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1562 Johnny Cake Alcove*° City of Eaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: / 3,20b3 Permit Fee: � Date Received: ( T/�3//1 Staff: 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date:' ` / Site Address: /5—C; ,2 To,- i7;1 CA& Aices vr Unit #: Resident/ Owner Type of Work Name: scp T: �jQic t Address / City / Zip: Applicant is: Phone: ‘57— oy 4 6* / 5-6 Ca Ke a /c©ve Owner Contractor Description of work: Pa° y^ tia f 'ice% y i jer/owl Construction Cost: it/ BGS Multi -Family Building: (Yes / No. ) Contact: D�Gt k7 J�®/C�st� Company: /Y". z / cep /76 t Address: ;/ %S 3 '� Y Sr £ City: /) /? /4/Ce State: j?7/'1 Zip: 53-372 Phone: 73-2—' 23 7 C557 License #: r --)c 5-7 3 7/2 Lead Certificate #: it) a "7""— � �� 57 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) /`iea; er -7-i ! c77 - 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: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: 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 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.00pherstateonecall.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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be complex;. within 180 days of permit issuance. x 010r7 1:),/Cz( Applicant's Printed Name x Applicant's Sign�fture Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Single Family Multi 01 of _ Plex WORK TYPES New Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100%_) Census Code #of Units # of Buildings Type of Construction Fireplace Garage Deck Lower Level Porch (3 -Season) Porch (4 -Season) Interior Improvement Move Building Fire Repair Repair Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Roof: Ice & Water _Final Framing Fireplace: _Rough In _Air Test Final Insulation Sheathing Sheetrock Fire Walls Braced Walls Siding Reroof Windows Egress Window Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Accessory Building Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required Final / No C.O. Required HVAC Gas Service Test Gas Line Air Test Pool: _Footings _Air/Gas Tests Final Drain Tile Siding: _Stucco Lath _Stone Lath Brick Windows Retaining Wall: _ Footings _ Backfill Final Radon Control Erosion Control Other: Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 ;_?- I (." (? ) o ck 3 S-4- w -p 4-1 -19 -1 b ? _a. L `Z C) OA.(o q_r? t5-t-'L-' RESIDENTIAL BUILDING PERMIT APPLICATION ? CITY OF EAGAN ? 3830 PILOT KNOB RD - 55722 657-681•4675 9 0 New Conatruedon Reauirements RemodeliReoair ReauiremeMS • 3 regislered site surveys showing sq. tt of lot, sq. R N house; and all roofed areas • 2 copies of plan -7 (20% mauimum ht ooverege allo-xed) . 15et of Eneyy Calwlations for Iceated additions • 2 coDies of plan slwwirg beam & window sizes; pourad fand design, ek.) ? ?g ?? y . i site survey for eMeria additions & decks )0 ?c • 7 setof Eneyy Cala:aaons • 3 topies of Tree Preservation Poan if bt platted after 711193 ?' • Rim Joist Detail Optians seleclion sheet (bldgs wBh 3 or less units) ?F 1?P? J 9 DATE 1a ) f o I VALUATION (EXCLUDING LAND) .iJB $ITE ADDRESS /SCa_1 5_ .>n X Ga l,, 4I c vc IF MULTI-FAMIIY BUILDING, HOW MANY UNITS? PROPERTY OWNER P l!L 4.-.us b-F /YI lt! C,.02 TYPE OF WORK /Ve,.., FIREPLACE(S) _0 -)(1 _2 _3 APPLICANT f K Nt go irre s oC IYJN Cn..O PHONE # ADDRESS ElS Alol*? ? t R rlcwav i PAGER # CELL PHONE #'b1z`3d y- n'l FAX # &S`l - //sa2 -5.100 P CODES:D_-V NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 (check one) - ResidenGal Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Su6mitted ? MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor: va 1 piu Phone #: (GS! ) q5.2 Plumbing Sys[em Includes: _ VVater Soft ner Larvn Sprinkler Fee: $90.00 ZC Water Heater ? No. of R.I. Baths -3 No. of Baths Mechanicai Contraetor. 8 c. r s v'M' /-)rF {;,, Phone # ?95?? 89 `/ -Ooa S hlechanical System Licludes: ? Air Conditionino Fee: $70.00 Heat Recovery System Sewer/Water Confractor: ly/e tt o Ueo,r ra 1 Phone # (-7L 3)1 i /-29 -_2 9 3$ All above information must be submitted prior to processing of application. I hereby acknowledge ihat I have read this application, state that the information is correct, and agree to comply with ail applicable State of Minnesota Statutes and City of Eagpn Ordinances. Signature of Applicanf ?ZZ4 - = - w / 6c ... Y Certificates of Survey Received Tree Preservation Plan Received _ Not Required ? Updated 1101 OFFICE USE ONLY 0 01 Foundation 'pp 02 SF Dwelling ? 03 0 7 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex ? 07 OS-plex ? 13 16-plex ? 08 06-plex ? 16 Fireplace ? 09 07-plex ? il Garage ? 10 OB-plex ? 18 Deck ? 11 10-plex ? 19 Lower Level ? 12 12-piex Plbg_Y or _ N _ Other _ Paol Ftgs Air/Gas Tests _ Final _ Siding Stucco Stone _ Windows (new/replacement) ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF O 36 Multi 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair O 33 Alteration ? 37 Demolish (Bldg)• O 43 Reroof ? 46 WindowslDoors ? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applieant Valuation Occupancy MC/ES System Census Code Zoning J f City Watei SAC Units C-) Stories ? Booster Pump Nbr. of Units _L Sq. Ft. l 7 PRV •- Nbr. of Bldgs ? Length /-/(T Fire Sprinklered ? Type of Const ?`-'^- Width 17? ? Footings (new bldg) _ Footings(deck) Footings (addition) ? Foundation Drain Tile Roof Ice & Water Final Framing Fireplace _ R.I. _ Air Test _ Final ? Insulation Approved By 614 , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply 8 Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total aC) (a -l - (- ---? REQUIRED INSPECTIONS ? FinaUC.O. _ FinaUNo C.O. _ Plumbing _ HVAC ?-;,ti Z - /, c' YYG?¢.llv L C ? 20 Pool O 21 Porch (3-sea.) ? 22 PorchlAddn.(4-sea.) 0 23 Porch (screened) ? 24 Storm Damage ? 25 Miscellaneous l&/ .2,5'o °= ac9 a ?LCV?L. U 7 -7 ??y ? I I 6a.0 Dterwos d or L6 g 50 ScUI-ion 2-I August 16, 2000 To Whom It May Concern: RE: Parcel 10-02100-015-50 ; It is City oF Eagan Policy to pro-rate assessments on an area basis or on a unit basis to the succeeding pazcels, which are the result of a division of a larger parcel. The referenced pazcel has defetted assessments that total $43,621.87 and pending assessments in the amount of $36,526. In this case the City would prorate the assessments using the area basis. The City would allocate the deferred assessments in the following manner: Pazcel Areas Improvement Sanitary Sewer Lateral Water Trunk Lateral Benefit Water Total 5 Acres Assessment $25,017.61 $7,001.76 $11,602.50 $43,621.87 1.5 Acres Lot 1, Block 1 Pro-rata Share $7,505.28 $2,100.53 $3,480.75 $13,086.56 3.5 Acres Outlot A Pro-rata Share $17,51233 $4,901.23 $8,121.75 $30,535.31 The City would allocate the pending assessments in the following manner: Pazcel Areas Improvement Project 648 Total 5 Acres Assessment $36,526 $36,526 1.5 Acres Lot 1, Block 1 Pro-rata Share $10,958 $10,958 3.5 Acres Outlot A Pro-rata Share $25,568 $25,568 Sincerely Tom Pepper Acting Finance Director GRW CC: Pazcel File - ?6a0 Deerwood ? /0 - 00?iDV - oiS =So 1434136 Dr SETTLEMENT AGREEMENT This Settlement Agreement ("Agreement") is made this IkL day of , 1997, between FRANK H. RECHTZIGEL, a single person, (hereinafter "Lando er") 4tlhe CITY OF EAGAN, a Minnesota municipal corporation, (hereinafter "CiTy"). WHEREAS, Landowner is the fee owner of property located in the City of Eagan, County of Dakota, State of Minnesota and legally described as: 1 That part of the North Half of the Southwest Quarter of Section 21, Township 27, ? Range 23, Dakota County, Minnesota lying southerly and easterly of the most southerly and easterly right of way line of 35E as shown on Minnesota Department ? of Transportation Right of Way Plat No. 19-72 and 19-40 and which lies northerly "S and easterly of the following described line: Commencing at the Northeast comer W, 5 of said North Half of the Southwest Quarter; thence South 0 degrees 30 minutes 39 seconds East, assumed bearing, along the east line thereof 735.20 feet to the point of beginning of the line to be described; thence North 89 degrees 47 minutes 34 seconds West 335.48 feet; thence Nor[h 27 degrees 27 minutes 16 seconds West 385.80 feet to said southeasterly right of way line of said Minnesota Department of Transportation Right of Way Plat No. 19-72 and said line there terminating. (hereinafter the "Property") WHEREAS, as part of Public Improvement Project No. 682 (hereinafter the "Project"), the Property was assessed for the following improvements: Improvement Assessment Amount Sanitazy 5ewer Lateral $25,017.61 Water Trunk Chazges $ 7,001.76 Lateral Benefit Water $11.602.50 TOTAL: $43,621.87 (hereinafter the "Assessment") WHEREAS, the Landowner has objected to the Assessment as he believes that his property may not have benefited by the Project in the amount of the Assessment; and WHEREAS, the Landowner and the City aze desirous of amicably resolving any dispute concerning the Assessment to the Property as set forth in this Agreement. ... Page 2/SETTLEMENT AGREEMENT NO W, THEREFORE, in consideration of the mutual promises contained herein, and other good and valuable consideration, the receipt and sufficiency of which aze hereby acknowledged, the parties do hereby agree as follows: 1. The Assessment shall be defened without interest and said deferment shall end if the Property is given an additional Property Identification Number from Dakota County or on December 31, 2009, whichever occurs first. Then, the Deferred Assessment shall be payable over a term of fifteen (15) years with interest at the rate of seven percent (7%) per annum. 2. Landowner hereby waives his right to object or appeal the Assessment, pursuant to Minn. Stat. §429.081, and further waives notice of heazing and heazing on this Deferment Agreement. 3. Notwithstanding any statement contained herein to the contrary, this Agreement shall be void unless it is duly approved by the Ciry and fully executed by both the Landowner and the City on or before July 1, 1997. Fully executed copies of this Agreement shall be immediately furnished to the Landowner and City upon execution by both parties. 4. This Agreement shall be binding upon and inure to the benefit of the parties heirs, successors and assigns and shall run with the land. CITY OF EAGAN ? flionfasA. E'gan Its: Mayor - ?:- :? - r, BY: ... F an(lvrrheke ...... Its: ?!lerk , f: ZK?-' Frank H. Rechtzigel 0 0 0 ? ? C? ? ? r, Page 3/SETTLEMENT AGREEMENT STATE OF MINNESOTA) )ss. COUNTY OF DAKOTA ) The foregoing instrument was acknowledged before me this /d4? day of , 1997, by Thomas A. Egan and E. J. VanOverbeke, the Mayor and Clerk of the C' of Ea an, a Minnesota municipal corporation, on behalf of t The foregoing insritiunent was acknowledged before me this "11"4 day of VC/i1Q , 1997, by Frank H. Rechtzigel, a single person. STATE OF MINNESOTA) )ss. COUNTY OF DAKOTA ) APPROVED AS TO FORM: f ? City Attorney's Office Dated: 3 l/?.?t-?? ??G? Notary Public ? I.OLALVFHW PUBIJG-W&&OTA r?KOTacoUNiN tiyc? .. ,:?ares,W+s,,zaoo .T.... a...... .. .. . APPROVED AS TO CONTENT: 4 ?- Fi nce Depar[ment Dated: 6 ' 3Q -Cl'I THIS INSTRUMENT WAS DRAFTED BY: SEVERSON, SHELDON, DOUGHERTY & MOLENDA, P.A. 7300 West 147th Street, Suite 600 Apple Valley, MN 55124 \(612) 432-3136 RBB: #206-12919 Prj. 682 ? ? W P ? < a?iga L7 o? o ? Ol ?? rn W w U(W7 W w V1 ? W > Q O ? z' '4 o 2 _ m U W W?? z =? tl1 LLl ?.. 8t?,?W~ N ? =) 00 OF°¢ `? ??G1r ? r? o p Q oLL8 °z 0 ¢ ZN ? ? ? oQ U. U Q ? 2 ? U ? ? . , f ?ao beerwood N. oa/oo - o?S?so m - ADDRESS CHANGE: 1561. JOHNN'i CAKE ? AL:;OVE SETTLEMENT AGREEMENT This Settlement Agreement ("Agreement") is made this 4:9-1? day of , 1997, between FRANK H. RECHTZIGEL, a single person, (hereinafter "Lando ?eerr"')d e CITY OF EAGAN, a Minnesota municipal corporation, (hereinafrer "City"). WHEREAS, Landowner is the fee owner of property located in the City of Eagan, County of Dakota, State of Minnesota and legally descxibed as: That part of the North Half of the Southwest Quarter of Section 21, Township 27, Range 23, Dakota County, Minnesota lying southerly and easterly of the most southerly and easterly right of way line of 35E as shown on Minnesota Department of Transportation Right of W ay Plat No. 19-72 and 19-40 and which lies northerly and easterly of the following described line: Commencing at the Northeast corner of said North Half of the Southwest Quarter; thence South 0 degrees 30 minutes 39 seconds East, assumed bearing, along the east line thereof 735.20 feet to the point of beginning of the line to be described; thence North 89 degrees 47 minutes 34 seconds West 335.48 feet thence North 27 degrees 27 minutes 16 seconds West 385.80 feet to said southeasterly right of way line of said Minnesota Department of Transportation Right of Way Plat No. 19-72 and said line there terminating. (hereinaftex the "Property") WHEREAS, as part of Public Improvement Project No. 682 (hereinafter the "Project"), the Property was assessed for the following improvements: Improvement Assessment Amount Sanitary Sewer Lateral $25,017.61 Water Trunk Charges $ 7,001.76 Lateral Benefit Water $11.602.50 TOTAL: $43,621.87 (hereinafter the "Assessment") WHEREAS, the Landowner has objected to the Assessment as he believes that his property may not have benefited by the Project in the amount of the Assessment; and WHEREAS, the Landowner and the City are desirous of amicably resolving any dispute conceming the Assessment to the Property as set forth in this Agreement. . y Page 3/SETTLEMENT AGREEMENT STATE OF MINNESOTA) )ss. COUNTY OF DAKOTA ) The foregoing instrument was acknowledged before me this i/ day of 1997, by Thomas A. Egan and E. J. VanOverbeke, the Mayor and Cferk of the C? Minnesota municipal corporation, on behalf of the STATE OF MINNESOTA) • )ss. COUNTY OF DAKOTA ) The foregoing instrument was acknowledged before me this 1997, by Frank H. Rechtzigel, a single person. PiiAFiILYN L. NoTar,Y P 37,2000 a ? day of Notary Public APPROVED AS TO FORM: 77& " x City Attorney's Office Dated: IAIALV?i?ii ? pUgI1G-1?IM?6SOTA DAKOTA(? . ._...?.-?.....n'--.. ... APPROVED AS TO CONTENT: I" Fi ce Department Dated: (o - ,?jU -q`) THIS INSTRUMENT WAS DRAFTED BY: SEVERSON, SHELDON, DOUGHERTY & MOLENDA, P.A. 7300 West 147th Street, Suite 600 Apple Valley, MN 55124 (612) 432-3136 RBB: #206-12919 Prj. 682 Address 1562 7ohnny Cake Alcove Zip 5512_ IAt 16 Blk 3 $Ub Oakbrooke Sth THESE TI'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: Yes No Inspector: Final grade (6" from siding) lp_4?d C w, ?4e,v Permanent steps (garage) Permanent steps (main entry) Permanent driveway Permanent gas ? Sod/Seeded grass ? TraiUcurb damage C, Porch ? Basement finish Deck Please verffy with the buildet the removal of mof test caps from the plumbing system and the shu6off of water supply to ? the outside lawn faucet before freeze potential ezists. A Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. White • City Copy Yellow - Resident Copy Pink - Contractor Copy e ;L1L='?_??f?3a ta:4?: ?=UL?'E HGMES MNchWek COldFLIAiG"E REPQRT !Kinne3aEa Enezgy C:oBe ?Mche^k Software versiOri 3.0 `pil:•i2'Y: Dakota 3TP.TE: Minneacca zarE: a LOl38TRUGTSON TYPE: :iinale Psmilv IIAT'E: 7-21-2000 P_d),TE OF PLAN°: '712E/07 T.T,TLk.: oakbrOOke Scarlirg w`_th Loolcout C'J:4PLSATtiCE,. PASSES Chec cd b3• Date Rsqairec TA = 532 Your xome - 403 24.2% Bett:er Thar. Code px.ea or Cavity Cont. alaxing/Door Ferimecer R-Vdiue R-Value U-Valtle _ -...'.-_----..... ---------- ---------------' --- 1z1s ae.a 0.0 Wc,oa Fx'ame, 16" C.C. 2673 7.9.0 ?.,0 1 B9M'1': Con.e. 5.0' ht/8.31 bg:9.6' ineul 1.041 1-1.0 0•0 n.350 1 OL•A^SN3: wi.zlGaws or Doors. Aoove drade 438 0.350 l; W?;?R u .? ?1 3e,0 C. 0 C?Vpr OUta?.de A]r :itiAC EoJTPMENi: Furnaca, 92.0 P?'1IE ---- -- - - ----------------- ?;?;,;,Z?a,yC?E gx,yTE;v,?DTi Y Z'kie proFoeed build:ng de&ign de9eribtsci r?ere ig co::aiatenb", with r.re huildi.ng plans, 9peC].f1Gd'GW6`-15, and othex aalculat.3one !?;.bmitte3 with the per;. ap Zir?? Proposed buildGC9?@hae been d.asic?:led eo m?a?--blze e ?men ?? inneecta Enexgy 5uildes1'7e Date 1 r Tf7TRI_ F.U2 LOT SURVEY CHECKLIST FOR RE5IDENTIAL . BUILDING PERMIT APPLICATION . ' PROPERTY LEGAL L o?' DATE OF SURVEY: LATEST REVISION: m rn c a U DOCUMENTSTANDARDS Y ¢ o z o a u?'?] ? • Registered Land Surveyorsignature and company r ? ? . Building Permit Applicant V/ ? ? • Legaldescriptlon ?a' ? ? ? • Address l ? ? • NoM artaw and scale v 0 ? • House lype (rambler, walkout, split w/o, split entry, lookout, etc.) ? ? • Diredional drainage arrows wdh slope/gradient °h ? ? • Proposedlebsting sewer and water services 8 invert elevation ? a( ? ? • Street name D ? • riveway [i ? ? • Lot Square Footage E( ? ? • Lot Coverage fia/ ? ? • Benchmark ELEVATIONS Existinq t9? ? ? • Sewer service (or Proposed) l? ? 0 • Property comers L? ?? • Top of curb at the driveway and property line eMensions ? V? • Elevations of any existing adjacent homes ?V Ct . Adequate footing depth of strudures due to adjacent utllity trenches ? ?/? • Waterways (pond, stream, etc.) Prooosed 0/ ? ? • Garage floor ?0 ? • First floor ? • Lowest exposed elevation (walkout/window) [s?/ ? ? • Property camers 0 ? . Front and rear of home at the faundation PONDING AREA (if aoolicable) ? ? ? • Easement line ? [9? ? • NWL ? Gd// ? . HWL C] v ? • Pond # designation ? V ? • Emergency Overtbw Eievation DIMENSIONS Xi ? • Lot lines/Beartngs 8. dimensions 0? . Rightof-way and street width (to back af curb) vo ? . Praposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. all sWCtures requiring permanent footings) lal ? ? • Show all easements of record and any City utilities within those easements ?? ? . Setbacks of proposed swctu2 and sideyard setback of adjacent existing sWctures C?O ? • Retainingwallrequirements,'rfany Reviewed: Name 7°° /Date Surveyor's Certificate SURVEY FOR :PULrE HoMEs DESCRIBED AS :Loc 16, Block 3, OAKBROOKE STH ADOIION, City of Eaqan, Minnesota and reserving easements of record. ? , ? ? # ,8o5z PROPOSED ELEVATIONS LOT SQ. FOOTAGE = 10,509 HSE SQ. FOO TA GE = 9, 79 7 LOT COl/ERAGE _ Top of Foundation = qqi,o Garage Floor =qqo.i? Basement Floor =932.0 Aprox. Sewer Service =q29•ot Proposed Elev. _ C:--D Existing Elev. Droinage Directions = - Denotes Offset Stoke = • SCALE: t inch = 30 feet 177 BENCHMARK, c.v m4r ?, MIN. SETBACK REQUIREMENTS Front - House Side - Rear - Garage Side- N0: HEDLUND I HEREBY CERTIFY THAT TFiIS IS A TRUE AND CORRECT REPRESENTATION OF THE BOUNDARIES OF THE ABOVE DESCRIBED PROPERTY AS SURVEYED BY ME OR UNDER MY DIRECT SUPERNSION AND DOES NOT PURPORT 70 PLANNWG 6NGWB6R/NG SURV6Y/NG SHOW IMPROVEMENTS OR ENCROACHMENYS. EXCEPT AS HOWN. 2005 Pin Ook Drive 9?L3pl Q • En9an, MN 55122 oATE __ Phone: (651) 405-6600 J F E D IINDGR N, LAND StlkVEYOF Fa%: (651) 405-6606 NE O A LICENSE NUMBER 4376 01 R-427 FILE: Oakbronke 5 Site address: /S? -?h n rr v L? ??? ve- Lot j & Block 03 Subd. ()a V- L c oo% -S t-'- +.+ 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 Certifcate of Occupancy. _ This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670 OR U--"This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674 APPLL4NCE GAS ELEC MANUFACTURER MODEL BTU'S VENTINGTYPE waterHeater ? j'yJ'rs k?e„ Oz? l3 Furnace V 41- 20 ?lo 70OoO ?J?rte[.r't Dryer EXHAUST SYSTEM LOCATION TYPE MODEL CFM's VENTED ves r+o Kitchen kitchen Bathroom 1 a? ?,A . C n i5ort .,-LG F - 1rQ gC) f Bafhroom 2 117vs b,t?, i?an;so? ; ?l?-o Y 5? Bathroom 3 Bathroom 4 Other FIREPLACE S LOCATION GAS WOOD MANUFACTURER MODEL BTU'S VENTING DIRECT ATMOS I '? «t /U . I ?0 000 T !: - R ?700V ? MAKE•UP AIR MODEL TYPE CFM's I hereby acknowledge that the above information is correct and agree lo comply with the Minnesota Energy Code and City of Eagan requirements. ' ^--. I 30 ?0 2 Si tur/e ?? I i (, Date ? !ie ,?o.e.r r o N or ? CompanyName ' This form is the responsibility of the General ConUactor. 1. Use BLUE or BLACK Ink For Office Use Permit nn City of Ea ` I /'9 R I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: I"`DN `f A E Unit Name: s(f0V_ TLIGAl- Phone:LS-7 _Z`/S _q62~6 RESIDENT / OWNER Address/City/Zip: IsLZ ~IbHQYC,44 II LN6 Applicant is: Owner Contractor - TYPE OF WORK Description of work: ~i D ge ,ew 1 Construction Cost r ~0 Multi-Family Building: (Yes /No ) Company:( )Q~S f2 ~J Contact: 4_~LmCJ CONTRACTOR Address: A~) City: L6l/~=E State: / v l Uv Zip: 55-0 Phone: b '7 -7 ^©245 License (2 6 _30 0 ~ Lead Certificate 6~-F - ' 0'~__7 -7 -7~ 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. 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 compI ed within 180 days mitissuance x x A licant's int N me Applican 's Sig ture Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA166195 Date Issued:12/18/2020 Permit Category:ePermit Site Address: 1562 Johnny Cake Alcove Lot:16 Block: 3 Addition: Oakbrooke 5th PID:10-53764-03-160 Use: Description: Sub Type:Residential Work Type:Replace Description: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: 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 - Scott H Trick 1562 Johnny Cake Alcove Eagan MN 55122--550 (651) 295-4625 Milbert Company (culligan) 1801 50th St E Inver Grove Heights MN 55077 (651) 451-2241 Applicant/Permitee: Signature Issued By: Signature