4961 Sycamore Dr INSPECTION RECURD
CITY OF EAGAN PERMIT TYPE:
~3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date rssued:
(651) 681-4675
SITE ADDRESS: ' ~ ' APPLICANT:
;~,i ,
,i~ni~t n~ ~~r~~. f
PERMIT SUBTYPE: TYPE OF WORIC:
. .
. , , ,
, .
, . ~ , , ~ , ,
j.~ i~?~?a~~ W i•~~.F N~ r, i•:~~~ i•i~~~tr! » t; ~atrs -
~ ~ ~ ~
~ ~
~ Permit Holder Date Tslephone N
5EWER/
WATER
PLUMBING , 'S 9 ~ O
HVAC 9 . g~
I~spection Date Insp. Comments
FOOTINGS c
FOUND .
FFiAMING ~ . C
ROOFING
ROUGH r
PLUMBING - . - il.~; " Fi ~ ~
PLBG ~
AIR TEST •
ROUGH
HEATING ~
GAS SVC
TEST
INSUL c ^
-
GYP BOARD
FIREPLACE ~
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
QRSAT
TEST
BLDG FINAL
DOMESTIC
ME7ER
IRRIGATION
ME7ER
FLUSH
MAINS
CONDUCTIVITY
TEST
HY~FIOSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
. . . • ,
11' _ _ . _ . . a r_~ 'ti 1 r °jj~.''s~t.. ~ i
' ~ ; . u '
~1 y ~•,~y ~ ; ;q~hY,y;
t
(~L`h~iCQte 0~ ~CCli~1Q1iC~
~it~ v~ ~agatt
~?e~rartmcat eF ~aitbing .3`u~pectiun
This Certificate issued pursuant to the neq~iremerets of the Uniform Bui~ding Code
certifying that at the time of issuance this stnecture was in compliance with the vario~rs
orrtinances of the City regulating 6uitdireg construcrion or use. For the fo!(owing:
Ux Classifivtion: ~ QA~ Bldg. Pmnit No.
p~~Y ~ j~ y~~ pi~ ~ Type Const. ~
o.~ or s~~w;~s R(~72T ~~?R'It ~IST wea~ 14q[lfi A4AI~Iffi] R~,_~RRI(R_I~SE
eww~ng ~ea~s 4Q61 S~",.E~iE DIRIVE ~.o~uy~2- B3. PTI3.ZS~ F(~ST
. ~ . ~ ~
- ~ 5
k~m~ o~;
~ POST ItJ A COfVSPICUOUS PLACE
r ~
~ l, ~
. '
Address _ 4e~ i sv! ar~rzE nuzvE Zip 5512 3
IAt 2 Blk 3 SUb PINEl?tEE FC)REST ~
TEIESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: V~ ~j' ~j Yes No Inspector: ~ '
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
TraiUcurb damage
Porch
Basement finish
Deck
Please ver' with the builder the removal of roof test caps from the plumbing system and the shut-off of watet supply W
the outside wn faucet before freeze potential exists.
Contact en~neering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ~
W6ite - City Copy Yellow - Resident Copy Pink - Contractor Copy
~ ~
?..;K:hiX>Y9xY,o;:x:Y,: ,:Y,;Y.;;;;%".c7~:P~:~;:~:tok~:;i:?FX ~ ;Xtxc ~,,:>',r,X<$:>.:';. , .
CTTY U'- r:~'-1G;F~ir'
CA'if-CI:I:_!t; 53 I'EfRM'C~.FaL tQO~ F')r
T~P~'ii=.a li./2l'1tS32 'flhiL:a i.fi;,45,:::,J
IlJ
t,~a1Pf;;.;: ROS:;F::FiT L CL.Ati'K Cp~SY'fiU~; i:CCitd
? c•~•;~• i p F; 1 1.? ~
_~...,e., : nn:~ as~F:~. ,,;..:,artc.~~:r _ ~
_ .
, r'llr~ot:'r1~1;: 4~?°3.~_'i.,~~F~.
<l-ll`~l7'r
N',<;CY,{.,:;vY:i;;'t$CYF%F~:NY,;',~r ~iiiW.7FN;?~'$;i:i>n`$:f1Fi~O;':~% ~;~;G, .,;!7~:.(q,
, • PERMIT ,
, CITY OF.,,EAGAN PERMIT TYPE:
3830 P~I~t Knob Road B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 3 q 0 t~ 3
(651) 681-4675 Date Issued: 11 / 2~/ 9 8
SITE ADDRESS:
4961 SYCAMO~RE DR
L(J'(. 2 BL~7CK: 3
PI~~i'REE FOREST
P.I.N,: 10-57650-020-03
DESCRIPTION:
Suilding'Permit Type SF DWG
Buildinq Work l"ype NEW
UBC Oc;cupancv F2-3
ConstrucY.i.on Typ~e 5N
~ ~ Zoninq R-1
Buildinq Len4rh 54
Buildinq Width 3A
Buildiny stories ~ 2
Cerisus Cnde 101 1- FFiM. DETACH
, j ~
~z~ ~ . ! ~ ~ '
REMARKS:
PLAN C3EVESWE.O E`( CRASG NpVt1CZYK. ~
S& W PIUMBER IS GENF OLSON PhiONE #432-9079.
FEE SUMMARY:
VALUA1'T.ON 3192,~00
Bi35E Fee $1.347.25 MISf... PFES ____,~1,_592.50
Plan Review $875.71 Tota1 Fee $4,911.46
Surcharge $96.8~7
SA~ $1,000.N0 .
SAC ~ 100
5l~C Units 1
Subtotal v $3.318.9G
CON7RACTOR: - aPoticant - sr. ~zc. OWNER:
iG3~F,.T L CLARK CONST 14476990 11s30 ROBERT CLARK CON57RUCTSON
LA90~ MANT70U RD IVE ].A905 MANITOU ROA~
RIOH LAKE MN 55372 PRIOR LRKE hlPl 55372
f612) 447-6990 (6121497-699~
I herebv acknowledg2 that I have read T.hi~ applicatS.on and state that the
ini-orination is correct and aqree to complv with ali applirable state aT Mn.
~ 5tatutes and C9.ty ot Eaqan Ordir~anr.es. J
APPLICANT/ ERMI E
SITE GNATUP~ ~UED
B~
,
.
' ' 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
- CITY OF EAGAN
~ 3830 PII.OT KNOB RD - 65122
~ ~I 0 ~S 3 68~-~~5 $ , ~ i . ~
New ConaWCtion Reauirements RemodeUReoair Reauirertrents ~
? 3 iegistered site surveys ? 2 copiss of plan
• 2 copies of plans (inGuAe beam 3 window saes; poured hq. tlesign; etc.) ? 2 s8e surveys (exterior additions 6 decks)
? 7 energy e~leulatbns ? 1 ene
? 3 eopiea of Gee preaervatlon plan if bt plaBed alter 7/1/93 ~9Y ~~alations for heated atlditions
roquircd: ~Yes _ No ~
DATE: /l ~l7 ~ 9 S~ CONSTRUCTION COST; GY ~S~
DESCRIPTION OF WORK: ~r-~ G+~ ~~~~u~ ~~G-.- G 4-.-
STREETADDRESS: GI~6I SYGA/~9D/~~ D/d
LOT: BLOCK: SUBD./P.I.D. ~no T/~-e F~^~S~
Nama ~tvn S~ 4T-2T~ ~~oc~~l2 Phone ~~3-" ~~6~
PROPERTY Lest Pirst
OWNER
Street Address:
c;cy /c~ 5e~o-~.-~ sr~ce: ~r l•1~ zip: .3"~#'66S
Company:_ /Co~/f ~ ~u-?~ ~y~~ Phone#: Y~I7 -69Q~
CONTRACTOR f
Street Address: J~I tr'~~n {~~~.c / au ~ tl License # 1~~~
City ~rL6~ L~.l~ State: ~C vv Zip: 37~
ARCHITECT/ r1 ~ 7~ y
ENGINEER Company:~`~ /Gc~u l. (J Phone /S ~I -
Name: ~ih~-~ K d?/~ Registration
Street Address: ~ J7 ~J wLLS ~ T~v ~iZ ~'f~i ~
i
Ciry ~i G-~~ State: l//i! ~ Zip:
Sewer 8 water licensed plumber (new construction only): ~ ~/S~ . Penalty appiies when address chang
and lot change is requested once permit is issued.
~13a-9o~q ~
I hereby acknrnWedge that I have read this appliqtion and sTate that the infortnation is correCt and agree to compy with all applicabl
State of Minnesota Statutes and City of Eagan Ordinances. /y
Signature of ApplicanC ~~~~(~~~+/t - - ~
OFFICE USE ONLY ~1lr ,
u~lf `
/ V
Certificates of Survey Received ? Yes _ No N~V ~
Tree Preservation Plan Received ? Yes _ No _ Not Requir
1
F ~
OFFICE USE ONLY ~
; _ ~ -
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
~02 SF Dwelling ? 07 4plex ? 12 Mutti RepaidRem. ? 17 Swim Pool
O 03 SF Addition ? 08 &plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 = plex ~ 15 Deck
WORK TYPE
~ 31 New ? 33 Afterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL ~NFORMATION
Const. (Actual) s-~1 Basement sq. ft. G 77 MC/WS System
(Allowabie) S- Main level sq. ft. ~'7 City Water
UBC Occupancy ~ `Dt- sq. ft. ~ Fire Sprinklered
Zoning -I ~ sq. ft. 5 SZ PRV
# of Stories Z sq. ft. Booster Pump
Length ~ sq. ft. Census Code. 6/
Depth Footprint sq. ft. ~f~ SAC Code
Census Bldg T
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $ 7 Z
Surcharge
Plan Review
License I(e77x /Y^- 2~ ~`S~° ` ~
MCNVS SAC
CitySAC ~ ~p77,K ~r GId~S~B
Water Conn. ~ (07, ~~L r ~
Water Meter ~ ~ ~~X '
~
Acct. Deposit ,rc~ 2k ( ~ - ~~i3 2 -
SNV Permit •
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies •
Total:
% SAC
5AC Units
LOT SURVEY CHECKLIST FOR RESIDENTIAL
' ' ' BUILDING'PERMITAPPLICATION
PROPERTY LEGAI: ~_fT~~ _ ~ ~.Qi.n v ~e 4 ~
~ ~ DATE OF SURVEY: l / ~
~ ~ ~ IATEST REVISION:
~
~ ~ ~ DOCUMENTSTANDARDS
°z
? • Registered Land Surveyor signature and company
? O • Building Permit Applicant
47~0 ? • Legal description
Gl~o ? . Address
~ ? ? • North arrow and scale
? • House type (rambler, waikout, splR w/o, split entry, lookout, etc.)
~~o ? • Directional drainage arrows with slope/gradient %
? • Proposed/ebsting sewer and water services & invert elevation
~~o ? • Street name
~0 ? ~ Driveway
ELEVATIONS
'stin
? • Sewer service (or Proposed)
? • Property comers
[3~0 ? • Top of curb at the driveway
? • Elevations of any ebsting adjacent homes
Prooosed
~ • Garage floor
F~o ? • First floor
[a~ O • Lowest exposed elevation (walkouUwindow)
a~ ? • Praperty corners
~ ? • Front and rear of home at the foundation
PONDING AREA fif aoolicablel
? • Easement line
~ ~ ? • NWL
? C3~ ? • HWL
? ~ • Pond # designation ,
~ ? • Emergency Overtlow Elevation
DIMENSIONS
Pf ? ? • Lot IinesBearings & dimensions
o ? • Right-of-way and street width (to back of curb)
C~ ? ? • Proposed home dimensions including any proposed decks, overhangs greater than 2',
/ porches, etc. (.e. all structures requiring permanent footings)
C~ ? o • Show all easements of record and any City utilities within those easements
~ O ? • Seffiacks of proposed structure and sideyard setback of adjacent ebs6ng sVuctures
? e' ? • Retaining wall requirements, if any
Reviewed: ~ ~
ame / Date
January 1998
1BBfl9LOGPRbir.FM
. : . ~ ~t8-~3 ~
~
~ ENEKGY CODE''WORKSHEET FOR 1& 2 FAMILY DWELLINGS
SITB ADDRE3S e+ 1 ' .~.~Z~;-" _ . .
, .'i'=
q ~ ` T~,`..~~ ~'.~a~'~'`=~ . CITY
~ COHPL8T8D HY~ D ULAR, CV~} f~ PIION~ ~p~'~ ' .
DATE
BVILDIN6 CLA9SIFICATION: ? category~l~(mtendard or
1 ~ category ] (muet inaluda ventilation)
SINIMUH CRZTSRIA ' . „ .
FoUndation Ineulation-R10 Walle 4 Windowu
~ (See table on reveree eide Roof Attia lnnulation~
Slab on Grade Zneulation-R10 Eor ullowable ercenta ee
. P 9 ) R44-With Attic No fleel
Floor over unheated'spacee-R24
R38-With Attic Raieed fieel
. ~Foundation Windowm 1/2"
inuulated claes. ~ - R3B ~ R5-9olid Rafte're
-Wood or Vinyl Prame ~
STBP 1 Wiadaw 4 Door Area STBP 1 Calculate srea ae a- ercent o£
p wall
A. Total Window 4 Door Area in Sq, Feet ~ ~
YIINDOWS (Including Foundation W~ndowe):
WINDOW MAN[7gACTURE l7AMB: C. FYOm Step 1 dlvide box A(i7lndoW & Door
WINDOW MAN[)pACTUR6 Typge L~~I~'J~ ~ D~~ Area) by box B(total wall area) times 700
equale tlie window and door area ae a
WINDOW MAAIVpACT[7R6 U FACTOR~ ~3 percent oE wall area (box C),
R. O. Quantity sq.EC.Atea ~OX A"i d~
Dimensione X 100 = C ' ' ~
Bax B ~~2 ~ °
J
' co`~ X 5-0" i 75
~ k 9TeP 3 Deeign Featuren
Z~v" x~i...~ t~ 2!7 nssews~Y
y~o~ix4~-o" II ,A -
pRAMING TYP6i ~ ' ~
Zt 4k x~ro~ STANUARD FRAMINQ ~
k ~ otuae 16° o.c.
~"-~0 X 3~0N 1 AOVANCBD FRNiINO
r w ~ot~aa z4~~ o.~.
t~ XS~ Un 1~ 1iZ CAVITY INSULATION n~K/
`f!o." x5~" 1 ~Z-
9RSATBIHO TYP@t
~~'Du~ ~1II `j~ LE53 TIIAN < R-5 ~
Z~-o" X 3~-o N 1~ j 2
R-5 > OR MORB
X
U-FACTOR p ' ~
DOORSi Q Prom the table,
o (y v ~ Irevoroe eide) determine the
maximum percent window 4 door area for.the
x g ~ deeign op[ione eelceted and enter hhe t valuo
2 E ~ I in Box D below bneod on the window mEg. U-
~o X ~ / factor: ,
9---- ~ D
Tutal Area of A_ ~
Windowe E Doors ~ 9.£t. ,
B• Total Wall Area in Sq, Ft. . . The } value Erom tlie Cable in Uox D ehall be
~ equal to or grQatnr than tha t in 0ox C
Wall Total- Fleight~ Area~~~ '
Perimeter . ~ .
I 4 D~ v '
_ ~33 -g.g~
1bta1 Area of Walle ~ O=~I~ /t~q.f[ -
a .
. . .......::..i_:..!.i:~6._:.L-1:IL_.. . . ' " .
, ~
•
~ . . . , .
ONE- & 'I'yyp_pq*,pLY RfS1UENTIq[, p(n~~ryG p~p.rn~ ~COOK-DOOK)
~?rrROnt~t
MAXIMUM WiNDOW qND DOOR AREA AS A PERCGNT OF OVERALL WALL
. AREA
Fmm
MI~~. PetR 7670 0475 a s
~-----a~.s~l~Fr~~ c. ~iem r
Sxterior Window U•Factor
Pramin Inaulalion Sheathin 0.49 0.36 0.31 p,2~
STANDqRD R-13 L R• 7 13.4'Ye ]7,8% 21.3% 24.3%
STANDARD R•13 R- 5 12.49'. 16.496 L9.7% 22.5'Yo
. S7ANDARD R-15 > R- 5 12.996 I7,1% 20.19'0 23,4%
STANDARD R-18-1? < R- 5 12.19'e 16.05'0 16.8% Z2,0%
STANDARp R-18_19 R- 5 14.096 18.69'0 21.8~0 25.3%
ADVANCED R-18-19 < R- 5 1T.9% 17.1% 20.1% 23.4"/0
ADVANCED R-18-19 2 R- 5 14.5% 19.29'0 22.5% 26.1%
SI'ANDARD R-21 < R-$ 12.8°/. 17.0°Yo 19.9g'e
STANDARD R-I] > R- 5 14.5°!0 19.396 22.$% 26.1°0
ADVANCEp IZ-21 < R- 5 13.6°6 18.190 21.2°!e 24.6%
ADVANCED R-21 R- 5 15.0Ya 19.9% 23.2Y, 26.9%
~culated val~~9
STANDARp R-1~ < R- 5 11.9% 15.79'n 18.4°!0 2t.5%
STANDARD IZ-17 Z R- 5 13.89's 18.4'/e 21.5% 1S.OYo
ADVpNCL•D R-]7 < R• 5 12.6% 16.84~0 19.695 22.9%
ADVANCED h-17 It - 5 14.396 19.O~o 22.Z9'e 25.7°Yo
Notee:
Wlndow ~rea equals rough opening minus Inetallallon clearances.
Window U-factor maet be delermined by either the National Fenestratlon Rating
Council etendard ]00-91, or ASHRAE 1993 Handbook o[ Fundamentals, Chapler 27,
Table 5.
Po~FIP F~K Note ~g~~ o¦s ~
n ~
rrem
~ ~
~ pl~py ~ R
u~ 41
. ~
~ 8~ T coNSU~nNC a~aNm~s. BOB CIARK CONST.
II~~E PLANNERS and LAND SURVEYORS PROJECT N0. 8766.00
NGINEE~ING BaoK 2~9
COMPANY, INC. PAGE Z7
l__ 1000 EAST 148th STREET, BURNSVILLE, NINNESOTA 55337 PH 432-3000
CERTIFICATE OF SURVEY
Legal Description: LOT 2. BLOCK 3 PINETREE FOREST
DAKOTA COUNTY, MINNESOTA.
~7R,5J DENOTES EXISTING ELEVATION
~98/-2 DENOTES PROPO$ED ELEVATION
IND~CATES DIRECTION OF SURFACE DRA~NAGE
~ a= FINISHEO GARAGE FLOOR ELEVAl10N
~ = BASEMEN7 FLOOR ELEYATION
= TOP OF FOUNDATION ELEVATION
SCALE : 1" = 30'
~k~R~ss : 4~t61 sYc~mv~¢c DRtvE
~ m~ ~ .
TNH ~hT LFff ef-i BC~f-' 2-
Ec~+/. ~ q7B.3(
i ~^~-r - ~ 30.00
ry~ :__:i I L.~
W
~ V A CA N -f" (~pT
~ _i ~ N89'41'52°E N~s=9"19,i8 9l9•~ l~~ /v
~78]~ 8= 979,05 136.5D OIS.ec~ ~,778.9 ~~1 ~~I
~n 21~0o q81 2 ~ 981, ~
~ 24.33 a
30 (q79'il o ° ti~
/ VI w N
1' , ~98i' ~ f ~ 2.OO ~
/ , ~j89i 2s.e~ ~ o t„ 6.2~o r~~ t.~+
I>
~ Pn I.` o j ~ N°~ o
Q7 0 o N`~ ~ t~`'i~ L , a.oo o_ w
a0 ~ ~ j~~ o O W o 30.33 °0 . m oo
ao r ~ ~ Ln ~ 979.3 ~ ~°o o O
; o Q •_;`J*~ ~ o ~`1` 9E1~2 ~ ~ °z a
--s Z j ~ _ I ~ ~ ~ }
il'' 3.OOp .
~
~79~31 N ~ 18,9 ~ 13 17
34.00
~ ~I ~98i,~ l .T48~,2 I -..y~ ~oi 1
` ~n913~ao r~~ ~n t IMI ~rj~'
B.aL ~ N"~=q74.4o 136.50 ~46,m ~q79~1~ ~ i~
:r~ q~B.~ ~ N89'4i'S2"E F{UB=97B.97 ~~9.~ v
!1v ~ V A C A l~l T~ 0-j"'
F-- ~ r,-; ;
~ i ~
~ DRAINAGE AND ~
UTILITY EASEMENT ,m y^~ ~
_ , ~t r~' r ° i
~.r'~ y, - . .
,
~ - .
~ ~ ___.__/_/~~a~ ~ ~ .
I hereby certify that this is a true a~nd correct representation of a tract as shown and described
hereon. As prepared by me this L_ day of Nov~Ma,~- , 1g~.
/~UQC~.QP P WoH.~r Minn. Reg. No. `~D 6
car+su~nHa aarm~s, BOB CLARK CONST.
AOBE ~ ~S a~e wm suRVEraas ~o,~cr No. 8766.00
. N6INEERING B~K Z~y F~~l~~"~
COMPNNY, IN~. PACE Zy
~1000 EASi 1481h SIIiEET, 9URNSNLLE, MINNESOTA 553J7 PH ~32-7000~'~. D O` ~
CERTIFICATE OF SURVEY C
L298I D@SClIpb011: LOT 2. BLOCK 3. PINETREE FOREST
DAKOTA COUNTY. MINNESOTA.
(979,51 DENOTES EXISTING ELEVATION
~9B/•2 DENOTES PROPOSm ELEVATION
INDICA7ES DIRECTION OF SURFACE DRAINAGE
~ ~ = FINISHED GARAGE FLOOR ELENATION
2 = BASEMENT FLOOR ELEVAiION
= TOP OF FOU
SCALE : 1" = 30' T ~.,W y o ~
x_is~i
,4~FS5~' : 4°I61 sYcAm~pc DR WE L~ 1! N p I~/+/~-w~y /~i ~
: ~lr-, a 9~oE`1~ 7y~,...s~I~d
g~,rH mn~K r ~v w, ~ oc¢d
TNH A~T L/1T Q-i BCaK'I.~Y~ Q,,,.~Lc r L~ ca~'r~y. /~u v 9 S
Ef~V. = 97B.3(c ~~1~ o~~'`ze 5 L~ i ~
~ G u~`
~ Q/ r__ ~
i ~
~ ~ r-i-i-~ 3o.ao
~ ~ ~ ~_L. i
~ vacAN-r ~o-r
~ ~
o ^
~ i q~8.7 ~ ~i N89'41'52"E Hu8=9'~9,~B 919,~ N
~BJ) 8: 979,n5 136.50 018,cn ~/S,9 ~~1
~ ~ ,J ~ Zl,ao q8l _'s , °i~ ~ ~
~ ~ ~9~~ 0 2a.33 0 . ~
~ ~98i•~ ~ z.oon l
a~tl ~`1~8yi 25.s~ ~ o tn 6.2y ~m~ 1
I Q ° ~ ~al
< w ~ ~
~ ,o f ~ ~ ~ ~ N o
~7 0 ~ ~ L ie.oo °p
o O W a 30.33ya4 .~aD ~
F-; O O , x + d N ri 3 di~ ~ ~p ij ~
Z = ao o^ r- 981~~s, Z I a
1 ~ I j~r
a.ooo N
(y79,3i aa.oo r~ie~.9 i 13 i7 ~
o jl ~8i~~ ~YB~IZ,I to~ 1
~ L_ `
u~Q13.oo ' r ~ ,n ` Im ~rj~
B~ v N~e=979. 136.50 p46,m ~j~~ ~~t~.
~ i q~g,o ~ N89'41 ~52"E µ~e- 978.97 ~-~y,~ ~
~ VACArJT LOT
F 1 Y 1
!
_ :__l: i i
~ Dw,Iru,cE nrrD EACiAId FORESTFI DIVISION
UTIUIY EASEMENT `@
~~Y~~~i~ ~
~e
DATE ~ ~'l~ ~ `~_s
I hereby certlfy that this ts a true asd correct rgpresentatlon o rac as shown ond described
hereon. As prepared by me thls l~~ day of Nw~ni , 19~.
/uAQOAX!' P Minn. Reg. No. q0 6
, / CITY USE ONLY
LOT ~ BL RECEIPT ~ I C~ ~j 3
StiBD.(`f"~[~,~OI ~ RECEIPTDATE: a-~~-~n'~et
1999 M~C~I~lNIC~4L ~~MIT (~SID£NTIAI.~
CI'fY OF EkfiAN
SSSO P1LOT KNOB itD
$f?fiAN b!N SSl YY
d ~ / (651)B$1-4675
Date: G
Complete this section onlv if you aze installing HVAC in single family, townhomes or condos under
construction and not owner /occupied
• HVAC: 0-100 M B T U $ 30.00
ADDITIONAL 50 M BTU 6.00
3
• Gas outlets (minimum of one required @$3.00 ea.) ~
• State Surcharge: .50
• TOTAL: l-.~ rj r~
Complete this section on if you are remodeling, adding to, or repairing existing single family dwellings,
townhomes, or condos. Please indicate if it is a new item, replacement item, or repair.
_ New _ Replacement _ Repair Other
" Fumace Air conditioning
_1'
A exchanger, i.e. Vanee system, etc. _ Other
Renriiider: Ca11681-4G75 far inspecfions. $ 30.00
State Surcharge: .50
Total: $30.50
SITE ADDRESS: G( S
O~~".~'ER NAME: PHONE
I~STALLER NA'.vIE: 4 PHOIv'E ~S~ - ~C
STREET.4DDRESS: ~Q ~
CITY: _ ~ ~ /y STATE: P: SSd ~I ~I
/ \
SIGNATURE OF PERMITTEE
7S,F02~15 BLD~~IECH PER,YIIT (RES) - 1999
CITY USE ONLY
L BL _ RECEIPT
SUBD. RECEIPT DATE:
APPROVED BY: , INSPECTOR
7 999 M~CHRIVIClkL PEitMIT (COMM£RCIAIJ
CTfY OF £RfiAN
3830 ~u.oT xxos ~tn
~,te,e?iv, r~tx ss i Q~
(651) 6$1-4675
Please complete for: all commerciaVindustrial buildings
muiti-family buildings when separate permits are n~j required for each dwelling unit
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: 1% of contract price OR $30.00 minimum fee, whichever is greater.
Processed piping - $30.00
CONTRACT PRICE x 1%
PROCESSED PIPING
PERMIT FEE
STATE SURCHARGE ($.50 per $1,000 of nermit fee due on all permiu.)
TOTAL
SITE ADDRESS:
OWNER NAME: PHONE
TENANT NAME (~tPROVEMHNTS oNLY):
INSTALLER:
ADDRESS: PHONE
CITY: STATE: ZIP:
SIGNATURE OF PERMITTEE
CITY USE ONLY p~
L~ BL ~ RECEIPT#: ,fD.3/ 9 O
SU60. ~ ~ RECEIPT DATE: ~ 5/9
Y 999 ~LUM$INF ~P~tMIT (i~SID~NTI~W
sgs`~
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snsa~r?,MrrssiaQ ~~„o,•~~. tE~~7sso
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Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
------~~~~w~~,__~~~~_~_~~~~_~~__--____-'-____~~~------------'---------
FIXTURES EACH # TOTAL
Shower 3.00 x ~ = 3.4~
q. u~
Water Closet 3.00 x -
Ba?h Tub 3.00 x _ _ to
Lavatory 3.00 x = lr_tA
Kitchen Sink 3.00 x = w
Laundry Tray 3.00 x = . w _ Q~,/
Hot Tub/Spa 3.00 x - _ ' ~~i°'~~
Water Heater 3.00 x _ ~ ~
Floor Drain 3.00 x _ R 9
Gas Piping Outlet ' minimum - ~ 3.00 x = 3~_
Rough Openings 1.50 x ~ _ ~~.5 0 O~
Watef Softener ` tor dwellings under construction 5.00 x = ~ flu~
Water Softener ' for existing dwelling 30.00 x = ^
U.G.Sp~inkler ' fordwellingimdercons!. 3.00 I = ~ LL'
U.G. Sprlnkler ` for existing.dwelling 30.00 = X~
AlteratlOns * toexistingresidence 30.00 =
Water Turn Around 30.00 =
Private Disposal System " MPC iic. 75.00 =
(new and refurbished systems)
Private Disposal Systems ` a.bandonmem 30.00 =
RPZ (new installationlrepair) 30.00 =
STATE SURCHARGE .50
Reminder. Cal~ 681 d675 for inspections of water heaters,
water softeners, alteretions, etc. 5~.3.
W~
TOTAL
• •
I hereby adcnowledge that I have read this applicaUon, stale tliat the infortnaBOn is mrtect, and agree to comply with all applipble Ciry of Eagan ordinances.
It is the applicanYs responsibility to noUfy the property owner that Ihe Clty of Eagan assumes no liability for any damages pused by the Ciry during ifs normal
operatlonal and maintenance activities to ihe tadlities consWded under this pertnit within City propertylrighbof-way/easement.
SITE ADDRESS: ~ p I S~ C 1~+ ~'D '1~ ` r/
OWNERNAME: C L.A ~'G K C~b-t^~S
tNSTALLER NAME: n G c~ ~~~~~~~?G TELEPHONE e~ I~ 5~,~.~ '1 O ~ I
STREETADDRESS: ~~6 D ~3/ ~ ,S /
CITY: InI ~'~L ~ V o4 l-~ E`I STATE: J~ I'f/ ZIP: S l02
-
SIGNATURE OF PERMITTEE
CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1999
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Use BLUE or BLACK Ink
r________________,�
I For Office Use �
I / I
C�+ O� nn nn j Permit#: / �� �
by �;a�all � ��S� �
� Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 � Date Received: �
Phone: (651)675-5675 I I
Fax: (651)675-5694 ► Staff: �
I I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: '7`�(D I C�rn� .CL+�� Unit#:
Name ��fJ;i�� �/✓�+�►��� /r�l,'r•2��.°-� Phone: {t.�.�'• ��� �c'0�
Resident! ,l
Owner Address/City/Zip: � P�w 1 � �L�.�i,*�r .L.J✓` Z 4 $ i`
Applicant is: Owner �Contractor
Type Of Work . Description of work:�� 3 /'�c°'-�
' Construction Cost:� ��c:-�'r.�'�4 Multi-Family Building: (Yes /No�
Company: ,�)/�-� r��.` �;��,r�� l':.�a��.�.:�iK:,:-; Contact:�1��1 ��a�'`�c.����'�
COntractol' Address: .5�� ,�r/� City: ����,r� t'�� �`y�rr,l
s��
` State: ,�:' Zip:-�''��,�� Phone: ���_�'`l�•r�(�c�EmaiL
a
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License#: ���.,(������ � Lead Certificate#:
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
�r��� ���
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:
P
Sewer&Water Contractor: Phone:
NOTE; Plans and 5upporting documents that you submit are considered'fo be public information. Portions of
the information may be classified as non-public if you provide specific reasons thaf would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651 j 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 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 permit issuance.
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X �."�e'g i �7'li�t9��riJsf•✓�- X � ,,'",�.,
ApplicanYs Printed Name A plicanYs Signature
Page 1 of 3