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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 ,'. Det a hed 3 u u? ti -ap j - t s 3 B % stii eyf4iitiL „ h t? e , °Y ai om ""hs yd - sstTtYzshgvand vetititatioli,` de ?? ' a er 1670iuCat "o ?I-e+. 4th?statu " , iG r". +.h p { ?ry .y f ?j ? ? ? ?? ." itielied ? n LLwiW„KOyM(F ryl P 1 't lx - y ( ? ,? j''?`-Epy bi G.-?}T I X.. lNI' ?/5 ,}, r JLLOpteC 7674y nrl Cl I?r?' 1 j Ai?'?(l - ? ' e " i su' t f r u 2 1 C t e fti t E a ? } •`r 1 ` `' . Exam l loi:! o viiht ses aiid:tnw houses e: _ m ,13,E ord. C te o .= ovtstonss44 . ;at ,. er,767 Or? vr her her., lvowapanry bui tdings)oF3'stones?rless`?"" - ? t ? r ? .,Exam'lee=?'c`dndf">Iriuiums;oi', arbhentsG?,. ? }p aCtia ' r;. ' 2 ,+`io'vlsions ', "ei76?0,`rivtitli?,eifhar CatB` o yor `Gate .', 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 nplis y e us Sealed com un ? trect or power vented ? Direct or power vented Y? J t0'Al1iX+eRte?1[ ? t+e t ed o h .. -W"Oog notisoltdaftte1y 1 _ Sealed combustion see?d'tt s-rtsa t °I , p , . ? Atmospherically vented ,` = ?' I -A 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 un)e,dnansc Ld fuel s ree h gtr mshdf)ed th ake i latch' t p r. p gp m e up?tr o: r . flow,rs're°uuedAforeaob indip?idualexhaiisJ; drzytce fitera whtdh"xeeds3fl4: xiliiq'feetporm _ , , g m Part C1. VENTILATION M - -'tiS rtY f .yVEl\,LtV . `IUt`?l'],`.f` y(}+=fi£' } #%1 - { , 5'4 ?- 3' rv "^? t -? ' ' " . ";'I s. ?,; (Iv)`echarttcal??nCilh?topamust'??ardvl?pt} peer tltetlar of tt?+i`tt al?iilared'eUelow) ` ? €. ? .. °.' `? ?, 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" 'I3 f t -- ;a,'"a„„:?. ' EI5UIE''?`',f''di r 1W , iteck met)agdg)1rpptfac} + ' LA Exhaust only , ? Balanced , - - ? eat recove ventilator air exchan er etc " , . Iats deSOCI ho br agti'n ) + I F" C TALS ,- „ , RC ? , : -T. 'VENTIL TIG ;:?';Intaka'{ s?c`fiii;'° efm•: ',ofm?; ;ofm?: `;:cfrii.:. 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 alyXltltust, w cfin: q ciin`: cfm'. " , -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), yx_ '::.,' 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 , OZ a ? H ? R ? H ? X ? $ ? X 0 m rA C a t U 9 Q 0 ? ? 0 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