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1119 Tiffany DrCITY OF EAGAN Remarks lU 22 9 Addition CANTERBURY FOREST Lot 18 811c Owner L??xl 1,? '1 L ??ia1Q L treat 1119 TIFFANY DRIVE t ndr, I l : , MnL?.. /N h/;44!24 EAGAN FIN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF, gob 1979 Paid unde original pd rcel STREET RESTOR. GRADING y` 1981 106.78 5.34 20 as." A013446 1-12-M SAN SEW TRUNK Z 1973 Paid ands original reel SEWER LATERAL 5 1981 439.42 21.97 20 I -qd A01 4" -112-94 WATERMAIN WATER LATERAL 9 1 20 WATER AREA .-{Q 1979 Paid unde original T xcel STORM SEW TRK X1, Z- STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK SEWER & WATER PERMIT CITY OF EAGAN 3830 Pilot Knob Rd. P.O. Box 21199 Eagan, MN 55121 OFFICE USE ONLY PERMIT DATE WATER PERMIT # METER # PEADER # METER SIZE ISSUE DATE J SITE ADDRESS ?t LOT , {:: BLOCK SEC/SUB = APPLICANT: h' ?' = ' 4 ADDRESS: _2 I _ u r - . y /`1 G`{ CITY, STATE /! E'er ZIP PHONE: PLUMBER: 11/28/99 SEWER PERMIT # B.P. RECEIPT # ^ 2-'113 B.P. RECEIPT DATE 8 11 / 89 PRV -BOOSTER PUMP PERMIT REQUESTED X SEWER A WATER _ TAPS COMM/IND RESIDENTIAL X NEW - EXISTING ADDRESS: ?? - T 2 ?- k 1 AGREE TO COMPLY WITH CITY OF - Zip N O R OR?NANCES: CITY, STATE PHONE: -???Gr. t L .-y OWNER: ADDRESS: `? Y SI 4ARE HEN M ER SUED CITY, STATE ' ` ZIP PHONE: PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. SEWER & WATER PERMIT CITY OF EAGAN 3830 Pilot Knob Rd. P.O. Box 21199 Eagan, MN 55121 OFFICE USE ONLY PERMIT DATE WATER PERMIT # SEWER PERMIT # METER # B.P. RECEIPT # "1413 ? READER # B.P. RECEIPT DATE 8111/8 METER SIZE ISSUE DATE - PRV -BOOSTER PUMP SITE AD?ESS , E LOT _ I ?)BLOCK __?_SEC/SUB APPLICANT: ADDRESS: -Cur ^ ? ?. ! CITY, STATE ZIP PHONE: PERMIT REQUESTED SEWER X WATER - TAPS COMM/IND NEW RESIDENTIAL EXISTING ' PLUABER: ADDRESS: I AGREE TO COMPLY WITH CITY OF EAGAN ORDINANCES: CITY, STATE _ ZIP PHONE: OWNER: ADDRESS: SIGNATURE WHEN METER ISSUED CITY, STATE ZIP PHONE: PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. t;. CASH R ' CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 1 19 4 RECENEO FFM _4 AMOUNT S Z , 8 DOLLARS 100 O CASH ? CHECK BY C '? 1 Whit-Payers Copy t' Yek- -Posting Capy Pir*-FUe Copy Thank You Address: 11 Iq =ANY DRM Lot 18 Blk 1 Sec/Sub CANIEBARY FOREST These items were/were not complete at the time of the final inspection. 11/27/91 Yes No Final grade (6" from siding) Permanent steps - garage Permanent steps - main entry Permanent driveway L-Z Permanent gas Sod/seeded grass V Trail/curb damage Porch J 2 Basement finish Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before E,ze potential exists. ?fo wu ite - City copy Yellow - Resident copy Pink - Contractor copy W."- 7tt M (Ur#ifirat a of (Orrupaury Citp of (Eagan aepx rt of Want" impertwu n& Certrficate issued pursuant to the requbrm&,& of Saxton 306 of the Unifona Building Code certifying that at the lime of issuance this structure ups in comp&usm with the swious on&anoas of the City regulating building cam7ru *n or use. For the following: the comma m SF 1>GX•',1ra W& Famk Km 16930 Oar %ve R3/M l z..Iw Dw is -SD.JR 1 True com UN MOM & HMJU RIM &w" A936 4M =I has 1119 TIFFANY ]I Xe L=aq T.18- B1, CANT Mmv F(VdSr DOC 11127121 .77 Fluldms otc?,I POST IN A CONSPICUOUS PLACE CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 0 16930 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for SF DW/GAR Est. Value $121,000 Date ALK Site Address 1119 TIFFANY DR Lot 18 Block 1 Sec/Sub. CANTERBURY FORM Parcel No. W Name BENTON 8)ll- FORD 3 Address AVE9 #1 o City Phone 721-7101 IS OV Name Address SAME city Phone U¢ W Name Address i W City Phone I hereby acknowlege 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. Signature of Permitee <'? r { A Building Permit is issued to: BZN7`ON0R UftU FM on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official OFFIC E USE ONLY 3 Occupancy R.- P H+1 D R FEES Zoning (Actual).Const +1 N:;u- Bldg. Permit 714e00 (Allowable) V? 60'30 Surcharge # of Stories two Plan Re iew 337 * 00 Length v 100000 Depth SAC, City S.F. Total - 575*00 S.F. Footprints SAC, MCWCC On Site Sewage Water Conn W0,00 On Site Well Water Meter ??? MWCC System Acct. Deposit 3o.OD City Water - 20*00 PRV Required &W Permit Booster Pump S/W Surcharge /? 1000 228900 Treatment PI APPROVALS Road Unit 34oeoo Planner n il Co Park Ded. u c Bldg. Off. Copies 3•?5'? Variance - TOTAL Permit No. Permit older Date Telephone # W*TER E I5 R E /S lf PLUMBING 9, ?- H.VAC. / [7 ELECTRIC Inspection Date Insp. Comments Footings I Foundation JV /V44PS C1110,15,;7- Framing C),-- 6V G-, . g Roofing qr7 rQv,? ,gQG2 Rough Plbg. pQ Rough Hlg. Fireplace 2 ~?t" Q S G 2 PQ Final Htg. Final Pbg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan U00 -2 h 2 c S Bldg. Final //2>I/ Deck Ftg. - s' Deck Final Well Pr. Disp. For Office Us's Only: ??' • + MECHANICAL PERMIT CITY OF EAGAN PERMIT # RECEIPT # ' CONTRACT PRICE: 3830 PILOT KNOB ROAD, EAGAN, MN 55122 PHONE: 454-8100 DATE: Site Address ` TYPE WORK DESCRIPTION BLDG Lot Block Sac /Sub . t k New Res Ti D Mult. Add-on Name - Address Comm. Repair City I - -71u Z PT one Other ` d ?t'? FEES Name Et: 0 r. x - RES. HVAC 0-100 M BTU - $24.00 c Address ADDITIONAL 50 M BTU - 6.00 p Ciry Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) PER PERMIT 1 50 EA ) - . . GAS OUTLETS (MINIMUM -1 TYPE OF WORK Forced Air k> M BTU ?-?• COMM/IND FEE -1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES Boiler Unit Heater Air Cond. M BTU M BTU M BTU TOWNHOUSE & CONDOS - RES. RATE APPLIES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & REMODELS - 12.00 MINIMUM COMMERCIAL FEE - 20.00 Vent CFM - STATE SURCHARGE PER PERMIT - .50 Gas Piping Outlets # ? (ADD $.50 SIC PER EACH $1000.00 OF PERMIT FEE) Other PERMIT FEE ?'.?• : S/C: GNATURE OF PERMITTEE TOTAL: FOR: CITY OF EAGAN CITY OF EA CONTRACT 3830 PILOT KNOB ROAD, PRICE PHONE 454 Site Address f / Lot Block ec/ Name Addresst? City ` Phone Name Address City ?S , Phone FEES COMMAND. FEE -1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE $12.00 MINIMUM - COMM.IND./FEE $20.00 STATE SURCHARGE PER PERMIT .50 (ADD $.50 C PER EACH $1,000 OF PERMIT FEE) FOR: For City Use PERMIT # MN 55122 RECEIPT # DATE: Ii': -I Res. New Const. L-0"- Mult. Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00 _ Shower - $3.00 _ Kitchen Sink - $3.00 Urinal/Bidet - $3.00 Laundry Tray - $3.00 Floor Drains - $1.50 j Water Heater - $1.50 . rj Whirlpool - $3.00 Gas Piping Outlets - $1.50 (MINIMUM -1 PER PERMIT-MEW CONST.) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 U. G. Sprinkler System - $12.00 PERMIT FEE: STATES S/C: _rn U GRAND TOTAL: T • f i? AD,35oa£-' 9719 I 8x31x147 61 4,515 D° Request Date ` 1.6 ??C, Fire No. Rough-in I Required? ectin ? Ready Now (](Will Notify Inspector O When Ready? O? / XYes ? No I Alicensed contractor ? owner hereby request inspection of above elec or 1: DD Job Address (Street, Box or Route No.) / 1 ( I 4A-kt_? City O/ % Section No. Township Nam o o. Range No. un Q Occopant(PRINT) enl ,2 a/ Phone No. 454---:L 3d3 Power Supplier y/ fD / Address T7 C 0 W. Electrical Contractor (Company Name)z) a_ - ?- - lt - n ^ Contractor's License No. x V Q Mailing Atltlms IGOntractor or ner Making Installation) 5s?i7 AuIDOraetl SignaWre IConvactoriOwn Making Installation) Phone Number 915- MINNESOTA STATE UARO OF ELECTRICITY Griggs-Midway Bldg. - Room 5.173 1811 University Ave... St. Paul. MN 55104 Prone (811) 841-0800 THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION +4" EB0w01-0z jl? See instructions for completing this form on back of yellow copy x{ 4 j el 9 31147 X, Below Work Covered by This Request lG y? 7 New Rii. Typeo}'Buildma Appliances Wired Equipment Wired Home - Raage Q.? Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (speedy) contractors Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuiis/Feeders Fee Swimming Pool D to 200 Amps / 0 to 100 Amps /,S 6 O, Transformers Above 200 Amps Above 00 _ Amps Signs Inspector's Use Only: TOTAL Irrigation Booms sG S , .a Special Inspection . f- 7 9 ,. 4k? Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in - Dater 11- - certify that the above inspection has been made. Final f'.'? Date 2' OFFICE USE ONLY ? `( ?? This request void 18 months Irom r&94,10? 13 o/. /Icn 0/c°/ V / " 46102 ,cc 72-,)('1C7 -11 Request Date Fire No. Ro ugh Ins n Requi _ ? Ready Now LII Notify Inspector a ? Ves % Ao When Ready? I licensed contractor ? owner hereby request inspection of above electrical work at: Job Address (SheeL Box or Rcute No.) City J ? / / V Section No. Township Name or No. Range No. Cou ,L?U Tom' Occupant (PRINT) Phone No. PO S -lie L /C. -2 0 Electrical Contractor (Company Name) d Contractort License No. / 'li Add row (Contractor or Owner M "ng nstallafion) 22 • t EG AWhori:ed ( a tal - Phone umber Z114:7- Vz3 MIN TA STATE BOARD CTRICRY Grigg.MWway Bldg. - R 113 1821 University Ave., SL Pearl, MN 55104 Phone (812) 642-0500 THIS INSPECTION REQUEST WILL NOT BE ACCEPTED By THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. 0//85 V 49102 REQUEST FOR ELECTRICAL INSPECTION ll? See instructions for completing this tone on back of yellow copy. X" Below Work Covered by This Request E&ccccl-07 9600/ ew Add Rep. Type of Building Appliances Wired Equipment Wired ` Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify{ Comm./Industrial Furnace Farm Air Conditioner Other (specify) contractors Remarks: Compute Inspection Fee Below., # Other Fee # Service Emrancesize Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 _ Amps Amps Signs Inspectors Use Onty: /? OT L Irrigation Booms Special Inspection Alarm/Communication Other Fee I, the Electrical Inspector, hereby RoughAn care certify that the above inspection has been made. Final OFFICE USE ONLY This request mid 18 months from BUILDING PERMIT To be used for SF DWG Value $121,000 N° 16930 Receipt # 30 Site Address 1119 TIFFANY DR Lot 18 Block 1 Sec/Sub. CANTE$BURY FORES Parcel No. rc Name BENTON & BRENDA FORD Address 4236 46TH AVE, #1 City MINNEAPOLIS Phone 721-7101 o Name SAME g Address City Phone Ww Name z 30 Address <W City Phone I hereby acknowlege that I have read this application an state at the information is correct and ag to mply with all ap cable tale of Minnesota Statutes and City ag Ordinan s. Signature of Permitee A Building Permit is issued to: BENTON 0 R ND FOXD on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 . 19 89 OFFICE USE ONLY Occupancy R-3 -N-1 Zoning PD RR=1 (Actual) Const VN Bldg. Permit (Allowable) VVN Surcharge # of Stories Length Depth S.F. Total S.F. Footprints On Site Sewage On Site Well MWCC System City Water PRV Required Booster Pump APPROVALS Planner Council Bldg. Off. Variance 43' 51' .XX XX FEES Plan Review 714.00 60.50 357.00 SAC, City 100.00 SAC, MCWCC 575.00 Water Conn 580- 00 Water Meter 90.00 Acct. Deposit 30.00 SM/ Permit 20.00 SMJ Surcharge 1.00 Treatment PI 228.00 Road Unit 340.00 Park Ded. Copies TOTAL 3.095.50 SINGLE FAMILY DWELLINGS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS 1 SET OF ENERGY CALCS. SERER & WATER PERMIT FEES AND ACCOUNT DEPOSIT FEES WILL BE INCLUDED WITH THE BUILDING PERMIT FEE. PROCESSING TIME FOR SEWER AND WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED INDICATING A LICENSED PLUMBER. 1989 BUILDING PERMIT APPLICATION CITY OF EAGAN IL950 MULTIPLE DWELLINGS 2 SETS OF PLANS REGISTERED SITE SURVEYS - (CHECK WITH BLDG DIV.) 1 SIT OF ENEM CALCS. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS • OF UNITS NOTEt ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER NDST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.. PENALTY APPLIES WHEN: PERMIT IS NOT PAID FOR IN SAME MONTH IT IS REQUESTED. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.AUG 0 81989- To Be Used For: h10G9 FPM "15U,. Valuation: -4ti ' Date: hi6r 7, eq Site Address 1119 'C'W pt t01( "Ra. L.ot IS Block ? Parcel/Sub ?*V-ST 000- OFFICE USE I Z.I / Occupancy ?11 -3 M-I Zoning Pr) R-? Actual Const V- N Allowable V-N # of stories Length 4 Owner tJ Y WWC'>N roRU Address ?,$6 - ka M e. 'Or k City/Zip Code 'MMS WS P54<* - Phone 77,1'-710? Contractor OOAV-- - Address City/Zip Code Phone Arch./Engr. _ Address Depth S.F. Total Footprint S.F. On site sewage On site well MWCC System City water PRV required Booster Pump APPROVALS Planner _ Council Bldg. Off. Variance COMMERCIAL 2 SETS OF ARCHITECTURAL 6 STRUCTURAL PLANS 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALLS. FEES Bldg. Permit 00 Surcharge irnp'50 Plan Review ?Sr7.Oo SAC, City /00100 SAC, MWCC 57510b Water Conn 15*F?4),0 0 Water Meter ,00 Acct. Deposit :3.0,oo S/W Permit 7-0,00 SIN Surcharge 1. OD Treatment P1. Z 2 ,ao Road Unit "' p a Park Ded. Copies SUBTOTAL Penalty TOTAL City/Zip Code Phone 4 _ ? qj? b ghCo 4 O L-o-C 18 $I.OGI'r; 1 GAt TrSF-60VLY VOOP-P-sT 12A14O-rA Goo*ry w4AVSd .Ar O \ a ro ??L ?` gel \ al k/ \ C 4D , \ SGAcL? 1'1- 3d? 0 o,?aar , Woa 1rAOtAO $?P?iCtwlCt?? R5? h ?M?D lrARMxP- ??.? ? ?hSG-s??C ?L? Yl.? V 1594- EP:GAN ENGINEERINt! 17Ex 60 II I certify that I am a duly registered land surveyor under the laws of the State of Minnesota. I hereby certify that this is a true and correct representation. of a survey of the boundaries of the land above described and of the location of all buildings, if any, thereon and all visible encroachments, if any, from or on said land. Dated this Z-Y day of 1989. by_ Minnesota Registrati n No. I1-1 -t3 EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION SPITE ADDRESS: 141 j T1hNYpCrpdJ , MSJ ?5 CONTRACTO R: OWIdvn?p DATE: S ?zIB? PHONE: 7Z1- 1101 DETERMINE WORKING SQUARE FOOTAGE OF EACH: 1. TOTAL EXPOSED WALL AREA,,,,,,,. 3 o So sq ft x "U" 11 3 3 5.S 2. TOTAL ROOF/CEILING AREA........ 1 3-T5 sq ft x "U" 026 3 ?•7 5 3. TOTAL EXPOSED WALL AREA CALCULATIONS: Total exposed wall area above floor,,,,,,,. ?? IS sq ft a) Total wall window area: ?W P- p?a?X glazed,,.... 525 sq ft x "U" o_Zro * g-0.5 glazed„ •••• sq ft x "U" b) Total door area ••,•„••, &0 sq ft x "U" a,5o 30.0 c) Total sliding glass door area: glazed....., tJ/h sq ft x "U" - glazed....., sq ft x "U" d) Total fireplace wall area sq ft x "U" e) Total.,'wall framing area (Average 103,).......... Z? sq ft x "U" C>,lo a = 7-1 f) Total net wall area above floor (Insulated)....... '5 vs sq ft x "U" 4-6 = g3,5 g) Total rim joist area...... 4 nea sq ft x "U" o4-4- = 17,G Total foundation area (Exposed).......... 1570 sq ft h) Total foundation window area............ sq ft x "U" _ I) Total net foundation area above grade........ 2 ya sq ft x "U" O, o 4-9 3• TOTAL a ) thru 1) =l 7919, if i y te m N3 is the same as, or less than item fl, yo u hav e me[ the intent of l S.P..C. Section 6006 (c) 2. 4. TOTAL EXPOSED ROOF/CEILING CALCULATIONS: Total exposed roof/ceiling area........ 1 3"75 sq ft j) Total skylight area....... N/!R sq ft x "U" - Q Total roof/ceilinq framing area (Average lnry)...... sq ft x "U" 0 36 = 5.6 4 1) Total net insulated roof/ceiling area....... . tZ 35 sq ft x "U" aZ 57 _ -2? g 8 4. TOTAL j) thru 1) 3S.°JZ If total of 114 is the same as, or less than t2, you have met the intent of S.B.C. Section 6006 (c) 1. - ALTERNATE BUILDING ENVELOPE DESIGN 35.?5 MQe ?Jaaop? To utilize the total envelope system method, the values established by the sum of items R3 and N4 shall not be greater than the sum of items N1 and N2. ----- 1.__ 335.5 + 2. 35.-7 5 371.25 3. Z d 9.45 + 14. 35 . h z 285 •37 C E R T I F I C A T 1 0 N I hereby certify that I have calculated the "U" factors and "R" values herein and that the building here described meets or exceeds the State of Minnesota Energy Conservation Act. i?nature ri /-7/9-2 (Date) NSTRUCTION AMING SECTION: Interior air film R VALUE 0.68 5`/,° inches softwood t, q7 xterior air tifm 0.17 TOTAL R = 9.7 ¢ U= 1/R=0.108 SECTION (INSULATED) Interior air film O.tR 46 %z' Gyla . 0.4? 43 44 LEGP.4Z SNitilfaLS r '1'ty ?K a. 45 Exterior air film 0.17 TOTAL R = 7.1.37 U= 1/R=o.o4,0 ST SECTION: Interior air film n.A,R C /z "K +r? a o tsT l• g9 P Loco p 0,67- G?DA'F-• Exterior air film 171.17 TOTAL R 22, U = 1/R - c.o4-4- I011 SECTION: ?D FwrJP/?Tlo?1 Interior air film n.FA V, P Yw? s? o.?z Exterior air.film 0.17 TOTAL R - 7v.47 U = I / R = D. 04-cj y.a••1 A• SLAB ON GRADE 4 f ' Q 4 1 4 ./.: C1. V .d.,. Lft 1 CEILING SECTION (INSULATED): I Interior air film 0.61 2 _ %z" 644& 0.410> 3 wl F wir= ? 38•? „4 Exterior air film (still) 0.61 TOTAL R = 39,62 U- 1/R=0.075 CEILING FRAMING SECTION: 1 Interior air film 0.61 2 ?/ti G-W C3 p. 40 3 h'' ?e??+?-mss .n 4 Interior air film still o. 1 5 5 T" inches soft wood 6.57 TOTAL R - 214'1 U = 1/R - o.o?& CEILING SECTION (INSULATED): 1' Interior air film 0.61 2 3 4 Exterior air film still. n, 1 ----- ---- -- - - TOTAL R? U - 1/R= VENTED 4 Exterior air film still 0.61 5 Inches soft wood TOTAL R = CEILING FRAMING SECTION: 1 Interior air film 2 3 U= 1/R= 1 Inside air film n.61 2 Ye et-iqAc?D o. b2 3 ?5 L-3 F-ot-"4- PRPcK O,to 4 z3,o c6 SFE N HS 0,40 5 Outside air film n.17 TOTAL R - 1,90 U - 1/R - 0.61 Use BLUE or BLACK Ink r For Office Use Permit City of EaPermit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit Name: Phone: Resident/ Owner Address/ City/Zip: Applicant is: Owner Contractor ~lCi l Type of Work Description of work: rt, Pizzo j Construction Cost: Multi-Family Building: (Yes / No w~ Company: i L C ntact: Zf L""A/ Contractor Address: 25 40 Ila L(& 1,111f AAiZlz City: a k 6fw State: tY 4 Zip: Phone: License Lead Certificate r If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) s 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: I Sewer & Water Contractor: 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 (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.ora 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. Od" Apant's Printed Nam Applicant's ignature Page 1 of 3