4134 Lantern Lane' 'PLUMBINGPERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
Lot _
? iCity Name Address c ?„ -r.1AL,.A r'%^ Phone r75
Name 706-. )eti f,ae
3 Address
p City //r Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $3,000.00) .,
OF
PERMIT M
RECEIPT q
DATE:
BLDG. TYPE . WORK DI
Res. v" New -
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
FIXTURES TOTAL
_!L-Water Closet - $300 $
I Bath Tubs - $3.00
-L-Lavatory - $3.00 '
J_Shower-$3.00
--4_Ki?chen Sink - $3.00
Urinal/Bidet - $3.00
T -
__i?_Laundry Tray - $3.00
--t-Floor Drains - $7.50
_o Water Heater - $1 50 1 -
_Whirlpool - $3.00
? Gas Piping Outlets - $1.50 i
(MINIMUM - 1 PER PERMIn
-Softener - $5.00
-Well - $10.00
Private Disp. - $10.00
=Rough Openings - $1.50
FEE:
STATE S/C:
;.
FOR: CiTY OF EAGAN GRAND TOTAL•
PERMIT #
. ,
,
MECHANICAL PERMIT
RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100 For Office Use Only:
Site Address ' BLDG. TYPE WORK DESCRIPTION
Lot Block Sec/Sub
Res. New
Mult Add-on
Name
Comm. fiepair
m Address
Other
' c Ciry Phone
?
Name F FEES
RES. HVAC 0-100 M BTU -$24.00
c Address ADDITIONAL 50 M BTU - 6.00
O City - Phone ?
y (RE5. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1
50 EA
.
.
TYPE OF WORK ?
CONTRACT EE
COMMAND
FE
ForCed Air
M BTU
'r ?
qp
gDGS.
COMM, RAE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU $ REMODELS - 12.00
'
Air Cond. M BTU MINIMUM COMMERCIAL FEE _ 20.00
I
Vent STATE SURCHARGE PER PERMIT .50
, CFM (ADD $.50 S/C IF PERMIT PRICE GOES
? Gas Piping Oudets # BEYOND $1,000)
I Other
i
?
FEE:
14 SiGNATUFE OF PERMITTEE
S/C: ? V
I? _. TOTAt: FOR: CITY OF EAGAN
. , , hb:"?:,r 'k•:'. Y ..,4
CITY OF EAGAN . •
454-8100
DEPT. OF BUILDING INSPECTIONS ?
Correction Notice
Located at y / 3 Y L4?-/ crh L 47.
I have this day inspected fhis structure an'd
these premises and have found the following
violations of city codes governing same:
') t)/ 11 1 61h? l2.i?7 I7F OUf G, ?,;y?
v -
0?
D? i0n?-
? o '` ! 0 ' G? ;
?p'? i aHiirC -f[hr vvS5 9
:
???? ', Vn Ei iAvPe i c? Ix?rr?• ??e. ir i,
s/'?'4en)correctio{rs have/been made please
call 454-8100 for inspection.
Date Inspector Ciry of Eagan
DO NOT REMOVE THIS TAG
? . ?. . ,,.• ,,., „ -,. -. :.,.y,.w :. ? _ . ? ? . .
CITY OF EAGAN . .
454-8100 x
DEPT. OF BUILDING INSPECTIONS -
Correction Notice
,
Located at y/ 3 y La h J`'"" 4"
T
I have this day inspected this structure and
these premises and have found the following
violatiQns of city codes governing same:
,) P<„ /Q '' 1/14., 'I sn , i. c , ' ,- : 1.4 <
0 ?-
5?u
. , iv?.-t' a
When corrections have been made, please
call 454-8100 for inspection.
Date
Inspector City of Eagan
DO NOT REMOVE THIS TAG
...?+'.iarau •an? ui.uN ai+CUl 1uiv1GWGU // 1117V
1;1101AEL'YOf7rx'r? (H)688-2941 CITY OF EAGAPf
(W)298=1311 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
MLAN K[,g¢x-'„CNM, 866-7794 PHONE: 454-8100
BUILDING PERMIT Receipt #
To be used for Est. Value Y 1 12.?'Q!-% Date 12,
Site Address L
Lot Block ? SeciSub. '-L'U`svTRY 04Li"?
Parcel No.
W Name
o Address City Phone
o Name ? r
?Q Address
? City Phone
Name _
Address
City -
Phone
I hereby acknowlege that I have read this application and state Ihat ihe
information is correct and agree to comply with all applicable State of
Minnesota Statutes and Ciry ot Eagan Ordinances.
Signature of Permitee
A Building Permit is issued lo:
on the express condition that all work shall be done in accordance with all
applica6le Slate of Minnesota Stafutes and City of Eagan Ordinances.
Building Olficial
OFFICE USE ONLY
Occupancy F? ---1 -N-?t FEES
Zoning
(Actual) Const Bldg. Permit 682 • 00
(Allowable) Surcharge 56,00
8 of Stones -
Lengih ?G?' Plan Review 341 ?00
Depih -ALV SAG City I{l.!?ri
S.F. Total - SAC. MCWCC 5 ' •
S.F. Footprints
On Site Sewage _ Water Conn
On Site Well - Water Meter
MWCC System
City Water Acct. Deposil
PRV Required XX &W Permit ° l?
Booster Pump - SiW Surcharge
Treatment PI
APPROVALS qoyd Unit
Planner - park Ded.
Council
BIdg.Off. _ Copies
Variance - TOTAL
PermR No. PermR Holder DMe Telephone #
WATER
SEWER
PLUMBING
H.V.A.C. L'? c Gc,C[F? ///??
ELECTRIC
Inapection Date Insp. Commenta
Footings I , : -
Foundation
Framins S--r z,F 's
Roofing
R°u9A PIb9. -? d/ el Gl'[?., i?
ao,sh Fft9_ s A D.S
isui. it->S
Fireplece
Flnal Htg.
FnalPlbg.
Consl. Meter Plbg. Inspector - Notity Plumber
Engr./Plan
Bldg. Final /. p f?ll
Decic Fig. 7-/ L. g0 QS
Deck Finel
Well
Pr. Disp.
I RI nr. PFRMIT Nft ? ?'1?
;, ( X.L / ?
?z L,',
01-3210 ;
,
Bldg. Permit ,
? 8a
01-3422 Plan Check
01-3445 Surch./Adm. ?
01-3446 SAC/Adm. ?
01-2155 Surcharge
#75-3860 Road Unit ?-?
20-2275 SAC
' 20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter C
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
28-3855 Park Ded.
TOTAL
13.
CASH RECEIPT ?0%
CITY yOF tAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 19 ?
/
?ceivEn
?
,v
MouHr s
m
ooLLAas
? CASH p CHECK
?; ?'. t;;;t :, ?`?-(%Li?c, -- ?, /(?:??,,yC jtr ,
C wnn.-aere?acoav
YeNpw--1,06lk9 Cppy
PINc-Fib Copy
Thank You ?
?.
sv - - ;'; '
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
P.O. Box 21199
Eagan, MN 55121
OFFICE USE ONLY
PERMITDATE 4 /11 l
WATER PERMIT # 10356 SEWER PERMIT # -
METER #
READER #
METER SIZE -
ISSUE DATE -
SITE ADDRESS ??? ? '• ; ? ??t? ? E '?
LOT _/_?'_BLOCK ???--6'?-- • ' ' ?`- r_=.? ?
. , / ,-
l
APPLICAN7:
ADDRESS: ?"t ?•S '"'` Ii f/ r w/?i'
CITY, STATE ?-" - ` ? . s v . •' / ? "Zt iZIP S j J
PHONE:
*
PLUMBER:
ADDRE?: ?
CITY, S TE ZIP
PHONE:
OWNER:
ADDRESS:
CITY, STATE ZIP
PHONE:
B.P. RECEIPT # ; 1446
B.P. RECEIPT DATE ?? f?n
_X.7PRV _ BOOSTER PUMP
PERMIT REQUESTED
? SEWER - WATER _ TAPS
-COMM/IND ? RESIDENTIAL
?
? NEW - EXISTING
I AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES:
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMITS, CONTACT
ENGINEERING DEPT.
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
P.O. Box 21199
Eagan, MN 55121
OFFICE USE ONLY
PERMIT DATE t"i l39
'
WATER PERMIT #E 1 j-' 5 6 SEWER PERMIT #
. METER # 4t24/ ,*7 D j ? 3 B.P. RECEIPT #?? +?
? B.P. RECEIPT DATE
ME? .. TER S ZE???;??
ISSUE DATE G" -PRV - BOOSTER PUMP
SITE ADDRESS
LOT_k`?,...9LOCK;
APPLICAAT: •J
'" SEC/SUB
r-+?-e in.l
ADDRESSa ? ?
CITY, STATE
PHONE: , ZIP
O ? ? ; i. ..' /?: i LY ! _ `
PLUMBER: ? ^ _
ADDRESS: ' x
CITY, STATE ZIP
PHONE: _
OWNER: _
ADDRESS:_
CITY, STATE
PHONE: -
PERMIT REQUESTED
? SEWER WATER - TAPS
- COMM/1ND RESIDENTIAL
f
NEW - EXISTING
I AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES:
i
ZIP
SIGN E WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMITS, CONTACT
'I ENGINEERING DEPT.
? CITY OF EAGAN NO 16284
? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 (? /?z Q?
BUILDING PERMIT Receipt# /
To be used for SF DWG/GAR Est. Value $112, 000 Date APR 12
Site Address 4134 LANTERN LN
Lot 19 Block 4 Sec/Sub. COUNTRY HOLLOW ?FFICE USE ONLY
P8fC21 N0. Occupancy FEES
R-1
Zoning
W Name JOHN SEXTON (nctual) Const V-N Bldg. Permit 682 . 00
o Address 3216 SKYVIEW DR (Allowable) y-N h
S 56.00
City BURNSVILLE phone 895-5968 uotstories - urc
arge
341
541 Plan Review .00
Len9th
o Name SAME Depth 4' snc
ciry 100.00
,
z1-
Q
O
Address
S.F.Total
- ,
575.00
U
m City Phone S.F, Foolprinis - SAC.MCWCC SHO
00
Water Conn .
On Site Sewage -
?
$w
Name
On Site Well
-
Water Meter
90.00
q'? Addf2SS MWCC System xx
OC
3 n
00 Acct. Deposit -
<w City Phone City water ?
XX
S/W Permit 20. 00
PRV Required
I hereby acknowlege that I have read this application and state that the Booster Pump - S/W Surcharge 1.00
information is correct and agree to com_ply with all applicable State of 228
00
Minnesota Statutes and gandinano
es ? Treatment PI .
?
SignaWre of Permitee !?%? - APPROVALS
Road Unit 340 . 00
\ Building Permit is issued to: .TOH9'?SEXTON Planner - park Ded.
n the express condition Ihat all work shall be done in accordance with all Council
,jplicable Slate of Minnesota Statutes and C
ity of Eagan Ordinances. gldg, pff. _ Copies
/
iilding Official I-1.'t1 Variance - TOTAL 3,043.00
Thfs request void ?/?,/?
18 months Irom - ^-
E 422241 ?? A4 ('?*f1lr?_
Request Oate Fire No. Rouph-in Inspection
Reqwred?
g]Ready Nuw ? Will Notify_ Inspec-
Yes ? No tor When Ready
? Ucensed Electrical Cootractm 1 here6y request inspaction of ebove
Owner electrical work installad at:
Stree[ Address, 8ox or Route No. City
• ecLOn o.
1
ownsip Name r o.
-
1
Range No.
County
Dakota
OccuUantIPRINTI
Vacant John Sexton
Con Phone No.
Power Supplier
akota o;ver co. Addres5
4300 20th
F
Electiical Contractor (Company Name)
Electrical Producti
on Servicec Cnnirar.tor's License No.
' 5
Mailing AdJress (Con[ractor or Owner Making InstailatioN
Aut ized Signawre (Co r tor?Ow aie ?nstallatiun
-?
?- Phone Number
? THIS INSPECTION REQUEST WILL NO7
MI NESOTq STATE BOARD OF ELEGTRICITY
Griggs-Midway Bldg. - Room N-791 BE ACCEPTED BY THE STATE BOARD
1821 Universitv Ave.. St. Paul. MN 55104 UNLES5 PROPER INSPECTION FEE IS
oh....e 191o1 eno_nenn ENCIOSED.
LO/g? REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-os
See instructebns tor completing this form on back of vetlow copy.
11,
C
G 4 2 2 2 4 "X" Below Work Covered by 7his Request
Nev, AAd Rep. Tyoe ot BuilAing Appliancas Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lightiny Fixtures
• Apt. 8uilding Dryer Electric Neatin
Commercial Bldg. Fumace Siio Unloader
Industrial BIAg. Air Conditioner Bulk Milk 7ank
Farm Otner Pect v Othe, ISVer.ilyl
Ihef SVecify t 0r Other
nspeczion Fee Below
p Fee ServiCe EntrenCe Size 8 Fee Fxe.ders/5ubfeaders N Fec Clrcuits
1 ], R. 0@ 0 to 200 Am s 0 to 30 Am s 0 to 30 Am s
Above 200 qmps 31 to 100 Amps 31 to 100 Am s
Swimming Pool Above 100_Am s Above 100_Amps
` Transformers Irrigation Booms , 5 Partial," er
5gns Special Ins??ection ?5
50
TOT FE
??
Rerrr??k,?
a_ rnnnn? 1_ _ _I._ - A.. _ A r r . J
auNNI. Lu c'+cccJ nave a_I rea4y;upiu oo.Z)u `
Raugh-in
??
?
? ' ' D1te I, the Electrical
? '/
•t
?./?
:
inspeclor, hero6y
certity Ihgt th6 ahove
Final Di E G
- inspection has been
?g
? .
! .
;!.'f
t
;? _0
q mede
. ,.
.
.r
.. .
Thla request voiC 18 montha trom
This reques[ void 31g9
78 nwnths from
E 42223i r?? '?,"7zv?
>?S?
Y"?? S• ?
Ruquest Date
?- Fire No. uPh-in Insper.tion
R quired7
Ready Now Q Will Nnlify. InsPec-
t
Wh
zs
r 1'es ?No or
en Ready
icensed Electrical Contractor I hereby request inspection oT above
[3Owner electricel work installed at
Street Address, Boz or Route No.
k3 C_,4J --2 ?lS L:;?? City
?? ?z? rJ
ection, o. Township Name or No. Range Nn. County
AAWTA
Occ ant (PRINT)
?'?,.l l 'Z.W 561-MN (f0,1-P5-7-, Phone No.
.-
Power Supplfer Address
ELEC- ,
Electrical Contractor ICompany Namel
?"x'?VAGC Contraclor's License No.
G 5<Z6,5-VS
Mailing Address (Contractor or Owner Making Instailaiion)
?6L
IO
U
IZ
-zo
^jg
?
I
I
-
Ir
t
/
Autho Signature I ontm o/Own ng ns Phone Num r ?'I
-
i
MINNESOTp STqTE BOAHD OF ELECTHICITY 7HIS INSPECTION NEQUEST WILL NOT
Griggs-Midwey Bldg. - Room N-197 BE ACCEPTED BY THE STATE BOAflD
1821 Universitv Ave.. St. Paul, MN 55104 UNIESS PROPEN INSPECTION FEE IS
Phone 16121 642-0800 ENCLOSED.
REQUEST FQR ELECTRICAL INSPECTION « /?
? See instructions toL completing this form on back of yallow copy. r gc?eY-v V'
E .422.23 X" Below Work Covered by This Request
Nw4 Adcil ReD• ` Type oi Building ApPlianCea Wired Equipme"l Wired
Home Range Temporary Service
?
Duplex Water Neater Li9htin4 Fixtures
Apt. Building Dryer Electrii; Heatin
Commerciai Bldy. Fumace Silo Unlnader
Industrial Bldg. Air Conditioner l3}ilk Milk Tank
Farm Ocht,r UP.r,i y O?hF.t„ISu??c?ry)
t r:r VeciFy Oth?r Othi¢r
Compute lnspectron fee Below ''`?
k Fee Servite EntreneBSize M Fee feeders/Subfeeders # FeA Circuit
0 to 200 qm 5 0 to 30 Am s 0 to 30 Am s
Above 200 Amlis 31 to 100 Amps 3170 1 C)0 Am
Swimming Pool Above 100_Amps Above 100_/>mP5
Transformers Irrigation Booms Partial-'Qther Fee
Signs Speciallnspection 5 /
TO
TAL FEE
Re".'?rks ?
I
vc7 vt
„-,,.
? 1, th E?a?t.,?e?
- -? Insvec
-? I
certify that the above
Final
/?1 ?'?le
? inspect
ion has been
made.
rnis mvua9i voia
. '" 2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements
RemodellReoair Reauirements __ ...__
ClEfice Use CJriTv
3 registered site suNeys showing sq. fl. of lot, sq. fl. of house; and all roofed areas 2 copies of plan Cert af SunteyRecd .;: Y> N
(20% maximum lot coverage allowed) 1 set of Energy Calculations tor heated additions Tree Pres;Pl9o RedtJ Y?i:: N:
2 copies of plan showing beam & window sizes; poured found desigq etc. 1 site survey for additions & decks 7ree Pres Requrce¢ Y; N
1 sel of Energy Calculations Addition - indicate if on-site septic system Ort-site SepCiCSystem - Y.? N.
3 copies of Tree PreseNation Plan if lot platted after 7l1l93
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date A Construction Cost 3. r ? ?
Site Address G?( ?y l- 4,o
a. T U -?Q, N
L4'U
U nit/Ste #
Description of Work ??Ia ee-s d L?
Multi-Family Bldg ? Y _ N Fireplace(s) _ 0 _] _ 2
Property Owner Ahe4 !$ b4,rU Telephone #
Contractor a
Address ?Z( City L7( ? 12f ? ? N
State 13 Zip S7 Z{ Telephone #(7e:j ) 2,5- 7-00-2 ?
Cel( s( 2,- :7b,G -3 / ¢`
COMPLETE THIS AREA ONLY IF
Energy Code Category N&nnesota Rules 7670 Cateeorv 1 _
(J submission type) • Residential Ventilation Category 7 Worksheet
Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
Telephone # (
N If so, 25% plan review
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
A NEW BUILDING
Minnesota Rules 7672
. New Energy Code Worksheet
Submitted
? c
Applicant's Printed Name p ica Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-piex
? 02 SF Dwelling ? 08 06-plex
? 03 01 of _ plex ? 09 07-plex
? 04 02-plex ? 10 08-plex
? OS 03-plex ? 11 10-plex
? 06 04-plex ? 12 12-plex
Work Types
? 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
Valuation
Census Code ? 3 y
SAC Units
# of Units
# of Bldgs
Type of Const 'y b?
? 13 16-plex
? 16 Fireplace
? 17 Garage
? 18 Deck
? 19 Lower Level
Plbg_Y or _ N
F C- Tze-sS
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screen/gazebo)
? 24 Storm Damage
p 25 Miscellaneous
J,v> rr P 6,..-)
r_ .
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Eut. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish Interior ? 44
? 36 Move Building ? 42 Demolish Foundation ? 45
? 37 Demolish Building• ? 43 Reroof ? 46
'Demolition (Entire Bldg) - Give PCA handout to applicant '
Occupancy MCES System _
Zoning ?-? City Water _
S{ories Booster Pump _
Sq. Ft. PRV _
Length Fire Sprinklered _
Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundarion
Drain Tile
Roof Ice & WaYer Final
"u Framing
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
Approved By: =
REQUIItED INSPECTIONS
_ FinaUC.O.
?O FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests Final
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wall
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 -
Total
Siding
Fire Repair
Windows/Doors
1? /4. -r
12'47 N0.701 P002r063
. 9 PE?ERS, PRICE &. SAMSQN
_ LAND SURVEYORS. LTD, ?
12400 PRtNCETQN-AVENUE SOU'1'H, SAVAGE, MWNfSQTA 553780 612-890119201
`+J
?
Q
?
?
;?b
?
Certlflcats Of Suryey
JOHN SE%TUN
? ????
?E?2N, ?? .
( ??.-? ?Y <.P
? ?w o ? .` A?'?
I fS ???.?
, L- t?aaeaDlV 6??F??T10
30?,0 N89°38`3/"W
?A..
e? 142.00
?'? '^ _.,_..;? •-d?-- - ?
? /0 IG L ?
e ?6 9f$3,,1? ?? --- ±e2' '? X ? o S ?
//3 N
v ?Q 30 ?W
u I ? i f ? N
itt
x
? $2?- ??-
I ?----- ?
t3 /o t -1/o e
a
142.0001
'
3?
T \
N ra.. i
1! •..y ?'.'wl
?.._..
scaLE, •ir?::l.;'u ,r
.
oDenotes
, 021.5 Denotes
mj.oi Denotes
iroa mopument
exiating elev.
praposed elev.
DESCBIYTI4N
i.U'F 19.. ELOCIC 4
COUbTxY HOLLOMI
DAiCUTA CULiNTY, MINNESUTA.
P.R.V. REQUIREQ
we hsropy cattly lnet tnio 16 a uuG ana cornci lopleaenlalion ol a oytm p) the poyn411ryy p( We Apm d9sprbed ynd, wW ol ths Iocaiion ai ali
buliWnpe uiereon. 4kn0 vu rirlDlo ancro4clvn+nU. If &ny, from W on eab I".
Aa aurvsyw by ua uuo /p .1% aar ol A$91 c1?-
?*?.,..
Mw.oma uaw.. No.14890
- 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
ir
CITY OF EAGAN
J?x 3830 PILQT KNOB RD - 55122
651-681-4875
New Conshucflon ReaulremeMs Remodel/Reoair ReauitemeMs
? 3 regfstered sMe surveys showing sq. fl. of lot, sq. R. ot houae 2 copies of plan
and gp roofed areas 1`20% maxlmum lof coveraae aliowed) 1 set of energy calculatlons for heated oddfflons
? 2 copies of plans (show beam S window sizes; poured ind. design; etc.) 1 sMe survey tor exterior addNions 3 decks
D 1 set of energy calculations
? 3 coples of hee preservaNon plan N lot plaMed after 7/1/93
DATE: r Z.,P - Y
DESCRIPTION OF 1
STREET ADDRESS:
LOT:
Name: (?? f4 s?ve Phone?: %7
PROPERTY Last Ftrst
OWNER ?f/3y ?
Sheet Address: ?-?
Ci}y ? . ? State: /"?/U Zip:
Company: Phone #:
(area code)
CONTRACTOR
Street Address: License # ?6/??? Exp• <fG
Cify State: Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone #: area code ( )
Street Address: Registration #:
Ci}y State: Zip:
Sewer & wafer Ilcensed piumber (reauired for new consnuction onlv):
PenaNy applies when address change and lot change is requesfed once permit is issued.
1 hereby acknowledge thaF I have read this applicaHon, state that fhe informaHon Is cortect and agree to comply wNh all appUcabt
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY I ?
Certificates of Survey Received _ Yes _ No ,
Tree Preservation Plan Received _ Yes _ No _ Not Required ;
• .
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1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCULATIONS
MULTIPLE DWELLINGS
COMMERCIAL
2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
(CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMSER.
To Be Used For: ?-K, Valuation:
Site Address '4134 L.pNTEQ1.J L,ANE
Lot 11 Block ?
Parcel/Sub ?u.N1'} qu-O w
owner MIC. 14E(, p Ul4 (j-
Address ?`3? LpN1?Q?N LAIiE
City/Zip Code CIF}qAN
Phone Vk -1,pUp",2"ly' W-0291B-l311
Contractor I QIAN 0 1 1MQ.C
Address -( S01 PteAsAr-?+ Ave ?
City/Zip Code P\\C01'Q.Ij m 1J
Phone CJA - -719 1
Arch./Engr.
Address
City/Zip Code
Date: I? c)
OFFICE USE ONLY
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length .23
Depth ?
S.F. Total
Footprint S.F.
On site sewage_
On site well _
MWCC System _
City water _
PRV _
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off.
Variance
FEES
Bldg. Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit'
Park Ded.
Copies
SUBTOTAL
Penalty
TOTAL
5d
?
Phone #
?-?07/10/90. .? 12:47
N0.701 P002/003
PETjwwRS, PRICE & SAMSaN
LAN_D URVEYQRS. LTD,
12400 PRINCETQN-iqVE1VUE SOU'!'H, SAVAGE, MINNESOTA 55378 0 612-896•9201
Certi}Icate Of Surwy For.
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30 ?
a??.0 ?l28 ? eZ29 `??`
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? e??2ti ? ?n ? ?-" • 4? - - ?' - ---- - ? ?.?'? ??l
? 30 N #
INI
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SCAL3E
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.
oDenotes irom monua?ent DESCBIYTIOt1
,. eP1.5 L]enatea exieting elev. LOT 19 f BLOCK 4
re25.oi Denotea proposed elev. CO1INTRY HOLLOMi
DAiCOTA COUNTY, MINNESU'FA.
P.R.V. REQU#RED
Wo lyeopy Corllly Ihal Ihln iy a Irus sntl co?reCt r4ptNSflulion ol 0 aunGy ot VM DourWnrirs o! Ihw adow dosoribed Nnp, WW OI 1hs localion ol pll
buliONlpt Ihsreon. Wd rY viaiDN OncroWdvnilntil. U any, lrom or on aNa Wd.
Ai 8YfY0yW Oy ui Ulli'O ?? tlYy pl 40f/ ?'??OG •?? L.B.
`?•+W,?.-?'". ?`-
Mhn.ew. Lww.. No. 148 90
JOHN SEXTON
.••?•?------.?-?-- ___-_ . -._ ... -
PO?=t 1
hrIESSAGE CC1NF I P,MA,T I(lPd P,EPOP,T
07/10/90 12:49
1 D : 612-298-0050
SESS. h10DE DATE.'T I f9E T I f9E D I STAIJT STAT I ON I D FAGES D I RL RESULT
7n1 G3S 07/"10 12:47 01'54" 003/003 01 0 K 5000
Sef 'bac( ar-),vx
S 12¢_ o(' Je-C'. K
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1989 BQILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLIlVGS I '1
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SQRVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MQST DESIGN9TE WfiICH ADDRFSS
IS DFSIRED. NO CHAIJGES WILL BE ALLOWED ONCE BIIILDING PSRMIT I3 ISSQED.
M[TLTIPLE DWELLINGS RENTAL iJNITS FOR SALE UNIT3 # OF UA1IT3
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECB WITH BLDG. DEPT., 1 SET OF ENERGY
CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAi. & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 5ET OF ENERGY CALCULATIONS --
To Be Used For:
Site Address ?lu)? 'Aa,y,??yA J'Al
Lot AUf Block
Parcel/Sub (f e?y7?vS ?lfu ?
Owner
Address
City/Zip Code
Phone
Contractor V 6
Address
City/Zip Code
Phone p 7.5-
Arch./Engr.
Address
City/Zip Code
Phone #
APR Y 0 1989
Valuation: Date:
2?ooo-
1) OFFICE T1S1
oecupancy R'3 M-I
Zoning. R- 1
Aetual Const V- N
Allowable V-N
96 of stories
Length ?
Depth yl
S.F. Total
Footprint S.F.
On site sewage_
On site well _
MWCC System v
City water ?
PRV required ?
Booster Pump _
41?-
Bldg. Permit 21 0 4)
Surcharge Sb, Do
Plan Review
0
3LIlto
SAC, City
o
100,0
SAC, MWCC S 5 0 0
Water Conn S$O,oe
Water Meter O.co
Aect. Deposit a,OJ
S/W Permit 20,00
S/W Sureharge 1,00
Treatment Pl. 226,00
Road Unit 3O,oo
Park Ded.
Copies
TOTAL
6PPROVALS
Planner
Couneil y
Bldg. Off.
Varianee
Council
NOTE: Sewer & Water Permit fees and account deposit fees yri.ll be included in the building
permit Pee. Processing time for serer and vater permits is txo days once a lic:eased
plumber has applied for a permit at City Aall.
V/a. LLn Ar Tl v A-)
GA R A ?c
30 x 2? ^ e7,j o
sX?= CyB?
__---
??2
I 3 x y?/ ? S?2
36 ?
aBa x i4! 13?2.4
IST ?LOvYL.
6Sm T ; ?i `6v
I'?i x Z3 = 3'-f'
I o14 X 50 = 60-70v
??? ??0,t,
Z?x2y= 67Z
V/z u 1 3 = 20
l yi. x ry = zI
1
??? XSo = 35650
I11 9so
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PETERS, PRICE & SAMSON
LAND SURVEYORS, LTD.
12400 PRINCETON AVENUE SOUTH, SAVAGE, MINNESOTA 55378 • 612-890-9201
Certificate Of Survey For JOHN SEXTON
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oDenotes
x 821.5 Denotes
le2s.oi Denotes
y % N 89°38'31"W
' e`i3? 142.00
to I
6
I 8223 ? 28
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?30 h)?
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iron monument
existing elev.
proposed elev.
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DESCRIPTION
LOT 19., BLOCK 4
COUNTRY HOLLOW
DAKOTA CUUNTY, MINNESUTA.
po'no-l0Ve (??GURED
We hereby certiry ihat ihis is a true and correct representation of a survey o1 the boundaries of the above described land, and oi the bcatlon of all
buildinga thereon, and all visible encroechments, ii any, (rom or on said land.
a,e Suryerea ny us inis /o J aar or A/; 9 8 9
Minnesota License No. 148 90
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4u1?CR: .
CkTER10R ENVELOPE AYERAGE "U" COHPUTATION
SITE ADDRESS: 7b; 111 '/"P Q ?S
CONTRA[TOR: Q?S''JDATE: - ? _PHONE:
DETERMINE 11CRKINC, SDUARE f00TAGE OF EACH:
: 1. TOTAL EXPOSED 41ALL AREA,,.,,,, , ?4fa,[) sq ft x"U" .11 . a(o?p,ao
2. TOTAL ROOF/CE I l 1 NG AREA, ., ? s 026
f t x
Z7 ?I
.
q . o
3.' TOTAL EXPOSED NALL AREA CALCUl AT10N5:
7ota1 exposed wall ,
erea abovr floor,,,,,,,, sq ft
t
a) Total wa11 wlndow area: /a 7
31 1
/
^7 `
qlazed...... sq ft x uVll .5 7c
,
-?,
glazed...... ? sq ft x uU41
b) Total door area ,,,,,,,,. 39 sq ft x"U" e 407
? a•'?3
c) Total sliding glass door area:
ii
gla2ed...... _ 174a. Sq ft x "Ull
_L=!
qlazed...... sq ft x"U"
d) Total flreplace wall area p?U Sq ft x"U" $?ydo,?
e) Total walt framing area 8? `•
(Averace 15%)......... .. ? sq ft x "U•" • ?? 3
f) Totai net wali area above
floor (tnsulated)....... 15a 6 sq ft x"U" n 0 1/?f ? 7. fLI
g) Tota1 rim Joist area....., asg sq ft x"U" O? ?= Q,
Total foundation iy?
area Exposed)........., 1sq ft
hj" To[al foundatlon
window area............. d sq ft x"U"
1) Total net foundatlon Q?
4hrea above grade........ 7 sq ft x"U"
3.
0
0 0
./q-/ - 3,s/
TOTAL a) thru 1) •?? a.0
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. if ttem 13 is the same as, or less than Item pl, you heve mat the (ntent of
2 MCAR 1.16008 A and 0. .
Page 1
,
.. . 3 .
.. . f .
GTAL EXPQSEQ RAOF/CEILINf CALGULATIONS:
Tqtal expnsed
roof/celling area........ sq ft
)) Tota1 skYliaht ? sq ft x"U" 0 ? O
area.......
3
k) Total roof/cetlinq framing
area (Averave 1nR),,..., (l sq ft x"u" . e0 3°z/ ? 3 3
1) 'Total net Insulated q
roof/ceillnq erea....... /??? sq ft x"U" ?Oa7 ? ?oZ•9?
?• TOTAL J) thru 1) G7, 3
If total of 04 Ts ttte same as, or less than F2, you have met the intent of
2 MCAIt 1.16008 A ead 0.
ALTERNATE BUILDING ENVELOPE DESIGN
T o u t l l t z e t h e t o t a l e nve lope system met h o d. the values established by the sum
of (tems 03 and N4 shail not be greater than the sum of items pl and x2.
o + z.
3. 0- p/ + a. ??. 33
s
L E R T i F 1 C A T 1 0 N
I hereby certlfy that I have calculated the "U" factors and "R"
values here(n and that the buildtnq here described ets or exceed the State
of Minnesota Enerpy f.onservatian Act.
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. Siq ture ?
(Date)
PaEe 2
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a X(O "'f 25/3a" SHT6, .
iNSTRUCTION
WALL AHING SEC7i0N:
Interior air fitm
/a" yp- ScA?eD
$?f 0, `I nthes so t wood
as/3au SHr6.
S iDlju ?
Exter(or a r film
WALl Sf•.CTiON (INSULATED)
-{1 interior etr film
2 n BO&ACP
? 3 " X _su t-.
---{5 _$ IDINCo
--{(+ Exterior alr film
?-R VALUE
A.f+a
TUTAL H ? /O.Sj
U ? {/R ? .093
n,FR
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co
a. Q!a
i n
70TAL R - a.
U - I/R ° •Dy/
(.1;
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0: "?• 'a
. , :a ,
, • a= _•,
- • • a.
: Q•?'• ?•
'4
RIM JDIST SECTIOtJ:
- '1 lnterior air film f1.6R
2 - j!;e 81.A,,,..,,1, . /9, Oo
(3 / T' u;t)pv /. 8 9
Is sH76 a. o(P
5 sioj,) C. •64
6 Exterlor air film n.17
70TAL R - ?.,ypZ
FOUNDATION INSULATION REQUIRED:
Min. R-5 on entire wall OR U- 1/R -
Min. R-10 down to frost depth
FOUNDATIOtI SELTION:
-?1 Interior air film n.hR
?2 ?o? ?COrvGRErE LLaC? I' ?r ??
--{3 srrQO• S.oo
--{4 ExCerlar a r Ilm 0,17
[S
TOTAL R ? 7e /3
U` 1/R?
SLAB ON GRADE
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,?;?.a;;v•,, ;,•.;
4 : <j .•, ° o? '. ,
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0
Heated Slabs:
Minimum R a 8:5
Unheated Slabs:
MinimumR=6.2
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a-a U Q? .?0 ':+`:
,"?,.,,???•o -'4 ct
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14
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4 .'• .,.
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.t? ?:•q? ? ??? ,?•???'
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Page 3
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CONSTRUCTION R VALUC
CEILINf SECTION (INSULATEO):
1 interior afr film 0.91
2 je YP A.D. ?5_"S
3 T?u su i. Do
4£xterlor a(r film still n.A1
TOTAI R w -WL$
U a 1/R - •OZ.`f
nIM
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CEILING FAAHIKf SECTION:
1 Interlar alr film f1.(,1
2 " P RD. .SS
3 axq TRaSS?G 2Ausul. 30.01
4 Interior atr film Tstill (). I
S
70TAL R
r
.
:A%
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CEIl.lNG SEf,TtOH (11lSULQTED :
1' tnterT'or air 1 m ?.F1
2
3
4 fxterior ai -f 1 till 57771
T0T/1L R Q
U 0 1/R a
VENTED
CEILINq FRAMItIG SECTION:
1• Interior air film n.Fl
3
4 Exter(or ai ri n, i
5 Inch s oft w od
O7AL R -
Uo 1/R?
1 inside affn•Fl
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3 4
5 Outsi,^? 1177
TOTAL R ? U - IIR 0
p -`7o
U a I/R p IO/2.
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` GUiOELiaF. 'i0 (R) ri,CTORS FROM ASHP.AE NAKUAL '
• ' ' ?r OF TYPICALLY USED PRODUCTS •
FlLMS
- - (R) SHERTHING
?
:Interior Air Film (41a1Is) 0.68 3/4" Wood Subfloor or Sheathing 0.94
Extet-ior Air Film (Walls) 0.17 112" Plyriood Sheathing 0.62
Interior Air Film (Vented Ceiling 0.61 112" Particle Board 0.66
Fxterior Air Fi1m (l,?ented Ceiling? 0.61 Gypsum or Plaster Board 3/8" 0.32
Interior A i r film (Non Vented) 0.67 Gypsum or Plaster doard 112" 0.45
Exterior Air Fitm (Non Vented) 0.17 Gypsum or Plaster Board 5/8" 0.56
. Plywood 3/8" 0.47
P1Ywood 112" 0.62
BLOWING WOOLS Plywood 3/4" 0.93
aporox. 3" 900 Sheathing, Reg. Oensity 112" 1.32
Approx. 4 112" 13
00 Sheathing, Reg. Density 25/32" 2.06
Approx. 6 1/4" .
19 00 Nail-Base Sheathing 112" 1.14
^.pprox. 7 1/4" 24.00
1lpprox, 14"
" 30•00 ROOFS
Approx. 1$ 40.00
All other insulation materials must Built-up Roofs
Asbestos-Cement
shingles 0.33
0.21
De verified (R Factor) .
Asphait Roil Roofing. 0.13
Asphalt Shingles 0.44
1N5ULfii ION
:nsulation: 2-2 3/4" Fiberglass 7,00 . SIDING
`nsulation: 3 1/2" Fiberglass
" 11.00 Aluminum Siding 0
61
:nsulation: 6
Fiberglass 79.00
Aluminum with dacker .
1
02
?nsulation: 3 5/8" Fibergless
" 13.00 Aluminum viith Backer PFoiled .
2
96
'nsulation: 9
Fiber9lass
'
" 30.00 112 x 8 Lap Siding (Wood) .
0.81
:nsulation: 12
Fiberglass
" 3f3.00 7/16 x 12 Hardboard Siding 0
67
'nsulation: 8
CeTlulose
:nsulation: 10" Cellulose 2?.Q?
37
00 asbestos Sidings 1/4 i.apped .
0.21
[nsulation: 12" Cellulose .
44.00 Stucco (arown and Finish Coat) ----
':nsulation: 1 112" Thermax 12.00
'nsulation: 2" Thermax 16.00 DOORS _(L
1 3/4" Sol id Core Ooor .46
-- w/Storm, Wood .31
i.r, Pir.e R Similar Soft Woods w/5torm. MetaT .26
1 11211 1,89 Pease Steel poor ]nsl/N/GL 7.45R .13
2 112" 3.12 5liding Glass Door. Wood .65
? 3 712" 4.35 Meta1 .72
5 1/2" 6.81
"ONCRETE BLOCK WINDnWS '
_ _- - ,
Concrete aiock (S b G Reg.) 1,11 All Windows
(Filled with Vermiculite) 1.93 (w/5torms 1" to A" Soace) .56
12" Concrete alock (5 & G Reg.) 1,28 Removal DoubTe Glazing (RUG)
" .55
hg
(Filled with Vermiculite) 3.15 Air Snace
_ 7hermo or Welded 3/16
" Air Space
1/4 .
.b5
:" Liqht We;J?ht 2.18 112" Air Space .58
(Filled with VermiculiLe)
" 5 . 03
(Other windows specifically tested
Light Weight
+2
(Filled with Veriiiiculite) z,?lii
5.82 can use better ratinqs)
PiPe 5
2006 RESIDENTIAL BUILDING rERMIT arrLicATioN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 4 651-675-5675 FAX # 651-675-5694
New Construdion Reauirements
3 registered sde surveys showing sq. ft. oi lot, sq. it of house; and all roofed areas
(20% maximum lot coverage allowed)
2 copies of plan showing beam & window sizes; poured found design, etc.
1 set of Energy Calculations
3 copies of Tree Preservation Plan'rf lot platted after711193
Rim Joist Detail Options selection sheet (buildings with 3 or less unifs)
Minnegasco mechanical ventilation form
Remodellftepair Reauirements
2 copies of plan showing footings, beams, joists
1 sel of Energy Calculations for healed additions
1 site survey ior addflions & decks
Adddion • indicate i(on-site sepfic sysfem
!?.W. v-v
Office Use Onlv
Ced of Survey Recd _ Y_ N
Tree Pres Plan Recd _Y _ N.
Tree Pres Required _Y _ N
On-siteSeptioSystem _Y _N
Date Construction Cost
Site Address ? ?,)?'? 1!•I r' I_?%J L? Unit/Ste #
Description of Work Vn)_?0??
?
Mu1ti-Family Bidg _ Y_ N Fireplace(s) _ D ? 1 _ 2
Property Owner
Contractor
Address
State
Fireside Hearth & Home
14399 Huntington Avenue
Savage, MN 55378
952.736.7761
License#20512060
Telephone #
D
City O,. V ?S
_ Telephone # ( ) 2 0 ?rn.,F ?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(q submission iype) Submiried Submitted
• Energy Envelope Calculalions Submitted
In the last 12 months, has the City of Eagan issued a permit for a simitar 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 Pennit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the app4App in the case of work which requires a review and
approval of plans. ;
Applicant's Printed Name ant' s Signature
l For € tJae '
j Permit
City of Eajan ;
Permit Fee: d i
3830 Pilot Knob Road 1 1
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 staff:
Fax: (651) 675-5694 1 1
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 5-- I 1-t' Site Address: 'yl 3r( L.-n- LCL yr
Tenant: Suite
RESIDENT/OWNER Name: /9f✓ ® 1"~g~ Phone: G57_41 S-'2 06 F7
Address / City / Zip: ql 3-q C I"
Applicant is: Owner P" Contractor
TYPE OF WORK Description of work:
Construction Cost: 7 Multi-Family Building: (Yes ! No _
CONTRACTOR Name: fOV tfi A5vh et107'W 6"J' i77 License* 403 _717994r
Address: 'yk/ d-04IKA 0-6c. 11,E
City: l`- r -4i State: AM Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
N submission type) a 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 Contractor: Phone:
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 the are trade secrets.
1 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 1 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.
xZfJ
Applicant's Printed Name Applicant's Signature
Page 1 of 3
Use BLUE or BLACK Ink
r I
I For Office Use
I ?
C' Permit o Z
Ity of Eajan 1 (00 00 1
I Permit Fee:
3830 Pilot Knob Road I
Eagan MN 55122 Date Received: I
I i
Phone: (651) 675-5675 RECEIVED I
Fax: (651) 675-5694 JAN 19 2012 ~ Staff:
2012 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: Z Site Address: / BCI LI:S( ~r r) b o
Tenant: Suite
Name Phone: &1r), -X76)
RESIDENT 1 OWNER I
7! 7 Z~~ LNG ' , /~»IV
Address / City / Zip: ~ Y
Name: License
CONTRACTOR Address: City:
State: Zip: Phone:
Contact: Email:
TYPE OF WORK - New _ Replacement _ Repair _ Rebuild Modify Space _ Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Water Softener
PERMIT TYPE Lawn Irrigation RPZ PVB)
Septic System Add Plumbing Fixtures CX Main Lower Level)
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $166.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
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.goi)herstateonecall.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 th approved plan in the case of work which requires a review and approval of plans.
x Y1
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
Use BLUE or BLACK Ink
r
For Office Use
Permit
City of Ea a- 4/ GeI Permit Fee: 1
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 RECEIVED I I
i
Fax: (651) 675-5694 i Staff. I 2_
JAN 19 2012 CaA v ,1
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: /71/ 7, Site Address: 7 f 3 ~ trl /V/J ~Unit M
Name: ~)Cl' 1 ~4-PcA 1' Phone: tO~Z~a~ ~D 3~
RESIDENT / rl
OWNER Address /City /Zip: MN
N
Applicant is: ~X_ Owner Contractor
Description of wor : yl k YIY I~
TYPE OF WORK
li>"tA. ~ anf TS
Construction Cost: Adw Multi-Family Building: (Yes / No )
? di'
Company:
Address: gl3'7" `
CONTRACTOR ~r' ~C
State: m Zip: a ____S
Phone: o~ Q CJ
icense Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
1604r
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 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 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.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 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
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation Fireplace _ Porch (3-Season) _ Storm Damage
Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
01 of Plex _ Lower Level _ Pool _ Miscellaneous
Accessory Building
WORK TYPES
New _ Interior Improvement _ Siding _ Demolish Building*
_ Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair Windows _ Demolish Foundation
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation ?Oaf Occupancy MCES System
Plan Review Code Edition av7 SAC Units
(25%_ 100°/a Zoning City Water
Census Code 31 Stories Booster Pump
# of Units / Square Feet PRV `
# of Buildings / Length Fire Sprinklers _
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas LinWAir Test
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
7* Framing Siding: `Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall: _ Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL FEE 3 3 (g ego 7G0 0-0'
Base Fee / y 7
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA168660
Date Issued:04/28/2021
Permit Category:ePermit
Site Address: 4134 Lantern Lane
Lot:19 Block: 4 Addition: Country Hollow
PID:10-18275-04-190
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Daniel T Plash
4134 Lantern Ln
Eagan MN 55123--160
All Craftsmen Exteriors Llc
1020 East 146th St
Ste 226
Burnsville MN 55337
(952) 898-4680
Applicant/Permitee: Signature Issued By: Signature