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1639 Sherwood WayCity of EaQali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit #: Permit Fee: Date Received: Staff: L INFLOW & INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water /�—y Date: /27-30-/t)�/27-30-/t)6 3 Site Address: / ' Tenant: Suite #: RESIDENT / OWNER Name: C/a`�// Phone: Address / City / Zip: 3 7 v bhectoced tiJct,-( /63 CONTRACTOR Name: 111 /' ` +ri f/1l44'Ly_ License #: Address: X- 294N City: (! ,�� �� y}"� q57 2C/Z ///' State: / /t," Zip: c Phone: C -e/( Contact: J &V\ Email: L _��► ' TYPE OF WORK PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) Sump Pump Repair Repair Other: Other: DESCRIPTION Description of work: ,I zip Pk. 1 of P/66d Q( r/ 1 FEES $55.00 I Each (includes $5.00 State Surcharge) TOTAL FEE $ * *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit Ill repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.cityofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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.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 hich r ires a review and approval of plans. . Jc v� Applicant's Printed/ ame cant's Signat CITY OF EAGAN WATER SERVICE PERMIT 3830 Piloe Knob Road PERMIT NO.: P. O. Bo:: 21199 E: n, MN 55121 DAT No. of Units: 9 L ss: 639 S d va 141t w rreAddress; _ . 1 _. KOXMI to ? surcharge: rrit6 the Cih ? Met` eves Misc. Charges: ordhmwcee. Total, Daft Paid: By Insp.: Date of Insp.: CITY OF EAGAN 3830 Pilot snob Road P. O. Box 21199 Eagan, MN 55121 Address: WATER SERVICE PERMIT PERMIT NO.: 1 i r ?. DATE: 1 . No. of Units: No.. No.: to am* v1* the city of 11"Pa any Connection Charge: Account Deposit: Permit Fee: P ' surcharge: 63. UU pd met:ell Misc. Chorges Total: Date Paid- Insp.: Y OF EAGAN SEWER SERVICE PERMIT CIT 3830 Pilot Knob Road £. ?rl F PERMIT NO.: P. O. BOX 21199 i I Eagan, MN 551 1 it DATE: U nits: No. of Zoning: Tollef son Owner Address: d S 3 L7 B2 Brittany 2nd Wa . herwoo 16. 9 Site Addy y Plumber. to ma wkb &e cay of glen C vvectlan ChaMe: 14LJ.uv F" M : Account Deposit:. j,-, -no-? `' Permit Fee: t {? - ?`n---- Surcharge: By Misc. Chorpes+ Date of Insp.: Total: Irnp.: Date fold: BUILDING PERMIT CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 Receipt To be used few '032 1)', R;/ ;:. Est. Value $66,000 Date,- Site Address 163) SH"'? )OD WAY Erect I Lot I Block 2 Sec/Sub. BRITTANY 2 Remodel ? Parcel No, Repair ? Enlarge ? Name T0f,L L:FSOP: BLDRS Move ? Z {,J`--- Demolish ? b3 Address f:,. 454-156/3 Grade g ? O Name U Address C ltv Name _ Address City - Phone I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. :., 9542 '-/w) Occupancy Zoning Type of Const. No. Stories Length 5 0 Depth 3 8 Sq. Ft. Assessment Water & Sew. Police Fire Planner Council Bldg. Off. 9/2 5/8 4 APC Var. Date Permit '? -').3.L . V v Surcharge 33.00 Plan check. 1?5-59 SAC 525.00 470.00 Water Conn. -?0 Water Meter Road Unit 76 0.0 0 Parks Total r • 5 Signature of Permittee T="8014 BWR$ A Building Permit is issued to: 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 ` Permit No. Permit Holder Date Plumbing H.VA.C. Electric Softener Inspection Date Insp. Other Footings Foundation Framing Rough Plbg. Rough HVAC Insulation / Final Plbg. Final HVAC Z_ai.sy , Final Cert/Occ. /k r Water Describe Location: well Sewer Pr. Disp. Receipt l [ l y MECHANICAL PERMIT Permit No. CITY OF EAGAN l Fee ,._ Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date - 2. Installation Cost 3. Job Address Lot I 1 Blk. f Tract 4. Owner 5. Contractor Phone 6. Address r. 7. City ' State Zip 8. Building Type: Residential 9. Work Description: New '? 10. Describe 11 Commercial ? Institutional ? Add ? Alter ? Repair ? Type No. Equipment BTU - M. Ea. Forced Air No. Equipment CFM Air Handling: Mfg. Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. 1 hereby certify that the above Information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for `Aough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454.8100 BUILDING PERMIT Receipt To be used for Est. Value Date t'AY ,19 Site Address Mi-01 :i) JAI Lot f Block Sec/Sub. tfY. _ ? 1 r.f•1 Parcel No. a Name W 3 Address o City c Name i Address P City Phone U W Name FW z z5 Address t m City Phone 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. Signature of Permittee A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. OFFICE USE ONLY On Site Sewage Occupancy MWCC System Zoning On Site Well (Actual) Conat City Water (Allowable) PRV Required # of Stories Booster Pump Length Depth S.F. Total Footprint S.F. APPROVALS FEES Engr./Assess. Permit ` Planner Surcharge Council Plan Review Bldg. Off. SAC, City Variance SAC, MWCC Water Conn. Water Meter Road Unit Treatment P1 Parks TOTAL 44 ' Permit No. Permit Holder Date Telephone # Plumbing H.V.AC. Electric Softener Inspection Date Insp. Comments Footings 1 5.2, S Footings II Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Bldg. Final Cert. Occ. Temp. LP Deck Ftg. Deck Final well yr ?- Pr. Disp. t --- v CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 , BUILDING PERMIT Receipt To be used for CMI107LY RIPAIR Est. Value $900 Date 19 Site Address 1639 SXIMWWD WRY Lot 7 Block 2 Sec/Sub. ERITTA" 2ND Parcel No. Name JET! SWRRHOU z Address 1639 SHERWO D ULY ° City !i Phone 432-0303 o Name ICI, INC o< Address 626 ARNSTRIM AYE City S7 PART. Phone 222-2622 ?- jr UW Name W y? Address W City Phone 19 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 Perm ittee ___ _._ __. A Building Permit is issued to: __ LCYf_ in 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_____-.-__ i. OFFICE USE ONLY On Site Sewage Occupancy MWCC System Zoning On Site Well (Actual) Const City Water (Allowable) PRV Required * of Stories Booster Pump Length Depth S.F. Total Footprint S.F. APPROVALS FEES .4. 00 Engr./Assess. _ Permit Planner Surcharge .50 Council _ Plan Review Bldg. Off. SAC. City Variance _ SAC, MWCC Water Conn. Water Meter Road Unit Treatment P1 Parks ?' ?? TOTAL Permit No. Permit Holder Date Telephone e Plumbing HN.A.C. Electric Softener Inspection Date Insp. Comments Footings l Footings II Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Bldg. Final Cert. Occ. ?O Temp. LP _ Deck Ftg. Deck Final Well Pr. Disp. CITY OF EAGAN ; ,??J 8223 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT To be used for GARAGE ADDITION Fst Vnkw, Site Address 1639 SHERWOOD WAY Lot - I Block 2 Sec/Sub. B1tITTANY 2ND Parcel No. W Name JEFFREY SODERHOLM Address 1639 SHERWOOD WAY ° City EAGAN Phone 452-0303 o Name THE CONSTRUCTION ASSOC u< Address 13616 COUNTRY LN City EURNSYILLE Phone 433-7504 Name _ Address Phone I hereby acknowlege 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 Permitee A Building Permit is issued to: THE CONSTRUCTION ASSOC 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 ' Receipt # i l ° J •f OFFICE USE ONLY Occupancy H-1 FEES Zoning (Actual) Const Bldg. Permit 91.00 (Allowable) Surcharge 3.00 # of Stories Length ,Z Plan Review Depth 12M SAC, City S.F. Total SAC, MCWCC S.F. Footprints - On Site Sewage Water Conn On Site Well Water Meter MWCC System City Water Acct. Deposit PRV Required S/W Permit Booster Pump SMf Surcharge Treatment PI APPROVALS Road Unit Planner Park Ded. Council Bldg Off. -- Copies 2.00 Variance TOTAL 86.00 Permit No. Permit Holder Date Telephone # WATER SEWER PLUMBING HN.A.C. ELECTRIC Inspection Date Insp. Comments Footings I !? (!/ Foundation C Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final C'- Z S' Q S Deck Ftg. Deck Final Well Pr. Disp. CASH RECEIPT CITY OF EAGAN P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE 19 Rec civeD ??. PROM AMOUNT $ DOLLARS 100 ? CASH p CHECK FUND CODE AMOUNT Thank You BY White-Payers Copy Yellow-Posting Copy Pink-File Copy CASH RECEIPT; CITY OF EAGAN P. 0. BOX 21-199 EAGAN, MINNESOTA 55121 DATE - i 4 RKCSwED PROM I AMOUNT Is & -DOLLARS roe ? CASH _-`{] CHECK won FUND CODE AMOUNT J Th You 6Y White-Payers Copy Yellow-Posting Copy Pink-File Copy CITY OF EAGAN Addition Brittany (2nd Additio Owner i l?) I IA. Ilk 2 Parcel #10 15001 070 02 State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. (C 1982 2013.03 402,61 5 402.63 A015085 1-15-99 STREET RESTOR. GRADING 19 2 5 119.26 A015085 1-15-85 SAN SEW TRUNK Q 1976 ? ?. is 47.71 A015085 1-15-85 *SEWER LATERAL 1982 3830.10 766. Q2 5 766.02 " - WATERMAIN *WATER LATERAL 1982 5 WATER AREA 1982 296.92 59.38 5 59.40 A015085 -15-8 * Services 1982 5 STORM SEW TRK Q&e 1982 628.22 125.64 5 125.66 A015085 1-15-85 *STORM SEW LAT 1982 5 CURB & GUTTER SIDEWALK STREET LIGHT Road Unit 260.00 46628 9-26-84 WATER CONN. 70.00 11 BUILDING PER. 9542 SAC 525.00 If PARK This request void '({"?'\ lv 18 men 'h' tram` :Y A 094433 ?j ?/ fl q uad? ' ' o ?Ready Now Will Notify Inspec- Q/ es ?NO to, Wh; udy 1111-1crused Electrical Contractor I hereby request inspection of above ? Owner electrical work installed at: Street Address, Be. or Route No. `, City ? k1) Section No. Township Name or No. Range No. County Occupant IPRINTI Phon Nu. 2S <,F7 Po $upDlier Address ?T Elect -cal Contra ctor (Company Name) 7RAc Contractor's License No. Mailing Address (Contractor or Owner Making Instal lationl U Au wiz ignature ( 1raclo nev Makin Installationl I Phone Number L L> 6S 3v MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-191 - BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS 1821 University Ave., St. Pool, MN 66100 Ple.m 181121 21297 97-2111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION 10 E0-001101.004 T ' See instructions tpr Completing this form on back if yellow copy. A94433 " X" Below Work Covered by This Request Add Rep. Type of Building I Appliances Wired Equipment Wired lectric Y Fee Service Entrance Size MT - Fee Fenders/Subteeders # Fee circuits sZ 0 to 200 AMps 0 to 30 Am s !d 0 to 30 Am s Above 2 31 to 100 Amps S to 100 q M Swinlmin Ave 100_Am s Above 100_Amps Transfor Irrigation Booms ,S Partial' ther Fe Signs Special Inspection TOTAL Herrarks 9 9'(r? the Electrical t't?(,+ Inspectoq hereby "I/ certify that the above Final Dale ( spection has been made. This request cold 18 months CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 4548100 BUILDING PERMIT Receipt $ (°?//9?542 N?/ l ` & j? To be used for SF DWG/GAR Est. Value $66r 000 Date S EPTEMBER 26r ig 84 Site Address 1639 SHERWOOD WAY Erect IN Occupancy R3 Lot 7 Block 2 Sec/Sub. BRITTANY 2 Remodel ? Zoning R1 Parcel No. Repair ? Type of Const. V Enlarge ? No. Stories W Name TOLLEFSON BLDRS Move ? Length 50 z Address 1655 NORWOOD DR Demolish ? Depth 3$ 9 EAGAN 454-6873 Grade ? Su. Ft. City Phone Name - SAME.. Phone Name City Phone Approvals Fees Assessment _ Water & Sew. Police Fire Erg. Planner Council Permit 4 331. UU Surcharge 33.00_^- Plan check 1 f 5 -5 SAC 525.00 Water Conn. 470.00 Water Meter 63.00 Road unit 260.00 I hereby acknowledge that I hove read this application and state that Bldg. Off. 9/25/84 Parks the information is correct o agree to "-ply with all applicable APC Total 1 r 47 . 5 State of Minnesota Statut nd Cify of an'Ordinonce Var. Date Signature of PermiMee A Building Permit Is issued to: PO LEFSON BLDRS - on the express condition that all work shall be done in accordance with cal;le ?t of Minnesota Statutes and City of Eagan Ordinances. Building Official ?",(?'e A ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN S L?a INCLUDE © SETS OF PLANS, © CERTIFICATES OF SURVEY S. P. pWU./Gg12. Q SET OF ENERGY CALCULATIONS To Be .Used For: Qtla Valuation: (6Ca1-00-O• W Date: Gjp 20? I?iP4 Site Address: 1 • • Lot: B1ock:,2 , Sect/Sub: ov'i kl hC? Erect: Occupancy: R 3 . Parcel #: Remodel: _I Zoning: Repair: Type Of Const: Enlarge: # Stories: Owner:??(??? Move: Length: 50 Address: Demolish: Depth: 3 S City/Zip Code: Grade: Sq. Ft.: Phone #: Contractor: ?14?? Address: I?rj NorWoo l nvW., Assessments: Permit: 33I - City/Zip Code: Water/Sewer: Surcharge: s Police: Plan Rev.: \ln?j. Phone #: 4ci4- Fire: SAC: 525•° Engr.: Water Conn: Arch./Eng: Planner: Water Meter Address: Council: Road Unit: Bldg. Off.: j Sls Parks: City/Zip Code: - APC: Variance: Q•? l? J?? Phone#: ~' 4t N - ? `n ,x X 0 A G ?1 v- d x x ? ? ? l51 ? c ? 0 CITY OF EAGAN ND 1 8223 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 q BUILDING PERMIT PHONE: 454-8100 Receipt p - o` Tobeusedfor GARAGE ADDITION Est.Value $6,000 Date AUG 2 , 1990 Sit,Vddress 1639 SHERWOOD WAY Lot ,#-, Block _2- Sec/Sub. BRITTANY 2ND Parcel No. IName JEFFREY SODERHOLM Address 1639 SHERWOOD WAY City EAGAN Phone 452-0303 J Name THE CONSTRU TON ASSOC gQ Address 13616 COUNTRY LN City A rR_i NSVILLE Phone 435-7504 GW Name u3 Address a City Phone I hereby acknowlege that) have read this application and state that the information is correct and agree to comply with all applicable Stale of Minnesota Statutes and( cit(ty,,ofEagan dinances. Signature of Permitee ( 'L K I& A Building Permit is issued to: THE CONSTRUCTION ASSOC 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 ` A-01 A, I Occupancy Zoning (Actual) Const (Allowable) # of Stories Length Depth S.F. Total S.F. Footprints On Site Sewage On Site Well MWCC System City Water PRV Required Booster Pump APPROVALS Planner Council Bldg. CB. Variance OFFICE USE ONLY M1 FEES SrU 19x96 Bldg. Permit Surcharge Plan Review SAC, City SAC, MCWCC Water Conn Water Meter Acct. Deposit SMf Permit S/W Surcharge Treatment PI Road Unit Park Dad. Copies TOTAL 81.00 3.00 2.00 96.00 CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N? 15629 PHONE: 454-8100 BUILDING PERMIT Receipt # 75 To be used for CHIMNEY REPAIR Est. Value $900 Date 9 a ,19? Site Address 1639 SHERWOOD_WAY Lot 7 Block _2 Sec/Sub. BRITTANY 2ND Parcel No. W Name JEFF SODERHOLM Z Address 1639 SHERWOOD WAY o City EAGAN Phone 452-0303 o Name ICI INC I oa Address 626 ARMSTR NG AVE U: City ST PAUL Pho; 222-2422 a W Name_ = Address w City- 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 E an rtljgances. Signature of Permittee A Building Permit is is ed to C IN1C_ 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 ?yu? OFFICE USE ONLY On Site Sewage Occupancy MWCC System Zoning On Site Well (Actual) Const City Water (Allowable) PRV Required . * of Stories Booster Pump Length Depth S.F. Total Footprint S.F. APPROVALS FEES Engr./Assess. Permit 24.00 Planner Surcharge • 50 Council Plan Review Bldg. Off. SAC, City Variance SAC, MWCC Water Conn. Water Meter Road Unit Treatment P1 Parks TOTAL 24.50 CITY OF EAGAN N_ 15 0 5 2 2830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121 PH ON E: 454-8100 q BUILDING PERMIT Receipt # 7) C? To be used for DECK Est. Value $1,000 Date MAY 23 ,19 H8 Site Address 1639 SHERWOOD WAY OFFICE USE ONLY Lot 7 Block 2 Sec/Sub. BRITTANY 2ND On Site Sewage Occupancy MWCC System Zoning Parcel No. On Site Well (Actual) Const m Name JEFFREY SODERHOLM City Water (Allowable) W Address 1639 SHERWOOD WAY PRV Required i of Stories o City EAGAN Phone 452-0303 475-6637 Booster Pump Length Depth a Name S.F. Total . o a Address Footprint S.F. i- City Phone APPROVALS FEES Engr./Assess. Permit 24.00 Name i Planner Surcharge .5o i- Address Council Plan Review a W City Phone 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 Ordin ncea s. !I Water Meter •tu.:n? a ,-?ti nature of Permittee Si = W I g - Road Unit A Building Permit is issued to: JEFFREY SODERHOLM 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. 24 50 r il P TOTAL . u ??C. Building Official 1 016 4005 RESIDENTIAL MECHANICAL PERMIT APPLICATION' 1 City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit r Date ? / / Site Address OrWO 0 Unit # Property Owner Telephone #Os1)_ 7 -q?L Contractor (Y Street Address (?J/) T V U V State (A (/L[? / t V City <j 5T Zip ?55! o Telephone # 2 (? Bond Expires: The Applicant is Owner Contractor Other Add-on or alteration to existing dwelling unit $ 30.00 furnace -Additional -Replacement air exchanger air conditioner New - Replacement other State Surcharge $ .50 Total $ 3 . I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and zitfi Ne Mechanical odes; that I understand do -s not a permit, but only an application for a permit, and work is not to start withq t a pe mit; that the Wa? be in accordan wi h the approv in the case of wo k which requi sa review and approval o?l,? ?lm C?-1 s Applicant's Printed Name Applicant's Signatuf J 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) Bond #: Expires: The Applicant is Owner Contractor Other Work Type New Construction _ Underground Tank - Install -Remove "see below Interior Improvement - Install Piping - Processed -Gas Nature of Work: "When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector Permit Fees: $70.50 Underground tank installation/removal $50.50 Minimum (includes State Surcharge) or Contract Value $ x 1% _ $ Permit Fee • If pe rmit fee is $1,000 or less, add $.50 => $ State Surcharge If ep rmit fee is over $1,000, add $.50 for every $1,000 permit fee $ Total Fee I hereby apply for a Commercial Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; 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 Applicant's Signature Approved By: , Inspector Date: Tollefson Builders Inc. Or.11563 183-78 JACKSON - SURVEYORS REGISTERED UNDER LAWS OF STATE OF MINNESOTA ?. 3616 EAST 55th STREET, MINNEAPOLIS, MN 55417 727-3484 Scale V 30' fourlupor'9 QCtrtititatt - .Drainage 6 Utility Easement - = Drainage Proposed Garage Floor Elav. 101.5°-Q0 °O0_o = Existing Elev. a Denotes Iron N ,, ?/jA.(' ?o I ? 0 l ,Z, l1yrq N .-?? _ a GO zz-. ? __ le \ a "1 1 `L 1y? ? S? -7 I HEREBY CERTIFY THAT THE ABOVE IB A TRUE AND CORRECT PLAT OF A SURVEY OF Lot 7,Block 2,Brittany 2nd. Addition, I Dakota County,Minnesota. M.N AS SURVEYED BY ME THIS 20th,_DAY OF Sept. A.D. 1984 ? )I SIGNED / ?- F. C. JACKSON. MINNESOTA Fj. GISTRATION, NO. 3600 CITY OF _ Ef76if}A1 BUILDING DEPARTMENT EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION (To be submitted with building permit application) One or Two Family Dwelling Owner 1y - All other -T' Site Address 11L: f-ef uYX? U k Contractor IOLLE)?ao? Date Q Phone 454- &/o 7'j I 17-oz sse. ?T 4-ievet- LINEAL FEET OF SEE /?f ?cl?K 'lq1 o; f , EXPOSED WALL 5 6-F-T/ft: above grade = TOTAL EXPOSED WALL AREA SQ. FT. OPAQUE WELL COF.STRUCTION: "U" Value x Area Detail FR'4a1F_ nUrr .093 x sq. reference @0a1c• Stuff .098 x 5q, from - ?? ?/iT "U" .040 x SQ. attached fluff x SQ. sheets -flute x SQ nun x SQ WINDOWS: "U" Value x Area FT. h4`13406 694.7_1 (U) (A) FT101-5L = 10•L4(U) (A) FT:--- 5.1-7 4 =(U)(A) FT. - (U) (4) FT. - (U)(A) FT. _ (U) (A) Make & Type w5tx . S "U" •S 1 x SQ. FT. w/ 5.60 = (U)(A) flute x Sq, FT. c (U)(A) it it nun x SQ. FT. _ (U)(A) it " "u" _ X SQ. FT. (U)(A) DOORS: "U" Value X Area Make & Type iTL• INSVL • "U" . /Q x SQ. it " PQTio fluff •47 x SQ It n fluff x SQ It it - nun x SQ. TOTALS 1984.00 SQ. AVERAGE "II" TOTAL (U)(A) VALUES 19 (Oct •- DIVIDED BY TOTAL WALL AREA 1'70+.00 _ AVERAGE "U" ?or less for 1&2 family dwellings ROOF/CEILING: TOTAL AREA: /ZO Z FT. 49.0o = 6.8f0 (U) (A) FT. Z•co H-74 (U)(A) FT. _ (U) (A) FT. a (U) (A) r'T. 190.9 _(U) (A) Detail reference 'IU'' •OZI x SQ. FT. /ZOZ = L$.L (U)(A) from flute x SQ. FT. (U)(A) attached sheets. rrur' x SQ. FT. _ (U)(A) Describe openings .,out, x SQ. FT. -, - (II)(A) in roof. "II" x SQ. F+T. - (U)(A) TOTAL (U)(A) VALUES DIVIDED BY ZS. Z¢ s ToTIFLS /ZoL zS•Z4C?1\ TOTAL ROOF/CE G AREA IZOZ.QO . OL, ? AVERAGE "Urr .025 or ventilated roofs. --WALL SECTIO -- Determining "U11 values at Roof, Wall, Rim, and Conc. Block ROOF/CEILING 1.) Interior Air r'ilm 2.) 5/811 Gyp. Bd. 3.) Insulation 4.) 5.) Exterior Air Film (STILL) (R) VALUE o.61 .56 44. CFO .61 11U" = 1/R= .pZI DOTAL (R)=96,78 WALL 6.) Interior Air Film 7.) 1" Gyp. Bd. 8.) Insulation 9.) 4_%e' BvrGT-R'rrn7 10.) Masonite Siding 11.) Exterior Air Film (R VALUE o.68 .45 19• v0 Z-0 .17 "U" = 1/R= .OQ3 TOTAL (R)=03.01 RIM 12.) Interior Air Film 13-) Insulation 14.) 211 Fir Rim Joist 15.) 2547-11 Bear-Rim 16.) Masonite Siding 170) Exterior Air Film (R) VALUE 0.68 t9,0o 1.88 Z• 04 .67 .17. "U" = 1/R= ,deb p TOTAL (R)=ztf FOUNDATION 18.) Interior Air Film 19.) 20.) 21.) 1211 Concrete Block 22.) ?-lGlb IA*01-. 23.) Exterior Air Film R VALUE 0.68 1.28 F•o0 .17 1 tU" = 1/R= .OQ$ TOTAL (R)= JD.I3 ?? Wow 51I To !$RosS Ekseb W--4(-(-_ /*.soX(4o+r8+-zltz4) . 15-sZoo 9.50X ( &*,vz+ ?4) = 399,oo 4•n? x rz = 9B•vo 1, 9P?. 00 CouG, rim -?eqsr 83X??fo?¢ot38t38? _ !27¢S.k Il+uboauS (-::Vrw) (&x3(o = $•oo X01 = 70X¢s =- 134 X 4 = zo X 3fo = !o. ct7 X 2 - z4 x 3l0 = 12.00 X 3 = z? x4B = r?.oo X 3 = 8.0m 53.60 av. vo 3(0. coo g$.oo I(v5.loo• bvclz 5, _ aTZ wl?l.. = 28. o0 Z? 6:m. se7e. zt.oo _ PAT/o - 42.00 `Il •nv NEr & ,??c. E??.Ks 6? 144C. 1)98¢. ap . 1,65?9 CawG. R,?1 12v.¢s '? Gopw's /(os. ova -490. (oo q Da?12.5 9/• o0 1----- gwE z4 x¢o = ?XZZ = $X /z = j5x 5S = 9(00 9(P /3as' l? ZvZ ?- SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS _# OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. To Be Used For:Af7'y40 rg4)*EAAMOf3 Valuation: a0&-0 Date: 7-0-70 Site Address he3 1 sHfpzwoob UJA-`f Lot I Block -- bF-t r rA,.J'1 2-to a Parcel/Sub Owner JEFFgEi SWEPLR0 I4 Address RPM S{FE/LWOOD L)A-Y City/Zip Code 66-6.? 5S/A:?1- Phone 6?U -C&O-3 Contractor 7yf e0AA MLje_Tj,0A) 4SSOC, Address L:?4oj (o POUAf7j„y LAtn)E E 55337 City/Zip Code AwAisviv !` Phone li 35- /60L Arch./Engr. Address City/Zip Code 141-1,3 1990 BUILDING PERMIT APPLICATION CITY OF EAGAN Occupancy Zoning Actual Const Allowable # of stories Length Depth S.F. Total Footprint S.F OFFICE USE ONLY FEES IVI - I tihx Iz. 12- x20 On site sewage_ On site well _ MWCC System - City water PRV Booster Pump APPROVALS Planner Council Bldg. Off. !klllb Variance Bldg. Permit J,00 Surcharge PO Plan Review SAC, City SAC, MWCC Water Conn Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Copies SUBTOTAL Penalty TOTAL t.; n Phone # t/ AL ,.- ,at I _1 j2-Y," y/fix/y, ? I2-. r 15 JACKSON - SURVEYORS REGISTERED UNDER LAWS C, STATE OF MINNESOTA 3818 EAST 55th STREET, MINNEAPOLIS, MN 55417 727-3484 Scale 1" 30' lbuchcpor's ft rctfticate - -Drainage 6 Utility Easement - Drainage Proposed Garage Floor Elev. Existing Elev. a Denotes Iron - - I O S ? I ?4 q .5 a; Yo ?O l`II ? 1 ?? • -O . 0 /V Ml \ ?j ?N 1 HEREBY CERTI" THAT THE ABOVE IS A TRUE AND CORRECT PLAT W A SURVEY OF Lot 7,Block 2,Brittany 2nd. Addition, Dakota County,Minnesota. AS SURVEYED BY ME THIS-20t h.-DAY of Sept. A. 11- 1984 a O 183-78 lv ? \I I?1 I? . ? 9 VED / F. C. JACKSON. MINNESOTA GISTRATION. No. 3600 altvoF ? d 3830 PILOT KNOB ROAD P.O BOX 21199 , . EAGAN, MINNESOTA 55121 VAC ELLISON PHONE: (612) 454-8100 Mayan THOMAS EGAN DAVID K. GUSTAFSON PAMELA McCREA THEODORE WACHTER cau ll Members October 19 1988 THOMAS HEDGES , CityA miNSttator EUGENE VAN OVERBEKE City Oerk TOLLEFSON BUILDERS 12617 FAIRGREEN AVE APPLE VALLEY, MN 55124 ATTENTION: CARL TOLLEFSON RE: 1639 SHERWOOD WAY Dear Mr. Tollefson: We have been contacted by Jeff Soderholm, homeowner at 1639 Sherwood Way, regarding construction of the fireplace in his home. Damage was done to this fireplace during a storm this past summer and in an attempt to have the fireplace repaired, a question has come up as to whether or not the fireplace was properly constructed. After inspecting the fireplace, at the owner's request, it appears that there may be some problems. In an effort to resolve this, we would like a representative of your company and the contractor that built the fireplace to look at it and give us your opinion. If you have any questions regarding this matter, please contact me. Thank-you for your anticipated cooperation. Sincerely, IV Doug eid Chief Building Official DR/js THE LONE OAK TREE ...THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY 1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS gG 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 # 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: A f Valuation 22 Date: 9- /-gg-l Site Address //j9 OFFICE USE ONLY Lot q Block _ Parcel/Sub fl -y LM4 Aft, Owner J G f? Socj- e?.Lo .«- Address S oq , e City/Zip Code Fpa,g $'S/ar?? Phone ys? - o ?0 3 Contractor L G L Z w G Address / 02l /a 2 ?sT.co - u a ?, e City/Zip Code S/ d??L ,C/off Phone dam - c>A yda Arch./Engr. Address City/Zip Code On site sewage_ MWCC system On site well _ City water PRV required Booster Pump _ APPROVALS Engr/Assess Planner Council Bldg. Off. Variance 2y So Occupancy Zoning Actual Const Allowable 11 of stories Length Depth S.F. Total Footprint S.F. FEES Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn Water Meter Road Unit Treatment P1 Parks Copies TOTAL Phone # 1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS 15o,51, Vo? 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 # 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: yEZ*.-_ Valuation: ID0a Date: Site Address 1639 yFQwono WAY Lot Block o2 Parcel/Sub BR/7fm1y ZuD 4D©/T10/•1 Owner JLrFR6Y ?IJERN?7LJV( Address (632 .94"WO©D WA'( City/Zip Code EA&A-IJ -0303 Phone ape/{ z/7-5--(Plo37 Contractor Address City/Zip Code Phone Arch./Engr. Address City/Zip Code Phone # iff" 1 M.4 i d f; fft FAti G T A V^N? On site sewage_ MCC system On site well City water _ PRV required _ Booster Pump APPROVALS ONLY Occupancy Zoning Actual Const Allowable # of stories Length Depth S.F. Total Footprint S.F. FEES Engr/Assess Permit C1,0O Planner Surcharge ..Sp Council Plan Review Bldg. Off. /==- S/I-ISPC, City Variance SAC, MWCC Water Conn Water Meter Road Unit Treatment P1 Parks Copies TOTAL 2/84 lI CITY OF EAGAN l APPLICATION FOR PERMIT - SEWER AND/OR WATER CONNECTION (PLEASE PRINT) 1) PROPERTY ADDRESS: /v3 LEGAL DESCRIPTION: C2 ( t/B1 /Subdivision or Tax Parcel I.D. N IF EXIS_= .G STRUCT mE , DAi? OF ORIGINAL Eu1=2.C PEF S1T ISSJAV `:on r i PRES-;T ]]"1I-"(-'/PROPOSED USE: L7 R-1 SIdGLE F NIILY ? R-2 DUPLE{ (7,,,'0 UNITS) ? R-3 TaZMOUSE (THREE + UNITS)( UNITS) ? R-4 APARTMENT/CONDCMIN=, ( UNITS) ? CONEAERCIAL/RE.TZ-1II,/OFFICE ? IIMUSTRIAL ? INSTITUTIONAL/GOVERIQ'fENT 2) APPLICANT (PLEASE PRINT) NAME: ? l B T.G?rOB'H/ 9'Y??GIiO ADDRESS : CITY, STATE, ZIP: ? AJ?• d>j/d Jam`/SL3 PHONE: ys ? (pg ?J?i' 3) PLUMBER NAME II '' PLEA RINT) ? Y4A) FOR CITY USE ONLY ADDRESS: /y7' ys 5 d 0eNWA 20ag997' 77?iQ/L PLUM S LICENSE: Active CITY, STATE, ZIP: ?OS b'j ,o&wwTi /" 6j y& 0 Expired PHONE: MA?ItH ?a PLUMBER LICENSE # /8y9A1 0 Not a Repord Staff Initial 4) OCCUPANT/OWNER NAME: (PLEASE PRINT) ADDRESS: CITY, STATE, ZIP: PHONE: 5) INDICATE W11ICH PERMI IS BEING REQUESTED: SII?IECI?ION TO CITY SE?]ER ??//CONNECTION TO CITY WATER OTHER (PLEASE DESCRIBE) 6) INDICATE ONE: QE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 2 04 ABOVE (Circle one) 7) SIGNATURE: DATE: /?a ??ewHwiw?yr?,a?ye.e ? ?' ac?.a?ai. ,?!'_'=???khs?s, .." t?tiass?r:ra?tae, .,. srt;r ? sa??hl?hcsrw F O R C I T Y U S E O N L Y PERMIT 4 ISSUED 1 -1 FEES: $ io mac- o $ eJ ? 6 Y $ $ $ SEWER PERMIT (INCLUDE SURCHARGE) WATER PERMIT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP ACCOUNT DEPOSIT - SEWER ACCOUNT DEPOSIT - WATER WAC SAC TRUNK WATER ASSESSMENT TRUNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SEWER LATERAL BENEFIT/TRUNK WATER OTHER $ TOTAL $ z?-< J? AMOUNT PAID/RECEIPT # DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING DIVISION. LIST AS A CONDI- TION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY:c TITLE: .?? DATE: 1J- ?! Mkswwam wwsm lwlM lw?wum jaw plwJlORf/w ?'?+wQ?ilJ??li?lk?ASAwr 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CJ2 _ CITY OF EAGAN 3830 PH OT KNOB RD - 55122 q ` (651) 681-4675 S - (3 C 1 New Construction Requirements Remodel/Repair Requirements ? 3 registered site surveys ? 2 copies of plans (include beam 8 window sizes; poured fnd. design; etc.) ? 1 energy calculations ? 3 copies of tree preservation plan If lot platted after 711/93 required: _ Yes _ No DATE: 4/0??! ?f ? 2 copies of plan ? 1 site surveys (exterior additions & decks) ? 1 energy calculations for heated additions CONSTRUCTION COST: DESCRIPTION OF WORK: Az &90 / ?o ? jy ? " a--QkA/,- "k n STREET ADDRESS: A 3,7- tir ? rc ?t m4 d W'y LOT: BLOCK: SUBD./P.I.D. #:' V Vl t.. Name:. 72 Phone #: (/o SI - b ?l - ?I I PROPERTY Last First OWNER 16 Street Address: 3 C?tG /?Jp o City EV.9^-- State: W Zip: ,65 /Z 2- Company: .,4 f ` e Phone #: 04L ?-e5) n4l a CONTRACTOR Street Address: / 15"9 3 License # 7O/3?j?y0 Exp. City wx?'5 0'-4z r-' State: Zip: -?2 ARCHITECT/ ENGINEER Company: Phone #: Name: Registration #: Street Address: City State: Zip: Sewer 8 water licensed plumber (new construction only): Penalty applies when address change and lot change is requested once permit is issued. 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 -- - iI I Certificates of Survey Received Yes No ??"I? MNY 2 i,, J Tree Preservation Plan Received Yes No Not Required','/; - L- -_, OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool ? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. ? 10 --plex ? 15 Deck WORK TYPE ? 31 New ? 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Engineering Census Code SAC Code Census Units Census Bldg MC/ES System City Water Booster Pump PRV Fire Sprinklered Variance Permit Fee Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Park Ded. Trails Ded. Other Copies Total: Valuation: % SAC SAC Units Y goon g 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 /DoZ,7• -2-3 New Construction Reouhaments Remodel/Repair Requirements t toa0nir 3 registered site surveys shovdng sq. ft. of lot, sp. R of house; and gg roofed areas 2 copies of plan showing footings beams. joins fort arSraeeyAkd Y 13 (20% maximum lot coverge angered) t set of Energy calculations for heated additions S®ts RepuE Y N 1 Soils Report if proposed building is to be placed on disturbed soil 1 site survey for additions & deft TSefRaaPipttt2d )f 2 copies of plan showing beam & windm sizes; poured found design, W. Pdditbn - indicate ff on-age septic system tfeepmsAsquxal y : ,N Y- l set of Energy Calculations OnAft 3 copies of Tree PreaerWion Plan I IIX platted altar 711193 Rin Joist Detail Options selection sheet (buildings with 3 or lass units) Minnegasco mechanical ventilation form Plans are considered nuhlic information unless you state thev are trade secret and t e reeason. Date-q-/ :2 t / _(37 1 Construction Cost 9,?,-Owe site Address 5 !'/'2 K wu d/J W A y unit/Ste # Description of Work C-&t-.-7 4 ,4 +4 GJ Multi-Family Bldg _ Y //P' Fireplace(s) _O -1 -2 Property Owner e I ? CA C e 4-- 'h 14 to, r -P I< L 'A Telephone it ((6l ) Sr .'?- a - "Y -7) 0 Contractor PQ( , 01 !5r 0h 4yR4c.41u\4 Address 14 -1 State ley% h ? a )< 0L, 4L J"-% K w r'S &-?!-44 City 4?-Iqwh . Zip Jar-x'1'13 Telephone#(.g'1) '?i:17J ?W COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv I _ Minnesota Rules 7672 Energy Cade Category . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelops Calculations submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone # ( Telephone # ( Telephone #( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a 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. M is L? t9 -e Applicant's Printed Name Applicant's SEP 2 1 2007 ii DO NOT WRITE BELOW THIS LINE Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? ? 03 01 of_plex ? 09 07-plex ? 17 Garage 22 Porch/Addn. (4-sea.) ? ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo/pergola) ? ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work Types ? 31 New 32 Addition ? 33 Alteration ? 34 Replacement 30 Accessory Bldg 31 Ext. Alt - Multi 33 Ext. Alt - SF 36 Multi Misc. ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors `Demolition (Entire Bldg) -Give PCA handout to applicant Description: WaterDamage_Ye! r Valuation t? Plan Review 100% or _ 25% Census Code T-7T- SAC Units # of Units # of Bldgs Type of Const NA Occupancy b MCES System Code Edition fJjL QO(o Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered Width Footings (new bldg) _ Footings (deck) Footings (addition) Foundation _ Drain Tile Roof Ice & Water Final ?. Framing Fireplace ?( R.I. Air Test Final Insulation T REQUIRED INSPECTIONS Sheetrock _ Final/C.O. Final/No C.O. HVAC Other _ Pool _ Ftgs _ _ Siding _ Stucco Lath _ Windows Retaining Wall Approved By: Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total as Tests _ Final Stone Lath Brick X23 , ?,? ? ?X?` jJq??l7? No RESIDENTIAL BUILDING PEI?iuAPmc4nw City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements 3 registered site surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas (20% maximum lot coverage allowed) 1 Soils Report if proposed building is to be placed on disturbed soil 2 copies of plan showing beam & window sizes; poured found design, etc. 1 set of Energy Calculations 3 copies of Tree Preservation Plan if lot platted after 7/1193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form RemodeUReoair Requirements 2 copies of plan showing footings, beams, joists 1 set of Energy Calculations for heated additions 1 site survey for additions & decks Addition - indicate if on-site septic system Office Use Only Ced of Survey: Recd Y =N Soils Report > Y -N Tree Prep Plan Rood -Y _N. Tree Pres Required _Y. _N On-site Septic System Y _N Plans are considered public information unless you state they are trade secret and the reason. Date Site Address Construction Cost Unit/Ste # Description of Work Multi-Family Bldg _ Y _ N Fireplace(s) _ 0 - 1 - 2 Property Owner Telephone # ( ) Contractor Address State City Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (submission type) -Submitted Submitted • 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? Y - N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( Telephone #( for a Residential Building: Permit and acknowled¢e that the information is comvlete and 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 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 Applicant's Signature REScheck Software Compliance Project Title: Bruce and Anna Everling Report Date: 09119!07 Data filename: C:wocuments and settings\owner.mon: 4.1.0 ificate Design\Energy cal s\EVERLING.rck Energy Code:- 2000 Minnesota Energy Code Location: Hennepin County, Minnesota Construction Type:. Single Family Glazing Area Percentage: 27% Climate Zone: 2 Construction Site: Owner/Agent- 1639 Sherwood Way Fagan, MN Designer/Contractor. Bill Ritenour Drafting 8 Design Services 952-292-5091 Maximum UA: 108 Your Home UA: 108 = 0.0% Better Than Ceiling 1: Raised or Energy Truss Wall 1: Wood Frame, 16" o.c. Wintim 1: Above-Grade:Wocd Fmme:Double Pane with Low-E Basement Wall 1: Wood Frame Wall height: 8.0' Depth below grade: 3.5' Insulation depth: 8.0' Crawl 1! Solid Concrete or Masonry Wall height: 4.0' Depth below grade: 3.0' Insulation depth: 4.0' Inside below-grade depth: 3.0' Compliance Statement: The proposed building design described here calculations submitted with then. The proposed buildi require me in c 1.0 and to comply with the mand Name - Title Sign 280 585 158 438 38.0 0.0 19.0 0.0 0.320 19.0 0.1 7 25 51 22 40 is consistent with the building plans, specfications, and other 1g has been designed to meet the 2000 Minnesota Energy Code ?tory irequireme li in the Rck Inspection Chm ist. AIM- l/ ( Date v 0.0 12.0 3 Bruce and Anna Evening Page 1 of 1 JACKSON - SURVEYORS REGISTERED UNDER LAWS Or STATE Or MINNESOTA 3618 EAST 55th STREET, MINNEAPOLIS, MN 55417 727-3484 Scale V 30' 1%urhtpcr'% 6trtificatt - :Drainage 6 Utility Easement y - Drainage Proposed Garage Floor Elev. 1 .5 '_4• n, = Existing Elev. • Denotes Iron - /30 O ? q IT, I ? 00 •.3 moo' - Q °? 7 ! 2 acT 7 Q1 / '? N 01 zz' _?le r• - - 11 (1 V I? ?I /3 e-j - ? I HEREBY CERTIFY THAT THE ABOVE IS A TRUE AND CORRECT PLAT Or A SURVEY Or Lot 7,Block 2,Brittany 2nd.. Addition, Dakota County,Minnesota. 183-78 IV \ \I 111 D l l.? r I As SURVEYED By ME THIE?Oth _DAY OF Sept. A.D. 1984 F. C. JACKSON. MINNEEoTR GIETRATION. No. 3600` ?Oql? 2or RESIDENTIAL BUILDING PERMIT APPucAnm City Of Eagan 3530 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reaukemenls 3 registered site surveys shoving sq. R of lot, sq. ft of house; and all roofed areas (20%mazimum lot coverage allowed) 1 Soils Report 0 proposed building is to be placed on disturbed soil 2 copies of pan showing beam & window saes; poured found design, arc 1 set of Energy Calculations 3 copies of Tree Preservation Plan g lot platted after 7/1193 Rim Joist Detail opfiaug selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form Remode[Repair Requirements office use Only 2 copies of plan shaving foobrgs, beams, joists Cart of Survey Recd _ Y _ N 1 set of Energy calculations for heated additions Soils Report _Y _ N I site survey for additions & decks Tree Pres Plan Recd _Y _ N. Adddion - imiicate d on-srte septic system Tree Pres Required _ Y _ N On-sde Septic System _Y _N Plans are considered public information unless you state the are trade secret and the reason. Date 10 Construction Cost Site Address 1 (0-3 I Cz%e{ t Cyx')eA `QaAA Unit/Ste # Description of Work Multi-Family Bldg - Y 'LC N Fireplace(s) _ 0 '6 1 _ 2 Property Owner {?)f,(AfP ? , )ect ?C1 ) r Telephone #(65/') YW - C' ?l?1D ( Contractor kJ?3? ?`?L21\?? C?CCa( ? Address -3 Kw L't-) t.C n i l(-?- city State -MY\ Zip Telephone#(T'!-) 89ei --?aL 0 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (J submission type) Submitted Submitted • 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? - Y - N If yes, date and address of master plan: Licensed Plumber Telephone #( ) Mechanical Contractor Telephone #( ) Sewer/Water Contractor Telephone #( ) I hereby apply for a Residential Buildina that the information is complete and accurat e; 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 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. &A-tin ,eW Applicant's Printed Name Applicant's Signature �-Use BLUE or BLACK Ink r For Office:e: Use Permit / �Clty 0 Ea �Il Permit ��� ' ' 3830 Pilot Knob Road ... Eagan MN 55122 Date Received: Phone:(651)675-5675 buildinginspections(a�cityofeagan.com Staff: 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: Name: IS 1� k C A , 4- U p,t Phone: �- .� - h '�C, /.. ..-1—' 15 11/ 10 'iv tt Iden s C� J conn � Oyv'" Address/City/Zip: 1 3 14e `\ (.Jc)c�� W rt� Applicant is: Owner Contractor i� (� J T •e oW• k Description of work: i- q C-.P '� t ) I t q- T T I C� �e 1 � x M ..» Construction Cost: Multi-Family Building: (Yes /No ) Company: �O V l �J ) t�ire �pvvSl Contact: e ` 603- �y�l l I-1 �or Address: �[ Klt -�t fr v` tib LA) City: ii ei'r" on.r.:,, 44 � w �- t / -115n,x N'� p: ��1`�-� Phone � `D-Y7d� Email: t•-• I R>7 t Ve✓1 d�t�. 04 S t/'�'( State: Zi yos fir£ .;,x License#: l Lea Certificate#: If the project is exempt from lead certification, please explain why: knit- i � � COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE Ply and ;. ppo documents r at you it are ev rc#e ed to be . bj '' .`Po - s e info' .on ma .. e . fl, as'non a ilc if> -rov ® �, 7f c reas:: o • ® ` ® sncI t,� �' de secrets .: . You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cityofeagan.com/subscribe. 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. CALL BEFORE YOU DIG. Call Gopher State One Call at(851)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. x -CRAY� r(- 1Y Applicant's Printed Name A licant s Signature pP g Page 1 of 3 Use BLUE or BLACK Ink r ,- f*. For Office Use of Eaaall City Permit#: X5` Permit Fee: 4 i4i; 3830 Pilot Knob Road � r-- � r Eagan MN 55122 Date Received: . Phone: (651)675-5675 I 'ff•CE1vED buildinginspections aC�cityofeagan.com Staff: � , AUG282017 • 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit#: 1 1 , Name: A k 4 C Y d- A-rr r.rs t vgt R 1 t h) v Phone: �O�r-Y5 '�- � ? / I Resident! owner Address/City/Zip: k.0 3 c' SIA 'e VZ t..t cu d(-0 tu a5 t W%.....•- i i Applicant is: OwnerContractor Descri tion of work . . .,,.b Type of Work p : I Il,S4 AM 1-1-a 4.44?'? - V W t c�eti Op. r\‘6;,, ,. .c5 8 1 - I Construction Cost: p1 Obc, Multi Famil Building: (Yes /No Company: K o u i,5 i D kv. l `� Contact: {'vf Sc I 80 4,--/ cc e, j Address: `13 7" . KA til ry i�h a'.5 Li 94 City: ea-, i��-- Contractor �j / State: Zip: rj 1J l'a.-'3 Phone:4 `.Jl_4 yy Email: A (� ►c C� h e I I ; t 1 -t o»,Cr15 License# Lead Certificate#: I If the project is exempt from lead certification, please explain why: I I 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? I Yes No If yes, date and address of master plan: 1 Licensed Plumber: Phone: I a Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: i Fire Suppression Contractor: Phone: I,. 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 I are trade secrets:______ __ _ �You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cityofeauan.com/subscribe. 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. 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. x hit-LIZ be ire. lX Applicant's Printed Name Applicant's Signature Page 1 of 3 1139 5h ro-0c d k DO NOT WRITE BELOW THISLINE j/Lf cV3 7 SUB TYPES Foundation Fireplace Porch (3-Season) Exterior Alteration (Single Family) Single Family _ Garage Porch (4-Season) Exterior Alteration(Multi) (� Multi Deck Porch (Screen/Gazebo/Pergola) Miscellaneous 01 of Plex Lower Level Pool Accessory Building WORK TYPES _ New Interior Improvement Siding Demolish Building* Addition Move Building Reroof Demolish Interior / Alteration Fire Repair Windows Demolish Foundation Replace _ Repair Egress Window Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation .9(Olt° Occupancy MCES System Plan Review Code Edition SAC Units (25%_ 100% ) Zoning City Water Census Code Stories Booster Pump #of Units • Square Feet PRV _ #of Buildings Length Fire Suppression Required Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) X Final/No C.O. Required Foundation Foundation Before Backfill r HVAC_Gas Service Test Gas Line Air Test _ Roof: _Ice &Water _Final Pool: _Footings _Air/Gas Tests _Final F Framing 30 Minutes 1 Hour Drain Tile Fireplace: _Rough In Air Test Final Siding: _Stucco Lath Stone Lath _Brick_ EFIS Insulation Windows Sheathing Retaining Wall:_Footings_ Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression: _Rough In_Final Braced Walls Erosion Control Shower Pan Other: fi,Reviewed By: , Building Ins ector RESIDENTIAL FEES tlni) il Base Fee14 Mil Surcharge Plan Review MCES SAC City SAC t 1 Utility Connection Charge S&W Permit& Surcharge Jr Treatment Plant a �*' Copies0. TOTAL Page 2 of 3