4159 Ethan Dr2005 RESIDENI'IAL BUILDING PERNIIT APPLICATION
City Of Eagan 3jAO
3830 Pilot Knob Road, Eagan MN 55122 Telephone 4 651-675-5675 FAX # 651-675-5694
New Constructan ReauiremeMS RemodebReoair Reauiranents Oifice Use Onlv
3 regi5te2d slte surveys showing sq. R. of lol, sq. ft. oi fwuse; and all mofed areas 2 copies of plan Cert of Survey Recd _ Y_ N
(20%mauimum lot caverage allowed) 1 setof Energy Calalations for healed addiGons T2e Pres Plan Real '_Y _N,
2 copies af plan showing beam & wiMOw sizes; poured found design, efc. 1 sfle survey for additlons 8 decks T2e Pres Requfred _ Y_ N
lsetofEnergyCalculafwns Adddion-indicafei(ort-s8e&epGcsystem On_sReSeptkSyatein _Y _N
3 copies oi 7ree P2servatlon Plan if lol pWlled aRer 711193
Rim Joist Detail Optans selectbn shcet (buildings wilh 3 or less unlts)
Date _? / d-31 as Construction Cost
Site Address ??J,S9 ?yHy/Ouj L)V- UoiUSte #
ek
Description of Work
.
Mu1H-FamilyBldg _ YLON Fireplace(s) ?0 _ 1 _ 2
Property Owner ?Dh Telephone#( ?!) 8-7<oS?2-
?
Contractor t
--
Address City
State /? Zip 5} ne #(65/) -7 ? z
?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Catecorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Cafegory 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Telephone #(
Mechanical Contractor
Sewer/water Contractor
Telephone #(
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the 5tate 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 approved plan in the case of work h-rec}u'
approval of plans. ?,ci?
li
? ? ? i J U N 23 2005
Applicant's Printed Name Applic,yAt's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation O 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace A 21 Porch (3-sea.) ? 31 Ext.:Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
)1 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolitlon (Entire Bldg) - Glve PCA handout to applicant
Valuation /C? mG0 Occupancy 9'3 MCES System -
Census Code Zoning A- 1 City Water -
SAC Units - Stories ? Booster Pump -
# of Units Sq. Ft. ? PRV -
# of Bldgs ? Length 4; Fire Sprinklered
Type of Const ? Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
Footings (deck) ? Final/No C.O.
? Footings (additiun) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof $ Ice & Water ? Final _ Pool _ Ftgs AidGas Tests Final
? Framing _ Siding _ Stucco _ Stone
Brick
_ Fireplace _ R.1. _ Air _
Test _ Final _ Windows
_ Insulation Retaining Wall
_
Approved By:
--- , Building Inspector
--- ------------- - --
- -- -------
Base Fee
-----------?-_---------------------------------°-----------------------
3 5',C,1.fPZ. 9 30
??r
---- ------ --
-------
Surcharge ?
Pian Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total 4o> ?vbu
X4rj ?'r„S = .?,,0 7
Aad ?N
rm? ? i tm i c.? irm?t- CPu rC V rm T
FOR: Mcr.ley 6r.thers Construction ? ?
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pRoPnse-D FVASIONS:
GARAGE FLdOR = 915.Z
TCP CF WALL = 'i: y
LOWES i FLOGR a 90(,.8
TOP F0071NG = 906.5 ylO.D
CIAG. = 3Y.3 X 95'.0 I hereby certify that this survey, plan, or repOrt wos preparsd by ma r. G. vwuw a ,
or under my direct supervision and thai f am a duly Reyistered Lar.d L? ?
Surveyor„yndsr the Ic?;s o`.t?he ?tote oi Mirnesota. 9f8m LfEXlI?Cs?J E1vG.I?tC
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Lot= 14,025 sq. 'ft.
House= 2324 sq. ft.
2 DEf?0TE5 WOOD HUB A- 11 FT. OFFSET.
xx. DENOTES PROPOSFJ EL°_VATtOV.
? DENO7cS DIREC-ION OF DRAINAGE.
L4T 4, BLOCK Z. OAK BLUFFS, ORKOTA CCUti7", MINNESOTA.
Scale 7'=30' Drown By. RAJH Disk: Job No.: 99443hs
? Demtas Iron Monument ? Becr'mgs srorin are on an assumed datum.
?$ ?r?
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GIRGA R;Tra6, MINNR60TA
°r5mid-3b:5 -LL. 784-5556
TOTf+L P.01
,
RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PIIOT KNOB RD, EAGAN MN 55122
651-681-4675
NewConaWetlon Requiremants
• 3 registered site surveys showing sq, ft. of lol sq. R of house; aM all roofed areas
(20°k maximum bt coverage allawed)
• 2 copies of plan showirg beam & window s¢es; poured found design, elc.)
. 1 set of Energy Caiculations
• 3 eopies of Tree Preservatian Plan H lot plaHed after 711193
. Rim Joist Delail Optlons selection sheet (hldgs with 3 or less uniLs)
DATE I • ?--b2
SITE ADC
TYPE OF
APPLICANT Cedar
Exteriors, Inc.
ULTI-FAMILY BLDG _Y _N
FIREPLACE(S) _ 0 _ 1 _ 2
STREET ADDRESS Coon Rapids. MN 55433 CITY
TELEPHONE #?In???'a?? I CELL PHONE #
PROPERTY
STATE ZIP
Fax # 1Ia--755 -53RQ
TELEPHONE#(Oi ll'lQffi-licSD,
----------------------------- ----------------------------°-------°------°-------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULF.S 7670 CA'CEGORY 1 MINNI:SO'1'A RUl.LS 7672
(J submission [ype) • Residential Ventilatlon Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calwlations Submitted
Plumbing Contractor: ___
Plumbing systcm includes:
Mechanlcal Contractor:
Mcclianical systcm includes:
Sewer/Water Contractor:
Air Condiuoning
_ Hcat Recovery System
Phone
Phone
Fce: $90.00
?
n
--------------------°----------------°------------°°----------------- ------------------------------------------------
I hereby acknowledge that I have read this application, state that t information i rrect, and agree to comply
with all appiicable State of Minnesota Statutes and City of Eagan r inances.
Slgnature of Applicanf ??c Q I 'd?'
OFFICE USE ONLY
_ Water Softener
Water Heater
No. oF Baths
RemodeUReoair ReauiremeMs
. 2 copies of plan
• 1 sel of Energy Calculations for healed addi6ons
• 1 site survey for e#erior additions 8 decks
. Indcate if home served 6y septic syslem for additions
_ Phone #
Iawn Sprinklcr
No. of R.I. Baths
VALUATION q l !?a ?j
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updaled 4102
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
? ? CITY OF EAGAN ?
3830 PII.OT KMOB RD - 55122
(661) 681-4675
Naw Construchon Reauirements RemodeVReoair Reaulrements
? 3 registered sde surveys ? 2 wpies of plan
? 2 wpies of plans (include beam 8 window sizes; poured fid. design; etc.) ? 1 site survays (erterior additions & decks)
? 1 energy calculations ? 1 energy wlculations for healed addkions
? 3 copies of tree preservation plan if lot platted efter 7/7193
required: Yes No
DATE: gLq (GG CONSTRUCTION COST:
DESCRIPTION OF WORK: _ ?Q(j ffil'1,-)`?'/\u-bt?0?)
nTMrrT w?MMrnn. 4-I G, C1
LOT: q BLOCK: ? SUBD./P.I.D. #: OaK. 616CLL
.
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
.
Name:
Last
City Phone #:
Street Address:
Zip:
Company _'1 1+o/) r64,6rOthel"5 ?J)l731 Phone #: Cy'a?-
Street Address: !?/V 7-YI / SC(Y) (J? JaCi, License #of UX "bc / Exp- J? G(?
City J4-C.{ " State: ///A) Zip: 55D /(
Company: '4)I 0-n co Phone ?5L? ' (7
Name: Registration #:
Street
. U ? y
City ?QaCU'1 State: n / "(P Zip: ,? ? kJlZ
Sewer 8 water licensed plumber (new construction oniy): /? . Penalty applies when address
change and lot change is requested once permit is issued.
(?, I -?, -
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey ReCeived Z Yes
Tree Preservation Plan Received _ Yes
State:
No
_ No ? Not Required
?
}I-- s-in LIV
r
a1 pUG 2 0
1??--A-
OFFICE USE ONLY
BUILDING PERMIT TYPE
. • i
? 01 Foundation ? 06 Dupiex ? 11 Apt./Lodging ? 16 Basement Finish
,0 , 02 SF Dwelling p 07 4-plex ? 12 Multi RepaidRem. ? 17 Swim Pool
??'03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 5F Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 _-plex ? 15 Deck
WORK TYPE
?31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) rN gasement sq. ft. Census Code vz
(Allowable) Main level sq. ft. SAC Code 0
UBC Occupancy sq. ft. 7?t/r.I? -?'??? Census Units
Zoning sq. ft.Census Bldg
# of Stories ? sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. ::?,2L? Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building S4 Engineering Variance
Permit Fee
Surcharge
Plan Review
License
McrES sa,c
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
9aI L4 .82)
Valuation: $.2 .2 A:,5,?
iy z ?1 '/70
)y 32 X sy> 7,7 32
?
>3.S?X ;7.5'I/(
??IxIG" 1317 SZ
.
,
°/a SAC
SAC Units
ENERGY CODE WORKSHEET FOR 1& 2 FAMILY DWELLINGS
SYTB ADDRESS VAKV I ' CITY
? DATE
COHPLSTED 8Y: ? P1?ON6 p,?
9IIILDING CLASSIFICATION: ? cat egoiy 1(etandard) or category 2(muet includo vantilation)
pZNIMUM CRITBRIA
Foundation Insulation-R10 Yialle & Windowo Roof Attic Ineulation:
(See Lable on reverse eide
S14bon de Inculation-R10 Eor allowable pe zczntage s) R44-With AGtic No {Ieel
unheated spaces-R24 R38-With Attic Raised Heel
L
Windowe 1/2" R38 & RS-Solid Raftezs
lasc.
nyl Frame
STSP 1 Wiodow & Door Area STHP 2 Calculate area au a percent of wall
A. ToGal Window & Door flrea in Sq. EeeC
I WLNDOWS (Including Foundati on Windowe):
HINDOW MAN[JFACTURE NAMe: C. From S:ep 1 divide box A(47indooi 8 Duoi-
[ Area) by box B(toCal wall ai'ea) Limes 100
WINDOW MAtNFACTURE 1'YPH:T), y equaly the window an3 door area as a
pei-ce,ic oE wall arza (box C) .
WItiOOW MA14UFACT[7RB f7 FACTOR:
R. O. Quantity cq.CL.Are. POX A 100 = C O
?
I
Dimensions ?0
U 14,f„U?
1
g STEP 3 Ozeign Peaturco
JJLJ-u1_
--
IZ'-o" x 3'-p~ ? FSSCIIELY
u ? ?11y1) ?
,?j
?3 PRAHI[!G_T'lP2.
«L
q
L STA1tDARL FRAMING _ X ecuds 16" o.c.
?
Il?W
' cl ( f
?In ADVANCEC FRNIING r,tuds 24" o.c.
X
-lJ +?---
x ?q
CAVITY It75ULATION R
7 +r X
; U -
? 7
7
SH&ATHIt73 TYPS:
-
x LE55 THAN < R-5 x
x R-5 > Ok hIORE
X U-FACTOR Q
DOOR? From the cable, (reveree side) determine the
maximum percent windcw 6 door area £or the
t value
t
th
]
d
d
i
one se
er
e
ecte
an
en
deeign opt
p g
e) in Box D below baced on the window mEg. ti-
b ? factor:
v -
D
X -'td II(e
/OI
1'utal-Area oE a:25uq.ft. -
Windows & Doors Y?
B. Total F]all Area in Sq. Ft. The : value Erom the ca61z in Box D shall be
cqual eo or greater ttw n Che k in Box C
Wall Total Height Area
Perimeter
F ?
F
061
I ft
=
?
-7 Z-
-
T
t
ll
f ft
?? dq
o
s
al Area o
Wa _
_ ____
? .
? • ' o
ONE- & TWO•PAMILY RES?DEN'('IAL pUJLD(NG PRFSCRIf''TiVE (CUOK-IIOdK)
API'ROA4i
MAXlMUM WINDOW AND DOOR A2EA AS A PERCENT OF OVEftALL WALL
AREA
From Mlnn??Fart7670 0;75 aGbPA?F
Cavlk Exterlor Wlndow U•Factor
Framitt [neulalion Sheathin 0.49 0.36 0,31 0,27
STANDARD
STANDARD R-13
R-13 Z R• 7
R- 5 13.4%
12.4% ]9,Sqe
16.4% 21.39'0
19.7% 24.3°/,
22.5%
S7'ANDARD R-15 > R- 5 12.9°h 17.1°Ie 20.1% 23,¢'/c
STANDARD R-18_19 < R- 5 12.19'0 16.0% 18.8% 1210%
STANDARp
ADVP.NCED R•18_19
R-18-19 R- 5
< R- 5 14.096
12.4% 18.63',
17.1% 21,8%
20.1% 25.3%
23.4%
ADVANCED R-18 -19 > R- 5 i4.5qo 19.29'0 22.59'0 26.1°/,
STANDARD R•21 < R• 5 12.6% 11.0% 19.9% 23.1%
STANDARD R•21 >R- 5 14.5% 19.396 22.5% 26.1%
ADVANCED R-21 < R- 5 13.6°h 18.1°a 21.2°/a 24.6°1,
ADVANCED R-21 R- 5 lS.OYe 19.9°/a 2319'0 26.9%
A"itlonal qalctlatr values
STANDARD
STANDARD R•17
R-17 < R -5
> R• 5 11.9%
13.8% 15.79',
18.4ye 18.4%
21.5% 21.5%
25.09'0
ADVANCGD R•17 < R• 5 12.6% 16,8% 19.69'o 22.9%
ADVANCED R•17 > R- 5 14.3% 19.0% 22.2% 25.7%
Notea:
Wlndow area equals rough opening minus Inatallation clearances,
Window U-factor must be determined by either the National Fenestration Rating
Council etandard 100-41, or ASHRAE 1943 Handbook of Fundamentals, Chapler 27,
T'able 5.
'LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTY LEGAL. L d Y- 4 S! J/'I'Z
DATE OF SURVEY -?3-'
LATEST REVISION: ?-?-
DOCUMENTSTANDARDS
? • Registered Land Surveyor signature and company
? ? ? • Building Permd Appiicant
? ? ? • Legaldescnpbon
? ? • Address
? ? ? • North arrow and scale
?? ? • House type (rambler, walkout, split w/o, split entry, lookout, etc.)
m/ c o • Directional drainage arrows with slape/gradient %
?? • Praposed/existing sewer and water sernces & invert eleva4on
? ? ? • Street name
? ? ? • Driveway
v? ? • Lot Square Footage
u-- o ? • Lot Coverage
ELEVATIONS
Ebstina
2/1o ? • Sewer service (or Proposed)
? ? ? • Property corners
?? • Top of curb at the driveway
v ? • Elevations of any existing adjacent homes
? Adequate foofing depth of structures due to adjacent utiliry trenches
Prooosed
m/ ? ? • Garage Boor
? ? • Firstfloor
? ? ? • Lowest exposed elevation (walkout/window)
m? ? ? • Property corners
?V ? • Front and rear of home at the foundation
? . PONDING AREA (if applicaWe)
? Easement line
? • NWL
? • HWL
? ? • Pond # designation
la/ ? ? • Emergency Ovefiow Elevation
DIMENSIONS
/o ? • Lot lineslBearings & dimensions
13 o • Right-of-way and street width (to back of curb)
?? • Proposed home dimensions including any proposed decks, averhangs greater than 2', porches, etc
(i.e. all structures requiring permanent footings)
Y? o : Show all easements of record and any City utiliBes within those ease nts
?? Setbacks of proposed structure and side ard setback of adjace xisting sVudures
??? • Retaining wall requirements, if any
Reviewed/??
March tM9
CRAIOIBLDGPRMT FM
,OR: Monley Brothers Construction
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ft.
future ^ LOt= 14,025 SQ.
PROP05ED ELEVATIONS: O POd O House= 2324 sq. ft.
GARAGE FLOOR = 9is 2 SEP 0 9 1999
TOP OF WALL = 915-?,
LOWEST FLOOR = 90c8 0 OENOTES WOOD HUB AT 11 FT. OFFSET.
TOP FOOTING = 9o6,S DENOTES PROPOSED ELEVATION.
DIAG. = 3Y.3 x q$,o =/p/,o? E--- DENOTES DIRECTION OF DRAINAGE.
LOT 4, BLOCK 2, OAK BLUFFS, DAKOTA COUNTY, MINNESOTA.
Scale 1"=30' Drawn By: MJH Disk: Job No.: 99443hs
• Denotes Iron Monument Bearings shown are on an assumed dotum.
I hereby certify that this survey, plan, or report was prepared by me E. G. RLID 4 30NS, (N(:
or under my direct supervision and that I a m a duly Registered Land LAND BUiZYEYORS
Surveyor under the lay!s of tate of Min
? nesota. 9i$m 68XINGTON AYE. NE
?.-.,r.?-? _? ? -- • - CIRGL•E PINE6, MIMVE80Tb
Date Registration No. ???8 5bmld-3b25 TEL.'f8b-5556
1-1vn Nkl3T/NG ,7'ZgV.# Tlaas 1-4-62
*********i****************************4
CITY OF EAGAN
CASHIER: JS TERMINAL NO: 708
DATE: 04/14/00 TIME: 12:00:12
ID:
NAME: JON OR JEAN GARVIN
3210 9001 4159 ETHAN DR 60.00
2155 9001 4159 ETHAN DR 0.50
Total Receipt Amount: 60.50I
CR126380
USER ID: JAN
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Af:. 90CI 051 ' -"r-r?: ?':F: 10,59
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CITY USE ONLY
L BL
Su BO. k?S
RECEIPT#: ` 12 ?5 I
RECEIPT DATE: I04'1
1999 PLUM$IN6 PEiiMIT (RESIDEN1ZAL)
Ctl'YOf P?RfiAN
3$30 PILOT KNOB RD
Ews", MN 55122
(651) 6$1-4678
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
Bath tub $ 3.00 x = $ '
Floor drain 3.00 x = $ '
Gas i in outlet ' minimum -1 3.00 x = $ '
Hot tub/s a 3.00 x = $ '
Kitchen sink 3.00 x = $
Laund tra 3.00 x = $
Lavato 3.00 x = $
Minimum fee alterations to existin dwellin 30.00 x = $
Private Dis osal S stem new/refurbished ' re uires MPC iic. 75.00 x = $
? Private Dis osal S stem abandonment 30.00 x = $
RPZ new instaliation/re air 30.00 x = $
Rou h o enin 1.50 x = $ G
Shower 3.00 x = $
Under round s rinkler if dwellin is under construction 3.00 x = $
Under round s rinkler if existin dwellin 30.00 x = $
Water closet 3.00 x = $ta . W
Water heater 3.00 x $ . OD
Water SOftener if dwellin under construcuon 5.00 x = $
Water sokener if existin dwellin 30.00 x = $
Water turnaround 30.00 x ----
State Surchar e .50 --> ----> ----> $ .50
TOtal --> --> ----> ----> $ . UO
Reminder: Call 6814675 for inspections of water heaters, water softeners, alterations, etc.
----------------------------•---------------------------------------------- ---------
-
-
-
-
-
-
- -
-
- -
-
- ,- state-
- that the in-fo-rtnation is conect, and agree to comply with all applidble City of Eagan ordinances.
- that-
I hereby--
- ac-lc-nowled9e-
- I have read this applicahon-
It is the applipnPS responsibiliry to noby the property owner that fhe City of Eagan assumes no liabdity for any damages pused by the Ciry dunng its nortnal
opera6onal and maintenance activitles to the faGlities constructed under this permit within City propertylrighbof-wayleasement.
SITE ADDRESS: qlSq
OWNERNAME: mQnyaI
INSTALLERNAME: S&er(Lr P?umbi(?C?` TELEPHONE#: toa-141AQ' 693y
STREETADDRESS: qsw
CITY: Nl Qc LQV\sL STATE: MN ZIP: S S 37Z
TURE OF PE!RMITTEE
??%0
CDlPERMIT FORMS/RPLBG PERMIT (RES) - 1999
CITY USE O\ZY
BL Z xECEIPT a: 11 q'a-o S
SUBD. RECEIPT DATE: 1 \ -
MECHANICAL PERMIT # 3 ? (p J 6
1999 MECHANICAL PEiM1T (RES1D£NTIAIa
CfI'Y OP £ihfi!!N
3830 Puor Kxoa xn
EkfiAN MN 55122
Date: 11-3-29 (651) 6$1-4675
Complete this section onlv if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not owner /occunied.
• HVAC: 0-100 M B T U
ADDITIONAL SO M BTU
• Gas outlets (minimum of one required @$3.00 ea.)
State Surchazge
Total
$ 30.00
6.00
• DO
.50
$ y
Complete this section onlv if you aze remodeling, adding to, or repairing an existing single family dwelling,
townhome, or condo. Please indicate if it is a new item, alterarion, or repair.
_ New Alteration Repair _ Other
Reminder.• Ca11681-4675 for inspections.
Furnace _ Air conditioning
_ Air exchanger _ Other
$ 30.00
State Surchazge .50
Minimum Total Due $ 30.50
SITE ADDRESS: ? I ?,? ?/LQ JYl & •
OWNER NAME:
INSTALLER NAME:
STREET ADDRESS:
CITY:
- ? ??- 'y
STATE: Ma ZIP:_ti5.&Qr?2 ?/
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
Q, 3830 PILOT KNOB RD - 55122
H U 651-881-4875 1 ¢???J
?-(-?y ?
c_ U
New CoruhueHan ReaNrements Re lReoalr ReaWremanM
> 3 reylttered 3Ite wrveys showing eq. H. ol lot, aq. B. of harse
and,gU roofed areaa (1096 mmclmum bt covemae albwacD
> 2 coples of plana (ahow becm & wlndow s{zes: poured Ind. design; efc.)
> i set W eneryy calculations
> 3 coples of hee preservaHOn plan Il iot platted mter 7/1/93
DATE:
DESCRIPTION OP 1
STREET ADDRESS:
LOT: --?-
Name: C?+?rlrN ? Phone41: 6?51-
laat Pirsr
PROPERiY
OWNER
street
2 copies W plan
1 tef of energy cplcWOHons for heated addiHOns
1 sife survey for exterbr additbns & tfecks
CONSTRUCTION COST:
br
ciri fx%d?n store:
N)Ilf
CONTRACTOR
Sheet
zip: S SI Z3
Phone A: d251- lm
(area code)
ucense # Enp.
v
Ciry state:
ARCHITECT/
ENGINEER Company: Name:
Telephone #: ( )
Zip:
Sheef Address: Regishation #:
City
Stote:
LP:
Sewer/water licensed plumber (ff Installina sewerlwaterl: Phone #: (?
1 hereby acknowledge ihat 1 have read thts aPAlicalbn, date thaF 1he infortnatbn is cortecf. and agree?iply wNh aa apP?le StatE
of Mlnnesota Statufes and City of Eagan Ordinances
Signature of AppRcanh
OFPICE USE ONLY
Certificates of Survey Received _ Yes No J ? 2
Tree Preservation Pian Received _ Yes _ No Not Required
BLOCK: Z SUBD./P.I.D. C 06-k -&,'f7?
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
p 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.)
? 02 SF Dweliing ? 08 06-piex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened)
? 04 02-plex ? 10 08-plex ? 79 Lower Level ? 24 Storm Damage ,
? 05 03-plex ? 11 10-plex Plbg _Y or_ N ? 25 Miscellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bidg.
WORK TYPE
131?--31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bidg)' ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
* Give PCA handout to appl icant for demolition pertnit
GENERAL INFORMATION
SAC Code a+
No. of Units ei
No. of Buildings 1
Const. (Actual)
(Ailowable)
UBC Occupancy
Zoning "
# of Stories
Length
Width
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq.ft.
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building g G Engineering
sq.ft.
sq.ft.
Footprint sq. ft.
Census Code
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
? 31 Exc. nu - Muni
p 33 Fxt. Alt - SF
? 36 Mutti
4/3 q
Permit Fee U6 0.S 0
Surcharge
Plan Review
License
MC/ES SAC
Ciry SAC
Water Conn.
Water Meter
Acct. Deposit
S!W Permit
S!W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total: -t 6 a - S a
Valuation:
SAC Units
% SAC
?
L`
?
G.r?1'? I Ir I Gi? I? G/'r 760'C Y= T •,.^ "
F"OR: Mcr,ley Brothers Construcfion
?
?
???a •°s
- ? Qo
.:
i3y.n /
?
?
?
\
g0
s,?h\
? t \
\
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\
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N
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?
?
R
n
:
?
74Z.67
?. .. , ..
p4oPna?p e?EVn?iotis:
GARAGE FLOOR = 9rs Z
TCP CF WALL = 915+
LOWEST FLOGF -90(,,8
TOP FOOTING m 9o6.S'wry,rp?v ,•,?, ?/O.D
00
CIAG. = 3Y.3 X 95,10 = i011
Lct= 14,025 sq. 'ft.
Nouse= 2324 sg. ft.
3 DENO?E5 WOOD NUB A- 11 FT. OFFSET,
)(x. DENOTES PROPpSE? ELEVt+n0N.
?-- DENOTES DIREC?ON OF DRkINA;E.
lOT 4, BLOCK 2, OAK BLUFFS, DAKOTA CCUti7", MINNESOTA.
I Scale 7'=30' f Drawn Bv MJH I D'.sk: I Job No.: 99443hs
LoDmotes iron Monument I Becrinqs shown ara on an assumed datum.
I Pereby certify that this survey, picn, or repOrt wOS prepa^ad by me ?. C1. RuQ 4t SOWg, fNri
or under my direct =_upervisfan and that I am a dLly Reyistered Land 11wf.= "Myrroft
Surveyor ndx the la s o° ?e otc of ?Airnesota 8i" ?,IXr-Cµ Ayg, NG
'
._. - . . - CIRGL-M p.NE6, MINNi80TA
Oate -;''9 Reqiatration No. 9.OeE 5W;•31VA$ MML ITSb-5586
AJtLfE I
m1 pod l ?
TOTRI. P.01
Use BLUE or BLACK Ink
� r-----�-�-�---------�
I For Office Use �
C' � Permit#: ��� ����
��d O� ��6�� � Permit Fee: 1 v��' �
3830 Pilot Knob Road I I
Eagan MN 55122 � Date Received: �
Phone: (651) 675-5675 I I
Fax: (651)675-5694 i Staff: i
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: �« 1—�G Site Address: -1 I �.� �'C"�,��. C%������'-- Unit#:
Name: �O� ��<a1 11 �`6'� Phone:
Resident/ �j��. � ���
Owner ' Address i City/Zip: ��-r.-. ��..�,.�v.�
' Applicant is: Owner �/ Contractor
Type of Work Description of work: " p�� 2.— �~ ' �.— � �(I�, L's �G2� <r�
� ,,�
Construction Cost: ��� Multi-Family Building: (Yes /No�
Company: ���`tR.('��,,..E',t�� �',.OV��I'��E�Contact: W i�� �
Contractor ` Address: ���.,� Ct�,�� �_c;ta� , city: S4�cR-.t:L��f?�
State:�Zip: �,,r"G �v Phone: �,�a,`,��'"5��-t�'nail:
License#:_�2���� 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:P/ans and supporting documents fhat you submit are considered to be public information. Portions of
the information may'be classified as non-public if you provide specific reasons thatwou/d permit'the City to
conclude that the are trade secrets:
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuan .
x . E
�
x
ApplicanYs Printed Name ApplicanYs Signature
�„ Page 1 of 3
���� 5\�t�.�,,�.1�-�"�1,
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA131202
Date Issued:06/08/2015
Permit Category:ePermit
Site Address: 4159 Ethan Dr
Lot:4 Block: 2 Addition: Oak Bluffs
PID:10-53400-02-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jean M Garvin
4159 Ethan Dr
Eagan MN 55123
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA156964
Date Issued:07/26/2019
Permit Category:ePermit
Site Address: 4159 Ethan Dr
Lot:4 Block: 2 Addition: Oak Bluffs
PID:10-53400-02-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jean M Garvin
4159 Ethan Dr
Eagan MN 55123
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA168766
Date Issued:05/03/2021
Permit Category:ePermit
Site Address: 4159 Ethan Dr
Lot:4 Block: 2 Addition: Oak Bluffs
PID:10-53400-02-040
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
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. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
Valuation: 10,000.00
Fee Summary:BL - Base Fee $10K $191.75 0801.4085
Surcharge - Based on Valuation $10K $5.00 9001.2195
$196.75 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 -
Jon L & Jean M Garvin
4159 Ethan Dr
Eagan MN 55123--490
(651) 283-0861
Schmidt Roofing Inc
3509 West Highway 13
Burnsville MN 55337
(952) 888-4889
Applicant/Permitee: Signature Issued By: Signature