4092 Oakbrooke Alcove
Use BLUE or BLACK Ink
r
For '477 Office Use /
~ Permit q4 B j
City of Ea a~
I Permit Fee: 6-0
3830 Pilot Knob Road
1-Ho
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: z~,aG
Tenant: Suite
RESIDENT /OWNER Name: e7- Phone: 61
,a Address / City / Zip:
~v~
Applicant is: 1K Owner Contractor
TYPE OF WORK Description of work: ~~ze L W 8 /-CIO
c_
Construction Cost: Multi-Family Building: (Yes / No
CONTRACTOR Name: £~~License 6~w
Address: ~3 75 rv ~ ~~"l~i~ AAleIq City: l/f-/15k
State: -1 Zip: 0s''3 Phone: 7V/
Email: d 7L
Contact:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.ciopherstateonecall.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 out a permit; th a work will be in zll
accordance with the approved plan in the case of work which requires a review and approval of plans.
x~/ ✓7 x
Applicant's Printed Name Applicant's Signature
Page 1 of 2
Address 4092 Oakbrooke Alcove Zip 55122
I.ot I Blk 3 Sub
Oakbrcoke Sth Addition
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: - 9-0 Yes No Inspector. L2?
Final grade (6" from siding)
Permanent steps (gazage) x
Permanent steps (main entry) X
Permanent driveway
Permanent gas
?
Sod/Seeded grass y-
TraiUcur6 damage 31/-
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shutoff of water supply to
the outside [awn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Conveccor Copy
' ` • RESIDENTIAL BUILDING
Permit Application
? City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
--jj 1`7 Q . 2-?
New CanstrucGOn Reauirements RemadeUReoair ReauiremenLS Otfice Use Onlv
3 registe2d sde surveys shavirg sq. f4 of l04 sq. R of house; and afl roofed areas 2 copies of plan Cerl of Survey Recd
l20% manimum bt coverage allowed) 1 set ot Energy Cakulations for heated additions Tree Pres Plan Recd
2 copies of plan showing beam & window sizes; poured found design, etc. 1 stte survey for additions & decks Tree Pres Not Reqd
1 seta(EneryyCakula6ons Addition-indicafei/on-sdesepticsystem _On-sReSeptlcSystem
3 oopies otTree PreseNation Plan if lot plaried aBer 7/1193
Rim Joist Oefail Options selection sheet (bldgs vrith 3 or less uniLa
Date LZ /
Site Address 409Z
E? u 3
Oekbruo?e Atoov?
a,., 551 z Z Construction Cost 5I oo?
UniUSte #
Description ot Work b_,oj[--
Multi-Family Bldg _ Y X N Fireplace(s) _ 0_ 1_ 2
Property Owner
?- 3
V.a;,,d-y "f1,cv, s}
r
Telepho¢e#(C,5! ) 4S? 374
Contractor .-?ia,.{-k, 1"c, •
Address 34GV
State Y"1 tj b,r. Sti-4c- 2.3U4 City Ea!!?ay?
Zip 551 Z.3 Telephone #(`7S z) 2( a 1"7 os
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv I _ Minnesota Rules 7672
Energy Code Category . Residential VenUlatlon Category 7 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculatlons Submitted
Licensed Plumber Telephone #(
MechanicalContractor Telephone#(
SewerlWater Contractor Telephone # (
172 V
I hereby apply for a Residential Building Pennit 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 5tate 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.
A\,ex bv,- \e.
Applicant's Printed ame
ApplicanYs Si ture
OFFICE USE ONLY
Sub Types
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? OS 03-plex
? 06 04-plex
Work Types
-A 31 New
? 32 Addition
? 33 Altere6on
? 34 Replacement
?
?
?
35 Int improvement
36 Move Bldg.
37 Demolish (Bldg)"
'Demolition (Endre
Occupancy _
Valuation oeio
Census Code y
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const IA
? 38
? 42
? 43
Bldg) - Give PC
? '3
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn.(4sea.)
? 23 Porch (screenlgazebo)
? 24 Storm Damage
? 25 Miscellaneous
Demolish (Interior) ? 44
Demolish (Foundation) ? 45
Reroof , ? 46
A handout to applicant
MC/ES System _
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length ? Fire Sprinklered
Width
4
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 EM. Alt - SF
? 36 Multi Misc.
Siding
Fire Repair
Windows/Doors
Footings (new bldg)
Footings(deck)
_ Footings(addirion)
Foundation
Drain Tile
Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. _ Au Test _ Final
Insularion
REQUIREDINSPECTIONS
FinaUC.O.
?C7 FinaWi o C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ 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
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 OS-plex IRA 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or _ N
?y-r
Surveyor's Certificate
SURVEY FOR :PULTE HOMES
DESCRIBED AS :Lot 1, Block3 OAKBROOKE %TH ADDIION, City of Eagan, Minnesota and reserving
easements of record.
P1Ak (i f; ViLCU
/ s
ao
S/ LT
fr-.A,GE
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J/
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? Exist. Home ?
7,0 ? TOB =997.9 ?
r ?
996.3 0 995.'7` 1
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-° - - ??E 163 g
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941.8 '
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22.0
o? I 996.1 ?D_....__ ProPosed
2-
yr) - 9 Story
'pcw d??
N v^, ? r o
? I I ?0 947.3 0
B. b,o 27.oo
-
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-?QWKBROOKE TERRA CE -- ?
945.5
/
PERMIT# -? `
RECEIPT DATE:
8008 MTDENTI!!L PLiJM$ING PEiM1T APPWCATION
crrY og EAem
S$SO i'ILOT KNOB RD
SAHAA, bd1Y 551 ES
651-681-4675
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
SITE ADDRESS:
OWNERNAME:: 2?4 ?2?c.c.?
i
INSTALLER NAME:
STREET ADDRESS: 1-7 I'f oc¢t? N? i
?
CITY:
TELEPHONE #:i
(AREA CODE)
TELEPHONE #: 6
? (AREA ODE)
STATE: All'-t-7 ZIP:
_ SEPTIC SYSTEM, new/refurbished (requires two sets of pians and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply
• MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding fixtures to lower levels or room additions, excluding water sokeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water tumaround - existing dwelling unit (+ 5/8" meter if needed -$118)
Other:
_ RPZ: new installation/repair/rebuild $ 30.00
??lawn irrigation system ?u Q
e
ReplacemenUadditional: _ watersoftener _ waterheater $ 15.00
State Surcharge .50
?
TOtal $
KT
I hereby acknowledge that I have read this application, state fhat the infortnation is correct, and agree to complywith all applirable Cityof Eagan ordinances. It
is the applicanYs responsibiliry to notify the proporty ovmer that ihe Ciry of Eagan assumes no liablli r any ages usned by the City during its normal
ent
operational and maintenance activities to the facilities constructed under this permit withi City rty/rig --wa! y/ e
??
SI??IGATURE OF PERMITTEE 1102
Lb _?- l 6 loc?k.? R SI N IAL -?1q3.11
o BUILDING PERMIT APPLICATION
° CITY OF EAGAN ?IU • ta)
3830 PILOT KN06 RD - 55122
651-681-4675 e,P L-4 q
New ConstrucNon Reauirements
• 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; anchll roofed areas
(20% maximum lot coverage albwed)
. 2 capies of plan showing 6eam & window sizes; poured found design, etc.)
. i set of Energy Cakulations
• 3 copies o( T2e Preservation Plan iF lot platted afler 717/93
RemodeUReoairReouirements
• 2 copies af plan
• 1 set of Energy Calculations for heated addNons
. 1 site survey tor exterior additions & decks
. Indipta'rf home served by septic system for addiiions
• Rim Joist Detail Opdons seledion sheet (bldgs wiN 3 or less units)
3
DATE VALUAfION
.
c_L,AQ-? 3 = fq ,a?
JOB SITE ADDRESS yv 5-Z OG ? L ? ?oa/cc. 4,1,.•
IF MULTI-FAMILY BUILDING, HOW MANY UNITS? V 1,4
PROPERTY OWNER PIge 4? o-f /yJ& Go rP
TYPE OF WORK _V e:.. Co n s??? c??.?+ FIREPLACE(S) _ 0%/ 1 _ 2
APPLICANT Pk 4a 4?, oT Hlit/Co,O PHONE#&5i/z/s.2
ADDRESS 9'19' /llvr t-Z. 4,<s -r * t I ud ZIPCODE ?s/ -14
PAGER # CELL PHONE #
FAX #
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COM D ????
Energy Code Category MINNESOTA RULE3 7670 CATEGORY ?pR 0 6 ZD02
(check one) - Residential Ventilation Category 1 Worksheet S tt
- Energy Envelope Calculations Submitted ?
?
? MINNESOTA RULES 7672 By------
- New Energy Code Worksheet Submitted
Plumbing Contractor.
.?, Phone #:
Plumbing System Includes: _ Water Softener Lawn Sprinkler ee: $90.00
1 Water Heater ! No. of R.I. Baths
_a No. oF Baths
Mechanical Contractor. 13t. r N 1 v" )) e, /"''?m t-, , a Phone # cl-SoZ??fS C/ - dOOS
Mechanical System Includes: X Air Conditioning Fee: $70.00
Heat Recovery System
Sewer/Water Contractor. At i « G-e.,,,pl, k 1 Phone # 7? 3A.:11 8-38
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the informatio 's correct, and agre to comply
with all applicable State of Minnesota Statutes and City of Eagan Or ' e ?
Signature of Applicant u.-
Certificates of Survey Received Tree Preservation Plan Received _ Not Required
Updated 2002
OFFICE USE ONLY
K01 Foundation
?
? 07
05-plex
? 13 16-plex
? 20 Pool IO
30 Accessory Bldg .,
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) IO 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) 'O 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ?O 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage I
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ?
31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
I
Valuation
-
- Occupancy MC/ES System
Census Code ?
f D 1
Zoning ?1
City Water
SAC Units ? Stories Booster Pump
Nhr. of Units Sq. Ft. PRV
Nbr. of Bld
gs
Length
? Fire Sprinklered
Type of Const ilY1/ W idth
REQUIRED INSPECTIONS
? Footings (new bldg) ?C FinallC.O. i
_ Footings (deck) _ FinaUNo C.O. I'
Foorings (addirion) Plumbing
I
Foundation _ HVAC
? Drain Tile Other I
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
? Franung Stucco _ Stone 'I
Siding
? Fireplace )( R.I. 1c'AirTest al
?m _
_
Windows(new/replacement) I
Insulation =
Retaining Wall j
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
5&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
ToWI
P,pproved By II , Building Inspector T 2- -- --- ? rL ---1 I ---- ?- j-s,l -------------
? o
??yi? G 3,
t?? (??? I 1 70 y
y- Co 5?,' 2 7)_
I M lil ` ??r Y? f--
?----
'?? ? 5"?? ?l ?`
1 1
MNr.hPCk COMPLIANCE REPORT i
? pPrmit #
MinneGnta Enemv CndP ?
MNr.her.k Snftware VerSinn :i.0 1 I
I Cherkad hvlDatP I' I
?
COUNTY' Dakota
STATE: Minnesota
ZnNF: 2
CnNSTRUCTION TYPE: Single Family
DATF: 1-11-2002
DATE OF PLANS: 7/25100
TITLE: Oakbrooke Sterling with Lookout
COMPLIANCE: PASSES
RenuirPd UA = 532
Your Hnmt? = 403
2420/, Bettar Than Corie
ArPa or Cavitv Cnnt. Gla7inn/Donr
Perimeter R-Valua R-Value U-Value UA
CEII_INGS -------- 1218 39.0 0.0 37
WAI
B.SMTSC nc 9 0' hU8-3' ba 9_0' insul 104773 1110 n 0.(2l n 6? 50
GL.AZING: W indows nr poors. Ahnve Grade 402 0.350 141
DOORS 38 0.350 13
FI.OORS: Over Outsida Air 48 38.(l 0.0 '1
HVAC FO111PMENT* Furnar.P. 92.0 AFUF_
COMPLIANCE STATEMENT- The nronnsed huildinn dasinn dPSr.rihed here is
conSistant with the buildino nlans. sner.ificatinns. and nther r.alr.ulations
suhmittPri with thP oermit nlir.ation. The mmnosed huildinn haq heen
designed to meet the,re ' er?ts of e n esota er^gy,Code.
?
BuildedDesigner -? ??-- - l? Date
PULTE HOMES OF MINNESOTA
RECAP SHEET
DATE: 2115102
JOB NO:
COMMUNITY:
ADDRESS:
MODEL:
BUYER:
SALES REP:
21-Feb
0320-301-03 LOT: 1 BLOCK: 3 UNIT: 0
Oakbrooke Single Family ADDITION: PHASE 3
4092 Oakbrooke Alcove CITY: Eagan STATE: MN ZIP: 55122
STERLING MODEL#: 18232 ELEVATION: 2 GARAGE: 0 LEFT
GUY THERIOT & MINDY LEE PHONE #: 651-456-9374 PHONE #: 0
Jolayne Moberg PHONE #: 651-686-2862
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
' PROPERTY LEGAL' L 0'I ? rS'Ier_ k. ? o/i k LrCi 0 K P. JIfI?2
DATE OF SURVEY:
LATEST REVISION:
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DOCUMENTSTANDARDS
Y a °v
oz a ,-.
r
? ? . Registered Land Surveyor signature and company
?/ ? ? • Building PermitApplicant
? ? • Legal description
/? ? • Address
Gy/ ? ? • NoRh errDw and scale
0 ? • House type (rambler, walkout, splk w/o, split entry, bakout, etc.) `'.
? i? • Directional drainage arrows with sbpe/gradient 95
kd'/ ? ? • Proposed/existing sewer and water services & invert ebvation
? ? • Street name
'? ? • Dmreway
?
K ? • Lot Square Footage
? ? • LatCoverage
? ? • Benchmark
ELEVATIONS
? Existina
d/ o? • Sewer service (or Proposed)
td /o ? • Property comers
/ ?? • Top af curb at the driveway and property line extensions
d?/? • Elevations of any existing adjacent homes
? r;(, ? • Adequate footing depth of structures due to adjacent utllity ffenches
? hj ? • W aterways (pond, siream, etc.)
` Propased
@
'
? ? . Garage floor
`
?
?r/? ? • Firstfloor
o' O ? • Lowest exposed elevation (walkouW+indow)
? ?
C? ?
? • Property comers
F
0 • ront and 2ar of home at the foundation
? PONDING AREA ('rf aoolicable)
/
? ? • Easement line
? [?'
? ? • NWL
?
? r • HWL
?
? fd/ C • Pond # designafion
? ? ? • Emergency Overtbw Elevation
[9/ ? ?
d ? ?
;/? ?
V ? ?
? ?
a ?
OfMENSIONS
• Lot Iinesl8earings & dimensions
• Right-ot-way and street width (to badc of curb)
• Proposed home dimensions including any proposed decks, ovefiangs greaterthan 2', porches, etc.
(i.e. all structures requiring pertnanent footings)
• Show all easements of record and any City uUlitles within tlhose easements
• Setbacks ot proposed structure and sideyaM setback of adjacent exsting structures
• Retaining waN requiremen' '" any
Reviewed:
. Surzeyor's Certificate
SURVEY FOR :PULTE HOMES
DESCRIBED AS :Lat ,, Block3 OAKBROOKE bTH ADDIION, City of Eagan, Minnesota and reserving
easements of record.
MAR 0 6 REC'D
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? Exist. Home ?
f TOB = 997A ?
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\ 0-4 KBROOKE TERRA CE ? ?
-.-.- - - ???AN ?
L 0 T SQ. F00 TA GE
HSE SQ. FOO TA GE
L0T COI/ERAGE _
,,,??„
# 18232
PROPOSED ELEVATIONS
Top of Foundation = qqg.o
Garage Floor =qq7.(,
Basement Floor =q39.0
Aprox. Sewer Service =vae.o'-
Proposed Elev. = 0
Existing Elev. _
Drainage Directions =
Denotes Offset Stake = •
frEOLuND
PLANNING BNGINBBRING SURVSYING
2005 Pin Oak Drive
Eagan, MN 55122
Phone: (651) 405-6600
Fax: (651) 405-6606
SCAIE: 1 Inc h = 30 feet
p?%fl
15,
s 7, 9 ?.,?
?;?,,,? Is,tSPECTIONSUL-t4.
a tl O ? ??U??SO
BENCHMARK, ?,p 14001
E1tu : q5o.39
?
MIN. SETBACK REQUIREMENTS
Front - House Side -
Rear - Garage Side-
I HEREBY CERTiFY iHAT THIS IS A TRUE ANO CORRECT REPRESENTATION
OF THE BOUNDARIES Of 7HE A80VE DESCRIBEO PROPERTY AS $URVEYED
BY ME OR UNDER MY DIRECT SUPERNSION AND DOES NOT PURPORT 70
SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS HOWN.
DATE
JEF EY D. LINDGREN, lANO RVEYOR
MINNESOTA IICENSE NUMBER 14376
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02R-062
BOOK:
Oakbrooke 5
,Surveyor's Certificate
SURVEY,FOR :PULTE HOMES
DESCRIBED AS :Lot 1, Block 3, OAKBROOKES7H ADDITION, City of Eagan, Minnesota and reserving
easements of record.
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? Exist. Home ?
? TOB = 947.9 ?
N 897T20"E -14,
°-`° -1 °--- r - - -
--
??u-- ,o -
Corp9s
I `j,'?? 22.00 Proposed
tV`--/1 I 946! 2-Story
J/ o AL--? 9PCW W/0
??• I 27.00
o
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r 11 Wo 9 Y? -?' --
41 N O \ 94?e
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0-41VBROOKE TERRA CE ? ?
LOT SQ. FODTAGE _ 15,567
HSE SQ. F00 TA GE _ 1, 9 74
LOT COVERAGE _ 72%
y 18232
PROPOSED ELEVATIONS
Top of Foundatian =9vsA
GOr4g2 Fl001' = 947.I.
Basement Floor =y,9.o
Aprox. Sewer Service = 93&,.o`-
Proposed Elev.
Existing Elev.
Drainage Directions = -
Denotes Offset Stake = .
SCALE: 7 inch = 30 feet
BENCHMARK,
4° 9a'l
E/rv= Rsp.3y
/
MIN. SETBACK REQUIREMENTS
Frbnt - House 5ide -
Rear - Garage Side-
JOB N0:
HEDLUND I HEREBY CERTIFY TMAT THIS IS A TRUE AND CORRECT REPRESENTATION 02R-062
OF THE BOUNDARIES OF 1HE ABOVE DESCRIBED PROPERTY AS SURVEYED
BY ME OR UNDER MY DIRECT SUPERVISION AND DOES NO7 PURPORT TO BOON: PAGE:
PLANNINC d'NCJNh'SRING SURV6YING SHOW IMPROVEMENTS OR ENCR CHMENTS, EXCEPT A SHOWN.
2005 Pi ?Oa 551D22 e
Eago DATE ?/?Z/b Z ?• CAD FILE .
Phone: (651) 405-6600 RE . LINDGREN, LA SURVEYOR
Fox: (651) 405-6606 . w-NINN LICENSE NUM ER 14376 Oakbrooke 5
RECEBVED
MAR 1 4 2002
EAGAN
ENGINEERING DEPARTMENT
Site address: 9?xe &&4 ?/CO?? Lot _ Block _ Subd.
On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air
tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be
submitted prior to issuance of a Certificate of Occupancy.
_ This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
? This structure: will 6e constructed to meet more restrictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE
Water Heater ? s "
Fumace
ccT-
Dryer
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
YES No
Kitchen kitchen
Bathroom 1 d
?/L FV- Q ?0 ?
Bathroom 2 t `v` 05- " vo -50 ?
Bathroom3 ? ?T-&iQ S0 ?
Bathroom4 ?` ? ;s-v S0 ?
Other
FIREPLACE S
LOCATION
GAS
WOOD
MANUFACTURER
MODEL
BTU'S VENTING
DIRECi ATMOS
Pa?A16lo ' 'pXQ ' ?
I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan
requirements.
?
re l?G ?rmeS
Company Name
7?jOZ
Date
' This form is the responsibility of the General Contractor.
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114673
Date Issued:09/17/2013
Permit Category:ePermit
Site Address: 4092 Oakbrooke Alcove
Lot:1 Block: 1 Addition: Oakbrooke 7th
PID:10-53766-01-010
Use:
Description:
Sub Type:Reroof
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.
Carbon monoxide detectors are required by law in ALL single family homes .
Laura Gillespie
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 -
Guy A Theriot
4092 Oakbrooke Alcove
Eagan MN 55122
Able Restoration Group Inc.
17316 Kenyon Avenue, Suite 103
Lakeville MN 55044
(952) 378-5000
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117998
Date Issued:10/25/2013
Permit Category:ePermit
Site Address: 4092 Oakbrooke Alcove
Lot:1 Block: 1 Addition: Oakbrooke 7th
PID:10-53766-01-010
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments: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.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Guy A Theriot
4092 Oakbrooke Alcove
Eagan MN 55122
Able Restoration Group Inc.
17316 Kenyon Avenue, Suite 103
Lakeville MN 55044
(952) 378-5000
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA144377
Date Issued:07/24/2017
Permit Category:ePermit
Site Address: 4092 Oakbrooke Alcove
Lot:1 Block: 1 Addition: Oakbrooke 7th
PID:10-53766-01-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Guy & Melinda Theriot
4092 Oakbrooke Alcove
Eagan MN 55122
Angell Aire
12253 Nicollet Ave S
Burnsville MN 55337
(952) 746-5200
Applicant/Permitee: Signature Issued By: Signature