4576 Oak Chase Rd
BUILDING PERMI
To be used for , 5 F IJ
11?',?5
3830 Pilot Knob Ro d! P.O. Box 2?-A199, Eagan, MN 55121 .-
PHONE: 454-8100
T Receipt #
Site Address 4576 OAK CIIASE RD Erect liK Occupancy 1i j
Lot- '
VAh CiiAS
Block I SeciSub E 5`i'h Remodel ? Zoning
_
.
Parcel No. Repair ? Type oi Const V
Addition ? No. Stories
? Name JQf1NS01r`--k1:ILX-?f3 CUNS
Move ?
'i'
Length 64
13301 a 10RGAIi ATi7E SO
Add Demolish ? Depth
o
3 ress Int Impr. ? Sq. Ft
City BUR'..;:;V0f":c: 894-9304 Install 0
= o Name
0
-c Address
Assessment I Permit Z? 515 _ 50
Water &Sew. Surcharge (.6- 50
? ¢ Police
F = Name Fite
? ?
z Address Eng.
< W Ciry Phone Planner
Plan Review257-75
SAC 575 _ vQ
Water Conn. S O 0 - 00
Water Meter_ri.3_..50
Road Unit 29 a- 00
I hereby acknowledge that I have read this application and state that the gldg. Off. Z/Z 7/$ Tr. PI.
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eaqan Ordinances. APC Parks
Signature of Permittee ??sfG------?---- Var. Dete Copies
Total $2.424.25
A Building Permit is issued to: 30HNSOII-RE tLA14D c;OtiSTRUCTION CO on the express condition that
all work shall be done in accordarrce with all applicablg State of Minnesota Statutes and City of Eagan Ordinances.
Building Official ?=L I, t.l -
x:..,
I I , prrmll No. PermN HoW-r DOh TeWphonM 8
PIYTbNIg ?? LJ Ip
IH.V.A.Q.
Qc?ti
y ? ?p
JE"c
?j S?j
I Cti ?$
-
Softener
I
inspscUon Date Inap. Commanls
Footlnqsl -?1
Footlnpsll
Foundatlon
Frsminq
RooHny
Rouyh Plbp.
Rouqh Htq.
r 9 ?
Inwl.
Fir?plece
FMN Hty. 41
Flnsl Plby. . ?
&dp. Finsl ?/ a • /,? - ?7 !.[?.o
CeA. Oco.
ff t
PERMIT #
DATE (4 CITY OF EAGAN
RECEIPT #
PLUMBING PERMIT
454-8100
FEE y" , ` -?
S/C J Z
MINIMUM RESIDENTIAL FEE - $10.00 + $.50 TOTAL ysJ-2)
MINIMUM COMMERCIAL FEE - $20.00 + $.50
1. Bldg. Type: Res _2[_ Comm Inst 2. New Add
3. Total Bid Price 4. Job Address -/?
Lot _2 Block Z_ Sec
s. contractor ? aX' ?v e- rXdl 0 r,)Ke_.
(Name)
7. Contractor Phone #
NO. FIXTURES
? Water Closet - $3.00
?Bath Tubs - $3.00
?Lavatory - $3.00
:EShoyRer - $3.00
_!L-Kitchen Sink - $3.00
-Urinal/Bidet - $3.00
NO. FIXTURES
/ Laundry Tray - $3.00
7Floor Drains - $1.50
/ Water Heater - $1.50
Whirlpool - $3.00
7Gas Piping Outlets - $1.50
_Softener - $5.00
Alter Repair
5. Owner
i.:, -.9cr_ __f,
(cih) 2iP)
NO. FIXTURES
-Well - $10.00
Private Disp Syst - $10.00
--TRough Openings w/o
Fixtures - $1.50
COMM./IND. RATE - 196 OF TOTAL BID PRICE PLUS $.50 STATE SURCHARGE FaR EACH $1,000 OF FEE.
Signed: for ? e??.-«:.; ?' ?? Y •. ??,
Approved Inspections: Date Rough Insp. Date Final Insp.
I,
PERMIT # ? CITY
C
RECEIPT # MECHAI
4
y MINIMUM RESIDE
DATE •
? g? MINIMUM COMME
PERMIT
FEE
Ie'A" / .
S/C
- $10.00 + $.50
- $20.00 + $.50
1. Bldg. Type: Res 9 Comm Inst 2. New x Add
3. Total Bid Price y:14 4. Job Address
Lot ? Block / Sec
6. Contractor
?
TOTAL _
Alter Repair
5A.. w
(Name) (Streeq (City) (Zip)
7. Contractor Phone # Yy7 "S)e3 Y
RESIDENTIAL HEATING - 01-100,000 BTU's -$24.00. Each additional 50,000 BTU's or fraction -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONSlALTERATIONS -$10.00 minimum fee
X HEATING ? VENTILATING HOT WATER STEAM ? AIR COND.
AIR PIPING PROCESSEO PIPING AIR HAND. EQUIP. RtFRIG.
'r RES. GAS PIPING OUTLETS -$1.50 TANKS: LP. UNDERGROUND OTHER
COMM./IND. RATE - 1% OF TOTAL BID PRICE PLUS $.50 STATE SURCHARGE FOR EACH =1,000 OF FEE.
Signed: ?-Lfor
Approved Inspections: Date Rough Insp. Date Final Insp.
r-ITY Of EAGAN Remarks
Addition ' OAK CHASE 5TH ADDN ?ot ? 2 Rik
Owner street 4576 OAK CHASE ROAD
hIN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK ZZ ?
SEWER LATERAL ZZ
Z
WATERMAIN
WATER LATERAL
WATER AREA , 1984 155.00 155.00 C008422 4-26-83
STORM 5EW TRK 1984 272.50 " 272.50 CQ $422 4-26-83
S70RM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
/,/,7 - Oa?oo - oir - 77
GITY OF EAGAN Remarks
Aiidition ' OAK CHASE 5TH ADDN Lot 2 Rlk 1 Parcei 10-53504-020-01
Owne? street 4576 QAK CHASE ROAD State EAGAN MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
i--
STREET RESTOR.
GRADING
SAN SEW TRUNK 1984 41-79 5
SEWERLATERAL
WATERMAIN
*WATER LATERAL ?L7- 1984 54.82 90.96
WATER AREA Z
8 155.00 155,00 C008422 4-2 -83
*STORM SEW TRK 1984 S
*STORM SEW LAT 1984 5
STORM SEW TRK 1984 272.50 272.50 C008422 4-26-83
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
CITY OE EAGAN WATER SERVICE PERMIT 3830 P31ot Knob Road
P. O. Box 21199 PERMIT NO.: !
Eagan, MN 551;1 DATE:
Zoniny: _ F1 No. of Units: I
Owner, J0hjison-i:eilan ,on s t .
Add?ess: Sn. Meress• 4 r ?, a Ic C ase ?,aad _,?. Oa ase t ?
Mumber:
Metsr No.: ion CFwrpe: p' j
Siza: " +t Devoatt: . Reader"No.: 05N T
1 nm to eemply MMii
met
By 6A 4_.
Qate of I nsp.:
; y f,:r _
Daft Poid:
CITY OF EAGAN
3830 Pilo* Knob Road srim s?vKz P"IT
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 pATE;
ZO^i^D: No. of Units:
Owner;
Addrcss:
Site Address:
Plumber.
1 rlne Ir e? olr wYb !M cy d yNm Coru»cfion Chorgs:
"Mnom AcaouM Deposit:
PrrtNt Fer:
Surthorpe:
BY Miae. Charpp:
Doh of Insp.: Tatal:
DioM Pold:
)F EAGAN WATER SERVICE PERMff °
'ilot Knvb Rosd
ox 21199 PERMIT NO.:
MN 55121 DATE:
' Na of Units:
Sitr Address: , t; C'3r. ';ha3e
Plumber. e£iue ? uff_ ?i
Meter No..
Size;
Recder No.: -
1 qm to oowy wqb Nw Ci1r af Eavea
OrAMmom.
Ce.inection Cho.qe:
AcaourM Depostt; _
Parmit Fee:
Surchorpe;
Misc. Choryss: _
Totnl:
Date Paid:
By
Dote of Insp.:
RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4875
NewConshuctlon Reauirements RemodellReuairReaulraments
• 3 regisfered site surveys showing sq. fL of lot, sq. ft. of house; an?ll roofed areas • 2 caples of plan
(20% mazimum lot coverage albwed) . 1 set of Energy Calculations for heated additbns
• 2 copies of plan showing 6eam & window sizes; poured found design, etc.) . 1 site survey for ezlerar addNOns & decks
. 1 set of Energy CalculaGons . Indicate rf home served by sepUc system for addiUons
• 3 coples of Tree Preservation Plan'rf lot plaBed after 711193
. RimJoistDetailOptionsselectlonsheel(bldgswAh3orlessunAS)
DATE /G- 3.0 - oi
JOB SITE
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER 94,_, Ac/.,-
TYPE OF WORK /ASa-N, G05 .O/ rtcq? vr.-? FIREPLACE(S) _ 0 JCl _ 2
APPLICANT PHONE#
ADDRESS ?J (,J, /GjR^.. S-t (/24c.w„e, /LW ZIPCODE SS3f5'?
PAGER # ?/a ?35. G?7?/ CELL PHONE # FAX # 962
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RUI.ES 7670 CATF,GORY 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:
Mechanical Contractor.
Mecharucal System Includes:
Sewer/Water Contractor.
_ Air Conditioning
_ Heat Recovery System
Phone #
Fee: $70.00
Phone #
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that ihe information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordina,..5 ?
Signature of Appl nt 'IM ,/
_ Water Softener
_ Water Heater
No. of Baths
y
VALU/RION .200D.
Phone #:
I,awn Sprinkler Fee: $90.00
No. of R.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updaled 11D1
• CASH RECEIPT •
CITY OF EAGAN
P. O. BOX 21-199
EAGAN, MINNESO 55121 ?
,- / pATF.? 19 _
iy I/.,U
AMOUNT I f /S?S f-'
? / h_POLLARS
[]CASH ? CHECK ' oa
? ??Y6
???? /?u
FUNO AMOUNT
b " / 30 ?v
Thank You
BY
N_ 60861
White-Payers Copy
Vetlow-Posting Copy
Pink-File Coav
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N°- 11595
PHONE: 454-6100
BUILDING PERMIT qeoeipt g fg.D Y a'?
iobeusedfor•SF DWG/GAR Est.value $133,000 oate MARCH 11 1986
4576 OAK CHASE RD R
SiteAddres,4 Erect LT Occupancy
Lot Z Block 1 Sec/Su6. OAK CHASE STH fiemodel ? Zoning
Parcel No Repair ? Type of Const V
. Addition ? No.Stories 64
a Name JOHNSON-REILAND CONST Move ? Length
---------- $
Demolish ? Depth
3 Address 13301 MORGAN AVE SO l
t ? S
F
° ciry BURNSV?P 894-9300
n
llPr.
I
t
?
q.
L
ns
a
' o Name SAME
$ Q Address
City Phone
?a
F W
Name
u Address
u
a W Ciry Phone
I herehy acknowletlge that I have reatl this application and state that the
information is correct and agree to comply with all applicable State of
Minnesota Statutes and Ci of an r na ces.
Assessment
Water & Sew.
Police
Fire
Eng.
Planner
Council
BIdg.Off. Z?Z??8f
APC i
Var. Date
Signature ot Permittee- JOHNSON-REILAND CONSTRUCTION CO
Permit ? 515.50
Surcharge 66.50
Plan Review 257.75
SAC 575.00
Water Conn. 500.00
Water Meter 63.50
Road Unit 290.00
rr. PI. 156.00
Copies
Total $2.424.25
A Bwlding Permit is issued to: on the ezpress condiUon that
ali work shall be done in accordance with all appl' t of Mi neso Statul? es and City of Eagan Ordinances.
Building Oflicial-
?
id q-'O -(%/ , ? /?/Z
one "1wi1`!vo316 G?? , /°\
6 L-G"/L4..r-?- ?5 4 4/ ?
Re uest Date
? Fire o. Rouph--n Inspection
ftequ?r ?
fleaAy Nnw
ill Nn1ifY ??spec-
? ?a
Fl
Wh
?NO on
?
eatly
icensed Electrical ConVactor I hereby raQUast insoection oi ebove
? Owner - electrical work installed et '
Siree Address, eon or H No.
.? City
E- G'.4?
ecbnn o. Township Name or No. Range No. Cnunty n ?
/> ?C?? II??
Occ ant (P INT)
0 /? SD !?
?? L i?- Phone No.
PowQ pplier Address
Electrical Conha(c't'?or ?ComO??-?t+b,kn
11 j T ?..Ijy, LJ1.L??S?.'lJ C hacY ?s LiCense No.
M&ATTWA 1 Jres ?o
4 Is[ionl
N 55124
Autho u or/ wner Making Installation) Phwe Nvmber
MINNESOTA STATE BOAND OF ELECTflICITY THIS INSPECTION flEQUEST WILI NpT
-''?i¢?ey 91dg. - floom N497 eE ACCEPTED BY THE STATE BpqRO
sa y Ave., St. Peul, MN 55104 UNLESS PflOPEH INSPECTION FEE IS
?, ill . ENCLOSED.
? ??o
6
? 5
503 .o.?
Pequesl Date ?
??? Fire No. Rough-in Inspeclion
-
RQQ
tl'
(Reetly Now ? WIII No[ify Inspector
Wh
n q
tl
?
? a
Ves e
ea
y
Ib4teensed comractor E) owner hereby request inspedion of above electrical work at:
Jo5 A
tltl
ress ISVeeI. Box or Route No.I City
,
1
l?? ? ci ?
Section No. Township Name or No. Range No. County
OccupantiPqlNTi
r Phone No.
'??L
Power SuppLer Atltlress
Ei m I Comrac:orlGO ny Name? ?
KUkA_ Co/nev?actors License No.
Meeing Aadrus iCo Vat[or O?vner Meuing In lation7
? lq ? ? l S
Pnone Numeer
Aoi Si5 aWre ont na-0wn?r Ma g In aliatiom I 33??
'?
?
MINNESOTA STATEVOAflD OF ELECTRICITY THIS INSPECTION REOUEST WILL NOT
Griggs-MlEwey Bltlg. - Hoom 5-173 , BE ACCEPTED BY THE STATE BOARD
1821 Universiry qve., SL Poul. MN 55104 UNLE55 PROPER INSPECTION FEE IS
Phone(611) 602-0800 ENCLOSED.
;EQUESToFORoE?LECTRI?CALoNSPECTION
?j 5 n? "X".Below Work Covered by This Request
EB-OOOOAOB
<
ew, Add Rep. TypeofBuilding AppliancesWired EquipmentWired
Home Range Temporary ServiCe
Duplex Water Heater Electric Hea[ing
Apt. Building Dryer Other (Specify)
l COmm.llndusirial Fumace
Farm Air Conditioner
Omer (syecity) Connaomr's Remarks. A.-YY vr `l
??p ? 1t"? Y !-N ,
W ?.w
'`?CV'?. •v?. •I ?? ??-
Compute Inspection Fee 8elow: .?. UILA
•
? a ? Other Fee # ServiceEntrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0[0 200 Amps O l0 100 Amps
Transtormers Above 200 _ Amps A Amps
Signs inspector's Use Only?
irrigation eooms
Special Inspection
AIarMCommunication THIS INSTALLATION MAY 8E ORDERED DISCONNECTED IF NOT
Olher Fee COMPLETED WITHIN 18 MONTHS.
1. the Electrical Inspector, hereby R°°9n-'" oaie
certify that ihe above inspection has
been made. F,,,ai oa?eg
7
OFFICE USE ONLV
This reQUest void 18 momhs from
REQUEST FOR ELECTRICAL INSPECTION ea-oowi-oa
?.
' See ire?metions for comvleting this }orm en beck of Yellow copy.
19 -'X'" Below Work Covered by This Request '?,
kIe4AddrRep:j _Type ot Builtling I Apoliances Wirod I Equiprlet?[ Wired . I
EI
I I I I InAustrial Bldo. 1 I Air Conditioner 1 I Bidk Milk Tank I
p Fee ServiceEnhenceSize p Fee Feeders/SUbienders p Fa,e Circuits '
U to 200 qm s 0[0 30 Am s ? 0 to 30 Am s
A6ove 200 qinps 31 to 700 qmps 31 to 100 Ar s
Swimming Pool Above 700_Am s Above 100_AmVs
Transformers rrigdtion Booms artial%Other F e
Signs I I _ PUeciallnspecLOn ?S
Rouqhtin ? ua?a f I, the lectr'
InsPectoq ereby
certifv that the above
I Fi
nal insoeetion has been
1 7-?-1lD made.
request volC 18 months from
??
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
(o y- ? IcA CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date JC 1 /,:;Z I e? 4/
Site Street Address _1151261 Q„& k Unit #
Property Owner Telephone # 9/0-61,/7
Contractor W Telephone # (( 51) 3 4,5 y/ ,Wd
Address ?a?etk `rQ d• City State 1hn, Zip /?
The Applicant is: _ Owner YGOntractor _Other
Alterations to existing dwelling $ 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 i f a 5/8" meter is required)
Other:
Water Softener ? Water Heater $ 15.00
? replacement _ additional
_ Lawn Irrigation System RPZ_ new _ rep r? $ 30.00
ey 1
1?
State Surcharge Oq $ .50
Total $ . 0
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
M 14 ,? ? :!?7`e Ve- rL5
ApplicanYs Printed Name ApplicanYs ignature
?'MM%F)BX?.,tXtM:dYF??9F?W.?k#lk:?'t7kkcY,;;;(W.3%?k#X?N?%KX?%R%O'f.Yn 'M '?[?
CS'CY f)F EAGfyN
CASFI:Cf:R: :75 ff:RMINFd. N0t t`Jr
I7Ai[ s 08/10/99 1'TMF.:: iCl:2025
ID:
A!F<ME^ F1L..L_5TAf2 :'URSri;ucr:r.nN, TNi'..
320 9001 4576 onK cwaSE 0:3.25
2155 9001 45?6 OAI•: i:FiASG 4.00
1'o'i:al F;eceipt, Amuurti';e 07.25
CR:I. i`i0'79
LISEF' .T.I?, .7AN
1F1k?FX??&XcXt%k?F%k?F?X(?(SK?k?(?X!k??X???X>,?M?X 'M 'M?M #M?k?WYF
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 P 651- 8 -46 5- 55122 ?--
New Conshucllon ReaulremeMs RemodeUReoah Reaulre?
? 3 registered sMe surveys showing sq. H. of 101, sq. M. ol house
and all roofed areaf f20% maximum loT eoveraae allowed)
> 2 copiee of plans (show beam 3 window sIzes; poured Md. design; etc.)
* 1 set ol energy calculatbns
D 3 copies of hee preservaHon plan H lot plafted aMer 7/1/93
DATE: 9- 10' qq
DESCRIPTION OF WORK:
STREEf ADDRESS:
e /C/
LOT: ?- BLOCK: I_ SUBD./P.I.D. #:
Name: 13 02 h u3'I C-i I f<' V1 Phone #: 6?6- 6617
PROPERTY L°sl Ftrst
OWNER SfreetAddress: VJ' 76 49L A3se oCd
City ? A??` v) State: VV14 Zip:
?
5
Company: Phone #• ?
(area code)
CONTRACTOR street Address: 3 3 I S N Nk? li( 1 D () llcense # ?EP3/31
City State: Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone #: area code (
Street Address: Registration #:
CiFy
2 coples of plan '
1 set M energy calculaflom for heafed addHbns
7 sHe survey for exferlor addHbns 3 decW
CONSTRUCTION COST: ?7 ?6-0
State:
Sey,rer & water Iicensed plumber (reaulred for new conslrucllon onN):
PenaHy applies when address ehange and lot change Is requested once permB is issued.
Zip:
I hereby acknowledge thaf I hwe read fhls applicaHon, state tha} the IntormaHon Is conect, and agree to comply wtih all applicabl
Sfate of Mlnnesoia Statutes and CNy of Eagan Ordlnances. -/
Signature of ApplicaM: •' uti^? ??`(
OFFICE USE ONLY
Certificates of Survey Received _ Yes
rero oF
No
AuS i D
Tree PreservaGon Plan Received - Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-piex ? 17 Garage ? 22 Porch/Addn. (4sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
" Give PCA handout to applicant for demolRion permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length ?
Width
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
Permit Fee ? ? - -)?S
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
TotaL• I5? • -j ??-
Valuation:
:
SAC Units
% SAC
,
1985 BUILDING PERHIT APPLICATION - CITY OF EAG9N
NOTE: ALL CONTRAC'fORS MUST BE LICENSED tlITH THE CITY OF EAGAN
COI4IERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL
& STRUCTURAL PLANS, 1 SET OF
SPECIFICATIONS AND 1'SET OF
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND
To Be Used For :?QGG. Mp-l. ad1w,
Site Address Ly S 7 (o 9AX
SINGLE FAMILY DWELLINGS
? INCLUDE 2 SETS OF PLANS
3 CERTIFICATES OF SURVEY
? 1 SET OF ENERGY CALCULATIONS
GnO
Valuation • Date • z-19-P4'
Lot 2 Block /
Parcel/Sub 115?la
Owner C?OnSA
Address
City/Zip Code
Phone 340 SS33'7
Contractor
Address
City/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code
Phone #
Erect X
Remodel ,
Repair ?
Addition
Move ?
Demolish '-
Int.Impr. ?
Install ?
APPROYALS
Oceupancy
Zoning
Type of Const
0 oF Stories
Length
Depth
Sq Ft
FEES
Assessments Permit
Water/Sewer Surcharge
Police ? Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Road Unit
-
-
Bldg 0f72
Z
2 ]?Treatment P1
_
P.PC Parks
Variance Copies
TOTAL Ili
? UYi ? l
?
2co X 3? _ ?18??c So = 5130 4-
l4
Z-
_ (or4 4ek9r?
2?
1320sz?
J
CERT/F/CAT£ oF sw?vEr
?
?
?ss
?• o•
7 ?c,-0;
N 6L ? S,00
o??= =
I DESCRI Pi l Oti'
Lot 2, Bloc4: 1,
. / NFF£BY C£R71FY THAr TH/5 S(,FM'FY, fLAN G:? RE"fCcRT OAY, CHASE FIFTH P.QDITIOh
? 1';15 Pf?£P:nED BY R:'.f 3rf L'' .__R R!Y C;i7,rL1' "••:":Fii',';'l;-! ??JOtd County, ?illil`EiS??td
?;!/:D 7KAr J A6t ,E AIX'LY .5 ,;i;?EO Ll.'.'D r! :. !'Z1Z#7
? UhD£N rn£ LAY:'S GYr TNE 57,4rE LF K/h'ATSOiA. Pldt hBdrlno5 shown
0 DEIlOt2S lI'Ofl monument
? o.ar£_L0?-?5' F_c nb. 8140
1" = 30'
?, -.....??a:'°w' .:,'•., . . .-.+ -? _'
??nindt engdniagrincj a rure?avjicag
Lo?odt trail
?I?a?aadota 55557
. . _ . . _ . _ _. _. _ _, . _ .
. . I _ti".-_ ;--
`1 l :
1 3? l --
MTrr,Ion rww:r,orr•, A1a1Mncr: "u" CUHPU'l11'PION
?
sil'e rDDiarss
,
cOr.•rPncrort nnrr '1-/?• ?,( rnoru: ??? ??DD
. i
A^_termi..nc o:o.rldng squarQ £oot.ugc of cach.
1. '[btal exposed kall area ...... sq. EL•. X?
2. Total roof:/ceiling area ..... ?q.
A. ?r?:r.a7. w?ll hindow ar.e:? .......................... 7Jl3.7 ? .
D. Tc,tal door tirea ...........:..................... 37• J$
C. Total slidinry glass <loor area .................. ?/ZO.ay
13. Total fireplace wall ar.ca ..........................
L. 7'r.tal wall .l?sa?ning area (average lOC)........... E'. Totnl Ri_m jol.st arca..................... •.•.•• _IG.2.?3
G. Total taet, wall :xre.a above flooz................. 7-??7•??
10
4ota1 m:yosed fowidation area
. ' _
1!: Tot-al fo,:nr3ati.rni ??in?ow ar.ea ...................
I: Total r?e_ faundation arr.a al?ore gradc_...._..... ,OS
Deiermine "U" value oi each walZ :.•eyumttt.
' A• ?f?'???7? '?x au°
' b.
- ??.•1f?
-----r x ?~us,.,
-
?
.. C. x -.U" r??"Y c __ `•
. C?. ? . x wuu / ? ?
C. /ii3•?/? x ?iV-, ??6i
r. a4,-2.?.'? x ^n". •D =' .??_
, h. 141 -„-
'h. a IV.
x "Il" rVl?+ ?•e ??
3........ ........................'hota.l, Ar.
tr
].i iCcm 113 ie. t.lu+ sajuu ns, or last: tli:m i.ti•j., 1!1. You hnvo vleC Chc 3nLcnt of
S:UC 60I+(i(c) 2.
??
?
TuL:?l tt::piit:cdPTOeC?r??ilinh 1CC.< <' ?
•G
?
_. .__
? ?
j. 7'ot;.tl ............r: :...........
O:?11c111C Ot'c-1 ... ... •
_,_?.
):. ToCal arca (avcr.anc lUZ).. .... ?
1. Total ne?C in::ulaLeil rcof/cc.ilin?g :u•ca .......... ...
Dc;termine "U" v.ilae fvr r.ach roof/cail3.ug segmanl.
?. / X t.ull
x slu" . D?
X „u„
A ............ .........................'roCal . ?,• '?/?fJy .
If l•oCnl of 04 is tho r,amEt an, or less tlian 02, you have fnet the inL•enE oC
sec EOpF(c)le . .
? . ..
A1t.er.nate Duildinry Envel.opr. Design '
'.CO util.ixe tiui L•otal env:?lopo sy:;L-em meChod, tl+e v:ilues eslabl3.shed by the
:;mn oE iteins li3 und i<<1 ::liall not bc 9r.eal:er than thr; :;um oE it:em. II1 aiid 02.
+ 2. ? ? ? ? ?.Qlo
3.-??3/?. ?? ?'+ a.
i, :
llcat tlo!a
up
raa. q? '
t..l `j?J
?J
Ilr.nt f.lr.v vp .
?? ?7.L;. ??. .,.
rt?.rl...:-:';?..,.d,.•,•; ?.
1' .. .. . __....' ? , '.?
ron^+•.riicti?;i (U.c rc?r z
l:em L) _ _ •
1: v.?lu??
nCar.3.oc• tiir f:1.lm
1. 7
,
2.
3.
A. ?::?L.CI"1U1: 71fY???1?19 (f:l..L.l?) _,U__VI
Total
CI,G. FRA'eIIPIG(U:;e Lor. item K)
3. InLcri.ur Atr. 0.6.1
?. •y1 w _1iN8af.PiL^?- -- ??-
3. Inahc r e:of.t: wo6d
}9. Inc•he, insnl nbove fra?_ -nit1
-- -5(0
-----
5. Aii: ti.i7.in ' O.GJ.
r 1•
7..
3.
4.
? . VCt1tCd
L?J a I . Cn::i.dc 2,
/
..
?
-r' 4.
s. ch?t.r.tdc oi. • ril:o _..?
.?
?
.
?
• NU?6-?'l i?T['11' . ? ,
'.. . llu,.tt: ' LI
f:luu up
0. G?.
.uW.i,.'.ioi1n7. ::hout.o i.t mnrr! q,7a-1. lc.
.? ??i?edced for. <totnilu nnd c:%Icalnl:iann.
.
, . - ,qAt.t. 1;Cr•1'?rolL; .
Ii'oT' wall aXCa LoY
?,SL??:on r.onstrucCion
Dti51 C ??_-?t7
wnLr,
?' .
ezr.,, n1 TOPVIEIV OF
FlsritM1L Wnf,I,
ric. ;iz
.irLL I??"r,Le
XINzi\TT.Cii
VIhLt,
_...?-
f
CanAa-uctinn tt-V?luJ
1. 2r
.Lltt:G , f. E .lt? 0_GO
? ,46
3. /y i nc: ?cs rr ,nll: ?a?a?l G,8°r?
4. :2542 '-:v&271ff1N2 2,0/c
6. Iixlc>r.ior. .tiir iilm = 0•].'7
?io.9i = .G?y rowi o7191
7•
3.
G.
7nt:r_r.for air Li].m 0.60
2:
? ;.!?•. _ I ?
? ??.. ? ? .
? 3. / 1 G-vDD ?SS
?
-.??,.
._.. __._...._..
..?, 4. Zs?s' S?rtri?/G 2,
6
1 6-7
, -'"01
-
05 6, Lv.Leri.c+r air
':",' •? ?
j"
- 0 ? ToL•al
%d•?/6 ?
I.
u' •
w
! ' ? •
? ? .l. InL•crior air. film
? 0. G[?
.
? 2. 3/y" ?.??onZ //, Do
(N , `?`•;
: "" ?-? ?• . 3. ?O " COn1C
-,
, ?i. , •n ...._..._<3 . • n. ?
. a .._.ry 11,1,1r
•
• s.
.?
;
? n
?r?
?-?;"• •
G.
lixtcr.ior air film
0.1'l
?
. ?
7'otal
Sl.n13 ?0:1 GRAU!' r
6 • ?
?- --° ?
r • • ?? ? . 111 ???'``
=? --? - ?'?_? •? --- ??(
?. . . .._ .
.• .. ,? • ,, 'yl
? ? f %t
' (ff''1.\52r,.-llt..? • • , ` ? ` :
G 1
Irt?' ?--•
_ " ? ' ?, ?. • , ' • i i i =..
?i? '. ,, . . • ?fi^ .
!f1 'Y. •, o •
I:U'fl:: )n;llcr?lr. t.)'?•a, ???:?? V:+luer ?lCtil'.!? ?nd
1>I. cecir.nl• o( 1noul;?l:Suu.
IPERSONS;REQL?IRING ADDITIONAL COPIFS WILL BE CHARGED A$20.00 FEE TO CO
CITY OF EAGAN
APPLICATION FOR PERMIT SEWER ADID/OR WATER CONNECTION
Please Print)
1) PROPERTY ADDRFSS:
T•FYSAT, DFSCRIPTION:
IF EXISTING STRL'CTURE, DATE OF ORIGINAL BUILDING PERNffT ISSL?ANCE:
PRESENT ZONING/PROPOSID USE:
(Nbn Year)
R-1 SINGLE FANIILY
R-2 DL'PLEX (TG;o L'nits)
R-3 TOWNIIiOCSE (Three + Cnits) ( Units)
R-4 APARTMENP/CODIDONffNitM ( Units)
CONIIHERCIAL/RETAIL/OFFICE
IbIDL'STRZAL
ZNSTI'li'TIONAL/GOVERDA1EN'I'
2) ?
NAME: L(l I''P r>I(YC clPi.010,r'T,tnO •
ADoREss: 12.4 ??2 7, r,r J ,n /at)Q.
CITY, STATE, ZIP:
PHONE: VIA-?(p0c7)
3) • i: ?• /? For City Ose
??: ?n?? f('j? L?ta 114 ea ii YY'a , l-n(' . P1LUnbers License:
?DREss: 12A?aq I ti? CZ,- 2, cJ Active
CITY, STATE, ZIP: ('i.p , ?1r1 LZ E?cpired
PxoNE: a n C? MAsTEa LrccEass # O Not Recorde
rhn?;? c7 rn.
statf?al
4) • • ?• n /?
NAME:
ADDRESS: !S1 4? lnn. '?az-66aj &21aJ?01-0
CITY, STATE, ZIP: ? C <-?PHONE:
5) MUNSOM, • ?
? COLVNECTION TO CITY SEWER CONNECTION 'IC) CITY [+ATEE2
Q OTfER (Please Describe)
6) u • • i
? PLEASE HOLD APPROVID PEEtNffT FOR
PLEASE MAIL APPROVID PERMIT TO
F
7)
PICK-UP BY ONE OF ABOVE
1, 2,OL 4, ABC)VE
(Circle one)
? -z ?
FOR C I T Y U 5 E ON:,Y
,.
PER*1IT ° ISSUED
FEES:
$
/G '
J D
SE.iLR ?'ER^1T_T II`ICL::L'E SU°CtilRCL)
$ ?10' 'S U WATER PERP1IT (IPiCi;JDE SliRCHARGB)
$
WATER METER/COPPERHORN/OUTSIDE READER
$ WATER TAP (INCLUDE CORPORATZO:I STOP)
$ SE:dER TAP
$
$ _ /T D ACCOliNT DFPOSIT - F7ATER
$ WAC
$ ,> 7S , ?- -v sp c
+S TRliiIK SVATER ASSESSi4ENT
$ TRliNK SEti4ER ASSESSbiENT
$ Le;TEP,AL BENEFIT/TRUNK SE;9ER
$ LATERr1L BENEFIT/TRUNK S9ATER
$ /6Z .C` to WATER TREATMENT PLANT SURCHARGE
$ OTHER:
$ TOTAL
$ •?Y'?? ? .?'? AMOCJ:VT PAID/qECEI?T # ?p VZ V
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR 'AORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
? hC) ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SUIIJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
?
TI:LE:
DATE : `??7_ c.• ?? ?
ELIE CARRIER LOAO
INFOIaMATION CENTER
METRO
d Lc;r4-- - ??
? ? ?-
19407 Nofmardala Roa
Prior Lake, f?I;??res %La 55372 ?.
5?
(612) 41-47-8124 OP*ION 1 OP*ION Z OPTION 3
t. Summerdesign degrees .............. .
(90, 95, 700, 705, 710 or 115)
(If 90, 105. 110 or 115, Item 2 N.A.)
2. Dailyrange(0°-35°) ..... .......
.
3. Winterdesiqn tlegrees ................ .
(Precede a minus number with M)
4. Numberotwintlowpanes .............
(1, 2 or 3. If 2 or 3, Item 5 N A.) .?
5. Storm windows? (V or N) .. ........ {t. N x
6. Wintlows weatherstripped? (YOr N) .... .
7. Four window areas staiting with N or
NEOrientation .. ..
.
(Ex: N#25#30020#25u#; Max per side:
999 sq. ft)
71 N orNE
72 E or SE
73 S or SW
74 W or NW ??jj ## ## ##
8. Shatletlwintlowarea . . ..
(0 or sq. ft Enter 0 if not applicable.
Max: 999 sq. ft.)
9. Doorarea .......................... ..
(Oorsq. ft. Max:999sq. ft. If 0,
Items 10 8 11 N.A.)
10. Doorweatherstripped?(YOrN)....... ..
?
11. Storm doors? (Yor N) ... ... ...... ..
72. Firststory perimeter ...................
13. Secondstory perimeter ................ /yy #
14. Thickness of wall insulation ............ -/ 9 t1
(0, 2, 4 or 6" fiberglas. Enter MA for
masonry; R values, enter R, then value.
Ex: R19)
15. Basementperimeter . .. ? p
(OOrlinearfLlfO,ltems16,17&28N.A.)
16. Basement he6ted? (V Or N) ... ...... ? 5 # N N
(If N, Item 17 N.A.)
17. Percentabovegrade(Ex:S%=5) .......
18. Area ol roof with exposetl Deams or
studioceiling ,_ ......................I ? ##I I NNI I MAI
(0 0r sq. ft. If zero I[ems 19 20 & 21 N.A J
19. Woodorfiber . ........ . . .....
(W for wood, F lorfiber. ItW, ttem 20 N.A.,
If F, Item 21 N.A.)
20. Thicknessotfiber ....................
(1.5, 2 or 3" or R velues)
21. Insuletion ........... ........ ... ?
" ? ?
(Y, N or R values, V assumes 1 5
)
OPTION 1 OPTION Z OPTION 3
22. Area of ceiling under vented roof or
unconditionedspace ..................
(0 or sq. it. If 0 Item 23 N.A.)
21 Thickness oflnsulation ................
(0, 3, 6, 12 o r 1 B" of f i berg las or F val u es. ?P-???
Ex: R30)
24.
Areaoffloorsoveruncontlitionetlspace ?
(0 or sq. It. If 0 Item 25 N.A.)
25. Thickness ofinsulation ................ ?
(0, 3 or 6" fiberglas, or R values)
26. Areaoffloorsoveropenorventetlspace,
orgarage ............................ ? N# N# N#
(0 or sq. ft N 0 I[em 27 N.A.)
27. Thicknessotinsulation ................ ?
(0, 3 or 6" of fiberglas or R values)
28. Basementarea ....................... R ? O
29. (0 or sq. ft. If Item 151s 0 ekip ihla entry.)
Totalheated area .................... -.
(sq. ft.)
30. Perimeterofconcreteslab .............
(0 or linear ft.) (If D, Nem 37 N.A.)
31.
Thicknessotslabinsulation............ ?
(0. 1 or 2")
32. Desired summer indoor temperature
swing ................................ '3 #8 k# NN
(Value between 1 and 6 inclusive.)
33. Desiredwinterinsidetemperature
34. Ductloca[ion ......................... . /T M
(AT = attic, BA = basement, SL = slab,
CR = crawl space, CO = conditioned
35. space) (If BA. SL, or CO, Item 35 N.A.)
Thicknessotinsulation ... .,.......
?
(0, 1 or 2". Use 2 for 1" rigitl ) "
`REPEATOATAp.............. .............
YorN
.`CORRECTIONS4......... ................
If there are no corrections required enter ##.
If there are corrections to the data, enter
question number. N. the new data, and gp.
Ex: 19riWk# K N# u ri# # ttri
If no further corrections, enter## only, ak pq n
COOLING B.T.U.N.
EOUALS -79576 ATF B.T.U.H. AT °F B.T.U.H. AT °F
HEATING B?.T?.?U?.9H?. ?`?jJ?'
/ ,/ .?NPuf' ?i?T/?6'
EQUALS?AT?°F : 70 ? B.T.U.H. AT °F B.T.U.H.? AT °F
"REPEATTHEANSWERS"(YorN)......... F #p
.•SAVEYOUROATA4" ............ ........I q#I
Y or N; or VR#k will save your tlata and goes
to beginning for new Analysis; or NR## will
not save data but goes back to beginning for
new Analysis.
JOB NUMeER ............................
If you want to save your data CLIC assigns
Jo6 Num6er
"STRUCTURE CHANGES?.................
If there are no changes required enter kn.
If there are changes to the data: enter
question number, a, (he new tlata, anA pu. # NH
Ex: 25#R30Nq
If no further changes, enter a# onty. Na
aa
aa
p MN
aa
p#
aa
k ##
ua
METRd ,???
?????? 19401 Normandale Road
??I?? Prior Lake, Ni:r'nescta 55372
OPPORTUNITYHOME 3-78 G612) 447.8124 prinleC in U.S.A. 838-039
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA113755
Date Issued:09/09/2013
Permit Category:ePermit
Site Address: 4576 Oak Chase Rd
Lot:2 Block: 1 Addition: Oak Chase 5th
PID:10-53504-01-020
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
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.
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Steven M Boehm
4576 Oak Chase Rd
Eagan MN 55123
(651) 686-6617
Aspen Exteriors Inc
14245 St. Francis Blvd
Suite 101
Anoka MN 55303
(763) 277-8869
Applicant/Permitee: Signature Issued By: Signature