4105 Oakbrooke CurveAddress T ? 05 Oakhrooke, O.v r?-2-- Zip 5512 a
I.ot 4 Blk I_ Sub OcJ<j)ra okG rJ-tll
THESE TI'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: a• 4j p• p Z Yes No Inspector: ?
/
Finai grade (6" from siding)
Permanent steps (gazage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
Trai]/curb damage
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 W
the outside Iawn faucet beforo freeze potential exists.
Contact engineering division et 681-4645 before working in rightof-way ot installing underground sprinkler system. ?
White - City Copy Yellow • Resident Copy Pink - Contractor Copy
Siteaddress: '`-\M? Lot?\ Block"-\ Subd.I?NEINN?AA?
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
11__?This struoturei will ba constructed to meet more resUictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTINGTYPE
Water Heater ? ?, ?? J wk
Fumace
Dryer
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
GFM's VENTED
YES No
Kitchen kitchen
Bathroom 1 V? - ? ' ??L7 ?
Bathroom 2 .? F J-?y5 v? 'S,Y ?
8athroom 3
Bathroom 4
Other
FIREPLACE S
LOCATION
GAS
WOOD
MANUFACTURER
MODEL
BTU'S VENTING
DIRECT aimOS
v ?3
I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan
?
Date
" This form is the responsibility of the General Contractor.
C) c-C .? ? ?ESIDENTIAL (3 {, l'
BUILDING PERMIT APPLICAT?ON
" CITY OF EAGAN 1'?'1 SOa-(o'1
3830 PILOT KNOB RD, EAGAN MN 55722
i 651-681-4675 ep e5-0-?,-(o '
5-U3'1 a'7
NewConshuction Reuuiramenta f`?, ?l D- L 3? RemodeVReuair Renuiremenh
. 3 registered site surveys shaxing sq. ft. of bt, sq. k. ot house; antl alf roofe areas • 2 copies of plan 5 I g ga?
(20 % maximum lot coverage allowed) _.n ?- . 1 set of Energy CalculaHons (or heafed add'Alons
• 2 copies of plan showing beam 8 window sizes; poured found design, etc.) ??? D, ?S I' I . . 1 sAe survey for extedor additions & decks
• 1 set of Energy Calculalroris Indipte if home served by septic system for additlore
• 3 copies of Tree Preservation Plan if lol platted after 711/93
• Rim Joist Detail Optbns selection sheM (bldgs with 3 or less units)
DATE S`6 -OZ VALUATION OOUCO
T-?
SITEADDRESS ??I?S a?lhnvke ('W?-t MULTI-FAMILYBLDG _Y XN
TYPE OF WORK P.cJ AloMe tl?slrUibi? FIREPLACE(S) _ 0-/1_ 2
APPLICANT
STREET ADDRESS dIS ArduJ -est 2kA./a../ ?" ZITYC? STATE AAI ZIP
TELEPHONE # C&-sl) 0S_Z Syoo CELL PHONE #1&?)369-/7lL CJ FAX #(&51) /?19-?af3L7
PROPERTY
TELEPHONE #
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category ? MINNESOTA RULES 7670 CA'f'EGORY 1 MINNrSOTA RUI,LS 7672
(Jsubmission lype) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
. Energy Envelope Calculations Submitted
el-Y Plumbing Contractor: blem vh? Phone #
Plumbing sysCem includes: Vl?er Softener Lawn Sprinklcr Fec: $90.00
Water Heater No. of R.I. Baths
No. of 13aths
Mechanical Contractor: C?i 7/1G A?q Phone #(?-TL) '660?
Mechanical system includcs: Air Condition`1 g rec: :670.00
Heat Recovery System
Sewer/Water Conhactor: 41"o (0e.Jen'l ??eG Phone # -&f3 -273A
- - '(?-?---------------------------°---------------------° - ------------
-information-
- is-correct,-and agree to comply
I ?c?vl?ti? t I-have read-this-application, state that-the-
a??p li q a f Minnesota Statutes and City of Eagan Ordinances.
MNY ?ti??
? Signature of Applican?
By
--- --°---------- __.._?._.r?_? _r..------------------
OrFICL i1SL ONLY
Certifcates of Survey Received ?_ Tree Preservation Plan Received _ Not Required %
Updated 4J02
OFFICE USE ONLY
? 01 Founda!icn ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg?
>? 02 SF Dwe:ling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 E#. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) 13 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
x 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Oemolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement `Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy ? "3 MC/ES System
Census Code 6i Zoning 19t) City Water
SAC Units C? Stories ?L Booster Pump
Nbr. of Units ? Sq. Ft. o°L.3C? PRV
Nbr. of Bldgs ? Length Fire Sprinklered
Type of Const Width ?( G
REQUIRED INSPECTIONS
? Footings (new bldg) FinaVC.O.
_ Footings (deck) _ FinallNo C.O.
Footings (addition) _ Plumbing
? Foundation _ HVAC
? Drain Tile Other
Roof _[ce & Water _ Final _ Pool _ Ftgs _ Air/Gas Tesu _ Final
Framing _ Siding Stucco Stone
? Fireplace ,? R.I. XAir Tes[ tFinal _ Windows (new/replacement)
? [nsulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MGES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
z c7SM 7 7a26 al`° r?
gv a
(9 /G
U?yk/?'l'/1d2?
?
30 $$? -
?o
NOU-20-2060 03:13 PULTE HOMES
MNcheck COMPLIANCE REPORT
Minneaota Energy Code
MNCheCk Software Version 3.0
651 452 5727 P.02i02
Permit #
Checked by Date
COUNTY: Dakota
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Family
DATE: 11-20-2000
DATE OF PLANS: 8/14/00
TITLE; TYLER ELEVATION #4
PROJECT INFORMATION:
OAK$ROOKE SINGLE FAMTLY
COMPLIANCE: PASSES
Required UA = 520
Your Home = 442
15.0% Setter Than Code
Area or Cavity Cont. Glazing/DOOr
PerimeteT
------ - ---- R-Value R-Value U-Value
--------------------------
CEILTNGS 1656 ----------------
44.0 0.0 --------------
WALLS: Wood Frame, 161, O.C. 2049 19.0 2.0 1
WALLS: Wood Frame, 16" O.C. 243 910 2.0
ESMT: Conc. 8.0' ht/7.3' bg/7.3' inaul 640 11.0 0.0
BSMT: Conc. 7.0' ht/7.01 bg/7.0' insul 224 12.0 0.0
GLAZING: Windows or pooYS, Above Grade 378 0.350 1
DOORS 38 0.350
FLOORS: Over Unconditioned Space 352 38.0 0.0
SLAB FLOORS: Unheated, 42.0" insul. 72 5.0
HVAC EQUIPMENT; Furnace, 92.0 AFUE
-
-------------------------------------
COMPLIANCE STATSMENT: Tha proposed building ------------- ---
design described ----------- -
here is
consistent with the building plans, specificatiOne, and other calculations
submitted with the permit application. The pYOpoaed building has bean
deeigned to meet the requiremeata of the Minnesota Energy Code.
Builder/DesignPx---.?, Date 5--6-02-
TOTAL P.02
. PULTE HOMES OF MINNESOTA
RECAP SHEET
DATE: 3r23102
JOB NO:
COMMUNITY:
ADDRESS:
MODEL:
BUYER:
SALES REP:
0320-304-04
Oakbrooke Single Family
4105 Oakbrooke Curve
Tyler MODEL#:18281
Mike & Kathleen Prinskie
Jolayne Moberg
24Mer
LOT: 4 BLOCK: 4 UNIT: 0
ADDITION: PHASE 3
CITY: Eagan STATE: MN ZIP: 55122
ELEVATION: 1 GARAGE: RIGHT
PHONE #: 952-891-1121 PHONE #: 0
PHONE #: 651-686-2862
1 18281 Tyler g274,990
1 00000 Lot Premium $15,000
1 10000 PROFILE PKG. - ELEC. RANGE, DW 8 MW $1,350
1 13077 WHIRLPOOLTUB $1,175
1 14001 1ST CARPET UPGR,4DE $1,500
1 14004 1ST CARPET PAD UPGRADE $440
1 15002 VINYL UPGRADE BATH 2 $300
1 15026 VINYL UPGRADE - KITCHENlDINETE $425
1 15027 VINYL UPGRADE FOYER $700
2 17000 ADD'L ELECTRIC OUTLET gar, mstr bath $100
1 17005 ELECTRIC DRYER OUTLET $100
7 17024 CEILING ELECTRIC OPENING $700
1 18015 ELEVATION #1 $0
t 21021 GAS FIREPLACE - CER,4MIC WlWOOD $4,250
1 22041 4'ADD.GAR-EL#1 $2,995
1 23007 3 TON AIR CONDITIONER $2,350
1 28046 CABINETS - RAISED PANEL $760
1 29006 CAST IRON KITCHEN SINK $425
1 31011 LAUNDRY TUB SNGL COMPRTMNT basement $275
3 32002 CAT 5 PHONE/CABLElMEDIA OUTLET $165
1 35066 4TH BDRM-FL OAK DRS $1,700
1 99000 N.S.O-DECK LEDGER BOARD: 16 FT $280
1 99000 N.S.O-EXTEND COUNTER TOP TOWARDS DINETTE $50
1 99592 PRICE ADJUSTMENT ($360)
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTV LEGAL: ejp cY? L-? //q,???%rn 5?21
DATE OF SURVEY:
LATEST REVISION: %-D 2
?
?
c
m
v
DOCUMENTSTANDARDS
Y ¢
O Z ?
Q
?
/L ? . Registered Land Surveyor signature and company
?
!N' CI
? ? • Building PermR Applicant
?
? ? • Legal descnption
!?
? Ci • Address
z/ n ? • North arrow and scale
r ?
ii? ? . House type (rambler, walkout, splK w/o, split entry, lookout, etc.)
D
°
? ? • irectional drainage arrows with slope/gradient
h
^/i: ? • Proposed/existing sewer and water services 8 invert elevatlon
?? U ? • Street name
? ? ? • Driveway
C? ? ? . Lot Square Footage
? • Lot Coverage
d ? CI • Benchmark
ELEVATIONS
/
?d u
?
• Existina
Sewer service (or Proposed)
E? ? ? • Property corners
W/ ? ? . Top of curb at the driveway antl property line extensions
?? ? • Elevations of any existing adjacent homes
r ? n
? •
• Adequate footing depth of structures due to adjacent utility trenches
W
atervvays (pond, stream, etc.)
Prooosed
/
[u'/ ? ? • Garage floor
fd CI
ta? ? G
? • First floor
L
? • owest exposed elevation (walkouUwindow)
u
? ? . Property corners
?? ? • Front and rear of home at the foundation
/ PONOING AREA ('rf anolicable)
? ? • Easement line
? ? • NWL
r ? • HWL
? [7'/? • Pond # designation
? iU? ? • Emergency Overtbw Elevation
1I "I ?
•
I I / I:I ? •
?vY l1 ? •
IW/ fl ? .
I(/ ? I C: •
Reviewed:
Name
DIMENSIONS
Lot IinesBearings & dimensions
Right-of-way and street width (to back of curb)
Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring pertnanent footings)
Show all easements of record and any City utilities within fhose easements
Setbacks of proposed structure and sideyard setback of adjacent existlng structures
Retaining wall requirements, if any
1 l'-F-O
Surveyor's Certificate
SURVEY FOR :PULTE HOMES
DESCRIBED AS :Lot 4, Block 4, OAKBROOKE 5TH ADDITION, City of Eagan, Minnesota and reserving
easements of record.
yi??.i
_ ?17
-- ,
9(ag o?
?i
?
I
Exlst. Home I
TOB = I
?J
?
?
?
9b2.7
?i
-VACANT-
L 0 T SQ. F00 TA GE
HSE SQ. FOO T,4 GE
L O T CO I/ERA GE _
= 70,778
= 7,877
17q'
U o.f; o V o ?12 " u E 3? L'?0
// 18281
PROPOSED ELEVATIONS E
Top of Foundation = 0145,7
Garage Floor = 1)q113
Basement Floor =q3ITI
Aprox. Sewer Service =433.7 r
Proposed Elev. _ C=D
Existing Elev.
Drainage Directions =-
Denotes Offset Stake = •
SCALE: 1 inch = 30 feet
a.?
BENCHMARK,
MIN. SETBACK REQUIREMENTS
Front - House Side -
Rear - Garage Side-
JOB N0:
HEDLUND I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION 02R-069
OF THE BOUNOARIES OF THE ABOVE DESCRIBED PROPERTY AS SURVEYED
BY ME OR UNDER MY DIRECT SUPERVISION AND DOES NOT PURPORT TO BOOK: PAGE:
PLANNINC BNG7NEdR7NG SURV6YlNC SROW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS HOWN._
2005 Pin Oak Drive - ' Eagan, MN 55122 DATE ? CAD FILE:
Phone: (651) 405-6600 FF D. LINDG EN, LAND URVEYOR
Fox: (651) 405-6606 MIN SOTA LICENSE NUMBER 14376 Oakbrooke 5'
..
FiECEIVED
MAY 14 2002
EAGAN
ENGINEERING DEPARTMEDJ7
2004 RESIDENTIAL BUILDING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
I
New CansWdion Reauiremenfs
3 registered site surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas
(20% maximum lot coverage all(ywed)
2 copies of plan showing 6eam & window sizes; poured fouM design, etc.
1 set ot Ene(gy Cakulations
3 copies o( Tree P2servation Plan if lot platted after 7l1193
Rim Joist Detail Opqons selection sheet (bldgs with 3 or less unBs
RemodeVReuair Reouirements
2 copies of plan
1 set of Energy Calalalions for heated additions
1 sfle survey for additions & decks
Add'dion - indicate fl on-sde sepfic system
A '-10.o0
?.?
b (fiegklse Onl4
erid(SUrvey?acU =Y =N
?iee:PresPlanRecd=? ; ?.?= a N
?rdePfea°ReQwte? °, n 7X _Pl
Of?ite.SLePfiaSystern' : ,,._Y, =P}
Date `' / (& / (:)?
Site Address A t b S d?? Construction Cost ? 62-oo • c) J
?(Lo 0?? C, Cl n- v l= UniUSte #
Descriplion of Work
Multi-Family Bldg _ Y?V Fireplace(s) _ 0d-1 _ 2
Property Owner M ? C,, Pn, ri s Telephone #((09 )? S Z'5 S ZZ-
Contractor
Address
State
Zip City
Telep6one # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code CategOry . Residential Ventilation Category I Worksheet • New Energy Code Worksheet
(4 submissiontype) Submitted 5ubmitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan?
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone
Telephone
N If so, 25% plan review
I hereby apply for a Residential Building Permit and aclaiowledge that the inform rion is ?t I"ete an curate;
that the work will be in conformance with the ordinances and codes of the City e tate of MN
Statutes; I understand this is not a permit, but only an application for a pemut, and work is not to start without a
pernut; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
Applicant's Printed Name Ap icanl Ys Signature
OFFICE USE ONLY
SubTypes '- ,
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 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 OS-plex ?'&[ 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 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 Siding
A 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy A '"'3 MCES System ?
Census Code Zoning 2 City Water
SAC Units Stories --- Booster Pump ?
# of Units Sq. Ft. PRV ^
# of Bldgs Length Fire Sprinklered ?
TypeofConst Width /G
REQUIRED INSPECTIONS
Footings (new bldg) FinallC.O.
? Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof Ice & Water Final Pool Ftgs Air/Gas Tests Final
? Framing _ Siding _ Stucco _ Stone _ Brick
_ Fueplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation Retaining Wall
Approved By:
Base Fee "
Surcharge
Plan Review
MCIES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
,7d 12v-
l
Surveyor's Certi,ficate
( Sl
? Df
IRVEY FOR :PULTE HOMES
:SCRIBED As :Lot 4, Block 4, OAKBROOKE 5TH ADDITION, City of Eagan, Mlnnesota and reserving
easements of record.
Y II
a
....
Y k
? ?- ?
. ..
?-
-.
9faS.o .
S85°28'2
sl? ---------9?1'i^
co f ? - - - -
(0
w I aas.?
q4
O
' f lx ?
N
z
1 L - 995.0
L __-__ _ _
? I
? Exist. Home I
? TOB = I
I
---L60.0^ ?
999
160.67 a
o ? -
0
° 22.00
28.00 d?
0
Unex. Gorage ?
N
. Drops 1' 18.an
Proposed
2-Stary
B?PCw
S85°28'28"E 162.66
-VHfANT- • qQ4.3
Sr LT 'ji:rENG 15
L 0 T SQ. F00 TA GE
HSE SQ. F00TAGE
L 0 T CO I/ERA GE _
1
j
'
11 11
o ?
_ ?-- - J ie
- 10,778
- 1,877
177o
?0V. P?Q U ? R, E: D
# 18281
PROPOSED ELEVATIONS "
Top of Foundation = q45•77
Garage Floor = q493
Basement Floor
Aprox. Sewer Service
_
q33??
Proposed Elev. = 0
Existing Elev.
Drainage Directions =-
Denotes Offset Stake = •
SCAIE: 1 Inch = 30 feet
3?}+
? f
30
?..;.
BENC_ H_MAF21C'
MIN. SETBACK REQUIREMENT
Front - House Side -
Rear - Garage Side-
OF SURVEYED
HEDLUND IETHE BOUNDARIES OF'fNIE BOVERDESCRIBEDOPROPERTYPASS
E NO
SHOW I?1PROVEMIENTS OR ENCROACH ENTS, EXCEPTRSHOWN PORT TO
PLANNINC 6NGINE6RINC SURVBYING •
2005 Pin Oak Drive DATE
r..,..? iiN 55122 pF D. LINDG EN, LAND_URYEcO
N0:
02R-069
5
Oakbrooke 5 1
PERMIT
Permit Type: Building
City of Eagan
Permit Number: EA105331
Date Issued: 07/10/2012
Permit Category: ePermit
Site Address: 4105 Oakbrooke Curve
Lot: 4 Block: 4 Addition: Oakbrooke 5th
PID: 10-53764-04-040
Use:
Description:
Sub Type: e-Reroof
Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434 -
Occupancy:
Zoning:
Square Feet: 0
If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are
Comments:
not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes.
BL - Base Fee $4K $103.25 0801.4085
Fee Summary:
Surcharge - Based on Valuation $4K $2.00 9001.2195
Valuation: 4,000.00
Total:
$105.25
Contractor: Owner:
- Applicant -
Erickson Building Michael P Prinske
2667 Cottage Grove Place 4105 Oakbrooke Curve
Woodbury MN 55125 Eagan MN 55122
(651) 248-9339
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.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA126499
Date Issued:08/27/2014
Permit Category:ePermit
Site Address: 4105 Oakbrooke Curve
Lot:4 Block: 4 Addition: Oakbrooke 5th
PID:10-53764-04-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Joshua Herzog
3110 Washington Ave N
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Michael P Prinske
4105 Oakbrooke Curve
Eagan MN 55122
Uptown Heating & Cooling
3110 Washington Ave N, Suite 100
Minneapolis MN 55411
(612) 827-4674
Applicant/Permitee: Signature Issued By: Signature
�
Use BLUE or BLACK Ink
�-----------------
� For Office Use �
' j Permit#: � " v � � j �
C l t� o f �� a� � �,� F : �� �
� Pe t ee � �
3830 Pilot Knob Road �
Eagan MN 55122 j Date Received: j
Phone: (651)675-5675 I C'�(� I
Fax: (651)675-5694 I Staff:(� K� I
� ' ------� ��,
.----------- �
2014 RESIDENTIAL BUILDING PERMIT APPLICATION ��� ��
Date: S ( w Site Address: "� � O S O�('�`g�O��� C.�R-V�c Unit#: �a^g ��
�r �J
�.� Name: ��1�� �fl-�r�S1=L� P�S�—�1.3'-7 '��gg
� � �
���;��@S�C�s ��,`. � ,� _(
����{'�W��" Address/City/Zip: � � O s Of�t'I��/Lo o l%` G.f�(LV� �''"-��o �Y"
`Y� SSt 2
u��ar �.��:r,., ' Applicant is: � wner Contractor
�4 iy fi ,x
�` p (,,.�.0 1i✓v�/L.. 1.+L V lT��— � r!1 '�'
' Descri tion of work: � t s �
�����i��
,�,�:ra` Construction Cost: Multi-Family Building: (Yes /No�
,� Company: Contact:
��
���t�,� _' Address: City:
��OP
.:� ,�� �
��� s
` State: Zip: Phone: Email:
' License#: Lead Certificate#: '
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) ',
I3v��r �.omt l�i� �I
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:P(ans and sup�,i�tfng dc►�r�r�t��#hat you sa,��it are�a�n�sldered to be pubtic infor�natfon. Po '��f '
the fnft��rnation may���#��s�f��i�.;��� =�ubffc if y�3u provide specific reason��that woul+d permlt the ' �Eo
.
r
y
- ""' � ; . �.d�that the are#����s�� �
�
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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. wuvw.aooherstateonecall.orp
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.
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x M � �� � rZ.�,�s�-�l�—`�
x
Applicant's Printed Name Appli anYs Signature
Page 1 of 3
.
' �c� � ���h,ti�� �'�,��
DO NOT WRITE BELOW THIS LINE �-g�'� C.0
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 � frower 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 � �Z, ��,� Occupancy �L.�- MCES System
Plan Review Code Edition ���r� ,r,a��c;.- SAC Units
(25%_ 100%X ) Zoning `�'� City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Sprinklers
Type of Construction :�� Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) � Final/No C.O. Required
Foundation HVAC Gas Service Test Gas Line Air Test
Roof:_Ice&Water _Final Pool: _Footings _Air/Gas Tests _Final
� Framing Drain Tile
Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick
� Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Erosion Control
Braced Walls Other:
Reviewed By: �rT , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge ?� L� i � �� �- � r�, � ��
Plan Review 1 ��� ��� .� � �
MCES SAC �
City SAC � Va ��
Utility Connection Charge �C� �?
S8�W Permit& Surcharge
Treatment Plant ,�. � � „��
Copies �
TOTAL
Page 2 of 3