1973 Chipmunk Ct(gPr#ifirtttr nf (Orrupttnry
Citp of (Eagan
Drpttrimpnt uf +uilDitcg 3naprrtiim
Tbit CMrficate issued purJrraru ta the +rq+drementt of Section 306 of the U»iform Building
Code arti frrng tbet at the time of ifruance tbir thurtarr war in com pdiantt witb the variout
ordinanar of the City+rgulatrng buildiag connnurion or un. Fw the follouing:
u.cSF Dwlg/Garage eias.e..tr+a. 5441
o?w,o.rrw R3 rrPC.?e. v fiRz. III z? out..1 R
.inGeoh Miller 13015 Cedar Ave.S
By April 21, 1980
mr
.a.. .. . ?e.?..?I.w. ...<.
CITY OF EAGAN
3795 Pilet Kno6 Read Fagan, MN 55132 N9 5441
? PHONE: 454-8100
/
BUILDIN(i KRMIT APPLICATION Re?ipt #
$44,000,
Ta 1. uaod for SF Dwlg. Esr. Value pme 9ct. 2, . 1q 79
Site Address 1Q74 l:hipmttnk C.t Erect [FE Octuponry R3
Lor 32 Blxk 1 Sec/Sub. Meadowlands qlrer ? Zoning RL
Pa?? # 10 48050 032 Ol Repoir ? Fire Zone 3
l T
V
En
arge ? ype of Const.
w Name -inQpph Mi 1 1 ar Mo fk Stories
w p .
9 z Address 13015 Cedet A e. So. _ Demolish ? Front 64 ft.
r;ti, Apple Valleyp?,,,,,e 432-8003 Grade n Deoth 26 k.
p Name _
?? Address
r .-:...
Nome _
Address
I hereby acknowledge that I hove reod this oppiication and state that
the information is correct and agree M Comply with aIl applicable
State of Minnesota Statutes and Ciy of Eagan Ordirwnces.
SignMUre of Permittee _
A Building Permit is issued to:
oll work sholl be dane In ccrn
8ufidirp Official
Assessment -
Water & Sew.
Police _
Fire
Eng.
Planner _
Council _
Bldg. Off. _
APC
Permit LZD.DU
Surcharge 22.00
Plan check 62.75
SpC 525.00
Water Conn. 270.00
Water Meter 60.00
Rd Unit 75.00
Torol 1140.25
.I052p Mi11ET on the express mndition tFwt
all opp? e State of Minnesoto StMUtes and City of Eagan Ordinonces.
CITY OF EAGAN
. 8795 Pile* Knob Road Eagan, MN SS122 Ng 5441
? ..?
. PHONF: 4S/-8100
BUILDING PERMIT Receipt #
To be umd for Est. Volue Date 14
Site Address Erect p Occuponcy
Lot Block 5ec/Sub. Alter ? Zoniny
Porcel Repa(r ? Fire Zone
Enlorge ? Type of Const.
W Name Move ? * 5tories
z _ Address .,.eti<o' h_c•
Demolish ?
Front ft.
Ci Phone CrodE ? Depth ft.
°C Nome Approyais Fees
oG Address
u Assessment Permit
? Water & Sew. Surchorge
Ci Phone Police Plan thetk
?W Name Fire SAC
_u Address Eng. Woter Conn.
u
<W Ci Phone
Plonner
Woter Meter
Council
I hereby ecknowledge thot I hove read this application ond scote that Bldg. Oft.
the infortnotion is correct and agree to comply with all opplicoble APC Totol -
State of Minnesotn Statutes ond City of Eugon Ordinances.
Signature of Permittee
A Building Permit is issued to: on the express condition that
oll work sholl be done in xcordance with oll opplicable State of Minnesota Stotutes and City of Eagan Ordinances.
Officiol
Buildin
g
A.
P?ir # oab Iwd P@MIffM
Plumbing f5 13 I ? ? ? ' 7 - - - ['? -
Mechanical ?Ct
?t:... . 53075/ /z2 -
INSPECTIONS DATE INSP• Rough-In Firal
Footings Oate Insp. Date Insp.
Foundation Plumbi ` /._ -$t) Z /
Frome/ins. Mechanical 0 -,2y,?
Final ? .-?.. 2-
Remorks:
i .
CITY OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesoca 55122
Phone: 454-8100
PUPSIX PERMIT No. 1513
l I-5--79 16308
Date: Receipt No.:
?
1?7-1 (bimm.mk QC7llrt Single
i
l
Site Address: dentia
Res
1 I
Lot Block
Sub/Sec. Multi Res., Comm./Ind.
Name /Repair
New/Alter
.
m 13015 !'ecl?r A?. cc±.
Address
Cost of Installation
;
°
Anpl.e Valley it2 551;'d 432-£3(:0:3 ?C,^,i
City Phone: Permit Fee
M7.dW?CtE'Z7l I''eC?7aT1.??1
Name Surcharge
.
1175 i?av?.
.r?ort ?7ourt
-
ddress
t
C
ity y Phone: Total
This Permit is issued on che express condition that all work shail be done in accordance with all applicable $tate of
Minnesoto Statutes ond City of Eagan Ordinances.
Building Officioi
' CITY OF EAGAN
' . 3795 Pilot Knob Read
Eagan, Minnesota 55122
Phone: 454•8100
'+2A tin4 PERMIT
I2,/?f?/'??j
Date:
Site Address:
1973 Chipannk Ct.
I.ot 32 Block 1 Sub/Sec. _ 1?P.sdaRlB.Tld:,
Name Jpe ???.ill@T COnS tI'.
°e Address 131-15 Cedar AVe. SO.
?
City kPp12 VBllec Phone:
Name PLa,Y welter ;.tg.
.
g Address 47 MiCaro Avc ,
e
e
V
:
City cc
Phone:
This Permit is issued on the express condition thot oll work shall be
Minne9oYa 5totutes ond City of Eogan prdinances.
No.
Receipt No.: 17249
Single
Residential
Multi Res., Comm./Ind. I
New/Alter./Repoir
Cost of Installation
Permit Fee '-
C?fl
Surcharge
Total
done in accordance with all npplicoble 5tate of
Building Offitiol
. cirr oF EAc,AN
' 3795 P71ot Knob Read
6ayen, Minnesota SSIU INSPECTOR NOTIFICATION
No. phene: 454-8100 REQUIRED BY LAW
PERMIT FOR ALL INSPECTIONS
Dote:
Site /?ddress: ;-•?'? "j C i
Lot Block ? $ub/Sec. 12
Receipt No.:
Single
Residentiol
Name Toe Htller Constr.:ation New/Alter./Repair. I?F
. . „
; Address > Gedar 'xB, Cost of Instollation
O
Gity % 'd-'1' } ;an• Phone: Permit Fee
Name Surchorge
r
?
? Address '
City Phone: Total
This Permit is issued on the express condition thot oll work shall be done in ocoordance with all applicable State of
Minnesoto Statutes ond City of Eogan Ordinonces.
Building Official
• '
• CORRECTION •NOTICE
6 3 2-Ok /u P 4".1- LJ\Q *"-a.
DATE: ? -
Address •-
I Owner/Agent C" :
Owner/Agent Address
? Ordinance Nos. and Corrections - Correct By_
I ' ? . , •?-.
._•-a k
4
For reinspection
Eagan Dept. of Inspection
3795 Pilot Knob Rd.
Eagan, Minnesota 55122
454-8100
I nspector: °-
Dept.. .. - . ? ,?. ??..
Site
CITY OF EAGAN
Addition_Mladewl_nnd 1a AA3tien Lot 32 elk I Parcel 1f) 48050 032 nl
Owner ??, '•A," ' Street 1973 Ch1AMMk ODUl't State Eaqal1, MN 55122
?
, „',;•; ,.? Cr 'q
Improvement Date Amount Annual Years Payment Receipt Oate
STREETSURf.
STREET RESTOR. IDP• '/ • 99 •
GRADING
, SAN SEW TRUNK ? 1970 77.95 3.12 25
* SEWERIATERAL s? 156.5$ C005423 6/6/80
WATERMAIN
* WATER LATERAL 10
WATER AREA 1
N
STORM SEW TRK I
1- cq) 7 282.92 4.15 20
* STORM SEW LAT
*
CURB & GUTTER
SIDEWALK
STREET LIGHT
75.00 15124 10 2/79
WATER CONN. 270.00 ?? 11
13UILDING PER, 5451 tt
SAC ? T
PARK
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
101 i i i1 iN;4
•?1:1?r?
SITE ADDRESS: , „ r;
t , i ii I i MiiNt. r. T
Mi AIirN11 AMO',
PERMIT SUBTYPE:
-.I r
1,1111 I No,l,
ii ? t I t r
APPLICANT:
s r\t ?ir.1 ? iIUU
TYPE OF WORK:
I Irini
- --------------- -- -----?
INSPECTION RECORD
Permn No. Permit Hoider Date TNephone #
SNV
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inepection Dats Insp. Commenta
FooGngsl
Foundation
Framing
Roofing
Rough Pibg.
Rough Htg.
Isul.
FireplaCe
Final Htg.
Orsat Test
Rnal Plbg. Plbg. Inspector- Notify Plumber
Const. Meter
EngrJPlan
Bidg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
To se vsea r'or "&2
Site Address:
Lot 3 0? Block l
Parcel # : / n AIk19 .
owner:M
.
Zip Co
Pnone # /?
CITY OF EAGAN ?Include 2 sets of plans,
k1 site plan w/elevatians &
, PERMIT APPLI?TION 1 set of energy calculations.
fC'
iation Date g- Z S' ? q
!'6:ez? OFFIGE USE ONLY
Gity/Zip Code: '
Phane # : bU 3
Arch. /F:ng. .
Adr3ress :
City/Zip Caie:
Phone #:
Erect _X_ OccqancY
Alter Zonin9
genai r Fire Zorre
Enlarge Type of Qonst.
Nbve # Stories
Demalish Front /1 -1/ ft.
IGrade Depth a G ft.
???? ? ??I Permit /45 JE-0
Waber/Sewer Surcharge a?z
Polioe Plan checlc .2 ?
Fire SAC 16'25 °O
Enq . Water Cann . ?-
Planner Water Meter v 4
Council Ftoad Unit 73`
Bldg. Off. ,•
APC
TCTAL &14
?
i agree to tomply with the Citr of Eagan Connection Chorge:
f pF EAGAN WATER SERVICE PERMIT
i Pilot Knob Road PERMfT NO.:
n, MN 55122 DATE:
ng: _ No. of Units:
Address: '_.
N., •
M comply with the City of Eagan
of Insp.:
Connection Chorge:
Account Deposit:
Permit Fee:
5urchorge:
Misc. Charges:
Total:
Dote Paid:
I nsp.:
c+rr of EaGaN SEWER SERVICE PERMiT
3795 Pilot Knob Road PERMIT NO.: ?
Eagcn, MN 55122 DATE:
Zoning: No. of UniYs:
Owner.
Address: ?
Site Address:
Plumber: _
? , •?
Qrdinances. Actount Deposit: _
Permit Fee:
Surcharge:
BY Misc. Chorges: -
Dote of Insp.: Total:
Insp.: Dote Paid:
This request void 18 months from 17 / l's-
'Jate Qf this Request 12-12-1979 s 30791
I, as Micer?sed Electrical Contractor DOwner, do hereby request iospection of the above electri-
cal wiring installed at: ,-;' j,? 1 -P?,?'
5treet Address or Route No. 1973 ChiPmunk Court CityEagan
Section Township Range County Dakota
Which is occupied by
Name o Occuaant)
Is a roughin inspection required on this job? No ? YesE Ready Now O Will Call tilc
Power Supplier Dakota Cty. Address Farmingto n
Electrical Contractor O.B. Thompson Electric Co. Contractor's License NoA37962
(Company Name)
Mailing Address 12201 Mtka Blvd o, IuItka 55343
Authorized
STATE BOAttD
:? - -
No.
Minnesota State Board of Eiectricity
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
ICAL
R
'ON
CHECK ELOW ORK COV RED B
Y
THIS REQUEST s 30(91
Type oP Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For
Home XE] ? ? Range ? Temporary Wiring ?
Duplex ??? Water Heater ? Lighting Fixtures ?
Apt. Bldg. ???
C
?? Dryer ?
00
2 Electric Heating ?
ommercial Bldg.
? Fumace 19
° Silo Unloader ?
Industrial Bldg. ??? Air Conditioner ? Bulk Milk Tank ?
List List
Oth r ??? p
Hehers? jj1Sp.Dj911.XX4,X, Rer?els?
COMPUTE INSPECTION EEE BELOW
Seivice Entrance 5ize: # Fee Feedets&Subfeedets: * Fee C'ucuits: # Fee
0 to 100 Am s10 UG o 0 0 to 30 Am res D to 30 Am res ?
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am eres
Above 200_Amps. Above 100 Amps. Above 1Q11 Amps. +J
Transformers Remote Control Circ. Partial or other fee ?
Signs Special Ins ection Minimum fee ?
Remarks
Ran Caples
TOTAL FE,O. "
!? 34O d?
I, the Electrical Inspector, hereby ce that ovb inspection has been made.
(Rough-in) Date
(Final) ?. ? Date
This request void 18 months from ` -
Cert.tflca,te for: ' Showi;.L Frop')::,eo
Dunn s Curry Houc;e for:
Jae Fill,:r
13u15 Cctiar Avc. 3,.
Apple Vslle;;
DELMAR H. SCHWANZ
LANDSURVHYOR
Ryisbn0 Untln Laws of Tb SbU of Mmnsso[a
2978 - 146TH STREET W. - BO% M ROSEMOUItlT, MINNE60TA 56088 PFIONE 812 423-1769
8URVEYOR'S CERTIFICATE
Cp. Ror\o N o. 30 SCAL3 : 1 inch ? 30 feft
4\ U\
\C ?Y
??y"? -? 77.00 S89°29 22"
.--._--
? OQn,aAC,E ?.
i' ^4'i P
?
0
"
LLF
• ?
?
O -T
C?
-0 ?
r\ Djnr,t-c
'
s
,
ropoir?ci fir
ti', . r:nc
.
a
0 ,
o
2 ? .
? Is ? O --` ?
"
iz"
_ 4 q? ? f 6?tt
6 ?
'
?•'
? Gurage Floor
p
0 19.1
?,
- a
D
i ??,
°
s?
0 a
' a2 Y :`-
ZZAO
7
T hureby ctrt2fy t}i:at, aY?:.n
o ? ia a true ar.d r)r.r,-ct
'
? .
--
7'- -- - ---- -
I,,t.
reprearntation of
?. Q
?.
w EloCk 1, M_:AD`UT,A. r, t --'''i
°
'
"
o ADDI'IUTd, acc.?rt'f n '.. °i^.
94. 18 ? g9
29
22
E. iv recorded pl2t
`
'"
ir„cil;,
. i.
nakota Ccunt.y,
? Dated: J+ily 16, 27?.'
o
m ?
1F
?ou?
"7
CH1 P I?/1aV,
ReviBed to nhax pr•uoa:;c.c +k i
`
.
. on this 2^ da,y of
Approved for Dunn k Curry F.eal Estate Ma.nage meriY., Inc. by: _
,
,
? y??;:r .A ? ? • i
A?. ? , • ?
h11NNE80?A RE619TfiATION NO 8625 /
/?
r.owPuTnrtQ?a
adNER ----------------------r--- --
S1TE ADORESS ----- -----------------------_?_--
CoNT(L1cioR onrf PIIOHE
puteim;ne working square footagc of Cach.
, 1. Total exposed wal l area .... ••59• ft. x.___17
Z, Total roofJceiling area ..... _1 otj2=?_ sq. ft. x .05
Total exposed Nail area above floor = 109 6. __
a. Total wall window area.................. .........
b. Total door arca ... .................... .........
•.••.•
c. Total sliding ylass door area .......... ...
-
d. Total fireplace wall arca ...............
a (avrra9c 1Q't)...
i .........
'........, DAA
e. Total ng arc
wall frarn
f , 7otal net wa11 area above f loor . .. . ....
•
? . • . • • . • • .
.?.......
g. Total joist arca
rim 7ot,+1 exposeA foundat!on area • ___?___ _
h. Total.foundatinr. windoH area ..................... _
1. Toal nct founJatinn area ahove 91'adr. ...,...•.,,•
Uetcrmine "U" valuc of each wall se9ment,
a.- ---A--- -
l?._
.,_?1?'_`?_-- K
• IIUII Z-
c. `.,°Z"?(a X u?? ?55
d. --
e. ---1-?9 _?--- - X " u„
f Y ??U"
.
y'
---?-3?D ---?--- X
'- „U„
--_._ ??--
h. __ z
i.
X ?l,
u
--- --
3 .....................................Tat.,1 ^ E,
If ikem k3 is [hc suiw as, nr less than itr.m Rl, you have met the intent
of S13C 6006(c)2.
.s •
Y
? fut?i c?pnsc.l roof/crlling arra = _1gress runf /<c 111n9 arca ------ 2._..._ .
--------'---.
j. iotal skyli9ht arr.a ........................
k. Total ?eoflceilin9 fra?n?n9 area • - c1???
1. Total net insulated roof/cei11n9 area.....,.
paterniinc "U" va1u? for cach roor/cn111ng sc9ment.
• X 'lu,l M e ?
' ?'--- ..____ --?------•-- `
.,ul,
"u?,
4 ...................... ............Tota, FC???gJ
If total of 04 is the same as, <rr less than k2, you hnve met the in[ert of
SBC G006(01. io utillzed the totai envelnpe Systm methnA, the valuc5 establi5hed by the
sum of items Y3an?1 8M1 shall nnt bc 91-eatcr Lhan thc Sum of Itens P1 and R2,
i . Zz! . ?> ? ? ' •--- 7? ? ? _ _ • -_ ?-"? 3--?____
a 4 ?'
'7 • _.__
'f ;
F'LAk!
LI ?je-:AL FT, E.xposED
?
?6?..???E ' _
--
;
?:ULL I ,
Fi?.?.?L.A?E ; -
WALL
Scz . ?'-r, Ski?)osED wA LL
K
x 5 =
1= uLL I',
,
FuL.I_Z" - k ?
F. p
,
To-?AL = ??,??
AzEA
? Sc?.Ft. ?KaoS?D GEiLIUC? _ Z.
?
w DWS 1? ? . D
00? ?
o x
2O/ 4p?y -? i ? ? = Z. y, !o '3 G•`?
?ATI O
3R,?
g,M-+ U?i+S L?!
ConatX??riT! R. Value
r? r ir film
x
3, inches soft ranod ,
, .Od
4. .(o1r
5. j1p%N-e?----- ? 0.17
6. Ext? ??'lor air film
r Total, ?' ."?,'?
. u= .O? . .
FRATIE Si7iI,L
1.
2,
3.
4.
5.
6.
'-4±L
:1z
?;_???lcra
Interior air fi7m 0.60
0
2.
+
?D 1
S'1" L?' °1
3. d
9_ Y 1 D 2l A v o
a.
c i n? w? r . . fo2
5.
g,
Cxterior air,
film 0.17
Total
? ??.o?
g, xnterior sir film o . c a
2.
? 7 fL
?
T'T'? _-?-
Fh bsT ll N? ?. ? o
4 . ?
-e
s.
{? ___._------
Exterior air ?-
film o.i
. Total •
SI.AB O_ N -GX?T+DE
?
'
_J •
e
?
, ' lr
. ~
. . ,
.`
, 4L -
` • ,
-!
?.
?' '? `. ?
, ?t) ? ??? to
?
,
?? '
' ?1,`1...
.
? 6.
r
4 p?
?` - ??/
? .
. ??? • i .
.
•
???. '
°-,. •`? .
/
`(I FIG. 64 trr
. [` _ '
? „ ' s •
t 7c.. ;43 ,
. ? r X
P?r K ? ? r(
,, .- • ?„
. a 4 i?( ? irr
NpTE: Indicato tyoe, = r,t ?. _ .
"R" value, depth and -
•
a .. . ° L*- ? • placenent of insulation. '
,
e
.. -
?l ' • ,
b -
' .
'3T4Ro
. .. .. .
p _ .
- 41ALL SECTIONS
27?E: UFe 15a, of oPa9uc wall area for
gf%3me consCruction
,
RQOV./CIiILTNG
rj?• " ? '
? ) J
.?:
??.i?:?S!i????
vzilI' ?....?'.
--
..? . -
VenCed UcJC L).oW
• y7--' t t ? '
Fxc. R5
!i;Vnlt_e
Con:;truction -
0.61
1. finCrt;lo- - nir
3. Lj c-------= -o.-?t
?. film (sCi111
,C -41
oC?il D
?SL-' ?Iv BA1T' ?2.°3?? IN VAUL
0 . E? 1
1. 7?itcr.lc?r Zir film
0. 3t
_(?G I
4. ltri?•rior niL? ri7??J.?5t11? --_??,1?
---------` ToL•a1
PIC. @6'. .
. _{?----- ^
• `?
• .. i•::.i•.
_? • -?' ': . ? ' ? '"'r-? i
> (L?
- ? . ? .
• t70.1-VI:2;TE'1] .
' , ? }Icuc ,
flou up
FLr,. @7 . . ,
0.61
'? . 5. Ou C? i dc a i r. t f lm _.--_----
--- Total
t .
11occ: Usc additionnl ?hcets if inore cpaco
^-J r,ceded for deLails onJ calculaliong.
..
R-=4 d
Floc) up vCtltCC1
_ ?. , PERMIT cR2G23i
CITY OF EAGAN PERMITTYPE: aui?loI G?
3830 Pilot Knob Road
Eagan, Minnesota 55123 Permit Number: 024075
(612) 681-4675 Date Issued: 0 7/ 11 / 9 4
SITE ADDRESS:
1973 CHIPMUNK CT
L07: 32 BLOCK: 1
MEADOWLAND5
p.I.N.: 10-48050-032-01
DESCRIPTION:
Bu'ilding _Permit Type OECK
Building Work Type NEW
?Qi?I"
REMARKS:
FEE SUMMARY:
Base Fee $30.00
Surcharge $.50
Total Fee $30.50
CONTRACTOR:
OWNER: - Applicant
LARSON TODD
1973 CHIPMUNK CT
EAGAN MN
(612)6$6-6772
55122
I
I hereby acknowledge that I have read this application end state that the
inPormatian is correct and agree to domply wit'h"all applicable State of Mn.
Statutes and City ofi Eagan Ordinances.
4a 4.2tcle
APPLICANTlPERMITEE SIGNATURE
f?er,a RoA4I rn.?l
ISSUED BYISIG A7U E
I
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITEADDRESS: Lor: 32 BLOCK: 1 APPLICANT:
1973 CHIPMUNK C7 LARSON TODD
MEADOWLANDS (612) 686-6772
PERMIT SUBTYPE:
DECK
TYPE OF WORK:
NEW
BUILDIN6
024075
07/11/94
INSPECTION .. . .•
FOOTINGS FINAL
? ?
•,
=
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
?sA,
[RTCE,v D
JU L Q U SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3] lot change is requested once permit
is issued.
ate 7 Valuation of work
rt
e Address:_073 GHiPMVivk GT'
STREET SU1TE #
Tenant Name: (commercial only)
IAT 030' SLOCK I SUBD.., f P.I I.M. #
i:r,??
Descri tion of mork: EMaUE EXis?A/ ooD Ec I?C eTr/ ?+?.?iS:25 to EnTE,d
Lu?1 Ef2
The applicant is: Owner ? Contractor ? Other (Describe)
Name _t-6 RSON T°PD Phone 6$6- 677a
Property LAST FtRST
Owner Address W? 0*PM vNk' c T.
STREET , STE #
City EOG W state M N Zip 5S/aa
n
Company Phone
Address License # Exp.
O WNE dZ Citlv State " Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this apptication and state that the information is
correct and agree to comply with all ppl' able State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
y ?( U
? ficate for:
d' n i Curr^j
?
? DELMAR H. SCHWANZ
LANOSURVEVON
RpatMb VnMr La? M TM Sbto M Mmnne4
7178 - 144TM ETREM W. - OOX M ROSfiNOUNT, MINNfi60TA 560i{
SURVEYOR'S CHRTIFICATE
Ca, R:7)r\lc
y ?.f
,5v„-? .4 7700 S89°2922'E ? ?,y47
C-'¢P,??AGE, ?.
7?L I TY c1',EMC•iT %
.
w ;
:C' d I
d ?
I,O T
?L
v
i
U?
0
G
?
. ?n
?
0
?-- ? Cenctea
-F-ropoaed finish grad!
- '?-
?- yz 1 6. ? Gara.Re floor Elev. '
? i 9. t8
?
? .
?? ?` ? N y
•. ,?
?
`
'
t
:
ZiGOI`?'"?
7.
. ?h
??9
)
T hcreby ceT?.*,: fy that this
\
n Ls a true and cirrect
-- -- ' re,.resentstion of Lot 32,
.?--- o Nia A, 3i o^ k 1, 74°ADOWLAh'D F IrZST
1v,,
v AL?,I?IOU, ar.cording to the
94, tS ? s9° 29' 22' E ,
h recorded pl it thereof,
DaKOta C•.unty, finnesota. i
Dated: •Ilily 26, 1979
M J N.K `?,?RT Revieed to sho++ proposed- houl
{ on this 20 day oP September,,
Apf>roved for Du .?n ?c Cur?j Peal .
Es*.ite Management, Tne,. 1979
>a
Gy: _
• MINNRlfOTA REC118TMT10N NQ.lEaQ
' ??S
?.?
_.\
3howing Proposed ?
Houae for:
Jos Miller
I3015 Cedar Ave. 30, ?
Apple Valley
PIION4 {17 I23-17M
{
°CAT.---: 1 tncn = 39 feet
RESIDENTIAL
4 2 /BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EAGpN MN 55122
651-681-4675
New Conatruction Reauiremenb
. 3 regatered sile surveys showing sq. ft of lot, sq. R. ot fwuse; and all roofed areas
(20% mazimum lot coverage allowed)
• 2 copies of plan showing beam 8 window sizes; poured found desiqn, etc.)
• 1 Sel of Energy CalculaGons
. 3 copies of Tree Preservation Plan d lot platted after 7l1/93
. Rim Jo'st Detail Options selection sheet (bldgs with 3 or less uni4s)
DATE
SITE ADDRESS f?7 3 CG1 `i
TYPE OF
APPLICANT
STREETADDRESS /?/7.3 G??pryrvr+?F
TELEPHOli 69-677a ELL PHONE #
ON . ? .5
C..-AL"
7 -
RemodellReoair ReauiremeMs
. 2 copies of plan
• 1 set of Energy Calculations for heated addi6ons
• 1 site survey forextenor additlons & decks
• Indica[e dhome served by septlc sys[em for additions
VALUATION '.
MULTI-FAMILYBLDG _Y _N
FIREPLACE(S) _ 0 _ 1 _ 2
CITY ??9Gh STATEAAI ZIP 5510'd,
v
FAX #
PROPERTYQWNER TodG' 4GrvSoh . TELEPHONE# &L51 6'gZ-
--?--------------------------------------------------------------------------------------.-----
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNES01'A RULGS 7670 CATEGORY 1 MINNESOTA RULES 7672
(J submission type) • Residential Ventilatlon Category 1 Worksheet Submitted • New Enerqy Code Worksheet Su6mitted
• Energy Envelope Calculations Submitted
Plumbing Conhactor: Phone #
Plumbing system includes: _ Water Softener Lawn Sprinkler Fee: $90.00
Water Heater No. of R:I. Baths
No. of Balhs
Mechanical Conhactor. Phone #
Mechanical system includes: _ Air Conditionina re-Heat Aecovery System nl? 7 2002 Sewer/Water Contractor. ?
--°---------------------------------°--------°----------•---------°------°-- Y-------- ?- -°--°------
I hereby acknowledge that I have read this application, state ihat the orma ion i ect, nd agree to comply
with ail applicable State of Minneso/t?l_$st \utes and City of Eagan Ordin ce .
Signature of ApplfcanT
OFFICE USE ONLY
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
' Updated 4102
OFFICE USE ONLY
u .?
? 01 Foundation ? 07 05-plex ? 13 18-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plax ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multl
? 03 01 of _ plax ? 09 07-plex X17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Eut. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multl
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex O 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
X, 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repav
? 33 Alteration O 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bidg only) - Give PCA handout to applicant
Valuation
? Occupancy 1411 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 _VIQ W idth
REQUIRED INSPECTIONS
_ Footings(new bldg) FinaUC.O.
Footings (deck) ?L FinaUNo C.O.
? Footings (addition) Y Plumbing
?C Foundation HVAC
? Drain Tile
_ _
Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
? Framiug _ Siding Stucco _ Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/rzplacement)
_ Insulation _ Retainuig Wall
Approved ByT 2-
Base Fee
Surcharge
Plan Review
MC/ES SAC
ary sac
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
I.tcense Search
Copies
Other
7otal
/ '"r?"
12-x'I-v
Building Inspector
?/ ?V°
.?/J.i'lcate iur:
An !k Curr;+
? . .
DELMAR H. SCHWANZ
LAfID SURVEYOR
RMiftwW UnUw L*rf Of TM Stab !f MinMSOU
7978 - 144TH 9T11EET W. - EOX M ROEEMWNT, MINN@80TA 060N
SUR V E V OR'E CERT I FICATE
Jl1Vr1111? c i'V}IV064
Houae for,:
Joe Miller '
13015 Cedar Ave. So,
Apple Valley
PNONE 072123-17M
l?0• , 7P\ C r J n, ?\'? SrAC,3: 1 tncn - 39 feet
7700 589°29 Z?' E-
_
[JFa.?.1AGE ?.
?Jr??zY c?:EME•T = .
., ^P
-, ?
- -- - -- ` ?? G
19
J
??07
?^? Denetee
--'?ropoeed flniah grade
' o
_ aZ r?> Garage floor Slev.
U !9 ?B ? •<:' ? :?'l- c?" . D .
0
I., ;//s '1= ? l
U 70 N - ?
-:
\ ? r N 1? ?•?I I hereby cerr'_ fy that thls
ls a true and c-)rrect
rerresentation of L,ot 32,
? - o ,I, t --- -- - . NLa \.? Ko.^.k 1, M=ADOWLAtiD PLRST
?y ??.,,v AL^LTIO*I, according to the
94. 59' 29' 2Z' E p tih ?PD recorcled pl it thereof,
Dakota C,.urtty, 'flnneaota. _
F; Dated: •Pily 16, :979
n
"
C N M a N 'rt U. R T Revi aed to shoa proposed' howf
{ ?on this 22 day oP September,
Aof>roved for Punn 'c Curr-j Peal :st-ite Management, TqC. 1979
by: u
MINNlSOTA 11Lf318TRAT10N NO. Oril6_
't
?
+
?aaututfr??ilirvn?utlE? \
MVoigt & Associates, Inc.
? STRU(:TURAL ENG3NEERING SERVlG'ES
4635 NICOLS RD. SUiTE 204
EAGAN, MN 55122
- PH. (651) 686-7727 FAX. (651) 686-8444
FIELD REPORT 4tZ
PROJECT:
IIdSPECTION REPORT NO: VP Z
REPORT BY:
L
DATE: I, tl 1y,IQ•6
TIME: S: L7Q PP?,,1
PRESENT AT INSPECTION P?? ??.vr ?0?gsa?j
Notes:
l?
N"ILW69 Lv 0 IK.
N k3 (z-.NaaLAA-
?Aaw,.,ttZt&0 -
i eerebY c:ertify r,ha,r, tt,is P1an, sp?c?7??,..?xa,
O oprt ae w? Prep?,red? ?b,?3r ??
dbeci
??} ?°i'+v?9jC1:1 ? ra+dti r r^:5m n. GJ:z/
-"'"'"'y`? .?yylY?`D'9$?1?' na.., i-}-3r+
?
ysLJ11. ?In
?r
??"? ?& 8q? fiQ7?k
??50
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 4 651-675-5675 FAX 4 651-675-5694
New Construction Reauiremenis
3 regisfered site surveys shaxing sq. ft of lol, sq. ft. oF house, and all roofed areas
(20% macimum lot coverage albwed)
1 Soils Report 'rf proposed building is to be placed on disNrbed soil
2 copies of plan showing beam & window s2es; poured found design, etc.
1 set of Energy GalwWtions
3 copies of Tree Preservalion Plan'rf lot plaried afler 711193
Rim Joist Dehail Opfans selection sheet (buildings wifh 3 or less units)
Minnegasm mechanipl ventilation form
RemodeVReoair Reouiremen5 OficeUse OnN
2 copies of plan showing foo6ngs, beams,joists CeA of Survey Recd Y N
1 set of Eneyy Calailatlons for heaied addiGOns Soils RepoR _ Y_ N
1 sife survey for addiGons & decks Tree Pres Plan Recd _ Y_ N.
Addffion - indicate if on-sAe septic sysiem Trce Pres Required _ Y_ N
OnsiteSepticSystem _Y _N
Date 1-7-1 Construction Cost
Site Address i7'l V24 UniUSte #
? ,-- „
Description of Work pnSiN ?'? ???? ? ? ??•/i/
Multi-Family Bidg _ Y? N Fireplace(s) ? 0 2
Property Owner zUd,? ??i'sO-, Telephone # (65? ) F16 -
a
Contractor
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF
Energy Code Category Minnesota Rules 7670 Cateaorv I
• Residential Ventilation Category 1 Worksheet
(J submission type) Submitted
• Energy Envelope Calculations Submitted
A NEW BUILDING
Minnesota Rules 7672
. New Energy Code Worksheet
Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of masier plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
,
lj AUG 0 7 2006
Telephone #(
Telephone #(
Telephone # (
rsLy _ - -v--cr - +
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 start without a
permit; that the work will be in accordance with the approv?d plan in the?ase?e?work which requires a review and
approval of plans. ? )
2006 RESIDENTIAL, BUILDING PERMIT APPLICATION
Applicant's Printed Name Applicant's Signa
DO NOT WRITE BELOW THIS LINE
Sub Tvpes
? 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 EM. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage 4P 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
O 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo/perola) ? 36 Multi Misc.
? 05 03-plex ? 11 10.plex ? 19 Lower Level ? 24 Stortn Damage
? 06 04-plex ? 72 12-plex ? 25 Miscellaneous
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
IP 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alieration ? 37 Demolish Buildin g` ? 43 Reroof ? 46 Windows/Doors
? 34 ReplaCement •Demolitlon (Entire Bldg) - Give PCA handout to applicant
D@SCflption: WaterDamage_Yes
Valuation 3 5, oo Z)•? Occupancy MCES System
Plan Review 100% or 25%
Census Code Q3q_ Zoning F? City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings(new bldg) Sheetrock
Footings (deck) FinaUC.O.
? Footings (addition) ?o FinaUNo C.O.
Foundation ?e HVAC
,?d Drain Tile Other
Roof ? Ice & Water ;,b F inal Pool Ftgs AidGas Tests Final
p Framing _ Siding _ Stucco Lath _ Stone Lath _Brick
? Fireplace ?'1 R.I. '?6 Air Test g Final Windows
? lnsulation Retaining Wall
A _
Approved BY
O-Ew , Bu
--------- - ----- ilding Inspector
--
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Aii¢,- n I' roo k--
,oe
21 XzYx: 27216
Z t X 2? X lS= e?? 11$1 -? Sbo .?c)
,?tWotiojeP 1-a Zp?czS`6" 9001-7PL"
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Oct.31. 2046 2:14PM BASF Ff 7635509916
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(Finished
product)
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No.1274 P. 3
PROPL?R7`Y 1'E8T TY'PiCAL
Y2FS1UC,15
DZ
rc3'' ?+a ASTM tY1622
„ z.iazss
4- t.as-i.9a
crosoa ceu c ,? ?2? ,?%
TC-Fac6or. Initiel ASTM G51g 0.155-0.170
Permeenw (pemte) ASTM E.96 291
? 2.99
Ditneusional Sta6ility (% Vo1Wno AS']'M I} 2t26
I?
Change)
Dry Agc 28 Dqs (158°Fx Dry) +33 to +8.2
Fraao 14 Dnv (-2p'F) .0,37 tv -0.96
$utface'Burniog Cheracta?tietics?? AS1M &84
1?oem Thicllem 4,+
Flame ,
?
S'°°t? ne
?' asA
?r pJ?wicul properry re,u%a me ypfomfo. rhia ewreria! as qppnwrat wr
development facility ahder caW'ollatf conc?PeYara, Mfoammnd rioedtmg
D?p'?lco1 DroperhiBa cun vmy w9fh Cltangrs fx 1he ap?plicmfai pmomeferr: ie-.
usaFc+'a'wrea threkxesr, P+'ocasatng alluippmenl, mez Jhoad vralnrfoW. lhraWApA
GS@
era Rs n rasulr. Rdcse publuhed propertlar mx xre, jd. far' evulucrion gyiCelines,
PiOwd PraP" SPWVkaTlons skmdd be deearnmadfiorh actualproJrdon
sed ?ap?iol.
Tki,t rmmortcal f7ame spread rptle fe not i)dendyd ro sojlecf Jurardt prmanmd
b 1lris or g?y other marar d wufer aelw caxlitiau.
xne recommended applicatlon and handling proccdures forthe spa+ific
produLt beig used should ba lmown and followed by ihe £qam
aPPlicafar. A=all "tost area" of spray foam shouid be applied and
v?sPected Prior to oommencing the projack Thia slmple,low-cost tast
erea cm indicato iaadequate adhesion, improper auuface preparaoon
anrllor need for premer, swface oontamination, 3mpsoper substrato aud/or
smbient DemPoiature. equupmont malfunctlons, material contaminaaou,
or imPmPcr aPPEicatian tcchniGue. A simple Wisual iavpectiaa of a
sample cut from a test spray and periodic job samples can revea]
1mtmtia1 P?lems that may be due to oae w more oP1he above
Page l of 3
)ob Silc Addicss:
ENERGY CODE WORKSHEET FOR
ONE & TWO FAMILY DWELLINGS
1N57'RUCI'IONS: Complctc Parts [, II and III. Clearfy mark plans wilh: insulation R-vafues; window and skylight U-valucs; size and
qpr of cqmpmcnt; equipmcnt controls; and location oF interior air bazricr, vapor retardcr and windwash barricrs. Morc dctailcd
inl'orruanon tan bc found in lhe Mimiesom Energy Code Srumiinry Sheels available from thc Minncsota Dcpartment of Public Scrvicc.
Pa,-t I. BUILDING ENVELOPE
.+ r.a. n-iy mswaGOn. < R-5 shcathine 037 0 y y V V
~ ?
'
.
_
?? ?. R13 msulation. 0 R-5 sheathme 037 ..6 0.30 0.26 0.?3 0.20 0.18 0.16 0.15 0.14
C-1 _'xJ. R-1} msulauon. a R-7 sheathm¢ 0
37 0.37
0 037 0.37 0. 35 031 0.23 0?5 0.23 0.22
.
L.l _'\G. R-19 msulauon, < R-5 shcathine
0
37 37 037 0.37 0.37 034 031 0.23 0?6 0.24
,
.
??sG. R-19 msulauon, 4 R-5 shcaihine 037 037 037 0.37 0.34 0.31 0.?3 0?5 0.23 0.21
U
hC,. R-' 1 msulation. < R-5 sheathine 037 0._7 037 0_37
0.37
0.37
033
0.30
0.28
0.26
3r6. R-?I insulation. 0 R-5 sheathin¢ 0
37 0.=7 0.37 0.37 0.37 033 0.30 0.27 0.25 0.23
.
u,u r.?,tti a_in c...._._.- , 0.37 0.37 037 0.37 037 0.35 031 0.29 0.27
- - - ????.,?wn msmanonJ: I Maximum 4cera2e Window U-value (esceDt (ounda[ion windmo, n; F?n•
i
-
-1 -.•_ ^-? non.
?,a. R.I ? insulanun, I tc--) s 1 calhm,2
0 R-5 shcathme 03i
037 0.37
03 0.J3 0?3 0.25 0.22 0.20 --0.13 O.I7 0.15
-J
2%4.
K-1? msulation.
4 R-7 shcachme
0
37 7 037 0._ 7 0.37 033 0.30 0.27 0.25 0.23
2x6.
R-19 msulaiion.
< R-3 sheathina .
0
37 037 0.37 0.37 03? 0.36 033 0.30 027 0?5
?
?xG.
R-19 msulation,
3 R-5 shcathine .
0
37 0.37 0.37 0.37 0.37 0.32 0.29 0.27 02d 0.?3
NC.
R-21 msulation.
<R-5 sheathin¢ .
0
37 0.37 0.37 0.37 037 037 0.35 0.32 0.29 0.27
-J
2x6.
R-'_ 1 msulation.
?S R-5 sheadiine .
0
37 0.37 037 0.37 037 035 03l 0?9 0.2G 0.24
A1,11 T....,. !.. , r l. D? 1 n r"'_' . 0.37 0.37 0.37 0.37 037 0.36 0._: 0.30 0?3
?ii??Uduvn inswanonl: MaximumAveraee Window U-valuc exce t Coundation windows p 5 6 f1•
J
_\-4. m
R-I: sulahon. < R-5 shcathine 0
37
?4.
Ft-I: i
nsulation. 4 R-5 shcathine .
037 0.37 0.34 OZ9 0.2G 0.23 0.21 0.19 0.] i 0.16
x4.
R•I: insulation. (1 R-7 sheathine
037 0.37 0.37 0.37 037 0.34 0.31 0.23 0.26 0.24
.7
'\0.
R-19 insulatwn. < R-5 sheathine
037 0.37 0.37 037 0.37 0.37 0.34 0.31 0.25 0.24
)
_'\G.
R-19 msulation, 4 R-5 shemhine
' 0
37 0.37 037 0.37 0.37 0.34 0.30 013 0.25 033
J
_?b.
R•? 1 msulation. < R-5 sheathine .
0
37 037 0.37 037 037 0.37 036 033 0.30 0.28
1
1\G.
R-21 msulation. a R-5 sheathmg .
0
37 0.37 037 037 037 036 0.32 0.29 0.27 0?5
. 0.37 0.37 037 037 0.37 0.37 0.34 031 0?9
Wmda? U-value: ! , I I i
100 X
r?
window fi door area
Source: ? ?IFRC ?
?
?-
eross exposcd wall area
%?<' %?
DESIGh` ALLOWABLE (from tabic
Chick opliott used: f?f` "Cookbook" Method (complrte worksheet below) ? MnCheck mediod (attach reporQ
? Buildine Component method (attach calculations) ? Systems Analysis me[hod (attach analysis)
,ifficate foT: onowing rrvpoaec --:
Houae tor: ?
nn ? Curr°j
. .. Joe Miller •
13015 Gedsr Ave. So. `
App2e Valley
DELMAR H. SCHWANZ
LANOStJRVEYOp '
RMiRM?O VnMr L?rs.N T?? Statt M Minnneta -
2978 - 1AiTH fTRFET W. - oOX M flOSEMOUNT, MINMESO7A 06Qit ?MGME 612 473'170
SURVEYOR'E CEIiTIFICATE '
?j? ?? ?, ? J SCAT.?: 1.tnch = 3? feet
CO
•
? '•?
7 -, 77.da 5E
C1eP,NAGE ?#.
.
.
A
L? .
?
' - - - - ?? i G
--
s ? ?1h
W '
o] ? Q 7
J+ -
Denctes
rade
ed flnish
T
o
g
rop
s
o
Gara.Re floor Hlev.
0 /
?: '?
1
A
? T. h,2reby cer*i fy that this
?
is atrue and correct
of Lot 32
t
t±
,
on
a
represen
?lock 1, N=a1DOW.LA."?'D FRST
A?LITIO*i, acc?>rding to the
= g9° 29' 22' E p
? recorded p13t thereof,
corded
t
'ri
nneso
a. _
Dakota Ccunty,
,
Dated: Jlzly i6, .479
u• R7 Revi sed to show proposed' hous
on this 20 day oP Septemher,,
1 ` 1479 "
Aoproved for,Du.nn 4: Curry Peal :,stste Management, Inc.
• -u
by:
y
MINME=TA REf378TRAT}ON 1'10•lM.
.. - ??,
I
EAGAN, MN 55122
- PH. (651) 686-7727 FAX. (651) 686-8444
FIELD REPORT
tt1Bt th18 P?+ BP°if'ca?'°R'
I am auduly
??y'p?i°n gnd th t m ?Y
??? .
c'? ?'1? l,? =172mnwo ? ?-?lulf)Sv__Reg.Ao.A07'OB
PROJECT:.7' WSPECTION 1
REPORTBY:
DATE: 1v I IU 1 C+?
TIME: 5 -1j PP?X
WEATHER: ?„ ?}
PRESENT AT INSPECTION:
WORK IN PROGRESS:
Notes:
?>
71 J
c? ?
=Voigt & Associates, Inc.
STRUCTURAL ENGINEERINC SF.RV/CES
?
4635NICOLS RD. SU17'E204
2006 RESIDENTIAL MECHANICAL rExMiT arrLicATioN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete forsingle family dwellings & townhomes/condos when permits are required for each unit
Date
Site Address /? 73 Clil /4 1'+9 !/L'
-? Unit #
Property Owner ?('G?GI l? I ?Oh Telephone # (651 ) b F [? 7 7-2,
Con[ractor ?
Street Address City
State Zip Telephone # ( )
Bond #: Expires:
The Applicant is ? Owner _ Contractor _ Other
Add-on or alteration to ezisting dwelling unit $ 30.00
? furnace ?Additional ?Replacement _ New
air exchanger
air conditioner
_ heat pump
'
, .?
r
, ? •-, , ?
other i
b ? e '7 ? gSa
State Surcharge $ .50
T
t
l $
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o
a ?
I hereby apply for a Residential Mechanical Pemut and aclmowledge 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 with the Mechanical Codes; that I understand Hris is not a
pernut, but only an application for a permit, and work is not to start without a p t; that the work m accordance with the
approved plan in the case of work which requues a review and approval of plans. n
ApplicanYs Printed Name Applicant's Signa
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA171565
Date Issued:08/23/2021
Permit Category:ePermit
Site Address: 1973 Chipmunk Ct
Lot:032 Block: 1 Addition: Meadowlands 1st
PID:10-48050-01-032
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
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.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Todd J & Kristine E Larson
1973 Chipmunk Ct
Eagan MN 55122
Estate Claim Services Llc
6701 Penn Ave S, Suite 201B
Richfield MN 55423
(651) 309-1114
Applicant/Permitee: Signature Issued By: Signature