4944 Pine LaneCITY OF EAGAN
3830 P' -Knob Road
L,Egg'an, Minnesota 55122-189
(651) 681-4675
SITE ADDRESS:
PERNIIT SUBTYPE:
TYPE OF WORK:
INSPECTION .. . .•
i Pl i I'!?? I 141,
li+,.t 1 I t;?, ?Ilrlt
kFMARK?! PI.AN RFVIfWflt iiY UAYht Mi11FF:
$ 7? tJ PlI1MHi:14 X?; ;f.NlftCN (1LUMRfN
F
L
INSPE(;TI()N KE(:UlzD
PERMIT TYPE:
Permit Number:
? Date Issued:
APPLICANT:
,?.? •? .?,..? ??,t1
-1
I
vermn Hoiaer Daft Telephone #
SEWER/
WATER
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS ?n . /?gg
?+-
[V!/L
'
FOUND ? ? • ? , `j c? -
?'? G L
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
MEfER
IARIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDFOSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
Address 4944 PINE LANE Zip 5512 3
L.ot 17 Blk 3 Sub PINETREE FOBEST
THESE TI'EMS WERE / WERE NOT COMPLEI'E AT TI-IE TIME OF THE FINAL INSPECI'fON. '
Date: Z, Yes No Inspector:
Final grade (6' from siding)
Permanent steps (garage) V/"
Permanent steps (main entry) ?
Permanent driveway ?
Permanent gas
Sod/Seeded grass Ll-
Trail/curb damage ?
Porch i ?
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 jawn faucet befote freeee potential exisis.
Contac[ engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. ?
White - Ciry Copy Yellow - Resident Copy Pink - Contractor Copy
o35`I
?so so
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Ct? ,- 30 33`
Please complete for modifications to existing residential dwellings.
Date ? I 30 105
Site Street Address ?c? UQ e Unit#
Property Owner Telephone # ( )
Contractor. ;tAY'mi o. r; Telephone # (L5I ) q 1o3-'7 92 4
Address vR1034 a;ppq?tMe Cityr,nnt '? State;M,. Zip650?24
The Applicant is: _ Owner )C Contractor _Other
Alterations to existing dwelling $ 50.00
? Add plumbing fixtures (excludes water softener and/or water heater--complete next
section if installing these appliances).
_Septic System Abandonment
_Water Turnaround (add $125.00 if a 5/8" meter is required)
Other:
Water Saftener _ Water Heater $ 15.00
_ new _ replacement
Larm lrrigation _RPZ _PVS _new _repair _rebuiid $ 30.00
State Surcharge $ 50
=Total, $ 0 .S d
I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
ApplicanYs Printed Name ApplicanYs Signature
A PR 0 1 2005
?$ ?'o-4-
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
0'?o. 00
Clj,.,c -Z
,i23/Qs A4J
New Construdion Reauiremenis RemodellRepair Reauirements Offtce u4e0niv
3 registered site surveys shaxing sq. R. of lot, sq. R. of house; and all roofed areas 2 copies of plan CertcdSmveyftecd L 1' YJ
(20°lo maeimum lot coverage allowed) 1 sat of Energy Calculations for healed additions TtEe PfeSPlo Fiecd -Y ._N
2 copies of plan showing beam & window sizes; poured found design, etc. t site survey For additions & decks Tree presRequrced i'. Y N
lsetofEnergyCalalations Addifion - indicateiion-sitesepticsysfem 4n-siEe5epticSyslem _"Y _N.
3 copies of Tree Preservation Plan if lot platted after 711(93
Rim Joist Detail Options selection sheet (buildings with 3 or less units)
DatC {,
(U
Construction Cost -,- ;??o t ol?
Site Address ???' ? Y 115?. L ?N? Unit/Ste #
?
Deacription of Work L?C?ER
Multi-Family Bldg _ YXN Fireplace(s) 1 2
PropertyOwner V?
.--? kAJRC41?? Telephone#(?I?
Contractor S/? K i P""?`?t?• p'?-? ???? 1 '?l`?? '?/???1?-'?0 f?
Address City
State 0jv Zip 5 011 Telephone# (`f?j2) 135- 0!3 BZ
L.IC? 2 2. LA..f'.L : G( -
COMPLETE TNIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
licensed Plumber
Mechanical Contractor
SeweNWater Contractor
Telephone # (
Telephone,#(- -)
"n'l4 _ _-
I ?.
I' U
Telephone# f )
I hereby apply for a Residential Building Permit and acknowledge that the infoitnation is co e and accurate;
that the work will be in conformance with the ordinances and codes of the Cit r' ?f-E a e of MN
?
5tatutes; 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 lan in the cas of wor w'ch requires a review and
approval of plans.
L) %=1 ?S'V=K ?. ? k?`'s'E? ? ?? NC,iv I
Applicant's Printed Name ?pplicant's Signature
? IPC.
OFFICE USE ONLY
Sub Types
? 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. Alt- Multi
? 03 01 of_ plex q 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 Ext. Alt- SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-p(ex ? 12 12-plex PI6gj?Y or_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Impravement ? 38 , Demolish Interior ?44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ?. 45 Fire Repair
? 33 Alteration ? 37 Demoiish Building` .? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation _9-6 tl ? Occupancy _ t?-?_ MCES System
Census Code 4*4 Zoning g If City Water
SAC Units Stories Booster Pump
# of Uni[s C7 Sq. Ft. PRV
# of Bidgs / Length Fire Sprinklered ?
Type of Const S? Width Footings(new bldg)
_ Fooungs(deck)
_ Footings(addidon)
FoundaUon
Drain Tile
? Roof Ice & Water Final
/ Framing
i Fireplace _ R.I. _ Air Test _ Final
Insulation
REQUIRED INSPECTIONS _
FinallC.O.
? FinaUNo C.O.
? Plumbing
/ HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wall
3 - y!- 05
Approved By: Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(651) 681-4675
SITE ADDRESS:
F.I .N.: 10-5765G7-'j.7(A, -03
PERMIT
F ? P d L T ' ft E F F O R t S ' ! P E R M I T TYPE: B U T i [ I r ri b
1991 PINF LAIVf_
I..01": 1; c1LCiCK: 3
Permit Number. 0 3 q 58 4
Date Issued: C) 2/ 7 6 i 9 s
DESCRIPTION: '
S F OWi;
fJ[W
R-3.U-:L
V iV
R-t
ES
42
2
2.003
101 7. - PAh'I. IICTAGhi
? _. ,.... :..?? . .
Ctu,d'1dlnca'-:PEr-mit Tv oe,
B) Iildinq Wt3-i:k Typc
k3FSG OccUpUncy\,
>
r?7anYnq ??.. ,
f 6,ji1d'rt9 LvnQCh ?
? i3ui irfinq GJic1th
8ut3ZSitin stczr•zes
Fu".t
,.
<
C o d l_ ?
,
s t
REMARKS: _
Pi-P?ra ht?vlEwFf7 r'Y 611AYIVE IN71_I_?_k.
& W Pi_Ui'4SER 15 SC:IIFkrR PLUh133IIdG Pl -{ONF 9t(E1Z) 44 7--E?3 4.
FEE SUMMARY:
Beise f'ce
Pl.an S'ieview
Si.irchai`qe
SAC
SAC „
SiiC llniYs
5ubtotal
v A L. u H7 'r T a r.i
$1,'.'',0 J.i35
$849.78
$78.00
$1,060.00
1
--` - -_$.3 , ._ 85 . 9. .?
$tsr.00n
hITSC. F EEr
l"oCaJ. Fee
$1,637.!iV?
. . 9?"'.63
CONTRACTOR: - f} P P l.z c a ri r, -- s T. i_ ic. OWNER:
i'4ANLt=.111 6R0S COfdST 14544933 20O5432; MAIVLEV BftOTMEF2S
1Efj78 . ALLTSCJIV WA'i :10773 ALI.;CJN WFIY
IIV'JER GROVE HCIS NIPQ 55877 ZNVGR GROVE HGTS MN 55077
(6-i2) 0.E+4-4433 (657.)454-4933
I. he,'ar3V rcknow..edUe i;iiat ! ?7Gti,ere::.d t;7.is e:hola.r.itvin ri onc! st,3l.e 1:;i:?L
?ralor'mativri is carrrCi snc4 r4rar i:Q ua,l,icrtl` i.j xT.h P. 11 a ej nLic r.f^??a
;.;.atutas arrd CS.ty ot Faoar 0:-hinsnce?.
L
' • ?'1'v? ?
APPLICANT/PERMITEE SIGNATURE
-?` .SSUED BY: SIG ATURE
?
, . . .
*?C??t'????.Xc?k##*#W:k?F%?:k?K*#?FX??K?%?#?##*#:Kik#? *?K?#
CI7Y OP E:AGAN
c:'AS!-17:L"Rs `i TEkMSNAL NO» 739
nA7F.w 02/26%99 TCNE: 1.5:C16r57
m-
NAMF_: MANLE:Y =,horHE.r;S rUNS?'RUCT.T.{]N
4,9?2.E,3
225E, 1300]. 4944 P.Y.NE I...ANE
4,9?_2.E,3
TO'F7.I. Iic'CB7p+, Amn+an+:
CRS.43?30"i
L15ER ID: hAMC'1'
#?'?*?F*#X?Xc???k????'?K?*%K?#X?*?k!X?# ?K##?K??K?#*#k?
A
i' ?
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN /
3830 PILOT KNOB RD - 55122
(651) 681-4675
!
uew Construction Reauiremen[s
RemodellReoair Requirements
,? 3 registered sile surveys ? 2 copies of pian
r 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) • 7 site surveys (exterior additions & decks)
? 1 energy calculations ? 7 energy calcula[ions for heated additions
? 3'copies of tree preserva[ion plan if lot platted after 7/1193
required: _Yes _ No
DATE: I -'Q?0`CA CONSTRUCTION COST;
DESCRIPTION OF WORK: b ) 00n?,?LCCl'JVl
STREET ADDRESS: `Yq 4)I h?_ I-cLnP
LOT: I / BLOCK: ?3 SUBD./P.I.D. #: rt'!?,°-I r??? 7??Sf
PROPERTY
044'NLR
I_ut
First
Phoue k:
Strert
Ci[y
State:
"/_ip:
US?-y933 ----
LU.TR,,LfnR l? / / &
Strce[?lddress: Z'l )a-" -_-p-L-- License' "?`? ?. ?L_k:zP?-.2?J
Cit}??U?/f Su1te: --% ?// U ---- L'P ??.LL-L----
ARCHITECT/ ?I?nn !-?1 _ C/?? _O70
C? _
ENGINEER Company:_-/_ ? ?r,v---------------------------- Phonc#: UJ?-- --- --- -
Namc:---- ------------------- ?-/----------- --- Regislra[ion tt: -----------------
SuectAcldress:13?J _?Q?!1ln6fD/7 1?
_ /-?i---------------------------------
citv --------- ------- s?,«:
Sewer & water licensed plumber (new construction only): l X??r Penalty applies when address
change and lot change is requested once permit is issued.
co i
I hereby acknowledge that I have read this application, state that the information is correct, and agree to compiy with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
OFFICE USE O
Certificates of Survey Received Yes
Tree Preservation Plan Received Yes
Signature of Applicant:
No RECEI?JED
_ No _ Not Required .1AN 2 7 1999
BY.
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 _-plex ? 15 Deck
WORK TYPE
? 31 New ? 33 Alterations ? 36 Move
32 Addition ? 34 Repair ?, 37 Demolition
GENERAL INFORNiATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
L/k) Basement sq. ft.
_v k-, Main level sq. ft.
R3,? VP&OZ sq. ft.
?_L 4i92 sq. ft.
? sq. ft.
? sq. ft.
//0-44
Census Code
SAC Code
Census Units
Census Bldg
MC/WS System
City Water
Booster Pump
PRV
Fire Sprinkiered
D
O/
?
X-
Y/
Footprint sq. ft
? nass
APPROVALS•
Planning Building Engineering
Variance
Permit Fee
Surcharge
Plan Review
License
MC/WS SAC
Ciry SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Traiis Ded.
Other
Copies
Total:
% SAC
SAC Units
130"7.
? valuation: $ 15-
?
ScMGnt ?
2,20
y x
10 SU X ? `
1' 98 ?
;tysX ta = 36_"7•
A x 7 *°
/04,r /
ia x 6 _ 2A ?
X /5= is 5'6q,??
/o37,v7
Ma'n
du5c -? 1037H7
6 X ?= 6
.¢&X7= /D•S
Y??HH7 K.7y= 56?/H/•3`?
uPPE-R f' A 1 6 3-7•`Sv
31 x ;R7 = 83? s
6yV ls 6,33
,A x '7
ixH9,33 Xb?J'= 67y63512'
- ,yRR
,a X1o - ?ao
2.?HX 2 = 4 y,66
- /cX?9= lO?,'S
RS
?s?7e,7z
=
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' 2422 Enterprise Drive
?* lf ? Mendota Heights, MN 55120
* PION66F? (612) 681-1914 FAX:681-9488
LAND AIR?EY0R5 • pNL EM(iNFERS
? eng neer ng NMD PLNINERS• UNDSGME ARCNIIECTS 625 Highway 10 N.E.
? *. Bloine, MN 55434
? * * (s?2) ?a3-?aeo Fax:?aa-?esa
Certificate of survey for: MANLEY BROS. CONST.
4944 PINE LANE
l ???
l
BENCH MARK
TOP OF PIPE -,,
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SERVECE ,
ELEV.=96?4.8 r'
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16
(VACANT)
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.- (EMERGEfV7CY ?VERFLOW) ?? ?
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!47 5?3) g89'?978.9 136.50
? ; s?s.s ?,
3 BENC? MARK .' zv?'i I
TOP F PIPE '' r? . ,
ELEV. 977.76 Xo - . : ?i ? ° !
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NOTE: PROPOSEU GRAOES SHOWN PER GRADING PIAN BY: E.R. RUO PROPOSED HOUSE ELEVATION
NOTE: BUILMNG DIMENSIONS SNOwN ARE FOR HORIZONTAL AND ?'ERTICAL LOCATION LOWEST FLOOR ELEVATION? ?? 4'
OF 51RUCTURES ONIY. SEE ARCXITECTUAL PLANS FOR BUILUINC AN? ?
FoudoanoN oiMeesia+s. TOP OF BLOCK ELEVATION: ??- .
NOTE: NO SPEQFIC SOI?S INVESTIGATION HAS BEEN COMPLETEO ON THIS LOT BY THE fT
SURVEYOR. THE SUITABILITY OF 500.5 TD SUPPORT THE SPEC?FIC HWSE GARAGE SLAB ELEVATION: . ??° "?
PROPOSED IS NOT TNE RESPONS?B?UTY ?G TME SUR?YOR.
NOTE: TMIS C(R?IFICATE DCE$ NCT PUR?pR? TO 5.40W EASE!.1Ek'$ OIY.£R T4Rk X ODO.CO CENCTES EXIS:ING ?L'cVA710.?
TNOSE SHOWN ON THE RECORDED PLAi. ( 000.00 ) DENOTES PROPOSED EIEVAl10N
? ___ DENOTES ?RAINACE N7D UTIUTY EASEb1ENT
NO7E: CONTRACTOR MUST VERIFY DRIY?WAY DESIGN. pENOTES ?RWNACE FLOW DIRECTION
N07E: BEARINGS SHOWN ARE BASED ON AN ASSUMED OpTUM -? ?ENOTES MONIIMENT
--^?- DENOTES OFFSET H118
WE HEREBY CERTIFY TO MANLEY BROS. CONST. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A
SURVEY OF THE BOUNDARIES OF:
LOT 17, 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 8 DAY OF , 1999. q
?¢.ci? 5-? ? 2?' Z?l 51 NED??PIONEER ENGIN RING, .A.
P`?'. E?..?.
SCALE : 1 INCH = 30 FEET e„ ?
. . LOT SURVEY CHECKLIST FOR RESIDENTIAL
• B DING PERMIT AP LICATIO
• PROPE RTY LEGAL: ?? ?T'?`
?
DATE OF SURVEY: -2r
C
? LATEST REVISION:
s
? ? DOCUMENT STANDARDS
?? ? • Registered Land Surveyor signature and company
? ? ? • Building Permit Applicant
ff-- ? ? • Legal description
E3? ? ? • Address
al- ? ? • North arrow and scale
C1-- ? ? • House type (rambler, walkout, split wlo, split entry, lookout, etc)
o' ? ? • Directional drainage aROws with slope/gradient %
H-- ? ? • Proposed/exdsting sewer and water services & invert elevation
e' ? ? • Street name
r,Y ? ? • Driveway
ELEVATIONS
Existina
4-- ? ? • Sewer service (or Proposed)
p- O ? • Property corners
0- O ? • Top of curb at the driveway
2- ? ? • Elevations of any ebsting adjacent homes
Prooosed
e' ? ? • Garage floor
ff' ? ? • First floor
cr ? ? • Lowest exposed elevation (walkouUwindow)
er ? ? • Property corners
[a' ? ? • Front and rear of home at the foundation
PONDING AREA fif avalicablel
? [l" ?
? d ?
? d/ ?
? b ?
? [f ?
cr? ? ?
e' ? ?
[? ? ?
[y? ? ?
C] ? O
? 9, ?
Z
Easement line
NWL
HWL
Pond # designation
Emergency Overtlow Elevation
DIMENSIONS
Lot lines/Bearings 8 dimensions
Right-of-way and street width (to back of curb)
Proposed home dimensions including any proposed decks, overhangs greater than 2',
porches, etc. (.e.'all structures requiring permanentfootings)
Show all easements oF record and any City utilities within those easements
Setbacks of proposed structure and sideyard setback of adjacent existing strudures
Retaining wall
.
.
.
Reviewed:
January 1998
CRMGiBGfliBLDGPRMT. FM
ut? CUo?
. ? 1
Lot Number
Address
Builder
Tree Protection Reauirements:
_Y- Tree Fencing
Oak Tree Pruning (Seai wounds during April 75 to July 1)
Therapeutic Pruning
Retaining Wall
Other:
Reolacement Trees:
Not Required
As Follows:
Attachments:
Yes
No
Additional Notes:
??? ? DIVOSQ
REWEtmiED
d?
?a7 m i
(SEE ATTACHMENTS)
Development k "'4-e "J "
I I Bloek Number 3
612 4546030
,FROM V MANLEY BROTHERS CONSTRUCTION PHONE NO. : 612 4546030 Feb. 16 1999 10:30FiM P2
? 2422 Enterpriae Drive
MMtlolo Hei4hte, MN SS120
? ??? C6t2? d87-1974 FAX:681-9488
.wo w?mws . mn woxcros
# nu+ncw. w?o?eix .womcen 625 Hignwoy 10 N.E.
Bloine, MN 55434
(812) 783-1890 FAX:783--1883
of urvey for: ANLEY BROS. CONST.
. . 44 PINE LAN
? " ? ?lR?• ?. O
2 "2Z??" ?a- a ? ao, ? ? ?.?..a be
16
CANT)
? . MAR . (VA
..?•P? ELOE .?977 }g
(EMERCatN?YS?VERFLON)
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Z I ? SER'hCE 977.7, ,.-, 7.005 s?p
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Moic: ewi.awe dueMSONS sNOrm ARE FM Na+Iza+iwL wNo WnncwL tounon LOMiEST FLOOR EIEVATION' ' T'
OI SIMMUCTUMES ONIY. SEE 1Rd??TECIUAI PlI?NS /OR BIINDING AND ??
ialNDATHN+ oo+E„S?oN9. TOP OF BLOCK ELEVATION: Y?
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WE HEREBY CERTIFY TO MANLEY BROS. CONST. THAT TH75 75 A TRUE AND CORRECT REPRESENTATION OF A
SURVEY OK TNE BOUN0ARIES OF:
LOT 17. BLOCK 3, PINETREE FaREST
DAKOTA COUNTY, MINNESOTA
IT DOES NOT PURPORT TO SNOW IMPROVEMENTS OR ENCHROACNMEN75. EXCEPT AS SHOWN, AS SVRVEYED BY ME OR
UNDER MY DIRECT SUPERVISjON THIS 8 OAY OF 1999.
?IS, ?• 51 `? `z - 1 gg +'0)/=ON EER? ENG?N RINC, .A.
...?•
SCALE : 1 INCH - 30 FEET E/
612 4546030
FROM f MANLEY BROTHERS CONSTRUCTION
.
PHONE ND. : 612 4546030
Feb. 16 1999 10:30RM PS
DATE : GY ' 1(10-q%
m A 8 Lff
BiOTMflS 70NS11UC110N. INC.
TO : C f? .(.D'l ' t T1.
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FAX NO.
FROM: /? I M
PAX NO.
NO. OF PAGES TQ FOLLOW:
COMMENTS: + r-eP.. Pr
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10778 Alison Way • inver Grove Heights, MN 55077 • Business 454-4833 - NSobile 386-3359
JFlN-2S-1?99 13:40 PLANI2J, INr, 1 612 =52 3659 P.01i02
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Notea;
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Window U-4ceor muel be dekrmincd bq either the Na8onal Fenestratlon Rating
Coundl atandscd 100•9l, or ASNRAE 1993 Hand6ook of Fundsmenlals. Chapter 27,
Tabk S.
i PeddN Fu Nv?? 7671 y? .
n..
G.
T
•
r Y
TOTpL P.02
CITY USE ONLY
LOT ?? BL ? RECEIPT#: ?(J ?,3 ?o ZS
SUBD. d?,? ,v, c-? ?t? C( ? t,? RECEIPT DATE: L? - I? ??I ?
MECHANICAL PERMIT # ??? ? ? ??
1999 M?GFi?NIC?L ???{MIT f??SID?ENTI?L)
CITY OE gAfiAN .
3830 PILOT KNOS fiD
?4HAN MN 551EE
t,/ `? ?C?' (651) B$1-4675
Date: s ? i
Complete this section onlv if you aze installing HVAC in a single family dwelling, townhome or condo under
construction and not owner /occuoied.
• HVAC: 0-]00MBTU
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one required @$3.00 ea.)
$ 30.00
6.00
(o, pU
State Surchazge .50
Total $ `--{??•S U
Complete this section on/v if you aze remodeling, adding to, or repairing an existing single family dwelling,
townhome, or condo. Please indicate if it is a new item, alteration, or repair.
_ New
_ Furnace
_ Air exchanger
Air conditioning
Other
$ 30.00
State Surchazge .50
Minimum Total Due $ 30.50
?
SITE ADDRESS: ?
OWNER NAME: _
INSTALLER NAME:
STREET ADDRESS:
? ?
CITY: ?""(? C2 W?
Alteration Repa'v _ Other
Reminder: Ca11 681-4 6 75forinspections.
? ?O. ?J - PHONE#: -
(AREA CODE)
a d- rxor•rE #: ??s r-?O- g313
(AREA CODE)
?? ???? T2.
_ STATE: IP:?
SIGNA RE OF E
L BL
SUBD.
APPROVED BY:
INSPECTOR
RECEIPT #:
RECEIPT DATE:
MECHANICAL PERMIT #:
1999 MECiIANICAL f'£RMIT (COMMERCIAL)
CITY QF EAHikN
8$30 P1LOT K1V08 ItD
EAeArt,lKrl 55122
(651)681-4675
Piease complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: 1% of contract price OR $30.00 minimum fee, whichever is greater.
Processed piping - $30.00
CONTRACT PRICE x 1%
PROCESSED PIPING
PERMITFEE
STATE SURCHARGE ($.50 per 51,000 of nermit fee due on all permits.)
TOTAL
SITE ADDRESS:
OWNER NAME:
TENANT NAME (IMPROVEMENTS ONLY):
INSTALLER:
ADDRESS:
CITY:
PHONE #:
(AREA CODE)
PHONE #: -
(AREA CODE)
STATE:
ZIP:
CITY U5E ONLY
,
SIGNATURE OF PERMITTEE
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4944 Pine Lane
Lot: 17 Block: 3 Addition: Pinetree Forest
PID:10- 57650- 170 -03
Use:
Description:
Sub Type: e - Air Conditioner
Work Type: New
Description: Air Conditioner
Comments:
Fee Summary:
Contractor:
Haley Comfort Systems
122 West 3rd St
Hastings MN 55033
(651) 437 -0338
Quesetions regarding elec
445 -2840
Larry Leacock
15966 Fennel Ct.
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
Permit Type:
Permit Number:
Date Issued:
Permit Category:
cal permit requirements should be directed to Mark Anderson, State Elec
ME - Permit Fee (Replacements)
Surcharge -Fixed
- Applicant -
Owner:
Alexander Burger
4944 Pine Lane
Eagan MN 55123
$50.00 0801.4088
$0.50 9001.2195
$50.50
Mechanical
EA090541
08/06/2009
ePermit
cal Inspector, (952)
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
C!tyofEaail
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
e
Permit #: '/ 77€ 9--
Permit Fee: 7g� / 1
Date Received:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION CA _
Date:
1(10 f l ( Site Address: 14q141-4 � g
G .A., I"v 0
r 2-3
Tenant: 1 CAA/ pia.c1
Ca'
Suite #:
RESIDENT / OWNER
Name: 4 I 6-wcL Wavy/
i vy/
Address / City / Zip: /
Applicant is: Owner Y. Contractor
Phone: (95 fr �ZZ� Li 1
561 avt NDN 5-&72
TYPE OF WORK
Description of work: D wA I L 61144 --OA Fe
Construction Cost:
D OD
ee.rct-Drv by 0.140.0N,
Multi -Family Building: (Yes / No )
CONTRACTOR
Name:
Address:
11o?
State: N Zip: 53 423 Phone:
Contact:
Email:
License #: 1 1/2?
City: Ri.v142,-14 1,
617--21(¢1-O(g�3
rr-q 9 V I Ye-s-I-rr_
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:
TE= Pia s and sup • o ing documents, that, you sub are co s dered o b public infor ation.Pori o s
.1
• • rov d • !igtha would permit the:
`u�
cons .
ude tha hey, are rade s c s.
the information may
CALL BEFORE BEFORE YOU DIG. Call Gopher State One Cali 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.aopherstateonecall.ora
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 •!ans.
G t4-60t\So
Applicantnted Name
x
Applicant's Si
nature
Page 1 of 3
r CO44
I r ` DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation
/
,[ Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
Addition
XAlteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100%
Census Code
# of Units
# of Buildings
Type of Construction
_ Fireplace
Garage
Deck
Lower Level
Porch (3 -Season) _
Porch (4 -Season)
_ Porch (Screen/Gazebo/Pergola) _
Pool
Interior Improvement
Move Building
Fire Repair
Repair
v
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water _Final
'y Framing
Fireplace: _Rough In Air Test
Insulation
Meter Size:
Reviewed By:
I Df 'L
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Final
�Lr
Siding
Reroof
Windows
Egress Window
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
VA4149 0-7- l m
Demolish Building*
Demolish Interior
Demolish Foundation
_ Water Damage
*Demolition of entire building — give PCA handout to applicant
h- C' -►� MCES System
IN/ �(91.i) 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
Olico°
000
Page 2 of 3
t
Z-01141 P171- L71
q7'76
Es ICC EVALUATION
SERVICE
Most Widely Accepted and Trusted
ICC -ES Evaluation Report
ESR -2642*
Reissued February 1, 2010
This report is subject to re-examination in two years.
www.icc-es.ora (800) 423-6587 I (562) 699-0543
A Subsidiary of the International Code Council®
DIVISION: 07 00 00—THERMAL AND MOISTURE
PROTECTION
Section: 07 21 00—Thermal Insulation
REPORT HOLDER:
BASF POLYURETHANE FOAM ENTERPRISES, LLC
13630 WATERTOWER CIRCLE
MINNEAPOLIS, MINNESOTA 55441
(800) 888-3342
www.basf-ofe.com
EVALUATION SUBJECT:
BASF POLYURETHANE FOAM ENTERPRISES SPRAY -
APPLIED INSULATIONS: SPRAYTITE° (158, 178, 81205
AND 81206); COMFORT FOAM. (158 AND 178) AND
WALLTITE. (US AND US -N)
1.0 EVALUATION SCOPE
Compliance with the following codes:
• 2009 International Building Code (IBC)
• 2009 international Residential Code (IRC)
• 2009 International Energy Conservation Codee (IEEC)
• Other Codes (see Section 8)
Properties evaluated:
• Physical properties
• Surface buming characteristics
• Water vapor transmission
• Attic and crawl space installation
• Air permeability
• Fire -resistance -rated construction
• Exterior walls in Types I through IV construction
2.0 USES
SPRAYTITEe (158, 178, 81205 and 81206), COMFORT
FOAMe (158 and 178) and WALLTITEe (US and US -N)
spray -applied polyurethane foam insulations are used as
nonstructural thermal insulating material in Type I, II, Ill, IV
and V construction under the IBC and dwellings under the
IRC. See Section 4.6 for use in Type I, II, 111. IV and V
construction. The insulation is for use in wall cavities,
floorlceiling assemblies, or attic and crawl spaces as
described in Section 4.4. Under the IRC, the insulation
may be used as air -impermeable insulation when installed
in accordance with Section 3.5. The insulation may be
used in fire -resistance -rated wall assemblies when
construction is in accordance with Section 4.5.
3.0 DESCRIPTION
3.1 General:
SPRAYTITEe (158, 178, 81025 and 81206), COMFORT
FOAM° (158 and 178) and WALLTITEe (US and US -N)
are two -component, closed -cell, rigid foam plastic
insulations. The insulations are produced in the field by
combining an isocyanate component A with a resin
component B, resulting in products having a nominal
density of 2.0 pcf (32 kg/m3). SPRAYT1Tr, COMFORT
FOAM" and WALLTITEe insulations use an A component
designated as ELASTOSPRAYe 8000A. Each insulation
uses a different proprietary blend for the 13 component. The
insulation components B have a shelf life of three months
and components A have a shelf life of nine months when
stored in factory -sealed containers at temperatures
between 50°F (10°C) and 80°F (27°C) before installation.
3.2 Surface-buming Characteristics:
The insulations have a flame -spread index of 25 or less
and a smoke -developed index of 450 or less when tested
in accordance with ASTM E 84 at a maximum thickness of
4 inches (102 mm).
Thicknesses of up to 8 inches (203 mm) for wall cavities
and 12 inches (305 mm) for ceiling cavities are recognized,
based on testing in accordance with NFPA 286, when
covered with a minimum 1/2 -inch -thick (12.7 mm) gypsum
board or an equivalent thermal barrier complying with, and
installed in accordance with, the applicable code.
3.3 Thermal Resistance, R -values:
The insulations have thermal resistance (R -values) at a
mean temperature of 75°F (24°C) as shown in Table 1.
3.4 Vapor Retarder
The insulations have a vapor permeance of less than 1
perm [5.7 x 10-11 kg /(m2sPa)]. in accordance with ASTM E
96, when applied at the following minimum thicknesses,
and qualify as Class II vapor retarders:
SPRAYTITEe (158, 81205) = 3 inches (76 mm)
SPRAYTITEe (178, 81206) = 2 inches (51 mm)
COMFORT FOAM. (158) = 3 inches (76 mm)
COMFORT FOAM° (178) = 2 inches (51 mm)
WALLTITEe (US and US -N) = 2 inches (51 mm)
3.5 Air Permeability:
SPRAYTITEe (178 and 81206), COMFORT FOAM° 178
and WALLTITEe (US and US -N) spray -applied
polyurethane foam insulations, at a minimum thickness of
*Corrected August 2010
ICC -ES Evaluation Reports are not to be construed as rqwesenting aesthetics or any other attributer not specifically addresseti nor are they to be constreed
ar as endorsement of the subject of the report or a recommendation for its issc Ther uwo warranty by ICC &siltation Sen,ice, LLC express or bin:lied at
to any finchng or other matter m this report, or as so any prcrista covered by the report.
Copyright (0 2010
ESR -2642 1 Most Widely Accepted and Trusted
Page 2 of 5
1 inch (25.4 mm), are considered air -impermeable
insulation in accordance with Section R806.4 of the IRC,
based on testing in accordance with ASTM E 283.
3.6 ELASTOCOATTM 1500 ignition Barrier:
EUNSTOCOATTm 1500 Ignition Barrier coating is supplied
by BASF Polyurethane Foam Enterprises, LLC. The
coating is water-based and available in both 5- and 55 -
gallon containers (18.9 and 208 L) and has a shelf life of
six months when stored in a factory -sealed container at
temperatures between 50°F (10°C) and 80°F (26.5°C).
3.7 ALDOCOAT 800 Intumescent Coating:
ALDOCOAT 800 intumescent coating is manufactured by
Aldo Products Company and is a water-based latex
coating supplied in 5 -gallon pails and 55 -gallon (18.9 and
208 L) drums. The materials have a sheff-life of six months
when stored in a factory -sealed container at temperatures
of 40°F (4.5°C) and 90°F (32°C).
3.8 NoBume Plus Intumescent Coating:
NoBume intumescent coating, manufactured by No -Bum,
Inc., is a translucent aqueous liquid supplied in 1- and
5 -gallon (3.8 and 18.8 L) pails and 55 -gallon (208 L)
drums. The coating has a sheff life of three years when
stored in a factory -sealed container at temperatures
between 40°F (4.5°C) and 90°F (32°C).
4.0 INSTALLATION
4.1 General:
The insulations must be installed in accordance with the
manufacturer's published installation instructions, the
applicable code and this report The manufacturer's
published installation instructions must be available on the
jobsite at all times during installation.
4.2 Applic.atIon:
The insulation is spray -applied at the jobsite using a
volumetric positive displacement pump as recommended
in the manufacturer's published installation instructions.
The insulation is applied in passes having a minimum
thickness of 1/2 inth (12.7 mm) and a maximum thickness
of 2 inches (51 mm) per pass, up to the total thickness
specified in Sections 3.2, 4.3 and 4.4 of this report. The
insulation passes must be allowed to fully expand and be
cured for a minimum of 15 minutes prior to application of
an additional pass. The insulation must not be used in
areas that have a maximum service temperature greater
than 180°F (82°C). The foam plastic insulation must not be
used in electrical outlet or junction boxes or in contact with
rain or water (e.g., rain, condensation, ice, snow). The
substrate must be free of moisture, frost or ice, loose
scales, rust, oil, and grease or other surface contaminants.
The insulation must be protected from the weather during
and after application.
4.3 Thermal Barrier:
The spray -applied insulations must be separated from the
interior of the building by an approved thermal barrier of
0.5-inth (12.7 mm) gypsum wallboard or an equivalent
15 -minute thermal barrier complying with IBC Section
2603.4 or IRC Section R316.4, as applicable, except
where installation is in an attic or crawl space as described
in Section 4A, or when the installation is in sill plates and
headers at a total thickness of 3.25 inches (83 mm) or less
as permitted by IRC Section R316.5.11. Thicknesses of up
to 8 inches (203 mm) for wall cavities and 12 inches
(305 mm) for ceiling cavities are recognized, based on
testing in accordance with NFPA 286.
4.4 Attics and Crawl Spaces:
4.4.1 Application with a Prescriptive Ignition Barrier:
When the spray -applied insulations are installed within
attics or crawl spaces where entry is made only for service
of utilities, an ignition barrier must be installed in
accordance with IBC Section 2603.4.1.6 or IRC Sections
R316.5.3 and R316.5.4, as applicable. The ignition barrier
must be consistent with the requirements for the type of
construction required by the applicable code, and must be
installed in a manner so that the foam plastic insulation is
not exposed.
4.4.2 Application without a Prescriptive Ignition
Barrier: The SPRAYTITE® (78 and 81206), COMFORT
FOAM e 178 and WALLTITEe (US and US -N) insulations
may be installed in attics and crawl spaces as described in
this section without the ignition barriers described in IBC
Section 2603.4.1.6 and IRC Sections R316.5.3 and
R316.5.4, subject to the following conditions:
a. Entry to the attic or crawl space is to service utilities,
and no storage is permitted.
b. There are no interconnected attic or crawl space areas.
c. Air in the attic or crawl space is not circulated to other
parts of the building.
d. Attic ventilation is provided when required by IBC
Section 1203.2 or IRC Section R806, except when air -
impermeable insulation is permitted in unvented attics
in accordance with Section R806.4 of IRC. Under -floor
(crawl space) ventilation is provided when required by
IBC Section 1203.3 or IRC Section R408.1, as
applicable.
e. Combustion air is provided in accordance with IMC
Sections 701.
In attics, the insulation may be spray -applied with no
covering (no ignition barrier) to the underside of roof
sheathing or roof rafters, and/or vertical surfaces. In crawl
spaces, the insulations may be spray -applied with no
covering (ignition barrier) to the underside of floors and/or
vertical surfaces. The thickness of the foam plastic, applied
to the underside of the top of the space and/ or vertical
surfaces, must not exceed values set forth in Table 2.
Surfaces to be coated must be dry, dean, and free of dirt,
loose debris and any other substances that could interfere
with adhesion of the coating. The intumescent coating is
applied with a medium-size nap roller, soft brush or
conventional airless spray equipment at a rate specified in
Table 2. The coating must be applied when ambient and
substrate temperatures are above of 50V (10r). Th e
coating requires a 24-hour curing time. The insulation may
be installed in unvented attics as described in this section
in accordance with IRC Section R806.4.
4.4.3 Use on Attic Floors: The SPRAYTITE. (178 and
81206), COMFORT FOAMED 178, and WALLTITE. (US and
US N) insulations may be installed in accordance with this
section and Table 2 at a maximum thickness of 91/4 inches
(235 mm) between and over the joists in attic floor. The
insulation must be separated from the interior of the
building by an approved thermal barrier. The ignition
barrier required in IBC Section 2603.4.1.6 and IRC Section
R316.5.3 may be omitted.
4.5 Two-hour Fire -resistance -rated Wall Assemblies
(Load-bearing):
SPRAYTITE. 158, SPRAYTITE* 81205 or COMFORT
FOAM® 158 may be installed on interior load-bearing two-
hour fire -resistance -rated walls, provided the system is
installed in accordance with the following:
ESR -2642 I Most Widely Accepted and Trusted
4.5.1 Wood Framing: Two rows on separate plates,
3 inches (76 mm) apart, of minimum 2 -by -4 wood studs
(No. 2 Douglas fir) spaced a maximum of 16 inches
(406 mm) on center.
4.5.2 Wall Finish: Base layer of 5I -thick (15.9 mm),
Type X gypsum wallboard is applied horizontally and
fastened to each outer side of a double row of studs with
6d by 17/8 -inch -long (48 mm) coated nails, spaced 2 feet
(610 mm) on center. Face layer of 5/8 -inch -thick (15.9 mm),
Type X gypsum board is applied horizontally and fastened
to each outer side of studs over the base layer with 8d by
23/8 -inch -long (60 mm) coated nails, spaced 8 inches
(203 mm) on centers. Gypsum wallboard joints must be
staggered 24 inches (610 mm) between layers and on
opposite sides of the wall.
4.5.3 Insulation: SPRAYTITE. 158, SPRAYTITEe 81205
or COMFORT FOAMe 158 is applied in the stud cavities of
both rows at a thickness of 3 inches (76 mm).
4.6 Exterior Walls in Types I, II, Ill and IV
Construction:
Page 3 of 5
When used on walls of Type I, 11, 111 and IV construction,
the SPRAYTITEe (178, 81206), COMFORT FOAMe 178,
and WALLTITE® (US and US -N) spray -applied foam
insulations must comply with Section 2603.5 of the IBC at
a maximum thickness of 3 inches (76 mm), when installed
per the manufacturer's published installation instructions
and this report. The potential heat of the foam plastic in
any portion of the wall or panels must not exceed the
potential heat, expressed in Btu/ft2 (MJ/m2), of the foam
plastic insulation contained in the wall assembly tested in
accordance with NFPA 285. The potential heat of
SPRAYTITEe (178, 81206), COMFORT FOAM. 178, and
WALLTITEe (US and US -N) spray -applied insulations is
1961 Btufft2 (22.3 MJ/m2) per inch of thickness.
5.0 CONDITIONS OF USE
The BASF Polyurethane Foam Enterprises spray -applied
insulations described in this report comply with, or are
suitable alternatives to what is specified in, those codes
listed in Section 1.0 of this report, subject to the following
conditions:
5.1 The spray -applied insulations and the intumescent
coatings must be installed in accordance with the
manufacturer's published installation instructions, this
evaluation report and the applicable code. The
instructions within this report govem if there are any
conflicts between the manufacturer's published
installation instructions and this report.
5.2 The spray -applied insulations must be separated from
the interior of the building by an approved 15 -minute
thermal barrier, as described in Section 4.3, except
where installation is in an attic or crawl space as
described in Section 4.4.
5.3 The spray -applied insulations must not exceed the
thicknesses noted in Sections 3.2 4.3 and 4.4.
5.4 The spray -applied insulations must be protected from
the weather during and after application.
5.5 The spray -applied insulations must be applied by
professional spray polyurethane foam installers
certified by BASF Polyurethane Foam Enterprises or
by the Spray Polyurethane Foam Alliance (SPFA) for
the installation of spray polyurethane foam insulation.
5.6 Installation in fire -resistance -rated construction must
be as described in Section 4.5.
5.7 Use of the insulation in areas where the probability of
termite infestation is "very highmust be in
accordance with IBC Section 2603.8 or IRC Section
R318.4, as applicable.
5.8 Jobsite certification and labeling of the insulation must
comply with IRC Sections N1101.4 and N1101.4.1
and IECC Sections 303.1.1 and 303.1.2.
5.9 When use is on buildings of Type 1, II, Ill and IV
construction, documentation must be submitted to the
code official verifying that the insulation has been
qualified as a component of an assembly tested in
accordance with Sections 2603.5.1, 2603.5.5 and
2603.5.7 of the IBC, as applicable. The maximum
potential heat of the foam plastic used in the
assembly must be no greater than that noted in
Section 4.6.
5.10 The polyurethane foam plastic insulation components
are produced in Houston, Texas, and Minneapolis,
Minnesota, under a quality control program with
inspections by Underwriters Laboratories Inc.
(AA -668).
6.0 EVIDENCE SUBMITTED
6.1 Data in accordance with the ICC -ES Acceptance
Criteria for Spray -applied Foam Plastic Insulation
(AC377), dated June 2009, including reports of tests
in accordance with Appendix A Section A1.2.2 or
Appendix X of AC377.
6.2 Data in accordance with ASTM E 119.
6.3 Reports of water vapor transmission tests in
accordance with ASTM E 96.
6.4 Reports of air leakage testing in accordance with
ASTM E 283.
6.5 Reports of fire propagation characteristics tests in
accordance with NFPA 285.
6.6 Reports of potential heat of foam plastics tests in
accordance with NFPA 259.
6.7 Reports of room comer tests in accordance with
NFPA 286.
7.0 IDENTIFICATION
Each container of components A and B of the polyurethane
foam plastic insulation bears a label with the BASF
Polyurethane Foam Enterprises, LLC, name and address,
the product name, the product type (A or B component),
density, the flame- spread and smoke -developed indices,
the evaluation report number (ESR -2642), the shelf life
and the date of manufacture. The containers also bear
the name of the inspection agency (Underwriters
Laboratories Inc.).
ELASTOCOATN 1500 Ignition Barrier coating is
identified with the BASF Polyurethane Foam Enterprises,
LLC, report holders name and the product name.
ALDOCOAT 800 intumescent coating is identified with
the manufacturer's name (Aldo Products Company) and
address, the product trade name, and use instructions.
NoBume Plus intumescent coating is identified with the
manufacturer's name (No -Bum, Inc.) and address, the
product trade name, and use instructions.
ESR -2642 1 Most Widely Accepted and Trusted
8.0 OTHER CODES
8.1 Evaluation Scope:
In addition to the codes referenced in Section 1.0, the
products in this report were evaluated for compliance with
the requirements of the following codes:
• 2006 international Budding Codee
• 2006 international Residential Code°
• 2006 international Energy Conservation Codee
• 2003 international Building CodeoD
■ 2003 international Residential Code°
■ 2003 international Energy Conservation Codee
• 2000 international Building Codee
Page 4 of 5
• 2000 International Residential Code
• 2000 International Energy Conservation Code
8.2 Uses:
The products comply with the above-mentioned codes as
described in Sections 2.0 through 7.0 of this report, with
the following modifications:
■ Application with a Prescriptive Ignition Barrier: See
Section 4.4.1, except attics and crawl spaces must be
vented in accordance with the applicable code.
• Application without a Prescriptive Ignition Barrier:
See Section 4.4.2, except attics and crawl spaces must
be vented in accordance with the applicable code.
ESR -2642 I Most Widely Accepted and Trusted
TABLE 1 -THERMAL RESISTANCE (R -VALUES)
Paae 5 of 5
SPRAYTITE•(1 , 81205); COMFORT FOAM. 158
THICKNESS (INCHES) 1 R -VALUE (F.112.h/13tu)
ASTM C 518 TESTED VALUES
1
6.6
4
272
CALCULATED R -VALUES'
2
13.2
3
19.8
3.5
23.8
5
34
6
40.8
7
47.6
8
54.4
10
68
11
74.8
12
81.6
SPRAYTITE" (178, 81206); COMFORT FOAM. 178 and WALLTITE. (US and US -N)
ASTM C 518 TESTED VALUES
1
6.7
4
27.6
CALCULATED R -VALUES'
2
13.4
3
20.1
3.5
24.2
5
34.5
6
41.4
7
48.3
8
55.2
10
69.1
11
76
12
82.9
For SI: 1 inch = 25A mm; 1 'F.ft2.h/Btu = 0176 110 'K.m2/W.
'Calculated R -values are based on tested K values at a 4 -Inch thickness.
TABLE 2 -USE OF INSULATION IN ATTICS AND CRAWL SPACES WI OUT A PRESCRIPTIVE IGNITION BARRIER
INSULATION TYPE
MAXIMUM
THICKNESS (in)
(Wall Cavities &
Atdc Floors)
MAXIMUM
THICKNESS (in)
(Underside of Roof
Sheathing/Rafterss &
Floors)
INTUMESCENT COATING
MINIMUM THICKNESS & TYPE
(Applied to all Foam Surfaces)
MINIMUM
APPLICATION
RATEOF THE
INTUMESCENT
COATING
TESTS
SUBMITTED
(AC377)
WALLTITE. US -N
91/4
11%
l8wetrnitsofALDOCOAT800
1.12 gallon per 100 ft2
Appendix X
WALLTITE. US
91/4
111/4
No coating required
NA
Appendix X
COMFORT FOAM 178
914
111/4
No coating required
NA
Appendix X
SPRAYTITE(178
914
11114
18 wet mils of ALDOCOAT 800
1.12 gallon per 100 ft2
Appendix X
WALLTITE. US -N
91/4
111/4
No coating required
NA
Appendix X
WALLTITE. US
91/4
111/4
18 wet mils ALDOCOAT 800
1.12 gallon per 100 ft2
Appendix X
COMFORT FOAM. 178
914
111/4
18 wet mils ALDOCOAT 800
1.12 gallon per 100 ft2
Appendix X
WALLTITE. US
91/4
111/4
12 wet mks of NoBum Plus
0.75 gallon per 100112
Appendix X
waLunTe US -N
91/4
11/4
12 wet mils of NoBum Plus
0.75 gallon per 100 ft2
Appendix X
SPRAYTITE. 178
914
111/4
12 wet mlls of NoBum Plus
0.75 gallon per 1001t2
Appendix X
SPRA T 7
91/4
111/4
No coating required
NA
Appendix X
COMFORT FOAM. 178
91/4
1114
12 wet mils of NoBum Pius
0.75 gallon per 100 It2
Appendix X
SPRAY11TE.(178 & 81206);
COMFORT FOAM* 178;
WALLTITE• US & US -N
3
7..
16 wet mils of ELASTOCOAT 1500
1 gallon per 100 Tr
Appendix
A1.2.2
For SI: 1 inch = 25.4 mm; 1 mil = 0.02
un; 1 gallon = 3.38 L; 1
= 0.93 m2; NA = not applicable.
Liqt-14 47r),(; born&
q-776-7-)
IF
* PIONEER
* eng neer ng
LAND SURVEYORS • CIVIL ENGINEERS
LAND PLANNERS • LANDSCAPE ARCHITECTS
2422 Enterprise Drive
Mendota Heights, MN 55120
(612) 681-1914 FAX:681-9488
625 Highway 10 N.E.
Blaine, MN 55434
(612) 783-1880 FAX:783-1883
Certificate of Survey for: MANLEY BROS. CONST.
4944 PINE LANE
PINE LANE
SERVICE
ELEV.=964.8
BENCH MARK
TOP OF PIPE
ELE.=977.13 --�,\
3 �
974.1
C.B.
974.3
16
(VACANT)
- (EMERGEN5
CY VERFLOW)
(g7L'L4) ‘148941'52"E 976.7 136.50
TV.
30.00 42.33
(t%
9 7.8
974.5
(47N•0)
976.5 x976.3
97.3
'co
x 977.5
975.0
3
HYD 76.0 30.00
(416.3)
BENC MARK ,'
TOP F PIPE
ELEV. 977.76
i
tO 42.33
978.3
589 978.9 978.9 136.50
978.9
NOTE: PROPOSED GRADES SHOWN PER GRADING PLAN BY: E.R. RUD
NOTE: BUILDING DIMENSIONS SHOWN ARE FOR HORIZONTAL AND VERTICAL LOCATION
OF STRUCTURES ONLY. SEE ARCHITECTUAL PLANS FOR BUILDING AND
FOUNDATION DIMENSIONS.
NOTE: NO SPECIFIC SOILS INVESTIGATION HAS BEEN COMPLETED ON THIS LOT BY THE
SURVEYOR. THE SUITABILITY OF SOILS TO SUPPORT THE SPECIFIC HOUSE
PROPOSED IS NOT THE RESPONSIBILITY OF THE SURVEYOR.
NOTE: THIS CERTIFICATE DOES NOT PURPORT TO SHOW EASEMENTS OTHER THAN
THOSE SHOWN ON THE RECORDED PLAT.
NOTE: CONTRACTOR MUST VERIFY DRIVEWAY DESIGN.
NOTE: BEARINGS SHOWN ARE BASED ON AN ASSUMED DATUM
WE HEREBY CERTIFY TO MANLEY BROS. CONST.
SURVEY OF THE BOUNDARIES OF:
EE V a { Q
976.7
C975.5)
PROPOSED HOUSE ELEVATION
LOWEST FLOOR ELEVATION• ! 7 4-3
TOP OF BLOCK ELEVATION• 6
GARAGE SLAB ELEVATION. _ /7/71.5
X 000.00 DENOTES EXISTING ELEVATION
( 000.00 ) DENOTES PROPOSED ELEVATION
_ - DENOTES DRAINAGE AND UTILITY EASEMENT
-T DENOTES DRAINAGE FLOW DIRECTION
---II- DENOTES MONUMENT
$ DENOTES OFFSET HUB
THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A
LOT 17, BLOCK 3, PINETREE FOREST
DAKOTA COUNTY, MINNESOTA
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN,
UNDER MY DIRECT SUPERVISION THIS 8 DAY OF , 1999.
ui 5.4 d 2- 299
SCALE : 1 INCH = 30 FEET
1968
98275.17 NJK
SI
AS SURVEYED BY ME OR
PIONEER ENGIN
BY.
John C. Larson, L.S. Reg. No. 19828
City of Eagan
Eagan,
PERMIT
City of Eaan
Permit Type: Plumbing
Permit Number: EA104147
Date Issued: 05/07/2012
Permit Category: ePermit
Site Address: 4944 Pine Lane
Lot: 17 Block: 3 Addition: Pinetree Forest
PID: 10-57650-03-170
Use:
Description:
Sub Type: e - Water Heater
Work Type: New
Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:
Tony Boerner
2090 County Road 42 W
Burnsville, MN 55337
952-435-2442
Fee Summary:
Valuation: 1,021.00
PL - Permit Fee (WS &/or WH) $55.00
Surcharge -Fixed
$5.00
0801.4087
9001.2195
Total: $60.00
Contractor:
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
- Applicant -
Owner:
Alexander Burger
4944 Pine Lane
Eagan MN 55123
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.
Applicant/Permitee: Signature
Issued By: Signature
4Plij'
City of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
r �
For Office Use
Permit #: _
Permit Fee:
Date Received:
Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: —15 * 1 2 Site Address: l &e- . L/1 6/95'fj-,i ,55/3 Unit #:
Name: K — -2 4C � . /tic ,14 Phone: G! 5f_5Z — -734-1
Address / City / Zip: zm'7 '7 114
Applicant is: Owner i ---"---Contractor
Description of work: Te/M r F Re)) -2—
c
(mac/' C( °
Company: SAC -/ r— W4 Fr
Construction Co
Multi -Family Building: (Yes / No
Contact: Ch -13 65-/ /390Oi
Address: 7g S --S cru Tit Svt, ZOo City: e4 ke 14 •^d'
State: Zip: 551161 3 Phone: to 57 — 473 "off 7 8 )
License #: b -73151 Lead Certificate #: Pei+ CIO? gj — f
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 public information :Portions of
the information may be classified as non public if you provide specific reasons that would permit the Cityto_
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.qopherstateonecall.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 per it issuance.
x
C it 1 C 14otif,<t/
Applicant's Printed Name
Applicant's Signature
Page 1 of 3
For Office Use /'
; / Permit#:
.21
EAGANMEC EP Permit Fee:
Date Received: O
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 AUG 2 8 2019
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinginspections(a citvofeagan.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION Ca1
Date: 8/27/19
Site Address: 4944 Pine Ln. unit#:
Name: Nancy Burger Phone: 651-322-7341
Resident! 4944 Pine Ln
Owner Address/City/Zip:
Applicant is: Owner X Contractor
Type of Work
Description of work: Re-rail front porch Wry
Construction Cost: 3,618 Multi-Family Building: (Yes /No X )
Company: Outdoor Spaces Design and Build Co. Contact: Jon Hassenfritz
Contractor
Address: 19205 Harappa Ave city: Lakeville
State: MN Zip; 55044 Phone: 952-457-0597 Email: jhass415@gmail.com
License#: BC689582 Lead Certificate#: NAT-F168253-1
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:Plans and supporting documents that you submit are considered to be public Information. Portions of the information maybe
classified as non-public If you provide specific reasons'that would permit the Cites to conclude that they are trade secrets.
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.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 oflans.
Jon I-fassenfritz '20;9 7y155049-05'00
ltf
x Jon Hassenfritz
Applicant's Printed Name Applicant's Signature
.. . Liq iipl,,,41 e/s- 7 6,,,i(
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
le Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
Multi _ Deck — 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
e. 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 4 2,�'�•"� Occupancy X12 G r/ MCES System
Plan Review Code Edition ,f4 21:/r SAC Units
(25% 100% Y► ) Zoning 12% - ) City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction V 3 Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) X Final/No C.O. Required
Foundation Foundation Before Backfill HVAC Gas Service Test Gas Line Air Test
Roof: Ice&Water Final Pool: Footings Air/Gas Tests Final
Framing 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 O ill !l%<()7/9- , Building Inspector
RESIDENTIAL FEES
/h r /7
Base Fee
%'I o--,-) /=e e.
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies '/Q . a j i . 0-0
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA166776
Date Issued:02/04/2021
Permit Category:ePermit
Site Address: 4944 Pine Lane
Lot:17 Block: 3 Addition: Pinetree Forest
PID:10-57650-03-170
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Alexander & Elaine N Burger
4944 Pine Ln
Eagan MN 55123--491
(651) 322-7341
Builders & Remodelers Inc
3517 Hennepin Ave S
Minneapolis MN 55408-3830
(612) 827-5481
Applicant/Permitee: Signature Issued By: Signature