4669 Nicols Pt
Use BLUE or BLACK Ink
O-ffi-ce-U-se
~ far I
City of lon I Permit Q-
dv 1
I Permit Fee: I
3830 Pilot Knob Road
Eagan MN 55122 I Date Received: j
Phone: (651) 675-5675 1 1
1 staff: I
Fax: (651) 675-5694 1 I
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit M
Name: __4 (.WI Phone:&Z2 '7
RESIDENT /
OWNER Address /City /Zip: S P
Applicant is: Owner Contractor
TYPE OF WORK Description of work:
Construction Cost: Multi-Family Building: (Yes / No )
Company: Contact:
CONTRACTOR Address: City:
State: Zip: Phone:
License M Lead Certificate M
Does this project require Lead Remediation? ❑ Yes ❑ No (see Page 3 for additional information)
If no, please explain:
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 the 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.gor)herstateonecall.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
accordan approved pl a case of work which requires a review and approval of
x
Applicant's Tinted Name Applicant's Signatur
Page 1 of 3
RESIDENTIAL
BUILDING PERMIT APPLICATION
- CITY OF EAGAN
3830 PILOT KNOB RD • 55122 ?
651-681-4675 ?
flewConsWCfionReauirements RemodeVReoairReauirements __V• p..?-t,
. 3 regisfered stte surveys showing sq. fl of b1, sq. ft af house; enll roofed aieas . 2 coPies of plan 11??S-??.?n?'?
(20% maximum bt coverage elhwed) . 1 set o! Energy Calalatbns for heated addrdons
• 2 copies of plan showing beam & window siss; poured found design, etc.) • 7 ffie suney for exterior addiGons & decks
• 7 set W Eneigy Calwlatrons . IrdkaEe if Aane serve6 6y septic system for atldNOns
• 3copiesot7reePreserva6onplan'rfbtpletledafter717193
• Rim Joisl Detatl Options selection sheet (bldgs wflh 3 a kss uniLa)
DATE _ ?f2I ?-IO ? T VALU/iION
JOB SITE ADDRE55 ??G?/ ?/Ce? (S P P
If MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWN
Tl'PE OF
FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT ?C} d _07e
PHONE#6bI
ADDRESS_ s42) oa7 P ZIPCODE
PAGER #
CELL PHONE #
PAX #
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
1 W ' d
(check one) - Residential Ventilation Category
- Energy Envelope Calculations Submi ,_ r'S
?s
_ MINNFSOTA RULES 7672 ?
- New Energy Code Worksheet Sub ?
Plumbing Contractor. _
Plumbing System Includes:
Mechanical Contractor. _
Mechanical System Includes:
Sewer/Water Contractor.
_ Water Softener _
_ Water Heater _
No. of Baths
Air Conditioninbn
Heat Recovery System
All above information must be submitted prlor to processing of application.
Phone #
Phone #
Fee: $70.00
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 Eogan Ordinanc /-
Signature of Applicant La 0? (L?¢ /-'o
Iawn Sprinkler
No. of R.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 1101
Address 4 6 6 9 N i c o 1 s P t ZIP $$IZ_,
IAt 7 Blk 1 SUb Cedarview 2nd Addition
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: G-?? c) Yes No Inspector:
Final grade (6" from siding) ?
Permanent steps (gazage) X-
Permanent steps (main enhy) ,Y
Permanent driveway
Permanent gas ?
Sod/Seeded grass
Trail/curb damage
Porch J?
Basement finish ?
Deck ?
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 6814645 before working in righ[rof-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
Oltvcse\/
Siteaddress: 1410kel N1CUlS ??• . Lot_I Block 1 Subd.l.ICAaYUi-PC,U
,
is On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air
tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be
submitted prior to issuance of a Cert'rficate of Occupancy. ?
? This structure: Is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
_ This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE
waterHeater M?? pp_ooSS$? -S/ y(ooo
v
Fumace I/l _ •
?}'c1'1r .??, {?
n'l gt0
/Bo?l? ??1 / '
f /?„-Q [ d
Dryer
?
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
YES No
Kitchen Idtchen pu cT Ve4e
Batnroom 1 ce: I ;, r Ao-
Bathroom2 Q:I:n 62 r00..1 X
Bathroom 3
¢.?.n
?r00.h
b?
Bathroom 4
Other
FlREPLACE S
LOCATION
GAS
WOOD
MANUFACTURER
MODEL
BTU'S VENTING
DIRECT ATMOS
I Q & G/o GO V6 000 3Sooo
MAKE-UP AIR MODEL TYPE CFM's
y2 h mfh' Ga n 54'+- ? G°IV UNn rl R r Fl : EYC?.?m E'' ?-2 3
Gov?bv5?lc?? a,. r-
I hereby acknowledge ihat the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan
requiremenis.
• ` q,Z 7_2o
Signature nA C'_ f=ra r? Date
L I q ?j ?h. ? f
Company Name
` This form is the responsibility of the General Contractor.
-4 J-I / v U S?
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
cmr oF EAcaN
3830 PILOT KNOB RD - 55122
" I•o I ? 851-881-4875 (o Q
Sa5-u0
> 3 reOsTered qle auveys ahowinp sq. ll d lot, sQ. R. d house
antl yQ rootad aroaa (2D'b maxlmum bf covemae albweel
D 2 eaples o1 M? (MOw bean R window qzes: Pouretl hW. desipn: etc.)
D 1 tet ot enerfly ccdculaliqu
> S caplet oi hae preservaHOn plan H bt plalfeC aRer 7/1/93
DATE: I? GiA.Ti '7-ADO
DESCRIPTION OF WORK: Nl W CDY1S+vt.Lc?
Remodel/Re "vltse\I
1
2 coplas of plan
t set o1 energy catcWaHOns ror heatea addiHOna
1 sHe wrveY for exleAa addiXOns R tleeks
CONSTRUCTION COSf:
SiREET ADDRESS: 4AUJI96 1S I CbI S R-.
LOT: -1 BLOCK: I SUBD./P.I.D. 9: ?PCIQ V(;l ? P-t .U 2??1?
Name: Phone 1I:
PROPERIY twf Flrar
OWNER
Sheet Address:
CHy
Stafe:
Zlp:
/? , 64 /?,?-? 'I??n
. Company: ?.U??_ ?' l ??p'!'? f S Phone ?: ?`t10`?"1
CONiRACTOR ?n?? I (area code)
Street Address: ?"?-12P l LLVeli1 I If, Tj I11 GI ucanse a I,20Exp. 0 ?
Cly Stafe: Zip:
ARCHRECT/ ? I
ENGINEER Company: IQcI Qi bh4 ++tNl/1 e S Name: I 1,1?rnin,, 1.a l?L^u-?.11 ??--
Telephone A: ( "I6?) .iA. 066
Sheet
CHy
State:
RegishaNOn Y:
Sewer/water licensed plumber (N Installina sewer/water): ?2
I hereby xknowledpe Mqt 1 have read this appiication, state tlwllheYn o pec
of Minneaota Stalutes and Cify of Eagan Ordinaneea /?
Slyrwlure ot
Zip:
Phone #: ( l nr"J 11 ' 1
and ogree b compty wllh a6 app4oable State
OFFICE USE ONLY
CeNficates of Survey Received ? Yes _ No ' /
Tree Preservation Plan Received _ Yes _ No ? Not Required
i iAY 10
/ b
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
0 01 Foundation O 07 05-plex ? 13 16-plex ? 21 Poroh (3-sea.)
A?--02 SF Dwelling O OB 06-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 01 of _ plex ? 09 07-plex ? 18 Deck 0 23 Poroh (screened)
0 04 02-plex ? 10 OB-plex O 19 Lower Levet O 24 Storm Damage
? OS 03-plex ? 11 10-plex Plbg _Yor _N O 25 Miscellaneous
? 06 04-Plex ? 12 12-piex ? 20 Pool ? 30 Accessory Bldg.
woRK nrPE
)2? 31 New O 36 Move Bidg. O 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)' O 44 Siding
O 33 Alteration O 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair O 42 Demolish (Foundation) ? 46 Windows/Doors
" Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code v k # of Stories 2 sq. ft.
No. of Units i Length c 6 sq. ft.
No. of Buildings 1 Width 34 Footprint sq. ft.
Const. (Actual) vA/ Basement sq. ft. )OyH Census Code
(Allowabie) Main level sq. ft. iova MC/ES System
UBC Occupancy sq. ft. '? o o City Water
Zoning sq. ft. Sti 0 Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $ ?0o0
Surcharge
Plan Review .x ¢'
License ?/? ?,LI 1 o?'N k j 5 - I 5jS Ix
MC/ESSAC M?lr /UH?f k Sy =?'56?376
City SAC 4
WaterConn. z^d I4...,I 7oUr-, Sy =37,frGfl
WaterMeter G? w}t
Acct. Deposit S,10 Ay/` ,rjjyNd
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Tota,: '?' L c, o• 9 9
? 31 Ext Alt - Muiti
O 33 Ext. Alt - SF
O 36 Multi
I63N
?o r
SAC Units
°k SAC
• -
410, $PctT IGA'AD
st•rl: ADDItL•'SS
L-'X4'GItIUIt IiNVLi[.OI'G AVlili/1Gli '•U•' COtaf'U9'ATIO17
CoNTTtnCTOa Colleqe i v c' nctruction G -
DATC M O 2-C(X) PIlOt7Ii 44444mMA ?(A" 10060
Determine workiny squarc foot•aqc of cach.
1. 'fotal exposed •.+all area ....... LIyS10 :q. Et. x .11 . = r q 1• q
2. Total roof.cciling area ....... sy• Ct- x '025 = Z7•1
Total exposed wall area above floor = / 7qS•o '
a. Total aall window area .................................... I 2q•q
b. Total door area ..............................:............ 4/0• g
c. Total sliding glass door'arca ............................. 31-21
c1. Total firePlace N.]LL area ................................. O
e. Total wa11 framing area (averaqe 10e) ..................... /7Y-s
f. Total net vall area above floor ........................... sj7 •1
q. Tota1 rim joist area ......................................? II40.(o
T.5>tal exposcd foundation area = '( 3'3 h. Total foundation WindoW area .............................. O
3•3
i. Total net foundstion area above gradc.....................
Getermine "U" value of cacYi wall seqment.
a lZy,q X ..U.. .SS = !v$.
b. yd.g x ..U.. 3•1
x ..u.. • S s' = 17. z
d_ O X „V ' 0 ? O
e. f 74? 5 x ••u•• ,12. = 7n . 4
r-.-L3.?SJ-- " ..U.. , 0 2_ ° 57.7
??. f l b• ? . .,?,,, . o y7 S.S
93•3 .... . 083 7. 6
1 ......................................Total
IC itcm qJ if-, thc samc as, or Les:; than iCCm ql,
' you ti?? t:hc i.nCent
(l41
4? ??f ??
+'
of suc 6006(c)2. ,C,la„ • 3 (go. `? L m-
9.? .
/
? S0 G (P O D fi CC ? Z
Total exposed _roof/ ccilin(j area = /O O
j. Tqtal skylight arca ....................................... O
---
Y.. To[a1 root/ccilinq Ersniny aroa (avcra(ju LO't.) . . . ...... ... . /O6•?_
1. Tota1 net insulntcd roof/cuilinli aec:a ••••••••••--•••••••••
Detcrminc "U" valuc for cach roof/cciliny scymenr.,
Q x "U" Q = O
k. ?o.S.y x ..U.. ,ozs = z.7
i. 4-7S.L x •.U.. .pzl = Zo•S
4 . . ... ................ • • • • • • • . .. ....Total = 23.
If total of 04 is the same as, or less than N2, you have met tlic intent of
SBC 6006 (c) 1. C14? • w Z (?Z'
?t
Alternste euilding Envelope Design
To utilize ttlc total envelope system meth«l, chc values ?.s[a61ish•:d by tlie
sum of items R3 and 94 sha11 not be greatcr than G}ie sum o° itemy F1 and K2.
?. l9r.9 + z. _zr9. b
a. 18m.? + a. 73•z = Zo
?01•8)
?,,.o 4.0.. ..u..?.-?'
r
L
h
u
?
?
C
0
O
o ?
?? ?
? ? ?
?? ?
e?/ o ?
?/ ? ?
m', ? o
?'/ ? ?
d( ? ?
?? ?
?
? ?
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTY LEGAL 1or 7,f Lael? l L?EQai/IEG/ ZNO 4G?nr?
DATE OF SURVEY: 5''7-00
LATEST REVISION:
DOCUMENTSTANDARDS
• Registered Land Surveyor signature and company
• Building Permit Applicant
• Legal description
• Address
• North arrow and scale
• House type (rambler, walkout, split w/o, split entry, lookout, etc.)
• Directional drainage arrows with slope/gredient °h
• Praposed/existing sewer and water services 8 invert elevation
• Street name
• Driveway
• Lot Square Footage
• Lot Coverage
ELEVATIONS
Existin
?? ? • Sewer service (or Proposed)
? ? ? • Property corners
?? ? • Top of curb at the driveway
pl ? o • Elevations of any exdsting adjacent homes
?;/ ? Adequate fooUng depTh of structures due to adjacent utiliry Venches
Prose
/
0 ?
0 • Garage floor
;/? ?
? • Firstfloor
i
d
l
V
? ? n
ow)
• Lowest exposed elevation (wa
kou
w
? ? • Propetty comers
c? ?? • Front and rear of home ai the foundation
PONDING AREA (if aodicable)
/
o / ? • Easement line
? o'/ ? • NWL
? d/ ? . FIWL
? ?5 ?
? • Pond # designation
? ? • Emergency Ovefiow Elevation
4'/ o ?
m' ? ?
f? G ?
¢S a ?
W? o
? r?/ ?
DIMENSIONS
• Lot IinesJBearings 8 dimensions
• Right-of-way and street width (to back of curb)
• Proposed home dimensions induding any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent foolings)
• Show aA easements of record and any City utilitles within those easements
• Setbacks oi proposed sVucture and sideyard setback of adjacent existing atruGUres
• Retaining wall requirements, if any z
Reviewed:
March 1999
CqAI,IgLpGPRMf.FM
, . • Surveyor's Certificate
SURVEY FOR :coLcacE arr
DESCRIBED AS ;Lo! 7, Block 1, CEOARVIEW 2N0 ADDITION, City o( Eogon, Dokpto County,
Minnesoto ond reserving eosements ol recard.
7"W
l.T
A ,o- - - - - - - - - - - - - - - - - - - - - - - ------ -----------------
?
° ?
--
_
W I
I i
--i
'
Ln
Co 93 0o
, f9A9'?o I ?
937
0:..
Ln
94, 4)??? . cn
94D.5 ? ? ?
?
? ?'-----42.0 _
O
I
oyc b 1 o ? r9?13.2 ?
d` OO ? I I r+i
J
• \? q?? ?I 4ry6/? I ? O
? n?
S6? 4°82
99
o
4953
0
°
`
? yo cP
o
? /
so,' qaa2 cM29
9yg 263'S
?J6 \>k/ti?. ? ? n
^ ?
? ?Z
992
5
RE° fl E ^?J?oa / f/93.q
?,? .
I
13 ? i
q
Dat:e? i Ezist. Home
z
fi?;
?717y
' ros = sso.s
?
?
-
.
Tf?3i?dl!'FiP.ZZ?'?
'x LEPI'. ?Ci
Q
45
, ?
LOT SQ. FOOTAGE = 18,777
HOUSE SQ. FOOTAGE = 1,636
LOT COVERAGE = 8%
PROPOSED ELEVATIONS
BENCHMARK, 7NH& I-/I
Top of Foundotion = qyc%s
Garage Floor =qqb,2
E?¢?=95o,iq
Bosement Floor = 937:1
Aprox. Sewer Service = 935,11
Proposed Elev. _ (Z-D MIN. SETBACK REQUIREMENTS
Existing Elev. _
Droinaqe Directions =- - Front - House Side -
Oenotes Offset Stoke = • scnLe: i incn ? 30 leet Reor - Garoge Side -
JOB N0:
HEDL[/ND I HEREBY CERTIFY THAT THIS IS A TRUE ANO CORRECT REPRESENTATION OOR-199
Of THE BOUNOARIES OF THE ABOVE DESCRiBED PROPERTV AS SURVEYED
BY ME OR UNDER MY pIRECT SUPERVISION AND OOE$ NOT PURPORT TO 800K: PACE:
PLANNINC 6NCIN66RINC SURVBYlNC SHOW IMPROVEMENTS OR ENCROACMMENTS, EXCEPT AS $HOWN.
2005 Pin Ook Drive
Eagon, MN 55122 DATE CAD FILE:
Phone: (651) 405-6600 R P. UHOGREU, Ca SURYEVOR CV2
Fox: (651) 405-6606 MWN 7A UCENSE NU R 14576
RECEIVED MAV 2 3 2000
I L --7 BL CITY USE ONLY
( I
1 n?
sueo. C eclo,r
RECEIPT#: J 3 C?? -7S
RECEIPT DATE: rJ' I s-OU
PERMIT#
2oo0 PLUM$INfi PEfiMTl' (R:S1DwN17i4L)
crrY or easm
3830 Pu.ar xxos xu
f.E1&AF. MlY 5512E
681-6$1-4875
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
A backflow preventer for underground sprinklersystem
FIXTURES
EACH
TOTAL
Alterations to existing dwelling - minimum fee
Describe:
$ 30.00 I
Bath tub $ 3.00 x = $ °O-
Floor drain 3.00 x f = $
Gas i in outlet ' minimum - 1 3.00 x 1 = $
Hot tubls a 3.00 x = $
Kitchen sink 3.00 x I = $?-
Leund tra 3.00 x 1 = $
Lavato 3.00 x 2 = $ -
SB fIC $ Sl@fTl newlrefurbished 'requires MPC Iic. 75.00 X = $
Se tiC S Stem abandonment 30.00 X = $
RPZ new installatioNrepair/rebuild 30.00 X = $
Rou h o enin 1.50 x 3 = $ t-1S'Q-
Shower 3.00 x I = $ 3rO-
Under round s rinkler if dwelling is under construction 3.00 x = $
Under round s rinkler if ezisting dwellin 30.00 x = $
Watercloset • 3.00 x Z = $ lfl -
Water heater 3.00 x I = $ !=
Water softener If dwelling under eonstruetion 5.00 x = $
Water softener if existing dwellin 30.00 x = $
Water turnaround 30.00 x ---- _ $
State Surchar e .50 --> ----> ---> $ .50
To±al -> --> ---? ----> $
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
---------------------------------------------------------------- -----------------------------------------------------------------------
I hereby acknowledge that I have read this appliration, state that the information is correc[, and agree to comply with all applirable City of Eagan ordinances.
It is the applicant's responsi6ilily to notify fhe property owner that Ne Ciry of Eagan assumes no liabiliry for any damages caused by Ne City during ils nortnal
opera[ional and maintenance activities to the facilities consWCted under this permit within City property/rightof-wayleasement.
SITE ADDRESS:
OWNERNAME:: frm le[-f. t J'(u oCYyy-S TELEPHONE#: 1012 k4lr,q-1"90Zo
(AREA CODE)
INSTALLER NAME: ??P42- TELEPHONE #: t6l UZ?J' I I U?
STREET ADDRESS: I LI`??? fU (AREA CODE)
, ..?
arv: ,n T- sT,ar? : N ziP: ssLCoB
SIGNA URE OF P RMITTEE
CITY USE ONLY
LOT ri BL ( PERMIT #:
susn. Gedc?rvi e,?J ?"?' aEceipr a:
Date:
RECEIPT DATE:
W o?a7
I 3c) 3-7 s
?- a -oC)
2000 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT FQIOB RD
EAGAN LM7 55122
651-681-4675
Complete this section onlv if you are installing HVAC in a single fatnily dwelling, townhome or condo under
construction and not ownedoccupied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @$3.00 ea.)
$ 30.00
6.00
3 &
State Surchazge .50
Total $ 33sO-
Complete this section only if you are remodeline, addina to, or reoairine an existing single-family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
New Alteration
_ Furnace
_ Air exchanger
Reminder: Call for inspectiorrs
SITE ADDRESS:
_ Repair _ Other
_ Air conditioning
Other
Fee $ 30.00
State Surcharge .50
Tota1 $ 30.50
OWNER NAME: PHONE #: W Z - t40 - LP-IM
(AREA CODE)
INSTALLER NAME: ? Z- PHONE #: n S( -C-F7 7? - I I U L?
(STREETADDRESSI .I??S `?''` CODE)
CITY: V?__C? f(c11`Sl pY? -1 STATE: ? ZIP:_K; ?6a
,?i?J ?d 'bJ 1b?3bHl'I k1Vtk?111 I'IVKI?Hbt .` ??y1-r?/f? ????
j x1 ,' I
.SurveyQr :s Cereate
;..
SuRVEY FOR :couAcE arr ,
DMeRMED •AS :tot 7, 6fock I, 6f0ARbCW 2ND AOOIIION, Clty of Eopon, Ookoto County.
' Minnaaota an0 reserving eoaqnente o( reeord. ?' •
j. ; .
? .. . , . .
I
: ,
. \
. . ? c?ll?t. Home ? i
??' ' ? T09 r 950.5 ?
? r
LOT SQ. FOOTA.GE: =.180777,
OUSE SQ. FOOTAGE--1;636
L O T CO VERA GE = 89" ,
i. , .
,.. .
PRq1?ASED ELEVATIONS •
_-!
Yop',Qf Foundoki BENCH?IARK,
on oq?k5
Gor?iqe Floar • =9a6,2 ?kvz950.1q
B
•-?
asfEment Floor o 937,-l , , •
Apr64. 5ewer Service = 935,1!
Proppsed Elev. = Q " Exisi+ng Elev. MIN, SETBACK REQUIREMENTS i
4 . . I
Droiwn;ge, DirectiOns = . , • Front - HoWSe Side - Deno;tes O(fset 5tcke ?. u?LE 'I wtn -?30 r.., Reor - Garage Side- ?
-: . .
? ' - JOB NOi I
, i . . . ... .
1 HEREBVCERTiFY f?Ai TMIS IS A TpUE u10 CORISECT NqPpESENTaT10N 6OR-199
???L??? oi .THE BWNDU+IFs OF TNE ABOVE DESUtiBED PROPERir As SURVEirEo
8Y MI OR UNDEA U1' DIRECT $UPENVlSION ANO OOES NOT PURpORT TO
PlAN?'(INC 6.yC71ydZRJ1N0 SURY6Y/,NG _H OW IMpROVEMEAiS OR ENGRDACWAENTS, (XCCPT AS SNONN,
i','2005 ain Ook Dr(ve . ' ? ? .
. Eaqon. MN 55122 OatE
lPdonc (851) 405-8600 . A . ?NOptEK u Sunv[rpA
'ToM: .(6St) 409-6606 . NiNr+ T? ?ICENSf NU R t4J7e
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PERMIT# LtriOq 3
RECEIPT DATE:
2002 MIDERTIAL PLUM$1Nfi PEgM1T AffLICATION
crrY oF EAsAx
3$30 fILOT KAOB iiD
gAHAA, MA 587 EE
651-6e1-4e75 Please complete for: single family dwellings, townhomes and condos when pertnits are required for eac it,FEB 2 2 2002 I
backflow preventer for irrigation system n
/ By ?J
SITE ADDRESS: ?(
?6? ? , / Co 4S r -7-
OWNER NAME : &2/aa-) ? O-,Q.Se-ei TELEPHONE #: b&l 4?1Y '._.c:/
(A EA CODE)
INSTALLER NAME: 5? TELEPHONE #l2 6,3 77C
?//? ,p (AR CODE)
STREET ADDRESS: Y?J6'?I I A.I I CD X
CITY: ?? STATE: LI N ZIP: Jr ?2
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply
• MODIFICATIONIALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
?
ZAdding fixtures lower levels r room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of sep i em.
_ Water turnaround - existing dwelling unit (+ 5/8" meter if needed -$118)
Other:
_ RPZ: new installation/repair/rebuild $ 30.00
_ lawn irrigation system
ReplaCemenUadditional: _ water softener _ water heater $ 15.00
State Surcharge $ .50
rotal n / $ 50
I herebyacknowiedge that I have read this application, state that the inforcnation is corteG, and agree to comply with all applip6le Cityof Eagan ordinances. It
ie the applicanPs responsi6ilityto notiry the property owner that the Ciry of Eagan assumes no liability for any damages caused by the City during its normal
operational and maintenance actlviGes to the facilities constructed under this permit within(`??/%pproperty/right/-p?f-'wayleasement. ?J 7 [?
//.sn/2h //?-.? /Jn )
SIGNATURE OF PERMITTEE 1/0
RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN
l C? `7 Q V 3830 PILOT KNOB RD - 55122
651-681•4675 n o ?
NewConeWCtionReaWremenb RemodellReoairReauiremeMS
• 3 registeied site surveys showiig sq. k. at lot, sq. 8, af house; and LO roofed areas • 2 copies of qan
(20% maximum bt coverage allowed) • 1 sel of Errergy Calculatlans for heated addNOns
. 2 copies of plan showirg 6eam 8 window s¢es; poured found desgn, etc.) • 1 sde savey for rxterior additions 8 decks
• 7 sel of Energy Calculatlcns • Indicate'rf hane served by septic system for additions
• 3 copies of Tree Preservatlon Pian'rf lot plaCed after 717/93
. Rim Joist DeWil Options selectbn sheel (bldgs with 3 or less unils)
DATE
JOB SITE ADDRE;
IF MULTI-FAMILY
PROPERTY OWNI
TYPE OF WORKz
APPLICANT ?
ADDRESS 41!
PAGER #
CELL PHONE #
FAX #
rrEw RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Plumbing Contractor: _
Plumbing System Includes:
_ Water Softener
_ Water Heater
_ No. of Baths
Phone #:
Lawn Sprinkler Fee: $90.00
No. of R.I. Baths
Mechanical ConNactor.
Mechanical System Includes: _ Air Conditioning
_ Heat Recovery System
Sewer/Water Contractor.
Phone #
Phone #
Fee: $70.00
All above information must be submitted prior to processing of applicaGon.
a ? 1 '?k 2'00 a-
I hereby acknowledge that I have read this application, state that the information is 66rrect, and agree to comply
with all applicable State of Minnesota Statutes and City of Eag tnam;mtS??
Slgnature of Appflcan B?!
VALUATION
HOW MANY UNITS?
?
/ S/`) FIREPLACE(S) _ 0_ 1_ 2
PHONE#
CODE
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
Updated 2002
OFFICE USE ONLY
? 01 Foundation ? 07 OSplex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Aft - Multi
? 03 01 of _ piex ? 09 07-plex ? 17 Garage ? 22 PorcFVAddn. (4-sea.) 0 33 EM. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Parch (screened) ? 36 Multi
? 05 03plex ? 11 10-plex }?19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12
12-plex / ?
Plbg;KY ar _
N ? 25 Miscellaneous
? 31 New x 35 Int Improvement ? 38 Demolish (Intenor) ? 44 Siding '
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair '
? 33 Alteration ? 37 Demolish (Bidg)' ? 43 Reroaf ? 46 Wndows/Doors
? 34 Replacement •Demolition (Entire Bldg only) - Glve PCA handout to applicant ?
Valuation ? CXci ? Occupancy g-_s 'L "I MGES System
Census Code Zoning p D Ciry Water '
?
SAC Units
Stones
, Booster Pump
?
Nbr. of Units -? Sq. Ft. PRV
Nbr. of Bldgs ? - Length Fire Sprinklered
T
f
v ' NJ ?
ype o
Const Width
?
x
x
Other
_ Pool Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
Approved By
Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
aty sAc
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies a . O ?
Other
REQUIRED INSPECTIONS
Footings (new bldg)
Footings (deck) FinaVNo C.O.
Footings (addition) Plutnbing
Foundation
Drain Tile
Roof Ice & Water Final
Framing
Fireplace _ R.I. _ A'u Test _ Final
Insulation
FinaVC.O.
?
? HVAC
?G U?-? ??-?7G-? ?
Total _ 11 5 .U U