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1665 Oakbrooke CirRESIDENTIAL BUILDINC PERMIT APPLICATION ' CITY OF EACAN 3830 PILOT KNOB RD, EAGAN MN 55122 L? 651-687-4675 NewConstruction Reauirements • 3 registered site surveys showing sq. ft, of IoC sq. fl, af house; and all roofed areas (20%maYimum bt coverage allowed) • 2 copies of plan showing beam & window sizes; poured found design, etc.) • i sel of Energy Calculations • 3 copies of Tree Preservation Plan if lot platted aNer 711193 . Rim Joisl Detail Oplions seleclion sheet (bldgs with 3 or less units) DATE m° t ? . Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted SITEADDRESS IWCJ {aJkP- Cir_GIf? MULTI-FAMILYBLDG _Y _N TYPE OF WORK Z)f? . FIREPLACE(S) _ 0_ 2 APPLICANT (11eK 6?^Ael <?-orS?rtvGLc, e-) STREETADDRESS V{e.c,) Of. 4Z'jrxl CITY E _STATE rZIP ?;SlL3 TELEPHONE #9S Z • 7-I0 - l?o?. CELL PHONE O I S S- Zlo • 1 loS FAX # Ca S l ? 405 3Gi`? I PROPERTYOWNER TELEPHONE# CnS?' C??3 ' C?SZC? Energy Code Category (4 submission type) Plumbing Contractor: Plumbing system includes: Mechanical Contractor: Mechanical system includes: Sewer/Water Contractor: _ Air Conditioning _ Heat 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 Eagan Ordirya.r?ces. Stgnature of Applicant Fce: $90.00 Fee: $70.1 OFFICE USE ONLY COMPLETE POR "NEW" RESIDENTIAL BUILDINGS ONLY _ MINNESO'PA RULES 7670 CATEGORY 1 MINNFSOTA RiJLI'S 7672 Water Softcner _ Water Hcater No. of Baths ,.Qtij-k RemodellReoalr Reauirementa . 2 copies o( plan • 1 set of Eneqy Calculatbns Por heated additiom . 1 site survey for ezlenor additions & decks • Irdicate N home served by septic system for addNOns VALUATION ?D}Uoo Phone # • New Energy Code Worksheet Submitted _ Lawn Sprinkler No. of R.I. Badis Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ _? Updated 4/02 OFFICE USE ONLY ? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory BPJg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex x 18 Deck ? 23 Porch (screened) ? 36 Mu16 ? 05 03-plex ? 11 10-plex ? 19 Lower Level O 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous A 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair ? 33 Altaration ? 37 Demolish (Bidg)` ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to appiicant Valuation a0li-e-9- Occupancy MC/ES System Census Code 4*t? .. - Zoning City Water SAC Units 01 Stories Booster Pump Nbr. of Units 0 Sq. Ft. PRV Nbr. of Bldgs I Length Fire Sprinklered Type of Const ?'? W idth REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) FinallNo C.O. _ Footings (addirion) _ Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framiag _ Siding SNcco Stone _ Fireplace _ R.I. _ Au Test _ Final _ Windows (new/replacement) _ Insulafion _ Retaining Wall Approved Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit 8 Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total S'urveyor's Certificate .URVEY FOR :PULrE DESCRIBED AS : Loi 3, 81ock 5, OAKBROOKE 4TH ADDITION, City ol Eogon, Dokoto County, Minnsoto ond reserving eosements of record. r ? 'L' a S ,,A\6? i ? . . . . . ? rt. . ? ,- n \\\ rog.1132 38. ? a OI. K ? \\ ' ? a30?tio? 0, ? \ sa° " `''y ? 50 7.?C - (3 _ G??p96 •1? ? ?' ??- ,....._,_..'__ T FE'NCE ? OiAb ?\ , ? ? yf' \{ 61. 0 w LOT SQ. FOOTAGE = 8,905 j 0A? tirob HSE. SQ. FOOTAGE = 1,660i ?. LOT COVERAGE = 15% Ci Inii 4? J n ., d Plan # 18231 ';.d..` FROPOSED ELEVATIONS Top of Foundation BENCHMARK, = q45,3 Garoge Floor = 9444 C0 P L,C, Basement Floor =q36.3 ??`?'936.Bo Aprox. Sewer Service = 9 3), 3± Proposed Elev, _ ? MIN, SETBACK REQUIREMEN75 Existing Elev. - Droinoge Directions = Front -25 House Side - Denotes Of(set Stake = . scaie: i u,cn . 30 fsel Reor -15 Goroge 5ide- HEADLUND 1 HEREBY CERTIFY TNAT iH15 IS A TRUE AND CORRECi REPRESENTATION OF THE BOUNOARIES OF THE ABOVE OESCRIBED PROPERTV A$ SURVEYEO BY ME OR UNDER AIY OIRECi SUPERVISION AND DOES NOi PURPORT TO PGNN/NC 6NC1NB6RlNC SURV6Y/NC SHOW IIAPROVEMENTS OR ENCROACHMENTS, E%CEPT SHONN. 2005 Pin Ook Orive I ' Eogon, MN 55122 DA7E Ptrone: (651) 405-6600 R Y D, IINOGREN, ?FRVIYOR Fax: (651) 405-6606 NN OTA IICENSE NUTABER 14376 JOB N0: OOR-189 BOOK; OAKBROOKE :i , 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 3 4'`7 651-681-4675 p7y? ? C) ? New ConstrucMOn Reoufrements RemoCel/Re tr Reauiremenfs ? 0 f a 3 regisfered 9te wrveys showing aq. fl. of lot, sq. fl. of house 2 copiea o1 plan and 9I_I roofetl areas (ZO% maximum lot covaraae allowedl 1 sef ot energy calculaflona tor heated atltlitions ? 2 copies of plana (ahow beam 8 window sizes; pouretl Md deslgn; etc.) 1 site wrvey Ia entedor addiHons & decka ? i set of energy colcWationa ? 3 copfes of tree preservaHon plan H bt plaRed after 711193 DATE: CONSTRUCTION COST: 60 DESCRIPTION OF WORK: Re_S )!l Lj1G, ) If multi-famity bldg., how many unlis? STREET ADDRESS: I?7 b? OI71CR??K? C 1(c-4t ? LOT: J BLOCK: ? SUBD./P.I.D. N: d.E} k13fw1(r- Name: Phone #: PROPERTY Last First OWNER Shaet Addtess: Cify State: Zip: Company: Yt) Yc IJomIS Phone#: b`-?-j (area code) CONTRACTOR StreefAddress: ?35S AAR nG?b?h 9 51??5 /CGl SVJ?C 2oa License# 1371 Exp.3"3?J0 city )`4trJ04 srate: A v zip: ARCHITECT/ ENGINEER Company:SAwE ASAba?` _ Name: Telephone M: ( ) Sheet Address: Regisfratbn #: Cliy State: Zlp: Q SewerAvater licensed plumber (if installina sewerlwaterY. VrT Phone #: ( e-<1 ) 1 hereby acknowledge Maf 1 have read fhis applicafion, state that the informafion is cortect, and agree to compty wilh allapplicableState of Minnesota Sfalutes and Cify of Eagan Ordinances. Signalure of Applicant: ??tvM ? ?ZAA?C? OFPICE USE ONLY 7OCCertifcates of Survey Received Yes No I 1 z 2Q00 Tree Preservation Plan Received _ Yes _ No _ Not Required ? OFFICE USE ONLY BUILDING PERMIT SU BTYPES ? 01 Foundation ? 07 05-plex . ? 13 16-plex O 21 Porch (&sea.) 13 31 Ext Alt - MulU JU 02 SF Dwelling ? OS 06-plex ? 17 Garage ? 22 Poroh/Addn. (4-sea.) ? 33 Ext. AR - SF ? 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23 Poroh (screened) ? 36 MuRi 0 04 02-plex ? 10 08-ptex ? 19 Lower Level ? 24 Starm Damage ' ? OS 03-plex ? 11 10-plex Plbg _Y or_ N ? 25 Miscellaneous 0 D6 04-plex ? 12 12-plex O 20 Pool ? 30 Accessory Bldg. ?M1I ORK TYPE I? 31 New ? 36 Move Bidg. ? 43 Reroof ? 32 Addition p 37 Demo{ish (Bidg)" ? 44 Siding ? 33 Alteration ? 38 Demof+sh (interior) ? 45 Fire Repair [3 34 Repair O 42 Demolish (Foundation) 0 46 Windows/Doors " Give PCA handout to applicant for demolition permit GENERAL INFORMATION SAC Code # of 5tories ?2 sq. ft. No. of Units / Length Z/a- sq. ft. No. of Buildings f Width ? Footprint sq. ft. 5s- q Const. (Actual) Basement sq. ft. lD 9z Census Code (Allowabie) s=,r? M'n level sq. ft. ? io R Z MC/ES 5ystem UBC Occupancy ? a .?u ( sq, ft. 1 1 7G City Water Zoning , (;a,Fa4 sq. ft. q16 a Booster Pump PRV ? Fire Sprink{ered MISCELLANEQUS INSPECTIONS ? Stucco/Stone APPROVALS Pl i a4 ann ng Bui iding En gineering Variance Permit Fee Valuation: 61 C, $? J Surcharge Plan Review License MC/ESSAC yol,E?'.2b = ?6 9ak?5 ?yp, ? Ciry SAC " WaterConn. Water Meter _ ?? 9,/ Acct. Deposit lo4a kSq S/W Permit S/W Surcharge Treatment Pi. L eU e ( Park Ded. Trails Ded. - Jl76 k S y fP 3? ?? 7 ? Other Copies Totai: SAC Units % sac '-4 °12 3 . ?-I ? Ua-ra? e ?G a-?e G?e 41 13 , F? 2 + pi LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILOING PERMIT APPLICATION ? PROPERTYLEGAL: Z- oT-- j' &-o<',/f"S OA?'B,PLt??"E? `fTN?t?OZ7"TdN h DATE OF SURVEY: ?- I S-'OCJ ? ? LATEST REVISION: /F -'f7U ? C 0 DOCUMENTSTANDARDS o g Q a ?o ? • Registered Land Surveyor signature and company ? ? ? • Building Permit Applicant 0/ ? ? • Legal description ? ? ? ? • Address l N d ? ? sca e orth arrow an • p? ? .? • Hause type (rambler, walkout, split w/o, spiR entry, lookout, etc.) q, ? ? • Directional drainage arrows with siape/grachent % ry a ? • Proposed/ebsting sewer and water services & invert elevafion ? ? • Street name r? ? ? • Driveway g/. ? ? ? • Lot Square Footage t C L a ? overage • o ELEVATIONS Enistln / tr' ? ? • Sewer service (or Proposed) ?? a • Property comers ? o ? • Top of curb at The driveway s?? ? • Elevations of any adsting adjacent homes ? G? ? Adequate footing depth of structures due to adjacent utility trenches Prooosed m? ? ? • Garagefloor ? ? ? • Firstfloor R( ? ? • Lowest exposed elevation (walkouUwindow) d ? ? • Property corners 5a/ ? ? • Frorrt and rear of home at the foundaCon PONDING AREA (if a ticaWe ? te ? • Easement line ? a/ ? • NWL ? cv/ ? • FIWL ? W' ? • Pond # designatlon ? i" ? • Emergency OveAlow ElevaOon DIMENSIONS ? ? ? • Lot IinesBearings & dimensians ? o ? • Rightof-way and street width (to back of curb) q? ?? • Proposed home dimensions induding arry proposed decks, overhangs greater than 2', porches, etc. (i.e. all structures requiring permanent fooBngs) rf? ?? • Show all easements of record and any City ublifies within those easements d?? • Setbacks of proposed structure and sideyard selback of adjacent exassting structures ? 'Er ? • ReWining wall requirements, if any , /? 'Z' Reviewed: Name March 1989 CqAKygLOGPRMf.FM MHR-28-2909 E9:03 MNcheck COMPLIAI3CE REPOItT Minneaota Energy Code MNahack Software Varsion 3,4 COUNTY: Dakota STATE: Minrieaota ZONE: 2 CONSTRUCT2pN TYPE: Single Pamily DATE: 3-2$-2000 DATE QF FLANS: 3/29/00 TITLE: 9HEFFiELD 4512 WJo EL. 42 COMPLIANCE: PASSES Required UA = 569 Your Home = 425 P. 02%03 PF.mit Checkad by/D3te 24.6t Better Than Code j ?t RY'Cd OY Cavity Cont. l3lazing/DOCr PerimeCer R-Value R-Valve i;-Va1ue ---------------------------°- !_ ----------------------------------- CEIL3NGS 1176 44.0 0.0 wALLS: Wpo. Frame, 16" D.C. r 2772 19.0 2.0 WALLS: Woocl Frame, 1611 O.C. ? 290 10.0 2.0 SSMT: Conc. 9.0' ht/6.3' bg/9.0' insul 936 11.0 0.D GLAZING: WiRdOw5 or noors, Above Grade 460 0.350 1 DC+ORS 38 0. 3 5 0 FLOOkS: pvar 0ut5id° Air 84 38.0 2_0 FiVAC EQUIPPIENT: Furnaca, 92. p AF'UE -"...--------------------------------------'--- " ----'--------------- COMPLIANCE STAT&MENT: The proposed building design describeri here is co;lsistent with the hu-_lding plans, epecifioations, and other calculatione submitted wit?1 the permit application. Tk!e pz'oposed building has been deaigned to meet ,t,h/e requirements o£ the Minneeota Energy Cpde. Euiider/D?signer_?s,r.?!Y?a Date/0// vD ? ?_ ra erW 50rYey JOB INITIATION ORDER Pulte Homes of Minnesota Corporation 1355 Mendoq Heights Road, Suite 300 Mendofa Heights, MN 55120-1 112 Phone: (651) 452-5200 Fax: (651) 452-5727 CONTRACTOR/SUPPLI ER: J08 NO. 0320 / '5?03 ? OS LEGAL DESCRIPTION: LOT 03 BIOCK p$ UNIT coMMUNirv: Oakbrooke SF ADDITION: oick -z,- 6UILDING ADDRESS -ti3r) CITY: Ea9ap STATE: MN ZIP: 55104 MODEL NAME: MODEL NUMBER: ?/22 ELEVATION: GARAGE: LEFT RIGHT _ y v W BUYER'S NAME: U? ?-, C) U,3 6? DATE OF ORDER: CURRENTADDRESS: bvi Ynzy- PL"-g? CITY: .?'? STATE: ZIP: -Jr,S( - HOME PHONE: -q52 BUSINESS PHONE: ?/Z --gS2 -J?Q? BUSINESS PHONE: rpcj( - a31 _70U SALES REPRESENTATIVE WD APPROVED BY BUYER(S): ? , ? APPROVED BY SALES: EQUAL NOUSING RELEASED TO START CONST.: oPPORruNiTv This constitutes a contract between the Seller an e Purchaser(s) for the above items Builder's License #0001371 CHANGE ORDER CONTRACT Pulte Homes of Minnesota Corporation 1355 MENDOTA HEIGHTS ROAD, SUITE 300 MENDOTA HEIGHTS, MN 55120-1172 PHONE:(651)452-5200 FAX(657)452-5727 .IOB NO. COMMUNITY:, BU4AING ADO MODEL NMAE: Bl/YER'S NAME(S): I d'1.(3l/? CVRRENTADDftESS/: HCMEPHONE: l.Pl a? ?-? CONTRACTOR/SUPPUER: 0!??z LEGTLOESCRIPSION: LOT, 3 ? BLOCK ? . UNIT ADDI1lON: /("" ?ezs'r- ? CTfY: ?eG=?STATE: _ ZIP:??-/--;)a- /y -Z ? MOCELNUMBER: l(3 ?'??Z ELEVATION: GAR4GE: LEFT R?IGHT ?J] ? /"I ? YIIi/' Yv-i.LGv ATE OF ORDER/:?? ?? QD C-17?Y/: STATE_ AW? 7lP:- BUSINESSPHONE: lP??-Sr?a S7Py 8l1SINESSPHGNE: -)---9 000 SALESREPRESENTA7NE: e.J41V CHIWGEOROERFEE: YES OR PREVIOUS J.I.O. OR CHANGE OROER. _.>.iPltlCE. # TOTAL: E . QTY, OPTION #,!: . !. 'QESCRIPTtON OF CHANGE D Gh ? -36rd p0 D a ao15- 7h rte, !LYA a 1 i 9aa Fuv v/-e4,u 6 1 a 500- o Qe-wh o- VA?wi cy d-av? - i-nxsle.,- v- I,? a a(i -,yuc 62 r3oo l qb e 2,00., i zz 2 c w(3cibw c;v, r2 i )S, 4 nom VtAck(; ?n aJT? i a?-D 02 1--? F-( c?.?. (5a i 002V l.s004WAL ? ? 175- 57-- Y i on5 t/fu-tiOLL LOo i m5 I a" I 3 6 l? (',abun,jS -V2a 4-e-- a S'z? 1 ? I 0 l1 - u MasterBuilder- °_utlders License #0001377 APPROVED BY BUYER: APPROVED BY SUPERINTE E T: ??l APPROVED BY SALES: This constiiutes a contract betwean ,he Seiler and the TOTAL CC4• for the aoove items. CWAN'GE ORDER CONTRACT ? Pulte Homes of Minnesota Corporation 1355 MENC70TA HEIGHTS ROAO, SUITE 300 MENDOTAHEIGHTS,MN55720.1112 . PHONE: (851) 452-5200 FAX (851) 452-5727 Joe r+o. 0 --3 Z 01 .21 O CONNKIN(TY: ( /LP ?-I ?YlJZl?E1! b10DEL NMAE: CONTRACTOR/SUPPLI ER: E, OZ?; IEGAL DESCRIPTION: MOOELNUMBER: euveas wuE(S): i rtsma--> Y a wt c,t? aUFtRerrraooRe/ss: 129?I HOME PFIONE: .. BUSME SALES REPRESENTATNE: -rrYQD .. LOT BL?O^C?K UNIT ADDRION:?J/{ v /?. }-c? CfiY: G LZU?'F'?STATE: ^NV LP: f?a' ELEVATION: ? GARAGE: LEFT RIG?HT DATE OF ORDER: ? C/tT?Y,:(}-?? ' STATE-/AL ZJP: ??/ J`Y Q K BUSINE55 PHONE: IO?^ %?-2-32-70,?C PREVIOUS J.I.O. OR CHANGE ORDER: •• PRICE . # TOTAL• ??rhz?DESCRIPTtON'OF6HANGE ,_ uU (xdS ?rk, 50 0 I ouilders ucense n0001371 X Jr ..,. APPROVED BY BUYER: ?f ?ND APPROVED BY SUPERINT ENT: APPROVED BY SALES: This constitutes a contrdd between the Seller and the _ TOTAL ??i'3, INo f ?%?DI e u aser(s) for the above items. ? CHIWGE ORDER FEE: YES OR l/ /+V ?? . Surveyor's Certificate SURVEY FOR :PULTE DESCRIBED AS : Lot 3, Block 5, OAKBROOKE 4TH ADDITION, City of Eagan, Ookota County, Minnsoto and reserving easements of record. ? q 3t,, o rL'S s`^` 5 •', ? ? , - ?, ?P -? ? . ? > ` a `, rn EviglNoMp rog.4432 ? .` ? q 38, oo A ' S,e et°???`'a I \ 9 o-W ti.• \\\ \ ?? ?\ `po r .' LOT SQ. FDOTAGE = 8,905 HSE. SQ. FOOTAGE = 1,66,? LOT COVERAGE = 15% !_ ' S i ? b5 ? o Pton # 18231 PROPOSED ELEVATIONS Top of Foundation = q¢53 Garage Floor = 944.1 Bosement Floor =cf363 Aprox. Sewer Service = 9 30.3t Proposed Elev, = 0 Existing Elev. Droinoge Directions = - Denotes Offset Stake = • SCALE: 1 Inch > 30 feal BENCHMARK, C,P, L.C. ?leu•q3b.Bo ,wt, MIN. SETBACK REQUIREMENTS Front -25 House Side - Rear -15 Garoge Side- JOB N0: HEDLUND I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OOR-1$9 OF THE BOUNOARIES OF THE ABOVE DESCRIBED PROPERTY A$ SUR4EYED BY ME OR UNDER IAY DIRECT SUPERVISION ANO DOES NOT PURPDRT TO BOOK: PACE: PUNN/NC BNC/N68R/NC SUR['6YINC SHOW IAIPROVEMENTS OR ENCROACHMENTS, E%CEPT SHOWN. 2005 Pin Ook Orive ? ? Eagan, MN 55122 DATE ?/IS 7r//'? y/0 CAD FILE: PhOnE: (6$1) 405-6600 ? R Y D. LINOGREN, LAN jURVEYOR ' Fox: (651) 405-6606 _•_? NN OTA LICENSE NUMBER 14576 OAKBROOKE :? ? ??? 7j r . ? n._._?... t /o /9 e E.ai3.p.,11 vEPT. -- F-riie? ? Goi°9 a0 °i43XtUtivt--U UE:I 1 9 2300 ""` CITY USE ONLY PER?fIT #: `7 SS? ?7 RECEIPT DATE: (O - ! 101 RESIDEN1'IAL MECf1ANICAL PEiiMTT AP'PLICATION crrY oF Ertesx 3830 PaoT xxoa [tn EteAx buv 55122 651-6e1-4675 Please complete for: ? singie family dwellings wnhomes and condos when permits are required for each unit Date: v? SITE ADCRESS: OWNERNAME: TELEPHONE#: ???? ? (AREA ODE) I?AP.@Af?ARE60':^'tl7°.";^3 M INSTALLER NAME: 600nGCGFET'L':??:wrl TELEPHONE #: swevau%f::+1 Gwxu'23 (A EA CODE) sewaam STREET ADDRESS: CITY: STATE: Z I P: Place a check mark nert to the nermit wnrlr tvna New residential dwelling unit under constructionand not owner/occupied $ 70.00 Y" Add-on, modification or alteration to existina dwelling unit $ 50.00 , • furnace replacement • air exchanger • air conditioner ? • other JJ Nature of work: J 1? s?? I I ??V State Surchar e $ 50 L Total $ Reminder: Call far ii:spections. Updated f/01 CITY USE ONLY PERMIT #: APPROVED BY: INSPECTOR RECEIPT DATE: COMMERCIA1. MECM.NICAI. PEitM1T AppLICATION CiZ'Y OF E+k6lkN S$SO PILOT KNOB RD E4HlE1V, hiN 55122 651-6$1-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: SITEADDRESS: y„ ?„? i. .. ' e OWNER NAME: .. md? PHp TENANT NAME (IMPROVEMENTS ONLY): _ WAS THERE A PREVIOUS TENANT IN THI$ SPACE? Y N. N.AivIE: 1NSTALLER: ADDRESS: RHONE-#: (AREA CODE) CITY: WORK TYPE: New construction _ Interior Improvement _ Processed Piping Specify Nature of Work STATE: _ Install U.G. Tank Remove U.G. Tank When installing/removing underground tank, call 65I-681-4675 for inspection by Fire Marshal and Pfumbing Iinspectnr. Fees 1% of contract price OR $50.00 minimum fee, whichever is greater. Underground tank removaVinstallation = minimum fee Contract price: $ x 1%_$ (Base Fee) State surcharge calculate at $.50 for each $ 1,000 Base Fee TOTAL g (AREA CODE) . SIGNATURE OF PERMITTEE Updated 1/O1 Address 1665 OAKEROOKE CIRCLE Zip 5512? LAt 3 Blk 5 Sub OAKBROOKE 4TH THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: Yes No Inspedor: Z Final grade (6" from siding) Permanent steps (gazage) Permanent steps (main entry) Permanent driveway Permanent gas Sod/Seeded grass TraiUcurb damage Porch Basement finish Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. Contact engineering division at 6814645 before working in rightof-way or installing underground sprinkler system. ? Whiu - Ciry Copy Yellow - Resident Copy Pink - Contractor Copy Siteaddress: l? 6A(GbfopKe- GrG[e Lot-?' Blocky Subd. (%L(poa-e? 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'thefollowing information b:e submitted prior to issuance of a Certificate of Occupancy. This sWclure: is consVuctedto meet minimum requiremenGs of the Mn Energy Code, Chapter 7670 ? /? OR V This skucture: will be constructed to maet more restrictive requirements of Chapters 7672 or 7674 APPLUWCE GAS ELEC MANUFACTURER MODEL BTU'S VENTINGTYPE Water Neater Q fa? r'- y/1 P- I DS " S s Fumace ? 3S?Mrtc/p3(ooCPO S Wo Dryer VENTED EXHAUST SYSTEM LOCATION TYPE MODEL CPM's vES No Kitchen kitchen Bathroom 1 Qln L4 "05 (-/ d ' Bafhroom 2 -oSVO S-6 ? Baihroom 3 ? o p ? `cy' O N S ? Balhroom 4 Ofher FIREPLACE S LOCATION GAS WOOD MANIIFACTURER MODEL BTU'S VENTING DIRECT ATMOS NG?o o000'TI'Z -L o2700c? I hereby acknowledge that the above informa6on is correct and agree to comply wiN the Minnesota Energy Code antl City of Eagan . requiremenls. Signaturey p? I-/P 14rcy Company Name Date ' This form is the responsibility of ihe General Contractor. CITY USE ONLY , PERMIT I*J ' J RECEIPT DATE: ?J -0 I RESIDENTIAL MECHAIVIC A1. PERMIT APPll.ICATION crrY oF eAs,vv 3830 Paor Kvo$ Ru EAHAIV MP 551 28 651-6$1-4675 Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit Date: SITE ADDRESS: 16106 LD?-Y?'(bbkb OWNER NAME: RLLe Ud/K1-5 TELEPHONE 5-1 4/5x ?a vo (AREA CODE) INSTALLER NAME: &Ji`Y15 V1 I(P_ NVQ'I7h4 940?(c TELEPHONE #: q5a $9 Lt 000S_l I (AREA CODE) STREET ADDRESS: I a-qn ZAAr-I&n W?(a-YY? WN S - CITY: SQ.OCA.qa' STATE: ?kfJ ZIP: `SS3-7 g' r- $ 70 00 V New residential dwelling unit under constructionand not owner/occupied . _ Add-on, modification or alteration to existin dwelling unit $ 50•00 • furnace replacement • air exchanger 0 • air conditioner • other Jp" ? ? zao? Nature of work: Y State Suroharge $ .50 Total $70 5_0 Remdnder: Call for inspecttons. ? SIGNA U 6F PERMITTEE Updated 1101 arr use on?Lv PERMIT #: APPROVED BY: INSPECTOR RECEIPT DATE: co?EftclAL MEcHANacAL ?ERMrr APPLIcATIoN crrY oF EAeAv 3$30 PILOT KNOB RD E46A1V, MN 551E2 651-6$1-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: SITE ADDRESS: OWNER NAME: TENANTNAME (IMPROVEM6NTS ONLY): PHONE #!: (AREA CODE) WAS TfERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: ADDRESS: CITY: WORK TYPE: Specify Nature of Work New construction _ Interior Improvement _ Processed Piping Install U.G. Tank Remove U.G. Tank When installing/removing underground tank, call 65I-681-4675 for inspection by Fire Marsha[ and Plumbing Iinspector. Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater. Underground tank removaUinstallation = minimum fee Contractprice: $ x 1%= $ State surcharge TOTAL $ (Base Fee) calculate at $.50 for each $1,000 Base Fee SIGNATURE OF PERMITTEE PHONE#: - (AREA CODE) STATE: ZIP: Updated 1/Ol rr? CITY U5E ONLY L 8L ?/ ? sUBO. QqlCbr?n RECEIPT #: RECEIPT DATE: ILB-00 PERMIT # 2000 PI,UMSING PERMIT (RESIDENTIAL) CITY OF EAC,PN 3830 PILOT KNOB RD EAGAN, IA1 55122 651-681-4675 Please complete for: .?v ?? o ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinklersystem FIYTIlRFS EACH # TOTAL Alterations to existing dwelling - minimum fee Describe: $ 30.00 Bath tub $ 3.00 x = $ - Floor drain 3.00 x Gas piping outlet ' minimum - t 3.00 x Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x f = $ ? Laundry tray 3.00 x = $ ? Lavatory 3.00 x = $ z `- Septic System new/refurbished 'requires MPC lic. 75.00 % _ $ Septic S stem abandonment 30.00 x = $ RPZ new installation/repair/rebuild 30.00 x = $ Rough opening 1.50 x = $? Shower 3.00 x T = $,3 - Underground sprinkler if dwelling is under construction 3.00 x = $ Underground sprinkler if existing dwalling 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ --- Water softener If dwelling under construcHon 5.00, x = $ Water softener if existing dwelling 30.00 x = $ Water turnaround 30.00 x $ State Surcharge .50 --> ---> ---> $ .50 ?Ota! _> Reminder, Call for inspections of alterations, i.e. water heaters, water softeners, etc. - - • - - - - - - - - - - - - - ---------------•-----•-•----------------------------------------- I hereby aGinowledye hat I have read this applica6on, state that the infoirnatio? is wrtect, and agree to cnmply with afl appticable Gity of Eagan ocdinances. t It is the applicant's responsibility to notify the property owner that the C@y of Eagan assumes no lia6ility for any damages caused by the City during rfs normal operetional and maintenance activdies fo the facilities construded under this permit within City property/nght-of-way/easement. . _ .. , i _ , I SITE ADDRESS: OWNER NAME: : C/,C / 7'C, TELEPHONE #: - (AREA CODE) .. INSTALLER NAME: TELEPHONE #: STREET AODRESS: oaia (AREA CODE) CITY: ??? ,?TATE: ZIP: .72?Y SIGNATURE OF PERMITTEE Use BLUE or BLACK Ink ' r__________ I For Office Use I I ~l I City of Ea a Permit#: I ~I 1 ~ Permit Fee: ~ • 2) I 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: j I I 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ,-7/ IQ I 1 Site Address: I L.AoS- ®C C, V- r Ch's / e C!. % t Unit Name: Irn c.Nti Phone: RESIDENT / OWNER Address/City/Zip: IL ~~,ca 0a 1.(_ Koptt 9Z- rc t Applicant is: Owner Contractor TYPE OF WORK Description of work: Construction Cost: Multi-Family Building: (Yes / No ) Company: R, ' Contact "MCC CONTRACTOR Address: City: ry'N0% r-, State: Mt A_) Zip: Phone: tra I License Lead Certificate M 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: 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.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 1 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. Applicant's Printed Name Applicant's Signature . _...v~- „ Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA115267 Date Issued:09/25/2013 Permit Category:ePermit Site Address: 1665 Oakbrooke Cir Lot:3 Block: 5 Addition: Oakbrooke 4th PID:10-53763-05-030 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 . Ivan Tkach 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 - Thomas M Bowlin 1665 Oakbrooke Cir Eagan MN 55122 Marshall Building & Remodeling Inc 6975 Washington Ave S Suite 215 Minneapolis MN 55439 (612) 369-0123 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA120383 Date Issued:02/05/2014 Permit Category:ePermit Site Address: 1665 Oakbrooke Cir Lot:3 Block: 5 Addition: Oakbrooke 4th PID:10-53763-05-030 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. 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. 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 - Thomas M Bowlin 1665 Oakbrooke Cir Eagan MN 55122 Marshall Building & Remodeling Inc 6975 Washington Ave S Suite 215 Minneapolis MN 55439 (612) 369-0123 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink/f4 r For Office Use f ;.1Permit#:• 7 / 0,6 06 / Cit** y of aall Permit Fee: —/ C `"2 5 1 3830 Pilot Knob Road RECEIVED -/7Eagan MN 55122 Date Received: Phone:(651)675-5675 Fax:(651)675-5694 JAN 0 3 2017 Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION X14. ,x Date Site Address: /V Do �f ?�' )/fC e ye ,i fe"c dJ Unit#: Ln Vit 0`rr;F t Name• a796 '') '4C/ , /c iC4.. (/, ye--A / Phone: 2--Z;)J Re , tnt/ E _ �a ,v / 0\,ner Address/City/Zip: /66 'k c-'.- irfc' 6,c,, e. ,�C i , i-: .V "..5/ . Applicant is: rA Owner Contractor pe f Ork Description of work: /� c iiii`/L l i'22Je---77" Construction Cost: Multi-Family Building:(Yes /No K ) Company: Contact: Address: City: Contractor � r EE State: Zip: Phone: Email: l License#: 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: E TE:,ti can a rt cE ,� �: ,F' '001#-:','(9. .,,,, - - . R�► do cu �+s»ts;th cru�ttlx t` Tire i� idere,I fie p 01#-;�r.,2.!, tati ns#tib e it o! s 1ddo >a b class . as fto a lic ifyoprovic a specific reasons that wool e ; t Ci� ,,, ate._ afe.:that`tthe, ° ,. de 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.cooherstateonecall.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 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. w-- -- j x /- `r� - -tel L�'�t'6l1yet, �Y x - . Applicants Printed Name t Applicant' igs�5 natur Page 1 of 3` „ ,2_ , o„-- / ( ( ,/ , _...„___ oo DO NOT WRITE BELOW THIS LINE /44z3606 SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) Single 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 Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair Egress Window Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation 6,5/17 Occupancyik, .. MCES System Plan Review Code Edition jJ SAC Units (25% 100%f\ ) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction trWidth REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings (Addition) )e Final/No C.O. Required Foundation Foundation Before Backfill y HVAC_Gas Service Test Gas Line Air Test Roof:_Ice &Water Final Pool:_Footings _Air/Gas Tests _Final Framing )(30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath Stone Lath _Brick EFIS X Insulation Windows Sheathing Retaining Wall:_Footings_Backfill Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: t ” t , Building Inspector RESIDENTIAL FEES Base Fee ? \415Ct Surcharge 1 Plan Review MCES SAC City SAC Utility Connection Charge 0 t S&W Permit&Surcharge 1-/0 y do -, 16/ Treatment Plant 1 Copies TOTAL Page 2 of 3 Use BLUE or BLACK Ink r For Office Use City of Ea all Permit#: /qo O I4 Permit Fee: 6-70'0IC) 3830 Pilot Knob Road Eagan MN 55122 RECEIVED Date Received: ~� Phone: (651) 675-5675 Fax: (651) 675-5694 JAN 0 3 2017 L Staff: 2017 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: //3/1l Site Address: //5.65 Da/i /e (7 7.-"7 4-i/V 5-5-4-2- i 5 %Z2 Tenant: Suite#: IPhone: 6 / 5C/�-0303 Name:ResidentlOwner '6'2.7" '1. " '1. 7GP_7/7/ 1'711y t _4 Address/City/Zip: Name. .��z` License#:._, Contractor Address: City: State: Zip: Phone: I I Contact: Email: I T e of Work —New Replacement —Repair —Rebuild —Modify Space Work in R.O.W. Description of work: /' ' `) / RESIDENTIAL t Water Heater Lawn Irrigation ( RPZ/_PVB) Water Softener Permit Type Add PlumbingFixtures Main/ Lower Level) Septic System ( — ` —New I Water Turnaround t Abandonment RESIDENTIAL FEES: s $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) ay $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround*(includes State Surcharge) *Water Turnaround (add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ i undergrounYYYPHY,YYYYNYY,SY,MY. d utility damage. . CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against t 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. --------- x __..---::::---7-. -- x /3//6 �Srit's ed Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final Meter Related Items: Meter Size Radio Read Manometer Staff: PERMIT City of Eagan Permit Type:Building Permit Number:EA177650 Date Issued:07/12/2022 Permit Category:ePermit Site Address: 1665 Oakbrooke Cir Lot:3 Block: 5 Addition: Oakbrooke 4th PID:10-53763-05-030 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the water damage. Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Bogdan L & Maria M Chernyavsky 1665 Oakbrooke Cir Eagan MN 55122 (612) 750-6051 Midwest Building Exteriors Inc 6417 Penn Ave S Suite 8 Unit 270 Richfield MN 55423 (612) 750-6051 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA177928 Date Issued:07/26/2022 Permit Category:ePermit Site Address: 1665 Oakbrooke Cir Lot:3 Block: 5 Addition: Oakbrooke 4th PID:10-53763-05-030 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. 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. When a weather barrier is installed or Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Bogdan L & Maria M Chernyavsky 1665 Oakbrooke Cir Eagan MN 55122 (651) 592-0303 Midwest Building Exteriors Inc 6417 Penn Ave S Suite 8 Unit 270 Richfield MN 55423 (612) 750-6051 Applicant/Permitee: Signature Issued By: Signature