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3555 Lemieux CirMNcheck COMPLIANCE REPORT Minnesota Energy Code MNCheck Software Version 3.0 Permit # Checked by/Date COUNTY: Dakota STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 2-15-2005 DATE OF PLANS: 2-20-05 TITLE: DIFFLEY MODEL W/ FOV? PROJECT INFORMATION: LOT *3, BLK 1 PEARLMONT COMPANY INFORMATION: PEARLMONT HEIGHTS, INC. 7500 WEST 78TH ST. EDINA, MN 55439 COMPLIANCE: PASSES Required UA = 461 Your Home = 360 21.9% Better Than Code --------- ------ CEILINGS: Raised WALLS: Wood Fram? BSMT: Conc_ 9.0' BSMT: Conc. 4.5' GLAZING: Windows DOORS Cavity Cont. Glazinq/Door R-Value R-Value U-Value 38.0 0.0 19.0 6.0 5.0 0.0 5.0 0.0 0.320 0.350 UA 33 115 88 1 109 14 Area or Perimeter ---------------------------- Truss 1306 _, 16" O.C. 2445 ht/8.3' bg/8.3' insul 1052 ht/4.0' bg/4.0' insul 10 or poors, Above Grade 341 39 HVAC EQUIPMENT: Furnace, 92.0 AFUE COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet th quirement f the Minnesota Energy Code. r Builder/Designer , Date_T?_OCAV je,l14 .?`'?i/z-s/7 Address: 3555 Lemieux Cir Zip: 55122 Permit: 74461 THE FOLLOWING TTEMS WERE/WERE NOT COMPLETE AT FINAL INSPECTION ON : I2- ??L/ -* Yes No Comments Final grade - 6" from siding Permanent ste s - garage VII" Permanent steps - main entry Permanent driveway i/ Permanent gas Retaining Wall or 3:1 Maac Slope Sod/Seeded lawn Trail/curb dama e Porch Lower level finish Deck Fireplace • Verify with your builder that roof test caps from the plumbing system have been removed. • Tum off water supply to the outside lawn faucets before freeze potential exists. • Call the City's Engineering Depariment at 651-675-5646 prior to working in right-of-way or installing urigarion system V BUILDINC INSPECTOR: Lot _ Block _ Subd. , 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air Fventilation, was adopted. As a result, the City of Eagan is requiring that the foflowing information be submitted prior to issuance of a Certificate of Occupancy. _ This structure: is construcfed to meet minimum requirements of the Mn Energy Code, Chapter 7670 OR _ This structure: wili be constructed to meet more restrictive requirements of Chapters 7672 or 7674 APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE Water Heater Fumace oryer EXHAUST SYSTEM LOCATION TYPE MODEL CFM's VENTED ves tdo Kiichen kitchen ve ? Bathroom 1 Bathroom 2 ; 8athroom 3 Bathroom 4 Other j FIREPLACE S LOCATION GAS WOOD MANUFACTURER • MODEL BTU'S VENTING DIREC7 ATMas D GU 1Z, MAKE-UP AIR MODEL TYPE CFM's I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and Ciry of Eagan requirements. ? Signat Dat Company Name ` This form is the responsibility of the General Contractoc. , ?p 144[el 5OVi.9.01 pip qo.150 2006RESIDENTIAL BUILDINC?a PERMIT APPLICATION MP 'I`4%3 `70,50 City Of Eagan iEw 114101f ? 3830 Palot Knob Road, Eagan MN 55122 ? 'i'etephone # 651-675-5675 FAX # 651-675-5694 New Consiruclion ReauiremeMs RemodeUReoar fteauiremenis 3 regisWred sAe sLxveys showing sq ft d lot, sq_ ft. of house; and gfl roo{ed areas 2 copies of plen showing faatings, bearns, joisk (20% maximum lat coverage allowed) 1-7-a Dq,y, W, c.t ? t?t of Energy Cakulations tar fieated additiens 1/,2 copies oi plan showi? beam & windowsfzes; poured found desigi(etc. t sde surveyforaddd"nns 8 decks ?17 set oP Enetgy Calculations Addilion -indicate Aonsite septic sysfem 3 copies d Tree Presenratiaa Plan if lot piatted after 711193 R'un Joisl Detail Oplions setection sheet (buJdings with 3 or less unds) Minnegasco mechanical venrilation focm OfticeUseOnN C f S t R d v er o urvey ec Tree Pres Plan Recd Y N Y iLM? Tree Res Required _ Y !?'N Onsite Septic Syslem - _ Y_ N -' 1a5 u Date 0 °? ConstrucHon Cost ? IZZ? 000. ? Site Addresa 35,5 z-LL\-1(?.'uX Unit?fe ---_ - )?? ! ? nescripfionofwork t iaw co1% . (L-r ttJ HoY1EI ; J?rr MultrFamely Bldg _ YZ N Fireplace(s) _ 0 1 ? 2 + IV Properly Owner ft ',???,?"? «14?1'r H ? T45 L ?.,?.. Telephone # Contractor p0161 " Ar.k Address -is= Ciiy wvf" ` State ?? - Zip 8554.31 Telephone #A9Z) q41 . 50000 COMPLETE THIS AREA OHLY IP CONSTRUCTIN6 A NEW 6UELDING ? Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category • Residential VentiNation Ca (d submission typej [egory 1 Worksheet . New Energy Code Worksheet Submitted Submitted . Energy Envelope Calcufations Submitted in the las 12 months, has the City of Eagan issued a permit Por a similar pian based on a master 1 n? 404 Y _ N If yes, date and address of master plan: '? 20 0=-'?55 ??Ml'"e»VX G'? . ? Licensecf Piumber 1ffLA6bz12._ +IN(49. Telephone #"S?.) 445 . 4" 2 Mechanical Contractor %L&W120g.`L-jz;A4. Telephone # MgZJ 4'45 •4(04I2 Sewer/Water Contractor LAA1Lle Gd'Pn tj, Teiephone #(p51J 4'I2. . 2-3i &* rclZ 240 • &WZZv I hereby apply for a Rasidential Building Permit and acimowiedge that the information is complete and accurate; that the work will be in conformance with the ocdinances and codes of the City of Eagan and the State of MN Stahrtes; I understand this is not a permit, but only an application for a permit, and work is not to start without a pernut; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 1.4 _ 111^01t75^W.I1Q- 41? • ApplicanYs Printed Name Applicant's Sign e DO NOT WRITE BELOW THIS LINE 5ub Tvoes ? 09 Foundation ? 07 05-plex ? 13 76-plex ? 20 Pool ? 30 AccessoryBidg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 porch (3-sea,) ? 31 Ext qlt - Multi ?i., 03 01 of,I p{ex ? ? ? 09 07-plex ? 17 Garage ? 22 porch/Addn. (4-sea.) ? 33 Ext. Ak-SF o 04 02-p1ex ? 70 DB-plex ? 18 Deck ? 23 Porch (screeMgazebo) ? 36 Mutti Misc. ? OS 03-plex ? 11 10-plex ? 19 Lowertevel ? 24 StormDamage . ? 06 04-plex ? 12 72-plex ? 25 Miscellaneous Work Tvoes 31-1 39 New 0 35 Irrt ImprovemeM ? 38 Demolish Interior ? 44 Siding ? 32 Addition 0 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Afteration ? 37 Demolish 8uiiding* ? 43 Remof ? 46 WndowslDoors ? 34 Replacement 'Demoiition (Entire Bidg) - 6ive PCA handout to applicant DeSCrlptlon: Water Damage _ Yes Valuation ) 2? cQ ? Occupancy a`" MCES System Plan Review ` 100% or _ 25% Cerrsus Code ? Zoning City V1later SAC Units ? Stories Booster Pump # of Units Sq. Ft. pRV # of Bldgs F Length Fire Sprinklered Type of Const Wdth ? REQUIRED INSPECTIONS Footings (new bldg) Sheettvck _ Footings(deck) ? FinaUC.O. Footings (addition) FinallNo C.O. ?C Foundation FIVAC --d Drain Tile - pther Roof Ice & Water Final - Pool Ftgs Fra Air/Gas sts _ Final ? i°'?? Siding _ Stucco Lath Stone _Brick Fireplace 1[ R.I. ?'Air Test kFinal Windows Insulation T? T' Retainutg Wall ApProved By: Buifding Vnspector Base Fee '- Surcharge Plan Review MCfE55AC City SAC yf tf =- y71 Ublity Connection Charge ?/ SB?W Permit 8? Surcharge L.! = ?? ? x 0 8 (,7"2' Treatment Plant License Search ? Copies ? y -Yp &I Other ?G Panv?? l?? X s?Ll I/ Total OC70 0 /"lJ""` Certifica te of Survey for: R01Y CL4RK CONSTRUCTION & DESIGN LOT 3 AREA = 3,775 S.F. LOT 3 HOUSE ARSA = 1,408 S.F LOT COVERAGE = 37.3% BENCHMARK: TOP NUT OF HYDRANT 590 FEET +- 1fEST OF TfiE INTERSECTION OF FEDERAL DRIVE & VIOLET LANE. ELEVATION = 675.75 LOT 4 AREA = 3,800 S.F. HOUSE TYPE: LOT 4 HOUSE AREA = 1,408 S.F. PROPOSED 1 LOT COVERAGE = 37.1% GAR. FLOOR LOT 3 886.6 3: 1 Maxir -tum Slopes LOT 4 888.5 or Rv'-ais+lng Wall VdiN Sa Fiequired VACANT ? - - - J \ \ ? ? ALL OF LOT 29 IS A DRA/NAGE \ & UTILITY EASEMENT ? \ ? ., .. \ iNsTA??.? osaoN NiiET CP*-.,SOD -RIGHT OF ? r \ ?T 83.f1 ? x B84.8/ 885.03 ? F "0 ` W'?' LIIVE a84.60 x 8BA54 Z ? SER oC8 4 0 u IN`?R? r PRoPoWAD DR?? .... .,;. _ . X 886.05 ?-- BENCH MARK ? ELEV.=885.71 ? as5.os 1 ? I ? I ? i 1-7 xasa.s5 p0 ? N70@26r10o SWA?E ° ~ t 885.55 3 ^ / EG E55 0, L~ ?? ? N rn sss.as.X.. V ? 61 1l? /' / 2S•? _s2 i \ i? 882.66 ? 0 \ ?? ? , ,- ? / / I m I U ? Qo -\ ? W ? By EAGAN _ 35.50 ? r'I' N 9.1% pSED r e? , PDR ? ? 1v i I ? I \ r I 1-SfRVICE 97 I INVERT=874.0 I I I ? I Dam DESCR/PT/ON: Lots 3& 4, Block 1, PEARLMONT HEIGHTS, Dakota County, Minnesota. 11 77 i ? i- ? 2 ? 889.72 ? J wo ?o ? m lT1 -, W2? 92-j p?3 m? SCALE.• 1 /NCH = 20 FEET DATE: 7/07/06 BK/PG: NONE DRAWN BY: 8RK CHECKED BY: RMM REVISIONS I hereby certify that this Survey was prepared by me or under my direct supervision and that I am a duly Licensed Land Surveyor under the laws of the State of Minnesota. Signed: 4m?g Ranly M. Morton Date: 7/07/06 Lic. No. 21401 TIPO STORY DIFFLEY iOUSE ELEVATIONS: TOB BASEMEIVT FLOOR 886.9 878.2 886.9 878.2 @2006 John 0/iver & Associates, Inc. x 9329o Denotes Egisting Elevation (932.90) Denotea Propoaed Elevation aO Denotes Surface Drainage p Denotea iron pipe aet. • Denotea iron pipe found. Addrees of Lot 3 is 3555 Lemieux Circle Address of Lot 4 is 3557 Lemieug Circle ? ? ? xe8soe .: ? VqCANT / / pECK X(aB es )1o a'01 LL 15 'XLO? ? Ap(iN? _ An / for TOw'"' ? ?- --' ` L , 1^E , ?2•33 N70?261 LA 55•0? ee5.12 864.5( OSE?as.r 20 0.3 N? x i po?HOME /,..s. /// ed4 41 J?O ? w 6 ' . 1 ( 2) 6i ?864.62 `SaR?55 ?L? . /4 q I _.n•76??7 ? $S•Z ? BENCH MARK ELEV.=884.57 X BB3 65 x 883.23 - - - - John Oliver & Associates, lnc. ci„u saWcnse,;ng. Zana sua„eyi+g. aana ria+ua•nA 580 .l)odge dveraue .Elk River. Mmnnesota 55380 (763)441-2072 (FAX)44f-5665 20f W. Travelera Tr¢dl, Sutite 200 Bur»sville, Mtinnesota 66337 (952)894-3045 (FAX)894-3049 DRAWING FILE: I FILE N0. L3-4B1_DWG 1601.10-107 ....?. ? ?i- ? ?•?#` „W gn'n0 0o xaaeaa JUL-24-2006 08:30 RON CLARK CONSTRUCTION pate: 712012006 Revisfon Date: 712Q12006 Sft lgrarnuoqn Address 1: 3555 Lemieux Circle Address 2; Clty: Eagan County: 11oplicatlar) Infornmtion Business Name: Elander Mechanical lnc. Contad Person: Todd N6W r.QRWuCH0[I Projed #: ; Lot Biock: Subdh?[sion: MN Contractw License #: Office Ph: 552-445-4692 Fax: 952445-7467 Ce{I Ph: Address 1: 591 C'dation Drive City: Shalwpee State: Minnw*ota ZiR Code: 55379 9529473030 P.08i08 Houm Ddeils 5quare Feek 18d8 sq_ ft. AVg. Ceiling Hr 9 R. Nurnber of Ssdrootns: 3 Vetd Iatloe.? ? Baisttmed Total Ventilation Capacity : 73 dm. Wnimum Continuous Ventildon :60c4m. lrttermittertt Vsr1Gt2Alon: 13 c4m. CombMon Auol nce Water Heater. NA FumacelBaler. Direat VenVSealed Combusfion Input 9TUs: 70,000 fndepsndentlY Wentgd CthK Combustion Anol ances Gas Fired Direct Vent Firepface(s): Yes aas Fred pawe? Vent Freplaoe(s): Pla Gas Flred Natural praft Freplace(9): No Sofd Fuel Appliance(s); No ExhAUSEbuipment Conflnuaus Exhaust Ventilatlon Capacity (cfm): NA ClaRhes Dryer icfm?: 135 ExAaust Fan flatlng (cfm): 300 M n Air Tatal hAake-tJp Air Required (cfm): 98 passive Make-Up, Round Rigid: 5 inches or Insulated Flex: 6 trtches Combustlm Alr Minimum Canbustion Air Requiremerft Have Beert Mat. Applicant Name (print)• 1•IA ID "Aa11K SignaturelDate 4 '77•Zij'oG Code Official (print): SignaturelDBte: 0 3004 Cmtaftiat E[msy Wnmegum. 2004 Mcdsanitxl Cndc CwidcfSoes. pw1 TOTRL P.08 •'~ • LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDlNG PERM(T APPLICATION PROPERIY LEGAL: ko4 30?BIoL' k- I f2ovflrn3v? 964i4S DATE OF SURVEY: '7/7, LATEST REVISION: m ? c R t U o `z ? a DOCUMENT STANDARDS ? ? . Registered Land 5urveyor signature and company ? 0 ? • Building Permit Applicant ? ? ? • Legal description ? ? 0 • Address g ? ? • North arrow and scale El O • House type (rambler, walkout, split wlo, split entry, lookout, etc.) 0 0 • Directional drainage aROws with slope/gradient % ? ? • Proposedlexisting sewer and water services & invert elevation ? ? • Street name ,F ? ? • Driveway (grade & width - in R/W and back of curb, 22' max.) 0 0 0 • Lot Square Footage .0' ? 0 • Lot Coverage ELEVATIONS Existina ? ? o • Property comers „ff ?? • Top of curb at the driveway and property line extensions ,,H ?? • Elevations of any existing adjacent homes fd' L3 ? • Adequate footing depth of structures due to adjacent utility trenches ? _/ ? • Watervvays (pond, stream, etc.) Prooosed 'm ? ? • Garage floor p' ? ? • Basement floor ? ? D • Lowest exposed elevation (walkouf/window) D ? • Property corners ,B 0 ? • Front and rear of home at the foundation PONDING AREA (if appficable) ? J? ? • Easement line ? ? • NWL 0 D • HWL ? p 0 • Pond # designation ? ?PI 0 • Emergency Overflow Elevation 0 ,g ? • PondNVetland buffer delineation Y . Shoreland Zoning Overlay District Y (? • Conservation Easements DIMENSIONS g p ? • Lot Iines/Bearings & dimensions ? ? ? • Right-of-way and street width (to back of curb) ? 0 0 • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. , (i.e. all structures requiring permanent footings) g 0 ? • Show all easements of record and any City utilities within those easements ? ? • Setbacks of proposed structure and si d setback of adjacent existing structures ? ? • Retaining wall requirements: Date ? d¢ 6 d B R i ewe y: ev G:/FORMS/Bui lding Permit Application Rev. 11-26-04 Certit'ica te of Survey for: RON CLARK CONSTRUCTION & DESIGN (D 2006 John Oliver & Associates, Inc. BENCHMARK: TOP NUT OF HYDRANT 590 LOT S AREA = 3,775 S.F. FEET +- WEST OF THE IlVTERSECTION x 932.9o Denotes Eristing Elevation LOT S HOUSE AREA = 1,408 S.F. OF FEDERAL DRIVE & VIOLET LANE. g?ATION = 875.75 (932.90) Denotea Proposed Elevation LOT COVERAGE = 37.3?6 1&0 Denotes Surface Drainage p Denotes iron pipe set. LOT 4 AREA = 5,800 S.F. HOUSE TYPE: T1f0 STORY DIF'FLEY ? Denotes iron pipe found. LOT 4 HOUSE ARSA = 1,408 S.F. PROPOSED HOUSE ELEVATIONS: LOT COVERAGE = 37.1% GAR. FLOOR TOB BASEMENT FLOOR Address of Lot 3 is 3555 Lemieuz Circle LOT 3 888.5 688.9 878.2 3:9 Mm191fium SIOPU LOT 4 886.5 886.9 878.2 Addreas of Lot 4 is 3557 Lemieuz Circle or Reia9ning1 lfVSBU WO Be Requieed ,;. ._ , \ V ' I I ACANT xeasoe xea6.o5 r i / ?-- BENCH MARK I I / ELEV =885 71 . . VACANT sas oe . I XB8A65 / QD 1 ? 6'1'? 0 % SWA?E t ? I ALL OF LOT 29 /S A DRA/NAGE 702 r ? ,m _Z) 55 8S6 ? & UTILlTY EASEMENT ? N es5 . 0 X? 33 ? xeas. to ,?, ? \ \ E? E55 10. 86.2) w r \ ?8 20.3 ° ? y ¢ \ .' x aas.8r 8W850.3 15 0.3 8s4 48 • IN W?NfR ?? e89 72 ? : o, ,x . w/ ?50 oT a , , 5 , t _ Qad r???oos? ? ; ? ? -W ? , ,7 - o c ? f n ? p ?-R/GH7 OF WAY UN£ Ln I 6•2) sO' h Ro NpM u DECK 100,00?.17 / w rn Ne\ r e84 6 o I W ? 67 t?? . ? ? T X eaa.Z \ E E? `4C ' 6 oww ? ? n sn ? S 0 2 ? 5 R1as?4• ?c ? pR0 RAGE 114 7V ? . DE? I ? ? ? ?, o 55•0? e85.12 ?Xs? o ? i I . f E Ep w p.3 N m g, o S S ? . Po?NNOME? 2 ? P Rj?PIEWAY \ ' p P OPpSED ?? to 50 AGE s 884 \ e9 5 G ? 3 . ? I . ? o p,R -f. aezss , 3 e 28.3 ? ? N w m ?D? w 0 67 9j% . SE? r N sz ?a$ 866- 56%'as4 PR WAY . Ess ? ( ?/E 2 a'25 ?BE DR 8e 3 75 4 E?R C p? a 1 . . N H MARK 92? I 1 7 ELEV ? 1' =884 57 ? . . I 6 xBB.?65 Co W I 1 _? 88213 S?OXB8.3.23 ' ? T K 1 ae2.79 . .sa s _ - - - 4 .r 12• D0pW ;; t 00? x884.4s Be.Z77 I -SERNCE N9O I I ? U J f.9Jh t : ? ?c m ¢ ? ? ExrsnNc I 2 x? i? ? I I TOWNHOME ye ? Wm J pz I ? W yz? I F- ---- I 'W J I I ExrsnNC ' , I I TOWNHOME 50 -- -- I I ? ? ? I TF VE B y I ? Da,e 77/2-4-Za? EA?AN ENGnvEERuvc DEFIa; DESCR/P 770N: Lots 3& 4, Block 1, PEARLMONT HEIGHTS, Dakota County, Minnesota. SCALE.* 1 /NCH = 20 FEET DATE: 7/07/06 I hereby certify that this Survey was John Oliver & Associates, lnC. BK/PG: NONE prepared by me or under my direct cc,,as,g;,wer„e, Lana s,a„evow, Lana PkwosM DRAWN BY: BRK supervision and that I am a duly CHECKED BY: RMM Licensed Land Surveyor under the 580 nodye Aver+aae Ett g.;,,,er, M;nneaota, 55330 laws of the State of Minnesota. (783)441-2072 (FAX)441-5665 REVISIONS: 201 W Travedera Trai4 Suite 200 . Burnavible, Minneaota 55337 Signed: ? (962)894-3046 (FAX)894-3049 Ra M. Morton DRAWING FILE: FILE N0. Date: 7/07/06 Lic. No. 21401 L3-4B1.DWG 1601.10-107 Use BLUE or BLACK Ink I i For 'co Uri 4 Ciq of Ealan I P I Permit Fee: L ~ ✓ • , 3830 Pilot Knob Road Eagan MN 55122 I Date Received: 01 Phone: (651) 675-5675 I Staff l r~ 1 Fax: (651) 675-5694 1 1 ----------------J 2013 RESIDENTIAL BUILDING PERMIT APPLICATION 7 Date: \ Site Address: SJ - -3 7 e X C' C Unit # Name: enqZC 1!k qL Nc j v,,. oa..ncs i J Phone: SL-.9I t 7 ' 3t~ Resident/ Owner Address / City Zip: Applicant is: Owner Contractor of Work r Description of work: fLa- Q C 6 - - 1A /few A r,-- Type y Construction -Cosst Multi-Family Building: (Yes ! No Company 1 ]D?, 7-14QFT JJ G d+1 - Contact: Address: J I Z o 0 b l v d Al, City: La k e_ ~ t ,xo ~ Contractor State: 0 Zip: J J2> Phone: (D S _777-1,31"A 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 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. s CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Cali 48 hours before you intend to dig to receive locates of underground utilities. w ww_gopherstateonecall.ores 1 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 authored by a building permit issued in accordance with the Minnesota state Building Code must be completed within 180 days of permit issuance- x_ ,f&,~ v, SA-ra k k: r,,-L- x Applicant's Printed Name Applicant's Signature Page 1 of 3 days of permit issuance- - t X X ~Q a SAC` r'b 1r~ k r c~ Applicants Signature page 1 of 3 Applicant's Printed Name PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA179224 Date Issued:09/26/2022 Permit Category:ePermit Site Address: 3555 Lemieux Cir Lot:3 Block: 01 Addition: Pearlmont Heights PID:10-56950-01-030 Use: Description: Sub Type:Water Heater & Water Softener Work Type:Replace Description:Standard Water Heater & Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after started. 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 - Ann C Stegmaier 3555 Lemieux Cir Eagan MN 55122 Haferman Water Conditioning Inc 12142 12th Ave. Burnsville MN 55337 (952) 894-4040 Applicant/Permitee: Signature Issued By: Signature