4084 Oakbrooke Alcove• ?RESI EN IA
BUILDINC PERMIT APPLiCAT10N.
CITY OF EAGAN
3830 PILOT KNOB RD • 55122
?P- 4eqbo- I
MP-qb9 ?I -
I D?370?f 653 03 - Qa(46roo?.Q ?y 851-881-4875
New Construction Reauirements
• 3 registered sM1e surveys sAowirg sq. ft W lot sq. fl. of house; and all roofed areas
(200/o macimum bt coverage allavO
• 2 copies W plan shaxing beam & wiMOw saes: poured faund design, etc.)
• 7 set of Energy CalalaLons
• 3 copies ot Tree Preservation Plan if lot platted after 711193
• Rim Jaisl Detail Op0on5 selecfion shcet (bldgs wNh 3 w less units)
DATE ?)WOJ
jJB SITE
IF MULTI-FAMILY BUI
PROPERTY OWNER?
TYPE OF WORK
APPLICANT AU 1 i
?s
ADDRESS 95
PAGER #
HOW MANY/? UNITS?
oV IV
pP ?b?6z
RemodaVReoairReauiremeMS -
. 2 coPies M plan
. 1 setof Energy CalcuulaUUns fur healed additbns
. t site survey for exterior additions 8 deck5
k4f j lq24
5IZ6, ll
70, 50.
?0,50
.f-
51??, I?
?
p ??42i 1 ja?33o
ALUATION (EXCIUDING LAND) )
I
? FIREPLACE(S) _0 _L1 _2 _3
U i'*N C0JrI PHONE #
'?b / Gt,I'ICyvw ZIPCODE Sslal
CELL PHONE # I.2 -3 b tHFAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
D?r ? ? r? ?
Energy Code Category MINNESOTA RULES 7670 CATEGORY 1
? U
(check one) - Residential Ventilation Category 1 Worksheet Submi N
- Energy Envelope Calculations Su6mitted ? ?
uu
? MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted By
PlumbingConhactor: aPr? Pl-WASPG Phone#:
Plumbing System Includes: _ Wa[er Softener Lawn Spruikler Fee: $90.00
Water Heater T No. of R.I. Baths
3 No. of Baths
Mechanical Contractor. &fnsY1Git /Jt?Anatf Pfione# ?ooor
Dlechanical System Includes: Air Conditioning Fee: $70.00
Heat Recovery System
Sewer/Water Contractor. ALifa eC o c,Jh 1s2/y1 lct5 Phone # 763-qQ$443d
All above inEormation must be submitted prior to processing of application.
I hereby acknowledge that I have read ihis application, state that the information is correct, and agree to complywith
all applicabie State of Minnesota Stotutes and City of Eagan Ordinances.
Slgnature of Apptlcant iov/Y
Certificates of Survey Received Y_ Tree Preservation Plan Received _ Not Required )(_
UpGated 1101
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 73 16-plex ? 20 Pool
P"02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of_ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn.(4-sea.)
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened)
? 05 03-plex ? 11 10-plex ? 19 Lower Level p 24 Stortn Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
[?P 31 New
? 32 Addition
0 33 PJteration
? 34 Replacement
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Valuation t 00- Occupancy ?
Census Code !O ( Zoning N T/)
SAC Units ?L Stories o2
Nbr. of Units Sq. Ft. S a
Nbr. of Bidgs ? Length f?
Type of Const ? Width S-l
? Footings (new bldg)
_ Footings (deck)
Footings (addition)
?J Foundation
rt ? Drain Tile
Roof Ice & Water Final
? Framing
Fireplace _ R.I. _ Air Test _ Final
? Insulation
_ Other
_ Pool Ftgs Air/Gas Tesu _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
Approved By b _, Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
ciry sac
Water Supply & Storage
S8W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
O 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
? 37 Demolish (Bldg)" ? 43 Reroof ? 46 WindowslDoors
`Demolition (Entire Bldg only) - Give PCA handout to applicant
REQUIRED INSPECTIONS
? FinaUC.O.
_ FinaUNo C.O.
_ Plumbing
_ HVAC
/l7of?- d?' z
11?1.?10 /r7v ?csY =
/aG8? L%Sq? 2
? 30 Accessory Btdg
? 31 Ext. Ait - Multi
? 33 Ext. Alt - SF
0 36 Multf
l7/ 5`SO"C?
??-
C',f?G'6- ,- rr
2 /
YJ
Addtess 4084 Oakbrooke Alcove Zip 55122
L,pt 053 $lk 3 Sub Oakbrooke Sth
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: /'" , - .? I-C; Yes No Inspector:
Final grade (6" from siding) `'~^
Permanent steps (garage)
Permanent steps (main entry) x
Permanentdriveway X
Permanent gas X
Sod/Seeded grass
TraiUcutb damage ?
Porch ?
Basement finish
Deck x
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exisis.
Contad engineering division at 681-4645 before working in righbof-way or installing underground sprinklet syscem. ?
Whice - Ciry Copy Yellow - Resident Copy Pink - Conuactor Copy
. • RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
U U 3830 PILOT KNOB RD, EAGAN MN 55122
657-881-4675
NewConstruction Renuiroments
• 3 registered site surveys showing sq. k. of lot, sq. ft. of house; and all mofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing 6eam & window sizes; poured found design, etc.)
• 1 set of Energy CalculaHOns
• 3 copies of Tree Preservation Plan'rf lot platted a$er 111193
• Rim Joist Detail Options seleclian sheet (bldgs with 3 or less unAS)
DATE
SITE ADC
TYPE OF
APPLICANT
MINNESOTA RULES 7670 CATEGORY 1
. Residential Ventilation Category i Worksheet Submitted
. Energy Envelope Calculations Submitted
ULTI-FAMILY BLDG Y N
FIREPLACE(S) _ 0 _ 1 _ 2
STREET ADDRESS /-t%J-- CITY_s?STATE
TELEPHONE #/ U99? CELL PHONE #?6/Z? ?19-/7ZZ FAX #
PROPERTY
OWNER?„1 ZCV-S01-J TELEPHONE#(0 6P8'OW
-----------------------------------------------°-----------------°---------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category
(J submission type)
Plumbing Contractor: ____
Plumbing system includes:
Mechanical Contractor:
Mechanical systcm includes:
Sewer/Water Confractor:
_ Air CondiLioning
_ Heal Recovery System
Phone #
Phone #
I hereby acknowledge that I have read this application, state that the information is
with all applicable State of Minnesota Statutes and City of Ea an Or nces. /
Signature of
P'ee: $70.00
and agree to comply
OPTICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
o.J
Water Softeoer _
Water Heater _
No. of lialhs
0.o-?)
Remad"e air. uirements 2 caoies of pT-•,
• 1 set of Ene ? ns for healed addifions
aufoe?lenoredditions e
. n icate if home served by septic system for additions
VALUATION
P}l01]C #
Lawn SprinL
No. of R.I. 1
Updated 4102
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? OS 03-plex
? 06 04-plex
?! 31 New
\
?q 32 Addition
r?' 33 AlteraUOn.
? 34 Replacement
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn.(4-sea.)
? 23 Porch(screened)
? 24 Storm Damage
? 25 Miscellaneous
,
? 30 Accessory Bldg
? 31 EM. Alt - Multi
? 33 EM. Alt - SF
? 36 Multi
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)" ? 43 Reroof ? 48 Windows/Doors
'Demolition (EnUre Bldg only) - Give PCA handout to applicant
Valuation _02:?E7 Occupancy MC/ES System _
Census Code ? Zoning City Water _
SAC Units Stories Booster Pump _
Nbr. of Units Sq. Ft. PRV _
Nbr. of Bldgs ? Length Fire Sprinklered _
Type of Const Width
REQUIRED INSPECTIONS
Footings (new bldg) FinaUC.O.
Footings (deck) Final/No C.O.
? Footings (addition) Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replace ment)
_ Insulation _ Retaining Wall
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 OS-plex _)<18 Deck
? 11 10-plex ? 19 LowerLevel
? 12 12-plex Pibg_Y or _ N
Approved By TL Z,, Building Inspector
r f
Surveyor's Certi,ficate
N
PF
Top
Prop
IfA
RVEY FaR :PULTE HOMES
SCRfBED AS :Lat 5, 91ock 3, OAKBROOKE 51H ADDIION, City of Eagon. Minneso{a and
aaaemente pf rocord.
.: h
5>2 a ' i
40?0
?'3gJ,0 i,
?
VJ
?38 , q? ? ?I .
^ ` M1? N j /' i i!
?
946 q l?Ql ,y?A / ? L;?
!? ?•• ?q? ,?• / B
947.
q ?.9 < ? ,r /f ? / e ? ????
3^??x?
Qqa ?N5 3 g? n'ur?r/ruk ?/?e? ?o '
4484?
qdSt
afLi W-,A. LO
L T SQ. FOOTAGE = 14,590 ''''
E
HSE SQ. FOO 7'A GE = 1,914 L 0 T C01/ERA GE = 13?'
!,
?
;.,
,
;
?, .
i,
,
;. ;
?2
?
?SED ELEVATIONS
BENCHMARK,
Foundatf.on = qqg,p +!
? FloAr -q47.?,
ent Floor = 939.0
Sewer Servfce = qsc,.a? ?i i !
ed Elev. -Q MIN. SETBACK REQVIRE(illIg
? Elev.
3e Directipns s Front - Fiouse Side?
s Offset Stake =. SCALE, I fth ?30 feet ReAf - Garoga. Sid,9-;
??UND I MERFBY CERIIFY 1}{AT TMIS IS A TRtIE ANp CDRRECT REPRESENTAIIQN 01
Of iME BOUNDI1RIfS OF 7HE ABOVE DESGAIBW PROPERTY AS SURYE7ED
BT ME OR UNOER M1' DIRECT SUPERMSION AND DOES NOF PURPORT i0 BOOK:
SNFlNS6pmG SURV6YIKG SHOW IMPROYEMfNi$ OR EryCRpAqiMENT3, E7fCEPT AS &101M7.
M7b Pin? 5,5122 ? DATE JLIf=Q/?- ?'? CAD FlLi
agam, Ne: (851) 405-68AO E D. tJNDCREN, LMip qVEYOR '
(851) 4Q5-86Q8 ,?u,Y?-2(? ir/ Q?j? MIN OTA LIOENSE NUMBER 14378 OOI
B
d 0186'ON ac'/Cr 9NIa33N19N3 ONf1103N WVlZ?B 100Z '8?'a
. Jlk-27-20,33 14:42 ?--uL?E HUMES F.O---/02
MXC'sieck CQMFLIA..NCE REPOR'I
Mix:neaota Energy 4ode
MNche^k 9oftware zJersion 3.0
CO+IN'PY: Dakata
STATE: MinaesOta
ZdNw' : 2
CONSTRUCT;;pN TFPE: Binale Psmily
DATJE: 7-27-2000
T_'I+TE (.IF pLP.h:: 7!25/00
TSiLE; oakbrecke 5terlir-g with Lnoko:zt
COMP'tfA.NCE: PFaS°ES
ReqUired LTA = 532
Yotir iiGme « 403
24.2`: Bette.l' Va2: COtje
Y Fexrnit # -
Checked bW 1Jate
area or L'avity Cant. Glaaing,rpoor
PerimeLer R-Va'_ue A-Valu9 U-VaIUe
------°^' ----
___. ---'-----_-'__-.--- -----------------'°'------.._.»___'_-^•_
rr_.T;,;IIi?g 1218 38.0 00
d1A'-:L!9c Tr+oc:i Prame, ?E" 4.C. 2673 1910 2.0 1
BSNIT: Con4. 9.0' YstJ8.3t b9J9,0' ir.sul 1447 11.0 0.0
GLAc:ZNCI: w:.ndows cr Doora, e7cove Grade 402 0.350 2.
I;;;OM 38 C.>SO
FiCr^RS: Gvar Outaide Air 48 38.0 0.0
rIVAC ERT?IHM.Eh'T: FLrnaca, 92.0 AFUE
C3F?tPLZFadGB STATE?SENTw??The proFosed buzlding design descsib?n ;ese is ?.~
caris5-&te:,C witt, the ouildi_ng alans, epecificatior.s, and other calculations
au}amitted wzth tha per,mit ap l:carian. The proposed building has been
aesigned to eme'n.14e?innesota 8nmr,qy ;,•cde.
9uildez(7ea
nate
T17TRL P.02
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTYLEGAL: L&,-t S- BlO?IC -3> j
.IIthrnmKG
DATE OF SURVEY: o°-
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LATEST REVISION:
DOCUMENTSTANDARDS
• Registered Land Surveyor signature and company
• BuiklingPermdApplicant
• Legaldescription
• Address
• North artow and scale
• House type (rambler, walkout, split w/o, splR entry, loakout, etc.)
• Directlonai drainage arrows with sbpe/gradient 9'0
• Proposed/existing sewer and water services & invert elevation
• SVeet name
• Driveway
• Lot Square Footage
• Lot Caverage
• Benchmark
ELEVATIONS
Existinq
• Sewer service (or Proposed)
• Property comers
• Top of curb at the driveway and property line eMensions
• Elevations of any existing adjacent homes
• Adequate footing depth of siructures due to adjacent utility trenches
• Waterways (pond, stream, etc.)
/ Proposed
d 0 ? . Garage floor
fi?/ ? ? • Firstfloor
? ? • Lowest exposed elevation (walkouUwindow)
r+a?p ? • Property comers
r? ?? • Front and rear of home at the toundation
PONDING AREA (if aoolicable)
? ? ? • Easement line
? C? ? • NWL
? ? ? • HWL
? R/ ? . Pond # desynation
? Q/ ? • Emergency Overflow Elevation
OIMENSIONS
VLl ? • Lot lines/Bearings & dimensions
?? • Rght-of-way and street width (to back of curb)
r9/? ? . Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
/ (i.e. all structures requiring pertnanent footings)
[3' o? • Show all easements of record and any City utilities wdhin those easements
?? . Setbacks of proposed structure and sideyard setback of adjacent exisGng structures
C? n ? • Retainingwallrequirements,'rfany
Reviewed:
Surveyor's Certificate
SURVEY FOR :PULrE HoMEs
DESCRIBED AS :Lot 5, 81ock 3, OAKBROOKE 5TH ADDIION, City of Eagan, Minnesoto and reserving
easements of record.
AUG 31 REC'D
SlL?r
t ?
r??G? 572?40' ?,.
0 f
?39•3p
932.
932`5
p ?
h ? 9382 -? °
? O
385
? /?/ Qo ?J69 938.2
s 64-
ti? v 'a 438. / ? ?=- j
9a?.9 ?l7 0 ??°o ?Aan 4-'`?
Oo ,y,p ?ZDD `ti^ / rL?
? 9475 9427 44to.2 < ?% ; i ? QD ??
q45• Q \ ? ?tio ? ?'? ? i N62°
g0 \ /
94S ? ?? ? ? - -?9966 •._..T . .?.
?4qe M . ? O ;p V ..
995?rc .99b,o „oiJUnVn ?1???6??L`?1??.
4084
OAKB KE4? ' "AL E L O T SQ. FOO TA GE _ 14,590
HSE SQ. FDO TA GE _ 7,914
LOT C01/ERAGE = 13%
:
? ???? ????EL? 4}
rly
?.,
p' 18232 ,!
PROPOSED ELEVATIONS
BENCHMARK,
Top of Foundation = 998.0
Gorage Floor =
Basement Floor = 939.0
Aprox. Sewer Service =q3c?ot
Proposed Elev. = 0 MIN. SETBACK REQUIREMENTS
Existing Elev.
Drainage Directions = Front - House Side -
Denotes Offset Stake =. SCALE: t in<n ? 30 feet Reor - Garage Side-
JOB N0:
HEDLUND I HEREBY CERTIFY TNAT 7HI5 IS A TRUE AND CORRECT REPRESENTATION O1R-385
OF THE BOUNOARIES OF THE ABOVE DESCRIBED PROPERTY AS SURVEYEO
BY ME OR UNDER MY DIRECT SUPERNSION AND DOES NOT PURPORT TO BOOK: PAGE:
PLdNN/NC 6NGIN6dR/N47 SURV6Y/NC SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN.
2005 Pin Dok Drive
Eagan, MN 55722 DATE ?,?,Q1 • CAD FIIE:
Phone: (657) 405-6600 a"F D. LINDGREN, LAND RVEYOR Faz: (651) 405-6606 OTA LICENSE N11A16ER 14376 Oakbfooke 5
Site address: Lot Block 3 Subd. 0l1ll?
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 requirirjg that the following information be
submitted prior to issuance of a Certificate of Occupancy.
This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
? This structure: will be consVucted to meet more resVictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYRE
Water Heater
?fj9??
as
Fumace ?0
Dryer
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
4ES No
Kitchen kitchen
Bathroom 1 ? ? ,WV G -Q5y
Bathroom 2 , A59V )p 5qA)
Bathroom 3
'
2-0
Bathroom 4
Other
AiMO$
MAKE•UP AIR MODEL TYPE CFM's ?
YP i7
I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code antl Gity of Eagan
requirements.
v
S?ii°I?e JIklft c s
CompanyName
lz/??? I
Date
This form is ihe responsibility of the General ConUactor.
RESIDENTIAL BUILDING
Permit Application
y?-- r G City Of Eagan
'" i??o O 1 3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674
New Construction Reauirements RemodeURepair Reauirements OKce Use Onlv
3 registered si[e surveys showing sq. ft. of l06 sq. fl. of house; and all roofed areas 2 copies of plan CeA M Survey Recd
(20% manimum lot coverage allowed) 1 set of Ene(gy Calculations for heated additions Tree Pres Phan Recd
2 copies of plan showing heam & window sizes; poured found design, etc. 1 site survey for addilions 8 deaks Tree Pres Nol Reqd
1 setofEnergyCalcula6ons Add'rtion - iridkateHar-sitesepHcsysfem _ On-siteSeplicSystem
3 copies of Tree Preservalion Plan if lot platted after 711193
Rim Joist Detail Options selection sheei (hldgs with 3 or less uniLs
Date 13 / 03 Construc6on Cost
Site Address UniUSte #
Descriptio¢ofWork
Mul[i-Family Bldg _ Y k N Ftireplace(s) _ 0? 1 _ 2
Property Owner ?J ' SON Telep one # ,.36/
Contractor
Address City
State 2ip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 su6missiontype) Submitted 5ubmitted
• Energy Envelope Calculations Submitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone # (
I hereby apply for a Residential Building 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 State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work * a
permit; that the wark will be in accordance with the approved plan in the case of work rAla re v- d
approval of plans.
/ JAN 13 2003 U
?.v Gc,rs o n/
AppTicanYs Printed Name P?p ' s5? ure ?„ ??-?
OFFICE USE ONLY
Sub Types
? Di Foundation ? 07 05-plex ? 13 16-plax ? 20 Pool
? 02 SF Dwelling ? 08 06-plex * 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? 05 03-plex ? 11 tp-plex ?t 19 Lower Level ? 24 Storm Damage
? 06 04•plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
Work Types
0 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to appltcant
?
Valuation Occupancy MC/ES System _
Census Code -?i 3q _ Zoning City W ater _
SAC Units Stories Booster Pump _
Nbr. of Units Sq. Ft. PRV _
Nbr. of Bldgs Length Fire Sprinklered _
Type of Const i ja _ Width
_ Footings (new bldg)
_ Faotiugs (deck)
_ Footings (addition)
_ Foundation
Ihain Tile
Roof Ice & Water Final
Framing
? Fueplace"10 R.I. P Air Test 4 Final
? Insulation
O 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Eut. Alt - SF
? 36 Multi Misc.
Siding
Fire Repair
WindowslDoors
REQUIRED INSPECTIONS
FinaUC.O.
? FinaUNo C.O.
Plumbing
? HVAC
Other
_ Pool _ Figs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By
Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
5&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
PLUMBING (RESIDENfIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephoue 4 651-675-5675 FAX # 651-675-5674
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required for each unit
Date 1.3 / d --
Sit
Add
& U
it #
ress ,.
e
pve- n
Property Owner ? •.?t? LC?(50?J Telephone # ( Fi/L ) 3E P'17ZZ
Contractor
Address City
S[ate Zip Teiephone # ( )
V
The Applicant is
Owuer _ Contractor _ Other
Septic System New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00
Includes County fee. Additional consultant fees may apply.
Alte atio s To Existing Dwelling Unit, Including $ 50.00
Adding fiMures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water turnaround (+ 5/8" meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
_ Water softener _ Water heater $ 15.00
_ replacement _ additional
State Surcharge
I? LJ $ .50
JAN 1 3 2003 U?
Torai N 1 $
I hereby apply for a Residenfial Plumbing Permit and aclrnowledge that the info?tion is complete and acc te; that the work will
be in conforxnance with the ordinances and codes of the City of Eagan and with ? Plumbi? derstand this is not a
pernut, but only an application for a pemut, and work is not to start without a permit; that the work wi 1 be in accordance with the
a roved plan in khe case of work wluch requires a review and appro of plan's:
O,.I ---_.f
p icanYs Printed Name ? Appl?eazft'i&?a e
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA110636
Date Issued:05/20/2013
Permit Category:ePermit
Site Address: 4084 Oakbrooke Alcove
Lot:5 Block: 3 Addition: Oakbrooke 5th
PID:10-53764-03-050
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 -
Daniel E Larson
4084 Oakbrooke Alcove
Eagan MN 55122
Applicant/Permitee: Signature Issued By: Signature
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For Office Use
Permit#:‘ •:‘% E AG N
•�•• ••�� Permit Fee:
74-/?Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 RECEIVED d'
(651)675-5675 I TDD: (651)454-8535 I FAX:(651)675-5694 Staff:
buildinginspectionsacitvofeagan.com ----
JUL 16 2019 J
2019 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:7/15/19 Site Address:4084 Oakbrooke Alcove Unit#:
Name: Brett Forsman Phone:952-994-996
Resident/ 4084 Oakbrooke Alcove, Eagan 55122
Owner Address/City/Zip:
Applicant is: Owner ✓ Contractor (:)11
Description of work: Solar PV Installation
Type of Work
Construction Cost: $9,261 Multi-Family Building: (Yes /No ✓ )
BigDogRenewable EnergyLLC Tephi Zitting
Company: Contact:
Contractor
Address:620 Pheasant Ridge Dr city: Chubbuck
State: ID Zip:83202 Phone: 385-219-1552 Email: permits@vetrixsolar.com
License#:EA748433 Lead Certificate#:
If the project is exempt from lead certification, please explain why:
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:
Fire Suppression Contractor: Phone:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe
classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaaan.com/subscribe.
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.
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 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 lans.
XTephl Zitting
Applicant's Printed Name Applicant's igna ure
I
L i
AtCC1/C-` C �DO NOT WRITE BELOW THIS LINE D � �1b�< C � �
SUB TYPES
Foundation _ Fireplace _ Porch(3-Season) _ Exterir Alteration(Single Family)
XSingle Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
— Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex Lower Level Pool Accessory Building
WORK TYPES
New _ Interior Improvement _ Siding _ Derr of sh Building*
Addition _ Move Building _ Reroof _ Dem of sh Interior
1 Alteration _ Fire Repair . . _ Windows _ Dem of sh Foundation
Replace _ Repair _ Egress Window _ Water amage
Retaining Wall *Demolition of entire building—give PCiN handout to applicant
DESCRIPTIONei f
Valuation 2(9° OccupancyDv/4 MCES System
Plan la Review Code Edition v rj ("51 SAC Units
(25%_100% ) Zoning —14City Water II
Census Code Stories Booster Pur iii
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction W Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings (Addition) Final/No C.O. Required
Foundation Foundation Before Backfill I- HVAC Service Test Gas Line Air
Test Hood
Roof: Ice &Water Final Pool: Footings Air/Gas Tuts Final
1( Framing 30 Minutes 1 Hour Drain Tile
Fireplace: Rough In Air Test Final Siding: Stucco Lath Stone Lath Brick EFIS
Insulation Windows
Sheathing Retaining Wall: Footings Backfill Final
Sheetrock Radon Control
Fire Walls Fire Suppression: Rough Ir Final
Braced Walls _ Erosion Control
Shower Pan Other:
Reviewed By: 11—, Building Inspector
RESIDENTIAL FEES
Base Fee .50 lime
Surcharge
Plan Review 101, L'i
MCES SAC P\i'
City SAC
Utility Connection Charge (.- 00 *00
S&W Permit& Surcharge
Treatment Plant
Radio Meter Read
Copies 3.2 p .a.1 O • o b
TOTAL
Page 2 of 3
1
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA164355
Date Issued:09/25/2020
Permit Category:ePermit
Site Address: 4084 Oakbrooke Alcove
Lot:5 Block: 3 Addition: Oakbrooke 5th
PID:10-53764-03-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater & Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Brett S Forsman
4084 Oakbrooke Alcove
Eagan MN 55122
(612) 730-6355
Dean's Professional Plumbing
7400 Kirkwood Court N
Maple Grove MN 55369
(763) 428-1321
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA165079
Date Issued:10/16/2020
Permit Category:ePermit
Site Address: 4084 Oakbrooke Alcove
Lot:5 Block: 3 Addition: Oakbrooke 5th
PID:10-53764-03-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Brett S Forsman
4084 Oakbrooke Alcv
Eagan MN 55122
(612) 730-6355
Dean's Professional Plumbing
7400 Kirkwood Court N
Maple Grove MN 55369
(763) 428-1321
Applicant/Permitee: Signature Issued By: Signature