4913 Slater Rd INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: ~ r~~ r,
3830 Pilot Knob Road Permit Number: ~ T fa
Eagan, Minnes~ta 55122-1897 Date Issued: ~
(612) 681-4675
SITE ADDRESS: ` ' f ~ ' ' ' ` APPLICANT:
~ i : . r:it,F;E.~ : ~
- ! FriFR Rfl ~ ~
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PERMIT SUBTYPE: TYPE OF WORK:
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Permit No. Permit Holder Date Telephone ~
ELEC7AIC
PLUMBiNG ~ a
HVAC
Inspecdon Data Inap. Comments
FOOTINGS
FOUND
FRAMING ~t`v H"~ ~ /1(c..'/~ p"' `i~lerf
- 3-~-~ dt~,f1
ROOFING
ROUGH ~ '
PLUMBING . 3. . ~ -
PLBG
AIR TEST
ROUGH ~O - 3-4 7~3 3~ a~ 6wl~l.
HEATING -t ?~C,.,,~ ryuS ~ ~~r~s~. ca J~[~
GAS SVC
TEST
INSUL
GYP BOAfl~
FIREPLACE
~G ~ 3' ~ F~
FIREPLACE °~'1 ~!•a ~ed~~
AIR TEST jV -/O IC~1~
FINAL PLBG
FlNAL NTG
ORSAT
TEST
BLDG FINAL ~
I
BSMTR.L ~p.3_~ ~~p ~
~
BSMT FINAL I
~
DECK FTG I
DECK FINA4 I
~
~
- ~
~
~
~
~ - INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Numbe~: ~
Eagan, Minnesota 55122-1897 Date Issued: ~
(612) 681-4675
SITE ADDRESS: ' ' ~ ~ APPLICANT:
i , it~ +
: r'E r. r;~, „ , ~
, . , , ~ , ,
PERMIT SUBTYPE: TYPE OF WORK:
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, ~
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.w3~.~..yuYf~. .T`-.-...ri ~ '~,.tlh'~'`.i,v~.J4_~~,i .~i'~'x`~ .
Permit No. Permit Holder Date Telephone #
_ ELECTRIC 3~3 j + /D y ~g~
. PI.UMBlNG ~p ~
HVAC ~j ~ ~'~iS.~O~
Inapaction e nsp. Comments
FO~TINCiS /GT
l~
FOUND
y 47 ~'d
FRAMING
ROOFING
ROUGH ~ ~ J
PLUMBiNG ..-I~ ~ f~
PLBG
AIR TEST
ROUGH ~ - C~~~ riv~- a '
HEATING ~-~-~7 `
GAS SVC l~ ~ ,~..~y~ ~
TEST
INSUL rJ 7
v~
GYP BOARD
FIREPLACE r
FIREPL,ACE / ~
AIR TEST
FINAI PLBG c~ ~
~ 2 i ~~7~
FINAI HTG
C
ORSAT
TEST
BLDG FINAL ~~5'/
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL ~
. . ~ _ ,
• . w
C~`ftf tCQt¢ n~ ~CClt~1Q~iC~
~i#~j o~ ~agatc
~cpartmettt oi 8xiibixg ~u~~cction
Tieis Certifrcate issucd pursuaRt to the requiremertts of the Uniform Building Code
cenifyrng that ar the rime of issuarrce this srn~cture was in compliance with the varroas
ordinances of rhe Cety regu~eting baildireg constructrorr or use. For the fo!lowing:
use c~.ss~r~cation: SF Qi+1G s~ag. Pertmt No. 2~3
Occuporcy Type cV/ U I 7~oiua Dssaia RI Type Cani. VN
OwnerotBuifdin~ ~1TI]~R ~T1~: Md«s P-f1_ PL)R 765Q7- APPfR VATIFV
Building Adm~ss 4q ~ 3 lsdity
' ~ ' ~ . ~
\ Drr.
Buildi~ Officia! ~ ~ '
POST IN A CdNSPICU0U5 PLACE
, Address 4913 STt1T~R RDAD Zip 5512?
L.ot 3 Blk 1 Sub wHisr~G t,roons Io1tt
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: (p ~ y"~ Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway l.~
Petmanent gas ?
Sod/Seeded grass i/
TraiUcurb damage r/
Porch ~
Basement Finish ?
Deck ?
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ~
Wl~ite - Ciry Copy Yellow - Resident Copy Pink - Contractor Copy
II (I II I I II I I II I II I I III I III t~ MS QUoiS
SstyO Ae.,~Rm. SRe 28,cSt PaPEMNION04rJO
* 0 3 5 3 5 1 5 0* Phone (61"2?~4z-osoo ~~p 9
Home Duplex Apt. Bidg. Other: New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Htg. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat emp. Service
"X" above 17re nnrk coveretl by this ~equest Enfer remaiks in this ~oace antl on the t~ck ot the white copy only.
i 27
~~6~51~
Calcufate frx;oection Fee - This Inspection Fequest will nof be acceptetl wi[houf f6e covect /ee:
Other Fee Service Enhance Size Fee Clrcuils/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps ~ 0 to i/e ~O
Sheet LtgJTraffic Sig. Above 200_Amps bove/// fff100 mps
Transformer/Generator INSPECTOR'SUSEONLY ' TAL
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
SWimming Pool I hereby ce' tnat I i pectea iM el rka cribetl herein on the ate
Irrigation Boom no~yn-i o~ce
Special Inspection
Fin Da~e
Investigative Fee
THIS INSTALLATION MAY BE ORDERED DISCO NOT COMPLETED WITHIN 18 MO HS.
OFFICE USE ONLY This reques~ witl 18 monihs irom valqaGon tlate prin~ed in Lhis box.
353-515 ~0 70 ~o s
~~/0~9 7~3, Q1, I.~~a~, . W oe~o~.10~ ~-p' w
PLEASE PRINT OR TYPE ~ O~ y
Reques~ Date pough-in inspectbn requiretl? Yea ? No Inspection Other Than R~
.0~ W II Call
3~~"4 ~ ryou mvst call ~he inspector n ready) _ y:, " -
I, ensed contracror ? owner hereby request inspection o the above el trical i '
Job tlmss ~S(met, Box, or oute NoJ Ci~y ~ c. ' i ~ ~
~ ~ ~7 '
Section No. Township Name o~ No. Far9e No. Fire No. County
anl Phorie N~ - ~
PoNer Supplier tlress
Q IC~"' l Fp;rm
ElecMcal GonVactor (Coriroany Name) Con[rac License No. Master Lic. No. (Plant Elect Only~
B & L II.ECTRIC INC
Maili~g Atldress (ConVacror or Owner Pedormirg Installa~un)
A h ( tracmr r wner Peda ing InstalHlion Phorie No.
894-3333
EB-00001A-11 S/95 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
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7k~kXc9c***~:7R*:k*"Ah7~,:F:~:R .7k;~c7~lc*~*#~Y.cKnK~:.Y.~*~* '
CITY 0~ • AN . .
f:A5,4IERx 5 TE?,MI~A! N0: 341 •
~A?e~ 02/14/97 TIME: 15:12p45••
LDs '
NAME: EF HULDI7{G C~tiPANY
2256 900+_ 4S13 SLATFR Rif 5~i.08.4iE
.
i .
J .
Tota~ Receipt 4TO~1nt: 5}1~8.46
CR07~b82 .
115ER TDs VANCY
~K#:k7k76~*~**![:~Cffi*%~#~:7k~M~6~c;Y8c~~~*7K:Kk:7k#*~k
~ , ' .
PERMI~
~ITY~OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B u a ~ o a N e
Eagan, Minnesota 55122-1897 Permit Number: ~ z g q g g
(612) 681-4675 Date Issued: 0 2/ 14 J 8 7
SfTE ADDRESS:
4913 SLA7ER R~
. LOT: 3 BIOCK: 1
WMI5PERING WOODS 10TH,
P.Z.N.: 10-83954-030-01
DESCRIPTION:
~'~l,i3~e~i(tc~t~aPermit 7ype SF DWG
~u~~~~ng ~,~k Type NEW
~-~UB~~QcenpaYi~~~, R-3 U-1
~f Grs~+~~C1^uC~a~tFYi Ty~ ~'-N
~ %SxYtSEiQ ` t~ R-1
~ . ; ~Fu.~~.rling stsr~~s ~
~ ~ Sq~~r~~~~~C. ~ 20@37
~ 7,01 7, - FAM. ~ETACH
~ ~~~~~4~~~~ ~ 7
~3 ~8~~~?~
~ ~
y p`~'
~ ~ ~'fi ~ n. ~~i~a ~ e~e[.~~.,~~~'~~~j ~e~" ~ 6~
~ ~ ~ 6 ."'F!« ~ ~q:tiT a "A~ ~3 ~.~S:t ik i~ 6;i~ W ~~*3R+
~~.w.'X"R~
R~~` t~`...4
t
REMARKS:
S& W PLBR - WELTER & BLAYLOCK
FEE SUMMARY:
VALUATION $176,800
Base Fee $1,267.25 MI5CELLANEOUS $1 979.50
Plan Review $823.71 7ata1 Fee $5,108.46
Surcharge , $88.00
SAC $950.@0
SAC ~ 100
5AC Units 1 -
Subtotal $3,128.96
CONTRACTOR: - ppplacant - sT. I.IC OWNER:
BUTLER HOUSING CORP 14314192 9001715 BUTLER HOUSING CORP
P 0 BOX 24597 P 0 BOX 24597
APPLE VALLEY MN 55124 APPLE VALLEY MN 55124
(612) 431-0.132 (612)431-4132
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, T heretrY ~~,ek~airw~~d~e ~hat'i-.f h~ve' ri2a.tl°.'t~asa ~pp~.°~G~~a:an and sta,,t~ tt,at ehe
`a~farm~tab~n' ~ptt~~~„~ared ~gr~~~„tu~ ~~~pl~~.tiu~~~ ~i~' a°p~Y'sCebS~'~~ate ~f~ Mn.'~ ~
a~a'x ~n~°~i'~~,-t~;F ~~`'~t3 ~i'd~fxart~~~ ~ , ~ k.
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APPLICANT/ ITEE SIGNATURE ISSUED B. 7
' 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) j j~ c~~
~ ~ 3830 PILiOT KN B RDN 55122 '
~ 681at675 z~~~
New Construdion Reauirements RemedeVReoair Reouirements
? 3 rogisteretl aite surveys ? 2 copies of plan
? 2 coDies of plans (indude beem d wim7pw s~es; poured fid. design; etc) ? 2 site surveys (exterior atldilions & dedcs)
? i energy calalatlons ? 1 energy ealcutations for heated addkions
? 3 copies of Vee p etlon plan if lot platted after 7H/93
required: ~Yes _ No •
DATE: ~ 11 CONSTRUCTION C~ST: 1[+~~
DESCRIPTIONOFWORK: ~PV~M'~ cJ! M~C(,{~ r-F~YY~ I L"~
STREET ADDRESS: ` ` ~ ~ ~~T~ I~~
LOT ~ BLOCK ~ SUBD./P.I.D. r, ~ (
PROPERTY Name: +-~IL'~~T~l~ I 11C.~ Phone 43 ~~~t3Z
OWNER m "
Street Address r, ~ ~ ~5~~
City: ~'C Vic~N State: Zip: ~J 'rJ ~ sZ.y" ^
CONTRACTOR Company: ~~7~CL'~~ Phone ~!`T `
Street Address: ~ ~ ~ ~ s ~ License ~ , ~ ~
City: ~ ~c~,~~T State: tl~~ Zip:
ARCHITECTI Company. . wN Yv ~~Phone
ENGINEER
/ ~
Name: ~~i,~~~ 1~~!^ Registration i~J~~
Streef Address: ~ ~ ~
City: `~-G~ State: I~ • Zip: ~ a~
Sewer & water licensed plumber (new conshvction only~,~~~'~""_Ir I~^'Penalty applies when address change
and lot change are requested once permR is issued.
I hereby acknowledge that I have read this application and state that the infortnation is correct and agree to co piy with all a licable
State of Minnesota Statutes and City of Eagan Ordinances.
s"
Signature of Appli t:
OFFICE USE ONLY D
Certificates af Survey Received es _ No FE~ 12 19g~
Tree Preservation Plan Received ~Yes _ No _ Not Required 8~_ _
OFFICE USE ONLY ,y~ ~
's1
~ky6. ~ . riih,
.efA i~r~" ~'6 i'
BUILDING PERMIT TYPE . ~
0 01 Foundation ? 06 Duplex ? 11 Apt./Lodging n 16 Basement Finish
8' 02 SF Dwelling ? 07 4-plex ? 12 Multi RepaidRem. ? 17 Swim Pool
0 03 SF Addition o 08 8-piex ? 13 Garage/Accessory o 20 Public Facility
0 04 SF Porch o 09 12-plex n 14 Fireplace n 21 Miscelianeous
? 05 SF Misc. 0 10 =
plex o 15 Deck
WORK TYPE
a' 31 New n 33 Afterations o 36 Move
0 32 Addition ? 34 Repair ? 37 Demolition
GENERAL lNFORMATION
Const. (Actuai) J~ Basement sq. ft. ' 3~ 7 MC/WS System ~
(Allowable) v Main level sq. ft. i 3 80 City Water i
UBCOccupancy ~-3,~-1 2~ sq.ft. i~-~~ FireSprinklered
Zoning ~ sq. ft. vsh PRV
# of Stories 2 sq. ft. Booster Pump
Length 6~1' sq. ft. Census Code. i~_
Depth 44 ~ y,, Footprint sq. ft. zo SAC Code ~ i
Census Bidg i
Census Unit i
APPROVALS
Planning Building Engineering Variance
Pertnit Fee Valuation: $ 1~ b, ooo.--
Surcharge '~s~
Plan Review ~vw s. s
License 3~-,~ z~. ,S r 7. S
MC/WS 5AC q S~ 3~ 3 a~,
City SAC ~ g
Water Conn. f3~
Water Meter , r~ s ~
a
l~ S~
Acct. Deposit ~ ~ z~ 9 ~7 ~ r s= z o~ G S S, -
S/W Permit ~
SNV Surcharge s~ + , ~ 7 ~
Treatment PL z, 8 r~
Park Dedt y 8~h ~ s`~ ~`l' S~ 9. -
Trails Ded. z
Other 3~ sc..-•-~- ~ 3~ ~
Copies ~ r ~ L , z
-,yua _ii2
Total: a,y ~ sa : ~ a', ~ s 8. r
% SAC
SAC Unfts ~O~ ''c . 33 ~06. ~
zo• 33.i a
~+0,7
~~ck Cas7~ 3~31 ico ~ in st~, -
J ~ 2- J u ,
~ ~ S. 8 39 .
~OT SURVEY CHECKLIST FOR RESIDENTIAL
~ BUILDING PERMIT APPLICATION
PROPERTY LEGAL: Ld/' 3 BL~CK / I.IfI'SPE,Z?'d/~ ~~DS T~N7'N
~ ~ DATE OF SURVEY: ~Z ' 27 - 9~
~ LATEST REVISION: Z-/ 3- 47
~
~ ~ F DOCUMENTSTANDARDS
d/
? • Registered Land Surveyor signature and company
~ ? ? • Building PermR Applicant
~ ? ? • Legal description
~ ? ? • Address
? ? + North arrow and scale
? ? • House type (rambler, walkout, split w/o, split entry, lookout, etc.)
? • Directional drainage arrows with slope/gradient
? • Proposed/ebsting sewer and water services & invert elevation
? ? • Street name
q' ? o • Driveway
ELEVATIONS
F~astina
E~/ o ~ • Sewer service (or Proposed)
rY ? ? • Property comers
? • Top of curb at the driveway
• Elevations of any eristing adjacent homes
Prooosed
~ ? ? • Garege floor
m~ ? ? • Frst floor
~ ? ? • Lowest expased elevation (walkouUwindow)
? ? • Properly comers
~ • Front and rear of home at the foundation
PONDING AREA (if aoolicable)
O ? • Easement line
Q~ ? ? • NWL
• HWL
A • Pond # designation
? m~ ? • Emergency Overflow Elevation
DIMENSIONS
? ? • Lot IinesBearings & dimensions
C~ O ? • Right-of-way and street widfh {to back of curb)
(9~ ? ? • Proposed home dimensions including any proposed decks, overhangs greater than 2',
/ porches, eta (.e. ali strudures requiring pertnaneM footings)
L~'/ ? ? • Show all easements of record and any Ciry utilities within those easemenls
Cd~ • Setbacks of proposed structure and sideyard setback of adjacent eristlng structures
~ i9' ? • Retaining wall requiremen ,'rf any
Reviewed: ~h~
ame ! Date
Jamury 1996
CFA1019BGBLDGPRMf.FM
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~7~R1~GY FV~f • Butler Homes
~~I~ AS . L,ot 3, Blocls. 1, NHISPBRING TeIOODS THNTA ADDITION, City of Ea~an,
Dakota County, Minnesota and reserviny easements of record.
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-VACFINT- ~ i~ER
L_~J I L_ e~
990.~ ~4~~
5B9° 47' 10° W 142. 46 937 ~_o
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SS`~ 98oS ~ -58.10.. u°.~~
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a FES: ~ g qlT.~ mwav~ ~--I
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W ~ °0 12.50 3
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°o PON~ ~ ~ ~w°' °z ~
NWU y
N NWL=9lbAo ~ I 976.5 ~9.SD 5.0 m ~ ~Se~u~te
9r~~~ ^ ~ I
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4O I o 31.33 q~q ~ _ I I
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~ N89° 47' 10' E 142. 46 98?3 98os 9~8.9
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-VACANT-
LOT SQ. FOOTAGE = 13, 391 f
GQ~IQf~I
G°~C~~I~~,~C~D ~o
BY ~ S
DATE Z - / 5 ~ .
BUILDING INSPECTIOf~l: "?T. `=~-Le " GII9~
T,AG
hN EI~1GII~
PAOPOSED ELEVATIONS BENCHMARK,
Top af Foundatlon = aaez
Garage Floar °993."!.
Basement FIooP °q~7•q
Aprox. Sewer Service Elev. °9~i~s`-
Proposed Elev. = O N MIN. SETBACK RE~UIREMENTS
Existing ~lev. °
Drafnage Directions ° Front - ao House Side -~o
Denotes offset Stake SCALE : f Inch • 30 Feet Rear - NiA Garage SI de
JOB N0:
I HEREBY CERTIFY THAT THI5 IS A TRUE AND COflN:CT REPNE5ENTATION 9~R-5~
~~E~~~~~ Of THE BDUNOAAIES OF iHE ABOVE DESCRIBED PHOPEATY AS SUNVEYEO
BY ME OA UNDEH MY DIqECT SUPERVISION AHD DOES NOT PUHPUNT TO BOOK: PAGE:
SHON IMPROVENENTS OR ENCPOACHNENTS. EXCEPT AS SHONN.
Plannlnp En9fneerJnp SurveYlnp ~ ~ ~
iMl Ent Blw~lrqten fn~iuY Blevlnpten. Nlro~io4 !b~t0 Uate ~
..i~one~. ie~:~ mrwa U. L IDGHEN, LAND SUP YOP CADD F I LE: DWG. CHK.
M 4ES0 LICENSE NUXBER l4376 r_~~t9c~
a
, 1 ~ ~~f
~ .
$~II~Y F~ % Butler Somes
Lot 3, Block 1, iiHISPEEING HOODS TBNRH ADDITION, Ci~y oE Ea~an,
Dakota County, Minnesota and reserviny easements of re ord.
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-VACANT•
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w ~ ~ ' o iz.5o ~
~ alck ~ 47i6 ~ ~°n ~r''1i ~
- Propoeed iv cy ~ ~
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~ 13c~. 9;.. ~ 98 o I
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II Q76.5 ~9.50 5.0 ~ " J
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-VACANT-
LOT SQ. FOOTAGE = 13, 391 f
= ~Q~?~ i N G~ l.. ? ~K't
. - = ~'2tN'~.Tt~~ i'~r ~.r~~
PROPOSED ELEVATIONS BENCHMARK,
Top o! four.dat~an =9a4.i
Garage Floor ~983.7
Basement Floor °975.3
Aprox. SeWer 5ervice Elev. •9~i•S`
Praposed Elev. ° O N MIN. SETBACK REOUIREMENTS
Exlsting Elev. ~
Drainage Directlons • Frant - ao House Side -~o
Denotes offset Stake SCA~E Inch • 30 Feat Rear -"lA Garage Side -~o
JOB ND:
I HEREBY CERTIFY THAT THIS IS A THUE AND CORRECT REPRESENiATION qmR-5~
,~~~~~~Q OF THE BOUNDAHIE5 OF THE ABOYE DESCHIBED PROPEATY AS SUNVEYEO
BY ME OR UNDER MY ~IRECT SUPEHYI510N ANO DOES NOT PUFIPORT TO gpOK: PA6E:
SHON 1NPF10VEHENTS OR ENCROACNMENTS, EXCEPT AS SHOXN.
Pl~nnlnp fnpln~~rtnp Su~veylnD ` L ` ~ ` `
Y701 Fnt UwdM~ Fnrry Ilonlnltoq Mlmm~U W~tO oate L
,.,„~,M,,,,,,..,,~ Ly 1U6HEN, LAND SUR roa CADD FILE: DwG. CHK.
M SOTA LICENSE NUNBEH 14376 ~~t9b
ENERGY CODE WORKSHEET FOR 1& 2 FAMILY DWELLING5
SIT: ADDFE85 i3 s~~r~ rl v~-~ ~~~~~~}y
CODIPLBTHD HY: ~ r P80N8 # DA2S ~ I~ % ~
BOILDING CLA33IFSCATION: ? aategory 1(muet inalude vsntilation) or ? category 2(etandard)
MINIMDM CRZT&RIA
Foundation Sneulation-R10 W111s 8 Windovo Roo£ Attia lasulatioat
(See table on reverae aide
31ab on Grade Ineulation-R10 for allowable percentages) R44-With Attic No Heal
Ploor ovnr unhnuted up:.ceu-R24 R38-With Attic Rataed Huel
Foundation Windowe 1/2" R38 & RS-Solid Raftera
ineulated Glaes.
-Wood or Vinyl Frame
STBP 1 Window 4 Door Ar~a 9TSP 2 Calaulat• ar~a aa a p~ta~ab o£ wall
A. Total Window & Door Area in Sq. Feet
WINDOWS (Including Poundation Windowe):
WINDOW MANOFACTURE NAMSs ~j""`"`-"~2 C. From Step 1 divide box A(Window & Door
p_ L~+ Area) by box B(total wall area) times 100
WINDOW MANOFACTQRB TYPBS Ldld f~~C~ equals the window and door area ae a
percent of wall area (box C).
WINDOW MANDFACTURB II 8ACT0&: "3 ~I ~~'77~.
R. O. Quantity eq.ft.Area ~ BoX A X 100 m C=~2y`~2}
Dimeneione BOA B ~ J
~j~ ~3.
X gTgp y Deeiga Faaturea
X ASSEMBLY
X ~ FRAMIN6 TYPB: ~
X STANDARD FRAMING ~~btuds 16" o.c.
x ADVANCED PRAMING stude 24" o•a•
X CAVITY INSULATION R I
X ~
- SHEATHING TYPE:
X LESS THAN < R-5
X R-5 > OR MORB
~~j, `''f ~/i U-FACTOR v~
x
OOORS: From the table, (reverse side) determine the
maximum percent window & door area for the
~ deeign options selected and enter the 'k value
x in Box D below based on the window mfg. U-
factor: ~
X `°LJ ~ D
~a
Total Area of A3 aq.ft.
Windowe & Doora
B. Total Wall Area in Sq. Ft. The 8 value from the table in Box D shall ba
equal to or greater than the ~ in Sox C
Wall Total Height Area
Perimeter
'
~ •
Total Area of Walle B= eq.ft I
~ .
~ ~
Page 1 OF 2
BUT E 0 0 CORPORATION
CALCULATIONS FOR: ~13 SLATER ROAD E 0 ~ MI~.
WINDOW AND DOOR SCHEDULE
QUANTITY TYPE SIZE FACTOR WINDOW
OPENING
6 BASEMENT 26 X 38 6.86 41.17
2 PATIO ~R 6 R 6 36.00 72.00
5 CASEMENT 20 X 48 6.67 33.33
3 CASEMENT 24 X 60 10.00 30.00
2 CASEMENT 20 X 60 10.80 21.60
3 CASEMENT 24 % 36 6.00 18.00
1 TRANSOM 36 X 66 16.50 16.50
2 TRANSOM 12 R 32 2.66 5.32
2 PICTURE 24 % 48 8.OD 16.00
2 PICTURE 24 X 60 10.00 20.00
1 GRP. PICT.60 X 72/6D 15.80 75.00
3 DBLE HUNGS 32X24/36 15.80 47.40
2 DBLE HUNGS 16X24/36 6.70 13.40
4 DBLE HUNGS 32 X 26 13.60 54.40
4 SIDE LTS. 1 X 1.3 6.20 24.80
42 TOTAL GLASS AREA: 488.92
DOOR SCHEDULE
QUANTITY TYPE SIZE FACTOR DOOR
OPENING
1 THERMATRU 3'-0" X 6 19.00 19.00
1 THERMATRU 2`-8" X 6 16.80 16.Sa
o.ao o.oo
o.ao a.oo
o.ao o.oa
o.oo o.oo
TOTAL DOOft ABEA: 35.80
Page 2 OF 2
TOTAL WALL WINDOW AREA: 375.75 U-VALUE 0.361
TOTAL PATIO DOOR AREA: 72.00 U-VALUE 0.367
TOTAL BASEMENT WDW AREA: 41.17 U-VALUE 0.421
TOTAL WINDOW AREA 488.92
TOTAL DOOR AREA: 35.80 U-VALUE 0.066
TOTAL AREA- WINDOWS & DOORS: 524.72 [A]
TOTAL AREA OF WALL: 3,823.00 [B]
ACTUAL. WDW & DOOR AREA AS ~ OF WALL: 13.73~ [A] ~[B)
STANDA~~ WALL FRAMIN
SHEATHI~ iR=51 IN~04_ $-34~ ~xd.D9_W MA~L ~D17LDB ARSA
CALCOLAT~ONS F0~[_ 4~11~ $.LaT$S $OAp, $HGA~ MIV.
BUTLER ~Qf~@~ CORPORATION
:Yff:Y,;.`X~/.?.'.~~.:~.
;::'t~H,tA(~Y':~;~"%k,v,.~y.~k-.;:~:',rXY,r):; ~::~YcYbyf:k~Ci;(7k:f:.;~X.",.(
C:['(V 0! F.:.Af.FdnJ
CASF'.:l:I:~io MG' CL.F;ti:LNAI... NQ~ 3:=i7
L'in'~-~.•„ Lti/~i'_f`.)i flifii?~ ;.".:,,ttF'~~:i
c~r.i ~
Nt.~°i+~ ~ t~lE,'L..Ii:Y I~nOF(
3:`'i.0 !?Cln:. Fr`_?i:i ',i4..Pitl::Fi f',:1j Pii).f.10
e2:lCi:i `.:7~.SQ1. 4~`,.~:i.3 ~^I..Fl'f!ii.F; ~i"<~ f1~°ii~
3~'Ji? `~Q(7:1. fi'?i,l '':L't'ik-h FiT~ 'C'~C~O
c:!.;'i[ii .')Oq:! ~`.'r7j.Zi 3f_A'lc:~' ;'{D 0,.;91.7
-~~':~.~i1 ~;s;^e.:y.,i: Air~o~.:e:~;;: 'r
1.,On
i:1:0~3i7::-~yq
U'ii'tR "Il e t`!A"il_~!Ni~i
a>t:Yy:i$X: "_'~C:i:Y~.",t8~?F?n';'6:ii:k:i<M~?; ~i?y,>0;;;, ,d,$;;?k.~?Y:$W n~'::',:;:.::PqJ(
PERMIT ~
e ;
i~ CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B u z ~ o z N ~
Eagan, Minnesota 55122-1897 Permit Number: 0 3 0 6 7 4
(612) 681-4675 Date Issued: 0$~ 2 z~ 9 7
SITE ADDRESS:
4913 SLATER RD
LOT: 3 BLOCK: 1
WHISPERING WOODS 10TH
P.I.N.: 10-83959-030-61
DESCRIPTION:
(_.~..._t .
&uilding'~Rermit Type BASEMENT FINISH
~ Building W~rk~Type A.LTERATION
Census Cod'e 434 ALT. RESIDENTIAL
r~ ~
~
~
t~ ' v -
~ ~r"~
F /
~n5'_ VY.. . - /
~ ~
' ~:I l.. ..~'wi'\w.
~e 1!/-n::;~"
,
~ ~ , kyy a ; ~ , ~ ~ ~ k~ ~S"'
/ 4':~.. l~ ~ `4-:.._ ~'l~~ ~:.w,~i ~~t,._..~:f~.d ~ ~
~I~ .JCti +
k.
y~
~ f~~._.! .
REMARKS:
SEPARATE PERMIT REQUIREO FOR ANY PLUMBING WORK
CONTACT STATE BOARD OF ELECTRICITY AT 496-9615 REGAROING ELECTRICAL PERMZT
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
,
~
CONTRACTOR: OWNER: _ q p p 1 i c a n t-
BOOK WESLEY
4913 SLATER RD
EAGAN MN
(612)895-9059
..,r. . . . .
I hersby acknowiedge that I have read this application and state that the
itt~orma;C on is c r t and agrse to coitlply .w~.th a:ll ~pp13~-able St~'Ce af Mn._
L Statute and i y an Or "nences. J
~ac~n ~.~:cl.f mt~
APPLICANT/PERMITE IGNATURE ISSUED B: SI ATU
s~
•~O I_~~ 1997 BUILDlNG PERMIT APPLICA710N (RESIDENTIALj /f
CITY OF EAGAN ~k!~G~~ ~
5830 PILOT KNOB RD - 55122
881~675
N~w Conatrue[ion Reauirements RemotleUReoair Reauirements ~ f°i ~ .
? 3 registered sita surveys ? 2 copies of plan
? 2 copies oT D~ans (indude beam & wfndow sfzes; poured fid. design; etc.) ? 2 ske suneys (exterior addftbns & dedcs)
• 1 energy calwlations , • 1 energy celwladans for heated addi[ions
• 3 copies of tree preservetion plan if lot platted efter 7/1183 ~
requiretl: _Yes No . ~
DATE: . 1 g R~ 7 CO TRUCTION C05T: ~~'1~"~
DESCRIPTION OF WORK: (!A-'~5 2 (r~t
STREET ADORESS: ~ 3 J A-
LOT ~ BLOCK ~ SUBD./P.I.D.
PROPERTY Name: Phone ..C1~~!~
~
OWNER r_,m„
Street Address: ~9! 3 ,~s~'~n
City: ~W-G~'~-iv State: l~ Zip: ~S'~ ~Z ^
coN7RacroR Company: ~~,u n.e/( Phone
Street Address: License
Ciry: State: Zip:
ARCHITECT/ Company: IVr1Q Phone
ENGINEER
Name: Registration
Street Address:
City: State: Zip:
Sewer & water licer.s~ plumber (new construction only): . Penalty appties when address change
and lot change are ~pquested once permit is issued.
I he2by acknowledge that 1 have read this application and state that the information is correct a ag ply wi all applicable
State of Minnesota Statutes and City of Eagan Ordinances. `
Signature of Applicant:
OFFICE USE ONLY D ~ ~ ~ ~ ~ `
Certificates of Survey Received _ Yes _ No ~ ~ 9~
Tree Preservation Pian Received _ Yes _ No _ Not Required
OFFICE USE ONLY , ;
BUILDING PERMIT TYPE
0 01 Foundation ? 06 Duplex o 11 Apt./Lodging 16 Basement Finish
o D2 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. 17 Swim Pool
? 03 SF Addition o 08 8-plex n 13 Garage/Accessory o 20 Public Facility
? 04 SF Porch ? 09 12-plex o 14 Fireptace n 21 Miscellaneous
0 05 SF Misc. ? 10 _-plex o 15 Deck "
WORK TYPE
0 31 New ~ 33 Alterations o 36 Move
0 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actuap Basement sq. ft. MCNVS System
(Allowabie) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. ' PRV
# of Stories sq. ft. Booster Pump ~
Length sq.ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bidg
Census Unit
APPROVALS
Planning Buitding ~ Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCNVS 5AG
City SAC
Water Conn. •
Water Meter
Acct. Deposit
S/W Permit
S/W Suroharge
Treatment PI.
Road Unit ,
Park Ded.
Trails Ded.
Other ~
Copies ~
Total:
. ~
9~ SAC ~
SAC U~ ~ ~
, CITY USE ONLY
~ L BL _L RECEIPT#: 71OOL4
SUBD. I,~~llt~b~h/MIOL~ ID3~ RECEIPTDATE:~~~
1997 PLUMBING PERMIT (RESIDENTIAL)
CiTY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55722
(612) 681~675
Please complete for: . single family dwellings
~ townhomes and condos when permits are required for each unit
. backflow preventer for underground sprinkler system
FIXTURES ~ EACH ~ TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitche~ Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/5pa 3.00 x =
Water Heater 3.00 x =
Floor ~rain 3.00 x =
Gas Piping Outiet * minimum -1 3.00 x =
Rough Openings 1.50 x =
Water Softener ' for dwellings under construction 5.00 X =
Water Softener " for existing dwelling 20.00 x =
U.G. Sprinkler 'fordwelling underconst. 3.00 • _
U:G. Sprinklef *torexistingdweliing 20.00 =
• ~Alteretlons' ' "°to existing residence d 20:00~ _ ~C7G
Water Turn Around 20.00 =
Private Disposal System ' oak cry iic. 75.00 =
(new and refurbished systems) ~
Private Disposal Systems'anandonment 20.00 =
STATE SURCHARGE .50
TOTAL
I here6y acknowledge that I have read this application, state that the informa6on is correct, and agree to comply with all applica6le City
of Eagan ordinances. It is the applieanPs responsibility to notiTy the p~operty owner that the City of Eagan assumes no liability for any
damages caused by the Ciry during its nortnal operational and maintenance activities to the hacildies constructed under this permd within
City propertylright-of-wayleasement.
SITEADDRESS: J~~ ~
OWNER NAME: r
INSTALLER NAME: ~~~-P TELEPHONE 7~'/~`~ ~7
STREET ADDRESS:
CITY: STATE: ZI P:
_--i~
SIGNATURE OF P MITTEE
CITY USE ONLY /y,`
~ ~ ~ gL / RECEIPT 7
, SUBD. IO ~ DATE: ~ 97
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3$30 PILOT KNOB RD
EAGAN, MN 551i!2
(612) 681-4675
Piease complete for: ~ single family dwellings
? townhomes and condos whean permits are required for each unit
FIXTURES EACH N.Q, J9TAL
Shower 3.00 x 1 = .3~ oa
Water Closet 3.00 x ~ _ , o 0
Bath Tub 3.00 ;c ~ _ , o p
Lavatory 3.00 x S = s, o 0
Kitchen Sink 3.00 x = 3. oa
Laundry Tray 3.00 ;c / = 3, o0
Hot Tub/Spa 3.00 ;c =
Water Heater 3.00 = 3, ov
Floor Drain 3.00 ! = 3,az~
Gas Piping Outlet ' minimum -1 3.00 = 3, o0
Rough Openings 1.50 = 6• oa
Water Softener 5.00 x =
Private Disposal ' Dakota Cty. license B5.00 =
(new and refurbished systems)
U.G. Spfinkler ' home under const. 3.00 =
Alterations ' to ex~sting 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .50
TOTAL ~ Sy, S~
51TE ADDRESS:----~ g~~ s~4 ~{'e~' /(~d'
OWNERNAME: ~ufler /~ous~oay ~1o~~ao~cr~iov~
INSTALLER NAME:-~ ~~f~ q'- ~~a ~o c k, l
h
STREET ADDRESS: ts~ ~ ~ ~1+,~-' ~ / 3
~~N: ~u rv~ s v~//~ STATE: /~l ~t./ ZI P: SS_33 7
PHONE (bia ) ~ g~- 86 g'/ -
G~..~~-~~ l
~T~RAT -
OFFICE USE ONLY
L _ BL _ RECEIPT r, " .
SUBD. pATE:
1996 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 P1LOT KNOB RD
EAGAN, MN 55122
(812)681-4675
Please complete for: ~ all commercial/industriai buildings.
~ multi-family buildings when separate permits are ~Qt required for each dwelling
unit.
DATE: CONTRACT PRICE:
WORK TYPE: _ NEW CONSTRUCTION _ ADD ON _ REPAIR
Gt3CFtIP'I"IpN OF WOftK:
~S WATER METER REQUIRED7 _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETER:i TO BE INSTALLED? YES NO.
FAILURE TO PR~VIDE THIS INFORMATION WILL RESUL7IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? YES NO.
IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINY(LER PERMIT.
FEE: $25.D0 minimum fee or 14~0 of contract price, whiche~~er is greater. State surcharge of 5.50 per
$1,000 of permit fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
SITE A~DRESS:
TENANT NAME: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
PHONE SIGNATURE:
APPUCANT
OFFICE USE ONLY
METER SIZE: DATE: INSPECTOR:
? •Y CITY USE ONLY
L ~ BL _L RECEIPT#: ~/5l(vC7
SUBD. ~D ~ RECEIPTDATE: ~~97
1997 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 56122
(812) 681-4675
Please complete for. ? single family dwellings
? townhomes and condos when pertnits are required for each unit
New canstruction Add-on fumace
Add-on air conditioning Ada-on air exchanger, i.e. Vanee system, eic.
Date: ~
FEES
9
? Minimum Fee: Add-on/Remodel (existing residence onty) $20.OQ ~
? HVAC: 0-100 M BTU 24.00?
Additional 50 M BTU 6.00~
? Gas Outlets (minimum of 1 required $3.00 each) -!r
? State Surcharge .50
TOTAL
~d7 ~iv
SITE ADDRESS: ~ T
OWNERNAME: + ~ PHONE#:_1z1~G aa~/~
INSTALLER NAME: ~L- 7~ PHONE O~S,~~D~
STREET ADDRESS: 60~~ ~ ~
CITY: i'~ 6' STATE:/'~/'~i ZIP: S D/
t~ ~
SIGNATURE OF PERMI EE
RSr1. -
r, 3 s /
svsn ~ ~ -
rrEw ~c$=~r # 9~a? 7
RECBIPT DATE S I~ tI
DATE ~ `~l~
~ i35~- G /%%eG t
- _ _ _
- so~ 5~'~-t'~.~
o~ER ~j a f'/~ 2 fi~Qirs'.'e~-g
~
PLEA.SE B8 ADVI3ED TBAT THERE IS A FSE SHORTAGE ~T '1'$$ ASdV&
ELECTRICAL INSTALLATION IN TSE AL~DUNT OF
R$~iRR3
~ ~0 - 30 A1~ CIR~t#IT3 = ~
f 31 - 1~0 ~ CIIZCCT~TS = 7
0 - 100 A1~lP SERVtC~ _
~ 101 - 200.AMP 8&~lvICE _ ~0
To~z ~ nas = ll 7 -
r.ESS ~ ~cgxv$n G' ~ _
xo~r~ ~ saoRTa+~ nu~ _ ~9'
PERMIT # 3 ~3 ~~5
ORIG REC~IPT # 76~~ J~
RECEIPT DATE ~ /O
PLEASB RETURN !1 COPY OF THIS FORM LPITH YOUR RE[~TTANC~.
THANR YOB
`16
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Date.JS
Use BLUE or BLACK Ink
Permit#: .f ?� e�
Permit Fee: 99- 0 6
Date Received:
Staff:
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
0I V Site Address: t
Tenant: Y V• f)(1>a4.._.
7-1304,
Suite #:
RESIDENT / OWNER
Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK
Description of work: INtsi ""
Construction Cos —49 CO Multi -Family Building: (Yes / No ?<11)
CONTRACTOR
Name: i' IF T—624J p License #: So 4 .51
6,64 3 124 e
Address: I1 b 'LJ ea ,r City: Jgi,
State: AA/ N Zip:1 Z.,"'' Phone: .....
Contact: Email:
COMPLETE
In the last 12 months, has
Yes No If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:
Phone:
E:> Plants and supporting documents that you submit are z.:?).,.ere tiered to be public rnforrrta ion ortfons of,'
e40 otmatierimaybe classified as nor iublic if yrou provide!specrfic reasons that would permit (% City to
` °conclude.that they' are` trade.,secretsA,..
CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage.
CaII 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 onformance with th ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and wor is •t to start with ut a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval o
Applicant's Printed Name
x
App 'cant's Signature
Page 1 of 2
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments: P
Fee Summary:
Valuation: 3,000.00
Contractor:
Signature Home Services
758 Reaney Ave.
St. Paul MN 55106
(651) 731 -1147
ctures are not acceptable in lieu of inspections.
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
Site Address: 4913 Slater Rd
Lot: 003 Block: 001 Addition: Whispering Woods 10th
PID:10- 83959- 030 -01
Use:
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
Construction Type:
Occupancy:
$88.50 0801.4085
$1.50 9001.2195
$90.00
Owner:
Wesley C Book
4913 Slater Rd
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Issued By: Signature
Building
EA079951
09/21/2007
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA130304
Date Issued:04/16/2015
Permit Category:ePermit
Site Address: 4913 Slater Rd
Lot:003 Block: 001 Addition: Whispering Woods 10th
PID:10-83959-01-030
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Wesley Tstes C Book
4913 Slater Rd
Eagan MN 55122
(651) 895-9059
Sandstrom Enterprises
888 Burke Ave
Roseville MN 55113
(651) 983-4340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA160246
Date Issued:02/25/2020
Permit Category:ePermit
Site Address: 4913 Slater Rd
Lot:003 Block: 001 Addition: Whispering Woods 10th
PID:10-83959-01-030
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Matthew D Quaschnick
4913 Slater Rd
Eagan MN 55122
(952) 210-3266
Mayday Restoration
18062 Judicial Way N
Lakeville MN 55044
(651) 253-4085
Applicant/Permitee: Signature Issued By: Signature
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Permit Fee: /,?0 " a.
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 i FAX: (651)675-5694 Staff:
buildinginspections c(r7cityofeagan.com .,
2020 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 5-11-2020 Site Address: 4913 Slater Road Unit#:
Name: Matthew Quaschnick Phone: (952) 210-3266
Resident/ 4913 Slater Road Eagan MN 55122
owner- - Address/City/Zip:
Applicant is: Owner / Contractor
Type of Work
Description of work: Re Roof
Construction Cost: 21376.67 Multi-Family Building: (Yes /No i )
Company: Mayday Restoration contact: Corey Gindorff
Contractor
Address: 2400 N 2nd St Ste #400 City: Minneapolis
State: mn Zip: 55411 Phone: 6127416336 Email: corey@hailmayday.com
,, License#: bc768347 Lead Certificate#:
If the project is exempt from lead certification, please explain why:
re roof
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:Plans and supporting documents that you submit ars considered to be public information. Portions°,the information may be ,
classified as non-public if you provide specific reasons that would permit the City to conclude that they are treds seeruts.its
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.citvofeaqan.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.
xCorey Gindorffx Corey ainbrf
Applicant's Printed Name Applicant's Signature