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4082 Johnny Cake Ridge Rd Use BLUE or BLACK Ink r I For Office Use City Ol nn o n Permit E f b I Permit Fee: 3830 Pilot Knob Road f I Eagan MN 55122 I Date Received: l Phone: (651) 675-5675 Fax: (651) 675-5694 1 Staff: rlL~ I I I 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: CA l2 Site Address: J7C)67 CC?kc P_ Unit#: Name: S4-e'_J(,- L.. o C t'1 tpc! r Phone: ~y 7 2 r RESIDENT I OWNER Address /City /Zip: C4 0!v r__ I Applicant is: Owner Contractor i Description of work: TYPE OF WORK i 010 Construction Cost: V Multi-Family Building: (Yes /No tl ~ L Company: _ G to sk I r I,Crv m Contact: I CK, rck u=c~ Rd CONTRACTOR Address: r P 1 City: Stater Zip: J J ~Q S Phone: License G C© 0 1 S(~ I Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) i 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 4No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of L__ 7th 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.oopherstateonecall.org 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. r Applicant's Printed Name Applicant's Signature Page 1 of 3 Address aosz .rot,nng Cake u;age ua Zip 55129 LAt $ Blk 5 Sub Oakbroo?ce THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECfION. Date: Yes No Inspector: Final grade (6" from siding) ? Pecmanent steps (gazage) ? Permanent steps (main enuy) x Permanent driveway Permanent gas ? Sod/Seeded grass x TraiUcurb damage Porch ? Basement finish ? Deck ? Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to Ihe outside lawn faucet before freeze potentia{ exists. Contad engineering division at 681-4645 before working in rtght-o&way or installing underground sprinkler system. Whice - City Copy Yellow - Resident Copy Pink - Contractor Copy w Site address: 4082 Johnny Cake Ridge Rd Lot 8 Block 5 Subd. Oakbrooke On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be submitted prior to issuance of a Certificate of Occupancy. _ This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670 ? OR _ This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674 APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE Water Heater V o YS,8 Furnace y ?j? Gtn ?.?0 lfmileo bC? ?oua S??)!r?°? Dryer EXHAUST SYSTEM LOCATION TYPE MODEL CFM's VENTED YES No Kitchen kitchen Bathroom 1 as- Y q S6 ? Bathroom 2 1 ? y-6 s Bathroom 3 Bathroom 4 Other FIREPLACE S LOCATION GAS WOOD MANUFACTURER MODEL BTU'S VENTING oiaecr ATMOS c?,h G c?b - r E I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code antl City of Eagan requirements. "j?T Sig tur I? ?U?'l1'`c /?Ow,c'S CompanyName ?Ia ? l5z Date ' This form is the responsibiliry of the General Contractor. CITY OF EAGAN CASHIER: JS TERMINAL NO: 014 DATE : 04/04 /00 T IME : 14:12:31 ID: NAME : PULTE MASTER B UILDER 2252 9220 4082 JHNNY CK R 30.00 3210 9001 4082 JHNNY CK R 1,206.55 3866 9379 4082 JHNNY CK R 100.00 3422 9001 4082 JHNNY CK R 784.26 2275 9220 4082 JHNNY CK R 1,089.00 3446 9001 4082 JHNNY CK R 11.00 2155 9001 4082 JHNNy CK R 0.50 3743 9220 4082 JHNNY CK R 50.00 2155 9001 4082 JHNNY CK R 69.00 3868 9220 4082 JHNNY CK R 492.00 CR125571 ** CONTINUEL USER ID: JAN ** CONTINUEL ***?******?*************?????*?***?**** U 31 ) *:r******* *r?*****?**?****???,r?* CONTINi CITY OF EAGAN CASHIER: JS TERMINAL NO: 014 DATE: 04/04/00 TIME: 14: 12:32 ID: NAME: PULTE MASTER BUILDER 3716 9220 4082 JHNNY CK R 114.00 3713 9220 4082 JHNNY CK R 50.00 3865 9220 4082 JHNNy CK R 840.00 , Potal Receipt Amount: 4,836.31 2R125571 7SER ID: JAN ??++?******???***:r****?****??**?*****?* 2000 BUILDINC PERMIT APPLICATION (RESIDENTIAL) anr or encAft q_ I?? 3830 PILOT KNOB RD - 55142 ?j (o .3 ( ?t L? ? 651-881-4675 ? ?Q ?(`(], I I1 New Confhuctlon ReauhertienA R?d,.X?A527 ?J- D 3 repisferotl We wnari showln9 +4 R o/ bt W. R of ?Wtiw 2 coNes d plrn onE 92 rooted areat (20% maximum lol coveraae allowedl 1 s61 of eneryy ealeWalioru for healeE adt9HOro > 1 Ooplas d Plan (show beam d wlndow gei: PoureG Ind tladgr, etc.) 1 dfa wneY fOr eideAOr adcOMOm & decb D 1 tet d enerqy cdpAOtiqq . D 3 caPka o1 hee Wes6rvatlon Plan B Id Db"od MW 7/1/43 / cnh: V13a coNsTRucnoN cosr: DESCRIPTION OF WORK: Re.s4r,?cn?q1 STREEi ADDRESS: LOT: D BLOCK: L SUBD./P.I.D. #: 6A j03ROD)f L Name: Phone 9: PROPERTY last Flrst OWNFR Sheet Address: CHy State: Zip: ComponY:P(/)fc ?Imcc 044n? Co?O Phonei: ?s/ 1fS,2-S2o0 (area code) COMRACTOR Sh6et AdChesx ?35,? t,n (?o? 4 }S ?? C4 r? LiCense M ?•? 91 Exp. j3' Ob citY WO,Aw 1%1f5 Stafe: Lp; `? IZO ARCHRECT/ n ENGINEER Company: Ncme; Telephone Jf: ( Sheet Addresa: Registraflon Y: citY State: Zip: Sewedwater Iicensed plumber (H Installina sewer/waterl: IIAI IFVPLUM}Sf-r\I G Phone #: ( b r9. )Ih1-a)11 I hereby ackrawledge that i have read Ihk applfcafion, alale lhat the iMomwifon 4 corteel, and apree b comply wiTh al appBCable Sfale ol Mirnreaota Sfafufes and CNy of Eapan Ordinances. '. Signature of Applicanr Y L419"? 3 OFFICE U8E ONLY Certificates of Survey Received ?Yes _ NO MAR 2 g Tree Preservation Plan Received - Yes _ No -40t Required ? OFF{CE USE ONLY BUILDING PERMIT SUBTYPES 0 01 Foundation O 07 05-plex )8:?'02 SF DwelGng O OS 06-plex O 03 07 of _ plex O 09 07-plex 0 04 02-plex O 10 08-plex 0 05 03-plex O .11 laplex O OB 04-plex 0 12 12-plex W9 RK TYPE r? 31 New O 32 Addition O 33 Alteration O 34 Repair O 13 16-plex p 27 Porch (3-sea.) E3 31 Exc Alt - Muld 0 17 Garage 0 YL Porch/Addn. (4sea.) O 33 Ext AIt - SF ? 18 Deck ? 23 Porch (screened) O 36 Multl 0 19 Lower Level p 24 Stortn Damage Pmp Ya_N O 25 Miscellaneous O 20 Pool O' 30 Accessory Bldg. ? 36 Move Bldg. O 43 Reroof 0 37 Demolish (Bldg)• O 44 Siding 0 38 Demolish (Interior) O 45 Fire Repair O 42 Demolish (Foundation) p 46 Windows/Doors • Give PCA handout to applicant for demoiition pertnit GENERAL INFORMATION SAC Code 0 t No. of Units i No. of Buildings i Const. (Actual) --1En/ (Allowable) -U,? UBC Occupancy e-Vv - i Zoning P-b # of Stories Length W idth Basement sq. ft. Main level sq. ft. z.? Lv , sq. ft. sq. ft. MI3CELLANEOU3 INSPECTIONS 0 Stucco/Stone APPROVALS Planning Building -Elf7- 2 sq. ft. s ? sq. ft. Footprint sq. ft. 1 ?24 lo?z Census Code r o 1 ? co MC/ES System to I Z. City Water Booster Pump PRV Fire Sprinklered Engineering variance PermitFee ?r?.°0 ValuaUon: $ /3Z4 Suroharge ? PlanReview tj??.?? tuazX IS = l6,3S- U License MC/ES SAC lvqz X S? = Sss, 1169' CitySAC loiz rS4= 54,C4Y WaterConn. Water Meter 5 L16z a-16 z 7,3a Z Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Totai: ?. 'J t . SAC Units °k SAC JOB INITIATION ORDER Pulte Homes of Minnesota Corporation 1355 Mendota Heights Road, Suite 300 Mendota Heghts, MN 55120-1112 Phone: (651) 452-5200 Fax: (651) 452-5727 GO a3? d e? r 913 ,roeno. y _ ?ouoescRiaTroN: ior ? COMNUNITY: S?= ADDITION: eimar+onooRess: '?0 2 hnn ?C? cmr: eLocK s urar mom MODEL NNr1BER: 11,72)1 ELEVATION: OARAGE: LEFf Po\GfT,?f ?`?' eurea?sr+nnnE: DATEOFORDER: .ZG WRREMADDRE55: crry: ra _ STATE, MN zm: !22 r+aMEP+oNE: euswessvt+or+e: auswessarroNe: SAIES REPRESENTATIVE 0000 BASE PRICE ---- LOTPREMIUM ELEVATION # „ u ac?e eaC?cn? . 3?olq a?t-t' ?as-- I !N3 P-l I Lo ? 500 ) -?3003 erl ?c -Q3sD 1 ;= sa . ? TOTAL a5?,3:70 -------------- ? APPROVED BY BUYER (S): ? APPROVED BY SALES: : ,,.RELEASED TO START CONST.: eouai HousiHc OPPOflTUNIIY Builder's License #0001371 This constitutes a contract between the Seiler and the Purchaser(s) for the above items. MAR-28-20e'10 09:03 MNcheck COMPLT_AI3CE REPaRT Minneeota 8nergy Code MNCheck SoPtware Vereion 3.0 COUNTY: Dakota STATE: Minnesota 20tdE : 2 CON52RUCTIpN TYPE: Sirigle Pamily DATE: 3-28-2000 DATE OF FLANS: 3/28/00 TITLE: SHEFFIELD 4BR w/O EL. #2 COMPLTA1vCE: PASSE5 Required UA - 569 Your Home = 429 24.64 Better Than code P. aa: e3 PeYmit # Checke3 by/Date AY'ea or Cavity Cont. C3lazing/Door Perimeter R-Value R-Value G-Value ----^-----------------------°-----------------------------------------°---- CEILING3 1176 44.0 0.0 WALLS: Wood Frame, 16" O.C. 2772 19.0 2.0 1 wAI,LB: Wood Frame, 16" O.C. 290 10.0 2.0 BSMT; Conc. 9.0' ht/8.31 bg/9.0' insul 736 11.0 0.0 GLaZiNG: windcws or poors, Above Grade 460 0.3SG 1 DOORS 38 0.350 FLOOAS: Over CutBid_ Air 84 38.0 2.0 HVAC EQUIF.+'lENT: Furnace, 92.0 AFUE " '----------------------------------------- " -------------------- - ------- COMPLIANCE $TATSMENT: The proposed building design described here ie coasistent with the bu'_lding plans, epecifivatious, and other calculations su?omitted with the permit application. The proposed building haa been deaigned to meet the requirementa of the Minnesota Energy CUde. Builder/Designer Date ` JOB INITIATION ORDER Pulte Homes of Minnesota Corporation 1355 Mendota Heignls Road, SuRe 300 Mendola Heights, MN 55120.1112 Phone: (651) 452-5200 Fax: (651)452•5727 J08N0.0 (2 1 " 0 CONmNffY: d? CONTRACTORISUPPLIER: C 1 lE4ALDE5CRIPTIOtJ: LOT B' BLOpC S UNff etmdrmaooRess: h (_.#?" VAA * VILI-- crtt: ? sTnTE:MV ar+:? t? NpDEL NPME: NIODEL NUMBER : 162 a? ELEYATION: (7AR11GE: LEFi RK3Hf eureas wuAE: J.YV Wl .``i Cv-n&f G1 f'l C?e ????n on?oFOrtoe?R:` 2, Z O CURRENTADDRE55:_ ??-{ .1'?!C?? Cex- Q(?„LQJ {? ?O t CITY: STATE: I14v ZIP: 'S51'2.Z E+ou,E arroNe: bC) l-4bfo-C' 33-1 eVsu,essPar,e: evsmessrHONE: SALESREPRESENTA7IVEp{A-e J 6 . n O...? ? 0000 • : ? ,.. ; .. . . . s . : -:..? il ... . . BASE PRICE , _• , a)(o qQo ? - - - - LOT PREMIUM QQ 0 1 IWIT ELEVATION# ! 11000 li,l( ?k e?rye?} -i-noh ou4 2275 ? 0? 70v ? ? z /iUna,;e 7n?x.h?(? 34p,5o ? ?6 D/l VGLU,Q.?d{- aS{-r.v ?3?GQ,?-t? / ?vc?0 ? c? . 0`l" 3 wOD? Y. ?2 "d f-!IOVV I bzC 1e07 177s- r oa ?? 9iri- La?r Pe e,4- m le. i 700 t ooVo dot r=-ra-,or 8 *3 (,e.., a,s-v l ?00 Mgt-v Ce1 00 73' / i oaO tu?c d-W-A 1,Va S c?_W 35's J 1-7oo(, ?rn?te zza v..?-?h?:v PULTE Master Btcilcler APPROVED 8Y BUYER( APPROVED BY SALES: RELEASED TO START C c?rt, 112t EOVAt HOUSING OPPORTUNITY Builder's license q0001377 This constitutes a contract beiween the Seiler and the Purchaser(s) for the above items. ,? . LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION ? PROPERTY LEGAL L-c+r ? fSLOf'. h DATE OF SURVEY: H ? LATEST REVISION: W ? 3 - I 3 -OU a DOCUMENTSTANDARDS o g 0 a ? a/? ? . Registered Land Surveyor signature and company y?/? ? Building Permit AppGcant : ? Legatdescription ¢Y ? ? • Address G7"D ? • North arrow and scale D-10 ?. • House type (rambler, walkout, splRw/o, spiit entry, lookout, etc.) T/a ? • Directional dreinage arrows w7th slope/gradient °,6 ?? ? • Proposed/epsting sewer and water services & invert elevation r?/y? ? Street name ? ? : ? Driveway D/ ? ? • Lot Square Footage 9"'? ? • Lot Coverege ELEVATIONS Eiascna / Y} ? • Sewei service (or Proposed) ?? ? • Properry corners s'y? ? : Top of curb atthe driveway ?? 9 Elevations of any existing adjacent homes ?? Adequate footing depM of structures due to adjacent utility Venches Prooosed ?/ ? ? • Garage floor a' o ? • Firstfloor s? o? ?? ? • Lowest exposed Nevation (walkoutlwindow) • Propertycorners 11/0 ? • Frant and rear of home atthe foundation PONDING AREA (if aodicaWel o r/o • Easementiine ? ? ? • NWL o p? o . HWL = g' ? ? m,"? • Pand # designaDon • Emergency Overflow Elevation DIMENSIONS M/? ? • Lot lineslBearings & dimensians ? • Right-of-way and street width (to back af curD) ?' ?? • Proposed home dimensions induding any proposed decks, overhangs greater than 2', porches, etc. ? (i.e. all structures requiring permanent footlngs) ? o • Show all ea§ements of record and any City uOiNes wRhin those easements ? ;/ • Setbacks of proposed sVucture and sideyard setback of adjacent epsting shuctures ' ? ? • Retaining wall requirements, rf any ,, Reviewed: 3'zq- March 79BB CRAMJBLDGP1iMi.FM ?: - - Surveyor's Certificate I SURVEY FOR :PULTE DESCRIBED AS : Lot S, Block 5, OAKBROOKE, City of Eogan, Dokoto County, Minnsota and reservinq easements of record. i 1 . . w ?? ? ?^ k Br. A < u" •.2li.a::1 l.:.t LV.':?_.... 4? V i ? ?8•. .- ? / ?0 o i°` o' ? o zS OV`y? Ss .}CO\ o.M 10 `'. II ? G? ati?r '\ ? ia ry? ?oo ? i ? p . p\a? gpcya?sco, I /? ? 6 Y Q di p) t0 / ? 3j 0 0.?~ ti py/ ^ Cp- O ? ?'? ryt° ?\ ? o9P o O . / D` Aj 3Q0 / ,??) gJop . ? Q OtS? ? - - wy EziSt Home 09\ ``?? o q;j r? Toe =9ZY.H 0=3 7 2p ,s • O / R g 1 L 3 ? JO? 0 1AJn T ^?/ ? ?f0cZ' y 9 ?? {? y OT SQ. FOOTAGE = 11,552 ? . SQ. FOOTAGE = 1,801 Plan # 18231 LOT COVERAGE = 15% PROPOSED ELEVATIONS Top of Foundotion = 933•S BENCHMARK, - Garoge Floor - 933.1 E1eu=45z.50 Basement Floor = 9z'i,s Aprox. Sewer Service = Proposed Elev. _C=) MIN. SETBACK REQUIREMENTS Existing Elev. _ Drainoge Directions = Front-25 House Side - Denotes Offset Stake = • scnLe: i incn = 30 ieei Reor -i5 Garoge Side- IrEQicuNAD PLANNlNG 6NC/N6ER/NG SURV6YlNC 2005 Pin Ook Drive Eagan, MN 55122 Phone: (651) 405-6600 Faz: (657) 405,36606cItii-.r,, I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT RE7RESENTATION OF THE BOUNDARIES OF THE ABOVE OESCRIBED PROPER7Y AS SURVEYED BY ME OR UNDER MY OIRECT SUPERVISION AND DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACNMENTS, EXCEPT AS,SHOwN. DATE _I! /I i/1^L JOB N0: OOR-086 BOOK: PACE: CAO FILE: OAKBROOKE INDG EN, LAN SURVEY LICENSE NUMBER 14376 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) anr oF eacaH ? ? ? 3830 PILOT KNOB RD - 55122 ? U ? 851-681-4675 New Cornhuclion ReauiremeMs n 3 registered sIte wrveys thowlnp $q. H. 01 lot, aq. H. of house RemodellRomir and gfi rooled areas f20% mmdmum lot covemae alloweN ? 2 caplea of Plana (ahow beam 8 wlndow alzes; poured tntl. deqyn; etcJ > 1 set af energy calcWaHau a 3 copiea of hea preservaMOn Wmn H iol ploMed aHar 7/T/93 DATE: ! /4A.[ 2-'?r , Z ao r DESCRIPfION OF WORK; S?REET ADDRESS: 1 LOT: Q BLOCK: ? SUBD./P.I.D. PROPERN OWNER Name: Z-?V \/ ' {,ost Flrst StreAf olt n n 'o q 2 Sm?t w 2 coptea of plan 1 set of energy cdcWaHOns iw heated admtlons t site wrvey tor exteda addltlons d decks CONSTRUCTION COST: ? 3-G0?-. ys-?- oc?37 Phone ri: ? ? ?o1-?J C ?? `J State: ri'l. ?_ zIP: CMy ? CT "z p ( ?p z.. ?I6g-6o2?f Ccmpany. D lc,c l? 1v c. ls I? ?m ?+.pl,one e: L (area eode) COMRACTOR ?,/-? ? 5 p. ??? ? f t 3 0 ?. Street Address: ?-? ? 'T'? ciy x Is? swre: A4 zip: S 5`f Z 3 ARCHITECT/ ENGINEER Company: Name: Telephone #: ( ) Sfreei Address: RegistraHon 11: City State: Sewer/water licensed plumber (jf installina sewer/waterl: Phone #: Lp: I hereby acknoaAedye Nwf I have read this applkaHon, state that Ihe iMomwlion is cortect, and agree to comply wNh aq applicable State of Minnesofa Stahifes and City of Eagan Ordinances. t--) 19 Signalure of Applicant OFPICE USE ONLY 7V. Certif icates of Survey Received ?? Yes No G 2 8 2000 Tree Preservation Plan ReCeived _ Yes No ? Not Required - ? ? Surveyor's Certificate SURVEY FOR DESCRIBED AS : ,. ?t :`; ? ; a? ?k' ??. ? : PULTE Lot B, Block 5, OAKBROOKE, Cily o( Eogon, Dokoio County, Minnsoto and reserving eosements of record. rr^ ,s ? C ? ?:?? ? . .' ? ;'.? / ??JS?? t0 'Ei:? E??'='G,?? 1--? i?a?.- ._?:?3=.4_CJ_- r _ - r ,-;,.; y ?.;.?::?;., ,.,; ..????;:.. _._.__ / f-:;.;:??. ? / ? / ???' / ?? ? ? /?'?? . o°? / / ? ? / ? ?? ??°?// / a d.'?/ ?p ? G ?? tiA% P ??°? ryc ati o , L ?' / / ' ?p'? / i R i ^,~. \ /? \ \ ? p J? ? ? ? ? i / / Q,y? ? / 9g :rr? ? ? o ? ., ?=3 7 ?? , 1 J??T ?Ov? ? ?w RI ?Ny ?/ C? I?? y ? ? ??? ?L Plan /? 18231 ?? xy a ? PROPOSED ELEVATIONS Top of Foundotion = 433.5 Goroge Fioor = 933•1 "!R`' Bosement Floor = 9ZY•5 Aprox. Sewer Service =???4i4•5@?t'd`. Proposed Elev. _ ? Existing Eiev, _ Drainage Directions = Denotes Offset Stoke = • scA?E: "? S=?T t'E?il "° ?'. `r?'? ? A ? , ,? , , . , , ?8? • _ , . ?.. , , ?. , A , ? s ,-, . ? . - a `. ,? ?i _ ?? a ,• , , . . ? , ?. A // A2 9i - Q ?o q,C /i . ? ??o . 9p S??sea ? ? °w y ?a d? oo , o, ryro?/? ?'? ?? 1 L a n ? ? ? Co o9e oo p.? ?? ry?O? \`? ryti. ? . ?` ?m, / ?`. N? ?'7? ? ? ?? ' //.y ? ' Exist Home oY"?' ^ Toa - 93Y.4 ?,o ? 0? ,, / N ( ? 0. ? , ?- \ .? . a? ?? i ?^i 93LO '?` . ?OT SQ. FDOTAGE = 11,552 ?EySQ. FODTAGE = 1,801 LOT COVERAGE = 15?' BENCHMARK, Gp p?k E1eu = q52.? MIN. SETBACK REQUIREMENTS Front - 25 House Side - Rear - 15 Goroge Side - t ?o?n - ao roee JOB N0: HEDL(J,HD ' HEREBY CERTIFY THAT THI$ IS A TRUE AND CORRECT REPRESENTATION OOR-086 OF TME BOUNOARIES OF THE ABOVE DESCRIBE? PROPERTY AS SURVEYED BY ME OR UNDER MY ?IRECT SUPERVISION AND DOES NOT PURPOftT TO BOON: PACE: PLANN/NC BNC/NEBR/NG SURV6Y/NC SHOW IMPROVEMENTS OR ENCROACHMENTS. EXLEPT A SHOwN. 2005 Pin Ook Drive ? Eoqan, MN 55122 DATE ?/l?/? D• CAp FILE: PhOne: (651) 405-6600 . IINOGREN, lAN 'URVEYOR ? Fox: 651 40S"; 606 - N A UCENSE NUMBER 14576 OAKBROOKE ( ) . ?_3 r_??,rC..?b -i;:?, .. L V c/.,?/ 8L CJ CITY USE ONLY sueo. oat RECEIPT #: I a J ? 5-7 RECEIPT DATE: "1 -W' O o PERMIT # `f U ? 0 l 8000 PLUbI$INH PEMiT (ii3:SIDENTlAL) crrY og RAsM 3830 Pnor KNos xn gA6RR, MN 5518E 651-6$1-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit D backflow preventer for underground sprinkler system rixrHocc Fnr.H ie TOTAL Alterations to existing dwelling - minimum fee Describe: $ 30.00 Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ ? Gas I If1 Outl2t ' 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 = $ /Z Se tic S stem newlrefurblshed ' requires Mac iic. 75.00 X = $ Se tiC S tem abandonment 30.00 X = $ RPZ new inshallation/repairlrebuild 30.00 X = $ Rou h o enin 1.50 x = $L . Shower 3.00 x $ Under round s rinkler if dweliing is under conslruction 3.00 x $ Under round s rinkler if exisUng dwelling 30.00 x $ Watercloset 3.00 x $ Water heater 3.00 x R $ W ater softener if dwelling under construction 5.00 x $ W ater softener if existing dwellin 30.00 x $ Watertumaround 30.00 x $ State Surchar e .50 > ?- $ .50 Total --> --? ----> ---y : . C) Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc. ------------------------------•• - ce - ------------------------------------------------------------ ---------------------------------- I hereby acknowledge that 1 have--read this appliWtion- , state-that the information is correcC and agree to comply with all applirable Cityof Eagan ordinans. It is the applicanes responsibility [o noGfy Ne property ovmer that the Ciry of Eagan assumes no liabiliry for any damages raused by Me Ciry during its normal operational and maiMenance activilies to the facilities wnsUucted under this permit wi[hin City property/rightof-wayleasement. SITE ADDRESS: OWNER NAME: : TELEPHONE #: (AREA COOE) INSTALLER NAME: STREET ADDRESS: CITY: TELEPHONE #: /6d ?rr ,G( SIGNATURE OF PERMITTEE CITY USE ONLY LOT BL PERMIT #: qO f J QJ SUBD. OiK, krb oRECEIPT #: / '; oC7 a S RECE[PTDATE: S'I6'00 2000 MECHANICAL PERMIT (RESIDENTIAL) Date: Vd Complete this section anlv if you aze installing HVAC in a single fami]y dwelling, townhome or condo under construction and not owner/occuoied. • HVAC: 0-100 M B T U ADDITIONAL 50 M BN • Gas outlets (minimum of one required @ $3.00 ea.) _ Other State Surchazge .50 Total $ 31bD Complete this section onlv if you are remodelina, addine to, or revairine an existing single-family dwelling, townhome, or condo. Please indicate if it is a new item, alteration, or repair. _ New _ Alteration _ Repair _ Furnace _ Air exchanger _ Air conditioning Other $ 30.00 6.00 3. Da Fee State Surcharge Total Reminder: Call for inspections SITE ADDRESS: "? 0 ?R a $ 30.00 .50 $ 30.50 OWNER NAME: -p-[J JIL U`4 Q?7 Us PHONE #: 66- INSTALLERNAME: --BUYYI,Sfl? JCQ.. M? PHONE.#: (AREA(o/CA-DE} STREET ADDRESS: J r2L/?l -121-2U ' ?bI C¢/2 P_ AJ. S . (AREACODE) C[TY: -Sce-.0Grwg. STATE: Aloii ZIP: ?? ? ?c7 SIGNATURE OF PERMITTEE CITY OF EAGAN 3830 PIIAT KNOB RD EAGAx MRi 55122 651-681-4675 _ _ -Use _BLU_E or_B_LA_C_K_Ink For Office Use / j Permit z I City of Eana Ed I n I Permit Fee: ~U 3830 Pilot Knob Road Eagan MN 55122 ~ rrrR~ I Date Received: Phone: (651) 675-5675' I I I Fax: (651) 675-5694 Staff- JUL 19 2012 ! 2012 MECHANICAL PERMIT APPLICATION Date: r~. Site Address: .e r i I ~ ,t W Tenant: Suite RESIDENT OWNER Name: Phone:( (21~-,^9~~< Address / City l Zip: (.4 Name:; 11 11~oI1:4:1: I /VCrJNC License#: ~1 ( I i q Address: 3454 W. Burnsville Parkway CONTRACTOR City: LFI►6 State: Ziptlirnm~Jllla MN 5ri~ Phone: Contact: - ,r,.. Q Email: New L Replacement Additional Alteration Demolition TYPE OF WORK Description of work: > J -I TacL NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL Furnace - New Construction - Interior Improvement PERMIT TYPE ;t< Air Conditioner - Install Piping - Processed - Air Exchanger _ Gas _ Exterior HVAC Unit _ Heat Pump _ Under / Above round Tank 9 Install / Remove) Other RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x 1% $60.00 Minimum (includes State Surcharge) Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee = $ Surcharge $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) TOTAL FEE 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.oopherstateonecall ore I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and odes 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 wit a approved plan in the case of work which requires a review and approval of plans. x App icant's Printed Name x Applica s SignatureFOR OFFICE USE Required Inspections: Reviewed By: _ Date: Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening 102973 Use BLUE or BLACK Ink I Fo~aO;ffic`z~Jse I 1~t f 1 j Permit 1 1 j Clay Ol tap 11 I Permit Fee: I 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 i staff: I Fax: (651) 675-5694 I %J I 2011 RESIDENTIAL BUILDING PERMIT A,PyPLICATION Date: Site Address: sdl rA N 6~ Unit Name: bigaA o'' Phone: X/_z T d 1 RESIDENT / OWNER Address / City / Zip: ZZ Applicant is: Owner A Contractor Description of work: L G7/a. u' e- l9tC~to,~ I ~f TYPE OF WORK y Construction CostfT Multi-Family Building: (Yes / No ) Company: V'r Contact: CONTRACTOR Address: %e~O`r G~4~r~ Tt~ ~ 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: NOTE: Plans and•supporting documents that you. submit ac'e consideredao'lie public rnformatron Porfio'nsof .t rt ,s"~sa e t k r y the rnformatron maybe classified_as non pubhc'►f you pro rde specifi reasons that would permit eh 'CItk'l n~ ts, • I• r conclude;that the ,arferadeseere, CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org 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 iinnJ the case of work which requires a review and approval plans. x l a7~ x r Applicant's P inted Name Applicant's Sig ature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA141704 Date Issued:03/27/2017 Permit Category:ePermit Site Address: 4082 Johnny Cake Ridge Rd Lot:8 Block: 5 Addition: Oakbrooke PID:10-53760-05-080 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)$59.00 0801.4087 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 - Steven G Loehrer 4082 Johnny Cake Ridge Rd Eagan MN 55122 (612) 840-7213 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature