2887 Highridge TerAddress 2887 HiQhridQe Terrace Zip 5512 I
Lot I Blk Z Sub
Delosh Addition
THESE I1'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: _ 1 _0 Yes No Inspector: -
Final grade (6" from siding)
Petmanent steps (garage)
Permanent steps (main entry)
Permanentdriveway
Permanent gas
?
Sod/Seeded grass
Trail/curb damage
Porch V
Basement finish v
Deck V
Please ver' with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside awn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contracror Copy
EXTFAfOR ENVEIAPE
1& 2 FAMII.Y RESmENCtAI. "COOKBOOK" WIHOD
S17'E ADDRESS? $g ?l b?' nl ? CITY:
?, ?
0-
BUIIDER, DATE:
Criteria: Rnof: R-38 with energy tiusses or R-44 with slandard Wssess.
Rim Joist: R-19 insulation Foundafion Windows: Insulated glass, 1R" air spaa, wood or vinyl fiamc.
wood with storm or better
STEP 1 Window & Doar Ara STEP 3 Daip Featurea
Total Window 8c Door Area In Sq. Feet
OPTION
WWDOWS (including foundation windows): ASSEMffiLY
Dimcasions Qaty. Arra FRAME WAI.L:
-b X Ls'-o
L.. ? x
STANDARD FRAMWG
7{ L '
? n x L1-b 49 ADVANCIDFRA1vIING
X I " I O
Z i- 11 X $1- " Iz- 20
L-D" X 31-0' Z, t
" q
CAVfIY WSULATION R I 1
L-01?X 1 u L
DppRS; SHEA1'FIING:
D X -O LESS TfL4T1 R-S ?
Z` g 17)-0 ` R-S OR MORE l?J
,r i1X
442
2LPn 2
.
-
7t WWDOWS (exccpt foundation aindows):
Total Arca of -:?ttjj, s A
Window & Doors
U-FACfOR
Total Wall Area in Sq. FL
Wall Tota! Perimeter Hcight Area
From the table, deteimine the maximum PeTant window dt d°°r
' arta for the design optlons selated and entu the value in bux D
I • D bclow.
°I - 3
?p q I ? D
B
Tota, Area
q 1
Z
3
of wall
Step 2 Calculate area u a percent of wall
Bax A(window dL door acw) divided 6y Box B(total pall
area) times 100 aniais the window and door area as a perant Box C mus[ be less than or tqual to Box D
of wall arca (Box C).
Box A x 100 =
I? C
t
Box B
F. The building must not exceed the maximum window and door ara as a perantage of overall exposed wa11 arra listed
bciow for the combinaCon of framing technique, R-value of insularion within the iasulated caviry, s6eathing R-value,
and window U-factor. Othet compournu must meet t6e requiraneats of this subpart.
ramipp
Cavity
i ailaion MAXIMIJA•i WINDOW AND DOOR AREA
AS A PERCENT OF OVERALL EXPOSED VYALL
Window U-Factor
Shrathine 049 036
.31
.27
STANDARD R-13 ?R-7 13.4% 17.81/6 213% 24.3°h
STANDARD R-15 >R-S 12.9'/0 17.1% 20.1% 23.4%
$1'ANDARD R-18 <R-S 11.1% 16.00/o 18.8% 22.00/o
STANDARD R-18 >R-5 13.5% 18.66/9 21.8% 25.3%
ADVANCED R-18 <R-5 11.1% 17.1% 20.1% 23.40/a
ADVANCED R-18 ?R-5 13.5% 19.2% 22.5% 26.1%
STANDARD R-21 <R-5 11.80/0 17.00/a 19.90/0 23.1%
STANDARD R-21 ?R-S 14.01/9 19.3% 22.5% 26.1%
pDVANCID R 21 <R-S 11.8% 18.1% 21.2°h 24.6%
ADVANCID R-21 >_R-S 14.0% 19.90/0 23.21/6 26.90/a
Subp. 3. Performance criteria The combined thermal transmittance (U, ) Factors for Kalls, rooflceilings, and
floors over unheated spaces must be less than or equal to:
A. 0.110 Btu/h ft°F for walls;
B. 0.026 Btu/h ft°F for raoUceilings; and
C. 0.04 Btu/6 ft°F for floots.
STAT AUTH: MS § 216C.19
HIST: 18 SR 2361
7670.0480 Repealod, l8 SR 2361
G?FF ? CC ? ? i L?c
(SEE ATTACHMENTS)
CU i j
Development
Lot Number
Address
Builder
Block Number
Tree Protection Requirements:
f, Tree Fencing
?_ Oak Tree Pruning (Immediately seal wounds during April 1 to July 31)
' Therapeutic Pruning
Retaining Wall
Other:
Reqlacement Trees
Not Required
As Foilows:
ftq
Attachments:
Yes
? o
No ?m,e
Additional Notes:
J
H:\ghove\2000fi1e\Veepres\Tree Preservation Plan Summary-2000
*
* P106\IEER
? engineering
? tpTil l i, zooi
Mr. Gregg Hove
Supervisor of Forestry
Ciry of Eagan
3501 Coachman Point
Eagan, Minnesota 55122
Civil Engineers • Land Planners • Land Surveyors • Landscape Architects
RE: Preliminary Tree Certification
Lot 10, Block 2, Delosh Addition
Eagan, MN (Dakota County)
For: Ventura Homes
Dear Sir:
Tius letter is to verify the status of significant trees located on Lot 10, Biock 2, Delosh Addition.
During a site visit on April 10, 2001, it was noted that tree clearing had already begun on the site.
Four significant red oak trees had been removed off site (see graphic for size and location).
Aloug the north property line aze three significant trees listed as off site that will need to be
pruned before construction takes place. Tree #28 (18" Scotch Pine) will need major crown
removal in order for the house/gazage to be built. The other option would be to remove these
three trees due to their proximity to the proposed house, but since they are located on adjacent
properties that may not be pernuted.
The house has been staked. Tree fence will need to be placed outside the dripline of all significant
trees to be saved. Future grading and construction should not have a negative effect on these
trees.
Ifyou have any questions, please call me at (651) 681-1914.
Sincerely,
PIONEER ENGINEE G, P.A.
G'..
n J. rndt
Urban Forester
cc: Ventura Homes
2422 Enterprise Drive • Mendota Heights, Minnesota 55120 •(651) 681-1914 • Fax 681-9488
625 Highway 10 N.E. • Blaine, Minnesota 55434 •(763) 783-1880 • Fax 783-1883
,* »
i` PIONEE
* enginei
* „ * *
HW? F?7EA ?,Z972 R
p.
CA?YE?R.1? - 31 ?•1X 3'701 R
FLLV
SCALE:1"=40'
880 FAX:783-1883
?-_ _______ ___x
10? 24
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?_y ?0 23 ?
22 ?27
.
20
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SIGNIFICANT TREES
NO '1'YPB ATES ?
?
o\
1 iJ' RED OM SAOE - - _- --__
t
z is' REO oac save
3 15 REO ON(
' SAVE ?
a 15
RED Qac SAVE
5 13' RED OhY SAVE
8 16" RED OAK SAyE (8340)
485.30
]a_l? i 8 ---- .-_
i-_ ----E6a.o?x965.3 ---
i 863.8 o x i
i 6ARAGE
i
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m62r ?z •'
Qi B6a.2
a -. \ .3
i7
mi 1 aso.s ;
SIGN;FICAN'I'WOODLANDS I ?
------------ J 0 O(0
i N 0
? -0
134.32 -' Z
) 17' RED OnK REMOVEO N89'45?ZB?E
8
9 17
15 REO OAK
REO OAK SAVE
REYOVE
10 13' RED OAk REMOVE
il 18- RED OAK (2) REMOVEp
12 13 REO Ouc S,?yE
13 12' REO Oa( SnVE
14 15 REO Q4K SAVE
15 ta'
' RED Oac SAVE SITE SUMMARY
16
t] 15
10" RED OAI(
RED OAN $pVE
SAVE
18 18'
' RED OPJC REMOYEO ]'Q7?$S$qyg: 19 (76%)
19
20 1a
13' REO OP1C
REO Oac SnvE
SAVE
TAEESREMOVB: 2($.0%)
21
P2 1B'
ia' REO OAK (2)
RED OAN SeOE
SAOE '?'j«$ pgMOVCO: 4 (1
6A7>)
23 16' RED ON( SAVE 1'OTALTREES: 25 (700%)
]a 18' RED dV( y,vE
25 1S' RED Onx REMOVED
28 13' OUN(ING 15PEH OFF SRE
27 15' BUCK LHERM OPf SRE
28 te' $COiCM PINE OIF SITE rvEE05 i0 BE PRUNEO FOR CIEARANCE OF n0U5E
I hereby cartify that this plan was preporetl by me or untler my Ofrect
supervieian antl thot i am on Urban For¢yler.
SICNEO: PIONEER ENGINEE ING, P.A.
BY: ? OaTE: LI-I[ I
Ken ArnOt, an Fwes(er
21•Z.00 853J
(853J)I O
U
6
TREE HAS BEEN RECENTLY REMOVED FROM SITE
14O
x873.8 x876.3 x8]6.2
l875.]I
z5.3 BJ'e.]
I10 I I
I "?W
LO
J5, g
?10 ? p?
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5.6)? I I
t? I
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- - - - - - - - - - -
15 .4 /
?Na
,5 876.487i
,y
?cS' /s k+j°?y9 9 5850.OOfipW
TREE PROTECTION FENCE
ADDI'fiONAL NOTES:
. x0 TREE ItNEHiORY wlS AVMABLE FOR THIS OEVELOPMENi
•NO FlLL SHOULD BE P1ACE0 AGYNST THE TRUN14 Ou 1HE ROOT CROWN.
OR WITMIN THE OPoP-LINE ARFA OF AN! tREES TW1i P4E TO BE 54VED.
•CIRE NUSi BE TAItEN ip PRMM LWNCE IN THE 501L CXFW51liY DUE TO
CONCRETE WASHq1T OND LENUCE OR SRLI.WE Of ttl%IC NATERIN.$ SIICH
AS PNMS OR fUELS.
• PRUMNC OF ONt iREES MUS1 N0T TM(E PVCE tROM AiR0. IS TO JVLY 1.
•iF WODUOiNG OP ON( iREES OCWR, A NON-i0%K WOUNO DRESSINC NUST BE
MPUEO IMNGDNTEb. EXGV/.TORS MUST wK A NON-i0%IC TREE WOUND
DRESSINC WIiN iHEM N OEVELOPMEM SRE).
• iREE PROiELiION fENCE IS ttI BE PUCED OURIDE lxE DFIPUNE 0( lHE TREE.
•TREES WERE YISl1PLlY LOGiED BT FIONEEH ENGiNEEWNG
OATE:
SICNATURE OF OWNER
xats enteronae o.i.a
umaotc Heiqnb. MN 55120
(851) 681-1914 fA%:867-9488
Certificatefor: VENTURA HOMES
LOT 10, BLOCK 2, DELOSH ADDITION
2887 HIGHRIDCE TERRACE
EAGRN. MirvNE50TA (DAKOTA COUNTY)
TREE CERTIFICATION
-_________ __ _______
i-TREE LINE
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LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTYLEGAL: I?lLI K. 2 De?, sLi 1'72 a!'?
DATE OF SURVEY: -3-/3 -0i
R
LATEST REVISION:
DOCUMENTSTANDARDS
• Registered Land Surveyor signature and company
• Building Permit Applicant
• Legal description
• Address
• North arrow and scale
. House type (rambler, walkout, split w/o, split entry, lookout, etc.)
• Directional drainage arrows with slope/gradient %
• Proposed/existing sewer and water services & inveR elevation
• Street name
• Driveway
• LotSquare Footage
• Lot Coverage
ELEVATIONS
Existin
L,?? _, . Sewer service (or Proposed)
Cu? ? ? . Property corners
? G ? • Top of curb at the driveway and property line extensions
C? C C . Elevations of any existing adjacent homes
??? . Adequate footing depth of structures due to adjacent utility trenches
Prooosed
Ca? ? ? • Garage floor
LR?/ ? ? • First Floor
L
d
l
i
lk
U
i
d
? ? n
.
owest expose
e
evat
on (wa
ou
w
ow)
C3??/ ? ? • Property comers
(3 G ? . Front and rear of home at the foundation
PONDING AREA (if aoolicable)
? ¢K ? • Easement line
? EK G • NWL
? P/ ? • HWL
? VJ7 • Pond # designation
n ? ? • Emergency Overflow Elevation
?? ?
L9' ? I I
IiY CI !::I
'? ? Ci
V7/? CI
lY ? ?
DIMENSIONS
-/3 D
• Lot lines/Bearings & dimensions
• Right-of-way and street width (to back of curb)
• 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
• Setbacks of proposed structure and sideyard setback of adjacent existing structures
• Retaining wall requirements, if any
Reviewed:
Name
A city oF eaqan
t+'? f
Name: Date: ?...t -q " d (
Site Address: ZDO? J) bC Telephone#: -2I09DDD
Rim Joist Detail Optioos
As out(ined in the nerv Energy Code, buildiags constructed with three units or less require
that rim joists be put up according to detail optioos shown betow. Please circle/highlight
the option you will be using.
6
# 8 Other :
Site address: siock Subd.
?
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.
X This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
_ This struclure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674
APPLUhNCE GAS ELEC MANl1FACTURER MODEL BTU'S VENTINGTYPE
Water Heater A D?/ ? S µ qa z?O a (f? LMU Urin7-
Fumace x g,e Akr7. 3 SD !/YjflU 031,0D-f o rnwwlVexr-
Dryer kE1J VYIOe-e 14 f( q l 2O O 1fJ DO AIM2
v
U
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
ves No
Kitchen kitchen J?SD
Bathroom 1 ? C.,- 0n? M-tar oeOA-4 3 D x
Bathroom 2 G? writp tc I! 940 fi SD
Bathroom 3(U Gal 14 it i! 40 3b
Bathroom 4
Other
FIREPLACE S
LOCATION
GAS
WOOD
MANUFACTURER
MOOEL
8TU'S VENTING
oiRECT ATMOS
Arn.e4e. 3 D 38'e
MAKE-UP AIR MODEL TYPE CFM's
a- 2v j-- -? P-v ?3
I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan
requirements.
l?a•G--b?t.Y2?+? ? 1--1??fl ?
Sigqatqrep Date
Company Name
AA
This form is the responsibility of the General Contractor.
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**'**
* PIONI
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Certificate of Survey for:
LOT AREA = 50,547 sq. ft.
HOUSE AREA = 2,972 sq. ft.
DRIVEWAY AREA = 3,704 sq. ft.
COVERAGE =13.27,
HOUSE TYPE=RAMBLER, WALKOUT
851.1
PROPOSED HOUSE ELEVATION
LOWEST FLOOR ELEVATION: 158•(p
TOP OF BLOCK ELEVATION: 'Ec07• 1/
GARAGE SLAB ELEVATION: V0710
T08 0 LOOKOUT EIEVATION:
X 000.00-TENDTMEXISTING ELEVATION
( 000.00 ) DENOTES PROPOSED ELEVATION
--- DENOTES DRAINAGE ANO UTIUTY EASEMENT
DENOTES ORAINAGE FLOW DIRECTION
• OENOiES YONUMENT
-B- OENOTEi ')FFSET HUB
6-53f•o) N89'45'26°E
? •!
9
WE HEREBY CERTIFY TO VENTURA HOMES THAT THIS IS A TRUE AND
CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
?.?
LOT 10, BLOCK 2, DELOSH ADDITION y"
OAKOTA COUNTY, MINNESOTA
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN,
AS SURVEYED 8Y ME OR UNDER MY DIRECT SUPERVISION THIS 13TH DAY OF MARCH, 2001.
SCALE : 1 INCH = 40 FEET
-
-
----
- BAT -
?i 101058.00 -
NOTE: PROPOSED GRADES SHOM4! PER GRAUINC GLAN BY: OEVELOPMENT ENC.
N01E: BUILDING DulEN510N5 SHONN ME FOR NpRIZOHTAI AND VfRTICAL LOChT10N
OF SIRUCNRES ONLY. SEE ARCHIIECTUAL pLONS FOFt BUILDINC AND
FWNDATON DIMENSIONS
N07E: NO SVEqFlC Sq1,5 IN4ESTGA7ION HAS BEEN COUVLETED ON 7lu5 LOT BY 1H[
SURVEYOF. 7HE SUI7ABILI7Y OF SOILS TO SUPPoRT THE SPEqFlC Mq)SE
PROPOSED I5 NOT THE RESPONSIBILITV 0F THE SURVEVOR.
NOTE: THIS CERTFlCATE OOES NOT PURPORT TO SNOW EASEMENTS OTHER THAN
iHOSE SHOVM ON THE RECOROED PLAT.
NOTE: CONTRACTOR A1UST YERIFY OFIVEWAY OESIGN.
N07E: BEARINGS SHOwN ARE BASEO ON AN ASSUMEO DATUM
APR 13 RECI'
M
485.30 ? 876.7
260.14 875.3
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x 866.1
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x 873.8 x 876.3 x 876.2 ? 875 E
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HOUSE W
g S89'45'26"W a
150.00
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SANITAR I Y SEWER
BY OTHERS
SIG Pn PIONEER ENGI IEE?BIDF?, P.A.
---
-_
BY:
C. Larson, L5. Reg. No. 19828
i
n+s • Cr.k rnaNOes
• wmswsc ueoaacrs
2422 Enterprise Orive
Mendota Heights, MN 55120
(851) 881-1914 FAX;681-948B
625 Highwoy 70 N.E.
Blaine, MN 55434
(612) 783-1880 FAX:783-1883
VENTURA HOMES
2887 HIGHRIDGE TERRACE CLIENT-HAYES BENCH MARK
TOP OF PIPE
- ELEV.=865.09
i
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r
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N89'45'26"E I
?
867.3 ,- 74.17 --J ?-
N
? - - - - - - - 859.3 x 48.67x 4. 6 x 865.3
o 25.50 p? 8f?.f; -o o DRI?VEWSA?
/ o GARAGE ? n
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\???-yc L? /v .5
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858.6 OO a/ 12.D
N?• \?? 858.0
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38.33
857.0 858.5 29.84
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FiENCH MARK
7Op OF PIPE
?i tLcV.=857.77
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?IDENTIAL a ? ? F? 9? S?? 0,I1
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a gUILDINC PERMIT APPLICATION y?15a'
CITYOPEAGAN Mp-"/Sm- 70-5Q
3830 PILOT KNOB RD - 55122
651-681-4675 ! p^151 C? b ? 10.50
New Constmction Revuirements IS? p,,/??-- ? py ? RemodellReoair Reauirements
. 7 registered site surveys showing sq. R. of lot, sq. ft. of hoL?€ 3nd2il P6bred areas `. 2 mpies of plan - - - - - - - - -
(20% maximum Ict coverage allowed) . i set o( Energy Calculatlons for heated addifions 1 ?
• 2 copies of plan showing beam & window sizes; poured found design, etc.) . i site survey for extenor addilions ,5,2 & decks 09 ?
• 1 set of Energy Calculations /
* 3 copies of 7ree Preservation Ptan il lot platted affer 711193 /? t
• Rim Joist Deiail Options seleclion sheet (61dgs with 3 or less units) 1 Q+I?{
\. ??1 J !
DATE - l-!D VALUATION (EXCLUDING LAND) 22-? F) ?? ?
JOB SITE ADDRESS Z i?9:j 1 I-,b4:?1
IF MULTI-FAMILY BUILDING, HOW MANY NITS?
PROPERTY OWNER QIJ?-
TYPE OF WORK FIREPLACE(S) _0 1_2 _3
APPLICANT PHONE # (y?T_?(p?
ADDRESS ZIPCODE
PAGER # CELL PHONE #JQS 1-2'-E8 AX # ?
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MIV NESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
,_--?Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor: fq(A W1 eWi-b k4une #: ?I 3? - l 21 S
PluinUing Systcin Includes: Wa[er SoF[ener _ La?c?i Sp ? kler Fee: $90.00
'vVater Heater No. of R.I. Baths
? ??.,No. of Balhs Mechanical Contractor:0'-2 P11.(m4'/1/1k1 "PAne # ' I
Vlech.uiical Sysucm Includes: Air Conctitioning Fee: $70.00
Heat Rccovery System
Sewer/Water Contractor: _ la exoko"?jj ob Phone 4 YD_ ?_ I
All above information must be submitted prior to processing of application. II n I?? k„_Q e(
iii ?w
I hereby acknowiedge ihat I have read this application, state that the information is correct, nd agree 1
all opplicable State of Minnesota Statutes and City of Eagan Ordinances. gy
Signature of Applicant t
Certificates of Survey Received Tree Preservation Plan Received _ Not Required
Updated t101
OFFICE USE ONLY
? Ot Foundation
p 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
O OS 03-plex
? 06 04-plex
f 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn.(4-sea.)
? 23 Porch(screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)* ? 43 Reroof ? 46 WindowslDaors
'Demolition (Entire Bldg anly) • Give PCA handout to applicant
Valuation ?
i 0a(J
Occupancy
- ?
MC/ES System
Census Code /G l Zoning ? City Water
SAC Units Stories ? Booster Pump
N6r. of Units ? Sq. Ft. PRV
Nbr. of Bidgs Length oa'? a Fire Sprinklered
Type of Const Width s6?
? Footings (new blde)
_ Footings (deck)
Footings (addition)
jp Foundation
40 Drain Tile
Roof ?- Ice & Water X! Final
?G Framing
Fireplace R.I. Air Test Final
? Insulation
_ Other
_ Pool Ftgs Air/Gas Tests _ Final
_ Siding Smcco Stone
_ Windows (new/replacement)
Approved ByLid_, Buiiding Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
city sac
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Ga2ge
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or _ N
8 S?T
zeezv)-- zs ?
?'l#1-?v G&d?-L
?g k ?l? `17 8?l? a?
REQUIRED INSPECTIONS
FinaVC.O.
Final/No C.O.
Plumbing
? HVAC
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City of hp
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: /0 rro
Permit Fee:
Date Received: 6 -/1.17 -
Staff:
-/ I
Staff: ' J 5
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit #:
O
OWNERS
S/— V92C7
Name: �jPL)� �A e� Phone: 6 -Zi
Address / City / Zip: 2 1 \` cj h f -, air -P I E' Y V et c se
Applicant is: Owner YContractor
Description of work: X d
PE OFWORK�
_
Construction Cost: lVi 5 vC7 Multi -Family Building: (Yes / No �')
CONTRACTOR
R
P 0c, H Contact: t G,C�
Company: 0Oete.."' }E.T'�,cx
Address: Of 120 ,141 Y-Pcz-.c.) Q.ci2 £0 City: cdqa +2 GYav-,-
State: W Zip: SS Q / ( Phone: ' 1- /- 2-32' 9 73
License #: G 09'Z0 -. 5 Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
_Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE Plans and supporting documents that you submit are considered to be public infortr►etion Portions of
•61/7 Ormation maybe classified as non public if you provide specific reasons that would permit the City to
conclude'.that they are trade secrets.:- LL
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.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exter = work thorized by a building permit issued in accordance with the Minn
d. sof peri ' issuance.
lica is Printed Name
clr\et r&
-�,
vY
e Building Code must be completed within 180
x
pplicant's Signature
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