4270 Heine StrasseCiti of Ea all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEIVED
APR 0 3 2014
Use BLUE or '>LACK Ink
For Office Use �J
Permit #:
Permit Fee: /C
Date Received:
Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: J "1 ^- Site Address: 1402 ----1 0 Unit #:
Residen
Owner
Name: rn 1 C.A QA. L P Phone: 2- ' 0
Address/City/Zip: 1102-70 l/J ,Sse 574 44_74A
Applicant is: Owner Contractor
Description of work: ,,4%/jr'f
Construction Cost: 5 17, 0°
Gay 4fiv«4,44,/ 4A221,. ,e/
Multi -Family Building: (Yes / No >,)
Company: Welt/Ai/01 /4"e- yL1.17r'k✓ c r1S Contact: /'14/1i4 -- �- 5
Address: 36/38 / beetikeil eh- City: 5/ Zoo --"J /%/X
State: /f`i & Zip: ,, jjt,5751/2-6 Phone: y_7 z —6133 _6 3 v
c'
License #: 1�1�`'a (q 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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are ,considered to be public information. Portions of
the information may be classifieal_as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets:
CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
c
Applicant's Printed Name
x
Applicant's Signature
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CITY OF EAGAN Remarks !?_171 4p/.;?D
Addition HEINE FIRST ADDITION Lot 10 alk 1 Parcel 10 32300 100 OD
Owner 4270 Heine Strasse Eagan, I?IlV 55122
Street State
Improvement Date Amount Annual Years " Payment Receipt Date
STREETSURF, '• 3978 101.25 10 404.97 CO 8538 9-22-83
STREET RESTOR.
GRADING
SAN SEW TRUNK 1973 190.00 9.50 20 85.50 C008538 9-22-38
SEWER LATERAL wat 3 1978 1307, 22 -' 87.1$ 15 34
WATERMAIN
* WATER LATERAL & SeW 197$ 139.87 15 87
WATER AREA 1976 66.00 6.60 10 13.20 C008538 9-22-83
* -
* STORM 5EW TRK 1978
* STORM SEW LAT 1978
ston-a sew Later - 19 82 1500.00 100.00 ls 00. ? Z r- c:5?
CURB & GUTTER `
SIDEWALK
STREET LIGHT 1989 16.35 5
WATER CONN. 270.00 14700 6-11-79
BUILDING PER.
sac 525.00 14700 6- - 9
PARK 120.00 7680 10-12-77
ptti CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19
_
RECEIVED
FROM
AMOUNT $ I
a? ooLLwaa
,oo
? CASH ? CHECK
. ?, . -
POR
?,_i)? i ? ? ?
FUND CODE AMOUNT
c: .
t
.. . . ?' ..
_ ?'' .
Thank You ?
BY e,
4 ?7 L +`J
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
e ? ..0
CITY OF EAGAN
3745 Pllot Knob Rood Eagan, MN 65122 N0- 5251
PHONE: 454-8100
BUILDING PERMIT Receipt #
Te wwed for Est. Value Dcte , 19
Site Address Erect 0 Occuponcy
Lot Block Sec/Sub. Alter ? Zoning
parcel ,# Repair ? Fire Zone
Enlarge ? Type of Const.
W Nome Move ? # Stories
3 Address Demolish p Front ft.
b t-;,,, c11.,..e Grade ? Depth ft.
? Nome
zo
v? Address
rfi, ati,,.,a
Name
I hereby ocknowledge that I have read this appliwtion and stnte that
the information is carrect and ogree to comply with all applicable
State of Minnesoto Stotutes ond City of Engon Ordinonces.
Assessment Permit _
Waier & Sew. Surchorge
Police Plan check
FI re SAC
Eng. Wcter Conn.
Planner Woter Meter
Council
Bldg
Off
.
.
APC Total
Signature of Permittee I
A Building Permit ls issued to: on the express rnndition that
all work shall be done in occordo?ue with oll opplicoble Stcte of Minnesoto Statutes ond City of Eagan Ordinances.
8uilding Officiol
PenaM # Dsb Isuad POwktN
Plumbing - /t) - "79 C_ /? • ?q-r+. - ?,w'n??
Mechanical /U f 7',?
?.? ? ? f- a
INSPECTIONS DATE INSP.
Rouqh-In
Find
Footings -? jr-/t-N Date Inw. Date I
Foundution Plumbing
Frame/ins. MecFwnical
Finol
Remorks:
,y `' ,Trr C o r r- M D?''e
A?
5?4
7- 27 -??A
' • , ' CITY OF EAGAN
3795 Pilot Knob Road
Eogon, Minne:ota 95122
Phone: 454-8100
PERMIT
Date: 7- lcr-79
Site Address:
1270 flP..inP_ StSdsse
Lot Block 5ub/Sec. 1?'? ri?t Addn'
No.
Receipt No.: -
Singfe I
Residential '<
Multi Res., Comm./Ind. I
Name ' it' isaacsc" New/Alter./Repair. ; Address
Cost of Installation
O
City Phone: ' Permit Fee ' .
Name ?" - Surcharge n ^
?
g Address
e
0
V
City Phone: Total ?
This Permit is issued on the express condition thot oll work shall be done in occordance with all applicable State of
Minnesoto 5totutes and City of Eogon Ordinances.
Buildin9 Officiol '
}
?
:
doaoo
?D ? ?
CITY OF EAGAN
3795 Pike Ksob Roed
Eogen, Minwesoto S5122
P6ene: 454-8100
? - PERMIT
Date: , r" / 7 9
Site Address: i ?7einf= Stresse
Lot Block _
_ Sub/5ec. _
Receipt No.
Single
Residential
I
Ind.
(7 T'
Name
New/Nlter./Repair
4
A
; ddress
O
Cost of Instollofion _
- _, ?- r: 17
City . Phone: , - - -, .-,
Permit Fee
i?oValat ?Itq. it T.C
Nome -
.
Surcharge
? Address , 14
?
City . Phone: Total
This Permit is iuued on the express condition that all work sholl be done in xcordance with ail opplicoble State of
Minnesoto Statutes and City of Eogon Ordirronces.
Heine First
No. ?
Building Officiol
CITY OF EAGAN WATER SERVICE PERMIT
3793 rilot Knob Roed
Eagan, MN 55122
Zo;.ing:
Owner: PERMIT NO.:
DATE:
No. of Units:
Address:
Site Address ?
Plumber:
Meter No.: ,- - Connection Charge:
Size: _ Account Deposit: _
Reader No.: Permit Fee:
1 agroe to eomplr with the Ciry of Eagon Surcharge:
?Ordinanees. Misc. Charges:
Total:
gy
1 Date Paid:
of Insp.:
Date I nsP•:
ciTr oF EA"N SEWER SEI
3795 Pdot Knob Roud PERMIT NO.:
Eagon, MN 55122 DATE:
Zor ;ng: -- No. of Units:
r...----
Address:
to comply wit6 the Cify of Eagan
r• s.:
Connection Charge:
Account Deposit:
Permit Fee:
Surcherge: - ,.
Misc. Charges:
Total:
Date Poid:
of Insp.:
This re4uest void 18 months from ?
` ` 'R 96685
Date of this Request
l, as R'Licensed Electrical Contractor OOwner, do hereb request " s ection of the above electri-
cal wirirrg installed at: L?l2?J??
Street Address or Route No.
Section Township Range County
Which is occupied by
(Nama of Occupant)
Is a roughin inspection required on this job? No ? Yes ? Ready Now ? Will Call ?
Power Supplier Address
Electrical CoMractor
Mailing Address
Authorized
or
?ji-q?
Contractor's License No? J'? ?
Phone No. f 7 3- 6 it'£'
NQVE? ?01%
This inspection request will nat 6e aaepted by t6e
State Board unless proper inspection fee is enclused.
i 'ti Minnesota State Board of Electricity
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
REQI.' 'EST FOR ELECTRICAL INSPECTION
CACK bELOW WORK COVERED BY TH1S REQUEST
/ 7 S"a 6
R 96685
Type of Building New Add. Rep. Check Appliances Wired For Check Fquipment Wired Fm
Home ? ? ? Range 11 Temporary Wicing ?
Duplex ? ? ? Water Heater ? Ligh[ing Fixtures ?
Apt. Bidg. ? ? ? Dryei ? Electric Heating ?
Commercial Bldg. ? ? ? F'umace 0 Silo Unloader ?
Indurtrial Bldg. ? ? ? A'v Condiuonec ? Bulk Milk Tank ?
Farm ? 0 ? List
) Lut
Other ? ? ? p
}
Heie?Sl p
HeieTS?
1
COMPUTE INSPECTION FEE BELOW
Service Entrance Size: it Fee Feedeis&Subfeedeis: a Fee Cucuits: # Fee
0 to ]00 Am s. 0 l0 30 Am res 0 to 30 Am eres
101 to 200 Amps. 31 to 100 Ampeies 31 ro 100 Am eres
Above 200 Amps. Above !00 Amps. Above 100 Amps.
Transforme[s Remote Conuol Circ. Pa[tial or other fee
S' s S ecial Ins ection Minimum fee $-
Remarks TOTALF
I, the Electrical Inspector, hereby certify that the above inspection has been nvaAe:
(Rough-in)_ Date
(Final) Date
This request void 18 months hom '
This re4 G3 ?/
uest void 18 months from /
. 'R 96679
Date of this Request
I, as O Licensed Electrical ContractoL? Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No, ? City- Eqd-,
Section Township Range County?
Which is occupied by
(Name of Oc<upant)
Is a roughin inspection required on this job? No:Er?Yes ? Ready Now ? Will Call ?
y 3oc
Power Supplier Address 'a6a . ;.[s .-t? S 7 L
?'?S/3,?
Electrical Contractor Contractor's License?o. _
Mailing Address
Authorized Sign
SUVE BOARD COPYThis inspection request will not be accepted by the
. State Board unless proper inspectian fea is enclosed.
Minnesota State Board of Electricity
7954 University Ave., St. Paul, Minn. 55104-Phone 645-7703
1
REQUEST FOR ELECTRICAL INSPECTION
C?iECK BELOW WORK COVERED BY THIS REQUEST
i???? /
R 9'6679
Type ot Budding New Add. Aep. Check Appliances W'ved Foi Check Fquipment Wired Foi _
Home ? ? ? Range ' ? Temporary Wiring ?
Duplex ? ? ? Watet Heater ? Lighting Fixmces ?
ApL Bldg. ? ? ? Dryer El Electric Heating ?
Commercia( Bldg. ? ? ? Fumace
. 13 Silo Unloade[ ?
Industrial Bldg. ? ? ? ?
Au Con
„ ? Bulk Milk Tank ?
Fatm ? ? ? List ?i
;y Lis[
Other ? ? ? p
94W, I. Heheis#
COMPUTE INSPECTION FLWWCA^'
Secvice Envance Size: n F' &Subfeedeis: # Fee C¢cuits: # Fee
U t6 100 Am s. \l k 0 ro 30 Am eres 0 to 30 Am res '
]Ol to 200 Amps. 31 to 100 Am res 31 to 100 Am eres
Above 200 Amps. Above 100 Amps. Above 100 Am s.
7'ransfocmtts RemoteContiolCirc. PartmAl or otherfee -Go
Signs Special Ins ection inimum fee 55.00
*
Remazks
f I.K
OTAL FEE
1, the Electrical Inspector, hereby y pecJ?p certif '.ttfat t n has been
h€ ??, ? " v
. '
(Rough-in) °jvli?-6U Date '"d?e/
(Final) Date
This request void 18 months from
cirr oF Ee,caN
3795 Pilet Knob Road Eagan, MN 55122
' PHONE: 4548100
BUILDING PERMIT APPLICATION `.. Receipt #
SF
52,000. i
Site Addrea 42-/1.1 H21ri2 StrdSS2
Lor 10 Block 1 sec/sub. Heine First Addn.
Pomei # 10 32300 100 01
w IN,rn, C. H. ISdaCSOri
; Address 5420 4th St. No.
b .,:._ ? - -
W Name NOYtYI'I'.OWRl Sa125 d/b/a Da1SOt.d HOITIES
g? Address 3660 DOdd EZr3.
r I,,.. Eaaan .,L___ 452-5353
Name _
Address
N9 5261 -
7 %o t]
Erect M Occuponcy R3
Alter ? Zoning Rl
Repair ? Fire Zone 3
Enlarge ? Type of Const. U
Move ? # Stories
Demolish ? Front 72 ft.
Gmde ? Depth 28 fr.
ADOrovals Feea
Assessment _
Weter & Sew.
Police -
Fire
Eng.
Planner _
Council _
Bldg. Off, _
APC
Permit 143.71.1
Surchorge 26.00
Plan check 71.75
SAC 525.00
Woter Conn. 270.00
Water Meter 60.00
I hereby acknowledge that I hove read this application and state thot
the Information is correct and agr§e to omply with all opplicable
Stote of Minnesoto $totutes/ cNlity of Ordinonces.
SignMUre of Permittee? ??
A Buflding Permit is issued to: DdkO'tcl FJdR1E5
all work sholl be done in accorda te wjth all . ppli big_State of Mipn
Tota
on the express wndition that
Statutes and City of Eagan Ordinances.
Building Official
r=
CITY OF EAGAN
BUILDING PERMIT APPLICATION
I e 2 sets of plans,
1 site plan w/elevations S
jffi 1 set of energy calculations.
f
To be used for Valuationqp6'a2000 Date 6`41',)9
Site Address Y,Q,M OFFICE USE ONLY
Lo[ Block _L Sec. /Sub. /?Pt?zo'< Erect ? Occupancy
Alter Zaning iF /
Pazcel Re air Fire Zone
Owner:
Address
Phone 0: e?i (r D -
Contractor: /JJ ^c
Address:
Phone 3??--
Arch/Eng.:
Address:
Phone li:
P
Enlarge Type of Cons[.
Move lk Stories
Demolish Front 7?2 ft.
Grade Depth ft.
; Approvals Fees
Water/Sewer
Police
Fire
Eng.
Planner
Council
Bldg. Off.
APC
' -
Permit /'93?
Surcharge
Plan Check
SAC ?.
Water Conn. '" O •
Water Meter
Road Unit LiVP r
TOTAL
41
i '
?
?? . .?.
.
?
? .
?
r$
-?- .?
'e?? •
I k QE
{3 ?
n '
0
.
?
?
?I
?
,
?
i?
?
? r
-s -
Ck
?,
• ? ' EXTERtOR Eh4ELOPE THEtL"!AL TRA"ISMITiASCE A+141n GE T
- ? STANDARO IWOR.(SNEE'f
Si;e Address -? Dwner r,,Q9-?y? , SaacSari
Cantractcr C. .?aUC SeR da Hi?`,),?rteS Phone syG?? Date G''?'?9
---,Bvilding Type (check one) One and T•.o Family Paellina ( i Orher ' Assembly (Oescribetype fram Table ? or Area (A) U-Value U x.A
Sfiow caioulation5 on Pane 2 5 Ft)
Insulated Aroa ,0-Z.3 Z
?
frarnin Aroa
871
0
Sk 1lohts Tv e
a
` Other describe
Other describe
1 Totals ? d ****** ?? d
2 Averaae U-Value Ux0. / A from Line 1 .O3'ljr
3 R uired U-Yalue frcm textl •05
Insuiated Area O 9 I .3J?
Framfin Area
Windows, T pe j! 4 ? ?jA ?
Ooars T e Z33
Rim ,1aisL Area 9.0
Fire tace Wa17
3
a
Foundatian Na11 aSove radt 370./ O rl?i
m
a Faundation Windaws T oe
?
Other describs)
Other descrite
Other. aescribe) ?
a roea,5 y ,ti,****
5 Averaae U-Value, UxA / A frp.n Line 4 ?`?" ,?9?? ******
6 Reauired U-Value From text ****** ?/? - ******
If Line 2 is greater than Line 3, or Line 5 greater thart Line 6, ccmplete tha
follawin to determine atternative U-Yalue for total ezterior enveio e.
0 7 Area (Lir,t 1) • Area (Line 4), + •
r
V
?
8
UxA (Line 1) ? Uwl(Line 4). +
******
d
a
u
9
Area (Line 1) x U-Yalue.(Line 3) _ x
******
? 10 Area (L1ne 4) z U-Value (Line 6)
x m ******
W _
;, 11 "Budget". Line 9+ Line 10
.,
0
?
12
Alternative U-Value, Line 77/Linr 7
+r*?,t+.?
If Line B is greatar than Line 11, alier assem6lies as required ao Line 8
d oes not exceed Line 71.
?+,5 2r..L lI „Sa e-? I 1?_ :
t•taterial describe Tnickrtess R-Va ue h!aterial 'descrihe) 7hickr.=ss
!
Interior f-Value se= T able 2 In;.erior f-Valuz se= T ahle 2 I
Ext2rior f-Value see T abTe 2 Ext=_rior f-Valuz see 7 a61e 2
Total Assem6lv Thernal Resistznce Totzl Ass=_?ol Ther-ial Resistance
Assembly U-Value see Table 4
Enter on Pa e 1 Ass?61y U-Yaiue s?e Ta6le 4)
Ent=_r on Pac=_ 1
ssembl ssemo?v
hlaterial describe Thickness R-Va ue (aat2rTa1 descri.b= Thickness R-Value
I
I
?
Intzrior f-Vaiue s?e Table 2 Int2rior r-Value see T able 2
Exterior f-Value s:e> Table 2 Exterior f-Value (s?= T able 2)
Total Asse?nl Ther?rtal Resistancz Total Asse^+bl 7ner.-?al P.=Sistanc_
Asszmbly U-Valuz see Table 4
Enter on ?aaA 1 Assembly U-Value (see Table 4)
Enter on Paae 1
?
ss_mblv ' ss=mblv i
hlaterial describe Thickness R-Value ? h?aterial Ezscri6e Thicknass P,-'/aTu. ?
I
i
nt=rior f-VaTue see Table Z nterior f-4alue see T able 2
Exteri6r f-Value ses Table 2 Ext=rior f-Value s=_e T able 2
TOL31 Assembl Ther+al Resistance Total Assembiv Ther^i31 Rzsistanc_
Assembly U-Value ses Table 4
Enter on Paae i Ass:rbiy U-Vaiue (see Table 4)
Enter on Pac2 1
55emblY sserrhl
t•iaterial Eescribe Thickness R-Va ue htaterial describe ihickness P.-Vatue
.. I .
Interior r'-Value see Table 2 Interior f=+/alu= sp; T ahle 21
Ext=_rior f-Valua see Table 2? Ex:erior f-Valee see T able 2 I
To:al Ass_mhly Thernal R=sistznce To:zl Asserrhlv iner.^:.zl R=s95tanee I
Fsserbiy U-tialue (see Table d)
Enter on ?aae 1 Assa?bly U-Valua (;eo Table S)
Enter on Pzce 1
, lJA1.L SlC(PI'lUNti . -NO'CL:_ Us? 10% of opaque'wall 'area
` fnr framing members
0 ' FRAMING _ _...._ MEMB?R_..S... __.. .__IN WALLS
Top View __.._ ...._.
_Exterior air, film.___
vSidinK???Q? ?as?L151- --.
Sheathing
-_? 1 ??-?-C?.?•.. ...
3Y" soft wood
Y' .d .ry wa21 ? - -
P2ge `l
R-Value
_ __ _ . ... .17._ _---
-- -. ., 0 L .
-----?oo
4,38
.45
.68
1917
TOTAL R = If?Qp
U = 1/R U ? 916
Interior air film
3?? %/ycuo 5hla7hl?j
FRAMED WALL _
cvood {?ram;n ,Z'x6'?a
•17
? a3
. (03
? "Pf oc( .
73'
u= •
Exterior air film
Siding
Shea[hing ?5,OO
3?" batt insulation /I,afl ?
?" dry wall .45
Interior air film '68
U = 1/R
U , oy9z
RIM JOIST AR,- -_
Exterior air film
Siding
Sheathin
g ',r P/y = . y7 /P:? s. y
,L" soft wood --1.88----.
od
,_ ,a.a_- / •? ?!9 /9. - -
....
.6A
Interior
T.OTAL N
u = i/x o
Cver sfra? cvoocf baserhenfi
Gxterior air film .17
Interior air film •68
_ TOTAL R
U = 1/R iJ
? 1? ----
t
n
ROOr CFILINr
Paqe 3
Outside air film .6.1
Insulation pD
- -----------------------------
Drywall .45
Outside air film .61_
yoo-A f-russ
.45
Interior air film
Interior air film
U = 1/R
U = 1/R
Outside air film
Huilt up..znn£inv. .-------
Insulation
Wood decking
A
ROOH'/CGILING:
i'OTA1. ARF.A:
Uetail refe[ence
t"rom above.
Desc.rLbe openings
tit roof
'CO'1'AL (U) (A) VAI.UI:S
DIVIDED ISY 'C01'PJ. [:OOP/
cLrt.Inc nizrn
Interior air film
U = 1/R
.61
TOTAL R = ,/?/a,(o7
u ---
.61
TOTAL R = ?j ,?,? •
U = : ?6S
17
_?.33.._.. ..
.61
TOTAL R =
U =
sq. ft.
x sq. ft. (U) (A)
x sq. ft. _ (I,') (A)
x sq. ft. (U) (A)
x sq. ft. (1J)(A)
x sq, ft. _ (F')(A)
x eq. ft. ?l!)(A)
x sq. ft. (ll)(A)
TOTAI,S sa, ft. 0) (A)
= AVG. "U"
,1VIS12AGE °U" .OS for venCilated roofs .1.0 for all other construction
;lOrl'IS: If averay,e "U" val.ues as calcul.ated above do not meet the Engerg,y Code requir.ements, the
"Altrrn:,ite Gnve]ope Design" as indicated on Page 5 may be used.
»
f'
(' i
?.
BER BLOMOUIST '
MAtOP . . . i.f? ?p.?? .. ,.
iMOMASEf.AH
CITY OF EAGAN
MPRK PPPUnNtp +
JAMESN.SMITN ? 9799 PILOT NNOB ROAO?
TNEODOREwnCNTER a?.+• '? .
couNaL x.iMneas -
EAGAN. MINNESOTA
.,.? . : $6122 ..v"? . .
...>r' PNONC A34-0100 r y'J
" . . -•,D
. ?. . r .. .ii
.
??
July 23, 1981 - ? ----
C. H. Ieaacson
4270 Heine Strasse
Eagan, !,W 55122
Re: 4270 fteine Strasse, Lot 10, Block 1, Heine lst Addition-
Final Inspection Required By Law
State of Minnesota, 2 MCAR Section 1.0101 - 2 lACAR Section 1.18901
City of Eagan, Ordinance 36
Dear Mr. Isaseson:
To complete our files a fir.al inspection is needed on:
Plumbinq _x Heating g Structural X
THOMPSHEDGES
CITY ApMiNiSlPRiOP
EVGENE VpN DVENBEKE
CITY CIENK
Final insnections are necessary to nrovide the greatest possible protection
for the present or future occupants pertaining to life safety and environ-
mental health.
Please contact us immediately for the inspections checked above.
City of Eagan Building Inspectors
TME LONE OAK TREE ... TME SYMBOL OF STRENGTH AND GROWTM IN OUR COMMUNITY.
aOaG RESIDENTIALBUILDINGiff
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtion Reaui2menls
3 registered site surveys showirg sq. ft. of lot, sq. ft of house; and all roofed areas
(20% maximum lot coveroge allowed)
2 copies of plan showing beam & window sizes; poured (ound design, etc.
7 setof Eneqy Calalations
3 copies of Tree Preservation Plan N bt platted after 71153
Rim Joist Detail Dptions seleciion sheet (buildings with 3 or less units)
Minne3asco mechanicalventilationform
RemodeVReoair ReouiremenGs
2 copies of plan showing footirigs, beams, pisis
1 set of Energy Calculatlons for heated addNons
7 site survey for addNOns & decks
Add"rtion - irrdicah dar-sde sepfic sysfem
Ca,liG) s h z .B,?l
Office Use OnN
Cert MSurveyRecd ,,.._Y_N
Tree Pres Plan Recd '_Y;._ N,
TreePresRequired` . _Y`_N
On-siteSepticSyskm _Y _N
Date ? l u? l c? 6 Construction Cost ..S"oV "lJ.
f
Site Address ??'O f,GiirlL ?S,''•?i/fS? UniUSte #
,C ='AN, /'Y/i? 5` .i'/ Z Z
? r
Description of Work
Multi-Family Bldg _ Y Fireplace(s) _ 0 2
PropertyOwner
.?
Telephone#k;?S/ ) ?aG 775
Contractor
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv l Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet
(4 Submission type) Submitted Submitted
• 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?
_ Y _ N If yes, daTe and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit 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 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 approved plan in the case of work which requires a review and
approval of plans.
/r?n??EG v ?%>-'f-l/,' ?
ApplicanYs Printed Name Applicant' ignature
DO NOT WRITE BELOW THIS LINE
?
.
Sub Tvpes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 07 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex V 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ?'I 1 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
? 31 New 0 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (EMire Bidg) - Give PCA handout to applicaM
D85CrIpt1o17: Water Damage _ Yes
Valuation ?i ?? • ? ? Occupancy ? -? MCES System
Plan Review 700% or 25%
Census coae 3 y zoning R-I city water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const V? Width
REQUIRED INSPECTIONS
_ Footings(new bldg) _ Sheetrock
? Footings (deck) FinaUC.O.
_ Footings (addition) o FinaUNo C.O.
Foundation HVAC
Dnin Tile Other
Roof Ice & Water Final Pool Ftgs Air/Gas Tests Final
?O Framing _ Siding _ Stucco Lath _ Stone Lath _Brick
_ Fueplace _ R.I. _ A'v Test _ Final _ Windows
_ Insulation Retaining Wall
Approved By:
Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
ToWI
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r3'x5 '
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..
,
EAGAN
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2007RESIDENTIAL BUILDING rEwnnrrurn'uoiv
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtion Reauirements
3 registered site surveys shovring sq. fl. of lot, sq. R of house; and all roofed areas
(20% mauimum bt coverage allowed)
7 Soils RepoR if pmposed building is to be placed on disturbed soil
2 copies of pl2n showing beam & window sizes; poured tound design, etc.
1 set of Energy Calculatiau
3 wpies of Trce PreservaGon Plan if lot platted a(ter 717/93
Rim Joist Detail Opfions selecUon sheet (buiMings with 3 or less units)
Minnegasco mechaniplventilationfoim
RemodeVReoair Reauirements
2 copies of plan showing footings, beams, joisis
1 set of Energy Calalalions for heated additions
1 site survey tor additbns 8 decks
AddiNon - indicate if on-sRe sepfk system
Telephone #(
Plans are considered public information unless vou state they are trade secret and the reason.
?
Date ? /U
-7 ?QDZ ° o
Construction Cost
?
Site Address Vo7?0 UniUSte #
Description of Work
Multi-Family Bldg _ Y Fireplace(s) _ 0 ?-'J _ 2
Property Owner Telephone #(,4 5-7
Contractor i r/%<L Y T17
Address `r•-
' ?
City ??99•F/l?
State /-1-2tz ZipJ?Sl Z Z. Telephone#(ES/)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate¢orv 1 Minnesota Rules 7672
Energy Code Category . Residenfial Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submissiontype) Submitted Submitted
. Energy Envelope Caiculations Submitted
In the last 12 months, s}he City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
I hereby apply
Telephone #(
Telephone #(
C?
Office'USe.Onlv
Cert ofSurvey'Recd '?-Y _N
Soils Repod Y -'N
Tree Pres Plan Recd _Y _N,
Trce Pres Required Y -.: N
On-sdeSepticSysfem-'+-- _Y' _N
that the information is
accurat
e;
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 wark 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.
? ? D ' .....
?c.c/BEG 'V •7-Y?'.?? . __.
Applicant's Printed Name ApplicanYs Sign ure
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 Ext. Alt - Multi
? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Eut. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo/pergola) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
E3 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
D65cfipti0ll: Water Damage _ Yes
Valuation Occupancy MCES System
Pian Review 100% or 25% Code Edition
Census Code Zoning 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 (addirion) _ FinaUNo C.O.
Foundarion HVAC
Drain Tile Other
Roof Ice & Water Final Pool Ftgs Air/G as Tests Final
_ Franvng _ Siding _ Stucco Lath _ Stone Lath _Brick
Fireplace _ R.I. _ Air Test _ Final _ Windows
_
_ Insulation _ Retaining Wall
Approved By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
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Use BLUE or BLACK Ink
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For Office Use I
\
Ci Permit ty of EaRan I Permit Fee: ~T 1
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff. I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: //-Site Address: 70A'"~/~_4Unit
Name: > Phone:
Resident/
Owner ~ Address /City /Zip:
Applicant is: _zowner Contractor
Type of Work Description of work: ZLZ
Construction Cost: i~-Iaeo -00 Multi-Family Building: (Yes / No
# Company: A~WContact: Wowic/
Contractor Address: City:
State: Zip: Phone:
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
---o.._. . . od...1- -.~v~ ~A-
NOTE• Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.oro
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 mus be c mpleted within 180
days of permit issuance.
X /ee°/5~,X . `V,
Applicant's Printed Name Applicant's Sig ature
Page 1 of 3
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