1537 Stonewood LaneAddress: 1537 Stonewood Lane Zip: 55122
Lot: 33 Block: 01 Subdivision: Woodstone Townhomes
THE FOLLOWING ITEMS WERE/WERE NOT COMPLETE AT FINAL INSPECTION ON
Yes No Comments
Final grade - 6" from siding
Permanent steps - garage
Permanent steps - main entry
Permanent driveway
Permanent gas
Sod/Seeded lawn
Trail/curb damage
Porch
Lower level finish ?C
Deck JC
Fireplace
• V erify with your builder that roof test caps from the plumbing system have been removed.
• T urn off water supply to the outside lawn faucets before freeze potential exists.
• Call the City's Engineering Department at 651-675-5646 prior to working in right-of-way or installing
irrigation system.
BUILDING INSPECTOR:
CONTRACTOR:
MW Johnson Construction
17645 Juniper Path, #100
Lakeville MN 55044
Site address: 5 SL%!A i A Lot Block Subd.
On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air
tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be
submitted prior to issuance of a Certificate of Occupancy.
This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
This structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE
Water Heater ? f? p 5/ px O 21-7 0 6 7¢D pct V L
Furnace
?/jS4Rf?
r ?
3?fli ew
Dryer --
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
YES NO
Kitchen kitchen
Bathroom 1 +? A
Bathroom 2
Jan Sv
Bathroom 3
Bathroom 4
Other
VENTING
FIREPLACE(S) LOCATION GAS WOOD MANUFACTURER MODEL BTU'S DIRECT ATMOS
MAKE-UP AIR MODEL TYPE Es
I hereby acknowledge that the above information
requirements.
?v
Company Name
is correct and agree to comply with the Minnesota Energy Code and City of Eagan
Date
t* This form is the responsibility of the General Contractor.
Lot
1k)f?Az? how ?l om?o $p- lpl(?5`7 -tt1.g3
KESIDEIN ILAL 1SU1LVIINU
Permit Application W
City Of Eagan e p -
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX 4 651-675-5694
?I?58 ?10.Sb
c?l(o5? cgo.Sb
New Construction Requirements RemodellReoair Requirements 0t UseOnOnlY
3 registered site surveys showing sq. I of lot, sq. ft. of house; and all roofed areas 2 copies of plan -- CBd of Survey Recd
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated addillons Tree Pres Plan Reod (Yaloo
2 copies of plan showing beam & window sizes; poured found design, etc 1 site survey for additions & decks Z!9Jrree Pres Not Reqd 1 a/p3
1 set of Energy Calculations Addition - indicate ff on-srfe septic system _ On-site Septic System
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date / 2-1 / /U Construction Cost
Site Address 15n - l
3k '1n c JC[ ka ii C? Ur it/Ste #
Description of Work Alew how, "coy?
Multi-Family Bldg X Y- N Fireplace(s) Z o X1 _ 2
PropertyOwner m -W - JohnsOVI Telephone # (952) SqZ- 117-0
Contractor M.W .Johnson
Address I?Tt? r?
JUnlt??Y ?641, ?"
city l?n \iIIfi
State ?1lYty?PF t.? Zip c_?6044 Telephone # (9E>Z):59?--_17 .l)
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateaorv 1
• Residential Ventilation Category 1 Worksheet
(J submission type) Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber Va`VC ?'?i AAIY?U1no,
Mechanical Contractor Il d AIY
Sewer/Water Contractor
A NEW BUILDING
_ Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
Telephone #(q_c;l) 4qZ-2121
Telephone # ((AR5I )4U0 ` 0022
Telephone I#:( l 057- 15US-
,l I ... V?1 L.. .. I r 1
IIUL
I hereby apply for a Residential Building Permit and acknow)dge that the information is complete and accurate;
that the work will be in conformance with the ordinances ancodes of-tom"City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
-Tarn q CarcU
Applicant's Printed Name
Applic t' Signa r
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
x 03 01 ofjplex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
x 31New
? 32 Addition
? 33 Alteration
? 34 Replacement
Valuation /ev Dl?
Census Code
SAC Units
Nbr. of Units 01
Nbr. of Bldgs a'/
Type of Const
. ,
? 30 Accessory Bldg
? 31 EM. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
'Demolition (Entire Bldg) - Give PCA handout to applicant
Occupancy MC/ES System
Zoning /2 l City Water
Stories / Booster Pump r-
Sq. Ft. Ia 7? PRV
Length gQll Fire Sprinklered
Width K ?- _
Footings (new bldg)
Footings (deck)
_ Footings (addition)
Foundation
_ Drain Tile
Roof Ice & Water Final
Framing
_ Fireplace _ R.I. -Air Test -Final
Insulation
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
REQUIRED- INSPECTIONS
Final/C.O.
_ Final/No C.O.
Plumbing
HVAC
Other
- Pool _ Ftgs _ Air/Gas Tests _
Siding _ Stucco _ Stone
Windows (new/replacement)
- Retaining Wall
Approved By
Un/r,,? 135M v / 3 6r-, to
? ?' 1--ti d, / 3 00.0
/Go /00
Building Inspector
/ /95-00
p'200
??? ?7_ CO
4 IL MNcheck COMPLIANCE REPORT
Minnesota Energy Code
MNcheck Software Version 3.0
Permit #
Checked by/Date
COUNTY: Dakota
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Family
DATE: 7-17-2003
DATE OF PLANS: 07/17/03
PROJECT INFORMATION:
Lot 33 Block 1
Woodstone
Eagan, MN
COMPANY INFORMATION:
MW Johnson Construction Inc.
17645 Juniper Path #100
Lakeville, MN 55044
COMPLIANCE: PASSES
Required UA = 534
Your Home = 515
3.6% Better Than Code
Area or Cavity Cont. Glazing/Door
Perimeter R-Value R-Value U-Value UA
--
CEILINGS --------------
1309 44.0 ---------
0.0 ------------- -----
35
WALLS: Wood Frame, 16" O.C. 1902 19.0 2.0 107
BSMT: Conc. 8.0' ht/4.0' bg/4.0' insul 944 10.0 0.0 150
GLAZING: Windows or Doors, Above Grade 212 0.480 102
DOORS 38 0.350 13
FLOORS: Over Outside Air 16 30.0 0.0 1
SLAB FLOORS: Unheated, 42.0" insul. 156 10.0 107
HVAC EQUIPMENT: Furnace, 90.0 AFUE
- -----------
COMPLIANCE STATEMENT: The proposed building design ---------
described -------------
here is -----
consistent with the building plans, specifications, and other calculations
submitted with the permit application. The proposed building has been
designed to meet th req iireme is of th e Minnesota E nergy Code
.
Builder/Designee Date Cr7
Job Site Address:
"CATEGORY V ALTERNATE FOR
ONE & TWO FAMILY DWELLINGS
INSTRUCTIONS: This alternative may be used for one- and two-family dwellings built to meet the Category I requirements of
Minnesota Rules, Chapter 7670. Complete Parts A, B, and C. Clearly mark plans with: insulation R-values; window and skylight U-
values; size and type of equipment; equipment controls; and location of vapor retarder and windwash barriers. More detailed
information can be found in the Minnesota Energy Cade summary sheets available from the Minnesota Department of Commerce.
Part A. BUILDING ENVELOPE
,Cheele"roposedenvlelnp Jbmtaeah?g?aptlansii? Presenphve(caulkmg,gaskets etc) ? Performance (test per 7670.0470subp.7.C.)
Check thermal energy calcula0on ophonused ?th1 ? "Cookbook" (complete worksheet below) [Y_,(?MnCheck method (attach report)
.- -. _ « "-_ ? ';.'? .;:, ? Performance (attach U-value calculahons) -? -Systems Analysis method (attach analvsisl
"Cookbook" Worksheet
INSTRUCTIONS
Step 1. Check item(s) that design meets on Minimum Requirements list
to the right, Must meet all items to use "Cookbook" ophon.
Step 2. Indicate proposed wall type on table below.
Step 3. Indicate Window U-value and source.
Step 4. Verify total window (including area of all foundation windows)
and door area is equal or less than allowable percentage.
„ +1? -- '>M11VIl1IUM?REt?Y7IREMENIS-",.t
?.= s a 1 tor'"Cookbook';;o 6on4onl : r
? Ceiling Insulation: Minimum R-38 with 7%" energy heel; or
Minimum R-44 with tow truss heel; or
Mimmum R-38 with R-5 sheathing when no attic.
? Ent Doors: Max. U-value of 0.30 or K' solid wood with storm
? Rim Joist Insulation: Minimum R-19
? Floors over unconditioned spaces: Minimum R-24
? Foundation Insulation: Minimum R-10
? Foundation windows: '/_" insulated lass wood or vinyl frame
' -`,FOR: DETERMININGMMU MvWINDOW!AN D)DOOR AREA•€ - '?:=
Maxtmum, A,lfowab?lew'?ofebWmd6$,aild'33o?ryArea
a '''
2
r WaILT p6,, Standaid'F'atuin - -- - * ` ; Ivfaximum Avem • : V,'indowdL :vafuet a c e t"ftiunda[ion windows r
? 2x4,R-l3 insulation, R-7sheathing ;x035 `?`047? x`:0:41"-' • 0:36„'' ,,+,033ts x030'.:; + fr027 '. `-`:0125 ; ,'"_0.23.,
? 2x4, R-I5 lnsulaton, R-5 sheathin u ,0 52,,E Q $ i ;;0 39r, , r :0.$5 0139, "?'tl28 'i <' 0.26K . ? 024 t t `'=0' 2si:?
? 2x6, R-19 insulation, <R-5 sheathin 0r221„ 21' ?
? 2x6, R-19 insulation, R-5 sheatlung ,T=0:56;=;? 'x'!0:48+jo- ' 2x6.'42 ; ";a'0 3T`„ r`;0 34' ^ ??0;3!l * 0:•28 Qr26y':t = =0124:'
? 2x6 R-21 insulation, <R-5 sheathing '?, 0'51' . 10.43?txi Ys O 38 s ?- 0,311 'O. ,.PA:30 „?` 'f10.28 ; io 0 25 "' MO 23 ,. X1):22 -:'
? 20, R-21 insulation R-5 sheathin s;: Q,S8„'", h50 SQ'ys' «444,1 l? ,;trOt39' :3'S;?
Walla e, Advadood Fianub ,' _,
- ,r, ?•: r . • .• -.,._,
MaXunu °
m"tSve' eV?in ow`U.Yalu€ exc --
e''tsfpunda
lion"'wfndo ., -
we: '' ?i. - -
? 2x6,R-19 insulation, <R-5sheathing 39"- ;: :3Sx- 26'i; „0.24w*, 22
? 2x6, R•19 insulation, R-5 sheathin 0.58' Oi,4,4' :39 0.3 32 29S 027;:;? : 025"
? 2x6 R-21 insulation <R-5 sheathing ,-0;55,S1 ,7 0 47 0 41 OG27 a,: .?-A 25,. % 0.23
? 2x6, R-21 insulation, R-5 sheathing -ird1Q.60?"` ,'1d0'S2try ,_1Y16y; ''_?O,AI;, r?+096',s O'3:3;?,Ft °f.01 0''28 '' ,;;'_0i26:,:.
• ?Windowiuvalue=i? ?NFRC ? ASIIRAE1993Handbook
MINNESOTA ENERGY CODE - WHICH RULES MAY I USE ?
YPE;OR3RESIDErNTTAE BUIZDING' ?9
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sIt'?1,dceuP.R°eYbuiLlidgs over 3ost{trles.h, ighl?"a "_i ij o{,ChaP eR7,fi%d
Part B. DEPRESSURIZATION PROTECTION
Check option used: Fuel burning equipment (complete schedules below) ? No fuel burning equipment
INSTRUCTIONS
Step 1. Complete the Combustion Equipment Schedule below. Only equipment
with a Y (Yes) may be selected under the "Category I" alternate,
Step 2. Complete Exhaust/Make-up Air Schedule on the right if direct or power
vented or solid fuel atmospheric vent space heating equipment is
selected
FiXHA{)STtf;Mi1U£'R 'CT[(Dt]LE*:''
.'?y?_ e118t'=.tI?VICES+U'V?er?"31)?;efin's' ??=''=?<Flbiv';:.?,
`'xc&ns
, Q1GIBiJ ION Et CYIP P 1$t WEDUI it
$paeeheahng nonsnhdfuei Scaledcombustion Y He
th
til
dfu
l '; ?
b
t ?Y
ar
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y
e us
Sealed com
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? trect or power vented
? Direct or power vented
Y?
J t0'Al1iX+eRte?1[
?
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see?d'tt s-rtsa t °I
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? Atmospherically vented
,` = ?'
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L] Direct or power vented , Y = W (ter heap' " sAttfiie1 El Atmos hericall vented
_ -=ti3iba te)'icall yeiited+ ?,;..'. `? 3e` _snliiltfiYel'+? h7, f,''-„„ ? Atmospherically vented
*' 'If atmoshencally'vented sohdfpel ovdueS?or
owe
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Part C1. VENTILATION
M - -'tiS rtY f .yVEl\,LtV . `IUt`?l'],`.f` y(}+=fi£' } #%1 - { , 5'4 ?- 3'
rv
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q
`f cubi?tbet x ll b0583 /mrnute' l/ cfm (? x tS'cflnibeitro4Pt) ?'t5•efm ? cSn-'r
,vplutii tif?htl'_itable.tdoms - . ?,',I? ? 'atumb?edtoptgs <? ?_'
t NTI19`?i'1`iONTFAIV`.4"
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eat recove ventilator air exchan er
etc
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pS:DESIGN}aD . ,,, , .-:Exhaust': Ca .; kfrii:,': . :;of ri cfiii "; efm' 'nfrn
Statement of Compliance: The proposed building design represented in these documents is consistent with the building plans,
specifications, and other calculations submitted with e permit lication. The proposed building has been designed to meet the
reg?irements of the Minnesota Energy Code.
Applicant (print name) Signa Date Telephone number c
Part C2. VENTILATION (Submit Part C2 upon completion of system verification-)
x --------------------- - ---------------------------------
Job Site Address: Permit Number
iF?it descri tipu or Idcatiii'n+ ' '? `?
OTAI.S''.``" .t
JvIEA?iXRED r _ `Itlt'ake'.? _
afm:
PhR) ORIVIANCEt
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-t _ Vcnttlatiog za#F )tru _ bb' rpedsnfed'uu
d eY) ed whenatfie performance opnan,TS?us ..tilt hen of ,the#rr"sspnpi ve rhon for the
-oft]omts ii fl e building
sealing i
codt6`tttttd onvelppe'' r,
(fram Patt A),
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Compliance Statement: Installed ventilation system is in compliance with MN Energy Code and is sized to provide the design air
flow.
Applicant (print name)
Signature
Date Telephone number
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LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTY LEGAL: LofS 33 ,?e 3
g/®c-4-- /
ha""- -S
DATE OF SURVEY: -7-25-0,3
LATEST REVISION: a-Zt=O3
ro-,-o3
DOCUMENT STANDARDS
• Registered Land Surveyor signature and company
• Building Permit 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 % 3 n1;sr•?
• Proposedlexisting sewer and water services & invert elevation CLoP `f
• Street name
• Driveway
• Lot Square Footage
• Lot Coverage
ELEVATIONS
Existing
18 ? di OL. • Sewer service (or Proposed) r+
0 • Property comers T?
?
88 '?
• Top of curb at the driveway and property line extensions ( vs
?H. ? ? • Elevations of any existing adjacent homes
21, ? 0 • Adequate footing depth of structures due to adjacent utility trenches
? R, 0 • Waterways (pond, stream, etc.)
Proposed
0 0 ? • Garage floor
Jil' ? ? • Basement floor
(a ? 0 • Lowest exposed elevation (walkout/window)
JK 0 0 • Property comers
Is' ? ? • Front and rear of home at the foundation
PONDING AREA (if applicable)
? IS' ? • Easement line
? li ? • NWL
O R ? • HWL
0 Pz 0 • Pond # designation
? gt ? • Emergency Overflow Elevation
? P- ? • Pond/Wetland buffer delineation
DIMENSIONS
;, ? 0 • Lot lines/Bearings & dimensions
? ? • Right-of-way and street width (to back of curb)
? • Proposed home dimensions including any proposed d cks overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent footings)
X 0 ? • Show all easements of record and any City utilities within those easements
K 0 0 • Setbacks of proposed structure and sideyard setback of adjacent existing structures
X ? ® • 1os of `fon {t ?io2 fO no GtJal
Retaining wall requirements, if any sh-610
^
Reviewed: ',r?i' y 1 S??? ?3
Name Date
infq.
L,7 Se T
GJFORMS/Building Permit Application
• C'ER T
TFTCA TE OF SURVEY
M. W. CONSTRUCTION
JOHNSON
DRAINAGE 8 UTILITY, EASEMENT.
3 5 OVER ALL OF LOT 35
S 90°00' 00" E 100.00
EXIST RETAINING WALL
i W
T 8]8x0 - - ------.=-
DECK °
880xDECK 97 x6 N
T2. - 14.] t
L 3 37.83
B-4-
77x5
B85x5 Co 8. 8
p
977.5
L (? r oi
r PROPOSED to
SED w TOWNHOME
IJ.I HOME ? FB/WO
O c
[c888x5 4 33
O 17.16 17.16 GARAGE
855x3 17.35 17.35 18.50 H -
N ..xr_T ..xn .1 f895Z1
26' (B.0 C.)
S 90°00x00" E 100.00
STONEWOOD LANE
NOTE:
ALL HOUSE DIMENSIONS ARE TO
OUTSIDE FOUNDATION
BENCHMARK - TNH WEST END STONEWOOD LANE - 888.36
LOT 33 1537 STONEWOOD LANE
PROPOSED GARAGE FLOOR ELEV =885.6
PROPOSED TOP OF BLOCK ELEV.=885.9
PROPOSED BASEMENT FLOOR ELEV =877.9
LOT 34 1539 STONEWOOD LANE
ELEV =886 3
12.
N
O
O
? O
O
653x3 0
E%P5T n1
NousE J
Ln
584x8 ?
CABLE
Yt'
Mr
Gam.
>z„
.i
LOT 33 AREA = 3750 SO. FT.
HSE AREA = 2007 SO. FT.
LOT 34 AREA 3750 SQ. FT.
HSE AREA = 2007 SO (PER PLAN)
SEWER SVC LOT .33 = B75.2 SEWER SVC LOT 34 = 875.4 (PER PLAN)
OCR 0 1 PLr'n
PROPERTY DESCRIPTION:
BLOCK
INNESOTA OMES,
LOTS 33 &
1, WOOOS CITY OF EAGAN, DAKOTA COUNTYT MONE TOW
PROPOSED GARAGE FLOOR
PROPOSED TOP OF BLOCK ELEV.=886.13 -ee- DENOTES
S PROPOSED DRAINAUL
PROPOSED ELEVATIONU1RCy V
PROPOSED BASEMENT FLOOR ELEV: 878.6 OOOXO
O DENOTE
DENOTES EXISTING ELEVATION
?
0 DENOTES
DENOTES HUB SET
MONUMENT
FOUND PIPE
O
0 DENOTES LOCATION
SERVICE
I HEREBY CERTIFY THAT THIS SURVEY WAS PREPARED BY ME
T I AM A DULY REGISITERD OR UNDER
LAND Bohlen
MY DIRECT SUPERVISION AND THA
THE LAWS OF THE STATE OF MINNESOTA.
Survey Engineering
Engineering
ing &
SURVEYOR UNDER 35
street w.
CR1VEWAY n'5 8g -2 I pWVEWAY
8.3R
_ MINNESOTA LICENSE NO. 10795 Fx: 1 tx = 30x
47
- 31462 Foliage Avenue suite 200
7-25-03 J(? /r?/NarNf(50) 55057 Savoge, 5 55378
DATE B E Phone: (952) 895-9212
REVISED 8-2D-03 LEROY H. OHLEN, LAND SURVEYOR Phone:(507)645577998 Fax: (952) 865-9259
Aaron Perkins
40/11. City of Evan
Date:
RESIDENT
OWNER Address / City / Zip:
Applicant is: Owner X Contractor
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
651-493-0706 p.7
Use BLUE or BLACK Ink
For Office Use
Permit*: /(/ �‘,.5—c
Permit Fee: /b& • c2 -S
Date Received:
Staff.
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
6 Lill Sits Address: 1537/53(3 5+0 etxt ocd Lame
J
Unit #:
Name: Phone:
5-+onewoock ],.a-ne
•
i Description ofworlc ea'r— o �i- ok14 YC_— Poe?
1 TYPE OF WORK €
Lt Construction Cost /135°D 15 00 O Multi -Family Building: (Yes J No )
I -F
KI Wonokr4►I Home gu;L&ers Contact: Ao►rov% Parkir►S
Address: 6136 Linda Lame
CONTRACTOR
State: MN v Zip: ..75.0114
License it:1:2C- 631 1 83
City: Ciec1e Pines
Phone: 74? -241S -33W
Lead Certificate* NAT— 1 % .53A3 —1
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
Phone:
Sewer & Water Contractor:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Cal Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Cat 48 hours
before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.ora
t 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 1 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 work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x Q ir`O n 1rkrvt
5
Appli s Printed Name APplas Signature
Page 1 of 3
Use BLUE or BLACK Ink
r
For Office Use I
I 551
Permit I I
City of Ea Rd~ . I• as
I Permit Fee.
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: / Unit
Name: ~L Phone:
Resident/
Owner Address/ City/ Zip: t) ) 40 C)GGn
Applicant is: Owner Contractor
Type of Work Description of work: & i
Construction Cost: `>a Multi-Family Building: (Yes / No )
Company: a 4 5Contact: _
Contractor Address: ~~2 y ~9C dur~ City:
State:/_ Zip: Phone:
License M Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
NOTE: Plans and supporting documents that you submit are considered to be, public information." Portions of
the information maybe classified as non-public if you provide` specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of per it issuance.
X X
Appl' ant's Printed Name _-a4ptifica s i ure
Page 1 of 3