4969 Pine Lane` Fr,o R t Ir. i G,4
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Jim Burns
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FOR:
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10DRAfNAGE
I EASE!
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Deck ? ? ? ?
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? 188.89
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.... .. ..... . . . . ? ? ?
D1AG; 43.50 x 92.80 = 10149 ,
C=?> DENOTES PROPOSED ELEVATION,
x1011.2 DENOTES EXIS7ING ELEVATION.
DEN47ES DfRECT{ON OF DRAINAGE.
? DENOTES WOOD HUB AT 11 FOOT OFFSET.
PORCH AREA - 224 SOUARE
LOT AREA = 12,446 SQUARE
2798/72440 = 22.51L
Lot 10, Block 1, PINE7REE FOREST, Dakoto County, Mfnnesota.
Scnle 1"=-M • Oenotes Iron Monument aearin vawm: n-111=u
I hereby certify that this plan, survey or report was prepared by me
or under my direct supervision ond that I am a duly Licensed Land
Surveyor under the laws of the State of Minneso
E. G U4. INC.
8 y.
Dated this Z4?? day of ri ? 1999. Minnesota Licanse No.??3
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---? GARACE FLOOR ? 98u•3
TOP OF BLOCK - 380.7 (13 CB W/o)
LOV+EST FLOOR - 971.9 _
s. Co. r uc a 0ON5, iN
LANG S41R1/eYDRB
918fA 1."?4'fON AvE. IVO.
GIRGLR PINK6,1"'fINNIESOTA
515014-3628 Tg4. "188-86$b
BL:S S0. Lz'I^f
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
? CITY OF EAGAN
4? 3830 PII.OT KNOB RD - 55122 ? S n ` r
(651) 681-4675
New Construction Requirements RemodeVReoair Reauiremants
? 3 registered site surveys ? 2 copies of plan
• 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 1 site surveys (exterior edditions 8 decks)
• 1 energy calculations ? 7 energy calcuiations for heated additions
? 3 ccpies of trea preservation plan if bl platted after 711193 ?4
raquired: ? Yes No
DATE: _ T-1 -9/ CONSTRUCTION C05T: 3Z5-? ODo
DESCRIPTiON OF WORK:
STREET ADDRESS: VM 7 7b`-?
LOT: ?C? BLOCK: ? SUBD./P.I.D.#: r/Ne?-?--e- t-0 r-e 57-
Name: ? ??? A"dLiC'ZS P6one #: (o ? j - ys y - ?o y.3
PROPERTY Last Finc
OWNER Street Address:4? ? S /? P//F? .?Je (?7 T
`,q? SSiL
Ciry State: ?/'/?? Zip:
L'
G'Si- 5?S-Y 7d13(fl-)
Company: Phone#: t/,IZ - KSy- 36 z/
CONTRACTOR
Street Address: r License # Exp.
City State: 119"'7/ Zip: Z
ARCHITECT/ I Je ? ?
ENGINEER Company: fAtlf-
Name: lL % w 1-<?'LI e -h2 2
Phone #: 612- ~ ?? y G
Street
Registration #:
4?. e/lf 6T
City N 1 NNPe-,22' f S State: 'vl 14 Zip: ?Yo -9-
Sewer & water licensed plumber (new construction only): Penalty applies when address
change and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application, state that the information is correct, and agree ta comply with all applicable
S+,ate of Minnesota Statutes and City of Eagan Ordinances.
Signature of
OFFICE USE ONLY
Certificates of Survey Received ?Yes _
Tree Preservation Plan Received ?es _
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
K 02 SF Dwelling ? 07 4-plex
? 03 SF Additian ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 _-plex
WORK TYPE
A 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(AI[owable}
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
? 11 Apt./Lodging ?
? 12 Multi Repair/Rem. ?
? 13 GaragelAccessory ?
? 14 Fireplace ?
? 15 Deck
? 36 Move
? 37 Demolition
• 4 ,
. ? . ?
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
5'tj Basement sq. ft. Census Code I O?
Main level sq. ft. f q(?? SAC Code a r
2 2`P L-d sq. ft. 17 4 3 Census Units 1
(L •( CgkZA-r sq. ft. g4-7 Census Bldg {
sq. ft. MC/ES System
71 • sq. ft. City Water
`SS, (o Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
, Buildi ng
"
rf Engineering . Variance
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: $ -X"f"yi °o d?--
lVscoc 2S- = 14 ,
q-15-x 1'6- = r W, a
lR(.3K54 loGieo
ti q3x S1F = R4
S?f7X f (o = f 3??SZ °=
i
% SAC
SAC Units
C:!'?Y rif-' i:::,1(::AN
i:r'19HSI;:R; kii "fE:Fif'1:I:NAE_ t,•f):; ?.';?:i.
I)q'j'En 04/28i99 T:[Mlii:a 00200
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CA:i!-I:[!ii:R^ 8 l'_:IiMInlFll._ N(l. 894
Iif?7L:: 04%26/99 'i'IM1i;:;, I.5112e01.
?Da
NfFMF: JFdMCEi PI BI.11iNS
205 9001_ 4969 r•iPF(:. LANE 123.00 ..):C:.C.. •:??j".'.") q" ..:?.lnj. 4.9Fr_ C1'.!.7
PA.NE LANr
Q173.74
2232 9220 4969 r•rNi- t_Arar.:: 30..00 321.n 9001 4969 PINi: t.ANr QS05.75
3713 ::700 4969 P:i.NE ;.FaNF: 50.,00
3742 ._,???::U t.?,,r-,?} F:Ti.r I._nRr': ;(:,..i:,?,
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ir.'ri-i 7220 4969 I':[NE: 1...AN1_
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3446 9001 4969 F']:t,E: i..P1,!E 10..50
Tota:t Receipr:`, i "nnounti: 5„7:z9.43
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CSRT frWI C,4t0 OF 5URVBY
FOR: Jim Burns
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43.50 x 92.80 = 102.49
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PROPOSED ELEVAT70NS:
GARAGE FLOOR a 980.3
TOP OF BLOCK = 980.7 (13 cs w/o)
LOWEST FLOOR = 971.9
<? DENOTES PROPOSED ELEVATION. LOT AREA = 12,440 SQUARE FEE
x1011.2 DENOTES EX4STING ELEVATION. 2798/12440 = 22.5%
DENOTES DIRECTION OF DRAINAGE.
o DENOTES WOOD HUB AT 11 FOOT OFFSET.
Lot 10, Block 1, PINETREE FOREST, Dakota County, Minnesoto.
Scale 1"= 30' *penotes Iron Monument Bearin Datum: Assumed Job No. 99117HS Drw B ERV
I hereby certify that this plan, survey or report was prepared by me E. C?. RUD 4SONS, INC
or under my direct supervision and that I am a duly Licensed Land LqND gURygYORB
Surveyor under the lows of the State of Minneso . QI80 LEXINC?TON AvE. NO.
E. G UD. GS i INC. GIRGLB PINES, MIIVNESOTA
BY bS014-3626 T6L. 186-6656
D4ted this Z+4 day of -gCri l 1999 Minnesota License No.?341
NORTH
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LOT SURVEY CHECKLIST FOR RESIDENTIAL
PROPERTY LEGAL' i-? L(1. O-(/_dof,-_. l TIi?Q
OATE OF SURVEY:
IATEST REVISION:
DOCUMENTSTANDARDS
• Registered Land Surveyar signature and campany
• Building PermitAppficant
• Legaldescripdon
• Address
• North arrow and scale
• House rype (rambler, walkout, spl'rt wfo, spfit entry, lookout, etc.)
• Directional drainage arrows with sbpe/gradfent %
• Proposed/ebstlng sewer and water services & inveR elevation
• Streetname
• Driveway
• Lot Square Footage
• LotCoverage
ELEVATIONS
Fxistinfl
a'a? • Sewer service (or Proposed)
a-' c :3 • Propertycomers
:2 • Top of curb at the driveway
?./ ?? • Elevations of any epsting adjacent homes
Pra se
efo ?
? • Garegefloor
a ?
E • First floor
25, c ? • Lowest exposed elevation (walkouWvindow)
2-'a ? • Property comers
o'o o • Front and rear of home at the foundaGon
PONDING AREA (H aodipde)
/
? 6 0 • Easement Bne
? -5, a . NYVL
? XI a • HWL
? cy, ? • Pond # deaignatlon
? cr'a • Emergenq Overllow Elevadon
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DIMENSIONS
• Lot lineslBeeringe 8 dmenaions
• Rightof-way and streetwidfh (to back of curb)
• Proposed home cktneneiorre indudn9 any proposed decks, overhangs greater than 2', porches, e1c.
(i.e. aq structures requiring permanent ioodnga)
• Show all easements ot record and any Cily u0'6tles wifhfn those easements
• Setbacks of proposed structure and sideyard setback of adjacent exasting structures
• RetaiNng well requiremenb, if apy?- ./
Reviewed:
March 7989
caNCreLoovnW cM
,A77I0A7IT O1 ExENIITION FROM 9TAT6 CONTRACTOR LSCENBB
Stata o! Hinneaota ?
,/???,y?{??1; es Affidavit o! Jr?iES Rrl CLc -
County of _!?,?"""""_ ) Buildinq Permlt Applicent
SAMES BURAS k , being firet duly evorn, upon
(Bvildinq Permit AQplicant)
oath, depoaee end etates_the following:
1. This Affidavit is eubm3tted in connection with the building
germit epplicetion made by JAMES BURrrs (Baildinq
Permit Aoolicant) for r proposed Eegan, project
at 4964 PINE LANE •
2. I acknovledge and understand that Minneaota Statutes,
$326.84, reqaires all residential buildinq
contractore/remodelera to obtain a licenae fzom the
llinnesota Depertment of Commerce, unless otherxise exempt
• under the statute.
;. I am exempt.lzom the residential building contractor licenee
reqvirement pursvant to Minnesota Statute 5326.84, Subd. 3,
!or reason(s) indicated helow (check thoae that apQly):
X a. I am the owner of the residential seal estate vn which
the home ehall be bvilt and I vill do the vork myself
or jointly with my oorn employees or aqents and I am
building such home as lay own personal r•esidence and
}ntend to permanently live therain.
b. I am an architect or enqineer engaging in professional
practica as delined in llinnesota Statutes, Chapter 726.
_ c. My anaual gross receipts are less than S15,000.
_ d. My contracts on individnal projects in aggregate do not
ezceed S2,500.
e. i am a mechanical cvntractor, plumber, or an
elecirician.
i. I am a speciality contractor, remodeler, or material
supplier . invalved only in part of the proposed
improvement to the reaidential real estate. .
4. I ecknowladge end undarstand that the etatements in thia
Affidavit are made under aath and if I make any statement in
thie APfidavit that 1 know to be false or incorrect, 2
underetand that I could be subject to criminal prosecution
or denial or revacation ot the buildinq permit er both.
FURTHER YOUR AFFIANT SAYETf! NOT.
_? ? r ?U?/i's .a?
Dated: '55
Buildind PeY aalicant
?? -
and
Subscri dna swo
this C.. dey ot
me
191-9_
NANCY L.
Jen.
;. . . 1' 1 NE 1??? Fa [Z FS?
." ? • --
;`?;[t? _ ctj',.
?, -
(SEE ATTACHMENTS)
Lu7 to 6Lv. 1
Development 41,-C e. Grm?V
Lot Number l0 Block Number ?
Address
Builder
Tree Protection Reauirements•
Tree Fencing
Oak Tree Pruning (Seal wounds during April 15 to July 1)
TherapeuUc Pruning
Retaining Waii
Other.
Reolacement Trees:
No! Requlred '
As Follows:
Atfaehments•
Yes
No
Additional Notes: ??? FORES"?RY ?1?,??oN I
asz esa 7586
. 'FlFR-06-1999, 14:44 H.S. MULCAHY
•'ApR-e?-issn 12-39 s..r. enLeAW
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612 854 7586 P.02/02
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MINNESOTA
1-2 Family Residenlinl Building
RESIDENTIAL "COOKBOOK" WORKSHF,ET
ApplicantName Phone
??i?s av 651nS - 70Y3 Date
- - Statemento(Compliance: BuilJingOfficialUse
APJ?lic?an[ Addrcssn/?.? ry' L? T
Y? 7?? The proposed building design rcpresrnted in thue
d
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ocumen
s
f cons
stent w
th t
e building plens,
specifications, end other celculUions submitted
Building Addrcss: . wilh the 'mit epplication. The proposed b' mg h been designed to e
? mquiro nLtof rgyCode.
pplicanUEnginee - . .
MINIMUM REQUIREMENTS for "Cookbook" ODHOO:
Entry Doors I-3/4:" solid wood w/ storm Ceiling with energy truss R-38*i Rim joist R-19
door br equivalent (Min. 7%n" top plate to sheathing)
Foundation Windows• Insulated Glass w/l/2" gap in Ceiling with low heel truss R-44•* Floor over R-24
wood or vinyl frame unconditioned space
•Include square foatage in calculation of Window/Daor Area Ceiling-no attic R-38 w/ R-5 sheathing
to determine above grade Window U-Value.
-- mamnuou rcuvnuancc at w m[er UCSIgn l,onaltlOn3
Wlndow and boor Aree ` 100 x + 3 7C L= iO %
As °/s of Exposed Wall Area lbove Gnde Window and Crou Wall Arcs Window/Door Area
FoundaNoeWfndow/Door Area .?.
i ?
?
M FM'V) nl -r?vf Q
¢q Yi -?l
WiNDOWU-VALUE: + 31
Source: NFRC_t-? orASHRAE1993Hend6ook
MAXiMiTM WINIInW iT_VAi irVc
Check Wsll
. WAGLTYPE .. _ - - - - ----_.?
MAXIMUM.WINDOW AND DOOR AREA %OF EXPOSED WALL AEA
TypeUslld ' 121% 14"/0 '16% IS% 20%; 22% -24% 26% 28% 30% 32% 34%
7'YPE A 2x4 freming, R-13 insulation, shealhing R-7 or greater. 0.55 0.47 0.41 0.36 033 0.30 0.27 0.25 0.23 0.22 0.20 0.19
7'YPE B 2x4 framing, R-I S insulation, sheathing R-5 or greater. 0.52 0.45 039 035 0.31 0.28 0.26 0.24 0.22 0.21 0.20 0.18
Vl- TYPE C 2x6 framing, R-19 insulation, sheathing less than R-5. 0.48 0.41 0.36 .32 0.29' . 0.26 0.24 0.22 0.21 O.19 0.18 0.17
7'YPE D 2x6 framing, R-19 insulation, sheathing R-5 or greater. 0.56 0.48 0.42 0.37 034 0.31 0.28 0.26 0.24 0.22 0.21 0.20
TYPE E 2x6 framing, R-21 insulation, sheathing less than R-5. 0.51 0.43 038, 034 0.30 0.28 025 0.23 0.22 0.20 0.19 0.18
TYPE F 2x6 framing, R-21 insulation, shealhing R-5 or greater. 0.58 0.50 0.44 039 035 0.32 0.29 0.27 0.25 0.23 0.22 0.21
- i ms taore comams mterpoiauons of the values m Ihe L•nergy Codc, 1'en 7670A475, Subp. 2.
This is a summary only. Other requircmenls may epply. See Ihe Minnesole Energy Code. 215196
Queslions7 Call Department of Pu61ic Service Information Cenler at 6121296-3175 or 1-8001657-3710.
9PS ?'?
. ?
J •
1-2 FAMILY RESIDENTIAL BUILDINGS PACKET
MINNESOTA
1-2 Family Residentia! Buildings
SUMMARY OF BASIC REQUIREMENTS
ROOF/ . .IN. WA . . . OOR :
• Either meet "Cookbook" criteria as outlined in Residential "Cookbook" Worksheet OR
meet U-Value criteria as outlined in Exterior Envelope U-Values Worksheet.
O R. OP . T. iA;
• Slab on grade floors must have continuous perimeter insulation of R-10 to depth of frostline.
• Foundation walls must be insulated with R-10 minimum from top of wall.
• Loose fill insulation installed must provide the required performance at winter design conditions.
FFFECTIVENESS OF IZFQ TiRF.D TAF. MA IN Ti ATION•
• Building design must meet Category 2 requirements for vapor retarder, air leakage and wind wash barriers, and
ventilation.
DUCT INSUi ATION A?M C .A .IN:
• Insulation for ducts encased in cement or within ground must be R-5. Insulation must be instalied on bottom and
side ofplenums.
• Ducts installed in attics, garages, exterior walls or unheated crawlspaces must be R-8, minimum.
• Retum air ducts conducting air into a furnace through the same space as the furnace must be sealed continucusly
airtight.
• For ducts running outside the vapor retarder or of greater than 0.25 inches water gauge pressure, all transverse joints
must be sealed.
HVAC PIPE INSULATION:
Insulation Thickness, Inches
Pipes 1" and Pipes
System Runouts` Less to2"
Heating '/: I-%, 1-%:
Cooling (Suction) %, '/.
'Applies to runouu not exceeding 12 feet in length to individual terminal units.
S .RVI WAT .R :ATIN:
• Either the first eight feet of both inlet'and outlet pipe must 6e insulated with %x inch thick pipe insulation or heat traps
must be installed.
• Energy requirements for swimming pools and spas aze in Part 7670.0710, Subpart 5, page 55 of the code.
MAT . iA .4 AND INTi.ATION INFO MATION:
• Materials and equipment must be identified so that compliance can be determined. Completed insulation receipt attic
cazd must be supplied neaz access opening. -
• Manufacturer manuals for all installed equipment requiring preventative maintenance for efficient operation must be
provided. • Insulation R-Values, window and door U-Values, and heating and cooling equipment efficiency must be clearly
marked on plans.
This is a summary only. Other rcquirements may apply. See the Minnesota Energy Code 2/5196
Questions? Call Depar[ment of Public Service ]nformation Center at 612/296-5175 or 1-800/657-3710. 0 ON
MINNESOTA ENERGY
SUMMARY OF BASIC CATEGORY 1 AND CATEGORI' Z BUILDING REQUIREMEM1TS
FOR INSULATION PROTECTIOr, AIR TIGHTNESS, AND VENTiLATION
MINIMIJM: All buildings must meet the following minimum code requirements:
NTI .ATION: A Category 2 building is one where infiltration and passive ventilation (operable windows) are
relied on to provide necessary year-round ventilation. If one or more of the Category 1 measures below is
incorporated into tLe residential design, however, a resideatial mechanical venrilation system as specified below
must be installed.
VAPOR FTA R• A vapor retarder, also known as a moisture barrier or vapor barrier, must be installed on the
warm side of insulated ceilings, walls and floors. Polyethylene vapor retarders must be 4mills or thicker. The code
requires a vapor retarder to be installed only on rim joisu that aze susceptibfe to condensation from moisture diffusion.
AIR BARRiF]2; A barrier against air leakage must be installed to prevent leakage of m oisture- laden air from the
conditioned space into exterior ceilings, walls and floors.
• Plumbing and heating penetrations must be air sealed. An air bamer must be provided behind any tub or shower that
is located on an exterior wall.
• Air sealing must be done at all dropped ceiling areas, chimney flues, ventilation ducu, and other fire stops that
penetrate the vapor retarder.
• Holes in the building envelope for electrical and telecommunications equipment must be air sealed, including the
service entrance, wires, conduit, cables, panels, recessed light fixtures, and fans (where vapor retarder is penetrated).
• Joinu in the building envelope must be sealed, inciuding azound window and door frames, between wall cavities and
window or door frames.
• Tested air infilvation rates must not exceed 0.34 cfm/squaze foot of operable sash crack for windows, 0.5 cfm/square
foot for residential doors and 1.25 cfrn/square foot For commercial doors.
WiND WARH BARRTF.R: qn air-impermeable barrier must be installed at the attic edge (baffles must be rigid
material resistant to wind driven moisture); and overhangs, such as cantilevered floors and bay windows.
? vr i ivNtiL: category 1 Buildings meet all requirements as listed above p[us the followine:
RFSIDF.NTIAT. ]VIF, HANI A NTI ATiON CVSTFM F(1R RFcri?c'NTiei uirrr nrwtrc
A system that, by mechanical means, is capable of inuoducing and distributing outdoor air to all habitable rooms and
removing indoor sir at a rate of not less than 0.35 air changes per hour or 15 cfm per bedroom plus another ] 5 cfm,
whichever is greater.
AIR i.EAKAC:F BARRiFR; A bamer against air leakage must be installed to prevent leakage of moisture-laden air
from the conditioned space into the building envelope:
• Electrical boxes and fan housings must also be sealed.
• All rim joists, band joists; and where floor joists or trusses meet oufer walis must be sealed.
• The top of interior partition walls that join insulated ceilings must be sealed.
• Joinu must be sealed between wall assemblies and their rim joisu, sill plates, foundations, between wall and
roof/ceilings, and between separate wall panels.
WiND WASH BARRiFR: All exterior joints in the building envelope that may be sources of air leaks must sealed.
This is a summary only. Othcr rcquircmrnu may apply. See the Mimesota Encrgy Code. 2/5/96
Questions? Call Departrnent of Public Service Infortnation Crnttt az 612/296-5175 or 1-800/657-3710.
P ?
, . . L . n BL CITY USE ONLY -"? ?
V RECEIPT #: L
SUBD. tt RECEIPT DATE: T rT-??` 1
RVVWI' W z qIruliq ,---
1999 PLUM$INC PEfiNilT (RUIFDENTIAL)
CITY OE' £AfiAN
3$30 PILOT KNOB fiD
£AfiAN. MN 55122
(651) 681-4675
Please wmplete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
-----------------------------------'-----------------'----------------'--------------------------°------'
Alterations to existina residence 30.00 =
Water Turn Around 30.00 =
Private Disposel System ° iviFC iic. ?F.nn =
(new and refurbished systems)
Private Disposal Systems " abandonment 30.00 =
RPZ (new installation/repair) 30.00 =
FIXTURES EACH # TOTAL
Shower 3.00 x 31
WaterCloset 3.00 x S = fS"
Bath Tub 3.00 x - _?
Lavatory 3.00 x
Kitchen Sink 3.00 x
Laundry Tray 3.00 x
Hot TublSpa 3.00 x _17
Water Heater 3.00 x
Floor Drain 3.00 x
Gas Piping Outlet ' minimum • 1 3.00 x 7. _
Rough Openings 1.50 x .Z = 3
Water Softener ? for dwellings under construction 5.00 X l = S
U.G.Sprinkler ' for dwelling under const. 3.00
Reminder: Call 681-4675 for inspections of water heaters,
water softeners, alterations, etc.
STATE SURCHARGE 50
TOTAL
37, _So
-----°----------------?-- -------------- • ------------------------------------------------------------------------- ----ces--
I hereby acknowledge that I have read this application, state that Me information is correct, and agree to comply wilh all applicable Ciry of Eagan ordinan.
It is the applicanPs responsibiliry (o notiry the pmperty owner that the City of Eagan assumes no liability for any damages caused by fhe City during iLs
normal operational and maintenance activities to the facilitles constructed under this permit within City propertylright•of-way/easement.
SITE ADDRESS:
OWNER NAME:
s
INSTALLER NAME: TELEPHONE #:
STREET ADDRESS: &Aa
CITY:
STATE: XI-41, ZIP: l, ?'a TJ' S.Z
SIGNATURE OF PERMITTEE
CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1999
CITY USE ONLY
LOT ? BL RECEIPT #: 62 6:7
SUBD. RECEIPT DATE: F/' / /
MECHANICAL PERMIT #
1999 MECHANICAL PERMIT (RES1DENTIAL)
crrY oF EAsatx
S$SU PILOT KKO$ itD
g1k6kN b!N 55122
(e51) 661-4675
Date:
Complete this section oxlv if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not owner /occuoied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BTU
• Gas outlets (minimum of one requued @$3.00 ea.)
State Surchazge
Total
30.00
6.00
T,Q2"J
.50
g j, SL7
Complete this section anlv if you are 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 Alteration Repair _ Other
Reminder: Ca11681-9675 for inspections.
Fumace _ Air conditioning
le,
Air exchanger _ Other
$ 30.00
State Surchazge .50
Minimum Total Due $ 30.50
srTE aDDREss: r-? ?? y ?.?,? C_.?w,? -?.?-??r-,?
OWNER NAME: -5rt?KA ?3 O vlL11l 5 PHONE SI - YS-Y 76Y3
INSTALLERNAME: ?(wt / v2iv5 B, Mut?ky ?0 PHONE#?. ACO6 - ??- ?aY3
STREET ADDRE55: ? 5-7 7 l? l lc?F (AREA CODE)
CITY:
TE: /uALi ZIP: S?l Z"''3
OF
cirr use oNLv
L BL
SUBD.
APPROVED BY: , INSPECTOR
RECEIPT #:
RECEIPT DATE:
MECHANICAL PERMIT #:
1999 idECiii4NlCikL PERMIT (COhIMEftCIAtL)
C[TY Qf f-A&i41V
3$30 PILOT KNOB RD
E4flrtN, MN 55122
(651)681-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE: CONTRACT PRICE:
WORK TYPE:
DESCRIPTION OF WORK:
NEW CONSTRUCTION _ INTERIORIMPROVEMENT
FEES: 1% of contract price OR $30.00 minimum fee, whichever is greaie*.
Processed piping - $30.00
CONTRACT PRICE x 1 %
PROCESSED PIPING
PERMIT FEE
STATE SURCHARGE ($.50 per $1,000 of nermit fee due on all permits.)
TOTAL
SITE ADDRESS:
OWNER NAME:
TENANT NAME (IMPROVEMENTS ONLY):
INSTALLER:
ADDRESS:
CIT'Y:
PHONE #:
(AREA CODEj
PHONE #: -
(AREA CODE)
STATE: ZIP:
?
?
!
SIGNATURE OF PERMITTEE
° CITY IIF ER6AN PERMYT
3830 PILOT KNOB RD
EA6pN, MN 55122
651-681-4617
BATCfG A1B
S-A-LfS D-RirF-T
73(i75ffi6
"memo
vH: gota
W TVPE: UISI
TR TIPE. NRQM
IMS: 36d14
DATE: .AH 18, 99 14:41'42
TOTAL $45.59
FCCf: 4190914312428331 E7P: 9B+B3
AP: W24
iWPIUM
fARM AtiUMM MIEIPT UF SOm6
W/M SERUICES IH llf MNT OF 11E
TOTa, M IffREM N 00 TO P"
Tif OBLIGATIN SET FOM BY TfE
Cfd1YOBER'S AffEg}{f d(1H TIE i5M
T4K5 ffR {SIi6 UISA
g ?.?3 P, ! ?.( e
TOP CP-OW 60RON MvY-AJM
?
2005 RESIDENTIAL BUILDING PII2MPC APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
t3o2.2S
o`6# ti, 4?- 'e/Ya4. d?
New Construction Reouirements RemodellReuairReauirements Ofl'xx Use Onlv
3 registered site surveys showirig sq. N. of l04 sq. R. of house; and all roofed areas 2 wpies of plan CeA of Suivey Recd _ Y_, N
(20°h maximum lot coverage allowed) 1 set o1 Energy Cawulalions for heated addi6ons Tree Pres Plan Recd _ Y_N,
2 wpies ot plan shawing beam & windaw sizes; poureA Wund desgn, etc. 1 site survey for addit"rons & deaks Tree Pres Requfred _ Y_ N
1 set of Energy Cakulations AddNon - indkate Monstte septic system On-site SepUc System _Y _N
3 coples of Tree Preservation Plan'rf lot platled affer 717193
Rim Joist Detail Options seledion sheet (buildings wkh 3 or less units)
Date Q ?2/0,5-
SiteAddress s Constnctioo Cost /8', d a d
UniUSte #
Description of Work ??2 ? °? ? •
Multi-Famity Sldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner ?Q*.» ,&.s ..? ? Telephone # ( ./oS7 ) c34A
Contractor _1'e i rleI&
Address ??9/
State n
C3h'
Zip 675-337 Telephone # (9J-9) 014
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv I ? Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(dsubmissiontype) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone # (
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
•perxnit; that the work will be in accordance with the approved plan in the case of work l?icb_red}u?res a r?v and
e
; approval ofplans. ?p ?s ? ?
^ ? I
1ul- ? 8 2005 ?
Applicant' Printed ame Ap cant's gnature ??? ? ?
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex jli? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.)
? 04 02-plex ? 10 08-plex ? 18 Deck 0 23 Porch (screenlgazebo)
? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Starm Damage
? 06 04-plex ? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
Valuation
Census Code S Z I
SAC Units
# of Units
# of Bldgs
Type of Const V13
_ Footings (new bldg)
` Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
` Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
Insulation
Approved By:
Base Fee
Surcharge
Plan Review
MCIES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Piant
License Search
Copies
Other
Total
?
,
? 30 Accessory Bldg
? 31 Ext. Alt - Mutti
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 38 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
'Demolitlon (Entire Bidg) - Give PCA handout W applicant
Occupancy MCES System
Zoning ? - ( City Water
Stories Booster Pump
Sq. Ft. PRV
Length ( S Fire Sprinklered
Width
REQUIRED INSPECTIONS
_ FinallC.O.
_ FinallNo C.O.
_ Plumbing
HVAC
Other
Pool ? Ftgs _P Air/Gas Tests r Final
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wall
Building Inspector
?
POOL PERMIT - APPLICATIOPI SUBMITTAL REQUIREMENTS
Address: 4q 69 1^ 2 l.? t,
Applicant Name: 4 ro auyn S ---
v
o?
?
?
GENERAL INFORMATION
o
d
'z
1
,
? ? Applicant - name, address, phone & fax numbers, signature
? O ? Property owner name
p ? Lega1 description and address of property
A 0 ? North arrow, scale (1" = 30' or 40') and date
? ? ? Location and name of all streets adjacent to property
? ? ? ' Site Plan drawn to scale showing location of house, pool and other existing or proposed structures
,2( ? ? Directional drainage arrows (existing and proposed)
ELEVATIONS
Existinsa
,d ? ? House corners
? ? ? Property comers
? fGf ? On property lines at point of ineasured dimension to pool (see below)
??d ? If applicable, ground elevation at each end of retaining walls and at wa1Ps greatest height
Proaosed
y3' ?? Finished pool deck wmers
? JZ ? Top of retaining walls (if $ny) and at each different elevation (if it ciianges)
,d ? ? Pool bottom (or max. depth)
Existinsa
,0 ? ? All property/lot lines
Proposed
? ? ? Poo1 ?
? ? Pool plus integrated deck/patio
?? 0 Shortesi distance from outside edge of pool deck Co lot lines and house
P?2 os
Reviewed: X 2 yz2,?
Name Date
6:FORMS/Poo1 Pamit Checklistl06-02-04
?,?"'' Z s
? Gra?cT 5UR
D
' FOR: Jim Burns ?qGpN p,1?GII?tEB G DEPT.
3:1 ?Rax(mum Slopes
Wl
or 9?ztaining Wsll WlY
Ba Requited ?
V V ?/? I
? o i NoRt?
`a
0 I
? 188. f6 ?? ? ir? C. ,?r I.TF?a71?- I
? SB9°9f'S,Z'"AP C? ?:7 ? I
67 y kn •? 30.50 ? T04
- ? To cx o ea (
ro ? o?aniN.ncE I?irr ? W_ I
? EASV J'
?r0(1038 z
Cl ?
? ? ?? ? ? „ Ipro1l I vewOy
I ? ?I A r? ? ? H\/? 6? ? "? ?
? t 1 1 I I ? I
I?1 = I -? Iv L...?- ?
, ._. oC" ? r4.0 6.01 o ? sNV`?
Deck I ,aw
W? ?
'I` n ? o I
O? I oc? ? n r'' ?
:.. W
so.a L oo ?, I
z.o o ? I
?? ? Porch I " N ??--) I O? + I
14. 41.5 ? I u i O C"' ?
Ga h Baeini
10 1 L?- I
7 I N89•9>'5,2"E
138.29 r°'8
g
:-,
C_-- ?,
? W PROPOSE? FI FVA710NS;
GARAGE FLOOR ? 980.3
iT, TOP OF BLOCK . 980.7 (13 ca w/o)
LpWEST FLOOR . 971.9
,a DfAG; 43,50 x 92.80 = 702.49 I°-?` • r
WOUr?w,.n.?w.^- EET
? PORGH AREA - 224 SOUARE
CSg37 DENQTE5 PROPa5ED ELEVATION. LOT AREA = 12,40.0 SQUARE FEE
x1011.2 OENOTES EXISTNG ELEVATION. 2798/12440 = 22•5X
DENOTES OfRECT10N OF DRAINAGE.
DEN07E5 WOOD H118 pT 11 F00T OFFSET•
Lot 10, Biock 1, PINETREE FOREST, Dakotc County, Minnesvta.
?
?
?
Scdle 1"= 3Q' FrDenotes Irpn Monumenl [ 6earing uacum: ?smulll?v
I hereby certity that this plan, survey or report was prepared by me
or under my direct supervision ond that I am o duly Licensad Lond
Surveyor under the lows of the Stote of E'neso uD INC.
6y.
ppted this ZOfi? day Of rd1999. Minnesota Licsnse No.?53
? No. 991171-15 IDrwa tiy tR?
S. Co. Ruc ; scnvS, iN
LANI7 BLIRI/NYOR9
9i8o L6XIhltrtOhJ AvE. NO-
GIRGLR PIAik'8. MINNO60Td
$60l-4-3626 TIRL. '186-66Bb
T'd Xtl-1 ' OS:S S0. L2'Inf
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA178955
Date Issued:09/12/2022
Permit Category:ePermit
Site Address: 4969 Pine Lane
Lot:10 Block: 1 Addition: Pinetree Forest
PID:10-57650-01-100
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
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:
This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after
started.
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 -
James W & Debra A Burns
4969 Pine Ln
Saint Paul MN 55123--491
Act Group Inc
4951 West 77th Street
Suite 4
Edina MN 55435
(612) 412-4140
Applicant/Permitee: Signature Issued By: Signature