1621 Summit HillCiti of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
3 Co 6S
Use BLUE or BLACK lnh
FOP bfl'iCe':
Permit*
Permit Fee
Date Received:
Staff:
/ 2011 RESIDENT/IAL/ BUILDING PERMIT APPLICATION
6
Date: VII Site Address: I E f X'i 11, i r1+ %� Unit #:
RESIDENT /,,.
OWNER
Name: ,1 et am, eiact;e: a 1 t C .5 Phone: ,457- 15d- % 311
c,„' lir
Address /City 1 Zip: %t' 1-1 -1,-/ 01 44 i, -t' f JI , r`,?i C� a /11A,/ 5-1-/ )- 2
Applicant is: Owner X Contractor
TYPE OF WORK
Description of work: ..c),e ,r ,. 4
Construction Costg"7` 525 (% Multi -Family Budding: (Yes ^ / No
CONTRACTOR
Company: Ofika-!ak, 7,4, r1s'Ic Contact: Ian 0tv? a fi
Address: 07413-6(/.j'n3�14,( `/,
/j ,,? 3v, fit/ 7; :if �t/.-at /`C'y//hlie
ryCity:
State: 5":5-11/ Phone: g/i VJ i'' U J / 2
r'L/zip: L�%
License #: ad -V 41 6 51 5 3 L' Lead Certificate #:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
/1 i( fly, ii tlr1 1
In the last 12 months,
_Yes _No If
Licensed Plumber:
Mechanical Contractor
Sewer & Water Contractor:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Phone:
Phone:
Phone:
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. Call Gopher State One Call at (661) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. :we w.gonherstateonecall.crq
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.
Applica yy
Vs Printed Name Applicant's Signature
Page 1 of 3
DO NOT WRTTE W THISA LINE
9Q72o
SUB TYPES
Foundation
Single Family
Multi
01 of _ Plex
Accessory Building
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100%_)
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
j Lower Level
/Interior Improvement
Move Building
Fire Repair
Repair
513
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: _Ice & Water _Final
X Framing
Fireplace: / Rough In
r Test Final
Insulation
Sheathing
Sheetrock
Reviewed By: Ze lZ
/it 5 P
Siding
Reroof
Windows
Egress Window
Storm Damage
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
F'nal / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Other:
Pool: _Footings Air/Gas Tests _Final
Siding: _Stucco Lath _Stone Lath Brick
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Erosion Control
Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
Address:, 1621 Summit Hill S Zip: 55122
Lot: 16 Block: 1 Subdivision: Summit Hill
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
Deck
Fireplace
r
• Verify with your builder that roof test caps from the plumbing system have been removed.
• Turn 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.
V BUILDING INSPECTOR: + -
CONTRACTOR:
Delta Development
3902 Cedarvale Dr
Eagan, NIN 55122
Site address: / 6-2 l 5c)M114 j T jr4t L L- Lot Lj Block L Subd. 50M M t T' A+ L L
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 1 11 ^ Ili 1A 6?d (, IiL
Furnace I X, Iv - -
T21-
ooao
Ole?r3`' Pdc?
Dryer -
1W 6 _ njDL 4i • j# `1? DcrcT
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
YES NO
Kitchen kitchen Q[) U r- L-7V I1 3 US
Bathroom 1 13 POA" 3 e de -S LP)
Bathroom 2 '31?401L1 e / gap Sa
Bathroom 3 ,5-0
Bathroom 4
Other
FIREPLACES
LOCATION
GAS
WOOD
MANUFACTURER
MODEL
BTU'S VENTING
DIRECT ATMOS
r - 7 1,•4 s7) 3-W"S046 ,0
` Over /S zi
MAKE-UP AIR MODEL TYPE CFM's
W- C'QP?7-Za0V a.? GILVIn4e-
I hereby acknowledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan
//- T 0 3
Date
This form is the responsibility of the General Contractor.
Lo ? l to
S ? w? vv\ .
at w S q t-c?-j e,? 5ga5'> A 539 8 03
t ` RESIDENTIAL BUILDING MQ Scl a5 y - # ? 0, 5 b
Permit Application
City Of Eagan PP 5CI a i55
3830 Pilot Knob Road, Eagan Mn 55122 _
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reouirements Remodel/Repair Reauirements
3 registered site surveys showing sq it of lot sq. ft of house; and all roofed areas 2 copies of plan
(20% maximum lot coverage allowed) 1 set of Energy calculations for heated additions
2 copies of plan showing beam & window saes; poured found design, etc. 1 site survey for additions & decks
1 set of Energy Calculations Addition - indicate hon-site septic system
3 copies of Tree Preservation Plan if lot platted after 7/1193
Rim Joist Detail Options selection sheet (bldgs with 3 or less units y 7 (4 S
It to 50
A' 5559.03
e Use Onl
2ert of Survey Recd
' I I b I
Pres Plan Recd
T Pres Not Reqd
_On-site Septic System
Date Y' / / Z
Site Address -E '
1621 / 03 Construction Cost
E- 9 ? Unit/Ste #
Summit Hill
Description of Work New Home Construction
Multi-Family Bldg _ Y }L N Fireplace(s) _ 0 X I _ 2
Property Owner _Delta Development, Inc Telephone#(651)454-1600
Contractor Delt a Development, Inc
Address 3902
State MN Cedarvale Dr
Zip 55122 City Eagan
Telephone#651 Y454-1600
COMPLETE THIS AREA ONLY IF
R Minnesota Rules 7670 Cateeorv 1
Energy Code Category • Residential Ventilation Category 1 Worksheet
(J submission type) Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber Matthew Daniels
Mechanical Contractor Wenzel Heating & Air
Sewer/Water Contractor Star Plumbi
I hereby apply for a Residential Building Permit and acknowledge that the inf ation is cosh Pte accurate;
that the work will be in conformance with the ordinances and codes of the 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. n
A NEW BUILDING
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
Telephone #6151) 423-3730
Telephone #651
5-a-bkv TF'141&&?r2'-'CXUTJ? 1bri46-5.
Applicant's Printed Name Applicant's 'gnature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
`X 02 SF Dwelling ? 08 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 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 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
31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement / 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation tC ?? Occupancy (Bl C 3 ° Yd- MC/ES System
Census Code _ r o J Zoning /2.0 City Water
SAC Units _ Stories C;? ???3ttt ( Booster Pump
Nbr. of Units T Sq. Ft. PRV
Nbr. of Bldgs Length ?flr040 If Fire Sprinklered
Type of Const A- Width V y,
REQUIRED INSPECTIONS
Footings (new bldg) Finab'C.O.
Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Plumbing
?C Foundation _ HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests -Final
Framing _ Siding _ Stucco - Stone
?,C Fireplace 4 R.I. _(Air Test coal _ Windows (new/replacement)
Insulation / _ Retaining Wall
r
Approved By Z Building Inspector
-------------------------------------------------------------------- ----- - -- - ------ - - - - ---------------------------------------
Base Fee n 1-511 I -- J 3 0 x i e-
B
Surcharge r
Plan Review J
MC/ES SAC q A o 3 3Q
-I?
City SAC ?- An 1173
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant f _U J?? 4° r
License Search
Copies !
Other
Total J S /
0 -e
Permit Number
MECcheck Compliance Report
2000 Minnesota Energy Code
MECcheck Software Version 3.3 Release lb
Data filename: C:\Program Files\Check\MECcheck\Woodbridge.cck
TITLE: Summit Hill - Woodbridge
COUNTY: Dakota
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Family
DATE: 04/25/02
PROJECT INFORMATION:
Delta Homes
3902 Cedarvale Dr.
Eagan, MN 55122
COMPANY INFORMATION:
ESG Architects, Inc
700 Third St. S.
Minneapolis, MN 55415
COMPLIANCE: Passes
Maximum UA = 435
Your Home = 396
9.0% Better Than Code
Second Floor Ceiling: Raised or Energy Truss
First Floor Ceiling: Raised or Energy Truss
Second Floor Wall: Wood Frame, 16" o.c.
2nd Floor Window:
Above Grade, Vinyl Frame, Double Pane with Low-E
First Floor Wall: Wood Frame, 16" o.c.
1st Floor Window:
Above Grade, Vinyl Frame, Double Pane with Low-E
1st Floor Door: Solid
Basement Wall:
Solid Concrete or Masonry, 82' ht/7.7' bg/8.2' insul
Basement Window:
Basement> 5.6 ft2, Vinyl Frame, Double Pane with Low-E
Floor over Entry: All-Wood Joist/Truss, Over Outside Air
Checked By/Date
Gross Glazing
Area or Cavity Cont. or Door
Perimeter R-Value R-Value U-Factor UA
1082 30.0 0.0
169 30.0 0.0
1269 19.0 0.0
79 0.370
1740 19.0 0.0
229 0.350
40 0350
1208 11.0 0.0
15 0.370
75 30.0 0.0
35
70
29
87
80
14
68
t
Proposed and Maximum U-Factor Averages Proposed Maximum
Average U-Factor Allowed U-Factor
0.356 0.370
Above-Grade Windows and Glass Doors
Includes Foundation Windows> 5.6 ft2
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 the 2000 Minnesota Energy Code requirements in MECcheck Version
3.3 Release lb and to comply with the mandatory requirements listed in the MECcheck Inspection
Checklist.
Date S j Z- o3
Builder/Designer
04/08/02 13:20 FAX 6518949955 WENZEL.HEATING & AC + DELTA CONSTR 16005/005
Part B. DEP'J"MESSURIZATION PROTECTION
Check option used,. O Fuel burning equipment (complete schedules below) O No fuel burning e
I mucnoiis
Step 1. Complete the Combustion Equipment Schedule below. Only aryipmem
with a Y (Yes) may be selected under the "Category I" alternate.
Step 2. Complete Erhaus Makr-vp Air Schedule on the right if direct or power
vented or solid fuel atmospheric vent space heating equipment is
selected
RM / MAK IUP AIR S CHEDULE*.
F.tiLatmdWoJeesover 3110dm- ':.Flow-,
=cfm
?cfh-
;e5m
ventilation must be provided per the larger quantity calculated below)
cubic feet x 0.00583 /minute cfm I [ L.?1 1 x 15 efttdbedroom)+ 15 cfm cfm
Statement of Compliance: The proposed building design represented in these documents is consistent with the building plowso
specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the
cetig sums of th to Energy Code.
Applicant (print name) Signature to Telephone number
nmaele?
Part C2. VENTILATION (Submit Part C2 upon completion of system verificationt)
}C ---------------------------------
t,.t, c•.. e.t,t. , Permit Number `1-
TOTALS
Fan description or location
MEASURED Intake cfm chn crm cfm cfm
PERFORMANCEt Exhaust cfm cfm clrrr cfin
t Ventilation rate must be measured and verified when the perftxmance option is used in lieu of the prescriptive option for the
sealia of fats in the building conditioned erne a (from Pan A).
Compliance Statement Installed ventilation system is in compliance with MN Energy Code and is sized to provide the oesign air
now.
Applieam (print name) Signature Date Telephone number
Part Ci. VENTILATION
V
Oa
1
f ?
?
Vo
?
62' ?
Q/ ?
B? ?
2/0
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATIONS 1
PROPERTY LEGAL: 4L 6 K I S u'.w m 't t 17) LL
DATE OF SURVEY: S- 9 - 0'3
LATEST REVISION:
C
rc
m
r
U
Q DOCUMENT STANDARDS
? • Registered Land Surveyor signature and company
? • Building Permit Applicant
? • Legaldescription
? • Address
? • North arrow and scale
? • House type (rambler, walkout, split w/o, split entry, lookout, etc.)
? • Directional drainage arrows with slope/gradient %
? • Proposed/existing sewer and water services & invert elevation
? • Street name
? • Driveway
? • Lot Square Footage
? • Lot Coverage
ELEVATIONS
Existing
Ei?/ ? ? • Sewer service (or Proposed)
I/ ? ? • Property comers
IDS ? ? • Top of curb at the driveway and property line extensions
? W/o • Elevations of any existing adjacent homes
? Ii3?? • Adequate footing depth of structures due to adjacent utility trenches
? V ? • Waterways (pond, stream, etc.)
Proposed
? • Garage floor
LP' ? ? • Basement floor
L9?? ? • Lowest exposed elevation (walkout/window)
Cai? ? • Property comers
0/0 ? • Front and rear of home at the foundation
PONDING AREA (if applicable)
? 2"D • Easement line
? V
C] • NWL
? -/
CRI ? • HWL
? V ? • Pond # designation
? tom?
/ • Emergency Overflow Elevation
? 0
; • Pond/Wetland buffer delineation
p/? ?
2" C ?
vb ?
?/? I7
• Lot lines/Bearings & dimensions
• Right-of-way and street width (to back of curb)
• Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent footings)
• Show all easements of record and any City utilities within those easements
• Setbacks of proposed structure and sideyard setback of adjacent existing structures
• Retaining wall requirements, if an
Reviewed:
GJFORMS/Building Permit Application
Surveyor's Certificate
SURVEY FOR : Delta Homes
DESCRIBED AS : Lot 16, Block 1, SUMMIT HILL, City of Eagan, Dakota County, Minnesota
and reserving easements of record.
MAY 1 ;? RECD
$1 L-r
'11:Ea.s1
.T i `G? Il'wy `
1"<f'
LOT SQ. FOOTAGE = 3,696
HSE SQ. FOOTAGE = 1,568
LOT COVERAGE = 42%
PROPOSED ELEVATIONS
Top of Foundation =964.8
Garage Floor =964.4
Basement Floor =956.7
Aprox. Sewer Service =952.5
Proposed Elev. = 0
Existing Elev.
Drainage Directions = -
Denotes Offset Stake =
BENCHMARK,
CP# 9002
EL=953.41
i'
Y
MIN. SETBACK REQUIREMENTS
Front - House Side -
Rear - Garage Side-
HEDL UND I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION
OF THE BOUNDARIES OF THE ABOVE DESCRIBED PROPERTY AS SURVEYED
BY ME OR UNDER MY DIRECT SUPERVISION AND DOES NOT PURPORT TO
PLANNING ENGINEERING SURVEYING SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN.
2005 Pin Oak Drive
/?/ j?.
Eagan, MN 55122 DATE !./
Phone: (651) 405-6600 J E LINDG N, LAND RVEYOF
Fax: (651) 405-6606 INNESOTA LICENSE NUMBER 14376
JOB NO:
03R-275
Summit Hills
SCALE: 1 inch = 30 feet
Cities Digital
ity Control
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Every effort was made to capture the content
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Trust Repair (111)
Truss installed backwards.
1. Remove point toad at 6.5.12.
2. Install new (2) piy 42 01102 SPF diagonal web in location shown cutting ends accuratelY to bear.
3.''Applyi- 314°s4PA rand 48124 sheathing to eack face of the truss in locations and dimensions as shovm_aaiag coustructiofiz
;adhesive iµ all contacting surfaces, nslling to tall members with (6) Sd common nails per linear foot ina stasserod pattern.
4. Relocate bearing to location shown.
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA108933
Date Issued:01/24/2013
Permit Category:ePermit
Site Address: 1621 Summit Hill
Lot:16 Block: 1 Addition: Summit Hill
PID:10-72970-01-160
Use:
Description:
Sub Type:e - Water Softener
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Jolene Mehle
17484 Goodland Path
lakeville, MN 55044
952-953-4643
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
$60.00 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 -
James Jarvis
1621 Summit Hill
Eagan MN 55122
Dakota Water Treatment
17484 Goodland Path
Lakeville MN 55044
(952) 953-4643
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117284
Date Issued:10/16/2013
Permit Category:ePermit
Site Address: 1621 Summit Hill
Lot:16 Block: 1 Addition: Summit Hill
PID:10-72970-01-160
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
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 by law in ALL single family homes .
Ashley Harrington
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
James Jarvis
1621 Summit Hill
Eagan MN 55122
Cedar Creek Construction
23383 Redwood Ct NW
St Francis MN 55070
(612) 564-6888
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type: Mechanical
Permit Number: EA135465
Date Issued: 03/16/2016
of ER 1n Permit Category: ePermit
Site Address: 1621 Summit Hill
Lot: 16 Block: I Addition: Summit Hill
PID: 10-72970-01-160
Use:
Description:
Sub Type: Residential
Work Type: Replace
Description: Furnace
Comments: Questions regarding electrical permit requirements should be directed to State Electrical Inspector,Mark Anderson at(952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes(Minnesota State
Fee Summary: ME-Permit Fee(Replacements) $59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
Total: $60.00
Contractor: - Applicant - Owner:
Wenzel Heating&Air Conditioning James Jarvis
4145 Old Sibley Memorial Hwy 1621 Summit Hill
Eagan MN 55122 Eagan MN 55122
(651)894-9898 (651)330-6399
1 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.
Applicant/Permitee:Signature Issued By:Signature