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4138 Oakbrooke CurveSURNSVILLE Heating & Air Conditioning, L.L.C. 12481 Rhode Islartd Av¢ S, SavaKe, MN 55378 • 951-894-0005 Orstat Test Report for JobS `1875 Address 'y13P Ufi4f6'0oe9t C'L«vL- City EAGrnn? Date of I nstall 3-11 -23 Type of HT. F/A X HW Space HT Unit HT Ofher Malae ? c:Ntic? x Model C?-:2 6- G?3 7 7 ? Serial !?'FU sS / S-... Input ?,? ,ovo 13 7t? r/ Pilot Type HOT SURFACE IGNlTOR Pressure 3. S ? Wc- C02 1-3 Input CFli 175' 02 StackTemp 99 CO .? Date Tested °/ Company BURNSVILLE HEATING & AIR CONDITION/NG Technician ??`? 30 Site eddress: 113 r`? ()/VV5koo ? Lotq i Block subd. 0 ?-1 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 conaUucted to meet minimum requirements of the Mn Energy Code, Chapter 7670 OR ? This strucmre: will be constructed to meet more restnctive requirements of Chaptera 7672 or 7674 APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTINGTYPE ^ WaterHeater Fumace +(Y) ?1?? M o :;t `1 70 &-,45 0 , 12 .e_0 Dryer EXHAUST SYSTEM LOCATION TYPE MODEL CFM's VENTED YES No Kitchen kitchen v 3 00 ? Bathroom 7 ?'Y??.I?' Yra?! ?iNt \ ?"d _?/ p ? Bathroom 2 F Ay aw??? C FU _ p ?Qd Bathroom 3 (15TN2, ??O4y ? r'j?J - SC} Sa Bathroom 4 ? Other FIREPLACE S LOCATION GAS OOD MANUFACTURER MODEL BTU'S VENTING DIRECT A7MOS ? F?^„ l }.?en?-Pt- Cz( a ?a? -C1Z- ? ? I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan requirements. &,q/a8 /a3 Si atur Dat ?ul? 1?o?eS CompanyName w This form is the responsibility of the General Contractor. CITY OF EACAN 4N'j vc7 ? 3-7 3830 PILOT KNOB RD - 55122 651 •681-4675 New Conemiction Reauifemenb ,?L ? . 3 registered sde surveys showing sq. ft af lat, sq. ft. M house; end aY roofed ? (20% maximum lot coverage aikwed) . 2 capies of plan showing 6eam 8 windaw s¢es; pou2d (aund deslgn, etc.) • isetofEneigyCalculatlons . 3 copies of Tree P2servation Poan If lot platted aRer 711N3 • RimJoistDetailOptiorsselectipnsheet(6ldgswRh3arlessunits) 919 .3. / / 9 o, s-?o 53 Sy. // 3_7&of9eVReoair Renu4emnfs • 2 copies of ptan • 1 set of Energy Cakulatbns for heated additbns • 1 stte wrvey tor euterior additions & decks • Indicate'rf home served by septic system for additioris C,M?-r's+-??'I J DATE ?? 2?-?VALUATION JOB SITE ADDRESS IF MULTI-FAMILY BUILDING, HOW MANY UNITS? ? PROPERTY OWNERQuAe \Xl? TYPE OF WORK _kAW S? ??\Q- APPLICANT ADDRESS FIREPLACE(S) _ 0 V 1 _ 2 PH0NE#_Z\-CA0ku -V'?? ZIP CODE SS\Z? PAGER # CELL PHONE #A1'X1-CC,4- ?A$I PAX #VSA-Ck?LI' k4:k54'I NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLT Energy Code Categary MINNESOTA RUI.ES 7670 CATEGORY 1??I (check one) - Residential Ventilation Category 1 Worksheet Submitted ti"" ! ?, 9?77 - Energy Envelope Calculations Submitted -vl MINNESOTA RULES 7672 .?- New Energy Code Worksheet Submitted Plumbing CoMractor V Phone #•'"??-"'??a ???.,? Plumbing System Includes: Water So r Iawn Sprinkler Fee: $90.00 ? Water Heater ? No. of RI. Baths _je?i,No. of Baths Mechanical Contractor. Phone # Mechanical System Includes: _ Air Conditioning Fee: $70.00 _ Heat Recovery 5ystem Sewer/Woter Contractor.N&MU4,4? Phone # All above information must be su6mitted prior to processing of appliwtion. I hereby acknowledge that I have read this application, state t at the informdti n is c ect, and agree to comply with all applicable State of Minnesota Statutes and City of Eag Ordinances. Signature of Applicant Certificates of Survey Received ? Tree Preservation Plan Receive Not Required / Updated 2002 / ? Y- s 7 a3.s- n,-? s,a3` RESIDENTIALf d'- s -7a-;5S BUILDING PERMIT APPLICATION OFFICE USE ONLY ? 01 Foundation ?(02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? OB -04-plex ? 37 New ? 32 Addition ? 33 Alteration ? 34 Replacement O 07 05-plex ? 13 16-plex O 08 06-plex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 08-plex ? 18 Deck O 11 10-plex ? 19 LowerLevel ? 12 12-plex Plbg_Y or _ N ? 20 Pooi ? 21 Porch (3-sea.) O 22 PorGVAdda (4sea.) ? 23 Porch (screened) ? 24 Stortn Damage ? 25 Miscellaneous ? 30 Accessory Bldg ? 31 EM. Alt - Mum ? 33 Ext. Alt - SF ? 36 Multi ? 35 Int Improvement ? 38 Demolish (lnterior) ? 44 Siding ? 36 Move Bidg. ? 42 Demolish (foundation) ? 45 Fire Repair ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors 'Demolition (Entire Bldg only) - Give PCA handaut to applicant Valuation 16:Y?0V a Occupancy r2,3 _t/t Census Code ?(?/ Zoning "'L,L_ SAC Units ?L Stories Nbr. of Units . Sq. Ft. Nbr. of Bldgs ? Len9th _IS ki ' Type of Const Width 6-41 REQUIRED INSPECTIONS Footings(new bldg) FinallC.O. Footings (deck) FinaUNo C.O. Footings (addition) _ Plumbing Foundation HVAC Drain Tile MC/ES System City Water Booster Pump PRV ? Fire Sprinklered Roof _ Ice & Water _ Final _ Other Framing Pool Ftgs Air/Gas Tests Final Fireplace _XAir Test Final _ Siding Stucco Stone _ [nsulation _ Windows (new/replacement) 4,. dZrVrAs?vtn..c- w?'tc.,e, Approved By Building Inspector Base Fee 7 ? S J v Surcharge , ? MC/ES SAC ciry sac Water Supply & Storege )/V0 yrv ?i 7 7 '] „L S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search y Copies [ l?? ll 0 Other L7 r y?I Total MNr.hPr.k COMPLIANCF_ RFPnRT ? MinnPSnta FnPrnv Cnda I Pprmit # ? MNchar.k Softwara Versinn 3.0 I 1 I ? I Cher.kPrl hv/DatP f . CnUNTY- Dakota STATE: Minnesota 7_ONF. 7 CnNSTRUCTION TYPE: Single Family DATF: 1-11-2002 DATE OF PLANS: 7I25100 TITLE: Oakbrooke Sterling with Lookout COMPLIANCE: PASSES RPauirPr! UA = 532 Ynur Hnme = 403 242% RPttPr Than Coda Area or Cavitv Cnnt. GlaAnn/Door PerimPter R-Value R-ValuP U-Value UA - - --------ILIN--GS ----------------------------121 R ? 39--- 0---0 ---- 0 -- ------- 37 CE BSMTSCnn?n 9 ?r h/fi.3' bn 9 ?' insul 1 047 3 111.0 n 00 n 6? 50 GLA7ING: Winrinws nr ponrs. ?? hove Grade 409 0.350 141 DOORS 0.350 FLOORS- Over ClutsidP Air 48 38.0 00 HVAC FQUIPMFNT: Furnar.e. 920 AFUF CnMPI IANCF STATEMENT- The r.nnsistPnt with thP hiiildina nlans. s suhmitted with thP nermit annlir.atic designed to meet thVeMirerr?nts Builder/Designer 13 1 ---------------- - 4d huildina dasinn tiesr.rihPCi h0r2 iS tinns. and nther r.alr.ulatinn5 nrnnncPrl huilcfinn has heen aionPSOtmEnerav Code. Date LOT SURVEY CNECKLIST POR RESIDENTIAL BUILDING PERMIT APPLICATION PROPERTYLEGAL: L-D I 1 ,f>/Dt K J VOr h DATE OF SURVEY: LATEST REVISION: m a c a t U Ya O ? ? Q DOCUMENT STANDARDS pi? ? • Registered Land Surveyor signature and company lB??[7 ? • Building Permit Applicant d/? ? • Legal description Cl ? • Address a' n ? • North arrow and scale a ? • House lype (ramhler, walkout, split wlo, split entry, lookout, etc.) [Y/CI 0 • Directional drainage arrows with slope/gradient % Ef/ O 0 • Proposed/existing sewer and water services & invert elevation fl' 0 0 • Street name o ? • Driveway ? v ? • Lot Square Footage W? 0 • LotCoverage ELEVATIONS / Existina ? • Sewer service (or Proposed) nV ? 0 • Property comers ?/? ? • Top of curb at the driveway and property line eMensions [9?? ? • Elevations of any existlng adjacent homes ? q?/ ? • Adequate foofing depth of structures due to adjacent utility trenches ? ?v ? • Watenvays (pond, stream, etc.) Prooosed IX ? ? • Garage floor 9? ? ? • Basementfloor W? ? • Lowest exposed elevation (walkoutlwindow) V / ? ? • Property comers f?' ?? ? • Front and rear of home at the foundation PONDING AREA (if aoolicable) ? Pa/ ? • Easement line ? ? f3J ? • NWL ? d/ ? • HWL ? I? ? • Pond # designation ? ? ? • Emergency Overflow Elevation ? IB? ? • Pond/Wetland buffer delineation ? L7 ? ?? u EA? ? ? ?n ? iu?/? n [Y Cl ? DIMENSIONS I • Lot IineslBearings & 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 permanent footings) • Show all easements of record and any City utilities within those easements • Setbacks of proposed structure and sideyard setback of adjacent existing sVUCtures . Retaining wall requirements, f Reviewed: G:lFORMS/8uilding Permit Application Surv e y o r's SURVEY FOR DESCRIBED AS 962.6 PULTE HOMES ; Lot 1, Block 3, OAKBROOKE 6TH ADDITION, City of Eagan, Minnesota and reserving easem ents of record. Certif2cate i , L 0 T SQ. F00 TA GE = 38, 6,32 HSE SQ. F00 TA GE = 1, 852 L O T CO l/ERA GE = 5% s??? ?°CAli ? . ._. , .. • ?'? / mP ? ? i / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / i s/ i '------------------------------------------ ,o N89°42'35"E 172.00 # 18232 PROPOSED ELEVATIONS Top of Foundation = 947.5 Gorage Floor = 947.1 Basement Floor = 939.5 Aprox. Sewer Service = 935.5 Proposed Elev. _ ? Existing Elev. Drainage Directions = - Denotes Offset Stake = • HEDLUND PLANNING ENGlNSERING SURVEYING 2005 Pin Ook Drive Eagan, MN 55122 Phone: (651) 405-6600 Fax : (651) 405-6606 i 3j ?03? o B'?pwoyd 9460 2? ? ? / / / / M@ld=m Rmfaining lWd9 WIG] i Required ? . ? % ry N / ?N / / 40 / ? o?ry / / ?rv,J / / / / / / / / / / / / / / / / / / / / { / / / ? / / ?, ? 11 V ?? ? n 0 so.a starm BENCHMARK, TNH@1&2/2 . EL=949.25 ;+?daYy MIN. SETBACK REQUIREMENTS SCALE: 1 Inch = 30 feet Sr ° ' \ a<2.8 138 ? 43.0 ^ 943.9 R? 0 'l.3F. Front - House 5ide - Rear - Garage Side - I HEREBY CERTIFY THAT THIS IS A TRUE AND 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 SHOWN. DATE _(/? ? . F D. LINDGREN, AND SURVEYOR MINNESOTA UCENSE NUMBER 74376 , , ? liProp. Home t TOB = 949.; r r 02R-754 Oakbrooke 5 C'or °9a b JOB N0: ' ii-IV City of Evan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: LI Use BLUE or BLACK Ink For Office Use Permit #: i 1 0 I L-1-5 Permit Fee: Date Received: -- t3 Staff: rY\,L_ 2013 RESIDENTIAL BUILDING PERMIT APPLICATION 5. 13 Resident/ Owner Name: Site Address: t\ 3 7 OcA bvoo Caro ecb k&.k.a,,r L%yk poi Unit #: 1 L (j �e Phone: I1 -• (� - q 54 G.Address / City / Zip: 91 i ' 0oc aa�'`e— CAw &- 4� Yrq+in . $S 1 2— Applicant is: °< Owner Contractor at Type of Work Description of work: Re._- - Q,0 Construction Cost � ( Contractor Company: Address: City: State: License #: Multi -Family Building: (Yes / No >e ) Contact: Zip: Phone: Lead Certificate #: 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: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: 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 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. X tlet cup) PAI Applicants -Printed -Name x S Applicant's -Signature Page 1 of 3