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684 Stonewood Rd : -2-$8 CITY OF EAGAN Permii No: Date: 383G'Pilot Knob Road Meter No: I-ZI 00 -11 00 Size: f Re. P.O. Box 21199 Reader No: Date: F Eagan, MN 55121 Owner. ?tnhn Gr~,-, SItBAddfASS: - •=_=ii SYrnve.iund rtsxcj L L,1. iliilciLT"-E `)ttl Plumber_ Fxr47t,nen Flurnbing Conn. Chg: Zoning: Acct Dep: No. ot Units: Z Permit Fee: 7 c) - ~oPd Surcharge: 5DIld I agree to comply with tho lty of Eagan Tr. Plant 2n4- nnp# Ordlaances. Meter. Misc.: gy , I WATER SERVECE PERNHf ~ ~ CITY 8F EAGAN Permit No: f`?" Date: °'Z-~'' ~ j 3830F Pilo! Knpb Road Mater No: • Size: ' P.O. Box 21199 ReaQer Na Date: I Eagan, MN 55121 . . 1 Owner. a r:onai . , Site Address ~ t~evao$ B,oau I~? ~i ~Tindt~~e 5C?s . Plumber. '~:;staua &Xq/'.t'hoc+n Plurnblr.g ~ w Conn. Chg: 550* 000d Zoningo Acct Dep: 15.• Oop~-.r No. of Units: 1 ! Permit Fee: 10. ~ Surcharge: • S00 t agrQe to comply with the City o1 Eagan Tr. Plant = 34 • Qfpfi , Qrdlnancea. ~ ' Meter. 67 00;'„ ~ Misc.: sy WATEi $ERVICE PERMIT i CITY pF EAGAN Permit No: 1077 T Date: _ 6-9_RB ~ 3830 Pilot Knob Road B/P No: - 83972 Date: S_111_.f3R P.O. 9ox 21199 ~ Eegan, MN 55121 Owner. .?ohasaa Canst . ~ Site Address: St4newoai P,oad L?_ B1 fJiadtree 5th i Plumber. xtYstone Ezc/'Thoea Flu:mh_ng , MWCC: - 550. ^Cnd Zoning• F' cicn io:~. nc~~.,~; . tY 9~ No. of Units: 1 Acct Dep: ~ Permit Fee: 10•00F3 I agree to comply with the City ol Eagan ; Surcharge: Ordinances. ! Misc.: gy . ; SEWER SERVICE PERMIT • S5DGWICK HEATING & AIR CONDITIONING CO. • 1 ' HOUSE HEATING tEST RECORD ADDRESS CITY y OCCUPANT OWNER ~4A • ---1 } HEAT L05S DATE HTG. INST. SOLD BY INSTALLED BY `~'C•y~. ~ C .t Electrical Work By Gas Line By - - TYPE OF HEAT GA_ FA_ HW_ STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE VMAKE OF BURNER Model Model Serial g`~ Max. BTU Rating INPUT i 1`9 MAKE OF FURNACE Model NTROLS ~ TFf~~VIQ~ST~QT ~ w!C ~Heat Plug . Vent Size Valve ~~1 S AW KIND OF LINER SIZE NONE Limit Na "f 11v~2 ; Draft Hood Regulator Limit Setti g Filters Size Number ~ Fan Setting Chimney Location Inside Outside Pilot Type Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilot Timing , 1_' UT Draft Test Tag L.W. Cut Off Door Pressure ~Lighting Inst. Pressure 5 ' > Percent COZ - Date Tested r ^ ` l Input CFH ' Percent OZ Company Tes+ino Stack Temp. ?72 t~ U~' Percent CO N2 K'l'~ Name of Tester `~"`I ('J 1-Form 235 , CITY OF EAGAN '3830 Pilot Knob Road, P.O. Box 21-199, Eagan, NFN 55121 PHON E: 454-8100 - BUILDING PERMIT Receipt# To be used for Est. Value Date ,19 5ite Address OFFICE USE ONLY On Site Sewage Occupancy Lot ,_Block Sec/Sub. MWCC System Zoning ' Parcel No. On Site Well (Actual) Const cc Name : I(;iti City Water (Allowable) W PRV Required # of Stories z Address Booster Pump Length ~ City Phone " -'alj Depth , p Name S.F. Total o 1- 0 Address Footprint S.F. a ~ City Phone APPROVALS FEES ~ ac Engr./Assess. Permit W y~Name IY . ~ Planner Surcharge _ g Address Council Plan Review Q W City Phone Bldg. Off. SAC, City 1 heseby acknowledge Shat 1 fiave read this appVication and state that the VasSance SAC, MWCC information is correct and agree to comply with all applicable State o( Water Conn. Minnesota Statufes and City of Eagan Ordinances. Water Meter 5ignature of Permittee Road Unit A Building Permit is issued to: Treatment P1 on the express condition that all work shall be done in accordance with all applicable State of Minnesata Statutes and C+ty of Eagan Ord+nances. Parks Building Official TOTAL ` ' Permit No. Permit Holder Date Telephons # Plumbing H.V.A.C. Electric Al'~" 7 -1" Softener ` Inspection Date insp. Comments Footings I ~-2 3 g& ~ S= Footings II Foundation Framing Roofing Rough Pibg. ~ Z 4eg Rough Ht9• Jsul. Fireplace Final Htg. Final Plbg. y~ Bfdg. Finat ~ jj fe~ a- %o `o Cert.Occ. Temp, LP • Deck Ftg. DeCk Final Well Pr. Disp. (gertif iraft o# Orrupanry titp of (Cagan 181,ptrhitpnt of %Datg jwPrtinn This Certifrcate issued pursuanr to the requimments ojSecrion 306 ojthe Unifornr Building Cale certifyrng rhat ar the time of issuance this structure was in rnmpliance wuh the various ordinances of the City regulaling buildtng construcuon or use. For the following.• Use G7seifiafion SF L"~J('i GELR BWg. Rrmit No. 15012 p-pancy 7Ya R3/M 1 zoaiog piym RI Tya Cow, ~~l Ownef of BugdhV MAItK JM50N 0R3SIRUrTIQ"',, 4149 SLRAi+iBEFYi IA'vT•., ElC',A.",? Buftng A4d= 6&'4 SIt7NS10CA HC1AD Localiry L2, B 1, WIN7BE 51}1 q7ZMeM 15. l8M aLu,ainB afacw - POST IN A CONSPICUOUS PLACE - . . . PERMIT # MECHANIEAt PERMIT RECEIPT # CITY OF EAGAN, . r 3830 PILOT KNOB ROAD, eAGAN, MN 55122 DATE: CONTRACT PRICE J v(~ S! PHONE: 454-8100 ^31t8 Addness V f BLDG. TYPE WORK DESCRIPTION Lot - Block ~ Sec/Sub Res. New, Name AIR COND. Mult Add-on S Comm. Repair Address - ~ ib':!'F,AVE. • ~ ciry ottier - ( FEES ~ Name RES. HVAC 0-100 M BTU - $24.00 c Address ADDITIONAL 50 M BTU - 6.00 p City ' Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - t PER PEkMIn - 1.50 EA. TYPE OF WORK COMM/IND FEE - 146 OF CONTRACT FEE Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE 8 CONdOS - RES. RATE APPUES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8 Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 Vent. CFM (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # BEYOND $1,000) Other FEE: S/C: SIGNATURE OF PERMITTEE TOTAL• FOR: CITY OF EAGAN , PERMIT # PLUMBING PERMIT RECEIPT # ~ CITY OF EACiAN 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: CONTRACT PRICE PHONE: 454-8100 Site AdSlfess BLDG. TYPE WORK DESCRIPTION Lot BI ck ~ Sec/Sub X x Res. New ~ Name y' Mutt Add-an 1521 4tti LIV UE Address Comm. Repair ~ Ciry Blaine Phone 7B6~~ 7 Other FIXTURES ~OTA~ Name r o on t1s • Water Closet -$3.00 ~ ~ ~ c Address Bath Tubs - $3.00 p City g~ Phone Lavatory -$3.00 • U U Shower - $3.00 ' ZKitchen Sink - $3.00 ' 00 FEES Urinal/Bidet - $3.00 COMM/IND FEE - 1% OF CONTRACT FEE L.aundry Tray -$3.00 • U G MINIMUM - RESIDENTIAL FEE -$10•00 Floor Drains -$1.50 • S U MINIMUM - COMM/IND FEE - 20.00 Water Heater - a1•50 STATE SURCHARGE PER PERMIT - •50 Whirlpool -$3.00 (ADD $50 S/C IF PERMIT PRICE GOES Gas Piping Outlets -$1.50 BEYOND $1,OOO.00) Softener - $5.00 Well - $10.00 1 Private Disp. - $10.00 L,,t~.~ s =Rough Openings - $1.50 SIGNATURE OF PERMITTEE FEE: STATE S/C: ' 9'0 FOR CITY OF EAGAN CaRAND TOTAL• vq• S 0 , r . _ . . . . r'rr~+issr- . CASH RECEIPT . . CITY OF EAGAN ~ • 3830 PILOT KNOB ROAD ' EAGAN, MINNESOTA 55122 DATE 19 rkaivEU FfiO\I ~'t' L,I . ` - • ~ l 5 AMOUNT & DOLLARS ,oo ' p CASH ~ CHECK .j- / FUND OBJECT ~ AMOUNT ~ cl J ; < < ~ C_-~ Thank You ~ 8Y White--Payers CoPr Yelbw-Pa9tln9 CoPY " Pink-File Copy CASH RECEIPT ~ CITY QF EAUGAN ' 3830 PILOT KNOB ROAD • EAGAN, MINNESOTA 55122 - ~ • DATE d~ ?1 v 19 .J , ~~-,~~Ll f ~fi? L~l`~i~L~ AMOUNT ' $ J C7i 8 DOLLARS ~ ia O CASH xCHECK ~ FOR /4;<, -z' , . FUND OBJECT AMOUNT Thank You BY 1Nhile-PaYers CoPY Yelbw-Postln9 CpPY t' Pink--Flle CoPY CITY OF EAGAN f ~ 0 12 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454•8100 Receipt # 7 ? 3 D 'U-' To be used for SF ~~V% Est. Value 11J1 ,DW Date FAY 12 ,19_db 5ite Address od,!' STOtiEVOC D OFFICE USE ONLY y k-3 ;1--1 Lot Block 1 Sec/5ub. wZNpTitEE 5";:i On Site Sewage Occupancy MWCC System ~ Zoning R`1 ParCel No, On Site Well (Actual) Const V"N ~ Name ?'!Ai~K JOf~~iSOti Gpf!$TRIiCTIU~i Ciry Water X (Allowable) v~" z Address 4144 3?'?tAlq$F,R)~'kY LN PRV Required # of scories o ~ Booster Pump Length ~ 9 City EA +r1;V Phone ~ Sj.--t~623 38 ~ Depth , o Name 5An S.F. Total ~ Q Address Footprint S.F. ~M- City Phone APPROVALS FEES Engr./Assess. Permit 474•00 U¢ W W Name ~ ~ ~ 5Q _ ~ Address Planner Surcharge uZ City Phone Council PlanReview 337•00 4 W Bldg. Off. SAC, City 100•00 I hereby acknowledge that I have read this appiication and state that the Variance SAC, MWCC 550•00 information is correct and agree to comply with all applicable State of WaterConn. 550•00 Minnesota Statutes and City of Eag4n OrdinIa~nces. Water Meter 67, ~ Signature of Permittee %*~/1~~~ ~ r~ -a'?~"~, Road Unit IL75.OQ A Building Permit is issued ta CQhl:iT Treatment P1 2"•oo on the express condition that aliwork shall be done in accordancewith all applicable State of Minnesota Statutes and City of Eagan Ordinances. Parks TOTAL 72.50 Building Official INSPECTI4N RECORD ~-CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: i~~'• r;' Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 , . SITE AQDRESS: OCY APPLICANT: ; iriu1) 4t1) I f'-. PERNIIT SUBTYPE: TYPE OF WORK: INSPECTION D, ON TYPE D. I'F111 F Nt:1:M.1. l Pf uEf I REII t iak ANY P! HMItlNi, i.1(1F+h: ir~Ir, t I r r 1 1,1~ l.! I,M I r :'firl tr!'.r'f-r' t tWn1_ ~ L 3 aa Permit Holder Date Telephone 11 PLUMBING HVAC Inspection Dete Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC I METER I IRRIGATION METER FLUSH MAINS coNOUCTiviTv TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL RESIDENTIAL ~ BUILDING PERMIT APPLICATION ` CITY OF EAGAN 3830 PILOT KNOB RD - 55122 ~ ~ y3 651-681•4675 NewConstruclionReauirements RemodellReoairReauirements ~ o , 3~ • 3 registered site surveys showing sq. ft of bt sq, fl. of house; an~ll roofed areas • 2 copies of plan (20% maximum lot coverage albwed) • i set of Energy CalculaGons for heated additlons • 2 wpies of plan showing beam & window sizes; poured tound design, etc.) . i site survey (ar extenor addilians 8 decks . 1 set ot Energy Calculations . Indicate il home served hy septic syslem for additions • 3 copies of 7ree PreservaGon Pian if bt pletted after 711I93 . Rim Joist Detail Options seleclion sheet (bldgs with 3 or less units) 47 DATE VALU,QION JOB SITE ADDRESS 6TPZ>QC" IF MULTI-FAMILY BUIL\DING, HOW MANY UNITS?,\ PROPERTY OWNER TYPE OF WORK FtREPtACE(S) 0_ i_ 2 APPLICANT ~ ~-'~'~C~ ~ `PHONE#_ ~Z - b~' ~!AOC7 ADDRESS ZIPCODE PAGER # CELL PHONE FAX 45 1 NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY Energy Code Category _ MINNESOTA RULES 7670 CA'TEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing Contractor: V~cj '*L Phone Plumbing System Icicludcs: 'Watcr SoFtener _ I.aovn Spdnkler P'ce: $90.00 Water Heater No. of R.I. Baths No. of Saths Mechanica! CantraCfor: v~Y7p_ utg- _ Phone # Mechanical Systetn Includes: .1ir Conditioning P'ee: $70.00 _ I-Icaf Recovery Systcm = ~l~ Sewer/Water Contractor: N o~r L Phone # 'I, All above information must be su6mitted prior to processing of application. ~ „ I hereby acknowledge that I have read this application, stote that t rmati correct, and agree to comply with all applicable State of Minnesota Statutes and City of E r' e. Signature of Applicant Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required ~ Updated 1lOt OFFICE USE ONLY . ~ ? 01 Foundation CJ 07 05-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBldg ? 02 SF Dwelling O OS 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 E#. 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 'A 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (81dg)• ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement "Demolition (Entire Bidg only) - Give PCA handout to applicant Valuation 6) l~L7 Occupancy 23- /1- MC/ES System Census Code U~~ Zoning ~ City Water SAC Units (21_ Stories Booster Pump Nbr. of Units Sq. Ft. oq_" PRV Nbr. af Bldgs Length Fire Sprinklered Type of Const v K) Width REQUIRED INSPECTIONS _ Footings(new bldg) FinaUC.O. Footings (deck) FinaUNo C.O. Footings (addition) ~ Plumbing Foundarion HVAC Drain Tile Roof Ice & Water Final Other x Fiaming _ Pool _ Ftgs _ Air/Gas Tests _ Final ~ Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone _ Insulation _ Windows (newhaplacement) Approved By 'T 7- , Building Inspector Base Fee Surcharge Plan Review ~ nv v~ MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total This requesl void~ (~y-cjj y 18 months trom E 29371 rv 6i t4-'JtE~ a~- Nequest Date ~ Fire No. FouPh-inInsVer,tion Z/~ ~yyf/ Rep Ted? ?Neady NowlJ~ll Notity.lnspec- - ~ V4 es ?Na 'or When Reedy Licensed Elec[rical ConVaclor 1 hereby repuest inspection of above Ownp, eleclrical work ifretalleC et: Sveet AAdress, Bax or Rout ~ Cily ~{G V W ection o. Township Name or No. flange No. County Occup- IPpINT) Phone No. Power u0olier Address Elechic I ont actor ICO y Nam 1 Contrar.lor's License No. ~ .f/ ilinq Ad s IConVactor or Owner Makine ostailationl S /A Z- Authorized 5nalur IConhact dOwner aking Installatio Phone Number MINNESOTA STATE BOAPO OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT GriB9s•Midway Blda. - Aoom N•191 BE ACCEPTED BY THE STqTE eOAHD 1821 Univerxitv Ave.. St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS we1.nvnn ENCLOSEU. REQUEST FOR ELECTRICAL INSPECTION es-oaooi-os 1 1 See instmctions lor comDleting this lorm on back oi yellow copy. WWRV S'~ c1 "X'' Below Work Covered by This Request E ~ 2937.1 - ~ Vv# FAQ Nep. Type ot BuilAing AooIi.nces Wired Epuiumant Wiretl Home Range Temporary Service Duplex Water Heater Lightin,y FixtureF Apt. Buiiding Dryer Electric Heatm Commercial Bldy. furruace Silo Unloader Industrial Bldg. Air Conditioner Buik Milk Tank F3rm ther pec:i y Oiher(5ner.ity) t ,r Suecify ther Othi.r ompute Inspectron fee Below p Fee ServiceEntranceSiza tt Fee Fexdars/5ubleetlerx N Fee Circuits 0 to 200 qm s 0 to 30 qm s 0 to 30 Am. s A6ove 200 qmps 31 to 700 Amps O 31 to 100 qm • Swimming Pool Above 100_Amps Ahove 700_Amps Transiormers Irrigation &ooms Partial." ee lhps Signs Specialinspection T p E Nertwrks e-al , V Nouah-in ~ e I,t Elechica . Inspe , reby ertify thei the abova Final ' ~ ~r ~j inspection has Ceen 41 1 ~ /O meda. b repuast rdE 18 monthe irom This request void 18 months fwm . E 57-66 / u) ~tD_k_ 6 Request Oate Fire No. Rouph,in Insuer,tion Ile] . ~j/~~f~ H retl+ ~fleatlY N W II Notily Inspec- ~ G/ Q~r Yes ? No ow r When Feady MLice.sed Elecvical Contncmr I hereby request inspection ol above L~0wne, elaclricel work installed ac SIr¢et Address, Box or F C 11 Kl ecu o. Towns ' or No. Nanpe No. Coum OccuG' PRINT) Phone No. Po er SuODIier ' Address Electrical Con c r ICompany N e) Comractor's License No. r l 3s-l Maili e.4ddress ontractororOwnerMakinelnstailationl 3 Authorized Ngnature ICmhactor Owner Making Installation Phnne Number 11IL21k 6-;, )acca--- MINNESOTq S7ATE BOAPO OF ELECTpICITY THIS INSPECTION HEQUEST WILL NOT Gri89s-Midwey Bldg. - Noom N-191 gE ACCEPTED 9Y TME STqTE BOARO 1821 Univarsitv Ave.. St, Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS PAnnnIfil2Ifi620A00 ENCLOSED. ~ LDG. PERMIT NqO. ~ (C1~ tKr , 01-3210 I g. Permi 01-3422 Plan Check 01-3445 Surch./Adm. 01-3446 SAC/Adm, ~ Q 01-2155 Surcharge ~ 753860 Road Unit a ~ 10-2275 SAC 20-3865 Water Conn. 20-3868 WaterTrmt. 00 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. 28-3855 Park Ded. TOTAL ~ ~ a / CITY OF EAGAN N~ 15O 1 2 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ' 03pryZ BUILDING PERMIT PHONE: 454•8100 Receipt # d 7/ Tobeusedfor SF DWG/GAR Est.Value $131,000 Date MAY 12 ,7988 Site Address 684 STONEWOOD RD OFFICE U5E ONLY On Site Sewage Occupancy R-3 M-1 Lot 2 Block 1 Sec/Sub. WINDTREE STH MWCC System X Zoning R-1 ParCelNo. OnSi[eWell (ACtuaqConst V-N m Name MARK JOHNSON CONSTRUCTION Ciry water X (Allowable) V-N W PRV Required # of Stories ~ Address 4149 STRAW&ERRY LN - ° City EAGAN Phone 454-0623 BoosterPumo - Lengtn 54' oepth 3$' 8 Name SAME S.F.7ota1 . DQ AddreSS FootprintS.F. U ~ City Phone pPPROVALS FEE5 W w Engr./assess. Permit 674.00 Name 65.50 Planner Surchar9e x- Address aw City Phone Council PlanReview 337.00 BIdg.Off. SAC,City 100.00 I hereby eCknowletlge that I have read this appliCation and s[ate that Ihe VatianCe SAC, MWCC 55O. Q0 information is correct and agree to comply with all applicable State ot Water Conn. _5-50. Q Minnesota Statufes and Ciry of ag@n Ordi ancep s. b7. OQ Water Meter Signature of Permittee C, ~ iJbVw~ Road Unit _19$..,jJQ A Building Permit is issued to: MAxn?JOHNSON CONST Treatment Pt 204.00 on [he ezpress condition that all work shall be done in accordance with all applicable State ol Minnesota Stahtes and City of Eagan Ordinances. Parks Building OHicial 1 II f~,,~~•Hk1,i R-S'fL TOTAL 2,$72•50 SEDGWICK HEATING & AIR CONDITIONING CO. resTaecoRO JOBNO.~ 8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 c ~ a ADDRESS CITV -f XIA3 OCCUPANT n OWNFii "~j~a'4~ t,--- SOLDBY INS7ALLED BY MAKE I-e- Pi i-4 1]~- MODEL r,,`f ,(2U&v36".509!(2 SERIAL NO. a ? C~ S v'J ~7,7 INPUT 6 THERMOSTAT VENT SIZE VALVE~ja.~aCF NPEOFLINER~ LIMIT.~~ ~dd---~- LINERSIZE LIMITSETTING~ FILTERS: SIZE NUMBER ~ ! n FAN SETTING ~f;.t"CCi WIRING PILOTTYPE 7ESTTAG IGNITION MODEL `^'1'~~' r LIGHTING INST. PILOTTIMING DATE TESTED 1~~~ I r 1 PRESSUFiE T PERCENT COz (L~ c ~ INPUTCFH 4 ~1-~_ PERCENTOZ COMPANYTESTING J STACKTEMP. PERCENT CO NAME OF TESTER7-7~_t ~ . FOHM2%(PEV.11/89) FORMOIST qBUT10N: WHITECOPY - JOBFILE YELLOWCAW-CITY v 7 -7/ 2007 RESIDENTIAL PLUMBING PeRmir,aPPUCaTiorv CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 n ~ IUl ~~Qb Please complete for modifications to existing residential dwellings. Date Site Street Address Unit # PropertyOwner Telephone# ( lpsy ~D~ ~-~'1~~ Wv~eS ?uN4j,V`FA (k1.Y-!~ `~Ay- SQYviC.Q Telephone# ((46~ ) ~-Z~"~ll Contractor Address --)S n nJC1lJ)~ ky-1- City 5{`G~'a State(Y+'\ ZiP5s The Applicant is: _ Owner ~ Contractor _Other fee Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license i Includ $ 100.00 Per as-built $ 10.00 Fire Repair (replace burned out fixtures, etc.) $ 90.00 Alterations to existing dwelling $ 50.00 . Add plumbing fixtures. This fee includes installation of a water softener and/or water heater at the same time. 1f you are insia!ling onlv a water sofiener and/or water heater, do not .complete this section; move to the next section and check the appliance(s) you are installing. _Septic System Abandonment Water Turnaround (add $136.00 if a 5!8" meter is required) Other: Water Softener ~ Water Heater $ 15.00 new _ replacement Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State EEE $ 50 $ ~ 5.5a Total I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I i understand this is not a permit, but only an application for a permit, work is not to start witho et~a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and app o , tDr\6-e_. ApplicanPs Printed Name ApplicanYs Signature ~ ~ ~)7,-•: ~ ~•:t,'rl~, .~p TTi .r , ...IJ}..,..1 • ~ .._i..~~ ,n_+ .i._.. ..i. , ..t' _ . . . , . . ~t .i.~`; , . . . . . . URVEYOR'S CERTIFICATE MARK JOHNSON %A/inir~-,-r)r-,_ e~ -rI _i A r)r~1'r i'N r~I vv iiv~ I 1~1=1 _ r i i i i-, i I iI ~ . 1 0 `~.69.21 S 860 25' 12° ~ W. - - g6.87 582 40 o o ~ . o LOT 2 i ,1 l 5'~' s^ DMENf PER FL'47v 5 I l ~J < FJ~ 03 \T\/ \ 91 / W \ tr..f \ p\ .2~.69 " ZK 4~ v \ ~~8.\~ • u~ 'O ~ T q-- k90e.1i y4 0 m x = m /OS DUSE W O1~ N ~ / V I A m RpP E~ w ~ w Z , Y ~1 w 1.0 o~q.33 0, ex ~ i .T m \ : - <n m ul .Z RPGE O ~ U u i m 'p' 2g9 ° N s ~lfl ~ vlg~4T1 5 y~ y GiP 6 4~• ° 7J V I W ~a 0, 9 123x ~ ~C9N.s7 70 07~ 1A 1, ' 9u.o Coc~~~~t b7~ p0 s26'f•~3~`~ ~13 • g125 . / s10 r ROAD - w / 0 O 1: , ..q a y:-.. . • N~~~• , j ~ ( a 'tti~~ ' 1.?~ JI'.9`-0 / E CJ~C ~ 1; ~ ,a DENOTESPROPOSEDSURFACEDRAINACaE O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FE • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 916.0 FE X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR -908.3 FE (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK -916.4 FE WE HEREBY CERTIFY TO MARK JOHNSON THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 2. Block 1, WINDTREE 5TH ADDITION, according to the recorded plat thereof, Dakota County, MinnesoTa. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME "vR UNDER tvlY DIRECT SUPERVISION THIS 4Thi DAY OF (+AAY , 1986. SIGNED: J ILL, INC. n ~ i BY: Zaq44,e C. 1-- HAROLD C. PETERSON, LAND SURVEYOR MINNESOTA LICENSE NUMBER 12294 m ~ m~ T~~ N o ~ o n m James R. Hil I, inc. O m W~ ~ O ~ i o o n a 6 0 0~" ; Z~ m~~ PLANNERS / ENGINEERS / SURVEYC T ~ otOm dD - Z 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884 a ~ 0 ~ - ~ URVEYOR'S CERTIFICATE MARK JOHNSON vviivL. r i 1 ' ~ W~ 69.21 S 860 25 12" S82°40'30 W`, . - m . X o ~ ~ LO.i- ~"~gEMNAGC EN7 PER P4A7v f\: `p~J\~a 5 o < ~ 9 ~ A „ 'O \ ~ m o . Z ~ . N 19og11 5-0p m P. (g 0N X x ouSE W ~ \V ~ a , A m ~n z 2, ~ ro ROPO`'E~ / m c~ z G ~ lJ ~0 m 1~70 0~4.33 0 k R~Eo y`~'.A 0 m ygT ~ ° u i ~ , 0 5 o pls%y ;T1 \ ~ I ~4p' °a /(9l/.3) w Vrl~~' o psl'f ~cKV'6~i3,m1' ,_8p.00 b R *26 . ROAD - w O r i / NE`NC)C. 0 S~ ~ DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FE ! DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 916.0 FE X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR -908.3 FE (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK -916.4 FE WE HEREBY CERTIFY TO MARK JOHNSON THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 2, Block 1, WINDTREE 5TH ADDITION, according to the recorded plat ihereof, Dakota County, Minnesota. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 4TFI DAY OF MAY , 1989. SIGNED: J ' ILL, INC. BY. .~,.4 lQ HAROLD C. PETERSON, LAND SURVEYOR MINNESOTA LICENSE NUMBER 12294 m„T~oNo mcn m o James R. Hill, inc. < , o ~ D ~ 0 o 6 ~ 0 ao 0 ~ 0 ~ 0 n o ~ m W PLANNERS / ENGINEERS / SURVEYO „ o~m o{ - z 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884- a 0 p ~ 1988 BUILDING PERM.IT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS 01 INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDHESSES FOR COHNER LOTS - COt3TRACTOAJHOME0WI3ER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. M[JLTIPLE DWELLINGS RENTAL ONITS FOR SALE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTZFICATE OF SURVEY - CHECK WITA BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS CONA7ERCI9L INCLUDE 2 SETS OF ARCHITECTURAL & STR[tCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET, OF ENERGY CALCULATIONS To Be Used For: 5e Fr.,,, p,.a Valuation: 41 4e$700,MA Date: ,5h(Vir Site Address 68y 4Pwocv( I-4 rj aou~ OFFICE USE ONLY Lot ~ B1ock / On site sewage_ Occupancy MWCC system / Zoning R- Parcel/Sub Wo,Q,(, S R6+d. On site well Actual Conat V-M City water ? Allowable V~-l- Owner PRV required IP of stories Hooster Pump _ Length - o Address Depth 38 -3° S.E. Total City/Zip Code Footprint S.F. Yhone APPROVALS FEES Contractor /Y?alk J4i.4ov.. ('r,r.s4, Engr/Assess Permit Planner Surcharge 65.SC7 Address H)yq S4ra,wseer~ jwn2 Council Plan Review 33r7,0v Bldg. Off. ~S~lo SAC, City O/ D,Dp City/Zip Code a,yt„ S5/a3 Variance SAC, MWCC 5.50,0 Water Conn 550,00 Phone Water Meter 6 00 Road Unit 325400 Areh. /Engr. ~o,,,~ ~ns/~Qd(.f Treatment Pl 04 ,OJ Parks Address Copies { TOT6L ~ U City/Zip Code i Phone If VALuAT1oN , 6ARAGC- ZZxZZ= 4gyX 14'= (pr?r)(v BAs,FMC,,vr ly X 30 = Ll ZO l8 X Z6= yG e z2Xl6= 3SZ i IZyO X/3. ?612o ~~mT = 12yu 1 X ~ = S Z7c~o lr~ ~_.----12sa Ktiq= G/6y2- ZN~ ~luu~ 3z x zc, = sr32 z2 I 931 x yq_ ys~i9 13ois~ SURVEYOR'S CERTIFICATE MARK JOHNSON _ ~ tAnniri; ra~-r ; i_i nr~r~1 -r ii vviivL. ' i~1=1_ 1 ~ ~ . 69.21 S 86e 25 121' W . - - . , , 6.87 S82 ,40,3d1W', , 0 0 LOT 2--~a N`. I a un p~ v g ~c\J\\J ` g'~ ORSEMENr PER r I L: J C fa ~ C~ ~ I w 2~.69 ~ ~ 180g.11 Q x I ~ O _ tk 9p9.11 y4.0 Z ~i~ p /OSEp OUSs w~ m ai ~ PR P / OD a ~5.T~ Ff ~ ~~%I m /-R,5'NO ~y y`~r O \ m 2261 . o~ ~y t1 x o. " c-~oyl9~bx^~ 5 w F •\2~.• ~Q w, I m ~ ~ 8i,wtin .h J I WU 5~ .a.''r !~ti „ ' o- 14 91o 6~ ~~3 ~q~3•6 ~ ._8~~~ b Ft e2 / s\5- ROAD - - _ / oN~~?°°f Ro ED ~`j~ By . Dat S'-~ DENOTES PROPOSED SURFACE DRAINAGE EAGAN EIVGIIVEERING DEPT O DENOTES IRON MONUMENT SEf SCALE: 1 INCH - 30 FEET • DENOTES IRON MONUMENT FOUND PfiOPOSED GARAGE FLOOR - 916.0 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR -908.3 FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK -916.4 FEEf WE HEREBY CERTIFY TO MARK JOHNSON THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 2, Block I. WINDTREE 5TH ADOITION, according to ihe recorded plat ihereof, Dakota County. Minnesota. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 4TH DAY OF MAY , 7988. SIGNED: J ~ ILL, INC. BY. ' HAROLD C. PETERSON, LAND SURVEYOR MINNESOTA LICENSE NUMBER 12294 cn m~ W James R. Hi inc. ~ OmWm070 c ~°o> , ° Z U 0 v 0 Z PLANNERS / ENGINEERS / SURVEYORS ~ ~OOZW~ ai~ O{ _ O(p m Z 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 o 612•884-3029 a ~ 0 b f . ~ ` ` - . F.XTL':t]OR ET.V[LOPE AvLRnGt. "U' COrtii>UT1,7•IOu Oi9NLit . : ~9------------------------ SITE ADDt2E5S LOT Z_.6~a~ 1 ~~~p~~THA~~ ~ CONTIiA(;TUR ~ DATG ~ _ _ ?liONE Detecmine vorl:ing square footage oC cach_ 1. 7bta1 exposed v~l~ area ._~~8~~ 5q. ft~ x .71 , = L_.~~__~ 2. Total roof/ceilinc area sc. ft_ z_02G - C -3.~ a~-J To[al floor/c~n:_ acea su. f:. x.OS - L__'07__~ •rotzl E~:~ose: ~all :::ea ;:bo~._ ,~loor = ----~,~Y$_~~--- z- 3ota1 v~ll t~in@o_ area b. io:a? Doo_ a:ez . . . . . . . . . _-_1D~G~ c. ?otz? s?ici~c yta:s coor a:•.a. • - • • ' ---'~e-~~----- Total :i:e~?~~e _•all a:ez . . . . . . - ----"yQD~----- e. iota? ti•al] frer.:nc area (a~~e:a,e 1C:) f. ?otal net t~?1 2:E2 a~o•:, :io~: ---13~~ 3ota1 ria jaist a:ez . . . . . _ . . . . _.-1i~2Q1i.~$~-- . . . . . ----.~,~..y~---- iOL2~ r?;705E,^~. iOL•q:]ci1071 ..:E2 = ~ h. To[al icur.ca:ioa vin2oL• e:ee i. 1'otel nec :o~~oeticn are~ ahove crzce , r Uetermine 'U' Yalue o: cach vall srcnent. b. --..LO~G~_~_ x --_Zr~1 ,_~.Qa~._ d- - ~ ~ .--_-ta'g.y~---- x ~ ~11~_ ~ ' f- __,t3yi'~' X "U« '___.ay' a ___1~y^7 _ . -~1i~Q~ca31 x ~ U ~ . • ~ ° ~~L9.Y~-- h . ---Ls3~~___ x ' ~ ~ ---~y ° -.T ~1 i - z • - z - _ • suaror~?c = ~a~~ y5 4~ TOTAL s • L~G41Sd=V . ' ' If item =q is thc same as, or less ihan iLeo {l, you have oet the in:en[ of SIiC 6006 ~c) 2_ , • ~ ~L ToCal Gxposed Fiooi/Ceilinq Area 7'otal s4:ylighc area - • - • • • • - . k• 7'otal flat roof/ceiliny framing area 1• 1'otal net inslted flat roof/ceiling area M. Total vault roof/ceiling framinq area-10% n. Total net inslted vault roof/ceiling area - Determine "U" value foc each roof/ceiling segmeni. ) _ x "U" k -_~3.$/---- i . ---J1YSC~_ x "U" ---1-~--- - ----~.28_~--- m. x .U., n x «U. ----o~----- _ - , 5' TOTAL If item lr,~5 is the same zs, or less than iten $2, you hzve met the intent of SBC 6006 (c) 1_ 'I'otal E>:posed Floor/Cant. Areas o. 1'ocal floor/cant. framiny area (avrg. 102) ' p. Total net insulated looc/cant. arez Determine "U" value for each floor/canL. secment. 0. _ 4~LU_---- x .lU ,l P - _-~aleC2 x U„ --~8--- 6• TOinL = L_ 38lp__~ If total of ;6 is the same as, or less than 113, you have met the intent of SBC 6006 (c) 3. ALTERIaATE BUILDING ENVELOPE DESIGN To utilize the total envelope system method, the values established by the sum of items t'9, $5 and ;6 shall not be greater than the sum of items P.1, $2.and $3_ - z . 39,Q7 - 3 . __.O a • 5. ,a~.~ ~ 6. _-2M f3 _ Prepared By . . Da te ` ~ - • ~E C, . 7b[a1 Esposed t-la11 Area Abovc Floor a. Total vall vindov area . . . . . ' ' ' , b. Total door area . . . . . . . . . . . . . c. Total s2idinq glass door area . . . . . . - - d.• Total fireplace vall area . . . . . . . . - e. Total vall framing area (avrg. 10g) . . . ~ - • ' f. Total net vall area above floor - - . . . Total rim joist area _ . . . . _ . . . . . Total Exposed founda[ion Area Total Foundation H;indov Acea - Total Nc[ Founda:ion Area Above Graoe ~ ~ CeCermin'e "U" value of each vall segmeni. z . ---o2 Y " "U" •3S~ _ -0 41.~-- b. x -U. - _ - ~ c x . U. ` _ o . x . U. e' x U. - - f- ' -~Dy----= _ ----ez---- ° ~ ~~a,42- ~ ~ ~ • -~Q ~ _ r~. - .u. ~ . ~ . U. SU3T0?nL = . . - „ WO, ' T Total Ezposed Wall Area Abovc Floor , a. Total vall vindov area . . . . . . . . . b. Total door area . . . . . . . . . . . . . C. Total s2iding glass door area . . . . . . d.. ToEal tireplace vall area . . . . . . - . e. Total vall traming area (avrg. 1'0i) f. Total net vall acea above floor g_ Total rim jois[ area . . . . . . . . . . . Total Exposed Foundation Area Total Foundation Kindow Area Total het Foundation Acea Abovc Grade -_1~~~e---- . ~ CeCermine "U" vzluc o: each vall segir.en:. a. S •V• __t.~vaZ__~ ~__~V~LCZ___ b. x •U• c . - ---YlL~ - " ~ U. d. x "U^ e . _ x "U" - . f. x -U" --~Oye l; " g. - x - - h. - x U. _ U. ---j~- - SUBTO?:.L = ' . . - . . _ , ; -TFRU'STUD i(c. F.ir .68 ' T}IRU INS. 4JALL Int. Air N/ S.R. 6 SIDING S.R. ,yS - • '6~ . Stud w/ S.R. E SIDING S.R. G~7 ' Ins. Shtg. • Siding fG7 SHTG. a•a9 " Siding.& 7' • Ext. Air .17 I Ext. Air .17 ' TOtal "R" = /6,93 Total 1/R= foult = Ft-0-39 ' . • ' 1/R TYRU CLG. Int. Air .61 THRI! CLG. Int. Air .61 ME1:9ER S.R. ( •S(o I!lSUL.ATI01•i S.R. ( •.f~ Clg. I•iemb. y&T Ins. Ir.s. ( aS,LY} Still Air - .61 Still Air .61 Total "R" To:al "j(n 1/R o nUa - ~ .lU„ . THRU CONC BLOCK'.Int. Air •-,68 THRU RIH . Int. Air .66 C.B. ( ~.r7S JOIST Ins. /~~J Opt. Ins. 4046 ' A" Wood .1.89 Ext. Air _17. . L Shtg. d7.Of ' ! • Dpt. S.R. , , . . i Siding • ..aQ Opt. Sid. ' _ • Ext. Air • • .17 . , • Total "R" = -d,.%b Opt. Brick . . ~ •1/R • Total "R" o~y-~ 1/R = ItUt' - ..,by THRU STl!n Int. Ai(- .68 TF?RtI ?PlS. ~ Int. Air .6 5/8 F.('. Stud 5/8" F.C. S.R. (Opt.) Shtf. S.R. R N SIPFS (Opt.) Shtg. AO^_'!' SIPf'S Ins. 5/8" S.R. .56 R. .56 . 18" S.R. .56 ~ 8" S.R. .5_6. ~ £,xt Air .17 J' Ext. Air .17 Total Total "F." _ 1/P. _ tiutl ~ THR1J STUn Int. Air .68 THRl! INS. 1dALI. Int. Air .68 w/o S.R. Stud w S.P.. Ins. w/ 5IDI1'G Shte. w/ SI.. ':G $htg. Siding Siding i ; Ext. ir _ .17 Fxt. Air .17 r tzl "R" - otal "R" - 1/f. ~ , f , . , THRIi MrMAER Int. Air :92 '.':HRU I1!S. Irtt. Air .92 AT CA*'T. Carp.-Pad A? CA*!T. Carp.-Pac? 1.0$ Vinyl , Vinyl " Und. ' tlnd. ~ Ply' PlY' 9y Joist Depth. • /~J~ Ins. . acoo. ; . .Y7 P4 1Y• . . Ply. . Ext. Air .17 • F.xt. Air .17 { . Total "R"•=A0/3 . . Total "R" = 3~ 1/R = "U" 1/R= nUn - Q' I . . PERMIT CITY ~F EAGAN 3830 Pi1ot nob Road PERMIT TYPE: B U T L O I N G Eagan, Minnesota 55122-1897 Permit Number: 0 3 2 2 7 2 (612) 681-4675 Date Issued: 0 6/ 2 3/ 9 8 SITE ADDRESS: 684 STONEWOOD RD LOT: 2 BLOCK: 1 WINOTREE 5TH P.I.N.: 10-84474-020-01 DESCRIPTION: EXTEND LAUNDRY ROOM Buildin'g.,Permit Type SF (MISC.) ,6uildtng GSprk Type flLTERA7I0N Censu9 Cade " 434 ALT. RESIDENTIAL i F / / - . i c.: .6J\.... t ~ .`.Y. ~ REMARK~:REveweo BY JOE VOELS SEPRATE PERMIT REQUIRED FOR ANY PLUMBING WORK CALL 445-2840 REGARDING ELECTRICAL PERMIT AND INSPECTION3 FEE SUMMARY: VALUATION $4,000 Base Fee $87.25 Surcharge $2.00 Tatal Fee $89.25 CONTRACTOR: - Applicant - sT. LIC OWNER: DUTCNER REMODELING 16880758 200359911 HENDERSON JOHN 03643 WOODLAND TR 684 S70NEWDOD RD EAGAN MN 55123 EAGAN MN 55123 w(612) 688-0758 (612)681-1781 I hereby acknowledge that I have read this application and state that tfie information 3s cvrraet and agree to comply with all appli:cab7,e State of Mn. Statutes and CiCy of Eagan prdinances. L ~ APPLICANT/PERMITEE SIGNATURE I SLIED V: N Z~~ 8 BUILDING PERMIT APPLICATION (RESIDENTIAL) JX1 CI~'Y OF EAGAN ~ . • 3830 PII.pT KNOB RD - 56122 681-4675 69.15 New Construction Reavirements RemodeVReoair Reauirements J ? 3 registared sde surveys ? 2 copies ot plen ? 2 copies ot ptans (inGude beam & window s¢es; poured fnd. design; etc.) ? 2 sita surveys (ezterior additions & decks) • 1 energy wlalations ? 7 energy ralculations tor heaied additions ? 3 copies of tree preservation plan H bt platted after 7H/93 required: _ Yes No . DATE: CONSTRUCTION COST; ~La:o c ' DESCRIPTION OF WORK: \Ij STREETADDRESS: 9' tS'~rne-wooc9• l~ LOT: ~ BLOCK: SUBD./P.I.D. Name: FkG't SPi1'-~ 0v\- Phane (PFj- PROPERTY Last First owrEx Street Address: (084 S~~ v~onj City Flc-~f.(nn State: Vy~v\, Zip: S S(z, 3 Company: Phone bTg`iO 7 ST CONTRACTOR _ n Sueet Address: 3~o 43 ~ CTUZ~ ~UA,,,L 1 Y License # 7n0 3~q(?~9 x Ciry G Ce c1 State: w~ w Zip: SS 1?i 3 -13 ARCHITECT/ ENGINEER Company: Phone Name: Registration Street Address: City State: Zip: Sewer & water licensed plumber (new construction ony): . Penalty applies when address chang and lot change is requested once permft is issued. I hereby acknowledge that I have read this application and state that the infortnation is conect and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Recsived _ Yes _ No _ Not Required : ~ ~ a,~ OFFICE USE ONLY BUILDING PERMIT TYPE O 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish ? 02 5F Dwelling ? 07 4-plex ? 12 Multi RepaiNRem. ? 17 Swim Pool ? 03 SF Addition 13 08 8-plex 0 13 Garage/Accessory ? 20 Public Facility ? 4 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous 5 5F Misc. ? 10 _-plex ? 15 Deck WORK TYPE ? 31 New 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Gensus Code. ~/3 y Depth Footprint sq. ft. SAC Code di Census Bidg APPROVALS Census Unit Planning Building /:~~-~Engineering Variance Permit Fee Valuation: $ yoz-z W Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W 5urcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: °k 5AC SAC Units CITY USE ONLY LOT 1 RECEIPT t~~~ l p SUBA BL 'r'6 RECEIPT DATE: MECHANIC.:;. °£RM.1T 1999 M£CHANICAL PERMIT (RESIDENTIAL) C[TY OP EkfiAN 3$30 PILOT KNOB RD • E,46Ax MN 551E2 Date:,,2- /`f-c ~ (651) 681-4675 Complete this section onlv if you are installing HVAC in a single family dwelling, townhome or condo under construction and not owner /occupied. e.:VAC: 0-100M E T U $ 30.00 ADDITIONAL 50 M BN 6.00 • Gas outlets (minimum of one required @$3.00 ea.) State Surchazge .50 Total $ , Complete this section anlv if you aze remodeling, adding to, or repairing an existing single family dwelling, townhoroe, or condo. Please indicate if it is a new item, alteration, or repair. )C', New _ Alteration _ Repair _ Other 7 itl Reminder: Ca11681-4675 for inspections. _ Furnace ~ Air conditioning _ Air exchanger _ Other $ 30.00 State Surchazge .50 Minimum Total Due 30.50 SITE ADDRESS: J'4-6 /1.2 e- i.C9 0 6 O C•c OWNER NAME: tlal cS a la PHONE 5 I - V 4 1 1`18~ n II (AREA CQDE) INSTALLER NAcM lv^ PHONE 4: [n II `f',11~/ r (AREA CODE) STREETADDRESS: I d-~~'I CITY: STATE: ~ H ZIP: I RE OF PERMITTEE CITY USE ONLY L _ BL _ RECEIPT SUBD. RECEIPT DATE: APPROVED BY: , INSPECTOR MECHANICAL PERMIT ~ 1999 MECf{ANICAL PERhIIT (C014IMEiiC.AL) CITY QF EAfiAN 3830 PILOT K160S gD E,e?sAx, Mr155122 (651) 681-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: CONTRACT PffiCE: Wnp,K TynE; _*;E"I CCA:ST. JC::ON II1ii:RivR iMFROVEMENT DESCRIPTION OF WORK: FEES: 1% of contract price OR $30.00 minimum fee, whichever is greater. Processed piping - $30.00 CONTRACT PRICE x 1 % ~ PROCESSED PIPING PERMIT FEE STATE SURCHARGE ($.50 per $1,000 of oermit fee due on all permits.) TOTAL Ii a i1LL1lC,SJ: OWNER NAME: PHONE (AREA CODE) TENANT NAME (IMPROVEMENTS ONLI): INSTALLER: ADDRESS: PHONE - (AAEA CODE) CITY: STATE: ZIP: SIGNATURE OF PERMITTEE . . Y " APFLICJATION FOR PERMIT *NM° pAYD1FNP OF FEE AT TIME OF ~ i AYPLICATION DOFS NOT CIX7- ~ •y SPIYSflE APPRGJAi. OF PIIttQT_ ~ • ? SEW ER AND/QR WATER CONNECTION = I~~~ ~T~ _ xcasrauaxxor~s vrna, c~ar ae scmo[,rn ; . • i[R7lIL PIItPIIT HFS B@1 APPROVID. ' . e++~a~++ex~~r<r~~+kke~+ir~f~eiw+~++r~a ~ CItV OF GClgaP9 (PLEASE PRINT i) PRoPmxY AooREss: . . $.`I Pwr) a T•FI;AT, DESCFtIPTION: Lot oc S ivision or Tax Parcel ID IF EXISTING STROCTURE, DATE OF ORIGINAL BUILDING PERMiT ISSUANCE: Nbnt Year PRESENT ZONING/PROPOSID USE: Q .CObIIv]ERCIAL/REPAIL/OFFICE ~ R-1 SZNGLE FAMILY Q INDUSTRIAL ~ R-2 DDPLEX ('iWO L~nits) a,INSTITUTIONAL/GOVaw&-NT q R-3 TOWNHODSE (Three.+;Units) ( Units) M R-4 APARIME[SI'/CODIDOMINIUM ( L~nits) . . 2) NAME: i1 eV.S-'f'On e~5 Y c. c. ADDRESS: 7 d1~ Z4 .ad,,r 04 /1 i?d. CITY, STATE, ZIP: ~?n &r i r, r~/y.// 41 PHONE: G~ L( 0 4 For City Ose 3) NAME: BY.h Pl rume s License: ADDRESS: n Active EStpired CITY, STATE, ZIP: ,s/; Not recorded PHONE: 4-pi7//,/- MASTER LICENSE #.Z Z f ti St Ia n~f itia~ 4) e •4~i~ e,~~~• nAME: ADDRESS: 'qj y ,1 $ Tv aw b~v v v L r,.. r CITY, STATE, ZIP: /kf/; PHONE: 4(t~~- Ez-G 4 5) s ~ ' a • ..i ~e Q CONNECTION 'IC) CITY SEWER ~ CONDIEX."PION TO CITY WATEE2 ~ OTHERR 6> MUF0,111:r~ * THE GOLD COPY OF 7HE PII2NIIT WIIS, BE SENf DIRECPLY TO PUBLIC WORFCS TO FACILITATE METER PICK-fJP. * * PLEASE ALIAW 2W17 NARKING DAYS FOR PROCFSSING. SOMEONE FROM TM CITY WIIS, CONfACT YOU IF 1HE2E x * ARE ANY PROBLF3MS. ~**************~*~**********~+*~*,r************+***+***~******~*«***~**+***,r~+*+~~*,r*****+**+~******y .-FOR CITY USE ONLY , . , PERMIT # ISSOED . z `i Pd w/Bldg. Permit FEES: $ $ J[+- n1 SEWER PERMIT (INCLUDE SURCHARGE) $ WATER PERMIT (INCLDDE SURCHARGE) $ /ii$ WATER METER/COPPERHORN/OLTSIDE READER $ $ WATER TAP (INCLL'DE CORPORATION STOP) $ $ SEWER TAP $ $/~-•C-i) ACCOLNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ 01 $ WAC $ $ sAc $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRLNK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ $ TOTAL S2-3. 9 7 C:'S'~2 71 RECEIPT RECEIPT DOES UTILITY CONNECTION REQLIRE,EXCAVATION IN PUBLIC RIGHT OF WAY? F--j YES IF YES, THEN A"PERMIT FOR WORK SVITHIN PUBLIC Q , ROADWAY" MLST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 684 Stonewood Rd Lot: 2 Block: 1 Addition: Windtree 5th PID:10- 84474 - 020 -01 Use: Description: Sub Type: e - Furnace Work Type: Replace Description: Furnace Comments: Fee Summary: Contractor: Sedgwick Heating & Air 8910 Wentworth Ave S Minneapolis MN 55420 (952) 881 -7739 Quesetions regarding electrical permit 952- 445 -2840 Crystal Gemuenden 8910 Wentworth Ave S ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Permit Type: Permit Number: Date Issued: Permit Category: equirements should be directed to Mark Anderson, State Elec $50.50 Owner: John F Henderson 684 Stonewood Rd Eagan MN 55123 $50.00 0801.4088 $0.50 9001.2195 Issued By: Signature Mechanical EA080688 10/25/2007 ePermit cal Inspector, 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 City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 684 Stonewood Rd Lot: 002 Block: 001 Addition: Windtree 5th PID:10- 84474 - 020 -01 Use: Description: Sub Type: e- Fireplace Work Type: Gas Insert Description: Census Code: 434 - Zoning: Square Feet: 0 Comments: Fee Summary: Valuation: 3,000.00 Contractor: Fireside Hearth & Home 20802 Kensington Blvd Lakeville MN 55044 (952) 985 -6675 Improvements to the home may requ concealing. Total: Applicant/Permitee: Signature PERMIT City of Eaan BL - Base Fee $3K Surcharge - Based on Valuation $3K - Applicant - Construction Type: Occupancy: e smoke detectors in all bedrooms. Chimney / flue must be inspected prior to Carbon monoxide detectors are required by law in ALL single family homes. $90.00 Owner: John F Henderson 684 Stonewood Rd Eagan MN 55123 Permit Type: Permit Number: Date Issued: Permit Category: $88.50 0801.4085 $1.50 9001.2195 Issued By: Signature Building EA088951 04/29/2009 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 , Use BLUE or BLACK ink �---------------- `�,�; � For Office Use �� C• i Permit#: ~�� 7 Cr�� I�i�f�,� �6� �1 �� Permit Fee: ��'� I�� 3830 Pilot Knob Road j -( �I �� Eagan MN 55122 ,°z � Date Reoeived: � Phone:(651)675-5675 {- `' I I Fax:(651)675-5694 I Staff: � I � ��_��__��_.�.��J 2015 RESIDENTIAL BUtLDING PERMIT APPLICATION Date: �, _f�+ _ I� Site Address: G:� i �.�^��i��-.`�%�� ,�� Unit#: Name: C(�'1 �C � //G{,I^ t t �'�'�tf�^� i� Phone:, �� J /;� �J /�� Resident/ • 7 � '° Owner Address I City i Zip_ '"�' " � �'� �� ` �� Applicant is: �,Owner Contractor : ____._ ; / 4� �� - � •, �� '`��. Type of Work pescription of work: � � � -�;� � Construction Cost: `�;'"�(s�T, r� � Multi-Family Buiiding: (Yes /No� Company: ��.�� Contact: Contractor Address: ��Y� State: Zip: Phone: EmaiL `�� z��:S�r��; `�'"��'��'� License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: r .. ,� �(�` ,� �, � x' � '� � .-- �>��.� Y COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUfLDING 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 af master plan: Licensed Plumber: Ph°�� Mechanical Contractor: Phone: Sewer&Water Contractor: �a�� Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents�►at you submit are considered to be poblic information. Portians of the information may be classified as non public if you provide specific reasons Uiat would pernrit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher Stale One Call at{651)454-0002 for protectio�against un�rgra�d utility damage. CaN 48 hours before you intend to dig to receive locates of underground util'dies. www.qopherstateonecall.om 1 hereby acknawledge that this information is complete and accurate;that the work will be in conforrnance with the ordinanc�s and codes of the City of Eagan; that I understand this is not a permit, but o�ly an application for a permit, and worlc is not to start without a perrnit; that the work will be in accordance with the approved plan in the case of work wrhich requir�es a review and approval of plans. Exterior work authorized by a building permit issued in accordance wlth the Mlnnesota State Building Code m�t be completed within 180 days of permit issuance. � ��G/�'�� 4 '� T X `t, ��''�°'�.�F��'V",_��"y',�. X App� nYs Printed Name Ap nYs Signa►ture Page 1 of 3 , �� L��(�� r DO NOT WRITE BELOW THIS LINE �� SUB TYPES _ Foundation _ Fireplace � Porch(3-Season) _ Exterior Alteration(Single Family) � Singfe Family Garage _ Porch(4-Season) _ Exterior Alteration(Mutti) _ Multi � Deek _ Porch(ScreeNGazebotPergola) T Miscellaneous _ 01 of,Wiex _ l.ower I,.evel _ Pool � Accessory Building WORK TYPES _ New � Interior Improvement _ Siding _ Demolish Building� _ Addition _ Move Building � Reroof _ Demolish Interior _ Alteration T Fire Repair T Windows � Demolish Foundation _ Replace ____ Repair _ Egress Window _ Water Damage � Retaining Wall "Demolition of eMire building-give PCA handout to appiicarrt DESCRIPTtON Valuation ��d� Occupancy ��r�� MCES System Plan Review Cade Edition ��5 SAC Units (25% 100%�} Zoning ��_ City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings L.ength Ffre Suppressian Reqwired Type 4f Construction � Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: � Footings(Deck) Final/C.O. Requlred Foatings(Addition) � Final/No C.O.Required Poundation HVAG Gas Service Test Gas l.ine Air Test Roof:,Ice&Water _,Final Pool:_Footings Air/Gas Tests iFinai Framing Drain Tile Fireplace:_Rough In Air Test 4Finai Siding:_Stucco Lath �Stone Lath ,,,��3rick Insulation Windows Sheathing Retaining Wall:_Footings�Backfill_Final Sheetrock Radan Control Fire WaUs Fire Suppression:,Rough In_Final Braced Walls Erosion Cqntrol �- Other: Reviewed By. 1 " , Building Inspector RESIDENTIAL FEES / Base Fee � � �,�.�� I Surcharge ��'Y ��,,�� Ptan Review � MCES SAC ��``� City SAC Utility Connection Charge / � � � n � � C � � V S8�W Permit�Surcharge �� Treatment Plant Copies TOTAL Page 2 of 3 �� / ��~7�C� •,° � � � �` � �� C.� . URYEYOR'� CERTIFICAT� MARK �QHNSON : �` +AI�n� �rti`i r_�r�� i —�E � n r1r1�`�� f�rt! � v v i� v�.. + � � I_I_ r � i�"� �—��. s� I i � � 1 + v < « � .69.21 S�86°25'12"� �., <: 87 S82°44� � M � _._.--- - x � / ., � � 1� % ! � � � !n � �� • r..>> -�"'�)a f�`. ��, � �� I � -. � a O �--'r- ♦C`� I f i`�) �, m �---""' S _ � '� ` �� T„pRAt�EMt pER ��L , � � r� �r� 1�� r �� 4��' `.� y rr`� �,�� r�''` W __� �\ ` �pi.K,S� r�� v u' ;�� ' G�"� 3�� _ � - ,�- - .. -- 1 R� � pa'd't" �'2tg9 _' �� ,` � - --_..__. �� , ��,�a.11 f -^" v �, ,2 x �.� +� � � ; �o � 1 � m '�,s-� ` 9,t y �A,Q °`1' �i u 3c = t%i �,""r' , '��'�'�% / qt1$�- � ap W � -i �/ /� � t��" os A in z -/ �, j 1'�� ;,+ RpgOs�'� j// � � m cs �� j � �� l� �,,�,iv�' �� w � � � �7� p�� fi�4r I '�',p,� �O � �µ �g1�T� � ��- � R� ( �, � '.i �% � � �w � �v �� `1 aAc�+� ---.. o N ' o ��i�' V•i �• � ip � O ,�,►'r� "N �� ,� !' Z�'� o � ��G��y�, "'� �Viy� o -019t"�71 � 5 N �� + ` . � � � ,� � r � 1 I, ��• .'•'�.. Jr,r � �Q �� ttix.►x '�C91!•3�� "C�'� �,►� � ; e. y1 • °�.••` '' � r 1�Z'Y.`L4- s� � � ti �Ar . `��,� , � a��7° a�3 g,�.o �,� .: R 6�. �'��,�i3��° --8a��.� "2 . g,�.� ROAo_ _ . / � , r —��r ° {!� iC�►+�'� � � .� � " .; J" !' � �; V� � � � i •y�..'�� 1•! i.�.. �... �� v1� i..`3/ � �� . ��"��' ..�~j�r'�'��'f' +� — DENOTES PRC3Pl7SED SU RFACE QRAINAG� �;•`i t.�', , � i . , ',i• ;i ' ;;;! ; ' • , Q dENOTES 1RON MONUMENT SET SCAi.E: 1 INCH -�30 F ! DENOTES lR(]N MONUMENT FOUND � PROPOSE� GARAGE FLOOR --916.0 F X000.0 DENOTES� EXISTING �LEVATICIN PRUPOSED �OWEST FLOOR —908.3 F ' � (UQ0.0) DE1rJC?TES PRaPOSED ELEVATION PROPOSED 1'OP �F BLl3CK—916.4 F WE HER�BY CERTIFY TO MARK JOHNSON THAT THIS IS A TFtUE AND CORRECT REPRESENTATil7N O� A SURVEY OF 7HE BOUNDARIES QF: Lot 2 , PJlock t . V1tiNDTRE� 5TH ADDITION� caccarding_ to the recorded plat thereof, Dakota County� Minnesota. IT DO�S NI�T PURPOR7 TO SNOW iMPRQVEMEhJT� C1R ENCROAGHMENTS, EXCEPT AS Sh{OWN. AS � S[1RVEYED SY ME OR UNDER 11r1Y DIRECT SUF'ERVISION 7HIS 4TH C}AY�F MAY , 1988. SIGNED: J�AA�9` . ILL, INC. �-r� BY: .:'� �, ��'�lr�t.�� ,��.�d•�l��— HAROLD C. PEfERSt]i�i, �AND SURVEYQR MiNNESOTA LICEhISE Nt,MMBER 12294 m 'i'1 T � p N O m (J� � 7�0 � � �• �� • � 4rOD � 00 < � p DD � � � C7 � W n � `� -� '' ro � � m � � PLA�JNERS 1 ENGINEERS / SURVEYt �. Q � ot7o � m � � � � �:. _ � 9401 JAM�S AVE. S. + BLQflMINGTON, MN. 55431 • 612-$S� •.',O Ho p Use BLUE or BLACK Ink r----------------� � i For Office Use � ��i� f �� '��. 7 ' t �• i Permit#: � � / �� I �� 16y Ol �� I Permit Fee: �� (J ��s I 3830 Pilot Knob Road . I . I�� Eagan MN 55122 �`� '�'�� Date Received:�� j Fax: (651 j 675-5694 75 NOV 0 9 2015 j Staff: �`"/ i I 2015 RESIDENTIAL BUILDING PERMIT APPLICATION � � /`;, �,��? y� �,(� /��-c Date: �/(�° Site Address: � J � ' ��{'�"` V Unit#. _ .e��,�..�.w,�.� .� .�a..�,. ,�. .._ �... ,.w...�.�,a.a�.�.. � ��.�.�,�d��..�_ �...,,��.,�, �...�.,�.„_��»�, �.�.�,� �,r„�� .P,�...��...._.�.�,,�_ ��-_� � � ....� � � � �� t e.�l�eofi��✓� Sl 3 ��' �1,� � � Name: Phone: Residentl � ��-� � Qyyn�;� � Address/City/Zip: � � � � ; � , . — � � �( � � Applicant is: +/` Owner Contractor ��n._�.� .. .��,� �,.m,�,. �..m_,..�..�...w�,._..�»,�..�,,..�m� ,�,.�� .,�em��..� ��_�� .,,��.�.��.�,..�.� � a Description of work: � �� s Type of Work � , � ; . � s � Construction Cost: �yx� � Multi-Family Building: (Yes /No_) o� _ ,�...P,�,�. ��.�.�,�.� „�,��.,�,�.�.,..� �...r.�.,.�.,��..�....� .�„�� m�.�,�,�..�.�.�...,��.�.�..� • �...�.�_ � �� Company: Contact: � � COn#CaCt01' Address: City: � `'6 State: Zip: Phone: Email: � p 3 f License# Lead Certificate# ,.,�.._,mA�,��,,....��..�.�,.��,. �„�,�u.., ._�,.x,�o.,� �4� �_..._.,,�A.,�,�..�,.�,.��.,..��.,�,�,.k.�� .,,�.,�.».�.,��.,..�,.��..�...a_ ,.�...�� If the project is exempt from lead certification, please explain why: � � �,_ \ �_ �_v _ �� _,�.� . . �_a.w.��e �A��.��.� ��..��.��.��.a..�� ..�.. ��_,� __�..�� .� �a�...��.��.��.�� 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: i $ �� Sewer&Water Contractor: Phone: � � Fire Suppression Contractor: Phone: � � , .w �,_.,��_„�.�,� ,m.� �W..,...._ , �..�.,��r� �. �� ., .__ �e.. u. � �..u,� �w. .��.o.� NO�'E. P/ans and supporting documents that you submit are considered to be public information. Porfions of @ fhe informa#ion may be classified as non-public if you provide specific reason5 that wou/d permit the City to ; conclude that they are frade secr^ets 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.qopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior ork authorized by a building permit issued in accordance with the Minnesota State Building ode must be completed within 180 days o p r it is an e � � '� � /l�,�'1�'\ �, �� 'V�E'�� x x� Appli anYs Printed Name ApplicanYs Signature Page 1 of 3 �� 'A,�`�',�a��d.�r�, N�c, .- , ! .,-, i � ��.. `" a/ � � �`j`�I �,s��,�t�_ �;��,;�� DO NOT WRITE BELOW THIS LINE 1 =>L�,-��`S� ' SUB TYPES ' , _ Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration (Single Family) Single Family Garage Porch (4-Season) Exterior Alteration (Multi) _ Multi _ Deck � Porch (Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building" � Addition _ Move Building _ Reroof _ Demolish Interior Alteration Fire Repair Windows Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION � Valuation $'� '� Occupancy �'�1G 'f MCES System --- Plan Review Code Edition � / SAC Units � (25%_ 100%� Zoning fL -� City Water �' Census Code 3 y Stories / Booster Pump - #of Units 1 Square Feet �.j� PRV - #of Buildings � Length � Fire Suppression Required — Type of Construction � Width �_ REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) � Final /No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test � Roof: _Ice &Water _Final Pool:_Footings _Air/Gas Tests _Final � Framing Drain Tile Fireplace: _Rough In _Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick Insulation Windows Sheathing Retaining Wall: _Footings_ Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Other: Reviewed By: , Building Inspector RESIBEN FAL EES a� f-�aZ-�.�G✓��ky /�p�Cy� �O� a��:�� ase ee /Go2 -�'" v.� rwsr�� 7,��0� Surcharge ��G� Plan Review /p�j � MCES SAC City SAC Utility Connection Charge SS�W Permit& Surcharge Treatment Plant Copies TOTAL Page 2 of 3 � ' � � jf t I . � . � t lC'�I �� f�d1� j�� al- �r1. �:.5��/� . URVEY4R'S CERTtFICATE MARK �OHNSON : � ��l�n ir�`�r_��-�� -►�_� n �1r��-�i ��rti � vv ii v�. + � � 1=I_ r � i i ��L� i� l � i � � , v � o4O��Q«w�� .69.21 S 86°25'12"W �. _._.--- - � ,<,. , �5�g7 S82 � o t �t: , � 1 �j�V '� r..1'^ � / C_� � _``� ��. /\�\ � � P O �-1'" �� /��`j � �+ �`� �TILITY � 5 �� ,•.ORa�MENT pER PGAr .,�� r � J 1�1 / EAS �` \,i � <\f ��''��'-��r�'" � --� � .� -� � �� `T c�.�"�-' ��b�'S� W+'�'� U1 ;��=J/ ' $ po1��'� G;�y`�' �,�.a5k � / ,,.f t (�-�"� ,�.-�— __ � `��;, � . ► 16 9 � ri , t s t `�.�, �u� ,�� e.ti� .zf r ', ZK �V �'� _ s .'� � �• o m . � •tiy �A.� a� �� x yyt1 s � ,-��"'�7S � OUCj�' � W W G � rnl� `'�i o�A �n z ��l v � � *+ R�pns�� v � m � �v� � Z ' ww z �, � �' aa �,Q�� N m 1 tit o p.tia33 �, {� +� �p� � g+�T� ` '� � RX � �/la'� F� '� �� r RAG�Q �-�'�� o � � } °� � �'�7 f � yQ{��fy � �� ' �s�b�� 5 � ,J/ � �+�G+ '�+ � • o Z � � � � , � ' . , '"'�� ! � 1 ��y�� •. , � � �a�z.�x ' ��`11!'3�� '�, � ; ` ,, , ��z��,�.4. �w� �..�. `.� �'r ' �t `�t .. � � ° p� 1�° � 3 9,�.0 �� `�w�.- �� 6-�,T �c�`b�,13,b --ea�o.� R .2 g�� R�AD - , . / w „r ---�`��.� , o O(1� t • � • , � •./ 1: k, � . v.� � �r • . , . � �� ... ._.. . � , . - . , . � � : . , .� . • s_ '.,, 1. ' i: :� ___._�_ ^ ��,a� . ....�" ._ . _ .. �� / /� �. "�s�.. . - ./ � � � _ _. __,. w. _.___._ . I�"��' ..S�"��o�'�� + DENOTES PROPOSEO SU RFACE DRAINAGE ��:i t�:,', ; i i. '!• ;; ;�.,; : ��;? : � � � O DENOTES IRON MONUMENT SET SCALE; 1 INCH— 30 F � DENQTES IRON M�NUMENT FOUND � PROPOSED GARAGE FLOOR --916.0 F XpOQ.O DENOT�S EX{STING ELEVATI�N RR4POSED LOWES7 FLOOR —908.3 F � (U00.0) DENQTES PROPOSEO E�EVATION f'ROPOSED 1'UP QF BLOCK—916.4 F WE HEREBY CERTIFY TO MARK JOHNSON THAT THIS IS A TRUE ANO CORRECT REPRESENTATiON U� A SURVEY OF 'fHE BOUNDARIES OF: Lot 2 , Black } , iNIIVDTR�E 5'TI� ADDITION� accardir�g to the recorded plat ther$of, Rakota County. Minnesota. IT DOES NOT PURPORT TO SHQW iMPROYEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS � SURVEYFD $Y ME OR UNDER MY DIRECT 5UPERVISION THIS 4TH DAY OF MAY , 19BB. SIGNED; JgAAF,,9' . {LL, INC. �i' �� BY: .:�' � �� ,.d�.��s.�aaa.� � HAR�LD C. PETERSaN, L�4ND SURUEYQR MiNNESOTA LICENSE NUMBER 12294 m �1 ,.n Gp p N O m CJ� � .�ao �� • �1 � ��• � f' ir,��,J `mO � � � D QD I « � "' � �` � o `'� m uri z PLAI�JNERS / ENGINEERS / SURVEYt �. o � oo � W � � � o � ,: o c.p m — Z 94U1 JAM�S AVE. S. • SLOUMINGTON, MN. 5543i + 612-88� �.:�s h R PERMIT City of Eagan Permit Type:Building Permit Number:EA164883 Date Issued:10/09/2020 Permit Category:ePermit Site Address: 684 Stonewood Rd Lot:002 Block: 001 Addition: Windtree 5th PID:10-84474-01-020 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 - John F & Mary U Henderson 684 Stonewood Rd Saint Paul MN 55123--132 (651) 398-3150 Walker Roofing Company 2270 Capp Rd St Paul MN 55114 (651) 251-0910 Applicant/Permitee: Signature Issued By: Signature