4345 Orion Lane%I
? CASH RECEIPT
CITY 4F EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE
ReceIvEu
19
AMpUNT $ I
& DOLLARS
?oo
F]CASH ? CHECK
FUND CODE AMOUNT
..' . __ .. ?
_ ?. .
r
?
I
I ?
-- - ??.. .
- ? --
-
I
Thank You
L/ 1 L/ V B Y
\
White-Payers Copy
Yeliow-Posting Cop?
Pink-File Copy
. ; cinr oF E?cAN
? . 3795 Pilo! Kaeb Rood Eagen, MN 55122
PHONE: 454-8100
BUILDING PERMIT
Site Address
Lot Block 5ec/Sub.
Pcrcel #
W I Name
z
9 I ndaress
°C Name _
,o
?? Address
? r;h,
Nome _
Address
Receipt .#
N2 5368
Erect ? Occupancy
Alter p Zoninp
Repair ? Flre Zone
Enlorge ? Type of Const.
Move ? # Storles
Demolish E] Front ft.
Gnade ? Depth ft.
Approvols Feea
Assessment _
Water & Sew.
Pol Ice
Fire
Eng.
Planner
Counci I
Permit
Surchorye
Plan check
SAC
Woter Conn.
Water Meter
I hereby acknowledge that I have read this opplication and state that gld9, pff.
the infortnation is correct and agree to comply with all applicable ApC Tot01
SMte of Minnesota Stetutes and City of Eagon Ordinances.
Signoture of Pertnlttee
A Building Permit is issued to: on the express condition that
ail work shcll be done in occordonce with all applicable Stcte of Minnesota Statutes and City of Eogan Ordinances.
Building Offtcial
P«mn # o.re k...d r«O"t..
Plumbing -.Lp_
Mechanicoi
INSPECTIONS DAT'E INSP.
Rough-In
Firal
Footings Date Irvp. Dote Irop.
Foundation Plumbing
Frome/ins. Mechanical
Finol -
Remorks: A/- t.1 0?77 '
r/- 2 i- 7 y
r,r.. N xv 7 xc /d.
C, a0^
CITY OF EAGAN
3795 Pilot Knob Rood ??-?..r,? _•.r.;: ,.. '??: - TY -1;T7-r-.
Eagan, Minnesota 55122
Phone: 454-8100
FMTIWI PERMIT
Date: $-1 3-79
5ite Address; -
f,
Lot -
,
Block _
_` ..? denyess Pa&, 2rd
Sub/Sec. _
"
Nome Peter"9'!'1 OC7!_5t2'ttCtlr:?,
?
e° Address 47`11- rt lY)flt `;f-
3
° '•nls 55" ? %
City Phone:
'?eez-Ry-??n
Name
?
P Address 14745 So. TY)be-r- 'ft't31.1
e
?j '
Ciry Phone: ?'?
This Permit is issued on the express condition thot all work sholl be
Minnesota Statutes and City of Eagan Ordinances.
No.
I542
1?; L.
Receipt No.:
Residential I
Multi Res., Comm./Ind. I
New/Alter./Repair
i Cost of Instollation
Permit Fee
.50
Surchorge
I Total
done in accordance with nll applitable Stote of
Building Officiul
CITY OF EAGAN
3795 Pilot Knob Road
Eogon, Minnesota SSIu
Phone: 4544100
puimINf'
4-2a-79
Date:
5ite Address:
4345 O'LfOtl IaBx'
PERMIT
Lot F Block 1
Sub/SeV_deiT7PBS PeiLic 27Xj
N,. 1469
Rece(pt No.: 1 Sfi72
Single
Residentiol 't
Multi Res., Comm./Ind. I
C. F't'9?'t (]os?st. Ct).
Nome New/Alter./Repair. ; Address 477I Z•7' ?.Ott St.
Cost of Installation
a ?ls 55437 Phone: 44 Permit Fee 2?.oC
City _
/ame , An'--P-yan SurtFarge .5p
.
Addreu 14745 So. Tkt3ert "tai.I
r:144 10,50
City Phone: Total
This Permit is issued on the express condition thot all work shull be done in accordance with all applicable State of
Minnesota Stotutes ond City of Eogan Ordinances.
Building Official
CITY OF EAGAN Remarks
Addition WILDERNESS PARK 2nd f1DTTTON Lot BIk I Parcel 10 84251 060 01
owner4Y-• street 4345 Ox'io11 Lane state- EaQan, MW 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SUR F.
STREET RESTOR.
GRADING
SAN SEW TRUNK 1 1973 1 7.31 20 92,53 A008686 12 4 79
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA Vd4L 1979 618.00 61.80 10 494.40 A008686 12 4 79
lE STORM SEW TRK 1979
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
road u it 75.00 15549 1
WATER CONN. 270.00 It iT
BUILDING PER. 5368 tt
5AC
PARK
'ilot ICnob Rood PERMIT NO.:
MN 55122 DATE:
- - No. of Units:
Connedion Charge:
Account Deposit:
Permit Fee:
Surcharge:
Misc. Charges:
Totol:
Date Paid:
SEVI/ER SERVICE PERMIT
PERMIT NO.: _
DATE:
No. of Units:
ldress: ?r.
- ? - )• . -} r.
tO comVlY N'ith fhe City of Eogon Connection Chorge:
?ces• Account DeposiY:
Permit Fee:
Surcharge: -
- Misc. Charges:
? Insp.: Totoi:
;eader No.:
agree to eomplr witfi the City of Eagan
CITY OF EAGAN
3795 Pllot Knob Rood Eagan, MN 55722
PHONE: 4548100
BUILDING PERMIT APPLICATION
Site Address 4345 OYlOri Ln.
6 W. PdY'k 2rid Ad
1
Lor Block
Sec/Sub.
Pnrcel # 10 84251 060 Ol
z Name S. Petersen Const. Inc.
701
4
W. 110th St.
o n
19 5
_
43/-
?
Ci Phone
o Nome GaME
0? Address
? Ci Phone
1-1
Name
Fw
_? Address
1 hereby acknowledge that I have read
the Infortnatian is correct and agregv
Stote of Minnewta StuYUtei and GY?e
Signature of Permittee ' -' A Building Permit is issued to: f
all work shall be done (n accordance
.state that
applicable
N4 5368
Receipt #
Erect $] Occupancy %
Aiter ? Zoning
Repair ? Fire Zone
Enlarge ? Type of Const. V
Move ? # Stories _??
Demolish ? Front ft.
??-
Grada ? Depth
fr.
Aoorovals Feas
Assessment Pertnit 1?7• V V
e 31.50
Water & Sew.
P Surcharg
Pl
k0
h
olice ec
an c
5T5
0
Fire SAC
'
Eng. Woter Con,270•00
Planner Water Meter 60.00
Cou„cii Road U. 75.00
Bidg
Off.
.
APC Totel $1200.00
L-C' . on the express mndition thut
of Minnesota Statutes and City of Eagan Ordirwnces.
Building Official ?sl'o
CITY OF EaGa.Y Include 2 sets of plans, i
I Site plan v/elevations 6 ?
BUILDING PERMIT APPLICATION 1 set of energy calculations.i
v
Valuation Date 7% ;
To be used for
Si
Add ,
?t ( ?`/ L'/L/ OFFICE USE ONLY ?
ress
te
Block Sec.
Lot ? Su6. Erect _? accupancy
i
?
_ Alter ng
i
Zon
3
Parcel 11 Repair }
Fire 2one
Ovner: c? Enlarge
M Type of Const.
/ Stories i
447 D/ 6el ove
Demolish
-- Frant 75 ft•
Address:
Grade ft.
Depth 3?
?jO?T /i1N .S?Zf37
ppprovals Fees
I
o ?
Yermit I?9
ntzactor:
C pssessment v
Water/Sever Surcharge 3/
Address: Police _ Plan Check 79 v
F1re SAC
Eng. Water Conn.g7a
Phone Planner Water Meter
Council ' Road Unit xr
Arch/Eng.: Bldg. Off.
Address: APC ?
TOTAL
Phone
6:
5 ? ; ,?
; ; , ? ??
v??? ,? ? ?
ctricity
I II I II IIII II I IIII I I I III IIII ?? III ",, MB ?U? e sity ?a Rmo SRI 8AS'Pb?UIr
O 04w 0 3 2 0 4 2 8 4111111111ta (612) 642-0800
Home Duplex Apt.8ldg. Other: New Addn
Commercial Industrial Form Remod Re air
Air Cond. Hfg. Equip. Waler Hfr. Load Mgmt. O?ec
D er Ran e Elec. Heaf Temp. Service
"X" obove fhe work covered by ihis request. En}er remarks in this space ond on /he back of the white ropy only.
w „-c, kc,+ -t1)b
Calculote lnspeciion Fee - ihis Inspection Request will not be occepted without the corceci fee:
Olher Fee # Service EMrance 5ize Fee # Graiis/Feeders Fee
Mobile Home Park Siall 0 ro 200 Amps 0 to 100 Amps
S}reet L}g./Traffic Sig. Above 200 Amps A6ove 100 Amps
Tfaltsfoffiter/(?ienefa}of INSPECTOR'S USE ONLY TOTAL
Sign/Outline Lfg. Xfmr. -) O
? S
Alarm/Remofe Conhol
$wimming Pool i he?b ?that i ??,eaxd me ei«mwi m Ilotion desnbed hercin on ihe daxs elaled
Irrigtltion Boom Roogh- ? DK
ecial Ins
edion
S
p
p
Invasfigative Fee Fin
E
E
I Dahq
C
COMPLETED WITHIN 18 M THS.
THIS INSTALLATION MAY BE OR
SC
IF NOT
IN
320 e
428
OFFl E USE ONLY This request.oid 18 manths fmm validanon dala pnnted in Ihie bar.
PLEASE PRINT OR TYPE
Requesl Dqf Rouqh-in impecnon rryotred2 ? Yes ?lo Impection OtherThon Rough-ln: eady Now ??0 Coll
?
=?? (You mmt wll the impaMrwhen reody) Dale Reody:
I, tipicensed confrodoi ? owner hereby requesf inspedion ol ihe above elecirical work af:
Job Addresz (Slmel, Bae, or Rovle No.)
TS o(,or, ?F1 City Zip Cade
SstZ-3
Secnon No. Township Name or Na. Range No. Flre Na. Coun_ry _
}r(.?AV.?
Occvpant Phone No.
Pawer Sapplier
?. Pddresn
E?'?1lecrviml Con aor (Campony Nome)
.?, Convado. Li<ense No.
lz3"l Masrcr lic. Nn (Planl Elecr. Only)
nnaiimenddm.lconnam,o.o.n«Pa?ro,mm9 nor,on)
n sstz,Z
AuIhorixe ' nalure ?Coyptl?r lormiig Insmllofon)
t8t? ? Phana No.
? tO
EB -10 95 3(ATEBOARpCOPY'gEVJNSTRUCTION50NBACKOFYELLOWCOPY
I4 Minnesota State Board of Electricity
3964University Ave., St. Paul, Minn. 55104-Phone 645-7703
*> REQUEST FOR ELECTRICAL INSPECTION
CHEt;K BELOW WOAK COVERED BY THIS REOUEST
i ss8?
R 49974
Type of Building Hew Add. Rep. Cheek Appliances Wired Foi Check Equipment W'ved For
Home ? ? ? Range ? Temporaty Wiring
Duptex ? ? ? Water Heater ? Lighting Fixtuxes
Apt. bldg. ? ? ? Dryex ? Electric Heating ?
Commercial Bldg. ? ? ? Furnace ? Sdo Unloader ?
Industrial Bldg. ? ? ? Ait Conditione[ - ? Bulk Milk Tank ?
pazrn [:] [] E] Lis[ List
O[h
er
?
?
? Otheis?
Hete 1 Othexs?
flere )
COMPUTE INSPECTION FEE BELOW
Smice Entrance Size: # Fee Fcedecs&Subfeedeis: # Fee Circuits: # Fee
0[0 100 Am s. .
40
-ID
0 t A 0 to 30 Am eres
101 to 200 Amps. 31 t i
? q 31 to 100 Am eres
Above 200 Amps. 4 7 Abo --
A
' =f Above 100 Amps.
Ttansformers Re `eCo Partialur otherfee
Signs Special lns
.ctwn Minimum Pee S5.00 s[?
Remarks "?°A" ' ? ` ?
T"""w-?c?!.
TOTAL E ?
y.5'z
?
I, the Electri cal Inspec or, hereby rtify that the above inspection has been
(Rough-in) t Date
(Final) Date
This request void 18 months from
This request void 18 months from
'R49974
Date of this Request R- 9 --`7 9
I, as W ticensed Electrical Contractor OOwner, do hereby request}nspection of the above electri-
cal wiring installed at: ? {V-
jr4?S zJ?•
Street 5Lddress or Route No. /? y3 ?S Die/pstS ?.s/Ciry E?G
Section Township
1Vhich is occupied by
Range County 0,4 kc>TR-
Is a roughin inspection required on this job? No ? Yes)< Ready Now ? Will Call W
Power SupplierQQ??EteG'l iT55/'wdress ?.2( S(L[Q S-r
, ssa:?.
r-.?rRa?„)?rL,)
Electrical Contractor-X?K ? ?-KS?7L ?lerv,t}-i?ntractor's License No.4-$-4-?%
(company Name)
Mailing Address R0 7 0 Ai)e- Electrl<al Contr r O r ng Thls Installatlon 1?;,SZ fox
Authorized Signature 1 _?one Na
(Electrlcal Contractar or Ow er Making This Installatlo ?
p ? p? This inspection request w li not de accepted 6y the
(? ?
tJ?lri1UE ??t=;l. ?rOPIV Stste Board unless proper inspection fee is enclosed.
This re*est void 18 months from /C-,S'v?2 Z';?Z - e' 60
Date of this Request 5eptembez' 20. 1979 5 12154
I, as 99 Licensed Electrical Contractor ?Owner, do hereby request inspection of the above electri-
cal winng installed at:
Street Address or Route No. 4345 02'l.on Ln. City Eagan
Section - Township Range County Dakota
Which ik occupied by Svend Peteraon Construction
- , . (Name of Occupant)
Is a roughin inspection reqUired on this job? No ? Yes W Ready Now ? Will Call EE
Power Supplier D ko a Ei en ri r. Aneo i n i Address 821 4rd St. , Fai7ni.ngto-ns MN
57024
Electrical Contractor KPn Snrancnn EI Prttri r. Contractor's License NoA3$4$3
(COmpany Name) '
Mailing Address 8070 12th Ave. 50. , Bloomington, MN 55420
Authorized Signature
- iuecm<m coniracmr m uw
KlM p OARD COPEI
No. g54-/470
This inapection request will not 6e accepted by the
State Boerd unless proper inspeetion fee is endosed.
Minnesota State Board of Electricity
19F4 University Ave., St. Paul, Minn. 55104-Phone 645•7703
' REQUEST FOR ELECTRICAL INSPECTION
CHE'CK BELOW WORK COVERED BY THIS REQUEST
16,6 71,
§ 1 21 94.
Type o[ Building New Add. Rep. Check Appliancen Wired For Check Equipment Wired Fo:
Home X ? ? Range ? Tempoiary Wiring ?
Duplex ? ? ? Water Heatet ? Lighting Fixtures ?
Apt. Bldg. ? ? -? Dryei
? Elecuic Heating -?
Commercial Bldg. ? ? ? Fumace Silo Unloader ?
Industrial Bidg. ? ? ? A'u Condi ioner ?
i Bulk Milk Tank
L ?
Fazm - ? 0 ? L
St ) ishwasher ?t
Other
?
?
? p }
He[e151 p
flerelS?
o ?: x
COMPL?TE INSPECTION FEE BELOW - q,. ?
Smice ntranre Size: x Fee e " a f' Fee Circuits: # Fce
0 to 100 Am s. '0 3?. m 0 ro 30 Am eres
101 to 200 Amps. .OQ .0 1 Amperes .ap 31 to 100 Am exes
Above 200 Amps. ve 100 Amps. Above 100 Amps.
Transforme7s RemoteCon[rol Circ, Partial or othet fee
Signs Special Ins ection Minimum tee $
Remarks COIDP18t8 House Wiring TOTALFEE '/6 - 0 ,r
1, the Electrical Inspector, hereby certif t th%S'q '?s ec ' has been? ade; ? j_??
(Rough-in) ? ?'?? ? Date
(Final) c.), 0 Date ? p Sr-R?
This request void 18 months from
(gPrfifixtttP Uf MIlltpttrity
Citp uf (Eagan
Dr}rttrtment uf guilhing 3nsprriian
Tbrr Cntificate irsutd ptntrant ia tbt +cquiremerur of Sertion 306 of tlx Uniform BNilrlittg
Code cau fyisg that at tix timt of itursrue t8ir n+rrrturr war rn cmnpliaacr with the naaraaxt
osdirwuces of tGe City rcgulatisg bxilding rorutrurrion or urr. For tbe faldouang:
u«cl..e?em SF DWlg & Garage &dg.PermitNa 5368
o?war*rw R3 c?.?? V F:ha 3 z??,?.
o.K.areumama S. Pe sen Cbnst. na? Minne3pOli5 MN
By NovenbPr 21, 1979
bl 33-Z
2004 RESIDENTIAL PLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN
651-675-5675
APPLICATION
MN 55122
Please complete for modifications to existing residential dwellings.
P,f. So
Ek Km. i 7 /B
Date ?p I 1 /
?f _
Site Street Address 1f ?
/X/?/D/lJ ,?-,/ /p/ e- Unit #
Property Owner Telephone #
Contractor Tele hone#
Address A2 A-(Y? & ? City StateZip«-?
The Applicant is: _ Owner ? Contractor _Other -l?-?
„, -
-!uJ !:?
Alterations to existing dwelling DE? ?- 2004
I
$ 50.00
_Add plumbing fixtures
If you are only installing a water softener and/or water heater, the f Ns $15.00 pius the
state surcharge - see next section.
_Septic System Abandonment
_ Water Turnaround (add $121.00 if a 5/8" meter is required)
Other:
Water Hea ter
r $ 15.00
ent _ additiona
=repl
acem
Lawn Irrigation System _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total $ l I • 50
I hereby apply for a Residential Plumbing Per
and accurate; that the work will be in conform
Eagan and the plumbing codes; that I underst
permit, work is not to start without a permit and
the event_a plan is required to be reviewed and
mit and acknowledge that the information is complete
ance with the ordinances and codes of the City of
and this is not a permit, but only an application for a
work will i ac rd?n e approved plan in
approvecJ?
0 ?
Appli'canYs Printed Nam6( Applicant's Signature
? ?/) Q; ?
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauiremen4s RemodeVReoair Reauirements
3 registe2d sde surveys showirg sq, ft of IoL sq. fl. af house; and all roofed areas 2 copies of plan
(20°,6 maximum lot covera3e allaxed) 1 set of Energy Calalafions for heated addifions
2 mpies of plan showing beam 8 wirMow sizes; poured foun0 design, etc. 1 site survey for addNOns & decks
1 setof Energy Calculations Additian - indkafe ilon-sde sepGbsystem
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Detail Options selecGon sheet (bldgs with 3 or less units
g Izo'o3
Office Use OnH
Cert of Survey Recd
_ Tree Pres Plan Recd
_ Tree Pres Not Reqd
_ On-site SepUC System
Date 9 // / / Q3 Construction Cost $10i OUC7
Site Address !4?)4 S C)p I Qo j fk?'1-. Uuit/Ste # ?J'R
, WU rnvJ cs::-?>L3
Description of Work SGa Son o ?c ?+
Multi-Faroily Bidg _ Y X N Fireplace(s). 110 1? 2
Property Owner (),. {Q_?? `?IR ?IL Telephone # ( 6SI) 994--?q?R`7
wo? .- 9 -7
`s
Contractor
e ,
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Ca[eeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventila6on Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
I hereby apply for a Residential Building Pernut and acknowledge that t]
that the work will be in conformance with the ordinances and codes of
and accurate;
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
approval o?ans. ??
Y V?ar ' .,
Applicant's Printed Name A plicant's Signature
Telephone # (
Telephone #(
? ?
f
9
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace X 21 Porch (3-sea.)
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.)
? 04 02-plex ? 10 OS-plex X 18 Deck ? 23 Porch (screenlgazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-p18X ? 12 12-plex Plbg_Y or _ N ? 25 MisCellaneOUS
Work Types ?
? 30 Accessory Bldg
? 31 Eut. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 31 New ? 35 Int Improvement ? 38 Demo6sh (Interior) ? 44 Siding
32 Addition ? 36 Move Bldg. ? 42 Demo6sh (FoundaGOn) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation ? Occupancy MC/ES System " '-
Census Code Zoning ?12 City Water -
SAC Units - Stories / Booster Pump -
Nbr. of Units - Sq. Ft. 3/0 PRV ^
Nbr. of Bldgs - Length ? Fire Sprinklered ?
Type of Const W idth oZ ?J
REQUIRED INSPECTIONS
Footings (new bldg) FinallC.O.
? Footings (deck) ? FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tife Other
Roof _k Ice & Water ? Final _ Pool _ Ftgs Air/Gas Tests _ Final .
j? Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review '
MGES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
i 45, /l
A ? 9 40
b k c-k,
Building Inspector
// Gh'a ?
130?0 ?
, ?..
fiq,ai "
ii
.06 r
0
90
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.n:9.::.tb...eFS.:._ ...a.._.. ?Su.. .,_,.,+,.. .;?.._.. - ?.+....?,..a 9n .:r?..?...w...w.-M?
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RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Reauiremente
• 3 registered s'de surveys showing sq. ft. of lot, sq. N. of house; aM all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing beam 8 window s¢es; poured found design, etc.)
• 1 set M Energy Calculations
• 3 wpies af Tree Preservation Plan'rf lot platted after 711193
• Rim Joist DefaO Optlore selection sheet (Mdgs with 3 ar less uniGS)
DATE 5-4a ( 6 2,
Q 9 , a5
RemodellRaoairReauiremenls
• 2 copies of plan
• 1 set of Energy Calculatlons for heated additions
• 1 sde survey for exterior addiiions 8 decks
• Iridicate if home served by septic system for additions
I
VALUATION 23 oc)
SITE ADDRESS '4?LI S Lq,NQ MULTI-FAMILY BLDG Y x' N
TYPE OF WORK FIREPLACE(S) _ 0_ 1 _X2
APPLICANT M
STREET ADDRESS ?_?Ll ? 0 C'iov\ L`CvLe_ CITY 09wh STATE ?!V ZIP SS/?3
TELEPHONE # I VJ9y'M 7 CELL PHONE #?Osj?y?a-?2s9 FAX #
PROPERTYOWNER MClfk - CDCk )i- Anrl l'Gd??C-?011 TELEPHONE#65-I-Z9`TY2Z
-7
----------- ------------------ ---------- ------- -------- ---------- --------- --°-----
COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RiJI,GS 7670 CATEGORY 1 MINNL,SO'TA RULES 7672
(4 submisslon typa) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculalions Submitted
Plumbing Contractor:
Plumbing system includes:
Mechanical Conhactor:
Mcchanical system includes:
Sewer/Water Contractor:
Air Conditioning
Heat Recovcry System
Phone #
Phone #
Fee: $90.00
n{i MAY 2 1 2002
--°-------------------------------°------------------------°-----°---------------------°- o.t
I hereby acknowledge that I have read this application, state ihat the inf rmation is correct d agree o comply
with all applicable State of Minnesota Statutes and City of Eagan grX ce
Signature of Applicant
OFFICE USE ONLY
_ Water Softcner _
_ Water Heater _
No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 Foundatron ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) O 31 EM. Alt - Mufti
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4sea.) O 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Poroh (screened) ? 36 Muki
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Yor_ N O 25 Miscellaneous
0 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) O 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof O 46 Windows/Doors
O 34 Replacement *Demolition (Entlre Bldg only) - Give PCA harniout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco _ Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
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
Z p "5-3 ?CV
? l?L-` ??.t's ? i? t
ir
8$
"I-,
?
0
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i
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yL ! o o ` tpo
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lit.
,E P, c-'3 6?P
EXTERIOR EYdVELOPE AVERAGE `U ' COP4PUTATIQi7
oWmrEx _sS?7 5 `i? &CTn/57'72 a 0 ii JA) /iv_Q
SITE ADDRESS ? pT (7 - ?3 C cG R? ? L!/!L /J???f/?sS r??jBk 2~?
CONTRACTOR nATF ? -79PHONE?,?i,1 ?!X
Determine vrorking square Foothge of each.
1. Total exposed xall area .,..,/,7??/ . eq. ft. x.17
2. Total roof/ceiling area .... /!!57-/q, ft. x.05 = 7'i??(
Total 2xposed wzll area above flooV =
a. Total wall window area ................ /4/0_
b. Total door area .............. ....
3 8
e. Total sliding glass area .... _
....... ?30.
d. Total fireplace wall area .. . . ."/ o
e. Total wall framing area (average 10/75/
f. Total net wa1Z area above floor ........f??z
g. Total rim ioist area ........... ... .. Zaz3
Total exposed foundation area = 8-1
h. Total foundation ia+indow area ... ....... ~.a
i. Total net foundation area above grade . g y
Determine "iU" vaiue of each wall segment.
a. ?cb/o X IlUl: O SS = ?7____°-a
b. JC nUi; F?_/.Z8 = ?,86
c. 80 R "U" o_S? = H?l. vo
D.?t R t°U" _ .,2s. v a
e. i 7V X °;U" O.!/9 = ,?,o. 70
f. /.Z 72 X ':U,: o. vY9 = /;Z 3?i
P; - /1 3 X 'fU`? tJ, o'?T = S. 7 8
h. - X "U'" - a ?
i.? X liU" O.5'7
3 .................................. .......Total s-.j
r
If item #3 is the same as, or less than item #1, you have met i;he
intent of SBC 6006(c)2.
,*
Total exposed roof/ceiling area = le5l•Z
J. Total skylight area ....... ............ NI-a
k. Tot31 roof/ceilfng frainirig area (average 16Z) 1SI
1. iotal nat insulated roof/ceiling areg ....... /?3/ /
Determine "U' value for each roof/ceiling segment.
i X "U `
k. Z:57/ X ;:Un
--?-L=?
1. /3(?x „v,?- 4 3 3=??l
4 .........................................motal
If total of k4 is the same ass or less than #2, you have met the
intent of SBC 5006(c)1,
Alternate Buiiding Envelope Desirn
To utilize che total envelope systen: method, the values established
by the sum of items #3 and #b shall not be greater than the sur.i of
items #l an3 #2.
1. + 2, _
3 . -r J4. _
From: Shane Paulson Fax: +1 (866) 316-7169 To: Building Inspections/ P. Fax: +1 (651) 675.5694 Page 2 of 2 10/30/2013 9:33
Use BLUE or BLACK Ink
' -
I For Offiice Ilse-- j
i
all J;r u_n ~ l%J I '
Qq of 1 er1,~ : I alaV CaA ,nt tK141.r 6 J i - ~.~Q =759 ermit Fee:
3830 Pilot Knob Road 1 I
W i I ~Q ~ e Received: I
Eagan MN 55122 S
Phone: (651) 675 .8875 t Pi< q rtA l
I
Fax; (651) 8755694 i I Staff I
v
RESIDENTIAL UI D NG PERMIT APPLICATION
2913
Data: Site Address: ` ~ " 01Z 101J LA C _ Unit _
Name: ~S) n VJOA Ok Phone: f7 s~" 31 s ~ ~ ? `f
a
Resident) I
Owner Address i City Zip:
Applicant is: Owner Contract
t ~Q t'b iJ j
Typo. of Work Description of work:
YPe
-J
Construction Cost 1, Multi-Family Building: (Yes I ND
-PAW-SZ'
{ PantSIG&Wag-C 170~16SEeVI"05/ Co tact: SWAA
Com
Address: 15631 bml-w~ P &M City: i~~t~u1~T
Contractor
5
°7
ff
Sate: Zip: Phone:
q
13C-3 6 5'0 49 Lead Certificate 57396r-
License 1
I.
If l V'TT
If the project is exempt from lead certification, please explain why: (see Page 3 for additional Information)
v..
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'
i NOtE=: Plans and sr~ppgrling documents that yaw submit are cor►sYdered1o be public lirftr~mation PoK+ans of
the irtfermatio» may be cJasslFed as nonput, F d you provide specific rlsasons that wo permitthe:City to
ntrlud o that they are trade sec _
CALL BEFORE YOU DIG. Caa Gopher stagy one Cap at (851) 4644002 for protection again tndergrourld utility damage- Call 48 hours
before you intend to dig to receive locates of underground Unities w-.x w aooheReanecall ora
I hereby acknowledge that alms 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 wi8wtrt a permit; gW the work will be in
accordance with the approved plan in the rasa of work which requires a review and appr" of plans.
Exterior work authori"d by a building permit issued in accordance with the Minnesota State Buliding Code must be eornplemad within 180
days of permit Isauarttce.
sw~ P,4i4 LSad Ch-eifnORV- x
App, e B stenaaure Page 1 Of 3
Applicants Prinlad Name a l ~ "~I C r "v `t r tc ►(C
V
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