4741 Pebble Beach WayREDUEST FOR ELECTRICAL INSPECTION T,"F 2k Es-ooool-os
? • 10- See instructions lor compleling this form on back of yellow copy.
"X" Below Work Covered by Thrs Request 4•rKr•=?`
Ne Aod Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Buildin Dryer Load Management
Comm./lndustrial Furnace Other (Specif )
Farm Air Conditioner
Other (specity) Caitractor's Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feede[s Fee
Swimming Pool 0 to 200 Am s 0 to 100 Amps
Transformers Above 200 Amps Above 100 Amps
SI f1S Inspector's Usn On1y: . t TQT/4?.
Irrigation Booms : f f '?
i
S
on
pecial in ct
AlarmJCommunication THIS INSTALLATION MAY BE ORDERED DiSCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
hereby
the Electrical Inspector
I Rough-in Date
,
,
ceAify that the above inspection has Final Date
been made.
THIS REQUEST FOR INSPECTION VOID 18 MONTHS F ?TE S PE ECEIVED BY STATE
BOARD OFFICE ON ORIGINAL COPY. A NEW REQUEST FOR iNS TI AND APPLICABLE FEE
SHALL BE FILED ON ALL UNFINISHED WORK.
?
0-19ro-013 p
Request Date :-, Flre No. Rough-Ia.Inspection:Required
(You t call inspector when ready) In ection Other Than i?ough-In
? Read
Now
[:?Will Notlty Inspector
? y
.
No
Yes Date Rea
I? licensed contractor 6owner hereby request inspection of above electrical work at: '
JOb Address (Slreet, Box or FtOUIe No.)
?
1
J city
. .
1
! ,. ?
Sacllon No. Township Name or No. Range No: .• CouMyr
Occupgpt.(ARINT) Phone No.
Power SuppBer - Adtlress
Electncal ConVador (Company Name) Contractois Licenge No,
Malling AddresR (ConVeclor or Owner Making Inslalfation)
AulFwnzed Signature (COMractodOwner Making Inslallation) Phone Number
, . . . . . . . \? ?
!. ? ? ? ?
MINNESOTA STATE 80ARD OF ELECTRICITY THIS INSPECTION REOUEST WILL NOT
Griggs-Midway Bldg. - Room 5-128 8E ACCEF'TED BY THE STATE BOARD
. 1821 University Ave., St. Paul, MN 55104 UNLESS PHOPER HJSPECTION FEE IS
e- 1.11% e?l-ann FNCI (fAFf1
INSTRUCTIONS
At or before commencement of any new electrical installation, the person responsible for
making such installation shall submit to the Board a Request for Inspection in a form
prescribed by the Board and the inspection fee for such installation.
Fill in all information in detail with particular attention to address. if in the rural area, draw a
map on the hack of the white copy for the inspector. Also, fill in the section, township, range,
county and fire number. Complete information on amount of work to be done. Consult fee
schedule for correct amount of inspection fee to be submitted.
Now consult your power supplier on capacity or location of service equipment if such is to be
installed.
Electrical wiring must be installed in accordance witii ihe current adopted edition of the
National Electrical Code and the current adopted edition of the State Building Code where
applicable.
BefQre insulating. sheetrocking or paneling, etc.. filling trenches, pouring concrete, etc., the
inspector must be notified in reasonable time to complete a rough-in inspection prior to
concealment, exctusive of Saturdays, Sundays and Holidays.
Inspectors take phone calls at their residenr,e, Monday thru Friday, 7:00 to 8:30 a.m. only.
Make proper arrangements wiih the inspector so he may gain entrance to the installation to
make inspection. Send a key by mail to the inspector or leave a key with instructions on how
to find it.
The white and pink copies, together with fee. are to be sent to the State Board of Electricity.
(See A-B - C for proper distribution of all copies.)
A. White and Pink Copy - Shall be sent to the State Board of Electricity. All fees shall
accompany these copies in all cases and are to be made payable to the State Board
of Electricity. If in a rural area, draw a map on the back of the white copy for the
inspector.
B. Blue Copy - This is the certificate: portion to be filed with the electrical utility
company supplying power when the electrical installation is ready to be connected
or reconnected for use. The signature wiil be a carbon copy, which may not satisfy
the power company. if not, the responsible person must resign the blue copy before
mailing it to the power company.
PLEASE NOTE: Before this coPy is filed with the utility company, the law
requires that the white and pink copies must be an file with the State Board of
Electricity.
C. Yellow Copy - Retain the complete copy for your records.
A Rcquest for Inspection becomes void 18 months after the issuance date. It is the
responsibility of the person doing the wiring (Electrical Contractor, Installer, Special
Electrician, or Owner) to file with the State Board of Electricity a new Request for Inspection
with the proper fee upon the expiration date of the original Request for Inspection for all
work not completed.
STATE BOARD OF ELECTRICITY
Griggs Midway Bldg., Raom S-128
1821 University Avenue
St. Paul, MN 55104 ,
(612) 642-0800 ?
OFFICE HOURS MON-FRI 8:00 A.M. - 4:30 PM.
?
yol:.rr? .
db CERTIFICATION FOR CONNECTION BY UTIUTY =? EB-00001 -09
, See inSlruCtiDns far completfng Ihis fprm on batk Of yellow Copy.
'X" Below Work Covered by This Request
Ne Add Rep. Type of Building Appliances Wired Equipment Wired
i- Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (S ecify)
Farm Air Conditioner
Other (specily) Contractor's fiemarks:
Compute lnspection Fee Below: L
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimmin Pool 0 to 200 Amps 0 to 100 Am s
Transformers Above 200 Am s Above 100 Am
SI f1S Inspectar's Use Only: TOTAL
Irrigation Booms «?
S ecial Inspection
AlarmlCommunication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
THIS CERTIFICATE MUST BE SIGNED AND FILED WITH THE ELECTRIQ&* UTILITY BEFORE
J'
SERVICE WILL BE CONNECT ED. ? >sD
?
r
`
_/
?
0-19?-913
Request Date ;-•. i Fire No. Rough-In,lnspection Required
(You m t call inspector when ready) InspeClion Other Than ugh-In
U Ready Now WIII Notily Inspector
' ?
. Yes
N. Date Read
here6y declare ihat a Request for Inspection has been fi{ed with Ihe Minnesota Slate Boartl of
I? licensed contractor OWI18f Electricity and that the conditions ol the installation are sate for energizalion on tho property
/ - doscribed below, in accordance with the Minnesota Electrical Act.
Jo6 Address (Street, Box or Ronte No.) City
Section No. Township Name or No. Range No. County
pccupa }? Phone No.
?J? f . . ? .. 1 ?. ? j • f
Power Suppller Address
Elecnical Contractor (Company Name)
? ConlraCtoYS License No.
I
Maling Address (Contraclor or Owner Making Installatlon)
r '- ? l1-
Authorized Signature (Contractor/Owner Making Inetallation) Phone Num6er
/ / ? /. _ j f'•"i ?
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs•Mldwey Bldg. - Room 5-128 BE ACCEPTEO BY THE STATE BOARD
1821 Univeraky Ave., St. PEUI, MN 55104 UNLESS PROPER INSPECTION FEE IS
o- ,e.... Q.., - Fut-i naFn
qo REOUEST FOR ELECTRICAL INSPECTION 7 E?-? ? p9
' See mstrucGons lor complaung this form on back of yellow copy.
?.. ,
"X" Below Wqrk Covered by This Request ????;•??
e A Rep. Type of Building Ap riCek-Wired Equipment Wired
Home Range Temporary Service
Dupiex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (Specify)
Farm Air Conditioner
r
.S ?
Other (specity) Coniractor's Rem f I
Compute lnspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimmin Pool 0 to 200 Am ,s 0 to 100 Amps
Transformers Above 200 Amps 9boYe 100 Amp +
$I f1S Inspector's Use Only.
l TOTA4
Irrigation Booms , G
S ecial Inspection
Alarm/Communication THIS INSTALLATION MAY BE O RED OISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in Date
certify that the above inspection has
been made. Flnal oata
OFFICE USE ONLY
This requeat vdd 18 months from
- ---------_-'_--'- - ---
0- ??
,
flequest Da[e
?/? /.
y Fire No. Rough-In nspeci' n'?iequlred
(YOU mt call inspectorwhen ready)
Yes Q No Ins ection Other Than ugh•In
? Reatly Now ill Notrfy Inspector
Date Rea
I? licensed contractor Awner hereby request inspection of above electrical work at:
Job Address (Street, Boxo?-"o?g No/ ) "-\?? /
N7y? J?P`f"c_,c11 c+h
Secdon No. Township Name or NO. Range No. County
pc,cu T)
611qcA1 L 41 ? Phone No.
Power Supplier
' Address
t
ElecMcal CIntact (Com pany Name)
v j4;1 .- 0 (.c ?)h Contmctors License No.
Mailing Addres5 (Contfeda Or Owner Making InslaUatiOn)
?
ACi,,. SfgnatureA1Can dOwner Making C 11 tion) Phone Number
NESOTA STATE BOARD OF ELEC?RICITY THIS INSPECTION REQUEST WILL NOT
rtgqs-Mldway 81dg. • Room 5128 BE AGGEPTED BV THE STA7E BOARD
B21 UnWerstty Ave., St. Paul, MN 55104 UNLESS PROPER INSPEC710N FEE IS
..?___ 1-1 - cmri neGn
CoINSPECTIUN RECORD I "t?°' "°.
' CIl'Y OF EAGAN PERMIT T1fPE: ?????xNs
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued: ??/.?b /92
(612) 681-4675
SITE ADDRESS: c or i 1 f3l OC K_ 1 APPLICANT:
4 /41 ptRBlE BEACH WAY BEKO! D f3RnT'HER3 CQNST
f AIRWAY NtLLS 41N (61: ) 446-3171
PERMIT ?'4PTYPE:
TYPE OF WORK: NEW
INSPECTION
I E,ti 1 t K6 . .
FRA141 Ni5
1ry Alt nti(1N FINAL
I o'Il1Ck
FtC11AFK ;, ntlOS7ER PUMp 5 ir N CONTRACTOR - PAREOMS F'1.116
Pennft No. FennR Holde? oINu rN.prwna r
S/V1r
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Commente
Footings I ?d/? 4?je
Foundation -
7? 2 '"
Framing f
Roofing
Rough Plbg.
Rough Htg. QL Z ?i, ?
u
Isul.
Fireplace
Final Htg.
d!
Orsat Test
Flnal Plbg. Pibg. Inspector - Nottfy Plumber
Const. Meter
Engr./Plan
Bldg. Finai
Dedc Ftg. a 44 L
Dedc Final
Well
Pr. Disp.
!
/
?
I
?¦?m
Wemlicatc of Cccupancv
94 of ftelm
This Cernficale issued pursuant to the reqirinments of the Uniform Building Code
certifying thot at du tinee of issuance this siiwhere was in conrpliance with the various
ordinances of tbe City regrrlating building corrstrycrion or use. For the following:
use ctagar,ckno.: SF DWGZ sW8. rouw ro. 812
o?d ? (?D z? o:,n;? ? V cw?u.
B.. Ad&= 4741 PEE=WAY L-Mlity L1, B1, FAIladAY HIII.S 4Ili
10/2/92
POST IN A CONSPK;iJOUS PLACE
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: it 1- t r? i0 c, K
'1;4 i I`I t;141, t- BE ACH tJAY
FAfhIJAY 1411.Ly 41N
PERMIT SUBTYPE:
I IIt ti J I i;t l'.li
i APPLICANT:
?,;,????n?.?•.,??
TYPE OF WORK:
fiut I I+:%
inMi ?
A{ 11 f;Ai (t)W
INSPECTION
ir i 111. .A •
! f? 'i: ?; I ;r, .•
!1ill4.fl TFi ?'1 fsli i lMFtil
Rt MIARk `; • A•.h 1'AHn 1 F I[I1' I+M 1 1 1'- NF pEIf t+t: tf 1`0114 AM1' N 1 Iip1E1 I Nr 014 1 I i( t fr I t AI 11441
?
n?
?`7 pV
???
Permit No. Permft Holder Dete Telephone #
ELECTRIC /
Ob
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND •
FRAMING ?/'?
?
ROOFING
ROUGH
PLUMBING
PL(iG
AIR TEST
ROUGH
HFATING
GAS SVC
TEST
--- - --
INSUL 5 1 ? _
? -?,
GYPBOARp
FiREPLRCE
FIRFPLACE
AIR TEST
FINAL PLBG
FINAL HTG
-
- -- - - -- - - --
URSAT --
TEST --- - ?
-
" - - - -- ---- - ---- -- -- - -
BLDG FINAL
E;Sp,1T R.I.
? -- -
- -
I
? - -
`- - - -
_
--
BSMT FINAL L*,g t-
DECK FTG
DECK FINAL
?7
, Addrass: 4741 ?? ?? y?Y Lot I Blk I Sec/Sub FAIIdJAY HILLS 41H
These items were/were not complete at the time of the final inspection.
10/2/92
Date; Yes No Q
TnqPPrtnr,
Final grade (6" from siding) V
Permanent steps - garage ?
Permanent steps - main entry V
Permanent driveway ?
Permanent gas v
Sod/seeded grass
Trail/curb damage
Porch
Basemant finish v
Deck
Pleasa verify vith the builder the removal of roof test caps from the plumbing
system and tha shut-off of water supply to the outsida lavn faucat before
freeze potential exists. ?
mcrweowax
White - City copy Yellow - Resident copy Pink - Contractor copy
2 O O? O? n
?
O O L OFFICN. ONLV This request wid 18 months imm validalion dme prinled in Ihis?
/
6
t J
PLEASE PRINT OR TYPE
Raquesl Dak Ro?gbin iiup«non reqvired2 N. Inapecnon OtherThan Rough-In: [] ReadY Now II
(Yoo most call Ihe inspedor wEen reody) ?ore Reody:
I, icensed conirador ? owner hereby request inspedion of the above elecfriml work at:
lob Mdrae fSVeet, Boa, or Route No.) Ciry Zp Code
w ?d
Seaion No. Townahip Nome or No. Ranee N. Fin No. Counry
Oaupont Plwne No.
6 4 ?s
Povrer Svpplier Pddress
Elannml C cror ?Compony Noma? Connodor b<ense Na. Momr lic No. (Plam Elea. Only)
?.
LAO 7
Mailing drus (C r?adar or er(oimiig InsalloNan)
? Kk r,-? wtrJ
Aulhonmd Sig m ?Conhatlor o kP..r PeAorming Imbllanonl
{J
00L-^ Phane No. ?
EB-OOOOlA-10 6 5 STA OCOPY•8 RUCTIONSONBACKOFYELLOWCOPY ?
IIII IIII I I?I I?? REQUEST FOR ELECTRICAL INSPECTION%.fGQ-5
Minnesota State Board of Electricity
1827 University Ave., Rm. S-1 8, SY. Paul, MN 55104
* W38 7 s Pnone (si?) eaz-oaoo 1?
ome Duplex Apf. Bldg. Other: New Addn
Commarciol Indushial Form Remod Re air
Air Cond. Hfg. Equip. Water Hic Laad Mgmf. Other:
D er . Ran e Elec. Heaf Tem . Service
"X" above the work covered 6y this reqvest. Enter remorks in fbis space ond on the back of the white copy only.
•
o.s?yv-??
Cvltulate InspecHon Fee - This Inspech'on Requesl will not be accepted withaut Ihe correcf fee:
OlFier Fee # Servim Errhonce $ae Fea # Circuils/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Sheef Lfg./Traffic Sig. Above 200 Amps Above 100 Amps
Tronsformer/Generator INSPECTOF'SUSEONLY TOTAIL
?
$ign/OuHine L1g. Xfmr.
3 Y
Alorm/Remofe Control
5
Swimming Pool I he.eb rom fiot I ins eded the decM1icai'
?bn,?
ed hin on the d.A,Iq4
6,,
qk?
Irrigation Boom Ro.eh-In
Speciol Inspecfion
Investigative fee Finai oaj/ '?.
THIS INSTALIATION MAY BE ORDER DISCON ED IP NOT COMPLETED WITH7N 18 ONTHS.
??-
??? io8s
a?i?
J 4?92?C?
? / ?
Request Dale Pire No. Foug ' ection
Requ 0?
? fleetly Now ?MVIII Notily Inspecl?
L ? L s G No '?'1e R °
ricensad coniractor ? owner hereby request inspection of above electr 1 wo V v
c
Job Adtlres4 ISiree4 Box or Route No.)
72
L(
?
?" F
.
,
val e
Saction No&. Townsnio Name or No. Rangq No. u
a
OccupanllPRINT^ . M. ?1 a. -agY
M
Power Supplier - qdtlress
Z.MIr
Eleclrical Co UacIor (Company Name) / Conhactor5 License No.
Y 'Lt_!i a ?
Mailing ress ICOntraclor or ner Making Installalionl ?
?
Authorrzetl ture ICOnvacl 0 er Mak?ng Installalron? PM1One Numper
MINNESOTA $TATE BOARU OF ELECTRICITY TMIS INSPECTION REQUEST WILL NOT
Grigga-MlOwey Bltlg. - Room $-113 BE AGCEPTEO BY TME STATE BOARO
1831 Univerolty Ave.. SL Paul, MN 55104 UNLESS PflOPER INSPEQION FEE I$
Plqne(612) 602-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ig? °'"°-??? ogC e
See mslmctions br complating this brm on back ol yellow mpy. `
?s 4Z?
2 5 9 2 - - X" Be/ow Work Covered by This Request ??. /p s' 1fj'r
e •Add Rep. TypeofBuilding AppliancesWiretl EquipmentWiretl
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Indusirial Furnace
Farm Air COndilioner
Olher?spaciy) Conhacmr's Remarks:
Compute Inspecfion Fee Befow: '
# Other Fee # ServiceEntrar?ceSize Fe # CircuiWFeetlers Fee
Swimming Pool 0 ro 200 Amps 0 to 700 Amps
Transformers A6ove 200 _ Amps Above 100 _ Amps
SICJnS Inspecmr5 Use Only: ? TOTAL
Irrigation Booms p?
4 L
TUT
Special Inspection i
/.,./
?
AiarmiCommunication THIS INSTALLATION MAY BE ORDERED DIS ONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MO f
I, the Electrical Inspector, hereby Rough-in ? o •/ p
6
certify ihat the above inspection has
been made. F,,ai oe?e
-i-,
OFFICE USE ONLY '
This repvest voitl 18 months !mm
qe -??/ ? ? REQUEST FOR ELECTRICAL INSPECTION i? ee-ooooi-/py
/ Sea instrucnons Por compleling this form an back ol yellav copy.
/
elP 94v "X" Be/ow Work Covered by This Request a.
Ne A Rep. Type of Building Appliances'vVired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heatin
Apt. Building Dryer Load Management
Comm.llndustrial Fumace Other (S ecify)
Farm Air Conditioner
Othar (specity) ConVadors Rema :C?
?,yf?
Compute Inspection Fee Below:
N Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200_Amps Above 100 -Amp
Sigf1S Inspector's Use Only: ( TOT
Irrigation Booms r fo ;G?
S ecial Inspection ?
Alarm/Communication THIS INSTALLATION MAY BE D DISCONNECTED IF NOT 011
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby
i ROUgh-in oare
ceR
ty that Ihe above inspection has
been made. Finai D.L.
OFFICE USE ONLY
This reque,l voi0 18 months irom ,
0- 9-
013 .7eY0 ?
G
Requ t Oat
/
/ Fire o. Rough-In nspect equiretl
(YOU m 1 ce0 in ror when reatl
) Inspecfion O?her Than ghln
ector
Now ill NotH
Ins
? Reatl
?
? y
? y
p
y
? Ves
No Dafe Reatl
I El licensed contractor owner hereby request inspection of above electrical work at:
Jo0 Mtlress (Sireet, Box No ) Ciry
Secfion No. Township Name or No. Fange No. Gauny
Occupan ? Pnone No.
?e awt
Powef $uppiier naaress
Eledncal Cont act r(COmpany Nama) Contracrors License No.
BP" e-041 (P4e-
Mailing Addrilves (COntrac[or or Owner Makinq Installatbn)
J?-
Au riietl Signature Conhac r/Owner Making I IlaNOn)
? Phone Number
a^-.y ?/G d3 s
NESOTA STATE BOAHD OF ELECTfiICRY I THIS INSPECTION REOUEST WILL NOi
?iggs-Mitlway Bltlg. - floom 5-128 1 1111 1111 1111 111 1111 111 11 I I I I ? I I I I BE ACCEPTED BY THE STATE BOARD
821 Unlvanily Ava.. St. Paul, 6AN 55104 IINLESS PROPER INSPECTION FEE IS
Phonel61416d2-OP00 ENCLOSED.
11 City of Eagn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax:(651)675-5694
2008 RESIDENTIAL BUILDING
Date: I--? O V Site Address:
"-----------------
i ?? `? i
? Pertnit #: . 9?/ U/3 ?
I Pertnd Fee:
I 1? I
? Date Received:
j staff:
r I
-----------------?
MMIT APPLICATION
I e. IiZaO,C°.lv
Tenant: ?l Ir? L Suite#:
RESIDENT 1 OWNER Name: Phone:
Address I City I Zip:
Applicani is: _ Owner /l Contractor
TYPE OF WORK Description ofwork: ?a?1Q
Construction Cost: ? -1, {OU • ?.C.! Multi-Family Building: (Yes No ?
? n r ( (
1
CONTRACTOR License #:
-
Name:
W(
V
0(1
1
Address:
T D
City: ? State:_ti? Zip:
Phone: ZZ.? atA 1 Z Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv t Minnesota Rules 7672
Energy Code . Residential Ventilation Category i Worksheet • New Energy Code Worksheet
Cat6gOry Submitted Submitted
(4 submission type) • Energy Envelope Calculations Suhmitted
in the iast 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:
a?e cansideretl to be publrc +fformaflon ?Poijions of '
NOTE Plans andsupportmg alocumen?
that yoti s??imit
ti
,
would permii the Crtyto
;
cfass?ed as non publrc ?f you provrde speuicreasons #hat
N,the mfo mabon may,
b
4
?
,
M
aret
secref?
ncludethatth
ad
"??
.
e .
r
gAk o
e
I hereby acknowledge that this information is wmplete and accu2te; that the wor9c will he in confortn w' ord an d des of the City of
Eagan; that I understand this is not a permit, but only an application for a pertnit, work is no to s wdhc t a d; th he work will be in
accordance with the approved plan in the case of work which requires a review and a ova lans x1?)? , l. L*,¢.a ?,.wti s p/ X
Appticant's Printed Name ApplicanYs Signature
Page 1 of 3
INSPECTION RECORD I Control No. 0706
CITYOF EAGAN PERMITTYPE: eulLDiN6
3830 Pilot Knob Road Permit Number: 000812
Eagan, Minnesota 55123 Date Issued: 06 / 2 b/ 92
(612) 681-4675
SITEADDRESS: Lor: i eLocK: i APPLICANT:
4741 PE88LE BEACH WAY GEROLD BROTHERS CONST
FAIRWAY HILLS 4TH (612) 446-3171
PERMIT SUBTYPE: TYPE OF WORK:
SF DWG NEW
INSPECTION
FOOTINO ., .
FRAMZNG .,
xN3ULATION FINAL
fIREPIACE
REMARKS: B003TER PUPIP S S W CONTRACTOR - PARSONS PLBG
?
?
. , .
CITY OF EAGAN
? 3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
4741 PE88LE 9EACH WAY
LOT: 1 9LOCKs 1
FAIRWAY HILLS 4TH
SITE ADDRESS:
DESCRIPTION:
-6ui1'd'3ng Permit Type SF DWG
Bailding-?Work 7ype NEW
? U8C peeu:p4hpy R-3 M-1
Construetioti'-Type V-N
10nirtg R-1
?8,uildi;srg tengtfs ; 64
6uilding 1Jidth 42
t
l 1 a? ?? ?
L .t 4fy
.._..:r ._,.
REMARKS:
BOOSTER PUMP S& W CONTRACTOR - PARSONS PL86
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC 8
5AC Units
5ubtotal
COGEROAL6 T?ROTNERS COPIST
1704 280TH ST W
NEW PRAGUE pIN
(612) 445-3171
PERMIT C°n °"° 0706
PERMIT TYPE: 8ui LoinG
Permit Numher: 000012
Date Issued: 0 6/ 2 5/ 9 2
vnLuarzoro
$926.50
$602.23
$91.0@
$700.00
100
$2,319.73
;le2,eee
MISCELlANEOUS 51,610.59
Total Fee $3,930.23
Appiicanc - sr. L"OWNER:
19953171 0001115 GEROLD BROS CON5T
1704 280TH ST W
56071 IVEW PRAGUE MN 56071
(612)445-3171
? F h•ereby aoknowledge thatt I have read this application and state thet the I
information is carrect antl agree ta comply with aYl applicable State of Mn.
Statutes and Gity of Eagen Ordinartess.
L ?
.
?. _ 6--?-?-1-D
APPLICANT/PERMITEE SIGNATURE ISSU BY' SIGNATURE
PERMIT M
RtACTIYATE
CITY OF EAGAN
1992 BUILDING PERMIT APPUCATION
681-4675
JpN 1 5 RECD
4.3, l30. 23
C??`i:r( L-1$
SINGLE & MULTI-FAMILY 2 sets.of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made lot chan e is re uested once ermit is issued.
Date AlKlq2/ / Valuation of work /cSSLOOC?>
5ite Address: P"b6_
57REET SUI1E f
Tenant Name: (commercial only)
IAT BIACK ? SUBD.
Descri tion of work: e ?
The applicant is: ? Owner Contractor O Other (Descrfbe)
Name Phone VllS -30(
Property «ST F,RST
Owner Address 1204 2Ls?C) tl-- 1(-
STREET STE K
City DeW P(Taqc"?_ State t_kA? Zip ??667
Company Phone
Contractor Address License NoroncS Exp.
City State Zip
Company Phone
ArchitecU
Engineer Name Registratian #
Address
CitiY State Zip
Sewer 3 water ltcensed plumber r-Sor"_ p ?ccu,c?[.uc Processing time for
sewer b water permits is two days once ar a has been pproved.
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. -
Signature of Applicant: .?-?.._4n-?'-?
BUILDING PERMIT TYPE
? 01 Foundation
EX 02 SF Dwg.
? 03 SF Addition
O 04 SF Porch
? 05 SF Misc.
WORK TYPE
R 31 New
O 32 Addition
OFFICE USE ONLY
? 06 Duplex
O 07 4-Plex
? 08 8-Plex
? 09 12-Plex
? 10 Multi. Add'1
? 33 Alterations
? 34 Repair
GENERAL INFORMATION
? 11 Apt./Lodging
? 12 Multi. Misc.
O 13 Garage/Accessory
? 14 Fireplace
? 15 Deck
? 35 Tenant Finish
O 36 Move
? 16 Basement finish
? 17 Swim Pool
O 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 31 Demolish
Const. (Actual) V- N Basement sq. ft.
(Allowable) V, N lst F1. sq. ft.
UBC Occupancy 2-3 M -I 2nd F1. sq. ft.
Zoning 2-i Sq. Ft. total
I of Stories Footprint Sq. ft.
Length 6 On-site well
Depth ? On-s9te sewage
APPROVALS
Planning Building
Engineering Variance
REOUIRED INSPEC`TlONS
? 5ite
0 Wallbaard
? Footing
? Final
MWCC System yc5
City Water YE5
PRY Required
BaosLer Pump y?
Fire Sprinkler
Census Code 1 p L
SAC Code
Assessments
? Framing 11 Insulation
? Draintile ? Fireplace
Permit Fee
Surcharge
Plan Review
license
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC X Imp
SAC Units i
rd`Rf'? ? Io`i
Zixtu? ?.
9?U
r4,?> x s3=?u?,??
vatuet;on: S L? 2. ? 0 (?} ?
CxARAG-S IST ? c<xar2.
?kx3z= 89` '
(l
?tJ BoXfb=
`?tr) r y' j fi ?
?
}? „? __ Zu
12H te?ZK'='
' ZxK. 1G
? xs3-?3,67a
-?----?-_.?.
yr
Z y 'l a
3z?,
z
A
a-1 '7
xlS? ?0730
?y CONSULTINd EHGIHEEqS
oa4E PIHNNEI4S cnd LpND SUflVEYOfIi ?. ?'-5D8(•D/
?'l
?NGINEEAING ?1?2
INC.
L 1000 EAST 1461A STREET, BURNSVILLE, MtNNES07A 55337 PM 432-3000CERTIFICATE OF SURVEY
Legal Description: 4?e7- /, dLoi,
??PT? cou,v?? r?i,v?vESor,CI.
,
(L°?z'rD ) DENOTES EXISTING ELEVATION
(1,044•-S ) DENOTES PROPOSED ELEVATION
?---- INDICATES DiRECTiON OF SURFACE DRAINAGE
/0 4`4:83 = FINISHED GARAGE FLOOR ELEVATION
ia37. /Z. = BASEMENT FLOOR ELEVATION
/a9./6 = TOP OF FOUNDATION ELEVATION
-6- DENOTES "RIGHT OF ACCESS"
SCALE : 7" = 30' DEDICATED TO DAKOTA COUNTY
?
?
? I (
? D
O
D ?N
D
D
?t
p D
`V I
0
O N
? I
D
l(045 . s1.
?Oy$; DI
10 (N316.8) (1036.6 m
I N?e=1??5? ?038•$? FBiN.O ,r(°_35,8` I?
?
° ++.? ? 54,00 ?
? ? ,o.? --, N ,?
la, oc
GARA6E
I.,...,,\ IN M 10.67 /oa-i.a?
0
O ?-?? Jr
- -J
_ -, - -
CI°''
?o33?oi
.ORA/.Vfj6E 4.va
UT/L/TY EASE/1'/ENT
W ?vayv,
i ?
DEPT
?
J
l1ce= /043.16
3ofr ??vrs?r,g?c
/ GiNE
?°42
?;?,?
PEBBl? ??, ,.'ot,
? STER PUMP
? RE IJIRED
2 hareby cartify that this is a true and correct representation of a tract of
land as shown and described hereon. As prepared by me this 97w day of
?v,ve , 19-?Z .
Minn. Reg. No.
00 (,vr.s.
604o,7,) 35 FT. SET9ACK LiNE ?/s`r ?ARiRNCE D.aTA/NEp'4-9-92
rt„a,-,? Llj-? AXO/yJ E469N C17Y COVN('/L)
? ?.
)tJ11 E R : ...? 1 ry
;ITE ADDRESS:
fXTER10R ENYELOPE AVFRAGE "U" CDMPUTATION
f'rwt11-Cv?c4 ????5
O &ZS DATE: 4bLZISz PHONE: y5/5-317/
7
5:QOL
DNTRACTOR
o
,
5
j
:
:
i DETERMIHE NORKIHf SOUARE FOOTAGE OF EACH:
'. TOTpL EXFOSED HALL AREA,,,,,,,, :.;4141 3z sq ft x"U" _• ti? ? y8
?. TOTAL ROOF/CEILtHG AREA,,,,,,,, /y Z'V sq ft x"U" •(
). TOTAI EXPOSED wAll AREA CALCULATIONS:
Total exposed well
aree above floor,,,,,,,, sq ft Q
. ??-
s) Total wall window ares: ?-
J
9lezed...... ? If/OZj,- sq ft x "U" . 3Z * ?zcT ?
pC
glazed...... sQ ft x"U" • 1
?
D) Total door area ,,,,, 78 sq ft x"U"
.... •/3 ' ?0 2
Q
ci
c) Total s1lding glass door area:
glazed...... qZ sq ft x"U"
J
glazed...... sq ft x "U" ?
C
d) Total firypptac wall area sq ft x"U"
? , 0`?(p
?CoAS
e) Total wal framing area
)
(Avera
IOf
qDg sq ft x"U"
q3 9
,
...........
ge N
f} Total net wall area above
floor (Insulated)....... sq ft x"U" • pyG ? 1'l3
g) Total rim )otst area...... 350 sq ft x"U" . 6 L/3
Total foundatlon
area (Exposed).......... 25-o sq ft
h) Total foundatlon
window area ............. sq ft x"U" "- ? '--
I) Total eet foundatloo
"
"
area above grade........ 7150 sq ft x
U
. TOTAI a) thru 1)
If Item 03 is the same ss, or less than Item 11. you have met tha Inten[ of
2 MCAR 1.16008 A and 0.
Page 1
4.'-TOTAL.EXPOSED ROOF/CEtLING CALCULATIONS:
Totsi exposed
ro.of/ceiling area........ / Z sq ft
J) Total skyltght area....... sq ft x"U"
k) Total roof/celllnq framing 3
? ( ) ...... ` 2- sV ft x'?U?? . OZ ? .
area Averace IOf. ._---
I) Total net insulated ? 0116 Z
roof/cellinq area....... 1 28 Z sq ft x"U" ?
b. TOTAL )1 thru I) .
i p
If total of #4 is the same as, or less than 02. you have met the Intent? f
2 MCAIt 1.16008 A ar.d 0.
ALTERNATE BUILDING ENVELDPE DESIGN
To utlllze the total envetope system method, the values establlshed 6y the sum
of items 03 and 04 shall not Ae greater than the sum of ttems fl and /2.
1. + 2. ?
3, + a. -
C E R T I f I C A T 1 0 H
1 hereby tertify that 1 have calculated the "U" factors and "R"
values hereln and that the bultdlnq here.described meets or exceeAs the State
af Mlnnesota Energy Conservation Act.
W?r
5 nature
6/z/9 z
(Date) '
Page 2
GUIDELINE TO (R) FACTORS FROM ASHRAE M1INUAL
OF TYPICALLY USED PRODUCTS
AIR FILMS lq SHEATHING i?l
Interior A1r Film Malls) 0.68 3/4" Wood Subfloor or Sheathing 0.94
Exterior Air Film Walls) 0.17 1/2" Plywood Sheathing 0.62
Interlor Air Film Vented Ceiling) 0.61 1/2" Partlcle Board 0:66
Exterior Air Film Vented Lei]ing) 0.61 6ypsum or Plaster Board 3/8" 0.32
Interior Atr Film Non Yented) 0.61 Gypsum or Plaster Board 1/2" 0.45
Exterior Air Film Non Vented) 0.17 6ypsum or Plaster Boerd 5/8" 0.56
Plywood 3/8" 0.47
Plywood 1/2" 0.62
BLOWING MOOLS Plywood 3/4" 0.93
Sheathing, Reg. Density 1J2" 1.32
Approx. 3" 9.00 5heathing, Reg. Density 25/32" 2.06
Approx. 4 112" 13.U0 Nail-Base Sheathing 112" 1.14
Approx. 6 1/4" 19.00
Approx. 7 1/4" 24.00
Approx. 14" 30.00 ROOFS
Approx. 18" 40.00
Built-up.Roofs
0.33
All other insulation matertals must AsDestos-Ce+nent Shingles 0.21
be verified (R Factor) Asphalt Roll Roofing 0.13
Asphalt Shingles 0.44
INSULATION
Insulation: 2-2 3/4" Fiberglass 7,00 SIDING
Insulation: 3 112" Fiberglass 11.00 pluminum Siding 0.61
Insulation: 6" Flbergtass 19.00 pluninum with Backer 1.82
lnsulation: 3 5/8" Fiberglass 13.00 Aluminum with Backer d Foiled 2.96
insulation: 9" Fiberglass 30.00 112 x 8 Lap Siding (Mood) 0.81
Insulation: 12" Fiberglass 38.00 7/16 x 12 Hardboard Siding 0.67
Insulation: 8" Cellulose 29.00 Asbestos Sidinqs 1/4 Lapped 0.21
Insulatlon: 10" CelTulose 31.00 Stucco (Brown and Flnish Coat) ----
Insulatlon: 72" Celtulose 44.00
insulation: 1 112" Thermax 72.00
Insulation: 2" Thermax 16.D0 DOORS u
1 3/4" Solid Core Door .46
NOODS w/Storm, ilood .31
Fir. Pine 6 Similar Soft Moods w/Storm, Meta1 .26
1 11211 1,69 Pease 5tee1 Door Insl/N/6L 7.45R .13
2 1/2" 3.12 Sliding Giass Door, Nood .65
3 1/2" 4.35 Metal .72
5 1/2" 6.87 .
CONCRETE BLOCK MIND(1NS
8" Concrete 81ock (S E G Reg.) 1,11 Al1 Mindows
(w/Storms 1" to 4" Space)
.56
(F111ed with Yermlculite) 1,93 Removal Double 61az1ng (RDG) .55
12" Concrete Block (S 6 6 Reg.),. 1.28 Thernio or Melded 3/16" Air Space .69
(Filled with Yermiculite) 3.15
" Rir Space
1/4
.65
B" Light Yeight 2,18 1/2" Air Space .58
(fiiled wlth Yermiculite) 5.03 (Other windows specifically tested
12" Li9ht Weight
(Filled with Vermicullte) 2.48
5.82 can use better ratings)
P%r E e
@ Insulating Values
?
.
0
(D
(D
PERFORMANCE DATA
TS/TECNNICAL SUPPORT
ProAuM 1992 Values Based on
Lawr"ce Berkeley Labs. Window 3.1 % Relativa
Xumldity
Whan
Inside
ANDERSEN" RESIDENTIAL
WINDOWS AND PATIO DOORS
Ceoter o/
Glass
°U" Value
Unie °U"
Value
Center of
Glass
°R" Value
Unit
Value Moisture
Fonns at
Center of
Olass Glass
Surfaee
Tem-
perature°
ShaAing
Coefficients'
Relatire
Xeat Oain°
HIGH•PERFORMANCE INSULATING GLASS' H.P. H.P.
H.P. Sun H.P. Sun
Casement .26 .32 3.8 3.1 62% 56` J4 .37 752 78
Awning 26 .32 3.8 3.1 63 % 57° .74 .37 752 78
CasemenUAwning PicWre Windows 27 .32 3] 3.1 61% 56° .73 .35 148 74
Narroline 26 .32 3.8 3.7 63% 57° .74 .37 152 76
Narroline Pidure Windows 27 .32 3.7 3.1 62% 56° 73 .35 148 74
Gliding Windows 26 .32 3.8 3.1 62% 56` .74 .37 152 78
Frenhwood Hinged Patio Doors' 26 29 3.8 3.4 62% 56° ]2 .35 148 74
Frenchwood Glitling Patio Doors` 26 29 3.8 3.4 62 % 56' J2 .35 148 74
Gliding Paiio Doors 27 30 3.7 3.3 61 % 56' 72 35 147 74
CircleTOpWindows' 26 .31 3.8 32 62% 56` J4 .37 157 77
Elliptical 26 .31 3.8 32 62% 56' .73 .35 150 74
ArchWindow .26 .34 3.8 2.9 63% 57` .73 36 150 76
Circle/Oval 26 .37 3.8 32 62% 56` .74 .37 152 78
Fleziframe 26 .37 3.8 32 63% 57` .77 .35 143 73
SkyligM 26 .36 3.8 2.8 60% 55° .54 .35 110 74
Roof Wintlaw 26 .36 3.8 2.8 60% 55° .54 .35 110 74
TRIPLE•GLAZED
Casement with Hgh-Performance 20 25 5.0 4.0 70% 60' .70 .41 144 85
Double Pane and RGP
Awning with High-Performance 20 24 5.0 42 70 % 60= .70 .41 144 85
Double Pane and RGP
Narroline with High-PeAorm- 20 24 5.0 42 70 % 60' -70 .41 144 85
ante Double Pane and Gombination Unit
SINGLE-GLJI2ED P?ene P?anee
Basement Windows' 1.71 .84 0.9 12 13 0 77° 1.00 - 216 -
BasemeM Window Single Pane with RGP .49 .43 2.0 2.3 41 % 45° .90 - 187 -
Footnotes:
? Except as rwtea all ligures pertaining to High-Pedormance insulating glass
also appty lo solar con[rol High-Pedormance Sun insulating glass.
' 72'z80° tloor size used. All patio door glazing is lempered.
' Based on equivalent square lootage; size approximatetl.
• All rool window glazing is tempered.
' 8ased on largest size Andersen Basemenl Window.
' Inside Blass sudace temperaWres for determining %relative humidiry are
taken Irom center of glass.
' The shaCing wetlicients lisled may vary (+ or -) a few percemage poinls.
For shatling Ccettiaents on specific size units coMad Andersen Corporation.
' Relative Heal Gain BTU/Sq.Ft./Hc: When ASHRAE 5olar heat gain facior is
200 BTU/Hr.Sq.Ft. and outdoor air lemperature is 14° heat than the
indoor temperature.
Ab6reviatians: N'A: Not ApplicaWe RGP: Removable Glazing Panel
Data Sources:
• The unit fiqures in ihis table have Ceen determined utiiizing cwreM ASHRAE
methods arid are consistent with the current issue of the ASHRAE Handbook of
FundameMals (1989).
• All calculations are based on Lawrence Berkeley Laboratories Window 3.1
computer program and ASHRAE recommentled window 5izes. The LBL piogram
accounis for edge eRect of insulating glass and irame materials of ihe window
unit.
• The cenler of glass "U" values are supplied by the glass manulaclurer.
• Calculations assume the following:
ONSitle temperature: 0 Degrees F.
InsiCe room temperature: 70 Degrees F.
Outside wind velociry: 15 MPH
No air movemem inside; and unitorm heatirg contlilions.
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITEADDRESS:P'I•N.: 10-256e3-e1e-e1
APPLICANT:
LOT: 1 BLOCK: 1
4741 PEBBIE BEACH WAY HAMMOND
FAIRWAY HILLS 4TH (612) 6$6-9835
PERMIT SUBTYPE: TYPE OF WORK:
BflSEMENT FINISH
BUILDING
027091
03/06/96
JAMES
ALTERATIpN
INSPECTION
FRAMTNG .. .
INSULATION ,.
OUGH IN PLBG FINAL
REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK
? ?
CCITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
4741 PEBBLE BEACH WAY
LOT: 1 BLOCK: 1
FAIRWAY HILLS 4TH
P.I.N.: 10-25603-010-01
DESCRIPTION:
B
rmit 7ype
?k Type
BASEMEN7 FINS5H
ALTERATION
434 ALT. F2ESIDENTTAL
r c , t^
BUILDING
027091
63/06/96
{?rc?'p? p /?
Pa 1.?? ? i'° X J? Y?"
C y j 1°-
a t_? ? Ii ..
0 ..?
k5. V»} ?
REMARKS:
A SEPARATE PERMIT IS REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK
FEE SUMMARY:
Base Fee $50.00
5urcharge $.50
Tota1 Fee $50.50
CONTRACTOR: OdVNER: - APPlicant -
MAMMOND JAMES
4741 PEBBLE BEACH WAY
EAGAN MN 55123
(612)686-9835
?` •h? r,e
Ad ' tltis =and? st3te 'that the
;ectrnply, with 'al1 `aPpi3cable State af` P4n.
e?
lqoql CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1996 BUILDING PERMI681-4675 ATION (RESIDENTIAL) ? ?q??C
,l..r
New ConsWdion Reauiremenls RemodeVRenair Reauirements
? 3 regislered site surveys ? 2 copies of plan
? 2 copies of plana (include beam 8 window sizes; poured fid. design; etc.) ? 2 ske surveys (exterior additions & decks)
? i energy caiculationa ? t energy caleulations for heated addilions
? 3copks of hee preservaNon plan H lot plaUed after 7/1193 required: _ Yes _ No '
DATE: CONSTRUCTION COST: /?i 7AO, °=
DESCRIPTION OF WORK: 84SE'M6AJr FiAIiS µ
STREET ADDRESS: Y7q/ PEi3F Ler 8E4ctir &Jqy
LOT I BLOCK I SUBD./P.I.D. #: FRiRwAy 1-11&.cs y'u /?irv?Tim?d
PROPERTY Name: y4M0"v.s0 ZY-40fors Phone#: 6'?4-9'?3r
owNeR w, ,^„
Street Address: 47yl PF6Bj_E geracu 41,ray
City: 6Q64A) State: mAI Zip: 55 t Z3
CoNTrtacTOR. Company: ' Phone #:
Street Address: License
City: State:
ARCHITECT! Company:
ENGINEER
Name:
Zip:
Phone #:
Registration #:
Street Address,
City:
State:
Zip:
Sewer & water licensed plumber: Penaity applies when address change and lot
change are requested once permit is issued.
1 hereby acknowledge that I have read this application and state that fhe information is correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: ?i°•-d
OFFICE USE ONLY
Certificates of Survey Received
_ Yes ? No
Tree Preservation Plan Received _ Yes _ No
????
FE9 2 3 1996
---------------
OFFICE USE ONLY "
BUILDING PERMIT TYPE M ». ..
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch o 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
0 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
? 31 New ?33 Alterations ? 36 Move
? 32 Addition ? 34 Repair o 37 Demolition
GENERAL INFORMIATION
Const. (Actual) Basement sq. ft. MC/WS 5ystem
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump ?
de
C
Length sq. ft. .
o
Census
Depth Footprint sq. ft. SAC Code
Census Bidg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MC/WS SAC
City SAC
Water Conn. Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $
°k SAC
SAC Units
CITY USE ONLY
L / BL I • RECEIPT .55?87
SUBD. J ? DATE:
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAM
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit,
FIXTURES EACH NSL TOTAL
Shower 3.00 x / _
Water Closet 3.00 x ? _
Bath Tub 3.00 x =
-
Lavatory 3.00 x
? _
Kitchen Sink 3.00 :c =
Laundry Tray 3.00
Hot Tub/Spa 3.00 x =
Water Heater 3.00 :c =
Floor Drain 3.00 x =
Gas Piping Outlet " minimum -1 3.00 :t =
Rough Openings 1.50 :c =
Water Softener 5.00 x =
Private Disposal " Dakofa Cty. license 65.00 =
(new and refurbished systems)
U.G. Sprinkler ' home under cronst. 3.00 =
Alterations ' to exist+ng 20.00
Water Turn Around 20.00
STATE SURCHARGE
TOTAL
.50
SITEADDRESS: 4741 YEf??,gLT ?64-r-ik Wqy E,46-4,d /Y1AJ
OWNER
INSTALLI
STREET ADDRESS: 31?D <.rT' S
CITY: Awr60"oQY STATE: 0Aiv ZIP: 549949
PHONE #: ( ??'L
OFFICE USE ONLY
L BL . RECEIPT
SUBD. DATE:
1996 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Piease compiete for: ? ail commerciaVindustriai buildings.
. multi-family buiidings when separate permits are D_Qt required for each dwelling
unit.
DATE:
CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR
•
DESCRIPTION OF WORK:
IS WATER METER REQUIRED71_ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED? _ YES _ NO.
FAILURE TO PROVIDE THI5 INFORMATION WILL RESULI' IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? _ YES _ NO.
IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINi:LER PERMIT.
FEE: $25.00 minimum fee or 19'0 of contract price, whichever is greater. State surcharge of $.50 per
$1,000 of permit fee due on aIi permits.
CONTRACT PRICE x 1%
STATE SURCNARGE
TOTAL
SITE ADDRESS:
TENANT NAME: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
cirr:
PHONE #:
STATE:
ZIP:
SIGNATURE:
APPLICANT
OFFICE USE ONLY
METER SIZE: DATE: INSPECTOR:
CLA1M VOUCHER-REFUND REQUEST
" CITY OF EAGAN
MAKECHECKPAYABLETO: _,IAMes HaMMONn
ADDRESS: 4741 PF.ARi.E RRACH WAY
EAGAN MN 55123
LOCATION: 4741 PFRRT.R RF.arH WAY LI.BI, FAiRWAY HILLS 4TH
RECEIPI'#/DATE 53824-03(06146 VALUATION
REASON FOR REFUND HOMEOWftER HIRED ELECTRICIAN TO DO THE WORK.
TYPE OF REFUND ELECTRSCAL PERMIT ll 0- l 4 0- 0 1 3 3211-9001 $ 4 0. 0 0
PLUMB[NG PERMIT 3212-9001 $
MECHaNICAL PERMIT 3213-9001 $
BUILDING PERMIT FEE 3210-9001 $
PLAN REVIEW FEE 3422-9001 $
SAC (MCiwS) 2275-9220 $
SAC(CITY) 3866-9379 $
Sa,C/aDtvtnN 3446-9001 $
WATERCONNECTION 3865-9220 $
SEWERPERMIT 3743-9220 $
WATERPERMIT 3713-9220 $
ACCOUNT DEPOSIT 2252-9220 $
WATER METER 3716-9220 $
ROAD tJNIT 3860-9375 $
WATERTREATMENT 3868-9220 $
SURCHARGE 2155-9001 $
UTILITY ACCT OvERPAYMENT 2250-9220 $
CURB BOX DEPOSIT REFUND 2253-9220 $
CONSTRUCTION METER DEP REFUND 2254-9220 $
WATER USAGE CHARGE 3711-9220 $
TOTAL $ 40.00
I declare under the penalties of law that this account, claim or demand is just and that no part of it has been paid.
.TANIiARV 8, IQ9 7 -- -
Sigr.at Date cLA:M.vOu
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5UBJEC-D VARL4,NCE 3y 1? f-3- ?z
APPLICANT: BRIDLE R'II.D JOINT VENTURE
LOCATiON: NR' QUARTER SECI'ION 34
MSTING ZONING: SINGLE FAMII,Y RESIDENTIAL (R-1)
DATE OF PUBLIC HEARING: APRII, 9, 199'l -
DATE OF REPORT: APRIL 11 1992
COMPILID BY: COMMUIVITY DEVELOPMENT DEPARTMENT
APPLICATION SUMMARY: An application has been submitted requesting a Variance of
15' to the required SO' setback off Pilot Knob Road for'I.ot-1,-Block,l,1and Lot 5, Block 2,
Faiiway Hills 4tfi ?idditioa tocated east of Pilot Knob Road and west of George Ohmann
Pazk. -
COM11ENfS: To insure house sizes are compazable to homes throughout the Fairway Hills
subdivision, as well as those anticipated with the Fourth Addidon. The applicant believes
the 50' setback off Pilot Knob Road severely restricts the buildable area. If the proposed
Variances are granted, future homes on the two lou listed above will maintain a minimum
setback of 70' from the east curbline of Pilot Knob Road. If appraved, these Variances shall
be subject to the following:
1. No other Variances shall be granted for Lot 1, Block 1 and Lot 5, Block 2,
Fairway Hills 4th Addition.
2. All applicable Ordinances.
7Me 7 . It
2007 RESjDF.NTIEIL BUII.DINGPERMIT APPLiCATION
City Of Eagau
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651fi75-5675 FAX # 651-675-5694
New CansGUCfion Renuirements
3 re9istered sife swveYs slrowing sV. R. of lol, sq. R M Iwuse; aM all mnfed areas
(20%muedmum lot coverage allorredi
t Soils RepoR if proposetl buil0ing is in 6e pWced an disWNed sail
2 cq7ies of plan shaxiig 6wn & w6idow sies: PWred famd desgn, efc.
t set M Energy Caiala6ons
3 copies M Tree Presenation Plan if lot plaCed arter 7f1/93
Rim Jdst Detail Optlais selecW slceet (butlOlrgs wilh 3 a less units)
Mmnegasco mechamcal vantiWtim kmi
Plans arn rnnsidQred euhlic informa4ion unless vou
7
Ca.e.?
sta4e thev are trade secret and the ea.
- ---- - - -- ---- -- - -
nau
TX
??' .Son e 'V
coo??Mioo c?t
Site Address ?? ? j? plQ I ? UniUSte #
Y«,r?
? cg
Gwv-? ? 5) Ti ? 4 rows? /?ew r'?x? ? irS
'
Descriptioo of Work wtc5?. A 1n5-Vv- '1-c?? SsxcJ? 440,,
*CL? Q- Pc,? ?S
?125 i
Mu?ti-Family Bldg _ Y_ N Fireplace(s) _ 0 T
_ 1 _ 2
Property Owner J?atilotMe?A? Telephone # ( )
CootraMO. Gerja
?5
,1,?,
Address JX?,? E N"?c? ',rT7 ? -P.O- l? City1?-)?? n? q
State Zip $'6071 Telephone#??'i) ?C?8^ 2?cJ'Z
96g• D`11
RemotleVReoair ReaWren? ORca Use OnM
2 copies of pmn shaving footings, beams, jasis Cwi af SunaY Recd _Y _ N
15etotEnM9YCalculalimsTorhe" additim5 SOiISR9pat _Y _fd
1 sile wrvey fm additias 8 dedcs Trea Pres Plan Racd _Y _ N,
Add'rtron-iiMicato ifon-sitesepticsysfem Tre6PresRequi2d _Y _W
On-slteSeptlc3ystem _Y _N
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 ? Minnesota Rules 7672
Energy Code Category . Residentlal Ventila6on Category 1 Worksheet • New Energy Cotle Worksheet
(4 submission Type) Submittetl Submitted
• Energy Emelope CalwlationS Submit[etl
In The tasi 12 months, has ihe City
_ Y _ N If yes, c
Licensed Plumber
similar plan based on a master plan?
Mechanical Coniractor.
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone # ( )
r
?
I hereby apply for a Residential Building Permit and acknowledge that the information is compiete and accarate;
that the work will be in conformance with the ordinances and codes of the City 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 stazt 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.
)?
Applicant's Printed Name Applicant's Signature
DO NOT WRTfE BELOW TEIIS LINE
Sub Tvoes
'? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBldg
?02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt- Mufti
? 03 01of_plex ? 09 07-plex ? 17 Garege ? 22 Porch/Addn.(4sea.) 0 33 EM.Ak-SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screenlgazebolpergola) ? 36 Mul6 Misa
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
? 5T(?'v ?o '7?1?
? 31 New
, " ? 35 Int Improverrient ? 38 Demolish Interior ? 44 Siding
? 32 Addition
/ ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
?6 33 Akeration ? 37 Demolish Building` ? 43 Reroof ? 46 WindowslDooB
? 34 Replacement `Demolition (EMire Bldg) - Give PCA handout M applicaM
D@SCriDtiOn: WaEer Damage! Yes
Valuation Oceupancy MCES System
Plan Review 100% or 25% ?p)
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIItED INSPECTIONS
_ Footmgs (new bldg) _ Sheetrock
_ Footings (deck) Final/C.O.
_ Footings (addition) x Final/No C.O.
_ Foundadon y HVAC
Drain Tile Other
Roof Ice& Water
? Framing Final Pool Ftgs
_ Siding _ Stucw Lath AidGas Tests Final
_ Stone Lath _Erick
Fireplace _ R.I. _ Air Test _ Final _ Windows
?/ Insulation
7v _ Retaining Wall
Approved By: T Z . Building Inspectw
--------- ------------------------
Base Fee --------------------- ------------ ------- ----------
Surcharge T?(z,L
Plan Review f
MC/ES SAC
l7fr'v?.-?
;
City SAC
Utility Connection Charge
58W Permit & Surcharge
???
TreatmentPlant
License Search
Copies
??iµf?7?"C(????1r
Other
Total
WALKING SURFACES GREATER TleN 30"
ABOVE ARBABELOW REQUIRE GUARDRAILS
MINIMUM 36" IN HEIGHT AND DESIGNED
SUCH THAT A4" SPHERE WILL NOT PASS THROUGH
A VAPOR BARRIER MUST BE q-7 9( egc-
IN6TALLED ON THE WARM SIDE OF
ALL WALLS AND ATTIC CEILING.
A FOUNDATION WALL MOISTURE
BARRIER IS REQUIRED BETWEEN
INSULATION AND FOUNDATION IOU
FROM F7 (i)P Tn GRADE.
gq(07
FIRE STOP SOFFITS AND ALL
OTHER DEAD SPACES.
at.44 107
SMOKE DETECTORS ARE REQUIRED
ON EVERY LEVEL OF THE HOUSE AM IN
EVERY SLEEPING ROOM AM IN EVERY
HALLWAY LEADING TO A SLEEPING ROOM
STAIRS SHALL BE PROVIDED WITH ILLUMINATION IN
THE IMMEDIATE VICINITY OF THE TOP LANDING.
e- 60ortfre-,
EAGAN
VEP
7/%9iPECTIONSISION
9-