1612 Johnny Cake Ridge WaAddtess 1612 Johnnv Cake Ridge Way Zip 55122
LAt 14 $]IC 6 $Ub Oakhronka
THESE TI'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: 3(, /0 Yes No Inspector. ,
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
TraiUcarb damage
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shutoff of water supply to
the outside lawn faucet before freeze potential exisls.
Coniact engineering division at 6814645 before worki¢g in right-0f-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
..
1999 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
w Con
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
? 3 regisTered afle aurveys showing sq. H. of lof, aq. ft. of house
and QJ rooied aeaa (20% maxlmum lot eoveraae allowed)
D 2 eopies of plans (show beam a wlndow ihes; poured fnd. design; etc.)
? 1 set of energy calculaNons
D 3 copies of hee preaervaHon pMn B bt ploMed after 7/1 /93
'°)1
Remodel/Reoatr Reauhemenh
2 copies ot plan
1 set of energy ealculatbns for heated addXions
1 ske survey for exterlor addkfons L decb '
DATE: j?f ?I? CONSTRUCTION COST:
/30, a6
DESCRIPTION OF WORK: lfCb lGon ?)u I
STREEt ADDRESS:
LOT: ? BLOCK: f? SUBD./P.I.D. 0,9IcsiP0OiCF_'
tf? b
Name• PUlfe- /?ome"s Phone#• am*
PROPERTY Last prst
OWNER / J p
SfreetAddress: l`3'?/V?'Y.(,?/ld cShckac7d
Cffy 4a1 c.ln f'i; N?r?S State: Aq/ Zip:
Company: sAAc As AML
CONTRACTOR
ARCHITECT/
ENGINEER
Street
City
Telephone #: area code (
Stredt
City
Phone #:
(area code)
License # _
Stafe: Zip:
Name:
Registration #:
State:
Zip:
Sewer R water Iicensed plumber (reaulred for new conshuction onlv): 11)9I1L- T ILUXA??/YG ?19Q `a 1a 1
Penally app0es when address change ond lot change it requesfed once permH ls bsued.
I hereby acknowledge that I have read ihis applicaflon, stcFe that the InformaNon Is cortect, and agree to comply wHh all applicabl
Stale of Minnesota Statufes and City of Eagan Ordinances. /
Signature of AppllcanY.
OFFICE USE ONLY
Certificates of Survey Received ? Yes _ No
r,i!y
Tree Preservation Plan Received _ Yes _ No ? Not Required ?
°L
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
X 02 SF Dwelling ? 07 5-plex 0 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
O OS 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.' ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
` Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
-<111 Basement sq. ft.
.?iV Main level sq. ft.
sq. ft.
? sq. ft.
sq. ft.
? sq. ft:
_ Building P 14
Footprint sq. ft
?
.4 4 7:Z
Engineering
Census Code
5AC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC ?
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SNV Surcharge
Treatment PI.
Park Decl.
Trails Ded.
Other
Copies
Total:
Valuation: $
?
T
L ?( /J = /l: ? ?G? •
jCJ /Z
R(, p I
SAC Units
% SAC
'
EXTERIOR ENVE CO
LOPE AVERAGE "U' MPl1 TA TI0N
pW1I E R : ,. .
•---°- __...
? O
J
?
a C
t
SITE AOpR E55:
?! d
•
I1Y1Y) -
l ---
COt7TRACTO R: EUl
?
S
TE Cto?K?S DATE: ? PF10NE:
-
.
r
_ _?_
DETERHINE HORKINf, SOUARE FOOTACE OF EACH!
'?
1. TOTAI EXPOSED l1ALL AREA,,;,,,,, 2?(v Sq ft x "U" t
? 5- "X
' 2. TOTAI ROOF/CE I L IlIG AREA
; 5Q ft % 'full
I ?/?
/
A
, ,,, l??
?
3. TDTAL EXPOSED 14ALL AREA CALCULATIONS:
Total exposed wall
area above floor,,,,,,,, Z?I?Fj sq ft
? a) Total wall wlhdow area: .
DOUF3LE 9lazed...... 23?. sq f[ x ?'U" ? 5?- • ?1 ??i
,. H' P, glazed...... sq ft x 'iU"
6} Total door area 37t 7 Sq ft X "U"
,,,,,,,,, _
c) Total sildllig glass door area: ' • •
DOUEiLE glazed...... .
sq
ft
x
"U"
glazed...... ` sg ft x "U'i
d) .To[al flreplace wall area sq ft x "U"
e) Total wall framing area
(Averagc lOR)...... ...
. sq
ft
x
"U" .Q9Z
ZX.Z.
f) Total net wall area above
floor (insulated)...... . ?7
f8Of 3 sq
ft
x
"lJ" •?`t'"1 "
,??
?
2 , r 12_? a
g) Total rlm Jolst area..... . sq Ft x "U" •Q9'? ^° ,_--,----..._.
Total foundatlon
erea (Exposed)......... . /1J 6 sq f[
h) 7otal Foundatlon
wlndoH area ............
. sq
ft
x ?? ??
U
1) Total net foundatlon
"
"
area a6ave grade......, . sq ft x U
° 3 TOTAL a) thru
If Item R3 Is the same as, or less than item P1, you have met the fntent oF
2 tICAR 1.16008 A and 0. •
P -t ?j,? l.
' aTnL EXPqSED RQOF/CEILRIG CALLl1LATI0t15:
Total exposed
roof/cefllnq area........ 59 ft
.?) Total skylloht area....... ? sq ft x"U" ° ---
k) Tatal roof/cefllnq framing Sq ft x"U"--. QZ ? ° ? tl
- area (Averaae 1n1).••.••?
I) Total net Insula[ed sq ft x"U" .077- ° Z3r 7
roof/celllnq erea.......
?i. TOTAI J) thru 1) 2-??-
If total of 04 Is the same as, or less than R2, you have met the Intent of
2 P1CAR 1.16008 A and 0.
.. ? _.
? ?'...
ALTERNATE BUILDItIf, ENVELOPE DESIGN
To utilfze [he total envelope system method, the values established by the sum
of i[ems f3 and 94 shall.not oe greater chan the sum of icems 91 and N2.
+ 7.:
+ 4. ° -
C E R 7 I F I C A T 12. N
I hereby certlfy that I have calculated the "U" factors and "R"
values hereln and that [he bulldlnq here.descrihed mee[s er exceeds_the State
of Minnesota Energy f.on5ervatlon Act. i"?
' Slqnature _
(Da[e) ?
1`:i i',r .
S`;X3Z l5 J!(..: <? ,z-, „?::...Jiv\ j j vI-t VtuLj1,-
COIISTRUCTfOfl R VALUE
, - NALL fRANING SELTION:
1 Interlor a(r-.fllm q.6R
------?2 I/Z"qC' .d$ ..
? -{3 5'/Z i.nches so t woad
-{4 = /SZ' qUIL?i'f? 7 2
r i'?t?1ri?C'?
f+ Exterlo Im 0.17
• 70TAL R - Ip. L-1
U- 1/R- L27L
• WALL SECTION (INSULATEO)
• -{1 Intertor a(r film n,6,9
- 'z /z' tuC?T2.DGL Zg
3 R-??7 If.l?S()?A??of` j??
N1CJ1I.?2!"1"- 7 n ,
5 D.I_11J??1 ? I DI I.1C? / I
(+ Extertor alr fllm • 0,17
? TOTAI. R - 7'7 '
. u . I/R -
R!M JOIST SECTI0IJ:
1 Inter(ar aIr film n.6R
3 kArnl:r? r ?F3 _
? 4 ?/iZ' S ll TRI'T?.
dd 5 ALUM .-SiIRlC? cqI
6 Exterior air fllm - n,17
TOTAL R = 7.?.C{)
FOUNOATION INSULATION REQUIRED:
• Min. R-5 on entire wall OR U? i/R
p,p•;•,s Min. R-10 dawn to frost.depth "
., :
' FOUNDATION SECTION:
? ?' ? A• -(1 Interior air film n.f,R
Z 21-111 FSA'f`( f +4Y ( ,D
.?'.a'.?=' 3 12" ('nAl[? C?l OCIL I.Z,?g
-,.-
Exterlor air iilm n.17
d'A-" G
' • c.• (5
?. ? 4.:?•..4 v, ,,. ? (F
rnTnL R
-L u
u - i/R ? ?CTIb
SLAA ON Gf1ADE
_a ,? .•, .?V? :-4'? <l., ,?j •Q.
?. .•d' ? i . 4 ,, f? • + _ ? '?'.. "' "
• .o ?a•:,tl'. •'•r E „ ? ? . 'q ? • . ..d
, •v .; °? o`'.. ??, A ,;... ,? cs • d . ,• , , ,• • •
\.4 . ^ a• o' ? ? / //?;,, --
? , • ; Heated Slabs:
• , % •f ?.
Minimum R = 8.5 a, 4.41 ? ? U ' .
Unheated Slabs: : 'a4 . • Q ;' ? 9
. ;• '? . . Minimum R = 6.2 . ? , . -
4,. • Q•,• 4, ?;'t
.i• ' •v ," . , ?a?,. , - ' t
a .> , .
?• '`
.; ? v •
v
Y
?
.
CM
CONST, R?T?aM
CEILlMt; SECTIQN (lrrsni nrrDi .
1
2
3
4
CEIf,IMG FRAtlING SECTtnu.
T
2
3
4
S alilirr
R Y1E.
CEIi.ING SECTIQN (1!lSUTATED):
In[erlor air film
2 n.61
3
4 Exterior air P, m still
1
76TA? R =
U4 1/R=
VENTED
CEILINr, FRAMJtlG SECTI0p1;
lnterlor air F}im
z 0.61
3
4 Exterlor atr f?)m '
? srti? n. t
fnches so t wood
TOTAI R =
U = I/R >
?
I Insfde afr film
y n.?l
3
4
? Outside air film
n,17
rOral R ? .:
u- i/R -
v - I/R a z
U ° 1/R a -?}z7
?_
in
? Pulte Homes of
Minnesota Corporation
1355 Mendota Heights Road, Suile 300
Mendota Heights, MN 55720•7112
Phone: (651) 452-5200 Fax: (651) 452-5727
JOBNO. .-i
conMuNin: }I,, k4, ci
BUILDINO ADDRESS: I I.?I
MODEL NPME:
BUYER'S W WiE: l "
CURftENTADDRES'?S: O C-•
HOMEPHONE: / lOf2 Q/q-0-;!_I
SALES REPRESENTATIVE "xtii
;,:,YY.i , _?.O.P,TtON #::
0000
BASE PRICE -PRICEt?
c2!47+ 99d
--- LOTPREMIUM lo,p00
ELEVATION # .?j (oa150
.
27-025 -¢so
2 50)-n a?-2. ea-a F?vr,a.S?-er at-cra,-s N c
2?0ll3 6vo0d ? f0 2^"4 plavY 1b.25
iVoo -7 zC- PX-oL :2 o o
I?fll?? ?? c z?eo
lo °87
lL9/D-L
I Dll`I vaic.p-
Irt1G?5<u,l lPcio
/DS-O
5 2900("
' 70a y Caq i reyj K, cl,..4, S ?r,lc-
s C?- ??,c !?a's
5?0
??s
l 1300 ?3 rnv ? ?350
TOTAL
•? : ? •
6uilder's License M0001371
INITIATION ORr=,.R
oo
LEGALDESCRIPTION LOT BLOCK ?Y J
: uNR
aoomoru:
N \.LUd.P ? 11AL1(? {?/Q.?, - CITV: C?ap C?' ? STATE/ % ZIP?
MOOEL NUMBER: LO A J I
L ELEVATION: 6ARA6E: IEFf I
F
tL"
DATE OF ORDER:
CIN: Qkftwm-lwl ? .?/??j
STATE: ? LP: ?(?J
T1CU U A4 Li li {,? M.EY
APPROVED BY BUYER
APPROVED BY SALES: ? s
RELEASED TO START C EOUAL HQII$111G
OPPOftiUGITY
This constituies a contract between the Seller and the Purchaser(s) for the above items
BUSME53 PHONE: BU51 SS PHONE:
JOB INITIATION ORDER
Pulte Homes of
Minnesota Corporation
1355 Mendota Heights Road, Suite 300
Mendota Heights. MN 55120-1112
Phone: (651) 452-5200 Faz: (657) 452-5727
JoB NO. `01) -d-Q 1 d ?
COMM,NIr: N-V bvo 0 lce -
MODEL NAME:
BWER'S NAME: W" 4 l • , i
CURRENTADDRES,,S: ?oU
HOME PHONE: + `? ?7' 0-O7Q
SALES REPRESENTATIVE &$"-
no , 2 ")F
J
CONTRACTOWSUPPUER:
O `r LEGAL DESCRIPTION: l0T ? BLOCK
uNrr
ADDITION:
? UJ?Ify?, CITY: ZwYil?? STATE:
MODELNUM6ER: ELEVA710N: .> OARAGE: LEFT RIGHT
"P,?M` ' " D^ATE OF ORDEpR?:
CRY:_yY/1u7????? STATE: Iu?I ZJP.Q2V;_rz
BUSINESS PHONE: BVSINESS PFiONE:
E:.GtTi1f ? .,;OPTIONI„
0000 On?`?3¢?#3s'i
BASE PRICE , PRICE'F
--- LOTPREMIUM
ELEVATION #
i a 30lV-- ?
? 3 aola TV 50
1 Cl ? ??e,? 1'?e„ ??cpeu-??i?-?? 13aa
? 310011 watev UIV-& r.ce? kRv-
TOTAL -?
Builder's License 40001371
APPflOVED BY BUYER ( ?
APPROVED BY SALES: ? p
RELEASED TO START CO eaunL E{ousiwc
OPPOAiUr11TY
This constitutes a contract between the Selier and the Purchaser(s) for the above items.
LOT 5URVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTY LEGAL: 1;7- 14 Vo[°K j?? dAt'b'/1oo/"E
DATE OF SURVEY:
LATEST REVISION:
DOCUMENTSTANDARDS
&1-1? ?
aff-, ? ?
?o ?
? ?
?
?.
p ?
?? ?
?
me ? ?
p/? o
V ? ?
o/ a a
m?o ?
?o ?
? ?o
? m?c
- Registered Land Surveyor signature and company
• Building PermitApplicant
• Legal description
• Address
• North arrow and scale
• House type (rambler, walkout, split w/o, split entry, lookout, etc.)
• Directianal drainage arrows with slope/gredient %
• Proposed/epsting sewer and water sernces 8 invert elevation
• Street name
• Driveway
• Lot Square Footage
• Lot Coverage
ELEVATIONS
Existinn
• Sewer service (or Proposed)
• Property cornera
• 7op of curb at the driveway
• Elevations of any ebsOng adjacent homes
Adequate foo6ng depth of structures due to adjacent utiliry trenches
Prooosed
/
t?' o ? • Garege floor
q// ? ?
? ? • Firsttloor
• Low
sed elevatian (walkouUwindow)
t ex
q es
po
oa? o ?
? • Praperty corners
? ? • Front and rear of home at the foundation
PONDING AREA (iF aoolicade)
? m' ? • asement line
o 1/ ? • NWL
? ? • HWL
? ? • Pond # designation
? B' ? • Emergency Ovefiow Elevation
?' A ?
? ?
? ?
cd ? ? .
C."?? /? .
? h' o •
DIMENSIONS
Lot Iines/Bearings 8 dimensions
Right-of-way and sVeet 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 recard and any Ciry utilities within those easemenCs
Setbacks of proposed structure and sideyard setback of adjacent exisUng structures
Retaining wall requirements, if any A n i
Reviewed:
March 1998
cwuc,aLoovi+r.rt.FM
Surv e y o r's
:
%ri^
SURVEY FOR ; PULTE
DESCRIBED AS : Lot 74, Block 6, OAKBROOKE, City o( Eagon, Dokoto County, Minnsolo ond
reserving easements of record.
E E? ?
E t
? .
?? /0 -? °"
t ---wr„
LOT SQ. FOOTAGE
HSE. SQ. FOOTAGE
LOT COVERAGE _
Plon # 18231
PROPOSED ELEVATIONS
Top of Foundotion = 1?32.0
Gorage Floor = 93i.(o
Bosement Floor =92q.0
Aprox. Sewer Service =qi9.5±
Proposed Elev.
Existing Elev. _
Droinoge Directions =
Denotes Offset Stake = .
HEDLUHD
PLANN/NC 6NC/N66R/NG SURV6YINC
2005 Pin Ook Drive
Eogon, MN 55122
Phone: (657) 405-6600
Fax : (651) 405-6606
.:
BENCHMARK,
Con{rol Dai,i
Eleu : q5z,5o
MIN. SETBACK REQUIREMENTS
Certific a te
= 13,422 ° ,
'1
= 1,801 ?Q?
0
.?
$CALE: 1 inch = 30 leel
Front - 25 House Side - 25
Rear - Gorage Side -
I HEREBY CERTIFY THAT THIS t5 A TRUE AND CORRECT REPRESENTATION
OF THE BOUNDARIES OF THE A80VE DESCRIBED PROPERTY AS SURVEYED
BY ME OR UNDER MY DIRECT SUPERVISION AND DOES NOT PURPORT TO
SHOW IMPROVEMENTS OR ENCROACFIMENTS, E%CEPT AS SHOWN.
DATE ly /1f_/Q[
FF Y D. LINDGREN LAND SURVEYOR
MINNESOTA LICENSE NUMBER 14376
JOB N0:
99R-547
800K: PACE:
CAD FILE:
OAKBROOKE
L 4 BL` ?
SUBD. O(?,1L\n r n "
CITY USE ONLY RECEIPT #: I lgqS
RECEIPT DATE: 10 '0-kI?
PERMIT # '3 ? 7"3 ?
1999 PL17M$INfi PEfiMTi' (RESIDENTilkl.)
crrY oF !.,
?? ???
S$SO PILOT KA08 iiD f` ?
gAHAN, biN 551 e^.2 ? v
(651) 681-4B95
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinklersystem
FIXTURES EACH # TOTAL
Bath tub $ 3.00 x $
Floor drain 3.00 x = $
GeS i in OUtlet ' minimum -1 3.00 X = $
Hot tub/s a 3.00 x = $
Kitchen sink 3.00 x = $
Laund tra 3.00 x = $
Lavato 3.00 x = $
Minimum fee alterations to existin dwellin 30.00 x = $
Private Dis osal S stem new/refurbished ' re uires MPC iic. 75.00 x = $
Private Dis osal S stem abandonment 30.00 x = $
RPZ new installation/re air 30.00 x = $
Rou h o enin 1.50 x = $
Shower 3.00 x / - $
Under round s rinkler if dwellin is under construction 3.00 x = $
Under round s rinkler if existin dwellin 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x
Water softener if dwellin under construction 5.00 x = $
Water softener if existin dwellin 30.00 x = $
Water turnaround 30.00 x $
State Surchar e .50 --> ----> ----> $ 50
Total -> --> ----> .... > $
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
-----------•-----------------------------------------------•----------------------••--------------•-----------------------------------
I hereby adcnowiedge that I have read fhis appliwtlon, sfate that fhe infortnation is correct, and agrce to comply wilh all applirable Cily oi Eagan ordinances.
It is the applicanPS responsibiliry to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its
nortnal operaGOnai and maintenance activities to the fqcilities constructed under thispertnit within Ciry pmperty/rightof-wayleasement.
SITE ADDRESS
OWNER NAME: :
cirv: TELEPHONE #:
INSTALLER NAME:
S
STREET ADD7zl,,
(AREA CODE)
?.W? ziP:15?
/
SIGNATURE OF PERMITTEE
CITY USE OnLY
LOT BL ? RECEIPT #: U U?
SUBD. LJ ? J Y' RECEIPT DATE:
MECHATIICAL PERMIT #
,
1999 MEcHArncAL PERMrr (REsinENriAw
crrY oF Ertsaiv
3830 PaoT Krroa gn
£A6AN MN 55122
/
Date: (651) 6$1-4675
Complete this section onfv if you are installing HVAC in a singte family dwelting, townhome or condo under
construction and not owner /occupied.
r
• HVAC: 0-100 M B T U $ 30.00
ADDI"I'IONAL 50 M BTU 6.00
oe
• Gas outlets (minimum of one required @$3.00 ea.) 3
State Surcharge .50
Total $ 39V
Complete this section onlv if you are remodeling, adding to, or repairing an existing single family dwelling,
townhome, or condo. Please indicate if it is a new item, alterarion, or repair.
_ New
Fumace
_ Air exchanger
SITE ADDRESS:
Alteration Repair ? Other
Reminder: Ca11681-4675 for inspections.
_ Air condirioning
Qther
$ 30.00
State Surcharge .50
Minimum Total Due $ 30.50
OWNER NAME: ptlc_? ?'O`?-?-? PHONE #: ? s ? _ ?Sa Sc3oQ
n (AREA CO )
INSTALLER NAME..(Jt. q- O!? PHONE #: (AI Co )-F? SiDDO r"
STREET ADDRESS: ? a'"S??/ ?...d cQP ? Y? y?•.?•G' ??
CIT'1':
STATE f-;?7 J-1 ZIP:
Gc f,0?_???0
SIGNATURE OF PERMITI'EE
n?.C
9
,3 3<?
Use BLUE or BLACK Ink
r---------------- i
I For Office Use
Permit #:I I I t ~2 j
City of EaWin I Permit Fee:T'c 3 I
3830 Pilot Knob Road I I 3 I
Eagan MN 55122 Date Received: I
I I
Phone: (651) 675-5675
Fax: (651) 675-5694 i Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION `k
Date: Site Address: Unit
Name: ~ to ~ i Phone:
Resident!
Owner r Address !City !Zip:
Applicant is: Owner Contractor
o
Type of Work Description of work: JM 1
Construction Cost: Multi-Family Building: (Yes / No
Company: Contact:
Contractor Address: City:
State: Zip: Phone:
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
1
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 'y(:< 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 i
the information may be classified as non-public if you provide specific reasons that would permit the City to
t 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 mu t be complete 180
days of permit issuance.
App ant's Printed Name Applic nt's Signature
Page 1 of 3
r
DO NOT WRITE BELOW THIS LINE
SUB TYPES
oundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration (Single Family)
Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi)
Multi Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous
_ 01 of _ Plext Lower Level _ Pool _ Accessory Building
WORK TYPES
_ New _ Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
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 //Coo qp~ Occupancy ZA6 - t MCES System
Plan Review Code Edition Zg4 SAC Units
(25%_ 100% Zoning City Water
Census Code /Y Stories Booster Pump
# of Units J Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction f/J Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall: _ Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: , Building Inspector
RESIDENTIAL FEES gg
Base Fee 2pL 6IV
Surcharge
Plan Review /-3
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
4,111
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
rcli
Date Received:
Staff:
`� J 2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: /`/ 7 /3 Site Address: ( 7 / Jf 7
Tenant:
Suite #:
dei er
es! en wner
Rt/O
- tName: e 1 frlik..- Phone: 41F' 71 (
Address / City / Zip:( 2 kin L i 41047 4411) 1\ 57 z
Contractor
Ulryn
Name: License #:
Address: City:
State: Zip: Phone:
Contact: Email:
Type of �IVork
•-/New Replacement Repair Rebuild Modify Space Work in R.O.W.
— —
Description of work:
} `
Permit Type -
RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation (— RPZ / PVB)
Add Plumbing Fixtures (— Main / Lower Level)
—
Septic System
Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater,
$60.00 Lawn Irrigation
$60.00 Add Plumbing
*Water Turnaround
$105.00 Septic System
Water Softener, or Water Heater and Softener
(includes $5.00 State Surcharge)
Turnaround* (includes $5.00 State Surcharge)
and $5.00 State Surcharge)
TOTAL FEES $
(includes $5.00 minimum State Surcharge)
Fixtures, Septic System Abandonment, Water
(add $200.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee
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.
x c /r✓l LTrt
Applicant's Printed Name
x
Applicant's Signature
FOR OFFICE USE
Required Inspections: _Under Ground ,. Rough -In Air Test Gas Tes
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117518
Date Issued:10/18/2013
Permit Category:ePermit
Site Address: 1612 Johnny Cake Ridge Wa
Lot:14 Block: 6 Addition: Oakbrooke
PID:10-53760-06-140
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 .
Danielle Merritt
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 -
Jim T Luangrath
1612 Johnny Cake Ridge Wa
Eagan MN 55122
Merritt Restoration
2031 Basswood Ct
Rockford MN 55373
(612) 282-9979
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117706
Date Issued:10/22/2013
Permit Category:ePermit
Site Address: 1612 Johnny Cake Ridge Wa
Lot:14 Block: 6 Addition: Oakbrooke
PID:10-53760-06-140
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments: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.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Jim T Luangrath
1612 Johnny Cake Ridge Wa
Eagan MN 55122
Merritt Restoration
2031 Basswood Ct
Rockford MN 55373
(612) 282-9979
Applicant/Permitee: Signature Issued By: Signature