570 Prairie Cir ECity of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
o ,=O. ce, se
Permit #: /6000
Permit Fee:
Date Received:
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address:
Unit #:
RESIDENT /
OWNER
Name.. •-`f..i L,' ti' -CM"' y/ /( k_ 76/ Phone: 65/ 6- 88-, -7
Address / City / Zip: 70 ^ / v7: -c? Civ- E
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: K V -� C `jC i ct
Construction Cost: Multi -Family Building: (Yes / No )
CONTRACTOR
Company: Contact:
Address: City:
State: Zip: Phone:
License #: Lead Certificate #:
Does this project require Lead Remediation? ❑ Yes D No (see Page 3 for additional information)
If no, please explain:
In the last 12 months,
Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and w. i'. 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 approv_ of 'fans.
Applicant's Printed Name
x
App icant's Signature
Page 1 of 3
'r??"a-r•.r4.; r.v,. . w. ?R„r•-?,?,?y?r -
CITY OF EAGAN 30 18621
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt # -
To be used for Sp DWGf GAQ Est. value a153, OQ(} Date UEC 14 19 90
Site Address 370 PRAIRIE CIR 9
Lot 4 Block 2 Sec/Sub.COUNTRY HOLIAid
Parcel No. _
W Name
3 Address
0 ..:... KIFLS .,?___
Name
Address
City Phone
Name _
Address
City -
I hereby acknowlege that I have read this application and state that the
information is correct and agree tq comply with all applicable Stale ol
Minnesota 5tatules and City ol Eagran Ordinafices:
`-
Signature of Permitee ;Z(:
DAVE IiEi3DRICKUM
A Building Permft is issued to:
on the express condition that all work shall be done in accordance with all
applicaGle State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
OFFICE U5E ONLY
ii-3 H-1
occupancy t?-
z«,iny
(Actual) Const ? Bldg. Permit
(AJlo'"able) - Surcharge
# of Siories
Length
Dev+h
S.F. Total
S.F. Footpnnts
On Site Sewage
On Site Well
MWCC System
City Water
PFiV Required
Booster Pump
APPROVALS
Planner
Council
Bldg. Oft.
Veriance
-m
4v
?
K-
?
FEES
825.00
76.50
536.00
100.00
Plan Review
SAC, City
SAC, MCWCC
Water Conn
Water Meler
Acct. Deposit
600.00
625.00
90•?
?.00
S/W Permit w OW
.50
S/W Surcharge 2S2•00
Treatmenl PI
355.0(1
Road Unit
Park Ded.
Copies
3,520.00
TOTAL
o' psrmit No. Permit Holder Date Telephone #
WATER
SEAER
PLUMBING
H.V.AC. ?.
?
?I J ?
O
ELECTRIC
Inspection Date In . Comments
Footings 1
Foundation
Framins z-z?3 DS
Roofiny
Rouyn Plt?g.
Rough HIg. i Q.
??5
Isul. . `i ? ? ? + _•
Freplace ,
?
Final Htg.
Fnal Plbg. •ZS r/ ? - /? J?? i?
Const. Meter Plbg. in - Notify Plumber
Ergr.{Plan
Bidg. Final 7:26
Declrftg.
Decg F,nal t
We 4?
^?. 6isp.
r ?
/;.
' (gtx#i#iraft nf (Oxrup?ury
cirp of (tagan
lop}1rhnPttt id %ai" -iIiwtttDtt
T his Cartifuate issued pursuaxl to tfie requkrnuirls of Sectioa 306 ojMe unijorni Burlding
Cosfe cerlill'?8 &a & tTre tirne of issuaxce lhis structure Kas iR cbnrpliance with !he t+arious
ondinaxars of the C+tY &8laft buildin8' c+aastruction or um.For the following:
tt,e a."? Sb' uc4G1R eldt. Rxma xa. 18621
00-P.-7 75w RlA9! -7,.ic amia R 1 T?w c- VN
r
PpST M! A CONSPICUOUS PLACE
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
;
liilll I j? , I1F11 I oN
PERMIT SUBTYPE:
11 ; I . , ,?1
F
L
INSPECTION RECURD
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
t ? ? .' 4 ••1f?S 1S?,k9
TYPE OF WORK:
t:l? I i io i tvO
c+. f 4:;
-1
I
Rt 14 A1?h' , A") F'Ahli II I I I:MI t!•. i.l uli)f(l ii I Qff AN'1' 1'll+PllslW, s1i, f 11 0 I14 1 1.f11 4J i1t0
Permit No. Permk Molder Date Telephone N
SNV
PLUMBING
HVAC
ELECTRIC 3 ? A
ELECTRIC
Inspection Dete Insp. Commenta
Footings I
Foundation
Framing
RooHng
Rough Plbg.
ROUgh Htg.
Isul.
Freplace
Final Htg.
Orsat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Final
Deck Ftg. 7-V
(JF 7tf7 S 1 T S EXiqlea
Deck Final W 77 vOl., pF 77 Sr2-.
weli
Pc Disp.
dr ? ? ke•2 ?e a.?
i?f
?
SEWER & V"ATER PERMIT
CITY`OF E X6AN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE rWC 14- 1920
METER #
CHIP #
METER SIZE
ISSUE OATE
PERMIT DATE ' •-? 1 »9f}
PERMIT # 1 ) 766
B.P. RECEIPT # ? ? 11 `? ?
B.P. RECEIPT DATE 1 14 90
_X PRV - BOOSTER PUMP
SITEADDRESS 570 PRATk:',: CiR F
LOT 4 BLOCK 2_SEC/SUB COUIiTRY RO[.[.OW 2NC
APPLICANT:
ADDRESS:_
CITY, STATE
PHONE:
ZIP
PLUMBER: VALLLY PId1MDIfiG
ADDRESS: 410 CRM Ltd
CITY, STATE JORDAN ilU ZIP 55352
PHONE: 492-2121
OWNER: DA1rE HENDRICXSON
ADDRESS: 3912 25TH AVE S
CITY, STATE HINHF.A!?(1L1R +na ZIP IS 5A06
PHONE: 7: ' • ''7 ?,3
PERMIT REDUESTED
JL_ SEWER
- COMM/IND
X NEW
-1- WATER - TAPS
Ir RESIDENTIAL
EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WIL,f NOT be given for Deduct Meters.
/ 'l , r .
1 AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
RE:
DATE:
EEC 17, 1490
570 PRAIRIE CIR E(DA\?E HENQBICKSON)
X Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
.
CASH RECEIPT
.: . CITY OF EAGAN ?
3830 PILOT KNOB ROAD ,
EAGAN, MINNESOTA 55122
i
oA'M iqgL2-_
??
FIqU
-?,?,
AMOUNT S
• & DOLIARS
,ao
? CASH CHECK
roR ? ? ?
?1tr?.?1.??P_ ?') • ?
C 11 430 ??
Thank You
BY ?
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE [1EC lti , 1499
, OFFICE USE ONLY
METER # ?t7f Z_ ? G PERMi7 OATE 12 / l 7/ 9Q
CHIP # +7SlO -7 PERMIT # 117
METER SIZES f 6 t'? " B.P. RECEIPT #J
ISSUE DATE s' / 3" 9/ B.P. RECEIPT DATE 1 2 f 14J'10
PRV _ BOOSTER PUMP
SITE ADDRESS 571?DRAIRiB CIN E
LOT _4 BLOCK 2 SEC/SUB C0111,11TRv Wnr_t.n? 7Nn
APPLICANT:
ADDRESS:_
CITY, STATE
ZIP
PHONE: -
PLUMBER: VAL,FY Pi.IiltRiN(:
ADDRESS: 61Q CRFF.K I.N
CITY, STATE _ .YORnAN MN ZIP 553 52
PHONE: 492-2121
OWNER: nAVF. itFHDRi[:KSCIN
ADDRESS: 3912 25TH AVn S
PERMIT REGIUESTED
1L SEWER XL WATER _ TAPS
_ COMMlIND -y_ RESIDENTIAL
X_ NEW
EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of 9omestic Meters on Water Line.
Credii WI NOT be given for Deduct Meters.
I ,! f ? C
I AGREE TO COMPLY WITH CITY OF
EAGAN O DINANCES
14
CITY, STATE Ni N ? I
A'FJIBUULiS N - !4 ZIP 5 54nf, ?-
TER ISSUED
PHONE: ?0-27??'? SIGNATURE WHEN fillf
. ?
PLEASE aLLOW TWO 'WORKING DAYS FOR PR&CtSSING. CALL 454-5220 FOR INSPECTtONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
' i ?J.
CITY OF EAGAN Np . 1 862 ?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE: 454-8100 Receipt # L ?L ?'' I
il. ?LD
1 tor SF DWG/GAR Esl. Value $153,000
Site Address 570 PRAIRIE CIR E
Lot 4 Block Z SeGSub.COUNTRY HOLLOW
Parcel No. 2ND
W IName DAVE HENDRICKSON
o Address 3912 25TH AVE S
City MPLS Phone 729-0763
Name _
Address
Phone
Name _
Address
City -
Phone
I hereby acknowlege that I have re?d this a plicatipn and stale that the
intormation is correct and?a?lree tq,comofy with dll applicable State oi
Minnesota Statutes and C' bt Eaa4rf Orp( sA
SignaWre ol Permitee
A Buiiding Permit is issued to: DAVE HENDRICKSON
on Ihe express condition that all work shall be done in accordance with all
applicable Stale ol Minnesota SiaNtes and City of Eagan Ordinances.
Builtling Official
t s9a_
OFFICE USE ONLY
Occupancy R-3 M=1 FEES
Zoning R-1
(ACtuap Const V-N eldg. Permil R9 5_ 00
(Allowable) V=N Surcharge 76- 50
M ofSrories -
Length 13' Plan Review
0
536.0
Oepih 41 ? SAQ City 100.00
S.F. Total - SAC, MCWCC 600.00
S.F. Foolprints -
OnSiteSewage _ WaterConn 625.00
On Site wall - Water Meter 90.0
0
MWCCSystem -x
qect.Daposit
30.00
City Waler X
PRV Required X S/W Permil
0
30.0
Boosler Pump - S/W Surcharge
0
.5
Treatmenl PI 252.00
APPROVpL' RoadUnit 355.00
Planner - park Ded.
Cauntil
BIdg.Off. _ Copies
Varience - TOTAL
?
3,520.0
Address: 570 PRAIRIE CIRLT,E EAST Lot 4 Blk 2 Sec/Sub CIX1NT3Y HOLLOW M
These items were/were not complete at the time of the final inspection.
Date: }J26?g}- !v 9/ Yes No
Tnspertor-
Final grade (6" from siding) ?
Permanent steps - garage ?
Permanent steps - main entry ?
Permanent driveway
Permanent gas
SodJseeded grass
Trail/curb damage
Porch
Basement finish
Deck
Please verlfy vith the builder the ramoval of roof test caps from the plumbing
system and the shut-off of water supply to the outside lawn faucet before
freeze potential exists. ?
xc?uEOrwEa
White - City copy Yellow - Resident copy Pink - Contractor copy
4/n , /n..
? o /
0-100-974 °`'°`?
`
,s1 q
Requeat Dete
9 Fire No. Fo gh-In. repeptlo q retl
(YOU call insp en rea0y) nspectlon Ot?er Than ugh-In
I
? Reetly Now Will Notity Inspector
Yes No Dele Reatl
I, D licensed contractor ptpwner hereby request inspection oi above electncal work at:
d'oe nddress (sbee6 eox o ute No.)
?
' ciry
r,
5?v ra?r;e
Secnan No. Township Neme or No. Renge No. County
upent(PRINT) Phone No.
?e ? } ri?I?Sov?
Power Suppller Atltlress
Elecidcal Co re or (COmpany Nama) . Contracror's Ucanse No.
v? e? o wn e,c?
Malling Atltlress (
or Owner Melting Inatalletbn)
V
X0
AuNOri tl S' naWra ( ractor/ Makin stallation) Pho e Nunu9{
` ?
?7V
?CRY
B T
?
o
mS?N8
N
? II I I I I I I II II II II II III O
T
F
51
P
Vere
ityAVe,
St
829U ON
EE
OPER NSPEC
?
E
Phone (612) 692A900 . OSED.
NC
-7, REQUEST FOR ELECTRICAL INSPECTION
? See insUvttions for compleling this brm on back oi yellow copy ea-o oooi-os
'ig/
0
.
"X" Below Work Covered by This Request 11
-•
Ne Add Rep: Type of Building ApplianceslNired Equipment Wirad
Homa Range Temporary Service
Du lex Water Heater Electric Heatin
Apt. Builtlin Dryer Load Management
Comm.llndustrial Furnace Other S eci )
Farm Air Conditioner
Other(specity) Cont2crois Remerks:
?Sm '?1?S
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimmin Pool 0 to 200 Am s 0 to 100 Am s
Transformars Above 200_Am 5 0_Am s
SI f15 Inspector's Use Only.
? TOTjn4L
?
IrrigationBooms l,??• T?(/
S ecial Ins ection
Alarm/Communication THIS INSTALLATION MAY BE O ED DIS1ONNEC7ED IF NOT
Other Fea COMPLETED WIT IN 18 M Th ?
I, the Elactrical Inspector, hereby Rou9mm
certify that the above inspection has
been made. Finai o?e
OFFICE USE ONLY
This raquest void 18 months irom
°°3
H 44739;??4, ? Od,,T
RaQU Date Fire N. 'n Inspeclion
ui 7
?
? Reedy Now
ly InspaclOr
Wh
R
d
?
es ? No en
ea
y
I censed contractor O owner hereby request inspection of ebove electrical work at :
ss S L Box ar o rvo.1 ?
, Ciry
Sactian No. T hip Neme or No. Range No. Caunly
an? (PRIMI ? Plione o. Q
Power 5 i r AdOress
1
EieeVk ontracta (COmpany Name) v or 'ce No.
• r
Mailinq A r o cbr o ner akinq Installatqn)
• ?
Auflhon2B SigndNrB ICOnhetl0/ n Making Installation) On ro
M
&so ??'tM
MINNESOTl1!'fATqpOAHD OF ELECTfiICRY O I• THIS INSPECTION PEQUEST WILL NOT
Gr10BHAMx'ay Bltlg. - Room 5193 0E ACCEPTED BY THE STATE BOFPD
1831 UnlvmHy Ave.. SL Poul, MN 55104 UNLESS PROPER INSPECTION FEE IS
OMnn (812) 6/2-01100 ENCLOSED.
a 0/?/ REQUEST FOR ELECTRICAL INSPECTION
0, See instmclions iw completing ihis lorm on back oi yellow copy
N 4 4 7 39- - 'X" Be/ow Work Covered by This Requesf
E&00001-OB
h}3?:r? ?OOo?O?.
e A Rep. TypeolBuiltling AppliancesWired EquipmeniWired
? Home Range Temporary Service
Duplex Water Heater Electric Heating
Apl. Building Dry Other (Specify)
Comm.llndustrial urnace
Farm Air Conditioner
Olherispecily) ConVactorS Femahs: Compute lnspecNOn Fee 8elow:
# Other Fee # ServiceEniranceSize # Circuits/Feeders Fe
Swimming Pool 200 AmpS t0 100 AmPS ?
hansformers Above 200 _ Amps 100 _ Amps
SIgnS Inspector§ Usa Only: O TOTAL
Irrigation Booms Q- ?
Special Inspection
Alarm/Communication THIS INSTALLATION MAV B DER D CQNNECTEU IF NOT
Olher Fee COMPLE7ED WITHIN 18 S. -
1, the Electrical Inspector, he2by RougRin . `p-.?
[
certiry that the above inspection has
been made. Finai
DFFlCE USE ONLY . ?
This requesl witl 18 months irom
' 2000 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
?ITY oF EAGAN ? I?b25
3830 PILOT KNOB RD - 55122
? 7,:) 5y ? 651•681-4675 Ca[W iI'1-00
New CanshucNon ReaNremenh Remadel/Reoair ReaWremenh ?
> 9 reglafered slte wrveya slrowing sq. B. of lof, sq. R, of I?se 2 copies ol plan
and gfl roofed areas (4076 maximum lof eovemae allowed) 1 set of energy calcWaHons lor he Wed addiflons
> 2 coples ol plmn (ahow, beam Q wlntlow sizea; poured fntl. design; etc.) 1 slte suney lor exteAor adUlflons d decks
> 1 sel of energy calculallons
> 3 coples o1 hee pretervaflon Dlan ff lof platted aHer 7/1l93
DATE: j0
il- 60
CONSIRUCTION COST:
DESCRIPTION OF WORK: IJPC?K Gi d/O ?} S,eQ SD/? QO(h
STREET ADDRESS: S70 bY//t'/, C/r ?
LOT: -?- BLOCK: Z SUBD./P.I.D. #: COUli? t14110V'? 2tiG? ,Ad{?i11nN
Name: lT??JOs^ll?s0/tJ iQ!/ lP Phone #: ??l 0g ? g50 7
pROpEQ7y LCSt FIrSi
OWNER '
C
70 ?
?
/`
{Y
Sfreet Address
i
Y[ /c
! .O
:J
Cily Ed R /l /(l !'14 tJ State: Lp: ?5-5
. ComPanYbn ?ICl LL?? UFV'qhone #: 6 s ? ? $ $ `?SC? 7
(area code)
CONiRACTOR (6050 3- G 1
Sheet Address: ee ticerue # Fxp.
CNy State: Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone t: ( )
Skeet Address: RegishaHon #:
Cly State: 21p:
SeweNwater licensed plumber pf instalflna aewer/waterl: Phone #:
I hereby acknowledge that I have read this applicaNon, state fhat the infortnatb rtect, a d agr to co ply with an applfcable Sfate
of Mlnnesota Sfatutes and Cify of Eagan Ordinances.
r
Signature of Applicanf:
?
OFFICE USE ONLY
certificates of survey Received _
Tree Preservation Plan Received _
Yes _ No
Yes - No - Not Required
Nov o i 2000
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.)
? 02 SF Dwelling ? OB 06-plex ? 17 Garage %( 22 PorohlAddn. (4-sea.)
? 03 01 of
plex ? 09 07-plex )$d 18 Deck ? 23 Porch (screened)
? 04 _
02-plex ? 10 08-piex ? 19 Lower Level ? 24 Storm Damage
? OS 03-plex ? 11 10-plex Pibg Yor_N ? 25 Miscellaneous
? 06 04-plex ? 12 12-plex ? 20 Pool ? 30 Accessory Bidg.
? 31 Ext. a,n - Muni
? 33 Ext. Att - S F
? 36 Mum
WORK TYPE
p 31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATiON
SAC Code O( # of Stories S4• ft•
No. of Units Length sq. ft.
?
No. of Buildings Width Footprint sq. ft.
Const. (Actual) - t? Basement sq. ft. Census Code y3v
(Allowable) ,s= Main level sq. ft. MC/ES System
UBC Occupancy sq. ft. City Water
?
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS IN5PECTIONS
? Stucco/Stone
APPROVALS
Planning Buiiding 19
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:
Y sjr?,#.sarJ PC, tc%
17sx6- yz ysDzv
SAC Units
% SAC
? . ?
?
nn GoC
METRO /875 PLAZA DR.
SURVEYORS suirE 200
?NC. EAGAN, hW. 55122
Certificate of Survey for; (02)452-7850
DAVE a SHELLEY HENDRICKSON
LEGAL DESCRIPTION; LOT?,BLOCK_Z9 COUNTRY HOLLOW 2nd GDDN.
ACCORDING TO THE RECOROED PLAT
THEREOF ooKOTO COUNTY,MINNESOTAI"111%
PRAIRIE CIRCLE EAST
0
? _iia* 02'15"
? =so.ooo
c? f ?o
?
?.
rn 51
io 12.o N 2 ^, Y.0 io. ..
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n uN Go 1•?i M H
a e1? - c>
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o ?I Ib•7 QQ-?PpJyy
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? .??1? p; ? 1•? Z,.
? (.? .... ? .o &tc
?
?
5L DRAII
o?--1? -.
Lo-r 5
I :. EGE!!o
o DENOTES IRON MONUMENT
o DENOTES W000 MUB SET
$2?.3 OENOTES EXISTING SPOT
ELEVATION
DEHOTES PROPOSED SPOT
ELEVATION
f DENOTES DFAINAGE DIRECTION
? fr
SCALE I" =
g?C]
I ?0
8 UTILITY EA's
A?
?. F
NI•38'SI"E
29.15
t\ I
--- -o ?;
S 89° 38' 31" E 232.£5;.,, ..
I _
?
4
¢
?
J J
oa
H
.01"
I ?aoPo???? - w?4 gASEM ?+.?r
iNVE+T ELEvi+TION AT SEZ'JiC[ EXT?tvS,'a:?-_
PROPOSED GARAGE FLOOR ELEVATION •fK
PROPOSED FIR5T FLOOR ELEVATION •
PROPOSED BASEMENT FLOOR • =
E T
?-'?1i. 1?Er', 1-1 NOTE'• VERIFY ALL FLOOR MEIGHTS WITH
FINAL H WSE PLANS
1 hreby certify lhat fhit surveY,Rlon or
reput ww prepand by mo or under my
direct suprriaian and that I om a duly
Repistered Land Sulr*ror undM fhe
Lara of tM Sfofe of Minnesota
L_0 T ;
&adley J. SOWwn. Mn. Req. No. 13233
Date : / "Z_ /i z j9?}
_•„ -
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS dF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS $EEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For
Site Address
S`rd`° 161"1 (V fIP$ Valuation
576 CWtte ru5 fi i
Lot `i Block A
Parcel/Sub Cnu??'"V` `4)"w DdK?• ??
dK?
Owner
Address 39 r? - a J.p ?
City/Zip Code
Phone 7e? ! - 0 76 3
Contractor h/pUe R6?1-00U
Address
City/Zip Code
Phone
Arch./Engr. \"t) yyxAIQy
Address
City/Zip Code 101{/?NdIC14
Phone # ?SJ," /C9 76
?reA?, fd- I ?- g b
3°i?? Date:
I'SJ2' O.,a OFFICE USE ONLY
occupancy g-3 M'1
FEES
, Zoning `R - (
'Actual Const V- N Bldg. Permit qZ5,00
I Allowable v- I'{ Surcharge /o,$p
# of stories Plan Review (0,00
Length 7T SAC, City /'pp,00
Depth y?• SAC, MWCC 6Q0f00
S.F. Total Water Conn GZE-10
Footprint S.F. Water Meter 'tOtoD
Acct. Deposit 3DOD
On site sewage_ S/W Permit 30,0
?
On site well S/W Surcharge 150
MWCC System ? Treatment P1. Z52, 00
City water V, Road Unit 355,OD
PRV Park Ded.
?Booster Pump _ Copies
SUBTOTAL
APPROVALS Penalty
Planner TOTAL ?
Council /
Bldg. Off.
Variance
?
i?
Vl1LUA1 Fj? •
C1 A R AGE "°"`" .<'?• .. rq
6 7 1- 5S'?
12x 23,r.7=
35MT, 92q x l?5'= /3135
ZG'X 3? ; 93?
ix23=23_
?3ozk ?`? _ l?f27-?
H ous E _ isf pc,oax.
----?-_....
TSSrnr, ? i 3o Z
t xy _ ?O
Iv4S = ?
??1y2 = I2
t 338 x 51 =6Y Z 3?b'
ZN-D Fi.oar2
? +? YZ y V = 213H
3y ? ?2= 4a%
IS ?c 11/2 ; Z2
I?x ?? ?. 306
.?---
102? x s?- SZazo
oiz 153,000,?-
t52w 21
,,__ ;
John Bradley .
o?rchitectural consulta?nts inc.'
6008 bdET. _D. E. OSSEO, YN. 60b69 PM. (612)-121-9772 -- I
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
Plan" Zlo-q°_ Date 1z/3/qb
Owner=
ContractorJ ?A?? ??Nb(ZILIL-SOI?I
SNe Address: 'OT `i LI,0c".??)24I-l?,llo,,) 7, A-Mi3PHONE
1)TOTAL EXPOSEO WALL AREA V 3752' sq.fti"U°-- 'rt 17- '7
2)TOTAL EXPOSED RQOF/CEILIN(i AREA I i77L, sq.ff.xV'j.2?
WALL AREA CALCUI.ATIONS:
TOTAL WINDOW AREA -s7g9 sQ.ft.z1 U01 '3S= ??•Z
17 rak . GLAZED
TOTAL DOOR AREA 3S sq.ft.xU '?= Z' •7
70TAL GLASS DOOR AREA gc) sq.ft.x'U" '3S = Z$.O
_ ? g'- • GLAZED
70TAL FIREPLACE WALL AREA 3g sq.ft.z'U'1 .3j6 - 13•
70TAL WALL FRAMING AREA 2-9+ sq•ftx. U14 • (O = Zq.4
NET INSULATED WALL AREA 24OS4 sq.ft.x"U" I 19 '4'
TOTAL RIM JOIST AREA Z73 sq.ff.x'U" -4'45,_
TOTAL FOUNDATION AREA (EXPOSED) sq.ft•xV' •?= I Z. I
TOTAL FOUNDATION WINDOW AREA ??- sq.ft.x"U" /__ ?
_ 3) TOTAL
. If ifem 3!s 1he same as,or less fhan Jtem l, you hove met the intent of
2 MCAR 1.16008 A and O.
ROOF/CEILINO CALCULATION3,
TOTAL SKYUGHT AREA WA sq.it.z"U"
.ozr,x 3•S
70TAL ROOF/PEILING FRAMINCa AREA 37,i iq.ft.x U
NET INSULATED ROOF CEILING AREA 12'?? sq.ft.xU•oZZ= Z„-
4) TOTAL . 30 . g
_ H i?em 4!s ihe same as,or less fhan Hem 2, you hove met the lntenf of
2 MCAR 1.16008 A and O.
ALTERNAT£ BUILDING ENVELOPE DESIQN
To utilize 1he tofal envelope system method, the sum of ftems 1, and 2 shall !
6e yreater ihon fhe sum of items 3 and 4.
1) +2)
. 3) +4J =
1 hereby certlfy fhat the bulldlnp here described meets or exceeds fhe State of Minnesota
Enerpy ConservaNon Act.
A7,
(slgned)
.
c...0 .v10,pc p5E-;, Vvn5 I nut.; ? wN
i
RAMING SECTION
fertor ir film
0.68
" ,4a
S' lnches of soft wood
yil VY FS.^? ?l.cla
6ICiA)l?
eMteria oir film 0 17
TOTAL R
U = 1/R 6 1
_
EC710N (INSULATED)
Jnferior air film 068
Yz% s.R. ¢?
5y2.' R,*. ; r ?9 0
Y " o.c f?i?> toC.O
5' o?noc? Yi 1
exlerior oir film 0.17
TOTAL R-2-1,11
U = VR 1v
'ST SECTION
inferior air film 0.68
SYzo eA-F?F- l.`?C?
Wi" wnon I ??9
I Yi'l o* f"o
, 8x1BriDr Oir film 70TAL R 29.41
U = I/R 10"
iION SECTION
inferlor air/ilm 068
1'f a7YIL S---
Iz" cor+g- [5.-7L },?'J
gx}eri0r air film
0.17
? TOTAL R 13
U = I/R!14-
CONSTRUCTION
CEILING_SECTION (INSULATED)
(1 ?interior oir fflm 0.61
(2
, ( 3
(4 exterior air film (still) 0.61
TOTAL R,45Jg
- U = __ I%R ' 022
CEILING FRAMING SECTION .
j I interior air film 0.61
(2-?'8 Sr+z<?v?xic I Slo
( 3 a?.? I ?+su?, 3?
(q interior air film 0.61
(5 34 inches of soit wood Q,s S
, TOTAL R 3°.13
U = I/R ,DZIv
VENTED
CEILING SECTION (INSUI.ATED)
( 1 inferior air /ilm 0.61
t2 .
_. (3
(q exterior air film (sfill) 0.61
TOTAL R
U = I/R
CEILING FRAMING SECTIOW _
( i,interlor air film 0.61
{Q
{3
(4 interior air film 0.61
(5 inbhes of soff wood
_TOTAL R
11 = I /R
EXPOSED BEAM CEILIN6 SECTIDN
(.1 interior a(t film 0.61
(2 .
(3
(4
(5 exterior oir /ilm 0•17
_. .. ? TOTAL R
L = J/R
.
JV?JVJ
METRD 1875 PLAZA OR.
SURVEYORS surrE 200
?NG.. . EAGAN, hW. 55122
Certificate of Survey for: (&2)452-7850
DAVE 8 SHELLEY HENDRICKSON
LEGAL DESCRIPTION: LOT4 ,eLocKi, COUNTRY HOLLOW 2nd ?DDN.
ACCORDING TO THE RECORDED PLAT
THEREOF noKnro COUNTY,MINNESOTAN
PRAIRIE CIRCLE EAST
r'-
N
N
re)
N
N
e
0
?
51
I
a
=113° 02' 15"
=60.00 ,
J f?
SCALE I" _
LOi ;,
s,
i
21,7
?2 \1 = D ; .,m ?? F
h? I3.7 \
d,NI•3B'51"E
? 4
Z DRAINAGE 8 UTILITY EA
.0 -'?.1'C------- ??.
?itil'---
29.16 `
?
?
?
S 89 0 38`.31". E s 232.?5r
I 4
L
LOi 5
1 LEGEyD
o DENOTES IRON MONUMENT
o DENOTES W000 HUB SET
$29,3 OENOTES EXISTING SPOT
EIEVATION
DENOTES PROPOSED SPOT
ELEVATION
j DENOTES ORAtNAGE DIRECTION
I Iweqr aeAffy 1Aaf tAis surveY, Plan or
repat wos prepond py nN or unMr my
direct suprvisian and fhaf I om a duly
Repisfered Land Sulviyor undN tM
Laws of tM Stafe ot Minnesota
&adleY J. SoWuon, Mn. Rop. No. 13235
Date : / Z /i L
0
?
5
J
?a
rc
aa
4T
I PiLoPosE? - Fu??. B?EM ?4?.kc?.r'r
ihlVERT ELcvNTIGV AT SE'rtvlCE 4XTNS!0N---
PROPOSED GARAGE FLOOR ELEVATION•
PROPOSED FIRST FLOOR ELEVATION •
PROPOSED 9ASEMENT FLOOR • '' 3
E`EPTMoVo R E 0 U Bt?"11E-
?
NOTE'? VERIFY ALL FLOOR HEIGHTS WI M
FINAL HOUSE PIANS
? L BL CITY USE ONLY ??Q
.? ? RECEIPT #: ?
SUBD. DATE: 31, cl-r
7995 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 687 -4675
Please complete for: ? single family dweliings
? townhomes and condos when permits are required for each unit
FIXTURES EACH NO. TOTAL
Shower 3.00 x =
Water Closet 3.00 x : v o
Bath Tub 3.00 x 3 v ti
Lavatory 3.00 x 1_ = 3• o u
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping Outlet * minimum - 9 3.00 x =
Rough Openings 1.50 x =
Water Softener 5.00 x =
Private Disposal * Dakota Cty. license 20.00 =
U.G. Sprinkler * home under const. 3.00 =
Alterations " to existing 20.00 = a o. s c
Water Tum Around 20.00
STATE SURCHARGE .50
TOTAL a u. S a
SITE ADDRESS: 5 76 r c C; r_ G
OWNER NAME: V e v e C!J Lf .. .
INSTALLER NAME: Se -,
STREET ADDRESS: Tr ? ! ? ??
CITY: T- C, - /-,/ STATE: /" " ZIP: SS °77
PHONE #: (G ?-
?
STZ?ZA TQ Ut- F?=RAfITT I=h
OPFICE USE ONLY
L BL
SUBD.
RECEIPT #:
DATE:
1995 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(672) 681-4675
Please complete for: ? all commercial/industrial buildings.
? multi-family buildings when separate permits are noi required for each dwelling
unit.
DATE:
WORK TYPE: NEW CONSTRUCTION
DESCRIPTION OF WORK:
CONTRACT PRICE:
ADD ON _ REPAIR
IS WATER METER REQUIRED? YES NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED? _ YES _ NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? YES NO.
IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT.
FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per
$1,000 of permit fee due on all permits.
CONTRACT PRICE x 1°h
STATE SURCHARGE
TOTAL
SITE ADDRESS:
TENANT NAME:
OWNER NAME:
INSTALLER:
ADDRESS:
ciTr:
PHONE #: SIGNATURE:
OFFICE U5E ONLY
STE. #
STATE:
APPLICANT
ZIP:
IMETER SIZE: DATE: INSPECTOR:
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
BUILDI! NG
025148
02J22/95
SITE ADDRESS:
570 PRAIRIE CIR E
LOT: q BLOCK: 2
COUNTRY HOLLOW 2ND
P.I.N.: 10-18276-040-02
DESCRIPTION:
Bu3lding'Permit Type
Building Wo,rk Type
f?
,
?
? ?..
?i-
i?
(! ?__, A
?
PERMIT TYPE:
Permit Number:
Date Issued:
BASEMENT FINISH
AITERFlTION
REMARKS:
A SEPARATE PERMIT IS REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK
FEE SUMMARY:
Base Fee
Surcharge
Subtotal
$35.00 COPY
$.50 Tvtal Fee
$35.50
$.50
$36.00
CONTRACTOR:
OWNER: - Applicant -
HENDRICKSON DRVE
570 PRAIRTE CIR E
EAGAN MN 55123
(612)688-8507
I hereby acknowledge that I have read this
information is correct and agree to comply
Statutes and City of Eagan Ordinances.
?
A /1. 0 ?100"
PLICAN ERMITEESIGNATURE
epplication and state that the
with all applicable 3tate of Mn.
-i
, .lrntf
(Awa I D Er. SI A R
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: Lo T: a B L 0 C K: 2 APPLICANT:
570 PRAIRIE CIR E HENDRICKSON
COUNTRY HOLLOW 2ND (612) 688-8507
PERMIT SUBTYPE:
BASEMENT FTNISH
TYPE OF WORK:
BUILDING
025148
02/22/45
qAVE
ALTERATION
INSPECTION
FRAMING ., .
INSULATION .•
ROU6H IN PLBG FINAL
REMARKS: A 5EPNRATE PERMIT IS REQUIRED FOR ANY PLUMBING OR ELECTRICAL WtlRK
I ?
? ?
25 1 CITY OF EAGAN ^k%.00
S4i 3830 PILOT KNOB RD - 55122 ? ,
7995 BUILDING PERMIT APPLICATION (RESIDENTIAL) ? ?t
681-4675
New Construdion Reauirements RemodeVReoair Reouiremenfs
? 3 registered site surveys ? 2 copies of plan
? 2 mpies of plane (inelude beam 8 window sizes; poured fnd. design; etc.) ? 2 afte surveys (eMerior addilions & decks)
? 1 energy calculations ? 1 energy calwlatlons kr heated eddifions
? 3 copies of trce preservation plan if lot platted after 7H/93
required: _ Yes _ No
DATE: CONSTRUCTION COST:
DESCRIPTION OF WORK: _ r(+J LS oer ??- ?. P L) e_ ?
STREET ADDRESS:
LOT y- BLOCK ? SUBD./P.I.D.
PROPERTY Name:??•?(_??lG?`l-?/ ,/ /iIU,?? Phone g5 2 7
OWNER S ? t F1R8? ?
Street Address TD
City: State: ?t6t) Zip:
CONTRACTOR Company: ?evNe!? Phone #:
Street Address: License #:
City: State: Zip,
ARCHITECT! Campany: Phone #-
ENGINEER
? Name: Registration #'
Street Address•
City: State: Zip:
Sewer & water licensed plumber
change are requested once permit is issued.
Penalty applies when address change and lot
I hereby acknowledge that I have read this applicatlon and state that the infa a on is co ed a ag to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. o
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received
_ Yes _ No
FEB 16 }995
Tree Preservation Plan Received - Yes - No
OFFICE USE ONLY »
?. ?,?. .
, ? ? n., f!F
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging cc(-- 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi RepaidRem. 0 17 5wim Pool
0 03 SF Addftion ? 08 8-plex ? 13 Garage/Accessory o 20 Public Facility
? 04 SF Porch ? 09 12-plex o 14 Fireplace ? 21 Miscellaneous
0 05 SF Misc. 0 10 = plex ? 15 Deck
WORK TYPE
0 31 New c"3 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
y3Y
o/
/
O
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
15,10 MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
_ Engineering Variance
h
Valuation: $
% SAC
SAC Units
954870
COONTRY HOLLOW 88COND ADDITION
PRESSIIRE REDOCING VALVE AGREEM8DIT
This agreement, made and entered into the day
of , 1990, by and bstween the CITY OF EAGAN, a
municipaYity 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
WHEREAS, the Owner and Developer agree to notify the proposed
potential buyers of all lots within COUNTRY HOLLOW SECOND ADDITION
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 a pressure reducinq 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 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
recordinq of this agreement.
2. Notice. The recording of this document shall constitute notice
to all 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 @ue to high water
pressure.
3. Validitv. If any portion, section, subsection, sentence,
clause, paragraph or phrase of this aqreement is for any reason held
to be invalid, such decision shall not affect the validity of the
remaining.portion of this Contract.
4. Binding 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
referenced in this Contract.
IN WITNESS WHEREOF, we have hereunto set our hands.
f
(
CITY OF
(Date:1
OWNER AND DEVELOPi:R:
PROGRESS LAND COMPANY, INC.
7.?
By: u
tts: P??C'f?c?ENr
Bv:
its
Attest: . J. VanOverbeke
Its: 9erk
STATE OF MINNESOTA
COUNTY OF DAKOTA
ss.
On this o?/ s% day of 1990, before me a Notary
Public within and for said County/J personally appeared THOMAS A. EGAN
anc? E. J. VanOVERBEKE to me pe'rsonally known, who being each by me
duly sworn, each did say that they are respectively the Mayor and
Clerk of the City of Eagan, the municipality named in the foregoing
instrument, and that the seal affixad on behalf of sair2 municipality
by authcrity of =ts City Council ar.d said Mayor and Clerk
acknowledged said instrument to be the free act and deed of said
municipality.
y 'NI'f?t•1PSeNINIfNNHN - i??? .
'cMN?S
l. Y;?._?.',•. ? . ' .1
$J1A
I `! • ' ,f' ? ????!. . l/ ? ??:yt' ?%<.62'?/? ?'?s???'? 41'
? Not,?ary !PUblic ?
.. ....... .?y ? ? . . .
STATE OF MINNESOTA )
) ss.
COUNTY OF I'tk i
On this day of 1990, before me a Notary
Public within and for said County, personally
appeared ?.. ?; ;;:; i:_4.C? C' 1',! r., ,alie}- to me
persona?l ,k own, 1who being-0ac?by me duly syorn, eaati did say that
ti?ey--?resg?.?etivel-,y6 the I ?-< ?,? d c i? 1
arici- of the corporation named in the
foregoing instrument, --1 t'-_< , _rf_.__d t_ ___d __t_.____•
, and that said instrument was
siqned aru}seele on behalf of said corpor?j ion,by authority of its
Board of Directors and said rrrS ?dc.?2?1'
acknowledged said instrument to be the
free act and deed of the corporation.
?`"?-_?_...... ..,_.. ??s,:A:,w..?..w?,,,? . . .
[
Notary Pub• ic
APPROVED AS TO FORM:
?'.
11
Public Wo s Department
Dated: A.??y Jo
TFiIS IN5TRUMENT WAS DRAFTED SY:
SEVERSON, WILCOX & SHELDON, P.A.
600 Midway National Bank Bldg.
7300 West 147th Street
Apple Va11ey, MN 55124
(612) 432-3136 ,
MGD
AoL -595/lp-b
APPROVED AS TO CONTENT:
CITY OF EAGAN FOR CITY USE ONLY
3830 PIIAT RNOB ROAD
Encax, aN 55122 PERMIT #1,2 79/
YHONE (612) 454 8100 RECEIPT
M ?1?,'f'T??"•A7.,:YT:`?ttf?;':G` DATE: 02?!// 9
R"IA"Tm PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
------------------------ ----
WORK DESCRIPTION --------------------- --------------------
FEES -----------
NEW CONST ? ADD-ON MINIMUM $15.00
ADD ON HVAC 0-100 M BTU 24.00
REPAIR ADDITIONAL SO M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
OWNER NAME:
??d
/G"
1
r
I SUBTOTAL: $3?.P0
r_
SITE ADDRESS:
/?
! , STATE SURCHARGE: .50
IAT:_?Z_ BLOCK (;Z SUBD. A11AILJ TOT
INSTALLER: C ?
ADDRESS: GNATU OF PERMITTEE
CITY: ' ZIP:
PHONE zl 7.1, - 234? 0
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDZNGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
WNTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
IAT: BIACK _ SUBD.
INSTALLER:_
ADDRESS
CITY:
PHONE #:
ZIP:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING = $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE
TOTAL:
?
(SIGNATURE)
FOR:
CITY OF EAGAN
CITY OF EACAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454 8100
NAPOTR,;PEW
FOR CITY USE ONLY
PERMIT #
RECEIPT # ?I
DATE: ? .3 91
PLEASE COMPLETE UPPER PORTZON ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMZTS ARE REQIIIRED FOR EACH UNIT.
---------"--------------------°-----------°----------------------
WORK DESCRIPTION
NEW CONST X
ADD ON _
REPAIR _
OWNER NAME: 'k Ajt Ae? A r. cX s0.?
SITE ADDRESS: rJ Ib -?rQ ?r,'c
LOT:/r/_ SLOCK [+ SUBD. Cv??F•y No\\c-+d
INSTALLER: VAW
ADDRESS: 6IU L,.l
CITY: ???afA?. ZIP: J S3S a
PHONE #
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
? SHOWER 3.00 3
73 WATER CIASET 3.00 °l
? BATH TUB 3.00 3
73 LAVATORY 3.00 ?
? KITCHEN SINK 3.00 3
? LAUNDRY TRAY 3.00 z
HOT TUB/SPA 3.00
? WATER HEATER 3.00
3
! FLAOR DRAIN 3.00 °
GAS PIPING OUT.
? (MINIMUM - 1) 3.00 3
=5 ROUGH OPENINGS 1.50
OTHER
WATER SOFTENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
SUBTOTAL $
ST. SURCHARGE .50
TOTAL:
MMI?ER4IAL?iNbUST&!AL;' PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDIISTRIAL SUILDINGS AND
? MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE
FOR:
a.i a
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE $
TOTAL:
(SIGNATURE)
CITY OF EAGAN
RESIDENT / OWNER
Name: .01.i') I l _CAS
Address / City / Zip: U 4/I
'A..J Ph��o 6 (� � 15
I& 1 fL. ,c_ &
CONTRACTOR
Name: V1 0 y 4')1?4'hL License #:
1
Address: 1 J& 6 � J e at_ City: S
State: A 6 a Zip: P 1 Phone: / A — C1 gt /
__.5.
Contact: Email: V 1 C L4. 4 - JJ e N b ef.(i ' C
TYPE OF WORK
_____ New = 1tReplacemen
even
Description of work: L ri1 cp
additional Alteration Demolition
_ _ !
d a . , 061) .aa o
.tA) >x ei2 filtui ildi1/AO 104 iitgi likAtii
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code_ Please contact the Mechanical Inspector for information on permitted screening methods.
PERMIT TYPE
RESIDENTIAL
Furna 1jfuw4x), MC 15li h
COMMERCIAL
New Construction _ Interior Improvement
_
1 tit 7 Ralf 6lI1 4$-
j Air Conditioner
_ Install Piping Processed
Air Exchanger
Gas Exterior HVAC Unit
— Heat Pump
Other
Under / Above ground Tank ( Install / Remove)
___
**When installing /removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add -on
or alteration to an existing unit (includes
burned out appliances, ductwork, etc.) (includes
$.50 State Surcharge)
$.50 State Surcharge) $ .5S ► TOTAL FEE
$90.50 Fire repair (replace
COMMERCIAL FEES:
$70.50 Underground tank
$50.50 Minimum (includes
installation /removal OR
State Surcharge)
surcharge is $.50.
increases by $.50 for each
$2,000 Permit Fee requires a $1.00 surcharge).
Contract Value $ x 1%
_ $ Permit Fee
- If Permit Fee is less than $1,000,
= $ Surcharge
- If Permit Fee is > $1,000, surcharge
$1,000 Permit Fee (i.e. a $1,001-
= $____ TOTAL FEE
City of Eagan
Date: /1)
Tenant:
CALL BEFORE YOU DIG. Cali Gopher State One Call at (651) 454 -0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not t :° o t a permit; t at/ to work will be in accordant
with th approved plan in the case of work which requires a review and approval of plans
x
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
FOR OFFICE USE
Applicant's Printed Name
2010 MECHANICAL PERMIT APPLICATION
Site Address: 6 P8 n
Suite #:
Applicant's Signature
Use BLUE or BLACK In
ce Use
Permit #:
Permit Fee:
Received:
Staff:
Reviewed By: Date:
Required Inspections: ___Under Ground Rough In __Air Test Gas Service Test In -floor Heat Final
ir City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:. -/_t'® Site Address: 570 ) f�% Kr* 4, Cry Unit #:
RESIDENT /
OWNER
Name: Alje 5/'Je//+L/ J�%i.(/� iGA�4) Phone: 63/ 6 -.,. 7
�,� //�
Address / City / Zip: %a r;toCr r"-. e
Applicant is: Owner Contractor
TYPE OF WORK
/C
Description of work: A1c4 e✓tJ - jjv✓4 eete' /
Construction Cost: Multi -Family Building: (Yes / No K )
CONTRACTOR
Company: xi/1 rC� kii� • 41Afc C nt ct: ,t/ C� a rd. 7Qv—
Address: S7i , F Yi e C r^ (I City: Ee Q
5 //
State: /4 Zip: Sf-4713 Phone: 61Q? 02 --7e - 6 V7/
License #:23( 5-1193 Lead Certificate #: OW– /a ®4qg _
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
/-Gf / /-fr lrl) /7' /
In the last 12 months,
Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documentsthat you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota S •te Building Code must be completed within 180
days of permit issuance.
x Dtto°e aetod lr'cek Sod
Applicant's Printed Name
x
Applicant's Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation Fireplace
Single Family Garage
Multi Deck
01 of Plex Lower Level
Accessory Building
WORK TYPES
New Interior Improvement
Addition Move Building
Ai Alteration Fire Repair
Replace Repair
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100%_
Census Code
# of Units
# of Buildings
Type of Construction
7®oG
h`34/
REQUIRED INSPECTIONS
/
V3
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water
t- Framing
Fireplace: _Rough In _
Insulation
Sheathing
Sheetrock
Reviewed By:
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Siding
Reroof
Windows
Egress Window
�
L C� Pr,, ; r t r- C -
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
v7
R '!
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Other:
Final Pool: _Footings Air/Gas Tests _
Siding: Stucco Lath Stone Lath
_Air Test Final Windows
Retaining Wall: Footings _ Backfill
Radon Control
Erosion Control
)1\11 , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
/'17
Final
Brick
Final
X 23 ktr mik,2)
4/14 od Ll op/ .Arj)
3 A Sao-
90
Page 2 of 3
PROCEDURE TO DETERMINE MAKEUP AIR QUANTITY FOR EXHAUST EQUIP ENT IN DWELLINGS
Use the Appropriate Co!umn to Estimate House Infiltration
1. a)
e factor
0.15
0.09
0.06
0.03
b) conditioned
Boor area (sf) fl
(including unfinished basements) 3 6 QQ
RECEIVED
JUL 17 2012
Estimated
[1a x tbj
libation (cfm):
2. Exhaust Capacity
a) continuous exhaustonly
ventilation system (cfm):
(not applicable to balanced
ventilation systems such as HRV)
b) clothes dryer (cfm)
135
c) 80% of largest exhaust raing
,,DO (cfm):
(not applicable if recirculating
system or if powered makeup air
is electrically interlocked and
matched to exhaust)
r') 80% of next largest exhaust
rating (cfm):
(not applicable if recirculating
system or if powered makeup air
iselectricatiy interlocked and
matched to exhaust)
Total Exhaust Capacity (cfir,):
[2a+2b+2c+2dj
3, Makeup Air Requirement
a) total exhaust capacity
(from above)
b) estimated house infiltration
(from above)
Makeup Air Quantity (cfm):
[3a -3b)
(if value is negative, no makeup
air is needed)
135
4. For Makeup Air Opening Sizing.
refer to Table 501.4.2
Use this column it there are other tnan tan -assisted or at, spher aliy vented pas or o f appances or :f there are no combustion appliances.
s Use this column if there is one fan-asssted appliance per vent rg system. Otter than atmospherically vented appliances may also be included.
c Use this column if there is one atrnosptrericaliy vented (otter than fan -assisted) gas or oil app=fiance per venting system or one solid fuel appliance.
D Use this column if there are multiple atmosphenicafly vented gas or o4 appliances using a common vent or if there are atmospherically vented gas or
oil appliances and solid fuel appliances
TABLE 501.4.2
MAKEUP AIR OPENING S s TABLE FOR NEW AND EXISTING DWELLINGS
(cfm) (inches)
Passive Opening
1-36
1-22
1-15
1-9
3
Passive Opening
37-66
10-17
4
Passive Opening
42-66
18-28
Passive Opening
Passive Opening
Passive Opening
164.232
101.143
47-69
70-99
29-42
43-61
7
233-317
14-195
100-13.` 62-83
8
Passive Opening with
Motorized Damper
318-419
196-258
136.179
84-110
Passive Opening with
Motorized Damper
420-539
259-332 180-233
111-142 10
Passive Opening with
Motorized Damper
540-679
333-419
231-293
143-179 11
Powered Makeup Air"
>290 1 X179
not applicable
A Use this column it there are other tha fan -assisted trnosphetatly atmospherically vented gas or 09 a Lances or if there are no combustion appliances.
a Use this column if there is one fan-asssted appliance per venting system. Other than ethos encally vented appliances may also be included.
c Use this column if there is one atmospherically vented (other than fan -assisted) gas or oil appliance per venting system of one solid fuel appliance.
D Use this column if there are multiple atmospherically vented was or -a appliances using a Amor vent or if there are atmospherically vented gas or
oil appliances and solid fuel
An equivalent length of 130 feet of round smooth metal d;r is assumed. Subtract 40 feet for the exterior hood and ten feet for each 90 -degree elbow
to determine the remaining length of straight duct aficwab e.
F If flexible duct is used, increase the duct diameter by one inch. Flexible duct shah be stretched with minimal sags. J
c Barometric dampers are prohibited in passive ria eup air openings when any atnos: herically vented rvoliance is installed.
Powered makeup air shall be electrically interlocked with the largest exhaust system.
411111111‘' City of Esau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
Permit*
Permit Fee:
Date Received:
Staff:
2012 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: ) 3/ -/ Z site Address: J 0 R' t < C t r c
Tenant
RESIDENT /OWNER
Name: O4 v.( 14 e h t i t (4.1
4J c Phone:
Address / City / Zip: S-7 d ft r % I s t Circ 14 a ? i* "e3i s S 12.
CONTRACTOR
Name: M eJ'1 ` r c .- P ir,4. Se, f.. i c. i T c License #:
Address: P 0 6 r * r� (2 ) i 2 City co ►,
state: illiv Zip: SS i Phone: (. J 9 4 I'/ 8 Z Se
Contact: 1/)' t144Email: j 16 (5 h C l f / c ti , / M 3 / n� lh (.• .4,
TYPE OF WORK
New Replacement Repair Rebuild X Modify Space Work in R.O.W.
_ _ _
Description of work: *F P- a de t I. , -t.c t H - a c% A. re -- 3 c 4' - "?v f"-**
PERMIT TYPE
RESIDENTIAL
Water Heater
c-- ) cp I + ^o
Water Softener
Lawn Irrigation L_ RPZ / PVB)
Add Plumbing Fixtures (L Main / Lower Level)
_
Septic System
Water Turnaround .404,b r r f '+ K
New
Abandonment
RESIDENTIAL FEES:
$60.00 Minimum Water
Heater, Water Softener, or Water Heatertaxi
(indudes $5.00 State Surcharge)
Fixtures, Septic System Abandonment, Water
Softener (includes $5.00 State Surcharge)
Turnaround* (includes $5.00 State Surcharge)
and $5.00 State Surcharge) /_
TOTAL FEES *- . 00
$60.00 Lawn Irrigation
$60.00 Add Plumbing
`Water Turnaround
$105.00 Septic System
(add $189.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to sit without a permit; that the work will be in
accordance wth the approved plan in the case of work which requires a review and approval of plans.
x /t 4 $C) ;/`-
Applic nfs Printed Name
x
APP
as Signature
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: __Under Ground _Rough -In ' Air Test Gas Test Final