4653 Summit Pass
(~SG~b .30~5?.~
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date ~ / I ~'I / ~ ~ C I nG~
Site Street Address ~-Y~L ` Jv~ ~'1'1 itiLc i-/t
~~lT~.U Unit #
Property Owner l~~C'~C%~
~J~,~.~Cx-~ 1r~ "CJ~ Telephone# F%~~ '~7~ '~"f
`J -
Contractor JtC:.~:
-~~i , '~i..~11~~~~\ X Telephone# ~I~~i G~ ~~i~j
~ ~ I1'
Address i~~t~~~'l ~~-~C'a~ ~Z~ 1~.7 City~ Lc~-~-~~. State Zip
~'v
The Applicant is: _ Owner ~Ctontractor Other
~
Alterations to existing dweiling ~~`y ~ 4 $ 50.00
_Add fixtures to rooms, excluding water soft n~r ~~d~y~~t~ rceater
_Septic5ystemAbandonmeM ~~j
_WaterTurnaround (add $121.00 if a 5/8" me r is r~r _
Other: gy
Water Softener _ Water Heater $ 15.00
_ replacement _ additional
_Lawn Irrigation System RPZ_ new pair _rebuild $ 30.00
State Surcharge $ .50
~SC~
Total ~
I hereby apply for a Residential Plumbing Permit and acknowledge that the +nformation is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
~~,u,~~~ ~ ~~rlf~' / ,/G~ `7_~
AppiicanYs Printed~ ~---J j'' ApplicanYs Signature '
Address: 4653 Summit Pass Zip: 55123
Lot: 4 Block: 1 Subdivision: Pinetree Pass Sth
THE FOLLOWING ITEMS WEIiElWERE NOT COMPI,ETE AT FINAL IT'SPECTION ON ~'Z~ /Q ~
Yes No Gomments
Final ade - 6" from sidin
Pertnanent steps - arage
Permanent st s- main ent
Permanent drivewa
Permanent as
ReYainin Wall ar 3:1 Max Slo e
Sod/Seeded lawn
Trail/curb dasna e
Porch
Lower level finish
Deck
Fire lace f~ i~ 6
• Verify with your builder that roof test caps from the plumbing system have been removed.
• T~im off water supply to the outside lawn faucets before freeze potential e~cists.
e Call the Cih;'s Engi;.~ering Depar:ment at 651-675-55A6 pr.or-to wozking in right-~: ~.n~ay oz instal:ing - :
irrigation system. ` "4-~
Y BUILDING INSPECTOR:
CONTRACTOR:
Lundgren Brothers Construction
935 Wayaata Blvd E
Wayzata MN 55391
Sileaddress: ~~p ~(a i`~~5 Lot~ 81ock~ Subd. ~/~I~T/Z~~ 5
On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air
tightness, and ventilation, was atloptetl. As a result, the City of Eagan is requiring that the following intormation be
submitted prior to issuance of a Certificate of Occupancy.
_ This sWCture: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670
~ OR
This structure: wlll be construcled to meet more restrictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MO~EL BTU'S VENTING TYPE
waterHeater ~ (,S - c~ PV~-
Furnace ~Q ~ Z Q (2 U ~
Dryer
VENTEO
EXHAUSTSYSTEM LOCATION TYPE MODEL CFM'S Yes Na
Kitchen kitchen
Bathroomi Q~v~~~ p C ~
- Batnroom2 L~ ~~v
s ~ ~~o ~ ' M 56
Bathroom 3 Z ~ 56 ~
Bathroom 4
Other
VENTING
FIREPLACE S LOCATION GAS WOOD MANUFpCTURER MODEL BTU'S DIFECT qrntos
I ~ ~ ' ST L '~J ~J
MAKE-UP AIR MODEL TYPE CFM's
~ ~ ~ i Z,O ~
I
I hereby acknowiedge that the above information is correct and agree to comply with the Minnesota Energy Code and Ciry of Eagan
requirements.
- /~-9 -6~ 3
Sig ature Date
/"c s, S72P~1'ld7~
CompanyName
' This form is the responsibility of the General Contractor.
~~--=w ~a~~:3-- ~Q_~aglZ ~~~~~-~.3~
~of- +-I- (3 l oc~- i ~SIDENTIAL BUILDING
Permit Application '(~'1 (Q Z$13 ~
~ ~1 ~ City Of Eagan P P,~ Zg ~ y ~1'D .,Sa
~~R-~~ ~~S 3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5674 ~~g, 3S
New Construcdon Reauiremenls RamodeVReoairReauiremenis Oflice Use On
3 registered sRe surveys showing sq. R of loi, sq. (t ot house; and all roofed areas 2 wpies of plan rt of Survey Recd ~ ~ Zt0 ~
(20% manimum lol coverage allawed) 1 set af Energy Calculations for heated ~ditions Tree Pres Plan Recd
2 copies af plan showing h~m & window sizes; poured found design, etc. 1 site survey for edtlitions 8 ded~s ~ Tree Pres Not Read
1 set of Ene~gy Calculatiars Addition -indicate ilon-sde sepGc system _ Oo-site Septic System
3 wP~s of Tree Pmservation Ptan i( bt platted after 7f1193 y
Rim Joist ~efail OpUons selec0on shcet (bldgs wAh 3 or less units
; ri l.
Date _L / ~ / (~.3 n Construction Cost ~ ~ ~ J~~
Site Address YCo 5~ ~ L+ rn vn i t t`~JSS UniGSte # ~
Description o[ Work S~ n
Multi-Family Bldg _ Y x N Fireplace(s) _ 0 ~j L _ 2
Property Owner Telephone # ( )
Cootractor ~-,~~)DG2E,l1 ~}t.S l.c1n 757 Rt~l~T/ O wS
Address 5 ~15 ~ /~ouna ~ ~ . c~ty )R Yz T~
5tate ~ ~ Zip 553~ I Telephone # (~J'S71 a, - q ~ ~
COMPLETE THIS AREA ONLY IF CONSTRUCT S's._A,.NEW BUILDING
Minnesota Rules 7670 Cateaorv 1~~ esota Rules 7672
Energy Code Category ~ - I
• Residential Ventllation Category 1 ~~~C 0 9 2003 New Energy Code Worksheet
(J suhmission rype) Submifled I Su6mitted
. Energy Envelopa CalculaUons Suh d
Licensed Plumber L DE By ~ ep one l,~ `~~S'~(~9 Z
Mechanical Contractor ~ ~A ht DF,2 !~'1 E '(~{ft ! C ~ Telephone # (R~ L~ ' ~(~~''i ~
Sewer/WaterContractor ST~96L ~LG m E,l ,u ~r Telephone #~?7~~4~1f g~~
1 hereby apply for a Residential Building Permit and acknowledge that the infarmation 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 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.
~~1-Ra~~/LA LLF~U2D h~ , ~ Y ~4./~'
~SV
ApplicanYs Printed Name App
i~t's Signature /1
aE'~9sz~~~9 ~~/s~~l
i
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-p~ex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
02 SF Dwelling ? 08 O6-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 E#. Alt - Multi
? 03 01 of _ plex ? 09 07-plex 0 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-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 PI6g_Y or _ N ? 25 Miscellaneous
Work Types
~ 31 New ? 35 Int Improvement ? 38 Demolish (Inte~ar) ? 44 Siding
? 32 Addition ? 36 Move Bldg. O 42 Demolish (FoundationJ ? 45 Fire Repair
? 33 Alteration ? 37 Demotish {Bidg)' ? 43 Reroof ? 46 WindowslDoors
? 34 Replacement •Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation ~%l ~l.l~~ Occupancy (G'3 MC/ESSystem
Census Code D ~ Zoning ~Z. ~ j City Water
SAC Units I Stories Z- Booster Pump
Nbr. of Units I Sq. Ft. Z S~O S PRV
Nbr. of Bidgs ~ Length y Z Fire Sprinklered
Type of Const ~(1`1 Width ,
REQUIRED INSPECTIONS
~ Footings (new bldg) ~g FinaUC.O.
_ Footings (deck) FinaUNo C.O.
Footings (addition) _ p~~~g
~ Foundarion _ ~pC
LO Drain Tile Other
Roof ~ Ice & Water 1? Final _ Pool _ Ftgs _ Air/Gas Tests Final
~q FraTrung _ Siding SNcco _ Stone
~Q Fueplace ~ R.I. Air Test ~ Final _ Windows (new/replacement)
~j Insulation _ Retau~ing Wall
Approved By,~~ Building Inspector
~
BaseFee ~4~~0~,~~ S+~-UP X,?'~~°O = ~8~~' ~
Surcharge ~
Plan Review ~~2~~j 'i-° ~ z sx ~b. o~ - by ~ 'D
MC/ESSAC V~~S~»~etaf iy7~ X i!'ao = ZZ~y~~Q~
c~cysac mr~,~F~oa~. ty9y ~cS~l. ou ~ ~jO~i'7to.Od
UtilityConnection Charge UPP B~ ~1on~ l/~~ X~y~ = ~j 77'
S&W Permit 8 Surcharge
Treatment Plant
License Search
Copies
Other
Total
Permi[ Number
MECcheck Compliance Report
1999 Minnesota Energy Code
MECcheck Software Version 3.2 Release 1 Checked By/Date
TITLE: Chatham "B" Inventory Home
COUNTY: Dakota
STATE: Mirmesota
ZONE: 2
CONSTRUCT[ON TYPE: Single Family
DATE: 12/24/03
DATE OF PLANS: ] 2-4-03
PROJECT INFORMATION:
4653 Summit Pass
' Stonecliffe
COMPANY INFORMATION:
Lundgren Bros. Construction, Inc.
545 Indian Mound East
Wayzata, MN
NOTES:
9' Foundation
Full Foundation
COMPLIANCE: Passes
Maximum UA = 574
Your Home = 492
14.3% Better Than Code
Gross Glazing
Area or Cavity Cont. or poor
Pe~imeter R-Value R-Value U-Factor UA
Ceiling 1: Flat Ceiling or Scissor Tmss 1710 44.0 0.0 46
Wall 1: Wood Frame, 16" o.c. 184 12.0 2.0 14
Wall 2: Wood Frame, 16" o.c. 22 19.0 2.0 1
Window I: Above Grade, Vinyl Frame, Double Pane 9 0320 3
Wall 3: Wood Frame, 16" o.c. 128 12.0 2.0 10
Wall 4: Wood Frame, 16" o.c. 1800 19.0 2.0 85
Window 2; Above Grade, Vinyl Frame, Double Pane 212 0320 68
Door 1: Solid 18 0.067 1
Door 2: Glass 47 0320 15
Wall 5: Wood Frame, 16" o.c. 1296 19.0 2.0 64
W indow 3: Above Grade, Vinyl Frame, Double Pane 154 0320 49
Basement Wall 1:
Solid Concrete or Masonry, 9.0' hU8.5' b~9.0' insul 1616 0.0 5.0 129
Floor 1: All-Wood Joist/Truss, Over Outside Air 44 33.0 0.0 1
Floor 2: All-Wood Joist/Truss, Over Unconditioned Space 195 33.0 0.0 6
Furnace 1: Forced Hot Air, 90 AFUE
Proposed and Maximum U-Factor Averages
Proposed Maximum
Average U-Factor Allowed U-Factor
Above-Grade Windows and Giass Doors 0320 0370
(ncludes Foundation Windows> 5.6 ft2
Floors Over Unconditioned Space 0.030 0.033
COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans,
specifications, and other calculations suhmitted with the permit application. The proposed building has been
designed to meet the 1999 inneso E y Code requirements in MECcheck Version 3.2 Release I.
Builder/Designer Date~~~ ~~A~7
~
LOT SURVEY CHECKLIST FOR RESIDENTIAL 6
BUIIDING PERMR APPIICATION 3
' ~ PROPERTYLEGAL: ~oT 4 Bcaek / ~,vEt2E~ ~QSS" 5 ~H LIDDirioN
DATE OF SURVEY:
LATEST REVISION:
m
~
c
m
L
U
Ya ~
O~ Q DOCUMENTSTANDARDS
? . Registered ~and Surveyor signature and company
~1~ ? ~ • 8uilding Pertnit Applicant
~ ? ? • Legaldescriptlon
~ ? ? • Address
~ ? ? . North arrow and scale
d~ • House type (rambler, walkout, spl'd wlo, split entry, bokout, etc.)
Q~ • Directional drainage arrows with slape/gradfent Yo
0' • Proposed/existing sewer and water services 8 invert elevation
~ ? ? • SVeet name
? ? • Driveway
ES~ ? 0 • Lot Square Footage
? • lotCoverage
ELEVATIONS
~ Existin
~O ? • Sewer service (or Propased)
~ ? ? • Property comers
LA~ ? C • Top of curb at the driveway and property line extensions
? • Elevations of any existing adjacent homes
• Adequate footlng depth of sWCtures due to adjacent utllity Venches
a ~ ? • Waterways (pond, stream, etc.)
Prooosed
H" 0 C • Garage floor
? ? • Basement floor
~je G • Lowest exposed elevation (walkouUwindow)
Lg'~ ? • Property comers
6' ? C • Front and rear of home at the foundation
PONDING AREA (ff applicablel
? d./ ? • Easement line
? H/ 0 • NWL
? L7/ 0 . HWL
? 6 ? • Pond # designation
? f~ ? • Emergency Overflow Elevation
? ~ ? • Pond/Wetland buffer delineation
DIMENSIONS
Ls3 ? ? • Lot Iines/Bearin9s & dimensions
? • Right•of-way and street width (to back of curb)
0~ ? a • Proposed home dimensions including any proposed decks, ovefiangs greater than 2', porches, etc.
(i.e. all structures requiring pertnanentfooUngs)
? • Show all easements of record and any Ciry utilities within those easements
C7 ? • Setbacks of proposed sWcture and sideyard setback of adjacent e~risting sWctures
? LN~? • Retaining wall requirements,'rfany
Reviewed: ~ ~~--3~-03
Name Date
GJFORMSlBuild(ng Permrt Appliratlon
~
30 15 0 15 30 60 • REVISIONS ~
LEGEND RES
i imroa as
, - fl 3:9 ~m O$ DENOTES SANITARY MANHOLE ~ iyuyoa
Rs
SCALE IN FEET
~~~~llll~~ ~r ~ DENOTES ITYDRANT REV79/03OGRGRSS
5a
' ' ~ v\\ ,i{~~ ` ~jO T ^ 1 ~ ~~Ulf~ ~ ~ DENOTES CATCH BASIN
U
~ DENOTES STORM MANHOLE
~ ~ ~ 12
M~p~ ~ ~ DENOTES STORM APRON
" ~ \ - ~ - DENOTES APPROXIMATE REAR OF BUILDING PAD ~ o
~ O DENOTESIRON MONUMENT NORTH Z~
I ~ 1 a,s . Na _ <
~Z f 0 ~ ~ $ /y x 000 .7 DENOTES EXISTING ELEVATION ~ m
EX~ D N= 9 3 4. 6 E! D~~"`~ 6~~~~~a~~~ D~ ~ \ (OOO.O) DENOTES PROPOSED ELEVATION N'm'
N ~p~~ ~i
, og4 47 g33.93 O , i ~~l ~ " ~ V DENOTES DIRECTION OF SURFACE DRAINAGE ~ a
183.80
N89°19 27"E w °r ~ ~ ~
953.3 a ~7j ~ O J "'r 922. DENOTES SANITARY SEWER SERVICE ELEVATION S
9. 4 x 9 3 3 7 9 4 9 8 x 9 3 3. 3 0 ~ o ,,s ~ Q
N ~ W 3
m>
~9''~. Zo_33 ° y~ . ' ~~i ~ / HARDCOVER TREE SUMMARY
N N N N + E t. P S i O ~ Q
I ' O I ~V
%9FSZF3 „~jT N i~~
5 ~~~~I 5 6X i~~ I " 0~.•:;~ ' Q~ LOT AREA = 16.838 S.F. EXISTING TREES' 0 ~ m
O I~ CANT. Q~ Za ~.~~„,p, ._g , H O U S E A R E A = 2, 0 7 3 S. F. T R E E S R E M O
V E D = 0
~
. 4.02
00 o, 19.65 Z ~ Q; = ~ _ ~.N ls., COVERAGE = 12.3% ~ o
~ ( ~ W N fl ~ ~ f/1
P~~4.~C Q V1 Q ~.~G ~~§~L.... "'C. ~j ~ N
~ x 9 a 0 2 7~ ~33 11 x ai 5.0 m a m vi ~ . J ~ / ~yoas gb~
H
N I 932.%a h In ~ O J~ S ~
o, p' f (t,~~ NOTES: 6
N y N I 6A ` Ci ~ v ~?-9-2}--- S BUILDING PAD CORRECTION PER GRA~ING PLAN APPROVED BY w
n~ ~ o THE CIN OF EAGAN. THE CONTRACTOR SHALL BE RESPONSIBLE ;
O I x I a,°; y~ a ~ ~n ~,ti~' ~ ~ r.~ FOR THE FIELD VERIFICATION OF THE EXACT LOCATION OF THE "'m,~ ~2'~
O 9`'i~g~ ~rn a a ° o'd BUILDING PAD. ~roj oES`
_w y I o ri o ~ rn G~ Q
Z I DRAINAGE & UTILITY x 937 fi3 2; a ' / R/ ~O 4~• :A ~ 3 MUST MAINTAIN A MINIMUM 2% SLOPE GRADIENT TO ACCOMODATE
•
~ EASEMENT ~ = 29~96 ~ POSITIVE DRAINAGE.
~ ~ p No 937y53 93a.5) -01 ~ ~Q.~
931 .,2 x
~ ~ 932 23 (93~}x O ~ ALL OFFSET IRONS ARE MEASURED TO HUNDREDTHS OF A FOOT
x^ + Ncy1 ~`l~ O ~ / AND CAN BE USED AS BENCHMARKS. }
"sa5 a~ ys~.r31 as 4.84 ~y°~ o,. ~ W ~ a
(946.4) N89° 19~27~~E g32 83 ~ 8~~~32 68 L 0 ~ D O E S N O T P U R P O R
T T
O S H O W E X A
C T LYO H O W T H ~ R I V E W
A
Y ~ ~ U~
H~~ / / SHALL BE BUILT. (n o m Z Z
1FDN~933.4 ~ ~ u- LL ~
I A TITLE OPINION WAS NOT FURNISHED TO THE SURVEYOR NOR
~ w ~ z
W
A S A S P E C I F I C T I T L E S E A R C H F O R T H E E X I S T E N C E O R
y tq NON-EXISTENCE OF RECORDED OR UNRECORDED EASEMENTS ~ a W
/ CONDUCTED BY THE SURVEYOR AS PART OF THIS SURVEY. U~~ Z w
~ y~ l~ a ~ ~ o
` ' ~ 1 / ~ - 1 i , ~ Z
~ ',i . I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT ~ ~ U U
I l / REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: V J
~
6O LOT 4, BLOCK 1, PINETREE PASS STH ADDITION
/Z ~ ' DAKOTA COUNTY, MINNESOTA
' L
' . AND THE LOCATION OF ALL BUILDINGS, IF ANY, THEREON, AN~ ALL
VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND. AS DRAWN
SURVEYED BY ME THIS 20TH DAY OF OCTOBER, 2003. DBPIRS
CHECKED
PROPOSED ELEVATIONS SETBACKS GRG
PROPOSED GARAGE FLOOR ELEVATION= 934.63 MIN. FRONT YARD SETBACK = 30' DATE
`(~(,L, 11/18/03
PROPOSED TOP OF FOUNDATION ELEVATION= 935 MIN. SIDE YARD SETBACK = 5' GARAGE, 10' HOUSE
PROPOSED BASEMENT FLOOR ELEVATION= 926.33 MIN. REAR YARD SETBACK = 15' SCALE
Gary R. Germond AS SHOWN
Licensed Land Surveyor, Minn. Lic. No. 24764 ,106 NO.
5402-673
~ ' ) t~, B~
b~b Zoo~ RESIDENTIAL BUILDING rExn7iT arrLrcaTioN ~
J
City Of Eagan ~/l S
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsUuc6on Reauirements RemodeUReoair ReQUiremen6 O(fice Use Onlv
3 registered site surveys showmg sq. ft. of lot, sq 8 of house; antl all roofed a2as 2 copies of plan showing footings, beams, joists CeR of Survey Recd _ Y_ N
(20% manimum lot coverage allowed) 1 set of Energy Calculations for heated additions Soils Report Y_ N
1 Soils Report if pmposed buiMing is to 6e placed on disturhed soil 1 site survey for addihons & decks Tree Pres Plan Recd _ Y_ N
2 copies of plan showing beam & window sizes~ poured found design, etc. 4^~~ldd8ion - mdicate ifon-s8e septic sysfem Tree Pres Required _Y _ N
1 set of Ene~gy Calculations ~1 9 1 L On-site Septic System _Y _ N
3 copies of Tree Preservahon Plan H bt platled aRer 711193 Mp,` a
Rim Joist Dehail Options selectbn sheet (buildings with 3 or less unifs)
Minnegasco mechaniral ventilation form ~ /
Ptans are considered public information unless ou state the are trati)
e~c~et and h reasan.
Date ~ S / S/ / n 7 Construction Cost ~ Z~~
Site Address ~d~ ~ S ~ -S ' ~ UniUSte #
Description of Work / ~'-P"~ ~
Multi-Family Bldg _ Y~N Fireplace(s) _ 0 _ 1 _ 2
Property Owner ~ r-` ~7 4 a
9~~ Telephone 6~/ ) ~2- g 9 Y~
Contractor ~ ~ ~ ~ ~ ~4a ~T` ~
Address g~12 ~a`•",a`, w`'d City ?~c ~~is
State Zip ~S3 Telephone S! ) Z 3 S S~l'7 Z
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New E~ergy Code Worksheet
(~submissiontype) Su6mitted . Submitted
. Energy Envelope Calculations Submitted ~
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, date and address of masTer plan:
Licensed Plumber Telephone J
Mechanical Contractor Telephone )
Sewer/Water Contractor Telephone )
I hereby apply for a Residential Building Permit and acknowledge 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 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.
Po.~~/~ Sa~~4~~~
ApplicanYs Printed Name A plic s ignature^-~~
DO NOT WRITE BELOW THIS LINE . -
Sub Tvpes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? D2 SF ~welling ? OS 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 l~ 18 Deck ? 23 Porch (screen/gazebo/pergola) ? 36 Multi Misc.
/
? OS 03-plex ? 11 10-plex ? 19 Lower Level. ? 24 Storm Damage
? O6 04-plex O 12 12-plex ? 25, Miscellaneous
Work TVUes
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
33 Alteratlon ? 37 Demolish Building" ? 43 Reroof ? 46 WindowslDoors
? 34 RBp18Cement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Description: Water Damage _ Yes
Valuation /y~~ Occupancy MCES System
Plan Review ~ 100% or _ 25% Code Edition
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
Footings (new bldg) _ Sheetrock
~C Footings (deck) FinallC.O.
7 Footings (addition) ~ FinaUNo C.O
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool Ftgs Air/Gas Tests Final
_ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick
_ Ficeplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
/
Approved By: ( ~ , Building Inspector
Base Fee
Surcharge y ) / /C ~ c7
Plan Review Z/(.-'1 C/ w~?
MClES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
30 15 0 15 30 60 REVISIONS
LEGEND RESTAKE
3.y M OO DENDTESSANITARYMANHOLE 112vo3R5
SCALE IN FEET aXlln[~m ivoama Rs
REV. PRO. GRADES
~jO 8~~~~~~1~f19W~
w~ ~ DENOTESITYDRANT H9/03GRGRS
3p 1 ~~qUired
DENOTES CATCH BASIN
~ ~
- ~ 7,, ~ v ' -.o
''~,['~5,~' ~ ` ~f Q DENOTESSTORMMANHOLE
~p H ~s f
~m~~*~J~~ J V - 12 ~ ~ DENOTESSTORMAPRON
~~~I~ ~ \ DENOTES APPROXIMATE REAR OF BUILDING PAD U o
°w
I , ; _;a . N~ O D E N O T E S I R O N M O N U M E N T N O R
T H Z a
p~ ~ ~z' 3 ~ p' S ~ x!~00 0 ~ENOTES EXISTING ELEVATION ~ m
EXISiING HOUSE, , O~~!? ~~~'~~~~~tl`~~ ~ ~ ~ (000.0) DENOTES PROPOSED ELEVATION ? ~
• TFDN 934.6
a34_47 ~933.9? ~ i ; ~ f DENOTES DIRECTION OF SURFACE DRAINAGE
953.3) N89°19~27~~E o ~F33.HO ; c)~~~~ Vo J~`~i ~ \ 22. DENOTESSANITARYSEWERSERVICEELEVATION
gt p .c x 933.79 47.9$ x9..3.3D ;o ~ ~ / W 3
.N _ 9 1.,-_ ~ ~e . q~ ~ m Q
~ ~ ~ zo.33 ~ ~1~,q-. o ~ / HARDCOVER TREE SUMMARY ~j o
~ ~ ~ O~,'~° > ~ ~6V Q
x g43.26 ~
p ~ ~ ~ rai u ~ ~ ~ ~ E ~S 6z ~ ~;1 ~ ' S7~ ~ LOT AREA = ~6,838 6.F. EXISTING TREES = 0 ~ &
CANLa' ¢ ~ 20 m.~ " ~t'~'.~'~r~{t~~'~.~ "~j$' S
~ P a a . ~ n ~F ~,.k.q j ~ ~ . HOUSE AREA = 2,073 S.F. TREES REMOVED = 0 ~ j
~ ~ 4.02 rn 19.65 c9 0~ n C ~.1 zr a, n.„ ',S.
z y, h~..~ \ COVERAGE = 12.3% p
N ~~3'.,s.:~:1~'~.:.53~,'+IYS~.'=.= \ Q N
~ I ~ W 4.~2 UD W N '.1qi, ':.k~JY;';_'.'ii~.`„~ J 1 ~ Si
V VI Q 1.02 .n j~ -
N . x 9a0.2' ~33 1~3 oi 5.0 m a 10 . J ~ S/ ~~oas gy~ry
I C~ ~ i(~-~` NOTES: e "6
Jg ~ q µ 6
N 6.0 ~ ~i 3~?:4~---- S BUILDING PAD CORRECTION PER GRADING PLAN APPROVED BY
p u~ a o`" ~ ~ THE CITY OF EAGAN. THE CONTRACTOR SHALL BE RESPONSIBLE ~ ; p
O °i „a~ ri $'iv"'i d I~ q`ti ~ ~ FOR THE FIELD VERIFICATION OF THE EXACT LOCATION OF THE "'my ~a"
~ I ~ 9 a a °o ~„'~j , BUILDING PAD. ~~3 o£s•
z „ ~ ~ ~ ~ h p ~
DRAINAGE & UTILJTY " 9~''~=3 I 29 96 ~I v ~0~~' t~' MUST MAINTAIN A MINIMUM 2% SLOPE GRA~IENT TO ACCOMODATE
EASEMEN7 ~ ~ '~j~ ` POSITIVE DRAINAGE.
L~ 937 82 _ ~ 93}` 3 93~.5) 01 ~ ~Q./..
~ ~ ^ 932
25 (93t)x O t~ ALL OFFSET IRONS ARE MEASURED TO HUNDREOTHS OF A FOOT
"~ee.a~ X ys~ s~ 4. ~
~s- 4. 8 4 ~,a ~~J / AND CAN BE USED AS BENCHMARKS. w
(946.4~ Nggo ~ 9'27"E 932.83 ~ 86 I932 ES ~O~ ~ THE PROPOSED DRIVEWAY SHOWN IS CONCEPTUAL ONLY AND ~ O O
pp511NG I / DOES NOT PURPORT TO SHOW EXACTLY HOW THE DRIVEWAY ~ ~ U cn
HWSE / A SHALL BE BUILT. (n o m Z Z
~-9~4 ~y~ A TITLE DPINION WAS NOT FURNISHED TO THE SURVEYOR NOR Q W Z~i Z
1 ~ t WAS A SPECIFIC TITLE SEARCH FOR THE EXISTENCE OR W~ W a
Q~,
1~ rj y NON-EXISTENCE OF RECORDED OR UNRECORDED EASEMENTS F- a~
\(.\O ~ / CONDUCTED BY THE SURVEYOR AS PART OF THIS SURVEY. U~ Ur z w
1 y~ LL a ~ ~~`O
i - V
y~ I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT W J U V
~j~
~ T s .3¢ / REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: V
I / y Z
c~~r~n~~f--_- 'v ~".e.-~,...-.- I
~ ~ 6O LOT 4, BLOCK 1, PINETREE PASS 5TH ADDITION
DAKOTA COUNTY, MINNESOTA
. AND THE LOCATION OF ALL BUILDINGS, IF ANY, THEREON, AND ALL DRAWN
VISIBLE ENCROACHMENTS, IF ANY, FROM OR ON SAID LAND. AS DBP/RS
SURVEYED BY ME THIS 20TH DAY OF OCTOBER, 2~03.
CHECKED
PROPOSED ELEVATIONS SETBACKS ~ GRG
on-re
PROPOSED GAR4GE FLOOR ELEVATION= 934.63 MIN. FRONT YARD SETBACK = 30' 11/18/03
PROPOSED TOP OF FOUNDATION ELEVATION= 935 MIN. SIDE YARD SETBACK = 5' GARAGE, 10' HOUSE SCALE
PROPOSED BASEMENT FLOOR ELEVATION= 926.33 MIN. REAR YARD SETBACK = 15' GB~y R. GeffllO~d AS SHOWN
Licensed Land Surveyor, Minn. Lic. No. 24764 JOB NO.
5402-673
City of Eaafl
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit Fee:
Date Received:
Staff:
Permit #: / D / Y 3
Io,3LI2,
2012 RESIDENTIAL PLUMBING PERMIT APPLICATION
Site Address: 3 Jv cwt LSA
---------- ----
Tenanti,`'k�GYtt.��
Date:
Suite #:
RESIDENT / OWNER
Name: 3kkrV-&__-. D r "
Address / City / Zip: /P� Si/11't1 alK
-- Phone: (P5 I - 46Z - ,� 1
$ S
CONTRACTOR
31-1115874
Name: APFi i License #: 5-12-0q Pivk
Address: ; 1313 Danita Circle City:
Shakopee, MN 55379 ,i , t
State: Zip: --- Phone: �h �' `1 b '"` `t .."
Contact: - tU tom PC--` Email: k. 11 CLA e e -C 0 nAcc C n s e4661.co . coil
TYPE OF WORK
New Replacement Repair __ Rebuild Modify Space Work in R.O.W.
— ___ — ___
Description of work: rev\OCe,y�a.+a-s of t' h -
PERMIT TYPE
RESIDENTIAL
Water Heater
- Water Softener
____ Add Plumbing Fixtures L__ Main / ___ Lower Level)
Water Turnaround
_ Lawn Irrigation (_ RPZ / _ PUB)
_._ Septic System
New_
Abandonment
RESIDENTIAL FEES:
$60.00 Minimum Water
Heater, Water Softener, or Water Heater
(includes $5.00 State Surcharge)
Fixtures, Septic System Abandonment, Water
and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation
$60.00 Add Plumbing
*Water Turnaround
$105.00 Septic System
Turnaround* (includes $5.00 State Surcharge)
and $5.00 State Surcharge) U[%`�
TOTAL FEES $
(add $189.00 if a 5/8" meter is required)
New ($10.00 per as built) (includes County fee
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility
Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecalf.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.
Applicant's Printed Name
FOR OFFICE USE
Applicant's 'i : nature
Reviewed By:
Required Inspections: Under Ground Rough -In Air Test Gas Test Final
City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit#: 'tJgLj
Permit Fee:
Date Received: 3- I ?H3
Staff:
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION',
Date: 3-12- /3 Site Address:
Tenant:
y(53 5wn Pa SS FajctiA ulV
Suite #:
Resident/Owner
Contractor
Name: Phone:
Address / City / Zip:
Name: Prec,s/crt flu -04/j /AC . License #: PGS, '.? '
Address: 11/21/ keifzie City: S/:/el
State:
Contact:
NA/ Zip: 5:5376
Type of Work
Phone: 74,3-gf97-7 8t
* These Email:
S New _ Replacement _ Repair Rebuild Modify Space Work in R.O.W.
Description of work:
Permit Type
laSestek, lathier*
toee
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ / _ PVB)
Septic System
New
Abandonment
Water Softener
Add Plumbing Fixtures ( Main /
Water Turnaround
Lower Level)
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surchlarge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $189.00 if a 5/8" meter is required)
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 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.qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances ani 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
dt K i peruk
Applicant's Printed Name
FOR OFFICE USE
x
Applicant"s gnature
Reviewed By: Date:
Required Inspections: - Under Ground _Rough -In Air Test _Gas Test Final
*'
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUR or BLACK Ink
For Office Use
Permit #: t iC Li
Permit Fee:
Date Received:
Staff:
/3
f 2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1 5 `! Site Address: +053 UpikMUM I I 5 Unit
Resident/
Owner
Type of Work
Contractor
Name: <.Lt g.,\I P e6 1 . Phone((es,'+S'
Address / City / Zip: 4-14.0 E1 ‘..1A-84.0/1 t'1' -fks r E1q h Poi 5.5122
Applicant is: Owner kContractor
s4q (o
Description of work: 1-1't?- (XV ?)'' 11 t1/4.14,--1
Construction Cost: 2.51 `O
Company: r,.l iSP1 Lli (• vyk -
Address: ( 0(0 Vs -14X, tt/-3--
Multi -Family Building: (Yes
Contact:
City:
2 lilt -i-- Coo 3
State: Zip: G 53 4 Phone:
License #:C. o`? ) 2251
/N
q6
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public informatio
the information may be classified as non-public if you provide specific reasons that would per
conclude that the are trade secrets.
Portions of
it the City to
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damag
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances an
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; th
accordance with the approved plan in the case of work which requires a review and approval of plans.
Call 48 hours
codes of the City of
t the work will be in
Exterior work authorized by a building permit issued in accordance with the Minnesota Stye Building Code must be comp eted within 180
days of permit issuance.
x
Applicant's Printed Name
x
Applicant] Signature
Page 1 of 3
L+11) 53 SUL ?Cis°�'
DO NOT WRITE BELOW THIS LINE
oi4DT
SUB TYPES
Foundation Fireplace
Single Family Garage
Multi Deck
01 of Plex �jtower Level
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100%
Census Code
# of Units
# of Buildings
Type of Construction
Interior Improvement
Move Building
Fire Repair
Repair
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Drain Tile
Roof: Ice & Water _Final
Framing
Fireplace: Rough In _Air Test Final
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
S. Insulation
Sheathing
Sheetrock
Reviewed By:
1 , Building Inspector
Siding
Reroof
Windows
Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building — give PCA handout to applicant
14
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Sprinklers
Meter Size:
Final / C.O. Required
Final / 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
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
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA149893
Date Issued:06/13/2018
Permit Category:ePermit
Site Address: 4653 Summit Pass
Lot:4 Block: 1 Addition: Pinetree Pass 5th
PID:10-57664-01-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 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 -
Suryanaray A Duggirala
4653 Summit Pass
Eagan MN 55122
Benjamin Franklin Plumbing
5718 International Parkway
New Hope MN 55428
(612) 238-9709
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA155389
Date Issued:05/14/2019
Permit Category:ePermit
Site Address: 4653 Summit Pass
Lot:4 Block: 1 Addition: Pinetree Pass 5th
PID:10-57664-01-040
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Suryanaray A Duggirala
4653 Summit Pass
Eagan MN 55122
(651) 452-8946
Bayport Roofing And Siding Llc
2240 Edgewood Ave S, Suite 201
St. Louis Park MN 55426
(612) 235-7663
Applicant/Permitee: Signature Issued By: Signature