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4902 Safari Ct S .� • e Use BLUE or BLACK Ink �----------------- � For Office Use � ' j Permit#: � ��/ T j Cit� of �a�a� � �j � RECEIVED � Permit Fee: ��'� " � 3830 Pilot Knob Road � G j ' Eagan MN 55722 �� Z g �D'� � Date Received: � � � Phone:(651)675-5675 � � Fax:(651)675-5694 I Staff: I �I _____ J �� 2014 RESIDENTIAL BUILDING PERMIT APPLICATION ��"" � Q� �Jp + � ' Date: v �� Site Address: �1 1�2 �rtri CQ�'fi � Unit#: Name: .J2.�*Gi' � cJU�'�`'? �A'�se^') Phone: �£.'SIL��1'i'� �v t (�y�� Address/City/Zip: �q D� �a-lrari Cb-r/'wt � Applicant is: Owner �Contractor ,�,��,��,� , Description of work: I�et..� �E.L�c., � �.'.br►�r �ECr C�G�a�tr+� d� Construction Cost: � Multi-Family Building: (Yes /No Company: �IGtwL2C F�c�rr-�a� �5ic,v, �+.s[l� Contact: J��S MCdS�r1 C�t�CBC'�83` ' '' Address: ��Z f7 �`�Q)°�� $}- tn�. �!17D City: ft � State:�zip: 5l2 Phone: YSZ-y3i-I67/� Emai�: ,Javr�5 � t� �. b,"Z. License#:'(�C..1q��2� Lead Certificate#: �r[T^ Z��D�I �� ' If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) � �� CZ� 1 �, COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING , 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: l�IQi'�.�t�s�r�d s�pp�rting�tc�ce�met�#s tl�at you su��it ar�ccir�si�'e��t f��ie��1��rrff�r�� ; � �,�,, �.i��`o�a�!on r��y 6e cl�ssi�ed�s n�n pubt;�c�#ycru pro��le spe��c rea��s tl�at�u�ir��_ ' � y �� ;f{ cc�ncl�de tfaat tlre are frat�e secre�. ��, � . ' ''- CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 wili be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x ...��lnr� 1(Y�. Yl�.1�1r x Applicant's Printed Name Applican Signature Page 1 of 3 .. �{`I'�� ra��r C�- j� /�(� 7y� DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) Single Family Garage Porch(4-Season) Exterior Alteration(Multi) _ Multi � Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex Lower Level Pool 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 (�t?�, Occupancy �� MCES System Plan Review Code Edition �� SAC Units (25%_100% 2� Zoning R—.�.. City Water Census Code Stories � Booster Pump #of Units Square Feet '` PRV #of Buildings Length Fire Sprinklers Type of Construction � Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: � Footings (Deck) Final/C.O. Required Footings (Addition) � Final/No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Roof:_Ice&Water _Final Pool: _Footings Air/Gas Tests _Final � Framing Drain Tile Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick . Insulation Windows Sheathing Retaining WaIL•_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Erosion Control Braced Walls Other: Reviewed By: �� , Building Inspector RESIDENTIAL FEES Base Fee ��,�8yy� ��(��f1/l( 4'l� Surcharge � Plan Review MCES SAC City SAC Utility Connection Charge S8�W Permit 8�Surcharge Treatment Plant Copies --�„ TOTAL Page 2 of 3 � �� . �� l��G� �O.�i^'aS'7�f G�C �"�'Di,� J .L...07�� ,�'�OG'r�"� �C17'nc2f-� �S%`��Z�c-s- 1 t� � � � �% �r ,��,.�a�'',� G�o., ,�r,r � � / / � � � .�� ) � � �/, �.s>/ � �� t9�o.ol � // ��/ � � � � S'� % �`� & /0 `�_ �� , � X � � �S�'��_ / J I � ��._ � C� / 1� -- ._ _- , 8 ,� / � -�- _ _ _ � �� i /� ��' - - _ __ �� ,, , �- �, '� � , _ �_, � � � / � \ ��,,_` ��S' I m ( � ` �� I � � i �'�� _� �� / � � _ � � � ��'��-,,�.! �'' / � ' r� V/ ' !9GL.o) r � `'C_� 1`- \ � � c��, I G� �Y? � r� '1 �°-� 1 i � � � rl '� ��-7.'Z �''�,'T�.,\ � c 4 � jD I ' ' � � � i 1 _�' � \ �f � / � , 1 ��i_�� a; ; � � � � � � �9�s 7) 0� o � , � N ' _..______,_`_'-----_ N� � % -...�._ _ �1� ,� li°° � � CQ' , �.o __,_____�� i V q � `��V.�� a � o , Q � / � �d 9�3•�)� i (v � Q ____ (� b sc. / � � _ , � �J � � '- �`4,9.�,� �i 4 �,Q (�J �ch % \ \`� � + -_ - ",- _ _ .� �. � �� I � 7.0 "'--7 i`� / � � .� . , � v ; oeo.� / .V � --�_ _ y o u � i q /7•£5 3 - / / � � n m N j/a.��`b Ch�M�" 1 � f''I ___.. ' C! � - � .�-.__� �� .D � / � , -F--- _.___ --- " � " � � � �� _""-- . � � � ��c'�;°.� '� � � m o.�,� z z� � �;o�' ,� l � {/1 � :6�� II OJ /v �98 I �9�U � � � ;� -T�9��.�� t� �,� �� 973,9�� R�"$ � p �.�� .49 i�, '----__----� N � ' ' � � n� � �;---,_____ ---_ � � \ V ("n 198z.z5 SO.p� -----1---_____..__.___ '� �` �� --------- _ ' s� o z �.� ��g„ ��4.�8; -� _.— ,� � � � � �GcG� q �f (� ��, �� _ �� , i i / / LEQ��iD c� iron monumer�ta PF20P(3�ED ELEYATION� `°�'J �� oxi�tin� elev�ttan� ,�1GG3 Ioa�r,�st floor (��s`� proposed �ievati�ns 9�5� g�ra�e floor ..- �^--- cfiraction of proposed surface drelnage [97s.e] top of loundation t hereby certify that this survey,prepared by me ar undar my direct supervision,is a true File No �� Hansen Thor� and correct rep�esentation ot the boundries �f 4hs ahove described land and of the �� 28� � p + lacation of ali buiidings,if any#he�eon,and all visible encrcrachrrierrts,if any,from or on �- - � 1-��n�(� ��SQf� i nC, safd land and that I am a duly registered land surveyor u��SerState of f�4:nnesota Statutes ------ "` Section 325.02 to 326.1+6. Book- Page � � Consuiticig Engineers&Land Surveyora �c' �� 7565 Office Ridge Circie � � ! .� / _, —_. _ � �. / . � � . Eden Prairie, AAN 55344-384�9 _ � `=�-� CC�%�_ � /�' JCOI� ---->�-- ,c �sys� szg-0aoo �, , � /3�_.3� ��^�o � Date: ;'`:_� G`G -cg.� Regiatrati�n N<�. „_� _�_r.—_� �.__ CITY OF EAGAN +I 11 ~ ~ $ ~ 3830 Pilot Knob Road, P.O. Box 21-188, Eagan, MN 55121 ' d•- PHONE: 454-8100 BUILDIMG PERMIT Receipt #i , To'be used for $ F DWG/GAR Est Value $14 9, U G 0 Date •7 A?d I1 A,,t Y~_ g_~5 SiteAddress 4902 :..'AF11RI i:'I' Sn Erect ~ Occupancy tt3 Lot 4 Block 1 Sec/Sub. tiAFAR T E'S^'ATE~emodel ? Zoning tt1 Parcel No. Repair ? Type of Const V Addidon ? No. Stories ¢ Name L ~ C Y CC~:~i STRUCT I ON I 1vL Move ? ~ength _ Z Demolish ? Depth o Address 53do XYL(~i~I CIrZ Intlmpr. ? Sq.Ft City f3LNiTl~hone 9 4 4- 9 4 9 9 Install ? = o Name c Approvals Feei ~,4ddress Assessment Permit S 5 S 5. 5 U ~ Ciry Phone Water 8 Sew. Surcharge 7 9- 50 Police Plan Review~ZZ~7 5 F= Name Fire SAC 52 5- 00 ~ Z Address Eng. Water Conn.~~.0 G < W Ciry Phone Planner Water Meter ~ 3- U 0 Council Road Unit 2~ 00 I hereby acknowledgethat I have read this application and state that the B~dg. Off. 1~/ ~ 5~ 5r. PI. 1-i U 0 information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. APC Parks Signature of Permittee~_~ ~ if; pT~,~~ Var. Date CopieS Total ~ d ~ ~ 7 r 75 A Building Permit is issued to: LECY CU[': STIZUC`1'1C)rj Y~l~- on the express condition that all work shall 6e done in accordance with a41 applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official ' Pwmlt No. PNmM Mdd~r DNe TM~phone N Plumbin~ ~D ~..o ~'i ~~-G!~.~ ~ ~ ~ C~ 3 ~P 5 M.V.A.C. , El~etrlc Q ~ ( ' 8 ~ So11~n~r Inspectlon Dtls In~p. Commsnb Foounpa ~ ~3 Lc.~~ FooHnyall Foundstlon Framinq ts'~ Rooifny Rouyh PI6y. ^ 6 /a 2' . -G Rouyh Hf9• •~e GC /J le D Inaul. fG~o ~ C -3- ~ .Q ~ Finp~aae Fl~al Hty. 3 L~ t ~ Flnal Plby. '?O~ e~ao. F~na~ 3 3 f-S` ~ c.~+. o~c. ~ o.~k F~. X Nd D~ck Frmy. ~ YY~N Pr. Dbp. - . w... ,.;e,,...:~•zysi~:.+~~,~.fwTw~rY,T7",~'F`TS,M.~'"aA,r~V'l#T~~+lv~rae~{~'.sw~~s~,~.~ ~+Mw~-^n~g~s~vr pa I' ~ (n v PERMlT # ' CITY OF E~kGAN FEE ` 1~; - PLUMBING PERMIT ; RECEIPT # J ~ ~ ~ 454-B1QO SIC MINIMUM RE5IDENTIAL FEE - =10.00 + ~.50 TOTAL ~ ' DATE ' ~ MINIMUM COMMERCIAL FEE - $20.00 + ~.50 1. Bldg. Type: Res Comm Inst 2. New Add Alter Repair 3. Total Bid Price 4. Job Address ' Lot Block ~ Sec ~ ~T'` ~ ' S. Owner - ~ 6. Contractor ' ~ ~ ~ ~ ~ ~ ~ ~ - (Name) ~ (Streeq (City) (Zip) 7. CoMractor Phone # ~ NO. FIXTURES NO. FIXTURES NO. FIXTURES ~Water Closet - $3.00 -Laundry Tray - $3.00 -Well - $1Q.00 ~Bath Tubs - $3.00 -Floor Drains - $1.50 Private Disp Syst - $10.Oa -La~atory - $3.00 yWater Heater - $1.50 -Rough Openings w/o ~Shower - $3.00 -Whirlpool - $3.OD Fi~ctures - $1.50 ~Kitchen Sink - $3.00 -Gas Piping Outlets - $7.50 ~UrinallBidet - $3.00 -Softener - $5.00 COMM./IND. RATE - 1~6 OF TOTAL BID PRICE PLUS ~.50 STATE SURCHARGE FOR EACH ~1,000 OF FEE. Signed: ~ - , for Approved Inspections: Date Rough Insp. Date Final Insp. . . ~ ~ c/ s~ ~ - . ~ RERMIT ~ CITY bF~ EAGAN FEE ~ ~ J U l MECHANICAL PERMIT RECEIPT # 454-8100 S/C MINIMUM RESIDENTIAL FEE - 510.00 + S.SO TOTAL U DATE ~ 1~-~~ MINIMUM COMMERCIAL FEE • 520.00 + 5.50 1. BIdg.Type: Res ~ Comm Inst 2. New~~Add Alter Repair 3. Total Bid Price ~ 4. b Address ~''x%.~f,~ Y ~ ~1' v ~ Lot ~ Block ~ Sec c~ 't ' a-'f 5. Owner ~!/r-~~ ~'~'t- - . . ~ - „ rO GC,:. ^ ' •T ~ , . ~ ~,.,i, ",J..~:.,~ 6. Con't~ctor., ~ . , . , . . L.:~~~~. . ~~~I (Name) (5heeq " - • ~ (City), (ZiP1 7. Contractor Phone # ~f~l~ AIII`~~~ri~ v_I:~•, (.;i~ 55416 ~ -;~11 RESIDENTIAL HEATING - 01-100,000 BTU's -$24.00. Each additional 50,000 BTU's or fraction -$6.00 RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additiona16,000 BTU's or fraction -$6.00 MODIFICATIONS/ALTERATIONS -$10.00 minimum fee , ~ l~1',~:'~N HEATING S m VENTILATING HOT WATER STEAM ~ AIR COND. ' eIR FIPING PFiOCESSED PIPING AIR HAND. EQUIP. REFRIG. ~ RES. GAS PIPING OUTLETS - 31.50 TANKS: L.P. UNDERGROUND OTHER COMM./IND. RATE - 1% OF TOTAL BID PRICE PLUS 5.50 STATE SURCHARGE FOR EACH 51,000 OF FEE. Si ned: ~ ~"~v'r>r:~r ~ ~lis g rd1lr~~,~~- for ; Approved Inspections: Date Rough Insp. Date Final Insp. CITY OF EAGAN Remarks Addition SAFARI ESTATES ~oc e~k 1 Parcel #10 65850 04U 01 Owner'~~~ ` ~ • st~eec 4902 Safari Court So. State , t~ ~~;~e"_. . -&4~1-Ga-laxi~ Avenue Improvement Date Amount Annual Years Payment Receipt Oate STREET SURF. g 7 . . STREET RESTOR. (f(..~ 19$2 1546.63 ~.3 ;5 GRADING t~~ • • SAN SEW TRUNK 1F SEWER LATERAL j~ WATERMAIN ~ WATER LATERAL 1 S WATER AREA ~ 6J~ 1 $2 STORM SEW TRK 'j 1 82 866. 1 1 . a 1F STORM SEW LAT 1 82 5 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. SOO.OO BUILDING PEFi. 8 SAC PARK GEO. SEDGWICK HTG. & AIR COND. CO. , HOUSE HEATING TEST RECORD _ ~ ~ ~ ADDRESS G G S ~i(`! r ;..:1 G ~CJt~G~ ?l~ L~ ~ ~ CITY OCCUPANT ` NS ~u OWNER = HEAT LOSS ATE HTG. INST. SOLD BY - - INSTALLED BY Electrical Work Bv f Gas Line By G e i~ ~ TYPE OF HEAT GA_ FA HW_ STEAM SPACE HTR. UNIT HTR. OTH R • GAS DESIGN CONVER I~ MAKE ~4~ MAKE OF BURNER Model - ~ ~ Model Serial ss''S ~~,1 -1` Max. BTU Rating INPUT ~ Z~ MAKE OF FURNACE Model ~ ONTROLS THERMOSTA ~ Heat Plug~ l Ve~t Size ~ ~ 4~~ Valve K'J~ e' S°1'~ ~ ~a ~S° ~ KIND OF LINER NONE Limit CU ~ S 4 Draft Hood ~l ' Re lator P S Limit Setting ~ 7~r Filters Size Number Fan Setting Chimney Location Inside x Outsifle Pilot Type - u K Chimney Constructian ~S~ ~ Pilot Arlake Qr~:..ti~w' C/~ Pilot Model 7 Smoke Bomb ~ Wiring Pilot Timing ~~5~°~+~ Draft Test Tag s L.W. Cut Off Door Pressure Lighting Inst. - Pressure Percent CO ~ ul~' Date Tested f ` ~ - Input CFH 1~~ Percent 02 ~ r~ Company Testing v P r t Stack Temp. 1~~°F Percent COZ ~~~G C Name of Tester Form 235 _ _ _ _ i CITY OF EAGAN ~7 WA~ ~RVICE PERMn 3830 Pilor Knob Road l' L~~~v P. d. Box 211~9 PERMIT NO.: Eagsn, ~AN 55121 D^~: ' ` Zuninp:. n~- No of Units: p,~,~~, I.ecy C~nstructio~, tnc. Addres~ SJt~ /lddrcas; -Oi'~' ~alar{ "t. So. L B Safari_ ~:states P~Un1blr. ~ ' ' i-ulr.i.. Met~r No.1T~I°'~ c~.G.. •on Charys: P Size: " ~ ~ _ 1 ` . O~~P~ Reods No.: U~e • ~''1Jn.: e«py nhl~~ ' ~ ~ VIR~O 6~~,0.~: ~ -;~~~pG1 ~ REQ To~ol: _ 3.OOnd meter By Dot~ Poid: Dote of I `Irnp.: 3- z o - Fr6 CITY OF EAGAN WATER SERVICE PERMI'E' 3830 Piloz Knob Road P. O. Box 211f9 PERMIT NO.: Es~n, ~NN 55121 D^~: Zoninp: _ ~ , ~~r: ' No of Unlts: ~:,,n:rLxu~t:~pr:, Ildd?esx -~`O ~Wfe~S: .:~+~V ) Safari Ct. r(J. u'i :5i . ~ ~~Z 1 Pi "r'c, ~1Jnlblr: ~CZS+~3rt:~; q~-~~, ~ - c«~~~«, aa.~.: i'~ si~: ~,~r a~ , , . Recd~. No.: ~r: Permit Fee: ~~YrN !e oespyr wi16 !i~ Clhr of l~~w Surcha?~e: ~i~Ow' Misc. Chor~es; 1 ' ~ - ' - Totoi: ' : 8y ' ; •'r C~oN Paid: Date of Irap.: IrqP,; ~ CiTY OF EAGAN s~V~ ~ 3830 Piloi Knob Road P. O. Box 211,r.9 PERMIT IV~.: Eagan, MN 55121 pA~; : Zonirg: N0. of Units: 1 OwrNr, iCC j~ C.o?28 i: , z riC Address: SiteAddress• 49d~ ,~xs.:. . 5n. Ia B~ SafB.~f 'srarf_<. Plumber: T~'t~,~,_ ' ' { ^ , . i • .'l~.l.~l~Ot~ ~~MM M eew~ly wili~ !IM Cil~r ~f f~M~ CorrNttlon Cho~; , Or~INew. Accouit Depaif: P~rmlt F~e: ' Surchorps: • eY Mi~c. Chorp~s; ~ Dote of Ir~sp.: ToMI: Dab P~Id: f This req~est void _ / ` 0`~~ ^ ~G~ 7O 18 npn[hs from Y P Q Q / 0 3 a-~~-~G ~~y,8 r, ~f~~2~ ~sra-rES s~~ay Ran~~est ~ te Fire No.~., Rouph-in Insuactiun RequireA? ~Ready Now ill NotifY Inspcr.- es ?NU ~~r Whr.n ReaAy Licensed E ectrical Contractor I hereby request insoaciion of abova ~Owner electnwl work installetl aU . Street AAdress, Bo r Rou No. Citg,~ ~ i ~ Ce e ect~on o. Township Name or No. RTnyc No. County~ Occu^LCIPBIC~~ ~rv~~ Phg~ie Np, ~ ~ 1 l~C. 11 Y ~ ~ Powpy$ Ifer~ AddreSs LlL(~~`~'li Elo ~ al ~n[raSWr ICi ompa~~I:~mel ~ Co;[racto~'s Lj~en~ o. (1~5G~ cy+.~IfYC~ ~ / Mai ~e A~~Jress IContractor o Owner Mekin Insta' ifoN n f) ~1.~ ~OS~~~L l' tu~.~ , f ~ Au ~ etl S~P~~~~ur (Co racto Owne Makine bistallatinn~ Phone Number ~ ° - ~a MINNE OTA STATE eOARD.OF EIECTflICITY TMIS INSPECTION flEQUEST WILL NOT Gri99s-Midwey Bldg. - Roam N-191 ' BE ACCEPTED BY TME STATE BOAHD 1921 UniversitV Ave., SL Pnul, MN 55104 ~1NLESS PXOPEF INSPECTION FEE IS Phona (612) 297-2117 ENCLOSED. v~ -C~-p~ (o REQUEST FOR ELECTRICAL INSPECTION ee-oooor-o ~aw p- ~ See inshuctions for completine this form on beck of yellow cooY. S~' J7U ~""X" Below Work Covered by This Request - S~~a Add fle0. -Sype of Building Appliances Wired Equipme~~ Wired Home Ranye Temporary Service - Duplex Water Heater Lic~htiny Fixtures Apt. Building Dryer - Electric Heatin Commercial Bldy. Furnace Silo Unloader Industrial Bldg. Air Conditioner 8ulk Milk Tank Fafm Otlier SDeci Y Othei (SUer,lfy) ther SVecifv - ther p~fii.~ ompuie fnspection Fee Below p Fee ServiceEntmnceSize p Fee Fanders~SubfaeAers # Fee Cireults 0 to 200 qm s~ 0 to 30 qm s 0 tn 30 Am ~ Above 200 qm~s 31 to lU0 qmps 31 to 100 A s Swinming Pool Above 100_Amps Above 100_Amps Transformers Irrigation Booms Partiah'Other Fee Signs SUecial Inspection Remarks TOTAL E ~ > S~ ~ ~ Rough-in ~ I, the E ' I r~ Inspectaq heroby Final Oatc cartily that the abave . i inspaction has been j ~_f~i, „~aa. ~ This reQUesl void 18 monMS fmm SEDGWICK HEATING & AIR CONDITIONING CO. HE^T~"~ J08N0. 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS. MN 55420 •(952) 881-9000 TEST RECORD ADDRESS ~ `D~ ' ~ CITY OCCUPANT + • ~ OWNER ' ' ~ + SOLD BY ~ INSTALLED BY MAKE V'y MODEL P V ~ D C ~ SERIALNO. ~ C f~ INPUT ~ ~ ~ ` ~ THERMOSTAT ~I1~~DDD VENTSIZE VALVE~' TYPEOFLINER~~~ /f !9/2 ~ LINER S2E G~ ~ / LIMIT_ 7 LIMIT SETTING.~ ' FILTERS: SIZE r 7~ c~ NUMBER ~ FANSETTING~ ~J L WIRWG .~~+'~~t.Y'SC~.`-~ .r TESTTAG PILOTTYPE~%~~ S.Y7iLL ~ IGNITION MODEL G., LIGHTING INST. u PILOTTIMING DATETESTED l PRESSURE 3~J ~~C i PERCENTCOa I~O G 1J S COMPANY TESTING 'L~ INPUTCFH ~ I PERCENT Oz ~ By NAME OF TESTER ` ~ STACK TEMP. PERCENT CO ~ v FORM 235 (REV. 11/B9) FORM DI~i~ON: WHRE COPY -JOB FILE YELLOW COVY ~ CITV ~ 2004 RESIDENTIAI, BUII,DING PERMIT APPLICATION , R City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 ~ L} "~2- ~o ~ U U~ Telephone # 651-675-5675 FAX # 651-675-5694 y,~~ New Construction Reauiremems RemodeVReoair Reauirements Office UseUniv 3 registe2d s%e surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas 2 wpies of plan Cert ofSurvey Real TT Y -N (20%maximumbtcove2geallowed) lseto(EnergyCalculationsforheatedadditions ~'reePreSPIa~Ret"~ ;`?M 2 copies of plan showing beam 8 window sizes; poured found design, etc. 1 si[e survey (or addiUons & decks Tree P"iesRequlred Y_ N 1 set of Ene~gy Cakulallons Add'dion - indicate Aoo-sife septic system 0~-site SEptic Sys7em `~4Y ~N 3 copies of Tree Preserva6on Plan'rf lot pla@ed after 7l1193 ~ Rim Joist Detail Options selection sheet (bidgs vriN 3 or less units Date 7 / QL/ , Construction Cost Li'OZ'l Site Address G/~iU~- ~w 1 ~T ~ Unit/Ste # Description of Work ~°'~~-/L Gc~c~ ~ ~lon "1 ~^/s~'~'~,~y~ ivl~ry MuIN-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2 Property Owner~Q~/' ~'i-~~^~~ ~'`^J'o?~ Telephone #~p rI )(e ~i' 1'~I 7 y r ^ Coatractor ~~.f f ~y- rr T Address '~i~,~i'L Cc7v,rr ~l-+a-~ .f~ /~P Is State ~ Jl~ Zip /O Telep6one ~-j '~/s~' ~ ~ 3 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672 Energy Code Category ~ , Residential VentilaUon Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan~ _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Telephone # ( ) Mechanical Contractor Telepho r2 2 Sewer/Water Contractor Telepho ~ ~ J~' ~ ~ ~ I hereby apply for a Residential Building Permit and acknowledge that the i formarion i complete d accurate; that the work will be in conformance with the ordinances and codes of the State of MN 3tatutes; I understand this is not a pernut, but only an application for a permit, and work is not to start without a pernut; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. l ~r~~~„ ~ Applicant's Printed Name ApplicanYs Signature OFFICE USE ONLY ~ , Sub Types r ? 01 Foundation ? 07 OSplex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ~ 21 Porch (3-sea.) ? 31 Ext. Alt - Multi O 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? OS 03-plex ? 11 10-piex O 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg_Y or_ N? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ~ 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ~ . • , . ? 37 Demolish Building• ? 43 Reroof ' ~ ~6 Windows/Doors . . ~ ~ O o 34 ReplaCement o,- ~ 'Demolition (Entire Bldg) - Give PCA handou} ta appliw°r,H`?~ j~' i o : , . . . ,Valuation 1~~ Occupancy ~Y~- MCES System Census Code ~ Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bidgs Length Fire Sprinklered Type of Const W idth ~ ' REQUIRED INSPECTIONS Foorings (new bldg) FinallC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addirion) _ Plumbing Foundation. HVAC Drain Tile Other ~ Roof _ Ice & Water _ Final = Pool = Ftgs =Air/Gas Tests Final Framing Siding Stucco Stone Brick Fireplace _ R.I. _ AirTest _ Final _ Windows Y Insulation _ Retauung Wall 7~ Approved By: ~ , Building Inspector Base Fee T~ I . Surcharge ~ - ~ 'S ~ ~}y~/ Plan Review I C~ 3' 3 ~ p a,~,~- MC/ES SAC City SAC ~ , I Utility Connection Charge ~ y 9 i ~ J~ S(('~ S&W Permit & Surcharge r ~ v r ~ v Treatrnent Plant License Search 2~ Q(>` v i Copies Other / ~ Total ~ a a- . ~ ~O ~ > , CITY OF EAGAN N~ I.14 O S 1 ' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE:454-8100 jG BUILDING PERMIT Receipt # 7obeusedfor SF DWG/GAR EstVa~ue $149~000 Date JANUARY,y ~g 85 4902 SAFARI CT SO R3 Site Address Erect ~ Occupancy Lot 4 Block 1 Sec/Sub. SAFARI ESTATES Remodel ? Zoning Pa~cel No. Repair ? Type of Const. V Addition ? No. Stories a Name LECY CONSTRUCTION INC Move ? Len9th 62 ' ~ 9308 XYLON CIR Demolish ? DepM ; Address Int Impr. ? S Ft ° ~ih, BLMTN phone 944-9499 Install ? Q .:o Name S~ME Approvala Feee $i nddress Assessment Permit $ 555.50 ~ City Phone Water&Sew. Surcharge ~4.50 Police Plan Review 2 ~ 7 5 FW Name Fire SAC 525.00 ~ Address 5 ~ ~ ~ ~ ~ Eng. Water Conn. aW Ciry Phone Planner WaterMeter 63.00 Council Road Unit 280. 00 Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.Oif. 12~25~8 Tr. PI. 132.00 information is correct and agree to comply with all applicable Siate of Minnesota Statutes and Cit of Eagan Ord~i §nces. ~ RPC Perks 'Signature oi Permitt~~-~-7~~1~ Vaf. Date COpies LECY CONSTRUCTION Total $2, 4~'1 - ~5 A Building Permit is issued to: on the express condition that all work shall be done in accoidance with all appli I te of Minn a and City of Eagan Ordinances. Building Otficial " ~ 1985 BUILDZNG PERMIT APPLICATION - CITY OF EAGAN NOTE: ALL CONTRACTORS TIUST BE LICENSED IiITH THE CITY OF EAGAN COl4IERCIAL SINGLE FAMILY DNELLINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS $2,000 LANDSCAPE BOND ~~r~'~ ~a~~"'~ To Be Used For: ~c~~(~~r~~ ~ Valuat3on: Date: 7~ Site Address ~ ~ OFFICE USE ONLY Lot ~ Block ~ Erect Occupancy .3 Remodel Zoning -I Parcel/Sub ~~F#~~_~.ST~~}Z~~ Repair , Type of Const Addition 11 of Stories Owner L~~~ l.py~T/~~~)~ ~i~ ~ Move ~ Length Cv2. DemoliPh ^ qpth Address x,~ ~ Q ~ Int,Im r. S Ft Install City/Zip Code ~LOl1~f~C[?va , ~}1%~ Phone `-(~~q~4~ APPROYALS FEES Contractor ~Y'~'7,~'L, Assessments Permit -rj~.'~ Water/Sewer ' Surcharge Address Police Plan Review Z"1"7's Fire SAC SZ . City/Zip Code Engr Water Conn Planner Water Meter 63. Phone Council Road Unit Bldg Off ( eatment P1 ~32, Arch./Engr. APC Parks Variance Copies Address TOTAL ~y i ~1 City/Zip Code Phone S 14x 43 " Co~2x 5g= 3`~`~rC~ . 3g= 3~e~ x 5~ ' ZZa4o • i~ ~ i8 = 34Z x 44 5048 lo ~ 2~ = 2~~ x 44 ° I l 4~~ '~~x " ~°8 X 1~- ` ~ ZRh 30 _ (80 ~ ~Z ` Z I~o l~ xt2-° 1~~ 1~ - ~3`~v - ic~2 x g - ~ ~ ~l x cp ' 3 2 ~c ~ " Z5 ~ ~X ~ ~ 2~ x~12 = I1~7h x~~4 ~ 5(~44 ~ 3 2. x Y~ = 2s~ ~ ~ - Iq~3i2 Paye 1 ai' 4 . EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION ~ Z~~ OWNER: DATE: I Z- ZO -~~j: SITE ADDRESS: PHONE: CONTRACTOR: I..C'G~ ~,~?/~6'Y~ I ~C. Determine workin~ square foota9e of each 1. Total exposed walt area..... 30 ~I~q•O sq. ft. x.11 = ~j 3 2. Total roof/ceiling area..... ~S'R~S•O sq. ft, x.026 = Total exposed wall area above floor= Z77(p ,Q a. Total wall window area 1(p0, b. Total door area c. Total sliding glass~door area . ~ d. Tota1 fireplace wa11 area......... ~ e. Total wall framing area (average 10%) f. Total rim joist area. . ~ d g. net wall area above floor. - h. wall area a6ove floor...... ~ ~ ~9 wal.l area atiove floor . y~ J. frame wall area et foundation Total. exposed foundation area= q3 . o ~ , k. Total foundation window area...... . ~ ~ ' I'~~ ~ 1. Total net foundation area.above grade _ p. Determine "u".value of each wall segment ,(e,g, window, door, each separate wall section) • . ' ' . . :r..: _ a• I10~/~~ ~ A . 111'll-~~= I \I . ' . V b. ~7..a X ~3~ ~l-__ ~ . 0~.~ g , 4~ - ee.Z , d. - X _ ~ e. 2T7. Co X~~~~~ ~ OC~ _ Z ~ f. 2zS.o X„~„ . 04 = , d 9 . zo9g ~ x , c ¢ " = 83 .9 n. X _ ; , x _ X _ ' If item H3 is the same k• X"~" = as, or less than item ~1, you have met the X"U" . 0~' Z = 7, (p intent of SBC 6006 (c)f 3 . ............Total = 3 ~ 0. Z . . , ~ U , ~ ~im~k n ~ jv~l r ~ ' I I l7: .~rior Envelope Average "U" Computation ' Page 2 of 4~~. Il ' • ~ ' : ' . . . . . ii ' ( ii ~ ' I ~~I i ",i+ ~~!Ii~~i~~ ' i ~ To~al exposed roof/ceilinq area = ~ ' 593 ~ ,k ~ r ~ ~I~~ ~~I,' i~~~F~,i~. m. 9bta1 skylight area ~~0~~~~:~ I~ R ~ ~;~j ~ ~,I I~ i~ I i~' ~ n. Total roof/ceilinq~framing area (averaye~l0~)..~. ~ ~ _ I~~ i,~;: o. lbtul net insulated:rqof/ceilinq area........... ~ 7:'7 "~II~ . I I ,j i ~ ~ ~ ~ ji 'Determine "U" value for each roof/ceiling segment I~; ; ~ ~q { ~ m. ~ 0 X nUu ~ ~ 4~' ~i ~ i' ~ i ! ~ ~.L_._ ~i ~ + i I I . . 1 II II ~ rl ~ ~i ~ ~~~~~.Ji n. f59.3 g uVa ,Qt.Z..•_ _ , u,' ~ I I~r i I' I . , , •i.~: , i . I i ~ , O. ~ ~ ~~Un _ /11d1 ~ ~ . i , . ~ ' 1_Z.1! :.J_. 4 Total = ~O.z. ~~il _ If total of #4 is the same as, or less 1:han A2, you have met the.intent of SBC 60~6 {c) 1.' Alternate Buildinq Envelope Desiqn To utilize the total envelope'system method, the values established by the s•,un of items #3 and ~9 shall not be qreater than the sum of'items S1 and S2. 3~0•3 + 2. e~ 1, - 3Q,1.7 3. ~'~.Z + 4. ~7~.Z = 348•4 ~ ~ ; I ~i ~ i' ' 1 i~ . , ~ i , ~~~.I i~p~,;'f,l ~i ~ ~ ,~7~~ . : I _ _ iJ'' ~ , , i r . ' . 4~~ ~ ~'x , e;~t u . t F ~ ~ u pLA~ ~k85z-?~ ~ ~ . , ' } S~~YS$.'+*'S ~,~"'.r~,n.~5tif K~.~n._ . . . . ~ ~ t ~ 2 . t~, . . . ~ ~ - . - . , ' ~ ~ ~Lr ~ F~4 t- FT, ,~,~CpoSED ~rV~4LL $ G3~ ~ ~~5~+43t43t1~-~!~~C ~~fo.0 , = I' - ~a~ti, , ,...r . • ~k:~~E~. ~ _ ' ; a+ ~a = 4z.o W,~o.~_~. ~U L. L ~ ~ ~ 10°I.o FVl'.l:' i_2.~+4Zfi.Z8t1a= Ilco~o ~ ~J_~.~ _ ~ E_: . , p . - - 3: 1ZlM= ~~I~~~.o.+Z4t43+2d~iStZz~ Saz . ~^r, ~t~~oS~D WA LL ~~.EA _ . , 9 _ i , _ So .uLac~C:,` I $~::o x , S - _ _ ~ k.N ~ ' - )C 5 = :W.O'~F~';~~~'~~ JC ~ =3~0.0 - ~ Z77to.0 -~u_~ ;fil_~_',_+~9.0 ~ S =~s1z~~ ~ _ . , ~ 80 . t _Fu.l~. Z:;::I~~c_.o ~ ~C Q> -9Z . ~ _ _ . - _ ~ . : . ~1'1?-1=~ :Z~~; ; c?, ~C Z ZS. o _ v ,ki• ~ ; ~a- • y.- •r-- a ' . ~ A w ~ _To-r-~ = ~94 . ~ - , r; , . : , ; . _ J,Q,F1=.: . ~KaoSED GEiLIUC~ 1593.0 } Y',~, li ' ' . , I S. ~ _ ' k~ . ' ~ . . - . ' ~ - ' . . _ W Dv~tS ti D oosz5 t'~ . ~~_3~ ~ Qo.o S?. ~ ~_.~il=lao ` 1~ ~ C 2 ~ ~ ~ g ~ ~.:~t:= g.o Y ~ ~ _ ` ~ t too.~ ` ; , ~ . . t ~3•3 ~ I~/~tT~ ~ DR.S ~ ~j x~ ~ Z ~.-41fi~'lll-BO:o / ~~-fo~- Itl-S- g~, ~ a . ~ ge~-t1=~.8 7 . . 10 , - ~l lo ~.o . - , ~ ~S M~' U ~ ~ +'S ` s~~., - ~ ~ ~ , r .,.~t a : i : : .r...=~-' 4 - ~L.w.., " - _ _ ' ~ . . !'d~~~.• 'ft:u . • ~.4/Ai.L ~rr.•i':pN3 Ues 1~j`' of ~!~~a~iuR w~~ll nren t~r Ir.~rtv: coix;tructlun can::t.ur.i ia~n r-vnin~: ' --O L JOlt~1J:'~_~ll.!,.li~ni _ 11~t:!) ...e~' . _ _ . . _ . _ , • ~ ~ ~i ~ ~ ~+-p• _.4S • 3, ~n~:h~o(r. ~,~,,,~i (~rg_~ t'~7.~-----_.------ 4, tG.~L_SflTI~ . ...Z.ols , • ~.r-{~ 5. ~ji.D.tw?fo----.._.._.--•------ ---..._._..-~PZ TC ' 6. Sr.lcriur nir film 0,17 nt.[. - -.i:~i~~i K: jo~ 85 ' ~!J Uti .o°t PIC. N1 TGPVIF34 OF 1, Tnt~rlnr . ?ir '~Im O.GtI , F1W1E I+IALt. - _ . . . . . 2. y'z'.s~yp .Inlt~_...----°-~-----...~_.`45 . i 3. _4,~! ...Zva5~1....._._..._..__._._._..--~--L°l,o. • . . ' 4• ,?.5~34._ ~'-Cli_ e.. . - ' 5 . _..loZ I ~ . p. 7'7 .a G. Extcrior. air til~.~.._.~. -----~r '1'otn 1 ~ r Z2 .~I $ Fic. . n2 ~ .._~.Q 4 . fl ~ ~ u~ ' • 1. ]ntr.1'ic~Y iLr film O_(,•`1 ; 1..~__..p z. l~.-„~.5uk _ - .-._iq,cz . ----T? , . 3. ~_.w....l~~~.~ _.__.-----~.tt.t ,,r 4 • _ z~/.as.--~c~ - ._-z .o~t, ; `Ft`~l -Q 5. _~~-'?~.+r.~-.. ~ =~e_2 ti:t.'al ~ -Q 6. }:xtr.rf.or nir f.ilm 0.~1.7 r '~+_l~, . . -{sj -..-1'oent ~,.~24. `l2 ~'~l~.Y~~, .r . . . ~ _ . o ~ _._.~._-0 _ . , p u • '~~4Uc _ _ .._-_--_._Q 1. In ~.r~ac ntr Cili:i D.Gn o ~ ~_O 2. __lL__ $k.o41G---._.___...._.../~8 .:zicia ~ ~ .a.;.:~. ~ • a. r~ .L ' c~~.~~Q: . :~r~~_bw+_e':t~c..__._....--~-- , • ~ u . • ~~~n~C 5. ~r ~r~ ' r' i•. ~ 6, l::tturic`c_~ii~_.: - . - 'Q_ll ~J~~ . ~ = a.~3 q ~ _ ~=~,047 ~ sc,ntt ori r,w+u~ I ~~lA~~~'/ij .._---;1~•-.-- s` ~'~'I I ~ ~ . : : ~ . ~ . ~ ~R.r - !rl"I,- . • ~ ' ~ ~ ~ ~ .I , ~ ~ 6 ' • ~III ~ , f~ ' , , 4, ~ • . - 11 ~ H - y . ...r /(1 ~ • , I(I ~ '~rr = k , l ,rr . etc. Ha ~n ~ ~ ~ ~ :~--.,.r. ) _ ~ ~ i3 ~ _ ~0.y1~ . , ~ _ . . ~ " • ° ~ ' o ~ ~ UU'1'L': Indlcnkc ty~~r, ^R" v.~lu~:~ drnCl~ nnd p ' ~ j' ' ~ ~ ~ ~ ' placenont of in::ul,ttion. 'Y~M' l~fY6'~S1 r~ : . . . . ~ FA~.~., . . tc .,~/CE3LL`1G . ' , . ~ . ± . . . . ~ ~ ; : ~ ~ ~ ~ ~ Const~i~~' , A-Value . ' s j ~ ~IRteAx-io~r air film . 0.61 3 ~ ' s. ~n ~ ~ . sR , =Jl~--- • ~-g_~Y,~c~~ ~~y! s. ,s~c. go:o~ /l~ ~ '~1 ~~,I'~, I 4, Extcri.or air filn (sti11) 0. ~ . ~ lll+. h~~111~~:~ ~ ~ 2 ~ . 1 ~ ~ . . . . ~ . . . . : ' . . . . , . - . . . ~ .0~9 . . ` . ~ . . ~1eat Elow.~ 1• ~~rior air film ~ 0.61 u~Ced • 2. -a!~~ , . °p ' a. 2r~-dx15uL 4 '~.3'S ' ~ ~ ' • 4. Fxtcrio_air Piln (sta.~-~T , . . . _ -rot3t 2 Y . . gxc. os~ ' . r ' U = . e~ . . • ' ~ - ~ ' . • .02Z,' ' . • • • ~ . . _ ~ : • ~o~.YrR'?tri os~.,_ 't.61 w~f)y~.~~uy;.v~i~~~~~~ili`~~"d'~~sJn~.t~~c.1 ; ' ,:iQ. ~ l. Inside air filin ~ - r~r • . • . . • b~ ~~~t ' 3- ' ~ ~ 4. ~ ~ _ y~ 5. Outsidc ~ir. film 0.17 ~i1~Il ~ il~ J~c'I;U(~I~~-~ J~11 ~ . To~~ ~ ~ ~.r~,^. ~ . g~ 3 . 4" ' • 1. Sasidc air film 0.61 • . ~ ~eat tlov np • , ~ r vanted • 3- ~ ~ ~ 4. • ' ' S. Outside air film 0.17 • ~ , .~G. @6: . . . ' • • . . . Total - . . : - - - ' . : . . . . . ' !3 ~ 5 ~ti 1. Inside air film 0.61 • , ~1~'~: 2. . , ' • • ~t,.~-,~~ 4. • - e~.~?'`~rr'~ • ' S. putsi.de air film 0.17 ,u,• : ` ~ - TOCa1 ~ • • / . . ~ ' ~ . I . . . • • • ~ • , : . - ~ ' • , ~I , : Hotes Use additional sheets if more cpaea i: • . pecded for deCails and ealcuSations. ~ $eat ~ , ~ ' • • , • ' . : tlov up . - • , ' YI~i. !7 a s• • ~ , ; . . • ~o,~ar. S~F~-,ei EsrR~s E~0 pa. 5,?9 . ~ ~ . 0~ ;i~ ~ . ~ ~ • ~ ' % . ~ ~ . ° HEAT LOSS CALCULATIONS HEATING & ABR CONDITIONING CO. MiNNEAPOUS, MiNN. Weatherstrips A.S.H.V.E. Construction No. ~~sulation NTindows Doors Guide Out. Wall Int. Wali C6iling Root Floor KinA How Applied Raference Yes-No Yes-No ~g__ FI. Room Length 3 Width d Height ~5 Room Leagth Width ~Q Height ~ YJindows and Doors-Crackage and Area ~ Windaws and Doors-Crackage and Area WiOrh Me~9~~ No, o( Li eal N. Area Witl~~ Ha~pht No. of Lineal fL Aroa No. ot ana ot pane liehts af crack sQ. fl. NO' oi ana of ane li hts of crack eq. It. 3 iL ~ ,2 ' Po 3 33 a s o ~o r a~- ~ a a ~ i~ ai coar aw coe+ e~~ Infiltration 35 ~3 S Iniiltration ~ ~ Glass ~ 0 .s Glass ~ f Exp. wall Exp. well / ~1 o Nat exp. wel I 3 ~ Net exp. wall t0 W O a ~ Int. wall Int. well Ceiling ~ Ceiling - Floor ~ / 5 O Floor ` Total Btu. ~ 5~ Total Btu. ~ Required sq. ft. E.D.R. or sq. ins. W.A. Leader area flequired sq. ft. E.D.R. or sq. ins. W.A. Leader erea I. r~~Room Length a Width ~ Height ~ I. t Length~a Width /p Height ~ Windows and Doors-Crackage a3Area - Windows and Doors-Crackage and Area No. W~d~h He~pht Na. of lmBal tL Area No W,~t~ Me~ght No. uf LmOal fL Area ot ane ot oana ~i ~[s of crack ~4~ ol ane of ann h ~ts of veck s.~t. o? ~o /L a7~ / / / e~ ~ ~i / a 'o G' 3 0 Coef Btu Coef Btu Infiltration ~ ~ ,j Inlikration ~ ,3 Glass S~ 5 Giass ,sp O~ ~ Exp. wall Exp. wali / Net exp. wall 3 ~ aa Net exp. wall f0 Int. wall Int. wall Ceiling Ceilinp c~ ~ Floor 5 Floor ~7 Total 8tu. (o ~j Total Btu. aa~ ~ Required sq. ft. E,D,R. or sq. ins. W.A. Leadar area Required sq. It. E.D.R. or sq, ins. W.A. Leader area ~ I, ~.~~L Room Length ~g Width ~ Hei9ht ~ ~>fL D~ Ropn Length W~d[h ~Q Height YJindows d Doors-Crackage and Area - Windows and Doors-Crackage and Area N~. Wimn Help~~ No. of Lmeal h. Aea lYimb ~ir~qht No. ol Lineal ft A~ea of ane ot Oane li his ol crack sq. It. N~' uf ane uf pnnr. ~IS ol crack 9~~~• ' P~ 1 ' b'~ ~9 ao Coef Btu Coef Btu- Infiitration Infilt~Ation ~ Glass b ~ Glass O ~D Exp. wall Exp. wnll Net exp. wall ~ ,3a Net exp. wall Int. wall Int. wxll Ceil~ng - Ceiling d vr Floor - flopr S ~ Total 8[u. ~ Total Btu. _ ~ Required sq. ~t. E.D.R. or sq. ins. W.A. Leader area Requited sq. ft. E.D.F.. or sq. ins. W.A. Leeder area HEAT LOSS CALCULAilOMS HEATING& AIR CONDITI~NIN(3 CO. MINNEAPOLIS, MIN1J. Weatherstrips A.S.H.V,E. ~ COnBtruCtion No. Ineuletion MTindows Doors ~uide 0~. Wall IM. We{I Aefarenca Gilinp ROO( ~ FIOOr Kfnd How Applied Yes-No Yas-No ~g__ - ~ Noom Leagth S Wldth H~Iphl ~ il, E~ Room Lenpth Width ~ Heiyh~ g. YJindnws and Doois-Crackage'8Rt1'qrea Windowa and Doors-Crackage a~Aree No. W~~~h Nniohi Na. ol ~inael II, A~eN y/ H ol ann ol ans li hb ol r k 1b ' ~ No. idin a~phl N0. ol L~neel It. Aren ~ G " el of • II hla 1 r k It. ~ a ~ i 01 ' ~6 ~a ~ D ~ Coef Btu ' . Coei 8tu Inliltration / InHltrstion (P _'~j/1~ Glass . p 3 Glaes . ~j ~6,~ Exp. wall Erp. wsll , Net eap. well S(p NB! exp, well ~ 3 (o ~ Int. wall ~ . Int. well . ' . Celllnp , / Calling 3a Floor ~ . - . Flaor J total Btu. ~ TTotel Btu. ~ Requi~aJ sa, ft, E.O.R, or aq. Ina. W.A, Leeder aree Required ~Q. It. E.D.R, or aq. Ina. W.A. Leedar erae 'FL qoom Length ~[~L Wfdth HelBht . FI. , ~-T Roam Lenpth ~ s Width /Q Heighl Windows nd Ooors-Creckage and Area Windows and Doors-Creckape and Area No. W~~n Heipht No. ol lineal 11. Aree . . ~i~ih Nxiq~l No. ol L~nsal 11. A~an of ~ ene o~ ana li h~t of cra o. f~. No. o ~ p~ ~~y 1~ hle o~ Cr ck •.~I• ~ o /G / a~5 d e7 /L ~ d/ coe~ ew coo~ -e~~ Inlihretion ~ / s . Infiltration ' q9 tf a Glass 5~ .a ~ Glass ~ 07( ,57 /OJrO E.p. well ~ ~ E~P• wall Net exp. wall . (03 /p 3 Net exp. wal~ (m ~ Q Int. wall Int. well Ceiling - Ceillnp - ~~D ~Q~ F~o« Piao. ~ - 5 - (otal Btu. ~ ~ 3p ~5 Totel Btu. ~ ~ . ~,3 Requlred sq. It. E.D.R. or sq. ins. W.A. Leader area ' Required sq. ft. E.D.H. or sq. fne. W.A. Leeder area fFI~L ~V Rodn Length Q Width ~p Helght . FI. r~ Roam Length Ot. Width 'J Height Windows an Odws-Crackege and Aree Windows and Doora-Crackage and Area ern Na~ n~ Na. ol L~neal h. Arsa We~n ~~n ~n Nn. nf L~~eal. 4. A~en No. a~' a~e o~ nne li hta ol cre k •.~1. ' . N~' ol ~ en . n~ nax 1~ hq of cr k s. h. - ~s~ c a 8 coer ew coer aw i~diltratim / J/ InfHeration ~ . 31ass ~ ~ U a~ Gless ~p ~ `-,ep• we~l Exp, wnll Net exv. wall - O ~p Nat eHp, wall (o ~j 33(~ nt. wall . Int. wsll ~ ~9i1~n9 . C611inp ' ~ 3 'Icxu • 5. - F1~7o1 . ~~ial 9iw . ~ Totel Btu. 02 HEAT ~OSS CAICULATIONS HEATINGB AIR CONDITIONING CO. MINNEAPOLIS, MINN. Weatherstripa A,S.H.V.E. Constructlon No. . ~~suletlon W~indows Doors Guide Out. Wall Int. Well ~ Ceiling Hoo! ~ Floor ' Kind - How Applied Reference Yas-No Yes-No ~y , F~• ~ E uom Lenqlh / Wldth Halgbt FI, Roan LenOtb Wldth Helph~ Windaws and Doois-Crackage an rea Windows end Doore-Creckage and Area rya; W~tl~h Ha~ah~ No. ol ~ineel h, Aren yy d~h Ho~pht Nn. o~ l~nsal h. Area of ana al ene li hcs of cr k H. ' - N~' D/ ~ ana ol ene li hts ol e~ t ~~-l Lo0 (L 1 c~$ Coef Blu Coel Btu Inliltration 3/ / J/ Inllltreelon Glass ~ ~a~~ Gless Exp. wall . Exp. well • Net exp, wall S Nel axp. well - Int. well ~ IM. wall ~ . Ceili~p Ce~llnp . ~ Floor . ~j - Floa rocei ew. 833 'roiei e~~. Roqul~ed sa. It. E.O.R, or eq. Ina. W.A. ~eader erea Requfred cq, tt. E.D.H. or aq. Ina. W.A. Leeder erea Pl.a 3Room Lenglh ~ Width ~ Height FI. Roam Lengtb Width Heiyht Windows and Doors-Crackage and Area - Windows and Doors-Creckape and Area No. ''~'~d~h Heiphl Na. ol L~neel It. Aren W~~~h Ni~~phl No. ol L~neal 11. 4rae o ene o~ ans li hta ol crac o. 4. NO' ol ene of nnu 6 Als ol cr k s. h• ~ a Coe~ Btu Coef Btu n(iltration ~ [~7 ~~(p Infiltretion ~ iIE56 Q ~ GIa6s ixp. well . - EMp. well Vet exp, wall . ~O Gs Net exp. weil m. wall Inl. wall - ~eiling G . Ceilinp 'loor - J'`'" - Floor ~ . rotal etu. ~ imal ew. . aequired sq. It. E.D.R. or sq. ins. W.A. Leeder area ~ Required sq. IL E.t1.H. or sq. ina. W.A. Leeder area ~ F~• ~ Roan Length ~ Width ~[7 Halpht FI. Rport~ LenBth Width Neiph[ Windows a d Dd6rs-Crackage end Aree Windows and Doors-Crackage and Area y~ tl~l. He~ph~ No. ol L~~anl fl. 4raa w~ip Hr~~phl Nn. nl U~eal 1~. A~en of ~~rb ol nne N h1! of ra k ~V• N~' ul ~ Bn ui nnn h h~5 0l Cra k COB( B~Y C08~ BtO' f~11~tf811p1 - ~~1~i~1111I~G1 ' . i1e38 ~ ~ GIae6 - :xp. walt EMp. wntl Jet exp. wall (Fj Net exp. well nt. well ~ Int. Well ;eilin9 / O Ceilind . 'IOw ' • ~F~Mn btal8tu. ~ TotelBtu. I 2/84 ~ ~ i CITY OF EAGAN APPLICATION FOR PERMIT SEWER AND/OR WATER CONNECTION (PlEASE PRINi) 1) PF~PEk7t1' ADDRFSS: ' r~nr" DE..~GRIPTION: ~ (Ir~t/Block/Subdivision or . . ~ I"r F`t7~'~?~ S?~[;CIL'RE, DATE 0° QRT_G?..~,L ~;I'i.DIIQG Pu~~L~'T ISS~1r\~: ~ - ~ ~ . . . ~i'f'.J. '_'1/ _=3 j ~ PRESE3T ~^.;7INr:/PROPOSf~J L15~': J~( R-1 SIlVGL~E FA2ffi.Y ~ ? R-2 DUPLEX (~S~A UNiTS) f O R-3 ~74v'NfiOUSE (THREE + ULVITS) ( UNTTS) ? F~4 APARIl~NT/C~IDOMIAIICP~il ' ( UNITS) ? 0~7AL/RETATI,/QFFICE ' O ~USTRIAL p 1NS'TP2tPF20I~+.L/c~7ERNhm~Tt' _2)._._...APPI,ICANr-- ..__._~PLEASE PRINT)_---... _ - . NAME. - - - ~ ADDRESS: } • ~ CITY, STATE, ZIP: t ~ ' 5 , 3~ - P E PRINT . FOR CITY USE ON~Y ~ PLUHBERS,CICEHSE• # ADDRESS: Active ~ ~ CITY, STATE, ZIP: ~x i d I ~ f Re rd ~ ~ -PH~: PLUMBEB LICEHSE $ ni i 4~ ~~p~~~~ (PL£ASE PRINi) ~ . NF1ME: ADDRESS: _ ~ CITY, STATE, ZIP: PHONE: 5) INDICATE WHICH FF~iMIT IS BEING RD~UESTID: ~ CONNDGTION ~ CZTY SE47ER . ~ CONNbL^TION ~ CITY WATEft ? CII'f~2 (PLEASE DESCRIBE) 6) INDIC.ITE ONE: ? PLEASE HOID APPROVID PERMIT £OR PICK-UP BY ONE OF ABOVE ~ PLFASE NfAiL APPROVID PIIL~1iT ~ 1, 2,~ 4 ABOVE ~Circle one3 si~mrn,-~: n~: ZZ . . ~ . . ~nl~yFet •~wware,asas~~rrarkr:. .~:~~s+~li+ti4isSria~ji#+?:iiii~~sw~?~a~aii.~~r!I..r+'.,..ae.'.a'i~r"~rar~'!l... , . wc±~cae-:. F O R C I T Y U S E O N L Y • PERMIT # ISSUED _ ~ . . F...ES • $ /U SU SET~IER Pz1RM2T ( INCLEiD: SUP,CHARGE) $ ~~~t~U WATER PERMIT (INCLUDE SURCHARGE) , $ i ~ WATER METER/CQPPERHORN/OUTSIDE READER ~ $ WATER TAP (INCLUDE CORPORATION STOP) $ SEWER TAP , $ IS=~~ ACCOUNT~DEPOSIT - SEWER . a l,~G[~ ACCOUNT UEPOSIT -'WATER $ S'~=e~, o U WAC _ _ 3-3--~.v-_ _-SAG - - $ TRUNK WATER ASSESSMENT $ TRUNK SEWER ASSESSMENT $ LATERAL BENEFIT/TRUNK SEWER $ LATERAL BENEFIT/TRUNK WATER $ - ~3.L, a t~ OTHER - - . S TOTAL $ AMOIINT PAID/RECEIPT , 4~ DOES UTILITY CONNECTIOLV REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN FUBLIC R~ADWAY"" MUST $E I5SUED BY TfiE NO ENGINEERING DZVISION_ LIST AS A CONDI-- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROV£D BY: TITLE: ~ DATE : ~ ir w. iJ~ ~~lfr wri~l ~kf~ /F ~ 1R sFl~ /t~lO l4 i A Mi4 RU/ d'kA ~k~ 14 ~l~7 ~4ii /7.i wEO!! aJ7 ~k~ R~ rr! iJrt~ ir~ CASH RECEIPT - • CITY 4F EAGAN ~ . . 2,-,99 EAGAN, MI S TA 55121 DA ' 1g ~ RECOV D ~ PR AMO $ ~ I ~U & OOL`LARS ~oo ? CASH ? C POR /`~lC/1i \~/--1'~ ~.ci fG. ~ "e.~.1; FUNO CO~E /~fAOUNT Q /U / / Thank You Y N_ 59312 " White-Payen Copy Vellow-Posting CopY Pink-File CApy ~E. fit oF g:S~ t~n ~ ~ 3795 PILOT KNOB ROAD. P.O. BOX 21199 BEA BLOM9UIST EAGAN. MINNESOTA 55127 ~^OyOf PHONE: (672) 454-8100 TFiOMAS EGAN JAMES A. SMITH JERRV THOMAS iHEODORE WACHTER DA.'"EI: M8y 10~ 1984 CouzilMembers iHOMAS HEDGES Cily AtlrtvMStrator EUGENE VAN OVERBEKE G~v Cier¢ P~mzrTC assESSr~ar sF.~cH ~ RE; Safari Estates, Lot 4, Block 1 4902 Safari Court So. Eagan, MN 55122 Parcel # 10 65850 040 O1 Requested by: DAKOTA COUNTY ABSTRACT C0. 1250 Highway ~i55 Hastings, hIlV 55033 I CERTL°Y THAT ACCOEtDING `!b 'I73E Rz'CORDS OF SAID O~ICE, TI-IF: x'OISrJi+TII~~ Ir'1PROUET'L~T~TS ARE COD7TFT~IPI~TED OR PENDING AF"TF12 HAVI?~~ B~EN APPROVID, P,A1~ ARE L~i^7 II~T '!'E]E FROCF.SS OF PLANNING OR COMPLETION. ECinq of Imorovement Approximate date of Com~?letion Approx~.mate cost NONE Fg~IVER: Neither the City of Fwgan nor its ~nployees guarantees the accuracy of the above in- formation which was requested by the person or persons indicated. Nor dces the City or its ~nployees assume any liability for the correctness thereof_. In consideration for the supplyirig of the indicated information in the above form, and £or all other consideration of any nature whatsoever, any claim against the City or its employees rising there fran is hereby expressly waiveci. Levied assessments ~ be paid to the COi]APPY TREAS[JRER AT HASTINPS, M1~T. 55033 or CI'°Y OT_' EAGAr!. Vexy truly yours, SPECIAL ASSES DIVISION ~?!G. 1HE LONE OAK TREE. ..1HE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNIIV 89-49 ity oF eegan 3830 PILOT KNOB ROA~. P.O. BO7( 21199 8 9 2 0 4 3 9 6 V~ ELL~ON EAGAN, MINNESOTA 55121 nnwor PHONE: (612) 454-810p Special Asaessment Search harVus Ecnr, P4V1D k GUSTAFSON PAMEIA McCRFA 7FIEODIX2E WACHiER Date: January 17, 1989 1HOMAS HEDGES . CkyPdminehalor Requssted By: R92 IO~GSBSO-O~IO-01=. ~ENE4ANOVERBEI~ L4 Bl Safari Estates°~ a,,,c,~ Stewart Title Co. of MN on the attached form is the City~s response to your search request on the identified property. The information includes the original amount of the assessments and the payoff amounts of the assessments on the parcel. In addition, pending assessments are included for improvement projects that have been ordered to be installed by the City Council as they may affect this parcel. The levied and pending assessments may or may not reflect the complete assessment obligation based upon the parcel's current use or zoning. Certain parcels have not been assessed at the appropriate rate per their zoning/use. The City's policy is to review the assessment obligation of parcels at platting, replat- ting, rezoning, waiver of platting, and grior to the issuance of conditional and special use permits and certain building permits and in other unique situations. A condition of approval requires the parcel to assume its additional assessment obligations that have not previously been levied for existinq public improvements. The City's Engineering Division can provide further clarification of this policy, if you desire. WAIDBR/DISCLA2MER• Neither the City of Eagan nor its employees guarantees the accuracy or completeness of the information provided which was required by the person or persons indicated. Nor does the City or its employees assume any liability for the correctness thereof. In consideration of receiving and using information on the attached form and for all other consideration of any nature whatsoever, any claim aqainst the City or its employees rising therefrom is hereby expressly denied. Pending assessments cannot be paid until levied. Levied assessments can be paid to the CITY OF EAGAN. Very truly yours, ~ ~ SPECIAL prS'SESSMENTS Attachment THE LONE OAK TREE. ..THE SVM80l OF SIRENGTH AND GROWfH IN OUR COMMUNI9V ~ TRAN~A~.:,TT~~r..i :!:C7;. F~,i~B SF'~CItaL ASSE~SMFhITS ~i1='ECIAL ASSCh<~i`1E:h!'I'B SEFtRCH .-^.+UMMARI' F'I;i_,i~•F.::RT'v I,17, fOD~;Yg DATE. 01/]J/84 ---SF'ECIAL FLFIGS---- 1-~- 3-4-,°,-6-; -8--9-1 S? i l_)-h.=~fa,`:~{.i-r:~i4i_i--f ) _ S. A~ d'. A~;SES;~;'?~~~T UESCR. Yli YR~ RA'T'L T~TAL AIVN. F'FIN, F'AYOI-I- COMMEI~T 10+?(-"ii; l~."_5.=;~:-';^.`;=1 81 B.n<i% 7iq7.~~r .C.i(7 .~~p PREF'Rl' i!iricSvl UJ T~'--;_'°~4 81 S S.UIY,: 4°~1.54 .OC> .iif~ FFiEF'AY iG~i6.~2 ~ TR--l:`.,'`..:,4 21 5 8~t?~~i. 451„64 .p0 .~i~i FREF'AY li~i~b=:~; SS '1"I~--:'~~4 `..i S.irC>% 86E~.9i .QC~ .~ii1 FFEF'AY 1i~nE.~:.'_: S"I'-~.~4 P 8:l ~ 11.{i~r% 154c,.6.= .i~i~ „i_~ci ~'FEFAY 1:~Oc97 ~T, ~li B1 1~S 1:.00% iU.'7.54 .U~? .~i~~ F'REF'AY liin6~8 GB-.';1 81 10 i:t,c~rp;: S~i:.ii~ .pi~ .i~i~ F'FEF'AY *~~~rn~c 5,ip1r1ARY O~ ~lr..f'TVL.. .0~~ .i.~i~ .~?i~ ~~a~r~-r TNI:; YEA!~: S TOT P':r .Uia a e~ a M W ~ . ~ CERTIFICATE OF SURVEY . . FoR - _ co~s~,-~~ ~o~ _ _ Lof~ .aio~,~i sa~a" ES ~Q ~~s l l T~,~o~a ~o., rr~~ ~ ~ q9c.v) l , ~~aS~/ 4i9~p.ol ~ `5 7i o io s9 s ~ X R~ J ~ I~I - ` ~ ~i ~ V .N - 0 ~ I ~ n~n ~ ~ ~ ' ~ 32S. 33 y~ ~ o , r o~, ~ l , ~ ~9~ ~ ~ / ~ ~G~~ ~ 1n (s~~.e) ~ ~ ~,j ~ ~Q A P ' ~ d95~ Z, ~.~X~ V ~ ' ~ ~ ~-,~.o ~ ~ ~ n' y / o~ ~ . `c o A ~as~~) 0 % i J Ni N~ 01 / . ~ g y;, ~3° r, 5,~~' , o ~ ~,a,)V1 ti o ~ / Ov m N m a~ ~ ~as.~~ `j' 0 0 N ca+tq I = ~.e-----, ~ ~ ~ ` ~J~. ~ ~ ~ ~ ~ o..t , a41 I y p j Q i~.g3 ~ l _ ~ ^ m eN, ~a.~~L i . :nc.~ - 1~ ~ ~ ~ ~ / o ` . , ` 9 , ^ ~ ~i T ~ ~ ~ ' ~4r."' A iii ~ j ~ ~O ~99O.e~~ti'_... ~ ~ - !O 4~ 8~P ' r 9 ~ i 9~B.b) ~ ~ l,~ ~ ~ 4t99~~ 9p~~g ~ Q ~ ~ ~/I 1^ 49.Vi i N 1 aQ ~ / ~ ~c ~ 1 ~98z z5 So.n--~j~-_..____ _ _ ~ \ ^U ~ 5 g~ o ~ ~ ~ I `~3 'pgi~ 9~9.3g iu f N 1 3Q6~6F - ~ ~ lEOEND o fron monuments PROP03ED ELEVATIONS (v~ss~ exfstiny elevatfons ~o.s loweat floor 4~s-e proposed elevatlona 9~s•s par8ye tloor direction of propoaed surface drainape ~~s.~ ~op of foundatfon ~ j 1 hereby eertly that thia survey, prepared by me or unde~ my direel supervlelon, is a true File No. Hansen Thorp and correet teprasentatlon of the boundries of the above described land and of the Ioeation of all bulldings, if any the.eon, and all rigible encrwncAmeMs, if any, from or on SS Z87 ~ Pe~~~nen ~~S~n ~nCi. saldlandandlhetlamadulyregisteredlandaurveyoru~derStateolM!nnesota5latutea ~ Sectfon 328.02 to 328.18. Book- Poge ~ ComulNng E~ploeero a Land Survsyon - 7565 OfHee Ridpa Circls 30 - 3 9 / EAen Prslris. MN 553M•38~•1 ; '~~vr ' ~ ~ Scole m _Y'l. ' ° (612) 82&0700 - ~ Date: l•~'~ ZU ~ 8.5 Reghtration N2 _/34_=l7 30 ~ ~ CERTIFICATE ~ SURVEY ~oR co~s~s-~~ ~o~ Lof~ ,B/oc,~/, s~, f'~ri~ Es ~a ~~.s / ~~t,~o~a C'o., /77~ ~ 9~p.~) l C~~.s~/ ~.9~0.01 ~ `l` io s s9 ~ ~ - x ~F ~ ~j m ' ,N - - - o~o ~ / ^ \ 3 ~q p Fi ~ ' \ ~ \ \ ~-4z~ `s.33 , ~ ~9~~ ~ ~ ~ ~0 G~j~ ~ ~ 1n (v~~.o) ~rP y m p ~ m ~ ~ d95~ Z~ ~ J ~ ~~x fD V ' ~ ~ ~ I °l9J.o Q ; ~ / \ ~ 0 A 945~7~ Q ~ i J a~ ~ r0• ` `~3 0 9~°"%~ ~ ~ V QO ~ q~V.D ~ \ 0 q13~~1~ r N ~ ~ / OQ sc ~av.~, m v ~1p p ~„~.h / J~/. ~ ~ 'A _ ~ ~ \ ` \ '1' ~ ~ ~ o.et / ~ av ~ e. y o ~ 1' q ~~~ea ~ / ~ n m e ~ro ~ / ; ~V 7 n ~ ~ V ~ ~~o , ~ ! I~7 ~ ? ~ ,o~ J fY) ^\1 ~ /D ~9a~.fe ~ rz.o i / / ~ Y/ .8~~ ~m ~ I(I ~9~B.c) ~ . I' ~ 9ie.9~~ y~4~e , o~~ ~ l ~ V 49.p~ ' N ~ ~ 9Q ~ Y (y~~ \ ~ ` ~ ~ ` I 9~ SO.p/ ' / \ ~v U1 25 J / Sgzo4 , ~ \ r,, ~ 3 'pg.E 979.36~ ~I ~u H ~ 306 . 6 g _ ~ ~ LEOE~tlD o iron monumen4a PGtOP03ED ELEVATIONS (e~sa) ezletfng elevotiona ~s lonrost 41oor e-,s-e proposod elevations 9~ss p0rage 41oor direction of propoaed surfece drnlntt8e e~s~s toD o4 4ounCatfon ~ I hereby certify that this survey, prepared by me or under my direct supervleion, fs e true File No t~ I Hansen Thorp and correct repreaentaNon of the boundrles of tAe above deseribed land and of the { locatlon of all butldings, N any the~eon, and all viaible encroachments, if any, from or on 8S Z87 ~ ~ Pe~~~nen ~~$~n ~nC. safdlandendtAetlamadulyregfsteredlandauroeyorunderSieteofMlnnesataStatutes t Secrion 328.04 to 326.18. Book - Page f Co~multlng Englne~rg 8 LenO Survoyore ~ , 7585 Offlca R6dge Clmlo 30 - 3 9 . Eden Prelrie, MN 55344-3844 ~-v«G ~~i. Scole `m tsixleze-a~oo /Z~ZU_g5 /3~37 /"=30' Dute: Regfatratian No. RESIDENT OWNER N Name: h 11« Phone �5 �Sl Q Address City Z•` 1 l>: r 3 c i CONTRACTOR N Name: ]Z i N i r l e ---..4 p nip__ City: id f f S TYPE OF WORK N New Replacement Repair Rebuild Modify Space _Work in R.O.W. Description of work: PERMIT TYPE R RESIDENTIAL Water Heater 4 Water Softener Lawn Irrigation Add Plumbing Fixtures RPZ PVB) Main Lower Level) Septic System Water Turnaround New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) (add $136.00 if a 5/8" meter is required) burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES CityofEa�all 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 2008 RESIDENTIAL j TIAL PLUMBING PERMIT APPLICATION C 6A Date Site Address: `t i Tenant: Suite 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 star without a permit; that the work will be in accordance with the appro plan in, the case of work which requires a review and approval of x 1 1 Applicant's Printed Name FOR OFFICE USE Required Inspections: _Under Ground x Applicant's Signature For Office Us Permit Permit Fee: Staff: }hL Reviewed By: Rough -In Air Test Gas Test _Final Date Received: E412009 Date: City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4902 Safari Ct S Lot: 4 Block: 1 Addition: Safari Estates PID:10- 65850- 040 -01 Use: Description: Sub Type: e - Furnace & Air Conditioner Work Type: Replacement Description: Fumace & Air Conditioner Comments: Questions regarding electrical perm 952- 445 -2840. Fee Summary: Contractor: Sedgwick Heating & Air 8910 Wentworth Ave S Minneapolis MN 55420 (952) 881 -7739 ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - equirements should be directed to Mark Anderson, State Electrical Inspector, $50.00 0801.4088 $0.50 9001.2195 $50.50 Owner: Jeffrey L Hansen 4902 Safari Ct S Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: Issued By: Signature Mechanical EA081730 01/22/2008 ePermit I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State ; . . .. Use BLUE or BLACK Ink ---------, j For Office Use I I • `,.��'J.� I C�� O� �n �n � Pertnit#: �� A 11 I I Y] I tl 11 1v�p j Permit Fee: /. �p I 3830 Pilot Knob Road �E�E I I Eagan MN 55122 � Date Received: Phone:(651)675�675 1�,F� �� "��"� � � j Fax: (651)675-5694 � Staff: � �------- -------� 2014 RESIDENTIAL BUILDING PERMIT APPLICATION � Date: �•�J�• �� Site Address: ~"l-1,�Z. �'_�C'��f"� (_(xN'�'F- S • Unit#: � . �� Name: ��f•/ k -JVL�� 'v�� Phone:S�S�-[o�S1•d��1y <' ResidenU Owner Address i c�ry i z�p: �►�ibZ �7G►�cr►ri �.��r� S. Applicant is: Owner �Contractor 7�/p@ Of WOPk Description of work:�Up:w- �o�r '�ovrr�o►,,� a��t ck� 1ZQ�r- �EV0.arkr.. � Q�WI� 51�+ Construction Cost: � vt.SCX� Muiti-Family Building:(Yes /No C ) Company: �'OarY1Eb �r�ran'�e,�.w�� Contact: .Jpin✓� �:`�t.r- Gontractor Address:�Tt� /�* 5� �✓ �,.�G �� Ciry: �� vp�a. State:/�?J Zip: / y Phone:�A�a��f�1 Email:_ �W1�►�11q��'J. ('JiZ License#: L�' 1�1117Z� Lead Certificate#: /Y�� Z��v�'7/- 0 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) b � ir� 9 . �� COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 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 8�Water Contractor: Phone: NOTE:Plans and supparting dacuments that yo�r submit ar�e considered to be perb/lc 3nforma�on. Por#lons af the infarmation may be classlfied as non-�rttbllc if you prov�de specl�c�asans[t►a#wau/t�p�rmit the C�'ty�o concluale that Nre are trade secrets. ' CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Ca1148 hours before you intend to dig to receive locates of underground utilities. www.qoaherstateonecall.ora I hereby acknowledge that this ir�formation is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eaga�; that I understand this is not a permft, but only an application for a permit, and work is not to start without a permit;that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x .J�.r. 1M.• 1N1,:1�e�,r ApplicanYs Printed Name Applicant' ignature Page 1 of 3 � . . � �io� .�� S _ �S,�fS DO NOT WRITE BELOW THIS LINE �� SUB TYPES Foundation Fireplace Porch(3-Season) Exterior Alteration (Single Family) � Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi) _ Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous _ 01 of_Plex _ Lower Level _ Pool _ Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* _ Addition _ Move Building Reroof Demolish Interior _ Aiteration _ Fire Repair Windows Demolish Foundation _ Replace _ Repair _ Egress Window � Water Damage _ Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION q�r Valuation ��— Occupancy ,�l,G• MCES System "' Plan Review Code Edition Q7'? SAC Units �-- (25°/o_ 100%� Zoning "1 City Water -- Census Code i�r3y Stories '�" Booster Pump �" #of Units I Square Feet ! PRV '"' #of Buildings � Length � Fire Sprinklers '� Type of Construction � Width � REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) �L Final/No C.O. Required Foundation HVAC_Gas Service Test Gas Line Air Test Roof: _Ice &Water _Final Pool: _Footings _Air/Gas Tests _Final � Framing Drain Tile Fireplace: _Rough In _Air Test Final Siding: _Stucco Lath Stone Lath Brick � Insulation Windows Sheathing Retaining Wall: _Footings_ Backfill_Final Sheetrock Radon Control Fire Walls Erosion Control ' Braced Walls ---� Other: !� Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee �j g" °.=°- Surcharge Plan Review ?� ..r MCES SAC City SAC Utility Connection Charge S�W Permit&Surcharge Treatment Plant Copies � TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA125518 Date Issued:07/25/2014 Permit Category:ePermit Site Address: 4902 Safari Ct S Lot:4 Block: 1 Addition: Safari Estates PID:10-65850-01-040 Use: Description: Sub Type:Reroof & Siding & Windows/Doors Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and house wrap and leave on site. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Valuation: 12,000.00 Fee Summary:BL - Base Fee $12K $221.25 0801.4085 Surcharge - Based on Valuation $12K $6.00 9001.2195 $227.25 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 - Jeffrey L Hansen 4902 Safari Ct S Eagan MN 55122 James Barton Design Build Inc. 5920 - 148th St W #100 Apple Valley MN 55124 (952) 431-1670 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA131965 Date Issued:07/16/2015 Permit Category:ePermit Site Address: 4902 Safari Ct S Lot:4 Block: 1 Addition: Safari Estates PID:10-65850-01-040 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 - Jeffrey L Hansen 4902 Safari Ct S Eagan MN 55122 (651) 687-0174 Urban Pine Plumbing & Mechanical 780 Igelhart Ave St Paul MN 55104 (651) 888-2275 Applicant/Permitee: Signature Issued By: Signature