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3559 Lemieux Cir June 14, 2010 Building Inspections City of Eagan 3830 Pilot Knob Road Eagan, MN 55122-1897 Dear Building Inspection, We are finishing the Spec. home at 3559 Lemieux Circle in Pearlmont Heights. We will be finishing this as a model. This unit is complete through mechanical rough-ins and the party walls and main floor ceilings have been drywalled. I have included two copies of the plan. We will be fishing this plan per the original submitted plan. The main floor and upper level will be finished. The lower level will remain unfinished. Thank you, Scott Holt f 6t~ 0 2007RESIDENTTAL BITILDING rExNnT ArrLIcATTOx City Of Eagan 3830 Pil b NIN 55122 ?E746 5j56 qo,so ??-- 74,5?,-7 qQ. 50 ot Kno Road, Eagan Telephone # 651-675-5675 FAX # 651-675-5694 ? F? ,?Ess? y E ew Can tr i? R, iremeMs RemodeVFteoav Reauirements Difice Use Oniv ? regdered sAe sieveys showing sq. ft. ot lot, sq. ft. M frouse; and all roofed areas 2 copies of plan showing foolirgs, beams, joisis CeR ot Survey Recd (20% mu6num lot covaage allovvo 1 set of Energy Calculations fa heated adcftrs Soils Repat 1 Soils Report rf proposed 6uildmg is fo be placed on disturhed soil 1 sde siavey for addifians & decks Tree Res Plan Recd copies of plan showing 6eam & windau sizes: poiaed found design, etc. Addi6on - indicele Aonsite septic sysfem Tree Pres Required ? set of Energy Calculations On-site Sepfic Sys9en copies a( Trce Preserralion Pfan'rf bt platted aRer 711193 + m Joist Detail Options selection sheel (buildings vAth 3 a less unds) Minnegasco mecheniql verdiiatian tam y 1!Y _N Y ZN _Y !A. Y ? _Y N Date 0/ l D.'r>' 10-7 Construction Cost sire aaaress 355 ?2 ?I ? uniuste # .A ? )C L G?i nl? 1 }?fGl??+?' ? Description of Work !YEVJ Malti-Family Bldg _ Y --,N Fireplace(s) _ 0 --'l _ 2 Property Owner Pe-/4$C., P4O P4T ?t'TS 1-6:7 Telephone # (9 ?j 2 ) Tz{/ • VO? Contrector 96 Al 0GA -Jf-? OOnl?.??-UC-7Zv^[ ? ?EsCG? ?/ Address -7 9? W. ? 8??r city f4-A- 5tate MA Zip 5CBF-45 Telephone#(WZ) 9q7• 3=xMiC?- COMPLETE THfS AREA ONLY IF CONSTRUCTING A NEW BUILDING -!e?Mirmesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Cabegory 1 VYorksheet • New Energy Code Worksheet (4 submmsio^ type) Submitted Subrttitted . Energy Ernelope Calculations Submitted In the last 12 months, hqs-Me City of Eagan issued a permii for a similar plan based on a master plan? _ Y L-?'N If yes, date and address of master plan: Licensed Plumber eLA'f4DEr- MRGq Telephone #(952) *`fS' MechanicalContractor E4,sl.n40Le-- I4TEG? Telephone#(% 2) el#5•`fC-9L Sewer/Water Contractor 6,4A(G4= C'epPcni Telephone #(IW72) 47Z - 2314 I hereby apply for a Residential Building Permit and aclrnowledge that the information is complete and accuraie; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I undeistand this is not a permit, but only an application for a pernrit, and work is not to start without a permit; that ihe work will be in accordance with the approved plan in the case of work wluch requires a review and approval of plans, [E C fll?7 Z4, . o ? ,0 Applicant's Printed Name ? pp ic t's Signature ,1 A N 0 y Z 0 U 1 C?4' DO NOT WRITE BELOW THIS LINE Sub 7ypes 0 01 Foundation 0 07 05-plex O 13 16-piex fl 20 Pool CS 30 AccessoryBktg O 02 SF Dwelling ? 0$ 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Fatt. AR - Mufti 03 01of?_piex ? 09 07-plex d 17 Garage ? 22 Porch/Addn.(MSea.) ? 33 ExtAlt-SF ? 04 02-plex ? 10 08-plex 0 18 Dedc ? 23 Porch (scteenlgazebo/pergola) ? 36 Mufti Misc. ? 05 O:i-plex ? 11 10-plex ? 19 Lower Level ? 24 $tprm Damage ? 06 04-plex 0 12 12-plex ? 25 Miscellaneous Work T s 31 New ? 35 Irrt Improvement 0 38 Demolish Interior ? 44 Sidirng ? 32 Add'Rion [] 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair 0 33 Alteration 0 37 Demolish Building* ? 43 Reroof ? 46 WindowslDoors ? 34 ReplaCement *Dem0lit{an (£vMire Btdg) - Give PCA handout to appikant D@SCriqti011: Wabr Damaga _____ Yes Valuation Occupancy MCESSystem Plan Review ? 100% or -425% Census Code Zoning ? City Water SAC Units Stories Booster Pump # of Units ? Sq. Ft PRV # of Bldgs ? Length r ? Fire Sprinklered Type af Const Width ?l Footmgs (new bldg) _ Footings (deck) Footings (addition) ?C Foundation ? Drain Tite Roof Ice&Water Finsl ? Frmning? ?c Fireplace ?/ R.I. ? Air Test y Final ? Insulation ? ? ?? REQUIRED INSPECTIQNS ?C Sheeaock Final/C.O. ? Final/No C.O. HVAC Other Pool Ftgs AidGas Tests Final ` Siding _ Stucco Lath ? Stone Lath _Brick ? Windows _ Retaining Wall Approved By: , Building Inspector Base Fee Surcharge Plan Review nncIEs sac City SAC Ufility Connection Charge 5&W Pertnit & Surcharge Treatrnent Plant License Search Copies Other Total , s_?D ?r ?- r poq? 7, aS' - ? ? dvl? s? 000 oo ? . ? E???! ? ---?----- 3 a I ?;. . . REScheck Software Version 4.0.0 Compliance Certificate Project Title: Pearimont Heights LLC (Diffley) Report Date: 01/05l07 Data filename: S:1CADIRCC\EAt;AN-2\PLAN-COMB0ILOT 5-6 BLK 11RESchedc\3559 Lemieux Cir.rclc Energy Code: Localian: ConsUuction Type: Glazing Area Peroentage: Climate Zone: Construction Site: 35591emieux Cir Eagan, MN OwnedAgent: Pearlmont Helghts LLC 7500 W. 78?h St. Edina, MN 55439 952-947-3000 Ceiling 1: Raised or Energy Truss: Wall 1: Wood Frame, 16" o.c_- Window 1: Above-Grade:Vinyl Frame:Dou61e Pane with Low-E: Door 1: Glass: Basement Wall 1: SaRd Cancreie or Masonry: Wall height: 9.0' Depth below grade: 8.3' fnsulation depth: 8.3' 8asement Wall 2: Solid Concrete a Masonry: Wall height: 4.5' Depth below grade: 4.0' Insulation depth: 4.0' Fumace 1: Forced Hot Air. 92 AFUE Air Conditioner 1: Electric Central Air: 13 SEER Designer/Cantractor. Ron Clark Construction & Design 7500 W 78 th SL Edina, MN 55439 952-947-3000 1306 38.0 2445 19.0 341 39 1052 5.0 70 5.0 0.0 33 6.0 97 0.320 109 0.350 14 0.0 SS 0.0 1 Compliance SYatement: The proposed building design described here is consisient with the building plans, specifications, and other calculations submilted wlth the permit application. The proposed building has been designad to meet the 2000 MinnesoW Energy Code requirements in RESchack Version 4.0.0 and to comply with the mandato requiremenis I ted in the RESchedc Inspection Chedclisi. I lq 0-7 Name - Tdle nature Date 2000 Mlnnesota Energy Code Dakota County, Mlnnesota SIngla Famlly 16% 2 Compliance: Passes Adaximum UA: 410 Your Home UA: 339 --> 17.3%o Better Than Code (UA) LO.T-SURVEY CHECKLIST FOR RESIDENTIAL • BUILDING PERMIT APPLICATION PROPERTY LEGAL' {.z4 S?? b? ?ge k??J'rrl t?-? fJf.?ll'I 7S DATE OF SURVEY: -7 LATEST REVISION m ? c ea t U ? O z ¢ DOCUMENT STANDARDS ? ? • Registered Land Surveyor signature and company ? ? • Building PermitApplicant ? ? . Legal description ?r ' ? ? • Address ? ? ? . North arrow and scale ? ? • House type (rambler, walkout, spiit w/o, split entry, lookouf, etc.) 'H ? ? • Directional drainage arrows with slope/gradient % )? ? ? • Proposed/existing sewer and water services & invert elevation '.2 c ? • Street name ,z ? ? • Driveway (grade 8 width - in RNV and back of curb, 22' max.) '0 ? O • Lot Square Footage X ? 0 • Lot Coverage ELEVATIONS Existinp "H ? ? • Property comers X ? o • Top of curb at the driveway and property line extensions ,13 ? D • Elevations of any existing adjacent homes ? ? • Adequate footing depth of structures due to adjacent utility trenches ?X ? ? • Watenvays (pond, stream, etc.) Proposed ,P1 ? ? • Garage floor 'z ? ? • Basement floor ,2( ? ? • Lowest exposed elevation (walkouUwindow) ? ? ? • Property corners ? ? ? • Front and rear of home at the foundation PONDING AREA (if applicable) 0 ?d ? • Easement line ? ? ? • NWL O ? ? • HWL ? '0 ? • Pond # designation ? ,6 ? • Emergency OverFlow Elevation ? ? • Pond/Wetland buffer delineation Y ? • Shoreland Zoning Overlay District Y • Conservation Easements DIMENSIONS 'z ? ? • Lot lines/Bearings & dimensions '? ? ? . Right-of-way and street width (to back of curb) r? ? ? . Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. all structures requiring permanent footings) )@' ? ? • Show all easements of record and any City utilities within those easements fC ? ? • Setbacks of proposed structure and sid d setback of adjacent existing structures j? ? ? . Retaining wali requirements: Reviewed By: G:/FO RMS/Bui lding Permit Application Rev. 11-26-04 Certificate of Survey for: RON CLARK CONSTRUCTION & DESIGN ? 2007 John Oliver & Associates, lnc. BENCHMARK: TOP NUT OF HYDRANT 590 FEET +- WEST OF THE INTERSECTION x 932.90 Denotes Existing Elevation LOT 5 AREA = 3,769 S.F. OF FEDEAAL DRIVE & VIOLET LANE. LOT 5 HOUSS AREA = 1,408 S.F. SLEVATION = 875.75 (932.90) Denotea Propoaed Elevation LOT COVERAGE = 37.4% r Denotes Surface Drainage O Denotes iTOn pipe set. LOT 6 AREA = 3,800 S.F. HOUSE TYPE: TWO STORY DIFFLEY • Denotes iron pipe found. LOT B HOUSE AREA = 1,408 S.F. PROPOSED HOUSE ELEVATIONS: LOT COVERAGE = 37.1% GAR. FLOOR TOB BASEMENT FLOOR Addreas of Lot 5 ia 3559 Lemieug Circle LOT S 887.5 887.9 879.2 LOT 6 887.5 867.9 879.2 Addreas of Lot 6 fa 3561 Lemieus Circle T ? ?-BOULDER 895.7 / R£TAlNING µ+s 894.5 1 WALL 894.71 11 e• / tA 3:1 V NlYnLUPPI VlO V • ? 8939 ?_ • f ii13g WalA VVill 892.5 C'Y 892.8 `????? es2.s , ssza ALL OF LOT 29 /S A DRAlNAGE & UALITY EASEMENT BENCH MARK--, •x 8.92.8 ELEV.=887.83 ? O. ta? . J. F p0 eso.s x' xaszs I r7 ? I P?I .ft ( \ P 3 ?.. ? i` tK 885.29 , ?.• . ?(?'' ( VACANT ? ?J ? ? 1 ? ? ?' J x B8s.9s '? ? ,?? ?SS J. 1 ? ; ; ? ! ; ; 1 • 5 xss2 s 1 X 889 1ry I 3 ' G?? ? (? 8e760 . Lj??o`'?.?,;; ; j ? ? I I h ??g?q? Q?oe?? e85.3e ?tib BouGD£R ?I ?V s p? ?? - - - • - fF?? w ? ? !? > , ; ! 0 ? ? ? 0? ?\ ? RETA/NlNG ? ??t?l d 6dO ? WALL ' ? ? ., I?1 ;1N1 xes 6.01 f i + % \ x i;88a2 ?-BENCH MARK =885 ELEV 62 o . . 885.40, ,?0• e` ry ? ? p GF,3 i Gj. j 1. ' 1 ; ry Oj• xaa5.97 i ? ? 9ss. , x i 886.05 xses.oe x esa P ! I ; . 865.21 r 30 5 ? . 4 .0 `'?. ,!O 0 ?.5 ? g r ?1. y ry,?1 ? 6 Z ? Ses.4a ALL OF LOT 29 IS ORA/NAGE 61 & UALIrY EASEMEN ?u?., ? ?'o? ! ; p• (?106/ ? \ •••, Py o JC 884.65 ? 886.6 ? SERVlC£ - - ? x 885.80 lNVERT=875.5 G 0 ? a { \ ? ?n x P a1 ?Q ?- R/GHT OF WAY UNE 90 '2? 6 ? S O• G ? ' ,? ?y c; h i Q x ees. ts i; 1 EX? NpME? ?, /? 4p / ? o \ • % f r'• ' ' \ o ' \\ y i ? ? / s f / ,(0 `i ?' r` { .? / 1 T I 883.11 Il g4Qd? ? ?? c?J IIV / -SERNCE ` ,??? ??,???•',1,? ? /E ?oME r1 ,?/f? fi 1NVERT=875 5 > > f % ? / ?' . ?? ?? //. f, 'j • ? .; f tO `'?? ? ? BB ---LEM/EUX ,, CIRCLE ? ?W E? i By ' Date 7 DESCR/PAON: Lots 5& 6, Block 1, PEARLMONT HEIGHTS, Dakota County, Minnesota. SCALE't 1 /NCH = 20 FEET ' DATE: 1/02/07 I hereby certify that this Survey was John Oliver & Assoeiates, IIIC. ' BK/PG: NONE prepared by me or under my direct owa a.rfm..+w, Z4=a Swv.yrW. La,s Pftnlww DRAWN BY: BRK supervision and that I am a duly 58-9 DUdge k"•JB7!et.2 I CHECKED BY: RMM Licensed Land Surveyor under the Erk- Rr,ver, fji?mwsoto, j.sssv t "° 7 ' laws of the State of Minneso a. ( 163)44 r. 2072 !:,PAX;?4-; g-5e=s; REVISIONS: ? 1 ? ?YOI lI. 74+eavea 7ti'ail. 3Yr,{te 800 ? m l ?? Minwootm ?sa ? (s Si 9ned : %V t9 s ? sx , Ran M. Morton DRAWING FlLE: E N0. L I L : Date: 1/02/07 Lic. No. 21401 L5-681.DWG 01. 10-110 LOT SURVEY CHECKLIST FOR RESIDENTIAL ;_ .. BUILDING PERMIT APPLICATION , PROPERTY LEGAL: ?O4 S & ? ? .? ? I ?J??'I fln^I' Yt?i6??S DATE OF SURVEY: /?ZId-7 LATEST REVISION: m rn c ? r U ? Q O z ? Q DOCUMENT STANDARDS rY ? ? • Registered Land Surveyor signature and company ? 0 ? • Building Permit Applicant p ? . Legal description 0 0 • Address ? ? ? • North arrow and scale z ? p • House type (rambler, walkout, split wlo, split entry, lookout, etc.) ' 10 ? 0 • Directional drainage arrows with slope/gradient % ,9' D ? • Proposed/existing sewer and water services & invert elevation 'R 0 0 • Street name ,g ? ? • Driveway (grade & w(idth - in R/W and back of curb, 22' max.) ? ? ? • Lot Square Footage ? ? ? • Lot Coverage ELEVATIONS Existin ? ? 0 • Property comers ? ? • Top of curb at the driveway and property line extensions ?13 ? ?. • Elevations of any existing adjacent homes ?X ? ? • Adequate footing depth of structures due fo adjacent utility trenches ? ? • Waterways (pond, stream, etc.) Proaosed ,Pl ? ? • Garage floor 'z ? ? • Basement floor .0 ? ? • Lowest exposed elevation (walkouUwindow) g ? ? • Property corners ' '0 ? ? . Front and rear of home at the foundation PONDING AREA (if applicable) ? jg ? • Easement line ? ?1 ? • NWL ? ? ? • HWL ? J0 ? • Pond # designation ? f ? • Emergency Overflow Elevation ? f,Z q • Pond/V1letland buffer delineation Y . Shoreland Zoning OVerVay District . Y U • Conservation Easements DIMENSIONS ,g ? ? • Lot lines(Bearings & dimensions 'g ? ? • Right-of-way and street width (to back of curb) ?e ? ? . Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. all structures requiring permanent footings) '0 ? ? • Show all easements of record and any City utilities within those easements ? ? ? • Setbacks of proposed structure and sid d setback of adjacent existing structures ? ? ? • Retaining wall requirements: Reviewed By: ? .? Date G:/FORMS/Bui lding Permit Application Rev. 71-26-04 . . CJREScheck Software Version 4.0.0 Compliance Certificate Project Titie: PeaHmont Heights LLC (Diffiey) Report Date: 01/05107 Data filename: S:\CAD\RCCiEAGAN-21PLAN-COMBO%LOT 5-6 BLK 1lRESchedd3561 Lemieux Cicrck Energy Cade: Location: ConsWctbn Type: Glazing Area Percenfage: Climate Zone: Construction Site: 3561 Lemieux Cir Eagan, MN Owner/Agent: Pearlmont Heights LLC 7500 W. 78th St Ed'ma, MN 55939 952-947-3000 Ceiling 1: Raised or Energy Truss: Wall 1: Woad Frame, 16" o.c.: Wrxlow 1: Above-Grade:Vinyl Frame:Douhle Pane with Low-E: Door 1: Giass_ Basement Wall 1: Solid Concrefe w Masanry: Wgll height: 9.0' Depth below grade: 8.3' Insulation deplh: 8.3' Basement Wa112: Solid Concrete or Masonry: Wall heighi: 4.5' Depth below grade: 4.0' InsutaGon depth: 4.0' Fumace 1: Forced fiot Air. 82 AFUE Air CondiEioner 1: Electric Central Air: 13 SEER DesignerlContractor: Ron Clark Consiruction & Design 7500 W 78 th SL Edina, MN 55439 952-9473000 1306 38.0 0.0 33 2445 19.0 6.0 97 341 0.320 109 39 0.350 14 1052 5.0 0.0 85 10 5.0 0.0 1 Complience SYafement: The proposed buikling design desaibed here is consistent with the building plans, specificetions, and oiher qlculations submiried with ths pertnit appl(cation. The proposed building has been designed to meet the 2000 Minnesota Energy Code requirements in RESchedc Version 4.0.0 and to comply with the man9`516 requiremerrts listed in the REScheck Inspectron Checklist. HPST?1I?;;P -?Jtk-- Vt?!5;ta?+? e '?- I z?0:1- Name - Tdle gnature Date .,__?___. . . - ._1._ . ...."m_... 2000 Minnesota Energy Code Dakota County, Mlnnesota Slngle Family 16°ib 2 ^--- . _. , Cornpliance: Passes Maxin:um UA; 410 YoLir Home UA' 339 -r> 17.3% Bettei' Than Code (UA) Certificate of Surney for: RON CLARK CONSTRUCTION & DESIGN - s- 0 2007 John Oliver & Associates, Inc. BENCHMARK: TOP NUT OF HYDRANT 590 FEET +- WEST OF THE INTERSECTION X 932.90 Denotes Existing Elevation LOT 5 AREA = 3,769 S.F. OF FEDERAL DRIVE & VIOLET LANE. LOT 5 HOUSE AREA = 1,408 S.F. ELEVATION = 875.75 (832.80) Denotes Proposed Elevation LOT COVERAGE = 37.49G A. Denotes Surface Drainage 0 Denotea iron pipe set. LOT B AREA = 3,800 S.F HOUSE TYPE: TWO STORY DIFFLEY S.F. • Denotes iron pipe found. LOT 6 HOUSE AREA = 1,408 S.F. PROPOSED HOUSE ELEVATIONS: LOT COVERAGE = 37.1?6 GAR. FLOOR TOB BASEMENT FLOOR Address of Lot 5 is 3559 Lemieus Circle LOT 5 887.5 887.9 879.2 LOT 6 887.5 887.9 879.2 Addreas of Lot S is 3561 Lemiewc Circle -BOULDER irnum SIpPO-3 895.7 1 RfTAlN1NG ?t 894.5 1 WALL 894.71 • • • • " . •. ?_ ., (DQ Re,,SSSing lNal9 WilB 8925 893.9 os Rlqtdlmd _j I 892.8 e926 892. ALL OF LOT 29 IS A ORAINAGE ?O & UALlTY £ASEMENT BENCH MARK--, •x892.e ?b? oo ss I I ELEV.=887.83 O. ?? ? ''s>? sO R J. F` '0O esas x' xeszs r 7 C O ?/ ?Ci V € M \ saaze VA CAN T x W5.53 ; r 'y x eae. s& 1•?c, ,??j 8?s J? 1? V' J r ? 0 ?Q, X 892.9 O 88760 888.1 X 4' s0, 6? BOULDER c„ RE7AlNlNG - -- I WALL b Xes ?66.01 / ry 4 ? aeaz x ? Q 1`' ' 1 I!< ? ?-BENCH MARK ' , 4' Q,O 613 fl?0 €? OJ ?1 ELEV 885 62 ? ? ? ? ? " .? .= . , ;y ; j Q 0 sas.4o 0• +?`d ry0 s. ?5?, G? x ?' ?• X 885.9 X 886.05 t?, S ? x 885.oe xss5 44 Q I . 885.21 ?? GP ?i? 1 y' i; 5730 ?, ? L J i 1 ? 9 6 •ti , ?;: ---- -- Q . /yry ?' ,?,9 ? • Q?? ?? : ' ti6 o ? ' ? S ? O / k8B5.4b 4 Q?P = 1 ALL OF LOT 29 1S A RAINAGE ? O- e ? & U77LlTY EASEMENT `'Q? ` r O?O C0y X 884.65 886.6 SERV7CE x BB5.80 INVFRT=875 5 . ` ' py ? ?j e?.o? 0 ? ` f -f ` ?r f ?r, 11.66 " ?-RIGHT OF 90 WAY UNE ' 10 ??6 0 03 57 F ? 's'? ti xeas fs T 9 S? / ? \ . 1 t ! Z?'xA ? ? ,r?;, ? / / t ?? •?? ? , O 883.71 .. .. \ f ,.. ?," f ? X r"I 4L°?C? O O I ? ? SERVICE iNVERr-875.5 1 r ? V?Lf / \` ?.66 --LEMIEUX ,. ?0 ni ? / ,. I ! 1`l \ \ ` F•? ,T _ Y> ?e ?' `? ' ClRCLE ? ? ? -? ? ' ? ? n o E By Qate EACnM1 ENCnIDVEEItING DEP1; DESCRIPTION. • Lots 5& 6, Block 1, PEARLMONT HEIGHTS, Dakota County, Minnesota. SCALE.• 1 lNCN = 20 FEET DATE: 1/02/07 I hereby certify that this Survey was lI1C. John Oliver & Assoeietes BK/PG: NONE prepared by me or under my direct , owu aroww.rev, r,a" sro,nhw, Lons rron+.bw DRAWN BY: BRK supervision and that I am a duly CHECKED BY: RMM Licensed Land Surveyor under the l f S aws of the tate o Minnesota REVISIONS: A i ,?---- 9 801 W. ??a.vsierx 7YaA Su{te 200 ?- ? I n ?''1 4 BurnevLiis, Af{'wweota 65337 Signed: - (962)884-3046 (Fd%)884-3049 ? Randy . Morton DRAWING FlLE: FlLE N0. Date: 1/02/07 Lic. No. 21401 I..5-6B1.DWG 1601.10-110 Use BLUE or BLACK Ink F-For--Office--- Use f I l ti3°i5 C14 of Eap j Pem~it#: I 1 I I Permit Fee. 05. 1 3830 Pilot Knob Road p~ Eagan MN 55122 1 Date Received: i j Phone: (651) 675-5675 i Staff Fax: (651) 675-5694 1 1 t_.---------------- J 2013 RESIDENTIAL BUILDING PERMIT APPLICATION g ~t c ~ Unit Date: ~ ~ 1 J Site Address: Name: ?e N~csvt'y t c> Zc~;ti or.. ow~n.zs 1~k~1° Phone: c(S---947 Resident/ , Owner Address / City / Zip. Applicant is: Owner Contractor Type of Work 'Description of work: oa Construction Cost 3 3 Multi-Family Building: (Yes ! No Company: c Contact 11a~. CC 4-,hi r-c,~•- Address: /Z Ll fi%r >rftef•- r b Ay J Al . City: La-k c Contractor _ StaterZip: J fib`` Phone: [a S) ' 7 ? ° I License *.QC Lead Certificate It 6 3 36-1 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: s Licensed Plumber. Phone: Mechanical Contractor: Phone: k 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. CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454-0002 for protection against underground utility damage. Cali 48 hours before you intend to dig to receive locates of underground utilities. www.got)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 the approved plan in the case of work which requires a review and approval of plans. Exterior work authortzed by a building permit issued in accordance with the Minnesota State Building Code must be completed within *180 days of permit issuance. x `bRyp S-k'rb k: rat-_ x _ . Applicants Printed Name Applicants Signature Page 1 of 3 Use BLUE or BLACK Ink F----------------- I For office Use I 1 i My I Permit J - 1 1 a Eap 105. a~ { Permit Fee: I 3830 Pilot Knob Road Eagan MN 55122 t Date Received: Phone: (651) 675-5675 I Fax: (651) 675-5694 1 Staff 1 qlf~' l J 2013 RESIDENTIAL BUILDING PERMIT APPLICATION 13 ~r f v^1 s x t^c ecll Date: n o Site Address: ro Unit k. Name: rC - M~w•~• i t taic~.'~ r.a ow. s t~3S° Phone: 9S -941 ' 3OtS Resident/ Owner Address / City 1 Zip: ~v.,.v _ Applicantis: Owner Contractor Type of Work Description of work: A^t t► Construction Cost -A 3 J .YQ Multi-Family Building: (Yes Jr No n Company: a19, 7J4©FT A) G -T-0 C Contact Contractor Address: t S Ttr l~ii.-te b /rr a City: U~i 1 Y~ ` -7 7 1 LA State: Zip: J Jam` Phone: tD S-) ? ° 3 License I IS~~ t Lmd Certrticate - (U -1 ' 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 rued a permit for a similar plan based on a master plan? Yes No If yes, date and address of master plan: Ucensed 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.gooherstateonecall_org I hereby acknowledge that this information is complete and accurate; that the work wlll 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. x x _ Applicanrs Printed Name Applicant's Signature Page 1 of 3