1363 St Andrew Blvd�9ow
City of Eaall
3830 Pilot Knob Road
Eagan MN 5
Phone: 651 675-567
ax: (651) 675-5694
JUL 2 9
Use BLUE or BLACK Ink
For Office Use
Permit #: / (Z ,-36
Permit Fee: 6 ®f 00
Date Received:
Staff:
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
J
Date: I J I i( Site Address: 1 ;(/2-2) &f4 -I 74- RI— % P Unit #:
RESIDENT
OWNER
Name: A), )C + Q,e) SA /1/1 L5 Phone: /05H 1450
-" 7'YS
!�/
M n
Address /City /Zip: L'VJ�� �"
12)(03 sA-! nor A -to O Vic .) D x J
�
Applicant is: Owner K Contractor SS I (,3
TYPE WORK
Description of work: �) Era S---fQ I17 6C) L T {- p l ( � J /
Construction Cost: MI, `I b-/ ' Multi -Family Building: (Yes / No )
NT
CONTRACTOR
1� l c (i !� E�ZS ---Agtact: 4- ( iTZ
Company: oR;rii' � I (,ttl. l � � � t�
Address: 114d 1 L- 2 NE- No City: oeu) gore-
i1/1 I) Zip: 5S14 a -7 Phone: ---7iG- '':3,5-6//::. y
License #: pC(J b f J Lead Certificate #: Id frr-""I'' D — l ''-7
�'r
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
_Yes _No
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting door t rl yt std reiad to I n.
the information maybe wed s non rlilc ilf you proves o'r o
Cly
r
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of ans.
Applicant's Printed Name
x
Applicant's Sig
Page 1 of 3
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CITY OF EAGAN
3830 Pilot Knob *Roa , P.O. Box 21-199, Eagan, MN 55121
IH ON E: 454-8
B 100
UILDING PERMIT Receipt#
To be used for Est. Value Date 19
Site Address O FFICE USE ONLY
Lot Block Sec/Sub. I f F•` On Site Sewage Occupancy y
MWCC System Zoning
Parcel No. l l
C
On Site We
l (Actua
)
onst
a Name
City Water
(Allowable)
W PRV Required # of Stories
3
o Address
City Phone ?
Booster Pump
Length
Depth
0°C Name S.F. Total
•
.
o Address Footprint S.F.
P City Phone APPROVALS FEES
`
F? Name Engr./Assess. Permit `
_ g Address Planner Surcharge '-
¢Z
W City Phone Council Plan Review
s Bldg. Off. SAC, City
I hereby acknowledge that I have read this application and state that the
Variance
SAC, MWCC
_
information is correct and agree to comply with all applicable State of Water Conn.
Minnesota Statutes and City of Eagan Ordinances.
Water Meter
Signature of Permittee Road Unit
A Building Permit is issued to: Treatment P1
on the express condition that all work shall be done in accordance with all
Parks
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official TOTAL
' Permit No. Permit Holder Date Telephone #
Plumbing
H.V.AC_ 9 F !? < <F
Electri c; 88 ?P
Softener
Inspection Date Insp. Comments
Footings 1 1 67
Footings II
Foundatio
Fram
ing F-7
Roofing
Rough Plbg
Rough Htg ? ?s p f v
Isul. .TdlST e ?/?
Fireplace
Final Htg. _ 2,1 '9M
Final Plbg. ? , A
Bldg. Final /ut yR./ r?a?? -G+uc/lt/rF /i
Cert Occ. S
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
• , . V
Tatifiratt of (Orruvaxtry
4Citp of Cagan
MrvarhltPttt of Wuiibwo 3wertim
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following..
U. cla?fication SF M/xkR Bldg. Permit No. W5
Occupancy Type R3?c 1'j 1 Zoning District R 1 Type co". Vh
Owner of Building SONS OMS. IRItCTION Addrew 4370 FAN RM, EAM
Building Address 1=163 ST. i1.1`FI 04 BLVD. (gpfity T9, B5, FAIFWAY HMS
Date:
Building Official
POST IN A CONSPICUOUS PLACE
PERMIT #
MECHANICAL PERMIT RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
Site Address 1 1
Lot 9 Block
y Name ?-?? ^ ??
Address
c City ??- ?--
BLDG. TYPE WORK DESCRIPTION
Sec/Sub Res. New X
Mutt Add-on
Comm. Repair
y y _011611 Other
one
Name I_ I
c Address y?0 C- a'
p City
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
1( 3(-) M BTU
M BTU
M BTU
M BTU
CFM
FEE:
S/C:
TOTAL
FEES
RES. HVAC 0-100 M BTU -$24.00
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA.
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
d
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
CONTRACT PR
J
Site Address
Lot Block
Name r ing
? Chester Ave
c !Zrthf y
City E Phone
Name Construction
"
3 Zann -Road
Address 43 M
0 452-472
City Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE -$12.00
MINIMUM - COMM/IND FEE -$20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
i
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
PERMIT #
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: J
PHONE: 454-8100
BLDG. TYPE WORK DESCRIPTION
ec/Sub Res. ' New `
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
N.Q. FIXTURES TOTAL
Water Closet - $3
00 ?
.
Bath Tubs - $3.00 -?
Lavatory - $3.00
Shower - $3.00
/ Kitchen Sink - $3.00 -3
Urinal/Bidet - $3.00
! Laundry Tray - $3.00
Floor Drains - $1.50
- '
I
Water Heater - 51.50
=Whirlpool - $3.00 3 `
-/Gas Piping Outlets - $1.50 ry
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
? -771
`f
Rough Openings - $1.50
FEE:
STATE S/C:
'
r
GRAND TOTAL: '
CASH RECEIPT
CITY Of FEAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE 1g L)
RECEIVED / ` l f I - ?-1L- /
tr
FROM
AMOUNT $ jj ?ljc?? c? C
8 DOLLARS
,m
? CASH L?CHECK
FUND OBJECT I I J ' I AMOUNT
Thank You
BY l i'? `?vvv
White-Payers Copy
f
814"" 0 18) Yello p o sting
Pink-File Copy
BLDG. PERMIT NO.
01-3210 Bldg. Permi
01-3422 Plan Check
01-3445 Surch./Adm.
s
01-3446 SAC/Adm.
0172155 Surcharge
7t-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Perini
20-3743 Sewer Permi
79-3866 Sewer Conn.
X3855 Park Ded.
TOTAL
CITY OF EAGAN -
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH ON E: 454-8100
BUILDING PERMIT Receipts b-j??JV
To be used for
Site Address
Lot 9 Block S
Parcel No.
a Name SONS a
3 Address 4370 RI
o ,Ity EAC,AN
0
O Ntme SAM
0 a Address
Cr
City
f?
W W
Name
SF okt;VAR Est. Value $129,000 Date APRIL 26 ,19 ti8
1963 ST
ILVD OFFICE USE ONLY
RWAY HILLS On Site Sewage Occupancy 2-3 N-1
MWCC System X Zoning R-1
V-N
On Site Well (Actual) Const
City Water X (Allowable) V-4
PRV Required * of Stories
-5355
Booster Pump
Length
Depth 39
S.F. Total
Footprint S.F.
1 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.
Signature of Permittee "L
A Building Permit is issued to: SONS CUi;;TRUCTION
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
APPROVALS FEES
668.00
Engr./Assess. Permit
Planner Surcharge 64.90
Council Plan Review 334.00
Bldg. Off. SAC, City 100.00
Variance SAC, MWCC 850•00
Water Conn. 550.00
Water Meter 67.00
Road Unit 325,
Treatment P1 204.00
Parks
TOTAL
CASH RECEIPT f
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE y 19
FECENED
AMOUNT s / G G?
& DOLLARS
,oo
? CASH M CHECK
w 1.
FUND OBJECT AMOUNT
Thank You
BY
^u A{ (ly •/?? Whho--Payers Copy
V V rT. ?J ;J YYelWwPP ?ng Copy
Pink-Flle
OF EAGAN Permit No. Date: 5-
Pilot Knob Road B/P No: Date: ?-
Box 21199
n. MN 55121
Owner. Sof1s ConSt .
Site Address;.-1161 St. Ardrew
Plumber: Jolmsor, Txc/f: C
MWCC: 550.00pd Zoning* rl
City Chg: 100.00pd No. of Units:
Acct Dep: - ' OOr?`-
I agree to comply with the City of
Permit Fee: Ordinances.
By
SEWER SERVICE PERMIT
Conn. Chg: 50.00gc, Zoning:
Acct Dep: 15 No. of Units:
Permit Fee:
Surcharge: I agree to comply with the City of Eagan
Tr. Plant Ordinances.
Meter raz":.-
Misc.: By
WATER SERVICE PERMIT
CITY OF EAGAN Permit No., Date:
3830 Pilot Knob Road Meter No:"SCD 7 Size: ? x
P.O. Box 21199' Reader No: Date: 7
Eagan, MN 55121
Owner. onst.
13,63 St. Andrew Blvd. L9 B_ Pa rwsy Rills
Site Address:
Conn. Chg: 550- RNlNG Zoning
Acct Dep: - 1 ? jiftof Units: -
Permit Fee: RtC- lA Etc
TELE Surcharge: =ELECT I agree to comply with the City of Eagan
Tr. Plant s n-B4r is
Meter.
Misc.: By
WATER SERVICE PERMIT
Rl
5r;r.CITY OF EAGAN Permit No: Date:
3830 Pilot Knob Road -Meter No: Size:
r .o. Box 21195' Reader No: Date:
Eagan, MN 55121
This request void t7/? j?.?
18 months from
® 30503 i-G
f ? m7
Request Date Fire No. RougZ it nspection ?
R ed ? Ready Now ill Notify Inspec-
/I,r n I / e?
??//?? Ves No ar When Ready
? Licensed Electrical Contractor I hereby request inspection of above
? Owner electrical work installed et:
Street Address, Box or Route No.
3 E 3 D1 0 r6(- vo City
,
ecvon No. Township Name or No. Range No. County
1?41rar4
Occupant (PRINT)
SCry? S Coll sr0LwCr1d,111 Phone No.
4!SZS35S-"
Power Supplier
Dfi?cmq C( rcr/l/c Address
'-*d-no
Electrical Contractor (Company Name) Contra rtor's License N
Mailing Address (Contractor or O ner M in Installation)
-2 3 ; 'ec Ile
- 44q -
C-
I ICont or - er ing I tallatiun)
Autho i it Sig
Pttorle
NNU Der
?
THIS INSPECTION BEQUEST WILL NOT
MINNESOTA STATE BOA ELECTRICITY
Griggs-Midway Bldg. - Ro li 81 BE ACCEPTED BY THE STATE BOARD
1821 University Ave.. St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION EBB-00/0,01/-0B
w See instructions lot completing this form on back of yellow copy. L, /J J T`Y °Z'
® 3 0 5 0 3 . '}X" Below Work Covered by This Request
Add Rep. Type oI Building Appliances Wired Enuipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heating
Commercial Bldg. Furnace Silo llnloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm O ther peo y thnr 151"cily)
t er Sppcily Other Othur
ompute Inspection Fee Below
N Fee Servic a Enhance Size H Fee Feaders
Bnbieeders # Fee Circuits
0 to 200 Am 1s 0 to 30 m S
A 0 to 30 Am
Above 200 Amps 31 to 100 Amps 31 to 100 Am
Swimming Pool Above 100- Amps Above 100_Amps
Transrormers Irrigation Booms Partial, Other Fee
Signs Special Inspection s ps
Remarks
0 TOTA FE
Rough-in
Final
n D
Z/,
iw Q
( I, the El
Inspector, hereby
artily Ihet the above
inspection has been
made.
This request void 18 months from
RESIDENTIAL
51660 BUILDING PERMIT APPLICATION CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Reaulrements Remodet Reoalr Reaulrements
• 3 registered site surveys slowing sq. ft of lot, sq. fl. of house; and 311 roofed areas • 2 copies of plan
(20% maximum lot coverage allowed) • l set of Energy calculations for heated addalons
• 2 copies of plan showing beam & window saes; poured found design, etc.) • 1 site survey for exterior additions & decks
• 1 set of Energy calculations • Indicate 9 home served by septic system for additions
• 3 copies of Tree Preservation Plan Slot platted after 711/93
• Rim Joist Detail Options seiodtlon sleet (brigs with 3 or less units)
DATE U Z VALUATION ? ?0 b- 3 ?a
SITEADDRESS /3&3 ST fl1/DRFW; AiV MULTI-FAMILY BLDG _Y _N
TYPE OF WORKS )?00F FIREPLACE(S) -0-1 -2
APPLICANT
STREET ADDRESS ?8 5 CDLA/y4CE ?B)v1) 6,,,r,. 1,30 CITYEoE)vPRs?R£ STATE M 4/ ZIP
TELEPHONE # 9Sa -0i7?/ 30 ?J CELL PHONE # FAX #_JS? -97Y -f,; fty
PROPERTYOWNER I/??i !//l1,_- S4m,,_rS TELEPHONE# (,5'1-,2 -/S?o
COMPLETE THIS SECTION FOR "NEWn RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • _
• Energy Envelope Calculations Submitted D M D
JUN 12 2002
Plumbing Contractor: Phone # A
Plumbing system includes: _ Water Softener _ Lawn Sprinkler B Fee: $90.00
_ Water Heater _ No. of R.I. Baths y - -
No. of Baths
Mechanical Contractor: _
Mechanical system includes:
Sewer/Water Contractor:
- Air Conditioning
Heat Recovery System
Phone #
Phone #
Fee: $70.00
--------------------------------------------------------------------------------------------------------------------------
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 Signature of Applicant Ar"
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Mufti
? 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 (screened) ? 36 Multi
? 05 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) _ Final/C.O.
- Footings (deck) _ Final/No C.O.
Footings (addition) _ Plumbing
_ Foundation _ HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final - Pool _ Ftgs _ Air/Gas Tests _ Final
- Framing _ Siding _ Stucco _ Stone
- Fireplace _ R.I.. _ Air Test _ Final _ Windows (new/replacement)
- Insulation - Retaining Wall
Approved By
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
Building Inspector
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
l 3830 PILOT KNOB RD, EAGAN MN 55122
` 651-681-4675
New Construction Reaukemems
• 3 registered site surveys showing sq, ft. of iot, sq. tt of house; and All roofed areas
(200% maximum lot coverage allowed)
• 2 copies of plan showing beam & window sizes; poured found design, etc.)
• l set of Energy Calculations
• 3 copies of Tree Preservation Plan it lot platted after 711/93
• Rim,iolst Detail 00cos selection sheet (bldgs with 3 or less units)
DATE s? 7 le 2
RemodeVRsoeh Reaulremente -'?o _( ?-
• 2copies of plan
I set of Energy Calculations for heated additions
• l site survey for exterior additions&decks
• Indicate if home served by septic system for additions
VALUATION :* 3 O,? `f
SITE ADDRESS 470 Sl AwdNe&? 13(0d MULTI-FAMILY BLDG _Y - N
TYPE OF WORK rep(ac4 dxv 7? ?eok d?Parv r.,44er 4~gri FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT
STREETADDRESS R63 sy; 4udrew
TELEPHONE #CCSr? yS2-7g?S CELL PHONE #
a,ff) 19?-lS`6? (w)
K STATEA(K ZIP S1/?2 3
FAX #6Lxf2 d 9,( 6D 1? >
PROPERTYOWNER ?a i+e a f-ar"ea Sccu<ef TELEPHONE# (00 fS,2 -7SO
COMPLETE THIS SECTION FOR %NEW- RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: Phone #
Plumbing system includes: Water Softener _ Lawn Sprinkler
Water Heater _ No. of R.I. Baths
No. of Baths
Mechanical Contractor: _
Mechanical system includes:
Sewer/Water Contractor.
- Air Conditioning
- Heat Recovery System
Phone #
Phone #
Fee: $90.00
Fee: $70.00
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.
Signature of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of-plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
X 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt- Multi
? 33 Ext. Alt - SF
? 36 Multi
? 31 New
? 32 Addition
? 33 Alteration
.0"'34 Replacement
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors
'Demolition (Entire Bldg only) - Give PCA handout to applicant
c 30oG e -
Valuation -'silliffir Occupancy MC/ES System -
Census Code !?3 Zoning l . City Water _
SAC Units I Stories Booster Pump -
Nbr. of Units O Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered _
•
VA/
Type of Const Width
REQUIRED
Footings (new bldg) Final/C.O.
-
- Footings (deck) ? Final/No C.O.
Footings (addition) _ Plumbing
_ Foundation _ FfVAC
_ Drain Tile Other
Roof
Ice & Water Final Ftgs
Pool _ Air/Gas Tests -Final
_
? Framing _
_ _
Siding _ Stucco _ Stone
Final
Fireplace _ R.I. _ Air Test Windows (new/replacement)
_
_? Insulation _
_ Retaining Wall
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
Approved By Building Inspector
L
Bridlewilde Joint Venture
Mr. Stan I.exvold
Sr. Engineering TecY,r.ician
City of Eagan
3830 Pilot Knob Road
Eagan, Minnesota 55122
Dear Mr. I_P.xvold:
RECEIVED
5pp 2 21993
September 15, 1993
We are in receipt of your August 31, 1993 letter. We are enclosing
a copy of your original survey showing the stamps from the Engineering
Department indicating that it has been reviewed and approved. That
same survey shows existing grades compiled by Probe in the last week.
Laura Budweg and Mark Nystrom, to this date, experience water problems
in their basement only when a ponding situation is created in the
backyard.
Fairway Hills F, when developed, was done in two separate developments,
The lots along Interlachen which include lots- 9_and_10-of block 5 were
built in 1988/1989. The homes on those lots were completed long before
the second part of the project (lots along the service drive) were even
started. All of phase II was accepted by the City after thorough Z
inspection prior to the submission of the home in question (4640 Pilot
Knob Road). [low you can say that the catch basin manhole between lots
9 and 10 was constructed improperly is beyond me, You inspected it
more than once and the City accepted it for perpetual maintenance.
If the homeowners or builders on lots 9 or 10 disturbed the berm that
obviously was there at the time of your inspections, I can't be held
accountable.
We agree that the manhole was put there to collect 40% of the water
flow heading through the swale to the rear yard of 4640 Pilot Knob
Road, This greatly increases the chancres for ponding in the rear
yard of that address.
The survey attached clearly shows that the rear yard flows downhill
at all points at 4640 Pilot Knob Road and further shows that it is
6" below the basement floor in the area of the walkout slider.
All drainage at all points flows away from the home and walkout door
to the North East. As to comments about the emergency overflow
RT)'3 i li: ??:..u Vl lu?V Ai,plr \/.X-t1!. ?hlttu cnil f,l l? I (6V) 68R 0(06
swale, that was an after thought done under the direction of Craig
Knutson. Both 4640 Pilot Knob Road and the house directly to the
North were constructed, inspected and occupied when Craig determined
the need for an overflow Swale. As you can see, it provides no
real help for 4640 Pilot Knob Road. I think what happened was that
Craig recognized a problem, did his best to fix it under the conditions
he was given and we certainly followed his instructions to the latter.
Stan, this whole problem comes about during heavy, quick downpours
only. When the City has repaired the obviously regraded areas
around the catch basin between lots 9 and 10, block 5 so it traps
the proper amount of water and install the items your letter
indicates on the other catch basin, I am confident the problem
will disappear. If it doesn't, we will talk further at that time,
Sincerely,
RoWDerr'i c?k ?1
President, DMS Investments
Partner
eAlHerrmann
President
Al Herrmann Construction, Inc!'
cc: Tom Colbert
Mike Foertsch
Doug Reid
Craig Knutson
?omrFRud eg and Mark Nystrom
SEP 13 193 15:27 TO 612 891 6072 FROM PROBE ENGINEERING
09-02-1993- 10153Ah1 FROM Al Her'rmarin f"On$t, ,,, TO
*., *
PION®Ep Lhn) nK.gRj C11L [sp lCrri
? t>rn 1? 11Gd?" ng urro r•uNwt;As • rAuoscerc Ranli•ecrs
T-388 P.02
4323723 P,02
2422 Emtr.prlee Ortys
Mendoto HVIghts, mm 50120
(612) 581-1914•Fox $81-0
~ 625 High*oy 10 Northeast
Blaine, MN 55431,
(612) 78J-18800FOX 78'J-'
Certificate of Survey for A} He.rrn cjnn _CQq 5tr g
House Address: Pilot_ Knob-Road Via, an mN
Model Name_ ,Qoua, Npme
C I.A.
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1
.:
u'.'ao ;?motes Exilstinq i_.ev+)tir,r• •
r••: oa, penvtes .
Proposed Fltnvotly .
ELI VATIN
= -- Denotes OFdlho0A & I)tilil,y Fom ri %- lowed Plop, ?,rl•,.,11ic,r, 5
L2
7t
nenotee
--p- t7enotas Droinega
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7%3 _J7 lvo2r3j
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_..-L" Denotes ()ffGet
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.
• } jILI
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•
DAKOTA rr•IJt•17y, MINNESC)Th
?
tN _
:
:`x?
AL7DIT10N
-
I hgf0i? gHdty Ihst this IUIUR%, Plan rw rrpq'r 1•??i C'Spe: r ,;'? 1!lt n. gnrl:n
snider IN fe„q pf 1he Slate Of Mirim,t r 11 s 1 -
e. C41ed toy
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, ^?••''-s soot. Jtipa and ...
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_ ?eY pr
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. n.:. r
h9 Swveyor ,
r•. ..1 ... 9 1.. mss. Y r.. \9
. _._. _- ._.I
01
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1.,
CITY OF EAGAN No- 1 4 8 8 $
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454.8100 8 i
BUILDING PERMIT Receipt# 3&Cqa
To be used for SF DWG/GAR Est. Value $129,000 Date APRIL 26 19 88
Site Address
Lot 9 Block
Parcel No.
1363 ST ANDREW BLVD
5
Sec/Sub. FAIRWAY HILLS
m Name SONS CONSTRUCTION
= Address 4370 RAHN RD
0 City EAGAN Phone 452-5355
p Nan
0 a Add
City
Name
City
I hereby acknowledge that 1 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 Ea9 Ordinal e
Signature of Permittee __-__
A Building Permit is issued to:-SONS CONSTRUCTION
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official_,.L11n1It-4tin.
OFFICE USE ONLY
On Site Sewage _ Occupancy
MWCC System X Zoning
On Site Well (Actual) Const
City Water X (Allowable)
PRV Required * of Stories
Booster Pump Length
Depth
S.F. Total
Footprint S.F.
APPROVALS
Engr./Assess.-
Planner _
Council _
Bldg. ON. _
Variance _
FEES
Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
TOTAL
R-3 M-1
R-1
V-N
V-N
50'
33'
668.00
64.50
334.00
100.00
550.00
550.00
67.00
323-00
204.00
2,862.50
'1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS U OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For: ddcL Valuation: Date: RR
Site Address /`3 (e 3 ?'0-•e4
Lot Block
Parcel/Sub f,__> Qc(,1} y , =ty
Owner '-Orr oesovl)
Address /&aQ ?'(7`?" tJjJ,`?*! jk
City/Zip Code ® s-el
/2R0po -
On site sewage
MWCC system JC
On site well
City water _
PRV required
Booster Pump
Phone 45.11
Contractor
Address - .S c L? }L AQ*. L
City/Zip Code. a;4' 6*41?
Phone ??;2- - .5 ;ra
Arch./Engr. AL Z-151
Address
City/Zip Code
Phone # y?' 3 5-5
Occupancy R-3 M -1
Zoning R-1
Actual Const V-N
Allowable N-N
11 of stories
Length y9?
Depth 33
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr/Assess
Permit p
p,Op
Planner Surcharge y.Sa
Council Plan Review 33 y. 00
Bldg. Off. SAC, City p p
Variance SAC, MWCC 550.00
Water Conn 550, 00
Water Meter i 00
Road Unit 3Z$100
Treatment Pl Ord,oo
Parks
Copies
TOTAL ?(Do150
R
-----------------
1.
i f, i i? irvA
fit
_ ;
.
y.
Y
2 '? A
BE
ENGINEERING
COMPANY, INC.
K30D EA57 146L? STA££T,
9on/S 6'A16-rKuc71oti1
#13.55, o!
CONSULTIHC1 EHDIHE£4S, gjoo? B5
PLAHHERS and LAHA SURVEV6ft PAS 79
BURNSVILLE, YINHES07A !.`.333 PH 432°3UG4
Cer?z}'z crz?`e ? S2!xr?4e
c1 t7?scr' °'L' 1 -DT 9 ,B! OCK5 , =AIWllgY 4'"
/
DAKOTA CDUW-rY MINNESOTA
DENOTE -Y.15TIN? = ,:/ f17t. oo \
17,
fit. 07ES PROPOSED 1, - /AMON
gaze
INDIA.-T__ I= =r ;,Jp 7
.e1z'
/o3a 83 _ FINISNi=D GARAGE rL70R
EL?Ur4TfOtJ
By
EAGAN
ROV
SCALE :1 30,
F 0
DEPT,
?o
'' 2S
?\\ Mao ?/ .
30'r-RONT BuILDINS
3=77bACK LJNE
t a
,A/ oO8S00
<¢4?
viV ???4 S?
I hereby certify that this in a true and cwrect representation of a tract of
land as Shown' and described hereon,. As prepared by me on this /sVIL day of
weic 19 SB .
Xinn. xR9C }to. /boBS
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
e,
OWNER: iSCro? Ol S0?
TE ADDRESS: __?.3?? Si A??r r} L r
ATRACTOR: ?j(?IJS CGf?i7CyIG"(IC'A1 DATE: 4-'22-Bb PHONE: DETERMINE WORKING SQUARE, FOOTAGE OF EACH:
TOTAL EXPOSED WALL AREA 23G 1
........ sq ft x "U" 11 259.-II
TOTAL ROOF/CEILING AREA
........ IcoSo sq ft x "Ul 026 1. TOTAL EXPOSED WALL AREA CALCULATIONS:
Total exposed wall
area above floor.......
??_ sq ft
a) Total will window area:
glazed
I148.5
sq
ft
x "U"
?6
a ZS
b) glazed, ,
•
Total door area .........
sq
sq
ft
ft
x "U"
x "U"
L4tp
. ?. 1 JC
c) Total sliding glass door area:
glazed...... ,L4l 5. sq ft x "U"
d)
e)
f) glazed....,
Total fireplace wall area
Total wall framing area
(Average 109;)..........
Total net wall area above
l?L•0
/L 3L0 sq
sq
sq ft
ft
ft x "U"
x "U"
x "U"
•11
• Ib
3.c.o
q) floor (Insulated)...,,,
Total rim Joist area...... .
2(4 2.
sq
sq
ft
ft
x "U"
x "U"
Total foundation
area (Exposed)......... 12 Cp sq ft
h) Total foundation
window area......... 0 sq ft x "U"
0 Total net foundation
area above grade....... ?2(p s q
q x "U"
,2
s.
TOTAL
a) thru I)
If Item N3 is the same as, or less than Item
::k:AR 1.16008 A and o. N1, you have met the intent of
Page 1
4. TOTAL EXPOSED ROOF/CEILING CALCULATIONS:
Total exposed
roof/cellinq area........ fly SO sq ft
i) Total skylloht area....... V sq ft x "U"
k) Total roof/celllnq framing
area (Average 1119,) ...... ILoS sq ft x "U" -c)2 3 3
1) Total net Insulated
roof/celllnq area...... 1 k85 sq ft x "U" - 02 241."7
4. TOTAL J ) thru 1) 33. o
If total of 94 Is the same as, or less than N2, you have met the intent of
"L MCA"% 1.16UUS A and 0.
ALTERNATE BUILDING ENVELOPE DESIGN
To utilize the total envelope system method, the values established by the sum
of Items N3 and N4 shall not be greater than the sum of items N1 and R'2.
1. ?-S9-it + 2. 42-.9 . 3o2.[01
3. 2'i 4.39 + 4. 3 3 - o 2"1 "7 . '69
C E R T I F I CAT I O N
I hereby certify that 1 have calculated the "U" factors and "R"
values herein and that the building here described meets or exceeds the State
of Minnesota Energy Conservation Act.
S gnature
42z,/A?
(Da e)
Par,.: ?
A
rot
Ii..Y
NSTRUCTION R VALUE
AMING SECTION:
Interior alr film O,(,q
z" 17??y4/ALl- 4S
5112" in6nes.soft wood
Sk4 LA-rv4 I ti [-1 2. D
Extter a r m 0• 'j
TOTAL R - 10.15
U - 1/R - •10
WALL SECTION (INSULATED)
---(1 Interior air 1`1
RIM JOIST SECTION:
V
3
4
5
A '•4
A.
o;
.p r-sL
s x::.0;,4
FOUNDATION INSULATION REQUIRED:
Min. R-5 on entire wall OR
Min, R-10 down to frost depth
FOUNDATION SECTION:
U - 1/R .04,
--(I Interior air film n AR
{2 _ W SUL. 12 AFC
--? 3 12" _ nr,>L 1 zr,
--- (4 Exterior air 11m 0.17
(5
(f+
TOTAL k
U - I/R -
SLAB ON GRADE
IV
6.
4'
Q' WA
2 , v ?• i lrr.•'
Heated Slabs:
Minimum R = 85
i; ?• -4; Unheated Slabs:
'? Minimum R - 6.2
- n!
4 .
4d c
4.
4. Q,' 19
, 4% 4 '
Pages 3
U + 1/R ,D'?
CONSTRUCTION R VALUC
CEILING SECTION (INSULATED):
1 Interior air film A.61
AIR 2D2VWA1 L
CUUTL ; I?J'!Jc A 1 1.)d
4 Exterior air film s A FI
TOTAL R - 41. t h
U - I/It - got
CEILING. FRAMING, SECTION:
1 Interior air film n.61
2 6'6" Dt'YWnLL
3 ?i15??n?I? ap.O
4 Werlor air fl lm still A. 1
S ?'z inches soft wood }. r
TOTAL R }?,Itn
U - I/R - .p2
CEILING SECTION (INSULATED):
P Interior air film 4.61
2
3
4 Exterior air film still n.1
TOTAL R
U - I/R w
VENTED
CEILING FRAMING SECTION:
1 Interior air film n.61
3
4 Exterior air film still A. v1-
5 Inches soft wood
TOTAL R
U- 1/R-
1 ,Inside air film A.FI
2
3
4
5 Outside air film A,17
TOTAL R
U - I/R -
Page 4
GUIDELINE TO (R) FACTORS FROM ASHRAE MANUAL
OF TYPICALLY USED PRODUCTS
Ali: FILMS SHEATHING
R
Interior Air Film (Walls)
E terior Air Fi l
m (Walls)
0.68
3/4" Wood Subfloor or Sheathing
"
0.94
Lori or Air Film (Vented Ceiling)
E 0.17
0.61 112
Plywood Sheathing
112" Particle Board 0.62
.terior Air Film (Vented Ceiling)
Interior, Air Film (N
d 0.61 Gypsum or Plaster Board 3/8" 0,32
on Vente
Exterior Air Film (Non Vented; 0.61
0.17 Gypsum or Plaster Board 112"
G
sum o
Pl
t
" 0.45
yp
r
as
er Board 5/8
" 0.56
Plywood 3/8" 0.47
BLOWING WOOLS Plywood 112" 0.62
- - - Plywood 3/411 0.93
AFPrux. 3" 9 00 Sheathing, Reg. Density 112" 1.32
np prox. 4 112" 13.00
, Sheathing, Reg. Density 25/32" 2.06
Approx. 6 1/4" 19
00 Nail-Base Sheathing 112" 1.14
APP ox. 7 1/4" 24.00
Approx. 14" 30
00
Approx. 18" .
40.00 ROOFS
All other insulation materials must Built-up Roofs 0.33
be verified (R Factor) Asbestos-Cement Shingles 0.21
Asphalt Roll Roofing 0.13
Asphalt Shingles 0.44
1NSULATION
Insulation: 2-2 3/4" Fiberglass 7,00 SIDING
Insulation: 3 112" Fiberglass
I
l
" 11.00 Aluminum Siding
nsu
ation: 6
Fiberglass 19
00 0.61
- Insulation: 3 5/8" Fiberglass ,
13
00 Aluminum with Backer 1,82
Insulation: 9" Fiberglass .
30
00 Aluminum with Backer & Foiled 2.96
Insulation: 12" Fiberglass .
38
00 1/2 x 8 Lap Siding (Wood) 0,81
Insulation: B" Cellulose .
29
00 7/16 x 12 Hardboard Siding 0.67
Insulation: 10" Cellulose .
37
00 Asbestos Sidings 1/4 Lapped 0,21
Insulation: 12" Cellulose .
44.00 Stucco (Brown and Finish Coat)
insulation: 1 1/2" Thermax 12.00
Insulation: 2" Thermax 16.00 DOORS
U
03DS 1 3/4" Solid Core Door .46
r, Pine & Similar Soft Woods w/Storm. Wood
w/Storm, Metal 31
.26
1 1/2" 1.89 Pease Steel Door Insl/N/GL 7.4511 .13
2 1/2" 3.12 Sliding Glass Door, Wood .65
3 1/2" 4.35 Metal .72
5 1/2" 6.87
CONCRETE BLOCK WINDOWS
8" Concrete Block (S & G Reg.) 1
11 All Windows
(Filled with Vermiculite) ,
1,93 (w/Storms 1" to 4" Space) 56
12" Concrete Block (S & G Reg.) 1,28 Removal Double Glazing (ROG) 55
(Filled with Vermiculite)
' 3,15 Thermo or Welded 3/16" Air Space .
.69
b
Light Weight 2,18 1/4" Air Space .65
(Filled with Vermiculite)
" 5,03 1/2" Air Space .58
12
Light Weight 2,48 (Other windows specifically tested
(Filled with Vermiculite) 5,82 can use better ratings)
Page 5
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
NOTE: PA)MENT OF FEE AT TIME` OFF F
APPLICATION DOES NDT CON- e
x S17UTE APPROVAL OF PERMIT.
s
x
? INSPECTION OF SEWER AND/OR WATER t
INSTALLATIONS WILL NOT BE SCEDUL®
a 1.=L PERMIT HAS BEEN APPROVED. s
c1tv ss+++++sssss+sss+sssssxs+++sxxs+++s+si
®F czagan
(PLEASE PRINT
1) PROPERTY ADDRESS:
LEGAL DESCRIPTION:
IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE:
(month/Year)
PRESENT ZONING/PROPOSED USE:
Q COMMERCIAL/RETAIL/OFFICE
a INDUSTRIAL
Q INSTITUTIONAL/GOVERNMENT
2) NAME:
119- R-1 SIDLE FAMILY
R-2 DUPLEX (Two Units)
R-3 TOWNHOUSE (Three + Units)
Q R-4 APARTMENT/CONDomiNIUM
0
ADDRESS: j U6'OS- (e, u( Ysz//
CITY, STATE, ZIP: Y ffer (g pQ.?? /pL
PHONE:(-/ ??T 5ly
'rs07S-
3)NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
MASTER LICENSE #
( Units)
( Units)
iunoers License:
Active
Expired
Not recorded
Staff I dtiaar
4)
NAME: J' (3.? s C` u s T
ADDRESS:
CITY, STATE, ZIP: er a s--J'/__z -
z--PHONE:
5) lll+ l d • ul• ao .. i ?e
CONNECTION TO CITY SEWER CONNECTION TO CITY WATER 0 OTHER
6)
*
* THE GOLD COPY OF THE PERMIT WILL BE SENT DIRECTLY TO PUBLIC FORKS TO FACILITATE METER PICK-UP.
* PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. SOMONE FROM THE CITY WILL CONTACT YOU IF THERE
* ARE ANY PROBLEM.
*
f
FOR CITY USE ONLY r
PERMIT # ISSUED
Pd w/Bldg. Permit FEES:
$ SEWER PERMIT (INCLUDE SURCHARGE)
$ $ (O•?( WATER PERMIT (INCLUDE SURCHARGE)
$ 7 CCU $ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ ACCOUNT DEPOSIT - SEWER
$ ACCOUNT DEPOSIT - WATER
$ WAC
$ (c5-O•0-6 $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ o2UY'G+ p $ WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
$ 1q71 e )o $ 5-1- C3' 2? TOTAL
Z c
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC
Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE: d`./!p O
I
2009 RESIDENTIAL BUILDING PERMIT
--For----Us----------- I
Office I
j Permit #: T2 1J? I
Permit Fee: r ? Vv
Date Received:
I I
I Staff: I
APPLICATIONCAI[ S2S0j
Date: 3- J S- Q)j Site Address: 3 3 s-f A y a x t w ^.' Li C1
Tenant:
Suite #;
RESIDENT / OWNER
?14M?S Phone:
Name: K 1? IZ< w t, SA C
?? ya
Address / City / Zip: rp ?4 7' I A Vj ?Z C LA.)
Applicant is: Owner Contractor
TYPE OF WORK Q
Description of work: c be C- w e" pl ? r 6??
Multi-Family Building: (Yes _/ No
Construction Cost: b (5 ?J
CONTRACTOR ,
??' tense #: 010 f( ?? 7 ??
®y^' 43
Name: ?
Q U 1 S I
t
r
Address: 1 .3 ? a- ((Ir)
City: ?0? 4, State: N" Zip: l? S I a'
Phone: 1-./ a. - r7 ?iJ 7 Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7672
_ Minnesota Rules 7670 Category 1
_
Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
Category Submitted Submitted
(J submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
t
_Yes _No If yes, date and address of master plan: ,.
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the Information may be classified as non public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name ??a ?.J l \'V? (? Applicant's Signature Page 1 of 3
D?c1J?" U
MAR 1 .3 2009
W
Fireplace _ Porch (3-Season) _ Storm Damage
_ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family)
Z( Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
Lower Level Pool Miscellaneous
SUB TYPES
Foundation
Single Family
_ Multi
_ 01 of _ Plex
Accessory Building
WORK TYPES
New
Addition
Alteration
_ Replace
_ Interior Improvement
Move Building
Fire Repair
Repair
'Demolition of entire building - give PCA handout to applicant
Valuation
Plan Review
(25%100%
Census Code
# of Units
# of Buildings
Type of Construction
DO NOT WRITE BELOW THIS LINE
_ Siding
- Reroof
Windows
Egress Window
_ Demolish Building'
_ Demolish Interior
Demolish Foundation
Water Damage
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Occupancy l4c, -1
Code Edition AW7
Zoning K-/
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
_ Foundation
_ Drain Tile
Roof: -Ice & Water -Final
Framing
Fireplace: -Rough In -Air Test -Final
Insulation
Meter Size:
Reviewed By:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
_ Sheetrock
_ Final / C.O. Required
Final / No C.O. Required
_ HVAC
_ Other:
_ Pool: Footings -Air/Gas Tests -Final
_ Siding: -Stucco Lath -Stone Lath -Brick
_ Windows
Retaining Wall
Building Inspector
1 30 -
TOTAL
For Office
Use-
City of EaRan Permit ._.~6
Permit Fee:
3830 Pilot Knob Road Eagan MN 55122 Date Received: '02
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 Staff:
-
2009 RESIDENTIAL BUILDING PERMIT APPLICATIONCN(
Date: Site Address: [3 43 fi i het L. C11
Tenant: Suite
RESIDENT / OWNER Name: K c ~v ~ - I~t1 11 t V-\-2 C--_'Ar s Phone:
Address/ City /Zip: A Vvd 'L) t 1- L
Applicant is: Owner LI-60-ntractor
v%j re C
TYPE OF WORK Description of work: C 1,2 L.
Construction Cost: fi~b L) C; Multi-Family Building: (Yes / No
~l
CONTRACTOR Name: `r Q (O' cense ;l-o' ci a tT
Address: '3 g- 1\1i kt L wi L 41
City: ae 4.,m- State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
('I submission type) . Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
X flies ~,A-e_ 1( ( x
Applicant's Printed Name Applicant's Signature
\ Ji LL- Page 1 of 3
r~
MAP 2009
DO NOT WRITE BELOW THIS LINE
SUB TYPES
_ Foundation Fireplace Porch (3-Season) _ Storm Damage
_ Single Family Garage _ Porch (4-Season) Exterior Alteration (Single Family)
Multi Deck Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi)
01 of Plex Lower Level _ Pool _ Miscellaneous
Accessory Building
WORK TYPES
New Interior Improvement Siding Demolish Building*
Addition _ Move Building Reroof Demolish Interior
_ Alteration _ Fire Repair Windows Demolish Foundation
Replace Repair Egress Window _ Water Damage
*Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation .3ow Occupancy .4 L MCES System
Plan Review Code Edition SAC Units -
(25%_ 100% Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV r
# of Buildings Length Fire Sprinklers
Type of Construction Width °
REQUIRED INSPECTIONS
Footings (New Building) Sheetrock
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC
Drain Tile Other:
Roof: Ice & Water Final Pool: Footings Air/Gas Tests Final
Framing Siding: -Stucco Lath Stone Lath Brick
Fireplace: Rough In -Air Test Final Windows
Insulation Retaining Wall
Meter Size:
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee .13o =
Surcharge
Plan Review AIA
MCES SAC 100,
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 1363 St Andrew Blvd
Lot: 009 Block: 005 Addition: Fairway Hills
PID:10- 25600- 090 -05
Use:
Description:
Sub Type:
Work Type:
Description:
Census Code:
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264 -4777
e- Windows/Doors
Windows/Doors-New/Replacement
House
434-
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
Applicant/Permitee: Signature
- Applicant -
Construction Type:
Occupancy:
If altering the opening size, a framing inspection is required.
Smoke detectors are required in
all sleeping rooms prior to final
inspection. When wall studs or
Owner:
Wayne M Sames
1363 St Andrew Blvd
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
$90.00
Building
EA077193
04/05/2007
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
Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA110256
Date Issued:05/01/2013
Permit Category:ePermit
Site Address: 1363 St Andrew Blvd
Lot:9 Block: 5 Addition: Fairway Hills
PID:10-25600-05-090
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.
Crystal Cochran
7588 Washington Ave S
Eden Prairie, MN 55344
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Wayne M Sames
1363 St Andrew Blvd
Eagan MN 55123
Pronto Heating & Air Conditioning
7588 Washington Avenue South
Eden Prairie MN 55344
(952) 835-7777
Applicant/Permitee: Signature Issued By: Signature
City of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
1013
r
Use BLUE or BLACK Ink
For Office Use
Permit#: 4 I (W, IU�
Permit Fee: t `�(1 . /s�
Date Received: - l Co-( 3
Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
• /6 /S� Site Address: /Z6.s`- S/ • lir 4,kJ Unit #:
Resident)
Owner
Name: tf— ie-, PIE'S Phone:
,rJP
Address / City / Zip: /S6 :* .S/ 4/F e J S/t/o%
Applicant is: Owner Contractor
Type of Work
Description of work: /tet'/./ c ls, u ()A) Q /"/ eller
Construction Cost: /�O .. Multi -Family Building: (Yes / No )
Contractor
Company: Sc,4> e • Contact:p 17
/4//r
Address: /2277 /lie 6 //A ho ( City: 15�.� / c.J> //
State: A) Zip: _5-5' Z 7 Phone: 9c12- 7 C. _—<�,g''
License #: /j(.... 4, 766 /S Lead Certificate #:
If the project is exempt
from lead certification, please explain why: (see Page 3 for additional information)
-I 6)4 t, t t
In the last 12 months,
Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude, that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One 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 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 Buil ' g Code must be completed within 180
days of permit issuance.
Applicant's Printed Name
Applic is ignature
Page 1 of 3
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
WORK TYPES
New
Addition
Alteration
/7C Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25% 100%
Census Code
# of Units
# of Buildings
Type of Construction
/ ? (3 974.. 2 s 8/vc/
DO NOT WRITE BELOW THIS LINE
Fireplace
Garage
N./ Deck
Lower Level
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Interior Improvement
Move Building
Fire Repair
Repair
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Buildin
Footings (Deck) 145
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water _Final
Framing
Fireplace: _Rough In Air Test Final
Insulation
Sheathing
Sheetrock
Reviewed By:
z
Siding
Reroof
Windows
Egress Window
1
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC Gas Service Test Gas Line Air Test
Other:
Pool: _Footings Air/Gas Tests Final
Siding: Stucco Lath Stone Lath _Brick
Windows
Retaining Wall: Footings Backfill Final
Radon Control
Erosion Control
, Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
/bfi•�Is
Page 2 of 3
SEP 13 '93 15:27 TO 612 891 6072 FROM PROBE ENGINEERING
-4,
09-02-1993 1t 3M FROM AI Herrmann Cont. \. TO
T-388 P.82
4323723
02
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* PION1BER
IK
. IrIn
242 Entraltries Days
Melt#oto litt9hte, MN 1Q:130
(612) 881-1914•Fox �t-,
0142_81.4httor, . enit. tmtp4t.01;
—........_" ......,........ .., -,...e•-•-.....
- - -"L:A;.ni-Lkiiiitas • tAtt9r.C.'tirc FACIIIICTS e25 Ilighsvoy 10 Northeast '
ETIDIne. MN 55434
(612) 781-1580,Fos 783-t
err crlat:iCQnstructiQr-ij_inc.
Certificate of Survey for: Al H
House Address: Pilot
Model Name: Pountry Home
QED'
(Ti
C)
P
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ce
4P.
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iv
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RE.44. E
EAG.A.14 ENGIFNERIl; DEP — ;‘)
1
,i1.
to22.#
• 9,1.0 Denotes Existing Levf)tinr.
• Denotes Proposed Frovotit,..
Denotes Drolhoge: & 1.111!ity ru
----Donates Droinooe ".•••-• • •
Denotes M9rturrt,.!1•'
Denotes Offset
L
BLOCK
nn;1•••:, •
DAKOTA nr.'IJNIY. MINNESOTA
i'..t.t.v* •
I. ()west. Floor
•
•:;iry •
R WAY
2ND ji,DDITION
Mga•Mb..m.
haftto/ certify that this futile'', ulati tritc-t I tr.!supt,.:00.%a.d • !
Undge Ott tiVVVI of 1h1 Slate Of 11.41r1r101,,f*. [Wild thll 421 tlay tit 4 kr... 12 12.
Rev. 7-C-41ft %%Vt.* fk/e iet;f1";:t4lar. 41C-
fi.J4
. z13 1002‘33
. • ' ;••
.•
r1:1);.tved itott Sutvryar
JAMES A. CLANCY
PROFESSIONAL ENGINEER
601 AS I:lURY AVENUE
NATIONAL PARK, NJ 08063
(856) 358-1125 FAX: (856) 358-1511
Date: January 28, 2016
FEB 1 : 2(116
Re: Structural Roof Certification
Subj: Wayne Sames Residence, 1363 St Andrew Blvd, Eagan MN 55123
We have provided a review of the house roof construction of the above named property in regards to
verifying the capacity of the existing roof for installation of a new Solar Panel Array.
We have found the residence roof to be of wood frame construction bearing walls with the main roof of
2x4 @ 24" o.c. truss framed roof and is sheathed with 1/2" ext -ply decking and a single layer of asphalt
shingle roofing.
The wood framed roof structure bears directly upon the framed exterior wall system. The existing trusses
and rafters as installed meet the required IRC -2012 table 802 design span ratings with sufficient capacity
to carry the 2.89#/sf additional load imposed by the proposed solar array per the details below.
Installation of solar rack systems shall be as follows:
Each panel row shall be supported upon 2 mounting rails. Rails shall be screw anchored through
roof and directly to rafters or purlins below. Rail attachment points to rafters shall be staggered
each row with exception to the first fastener row from the gable end which is attached to two
adjacent rafters/trusses with Stainless Steel fasteners.
When installed per the above specifications the system shall meet the required 90 MPH wind load and 50
PSF ground snow load requirements.
Should you have any further question or comment please feel free to contact our office.
Respectfully,
James A. Clancy
Professional Engineer
1 hereby oerthatmirpion, cpeai•
tiaadon, or repot was preps by
ane or model ow died supenfision;
end that t ma .:. need Pro?
ender tho last
`�`iu=tea.
Roof Structural Assessment Report, JobId: 15433 Page 1 of 9
ROOF STRUCTURAL ASSESSMENT REPORT
Date of Report:
Data Input:
Contact Email:
Contact Phone
02-25-2016
Roger Anderson
arcdesignlIc@comcast.net
856-358-1125
Job Name: Wayne Sames
Job # AES -012916
Job Address 1363 St Andrew Blvd
Eagan, MN 55123
I hereby certify thatthieplen, wear
f tion, or report wan prepared by
mea under •d &rear; supervision
ndthat i am a drily Unnamed Pm-
Espineer the Taws
of Minnes
3/2/2016
Roof Structural Assessment Report, JobId: 15433
Date of Report:
Data Input:
Contact Email:
Contact Phone
OUTPUT SUMMARY
02-25-2016
Roger Anderson
arcdesignlIc@comcast.net
856-358-1125
CAI 0:111 ATTONS
Page 3 of 9
Job Name: Wayne Sames
Job # AES -012916
Job Address 1363 St Andrew Blvd
Eagan, MN 55123
COMPLIANCY TEST
PFS111 T
Loading Combination #1:
(% of Code Compliancy=574.2 %)
Wind Uplift on standoff- 0.6 DL Solar
Loading Combination #2:
(% of Code Compliancy=414.3 %)
DL Rf + DL Solar + Roof Live Load
PASS
PASS
Loading Combination #3:
(% of Code Compliancy=341.8 %)
DL Rf + DL Solar + Wind Down
Loading Combination #4:
(% of Code Compliancy=102.3 %)
DL Rf + DL Solar + Snow
Loading Combination #5:
(% of Code Compliancy=142.9 %)
DL Rf + DL Solar + .75 Wind + .75 Snow:
PASS
PASS
PASS
Loading Combination #6:
(% Increase of Seismic Load=5.3 %)
Check Additional Seismic Load
PASS
Loading Combination #7:
(% of Code Compliancy=457.7 %)
DL Rf + DL Solar + Wind Up
PASS
This Report is based on Code required Engineering Calculations using the data which has been
input by the User. This Report indicates the Code compliance or Code non-compliance of the Solar
Panels proposed for the Selected Roof Type. This Report has not been reviewed by a licensed
Professional Engineer.
I henelsycedeytl�etthiepian, specs
ficatIon, or report wee prepared by
me or under wit, dred ewparvision
and that I am a they Lice need Prez
fessienal Bpineer under the
innesoto.
3/2/2016
Roof Structural Assessment Report, JobId: 15433
Date of Report:
Data Input:
Contact Email:
Contact Phone
02-25-2016
Roger Anderson
arcdesignllc@comcast.net
856-358-1125
A.. r A
S D.7
This Report is based on Engineering
calculations using the input data supplied by
the User, listed above. The User's input has
not been independently reviewed by a
licensed Professional Engineer for
appropriateness or accuracy; unless,
stamped and signed by a licensed
Professional Engineer.
This Report indicates Compliance/Non-
Compliance with the reference Codes listed
below. The following items have been
checked for Code Compliance:
• Load Combination#1:
Wind Uplift on the Standoff
attachment to the Roof Framing
members: Wind Uplift - 0.6DL Solar
• Load Combinatioji#2:
Supporting Rafter Strength with: DL
Rf + DL Solar + Roof Live Load
• Load Combination#3:
Supporting Rafter Strength with: DL
Rf + DL Solar + Wind Down
• Load Combination#4: Supporting
Rafter Strength with: DL Rf + DL Solar
+ Snow
• Load Combination#5:
Supporting Rafter Strength with: DL
Rf + DL Solar + .75Wind + .75Snow
• Load Combination #6: Check
Additional Seismic Load
• Load Combination #7:
Supporting Rafter Strength with: DL
Rf + DL Solar + Wind Up
Page 4 of 9
Job Name: Wayne Sames
Job # AES -012916
Job Address 1363 St Andrew Blvd
Eagan, MN 55123
Job
Data Input By:
Job Number:
Job Name:
Job Address:
City, State:
Information
Roger Anderson
AES -012916
Wayne Sames
1363 St Andrew Blvd
Eagan, MN 55123
Current Input Data
Payment Method
Roof Type
Ceiling Type
Collar Tie Space
Coverage %
Frame Size
Ground Snow (psf)
Sloped Roof Snow Load
(psf)
Lag Screw Diam. (in)
Lag Screw Embed. (in)
Overall Span (ft)
PV Weight (psf)
PV Width (ft)
Rafter Span (ft)
Roof Mean Height (ft)
Roof Slope (degrees)
Roofing Type
Sloped Ceiling
Standoff Spacing (ft)
Standoff Staggered
Wind Exposure
Wind Speed (mph)
Invoice
Truss
1/2 gyp. Bd.
0
28
2x4@24
62
35
5/16
2.5
24
2.7
2.75
5.5
20
26
Comp. Shingle
No
4
Yes
B
90
Reference Codes
International Building Code (IBC latest edition)
American Society of Civil Engineers (ASCE/SEI 7-05,
(NDS latest edition) CBC and NJ Edition
Legend: DL=Dead Load
Rf= Roof
I berets, certify ter the plan, spent•
fioneon, or repot wee prepared by
me or under my draw oupeivision
and that am a duly Licensed Pro-
fessiona ineer under the lave
e.`afMinnesota.
S A. CIANCY
-10) National Design Lifin fol oolWar459ss
3/2/2016
r City of Eaali
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEIVED
NOV302015
r
Use BLUE or BLACK Ink
For Office Use
Permit #: /0 /�
Permit Fee: ca i • / 0
Date Received: / - 30-454
i
Staff:
J
2015 RESIDENTIAL BUILDING PERMIT APPLICATION
Site Address:V.20 odk". AWJti Vk' d . j 1 I"N 512-3 Unit #:
1 f lQt CX\ 31U tv. 7 Phone: �5I 1 � -1159 5
Name:
GIL
Address /City / Zip: L�YJ-6 .k r1,t�YY�t t`y'\Y(N • l MN 55\0,3
Applicant is: Owner V Contractor (
Description of work: B 6)1( U 1 1 `l'.A - SCe a f 1 sakt-actk'
Construction Cost:iU I V� 000.00
Company:
Address: \Q9a
State: rim Zip:
License #:JQG 5 8 1
3olcur
Multi -Family Building: (Yes / No
Contact: t' 0)01 CL P uL Ur V
V • _ ` City: C7 T -'•17.X .
Phone:51 8/12- iZmairlytu a..Qak® cLutheiFysotar,Com
Lead Certificate #:
If the project is exempt from lead certification, please explain why:
3 v li r /42 IT
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:
Mechanical Contractor:
Sewer & Water Contractor:
Fire Suppression Contractor:
Phone:
Phone:
Phone:
Phone:
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 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.
xMo ria.ltl 1,
Applicant's Printed Name
App icant's Signature
Page 1 of 3
SUB TYPES
oundation
Single Family
Multi
01 of _ Plex
,10/tdi' 6 ((Id
' DO NOT WRITE BELOW THIS LINE
Fireplace
Garage
Deck
_ LOwer Level
_ Porch (3 -Season)
WORK TYPES
_ New _ Interior Improvement
Addition_ Move Building
Alteration_ Fire Repair
Replace _ Repair
Retaining Wall
DESCRIPTION
Valuation
Plan Review -
(25% 100% Y )
Census Code
# of Units
# of Buildings
Type of Construction
5
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: _Ice & Water _Final
Framing
Fireplace: Rough In Air Test
Insulation
T Sheathing
Sheetrock
Fire Walls
Braced Walls
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
Final
Siding
Reroof
Windows
Egress Window'
/1.-s.sox/
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final I C.O. Required
Final I No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Pool: Footings Air/Gas Tests Final
Drain Tile
Siding: Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings _ Backfill Final
Radon Control
Fire Suppression: _Rough In _Final
Erosion Control
Other: TOOT 1ITIeHonA.vvi ?o 1*Oil al
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review '7c —
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies f r e AO
TOTAL /
/1 tOz-
Page 2 of 3