1428 Kingswood Ponds RdAddress 1428 KingSwood Pondc ud Zip 5512_2
Lot 10 Blk Z Sub KinQSwood Ponds Ist Addition
THESE TTEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPEC'TION.
Date: 9-1i5__() Q Yes No Inspector: L
Final grade (6" from siding)
Permanent steps (garage) x
Permanent steps (main entry)
Permanent driveway
Pettnanent gas x
Sod/Seeded grass
Trail/curb damage x
Porch x
Basement finish k-
Deck ?
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 6814645 before working in right-of-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
C?. Y,. 0?
Date
Site Street Address /?/o7S /?? b1)CTz)j iQ?Jn ?• Unit #
Property Owner Telephone # ((G67) -73-7'dLIW7
Contractor 7. I.IUJx V? 0,(U0-x,l.? Telephone #(/% j)3Z&,-k[D0J
Address 5_ City Statebtr ZipSy'vlf?
The Applicant is: _ Owner Contractor _Other
Alterations to existing dwelling $ 50.00
Add plumbing fixtures.
If you are only installing a water softener and/or water heater, the fee is $15.00 plus the
state surcharge - see next section.
Septic System Abandonment
_WaterTurnaround (add $121.00 if a 518" meter is required)
?
?
Other:
? Water Softener _ Water Heater ?? ti $ 15.00
_ replacement I additional ?2 ?C,
Lawn Irrigation System _RPZ _PVB _ne r air _rebuild $ 30.00
State $urcharge $ .50
Total
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
_ ,_bm 51hriyr 0 ???
ApplicanYs Printed Name Ahlicar?fi Signature
sa
,???`1
2000 BUILDING PE??
?IIh PPLICA iO SIDENTIAL)
?.- r?1 D? CITY OF EAGAN 0q3
? U U , 3830 PILOT KNOB RD - 55122
9 651-681-0675
Nsw Conahucflon Reaulrements "' `?r Qs°I Gj `1
3 reglatered alte auneya slowlny aq. R. of bt, sq. N. of house -Z? - G o
and Qu rooted areaa (2096 maximum lot covemae allowed)
?
2 coples of plana (ahow beam & window sizes; poured Ind. design; efc.)
1 set of energy calculatiana
3 copies ol hee preaenaflon plon If lot platted alfer 7/1/93
DATE: D a
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT: to
2 coptes W plan
1 set of energy calculariona (or heated addi8ons
i site survey for exfedor addiflons & deCks
CONSTRUCTION COST: W 11
BLOCK:
Name: /170- 60 nc?U eravr,?.T? Phone#: 9/o1-
PROPERN taat Flrst
OWNER
Sheet Address: 71g c)! 144S ?k Lo c?
C11Y State: Lp:
Company:/pc [.bnc.1'v l?'ci:. s7, Phone #: (Hli, - qS9- 7 &01
(area code)
COMRACTOR
street address: 740<«! SrTl S 7'4J ts')?- ucense # Z Co E,cp, 14001
city 1???,01.?. ???-? srate: zip: 5`ri,2 4
ARCHITECT/ n(. ? J
ENGINEER Company:_V" ? , Name: "?G ?.?1?L `T
Telephone #: ( &S' (
Sheet Address: 211 35-LUI` RegishaHon #:
City .
Sewer/water licensed plumber
Zip: ??lo[ d
&a
I hereby acknowledge ihat I have read Ihis appliccifion, state that ihe tnformation is coRecf, and agree to comply wMh all applicable State
of Mlnnesofa Stalutes and Cify of Eagan Ordinances.
Signaiure of Applicant:
OFFICE USE ONLY
Certificates of Survey Received V Yes _ No 20
Tree Preservation Plan Received _ Yes _ No ? Not Required `/S
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex
SF Dwelling ? 08 06-plex
? 03 01 of _ plex 0 09 07-p1ex
? 04 02-plex D 10 08-plex
? 05 03-plex 0 11 10-plex
? 06 04-Plex ? 12 12-plex
wg RK nrPe
X, 31 New
O 32 Addition
? 33 Alteration
? 34 Repair
? 13 16-plex ? 21 Porch (3-sea.) ?
? 17 Garage 0 22 Porch/Addn. (4-sea.) ?
? 18 Deck ? 23 Porch(screened) ?
? 19 Lower Level ? 24 Storm Damage
Plbg _Y or_ N ? 25 Miscellaneous
? 20 Pool 0 30 Accessory Bidg.
? 36 Move Bldg. •'? 43 Reroof
? 37 Demolish (Bldg)* 0 44 Siding
? 38 Demolish (Interior) ? 45 Fire Repair
? 42 DemolisFi (Fo.undation). ? 46 Windows/Doors
* Give PCA handout to applicant'for demolltion permit
31 Ext Alt - Mufti
33 Ext. Aft - SF
36 Multi
GENERAL INFORMATION
SAC Code . 0 ?.
Na. of Units I
No. of Buildings I
Const. (Actual) :G?v
(Allowable)
?
UBC Occupancy e.-3` -1
Zoning I
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
MISCELLANEOUS INSPECTIONS
O Stucco/Stone APPROVALS
Planning _
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
1 , •sq. ft. .
7 -7 sq. ft.
tiH Footprint sq. ft. 2?? sr.
2 Census Code 10 I
2,1 3 y MC/ES System
7 y `/ City Water
Booster Pump
PRV
Building 6?) 6 Engineering
Fire Sprinklered
Variance
Valuation: $?a0 '
65Sr ?IIS
1LI s6 k as G
?t 3LI xsy ??11 5?23?
67&-aS e
=?71tioLl
?
Oec VC V
il
SAC Units
% SAC
** *
* PIONEEA
* B?f?BB
** * *
LN10 SURV£TqiS - G1NL ENGINEFXS
IAND PuNNEAS• LANGSCAPE ANq1IlEti2
Certificate of Survey for:
MCDONALD
2422 Enterprise Drive
Mendoto Heights, MN 55120
(851) 881-1914 FAX:661-9488
E-mail: PIONEEROPRESSENTER,COM
625 Highway 10 N.E.
Blaine, MN 55434
(612) M-18e0 Fax:7e3-1883
E-mail: PIONEER2@PRESSENTER.COM
CON ST.
1428 KINGSW00D POND ROAD
,. ?
REV
> .,a
i1.._...L.?, ._.. 1 _ ..
?
PROPOSED HOUSE EL
LOWEST FLOOR ELEVAl10N: EVATION
77C.3
TOP Of BLOCK ELEVATION: F S 0
GARAGE SLAB ELEVATION: 97-7,9
X 0o0.00 DENOTES E%ISiINC ELEVATION
( 000,00 ) DENOTES PROPOSED ELEYA710N
--- DENOTES DRNNACE AND UTILITY EASEMENT
-r DENOTES DRAINACE FLOW DIRECTION "
?- DENOTES M0NUNENT
$ DENOTES OFFSET HUB
NOTE; PROPOSED CRADES SHOYM PER CRADINC PLAN BY: PAAANWNT
NOTE: BUILOINC DIMENSIONS SHOWN ARE FOR NORIZONTAL AND VERIICAL LOCAlION
OF STRUCNRE$ ONLY. $EE ARCNIffCNAL PLANS FOR BUILDINC AND
FWNDA710N DIMENSIONS.
NOTE: NO SPECIFlC 501L5 INVESTICA710N HAS BEEN COMPLETED ON THIS LOT BY THE
Sl1R4EY0R. ME $UITABILITY Of SOILS TO SUPPORT iHE SPECIFIC HOUSf
PROPOSm IS NOT THE RESPON9BILITY OF iHE SURVEYOR.
NOff: THI$ CERTIFlCAff DOES NOT PIJRPORT TO SHOW EASEMENTS OTHER iHAN
7HOSE SHOWN qJ THE RECDROED PLAT.
NOIE: CONiRACTOR MUST YERIFY ORI4EWAY DESCN.
NOff: BEARINGS SHOVM ARE BASED ON AN ASSUNED DANM
SCALE : t INCH = 50 FEET
RECEAVED AirOI
17? 198087.05 BAT
.396'66
gp
i
04
POND JP5
- '
HWL=834
.2
NWL=826.0 p I
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BENCH MARK
T6P OF P1PE
ELEV.=881.26
,
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?
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?I
881.7
BBI.S \ a?
815 r?1
OI VK
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? 8)2.8 X
870.5'
?
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874.0
X
,-'? 6.51
i ?
9
LOT Af;EA = 34,491 SF
HOUSE AREA = 2,850 sq,it.
COVERAGE = S%
H6USE TYPE = 2 STORY W.O.
WE HEREBY CERTIFY TO MCDONALD CONST. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A
SURVEY OF THE BOUNDARIES OF: ?
LOT 10, BLOCK 29 KINGSWOOp PONDS 1ST ADDITION
DAKOTA COUNTY, MINNESOTA !
IT OOES NOT PURPORT TO SHOW IMPROVEMENTS GR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR
UNOER MY DIRECT SuPERVIS10N THIS 3RD DAY UF FEBRUARY, 2000. REVISED 2-15-00 MOVE HSE
RE415ED 2-16-00 RESTAKED
REVISED 3-29-00 NEW H5E
REVISED 3-31-00 RESTAKED
!
? 28.71 '
S23'452 04"E
"B91.5
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B1D'• 883.8 ?? Q
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BENCH MARK
TOP OF PIPE
ELE4.=883.04
SIG ED: PIONEER ENGI EP.A.
BY. (f
tin 4k, *dV'anI L.S. Reg. No, 11818
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
? PROPERTYLEGAL: ?/jr- /0 ??'?o?K 2 Plr,vr<cnaon T?orvn5 An,Ds?soN
vi DATE OF SURVEY: Z° .3 -00
N
?
w
LATEST REVISION: 3- 31 -d O
?
? DOCUMENTSTANDARDS
o
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? ? • Registered Land Surveyor signature and company
kll?o ? • 8uiiding PermRApplicant
? • Legal description
Cl ? ? • Address
?o ? • NoRh arrow and scale
?. • House type (rambler, walkout, split wlo, spiit entry, lookout, etc.)
? o • Directional drainage arrows with slope/grachent °k
? ? • Proposed/existing sewer and water services & invert elevation
rn? ? ? . Streetname
?o ? • Driveway
? ? • Lot Square Footage
4x ? o • Lot Coverage
ELEVATIONS
Existina
/
d o ? • Sewer service (or Proposed)
? ? ? • Property corners
?? o • Top of curb at the driveway
'f ? /? • Elevations of any e?asting adjacent homes
a?a' ? Adequate footing depth of structures due to adjacent utility trenches
Proaosed
ra' o ? • Garage floor
?/ ? ? • First floor
ra'/o ? • Lowest exposed elevation (walkout/window)
r1 a
v ? • Property corners
o ? • Front and rear of home at the foundation
/ PONDING AREA (if aoWicable)
m? o ? • Easement line
o ? • NVNL
r? ?
/ a • HWL
?
IV ? • Pond # designation
? v o • Emergency Overflow Elevation
? DIMENSIONS
?
pl ? ? • Lot Gnes/Bearings 8 dimensions
sa/a ? • Right-of-way and street width (to back ot curb)
?o ? • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
/? (i.e. all sVuctures requiring permanent footings)
?
V ? •' Show all easements of record and any Ciry utilities within those easements
o' ? /o • Setbacks of proposed structure and sideyard setback of adjacent epsting structures
? a' o • Retaining wall requirements, iF any /
Reviewed:
Name
1-
March 1909
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ENERGY CODE WORKSHEET FOR 1& 2 FAMILY DWELLINGS #C0'LZ8
S17E ADDRESS p ? clTY "
COMPLETED BY: MCA70niAjS? ?/?LST /IVC.,_-PHONE f DATE
BUIIOtNG CLASSIFiCATION: ? CatEgory 1 (must Incltde supplimentiil venUlatlon) or ? CategOry 2(sYandard)
MINIMUM CRITERIA
r'ounCaGon InSUlatlorrRlO Walls & wndows Root Attlc Insulation
Slab on Grade InsutaUOn-R10 (See table on reverse side for altowabie R44VJith Attic No Heel
Ftou over unheated spaces-R24 percentages)
R38-Wrth Attic Raised Heel
Founda6on Windows 72' insulated Glass. R38 & RS-Solid Rafters
-WOOd orYn Frame
STEP 1 iNindow & Door Area STEP 2 Calculate area as a percent ot wall
0. Tolal Window & Ooor Area in Sq. Feet
WINDOWS (Induding Foundation Windows):
I
N1INDOW MANUFACTURE NAME: C PES i C.aNL
C. From Step 1 divide box A(Window & Door Area) by box B
?
(Total Wall Area) Umes 100 equals C(the window and door area
; WINDOW MANUFACTURE TYPE: ? n5?M?1VT percent to wall area
WINDOW MANUFACTURE U FACTOR 3 G
I
BX 100 = C=
?5• q%
B
A
R. U. Oimensions Quantity Sq.ft.Puea .
ox
=
Box
x STEP J Assembty 6esign FeaWres i
x FRAMING TYPE:
"
x o.c.
STANDARD FRAMING luds tfi
"
x o.c i
ADVANCED FRAMING studs 24
x WALL CAVITY INSULATION R
X
x SHEATHING TYPE: R Value
0" I Z
X LESS TNAN < R-5 ?
x R-5 > OR MORE
Z +- " '- D'' I
^.AORS: X STEP<
x From the table, (reverse side) detertnine the maximum percent
window & door area for the design options selected and enter
x ta the % value on D below based on the window mfg. U-factor.
Totai Area of D %
Windows 8 Door Area A= 5S` sq.R
3. Totai Wail Area in Sq. FL The % value From the table on D shall be equai to or greater than
the%inC
WaU Total Penmeter Heght Area
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,
Totat Area of WaUS
803Hqr) *q-
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ONE- & TWO-FAMII.Y RFSII7F_NTIAL BUILDING PRFSCRIPTIVE (COOK-BOOK)
APPROACH
ft .
MAXIMUM WINDOW AND DOOR AREA AS A PERCENT OF OVERALL WALL
AREA
From Minn Rules part 7670.0475 subpart 2, item F
Cavi Exterior Window U-Factor
Framin Insulation Sheathin 0.49 0.36 0.31 0.27
STANDARD R-13 > R- 7 13.4% 17.8% 21.3% 24.3%
STANDARD R-13 > R- 5 12.4% 16.4% 19.7% 22.5%
STANDARD R-15 > R- 5 12.9°/a 17.1% 20.1% 23.4%
STANDARD R-18-19 < R- 5 12.1% 16.0% 18.8% 22.0%
STANDARD R-18 -19 > R- 5 14.0% 18.6% 21.8% 25.3%
ADVANCED R-18 -19 < R- 5 12.4% 17.1% 20.1% 23.4%
ADVANCED R-18 -19 > R- 5 14.5°la 19.2% 22.5% 26.1°/a
STANDARD R-21 < R- 5 12.8% 17.0% 19.9% 23.1%
STANDARD R-21 > R- 5 14.5% 19.3% 22.5% 26.1%
ADVANCED R-21 < R- 5 13.6°/u 18.1°/u 21.2% 24.6%
ADVANCED [Z-21 > R- 5 15.0% 19.9% 23.2% 26.9°/u
Additional calculated values
STANDARD R-17 < R- 5 11.9% 15.7% 18.4% 21.5%
STANDARD R-17 > R- 5 13.8% 18.4% 21.5% 25.0%
ADVANCED R-17 < R- 5 12.6% 16.8% 19.6% 22.9%
ADVANCED R-17 >R- 5 14.3% 19.0% 22.2% 25.7%
Notes:
Window area equals rough opening minus installation clearances.
Window U-factor must be determined by eikher the National Fenestration Rating
Council standard 100-91, or ASHRAE 1993 Handbook of Fundamentals, Chapter 27,
Table 5.
1 L BL CITY USE ONLY q q?? CY t RECEIPT Y7
2) !
SUBD. RECEIPT DATE:
PERMIT #
2000 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, NN 55122
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow Preventer for underground sprinkler system
FIXTURES
EACH #
TOTAL
Alterations to existing dwelling - minimum fee
Describe: $ 30.00
Bath tub $ 3.00 x = $ G vo
Floor drain 3.00 x = $
Gas piping outlet ' minimum -1 3.00 x = $
Hot tublspa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.00 x = $ c q
Septic 5ystem new/refurbished ' requires MPC lic. 75.00 x = $
Septic System abandonment 30.00 x = $
RPZ new installation/repairlrebuild 30.00 X = $
Rough opening 1.50 x = $
Shower 3.00 x
Underground sprinkler if dwelling is under construction 3.00 x = $
Undergroundsprinkler 'rfexistingdwelling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener if dwelling under construction 5.00 x = $
Water softener if existing dwelling 30.00 x = $
Waterturnaround 30.00 x $
State Surcharge .50 -> --> ----> $ .50
rotal --> --> ----> ---- > $
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
-----------------------------------------------------------------------------------------------------------------------------------•---------
I hereby acknowledge that I have read this appliqtion, state that the information is corced, and agree to comply with all applicable City of Eagan ordinances.
It is the applicanYs responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its
normal operationai and maintenance activities to the facilities construded under this pertnit within City property/right-of-way/easement.
SITE ADDRESS: I ?? g wz,-C? }po?,--V
OWNER NAME: : m ?J iIJ Z.yD ?, ?-4 TELEPHONE #: 7di 7? D J
° (AREA CODE)
INSTALLER NAME: OL-S I5? yp?? ? _ TELEPHONE #: CY?50i,
STREET ADDRESS: (AREA CODE)
CITY:
_ STATE: /713Y ZIP:
SIGNATURE OF PERMITTEE
CITY USE ONLY
LOT I O BL ? PERMIT #: `I I zb7
SUBD. kI YIum0d P0 h C1S RECEIPT #:
RECEIPT DA.TE: a6
2000 MECHANICAI+ PERMIT (RESIDENTIAL)
Date: ?s - b - 0c'?)
Complete this section onlv if you are installing HVAC in a single family dwelling, townhome or condo under
consiruction and not owner/occuQied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required Q$3.00 ea.)
State Surcharge
Total
$ 30.00
6.00
19.0?)
.50
$ ?r 5,0
Complete this section onlv if you are remodelin?, addins to, or re airin an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
New _ Alteration
Furnace
_ Air exchanger
Reminder: Call for inspections
SITE ADDRESS: ??? R'
Repair _ Other
Air conditioning
Other
Fee $ 30.00
State 5urchazge .50
Total $ 30.50
PHONE #: rol a
OWNER NAME:
? L (AREA CODE)
INSTALLER NAME: ?.r?•.1 PHONE #: G ?
-?" (AREA CODE)
STREETADDRESS: D??O? ?UI-- r
CITY:
STA1'E-7 A)f ZIP: Ef5:ib ?
SIGNATURE OF P RMITCEE
CITY OE EA6AN
3830 PZLOT FQdOB RD
EAGAN ZN 55122
651-681-4675
\?r
CITY USE ONLY
L BL PERMIT #:
SUBD.
APPROVED BY: , INSPECTOR
RECEIPT#:
RECEIPT DATE:
2000 MECHANICAL PERMIT (CONMRCIAL)
CITY OF EAGAN
3830 PILOT K+TOS RD
EAGAN, MN 55122
651-681-4675
Please complete for: all commerciaVindustrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
WORK TYPE: New construction Install U.G. Tank
_ Interior Improvement Remove U.G. Tank
_ Processed Piping
When installing/removiag underground tank, call 651-681-4675 for inspection by fre marshal and
plumbing inspector.
Description of work:
Fees: 1% of contract price OR $30.00 mioimum fee, whichever is greater.
Underground tank removaUinstallation = minimum fee .
Contract price: $ x 1%_$ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL
SITE ADDRESS:
$
OWNER NAME: PHONE #: -
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENAIVT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #: -
(AREA CODE)
STATE:
ZIP:
S[GNATURE OF PERMITTEE
4q6zoo7RESIDENTIAL BUILDING P?aPPUCnuo? '-f
? City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWction Reauirements
3 registered site surveys showing sq. ft. o( lot, sq. ft. of house; and all roofed areas
(20°k maximum lot coverage allowed)
1 Soils RepoR if proposed building is to be placed on disturbed soil
2 copies of plan showing beam & window sizes; poured found design, etc.
1 set of Energy Calwlations
3 copies of Tree Preserva4on Plan if lot platted after 711193
Rim Joist Detail Options selection sheet (buildings with 3 or less unils)
Minnegasco mechanical ventilation form
RemodeURepair Reauirements
2 copies of plan showing footings, beams, joists
t set of Energy Calcula6ons for heated addi0ons
1 sile survey for additions & decks
Addition - indicafe i( on-site septic system
. _ _
_. ._ _
Ofiice Use Oniv
CeR of Survey Recd •; _ Y N.
Soils Report ` Y N
Tree Pres Plan Recd Y _N.
Tree Pres Required _Y _ N
On-site Sep6c System _ Y _ N
Plans are considered public information unless vou state they are trade secret and the reason.
Date l1`'f la7
Site Address ?yo??' ?n4 J ?+n/•
k ? Construction Cost eo-u
? ???1) dro'/ UniUSte #
Description of Work
Multi-Family Bldg _ YN Fireplace(s) _ 0 _ 1 _ 2
Property Owner Telephone # ( )
Contractor b
(jC 1+? ? ??S/??v?
)(11G/7o11
Address /21o a /Td
5tate {
City.0 I
Zip M37 Telephone #(?s?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 CateQOrv 1 Minnesota Rules 7672
Ene?gy Code CategOry . Residential Venlilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #{ )
Telephone # ( )
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will 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 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.
e- l905e) & -*1
Applicant's Printed Name
Telephone # (
Appli ant's Signature
DO NOT WRITE BELOW THIS LINE
Sub Tvpes
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
Work Tvaes
? 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
? 13 16-plex
? 16 Fireplace
? 17 Garage
? 18 Deck
? 19 Lower Level
? 20 Pool ? 30 Accessory Bidg
? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 23 Porch (screenlgazebo/pergola) ? 36 Multi Misc.
? 24 Storm Damage
? 25 Miscellaneous
? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
`Demolition (Entire Bldg) - Give PCA handout to applicant
DBSCI'IptlOft: Water Damage _ Yes
Valuation Occupancy MCES System
Plan Review 100% or 25% Code Edition
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
_ Insulation
Approved By:
Base Fee
Surcharge
Plan Review
MGES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 07 OS-plex
? 08 06-plex
? 09 07-piex
? 10 08-plex
? 11 10-plex
? 12 12-plex
REQUIRED INSPECTIONS
_ Sheetrock
FinaUC.O.
FinaUNo C.O.
HVAC
Other
_ Pool Ftgs Air/Gas Tests Final
_ Siding _ Stucco Lath _ Stone Lath _Brick
Windows
_ Retaining Wall
Building Inspector
RESIDENTIAL
BUILDING PERMIT APPLICATION
3830 PILOT KNOB RD - 55122 c)
I
651-681-4675
New ConatruNion Reauirements RemodeVReoair Reauirements
• 3 registered site surveys showing sq. ft. oi lot, sq. fl. of house; and all roofed areas • 2 copies M plan
(20% maximum lol coverage allowed) . 1 set of Energy Calculations for heated addilions
• 2 copies of plan showing beam & window sizes; poured found design, etc.) . 1 site survey for exterior additions & decks
• 1 set of Energy Calculations . Indicale ff home served by septic system for additions
• 3 copies of Tree Preservation Plan if lot platted after 7/1/93
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE V
JOB SITE ADDRESS I?.rLS IU_;Haj5WC&j PpNOC
l
IF MULTI-FAMILY BUILDING, HOW MANY UNITS? ?J_
PROPERTY OWNER ! /`?ON?.-?'i ? ,51?(?A+ •
TYPE OF WORK ?N ( sl?t? ?`S
APPLICANT dN ADDRESS !(61 I7Zj.Sr'_"-' St. b
PAGER #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Cate9ory _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor: _
Plumbing System Includes:
Mechanical Contractor:
Mcchanical System Includes:
Sewer/Water Contractor:
Phone #
Phone #
Fee: $90.00
Fee: $70.00
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is co ect, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Or ' a es.
Signature of Applicant r
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1101
?''-
.?VW
FIREPLACE(S) _ 0 _ 1 _ 2
_ PHONE#
ZIP CODE?
GELL PHONE # FAX # "6_32I349
Water Softener
Water Heater
No. of Baths
_ Phone #:
Lawn Sprinkler
No. of R.I. Baths
Air Conditioning
Heat Recovery System
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-piex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition •' 0, 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 F.ire Repair
? 33 Alteration ? 37 pemolish (Bldg)' -, ? 43 Reroof , ? 46 ' WindowslDoors
? 34 Replacement *Der6lition (Entiret Bldg only)'- Give PCA handout to•applicant
Valuation
Census Code
SAC Units
Nbr.'of Unit's_
Nbr. of,Bldgs
Type of Const
. • Occupancy.
' =?-
Zoning. ?
Stories ?
Length
Width
REQUIRED INSPECTIONS
Footings (new bldg)
Footings (deck)
Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
Framing
Fireplace _ R.I. _ Air Test _ Final
Insularion
MClES System
City Water
,. ?
Booster Pump •
PRV,
• Fire Sprinklered •
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search ,
Copies
Other
Total
FinaUC.O.
_ FinaUNo C.O.
_ Plumbing
HVAC
Building Inspector
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA142661
Date Issued:05/12/2017
Permit Category:ePermit
Site Address: 1428 Kingswood Ponds Rd
Lot:Block: Addition: Shady Shores
PID:10-67470-01-020
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Steven Thielen
1428 Kingswood Ponds Rd
Eagan MN 55122
Estate Claim Services LLC
934 Cromwell Avenue, Suite 2
St Paul MN 55114
(651) 309-1114
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA159373
Date Issued:12/12/2019
Permit Category:ePermit
Site Address: 1428 Kingswood Ponds Rd
Lot:Block: Addition: Shady Shores
PID:10-67470-01-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Steven Thielen
1428 Kingswood Ponds Rd
Eagan MN 55122
(651) 454-1404
Wenzel Heating & Air Conditioning
4145 Old Sibley Memorial Hwy
Eagan MN 55122
(651) 894-9898
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA160259
Date Issued:02/26/2020
Permit Category:ePermit
Site Address: 1428 Kingswood Ponds Rd
Lot:Block: Addition: Shady Shores
PID:10-67470-01-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Steven Thielen
1428 Kingswood Ponds Rd
Eagan MN 55122
(651) 503-4667
Milbert Company (culligan)
1801 50th St E
Inver Grove Heights MN 55077
(651) 451-2241
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA174740
Date Issued:02/16/2022
Permit Category:ePermit
Site Address: 1428 Kingswood Ponds Rd
Lot:Block: Addition: Shady Shores
PID:10-67470-01-020
Use:
Description:
Sub Type:Garage Heater
Work Type:Replace
Description:
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Steven & Amanda Thielen
1428 Kingswood Ponds Rd
Eagan MN 55122
(651) 563-4667
Wenzel Heating & Air Conditioning
4145 Old Sibley Memorial Hwy
Eagan MN 55122
(651) 894-9898
Applicant/Permitee: Signature Issued By: Signature