1814 Jourdan Ct13 L? r
Address: 1814 JourdanCt Zip: 55122
Lot: 10 Block: 1 Subdivision: Forest View
THE FULLOWING 1TEM5 WERE/WERE NOT COMPLETE A'f FINAL [N5PECTION ON ) g( D3
Yes No Comments
Final grade - 6" from siding
Permanent ste s - garage vl?
Permanent ste s- main ent
Permanent drivewa
Permanent gas
Sod/Seeded lawn
Trail/curb damage
Parch
Lower level finish
Deck
Fireplace
• Verify with your builder that roof test caps from the plumbing system have been removed.
• Turn offwater supply to the outside lawn faucets before freeze potential exists.
• Call the City's Engineering Department at 651-675-5646 prior to working in right-of-way or installing
irrigation system.
? euILmHC msrECroa: M "IL2. te"'K661
CONTRACTOR:
Thorson Homes
4466 Wedgwood Dr
Eagan, MN 55123
l 0 13i y??e f, P- 5g?! sq -? 5?18. d3
,5G' Lt ?a ? ? ^? ? , ?Q
. ,? RESIDENT'IAI. BUILDING fne_ -
? `' /? ??,f1? I Permit Application
-t p
' v r V ?? ? i.J ?-ttJ`t?.r'?`? ? City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674 ? 5 S?5 (3
New Cans4uc6on Reauirements
3 registered site surveys showing sq. ft. af lot, sq. fl. oF house; and all roofed areas
(20°k maximum lot coveraqe allowed)
2 copies of plan showing beam 8 window sizes; poured tound design, etc.
i setof Energy Calculations
3 wpies of Tree Preservation Plan if lot platted aRer 7/1193
Rim Joist Detail Options seladion shcet (bldgs with 3 or less uniGs
RemodeVReoair Reauirements
2 copies of plan
1 set of Energy Calculalions for heated additions
1 site survey for addifions & decks
Addition -indicate Nan-site sepfk system
2#4c.0, c4 I
Office U Onl
Cert of Survey Recd ry?,t,q,d.lx/?•C.-
Tree Pres Plan Recd s ? L$
?,Tree Pres Not Reqd
_ On-site Sepiic System
Date _ r; / 13_ / o.;
Site Address 1814 Jourdan Court Construction Cost
Unit/Ste #
DescriptionoFWork New Construction
Multi-Family Bldg _ Y X N Fireplace(s) _ 0 X 1 _ 2
Property Owuer Telephone t! ( )
Contractor mhorson Homes
rnc _
F
Address 4466 Wedgewood Drive
State MN City Eaaan
Zip 55123 Telephone#( 651) 454-0644
COMPLETE THIS AREA ONLY IF CC
? Minnesota Rules 7670 Cate¢orv 1
Energy Code Category . Residentiai ventiiation Category 1'
(4 submission type) Submitted
• Energy Envelope Calculations Sub
Licensed Plumber
BUILDING
? esota Rules 7672
:_ w Energy Code Worksheet
#(95? 933-7717
MechanicalContractor'Kleve Heating & Ai ond' ionidglephone#( 957 941-4211
Sewer/WaterContractor Allied Excavatina Telephone#( 95;-894-8340
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work wil] be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a pemut, and work is not to start without a
permit; that the work will be in accardance with the approved plan in the case of work which requires a review and
approval of plans.
fi3.-,A- c--TivA
ApplicanYs Printed Name
6141z4,
Applicant's Signature
OFFICE USE ONLY
Suh Types
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screenlgazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg^Y ar_ N ? 25 Miscellaneous
Work Types
X 31 New ? 35
? 32 Addition ? 36
? 33 Alteration 0 37
? 34 Replacement
Valuation / 000
Census Code
SAC Units L)_
Nbr. of Units f
Nbr. of Bldgs ?
Type of Const I/ ._
,
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
Int Improvement ? 38 Demolish (Interior) ? 44 Siding
Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
'Demolitlon (Entire Bltlg) - Give PCA handout to applicant
Occupancy
Zoning ?
Stories
Sq. Ft. 1? 3 g
Length
?
W idth y 3 ,
? Footings (new bldg)
_ Footings (deck)
Footings (addirion)
? Foundarion
Drain Tile
Roof Ice & Water Final
Framing
Fireplace _I R.I. 4 AuTest ?Final
k Insulation
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
REQUIRED INSPECTIONS
FinaUC.O.
? FinaUNo C.O.
_ Plumbing
_ HVAC
Other
Pool _ Ftgs _ Air/Gas Tests _ Final
Sid'mg Stucco Stone
Windows (new/replacement)
? Retaining Wall
Approved By :T Z , Building Inspector
-------------------------- ---------------------- - ------ - ------ - --
6(tsc 1 179 x! ' 17, W?
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3 ? 9 y :
p y =
Pun,?,t? l ?s' x 3 0=
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._ l
MNcheCk COMPLIANCE REPORT
Minnesota Energy Code
tYNCheck Software Version 3.0
COUNTY: Dakota.
STATE: MinnesOta
ZONE: 2
CONSSRUCTION TYPE: Single Family
LlflE: J-J-LUVL
COMPLIANCE:FASSES
Required UA = 437
Your Home = 404
1.5? B2ti.@l Tiidii COiZ2
i
i
Permit # I
I
Checke- /Dat2 I
1
Area or Cavity Cont. Gldzing/Door
peT1mPtPT' R-VA2u? R,-value it-Val?ca UA
------------------------------------
CEILINGS ------
1276 -------
94.0 ----------
0.0 ------------ ---
39
WALLS: Wood Frame, 16" O.C. 1912 19.0 2.0 107
BSMT: Conc. 8.0' ht/7.0' bg/8.0' insul 986 13.0 0.0 55
GI.F,ZING: :.indows or IIocrs, Abcve Grade 3'%, 0.44C 166
DOORS 84 0.500 42
HVAC EQUSPMFNT: FU1°»ar.e, 93.(1 31F'[TE
------
-
----------
------------
-----
--------------------------------------------
CDMPLIANCE.STATEMENTc The propo.sed building -
des.ign described here is.
consistent with the building plans, specific ations, and other calculations
submitted with the permit application. The proposed building has been
uc5.tqi12C1 'O iTidi°t i.'I2 l:etji.iil' i2t5 Gi Mc MiiiiieSui.d Energy- Co3e.
$tTi le_IE.T/ilYelCJiiPrf/?O d F1 3tn
V? y?
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTY LEGAL: L V t I23 ?I U! K I
DATE OF SURVEY: 'h3Q -0 ?
LATEST REVISION:
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U/ ? ? • Registered Land Surveyor signature and company
r? ?
L9? ? ?
? •
• Building Pertnit Applicant
Legal descriptlon
fi" ? ? • Address
1/0 ? • North artow and scale
"
? ? • House rype (rembler, walkout, split w/o, splk entry, lookout, etc.)
0 0 • Directlonal drainage arrows with slope/gradient %
F/ ? ? . Proposed/existing sewer and water services 8 invert eleva6on
2( ? ? • Street name
[1? ? 0 • Driveway
Gd
?/ ? ? • Lot Square Footage
?
C?' ? ? • Lot Coverege
ELEVATIONS
Existina
g/ ? ? • Sewer service (or Proposed)
C
7/? ?
? • Property comers
t
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T
f
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t
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b
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v • veway an
proper
ens
on
op o
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y
ne ex
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? 6/? ? • Elevatlons of any existing adjacent homes
0¢ ? • Adequate footlng depth of structures due to adjacent utility Venches
? ? ? • Waterways (pond, stream, etc.)
Prooased
? ? ? • Garage floor
? ? cl • Basementfloor
? ? ? • Lowest exposed elevation (walkouUwindow)
¢( ? ? . Property comers
F/ ?? • Front and rear of home at the foundation
PONDING AREA (if applicablel
? B ' ? • Easement line
o ? • NWL
? fd? ? • HWL
? C3? ? • Pond # designation
? L?/ ? • Emergency Overftow Elevation
? 0' ? • PondNVetland buffer delineation
? ? • Lot IineslBearings & dimensians
v/ 0 O • Righ[-ot-way and sVeet width (to back of curb)
O" 0 ? • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all sWCtures requiring permanent footings)
gf ?? • Show all easements of rewrd and any City utilitles wifhin those easements
G?/?? • Setbacks of proposed structura and sideyard setback of adjacent existlng sfructures
?? • Retaining wall requirements, if any
Reviewed:
Name Date
GJFORMSlBullding Permit AppllcaUon
J .
? .. ' • *, * ? 2422 Enterprise Drive
? Mendota Heights, MN 55120
* PIONE@FI ur+o suaVEroas • GwL Euar+Erss (651) 881-1914 FAX:881-9489
? eng neer ng LAND PUNNERS• LANDSCME ARCHIIECTS 625 Highway 10 N.E.
* * * Blaine, MN 55434
* (783) 783-1880 FNf:783-1883
Certificate of Survey for:
LOT AREA = 14,204 SQ. FT.
HOUSE AREA = 1,147 SQ. FT. 18)q JOURDAN COURT EAGAN, MINNESOTA
GARAGE AREA = 650 SQ. FT.
PORCH/ PqT10 = 105 SQ. FT. \
DRIVEwAY AREA = 734 SQ, F? slOpge
COVERAGE = 18.6 % TA? wa11?mo
, Of? 'Cll?_?,a
}ip?y?t -T+f?c • rjZ?Mgl,?,.?2. ?,/ ? R? `? OPN OF SPIKE
Q=95`127'37" ELEV.= 866.18
.
gAr4.-TAay
gC-Qq n L._.
R=15.00 V, '
24.99
,..
861.8 e62.6 ? ? // '
' /? 863.5 \
I1J?? ?? ?......\` 863.8
Aj
N???Q ?
?' , ? ,?.,?? ? ? a\?Q?sy
? i 864.7,
' 8450.8 a° 866.2 ;?, aes.
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860.?
859.5 7JlS i
\ \ ae;?A` (
864
884.8
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861.9
860.9 \
864.8
r • ? ,??
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65.1
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BENCH MARK $ I
TOP OF SPIKE ?????
ELEV.= 860.88
v4LAto. 1
5 I
k?9
866.2
865.9
a
865.5 \
7
?. 866.0
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868.1 p'7
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NOTE: PROPOSEO G.RAOES 910VM PER CRADINC PLAN BY: GUST ENTERPRISES, INC PROPQ+ V
NOTE: BIIILDING DIM SIONS SNOWN ARE FOR HORIZONTAL ANO VERTCAL IOCqTION -? LOWEST FLOOR ELEVATION: 'd
OF SIRUCTUIE$ ONLY. SEE ARCHITECIDAI PLANS FOR BUILOING AND
FouNOnnoN oiMENSiaas. TOP OF BLOCK ELEVATION: ????
NOTE: NO SPECIFIC SOIlS INVESTICATION HAS BEEN COMPLETED ON THIS LOT BY I_
SURVEYOR. THE SWTABIUTY OF SOILS TO SUPPORT THE SPECIFlC HOUSE
PROPOSED IS NOT 7HE RESPONSIBIUTV OF THE SURVEYOR. rV7-0P\ / GARAGE SLAB ELEVATION:
NOTE: 1HI5 CERTIFICATE OOES NOT PURPORT TO SHOW EASEAIENTS OTHER THAN 1NOSE SHOWN ON 7HE RECORDED PI.AT.
NOTE: CONTRACTOR MUST VERIFY DRIVEWAY UESIGN.
NOTE: BEARINGS SHONN ARE BASEO ON AN ASSUMED OANA1
WE HEREBY CERTIFY TO THORSON HOMES, INC THAT THIS IS A
TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE
BOUNDARIES OF:
LOT 10, BLOCK 1, FOREST VIEW ADQITION
DAKOTA COUNTY, MINNESOTA
TOB 0 LOOKOUT ELEVATION:
% 000.00 DENOTES EI(ISTING ELEVA710N
( 000.00 ) OENOTES PROPOSED ELEVATION
--- OENOTES DRAINAGE ANO UTILITY EASEMENT
' DENOTES ORAINAGE FLOW DIRECTION
---?-- DENOiES SPYKE
6 DENOTES OFFSET NUB
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS Sl1RVEYED BY ME OR
UNDER MY DIRECT SUPERVISION THIS 30 DAY OF APRIL, 2003.
REVISED 5-1-03 STAKE HSE IGNED: PIO ER EN NEE G, P.A.
SCALE : 1 1NCH = 30 FEET ?S4Z,Z-I0 `?1(??/'jp3 B: ?
li? ?nnnecnnx n...- Q^f?? ?+InClO'2 n.... o ul....1e........ o.... AL. n?
i
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SEVERSON,SHELDON,
DOUGHERTY & MOLENDA, P.A.
svtT'E boo
7300 WEST 147TH STAEET
APPLE VALLEY, MINNESOTA 55124-7580
(952) 4323I36
1ELEFAX NUMBER (952) 432-3780
&MAIL bauerrQseversonsheldon.com
_Fn-f G'C
TO: Jo . rder, Assistant City Engineer
FROM: Robert B. Bauer, City Attorney 1?0
DATE: March 16, 2004
RE: Drainage and Utility Easement - Thorson Homes, Inc.
Project 858
Easement No. 1012
Our File No. 206-19446
f-7
John,
Enclosed for the City's records, please find the original Drainage and Utility Easement dated
June 18, 2003 and recorded with the Dakota County Registraz of Titles Office on June 25, 2003
as Document No. 504280.
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DRAINAGE AND UTILITY EASEMENT
504280
THIS +?,ASEIvIrNT, maue / 2-,Zn_ _day of Jvr,6 , 20C ;, between T:dORSON
HOMES, INC., a Mimiesota corporation (hereinafter referred to as "Lan.iowner); and THE CITY
OF EAGAN, a municipal corporation, organized under the laws of rhe State of Mimlesota,
(hereinafter referrtd to as the "City").
WITNESSETH:
That the Landowuer, in consideration of the sum of One Dollar ($1.00) and other good
and valuable consideration, the receipt and sufficieucy of which is hereby acknowledged, does
hereby grant and convey unto the City, its successors and assigns, a permanent drainage and
utility easei:7ent over, across and under the following described premises, situated within Dakota
County, Minnesota, to-wit:
N Tl:e northerly and northeasterly 23 feet of Lot 10, Block 1, Forest Vie?•v Additioil,
lX
according to the recorded plat thereof, as measured at right angle tr• the northerly
--?q line )f said Lot 10. The southerly line of said easement shall "a prolonged or
shorte.,?ed to tenninate on rhe easterly and westerly lot lines of 4 d Lot 10.
See also `?xhibit "A" attached hereto and incorporated herein.
The grant of the foregoing permanent easement for drainage anc4 utiliiy purposes includes
the right of the City, its contractors, agents and servants to enter upon the premises at all
reasoilable times to construct, reconstruct, inspect, repair and maintair, pipes, conduits and inains;
and the further right to remove trees, brush, undergrowth and other obsfructions. After
completion of such cor.struction, maintenance, repair or removal, the City shall restore the
premises to the condition in which it was found priox to the commencement of such actions, save
only for the necessary removal of trees, brush, undergrowth and other obstructi : ns.
And ttie Landowner, its successu::. and assigns, does covenant -,ith the City, its
successori; and assigns, that it is the Landowner of the premises aforesaid az, i has good right to
grant and c)nvey the easement herein to the City.
IN TESTIMONY WHEREOF, the Landowner has caused this easement to be executed as
of the day and yeaz Yirst above writteu.
THORSON HOMES, IAX.,
a Mimiesota Corporation
By: &77
Its:
STATE OF MINNESOTA)
COL;NTY OF
The foregoing instrument was acknowledged before me this ?day of -??-? , 2003,
by the /?, :?f THORSON HOMES,
INC., a Minnesota Corporation, on behalf of the Corporation.
JOEL ALAN RAU??="
? NOTARYPUBLIC-MINNESOTA. „ NOt y Public
r; . MyOammi55WnEzpitesJan.31,2LJ5 r?
APPROVED AS TO FORM: APPROVED AS TO CONTF,NT:
City Attorney's Office
Dated:&/ z-/- 3
?
P lic Works Departm-rnt
Dated: C- l 7` D 3
THIS INSTRUMENT WAS DRAFTED BY:
City of Eagan
Engineering Division
Public Works Department
3830 Pilot Knob Road
Eagan MN 55122
Easement No. 1012
2
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FOREST VIEW ADD.
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43
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SCALE
? / PRUPOSfD EASEMENT
?% A 23 fo?t ensement ecross the taltawing property:
v Tha narUiMy artd norgmmlrly 23 hat oi Lot 10, Bbek 1, Fanst Yiew AddldM occordng to tha raaordae yW tMreet,
m meanred at rlqM ongle to 1M northerly lina n1 saTd Lnt 10. TNe sculharty pna of sald saeanank
efiaY se prolorypd or aMrtaned to tmm4qt* on Ma eoshAy aid waeterty lot Bnss nf m}d Lot 10.
Mar, 22. 2010 7:43AM St Paul plumbing No, 0639 P. 2
Use BLUE or BLACK Ink
I------
Now=
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1 i
' ~ of Ealan ` Pennit~ 163
U 3V 110
i
. 3830 Pilot Knob Road ~ Permit fee: i
Eagan MN 55122 t
Phone: (851) 67$4876 j Date Reoeived; J~
Fax: (651) 675-5694 Staff. i
2010 MECHANICAL PERMIT APPLICATIO
Date' ZOf ~ Sit9 dd ss• t~ C 1`-f' u'r
Ten ~
ant; L- -
Suite p
RESIDENT! OWNER Name: _.0-e L
Phone:
/ V
Address I City / Zip: /2 6~
CONTRACTOR Name: License
AddressCl~`ti►»V 1r?['lf _ City: t
State,nn ! I-f-V Zp. w~3~ Phone: / gc t ~Tt~.X_ J~
Contact: - /G!M C Email: &42= PN
TYPE OF WORK New _ Replacement XAddiflonal Alteration Demolition
t ~
Description of works./•~
PERMIT TYPE RESIDENTIAL COMMERCIAL
Furnace New Construction Interior Improvement
_ Air Condilloner _ Install Piping _ Processed
-Air Exchanger -Gas Exterior HVAC Unit
Heat Pump Under / Above ground Tank Install / Remove)
C)ther "When instailiriglremoving tank(s), call for inspection by Fire I -muo Marshal and Plumbl Ins ctor
RESIDENTIAL FEES.
$50.60 Minimum Add-on or alteration to art existing unit (includes $.60 State Surcharge)
$80.50 Fire repair (replace burned out appliances, ductwork, etc,) (includes $,50 State Surcharge) TOTAL FEE
COMMERCIAL FEES.
$70.50 Underground tank installationlremoval OR Contract Value $ X1%
$50.80 Iffiffirrium (includes State Surcharge)
$ Permit Fee
- If ftrft "Is leas than $1,000, surcharge is $.so_
- if EMW EM Is > $1,000, surcharge Increases W $.so for each = $ Surcharge I
$1,000 Permit Fee (i.e. a $1,00142,000 Permit Fee requires a $1.00 surcharge).
= $ TOTAL PEE
CALL SE YOU DIG. Gall Gopher state One Call at (661) 4540002 for protection against underground utility damage. Gall 48 hours
before you Intend to dig to receive locates of underground utilities. ytww.goraheratsrtennecall.org i
I hereby acknowledge that this information is oomplete, and accurate; that the work Mi be in conformance with the ordinances a codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and vo" not to start without a permit; that the It be in accordance
with the approved plan In the case of work whl quires a review and approval of pl s
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Applicarii s Printed Name Applicant's Signs ur+e j
.,,a. , a;:y~w ~~"°',,,'i,~};•yr„c'•~x._T..:..:,~'r,•..~,:,~~.:.,.v.xii.y :.Y,r•:-~•,,, an
n ; irt st.
. n ~ ° ~aAS Seivis~ Tea
.,~.•_sy,•"',.:: 4'.-.,!._• ~!g., tr min r. tat- ;`:::.'s
. , :~:.r.. • __or. VAC;.c~creeni:FIKU ...ms tion`
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115134
Date Issued:09/24/2013
Permit Category:ePermit
Site Address: 1814 Jourdan Ct
Lot:10 Block: 1 Addition: Forest View
PID:10-27375-01-100
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
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.
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: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Jeffrey W Levis
1814 Jourdan Ct
Eagan MN 55122
(612) 702-5085
Cedar Custom Builders & Remodelers
1501 Keller Lake Rd
Burnsville MN 55306
(952) 215-5141
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
�----------------�
�, � , � For ONJce Use , 1
`��. ' __ �
a- � I Perrnil i�: � �� �
C�ty of�a�a� ����� � � ��,, ; �, �
� Permif Fee: I
� 3830 Pilot Knob Road � I
� Eagan Mht 85122 I DaEe Recei�ed: �
o Phone; (651) 675-5675 j i
� Fax: (651) 675-5694 I Staft _____________ �
2014 RESIDENTIAL PLUMBI(VG PERMIT APPLICATION
Date:_ �U�2��l v' Site Address: r�� ` ��.N�G+ri✓� �/�-j
Tenant: Saite#:
ResidenflOwner Name: 1�6 E l�!I�.E.�t � ,�(,t, ��G. �1 ��ia phone:
Address/Ciiy I Zip__+�d `T �V�_��/1 (�F1�.1���
Narne:� �5 l,�� �,,!f`��/���X License�1:��('�% � J�� �
Contractor Address: 1 OV ) �. �� �� , city: �(�,1�.� C�ir'�"t-�
State:��Zip: � Phone: (�°3� r r.�`� �"d� J '
Concact: �{ Y 1'�l(,� Email: � - y n-
Type of Work �New ____Replaoement _Repair _Rebuild ,_Modify Space _Work in R.O.W.
Description ofwork:
RESIDFNTIAL
Water Heater
Water Softener
Lawn Irrigalion�RPZ/ PVB) —
Permit Type �Add Plumbing Fixlures�Main 1� Lower Level)
Seplic Systern —
New WalerTurnaround
Abandonment
RESIDFNTIAL FEES;
$60.00 Water Heater,Water Softener, or Wafer Heater and Soffener(includes$5.00 Sfate Surcharge)
�8U.U0 Lawn Irrigation (includes$S.Oa rninimum State Surcharge)
$60.00 Add Pfumbing Fixtures, Septic Svstem Abandonment,WaterTurnaround"(incl�cdes$5.00 Sfate Surcharge)
'kWater Turnaround(add$200.00 if a 5!8"meter is required)
$115.00 SeptiC Svstem f�few($10.00�er as built}(inctudes County}ee and$5.Q0 State Suroharge)
TOTAL FEES � � .��
CALL BEFORE YOU DIG. Call Gopher State�ne Call at(651)434-0002 for protecfion against underground ulilify damage.
Ca11-48-haurs�befor�-youlntend fo-dig to receive locates of undezg�au�d i�tilities.w�vw.aooher§taleoneca�l:ora--- -
1 hereby acknowledge lhat Ihis infom�atiort is complele and aocwale;lhat fhe�voric will be in confarmance with fhe ofdinances and codes of the Cily of
Eagan;lhat 1 understand this is no1 a permit,buf only an application for a perm(t,and tvork is nol fo start+vilhout a perrnih,chat the work wtlf be in
accordance►vith the approved plan in�he case of�vork which req ures a review and approval of pl
� x_�� Ce,� '�C(s_�� x
� Applicant's Pnnted Name App i n s Signature
� FOR OFFICE USE Reviewed 8y: pate:
�
o Required Inspections: Under Ground Rough-In Air test Gas Test Final
�
Meter Related Items: Meter Size Radio Read: Siaff,
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Use BLUE or BLACK Ink
r------�----------
I For O�ce Use �
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:J���.1�' '
' � Pertnit# I
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(� �( �. ���. �s �.�� � � � a � �L�
� � "` "`� �'��, �..�`° s Y I Permit Fee: � �, r �
3830 Pilot Knob Road „_ �, „„r p � h i
Eagan MN 55122 �}`�� � � ,�U�� � Date Received: v � � �
Phone:(651)675-5675 I �
Fax:(651)675-5694 i Staff: �
'. ________ ________J . .
2014 RESIDENTIAL BUILDING PERMIT APPLICATION - � ,� I��
Date: ��-2 l�'�� Site Address: l��� `�V�'�"r�"`�'� � un�t#: ,
Name: � ' I« c� �L��✓�h /C!U�YGz Phone:
��5�#�ri� � 1 �
OW11@I'. :, Address/City/Zip: ��I[ �t'.��iLY�Gt�"l. Gfi�
Applicant is Owner � Contractor
' Description of work: ��h '�� ��f��'P��
��Ty���#illt��lt �
' Construction Cost���; ��� � Multi-Family Building:(Yes /No� )
Company: �;'` rc�'�'� �(,�t�f��-L�°-'t- �d.•�.��/b`'yContact L"1,�'�-C ���G/�-e✓
� �� Address: ���'� �l�G��f'��i/ �f�o'� Ciry.� ��- ��+��.T ���(,�
� _GOMtC1G'�Ot' � �
' State: �Zip: SJ ��� Phone:��7a�y��� mail: G}IG����'��'��%j��c�/���t �� Ca'''"`'
`' License#: �� ���7� � ad Certifica e#: ��
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
Cd,�t���h� �-�fi�' ��'? �� �--✓` �
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: �
[1iOTE'�"1a�s�ar��t.sr�pporttr��d�t�cumenfs thaf you scrbm�f ar�+cnn�idered ta be.pub/���ntormai�on .Porti�ns of
#he l�fo�tr�la�i�rn rna,y be;�/�ssi'fied'as,isart;�ubif�,if you prouide.spec��ic���srtns that ro�o�rld p�'rri#t the City fo
. �
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,, "�, .c+���d��tl7ka€the, 'a�e�a�le'���ei's.. ��. . .; -: ,,
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. wuvw.po�herstateonecall.ora
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 wo�ic authorized by a bullding permit issued in accordance with the Minnesota State Building Code must b eted within 180
days of permit issuance. �
X ���c l�i-c�f�-ti' X =.�
Applicant's Printed Name Applicant's Signature
Page 1 of 3
' ` ' � 8'1� �n��c� C--� /a ��l�'
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation 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_Plex �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 � � / D
Valuation Occupancy �(2..�� MCES System
Plan Review Code Edition 2c�v'7 wiS13Cr SAC Units
(25%_100%�) Zoning �_ City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buiidings Length Fire Sprinklers
Type of Construction �� Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Finai I C.O. Required
Footings(Addition) � Final/No C.O. Required
Foundation � HVAC Gas Service Test Gas Line Air Test
Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests _Final
� Framing Drain Tile
Fireplace:_Rough In Air Test �Final Siding:_Stucco Lath _Stone Lath _Brick
� Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Erosion Control
Braced Walls Other:
Reviewed By: � � , Building Inspector
RESIDENTIAL FEES ��6
Base Fee ���� �
Surcharge `� ��� ��� "� -.
Plan Review �
MCES SAC �
City SAC l I Z�
Utility Connection Charge ( f i
S�W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3,