3813 Riverton AveCity of Eaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675.5675
Fax: (651) 675-5694
AUG 0 5 RECD
Use BLUE or BLACK Ink
Permit #:
Permit Fee:
U sa99
Date Received: P- s- /0
Staff: /YLL
2010 MECHANICAL PERMIT APPLICATION
IEGate. Site Address: j
Tenant: }tia, 1 ' `IL)h
[ a - Zi i Suite #:
J
RESIDENT / OWNER
Name: +cam t
Address / City / Zip l'
CONTRACTOR
t -'l(, st1ne: k51 — 404. G SGL
vaifon AVL ka- Inn r72,
Name: ,�` j 1. O Y U of Com(
Address: 122— l--
State: 1 i U l zip:
Contact
Phone:
dense #: tl •
City: III
•
( '
Email:
TYPE OF WORK
PERMIT TYPE
New
(( Replacement Additional
Description of work:
Alteration Demolition
RESIDENTIAL
Furnace
7- Air Conditioner
Air Exchanger
_— Heat Pump
Other
RESIDENTIAL FEES:
New Construction
Install Piping
Gas
COMMERCIAL
_- Interior Improvement
Processed
Exterior HVAC Unit
Under / Above ground Tank (_-_- Install / Remove)
** When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
$50.50 Minimum Add-on or alteration to an existing unit (includes $,50 State Surcharge)
$90.50 Fire repair (replace bumed out appliances, ductwork, etc,) (includes $.50 State Surcharge)
$ TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $
$50.50 Minimum (includes State Surcharge)
- If Permit Fag is less than $1,000, surcharge is $.50.
- If Permit Fee is > $1,000, surcharge increases by $.50 for each
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
x 1%
$ Permit Fee
_ $ Surcharge
_ $ TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Cail 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 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 plan
xZ Q1
Applicant's Firinted Name
CITY OF EAGAN Remarks l~ ` , 7= 4
Addition _ BLACKkIAWK OAKS ADDITION Lot 5 e1k 2 Parcel 10 14387 050 02
owner Street 3813 Riverton Avenue 5tate Eagan, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF,
STREET RESTOR.
GRADING
SAN SEW TRUNK /ZS 1970 15 .1Z 3.84 25 j~
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 1977 9.45 15 ~7.
p l~ s/
-37 STORM SEW TRK 1983 RUM 30.58
1S b
STORM SEW LAT
CURB & GUTTER •
SIDEWALK
SrREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
.tEACTIVATED FOR DECRCITY OF EAGAN
~Q, 3830 Pilot Knob Road, P.O. Bax 21-199, Eagan, MN 55121
~ PHONE: 454-8100
BUILDIN,'a PERMIT Receipt #
To be used for SF DWU/VAR Est. Value 578,000 Date '?~IAY G .19 86
SiteAddress 381= r1`'E Erect m Occupancy
Lot 5 Block 2 Sec/Sub. BLAQKHAvlK OAKS Remodel ? Zoning -A I
Parcel No. Repair ? Type of Const. vii
Addition ? No.Stories
Q I)f;GSl'rL:l:; COhPAINTES Move ? Length S?
Name
Z 70i.'i .i~F%!tFEiJTL•'(~K e~VE E ~emo~ish ? Depth
a Address Int. Impr. ? Sq. Ft.
Ciry :i= i~E"U411one 776-1100 Install ?
a Name Approvels Fees
$ ~ Address Assessment Permit $ 3 6 7 - U4
~ Ciry Phone Water & Sew. Surcharge 39•00
Police Plan Review 1 133 • 5 J
F Z Name Fire SAC 575.00
~ n Address Eng. Water Conn. 50 0. OU
< W City Pnone Planner Water Meter 63.50
Council fioad Unit Z Qu•00
Iherebyacknowiedgethatlhavereadthisapplicationandstatethatthe Bidg.off. 5/5/86 Tr.PI. 15600
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.- APC Parks
~ •
Signature of Permittee Var. Date Copies Y Total ~2 , 17 4.(.' U
A Building Permit is issued to: •`1EZIIRIK CO~PAta IEti on the express condiGon that
all work shall be done in accordance with all appliCable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
' PermB No. Pormft Holder Dato TalsQhona M
Plumbin9
tsv.A.c. / f
Electric
SoMener
Inspectlon Date Imp. Commenb
Foonng.l
Footfngs 11
Foundaifon
Framfny
Roofiny
Rough Pibg.
Rouqh Nt9• ~I3 7 ~ ~ 16,t
s
Insul. ~i ~ fp(~JFireplaee
Final Mtq.
Ffnal Plby.
Bldy. Final ~
Cerl. Occ. ~
Deck Ftg.
Deck Frmy. P6
1Ne11
Pr. Dhp.
, . ' PERMIT pi
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN -T,
. 3830 PILOT KNOB ROAO, EAGiAN, MN 56121 DATE:
CONTRACT PRICE PHONE 154-8100
Site Address L f-~ / BLD(3. TYPE WORK DESCRIPTION
~
Lot - ~ Biock Sec/Su
Res. New
m Name ~/i, y-. ~ II/., C Mult Add-on
s Address ° t Comm. Repair
c Cihr Phone Other
Name FEES
~
c Address RES. HVAC 0-100 M BTU - a24.00
p City Phone ADDITIONAL 50 M BTU - 6.00
ADD-ON AIR COND. 0-24 BTU - 12.00
TYPE OF WORK ADDITIONAL 6 M BTU - 6.00 GAS OUTLETS - 1.50 EA.
Forced Air Z-,_ M BTU ~ y COMMIIND FEE - 1% OF CONTRACT FEE
Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00
Unit Heater M BTU MtNIMUM - COMM/IND FEE - 20.00
Air Cond. ~ M BTU / Z STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # BEYOND $1,000.00)
Other
, J .
FEE
s~C, C.~ SIGNATURE OF PERMRTEE '
TOTAL: v0 J
FOR CIN OF EAGAN
PERMIT #
• PLUIVABING PERMIT RECEIPT # 7 Y
, . CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
CONTRACT PRICE PHONE: 454-8100
S1te Addrsss L' J QLDG. TYPE WORK DESCRIPTION
Lot ~ Block Z- SeclSub ltL
Res. New
m Name Mult Add-on
~ Address f= w~ ~ r Comm. Repair
c City L f4' Phone - ~ C.' Other
` NO. FIXTURES OTAL
~ Name L ' - v - % Water Closet - $3.00
c Address ZBath Tubs - $3.00 - - '
p City Phone 7 Lavatory -$3,OU
_~Shower - $3.00
FEES /Kitchen Sink - $3.00 - - COMM/IND FEE - 1% OF CONTRACT FEE ~-Urinal/Bidet -$3.00
Laundry Tray - $3.00
MINIMJM - RESIDENTIAL FEE - a10.00 / Floor Drains -$1.50 ~
MINIMUM - COMMIIND FEE - 20.00 =Uyater Heater -$1.50
STATE SURCHARGE PEFi PERMIT - .50 Whirlpool -$3.00
(ADD $.50 S/C IF PERMIT PRICE GOES 1 Gas Piping Outlets -$1.50 ~BEYOND $1,000.00) Softener - $5.00
Well - $10.00
-Private Disp. - $10.40
Rough Openings - $1.50
~
S,IGNATURE O 'PERMITTEE FEE , r
STATE S/C:
FOR: CITY OF EAGAN GRAND TOTAL•
CITY OF EAGAN N 2 118 9 9
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454-8100 U
BUILDIM.S'a PERMIT Receipt» to
70 6e used for SF DWG/GAR Est. Value $ 7$,0Q 4 Date MAY 6 19 86
SiteAddress 3813 RIVERTON AVE Erect 41 Occupancy R3
Lot 5 Block Z Sec/Sub. BLACKHAWK OAKS Remodel ? Zoning R1
Parcel No. Repair ? Type of Const. 1.9n.
Addition ? No. Stories
W Name DEZURIK COMPANIES Move ? Len9th 57
3 nddress 701A LARPENTEUR AVE E Demolish ? Depth_4
° city ST PAULphone 776-1100 Int.lmpr. ? Sq.Ft
Install ?
a Name SAME Approvals Fees
,a Address Assessment Permit 367.00
~ Ciry Phone Water&Sew. Surcharge 39.00
8 Police Plan Review 183 . 50
w w Name
¢ 0
Fire SAC 575. 0
~0 Address Eng. WaterConn. 500.00
W
a City Phone Planner Water Meter 63. 50
Council Road Unit 290 • 00
IherebyacknowledgethatlhavereadthisapplicationandstatethatNe gldg.Off.S/6/86 Tr.PI. 156.00
information is correct and agree to comply with all applicable State of
"MinnesoW Statutes and_ Ciry of Eaqan Ordinances. APC Perks
~S Var. Date Copies
Signature of Permittee W Total • =o o
A Building Permit is issued to: DEZURIK COMPANIES on the express condition that
all work shall be done in accordance with app ' 61e State oi Mi s tes and City of Eagan Ordinances.
Bui9ding Official
This requesl voitl _ IG _
18 months fmm
C 18140 3kut L6 '`17 -
Pequest Date ' Fira No. Flough-in Inspac[ion
1LQ R qWred? ~Heatly Nuw Will Notily Inspec-
es ?No ror When Featlv
0 Licensed Elecfrical Conttactor 1 heraby reques[ inspection of above
? Owner elactrical work inatelled af: .
Sveet Address, Box or Noute No. Cit
V2, ecuo . Township Name or No. RanBe Na. County
O upnnt Phone No.
Po er upp ier Address
EI vical Convactor (Comvan dmel ~ Cnntractor's Lice se No. I-q
un r 1 ~ -
Mailinq Atldres=lChactorpr Owner Making Instailationl
M~ mti
Au orizeo Signacure (Contrector Owner Making Installation) P Number
~
MINNESOTA STqTE OARD OF ELECTNICITY THIS INSVECTION REQUE3T WILL NOT
Griggs-Midway Bld9. - Noom N•191 BE ACCEGTED 0Y THE STATE BOAXD
1621 University Ave., Si. Paul. MN 55104 UNLESS PXOPEX INSPECTION FEE I$
vhnnn 16121 297.2111 ENCLOSED.
REQUEST FOH ELECTRICAL INSPECTION ea-oouot-oa
~ See instruetlona lar complelinB ihis lorm on beck of vellow coov.
C 18140 "X"' Below Work Covered by lhis Request
AAd Rep TVde of Builtlinp AOPliencee Wired EQUipmenl Wirea
Home Range Temporary Service
Duplex Water Heater Liyhtiny Fixtures
Apt. Building Dryer Electric HeaUn
Commercial Bldg. . Furnace Silo Unloader
Industrial BIAg. Air Conditioner Bulk Milk Tenk
Farm me" oea v Nther I5nenWi
-Ut .r uccify Iher Olher
ompute lnspection Fee Be/ow
p Fee ServicaEMrance5ize tt Fee Feeders/SuEfeeders N Fae Circuits
U to 200 qm 5 0 to 30 qm s Gr) 0 to 30 Am s
Above 200 qm,- 31 to 7 00 Amps , 0 31 to 100 Amps
Swimmin Pool Above 100_Am s Above 700_Am s
7ransiormers rngation Booms Partial/Other Fee
Signs Special Inspeciion g ~/T TO AL F l
Remarks t7lJ
flouph.in ~ D~ 1. th
cal
• i nsoec<or, hereby
cartify thet the above
iinal insPectian hes been
~ de.
r
Tia reyueel vo101B monltu Irom
3 RESIDENTIAL
60&0 ~ BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
New ConaW ctlon Reaulremenb RemodellReoair Reaulremenh
• 3 reglstered site suneys stwwing sq. R. of IoL sq. ft. of Muse; ard all mofed areas • 2 capies of plan
(20%mazimum lol coverege allowed) • 1 set of Energy Calculalions fur heated additions
• 2 copies of plan sYrowing beam & windmv s¢es; pou2d found design, etc.) • 1 sile survey for exterior additions 8 detks
• 1 sel of Erergy CelcWations • Indicate if home served by seplic system for addNons
• 3 copies of Tree Preservation Poan if lat platted afler 711/93
• Rim Joist DeUO Oplbre selection sheet (Wdgs with 3 or less unils)
DATE 5- "P, VALUATION aO O,OU
S"~T'QE ~D'D SK~usr~n tttre.. MULTI-FAMILYBLDG _Y '~N
TYFE OF K ~e - roa-F B` SL1S- FIREPLACE(S) _ 0_ 1_ 2
n
APPLICANT Awtpr'ira
STREETADDRESS llaq 0 d l A-ve ~ia CITY STATE PIOZIP 553~'I
TELEPHONE #9Sa -707-b959 CELL PHONE # FAX #°JSa 70/7 ~~1 S a S
PROPERTYOWNER :S+eJ2 d 6-OLI.'e NGn~~ TELEPHONE#
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNF.SOTA RULFS 7670 CA'IT,GORY 1 MINNESOTA RULES 7672
(4 submission type) • Residential Ventilation Category 1 Worksheet Su6mitted • New Energy Code Worksheet bmitted
. Energy Envelope Calculations Submitled D, t(~i , , rn~~
lU ~
MAY 2 2 2002 i
Plumbing Contractor: Phone # _
Plumbing system includcs: _ Water Softener _ L.awn Sprinkler I'ee: $90.0
_ Water Healer _ No. of R.I. Baths By
No. of Baths
Mechanical Contractor: Phone #
Mechanical system includes: _ Air Conditioning Fee: $70.00
Heat Recovery Syslem
Sewer/Water Contractor. Phone #
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances
Signoture of Applicant r
OFFICE USE ONLY
Certifcates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
O 02 SF Dweiling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 6ct. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings(deck) . FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundaaon HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Franmg _ Siding Stucco Stone
_ Fireplace. _ R.I. _ Air Test _ Fina] _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
~x
, , w~
~
1986 BOILDING PBRKIT APPLICATIOH - CITY OF SAG9N
HOY6: 9LL COHTRACiOHS HUST BS LICSNSSD IiITH THE CITY OF EAGAN
SIAGLE FAEMY DWELLIAGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
MQLTIPLB DSiSLLINGS - HffiIDSNTI6L &ENTAL 0NITS FOH SALE DNITS
INCLUDE 2 SETS OF PLANS, CE6TIFICATE OF 3Qft9EY - CHECS WITH HLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS ~
- ~.~~c1~•~~ /,C
corMecIEAt. ~ ~/-he
INCLQDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, Se G~
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS, ~ sG 11~c
$2,000 LANDSCAPE BOND
1,
To Be Ne or• 9 SE'aSGJ~r`Valuation: SGGG Date:
Site~/ //(/Pr I a"~ ~c- OFFICE DSE ONLY
Lot 5 Bloek ~ Erect ~ Occupaney
p1-/~ Remodel Zoning
Pareel/Sub t,- Yl c~ W 1 CV C; Repair Type of Const
Addition ~ # of Stories
Owner JT~(/E f/vs e/L/ Move _ Length M4_
, / Ar Demolish Depth
Address /1~"P/?P~./7C' Int.Impr. _ Sq Ft
Install
City/Zip Code C ~
Phone APPHOVAIS FEES
Contraetor Assessments Permit
Water/Sewer Surcharge
Address Police . PlanReview
t~ Fire SAC
City/Zip Code S7=~U~^ Engr Water Conn
c~ Planner Water Meter
Phone Couneil Road Unit
Bldg Off Treatment P1
Arch./Engr. APC Parks
Varianee Copies
Address TOTILL ~
City/Zip Code
Phone #
NOTE: ADDHESSES FOR CORNER LOTS - CONTRACTORlHOFIE01iNER MOST DESIGBATE AHICH ADDRESS
IS DESIRED. NO CHANGFS iiI[.L BE ALLOiiSD ONCfi BQILDING PERMIT IS ISSIIED.
. . *******#**********#**~~******~*t*###
° CITY OF EAGAN * ~ ~F~„~ ~ °F :
APPROVAL OF PERMIT.
~ APPLICATION FOR PERMIT ~
* INSPF7CTION OF SSY= ArID/O2 FTAZER '
IULSTAT.T.ATTONS Y7IIS. NOT BE SCHED- :
SEWER AND/OR WATER CONNECTION ~mm umm POMT HAS mm
ArPxovID. '
*
.
* tk *+r,t,vrt** **+.*x,t **tr,t* t:r*****,t*t* i
P ease Print))
~ ~ 1) PROPERTY ADDRESS: `
LEGAL DESCRIPTION: Lkt 1< /b0~ e.. C: ~1 /t ~ si t(t
_ Lot Block Subdivision or Tax Parcel ID )
IF MSTING STRCCI[7RE, DATE OF ORIGINAL BI,+ILDING PERMIT ISSCANCE:
i
'
, P°ESII~lr ZCJNING/PROPOSE6 L'SE: Mon Year
? CQ1,JERCIAL/REPAIL/0FFICE n>,,R-1 SINGLE FAMILY '
Q IAIDIISTRIAL Q R-2 DUPLEX (Two L~nits)
n INSTITL'TIONAL/GOVEUZET]T r7 R-3 TDWNHOUSE (Three + Units) ( Cfiits)
, q R-4 APARTMEN'P/CODIDOMINIL'M ( Units )
2) • •'i4'~•
_ NAb9h':_
• ADDRESS:_
~
CZT7, STATE, 2IP:_ 3 7 7
PFiONE: `c. o ( J
• 3) ~ / ~ For City Use .
NA`'E=/ E2y k /A~{~,ef Pltmibers License:
ADDRESS:2- ~ C`I 7 i.L' ic H r~ ,.f C 2 Active
CITY. 5"PATE, ZIP: ~i. ~!si 1- 4;-' V Z NOtI'ECOZ'dE:d
1
LICE[QSE# ! t'•
- _ ~ St _ ?n~ t13?
4) u • i~- l\ I
NAP]E:~_~ J- E~(l ! I~ Lc.~, cl r. i2 S
_ ADDRFSS: "IcI f~ L F11' ctic' rl ( ` "t
CI21'STATE, ZIP: L 'S S
PHONE: •
5) ~ v ~ r • : o - a~ -
[N[~GTZON RO CITY SEWFT2 {~/CONI.`fION ZO CITY WATII2 ~ dIY~R ' .
7~' Y~
6) " Q PLFASE HOLD APPROVFD PEf2MT FOR PICK-L~P BY ONE OF }1BfJVE
~ PIFASE MAIL APPROVID PERMIT 3, 4, AHOVE
71i2,rcle one) 7) er r• u• - ~ : l ~"'c t JLOV
k-
, '•Y' • G" 'I: M t ~ • I' D I}' i~ YJI' ~
~1. ~i~ ~ ~ C } ~IC~'.!1?~ ~ ~ ~ .1' ~ iA' ~1,~ :f ~ .
. FOR CITY USE ONLY .
PERMIT # ISSL'ED
7y~ 3 /1 1-f
Pd w/Bldg. Permit FEES:
$ $ 16• 56 SEWER PERMIT (INCLUDE SDRCHARGE )
$ $ ~b - S 6 WATER PERMZT (INCLODE SL'RCHARGE)
$ $ WATER METER/COPPERHORN/OCTSIDE READER
$ $ WATER TAP (INCLC'DE CORPORATION STOP)
$ $ SEWER TAP
$ $ ~S~OZ ACCOUNT DEPOSIT - SEWER
$ $ ACCOUNT DEPOSIT - WATER
~ftD• ~d $ WAC
$ cJ 7.~, O-7) $ SAC
$ $ TRL'NK WATER ASSESSMENT
$ $ TRL'NK SEWER ASSESSMENT
$ $ ` LATERAL BENEFIT/TRLNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ f S~ • U--d $ WATER TREATMENT PLANT SLRCHARGE
$ $ OTHER:
S /,-z s7~ TOTAL
RECEIPT RECEIPT
DOES LTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN PLBLIC
Q ROADWAY" MUST BE ISSUED BY THE ENGZNEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING 60NDZTIONS:
e
APPROVED BY:
TITLE:
DATE :
' U
e
1986 BIIII.DING PEAMIT APPLICATIDH - CITY OF EAGAN
POTS: 9LL CAPTRACTORS MOS'P BE LICENS6D flITB THE CITY OF EAGAN
SffiGLE F6MffLY DWELLINGS
INCLUDE _~SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATZONS
MOLTZPLE DiIELLINGS - RESIDENTIAL RENTAL ONITS FOR SALS DNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SORVEY - CHECB SiITH BLDG. DSPT.,
1 SET OE ENERGY CALCULATIONS
COMAlLRCIAI:
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
t SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: Valuation: 7Se!X~ Date:
Site Address 312 I 3Qjvar"}cti, OFFICS U3S ONLY
Lot _E~_ Block ~ Erect J(- Oceupaney Q.3
Remodel Zoning it-T
Pareel/Sub Repair _ Type of Const
Addition # of Stories
Owner Move Length ~
Demolish Depth ~
Address ")0 1 Int.Impr. _ Sq Ft
Install
City/Zip Code /U up I~WGO~ ~S fl7 ~
Phone 1) Q b APPROVAIS FEFS
Contractor ue_'~~-v,VJQ Cbw+(~an~e S Assessments Permit 3~7
~^-i- Water/Sewer Surcharge ~
9ddress Zq ~~1 ~.o~pe-~euv /1~ti C Police Plan Review
'r( Fire SAC
City/Zip Code /U u42 (Q~N ooc~ ~S ) I~ Engr Water Conn ~
Planner Water Meter ,
Phone Council Road Unit O
Bldg OfLfZZTLL4L Treatment P1 IS,,
Arch./Engr. APC Parks
Variance Copies
Address TOTAL ~
City/Zip Code
Phone lk
IQOTE: ADDSES58S FOR CORNEB LOTS - CONTRACTOR/HOMEOWNEA lfQST DESiGNAYE WHICH ADDRfiSS
IS DESIRED. NO CHbNGF3 WILL BE ALLOWED ONCE BIIILDING PERMIY ZS ISSOED.
//70x ~9
77`J_
y~ A50
.
-
- . , _
bC ICATE CiriSURVE~
~
` For:DeZurik Compan9es N
RIVERTON AVENUE .
sB9•ss'se°w
- ~ ~
12 ~ I
d Ciar. I
N
~ n 22.7
I
~ v ProPore~ //aare h
i J N b ~ N
. ~ ~ VyDj \ I I ~
i `y C h
C
r ~ tl I
I 4 ~ I
~ I
FOR BUtLDINO
- PEII~ft ONLY
` BS. OD
SB9°SG'37"'W
~
i ~ Lot 5, Block 2, BLACKHAWK OAKS ADDITION, Dakota County, Minnesata.
o Denotes stake at 11' offset.
~ B.
SCALE~ inch =-S2.Feet o Denotes Iron Bearings shovm are on an ossumed datum. Job No.-&-As Book_ Poge_
i
w~ hsnpy certity thot tAis Is a tru* and cornct reonsantation of o surroy os tne E. G. RUD & SONS. INC.
eouoaw~'is of rne aeow eanlwa ioea ena or rn• low+tan or on euilainp., 1f anr, LAND SURVEYORS
• tMnan and oll v}dON oncroaehmwals, if any, from a on eoid land, 9560 L6xington AvenuB N.
,y E. G. RUD & SONS, INC. New &iqhton (Le~cinqton), Minneso!a
oot.e a 8 ear ~~b 55112
er Telephone: 786-5556
, ' Minn. p~p. No
O:JYI+ IVMI1- CONTRACTOR
1 - -
ADDRLSS ~ _ ADDRESS, ~
PHONE 3 _ PHONE
J013 ADDRESS
; Deterwine working square footage of each of the following.
1. TOTALf EXP05ED NALL AREAFT. X • f~o =['-30~~
2. TOTAL}. ROOF/CEIIING /1REA ~SQD _5Q. F7. •
i 3..BUtLD1NG PERII4ETER (not includin9 garage) Lin. ft. ,
, TOTAL#EXPOSED WALI AREA. (Walk-out bsrots. or 2 story homes, figure from floor line to
bottodi of uppenuost c19. joists. On split entries, figure from top of blocks to upper-
most ;eiling joists.) 1!!4 iq,7%7 SQ. f7.
~
a. Total wall window area....................................... J*L(. y SQ. FT.
; b. Total door area it9l T 'SQ. FT.
c. 'fotal slidiny glass door area a e SQ. FT.
d. YoCal Fireplace wall area (If exposed)...................... s4. Fr.
e. 1'Atal wali framing area (Avera9e lOS) SQ. fT.
F. Total net wall area 1 6 Z. L SQ. FT.
f 9. 7~ta1 rim joist area l 3 1 Zf1 SR. FT...
~ Tutal exposed concrete foundation rrall area 140 SQ. FT.
h. Total foundation window area................................ 7,,C7 SQ. FT.
i. Total net foundation area above grade (52.~2 SQ. FT.
DETERMINE "U" YALUE OF EACH WALL SEGMENT
x ~-u„_
x„U„_ , 2k
-
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dto~x .,u„~ , 36 = 34~ ~
ei_ 19z~__x tI = zt. az
;
f z62. & x ..U„
~ 9 _x „u.,-
' i h.
, , .
i_~.--•"`~~.7~~ x uUn...-----..•.~~.~...~.~+,..,.~~~ 4, TOIAL _
If tota~ of R4 is the same or less. than #1 you have met the intent of SDC 6006 (C)1.
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Total Exposed Raof/Ceilinry area = 'Ob
FT.,
. j. Totalskylirht area FT.
k. Total roof/ceiling framing area (10"'.),,,,.,,,,,,, FT
1. Total net insulated roof/ceiling area FT.
~ s
X ,OU.,
k''-j "~o--• -----X i,ul.~
_--~-'~-r°-----x ,.v
5. 70TAL...
If total of N5 is the same as or less than q2 you have met the intent of 5BC 6006 (c)
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ALTERNATE EiUILDING ENVELOPE DESiGN
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To utilize the totai building envelope system, the values established by thg
sums of items N4 and H5, shall not be greater than the sums of items !Il and*
q2.
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4 + 5 _
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RESIDENTIAL $UfI.DINli PERMIT APPLICATiOlY I`7 ~7 S
C.ity Of Eagau
393A Pilet Kgeb Aaad, F.ng" 1?uv 55122
Telc)ham # 651fi75-5675 FAX # 651-675-5694
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New cavsuucbm Pemmmm"
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3reggamd srtesuw'$dvxi95Pd.afMRs9.R.dMuw, aMaIlroMetlarm 2mpiesafDlan sMwugfomngs.hOMs.Joists CertdSlttvey.Rcd _Y _N
(20%maideenidmvaagaaVawem isetofEnerW CiOMIJOINOsforireeedadtlftm TreePresPlm RerA _Y
2apie5MPlan ehowni96eem8w6WorrsiaeS;DwretltwddesiiN.elc. isb wurxyTOraddtm $Aecks T[eePresRevpmed _Y _N
tsetMFim9YCdmoegm Addton-M)6pfeAanaAesVW 451601 Onat, sepkc Syslen _Y _N
3 capias o(Tree Pmsarvation Plan ii bt pWA aRm 771J93
%~nJdADemtlOptim6sekdionifee! ftitift wihSalessvWMinnegasm mee,hmeicad vie,rtilatioa fam
Date O lo ConstrnNioa Cost
Site Address e #
a/lr'f}
DacrhNSn of Wark 2-6 Y'nIJ Ss-f
Maiti-Family Bidg _ Y_ AF Fit+eptatt(sj _ 6 ` i _ 2
Pro@ertYowner Boe.n @.. Te?epboeek( )
coatractor V~a.-\,e.r (,O Q 4- 20 2 O~ ~
Addreas 34220 City Oa,.,,, A..l,L.-
5late Zip S's-dp9 Tekphooe#(b~2) 685-?7 'Zf?
GOMPLETf THIS AREA ONLY IF CONSTRUCTIN6 A NE1M B1lILDifiG
Energy Code Categoiy -Minrresota Rules 7670 Cateeorv 1 _ Minoesota.Rules 7672.
( Jsubrn"w type) • Residential VeMilation Cxiegory 7 Waksheei . New. Energy Caie Wwksheet
SLDmttteA Stitimfttad
• ErM9Y EnvelOPe Caladaati90n5 Su0mit0ed
tri thekat 12moMM.has ttie Cityof faganiswed o permiT for a simiku plan basedona mcater plan2
_ Y _ N IF yes, dote and address of masferplan:
ticensed Plumber Telephone #'I I
MechaniccO Caniroctar ~ ~ - 7 7 dePhone # ( ~
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SewerlWctterConfractor ~ Teiephone ~
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I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work wiil be in confcxmance wiYh the ordieances and cddes of the City of Eagan and the State of M1AI
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
}ermit; that the work wil{ be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
Sosor ~J ~ Zr.ssb~
ApplicanYs Printad I~ame A ' Ys Signature
~
!)E) FVOT WRITE BELOW THIS LllVE ;
Sub TVaes
? 01 Foumlalion ? 0705-plex ? 13 16-plex ? 20 Pw4- 30 Aecesaory Bfdg
02 SF Dweiling O 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) d 31 Ext. Alt - Multi
? 03 Ot of_plex O 09 07-plex ? 17 Garage O 22 Po[ch/Adckr. (MSea-.) ? 33F~d.Ai1-SF
? 04 02-plex O 10 DB-plex ? 18 Dedc ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
o0503-plex O 11 t0-ptex ? iS Lower Level ? 24 Storm Damage? 06 04-plex O 12 12-plex ? 25 Maoef6aneous
WOrI(TYPCS / ~,r~Ulv5 FG"vvf 3 ~jji~t~l~Un,Llf'
? sr wew ~ ? 35 Int Imlxovemmem ~ ? 38 DemaNsh IRtenw ? 44 Sidag
? 32 Addifion ? 36 Move Building ? 42 Demolish Foundatian ? 45 Fire Repair
~ 33 Alkeration 13 37- Deumosh 8uodW 13 43 Reroof 0 46 Nlirdo+nslfMas
0 34R6Wa;wnen4. 'DamQ#HwilEMiM8W81'rsirsPCAhandmrt~EOeppiitani
D@SG[IDftII: Water-Fmm"q_Ye6
Valuatlon 91op o pc;cupancy MCES System
Ptan Itevlew _ 10096 or _ 2556
Genscrs F,ode ~ Zoning City ftter
sAc ukuts stones eOOScOF PUMP
# of E.hiits Sq: Fk: RRV
# of B!djs Eength FireSprinklefed
Type of CExist ~ Vlfidlh
REQLTIRED INSPECTIONS
Fooking (new bldg) SheEGOCk
~C Footings (deck) FinaUC.O.
_ Footings (adbbon) ~ Final/Nn C.O.
Foundation HVAC
_ Drain TeNe Other
~ Roof _ Ice& Water _ Fina1 Pool Ftgs AidGas Tests Final
Frammg Sitting _ 3dreco Lath 36one Latl~ Brick
Fireplace _ R.I. _ Air Test - _ Final Windows
1G insulatian _ Retaming Wa14
T
Approved By: 72, , Building Inspector
- -
Base Fee
Surcharge
Plan Revietiv G?~~
hAC1ES SRC
City SAC O
unmy co,~;o~, cr,ow !7U
S&W Permit & Surcharge
TreatmeriF Plark
Lice,se seara,
copre5 ~(?7Z-~--(f ~ 0 c~g
olfier (
Total
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SURVEY
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, For:DeZurik Companies N
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RIVERTON AVENUE ~
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5.00
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Lot 5, Block 2, BLACKHAWK OAKS AODITION, Dakota County, Minnesota.
~
~ o Denotes stake at 11' offset.
s -g
SCALT° Inch=~.Feet o Denotes Iron Beanngs shrnvn are on an assumed datum. Job No.~ Book- Poge
WWe hsrlAy certitY thot thif fs a trua and cornct repreaantotion of a survey oi fne E, G. RUD ~ SONS, IN{~,.
Douadarl'as of the oDOVO dacriC~d land end of the loca7ion of all builditps, it anY, LANO SURVEYORS
thsnon~and au risiDh encroachments, if anr, frcm a on saie land. 9560 Lexington Avenue N.
r E. G. RUO & SON5 ,_INC. NeW grighton (Lexington), Minne~.
patsa .,~+ia Z8 Y of.-.~'~--- S~'G 6y ,('rAJ 55i12
Telephone: 786 - 5556
r~ Minn. Req. No. _
2006 RESIDENTIAL PLUMBING PeRMiraPPUCarioN
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date
Site Street Address ~ ~4,,,_ IAi41 1_2 Unit #
Property Owner Telephone #(b,S( )lod 7 CS7L{_I
Contractor PkAt1A6IVt& l JQS6K) Telephone# (IPIA it0g'^IIU~
Address 86J9 . Citv c 0. Qjw, State-NAJ Zip _55-<L-:~
The Applicant is: _ Owner Contractor _Other
Septic System ~ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Peras-built $ 10.00
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes installation of a water softener and/or water
heater at the same time. !f you are installing onlv a water softener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing. nbF
_Septic System Abandonment ~0 M~
_ Water Turnaround (add $130.00 if a 5/8" meter is required) A~G 8 2006 ~
Othec
Water Softener _ Water Heater $ 15.00
_ new _ replacement
lawn Irrigation _RPZ PVB inew _repair _rebuild $ 30.00
State Surcharge $ .50
Total $ 30, St..J
I hereby apply for a Residential Plumbing Permit and acknowledge that the infortnation is complete and accurate; that the
work will be in conforrnance with the ordinances and codes of the City of Eagan and the plumbing codes; that I
understand this is not a permit, but only an application for a pertnit,yt rk is not to start without a permit and work will be in
accordance with the approved plan in the event a plan is required 6 e review Q and approved.
~,ull r~-.
ApplicanYs Printed Name ican ' Signature
� • _
s! � ... + � 7473
:Sips 1�dnep 3 13 Xi- o* L r
No • $fit t
ttsaed Ma:: .
tare**. a sf ttspw sue. -
mss. - r chows- I
D of trap;: . .
CITY t
S,li 45121 taA ." 1--8
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Owner Mazur a Are.
site : 3813 Rtv 32 $1ac , ks
Plumber PliVabing
i 5-6-86 ' 62
*ar.. i. ems► • wNM dr. l
o e.o. Y A° "�r°�' Choir -mod
of 1 01;�
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fir. � {.
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115264
Date Issued:09/24/2013
Permit Category:ePermit
Site Address: 3813 Riverton Ave
Lot:5 Block: 2 Addition: Blackhawk Oaks
PID:10-14387-02-050
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Amanda Hanson
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Steven Hansen
3813 Riverton Ave
Eagan MN 55122
(651) 452-4604
Snap Construction
8200 Humboldt Ave S
Bloomington MN 55431
(612) 360-1033
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA136225
Date Issued:05/03/2016
Permit Category:ePermit
Site Address: 3813 Riverton Ave
Lot:5 Block: 2 Addition: Blackhawk Oaks
PID:10-14387-02-050
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Steven Hansen
3813 Riverton Ave
Eagan MN 55122
Tony's Appliance
2090 County Road 42 West
Burnsville MN 55337
(952) 435-2442
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA139843
Date Issued:11/10/2016
Permit Category:ePermit
Site Address: 3813 Riverton Ave
Lot:5 Block: 2 Addition: Blackhawk Oaks
PID:10-14387-02-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Steven Hansen
3813 Riverton Ave
Eagan MN 55122
Haley Comfort Systems
122 3rd St W
Hastings MN 55033
(651) 437-0338
Applicant/Permitee: Signature Issued By: Signature