4610 Stonecliffe DrCity of Eapi
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
JUN D Mt
Use BLUE or BLACK Ink
For Office Use
Permit Fee: e)
Permit #:
Date Received:
Staff:
2010 RESIDENTIALPLUMBING PERMIT(�rAPPLICATION
9
Date: 570i / 1(} Site Address: 1121 1) %Dile 0a.t''C4 b i•
Tenant: Suite #:
RESIDENT / OWNER
Name: 1C T(&v Phone:bS t otos .-611, .5
Address / City / Zip: . &S 0-66),/`42,CONTRACTOR
Name: c'\ f SOU AlthICA.1641 License #: 010 ZD
S. aid I
Address:OS- -Amyl O Vr_.e_ ►? 1,%VC1 City: C 04rd
State: MPJ Zip: 553,c";...Phone: / pia_ �a -Li t p
Contact: 39Lcati Email:
TYPE OF WORK
'?C; New — Replacement _ Repair _ Rebuild Modify Space Work in R.O.W.
_ ,
Description of work: 4 ‘,(AANION(A_OL ---fly" J /, ,) y) iivi�,�° h CIA
PERMIT TYPE
RESIDENTIAL a
Water Heater Water Softener
Lawn Irrigaflon Add Plumbing Fixtures
( RPZ / X PVB) ( Main Lower Level)
Septic System Water Turnaround
New
_
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation
$50.50 Add Plumbing
"Water Turnaround
$100.50 Septic System
$90.50 Fire Repair (replace
(includes $.50 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround" (includes $.50 State Surcharge)
(add $166.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $
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.
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 art 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 pl.
J24 -SU„ G.attw
Applicant's Printed Name
x
Appis Sig... re
FOR OFFICE USE
Reviewed By:
Date;
Required Inspections: Under Ground Rough -In Air Test __Gas Test Final
~ RESIDENTIAL
BUILDING PERMIT APPLICATION ~ 70, 00
CITY OF EAGAN
3830 PIL651 681-46R5 - 55122 ~0.I I~ J rl ~
9 ( (J
lew Constructian Reaulremenis RemodellReoair Renuirements .~n ^
3 registered site surveys showing sq. ft. oi lot, sq. R. of house; and all roofed areas • 2 copies ot plan ~U ~ y ~
(20%maximum lotcoverage allowed) . 1 set of Energy Calculations tor heated additio
2 copies of plan showing heam &windovr sizes; poured tound desgn, etc.) . 1 site survey forexterior additions 8 decks Qn~
1 set of Energy Calculations . I~Micate if homeserved 6y septic sysfem foraddi ~ n
3 copies of Tree Preservation Plan if lot plafled afler 7l1193
Rim Joist Detail Options selectlon sheet (bWgs vnth 3 or less units)
)ATE ~ ~ ~ VALUATION
IOB SITE ADDRES$ ~ ~r
F MULTI-FAMILY BUILDING, HOW MANY
~UN.I,T,S.?f
'ROPERTY OWNER_~t4GU~ ~-~YW L lY ~~I it~i~'TIGf/l~~S
'YPE OF WORK FIREPLACE(S) _0 ~1 _2 3
4PPLICANT 17F~'!
IK1C~S PHONE # lp~ /-3~0-~ ~I.~~
4DDRE5S ~~OfC) S^(OKIEGI_(~E L~1~ ZIPCODE-S~.~~
'AGER # CELL PHONE # FAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Ener9Y Code Category _ MINNESOTA RUI.F.S 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Su6mitted
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor: Phone
Pluinbu~g Syscem Includcs: Watc;r Soflener _ I..a~~~i Sprinklcr Fcc: $90A0
Watcr Healer No. of R.I. I3a~hs
No. of 13alhs
Mechanical Contractor: Phone #
Mechaivcal Systcm Includes: _ ~'1ir Conditionuig ree: $70.00
Hcat Recovery System
Sewer/Water Contractor: Phone #
UI above information must be submitted prior to processing of application.
hereby acknowiedge that I have read this application, state that the infor ti n is c ect, and agree to comply with
711 applicable State of Minnesota Statutes and City of Eagan Ordinanc
~ or~~~o~~~
Signature of Applicant a
~ ~
;ertificates of Survey Received _ Tree Preservation Plan R eive Not ired n
a-~J
ey
r
OFFICE USE ONLY ~
] 01 Foundation ? 07 OS-plex ? 13 16-plex ? 2D Pool ? 30 Accessory Bldg
7 02 SF Dwelling ? 48 O6-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
] 03 01 of _ plex ? O9 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 E#. Alt - SF
7 04 02-plex ? 10 08-plex l~ 18 Deck ? 23 Porch (screened) ? 36 Multi
7 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
7 06 44-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
~ 31 New ? 35 Int Improvement ? 38' Demolish (Interior) ? 44 Siding
] 32 Addition ? 36 Move Bidg. ? 42 Demolish (Foundation) ? 45 Fire Repair
] 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
7 34 Replacement •Demolition (Entire Bldg only) - Give PCA hantlout to applicant
/aluation o70/7/J ~ Occupancy y~, '.3 MC/ES System
:ensus Code ~ Zoning City Water
iAC Units ~L Stories Booster Pump
dbr. of Units _L Sq. Ft. PRV
dbr. of Bldgs ~ , Length Fire Sprinklered
~ype of Const W idth
REQUIRED INSPECTIONS
Footings (new bldg) Final/C.O.
1n Footings (deck) ,J-> FinaUNo C.O.
~ Footings (addition) 7 ~ pl~~g
_ Foundarion HVAC
Drain Tile
Roof _ Ice & Water Final O[her
_ Framing _ Pool _ Ftgs _ Air/Gas Tesu _ Final
_ Fireplace _ R.I. _ Au Test _ Fina] _ Siding Stucco Stone
_ Insulation _ Windows (new/replacement)
Approved By~_, Building Inspector
3ase Fee
iurcharge
'lan Review
AC/ES SAC
;ity SAC
Nater Supply & Storage
i&W Permit & Surcharge
-reatment Plant
~lumbing Permit
~lechanical Permit
.icense Search
:opies ,
~ther
~otal
Addre~ 4610 StnnacliFFe Drive Zip 5512 2
1
IAt 3 Blk 1 Sub Pinetree Pass 2nd Addition
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: Yes No Inspector:
Final grade (6" from siding) ?
Permanent steps (garage)
Permanent steps (main entry) ?
Permanent driveway ~
Petmanent gas
Sod/Seeded grass
TraiUcurb damage
Porch
Basement 5nish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shuboff of water supply ro
the ouuide lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 befote working in rig6tof-way or ins[alling underground sprinkler system. ~
Whice • City Copy Yellow - Resident Copy Pink - Contractot Copy
6128580350
MAR-09-O1 12:29 Fram:IHTELISTAF HEALTHLARE 6128580350 T-672 P 01/O1 Jah-149
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04i19/00 09:43 EPGF7~ ~>NG+COM DEV a 61285B035B N~•~~ P~~l~~l
FAX TRANBMlTTA~L
3$30 PILOT KNOB R47AD
EAGAN, MN~iNESnTA 55122
Clh/ OT BA$AI'1 . -
TO: .FAKM: ~ri12 • .i~• d3.5~'O DATE: ~ `J ~ -
A'Y"C~NTION: LL 4 ~s w.' s« 0 9 'I'A3E: GJ .''"f 7 ~
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2000 BUILDINC PERMIT APPLICATION (RESIDENTIAL)
~~;1 C,~ asaoai~oTiaoa~ss~~z ~b S (~~;3
851-681-4875 ~
c~A~9 a - ~ ~ C~
HeW cor~cnon rteauire~r~s
a a re~smrea sne awer• aiww~n~ ~y. n a wx w. a nou.. s coqe. a aw~
antl ~ roo/ed arew (20% maxlmum tot coveraae Wlowedl 1 18t d enerpy adadaliont for healed adcfMOnf
D Z coWet d P~~s (show 6aam A window ~aa; Doured hW. tleai{~~ etc.) 1 siq wrvay tor e~deda adClMOro d tlaeb
D 1 tef W aneryy cdcWaHani .
D J coWes of hee P~eaena6on WCn H bf pF01POtl aflx 7/1/9J
DATE: .~Z' {S-U U CONSTRUC?ION COST: 0~5~3 O~o~i
DESCRIPTION OP WORK: _ /~-J~
STREET ADDRESS: O ~ F
D
LOr ~ BLOCK: ~ SUBD./P.I.D.
7~1~i7~T2EE f~F~55 a-~-
Name: Phone 8•
PROPERTY Ia~t Fl~at
OWNER
Sheet Addresa:
cih srate: z~:
Comparry: L,t.r .n ~ ~s PhoneM: /a!2 ~7~-/23,/ c~irr~7~f
(orea eode)
CONTRACTOR
Sireai Addresx r t.ND Llcenae t~Q /Si/3 Exp~`~ - o ~
dly ~A~ZATS1 Stafe: Lp: 5S~ G'/~
ARCHIiECT/
ENGINEER Company: Name:
Telephone i: ( )
Sheet Address: ReglslraHon
~Y State• Lp:
c- ~ia(~'sy-ti~~tg
SeweNwater Ilcensed plumber (H I~tallino sewerMraterl: ~~Tj~R ~LLr irl i6 i/J6 Phone u
1 hereby acknowledpe ttw1 I hove read Ihk applkalbn, atafe Mwl ihe Infortnollon is cortect. and apree b comply wiM~ aA appBoable Sia~e
~ Minne~oM Sfalufea and CMy W Eaqon Ordb~ancea.
' Slprwhire of I?PP~ant _ ,~i/~'h 1.( ,~~~o~A-~)J/ '
OFFICE USE ONLY
Certificates of Survey Received ~ Yes _ No ~ ~ 7 ~OC~
Tree Preservation Pian Received _ Yes _ No ~ Not Required
OFFICE USE ONLY
,
BUILDING PERMIT SUBTYPES
D 01 Foundatlon p 07 OSplex p 13 16-piex p 21 Porch (3-sea.) O 31 Ext. Alt - Muld
~ 02 SF Dwelling O 08 08-plex O 17 Garege O 22 Poroh/Addn. (4-sea.) O 33 Ext. AR - SP
~ 03 01 of _ p~x O 09 07-plex O 18 Deck p 23 Porch (screened) O 36 Mutti
O 04 02-plex p 10 0&plex p 19 Lower level p 24 Storm Damage
O 05 ~03-plex O 11 10-plex P~bg Y a_ N 0 25 MisCellaneous
0 O6 04-piex O 12 12-plex p 20 Paol O 30 Accessory Bldg. ~
WORK TYPE
~ 31 New p 36 Move Bldg. O 43 Reroof
O 32 Addition O 37 Demolish {Bidg)• p 44 Siding
0 33 Aiteration p 38 Demolish (Interior) O 45 Fire Repair
O 34 Repair p 42 Demolish (Foundation) O 46 WindowslDoors
" Give PCA handout to applicant for demolition pertnit
GENERAL INFORMATIO n
SAC Code # of Stories o~ sq. ft.
No. of Units Length sq. ft.
No. of Bufldings Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. '7 ~ Census Code / O f
(PJlowab{e} Main level sq. ft. ` MC/ES System
UBC Occupancy ° ~ sq, ft. City Water
Zoning ~sq, ft. ~ Booster Pump
PRV
Fire Sprinkiered
MISCELLANEOUS INSPECTIONS
~ Stucco/Stone ~jl~
APPROVALS
Pianning Building (
' Engineering Variance
Pertnit Fee Valuation: $_-~T7~'O
Surcharge ~ "
Plan Review n G,~
LiCense r'~`: ~tl r ~ lS = ~
MC/ES SAC ~l E" ; r~ y'`~
c~ri sAC /5
D 3 k ~
Water Conn.
A~ ~~g~t m r~,~ 1 7`~~`` ~ ~~~l;~ - 9~/ ~ 3a
S/W Permit ~7 C~/ ~
S/W Surcharge " f ? = / '
Treatment PI. ~ ~ v~~ • .
Park Ded.
r~a~is ~ed. ) j!
ou,er ~-/~'12~r~~ ~ ~ ~ ~ ~ ~ ~O~
Copies ~
Toca?: ~9 r~F`~ 7~6p ~ 2~ ~ 3a = _ ~ _
~
. sAC un~cs
~o sac
. , ~,~M~,~ U
; ; .
~w~~~
EXTERIOR ENVELOPE AVERAGE U COMPUTATIDN
COt1SIRUCIION ~
t
iric
Site Address ~(p/O STi) F!'i FfF ~ Lot.~l3lock~
~~N~T2EE ~fFSs ~
~S"i7~JECL/G'Gcy o2'~~wT/onl
R& U Factors R U
oaSE.way~,ialuvd. Opaque Walls .043
W.iY~;~~~ Wa 11 Franii ng Areas , pg
611ipin,ola55701 Ceiling [nsluation Area ~ g' . D~l
lai2pN~ I211 ~e; ~ j nq Framt ng Area ~g~'
Rim Joist .04
Masonry Wall . Qfs
Windows , ~~j
Doors .31
Skylights .55
1) Lower Level (Oasement)
Total Exposed Wall Area `a Z.'
~ ~
Opaque Wall Area X (U) .OQJ =
Wood Frame Area ~__~X (U) .09 = ~j
Rim ~oist •~X (U) .04 ~
Exposed Block A X (ll) „13'2" _
Window Area (U) .35 ' ~2•~
S1lding Glass Door ~1Q X(U) .35 = 1
Ooor Area / X (U) .31 =
Total (,Q (,Q
~~M~~o~ o
2) ~irst Or Main ~loor
GOI~ISIRUCIIUIJ ~ Q
Total Exposed 4lall 11rea v
iric
ppaque , ~11 Area ~'~J~~.F'~ .0~3 = 'r~'' U
IJood Frame llrea ~~r11'~X (U} ,09 =
Rim Jo1st ~Gf'~ (U) .Oq = ~j•~
Window Area 2,10•~ X(U) .35 = 1~.t4
D~ ; L Wayzal~ Ulvd.
w,,~,~~~ Sliding Glass Door X(U) .35 -
Minnr.sola5,J91 poor Aped ~j $ K U ,31 = 11 . l
~ } -1-.
~f,l2)1l~ 1211
7oLa1 1~~.~
3) Second floor lf Two Story
To ta 1 Exposed Ida 11 Area ~`j'li7i'~
Opaque Wall Area I~CQ~$x (U) .043 =
Wood Frame Area t-~t.r 5X (U) ,09 = ~'Z. ~
Window llrea •~X (U) ,35 =
Sliding Glass Door _ ~ X (U) ,35 =
Door llrea X (U) .31 = /
Total I Og
4) Total Ceiling Area 2,D '~Gj
.oZ4
1lood Frame Area ZD~i•~X (U) „p~2~
Opaque Ce111ng Area ~'LZ~ (U) ~p~ - ~J~j.'~'!
Skylight ~ K (U) .55 = ~
Total
. _ ; _ ~~`t'°`{~~j~ , ~:_J
C~~L~o~}~
I~t~f~DG~Efi
~Rt~S.
conistaucnoN ~
tNC. MINNE507R U FACTORS Total Exposed Wall Area ~~~X .12 =~~~'1
MINNESOTA U FACTORS Total Exposed Ceiling
Area 2~ X ..026 = ~2-'~
(A) Total = 'rJ31
935 Wayzala Qlnl.
W~y~~~ Item 1 ~Q~,IC •3+ Item 2 1`~'~+ Item 3 1 b~_ + Item 4~'/
Minnr.sala 55391
(G 12)47& 1231
If Total Of Items 1-4 Is Less Than Item (A), euildiny Complies With
SBC 60Q6 (C)s
LO7 SURVEY CHECKLIST FOR RESI~ENTIAL
, BUI~DING PERMIT APPLICATION
~ PROPERTY LEGAL: L ir L'?"d! ~/~/l"T,Z~E~ 7f/ tS .G f/G~
~ DATEOFSURVEY:
H
~ LATEST REVISION:
lu
~
a DOCUMENTSTANDARDS
0
? • Registered Land Surveyor signature and campany
~X ? • BuildingPermitApplicant
rp ? • LegaldescripGOn
da~ ? ? • Address
Fg/"o ? • North arrow and scale
• Hause type (rambler, walkout, splitwlo, sqit enUy, lookout, etc.)
~ ? • Directional dreinage anaws with siopelgradient
a? . ProposedJe~dating sewer and water serrices 8 invert elevaEOn
~o ? • Streetname
~ o, ? ~ Driveway
? Lot Square Footage
? ? • Lot Coverege
ELEVAT)ONS
Ew'stina
~p ? • Sewer service (or Proposed)
~ ? ? • Property cpmers
? • Top of curb at the driveway
• Elevations of any eadsting adjacent homes
? Adequate footing depth of structures due to adjacent utifiry Venches
Prooosed
fa~ ? ? • Garage floor
~ ? ? ~ First floor
~ ? . lowest exposed eievation (walkouUwindow)
~ o Property corners
d o o • Front and rear of home ffi the foundation
PONDING AREA (if aooliqble)
? • Easementline
? q~ ? • NWL
? ~ ? • HWL
? ~~a • Pond # designatlan
? o . Emergency Overflow Elevation
DIMENSIONS
~p'o • Lot IinesBeanngs 8 dimensians
~/p~ ? • Right-ot-way and street width {to back of curb)
? • Proposed home dimensions indu~ing arry proposed decks, ovefiangs greater than 2', porches, etc.
(i.e. all sVuctur~ requiring permanent footings)
~o ? • Show au easements of record and any City utilides within those easements
• Setbacks of proposed structura and sideyard setback of jacent e~astlng structures
s
? ? • Retaining wall requiremenfs, if any
R~~,~, ~ % 6
me / Date
March 1988
cRn~c~s~oovnMr.Fn+
- REVI~~lS BY •
Ff~'
u .
r~:~
Y
C LI FF R 0 A D ~ jQ~~~~~
~
C. S. A. H. N O. 3 2) LEGEND
~
saa.i x S89°29~27~~W 87.60 x sa~.s ~ DENO?ES SANITARY MANHOLE +
~ DENOTES ITYDRANT °
~ ~ ~ ~ fil DEN07ES CATCH BASIN
S~ --""'rr'I S DENOTES SANITARY SEWER ~
1~ 5FT. SIDEWALK & TRAIL ~ I ~ 1 S W DENOTES WATERMAIN
/ EASEMENT PER ST DENOTES STORM ~WER W~ ~
I DOC. N0. 1496902 ~ I ~ ~ DENOTES STORM MANHOLE
DRAINAGE & UTILITYE\ - n DENOTES Si~DRM APRON
~ I EASEMENT ~ ~
SETBACKS ~ s
/ X 950.Z 3 / N ~ ~
p MIN. FRONT YARD SETBACK = 30'
I x ssi.o x 950.~ ~ ~ MIN. SIDE YARD SETBACK = 5' DYVEWNG, 10' GARAGE
~~?'10, 3g ' BENCFiMARK ~r MIN. REAR YARD SETBACK = 15' ~a`yp0.5
~9~2.g $ss,3 ~E~v = ssz.ss LOT AREA = 14,753 sq. ft. ~ 3 b~
I 52
q
~7 14~ ~ 3 ~ ~ ROOF AREA 96 =2175Xsq. ft.
' 20 xs`e2?s ~~L~
~ ~o~ Hou ~ „O
CC I 1 W~~ ~ R' N ~
0 5
~ I~ ss~.e N o s s
a. s X Z ~ t;~ V~ ,
Q ~~/J • Propoaed Top of Foundotion ElevatSon~ 962.33 V
O x 95 .7 '~1,g GqRq 1g ~ U V ~ Propoaed Gamge Floor Elevation~ 982.0 ~jj
A ~_x ss . ~962 0 ~ Propoaed Lowest Floor Elevation~ 953.33 ~y Z~
~
L pW ~
~7 \ i2.$ O ~ cy ~ - . L~'~7 ~ „W
5 ' ~1p {/38 ~961.g)1:;'~i~`,'> 20 . . . [al
/ , ~`'~F" X 958.9 , .•.:r'•~`";-~' - 1,.1
a x~'. "?T, O Denotea Iron Monument 1- ~ p; E"'
y'~, r'~-' + 910.0 Denotee Existin Elevation a~ C7 ~
L i 949.0 <,,N ~ +(910.0) Denotea Propos9ed Elevation V~ A z a
ssa s O ~ ,
~ ~ 33 Denotes Direction ot surtace ~i ~ z O
~ c~ F a t~
~ : p Drvinage ~
5 910•~ Denotes Sanitary Sewer Service ~ ~-1
ti ` Elevation
5800 i • . . . 959.8
36 31 " :~Y r'~%'~` I hereby certify that thia is a trua and corcect representaUon
958.~ e , ~
s of a survey o# the boundaries of:
sss.s ' LOT 3, BLOCK 1. PINETREE PASS 2ND ADDRION
S 95s. DAKOTA COUNiY, MINNESOTA
N Md the locatton of all buildfnge, if any, thereon, and oll visible '~S
TO ~ encroachmenta, fl any, from or on eaid land. As aurvayed by
.~CLI~~, S me thie 28th day ot Janu , 2000. -
.R ° ,
f scn~
~ ~ r ~ ~ ~F.~ 4 ~ ~f~~ Gary R. Germond ~
13censed Land 5urveyor, Mtnn. Lic. No. 24764 JOB N0.
5402-532
943.IX JIJJ LO CI C~ vl.VV X9A1.9 v ~
~ C
~ ~ ~ G~ [
• 5 - -t-~-I-~7-/7 S s [
1~ SFT. SIDEWALK k TRAIL ~ I ~ J W C
/ EASEMENT PER ` ST [
1 DOC. N0. 1496902 f
I DRAIN~GE 8: UT1lITYE\ - I 1 ~ [
~ EASEMENT ~I I
~
~
I X 950 2 3 I N
p ! ^ MIN. Fi
~ l z9si.o %950.7 / ~ MIN. 51DE YARD S
~ /^~~Q, 8 J BENCHIAARK ~r MIN. F
~ X 951.6 ~ ~ `ELEV - 952.66
95^~ I 17+ ~4~ 52.8) 5 33~ I / w RO(
a° 2o xe`sz~ ~ !,p ROOi
3 ~ 4fiPO WA Nf~ S£ f~ ~ O
CD I 1 s ~~V T ~R' N ~ ~
• / 957.9 ~ .
~ I N 958.5 x Z Pro OB~
o x es~_ 1p ~715 ~qRAC~B Propoe~
% 959. e Propoe~
~j ~ 12.S9o2.0) N
I ~ `96
~ 8 ~ . 20
1 / ) -
5 3g y
y^,~y~~~•~ X 958.9 O
~ + 910
~ 949.0 ~.ty\ r J / ~
. j• . cU `,r os 3 + 910.
958.9 K O . ~ ^ ~ 3
`ti ~ ' ~7
Q , O
5 910
C` po 0 Z~ ~ ty,~=A~~ 959.6
JU aJ 31~„~ : . o(hafea
958.7 'U~ ~ ' ' ' ' ' :
, t; , 959.6
~ LOT 3,
T 959 0~(~TI
O~ 7~~ Md t1
J
j I / T~i ~J~ S~ r-~~ me th
L/1 1 ' o
r
4 ~ r~ ~
;,l' ~ _ Y ~ ~ ~ Gary I
~Y.~,_,~ri' : - ~ . _ Ucen•
CITY USE ONLY
LOT ~ BL ~ PERMIT I~+ CJ
SUBD. ~I~1G~4PQ ~GS.S 2nc~ ~CEIPT / ~ o .;l~~
RECEIPT DATE: 3~
2000 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3630 PIIAT PINOB RD
EAGAN NJt1 55122
651-681-4675
Date: Z
Complete this section onlv if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not owner/occupied.
• HVAC: -100 M B T U $ 30.00
ADDITIONAL 50 M BTU 6.00
fZ e°
• Gas outlets (minimum of one required @$3.00 ea.)
~ State Surcharge .50
Total $ ~s~
Complete this section anlv if you are remodeline. addine to, or re airin an existing single-family dwelling,
townhome, or condo. Please ntdicate if it is a new item, alteration, or repair.
_ New _ Alteration _ Repair _ Other
Fumace Air conditioning
_ Air exchanger _ Other
Fee $ 30.00
State Surchazge .50
Total $ 30.50
Reminder: Call for inspectians
SI'I'E ADDRESS: Y' D ST7~rr P G~t"7`e ~ i
OWNERNAME: v~~~e.n /J~OS ~ PHONElk: l~I~ - I°~ ~ I
/ (AREA CODE) ~ s~-
INSTALLERNAME: ~~~Gp vtC~~P.~ fG~Q~CC UCc PHONE#:~-___1~
~ ~ (AREA CODE)
STREET ADDRESS: ~ ~ ~ ~l/ 4~ /!d~"/ ' v'~
CITY: Sv( l~lG~~.~~ STATE:,~ ZIP: S S~7/
~f O~
SIGNATURE OF PERM1TfEE
CITY U3E ONLY
L _ BL _ PERMIT
SUBD. RECEIPT#:
APPROVED BY: , INSPECTOR RECEIPT DATE:
2000 MECBANICAL PERMIT (CO1~~RCIAL)
CITY OF EAGAN
3830 PILOT ~t08 RD
EAGAN, 2~IlQ 55122
651-681-4675
Piease complete for. all commerciaUndustrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
WORK T1'PE: New construMion Install U.G. Tank
_ Interior Improvement _ Remove U.G. Tank
_ Processed Piping
When fnstalling/removing underground tank, call 65I-681-4675 for inspection by Jire marshal and
plumbing inspector.
Description of work:
Fees: 1°/a of conhact price OR $30.00 miuimnm fee, wEichever is greater.
~ Underground tank removaUinstallation = minimum fee
Contract price: $ x 1%= $ (Base Fee)
State swcharge calculate at 5.50 for each 51,000 Base Fee
TOTAL $
SITE ADDRESS:
OWNERNAME: PHONE
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONL~:
WAS TIIERE A PREVIOUS TENANT IN"fHIS SPACE? Y N. NAME:
INSTALLER
ADDRESS: PHONE -
(AREA CODE)
CITY: STATE: ZIP:
SIGNATURE OF PERMITTEE
~ CITY USE ONLY ~ O
L _ {~BL ~ m n RECEIPT
SUBD. f I V~e.~YL l, !"ls~ `~r RECEIPT DATE: ` d gr~C
PERMIT # ~ ~ o '~U?
~000 ~'LUM$INH ~P~1411T (i~SIDENTI~4L)
crrYoeeasnx
s8so ~u.or ~os Rn
~lkfiAA, Dl1V 551 EE
651-681^4675
Please complete for: ? single family dwalli~gs
? townhomes and condos when permits are required for each unit
? backflow pre~enter for underground sprinkler system
FIXTURES EACH # TOTAL
Alterations to existing dwelling - minimum fee
Describe: $ 30.00
Bath tub $ 3.00 x = $ ~
Floordrain 3.00 x / _ $
G0S i in Outlet ' minimum - 5 3.00 x ~ _ $ (o
Hot tub/s a 3.00 x - _ $
Kitchen sink 3.00 x ~ _ $
Laund tra 3.00 x = $ ° °
Lavato 3.00 x !o = $
SB tIC S YBfll new/refurbished ' requfres MPC lic. 75.00 X - _ $
Se tic S stem abandonment 30.00 x - _ $
RPZ new installationlrepairfrebuild 30.00 X _ $
Rou h o enin 1.50 x = $
Shower 3.00 x Z = $ ~ O°-
Under round s rinkler ifdwellin isunderconstruction 3.00 x = $
Under rounds rinkler ifeXisen dwelling 30.00 x = $
Water closet 3.00 x = $ / Z`O
W ater heater 3.00 x ~ _ $
Water softener If dwelling under construction 5.00 x - _ $
W ater softener if existin dwellin 30.00 x ~ _ $
Waterturnaround 30.00 x _ $
State Surchar e .50 $ •5~
Total $ G 3. ~o
Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc.
I hereby acknrnMedge that I have read ihis appliption, state that tl~e information is correct, and agree to comply with all applicable Ciry of Eagan ordinances.
It is fhe applinnYS responsibility [o notify the property owner fhat the Ciry of Eagan assumes ~o liability for any dama9~ ~used by ihe City during its normal
operational and maintenance activities to the facilities constructed under this permit within City property/nght-of-way/easamenl.
SITE ADDRESS: T(p / D ~T~/~~ /~i/T ( E~
~ s7
OWNERNAME:: L~tvtlf('il~ir~"~^l05 C-o~?ST, _ TELEPHONE#: IvIL S'~~~-
(AREA CODE)
INSTALLERNAME: ~(pr nG?~Cr /d'(~~q,~s/C~'~ TELEPHONE#: I~~ 7" ~~y~'r~
STREETADDRESS: S~~ L fL ~ (/+Re.4CODE)
~ 4- / iiv-~
CITY: S~ld~"LLD~i~i~ ST ~/1~ ZIP: S S~7
~ ~~~r
SIGNATURE OF PERMITTEE
I Fgc~ce~U'se
City of E~~a~ i PertnR# ~~JUU I
i Permit Fee: ~
3830 Pilot Knob Road
Eagan MN 55122 ~ oate Received: ~ j
Phone: (651) 675-5675 I ~
Fax: (651) 6755694 i Staff i
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
~ ~r C/9 1
Date: Site Address: ~Q G Q'1` ~ ~-f ~ l d
Tenant: Suite
RESIDENT / OWNER Name: / ~-f ~ ~2 ~ Phone: ~I ~ 7 7' 7` v
Address/City/Zip: ~~j/C~ ~oh~G~/,..~~ ~ ~Y, ~-rmt.~ 5- /J~
Applicant is: Owner _ Contractor
TYPE OF WORK Description ofwork: .
Construction Cost: Multi-Family Building; (Yes No ~
CONTRACTOR Name: License
Address:
City: State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Ven8lation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submined
- In the last 12 months, has the City of Eagan issued a pertnit for a similar plan based on a master plan7
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
_ . . Sewer & Water Contractor: Phone:
. -
.PP 9 _ Y
~he nformaGondma 6e cla§s~ed as ntonh ublou submif are eoqsidered to be putilic informaGon' Porfions oi`,
~p _,~c ~f you~prov~de speafic reasons that would perimt the Citj! to
s,j' F - ~ ~
: 'conclbde that ihe "are.trade se`crets a~_=;-
I hereby acknowledge that this information is complete and accurate; that the work will be in confortnance with the ordinances and wdes of th iLy-of
Eagan; thal I understand this is not a permit, bul only an application for a permit, and work is not to start without a perm@; th ork will be in
accordance with the approved plan in the case of work which requires a review and approval of plans. ~
X`~/l/!~?r~ T JZ~ l~( X
Applicanfs Printed Name ppp' ignature
Page t of 3
i
iv
For Office Use //� 1 1-`
° ,„R /4 7 30/ �I
e e L� ZOi� Permit#:
E AG A N'''' ----1---.1---
e� NI' ''m -s
Permit Fee: g(9C;? •(2 il
Date Received: /t �t
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff:
buildinginspections a(�cityofeagan.com i_
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
9 -� -&.'. r
Date: `"t - � Site Address: "� ‘-' '.--ce-,) cC-t-r'y j:)J4 ' Unit#:
Name: 1t Lam-- J. 'r Phone: ( ::iT( - tO-11 t(
Resident/ �/
Owner Address/City/Zip: (-'1ro(C. 5 cc —.GI l t^E--� R '( .
Applicant is: Owner Contractor
TYPe Of Wo Description of work: 0 C-Q t`C �5 ll r`� �L-C
Construction Cost:rK
a (3`)
Multi-Family Building:(Yes /No I( )
Company: t��k-,,-' "C� r--)1c-L- (2E57-,--0 \1-4---' Contact: d i*P-A�✓6c-'
L.--1/(1`3-i-
-Contractor Address: 13! k c OjO(_u - t�{Q �
" tt S i - City: At L L1�
Stater Zip: 55.(a `f Phone: 3 nail: --(-7it--OA-1--4 --7 ) (.'
License#: ( 6 S 5—(':' Lead Certificate#:
If the project is exempt from lead certification, please explain why: , d`
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 supportingdocuments that you submit are considered-to be public information. Portions of the information may be
classified as non-public if you.provide specific reasons that would permit the to conclude that th- are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.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.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.
x S rte, i2ta`-,30vz_ '
Applicant's Printed Name leant s Signature
, ,DO NOT WRITE BELOW THIS LINE
L /7 S nece% D . /zy0- -7•T�
SUB TYPES
_ Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
_ Single Family Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
Multi ys. 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
c J Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_ 100%_) Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings(Addition) x Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice&Water _Final Pool:_Footings Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: Rough In_Final
Braced Walls Erosion Control
Shower Pan Other: !(
Reviewed By: It- , Building Inspector � J
RESIDENTIAL FEES }` ( c
Base Fee Qtu" "ft.:.- ,
Surcharge f�l'� ;� �14♦
" c
Plan Review 14
MCES SAC X /S -
5 /'c
City SAC (((( 77
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
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4
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA176240
Date Issued:05/09/2022
Permit Category:ePermit
Site Address: 4610 Stonecliffe Dr
Lot:3 Block: 1 Addition: Pinetree Pass 2nd
PID:10-57661-01-030
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
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. When a weather barrier is installed or
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 -
Jayde Tran
4610 Stonecliffe Dr
Eagan MN 55122
(651) 890-7162
Summit Construction Group Inc
5325 W 74th Street, Suite 11
Edina MN 55439
(218) 343-8884
Applicant/Permitee: Signature Issued By: Signature