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
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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
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'------------------------------------------
,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? ?
?
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M@ld=m
Rmfaining lWd9 WIG] i
Required ?
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N
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/ 40
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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