4105 Pennsylvania AveCASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
i'
DATE / f 19 1 1
rWcerVEo 1 + i -
Fnpl
AMOUNT
?
DOLLARS
im
? CASH )1?`CHECK
-•? .. ?
r
wn C 016036 Whne-FaYetg ?PY ?
velbw--Postin9 ?PY
Pink-File C.opy
Thank You
BY ' .
ar DATE: OCT 31, 1991
?? RE: 4105 PSNNSYLVANIA AYE (C R PARTRIDGE HOISLS
X Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
' - REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
CITY OF EAGAN
' ? • ? 1S047
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
. PHONE:454-8100 ,
UILDING PERMIT Receipt #
o be used for 5i? Di?tG/GAR Est. Value f$O, 000 Date 31
. 193L-
Site Address 4105 PEHNSYLVANIA AVE
Lot 2 1 Block 3 5ec/5ub. STAF?Y1Rn Pl Ar1? OFFIC E USE ONLY
Parcel No. occupancy R-3 Ilml FEES
Zoning -IL-1
W Name C A Pl1it?i[IDGE HOIIHS (ACtuaq Const Y K Permil sso•oo
Bidg
; Address 13809 SlINSET z-A" iIg (AUowaWe) -VL-N .
1
?
p [1-(
?
Surcharge
City BURI?ISVILI.E PhOne ?Z-0122 # oi5rories _
A
, Plan Review -4S7 - f1(1
Len9th ik-
o Name SAHE oepm snC
100.00
Gt
= .
y
O? Address S.F. Total _
SAC, MCWCC 650-00
City PhOne S.F. Footprints _
ri 660.00
i
C
W
Fa On Sile Sewage _ a
er
on
, Name on sice weli 4S
nn
c
= _
er nneter
wa
x- Address Mwcc S iem
? ]?
i W City Phone Gry water ? '?c?. ???? ?-?
In
nn
PRV Required _ S/W Permil
-
I hereby acknowlege that I have read this application and state that the Boosier Pump - SrW Surcharge -?
iniwmation is correcl and agree to c I with all applicable State of
Minnesota Statutes and ?y? Fa?aq Or inariMrr_,{' - "?
` Treatment PI 276.00
'? ? "- ` •
Signalure of Permilb@ _ APPROVALS Road Unit 370.00
A Building Permit is issued to: Pianner - Park Ded.
on the express condition that all work shall be done in accordanc with all Council ?
applicable Slate of Minnesota Statutes and City of Eagan Ordinances. gldg, pry. _ CoPies
Building Ofticial _ ?
? r Variance - TO7AL 3,158.30
Permk No. Permfi Holder Date Tekphone #
WATER
SEWER
PLUMBING
?-, 7
H.VA.C. 5 1/4 - ,?, 4-
ELECTRIC a5a
Mspection Date Insp. Commsnts
FooUngs I
Foundation
Framing
Roofing `'??el-111
Rough PIb9•
Rough Htg. ?/i?
Isul. ?7 - ZG" F ?S
Fireplece
Final Htg. B
Orstat Test
Final Plbg. 3_6 9Z PI6g. Inspector - Notify Pium r
Const. Meter
EngrJPlan
eldg. Final
Dedc Ftg.
Dedc Final
Well
Pr. Disp.
0 --b, - q.
46 ?• •
?.
raffirui? ?f (Orrupaury
Citp of cagari
&Pwrtmrttt nf Buning iwrrti,mn
t
T&is Certificate issued pursuant to !he requirenrents of Saction 306 of the Unijorm Building
Cade cerrifyrng tlrat at the time of issuance this slructure was in complianae with the various ,
ordinmtca of the City regulating building canstrucliorc or ure For the fa!lowirrg.Ux aaail',wooe SF DWG/C+AR etdg. thmA No. 19Rl.7
0=4m9 TYP? R3/t4' Zwi08 Dkuict t I Typc Cnmt VN
o%mwo(emMinsCR PARTltIDGE HCWS AM,,. 13809 S[nv.= t.Ara? tR, BrFaMTrJF
Buflft A&k- 4105 PM15YI,VANiA AVEIViIE,.,1. B3, STArFuRD PLAC;E
POST IN A CONSPICUOUS PLACE
PERMIT
MN
TE OCT 31. 1491
OFFICE USE ONLY
METER #
CHIP #
METER SIZE
ISSUE DATE
SITE ADDRESS 4105 PENNSYLYANIA AVE
LOT 21 BLOCK 3 SEC/SUB STAFF'ORD PL.ACE
STATE
ZIP
'lUM6ER: ?NZEL PLi)tIBING
%DDRESS: 1959 SHAWNBE RD
;ITY
STATE $AGAN MN ZIP 55122
,
'HONE: 452-I565
)WNER: C R PARTRIDGE HOMES
\DDRESS: 13809 Si3N5ET LAKE DR
;ITY, STATE
'HONE: BURNSVILLE MN Zlp 55337
882-9122
TVYO
PERMIT DATE 10/31 /91
PERMIT # 12371
B.P. RECEIPT # .? - n- Lru ZE
B.P. RECEIP7 DATE I0/3I /91
_ PRV - BOOSTER PUMP
PERMIT REQUESTED
x SEWER X WATER - TAPS
_ COMM/IND X RESIDENTIAL
X NEW
EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
ILL NOT be given for Deduct Meters.
c
I AGREE TO COMPLY WITH CITY 9F
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
CALL 454-5220 FOR INSPECTIONS. FOR
SEWER & WATER PERMIT OFFICE USE ONLY
CITY OF Ei,GAN METER , tt_?4t' ,7L?9 (" 4a PERMIT DATE 10/31 /91
3830 Pilot Knob Rd. CHiP # O/ S/ 19a ?It PERMIT # 12371
Eagan, MN 55122-1897
/ S.P. RECElP7 #
METER SfZE
ISSUE DATE "r ? B.P. RECEIPT DATE 10 31 91
DATE dCT 31 , 1991
_ PRV _ BOOSTER PUMP
SITE ADDRESS 4105 PENNSYLVANIA AVE PERMIT REOUESTED
LOT 21 BLOCK 3_SEC/SUB STAFFORD PLACE
PPLICANT:
DRESS:
.
(TY, STATE
ZI P
HONE:
LUMBER: WENZEL PLUHBING
DDRESS: 1959 SHASiNEE RD
1TY, STATE EAGAN MN ZIP 55122
HONE: 452-1565
WNER: C R PARTRIDGE HOMES
DDRESS: 13809 SUNSET I.AKE DR
X `SEWER X WATER - TAPS
- COMM/IND A_ RESIDENTIAL
X NEW - EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
QpediLWILL NOT be given for Deduct Meters.
TO
1TY,STATE BURNSVILLE MN ZIP 55337 -
HQry?_ 882-9122 ??SiGNAI
lY'X??;&AC'YOW ??^ORKING DAYS F1 D /PROC?SSING /
E??. CALL 454-5220
L
EWER PERMITS, CONTACT ENGINEERING DEPT.
WHEN METER fSSUED
FOR INSPECTIUNS. FOR STORM
( i` /
CITY OF EAGAN N2 19847
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
' PHONE: 454-8100 n p?
BUILDING PERMIT Receipt x `'- ?! ?? ?^?1)
To be used tor SF D11,IG/GAR
$80,000
Site Address 4105 PENNSYLVANIA AVE
Lot 21 Block 3 SeGSuh. STAFFORD PLACE
Parcel No. .
w IName C R PARTRIDGE HOMES
o Address 13809 SUNSET LAKE DR
City BURNSVILLE Phone 882-9122
Name _
Address
City _
Phone
W W Name
YiE Address
aW City Phone
I hereby acknowlege that I have read Ihis application and state that Ihe
information is correct and agree to c ' h all applicablgState o1
Minnesola Statutes 8pdE?,iq'Eapt?n.Q?din ces. ( )
SignaWre of Permit ???
A Building Permit is' d e: C R PARTftI? E HO S
on the express condition that all work shall be done in accordan ith all
applicable State of Minnesota Stalutes and City of Eagan Ordinances.
BuildingONicial b ,n R.o; I m?
OFFICE USE ONLY
occupancy R-3 M=1 PEES
zoning R-1
(ACtual) Const V-N Bldq. Permit 550.00
(Allawa0le) V=N
Sumharge
40.00
M ofSlories
Length 46, Plan Review 357.00
Depth A-61 SAQ City 100.00
S.F.Total - SAC,MCWCC 650.00
S.F. Footprint5 -
On Site Sewage _ water Conn 660.00
on site well - yVater Meter 95.00
MWCC System XX
XX
Acct. Deposil
30.00
City Water
PRV Required _ S/VJ Permit 30.00
Booster Pump - SNJ Surcharge - Sn
Treatment PI 276.00
APPROVALS RoadUnit 370.00
Planner - park Oed.
CounCil
BIdg.Off. _ Copies
Variance - 7p7qL 3.158.50
91 °
? 73?7
? 3 ? ? ?
Requesl Date Fire N Rough-in Inspection
Re^ d?
CI Reatly Now ?I Will Notify Inspedor
c Q
- A V '?s L. No WM1en Ready?
I2ficensed coniractor ] owner hereby request inspection of above electrical work at
Job Atltlress(5lreet Bax Roule No.I Ciy
glus
Seclipn No. Townshlp Name or No Fange No. Cpynry
J \
/t/
OCCOCdntIP INT)
? Phone No.
C
• ?-
Power?ppeer Address
(l .
ElgCmcai oryractcy (Company Name) GontracbrS License No.
vj? . d a-3
MaJing tltlress ICOmrec?or or Owner Meking Installationl
.
Nmhonzetl Signarore cOmra r.0li Makinq Instal PhOn2 NUmbe'
ib3 -38/0
MINNESOTA STATE 80ARD OF IIECTFICITV y THIS WSPECTION REOUEST WILL NOT
Griggs-Midway BIEg. - Floom S173 BE ACCEPTEO BV TME STATE BOARD
1821 UNVersiy Ave.. SL Paul, MN 55100 . UNLESS PROPER INSPECTION FEE IS
Phone(612) 6a2-0800 ENCLOSED.
?/G+ /? A REQUEST POR ELECTRICAL INSPECTION
?f O?' li? See Inslruations lor completing hisform on bsak ofyellow cnpy.
73i17 "X" Below Work Covered by rhis Repuest
E8-00001-08
'ry 3 /04?S?S
? ewjA .L7"iep. TypeolBuilding Appli^ncesWlred EquipmeniWired
I Home Range ' 7.0j Temporary
Service
I Duplex Water Heater Electric Heating
j Apt. Building Dryer Other (Specify)
Comm./Indusirial Fumace
? Farm Air Conditioner
? Otner Isyecity)
I
Compute Inspection Fee Below: Cootraclor4 PemaMS:
# I Other Fee # ServiceEniranceSize Fee # Circuits/Feaders Pee
Swimming Pool 0 to 200 Amps ?J, 0 111 0 to 100 Amps 4
Transformers Above 200 _ Amps Above 100 Amps
Signs inspecior§ usa Omy: TOTAL S,
D
Irrigation Booms ?
i
Speciallnspection I
Alarm/Communication THIS INSTALLATION MAY BE ORDE DI NNECTED IF NOT
Othei Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rou9n-in oate
certify that the above inspection has
been made. oate
OFFICE USE ONLV
This request voitl 18 months 110m • ._.
ii/is/Si 103 8a 'o
? 52525 6a 1
$115°°
?? ? 1
Request Oate ire No. ? ugRin Inspeclion
equirea?
?ieady Nav ? Will Notily Inspector
0-3o -? ?Yes J3 NO WhenReeOy?
I;21icensed contractor ? owner hereby request inspection of above electrical work at:
Jo0 AOGress (SV
eet, Box or oule No,) City
c
O?.l ?
Section No. Township Neme or No. Renge No. County
t
Occupant ?PRWT? Phone No.
; c
R 58?--9?z Z
.
.
Power SupplLJa 'rt;s,Jn
c, ?
!t
Adtlress
Eleclrlcal nhaclor (COmpany Name) Gonhac[orS License No.
4,2 /'?-3
Melling Atltlress (COnhaclor or Owner Making Inslallatlon)
Amhorized SignaWre cOnlramor ner M Ing Installation) Phone Nvmber
- 3&?d
MINNESOTA $TATE BOAflD OF ELECFPICITY THIS INSPECTION REQUEST WILL NOT
GriggpMiAway Bitlg. - Poom 5-113 8E ACCEPTED BV THE STATE BOARD
1821 UNVerelly Ave., St. Peul, MN 55106 UNLE$$ PROPEP INSPECTION FEE IS
Phone(6/P) 662-01100 ENCIOSED.
ItI 8`/?,,? ;EQUEST FORaEL ECTRI?CA?L bINSPECTION
H52525 "X" Below Work Cover 1 by This Request
rX°"NI? E&00001-OB
ew Q$H Aep.? TypeofBuilding Apph ..., sWired EquipmeniWired
Home Range Temporary Service
Duplez Water Heater Elec[ric Heafing
ApL Building Dryer Other (Specity)
Comm./Industrial Furnace
Farm Air Conditioner
Other(specify) ConMac[or3 Remarks:
r
Compute Inspection Fee Below:
# Other Fee # ServiceEntranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps o to ioa Amps
Translormers Above 200 _ Amps Amps
Signs Inspecmrs U. ony: . /? OTAL
Irrigation Booms
L
Special Inspection
Alarm/Communication I5CONNECTED IF NOT
THIS INSTALLATION MAY BE OR
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspecior, hereby Rou9n-in Date
certify that the above inspection has
been made. F;,,ai are
Ze?
'
OFFICE USE ONLY
This reques[ void 18 monNS from
'9ddiess: 4105 PIIVNSYIAANIA AVENOE Lot 21 Blk 3 Sec/Sub gTAFFgp Pf.a!'F
These items were/were not complete at the time of the final inspectlon.
Dat : 03/17/92 Yes No / Tnsppcrnr,
Final grade (6" from siding)
Permanent steps - garage ?O
Permanent steps - roain entry
Permanent driveway ?
Peimanent gas i/
Sod/seeded grass v
Trail/curb damage
Porch
Basement finish f/
Deck
Please verify with tha builder the ramoval of roof test caps from the plumbing
system and the shut-off of vater supply to the outside la.m faucet before
freeze potential exists. ?
PEMlEONttR
White - City copy Yellow - Resident copy Pink - Contractor copy
.
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
v Construction ReauiremeMs
3 ragistered sile surveys showing sq. ft. of lat, sq. ft. of house; and all roofed areas
(20% maximum lol coverege allowed)
2 copies of plan showing beam & window sizes; poured found design, etc.)
1 sel of Energy Calculalions
3 copies of Tree Preservation Plan if IM platted after 1/1193
Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
4TE -0 - /J -0
)B SITE
RemodeVRenair Reauirements
. 2 copies of plan
• 1 set of Eneigy Calculations far heated additbns
. 1 site survey forezterbr additions & decks
• Indicate if home served 6y septic syslem tor additions
1 I! I ,
VALUATION ?3T.b6n
MULTI-FAMILY BUILDING, HOW MANY UN
:OPERTY OWNER KP 15TIPiF_ (?- ?STEVw 1?sYYUA3S?tJ
PE OF WORK ?D?ITfO? FIREPLACE(S) _0 ?S1 _2 _3
'PLICANT ?JTEVEIv Rl?c?M.US?? PHONE# hP(o-4,,M7-
)DRESS 4I 0C' f?01JSt) LW40) A (k\1¢. ZIP CODE SS IZ 3
\GER # CELL PHONE # 6090C4rz?otQ? -Z7`IZ FAX #
Nf1V RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
=nergy Code Category
(check one)
MINNESOTA RLTLES 7670 CATEGORY 1
- Residential Ventilation Category 1 Workshee
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
Plumbing Contractor: _
Plumbing Systcm Includes:
Mechanical Confractor:
Mechanical System Includes:
iewer/Water Contractor:
Phone #
Phone #
* 719. oy
P'ee: $70.00
above infortnation must be submitted prior to processing of application.
ereby acknowledge that I have read this application, state that the information is correct, and agree to comply with
applicable State of Minnesota Statutes and City of Eagan Ordinances.
C\??,' ?(
Signature of Appltcant
:rtificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Naw Energy Code Worksheet Submitted
Phone
Water Softencr _ Lawn Sprinkler
Wa[er Heatcr No. of R.I. Baths
No. oF Baths
Air Condiaoning
_ I-Ieat Recovery System
Calied 512?101
Updated 1101
OFFICE USE ONLY
01 Foundation
02 SF Dweiling
03 01 of _ plex
04 02-plex
05 03-plex
06 04-plex
X31 New
32 Addition
33 Alteration
34 Replacement
? 07 05-plex ? 13
? OB 06-plex ? 16
? 09 07-plex ? 17
? 10 OS-plex ? 18
? 11 10-plex ? 19
? 12 12-plex
16-plex
Fireplace
Garage
Deck
Lower Level
Plbg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 E#. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)", ? 43 Reroof ? 46 Windows/DOOrs
'Demolition (Entire Bldg only) - Give PCA handout to applicant
?
?
?
duation lz /J0?Occupancy ? MC/ES System
;nsus Code ? Zoning ?L City Water
kC Units O? Stories ? Booster Pump
ir. of Units Sq. Ft. 1:2_ PRV
ir. of Bldgs ? Length Fire Sprinklered
pe of Const J-4) Width
REQUIRED INSPECTIONS
Footings (new bldg) FinaUC.O.
?j Footings(deck) 0 FinaUNo C.O.
Footings (addition) Piumbing
Foundation _ HVAC
Drain Tile
Roof Ice & Water Final Other
?p Framing _ Pool _ Ftgs _ Air/Gas Tests _ Fina1
Fireplace R.I. Air Test Final Siding Stuceo Stone
?() Insulation _ Windows (new/replacement)
Approved By 4e , Building Inspector
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
ise Fee
ircharge
?
3n Review
'1iessa,c C RKAGE
ty SAC
ater Supply 8 Storage a'?-U K l ? 2 ?s O?
'4W Permit & Surcharge
eatment Plant
imbing Permit
;chanicalPermit
:ense Search ` fS
)pies ??? T
her ? lr 3 ?O
ital
.
?
??.
. ?
a7t?
3Zo
R.0. Dimensions Quanlity Sq. Ft.
X r1I G,.. °
- ?,d - p ?•?!r
u
, X ,' ? V'"J
X ? I
I ?
?
ff
?
x
I IA= A= A= Sq.=t.
Total Wall Panmeter Height Area ?
4 Cq
??`
C.c U.
t?? •0
t co'v
0?.7a
L? ?
?O? ?,?
a.
.?
.,
. ,?
BuWx Nrr? _
Bui?[M?ass .
Bubrglb&m
bLOm?QOG 9j _
CdHrqs, Sky**rtt, and Flaan Ovet Dvtside A'r r?t,aor? s?ys?x
? R-'h4e ;?Vete
?.ca..aN..?
cd:v I ? I -
sxr°?" ? r
i i
? I
F100f! iRd FO?1?it10(CB
Aran a 'rwUhxx"
o?.enr pl'hlM ?aD11
unaivmn
Fboc Qer lrcaxrtoned bDWe - - - -
p ? -
/
8t1CKYt Ybl P I
lhtrOed SRD R I -
FbAid 56E ? I
QYw 9Dam V" !' I
Take-Off Workshost
• u
6-acD i
Weils, V?docr3, ?nd Dooro r?,,?,n c:?ow
-._-'---- . Arva F?'?i1?,e LLVaL?
EquOment Etf 1dercY. Ma,eaw mar W brt a" rt rn rear at e. Wmn tix hahuac'?. ea+ornc*c)
- .1 a AFttnWF
?
aoft
? Y?YtkkbeeltpiaeDnr
,, .
MNCheck COMPLIANCE REPORT
Minnesota Energy Code
MNCheck software version 3.0
CoUNn': oakota
STATE: M1nn250ta
ZONE: 2
CONSTRUCfION TYPE: Single FdRllly
DATF: 5-15-2001
TITLE: REMODEL
PROJECT INFORMATION:
STEVE & KRIS RASMUSSEN
COMPLIANCE: PASSES
Required ua = 113
vour Hame = 99
12.8% aetter Than Code
Permit #
Checked by/Date
Area or Cavity Cont. Glazing/DOOr
Perimeter R-Value R-Value U-Value UA
------------------------------------------------------------------------------
CEILINGS 606 44.0 0.0 16
WALLS: wood Frame, 16" o.C. 596 19.0 2.0 33
BSMr: Conc. 3.5' ht/2.9' bg/3.5' insul 147 11.0 0.0 11
GLaztNG: windows or Doors, above Grade 100 0.310 31
FLOORS: over Unconditioned Space 320 38.0 0.0 8
-------------------------------------------------------------------------------
COMPLIANCE STATEMENT: The proposed building d25ign d85cribed here is
consistent with the building plans, specifications, and other calculations
submitted with the permit application. The proposed building has been
designed to meet the re uir ts of the Minnesota Energy Code.
auilder/oesigneroate
CITY OF EAGAN
3830 PIIAT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
990W«???":?
WORK DESCRIPTION
kESIL????,Tf?.,? PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE 1
TOWNHOMES/CONDOS WHEN PERMITS ARE REQOIRED FOR EACH UNIT.
NEW CONST
ADD ON ?
REPAIR
OWNER NAME: d? ?6io
FEES
SITE ADDRESS: hrL)S ?ewz?c
_ IAT:121/ BLOCK ? SUBD. -
INSTALLER: A/?/C/'Z,?i?U.
ADDRESS: ?/°L '?J' 72
CITY:ZIP:
PHONE #: "?` //
SUBTOTAL:
STATE SURCHARGE:
TOTAL:
DWELLINGS &
$15.00
24.00
6.00
3.00
$ /SS eb
.50
$ /S4-
le 94?
SIGNATURE OF PITTEE
731 /9 S 90' ,qk xlc_?
PLEASE COMPI:ETE THIS PORTION FOR ALL COMMERCIAL/INDIISTRIAL BUILDINGS,
APARTMENT BUILDZNGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING IINIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
IAT: BLACK _ SUBD.
INSTALLER:
ADDRESS:
CZTY: ZIP:
PHONE
FOR:
CITY OF EAGAN
FOR CITY IISE ONLY
PERMIT #
RECEZPT # /D
DATE: ? S .;2-
FEES
ADD-ON MINIMUM
HVAC 0-100 M BTU
ADDITIONAL 50 M BTU
_ GAS OUTLETS - MINIMUM
OF 1 PER PERMIT
18 OF CONTRACT FEE.
STATE SiTRCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED BIPING - $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE $
TOTAL:
$
(SIGNATURE)
? 98
RE91 EP)M :
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
TCA?.
PLEASE COMPLETE UPPER POR2ION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION
NEW CONST
ADD ON
REPAIR
OWNER NAME: C. i?. ?a 1-I r 1dC__1Q
SITE ADDRESS:q IO'-) anrrsc
LOT: 0?1 BL^CK d SIIBD. 6
INSTALLER:
nnDRess: 9303 Plymouth Ave. Na
uulurli .
CITY
ZIP:
PNONE #: 5-4/c2 'II ??L
FOR CITY USE ONLY
PERMIT #
RECEIPT # /O 5
DATE:
FEES
ADD-ON MINIMUM $15.00
HVAC 0-100 M BTU 24.00
ADDITIONAL SD M BTU 6,00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
SUBTOTAL: $ty / 21
STATE SURCHARGE: .50
TOTAL: j
SIGNATURE OF ERMI TEE
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL SUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLSNG IINIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: SLOCK _ SUBD.
INSTALLER:
ADDRESS:
CTTY: ZIP:
PHONE #:
FOR:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING = $25.00
$25.00 MINIMUM FEE.
CDNTRACT PRICE x 18
STATE SURCHARGE
TOTAL:
$
$
(SIGNATURE)
CITY OF EAGAN
? 1991 BIIILDING P IT APFLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MiTLTIPLE DWELLINGS C02IIiERCIAL
2 SETS OF PIANS 2 SETS OF PIANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PI2;NS
1 SET OF ENERGY CALCUTATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 1 SET OF'ENEAGY'CALCS
_# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES RHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS $EQUESTED ONCE PERHIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LATS - CONTRACTDR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PRDCESSING TIME FOA SEWER fi WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST 5HOW A LICEN5ED PLUMBER.
To Be Used For ?. Valuat ion: Date:
? bkause-
dd
LAMK- '
ress
Site A
(?S IW i? v OFFICE, IISE ONLY
L
y(L 00D
I.oc ? slock 3 FEES
Occupancy R•.', Hi -1 Bldg, Permit 75t)'00
Zoning [;z -I Surcharge p' op
Parcel/Sub Actual Const V-N Plan -Review , 3:?7, 00
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" Allowable y-N SAC, City ((}DRo 10
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Owne
,
K
; Inlm2s # of stories SAC, MWCC 6 1-1m,Ue
Length '-IL- Water Conn. (,GO,c-
Address ' f Depth !/?l Water Meter r5, ct3
1?Q
5%7 S.F. Total Acct. Deposit 30,co
City/Zip Code >L?S 0 l
-r PV?/x
X3 Footprint S.F. S/w Permit 30.00
S/W Surcharge ,S--v
??? q (ZZ
Phone On site sewage Treatment P1. P)6.ao
On site well _ Road Unit 3 7p,oo
Contractor MWCC System ? Park Ded.
City water ? Trail Ded.
Address V?0? S,?S?l - 1 h
t? a_ FW- PRV Copies
City/Zip Code?t?A-RStA Booster Pump _
SIISTOTAL
APPROPALS Penalty
Phone Planner Lot Change
Council ` TOTAL
Arch./Engr. Bldg. Off. (?i 7e/91 Q5
Variance
Address ?%k(? R?,U-Q-1?? Gll?•
City/Zip CodeqVv`vt? v?{A
Phone # - t5-
S /Water Licensed Contr.
z .. e. agrees that all wock shall be done in accordance with
(Signature of Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Cities Digital Qualitv Control
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GENErr=;L TnicpF:r..A?ION
'r`Jo+e: ;he section dasigri:t:orzs ("?er_tion Fl-, "Sect.i.on F" etc.) are for
convenienca in ca;.rulations only, and are r,ct rF?ated from or;e _et nf
calcula*:ons bzlcw to t;-;e :ne;:t.
1. $ldg, itia?1_
Sect i o;'i D F'°rimeter „
Section A :
Section Et :
SBCt_C;n C .
144
0
3ross Wall Arca
-:a1l heights, = Area
greund to eave
14.58 = 2099.52
f) - r>
_ 209'3. c"'
... uuild>ng r;imensi.er;_=_ Fioor cr
Cei:ing
Length :, Wiuth = Area
SEC t1 o!'1 a : , o b - 60
Section R , nr':J 26 _ 1040
SE'CtiGI'i C . .. :i = .
_2Ct1 O;l r? . c-j (_) = f ?
t C='Cl TiOGY" r. C' CB1 l1^u =t-c.3 = j 1:_}r_."
... Rim Jcist reri:r,cter = 144
F'lOor -O15L 2 48" - - 1-;?? cr. S6rrl?, -
. ? .
,.:.., 'oi ac ?Area. _
4. Dcor=_
Arec;: .,.-'.._ 7'hic4:..;.-_as ,.n:!;e==_.1:
r•=. imeter . ; eet` _
TYP° of cor.=_.tr:;ctic:n:
5. Total doc;r': ,,rrir::eter: r;
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0
.. G:ii:do!'S glc',_-. c,. =n ,`:jFi} - 125.5
Tupe Heinht . Leng+!-: .. ".lu:rber- = 7oca2
(fFCt) !feet? units SqFt
S. F'atio Doere 6.3 _, ? 40,8
1. Atriu?c:
10. FirEplace area
!..:.d*n: :, "eigr,t: C>
.TOtal Sq =±
il. E;:posed Fac;nda*ian
Hei.^,ht area v: 0.67 Per;.;ater area Ae 144
Sq Ft _.. __. A = qb. ;S
E::posed c.,undati=rn
Height arca L;: =r ;='e: ;r,;:_ter area B: C)
Sq F't area 8 = ra
i^. Sq F'c i.; factvr U ,. A
Grn=5 .ve.11 area 2099.52
nxi rus?
W1':C'JCtW 2;"Od I25.5 0.52 65.26
Fatio door area 40.2 0.47 19.13
Atrium area 0 0
F;im ;oi=.t ar-ec, 120 0.041 4.92
L''C!O;`- arE-' ; 43.8 0.14 6.1a
i=irepl"ce ar-er.. - -- p
Y.)tPCSEd .....,nCI. " 9b.•-';a 0.:4
.
13.51
? -rasr;ing aree. 279.952 0.045 1S.95
er.u=1E.
oca1= For r:et ainil: 1402.408 0,043 62.91
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16. L1C1 St A1'ea (1'_%°! C7' C°3 l_:"iC a. .?-:t) = - 110
17. NEt. CE'1111g a, ='? ( -irC.s... CF:.1 .:=:f"'E•2 - jo1s* £tl'.E'a) = 90'i
18. U c2iiing: 0.0:=1 ., Pdet: ccil. area = 20.79
19. lJ 4ram;-_, 0.024 ., Jai=,t a. °a = 2.64
20. Tc<t_>,l nr' it=m 18 :, item 19 = 23.43
21. _.. os_. iei'.i, a,r:?; :. ?'ac`o- `•:-;.c?v = +? .. r=: , code
f 6iJ.tc'1' 1 s • . 26 .or Fi "j. _.ntile . at7il 1 y & l:?:p:.Ci:
.033 IL;Y' F-: BCl^' C:y.I.l°°' i'9a;.C°:lt).2l
.06 `QI"- nther I_iuii.:J:;;ys
Facic-,r . _ .. i,, 00..
EtT! IF{ ? . 28.6 !'7L'•ST i{r . OF' _ 27.43
(C21cuI6ied 2bcv2}
5 ?
?LL
fITION
SiVfl
SHLTIdN
RIl'9
JOIST
FDN-
U YALUG ?t+?..?•••,??_,.._
Inside air
Interioc ?
Insulatio.
Sheathing
Siding
Outside air fi]m
U YALCI
R?.
film
.45 (fr'all ) U
?1
19.?
•
2.06
.67 .
'--1--
R TOTAL •
?
_ 23-3
Cnside air film
.68'`: .
tnterior wall (Framin9l U= 1=
Stud - 6 ° 6.50 .
; R
2.06
Sheathing
..67 , .095
Sidin9.r
outside air film '- 7 --
R T0TAi. 10'53
-Intecior air film
68 '
19 00 . r ..
_ Insulatioa? Rirm Joistl
1 88 l Q = 1 =
ynch soft woa R
2.06
_ .."'-
- Sheatttin9 ; .
.67
?Extecior kall coyering _ -?1
?
- Exterior air film -17
` _----
R q'OrPAy ' 24.46
Interior air film
Insulatian
5.00
8 (Foundati
'
on) U = 1 =
1.2
Foundation (12 " Block) R
Exterior ait film
.17 .
- .14
R TC'PAL '`_
= 1 =
R
.043
,
CEILING WITH VFZSPED ATTIC SPACE AHOYE
, . . R VALUE R VALUE
FRANINV CEiLING
0.61
36.00
4.38
Ai[ Film
rrs„t ation
Joist
0.61
44.00
? .56 Ceiling .56
0.61 Air Film 0.61
41.55 Total`R : '45.78
.024 U = R .021
`CATHEDRAL CEILING `
R YALUE 'R-.VALOE
= FRAMIIIG ' "; CEILING
0.61 Inside air film 0.61
.56 Ceiling .56
14.375 Joist(Spacer) -
- Insulation 33.85
- Air Space .50
.67 Roof deckirg .67
.06 . Felt .06
.44 Shingle• .44
0:17 Outside ai[ film"c 0.17
16.88 ' . 7bta1 R 36.86
.059.
R U , :...
.027
Windov infiltration .5 cfm/lineal foot of crack
Residential door infiltration 0.5 cfm/square foot or door and min;m,m code req,;rement
Nomresidential door infiltration 11.0 cfm/lineal foot of ccack
Ub 12" concrete block no insulation =.781 R 1.2q
double glass = .52
triple glass = .31
All exterior r,*al.ls and ceilings must have a vapor bacrier (0.10) perm m;x.?.
Yapor barrier must be on the inside (heated side) of vall.
Vapor bariers of the polyethelene thin film have no R value.
411?dtV oF eagan
e
PATRICIA E. AW.ADA December 12, 2001
Mayor
PAw BpKcEN ' BOARD OF ARCHITECTURE AND ENGINEERING
85 E 7TH PLACE #165
PEGGYCARLSON ST. PAUL, MN 55101
C7NDEE FIELDS
MEGTILLEY Attn: Pat
Council Munbers
RE: 4105 Penusylvania Avenue
Altered Engineer's Letter
THOMAS HEDGFS
CiryAdm;nisvacor Deaz Pat:
I received the enclosed two-page document from Steve Rasmussen (homeowner
/contractor) after a City Building Inspector requested engineering specs. for the repair of
Municipal ceo«r a cut truss on a building addition at 4105 Pennsylvania Avenue.
3830 Pilot Knob Road In reviewing the letter, I noticed that a portion of the front page had been voided out. I
Fagan. MN 55122-1897 contacted James Krech, Engineer for Krech, O'Brien, Mueller & Wass, Inc. regazding this
Phone:651.G81.4600 and was informed that this letter was written for a different project. Krech, O'Brien,
Mueller & Wass Inc. had not teviewed, or written, any letter for the project at 4105
Fax:GSl.681.4Gt2 Pennsylvania Avenue. Tom Korte, Planco Inc., appazently gave this letter to the
TDD: 651.454.8535 homeowner as an example.
In talking with Mr. Rasmussen, he stated that he thought because this letter was similaz to
Maintenance Faciliry: what he needed, it would be "good enough". Neither Mr. Korte nor Mr. Rasmussen will
3501 Coachman Poinc admit to altaring the letter.
Eagan, MN 55122
Phone: 651.681.4300 The City has requested the homeowner to discontinue work, provide signed engineering
specifications, and call for a safety inspection of this addition.
Faz: 651.681.4360
TDD: 651.454.5535 Sincerely,
www.ciryofngan.wm
J ff VJheeler
Building Inspector
JW/js
THE LONE OAKTREE
Thesym6olofstrengd, cc Dale Schoeppner, Chief Building Official
and grrnnh in our
wmmuniry
ities Diizital
ity Contro:
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PLRqCO INC.
'M:EKRECH, O'BRIEN,
611$ CahilJ qrenue . Inrer Grove He? hts ¦
? 651 .451 .4605 • iaX 6:1.451 0917 0esot8 55 76
MUEl.L;ER
• komw?kam?y,eom •
, www.kpmw eom
1015 ui,2
?lOj ?.s.s-N SyGV,yai%f /3u?
Tom KoRr S Jit?i?,,,.
Pkncv. Iac. R/I Sl,'.au SSw'i?
3435 Wa.slytqpn Drive
Fagsa, MN 55122
Q O i oL42Cj_
DeaT Mr, Knrte,
At yaur nRUCsz. this office haz smu,-curally reviewd the two a
above noted residence. No other azras ofthe home vrere review
included drawings and sketeha faxed by Plance
Copy
trusws a+id the 2x12 laeader
Documeau avaiiabie for rev
Tbe trusses shall be sheathed both sides with '/z" eheathing from the header to the next web
wEticfi is about 32^ away. ne CXisting sheathing can remaio as lo
A11 e.dges shalf be nailed with 8d nails ai 4" r',as alt jaints have Solid
o_t.. ,
The 2x70 header is adequa[e co span the4ft opening.
n1e1DtbrnllnOn and vP"ions contained hetein are b
be &?g of t}qs repurt, HQ ased upon the
ulLknown coaditions aot w?ntias are c?cyr?,yed or implied ri
en in ???[y ??? ? a'Ork is in acc
?eer8 ytandards and is noc in[rnded co be nelied upon or ttans
addressee. Shonld infornisiioa or conditions beeome knnrrn which
they may aI[er the opinions or macy,sinng of che undersigned.
Sincerely:
2e?Aak
a ?
K?!t. O'Sliai. Mudta & Wass, iac.
ffYau shoWd have any questions or require fuKher. inFormation, p1e
FaX 651 _ dS3_ 3659
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i investigacion dauibed rhe
8 the cxistence ofaher
_ WiEb S?aliy accep[ed
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fNIS ORA4)ING ]S FOR RfPA1R 1XFOpMAT164 OBLY OF a PR'$V10USLY
iN61HEER[0 DESIGW. S[C OAIGINAL DRAWIA6 Fop TRUSS DES1611 AND
ffIFOANATION #JOT SHOW;1 OM TN15 DRAHING.
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:ro valti ixe( euAirs enrt ens +[eruex;e c1 IUIUTUI OY fNl\ 1?,4'AId4.
CLIP A'•q" OFF OF fNE L(F1 EHO Oi TfiUSS. ADi) 2X4 WE85 AND
FAST[N 411iH GUSSEFS AS SNONH ANO I90TED, CLIPPED EUD TO f!E
SIIPPONTED BY HEAOERfDEAW BETHEEN TWO ENGItVEEAED GIRDEA TBUSSES. ?
GLUE GUSSETS NITH AFG-D) ( e.g, PL 400 ) SiRI1CTUqAL AONESIVE p
AS PEH FIANUFACTURCRS' SPES)FICAT10N5. ? a
USE 15J32, 32115, APA RATEO SNEA7NIRG ( PLYN00D OR OSB ) SIiEd ;n
ABD PLACF.D AS SHUS711. UNLCSS OTiIERWISE A07ED GUSSEIS ARE TD BE N
PLAf,EO ON BOTIi SIOES OF TAUSS UftIT AND FASfENEO NST11 Bd IIkSLS J
fROM AOlfl SIOES 1N All MEKBERS ( 3° q,C. - Z R01(S 1 STAGGERED. „
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T'OT.ID. 57.0 PSF
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SURVEY Fafl: C.P. Prn•triclgr, Ilomes inc.
DESCRIBED AS: I.ot 21 , Illock 3,S'I'AFPORD PI,ACIi, Ci ty of liagan, llakota County
Dlinnesota ind reserving casements of record.
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LOT SQ. FDOOTAGE _
PROf'OSEU ELEVA I IONS
Top vl Foundatlons
Garage Floor e qn?,q
Dasemant Floor
Approz. Sewer Servlce Elav. eu,3.21,•_
Proposed Flevailons ., O
Exisling Elevntlons
OrelnegeDireclbns ?-..._r
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MIN. SETBACK REOUIREMENTS
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9}01 EnI 8MOm1n010n frtYr?r. O?ppn?lrq1tm. MMM?CI? SS?A
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OF 111E BOUNDAfIIES OF INE 1180VE UESGrIBED PIIOPFt1IY AS SUfI-
VEVEDBY MF, OIt UNDEII MY DIfIFCi SUPEqVIS10NAND OOESNOL PUf1P011i
TO SIIOW IMPIIOVEMENfS Of1 ENC(IOACIIMENiS, E%CEPT !13 SIIOWN.
oau L0_r22r,2L ?? ?? l?t ??.•
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MINNES TAI.iCF.NSFNUMPFI1N77A
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JOB NO.:
91R-426
BOOK: PAGE:
CADD PILEIDWO. CHK.
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' LAncilor's G'ert?ficate
SURVEY FOR: C.R. Partri.dge Homes Tnc.
DESCFi18ED AS: Lot 21, B1ock 3,sTnFFOan PI,nCL, city of F,agan, llakota county
Dtinnesota and reserving easemeitts of recorcl.
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EAGAN ERTGI1dEER%RIG
PROPOSED ELEVA f IONS
Top ol foundations = '.1,;;,Z
Gerege Floor =
Basemenl Floor =
Approx. Sewer Servlcs Elev. - qoa.x?t
Proposed Elevallons . Q
Exisling Elevallons
brainageDirecllons
Denoles ollsel Slake = O
IAIEDLIlND
Planning Fngrneering Surveying
9A1 EW Bleomirpl? F?eew?ry B1?1on, MmMwl.55,]0
Iele0?0?? R131 ? ?
I
SCALE= I Inch = 30 Feet
6ENCHMARK. Tuu@ 303?
' £jeu- 915-79
MIN. SETBACK REOUIREMENTS
Front • so House Sida - lo
Rear - is Garege Sida -s
IIIEREBVCE11iIFY 11U1T71IISISATIIVEANDCORRECTREPIIESENIIITION
OF 7RE BOUNU4AIE5 OF iHE ABOVE DESGnIBED PqOPERtY AS SUR-
VEVEDBY ME OIl UNDER MY DIIIECT SUPEAVISIONIIM] DOES NOT PUIIVORT
TO SHOW IMFOOVEMENIS OR ENCf10ACHMEN73, EI(CEPT AS SHOWN.
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MINNES TAIICENSE NUMBER 14978
JOB NO.:
91R-426
800K: PA(3E:
CADD FILE: OWO. CIiK.
Rl,sc 91-2
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For Office Use
} of Ea~d 1 Permit City
Ina I Permit Fee: tJ -
3830 Pilot Knob Road Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I
Fax: (651) 675-5694 1 Staff:
c_ 2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: l O 3 _ 7,1S (ice n om- /
Tenant: j Suite
6112
RESIDENT/ OWNER Name: &%V420L1i. rJ Phone:
J
City / Zip: /2L?#h AI.S VG +'~I~~ ~
Address / Applicant is: Owner Contractor
TYPE OF WORK Description of work: C'
Construction Cost: Multi-Family Building: (Yes / No
CONTRACTOR Name: 2 License
Address:
City: State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
('1 submission type) • 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 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 they are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
X /uL, ) _t x
Ap licant's Printed Name Applicant's Signature
Page 1 of 3
Use BLUE or BLACK Ink
r-----------------..,
I For Office Use
I I
~ Permit j
City of Eali~d
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
I I
Fax: (651) 675-5694 i Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: S~bfy Site Address: Unit
W
C> f l~ Phone:
Name:
Resident/ ( 1 ~'7
Owner Address / City / Zip:
G. li L J a/
CA,
j Applicant is: Owner Contractor
Type of Work Description of work:
Construction Cost: Multi-Family Building: (Yes / No
.
Company: Contact:
a
Contractor j Address: City:
State: Zip: Phone:
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
wa_,z
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets. s
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.goaherstateonecall.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 of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota Stat Building Code must be completed within 180
days permit issuaE/~- x
/c~_'~A x
A l
icant's Printed ame App ant's Signature
Page 1 of 3
RELIVED For Office Use
;�i ::::e:
llza,
E AG AA tsi JUL 10 2018
Ci
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 /�`
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: f�(al
buildinginspections c(Dcitvofeagan.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION Vk/ {)
Date: Site Address: Unit#:
Name: tA
Phone: C7 1? - 32-633s
�"l� V�J
'1,0w-her � (7 ger � Address/City/Zip: � 3 rS f �
Applicant is: Owner Contractor
ofwork: fz t'7 - to h 4-01c
"Type of Workc� M - t"
Description
�1 �f L
Construction Cost: Multi-Family Building:(Yes /No ) 4
°WI
Company: Contact:
74
Contractor £ v
Address: City:
State: Zip: Phone: Email:
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
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:
Fire Suppression Contractor: Phone:
NOTE:Plansa,d supporting documents filet submit are considered to rebnt�tusn . rt onsry�
�fhe mformatr
class fiedas non dblic if Yourovide eg47c reasons Oat Would permit the"Crty ovconclude thatnthey are trac ecreti
p . . .. mix£.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.com/subscribe.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
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.aooherstateonecall.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
ac rdance with the approved plan in the case of work which requires a review and approval of plans.
'NA
Applicant's Printed Name Applicant's Signature
DO NOT WRITE BELOW THIS LINE 4 0-) ec t c I S` t v' '-, fie" D q )'
SUB TYPES
Foundation Fireplace Porch (3-Season) _ Exterior Alteration(Single Family)
_ Single Family Garage _ Porch (4-Season) _ Exterior Alteration(Multi)
Multi _ Deck '1,, Porch (Screen/Gazebo/Pergola) Miscellaneous
01 of_Plex _ Lower Level _ Pool _ Accessory Building
WORK TYPES
_ New _ Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows Demolish Foundation
_
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION Valuation LifQo ° Occupancy --(r MCES System
Plan Review Code Edition ► }3Q/S' SAC Units
(25% 100% ) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final I C.O. Required
4 Footings (Addition) y Final I No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Hood
Roof: _Ice &Water Final Pool: _Footings Air/Gas Tests _Final
N Framing Ni 30 Minutes 1 Hour Drain Tile
Fireplace: _Rough In Air Test _Final Siding: _Stucco Lath Stone Lath _Brick EFIS
Insulation Windows
Sheathing Retaining Wall: _Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: _Rough In_Final
Braced Walls Erosion Control
Shower Pan ��}} Other:
Reviewed By: 1---2i , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge q /)(P. 5-"b ---, 4--/
S&W Permit&Surcharge /
900
Treatment Plant
Copies
TOTAL
Page 2 of 3
. is_ i / 21
, ,
SYnicqor'secrtiflcate
, 2
SURVEY FOR: C . R. Partridge Homes Inc .
•
DESCRIBED AS: Lot 21 , Block 3 ,STAFFORD PLACE, City of Eagan , Dakota County
Minnesota and reserving easements of record.
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EAGI4isT ENGINEERING DEPT
PROPOSED ELEVATIONS BENCHMARK, TN11 Q, 30,31
Top of Foundations m .,1,. d Flet,: 415.79
Garage Floor = qNb,4
Pr
Basement Floor m(113.co
Approx. Sewer Service Elev, s rto3.24.t
Proposed Elevailons a MIN.SETBACK REQUIREMENTS
Existing Elevations -
Drainage Directions c.�,,,, Front 3o House Side +o
Denotes offset Stake 0 Rear-15 Garage Side -5
SCALE, I Inch = 30 Feet
JOB NO.:
• 1ERESY CERTIFY THAT 11116 IS A TRUE ANOCORRECT REPRESENTATION
IIEDLIIIND or HIE 130UNDAMES OF THE ATIOvE DEScRIBED PROPERTY AS SUR-
ToYS11oW I PRUNDER MY OVE tEN S"OR ETSUOACN, S,EXCEPT S PURPORT
WN 91f�-428
BOOK: PAGE:
Planning Engineering Surveying 7 q (\ � jf\�
Eq1 Mloornl.lo Rhtzn rfloetnplon.M7nnrsels 55470 OMNI 10/2.Z/ /' LJ. (71.4, 11-
9701 1.k^--
leMpnene ltl9s6�07 ♦ ,
Y 0 NO(3REN,LAND SIONEYorl CADt)FILE: DWG.CHK.
MINNES TA LICENSE NUMBER 14978
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA177916
Date Issued:07/25/2022
Permit Category:ePermit
Site Address: 4105 Pennsylvania Ave
Lot:21 Block: 3 Addition: Stafford Place
PID:10-72500-03-210
Use:
Description:
Sub Type:Air Conditioner
Work Type:Replace
Description:
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Kessete B Woldekidan
4105 Pennsylvania Ave
Eagan MN 55123
Haley Comfort Systems
3708 Broadway Ave N
Rochester MN 55906
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature