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1460 Kingswood Ponds RdAddress 1460 KINGSWQOL PONDS ROAD Zlp $512 2 Lot 4 , Rkk Sub KINGSWOOD PONDS 2IVB THESE 1TEMS WERE / WERE NOT COMPLETE AT THE TIME OF TFfF FINAL INSPECTION. Date: -? f'S p Yes No Inspector. Final grade (6" from siding) Permanent steps (gazage) Permanent steps (main entry) • Permanent driveway Permanent gas Sod/Seeded grass 4 Trail/curb damage ' 7 - Porch ' Basement finish 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 Iawn faucet before freeze potential exists. Contact engineering division at 6814645 before working in rightof-way or installing underground sprinkler system. ? White - City Copy Yellow - Resident Copy Pink - Contractor Copy 2007 RESIDENTIAL PLUMBING PERmiT aPPLicarioN CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existina residential dwellinas Date Site Street Address < Unit # Property Owner /? l- ? q Telephone # Contractor Telephone # ( ) Address City State Zip The Applicant is: X Owner & Occupant _ Licensed Plumbing Contractor Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built $ 10.00 Fire Repair (replace burned out fixtures, etc.) $ 90.00 This fee a lies when extensive lumbin re airs are made to a buildin . Alterations to existing dwelling $ 50.00 x Add plumbing fixtures to main levef lower level. This fee includes installation of a water softener andlor water heater at the same time. !f you are installing onlv a water sotlener and/o r water heater, do not complete this section; move to the next section and place a checkmark next to the appliance(s) you are installing. - _Septic System Abandonment ? D L- b"?Vj _Water Turnaround (add $136.00 if a 5/8" meter is required) APR other: 2 2007 Water Softener Water Heater $ 15.00 _ new _ replacement Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ .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. C? -6 r`.?-l? 0 ?UC? ? ' ApplicanYs Printed Name P,,{SplicanYs Signature V? ? •.ww Site addresx \W.oD \L?rQS M& Lot ? Block a Subd.lQi r???. t On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be submitted prior to issuance of a Certificate of Occupancy. This sVucture: is constructed to meef minimum requirements of the Mn Energy Code, Chapter 76704?.? OR _ This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674 APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE Water Heater ? C-0-L - ??? Lg?r+ . Fumace LO' tD. Dryer ' ?1 uD .ra (Q 3b b. PV VENTED EXHAUST SYSTEM LOCATION TYPE MODEL CFM's YES No IGtchen kitchen m LA) -. ? Bathroom 1 P WA Bathroom 2 Bathroom 3 01 v Bathroom 4 ? Other F FIREPLACE S LOCATION GAS WOOD MANUFACTURER MODEL BTU'S VENTING DIRECT ATMOS , MAKEUP AIR MODEL TYPE CFM's o I hereby acknowledge that the above in`formation is correct and agree to comply with the Minnesota Energy Code and City of Eagan requirements. . ?V ?naUJ Q ? ?`?r "1 Company Nam ' This form is the responsibility of the General Contractor. Date JB WOODFITTER & ASSOCIATES LLC 16817 DULUTH AVE. SE PRIOR LAKE, MN 55372 ki) 2000 BUILDING PERMI PP CA 14N (RESIDENTIAL) EAGAN L???1., f I 3830 PILI T KNOB RD - 55122 ?? j-'? -?> ? • lS- 651-681-4675 D, j3_O? New Construcflon Reaulremenis C ? ' 1 .?.1. I ?..I ? (P R?model/Repalr Reaulrements ? ` ? 9 registered sffe surveys showing sq. if. of lof, aq. fl. of house 2 copies o( plan and 11 rooled areas (20% maximum lot coveraae allowed) 1 set ot energy calculaNOns for heated additfons ? 2 copies of plans (show beam 8 window sizes; poured Md. design; etcJ i Site suney tor exfedor additions & decks ? 1 set o1 energy calculafions ? 3 coples of tree preservation plan if lot platted after 7/1/93 pATE: \0 % D\ m CONSTRUCTION COST: ' ? DESCRIPTION OF WORK: LCIr2?SACtvJ- hfll ?t?? ? i( STREET ADDRESS: 4 how many units? LOT: BLOCK: a SUBD./P.I.D. #: ?i V\A?S?(`??lc\ QbcY?,? ??".? p?fl? ?«uao??ouooa PROPERT1f Name:b(-APnr?-?c?fik?t? t Phone #: 4Qm OWNER Street Address: ?- City f? SMte: K01i Zip: Company:_ ? ? \??c? ?i ?P? ? W hone #: qSa CONTRACTOR (area code) SFreetAddress: \?Og?? ?)h-d? dk.t.e..? ucense # Exp. Cliy kS U_tr(LV-Q- State: rctiA- Zlp: ARCHITECT/ ? ? ? ENGINEER Company: Ari d Name: Telephone #: Sheet Address:_ Z1(d(f??zs Registration #: Cify ?ICIko • State: c--'C? Zip: Sewedwater licensed plumber f n tallin ewer/wate :?ACrD? ?1.?Cl? ?DQ? Phone #: I hereby acknowledge thaf I have read this application, state that the information is co t, and agree to of Minnesota Statutes and Crty of Eagan Ordinan? s. /'ILI--? L JC.`N 1' "C °' Sn?atuFe? of Applicant: ? 1'ar? '3 OFFICE USE ONLY 2S Certificates of Survey Received ? Yes _ No Tree Preservation Plan Received Yes _ No ? Not Required ?r &I [twt all applicable State ? i , ? L_ • _I OFFICE USE ONLY BUILDING PERMIT SUBTYPES 0 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.) IW 02 SF Dwelling ? 08 06-plex ? 17 Garage O 22 Porch/Addn. (4-sea.) ? 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened) ? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage ? 05 03-plex ? 11 10-plex Plbg _Y or _ N ? 25 Miscellaneous ? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bldg. WORK TYPE tW 31 New O 38 Move Bldg. ? 43 Reroof ? 32 Addition ? 37 Demolish (Bldg)* ? 44 Siding O 33 Alteration 0 38 Demolish (Interior) ? 45 Fire Repair ? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors * Give PCA handout to applicant for demolition permit GEPJERAL iNFORMAiiOPi SAC Code 0( # of Stories `Z sq• ft• No. of Units _4 Length sq• ff• No. of Buildings -4_ Width 4'c? r Footprint sq. ft. Const. (Actual) 5'-?(l Basement sq. ft. 13°7s Census Code (Allowable) S--AJ Maig level sq. ft. 6 y MC/ES System UBC Occupancy ? q? ? "Ge-v&(sq. ft. 7,0 City Water Zoning sq.ft. ?157- BoosterPump PRV Fire Sprinklered MISCELLANEOUS INSPECTtONS ? Stucco/Ston e APPROVALS Planning Building Uld Engineering Variance ? 31 Ext. Ait - Multi ? 33 Ext. Att - SF 0 36 Multi C489 Permit Fee Valuation: $ Zzo(Jo Surcharge Fian Review License l3 25k G S z a-bj 6 a-5 g MC/ES SAC City SAC Water Conn. -- ?? Water Meter ? 7 316 5? Acct. Deposit S/W Permit S/W S h arge urc Treatment PI. t 3 7b 16S? z 7? 4Fe - Park Ded. Trails Ded. Other Copies ? S ?a ?? G---- ' Total: • SAC Units % SAC NEW HOME FIELD INSPECTION ENERGY CHECKLIST MINIMUM REQUIREMENTS (CATEGORY 2) FOUNDATION: xterior foundation wall [A? insulation installed: R- [?y Vlab-on-grade insulation t installed: R- [cts in slabs have R-5 nsulation bottom and sides gp PENETRATIONS: [ X] Window and door frames sealed Framed wall openings into attic sealed [?] Other joints in wall sealed [ ] Dropped ceiling air-blocked OPTIONAL (CATEGORY 1) Foundation rim joist sealed airtight [ ?] Upper story band joists sealed airtight Ceiling poly sealed to top of interior partition walls [ Plumbing penetrations sealed [ Exteriar walls behind tub and shower sealed [ Plumbing vent stack sealed Chimney flues sealed at ceiling [?] Perimeters of all grills and registers sealed to vapor barrier [?] Electrical service sealed [?7 Recessed light fixtures sealed Wire penetrations into attic sealed Telephone, cable TV penetrations sealed [?] Fans sealed where vapor barrier penetrated [ ?] Electrical boxes sealed to vapor barrier [ ?C] Fan housings air sealed NEW HOME FIELD INSPECTION ENERGY CHECKLIST PAGE 2 MINIMUM REQUIREMENTS (CATEGORY 2) INSULATION: [?] Vapor barrier installefl [?[ 1 In_t?rior foundation wall: l? (?) Vapor barrier installed (?( Insulation installed: R-? Moisture barrier installed Attic,/insulation installed: R-.'?, Y Attic card posted with proof of bags installed [?] Floor insulation installed: R- [ x ] Wal insulation installed: ( R-19 ( )R-21 ( ) R- W N WASH BARRIERS: [] Wind wash barrier installed at attic edge [.?] Overhangs (cantilevered floors and bay windows)have wind wash barriers MECHANICAL: Ducts running outside conditioned space sealed and insulated witi'1 minimum of R-8 Returns in same space as furnace sealed [ ] Ducts in unheated spaces [. Water heater has pipe insulation or heat traps installed [?] Furnace AFUE: 6kO [ ] Central Air SEER: ?,? OPTIONAL (CATEGORY 1) [ ?] All exterior joints in building envelope sealed [ ] Residential mechanical ventilation system installed (Mandatory if one or more item in this column is checked) NOTES TO FIELD (Building Department Use Only)------- MNcheck COMPLIANCE REPORT Minnesota Energy Code MNcheck Software Version 2.0 Minnesota Department of Public Service 1-612-296-5175 1-800-657-3710 Permit # Checked by/Date COUNTY: Scott STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Sinqle Family DATE: 1-4-2980 DATE OF PLAN5: 10/10/00 TITLE: GRGAS RESIDENCE PROJECT INFORMATION: Tony & Margaret Grgas 7088 98th St. S Cottaqe Grove, MN 55016 (651) 769-2818 W) (651) 338-6108 ip y ?-" Cl-A ? COMPANY INFORMATION: JB Woodfitter & Assoc., LLC 16817 Duluth Ave. SE Prior Lake, MN 55372 (952) 447-0850 NOTES: Property: 1460 Kingswood Ponds Rd., Eagan, MN 55121 PID # 104205104002 LGL: L4 B2 Kingswood Ponds 2nd Addn. COMPLIANCE: PASSES Required UA = 394 Your Home = 354 Area or Insul Sheath Glazing/Door -- - - Perimeter R-Value R-Value U-Value UA -- - ------------------------ CEILINGS: Raised Truss -------------- 1380 --------- 38.0 ------- 0.0 ------------- °- 35 WALL5: Wood Frame, 16" O.C. 2736 19.0 2.0 141 GLAZING: Windows or poors 478 0.340 163 DOORS 42 0.350 15 COMPLIANCE 5TATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been desi ned to meAt the r q iremer}ts of the Minnesota Ener9Y Code. g -4 1-}?-SAv L,L C? Builder/Desiqner V Date 0 ou _ J ? 1 ??E'-? e# ?P?..?., ?.?-?-- '??te? S KC9t??.1S?,, ?P? COMBUSTION EDUIPMENT Space Heating Service Water Heating Gas Nearth Wood Hearth CO Alarm Required VENTILATION TYP People ventilation Supplemental ventilation Clothes drver Less than or equal to 175 cfm More than 775 cfm Kitchen Range Exhaust Less than or equal l0 250 251 to 500 cfm More than 500 cfm Other Exhaust Up to 140 cfm Moro thaii 140 cfm 2000 ENERGY CODE OPTIONS FOR COMPLIANCE TABLE ? Prescriptive Path 0 I Prescriptiv Path 1 I Prescriptive Path 2 I Prescriptive Path 3 I Sealed combuslion Sealed combustion Sealed combustion None No Balanced or exhaust 8alanced or exhaust' Passive infiltralion Passive opening for cfms over 175 Passive infillration Direcl 2ect power vented power venled Closed controlled combuslion solid-fuel burning appliance' (CO alarm required and adequate make up air required. See code.) No exhaust exhausl' Passive infillralion Passive opening for clms over 175 Passive opening Atmospherically vented' Direcl or power vented Almospherically vented' Closed conirolled or decorative' Only one appliance inslalled may be almosphericaily vented (See code) Yes Balanced Balanced or exhaust' Passive opening Powered to match Ilow tor cfms over 175 Almospherically vented Almospherically venled Direct venl None Yas Balanced Balanced Powered lo match flow Powered to malch flow Passive opening for cfms over 250 Powered lo malch Oow for cfms over 250 Powered to match flow for cfms over 250 Powered to malch flow for cfms over 250 Powered to malch Ilow Powered to mafch flow Passive opening Passive openiny Powered to malch flow Powered to match flow f'owereJ lo inalch Ilow (or Powered lo matcll Iluw lor I ctiny °vtf 140 cfms over 140 If exhaust exceeds .05 cfm/sf see code. A central vacuum that exhausts to the autside is not a mechanical exhausting device for Prescriptive Paths n ana 1 2000 MINNr+.soTA cNracv c.our - 1-2 Furnily Resitlentia! Uwellings "COOKI300K" WORKSIIEET Applicanl Namc Phone t`? ,n °?52'- '14-1-0YS ?-aa. Wocd.?"?'CQ- c J Y?1sca LL c. Applicant Compariy S c. v-. t? I3mlding AJdress: (D c r \ MINIMUM I2EQUIREMENTS for "Cookbook" Onlion: Dale P,?lan;s must be clearly marked with: tp-msulation R-values, ( d\ONDO q window and skylig6t U-values, P?size and lype of equipment, ? localion of interior air 6arrier, vapor retardcr unJ wind wash barricr, q equipmenl contruls. Statemeut of Complianct: 'ihc pmposcd 6uilding dcsign reprcsenltd in these docwnents is consistent with ihe building plons, spccifications, and othcr wiculalions submilled wilh lhc permit application. lhe propqcd building has bccn designed lo meet ihefequiremcpts,of the Lntry Donrs 1-314" solid wood or maxinmm U-value of 0.40 Ceiling R-38 (insulation perfomtance a( wiuter design conditions) Heating system efticiency: > 90 % Ai'UE Foundation 1/2" insulated glass in wood or vinyl frame, Windows' or maximum U-value of U-0.51 Poundation wall insulalion R-10 (if a different R-value is used, adjust tlie require(i average wiudow U-value by Rim joist R-10 'Incl d lo d i d li l f u e uu a on w u ow tota square uolage in i l l f Wi d completiug the workshect on (lie uext page). Fluvw uver uucuuditioiizd s4,ace R-30 ca cu at on o n ow/Door Area: Wlndow and Door Area ]00 z %, As % of Ezposed Wall Area N5'indaw/Daar Area Gross WaII Area Wludow/Door Area ? WINDOW U-VALUE : . 3L-A Sourer. NFRC or Code Default lable ? MAX[MUM AVERAGE WINDOW U-VALUES FOR R-10 FOUNllATION WALL INSUI.ATION & 900/ AFiIF sneNSCP Check NAII "I' )e Used Maiimum 1'otal Window anJ lloor Area as Percenln e of F.i iosed Wall: 10114, 12% 14°/. 16°41 t8•41 20°/. 22% 24•/. 26% v y 28°/. ?'? hiaxlmum Avera e Wiudow U-value: 2x4, R-13 insulation, < R-5 shealliing 037 0.37 033 0.28 0.25 0.22 0.20 0.19 0.17 0,15 2x4, Ii-l3 insulatiou, zK-5 shealhing ------ 0.37 037 6 .37 037 0.37 033 0.30 0.27 0.25 0.23 2x4, R-13 insulation, z R-7 sheaUiing 0.37 037 037 0.37 0.37 0.36 0.33 030 0.27 0.25 2x6, R-19 insulation, < R-5 sheathin 037 0.37 0.37 037 037 032 0.29 0.27 0.24 0.23 2x6, R-19 insulation,> R-S sheatliing 0.37 0.37 037 0.37 0.37 037 0.35 0.32 0.29 0.27 2x6, R-21 insulation, < R-5 shcathin 0.37 0.37 037 0.37 0.37 035 0.31 0.29 0.26 0.24 2x6, R-21 inuulatiun, Z R-5 sheat6ing 0.37 0.37 0.37 0.37 037 0.37 036 0.33 0.30 0.28 NOTE: If foundation wall insulalion is either less than R-ID (but not less (han R-5), or R-l9 nnd abovc, thcn use Uie taUlcs apprupriate for lhose values. G This is a summary only. Other requiremcnls may apply. See the Minnesota Energy Coda 5/99_ Questions? Call Deparbnent oLPublic Service In(ormation Center at 651 296 5175 or 800 657 3710. _, pQge-j , ? Prescriptive Path Worksheet 2000 Minnesota Energy Code Buiidin addres t? Co.mie.ted b ( Ciry: Date: \ cl. \ J p? InOICa[Q Wlifl 8 Cf7@CK fT18fK Lf76 6QUlpfflBfti Ir15lallec. Direct or Power - Atmospherically Indicate path used: Combustion Equipment Sealed Vented Vented Space Heating Gas or Oil ?-` PresCriptive Path 0 Water Heating Gas or Oil Prescriptive Path 1?>e Hearth Prescriptive Path 2 Gas ? Prescriptive Path 3 Wood Closed controlled Decorative Reauirements for combustion and dilution air for vented com6ustion eauioment are Drovided in ChaDter If any atmospherically vented combustion equipment is used, prescriptive paths 2 or 3 must be followed. ICO Alarm installed? Yes No A CO alarm is reGuired for prescriptive paths 2 and 3. Amount exhaust Total ventilation ?U t7 ctm or Peopie Ventilation and cTm Suoplemental Ventilation cfm The People Ventilation must be balanced for `ZOl7 C'?- - 'V\ ';? ?f d 3. The Supplemental Ventilation must be balanced for Prescrip6ve Path 3. Do cfim cfm cfm ptive paths 2 an Make-Up Air Requirements IPassive Infltration' Passive Opening (fill out tabie below) Powered to match flow Clothes Dryer t 5? cfrn \S?5 I cfm Range Exhaust oY-cfm ( cfm Other Exhaust C?t 0_ cfm f N!A ? C`m Fill out duct sized from able To Size PassiveaMake-Up Air Openings: Prescriptive path used ' sags. Make -up air appiication / locatior _?,Desicr air flow Duct size smooth ? flex cfm ? - ' ` ? cfm I crm cim Note: If flex duct is used, increase diameter by 1" over Table value. Flex duct must be sfretched with minimal 5/99 ? ? Maximum Window U-value with 90% AFUE space heating and R-10 Fotin?tio_.n Wall Insulation Max. Total Window and Door Area as a percent of exposed wall 10°a 12% 14% 16% 18% OO% 22°. 24% 26°. 28°a Wall'fype: L 2x4,R-13 insulation, <R-5 sheattiing 0.37 0.37 0.33 0.28 0.25 0.20 0.18 0.17 0.15 2xA,R-13 insulalion, >R-5 sheailiing 0.37 0.37 0.37 0.37 0.37 0.30 0.27 0.25 0.23 2x4,R-13 insulation, >R-7 sheathing 0.37 0.37 0.37 0.37 0.37 0.36 0.33 0.30 0.27 0.25 2x6,R-19 insulation, <R-5 slieattiing 0.37 0.37 0.37 0.37 0.36 0.32 0.299 0.27 0.24 0.23 2x6,R-19 insulation, >R-5 shealhing 0.37 0.37 0.37 0.37 0.37 0.39 0.35 0.32 0.29 0.27 2xG,R-21 insulalion, <R-5 sheathinU 0.37 0.37 0.37 0.37 0.37 0.35 0.31 0.29 0.26 0.24 2x6,R-21 insulalion, >R-5 sheathing 0.37 0.37 0.37 0.37 0.37 0.37 0.36 0.33 0.30 0.28 i Maximum Window U-value with 90% AFUE space heating and Px_5 up to R-1Q?teriar' FouIldatlon Wall Insu1a1L4i1 Max. Total Window and Door Area as a percent of exposed wall 10% 12% 14% 166% 1g% 20% 22% 24% 26% 28?0 \i'a!1 Type: L 2x4,R-13 insulation, <R-5 sheathing u.37 u.3d 0.30 0.23 0.20 0.18 0.16 15 0.14 2x4,R-13 insulation, >R-5 slieatliing 0.37 Q.37 37 0.35 0.31 0.28 0725 0.23 0.22 2x4,R-13 insulation, >R-7 shealfiing 0.37 0.37 0.37 0.37 -- 0.37 0.34 ---- ---- 0.31 -- 6.28 0.26 0.24 2x6,R-19 insulation, <R-5 sheathing 0.37 0.37 0.37 0.37 0.34 0.31 0.28 0.25 0.23 0.21 2x6,R-19 insulatlon, >R-5 sheathing 0.37 0.37 0.37 0.37 0.37 0.37 0.33 0.30 0.28 0.26 2x6,R-21 insulation, <R-5 sheatliing 0.37 0.37 0.37 0.37 0.37 0.33 0.30 027 0.25 0.23 2x6,R-21 insulation, >R-5 shealhing 0.37 0.37 0.37 0.37 0.37 0.37 0.35 0.31 0.29 0.27 Maximum Window U-valUe with 90% AFUE spaca heating and P 1- 19 or gr?at-QL.foupdltion waljjpswatI4[1 Max. Tolal Window and Door Area as a percent of exposed wall 10% 12% 14% 16% 18°/a 20°/a 22% 24% 26% 28% Wail Type: 2x4,R-13 insulation, <R-5 sheathing 0.37 0.37 0.34 029 0.26 023 0.21 0.19 0.17 0.16 2x4,R-13 insulation, >R-5 sheathing 0.37 0.37 0.37 0.37 0.37 0.34 0.31 0.28 0.26 0.24 2x4,R-13 insulation, >R-7 stiealliing 0.37 0.37 0.37 0.37 0.37 0.37 0.34 0.31 0.28 0.24 2x6,R-19 insulation, <R-5 shealtiing 0.37 0.37 0.37 0.37 037 0.34 0.30 0.25 0.23 2x6,R-19 Insulalion, >R-5 sheattiinfl 0.37 0.37 0.37 0.37 0.37 0.37 0.36 0.30 0.28 2x6,R-21 insulation, <R-5 sheathing 0.37 0.37 0.37 0.37 1 0.37 -- 0.36 0.32 A29 0.27 0.25 2x?i,R-21 fnsulalion, >R-5 shealhing 0.37 0.37 0.37 0.37 6.37 0.37 0.37 0.31 0.29 This is a sununary only. Olhu rcyuiremenis roay apply. Sce the Minnesola Gncrgy Cexle. Questions7 Csll Depaitment of Public Scrvice Infotmation Cenler at 651 296 5175 or 800 657 3710. pape-.q.. . ? n H > w ? ? O Q t? 4 ? 0 ? ? 0 g .? ? 0 0 m ? ? V/ o p ? ua? ? ? LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION ?oN PROPERTY LEGAL• 1-07-4-BLACA' 2.rZ.b?'Sl,cf?D rNOS -5?;Co,vp AII1?z7- DATEOF SURVEY: Io' 0 0 LATEST REVISION: DOCUMENT STANDARDS . . . . . . Registered Land Surveyor signature and company Building Permft Applicant Legaidescription Address North arrow and scale House type (rambler, walkout, split wlo, split entry, lookout, etc.) Directional drainage artows with siopeJgradient % Proposed/exasting sewer and water services 8 invert elevation Street name Driveway Lot Square Footage Lot Coverage ELEVATIONS Existin p ? ? ? ? ra'?'o ? m--'o ? ? a" ? . . aY ? ? . [a' ? ? • Vo ? • w" ? o . 0' o 0 • Sewer service (or Proposed) Property comers Top of curb at the driveway Elevadons of any ebsting adjacent homes Adequate footing depth of structures due to adjacent uhlity Venches Prooosed Garagefloor First floor Lowest exposed elevation (walkoutlwindow) Property corners Front and rear of home at the foundation PONDING AREA (if apolicaWe) p/? o • Easement line r,? ? ? • NWL ea/ ? ? • HWL mi ? ? • Pond # designatlon ? ? • Emergency Overflow Elevatlon DIMENSIONS ?o o • Lot 6nesl8earings 8 dimensions m, o o • Right-ot-way and street width (to back oi curb) Q-'o ? • Proposed home dimensions induding any proposed decks, overhangs greater than 2', porches, etc. (i.e. all structures requiring permanent footings) ar-, ? ? •' Show all easements of record and any Ciry utifides within those easements r,Y ?? • Setbacks of proposed structure and sideyard setback of adjacent epsting structures ca'? ?? • Retaining wall requirements, if any Reviewed: af 7? amw / Det6 March 1989 CRA10IBLDOPRMR.FM ., . JROiSE CONSUL7ING ENGINEERS, ON-SITE MARKETING PLANNERS and LAND SURVEYORS PROJECT N0. 10028.00 ENGINEEAING BaoK 3013 COMPANY, INC. PAGE Z? ? 1000 EAST 146th SiREET, BURNSVILLE, MINNESOTA 55337 PH 432-3000 "- CERTIFICATE OF SURVEY Legal Description: LOT 4, BLOCK 2, KINGSWOOD PONDS SECOND ADDITION DAKOTA COUNTY, MINNESOTA. ?8??J ) DENOTES EXISTING ELEVATION (9,59?0) DENOTES PROPOSED ELEVATION -?-- INDICATES DIRECTION OF SURFACE DRAINAGE 86,7, 33 = FlNISHED GARAGE FLOOR ELEVATION $ ,5O = BASEMENT FLOOR ELEVATION ? 868 _ 33 = TOP OF FOUNDATION ELEVATIO NO 92 32'_W LOT 4 1 ? ?? ? •, !__ rtW? = 826. ? ? N?nI?= 834z DRAINAGE ANO PONDING EASEMENT PER DOC. N0. 566949 • ?3 56 ? lJ 51? / ?\/ ? { 5??26 ?O 29 5 t11f ' g?a?•E W ? O ? \ ? 1 ---?Cl'4 '5N2 N OLOa ? ? o!a P r^ St a?r - ?ev%C.6 ?pC G k Q ?o ?o . ? PROPOSED.° HOUSE ?i SCALE : t " = 40' SEn/cy MA2K: T K HyO. C K/npsuiood ? OvPVlook Elev, = 865.6; '- ? C51 Lb-r AaEA = Z8? 370 S9. F?. NSE ReA = 2( O20 Sy. FE. ,4 A ODRE55 = 1460 KhHfswood PoHd Raxd ? r? SLOP?e sN THZS AREA Excaeas 36.1 A. 'Rer?a=NC a?A4? l?Ar t3. ?vEEbE D . ? ?sTr? 6 NpusE ?,aRa? -- $64: Bb`?? Z ro ?8b1,33?(s?7 L? 1, •? ? 'Y c? K 1•O E? , ? c?? ,- o 92.00 ate ROA as, ?c?? E?r?-?ER?G ns?r. ? _- • ? ----„?n PoN? I hereby certify that this is o true and correct representation of a tract as shown and described hereon. As prepared by me this 9? day of o??Fober , 2000. I/?-?-Q-P..K ?- a`'?.?-Minn. Reg. No. 17006 ? p aF ? ?Sb 2, ? 6 (g5?'o?'o', 85 0? 612 447 0859 03/08/01 THU 10:01 FAX 812 447 0859 ON-SITE MARKETING C0. 2002 ??'CC50.5 Lot ? Biock e? Subd. ? Site address: ` On April 15, 2400 the Minnesota Energy Code, Category I Buiiding Requirements far insu{ation protection, air tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring thaf the following infvrmation be subm+tted prior to 'sssuance af a Certificate of Occupancy. AXM-X-% ?'fhis sVuctura: is consUucled to meet minimumRequirements of the Mn Energy Cade, Chapter 7670 o This structure: will 6e constructed to meet more resfictive requirements of Chapters 7672 or 7674 DIRECT ATMOS ?_ AI ? f i nature? n Company Nam ' This form is the re5ponsibiVity of the Gen¢rel CAntrBCtor. pate J8 WOODFiTTER & A.SSOCIATES LLC 16817 DULt1TH AVE. SE pRIOR IAKE. MH 55372 ? ... .._?_.. { hereby acknowledge that ths above fYitomtiaGon is correct and agree to comply with t e inneso requirements. CITY USE ONLY PERMIT #: qwq RECEIPT DATE: J ft£SIDENTULL MECILNICAI. fEPMTf Af 'PLICATION crrY oF Etswx saso PaoT KNoa Etn EAsMaNssi2z 651-681-4675 Please complete for: ? single family dwellings • townhomes and condos when permits are required for each unit Date: ? _ 8- U ( SITEADDRESS: ?LlbO IYLS5 WV04? POVtJS PC'- OWNERNAME: ?? ??WG6? ?IT1?lC? TELEPHONE#.: 95%;k- yq?'OW) (AREA CODE} INSTALLER NAME: /--Ft'1,I7CI250110 At"t TW- TELEPHONE #: 95-?? - Opq-78P I q (AREA CODE) STREETADDRESS: E03 CITY: SkJkeOS04< Rd STATE: ZIP: SrS3 3? Place a check mark next to the nermit work tvoe ,k New residential dwelling unit under constructionand not ownerloccupied $ 70.00 Add-on, modification or alteration to existin dwelling unit $ 50.00 • furnace replacement • air exchanger • air conditioner • other Nature of work: State Surchar e $ .50 Total $ 7 d' S9 Reniinder: Call for inspections. SIGNATURE OF PERMITTEE Updated 1101 CITY USE ONLY PERMIT #: APPROVED BY: INSPECTOR RECEIPT DATE: COMMERCIAL MECRAN1CA1. PE$M1T APPLICATION CtrY OFEAem 3830 pu.oT xxoa Etn EE6u4N, MN 55188 651-8$1-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: SITE ADDRESS: OWNER NAME: PHONE #: - (AREA CODE) TENANT NAME (IMPROVEMENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: ADDRESS: CITY: WORK TYPE: New construcrion _ Interior Improvement _ Processed Piping Specify Nature of Work: PHONE #: - (AREA CODE) STATE: Z1P: Install U.G. Tank Remove U.G. Tank When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and PlumbiRg Iinspector. Fees: i% of contract price OR $50.00 minimum fee, whichever is greater. Underground tank removaUinstallarion = *n;n;mum fee Contractprice: $ xl%=$ (BaseFee) State surcharge calculate at $.50 for each $1,000 Base Fee TOTAL $ SIGNATURE OF PERMIT"TEE Updated 1/O1 li- SUBD BL ? CITY USE ONLY RECEIPT #: RECEIPT DATE: -C) v PERMIT # V `T 9 8000 PLUM$INfi PER1411T (ftESID£NTIAL) crrY oF EOLsAiv 3830 Pu.oT Kvoa ftn EAeAv, Mtv 55122 651-6$1-4675 Please complete for: ? singie family dwellings ? townhomes and condos when permits are required for each unit D backflow preventer for underground sprinkler system etvr"oce Geru U TOTAL Alterations to existing dweliing - minimum fee Describe: $ 30.00 Bath tub $ 3.00 x f = $ - Floor drain 3.00 x $ 3^- Gas i in outlet * minimum -1 3.00 x I = $ Hot tub/s a 3.00 x = $ Kitchen sink 3.00 x $ ?S- Laund tra 3.00 x 1 = $ 3'" Lavato 3.00 x $ S8 tIC S stem new/refurbished ' requires MPC lic. 75.00 X = $ SB tIC S stem abandonment 30.00 X = $ RPZ new installationlrepairlrebuild Rou h o enin 30.00 1.50 X x 3 = = $ $ Shower 3.00 x l = $ Under round s fitlklBf if dwelling is under construction 3.00 X = $ Under round s rinkler ifexis[ing dwelting 30.00 x = $ Water closet 3.00 x a = $ Water heater 3.00 x $ 3'" W ater softener If dwelling under construction 5.00 X = $ Water softener if existing dwelling 30.40 X = $ Waterturnaround 30.00 x $ State Surchar e •50 --' '---' "'-' $ •50 Total --> --> ----> ----> $ .0 ? Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. I hereby acknoevledge that ! have read this application, stale that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility [o notify the property owner that the Ciry of Eagan assumes no liability for any damages caused by the City during its normal operational and main[enance ac6viGes to the facilities consWCted under this permitwithin City property/nght-of-way/easement. SITE ADDRESS: (?O o K 'VA OWNER NAME: : ) 5> W (X_?c4 ?7j "--C / 5 INSTALLER NAME: TELEPHONE #: q?V7- G?SU (AREA CODE) TELEPHONE cl 5 '?'- ^ </C/7 ?? ? CODE STREET ADDRESS: 4 a U0 ?dd i AJ 0?` (AREA ) CITY: 1' (1c/- STATE: /,/: av" ?---ZIP• ra n-rm rr i ?i EC '/? (I ?t10n 2007 RESIDENTIAL BUII.DING PERMIT APPLICATION U? City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirgments 3 registwed site swveys shaaing sq. fl. of bt, sq. fl, of house; and ?II roofed areas (2096 ma)imum lot coverege albwed} 1 Sals Repori'rfpraposed buildng is tobe plaoed on dislmbedsoil 2oDpies of plan showing beam 8 window sizes; poured found design, ete. 1 set of Energy Calculagons 3 copies of Tree Preservation Plan 'rf bt pieted after 71193 Rim Joist petail Op6ons sefedion sheel (buildings wilh 3 or less units) RemodeUReoair Renuyea'en? 2 copies of plan showing footings, beams, joists t set of Energy Calalations fw heated addifions 1 siie survey for addi6ons 8 dedcs Addftn - indicale 'rf on,sito sep5c sys6em / ;30, ? - K [?ts??syReaf N Sc?R¢p?t X N '?#ee ACeS P??eCd ;: ?` N_ Tree#??:#?quir?d Y N t?.?te$EA6GS??m :: ,--Y :td Minnegasco mechanical ven4laton fam , r Plans are considered ublic information unless ou state the are trade secret and the rea on. D$te Construction Cos 7-0, OD s;te Aaaress uniUSte # i _ f Z- ' D \ ' Description of Work Multi-Famay Bldg _ Y X\ N 'replace(s) _ 0\4 1_ 2 aAae&na r Pmperty Owner 'Ile, . ? C? G jr? " Telephone # l ? Contractor Address City State Zip Telephone # ( ) K/l ? COMPLETE THIS AREA ONLY IF CONSTRUCTIN6 A NEW BUILDING - Minnesota Rules 7670 Categorv 1 Minnesuta Rules 7672 Energy Code CBtegory . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submission type) Submitted Submilted . Energy Envebpe Cakuiations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan2 _ Y _ N If yes, daie and address of master plan: Licensed Plumber Telephone #( D _ V ? Mechanical Contractor Telephone #( MAR 0 1 2007 Sewer/Water Contractor 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 pecmit, but only an application for a pemiit, 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. Annlicant'c Printe.ri Name An i?ant'c Rianahire. DO NUT WRITE BELOW TffiS LINE ?;. , . . Sub Tvoes CI 01 Foundation ? 02 SF Dwelling p 03 01 of _ plex ? 04 02-plex 0 05 03-plex ? 06 04-plex Work Tvpes ? 31 New ? 32 Addition )!?-- 33 Alteration 0 34 Replacement ? 07 05-plex ? 08 06-plex ? 09 07-plex O 10 08-plex ? 11 16-plex ? 12 12-plex O 13 16-piex 0 18 Firepiace ? 17 Garage ? 18 Deck )? 19 Lower Level 0 20 Pool C] . 30 Accessory Bldg ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi D 72 Porch/Addn. (4-sea.) ? 33 Ext. Ak - SF ? 23 Porch (screeNgazebo/pergola) ? 36 Multi Misc. ? 24 Storm Damage ? 25 Miscelianeous ? 35 Int Improvement E3 38 Demolish Interior C] 44 Siding O 36 Move Building ? 42 Demoliah Foundation ? 45 Fire Repair ? 37 Demolish Buitding' ? 43 Reroof Q 46 Windaws/Doors 'Demolttlon (Entire Bldg) -Give PCA handout to applicaM DB8CrIDti011: Water Damage _ Yes Veluation O -0 Plan Review 100% or _ 2596 Census Cqde ? SAC Units # of Units ? # of Bldgs Type of Const ? Occupancy r7 :3 - MCES System Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinldered Width _ Footings (new bldg) ^ Footings (deck) T Footings (addidon) _ Foundation Drain Tile Roof Ice & Water Final Framing ? Fueplace _ R.I. _ Air Test _ Final Insulation REQUIRED INSPECTIONS Sheetrock Final/C.O. ? FinallNo C.O. HVAC Other _ Pool Ftgs _ Air/Gas Tests _ Final _ Siding _ Stucco Laih _ Stone Lath _Brick _ Wiadows _ Retaimng Wall Approved By: Building Inspector Base Fee Surcharge Pian Review MC/ES SAC City SAC Utility Connection Charge S8W Permit 8 Surcharge Treatmerrt Piant License Search Copies Other /"L 1-f 0 D O 4 2007RESIDENTIAL BUILDING rmmarPUCamiv City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone 9 651-675-5675 FAX # 651-675-5694 New Construction Reauirements 3 registered sile surveys showing sq. ft, of lot sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) 1 Soils Report if proposed building is to be placed on distur6ed soil 2 copies oi plan showing heam 8 window sizes; poured tound design, etc. 1 set of Energy CalculaGons 3 copies of Tree PreservaGon Plan i( lot platted afler 7l1193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form RemodeVReoair Reauirements 2 copies of plan showing foo6ngs, beams, joists 1 set of Energy Calculations for heated additions 1 site survey for additions & decks Add'Mon - indicafe if on-site septic system "v°to.oa I C1111?GV- _... Office Use Onlv Cert of SurVey Recd Y _ N Soils Report _ Y _ N Tree Pres Plan Reod Y =N. Tree Pres Required Y _W On sfte Sep6c System Y _'N Plans are considered ublic information unless ou state the are trade secret and the reason. Date 7 / e:,-2 -7 ? a SiteAddress 1L/61>O ? Construction Cost ??-UniUSte # Description of Work Multi-Family Bldg _ Y? N Fireplace(s) /K 0 2 Property Owner S???-h wc'?? Telephone #(? j() Contractor /ilCvLv'rO- C??3 %/.?? Tr??f'? 2?-l ? aadress L'(( State Zip 5 c;ty Zn-APJz- Telephone # (G 1:2- COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code CategOry . Residential Ventilation Category 7 Worksheet • New Energy Code Worksheet (J 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 # ( 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. ; Applicant's Printed Name /Ap'plicant's 'gnature ? DO NOT WRITE BELOW THIS LINE Sub Tvpes ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-piex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo/pergola) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Tvnes ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 WindowslDoors ? 34 Replacem2nt 'Demolition (Entire Bldg) - Give PCA handout to applicant DesCriptlOtl: 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 Bidgs Length Fire Sprinklered Type of Const Width REQUIRED I NSPECTIONS _ Footings (new bldg) _ Sheetrock _ Footings(deck) _ FinallC.O. _ Footings (addition) _ FinaUNo C.O. Foundation HVAC Drain Tile Other Ice & Wa Roof ter Final Pool Ftgs Air/Gas Tests Final _ _ Framing _ _ _ Siding T Stucco Lath _ Stone Lath _Brick Fireplace _ R.I. _ Air Test _ Final _ Windows _ _ Insulation _ Retaining Wall Approved By: , Bu ilding Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total PERMIT City of Eagan Permit Type:Building Permit Number:EA125673 Date Issued:07/30/2014 Permit Category:ePermit Site Address: 1460 Kingswood Ponds Rd Lot:4 Block: 2 Addition: Kingswood Ponds 2nd PID:10-42051-02-040 Use: Description: Sub Type:Reroof & Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and house wrap and leave on site. 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 - Susanna K Wing Wong 1460 Kingswood Ponds Rd Eagan MN 55122 Dhg Consulting Llc 17754 Icon Trail Lakeville MN 55044 (952) 240-6720 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA125820 Date Issued:08/05/2014 Permit Category:ePermit Site Address: 1460 Kingswood Ponds Rd Lot:4 Block: 2 Addition: Kingswood Ponds 2nd PID:10-42051-02-040 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater 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. Jamie Rippel 12850 Chestnut Blvd Shakopee, MN 55379 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Susanna K Wing Wong 1460 Kingswood Ponds Rd Eagan MN 55122 (612) 735-3358 Appliance Connections Inc 12850 Chestnut Blvd Shakopee MN 55379 (952) 445-4803 Applicant/Permitee: Signature Issued By: Signature For Office Use i / HCl 37 Permit#: E AG N Permit Fee: (� Date Received: 5 1/ ( 7r 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: buildinginspections(acitvofeagan.com L 2018 MECHANICAL PERMIT APPLICATION ❑ Please- submit two(2)sets of plans with all commercial applications. ^ Date: c'� ` ( Site Address: i tC� Ir NGSS 1i4'000 0 A Tenant: Suite#: Resldentl er Name: V/0 M C. Phone: Address/City/Zip: NameN \ C /C-Wc 7 `'`)) 2 License#: Address: J kv e City: v� State:V)/) Zip: Phone:(DC-7.2 ( (Q v <7� \ L j Cont _ •------ Emaii:�1\\ i YY CC•N\f) `Tl 0 M CO s o-,07) ,c7cfry) New )>(Replacement Additional Alteration Demolition ,ilsoe of Work Description of work: -NOTE.Roof mounted and ground Mounted mePneniCe_lnittOpinentmechanical i r t ire screen t x Please contact the Mechanical Inspectoror fttaatiol iff # itted:screenin RESIDENTIAL COMMERCIAL Furnace New Construction Interior Improvement Air Conditioner Install Piping Processed Permit Type _Air Exchanger Gas Exterior HVAC Unit Heat Pump Under/Above ground Tank ( Install/ Remove) Other RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge $100.00 Residential New, includes State Surcharge =$ TOTAL FEE COMMERCIAL FEES $60.00 Permit Fee Minimum Contract Value$ x.01 $75.00 Underground tank installation/removal,includes State Surcharge =$ Permit Fee Surcharge=Contract Value x$0.0005 =$ Surcharge If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. 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 a'proved plan in e case of work which requires a review and approval . -plans. x fY'�e. ‘I\ • - fik: 1111Il[:::�� Applicant's Printed Name App:nt's igna T' �, $ :x 4 FOR OFFICE USE � • A,<444,r<4' < Inspections Underground fou h 1n Air Test Gas Service est ."".In floor Heat