26.1°/a STANDARD R-21 < R- 5 12.8% 17.0°la 19.9% 23.1°/a STANDARD R-21 > R- 5 14.5% 19.3°/a 22.5% 26.1% ADVANCED R-21 < R- 5 13.6% 18.1% 21.2% 24.6% ADVANCED R-21 > R- 5 15.0% 19.9% 23.2% 26.9% Additional calculated values STANDARD R-17 < R- 5 11.9% 15.7% 18.4916 21.5% STANDARD R-17 > R- 5 13.80% 18.4% 21.5% 25.0% ADVANCED R-17 < R- 5 12.6% 16.8% 19.6% 22.9% ADVANCED R-17 > R- 5 14.3°/a 19.0% 22.2% 25.7% Notes: Window area equals rough opening minus installation cleamnces. Window U-factor must be determined by either the National Fenestration Rating Council standard 100-91, or ASHRAE 1993 Handbook of Fundamentals, Chapter 27, Table 5. Flu-tl ? 714 TREE PR?56VAt0-wiar-,-.sp .;.?.a..'Il.'liG?.`.'-^.....'?: (SEE ATTACHMENTS) Development 'vJAW\ Lot Number ? Block Number Address LZl?O l?p?/urut? d?Y?v(, /owv??s (?ei2tiL acldTJS? J Builder Tree Pro3ection Reauirements: X Tree Fencing Mpc? Z7 Oak Tree Pruning (Seal wounds during-Apr#45 to July 1) Therapeutic Pruning Retaining Wall Other: Reolacement Trees: Not Required As Follows: Attachments: Yes No Additional Notes: 6AC11M ??RE-871f1? DOQ908B011 ft = ab ?Q'? 1?1 T-=C.) ./? TREE PRE5ERVATION PLAN FOR GOETZ FIRST ADDITION A: APPLICANT / OWNER / DEVELOPER: Name: Daniel and Deborah Phone Number: 651/ 452-4759 Address: 1260 Deerwood Dr. Eagan MN 55123 B: Building Delineation Reference Diagram A C: Grading Areas No urading PrOVOSed D: Eaisting Tree Identification Reference Diagram A and B for location and size of 30 existi trees E: Removal Tree Identification Trees "C". and "O" Reference Diagram A and B for location type and size F: Protection Measures i._ Install snow fencing azound impacted uees ? ? 5ignature: ? ?/ ? ^ Date: y ?9 ? LTREE IDENTIFICATION (DIAGRAM BA EXISTING TREES ( 30 total ): Diagram A Label Tree Type and Size Diagram A Location Coordinates A 5" White Oak L-19 B 6" Red Oak A- 20 C 9" White Oak E- 18 D 8" Red Oak J-20 E 17 " White Oak C-16 F 5 "Red Oak M-16 G 15 " White Oak F- 12 H 15 " White Oak D- 12 I 8" White Oak A-12 J 18 "Red Oak F-8 K 18 " White Oak D- 8 L 11" White Oak D-6 M 20 " White Oak H-8 N 21 " White Oak 7-8 O 18 " White Oak K-11 P 14" White Oak M-10 Q 14" White Oak L-13 R 14" White Oak M-13 S 16" White Oak N-13 T 10 " White Oak N-12 U 17" White Oak N-11 V 16" White Oak N-9 W 9" White Oak M-9 X 21" White Oak L-7 Y 14" White Oak 0-7 Z 7" White Oak 0-5 AA 7" Red Oak M-6 BB 5" Red Oak K-5 CC 18" White Oak M-3 DD 18" White Oak N-2 TREES TO BE REMOVED ( 2 total ): Diagram A Labe1 Tree Type and Size Diagram A Location Coordinates C 9 " White Oak Q 14" White Oak E-18 L-13 .*'? -._!.._.?.,.l..??...!_...,,_..t.,,.??..?.L,.....?.1,...?..1d?.._.?.1',..?.;..i._._..1......_,.R...,.r..3;._.?.J..?._.?.I.?o . ,. .. i.a.. ? ?? .r.1u...?.,46. ? ? ? ` ?? • , cr) Ie"' , r 1 S,w L. ? . . ?? PO N. D .; 6 t, a¢ 1 ?JI V)? . ic) e3 t?1 (C C) tJ ?ry 1 ?TrI ?a+v -"'.,..•?'"??"? ? 1 .? ?w l?J ,Ia-'wrl D i ?..r' f'i (n? \(°? ..?.-'""?? ?~f?E'F Pfie?.r? /ek?19'r?'?J?iJ i???6?!? ,..,.r ` p .i.,d ?j (5(x ,+??,?.?S t"' ,'7Z:??,+ ,;??,n7rJ l <) 7' +1 ? r . . . LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION ? laaL7"LOnI PROPERTY LEGAL 41r ILcYit' ? /? ?-TZ ?Gai<'sT n DATE OF SURVEY: 4- ? w LATEST REVISION: 4 -Zt? -617 ? fv DOCUMENTSTANDARDS O O? Q ? ? • Registered Land Surveyor signature and company ? ? • Building PermR Applicant q' ? ? • Legal description ? a ? ? Address m' p? North arrow and scale o? • House type (rambler, walkout, spftt w/o, split entry, lookout, etc.) s' o? • Directianal dreinage arrows with siope/gradient °h ?v e ? • Proposedlebsting sewer and water services 8 invert elevation V ? ? • Street name D/ o ? • Driveway d/ ? ? • Lot Squaie Footage d ? ? • lot Caverage ELEVATIONS F.xistina ? • Sewer service (or Proposed) m?/o ? ? Property corners d? p Top of curb at Uie driveway El ra? ? ? • ElevaOons of any ebsting adjacent homes Old h d t c m a y renc es jaceM u Adequate footing depth of structures due to a Prooosed ?? ? • Garagefloor ?/? ? • Firstfloor ?f o ? • Lowest exposed elevation (walkouUwindow) m/ ? ? ? • PropeM1y comers ti t h t th f d o ? a • oun a on Front and rear o ome a e / PONDING AREA (A aodiqde) ? ? ? ? • EasementGne ? ? );' ? V/ ? . • NWL HWL u ?? / • Pond # designation ? o ? • Emergency OverAow Elevatlon / DIMENSIONS / ? ? • Lot lineslBearings & dimensions yr ?? ? • Rightof-way and sVeet width (to hack of curb) orches etc tha 2' t h ? ? • , . er n , p angs grea Proposed home dimensions including arry proposed decks, over ?9' ?? • (i.e. ali structures requiring permanent footings) Show all easements of record and any Cily utilitles within those easements c? o?o • Setbacks of proposed structure and sideyard setback of adjacent epsOng strudures ? ?4' ? • Retaining wall requirements, if any Reviewed: Nama / D2t8 MefGh 19W CR/iKygLppPpMT.FM CITY USE ONLY LOT ? BL q PERM[T #: 41040 SUBD. Abt'tlh ?7d RECEIPT #: ? ?56 yI ? RECEIPT DATE: S- )&- 00 2000 MECHANICAI, PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PII.OT KNOS RD EAGAN LMI 55122 651-681-4675 Date: Complete this section onlv if you aze installing HVAC in a single family dwelling, townhome or condo under construction and not owner/occupied. • HVAC: 0-100 M B T U ADDITIONAL 50 M BTU • Gas outlets (minimum of one required @$3.00 ea.) State Surchazge Total $ 30.00 6.00 ? .50 $i Complete this section onlv if you are remodeline, addinQ to, or reairin an existing single-family dwelling, townhome, or condo. Please indicate if it is a new item, alteration, or repair. _ New _ Alteration _ Furnace _ Air exchanger Repair _ Other Air conditioning Other Reminder: Call for inspections 0 SITE ADDRESS: Fee $ 30.00 State Surchazge .50 Total $ 30.50 OWNER NAME: 'I J? ?? _?`y7P 1? PHONE #: - (AREA CODE) INSTALLERNAME: ( An? ? 1A Y? paorrE #: L?,?! - y23 -1 14N (AREA CODE) STREf C[TY: ?-1' CITY USE ONLY RECEIPT #: CR 171101 L i1i I?, gL 17? SUBD. RECEIPTDATE: 151 u OO ? PERMIT# . 404C) 2000 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT IQTOB RD EAGAN, NA7 55122 651-681-4675 Please complete for: ? single family dwellings ? townhomes and condos when pertnits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH # 058 , TOTAL Alterations to existing dwelling - minimum fee Describe: $ 30.00 Bath tub $ 3.00 x = $ - Floor drain 3.00 x = $ 30° Gas plpln outlet ' minimum -1 3.00 x = $ p° Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x = $ 3°?- Laundry tray 3.00 x = $ Lavatory 3.00 x = $ i26°- Septic System nrewireturtisned ' requires MPC lic. 75.00 x = $ Septic SyStem abandonment 30.00 x = $ RPZ new installatiaNrepair/rebuild 30.00 x = $ Rou h opening 1.50 x = $ '?5? Shower 3.00 x = $ o° Underground sprinkler if dwelling is under construction 3.00 x = $ Under round sprinkler ifexisting dwelling 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ :2?e Water softener if dweiling under constroc2ion 5.00 x = $ Water softener if ezisting dwelling 30.00 x = $ Water turnaround 30.00 x $ State Surchar e .50 --> -> --> $ .50 rotai -> --> -> -> $ Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc. 1 hereby adcnowlerlge that I hsve read this epplicetion, state thatthe inforrnation is corteU, and agree to comply with all eppliceble City-nf Eagen ordinenc;s. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any demeges caused by the Ciry during its ? normal operetional and maintenance adipities lo the facil@ies construded under this permit wRhin City propertyfrighbof-wey/easement. SITE ADDRESS: OWNERNAME:: ?-IJ (??PT7 TELEPHONE#: Cnh1 USZ?LF?rJ°] (AREA CODE) INSTALLER NAME: TELEPHONE#: loSl Lf2-?5 -II4 U (AREA CODE) STREET ADDRESS: I l.M%-{ S 'TQ ql L CIN: ? wlo f aT STATE: ZIP: ?S SIGNATU OF RMITTEE Certificate of House Location Eor. Dan Goetz - 1260 Deetwood Drive „ Eagan, !Ild 55123 _ ' - DELMAR H. *CNVIIANZ uwo sunvEroae. INc. RpIWFtl 11nOM LM d TM !bN M YMnM01? 14750 SOUTH ROBERT TRAIL A03EMOUNT, MINNESOTA 5460le sei /423- 1789 - SURVEYOR'S CERTIFICATE - \ ? N ? O ? .. ? .? F+ • • . .,p ? ? • 8 ?'. ? ?. a ~? ? ro H ? C a ? ? i ? tn cn ? J m ? m 160. 00 N0'03'09°w ? m N ? M a a O m ? ` 100.00 ?\ \ ? r W ` m K ? co ni) (? . ,.? ?tl ti m i 6 ` i 9p ? m `46 00 Nf5 5B'27•E? .. ? p.2?`? L2a . ro o. N V ., m r m m t m + .01. + .. .. ?3 m N m W+ G? UI + m v ?. ? 54? ? ? mm m a o ? a ? I ? J t /f? ?- y ••N N / 11.5 m +n / _ ? m ° m 11 ?. - 22 ol ? m 6'm I\ lo , o ? + 0 0 + ? o o? o lo ? 65.00 m w m cn m ? A W 0) rn 40 ln//1 7 5?rzvlc? 'U m _ .; _ . i. ??V E"- T'7.7 t?%3vu ??i%`'-T. : ? J DELMAR H. SCHWAh2 I hereCy ceAily Ihet Ihis survay. Olan, or npoN waf = propusd by me w undar my dirset supsrvhbe and - 8625 -;?,` . Ihat 1am a Auly Repista"d Land Simeyor un0er Ine Iawt ol tM Smb ol Mlnnnols.????i?'?... ?y? Vas " <i,urnSuCluR ?`°? , 04-19-00 DtloA Revised 04-20-00 Nlded hse type, square footage, uti.lity info ? RECEW D A,np M H m P9912 • I ? • II . 11 II II 11 ? . n ro ?, ? (D far 1-h N ?C% 0 "h W2 i ? I N •...,.,,.,?? J 01 m N N NS , ?. ..? ? 10 p ff hh ? J ?+ l7 1'h II ? ? n N (? F?-1 I?d N ? ? u rn w Ua p e?Oa ? . . yt?mv n. acnona MinnMOU Mohernlm No. eezs v= : . . RESIDENTIAL . BUILDING PERMIT APPLICATION cirY oF eacaI -,/?(?/f / - 7 3830 PILOT KNOB RD • 55122 ??0`? j ? c/ 651-681-4675 New Connmcfion Reaulremenh • 3 registered site surveys stwwirg sq. R of lot sq. ft. ot house; aM all mofed areas (20qa mazimum bt average allowed) • 2 copies of plan showing beam 8 winAaw saes; poured tountl design, etc.) • i set of Energy Calculatlons • 3 copies of ?ree Preservatlon Plan'rf lot platted after 711193 • Rim Joist Detad Optlons selection sheel (bldgs with 3 or less unils) DATE JOB SITE RemodeVReoairReauiremenb ?`` IIL? . 2 wpies of plan ?? ?I • 7 sel of Energy CalcWalions for heated additmns i d 1or M' addiii &d cks 011-0 • s esurvey e error ofs e ? . Indicale if hame served by septic system fw addiUoris VALUATION IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER(21?1 TYPE OF APPLICA ADDRESS -S/'? ? 9-- PAGER # CELL PHONE # REPLACE(S) _ 0 1 _ 2 PHONE#lOS? `-'?L-y7s ZIP CODE PAX # NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 (check one) - Residential VentllaUon Category t Workshe - Energy Envelope Calculations Submitted - i i lJ D MINNESOTA RULFS 7672 - New Energy Code Worksheet Submitted Plumbing Contractor. Phone rr ? Plumbing System Includes: _ Water Softener _ Lawn Sprinkler Fee: -39"Or _ Water Heater ? No. of R.I. Baths No. oE' Baths Mechanical Contractor: _ Mechanical System Includes: Sewer/Water Contractor: _ Air Conditioning Heat Recovery System All above informalion must be submitted prior to processing of application. I hereby acknowledge that I have read ihis application, siate that the with alt applicabie State of Minnesota Statutes and City of Eagan Or( Signalure of Applicanf Phone # Fee: Phone # ati n is cqFre,cjo& To cornply Certificates of Survey Received ? Tree Preservation Plan Received _?/Not Required _ ? Updaled 1107 $70.00 OFFICE USE ONLY • , ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex 13 09 07-plex ? 17 Garage 0 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex p 18 Deck ? 23 Porch(screened) ? 38 Multi ? OS 03-plex ? 11 10-plex ? 19 Lower Levei ? 24 Storm Damage ? 06 04-plex 0 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous # 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demoiish (Foundation) ? 45 Fire Repair ? 33 Aiteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement "DemoUtion (Entire Bldg only) - Give PCA handout to appllcant Valuation am Occupancy R- 3 MC/ES System Census Code Zoning A-1 City Water SAC Units ? Stories Booster Pump Nbr. ot Units ? Sq. Ft. PRV Nbr. of Bldgs ? Length Fire Sprinklered Type of Const S-!l? Width ? Footings (new bldg) Footings(deck) Footings(addirion) Foundation Drain Tile Roof Ice & Watec Final Franung Fireplace _ R.I. _ Air Test _ Final Insularion Other _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Siding Stucco Stone _ Windows (new/replacement) Approved By U46 , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC W ater Supply & Storage SRW Permit & Surcharge Treatment Piant Plumbing Permit Mechanical Permit License Search Copies Other Total REQUIRED INSPECTIONS FinaUC.o. ?j FinaUNo C.O. Plumbing HVAC *' City of Ea�all Date: u 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 S r Use BLUE or BLACK Ink For Office Use Permit #: I ) a 3a) Permit Fee: 10,57 a5 Date Received: 84-13 -13 Staff: 2013 RESIDENTIAL BUILDINGJ�PERMIT APPLICATION (3 Site Address: / j' ' cJ ems`' d Unit #: Type of Work Name: /,11 Z_ Phone: Address / City / Zip: / a (:) Applicant is: Owner Contractor Description of work: Re — C-`oc:s o 0.4:e Construction Cost: Multi -Family Building: (Yes / No ) Company: � l �--- Contact: j -S11 V e-ff Address: %j0O > ee%5iL— .Vlv" ` City: ,571 Zaz/fX -57-5- (71/�ci ,'yam State: ✓q' Zip:, �� (Q Phone: 6(-2-/ 2-cf a —775/6 License #: 0 0 0 / Oc-00 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 informat on. Porti 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 mu t r'ted within 180 �I %� days of permit issuance. d e �1 '-'- x � Applicant's Printed Name pplicant's Sig Page 1 of 3