1504 Pinetree Tr952 445 7487 Line 1
1,111 City of Eapli
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Tenant:
03:31:36 p.m. 09-15-2011
I VI VIIIVC UDC
Permit #: /a
Permit Fee:
Date Receiv
Staff:
1 /1'1
53:0a
4:919/'
2 11 RESIDENTIAL PLUMBING PERMIT APPLICATION
Site Address: /560 " /Cj,v, - /Z sl %✓.2t1
Suite #:
;:• . elli' '''' - OWfNER: i
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Name: /%%i4GG fi/ d 4' 0. Phone:
Address / City / Zip:
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Name: 1 .* d✓ to Aa /G4fL d.icense #:
Address: ./
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State: / Zip: S .S .3 77 Phone: 9 _$ �7 S”' 7 `7 .L
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Contact: / Email:£�a at4t✓hA¢.c_�t�./4ra�0.G•CO"�
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— New _ Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Description of work: s%'/ SST 6,9 -se i
1 l�,3!
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RESIDENTIAL
Water Heater
Water Softener
Lawn Irrigation ( RPZ / PVB)
Septic System
Add Plumbing Fixtures L Main Xiower Level)
Water Turnaround
_
New
_ Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation (includes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtures, Septic System Abandonment Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $166.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
$95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge)o n
TOTAL FEES $ 5
CALL BEFORE YOU DIG. CaII Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
CaII 48 hours before you intend to dig to receive locates of underground utilities. (www.gopherstateonecall.orgi
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 ns
Applicant's Printed Name
x
Applicant's Signature
Reviewe .E
utrea Inspecon
Address IIJ? r k-e Zip 55123
Lot -2-1 Blk -'? Sub -e -C Ru, S 5
T[-ESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry) '
Permanent driveway
Permanent gas
Sod/Seeded grass
TraiUcurb damage
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contraaor Copy ?
E IDENT AI L ??J ? 5 3? 5 1
fi l0?k 3 BUILDING` PERIIIAIT APPLICATION
?
?? ? ? `" ' CITY OF EAGAN m p 5315 3 -70 ?o
?', 3830 PILOT KNOB RD - 55122
I I net-'ee 651-681-4675 50
lJew ConretrucUon Reauirements RemodellReoalr Reauiremenri.--------
• 3 registered site surveys showing sq. ft of lot, sq. ft. of house; and all mofed areas • 2 copics of plan 2
(20% mazimum lot coverage allowed) • 1 set of Eneyy Calculations Por heated additions ?J
• 2 copies of qan showirg 6eam & window sizes; poured fourW desilIn, etc.) . 1 sile survey for exlerior addNons & decks a. S3
• 3 p s of TreeP2servatbn Plan'rf lot platted after 717/93 ? ?/(/? ? IiMicate if home served by sepUc sys'ons ? co ^
• Pom Jalst Detail Options selecfion aheet (61dgs with 3 or less unNs) l 7 7! I? ?`?
DATE
JOB SITE
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
VALUATION I
PROPERTY OWNER
TYPE OF WORK Sr--D FIREPLACE(S) _ 0Y 1_ 2
APPLICAN444Ma. .td?,?l'JnrnW,crida1 PHONE#
ADDRESS
PAGER #
CELL PHONE #
_ZIPCODE
FAX#
NEW RESIDENTIAL BUILDING ONLY - FILL OUT CO Ly
Ener9y Code Category _ MINNESOTA RULES 7670 CATEGOR JUN 2 5 LUUZ ?;II
(check one) - Residential Ventilation Category 1 Worksheet mitted
- Energy Envelope Calculations Submitted ?_ t
By
MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Plumbing Confractor. L"P/o//(a&7i,n4l Phone 752 /`Y"`I"'J? J 7?0?1 Z
Plumbing System Includes: Water Softener Lawn Sprinkler ?Fee: $90.00
Water Heater No. of R.I. Baths
No. of Baths
Mechanical Contractor. Phone # 4('?'l,2
Mechanical System Includes: Air Conditioning Fce: $70.00
Heat Recovery System Sewer/Water Contractor: ? w Phone #
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Oroinances. •
Signature of Applicant G()"
if'5,1) C??0-4s1crl
Certificates of Survey Received 6;) Tree Preservation Plan Received _ Not Required _
Updated 2002
d-w ? l ?
OFFICE USE ONLY
? 01 Foundation ? 07 OSplex ? 13 16-plex ? 20 Pool
02 SF Dwelling ? 08 06-plex O 16 Fireplace ? 27 Porch (3-sea.)
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.)
? 04 02-piex ? 10 08-plex ? 18 Deck ? 23 Porch (screened)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35
32 Addition ? 36
? 33 Alteretion ? 37
? 34 Replacement
Valuation
cer,sus code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
jq4(7 0 O
1 ??!
r^
?
. •J ?
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 EM. Alt - SF
? 36 Multi
Int Improvement ? 38 Demolish (Interior) ? 44
Move Bldg. ? 42 Demolish (FOUndation) ? 45
Demolish (Bldg)* ? 43 Reroof ? 46
*Demolitlon (Entire Bldg only) - Give PCA handout to applicant
Occupancy &?tlt MC/ES System
Zoning ? City Water
Stories ?Booster Pump
Sq. Ft. ?A. -7 c3 PRV
Lengt ? Fire Sprinklered
Width
? Footings (new bldg) ?
_ Footings (deck)
Footings (addirion)
?C Foundation
Drain Tile
Roof Ice & Water Final
y? Fraxning-
? Fireplace A R.I. ?L Air Test?/ Final
? Insulation r ? ^
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Suppiy & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
D INSPECTIONS
? FinaUC.O.
t
Siding
Fire Repair
W indows/Doars
T-
?/ ?
r
_ FinallNo C.O.
_ Plumbing
_ HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
Siding S[ucco Stone
Windows (new/replacement)
? Reqining Wall
Approved By Building Inspector
?
------------ - - - - - ---- - --- - - ----------------------------
0O
?r..
/ o0t5-L?4
2-yO,6c?
/564 ge7?wdi !":3- 3,cc.1- Sut"P
On n(1LI 15, 2000 ii":c Mi;ir2S618 COZf?V COCB, C.a?ey nr 12U!!?"1g r1-cqUi!cm°fliS fOf Ifl'oUldii0fl ?lOi?Ci.?•i,, c.i
tIChf(1c35, ufld V8f1i118i1Of1, W85 @dQ0t2d ?S 3 fcSl.'If, fh2 rIT1 Of CE3gi^ IS (9CU1'Li0 Ch7i If19 f01!QV;Ic'"y ifii0rfi'•3:0f? DC
SUO,Tdi;e?? Pfluf i0 ISSUn(1C° G( a CBtiliiC2t2 01 L'CCUpdi^C;l.
This shucture: is construc?ed io meat minimum requiremems of lne tiin Er,2rgy Coda, Chzpler 7670
OR
71? Tnu struc[ur2 will be ccnstruczc !o mes! mor2 restrichve reGwr2ments oi Chaolars 7072 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTLI'S VENTING TYPE
b'laler Hea?ar OSrr'h 0o PVC,
Fumac2 k7T ? D ?2
r
Dryer
VENTED
EXHAUST SYSTEM LOCATION TYPE MODEL CFM's ves No
Kitchen kitchen
Bathmem 1
8athroom 2 5T82 2 ? 0 01 0
Balhroom 3 ? 51
Bathroom 4 10 5? ET .,O
r
Otner /? F 1
l, J// ?1
FIREPL4CE S
LOCATIOPJ
GAS
W00?
MANUFACTURER
MODEL
6TU'S 4ENTING
oiaecr aTMOs
&MIL-9 ??Vv
MAKE-UP AIR MODEL TYPE CF.M's
E ';2 . c' ,? .?:2-cSo
1 hereby acknowledge Ihat the above information is correcl and agree to comply wilh the Minnesota Energy Code and City of Eagan
requirements.
?
Sign re
- 5<7"?Q"4?
Company Name(J
lo a 5 -a?
Date
' This form is the responsibiliry of the General Contractor.
.
i9NCheck C0;9PLIANCE REPORT
Pdinnzsota Energy Code
MNcheck Software Version 3.0
COUNTY: Dakota
STATE. Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Family
DATE: 6-10-2002
DATE OF PLANS: 6-10-02
TZTLE: CARIS & LAI MACCARONE
PROJECT INFORMATION:
CORNELL "B"
1504 PINETREE TRAIL
STONSCLZFFE
COMPANY INFORMATION:
LUNDGREN BROS. CONSTRUCTION
545 INDIAN MOUND EAST
WAYZATA, MN
NOTES:
8' FOUNDATION
FULL BASEMENT
BAY AT NOOK
CUSTOM EGRESS WZNDOW
COMPLZPNCE: PASSES
Required UA = 645
Yowr Home = 523
18.9°s IIetter Than Code
I
I Peimit #
?
?
? Checked by/Date
?
Area or Cavity Cont. Glazing/DOOr
Perimeter R-Value R-Value U-Value UA
----------- 6
----------'------------------'-
CEILINGS 2071
WALLS: Wood Frame, 16" O.C. 21
WALLS: Wood P'rame, 16" O.C. 172
WALLS: Wood Frame, 16" O.C. 111
WALLS: Wood Frame, 16" O.C. 1195
WALLS: Wood Frame, 16" O.C. 179
WALLS: Wood Frame, 16" O.C. 1405
BSMT: Conc. 8.0' ht/7.5' b9/8.0' insul 1327
GLAZING: Windows, Foundation, <= 5.6 ft2 29
GLAZING: Windows or poors, Above Grade 309
GLAZZNG: Windows or poors, Above Grade 195
DOORS 38
FLOORS: Over IInconditioned Space 144
FLOORS: Over Outside Air 87
? F ace 90.0 AFUE
44. 0 0 • 0 5
19- 0 2. 0 1
19. 0 2. 0 10
11. 0 2. 0 9
19. 0 2. 0 67
19. 0 2. 0 10
19. 0 2. 0 79
10 .0 0. 0 84
0.350 10
0.350 108
0.350 68
0.350 13
30 .0 0 .0 5
30 .0 0 .0 3
HVAC LQUIPMENT. urn ,
_______________'________'__
COMPLIANCE STATEMENT: The propased building design described here is
consistent with the building p1ans, specifications, and other calculations
submitted with the permit application. The proposed building has been
designed to meet the requirements o£ the Minnesota Energy Code.
IIuilder/Des Date
igner / ???'' //'?'=" /? / ??
i
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,
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??.TREE PRESERI?AT?O? PL?i4Pt SUMM'? ?? ???
' g'? ? CITY OFLEAGAN FOR??$TRY DIVISIQN ?- "''?'????
hEl?t
=a.ss1 -6a1_a3oau = ..??:
(SEE ATTACHMENTS)
Development
Lot Number ? Biock Number >
Address L S-C, 1? f N1s T-RIE5 r- 1 23" l l-
Builder i Ltt?>DG12?1? t?ZGS lc?'t.??t Tree Protection Requirements:
? Tree Fencing
Oak Tree Pruning (Immediately seal wounds during April 7 to July 31)
Therapeutic Pruning
Retaining Wall
Other:
Replacement Trees:
Not Required
As Follows:
Attachments:
?
Yes
No
Additional Notes:
EACaAN FORESTRV D@VSSSON
RENIEFft9ED
BY
D AT;E -7
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IOTCOVERAGE
LOT AREq =15.35I 5 F
HOOSE pREa= 2574 S F
H0115ECOVEPAGE•i6B%
JD 15 0 15 30 fi0
SCFLE IN FEET
LEGEND
Q OENOTESSANITARY M<NHOLE
14 DErvOTE3HY0PAM
Wi DENOTESCATGH643W
5 DErvOTESSANITARYSEWER
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ST DENOTESSTORMSE(ER
Q OENOTESSTORM MANHOLE
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NFC?. DENOTESEMERGENCYOVERFLOWSWPIE
SETBACKS
MIN FRONTYARpSEf&4CK=3P
MIN SIOEYhRDSET84CK=5' 10
MIN REAR YqRD SET8041i(=15'
I
PROPOSEO TOP OF FOlIN0ATI0N ELEVAI ION= 922 3
PROPOSEDGPPAGEFLOOREIEVPTON= 9219
PROPOSED LOWESTFLOORELEVATION= 9142
ALLOFFSETIRONSFRE MFASURED TO HpNCRE0TH5
OF R FOOT M10 CPN BE USEO AS BENCNMPRKS
p DENOTESIRDN
MONUMENT
% 0000 OENOTESEXISTING
ELEVPTION
(OOO O) DENOiESPROVO5E0
ELEVATION
- DENOTESOiaECiION
OF SURFwCE DRAiNAGE ?
4080 OENOTESSntJIinRY i
SEWER SERVICE EIEVATION
A TRLE OPINION wA5 NOT FURNISHEO TO TNE SURVEYOR
NOR WAS A SPECIFIC TITLE SEARCM FOR THE E%ISTENCE ON
NON-EXI5TENCEOFRECORDED00.UNRELOROEp 'EA3EMENTSCONWCTEDBYTHESURVEYORASPaFiOF II
iH15 SURVEY.
I nerepy fsnLy Nat Ws e a we ana conetl eaDre»mauon I
ol a survay of Ne bovManes m
LOT 3. BLOCK ], PwETREE Pq55 BTN ADITION
DAKOTACOUNTY,MINNESOTA
And Ihe boGOn ol all EmMin98. d any Ne., anC all vhSle
uoaCllm¢ntg, dBny. G001 o1n0 up IanU. PY surv8y¢CCy
melbist h UeyolJUne2002
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TREESUMMARY
E%ISTINGTREES=5
TREES REMOVEU • 0
DENOTESTREEttPE,
owri? SIZE.FNDLOCATpN
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8/10/D"[
SCALE
AS SHONM
JOB NO
5402.)f9
?
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPIICATION
PROPERTY LEGAL: Lp'r 3 tS I ?" CK _ 3 Piv1 L?rBPi PC?S? ??'41
DATEOFSURVEY
? lATEST REVISION:
rn
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DOCUMENTSTANDARDS
Y ¢
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Q
I u ? • Registered Land Surveyor signature and company
r"?? ?
? ? . BuikJing PermitApplicant
y
? u • Legal descnption
/ ? ? • Address
? ? . North arrow and scale
? ? • House type (rambler, walkout, splR w/o, spiR entry, bokout, etc.)
41 ? ? • Directional drainage avows wRh slope/gradient %
,Lx/? LI . Proposed/existing sewer and water services & invert elevation
? ? • Street name
? ? ? • Driveway
? ? • Lot Square Footage
yf/ ? ? • Lot Coverage
w? ? ? • Benchmark
ELEVATIONS
/ Existinq
D7 ? u • Sewer service (or Proposed)
i?? ? ? • Property corners
?? ? • Top of curb at the driveway and property line extensions
?? • Elevations of any existing adjacent homes
k( ?? • Adequate footing depth of structures due to adjacent utility trenches
? I_i • Waterways (pond, stream, etc.)
/ Praoased
V/ u ? • Garege Floor
? r • Firstfloor
??/ ? ? • Lowest exposed elevation (walkouUwmdow)
?f u !1 . Propertycorners
?? ? • Front and rear of home at the foundation
PONDING AREA (if aoolicable)
n / u • Easement line
? C?f/ Cl • N W L
? V? ? • HWL
rAI u . Pond # designation
? i_i ? • Emergency Overflow Elevation
/ DIMENSIONS
iY 7 L? • Lot lines/Beanngs & dimensions
?I ? • Rght-of-way and street width (to back of curb)
• Proposed home dimensions including aoy proposed decks, overhangs greater than 2', porches, etc.
/ (i.e. all structures requiring permanent footings)
I?! i.? ? • Show all easements of record and any City utilRies wi[hin those easements
i? i i n • Setbacks of proposed structure and sideyard setback of adjacent existing structures
1-' 11 • Retaimng wall reqwrements, rf any
Reviewed?? , yQpC? LI '-? /`.
Name ! Date
JUtA 2 6 nV9
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EAGAN EXGMFI?-
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TREE SUMMARY
EXISTING TREES = 5
, TREES REM1IOVED = 0
DENOTES TREE TYPE,
?r Oucu SIZE, AND LOCATION
-' LOT COVERAGE
LOTAREA=; 15,353S.F
- HOUSE AREA = 2.574 S.F.
HOUSE COVERAGE =16 8%
p DENOTESIRON
MONUMENT
X 000.0 DENOTES EXISTING
ELEVATION
(000.0) DENOTESPROPOSED
ELEVATION
r_ DENOTES DIRECTION
OF SURFACE DRAINAGE
Y 908 O DENOTES SANITARY
SEWER SERVICE ELEVATION
A TITLE OPINION WAS NOT FURNISHED TO THE SURVEYOR
NOR WAS A SPECIFIC TITLE SEARGH FOR THE EXISTENCE OR
NON-EXISTENCE OF RECORDED OR UNRECORDED
EASEMENTS CONDUCTED BY THE SURVEYOR AS PART OF
THIS SURVEY.
I hereby certify that this is a true and correct representation
of a survey of the boundaries oE
LOT 3, BIOCK 3, PINETREE PASS STH ADITION
DAKOTA COUNTY, MINNESOTA
And the location of all buildin9s, if any, thereon, and all visible
encroachments, 'rf any, from or on said land As surveyed by
me this 1?Ah day of June 2002. _
Gary R. Germond
Licensed Land Surveyor, Minn. Lic No 24764
30 75 0 15 30 60
SCALEIN FEET
LEGEND
QS DENOTES SANITARY MANHOLE
? DENOTES ITYDRANT
t
? DENOTES CATCH BASW ?
2
$ DENOTES SANITARY SEWER
W DENOTES WATERMAIN
ST DENOTESSTORM SEWER
?D DENOTES STORM MANHOLE
n DENOTES STORM APRON
5 !y 'I EOF-=> DENOTES EMERGENCY OVERFLOW SWALE
?
'7
SETBACKS
,g,
111:01 MIN. FRONT YARD SETBACK= 30'
CK = 5'
10'
ET
MIN SIDE YARD S
BA
,
'
MIN REAR YARD SETBACK= 15
?
1
6
??s s\
/
PROPOSED TOP OF FOUNDATION ELEVATION= 9222
? r'SJ PROPOSED GARAGE FLOOR ELEVATION= 921.9
PROPOSED LOWEST fLOOR ELEVATION= 914.2
?o
ALL OFFSET IRONS ARE MEASURED TO HUNDREDTHS
OF A FOOT AND CAN BE USED AS BENCHMARKS
SWO
?r,F{e4?in? W81?
as f1gquired
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CHECKED
GRG
DATE
6/20/02
SCALE
AS SHOWN
JOB NO.
5402-719
*City o[ban
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
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RECEt1!ED
S4:' 0 1 2011
Use BLUE or BLACK Ink
For Office Use
Permit #: /0/ o - l
Permit Fee: $
171f
Date Received:
Staff:
L
2011 RESIDENTIAL BUILDING PERMIT APPLICATION 70a 9194
/S ?4c- 7%cc aI'
L41 - Site Address:
Unit #:
Name:
Lot CA„,r
S IA" cCc. yeti. Phone:6,57— T `clayS---
Address / City / Zip: /.5-6V //14t, ,Zr Tri, � 9� 57.-57Z.
?
Applicant is: Owner Contractor
Description of work: 'r". -0'dd i -k\ v. --
Construction Cost: 4116ez9cs
Company:
Multi -Family Building: (Yes / No,,>0 )
Contact: 1farn 4i' w
Address: /5T( amu-` x \x v� city:
State: yo.) Zip: 5S 3 9? et Phone: 6/Z "f4/`/e/?O
License #: ZOG -3-7Z48
Lead Certificate #: r "%�r f -`E' 019
If the project i exempt from lead certification, please explain why: (see Page 3 for additional information)
--)(,..'( 1 ) - ( - - c) C-71 - D - "
COMPLETE THIS AREA ONLY W CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
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.gooherstateonecall.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.
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Applica is Printed Name
Page 1 of 3
Cfr /ra,/
DO NO WRITE BELOW THIS LINE
SUB TYPES
Foundation Fireplace
Single Family Garage
Multi Deck
01 of Plex Lower Level
Accessory Building
WORK TYPES
New
F Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100%j(
Census Code
# of Units
# of Buildings
Type of Construction
Interior Improvement
Move Building
Fire Repair
Repair
1-/;®oo
113L1
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water ,y Final
Framing
Fireplace: A Rough In Air Test
Insulation
Sheathing
Sheetrock
Reviewed By:
1
1
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
Y14/
TOTAL
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Siding
Reroof
Windows
Egress Window
//dq/
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
V2C.-MCES System
,2,c07 SAC Units
R -I City Water
/ Booster Pump
A? PRV
Fire Sprinklers --�
Meter Size:
Final / C.O. Required
Final / No C.O. Required
Ai_
HVAC Gas Service Test Gas Line Air Test
Other:
Pool: _Footings Air/Gas Tests Final
Siding: Stucco Lath Stone Lath Brick
Final AA Windows 7.'f ° Pi -A --
Retaining Wall: Footings _ Backfill Final
Radon Control
Erosion Control
G3Fr"
, Building Inspector
1At 1' An4001 01V 3Y./40
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Page 2 of 3
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41P11'
City of Eau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
1"73
4-7
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Vgeb
RESIDENT/
"OWNER: -
,
Site Address:
Unit #:
Name: ` 5 /«C /"q GD C' 41 fwd ja'C _.(.... Phone: 0,4(.5625/-91./....
Address / City / Zip: %J 6 .,/' rt../ J4-. 72a(,•(% -i2 Ki
pp
A licant is: Owner ✓ Contractor 0
TYPE OF WORK
Description of work:
Construction Cost: /5,600
Multi -Family Building: (Yes
/No
e�
Company: 1i,z.Lb_Z-/ Contact:
Address: "71,:;26, F46 L V"7 City: �i'!J4,6'
State: HAI Zip: ' / , Phone: 4C),i
License #: LI 6,135 ' 7 Lead Certificate #:✓t/4T .174`/37/7�J
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to, be publ.
the information maybe classified as non-
public if you provide specific,,reaso`ns the
conclude that they are: trade secrets.,
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.00pherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building • de must be completed within 180
days of permit issuance.
�r
4,0_77-71/
A licant's Printe Name
Appli
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA140294
Date Issued:12/07/2016
Permit Category:ePermit
Site Address: 1504 Pinetree Tr
Lot:3 Block: 3 Addition: Pinetree Pass 8th
PID:10-57667-03-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
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 -
Christophe R Maccarone
1504 Pinetree Tr
Eagan MN 55122
(651) 994-8045
St Paul Plumbing & Heating
640 Grand Ave
St. Paul MN 55105
(651) 228-9200
Applicant/Permitee: Signature Issued By: Signature