1621 Mallard DrCASH RECEIPT ? CITY OF EAGdN 3830 PILOT KNOB ROAD '
EAGAN, MINNESOTA 55122
DATE
REcErvEO
F,iOM
AMOUNT $
? <
? CASH
4 CHECK
. H# 1 T-;V- lL"? 1 ,C A:
-) F
FUND I 013JEC7 I I ' I AMOUNT
Thank You
BY
C 9598 ?t ?
Pink--File Copy
8 DOLLARS
im
SEWER & WATER PERMIT
ClTY'OF EAbAN -
3830 Pilot Knab Rd.
Eagan, MN 55122-1897
DATE ' ' ' IA 22• 19g4
OFFICE USE ONLY
METER # PERMIT DATE VF / 2 7 I9(i
CHIP # PERMIT # 11 k1QQ
METER SIZE B.P. RECEIPT # ? ? ?08
ISSUE DATE B.P. RECEIPT DATE V'? , '??) ,)s.
_ BOOSTER PUMP
I SITE ADDRESS i?IR
LOT 1 12 BLOCK 4 SEC/SUB TEI0141M" GAI:E WOODS
APPLICANT:
ADDRESS: _
CITY, STATE
I PHONE: -
ZIP
PLUMBER: ,`A'rTHEN DANIk?.S, TNC
.
ADDRESS: 15185 CAAOUSE.L 1!AY
CITY, STATE R(ISEMCfi1NT. !t?? Zlp 55068
PHONE: 423-?J730
OWNER: CARROZL CiJSTt`M H019".:ti
ADDRESS: 14355 CItlARRON AVE
CITY, STATE `-'0SI::,t0U3:T, MN ZIP 5506"?
PHONE: `'? 3-'-i OC)
PERMIT REOUESTED
?• SEWER ? WATER _ TAPS
_ COMM/IND X RESIDENTIAL ?
X NEW - E?CISTING ?
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be givQn for Deduct Meters.
I AG EE TO COMPLY WITH CITY OF
- EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWC1 WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, GONTACT ENGINEERING DEPT.
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE
OFFICE USE ONLY
METER # U3 21,7I D ,J PERMIT DATE ur /2 ? j" ' ,
CHIP # d??3 ?4 -5i' / PERMIT # 1161)0
METER SIZE ? O e? B.P. RECEIPT # C 9598
ISSUE DATE 9' 9d B.P. RECEIPT DATE 08 Z2/ C
x PRV - BOOSTER PUMP
51TE ADDRESS 1 21 =: = : : - ' 'DR
LOT t- BLOCK ?• SEClSUB TIIOMAS LAKE WOODS
APPLICANT:
ADDRESS:_
CITY, STATE
ZIP
PHONE: _
PLUMBER: MATTF:EW DANIELS, 1NC
ADDRESS: 15185 CAHOUSEL WAY
CITY, STATE 't'QSEyOUFrI', X.J ZIP 55068
PHONE: 42 3-_i T_' 0
OWNER: -AhROLL CUSTObI HOML•'?
ADDRESS: 14355 CIA1AkRON AVE
CITY,STATE RUSE:fQIJIaT, riN Zip
PHONE: 423-610u
PERMIT REGIUESTED
X SEWER
COMM; IND
x WATER _ TAPS
}= RESIDENTIAL
X NEW _ EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domesiic Meters on Water Line.
Credit WLL NOT be given for Deduct Meters.
1 AG EE TO COMPLY WITH CITY OF
EAGAN ORDINANCES ,
SIGNATURE WHE11 METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
.
,,. ? _---?? .
BUILDING PERMIT
Tn he Acced fer _ SF 1
Site Addrbss ._,_ ±
Lot 10 Block
Parcel No.
CITY OF EAGAN j 18289
3830 Pilot Knab Road, P.O. Box 21-199, Eagan, MN 55121 PHONE:454-8100 ? --
Receipt # - ? •
2AA Est. Value #95•000 Date AUG 22 , 1990
LI.AEtD DR
Sec/Sub. T??? ?= WW OFFICE USE ONI.Y
Occupancy R"3 ?i FEFS
Zoning
cc Name CARRQl't' CUgT'OM ROM (Actual) Const Bld . Permit
9 617 * ?
z
o 14355 CIMAtROTi AVE
Addf@SS (AUOwable) -?
- Surcharge 47*?
City ??K Phone 42 1? # or stories
l
Pl
R
i
401i00
p
Name s? Lengih
D
th f
? an
ev
ew
t?l?
Z ep SAC, City
00¢ Address S.F. Tolal - SAC. MCWCC ?•?
1- City Phone S.F. Footprints -
625.00
On Site Sewage water Conn
?¢
W W Name onsiiewen
M
W ?•?
~ -? ater
eter
??
Address MWCC System
X
ncct, oeposit ? ?
'
a W City Phone cily water
?-
?.oo
PRV Required S/W Permit
I hereby acknowlege that I have read this applfcation and state thal the 8oosrer Pump - S+w Surcharge '50
inlormation is correct and agree lo comply wiih all applicable State oi
Mi 232
00
nnesota Statutes and City of Eagan Ordinances. Treatment PI .
Signature of Permitee ?' • ,`r . APPROVALS Road Unit 355•00
A Bwlding Permit is issued to: CAgOLt' CU$TM ROM Plannar - park Ded.
on the express condition that all work shall be done in accordance with all Council
applicable State of Minnesota StaWtes and City of Eagan Ordinances. Bldg. Off. _ Copies
Building Ofiicial Variance TOTAL 3
? 1?'?
? Permit No. Permit Holder Date Telephone #
WATER
SEWEA
PLUMBING
H.V.A.C. 7O l+.o ? U O' /
ELECTRIC &Vl() -21 C-O
Inspsction Date Insp. Commenis
Footings I ?a
Foundation
Framing q? d
Roofing
Rpugh Plbg. -a,/?7 6
Rough Htg.
Isul.
Fireplace p - j
Final Htg. (> -3/-?a l( 7?
Fnal Plbg.
Consl. Meter Plbg. Inspector - Notify Plumber
Engr.lPlan
Bidg. Finai ?/
Deck Ftg.
Oeck Final
Well
Pt. Disp.
.?r
s' I ?• s
y?„s
(grx#i#ira#e uf Orr?panry
Citp of Cagan
&parfrnrw of Wuilding Jmwpr#i,vn
Tliis CernJ`caate iaueod pursuant to the rrquum&,& oJSecaion 306 of 1he unijonre Building
Code catifYin81ha1 at !!u linm of issuaace lhis s7mc[ure xres tn complianot with 11te Narious
arfiaaiurs of lhe C&t}' ngulalirrg buiW*g oonsouclion or tcse For !he followin,g:
uba.mmmm. sF nwG.Jr.aR eW& Pawk ro.
0=*@-T T}vX R3 f M 1 zomjcsDj*? p n rya caM
a,,,,orrotnkan:m('ARR( .?. rj1STf1M unMcAea,= 14355 rrM=v=_ ::E,---4,vr ?a'a= _
POST IN A CONSPICUOUS PLACE
m Name
?c Addre
c City ?
? Name
c Addre
O CityL
3830
MECHANICAL PERMIT
CITY OF EAGAN
Res. _
' Mult _
Comm.
Other
REI
MN 55122 DA'
For
#
r#
Office Use
WORK
New _
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM -/ PER PERMIn - 1.50 EA.
COMM/INO FEE - 1% OF CONTRACT FEE
APT BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPUES
MINIMUM RESIDENTIAL FEE - ALL AdD-ON 8
REMODELS - 12.00
MINIMUM COMMERCIAI FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
TYPE OF WORK
Forced Air ?.? M BTU
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent T_ CFM
Gas Piping OuUets # -
Other
FEE
S/C:
? .?_..
TOTAL: _ L t' ?`'"OF
, r?anno?naa r?nm? ? For OffiCA Use y
. ' CITY OF EAGAN ?
PERMIT#
CONTRACT, 3830 PILQT KNOB ROAD, EAGAN, MN 55122 RECEIPT #
PRICE PNONE 4548100 DATE: 0
Site Addre:
Lot __Z?',
? Name
City
FEES
COMM./IND. FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APLLIES
MINIMUM - RESIDENTIAL FEE $12.00
MIMIMUM - COMM.IND.lFEE • $20.00
STATE SURCHARGE PER PERMIT ' .50
$.50 S/C PER EACH $1,000 OF PERMIT
Res. ? New
Muft. Add-on r
Comm. Repair ?
ar,er
i
RE3. PLBG. ONLY - COMPLETE THE FOLLOWING: ?
Nq. FIXTURES TOTAL ?
( Water Closet - $3.00 $
Bath Tubs - $3.00
-? Lavatory - $3.00 ?
? Shower - $3.00
Kitchen Sink - $3.00 ?
UrinaUBidet - $3.00
Laundry Tray - $3.00
?
Floor Drains - $1.50
T Water Heater - $1.50 ?
/ Whirlpool - $3.00
Z Gas Piping Oudets - $1.50
° ({AINIldU6L- 1 PER PERfiAIn
'
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
?- Rough Openings - $1.50
U. G. Sprinkler System -$12.00 a
PERMIT FEE: , 3-Lo ?
STATES S/C:
GRAND TOTAL: ? ??°
DATE:
RE:
AUG 27, 1990
1621 MALLARD DR (CARROLL CUS?OM HOMES)
X Your Sewer & Water Permit for the above property has been completed. It will be held at the
P.ubW Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
.-
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy aliowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at Ciry Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES-TELEPHONE, ELECTRIC, GAS, ETC.
- REOUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
Address: 1621 MALLARD DRIVE Lot 10 Blk 4 Sec/SubTHOMAS LAKE WOODS
,These items were/were not complete at the time of the final inspection.
DATE: NOVEMSER 2, 1990 Yes No INSPECTOR: j
Fina1 grade (6" from siding)
Permanent steps - garage
Permanent steps - main entry
Permanent driveway
Permanent gas
Sod/seeded grass
Trail/curb damage
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plunbing
system and the shut-off of water supply to tha outside lawn faucet before
freeze potential exists.
White - City copy Yellow - Resident copy Pink - Contractor copy
BUILDING PERMIT
To be used for , SF DWG
CITY OF EAGAN N? 18289
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 551j? 1
PHONE:454-87p0 I ? . /???-/)ra?
Receipt # _ `? ?? L? ?
GAR Est Value $95,000 Date AUG 22 ,1990
Site Address 1621 MALLARD DR
Lot 16 L. Block 4 Sec/Sub. THOMAS LAKE WOOI
Parcel No.
w Name CARROLL CUSTOM HOMES
o Address 14355 CIMARRON AVE
Cjty ROSEMOUNT Phone 423-6100
o Name SAME I
?? Address
`- City Phone
N Name
Address
City Phone
I hereby acknowlege that I have read ihis application and stata that the
mformation is correct and agree comply with afl apphcabfe State of
Minnesota Statutes and Gty ol g n Ordin es.
Signalure of PertnRee ?
A Builtlmg Permrt is issued to: CARROLL CUSTOM MES
on Ihe express conditwn ihat all work shatl be done m accordance wrth all
apphca6le State of Minnesota Stawtes and City ot Eagan Ordinances.
Buildmg Official
OFFICE USE ONLY
Occupancy R- 3 -M-1 FEES
Zoning PD
(ACtuaq Const V-N 81dg Permit 617.00
(Allowable) V N
Surcharge
47.$0
# orstones
Length 52' Plan Rewew 401_ no
DepU 46' SA0. Ciry 100.00
SF Total - SAC, MCWCC 600.O0
S F Footprinls _
On Site Sewage _ water Conn 625.00
On Ste Weil - Water Meter 90.00
MWCCSystem X
Acct Oeposn
30.00
City Water -X-
PRV Reqmred X S/VJ Permil 30.00
Boostar Pump - $/W SurCharge . 5o
Treatment PI 2521DO
APPROVALS RoadUnil 355.00
Plannet - park Ded
Council _
BIdg.Ofl _ Copies
Vanance - TOTAL 3 14$.?0
2 Q C? l? 1? ?
O [J L
?
O E USE ONLY This request mid 18 monlhs from validaM1On date pnnted in Ihis_b;.7
U7
?
PLEASE PRINT OR TYPE
Requast ?a Mughnn inspeaion reqmred2 ? Yes Inspenian Olhar Than Rough-In eady Now ? WiII Call
G L (You most mll Me inspeWr whe n ready) Dote Rdy.
I, icensed contrador ? owner hereby requesf inspedion of fhe above electncal work af:
lob Addreas ( ar Rau No )? A
Ciry
1i
/ Tp Code
M1, ?
.
Sernon No Township Name or No. Rarge No. Fire No. Counry
?/07yJ A
OcwOam Phane N
o
/I? T (
P /
?
Vf? J -7'1
Power Suppliar Pddress
Elednml ConV r(Compony Nom<)
; Convonor Lcense Na
C? o ?i s?y Maskr Lic No. ?Plam Eied. Only)
?f s?r ?i'SZ?
?..? ?-,d m
MaiL, Ad s hatlor or er(orming Inswllofian)
?
GS
?
0 2 Z ? r o a.?
C
1 a
Aofhori ignaNre onha r Ci? PeAaimi Insm u nl ne No
?
? OS
EB-00001A-10 6/9 ATEBOARDC Y- EEINSTRUCTIONSONBACKOFYELLOWCAW
I II I II Ilf ?I REQUEST FOR ELECTRICAL INSPECTION 1:59? ?
?
I Minnesota State Board of Electricity ?? ?
* 8,6 2 1 2 6* 1821 University Ave., Rm. 5-128, St. Paul, MN 55104
0 ?
Phana (612) 642-0800 (?? 7ij(p
Home Duplex Apt BI g. ?(Fer New Addn
mmeraal Industrial Farm Remod Re ir
Air Cond. Htg. Equip. Wafer Hfr. Load Mgmt. Other:
D er Ran e Elec. Heof Tem . 5ervice
"X" above fhe work covered by fhis requesf. ENer remarks in this spoce and on Ihe bock of the whde mpy only.
Calculate Inspecfion Fee - iha Inspedion Requesf will nof be ac<epted wdhout the corred fee:
Olher Fee # Service Enfrance $ize Fee # Circuifs/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
$treet Ltg./rraRic $ig. Above 200 Amps ve 700 Amps
Trons{ortner/(?ienemfor INSVECTOF'SUSEONLY TOTAL ?
Sign/Ou}line Lfg. Xfmr, ? %
Alartn/Remote Con}rol
Swimming Pool i here ?ero ihet i i?: Fe ?lea?roi ??.mum?a? de:cnbad h?re,n on m? doks sm+?d
Irrigafion Boom Rough-In
?k
$
eciallns
eciion ?
p
p D
t
Investigafive Fee o
e
G-
THIS INSTALLATION MAY BE ORDERED DIS NNECTED IF NOT COMPLETED WITHIN 18 MON HS.
i??`Na/So
m 10746110 zl Sys?oE 99oiS?
R2 t Dale
? . ire No Rough-in Inspeciron
Raqwretll
? Ves ? No
? ReatlY Now
? W'I?n,Reetlspector
ON
I ensed contrector ? owner hereby request inspection of above electrical w aT
00
Job tl s(Stree6 B
77x ar R Na )
P
/
?
'on o ownship Name or No Range No. Counry
Occu t RINT /
L Pho No ?931
PowerSUppL
• Adtlress
EI al Convact r(CO ?Oan Name) ct 5 L¢en
Mei in tlre s I ractor wner Making InsGl twn) •
Autn zed Sgnat onVa or/ n a g Installat P
MINNESJ?AATATE BOARp OF EIECTNICITry ,R THIS INSPECTION REQUEST WILL NOT
Griqqs-Mitlwsy Bltlg. - Room S-ll] ?d BE ACCEPTED BV THE STATE 90ARD
182I Universitr Ave., St. Peul, MN 55106 UNLE55 PROPER INSPECTION FEE IS
Phone (613) BCI-OBOp ENCLOSEO
a 10746
REQUEST FAR ELECTRICAL INSPECTION
J? Seeinslmdions lor completing iNS brm on back oi yellow copy
'X" Be/ow Work Covered by This Aequest
'40W?ff'M.'R'? EB-00001.0
?.?.
??
ew ep. TypeolBuAding Appliancesffired EqmpmentWired
- ome Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Drye Other (Specify)
Comm./Indu5lnal umace
Farm Air Conditioner
01her (wapry) Conhacmrs Remarks'
•COmpu[e Inspection Fee Below:
# Other Fee # ServiceEniranceSize e # Circuits/Feetlers ee
Swimming Pool 0 to 200 Amps to 700 Amps
Transformers Above 200 _ Amps Oo _ Amps
Signs Inspecror5 Use Only
UU TO AL
Irrigation Booms ??
Speciallnspection 1 3a ? c,J
Alarm/Communication THIS INSTALLATION MAV BE ORDERED DISCONN?CTED IF NOT
Other Fee COMPLETED WITNIN 18 HS.
I, the Electrical Inspector, hereby R°"qn-in
, a?e/D_
certif thattheaboveins ectionhas
Y P
been made F;,,ei oate?
6p?
OFFICE USE ONLY
Tnis reqoest void 18 months hom
A
7l jp
a 1 716,e o
a&
, ywColo S
Re Dete
•
° Flreo fiougn-in Inapectlon
Feqwretl'+ ? ReaGy Now ? WAI Notdy InspecMr
• ? Yes El No lMien Reatly?
I5.NCensed contractor p owner hereby request inspection of above electrical work at:
Jab r s(SYr t, Box or o ? Ciry
ecuwn No ship N me or No Raige No CAUnry
u nt INT
/ f P?o No?
Power S tlress
EI i ? omract (Com Name)
V-i • s?en
Maib re h or o er Making I st II io ' •
Auihor eE SignaW ont M a ing Instellatro?
f? • 2 Ph r_
MINNESOVA SpTE BOARD OF ELECTFICIT ? THIS INSPECTION REOUEST WILL NOT
GrlpgaMitlway BWp - Raom 5193 BE ACCEPTEO BVTHE STATE BOARD
1821 Unlvenity Rva., $t. Poul, MN 551p4 UNLE55 PROPER INSPECTION FEE IS
Plnnw (612) 602-01100 ENCLOSED-
REQUEST FOR ELECTRICAL INSPECTION
?• ? Sae msimcnons for compleung IDis lorm on back of yellow copy
a 10 716 'X" Be/qyv Work Covered by This Request
?.?.?,.
fW Rep. TypeofBmltling AppliancesWired EqmpmeniWired
V Home Range mporary Service
Duplex Water Heater Electric Heating
Apt Building Dryer OMer (Specify)
Commllndustrial ' FUrnace
Farm Air Condrtioner
Olber(s0ealy) ConVac[or5 Remarks
Compute Inspection Fee Below:
8 Olher Fee # Service Enirance5ae Fee # Circufls/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Abov Amps
51gf15 Inspector5 Use Only ?
o ? ?
O?pL
?
Irngatwn BoomS /? • ?
P
Special Inspection
Alarm/Communicanon THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 78 MONTHS.
I, th2 ElectnCal Inspector, hereby Rougn.n oa?a
certify that ihe above inspection has
been made. F,nai oai J.?
?t?? EB-OOOOLOB
OFFICE USE ONLY
T?is repuest voM 18 months hom
R qo m
Abbb-
City of Eaiai
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Description of
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ? 115 V Site Address: 1tY 2-I 1 1 lu II a? d ?
Tenant: Suite #-
RESIDENT / OWNER Name: PhO^e: ?I-?-°
Address / City / T? .
Applicant is: _ Owner _x Contractor
TYPE OF WORK
CONTRACTOR
Construction Cost:
a45-qo
------------------
? ?
?
i Permrt Fee:
I
? Date Received: ?
I Staif: ?
I I
- J
Multi-Family Building: (Yes
License#: PnR/,)?A
Ciry: Qd?h«?r- State: 1_ Zp: SGJQ
Phone:GJI 'L1A9•Ll?117 ConqctPerson: T??re11
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code . Residerrtial Venfilation Category 7 Worksheet • New Energy Code WoAcsheet
Category Sunmmea suomitted
(J subm'ission type) • Energy Envelope Calculations Suhmiaed
In the lest 12 months, has tha Cky of Eagan issued a permit for a similar plan based on a masier plan?
_Yes _Na If yes, date and address of master plan:
Licensed Plumber:
MechaNcal Contractor.
Sewer & Water Conuactor:
Phone:
Phane:
Phone:
I hereby ad"owledge that Mis iMOrmation Is complete an0 axurate; tliat the work wlll be in eonformance with the ardinerkes arM cades of ihe CiIY of
Eagan; that I untlerstand this is not a pemik, but only an appiication for a permit, and work is not to start without a permit; thid the work wi0 be in
accordance with the approved plan in the case W work which requires a review and approval of plans.
Xng A i
ApplicanYs Pri ed N m ApplicanYs Sign ure
Paqe l of ?
. _ , o,*
6>>•oo+
47•50+
401•00+
2,082•50+
3, 148•00*+
617•00+
? 4,7, 50+
^C 401•00+
2,082•50+
3, 148•00#+
??Q,??N
1990 BUILDING PERMIT APPLICATION
CZTY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCNITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITN BLDG. DEPT.) 1 SET OF SPECIFICATIONS
' 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: Valuation
Site Address lljal ",p iCJ/l,
Lot '?O- Block _Y
Parcel/Sub TZL'rr
y/?? ,?,r??eCClpo'z
Owner J S,pN zgzv?
Address
City/Zip Code
Phone
Contractori(24??4 , Z!?ijrt-
Address
City/Zip Code/?p???,if
. ,
Phone 4zA,3
Arch./Engr. ZeAJiJ??e)
Address
City/Zip Code ?/??.,?a/1/
A U G 2 C RECD
? Date: ?
95, 000•- OFFICE USE ONLY
FEES
Occupancy R_3 M_I
Zoning p D
_
Actual Const V-1y
Bldg. Permit
6IF?, 00
Allowable V-N Surcharge 7,$0
# of stories Plan Review 4f01,00
Length SAC, City D ,OD
Depth SAC, MLICC (poO,OD
S.F. Total y Water Conn 2 1 00
Footprint S.F. Water Meter q O
Acct. ?eposi t D,OD
On site sewage_ S/W Permit so,Do
On site well S/W Surcharge .50
MWCC System -011, Treatment P1 . Z5
City water V/ Road Unit 355,Do
PRV ir7 Park Ded.
Booster Pump _ Copies
SUBTOTAL
APPROVALS Penalty
Planner TOTAL ?? .
Council _/
Bldg. Off. a/ZZ
Variance
Phone # !/r"? -a ? v
- - • VALUA-t'i c) N
-?-- _ -
GaRA?? . .?. • .?-'
?
•?µ i6
Z2 k22? ???{ X IS= 7 Z(?O
ZG xZ2= 5'12 ,
ZyX3?_ ?zo
_r
I 2c? 'L Y. ! y= I?`6 ?
Hoi.L.S iF
1'?2?10 = 15
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Certificate of Survey
Legal Descr7ption :z-oT /D, BLOCK 4, TNOMAS UlKE WOODS,
pAKOTq CDUNTY, M/Nit/ESOTA.
C9??,o ) DENOTES EXISTING ELEVATION '
(91.3.5 ) UENO'fES PIIOpOSEU ELEVA710N
? INUICATES Ulil[C'1'IUN pP SUIIfACE URAINAGE
963.g3 v rINISI-IEU C;AfIAUE rLUOR ELEVA710N
957,46= BASEMENT FLOOR ELEVATION
965.Soe TOP OF BLOCK ELEVATION
6CALE t 1' - 40' 4/1 '
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DRA/NLJGE AND H I \1?? `SS•-
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? MALLA20 OR/ ?E
P 11 1! a V e REW0 ll ED r259.54' ?2.6/, o_S,
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1
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l here6y certfly Iltiol tlds Is a trua aiid aotreol reptesenleUon ol a irnot o( land as sltown
and dasarlbed Nereoo. As poepetaJ hy*me on tlds -L!-' Jey ol _Av6U-;r o920 ,
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_ MINNESOTA STATE ENERGY CODE CALCULATIONS
'?- BASED ON CHAPTER 5 OF THE ?.?
MODEL ENERGY CODE - 1983 EDITION
Adoptlon Effectfve 1/17
Owner Phone Date
Site Address
?
Contractor C i?,' ! GiL=> O Phone
Building Classification: Type Ai (Single Family b Duplex) Type A2(Residential)
(3 stories or less
NOTE: Lomplete pages 3 and 4 first. (Other) (Over 3 stories)
GENERAL INFORMATION -
1. Building Perimeter??ihVlfp?kTi I?ft. ,
2. Wall height (ground to eave) ,% ft. , M35.0 3. 1. x 2. (above) gross wall area t2
.
4. Building dimensions (L) r- X(W)- = I? 33 ft.2 roof 6 floor area' ?
5• Square foot area of rim joist - Floor Jolst size (2 x
IC;? X Perfineter = Rim joist area = Z 4S ft2 i
12 6. Doors - AFea ?'I I I
1'hickness in. U factor o •
Type of Construction Perimeter ft.
Manufacturer
7.. Total door's perimeter ft.
`
8. llindows: Manufacturer ???-?.?f ?. ?i?}¢j}?l? ??' State approved
U factor
TYPE SIZE RREA (Ft.2) NUMBER OF TOTAL FEET Z
- EACH UNITS . .
9. Total ft.Z Glass i !j 10. Fireplace area: Width X hefght = X = Ft.Z
11. Exposed foundation: Height X Perimeter •(P X I'-- 'L 1? ? Ft.2
COMPLETION OF THIS FORM IS REQUIRED FOR ALL NEW ONSTR CTION, MAJOR REMODELING ANO BUILDINGS BEIN(
MOVED WHERE ENERGY, OTHER THAN THE MINIMAL CODE ALLOWANCE, IS USED.
= 10
f
ll
12: gross wa
area.
% o
Framing area
13. Gross wall area z53e-2 .OZ ft.Z
Window area A 1,'=19 1 75 ft.2 U windows = pU x A=?
Rim joist area A ft.Z U rim joist = . 44?rl 41 x A= 5•31
Door area A' ft. U door area = U x A
Ji'+IG? CIZ ,C z
F,i'r,p?la1P area A -TZ r C7 ft.
U €f fo?flp = U x
r
A
Exposed foundation A ft.Z U foundation U x A-
Framing area A??-+? rJ) f•?5? ft.Z U framing area U x A=
Net wall area A ?7iZ-1 ft. U wall- = o ?"f? l) x A=
? (138) TOTAL . . . . . . . . . . U x A = 'Z?J} • ?O
i
14. GroSS wall area z 0.11 (A-1 single family & duolex = allowable U x A/Code
(13. above) .
x 0.23 (A-2 other resident ial)
x .23 (Other buildings)
x .23 (Over 3 stories) '
'2_5 35
?Z BQ,TUH Must
136
' 'uF- be larger than
above
,
A
x U Code.._? ,
15. Ceiling framing area (Ap) equals 10% of ceiling area C, or the. same asj
I 33 2
fSA. Grass ceiling area =(L) ?r x (w) = 3 ft.
158 Joist aree (Af) = 10a ceiling area = F? 7 ft.2
ISC. Net ceiling area (Ac) (15A - 158) _
2
? Z ?D i v ft.
x A
_ ,? LZ x
ilin
U
c
g
ce
' U framing x A f= X l33 = o?
150. TOTAI'U x A ............................. ........... 2 .
16. Ceiling area (15A) x 0.026 (A-1 single `amily & duplex - code allowable U x A
x 0.033 (A-2 other residential)
x 0.06 (other)
n07,(42 BaUH Must be larger than -15D (above)
A(15A1 x U lcode)= F (or th2 same as)
NOTE: Use U and A values obtained from pages 1, 3 and 4.
GERTIFICATION: I hereby certify that I have calculated the "U" factors and "R" values
herein and tha[ the buflding here described meets or exceeds the State of Minnesota
Energy Conservation Act.
Date Signature
?
?,- 9C- 33g)
N ?k-laf
?U?t,
P,oX( 2+z4+z4+a5p+-4)_ ?12-0
It s4x( z4 +z4 +-3z+?P,s)= gzg,9g
ll ??1CC ?Z?z2?- Zb+ ?3 ) = Y?7, o?-
l? o x('?t?? = 15?o
PKQbvJs
1g ?,+x(,o = 15,
?S
11 ?OX3(a = 7-ax t _ H
l ZoX(00 = I l,ox1 = IIlo
??M ?sx? - I?-SX! = l?,s
l? ?x?= ja?oX 2=yo?o
_"'?1--
v g 5TL, ?. wl 5? ,= ZS, 0
z-sz. 42-1 JA(-
?I,o
U YALUE CALCULATIONS R YALUE U VALUE
wncL
SECTION
?
U=?=
R TOTAL Z3?O?j
STUD
SECTION
2ND L/AL'I
SECTIQN.
R1H
JOIST
• ?? 1
?
!• S
(Fdn.) U = R =
L_ E:terior air film R= .17 ?
? F TOTAL 81ack ,
.?.??r•'``,rade 3.
Inaide air film .68 '
Interior vail .45 (Nall) U . R :
Insvlation 19, 00 '
Sheathing Z,G?Q . ?LI.7?-
Siding , (p7 ?
Outstde air film .17
Ineide.air fLlm ? .68
Intetior vall _ •??
.
stvd "R= Af?1y (p,S (Framing) U
I
Sheething , Z,O[p _
Stding (p-]
Outslde air film ' .17
R 'fOTAL ID•
Inide air-film R= .68
In[erloc vall ?
Inevlation . ?
t ing
E:terior? ?ring
Exterior air film . R ..Ii
(Wall
?._..B _S.aTAL.- .___.._ ?
Intcrtor alr film R= .68
Lnsulation
l?t ineh soEt wood R=1.88 (Rim
JOISt) Sheathing Z'OtP
Ezterior vall coveting ,(p7
I
Extertor air f11m (tz ,17
R TOYaL z?. `T?O
Iaterior air film R= ,68
5.?0
Insulation
FoanJation 2
CEILING NITH VEPITED ATTIC SPACE ABOVE
I R YALUE UE
\ FRAMING CEILIHG
Ceiling .?p
0.61 Air Film 0.61
Z . ? Totat R x4xj. -70
_ .nZ3 ?u=a oZZ
FLAT ROOF OR CATHEDRAL CEILING R Va ue R `IALUE
FRAAIING CEILING
? 0.61
r
Air Film 0.61
Insulatian Al, C7
, q-• ?J?j doist
0.61
0.17
Inside air film 0.61
Ceiling
Joist (siud)
Insulation
Air space
Roof decking
Insulatian
Built-up roof
Outside air film 0.17
Total R
? U
R m -
4indow infiltration .5 cfm/lineal foot of crack
tesidential door infiltration 0.5 cfm/square foot or door and minimum code requirement .
•Ion-residential door infiltration 11.0 cfm/lineal foot of crack
Jb 12" concrete biock no insulation =.47 R 2.1
!b 12" concrete block insulated cores =.26 R 3.8
JS 12" ligfitweight block =.32 R 3.1
Jb 12" lightweight block insulated'cores =.12 R 8.3
J single glass = 1.13; with storm iaindow .54
J double glass = .55
J triple glass = .41
all exterior walls and ceilings must have a vapor barrier (0.10 perm max.).
?apor barrier must be on the inside (heated side) of aiall.
iapor barriers of the polyethelene thin film have no R value.
4.
.r)'?, RESIDENTIAL q5
BUILDING PERMIT APPLICATION 4a•
CITY OF EACAN
3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
NawConaWCtion Reauiremenfs
• 3 re9istered sde surveys showing sq. R. of lot, sq. R. of house; and all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing beam &window sizes; poured faund design, etc.)
• 1 set of Energy Calculations
• 3 copies of Tree P2senation Plan'rf lot platted afler 711193
. Rim Joisl Detail Options seledion sheet (bldgs wilh 3 or less uni4s)
DATE
SITE ADDRESS
TYPE OF WORK ?
APPLICANT
AIO, L t,9 R13
Oc&InJ6 (NC_
RemodellReoair Reauirementa
. 2 coples of plan
• 1 set of Energy Calculations for heated add'Aions
• 1 sAe survey for e#enor additions & decks
• Indicate'rf home served by septic syslam for addi6ons
VALUATION
j Vl- MULTI-fAMILY BLDG _Y XN
Ct` 5 I'I1N6LgREPLACE(S) _ 0X 1_ 2
STREET ADDRESS Z I Z S S VA(ILYM CITY /L)9 STATE /?t'U ZIP 5-5 3o3
TELEPHONE #h63)752-'-150y CELL PHONE # LG12)6?0--Sj?3 FAX #
1 /qC TELEPHON401/ 03 -0-] SI
PROPERTY OWNER
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNFSOTA RULES 7670 CATGGORY 1 MINNESOTA RULES 7672
(J submission type) • Residential Ventilation Category 1 Worksheet Su6mitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: ____
PlumUing system uicludes:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Confractor:
Air Conditioning
_ Heat Recovery Systcm
Fee: $90.00
Phone #
Fcc: $70.00
Phone #
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Orcynances. 12
Signature of Applicant
OFFICE USE ONLY
_ Water Softcncr _
Water Heater
No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updaled 4102
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Muki
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) • Give PCA handout to appllcant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) FinallC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HypC
_ Drain Tile Other
Roof _ Ice & Water _ Final Pool Ftgs Air/Gas Tests Final
_ Framing _
_ Siding Stucco Stone
_ Fireplace _ R.I. _ Au Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
Ciry SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA168618
Date Issued:04/27/2021
Permit Category:ePermit
Site Address: 1621 Mallard Dr
Lot:10 Block: 4 Addition: Thomas Lake Woods
PID:10-76100-04-100
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
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. When a weather barrier is installed or
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 Oberhauser
1621 Mallard Dr
Eagan MN 55122
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA179669
Date Issued:10/17/2022
Permit Category:ePermit
Site Address: 1621 Mallard Dr
Lot:10 Block: 4 Addition: Thomas Lake Woods
PID:10-76100-04-100
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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 Oberhauser
1621 Mallard Dr
Eagan MN 55122
Ashco Exteriors Inc
11164 Zealand Ave N
Champlin MN 55316
(763) 225-8333
Applicant/Permitee: Signature Issued By: Signature