1620 Johnny Cake Ridge LaAddress 16 ")- C) l" vv v? ? Lcle C.U? R Lc? Zip 5512 ?
I.ot 3 v Blk Sub ?n.?V1 vMD V f.
THESE ITEMS WERE / WERE NOT COMPLETE AT TfE TIME OF THE FINAL INSPECTION.
Date: _ d?2 Yes No Inspector.
Final grade (6" from siding) X
Permanent steps (garage) u
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
TraiUcurb daznage ?
Porch ?
Basement finish x
Deck
Please verify with the builder the removal of rooAest caps from the plumbing system and the shutoff of water supply W
the oufside iawn faucet before freeze potential exisis.
Contact engineering division at 681-0645 beforo working in rightof-way or installing underground sprinkler system. ?
Whik - City Copy Yellow - Resident Copy Pink - Contractor Copy
(3 L I ? R SID IA ? (3P 2-U 14`}
•
O BUILDINC PERMIT APPLICATION
CITY OF EAGAN r6 e ?j 7?
3830 PILOT KNOB RD - 55122
851-681-4675 0? q? . ?
NewConsWctionReauirements RemadeUReuairRepulrements
• 3 registered stte surveys showiig sq. ft. of bt, sq, ft of house; an?ll mofed areas • 2 copies of plan
(20%maximum bt coverage albwed) . i set of Energy Calculations for healed additioml, L+
. 2 copies of plan showing 6eam R window sizes; poured found design, etc.) • i site survey for eMedor additions & decks
• 1 setof Energy Calculations . Indicale if home served 6y septic system foredditions
. 3 copies of Tree Preservation Plan if lot plaried after 7/1193 ??? ??
• Rim Joist Defail Options selection sheet (hldgs with 3 or less unils)
. 2-?-a . ??
DATE
JOB SITE
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
•9Te
r?
VALUAfION ted, #.W>
PROPERTY OWNER i'., L4-<
TYPE OF WORK 2PS,sAe,-1?...I
APPLICANT P, 14-C
ADDRESS
PAGER #
CELL PHONE
FIREPLACE(S) _ 0 /--1 _ 2
_ PHONE#65-1 Y3-"Z- rzoe
ZIPCODE
t `I J FAX #
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
? MINNESOTA RULES 7672
- New Energy Gode Worksheet Submitted
Plumbing Contractor. Phone #: ? 5 L ? 2 1
Plumbing System Includes: _ Water So tener Iawn Sprinkler Fee: $90.00
Waler Heater No. of R.I. Baths
No. of Baths
Mechanical Contractor: 8v??.-¦?- l4 40*?k ,
Mechanical System Includes: Air Conditionuig
Heat Recovery System
Sewer/Water Contractor. I{." (
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state
with ail applicable State of Minnesota Statutes and City of Ec
Signature of Ap
Certificates of Survey Received -q,&- Tree Preservation
Phone # lJe2 8`T `f 4'-°6 S
Fee: $70.00
Pnone # -763 V'1`0t`3r
is co li" ?qt, a?Sfi?a?{gao
Updated 2002
OFFICE USE ONLY
? 01 Foundation
?¢'02
? SF Dwelling
12 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
r 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
0 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
-. ,
? 30 Accessory Bldg
? 31 Eut. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bidg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
•Demolitian (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy -E-? -W MC/ES System _
Census Code Zoning City Water _
SAC Units Stories ? Booster Pump _
Nbr. of Units Sq. Ft. l,) a PRV
Nbr. of Bldgs ?
Length _
Fire Sprinklered _
Type of Const W idth
REQUIRED INSPECTIONS
1( Footings (new bldg) ? FiaaUC.O.
f Footings(deck) FinaUNo C.O.
Footings (addition) _ Plumbing
? Foundation HVAC
Drain Tile _ Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
?
Framing Siding Stucco Stone
Fireplace 4 R.I. ][ Air Test
" V Final Windows (new/replacement)
?
Insulation ? =
7<
Retanvng Wall
Approved By -r L , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
rotal
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or_ N
Jr'G-/? %? c?I (rUco"%4e.
1 ? V D
11?i?.? -
? i
?.11
,
? ? ?
h1R r-12-20943 14 :M r. nrrn?
s....?,. ,
MNr_h9Ck COMPLIANCE REPORT
Minr.esota Energy Code Permit
MNCheck Softwarc Veroion 3,0
dctG y/Date
Cp[zarY: nakata
P.?.'A'SE: Minaesots
ZQNF: 2
!"oNSTRIJCT20N TXPE: Bingle Family
DATE: 5-12^2000
DATE OF pLAN$; 8/72/00
T1TLR: CRYB't'AL 9LA8 VP/PORCH EL.1
FP.aJaCT INFORMkTION:
OARARO(7KE
COMF'LIANCF3: PAB8E9
F.>qvired UA . 503
Yeur Floms - 399
2n.6t Setter 2han Code
Axea or Cavity Cant. 61a¢ing/Door
PeYimeter R-Vtslue R-Value u-Value
- ------------------------- -------------------------------------------
CETT'INGS 1713 44.0 0.0
WAI,z,S: S4ood Frame, 16" O.C. 1784 19.0 2.0 1
cr,aZ:tNGi Windowe or poar», Above Orade 299 0.350 1
DO'1R.S 38 0.350
SLAP FLDOR9: Vnheated, 42.0" inaul, 196 10.0 1
HVAC BQLTIPA4$NT: Fux'X1ACe, 92.0 10.P'OS
-------`-----...._------__-----`---_......__---^-------^•_---`-•`---`----`-- -
COMPLIAtICE 9TATEMENT: The propoeed building denigri deecribnd hare ie
conaietent wiCh the building plane, specitioatione, and other celculations
submitted aith the permit np . t€on. The propoeed building hao been
? eat?s of the Mi=ttlesoCQ AneYgy;;i?dg.
deeigned to meet t e 7V
euilder/De?4igsssr . '? LlAtte'"
?
LOT SURVEY CHECKLIST FOR RESIDENTIAL
" BUILDING PERMIT APPLICATION
PROPERTY LEGAL: L-o`I` ..7o
DATE OF SURVEY:
LATEST REVISION:
?
m
c
m
cL? DOCUMENTSTANDARDS
Y ¢ a
O Z Q
SL ? - • Registered Land Surveyor signature and company
?- • Building Permit Applicant
?? ^^ • Legal description
?
n ? • Address
/ + North arrow and scale
?? • House type (rambler, walkout, split w/o, split entry, lookout, etcJ
. Directional drainage arrows with slope/gradient %
??
? u
7 •
• Proposed/existing sewer and water services & inveR elevation
Street name
y.
?' ? _ • Dnveway
• Lot Square Footage
• Lot Coverage
ELEVATIONS
Existina
? ^ - • Sewer service (or Proposed)
, ? _' • Property corners
???`. • Top of curb at the driveway and property line eMensions
??_• Elevations of any existing adjacent homes
_ ?? , • Adequate footing depth of structures due to adjacent utility trenches
? L? - • Waterways (pond, stream, etc.)
Prooosed
?? G :_ • Garage floor
?/ - - • Basement floor
?t ': • Lowest exposed elevation (walkouUwindow)
? -
? • Property corners
l = • Front and rear of home at the foundation
PONDING AREA (if aoolicable)
? IV 7 • Easement line
? ? - • NWL
. H W L
. Pond # designation
iY . Emergency Overflow Elevation
? ?
V '
?
DIMENSIONS
• Lot lines/8earings & dimensions
• Right-of-way and street width (to back of curb)
• Proposed home dimensions including any proposed decks, ovefiangs greater than 2', porches, etc.
(i.e. alI 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 requireme
Reviewed:
OK
Surveyor's Certificate
SURVEY FOR :PULTE HOMES
DESCRIBED AS :Lot 30, Block 1, OAKBROOKE 67H ADDI110N, City of Eogan, Minnesota and reserving
easements of record.
_q
JOH
931.4
RID
!'Z
?
_ .J
y g31,t.
>?7LAA VN CAKE
'E NE
931.0
?ry o co^o ?
F
p`S ?0 9P 00 O
t ^^ 0 ryRr 932.0
ryb.
p ?
O
?J RD poy ? 31.9
O
oy o A?w o° ? r 6?
\ op p?
? 2Q , ? a?NGL?
00
933.8 0
tl O[l LLOVO L LL?Ii?QVORED
9.1
or Retaining
Be Raquired
# 17941
PROPOSED ELEVATIONS
Top of Foundation =934,5
Garage Floor =933.4
Basement Floor =926.5
Aprox. Sewer Service =922.5
Proposed Elev.
Existing Elev.
Drainage Directions =-
Denotes Offset Stake = .
BENCHMARK,
MIN. SETBACK REQUIREMENTS
Front - House Slde -
Rear - Garage Side-
JOB N0:
HEDLUND I HEREBV CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION 02R-497
OF THE BOUNDARIES OF iHE ABOVE DESCRIBEO PROPERTY AS SURVEYED
AGE?.
BY ME OR UNDER MY OIRECT SUPERNSION ANO DOES NOT PURPORT TO 77
PldNNlNG ENGINBSRlNG SURVfiYING SHOW IMPROVEMENTS OR ENCROACHMENTS, E%CEPT AS SH .
2005 Pin Oak Drive p
Eagon, MN 55122 DATE CAD FILE:
Phone: (651) 405-6600 EY LINDGREN-LAND
NUMBER ?14 76 R Oak6fooke 5
Fax: (651) 405-6606
?
L O T SQ. F00 TA GE = 5,608
HSE SQ. FODTAGE = 2,047
L O T CO l/ERA GE = 5 77o
SCAIE: 1 inch = 30 feet
PERMIT
City of Eagan Permit Type: Building
Eaaan. Permit Number: EA099924
Date Issued: 07/05/2011
OR Permit Category: ePermit
41 it~ of E3
E
Site Address: 1620 Johnny Cake Ridge La
Lot: 30 Block: I Addition: Oakbrooke 6th
PID: 10-53765-01-300
Use:
Description:
Sub Type: e-Windows iDoors Construction Type:
Work Type: Replace
Description:
Census Code: 434- Occupancy :
Zonin,:
Square Feet: 0
Comments: Tim Schenk
Elder-Jones Buildina Permit Service
1120 East 80th Street. Ste. -211
Bloominaton. MN 55420
Fee Summary: BE - Base Fee $500 $40.00 0801.4085
Valuation: 500.00 Surcharge - Based on Valuation $2.00 9001.2195
Total: $42.00
Contractor: - Applicant - Owner:
Home Depot At Home Services Cvril D Laurent
656 Nlendelssolm Ave. N 1620 Johim Cake Ridge La
Golden Valley MN 55427 Eagan MN 55122
(763) 42-8826
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 Cite of Eaaan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
PERMIT
City of Eagan Permit Type: Building
Eagan. Permit Number: EA102021
Date Issued: 11/08/2011
OR Permit Category: ePermit
41~ it~ of E3
E
Site Address: 1620 Johnny Cake Ridge La
Lot: 30 Block: I Addition: Oakbrooke 6th
PID: 10-53765-01-300
Use:
Description:
Sub Type: e-Windows iDoors Construction Type:
Work Type: Windows Doors-New ; Replacement
Description: House
Census Code: 434- Occupancy :
Zonin,:
Square Feet: 0
Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openin,s, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee S3K $88.50 0801.4085
Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195
Total: $90.00
Contractor: - Applicant - Owner:
Home Depot At Home Services Cvril D Laurent
656 Nlendelssolm Ave. N 1620 Johim Cake Ridge La
Golden Valley NIN 55427 Eagan MN 55122
(763) 42-8826
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 Cite of Eagan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
PERMIT
City of Eagan Permit Type: Building
Eagan. Permit Number: EA104210
Date Issued: 05/10/2012
OR Permit Category: ePermit
41 it~ of E3
E
Site Address: 1620 Johnny Cake Ridge La
Lot: 30 Block: I Addition: Oakbrooke 6th
PID: 10-53765-01-300
Use:
Description:
Sub Type: e-Windows iDoors Construction Type:
Work Type: Windows Doors-New ; Replacement
Description: House
Census Code: 434- Occupancy :
Zonin,:
Square Feet: 0
Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openin,s, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee S4K $103.25 0801.4085
Valuation: 4.000.00 Surcharge - Based on Valuation S4K $2.00 9001.2195
Total: $105.25
Contractor: - Applicant - Owner:
Home Depot At Home Services Cvril D Laurent
656 Nlendelssolm Ave. N 1620 Johim Cake Ridge La
Golden Valley NIN 55427 Eagan MN 55122
(763) 42-8826
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 Cite of Eagan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
PERMIT
City of Eagan Permit Type: Building
Permit Number: EA104825
Date Issued: 06/12/2012
tit~ of E(~ j]n Permit Category: ePermit
Site Address: 1620 Johnny Cake Ridge La
Lot: 30 Block: 1 Addition: Oakbrooke 6th
PID: 10-53765-01-300
Use:
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee $4K $103.25 0801.4085
Valuation: 4,000.00 Surcharge - Based on Valuation $4K $2.00 90012195
Total: $105.25
Contractor: - Applicant - Owner:
Krech Exteriors Inc Cyril D Laurent
5866 Blackshire Path 1620 Johnny Cake Ridge La
Inver Grove Heights MN 55076 Eagan MN 55122
(651) 688-6368
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.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA127910
Date Issued:10/20/2014
Permit Category:ePermit
Site Address: 1620 Johnny Cake Ridge La
Lot:30 Block: 1 Addition: Oakbrooke 6th
PID:10-53765-01-300
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Cyril D Laurent
1620 Johnny Cake Ridge La
Eagan MN 55122
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA128128
Date Issued:10/27/2014
Permit Category:ePermit
Site Address: 1620 Johnny Cake Ridge La
Lot:30 Block: 1 Addition: Oakbrooke 6th
PID:10-53765-01-300
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Lisa Nyberg
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Cyril D Laurent
1620 Johnny Cake Ridge La
Eagan MN 55122
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
!"
#$%&'()' *+*,
-./$%'"&0-123$45$,+
-./$%'63/7-.1 89:;9AB
>*%-'!??3-5199@A;@A<9B
-./$%'#*%-+(.&1- -./$%
C$%-'855.-??1''9=A<''R(M,,&'#*P-' $5+-'O*''
3'"# $% &&7)**+ + , &&E0%>/ %<&! M
456 7'893Y!98'783''&
;1<
>-?G.$0%$(,1
-=>&?@A< 2+,* B1C6 /1F ,1 /=$ + ,&?@A<
2 /%&?@A< D<A#0$<
6<1$/+A + , ?B & /&S /<&2+,* B1C6 /1
F<,1=1&F *< G3G&8&E$$=A0,$@
H ,+,I
-J=0/<&.<< '
5KA/ L<K<, 1& & M<&M K<&/<J=+/<&1K %<&*< <$ /1&+,&0##&><*/ K1N&5O&0# </+,I&B+,* B& A<,+,I1& /&+,1 0##+,I&"0@& /&" B&
#(//-,%?1
B+,* B1P&$0##&O /&O/0K+,I&+,1A<$ + ,N&F0##&O /&O+,0#&+,1A<$ + ,&0O </&+,1 0##0 + ,N
F0/> ,&K , Q+*<&*< <$ /1&0/<&/<J=+/<*&B+ M+,&7'&O<< & O&0##&1#<<A+,I&/ K& A<,+,I1&+,&/<1+*<, +0#&M K<1&RS+,,<1 0&- 0 <&
" &8&"01<&.<<&UGbU7'3N(9&'V'7NG'V9
H--'C3//*.&1
-=/$M0/I<&8&"01<*& ,&T0#=0 + ,&UGbU(N''&:''7N(7:9
T0#=0 + , &&GP'''N''
"(%*41I9<BJAB'
#(,%.*G%(.1KL,-.1
8&&)AA#+$0, &&8
\\ K<&6<A &) &\\ K<&-</L+$<1F@/+#&6& 0=/<,
!((G& 0%<#0,*&)L<,=<&ZP&e7'(7!('&_ M,,@&F0%<&D+*I<& 0
" %#@,&40/%&SZ&&99G(VW0I0,&SZ&&997((
RY!3\[&9G(8VV(!R!7(\[&V'78!3!3
5&M</<>@&0$%, B#<*I<& M0 &5&M0L<&/<0*& M+1&0AA#+$0 + ,&0,*&1 0 <& M0 & M<&+,O /K0 + ,&+1&$ //<$ &0,*&0I/<<& &$ KA#@&B+ M&0##&0AA#+$0>#<&- 0 <&
O&S+,,<1 0&- 0 = <1&0,*&F+ @& O&W0I0,&E/*+,0,$<1N
)AA#+$0, C4</K+ << &-+I,0 =/<511=<*&"@ &-+I,0 =/<
!"
#$%&'()' *+*,
-./$%'"&0-1 -EK*,$E*4
-./$%'63/7-.1 89:;<=<
>*%-'!??3-519=@==@=A9<
-./$%'#*%-+(.&1- -./$%
B$%-'855.-??1''9L=A''M(K,,&'#*N-' $5+-'O*''
G(#$ %& ''!*++, , - ''K3&?4 &0'\[ /
678 !(9;G:\[;9(!9G(('
<10
>-?E.$0%$(,1
=>?'@AB0 E01,+0- ,3$
D 4&'@AB0 E0B$3%0
801%4,B , - J>4-3%0'^'*,4'. -+, , -04
_>01 , -1'40C34+,-C'0$0% 4,%3$'B04P, '40I>,40P0- 1'1/ >$+'?0'+,40% 0+' '= 3 0'5$0% 4,%3$'7-1B0% 4Q'234&'*-+041 -'3 'SX;)T'
#(//-,%?1
FF;9)"F(O
.34? -'P - R,+0'+0 0% 41'340'40I>,40+'N, /,-'!('M00 ' M'3$$'1$00B,-C'4 P' B0-,-C1',-'401,+0- ,3$'/ P01'S2,--01 3'= 3 0'
25'9'604P, 'J00'SE0B$3%0P0- 1TV;XO(('("(!OF(""
F--'B3//*.&1
=>4%/34C09J,R0+V!O(('X((!O)!X;
"(%*41GLAHAA'
#(,%.*E%(.1IJ,-.1
9''*BB$,%3- ''9
=0+CN,%&'\\03 ,-C'^'*,4'. -+, , -,-C.A4,$'8' 3>40-
!F("'Z 4 /$3-+'84,L0Q'=>, 0'G!(!\[)('` /--A'.3&0'E,+C0' 3
20-+ 3'\\0,C/ 1'2Z'';;!)(53C3-'2Z'';;!))
SX;)T'""!9X(((
7'/040?A'3%&- N$0+C0' /3 '7'/3L0'403+' /,1'3BB$,%3 , -'3-+'1 3 0' /3 ' /0',-M 4P3 , -',1'% 440% '3-+'3C400' '% PB$A'N, /'3$$'3BB$,%3?$0'= 3 0'
M'2,--01 3'= 3 > 01'3-+'., A' M'53C3-'K4+,-3-%01O
*BB$,%3- \]604P, 00 '=,C-3 >40711>0+'#A '=,C-3 >40
SEDGWICK HEATING & AIR CONDITIONING CO.
1408 NORTHLAND DRIVE, SUITE 310 • MENDOTA HEIGHTS, MN 55120 • (952) 881-9000
ADDRESS ``o --Tit
,n CAA, 11-11(' "LtiC.
OCCUPANT 7yMt� J
SOLD BY
70S ,`
MAKE LAM. 0.`f
SERIAL NO
HEATING
TEST RECORD
CITY e21
OWNER / / L2uZn"1
INSTALLED BY �� /
17/
JOB NO 41 "I
MODEL SLM/ Vit010�VJ6j
INPUT
THERMOSTAT VENT SIZE
VALVE a ! , `' e / !' k:s
TYPE OF LINER
LIMIT '! t LINER SIZE
LIMIT SETTING I ' f ° FILTERS` SIZE ' C a NUMBER
FAN SETTING ' t l.', WIRING
PILOT TYPE i si 4-I TEST TAG _h
IGNITION MODEL I ti , 4 LIGHTING INST.
PILOT TIMING
•
i
PRESSURE PERCENT CO2
INPUT CFH PERCENT 02 (
Cr
STACK TEMP. �/ PERCENT CO
FORM 235 (REV. 10/10)
DATE TESTED
COMPANY TESTING
NAME OF TESTER
5
Zt
FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY - CITY
Use BLUE or BLACK Ink
For Office Use
Cly o Eall :::ee: Patel
�;
3830 Pilot Knob Road `� n ��
Eagan MN 55122 Date Received: _ ( /
Phone: (651)675-5675
Fax:(651)675-5694 Staff: lel
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 8/25/2017 Site Address: 1620 Johnny Cake Ridge Lane Unit#:
= Name: Cy & Evelyn Laurent Phone: 612-801-6363
Resident/- 1620 JohnnyCake RidgeLane, Eagan, MN 55122
- owner - Address/City/Zip: g
Applicant is: Owner X Contractor
Re lShower-SeeAttached Drawing
Descriptiace on of work: pg
Type of Work
Construction Cost: 5173 Multi-Family Building: (Yes X.__/No _.)
company: US Patio Systems Contact: Wendy Rache
-- Contractor
Address: 218 N River Ridge Circle City: Burnsville
MN 55337 952-314-9885 wrache a uspatiosystems.com
_: State: Zip: Phone:
Email:
License tx: BC661813head certificate : F119453-1
If the project is exempt from lead certification, please explain why: „^
Build after 1978
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:
Fire Suppression Contractor: Phone:
_NOTE:Plans and supporting documents that you submit arc considered to be public information. Portionsof
- 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. Cali 48 hours
before you intend to dig to receive locates of underground utilities. wmv.iopherstateonecall.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 completed within 180
days of permit issuance.
X Wendy Rache L1 '- L.xi
Applicant's Printed Name Applican s ignat re
Page 1 of 3
- liege) 3p lA n�� Cis. ( . (Z d e LoAq ( ' i 3,
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation — Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
1 Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi — Deck _ Porch(Screen/Gazebo/Pergola) Miscellaneous
_ 01 of—Plex _ Lower Level _ Pool ` Accessory Building
WORK TYPES
_ New _ Interior Improvement _ Siding _ Demolish Building*
_ Addition _ Move Building _ Reroof i Demolish Interior
_.1.*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 .)_97A Occupancy MCES System
Plan Review c Code Edition "�� y, ' SAC Units
(25°/0____100% `\) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction \i Width
REQUIRED INSPECTIONS`!
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
—
Footings(Addition) �.. Final 1 No C.O.Required
—
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice&Water _Final Pool:_Footings Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In Air Test Final Siding:_Stucco Lath _^ Stone Lath Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings—Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
eviewed By: A V
,Building Inspector
RESIDENTIAL FEES
Base Fee
i .
Surcharge r, \\ ),
/
Plan Review
MCES SAC NIA
�:
City SAC
Utility Connection Charge
S&W Permit&Surcharge I)/,
Treatment Plant
Copies
TOTAL 1\k,)\
V 6it, Page2of3
` ''.
Use BLUE or BLACK Ink
—7
For Office Use
City of EIIRII Pemit#: t�E5�3 � �
Permit Fee: D.0 St/i'1
3830 Pilot Knob Road i S'
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 Staff:
Fax: (651)675-5694 ,
2017 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 8/25/2017Site Address: 1620 Johnny Cake Ridge Lane
Tenant: Suite#:
_ Name: Cy & Evelyn Laurent Phone: 612-801-6363
Resident/Owner. _ ---
Address(city izip: 1620 Johnny Cake Ridge Lane, Eagan, MN 55122.
Name: US Patio Systems License#: PC708206
Address: 218 N River Ridge Circle City: Burnsville
Contractor ---
State: MN Zip: 55337 Phone: 952-314-9$85
Contact: Wendy Rache Email: wrache@uspatiosystems.com
Type of Work New I/ Replacement �_Repair _Rebuild _Modify Space _�Work in R.O.W.
Description of work: Replace Shower-See Attached Drawing
RESIDENTIAL
Water Heater
Lawn Irrigation(_ RPZ/_ PVB) Water Softener
Permit Type ✓ Add Plumbing Fixtures(1/ Main/ Lower Level)
Septic System
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,Water Softener,or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
`Water Turnaround(add$280.00 if a 3/4"meter is required)
$115.00 Septic System New(includes County fee and State Surcharge)
TOTAL FEES $60.00
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.goeherstateonecalLore
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.f plans.
x Wendy Rache x loft,_ 'lye
Applicant's Printed Name Applies Si rt. ure
FOR OFFICE USE Reviewed By. Date:.
Required Inspections:. Under Ground Rough In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Manometer Staff:
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA171487
Date Issued:08/18/2021
Permit Category:ePermit
Site Address: 1620 Johnny Cake Ridge La
Lot:30 Block: 1 Addition: Oakbrooke 6th
PID:10-53765-01-300
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 -
Cyril D & Evelyn M Laurent
1620 Johnny Cake Ridge Ln
Eagan MN 55122
(612) 801-6363
Milbert Company (culligan)
1801 50th St E
Inver Grove Heights MN 55077
(651) 451-2241
Applicant/Permitee: Signature Issued By: Signature