1573 Oakbrooke TerBi1RNSyILLE
Heating & Air Conditioning, L.L.C.
12981 RhoAe Islaird Ave .S, Snvrege, MN 5537R • 952-894-0005
Orstat Test Report for Job# 33 -? 3
Address_ City r4_?-,
?UpBllt ' 1"v?t? r ?? "
Date of Install V z 5 o z
Type of HT. F/A V' ;' HW Space HT Unit HT
Othef , ?'-
Malae Cr^??X
Model 6 2Go3 - -7 s• (.
Serial 5&02 c- o`(1 n
Inpld °7 5, coo a r.?
Pilot Type HOT SURFACE IGNITOR
Pressure 3 s? C02 (o -0
Input CFH '7r 02 ?. o
Stack Temp R4P CO D
Date Tested r y o'
Company
BURNSV/LLE HEATING & A/R CONDIT/ON/NG
Technician ????
Address I5i3 Oakbrooke terrace Zip 5512 2
IAt 12 Blk 3 Sub Oakbrooke Sth Addition
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL
Date: ? Yes No Inspector: 1i[/lf Le n t41-
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway ?
Permanent gas _
Sod/Seeded grass
TraiUcurb damage
Parch
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.
Contad engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ?
While - City Copy Yellow - Resident Copy Pink - Contractor Copy
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
17 ( $ 2- ? Telephone # 651-675-5675 FAX # 651-675-5694
c?,?t t o - i `F-?3
New Constructian Reau"rcements RemodeVReoair Reaui2menls Office Use OnN
3 registered site surveys showirg sq ft of bt sq. (L o( house; and aA roofed areas 2 copies of plan CeA of Survey Recd _ Y_ N
(200/6 marimumlotcoverageallowed) isetofEnergyCalculalionsforhealedaddiUons TreePmsPlanRecd _Y _N
2 copies of plan showirig heam & window sizes; poured found design, etc. 1 sile survey for additions 8 decks Tree Pres Reqd V N
15eto(EnergyCalcuWtbns Additlon-indicafei/on-sdesepticsysfem On•siteSeptlcSystem _Y _N
3 copies of Tree Preservation Plan rf lot platted atter 717193
Rim Jaist DeUil Options selecUOn shee! (bldgs with 3 ar less unifs
Date -9-L / -So/ ? Construction Cost ?A?:C,?700
Site Address A5 7 3 0"A (%T66`1(?F %ZiCyQ Unit/Ste #
k
Description of Work wI (
Multi-Famlly Bldg ,MY_,?N Fireplace(s) ?
40_ 1 _ 2
Property Owner Telephone #vS/ )
' G
Contractor
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
. Residential Ventilation Category t Worksheet . New Energy Code Worksheet
(d submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan8 _ Y ___. N If so, 25% plan review
fee applies.
Licensed Plumber Telephone #( )
Mechanical Contractor
Sewer/Water Contractor
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 Ciry 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
appmval of plans.
Applicant's Printed Name
ApplicanYs Signature
OFFICE USE ONLY
Sub Types
? 01 Foundatlon ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 27 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 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 MiSCellaneOUS
Work Types
? 31 New . ? 35 Int Improvement ? 38 Demolish (Interior) ? 44
.X 32 Addition ? 36 Move Bldg. ? 42 Demolisfi (Foundafion) ? 45
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46
? 34 Replacement •Demolttion (Entire Bidg) - G ive PCA handout to applicant
ValuaUon d Occupancy /[ ^.3 MC/ES System _
Census Code G? 3?! Zoning City Water _
SAC.Units - Stories Booster Pump _
Nbr. of Units Sq. Ft. h1 - 3 PRV _
Nbr. of Bldgs - Length /, L Fire Sprinklered _
Type of Const ? Width at ? -
Footings (new bldg)
? Footings(deck)
_ Foorings(addition)
Foundation
Drain Tile
Roof Ice & Water Final
Framing
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
Base Fee
Surcharge
Plan Review
MC/ES SAC
cay sac
Utility Connection Charge
5&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Ait - SF
? 36 Multi Misc.
Siding
Fire Repair
0
WindowslDoors
REQUII2ED INSPECTIONS .
Finavc.o.
?• FinaUNo C.O. .
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tesu _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
Approved By
Building Inspector
,! ----a- ---c... . Ry
143 ? 3G/L dXr/ / /?i/LGy 9?J?/+'" ??' 7,? '
pr 6K
g s-7? '
iJCSl,ttlk$r,U AJ ; Lol 12 BIOtN 3, OAKBRUIW,[ giH AUU:I(NJ. City of Enpnn. 4h.noaalo nnd •?ar.ir„
CC]C!tltnl9 Of flCOfQ.
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>
Lor sQ. FooracE = 21,221
HSE 5q. FODTAGE = 9,852
'33-1
LOT COVErAGE = 87.
y? I
k 18234 I
Pr.OPOSEL ELEVAT10N5
-' 9ENCHMARK, ?nn.,?ae?
Top of Foundatlon a n3ro F...•^ 3"
GqIO^yC fkGO( = q3?e.b
Bnsement FIDOf =92q0
Aprcx. Sewef Service = 923 oc ?
°roposed Elev. ? n NdN. Sc1fiACK P.EGUIREMENiS ?
Existinq Elev.
Dro?noge Direclions =--- Front - House Side -
Denetes Of(sel Stoke = . scnLe i mCn -30 r,a Rear - Caroge Sfde -
hI,EDLt!!VD
P4NNIHC 8NGlNlCRINC SURVfYlNC
2005 Pln pok Drlvs
Eaqan, MN 35t22
Pnons: (651) 405-6600
_ Poe : (657) 403-6806__ _
I HEREBT CERTIiY THAT THIS IS A 7PUE AND CORRECf REPRE5ENTAilOY
Of THE BbUNG/NiES OF THE ABOVE OESCRIBED PPOPERir n5 SuRVEY,;O
BY ME OR UNDER NY DtRECi SUPERNSION ANO DGES NUT PURPORT iC
SHOW IMPROVEuENiS Ofl ENCROACHMENiS. E%CEP7 AS SHOWN.
OAtE
0. lINDCNEN. l 0 SURVEYOR
P/o MINNESOiA UCENSF. NUTA9ER 14376
Oakhrocke 5
Site address: /S 73 Oo-? U roo (r.?. 1i rac c- LoL3 I 'Z Block O'Z Subd. 6o k b roa k? S, F.
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.
I This structure: is wnstructed to meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
_ This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674
APPLL4NCE GAS ELEC MANUFACTURER MODEL 8TU'S VENTING TYPE
Water Heater ?
?.???. ti
A.
f1'?j? O 5 3
Fumace f ?a,,,? n o G'o? (o o«?o i rec-?'
Dryer
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
YES NO
Kitchen kitchen
Bathroom 1 .
Q'?? ??\/
!4 SfON•`G ?[
V -0? V M
Bathroom 2
o s 1?'???
a oe c s o ?c- O S v G2 S a ?
Bathroom 3
8athroom 4
Other
FIREPLACE S
LOCATION
GAS
WOOD
MANUFAGTURER
MOUEL
8TU'S VENTING
DIRECT ATMOS
.?,. ? l ? ?t /U G' 1 Q70 T' !2 ' R 27 cuo
MAKE-UP AIR MODEL TYPE CfM's
I hereby acknowl dge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan
require ts.
m
Si
??ture Dat l,c- /k~,&
Company Name
` This form is the responsibility of the General Contractor.
Lo+- ia 61ock 3
O(Akbr'Wke S+-?
S+ w yg9s5
6 P#- y 2290
RESIDENTIAL M P 4 y gg q ?
BUILDING PERMIT APPLICATION
R a
CITY OF EAGAN wit 1-1 0
3830 PILOT KNOB RD - 55122
651-681•4675
5, aoa, ss
70 Sp
90•.5D
a`Cj 310. 95
NewConaWetlon ReouiremeMe RemodellReoair ReauiremeMs
• 3 registered sde surveys showing sq. ft of lot sq. ft. M twuse; aiW all mofed areas . 2 mpies of plan '
(20% maximum lot coverage allowed) . t setof Energy Caladations far Ieated addilions
• 2 capies of plan ahowing beam 8 window sizea; paured found design, etc.) ??,?aq6 + 1 sde survey for eMeioradditrons & decks
• 7 set ot Energy Calalations ?1 G . InOicale if Iwne served 6y septic system for addrtiore ?
• 3 copies of Tree Preservation Plan 81M platted after 711793
. Rim Joist Detail Options selection sheet (bldgs wilh 3 or less unils)
DATE ?????,;', VALUATION
JOB SITE ADDRESS /S 73 d 0.\-- 6 ? lti Te?tr -, - -
IF MULTI-FAMILY BUILDING, HOW MANY UNITS? WA
PROPERTY OWNER F?? lt-f- N0?5 o-F fk'N Co c,p
TYPE Of WORK /V¢-- Cons L?r..?b-+b„ fIREPLACE(S) _ 0? 1_ 2
??/S?'
APPLICANT P, Itr- C, r? PHONE# (,2)
ADDRESS N,rtl.?..est S,.;?- 1G/D ZIPCODE SS?aI
PAGER #
CELL PHONE #
PAX #
NEW RESIDENTIAL BUILDING ONLY - FILI OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - ResidenHal Ventilation Category 1 Woricsheet Submitted
- Energy Envelope Calculations Submitted
ZC MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor. + !!:5= Phone #: ri -S ?z 4/ 9? 1
Plumbing System Includes: ? Water Softener _ Lawn Sprinkler - F e: $90.00
? Water Heater 1 No. of R.I. Baths
3 No. of Baths
Mechanical Contractor: e 4 CN S Vi !I a_ 14-e-a -6 ;
Mcchanical System Includes: tC Air Conditioning
_ Heat Recovery System
Sewer/Water Contractor. /r/e Y ro I
Phone # yS -Z? F 5 L/, vo o,S
Fee: $70.00
Phone # 7 6ioZ L/-:;ZB "__? 9 3&
All above information must be suhmitted prior to processing of application. C)?
I hereby acknowledge that I have read ihis application, state ihat the information is correct, and agree tMompiy
with ali applicable State of Minnesota Statutes and City of Eagan Ordina ces
Stgnature of Applicant _ zez.67?
Certificates of Survey Received ? Tree Preservation Plan Received _ Not Required
Updated 2002
OFFICE USE ONLY
? 01 Foundatian ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
* 02 SF Dwelling ? 08 OB-plex 0 16 Fireplace ? 21 Porch (3sea.) ? 31 . Ext. Alt - Mutti
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 38 Multi
0 05 03-plex O 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
y 31 New O 35 Int Improvement O 38 Demolish (Interior) ? 44 Siding
? 32 Addition 0 36 Move Bidg. O 42 Demolish (Foundation) 0 45 Fire Repair
? 33 Alteration ? 37 Demofish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (EnUre Bidg only) - Give PCA handout to applicant
Valuation (OLA7 Occupancy MC/ES System
Census Code ?() ?
T Zoning ? Ciry Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. ? PRV ?
Nbr. of Bldgs _L Length Fire Sprinklered
Type of Const J[LV Width ?
?
?
-P?
?
?
Other
_ Pool _ Ftgs _ A'v/Gas Tests _ Final
_ Siding SNcco Stone
_ Windows (new/replacement)
Approved By Building Inspector
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
REQUIRED INSPECTIONS
Footings (new bldg)
Footings (deck) FinaVNo C.O.
Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
Framing
Fireplace ?[ R.I. X Air Test 4 Final
Insula[ion
FinaUC.O.
?f
_ Plumbing
HVAC
13
?r
PPO
..?
?16 ?
?
-?'-
// llc-?
t9 9
yr?
i i
MNcheck COMPLIANCE REPnRT I
MinneGOta Enerav Cnde I Permit #
MNr.her.k Snftware Version 3_0 I
Cher.ked hv/Date I"
COUNTY- Daknta "-
STATE: Minnesota
ZONE 2
CoNSTRUCTION TYPE: Single Family
DATE: 1-11-2002
DATE OF PLANS: 7/25/00
TITLE: Oakbrooke Sterling with Lookout
COMPLIANCE: PASSES
Reauired UA = 532
Ynur HomP = 403
242% BPtter Tfian CodP
ArPa or Cavitv Cnnt_ GlaAna/Donr
PerimPtPr R-ValuP R-Value U-Value UA
CEILINGS 1218 3A.0 0.0 37
WALLS- Wnnd Framp. 16" QC. 2673 19.0 2.0 150
BSMT: Conr.. 9.0' hUA.3' ha/9.D' insul 1f147 11.0 0.0 61
GLAZING- Windows nr poors. Abnve Grade 402 0.350 141
DOORS 38 0.350 13
FLOORS: Ovar Outside Air 48 38_0 00 1
HVAC EnUIPMENT: Furnace. 92.0 AFUE
----------------------------------------------_--____--_-
COMPLIANCE STATEMENT? The nronnsed huildina desian dPSr.rihPd here IS
tnnsistent with the huildina nlans_ snecificatinns. and other calculatinnS
suhmitted with the nPrmit annlication. The nr SP,d h ildina has heen
designed to meet the r ire nts 7oft esot ?ergy Code.
? BuildedDesigner ' , ,-? ??? Date
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMITAPPLICATION
PROPERTY LEGAL: ? UT 1:2 BI D t. K2 5'r4l
? DATE OF SURVEY: 1-11F'-02
LATEST REVISION:
m
m
c
m
v DOCUMENT STANDARDS
Y a '0
O Z Q
6'/ ? ? • Registered Land Surveyor signature and company
? ? • Building Pertnd Applicant
fd' ? ? • Legal description
;/?
W ? . Address
? ? • North artow and scale
Er' o ? . House type (rambler, walkout, split w/o, spfit entry, laokout, etc.)
¢? ? u • Directional drainage arrows wRh slope/gradient %
?? ? • Proposed/existlng sewer and water services & invert elevation
? ? o • Street name
? ? ? • Driveway
d? 0 • Lot Square Footage
? ? • Lot Coverage
C7 ? ? • Benchmark
ELEVATIONS
Existin
C? ? ? • Sewer service (or Proposed)
fd' ? ? • Propertycomers
¢? ?? . Top of curb at the driveway and property fine extensions
? FJ/ ? • Elevations ot any ebsting adjacent homes
?¢?'/ ? • Adequate footing depth of strudu2s due to adjacent utility trenches
? [?' ? • Watervvays (pond, sVeam, etc.)
Prooosed
? ? ? • Garage fbor
? ? ? • Firstfloor
d ? ? . Lowest exposed etevation (walkouUwindow)
G7/ / ?
' ? • Property comers
0
? ? • Front and rear of home at the foundation
PONDING AREA (if aooficable)
? ? .
/ Easement line
? C? ? • NWL
? [a/ ? . H W L
? [.t' ? • Pond # designation
? [9) ? • Emergency Overtlow Elevatbn
/ DIMENSIONS
L9' ? ? . Lot lines/Bearings & dimensions
0/ 0? • Rght-0f-way and sVeet width (to back of curb)
G? ?? • Proposed home dimensions including any proposed decks, ovefiangs greaterthan 2', porches, etc.
(i.e. all structures requmng permanent footings)
3)/0 ? • Show aA easements of record and any City utilities wRhin those easements
60 0 • Setbacks of proposed structure and sideyard setback of adjacent epsting structures
?? ? • Retaining wall requirements, N any
Reviewed:
Surveyor's Certificate
SURVEY FOR : PULTE HOMES
DESCRIBED AS : Lot 12, Block 3, OAKBROOKE STH ADDIION, City of Eagan, Minnesota and reserving
easements of record.
FEB 0 7 REC'9
/ 930.3
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111 18232
PROPOSED ELEVATIONS
Top of Foundation = 937.0
Garage Floor = q3(o,(p
Basement Floor -q2a.0
Aprox. Sewer Service = 925.o±
Proposed Elev. _ C=)
Existing Elev. _
Drainage Directions =
Denotes Offset Stake = .
HEDLUND
PLANNlNC 6NC/N6BRINC SORVBYINC
2005 Pin Ook Orive
Eagan, MN 55122
Phone: (651) 405-6600
Fax : (651) 405-6606
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op 7s
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933.b \
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SCALE: 1 inch ? 30 feet
?A o
.9? O 933.?
93q 7
?
? 93,
3D
s IlT
MNG E
= 21,221
= 1, 852
Sq
BENCHMARK, C,P m?,l Box
E1e0: 923.?.4
MIN. SETBACK REQUIREMENTS
Front - House Side -
Rear ,- Garoge Side -
I HEREBY CERTIfY THAT THIS IS A TRUE ANO CORRECT REPRESENTATION
OF THE BOUNDARIES OF THE ABOVE DESCRIBED PROPERTY AS SURVEYED
BY ME OR UNDER MY DIRECT SUPERVISION AND DOES NOT PURPORT TO
SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHO,WN.
DATE _y114-1D Z-
WFUD. LINDGREN, Ll&D SVRVEYOR
- 6?-Oe 17? _MINNESOTA. LICENSE NUMBER 14376
Qs`
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L 0 T SQ. FOO TA GE
HSE SQ. F00 TA GE
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02R-020
PAGE:
Oakbrooke 5
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA108051
Date Issued:11/13/2012
Permit Category:ePermit
Site Address: 1573 Oakbrooke Ter
Lot:12 Block: 3 Addition: Oakbrooke 5th
PID:10-53764-03-120
Use:
Description:
Sub Type:e-Reroof
Work Type:Reroof
Description:House
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 .
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 -
Melvin Scroggins
1573 Oakbrooke Ter
Eagan MN 55122
Haug Contracting Group dba New Line Roofing
3141 Fernbrook Lane N
Plymouth MN 55447
(612) 251-1152
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA125686
Date Issued:07/30/2014
Permit Category:ePermit
Site Address: 1573 Oakbrooke Ter
Lot:12 Block: 3 Addition: Oakbrooke 5th
PID:10-53764-03-120
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 -
Melvin Scroggins
1573 Oakbrooke Ter
Eagan MN 55122
Redstone Builders Llc
4084 Oakbrooke Alcove
Eagan MN 55122
(612) 236-8888
Applicant/Permitee: Signature Issued By: Signature
jt\''
� - `
�J� °, �/ Y� r For Office Use !j.7,I
E AG� � � q � `���(� Permit*: /-5 9/-37 ��-
A Permit Fee: .
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff:
buildinginspections(&cityofeagan.com
2019 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 10/29/19 Site Address: 1573 Oakbrooke Terrace, Eagan Unit#:
Name: Mark Morgan Phone: 612-704-9219
Resident! 1573 Oakbrooke Terrace, Eagan, MN 55122
owner Address/City/Zip: g
Applicant is: Owner Contractor
Type of Work
Description of work: Replace Existing Deck, ailing and steps
Construction Cost: $9,000 Multi-Family Building: (Yes /No )
Company: Contact:
Contractor Address: City:
State: Zip: Phone: Email:
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why: $1)�
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:Piens and supporting documents that you submit am considered to be public information. Portions of the iMbrma tion gray be
classified is nonpublic if you provide specific reasons that would permit the City to conclude that they we hada secreta.
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.citvofeagan.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.gooherstateonecail.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.
xMark Morgan xMark Morgan DT.'2 9;o so;':a :09°
Applicant's Printed Name Applicant's Signature
•
DO NOT WRITE BELOW THIS LINE / - 3 Ad/wok-6 /i�2/9LC l -9/ 7
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 t Repair _ Egress Window _ Water Damage
—
— Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation /6960 Occupancy Inc -/ MCES System
Plan Review Code Edition i/ SAC Units
(25%_100%.Z Zoning p1) City Water
Census Code ii 34' Stories Booster Pump
#of Units / Square Feet / 8'.-X PRV
#of Buildings / Length — Fire Suppression Required _
Type of Construction Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) Y- Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood
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
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: /' f/ / ,Building Inspector
RESIDENTIAL FEis-0 &/ .:
Base Fee o
Surcharge
Plan Review 57
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Radio Meter Read
Copies
TOTAL
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