509 Severn WayPERMIT
City of Eagan Permit Type:Building
Permit Number:EA169878
Date Issued:06/14/2021
Permit Category:ePermit
Site Address: 509 Severn Way
Lot:21 Block: 2 Addition: Coventry Pass 4th
PID:10-18403-02-210
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
James A & Dawn M Thorn
509 Severn Way
Saint Paul MN 55123--397
Roofs R Us
941 W 80th St
Bloomington MN 55420
(612) 282-8092
Applicant/Permitee: Signature Issued By: Signature
. INSPECTIUN REC4RD
CI~I( OF EAGAN PERMIT TYPE: . ~ ~ , ~ . ~ ~ .
3830 Pilot Knob Road Permit Number. ,
Eagan, Minnesota 55123 Date Issued: , .
(612) 681-4675
SITE ADDRESS: ~ APPLICANT: .
, „ , f,~ ,
5pq r, E~:, r i i~;i~~l~ ~ r~ 1 W~ . i ili
, ~ , ~ 1 ~ i ~ . ~ s~ si1-1
PERMIT SUBTYPE: TYPE OF WORK:
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r~ ,~11 P, 1 I~~N ~ I 1<! t I ~t~ I
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~
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, Permlt No. PermR Holder Date Telephone S
S/W
PLUMBING 7 q~_~~a/
HVAC rf ,~~~G ~
ELECTR I 8a ~
ELECTRf /~l "O
In~pectlon Date Insp. Comments
Footings I ~~D ~
Foundation 'E~ , j,Q
r.~~
Framing ti//~, -
t
Roofing
Rough Pibg.
Rough Htg. /i ~
Isul. '~~l G /~r,y
/
F~~ace y~
Final Htg.
Orsat Test
Final Plbg. ~ Plbg. lnspector - Notity Plumber
Const. Meter
Engr./Plan
s~. F~ I ~
Dedc Ftg.
Dedc Final I
I
Well
Pr. Disp. I
I
/S- ~ I
I
-~.n• F ~ - ~
~ ,y ~ ~ ~
t?,`erh~ca#e o~ ~ccu~anc~
~ii~ o~ ~agan .
~a~ca~t ~~t~~ ~~~c~ ~
'e This Certi,frcate issued prrsx~ant [o the requirements of the Uniforrn Building Code
certifying that at the time af issr~ance this structune was in campliance with the various
o~inances of the City ngulating building construction or use. For the fo!lowing:
SF DWG/GAR 228~~
use Classifi~tio¢ 61dg. Pmmit No.
°°~'~`Y ~ry'P` ~ . , 5 5 4 21
o~,~« ar B~ naa~
Y , , v ~ H ,
i Buildiog J?d~eas l.ocaliry .
V~,(~.(j.rc.c~ ~ MAY 16, 1994 F-~:~.:;~
Datc: ,,~..~,.4-4-
O~ci~l
P06T IN A CONSPICUOUS PLACE
INSPECTI4N REC~RD
CITY OF EAGAN PERMtT TYPE: > ~ ~
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: ,
(612) 681-4675
SITE ADDRESS: ` ' ' ' ' ~ ' ' " APPLICANT:
E~~ ~ . t fct ~
. ~ nrt Ein , , :
~ „ , ~ i i:i , . ~ •
PERMIT SUBTYPE: TYPE OF WORK:
. .
,
~ ~
~ ~
' ~ 1
wm~n Ho. Pe~n Hoi~ oaa r.~,n«,e ~
ELECTRIC
PLUMBING
HVAC
Insp~ction Date Insp. Comm~nts
FOOTINGS
FOUND
FRAMING
ROOFING
RQUGH
PLUMBING
PLBG
AIR TEST
RQUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FlREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FlNAL HTG
ORSAT
TEST
BLD(3 FINAL
BSMT R.I.
BSMT FINAL
DECK FTG S /
DECK FINAL ~ f
Address 509 SEVERN WAY Zip 5512_
TAt.. .21 B~k z $Ub COVENTRY PAS 4TH . ~
THESE 11'EMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: 5/ 16 / 94 Yes No Inspector:
Final grade (6" from siding)
Permanent steps (gazage)
Permanent steps (main entry)
Permanent driveway 1~
Permanent gas f
Sod/Seeded grass
TraiUcurb damage
Porch
Basement finish ~
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contad engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. ~
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
y 5 is e ~?gd?~` l9/~~
. 3 72~~~~ ~ ~8a
Reques~ ~ate re No. RougRin I ction ' NOTICE: You Must Call Elecvicai Inspedor
Require If A Fough-In Inspedion
es No Is Required. ' O~
I , icensed contractor ? owner hereby request inspection of abov~e~el rical work '
Job Atltlress (Street. Box or oute NoJ ~~l Ciry
W
Section No. Township Name or No. Range . Cou
Occupa PRINT) Phone po.
Power lier ~ ~ . Mtlress
Elecvical Cor~{y~jpLjGymp~nyE^~'C Conirac[or5 License No.
~i1~i~:S L v . INC. CA00381
Mailing AtlCre ontractor or ner Makin Ins •'O
I
Aut~onzed~5igiw~ire (COntractoriUvner Iting Inslallation) Phone Number
_-J
~
MINNESOTA STATE BOANU OF ELECTRICITY THIS INSPECTION REOl1E5T WILL NOT
Gri9gs-Mltlway Bltlg. - Roam 51~3 BE ACCEPTEO BY THE STATE eOARD
1821 Universlly Ave., SL Paul, MN 55109 UNLESS PROPER INSPECTION FEE IS
P~one(612)662-0900 ENCLOSE~.
9 ~ REQUEST FOR ELECTRICAL INSPECTION ::y°- ea-oooa,-os
~ Sce inshuctions lor completing t~is form on back o~ yallow copy. /~/~v
~7 3 4 7 2~ x" 8elow Work Covered by This Request ~
e~ A d Rep'. TypeoBuilding AppliancesWired EquipmenlWiretl
Home Range Temporary Service
Duplex Wa~er Hea[er Electric Heatin
Apt. Building Dryer Loatl Management
Comm./Industrial Furnace Other (Speciry)
Farm Air Conditioner
OIM1er (specity) Conlraclor5 Remarks:
Compute lnspection Fee Below:
# Other Fee # ServiceEnlranceSize Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps ~ 0 to i00 Amps
Vansformers Above 200 _ Amps A e100 _ Amps
SignS Inspec~or§ Use Only: ~ ~ TOT6L L~ d
UU.i F'8
Irrigation Booms . I!~ B I
SpeCial Inspection 0/~ L!~a ^rO 1 I 3 w
nlarmlCommunication THIS INSTALLATION MAV BE ORDERE DISCONN CTED IF NOT
Other Fee COMPLETED WITHIN 18 THS ~
I, the Electrical Inspecto5 hereby Rough-in a~ ~ Q
certify that the above inspection has F~~ai oa~e. „~.7 ~
been made.
OFFlCE USE ONLY
This reque6[ wid 18 monOts From '
~~i578 a ~ao~
Repues~ Oafe ~ Fire o. Reugn-In Inpse ~ n puiretl Inspection Othe i~an h.ln
(vou must r wnan ready) ~ qeedy No Wili NotHy InsO~ior
Yes No Date ReaE
I-' ~ sed contractor ~ owner hereby request inspection of above electrical work at: - . .
Job Atltlress IS~reet 8oa or RoNe No.~ Cil
` r~ ~~~~e~v G~J~ ~.9~ ~.cl
$eqion No. TownsNO Name or No. Rang No. Counry n~~~~
%
O[cupan RINT) Phone Na, .
~ U~
Power pplier AtlGress .
,g.~_ ~Lec~
Elecvical Conuacror ICompany Name~ Convactor5 License No.
(~7 1
Mail~ngNatlre~~u~"~i,-0wL~i94MaAj~j~n~'aildip~. ~iV ~'Z4
tiF:J~.`38~0
Aut~oriee~ onb or nstalla4on) ~ PhonB NumOer
_ _
MINNESOTA STATE BOARD OF ELECTPICITY THIS INSPECTION FEOUEST WILL NOT
Grlggs-Mltlway Bldg. - Noom S1]] BE ACCEPTEO BY THE STATE BOARD
i8T1 Univ¢nlly Ave.. SL Peul, MN 5510d UNLES$ PROPER MSPECTION FEE IS
Phone~fit2~662-0800 ENCLOSE~.
REQUEST FO INSPECTION ?'"'~4' EBA0001-OB
S
C ? See insVUCtions br c n back of yelbw copy 7Q
~~y.'
~ 1 J ~ "X" Be/o rk ave~ed by This Requesf "~•ws:~
eW - TypeofBuilding AppliancesWiretl EquipmeniWired
Home Range emporary Service
.f Duplen Watar Heater EleciriC Heating
- ApC Building Oryer Load Menegement
Comm./Industrial Furnace Other (SpeCify)
Farm Air Conditioner
Ot~er (sV~ifyl ConVacrorS Remarks:
Compute lnspection Fee Below:
# Other Fee # ServiceEnirance5ize Fee # Circults/Feetlers Fea
Swimming Pool 0 ro 200 Amps a to 100 Amp
Trensformers Above 200 _ Amps Above i00 Amps
Signs inspecror's Usa Oniy: Q7p~ ~y
Irrigation Booms ~G/ C~ af~
Speciallnspection
Alarm/Communication THIS INSTALLATION MAY BE ORDE CONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rou~n;~ r ~ oa~e
certirythattheaboveinspectionhas F~,nai o
been made. ' ~ 7
OFFICE USE ONLY
This reques~ vaitl t8 mant~s imm
PERMIT i~~~s i~~s~~
~-~'CIT"i( OF EAGAN pERMIT TYPE:
3830 Pilot Knob Road 6 U I L D I N G
Eagan, Minnesota 55123 Permit Number: A 2 2 g 71
(612) 681-4675 Date Issued: 01 / 2 5/ 9 R
SITE ADDRESS:
509 SEVERN WAY
LOTe 21 BLOCKt 2
COVENTRY PASS 4TH
P.S.N.: 10-18q03-210-02
DESCRIPTION:
B ild ni
g ermit Type SF DWG
uilding W 7ype NEW
„IJBC Ocaup~ncy R-3 M-1
fvnsCruction Ty ~ V-N
Znning R-1
Building Length 68
Euilding Width 38
E3(~ilding stories 2
\\~~1 i v
V
J~_
REMARKS:
S& W PLBR - VAL4EY PLflG
FEE SUMMARY:
VALUflTION $176,0@0
Base Fee $905.5~ MTSCELLANEOUS ~1,828.50
Plan Review $588.58 Total Fee $4,210.58
Surcharge $88,00
5AC $80@.0~
SAC ~ 100
5AC Units 1
Subtotal ~ $2,382.08
CONTRACTOR: - Appiicant - sT. ~IC. OWNER:
ROTTLUND CO INC. THE 15710304 @C~(71335 THE ROTTLUND CO INC
5201 E RIVER RD 5201 E RYVER RD 301
FRIDLEY MN 55421 FRTDLEY MN 55~121
(612) 571-0309 (612)571-0304
I hereby acknqwledge that I have read this application and state thaY ths
infarmation is correct and agree to comply with all applic~ble State of Mn.
L Statute ~ d C' of Fagan Ordinances. J
~
~ - ~ 113 1l.Dt/'A. ~ p~_
APPLICANT/PERMITEE SIGNATURE --rS~ED e SI NATUR
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: e u z ~ a x N ~
3830 Pilot Knob Road Permit Number: 0 2 2 s 71
Eagan, Minnesota 55123 Date Issued: 01 / 2 5 J 9 4
(612) 681-4675
SITE ADDRESS: ~ o T: z 1 B L 0 C K: 2 APPLICANT:
509 SEVERN WAY R07TLUND CO INC. THE
CqVENTRY PflSS 4l"N (612) 571-03~4
PERMIT SUBTYPE: TYPE OF WORK:
SF DWG NEW
. .
FOOTINGS FOUNDA'fION
FRAMSNG ROOFING
SNSULATION FSREPLRCE
ROUGH IN PL6G ROUGH IN HTG
FINAL PLBG FINAL
REMARKS: S& W PLBR - VAL~EY PLBf.,
. - - . . . . - . . . ~
~ _ ~
REACTI4ATE _ CITY OF EAGAN
PEt~~uT 19~3 BUILDING PERMIT APPLICATION;•~~~;~[~ ~D
~ ' ' 9~ 681-4675 , a~ A 1994
l9 ~ :n
" r ' ~J
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty appl.ies: 1) when permit is typed, but not picked up by last working day of month.
in which request is made, 2) address is changed or 3) lot change is requested ance permit
is issued.
Date ~ Yaluation of work ~0~
Site Address: ~-9~1 ~Vev~v~ ~Na~
STREET SUITE M
Tenant Name: (commercial only) `7~iv_ Qa~-~l~u,~ ('ic~. ~rct'-~
IAT SIACK SDBD. ~,~Iq P.I.D. M
Descri tion of work: ~i'
The applicant is: Owner ~.Contractor ~ Other co~«in~~
Name '°S"~-~~^4-~~Y~c~ ~i4~-F-qc. Phone . 7/-~3o
Property ~~ST FIRST
.Owner pddress -r,2<~t 6-(2i'uerl2r~a~7o1
SiREET STE M
City ~---~~•4~ State tit.~ Zip `~~f~
Company ~ r~ Phone
Contractor Address License l~~S` Exp
City State Zip
Company ~ Phone
ArchttecU
Engineer Name Registration ~
Address
City State Zip
Sewer S water licensed plumber ~ b~ . Processing time for
sewer & water permits is two days o ce a a has bee pproved.
I hereby acknowledge that I have read this application and state that the information is
carrect and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: L2~ .~G~kK-~:,
OFFICE USE ONLY
. ~
BUILDING PERMIT TYPE . ~.r~ .
? OI Foundation ? 06 Duplex 0 11 Apt./Lodging ~y ? 1fb~6asRD~4~~"finish
~ 02 SF Dwg. ? 07 4-Plex 0 12 Multi. Misc. ~~0 17 Sw1m Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ~ 18 Cortan./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comn./Ind. Misc.
~ 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
k7 31 New ? 33 Alterations ? 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) ~ Basement sq. ft. MWCC System ~
(Allowable) Vy lst F1. sq. ft. ~ City Water
UBC Occupancy p?-3 ,+•r-/ 2nd F1. sq. ft. PRV Required
Zoning R-1 Sq. Ft. total Booster Pump
~Y of Stories ~ Footprint Sq. ft. Fire 5prinkler
Length On-site well Census Code ~o
/
Depth ~,33 On-site sewage SAC Code
/
APPROVALS %
Planning Building Assessments
Engineering Variance
RE~UIRED INSPECTIONS
O Site ~ footing .~'Framing E~J' Insulation
? Wallboard Final ? Draintile ? Fireplace
Permi t Fee v.i~scso~: S ~ ~0
Surcharge ~s~-fd~
Plan Review a-3S _ 1336 ~a~•
License ~
MWCC SAC /G, S,r 3 = `/j~s5- ~~~f-3o = ~pO
City SAC ~o z~ zo
Water Conn. ~~o,t- 5 =
Water Meter (o~oX/Ga /ozya
Acct. Deposit ~ y-~'2 " ~
S/W Permit c
5/W Surcharge ~~g~.s°X~S ~ IDz 63~.s o
Treatment P1. ~
.
Road Unit z ~ ~~/9 S
~
Park Ded. " p~Z
Trails Ded. 38„i-z°/ '
Copies -
Other (G k l~, _ `
Tuta~: //~~~,re~.~~ (~3~o?i
sac x J
SAC Units
r
.a r~~'
* ]f- 2422 Enterprise Drive
Mendota Heights, MN 55120
* PIONEEF! W!D SUflVEYOFS • CIY1L ENGINEERS (612) 681-1914•Fax 681-9488
eng~neer~ng UND PLANNERS:• LANDSCME ARCHITECTS s25 Highway 7o Northeost
~ Blaine, MN 55434
* * ~ (612) 783-1880•Fax 783-1883
Certificate af s~r~ey fo~: The Rottlund Companv, ~t1C.
House .Address: 509 Severn Way~ Eagan, MN
Model Name: Monterrev
F.r
~ SV5~4r7~~~~~E
~ ~ 3L, 0~ 913.0
' ~ _ - _ - - ` ' - - ~ -
. S~ ~ - ~ _ _ ~ _ ~
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~
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VOCQ/1 r ~ ri/ l~j +9~ . I CD O
. 2 O ry~~~ / I 5
~ ~ . , \ I Z
C7 4 / / 1~sp ~
11.41 ~ ~
d `{P
~ ~~ii9\w~•QJ ~ $ ~~o {9i~~6 ~i
~ ~ q~~ ~ /
P yh /
~ ~ ~4~ cA m~~s~~ ~y~o1 ~ U
~C ~ °o ~ ~JCA y~~`~~~ ,R`p \s~? ~ i ~ / /
oy
v / ~ i
/ 'm ~yFO s~,,oo / c ~~F ~ i
/ , '"~s '~b ~ / ~
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974.9 ~ ~ \ ao ~i s q'~~~. ,~1
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S~~=~/ ~ S~~ 22~,~GAf~
~ ~ i ~ s~ak~ RENI~WED
9~''~ . R ~ 6' qn, 2`'~ 9(!•5~ 6.35 QY ~ -
~ 60 49~3 , 9~`•~°
- ~F ~ ' ~0 2 916.3 1 ~ qu
~ ~ ^ 9h5~66 ~~.__e- / ' / /
/1''/~ i ~ ` ~
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NOTE: CANTRACiOR MUST VERIFY ALL DI11EN510N5 AND ~RIVEWAY OESICN
. eoo.o Denotes Existing Elevation PROPOSED HOUSE ELEVATION
Denotes Proposed Elevation Lowest Floor Elevation:91Q.85
Denotes Drainage & Utility Easement
- Denotes Drainage Flow Direction Top of Block Elevation:918.96
Denotes Monument Garage Slab Elevation:918.63
Denotes Offset Hub Bearings shown are assumed
LOT 21 , DBLOCK MIN~soTA COVENTRY PASS
4TH ADDITION
~ I hereby certify that this survey, plan or repon was prepared by ma or under my direct supervizion and that I am duly Registered Land Surveyor
under the laws ot the State of Minnesota. Dated this 1f~ dey of J6^u4~`~ A.D.79~,
( .Al~S~.Y+'K~.~ ` ~
SCGIe. ~i"-ch=30feet ~"~"'x""
ROBERT B. SIKICH ~.5. REG. NO. 16891
1~ 92526.22
~ ~ 2AT iQRVEY CBECICI.IBT ?OS 1tE6ZDE2TZ'271L
~ sIIILDINO pZRItST SpPLIGTION
~R04ERTY LLG]1Lt ~
~
~ ~ . ~ a.c. o: .,u,?.p= ~!s"~L~ 5'______
DDCUMENT BTIINDARDS
H~D D • Aegistsree Lsnd surveyor siqr~ature and eompnny
8~D 0 • Suilding permit 1?pplicant , '
@~ 0 0 • Legal description
B~~~ 0 • 1?ddr~as
6~ G ~ • North arrov aad bar scale ~
B~0 0 • Iiouae type (ramblar, walkout, aplit .w/o, split antry,
lookout, etc.)
9~0 0 ~ Direetional drainage anows vith s2ope/qradiant
6~D D • Proposed/axisting sowar and water services
H~~~ 0 • street name
G~ D 0 • Driveway
ELZ'~?ATIONB
Existinc
D 0~0 • sewer service , ~
0~ 0 D • Lot eorners
8~ 0 0 • Top of eurb at the driveway
D~ 0 0 • Elevatioas of any exfsting adjacent homes
4ro~osed _
~0 0 • Garage floor -
0~ 0 0 • First tloor
~ G 0 • Lowest exporad slevation (Walkout/window)
0' D 0 ~ Broperty corners .
LYn D • Front and rsnr o! home at the loundetion
PONDiN6 I1REa8 ti! anol3eabi~)
D ~ D ~ ~Lement line
D ~ • ~twL ~
0 CI 0 • Pond ~ desiqr~etion
D ['~0 • Emerqenoy Ovezflow Elevation
nirtsxsioxs
D D ~ • Lot lines ~
~ D G • Rfqht-of-way and sts~et width (to beck oi curb)
Y~D D • propose9 Aome dimeasions ireiuding aay proposed •d~cks,
overhangs qreetez thaa 2', porchsa, etc. (i.s. all
stzuctuzes requiring permenent tootinqs)
~ 0 0 • ShoW all sasements of record and any City utilities within
thoce sasements
8~0 0 • Setbacks of proposed sLructure and setback oi adjacent
existing lsomes
D 0 • Retaining requ mentr, i! any
R~t+i~aeC:
Hame / Da
Oetobez 1992 , '
~r~r;~ort f:rrvr•.t,n~~r: nvt•:r,nrr: ^u" cnrrru•rn•ri~ur ~~r,~,-~rr~;
osrv~ 1
. ~ ' .
SITE ADDSESS
CONTRACTOR ~orTL UNTJ G~, D.qTE PHqNE
Determin vorkinr; square footv~e of ench.
1. Total exposed va?1 area 2r'l sn. ft. x 0.11 _~,~7,Zw
• 2. Total roof/ceiling area I J~ 9•~ sc~. ft. x e.0?6 _ 3O~ G(~
• •
Total exposed vail area nbovc flo~r = 2~~ Z
s. Total uall vindow area . 2 ,
_ b. Total door area (o.G2,
c. Total sliding glass floor area -r
d. Total fireplace va11 nrea 2 G
e. '~otal vall framing a:ea (avera~e lOP) D, i'~
t. Total net vall area above floor /pj q 7,G/ •
. 6• Total rim ~oist area ~ ZD,i-~
, Total eaposed frn:ndation arca = ~II 4' `
h. Total foundetion windov area ~J~•7,7
i. Total net foundation area ubove.grade 4,L~
. . Determine "U" value o: each ~all ;FFment.
~ a. I a~.2 „U„ 0,~2 - 77• 34
b. ~7 to. /L x„U„ O, l3g 7g .
- . X ,~U„ _
d. 2~ x,~s~~ . o, / 2,g ~
e.. 21~, ~'°J X.~,u„ ~~089 _ l$.75
r. 1~97;at X„U,. /~,~~r3 _ ~ g~).57 J
. g. 2 Z~ , o X.•t,,, o, D41 _ q.o S
~
n. I~.75 X„v~, 4«a _ ~ 7. Z~f-
9~. X„~„ : o, iq- _ /3.Zs
3. ~r~r,~~ = 2/7~ 4
.
If item'//3 is the same as, or les: :.t~:~n ite:a tll, you have meL the intent
or ssc 6oo6(c)2.
~ n
~
, , Total exposed roof/ceilin~ Rre1 = ~ I~~i~'J
'i . . . . _
Total gross roof/ceilin~ are:+ _
. . '
Total skyli~ht area _
k. Tot al roof/ceiling framin3 area !7~
1. Total net insulated roof/ceiling area ~(p/~ r7 S_ •
~ Determine '~U" vnlue for cnch ruof/cci 1 in~; ~eF,~ncnt.
~ X ~~U~i •
_ ,
k: li7 9~ X„U„ ~ ~,cz7 = 3;1~ ~ '
.
1. / 0!~/.,5~j' x~~~~~ G Z = 2 3..3'? ~
u . Totai =~Z G, 6 3
c~
If total of NL is the sa~ne ~s, or less than N2, you have met tt~e intent of
SBC 60o6(~)i. . ,
To utilize the total envelope system method, the values establi_hed by the ~
s~ of itens H3 and M4 shall not be greater. thxn the swn of iten,s Ill ead 112.
1. + 2. _ _
- ~ . 3. L = .
• . . ~ .
• , r~
: •
0
_ . O °
. . c>4-i~ :-Si>
. 1
DETAILED F;EF'ORT FOR EfJTIRE HOUSE
Frepar~d For: F'repared E+y:
N~rmnr.r.' h1.W. 6uerre
Flar-e Heatir~g
, Mn J~b Name: Custom HGUSB
****k.~:***~~.**~*~-******~-***k-%~**~~********~**4C'~'4~*$*~~:Y:Y:~**~:~n%k**n.'~F**~n%n*XC*Tm**
EX~'OSUFE
GLASS NOnTH SLIUTH EAST WE~T PJE/NW SE/SW HORZ. TOTAL
Arr{EA I 6? ~ ~ i~ .^.liry ~ 114 I 28 ~ i2 1 0 I 464 I
COOLIPJG ~ 1.6991 6~9~ S.28C11 5,^c~Vl ^o7'~i 1.103~ p~ 18~~1p1
HEATING ~ 2,9641 1,194i 8,°46; 5,04~{ 1,23^c~ 1,2.=+^0! 0~ 20,524~
BELOl+3
WALLS ~,O~TH SOUTH EfiST WcST PJc/D+'4J SEJSSJ 6RADE TOTnL
F,F'EA ~ 51~1 2=81 76C>I 94.31 <^i~; ~C.f 4~ ~9b~
CC~JLIN[ ; 742~ 77i>; 698~ 774I 1^c; 18~ U~ 3,i~~71
HEFiTIhd^u ~ ',075~ ,16~.; ~,Eb^c~ _,18^! 7~~ 757 7,4~~~ l~,0'02;
QOQRS I'dOF;TH SOUTH EAST P1EST NE/PJW SE/~W TQTAL
AREA ; UI i^o~ 2n; la; p; Qi 1 50~
CQGLIP•J6 I i~~ _~1; ?7^0~ 251~ c~1 L~I ~ 7E~~~
HEr^,TIPJG ~ n~ 1,~~3i~~ 1,145~ l,t~:0; q; C>~ , .'_.,?p5~
FL07fi AFE:, COOLING HEFTIPJG
3439 ~ O ~ 3,^~7
CEILIhJG nnEA COOLIPJ~ HEFTING
i I.iS'i i ~~b~o
MISCELLAPJEQ~~S COOLING LOr;DS
F'EG~ilE Sen=_ible LGau' 1,i~5 La.ter~t LC~dd ~ 7~~C~~'
Liqt'it= R, t^.~F~pi . Load 1, 195 LntErit SafEty c~tui
i =7~
Ventilation Lc~d 1,~E5
Duct Heat 6ain ii
Infiltratior~ Load ~'lt>
Scnsible S~fety L'tui~ 1,~4~~
TOTAL SEf•lSIBLE LOnD ~9~198 TOTAL LRTEfJT LOAD 7,08_
Summer FCH ii.C~7 Temp. Swing Mult. 1.0:~
Total Co~lir~o Lc,~d ':,~~8? FTUH Or =.0~ Tnr~s T~#
MISCELLAPJEQL~S HEATING LOADS
Infiltration Load 7,579 :'er~tiln±ior~ Load
D~tct He~t Less Safety Rtuh
Winter FCH i_~.1~
e.~ne TC~tr.l Heatl~~q LG~d b5.:~~= RTIJH m*+"~
, 04-C> = -9ty
, ' _.1
SUMMr^,R'f REF'ORT
F'reparEd F~r: F•rEprred Ry:
Norm~ndy M.W. G!iErre .
Flare Heatir~g
, Ptn Job Name: Custom House
:r.~kT.~IA~"fi*###~*~.~:***8#BcW.#a~:%#"~~~k:~K ~"~$C%tk~:M"~"~*:r.m~*#*~~"d:n"~F*%n%n$~~*m#~*mm8%n~m~**k#7F
DE~SGPJ COP;DITIONS -For
DUTDOGR INDOCIR
~VI4IMGR WIP~JTEfi SUMMEF bJiP•aTcR
Dry Ru1G -25 :2 7~
Wet Rulb 75 " 67
Daily Range 2~~ paily 5wing '.V
LatitudE 44 Elev~ti~n
Safety Factor 5
LatFnt Factor
"~*m".~.r~e.:nmm:s~iR:**%n~%n,~'r#~:K~~kX~*`r.:r.:r*~~~~.rf$m"~"~*".d*~*.'('+*~~'~:#$$:'~$W.~:"ei"~r*N'.~%nm:r%nyn~`.#~AcT."~c:r
5en=_.ible
Fc~om Hcating Heatino Cooiing Cooi~ng
IVame , BTUH CFi'i RT!
~H CFi1
R~serr~en t 1~~ a4o ~78 1, 868 94
Great Room 3,:55 47 ~,874 145
Dinettc 6.120 8b =,491 170
k:itchEr~ b,792 9S =,144 154
Dining Rc~orn 2,24~ 4~> 1,?'~5 1~>1
Foyer ~,=?6 75 _.4~~4 i?2
Office Den 4,422 6~ '3~ 118
bedroom 1 -;,bSJ 6~ ~',717 137
Pathr-c~or~ 4.402 b~ .67~: :~S
Master Redroom =.,021 Sb ,441 i~i
Pedroc~m _ ~,bb`~ 51 =~~2 llo
b5.~9= ?17 ~9.198 1,47~
HEF~TING DELTA T oS.i~ C~GLIN6 DELTF T l~.n
NOTE: Calculated F,irflc~w is based u~'ion lc,ad requir-ements.
Verify that airflc,w calc~ilated is compntit~le with
selecteu Fqui~~m~nt rEquirEments.
PERMIT ~~q~~~
~ CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B u r ~ o r N e
Eagan, Minnesota 55122-1897 Permit Number: 0 2 6 4 5 8
(612) 681-4675 Date Issued: 0 4/ 2 6/ 9 5
SITE ADDRESS:
509 SEVERN WAY
Ltl7: 21 BLOCKe 2
COVENTRY PASS 4TH
P.I.N.: 10-16403-210-02
DESCRIPTION:
Building'Permit Type DECK
Building Wo=~.k,Type NEW
~ti ~
i
~
~:i; ~ ;
zx ~
l, t . , ~ ~ ~ " .
'i ili.
~ . , . ~ _ Y I a.._
REMARKS:
FEE SUMMARY:
BaSe Fee $30.00
Surcharge ~50
Total Fee $30.50
CONTRACTOR: OWNER: - Applicant -
THORN JAMES
5@9 SEVERN WAY
EAGAN MN 55123
(612)455-6500
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply ~ith all applicsble Btate o~F Mn.
~ Statu s and City of Eagan Ordinances. J
' ~ru,n ft ~a;(..,~,~
__l~~
A TEE SIGNATURE -~1~D : S G TURE
~ INSPECTION RECORD
• CITY OF EAGAN PERMIT TYPE: g u z ~ o i N ~
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: 0 2 5 4 5 8
(612) 681-4675 0 4/ 2 6/ 9 5
SITEADDRESS:P•I•N.: 1e-seaes-z~0-az APPLICANT:
L07: 21 BLOCK: 2
509 SEVERN WAY THORN ,7AMES
COVENTRY PASS 4TH (612) 455-6500
PERMIT SUBTYPE: TYPE OF WORK:
OECK NEW
. .
OOTINGS FINAL
.r
~ ~
~ ~
« ,
CITY OF EAGAN ~ ~
~ 3830 PILOT KNQB RD - 55122
1895 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construction Reauirements RemodeVReoair Reouirements
? 3 registered si[e surveys ? 2 copies of plan
? 2 copies of plans (indude beam 8 window sizes; poured fiW. design; etc.) ? 2 slte surveys (exterior addkions & dedcsj
? t energy calailations ? 7 energy calwlatlons for heeted addkions
? 3 copies of tree preservation plan 'rf bt platted after 711193
required: _ Yes No
DATE: O~~ CONSTRUCTION COST: - y~~'
DESCRIPTION OF WORK:
STREET ADDRESS: ~ ~ ~J~~~
LOT a~ BLOCK _Q~ SUBD./P.I.D. J~~'~~`~ ~ L
PROPERTY Name: ~d~~ ~~~5 Pnone : ~a " ~~3
OWNER ~~.er ~ ~ YSS - (oS~~
street Address~ 5~ J~ lA /ic-~/
City: ~y ~~i'9 State: ~'~l Zip: ~~~~3
CONTRACTOR Company: Phone
Street Address: License
City: State: Zip:
ARCHITECTI Company: Phone
ENGINEER
~ Name: Registration
Street Address~
City: State: Zip:
Sewer & water licensed plumber: Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the in ation is corr and agree to comply with atl
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE U3E ~NLY ~'j r~[~~MI~~
Certificates of Survey Received _ Yes _ No pp~ Z 0 t995
Tree Preservation Plan Received _ Yes _ No
~ + .
OFPICE USE ONLY °~y " ~
, .
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 46 Basement Finish
0 02 SF Dweliing o 07 4-plex ? 12 Multi RepaiNRem. ? 17 Swim Pool
? 03 5F Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
n 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Misceilaneous
? 05 SF Misc. ? 10 _-plex ~ 15 Deck
W~RK TYPE
~ 31 New o 33 Alterations ? 36 Move
0 32 Addition o 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. y3 y
Depth Footprint sq. ft. SAC Code oi
Census Bldg /
Census Unit ~
APPROVALS
Planning Building Engineering Variance
~
Permit Fee Valuation: $ ~ 2 ° ° ~
Surcharge
Plan Review
License
MCNVS SAC
City 5AC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
96 SAC
SAC Units
; ~ F'.~
• ~:d •
~ S85'47'f8" ;
132.00 ~,3
. J/, ~ 4 __n .
~ ~
~ I W
~ ~,.~a 2 ~ i ° °
N
3 i ,m
/ ~.s ~ ~ : .
Vocan ~ ~ 40 `6~.~\ q`o ~?g ~ g:
2o N,~~'y ~ t~ ~ 5
. ~ ~ ~ ~ E
, . ~
,i k
~~9 °~~,ei~4~'~ 'A~ s •9~°.t
~ y~ j4~ ~ ~ ~ .
,
; ~ ~ -
~o~ i ~ \ ~
i
~ 'bg ~ '
~ \ ~~e,~ l~?v3
~ o ~ ~ ~ ~ ~ ~ ¢ ~ i ,~5'S9
rs'~ se. $ \ 4 4~'~~~t, ~-O :
. y~ ~ y 22
L~ ' ~
~ ~o ~
m3' ~ ~s•r ~°'y~~ ~ .
SE~ s°•~ :~2' ,e.
F,p~
y~,~ r \
I
~ fm1E conTiGC70R IWST KRMY u1 un~NN9oPS ?ND ORM1EwAY DESl6r7 . .
. uoo.o penotes Existing Elevatio~ ROPO HOUS~ ATtQN
¦c~ Denotws Proposed EJevation lowest Floor Etevation:910.85
Denotes Orainage dc Utillty Easeme~t
- Danotw Drolnoge F7ow Direction Top of Blodc Elevotion, 918.96
-o- Denotes Monument Garag 5iab Elevation; 918.63
-a- Dertotes dffset Hub Bearings ahown are aseumed
: LOT 21 , gLOCK 2 C~
TH TR ~T ASS ~
. DAKOTA COUNTY, AIiNNESOTA l
~ -l hrabY nrtMY lhet thh wrwY~ Plan or ra~iart rw~ V~~ee yy me a uMn mY direet Wpsrv4ipn snd tMt I~m duly ReOtmrad lunel BurMY« i
; under tM Wvt o! tM State of 611nnawu. D~tW tAh~_ dry of ~n
u.~
a.~ A.D. f9 ' . ,
.
r^ - - ~ - - e n r__a :
. ~^~'r~' g',;` d '~r -r~r: -
. ~.r~ @y ,
~ .:.,.....Y~./,°~;~..~YJ:l;2+:+
.l~~tl{'~~.S.Ifiri.GO..^..~w v..~~.G.+skr~~~rtk.,G~.. ~ . : ..R : .d`.af~a:t3kkf~[I~(~._f.`.'C'n.v~, .
~~y~~
t ~'~~"1~~~~"~
~ w;sl~ z~s y >ue.µ~~~w~,~~~~`~~~&.~~y~'~~am ~'~'s+c~a~ ~a,~iJ`~_s~""~.. a~~a i x
s=~~v~'~. ~<,r ~~jA
§~3 ~ F~~,~~5*~°<e`y~'a~~i~3~ a~ a~~i i
b
r$s~~~ F` ~g' 3'ay.~ z~ 3~, e r
~V~~ '3°y cSz' ~ s s~a~.a~"~s£<~,H~t33s43'~3hYir 3~#vt ~ffR^~e~7~~~+~~..{~~ ~
h-,: n<>.: ~ o-... .....u. ~ 7a ii3..a:...'~~ .zi:,a.:.,b 1.£,~ ' ~:..~~a .~e f..~?.>.:
a.. .,.,~.a a~o-. . . ¢ . . 3.,, ~ :
1994 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTTS ARE REQUIRED FOR EACH UNIT.
~ NEW CONSTRUCI'ION
ADD-ON AJC
ADD-ON FURNACE
FIREPLACE INSERT
DATE ~J~'~c
FEES
HVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1 @ $3.00 EACH)
ADD-ON/REMODEL (ExISTING coNS~tucrION) $ 20.00
STATE SURCHARGE .50
TOTAL c~'1~4
SITE ADDRESS: ~5:~ ~A_
OWNER NAME: Ck~c~,~ TELEPHONE #:5~~-~'~"~~
INSTALLER:~~~_ ~~~c~ Y.S~--
ADDRE35: ~~.~~t-~,_-~.sl~.~ ~.~e_
CITY: C-s- .V . STATE: ~'~n ZIP CODE:~y~1
TELEPHONE ~~.`~--\\~,b
~
SIGNATURE OF PERMITTEE
~'"~7~~
-"E ~x+ ...w -z~,t~&~q fa ~w-i+va a M'x S.o s`r, x c a z)-~~ a
~ ;"sf n.~Y'~~. -'c ^~,P~,'~~T'' 3it~`0`~' g,~ "ia3'g~'~'x~~'.'R~' d< .s. ~,~K °yc e~ r ~'.~t ~ ~ts ~ 4~ ~
3? x w.°~~rc~~~''~Hy ~'~3~ ~ 3~'~ ~c3 ,yo~°^~`R ~ ~Es r £~`s.3 t~ '~r~ S~~c >3' . : a <
ay Y x~'~~`a r S~A~3'~4~A i~ 35e4 ~,~?xw.. s„~£~1 S e s ~29F~*. ~s.~r sYa ~ 3£f s S€ z
~1 i' ~A fx ~ ~asc Y FDF f€ ~~r53 cM.b f~ ~ i~g~ ~~y hht?, ~ C'. F'<T s ~i
a~ h&x.~ ~ ~ r~~13S~;'~iys .y,aa~g z y,ir i s.ss3^u £ 3~~`{vr ,s4 x
t~LTS~a r x ~c ~E"t~Y~'sR&~~~~ ~$~i:v~niRe~a i~f3;3~. z~. ~33 FA t 9 ,5~ k'FN ~ i . ~F~ ~~x°',~ c.A ~ ~a. ~rz.s~. ~r:~c ~ £s ~
. ....,€.5...>,o-."?H~~ A$~+53~.~,:°'~-~a.'~.,~e~'?.sx`v>>k~'.a< ~<bn~~~&BSd?.Y.ta'~i..w.h~.°SU.Ym~... ~~<Str~~~~ ;'$,2,.`s°.a:.«.~`&?:is~aa '~s
1994 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
DATE: CONTRACf Pr:ICE: $
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1% OF ~i~~~G"~ FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF ~"~MT'~' FEE.
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPHONE
TENANT NAME: (IMPROVEMENTS ONL1~
INSTALLER:
ADDRESS:
CITY: STATE: ~ ZIP CODE:
TELEPHONE
SIGNATURE OF PERMITTEE CTI'Y INSPECTOR
y. },w+~y r NLY y~
L',~~°7~,rL Dl!:'- ' ~,~~.f~~' .•'w-"~~„'sic} y?>F F a
d ~
~s s~y £ . ,v a~°°'~ ~.~}~a~
6UBD
~ A~:~ ° ~
1994 PLUMBING PERMIT (RESIDENTIAL)
C1TY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WI~iEN PERMTTS ARE REQUIRED FOR EACH UNTT.
NO. FIXTURES EACH TOTAL
~ SHOWER 3.00 3 -
WATER CLOSET 3.00 ~
a BATH TIJB 3.00 l D-
3~ LAVATORY 3.00 ~ -
KITCHEN SINK 3.00 3--
LALJNDRY TRAY 3.00 3 -
HOT TUB/SPA 3.00
WATER HEATER 3.00
FLOOR DRAIN 3.00
1 GAS PIPING OUTLET • m~~~m~m • i 3.00
~ ROUGH OPENINGS 1.50 y ~ ~ °
WATER SOFTENER 5.00
PRIVATE DISP. • DakCTy. lic. ZO.OO
U.G. SPRINKLER • nome under oo~i. 3.00
ALTERATIONS • ~o aus~ing 20.00
WATER TURN AROUND 20.00
STATE SURCHARGE .50
TOTAL:
SiTEADDRESS:__ ~iOq ~evarJ
OWNER NAME:__~~~-l\~-c~
INSTALLER: V ~a c~~ C o a. c•
ADDRESS: lnl[) GQer~C L~,
CIT'Y: ~0 2 d 4. STi1TE: 9'`` ~ ZIP CODE: s s 3~'
PHONE ( ) 4 `l, ~ ala ~
~
SIGNATURE OF PERMITTEE
tF ~ ~ ~ ~ n ~~'~75~ ~z~7~'~~'' yy~~ ,y~L
i~ ~ '~.~'~a?-0~'~'~ ~ ~ M~~~L`
l~ s a'~'u~'yy 'x`a `
? ~ 4 p.'~"~ >3~"3s > 3~`S i3.~° a e q,~ Z`t, i h~'F w s~ r K ~ q> ~R.~~C a „
yw~': s ~ ~.Ea ~'a>~r ~y?Y3~~s~, )~~k`r'.tu`o,iq r~a~s' ,2"~, ~:a~'p'#°<a i£~ ..~£k~ ib~4e~ : t .
°~~`u~ a~3~ K~` :'f'~'
~ ~ ~e°2;y3~'i F F~ia g~{L`~u¢~ ~,~4ti."°z g9 ~ ¢$g ~as ~i§ y~' U y uo-,~ ~
. ....~.4~"~. .eo.o ~+'~..F+ ax~~
~.~~n3:~3~'iua<w<auwa~^..tR~~~~.~..\.mw
~~SR.~~ ...F. . w.:4..
1994 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PII,OT `KNOB RD
EAGAN MN 55122 '
(412) 681-4675
PLEASE COMPLETE FOR ALL COMMERCIAL/INDUS
.T~2IAL BUILDINGS. ALSO FOR MULTI-
FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING ITNIT.
_ NEW CONSTRUCfION
ADD ON
REPAIR
WORK DESCRIPTION: , _ .
CONTRACT PRIGE: $ '
FGC: t~lc OF CONTRACT FEE.
STATC SURCHpRGE: S.SO FOR EACH $1,000 OF ;~~RNI~ FEE.
DtINIbiUTi FEE: 35:00
CONTRACT PRICE' X 1% $
STATE°SURCHARGE $
TOTAL $
SITE ADDRESS:
s , y: , , x
TENANT NAIVIE: STE. # ` . . ' _
OWNER NAME:
INSTALLER:
ADDRESS: -
CITYc STATE: ZIP `CODEa
PHUn'E
FOR:
CITY OF EAGAN APPLTCANT
L ~ / B~
~L
~
SUBD
~
NEW RECEIPT d /
RECEIPr DAI'E c(~ /S /
~
.
.
~
J~ o ~i ~
~
. PLF/~SE BE ADVLSED TNpT TF~RE IS A FEE SHORTAGfi ON TF~ ABOVE
II.BCTRICAI. IISTALUTION IN TF~ AMOUNT OF 3 O' ~
SHORTAGE MIbT BE PAID YHITHIN 14 DAYS.
REMARI6 •
/~7 ~ ~
l./ 0 to 30 amn. circuits= V.
~
31 to 100 amn. d re~its=
0 to 100 amo service~
~ 301 to 200 amo. service= O~~
arJ
TOTAL FEE DUE~ o~ .
g c!J
LESS FEE RECIEVED IU~ 73 ~ ~OC'
TOTAi. FEF. SHORTAGE D[IE e , L~ D
FHRMITO I"L 7'~ '
ORIG. RE~EIPPd~QI!,Zd
RE~EIYT DATE ~
7
SENRN A COPY OF TFlIS FORM HIIB BE!!II'fAPCE-
~89y a`~
RESIDENTIAL BUILDING ,
Permit Applicatiou
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephooe # 651-675-5675 FAX # 651-675-5694
NewConSbuctimReouiremenls RemodeVFieoairReuuiremenb OffzeUse~lv
3 regisle~e0 site surveys shovnng sq. R ol bt sp. fl ol house: anC atl raoletl areaa 2 mpies of plan _ Cert af Survey Recd
(2096 mazimum lot mverege albwed) 1 set ol Energy Cakulations for n~ted addilions _ Tree Pres Plan ReN
2 copies ol plan showing beam 8 vrindow sizes; poured fountl design, etc 1 sile survey for additions 8 derks _ Tree Pres Nol ReQd
lsetolEneqyCalwWtlons Additlon-irMicatei/onsitese0asystem _OnalteSep6cSystem
3 a0~ of Tree P2servatlan Plan H lol plaCeO aRer 711N3
Rim Joist DelaJ OD~~s se~Ctiui sheel (bidgs wiN 3 ar less unib
Date / Construction Cost o~~,Ct'~J' .LO
Site Address ~ ~i~P~ GCf / UnitlSte N
Description ot Work ~ '
Multl-Family Bldg _ Y x N Fireplace(s) _ 0~ 1 _ 2
r^_ ~ /
Property Owner ~ / (NJ ~ (1//j Telephone q ( y - S~7~~
Contractor '
Address City
State Zip Telephone ll ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv I Minnesota Rules 7672
Ene~gy COde CategOry . ResldenUal VentilaGon Category 1 Worksheet New~Energy Code~ orksheet
(J submission rype) Submittetl D~ I ~ SubmiCeA ~ 2 D
• Enerpy Envelope Calalatlons SubmiUed
p APR 2 8 Z003
Licensed Plumber Telephone ~
Mechanical Coniractor. Tel~aoas#{=?
Sewer/Water Contractor Telephone )
I hereby apply for a Residential Building Permit and aclmowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
p that the work will be in accordance with the approved plan in the case of work which requires a review and
ppro al lans.
J ~ t~?/ /`lU
p can s rinted Name Applicant's Signature
' OFFICE USE ONLY
Sub Types
? Ot Faundadon ? 07 OS-plex ? 13 1&plex ? 20 Pool 0 30 Accessory Bldg
? 02 SF Dwelling ? 08 O6-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex O 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazeba) O 36 Multi Misc.
? 05 03-plex O 11 10-plex ? 19 Lower Level ? 24 Stortn Damage
? O6 04-plex ? 12 12-plex Vlbg_Y w_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) O 44 Siding
O 32 AddiGOn ? 36 Move Bldg. ? 42 Demolish (Foundation) O 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 WindowslDoors
? 34 Replacem6nt •Demalitlon (EnUre Bldp) - Give PCA handoul to applleant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addirion) . _ Plumbing
Foundation HVAC
Drain Tik Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final .
_ Framing _ Siding Smcco Stone
F'veplace _ RI. Air Test _ Final _ W indows (new/replacement)
_ lnsulation _ Reraining Wall
Approved By , Building Inspector
Base Fee ^
Surcharge
Plan Review ~
MGES SAC
City SAC
Utility Connection Charge
S&W Pertnit 8 Surcharge •
Treatment Plant
License Search
Copies
Other
Total
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA132170
Date Issued:07/29/2015
Permit Category:ePermit
Site Address: 509 Severn Way
Lot:21 Block: 2 Addition: Coventry Pass 4th
PID:10-18403-02-210
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
James A Thorn
509 Severn Way
Eagan MN 55123
Sedgwick Heating & Air Conditioning
1408 Northland Drive, Suite 310
Mendota Heights MN 55120
(952) 881-9000
Applicant/Permitee: Signature Issued By: Signature
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING ,1p8 NO.����L=
1408 NORTHLAND DRIVE,SUITE 310 • MENDOTA HEIGHTS,MN 55120 • (952)881-9000 TEST RECORD
ADDRESS � "� C1TY "
OCCUPANT OWNER �"�`
SOLD BY WSTALLED BY
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UMIT�[��T��� LINER SIZE S���
LIMITSETTING � � FILTERS: SI E ��`���X;�— NUMBER
FAN SETfING WIRING �, `
PILOT TYPE TEST TAG
IGNITION MODEL `'[+�� Sl�r��C� �IGHTING INST.
PILOT TIMING '�.������
��J� � DATE TESTED
PRESSURE i � PERCENT COZ �t�
INPUT CFH `��g� PERCENT 02 ���I COMPANY TESTING ������
STACK TEMR '.��_ PERCENT CO ��� NAME OF TESTER C `�n
FORM 235(REV.10/10) � . FORM DISTHIBUTION: WHITE COPY-JOB FILE YELLOW COPY•CITY