4912 Pine LaneCity of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: /
Permit Fee: / 0 5 -
Date Received:
Staff:
�
( 2012 RESIDENTIAL� BUILDING PERMIT APPLICATION
Date: (> 1 Site Address: 619 i B4 . CA 4 Unit #:
Name: S4 -e 15- -0 . r-
Address/City/Zip: e -//Z �i1e (ji-_
Phone: / 2 -
Applicant is: Owner (Contractor
Description of work: l+a/9TL OFF / 4,7 - eoofr
Construction Cos 9 6 72 O2
Multi -Family Building: (Yes / No
Company: 4...5e ( be -7- Contact: (741:5 6 r7%" 673 47-eo3c)
Address:7F 5 Sf. C, e0 j) %7Z_ L City: (4 7t q�
State: 144/1-/ Zip: -;3 3-0 C/3 Phone: 65/ - / 3 6 8-7
License #: C'. -7 3 I j g Lead Certificate #: Amy -9r)-7 31 -I
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:
Phone:
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 tc
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.gopherstateonecall.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 Code must be completed within 180
days of permit issuance.
x
Applicant's Printed Nanfe
x
Applicant's Signature
Page 1 of 3
City atEaQau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
2009 RESIDENTIAL PLUMBING
Date: `(J ( 2061 Site Address:
Use BLUE or BLACK Ink
1
Permit Fee:
55. oct
Date Received:/ vg
01.
Staff: �)
t 0
PERMIT APPLICATION �(4- -7- o
5
Tenant: Suite #:
RESIDENT / OWNER
Name- 1-6 ' Phone: 65 1142 6g3q (./.
�
Address / City / Zip: 9 1.l if r M 1�/
CONTRACTOR
Name: 67---r-License #:
Address:
City: State: Zip:
Phone: Contact Person:
TYPE OF WORK
New Replacement Repair Rebuild _ Modify Space Work in R.O.W.
_ _
Description of work:
PERMIT TYPE
RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
( RPZ / PVB) ( Main _ Lower Level)
_
Septic System Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation
$50.50 Add Plumbing
*Water Turnaround
$100.50 Septic System
$90.50 Fire Repair (replace
(includes $.50 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
(add $165.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
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:oocherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance Wth 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 start a permit; J4 the work will be in
accords with the approved plan in the case of work which requires a review and approval ans.
6 7-- fE7A)-rAps
Appllicant's Printed Name
Applicant's Signatur
FOR OFFICE USE
Required Inspections:
leviewed
Under Ground Rough -In
Date:
Cit of Eaaafl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Tenant:
Use BLUE or BLACK Ink
Permit Fee:
Date Recei
Staff:
7/2,9
d:`/"�
2009 RESIDENTIAL BUILDING PERMIT APPLICATION CA11
CCS a Site Address: qta 6tW L /0I
J
/- ..e)0/6
Suite #:
RESIDENT / OWNER
Name12 \ .‘1) Phone: G c l gia3 (0 69.-{
Address / City / Zip: gel 12- T(&YE �ik$J ,DttrikiK)) M t) CCP'S
Applicant is: K Owner Contractor
TYPE OF WORK
Description of work: fa) (5(-( A'S Erne r
Construction Cost: it t sped Multi -Family Building: (Yes / No _)
CONTRACTOR
Name: f
License #:
Address:
City: State: Zip:
Phone: Contact Person:
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 o
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.
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.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 no tart 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 pla
1.0E 9pI FA -D. x
Applicant's Printed Name Applicant's Signature
v'
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
Single Family
Multi
01 of Plex
Accessory Building
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% )
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
_(Lower Level
Interior Improvement
_ Move Building
Fire Repair
Repair
1(15
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water _Final
"14 Framing
Fireplace: Rough In Air Test _Final
Insulation
Meter Size:
Reviewed By:
-n
Siding
Reroof
Windows
Egress Window
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
settiv-Z-011)
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Sheetrock
Final / C.O. Required
Final / No C.O. Required
HVAC
Other:
Pool: _Footings _Air/Gas Tests _Final
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings _Backfill _ Final
Radon Control
Erosion Control
, Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
tri,/
es
00 X 2.0
96,ado
Address 4912 Pine Lane Zlp $$12_
Lot 13 Blk 3 Sub Yinetree Forest
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECITON.
Date: o Yes No InspeMor: _
Final grade (6" from siding)
Petmanent steps (garage) ;x
Permanent steps (main entry)
Permanent driveway
Permanent gas x
Sod/Seeded grass
TraiUcurb damage ?
Porch x
Basement finish ?
Deck ?
Please verify with the builder the removal of roof test raps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineeting division at 6814645 before working in rightof-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Conttactor Copy
(_O??? (
,
2005 RESIDENI'IAL BUILDING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 ?
Telephone # 651-675-5675 FAX # 651-675-5694
New ConstNdion Reauirements
3 registered site surveys showing sq. ft of l04 sq. tt. af house; and all roofed areas
(20°,G maximum lot coverage allowed)
2 copies of plan showmg beam & window sizes; poured found design, etc.
1 set ot Energy Calculations
3 coples af Tree P2servallon Plan if lat platted after 711/93
Rim Joisf Oehail Optlons selection sheet (buildings wflh 3 or less units)
RemodellReoalr Reauiremenls ORice Use Onlv
2 copies of plan CeRofSurveyRecd _Y _N
4.006 Tree Pres Plan Recd _Y _ N
1 site survey for additions & decks Tree Pres Required _ Y_ N
0aafft^^ - OnsOeSeplicSyslem _Y _N
Date Canstruction Cost ,,000
Site Address W? GGt AQy) , MN 55 ia3 UniUSte #
?
-tAG" '
Description of Work
Multi-Family Bldg _ Y_ N Fireplace(s) _ 04 1 _ 2
PropertyOwner 'VD?_ a?d ?h-rjW Telephone#(lp5I)
Contractor ?i CA VYl
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residenlial Ventilation Category 1 Worksheel • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Celculalions Submitted
Have you previousiy constructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Coniractor
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 wi ut a
permit; that the work will be in accordance with the approved plan in the case of work r u?r ?i ? and
approval of plans. ? ', ? '?
? o Q ??E 1?1 S( f?? ?? ? ? JUN 1 4 2005
ApplicanYs Printed Name Applicant's Signature ??
OFFICE USE ONLY
Suh Types
r . ?
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. AIt - Multi
? 03 01 of _ plex ? 09 07-plex O 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex H/ 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N O 25 MiSCellane0U5
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
R 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
I
? 33 Alteration ? 37 Demolish Building• ? 43 Reroof ? 46 WindowslDoors
? 34 ReplaCement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code N
T S C
? ? Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const 1 1(v Width
Footings (new bldg)
? Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
?c Framing
_ Fireplace _ R.I. _ Air Test _ Final
_ Insulation
REQUIREDINSPECTIONS
Final/C.O.
? FinaVNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests
_ Siding _ Stucco _ Stone _ Brick
W indows
_ Retaining Wall
Approved By: 11-1 , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Piant
License Search
Copies
Other
Total
19 twG 0? 0 C?p v
070
,?15
;g
m
8
?
?- • , .
2422 En[erprise Drive
Alendota Heights, MN 55120
* PIONEER ??Np SypyEpqS • QNL FHdNEFAS (651) 681-1914 FAX:681-9488
* engineer ng LnNO ?ws. Luaurae ?Xcrs 625 Highway 10 N.E.
* * Blaine, MN 55434
(612) 783-1880 FAX:783-1883
Certificate of Survey for: Hl1TTNER CONST.
4912 PINE LN EAGAN, MN
o.l/?? 1 ? ???„?
9 , FW.
E
? BENCH MARK ?
? 971 83
E?
? C7
EV
,
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C
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3.?
I -
? ,5.? Uj 3
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LU o 10
IN
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.?, ?69.8
S„I? c? ! GS 10 r
?
ED LU I?
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Z ? I
c
a W I
l o
i 977.3 00 ?
8
d)
972.0
7
. . n.trf? 'Tj?l /LC/
LOT AREA =12,012 sq. ft.
HOUSE AREA =2,391 sq. ft.
COVERAGE =19.97
HOUSE TYPE= 2 STORY f-p.MQu:-(Z CF''-A-r)
NOTE: PROPOSEO GRAOES SNOYM PER CRADING PLAN BY: E.G. RUO
NOiE: 9UILOING DIMENSIONS SHOWN ARE FOR MORIZONTAL AND VERTICAL LOCATION
OF STRUCNRES ONLY. SEE ARCHITECNAI PLANS FOR Bl11LDINC ANO
FOUNOAiION DIMENSIONS.
NOIE: NO SPEGFlC SOILS INVESTIGATION HAS BEEN CoMPLE7ED ON 1HI5 LOT BY iHE
SURVEYOR. 1HE SUITABILITY OF SOILS 10 SVPPORT THE SPECIFlL F70USE
PROPOSED IS NOT TME RESPONSIBILITY OF THE SURVEYOR.
PROPOSED HOUSE ELEVATION
LOWEST FLOOR ELEVAl10N: 9V7,(*
TOP OF BLOCK ELEVATION: 9NES
GARACE SLAB ELEVATION: 7s.3
TOB 0 LOOKOUT ELEVATION:
NOTE: THIS CERTIFICATE DOES NOT PURPORT TO SHOW EASEMENTS OTHER MAN % 000.00 DENOiES EXISi1NG ELEVATION
TNOSE SNOWN ON 7HE RECOROEO PLAi. ( 000.00 ) OENOTES PROPOSED ELEVATION
OENOlES DftAINACE AND U11LIiY EASEMENT
NOiE: CON7RPCi0R MUST VERIFY ORIYEWAY OE9GN. - pEry0tE5 DRAINACE FLOW DIRECIIDN
NOIE: 9EARINGS SHOriN ARE BASED ON AN ASSUMEA OATUM -O- DENOIES MONUMENT
--c^T- DENOTES OFFSET HU9
WE HEREBY CERTIFY TO HUTTNER CONST. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A
SURVEY OF THE BOUNDARIES OF:
LOT 13, BLOCK 3, PINETREE FOREST
DAKOTA COUNTY, MINNESOTA
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR
UNDER MY DIRECT SUPERVISION THIS 28TH DAY OF DECEMBER, 2001.
REHSEO s-e-00 NEW HoUSe SIG D: PIONEE ENGIN RIN P.A.
RENSED 6-23-00 NEW HOUSE
RENSED 6-28-00 RESTAKED
SCALE : 1 INCH = 30 FEET REVISED 12-28-01 NEW HOUSE Bv: ?
, RENSED 1-J0-02 RESTAKED
Z71 .- .ef?? I115102 oIIIIIm Dan . Westergren Reg. No. 79790
9
(9 7'/• a)
974.4
,
BENCH MARK'14
TOP OF PIPE
ELEV.=974.91
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
] 01 Foundation ? 07 05-plex
?( 02 SF Dwelling O OB 06-plex
1 03 01 of _ plex ? 09 07-plex
7 04 02-plex ? 10 OB-plex
7 05 03-plex ? 11 10-plex
7 06 04-plex ? 12 12-piex
dVORK TYPE
? 31 New
7 32 Addition
7 33 Alteration
? 34 Repair
? 13 16-plex ? 21 Porch (3-sea.)
? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 18 Deck ? 23 Porch (screened)
? 19 Lower Level ? 24 Stortn Damage
Plbg _Y or_ N ? 25 Miscellaneous
O 20 Pool O 30 ' Accessory Bldg.
? 36 Move Btdg. ? 43 Reroof
? 37 Demolish (Bldg)• ? 44 Siding
? 38 Demolish (Interior) ? 45 Fire Repair
? 42 Demolish (Foundation) ? 46 Windows/Doors
' Give PCA handout to applicant for demolition permit
INFORMATIO
5AC Code
No. of Units
No. of Buildings ?
Const. (Actual)
(Allowable) ?[ l?
UBC Occupancy ?C•?-
Zoning
# of Stories
Length
W idth
Basement sq. ft.
Main level sq. ft.
&?r) sq.ft.
? sq.ft.
MISCELLANEOUS INSPECTIONS
K' Stucco/Stone
APPROVALS
Planning Buiiding
T-?
? sq.ft.
sq.ft.
? Footprint sq. ft.
Census Code
J!a u Z MC/ES System
_-)a City Water
Booster Pump
PRV
Fire Sprinklered
Engineering Variance
?
? 31 Ext Alt - M ulU
? 33 Ext. Aft - SF.
? 36 MuRi
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $ Q f?of?
?
r?? 9-2)
?G 17 Y /,?' ~
l6??7 ?rq'
13u)..xSq =
?s 3os
!1- / ? D 9`?
79?X l ? : 11/731?
// y c, o
?v 7
-2-
SAC Units
% SAC
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
851-681-4675
New ConshueMon Reaulremenh Remodel/Raoair Reauireme? ? V b" f??1I
? 3 r e q l s t e retl sl t e w r v e y s s h o w i n g R, o t b t. a q. B. o l h o u s e 2 c o p i e s o f p l a n -? ? ,(7 f J ?. e?
and gp rooled areas 1 aet of energy ca4culatlons f heatetl addl H O n!-
; poured fid deHyn; etc.) 1 dte survey for exteAor ad Hona a deck ?/a 3/ O Z
D 2 coplef of plans (ahow beam 8 w sixes
n t se1 of enerpy calwlanons j
a 3 copfee d hee preservallon plan H bt plt?ttetl atter 7/1 /93
Mill
DAiE: 23 - 00 ? CONSTRUCTION COSf: ZO D°D ? ?
DESCRIP'f10N OF WORK: 57 it1 2-0
SiREETADDRESS: Z /r?
LOT: r3 BLOCK: . ? SUBD./P.I.D. Name: ne #:
PROPERTY ldst Firal
OWNER
Sheet
Ciy ,
Sheef
Cfly
e?t
?
CONRtACTOR
ARCHITECT/
ENGINEER
I
Telephone 0: (
Sheet Address:
CNy
Stafe:
9:
Zip:
Sewerlwater licensed piumber % /g Phone #: !J Z
I hereby xknowledge that 1 have read this a IicaHon, atate ttwt 1he in(ortnatio Lrtect, and agree cc
of Minnesota Stotutes and Cily of Eagan Ordi nces.
/}sL
Signalure of Applicant '-
OFFICE USE ONLY
Certificates of Survey Received v Yes _ No ' ,. . z 0
Tree Preservation Plan Received V Yes _ No _ Not Required ??\C J
)
Zip:
< Phone ?: 6 ,Sl T'?? ".?Q ff
(area code)
?License M &?:E-3 Ezp, d ?
state: ? zip: ?S/ 2-3
Na e:
a0 app6caWe Stafe
Site address: `7 / /Z /- IA- Lot 13 Block j Subd.
On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air
tightness, and ventilatiun, was adopted. As a result, the City of Eagan is requiring that the following information be
submitted prior to issuance of a Certificate of Occupancy.
? This sWcture: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
_ This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE
Water Heater Q 5ga h r35 SO - 26 U Y6 06D erted "[o
Fumace 21 ?6-??A1 Af+ U?r/p0OA 1,01we ' 5"led.^ Cow
Dryer
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
YES No
Kitchen kitchen
Bathroom 1
Bathroom 2 a 1' ?iNGe -d ?? J's-0 ,<
Bathroom 3 50 d e0
Bathroom 4
Other ?
II'll
FIREPLACE S
LOCATION
GAS
WOOD
MANUFACTURER
MODEL
BTU'S VENTING
DIRECT ATMOS
??I 6o eo e o , 319 06
MAKE•UP AIR MODEL TYPE CFM's
yvoit e-
.a/ kw
44fha
I hereby acknowledge that ihe above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan
requirements.
?
Signature //
r?ru.
CompanyName
//-Z S-o Z
Date
' This form is the responsi6ility of the General Contractor.
l :It) ` ?`-f Fs?TIa---? t?'P LI?s? o ? ?sU 4 . `? ?
- RESIDENAL
BUILDING PERMIT APPLICATIO? "
./ CITY OF EAGAN Pe 1-?- ?"7d3 g U.?
• '?'?, ??,..?5 3830 PILOT KNOB RD - 55122 ??-'aC)ba-
651-881-4675
NewConahuctlonReauiramanh RemodeVReoalrReauiremeMa
. 3 registered site surveys slrowing sq. R M lot, sq. R of house; and all roofed areas . 2 copies ot plan
(20% maximum lot coverage allowed) ?7 ?7 . 7 set of Energy Caialations for heated adddrons
. 2 copies of plan stawing beam 8 wiiMav s¢es: poured found design, etc.) ??d/! d ) • 7 sile survey for eMerior additiore 8 decks
• 1 set of Eneqy CalculaGons • IrM'ccate'rf lame served by septlc sysMm (or additions
• 3 copies ot Tree Preservation Plan'rf lot piatled aRer 717/93
• Rim Joist Detail Optlons selection sheel (Wdgs wi7h 3 or kss units)
DATE (- I?"''o/ Z _ VALUATION 3 OOOD4?
JOB SITE l?1DDRESS 7! Z //tQ L?
IF MULTI-FAMILY BUILDING, HO Y UNITS? I
PROPERTY OWNER W K ?L4y_4_
TYPE OF WORK FIREPLACE(S) _ 0_? 1_ 2
APPUCANT 'k PHONE# 651-ySZ30ff
ADDRESS /Ua o-J Y< lN ` ZIPCODE S'P23
PAGER # CELL PHONE #???-IZS' 2??0 FAX #Xg- 'L- 9/Jl
NEw RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category ? MINNESOTA RULES 7670 CATEGORY 1
(check ane) - Residential VenGlation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ NIINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Plumbing Corrtractor. M+°td ^Ua lr?A? Phone #: 6?-1?Y'a?.3
Plumbing System Includes: Y Water Softener ( Lawn Sprinkler Fee: $90.00
x Water Heater Q No. of R.I. Baths
-4 No. of Baths
z
-? ?
Meehanical CoMraetor. J) S ?l 1•`9 Phone# ?.?1`f? /???
Mechanical System Includes: ? Air Conditio ng Fee: $70.00
r,E Heat Recovery System
Sewer/Water Confractor. 14.rtPhone # 9?2- ff?'J? r?i/
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 corr ct, and ag e to omply
with all applicable State of Minnesota Statutes and City of Eagan Or
Signature of Appllcant
Certificates of Survey Received _70?) Tree Preservation Plan Receive?J Not Required _
Updated 2002
OFFICE USE ONLY
. j ,.
,
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
x 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt'- Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 MuIG
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04plex ? 12 72-plex Plbg_Y or_ N ? 25 Miscellaneous
9 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition O 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors
O 34 Replacement 'Demolition (Entire Bldg onty) - Give PCA handout to applicant
Valuation ?0 Oxupancy MC/ESSystem
Census Code 101 Zoning City Water •x
SAC Units 0_ Stories ? Booster Pump
Nbr. of Units ? Sq. Ft. 2-3 PRV
?
?
Nbr. of Bldgs 1 Length ?2S -o Fire Sprinklered
Type of Const v- Width L1,2, 1_6
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Footings (new bldg)
Foarings(deck) '
Footings (addition)
Foundation
Drain Tile
Roof X Ice & Water X- Final
Framing
Fireplace X R.I. X Air Test )< Final
Insulation
Okher
Pool Ftgs _ Air/Gas Tests _ Final
? Siding ? Smcco _ Stone
_ Windows (new/replacement)
Approved By
nnna? ?
Base Fee
Suroharge
Plan Review
MC/ES SAC
cicy sAc
Water Supply 8 Storage
S8W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Totel
.f? 0'+ -7 5
REQUIRED INSPECTIONS
? FinaUC.O.
Final/No C.O.
_ Plumbing
_ HVAC
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2422 Enterprise Drive
Mendota Heights, MN 55120
O„L INGNMORs (651) 681-1914 FAX:681-9488
62b Highway 10 N.E.
Blaine, MN 55434
(612) 783-1880 fAX:783-1883
Certificate of Survey for: HUTTNER CONST.
4912 PINE LN EAGAN, MN
?AIM 16 REC`D
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H OU SE
LOT AREA =12,012 sq. ft.
HOUSE AREA =2,391 sq. ft.
COVERAGE =79.9%
HOUSE TYPE= 2 STORY
NOTE: PROPOSEO GRADES SHOWN PER GRADING PLAN BY: E.G, RUO
NOIE: BUILDINC DINENSIONS SHONT! ARE FOR HORIZONTAL ANO VER7ICAL LOCATION
OF STRUCNRES ONLY. SEE ARCHIiECNAL PLANS FOR BUILDING AND
FOUNDAPON DIMENSIONS.
NOIE: NO SPECIFlC SOILS INVESTICATION HAS BEEN COMPLETEO ON iHIS LOi BY 7HE
SURVEYOR. iHE SUITABILITY OF SOILS i0 SUPPORT iHE SPECIFlC HOUSE
PROPOSED IS NOT THE RESPON5181LITY OF THE SURVEYOR.
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PROPOSED HOUSE ELEVATION
LOWEST FLOOR ELEVAiION: 907. (i
TOP OF BLOCK ELEVAl10N: 9Eo,Y
GARAGE SLAB ELEVA710N: 75,3
TOB 0 LOOKOUT ELEVATION:
NOTE: THIS CERTIFICATE DOES NOT PURPORT 70 SHOW EASEMENTS OTHER iHAN X 00000 DENOiES EXISTINC ELEVATON
THOSE SHOVM ON THE ftECORDED PLAT. ( 000.00 ) DENOTES PROPOSED EIEVAT10N
NOIE: CONiRACTOR MUSi VERIFY DRIYEWAY OESIGN. --- DENOTES DRAINACE AND UPLITY EASEMENT
DENOTES DRAINAGE ROW DIREC110N
N01E: 9EARINGS SMOWN ARE BASEU ON AN ASSUMEO OATUM -?- DENOTES MONUMENT
El- DENOTES OFFSET HUB
WE HEREBY CERTIFY TO HUTTNER CONST. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A
SURVEY OF THE BOUNDARIES OF:
LOT 13, BLOCK 3, PINETREE FOREST
DAKOTA COUNTY, MINNESOTA
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED 8Y ME OR
UNDER MY DIRECT SUPERVISION THIS 28TH DAY OF DECEMBER, 2001.
R ftEEHSED 6-8-00 Neu HoUSE SIG D: PIONEEF? ENGIN RIN P.A.
?1SED 6-23-00 NEW HWSE
SCALE : 1 INCH = 30 FEET REVISED 6-26-00 RESTAKED
RENSED 12-26-01 NEW HOUSE ?
. REVISED 1-J0-02 RESTAKED BY? 1 ?
:? i o7daom i.ic IZe`EK? '. I?ISI02 Westergren Reg. No. 19790
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUiLDiNG PERMR APPLICATION
, PROPERTY LEGAL: L 0 T_ /Sn l5I ? i t-' +? PiNe ! ?E?G 6rest
? DATE OF SURVEY: /2-25'r//
m LATEST REVISION:
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DOCUMENTSTANDARDS
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P, ? ? • Registered Land Surveyor signature and company
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? • Building PertnitAppliqnt
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descripUOn
R? ?
Ca? ? ?
? • Address
• North arrow and scale
C/ ? ? . House type (rambler, walkout, sptit w/o, spltt entry, bokout, etc.)
g', ?
' ? • pirecNonal drainage arrows with sbpe/gradient %
O
0 ? • Proposed/exisUng sewer and water services & invert elewation
t,? ?
? 0 • Street name
C
J ? ? • Drfveway
r?" ? ? • LotSquare Footage
?'/ ? ? • Lot Coverage
U1' ? ? • Benchmark
ELEVATIONS
Existina
E? ? ? • Sewer senrice (or Proposed)
[3? ? ? • Property comers
?? ? • Top of curb at the drveway and property line extensions
F? ?? • Elevatians of any epsting adjacent homes
?[? ? • Adequate footing depth of strudures due to adjacent utility trenches
? f? ? • Waterways (pond, stream, etc.)
Prooosed
q/ ? ? • Ga2ge Ibor
610 ? . First floor
Fd? ? ? • Lowest exposed elevation (waOcouVwindow)
? ? • Property comers
o ? . Front and 2ar of home at the foundation
PONDING AREA fif aoolicablel
? 9/ ? • Easement line
? q/ ? • NWL
? d ? • HWL
? d/? • Pond # designation
0 [a? ? • Emergency Overflow Ekvation
C3'/ O ? •
H ? ? .
0,? ? •
@' ? ? •
D/ / 0 ? •
o ? .
DIMENSIONS
Lot GnesBearings 8 dimensions
Rightof-way and street width (M back of curb)
Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring pertnanent footings)
Show all easements of record and any City uGlities wifhin Uiose easements
Setbacks of proposed structure and sideyard sefback of adjacent existlng structures
Retaining wall requlremen
Reviewed:
(SEE ATTACHMENTS)
Development -
Lot Number
Address l 7
nk?X
l'lN? Block Number 3
1ANE
Builder ?ki ? l l N r l'` C C? ST
,T tSl- ??2?'3cY?
Tree Protection Requirements:
? Tree Fencing
Oak Tree Pruning (Immediately seal wounds during April 1 to July 31)
Therapeutic Pruning
Retaining Wall
Other:
Reulacement Trees:
Not Required
As Follows:
EAGP? ???FSTRY DY!l6SION
Attachments: ??oEWED
? Yes ?
No By -
. DA1E
Additional Notes:
? -
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Part B. DEPRESSURIZA
Check option used: % Fuel burning equipment (complere schedules below)
CTION
? No fuel bumina, equipment
IN'STRUCTIONS
Step 1. Complete the Combustion Eqtiipment Schectule below. Only equipmen[
wich a Y(Yes) may be selecred under the "Category I" altemate.
Step 2. Complere E'xhausd.Ylake-up Air Schedule on the rigght if direct or power
vented or solid fuel a[mospheric vent space heating equipment is selecred.
EXHAUST / MAKE-UP AIR SCHEDULE*
Exhaust devices over 300 cfrn Flow
cfm
cfin
cfm
(check all types proposed)
Space heating - nonsolid fuel Sealed combustion Y Hearth - nonsolid fuel ? Sealed combustion y
? Direct or pawer vented Y' Direct or power vented 1'
Aunospherically vented N Aunospherically vented N
Water heating - nonsolid fuel ? Sealed combus[ion Y Space heating - solid fuel ? Atmospherically vented 1"
Direct or power vented Y Water heating - solid fuel ? Atmospherically vented Y
Atmospherically vented N Hearth - solid fuel ? Atmospherically vented Y
• (f atmospherically vented solid fuel or direct or power vented nonsolid fuel space heating is installed, then make-up air to match
flow is required for each individual exhaust device which exceeils 300 cubic feet per minute.
Part Ci. VENTILATION
VENTILATION QUANTITY
(Ylechanical ventilation must be provided per the larger quantity calculated below)
cubic feet x 0.00583 /minute =Ri cfm ( !?T_ x 15 cfm/bedroom) + 15 cfm cfm
volum o? f habitable rooms number of bedrooms
Check method(s) proposed 4. VENTILATIOIV FAN SCHEDULE
? Exhaust onlv Balanced (heat recovery ventila[or, air eschanger. etc.) ;
Fan description or location 4 '-t-i TOTALS
VENTiLATION Intake 2 cfm cfm cfin cfm cfm
AS DESIGNED Exhaust cfm cfm cfrn cfm cfm
5[atement of Compliance: The proposed building design represenred in these documents is consiscent with the building plans.
specifications, and other calculations submitred with the permit application. The proposed buildins has been designed ro meet the
requirements of [he Minnesota Energy Code.
Applican[ (princ name) -° Si.-nature Date Telephone number
Part C2. VENTILATION (Submit Part C2 upon completion of system verification+)
,.
-----------------------------------------------------------------
Job Sice Address: Permit Number
Fan descripcion or location TOTALS
MEASURED Intake cfm cfm cfm cfm cfm
PERFORb1.aNCEi Eshaust cfm cfm cfm cfin cfin
t Veneilation rate must be measured and verified when the performance option is used in lieu of the prescriptive option for the sealing
ofjoints in [he building conditioned envelope (from Part A).
Compliance Statement: Installed ventilacion system is in compiiance with Y1N Energy Code and is sized to provide the desi;n air Flow.
4pplicanc (princ name) Signamre Date Telephone number
"CATEGORY 1" ALTERNATE FOR
ONE & TWO FAMILY DWELLINGS
.:?..
INSTRL'CTIONS: This alternative may be used for one- and two-family dwellings built fa meet the Category 1 requirements of
Minnesota Rules, Chapter 7670. Complece Parts A, B, and C. Clearly mark plans with: insulation R-values; window and skyligh[ U-
values: size and type of equipment; equipment controls; and location oF vapor retazder and windwash barziers. Nlore de[ailed
informa[ion can be found in the .blinnesota Energ Code summary sheets available from the Minnesota Depattment of Commerce.
Part A. BUILDING ENVELOPE
-- -- - __. --- _. . _---. .
Check proposed envelope joint sealing option 4 Prescnptive (caulhmg, sukets, ett.) O Perf'ormance (tzst per 7670A470 subp. 7.C.) .
Chzek Ihermal energy caleulation option used 4 ?E °Cookbook" (complete workshtet below) Q MnChecA meehod (a¢ach report)
? Performance (attach U-value calculaeions) p Syseems .analysis method (at[ach analysis) "Cookbook" Worksheet
INSTRUCTIOUS
Stzp L Chack i[em(s) tha[ dzsiqn mee[s on .L(inimum Requiremenrs list
to [he rieht Ytust meet all irems [o use "Cook6ooA" option.
$[ep 2. Indicate proposed wall type on table below.
Sicp 3. Indicam Window U-valut and sourcz.
Scep 1. Verincotal \vindow (includins area ofall foundation windows)
and door area is equal or less [han allo%cable percentage.
MINIMUM REQUIREMENTS
(for "Cookbook" option only)
I$ Ccilins lnsulation: Ivlinimum R-38 wi[h 7%" enerey hetl: or
Minimum R-44 with low truss heel: or
Winiinum R-38 with R-i shea[hine when no attic.
EntnDoors: ivla.e. U-value of 0.30 or P/." solid wood wi[h stortn
* Rim Joist Insulation: Minimum R-19
* Fluors over unconditioned spaces: Nlinimum A-24
m Founda[ion Insulation: Nlinimum R-10
Q Foundation windows: 'h" insulated glass, wood or vinyl t?ame
T?.BLE FOR DETERMININC MA%IMUM WIYDOW AND DOOR.AREA
Marimum Allowable Total Window and Door Area-as a Percentage of'Esposed WaR... 12% . 14% 1 .16% 89 24% .22% 24% 26°, 28%
Wall Typn (S[andazd Framina} Marimum-Average: Window U-value (eaccepEfoundation windows):
? 2s4, R•13 insulation, 2 R-7 sheathing 0.55 .0.47, . 0,41 0.36 '033- ;; 030 0.27 . 0.25 0.23
? 2s4. R- IS insulation. ? RS sheathing 0S2 - 10.45` 0:39 0.35 0:31 - 0.28 0.26 0.24 022
??s6. R-I9 insuiacion. < RS sheathine 0.48 0.41 0.36 029 - 026 014 022 0.21
'? 2\6. R•19 insulation. 2 R-9 sheathing 0.56 -A.48 - 0:42 .37 034 0.31 0.28 0.26 0.24
? 2s6. R-21 insulation. <RS sheathing 0.31 ` 0.43 038 034. 030 028 0.25 . 0?3 022
? 2x6. R-? I insulacion, ? R-5 sheathine 0.58 - 0.50 - 0.44 0.39 0.35 ' 032 0.29 ' 0.27 0.25
WallTvpe (r\dvancedFraming): MaximumAveage: WindowU-value(exceptfoundationwindows):
??s6. R-19 insulation, < R-5 sheathino 0.52 0.45 - 0:39 035 0.31` ^- 0.28 0.26 034 022
O 2x6. R-19 insulation. 2 R-5 sheathing 0.58 ?. ?'0.50.: 0.44 0.39 . 035?- 032 029 0.27 0.25
??x6. R-21 insulation, <RS sheathing 0.55 0.47 -- OA1 0.36 . 0.33, ? 0.30 0.27 0.25 023
? 2x6. R-? I insula[ion. Z R-i shea[hine 0.60 0.52 ? 0.46 0.41 0.36 033 030 0.23 0.26
Window II-value:
100 x 3 Qo -
window & door azea ' Source: i
3760 = o
gross exposed walt area DESIGV ? NFRC
/o '< ? ASHRAf. 1993 Handbook ,
%
ALLOWABLE (&om [able above)
MINNESOTA ENERGY CODF - WHicH RuLFS Mar 1 USE ?
TYPE OF RESIDENTIAL BUILDWG APPLICABLE RULES
Detached R-3 occupancy 1- and 2-Family dweliings Chapter 7672; or -
Examples: single family, twin homes, duplexes Chapter 7670 "Category I" ivith statutory depressunzation and ventilation requircmen[s
Attached R-3 occupancy dwellings Chapter 7674; or
Examples: triplzx townhouses and row houses Chapter 7670 ivich either "Ca[egory I" or "Cate@ory Z" provisions
R-I occupancy buildings oC3stories or less Chapter7674; or
Bsamples: condominiums a apartments Chapter 7670 with either "Category 1" or "Ca[egorv 2" provisions
R-l occupancy buildings over 3 stories high Chapter 7676
E:camples: hieh rise condos or apartmen[s 11,. 1.
A CARBON MO
INSTALLED IN
AND MULTI F
G8 0
II.- o" 23 _
OXIDE ALARM MUST BE
LL NEW SINGLE FAMILY
ILY DWELLING UNITS.
SMOKE D
ON EVERY L
EVERY SLEE
HALLWAY LE
CTORS ARE REQUIRED
VEL OF THE HOUSE AND IN
ING ROOM AND IN EVERY
DING TO A SLEEPING ROOM
12'- o
EGRESS WINDOWS ARE MANED IN
ALL SLEEPING AREAS.
• MINIMUM 5.7 SQ. FT. NET CLEAR OPENING
• MIN. 20" NET CLEAR OPERABLE WIDTH
• MIN. 24" NET CLEAR OPERABLE HEIGHT
• MAX OF 44" FROM FLOOR TO NUMMI
PORTION OF IRE BNL4,
F-S9Fzaa$67
`N/W.1 i W uJCIL
NOTE: ININDAUNI HEIGHT AIME WE/TR WR*,
NOT ADD UP TO THE RIMMED LT SO. FT.
A VAPOR BA
t+ST y_LED 1 Tr
ALL WALLS AND A
All
II�
I=OUNDATIOIVI
BARRIER IS R
INSULATION ANt
FROIMFLOOr Ti
{6'- 0
ML 3T
WAi M SLOE
C CRAG,
lvvALL �1n^ OL
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UNIDATION
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BOARS �.
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA124391
Date Issued:06/30/2014
Permit Category:ePermit
Site Address: 4912 Pine Lane
Lot:13 Block: 3 Addition: Pinetree Forest
PID:10-57650-03-130
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Fireplace (new)
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Tor J Stenstad
4912 Pine Lane
Eagan MN 55123
Hearth and Home Technologies
2700 N. Fairview Ave
Roseville MN 55113
(651) 638-3309
Applicant/Permitee: Signature Issued By: Signature