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4561 Oak Pond Rd?:?k ? ?lc? ck 1 RESIDEN] 3830 Pilot K Telephone # 651-6 New Canstruction Reuuirements 3 registered site surveys showing sq. fC of lot, sq. ft. o( house; and all roofed areas (20°/, ma:imum lot coverage allowed) 2 copies of plan showing beam & window slzes; poured found design, etc. 7 set of Energy CaICUW6ons 3 copies of Tree Preservatian Plan'rf lot platted after 7l1193 Rim Joist Defail Options selection sheet (bldgs with 3 or less unAs s P (c o s9c,a ? P ? c? `T d-? plicatiouI P40 4 7 Eagan SW (vv? i, Eagan MN 55122 FAX # 651-675-5694 RemodeVFieoair Reouirements 2 copies of plan 1 set of Energy CakuWtlons fOr heated additions 1 site survay for additions 8 decks Add'N'on - indicate ifon,vte sepfic system '?Y?'? "hb.? ??R.d-? S'66Z,57 7o-Sp 90 . 5-0 S) 63,5? Ofl'?ce Use Onlv / CeRofSurveyRetd yY N Tree Pres PWn ReW E"Y _ N Tree Pres Not Reqd _ Y_ N On-site Sep6c S/stem _ Y_ N Date /'_! 2.9 / Site Address 03 0/6,6t Construction Cost f?? OC ' Unit/Ste # Description of Work ?? I? /?fJ (, ? ? . ?,?kNl • ! \ ?S. Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ i _ 2 Property Owner Telephone # ( ) Contractor ?1GK k?d,97?1jL.,Vlqb Address ;?u`^/ State IVM ? / 6d1[/T701V CT• Zip SJ l?-cc?- CiTy Telep6one #((aS/ )/?SZ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residentlal Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submissionrype) Submitted Submitted . • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan2 YN If so-2407 pian review fee applies. L ?". .?? 1??1 G i i ?t Licensed Plumber ? A4??<}? ?G?? TeleR e??(6SlJ '_ 1. i cl 97 'l I? I Mechanical Contractor?TlZp h?"y'l?A"C. Tele ?lione #?S",Z,) g9i??s6? Sewer/WaterContractor U?.?O ? Tefee-#k(i'/)- ° I hereby apply for a Residential Building Permit and acknowledge that the in£ormation 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 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. ,7)lclc 8ja??LV,Ivp Applicant's Printed Name ?? A icpl ant's Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool 1$ 02 SF Dwelling ? 08 06-plex IX 16 Fireplace ? 21 Porch (3-sea.) ? 03 01 of_ plex 0 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types p[ 31 New ? 32 Addition ? 33 Alteration ? 34 Replacement Valuation /87 aQa Census Code SAC Units ? Nbr. of Units 1 Nbr. of Bldgs ? Type of Const V Vl Y _. , 0 30 Accessory Bldg ? 31 Ext. Alt - Mul6 ? 33 Ext. Alt - SF ? 36 Multi Misc. ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)` ? 43 Reroof 0 46 Windows/Doors 'Demolition (Entire Bidg) - Give PCA handout to applicant Occupancy iZ ' 3 MC/ES System Zoning R- I City Water Stories 2 Booster Pump Sq.Ft. Z(06 2 PRV Length (O4Z Fire Sprinklered widcn `/°' q " ZC Footings (new bldg) _ Footings (deck) _ Footings (addition) ? Foundation )C Drain Tile C Roof ?C Ice & Water X Final ZC Frazning ?C F'ueplace ? R.I. XAir Test K Final ?. Insulation REQUIRED INSPECTIONS ?C FinaUC.O. _ FinaUNo C.O. _ Plumbing _ HVAC Other _ Pool _ Ftgs _ Air/Gas Tesu _ Final _ Siding Stucco Stone _ Windows (new/replacement) _ Re[aining Wall Approved By , Building Inspector Base Fee ? 1) /g se mevTT suronarge Plan Review ? 57- rt4o IZ MC/ES SAC Z nbi2 City SAC L) P PeQ bvt2?trE Utility Connection Charge S8W Permit & Surcharge Treatment Plant License Search Copies Other Total IS?Q XlS IS79 x??I,' 1?oox,Y,. S'Z,x 30?? SzBX ?6".. S^x. $ X /6" Z 36 K, - bS .- S'?.t?°'? ,- /??a. - $ q48,_ ? `?y? ? . • ' M1'check COMPLIANCE REPORT Minnesota Energy Code MNchcck Sottware Version 3.0 CpUNTY: Dako[a STATE: Minnesota ZONF.,: 2 CONSTRUCTION TYPE: Single Funily DATE: 7-25-2003 TITLI.: RANDY & LORI WENDOLEK PROJECT LNFORMATION: Pl,ANN 03-0522A3 COMPANY 1NFORMATION: DICK BJORKLL,TD CONST. COMPLIANCE: PASSHS Required UA = 547 Your Home = 532 2.7% Better Than Code Area or Cavity Cont. Glazing(Door Perimeter R-Value R-Value U-Value liA CF.ILINGS 1692 44.0 0.0 46 WALLS: Wood Frame, 16" O.C. 2909 19.0 2.0 163 WALLS: Rim Joists 449 10.0 2.0 36 BSMT: Conc. 21' hU8.6' bg/9. ]' insul 1113 10.0 0.0 68 GLAZING: Windows or poors, Above Grade 554 0350 194 DOORS 71 0350 25 COMPLIANCE STATEMENT: 'Phe proposed building desigo described here is consiseent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Minnesota Energy Co '? BuilderlDesigner , ???-A-. .. . . Date_ _ ? I2?1o3 \ ? , ' MNchecit INSPECTION C}[F,CKLIST Minnesota Energy Code MNcheck Softivare Version 3.0 RANDY & LORI WENDOLEK DATE: 7-25-2003 PLAN REVIEW AND INSPECT]ON ISSUES This list of items may be helpful for Plan Reviewers and Builcling ]nspectors to use as a guide for enforcing the Minnesota Enerbry Code. The items apply to Group R, Division 3 Occupancies, one- and two-family residential dwellings. The items marked with * apply only to detached one- and two-family residenrial dwellings. PLAN REVIEW ISSUES FOLINDATION INSPECTION [] foundation wall insulation R-5 minimum [] fuundation insularion extends from top of wall down to top of the footing [] exterior foundation insulation is covered by a protective coating finish CONCRETE SLAB OR ti\`DER-SLAB INSPECTION [] slab on grade perimeter insulation R-5 rninirnum [] slab insularion extends from top of slab to design frost line or top of foodng [] floors over unheated space R-30 minimum W INDOWS / DOOR5 / SKYLiGHTS [] average U-vatue is 0.37 maxnnum for windows and glass doors (excludes foundation windows) [] window U-values consistent with building pian and MNcheek RepoR [ j window and door areas consistent with buildiug plan and MNcheck Report MF.CHANICAL VENTILATIQN ISSUES [] residentiai mechanical ventilation system provides adequate vendlauon per code requirements* [] furnace efficiency is consistent with MNcheck Repart or building pian [] protection against excessive depressurizarion is installed per code requirements* F,iVVELOPE INSULATION FOR PLAN REVIEVV [] interior baseinent insulation R-5 minimum (if no exterior insulation) ceilings with attics R-38 minimum or consistent with building plan and MNcheck Report [] wall framing and insularion level is consistent with building design and MNcheck Report INSPECTION ISSUES CONCEALED[NSIILATION hraming and Sheathing [] wind wash barrier installed at attic edge [] exterior wall comers framed so that insulation can be installed after extenor sheathing is installed (] inlersecrions of interior partition walls and exterior walls framed so that insularion can be installed between the partition and exterior sheathing after exterior sheathing is installed [] gaps between framing less than one-half inch aze eliminatecl by securing framing together or aze insulated at the time of assembly * [] all penetrations behueen conditioned and uncondiboned spaces made prior to framing inspection are sealed * Interior Air I3arrier [] all fire stops are air sealed [] pipes, ducts, wires, equipment and flues and chimneys through the interior aic barrier ue sealed [] a sealed continuous interior air barrier is installed on the wazm side of the building envelope at ceilings, walls, and floor rim joist areas * [] air barrier behind tub and shower is sealed and protected ' [ ] , recessed ]ight fixtures are sealed Envelope lnsGlatian [ ] basement insulation R-5 minimum wind wash barrier on wall separaung house and garage is sealed [] loose fill insulation is prevented from entering the eaves [) insularion on skyGght shafts and walls exposed in attics is supported on the unconditioned side Attic Insulateon [] attic access panel insulated to R-38 fbr ceiling pane] and R-19 for wal] panel [] attic cazd attached to framing neaz access opening [) notification of attic R-value and date of installation posted near building pernvt inspection cazd This is a summary only. Chher requirements may apply. See the Minnesota Energy Code. Quesrions? Cal] the Department of Public Service Infonnarion Center at 651-296-5175 or 1-800-657-3710. ? r, oFpce F(c,c- co? ??-----? TREE PRE$ERVATION PLAN SUMM,? `CITY OF EAGAN FQRESTRY DIVIS(bN ? (SEE ATTACHMENTS) Development WCNI??OL?? U)UkY> Lot Number Address Block Number -C-W- 7?-' C? f?l? 1?C tiD ?0 suilder p(Ck ?RSC:QI(-'l_.UNi) CaNST. :,:(uC, CO N'CvkCC '- Ot CK. 13, Tree Protection Requirements: Tree Fencing Oak Tree Pruning (Immediately seal wounds during April 1 to July 31) Therapeutic Pruning Retaining Wail Other: Repiacement Trees: Not Required As Follows: Attachments: Yes No Additional Notes: EACaA6N FORESTRY D@VISIORI REd8E4ft9ED BY -9L L, oATE? ( I &'a"63 H:\ghove\2002fi1e1treepreslTree Preservation Plan Summary-2002 Significant Trees at Proposed Wendolek Woods Site, Oak Pond Road, Eagan, Minnesota Tree #; Species ? DBH ; Condition 259; Oak, red ' 15.0 5 Fate Remove 260i Oak,.red 14.5 6 Remove j 261 Cherry, black S.Oi 4 Save 262° Oak, red I 15.5i 7 Save 2631 Elm, Amencan ; 12.01 7 5ave _ 264; Cherry, black ! 6.0I 6 I Remove _I ? 265' Cottonwood 12.01 6 1 266' Elm, American 1 15.Oj 6 ---- 267; Oak, White 21.0 - 8 Averages ; 13.22; Remove Save ? Save -- -- -- -- --- - -t i -- ? T Total Number of Significant Trees = 9 ? 1. DBH is diameter of tree measured at 4.5' above round level. 2. Condition is rated on scale of 0-10 with 0 being a i dead tree and 10 a erfect tree. i ? i -7?? d3 -- h i h l S - - - tep en J. c o son Certified Forester #2369 Date ---- ---- ? 2489 Rice St. #160 Roseville MN 55113 --- - %u?xde Co., Inc. , 651-484-0114 ? --- www.kundeco.com ? - lb1 Kunde Co., Inc. , 1 of 1 ?F'q L. U ? ?? G 1 r IY L t ? isz.oo 3R. I ? I 3. 900J r'9J;9 T ?900J ? LOT ? 1 ' _ soz• B L I 03.6 29 Ex6TMG HousE #a565 1 ? \ g ? 900.1 \ \\ ? \\?? ?8 4 p 899.? %67°e I i l ? ? 0982 9 ^ .L . ? J Fi r r ? , ` S 80'10.53•. E ` (.l0 -' w ??? yy• o '? / ? ? ,5 t i? 90g29o , ?e0.1 ? ({/.?'?,r?,(\?!? ?/ `/ I.? of?$a?'i' ? I I 1 1 1 ?§? ??? ? I I 9a?i/?i 9 . i I ? 1 I ? I? 1 I r'eoila ?9 m ??as?.3 B l 2^? -I'-C I - .,?... _... r ? I I V ? A? ^ S.oan YM ? aee l i w? A I SipRM \ \ ? ? MM 0 ., S I I 1 '` 7% eq3?. S ? \ . 9 R' ?yS2S. / i ? ? i ].5 . / / 899.• p958 ? 1 ? 5 / ? 90?6 ? ? ? ?w? ? ?? ? 1 ?• ?. A? I I ,91? . ??? i J o ? / t O?A 5L' {I / Jl pni?16?1 "?98 7 J 5 894 o 094 ] `J_? 6e?- .,igsg '895/ ? ` ? ? 95.9 ?Wvo" 56.00 'a? 77.00_rg9 ' -?? \?\ ?_` 13.3.00 f 891. i 5 89'S6'S2" W____ i _ _ "m b O"•?' / B95? / 9951 / 09]J _-L=27.88 / / . R=35.OD L=45'38'35" / . LOT SURVEY CHECNLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION PROPERTYLEGAL: L=4- a0 I3/o<-k '1, ? Wan?ole?' WvojS DATE OF SURVEY: 7`d`l - a 3 LATEST REVISION: d m c A t U O ? Q DOCUMENT STANDARDS H0 ? • Registered L and Surveyor signature and company L? ? ? . Building Permit Applicant ? ? ? • Legal description / ? ? • Address d? 0 • North arrow and scale ? ? ? ? • House type (rambler, walkout, split w/o, split entry, lookout, etc.) ? ? • Direcfional drainage arrows with slope/gradient % ?? ? ? • Proposed/existing sewer and water services 8 invert elevation St t 11 ? . ree name ? ? • Driveway ? ? ? • Lot Square Footage ? ? • Lot Coverage ELEVATIONS / Existina H ? ? • Sewer service (or Proposed) ? ? ? • Property comers ?? ? • Top of curb at the driveway and property line e#ensions / ?? • Elevations of any existing adjacent homes 61/ ?? • Adequate footing depth of shuctures due to adjacent utility Venches 6? ? • Waterways (pond, stream, etc.) Proposed 0 ? • Garage floor ? ? • Basementfloor ? ? • Lowest exposed elevation (walkouUwindow) i ? ? . Property comers ?? • Front and rear of home at the foundation PONDING AREA (if applicable) ? ? • Easement line d/ ? ? • NWl O ? • HWL 0 ? • Pond # designation 0 • Emergency Overflow Elevation ? 9' ? • PondlWetlandbufferdelineation ? • Lot Iines/Bearings 8 dimensions f5/ CI ? • Right-of-way and street width (to back of curb) ??? • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. alI structures requiring permanent footings) ? ? • Show all easements of record artd any City utilitles within those easements ?? • Setbacks of proposed sWcture and sideyard setback of adjacent exisGng structures t?? • Retainingwallrequirements,'rfany wFl-. Wc f cu nc? ?+` In s nerd Reviewed: hav? QaAAef'+' Name Date G:/FORMS/Building Permit Applicatlon 08/06/2003 10:27 FAX 6514529278 DICK BJORKLUND CONST Dick Biurklund,Constrnction Inc. Fax Cover Letter Date: <i?' `6 1' To: Company; Ct Yy 1? ?G aJ - I?? 7w,Ne i Name: ??n,r icrO-Lvp Fax #: Phone #: .?.?_ From: Company: 1? ooaiooa iv ame:_ tv"e« is at l. S i_ z(, f - -9 q g-o -, Fax 651-452-9278 Phone 651-452-3434 ? iing: tN 4N na t'r Total number ofpages: `L (Tncluding cover letter) Please call if you do not receive all the pages, 2511 Condon Court - Mendota Heights, MN 55120 Custom Homas and Remodeling T,icense #; 20176281 6514529276 08I06i?2003 10:26 FAX 6514529278 DICK BJORKLUND CONST 08/06/09 10:37 FA% 651 788 0229 MOLIN CONCRETE PRODUCTS la 0011004 16003 HDLLOW CORE 4 .. L qp N6N--STRIiCTURAL GONCRETC MIN TOPPING aY OTNERS WATERPROOF MEMBRANE BY OTHERS • ' - `J 000 •#4 DOWEL 0 4'-0' 0/C ERECTOR '• TO DRILL THRU PLANK & 4" MIN. -1NT0 WALL & GROUT SOLID _ . ., POURED CONGRETE • - • WALL WOLLOW CORE NON-BEARING - ON PD-URED WALL DETAIL nnolin Ccncrete ProducM Cornpo^Y •41gLilac S?' Ltno Laksa, MN 55014 pffice: 651.766J722 • Fex' 631.786.0229 • Draftfn9 FaX: 857.783.3407 • Toll Frea: 800.338.6546 ? www.molin_mm • e-mall: sales(gimolin.G]m - drdftingOinolin.wm 08/06/2003 10:26 FAX 6514529278 OICK BJORKLUNO CONST IA0021004 08/06/03 10:37 FA% 851 786 0228 MOLIN CONCRETE PRDDUCX§_ 0002 ?. _ - -.--- - ?. _ - - Pqr,E 07?07 ?04l09/2063 13:30 6512750678 ?0???,9 HoLiw c?NNCRE'TS ? 005 05/28l03 10:16 FAS 851 7B8 0229 . HpLtow CORE 2" .3i" BRNG_ WpN-STRUCNRAL CONGRETE MIN.) TOPPING BY OTHERS WATERPROOF MEMBRANE .• ?...... 6Y OTHERS ?... ---- -. THICK MASOid{'TE BRNG, STRIP „•rr #4 DOWEI 0 4'-0•, OlC ERECTOFi TO bRtLL INTO KEYWAY & 4" MI.N_ •?. INTO WAL.L «9c GROUT SOUD ----POURED CDN CRETE WALL HOLLOW CORE BEARING 4N pouRED WALL DETAIL -Fleyti ??rojp prpdWefs Gompeny - 415 LDae 9treet • lhw Cakes, MN 55014 CKReo1651_7e&7722 , Fax: B6'1.788.0220• Fnf9np Fmc 061.783.9A01 • Tell Free: 900535-WC www?naTiTm.com - o-maiL• salesomolln.com - tlratSr+B@rrblrn.oom 08/06/2003 1026 FAH 6514529278 OICK BJORKLUNO CONST 08/04i09 10:37 FAX 851 788 0229 _ lIOLIN CONCRETE.PRODUCTS la ooaiooe 10001 ? (?/.l..Qi4 ?v ?}???- ? 8" x 24" Section ,d-?,tu-[ flexicore ?s 2 HOUR FIRE RATING PRESTRESSEDCONCREfESLAB 5Q-1`1? X2e?1`0,P,Q "-' 25Qk STR.AND 1 S??`n , M ? Cmfn 1 n'rl 7ahlo uMICORMLY dSTWBIlTm SUPLPOS9T LOAD IN PSF 9band M (4 b R 91intlYC OesynaWn SlrYdi ND. 8 Ske Area S4 h FL.KV8 pa Lkd K•wpW Cw lhrt 15 16 17 16 19 10 2i '4 a m ]5 76 27 ffi ?P 70 31 52 77 824GW61' 412 0.612 90.2 90.3 2&5 204 2<B 230 215 202 990 179 109 160 152 745 137 791 171 ?.1 I07 92 83 e24C.C9s0• a112 0.612 511) 903 4B5 254 ?A6 Z70 215 102 190 179 l!Y 190 162 144 129 ft8 104 94 84 75 BT SM-1358 4-12 4578 30.3 53.9 285 264 248 230 275 202 190 779 t80 '1!0 M 160 tZT 115 104 94 8+ ? 2-1Q6 2-7ne 0.504 31.7 487 285 7b? N6 250 215 7M '1B0 179 167 150 i34 120 1QB 97 7! 78 fi rf4l zacws a n-n?a o.aaz zr.a azi us zea z+e tn z1e ac, +te 1sa 1zs ,,, +oo ae 7s f1 es se 0710CC6 -me a z ,¢? v.876 76.2 77.2 " 1A6 223 19Q 1T2 152 134 110 108 83 S] ]] 85 b7 50 82{GO92 L31e o.97D 2Z7 92.z t 216 1B7 163 142 725 110 fl8 85 7a &! 57 ••- 5a - l2 btY? 47A! 2l2 28.3 = 2 22 1B1 165 W 175 10B BS B9 72 W 95 ? '7A6UU7FDLOAQS ARE BASED ONV • 1.10 a 111 AP1C1 W!!H Al1CAA0 BUPERIIPCSEO ON TNE 51AUC711RILSECTION CON$NEftfLD A9 WE LOAO. 'PlG.nv_ lkBriyf? 41PW a 3 A? ,qny -104?.sc c???¢L ?pX +- r?gb• r-- N.A, HOLLDW CORE ?y - 2. ill? 57/8" DIA. `n v ? ¦ . . . X N ? 23j" NdTES: . Grouud ddghs of stsuctisrl unit is 57 psPar 114 plf busad on concretc uait weighs of 150 pof. Desigu 'tn beaed an ACI Staadatd, "Buadiag Codc Requirements for Reiaforced Coocrete (AQ31 S) •• 3. No shcar rninforcaumit is required for the rabu- lated loads. 4. TabulaiEd lnadg to the left of solid stepped l.ine ase cv¢hvlled by sheaz saeagch afthe concrete. 5beaz reinforcemeat may be udded to incYease dhe safe loaas. 5. Tebuleted loeds writtsp ip italics azti controlled by peamiuible flexural teasion at service loads. 6. Tahulatad loads to the right of tne dashed mppad line have deflections in exaoas of L360. 7. All straxid szressed ro 700/6 of ultimaie er.ceps CB 60 which is sbessed t0 60%. 8. Borlongersponeaud cooditions notcovered in t6e losd table, coasuk Mol[n. 9. Cneasrs 6re rrciras paesible with restrainea coastrucrion or radonal design calcvlations. ? ? A= 109.7 in.' F. - 6000 psi b„ = 6.25in. fq = 3500pei T - 4 V43.2 ul.` ?° ZSO kSI a y = 4.0 in_ a 270 ksi , Molin Cancraie Producis Company • 415 Lilac Straet • Uno LaNes, Minneaoia 55014 OMca: 651-7e6.7722 • Fex; 657.796.0229 • DraPor+g Fax: e51.7113.3401 • Toll-Free: 800.336.6546 ? Emeii: salasOmdin.corn - draning Omolin.com - www.mvlin.com IT= = CO INSTANT TESTING COMPANY 4000 BEAU D'RUE DR1VE • EAGAN, MN 55 122 PHOA'E: (612) 454-3544 • FAX: (612) 452-1826 June 20, 2002 Mr. Randy Wendolek 4565 Oak Pond Road Eagan, Minnesota 55123 RE: Lot Adjacent To - 4565 Oak Pond Road - Eaqan, Minnesota 30th ANNIVERSARY At your request of your excavating contractor, Whitney Excavating, a site visit was conducted on May 28 & 29, 2002 to evaluate subgrade soils, for the construction of a engineered fill pad. The lot, located north of Oak Pond Road, lies within a natural ravine and slopes to a wetland area to the north. Our observations of the site indicated previous excavation work, clearing organics and subcutting in the southeast section of the lot. • The Proposed house pad area was excavated to remove surface vegetation, organics and 1 3/4 to 2 feet of undocumented fill (limestone chunks, bituminous and mixed soils) at the front pad line. Cleanout depths averaged 2 to 2 1/2 feet within the proposed pad area, with 7 feet of clean-out required near the mid-section west side. Instrument readings indicated elevations at the base of the excavation at 886.0 (front) and 881.0 (rear). With a proposed slab elevation of 891.0, we would predict a fill requirement of approx. 10 feet. Measurements indicated that the pad was constructed to approx. 59.5 feet in depth by 81 feet wide, which included a 11:5 foo± (fror.t) a:.3 13.8 ioot (rear) oversize extension of the pad to the east. Soil at the base of the excavation consisted of a firm, clayey sand below optimum moisture. Two 3 foot handauger probes conducted within the east and west section of the pad indicated clayey sand underlain by stiff clay at depth. The prabe conducted within the west section indicated water migration and soil at saturation. Our inspection indicated that the subgrade soils are acceptable and the pad area is approved for backfill. Sincerely, Instamb-?E 6ary St7ni sh Ins pectHA ng Company Supervis Charge codes: #605 -A hours #612 - 24 Miles (2 trips) I T- INSTANT TESTING COMPANY _CO 4000 Beau D'Rue Drive • Eagan, MN 55122 •(651) 454-3544• Fax: (651) 452-1826 Proctor Test Report RANDY WENDOLEK 4565 OAK POND ROAD EAGAN MN 55123 Proiect: 4565 Oak Pond Road Date Sampled: May 29, 2002 Submitted By: Tom Wamer, ITCO • • Reported: May 31, 2002 Performed By: Tom Wamer, ITCU Standard MoisturelDensi Test Curve Number. 2002-01 Visual Soil Class: Sand 8 ravel Standard Maximum D Densi : 134.8 O timum Moisture: $•Z Re resentative Of: Dens' test 1 Remarks: Copies To: Charge Codes: Standard Proctor Sample Prep #303 1 #302 1 J ? ! '• ,??? Q??? Signed Carl AndersonProfessional Engineer - fiegistration No. 10736 I T= INSTANT TESTING COMPANY _CO 4000 Beau D'Rue Drive • Eagan, MN 55122 •(651) 454-3544• Fax: (651) 452-1826 Proctor Test Report RANDY WENDOLEK 4565 OAK POND ROAD EAGAN MN 55123 Proiect: 4565 Oak Pond Road Date Sampled: May 29, 2002 Submitted By: Tom Wamer, ITCO 11 • Reported: May 31, 2002 Performed By: Tom Wamer, ITCO Standard Moisture/Densi Test Curve Number. 2002-01 Visual Soil Class: Sand & ravel Standard Maximum D Densi : 134.8 0 tlmum Moisture: 8•2 Re resentative Of: Densi test1 Remarks: Copies To: Charge Codes: Standard Proctor #303 Sample Prep #302 Signed /?'f ?` . _`'?'f'i?/Yl? . • Carl AndersonProfessional Engineer - Registration No. 10736 _ INSTANT TESTING COMPANY I T? 4000 Beau D'Rue Drive • Eagan, MN 55122 •(651) 454-3544• Fax: (651) 452-1826 =C0 DENSITY TEST REPORT RANDY WENDOLEK 4565 OAK POND ROAD EAGAN MN 55123 Proiect: 4565 C?ak Pond Road Date Tested: May 29, 2002 @ 1 pm Reported: May 31, 2002 Ordered By: Bill Whitney Field Technician: Tom Wamer, ITCO Inplace Density Results • Test Number: 3 4 Location: SE comer of lot SW comer of lot De th Below Grade: 6' 6' Visual Soil Class: Loam sand & ravel Proctor Curve Number: 02-01 Percent Moisture: 9.7 7.6 O timum Moisture: 8.2 8,2 Relative Moisture, Percent: 118 93 Field Densi , PCF: 132.1 135.7 Standard Maximum D Densit,, PCF: 1.14.8 134.9 Relative Densi . Percent: 98 101 Re uired Minimum: 95 95 Remarks: Copies To: Charge Codes: Oensity Tests 3-4 #601 1 Charge Per Test #306 2 Mileage #612 12 r 1 L J % /I ,1: ? Signed ? . ... Carl Anderson, Professional Engineer - Reg(stration No. 10736 - INSTANT TESTING COMPANY IT_cO 4000 Beau D'Rue Drive • Eagan, MN 55122 •(651) 454-3544• Fax: (651) 452-1826 DENSITY TEST REPORT RANDY WENDOLEK 4565 OAK POND ROAD EAGAN MN 55123 Proiect: 4565 Oak Pond Road Date Tested: May 29, 2002 @ 1 pm Reported: May 31, 2002 Ordered By: Bill Whitney Field Technician: Tom Warner, ITCO Inplace Density Results r 1 LJ Test Number: g q Location: SE comer of lot IA?llllll SW comer of lot De th Below Grade: 6' 6' Visual Soil Class: Loam sand & ravel Proctor Curve Number: pp_pi Percent Moisture: 9.7 7.6 0 timum Moisture: 8.2 8.2 Relative Moisture, Percent: 118 93 Field Densit , PCF: 132.1 135.7 Standard Maximum D Densi , PCF; 134.8 134.8 Relative Densi , Percent: 98 101 Re uired Minimum: 95 95 Remarks: Copies To: Charge Codes: Density Tests 3-4 #601 1 Charge Per Test #306 2 Mileage #612 12 • Signed Carl Anderson, Professionai Engineer - Registretion No. 10736 T_ INSTANT TESTING COMPANY I 1 ? 4000 Beau D'Rue Drive • Eagan, MN 55122 •(651) 454-3544• Fax: (651) 452-1826 CO DENSITY TEST REPORT RANOY WENDQLEK 4565 OAK POND ROAD EGAN MN 55123 Proiect: Adiacent to 4565 Oak Pand Road Date Tested: May29, 2002 @1:30 pm Reported: May 30, 2002 Ordered 8y: Randy Wendolek Field Technician: Tom Wamer, ITCO Inplace Density Resuks 0 Remarks: Copies To: Charge Codes: • Test Number: 1 2 Locatfon: NECornerof Pad Elevation 883 NWCornerof Pad Elevation 883 De th Below Grade: $ $' Visuaf Soii Class: Loamy Sand & Gravel Loamy Sand & Grevel Proctor Curve Number. 02-01 02-01 Percent Moisture: 6.9 7.5 0 timum Moisture: $•Z 8•2 Relative Moisture, Percent: 84 91 Field Densi , PCF: 131.3 139.9 Standard Maximum D Densi , PCF: 134.8 134.8 Relative Densi , Percent: 97 104 Re uired Minimum: 95 95 DensityTests 1-2 #601 1 Charge Per Test #306 2 Mileage #612 12 Signed Carl Anderson, Professional Enginear - Regi ration No. 10736 T, INSTANT TESTING COMPANY I L ? 4000 Beau D'Rue Drive • Eagan, MN 55122 •(651) 454-3544• Fax: (651) 452-1826 =C0 DENSITY TEST REPORT R.4NDY W ENDOLEK 4565 OAK POND ROAD EGAN MN 55123 Prolect: Adiacent to 4565 Oak Pond Road Date Tested: May29, 2002 @1:30 pm Reported: May 30, 2002 Ordered By: Randy Wendolek Field Technician: Tom Wamer, ITCO Inplace Density Results • Remarks: Copies To: . Charge Codes: 0 Test Number: 1 2 Location: NE Corner of Pad Elevation 883 NW Comer of Pad Elevation 883 De th Below Grade: $' $' Visual Soil Cfass: Loamy Sand 8 Gravel Loamy Sand & Gravel Proctor Curve Number: 02-01 02-01 Percent Moisture: 6.9 7.5 O timum Moisture: 82 8.2 Relative Moisture, Percent: 84 91 Field Densi , PCF: 131.3 139.9 Standard Maximum D Densi , PCF: 134.8 134.8 Relative Oensi , Percent: 97 104 Re uired Minimum: ' 95 95 Density Tests 1-2 #601 1 Charge Per Test #306 2 Mileage #612 12 Signed Carl Anderson, Professional Engineer - Regisrtration No. 10736 ACO INSTANT TESTING COMPANY 4000 Beau D'Rue Drive • Eagan, MN 55122 •(651) 454-3544• Fax: (651) 452-1826 DENSITY TEST REPORT RANDY WENDOLEK 4565 OAK POND ROAD EGAN MN 55123 Profect; Adiacent to 4565 Oak Pond Road Date Tested: May29, 2002 @1:30 pm Ordered By: Randy Wendolek Reported: May 30, 2002 Field Technician: Tom Warner, ITCO Inplace Density Results • Test Number: 1 2 Location: NE Corner of Pad Elevation 883 NW Corner of Pad Elevation 883 De th Below Grade: 8' 8' Visual Soil Class: Loamy Sand & Gravel Loamy Sand & Gravel Proctor Curve Number: 02-01 02-01 Percent Moisture: 6.9 7.5 O timum Moisture: 82 8•2 Relatlve Moisture, Percent: 84 91 Field Densi , PCF: 131.3 139.9 Standard Maximum Dry Densi , PCF: 134.8 134.8 Relative Densi , Percent: 97 104 Re uired Minimum: 95 95 Remarks: Copies To: Charge Codes: Density Tests 1-2 #601 1 Charge PerTest #306 2 Mileage #612 12 • Signed Cad Anderson, Protessional Engineer - Regi ration No. 10736 4CO INSTANT TESTING COMPANY 4000 Beau D'Rue Drive • Eagan, MN 55122 •(651) 454-3544• Fax: (651) 452-1826 DENSITY TEST REPORT Randy Wendolek 4565 OAK POND ROAD EAGAN MN 55123 Proiect: 4565 Oak Pond Road Date Tested: August 15, 2002 @ 8:50 am Ordered By: Bill Whitney Reported: August15,20D2 Field Technician: Tom Warner, ITCO Inplace Density Test • Test Number: $ Location: Center of Pad De th Below Grade: Grade Visual Soil Class: Sand & ravel Proctor Curve Number: 02-02 Percent Moisture: 9.6 O timum Moisture: 9.0 Relative Moisture, Percent: 107 Field Densi , PCF: 124.1 Standard Maximum D Densi , PCF: 122.8 Relative Densit , Percent: 701 Re uired Minimum: 95 Remarks: Copies To: Charge Codes: Density Tests 8 #601 1 Charge Per Test #306 1 Mileage #612 12 0 Signed Carl Anderson, Professional Engineer - Registration No. 10736 N ? •?°?o;'-' , INSTANT TESTING COMPANY 4000 Beau D'Rue Drive • Eagan, MN 55122 •(651) 454-3544• Fax: (651) 452-1826 , Proctor Test Report RANDY WENDOLEK 4565 OAK POND ROAD EAGAN MN 55123 Proiect: 4565 Oak Pond Road Date Sampled: August 14, 2002 SuBmitted By: Tom Warner, ITCO 0 • Reported: August19,2002 Performed By: Tom Wamer, ITCO Standard MoisturelDensi Test Curve Number: 2002-02 Visual Soil Class: Sand 8 ravel Standard Maximum D Densi : 122,8 O timum Moisture: 9.0 Re resentative Of: Densi test 5 Remarks: Copies To: Charge Codes: Standard Proctor #303 1 Sample Prep #302 1 117 Signed Carl AndersonProfessional Engineer - egistration No. 10736 T_ INSTANT TESTING COMPANY I 1 ? 4000 Beau D'Rue Drive • Eagan, MN 55122 •(651) 454-3544• Fax: (651) 452-1826 =C0 DENSITY TEST REPORT Randy Wendolek 4565 OAK POND ROAp EAGAN MN 55123 Proiect: 4565 Oak Pond Road Date Tested: August 14, 2002 @ 10:00 am Ordered By: Bill Whitney Reported: August 15, 2002 Field Technician: Tom Warner, ITCO Inplace Density Test 0 Test Number: 5 Location: SE corner of house Pad De th Below Grade: Grade Visual Soil Class: Sand & ravel Proctor Curve Number: 02-02 Percent Moisture: 7.0 O timum Moisture: 9.6 Relative Moisture, Percent: 78 Field Densi , PCF: 122.7 Standard Maximum D Densi , PCF: 122.8 Relative Densit , Percent: 100 Re uired Minimum: 95 Remarks: Copies To: Charge Codes: Density 7ests 5 #601 1 Charge Per Test #306 1 Mileage #612 12 L ?? ?LVypY/??!? Signed •?? " "'/' ' `?" Carl Anderson, Professional Engineer - Registration No. 10736 TRandy Wendolek 4565 OAK POND ROAD EAGAN MN 55123 Proiect: 4565 Oak Pond Road Date Tested: August 14, 2002 @ 2:15 pm Ordered By: Bill Whitney 11 INSTANT TESTING COMPANY 4000 Beau D'Rue Drive • Eagan, MN 55122 •(651) 454-3544• Fax: (651) 452-1826 DENSITY TEST REPORT Reported: August 15, 2002 Field Technician: Tom Warner, ITCO Inplace Density Results Test Number: 6 7 Location; NW corner of Pad NE corner of Pad De th Below Grade: 3' Grade Visual Soil Class: Loam sand & ravel Proctor Curve Number: 02-01 Percent Moisture: 7•9 10.0 O timum Moisture: 8.2 82 Relative Moisture, Percent: 96 122 Field Densit , PCF: 140.3 129.0 Standard Maximum D Densi , PCF: 134.5 134.8 Relative Densit , Percent: 104 96 Re uired Minimum: 95 95 Remarks: Copies To: Charge Codes: Density Tests 6-7 #601 1 Charge Per Test #306 2 Mileage #612 12 r1 LJ Signed Carl Anderson, Professional Engineer - Registration No. 10736 Address: 4561 Oak Pond Rd Zip: 55123 Lot: 2 Block: 1 Subdivision: Wendolek Woods THE FOLI.OWING fTEMS WERE/WERE NOT COMPLETE AT FINAL INSPECTION ON Yes No Comments Final ade - 6" from siding Permanent ste s- aza e ? Permanent ste s- main entry ? Permanent driveway / Permanent as ? Sod/Seeded lawn ? TraiUcurb damage Porch ? I,ower level finish Deck ? ??,?lut?ted ou,f- /??,KI-?:- N.ui4 Fireplace • V erify with your builder that roof test caps from the plumbing system have been removed. • T um ofF water supply to the outside lawn faucets 6efore freeze poten[ial exists. • Call the City's Engineering Department at 651-675-5646 prior to working in righUOf-way or installing irrigation system. 4 BUILDINGINSPECTOR: /VLk,-- ts?("e-' CONTRACTOR: Bjorklund Construction, Dick 2511 Condon Cour[ . r, ~wa.~ . . ~J .q : ~ p~ ~~g z ~Y , ~Q~ J ~ ~ ~ ~ t7!I, ; ~ ~ ~ ~ ~:1 ~ ~ ~ ~ w BbPes ~ ~ r ; / pr, ~ ~ . M ~ g111~NNWiII _ . . _ , r.. B~ ~p ~ ~ .p~°~yq~y~py ~~..w... ~ t, .0.i.2.~~~q.J ,+°~"'6; yy~p~' ~ 3 ` X R."9~y.".~1 .Alt."d-r.M~~`J~.F'J ~...JE~t..~ / ~ / ~ EXISTING NOUSE RVEY POND ( LP34 ) ~ Nw~=8~9.0 ' Surve for: RANDY WENDOLEK ~ Y )LEK HWL=887.2 ~ i 901.4 ~ / ' / ~ ~ ~ ~ i < / ~ ~p, ~ ~ 896.4) • i eois" ~ro~"~ i S i ~ 1 ~ ~ r $0°j ' » i eo r' o ~ ~ Q S3 star~, , ~ ~ ! ~ -2z.6 _ ~ e M~ ; ~ oa ,4~ ~ _ ~ 124,5g_ o ~ 1 0 { ~ _ ~ 88~'~ DEAD 18 ~ 1 ~ ~ ~ J / ~ J I i ~ ~ i~~ e9o.a i , ~ I. I ~ ~ r ~ i ~ ~ so~15 5 1 _I 1-as~'t ~ I i ; . i i~ ~ 1 15 ~i 1 1 ! ~ ~ I ~ ~ ~~CI i ~58.8 ~ ~ s i3° 1 1, 1 ~ ~ I i l I / ~ ~ 1 ~ 1 1 1~ ~ 1 ``t' ~ a• n~ 1 1 1 ~ ~ ~ 1 ~ez.a / / w~ ~ ~ ~ ~ . t ~ ~ ~ 88jL ~ / ~ ~ - $~7.2 ~ ~ orm "'80 10" ~ OA~1~" ~ ~~in l ~ ~ ~ ~ ~ 1i.~ 1 ~'o `~Ir DraiMa e& 1Ytilit E t I / . 0 9 Y o ~ea .a I ~ ~ ~ i ~ ~ ~ io4 ~ 88 ~ 1 11 1 ~ ~ 1 ~ ~ ~ ' a8e.e ~ ' 1, ` ~ ~ ' 1 , 1 ~ 1 ` ~ ~ ' ~eal S ` ~ 1 , e° 8$ ' Sl ~ ~ ~ 1 so io~ ~ ~ 0 , ~ .a,! ~ i ~ ~ S 86'00'00" E 1 \ S, ~ ~ ~ - 0 1 " ~ --)7. S( ! ~ 0 10'~ F, ~ i i / 9 i~V ~ 893. ~ ~ , 0~ . ,.~t1. . E ~ ~ ~ , I i ~ ~ ' 'i ~ i ~ .oo~O~ ~e'p0I°~ ~ ` ~ ~9 S' l ~ ~ ~ 1 il I I 5~ e " y ~ \ / ,3~ / h~ ' ~ s\ ~ \ ~ 848 \ / ' / i`' / (890~`~ ` ~ F ~ ~ , i ~ ' 'I I I ~ I . i ~ I~, I 1 1 l~~ ~ ~ ~ SCALE: 1= 20 ~ ~q ~ d I I I ~ 1 ~ ~ !891.0 1 ~ / ~ / / , ~ 3 ~ ~ ~ ~ ~ ~ ~ , , ~ ~ ~ ~ r / ~ 9~4 ~ , ~ ~ ~ / I ~ ~ ~ ` ~ ~ o ~ , ~ Y ~ 6/ j ' 3b . l I ~ ~ - 1 ~ ~ ~ o o g 0 r'/ ~ 9 5. 8 , _ _l _ -~-1, o,a} 2 i , ~ I m~ 1 ~ ~ 1 ~ ~ s / ~91.~ ~ ~ ~ ~ ~ ~ e _~--38.a ~ ~ ~ ~ 1 ; ~ 1 ~ J "ti , ~ ~ ~ ~ 90a. ~ ~ II ~ 80~7" ~ M I 1 1 ~ 1 , ~ ~ ~ ir~ ~ ~ I ~ ~ ! ~'o ~ ~ r ~ " , , ~ m. I m l~ , ~ J ~ ~ 90.6 ~ ~ , p, 898 0~ ~'c+ ~ Denotes iron Monument Found 1 ~I I'; ~~Ii N~~ 1 ~ ' I • ~ ~ ~ ~ ~ v~.~~ a~ : Found ~ I ~ o I' 7'{ I ~rn~i W ~ 1 a ~ 50~ ~ ~ 0 Denotes Iron Monument Set ~ EXIST~NG ~ 3 ~f ~ ~ o o~ ~ ? ~ ~ ! ~ , ~o ` ~ o ~ t Set ~ ~ I ~ asa.~ ~ o, o ~ ~ ya ~ I ~ y e. , o I i Jo ~ o ~ 89 .0 i o A HOUSE ~ f~~,~ i ~ ~ ol g o ~ / ~ / ~ _ , , ~?~oa~ ~o ;z ! 1 i ~ ~ ~'s~t.o~~ ~ ~ s ~ ~v: ; #4~J65 ~ p I o~ ~ o Gj~ ~ ~et^~~,i P ~ ~ ~ r ~ ~ ~ ~ ~ f ~ ) o Ih ~ ~ ~ 9 ~ A ~ ry ~ e,o, ing svap W OS I ~ i 2 QQ~ ail , Q ~ ~ ~ , ' ~ , ~ ' , _ _ _ l . ! @~`~ S~ ~ ; , y ~ T ~--,-4 ~ _ . , ; ~ : . ~ q , _ w_~_ , ~ , _ . , . r . . ~ . .n_t-`.~ . . „ . so .s ' ' '~~3i~~~ i~ ~ , ~ ~ - - - t - ~ i R , , ; 1 -,--4~0,3 ~ ~ ~ I i o I > i 899 8 _ ~ 1 t ' I ( ~ ti~~ o ~-1'~ l ~ 'I~" g; ~ ~ ~m I ~ ~ , ' ~ _ ~s" d ~ra a~'` ~ ~ ~ ~ x1 ~ ~ ~ ~ ' ~ ~1 ~ I ~ 'o ~ ~ ~ ~ ~ ~ I ~i ~ / o ss0~~ ~ s ~ / i ~ r ~ ~ ~ ~ ~ ~ I ~ ~ 1 \ ~ ,~y1 ~i ~ ~ ~ I i o s" zoo ~ ~ .o 99.~ ~i p~ , ~ ~ ~ ~ ~ ~ 896 3 ~ ~ p / ~ 1 1 i ~ S 8 'DO 00' E~ ~ -7 / ~ ~ ~ ' l , ; ~ ~ ~ 0 ~ ~ ~ :902J ~ l ~ ~ I ~ ~0~ ~ ~ ~ , L S i ~ ~ ~ f ! I ~ ~ ~ ~ ~ ~ 0 0 ~ ~ ~ ~ ~ ~~i ~q, ~ I / s~, ~ s, a, z., ~ ~ A ~ 899.8 ; a9 ~ ~ ~ 4 D~ ~ ~:'a ~ ~ ~ l ~ ~ ~ ~ y% ~ D~ , ~ ~ y ' i ~ ~ ~ i i i ~ 893~.4 ~ a ~ 1 i~ 895 1 ~ ~ , ! ~ \ ~ , ~ ~ i r'` / ~ 6,,~~ ~~E~ 12" ~ \ ,3~,~I ~ 1' i i ~ i~ ~ i \ , ~ / ' _ ~ ~ 0'g~. ~ _ _ t' , ~ 89 ~ ! _ ~ ~T~' 6" R 7" ~ ~ El ~J" % ~ ~ i ~ .d---""""% AREA ~F L~T = 21,816 s ~ft, ~ s~~`~ / q ~ ~ \ AREA ~F HOUSE = 2,084 sqft, ' iR d„ TR 8" ~ ~ ~ w ?R~7 ~ \ ti, f~ ,Cye~A . . ~ r ' E~ 6~ k~n ~ ~ ~ C7 `^'eF~ ~J.4 ~ ~ ~ 894.7 S I l~ . ~ ~~~6g 89 . ~ ~ ~ ~ - ~ A / ~ ~ ` k-~,./ \ \ ~ . ~ . . ~ ~ _ - ~ ~ ~ - - - ~ - ~ ~ R ~ ~ ~ 0 14 ~ 8958 - - - - - ~ - ~ ~ ~ ~T B 893.1 ~ ~80 9" ~EL 16" ~ ~ p~ ~o? ~95.9 Cur ~ ~3~n80 t~" ~ Curb , gg ~ ~ ~ St ~ ~ ~ ~ Sto ~ 8s7,27J p ~ ~93 I~ oA pian $s~ ~ Solid Contour Lines shown are fror~ approved grading p~an a ' =~L=:'7,88 ~ " s 9R - - , (dated 7-2-02) 'r.es~.o ~ --77.00 - R=.~5.00 m , „ S 89° ' W ~ ~ ~ L~= ~5'38 35 . ~ h ~j 0~i ~0 ~ . ~ ~ ~ ~ ~ ~ CB ~ 893.3 CB ~ AK POND ROAD 0 , 60 R\W TNH ~895.8 ~ DESCRIPTION: Lot 2 Block 1 ~dENDOLEK WOODS ~ , ~ i hereby certify that this survey was prepared by me or under my direct supervision, and registered land surveyor under the laws of the State of Minn o a, Dated this ~~pq day of :>erv+sion, and that I am o s~ day of July, 2003. ~ ~ ARLSON „ ? ~,i & INC. p~ / , ~ f CARLSON & CARLSON, INC. BY _ ~_~y=~" r:.~%:,.,.,~ ~-;2;! fAND SURVEYORS Larry f~. Couture, Land Surveyoi Land Surveyor 7ele. No. (952) 888-2084 Minnesota License No. 9018 No. 9018 900.5 900,0 L~~o suR~~o~s Proposed Grodes: Top of block Garage Fioor Basement Floor ement Floor _ 891.5 Revised 8-04-03 NOTE: Circied elevations are ro osed others are existin . Arrows denote direct;on of dr - 338-48a p p ' 9 direct;on of drainage. ~.a Use BLUE or BLACK Ink _ For Office Use x' ~ ~~13r n ~ City of Eq, Permit I Per mit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I I I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit Name: Z We, Phone: Resident/ Owner Address / City / Zip: ~v(~s'G~f\'_~ Yr~. I Applicant is: Owner Contractor Type of Work Description of work: Construction Cost: 2 Multi-Family Building: (Yes / No Company: f r a 07 Contact: ~J Contractor Address: -!1:4 ,L l City: L rJ~ State: M ~Q- Zip: Phone::) License#: Lead Certificate <sv - 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: i Sewer & Water Contractor: Phone NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that 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 completed within 180 days of permit issuance. x cQ~' L/01I It, x Applicant's Printed Name Applicant's Si Nature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA139263 Date Issued:10/17/2016 Permit Category:ePermit Site Address: 4561 Oak Pond Rd Lot:002 Block: 001 Addition: Wendolek Woods PID:10-83565-01-020 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Randy A Wendolek 4561 Oak Pond Rd Eagan MN 55123 (612) 382-3711 Carrolls Exterior Remodeling Inc 16402 Harvard Dr Lakeville MN 55044 (952) 356-3131 Applicant/Permitee: Signature Issued By: Signature