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4361 Nestling Cir1,111' City of hp Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 - Zai Use BLUE or BLACK Ink Permit #: Permit Fee: Date Received: Staff: L 2010 MECHANICAL PERMIT APPLICATION lLSite Address: 4-( ,� (-; c e --- Tenant: Tenant: AC Q fl 1'\ c e n-, c. j Suite #: RESIDENT / OWNER Name: A oxCo N\c,.c_\(-• t e e\^ -e- S Phone: 65 I - 3 5 7- -347 2 -- Address / City / Zip: H3 6 1 v€ 5* 1 k ,,, 5 C-- k C L c_ CONTRACTOR Name: Resident" Z i Heating & License #: Address: Ali Conditioning, Inc. City: 1815 East 41st Street State: Zip: M)nonapoIIS, MN'654 7 (612) 724-1899 Contact: Email: TYPE OF WORK New - Replacement Additional Alteration Demolition Description of work: NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. PERMIT TYPE RESIDENTIAL �. Fumace COMMERCIAL New Construction Interior Improvement ? Air Conditioner Install Piping Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under / Above ground Tank ( Install / Remove) Other ** When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) t: burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ --— TOTAL FEE $95.00 Fire repair (replace COMMERCIAL FEES: $75.00 Underground tank $55.00 Minimum (includes installation/removal OR State Surcharge) $10,010, surcharge is $ 5.00n surcharge increases by $.50 for each $1,000 Permit Fee requires a $ 5.50 surcharge) Contract Value $ x 1% r) = $ 2 &- V n Permit Fee - If the Permit Fee is less than /� Fee = $ l `-' " Surcharge - If the Permit Fee is > $10,010, (i.e. a $10,010-$11,010 Permit $ <--� 1 �, j� (�(,/TOTAL FEE 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 in4nformance 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 start withqut per_ it; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. c, x (-, c_-- Applica 's Printed Name x Applic Signet re FOR OFFICE USE Reviewed By: Date: Required Inspections: _Under Ground _ Rough In _Air Test _Gas Service Test In -floor Heat Final Exterior HVAC Screening Inspection CITY OF EAGAN Remarks addition Mallard Park Third Addition Lot 51 R,k 2 owner street 4361 Nestling Circle Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 0 Im . 1981 2698.43 539.69 539.71 A014788 10-25-84 STREET RESTOR. GRADING SAN SEW TRUNK *SEWERLATERAL 417 1981 3412 682.50 A014788 10-25-84 WATEFMAIN * WATER LATERAL 1981 WATER AREA STORM SEW TRK 117; 1981 467.74 93,55 5 93.58 A014788 10-25-84 * STORM SEW LAT 1981 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK _...- ;---.-.? . ?.. - ..,.r :---•,,?-?-,...-..?-- ?? PERMI ?F 1 CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N0 PHONE: 454-8100 T Receipt # 25 ,,, 87 SiteAddress 4361 NESTLIfvG CIR Erect 12f Occupancy R3 PIALLARE) PK Lot jl Block 2 Sec/Sub 3RJ Remodel ? Zoning RI Parcel No. . Repair ? Type of Const. v Addition ? No. Stories ? Nam S'PrYEl-?1?'?1 HOi?1LS Move ? Length z e 1434 0 i? I LOT KC30II R 7 Demolish ? Depth 44 o Addres City s A.V. Phone 923- 3 3 2 2 Int. Impr. Install ? ? Sq. Ft o Name SAM Approvals Z 0 i Address Assessment ~ City Phone Water & Sew. Police W W Name F ? Z ire ? = Address E ng. Q W City Phone Planner ?a Council I hereby acknowledge that I have r d this applicatio nd statethatthe . gld . Off. information is correct and agree?4o comply with all ap licable State of 9 A Building Permit is issued to: STEPIi--AiJ HOi•iE5 all work shall be done in accordance with all applicable State of I Building Official Permit "? 'Jyu.Jv Surcharge 57.50 Pian Review 274.25 SAC 625.00 Water Conn. 525. 00 Water Meter 67.00 Road Unit 305.00 Tr.PI. 130.00 Var. Date 1 Copie . 5 Total ' ' on the express condition that Statutes and City of Eagan Ordinances. 13266 j_ _ -.. Permft No. Psrmit Holder Date TNsphone # Ptuntbin9 IH.V.A.C. IlEloctric L(??I C?(? ?:<?? 1rr?"?:' 1 (r,•,? ??=%/5; ti:,?"?-?., son.nw I Inspectlon Date Insp. Commants Footings 1 ? , Footfnys II FoundaHon Framing / Roo1{nQ Rough Plbg• ??j- ,(?'• 12- _ Rough Hty. sQ Insul. Q Finplace Final Htp. Final Plby. .17-fy ? Bldy. Final Cerl. Occ. ? jy. y1 4:r. ? Deck Ftg. Deck Frmy. Well Pr. Disp. PLUMBING PEqMIT CITY OF EAGAN 3830 PILOT KNQB ROAD, EAGAN, MN 55122 Site Address Lot z - / ? Mame 'o Address ? Ciiy Phone Name 4 ? Address -"? 0 City Phone Sr:, .: FEES CQMM/IND_FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES - - TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM - COMM/IND FEE - $20.00 STATE SURCFiARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATU .3CSF ERMITT- E? FOR: CITY OF EAGAN BLDG. Res. _ Mult.,_ Comm. Other PERMIT # RECEIPT # ?- DATE: 3/?f . ONLY - COF FIXTUF r Closet - $3.OC Tubs - $3.00 ory - $3.00 rer - $3.00 en Sink - $3.00 I / Bidet - $3.00 WORK DESCRIPTION New X Add-on Repair THE -,t_Water Heater - $1.50 Whirlpool - $3.00 _QjZ-Gas Piping Outlets - $1.50 (MINIMUM - i PER PERMIT) Softener - $5.00 Well - $10.00 Pnv2te Disp. - $10.00 Rough Openings - $1.50 FEE: TQTAL $ 1, C3 U . 00 :I r.) '.O . 4 _3, DT STATE S/C: ? C% ;? GRAND TOTAL: y? ? 5C? ,? . MECHANICAL PERMIT CITY OF EAGAN CUNTRACT PRICE: Site Address 43 Lot _,:11 Bloc 3830 PIL07 KNOB ROAO, EAGAN, MN 55122 m Nam@ Wt?nSmann Homes ? Addr6SS 14440 Pi 1 nt KnoYi c Ciry ADple Va11eV Phone ? Name Kleve Heatin 3 Address 13075 Pi.one p City EclNn Pr 3 i r i e TYPE OF WORK Forced Air Lc :.nox ROPQO,Q M BTU Boiler M BTU Unit Heater M BTU Air Cond. Lennox tIS. IL3-71 M BTU Vent i.itcheii ho, 'A bItCFM Gas Piping Outlets # sans & dryFr Other Ftirnace anly FEE: S/C: TOTAL• ?ERMIT # _-2- RECEIPT # DATE _-Marcn 25, 1 . BLDG. TYPE WORK DESCRIPTION Res. ti New Mult Add-on Comm. Repair Other ditio FEES ?:AtS HVAC 0 100 M BTU . - ADDITIONAL 50 M BTU -$24.00 - 6.00 4211 (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUT ETS M M 24,0() L ( INI UM - 1 PER PERMIn COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES - 1.50 EA. TOWNHOUSE & CONDOS - RES. RATE APPUES MINIMUM RESIDENTIAL FEE ALL ADD 8 - -ON REMODELS - 12.00 MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT (ADD $ 50 S/C IF PERMIT PRICE GOES - .50 r? . BEYOND $1,000) 25.5U % . - SIGNATURE 0F PERMI7TEE ?6. FOR: CITY OF EAGAN TY OF EAGAN Permit No: 30 Pilot Knob Road Meter Ne: ?gS 7e 0. Box 21199 Reader No: 9-3 6-0 l tgan, NiN 55121 Stenh-an Homes Site Address: `1'v 1 Plumber. !.-Jenze 5Z5. 0 Conn. Chg: _ Acct. Dep: ?? Permit Fee: ? ` • ?? Surcharge: ? `' ?? • ?? Tr. Plant ^ •'??' Meter. ? Qate: Size: Date: u T::??. N ?0`' I agree to comply with the City of Eagan Ordlna es. r ?. gY WATER SERVICEPERIVIIT , CITY OF EACaAN SEWER SERVICE PERMIT 300 Pilot Knob Road PERMIT NO : P.O. Box 21199 Eagan, MN 55121 DATE: ; Zoning: No. ot Units: ? • -. Owner. Address: r?L• TTT - i` Site Address: 41(il NL'?rl'nO rirr l p . Plumber. 2-25-8 ' 7(?9`?8 lOc? . O?pd ? 1 agree to comply with the City of Eagan Connection Charge: __, Ordlnances. Account Deposit: . Permit Fee: \ Surcharge: . . _ Misa Charges: . By Date of Insp.: Insp.: ? k7 trom 6 9 7 0 6?. cl?Requ9§S 9ata-, Fire No. Rough-in InsOection 3- ?.?7 equiretl? es ?No ?Ready Nuw?Will Nn'ity, InsPec- ?or W?en Headv ?licensed Electrical CanVflctor I hereby requeat inspaction of above Ownar electrical work instalied at: Street Atldress, Box or Route No. Citv "13 6/ ssV4?6 ,4 ectmn o. Townsbi0 Name or No. Ha?Oe o- County D,g?o r4 Occupnnt(PPINT) pfy l-4?? llvs*c'?c S Phone No. Power SuvDlier Adtlress Elecvical Contractor ICOmpanv Namel Contracmr's License No. ?.PR? rn?w a .?- MailineAddress (COnhactor or Owner Makina Instailationl 'ff?i'.?*- f.z/w-r Jsr .-roet-e-3'` fz°v. Auth rized Sature ICOn[ actor OwnerMakine Installationl Phone Number ? ,- ys3-9?w MINNESOTA STATE 80AND OF ELECTRICITY TMIS INSPECTION flEQUEST WIIL NOT Griqpa•Mitlway BItl9• -Room N•191 BE ACCEPTED BV TNE STqTE BpAND 1821 University Ave.. St. Peul, MN 65104 UNLESS PPOGER INSPECTION FEE IS Phone(612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-00001-05 ? ? 3ee inetmuiona lor rompleting this brm on back of yellow copy. '? ld ir r, Q 7n r, "X" Below Work Covered by lhis Request JN.ARAdI pepT Tvoe o1 Builtling I Aoolioncee Wi.ed I Equiomant Wired I Unloader Milk Tun p Fee Sarvlca Entre.w Siza k Fee Feaders/SuCleeders p Fee Circwts U to 200 Am s 0 to 30 Am s D to 30 Am A6ove 200 qmps 31 to 100 Ainps - 31 to 100 A Swimming Pool Above 100_Amps Above 100_A s Transformers lvlgation Booms Partial.'Oth r'Fee? Signs Special I'spection g/-p,?+'?' .e? TOTAL FE ? perrorks J a , Ne EleMricaT Z pector, hereby tify that the abova inspection has been CITY OF EAGAN ? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N_ 13266 PHONE:454-8100 ?)Q CS9 BUILDING PERMIT Receipt # s 7o be used for SF DWG/GAR Est Va1ue $115,000 Date FEBRUARY 25 19 87 Sitenddress 4361 NESTLING CIR Erect C? Occupancy R3 Lat 51 Block 2 Sec/Sub. MALLARD PK 3RD Remadel ? Zoning R1 Parcel No Repair ? Type of Const. V . Addition ? No.Stories W Name STEPH-AN HOMES nnove ? Length 54 z 14340 PILOT KNOB RD Demoiish ? Depm 44 o Address A.V. 423-3322 Int. Impr. ? Sq. FL Ciry Phone Install ? , a Name SAME $ a Address x ? Ciry Phane w W Name . Address i W City Phone I here6y acknowledge ihat I ha information is correct and a Minnesota Statute5 and Ci Signature o( Permikee Assessment_ Water & Sew. Police Fire Eng. Planner Council statethatthe gldg.Off. able SWte of Permit Y "". "' Surcharge 57.50 Plan Review 274.25 SnC 625.00 Water Conn. 525. 00 Water Meter 67. 00 Road Unit 305.00 Tr. PI. 180.00 Cop To[al ies 2, 5 2.25 A Building Permit is issued to: STEPH-AN AOMES all work shall be done in accordance with all applicable Staty{of Minnesota on the express condition that City of Eagan Ordinances. Builtling Official 2005 RESIDENTIAL BUILDING PIItMI'C APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 00 ?,t?t??- A,7J New Construdlon Requirements RemoOeVReoair Reaui2menLa Office Use?OnN 3 registered sile surveys shawing sq. ft of lot, sq. (L of house; and all roafed areas ?? Z coPes of plan Cert of Survey Reod Y.- _ N (20% maximum lot coverage allowed) 1 set of EneMy Calculations for heated additions Tree Pres Plan Recd . "- Y-• _ N. 2 copies of plan showing beam & window sizes; poured found design, etc. ?1 s(te survey lar additlons & decks Tree Pras Requi2d lsetofEneqyCalculafions Addifron-indicateiton-sifesepdcsystem On-sileSepticSystem . _Y._N 1 copies of Tree Preservation Plan'rf bt platted after 711193 Rim Joist Detail OpGons selection sheel (huadings with 3 or Iess units) Date i?q ConstrucHon Cost ? ? 475(:X)- c_qt:> Site Address L(Ao) A19,6441,g (,yc P .F_cbc?f?l Aj!Np S6'1 ZZ UniUSte # Aescription of Work I16Y V%pb C37G???1 bL)l1U IlW i? SrAW18 g+-Ze Multi-Family Bldg _ YVN Fireplace(s) _ 00/1 _ 2 Property Owner ?irr n.Qy? Telephone # Contractor H%GkO/`(J DVAGY-Tr5 z 1flG I-t?r* Address '2157 ffrckwM ?-??? CitY ?-??k? State Zip Telephone #(( 5)) iJOZ -7t)?(.2 M COMPLETE THIS AREA ONLY IF ISMUCTM rr?; - Minnesota Rules 7670 Cateeorv l IJC Energy Code Category . Residential Ventilation Category?orksheet (Jsubmissiontype) Submitted g • Energy Envelope Calculations Kted4ZA, / Have you previously constructed a building in Eagan with a similar plan2 ? fee applies. Licensed Plumber Mechanical Contractor SewerlWater Contractor BUILDING New Energy Code Worksheet Submitted `N. If 'so, 25% plan review Telephone #( Telephone # ( b z?0 v ? Telephone # ( I hereby apply for a Residential Building Permit and ac dge 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 wark 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. 441naV\. -I, 2.?4-- Applicant's Printed Name A ? ApplicanYs Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plez ? 13 16-plex ? 20 Pooi ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-seaJ ? 03 01 af_ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 04 02-plex ? 10 OS-plex # 18 Deck 5 ? 23 Porch (screen/gazebo) ? 05 03-plex C] 11 10-plex O 19 LowerLevel ? 24 Storm Damage ? 08 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 ? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 ? 34 Replacement •Demolition (Entire 81dg) - Give PCA handout to applicant Valuation 2? ?? • Occupancy Z-3 MCES System _ Census Code LL I ? Zoning City Water _ SAC Units Stories Booster Pump _ # of Units Sq. Ft. PRV _ # of Bldgs Length Fire Sprinklered _ Type of Const Width Footings (new bldg) ? Footings (deck) _ Footings (addition) Foundation Drain Tile Roof Ice & Water Final _ Framing _ Fireplace _ R.I. _ Air Test _ Final Insulation Approved Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total F ? 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 38 MuIG Misc. Siding Fire Repair Windows/Doors REQUIRED INSPECTIONS FinaUC.O. ? Final/No C.O. _ Plumbing HVAC Ottier _ Pool _ Ftgs _ Air/Gas Tests Final _ Siding _ Stucco _ Stone _ Brick _ Windows _ Ketaining Wall Building Inspector F)'? ? ?n?- 1S1Z JC lZ'e" / [--Mn:nS L('X7, ,. --- e : _-v , , I ?. ? 0 ?r ? , f , / .. : 148•ao ?%?Oor w J40 . ? . NS6 ? h 84°'?3' t9" w ?Soo2,? ? ; , . , . c r? ? o? , W ? 41 ? ? l " u; ? ??Ty EPhEnr? M f a? • ? :z I ? J -~ IX g\?N P2opp5? ; _ ? UouSE m ;,? Iq-?YL:?.r; J O 4 38, oo d. o ? •°' ic.9zc:..4'i. R:??oO%7zz? Y •A?Y-?`?`•?'V R- % N C.? G NoeTH /,?,IALE I'= 30' a?L- 6EA.2iW,-5, At5W,,wv,ED o vE#4orss iRou MohcuMerlT D?c??PT?o?,l LoT 51 , eL-oe-V- Z) MALi-?6.rt..o PAR? TNI?D AD?lTlOl.l? flASLOTA GoUNT?(? M l ?.i?1 FiiD7'A I hereby certify that this survey was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. r` I,e-? o?-Bohlen Registered Land Surveyor No. 10795 , u ; / ? .•- ?. ; Y qp -- -_ ?•. tv? aM /S ? ? ? /32l0?6 1987 BQILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLIIDE 2 SEfS OF PLANS, 3 CERTIFIC9TES OF SORVEY, 1 SET OF ENERGY CALCOLATIOHS NOTE: ADDRESSES FOR CORNER LOTS - CONTR9CTOR/HOMEOWNER MIIST DESIGNATE AHICH ADDRESS IS DFSIRED. NO CHANGES WILL BE ALLOWED ONCE BIIILDING PERMIT IS ISSOED. M[TLTIPLE DiiELLINGS - RFSIDENTIAL RENTAL QNITS FOR SAf,E DNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SORVEY - CIiECg HITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COiIIMRCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFZCATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCA?E BOND lIS,D!qU To Be Used ror: ?/ Valuation: Z6?? Date: Site Address OFFICE USE ONLY Lot?V- Block ? On Site Sewage Occupancy tMWCC System ? Zoning Parcel/Sub On Site We11 Type of Const City Water ? (Actual) Owner (Allowable) Address City/Zip Code Phone Contractor ?!???- ^6,?77"h! Address /???/l???fi City/Zip Code Phone Areh./Engr. Address City/Zip Code Ik of Stories Length Depth S.F. Total Footprint S.F. APPROVALS FEES Assessments Water/Sewer Police Fire Engr _ Planner Council H1dg Off APC Varianee K3 9•I ? ? Permit 2aa Surcharge ,57, s` Plan Review 2? SAC, City 100. SAC, MWCC SZS, Water Conn 525. Water Meter 6 7, Road Unit (?S Treatment Pl I gb, Parks Copies TOTAL o2 S QoZ • Phone # ? ?j? rJ y ? f? ?Zg K ?2 ` 5 Z x 2e> ° gGc ?, 1- 44 = 4g ZSCo , 20 8 5 cj 60 33 G I 14 ,: , ??4z4 s y _. . i , ' EXTERIOR cNYELOPE AVERAGE "V" CDMPUTATION ONNER SI7E ACDRE55 CONTRACTOR 57e'a9.pv i4Doty. /?,??• DATE PHONE 47-3 -31z7 Detei-nine working square footage of each. l. Totai exposed wall area 20 6- F, 'V/1 sq, ft, z l 2. iotal rooF!ce•;lin-j area ..... (47Z-?'d sq, ft, x .E?j • Z•60 Tota1 expused rrall area above floor =t9890D a, Total wail window area,,,,,,,,,,,,,,,,,,,,,,,,,,, y o O.Oa b. Total door area .., c. Totel sliding ylass door area ................... ? C. Total fireplace ivall area,..,.,, ,,,,,,,,,,, e. Totzl wall frar,iiny area (average 10%),,,,,,,,,,,, ZoG-94 f, Total net wall ar-a above floor ,,,,,,,,,,,,,,,,, J3 66.DY g. Total rim joist area ............................ 17 8.22. Total exposed foundation aiaa = 6 4 U ` h, Totai foundati;;n rlindow area ..................... (3-r2 i. Toal net foundatiun area above gra?;? ...,,,,,,,., Determine "U" value of each se9ment. a. ZOa: oa_^ z „u„ L? b, 37-5/ X °U?? , 13 = 4 V c. X HU ,. d. -_' X 11 u I, ? c--- e. _ ?!'i/v•.9y X ?'Uu , 04 z "'„? X "U" .04 • SV-6 v 9. _ 17S Z:L z ?.u° 04 • -7-1 z h. "t Z A ?iUY ? ?l7 -T- a Z/ i. G7-? z ^U" ?_ • ;9 ?f ." : , 3.....,.....?, 9.4?a:,4? .............. Total • E:!Lq (. If item 13 is the sama as, or less than item !1, you have met the intent of 58C 6006(c)2. -r ?otat exposed roof/ceiling area = (072-D,:') j. Total skyliqht area...,,,,,. ,,,, k. iotai roof/ceiling Framing area (average i. Tota1 net in5ulated roof/ceilin9 area.,,,,,,.,,, ( 00 Determine "U" value for each roof/ceilinq segment, . X u -- -- ` ,. ro>z (n' -- X „U„ 4 .................(lI 7.?:.0U .,,....Total ' l b'0 if total of 84 is the same as, or less than 12, you have met the inten? of SBC 6006(c)l. Alternate Building Envelope Design To utilize the total envelooe system method, tne vatues established Dy the sum of items #3 and 94 shall not be greater than the sum of i±ems 11 and t2. t . _2 z7 -6-3 _.._ - --- * 2 L 6 Vo Y..?_ 3._ ?G^/? ---- + 4._ZL• ?? _ - ??_ WEP/A CO. PLAN SERVICE ED ANOERSON ARCHITECTVRAL DESIGNING qND VI.ANNING 5397 Upper 147th Streel Apple Valley, Minn¢SOta Resitlence: a23-S65B Oftice: 423-3775 Q I' 00 O : -- , .? ??. ?s ? e Q?._ ?. I 48• av h 84° ? in oa- ? ? i i % GAh? ?? i: . ui lA U\ 40 ? ? U-ftLiTy EFv???yy=r ZZ Zo?33? ,? . ";;"i 3i,?7 ?-?99ti°• PRop?? "? ? ? A - --_? FlouSE ; m / •?,s o :4A?wc iH?/ zL '0?. r ?V ? m L 38, co a j'' 0 p• ?0?? L ??a? R:?i3 ° \or?' oc ;Z I - Q•' NC? z' Y ? ti L o T 5 i, $ t-oGV- Z2 MALL,420 PARic. -TNIO-D ADC>ITIOw, DAK-oTA GoUNT?(j M l l?llJ E1-70TA I hereby certify that this survey was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Minnesota. r Le- olBohlen Registered Land Surveyor No. 10795 ? ? ., er? i w i x . / Nsb, - ?v . . ,' . 46 r•-, i. ? -?, ? 0 ?T 0) 0 S ?N NoerH 1?e-ALE 1'= 30• aLl. 6SA.W946, PeWl3MED o P&lor6S 19ou MohccSMErdT j??C 2 SPT t01,1 ? RESIDENTtAL BUILDING PERMIT APPLICATION ?? CITY OF EAGAN ?Q 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 NewConsWCtionReauirements RemodellRaoairRaouiremeirts • 3 registered site surveys showing sq. 8. of lot, sq. fl. of house; and all roofed areas , • 2 copies of plan (20% maximum lot coverage allowed) . 1 set of Ene Calculations for heated additiore • 2 copies of plan showing beam & window sizes; poured found design, etc.) • isetofEnergyCalculations • 3 copies of T2e Preservation Plan it lo[ platted aNer 7/1193 • Rim Joist Detail Options seleGion sheet (bldgs wiih 3 or less units) ? DATE SITE ADDRESS e 19Y • isitesurveyforextenoraddNons&decks . Indipte if home served by seplic system for additions VALUATION ?MULTI-FAMILY BLDG _ Y N ?YPE OF M!O RR ?'?'cz 11 r.r diaS ?;r er uok?`?' ? e/?[' h FIREPLACE(S) _ 0?1Avtw2 jruK a qas %h e cx?s?Yy APPLICANT F+fQ1 i-ruP 10nir l'lPr- 1.4164 FI'YeSide STREET ADDRESS ??S O CU, N?1i.A ??CITY ??- STATEMO/1IP S5 33 TELEPHONE CELL PHONE #FAX # PROPERTYOWNER ?( Vl 2(' LSCt K r{ f?? TELEPHONE# Pd?sl '4Ty- COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 (4 submission type) • Residential Ventilation Category 1 Worksheat Submitted . Energy Envelope Calculations Submitted Plumbing Conhactor: Plumbing system includes: '0C" 2°7g??bT Y_..._. Water Softener _ Water Heater _ No. of Baths _ Lawn Sprinkler No. of R.I. Baths Mechanical Contractor. '? &r1?L{\ Mechanical system includes: Air Conditioning Heat Recovery Syscem I Sewer/Water Contractor: Fee: $90.00 Phone # gs? "!/ ?W ' 0 23^8 Fee: $70.00 Phone # I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with oll applicable State of Minnesota Statutes and City of Eagan Ordi nces. Stgnature ot Applicanf OFFICE USE ONLY Submilted Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 CITY OF EAGAiV APPLICATION FOR PERMIT SEWER AND/OR WATER GONNECTION ?#***#***#******tt***#?*?*#?#?-?y . ..a M14iyj4??•.:.... * *TJ7.'F:: PA`QSFw OF FEE ATa:TI2fi:.',OE ? APPLscxTzorr DOES Mr ccrsMroME' ? APPROVAL OF PERhff'P. * » INSPFCTION OF SEWFR Atd]/M?y'?i ? IKS`rAr.r amrp? F7II?. LJOT 'S? ? UIED UNTIL PF1ihffT AAS BF$j"': + APPRWED. - ? 'E - •`': ??•::='::':.. ?iririr?t*yri??F*icfira?kYraFyrfic*#:s?taF}irle?tt*til P ease Print PROPERTY ADDRESS: LEGAI, DESCRTPTION: •- ,. or Tax Parcel ID ) IF EXISTING STRL'CIL72E, DATE OF ORIGINPS, gT,1ILDIM PERMIT ISSL'AN(M: ? . PRFSENr ZONING/pROPOSID L'SE: (y0n Year r__1 CChMMERCIAL/REPAIL/OFFICE ITIDC'STR7AI, [] INSTITUTIONAL/GpVIItNMENT 2) ' ? ruAME: ADDRESS: CIT]', STATE, ZIP: PHONE: R-1 SINGLE' FAMILY , ? R-2 DLPLEX (Tvoo Units) R-3 10WNHOUSE (Three + Units) ? R-4 APARThENT/COAIDUMINICTI AuruLrID•a NANE: ADDRESS: 36DD KF.NNEuEC DRI+IE, EAGAN, 651NN.55122 , CITY, STA`i'E, ZIP: '- PHONE: MASTER LICE[VSE# 001445M2 ( Ihiits). , .,. ( - Lk1itS)? . Act1S7E::,;_: .. : : -Exp1rE'di' ... -, . b3ot"z2cprdec St-a?'-7n,+, ?t s? ???a4'ld?N?' t?• IvAP?c : _ ADDRFSS: CITy. STATE, ZIP: PHONE: . - ?:^iti?`-,.i',?--'._ . . ':?_?-'.•: Y ? -5) ? u t r • x• : a ?? ? CONNEC.'TION 76 CITY SEWER ? CONNECTION Zu CITY WATER ? 6) •?[l PLF.,ASE HOLD APPRQVFD PERM2T FC)R PICK-UP BY ONE OF P.BOVE [J PLEASE MAIL APPROVID PERMIT To 1, 2, 3r)`?i ?E rf. (Circle one) ' 7) c r u• • i/i/Is?'? ?,''? ?" 9 v ^c . ,... ., ,. ... --. ' . . FOR CITY USE UNLY ?ERMIT '-r.' ISSOED ? .W.fv Pd w/51dg. Permit FEES: $ S /G6C $ j G. SEWER PERMIT (INCLL'DE SURCHARGE) WATER PERMIT (INCL'D C E SLRChARGE) $ $ WATER METER/COPPERHORN/OCTSIDE READER $ $ WATER TAP (INCLL'D° CORPORATION STQP) S $ SEWER TAP $ $ ACCUUNT DEPGSIT - SEWER S $ ACCOUNT DEPOS3T - WHTER $ $ WAC S G^ ?,S r G?`-G' $ SAC $ $ TRL'NK WATER ASSESS MENT ? $ TRCNY SEWER ASSESS ' - , MENI $ $ ' LATE4AL BENEFIT TR / UNK SBWER $ $ LATERAL BENEFI TjTRUNK 4ATER $ WATER TREATMENT PLANT 3URCHARGc $ $ 3 OTHER: $ I ??I / , $ J?A o n TOTAL ? . ?, - -.. REC?IP'T ;-?, - -- -' DOES QTILI:Y CONNEC TION REQUIRE EXCAVATION IN PUBLIC RIGN.T OF W.?_Y? ? YES IF YES, THEN A" pERMIT FOR WORK 54ITHIN PUBL=C ? AOADWAY" MOST BE ISSOED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION, SLBJECT ^O T?jL F'OLLOWIiVG CONDITIONS: APPROVED BY; TITLE: DAlF': / iocal Heat Loss (n. L No. Wphh matey ' HeipUt pf • nVwo ? ?Ne.el 1 d 9?^. LI 1. 01 Mck ...... Arn N. iL .. ....4 ' r?. No. ? WiEth ai pare, Ne?t ef pxM .....,... ? Ne.af I u s.... LinWlt. 01 ast . ...... An? ? . 0.11 .? .._. 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WNI 2436 ? . ?. . UNlnp - . ' ' 4 ? . ?310 TOWBIU. TaNBN. , . . Ff. Room Lyth. (, ,.• Wth. FI. ?? RoDm LYth. "viN1. I No. Wi ol CwM Melyn a1 Vw No.W II JrY LlnWit. ol enek ro M. li. - ? No. ' W oi XeIpM. el NOW Na.W 1 b I o1 wsY Arn . N. .. ? . ? ' ? . . . . ' ' ? ; ,. . . t.' ?'. . . . ,.... .. .:i:i, /e Wom ' leoan . W1. BTV . . Mothe r - ' `Cw1. BTU IMINnqpnWiMews InIilvHbnWbd? ..? ?. - ' 'x . Intiltrnbn W/Daan .. . , . . 178 IMlltmbn W/D? ? . ? ? . . 118 . IMihmbnSlOaa, I0IIVatian5/ppon ' ' - ... `. ' 71 . ? .. EW.Wal1 . . . . . . EW.WMI . . . . ' . GW.. Do«. G4,.. Doo.. 6 N•, Ew.well ... . :. - . . . ... ? . . .. .. .. : .,.i . : . . . , . . . , .. ,j 4 3 . Fbor - . .. ;: 1O6 . Gaw . . .. - ? ?7 10 Te1YBW. .. ? _. - r .. TeW BW. ' . . , + . . - . .. . ... . ? .....,. ? `. I*rrMA?s?.s..n X ? - . . ,,... . ? 'otal Heat Loss - =ToWI Btu I4 . i ?l. nuOm LTn. - nm. -- Mi. nOOm I lYt . Q. .. Am Altd "I.-ff Ne, Whmh el OW Heqnl of pshe Ne.M p. llnpH. ef enek Aro tl. it. . ? No. WiEqh oi Mn? Xelyhl ol W. N ( iaem /JOa? BTU Cerl. BTt/? 'p1"? Wi?s ' '? ' InlNtmbn WiMw( dYlrpianW/Oea? . 118 ' IM111nIbnW/Ooon . .. tt9 . . MllmbnS/Daen ' 71 I?nNVnIw? S/Daon . . 71 . W.WNI . . ' Ew.WMI . .. , ? . . . W S Oows ? Giw \ Doen ' . . . . 41. pFW.WdI - ? NME+V.WNI ? .? . ". ? ? , 4. . . tlliro ? .. • ' ? 2 Gu1rq. „ ? . 4 4 . . aer . . . . . 73106 ? Fqo. ' ?. otNBw. Tou1Bw. ? . . . .. `FI. ?L oom 11 LqM. "WM. • Ht. Roam LpM. . "Wth ? • , , Ht. •• Na. WidTh W t d ? No.ol 1 LM?YIt. Mcnck Ane .?O.N. .-? . No. W M n? XeWh, OIO? Ne.oi 1 b LInW 1. e1ttRk /p F :t .. . ' " 1 \ ?Y F*A Y . .. _ d . , - { I F 3Y?es y. :?.. . :, . _ ' `m - ... .l . . . .. . . . . . -, . , . . . .: ...( .? ? , ? ? . ? /?OOB ? . . ?tlOp? . . . . /Gms ' ?Cwl. BTU . lOwn MM. tiV . i/1hreti0^Wl^d°eog INNftmbnWintlews ? 38 diltatbnW/Uen? ' - 118 . . InllbmbnW/OOOn . . .-HB NlltmbnbfDeen ' - - 71 . IMiltrnlon.5lDOw? ' .. ' '.71 V.wW . . ? EW.Wa11 ? - - 0aa? 3648 GwaMOom . . . inEW.WMI. . . . . . . . . - . . ? aluM . . . , . ? 24 7 10 ? Fbor . . . . 7191 . 'OWBW. .. ... Toul Bro. . . FI. j-` ? Roam lY[h. ' - " Wth. " Nt. ' , FI. R oan LY M. ? Nt. • " . `. "^ ' 'i W Na WWIh W m Hekht oi m4 Ne.W . li t I It Menek Am oO.h. -' . No. • WN?h W H?Mk W Ne. al 1 s LM rNtl. Wask ' ? Ams .; M.K. ? . . .... . . . . °'t,[' - . . . . . , . .. . .. , .• . IdOOIf /COOn C.O. BTV ' /Oeen CM.' BTU dUnnbnWiMew? 38 Inlilvnbnw{MOws ' . ' .38 diWnkn W/Dem W/Oaan ? . ' . . 11 . %1illmtbn SfOaon ? . . . 71 • InlXtmlon 8/Doon. ' . ' . 71 . ?p. Will , . .. . . . . EaV. Wdl , . AMs oem, . . . - ai...a ooo.. ?.?t , N1fm.WY1 . . ' ? . ? 4 N?tE?P,WNI - tb ' . . . . .. :Nliea . . 4 6 Z u?nro 6 4 ? ? , ?? '7 1 0 .. Fbor< ? .. ' ' •?' 6 ? 'CtV BIY ; ?j t w`t"' ,di?n:..?'}A 4? 'y?? ?q 1 V 1??`,'tf? y ' +??T:4 r? ] ??? , 3?.? . TOHIBW 3??'?f ? hfv'::?".y,t K6 if`rat r J ? ..vsi J.{l?$??J,?, : . ? Nan # Time: v' 4PM esian Conditions: Ouuide : Drv Bulb 89: Wet Bulb 75 Inside: Dry Bulb 78; Wet Bulb 86 ITEM DIMENSIONS AREA SU. FT. U TD SENSIBLE HEAT LATENT HEAT CONDUCTION HEAT GAINS zterior wall, gross - - -- -- xterior glau .55 11 -- xterior wall, net .OB 11 -- otal walls and windows ,17 11 -- loor .OS 11 -- eiling or roof .OB 11 -- EXCESS SOLAR GAINS WALLS (direetion faoad) Vest .08 28 -- oof .O6 54 - GLASS (direction facsd) Vest b .55 IA? 6 - kylighu .55 116 -- BODY HEAT GAINS ensible No. of eo le x 225 J?il -- atent No. of people x 230 -- EQUIPMENT HEAT GAINS 3e00 aru lecvic motors HP x -lal- -- -- ifiltration • Sensible 1.085 x CFM x 11 -- ifiltrotion - Latent CMF x.87 x 30 -- ,) OTAL HEAT GAIN (SENSIBLE) -- OTAL HEAT GAIN (LATENT) - TOTAL HEAT GAIN BTU PER HR ONNAGE EQUIVAIENT OF COOLING LOAD =`f`xw- _ Tons ? 102 Page 1 of 2 Tom Colbert From: Russ Matthys Sent: Friday, August 24, 2007 3:00 PM To: 'tmrayl@yahoo.com' Cc: Judy Jenkins; John Gorder; Tom Colbert; Wayne Schwanz; Charlie Borash Subject: RE: Drainage culvert on pond Ms. Rayl, It is my understanding that you have been contacted by telephone in response to your e-mail dated August 17, 2007. I would like to update you on what has occurred since this telephone conespondence and how to proceed from here. City staff have been out to the pond behind your property to inspect the outlet for the pond and ensured that it is flowing properly. City staff wil] continue to monitor this pond outlet on a priority basis. City staff have reviewed the City's Stormwater Management Plan to verify your statement regarding flooding as a result of the July 2000 Storm. Based upon your account of 4 feet of flood water in your basement, we would like to pursue further discussions with you and your neighbors that share this pond. Within the next few months I will send a letter to you and your neighbors asking that we meet to discuss the flooding extent that resulted from the July 2000 Storm and any significant rain or snowmelt events since then. Since it is too late for the City to proceed with a public improvement yet this year, a meeting this fall will allow us to proceed with a storm sewer improvement in 2008, if we find that to be an appropriate solution. Thank you for contacting the City of Eagan with your concern. I apologize for the lack of a response to your telephone calls and encourage you to continue to communicate by e-mail or contact me directly by telephone at the following number with any future concerns or questions. R+44 MAm?4,, P.E. City Engineer Eagan, MN rmatthysC+?c ity_qfeagan. com 651-675-5646 office 65i-675-5694 fax From: Theresa Rayl [mailto:tmrayl@yahoo.com] Sent: Friday, August 17, 2007 728 AM ' To: Engineering; Webmaster; Maintenance Subject: Drainage culvert on pond -V-,ulZ I live in Eagan on Johnny Cake Ridge Road between Cliff and Diffley. My backyard is a pond between Nestling Circle and Teal Cp&t. In the 2000 flood of Eagan, my basement was flooded with 4 feet of water (as were many others by this pond and obviously elsewhere). However, after the floods there were many efforts by the city to improve the drainage system in Eagan. But not this pond. The drainage duct on the pond is extremely out of date and I am very concerned 8/31/2007 Page 2 of 2 about it's capacity to to manage drainage during storms like the ones the past weekend. I watched the level of the pond rise a little to much for my own comfort. As a homeowner, we have spent our own money trimming the trees along the shoreline to try to reduce the debris. However, I do not feel it is safe or my responsibility to actually clean and maintain this drainage culvert. In addition, I have small children and am concerned about their safet and this outdated drainage culvert. I have tried calling the city and left messages and have not gotten any responses. Thus I am wondering what the city's policy is about fixing insufficient drainage culverts or at the very least do some kind of maintenance on them? Since I have not had any response via phone, I am sending this to several people in hopes of getting some sort of response. Sincerely, Theresa Rayl Eagan Resident Nestling Circle email: tmrayl@yahoo.com Be a better Hearithrob. Get better relationshi ap nswers from someone who knows. Yahoo! Answers - Check it out. 8/31/2007 Use BLUE or BLACK Ink For Office Use 1 I ` U U Permit 4b~#: City of Ea Ed~ I Permit Fee: t I 3830 Pilot Knob Road I 1 Eagan MN 55122 Date Received: l1~ 1 1, 1 Phone: (651) 675-5675 I J I Fax: (651) 675-5694 1 Staff. I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit M Name: r/~7 rtiGf~'f.1~11~t.2J Phone: Resident/ Owner Address/ City/ Zip: Applicant is: Owner Contractor ` Type of Work Description of work: S71 Ad Construction Cost: ZQ Ova Multi-Family Building: (Yes / No ) Company: JS, ) 1~.. -Y, Gl Contact: Contractor Address: City: State: Zip: S 5"34'Z Phone:- C , License Lead Certificate -5C OlIql 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.goaherstateonecall.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 Code mu be corn ted within 180 days of permit issuance. 1 "?,/1 x oe4(~Sl -2, x Ap icant's Printed Name Applicant's Si t e Page 1 of 3 Use BLUE or BLACK Ink _ r - - - - - - - - - - - - - - - - - I For Office Use l Permit ) j City of Eain~cl i s I Permit Fee: f~ J, I 3830 Pilot Knob Road 31i~ I Eagan MN 55122 I Date Received: 1 Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION t Date: V' 3 Site Address: Unit Name: one: Resident/ Owner Address /City /Zip: A CIL Applicant is: Owner Contra for Type of Work Description of work: Construction Cost: ogdr6/ Multi-Family Building: (Yes / No Company: Contact: t ~ Contractor Address: ' 3 3 City: Oil State: J / Zip: 55a P Phone: ~E1..~/ /7 C_ License 6-3 J3LI Lead Certificate 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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be co leted within 180 days o rmitissuance. x 6 It 1 (11 " x Ap icant's Printed ame Appli an s ig ture Page 1 of 3 411,11 City of Eapll Mike Maguire Mayor Paul Bakken Cyndee Fields Gary Hansen Meg Tilley Council Members Dave Osberg City Administrator Municipal Center 3830 Pilot Knob Road Eagan, MN 55122-1810 651.675.5000 phone 651.675.5012 fax 651.454.8535 TDD Maintenance Facility 3501 Coachman Point Eagan, MN 55122 651.675.5300 phone 651.675.5360 fax 651.454.8535 TDD www.cityofeagan.com The Lone Oak Tree The symbol of strength and growth in our community. March 6, 2014 Aaron & Michelle Machtemes 436t ,fie Eagan, MN 55122 Re: City of Eagan — Pond BP -9 Outlet Improvements Project No. 1093 Dear Mr. & Mrs. Machtemes: This letter is to follow up on our email correspondence this past January regarding the timing of the retaining wall improvements on your property and the proposed pond outlet improvements planned by the City of Eagan. As mentioned in your email to me, you have no immediate plans to replace the retaining wall, as the existing wall likely has several years of useful life left. Because of the need to coordinate your replacement of the retaining wall with the pond outlet structure improvements, the City will also delay the outlet project accordingly. Please be reminded that until the pond outlet modifications occur, the area around the pond may be subject to flooding in a rainfall event similar to July 2000 storm. If you have any questions or wish to discuss further, please feel free to contact me at 651- 675-5645 or jgorder(a�citvofeagan.com . Thank you for sharing your schedule, and we look forward to coordinating the work in the future. Sincerely, N fr '49 ohn Gorder City Engineer Use BLUE or BLACK Ink r----_-_'---------� I For Office Use � I � � � Permit#: L. I Clty of ��o�� /�� ; b � Permit Fee: (,J � 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone: (651) 675-5675 j Staff: � Fa�c: (651) 675-5694 �_________________� 2015 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: , ' � � Site Address: /�(� � �L�t/i�'jG� �,i? . Tenant: Suite#: #2£SIdBt�#�UW�lef ` Name: Y' �.c.,Gt� Phone: ' Address/City/Zip: � �(9 / C 5f'�'Ya ��y'' Name: ��'��, ��r�e G�' �luyyt�h�LL� License#: P'"L(v��v 1�-� �ontractor Adaress:_��Z � �i'e�.T I city: L 2��,. State: Zip:� I ZZ Phone: g S^Z �� j Z 7�� Contact: ./VG�,� Email: �1�'�-� i7�'Ll� �'Te�" � � _ c�,a,� New Replacement _Repair Rebuild �Modify Space Work in R.O.W. T�pe ofi�Ic�rk — — — — Description of work:_�,��dCZ�—�` , �� l,j,�,p�-�-m ��i+ t�+/'. RESIDENTIAL Water Heater Water Softener ` Lawn Irrigation�RPZ/ PVB) ��r��g �Add Plumbing Fixtures�Main/_Lower Level) Septic System New Water Tumaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) 'Water Tumaround(add$210.00 if a 5/8"meter is required) $115.00 Septic Svstem New(includes County fee and State Surcharge) TOTAL FEES$ 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 ot 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 p ns. x ,�' ��' x App icanYs Prin ame A p' ant's Si fOR OFfICE USE Reviewed By: Date; Required Inspections: Under Ground Rough-ln Air Tes# Gas Test Final Meter Related Items: Meter Size Radio Read Manomefer Staff: