857 Ivy Lane
06/08/2011 14:37 6128616267 BEI EXTERIOR MAINT PAGE 01
//000.23
Use BLUE or BLACK Ink
I%Haq
I
City of EaLd I Permit
I I
I Pemttt Fee: V O
3830 Pilot Knob Road I I
Eagan MN 55122
t Date Received:
Phone: (651) 6754875 I
Fax: (651) 675-5694 I Stair I
20'10 RESIDENTIAL BUILDING PERMIT APPLICATIONa&w
Gate: &Z &L11 Site Address: s7 I V Y e- 4tig
Tenant: Suite x:
RESIDENT! OWNER Name:50 RGT MAiiJA6e-MCJT Rhone: X63- X93 9)70
Address/ City/ Zip: ?5V Pe g4M R. Ave ir/ eo Lr,¢y{ ~-y #Z A
i
Applicant is: Owner A Contractor
TYPE OF WORK Description of work: F-C&Dvu-' /W10 iL'GrlCr ,~'p~af
Construction Cost:
it Multi-Family Building: {Yes No
CONTRACTOR dame: 67 License X4.7 V1131
Address: os -57`/Z6r7- City: A&WV i!'bLWS.
Mate:_ zip: 56VIF Phone: 1y-1,W ` 9&1-6;7t1--,?
:Contact: Email: _ -I rJ-fo LO bty x rY7 . Corr,
COMPLETE THIS AREA ONLY IF CONST UGTING`A NEW BUILDING
In the last 12 months, has the City of Eagan issued a pennit for a similar plan based on a master plan?
_,.,Yes _No If yes, date and address of master plan:
Licensed Plumber, Phone:
i
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans 'and suprtfrrg'dtcu»aenits'that you 5ubmr.'af+a `Cflnsfdel6d ft~ :bej~ulin>r►tilatiir::.: Pottiot~`o;
.the in armation rrnay be cl ssl ed'as r n public's you: providb S edcffis~:r"scns tit t.whtr►ti pent~l ff~0 C/ty 90 '
c6nckrde flia :ero trade SeCmts."
GAL EEFOR OU 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 tocates o~ underground utilities, wwy app-herstatconerall om
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 w in
accordance with the approved Phil in the case of work which requires a review anti approval of plane.
-za
Applicant's Printed Name Applicant's Signature
Page 1 of 2
6ei-?tifica#e uf Cccupanc?
? Wit4 of Wagan
_ ?epartment oF ?4ni[bing ?a?pectiun
This Certificate issued pursuan[ to the requirements of 1he Uniform Building Code
certifying that at tf+e tinte of issuance this structure was in compliance wrth rhe various
ordinances of the Ciry regulating buildirtg corcrtruction or use. For the followeng:
SF DWG 30619
ux classificatioct: Bmg. eermit rb.
?p--y Type R-3 U-1 Zoning Disawt R-3 rype consi. Vn
ownffoteuiwins WOODLANDS ^vOUNTRYIiQ? 7625 METBO BLVD., ED1NA MN 55439
Building Addmss lffl 1VY LAPE l.ocaliry L6, B1, THE WOODLANDS NO 3RD
/
? ?:
.. s,,;,mng offic;;, .
POST IN A CONSPICUOUS PLACE r
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
, N F
E H1UU1i1 AtJ{?":. M1.?li111 ?RD
I PERMIT SUBTYPE:
TYPE OF WORK:
NUU
pF ,rRrF'Tx4N ZEKt] 1101 I tNf
INSPECTION .• . .A
• ? . . I F( l ? f i 1 f.
1 . - • -I i , : 7 ?
F , •
L
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
fi ES! 0? i
lai??) a,??s-•?11?6
?
f3 I Pemift No. Permit Ho{der Date Telephone 0
ELECTRIC ,
PLUMBING / Id Y .97 7VI-5
HVAC f /d 9 ?J9
Inspectfon Date Insp. Commenta
FQOTINGS
J
FOUND ?Y?E??>'?S ?j' ?IG QIL /L1l3
FRAMING ,
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
9
/Kr
INSUL
GYP BOARD
FIREPLACE
i
FIREPLACE
AIF TES7
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
INSPECTION RECORD
? CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: ?H '
Eagan, Minnesota 55122-1897 Date Issued: • +?° '
(612) 681-4675
SITE ADDRESS: APPLICANT:
?•! t AliT , . ,;i:.. ?.? ??.
i . ?i;? , , ii?? . l ;. ? ?• ' i . ! !
PERMIT SUBTYPE:
TYPE OF WORK:
! 111H ,"f f?t1 LEIi 1 1N!
INSPECTION .• • .•
, , • , ?,?.
?.?I?::' . , . ' . . . . • ... . 1! 1 ?;
I,;!,'. ? • f. ? ?,y;. l
F -1
? --
Pertnit No. Parmit Holdor Date Telophone f
ELECTRIC
N uAa
PLUMBING
inapecdan Date Insp. Comments
FOOTINGS
• ?? •t ?
I Su i ?'S - C lfx?
FOUND
FRAMING
?
ROOFING
PLOUMBING
AI ?EST
flOUGH
HEATING
7r
GAS SVC
7EST ? --?
INSUL
GYPBOAFD
FIREPLACE
AIR TESTCE
7lj
FINAL PLBG
9i
at
FINAL HTG
ORSAT
TEST
BLDG FINAL
O
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
?/j I
otrtifica#e of Cccoancv :
IKitv of
ZO cut of Zxilahlg 3"ape«nn
This Certificate issued pursuant to the requirements of the Uniform Building Code
certifying rhat at the time of issuance this structure was in compliance with rhe various
ordinances of rf?e City regylating buitdrng construction or use. For the followrng: •
uu aassiftmion: SF DWG Bag. Pem,;, No. 30618
O-P-y Type R- U-1 7aning Dwxia R-1 Type Const. Vn
o.,ner of suiwing WOODLANDS -IOUNTRYHOMHE 7625 METRO BLVD., ED1NA, MN 55439
857 1VY LANE I,S, B1, ?HE WOODLANDS NO 3RD
su?w?n8 an?s ?.o?1?ry,_?
Dwc
P05T IN A CONSPIC S PLACE t
. . .. _ ? \?? ,. ? .? .
C:[ 1 Y C11= EA.r.a-1N
CAsHrnEpt S Yi.:R:rTZNAt. W)s 52.
Bhlrl_,: t7.:'.;M/97 C.Lui:a 9.4:202E3
zM
NA-ME::; hlllClpl.(a\PI f:i:11..!N'Th,YfiilPi::Ei 7Nt..',
P25F1 9001 861 1V4 I_.AP?f.:- 4043.46
?'nta:I. f:r.:>rr,.,a.p'•: Amouni:r QW.fib
C'n'I:}798"i:]
t )!i1:: [i T tl : PJF{i\I(:4'
;? ? ? a;a ;??v. nJ$
, , )r.dl'?r."n.?,,,,?:Yh %
OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMITTYPE: BuzLozNG
Permit Number: 030619
Date Issued: 0 8/ 14 / 9 7
SITE ADDRESS:
861 IVY LANE
LOTc 6 BLOCK: 1
THE WOODLANDS NORTH 3Rp
p.I.N.: 10-75892-060-01
DESCRIPTION:
6 .'
•s?
ZERO LOT LINE
ermit Type SF DWG
Type NEW
R-3 U-1
VN
R - 1
86
30 '
102 1 - FAM. ATTACM
e7 r,??.?"?-
nm ?
REMARKS:
S&W PLUMBER -
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Swbtotal
VALUATION
$967.25
$628.71
$58.00
$956.00
100
1
$116,090
MI5C FEES
Tatal Fee
$1,539.50
$4,143.46
$2,603.96
CONTRACTOR: - Applicant - 57. I.IC OWNER:
CAl1NTRYHOME BLDIfS 18354126 0008508 WOODLANDS COUNTRYHOMES
7525 ME7RQ BLVD 145 7625 METRO BLVO 145
EDINH MN 55439 EDINA MN 55433
(-612) 835-4126 (612)895-4126
-s 4z i
YMk? ? ,?$ x r ' _
T here.by .acknowledg8 GF?at ;Z h?w??, ??????it4?4ti?
-'! ?B1SI, ATUR W
3830 PILIOT KNOB RDN 55122
199? BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construction Renuirements RemodeVRepair Reouirements
`?/ ?3 - VG
114-10?
? 3 registered site avrveys ? 2 copies of plan
? 2 copies ot plans (inGude bBam 8 window sizes; poured tnd. design; elc.) ? 2 site surveys (exterior addRions 8 deeks)
? 1 energy calculations ? 1 energy ca(culations fer heated addilions
? 3 copies ot tiee preservation plan R lot pleried after 711l93
requlred: Yes Y No
`//! t,
DATE?. CONSTRUCTIOWCOSTA 112,aov =
- ?n? • 0 °
DESCRIPTI0N OF V?lORK: ??)?^??gW?
STREET ADDRESS: 50I I VY LAU?
?
LOT (Q_ BLOCK SUBD./P.I.D. #:
3!?Q
DkrLir* °/ o,--s
PROPERTY Name: WoYJQ?AND-?? 6Wtij2( WG5 Phone #:
OWNER '
Street Address? uc.
7&25 MET12o rps*
tiwf] Gjui7E 145
City: FDIWa State: M? Zip:55431
CONTRACTOR Company: (?9Ll n112V6ME 'PJLjlL'J70LS_ _ Phone #: 8?'"412(0
Street Address: 7402S M?TRb FX-VD• License #: 00O5?506
City: EnINp State: MI) - ZiP.5543
ARCHITECT! Company: Phone #-
ENGINEER
Name: Registration #:
Street Address,
City: S1ate: Zip:
Sewer & water licensed plumber: LENN 011 EYCAVlkjIU-A (010 ^ 1400 penalty applies when address change and lot
change are requested once permit is issued.
1 hereby acknowledge that 1 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 OMinances _
Signature of Applicant: ?
OFFICE USE ONLY / ?' CEIVE
Certificates of Survey Received Yes _ No JUL 0 8 1997
Tree Preservation Plan Received _ Yes _ No BY:?
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex
)k'02 SF Dwelling o 07 4-plex
0 03 SF Addition ? 08 8-plex
? 04 SF Porch o 09 12-plex
? 05 SF Misc. ? 10 = plex
WORK TYPE
,?('31 New ? 33 Alterati
? 32 Addition o 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
? 11 Apt./Lodging ? 16 Basement Finish
? 12 Multi Repair/Rem. ? 17 Swim Pool
0 13 Garage/Accessory ? 20 Public Facility
0 14 Fireplace a 27 Miscellaneous
I _ . _ ...,.,.. • J ? ?G?.
2r:.??o •??- ?-
'-"?? ;y? ¦? -?'?
? 37 Demolition
:?r-H Basement sq. ft.
Main level sq. ft
l sq. ft
. ? sq. ft
? sq. ft
8<6 sq. ft
30 Footprint sq. ft
, Building z
/F qq& MCNVS System
45-90 City Water G<
Fire Sprinklered
PRV
Booster Pump
Yr 9 Census Code. o z
-7-, o 0 7 SAC Code a l
Census Bldg ?
Census Unit
Engineering
Variance
Permit Fee Valuation: $ 1164600
?
Surcharge
Plan Review '
License -?
MCNVS SAC
City 5AC /
Water Conn.
Water Meter
Acct. depasit
SN11 Permit
S/VN Surcharge
Treatment PI. ?
Road Unit
Park Ded.
Treils Ded.
Other
Copies
Total:
% SAC
SAC Units
EXTEftIOR ENVELOPE AVERAGE "U" COMPUTATIQN
01AMIFQ. WCbl?-'LAtilL>j CpU?1T2Y?M,? lNG.
SITE ADDRESS: 8S7 86;,/ IvY LAQE PHONE: 3ss"412'(D _
COUNTRYHOPiB BUILDERS -INC.
0co??rRacroR: ? _ oar?: ??r ]
DETERMINE WORKING SCUARE FOOTAGE OF EACH:
1. TOTAL EXPOSED WAIL AREA .............. 1,804.00 sq ft x"U" 0.110 = 198.441
2. TOTAL R00FlCEILING AREA :................ 1,435.00 sq ft x"U" 0.026 = 37.31
3. TO7AL EXPOSED WAII AREA CALCULATIONS:
Total exposed wall area above floor........ __ _ _1,804.00 sq ft
af Total window area:
Double glazed ........................ 134,00 sq ft x"U" 0.430 57.62
_glazed ........... ............. sq ft x "U" = 0.00
b) Total door area :.................................... 38.00 sq ft x"U" 0.070 = 2.66
c) Total sliding door area:
_
Dovble qlazed ........................ 80.00 sq f[ x"U" 0.430 = 34.40
glazed ........... ............. sq ft x"U" = 0.00
d) Total fireplace wall area :....................... NA _ sq ft x"U" 0.370 = 0.00
el Total walt framinfl area
{qVERAGE 10%) .......... 180.40 sq ft x"U" _ 0.095 17.14
f) Total net wali area
a6ove iloor 1insulatedl ........................... 1,279.60 sq ft x"U" 0.043 =_ 55_02
gl Totat rim {oist area :............................... 92.00 sq ft x"U" 0.034 = 3.13
Total foundation area Iexposedl ..............NA sq ft
hy Toial foundation window area .. ............. NA sq ft x"U" _ 0.430 = 0.00
i1 Total net foundation area abova grade..... 0.00 sq ft x"U" _ 0.045 = 0.00
3. Total al thru il 169.97
If item !Y3 is the same as, or less than item t!1 you have met the intent of 2 MCAR 1.16008 A and 0.
Pag= -1-
.
4. TOTAL EXPOSED ROOF/CElLING CALCULATIOMS:
Total exposed roof/ceiling area . ............. 7,435.00 sq ft
j} To(ai skylight area ................................ 0.00 sq (t x"U" = 0.00
Total rooflceiiing framing area
k) (Average 10% ............. 143.50 sq f; x"U" 0.039 = 5.60
d) Total netinsulated
rooflceiling area .................................... 1,291.50 sq ft x"U" 0.024 = 31.00
q. - Total al thru iF 36.59
if Item #A is the same as, or less than item X2 you have met the inteni of 2 MCAR 1.16008 A and 0.
ALTERNATE BUILDING ENVELOPE DESIGN
To utiiize the total evelope system method, the values os[ablished by the sum of Items #3 and item #4
shall not be 9reater than the sum of Items Kt and ?'2.
1. 198.44 ? 2
3. 169.97 + 4
CERTIFICATfON
37.31 = 235.75
36.59 = 206.56
I hereby cercify that I have calculated the "U" factors and "R" values herein and that the building here
in described meets or exceeds fhe state of Minnesota Enerpy Conservation Act.
wur. 4.----'-
(Si6nalurc)
7'U"/7
(Dala)
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F:i:'l,!'{?(Vt:'[v, ?<?!:,?x!?mX"l?'t.?th': ; :K$:iRiKi$Sk:MNMY3?.if.:C`Y.kt+:(1n.t'IF.
? ?CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
BUTLDING
030618
08/14/97
SITE ADDRESS:
P.I.N.: 10-75892-059-01
857 IVY LANE
LOTs 5 6L6CK: 1
TNE WOOOLANDS NORTH 3R0
DESCRIPTION:
ZERO LOT LINE
re^ =°, ??-
ihg=:,?' e r m i t T y p e
S F
D W G
u-1;ldi'r,ig;,^Wi?S'?? TYPe NEW
s''- R-3 U-1
? Cern?;Gr4?ett:a? rT'p?e VN
????A
? cti
?`r19 =
R -1
r
„ s f 86
90 '
?. 102 1 - FAM. ATTACH
q-??`'%?{
x
r ?
??'3ti ;iR "?.? ?o•??? ?&?»Fn"n` ?i?," .,. e -? "".? a
.?mr
REMARKS:
FEE SUMMARY:
VALUATION
Base Fee
Plan Review
Surcharge
SAC
SAC %
5AC Units
Subtotal
$967.25
$628.71
$58.60
$950.06
100
$2,603.96
$116,000
MISC FEES 1 539.50
Total Fee $4.143.46
CONTRACTOR: - Applicant - ST. I.IC OWNER:
COUNTRYHQME BLDRS 18354126 0008508 WOODLANDS COUNTRYHOME$
7625 METRO BLVD 145 7525 METRO BIVD 145
ED,TNA MN 55439 EDSNA MN 55439
(612) 835-4126 (612)835-4126
C
L° ; e
nou:]:`eage
7
_ in.. i Lei 111
ISS ED 8 SI NATII
CITY OF EAGAN
30.4-' 2 7 3830 PILOT KNOB RD - 55122
199,?BUILDING PERMIT APPLICATION (RESiDENTIAL)
681-4675
RemodeVReoair Reauirements
? 3 registered site surveys
? 2 copies ot plans (include beem 8 window sizes; Doured Ind. design; etc.)
? 1 energy calculelians
? 3 wpiea of tree presenation plan M lot platled eRer 717/93
p required: _ Yes ]L No
DATEi,, t ?L•.P1' ?? . . ? +e :"a?•
DfBCRIFT11ON OF WORK: OVJNIHOLISI=
STREET ADDRESS:
%
LOT S
857 I VY L,LNF=
BLOCK I_
SUBD./P.I.D. #:
2D
PROPERTY Name: WOOF)LAND?5 6OllN7R.i ROM£S Phone #: g3S-412Co
OWNER u•,
Street Address•1U25 FIRST
METRO gLV
SU?TE (?'?J
City: [-:?nINA State: MO Zip: 6G439
coNTtzac7oR Company: Gol1N7RYF ioME 5UIGI"E2S Phone #: 8116'442(E
Street Address: 7645 MTRv ftvD• License #: 000 8'50 e'
City: EG1N4 State: MN ' Zip:55439
ARCHITECTI Company: N ?,4 Phone #:
ENGINEER
Name: Registration #:
Street Address•
City:
State:
Zip:
Sewer 8 water licensed plumber: ?ENNOr1 E,CG?yi??101? (p9?'? 4'?' . Penalty appiies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the ' ormation is crorrect and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. ?
Signature of Applicant:
OFFICE USE ONLY RECFIVED
Certificates of Survey Received zYes _ No J U L 0 8 1997
Tree Preservation Plan Received Yes No BY.?
? 2 copies of plan
? 2 site surveys (exlerior add8ions 8 decks)
? t energy wlevlations for heated additions
?s *CQNSTRuCklON COST:
?
=
ooo
OFFICE USE ONLY
BUILDING PERMIT TYPE
n 01 Foundation ? 06 Duplex
,9` 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
0 04 SF Porch ? 09 12-piex
? 05 SF Misc. ? 10 - lex
WORK TYPE
?
? 37 New ? 33 Alt ?
? 32 Addition o 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
length
Depth
APPROVALS
Planning
? 11 Apt./Lodging ? 16 Basement Finish
? 12 Multi Repair/Rem. ? 17 Swim Pool
? 13 Garage/Accessory o 20 Public Facility
? 14 Fireplace o 21 Miscellaneous
( ?
? 36 Move
0 37 Demolition
-Ir - /-f Basement sq. ft.
_JL•ac1 Main level sq. ft.
•3 ? / sq. ft.
12.1 sq. ft.
/
? sq.
C?M4 sq. ft.
ft.
? 6 Footprint sq. ft.
Building
/ yyb MCNVS System
,?S9o City Water
Fire Sprinklered
PRV
Booster Pump
y47 Census Code.
2' 007 SAC Code
Census Bldg
Census Unit
Engineering Variance
102-
?
?-
?-
Permit Fee
Surcharge
Pian Review
License
MC/WS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S!W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
°k SAC
SAC Units
Valuation:
?? X !o. ?3 = /6s
Z6 x 30 • 780
/.33x /S ? 2°
2.61 xi2.s7 = 33
-
g 116L00 0?
2a X /y = ssz
a„w /zx rz = /-_
/ S so x s?'
l?
Z2 X /9. 67 = Y37
, 6 - G y
?/97xi6 =
7, qsz
a
/,yyb x'
-! ?
i?
, .
` EXTERIOR ENVELOPE AVERAGE "li" COMPUTATION
OWNER: WCbDLAAJD5 (?Q(JA1TRj fbMY?J' ING.
SITE ADDAESS: (5s7 46(aI IvIV 1-1NE PHONE: S?'?IZ(p
CONTRACTOR: COUNTRYHOME BUILDERS,- INC. DATE: 7-6 - 27
DETERMINE WORKING SQUARE FOOTAGE OF EACFi:
1. TOTAL EXPOSED WALL AREA .............. 1,804.00 sq ft x"U" 0.110 =? 198.441
2. TOTAL ROOF/CEILING AREA :................ 1,435.00 sq ft x"U" 0.026 = 37.31
3. TOTAL EXPOSED WALL APEA CALCULATIONS:
Total exposed wall area above floor........ 1,804.00 sq ft
af Total window area:
Double _glazed ........... ............. 134.00 sq (t x"U" 0.430 57.62
z ed ........... .............
sq ft x "U"
0.00
b) Total door area :....................................
38.00 sq ft x"U" 0.070 = 2.66
c) Total sliding cloor area:
Double fllazed ........................ 80.00 sq ft x"U" 0.430 = 34.40
glazed ........... ............. sq ft x"U" = 0.00
d) Total fireplace wall area :....................... NA _ sq ft x"U" 0.370 = 0.00
el Total wall framinp area
(AVERAGE 10%) .......... 180.40 sq ft x"U" _ 0.095 =_ 17.14
fy Total net wa(i ;rea
above floor (insulated) ........................... 1,279.60 sq ft x"U" 0.043 = 55.02
gl Total rim joist area :............................... 92.00 sq ft x"U" 0.034 = 3.13
Total foundation area (exposed) ..............NA sq ft
h) Total foundation window area .. ............. NA sq ft x"U" 0.430 = 0.00
i) Total nec foundation area above grade..... 0.00 sq ft x"U" _ 0.045 = 0.00
3. Total a) thru i) 169.97
If item k3 is the same as, or less than item #1 you have met the intent of 2 MCAR 1.16008 A and 0.
Page -1-
* 1
4. TOTAL EXPOSED ROOFlCEII.ING CALCULA710NS:
Total exposed roof/ceiling area .............. 1,435.06 sq ft
j) Total skylight area ................................ 0.00 sq ft x"U" = 0.00
7otal roof/ceiling framing area
k) (Average 10% ............. 143.50 sq ft x"U" 0.039 = 5.60
d) Totai netinsulated
roof)ceiling area .................................... 1,291.50 sq ft x"U" 0.024 = 31.00
4, - Total a) thru i} 36.59
If item #4 is ihe same as, or less than item li2 you have met the intent of 2 MCAR 1.16008 A and 0.
ALTERNATE BUILDING ENVELOPE DESIGN
To utilize ihe total evelope system method, the values escablished 6y the sum of Items #3 and Item #4
shall not be greater than the sum of items K1 and #2.
1. 198.44 ? 2
3. 169.97 + 4
CERTIFICATION
37.31 = 235.75
36.59 = 206.56
I hereby certify that I have calculated the "U" factors and "R" values herein and thai the building here
in described meets or exceeds the stata of Minnesota Ener9y Conservation Act.
-----
1• S-97
(Datz)
.
?* **
* PIONEER
* 9t?=a= F I
'k 4K * *
LAND SURYEYptS - qVIL
UND PIANNERS . UNOSCME MCHIlEC15
2422 Enterpriee Drive
Mendata Heighls, MN 55120
(e12) 681-1914 FAx:sst-sase
625 Highway 10 N.E.
Bluine, MN 55434
(612) 783-1880 FAX:783-1883
Certificate ot' survey for: COUNTRYHOME $UILDERS
House Address: 857 & 881 Iw Lane
House Model:
'?,0ZCE{VEi1 OCT 2 T 90
- rM1
'A
?
i?
i?
rI
6 ?
?,i,??,•S 6????$
?
; --/ ?'g 1
- ? i
/
3.7t
. Q
\ / . ?
/? 891 p 0 -
93. `?
NN?\
\
1
V
s
? ?.
6
??O??I p? 361b9? Q1'?? 1 ?i?
6
??° °'•; 6ry 5?\ 9s8
?OECK / ?
D ,,?,,?? ? 160 I
f ?,?t?'' Jh0 o ?e /
. ?A
?
?
78 ' l
o?l
? A
D?JG
D
[?F07
lA Lookout Elewtion: 893.6 Lookout Elevatfon: 893.6
Sawer lr.vert Etavatton: 888.0 Sewer fnvert Efevatiorr: E87
PROPOSED ELEVATION LOT 5 aunpo.aFp MVATION IAT 8
x sm.e Denotes ExtelMg Elevat7on Lowest Floor EIeNaHon: $$24 Lowest Flaor Elewtion: 8904
K(Joa Denokea ProQosed Etevatton 7op of Block E7evafion: 89$•5 Top o7 Block €fevation: 698•5
- Denotee Drafnage Flow Dfrectfon Garage Slab Elevation: $$$.d (iorage SFob Etevatlon: 898.0
=m-- Denotea Drolnoge dc Ut9ity Easement (at door) (ot door)
-? Denotes Monument NOIE: Propoaed bukdfng alte yoding ta in uccordance wtth the
qradln9 C(me approved bY 1AS city enqfnea.
-$- Derrotes Offset Hub Bearings shown are assumed NpTE; contracla must writy a/ AlmenMona s arive¦ar design.
LOTS 5-6 , BLOCK 1 WOODLANDS NORTH 3rd
Revised: Revlse Building Dlm. 10/23/97 DAKOTA COUNTY, MINNES07A
We herebY certlfy that thls eurvey. Dla^ w report wae prepared by me a under my d(rect eupeniafon and that I om du7y licenced
Land Surveyor under the lawa of the State of Mfnnesota. Dated this Znd dny of JulY A.D. 1997-
RevieM: Ploce new buOdMq on both lots. 5/20/97 Sfgned: PIONEER ENGINEERING, P.A.,
Revtsed Bu11dMg Elevationa 719197 Toke 2' Out of Garoga 1016197
Scale: 1 -c-h = 40feet e)r
Robert B. Sikich, 1.5. Reg. No. 74$91 or
334 9316919 Terrence E. Rathenbacher, L.S. Reg. No. 20595
\ V;X"4x\ /
?.*•* *'? M2422 endotatHelghls,DMN 55120
? y PIONEEF! LAND SURVEYq75 • CINL QJCINEERS (812) 881-1914 FAX:881-9488
T
er90 neer n0 LAND PLANNERS • UNDSCAPE MCHITECTS 625 Hfphway 10 N.E.
* ,* Blcine, MN 55434
* * ?. (612) 783-1880 FAX:783-1883
Certificate of survey ror: CO UNTRYHOME BUILDERS
House Address: 457-46i Iw Lane
House Model:
?•
,
0
?GGQC?n(?l ?
?
Cw.rour EL.= 4 Loeira..r Et.. 893.4
SExviG£ /Ivt! 9 $89•0 SERVKB iN?, c 887.0
PROP03h'D SL8'VATLON LOT 6 PROP0.4BD ffilr'VdTlON !AT 8
?vca.o Dr,nGtes Ex:sting Eiewtton Loweat Floor ElewNon: 860-1/ Lowest Floor Elewtion: 846.1
11? Denotee Proposed Elewtion Top of Block ElevaUon: $98r;5' Top of Block Efewtion: 898=5
- Denotea Drolnage Flow Dlroctlon Garo9e Slab ElevaUon: 896•0' Caraye Slab Elerotlon: 698.0
- Denotes Dra7nage & Ufflity Eosement (ot door) (ot door)
--o- Danotea Monument NOTE: Prapo"d 6ullaing dte grading b in accordonce riN tne
qrodlnq plant opprovsd by Ne olty enqineer.
-e- Denotea Ofhet Hub Beorings 9hOWR 0r9 assumed NOTE: Cantroolor mwt vMfy ap dhnmelona k dMvewoy deaiqn.
LOTS 5_6 , BLOCK 1 WOODLANDS NORTH 3rd
DAKOTA COt1NTY, MINNESOTA
We hereby certify thot [hfs survey, plan or report was prepored by ma or under my direct supervialon and that I am duly licenced
Land Surveyor under tne laws of lhe State of Minnesota. Dated thls day of JL? A.D. 19.'-)J.
GoitziW4 ?/o9/p7_ Signed: PIONEER ENGINEERING, P.A.
Scale: 1ine-h =40 et By.z? L??
Robert B. Sikich, L.S. Reg. No. 14897 or
334 93169.19 Terrence E. Rothenbacher, L.S. Reg. No. 20595
, .. .
- f-
-
Exte-ision of fanric and
wire inta the trench.
I 1. 5d- p0'"s i llc. 1rC.i2 1'i- .. ?. J?d0le wl^n °?,Ir;fl'; _Q
C!'e!1C.'7 '.1pi icjr ,S ?Cflrl C}Ie I I^C' Cfll pC5 z..
Of PpSLz.
C9 n'
r __/? °'i' ? • p.
y.
.? ?-
??
3. Attach the filter fabric to 4. Backfil] and comoac_ the
the wire fence and extenG tt excavzted soil.
into the trench.
Fil
, C0NSTRUC=0.`1 OF SZLi FEYCE SijTFj =POR2I\G S7IRE F°_:iC°
Source: Adapted `rom Installation oP Strax and fabric
Filter Barriers for Sediment Control, Sherwood
and Wyant
?
2 acres
Haximum drainage area 'Iop of hill
?.9` ? i
i. ? i •.
Silt feace placad on eontour
k ?
/ •
2ti+ra mds upslope t
preveat f2rnr hygass
/
/
/ - . , . • . ;
'lypieal Laqoat for Silt- Feaee -"
Filter fabric seenrely
fasteaed to post
Lay fabric ia the
Backfill over ehe eop --" 6"
- Steei or vood posc
1
30^ minimum heighc
of fabric aad 'eampact =': -
'the soil ' 24^ minimum depch
?
Construceion af Silc Fenee
I
CiTY USE ONLY
LOT ` BL I RECEIp'I' #: ?P
? /J// ° a9s
SUBD.i iA/(? /?t/#o , RECEIPT DATE:
1997 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
Date: -S 14 /? / (612)681-4675
Complete this section onlv if vou are installing HVAC in sinale familv, townhome, or condos that are
under construMion and are not owner /occupied.
• HVAC: 0-100 M B T U
ADDITIQNAL 50 M BTU
• Gas oudets ( m;r,ir+.um of one required @$3.00 ea.)
• State Surcharge:
• TOTAL:
_ . >Add-on
_ Add-on air exchanger, i.e. Vanee system, etc.
Minimum fee applies to all remodel or add-ons of existing residences
State Surcharge
$ 24.00
6.00
??. OU
.50
7? °54D
Add on air conditioning
Other
$ 20.00
.50
Total: $ 20.50
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME:
PHONE #: jn-?,"'1'( ;zL
PHONE #: ?j J.O' 4 3 D 1
STREET ADDRESS: ! II I L.j (2_G-?(^ 5 -I-
CI7'Y:
_ STATE: nao ZIP:_?;53X
q) rz")? a=====
SI A URE OF P I`EE
CITY USE ONLY
LOT BL ? d RECEIPT#:
SL'BD?',(,b(.c ? RECEIPT DA"fE: q??U/99
1999 MECHANICAL f'ERMIT (RESID£NTIAL)
crry of Ens,ax
3830 PaoT Kxos sn
EAanx Mrr 55122 Date: (651) 6$t-4695
7 /
Complete this section onlv if you aze installing HVAC in single family, townhomes or condos under
construction and not owner /occupied
• HVAC: 0-100 M B T U $ 30?.00
?L111V1?AL 5 O 1V1 p U 1 l/?
• Gas outlets (minimum of one required @$3.00 ea.) I a.00
• State Surcharge: .50
• TOTAL: ya.50
Complete this section oiilv if you are remodeling, adding to, or repairing existing single family dwellings,
townhomes, or condos. Please indicate if it is a new item, replacement item, or repair.
New _ Replacement
Fumace
_ Repair _ Other
Air exchanger, i.e. Vanee system, etc.
Renriiider: Ca11681-4675 for inspections.
_ Air conditioning
Other
$ 30.00
State Surcharge: .50
Total: $30.50
SITE ADDRESS: _?? 9` rV liL?
0W,vERNAME: l IAYI1yI kh( ?Y1C2 61,11 PHONE#:?.oloZ) ODI --2nl6L1 ` V6h-'
I\STALLERNA!vtEa(crtram. 1'LL(,m,d/)(.t26q. Hmb,(7_ PHONE#: (DEDI /y,37-qa/cj
STREET.4DDRESS: VL350 Ue(fYYLIH lM'U S1-
CITY
JJ.FORMS BLDAtECH PE2'NIT (RES) - 1999
_ STATE: RW ZIP: ??7?
?S L?? ??LLsS//1Y?
SIGNANRE PERMITTEE U
L BL CITY USE ONLY
SUBD.. U
RECEIPT#:
RECEIPT DATE:
1998 PLUI+BING PERMIT (RESIDENTIAL)
CZTY OF EAGAN
3830 PILOT FINOH RD
EAGAN, A48 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and wndos when permits are required for each unit
D backflow preventer for undergraund sprinkler system
???-------------------------°--???--
FIXTURES --------------
EACH
#
TOTAL
Shower 3.00 x 3
Water Closet 3.00 x _3 = 9
Bath Tub 3.00 x T
Lavatory 3.00 x 9
Kitchen Sink 3.00 x
Laundry Tray 3.00 x I_ = 3
Hot TublSpa 3.00 x =
Water Heater 3.00 x
Fioor Drain 3.00 x
Gas Piping Outlet ' minimum - 1 3.00 x
Rough Openings 1.50 x =
Water Softener ' for dwallings under wnstruction 5.00 x =
Water Softener ' for existing dwelling 20.00 x =
U.G. Spdftklef " for dwelling under canst. 3.00
=
U.G. Sprinkler ' for existing dwelling 20.00 =
Alteretl0n5 ' to existing residence 20.00 =
Water Turn Around 20.00 =
Private Disposal System ' MPC iic. 75.00 =
(naw and refurbished systems)
*
Abandonment
Private Disposal Systems 20.00
STATE SURCHARGE .50
TOTAL '115. ?Q
--------------------- ----------------------------------- -------------------- • • ------- • •-------------------------------------------------
I hereby adcaowledge tha[ I have read this application, state thet the inkrtnation is cortect, and agree M comply with all applicable City of Eagan ordinances.
It is the appliwnYs responsihiliry to notily the property owner that the City of Eagan assumes no liability for any damages pused by the City during its
narmal operational and meintenance activities to the facilkies constructed under this partnk within City propertylright-of-way/easement.
SITEADDRESS: E; Srl lVy ,? fJN/? ? £'?a'2 q
OWNER NAME: we? % ?/Oj L' f?
INSTALLER NAME: HA RlPI ?J 1142fA C TELEPHONE U
STREETADDRESS: ?JdCI ?/?/yTRIZ/?l. C>?G?15
CITY: s7• P/Pl+/L.
53?/a a
JSlFORMS BLDG/PLBG PERMIT (RESIDENTIAL) 1998
SIGNATURE OF PERMITTEE
_ ? 2? ? CITY USE ONLY
V' L RECEIPT #: 1037V13
SUBD.r1c.K? liVOOA•/'t??'/ RECEIPT DATE: °:?//O/99
?
1999 PLUM$INfi PEfiMIT (RuIDENTIAL)
crrY oF E?sa?x
3$30 fILCIT KNOB fiD
SAHAN, 6iN 55122
(ssi) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
------ ------------------------------------------------------ - -
FIXTURES - ----- »--
EACH --------- ----------- ------
_# -- - - - - ---
TOTAL
Shower 3.00 x a-- = 1s.?
Water Closet 3.00 x
Bath Tub 3.00 -
Lavatory 3.00 x
Kitchen Sink 3.00 x 1 = 3OD
Laundry Tray 3.00 x I
Hot Tub/Spa 3.00 x
Water Heater 3.00 x 1 _ 3. OD
Floor Drain 3.00 x ? = c3.CU
Gas Piping Outlet ' minimum • 1 3.00 x =
Rough Openings 1.50 x =
W9ter SOft2n@f ? for dwellings under construction 5.00 X =
Water Softener ' for existing dwelling 30.00 X =
U.G. Sprinkler ' for dwelling under const. 3.00 =
U.G. Sptinkler ' for existing dwelling 30.00 =
Alterations ' to existing residence 30.00 =
Water Tum Around 30.00 =
Private Disposal System " MPC iic. 75.00 =
(new and refurbished syslems)
Privale Disposal Systems ' nuandonment 30.00 =
RPZ (new installation/repair) 30.00 =
STATE SURCHARGE .50
Reminder: Call 681-4675 for inspections of water heaters,
water softeners, alterations, etc.
TOTAL
3q 50
-----------------------------------------------------------------------------------------------------------------------------?---------------
I hereby adcnowledge that I have read this appliption, sfate that the infortnatlon is cortect, and agree to comply with all applipble City of Eagan ordinances.
It is the applipnPS responsibility to noGfy the property owner ihat the City of Eagan assumes no liability fw any damages caused by the Ciy during its nortnal
aperetional and maintenance acOvities to the faciliGes constructed under this permit within City property/right-of-way/easement.
SITE ADDRESS:
OWNER NAME:
INSTALLER NAME: ?YA.f"l 6Yu -PI(,L(Yt,b TELEPHONE #: C?Q 5 I 1LI,37 -ca I S
STREETADDRESS: 3?"JFJL) Vcf''vy(W (CSYu St
CITY: +?f???IVLQ?? STATE: ZIF: S50153.
7
SIGNATURE
CDlPERMIT FORMS/RPLBG PERMIT (RES) - 1999
?
City of EaRan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
I - -
For Use ----- ?
? PermR#: O?yJJ G ?
; Permft Fee: a 71. 7 i ?
? Date Received: ?
? I
? Staff: I
i
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Tenant:
5?ite #:
d
A Ph
'
A
RESIDENT/OWNER one:
Name: /
oSG
??
2S 5? ? V ) LRr e-
Address I City / Zip:
_
V C
t
O
or
Applicant is: _
wner
ontrac
TYPE OF WORK Descrip6on of work: -5r? (Jlti /0
Construction Cost: Multi-Family Building: (Yes _/ No
CONTRACTOR Name: ?/.& C_!n 1'//u.clio? License#: ?051106 f?-
Address: 4?19U /&e '5?pL ? X
City: /f?sfr %te- State: _ Zip:
Phone: G 5? - 3g7 - 3? i rr Contact Person: .Uizz xP
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
CBtegon/ Submitted Submitted
(4 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 Contrector: Phone:
NOTE: Plans and supporting docutiients that you submif are considered to be public information. PoRions of `
the inforrna[ion may be classified as_non-public if yoq provide specific, reasons that would permit the City fo,?,;
conclude thaf the ?are trade secr'ets: I hereby acknowledge that this infortnation is complete and accurate, that the work will be in conformance with the ordinances and codes of the
Cdy of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to staA without a permd; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
ask, ?? ,r/r,ro( x
ApplicanYs Printed Nam -IE'- ApplicanYs Signature
C= u D Page 1 of 3
? AU G 1 1 2008
DO NOT WRITE BELOW THIS LINE
' SUB TYPES
? Foundation ? 05•plex ? 76-plex ? Accessory Buiiding ? Pool
? Single Family ? 06-plex ? Fireplace ?4' Porch (3-season) ? Ext. Alt - Multi
? 01 of _ Plex ? 07-plex ? Garege ? Porch (4-season) ? Exk Alt. - SF
? 02-Plex ? DS-plex ? Deck ? Porch (screenJgazebo/pergola) ? Multi Misc.
? 03-Plex ? 10-plex ? Lower Level ? Storm Damage
? 04-Plex ? 12-plex ? Miscellaneous
WORK TYPES
? New ? Interior Improvement ? Siding 0 Demolish Building"
1 Addition ? Move Building ? Reroof ? Demolish Interior
Alteration
4 O Fire Repair ? Windows ? Demolish Foundation
? Replacement 0 Egress Window ? Water Damage
' Demolition (entire 6uild ing)- give PCA handout to applicant
DESCRIPTION:
Valuation ?„-7
U" Occupancy
MCES System
Plan Review 1
Code Edidon
SAC Units
(25%_ 100% ? Zoning ? City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Const. ? Width
Footings (new bldg)
Footings (deck)
? Footings (additlon)
Foundation
Drain Tile
Roof: _Ice & Water _Final
? Framing
Fireplace:_R I. _AirTest _Final
? Insulation
Reviewed By:
RESIDENTlAL FEES:
Base Fee
Surcharge
Plan Review
MCIE5 SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
Total
SheeUock Meter Size:
Final/C.O.
y, Final/No C.O.
HVAC
Other:
Pool: _Footings _AirlGas Tests _Final
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall
Building Inspector
(YWs?°.
POPLAl-
Page 2 of 3
** *
* PIONIEER
* eng
LaNo
2422 Enterprise Orive
Mendota Helghts, MN 55120 .
(612) 681-1914 FAX:681-9488 ..
IFND PLANNERS • LANDSChPE AFtCHIlEC75 625 Highway 10 N.E.
Blaina, MN 55434
(612) 783-1880 FA%:783-1883
Certificate of survey ror: CO UNTRYHOME BIJILDERS
House Address: 857 & 861 Iw Lane
House Model:
acr 2 7 SY
;
A
a
'?
? 04
pROPOSED ELMTfON 7AT 5_ PROPOSID ELEVAT[ON IAT 8
?
Lowest Floor Elewtion: 890.4 Lowest Floor Elewtion: 890•4
x em.o Denotea Extst(ng Elevatlon Top of Block Elevaffon: 89$•5 Tnp of BJock E9evatJon: 839.5
x<? Denotes Proposed Elevation ?a e S?ob EtewQiun: 9?8.0
Denotes Drainage Flow 0lrect(on Garage Slob Elavaflon: $9$,0 _ 8
(at door) (at door)
- Denotea Dralnage dc UtNity Eosement
NOTE: Proposed bu?ding alta grading In fn occordonce witA Iha
-o- Denotes Monument qruEinq plane opproved by Ne clty en9lnex.
..-m?- Derrotes Offset Hub Bearinqs shown are ussumed NOIE: Con4ucla must vMty 01 dimanwa+s k drlvaMay dseiqn.
LOTS 5-6 , BLOCK 1 WOODLANDS NORTH 3rd
DAKOTA COUNTY. MINNESOTA
ReWsed: Revfse Bulldfng Dim. 10/23/97
We hereby certify that thie eurvey. Diun or repwt wae prepored by me or under my dlrec[ supervieion and that i am duly licenced
Land Surveyor under the lawa of the State of Minnesota. Uated this Z^d day of JulY A.D. 1997.
ReviseA: Place new bulldln9 on both lots. 5/20/97 Slgned: PIONEER ENGINEERING, P.A..
Revtsed Bullding Elevatlons 719197 Take 2' Out of Garaga 1016197
inch =/? feet BY
SCale. l- -?"O- Robert B. Sikich, L.S. Reg. No. 14891 or
Terrence E. Rothenbacher, L.S. Reg. No. 20595
? 93169.19 _
v yv
? Lookout Elewtfon: 693.6 Lookout Elawtton: 893.6
,(idi Saiver InvVrt Efawtlon: 88810 Setrer Intiert E7e•ration: ?87•?
i
r For Office Use (// /�
Ø4Ø
:::::
0 y ty � i tt •-i
F� Te: �L
it K1T'
,
al Y-1
3830 PILOT KNOB ROAD 1 EAGAN, MN 55122-1810 R ''C El D Date Received: l
(651)675-56751 TDD: (651)454-85351 FAX: (651)675-5694 Staff:
buildinginspectionsaAcitvofeagan.com JUL 24 2019. ,
2019 RESIDENTIAL PLUMBING PERMIT APPLICATION
Zn?
- ( f SeAddress: g7,-- Suite#:
Reililitt., :,.. Name: Mit Phone: 12..---loI'" '7ff
s; ,ttS!'i. ,,,14cAddress/Cit /Zip:
_ _
,..`` •. Name: MILBERT COMPANY dba CULLIGAN WATER
' . License it: WC641376
Address: 1801 50TH STREET EAST City: INVER GROVE HEIGHTS
'Cc ritrac:to'P..
State: MN Zip: 55077 Phone: 651-451-2241
Contact: BILL MILBERT Email: gloria.abas@culiigan4water.com
. New Replacement Repair Rebuild Modify Space Work in R.O.W.
Type.;of=:Work — _- --
Description of work:
Water Heater
Lawn Irrigation( RPZ/_PVB):
, x Water Softener
Add Plumbing Fixtures( Main/_Lower Level)
D.esc:rlpti.on* . —_Septic System •
Description:
New
Abandonment Connection to City Water from Well
RESIDENTIALFEES ....�.._........._..._..._.__�.._......_..,+,......._.._._.._...._...._._.__......_w.w....._._.._�.... ....__.._.........r.._..__.�.___._.......
$60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 New fixtures, adding or removing piping(includes State Surcharge)
$60.00 Septic System Abandonment
°$100.00 New Residential (fee collected with Building Permit)
$115.00 New Septic System (includes County fee and State Surcharge)
$60.00 Connecting to City Water from Well* + $290 for Meter and $190 for Radio Read = $540
*Sewer&Water Permit also required for connection charges
i.. .. ......_.___...-._..._TOTAL FEES $ GO�OO __.. __..
CALL:BEFORE YOU�DIG. Call Gopher State Ono 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.eopherstaleonecall.org
You may subscribe to receive an electronic notification from the City of proposed ordinancos by signing up for an email updato on the City's
wobsito at www.cityo(oagan.com/subscribe.
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 ' the approv planci a case of w "k which requires a review and approval of p ens.
bp t W /QC x ,
A/54,d-76 ,, .
Applicants Printed Name Applicant's Signature
Page 1 of=-2