4628 Pinetree CurveAddress 4628 PINETREE CURVB ZiP $512 3
L.ot 3 Blk I Sub
PINEI'REE PASS 4TH
THESE TI'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'fON.
Date: ?_a,l -()j Yes No Inspector:
Final grade (6" from siding) ,?.
Permanent steps (gazage)
Permanent steps (main entry) k
Permanent driveway
Petmanent gas x
Sod/Seeded grass .k
TraiUcurb damage
Porch x
Basement finish
Deck X
Please verify with lhe builder the removal of roof test caps from the plumbing system and the shutoff of water supply W
the ouzside lawn faucet befoce freeze potential exists.
Contact engineering division at 681-4645 before working in rightof-way or instelling underground sprinkier system. ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
? RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
CELL PHONE # &51`-z7'0 -60-5 Z FAX #
New ConsW ction Reouirements RemodellReoair Reouiremants
• 3 registered site surveys showiig sq, ft. of lot, sq. N. of house; and all roofed areas . 2 copies of plan
(20%maximum lot coverege allowed) . 1 set of Energy Calculations for heated additions
. 2 copies of plan showing beam & window sizas; poured found design, etc.) . 1 stte survey for extenor additions & decks
• 1 set of Energy Calculations . Indicate i( hane sened by seplic system for additions
• 3 copies of T2e PreServation Plan if bt plafted after 717193
• Rim Joist DetaJ Oplions selecUOn sheet (bldgs wAh 3 or less units)
DATE "j? 11 loz- VALUATION
JOB SITE ADDRESS 9&70 PG-dF_ I(LkF- C-)RV r
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTYOWNER KA`i ?v(L?wS
TYPE OP WORK OC-Gr- FIREPLACE(S) _ 0_ 1_ 2
APPLICANT J?A`1 lv???wS PHONE# 993
ADDRESS yG2S i,z"?C' Cu2L)j G ZIPCODE -S6710Z
PAGER #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT
Energy Code Category
(check one)
Plumbing Contractor: _
Plumbing System Includes:
Mechanical Contractor:
Mechanical System Includes:
Sewer/Water Contractor:
Air Condilioning
Hciit Recovery System
Phone #
Phone #
Fee: $90.00
Fee: $70.00
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ?
Signature of Appllcant
'fs 7o.vo
?-
t I "
d?
_ MINNESOTA RULES 7670 CATEGO?? 1?pR 17 2002
- Residential Ventilation Category 1 Workshubmitted
- Energy Envelope Calculations Submitted ?"
MINNESOTA RULES 7672 L
- New Energy Code Worksheet Submitted
Phone
_ Water Softener Iawn Sprinklcr
Water I-Ieater No. of R.I. Baths
No. of Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 2002
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-piex ? 17 Garage
? 10 08-plex J( 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn.(4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
... . _.
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Eut. Alt - SF
? 36 Multi
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
g 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement `Demolition (Entlre Bldg only) - Give PCA handout to appllcant
Valuation '' ? Occupancy ?-s MC/ESSystem
Census Code ?- 34 Zoning City Water
SAC Units --? Stories ` Booster Pump
Nbr. of Units ? Sq. Ft. PRV
Nbr. of Bldgs ? Length r Fire Sprinklered
Type of Const ??. Width `
REQUIRED INSPECTIONS
Footings (new bldg) FinaUC.O.
? Foo[ings (deck) ? FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Base Fee
Surcharge
Plan Review
MCIES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit License Search
Copies
Other
Total
Approved By
Building Inspector
r,
?
77
?
?:-. -
'COU1v TY STATE AID .ciIGHWAY N0. 32 30 ?(939. ;
939.2
i
/
?
?
(C)
3::
7
L
t0
N
iV
0
O
O
O
0
I
\\
947.7
0
N
?
rn
v
0
0
m
S89°29'27"W 110.42
15 FT. SIDEWALK &?TRAIL ?2
EASEMENT PER DOC. N0. 1496902
F-2 - - - - ? -942.73 X 5
I C DRAINAGE & UTILITY!
I EASEMENT
I 3
(944.5 L
?
1\ 945.7 X 944.8 ?/ 1 X
? M
? • N
1 ?
0
?
a
O I
M ?
M 5
0
_Y
?
_pINETREEy
?
17 O s a.a
? m 33
? m CANT.?
PROPOSED LOOKOUT o
19 4628 PINETREE CURVE 1d
GARAGE
;949.5) 23
a„ N 20.34 -r 13_67 STOOP _
(saai)
? e3e.s
\
\I
'?^
W
Oi
(O
?
x 18.F1
r co ?
ro
/ N ^
(949.3) J I
I/
-TI I
O
1s M
3 ry?0
n !M d??•
0
o O?
N rn co A
`Y
/
6, ?
v=15°340 56;4 `'??.
945.28
tt)
- _? O
^'
\
?
ROOF AREA = 2,611 S.F. ?
LOT AREA = 15,381 S.F.
LOT AREA
X = 16.97% \
15 0 15 30 60
SCALE IN FEET
LEGEND
DENOTES SANITAFtY MANHOLE
? DENOTES ITYDRANT
511 DENOTES CATCH BASIN
S DENOTES SANITARY SEWER
W DENOTES WA7ERMAIN
ST DENOlES STORM SEWER
Q DENOTES STORM MANHOLE
? DENOiES STORM APRON
a DENOTES 6' WOOD fENCE
o- ? ?
_ SETBACKS
MIN. FRONT YARD SETBACK = 30'
MIN. SIDE YARD SETHACK = 5' (GARAGE), 10' (DWELLING)
MIN. REAR YARD SETBACK = 15'
Proposed Top of Foundation Elevation= 949.8
Proposed Garage Floor Elevation= 949.5
Proposed Lowest Floor Elevation= 941.8
O Denotea Iron Monument
+ 000.0
+(000.0) Denotea
Denotes Exiating Elevotion
Proposed Elevation
Denotea Direction of Surface
937.5
Denotes Drainoge
Sanitary Sewer Service
Elevation
ALL OFFSETIRONS ARE MEASURED
TO HUNDREDTHS OF A FOOT AND CAN
BE USED AS BENCHMARKS.
?
?
A title opinion was not fumiahed to the surveyor nor was a
specific title aearch for the existence or non-existence of
recorded or unrecorded easementa conducted by the eurveyor
as part of this survey.
I hereby certify that this is a true and correct representation
of a survey of the boundaries of:
LOT 3, BLOCK 1, PINETREE PASS 4TH ADDITION
DAKOTA COUNTY, MINNESOTA
Md the Ixation of ali buildings, if any, thereon, and all visible
encroachments, if ony, from or on eaid land. As aurveyed by
me this 17th day of November, 2000.
$
Y
?
?
?
C
3
s
m
?
?
O"s
o-
a ?
y
nW F7?l;J ?
}
?
NOW?3
LL. LL_
? c3
OCZ
Qa
F?z°a
? a
DRAWN
RS
CHECKED
q2G
t?/Oo?%o
SCALE
AS SHONM
JOB N0.
5402-651
?
Gary R. Germond
licensed Land Surveyor, Minn. Lic. No. 24764
2000 BUILD NG P MI APPLICA4ION fRESIDENTIALI
5 an oF EAcaN
??l y06 b 3830 PILOT KNOB RD - 55122
651-881-4875
New CanshucHon ReaulremeMs ?. 'ti?? ? n_. ., n?S-x-} l) ?? Remodel/Reoair Reaulremenla
???
> 3 reyistered Yte wneys showinp sq. R d bl, fq. H. of houfe
and gp roofed areas (2076 max!mum lof covemae altowe?
> 2 coples of pldna (Whow beam 6 wlndow sizes; poured Md. deslyn; etc.)
> t set a enerpy caleulanons
> S copies o/ hee PreservaMOn plan H lot plaMed aRer 7/1 /93
DATE• ." - / 9- 00
? ???b.-t
WICGI )212?100
2 copies ol plan
1 aet o1 energy cdcWaMan for heated addldom
1 sife wrvey (or exteAor addiHau R Eecb
CONSiRUCTION COST:
DESCRIPTION OF WORK: J?'FD
STREEf ADDRESS:
LOT: A._ BLOCK: I_ SUBD./P.I.D. M:
Name: Phone #:
PROPERIY wat Flrst
OWNER
Sheet Addreas:
Cily State:
Zip:
Compan??_ALd[A'r94? 1?2d0 ?? Phone #: C?6;9 473 /Z31
(area code)
CONTRACTOR
Sheet Address: Q_:z CC, 62&0?? llcense # 00/AC ExP•
Cly ?kiw.,_State: rn?l'1 Zip: 'Jr J3?
ARCHITECT/ Name:
ENGINEER Company:
Telephone i: (
Sheet Address: RegisfraHon A:
Cily
Siate:
Lp:
Sewedwater licensed plumber (H InretalUna sewerhvater) : Phone #:
i hereby acknowledge lhat I have read 1hb applicatbn. slate Mwl Me infortnatbn B conect, and agree to compry wNh a0 aPPIcable Slafe
of Minnewta Stalutea and CNy of Eagan Ordinances. ? _•_ A
Signalure ol Applicanf: ft:wAidmaim
OFFICE U3E ONLY M ?
J D
Certificates of Survey Received ? ves _ No ' DEC ? y
Tree Preservation Plan Received _ Yes _ No ? Not Required By_ 700p I
''IYI
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation 0 07 OS-plex ? 13 16-plex ? 21 Porch (3-sea.)
0 02 SF Dweiling ? 08 06-plex ? 17 Caarage ? 22 Porch/Addn. (4-sea.)
? 03 01 of _ plex ? 09 07-plex ? 18 Deck ? 23 Porch (screened)
? 04 02-plex ? 10 OB-plex O 19 Lower Level ? 24 Stortn Damage
? OS 03-plex ? 11 10-plex Pibg _Y or_ N O 25 Miscellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bldg.
WORK TYPE
' a
? 31 Fxt. Alt - Mutti
? 33 Fxt. Aft - SF
? 36 Muid
? 31 New 0 36 Move Bidg. O 43 Reroof
? 32 Addition ? 37 Demolish (Bidg)' ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair O 42 Demolish (Foundation) O 46 WindowslDoors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
a
ft
SAC Code .
sq.
# of Stories
?
No. of Units Length -&ly sq. ft.
No. of Buildings Width h'ev Footprint sq. ft. 2.2,
Const. (Actual)
*
F- Basement sq. ft. t?7 Census Code 101
stem
MC/ES S
ft
(Altowable)
t
- y
. Y
Main ievei sq.
UBC Occupancy g -3 a LEV?t-- sq, ft, tl b'/ City Water
Zoning g? a.<a ? sq. ft. 72$ Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building Gl.?J Engineering Variance
Permit Fee Valuation:
? Surcharge
Plan Review
License iy76 ,f, 15 :7-
MC/ES SAC
City SAC
Water Conn.
Water Meter m
Acct. Deposit
S/W Permit
S/W S
h
urc
arge c-
Treatment PI.
d
P
k
` ll y 1.K5 ? -
' ? 3
7 7'/ ?-
.
ar
De L
Trails Ded.
Other
Copies `-?- ?
Total:
SAC Units /
% SAC
DEC-18-2000 11:53 LBC SALES 8 DESIGN 6124739713 P.elibl
:
?Mcheck COMPLZANCE REPORT
Minnesota Energy Code
MNcheck'Software Version 3.0
COUNTY: Carver
STATE: Minnesota
ZONE: 2
CONSTR.UCTION TYPE: Single Family
DATE: 11-20-2004
DATE OF PLANS: 11-15-00
TITLE: CHATHAM 'B'
PROJECT INFORMATION:
BURROWS RESIDENCE
4628 PINETREE CURVE
STONECLIFFE
COMPANY IPTFORMATION:
LUNDGREN BROTHERS CONSTRUCTION
NOTES:
LOOKOUT LOT
COMPLIANCE: PASSES
Permit #
- Checked by/Date
Required UA = 499
Your Home = 400
19.8t Better Than Code
Area or Cavity Cont. Glazing/Door
Perimeter R-Value R-Value
-------------- U-Va1ue
-------------
--------------------------------------
CEILINGS -------
1646 ---
44.0 0.0
wALL5: Wood Frame, 16" O.C. 214 19.0 2.0
wALLS: Wood Frame, 16" O.C. 1364 19.0 2.0
wALLS: Wood F'rame, 16" O.C. 1247 19.0 2.0
BSMT: Conc. 8.41 ht/7.8' bg/7.8' insul 85 10.0 010
GLAZING: Wirtdows or poore, Above Grade 52 0.350
GLAZING: windows or poora, Above Grade 300 0.350 1
GLA2ING: Windows or poors, Above Grade 161 0.350
DOORS 37 0.350
FLOORS: Over Outside Air 38 30.0 0.0
HVAC EQUIPMENT: Furnace, 90.0 AFUE
-----
---------
--------------
-------------------°-------------------------
COMPLIANCE BTATEMENT: The proposed building --
design deecribed here ia
consistent with the building plans, specifications, and other calculaCions
submitted with the permit application. The proposed building has been
emepnt,9-oL
-t
deaigned to meet the r hR-Minnesota Energy Code.
.
^
Suilder/Designer /14-/' (pr/? ?
Date
TOTAL P.01
,
(sas.;
939.2
/
?
S89°29'27"W
110.42
(s3s.i )
938.6
?
30 15 0 15 30 60
SCALE IN FEET
LEGEND
QS DENOTES SANITARY MANHOLE
7X DENOTES ITYDRANT
DRAINAGE & UTILITY r .._ .. ... fii DENOTES CATCH BASIN
? T S DENOTES SANITARY SEWER
I
W
?
DENOTES WATERMAIN
? ST DENOiES STORM SEWER
Y 0
1
3
DENOTES STORM MANHOLE
? 04 ?p Date /1 ZD-06 i.
? DENOTES STORM APRON
`L''ACTAN ENGWLEItIIV?'r DEF''.P, DENOTES 8' YlOOD FENCE
?
0
a
L
?
c
E
a
a
:5
a
ro
?
?
0
Ni
0
-o
n
?
i
?
?
?
n
?
I
ti
:D
a
_P
4a
COUNTY STATE AID HIGHWAY N0.32
? I -- ROOF AREA = ,'611 S.F.
LOT AREA = 15,381 S.F.
LOT AREA 96 = 16.97X
\
Proposed Top of Foundation Elevation= 949.8
Proposed Garage Floor Elevation= 949.5
Proposed Loweat Floor Elevation= 941.8
O Denotes Iron Monument
+ 000.0 Denotes Exiettng Elevation
+(000.0) Denotes Proposed Elevation
?- Denotes Direction of Surface
5
937 Drainage
. Denotes Sanitary Sewer Service
Elevation
ALL OFFSET IRONS ARE MEASURED
TO HUNDREDTHS OF A FOOT AND CAN
BE USED AS BENCHMARKS.
14
1
A title opinion was not fumished to the survayor nor wcs a
specific title aearoh for the exiatence or non-existence of
recorded or unrecorded easements conducted by the surveyor
as part of this aurvey.
i hereby cerY that thia is a true nnd correct representation
of a survay o the boundaries of:
LOT 3, BLOCK 1, PINEfREE PASS 4TH ADDITION
DAICOTA COUNIY, MINNESOTA
Md the location of all buildinga, if an?, thereon, and all viaible
encroachmenta, if any, from or on said lond. As surveyed by
me this 17th day of Pvem4r, 2000.
Gary R. Gertnond
Licensed Land Surveyor, Minn. Lic. No. 24764
V
° SETBACKS
MIN. FRONT YARD SETBACK = 30'
MIN. SIDE YARD SETBACK = 5' (GARAGE), 10' (DWELLING)
MIN. REAR YARD SETBACK = 15'
q ? Q
?
N
FaZ?a
? a
U
DRAWN
RS
CHE?f?ED
1t?2o00
SCAIE
AS SHOWN
J? N0.
5402-851
.
?
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
Or -3 t?COCJC
/
EGA
L PROPERT -
Y L
L:
h DATE OF SURVEY:
N
?
w
LATEST REVISION:
?
C
0
DOCUMENTSTANDARDS
O
Q?y Q
o ? • Registered Land Surveyor signature and company
p ? BuildingPermitApplicant
? ? • Legal description
da?j ? ? : Address
ef o North arrow and scale
?%a .? ? House lype (rambler, walkout, split w/o, split entry, lookout, etc.)
S ? Directianal drainage arrows with slope/gradient %
? o . ProposedJepsting sewer and water services & inveR elevation
? Street name
? ? Driveway
v ? . Lot Square Footage
? • Lot Coverage
ELEVATIONS
xistin
?
? ? • Sewer service (or Proposed)
? ? • Property corners
?d ?
? 9 • Top of curb at the driveway
r
„ o ? U • Eievatons of any ebsling adjacent homes
?? q? ? Adequate footing depth of structures due to adjacent utility Venches
Prooosed
/
&f/ ? ? • Garege floor
q ? ? • Firstfloor
r?
? ? • Lowest exposed elevation (walkout/window)
l
? ? • Property corners
m' ? ? • Front and rear of home at the foundaOon
PONDING AREA (iF aodicade)
/
? ?D' ? • Easement line
? d ? • NWL
o ? ? • HWL
? ?/ ? • Pond # designafion
? ? • Emergency Overflow Elevation
OIMENSIONS
? ? • Lot lineslBearings & dimensions
?
V ? ? Right-of-way and street width (to back of curb)
? o Proposed home dimensions including any praposed decks, overhangs gr¢ater than 2', porches, etc.
/ (i.e. all strudures requiring permanentfooDngs)
'
0
9 ? • i0es within those easements
Show all easements of record and any Ciry util
?
? ? • Setbacks of proposed structure and sideyard setback.of adjacent e?assEng structures
?
? ? • Retaining wall requiremeMS, 'rf any /, j,
Reviewed:
,70 - 0?
March 19BB
crwcreLocvnnrr.Fre
Site address: /°wi? (.:Lt/ffi?C? Lot S Block I Subd. &??A" 44
On April 15, 2000 the Minnesota Energy Cotle, Category I Building Requirements for insulation protection, air
tightness, and ventilation, 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 structure: is constructed to meet minimum requirements of the Mn Energy Cotle, Chapter 7670
OR
? This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUPACTURER MODEL 8TU'S VENTINGTYPE
water Heater x 64054450 *00V0 p v
Furnace x
Dryer
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
Yes No
Kitchen kitchen
Bathroom 1 PowheiL N 5
Bathroom 2 >C
Bathroom 3 ? 50
X
Bathroom 4
Other
VENTING
FIREPLACE S LOCATION GAS WOOD MANUFACTURER MODEL BTU'S DIflECT ATMOS
MAKE-UP AIR MODEL TYPE CFM's
2•0 a
I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Cotle and City o( Eagan
requirements.
Signat ?
u,4i0n
Company Name
ia-i!7-oa
Date
' This form is the responsibiliry of the General Contractor.
CITY USE ONLY
PERiYtIT #: " 1 q?! 7 RECEIPT DATE: _ 3.1h/ O ?
RESIDENTIikL MECHANICikI. PEMMTf ?PPLICATION
cmt oF eaearr
ssso PQ.ar xxos go
E?sM huv 5512E
651-6$1-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date 3? /? f
SITE ADDRESS: 7"-- v`Q,
OWNER NAME: l? w a C?4 '^ 8/'a S 69oV5 T_ TELEPHONE #:
(AREA CODE)
INSTALLER NAME: ?i C 4i v? GY t i NP riLa .+ f??ELEPHONE #: T 7-r-_XSd'
? (AREA CODE)
STREET ADDRESS: Ca 4, J`r o? /J
CITY: S??q K o F'?C!
STATE: /1?v ZIP'. 1-?5- 37 f
Place a check mark next to the oermit work tvoe
? New residential dwelling unit under constructionand not ownerloccupied $ 70.00
_ Add-on, modification or alteration to existinq dwelling unit $ 50.00
• furnace replacement
. air exchanger
• air conditioner
• other
Nature of work:
State Surcliar e $ 50
L Total $ 7O ?
Reminder: Call for inspections.
SIGVATURE OF PERiMtTTEE
Updated 1101
CITY USE ONLY
PERMIT #:
APPROVED BY:
INSPECTOR
RECEIPT DATE:
COMMERCU1. MECH"CAl. PERMTC ihPPLICAT10N
CiT'Y OF £Ac&ikN
S$SO PILOT KNOB fZD
F-AGu4N, MN 55122
651-681-4675
Please complete for: aIl commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME: PHONE #: -
(AALA CODL)
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS:
CITY:
WORK TYPE: New construction
_ Interior Improvemen[
_ Processed Piping
PHONE #: -
(ARF,A CODE)
STATE:
ZIP:
Install U.G. Tank
Remove U.G. Tank
SnecifyNature of Work:
When installing/removing underground tank, call 651-681-4675 far inspectia: by Fire Marshal and
Plumbing Xinspector.
Fees: 1°/a of contract price OR $50.00 minimum fee, whichever is greater.
Underground tank removaUinstallation = miuimum fee
Conhact price: $ x [°/a = $ (Ease Fee)
State surcharge calculate at 5.50 for each $1,000 Base Fze
TOTAL $
SIGNATURE OF PERNIITTEE
Updated I/Ol
PERMIT # ?I?i h 7.h
RECEIPT DATE: 'J I v I O1
RESIDBIVTUL PL[TMBINfi PERM1T APPI1Ci4T10N
crrYorEAGM
sBso enAm sNoe tto
$A6AA. l1F 55188
851-88]-4675
Please complete for:
SITE ADDRESS:
? single family dwellings
? townhomes and condos when parmits are required for each unit
? backflow preventer for irrigation system
?-8 x-?', "_ ?.? r(A r V
OWNER NAME: : L44 r1 & LD` ST TELEPHONE #:
(AREA CODE)
INSTALLER NAME: /Y"l R ?u?° ?
STREET ADDRESS:
ciTV:
S??e-, a
Place a check mark next to the nermit work tvoe
TELEPHONE #: 9 5-?
(AREA CODE)
STATE: ZIP: -?` S.5'7 /
? New resideMial dwefling unit under consVucNon and not ownedoccupied $ 90.00
Add-on, modification or alteration to existinq dweliing unit, including: $ 50.00
• abandonment of septic system
. new installation/repair/rebuild of RPZ
• lawn irrigation system
• water turnaround
Nature of work:
Septic System, new/refurbished - $ 225.00
. includes County & Consuking Inspedor fees
. requires MPC license
State Suroharge $ .50
Y0 ?
7otal S
Reminder. Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc.
I herebyaoknowledge that I have read this application, state that the infortnation is correct, and agree to complywKh all applicable Cityof Eapan ordinances. It
is the applicant's responsibiliry to notify iha property owner that the City of Eagan assumes no liabiliry tor any damages caused by the City tluting its normal
operatiunal and maiMenence activdies to the facilities constmcted undar ihis permit with' propertylr' ht-f
r
--??
SIGNATURE OF PERMITTEE
Updated 1101
05i21/2001 15:29 FA% 9524739191 LLTDGREV BROS. CONST,
e001
Siieaddress: ?Lot S 8''ockj Subd.??l?J??
On April 15, 2000 the Minnesota Energy CoJe, uategCry I Buildlrg FleqLirements foi, insulatian protectior,. air
tightness, and ventilation, was adop?ed. As aesult, the City of Eagar, is racuiring rhat the following Inforr,raY.on he
subrnitled priar to issuance of a Cerrificate of Gccupancy.
This &ucture: is :onsVucced to meel minin,um requirements of tha +An _nergy Cod:, Chapter 767p
-" 01?
Th1s structure: will be constructed !o meet mon, restncdve requirements of Chaptera 7572 er 7674
AP+'LIANCE GAS ELEC MANUfipU1REA ? MOpEL YENTINGFYPE
water Heater x ?? ?_??,j,), sj D +f0 Orv V
Fumace x 1 ?
Dryer
IXHAUST SYSTEM
ICnchen
LOCATION
kitrhan
7YI°E
?
PdQOEt
CFM's VENTEO
res no
BaNroom 1 Povineo-
8athroom 2 ? 1 ?
Bathroom 3
Bathroom 4
oNer ?
FlREPLAC S
LOCaTION
GA9
W000
MpNUFACiUREA
MDDEL
BTU°S VENTING
oiUcT arrnas
b1AKEUP Rlp fu40?I:L TYPE CFM's
l hereby acknowledge that the ahove informakn is :orreIX ard agrae ro canply wi[h r1ie Minnesota Energy Catle and Gity of Eagsn
requiremenis. ,
agnat a_4 -
Company Name '
--
?fl12
' T;jis iorm is qte responsidlity of ihe Genera! Can' racWr.
r________________-
? Permit#:
I 9? _t? I
I PermR Fee:
? Date Received:
? Staff: I
I
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ? Site Address: ,?'blrA i- e- [(/2
Tenant: Suite #:
RESIDENT/OWNER Name:?y .?U,g K?W.s Phone: ?S?Z7d?6a
Address / City / Zip: y62? ?/?/F ?6( Q C C?lZ
Applicant is: _ Owner Contractor
TYPE OF WORK Description ofwork:;!Z?kGIh d k-
aG
Construction Cost:0q• Multi-Family Building: (Yes No ?
CONTRACTOR Name: \nIZS?[i -151 R/.e%k License #: 2eP/ S!E5?G
Address: go00
? /,
City?7/I??D?/?/{ State.?Zip:?s 7 yl,
Pho e,?[0 3• 'Sr/?-O? - e5l S? Contact Person:/4/.1e?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
EflePgy COde . Residential Ventilation Category 1 Worksheet • New Enerqy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 72 months, has the City of Eagan issued a pertnit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical ContracWr: Phone:
Sewer & Water Contractor: Phone:
ilr70TE,= Pians artd supporting documsnis thaf yousubmit ar4 considereal ta be;pub/rc infprtmation.Portioasvf
#he rnforriiatran may ba Cfassif?edfas?qon qubitc if you pr?vrde specifle? reasoris that u?oLld permi[ the Crt?fo ..
,
..,,??eoRClr?dethatthe ar?tra?tire''se"vrets
I hereby acknowledge that this information is complete and accurate; that the work will be in confortnance 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.
z a+ G ? ?r/!'/1?'"i
?A'pplicant' rinted Name
/
x .?? ?' ?rT PJ- pplicanYs Signature
Page 1 of 3
Z
ÿû
ý
ü
û
þýý üïüú
ùýý ÿú ì
þþ
ÿþ
þýõ
úùø÷öõ úü þ
ù ÷öõ
ò
÷öõ úü
þ
õ ñ ùþð
ü
þùþ ìùõ
ö
ï ü
úîù
í
òþ
ü
þ óó ë
û
ë
çþ üë
ßèèø
þ
ùø
þÞ
þ õþ
ý
þù
ë
çëùë
è
ó
ó
þõ
ó
þ
è
ø ë ç
þ
îù
øö
ê þüó
ëö ëþè
þíå äåèè
ôù
úù
ü
þ æ
ù
å äåèãèâã
æ
ù
ûè
óûò
õ ñð
õõ
ô
öë ÷ù
êþ
â
ù
ý
ü
áàââ
øö
êü
þ
õõ
þ
ó
ë
þ
ü
ëõöê
õõ
øú
óáþ
ú
ù þ
ö óý
ü
ì
þè
õõ
é
ë úü
ù
þþùö úü
ù