4630 Summit Pass
~ 1- C31 d ck_ a
Po-~ S~' w fQ ~
RESIDENTIAL B DING
~ Permit Application
. . City Of Eagan
` 3830 Pilot I{nob Road, Eagan Mn 55122 \
Telephone # 651-675-5675 FAX # 651-675-5674
New ConsWC4on Reauirements RZ- O Reouirements ~ ce~se Onl ! 0
3 registered site suneys shawing sq. ft ol bt, sq. R of house; and II ioofed areas 2 copies W plan ert of Survey.Reaa~ _
(20q, maximum bt coverege albwed) 1 set of Energy Calcuiatlans for heated additions Tree Pres PlanTi~"'
2 copies of plan showing beam & windaw sizes; poured found desgn, etc. 1 site survey for addiUons & dedcs Tree Pres Not Reqd ~i`kio
isetofEneyyCakulatlons Addilion-mdicaterfon-s/Tesepfksystem On-site5eptlc5yslem 1-I-7.63
3 mpes oi Tree Preservation Plan d lot platted after 711/93 V\
Rim Joist Delail Options selection sheet (bldgs wilh 3 or less unifs C0 , SuV~/-Q A~
Date ~ / A0 / 03 Construction Cost
Site Address ~(0 3Q rn/~-i I T /~~155 UniUSte
Description of Work S f~
Multi-Family Bldg _ Y N Fireplace(s) _ 0_ 1 _ 2
Property Owner Telephone # ( )
Contractor
Address 5~T~J 11i21AN l~/OL(tilD ~ City jA)1qyza72A
State Zip 55391 Telephone #(~5Z y73 -O 5R-3
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Wwksheet • New Energy Code Worksheet
(d submission type) ' Su6mitted Submitted
• Energy Envelope Calculations Submitted
Licensed Plumber ELfFtiAE2 MECffA,JlCRC. Telephone #(9$2)
Mechanical Contractor LLPiUDEIZ, q (1192
SewedWater Contractor ~ II lC~ I T Ile hon #:Z)
II .1UL 1 6 1003 lil ~
u
I hereby appfy for a Residential Building Permit and ac1mlG~ledge=tYiat- ~mfoation is complete and 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 pernut, and work is not to start without a
permii; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
ApplicanYs Printed Name ApplicanYs Signature
OFFICE USE ONLY
Sub Types
,
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
?1( 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 E#. Alt - Multi
? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multl Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
O 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 (FoundaGon) ? 45 Fire Repair
O 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •DemOlidOn (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units 1 Stories v` Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs f Length Fire Sprinklered
Type of Const V A,J Width (p,5 ~
REQUIREDINSPECTIONS
Foohngs(new bldg) ~ FinaUC.O.
Footings (deck) FinaUNo C.O.
Footings (addirion) Plumbin~
Foundation HVAC
_ Drain Tile Other
Roof Ice & Water Final Pool Ftgs Au/Gas Tests _ Final
X Frammg Siding Stucco Stone
~ Fireplace K R.I. _XAir Test ~ Final Windows (new/replacement)
~ Insularion _ Retaining Wall
_ Approved By~ Z. , Building Inspector
Base Fee 1
Surcharge ~ ~ 7
Plan Review
MC/ES SAC ~~s' a L~ ~ S y = ~
cry sac fr, 7 r;L
Utility Connection Charge ~ 1~ 071
S&W Permit & Surcharge
Treatment Plant
License Search STUJP
Copies
Other
Total
. • Permit Number
MECcheck Compliance Report
1999 Minnesota Energy Code
MECcheck Software Version 32 Release 1 Checked By/Date
TITLE: Headley and Hynatu Williamson
COUNTY: Dakota
STATE: Minnesoia
ZONE. 2
CONSTRUCT[ON TYPE: Single Family
DATE: 07/14/03
DATE OF PLANS: June 19, 2003
PROJECT INFORMAT[ON:
7205
4630 Summit Pass
Stonecliffe
COMPANY INFORMATION:
Lungren Bros. Construction
NOTES:
Wakefield "A" Base Plan
COMPLIANCE: Passes
Maximum UA = 696
Your Honte = 653
6.2% Better Than Code
Gross Glazing
Area or Cavity Cont. or poor
Perimeter R-Value R-Value U-Factor UA
Ceiling 1: Flat Ceiling or Scissor Truss 1744 44.0 0.0 47
Wall l: Wood Frame, 16" o.c. 404 19.0 0.0 19
Window 1: Above Grade, Wood Frame, Double Pane with Low-E 86 0360 31
Wall 2: Wood Frame, 16" o.c. 1904 19.0 0.0 91
Window 2: Above Grade, Wood Frame, Double Pane with Low-E 327 0.340 111
Door 3: Solid 38 0.067 3
Wall 3: Wood Frame, 16" o.c. 276 13.0 0.0 11
Window 3: Above Grade, Wood Frame, Double Pane with Low-E 13 7 0340 47
Wall 4: Wood Frame, 16" o.c. 1716 19.0 0.0 89
W indow 5: Above Grade, Wood Frame, Double Pane with Low-E 213 0340 72
Wall 5: Wood Frame, 16" o.c. 407 12.0 0.0 34
Basement Wall 1:
Solid Concrete or Masonry, 9.0' htl8.5' bg/9.0' insul 1156 0.0 5.0 42
Floor 1: All-Wood JoisUTmss, Over Outside Air 32 30.0 0.0 1
Floor 2: All-Wood 7oisUTruss, Over Outside Air 144 30.0 0.0 5
Furnace l: Forced Hot Air, 90 AFUE
Proposed and Maximum U-Factor Averages
• Proposed Maximum
• Average U-Factor Allowed U-Factor
Above-Grade Windows and Glass Doors 0342 0370
fncludes Foundation Windows> 5.6 ft2
COMPL[ANCE STATEMENT: The proposed building desi~n described here is consistent with the building plans,
specifications, and other calculations su6mitted with the permit application. The proposed building has been
designed to meet the 1999 Minnesota Energy Code requirements in MECcheck Version 3.2 Aelease 1.
Builder!Desianer Date - "I'~
~ nF~cc~~Fc t.,G co~' Y
TREE PRESERVATION PLAN SUMIIIf44R~~
-CITY OF EAGAN FORESTRYDIVISfON
,"651-675=5300-
(SEE ATTACHMENTS)
Development -P i 1\3E lR C~~ P69S 7'- &u. _
Lot Num6er S Block Number Z
Address SLfLiMB'VL I Y Pf`}SS
Builder ll.vNDfcRlc~N 'RTZ(JS CONST. T~t~.
CoN-Ti,1C-t = (Sfln (t) ,
Plt~ NF a S2 - ZAq - yYN
Tree Protection Requirements:
Tree Fencing
Oak Tree Pruning ({mmediately seal wounds during Apri11 to July 31)
Therepeutic Pruning
Retaining Wall
Other:
Reqlacement Trees:
Not Required
As Follows:
EAGAN FDREoSTRY DIVIor9ION
Attachments: ~~~~EWED
Yes
No By
DATE
Additional Nates:
H:Sghove\2002fi1e\treepres\Tree Preservation Plan Summary-2002
" l 30 15 0 15 30 5p REV151 NS
Q ~
6 SGALE IN FEET
~ LEGEND
,u DENOTESSANITARVMqryHOLE
~ S Q
~ OENOTESNYDRANi
r ~ DENOTES CATCH BASIN J
S OENOiESSrWITPRY3EWEft U ~
~ I A I W DENOTESWATERMAIN uORTH Z M1
0 ST DENOTESSiORMSEWER ~
a ~ DENOiESSTORMMANHOLE ~ a
- OENOTESSTORIAAPRON ~ N
dr
J I (9665)~ OENOTESAPPROXIMqTEREAROFBIIILDINGPAD (/~^E
1 v r
9a'h (930.00 c»,.n ~ 47.97 m g,e 02 S89'19' 7"W 182.28 (sso.al SETBACKS ~ s
3
Lf~
Iw0.i) %955 1 m }
20Q ^SyJ s I pSH 18~ ~5 MIN.SIDEYARD ETeACH=S'~,q10'BOTHSIDES ~
9 10 ~
MIN ftEMYRROSEfHqCK=15'
I ~ O.. . 20 ~ 9Y_la"6SI ~ N
C ~ 9554 PROPOSED CsqRAGE fL00R El.EVATION~ 962 Q2
9
6 ~ gy A. 25.5 I\ y I ~ PROPOSEO iOP OF FOUNDATION ELEVATION- 963 (n ~
~ 9 ^ ASN I< PROPOSEOBASEMENTROORELEVATION= 950
8.02 W a y V W LOOKOUT OPENING ELEVATIDN= 95Z5 P`Owa S 3y,Y'
I ~ 9 W ~ 9"~h I I O. C o v~ ~ O - ~
9N, m ORAINAGE&UTLJTY ~ ALLOFFSEiiRON3AREMFAStIREOTOHUNDREDTHS ~
a EASEMENt I ~ OFqFOOTPND CnNBEUSEDA50ENCHhWiKS
5 0. a~ .o ~c v M1 Ss g K53
~ p ~ _ ~n+ o I a5N t< Z O DENOMS
O m
~ 958 q, i 397
T. i \ z 000.0 DENOTES E%ISTING
ELEV
- JS (OOOO OENOTEpSPROPOSED
U }
aS tn l~e] 95 ~ ELEVATION LyJ
9552)3O.OOf9~ u4 9 (910.3) + DENOiE31DIRECTION > rj) 4
ss ° S89'79-27"W 171.1 OFSURFACEORAINAGE cc O~j `o
DENOTESSANITARY D ~ w
Om Z Y
5 CAR FLR. SEWER SERVICE ELEVATION (0
7 I 8 (958.0) 0 o Z ~ f
RTIREOPINIONWASNOTFURNISHEOTOTMESURVEVOR W ~ W ~
NORWASASPEQFICTIRESEARCMPoRTHEE%ISTENCEOR ¢ F- ~
6 ~ NON-FXISTENCEOFftECOROED ORUNRECOROEO Q yadj ~C/) a
EASEMENTSCONDUCTEDBYTHESURVEVORASPAfiTOF U Z W
' THISSURVEY. LL ? O p
~ IHEREeYCERTIFYTHATTHISISATRUEPND CORRECT W J U ~
~ REPRESENiqT10NOFASURVEYOFTHEBOUNOPRIESOF. U
LOT 5, BLOCK 2, PINETREE PASS ]TN MpITION
DAKOTq COUNTV, MINNESOiq
TREESUMMARY ANDTHELOCATIONOFALLBOILDINGS,IFANY,THEfiEON,ANO
EXISTINGTREES=3 ALLVISIBIEENC0.0ACHMENTS,IFqNY,RjOMORONSND DRAWN
HARDCOVER ~I TREESREMOVED=O LANO. ASSURVEVED BVMETHI5~ OqY0FJUNE,300 RS
IOTAREA=15,022SF CHECKED
HOIlSEPREA=2,A165F GRG
DATE
COVERAGE=165% ~ ~ 7-01-2003
6 FV
p~
E Gary R. Germontl SCALE
AS SHOwN
BUIIDING PADCORRECTION PER GRADING PUN APPROVEO BYTHE CITV OF EqGqry, ~ryECONiRACTOft ^ Licensetl Land Surreyoq Mma Lia No. 24764 JOB NO.
SHALL BE ftESPON5IBLE FOR THE FlELO VEHIFICATION OF THE E%ACi LOCATION OF THF BUILDING PPD. 5402 06
~
g~
y 4
(n5S5(o 8/alo~l
2004 RESIDENTIAL BUII.,DING PERNIIT APPLICATIONL ~2.[&- ~
, City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauiremenfs RernodelRteoair Reaulrements
3 registered sile surveys showing sq. ft of IM, sq. R of house; and all roofed areas 2 copies of plan
(20% marzimum bt coversge aDOwed) 7 set o( Energy Cakulations for heafed eddi6ons
2 copies of plan showmg beam & window sizes; poured found design, etc. 1 site survey for addifions & decka
1 Set Of Eneigy CaIW IafanS Addition - indicafe ifon-sde sep6c System
3 coples ol Tree Preservation Plan H IM platted after711/93
Rim Joist Deiail OpHwis selection shcet (bldgs wilh 3 m less units
Date 8 / D¢ ConstrucHon Cost ~ g) 0 D D
Site Address s~- ( o2~ 0 '.~U m vri 14 Pa s 5 UniUSte #
Description of Work CtdA ? Vl p W
Multi-Family Bldg _ Y? N Fireplace(s) ?0 _ 1 _ 2
Property Owner Wd leIi1 Wl lhA VtlLS p 1'\.. Telep6one 16 1) G'i 810 - b S ~"Z-
Contractor 1'VDYI'ElC? CfiYl`+VvIG
Address 144 6D ~,t~~ v1 SV 1( ~ e, QV-W~ City gU. V n S i l l-C~
State Zip SS~i D(p Telephone #(4~1SZ) 44 0- l")SO
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category - MinIlesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
• Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J su6mission type) SubmiMed Submltted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber Telephone )
Mechanical Contracto' Telephone J
Sewer/Water Contract r Telephone )
B
I hereby apply for a Residenrial Building Permit and aclmowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a pemut, and work is not to start without a
pernut; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
V-0 vGt C~`1 v l S~-p ~ ~nC ?
Applicant's Printed Name ApplicanYs Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex O 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi
0 03 01 of _ plex ? 09 07-piex ? 17 Garege ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex X 18 Deck ? 23 Porch (screenlgazebo) ? 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
? 37 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
Y 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Rep18CCmCnt 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code ~L4- Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const VW Width
REQUIRED INSPECTIONS
Footings(new bldg) FinaUC.O.
~C Footings(deck) ~ FinaVNo C.O.
r-` Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Tes[ _ Final _ Windows
_ Insulation _ Retaining Wall
Approved By: Building Inspector
Base Fee l^
Suroharge
Plan Review
r
MC/ES SAC 70
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
ARCHITECTURAL C4NTROL
On this date, G O~ , pursuant to its authority and
responsibilities under the Declaration of Covenants, Conditions, Restrictions and
Reservations for Stonecliffe, the Architectural Review Committee and the Board of
Directors oted 1) on the acceptability of the plans submitted by
_o~rl 6.~.~iz. /~/,~i~S~/~ on s~21~0~ , for a
L' lw at I.ot , Block
yZO30 .Su._,=,- 10 S which aze more specifically identified, as
attached and 2) on the acceptability of'
which has been identified as the builder who will ast~au„~the improvements. The
Architectural Review Committee's decision is fCajgprove ~ve the plaiis
submitted. Homeowner is responsible for verifying whether improvement requires a
building permit from jurisdiction or residence prior to construction. Approval of
improvement does not imply that improvement meets with municipal ordinances or other
governmental regulations.
Notarions: •
1 ~
!~e'O/ 4119 1"'A"s
r-
The Architectural Review Committee's decision is that the proposed 33uilder is
acceptable/unacceptable for the following reasons: A`II
The above actions are hereby certified by Jeff Duncan, Chairman of the Stonecliff'e
Architectural Review Committee, on this /p4day of zLn e 204Y
Approval of any work by the Committee shall not constitute an expressed or implied
' warranty by the Committee ar the members of the Committee that the work cornpties
' with municipal ordinances or otlxer governnientai regulations or that the work has been
well designed or well built.
? ~ 30 15 0 15 3p 5p AEVISIONS
< $
~ h- ~ SCALE IN FEET
' LEGEND
-C, 40 ~
N J
OENOTESSLVITAftYMrWNOLE
OENOTESITYORAff
L Re
J • ` ` Wi DFNOTESCATCHBq51N
UJ I 1 \V ` 5 OENOTESSANITARYSEWER
4 y ~ ~ W DENOTES WATER0.wN uoxrn Z e
5T DENOTESSTORM SEwER p
DENOTESSTORMninNHOLE
~ ~6 ^ DENOTESSTORMMqON ~
~ I (986.5) - - DENOTES MPROXMIATE REAR OF BUILOING PM
a ~ ~4
_ os (901 1) .TAQ 47.97 m 89' . 7~.W 182.28
(93Q0~ ~ 6
n° 30.00 ~u~ ssa oz SETBACKS W t
99 . ~ . Iw0.f~ u 0] ~
` %955 t
9y10 ~,s~ p p.4~ o~333 I ` n5H t8-- S MIN.FRONTYARpSETBqCK=30' W
~ MIN.SIDEYPRDSETBACK=5',10'BOTHSIOES $
a 5 MIN.REARYAADSETBnCK=15'
v~ O 2.0 mA 9g99 . hb 1 1~ F-
g~~` (&TS}~° ' ]5.5 9554 PROGOSEOGARAGEFLOORELEVATION= 962 Q~
g~8 ~;r'ly.}' e "9 Ix I ~p PROPOSEDTOPOFFOUNDATIONELEVATON=9fi3
~O M~ ~~b='~:'.i g_p1 I~ ~ paN i4 PROPOSEUBASEMENTFLOORELEVATION= 954 i o
I 1s`y W 8' V u ~ W - LOOKOUTOPENINGEIEVATION= 9575 yp
"l p5~0 m ~ 9a~h I I o c r~ 2o Q
~ '~9~I I$ P 90 0~ ORAINAGE k UTil,ltt ~ ALLOFFSETIRONSAqEMEASUREO TOHUNDREDTHS
~ N 953~ EASEMENi I ~ OFAFOOTPNOCnNBEUSEDASeENCHM/.RKS
50. $ .o ~'nc° s x t0 *s oa+~`
p n~ ASH IL O DENOTES 95g~~ m 397 Z MONUNEM
y b DENOTESEXISTING
r^ 10 ry A ~ 1 % D000 5 ELEVATION
Vl ~qh M1~~ 9`~~~ ~n faaxfl~ Lu 9r - - - - - - (OOO.O) DENOWS W
(9553)}O.OO 47.97 (940.3) ~ DENOlESOiRECT10N > U) c
Q~, o g89•119'27'•yy 171.1 OfSURFALEORAINAGE O~ 0 U O
DENpTFSSPNRARY
S GAR. M. SEWERSERVICEEtEVATOry N Z~
LL ~ m ~ z
7 ~ 8 (956.0) - -g
ATIREOPINIONwnSNOTFUFNISHEOTOTHESURVEYOR 0 wZ
q NORWASASPECIFICTiLESEMCMi0RT1EEXISTENCEOft W ~ W ~
6 t \ I NON-EXISTENCEOFREfARDEDORUNltECOROED Q a~~IJ ~
` EASEMENTSCONDUCTEOBYTNESURVEYORASPARTOF UZ
~ TNISSURVEY. LL n 0 Q O>
y~ IHEREBYCERTIFVTHATTHISISATFUEANOCOPRECT W J U u
REPRESENTATIONOFRStIRVEYOFTHEBOVNOM1E50F: U
~ LOT 5, BLOCK 2. PINEfREE PASS TTH AOOITON
OAKOTA GOOMY, MINNESOTA
(hTREESUMMARY qNpTHELOCATIONOFRLLBUIL0INGS,IFANY,THEREON.AND
EXISTINGTREE3.3 ALLVISBIEENCROACHMENTS,IFANY,FlWM00.0NSA10 ORAWN
HARDCOVER RI ^ TREESREMOVED=O LAND ASSURVEYE08YMETHI526NDAVOFJUNE,2003. RS
LOTAREA= 15,0233 F. V CHECKEO
HOUSEMEA+2,4i85F GRG
COVEMGE=165% ^ O OATE
14 1-07-2003
NoMGary R. Germond SCALE
ASSHOWN
BULDING PAO CORRECTION PER GRADING PLAN APPROVEO BYTHE CITV OF EAGAN. TNE CONTRACTOR
III. SfULL 9E RESPONSIBIE FOR THE FlELO VE0.IFlCATION OF THE ExnCi LOCATION OF TFIE BUILDiNG PAO. Licensed Lantl Surreyor, Minn. Lic. No, 24764 JOB NO
5402-106
n
0
T W
V
Site address: 7~3 (J QQm rn iT (p s $ Lot -5 81ock Subd. ! j IU6T,Q.E5 eA S S '1~~
On April 15, 2000 the Minnesota Energy Cotle, 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 requiremeMS of the Mn Energy Code, Chapter 7670
OR
_ This structure: will be consUucted to meet more restrictive requiremeNS of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE
WaterHeater x QSm FPS `J '40 600 Pvc
Furnace F}NT ,3S d"1 V ~ 12o.000 1" vG
Dryer
VENTED
EXHAUST SYSTEM LOCATION TYPE MODEL CFM's ves No
Kitchen kitchen
Bathroom 1 50
Balhroom2 15D ~a I D 0
Bathroom 3 ~ ,9A-Q ~
Bathroom 4
Olher
VENTING
FIREPLACE S LOCATION GAS W00~ MANUFACTURER MODEL BTU'S DIRECT ATMOS
! ~ m 1 ~ ~ S~s i rC V3 0 ~O YZI
MAKE-UP AIR MODEL TYPE CFM's
e cE~ 1
I hereby acknowledge that the a6ove information is correct and agree to comply with the Minnesota Energy Code and Ciry of Eagan
requiremenfs.
ttitR. n,C.C.e~ % -7 ~ / Lo -D3
Sign re Date
Ai/j li?~p /.~f'1/~~. ~~GNww„(/1^
Company Nam
' This form is the responsibility of the General Contractor.
Address: 4630 Suuunit Pass Zip: 55123
Lot: 5 Block: 2 Subdivision: Pinetree Pass 7th
THE FOLLOWING ITEMS W F,RE/WERE VOT COMPLETE AT FINAL iNSPECTiON ON -~)Z(Z(f2LJ
Yes No Comments
Final grade - 6" from siding
Permanent steps - gara e
Permanent steps - main ent
Permanent driveway
Permanent gas
Sod/Seeded lawn
TraiUcurb damage
Porch
L,ower leve] finish
Deck
Fireplace
• V erify with your builder that roof test caps from the plumbing system have been removed.
• T um off water supply to the outside lawn faucets before freeze potential exists.
• Call the City's Engineering Deparhnent at 651-675-5646 prior to working in right-of-way or installing
irrigation system.
~ BOILDING INSPEC'IOR: 1 L/
CONTRACTOR:
Lundgren Brothers Construction
935 E. R'ayzata Blvd
Wayzata MN 55391
^ LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDINC, PERMIT APPLICATION
PROPERTYLEGAL: LaT ~ini-I'n?Oi /~A(,,^ 17,~
DATE OP SURVEY:
LATEST REVISION:
d
~
c
A
L
U
a
a
Q DOCUMENT STANDARDS
• Registered Land Surveyor signature and company
~F] ? • Building PertniiApplicant
? • Legal description
0' ? ? • Address
? • North arrow and scale
LN • House type (rambler, walkout, spiit w/o, split entry, lookout, etc.)
? cl~ • Directional drainage artows with slope/gradient %
er~a ? • Proposed/exis6ng sewer and water services & invert etevadon
B'~l ? • Street name
~ ? • Driveway
~ ? • Lot Square Footage
d ? ? • Lot Coverege
ELEVATIONS
/ ExisSna
~d 0 ? / • Sewer service (or Proposed)
X ? • Property comers
X ? ~ . Top of curb at the driveway and property line extensions
i~, ? • Elevations of any existing adjacent homes
iC1 • Adequate footing depth of structures due to adjacent utility trenches
? g' 0 • Watenvays (pond, stream, etc.)
~ Prooosed
V 0 • Garage floor
? • Basement floor
ildr'p ? • Lowest exposed elevation (walkouUwindow)
B~ ? ? ? / • Property comers
0.~L • Front and rear of home at the foundation
PONDING AREA('rf aoolicable)
? 0/~~ • Easement lina
? ? • NWL
? R}/ ? • HWL
? G~ ? • Pond # designation
? g' p • Emergency Overtlow Elevation
? g/? • Pond/4Vetland buffer delineation
/ DIMENSIONS
/0 ? • Lot iinesl8earings 8 dimensions
G3~~ ? • Right-of-way and street width (to back of curb)
? U • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
/ (i.e. all structures requiring permanent footings)
~/~Y7 ? • Show all easements of record and any City utilities within those easements
~ ? . Setbacks of proposed sVuctura and sideyard setback of adjacent existing structures
• Retaining wall requirements, if any tc n„ • ~>w c
Reviewed: l --12 43
Nam Date
G:/FORMS/BUilding Permit Appllcation
30 15 0 15 30 60 REVISIONS
REV.HSE.TYPES
GRADE54` 5/03RS
REV PERC
SCALE IN FEET o§mvm,.as y
~ LEGEND
Pa R o tJ o 4'E ;;.:1 ~ I1 d L!' O DENOTES SANITARY MANHOLE
- - DENOTES ITYDRANT
~ DENOTES CATCH BASIN
I ~ S DENOTES SANITARY SEWER b I
t I w DENOTES WATERMAIN NOR7H z~
I ST DENOTES STORM SEWER
~ DENOTESSTORM MANHOLE
n DENOTES STORM APRON
~ g6~1 DENOTES APPROXIMATE REAR OF BUILDING PAD d a
~n 966 42 X~ 960.87 (D aN
( 96 t. 1) c%~.»~`~47.97 ° S89°19'27"W 182.28 (gsa.a) S E T B A C K S W~
30.0035&.t72 950.3
° 0.5 cn Sg (.s) t m a
-3 h ~~3 J v= - 2a_4~ X9~S~1g- ~-~5 MIN. FRONT YARD SETBACK = 30' w 3
9Sg AS MIN. SIDE YARD SETBACK = 5', 10' BOTH SIDES ~ o
10 J I ~ /4 N MIN. REAR YARD SEIBACK = 15'
__I I ~
0 a g9 ~ o
~ nr o rni 9`~ ° j Fivii ~j PROPOSED GARAGE FLOOR ELEVATION= 962
I 0 ! ° - S.a
0 25.5 i`` ; r r A A~ f I Op PROPOSEO TOP OF FOUNDATION ELEVATION= 963 ~~2
~ 14 PROPOSED BASEMENT FLOOR ELEVATION= 954 yoas sy
ti
~ "O 6.02 LOOKOUT OPENING ELEVATION= 957.5 ~ryy
30.00 ~~5 N N~ ~ Q7
;
N~ o 0O k" DRAINAGE & UTILITY I ~ A L L O F F S E T I R O N S A R E M E A S U R E D T O H U N D R E D T H S
z 53.4 EASEMEPI7e \ O OF A FOOT AND CAN BE USED AS BENCHMARKS. ~Nj oES`
0
I~,~ ~ 0 Ny N~ I ASN 14 ~ Q DENOTESIRON
,LJ N ~ z MONUMENT
~ ~ 958 39.9 `O" ~ x 000.0 DENOTES EXISTING
960.2) A T. 957 - ELEVATION
L1~_ 'Np.L r~:~~- - - - 5 (OOO.O) DENOTESPROPOSED ~
5 V, ELEVATION W
a A ` 939 ~7 ~ DENOTES DIRECTION > U) F
~ 5°. (955.2) 30.00 955-6 °S89°19~27~~W ~7~.~7 ~g4~~3) OFSl1RFACEDRAINAGE ~ 0 ~
s 000.0 DENOTES SANITARY ~x ~ z w
SEWER SERVICE ELEVATION p m - Z
m GAR. FLR. . L1- a
1 (956.0) .~:1 o W Z
I 3 _ A TITLE OPINION WAS NOT FURNISHED TO THE SURVEYOR ~ Z
w OP FEPIIPPg ~II WIIP I NOR WAS A SPECIFIC TITLE SEARCH FOR THE EXISTENCE OR ~ a~ ~(a7
B~H R~GUIPB~ ~ NON-EXISTENCE OF RECORDED OR UNRECORDED U w~ U Z W
9 EASEMENTS CONDUCTED BY THE SURVEYOR AS PART OF a Q O o
w THIS SURVEY. H U
Z ~
9 I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT
9 W J ~
y ' REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF. U
m TREE SUMMARY LOT 5, BLOCK 2, PINETREE PASS 7TH ADDITION
o EXISTING TREES = 3 " ; ~ ~ li ,
~ TREES REMOVED = 0 ~ DAKOTA COUNTY, MINNESOTA
AND THE LOCATION OF ALL BUILDINGS, IF ANY, THEREON, AND
ALL V IBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID - DR~AS N
a HARDCOVER 7- Q~i LAND. 5 SURVEYE Y ME THIS 26th DAY OF JUNE, 2003. CHECKED
? LOT AREA = 15A22 S.F. r!'_Fiz.c'~I'+T F~.i4C.U°T~D ~R.~NG P~'' F~ GRG
o HOUSE AREA = 2,476 S.F. J ~ C E. P17 R'LC'B ~j DATE
~ COVERAGE = 16.5°h 7-01-2003
. David B. Pemberton, R.L.S. 40344 signing for SCALE
a NoTE: Gary R. Germond AS SHOWN
a` BUILDING PAD CORRECTION PER GRADING PLAN APPROVED BY THE CITY OF EAGAN. THE CONTRACTOR Licensed Land Surveyor, Minn. Lic. No. 24764 JOB NO.
SHALL BE RESPONSIBLE FOR THE FIELD VERIFICATION OF THE EXACT LOCATION OF THE BUILDING PAD. % 5402-706
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4630 Summit Pass
Lot: 5 Block: 2 Addition: Pinetree Pass 7th
PID:10- 57666- 050 -02
Use:
Description:
Sub Type: e- Reroof
Work Type: New
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Palace Restoration
912 40th Ave NE
Columbia Heights MN 55421
(612) 706 -4113
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Construction Type:
Occupancy:
If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not
acceptable in lieu of inspections.
Permit expired without required inspections. 4/20/2009 CE
- Applicant -
$88.50 0801.4085
$1.50 9001.2195
$90.00
Owner:
Headley Williamson
4630 Summit Pass
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Building
EA087149
10/28/2008
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
For Office Use
�
® Permit#: PP v�
1C
EAGANPermit Fee:
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff:
buildinginspections(c�cityofeagan.com L
2018 RESIDENTIAL PLUMBING PERMIT APPLICATION
, ‘.Date: ///,,// Site Address: / �v ��
Tenant: f-&j "/a A) if 'Mvi 6 t , Suite#:
} (
Name: GCQi !
S,(,
/// /1'r 50-v Phone: v -jResi nt/Okner (
Address/City/Zip: 4/" o =3-6, '3 t..441✓Vi i b. - 5 5-
Name:
Name: License#:
Contractor ".x Address: City:
State: Zip: Phone:
r Contact: Email:
New Replacement —Repair Rebuild Modify Space Work in R.O.W.
"Type of Work — —
"7: Description of work: C—(2( (' -{/(.
RESIDENTIAL
{ Water Heater
Water Softener
Lawn Irrigation(—RPZ/—PVB)
Permit Type
hi
Septic System T . Add Plumbing Fixtures(—Main/ ower Level)
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
*Water Turnaround(add$280.00 if a 3/4"meter is required)
$115.00 Septic System New(includes County fee and 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. www.gor herstateonecalt.orq
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.citvofeaqan.com/subscribe.
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 ication for a permit, and work is not to start without a permit; that he work will be in
ccordance with the approved plan in the case of work w ' requires a review and approval of plans.
Applicant's Printed Name Applicant's Signature
FOROFFICE USE S Re B `� «fT .
Required'It spections :. Under Ground Rough-In ;' mss# Test
Meter Related Iter s:' eter$Size -mann �+
For Office Use
•
„ f , Permit It: ! 171/6
E AG N
Permit Fee: ( q`i/
V'p
A p
RECI.- Date Received: �O �
3830 PILOT KNOB ROAD E
EAGAN,MN 55122-1810 VER
(651)675-56751 TDD:(651)454-8535 I FAX:(651)675-5694 Staff:
buildinginspections@cityofeagan.com FEB 2 0 2018 j"--
2018
'2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: f I 7V16 Site Address: Lt(3 '3 V �I 'r Pli- ,/1M Unit#:
Name: 14 e 4 C L f2 [(hy'n y 7/1'Gt-�- 16O i) Phone: 5 �o - t`D )4 iff l
n v A
def` Address I City I Zip: b 40m PI Cc,
rt ;`
Applicant is: X Owner Contractor
Description of work:
Construction Cost: Multi-Family Building:(Yes I No )
Company: Contact:
Tjiq
Address: City:
State: Zip: Phone: Email:
License#: Lead Certificate#:
If the project is exempt from lead certification, please explain why:
2 0 2 /& 11 &O
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:
�
ume MRiAt.Si ! # 'k'it-***** , $ W
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.citvofeaoan.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 YQU 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.copherstateonecall.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 ork is not to start without a permit; that the work will be in
accordance with the approved plan in the case ork,which requires a review and appro of plans.
X ��/ X
A • rc/Iant's Printed Name 77 A licant's Signature ( 1),/-•••
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family)
— Single Family _ Garage — Porch(4-Season) _ Exterior Alteration(Multi)
—
Multi _ Deck — Porch(Screen/Gazebo/Pergola) _ Miscellaneous
_ 01 of_Plex Lower Level , Pool _ Accessory Building
WORK TYPES
L , 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 Z Li, fl*;4:' •— Occupancy 2 L- I MCES System
Plan Review `'‘, Code Edition t010 2 D15-- SAC Units
(25% 1.00%e , ) Zoning Z i City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction V Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) Final/No C.O. Required
Foundation Foundation Before Backfill (k0 HVAC_Gas Service Test Gas Line Air Test
Roof: Ice&Water _Final Pool:_Footings Air/Gas Tests _Final
20 Framing 30 Minutes 1 Hour Drain Tile
fireplace:_Rough in Air Test Final Siding:_Stucco Lath _Stone Lath Brick_EFFS
i0 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:
--1-D171/29)Reviewed By: 217P 9- , Building Inspector
RESIDENTIAL FEES ,pe, ss, FT--
Base Fee
Surcharge ( ) L a-V ' . 5,'• 14,7=
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
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