567 Prairie Cir Eeontrof
INSPECTIQN RECURD No.
-'CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number: 00e'44 t
Eagan, Minnesota 55123 Date Issued: *
(612) 681-4675 -
SITE ADDRESS: LOT e2 si vctc :,APPLICANT:
1667 NRAIMI£ CIR f MCtaaMAlU CONST INC
ChUNTRY H01.10N 2M11 (tt?) 609--7061 ;
PERAAIT !?VPTYPE:
TYPE OF WORK: NeW
INSPECTION . •
INSUlAt1UN FINAI .?,
FIRf P! Al.F. ?
T
•t
RFMAF?R''y = 100V 5& N COMTRACTOR - S'YAR P1.8Q
0
n
PsrmN No. Wrmlt Holda Dete Talepha» R
S/1N
PLUMBING
HVAC O (p ' ??D
ELECTRtC
ELECTRIC
insp?ction DaDS Inap. CommMts
Ffloungs l V0I9A PiA
Foundatbn I Y14&d ???/
???T/
Framing
Roofin9
Rau9h PYb9. „? ?
Rough Htg. ? (!
Isul.
Flreplace ?
Final Htg. 7L
Or&8t Te81
Flnal Plbp.
r? - Plbg. Inspectar - Notify Plumber
Const. Meter
EngrJPlan
Bidg. Final ? L
Deck Fty.
oeak r.,.? Z 2 O
weu
Pr. Disp.
j4Gv'aWaL,w `/ tl/7 2.- 1-6- W t r t
Q ? ,? ,!f
Wtrfiftca#e of cccuvanc4
Wtt4 af Wagan .
?tat oi lovising anboection
This Cenificate issued pnrsuant to the requirements of the Uniform Building Code
certifying that at t/u tifie of issuance this stnechere was in compliance with the various
ordinances of rhe City ngalaling building construction or ase. For the following:
use clan;scation: SF DWG HWg. rermit r+o. Q43
y Douia
Owoer of Building ?D COW INC Addresa 1212 EIIEMI. Bff RD, B UIUE
BuilQiog Address 567 RAMM. CnUE BAsr L,ocaliry L2, ffi COWM SX1LW 2ND
Q/24/q2
> >.
?
POST IN A CONSPICUOUS PLACE ,
INSPECTION REC4RD
OtTY OF EAGAN PERIIAIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
, ,. . . .
SITE ADDRESS: APPLICANT:
i i?iii) r i2•: It,?l 1 ul.l r.,t? r e. ? o ,? 1 ?.? ?iF.
F _ 7
L I
PERMIT SUBTYPE: TYPE OF WORK:
. ?, . ? ??Alf+
Permit Nolder Date Telephone #
PLUMBING
HVAC
Inspection Date Insp. Commente
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
RpUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
!
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTiVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
K 04592 ,2 a ?- ?05
Pequesl te ve No.
3
? 1 R Inspection
p p v
L Na
? Reatly Now
III Notify Inspeclor
whan Reatly7
IM licensed coniractor '] owner hereby request inspection of above electrical work at
Y :
Job Adpress IreeL l ox or Rayt¢ No.?
Y
1 City
Seclion No. TownshiD Name or No. Range No. Count
OccuPanl ( m ? Ph?N - 1 W ?
Power SupPli
C AUtlress
'
EI t'cal Conha or(Co^pa Name? ? Vac r's L' ense .^ ,(1'?
6 6?
Mai q tloress I onlractor Owner Makinq Installat n)
Aulh nzetl ignaI onhactoa?in IQ ngb2?ly?ip
l? ^\ / ?
?
LJ-?ti]LL p?
I e m0er
MINNESOTA STATE BOARD OF EIECTPICITY THIS INSPECTION REQUEST WILI NOT
Griggg-MldwaY BIEg. - qoom SllB 9E NCGEPTEO BY THE STATE BOARD
1821 University Ave.. St. Peul. MN 55106 UNLESS PROPER INSPECTION FEE IS
Phane (612) 642-0800 ENCLOSED.
gj,evj?';--
K 04592
REQUEST FOR ELECTRICAL INSPECTION
1. See instmctions lor comDleling Ihis lortn on back oi yellow copy,
"X"-t'ie%w Nork Covered by This Request
EB-00001-08
/O 2!_3?2 5
¢x dtl Rep. TypeoiBuilding AppliancesWired EquipmentWired
Home Fange Temporary Service
Duplex Water Heater Electric Heating
Ap[. Builtling D yer Other.(Specify)
Comm.llndustrial urnace
Farm Air Conditioner
OIM1er (syecity) Conirector5 RemaMS'
Compute Mspection Fee Below:
» Other Fee # ServlceEniranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above 700 _ Amps ?
SIgnS Inspector's U. Onty: 707 l_
' Irrigation Booms
? m
Special Inspection Y?
AlarmiCommunication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 M HS.
I, the Electrical Inspector, hereby Aougn-in
` Data
certify that the above inspection has
been made. ?ai ? ?
F? a?a
OFFICE USE ONLY ?
This request voi0 18 montM1S irom
I? 2'154 4 3,?a ? `?
Request Oate t
r ire No, Roug Uspedion
Fe
u NOTICE: Vou Must Call ElecMCai Inspector
If A q
h
I
I
ti
q
? Ves ? N. oug
-
n
nspec
on
Is Fequired.
I 0 licensed contractor ? owner hereby request inspection of above electriral work at
Job tlres (Slreet, Box or?t?a)
f ?cA City?
?J
Seci,on No. Township Name or No. Range No. County
Il?lo
Ocuipant(PRIN /
S
5 Phone No.
c:o
Power Supplier /? Address
Eleclrical ConVact r(COmpany Name) OF, ContraMOrS license No.
4 ?V ?.
MeMi rner Making Inslalletion)
V
0 9V 55124
AuO??i ( a r wner M'ng Inst i n) Phone Number
{ j
MINNESOTA STATE BOApD OF ELECTpICITY THIS INSPECTION flEQUEST WILL NOT
Grlggs-MlAwey Bltlg. - Noom 5173 BE ACCEPTED BY THE STATE BOARD
1827 Univnsity Ave., Sl. Paul, MN 55100 UNLESS PROPER INSPECTION fEE IS
Vhom (812) 842-0800 ENCLOSED.
31ol 9/Fe/
M 21443
HEQUEST FOR ELECTRICAL INSPECTION
jl? See inshucliona br comple[ing Itlis farcn on back of yellow copy.
"X" Below Work Covered by This Request
? E8-00001.08
' -
Ne% A026 R6p. TypeoiBUil4ing AppliancesWired - EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
J Apt. Building Dryer Load Management
Comm./Industrial Fumace Other (Specify)
Farm Air Conditioner
Other (specity) ConVacbr§ Remarks:
Compute Inspection Fee 8elow: ? VC??? '?' '"??
# Other Fee # ServiceEntranceSize Fee # Cimuits/Feeders Fee
Swimming Pool 0 to 200 Amps o to 70o Amps
Transformers Above 200 _ Amps Above 100 _ Amps
Signs Imspector's Use Only: ' TOTAL
IrrigationBOOms ??
Special Inspection
Alarm/Communication THIS INSTALLATION MAY ORD E DI$CONN ECTED IF NOT
O[her Fee COMPLETED WITHIN 1 THS
I, the Electrical Inspector, hereby Rough-in ? r oaie
certify that the above inspection has
been made. Final e
OFFICE USE ONLY
This request witl 18 monihs lrom
Address: 567 pRA= CI Lot Z Blk z Sec/Sub GO= H?M 2ND
These items were/were not complete at the time of the final inspection.
pate: 9/24/92 Yas No
Final grade (6" from siding)
Permanent steps - garage V
Permanent steps ?- main entry V
Permanent dtiveway V
Permanent gas ?
Sod/seeded grass ?
Trail/curb damage
Porch j?
Basement finish ?
Deck v
Please verify vith tha bullder tha temoval of roo£ test caps from the plumbing
system and tha shut-off of watar supply to the outside lawn faucet befora
freeze potential exists. ` caj
?
x?numruEn
White - City copy Yellow - Resident copy Pink.- Contractor copy
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Conatmclion Reauiremenb.
• 3 registered.sAe surveys showing sq. ft. of lot, sq. ft. of Iwuse; and all mofed areas
(20%maximumlotcove2geallaxed) • 2 copies af plan showing beam & window s¢es; poured found design, etc.)
. 7 set of Energy CalculaUans
• 3 capies of Tree PreservaUon Poan if lot platted after 717793
• Rim Joist Detail Opfions selecGOn sheet (bldgs with 3 or 1e55 units)
DATE Q?
'Zzq . -I S
RemodeVReoair Reauirements
• 2 copies ot plan
• 1 set of Energy CalculaGons (or heated additions
• 1 site survey for extenor additiom 8 decks
• Indicate if home served 6y sepfic system for additions
VALUATION ?
SITE ADDRESS ?_ QAf( L_Q- ? ra ?• MULTI-FAMILY BLDG _ Y _ N
TYPE Of WORK PIREPLACE(S) _ 0_ 1_ 2
APPLICANT A`?nc , (-'? oi
STREET ADDRESS AQ ?l n k .) E? i?? 1 v rl CITY STATE ZIP
TELEPHONE # 4Sy lAlJi LO CELL PHONE #
FAX #
PROPERiYOWNER TELEPHONE# C?l ' LT13
-------------- -------------------------°--°°----------°---------------------°-------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MIr VESOTA RULES 7670 CATCGORY 1 MINNESOTA RULES 7672
(4 submission type) • Residential Ventllation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
. Energy Envelope Calculations Suhmitted
Plumbing Contractor: _
Plumbing system includes:
Mechanical Contractor.
Mechanical system includcs:
Sewer/Water Contractor:
_ Air Conditioning
_ I-Ieat Recovery System
?
Phone# ree: ?u70.00
Phone #
--°--°----°------------°---° °-----------------------°--------------------------
I hereby acknowledge that I have read ihis application, state that the information is conect, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicanf
OFFICE USE ONLY
_ Water Softener _
Water Heater _
_ No. of Baths
_ Phone #
L.awn Sprinkler
No. of R.I. Baths
Fee: $90.00
Certificates of Survey Received ,^ Tree Preservation Plan Received _ Not Required _
Updated 4/D2
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-piex Plbg_Y or_ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Damolish (Interior) ? 44 Siding
? 32 Additlon ? 36 Move Bldg. O 42 Demolish (Foundation) ? 45 Fire Repair
? 33Alteration ? 37 Demolish(Bldg)" 0 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addirion) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Finat
_ Framing _ Siding S[ucco Stone
_ Fireplace _ R.I. _ A'u Test _ Final _ Windows (new/replacement)
_ Insularion _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8 Storage
S&W Permif & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
PERMIT if
Piease complete for:
SITE ADDRESS:
OWNER NAME: :
INSTALLER NAME:
?ac) 2??
RECEIPT DATE:
8008 g£SIDENTIAL PLUM$Iftfi PEitbllT APPLICATION
crrY oF EAsativ
3680 PII.OT KAOB itD
EhfiAR, MA 551 EE
651-6$1-4675
single family dwellings, Wwnhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
STREET ADDRESS:
CITY:
TELEPHONE #:
(AREA CODE)
TELEPHONE #: F? Z-`i l9 I? O D-?
STATE: M 0 ZIP:
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply
• MODIFICATIONlALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
x Addi
f
M
ddi
l
l
ng
i
Ures to
evels or room a
ower
tions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water turnaround - existing dwelling unit (+ 5/8" meter'rf n
ed -$118)
eed
?
?
_ Other: W`.c...J- EcLp?'?l \,-(1o Y,\
_ RPZ: new installation/repair/rebuild $ 30.00
_ lawn irrigation system
ReplacemenUadditionai: _ water softener _ water heater
----?.1 $ 15.00
''-
I
?
l
State Surcharge
I
'
i
l $ .50
i
??- , r; ?nm I?I
t
TO
81
-=i
I here6yacknowledge that I have read this application, state that ihe information is correct, and agree to complywiM all applicable Ciryof Eagan ordinances. It
is the applipnYs responsibility to notifythe property owner that the Ciry of Eagan assumes no liabiliry for any damages caused by the City during its normal
operetional and maintenance actlvities to the facilities constructed under this permit withi ropartq!' f- a? asementYjcs?Q-2
?-
I SIGNATURE OF PERMITTEE 1/02
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651•681-4675
New ConsLUCtlon Reauiremenb
• 3 registered site suroeys showing sq. fl. of bt, sq. R of house; and all roofed areas
(20% mazimum lol wverage allowed)
• 2 copies of plan showing 6eam & wiridax s¢es; poured found design, etc.)
• 1 set of Eneryy Calculations
• 3 copies of Tree Preservation Plan M lot platled afler 711193
. Rim Joisl Delail OpUons seleclian sheet (Ndgs xith 3 or less unils)
DATE -1-
_ Water Softener
_ Water Heater
_ No. of Baths
SITE ADDRESS s67 !'iqirtie +/rsf !aSr im-3 MULTI-FAMILY BLDG _Y ZN
TYPE OF WORK &?e? 4A J FIREPLACE(S) _ 0_ 1_ 2
APPUCANT fie_ &W?114 quiL0ER-5_ ba..'re # 20l 3236 9
STREETADDRESS 1314k 41? 1/? CITY n,V• STATE ??'?ZIP ?2
TELEPHONE #?? CELL pHONE #?IZ;?__ 7V- FAX #IrL 322 '3Aal
?C"?\ br\ C¢l\
PROPERTYOWNER ??x?a?-c SG?w1q2?2- TELEPHONE# kl- 6PI 9a77
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RLiLES 7672
(J submission type) • Residentlal Ventilatlon Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
. Energy Envebpe Calculatlons Submitted
Plumbing Conhactor:
Plumbing system includes:
Mechanical Contractor:
Mechanical system includcs:
Sewer/Water Contractor:
Phone #
-1 '1b.C)U
I O -g-??a-
Fee: $90.00
ocr c 12002
Fee:
I hereby acknowledge that I have read this application, state that the information is correct, and ogree To comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances, _'-\ A
Signature of Applicant
L
OFFICE USE ONLY
RemodellReoair Raauiremanh
. 2 mpies at plan
. 1 set of Eneqy Galculations for heated addilbns
• 1 sde survey fir ezterior additans & decks
. IndiWle'rf homa sarved hy septic system for additians
VALUATION
Phone #
_ Lawn Sprink
_ No. of R.I. F
_ Air Conditioning
_ Heat ftecovery System
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
O 06 04-plex
? 31 New
? 32 Addition
116K 33 Nteretion
? 34 Replacement
O 07 05-plex ? 13 18-plex
? OB OB-plex ? 16 Fireplace
? 09 07-plex O 17 Garage
? 10 08-plex ? 18 Deck
? 71 10-plex W'19 Lower Level
? 12 12-plex PIbOfS' or _ N
Valuation vc o
Census Code tf' Se
SAC Units
Nbr. of Units 0
Nbr. of Bldgs /
Type of Const -5-/V
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn.(4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 6ct. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Slding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)' ? 43 Reroot ? 46 Windows/Doors
"Demolition (Entire Bidg only) - Give PCA handout to applicant
Occupancy n-3 MC/ES System
Zoning 1? - l City W ater
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
W idth
REQUIRED INSPECTIONS
_ Footings(new bldg) FinaUC.O.
_ Footings (deck) FinaVNo C.O.
_ Footings (addition) i/ Plumbing
_ Foundation ? HVAC
Drain Tile Other
Roof Ice & Water Final Pool Ftgs Air/Gas Tests
Final
'Is/ Framing _
Siding Stucco Stone
? Fireplace
R.I. Air Test Final Windows (new/replacement)
? _
Insulation _ Retaining Wall
Approved 8y ?P , Building Inspector
Base Fee
Surcharge
Plan Review
MGES SAC
Ciry SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
? ?°?D' RESIDENTIAL °??
? BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB HD, EAGAN MN 55122
651-681•4675
New Construction Reuuiramenh RemodellReoair Reouirements
. 7 reqisiereG site surveys showing sq, ft. of lot, sq. ft. of house; and a0 roofed areas • 2 copies of plan
j20"o maximum lot coverage allaxed) . I set of Energy Calculalions for heated additions
. 2 copies of plan shawing beam d window s¢es; poured found design, etc.) . t site survey for extenor additions 8 decks
• 1 se[ uf Energy Caiculations . Indicare if home served by septic system tor additions
• 3 copies of Tree Preservation Plan i( lot platted afler 711193
• Rim Joisl Detail Options selection sheet (hldgs with 3 or less units)
DATE ??/3?? Z. VALUATION
SITE ADORE55 56 -7 dg? 6,16& 9?67_ MULTI-FAMILY BLDG Y N
TYPE OF WORK C?d?a:7C??,v?a,oC?au- ???.? fIREPLACE(S) _ 0I _ 2
APPLICANT Aliied Fhmide
dba fireside Comer
STREETADDRES$ [iranggaginnonailt CITY STATE ZIP
2700 N. Falroiew
TELEPHONE # o„te,.m. ...? «.. ELL PHONE # FAX #
651/633 ?2561
PROPERTYOWNER SC? tja12yZ TELEPHONE#
------------------------------------- ----------------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RUI.ES 7670 CATI:GORF l NIIVNGSO'C.1 Ri'I.L5 7672
submission type) . Residential VenGlafion Category 1 Worksheet Sobmitted • New Enerqy Code Worksheet Su6mittetl
. Energy Envelope Calculations Submitted ?
Plumbing Contractor: Phone # Ca ? `
Plumbing system includes: _ Water Softencr I.atim Spri?
Water Heater No. of R.I.yvad?is o?,? ?
-- vo. of Baths
Mechanical Contractor:
Mcchanic<il svstcm includes:
Sewer/Water Contractor:
Air Condiuoning
Heaf Rccoccn' Svstrm
Phone
Phone #
Fcc: S70.00
------------------------------------------------------------•-•---°---°-------------------------------------------------
I hereby acknowledge that I have read this appiication, state that the information is correct, and agree to compiy
with all applicable State of Minnesota Statutes and City of Eagan Or nces.
Slgnafure ot Applican O?n?-
---------------- _.__-------- --------- ----- ------------ ----------- ---°°--°-°--------------------- ---- -- ' - ---- -
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4l02
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex 0 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
0 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 70-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-piex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire 81dg only) • Give PCA handout to appli cant
Va luation Occupancy MC/ES System
Ce nsus Code Zunir?g City VVa.er
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. tP.RV ?,
Nbr. of Bldgs Length ? Pire Sptinklered
?. .
Type of Const Width
,. . ?
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaliC.O.
_ Footings (deck) Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Wacer _ Final _ Pool _ Ftgs _ AiriGas Tzsts _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new?%replacemen[)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit 8. Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
8uilding Inspector
. ;
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-687-4675
NewConsWNion Raouiremenls
• 3 registered site surveys showing sq. fl. of lot, sq. ft of house; and all mWed areas
(20% maximum bt croverage allowed)
• 2 copies of plan showing beam & window sizes; poured found design, etc.)
. 7 set of Energy Calculatiuns
• 3 copies of Tree Preservation Plan if lot platted aNer 7/1193
. Rim Joist Delail Options setec[ion sheet (hldgs wflh 3 or less units)
DATE tJ 22- ' C>L
SITE ADDRESS ??,D? ?r0.-? CtJ?
TYPE OF WORK [ Q Gf( C??? ??-Q?Z31
% -- -
RemodellReoair Requirements
• 2 copies of plan
• 1 set of Energy Calculalions for heated addNOns
• 1 sitesurvey for eMerior additions & decks
• Indicate if home served hy septic system for addilions
VALUATION ? 5OE50 . ?i
?^ • E c MULTI-FAMILY BLDG Y N
PLACE(S) _ 0 _ 1 _ 2
APPLICANT FECROMY MOORM9 & §??OR19+ Umc•
49 Soath OWasao Blvd.
STREET ADDRESS I CITY STATE ZIP
i ume Canaaa,l?l 55117
TELEPHONE#???j? FAX#
PROPERTYOWNER TELEPHONE# S 1 (, s,
COMPLETE THIS SECTION FOR "°NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RiJLES 7670 CA1'EGORY 1 MINNESOTA RULES 7672
(d su6mission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope CalculaGons Submitted
Plumbing Contractor: ____ Phone # __
PlumUing system includes: _ Water Softener Lawn Sprinkler Fee: $90.00
_ Water Heater No. of R.I. Balhs
_ No. of Baths
Mechanical Contractor. Phone #
Mechanical system includes: Air Conditioning F+ee: `
_ Heat Recovery Syslem D `
Sewer/Water Conhac Phone #
?
,
---°----------------------------°----^-------------------°--°----------------°-------- --------°--------_?- L•----
I hereby acknowledge that I have read this application, state that the informaf is c , ncl agr e to om y
with all applicable State of Minnesota Statutes and City of Eagan Ordi es.
Slgnature of Applican
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
.W? :
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? OS 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? OS 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 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 Bidg
? 31 6ct. Alt - Multi
? 33 EM. Alt - SF
? 36 Multi
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation _ Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinallC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundarion HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing Siding Stucco Stone
_ Fueplace _ R.I. _ Air Test _
_ Final _ Windows (new/replacement)
_ Insulation _ Retaini?nn Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Building Inspector
Total
PERMIT ` Cont o"o. 0768
,
CITY'OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: BuiLoiNG
Permit
Eagan, Minnesota 55123 Number: 000943
(612) 681-4675 Date Issued: 0 7/ 0 7/ 9 2
SITE ADDRESS:
567 PRAIRIE CIR E
LOT: 2 BLOCK: 2
COUNTRY HOLLOW 2ND
DESCRIPTION:
r1§ ui3.cCi?ng Permit Type SF DWG
?';Work Type
Buildin9
NEW
- UBG Uccupancy R-3 M-i
Construction'7ype V-N
2o-rvirtg '
'
? R-i
f
Building Length 64
Bu:ilding W3,dth- 36
804 ldictg stpr iss ,-=
. 2
r
.
_ . ?
.. J
'
o
' G
i
???
,'
?
,,!' •\
j
`
`
t
?
at
.
,>.. "°
f
< `..`..u.
? l?_? ",.i? i
..a4 ?.:
u :.?
?
? . ._...
REMARKS: C Zl 15 -2 9 -5
PRV S t¦ W CONTRACTOR - 3TAR PLBG
FEE SUMMARY
VALUATZON
$130,000
Base Fee
Plan Review
Surcharge
SAC
SAC $
SAC Units
Subtotal
$744.50
$489.93
$65.00
$700.00
100
$1,993.43
MZSCELLANEOUS $1,610.60
Total Fee $3,603.93
CONTRACTOR: - Applicant - ST. LICpWNER:
MCDONALD CONST ZNC 16887061 0002376 MCDONALD CONST ZNC
1212 BLUEBILL BAY RD 1212 BLUEBZLL BAY RD
BURNSVILLE MN 55337 BURNSVILLE MN 55337
(612) 686-7061 (612)688--7061
i hereby acknowledg:e that I have read th'is application a:rcd stete that tMe
info-rmation is corroC't and agree to camply with Al1 applicable State of Iqm.
Statu'tes artd City of' Eagan Ordinances.
L
APPLICAN7/PE MfTEESI NATURE IUED Y: IGNAT PE
INSPECTION RECORD I Control No. 0768
CITY OF EAGAN PERMITTYPE: ' BurLoiNG-"
3830 Pilot Knob Road Permit Number: 000943
Eagan, Minnesota 55123 Date Issued: 0 7(@ 7( 9 2
(612) 681-4675
SITEADDRESS: LoT: z BLocK: z APPLICANT:
567 PRAIRIE CIR E MCOOMALD CONST INC
COUNTRY HOLLOW 2ND (612) 688-7061
PERMIT SUBTYPE:
SF OWO
TYPE OF WORK:
NEW
INSPECTION D. . ..
FOOTING FRAMING
INSULATION FINAL
FIREPLACE
REMARK5: PRV S S W CONTRACTOR - STAR PLBG
r-
?
PERMIT? #
REACTiVATE
CITY OF EAGAN
1992 BUILDING PERMIT
681-4675
APPLICATIOCN? ? ll
?b
fiEGB
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy af energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
PePalty, applies when typiny of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date 6 / a5 / 42- Valuation of work F?uD>ni!-
Site Address: 54 7 PY.L4I^ie ei?-Cle tasf GoT gr E'xnu4s)
SiREEi SUITE N
Tenant Name: (commercial anly)
IAT .Z BLOCR ? SUBD.
610 P.I.D. M
Descri tion of work:
The applicant is: ? Owner Contractor ? Other (Describe)
Name Phone
Property ??ST FIRST
Owner
pddress
STREET STE k
City State Zip
Company MC 1Jo" C*,?+Sfruc.ft`bn xxr-, Phone G df"? 7061
C011tf8CtOf Address 11-b'?, g(Gf&Ll bav QJ• License #002376 Exp.
City RuvnsJiUe? 5tate Zip 55337
Company Phone
Architect/
Engineer Name Reglstration #
Address
City State Zip
Sewer 6 water licensed plumber S4A..r diha . Process9ng time for
se:ver & xater permits is two days once area has been ap ove . '
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 Mirinesota Statutes and City of
Eagan Ordinances.
5ignature of Applicant: . V
BU1LDlNG PERMIT TYPE
? 01 Foundati.on
El 02 SF Dwg.
? 03 Sf Addition
? 04 SF Porch
? OS SF Misc.
WORK TYPE
0 31 New
? 32 Additlon
OFFICE USE ONLY
11 06 Duplex
? 07 4-Plex
? OS 8-Plex
? 09 12-Plex
? 10 Multi. Add'1
,E] 33 Alterations
? 34 Repair
GENERAL INFORMATION
,.% .. w X
.r?
. ? 4s
? 11 Apt./Lodging
? 12 Multi. Misc.
? 13 Garage/Accessory
? 14 Fireplace
? 15 Deck
? 35 Tenant Finish
? 36 Move
A
? 16 Basement Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
O 37 Demolish
Const. (Actual) y/r/ Basement sq. ft. MWCC System ,L, -
(Allowable) ? lst F1. sq, ft. City Water
7F
UBC Occupancy ?-314.? 2nd F1 .. sq. ft. PRV Required
Zoning ? ,
Sq. Ft. total Booster Pump
M of Stories z Footprint Sq. ft. Fire 5prinkler
Length On-site well Census Code
Depth 3s-s-0 On-site sewage SAC Code
APPROVALS
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
,0 Site
? Waliboard
E3 Footing
0 Final
13 Framing
? Draintile
-0 Insulation
? Fireplace
Permit Fee veiuacia,,: g ?`3 0 C:) do
Surchar e -
g
5
Plan Review
License (.?y 3
3,? ?S, yz
MWCC SAC e /a _ Z y
v
City SAC
Mater Conn. ' ??,r Jl, L ? = I z B, 37
Water Meter
Acct. Deposit .
?d z)
9g.? ?g= 6, ?2-
5/W Permit .
?' -
S/W Surcharge z H p,
Treatment P1.
t
3 Y
? 535`nS3 = y?s? Iz 9
?95; l6
Park Ded ?
Trails Ded.
Copies
Other
Total:
SAC %
SAC Units
P _ 02
2422 Enterpnse Drkve
Mendata Heighls, MN 55i20
* pIdMEF..A urvo surtA.oP. ' pNL CNGiNEEAS (612) 881-1914•F'ax 681-9488
? UN? PUNNEH3 • L?NDSC+?PE nncxiYEC73
* en?nee?+?n9 ? E25 Hlghwoy 70 Norfheask
* Bloin¢, MN 55434
(612) 783-1680•Fax 783-1883
Certificate of Survey for. MCDOCICIICI Construction, InC
House Address: 567 Prairie Circle East. Eagan, MN
?
?
?
U
?'L9 s
,') cv iT
^ ? j? 93
NQ?' 1? \Sr4,.
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\ F a,\ws
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9}
0 ? /? d'p `dS• ?,
DO"?O'1?.?,•? da.
-l ??827,44 ?
-- -?s' ~
Hyd ;K I le?e ''-r.
?k'?^
f? ?G {? N
113EWIE'JJE O
°? S
DATE
. 900.0 Denotes Existing Elevation
•6 Denotes proposed Elevatinn
- ----- Denotes Drainage & Utility Easement
? penotes Droinage Flow Direction
--o-- Denotes Monument ---s- Denotes Offset Hub 6earings shawn
LOT 2 , BLOCK 2
DAKOTA CtlUN7Y, MINNESOTA
143.
S g2'04
EACAlf' pNGTINFiF[IRiG
I
- -- PROPOSED HQUSE ELEVATION
Lowest Floar Elevation:829.22
7op of Block Elevation:837_33
Garage Slab Elevation:836,33
pre Qssumed
COUNTRY HOLLOW
SECOND ADDITION
w
rn
O ?
u-) o
N Q
? z
I here6y certlly thet tbl5 furveV, Olen or report Wif prepBred bV nic or under my direct suppe,.r.?ui?s;0n and that I am duly ftegistered 1,6nd Su*?eyp.
m}der thE laws 9t the Stat? of Minnesota, Oarod this 2lt? dey el JI'? h?^ A.D. 19 _? v.
PeU, 6-z.S-T? l?Jd ?YfS+ EIPVS
!
e P.
a?SP
Scale: 1-rh=3bfaet Qro
8.5 L.S, REO. NO. 14891
' k08EF
f4KV
9ASED aH CIIAPTER S OF TIIE
AIObEL ENG? GOU$,- ?983 TsbITJOH
" Adoptlon Effective
Slte Ac"
Contrec
te
Buildlnq clesslfiaetions Type A1 (Bingle E'amlly & Duplex)
Type A2 (Residential, 3 etories or less) (over 7 etories) (other)
NOTRt Comnl?yaagu,3 and 4 firgt.
9•!F 1ERAI_,I Fo &TjnN it
1. Bulldlnq Perlmeter"Et.
H
2. Wall heiqht (ground to eave) Ft, ,
?. 1. X 2. (above) qross wall areazIJ'I-614 sq.Et.
4. Bulldlhg dimensions (L) '- X(W) r ?Osq.ft.roof 6 Elaor erea
5. Sq. foot area of rim joist - .? F oor joist eize (2 X14)
)
X ( T(petimeter) ? +21 sq.Et.
6. Doore - Area 12
? ) .
Tlilcknesa In U. faetot ?
Type oE Construction Per meter ft.
Manuf ecturer_
7.. Total door's perimeter ft. . ,
e. Windowss Man epcturer (N.3f,IZ'C?SM7lS?, State approved
U factor ?l-1
'I'YPE 9IZE ?? AREA (9q.Ft.) • HUfdBER OF TOTAL
-??f? ?O?b EACN UNIT9 Sq PEET
VV
9. Total eq.ft. Glaes
So. Fireplece ereas WidElt X Ileiqht -. X ? eq.ft.
11. Exposed foundations Iieiqht X,Feirimeter4i??X/15:=,?:l sg.ft.
CONPLETION OF TIIIS FORM 19 EIEpUIRED FOR ALL NBN CON9TRUCTIOtto NAJOR
REFtODELIHtl AtiD BUILUIN(38 BBINO NOVED WIIERE ENERGYs OTIIER Tt1AN TIIS HININAL
CODB ALLO{9ANC6* I9 UBED.
-1- ,
_-_i u&nu ?q,EE,
WLIIdUW •OK9q A?v, - ?t?. ft. U NiIIdOWU d 02
7? U
A
Q
?
lilm lolnt nre
A x
d
t1j, ,
I
o _oq.Ft, U klm joler?!??
Uxl? d S
c
Uoor nrea U dooY ntoqe.
I UxA °
7 v
OEheK dovte ntep
q.Et. U bE(ier doorn- _
?}
uxA
Expvsed Endn A. ?-!:7 U Eoundatlon=??
UxA
d ?
Fremlhg areo Am4 8 ?q.E?. U ftamiuq ateanIQfS7-U
xA
lf9r WU11 dt90 R a.u q
fh
U
/f
.
•
Nqll°'
UXl1 s ? f/'
(lyd) 'i'O'CAL . . . . . . . . ? UxA
i. Crose wall area x o.ll tA-1 nlilgle Eemlly 6 duplax) ? ellowable UxA/Code
113. ebove)
x 0.23 IA-7 ot1ieC trenidenElel l
x •23 (vtlier bu11ding")
.
H .29 tOVeC y gEpkie9)
?j boUlt muet
be lnkger
? 24 x U c
d kl?an or a
,
o
e
?F. ea 17B ebove ema
?. calling Erominq erea JAE) equalu l01 oE oelling etee
iA. Ctvns ca11L?q aten d(L) ? x(N) •?- ?!Db 3
uq.[t.
iU. Jo1Dt nkee (A E) ° 101 Ce1liltq eYee1
iC. Ilet Cell.ihg oteo (AC) (15A .. Igb) r S r
•
g.IE.
q
?y
' U celling x A? e'?vL-r x_ 9s?, 7 s?o,. r
•
U[romLig x q .. "+ 3 r '
E xLO(a_ •
5U. '1'vTAL U x 11
............
.......??.....?.•,+?t_
....
6. Ce111hq nrea (15A) x 0,028 (A_1 oltiqle Eamlly i duplex)
° O1lOW9Vl0 (IXA/COtI9 '
x 0.931
'
1?
-a otiliet teuldenElnl)
oE1,erl
,?N x v.ae ?
t+(15A) ??0 'QZ 2'l ?• b7'UII mush be'1nrqAr
x U c
d
Elian bk dame •
v
u • d ? or. ae 15U ebo ve
o'rE1 vue u nnd A valuen obtelned Irom pageu i, 9 end 4.
EliMIQaTloHi I heKeViy cerElEp Eltqt I ltOV9 cnloulnEed Ehe „U??
It'l veluen I,ereln and EiinE EIiA buildin
I feoEoKU pltd
g
iere dennrlbed MeeEn or
tnte of Hinneeota Energy Connetvetlon hot# exoeedm klie
a
-t-
slgneEure • ,
, . ? l? ID ????? lr ?q2-?S8
45'
t4s+ 275' 1401, X (?f3? 27.sfZ7, ??) = l _?a?g,?
?i?
INDaVII S
?YUI L•?O x??O = 11.25 x 8 = g0
wq-tKF 12,5
3?0 = ? u 4
ZSo, s
of
}
-
Z8 STL• S? D?. = ?
? ?r
13???
UAL6 -
SECY'tOH
Inslde alt film .69 '
lntetlor valL .?y (Nsll) U. k a
Insulstlon
Sheething Z,p(p 'o4-3
Slding ,(y'1
Outslde elt'[llm
a rorAL 23 . 03
StUD
sEcrtoN
2Np 1JALL
SECtION.
RIH
Jo(ST
Extetlor uall eoverlns
Extertar Atr [tlm' R .,l)
R tOiAL
Inside.alt Ellm i .68
?
lntetiat w.« A5
ttud R? A(?19 (p.5 (Fruelng) U. R .
Shea thing 11-.0Io . ? 095
9ldlnd ? (n'7
•
Outsldn
alr Citm
R 10tAL ?Q.53
tnslde alt [llm R• ,68 '
lnterlor vitLl •
Insuletion (RaLL ? U . ? :
Shesthtne • ?
.
lnterlvr sIr film
lnsulatlon
11 (neh •att Wood
Sheathing
Eatetlot wall eovo
Extetlot slt film
R tOtAL
lntetlor elt film
Lnsuletlon
R' ,69
111.0
Re1,88 (alm
Jolst)
7.0(0
!tin6 .fp]
.
R? .11
?11". 4(O
R° .68
11.o •
?
U•IC¦
? 04? I
?
Foundstlon 1.75 (Fd11.) U ¦ R •
Extetlor AIt film R• .11 cq(D
? R i0TA1,
?'Expo?ed Bluck . ?.
`.?? •'????rade ?,
s
;FrirNG WtTH VENTSD ATTtr RpAC AgOt!g
R VALUE
FAAMING
R VALUB
CEILIM(i
0.61 AirF?lm o.6?
3 &,o Insulation 45• ?
4.39 Joist -------
0.56 Ceilinq o 56
0161 AirFilm a.61
4ZI(n mota1R_4cn.78.
.aZ3 U ml/R . oZI
Window infiltration 0.5 ofm/lineal foot of ereck
Residential door infiltrativn 0.5 cfm/square foot or door and minimum oode
requirement
Non-residential door infiltration 11.0 efm/lineal foot of crack
Ub 12" concrete block no insulatiion - .47 R 2
1
Ub 12" concrete bloak insulated eotes - .26 Ft .
7
8
Ub 12" liqlitweight block a .32 R .
3
1
Ub 12" liqlitweiqht block insulated corea - .12 R .
8.9
U single qlass = 1.131 with storm window .54 ?
U double qlass = .55
U.triple qlass = .41
All exterior walls and'ceilinqs must have e vapor barrier (0.10 perm max.).
Vapor barrier muet be on.the inside (heated slde,) oE well.
Vapor barriers of ttie polj!ethelene thin film have no R vslue.
F'
rCifY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-18276-020-02
PERMITTYPE: eurLozNG
Permit Nu mber: 9 9 2 3 4 6
Date Issued: 0 6/ 2 4/ 9 8
567 PRAIRIE CIR E
LOT: 2 BLOCK: 2
COUNTRY HOLLpW 2ND
DESCRIPTION:
,?? ? REROOF, RESI6E
??`°7,?416V Permit 7ype STORM DAMAGE
ua,ldIng"Ooq&rk Type REPAIR
onsias Ccrds434 AL7. RESIDENTIAL
.?
y
?
Y.
'G?',. m '9 b *' &I f':`..?•.yA -.flfr
'".
41,
PERMIT
aMi ? 7;"?
3?Y
?
n u?,e
a"5 k? zs?
? c,-` ?*`?=`_'v?t un LA
REMARKS:
FEE SUMMARY:
CONTRACTOR: - Rpplicant - sr. LTC OWNER:
SAMPSON-LINDGREN 17215546 0003129 5CHWART2 MICHAEL
2228 E 35TH ST 567 PRAIRIE CIR E
MINNEAPOLIS MN 55407 EAGAN MN 55123
(612) 721-5546 (612)681-9093
?ak?bWTedge thaC''fi hava ritad G3ris appklcat-a.an Oriid stake
zs aoeroc? amd agree to camply with sll app13cafr1o ?
•' Statut?g ina# tSty of Eagarr dr-c#inaneea'?' ,
t+,at the I
tafie of Mn?
APPIICANTlPEFMITEE SIGNATUflE
s 7-N098
New Construction Reauirements
City State:
? 3 registered sde surveys
? 2 copies of plana (indude beam & window saes; poured fid. design; etc.)
? 1 energy calwlations
? 3 copies M free preservetion plan H lot platted aRer 7N/93
required: _Yes No
DATE: I -a3` ?P n
DESCRIPTION OF WORK: -54a j2-oA
STREE DDRESS
/1 l ? kA L-? SCA??-.?-
RemodeVReoair Rsquirements
? 2 oopies of plan
? 2 sRe surveys (extericr adCdions & dedcs)
? 1 energy calculations for heated additions
CONSTRUCTION, COST; 020, ?' 6 ?
L?? BLOCK: SUBD./P.I.D. #:
Name: 9? ? C?w?1 ??'T ?-l f' l? L!? l9a`? Phone #:
PROPERTY 1-ast First
OWNER `?7 1
Street Address:S? 7 1 (? 3
d/a/ / INJ-y j2?dv
CONTRACTOR
Street
BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAC}AN
• 3830 PIIAT KM08 RD - 65122
681-4675
a? c- -
cicy /Iq P tS
ARCHITECT/
ENGINEER Company:
Street
City
Sewer & water licensed plumber (new construction ony):
and lot change is requested once permR is issued.
Penalty applies wheri address chang
1 hereby acknowledge that I have read this applicatlon and state that the iniortn ' n is correct and agree to comply wit all applicabl
State of Minnesota Statutes and Ciry of Eagan Ordinances.
Signature of Applicant: 4? r -j" -
OFFICE USE ONLY
Certficates of Survey Received _ Yes _ No
Zip: 5_75/ ;??
P6one /C,7-/ S ?/-?C}
License# ;? /-7?
state: i' ° V?? zip:
Phone #:
Registratioo #: _
State: Zip:
Tree Preservation Plan Received - Yes - No - Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 08 Duplex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 = plex
WORK TYPE
? 31 New ? 33 Aiterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
? 11 Apt.lLodging ?
? 12 Multi Repair/Rem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ,. ?
? 15 Deck
O 36 Move
? 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
Engineering
Valuation: $
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Variance
% SAC
SAC Units
Lol- BL CITY OF EAGAN
? PLUMBING PERMIT
Si3BD. ? (612) 681-4675
4RATTllL7TTAT.
PLEASE COMPLETE UPPER PORTZON ONLY FOR SINGLE FAMILY DWELLINGS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
CITY USE ONLY
RECEIPT
DATE -5
ALSO. FOR TOWNHOMES AND CONDOS
WORK DESC PTION
NEW CONST
ADD ON _
REPAIR _
OWNER NAME:
SITE ADDRESS:
INSTALLER: A `jCJ v
ADDRESS:
PH6NE
OF PERMITTEE
STATE SURCHARG
TOTAL:
E .50
?V 17, 01 0
COMMERCIAL
YLEASE COMPLETE THIS PORTION FOR ALL COMMEACIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS: _
TENANT NAME: _
SUITE #:
INSTALLER:
ADDRESS:
CITY:
PHONE
FOR:
ZIP:
COMPI.ETE THE FOLLOWING:
N0. . FIXTURES EA. TOTAL
REPAIR/ADD ON
SHOWER 15.00
3
00
?
.
? WATER CIASET 3.00 ?
? BATH TUB 3.00
? LAVATORY 3.00 N'uo
KITCHEN SINK 3.00 3,00
? LAUNDRY TRAY 3.00 C.Oa
HOT TUB/SPA 3.00 7&
? WATER HEATER 3.00 -3 QQ
? FLAOR DRAIN 3.00 -RA6
/ C-AS PrPItIG OLIT.
(MINIMUM - 1) 3.00 aGn
? ROUGH OPENINGS 1.50 4. S'p
_ OTHER
_ WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
W. TURNAROUND 15.00
CONTRACT PRICE:
1% OF CONTRACT FEE. .
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL:
$
$
(SIGNATURE)
CITY OF EAGAN
CITY( JR l1dQ, L ( 2 lY)U2 ,1 . ZIP: L-,-+` V/
t
CTI'Y OF EAGAN
L G? ? MECHAIVICAL PERMIT
SUBD. ?- ° c\ (612) 651-4675
?
RESIDENII'IAL
xECEIrr# /0 -7r95
DATE ?' - ? '? •
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMII Y DWELLINGS. AISO, COMPLEPE FOR
TOWNHOMFS/CONDOS WHEN SEPARATE PERMITS ARE REQUIRED FOR EACH DWELLING UNIT.
OR'NER: • ?C; - + ? a S FEES
SITE ADDRFSSy,? ADD ON/REMODEL (EIIISTING $ 15.00
CONSTRUCI'ION ONLI)
INSTALi.ER: HVAC: 0-100 M BTU 24.00
PAONE #: (?oO ??. ADDTI'IONAL 50 M BTU 6.00
.ADDREaS:
O GAS OYITLF,1'S - MIINLMU"ni 1@ $3 EA.
,
CITY: ?- ? ZIP: SURCHARGE $ .50
SIGNATU ? •
?c-- -
` lz TOTAL: $
„
?n
COMMERCTAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCWJINDUSTRIAL BUILDINGS. ALSO COMPLETE FOR
APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR
EACH DWELLING UNTI'.
WORK DESCRIPTION: CONTRACf PRICE: FFFC
l% OF CONfRACf FE&
STATE SURCI3ARGE IS $.50 FOR EACH
$1,000 OF PERMIT FEE. $
PROCFSSED PIPING - $25.00
$
MIIVIMi7M FEE - $25.00
OWNER: TOTAL: $
SITE ADDRESS:
TENAIVT:
SUTfE #:
INSTALLER
ADDRESS:
CITP: ZIP: '
PHONE #: CiTY SIGNATURE
SIGNATURE:
,
954870
COIINTRY HOLLOW BSCOND ADDITION
PR&SSIIRE REDIICING VALVS AGR$EMENT
This agreement, made and entered into the day
of 1990, by and between the CITY OF EAGAN, a
i
municipa;Xity of the State of Minnesota, (hereinafter called the
City), and the owner and Developer identified herein.
The terms "Developer" and "Owner" as used herein refer to:
PROGRESS LAND COMPANY, INC. whose address is 14300 Nicollet Court,
Suite 235, Burnsville, Minnesota 55337.
WHEREAS, the Developer has applied to the city for approval of
the plat or subdivision known as COUNTRY HOLLOW SECOND ADDITION,
located within the City; and
r
WHEREAS, the 'Owner and Developer agree to notify the proposed
potential buyers of all lots within COUNTRY HOLLOW SECOND ADDZTION
that' Lots 1-4, Block l, Lots 1-17, Slock 2 and Lots 1-10, Block 3 are
in a high water pressure zone and a pressure reducing valve shall he
installed in each home below the elevation of 875 feet..All costs
shall be the responsibility of the Buyer and shall be installed to
prevent damage due to high water pressure.
NOW, THEREFORE, the City, Owner and Developer agree as follows:
1. Recordina. This agreement shall be recorded with the Dakota
County Recorder so as to provide notice to the owners of Lots 1-4,
Block 1, Lots 1-17, Block 2, and Lots 1-10, Block 3. The Owner shall
provide and execute any and all documents necessary to implement the
recording of this agreement.
4
f
r
2. Notice. The recording of this document shall constitute notice
to a11 owners and future owners of property in the COUNTRY HOLLOW
SECOND ADDITION subdivision that Lots 1-4, Block 1, Lots 1-17, Block
2, and Lots 1-10, Block 3 are in a high water pressure zone and that
a pressure reducing valve shall be installed in each home below the
elevation of 875 feet. All costs shall be the responsibility of the
Buyer and shall be installed to prevent the damage due to high water
pressure.
3. Validitv. If any portion, section, subsection, sentence,
clause, paragraph or phrase of this agreement is for any reason held
to be invalid, such decision shall not affect the validity of the
remaining portion of this Contract.
4. Bindina Aareement. The parties mutually recognize and agree
that all terms and conditions of this recordable agreement shall run
with the land herein described and shall be binding upon the heirs,
successors, administrators and assigns of the owners and developers
referenaed in this Contract.
IN WITNESS WHEREOF, we have hereunto set our hands.
CITY OF A OWNER AND DEVELOPi:R:
(Date: PROGRESS LAND COMPANY, INC.
. T mas A. t4efi By:
Its: Mayor zts: P??s;vE,vr
sv.
Its•
?
Attest: . J. VanOVerbeke
Its: erk
STATE OF MINNESOTA
COUNTY OF DAKOTA
ss.
On this o7/ -S% day of
Public within and for said
and E. J. VanOVERBEKE to
duly sworn, each did say
Clerk of the City of Eaga
instrument, and that the s
by authcrity of _ts C
acknowledged said instrume
municipality.
1990, before me a Notary
County personally appeared THOMAS A. EGAN
me personally known, who being each by me
that they are respectively the Mayor and
n, the municipality named in the foregoing
eal affixed on behalf of said municipality
ity Council and said Mayor and Clerk
nt to be the free act and deed of said
?, 'NI.•tff!sf!?NIMIN?lft:N
p :
, _, . ....... ..w
STATE OF MINNESOTA )
) ss.
COUNTY OF
?-
;?
NoTt,\ary Rublic
'i
77
?'
On this day of 1990, before me a Notary
Public within and foi said County, personally
appeared t; l:-40r' l and-- to me
persona?ly? own, who being-0acla-by me duly sworn, easia did say that
tht?y--Rs'? resgeetiTely+? the d; i? 1
of the corporation named in the
foregoing instrument, ____ _____ _ _ ____ _"`_:__' t_ __id ___t_____•
, and that said instrument was
signed ?!nd .._1_6 on behalf of said corpor ion.L?y authority of its
Board of Directors and said ?rrS ,
-ereei- acknowledged said instrument to be the
free act and deed of the corporation.
?^^- ? ?... ?--•.?......?.?.,
.. . . . _ .w,e,.l
(3i i ;vr,aai
_ .. . _ . . } Notary, PubVic
?
?
APPROVED AS TO FORM:
?
11 A.???'
Public Wo s Department
Dated: f4??y 90
THIS INSTRUMENT WAS DRAFTED BY:
SEVERSON, WILCOX & SHELDON, P.A.
600 Midway National Bank Bldg.
7300 West 147th Street
Apple Valley, MN 55124
(612) 432-3136
MGD
o30L
APPROVED AS TO CONTENT:
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA140431
Date Issued:12/19/2016
Permit Category:ePermit
Site Address: 567 Prairie Cir E
Lot:2 Block: 2 Addition: Country Hollow 2nd
PID:10-18276-02-020
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
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: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Xueming Wu
567 Prairie Cir E
Eagan MN 55123
Craftsmen Home Improvements Inc
7455 France Avenue, #194
Edina MN 55435
(651) 430-1388
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA152553
Date Issued:10/22/2018
Permit Category:ePermit
Site Address: 567 Prairie Cir E
Lot:2 Block: 2 Addition: Country Hollow 2nd
PID:10-18276-02-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Xueming Wu
567 Prairie Cir E
Eagan MN 55123
(651) 413-5777
Pronto Heating & Air Conditioning
7415 Cahill Rd
Edina MN 55439
(952) 835-7777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA161338
Date Issued:05/19/2020
Permit Category:ePermit
Site Address: 567 Prairie Cir E
Lot:2 Block: 2 Addition: Country Hollow 2nd
PID:10-18276-02-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Xueming Wu
567 Prairie Cir E
Eagan MN 55123
(651) 413-5777
Pronto Heating & Air Conditioning
7415 Cahill Rd
Edina MN 55439
(952) 835-7777
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA169400
Date Issued:05/25/2021
Permit Category:ePermit
Site Address: 567 Prairie Cir E
Lot:2 Block: 2 Addition: Country Hollow 2nd
PID:10-18276-02-020
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Includes Skylight
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. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
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 -
Xueming Wu
567 Prairie Cir E
Eagan MN 55123
(651) 413-5777
Craftsmen Home Improvements Inc
7455 France Avenue, #194
Edina MN 55435
(952) 930-3777
Applicant/Permitee: Signature Issued By: Signature