4847 Shevlin Ct
CITY OF EAGAN , WqTER SERVICE PERMIT
3830 P,',,t Kr-ib Road
P,..,. Box 21799 PERMIT NO.:
Eagan, MN 55121 DATE:
Zaning: R 1 No. of Untts: 1
r: 1 f ii
Add
Si ress: 4347 p $ •
r+l r:
Meter No.: 3 3 7( A -r ~_6'- Conneetion Char9e: a 5(). 00,12d
Size: ir /lcoount Deposit: 15.00 ~d
Reade
(IgaA Nc.•
Permit Fee: 10.00 pd
ING
1 as to aon+~~ ~V~ UtIIS crge: YXNX .~0 ;)d
OrJi~ena~. ~F.-,:- - ELCCTRiG • GA J Chorqes: 63. 00 ~eter
~r~ ~i:
BY ~ Paid:
Dote of Insp.:
CITY OF EAC,qN
3830 P;lot KnoL Road SEWER SERVICJ PEWIj
P• O. Box 21199
Eagan, MN 551~? PERMIT NO.:
Zaninp: ATE;
O"'"er TollefsoA $ldrs No. of Units: 2
~?ddress:
,
Sita Address; 4Q47 Shev2in Court Ll i~~i tan 4.
Plumber: ~ ~
2~n. tu -2-5-4 42283
~
O?dlnee ~v+f~ wJeb N» Cih of Eeto, 101.00 i.c:
Charge: 1.7, ~0(1 , i
AcCa+n! Diepodt; 15.
Ps^r+ff Fee: O.Ot? p4
By Stirch°r0°'
Dote
of Insp,; Miac, C}qrgm
Insp.: T'otof:
DWs Roid:
CITY OF ;AGAN
3830 Pilot Knrtb Road WATER SERVICE pERMIT
P• C• ftx 21199
Eagan, MN 55121 PERMI7 t,10.: :,:i;;l
Zoning: DATE: q
Owner: ~ 'ollefson D~~;rs No, of Un;ts: I
+Address:
Sfte Addreas: :8 7 S ev in CAtlr
Ptumber: 3 t;c;nz ~ an t L2 ~;1 ~3rittar: 4t'~
Meter No.:
Size: Connection Charge: 450.00 pcl
' Reader No.: Accourrt DeResit: I5. 0(1
1 agroe h emPly whl~ !1. Ci Pem~it Fee: 10. 00 )d
OedinoneM, hof E~yo ~ Surchorge: XYmt
Mlse. Chorpes:
~;I ^~~ter
9y Totol:
Dcte of Insp.: Date Paid:
~nsp.:
CITY OP EAGAN • 8700
3795 Pilet Kwob Roed Eeqoa, MN Ss122
~ PHONEt 454-8100
BUILDING PERMIT ReteiRt
Te w wed fer S s llldG / GAR Est. Volue $ 5 2,00 0 Date
Site llddress 4347 S=I----VLIi1 COURT Erect ~ Occuponcy
Lot 1 Block 1 Sec/5ub. 5R17TliiiY 9 Tf " A?rer ? Zoniny 1-a1
Parcel # 1^-15 0 0?- O 10 - D 1 Repair p Fire Zorke IZ/A
Enlorfle ? TYpe of Cwut. v
19 Name `I'OLLL:FSON BLDRS. MoVe p # Stories
~ Address 1655 _~O?G•;00'~ i?RI1TT; Demoiish ? Length''~'?.[i - 1i(; 1_1:1 Phone , 'S 4 - 6 '3 ~ 3 Cxode ? Depth 4 !L Sq. Ft.
~ ~a~ APprorals Fees •V')
o=t /lddreu Assessment Permit Y ~ 26.00
U~ Water 8 Sew. Surchorqe
Cit P?wne ~ 5 ~3
G PoHce Plan check
W Nome Firo SAC 5 c~. J. 0 Q
=Z Addren Enp. Water Conn. 9 S 0. 0 0
V
~ f3.oa
~W Cl phorw Plonner WoterMeter
Council Rood Unit " 5 0- . 0 7
I hereby atknowledqe that I hove reod this applicotion and state thot BI . Off.
the inlormofion is co?rect and agree to comply with all applicable T~a~ y; 1~'~
Stota of Minnesoto Stotutes ond City of Eoflon Ordinances.
Sipnaturo of Permittee
TO:_,LL:FSO'.? i LDP•.F. the axress condition ~hn+
/1 Building Permit is issued to: on P
cll work sholl be done in occordance w1/h ell appliwble State of Minnesoto Statutes and City of Eaqan Ordinances.
Bufldinp afflciol ' ~`'t; ` ' -
Permit No. :Permit Holder Misc. Permit Na. Holder
Plumbing ~c 7 a40Y
H.V.A.C. 3n 4~:j I
Well
Water
Disp.
S~wer
E lectric 3V48j,, CA G tE j
Inspection DaM Insp. Other
Footinpt
Foundation
Framinp
Rou~ Plbp. c
Rouph HVA
Inwlation ~
Final Plb¢
Final HVAC
Final
Water Describe Location: -
VYell '
Sevwr ~
Pr. D'up. ~
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fee ~
Fill in numbered spaces S/C
Type or Prlnt legib/y Tot.
1. Date ~ 2. Instal4ation Cost
3. Job Address Lot Blk. ~ Tract
4. Owner - ` ` ~ ~ • i ; '
5. Contractor Phone
6. Address T
7. City ' State Zip - ' '
8. Building Type: Residential ~l Commercial ? Institutional ?
9. Work Descsipvon: New ~ Add ? AIteT 0 Repair ?
10. Describe
11. No. Fixtures No. Fixtures
Water Closet Cesspool/Drainfield
' Bath tubs Septic Tank
Lavatory Softner
' Sfiower Well
~ Kitchen Sink
Urinal/Bidet Other
~ Laundry Tray
_L F1oor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that tha-above information is true and correct, and I agree to
comply with all ordinar}~es 8nd codes governing this tYPe of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numj)ereo and approved.
Approved ' e"~ t--• i--CITY OF EAGAN 464-8100
~
- i ,
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fee
Fi!l in numbered spaces S/C
Type or Print leogibly
Tot.
1. Date 2. Installation Cost
3. Job Address Lot Blk. Tract
4. Owner
5. Contractor Phone
6. Address
7. City Lr ~ State Zip
8. Building Type: Residential El" Commercial ? Institutional ?
9. Work Description: New 0 Add ? Alter O Repair ?
10. Describe Fuel Type
11. No. Equipment 8TU - M. Ea. No. EQUiament CFM
Forced Air Air Handling:
Mfg.
Boilers Mech. Exhaust
Mfg.
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
12. I 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
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN Remarks
Addition $RITTANY 4TH ADDN Lot 1 Rlk I Parcel 10-15003-010-01
Owner street 4847 SHEVLIN COURT tate EAGAN 14W 55122
Improvemen Date Amount Annuai Years yment Receipt Date
STREETSURF. 1982 452.89 90.58 5
STREET RESTOR.
GRADING 1981 23.7~9 1.59 15 1-5.92
53- . 35 ~SAN SEW TRUNK 1976 173.90 11.59 15 *'SEWER LATERAL j 1981 246.32 16.42 15 Sewer lateral (trk) 1983 133.39 8.89 15 f I to
WATERMAIN 45 1984 629.29 62.93 10
* WATER LATERAL 1981 LS
WATER AREA JW_ 1981 229.95 23.00 10 STORM SEW TRK 1981 596.44 39.76 15 397.60
STORM SEW LAT 1981 15
CURB & GUTTER
SIDEWALK
STREET IIGHT
ROAD IT 250.00 41288 2-2-84
WATER CONN. 4SO.00 11 91
BUILDING PER. 8790
SAC
PARK
. . Fw Office Use ONy: .
. MECNANICAI PERMIT PERMIT # '
CITY OF EAGAN RECEIPT #
3830 PILOT KMOB ROAD, EAGAN, MN 55122 •CaNTRACT PRICE: PHONE: 451-8100 DATE:
Site Address BLpG. TYPE WORK OESCRlPTWN
Lot __L__..Block BeclSub Res. New
~ Name _ Mult Add-on
Address - Comm. Repair
c City Phone Other
. . FEES
~ Name - RES. HVAC 0-100 M BTU -$24.00
# Address _ ADDiTIONAL 50 M BTU - 6.00
p City Phone " (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM -1 PER PERMI'r) - 1.50 EA.
TYPE OF WORK COMM/IND FEE -1 °k OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES
Boiler M BTU TOWNHOUSE & CONDOS - RES. RATE APPLIES
Unit Heater M BTU MINIMUM RESIDENTiAL FEE - ALL ADaON &
Air.Cond. M..gTU . REMODELS - 12.00
-1110110411UMGOIVIMERCIAL FEE -20.00
Vent CFM STATE SURCHARGE PER PERMIT - .50
Gas Piping Outlets # (ADD $.50 S/C PER EACH $1000.00 OF PERMiT FEE)
Other
PERMfT FEE: ~ _
-
SIC: SI . T R TTEE 7ZZI
TOTAL: FO : CITY OF EAGAN
CASH RECEIPT
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
owTe 19
RRCtIVt ~
PROM
AMOUNT $ I
& OOLLARS
1 oo
? CASH ? CHECK
FOR FUNO CODE AeAOUNT
Th n I!u
BY
White-Payers Copy
v Yellow-Posting Copy
Pink-File CopY
. cmr oF FA"N jvo 8790
3795 Pilef Kwob RaeJ Eo9on, MN 55122
• ~ ~ PHON[s 454-8100 ~S
BUILDING PERMIT Recelpr #
Te be wed Mr SF DWG/GAR Est. Value $ 5 2 , 000 Date .BR RY 2 , 19$4
Site Addrcss aRd'] SHF.VT.TN Cni7RT Erect (3 Occupancy RI
Lot 1 Block 1 Sec/Sub. BRITTANY 4TH Alter p Zoniny Rl
pamel # 10-15003-010-01 Repolr p Fira Zone NlA
Enlorye D TYPe af Const. V
W Naffm TOLLEFSON BLDRS . ?ybve p # Stories
~ llddress 1655 NORWOOD DRI VE Demolish ? Length 4 0' 2"
Ci EAGAN ptq~e 4 5 4- 6 8 7 3 6rode p Depth 4 5~ Sq. Ft.
~ Nome SAMF. Approvsls Feas
Address Assessment Permit .00
Cf ph~ Water 8 Sew. Surchorpe 26.00
Police Plan check 144.50
Nome Fin SAC 525.00
I-W
Address Enp. Water Conn. 450.00
~ W Ci ph~ Plonner Water Mefer 63.00
Council Rood Unit 250.00
I hereby acknowledge that 1 have reod this applicotion and stote thot Bldy. Off.
the information is correct ond ogree to comply with ofl applicobls $1 , 7 4 7. rJ 0
Stote of Minnesota Stotutes and City of Eo9an Ordinonces. APC Totol
Siynoture of Permittee
A BuiIdir,9 vermit is tssued to: TOLLEFSON BLDRS. on the exprcss conditlon thni
oll work sholl be done ~n ordonceAvtlh all opplicable Stote of Minnewto 5tatutes ond City of Eapan Ordinonces.
Buildi~ Officlol
~
iM1is request void
78 months from
A 3558 L B2ITTANy H'* q!
Peques4Dat? . Flre No. HnuBh-in Insuectiun ~
n ~j Ro yrtetl? Beetly Nuw ~Will Notify. Inspec-
pC Ves ?NO for When ReadY
LicenseA ElecVical Contractor I hereby raquest ins0eciion ot ebove
Owner elecirical work installad at:
Street Atldres5, Box or Poute No. Cit
ecUOn o. iownship Name or No. Range No. COULI/Y
Occupant IPpINTI ` Phona No.
Power SupO ' Address
Ele ical ConVac[or ICpmpanv Namel ~ Contractor's License No.
Mailin ddress (ConVactor or ner Makine Installa -on)
'
~
Authorized ignamre rector Owner akiqg Installacionl one Number
MINNESOTA STqTE BOAPD OF ELECTRICITY THIS INSPECTION FEQUEST WILL NOT
GriB9s-Midway BIdB. - poom N•197 BE ACCEPTED BY THE STATE BOAPD
1821 University Ave., St. Paul. MN 55704 UNLESS PNOPEfl INSPECTIDN FEE IS
Phone (612) 297.2111 ENCLOSED.
w REQUEST FOR ELECTRICAL INSPECTION EB-00001-04
11" Sae instructions /or completin9 this torm on back of yellaw copy. ~114P q
"~11 ~ J X'" Below Work Covered by This Request ~
e, . Rep. ~ ~ pe of Building ApPtiancas Wired Equipment Wiretl
Wome Range Temporary Service
Duplex Water Heeter Liphting Fixtures
Apt. Building Dryer Electric Heatin
Commerclal Bldg. Furnace Silo Unloader
industrial BIAg. Air Conditioner Bulk Milk Tunk
Farm ff y inEr Isner,i(yl
ther Spacify 01her
Compute Inspection Fee Below
M Fee ServieeEntrenceSiza H Fee Fee.tleis/Subfeetle,s # Fea Circults
0 to200qms- 0 to30qms Oto30Ams
Above 200 qmps 31 to 100 Amps , Q 31 to 100 Am s
Swimming Pool Above 100_Amps Above 100_Am s
Transiormers Irrigation 8ooms Partial-'Other Fee
Signs Speciallnspection S
Nema rks
~ T ~~o ~
Nough-in n pe Date tha Elect '
: Ic or, hereb
Y
rtlfy thet the above
Final e i nsoection has been
maaa.
fhis reQUeat voitl 18 monlRS from
i - , ~ rnvrtr
1.5 FEET NORTH-~ N172.65 S89°59'44"W PLA7)
OF PROPERTY IINE _ 1.5 `^172.23 S89°57'39"W ~MEAS.)-
EL 172,52
v' 2.1 1. @~ r7 .7 0.
r-.....
23.13 13. 9n;''.,;: ~~a4.22
o c~-~ m • ~ i r'i M 23.4 ~ 22.7
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A0DIT1 23.~
w co' L\CYT .
~
r /
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~ BUILDiQJG INSPE~
120.31 S86°22'45"E (MEAS.)
° 120.76 S86 °20' 17"E
W (PLA T) ~ 4
R
z ~=cK 1 a=pg -
o ~
_ - _ 1
SHER WOOD WA Y -
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RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN v-70 _ Q ~
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Reauirements RemotleUReoalr ReouiremeMs
• 3 regisle2d site surveys showing Sq. R. of lot, sq. ft. ot house; and all roofed areas • 2 copies of plan
(20% maximum lot coverage allowed) . 1 set of Energy Calculffiians for heated additions
• 2 copies of plan slawing beem & window sizes; pouretl found design, etc.) . 1 sHe survey for exleriar additions & decks
• 1 set of Energy Calwlatlons . IiWicale if hane served by septic system for additions
• 3 copies of Tree Preservation Plan'rf lot platted aRer 711193
• Rim Joisl DeWil Options selection sheet (bldgs with 3 or less unKs)
d~l
DATE I Z'26: - OZ VALUATION ~Lw
SITEADDRESS MULTI-FAMILYBLDG _Y _N
TYPE OF WORK FIREPLACE(S) _ 0_ 1_ 2
APPUCANT
STREETADDRESS ~-17 .S/lZ--7-~v t7T CITY L-%t(s.sFir/ STATE~?yZIP S/ZZ
TELEPHONE #~of~qS Z GJ'9/ CELL PHONE # fAX #
AO?' - G~r 9'_cG- s -7 35'
PROPERTYOWNER <ST~iLff_ e('iF9~&~'t TELEPHONE# S/i~- c-
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNFS01'A RiJI,F_S 7672
(J submission type) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contracfor: Phone #
P1umUing system uicludes _ Water SoRener Lawn Sprinkler Fec: $90.00
Waker Healer No. of R.I. Baths
No. of Baths
Mechanical Confractor: Phone #
Mechanical system uicludes: Air Conditioning Fee: $70.00
Hcak Recovery System
Sewer/Water Contractor: Phone #
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 Ordin f~ces.
~
Slgnature of Applicant
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 O OS 08-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of , plex ? 09 07-plex ? 17 Garege X 22 Porch/Addn. (4-sea.) ? 33 EM. 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
g 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 `.7 MC/ESSystem
Census Code Zoning /D'b City Water ~
SAC Units ~ Stories S'PLiY Booster Pump
Nbr. of Units - Sq. Ft. ~ PRV
Nbr. of Bidgs Length Fire Sprinklered /
Type of Const
~ Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) ~ FinallNo C.O.
_ Footings (addi6on) Plumbing -
_ Foundation ~ HVAC f41"NL
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Au/Gas Tests _ Pinal
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insularion _ Retaining Wall
Approved By , Building inspector
-
BaseFee ~j~g~----°---------------- R!<RLl4GI'Lf
d
Surcharge - .11
Plan Review
MC/ES 5AC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
m P lv ~ S~ls 30:sv
• • 2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for, single family dwellings & rownhomes/condos when petmits are required for each unit
Date ~ / n
Site Address aco C r= Unit #
PropertyOwner Telephone#(~bl ) 4zl0" ur)3ff
Contractor ":\:ie,., 43~ ~ Cz?q
Street Address ct1 T\C:..O (-b l-Ig City '<T. ~
State ~ Zip Telephone # ( ~j~l ) ~O~(Jp ~ ~ ~
Bond 54~S7- «Expires: a~s
The Applicant is _ Owner ~ntracror _ Other
Add-on or alteration to esisting dwelling unit $ 30.00
~ furnace _Additional _Replacement
~ air exchanger
air conditioner `New -Replacement
other
S[ate Surcharge F-It2 .SQ
FN
•~n
TotBl Ll s
B
I herehy 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 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
approv('e~d plan in the case of work which requires a review and approval of plans. `4Signa
T~~~~App
licant's Printed Name Applic
2004 COMMERCIAL MECHANICAL PERNIIT APPLICATION • •
City Of Eagan
3830 Pilot Kno6 Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: commercial/industrial buildings
multi-family buildings when scpazate permits aze not required for each dwelling unit
Date
Site Street Address Unit if
Tenant Name (if applicable) Previous Tenant Name
Property Owner ' Telephone # ( )
Contractor Street Address City
State. Zip Telephone # ( )
Bond • Eapires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove *•see be/ow
_ Interior Improvement _ Install Piping _Processed _Gas
Nature of Work:
**When instalfing/removing underground tank, call for inspection by Fire Marshal and Plumbing lnspector
Permit Fees: $70.50 C,S,aErgrouad ;ar,k insiatia:ioilremoval
$50.50 Mimimum (includes State Surcharge)
ar
ConhactValue $ x 1% _ $ PermitFee
• If nernvt fee is $1,000 orless, add $.50 $ State Surcharge
If nermit fee is over $1,000, add $.50 for
every $1,000 nermit Fee $ Total Fee
I hereby apply for a Commercial Mechanical Pernut and aclmowledge ffiat the informarion 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 pernut, but only an application for a perxnit, and work is not ro 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.
ApplicanPs Printed Name ApplicanPs Signature
Approved By: , Inspector Date:
~ 7aS ~ RESIDENTIAL
BUILDINC PERMIT APPLICATION ~ ~ a
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
651-681•4675
New ConsWClion Reauirements RemodellReoair Ranuirements
• 3 registered site surveys shawiig sq. N. of lot sq. ft. of Imuse; and all mofed areas • 2 wpies ot plan
(20%macimum lot coverage allaxed) • 1 set of Energy CaICWalians lorheated additions
• 2 copies of plan showiig beam & window s¢es; poured found design, etc.) . 1 site survey for exlerior additions & decks
• 7 set atErtergy CalcWations . Indicate if home served hy septic system for additlons
• 3 wpies of Tree P2servation %an if lol platted afler 7!1l93
• Rim Joist Detail Opliore selecdon sheet (bWgs with 3 or less unils)
DATE \Z' ~ '2J ~ OZ VALUATION
SITEADDRESS LIvI .S~EV1,.lA1 GT, MULTI•FAMILYBLDG _Y /N
TYPE OF WORK l.J 1 1"'z FIREPLACE(S) _ 0 /1 _ 2
Su
APPUCANT 5TE L1,._pw'(L p~pFtW P'~.
RE M~'4~L~ ~v G/ c-rpciy MEb~Mn~a
STREETADDRESS S Z00 w.!Zqrl'sT CITY EDf N A STATE M NZIP s~39 ~
TELEPHONE #TSZ -FS 3 5'- CELL PHONE # FAX #
O 10'1
PROPERTYOWNER ST:EVC ~~„Z/NU~'C'EKANSGITLEPHONE#9S2^YSYo 'S73~f
COMPLETE FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNF.SOTA RULF_S 7670 CATI:GORY 1 MINNFSOTA RULES 7672
(J su6mission type) • Residential Ventllation Category 1 Worksheet Su6mitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: _ Phone #
Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00
Water Heater No. oFR.I. Baths
No. of Baths
Mechanical Contractor: Phone #
Mechanical sysCem includcs: Air Conditioning Fee: $70.00
_ Hcat Recovery System
Sewer/Wafer Confracfor. Phone #
~
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 O inances.
S(gnature of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
~ Updaled 4102
OFFICE USE ONLY
? 01 Foundatlon ? 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 - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. AR - SF
? 04 02-plex O 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 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 oniy) - 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) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
Drain Tile Othet
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 , Building Inspector
Base Fee ^
Surcharge
Plan Review
MC/ES 5AC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
651-681•4675
New Constructian Renuiremenh RgmodellRemir Reouiremenb
• 3 registered site surveys shovrirg sq. ft. of lot, sq. ft. of house; and all raafed areas • 2 copies of pWn
(20% maximum lot coverege allowed) • 1 set of Energy Calculatbns for heated addiUons
• 2 copies ot plan showing beam & window skes; poured found design, elc.) • 1 site survey for exterior additions 8 decks
. i set of Energy Caleulalions • Indipte if home sened by sepUc system for additions
• 3 copies of Tree Preservation Plan if lot plaqed aRer 711193
• Rim Joist OetaA Options selection sheet (hldgs wilh 3 ar less units)
DATE _ / ~-oa- VALUATION
SITE ADDRESS (;/7 GT MUITI-FAMILY BLDG Y N
TYPE OF WORK r ~c"_"
71. FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT C -,ie,
STREET ADDRESS Nh-~/ /6S CITY oc.rNSTATE!~~t/ZIP
TELEPHONE # G'~a--d7saZS7~ CELL PHONE # FAX
PROPERTY OWNER TELEPHONE#J k-isri ~ ~?F
~--J GJy ~/J'~ ~56
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNES01'A RULCS 7670 CA7'ECORY l MINNESOTA RtiLES 7672
(J submission lype) . Residential Ventilatlon Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: _ Phone #
Plumbing system includes: Water Softener _ Lawn 5prinkler Fee: $90.00
Water Heater No. of R.I. Baths
_ No. oF Baths
Mechanical Contractor: Phone #
Meckiinical systcm includcs: Air Conditioning 'Fee:'- $70:U~
HeaC Recovery System ' I I
Sewer/Water Contractor: Phone #..j
-
I hereby acknowledge ihat I hove read this application, state that the inf tion is correct, and ee to comply
with all applicable Siate of Minnesota Statutes and City of Eagan u~,anc s.
~J
Signature of Appilcan
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updaled 4102
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex O 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 6ct. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck x 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage \ S a/d i2po% vvnav
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous 1-1+e,v7 SZ~p
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
A 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 d,0 Occupancy p -J MC/ES System -
Census Code yZ/ Zoning City Water
SAC Units Stories Booster Pump _
Nbr. of Units Sq. Ft. PRV ~
Nbr. of Bldgs Length ~s Fire Sprinklered ~
Type of Const _,P7 Width
REQUIRED INSPECTIONS
_ Foorings(new bldg) FinaUC.O.
Footings (deck) ~ FinaUNo C.O.
~ Footings (addition) = Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Pina] _ Pool _ Ftgs _ Air/Gas Tests _ Final
~ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved 8y , Building Inspector
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
RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675 a" ~
New Construction Reouirements RemodellReoair ReauiremeMs
• 3 registered site surveys shovnng sq. k. of lot, sq. R. W Iwuse; and all roofed areas • 2 wpies of plan
(20%mauimum lot coverage allowed) . 1 set of Energy Calculations for heated additions
. 2 copies of plan showing heam 8vrindow sizes; poured found design, etc.) . 1 site survey forexterior additions 8 decks
• 1 set of Energy Calculatioice . Indicate if home sened by septic system kr additwns
• 3 copies of Tree Preservation Plan'rf lot platted after 711/93
• Rim Joist Detail Options selec0on sheet (Wdgs with 3 or less uniLs)
DATE 0 v. % ZO O v' VALUATION
SITE ADDRESS SI-StEIJI-\ N C~C t MULTI-FAMILY BLDG _Y _ N
TYPE OP WORK FIREPLACE(S) _ 0_ 1_ 2
APPUCANT JTC1.~.g~~ Q.oo'~t~JC>~
STREET ADDRESS V 0 CITY 'F Ul'(J 6 STATE-t~\_4IPt5:54
TELEPHONE#gS2--g3S-U-7O-PELLPHONE# (6l2- "Tb2-2~lZFAX#
PROPERTYOWNER TELEPHONE# ikSI-24540-57
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672
(d submission type) . Residential Ventilation Category 7 Worksheel Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Su6mitted
Plumbing Contractor. Phone #
Plumbiiig system includes: Water Softener Lawn Sprinkler Fcc: $90.00
Water Heater No. of R.I. Baths
No. of Baths
Mechanical Contractor: Phone #
Mcchanical systcm includes: Air Conditionug Fcc: $70.00
HeaC Recovery Systecn
Sewer/Water Contractor: Phone # ~
,,j 4J V 1-1 ~ u~L I
I hereby acknowledge that I have read this application, state that the information is c$Crect, and ayree~n-coFn~ly
with ail applicable State of Minnesota Statutes and City of Eagan Or inances. ~
Signature of Applicant
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4l02
OFFICE USE ONLY
? 01 Foundatlon O 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) O 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-piex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interiar) ? 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 Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addirion) _ Plumhing
_ Foundation HVAC
_ Drain Tile pther
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding StuccoStone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By , Building Inspector
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
this ~~a~+:F fr~rS c~~~
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675.
NewConstmctionReauiremeMS RemodeVReoairReauiremenls
.3 registered site surveys showing sq. ft. of lot sq. ft. of house; and all roofed areas • 2 wpies of Dlan
(20% mazimum lol coverage allowed) . 1 set ot Enecgy Calculations fw heated adddiore
. 2 copies of plan showing baam 8 window sizes; poured found design, etc.) . 1 site survey for extenor addNons & decks
• 1;etafEnergyCalculations . Iridicateifhaneservedbysepticsystemforadditions
. 3 copies of Tree Preservation Plan'rf lot platted aRer 711/93
. Rim Joisl DeTail Options selec1ion sheet (bldgs with 3 or less unils)
DATE VALUATION `f(J Gv
SITE ADDRESS MULTI-FAMILY BLDG _ Y
TYPE OF WORK ODl 170 A) Gt fGN~Ert/ a6cvO~L FIREPLACE(S) _ 0/1")_ 2
l./
_
APPLICANT AE44tl LN,S1A1)6h0yt1
STREET ADDRESS ?3,~ /l/}(l eh/k'- CITY&t S LSTATE ~IZIP SS/l
TELEPHONE # W1-450-9lS+l CELL PHONE # FAX #
PROPERTYOWNER EJE 1/9VSEdZ TELEPHONE# 6 5I"-57MP
""""'."""""""-"""""..-i. r--4. K. i aa ~so r„"" ^ r"""""""""""'
'CflAhPLEFE TIi1S SECiION.Fb3R "&EW" RESiDENTCAb BUILDINGS- 6NLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINVESO'PA NULES 7672
su6mission type) • Residential Ventilation Category 7 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: Phone #
Plum6ing system includes: Water Softcner _ Lawn Sprinkler Tee: $90.00
Water Heater No. of R.I. Baths
No. of Baths
Mechanical Contractor: Phone #
Mechanical system includes: _ Air Conditioning
Hea[ Recovery Sysfem ®rT Sewer/Water Contractor: Phone # ----------------------°-------°----------°--°----°°--°°--°---------°----°------I hereby acknowledge that I have read this application, state that the information is pIY
with all applicable State of Minnesota Statutes and City of Eagan Ordinan s.
Signature of Applicant dV=_=
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
OFFICE USE ONLY
01 Foundation . ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory eiliig *
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage K 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage v~ p
? 06 04-plex ? 12 12-plex Plbg_Yor_N /1, 25 Miscellaneous ~WlJw1~
? 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)` O 43 Reroof ? 46 Windows/DOOrs
? 34 Replacement *Demolltion (Entire BIdA 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 Vh) W idth •
REQUIRED IN5PECTIONS
_ Footings (new bldg) FinaUC.O.
Footings (deck) ~ FinaUNo C.O.
Y Footings (addirion) _ Phuaoing
7v Foundarion _ HVAC
T Drain Tile Other
Roof Ice & Water Final Pool Ftgs Au/Gas Tests _ Final
~ Framing _ Siding _ SYUCCO _ Stone
Fireplace aa, R.I. 'vtfAir Test Q,• Final Windows (new/replacement)
~ Insulation Retaining Wall
~ -
Approved By , Building Inspector
-
Base Fee °.2 i-}
Surcharge
Plan Review "~---I . C~) ~ r
MC/ES SAC ~ h ~
Gity SAC x i f~ a
Water Supply & Storage S&W Permit & Surcharge 06) '"N
Treatment Plant
Plumbing Permit i c'1. /7'' j_, /
~
Mechanical Permit
License Search -7 a~
Copies ~ J
Other
7otal
**C.-1TEGORY" 1" ALTER-NATE FOR J, city oF acig
O-NE & TNti`O FA-N1ILl" DWELLI-NGS
Iti5T2CCTD?NS: TSi> >lt:rnari}e may be usad tor une- and n.rfamily dwallin-V builc co maat ,he Ca[e;ory f requlr_nl2ncs ij.
~:inarsou 2uies. Chspttr 70'0. Compe?irts A. B. lnd C. Cia9t!;, r..a:k oians xi:h: lr.d
.emenc: equi?maa[ eune:oi3: and !ecaCen or vicer c_,:rCzr ard wir.4.:2si . Mor_
:ior. __r. ~e .`6u:C i.^, ;4a 4l;nnrsora Er.er,-, Coce;unmary s'r.aaa r;ailabie ::em :hz MC:.r,asoea ai Comr,.er:.
Part A. BtiILDING EiWELOPE
C'a_ic ~mecs:d er.ve(ece;ein[ ;eving opdoa 4 tZI Pr.unptive (caulkir.3. 3sskec, e.c.) ' ,]--p_-cr.racr ::es' ^a7670.,~'.470 sccv. '.C.1
_-r:k er.r:3y :alc~a~en apdon ued 4 O "CoekboolC' (cor..ole:a uer!c;nr: Selow) ? NL-.C~r.z .r.:,:cC (a
;..uS -;cr.; . ,
? Per.'omucc: (artac6 C-Valu Caicuiions) ? jvS:DTS A.31':5:5 SC:.SC(! ~]:JL1 3:.Itj' sli)
77 }IL`!D(L'bt REQL'1RE~ff\TS
::Cookbook `ti'orksheet rfar "Coakbaak" ooaoooml,, -
Ceitir.3 insWa::on: }L•- ^~a^t 3-13 .r.:S :ae:;.!:eei: er
Cv5:3cenoyS NGnimun 2-4 -zic4 `.ow caei; cr
..eo C,ecc ;t ;_,c _esign rees on.i1'~rtimmr.:4rguirsmrnu lis: lfiaimw: 2•:3 wi:h 2-i s'tra[c+`ec :o r.ic.
_ . . }(s ".e: a!! r i:ams :o~se "Cco!cbcok" ecncn. LF .^,Dcor: C-•: =f._ ar 7._9 :r I ;clid •.viceC ,xi::, >:c.~-:
. . :r._cesa' xtif c-:e ua scle Se:ew. m fois::.^sc!a:iua: NG
~ :.i~..c^ 3. fy .
r_c_,._ . .r. .
L.:s.~ ar:d am:r:c. crs ovr.c :::cc_ svacas: 2-_t
^
: :c-i Cc~z~ m _ ciding uea or vl ''our.da:icn indows) u:ucoaicr.: 1L.ic.~.. 2-YA-CCf IIeS J :C':~.i JC GS$ zYIS[I IIICW'lOIC pGK':.^.G9~:. 'S,C]COR'F'~j]lCR'£ :b :LSEIS:."d _lii. R'~'CL JC'A21vl ~,:.z
~ T.aBLE FOR DETERMIPrLiG NG.~R?f Ni'itiUOw.~N-D DOOR :1RE.a .~:to xabiz Taral Cv'ir.~:cu~ ~d Door Asa ss
I y`o.....~Z:J'=;^ose?'b'71! 12% 1 jj°,'e I 16'e I 19% I jpeia l22oio I24% ~ i6ara 1 28%
i;. -e i S•=r.Car1 c'srti:,¢?; Matimcm Avenze R'inCew L'-vLCe lesc:oe :c~;u:icn wi~Cews):
I 7 =z~.3-i; i:scia'cr.• 2""''t"4ir.g ~ 0.-;: 0.47 ~ 0.11 0.3 6 I 0.33 I 7.30 I 0.27 ~ 0.2: i 013
'_ss, 0.:2 O.a; I 0.:9 I 0.3; 1 0.31 I 0.13 I. 0.35 0?4 I 012
Zi3-lv .csc!a:i_r.. < R-J5 scraa4in I 0.48 0.31 0.36 I 0.32 I 0?9 I 0.25 I 0?1 0.22 I 011
r]2x5.R•19lnscia:icr.. R-i;heachin0.56 0.13 ~ 0.13 1 0.3; ~ 0.3. ~ 0.31 I 0.23 015 I 0.=4
?s5, R.71 irsulacca < Z-; ,;.ea:5in I 0.51 0.47 0.33 0.3f 0.30 J13 I 0.35 01i I D.?'
7 7xo. 2-: f in;ularan. R-i shrtthin 0.58 0.50 0.33 0.39 .5 1 0.32 ~ 0.39 0.27 015
W'itl Tv:e lA--vv;c-u Framia4 : Ma.¢imum Ave[a e Windaw U-value ezc:c[ foucdadco •xiaCawz):
rJ 2s6. R-f 9 insulation. < R•5 sheathin 0.32 0.45 0.39 035 03l 013 0.26 024 022 -c
=
O 2s6. R•19 intulauaa R-5 shnthin 0.58 OSO 0.31 0.39 0.35 0.32 029 11 017 0]5
~:c6. R•21 insularioa <R•5 shpchin 0.55 0.47 0.41 0.36 0.3J 0.70 027 0]S 0.23 -
??:c6. R-21 insularion, R•S shea[hin 0.60 0.52 0.16 0.31 036 0.33 030 0.28 025 -
W'indow U-vafue: ~ Sourc:: O NFRC O AiFRAL: 1993 Handhaok -
100 X~ 75-wiaCow & Coor .v:s goss aposed wall srea DESIGN ,iLLOW'A3L'c (.`:em'ahle above)
MINNESOTA ENERGY CODE - WHicy RuLes M,a r i UsE ?
TYPE OF RESIDE.`lTiAL BU[LD[YG .aPPLICABLE RCLES
Deuched R-1 occupancy 1- and ?-famlly dwelllnes Chapter767?; or
"e.c.~r..e!es: sir.,!e :inil• .:.via 4omes. du kza Chaceer 76%0 "G:e cr~ f" Ai:i sta^~:erv Cr_rss~:^::~:icn an~ rca(i7a:icn :~CUi:!^eacs
Attxhrd R-3 o<cuponcy dwellinEe Chaptec 7671; ar
'cc:r..oics: .^ei:a !ownhcu.ses v:d row huuses Cluoter76%0 wieh eicher"Caecsorv t" or "Ca:ezen?" omvisicr.s
R-I occupancy buildings of J eroritl ar lea I Chapcar 767d; ar .
E.umelcs: conCemi:,iumt ar aouunenn C. tcr 7670 widi :i:7:er "Gtc¢or or "Ca:czerv'_" orovisiun;
R. I uccupancy buildiogi over3 storla h1Qh C}upccr76i6 ,
'c.c Tolcy: hich r.se cor,dcs ar ioar.menu
~~.,u,.... , . ~.~~~I Siunat:~r~ :i.,.~ r...~•nhone Vumber
NEW CONSTRUCTIUN ONLY
Part B. DEPRESSURIZATION PROTECTIO`
-_ecn.n usrd: :1 cuel Sumim.; eqcicr.,ant (cumola:a schedu!es':e:aw) ] No
EXHAL'ST.' V!-LKE-CP AIR SCH°DL'LE•
l.[he Sqat.^m.1n: tC!Uw. Or.i; eqe!.r,.t.^.: c.v:aest dtc'et5 c iC0 I rlu•.v
a Y iYasi -ay'-e se'.eCm1 ur.dc: [he "Category t"1i:ena;e. a.^a I
ScaP l:or..ciece tht ngnt it direc: or?u,xer
:.-,VeC or ;wlid 7.:ei aenuspher.c v;ne space hasdn; aquipr.,:ae ii
ie:C_.-1. '
COMBG5TI0Y EQUIPMENT SCHEDCLE
(check all cmes orocosed)
Scar hesc:n; - ncnsolid iLet 17 Sastzd ~ambusdon Y Hzatth - nonsalid tuei I?Sz1-3 =cmbcsr.on I Y'
O Direct or power vented I-:1 Dirac: ac :ow.r venced Y
Y.
Atmosnhericall vented ?+x:esher.cal3 veac:d ~
a..: heacing - aonsofid uel D Saaled comousdoa Y Spue heaaag- solid 'n:el I?.>_..orcar.caiiy voned I
G Y.
O Directoraowervrnted Y Waterheaen- solidtue[ I Cl •;an.asvice.^:callvv:nted ( Y
AtmosohencaD vented N Heacth - solidiuel I ?.>=eseeer.ca;h+ven:ad I Y
' It scnwchzrically vented soGd fuel or diroct or power venud noasofid "neel space heating is instzL'ad, chea eiak=-w ?ir to macch
:'.uw is «quited fot each individual :xhaust devic; wiuch cacceds 300 cubic iat aer mincte.
Part Ci. VEI~TILATION
VEr'I'ILATIO`i QtiA-NTITY
I (Mech.=ical venrilaaon must be provided per the lar3er quaar.ry cainflatcd'or!ow)
cubic teet i 0.00583 ;minute cfm ~ i li efmlbedreoa; + 15 cfm cfm
voiw:.e ot habitable rooms number of'xdreoms -
YENTII.ATIO`i F.AY SCHEDLZE
I Cnzck methcd(;) procosad iCl Eshaus, or.br O Bafsrtczd (heat;ecover+ ver.r.iacor. ai, ax:iar.zo:, a:c.) 'i
: sn descri tion or locarion I TOTALS
V'ctiT[LATION [ntak: cfrn ctm cfm cfra c~
AS DES[GNED Exhausc cfm cfrn cfrn cim cfrn
Statement af Compllaace: The proposed building design represented in these documencs is consistent with the building plazu,
specificacions, and other calculadons submitted with the peecnit appticatioa The proposed building has been designed tn meet the
requirements of the blinnesota Energy Cade.
Applicant (print name) Signatum Date _ Telcrhone aumber
Part Ca. VENTILATION (Submit Pan C. upou cnmpletion'olsystem verification`)
x
Joo Siee Addmss: Permit Vur.iber
Fan descri tion or location TOTAI.S
.14 : ASURcD fntake cfm c41 c5n c;r.i cfri
?E2FORNL-MYCEt Eshausc cfm cEm c`m cfm cfrr'
t Vtntilation race must be measured and veritied when the perforntanc: option is uud in li<l of the presc^peive opaen for ehe
sntir, of joints in the 6uildinq conditioncd enveiooe (from Part A).
Compliance Statamenr. Installed ventilarun system is in complisnce with.VN 6nergy Code md is sized .o provida the design air
tlO'N.
Arplicint (?r:nt nsr..e) Sigr.aeur. Date T_iernune nunber
Lot: ~ Block ~ Subdivision 64
CONSTRUCTION WITHOUT PERMIT(S)
Owner Name:
Address: Q ~7 Jr'Jf /Z d
Type of Permit(s) Required: 7k Bldg _ Pibg _ HVAC _ Elec
Action To Be Taken
• Contact occupant (preferably) or /owner-x in person _ via telephone
• If unable to contact occupant, send letter to "Occupant" alerting them of the need for a
permit(s). If "Occupant" is different than "Owner", send cazbon copy to Owner and copy
Chief Building Official, Assistant Building Official, City Attorney, Assessor
• If no response within 10 days, send certified letter to owner giving a 14 day notice before
tuming over to City Attorney for action.
• Submit to City Attomey for action.
Outcome
Date ofverbal contact TZ 7~; 00-D 02LI
Name of contact person 'j'0(9 ,su!°,~/1.. ,.5JIMLYJ T ePrD/yfi1J~
Date of occupant letter
J
Date of certified letter
Date submitted to attomey vkv
Date permit application submitted
Date Bldg/Plbg/Mech permit issued
Other action taken DLO 7O PLZA- (L/o al°~/i
T r?LK 6~~ T I-r~~ (1nuc,~ /i~f ~ i~ 6-/~z,i vrvG1DT/
Si tur
RESIDENTIAL
BUIlDING PERMlT APPLlCATIOi11
3830 PILOT KNOB RDEACAN MN 55122
65'1-6$1•4675
N~wConsWCtionReauirameMS RamodeVReDalrReuuiremants A
• 3 regisfe2d site surveys showing sq. ft. of lot, sq. fl. of house; and all roofed areas • 2 copies of plan
(20°h marimum lot coverage allowed) . 1 set of Energy CalculaGons for heated add'Abns
• 2 copies W plan shovnng beam & windax sizes; poured found desgn, etc.J . 1 site survey for exterfar addifrons & decks
• 7 set of Energy Calculatlons . Indicate if home served by septic system for adtlitions
• 3 copies of Tree Preservation Plan if lot plattad after 7/1193
• Rim Joist Defail Oplions selection sheet (bldgs wAh 3 or less uni4s)
DATE 10/ z1 I UZ VALUATION
SITE ADDRESS '4'~:7 S 4~ %)Lk~ Co„~krs MULTI-FAMILY BLDG _ Y _ N
TYPE OF WORK -i,(\ - nzRzs FIREPLACE(S) _ 0_ 1_ 2
APPLICANT T~~~j~~~a • ~s rr
STREETADDRESS lFnD CtTYCSTAiEM13 ZIPs:!E}z?
TELEPHONE CELL PHONE #~~)z~L~-37b~ FAX #
(bs1 ""~I-3G'~v ~
PROPERTYOWNER J7_EUF KAa1~S~2- TELEPHONE~~J~77S~3'LS`Z.
COMPLETE FOR KNEW° RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RliLES 7670 CATL•'GOI2Y 1 ti1INNESOTA RULES 7672
(4 su6mission type) • Residential Ventilation Calegory t Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope CalculaGons Submitted
d~
Plumbing Contracfor: Phone # ~~r
Plumbing system includes: Wa[er Softener _ Lawn Sprinkl r .00
Wa[er Heater No. of R.I. B
No. of Baais _
Mechanical Contractor: Phone
Mcchviical system includes: tlir Conditioning ~ - ee:
Heat Recovery System OCT M 1 ZOOz
Sewer/Water Contractor: Phone # ~
By
I hereby acknowledge that I have read this application, state that th inf ation is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan dina ce .
Signature of Applicant
- - -
j OFFICE USE ONLY
Certifcates of Survey Received _ Tree Preservation Plan Received _ Not Required
Updated 4102
OFFICE USE ONLY
? Ot Foundation 0 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 - Multi
? 03 01 of _ pfex O 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4sea.) ? 33 Eut. Alt - SF
? 04 02-plex O 10 08-plex ? 18 Oeck ? 23 Porch (screened) ? 36 Muld
O 05 03-plex ? 11 10-plax ? 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) O 44 Siding
/X_ 32 Addition ? 36 Move Bldg. O 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Remof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Glve PCA handout to applicant
Valuation Occupancy 23 :iyy, 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 J/A,J W idth
REQUIRED INSPECTIONS
_ Footings(new hldg) FinaUC.O.
_ Footings (deck) FinallNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HypC
_ Drain Tile Other
Roof _ Ice & Water _ Final ~ Pool ~ Ftgs JrA'u/Gas Tests -kFinal
_ Framin8 _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaunng Wall
Approved By 1 c..i , Building Inspector
Base Fee
Surcharge
P1an Review
MC1ES SAC V
City SAC
Water Supply & Storage
S&W Permit 8 Surcharge
Treatment Pfant
Plumbing Permit
Mechanical Permit
License Search
capie5 ~ . S.~
Other
Total
CSTy F~iGAN ~~P• Include 2 sets of plans,
-7 pp `j 8 1 sitP p7.an w/elevations &
. ` HUIIDITIG PERMIT APPLICATZ~] 1 set of er~ergy calculaticns.
7b Be Used Ebr F/' Valuation ~S~i~d d Date ~ ~G~' -
Site Pddress /~~4 ~ pF'FICE USE Y
Iot Blodc Sec./Sub. ~ Erect O~ci~pan~Y
Paroel N: /6 S ~ 6 3- D_ Q / 7~l.ter zoning / ,
~ Repair Fire Zone
Owner: ~7Po~' ~7P~(17d~ Ehlar9e _ TYPe of Const.
Addzess: S•b~e iF Sto=ies
Usnolish Front p 2" ft.
a~,~Zyp ~r-ade - Depth yS ft.
Phone M:
APPF87VALS ~
Gontractor: 1 I~C I~'
~~~l / ~ 1~Q~l~(/_~ Assessrnenrs peimit ~ S~~z-
Pdciress: ~i~-~ I~L~Ih~ ~Y Il~~ Water/Sewer Surcharge m2G
?olice Plan Check 1~
City/Zip ~de: ~ 4 ~~/1~- ~~~~t~r
i~ ~ 'r ire S~PG .s~
Phore ~y~~-(~ ~J Watez Conn. yS"d
- Planner " Water Meter ~
Arc~./IIxJ.: . Council Rnad Unit _.,2577 _
B1dg. Off. -~i ~6q
Address: ~
City/2ip Cnde:
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~blte~son B»iiel~rc ~oc. P=.ll4@7
` ~1a3-7ti ,
/t/` - JACKSON - SURVEYOR5
.mt=~
p-~~~=aDl''=LAB~ A66INTiRID UMMq LAWS 0/ KATX O? YiMNl~OTA '
yW.0:P.ELYLIAg $ZQv. . ,
- - =Drainage & Ut11i Sasemente
- 9616 EAST 55th STREET, MINNEAPOLIS, MN 56477 727-3484
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i N6RlYY C[RTI" TXAT TN[ ABOV[ 18 A TRU[ AND CORR[CT PLAT OF A BYRY[Y Of
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Dakota Couaty.Minneeota.
Propoasd Csrage Ploor Blav.'lOi.S.i
Propssed Firit tloas Slev. 102.3
Propoaed Basedeot Floer Slev. 93.3
30th., daou4zy, 1984
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F. C. JACKlON. MINMpOTA IRwAttaw. 1'W. i~00
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4'5 od3 D i o o ~ i
BOULEVARD TREE PLANfING
OFFICIAL PERMIT
PART III
APPLICANT INFORMATION:
APPL.ICANT NAME: r-l t~
.e.DVltESS: e r- - :Tlitbil~v
TELEPxorrE:
ADDRESS OF PROPERTY TO BE PLANTED:
OWNER OF PROPERTY (If different from Applicant):5~4t2,,,-
TREES TO BE PLANTED:
Distance
Tree Varietv Size cation fr m cur
Example:
Marshall's Ash 1 1/2" dia. 15 feet south of driveway 11'
2.
3.
4.
DIAGRAM:
Please attach a rough diagram of your lot and the right-of-way azea showing the location of
structures, buildings, driveway, sueet edge or curb, and location of tree(s) to be planted.
AGREEMENT:
I agree to plant the boulevazd trees according to the above stated conditions. I have read
and understand the City Ordinance gertaining to tree planting and maintenance and
understand its contenu. A copy of the ordinance is attached to and made a pan of this
permit herewith.
I understand that the City of Eagan assumes no liability or responsibility for injury or
damage to persons or properry however caused through the issuance of this permit. All
work done under this permit shall be performed without cost to or obligation by the City
of Eagan.
i e of Oippliicaantt Date
7/~~Vas Date
Signature of Property Owner
(Please keep information sheet (Part IV) and return this signed portion to City Hall, 3830
Pilot Knob Road, Eagan, MN 55122.)
FOR CTTY USE: ~,,;Y i ~S~~~k '
1Otv-v +
PropertyI.D. # o- o\ Lot t Block l
Subdivision
Application Reco~[d - `~.0 - ~
~ ~i, /
Z~j
Reviewed by: (f C ~ -~7
Engmeering ( D&te ~
Reviewed by:
C,ore~t sa, ~.r' q -aU ~01~
' ~ Date
~
Recorded by: 4~0 Datf
,i .
22wp:blvdtree.pla P~. 9/20/90
mod af~s~J~~ .
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/G-iSoa3-o~~-~i 2/84
CITY OF EAGAN 6p
APPLICATION FOR PER14IT ~ O/
!
SEWER AND/OR WATER CONNECTIO~T
(PLEASE PRINT)
1) PROPEIYI'Y ADDRESS: 4847 SHEVLIN COURT
r Frar DESCRI_DTIC:I:
(Irot/Block/Subdivision or Tax Parcel I.D. Niunber)
ir E{I~=_;G S^'.,'jt'CP'RE, DaT'E G° CRIGi JAL :,iiIL^,L'G PF:;?IT TSJUPNC,•
P2S.-~:' USE: R-1 SENGLE rP'41ZY
~R-2 DUPLE.Y (Zh'O Wi ITS) - - - •
? R-3 TG4~'nIIiOIISE (TH2EE + UNITS) ( UNITS)
? R-4 APAR'IP?EnI7/CODIDC_~mS1NIU'"; ( iJi7ITSi
? COMMERCIAL/12ETAIL,/OF'FICE
? MDL'STRLAL
Q INSTITUTIONAL/GOVE5tn=
2.) jjppLIG~V-T (PLEASE PRINT)
NF~i~fE: /'r0/-LE/=5o,w ~(//.L0~71 S
ADDRE55: .y.S
cri^r, s=, zzP: ~5'A1w9'/'%' -'_j
' PxoNE: .f5V - 112 8'13
j) puj-,ffiER PLEASE PAINT) FOR CITY USE ONLY
r~NIE_ ,-&E&a -
ADDRESS: _Z ~24~5' ,j(), PLl1HBER5 IICENSE:
Q Active
CITY, STATE, ZIP: Expired
PHONE: Not of Record
PLUMBER LICENSE
a nitia
4) OCC[JPpNT/('J,ahlER (PLEASE PPINT)
M'`E:
ADDRESS:
CITY, STATF•., 7.IP:
PHG`NE :
5) INpICA'I'E WHZCH PERMIT IS SEI~.TG RF7LUESTID:
~CO.INECi'ION 'IO CITY SE.Tr7ER
~ COn".VFx.~ICV TO CITY NIATER
? OTY.II2 (PLLASE DESCRIBE)
6) L^dDIC,.^"'ic C.`;E:
P=E HOID APPRWID PER+1iT FOR PICK-UP BY ONE OF 71BWE
~ pLE.aSE bT.AJL APPROVED PII2tiLIT TO 1, 2. (o 4 11HWE
' (Circle one)
7) SIGN.a'IL'.RE: DATE: 0 ~
~fRY1:i1_e1#~Aio M . . '
. . . . . VW-~f~1~1l1etia~:~#1~1i1f~i~,wcst~a!~Rflrkf~I:1rHl~l:i~flf~l~~ts~~tem
F 0 R C I T Y U S E O N L Y
PER^IIT ISSUED
FEES: $ d S°`s^dER nEoxirm (T`;CL~DE SUP.CHARGE)
$ WATER PEI2DIIT (INCLUDE SURCHARGE)
$ WATER METER/COPPERHORN/OUTSIDE READER
$ WATER TAP (INCLGDi CORPORATICN STO?)
$ SE4+]ER TP.P
$ "`ze ACCOUNT DEPOSIT - SEWER
$ ACCOUNT DEPOSIT - WATER
$ WAC
$ SAC
$ TRUNK ?9ATEP. ASSESSME:]T
$ TRUNK SEb4ER ASSESSMENT
$ LATERAL BENEFIT/TRUNK SEWER
$ LATERAL BENEFIT/TRUNK WATER
$ OTHER
$ i' ev 9 ~ TOTAL ~
$ AMOUNT PAID/RECEIPT
,
DOES UTILITY CONNECTION REQUZRE EXCAVATION ZN PUBLIC RIGHT OF WAY?
~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST IIE ISSUED BY THE
~ NO ENGINEERING DIVISION. LZST AS A CONDI-
TION.
SUBJECT TO TfIE FOLLOLdING CONDITIONS:
APPROVED BY:
TITLE:!52
DATE:
MR s=wl Wkm w s~ okm immw wm wum w iw ia f ra w"w rt+ "ta le mm wA" a_s ner 3wajw Ra Ptm rt evr w~
CITY OF EAGAN
CASHIER: JS TERMINAL N0: 679
DATE: 08,430/00 TIME: 08:43:47
ID:
NAME: SCFMIDT ROOFING, INC
3210 9001 4847 SHEVLIN CT 83.25
2155 9001 4847 SFIEVLIN CT 1.50
Total Receipt Amount: 84.75
CR136639
USER ID: JAN
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Conshucflon RernAremenh RetnCdel/Reoalr Reaulremenh
> 3 registered sNa wrveys ahowing sq. R. of lot sq. B. of howe 2 copiea of plan
and g~l roofetl areds l20% mmcimum lot covemaa aliowe~ 1 Eei of energy calculaNOns for heafed a"gons
> 2 coples of plans (ahow beam & wlndow size& Poured fnq, tlealgn; efc.) t sire wrvey ror e:tenor aamnons a decics
> 1 aef of energy calculatlorro
% 3 copiea of hee Preservalion plan II IW plafted aRer 7/1/99
DATE: ~ l~J CONSTRUCTION COST:
DESCRIPTION OF WORK: ~ l~ b~'~~~ If mulH-famiry bldg., how many units?
1
STREET ADDRESS: I' `1
LOT: l BLOCK: SUBD./P.I.D. ; 4
Name: Phone~: ~-`1J~o-S7~"?~
PROPERTY tast Flrst
OWNER Sheet Address:`"I~H-j Sl-~~A~I~tn Q-o,~,a
City Eg~qaA'1 _ Sfate: ~ r) Zlp: SYj aU
Company:f>f Phone 9
~ (area code)
CONTRACTOR ~ )
Strest Address: `"I License N Exp.
c,ty`-34 02L\L~ State: mln ZIp: 6)~4 100
ARCHITECT/
ENGINEER Company: Name:
Telephone 9: ( )
Sheet Add?ess: Regishaflon t:
City State: 7Jp:
r
Sewedwater licensed plumber {if Installina seweNwaterl: Phone
I hereby acknowledge that I have read thia applicafion, stafe fhaf fhe intormafion Is corcact, and agree to w~p w8h allapplkable Sfale
of Minnesota Stahrtes and Ciryr of Eagan Ordinances.
Signafure of Applica .
OFFICE USE ONLY Certificates of Survey Received _ Yes _ No
Tree Preservation Plan ReCeived _ Yes _ No _ Not Required
OFFICE USE dNLY -
- /
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext Att - Muki
? 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Ak - SF
? 03 01 of _ piex ? 09 07-plex O 18 Deck ? 23 Porch (screened) ? 36 Mutti,
? 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
? OS 03-plex ? 17 10-plex Plbg _V or_ N? 25 Miscellaneous
? 06 04-plex ? 12 '12-plex O 20 Pool ? 30 Accessory Bidg.
WORK TYPE
? 31 New ? 36 Move Bldg. ~ 43 Reroof
? 32 Addition ? 37 Demolish (Bldg)' 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code # of Stories sq. ft.
No. of Units Length sq. ft.
No. of Buildings Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main fevei sq. ft. MCIES System
UBC Occupancy sq. ft. City Water
Zoning sq. ft. Bobster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation:
Surcharge
Plan Review
License
MC/ES SAC •
City SAC
Water Conn.
Water Meter `
Acct. Deposit
S/W Permit
SNV Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
~ RESIDENTIAL BUILDING 407501/75-
PermitApplication ow&Z-0(
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122 1-0~/~
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWCtlon Reauirements RemodeVReoair Reauiremenb OKce Use OnN /
3 registered site surveys shaxing sq. it of IoL sq. R of house; and all roo(ed areas 2 mpies o( plan Cert of Survey Recd V1' _ N
(20%maximum lotcoverage allowed) 1 set ol Energy Calculations forhealed addipons Tree Pres Plan Recd _Y N
2 copies of plan showing beam 8 window sizes; poured found design, ek. 1 site survey for addNons 8 decks Tree Pres Reqd _ Y_ N
isetofEneyyCalalations Addltion-indicafeNansitesepficsysfem On-siteSepticSystem _Y _N
3 copies af Tiee Preservation Plan if lot platted after 711193
Rim Joisl Detail Options selection sheet (bkys wAh 3 or less units q L ~
11
Date G,2 Construction Cost
Site Address cA~y 7 UniUSte #
Description of Work
MuUi-Family Bldg Fireplace(s) _ 0_ 1 _ 2
Property Owner Telephone # ( )
Contractor
Address City
State Zip 5 -~~'3 ~ Tetephone # VSe)
COMPLETE TNIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Enefgy CAde Category , Residential Ventilation Category t Worksheet • New Energy Code Worlcsheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a simiiar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber P a Telephone ?
SEp 2 2 u
Mechanical Contractor za i Telephone # ( )
Sewer/WaterContractor Telephone J
I hereby apply for a ResidSntial Building Pemut and acknowledge that the information is complete and accurate;
that the work will e in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I unders this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the/ w~ork ill be in accordance with the approved plan in the ca'se of work which requires a review and
approval of pl~ns. ;
Applicani's Printed ame App icanYs Signature
~
OFFICE USE ONLY
Sub Types ' .
? 01 Foundation ? 07 OS-plex ? 13 16-plex ~C 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Mu1G
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Pibg_Yor_N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
~ 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteratlon ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (EMire Bidg) • Gfve PCA handout to applicant
Valuation /5-000 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 Tile Other
Roof Ice & Water Final ~ Pool ~ Ftgs ~Air/Gas Tests/ Final
_ Framing _ Siding Srucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge fo Plan Review MC/ES SAC City SAC
Utility Connection Charge
S&W Permit 8 Surcharge
Treatment Plant
License Search
Copies
Other '
Total
; .
. POOL PERMIT - APPLICATION SUBMITTAL REQUIREIIAENTS
~
~ GENERAL INFORMATION
U
d
O Z d
0? Applicant - name, address, phone & fax numbers, signature
? ~ Property owner name
~ D Legal description and address of pmperty
?4W North arrow, scale (1" = 30' or 40') and date
?-W Location and name of all streets adjacent to property
Site Pian drawn to scale showing location of house, pool and other existing or pmposed
structures (5'hav hau.se /ana°scdpecP
D'uectional drainage arrows (existing and proposed)
ELEVATIONS
Existina
X ? ~ House corners
O R ~ Property comers
IK ?'lits On property lines at point of ineaswed dimension to pool (see below)
?MI ? If applicable, ground elevation at each end of retaining walls and at wall's geatest height
Prooosed
? dff- Finished pool deck corners
?E( ? Top of retaining walls (if any) and at each different elevation (if it changes)
J$ O* Pool bottom (or max. depth)
DIMENSIONS
Existina
0 ? ? All property/lot lines
Prooosed
1a ? ? Pool
21~ ?-0 Pool plus imegated deck/patio
jK Shortest distance from outside edge of pool deck to lot lines and house
Reviewed:
Name Date
G:/I'ECH/JR 2002/Poo1 Pemut Chcklist
~W
OR E V E U
20 ~
a,
o q ~ U _ `t-.~.3 - D3 o
NDSCAPE PAVER EOGE ,1p4NDSC.,. , (O
.~S ~ ~ ' 30
~ ~ CORNERIS i--IS 1.7 fEET NOR7H Of 6.i~F_~@T+fll:(N~O B,. SHED / PROPERTY IINE ' PROPERTY L1NE S1.SDFEET NORTH-, j -n172.65 S89 59',44''WPLAT) ~
CIF PROPERTY UNE 172.23 S89 57 39 W~MEAS.) ~FP
\ 112.32
J
- r - 1.5< ~ ~ s 1.8~ .
a
U) ci
~ 2.7
_ i - - prj•-
10 23. or'
' Q (n . - \ ~ ' 1 0 3 ~ r- C
n ~
~ C
t a Li¢-1
~ / j
o . 2-STORY 23.0 - -30. \"C L
W
~ . } a W FRAME ~
} ~ N W ~
0, LO
O ~ =W
~
~23.1 (~j • O
.
ELAQ(~,D LO
~
~j - LIA~ O
N()o
Lr)00 10 { , tl
N \
i` ~ ~ ~ I ~ v ~ Q
N '
10
,
120.31 S86°22'45"E (MEAS.) 30
3~ 40. 35
76 S86020'17"E (PLAT)
~ 396 , c-FOUND IRON 1.4 FEET
R=
~ i~ n ~ Jr $
CCwI `~po't"! S~O r n OAST OF ~ OT CORNER
, /
~ e~` ~ t~cc~`side 5~' 2ese.-r,~ f A=QS o49.'"j$ " E
~
SHERWOOD WAY -
~
City of Eapn
rviike Maguire January 31, 2007
MAVOR
PaulBakken Peggy Carlson STEVEN J. AND LI'NETTE KAYSER
Cyndee Fields 4847 SHELVIN COURT
Meg Tilley EAGAN, MN. 55122
COUNGL MEMBERS Re: Clean Up of "Brittany Monument"
Thomas Hedges Deaz Mr. and Mrs. Kayser: Cm.AoMtNisrnamA Thank you for your continued cooperation related to the accident that occurred on
September 28th damaging the "Brittany MonumenP".
Our Maintenance Supervisor, Kurt Schlegel, visited with Lynnette Kayser on
Friday, Jan 19`h and she indicated an interest in having the City clean up the area.
MUNICIPAL CENTER -
3830 Pilot Knob Road Enclosed aze two copies of a"Release and Hold Harmless AgreemenY' that
Eagan, MN 55122-1810 need to be signed by you and returned to me in the enclosed addressed envelope -
651.675.5000 phone by February 16`h. Following that, City forces will remove the debris related to
651.675.5012 fax the accident.
651.454.8535 TDD please feel free to contact me if you have any questions.
MAINTENANCE FACILITY
3501 Coachman Point Eagan, MN 55122
651.675.5300 phone TO SYIUVC 651.675.5360 fax Superintendent of Streets and Equipment
651.454.8535TDD Office-651-675-5315
Cell - 651-485-0701
www.ciryofeayar,.com C: Tom Colbert, Director of Public Works i
Jon Hohenstein, Director of Community Development
Mazy Granley, Sexuor Code Enforcement Technician
j
Kurt Schlegel, Supervisor of Streets/Equipment
I
THE LONE OAK TqEE I
The symbol of ~
strength and growth in our community.
~
%
•
~ ~ 1
¦
~ n 'r r L_V i w ~
PROPERTY DESCRIPTION: Lot_ 1, Block 1, E RITTANY 4TH _ ¦ ~ , a , - ¦ ~ ~ ~ ~
i 79.?8 S89 59 44 W PLAT ; , „ ADDITION, Dakota County, Minnesota. • N
. _ _ . 1?9.45 N89°5755 W MEAS.; _ S °O N
N m ~f ~I v
~ We hereby certify that this is a true and cor; ~ct survey of the above C ~ w )V e N ~
described property and that it was performed ,~y me or under my V ~
direct supervision and that I am a duly Licen ~d Surveyor under the 7e LU
~ laws of the State of Minnesota. That this sur e~ d ~ oes not purport to tO ca N ~
~ show all im rovements easements or encroac~ nents to th , p , , e property except as shown thereon. ty
Z ~ v
i n hfs 20th t September 1 , ~T n Sq ed f day o ,200 . James R. Htll, Inc., ~__v i `fi ¦ Inc., 00
~ , i ~~CN a
~Y - ' -
~ ~ Harold C. Pe rsan, Minnesota I_ S. No. 12Z94 I 4
; I
~ ~ . 0 eS: : ~ a
~ . . ~ ~ ~
' C 1. No specific tille search for :~Xistence or nan-
~ i .o eX~s~tence of i~corded or un--rf ~rded easements
1 . ~ E ~ ~ has been conducted by the s~ veyor as a part
of fhis survey. Only ensemeni per the reeorded 1
~ Q lat are shown. Q p
~ W J I ~ ~ ~ ~
< ~ J i
{ ~ ~ O L~ Denotes set s~ke ~ z
O ~ ~ ~ r1~~ ~ O 0 Denotes set ir n mor7ument O I-$
~.~J i :i ~ 1~ • Denotes founc ~ron monument E C-? ~
i ~ O ~ 1 I~ ~ Denotes brick aver edging ~ ~ ~ ~ A
~ ~ ~ ~ ~ ~ ~
'~r._ ~~G Denotes roil r~ ;d s~gn < ~ Q ~r, ~ ~ ~
~~i ~ ' , ~
= ~ _ . _ M~._ ~N N
i , ~
. . ~ « Z ~ O w` 0
~ ~ ~ i ~ ~ ~ ~ ~ °E c o, c o
~ ~ Bearih s assume the Vest line of Lot 1 - , g ~ ~ ~ i - - ~ - - -~w
~ ~ v~ Block 1, bears S C ~7'S2° E QQ i ~ c
<1 W Scale~ 1°= ~~0' m ~
_ ~ ~ ~ ~ ~ p j ~°e >
_ ~ -r ~ p ~.v i M o~ w a w o c
I ~ , ~ ~ tX~ n p v w w 0 C
~ ~ I ~ ~ LANDSCAPE PAVER EDGE ~ ;CAPE PAVER EDGE ~ w x J
4 -I5 1.1 F EE i iJORTH OF i,1 FEE ~ SOUTH OF - 1 ~ I.n 30 , ~ OM y~ O
~ SHED - ~ i PROPERTY LINE PROPER7Y LINE ~ ~ U i+i 1 1 N
Q ~;=iE7 .;Of2NE=h i~ : i ~ ~ - p ~ n , 100 , - F , ~ , ~ r_. . uoRT~~ 112.65 S89 59 44 W PLA 1
o ~ - N , „ M~ W
~ ~ ~~N~ ` , ~ 172.23 S89°57 39 W MEA~ ~ ~p ~ ~ ~ n ~,.s~ ~iz.3z •
< G I , ~ ¢ 2.9 1.8 ~3.7 0.8 ~ ~ ~ ~ w ~
W ' _ -T- ~ ---a-- _
~ " ~ ~ ~ ~~r-----23.13 ~ 13J9~.' ~ ~,~4.22 10 i' ~ ~ ~ ° ~ 22.7 / ~ ~ ~ ~ ~ ~ ~ . ~
~ (n ~ ~ ~ /?_3.4 ' ~ / ln Q ~ i , / ~ / a---- F~ i ~
.J 4 , o ~ ~ ~ ~ ~~p ~ ~ ~ ~ ~ ~ ~ W d' ~ ~ ~ ~ ~ ~ r ~
Q_ ~ z~~ p / ~ ~ GAR. ~ ~ ~.i ~ ~ ' Q~ ~ ~ / / ~ Q
, ~ . > `c '9.1 I ~ / ~ ~ o W . , - ~ ~ ~F,~ ~ ~ ~ ~ ~ ~ ~ O
~ L~i ~ n_ 0 p o~ ?-STORY' 23.0 ~ O ~ ~ ~ ~ OQ ~ FRAME 30.5 - - ~y
Q (~j C~ ~ ~ ~ Q~ 'h i ~ t~ ~i /
° !.t'l ~ / j ~ ~ ~ ~ ~ U (S) r 0 I ~
~ ~w ~ ~ % ~ ~ _ o ~ ~ ~ ; ~ i ~ ~
~ ~ ? w T- ~ EXISTING ~ ~ ' ADDITION U ~ ~y ~ a ~ - 23.1 ~ ln ~
Z cn .
; N O I~' ~ ~ ~ ' • ~ Z ~ DRAWN 8Y
c~~ , . ~ ~ ~ ~ , ~ ~ ~ `t I ~ ~ TP
~ ~ ~ i c~o ,n ~ , II _.1 OATE 9/14/01
~ ,co ~ s, ~ ~ If ~ ~ ~I
N V _ ~ - REVISIONS
_ to/u - _ _ 10/16/03 POOI AND HOVSE ADDI710N
I 1~ , v!
o j ~20.~~ ° ' >r " S86 22 4 BOOK/PAGE
5 E M A , 30 l 1~~ ~ ~ ~a. S o ~ „ , 606/52
. 86 2017 4 - E PL.q 0.3 T 5 CONTROL NO.
r - ~ _-FOUND IRON 1.4 FEET R-39 SCALE IN FEE1 20523
' 6• J~ 50UTH AND 0.3 FEET 8 ! Q.-QS o ' , EAST OF LOT CORNER ~ 20 40 60 60 CAO FlLE
49 5 ~ ~ 8 ~ ~
i 1 inch = 20 feet iia 20523.OWG PROJECT NO.
. _ , - 20523
, - _ _ FlLE N0.
1-01-247
S SHEET 1 0 F 1
_ r ~ u~r; ; ~ d.. _ . _
~ n-~ ~ L.v ~
o~ , FR~PE ~ ~ ! . ~ 179.78 S89 59 44 W~ R~'Y ~~~SCR~PTION, ~t ~ Block 1 BRITTANY PLAT a~ ~ O ~
~ ~ ADDfTION 179.4~ 1~89 57 55 .~Qkotc~ ~ount I~:nnesota 41
_ W M~AS. - . ~
/ - ~
~ 1~e hereb e t ~ 3' e~'-~~Y ~his is a~rue and correct surve of w
desc~ibed :ro ~rt &n Y the above P p y d that zti was perPormed b me o~ under he above r my
direct su e~visf~n and t,h y m'Y p at ~°m a~uly ~icensed Surve or ~nder th der the ~
iaws of ~he St~~e of Minnesota, Y e That t~~s survey does nat ur or~ ~o show aI1 imgrovements, easem~nts a p p ~rport to
r encroachme ts, ~o the property except as sho~+n thereon, ?roperty ~ cn
~ ~T ~ i ~ 2~th ~.v I I^ Sgned th~s day af _ ~epterr~ber ~
~ o~ J a R. Hill, Inc,, ~ R. Hill, Inc., 31
By: J
Harold C, PeteKSOn, Minnesala L,S, No, t2294 lo, t2294
I
~ . - - o es.
.
~J 1. No s pec~fic titfe seorch for ezistence or non-. nce or non-.
• ~ ezistence of recortled Qr un-recorded easements ~ f easements . as a part
. has been conduefed b~he surve or os a ~ ~ . Y y part
. of this survey, Onf easements er the record ~ ~ Y p ed fhe recorded
~ ~ q Q plat are shown. ~ W J
J ~ ~ ~ a- .
~
~ ~ ~ ~ Den ~ J t n o otes set s ~ke ~ ~ .P ~
~.V I ~ ~ ~ 4 Denotes set iron monument ~ • ' • Denotes found iron monument )nument ~
~ ~O t~ ~ ~enotes brick over ed in monument ~
P 99 ~ edging
.r ~ ; Q !1'i ` ~r Denotes rail road si n A ]n ~
W ~ ~ 9
~ ~ ' '
~ t,~
~ M t
u~ ~ . _ , , _ ~u: _ _
' . ~
N f-- + I Q ~ _ ,
i kf~;~~ ~rf~ ~ ~~f#~~ .~„tl A= ~ ~ b iJ J Q~ ~ ~ rAi~.~ ~'r~`bC i~~~ ~di ~.a,~i i~ L.oi B~ • . C
~ n. w Blo , . T ~ ~ ck 1, beara S 0~`:d 52 E E
I !1 ~ , ~ ~.v ~ ` Scale~ t 30 o~.
0o a 00 ~
, o~ Q O ~ LANDSCAP€ PAVER EDGE ~ I 1'~'1 p
(0 ~ _ - ~-IS 4,1 FEET NORTH ~aND~CAPE PAVER EDGE ~ w~ ~ W
~ SHED / PR P OF fS f~,t FEET SOUTH OF - ~ 30 100 SHED CORNER I ~ 0 ERTY LINE PR 1 ~ O S_ ~ OPERTY LINE !
1,5 FEEt NORTN ~ ~ ~2,65 0 ? »
£+F PROPERTY IN , ~ S89 59 44 W PLAT ~ l E \ o ~ ~ ~ „ 172.23 S89 57 3 V
9 W MEA . ! ~,5< ,~z.32 .a ~ M. ~
~ N ~ d Z~ ~,8` i`1 ~~7 ~ ~ W ~
~ -Q'-- oJ d U1 n ~ 0 1 \ w
Q \ ~ ~ ( Q f~
Q Q 1~ 23~ ~ 2,7 ~ ~ ~ M ~ ~
{.l~ ~ M~~ ~ + ~ I Y W'~ t Q'" ~ r ~ O 3 ' ~ e"'
lJ.I k?- cAR, o r- " a 9,1 N O
W - ~.t- ~ C~ Y ~ 3 ~a o 0
w F ~ / o _ 23, Q , 2 STORY 0 CO I w o~ -
N N a M FRAME -30, O ~ , ~ ~ -
~ • W z CL ~ f~ ~ w o
0 ~ Cj I ~ ~ p '~-w cv N Q t ~ ~
~ ~ d Z O N \ x a r ~fA ~
U? U ° W ~ ~a ~ 23,1 V 1Zt~ ,D Z en ~ ~ ~ ~ ~
N ~ ~ ~I ' ELEVATED ~ ~ N ' ~ _ ~ .~E~K. ~ ~ Q ~ ~ \ , ~ , r- ~
00 ~t' 1 ~ - ~~t' ~ Z ~ ~ ~ o^^~ kf"} Q ' 00 I ~'h U) o ORAWN B
' 100 ln ~ 10 ~ ~ . I~ tn ~ ~ ~ f 'f jD
~ ~ J . DATE
~ I ~ ~ r ~ u~ M 9/14/01
Q ~ ~ Q ~ ~ M ~ REVISION:
~ ~ I ~
I ° ~ 12Q, 3 0 ,
~ S8 ~ 6 22 ! 45 ~
~fEAS. o 120, 7 0 ? ~ ~o 6 ~8 ~ a 6 ~0
1? ~ ? . M ~`~.A T 4 - o. ~ B04K/PAC 606/52
~ ~ R=~ c. -FOUND IRON 1,4 FEEF CONTROI
I 96, 58 SOUTH ANQ 0, F 20523
I 4- a , ~~~T SCALE IN FE~T Q~ EAST QF LQT CORNER . _ 49 Q o 2o a _ I 58 ~ o so 60 CAO FIIE
. f 20523.DW(
_ _ ? _ I 1 inch = 20 feet PROJECT R
_ 20523
/r I 1 - FILE NO.
1-01-247
"~HEET 1 OF
~ i ~s ~ ~ C ~ -e I
~ . . , C q)
~
t3
G ~
~ ~ w
~.v i ° DE~CR P I~I3; ~~t. 1, Bloek 1~ BRITTANY ~4TH PROPER Y I T §4
179.78 S89°59~44~IN P~~T • ~1 ~
ADQfTION, L?aicofa ~ount , Minnesota, , , „ ~
1?9.45 ~J89 57 5~ N1 ME S. _ ~ _ r.__.._
~ We hereb eer~if thak t~is is a true and co. rect su~ve of the above / Y Y Y above ~
desc~ibed p~operty and that it ~:rws perforrned by rne or under ~y my
direet supervision and that j a~i a~uly Licen~~d Surveyor undec the er the ~
Iaws aF the St~te of ~(in~esota, 'Ehat this su~vey does ~at purporf, to )ort to co
show aIl improveFnents, ease~nents o~^ encroaehme ~s, to the praperty aPerty 4)
except as shown ~hereo~, 99, Hill, Inc.,
Si ned this 20~~ doy of Sep~emk:zr ,20 . J s R. HiN, Inc., ( ~"'~T A ~
L.V I `1' ~
"
By
~ Horold C. Peterson, Mir,neso~a LS. No. t2294 12294
I
~
~S: 0
.
~ . ` . 1. No s ecific title se~rch for existence or ron- ce or r~on-
I p C'~ ~ Pxistence of recortled ar un-recorded easemen~s easements
~ hos been conducted b~he sur~e or os a art . Y Y P as a Part
~ ~ af this survey, Only eosements per the recorded ie recorded
, ~ ~ ~ vi lat nre shown.
, ~ P ~ ~ Q
c ` t1} J ~ ` ~a
~ ~ ~c J . ~k ~ ~ Denotes set sp e 'z
~ p ~ 0 Denc~es set iron monument nument Q
~ C 0 nd iron monument ~ ~ ~ E~ • Denotes fou nonument
t.V I ~i ~ • ~ r Denotes brick paver edging edging A
` ~ I~ o~} ~1- e--
~ Denotes rail road sign I . ~n ~ 0
Uj . ^ ~ ~t !1^, ~
J ~ v ~
p- ~ ~ ~ ~ ~ ~ >4 N
~ ~ Z
~ N
~ , t~ ; e g w` ~ ~ W
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1--~ ~ ~ w~ _
Q Q Block 1, be~rs S C2°i7 52 E Q J W
l~l J Q, ; ~ ~ a Scale 1 30 rM1 ~ ~ ~
i ~T ...r r? L.V ! ~ ~ , O
I ~ ~ o ~ ~
~ ~ . c~ ~ . ~ p _ LANDSCAPE PAVER EDGE LAP;U3;APE PAVER EDGE ~ C3) 30 1°~~ TI W ~
_ i --IS 4,1 FEET NORTH OF IS G,1 FEET SOUTH OF -1 t!? - ~ ~ N
~ SHED / PROPERTY LINE ` ~ PROPERTY UNE !
Q ~ 100 ~ 34E0 CORNER IS I o r » ~h~~~~~~~i.k~°-- 1;5 FEET NCRTH- ~ 72,65 S89 59 44 W PLAT ~ r--- O
~ n: < <v , t? ~ ~ ~ ~ PROPERTY UNE ~ ~ ~ I~IW ~1I~EA . ~ f 172.23 S89 57 39 1
~ ~ i 1,5~ 142,32 I ~
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~ ~ ~ ~ a
~ a s.1 " Q ° W ~ W 31,t- ~a o -STORY 23,~ Q
Y ~ W ~ ~ ~ ~ ~30. ~I' ~ ~ ~ ~ ~ ~ FRAME Z i
A' W ;y,i M ~ ~ N ` v a~ n-
~ ~6 r a 1 ~ ~ t~ W z ~ ~
r- I~ ~ a w ~ ~r 2 0 ~ a ~ 0 ~ Z~ ~ C,~ ' j, ~ ,~q o _ c~ ' ~ c~ ~
~ ~ Q ' Q ~ N . a u~ t~. ~r- V O ` p w i 23.1 , ~ ,
~ Z cn o, ~ ~ cv ~r, ~ ELEVATED ~ r., O 'J DRAWN BY
~ -DE6K _ L. Z ~ ~ kl o a , _ TjD
N ~ r~ ev ~ ~ ~ o . = Cd f ~ _ ~ 1~ ~ DATE
,~w ~ 12,o M I , ! 10 ~ F~ ~ 0 g/14/01
tOG u^ i~' ~ ~ I ~ 1 ~ r- ~ e a REVISIONS
M ~ ~ N ~ ~
O ~ i
~ ! I ~ ~ I
a I
120, 31 ~ , S86 2 2 45 E _ 30 MEAS. , ~ BOOK/PAGE 6Q6/a2
120.76 ~ ~ „ I _ S~6 2p ~
i7 E , 1 40,3 ~ E 5 CONTROL NQ. 20523
~ j I IP R-3~ c_.-FOUNO ,~.ON 1,4 FEET SCALE IN F'EET ~ 6~~ SOUTH AplD 0,3 FEET
~ ~ 60 ? 0 ~ EAST OF LOT CORNER Q ~d ~ , ~-05 a 60 eAD F{LE 20523.DWG
49 ~ 58 M t ' PROJECT NO.
_ ` ; 1 inch = 20 feet 20523
_ _ i _ _ F'ILE NO.
, 1-Q1'-247
I _ SHEET 4 OF t
~
09f21/26tl1 15;35:~0 20532