4089 Pennsylvania Ave
PERMIT
City of Eagan Permit Type: Building
Eagan. Permit Number: EA094470
Date Issued: 06/15/2010
OR Permit Category: ePermit
41 it~ of E3
E
Site Address: 4089 Pennsylvania Ave
Lot: 25 Block: 3 Addition: Stafford Place
PID:10-72500-250-03
Use:
Description:
Sub Type: e-Fireplace Construction Type:
Work Type: Gas Fireplace (new)
Description:
Census Code: 434- Occupancy :
Zonin,:
Square Feet: 0
Comments: Improvements to the home may require smoke detectors in all bedrooms. Chimnev flue must be inspected prior to
concealin,.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee S3K $88.50 0801.4085
Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195
Total: $90.00
Contractor: - Applicant - Owner:
Heath and Home Technologies Traci Downing
2700 N. Fairview Ave 4089 Pennsylvania Ave
Roseville MN 55113 Eagan MN 55123
(61)633-261
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 Citv of Eagan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
?
CASH RECEIPT
CITY OF GAN ?-?
, _ArA
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
,s
RECEIVEO FAOM 4
?AMCadNfi' $
& DOLLARS
ioo
? CASH ? CHECK
wnne-PayeB covy
.. ?_ , . . • .' ? Yelbw--PosUng Copy
' - Pink-File Copy
Thank You
BY
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH O N E: 454-8100
BUILDING PERMIT Receipt #
To be used 1or &F Uti+iG/GAR Est. Value $60, 000 Date QCTOW 31 ,19-bl-
Site Address 4069 PE1iNS'Yi.VANIA AVE
Lot 25 Block 3 Sec/Sub. STA"ORD PLACE
Parcel No.
it Name FRDNTIER HIDWbST HOMLS
.zt Address 3902 CEDrllRVA1.8 AR
?Qlity EAGAAi Phone_ 454-v ,
, o Name SAI-LF
?Q Atidress
F, City Phone
Name _
Address
City _
I Rereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applic.able State of
Minnesota Statutes and City of Eagan 9rdinance,& '
Signature of Permittee .- __ ?" ^ •- t ? --
A Building Permit is issued to:-??C??TII:K i'.IGiJE$'C r,G:X
on the express condition 1 hat al I work shal I be done in accordance with all
appliaable 5tate ol Minnesota Statutes and Cily of Eagan Ordinances.
Building Official____
OFFICE USE ONLY
On Slte Sewage Occupancy R- t?I
MWCC System R Zoning B-i
On Site Well (ACtual) Const Y-w
City Water x (Allowable) Y-['I
PRV Required # of Stories
Booster Pump Length 44 ?
Depth
S.F. Total
Faotprint S.F.
APPROVALS FEES
Engr./Assess. Pe?mit 494•00
Planner Surcharge 40"00
Council Plan Review 24740
Bldg. Off. SAC, City 100.00
Variance SAG MWCC 5 50•(X)
water Conn. 550.00
WaterMeter 67•03
Road Unit 325,
Treatment P1 204•00
Parks
T4TAL 2rS77•v0
3830
BUILDING PERMIT
To be used for ? • -
ciTY oF EAGaM
Knob Road, P.O. Box 21-199, Eagan, MN 55121 ???j p '
PH O N E: 454-8100
Receipt #
,1 g
Est. Value occ Date =.'<:Tffbk;;. 31
Site Address
Lot - Block ? Sec /Sub. SI'Al
Parcel No.
¢ Name i: kGNTTER 1.taWEsr t
w
Address
-° 40a C£DA
I'.YAI.E FA
0 City ""N Pho ne -&5?+-
°Co Name SA?X
.
? Q Address
f- City Pho ne
I,,W Name
?
?? Address
z City Phone
4W
I hereby acknowledge that I have read this application and
Signature of Permittee -_.-` _--'
A Building Permit is issued to:__
on the express condition that all work shall be done in
applicable State of Minnesota Statutes and City of E
Building Ofiicial
... .... ., _. . _.i_.._ . ,?_ ..._,_?..
ihe
L. of
OFFICE USE ONLY
On Site Sewage Occupancy r-3 Y.-1
MWCC System ? Zoning
Qn Site Well (Actual) Const
Gity Water X (Ailowable)
? --i ?
PRV Required # of Stories
Booster Pump Length Y4`
Depth Z ' ?
S.F. Totai
Footprint S.F.
APPROVAL5 FEES
Engr./Assess. Permit
Ptanner Surcharge ?' "?
147'00
Council Plan Review A00• 00
Bldg. Off. SAC. City
Variance _ SAC, M WCC 550.00
:
Water Conn. 5 501' 00
Water Meter 67.00
Road Unit ?LS•?
Treatment P1 ??•?
Parks
2
577.00
TOTAL '
,
Parmit No. Permit Holdsr Date Telephone ?
Plua'ibing
.
H.V.A.C. 1111V9
i
Electric 9 IV' n
Softener
Inspection Date Insp. Comments
Footings I
Footings II
Foundation
Framing ?i
Roofing
ROUgh Plbg.
? ?
/( ! I, ,
??_' rfF %. ?,•,S
Rough Htg. ?
5,
- n ,
Isul. flaW
FirePlace
Final Htg. 6?
Final Plbg.
Bldg. Final
Cert. Occ.
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
, PERMIT #
MECHANICAL PERMIT
. , CITY OF EAGAN RECEIPT #
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
:T PRICE: $1700. 0!0 PHONE: 454-8100
Site Address 4 iDtI`i 1?'
Lot 2 5 Btock
? Name ????? LiLKLJ
? Address 1955 Shawnei
c City EaEtan
? Name ?ONT
c Address 392
O CitY Bagan
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
BLDG.TYPE
Res. Xx
Mult
Comm.
Other
WORK DESCRIPTION
New
Add-on
Repair
FEES
ft C6MPNAIES RES
HVAC 0-100 M BTU -$24
00
. .
ibley 1 Hwy. ADDITIONAL 50 M BTU - 6.00
Phone 454 -0433 (RES. HVAC INCLUDES A1C ON NEW
COMSTRUCTION)
1 PER PEFiMM
GAS OUTLETS (MINIMUM - 1
50 EA
- .
.
COMM/IND FEE - 1% OF CONTRACT FEE
8aT(lOQ M BTU 24,00 APT. BLDGS. - COMM. RATE APPLIES
TpWNHOUSE & CONDOS - RES. RATE APPLIES
M BTU MINIMUM RESIDENTIAL FEE - ALl ADD-ON 8
M BTU REMODELS - 12.00
M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
CFM (ADD $.50 S/C IF PERMIT PRICE GOES
1*52 BEYOND $1,000)
FEE
25.30 • ?" ' ?
( ? • '
?
S/C: -511 SIGNATURE OF PERMITTEE
TOTAL $ 2 ?' • ??
FOR: CITY OF EAGAN
, . . ,
CONTRACT PRICE _
Site Address 1,V ?, .,%114
Lot Block • ?? Sec/Sub
? Name 4` ', IU '1' ? ? r .',
Y ?' i i i; i',? I ?! ?'a L
? Address ? ?
c Ciry f tl A/ W hone
Name r` 1U7"c 1C.. fIC neS
c Address r?? J,! lE' '}, e r7)
p City P hone
FEES
COMM/IND FEE - 1% OF CONTR
ACT FEE
APT. BLDGS - COMM RATE APPL IES
TOWNHOUSE 8 CONDO - RES. R ATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12,00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE G OES
BEYOND $1,000.00)
?
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN I
? PERMIT #
PLUMBING PERMIT
?- CITY OF EAGAN RECEIPT i
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: -
PHONE: 454-8100
;
BLDG. TYPE WORK DESCHIPTI
Res. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
d0. FIXTURES
L -,4- Water Closet - $3.00
- TOTAL
$
7 Bath Tubs - $3.00
I ?
?
FLavatory - $3.00 •
Shower - $3.00
- - " G"
[
Kitchen Sink - $3.00 _`?• en
Urinal/Bidet - $3.00
T_
Laundry Tray - $3.00
7--
Floor Drains - $1.50
-
Water Heater - $1.50
?
Whiripool - $3.00
.,LGas Piping Outlets - $1.50
`' • ?
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $t0.00
Private Disp. - $10.00
enin
s - $1
50
h O
=R
f
g
.
p
oug
FEE:
STATE S/C:
GRAND TOTAL• - 3? • ? ?
(Iltr#iftraft af (Orrupttnry
titp of (Eagan
Mrparbund o# NWAbim 3wrrtintt
This Cerrifrcate issued pursuant to the requirements of Secdon 306 ojthe Unifam Building
Code certifying that at the time of issuance this shucture was in compliance with the vnrious
ordinances of the City regulaling building carstrrrction or use. For the following.•
Ux Clagifintion ?= L? J?`?-"- &dg. Flrmit No.
Ooc„p.-y TyPe R-1,'Ff ? Znomg D+sn;u .i;! lypc Coaet. YN
OwOGO(BUlldil? N.S?i.lidl i?'.'•..-,i'?:,? Mix= 3702 C+iWTWA.9 Lr1, 7'd?
awaa;Mqda" 'it.`1?'1 P'F2dr:,c,^.'r,?•.,, •,,Lo,uy 125., P3, STAH'xCXt!} M1siZ
p,k; rAAII?AT?Y li, 1489
Building OiTicial
POST IN A CONSPICUOUS PLACE
1
r
? CITY OF EAGAN Permit No:
Date: ?-??•,
3830 Ritbt Knob Road B/P No: ` Date:
P.O. Box 21199
Eagan, MN 55121
Owner. ;? ?' e? a`?''? f'•°- 'i?•?tet?
?SiteAddress: rernay'I'vflr.i:t Ave I.25 B3 Staffar<1 "nj.pc'p
Pfumber:
tiiWCC: Zoning• . .
City Chg: No. of Units: ?
Acct. Dep:
a
11o I agree to comply with the City of Eagan
Permit Fee: _
P
Ordinances.
Surcharge:
Misc.: gy
P:
?..r.._
,
CITY OF EAG*tN Permit Np: 10151 Date: 1.1-1-R8
3830 Pilot.Knob Rbed Meter Np: Size:
P.O. Box 21199 Reader No: Date:
Eagan, MN 55121
Owner.
Site Ad
Conn. Chg:
? Acct Dep:_
' Permit Fee:
Surcharge:
Tr. Plant_
; Meter. _
i Misc.:
Zoning:
No. of Units: -
I agree to camply with ihe City of Eagan
Ordinances.
ey
WATER SERVICE PERMIT
CITY OF EAGAN Permit No:_ 1,^`
3830 Pllot iCnob Rbad MeterNo; 1?//3 4A2 O 3
P.O. Box 21199 ? er No: a??f/ l
Eagan, MN 55121
Date: i Z -1 -88
5ize: S`/X R15C iF
Date:
N? w
Ave L25 B
Zoning: _
No. of Units:
R1
O-pd t agree to comply e C o( Eagan
Ordlnan
By ?- ?
WATER SERVICE RMIT
CITY OF EAGAN
, 3830 Pilot Kno6 Road, P.O. Box 27 -199, Eagan, MN 55121 N? 15810
PH ON E: 454-8100
BUILDINGPERMIT ReceiptKED-71
To be used for SF DWG/GAR Est. Value $80, 000 Date OCTOBER 31 ,19118
Site Address 4089 PENNSYLVANIA AVE
Lot 25 Block 3 Sec/Sub. STAFFORD PLACE
Parcel No
alName FRONTIER MIDWEST HOMES
W
z Address 3902 CEDARyALE DR
0
City F.AGAN Phone 454-0433
p Nan
? Q Add
` City
ww w Name_
zg Address
u=
aW City_
I hereby acknowledge that I have read this application and stat that the
information is correct and agr compappli bl State of
Minnesota Statutes antl City of E ? rdinanc
Signature of Permittee
A Building Permit is issued to:__E$QNTIEB-MIDjtiEST_HOMES
on the express condition that all work shall be tlone in accordance with all
applicable Stale of Minnesota Statules and Cpiry of Eagan Orainances.
BuildingOfficial?,????5?__ _
OFFICE USE ONLY
On Site Sewage - Occupancy R-3 M-1
MWCCSystem X Zoning R-1
On Site well _ (Actuap Const V-N
Ciry Water _X(Allowable) V-N
PRV Required _ x of Stories
Booster Pump _ Length 44'
oeptn 4R'
S.F. Total
Footprint S.F
APPROVALS FEES
Engi./ASSess. Permit 494.00
Planner Surcharge 40•0?
Council Plan Review 247.00
Bldg. ON. SAG City 100.00
Variance SAC,MWCC 550.00
Water Conn. 550.00
Water Meter 67.00
Roatl Unit -325-00
Treatment P1 204.00
Parks
TOTAL 2i577.0
O
BLDG. PERMIT NO. I C-:?3 IC?
i-f- 2-5 r.3I oe.4l? --"? ,?-Ic
01-3210 Bidg. Permit
013422 Plan Check
Of-3445 Surch./Adm.
01-3446 SAC/Adm.
> 01-2155 Surcharge
3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
?
20
71 W
-3
3
00 ater Permit
Q 20-3743 Sewer Permit
779
3866 S
- ewer Conn.
28-3855 Park Ded.
TOTAL
%?/5?8,{;• REQUEST FOR ELECTRICAL INSPECTION es-oooai-os
Sea instructions lor cogple6ri9.this form on back ol yellow capy.
0 ?9I,-2 S
D y? m'gpC'j "1(" Below Work Covered by 7his Request
-13
+.?.?na? xeo.1 rvoa oi aunains ? AOPliantea Wired ? eau?umen? w„e•+ ?
?I?T ?- Home Ranpe Teinnorarv Service ?
Water
rvl
p Fee ServiceEniranceSize p Fea Fendets/5oblenders N Foe Circuits
0 to 200 Amps 0 to 30 Am s D 0 to 30 Am s
Above 200 qm ?s 31 to 700 qmps 31 to 100 Am s
Swimming Pool Above 700_Amps Above 100_P,m s
Transrormers Irrigation Booms Partia6'Other Fee
L_j ISigns - I I Spec:al-Inspection IS?i.,`0 ITO7AL EFE/?
Remirk5 ' ?''? ?
1, the Elechicxl
Inspector, herebV
ce.tiiv tnei ma Teo"
?nsDection has been
: ade.
thlerepueslvolA
This request void /?s/?? ?}p?n C
18 mon[hs (rom Q? ? J
D 20285 ?3?
Re?uest ?ate ii¢ No. fl ugh-in Insuer.[ion qqq,,,///
r?e ireA? ?HeaAy Nuw,?[J W?II Notify, Inspcr
ves ?N. ?'\ 'or When Ready
licensetl Electncal Contractor i heraby request inspaction ol abova
7 wner electrical work installed ai:
SVeet Address, Box or Route No. City
'b
ecuon o. Towns ip Name o? No. Range No. Cou y
oyn
OccuVrnt(PplNT)
Phone No.
? e ,n•P ,S ,F1V3
Power Sapplie /
l /1 Atltlres
Elechical Con etor (C ny N e C.n[racmr's License No.
Mailinp AdJressoCo
ra?Ctoor Owner Makiny I ailatiun)
q
/
Y
Authorized g^a[ e IConvaaor Owner MakinB Installationl Phone Number
v'/
-1
MINNESOTA STATE BOANO OF ELECTRICITY TMIS INSPECTION HEQYIrsT WILL NOT
G,i89s-Midwey Bldg. - floom N-191 BE ACCEPTED BY THE STATE BOAFO
1821 Universitv Ave.. SL Peul, MN 55104 UNLESS PROPEft INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED. '
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
U 651-689-4675
NewConsWction Reouirements
• 3 regislered site surveys showing sq. R. of lot, sq. ft of house; and all raofed areas
(20% maximum lot coverege allaxed)
• 2 copies of plan showing beam 8 window saes; poured faund design, etc.)
• 15etofEnergyCalculations
• 3 copies of Tree Preservation Plan if IM plat[ed after 711193
• Rim Joisl Detail Options selectlan sheet (bldgs with 3 or less unils)
DATE ? 2a Ina
SITE ADDRESS
TYPE OF WORK
APPLICANT
FIREPLACE(S) _ 0 _ 1 _ 2
V
STREET ADDRESS U7lS- ['2-? f?.? N- CITY ?L TATE h10 ZIP
TELEPHONE # CELL PHONE # rr 6Q4o 'eS 6,IO? FAX #
PROPERTYOWNER? '0c l 1(Rb'-\ n QR, V TELEPHONE#
----------- °-.... ----------------- ---°-°----------------°-°---°°------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ M[NNGSOTA RUL.ES 7670 CATEGORY 1 MINNESOTA RUL,ES 7672
(4 submission lype) . Residentlal Ventllation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
. Energy Envelope Calculations Submitted
Plumbing Contractor:
Plumbing system includes:
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Contractor.
_ Air Conditioning
Heal Rewvery System
----------------------°-------------------------------------°----^-----------
I hereby acknowledge that I have read this application, state that the infc
with all applicable State of Minnesota Statutes and City of Eagan O din
Signature of Applicant
OFFICE USE ONLY
MULTI-FAMILY BLDG _Y _ N
VALUATION S
_ Water Softener
_ Water Heater
_ No. of I3aths
RBmodellReoair Ranuiremants
. 2 copies of plan
• 1 set af Ener9y Calculatlons tor heated additions
. i site survey For ezterior additions 8 decks
• Indicate if home served 6y septic system for addiGons
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
Phone #
Fce: $90.00
?? ???TT
MAY 2 2 2002
?---°------. _ ?---.
and agree to com
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
O 01 Foundation ? 07 OS-plex ? 13 1Eplex O 20 Pool ? 30 Accassory Bldg
0 02 SF Dwelling p 08 08-plex ? 16 Fireplace O 21 Porch (3-sea.) ? 31 Ext. Alt- Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garege 0 22 PorchlAddn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Poroh (screened) ? 36 Multi
? DS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg Y or _ N ? 25 Miscellaneous
? 31 New 0 35 Int Improvement ? 38 Demalish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration O 37 Demolish (81dg)' ? 43 Reroof O 46 WindowslDOOrs
? 34 Replacement •Demolition (Entire 81dg only) - Give PCA handout W 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
REG1llIRED INSPECTIONS
_ Footings (new bldg) _ FinaVC.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 Smcco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windocvs (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
W ater Supply & Storage
S&W Permit & Sureharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
1988 BUILDING PERMIT 6PPLICATIDN - CITY OF EAGAN
SZNGLE FAMILY DWELLING3 16 11 o
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTEs ADDRESSES FOR CORNER LOTS - CONTR9CTOR/HOMEOWNER MUST DESIGNAI'E WHICH ADDAESS
IS DESIRED. NO CHANGES WILL HE ALLOWED ONCE HUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL QNITS FOR SALE UNITS # OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF 3URVEY - CHECg WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS '
CO[•II,tERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
04;j? aoo
To Be Used For: NEW CONSTRUTION Valuation: $63?.aQ., Date: 10/21/88
Site Address 4089 PENNSYLVANIA AVE
Lot _25 Block 3
Pareel/Sub STAFFORO PLACE
Owner KOMMER. JAMES & FONG. EMILY
Address3346 37th AVE S0.
City/Zip Code MPLS MN. 55406
Phone 722-0554 JIM 722-0254 EMILY
Contractor FRONTIER MIDWEST HOMES
Address 3902 CEDARVALE DRIVE
City/21p Code EAGAN 55122
Phone 454-0433
Arch./Engr. PHILLIPS PLAN SEVICE
Address 14530 PENNOCK AVE
City/Zip Code APPLE VALLEY 55124
Phone # 432-2044
On site sewage_ Oceupancy
MWCC system ? Zoning K-/
On site well Actual Const 1/?Y
City water Allowable I/W
PRV required # of stories
Booster Pump _ Length 41.1
Depth y8, 3 3
S.F. Total
Footprint S.F.
APPROPALS FEES
Engr/Assess Permit
Planner Surcharge YO
Couneil
' Plan Review 2 Y )
Bldg. Off. ?
-0/2j SAC, City /Oo
Variance SAC, MWCC 51?6
Water Conn r -o
Water Meter ? J
Road IInit ,775,
Treatment Pl Za?/
Parks
Copies
TOTAL ? =, J ?
<?:: ;" ,I -
?--- ?
1
a .
? ? ,? •_? .
1
'I-ledlund Engineering Services 9201 E°s'&°°r^'^°'°^FrM."
Bbominqton, Minnamo 53420
Lond Survorors Cfril Enpineers Land Plonnsrs Phons: 888-0289
? Sur?vefor`s G'ert?, f "?cate
. _ BOOK_ PAGE _
- JOB NO.EM' S39
SURVEY FOR. Frontier Midwest Aomes Corporation
DESCRIBED A5: Lot 25, Block 3, STAFFORn PLACE, City of Eagan, Pakota County
----- Minnesota and reserving easements of record.
1
W
?
?
?
2
L
?
TOP OF FOUNDATION = `bg•O
?OARK' ar Lar35•<3,6 &&41 I 7DF a? GARAGE FLOOR =??•b
C? N'lDRdnrT = 906.$2 ' BASEMENT FLOOR =904•?
MIN.SETBpCI(qE0U6EMENTS SEWER SERVICE ELEV. =$O t
FRONT- 30 HME SIDE- 10 PROPOSED ELEVATIONS
RE+R- IS GaRnGE SIDE- l0 EXISTING ELEVATIONS :
DRAINAGE DIRECTIONS :?u?
NOTES LOT CORNERS : o
D OTES OFFSET STAKE : a
, ,a ?I = C.._?? as
L -
Dato
N?
1
r,
1 ;
N 86 03b%gm
5F-- t ?
? 4.
04 1.
I ? 3 25.
?? SC
i•-_ ;o ur _'
--?'+' -?10
I
a? qes.? 34a I
_ y 9oi.3 ?
I P-P?
N.
1 qpt.)
I? E..
?
w r
? 44 YO
O 7.6 .. ?
^wi.3 ? 1 - •..
Z •
O
I 10 ?
O -. 9oJ9
N86°30,E 145.0 I
, ti
z
Z ?
(II
C
?
, D I
m
Z
ts
pw?.
S.rJ<t
CERTIFICATE OF SURVEY
I herobY cortify thaf this survey, pton or report wos prepared by me or under my direct
supervislon ond fhot I am o duly Reqisfertd Lond Surveyor under fhs lawa of fhs
Stote of Minnesofo.
Date: 10 / ia / aa
No.143T6
• EXTERIOR ENVELOPE AVERAGE "U" COP1I`i1TATI0P!
OWNER: KOMMER, JAMES & FONG, EMILY f1ATf:_3_(2-87 -
SITE ADDRESS: 4089 PENNSYLVANIA AVE Ph!0"IE: 454-0433 FRONTIER
CONTRACTOR: F-,20,VTJ c c2
Determine working square foo*_age of each
1. Total exposed wail area..... ;,tGPf'1, s sq. ft. x .11 = 0?2?9•S
2. Total roof/ceiling area..... sq. ft. x .026 = 3)•3
Total exposed wall area above floor=_110 (al
a. Total wall window area ........................................... /44
b. Total door area .................................................. :? I
c. Total sliding glass door area ..................................... 40
d. Total fireplace wall area ........................................
e. Total wall framing area (average 10'") ............................
f. Total rim joist area ............................................:
g. net wall area above floor ..................................... /453.
h. wall area a6ove floor .....................................
i. wall area a6ove floor .....................................
i. frame wall area at ioundation ...................................
Total exposed foundation area= 76 •s
k. Total foundation window area ....................... -
l. Total net foundation area above grade .............. (o. S
Determine "u" value of each wall segment
(e.g. window, door, each separate wail section)
a. 144- X 1.ul. .4S = (04.8
b.. 31 x „U„
c. 4o z U. 045 = ?8
d. X "U" _
e. l8l0•? X u., , 09 = ll0•7
f. ?sa X ltul. . 04 = 40
9. l 4-53•9 x „u,, • 04-
n. x ilul. _
; . x „ul, _
? X ,iu„ _
If item 50 is th
g
k. ? X "U" = as, or less than
i
rl, you have met t
`]?o,?p X "U" .08 = 6, ? intent of SBC 6006
3 . ............................. ....Total = f 96. 3
r.:tr.,*ior Envelope Average "U" Computation
rage 1 0 4
1 Tota1 exposed roof/ceiling area
m. Total skyliqiit area ............................
n. Total rooF/ceiling f_-aming area (avcrayc 10%)...
o. Total net insulated roof/ceilinq area........... ?
Determine "U" value for each roo£/ceiling segment
M. X "U" _
n. la0.4 a "U" ai-8
o. ??•?D X --U-l p7/. to
4 ........................... 'Dotial = ?4.4
:f to:al c£ #4 is the same as, or less than #2, you have met the i.ntent of
SFSr 5005 ;c? 1.
Alternate Building Enve'_ope Design
To utilize the total envelope'system method, tne values estzblished by the s:ua of
items ;'.3 azd r4 sha11 not be greater than the sum of items m1 and n2.
z. AaR.B + z. 31.3 = a61. I
3. 1 640.3 + 4_ A4'•4' = d?10•I
i
• . • ' PL.AQ *i? ?VG'ODf2.fDU?.
? Li ?jFAL FT, Fxpos?D WALL_ -
/:53
??? t ' a,lo.-r44-+-o1?tlq-+?otlo+b?-ao =/5?-- .
?U l.L I ?
';:r U l., LZ.. '- ' --
._.. ?tR.Et?L?GE ? -
1ZlM=
? SGZ , ?T, ??t?05?D
3Lock:',
,
w.o. ,
,
FuLLZ%
,
x , s =
/a9 x S =
x g =
fsa X S -
k S -
?C =
WA LL, AizEA
?4s
/ sa, x ! _
T'o 7'A L=? 0 89. ?
? SQ,?f ?1C?OS?D GEl L(1JC?
?o'3?X44?+???-ia? = 1J441-?o=laa?f
¦ W DY115 Lt ? DooQS Ll
a,43? -l?tL. i i i - 48 3°- I z.o
010 3?0 -I't-I-?-
A448 - rt+l-1
ADG6 -t 11
A4 a$- ( L-7
42 3'1 ?
24 ? PATi o DR.S ,
444 , (0 - I -40
? gS t?-t? U ? i+s ?1
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• pI.ier.nunt of irosul.itinn.
, $l?0:/CEiLiYG
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, ' • • • • , ? , • -
Const? ^ . R-Valuc
l, Intcrior air film .0.61 '
2. 5 st /'? ?-( F31? ? _• sR
3. ln? uL. ' 44•OZ? .
{. Extcri.or air filn (sti111 O.G
_ Tot&-L 2. 457-80..
1. Inte.rior nir film 0.61
2. G
3. ? 4 dJ.(5uL 38.3?
4. I:xtcrie: air Piln tstill •b
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C o.t. '50r.?z ? ? ri o y` 0. 61
; 1_ Insldc air film
2. .
, 3. , .
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1• 5. Outside air fil:n
Total
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Llov up ' . . •
Pz ,. 47 ? • ' " t?
I. Tnsidc 3ir Eilm 0:61
2. . . -
3.
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Outside air fil:a 0.17
Total
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• •
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2. .
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Out;idc air fil:n
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and
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- MIVE'" Reside.,tiar
'?)-'?P 313147 Whole House Worksheet
Si?LF ?
?rl75Ma+P?L1L OV .
Cuntomnr'sName r/??1J-??? AP mi,-4_.uSC7- ,oddreae 70'E5 f/
ci,v T A?A? _siato LP SS/da TelephoneNum6er yS?l- oy 33 ?
WINTER:InsldeDssfpnTamp 7S °f-OutaideDssipnTamp -'1?10 °F.MeedoyTamDDlHaronae '75 °F
SUMMER: Outsida Dasipn Temp ?°F-Insids Design TemD -7- °F . Coolinp Temp DINeranea ANIQ•P
HEATINO .''•:i'?t'.COMMONDATASECTION^' ' - . COO lINO-+--
BTUNl088 XlATIMO
FACTOP
.,
n GROSSWALL coouwo
fACTOP BTUMUAIN
DOOHS&WINDOWSfTablaAorBl '?U SSIo
S i U NETWALL
fc L?) 3 O
CEILING //yfy S
r37 FlAORS O -
Mluu?ton
Bw1N Nw?ip
L04D Vdume
X1O% 1.1I80 % ICu.F1. Wlums /
ICwfl %
1.1I80 Codinp
X IsT% 6 NMmion
Bwlh
33.5
5
x
? SFl?o I.O x o.iaa? X 3a? 3oY x
SUB•TOTAL BTUH IASS (per 10°F)
ADJUSTMENT FACTOR (Table C)
TOTAL BTUH LOSS
PEOPL x300BTUHGAW ?pm?,?o,,,,°°?°"' o.o1a? x?u x. S = 3? SS
v
APPLIANCES BTUH
SUB•TOTAL BTUH GAIN (room sonsibla on1y) 7200
S ?
x DUC7 LOSS/GAIN FACTOR ITable FI x
SUB•TOTpL BTUH ISensible Gainl
MOISTUHE REMOVAL Isub total x 1.31 x 1.3
S TOTAL BTUH LOSS/GAIN O
TABLE A-NEATING-DOORS & WOOD FRAME WINDOWS
IPEH 10°F!
For slitliny glacc Coors - use tactore tor [he 9ame type window constmtliOn.
Window8 Framea
Ooor T eo Woodi TIM 11 stal x Ares ? gtuh Lose
if1g18 PBnB
CIBef
9.80
10.45
11.65
Wiih Storm 4.7 5.
Oou61e Pane
Clear
5.51
6.09
'.7.26' ?
f?0 (P
WithStorm qi 3.85 4.90
Triple Pane Clear 3.80 4.38 5.98:
Jalousw- -
Single
-
- ?? Q
V
Singlew/storm - - 6.0
k4lights
$mgla
11.07
11.69
12.92
.
Double 6.65 7.35 8J5
UOf
Woud Only
4.60
-
-
Wootlw/storm 3.20
Ureehane Core R-5 1.90
Ure[hane CoreIR-5lw/storm - - 1.7 0
TOTALS Vq /3S
TABLE 8- COOLING - DOORS & WINDOWS "
Factors assume winCaws have inside shading by draperias or venetian
Clinds and sliding glnsa qoore are treatatl as win0ows. .
Wiw[aWS oouwww Iwuauu
GsYm
u TEM/.01f1.
1{' L• ID•
?u a m TEM?.DIfi,
16• L' A-
14 1e 1e ilMP.OIIi.
1Y ]0' ]Y
n u w %wn? -lTUXOMM
rauirw '.n n e 31 a x s a a
exw a se m w r a .ti s n ??.
LEbpV w w q s ?? u a ?. s
s s a a e ?a n u m 2i.
s.Npw w ta in 14, Na ??e m ia w
U 10.0 1].1 6. 10.9 l.] LO IO.f ill S
wm.x L5 4.5 u as u a.? aa ..e "
OO ?'"p^a?? TOTALS
0 wunuumcaonrwaoon
TABLE D - INFIITRATION MULTIPLIERS
Wintar Air Chanpes Per Hour
FborArea 900ortesa 900.1500 1600-2100 ow2100
amr O.a 0.4 0.3 0.3
Averape 1.2 1.0 0.8 OJ
Poor 2.2 1.8 1.2 1.0
For wcA Iiripplece ad0:
BMt Meraps Poor
0.1 0.2 0.6
TABLE C- AOJUSTMENT FACTORS - IHEATINUI
F. Tempxroture Diff. 1 _?W Ap 50 60 70 80 9D
Adjustment factor 3. 4 5 6 7 8 8
I AmNrir,an StanAarA Inc 1986
Summer Air Changas Por Hour
F1ooiAna 9f10orlax 90G1500 75064100 owr2700
flest 0.2 0.2 0,2 0.2
Awapa 0.5 0.5 Q? 0.4
LP, 0.8 03 0.6 OS
Pub. No. 22-9;18-4
APFLICATION 1=0R PERMIT
SEWER AND/OR WATER CONNECTION
, . ,. .
,
?*. NOTE: PAYMElL OF FEE AT TIME OF .
.
w
t APPLICATION DOES AP.7P CUN- ?
? STINIE APPEi('idN. OF PFRPffT. s
?
; zrSPrMaa oF sEx•ER nrm/OR VaTER •
;.
IP6TAIdATI0N5 WIIS, NOT BE SCID[R.ID {
? f!NPIL PQtPIIT HhS HIINN APPROVID. w
f?r?tee??rxt++sr??ii+ea??f.wfeirs.+?:+fw
ity oF eagcan
( PLEFISE PRINT
1) PROPIItTY ADDRFSS: 4089 PENNSYLVEINIA AVE
i,FY;Ai, DESCRIPTION; -LOT 2 5BLOCK 3 STAFFORD PLACE Lot B oc 5 vision or Tax Parcel ID IF EXISTING STRL'CTURE, DATE OF ORIGINAL BUILDING PERNLiT ISSUANCE: N/A
Nbnt Year
PRESENT ZONING/PROPOSID USE:
j R-1 SINGLE FAMILY
Q .COMMERCIAL/RETAIL/OFFICE _X
Q IAIDLSTRIAL El R-2 DDPLEX (3Wo L'nits)
Q INSTI'ILTZONAL/GOVII2NMENT ? R-3 TOWNEiOt'SE (Ztiree .+ Onits) ( Lnits)
Q R-4 APARTMENT/CODIDOMINILM ( L'nits)
2) ? NAME: FRONTIER MIDWEST HOMES CORP:
ADDRESS: 3902 CEDARVALE DRIVE
CITY, STATE, ZIP: EAGAN. MN. 55122
PHONE: 454-0433 ?
3) NAME: STAR PLUMBING
ADDRESS: 1018 MDUND SPRINGS TERRACE
CITSt, STATE, ZIP: BLOOMIN6TON. MN. 55420 _
PHONE: 884-4149 MASTER LICENSE # 3329
? Active
Expired
Not recorded
Sta Inf£?it=
4)
NAME: KOMMER. JAMES & FONG, EMILY
ADDRESS: 3346 37th AVE S0.
CITY, STATE, ZIP: MPLS MN. 55406
PHONE: 722-0544 JIM 722-0254 EMILY
5)
CK3 CONNECTION 2b CITY SEWER FX-l CONNECTION TO CITY WATER a OTE3M
6) 0t2.01 i o /z i /s
**?*+??******+??*.***#?,r***+***??******?**?*****+****+***,r*******,r****?**?***,r*?*************.?**??x
W
* 1HE GOID COPY OF THE PERMIT WILL BE SENP DIRWPLY TD PUBLIC WORKS 7n FACZLITATE ME1'II2 PICK-DP. i
,*k PI,EASE ALL,OW RWO WORICING DAYS FOR PROCFSSING. SONIEONE FROM TfM CITY WIIS, CONfACT YOU IF THERE ?
* 11RE AAISC PROSLF.MS. +
,???*r.,r*********r*+?*?,r*r**?****,r?***t+*********,r***rr*?+*****«*w**?***?***w?**?+*****t*****,r?*****,t*;
FOR CITY USE ONLY
PERMIT # ISSC'ED
S /
Pd w/Bldg. Permit FEES:
$ /c - ?i
$ /L' ' 5"-Z%
c f -7.:. y.
?
$
$
$
$ !s--b
$
$
$
$
$
$ ?? ZZ OC^
RECEIPT
$
$
S
$
$
S
S
s
S
$
$
$
$
S
$
$
SEWER PERMIT (INCLL'DE SCRCHARGE)
WATER PERMIT (INCLCDE SCRCHARGE)
WATER METER/COPPERHORN/OtTSIDE READER
WATER TAP (INCLC'DE CORPORATION STOP)
SEWER TAP
ACCOUNT DEPOSIT - SEWER
ACCOUNT DEPOSIT - WATER
WAC
SAC
TRLNK WATER ASSESSMENT
TRONK SEWER ASSESSMENT
LATERAL BENEFIT/TRUNK SEWER
LATERAL BE[VEFIT/TRUNK WATER
WATER TREATMENT PLANT SL'RCHARGE
OTHER•
TOTAL
RECEIPT
DOES UTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR WORK S9ITHIN PL'BLIC
Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE :
0
zoos RESIDENTIAL BUILDING rExNUT arrLicATioN
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construetion Reauirements
3 registered sde surveys showirg sq. ft of bt sq. ft. of house; and ell roofed areas
(20°h maximum lot coverage allowed)
7 Soils RepoR if proposed building is to be placed on distur6ed soil
2 copies of plan stwwing beam & window sizes; poured iound design, etc.
1 set of Energy Calculations
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Dehail Options seledion sheet (buildings with 3 or less units)
Minnegasco medianical ven4lation form
RemodeVReoair Reauirements
2 copies of plan showing foolings, beams, joisls
1 set of Energy Calculations for heated additions
1 site survey for addNOns & decks
AddN'on - indicate if oo-site septic system
0,e9b
, ?7
office um onw
Ced of Survey Recd _ Y_ N
SoilsRepod_ - Y _N
Tree Pres Plan Recd _Y_N_
Tree Pres Required _Y _N
On-siteSep6cSystem . _Y _N
Date 'CJ l?d' l e C Construc[ion Cost
SiteAddress (,F Unit/Ste #
Description of Work e r
Multi-Family Bldg _ Y_ i
Fireplace(s) _ 0_ 1 _ 2
Property Owner / d a c.?
? a wH'? Telephone #( )
Contractor
Address 7/,2 0 City
State 1-17GTi Zip _?-Jc+ Telephane # (a(
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category
• Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(dsubmissiontype) Submitted Submitted
. Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master planB
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
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 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.
Appl ant's Pffited Name ??kpp?an ignature
DO NOT WRITE BELOW THIS LINE Sub Types
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ?
? 02 SF Dwelling ? 08 06-plex 0 16 Fireplace ? 21 Porch (3-sea.) ?
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ?
? 04 02-plex O 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo/perola) ?
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
? 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
r ?
30 Accessory Bldg
31 E#. Alt - Multi
33 Ext. Alt - SF
36 MWtl Misc.
? 35 Int Improvement O 38 Demolish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 37 Demolish Building• ? 43 Reroof ? 46 Windows/Doors
'Demolition (Entire Bldg) • Give PC,4 handout to applicant
De5Ci'iption: WaterDamage_Yes
Valuation Occupancy MCES System
Plan Review 100% or 25%
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIREDINSPECTIONS
_ Footings(new bldg) _ Sheetrock
_ Footings (deck) _ FinaVC.O.
_ Footings (addition) _ FinaVNo C.O.
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool Ftgs Au/Gas Tests Final
_ Framing Siding _ Stuceo Lath _ Stone Lath _Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Re[aining Wall
Approved By: , Buiiding Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? •.1 E n g i n e e r i n g S e r v i c e s 9201 Easi &oanlnpton Freawq
Bbominqion, Minrasofa 55420
.ra CIvi1 En9inoers Lond Planners Phone: 888-0289
?? Summor`s G'&Ncate
. ' BOOK_ PAGE _
JOB NO. 8;R" S39
SURVEY FOR: Frontier A4idcvest Eomes Corporation
QESGRIBED A5' Lot 25, Block 3, STAFFQRD PLACE, City of Eagan, PaY.ota County
------ Minnesota and reserving easements of record.
?
W
?
O
?
2
2
V
?y
r?
I
TOP OF FOUNDATION = 90g•O
BENGi MARK* [tr La'r 35•+3,6 &bck I TOF a? GARAGE FLOOR = QO?• 6
C? N1CIRANT =906I-SZ BASEMENT FLOOR = q o 4, 6
MiN. sEreqcK REOUwewENTS SEWER SERVICE ELEV._$O '
PROPOSID ELEVATIONS
FRONT-3o HouSE51DE-?d EXISTING ELEVATIONS :
REAR- 15 GARAGE SIDE- 10 DRAINAGE DIRECTIONS :?I-
??NOTES LOT CORNERS : o
; ?DENOTES OFFSET STAKE: o
zs
I
It?4 lu
•,-
6
,i,a N 8 30
sUl 0 ?
0*1
1 9oi.3
\ . Y z5.ii
1 .3
7
W I 44 • (wod-•?y ?
? I \ . 1
{ I ?
$-
_
O _ ._..,
1'I
f I 25
tapp•?.
SvJ«
ti.yt2,?w.5
'__" jy 86,301 E
GERTIFIGATE OF SURVEY
I hemby cenify that this su?vey, plan or report wos prepared by me or under my direct
supervisioo and ihat I am o duly Ra9istertd Land Survtyor under the lars of fhe
State of Mlnnesota.
Date: 10 / ta / a4
?Z_;o ur -'
-}- ? 10
341? I
i
?
? 901.3 ?
m
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-
30
License No. 14376
v?? Nov so2?s ? ?, -o
2006 RESIDENTIAL PLUMBING PeRnnir aPPUCarioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Piease complete for modifications to existing residential dwellings.
Date/ / Ja44 / l1c:?;
Site Street Address g Unit #
hone #((j1 )q05_ a/
!! & c 1
JlJV1( Tele
P
t
O
p
wner
.
roper
y
hone # (0-4 ) 3? `???10
S Tele
t
C
t
47' P1
4 0
k
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.
on
rec
L
0
? Address Io7c) City State-/V? Zip 55fa3
The Applicant is: _ Owner v Contractor _Other ,
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes installation of a water softener and/or water
heater at the same time. !f you are installing onlv a water sottener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
_Water Turnaround (add $130.00 if a 5/8" meter is required)
Otnec
J Water Softener •/ _ Water Heater
' $ 15.00
replacement
_ new ?
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ 50
f5 5 1)
Total $
I hereby apply for a Residential Plumbing Permit and acknowletlge that tne intormanon is compiece ana accuraie; inac me
work will be in conformance with the ordinances and codes of the City of Eagan and fhe plumbing codes; that I
understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in
accordance with 1he approved plan in the event a plan is required to reviewed and approved.
?ris oi 0-, _
ApplicanYs Printed Name ApplicanY Signature
?/.
Use BLUE or BLACK Ink
For Office Use
j Permit Q Q / j
City of EaEd~
Permit Fee: go.
I
3830 Pilot Knob Road
Eagan MN 55122 j Date Received:` j
Phone: (651) 675-5675
Fax: (651) 675-5694 I Staff: I
I
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: r ~ V Site Address: o g,7 19,en h5y1yo wcL Ayi &tag o Al) Ss 0-3
Tenant: / r1^-(~ tv A V% Suite
RESIDENT/OWNER Name: I rac /1 Phone: (OSI Lfog
Address / City / Zip: go 3 pivir, S j aY-) ~ C~ MW 55,1,P3
Applicant is: Owner Contractor
TYPE OF WORK Description of work: 9c 1A
Construction Cost: Multi-Family Building': (Yes / No
CONTRACTOR Name: FrJ O I-2va CCU rt 5`~ ~rc..~ cot License 2106,39 114
Address: 11,22 T (OVI -t.lv- yj City: -C I to
State: A`! Zip: Phone: 3 - 0?3
Contact: CA Email: Ck v< K 44j ' c . in
i
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: 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 the 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.org
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 f p ns.
L~ ` Jn
x I~ d_ N 4~ v x
Applicant's Printed Nalne Applican s i a
t Page 1 of 2
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA110881
Date Issued:06/03/2013
Permit Category:ePermit
Site Address: 4089 Pennsylvania Ave
Lot:25 Block: 3 Addition: Stafford Place
PID:10-72500-03-250
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
Bruce Gates
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Tracy Downing
4089 Pennsylvania Ave
Eagan MN 55123
(651) 405-8294
Gates General Contractors, Inc
3500 Vicksburg Lane North, Suite 400-351
Plymouth MN 55447
(763) 550-0043
Applicant/Permitee: Signature Issued By: Signature