4850 Rusten Rd r /
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SEVERSON,SHELDON,
DOUGHERTY & MOLENDA, P.A.
SUITE 600
7300 WEST 147TH STREET "
APPLE VALLEY,MINNESOTA 551244580
_ (952) 4323136 -
TELGFAX NUMBER (9i2) 4323780
, E-MAIL bauert a seversonsheldon.com
TO: Jolm Gorder, Assistant City Engineer
FROM: Robert B. Bauer, City Attorney ~
DATE: July 13, 2004
RE: Lot 1, Block 1, Thomas G. 5later Addition
Drainage and Utility Easement - No. 1026
Robert McNearney Custom Homes, Inc.
Our File No. 206-4768
John,
Enclosed for the City's records, please find the original Drainage and Utility Easement dated
December 18, 2004 and recorded with the Dakota County Recorder on Februazy 25, 2004, as
Docmnent No. 2178441.
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TREASIJRER-~v~,~ ;
DRAINAGE AND UTILITY EASEMENT
THIS EASEMENT is made this t~' ~ day of 1J~' `w~.:~,~-F~'~. , 2003, between
ROBERT McNEARNEY CUSTOM HOMES, INC., a Minnesota corporation, (hereinafter
referred to as °Landowner"), and the CITY OF EAGAN, a municipal corporation, organized
under the laws of the State of Minnesota, (hereinafter referred to as the "City").
WITNESSETH:
That the Landowner, in consideration of the sum of One Dollaz ($1.00) and other good
and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does
hereby grant and convey unto the City, its successors and assigns, a 20.00 foot permanent
drainage and utility easement, over, across and under the following described premises, situated
wittrin Dakota County, l~finnesota, to-wit:
Commencing at the Southwest corner of Lot 1, Block 1, Thomas G. Slater
Addition; thence North 89 degrees 57 minutes 29 seconds East a distance of 51.25
feet to the point of beginning; thence North 12 degrees 12 minutes 56 seconds
West, a distance of 75.21 feet and there terminating. The side lines will be
lengthened or shortened to terxninate on the right-of-way of Rustin Road and the
existing drainage and utility easement on the North side of said Lot 1, Block 1.
See also ef:hibit "A" attached hereto and incorporated herein.
The grant of the foregoing permanent easement for drainage and utility purposes includes
the right of the City, its contractors, agents and servants to enter upon the premises at all
reasonable times to construct, reconstruct, inspect, repair and maintain pipes, conduits and mains;
and the fi~rther right to remove trees, brush, undergrowth and other obstructions. After
completion of such construction, maintenance, repair or removal, the City shall restore the
premises to the condition in which it was found prior to the commencement of such actions, save
only for the necessary removal of trees, bnxsh, undergrowth and other obstnxctions.
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iREASURER-0.L17170R
, And the Landowner, its successors and assigns, does covenant with the City, its
successors and assigns, that it is the Landowner of the premises aforesaid and has good right to
grant and convey the easement herein to the City.
IN TESTIMONY WHEItEOF, the Landowner has caused this easement to be executed
as of the day and year first above written.
Robert McNearney Custom Homes, Inc.,
a 1VTinnesota corporation
By: fi~ ~
Its' ~~s,
STATE OF MINNESOTA)
)ss.
COUNTY OF L~a ~c-~
The foregoing instrument was acknowledged before me this ti~~'~day of
~~.C c p ~.,,~.~r1,i.~ , 2003, by ~~~o -2~~~ ~r1-ec~v v~2~ the
j;r ~-y of Robert McNearney Custom Homes, Inc., a'nnesota corporation,
on behalf of the corporation.
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_ - LINDA M~AR'E DR~;LLr~ y~ ~~~~.c~~- V~ , ~~rL~ l
NOTARYPUBLIC-MINNESOTA }p`,1+ NotaryPublic
My Commission Ezpires Jan. 31, 2005
!
APPROVED AS TO FORM:
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City Attomey's Office
Dated:
APPROVED AS TO CONTENT:
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Public Works Department
Dated: ~2 -
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THIS INSTRUMENT WAS DRAFTED BY:
SEVER50N, SHELDON, DOUGHERTY &
MOLENDA, P.A.
7300 West ] 47th Street, Suite 600
Apple Valley MN 55124
(952) 432-3136 ~
(RBB: 206-4768/Easement No. 1026)
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EX. DRAINAGE 8 UTILITY
EASEMENT
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O l S UTILITY EASEMENT PER ~
1 1 DOC. No. 694846 ~
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EXHIBIT
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01WeWms1ANRPHY FMM M A
Lot 1, Block 1, Thomas G. Slater Add. ~ ~~a~o3
Proposed Drainage & Utility Easement.
City of Eagan
~UQ, c~2(~-1°t ~`-1,`~4O,SZ~
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RESIDENTIAL BUILDING ~ ~ - ~ a ~ '~Q ~
. < Permit Application C,, s~ 1 ~f 6. Z)
City OfEagan
r----,
3830 Pilot Knob Road, Eagan MN 55122 ~y v~ S~
Telephone # 651-675-5675 FAX # 651-675-5694 '
C ~.~,t~ l~- I t~°
New ConstrucUon Reauirements RamodellReoair Reauirements INfrce Use Oniv
3 registered sile surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies oi plan Cert of Survey Recd •a~Y _ N
(20%maximum lot coverage allowed) 1 set ot Ener9y Calculaiions for heated additions Tree Pres PWn Recd ~,~1' _ N
2 copies ot plan shaxing beam & window sizes; poured found design, etc. 1 site survey for additinns & decks Tree Pres Reqd 7 ~ Y_ N
isetofEnergyCalculations AddNon-indicateNon-sfteseptlcsystem~~ On-site5epticSystem _Y _N
3 copies af Tree Preservation Plan If bt planed aner 7/1193 ~„~~z ~`~~Q
Rim Joist Detail Op6ons seleciion sheet (bldgs with 3 or less units ~~f ~~1 o,~v--_ ~ f~PS~ f ~ ` 1 I L) ~
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Date d 3 Cb~strucNon Cast
Site Address ~ 0 7~ ,Q l %
~v~~ S ~ ~~A%
e.~ ~~UniUSte #
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Description of Work ~/~1./0~ ~t /-~fm r Iy ~w ~ ~
Multi-Family Bldg _ Y I~ Fireplace(s) _ 0 ?1 _ 2
Property Owner o /~7c ~~,,q,e'nJ ~ Telephone #(`/S~ ) 9.~5- d f` ~S-
Contractor ~f~~,C'T//~~~ ~~c r7R~I P~J
Address i3~~~.3 /7~i~~N ~/JN C~t3' ~f~~ ~'i
State • ZipSS~ Y~" Telephone #(yS~) q$S O`f (pS
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 C~' Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsu6missiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan '~syr~0i W,a~ ~ N If so, 25% plan review
fee applies. l~7 LS IJ
LicensedPlumber -G~A.v~~f1 NOV 122$Q~p e#(9~J ~6Y-~o 99~
Mechanicai Contractor ~ /C Telepho e#(9.f~ Y`~ 9- 6 9% 9
. %-3~~°
Sewer/WaterContractor_ST~ ~~~~bi~fJq Telephone#(
I hereby apply for a Residential Building Perntit and acknowledge that the information is complete and accurate;
that the wark will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes, 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.
/ie~i~,Pr" /17tA~-~it .~N e y
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
Sub Types ' ,
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
~ 02 SF Dwelling ? OS O6-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of ^ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 E#. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Yor_N ? 25 Miscellaneous
Work Types
~ 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 (Bldgj' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation ~"/U Occupancy ~2 ` 3 MC/ES System ^
Census Code ~G/ Zoning ~l City Water
SAC Units Stories ~ Booster Pump -
Nbr. of Units a/ Sq. Ft. /,2. PRV ~
Nbr. of Bldgs Length ~ Fire Sprinklered
Type of Const ~ Width 77
~ REQUIRED INSPECTIONS
Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
Footings (addition) Plumbing
Foundation HVAC
_ Drain Tile Other
Roof ~ Ice & Water ~ Final _ Pool _ Ftgs Air/Gas Tests _ Final
~ Franilng Siding Stucco Stone
Fireplace R.L ~Air Test ~ Final Windows (new/replacement)
~ Insulation Retaining Wall
y~,
Approved By , Building Inspector
' - -r
BaseFee /G9°/~ U~?/,~v /3SMi /N C ~~3~~
surcnarge /s' /-"4i2 /,J`/D~ .7`~' ~'I 540
Plan Review /L~ 7z0
MC/ES SAC
aty sac J l ~ ~ ~?o
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies ; ~
Other
Total
. .
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MECcheck Compliance Report
2000 Minnesota Energy Code
MECc/recd- SoRware Version 32 Release lb Checked By/Date
TITLE: STANTON
COTJN'I`Y: Dakota
STATE: Minnesot~~
Z(?NE: 2
CONSTRLSCTION TYPE: Single Family
DATE: 11lI1/Q3
DATE OF PLANS: 09-.>0-0 ~
PR0IECT 7NFORMATION
LOT 1, BLOCK 1
THOMAS G. SLATER ADDITION
COMPANY INFORMATION:
ROBERT MCNEARNEY CUSTOM HOMES
21039 HERON WAY
LAKP,VILLE, MN 55044
COMPLIANCE~~c'es i ~
Maximum UA = 28i
Yourllome = 272
32% $etter Than Code
Gross Glazing
Area or Cavity Cont. or poor
Penmeter R-Value R-Value U Fac[or UA
Ceiling i: Raised or F.nergy Truss 1510 43_~ 0.0 33
Extcrior Wall L Wood Frame, l6" o.c. 93 p.p q
Window: ~'-0" X 5'-0" ANDERSON:
Above Grade, Viny] Freme, Double Pane willi Low-E 20 024U 5
Eaterior Wal] 2: Wood Frame, 16" o.c. 18 19.0 0,0 3
EaYerior Wall 3: Wood Frame, 16" o.c 101 19.0 0.0 4
Window: 7'-0" X Y-0" TRPL. CASEi~g:~'f' ,9}vi}ERSQN:
Abovc Grade, Ym'1 Frame, Doublc Pane with Low-E 35 0.240 R
Exterior Wall ~1: Wood Frame, I6" o.c. 2'7 19.0 0.0 2
Es[erior Wall S: Wood Frame, 16" o.c. 23 19.0 0.0 I
Exterior Wall 6: Wood Frauie, l6" o.c. 36 19_0 0.0 2
Ezcteripr Wall 7: Waod Frame, 16" o.c. 7U 19.0 0.0 2
Door: 5'-0" FRONT ENTRY ASSEMBLY: Solid 33 0.360 12
Exterior Wall 8: Wood Frame, 16" o.c. 46 19_0 0.0 2
Ex(erior Wa119: Wood Fraine, 16" o.c. 90 19.0 0.0 4
Window: fi'-0" X S-0" TRPLE. CASEMEN'I' ANDERSON:
tlboce Grade, Vinyl Frame, Dovblc Pane wiUi Low-E 30 p,24p 7
Ex[erior Wall 10: Wood Frame. 16" o.c. 90 19.0 0.0 5
Exterior Wail 11: Wood Frame, 16" o.c. l80 19A O.f) lU
Window: 2'-0" X 5'-0" CASEMENT ANDERSON:
Above Grade, Vinyl Frame. Double Pane w~tli Law-E 10 0240 2
Cxterior ~~f~all 12: Wood Frame. 16" o.c. 140 19.0 0.0 6
Window: 6'-0" X 5'-0" DBL CASEMENT ANDERSON:
Above Grade, Vinyl Frame, Double Pane wiih Low-E 30 O.Z40 7
Exterior Wall li: Wood Frame. 16° o.c. 54 19.0 0.0 2
2'-8" ATRItJM DOOR ANDERSON: Glass 18 0340 6
Exzerior Wall 14: Wood Frame, 16" o_c. 117 19.0 0.0 7
Exterior Wall li: Wood Frume, 16" o.c. 216 19_0 0.0 10
Window: 8'-0" X S-0"'I'RIPLE CASEMENT ANDERSOAI:
Abo~~e Grade. Vinyl Frame, Double Pane with Low-E 40 0240 10
Esterior Wall 16: Wood Framc, 16" o.c. 306 19.0 0.0 16
2'-8" STEEL GARAGE DOOR: Solid 18 0200 4
Window: 3'-0° X 4'-0" FIXED ANDERSON: Above Crnde. Other 24 0.240
6
Basemenc Wall l: Masonry Block with Empty Cells, 8.0' ht/8A' bgl8A' insul
3&1 11.0 0.0 19
Basement Wali 2: Masonry Block wiih Emptp Cells, 8.0' hU8.0' bp,lR.O' insul
245 ll.0 0.0 t3
Basement Wa113: Masonry Block with Empty Cells, 8.Q' hU8.0' bg/8.0' insul
245 11.0 0.0 1 ~
Basement Wa114: Wood Frame, 8.0' hU8.0' bgl8A' insul 296 11.0 0.0 9
6' SLIDING C,LASS DOQR: Glass 40 U.490 20
Window: 8'-0" X 5'-0"'1'RIPLE CASEMENT ANDERSON:
Basement> 5.6 tt2, Vi~yl Frame, Double Pane with Low-E 40 0240 10
Window; 5'-(1" X 4'-0" DBL. CASLNILNT ANDERSON:
Basement> 5.6 ft2, Vinyl Frame, Double Pane with Low-E ~30 0.246 10
Furnacc 1: Forced Hot Air, 78 AF[JE
Air Condiuoner L Electric Central Air, 10 SEER
Proposed and Masimum U-Factor Averages
Propased MaYimum
Average U-Factor A]lowed U-Factor
Above-Grade Windmvs and Gtass Doors ~.27h 0.370
Includes FoundaUon Windows > 5.6 $2
COMPLIANCE STAT'EMENT: The proposed building design described l~ere is consistent with the building
plans, specifications, and other calculations submitted with the permit application. The proposed building has
been designed to mee he 2000 3~Iinnesotx er{,ry Code requiremettts in MECcheck Vezsion 3.2 Release Ib.
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Builder/Designer //"i/~1 .C,J ! j`~ Date j~ r i/~F =1
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~ 4BSD R~STEN ROAD
CERTIFICATE 4F SURVEY
For: Robert McNearney Custom Homes
DENOTES
~ ~EXISTING TREE
-~-~E PRESERVATION FENCE
Proposed drainage and utililty eosements
per city plan to be verified and provided by client.
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Scale: i"=30' Page 3 of 4 dames R. Hill, Inc.
T
~ ' 4850 RUSTEN ROAD
~ ERTIFIC ATE 0 F S URVEY
For: Robert McNearney Custom Homes
THOMAS G. SLATER ADDITION
Tree Preservotion plon
Pre House Pro osed
Construction Tree Preservation
s- ui Post House Const.
w
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POINT N0. ELEV. TYPE DIA X w ~ a ~ w
W ~ 1/1 U ~
33 953.9 OAK 18 X X
48 945.3 OAK 18 x X
49 945.9 OAK 10 x X
50 946.3 OAK 8 X X
57 947.5 OAK 18 x X
52 944.8 ELM 9 x X
53 942.1 POPLAR 9 x X
54 938.2 POPLAR 9 X X
55 937.4 POPLAR 8 x X
56 944.1 CHERRY 8 X X
57 939.3 OAK t2 x X
58 943.0 OAK 19 x X
59 9a5.0 OAK 8 x X
60 946.5 OAK 7 X X
61 949,5 OAK 20 X X x
62 949.9 OAK 16 X X
63 951.0 OAK 13 X X ~
64 952.4 OAK 15 X X X
ss ssz.s E~M 9 x x
66 ' 953.3 OAK 14 X X
67 953.4 OAK 34 X x
68 9a5.3 OAK 14 X x
69 946.6 OAK 15 X ~ X X
70 944.6 OAK 17 X X X
71 945.3 OAK 17 x x X
72 948.2 OAK 15 X X ~ X X
73 949.6 OAK 16 X X X
74 950.2 OAK 16 X x x
75 945.8 OAK 18 x X ,t
76 943.8 OAK 16 X X ~
77 938.9 POPLAR 9 X X ~
78 939.5 POP~AR 8 x X ~
79 940.4 POPLAR 7 X X ~
80 953.1 OAK 24 X x . X '
ti
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Preliminary Tree Certification
During a site visit on November 5, 2003, oll significanl trees designated to be soved on the
Tree Preservation Plan prepared by James R. Hiil, Inc., were present and in good health, except
os noled in ihe table obove.
The house has been stoked. Tree (ence will need to be placed outside the dripline ol oll significani
trees to be soved. Fuiure groding ond construction should not have a negalive effect on these trees.
By. Dale: By. Date:
Jomes L. Sturm, Landscope Architecl Mn. Reg. No. 18380 Signalure of Owner
Scale: i"=30' Page 4 of 4 James R. Hill, Inc.
LOT SURVEY CHECKLIST FOR RESIOENTIAL
, BUILDING PERMR APPLJCATION
• PROPERTYLEGAL: LoT ~ b~Ck1 To/Y'AS G. S~.RrE~ A~DITION
DATE OF SURVEY: ~I I- O 3
LATEST REVISION: l2 - ~I - ~3
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O z'l Q DOCUMENT STANDARDS
? • Registered Land Surveyor signature and company
C~? ? • Building Pertnit Applicant
6~~ a • Legal description
~ ? • Address
, ? • North arrow and scale
? • House type (rambler, walkout, split w/o; split entry, lookout, etc.)
G?~ ? • DirecGonal drainage arrows with slope/gradient %
? ~ • Proposed/existing sewer and water services & invert elavation
? • Street name
G?~ ? • Driveway
? ~ • Lot Square Footage
? • LotCoverage
ELEVATIONS
/ Existln
@' O ? • Sewer service (or Proposed)
~ ? ? • Property comers
? • Top of curb at the driveway and property line extensions
L~ • Elevatlons of any existlng adjacent homes
~ a ? • Adequate foodng depth of struciures due to adjacent utility trenches
p~ ? ? • Watenvays (pond, stream, etc.)
Prooosed
H ? ? • Garage floor
l~ ? ? • Basement floor
? ? • Lowest exposed elevation (walkouUwindow)
~ ? ? • Property comers
o • Front and rear of home at the foundation
/ PONDING AREA (if aoolipblel
d ? ? • Easement line
fi~/ ? 0 • NWL
B' ? 0 • HWL
G}~ ? ? • Pond # designation
C~ ? ~ • Emergency Overflow ElevaGon
? ~0 • Pond/Wetland bufferdelineatlon
DIMENSIONS
0 O • Lot ~inesBearings 8 dimensions
? • Right-of-way and street width (to back of curb)
a' ? U • Proposed home dimensions inGuding any proposed decks, overhangs greater than 2', porches, etc.
/ (i.e. all sWctures requiring permanent foodngs)
CC99~p ? • Show all easements of record and arry City utilities within those easements
tY0 ~ • Setbacks of proposed structure and sideyard sel6ack of adjaceM exisdng structures
? ll0i CI • Retainingwall requirements,'rfany
Reviewed: ~ - 5- O '~5
Name Date
G:/FORMS/Building Permit Appliwtlon
~
4850 RUSTEN ROAD
~ CERTIFICATE OF SURVEY
For: Robert McNearney Custom Homes
PROPERTY DESCRIPTION: Lot 1, Block 1, THOMAS G. SLATER
ADDITION, Dakota County, Minnesota.
We hereby certify that this is a true and correct survey of the above
described property and that it was performed by me or under my
direct supervision and that I am a duly Licensed Surveyor under the
laws of the State of Minnesota. That this survey does not purport to
show all improvements, easements or encroachments, to the property
except as shown thereon.
Signed this ~ doy of LL~`CE~l,~iE~2 , 2003. James R. Hill, Inc.,
By.
J. Gary , Min e ta L.S. No. 11529
N es:
1. Building dimensions ShOwn ore for p Denotes set spike
horizontal & vertical placement of structure o Denotes set iron monument
onl . See architectu~al lans for buildin • Denotes found iron monument
Y P 9 x927.6 Denotes existing elevation
& foundaiion dimenSiOns. (930.0) Denotes proposed elevation
2. No specific soils investigation has been Denotes proposed droinage
completed on this lot by James R. Hill, Inc. TC Denotes top of curb
The suitability of soils to support the specific
house proposed is not the responsibility of Bench Mark: 959.67 _TNti-LOT 2. BLOCK i
James R. Hill, Inc. or the Surveyor. Proposed Gorage Floor= 954,3
3. No specific fitle SearCh for exisienCe or non- Proposed Garoge Top of Block= 954.7
existence of recorded or un-recorded easements Proposed House Top of Block= 954.7
has been conducted by the surveyor os a part Proposed Lowest Fioor= 9a6.6
of this survey. Only easements per the recorded 5. Proposed drainoge ond utlilty easements
plat are shown. per city plan to be verified and provided by client.
4. Proposed grades shown were taken from
the groding &/or development plon prepored by gearings are on assumed datum
JAMES R. HILL, INC. SCBI@~ ~'=.30'
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~ u~^~~' ~ n o 00 ~ m~ Z PLANNER$ ~ ENGINEERS ~ SURVEYORS
p u~ ~ u z o 2500 W. Crc. Ro. 42, S~ 120. 11N 55337
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A ~ ~ Z ~ PHONE: (952~91~6044 FAX: (952~6244
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~ 4850 RUSTEN ROAD
CERTIFICATE OF SURVEY
For: Robert McNearney Custom Homes
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CLAIM VOUCHER
CITY OF EAGAN
CLAIMANT:Lonnie Stanton
ADDRESS: 4850 Rusten Rd. Eapan, MN
BUILDING PERMIT 62679
RECEIPT 65932 BATCH 6777
AMOUNT: 5000.00 ISSUE DATE: ~d7 b
Refund retaining wall bond for: 4850 Rusten Rd
Address
9D01.2250.311
I declare under the penalties of law that this account, claim, or demand is just and that no part of it
has been paid.
,
n nspeCtor Jeff Wheeler
1
~ , t; ~Z'45 Mav 7. 2004
Department Sup~ f" Date
Site address: ~rYSd R~0 ~o~ L Block L Subdc~.,...~.
On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air
tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be
submitted prior to issuance of a Certificate of Occupancy.
~ This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
_ This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE
waterHeater ~~Qol~~~h;r~ ylilTtrJSO~<o(~+J/s- ~D°~~ ~rd-G
Furnace ~I L N 9~, PD ~ oo T /Gb'pOG ~tw~L`aM
Dryer o
Prycr 6e w 9z.oo~~..~
~ H 7 /SS x H-s VENTED
EXHAUST SYSTEM LOCATION TYPE MODEL CFM's YES NO
Kitchen kit hen ~ '
Bathroom 1
~vrt o c m So c F X
Bathroom 2 3-o cF
Bathroom 3
Bathroom 4
Other
VENTING
FIREPLACE S LOCATION GAS WOOD MANUFACTURER MODEL BTU'S DIRECT A7M05
"-"a - ~'SL - - G 7 0
MAKE-UP AIR MODEL TYPE CFM's
I"7tl oP Lz~ /z ~ /~7
I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan
requirements.
R..~.a- ~o~..~ A~ a~.:.0 2 7. a Y
Signature ~ate
~rs...~ h.c. h e~ewv.a.... P•c.c~i~,-. H~..o~.
CompanyName
' This form is the responsibility of the General Contractor.
Address: 4850 Rusten Rd 55122
Lot: 1 Block: 1 Subdivision: Thomas G. Slater
THE FOLLOWING ITEMS WERE/N'ERF, NOT COMPLETE AT FINAL INSPECTION ON y-~ 6~ UY
Yes No Comments
Final ade - 6" from siding
Permanent st s - arage
Permanent ste s- main entry
Permanent driveway
Permanent gas
Retainin Wa11 or 3:1 Max Slo e
Sod/Seeded lawn
TraiUcurbdama e -r Z
Porch
Lower level finish X
Deck ,1(
Fire lace
• Verify with your builder that roof test caps from the plumbing system have been removed.
• Turn off water supply to the outside lawn faucets before freeze potential exists.
• Call tha City's Engineerine Department at 691-675-5646 prior to working in right-of-way or insialling
irrigation system.
~ BUILDING INSPECTOR:
HOMEOWNER:
McNearney, Robert Custom Homes
P.O. Box 366
Lakeville MN 55044
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
~~.~.-~.S
l- 3830 PILOT lCNOB ROAD, EAGAN MN 55722 ~ ~~•~u
651-675-5675
Please complete for modifications to existing residential dwellings.
Date ~ 1 ~ I Q
Site Street Address yo~~ f1 ~`KVl ~G''GI C~ Unit #
Property Owner j~(; I~ f1 f C . J I Cl~~ Telephone )
1. ~
Contractor ~ ~ f ' ~ 1 ' Telephone # ( j~iJ~ )Z~ ~7! ~
Address~~I~ (.4.~ 3SlJ SQEJ~~ t~Jr c~ty ul State 1f''~ z~p~~
The Appiicant is: _ Owner _ Contractor _Other
Alterations to existing dwelling $ 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required)
Other:
~Water Softener _ Water Heater $ 15.00
_ replacement ~ additional
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.OD
State Surcharge $ .5D
Total $ /.S~S 0
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance 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
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
~ G a?v~ LiS a~ei ~ C~ 11
p IicanYs rinte Name Applicant's Signat e MAY I,0 z00¢ D
5~~~ BY
y
~~3~w~ ~ ~o -a~
. 2006 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConaWCtion Reauirements RemodeilRmair Reouiremenls Olfice Uae OnN
3 reg'stmed site surveys showing sq. ft of bt sq. ft of house; and all roofe0 areas 2 copes of plen shaving footings. beams, jdsts Cert ~ Survay Recd _ Y_ N
(20%~imum lot coverege atlared) 7 set of Ene~gy Celr.ulstia~s far Ireffied add~tia~s Tree Pres Plmi Recd _ Y_ N,
2 capies of plnn showi~ beem & windaw sizes; poured found design, etc. 1 aite smvey kr additions 8 dedcs Tree Pres Requiied _ Y_ N
1 set of Energy Cela4tions Add'dion - indicafe ilmsite sepfic system On-site SepGc System _ Y_ N
3 copies of Trae Preservation Plan tt lot plebed aRer 7M53
Rim Joist Defe~ Optims selectian dwet (buildigs with 3 a ieas unils)
Minnegasco mechanical ventilation fomt ~ n ~ n.
~"Ux-ee
Dste Ur l D 6 Coestructlon Cost ~/y O a 0
Site Address ~~,~(J iQ?S ~N ~Q~ UniUSte #
Descriptiono[Work ~i~O.N¢f V~~~l -~J~i6l.
MuUi-Family Bldg _ Y~ N Fireplace(s) JC 0 _ 1 _ 2
Property Owner (~Cnni F S'~RiJ~'J ~ Telephone k(foS I) ~,Q2 ~/e 35 6
~eN-
qS2- 2-9L-2333
Cootrector ~ ~n.~a_ p,,.~ M_ r
Address ~f~Y~U ,Q~S~.~J ~o'~ City ~,F~j.~,,.J
State Zip S~l Z Z Telephone # ( (os`t ) _ ~k Z ~ ? 5 ~
~
COMPLETE THIS AREA ONLY IF CONSTRUCTIN6 A NEW BUILDING ,
- Minnesota Rules 7670 Cateaorv I Minnesota Rules 7672
Energy Code Category , Residentlai Ventilation Catepory 7 WoAcsheet . New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Emelope Calculations Su~mitted
In the tast 12 months, has the City of Eagan issued a pertnit for a similar plan based on a master plan2
_ Y _ N If yes'datIe2.and.address.of.master plan:
Licensed Plumber II ~'J " ~ ~ ~ I II II Telephone # ( )
~~I JUN 0 6 200o I~
Mechanicai Contractor 1 Telephone )
Sewer/WaterConhactor Telephone#( )
I hereby apply for a Residentiai Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a pernut, but only an application for a permit, and work is not to start wit6out a
permit; that the work will be in accordance with the approved plan i e case of work which requires a review and
approval of plans.
~D.~.~,~ 5~,~~~ ~
ApplicanYs Printed Name A licant's Signature
DO NOT WRITE BELOW THIS LINE
Sub Tvoes
? 01 Foundation ? W 05-plex ? 13 76plex ? 20 Pool O 30 Accessory 81dg
? 02 SF Dwelling ? 08 O6-plex ? 16 Fireplace ? 21 Porch (&sea.) ? 31 Ext. Alt- MuIU
? 03 01 of _ plex ? 09 07-plex ~ 77 Garage ? 22 PorchlAddn. (4sea.) ? 33 Ext. Alt - SF
? 04 02-pleac Q 10 08-plex Q 18 Dedc ? 23 Porch (screeNgazebo) O 38 Multi Misc.
? 05 0&plex ? 11 14plex ~ 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvoes
? 31 New ? 35 tnt Improvement ? 38 Demolish Irdenor ? 44 Sidfng
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation CI 45 Fire Repair
~33 PJteration ? 37 Demolish Building• ? 43 Reroof ? 46 Windows~Doors
? 34 ReplaC8m8M 'DemolMlon (EMIro Bldg) - Glve PCA fiandoutto eppllcaM
~88Crlpt~0~: WaESrDamage_Yes
Valaation Occupancy 3 MCES System
Plan Review 100% or 25°k
Census Code Zoning City Water
SAC Units U Stories Booster Pump
# of Units ~ Sq. Ft. PRV
# of Bldgs ~ Length Fire Sprinklered
Type of Const S~ Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ Sheetrock
_ Footings (decdc) FinaVC.O.
_ Footings(addition) ~ FinallNo C.O.
Foundation Y HVAC
~ Drain Tile s Other
Roof Ice & Water Final Pool Ftgs AidGas Tests Finel
5~ Framing _ Siding _ Smcco Lath _ Stone Lath _Brick
Fireplace ` RI. _ Air Test _ Final _ Windows
y~ InsulaNon _ Retaining Watl
Approved By: P ` ~ ~ ~ ~ . Building Inspector
Base Fee
Surcharge ~
Plan Review
MClES SAC
City SAC
Utility Connection Charge
S&W Pertnit & Surcharge
Treatrnent Plant
License Search
Copies
Other
Total
73 ~97 _s`'
zoos RESIDENTIAL PLUMBING PeRm~r aPP~icaTioN
CITY OF EAGAN
3530 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residentia~ dwellings.
Date ~f' ! l ,~l~
Site Street Address ~u5k~-.- Q~ ~~~~'F~ Unit #
Property Owner ~o n~i e- ~~~9~/~~^~ Telephone # ( ) ~y'Z - 6 3~ ~
Contractor ~ ~ ~ ;~Nti e/' Telephone # ( ~p51 ) ~S~'Z - C~ 3`I b
Address City State Zip
The Applicant is ~.Owner _ Contractor _Other
Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee
$ 100.00
Per as-built $ 10.00
~ Alterations to existing dweliing $ 50.00
~ Add plumbing fixtures. This fee includes installation of a water softener and/or water
heater at the same time. If you are installing onlv a water sofrener and/or water
heater, do not complete this section; move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
_Water Turnaround (add $130.00 if a 5!8" meter is required)
Other:
Water Softener _ Water Heater $ 15.00
_ new _ replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total $
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the
work will be in conformance 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 permit, w rk is not to start without a permit and work will be in
accordance with the approved plan in the event a plan is requ ed /~reviewed and approved.
~Ur1/1'G SY~£Inl'fi/n/ G .J
ApplicanYs Printed Name `
pplicanYs Signature
/
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA177526
Date Issued:07/07/2022
Permit Category:ePermit
Site Address: 4850 Rusten Rd
Lot:1 Block: 1 Addition: Thomas G Slater
PID:10-76150-01-010
Use:
Description:
Sub Type:Water Heater
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
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 -
John A & Jennifer B Gouette
4850 Rusten Rd
Eagan MN 55122
(952) 451-1207
Clearwater Plumbing & Heating
19260 Mushtown Rd
Prior Lake MN 55372
(952) 440-3779
Applicant/Permitee: Signature Issued By: Signature