1641 Mallard CirCITY OF EAGAN
Addition ?allard Paxk-Second Additi.on. -Lot 28 eik 1- Parcel #10 4.7251 980 01
Owner Street 1641 Mallarri ('i rClE' State Eagan, h1N 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SUAF. Im
STREET RESTOR. 3 d _
GRADING
SAN SEW TRUNK ., lp O/?p 60
* SEWER LATERAL 1981 2430-43 486 09 5
WATERMAIN
* WATERLATERAL 1981
WATERAREA 1977 194-05 19-94 1, /-Jf -
STORM SEW TRK 0 1981 445
* STORM SEW LAT 1981
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 500.00 11 ?T
BUILDING PER. 11
SAC 595-00 +1
PARK
CASH RECEIPT
CITY OF EAGAN
P. 0. BOX 2'I-199
EAGAN, MINNE50TA 55121
DAT,E ? - 19
R«KI„KD
rwaw i AMOUNT $
& pOLLARS
? CASH [] CHECK
797
lsae ? , ?-l - . ,
` ,.
i
. {.... b..'..'-? ?
FUNq ' CODE AMDUNT
71
,,.
Thank Vou?
p'Y
.? ,• r` . ?
.
White-Payers CoDY
Yeliow-Posting CoPV
Pink-File Copy
IN
i CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
I t
SITE ADDRESS:
1r ?1 Inl'rli 1,'11i1"1
??? , ?? r: ? t, ?, ?• r:• rx t ?
PERMIT SUBTYPE:
? I . ,,FxHl? I , .
ON RECORD
PERMIT TYPE:
Permit fVurrrber:
Date Issued:
APPLICAMT:
; R t3l.c?rK, !
TYPE OF WORK:
I? ? { i W r: 41[il Ih1fi?
Permit No. Permft Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATINC3
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FfG
DECK FINAL
Reaipt
PLUMBINQ PERMIT
CITY QF EAtiAN
f!!l in numbered *ftar
Type or Prlnt /eyidly
Permit No.
FM -
S!C
Tot
1. Date 2. Installation Cost
3. Job Address L`/ f ? ?6 l f.bt' Blk. Tract .
r
4. Owner 1_ _ i. . rLti ; .,.. _„ .
, ? ,-?• ?? .
5. Contrector c_"• - - ? ?` - ; ` . -- . `i
'liorib -
6. Addross
7. City State Zip
S. Building Type: Residential ?
9. Work Description: New ?
Commercial ? Institutional ?
Add ? Alter ? Rapair O
10. Descri6e
11.
No. Fixtures
Water Cloaet No. Fixture
/D
l
C
Bath tubs oupool
rsinfie
d
S
i
T
Lavatory ept
c
ank
S
f
Shower tner
o
W
l
Kitchen Sink e
t
Urinal/Bidet h
Laundry Trey Ot
er
Floor Drains
Drinking Ftn.
S
Slop
+nk
Gaa Piping Outlets
12. t hereby oertify that the above information is true and correct, and I agrae to
comply with all ordinances and codes governiny this type of work.
Siynsd : for
- Rouph Final
Inspectiont: Date Inap. Date Insp.
This is your psrmit when numbered and approved.
Approved CITY OF EAGAN 4644100
, CITY OF EAGAN
3830 Pilot Krwb Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100
BUILDING PERMIT Rectipt #
To bsI owd ior ;.' + • . , i `l3.'1.7'' Est Value
e 19
Site Address 3 (6 41 ?:t' ??•".k?:? r- ?• R Erect Q Occupancy 1{ 3
Lot ; r Btock ? ?ec/Sub. Remodel ? 2oning ; (1
Parcel No. Repair ? Type of Const
Addition ? No. Stories
C'!)1 OiN
Name
- .
Move
?
Length /
W
; Demoiish ? Depth
b Address
Q??...(,
r+:... ^A1'Z??'.rl?G rj?n?: tmpr.
Int ?
.
?Ft.
a' Name wpprovols
ZF
u? Address Assessment
?- City Phone Woter & Sew.
F Police '
? W Name Fim
Sipnoture of Permittee
w
h Building Pem+it Is issued fo:
all work shall be done in ocrnrdonce with
Buildinp Officict
that Bldg. Off. 11/15/A
able APC
Var. Date _
Plen Review 1 3 2.
?
SAC 5 • "
Water Conn.
Water Meter ?-
Road Unit '
Tr. Pi. `
Parks
Copies
TOtel
b express tondition 1ha+
Pwmk No. Permk Hotder Deu Tslaphone #
Plumbinp ?i?
H.VA.C. O lo ?I G? QZZ
ENctric
Softaner
Irspection Dsta Inap. Other
Footings 1
Footings II
Foundstion
Framing
Roofing 447- e C
Rough Plbg. ?y ?J • - f- ?- . - cJ p4
RougA Htg. a--9
Inaul. e
Fireplace
F{nal Htg.
Flnai Plbg. a
Finai
Cert/Occ.
d 5
? ' (y CT
r I
Wabr Describe Location:
Wsll
Sewsr
Pr. Disp.
Receipt PLUMBING PERMIT Psrmit No. ?
CITY OF EAGAN
Fes y1 .
fill in numbered spaces S/C
Type or Prini legib/y T4:VL
^ 1 `? ! T'-'.S/
1. Date 2. Installation Cost
?, ?1 i G. .-% . [; , iM AL. L
3. Job%- Address r ?.. [. t? Lot c;Blk. ? Tract
4. Owner
5. Contractor - _ _ ?i l?; -' t.r%4 : ? Phone
6. Addl'e55 _-
,
7. City State y,??:i/? Zip
8. Building Type: Residential 'fl Commercial ? Institutional ?
9. Work Description: New 1;?- Add O Alter ? Repair ?
I 10. Describe
I 11.
No.
_-? Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
% Bath tubs Septic Tank
Lavdtory Softner
Shower Well
f
---?- Kitchen Sink
Urinal/Bidet Other
? Laundry Tray
` Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed :
Rough
for
F inal
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Apprpved CITY OF EAGAN 454-8100
Reoeipt ' MECHANICAL PERMIT Parmit No.
CITY OF EAOAN
FN • . _
f?ll fn numbered sPecas s?C
TYPe ar Print /eg/bJy ToL
1. Date 2. Installation Cost
3. Jcd Acldreas i? Lot - Bik. ' Tract
4. OWnBr C) G ? , L
5. Contractor Phone '• -
8. Address
7. C
ity i State j - Zip ? -
S. Buitding Type: Residential C3 Commercial ? Institutionai O
9. Work Dsscription: New Q--- Add O Alter O Repair ?
10. Describe Fuel Type? - -' ?- ? .
11,
No. F-auipmnt BT13 - M. Ea.
Forced Air - No. Eauiament CFM
Air Handlin
:
? .
Mfg g
Bd;lers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governiqlthis tYpe of work.
Signed : for
Rough ; Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464,6100
CITY Ori EAGAN
38A Pilot Knob Road WATER SERVICE PERMIT
P. 0. Box 21199 PERMIT NO.: Eagan, MN 55121 ? •. r = DA716 - - ,-% -7- ; _
Zonlnp: _ !•. No. bf Un ts:
r: ;','J .7Qi'7ils0n ..,?.. .,.,I! :1 ,!'I tioc
AddrlSx
umbe.:
r No.:
?
?
u:
$..
? r,ro.: . ? m 4 a o 6 i
oem to a? * W" IIw CItY oi Eaqs,
MIIMb
'By
Date of Insp.:
, ?
10 / SS
ConnettiOn O10fps: J i; J . :, . . , , .
Accourn oeposir: _ 15 . ???:?pil
Perm?t Fee: 11. ?r?d
Surchoroe: i 77d
Misc. Chcr+Des: 132. 00'['U
rorcl:
DoM Poid:
CITY OF EAGAN SEWR mV?m Pumn,
3830 Pilot Knob Road
P. O. Bax 21199 PERMIT NO.:
Eagan, MN 55121 p,4TE;
-,ZOrd^0: No. of llnits:
Owrnr: Addrcss:
Site Addross: 1 r '. 1 c'-c'
Plurriber.
1 pwe te ooaw* wMb fw CIFy af Vpw
OrilwweM.
8y
Dat+e of Insp.:
CITY OF EAGAN
3830 Pilot Knob Rosd
P. O. Box 21199
Eagan, MN 55121
Zoninp: _
Gonrnctlon Chorye: Ac+oount DeposFt: '
Pemnit Fee: --
Surdwr+pr _
Mlsc. CMrpes:
Totai:
DQM Paid: _
WATER SERVICE PERMIT
PERMIT NO.:
D/1TE:
Na. of Units: ?
Owrnr: Jh? Const.
Address:
sia Md?eas: '1I :`7a11 aru rr . - =:; -
Plumber.
Meftr No.: Connectian Chorge: ' --
Size: AcoouM Depoatt:
Reader No.: Permit Fee:
I M? ??ph wMh 1!w Ciy of Legen Surchorpe:
Odiwmas. Misc. CFwryes: -
Tocal: By
Dote of Irup.:
Date Paid:
Irnp.:
• CASH RECEIPT •
` CITY OF EAGAN
P. 0. BOX 21-799
EAGAN, MINNESOT 5121
i o e
T
-7i 1 P `
FUxO CODE MMOUNT
t
/ O 00
lU ae;
Thank You
r?
er
N_ 55173
White-Payers Copy
Vellow-Posting CoPV
Pink-File Copy
CITY OF EAGAN N°_ 10 8 5 0
3830 P'I K h R P MN 1
?ot na oad, .O. Box 21•199, Eagan, 5521
PHONE: 454-8100
BUILDING PERMIT Receipt #
Te M ased ier SF DWG/GAR Esr. Value $113,000 Dafe AUGUS 21 19 85
SiteAddress 1641 MALLARD CIR Erect 91 Occupancy R3
Lot 2$_ elock 1 Sec/Sub MALLARD PK 2ND Remodel ? Zoning Rl
. Repair ? Type of Const. 37
Percel No
.
Addition ? No. Staries
M.W. JOHNSON CONSTRUCTION Move ? Length 52
= Name Demolish ? Depth t] 2
? Address P.O. BOX 130 Int. impr. ?
sa. Ft.
FARMINGTON
City Phone 432-6838 Install ?
? Name $AME
?? Address Assessment Permit $ 465750
? City Phone Water 8 Sew. Surtharge 56 . 50
Police PlanReview 232.75
F
qW Name
FW Fire SAC 525-00
?z Address Enq. WaterConn. S00-90
?W City Phone Plonner WaterMeter 63.00
CAUncil RoadUnit 280•00
this applicohon ond stote that
I hereby acknowledge thot 1 ve read Bldg. Off. $]. rJ 8 rJ Tr. PI. 132.00
t
the inlormation is correct o d o9ree o comply with all upplicoble APC
$tate of Minnesota Stotute on 1 ity pf Ea pn O drtwnces. Park$
0 Var.Date Copies 1.40
Sipnoture of Permittee 7otal S2.254.75
M.W. JOHNSON CONST RUCTION
A Building Permir is issued to: w t ha axpress conditlon thol
nll work shall be done in accordance wifh appliwble 5 te o inn a Sfatutes ond Ciry of Eoqon Ordinoncea.
Buildirq Official Apptovals Feat
Z REQUEST FOR ELECTRICAL 1111S7ECTION Ee'°°°°.i'°a
q r? , See instruetions lor completirq thia torm m beck of yellwr caov. 619235 "X" Belaw Work Covered by This Request
Add Reo- TYDe of BuitAing Aoolfences Mired Epuioment Nired
Home Range Temporary Service
Ouplex Wa[er Heater Lighting Fiztures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air CorMrtioner Bulk Milk Tank
Farm O[ er peci v the.r ISUeciiyl
[ _r Spocify ther Other
Compute lnspectron Fee Below
M Fee ServiceEntranceSize q Fea Feeders/SUbfaeders N iee C"cuics
Um200Am 0 to30qm o Oto30Am
A6ove 200 qmpy 31 to 100 Amps .p 31 to 100 Arr4is
Swirmnin Paol Above 700_Am Above 100_AmPs
Transiormers Irrigation Bwms PartiaL'Other Fee
LI ISigns I I ISpecial Inspec:ion 'S / ?.
Remarks y'?.? TOTAL FEE
Rouph-in Daie \ /
?
??I?? . Ne Elqcbical
I.paetoq AerabY
unfih tha? ??.e ano..a
Final
r Dai'?
5d' ?pectim
has heen
i ?da.
11is?equaslvadlBmontlOtrom I / Y?(/
This request wid? --) / (?; -2--
????? Z ?;'
rc
E 5
flepue5t Daia Fue No. Rough-in InsyecGon
Requ retl?
[]1leatly Now ?Nf?ll Notify. Inspec-
Q`?? ? ? s ?No TZor Z. Peady
? Licensed Electrical Contractor 1 hereby request iaspeetion ot above
Owner electrieal work imtalled at
Street Address, Box or Houte No.
? City
<G fyI .?
a?c
ecUOn n. Township ame or No. ang
e Mo. C nty v-A-
Occupant IMiINTI Poo. No.
? Q ??
/1", . 41
Po,Dsuov?i
?f•? .[? `
!4.< Atltlress
?/-
<
EI?1'e(`ical
orn
tracl ICOmp ny Name
? Co ractar's Lic^ense No.
?
p
'
C l`?
Mailing Addrass (C}?ntractor or O er Making I?lailat? •
?
'
n01 -? ?-!?
? QI
c 1-?
Aufioriz Sip ure (COnhac[ ? wner Making IRSWIIationl Pho e um?er
3?3
,?
MINNESOTq STqTE BOAND OF ELE`ITY
Grigps-Yidway 81dg. - Room N•197
1821 Univarsitv Ave., 51. Paul, MN 56104
Plnm (672) 297.2117
THIS INSPECTIQN REQUEST WILI NOT
BE ACCEPiEO BY THE STpTE BOAMD
UNtESS PROPER INSPECTION FEE IS
ENCLOSED.
-----------------i
? Foi,QfficeUse
?°Y Of E`+ia++ ?? 18 2009 II Pemiit#:
C
n ? Pertnit Fee'1
3830 Pilot KnoY Road
Eegan MN 55122 Date Received: ?
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Stan: i
-----------------
2008 RESIDENTIAL BUILDING PERMIT APPLICATION fN'
Date: Site Address: IU? ??la L(1 b1L
Tenant: Suhe #:
RESIDENT / OWNER Nam . Phone: -
Address / Ciry ! Zip:
Applicantis: _Owner ?Contrador
TYPE OF WORK Description of k: ?{? t
?
ConstructionC
: <i?'Qvcp Multi-FamilyBuilding:(Yes_/No?
CONTRACTOR Name. License #:
Address:
City: Q, A ate: V_LZip: S
PhonO]5,? -%?l 1-3'[ Oo Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Enerqy Code Worksheet
C8TC90ry Submitted Submitted
Submi53ion type) • 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?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractw: phone;
Sewer & Water Cantractor: Phone:
NOTE: Pfatts and supporting documents fhat you submit are considered to be public /nEOrmation. Ponions of
the informa8on may be classilied as non-public N you provide speci/ic reasons that would permit the City ta
conc7ude thai the aroe fra secrets.
I hereby acknowledge that this irdormation is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagaq that I understand this is not a permit, but ony an application for a permit, and work is not to stan without a pe , that the work will be in
accordance vnth the ap=p1an ase o f work which requires a review and approval of pl
x ? f .
App icant's Printed Name pppN-
? Page 1 of 3
r
DO NOT WRITE BELOW THIS LINE
SUB TYPES
? Foundation ? 05-plex ? 16-plex ? AccessoryBuilding ? Pool
? Single Family ? 06-plex ? Fireplace ? Porch (3•season) ? Ext. Alt.-Multi
? Ot of Plex El 07-ptex ? Garage ? Porch (4-season) Q Ext. Alt. - SF
O 02-Plex 0 08-pfex ? DeCk ? PorCh (screen/gazebo/pergola) ? Muhi Misc.
? 03-Plex ? 70-plex ? Lower Level ? Storm Damage
? 04-Plex ? 12-plex ? Miscellaneous
WORK TYPES
? New ? Interior Improvement ? Siding ? Oemolish Building*
? Addition ? Move Building ? Reroof ? Demolish Interior
? Alteration ? Fire Repair ? Windows ? Demolish Foundation
? Replacement ? Egress Window ? Water Damage
' Demolition (entire bmlMng) - grve PCA hantlout to applicant
DESCRIPTION: a„
Valuation 3*t% Occupancy ?12 G -? MCES System `
?
?
Plan Review Code Edition a,V7 SAC Units ~
(25%_ 100% _) Zoning R-/ City Water -
CensusCode Stories '-' BoosterPump '
K of Units Square Feet PHV `
# of Buildings ? Length - Fire Sprinklers r
Type of Const. Width ?
REQUIRED INSPECTIONS
Footings (new bldg) Sheetrock
Footings (deck) FinallC.O.
Footings (addition) ? Final/No C.O.
Foundation ?C HVAC
_
Drain Tile 6ther:
Roof:_Ice&Water _Final Pool:_FOOtings _AidGasTests _Final
? Framing Siding: _Stucco Lath _Stone Lath _Brick
Fireplace:_R.I. _Air Test lFinal Windows
Insulation Retaining Watl
Reviewed By: Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S8W Permit & Surcharge
Treatment Plant
Copies
Total
30 °'
Page 2 of 3
?
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
New Canatrucfion Reauiromenh
• 3 regotered site surveys showirg sq. ft. of lat sq. ft, of house; and all roofed areas
(20%macunum lot coverage atlowed)
• 2 copies o( plan showing heam $ window s¢es: paured found design, etc.)
• 1 set of Ene(gy Calculatmns
• 3 copies ol Tree Preservalwn Plan if lol platted atler 711193
. Rlm Joist Det&i Oplions selection sheet (bldgs with 3 or less wib)
DATE
SITE ADDRESS
TYPE Of
APPLICANT
uk cc C?
'-? U.d_?
Remode1lRewir Reauirements
• 2 copies o( plan
• 1 set of Energy CalcLianons for healed addihons
• lsdesurveyfornxter.oradditions&decks
. Intliwte if home served by septic system ior additions
VALUATION !?JiQn(y -
p
? r • ?MULTI-FAMILY BLDG _Y _N
uSLr7sid?dL FIREPLACE(S) _ 0 ?l _ 2
e
STREET ADDRESS 3 5?? ('?J •??(L, CITY rttS' ??? STATE? .ZIP
TELEPHONE # QSa????O `d 76T? CELL PHONE # FAX #
1
PROPERTYOWNER? TELEPHONE#
-----------------------------------------------------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category M INNLSOT:1 RliLGS 7670 CATEGORt' 1 1fI?YC,?'il (??1 ? ?
(J submission type) . Residential Venulation Ca[egory 1 Worksheet Submitted • New E dh y&de Worksheet 5ubr
• Energy Envetope CaiwlaUOnS Submitted ?I n AUG 2 6 2002
Plumbing ContracSor. Phone # Isy-------
--z-- -
Plumbing system includes: _ Wa[er Softener Iaivii Sprinkler Fee: $90.00
Water Heater _ No. oF R.I. Baths
No. oF Ba[hs
MechanicalConhactor. C, I!`eSrPQ2 e OffIrl0y?
'Mcchanical sys[em includes: .air Conditioning
? Fka[ Recovery' System
Sewer/Water Contractor:
Phone# l?a7-p _!D -/1 (25?
Fee: 570.U0
Phone #
-----------------------------°---.._..---...--------°--------°---•-------------------------..._..------------°--------
I hereby ocknowledge that I have read this application, state that ihe information is correct, and agree to comply
wifh all applicable State of Minnesota Statutes and City of Eagan Ordinpnices. ???/ ?'
L 1
Signature of Appllcant
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preserva4on Plan Received _ Not Reqwred _
Updated 4102
cxrv nF FacAN
CASHIEfi: tS 7FRMINAI N0: 93
AATE: 04/29/37 T7MF: 14:32:33
zn -
NAMEn LAF:E S?ATC fiEMOLiELEFS
3zio yani 1641 MALLAkLi CI 124.75
ZSJJ 3001 1541 MALLAkv CI 3.50
To+al f,ecei.pt Amount: 128.25
cxo 7esoe.
uscR sD: aaN
PERMIT
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
BUTLDIN6
029558
@4/29J97
SITE ADDRESS:
1641 MALLARD CIR
LOT: 28 BLOCK: 1
MflLIflRD PARK 2ND
P.I. N. : 10-47251--280-01
DESCRIPTION:
(R00FING)
B`uiidirr'?y-_Permi L' 7ypr,
/Buil.cting lapx-k Type
' Censur, Code
V 41
Jr j
? yl
?
?r
t' f
Base Fee
SurcPiarge
Total Fee
Sf (MISC.)
REPAIR
434 ALT. RESSDENTIAI
,§;`. t?hE.e?
REMARKS:
FEE SUMMARY:
VFlLUATION
$124.75
$3.50
$128.25
$7,000
CONTRACTOR: - Applicant - sT. I.IC OWNER:
L.IAKE STATE REMODELERS 14240676 2064729 DAHL6ERG JIM
9278 TRINITY 6ARDEN 1641 MALLARD CIR
BROOKLYN PARK MN 55443 EAGAN MN 55122
('512) 454-0676' (612)688-7478
IL
I hereby acknawledge Chat T have reed th2.s app2icatiQn artd state tMst the
information Js,.correc,t? snd.ogree t,o, compl$e wiGh,ea1l ap-Placable Stat!R pf htn,
Statutes and City of,Eagan t3rdinsnces.
^
APPLICANT/PERMITEE SIGNATURE ISSUED eN: SIGNA7UR
9 7 BUILDING PERMIT APPLICATION (RESIDENTIAL) ,? (z$, ?i'
Vqf6v CITY OF EAGAN
3830 PILOT KNOB RD - 55122
881 -4675
New Construdion ReouiremeMA
? 9 regiatared site surveys
? 2 caples of Plans (inGude beam 8 window sizes; poured fid. tlesign: stcJ
• t energy celculations
? 3 wpies of tree presenation plan tt lot platted after 7/1/93
requfred: ,Yes _ No
DATE:
DESCRIPTION OF WORK:
STREET AODRESS:
LOT 10 BLOCK
Semodel/Reoair Reouirements
? 2 wpiea of plan
? 2 site surveys (exterior edditlons 8 decks)
? 1 energy calcwlations fa heated additions
CONSTRUCTIONCOST: `ycv< e?B
i
7PaecKeeoe ?
rn?t/la") C??, ('.
.-L_ SUBD./P.I.D. #:
PROPERTY Name: 0Q ti 1.4 7 ?V%„ Phone#: ?08 - --74 7l'
OWNER
/6
StreetAddress:
City: rex,? ? State: ?N Zip; S S/'Z 2
CONTw4CTOR Company: Phone #: I2 L0LL.
StreetAddress: 1276 r1,4;N 6`lx ''-4"^ License#: 2Do?7??J
City: k5 rao ¢ lYk 1"a f t State: Zip:
ARCHITECTI Company: _ Phone #:
ENGINEER
Name: ?'?.. Registration #:
Street Address: ?--,- - \
City: State: Zip:
Sewer & water licensed plumber (new construction onty): . Penally applies when address change
and iot change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the information is correct and agrc!ftPly with all applicable
SYate of Minnesota Statutes and City of Eagan Ordinances. ?
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received - Yes i No _ Not Required
i
r,..-
??.
2/84
CITY OF EAGAN
i; 11 APPLICATION FOR PE:ZMIT
-' SE[QER AND/OR WATER CONNECTIODI
(PLEASE PRINT)
1) PR,'JPE.TY?'Y ADDRESS: ?(p '57I ZWj??yC ? 17
r.Fr=,L DESG2IPTIC:I:
(LOt/31ock/Subdivisicn or ax Parcel I.D. :Iumber)
L r{l.'--,
_.l.C.:?:.t.?.4`.
'
i: .??,:i
, D.`?.? CF C '..?-L .=UlJ.+:?:C L.?_.1m T.::
_
, . ._-' -" - _ •
D^C=?-^ ?
U5E: R-i SL: '?',G?..? _pti?? ?,t y
? P.-2 DUPLE{ (?SCO UD3ITS)
? .°.-3 ZCil7NI-:OiiSE ('I".?4r;c + L?7ITS) ( li.II^_C)
O R--4 Pn^,F.r*.c-..,.?C?•?Ci LT?r?:l ? LNI:Si
? ca47=cz=,L„'REzazr?eFFTcE
? m^JCSTaZn'L
? INSTITL?IONAL/GGV?:??IE]T
2) ApPL2= (PL"„SE PRii)
ruk?!E: ?!/, Gd • Of?d+.??
ADnR..ss: ?
cITY, s=, zrP :
Pho:.-E: s???-- lvg J'?
3} pji,;.yqx? ?W
?TF ??PAtir)
d•L .rY? FDR CITY USE 0,4LY
ADDRE55: PLUMBERS L nSE:
Cl OL7? ttive
CITY, S=, ZIP: Expi d
PHO.IE: ?y ?H3?
PLIIMBER LICENSE No eeor
art':ni[ta
4 ) (JCS..?CTPPi1T/G!'7CI?
NAt'E:
ADDRESS:
CITY, STATE, ZIP:
PHO:;E:
kYLGNdG YNINIJ
S) INDIGAT'E WHICH PERMIT I%--19EIitiG REQCJESTID:
(dirLL"'1=1ION 'Io CI`PY Sor7EF2
TO CITl' 1vA'I'ER
? C1ITM (PLF.FLSE DESC?SBE)
07 1.•:u1C??::: (::.c:
71 SZG.AZT,m:
? P=E f:OID APP.?WEp PERMIT FOR PIC:-UP BY ONE OF ABO`.'E
- EaSE MAIL APPROVc.^D P=tIT TD 1, 2,4 r'1W7E
--C-' 'o, ? (Circl ne)
DaTE:
24??
??! ?li4s?}/Fls:r? i??c?a?a? ? s rerssa a?r aW s r:s::a:a ??[ ? f.? ?eryl? s a? ! rt ?a ?:?:;st t
F O
pER`tIm °- ISSUED
C I T Y U S E 0 N L Y
F°ES: $ 49,co
$ l
S
S
$ / S - c%p
$ /S= "(,
yS C C' C) (l U -
J
$
S
S
$
$
$
nz'c%trI (?_;CL-uc 3liRCFi?cG°)
WATER PERI'4IT (Zc`1CLUDE SURCI:ARGE)
WATER METER/COPPERHORN/OUTSI.^.Z RE;uER
WATE.°. TaP (INCi.UDE CCRrGRaT=O:I STCP)
SE:IE3 man
ACCOUNT DEPOSIT - SEWER
ACCOUNT DEPOSIT - S4ATER
WAC
sac
T4U:7K WAT`R ASSESSi-;E.dT
TRliNK SE:vER ASSESSL1EtiT
LATE°,AL BENEFIT/TP,UNK SEi,;ER
LATERAL BErIEFIT/TR'?]n WAT°R
OTHER /o ?? ?.t?( J1var .? ?--
---c-1r
TOTAL
AMOU:VT PAID/RECEIPT ,yr JS 7&
?
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
YES IF YES, THEN A"PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST SE ZSSUED BY THE
C] NO ENGINEEkING DIVISION. LIST AS A CONDI-
TION_
SUBJECT TO TfiE FOLLOGIING CONDITIONS:
APPROVED $Y:
TZT*E;
G
DATE :
a s? ws NOW iMW? ucftw EW MR:W wWw s?" wPr wa 9tIM wW_"4WW a? re ? s? sr+ wea rtWWWM mm
?
CI'I'f OF EAGi--N
BUILDING PERMIT APPLICATION
m
To Be Used For Valuation I l 3, c?- I
Site Address: 1(c41 171r/1r1rd ?? /'&lC-
z.ot 4q slocic,,.?Y sec./s,_,b./YW,0/d
Parcel #:
QJtler: `n Iti. ,f')/7?73on ?L»15trUP?iC? TnC Pddress: -PO t3?u /-lin
City/Zip Code: -?C7r? nn /Yl rl
Phone # =
Contractor: ? l l. (-(J. JQ?l;15CV? (?S?'-uCb'D')
Address: PU &k t.-x,
City/Zip Cocle:/Zr/r1 iog {tn P)n SScl-,?cl
Phone # : 171-3d ?E' ?' ?'
Arch./Eng.:
Pddress:
City/Zip Cocle: _
Phone #=
&'' ¢ ? 65
jpcjJ,adp_2 sets os plans,
1 s lan w/elevations &
set of energy calculations.
Z?
Date Y`l3 ys?-
OFFICE USE ONLY
Erect x Occupancy IZ-3
Alter Zoning (z-1
Repair Fire Zone
Enlarge 'Iype of Const. ?
Nbve # Stories
Demolish Front S4 ft.
Grade Depth 4Z ft.
APPROVALS FEES I
i s ?
4-?
Assessmnts Pesm
t a
Water/Sew2r Surcharge S(o ?
Police Plan Check 232 Z
Fire SAC SZ.s =
Enq, Water Conn. Soo-=`;
Planner Water Meter (03 =
Council Road Unit
Bl3g. Off. /5 -b + e7 Ct?PlG> ?2 ? I. m
APC "rPC? 1232 =
o? o ?jC/:-7S
ZUTAL
`
i
/
,i.
Zz n 3Cz? =lq2 kS?- - 47 -?c?b
20 X 20 - 400 x?? ' Z I c?? o
24- n 20 - 4b? fi+? 25 ? U2
- I oSo ? Q?- 430; z?
1 12('?q Y,
?
?
,
CERTIFICATE OF SURVEY
a /
O Ou / OflAiNAVF f? \
UTiuTY J
0
? LOT 2?3
// B?0 GK '
?
53
h?
---
ti
6R.
, 5z,-
s,
\\\
?
?
?
PN 5 B 2,
d m
36 N (
rs v ?
J r
?- ?
g
3?11
> ?
S?
/ io `
? 0-?p
3o O N C
t1 NN'9
5 10
Z
>
F3•°?i
/
78 .9
MALLARD
GI RGLE
1h-7. 9 7 „ - \
? ps ?
/1I g? ?j 3
F.levations shuwn are existing grades aad are assumed datiim.
Proposed garage floor elevat{on = 86.0
I hereby certify that this is a correct representation of a+urvev of:
?
Lot 28, Block 1, MALLARD PARK SFCOND ADDI'CION, Dakota County, Minnesota,
according to the recorded plat thereof.
and that I am a duly registered land survcyor Lhhlaws of the Statc of Minnesota.
Dated this 8th day of August, 1985 Gene L. Jacobson,6 nn Reg. No. 7734
DR. BYGP-3 SCALE - I" _¢p' o DENOTES IRON MON. BEARINGS ARE ASSUMED DATUM.
PREPARED FOR:
JACOBSON SURVEYORS
Johnson Construction
P. o. soX 130 .LAKEVILLE, MINN. 55044
Farmington, MN 55024
PHONE 469 - 4328
?Y
? - -- -- ' EXTERIOR ENVELOPE RYERAGE "U" COMPUTATION _. .,
r::. .
OWNER ---- =
. ,. : . - .
? ? . - - _ _- ? -'- - -- -- -
= -` - "" .-- _. - :: - - -
' .- . ..... : - ' ;,.? ?
? . . -=:.
SlTE ADDRESS" ? '.- .. -.--_: -+_:_= _ - _.:•-'-? _-- •- . --.._ ?:. - .. , . ? -
CONTRACTOR .W• J0 N????,? ° DATE PHONE -?- - -
k - Determine working square footage of each.
1. Total exposed wall area ...... 319 LOS I lo sq. ft. x??;
. .
2. Total roof/ceiling area .... 1kn`A O _ sq. ft. x,?=
Total exposed wall area above floor = 2R32,
a. Total wall windaw area ..................:........ 3 58.?'
b. Total door area ......... ........ c. Total sliding glass door area .................... .?-
d: Tatal fireplace wall area ...............:.......
e. Total wall framing area (average lOp)............
f. Total net wall area above floor ................. ZC4 S.IIa
q. Total rim jeist ar=a ........................... '31'+
7ota7 exposed foundation area = 17 Ci .? lo
'
h. TotaT foundation window area.....................
i. Taa1 net foundation area above grade ............ I t 91'3 Lc+
Detenaine "U" value of ez:n wal7 seg-_nt.
V .,ull 3Z = 14,b
?. 38 x „U„ ,i = 5,2a
c. lO ? xStu„ , S = 37-
- X „ul,
d.
e. X?.U„?_ = ZI . 81
z.OysI)to X ,ou„ , b43
, 9• 314 X .,U„ .oyl = ?z,8
n. X „u„
;. t 2..93 1o x??U"
3 ........:....... ..3???:. `?.._..Totzl
If
of it=m r3 is the
S3C 6K--5(c)2. same as, or less than it°m rl, you have m_t the int_nt
? -='°•' . - . : . _
Total exposed roof/ceiling area = ?lQya
' - -
??.. . . ,\. _ • .
, Total gross roof/ceiling area = IL??IC? .
.
_. j. Total skylight area ....................... '-
k. Total roof/ceiling framing area ............ i1?4 D
1. Total net insuiated roof/ceiling area....... tq?Le
Determine "ll" value for each roof/ceiling segment.
' • ... . ... X giuil
_.. ,• _
k. I b? X,iUli ,?Z= 3. ?13
1. I4 70 X oluit , ozZ
4..................? .........Total
If total of #4 is the same as, or less than #2, you have met the intent of
. SBC G006(01. • .
; R
To utilized the total envelope system method, the values.established by the
> sum of items 93 and #4 sha1l not be greater tfian the sum of itens $1 and f2.
E . ..
?
E . '
? - - - . . .
?. 1. . .. + 2. °
3.
MATERIALS
Bzterior Air
5lding Naterial
Sheathing
InBulation -
SheetroCk
Interiox Air
5tuds
Rim
Conc. Blks.
+ 4
Therm. Besistance "R"
? Ir7
.45
2.0
la
.y5
? l0 8
-,?
1 8
?Z
461, m &iXszk'(k arw
PERMZT qJ15665 `CYCLED A/C
'-- ----?
BEVERLY GUSTA£SON
1689 COVINGTON LANE
EAGAN. MN
ARNOLD DUBBELDE
4425 SLATER ROAD
FAGAN, tSN
CHARLES SHIRROTI
4714 W. WIND TRAIT.
EAGAN, MN
NORI4AN PETERSON
4337 SEQUOIA DRIVE
EAGAN. MN
JAMES DAHLBERG
1641 MALLARD CIRCLE
EAGAN. MN
? B & L ELECTRIC, INC.
EDWARD LANGE
4684 RIDGE CLIFFE DRIVE
EAGAN. t1N
JOHN DETERS
4423 SLATER ROAD
EAGAN, 11N
BRUCE CROSBY
1761 WALNIJT LANE
EAGAN, MN
F;OY CREELPtAN
1883 BEAR PATH TRAIL
EAGRN, MN
TERRY DAVIS
4895 SAFARI PASS
EAGAN, MN
2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes(condos when permits aze required for each unit
t ??D ?5D
Date / I / ), / C> s
Site Address / (° L( l Mr+- I (artX C; r c(t Unit #
Property Owner Telephone #(6(X) g 1V-70LO
Contractor
Street Address
Avenue
cscy
State Far OF9Jd?G9n? '?'p Telephone # (
?s
Bond #: ? ?0 u 5- & -7 Expires: 2 L"/
The Applicant is _ Owner X Contractor _ Other
Add-on or alteration to existing dwclling unit
6"?" fumace _Additional ?Replacement
$ 30.00
_ New
_ airexchanger -- -- --
air conditioner
- ' i
?I
? heat pump "'j" :• . •?.
other
State Surcharge I $ 50
Total
g 3o,Sv
I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that Ihe work will
be in conformance with the ordinances and codes of [he City of Eagan and with lhe Mechanical Codes; that I understand this is not a
permit, bu[ only an application for a permi[, and work is not to star[ without a peimit; ttiat the work will be in accordance with tLe
approved plan in the case of work which requires a review and approval of plans.
??9 y Z?XyeAe.1'4., ? 'X/_?
Applicant's Printed Name Applic nt's Signature
411 Clty of EagIl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax:(651)675-569A
------------------
? For Office Use I
j Permit#: OS?U 6? I
? Permit Fee:
? Dale Received: u! o j
I Staff:
I
- J
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ? Site Address: I l1 ?? I" LCI l? V ?AWAaC.
1 T
Tenant:
Suke #:
RESIDENT/OWNER Phone:
Name: ?I'n vu x t? "(
?
Address / City / Zip: '1,e c ?
,
Applicant is: _ Owner -xl Contractor
TYPE OF WORK Description of wor ; Qaf ? 0-0 SL ? l.,% ?\n (ASt_?C d Q??6 Y"C
?
Construction Co . ?? ? Multi-Family Building: (Yes No ?
CONTRACTOR Name:?) NAP (I? Ld b A- License#: ?_)10O?-I
Address: t '-'l ;v
City: State: Zip:
Phone: ?f ??-gel I GV Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Ef18f9y COdB . Residential Ventilati0n Category 1 Worksheet • New Energy Code Worksheel
Category Submitted SuMnitted
(4 submi55iOf1 type) • 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?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submlt are considered to be public iniormatlon. Portions of
the lnformatlon may be classHled as non-public i/ you provide specHlc reasons that would permlt the Clty to
conclude that the are trede secieis•
I hereby acknowledge that this information is complete and accurate; that the work will be in caMortnance with the ordinances and codes of the Ciry of
Eagan; that I understand this is not a pertnR, but only an applicafion for a permit, and work is not to start wilFaut a pertnit; that the work will be in
accordance with tha approved plan in the case of vrork which requires a review and approval of plans.
x ? l<i 91 ?*y </a 1/1 V l x
ApplfcaM's Printed Name Applica s gnatu
/ Page 1 of 3
*City of Eapi
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
I?-lr-r2_
Staff:
L
Permit #:
Permit Fee:
Date Received:
2012 RESIDENTIAL PLUMBING PERMIT APPLICATION
Tenant:
Site Address:
Suite #:
RESIDENT /;OWNER
Name:
V\ ‘-e
pckt6igho e:
Address / City / Zip:
Name:1 f't Pi6 i.. .fin
Address: '3c Lo
G}S (_ C,S)C"-- 7
c y '& vU <C /a,
License#: m L6 o)ti3 ]
City: ‘IuUc.�(�
State:vv.v Zip: fS 3�c% Phone: t 1 ' 3•
Contact: Email:
New Replacement
Description of work:
Repair'! Rebuild Modify Space Work in R.O.W.
RESIDENTIAL
Water Heater
Lawn Irrigation (_ RPZ / _ PVB)
Septic System
New
Abandonment
Water Softener
�tfper Ic'-%el
Add Plumbing Fixtures (_ Main / Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $189.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
rlf\ y 1+
Applicant's Printed Name
x
Applicant's Signature
FOR OFFICE USE
Required Inspections: Under GroundR
Reviewed By:
ough-In Air Test
Date:
Gas Test Final
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
r �
For Office le
Permit #: (--1 ' I 144
Permit Fee:
Date Received:
Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7-1 )Z Site Address: Unit #:
Name: 1 /4tAli-4577P 1)4741. -gar C„ r (` Phone:
Address / City / Zip: I w` ¶�/ itl64,10 (t L
Applicant is: Owner Contractor
bg----7`1A,
Description of work:
Construction Cost:
t7, .06
Company:
Multi -Family Building: (Yes
Ct L.kZ (VA 67`1.- L 4ontact:
Address: 070 ?4/ Av
State: Zip: 7'.5---55?
(,6z74s3
License #:
City: h7 17 !vt-Out-6-
Phone:
u -6"
Phone: ((V- L -Z t -Lf (40
Lead Certificate #: i J - ( 16'( l -1'
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
\60A.
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:
MechaiTical -Contractor: k Phone:
Sewer & Water Contractor: ' Phone:
CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minta)e Building Code ust be4 ompleted within 180
dayssf 01(peeissuange.
x�1Q
Applicant's Printed Name
Applicant's Sig$ature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
,C Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100%,
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
Lower Level
Interior Improvement
Move Building
Fire Repair
Repair
�3k
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water Final
jf Framing
Fireplace: Rough In
.alb Insulation
Sheathing
Sheetrock
Reviewed By:
(Aq 411[1
1 Lf' Hf 14 I tar c_4, -
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Siding
Reroof
Windows
Egress Window
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Other:
Pool: Footings Air/Gas Tests Final
Siding: _Stucco Lath _Stone Lath Brick
Air Test Final Windows
Retaining Wall: Footings Backfill Final
Radon Control
Erosion Control
, Building Inspector
RESIDENTIAL FEES 14
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
73
4107
Page 2 of 3
Use BLUE or BLACK Ink
r-------------------.
I For Office Use 1
Permit City of Eagan
Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 ; Date Received: ;
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: I Unit M
Name:,oe d J Ilt-&~ Phone: 6/07 8'/D - -7®%c3
Resident/ /n
Owner Address/ City/ Zip: 16'f/ / 4 ``4d r o-af ~a5~h► AlrJ S-3-1 7-L
Applicant is: Owner Contractor
Type of Work Description of work: ere
Construction Cost: Ddo Multi-Family Building: (Yes / No )
Company: 1. ka &07'" ~ Sr✓Y Y tt Contact: A//e£ 4S7 - 7S-r- 7Vf3
Contractor Address: AA6-- City:
State: Zip: Phone: 763, 7F6 ° s-le7
License CI( f 90D Lead Certificate M
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
NOTE. Plans and supporting documents that you submit are considered to be public' information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
ust be completed w
Exterior work authorized by a building permit issued in accordance with the Minnewr
ithin 180
days of p rmit issuance.
r
X
x
Applicant's Printed Name Appl nt's Signature
Page 1 of 3
T
Use BLUE or BLACK Ink
I For Office Use
I
PermitClty I1 S
of Equ~ I .o
Permit Fee: nobC
I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received: 11/4/1-3
Phone: (651) 675-5675 I
Fax: (651) 675-5694 I Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: /0- /5-- ` Site Address: Unit
Name: 91-0I Phone:
Resident/
Owner Address / City / Zip: LLL" C,
i
Applicant is: Owner XContractor
Type of Work Description of work: e,527* / v. 4rk
Construction Cost. Multi-Family Building: (Yes / N
Company:I Contact: L---
Contractor Address: 970 ~RI 4k AL C- City: WMIF I///1-
State: P Zip: 0-5,51 Phone: 1/0
W 6
2? 15~ Lead Certificate ~03 I
License
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
M95
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:
I
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets. f
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Cod must b completed within 180
days o permit issuance.
x
/ ~J
x c A;t__17
Applicant's Printed Name Applicant's Si nature
Page 1 of 3
I & yl M ~ llama ~t~
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*
x Addition Move Building _ Reroof Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation V t/ Occupancy d MCES System
Plan Review Code Edition SAC Units
(25%_ 100%) Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall: _ Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge J /00
Treatment Plant
Copies
TOTAL
Page 2 of 3
l I PS~~
CERTIFICATE OF SURVEY
0 u + DRAINAGE ~
O 0 UT IL-IT Y \ "Rr'Grr" I - v ~l}
i ~rASI: hl~iEN7
L07 2, 0
J~ l v\ N% Cc
s 81- O C K .s a
5 3 9"~ d n ~ ~ ' J10 ~
~ a~ ~ 0• 0
y` YZ 6 1 N 78.9
'4. C
ul MALLARD
z
\ s `r 9
pS
0
SMOKE DETECTORS ARE REQUIRED
ON EVERY LEVEL OF THE HOUSE AND IN
EVERY SLEEPING ROOM AND IN EVERY
HALLWAY LEADING TO A SLEEPING ROOM
A CARBON MONOXIDE ALARM MUS I Bc.
INSTALLED IN ALL NEW SINGLE FAMILY
AND MULTI FAMILY DWELLING UNITS.
4o.
34'4
- - btole4%
S. 19W
items WINDOWS ARE WWI= IN
ALL SLEEPING AREAS.
* INNNWS1 5.750. FT. PET arm OPPNINO
• MIN. 2011 NET CLEAR (VENABLE WIDTH
• MIN. 24" NET CLEAR OPERABLE Firma
• MAX. OF 44" FROM FLOOR 10 Noma
PORTION OF THE Ws
NOT& ININISIUN wow Ate YAM WILL
NOT ADD UP 70 ME REQUIRED 17 SQ. FL
58
.77,7
-.---
„ •
• §
••
BCRL)
FIRE STOP SOFFITS AND ALL
/rR DEv:). SPACES.
041. Fon
X/1/SP B oco.v t 4
P/k11-1.
137 265
LiVlyREA
Ceiling Hieght = 8Ft 3"
Soffit Height = 91 1/2" APPROVED PLANS MU::: I
Keep Ceiling as Tight As possible in projector Area REMAIN ON JOB SITE
Extend Knee Wall to Patio door to allow for panel height
21/2 inch panel SEPARATE PERMITS ARE
D FOR ANY ELECTRICAL
v 117t
heetrockigaiii.
tolAr4 51‘'41,--
1 inchpanel..
Split Wall
emo Split Wall
ipai.G a& co 10 ? v
iboovit
RiAloek NJairt ly/
Ivo) eUt/A
•:.';.4•-t-;•,...;.,
eep existing outlets in projector area
Mud Tape and Sand all Sheetrockfrasso
n',"17:: /11
Clip corner of soffit by projector
niNr. r c:CTIONS DIVISION
BY:
REQUIRE
OR PLUMBING WORK.
EAGAN
REVIEWED
/Pvt.