4092 Prairie Ridge Rd+ ? •- .. . _ __ . . ' . - ,M..p?r,,,._ , ..? ...?,, .. ?..,,.!"'y.,. M?:'? 7'N8n'Ml?s...!:?" #k-? ?-yi?. - ?t v . ? '?..?y?'r-_T- . tin..+s ?
f l (" ?°•``r, Y' -ifT ?
&xfifira#r of (O.rxupan?m
(Citp of (Eagari
wvarhuetcY uf lrildiag 3inspertimt
T hrs Ceraifuate issued pursuant w rhe requirwnents ojSeation 306 of the Urrijorm Building
Code certll'inS [hat at the 1rme of irsuance lhirstrucdure wns in corrrpliance with the aarious
ondiirances oJ1ke City regalalutg building consduction or usp- For rhe foUowing. , ._.
u-a-m-fi- SF DidG./ GA R ewa- Pomk rb. ! a u o__ l
poc„p.ec7lype R 3 f M 1 R3/ yigp;w;a R I Tya C- um ?
OnovdBwTdioe 1NT'i'm_CTA= AS?!'f11i1"Qf.' Ad&m,2f2S Cf1AiCRT D71'VR FAr'.AN
AOST IN A COHSPICUOUS PIACE
OFEAGAN
Pilot
0. Box 21-199, Eagan, MN 55121
JE:454-8100
,0 91
Site Address 'KNz FuwixlE RID(
Lot t 8iock 2 5ec/5ub. t
Parcel No.
W Name MIT!'E1.3YAEDT sit07
z
- Address 785 sUMET DR
° City EAGAN Phone _
?oName
.
Re Address Jg?Y?-4A?,,v f- .scLt --
?W ¢W Name
? W ; Address
a W City Phone
Treatment PI 276 • 00
APPROVALS Road llnit 370100
Plan"ef - Park Oed.
Council ^
BIdg.Off. _ Copies
3,568.50
Variance - TOTAL
OFPICE USE ONtY
Occupancy Q-3 UA FEES
Zoning R-1
(Actual) Const
Y11
Bldg. Permit ? ??n
_isa±tnn
?L
(Ailowabie)
# of Stories V-N Surcharge 70'00
Length _
0?
P1an Feview ??, •?
Dep1h 514 sAC,city 100•00
S.F. To1al - SAC, MCWCC 650`OU
S.F. Footprints
On Site Sewage -
_
water Conn 660•00
On Site well water Meler 45'00
MW CC SyStERI
City Water x
X
Acct• Deposit ?U ? Q?
PRV Required A S/W Permit 3n+00
Booster Pump - SiW Surcharge • 50
- Permit No. Permit Holder Date Telephone #
WATER
PLUM8ING
•
? ? .? ?,? ?? ??
H.V.A.C. & Z& 14h 47 ? -6DOS
ELECTRIC
,
ZMA
Inspection Date Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Pibg. d _ ' ? --?
Rough Htg.
I5ul.
Fireplace
Final Htg.
Orshat Test
F'rna! Plbg. PJbg. Mspector - Nofity Plumber
Const. Meter -2 _ L9 `
. •
EngrJPlan
Bldg. Final I
Dedc Ftg.
Dedc Final
?
Pr. Disp.
, A
?
CASH RECEIPT
- ??
??.
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE i I " 1 19 IJ
aE-CENEo -- -
ff10AI ?. •
r
AMOUNT 5
DOLLARS
,ao
O CASH CHECK
BY
?
C 016262 W,,,e-Pa,ers
?Y
Yal?-?I n? ?
Pink-File Copy
Thank You
? . ..
SEMER&VIfATER PERMIT
CIf1( OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE NOV 19, 1991
METER # _
CHIP # _
METER SIZE
ISSUE DATE
OFFICE USE ONIY
PEFiMIT DATE 1 1/20/91
PERMIT # 12387
? -?
B.P. RECEIP7 #' / /`• / ?,"
B.P. RECEIPT DATE I 1 19 91
.X. PRV - BOOSTER PUMP
SITEADDRESS 4092 P1tAIItIE RIDGE RIl
LOT 1 BLOCK 2 SEC/SUB COVENTRY PASS 213D
APPLICANT:
ADDRESS: _
CITY, STATE
ZIP
PHONE: -
PLUMBER: 14C170NALD PLUW.BING SYSTEMS INC
ADDRESS: 18271 KEAiWOOD T8
CITY, STATE IAKEVILLE MN Zlp 55044
PHONE: 435-.3334
OWNER: MITTELSTAEDT BROTflERS
ADDRESS: 785 SUNSET DR
CITY, STATE F-AGAN MN Zlp 55123
PHOrvE: 456-9125
PERMIT REQUESTED
x SEWER X WATER - TAPS 1
^ COMM/IND X RESIDEN7IAL ?
X NEW
EXIS7ING
Lawn Sprinkler Meters are to be Installed .i
Ahead of Domestic Meters on Water Line. 3
Credit WILL NOT be given for Deduct Meters. ?
?1 AGREE TD COMPLY WITN ClTY OF
EAGAN ORDINANCES
SIGNATURE WHEN METER 15SUED
PLEASE ALLOW TWO WORKlNG DAYS FOR PROCESSlNG. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
SEV4fER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE NOV 19, 1991
OFFICE USE ONLY
METER # PERMIT DATE 11 f 20/91
CHIP # PERMIT # 1g387
METER SIZE ? B.P. RECEIPT # 1 ?
•
a
ISSUE DATE ? B.P. RECEIPT DATE 11 19 91
__X.. PRV - BOOSTER PUMP
SITE AODRESS 4092 PRAIxIE RIDGE RD
LOT 1 BLOCK 2 SEC/SUB COVENTRY PASS 2ND
APPLICANT:
ADDRESS:_
CITY. STATE
PHONE: ?
ZIP
PLUMBER: MCDONALD PLUMBING SYSTEMS INC
ADDRESS: 18271 KENWOOD TR
CITY, STATE LAKEVILLE [9N Zip 55044
PHONE: 435-3334
OWNER: _
ADDRESS
PERMIT REQUESTED
X SEWER X WATER _ TAPS
COMMIIND X RESIDENTIAL '.
MITTELSTAEDT BROTHERS
785 SUNSET DR
X NEW
EXISTING
Lawn Sprinkler Meters are to be instalied
Ahead of Domestic Meters on Water Line. :
Credit WILL NOT be given for Deduct Meters.
c? -r
1 AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES
CITY, STATE EAGAN MN ZIP 55123
PHO?E: 456-9125 N GNATU HEN M ISSUEO
t;=
PLEASE/dLLOVff?fWd WORKING DAYSIIFOR PROCEiSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
CITY OF EAGAN NO 19891
3830 Pilot Knob Road, P.O. Bax 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE: 454-8100 C L!?G,?
Receipt #
iobeused(or SF DWG/GAR Est.value $140,000 Date NOV 19 ?g 91
Site Address 4092 PRAIRIE RIDGE RD
Lat 1 Block 2 Sec/Sub. COVENTRY PASS
Parcel No. N
a Name MITTELSTAEDT BROTHFRS
W
o Address 785 SUNSET DR
City EAGAN Phone 456-9125
Name _
Address
City -
Phone
?w Name
m,? AddreSs
aw Ciry Phone
I hereby acknowlege that I have read this application and state that Ihe
inlormation is correct and agree to comply with all applicable State of
Minnesota StaWtes and Ciry of Eagan Ordmances.
SignatureofPermifp,e--,?(1?? ?-?R?-
ABuildmgPermitisissuetlto' MTTTF.T.STAF.DT RROTHFR
on the ezpress condition that all work shall be done in accortlance wrth all
applicable State of Minnesota pStatules annd,City of Eagan Ortlmances
Building Ol?icial ? lll il atll 1 I l l?d
OFFICE USE ONLY
Occupancy R-3 hL-1 FEES
Zoning R--1
(Adual) Const V-N Bldq. Permi[ 7R0 _ 00
(Allowable) V-N Surcharge 70.00
# ol stones
Lengih -
491
Plan Reviaw
507.00
Depih 1r.1, SAC,Ciry 100•00
S.F.Total - SAC,MCWCC 6$0.00
S.F Footprints -
660
00
On Site Sewage _ Waler Conn .
On Srte Well - Water Meter 95. 00
MWCC System X
X
Aoct Deposil
30.00
Qrywater
PRV Required X S/VJ Permil 10.00
Boostar Pump - S/yy Surcharge . 50
Trealment PI 776_ nn
APPROVALS RoadUnit 370.00
Planner - park Ded
CounCtl _.
BIdg.Off. _ Copies
Variance - TOTAL 3,568.50
A'ddress:4092 P_RAIRIE RIDGE ?tD I.ot I Blk 2 Sec/Sub COVENTRy pA$g 2Np
T?hese items were/were not complete at the time of the final inspection.
Dat : 2/21 92 Yes No 6
Final grade (6" from siding) ?
Permanent steps - garage ?
Permanent steps - main entry ?
Permanent dtiveway i?
Permanent gas ?
Sod/seeded grass !/
Trail/curb damage L?
Parch V
Basement finish ?
Deck
Please verify vith the builder the removal of roof test caps from the plumbing
system and tha shut-o£f of vater supply to the outside lawn faucet before
freeze potential exists. ?
necx?eowxx
White - City copy Yellow - Resident copy Pink - Contractor copy
-- DATE: NOV 20 1991
RE.
4092 PRAIRIE RIDGE RD (MITTELSTAEDT BROTHERS)
XL_ 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 tor the above propeRy cannot be completed for the following
reasons:
Your Sewer R 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
contirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) beTore issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOH WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
d /25?'
O l ?
',?O
aw.e-
Requesl Daie Frre No Ro gh-m Inspec1uon
m.ed'+
Ready Naw f] WAI Nonry Inspector
Wh
R
?
tl
es ? No en
ea
y
I,Xlicbnsed contractor rJ owner hereby
i request inspection of above electrical work at
Job Atltlress (SVeet Box or Rou/?eJNyo/? ?
/ Ciry
r
ki, 0 - f /1 " C G /
G
- ?U_z
Section N. TownsNp Name or No Range No Gounry
OccupantlPFINT? Phone No.
2s-
Power SupDlter Atltlress
Electncai Gomractor (GOmpany Name) Gomracbr's License No
v L,u G,?' c. ?"? ? yZ
MaiM1nq qatlress fCon[rector o/r Owner Makinq Installauonl
/???/?`???L??,.?'
Auin gnaWre 1 onuacinnOwner Maxing InstallaLOn) Phone
Nu
mbp ?
????M? ?
L
? . ?? V
MINNESOTA STATE BO0.R0 OF ELECTHIGTY THIS INSPEGTION REQUEST WILL NOT
Gngga-Mldway Bltlg. - Room 5178 BE ACCEPTED 6V THE STATE BOARD
1821 Uniwrsity Ave. St Pavl, MN 55104 UNLESS PROPER INSPECTION FEE IS
PMne (612) 642-OBW ENCLOSED
r REQUEST FOR ELECTRICAL INSPECTION 'f""`•"'A? ee ooom-ue
?$ee inshuctions br complelmg tM1is lorm on back ol yellow copy ?~?,,€3 /OS y77
06400 ?"X" Belaw Work Covered by This Request ?:^`?
ew Add Rep. Typeoi8wlding AppliancesWVed EquipmenlWiretl
ome Range Temporary Service
Duplex Water Heater Electric Heating
Apt. 8uilding Dryer Other (Specify)
Comm./lntlustnal Furnace
Farm Av Conditioner
Omer (sVai comracmr's Remarks "Ar
F
Com oF /?Ela/ ee4i,E pd??
pute Inspection Fee Below.
# . Other Fee # SermceEnirance Sme Fee # CircuifslFeeders Fee
Swimming Pool 0 to 200 Amps 0 fo i00 Amps
Transformers Above 200 _ Amps A6ove 100 _ Amps
S19f1S Inspecmr5 Use Only.
v TOTAL
Irngation Booms
Speclal Inspecllon
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electncal Inspector, hereby aou9n-in
certify that the above mspection has
been made. Fmai
OFFICE USE ONLY
This requast voitl 18 monihs tmm
?
?
4.0 8 9 9
p
4=
Rear1ko oe,a
Fra No o? h ,n Inepea,ion
Fe irehl ? Ready Now ?tNill NoOry Inspector
/'' -
??. Yes C N. When Ready?
i licensed contractor D owner hereby request inspection of above electncal work at
dob Atltlress ISVeet Box or qoute No ) Gtly
b 9a ?? - F
Sectioo No Township Name or N. Ran9e No County
Occypam (PRINT) Phone No
A E/1T 6.Co?'
Pawe: Suppeer qaaress
?L
'
"
-?
cT
.P?
loT,4 .,
ElacLnwl Convactor ICompany Name7 _ Contrector's License No
E?v CN?c?IJ ???c7' C C ??2 lc
Maihng qtldress IGOnIractor or Owner M9kmg Installation)
iau
e-rA
f' a K?A K 7oZ
nut o??xetl SiqnaWre ICOmractooOwner Ma*ing Insieliavon) PM1One Number
MINNESOTA STATE BOAqp Oi ELECTRIQTY THIS MSPECTION FEDUEST WILL NOT
Gtlggs-MiOway BIUg - flppm 5473 6E ACCEPLED bV THE STFTE BDAFD
1821 pnrversity Ave. 5[ Paul MN 55106 , UNLESS PROPER INSPECTION FEE IS
Ghane (612) 662-0900 ENCLOSEO
?./9/?/ REQUEST FOR ELECTRICAL WSPECTION ee-ooom-os
ji See msimcliors lor mmD'etino Ihis lorm on back of yellow capy /O
? Q,nR qq_ .r "X" Below Work Covered by This Request
ew Add Rep TypeofBUilding
Home AppliancesWired
Range EqwpmentWired
Temporary Service
Duplex Water Heater Elechic Heahng
Apt Bwltling Dryer Other (Specfy)
Comm /Industnal Furnace
Farm Av Conditioner
OIhBr Ispemlyi ConVactofs Ramarks
Compute Inspecbon Fee Below
•
x Other Fee * ServiceEnirance5¢e Fee # Crccw7s/Feedars Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps /
Z nsfolmers AbOVe 200 _ Amp Ahove 100 _ Amps
ns Inspectar's Use Only TOTAI
Irri
gation Booms 413)
lp ,?
Special Inspection
Alarm/Communicahon THIS INSTALLATION MAY BE ORDERED OISC NNECTED IF NOT
Ocher Fee COMPLETED WITHIN 18 MONTW§i ?
1. ihe Electrical Inspector, hereby R°09n-'" . -
2 ?
cerirfy that the above inspection has
been made F,;i81 , oaie
y'ev
OFFIGE USE ONLY
This request voiC 18 momhs Iro:r.
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
851•681-4875
New Construction Reauiremenls
• 3 registered sAe surveys showing sq. fl. M lot, sq. ft. of house; and all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showiig beam 8 wind(yw sizes; poured found design, etc.)
• 1 set of Energy Calculalions
• 3 copies o! Tree Preservation Fan i( lol platted aRer 711193
• Rim Joist Detail Opfions selection sheet (bldgs with 3 or less uni4s)
DATE IU- Z-6 7
f?. e LU, n ,
SITEADDRESS ? 0 I? MULTI-FAMILYBLDG _Y _h
TYPE OF WORK FIREPLACE(S) _ 0_ 1_ 2
APPLICANT
STREET ADDRESS 7(S-- CITY
TELEPHONE # CELL PHONE # J?i G a-3z?-iy3/ FAX #
PROPERTY OWNER
ATE_ZIP
TELEPHONE#
COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RIJL,ES 7670 CATEGORY 1 MINNESOTA RUI.ES 7672
(4 submission type) . Residentlal VenGlation Category 7 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor:
Plumbing syslem includes:
Mechanical Contractor:
Mechanical syslem includes:
Sewer/Water Contractor:
Phone #
Phone #
------------------------------------------------------------------------•
I hereby acknowledge that I have read this application, state that the information is
with all applicable State of Minnesota Statutes and City of Eag r ina ces. ?
Signature of Applicant
OFFICE USE
_ Water Softener
_ Watcr Hcatcr
No. of Baths
RemodellRaoair ReauiremeMs
. 2 copies of plan
• 1 set of Energy Calculations for heated additions
• lsitesurveyforexterioradditions&decks
. Indicate if home served by septic system for additions
o-J
VALUATION 2- (5y C 0 Z)
Phone #
? Lawn Sprinklcr
No. of R.I. Baths
_ Air Conditioning
Heat Recovery System
I+ee: $90.00
Fec: $70 QQ?
nrTJ1 1 9(1(1? ? ?-
,
----------------------------
Certificates of Survey Received _ Tree Preservation Pfan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? Ot 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 E#. 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 ? 78 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex O 11 10-plex ? 19 lower Level ? 24 Storm Damage
? 06 04-plex p 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundatlon) ? 45 Fire Repair
? 33Alteration ? 37 Demolish(Bldg)• ? 43 Reroof ? 46 WindowslOoors
? 34 Replacement •Oemolitlon (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Staries Booster Pump
Nbr. af Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED IN SPECTIONS
_ Footings (new bldg) FinaL'C.O.
_ Footings (deck) FinaUtio C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ F (nal _ Pool _ Ftgs _ AuiGas Tests _ Final
_ Framing _ Siding Stucco Srone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ fasulation _ Retauilng Wall
Approved By
Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
W ater Supply & Storage
S&W Permit 8 Surcharge
Treatment Piant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
1BL o? CITY OF EAGAN
PLUMBING PERMIT
SUBD. (612) 681-4675
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS.
WHEN PERMITS ARE REQUIRED FOR EACH UNIT,
------------------------ ------------------------------
WORK DESCRIPTION
N0.
NEW CONST
ADD ON
REPAIR
owxER NnME: _Dlonx-1
SITE ADDRESS: `1'O(?r?_
-- -??
INSTALLER: _i&?A 1Z11W 1207L,,,l///,
ADDRESS: a71
GITY: z- ZIP:
CONTRACT PRICE:
1% OF CONTRACT FEE. .
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
STATE SURCHARGE .50
TOTAL: ; (d
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS AAE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS:
TENANT NAME:
SUITE #:
INSTALLER:
ADDRESS:
CITY:
PHONE
FOR:
CITY OF EAGAN
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1% $
STATE SURCHARGE $
TOTAL:
CITY USE ONLY
RECEIPT # C NW-Ar
DATE / ee 9 .5-
ALSO, FOR TOWNHOMES AND CONDOS
COMPLETE T1iE FOLLOWING:
FIRTURES EA. TOTAL
REPAIR/ADD ON 15.00
SHOWER 3.00
WATER CLOSET 3.00
BATH TUB 3.00
IAVATORY 3.00
KITCHEN SINK 3.00
IAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
WATER HEATER 3.00
FIAOR DRAIN 3.00
GAS PIPING OUT.
(MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50
OTHER
WATER SOFfENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
W. TURNAROUND 15.00
$
(SIGNATURE)
?ERM 1 r # I 98'9/
REACTIYATE D4
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
681-4675
SINGLE 8 MULTI-F/U1ILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made ar lot chan e is re uested once ermit is issued.
Date g //_ /Yaluation of work
Site Address:_ Q?022 a,?" ? .
STREE7 SUfTE N
Tenant Name: (commercial only)
LOT BIACK -? SUBD P.I.D. if
/
Descri tion of work: 61
The applicant is: ? Owner ? Contractor ? Other?(Deseribe)
Name _3Or `' ri ?,kQ Phone
Property
? LA:T F1R57
?
_
:?,?,ar Address _5tw?Q CW 8fiC?-4070
STREET S1E R
City ? State Zip
Company .r'' Phone
Contractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registratian #
Address
City State Zip
Sewer 6 Nater licensed plumber Processing time for
sewer & water permits is two days once area has een approve . '
I hereby acknowledge that I have read this application and state that the information is
correct and agree ta comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
L
Signature of Applicant:
.,? ?
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation
E1 02 SF Uwg.
? 03 SF Addition
? 04 SF Parch
? 05 SF Misc.
WORK TYPE
-0 31 New
? 32 Addition
? 06 Duplex
0 07 4-Plex
? 08 8-Plex
? 09 12-Plex
? 10 Multi. Add'1
? 33 Alteratlons
? 34 Repair
? 11 Apt./Lodging
? 12 Multi. Misc.
? 13 GarageJAccessory
? 14 Fireplace
0 15 Deck
? 35 Tenant Finish
? 36 Move
•, , ,
? 16 Basement Finish
? 17 Swim Poot
? 18 Coimn./Ind.
? 19 Cormn./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
GENERAL INFORMATION
Canst. (Actual)
(Allowable)
UBC Occupancy
Zon1ng
# of Stories
Length
Depth
APPROVALS
Basement sq. ft.
lst fl. sq. ft.
R-3 2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
?On-site well
iz' On-site sewage
P1 anni ng °i-"•'•'-?'• "•3
Engineering Yariance
REQUIRED INSPECTIONS
? site
? Wallboard
19 Footing
JO Final
.
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code _9T4_7_
SAC Code
Assessments
? Framing - ? Insulation
? Draintile O Fireplace
Permi t Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Mater Conn.
Water Meter
Acct. Deposit
S/W Permit
5/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Copies ?
Other
Total:
r.lusesan: 8
SAC %
SAC Units
- ? -FROM : DOU6 JORGENSON PHONE N0.
... . .. ?nr_
612 686 7859
P63
SURYEYDR'S CERYIFICATE
.,
M0741 NO /KCVtC tOL! INKaTIWTioN
NAt al[N CObir'lC1'm OM 711I!
lr6f I• rMg •UlrvlMON. RI[
' 1UITY1-11Y Ot Spl! t0 lUPOqni
t++R Irltlx Hou" +ftroua
is wor Y?i KMOSOLrtr oF
TK[ suotrom.
EAGAN
REVIEWED
eus. coni sr.
ar
oA7E
115,07 N 890 57' 39" E
- - ,. . .r -"..+
?t :4f4INAUL df U1ILITY
EASEMtN1 PEH PLAi ?}
? W 1 ?( ?na? y
? 1 --• 'b:?,a ' ?,w,w ?C?"/6 ,f ?
490! 1
W
?
?
n? y
.
IIosr
-- MMCM YA111i
"? 0f pIpi
¦ 6tv+M?'16
? •? ?? ?w. ?, eea.?
25J9 ??'t'ue?e•- ?"?.i ?.?.7, ?34.25 f --
1
i ? M •r,Wpo sCp,?
a ? v ? NOUS[ ,?
lstto
•e. a r.?e
e?iv.???aso ? ?A
+ bENOTES PROPUSEO SUHFACC Df1AiNAGF
O DENOTES IHUN MUNUMC-NT SEI
• DENOTES IqQN MONUMENT FpUNO
X0000 DENOTES CXiSTING ELEVnTION
(000.0) DENOTES PqONUSED FLEVATIC 1.
5CALE• 1 INCI4 - 30 FEET
PROF'OSCD GARAGE FLOOR -$S j,(p FEET
PROPOSED IOWEST FLOOfi ? 6419 FEET
PkCri'US[D TQP OF BLOCK - g 5 g,0 FEE'T
?
WE HERE6Y C;EPTIF'r TO MITTEISTAEGr El1tOS WNST 11 1At Ti II:i IS A THUE AN[7 CORHECT
REI'RCSk:NTATfON 0?- n SUkvF i'C?r r'HC t30(.JrlbA;tIES I)r
1,01 I, 8 loer 2 , COVEN7kY PASS 2NO AI7oiTIaN.,,??,,,w?,,.. .,. ..._
N
R 22
.o • ?
aRnc[ t;`
1 /
? 22.00 - N 'i9 49
($57 3) e0e.4
PAOP09EU 1 ^
e1 aAwEwnr _ J Io ?
_;`,,, fl , LD
ryst
r- r4 ••='"' ? 5?774 N 89°57'39' F
MOTE; 4UILDINa 61MQ+SIprS 9NpwN Aft /DP yipRijONTAL
6 VU1'ICAL LOCATIQN OR /TftCTUR[ 0116Y, Kt
AR?il CTUAI iL4rt ?OI1 lui4GM g fON1AAtlOi
OIAILw qM9,
2
nu itwcninu,,iv vr r4 )VRVC1 vp !r1C i5U1.1NUAI ilt?) I SF
1.oi 1, P lock 2, CpVENTkY PASS 2kD ADpiTION, utcordlny lo rfte
recorded pla+ InorscY, Dakota County,Mlnnesoro -
1T DOfiS NOT PURFOFII Tp SH(?W 1MPR0YLMENI5 UR ENGHUACNMENTS, EXGEPT qS SHOWN, AS
SURVEI'fD Bv ME OIl UNDEa MY UiFt[CT SUNERVISiON iHig 12TH DaY ur NOVEMtjER , 1991.
PA0/OSEO GI1AOtS SNOWN WtPE TAKEN
illOlA 1HE 0EVEL0P1AENT vLAN WP
`'CW[NTpr PA!! 2ND AODiTIOM , LAST
"TiO s-1Y•s9
SIGNEU?' ?,?A S H F11Lt., INC.
I
• ` ,. _
6Y -?NNC?AK?ON. 'LAN --
? M' ' D SURVEYOR
? tiIINN[9plA l Il.:ENSC- NUMBEfi 19828
O F L 0 O w n
m m ?
I I
^}
o
T r?no
. or ? ° ?
! ? ?' ^
? ?
? O m ` I+ I I y 1
\
.)afn-es R. Htil, inc;, ?PLANNERS / ENGINEERS / S4lA1fEYORS
ZSUU \i? CTY NC) 42 & BUi1N$VII,LE. MN, 55337 - 842-880-6044
0
. I
CITY OF EAGAN FOR CITY IISE ONLY
3630 PILOT KNOB ROAD
• -" EAGAN, MN 55122 PERMIT #
PHONE: (612) 454-8100 RECEIPT #?
MDATE:
R?F.53'pE?'1°?lkX;p; PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMSLY DWELLINGS fi
TOWNHOMES/CONDOS WHEN PERMITS ARE REQIIZRED FOR EACH IINIT.
------------------------------------°--------------------------------------------
OWNER
yWa
SITE .
LOT:/ BLOCK A SUBD.
INSTALLER:
ADDRESS:_
CITY: L//.I
COMPLETE THE FOLLOWING:
N0. FIXTURES. EA. TOTAL
ADD-ON MINIMUM 15.00
? SHOWER 3.00
? WATER CLOSET 3.00
/ BATH TUB 3.00
-/. , LAVATORY 3.00 J?
? KITCHEN SINK 3.00 3-
1 LAUNDRY TRAY 3.00
? HOT TUB/SPA 3.00
? WATER HEATER 3.00 ?-?
? FLOOR DRAIN 3.00 3 ?
GAS PIYING OUT.
,L (MINIMUM - 1) 3.00
? ROUGH OPENINGS 1.50 /,!2
_ OTHER
WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
PHONE #: - S y? y?
SUBTOTAL
ST. SURCHARGE .50
GNATURE 0 P TTEE
TOTAL:
Ci1?iMERCIAI:?!iNDUPLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS 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:
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE m $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $_
STATE SURCHARGE $_
TOTAL:
(SIGNATURE)
CITY OF EAGAN
WORK DESCRIPTION
NEW CONST
ADD ON
REPAIR _
ygu
CiTY QF EAGAN
3830 PILOT &NOB ROAD
EAGAN. 2N 55122
PHONE: (612) 454-8100
. ?I£GHANICAI:; :YERtfIT
r_
_
s???zrrrzai.:
?:., .....:. ... _ ,. .... ... . ...:.
----
WORK DESCRIPTION
NEW CONST ?
ADD ON _
REPAIR _
OWNER NAME: ///AhZZ-A/Y/x?
SITE ADDRESS:
IAT: ? BIACK ? SUBD.
INSTALLER:
AnDRSSS: 12481 Rhode Island Ave So•
cizx: 894•0?Qp:
PHONE #:
?0#44?RCIALJiNDU5TItTA7: PLEASE COMPLETE THIS PORTION FOR ALL CO'n?IERCIAL/INDIISTRIAL BUILDINGS,
?,.., .: ... . . .. ..: .: . . . . .. .
APARTMENT BUILDINGS, AND ?SULTI-FAMILY BUILDINCS iTHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DiTELLZNG IINIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
IAT: BIACK _ SUBD.
INSTALLER:
ADDRESS:
CITY:
PHONE
FOR:
CITY OF EAGAN
FEES
PLEASE COMPLETE IIPPER PORTION ONLY FOR • SINGLE .
TOWNHOMES/CONDOS SJHEN YERMITS ARE REQUIRED FOR EACH IINIT,
----------- --------------_-----------
FOR CITY DSE ONLY
PERlIIT #
RECEIPT VI , S I
DATE: 7
DWELLINGS 6
ADD-ON MINIMUM $15.00
HVAC 0-100 M BTO 24.00-
ADDITIONAL 50 M BTU 6.00 -
GAS OUTLETS - MINIMUM qe 3.00 ; (? •oo
OF 1 PER PERMIT
SUBTOTAL: $ 36•00
STATE SARCHARGE: .50
TOTAL: S-36-G'
. r?/J/Y? J 5S ?ULl.
SIGNA RE OF PERMIT E
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 QF PERMIT FEE.
PROCESSED PIPING - $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SUACHARGE
TOTAL:
$
(SIGNATURE)
2IP:
- ?,
7;io•oo+
5J!•u0F
2, 211•50?
3,5Gt1•5t)T
'780•D0+
JJ•OJ ?-
5kly•Up+
2 11•5Jr
>>,553•5 0
ro $A?'O I'1t11?lA
1991 BUILDI MI APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
MITLTIPLE DWELLINGS
COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED .4ITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCUTATIONS (CHECK WITH BI.DG. 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 MAI1E.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHIGH ADDRESS IS
I
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For: S(ot„ F2?
Site Address #02-4 A.4'iZ?
Lot L Block 2- le
Valuation: ? Date
OFFICE USE
Parcel/Sub iFM
Ownex
Address
City/Zip Code
Phone
Contractor
Address '7f 3
City/Zip Code GAIi.¢,J d9; Si2(/23
Phone Y"?(„ 'qj?:5
Arch./Engr.
Address
Gity/Zip Code
Phone #
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
R 3 M-1
?
U^T4
?
51?
On site sewage_
On site well
MWCC System f
City water ?/
PRV ?
Booster Pump _
APPROVALS
Planner _
Council
Bldg. Off. 11-/k%/D5
Variance
it ? ?/-7i
FEES r?
Bldg. Permit I80•oo
Surcharge 170100
Plan Review O C?O
O
SAC, City pO(D
SAC, MWCC Oo Otl
Water Conn. A601
OD
Watex Meter 475io
Acct. Deposit a?Da
S/w Permit OiOa
S/W Surcharge I5'D
Treatment P1. 176,04
Road Unit r)O,Oo
Park Ded.
Trail Ded.
Copies
SUBTOTAL
Penalty
Lot Change
TOTAL ._ ?( .
li agrees that all work shall be done in accordance with
Signature of Contractor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
. ? VAUl.t.n,-n
is
G A F2 k 6-r
? xsi ? b82.
Z)kro = Czo)
3x3xrz?
65'1 Y. I5_9055"
QSt?IT,
?----
1 iSr _FLoc,,
BSMT: 11? I X S3=
2: Np ?4,noR
6Z,v63
a? x3?= ?rq
Li .X ?s = 6 0
sn?i=.?..
?l6o?C53=- SO,gB?
?-
I 3?y ,1 `? Z o fZ
?Fa u?y = lo o a
.6K II = 5S
5x11= 55
8X6_ 4g
3X3k1/a.= 5`
I Iy= 1639?1
I qO? 000 '
?' ° .
&4-RVEYOR'S CERTIFICATE
NO7i+ NO fKCIFle fpLS INV(fTI0AT10N
Hlt ![LH COMPL"m OH 7H13
E TAOI?ITYCO? S? 1p ?lUppdqr
TH[ llUlflt HCUiC MpP0![D
15 NOT T11( 11[lPpKg"iTY Of
TMi aV"Ypp,
(?'??ZnM
se:n 157
W
d
?
tp
57' 39" E
DRAINAGE B IJTILITYJ/
EASEMENT PER PLAT
LJO1
ases . ? ??7 3
-?z5.ie'-ressa a?
14. -0 ?
m N
ses i
c? W
}'? c e
?
?
I
PfiOPOSED
I
• 22 OO
i eaeo
S?
Q
- (Es5?.8 i
Housrn /
MfTTELSTAEDT BRO$. CQNS'T'
? 90
rea7
n ae? ?
? 10 `
?606.Y w
? M
M 3 esa.a h
34.25 F,
{
I x
/ , reszs')i ? ;
? 21 . ? - 29,49
(g57 3 1 ? eoa. t ?
L ? {
PROPOSED
DRIVEWAY to ?
Q 85{ _ ?
B01C11 MApN
70/ rn
FL(y.Vt6C30
O
`-- 1q,,9?
? 22 R 'Z
? '' 80.74
N 89°5T'39" E
l
iiMCH YAIIN
iur o? ?in
[
q?yw. . ...?r
A?„i"' ?
0547 8545
Bsz,p
NqTE: -8U4,DINa D1MEN$IONS 9HOWN ppE Mp HNiWWu
8 V(RTILAL LOCATION OF fT11UCTUl18 ONLY !!E
AApiITILCfUAL WANf FOq eUiLONVG 0 FDl1NpAT10N
+-? DENOTES PROPqSED $URFACE DRAINAGE ot?.f[M qkg,
O DENOTES )RON MONUMENT SET
• DENOTES IRON MONUMENT FOUND
X000.0 DEtJOTES EX1571NG ELEVATION
(000.0) DENOTES PROPQSED ELEVATIpN
SCALE! 1 INCH -
PROPOSED GARAGE FLOOR -
PRpPOSED LOWEST FLOOR -
PR;6Pp5ED-TOP-OF BLbCK-
dc-R V R,.??O,L?
30 FEET
8 57, (p FEET
$V9.9 FEE7
FEET
WE HEREBY CERTIFY TO MITTELSTAEDT 9ROS. CANST 7HAT THIS 0 IS A 4 TRUE AND CORRECT
REPRESENTA71qN OF A SURVEY OF THE BOUNDARIES OF.
Lot I, Blcek 2,COVtNTRY PAS5 ZND AppIT10N,accordlnq tothe
recorded plai fhored, bokoia County,Mfnnesota
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHpWN, AS
SURVEYED 6Y ME OR UNdEH MY bIRECT SUPERVISION 7HIS 12TH DAY OF NOV€AABER , 1991.
;pROPOSEO GqAOEg Sr+owN wERE TnKEN SIGNED(- JA S R HILL, INC.
`?FRpM THE DEVELOPMENT PLAN FbA
:COVXHTRY PA98 2Np p001TI0N,LAS7
`DAT40 6-1i-99 '8y;? C
JpHN C. LARSON, LAND SURVEYOR
MINNESOTR LICENSE NUMBER 19$28
? ?
s
f?
71 T v
Q
? W
- p m
v m
o0 co ?
4 2
?n ? o ? D
o z
mo
o ?
n
? _ ?
m m?
Z
p m {I
I rn ?
- m
•
James R. Hi , inc.
PLANNERS / ENGlNEERS / SURVEYORS
2500 W. CTY RD. 42 • BURNSVILLE, MN. 55337 6 612-890-6044
,1-11-1.? 1 3:58 PnGE = 01
I Sld'ktVEYOFt'S CERTIFIGATE
Hor94 r+o snccinc Iows INvciriwr,oa
HAf S[gH LOM?tMO ON 7Ht!
L6T OY TN[ lY11V[YOR. TM[
tWT1101L17Y 0F lOILj 7p SUpppq,
TFI[ llqCwlt 1lWl![ I/10pOt[D
13 MOT 71iC R(VpMteLn'T 0I
rHe auMtrop.
c>)_ - 115.07 N 890 57' 39" E
W
b
in
f'O
1 FF->URAINAGE , -` I
BU7ILITY?
EASEMEN7 PER PLAT?
U. /?
J ?
?
•b63
m N
? x" eae i
Ga W
?
?
BD1CN M4N1{ 'i? ;I
T0P p/ " r" .
. FyV.s116&70
' <sss ?;` ?
?--- 14 2? `'
?22353 -
;
MtTTELSTAEDT BIiP3. CqNST.
N 067I' ?
? IO '
Y60.1
? - Ct556.8 ) ? N
( g? 7, 3 ?ew, eso.e ^
?25.IB asse' di , ? ?
? 14.0 ?' 170 i
I ?
? M f'FOPOSED x
? N? HQUSE
O N
I (P GARAGE O
m ? '^
? y ! -- CX MARK
2200 )I Y[y
F ._ N 2L ^ Ce5?.3 29.49 Tp? pw rypg
? eseo? ?c?57 3 ) ^ - - eae.s _• ? eLtY.rNf.M
PROPOSEO --
DRIVE WAY 10 ? Q N
4 ? o 8 42
. !
80.74 N 89° 57'39" E tta4??;??b??i6`'?
PRAIRiE RIrGE 'RO??a ..? ?u_._ _ +__?
eea 7 ee4.5 ... ..._ , .,.??r. , :,.
?,{
NOTE1 -BUILDIN7J,`eDIA?ENS101I5' '9HOWN AqE ?Qp }ppq*NTu
BYp171CA1. LOCATtON OP ETIMJCTURE OIKY. K!
AA611TECfUAL I+IANS ?OR BUILOING e FMNpATIqJ
•
DENOTES PROPpSED SURFACE ORAINAGE DIMQHyqN9,
O DENOTES IRON MONUMENT SET
• DENOTES IRON MONUMENT FOUND
X0000 DENOTES EXISTING ELEVATION
(000.0) DENOTES PROPQSED ELE1/A7ION
SCALE 1 INCH - 30 FEET
PROPOSED GARAGE FLflOR - 8 S7,(c, FEET
PROPOSEO LOWEST FLOOR - 8y9.9 FEET
PROP05ED TOP OF BLbCK -$s8 o FEET
' WE HEREBY CERTIFY TO MITTpLSTAEDT BROS. CANST THA7 THIS IS A TRUE AND COF2RECT
REPRESENTATION OF A SURVEY OF THE BOUNdARIES OF.
4ot 1, B lock 2, COVIENTRY PASS 2NQ AppITION, accordinq to the
` recorded plat ihareof, Dokota County,MinnasoTa
? IT DpES NqT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN, A5
s SURVEyED BY ME OR UNDER MY diRECT SUPERVISiGN THIS 127H DAY OF NOVEMBER , 1991,
'PRO+?oSEO GRAt7ES SHDWN WgqE TAKEN SIGNEpj JA S R HILL, INC.
;FROM 7HE OEVELOPMENT PLAN FOA +
'GCWENTRY PA98 2N0 ADOITION,LAST ?
;OAI'YO 6-IT•8i ?
a BY'
d
a JOHN C. LARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19828
,
?
a
Q
? O p _ Q
n
O n Q o o
- c..
m ?
p P z
Rl 0 0 Z l D p
z m
c0
- ? 0 m I ? I , y
o 1
nnoom
jam,es R. Hill, inc.
PLANNERS / ENGINEERS / SURVEYORS
2500 W CTY Rp. 42 • BURNSVILLE, MN. 55337 * 612-890-6044
`t1-11-1J l i:5'G F'ri'aF = Iii
ERTERIOR ENVELOPE AVERAGE "U" COMPUTATION
DATE
owNEx `j"u K ? ? 1 ? 7?• ?
SIiE
CONTRACTOR??'fT
nnnxESS 7g?sFr 6a Erxoxs N??
DETERMINE WORRING SQllARE FOOTAGE OF EACIi
1. Total exposed wall area ... Is 14 '7, 3 aq. ft. x• 11 ? Ld12
2. Total rooE/ceiling area ... /&yO sq. ft. x•026 4- ?
Total ezposed wall area above floor - 3 y5Q
a. Total wall crindow area ......................... y 25
3
b. Tatal door area ................................ ,
4, /
c. Total sliding glass door area .................. y 2
g
d. Total fireplace wall area .... ..•.. .. .... ,
p
e. Total wall framing area (average107.)
f.
Total ::::::::::
net wall area above floor . • ?
y
g. Total rim joiat area ...........................
'Z. o
31
Total exposed foundation area ? Q 7
h. Total foundation window area ................... ?
i. Total net foundation area above grade .......... 6
Determine "U" value of each wall segment.
a._ y 2 S, 3 x?tU„ , 4/2
b.- 34, r x„U., , 0? 2. 7
c.- 7C 'lUl, ? N 2 1 7-1
a. o x?fUl, o . a
e.- 3 5ti, o x?,U,, i) I - 3iT . 9
f._ 22'77 1 xefvtt ,oY3,? - 4 8.53
g•_ 17
h. / z x"„,, y Z 5,0
,
i._ $5 x "U" . 0 7L - G. J?
3 . ........................,......raeel
If item 03 is the same as, or less [han ites ui,ou-have`mthe intent
of SHC 6006 (c)z.
-1-
Page 2 of Z
Total exposed zoof/ceiling area - 11,04n
J. 'fotal skylight area ........................... o .
k. Total roof/ceiling framing area (average lOS).. 1,0 wi, 5
1. Total net insulated roof/ceiling area ......... ? S 3 7 5
Determine "U" value for each roof/ceiling segment.
j , l? X nOn A ? -
k. ?0 2 5 R„U„ 025,9 - 2. (,
.ozIg > ?3,5
4 . .. .. . . . .. . .. .. . --? '--?
........................ .Total ? i
?-
If total of 04 ia the same as, or less than 82, you have met [he intent
of SSC 6006(c)1.
Alternate Building Envelope Design
To utillze the total envelope system method, the values eatablished bq
the aum of items P3 and 04 shall not be greater than the sum of items
O1 and b2. 1
L. + 2. ? .
3. + 4. s
-2-
PERMIT # CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
681-4675
..
3pr? - '_%,?
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets af architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing 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 y Z. Valuation of work lt"? (.a?7°0
Site Location: az992 Rr1 -
STREET STE 0
Tenant Name•
LOT ? BLOCK 2 SUBD. v
??? P.I.D. $
w
?+_
Descri tion of work: ? y ?14? 6
The applicant is: ? Owner ,!?I_Contractor ? Other (Describe)
Name Phone
Property LASt FIRST
Owner
pddress
STREET STE p
City State Zip
Company /?l e TrE[... S,WeOT J?, Phone ?f .ilo 96Z 5
Contractor Address _7?'!!? 5ll.r-,?Pe-r !J/1.L/E _ License # 0703qy3 Exp. 4-3
City J??"V'42 State ?.v Zip 5KZ3
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
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 af
Eagan Ordinances.
Signature of Appllcant: _L"._
,
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 foundation
? 02 SF Owg.
? 03 Two family
? 04 Multi-fam. T.H
? 05 Apt. Bldg.
woRK nrPE
? 06 Garage/Accessory
? 07 Fireplace
? 08 Deck
;?, 09 Basement Finish
? 10 Swim Pool
0 11 Res. Add./Parch
? 12 Comm./Ind. New
? 13 Comm./Ind. Add
? 14 Comm./Ind. Rem
? 15 Public Fac.
? 31 New ? 34 Remodel ? 37 Move
? 32 Addition ? 35 Repair ? 38 Demolish
p 33 Alterations ? 36 Tenant Finish ? 99 Undefined
GENERAL INFORMATION
Occupancy R.- 3 Basement sq. ft.
Zoning ? lst F1. sq. ft.
Const. (Actual 2nd F1. sq. ft.
(Allowablei Sq. Ft. total
# of Stories Footprint Sq. ft.
Length On-site well
Depth On-site sewage
APPROVALS
Planning Building
Engineering Variance
REGIUIRED INSPECTIONS
? Site
? Wallboard
El Footing
R Final
,A5 Framing
? Draintile
]Z74-
? Insulation
? Fireplace
Permit Fee 3S,v °
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total: ?
sac x
SAC Units
valuectm:
? 16 Agricultural
O 17 Building Move
? 18 Demolition
? 20 Miscellaneous
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Assessments
I For officeUse
City of EllL Ull Permit#:
Permit Fee: /
3830 Pilot Knob Road I n
Eagan MN 55122 Date Received: MUG 0 4 2009
Phone: (651) 675-5675 I
Fax: (651) 675-5694 Staff//
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: fr/~'
Tenant: Suite
RESIDENT / OWNER Name: l 'r d-`6De Phone: 6i 7 5 / 7~
Address /City /Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work:--s4/// l~t'`~/'Sv S
Construction Cost: 4',?, al'!n6. Multi-Family Building: (Yes / No
CONTRACTOR Name: C /c~T L~c~ j- rr C b/t? I License
35 yJ9~ Addre `Ic/~/ ~ GI~C>/ _ _A G Lc?
C State. Zi
Phone: 3 ontact Person: - NHS l1
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
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.
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.
x 6 r Vu Ikers x
Applicant' rinted Name Applicant's
04 g "'--nature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation Fireplace _ Porch (3-Season) Storm Damage
Single Family Garage Porch (4-Season) Exterior Alteration (Single Family)
Multi Deck Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi)
01 of Plex Lower Level Pool Miscellaneous
Accessory Building
WORK TYPES
New Interior Improvement Siding Demolish Building*
Addition Move Building Reroof _ Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
Replace Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation 3~y Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_ 100% V) Zoning City Water
Census Code 4Y 3 Stories Booster Pump -
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC
Drain Tile Other:
Roof: -Ice & Water Final Pool: _Footings _Air/Gas Tests _Final
Framing Siding: _Stucco Lath -Stone Lath -Brick
Fireplace: _Rough In _Air Test -Final Windows
Insulation Retaining Wall
Meter Size: Radon Control
Erosion Control
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee 30 Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2of3
FROM : DOUG JORGENSON PHONE NO. : 612 686 7859 P03
C(
-o lpra~ SURVEYOR'S CERTIFICATE MITTELSTAE4T 8RD9. Cory e~:
EAGAN
REVIEWED
1107191 KO $KCV%C IOLS IWOKST104TION
"As itt.w t0bdp%-t m ow TH+y 13y J D
LOT VT TNt SURWYOk. 'Mi
1UIYA. L11 0I tolls 1v *jp0i0 W ' 1 - '21
t++9 Mf ft movk Pftpo o DATE
13 NOT YI~I[ IBC ITY Or
TK[ 3U*RYO11•
115 , 07 N 89° 57'39" E
I8`?
+y Lth61PaG'_ t!UIiLIT'Y+~
EASt tN7 PER PLAT
l 1 I W
O 0 1
Isse ,t~~5.~e ' !+~~«e' ,y, } s4 2S f -
4 I
It HOUSF ;
y fi i N i
11i ~PAG AIiAGc
G
~
/J
O V ..r NrcM Y~RIi
IOrCM WAN 1nrQ (857 3) ea,d$
TOO OP P?! f Q
gom** PROPOSED
__j
DRIVEWAY M Ip
1 Q ore..:
tJSf~~ 1 i ~
8.0.74 N 8 9° 57 39'
E
F=L c A a,
NOTE; 4ULDING DIUVOISICNS $HQWN AJIl: FOR NOAtyOK[itl,
6 VfATKAL LOCATION or ITftXTu,t ON66Y, see
AJ II CTUAL s'Lk4S FOR SUt t sK • F0l7SOA11
oII~sN ~a+rs,
bENOTES PROPOSED SUHFACL D1IAINAGE
Q bENOIES IRON MVNUMENT Si ESCALE- 1 INCA - 30 FEET
0 DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - FEET
X000 0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 8944 9 FEET
(000.0) DENOTES 11AONOSED El_EVA110N PPC)POSCD TOP OF BLOCK - g58,0 FEET
WE HEREBY CE PTIF'r TO MITTCLSTAEDT R:)5 CONaI IiA1 TIllS 15 A THUS AND CORRECT
RE.PRCSE:NTAT1ON OI- A SUkVi, r' C? T'HC UOUNDAitIE5 I )F
2
I,oT I B iocl+ 2 , COVENTRY PASS 2ND AI1f]IYl0ty. nomn.Ai.+.,
SURVEYOR'S CERTIFICATE MITTELSTAEDT BROS. CQNST.
NOt1E, NO SP'[CIrIC SOILS INVt$TIGATION
KAS SEEN COMPLt W ON THUS E7 LOT OY TH[ aUR Cyopt THE
IIIWTAAILItV or SOU 10 $UppORI THE scmc HOIJSt PIMOP0j"
13 NOT TINtI RE MK3?Ifl LITY Or
THE $tI04YQ11.
115.07 N 890 57 3911 E^Ks,,137
$0
n6Y0 ~ vti r. ~ 8tSA7
ri4aTi~ ti
DRAINAGE a UTlLITYI
EASEMENT PER PLAT
0 LO T ~ ~4aas w
-<ts5ra•8i N
a; ( nss ssai ti
DIMS _
~A19 - fiasae dl T-- 34.25 - e
14.0 17 C
PROPOSED
m I HOUSE
eea
GARAGE
01
q Ce5~,3)( ; "404 MARK
- _ nt 21. 29.49 r" ! , A TOP Of F1109
• eaecF, MARK ~22.00 TOP OF PEL
atAv.ssae so PROPOSER ro
DRIVEWAY IO 9 N
Q o 6542
f
114,26 - ~ ' ' 90.74 N 890 57 '39* E
40 ~4
225.1
54 7 004.5 ` ?'~x cC• ~
h,r f•y- • y
NOTE; -eUILDINNA 64631 ONs, `-SHOWN ARE FOR HORIZONTAL
11 VERTICAL. LOCATION OF STPLCTUAE ONLY egg
AACttI CTUAL PLANS FOR SUILDIP4G D FOUNDATION
DENOTES PROPOSED SURFACE DRAINAGE nlMt>+ IoN9.
O DENOTES IRON MONUMENT SET SCALE- 1 INCH - 30 FEET
0 DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR 85-7,fo FEET
X000 0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 8y9. 9 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK -
X5$.0 FEET
WE HEREBY CERTIFY TO MITTELSTAEDT BROS, CONST. THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF.
Lot I , B lock 2 , OOVENTRY PASS ZND ADDITION, according to the
recorded plot thoreot, Dakota County, Minnesota
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN, AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 12TH DAY OF NOVEMBER 1991.
'PROPOSED GRA18 SHOWN WERE TAKEN SIGNED JA S R HILL, INC.
,FROM THE DEVELOPMENT PLAN FOR
'CQVIENTRY PASS 2ND ADDITION, LAST
DATED S - 17.8 q
BY
JOHN C, LARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19828
r--L_to 70C_ James r- MOM ° z z W rn PLANNERS I ENGINEERS 1 SURVEYORS
O 6) M
j 2500 W CTY RD. 42 • BURNSVILLE, MN. 55337 + 612-890-6044
CityofEaaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
F�9 0 31p11
Use BLUE or BLACK Ink
For Office Use
�%
Permit #: G v 2-1 Z7
Permit Fee:
(0 0 J
Date Received: r 3- l
Staff:
2012 MECHANICAL PERMIT APPLICATION
Date: 0 Site Address: L C `F c -
Tenant:
Suite #:
Name: c ` k` Phone: USI -uis`1 -o dmf
V
Address / City / Zip: "1 PJ1JW..jJL. \ 1 , Ejcui as
License #: (�S�
Name: BURNSVILLE HEATING & AIC, INC. f}i
3451 W. Burnsville Parkway
Address: Suite 120 City:
J
State: zi,yrnsville, MN 55337 Phone: CkS GI.0 -
Contact: L t(A.C.-- Email:
New )( Replacement Additional Alteration Demolition
tt3RK ' ' Description of work:
/ RESIDENTIAL
+7�- Furnace
)Air Conditioner
Air Exchanger
Heat Pump
,,� rr,
Other t \ r S
COMMERCIAL
New Construction Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
Under / Above ground Tank ( Install / — Remove)
RESIDENTIAL FEES:
$60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $}�i'i TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal (includes $5.00 State Surcharge)
$60.00 Minimum (includes State Surcharge)
- If the Permit Fee is less than $10,010, surcharge is $ 5.00
- If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee
(i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge)
OR
Contract Value $ x 1%
= $ Permit Fee
= $ Surcharge
_ $ TOTAL 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.aopherstateonecaliorq
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.
xRCA SYLCs,`�l ` x `, ' UirleLkl-R
Applicant's Printed Name
Applicant's Signature
OR OFFICE U
qsired Insp'
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA121204
Date Issued:03/19/2014
Permit Category:ePermit
Site Address: 4092 Prairie Ridge Rd
Lot:1 Block: 2 Addition: Coventry Pass 2nd
PID:10-18401-02-010
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description: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.
Kris Oien
3670 Dodd Rd
Eagan, MN 55123
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 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 -
Gregory Volkers
4092 Prairie Ridge Rd
Eagan MN 55123
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
NOV 2 $ 2018
Use BLUE or BLACK Ink
-----------------�
(i
I For Office Use I
,
I Permit #:
I
1
Id .�rU
I Permit Fee:
I Date Received:
1� Staff:
-----_-----
2017 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 11/28/2018 site Address: 4092 Prairie Ridge Rd
Tenant:
Suite #:
New Replacement Repair Rebuild Modify Space Work in R.O.W.
_: TYpe.of-Work , -
Description of work: replace vanity, top, faucet
RESIDENTIAL
Water Heater
Water Softener
>: :::<::;::.: Lawn Irrigation RPZ/ PVB)
Pet`illlt T : @`::':: =; Add Plumbing Fixtures L Main / _ Lower Level)
Yp..:.........:
= Septic System
New Wafer Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes State Surcharge)
"Water Turnaround (add $280.00 if a 3/4" meter is required)
$115.00 Septic System New (includes County fee and State Surcharge)
TOTAL FEEs $ 01.00
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. ywiw.gopherstateonecall.orc
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 v rk 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 X.Plans.
x Wendy Raehe
Applicant's Printed Name
Appifca?tt',SigAafure
....
......
te:FOROFFICEUSE Ri
. ..ewed=:
Re ulred lns actions::.=:: ; : Under Ground - :';::- -:= Rou h in ` ` .Air Test -Gas Tes :.`F'nal
q..:.....:.a ::. P...:..: :.: :... :.:: 9 .........:......_:;.::. #...:-, .. 1...: .
.........:.:..,..._.,..:...; .:........:..:::... ..................
. ....... .... ...........:...: : - ....._.... .:..... .........:..:::.:.......................... .....-.
Mtater Related item::';: ;Meter:Size :. Radio -Read :........:Manometer Staff.: - ::::::: :-::
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA171046
Date Issued:07/28/2021
Permit Category:ePermit
Site Address: 4092 Prairie Ridge Rd
Lot:1 Block: 2 Addition: Coventry Pass 2nd
PID:10-18401-02-010
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 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 -
Gregory & Elizabeth Volkers
4092 Prairie Ridge Rd
Saint Paul MN 55123--393
Minnesota Rusco
5010 Hwy 169 N
Brooklyn Park MN 55428
(952) 935-9669
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA174608
Date Issued:02/07/2022
Permit Category:ePermit
Site Address: 4092 Prairie Ridge Rd
Lot:1 Block: 2 Addition: Coventry Pass 2nd
PID:10-18401-02-010
Use:
Description:
Sub Type:Fixtures
Work Type:Replace
Description:Bathroom(s)
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.
All tiled shower bases require a water test.
Fee Summary:PL - Permit Fee (miscellaneous)$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 -
Gregory & Elizabeth Volkers
4092 Prairie Ridge Rd
Saint Paul MN 55123--393
Minnesota Rusco
5010 Hwy 169 N
Brooklyn Park MN 55428
(952) 935-9669
Applicant/Permitee: Signature Issued By: Signature
r----------------------
I For Office Use 1
1 179995
I Building Permit #: 1
�0 .� I S&W Permit#: 1
EAG I I
-- I
I V E Permit Fee: 1
Saa
Date Received:
3830 PILOT KNOB ROAD EAGAN, MN 55122-1810
(651) 675-5675 1 FAX: (651) 675-5694 1 Date Issued:
buildinginspections(pD-Cltyofeagan.com BY, I ----------------
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 10/31/2022 Site Address: 4092 Prairie Ridge Road Unit#:
Applicant is: ❑ Owner 2 Contractor
Name: Greg Volkers
Homeowner Address: 4092 Priaire Ridge Road City: Eagan
State: Mn Zip: 55123 Phone: 651341 2067 Email:
Description of work: Replace decking, fascia, and stairs. Add approimately 16' of aluminum railing.
Type of R-1, Coventry Pass
Work Construction Cost: Y
Type of building: ® Single Family ❑ Townhome, of units ❑ Twin Home
Company: Uglydeck.com Contact: Corbin Lemmer
Building Address: 4870 12th Ave E City: Shakopee
Contractor State: Zip: Phone: Mn 55379 612 895 1330 Email: corbin@uglydeck.com
License #: BC570015 Expiration Date: 03/31 /2024
Sewer & Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction
License #: Expiration Date:
0 i understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
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. Contact Gopher State One Call at (651) 454-0002 or www.gopherstateonecall.org for protection against underground utility
damage. Contact Gopher State One Call 48 hours before you intend to dig to receive locates of underground utilities.
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 plqns. ,
. 6gzu� LLmmEz X A
Applicant's Printed Name A lic n ig ature
U)
0)
c
0
40-
07
ui
0
a 2
tm
C:
X—
LB
CV
LIJ
LLJ
40-
0-0
C:
0
E
0.0
4-
cu
0
0
4-
Q.
E
0
0
d
z
E
d
0
�O
LU
00
ui
co
CL
V
Lk—
5
v
0
E E
v
r
= E
0 ZN
L:
o
3:
CL
0)
(D
0 "t
LL 4c k=/
CL
cf)
LL (n x 0
CL
N
CL
0
CL
0-
0
0
(D
(D
c
0
IA
(1)
CL
0
to
c
CL
0
0
ZN
E
(D
a
0
CL
":,
g
0 0
0
0
A
0
0
ILD
0
(.0
LO
X
W
cy)
0)
E
>1
C\j
X
X
X
X
I-
U>il
L�
.0
m
uj
ui
ui
ui
0
CL
+01
C
E
m
0
0
0
E
-b
0
4-
L..
C)
10
0
-0
0
0
AN
0
U.
4�,
ctt
0
40-
0
-lid
V-
46
0
>
'2
ro
16.
4-
4-
OR
4-
o
E
0
CL
m
u
0
E
w
0
0
LL
V)
6
a.
iniz
0
-j
ca
CL
r
0
0
-7
0
11 EI D
11
11
11
0-
11
El
11
El
7
El
D D
ED
El
0
0
M
11
El
D
LE
�tl!.i v iT
su�! :i: u n au
I..... "J''i
ap J.
SUB TYPES
Single Family
01 of _ Plex
Deck
WORK TYPES
_ New
_ Addition
_ Alteration
Replace
FOR OFFICE USE ONLY
Site Address: 4092 Prairie Ridge Road
Fireplace
— Foundation
Garage
_ Repair
_ Fire Repair
Water Damage
Egress Window
DESCRIPTION
Calculated Valuation
Plan Review E125% 100%
Census Code
# of Units
# of Buildings
Type of Construction Nis
REQUIRED INSPECTIONS
_ Lower Level
— Porch
— Pool
_ Siding
_ Reroof
_ Windows
Solar
Permit #: QO00
_ Retaining Wall
_ Move Building
Demolish Building*
*Demolition of entire building — give PCA
handout to applicant
Occupancy 1 P& i
MCES System
Code Edition ;yWRC—zV%-0
SAC Units
Zoning Rr 1—
City Water
Stories
Booster Pump
Square Feet
PRV
Fire Suppression Required
Separate Stormwater Management Permit Required
Footings: New Addition Deck
_^ Foundation: Before Backfill Poured Wall
K. Framing: 1 Hour n Residential Alteration
_~ Braced Wall Framing/Blocking
— Braced Wall Sheathing (prior to house wrap)
Interior Braced Wall Panel(s)
_ Firewalls
_ Insulation
_ Fireplace: _Rough In _Air Test _Final
HVAC: Rough In Final
Siding: _Stucco Lath _Stone Lath _Brick
Roof: Ice & Water _Final
Erosion Control
Pool: _Footings —Air/Gas Tests _Final
Retaining Wall: _Footings _Backfill _Final
Fire Suppression: _Rough in _Final
Windows
Other:
0( Final/No C.O. Required
Radon Control Final/C.O. Required
Reviewed By: Y�;J_— ,Building Inspector
FEES
Calculated Valuation
Base Fee
Plan Review
State Surcharge
Met Council SAC
City SAC
Treatment Plant
Water Supply & Storage
S&W Permit & Surcharge
Meter
Radio Read
Other:
TOTAL $ 0.00