4733 West Wind Tr . , . --~--~,F---:--.~-..---- . ti
CITY OF EAGAN NQ gggi
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
(;i
dU1LDING ~ERMIT ~ Rece~pt qqt ~ i~S~
T~ w w~~ /e~ SF DWG/GAR Est. Volue $ f 3, 000 Dote MARCH 12 ~y g^-
i y~ 33 ~ ES T / D .
Site AddrsM' Ertct Occuponcy
Lot ~ Blxk 2 ~/Sub. PARI: RIDGE Aite?
10--56750-020-02 ~ zori'~
Pmel No. Repoir 0 Fire Zone rl
Enlarpe Q Type of Const.
RANDALL & JEA,*I RUEGG
~ A~ 1019 - 29TH AVE . S. E. ~~°~t~ ~ # Stories4
Citv MIIIIQEAPOIp~~e 6 2 3- 8 0 2 7 G~~ ? Depth Sq. Ft.
RUSCON HOMES INC. AoPro.al~ F..s
~ Name
o~ qddrei: O O E. TH ST. /~sseume~t Permit . C O
" C~~ BUR~*1SVILLEph~1e 4 32-14 33 Woter 3 5ew. 5urc}wrpe 3, y 0
Police Plan check
~ $ $
a~
W Name •
i~ q~~ 1000 E. 14FTH ST. • E~, WoterConn. ~70.00
~W City gURP1SVTLL'£pho~~2-2044 00
~ Planne? Woter Meter 0 O
Courxil Road Unit '
I hercby ocknowledge thot I hove reod this nppiicotion ond state that Bldp. Off.
ths intormation is correct ond a9ree to comply wirh oll opplicoble APC T~o' ~ 0
Stote of Minnesota Stotutes ond City of Eoyan Ordinor~ces.
SiQrroturo Of Permittee
A Buildi Pem?it Is iuued to: t" `-~-~`t='E on the e
n0 xprcss condition thnr
oll wo?k shall be done in occord~nfe with yll applifable StaM of Minnesota Stotutes and City of Eopon Ordinonces.
Buildinp Officiol _ ~ (~r ~'t_ ,
~ _ ~1.~
P~rmit No. PKmit Hold~r Misc. P~rmit No. Holdsr
Plumbinq a.U ~2 , ^ ~
H.V.A.C. p~ ~ ~/?2
W~11
W~r
DkP•
Swwr
EMcbk ' ? Q 3~.5
Irqp~ction D~b Imp. Other
Footinp~ 3 /S-
Foundstbn
Fnminq ~
Rau~ Pib~. f/_ ~ ~
Rou~ HV
Insulation ;T.j~~ o!{
Fiml Plba
Final HYAC
Firwi
/I-
W~r O~saib~ Location:
Y4r11 ~
S~w~r
Pr. Di~p.
CITY OF EAGAN Remarks T! 1 i, f`' ~~j' ~
Addition pARK R~DGE 1ST ADDN ~ot 2 sik 2 Parcel 0-020-02
Owner Street State ~C+~1 hW 55122
4733 WEST WIND TRAIL
Improvement Dete Amount Annuai Years Payment Receipt Dete
STREETSURF. 1 8 49 13 1 104.40 A014112 6-22-84
STREET RESTOR. ~+9]..99 C004671 10-11-$4
GRADING
SANSEW TRUNK 1982 147.21 9.81 15 117.78 A014112 6-22-84
SEWERLATERAL ~ 12~.23 C009671 1~-11-$4
WATERMAIN
WATER LATERAL9~~ 396.35 C~~96~1 10-11-$4
WATEFiAREA 19$2 147.21 9.$1 15 117•78 A01 1 2 6- 2-
STORMSEW TRK 7 g 7 370.93 C009671 10-11-84
STORMSEW LAT x g5 109 58 7 31 15 109.58 C009671 10-11-84
CURB & GUTTER
51DEWALK
STREET LIGHT
ROAD UNIT • 41957 3-12-8
WATER CONN. 4~0.00
BUILDING PER, $881
sac 525.00
PARK
~ . r ,
Recefpt MECHANICAL PERMIT Pe~m~t Na f.
, . . ~ , CITY OF EAGAN 'i '
~ f F°~ -
Pil! in numbered spaces ';S/C
Type w Print /egibJy -
ot. -
1. Date 2, irutailation Cost
r'
3. Job Address ~ - Lot Blk. ~ Tract' ` ~ - _
4. Owner -
~..1~` !
5. ConVactor ~ Phone ` `-,t ' . ~
i'
6. Address ' • - ` - L ~ s~ iz
a
7. City ~ - State • , , Zip „ ~
S. Building Type: Residential Commercial O Instiwponal O
9. Work Description: New Add ? Alter ~ Repair O
10. Describe ' - Fuel TYpe °~i `
11. No. ~ui ment 8TU - M. Ea. No. EQUiament CFM
~ Forced Air ~
~ Air Handling:
Mfg.
Boilers ~ Mech. Exhaust - ~
Mfg. ~
Unit Heater
Mfg. Other
~ Air Cond.
I Mfg,
Gas, ~ping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
oomply with all ordinances and codes governing this type of work.
Signed : ~
for
Roy~ Flnal
Inspections: Date ! Insp. Date Insp.
This is your permit when numbered and approved.
Approved ~ CITY OF EAGAN 454-8100
Receipt~~"~ PLUMBING PERMIT Permit No.
~ 4r CITY OF EAGAN ' F~ -
Fill in numbered space~s S/C
TYpe or P,rint legibly 70~
1. Date ~ Z. Installati~n Cost
- ~ . ~ ; , ,
3. Job Address ' ~ Lot~_Blk. - Tract •
4. Owner
- . .
5. Co~uactor ~ Phone • " '
6. Address ";~r "
7. City .j ' - State Zip
8. Building Type: Residential CJ Commercial ? Institutional O
9. Work Description: New D Add G~` Alter O Repair ?
10. Descxibe
11. No. Fixtures No. Fixtures
- Water Closet Cecspool/Drainfield
Bath tubs Septic Tank
` ~ Lavatary Sohner
Shower Well
/ Kitchen Sink
~
Urinal/Bidet . Other
Laundry Tray +l
i Floor Drains
Drinkinp Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and oorrect, and I agree to
comply with a?I ordinances and codes governing this type of work.
S~~~ ' for
Rouph Final
Inspections: Uate Insp. Dete Insp.
This is your permit when numbered and appraved.
Approved CITY OF EAGAN 464-8100
Th~s request vofd ~J Q~ ya ~ 3 3
18 rtwnths liom 7 fi
~ 3 472~~~ ~ a ~AkK ~D6t ~3a•S~
Requns~ Date Firo No. Rnuph-in InsU~:ction
Rnqu-rcd~ ~Reaay Nuw ili Notity Insoec-
~ 8•y~5 ?N~ ~or WhenACadv
l/
~nsed Elecenwl ConVncmr I horaby repuAS~ insOection oi ebove
? Owner eleclncel work installad at'
S~reot AAAress, Bu or Foute No. Ciry
~133 ~ ~U~
ecuon o. Townshiu Name or Nu. R:~nge No. Coumy
/~fl ~
Ocr nt IPflIM) Phone No.
Power Sup0l~er Atldress
, . f~ ,YliltvL~~~~
EI tn(Zcal ConVactor ~Cumpany Nume) Conlractor~s License No.
` ~ ~ ~ Q O
Maitmp Address (COn[mcmr or Owner Making Ins~alla[ion)
(~~C~' iQ-(~~
Authonzed ~ na~ Vncmr Owne~ king ins lation) Ohqqe Number ~
(73J
rni r
ti
THIS INSPECTION REQUEST WILL NOT
MINNESOTA STAT AXD OF ELECTNICITY
Griggs•Midwey Bldg. - poom N-191 BE ACCEPTED BY TNE STqTE 80APO
UNLESS PROPER INSPECTION FEE IS
1821 Universi~Y A~e.. St. Peul. MN 55104
Phonn 16121 29]-2111 ENCLOSED.
l~ ~~~8 ~ REQUEST FOR ELECTRICAL INSPECTION i ,r: ee-oowi-oa
~ ~ Sce instruc~ions tor complebne this ~orm on bock ol yel low copy. ~~a ~3~ 3
'"X" Below Work Covered by lhis Hequest
Add AeO~ Typa ol 8wleing Applmncxs Wired Equiument Wved~•
Home Range Tempprary erviCe
Duplex Wnter Heater Lighbny Fxture5
Apt. Bwldinc~ Dryer EleCtriC Heatin
Commercial Bldy. Fumace Silo UnloeJer
InAustrial BIAg Air Conditioner Bidk Milk Tank
Farm ~nr~ P~~;~ v o~h~:, Is~,c~.~rvl
thcr Suuulv Uthei Oth~r
Compu(e lnspection Fee 8e/ow
N Fee SarviceEnvaneeSue b Fae fdeders~5ablexders K Fee Grcwts
0 to 200 Am 5 0 l0 30 Am s 0 to 30 Am s
/ Above 200 qmps 31 ta 100 AmpS 31 to 100 qm>s
Swimmin Pool Above 100-Amps Above 100-A~~~PS
Transiormers Irnyanon E3oort~s ParLal.'Other Fee
Siyns Speciallnspection
TOT ~F~
Remarks ~
G
Rough-in te ,~he Elec~ I
G~~ ~i~~! Inspecbr. neioev
CBl~l~y ~~Ifll 1~18 TbOVO
Final ( i~ speclion has been
B ~ de.
Thin reQUest voi0 tB months from
.
CITY OF EAGAN ND 888i
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 •
PHONE: 454-8100
BUILDING PERMIT ke~eivr #
To !a uaed fo~ SF DWG/GAR Est. Value $ 63 ~ 000 Dote MARCH 12 . ~q 84
SiteAddress - ~1 33 ~ £-ST ~l~~ T(2 • R3
Erect ~ Octupancy ~
Lot ? elock 2 Sec/Sub. PARK RIDGE q~~er ~ Zoning
Perce~ No. 10-56750-020-02 Repoir ? Fire Zone N/A
Enlarge ? Type of Const. V
a Name RANDALL & JEAN RUEGG Mo~e ? # 5tories
Z Address 1019 - 29TH AVE. S.E. pemoiish ? Length 40'
city MINNEAPOL~„Q 623-8027 G~ade ? Depth 48 Sq. Ft.-
RUSCON HOMES INC. Avv~o.a1. Fees
O Name
o~ Address 1~~~ E. 146TH ST. Assessment Permit •OO
v~ City BURNSVILLEphone 432-1433 WaterBSew. Surcharge 31.5~
MARK NAGEL/PROBE ENGR. Police Pla~ check~S00
~w Name
Fire SAC
~z 1000 F_ 146TH ST_
Address Enp. Woter Conn. 4'I O. OO
~W City B
N~$__~UTT~T~FPhone 4~2-7n44 Plonner WaterMeter 63.00
Council Road Unit 260.0~
1 hereby acknowledge thot I have read this npplication and stare that Bldg. Off.
1he inlormation is correct and ogree to comply with oll opplicabla APC Total $1 ~ 83Z . 5~
State of Minnewto Statutes and City of Eagan Ordirwnces.
$ignoture of PermiMee
A Building Permit is issued to: on tha express condition Ihni
oIl work sholl be done in accor e ith oll opptiFoble State of Minnesoto Stotutes and Ciry af Eogon Ordirwntes.
/iV f~
Buildinq O4ficial •..LJ-~.(.! r
_ )
~ HOUSE EATING TEST RECORD ~ ~ ~ ~ P~'R'~~- ~~pV~ ~
ADDRESS / (,L4~/!7~ ~ni~ APT._F1.00R CITY SUBURB~ ~
OCCUPANT OWNER ~
HEAT LO55 DATE NTG. INST.
SOLD BY INSTALLED 8Y
Elecfrical Work By Gos Lins By
TYPE OF HEAT GA _ FA HW STEAM -SPACE HTR. _UNIT HTR. -OTHER
GAS DESIGN CONVERSION
MAKE~ MAKE OF BURNER
a y~•
Model Qn ~ ~ ~ Model ~ ~
Serial \7~ ~ ~ Maz. BTU Rating ~ ~ ~ ~
INPUT ~ ~n MAKE OF FURNACE ~G ~ -
Model / ~ -.if
< CONTROLS c~ ~ ,
THER ( ST~T~} eat Plug Vent Size
Valve A~• +SC~C.~'. ~ KIND OF LINER ~,SIZE ~ /NONE
Limit Qn«+~-1r~ ( Draft Hood Ragularon'4~
v~
Limit Sefting -~~~r}1LL~~~' Filtar: $ize Numbar ~
Fan Seteing 4~Z. 11~ Chimney Location ~nsiae._1~-~Outside
Pilot Type Chimney Consiruction el` ~
Pilot Make, Y1 Crl~f M__SQ](4( ~~U ~
Pilot Modal $moke Bomb -Wiring
Pilot Timing Draft Test Tag
L.W. Cut OJff 4o Door Pressure ? Lighting Inst.
Prossure _S~p ~ Petcent C02 Data Tasted `
InputCFH G~•h• percent O ~ Company Testinq Z e~ -
2 L
$ivck Temp.~I~ ~ Pmcent CO flJe~ Name of TesN.. L ~a
i
Form 235
loyg~6F ~ 1 ~ ~ u /
CI'PY OF P~1GAN Include 2 sets of plans,
Y
1 site plan w/elevations &
BUII,DING PERMIT AZ'PLICATION 1 set of energy calculations.
4b Be Used For Single Family Valuation Date 3 f~-~~~
Site Acldress ai 7'33 ~.ks-f ~J i,~ D 7~ • OFFICE USE ONLY
Lot 2 Block 2: Sec./Sub. pa,rk ~id~e Erect Q( Occupancy ~3
Parcel ~ U' S{o ] S Q°O Z-Q ~ Alter Zoning T
Repair Fire Zone ,{j
Owner: g~.ndall L& Jean E. Rue~~ Enlarge _~pe of Const. ~
Address: 1019 - 29th Ave. S. . A'bve # Stories
Darolish Front t1~ ' ft,
Gity/Zip Code: Minneapolis, MN 59+14 Grade Depth yh ft.
Phone 623-8027 ,
APPROVALS FEE$ -
Contractor: ~scon Homes, Inc. pssess~nents Permit 3~a
?4ater/Seaer Surcharge
Address: ~000 E. 146th St. Police Plan Check~
City/Zip Cocle: Burnsville, MN 5$337 ' Fire SAC
~ Phone 432-1433 g'9• water conn. y ~p
Ylanner Water Meter 3 °9
Arch./F~g.: Mark N el Probe Council Rc>ad Unit ,26 p~
ag / Engineering ' II].dg. Off.
' Acldress: 1000 E. 146th St. 7~PC
City/Zip Code: $,,,,„c,r, ~ i P, MN~~~i37
Phone 432-2044/43z-3ooo ZCrrau, ~3~, S ~
\
~
~ ~
~ a d
~
. ,
SEDGWICK HEATING & AIR CONDITIONING CO. resT RecoRO ~OB NO. ~~Z 6~
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000
ADORESS W e~ W. N i7 CITV ~C^`1 G"~
OCCUPANT ~ OWNER ~~Me~
SOLD BV ` /v-.r ~Q ~ti~}\ ~ ` INSTALLFf] eY ~,~A "1
`zHko.~ (~~ov~136s17d
MAKE p MODEL
SERIAL NO. ~ ~ O `7 v 2 O~~ ~ INPUT (9 ~j B 0 a
~ ,s- v a a .
THERMOSTAT VENT SIZE
~
VALVE ~ ~ , / TVPE OF LINER
d
LIMIT ( t LWERSIZE
LIMIT SETTING ~ FILTERS: SIZE /~J~n 2, NU ER I
FAN SETTING Z`' WIRING v Q ~ ~ u~
PILOTTYPE I z ~ ~ TESTTAG
IGNITION MODEL s~ I LIGHTING INST.
PILOTTIMING f ~ l r~ ~ "
DATETESTED
PRESSURE ° ~ PERCENTCOz ` S~ ~ ~
INPUT CFH 6 ~ PERCENT Oz ~ COMPANY TESTING
~ y Uy Z
STACKTEMP. ~ PERCENT CO NAME OFTESTER
FORM235(FEV fliB9) FOqMDISTRIBUTION~ WHfiECOPY-JOBFILE YELLOWCOPY-CITV
2005 RESIDENTIAL ME~'F,[ANICAL PERMIT APPLICATION ~2~•
Lj ( 1 City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for. stngle family dwellings & townhomes/condos when pecmrts aze required for each unit
Date { / QJ
Site Address ~Y' / ~J ~,/~~~~1/I'J~t ~ Tr• Uoit #
Property Owner ' Telephone # ~ ) ~~3 ~ ~ `t~~b
Contractor SEDG6VIGK HFGTiy~ g,q~o
rn~in,~ ~r ~~EE '
8910 t^JEr ~rth
Street Address Minnoa.~6 City
' ~
(952) 881-9000
State ` - _ _ Zip Telephone # ( )
Bond Expires:
The AppGcant is _ Owner ~Contractor _ Other
Add-on or alteration ta existin dwellin unit y~ ~ $ 30.00
g g ~~QC~ ~j0 ~T'~ rJ
~ furnace _Additional _Replacement _ New
air exchanger
air conditioner
heat pump
other
State Surcharge $ 50
Tatal $ '
I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work wil[
be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a
permi[, but only an application for a perntit, and work is not to start without a pemtit; that the work will be 'n accordance wi[h the
approved plan in the case of work which requires a review and approval of
planL-//1-
SEDGWICK HEATING 8 AIR COi+^'T'„"'!G LLC~ <
Applicant's P iti~en" ' A licant's Si nature /
Minneapolls, P~~~v 55;~~ pP g
{952) 881-9000
2005 COMMERCIAL MECHANICAL PERMIT APPLICATTON
City Of Eagan~
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete Cor. commerciaVindusirial buildings
multi-Camily buildings when separate pennits are not required for each dwelli~g unit
Date / /
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telep6one # ( )
Bond Eapires:
The AppGcant is _ Owner ~ ConVactor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove ""see below
Interior Improvement _ Install Piping ~Processed _Gas
Nature of Work:
'"When insfalling/removing underground fank, call foi inspection by Fire Marsha! and Plum6ing Inspector
PCPDIIt FCCS: 570.50 Under~oundtank installation~removal
350.50 Minimnm (indudes State Surcharge)
or
Contrac[ Value $ x 1% _ $ PermitFee
g State Surcharge
If pe~mit fce is less than S1,lI~Q add $_SQ
If permit fee is more than 51,000, surcharge
is $.50 for every $1,000 owed.
$ Total Fee
I hereby apply for a Commercial Mechamcal Permit and acknou~ledge that the information is complete and aceurate; diat ihe u~ork
will be in conformance with the ordinances and codes of ffie City of Eagan and with ihe Mechanical Codes; that I understand Ihis is
not a peanit, bu[ only an applicalion for a permit, and work is not ro start w~ithout a pernut; [hat ihe work will be m accordance with
the approved plan in the case of work which requires a review and approval of plans.
ApplicanYs Printed Nazne Applicant's Signature
Approved By: , Inspector Date:
Required Inspections: _ U.G. _ R.L _ Air Test _ Gas Service Test _ Infloor Heat _ Final
~ ~0~~ COHSULTINd lH61Nt(!IS
ENGdN~EAING - P~A?+HERS ond LAHD ~UI1V[YOIIS ~
i
COMPANY, 1NC. ~
L 1000 Ul3T 14i1A STRLCT, EURHSVILIC, MINHESOTA 'JS3]7 ~M ~S2~S000
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'?~c°ebq ecMify thst thia ia Q trua cnd correct rspren¢ntation of a Y~ct of
,efld a~ aho+rn' nnd de,cribed hareon~. ~la preparad by mo on thie Z`~ dny ot ,
~~~aQ y ~ 19 . '
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HE;T LOSS CALCUL.ATIONS ~ UFPAK I~tE\' I UP I\'tif'[:t'l10\
1L'eatherunpi A~S.H.V.E, II Conitruction No. II Imulatian
Guide
indowe Doon Rcfercnte Out. ~Yall Int. Wall Ceding Roof , Floor ~II Kind How Applied
n-No I t'e:--No i 19_. ~I~-~- -~I
~
FI.! Room Leneth 1p W~dth f 7° Heieht g~ ~ FL~ -a~~ = Room L~ngth / 4~~ Width S`Heiqht
Wmdow~~ and Doon-Crackage and Arca ~ I Windowa and ~oors-~racVcage and Area
~~~d~n I~e~tnt n.. o( L~nwll~ w.e• ' H'Imn H.~Y~~~ N~. n( L~nulh. w.w
: n~nr ol v~ne Iqn~a ~_f
pr~~F ~p t~ Ne of V~~.• of V~~~e II(rn. af er~o4 ~Q f~. f
z ~ Y. ~..i 8.Q rob I J zs Gg a~a2 i8. ~8 (
~ ~ 3~ DooR l. 20 ~ I
f 20 7Z '
I ~ Coef. Bt~ Coef. Btu
~ • -
in(~~Iration ~ 23 (~b Z C II . L/~ Z//~
]n~~lraUOn
:lase ~o iJb~ Pi60 III Glaea 'yC~~7 jC 23~'i
ai~...nfl 2Zo i ii Exp. wail 3z
\et <xp. wall 2~. ( ~21-~-( II ~Vet exp. wall ~ LP/.3 I~~~ g
in!..vall ~ ~i Int. wall
.':~:"~g il]OJ `J ~ ~ Jz II CuLnK ly~ ~.7 ~~0
f:,~,~~ ~I F~oo~ 90 3 z~c~
ro~ai t~~~. 3~ ij ?o~ai e~~-
ReVuir<d ~q. E.D R. or sq. im. W..4- Leader area i! ~Zeyuired sy R. E.D.R. o~ sq. ine. W.A. Leader eree I~n`~~S`j
~
f FI.~ I-~ Roam~Lcngth e Widih fZ° Haght 8` f GI.', ~t~~ RoomlLength ~2° W~ath Height
~'indow~ and Doon~rackage and Area 'I Windows and Doore-Crac~age and Area
~~iatn Heir~~ No of Linui It wrt~ µ~~~~~p ry~i~nt No ot Wnul h wre•
D~~e cf V~ne R(LI• OI cnick p!6 ~I No. ol p~n~ ol 0~^~ ~It~U Of c~~[\ ~Q ft.
L I 2U -310 ~/G,Z~ i~ ~
i
~ ~ i i
i I I~~-I ~ ~ 5 4
, ~ Coef. Btu II ; I CoeE. tu
lnhltration ~ ,2/.(0 CvCoy ln6ltration
~
c:a~. i i 3•2 o I ~cP~ I~ cia,~
E.zp. wall 7 ; I', Enp. well I
\e: eip. wall ~',$p,P' C~ 3~ 3 I,~, Net uP. wall u ~ z(
~nt_w_a~~-' - II jnt. wa~~ ~
~ ~ /3~ ~ _ c cr~i~~,~ 9~~T /y'~
~ . I i~ F;oo,
jole~ Blu. r-[~ ~
2rJ ~ 7 TOId~ B~U.
R-q~,~rrd sq. f1 E..D.R or ~q. ine. W.A. Leader area 1 Required sq. (t. ED.R. or sq. ins. W.A. Leader aren
I FI.~ /~i~,/;q+.Room ILength ` Width /3C Hngh~ 3' 'i 1~.~ HP~2 RoomlLength f 5~Wid~h /2`Height Q.<'
Windowa and Doora--Crackage and Area I~ W'~ndowe and Doore-Cratkagt and Area
\\'~.I~~ H~I~u-T Yu Lm~cl M1` pr • ~Tµ'I~un Hr~rut I ho af Llne+l lt w e~ I
I~.~~_~~~ft.~n f II4~~• uf~~~ck 1 II [~II 40 fV~.e t~({i~~~e I 1i51~1• I uf[f~fM ~•Vrfl
2 ~ i t l-
J 56.~' 32 4'0 ~ ~ ~ ZV :
~~-i /~/•k I/o•8i/5 I
2~'O~~'"'7z ~ ~ i T~J
3 ! /b ~~lx i~~ ~ TI I I ~ - -
I ~ I ( H~ I ~__r 1 T i~ 17 `
i ~COCI. FSfO ~I I ~COtf. BIU
lnfih~aaon ; 7"7•9 ' 3/ i(Y. Infiltrauon ~ I ~~~•i Lf~ ~ 77
C.la~e 7Q Z) I ~~L."b ~i- C:as~ i/G~ C~'~~7 S.>>
~cp wa~~ ~~1~~ ~ i ~xp. wa~~ . ?9` .
tiet exp. wall ~ 3'y~(~ ~ zc, C~, --,~.c~ exp_wall 2~'7. ~ ~ I?_:-='
~nl. wa~~ ~ ~nL wa~~ ' i
~ r~i~~~K ' 3.ri S: ~ ~5S I' crd~„~ l~~' .5 i c..~.~
f loor r F!oor ~ ~
?o~ai a~~. /a4y7 I~I Tota~ Btu. ~3C Z
Reqwr<d eQ (t. E..D R or eq. in~. W.A. I.,ender arm r ii Requircd ey. fl. E.D.R. or eQ. ms. WA. Le+der arta _
Sheet .2 01 Z , N~eiPusco~J 1o7S GF SA~,Y~~.tiR;, .
o~~e dddi'e99 ;
HE;T LOSS CALCUII~TIONS uF.P.aH I:~1E:X I' UP I~'~PEC ~1'~O~' -
A.S.H.V.E. n
R'cathcntrips I Canetruchon No. ~I Imuletion
Gwde
mdow~_ I Doon Rekrcnce Out Wa~~ Inl. Wall Ceiling RooF Floor ~ F:ind F{ow Applied
ee-1'o 1'e~-No i 19_
3FIi~ j Room Lcngth 2lo Width yG eight FI.~ Room L.ength Width Height
Wmduw~ and Doon-CrackaBe and Area !fp`~ I W~ndowe and Doorr-Lrackage and Arca
~~~iav~ ~i.i~M ol Linu~ n w... ~ ~ ~e~ei4 u.i~n~ n.~ nr l.inu~h wr..
a pane uf Y~ne li(M• nf ct~~ M W tt ~ Nn of V~n• ol 1'~~~• IiYLi• of c~~tY ~p f~.
ly 3~ l1. o,~6 ~ ,
~ 20 3i~ f /C.$ „-S _ ~ i ~
_1 ~
co~r. a~~ ~ , co~r. e~~
.n~~Ilration ~GF~ yD , 3 C~ 1~~ ~I In6ltration - -
.lafa (~.in .~~C' 3C00 ' C.la~a
~tp. wnll /CS(9 I E,yP. wall
~et eap. wall C/~/~/ (n~e ~I Ivet exp. wall ~
nt. wall I In[. wall
r:! ci I i
d ~ ' I LGi~m~
~ I~- I
. nr ~~D ~O'-5 ~ ~j/yli'~ f~wt
foial Hi~. /J 7 S~ i~ iotal B~u.
~~a~i~rd sq ft. E.D.R. or ~q. ine. W.A. Leader area
Reyuired sy. (t. E.D.R. or sq. in~. W.A. L.eader aren i
-'FI i-- Room ~ Lengih Wldth Hcight li i 1
_ FL Room I l.ength Width Neight
Windowe and Dooo--Crackage and Area '1 W'indows and Doore-Crackage and Area
'TI ~ep_in Huvn~ no ot L~ned n w~u ~I
\n I uf p~n• 4f V~ne ?11~U at r ac4 ~Q h \\'I(111~ H~Itnl TO. o[ Lln~~l fl Art•
_ II N~t D~n• ol o~n• Ltht• of n~c~ ~0 It.
I ~ ~ I' ~i I
I I i I ~
__T+_~ ~ tj ~ ~ 1 ~ ~
I ~ Coef. Btu ~I ~ ; oeE. cu
!
Inf~lttation i Inf~ltration_
Glau ~ ~ ~I Glav
Ezp. wall II E.zp. wall
\e~ cap. wall \'<< up. wal~
Int. Mall-_ - I Int. wall
l'riLny ~ (~riliny _
~•~~^r • i h Floor I
"fotal B~u. To:a! E3w.
Rrquued fe. E.D R. or eq. im W.A. Lcader ar<a ii; Rcquircd aq. ft. E.D.R. or eq. ina. W.A. Leadcr erea
~
FL~ koom I Length R`id~h Haght Room I Length W'idth Hught
Wmdowe and Doon-Crackage and Area Windowe and Doon-Crackage and Area
r\\I.111~ Il~~l(lil ~.`l~ f Llneu:ll Aft~ II TN'IJlli Hel~~t N~~ Of ~ Lll~~olll.
Nu I~~~ t ' I~~~u~~~ a~ u~ u i No ~ of G~~ouu ~~tnu ' ot ~ 4 ~ ,ft
~ ~ jI I I i~~
~
~ ~ i . , ~ ~
~ ! ~ I i; ' ' ' r i~
~~i I I iCoef.! Btu ~~I ~ i I : ~~C~oel. -B-tu
In6hraiion ~ ~ InhltraGon ~ ~ ~ ~ _
Glau ~ ' i i~ G!ase ~ ~ I
~
E.xp. wall ~ ~ .'~'...sp. wa~~ ~
Nel exp. wall ~ ~ ~ ~~e: ezp. wa~~ ~
Ini .vall li lnt. wall !
C~ri6ng Cci6ng i
i
Flour F!oor
I~
Tolal Btu. i Totai Btu. ~
i
f~rquvrd ~q. f~. E.D.R or ~q. ins. W.A. ~.tader arre ~ ii Repwrcd sa <<~ E.D.R. or .a. ~ns. WA. L.e,d~r ~rta ~
- ~ ~D~~ i _
- I EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION yQ-&~r~~_,' ~
~ r•_ .
'
. . _ . . - ,
- OFtNER - -
: - ~ _ - - : .
= . - i~:'-:~ SITE AD~RESS- - ~ . - _ _ - . - . ~ . .
_ : _ , - ~
: . . _ - - - -
_ - _ . -
: GONTRACTOR ~US~o=~ +r~Owt~s' ~~L DATE . _ ' PHONE ~~I3Z- (u,.~
_ Determine working square footage of each.
1. Total exposed waTl area ~~IZ~'' sq. ft. x_____ ° Z- •7
2. Total roaf/ceiling area 1 c~~15 sq. ft. x_ '1; 9S
ozc.
iotal expos=d wail area, above floor =
a. 7ota1 wa11 window ar°a Ir ~i
b. Total door area So ' ~
c. Total sliding giass door area
~ d: Total fireplace wall area -
e. Total wall framing area (averaq=_~1CA)...:........ i-~;~
f. Total net wall area abov° floor is~ ~ •
g. Total rim jeist area i2~
Total °xposed foundation area = ,
h. Toiai foundation windort ar=a_....._
i, Toal net ioundation area abov° crad=
D=ter~ine "U" value of eecn wali _°c-_nt. ~
_ ~q I
a n ~ _.J Z
u ~O A ~Vu {JC - I
y II'111 i.~ ~ I~i~~J
1~ ~ A U
d. - X ~~U~~ - - _
e L x"t]" . I 1 = 19
r I ~r u~u ~ ~ _ r~4 ~
i . lJ.'/.~ ~ i
9. ; `1 X ~~U~~" , 04 = '~,~=1
h. - X "U" _
1. r>.-~ X u~~~ . C~ _ (o~ ~~l
3 ......................................Tc_al = ~GZ'I~Y!~ ~
:T i~°n =3 15 ~^O ~3iT.;°_ c5~ Cl" ~_~5 ~f:~il :~°_~il }~OU F;dV°_ f:?t Ai.~° l.'1~'_iif
`7
~i .~..Jl. 6~J~.J~C~-.
_ , . . ' ~
. . . , . . C ~r ~
' Total exposed roof/ceiling area = l(~-1 5 ~
" - Total gross roof/ceiling area = - .
j. Total skylight area -
. k. Total roof/ceiling framing area S
1. Total net insulated roof/ceiling area.......
Determine "U" value for each roof/ceiling segment.
J: X - _
k. I D"l, S X"U" , 023' = 2,
1. 9t,~,~ X~~~~~ e o2 = ,~~3~
4 ..................................Tota1 ° ~.1,5 U _
If totat of ~4 is th= same as, or less than ~2, you have met the intent of
SBC G006(c}Z.
To utiTized the total envelope system method, the values.established by the
sum of items a3 and ~4 shall not be greater than the sum of itens ~1 and ~2.
1. + 2. _
3. + 4. _
MAiERIdLS Therm. B~sistance
Ezterior nir
Siding Naterial
Sheathing
Insulation
SheetroCk
Interiox Air
Studs
P.im
Conc. Bl}:s.
,
COkSUITIHb HH61HtIllf
~ ~NGiNE~AIPBG P~RHNtfli ond LAND ~UIIVQYORS
COMPA(dY, 1NC. ~
L 1000 W7 14{w STRCET, EtllIHSVILLC, YINHCSOTA SS~S7 ~M ~52~~000
Cer1~z}~f cc:~~ o~ ~zcry-~
~ r Z
/qjy~
~GT~lr I~C.lCT'1P4~~o7L•
/
~cr z, ~u. 2, fl~a+~ R~ovE ~ .
D4icora GeJaN ~ M~~aEy~A. •
`
c~s \
s~ ~
/ o qqti,.3)o Q~ ~
, .
/ 6~ 'r~, o .
~ o
~ ` ~ ~ \,91 ~F•
1 ~ ~ ~
~I B ~ / c r3
O ~ ~
O V ry~~ Qv / \ \v ~ ~
tJ O R? !-I Q" ~ ~ ~ ~
° ~,j .4 9 :b
sce.~e:l"=30' / Qti ~9~3 zjJ
~ ~ ~ ~,a ti+i% ro &3
~ •o /
G
/ ~ \
~ ~
/
/ry~ / 2r~ \ \
~y~ / 9Zj•J \ \ ' a~~ ~
v~ ~ ~ o ~
3` ~O / .4i
/ ~ ~sl / p"7 y
c~, ~ Lor Z 23~~~-0. ,,,°'.a~^
. /z~JJ \ 1 / ?M~
/ S ~.68 ~2?. ~i~ .
~ o3~/\s1 ` ~ /
\J C
i7c.oJCErk~ES ExY'sl.la' ELEJA'fl~ , ~ - ~
~ r'3~oR~.,g~ Et,~/Arlo~ ~ - .
f sG, o Dra.~xr5 /J• ' - •
_
O 9` ~ -
- c~,~ - , ,
~s~ti~ ~ z?~s~ ' ~
i..~De~a~ DiREtrivr.i oF ~/F Ft 2~~
S~.~RFAC.L DRn ~-Yu~ C ~ .
/
L \
.~~<_r7EU 64?-t.l..E ~~.rx.4 ~LS/~ ° 9Z3~$3
hetroDy cer4ify that thin ie ~ trua and correct rooreeentation of a tract oP
nnd nc nho+m'nnd de~cribed herQOn~. A~ pr~pnred by mo on thi~ Z9'~ day of
r`~~~,t,e y ~ 19 . ' '
G
%~~o=a- lfinn~ Res~ No~ i~u~
_ _
+ { ~ ' I~~~ - v - ~ '
- EXTEAIOR ENVELOPE hVERAGE "U" COMPUTATION yP. E'~f~' -
. ' . r'_-~. _ - ~ ~ . . ' ' _ . ~ ' - _ .
- owriER : ~ . ,
= = _ - _ - - _ - - -
: . - - -
_ . ,
-
= - ~ .
: s•:.: SITE A~~RESS- ~ . .
: ~ CONTRACTOR ~-c~~ E'na:7 ~O+'~ES ~ ti.9L DATE _ ' P1i0NE •~I3Z;- 1~...~3
Determine working square footage of each.
t. Total exposed wall area ~,1~' sq, ft. x_ 23~'
2. Total roaf/ceiling area ~~1~ sq. ft. x_ -7~7, 9S
oZC.
Total expos=d wall area above sloor =
a. Tota1 wail window area Ic,.~~
b. Total door area So ' ~
c: Tatal sliding glass door area z.9
~ d: Total fireplace wa71 area....... . -
e. Total wall framing area (averaqa~lCA)...:........
f. Tota1 net wall area above floor ~so ~ ~
g. Tota7 rim jcist ar°a i~-~
To~al exoosed foundation area = ~7 .
h. Total foundation windorr area
i. Toal net ioundation area aoove crade ~3
~°_t°_T^Ifl? nUn Vd~U° Oi c=:l h'3~~ :°__-Oiit. '
~ I! Y~ ^ ~~`r~i ^J = ~ i~
~lD
' V CO X u~Jn ^00 c f
.J
39 u~n ° i?~G
c.
d. - x _ _
e_ 1-?c. X~~~~~ . ~I = 19
~ ~J:7= A ~~Un i~~~~,, - '~f` ' .
5, i X . o~ _
h. - X _
1. iiUn = G,~,~
3 ..........................:...........io~al = ZZ~~Y,~ '
li li,°_^I '3 15 `f:° SdiT:°_ 25~ O1" ~°_S~ ~G~(7 1~°_:l °1~ }'Gll ~":2V? f.:°_t '~i.f,° l;ii.'_~~t
~1 .~..JL .~J..J~I.}~.
, . t J . , . C _ ~ 6,_,~
, ' Total exposed roof/ceilin9 area = 10-1 5 ~
- Total gross roof/ceiling area = - .
j. Total skylight area . -
. k. Total roof/ceiling framing area i m, S
l. Tatal net insuiated roof/ceiling area....... V'I~5
Determine "U" value for each roof/ceiling segment.
3..... _ " X _
k. 10~1, S X"U„ ~ 023 ~ = 2~ y1
1. cu X~~~~~ r pz = 1~~3~
4 ..................................Tota1 = .l.ni. .
If totaT of #4 is the same as, or less than ~2, you have met the intent of
SBC G006(c}1.
To utiiized the total enve)ope system m2thod, the values established by the
sum of items a3 and ~4 shz11 not be greater than the sum of itens 91 and s2.
+ 2. _
3. + 4. _
MAi.ERIALS Therm. Resistance
Exterior Air
Siding Ma~erial
Sheath'ing
Insulation
Sheetrock
Interioz Air
$tuds
P.im
Conc. B]J:s,
. ~13.S~ry xi.r = Y7S~J~-. 13;
y
Sheet. / ot I N~se ecdSC~i..l ! c>S 6F "
uas, dddS'e6s ;
HE~T LOSS CALCUI.ATiONS Uf.l~,~tc I~fE~' I ur I.~'~t~LC flon'
~'eathereui ~ A.S.H.V.E.I .
p ~ Conetructwn No. ~I Inmlation
Guide ~
'indowe I Doon Reference ~i Out. Wall Int. Wall Ceding ftoof . floor Kmd How Applied
ee-,'~o 1'e>--No i 19_ ~
i
FI ! Room Leng~h Zp Width 17 ~ Height E3o ~ FI.~ Q Room ~ Length / P~ ~ Width S`Height ~S "
W'indow~ and Doon-Crackage and Atea Wmdowe and ~oors---Crackage snd Arcn
Ni.ll~ Ilrq~~ 1u of Llnulft Are• IT K'I.IIp H~I{M1~ M1. nf Lln~~lft. Ai~~ '
~~f pu~r of O~ne Iqpl~ nl <ru M ~p fc ~ I No of 4~ne uf I`ane II(LI. of c1~c4 IY. H
,z ~ Y_ l..i B,o ~06 I 1 z9 6$ a~o2 ~g. ~8 ,
_t I ~ 3 ~ Doo2 2c~
~ f 20 7z - S
-i Coef. Btu I ~ CoeL Bw
In6ltra~ion ~ 23 [/p 2 Q ~n6ltration sz~~/ '~b ~l/L
:laef ~o ~.~b 860 I Grla~e 'ylo•f7' JC Z3~,~
~v~MA~~ ~Z~ I I LSP. Wd~~ v~G
\'ct czp. wall zC, ~ /Z2.~/ ~
I~ Nct up. wall LE?.3 `u
.n;. wall ~ Int. wall
i~:~K I J7S.J~ 5 ~ S! II Ctil~o~ j~fO ~ S~So
f:,,~,~ i~!~ F~.oa~ 9~ 3 z~~
rocal H~u. , 3~ 3~ li ?otal Btu
ReQuired sq f~. E.D R. or aq. ins W.4 1.eader arra ~i Reyutr<d sy (t. E.D.R. or >q. in>. W.A. L.eader aren ~rC~+~
1~ ~ ~G l~ Room~ Length 6 Widih ~2° He~ght 8° i~ ~ FI.' ~3p~ Room!Length (2° Width C',>° Heieht 8`'
Window~ and Doors-Crackage and Area I ~Z 'I Wlndows and Doore-Craciage nnd Area
~c~o~n NeiYnt n'o o~ un..i ri w~u i' wi~nn xe~ini no ot wn..~ n w.o
~n( D~ne cf Y~n• I:l~l• af «~ok .~Y f: ~I ~ I Dan~ 11[~U Of cr~[4 0 ft
~20 3 ~ J /O . ~ I ~ ~ & ~ I
' I ~ ! I
j ~ I i o 4
j ~ Coef. Bm II ~ Coef. tu
Ir.!iltrahon i 121.(~~ [~~,t ~C:G`-J ~i1 In6ltr~ation_
G:aie ~ 13 •2 iT qp i CoCo6 j Glaee
-
E.zp wall 7 ~I ~p. wall
\et eip. wall js~. , ?jj 3 Net exp_wall 2(^~/
Int. ~all_ ' II jnt. wa!I
l..Jinp_ i~3~ ~ L C/C CrilmR I 9~ ~
I ,,..i i . " rioor
~ il
~cie~ BIU. i Z~ ( 7 ~i Tola~ BIU. _
R•quir~d sq fl. E.~.R. or eq. in~. W.A. Leader area i i~l Required sq. ft. E.D.R. or aq. ins. W.A. Leader nr<e
~ FI.I (~r~,/;/,,/e~ftoom ILength 1~ " W~dth /3C Hcfeh~ 8° i~ ~~1.~ H1~~ RoomlLength f j ~'Wid~h !2'"Height
\~.hndows and Doore--Crackagr and Ar<a ~~I 14'mdowe and Doon--Crack~8e and Arca
\~~.ttn ~l~l Yu ~u[ Llnrql~ wr • I~ U\'LLltn Hel~nt No o! Llnul f~. wru I
t~ ~.Ln~ nf .~nn~ Ilµlt:• uf ~ r~[4 i n~ ( k ~ V II
~T C~~~ NO I[~~~.a~ fy~i~e I~RI~~•
~ (c I ~-1 l-
1 ~ S~a 3 2- Yd , ~ ~ ~ zY ~0 / ! /y• k I /o~a' ;
~
~~_~,-rt z~ 7z ~ i IS, 3 . lv ~I+~ ~i ~ ~ - -
I t i g~ I; ~ a~
t ~ I Coef. Btu ~i i ~i ICocf. 6tu
~r.f~~lral~on ; ~~]~~~I lf~, ' / ~(r Inf~Itration i I ~
Giaae 7c ! .:iC~ 'iL~ i G:'aie ~ /G. F ! ~
F_zp. wall ~ I ~zo. wa~~ ' 2~C _
'`'e~ ezP wall ~ 3y 6 ~ Zo7Co Ir --~.ee uP. wall iz~~i'. I ~ 2.~.~
i I
Int. wall ! ~ ~ lnt. wall
1~rilmg ~.3.j1 ~ ~ ~7J.S ~I l'<iling .~~~i ~ O
F:oor f!oor j
-ro~di a~~. 1 i/o~1y7 ~i To~ai e~~ ~ 33c L
ReQuurd sq ft E.D.R or ~q. ine. W.A. L.eader aree li Rrquved ny. ft. E.D.R. or ea. ins. WA. L<ader a~ea ~ _
Sheet.'2 ot Z ~ N~naiF?usc~~ lo7S CF SAC~i ,~r.aT~Z;'
o /Iddre a s ;
HE„T LOSS CALCULATIONS UEPAH I~fE\ I' (11~ I\'~PE<"I IO\
A.S.H.V.E.
R'eathcntrips I II Conetruction No. jl In~ulation
Gwde
indow~_ I Doors ftckrrnce jl OW. Wa~~ Int. Wall Ceiling fZoof floor ~ Kind How App~ied
ee-1'o 1'e~-No i 19_ 1j~- I
3F1~~ j Room LengtA 2lo~Width yG eight I FI.~ Room Length Width Height
Wmdow~~ and Doon-Crackage and Area ~jp`~ II Window~ and Doon-~racVcage and Arce
\\lilll~ Ile~(I~t af L1n~alll Afe~ ~ ~~.11~ I~el(I~I F. f Lln~~lfl. Af~•
,.f p.v of V~ne I~~ni• nf o uh ~a M1 i Na. ~t V.n• uf V~n• 1~[I~u of c~eY ~a. f~.
1 y 3(c 1 , . D.26
~ ~20 3ic ! /C.$ „•5' I i i
i ~ ~
ico~r. s~~ i co~r. B~~
~
.n(~Itrat~on ~ ~C h ~/O ~j C~ ~i Infiltration
~Iaa ~~•i~~~C 3CtS0 ~ Glaae
-t-
]yv, MAII ~C.SC^. Esp, wall ~
~<t cap. wall J~/~/ ~~J' Cn c tiet <sp. wall
nt wall I~- Ii~ Int. wall i
- ,
r: iau ~ C<iLn~
i
nr I~!~y~1~ 3 -J%~~iJ {'~uol
ro~a~ E,~~. r~-~ sv ;i ;o~a, a~~.
~
~~a~~rcd ~y. ft. E.D.R. or ~q. ina. W..4. L<ader arra I Reyuircd sq. ft. E.D.R. or eq. ~m. W./\. Leader aren ~
i~
Fl.{ Foom ~ Lenpth W~dih H~ight I~ F~.~ Room I Length Width Height
V~'induws and Doon-CracFage and Area 'I W'indows and Doon-Cracieage and Area
r\1'IJt~ )IelY~t Ho O( Llnul h A~u ' aVl~tll~ H<I[~~ No al Lln~~l ft Are•
I uf v~n~ I uf V~ne L'tlv• af crarY ~a h I ~I No 1 p~n• ~ ot o~n• 11(~b of c~~cV •o f~
. ~ I ~ i ~ I
~ : ~i ~
; i ~ i i I ;
I j i I ~
! ~ ICoef. Btu _ ~I ~ oef. -~3w
In6ltralion i Infiltration
~.~su ~ II Ci~aff
Esp. w~all EaP. wa!~
\et <ip well 1 ~i ~\'et exP. wall
Int...~all il I t all
l'riLnH ~ 1 d Crilmp '
I:~...~__ i i 1 li Flo ~
Totel Bw. i Total U'u ~
Rrawrcd ~q. (t. E D R. or ~q. in+. W.A. Lrader area Requ~red ~q. ft. E.D.R. or eq. ins. W.A. Leader aren ~ _
I
FL~ Room I Length Width H<ight li Room I Length Width Hught
~L'~ndo..~e and Doon-Cratkage and Area Window~ and Doors-Cracicage and Area
~\\t.fln n~~J;t~t `lo al ulne~i~ Arr• I' -rN'I.flti HrlYtit N~. of Lln~~l f4 e•
1i~ f 1~ I Iltl~l• f 4 •ii It. i tio. ~f V~~~e II{t~~• ~ uf (i~Ck r(t
~ I ( ~ II I ~ ~
~ i I
1 ~ I i P i
i 1 I i' '
-~i---~ ~ r ~
j I i I iCocf., Btu ~i I ~r ' ~C-o-ef--.}-
Btu-
Infiltration ~ I ~ In61tr~t~on ~ ~ I I
Glau i Glav ! ~
Eap. wall ~ j I ' Ezp. well ' _
Ne e:P. wall i: \et exP. w..ll i ~
Int wall ~ li int. wal! ~
J
Cvding I ~ Ceihnh : ,
~ Floor 1 F!oor ~
I~ I
Total Btu. i Totai Btu.
i
I f2equvrd ~q. E.D.R or ~q. iu. W.A. I..ender area ii Rcqwrcd ny. Ft. E.D.R. or ep ins. WA. It+der ~rea ~
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
i / 3830 PILOT KNOB RD - 55122 a
3 ~ 651•681-4675 ~ ~ ~ ~
New Construcflon Reoulremenis Remodel/Repair Reauiremenis
> 3 registered sNe surveys showing sq. fl. ol IoL sq. R. of house 2 coples ol plan
and all roofed areas (20%, maxfm~m lot coveraae allowed) 1 set of energy calcuiattons for heated addHions
2 coples ol plans (show beam 3 window sizes; po~red fnd. design; etc.) 7 sHe suney for exferlor cddNlons d decks
1 sef af energy calculations
. 3 copies of hee preservation plan H lot plaffed aMer 7/1/93
DATE: ~
~7 ~ CONSTRUCTION COST:
DESCRIPTION OF WORK: T~~,f ?~g~~P, ~~O S~~ ~`~w~~.,
STREET ADDRESS: _ ~
7~~ '1../P"~ / L.l !
hP~_~~'c{ I
LOT: ~LOCK: ~ SUBD./P.I.D. I L~J~,IC ~1
~ ~ .e ~
Name: r/ '\f J~\ Y~~ Phone
PROPERTY Last First
OWNER
StreetAddress: ~~'/11~--.P
City State: Iip:
Company: P { L ~ V 1 Phone v C ~ ~ ~ ~ I ~ , `-i'
(area code)
CONTRACTOR , /
Street Address: License # JO G xp. c~J (7 D
City State: Zip: ~ ^
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
Street Address: Registration
City State: Zip:
Sewer 8 water Ifcensed plumber (reaulred for new consfructlon onlv):
Penalty applies when address change and lot change Is requested once permit is Issued.
I hereby acknowledge that I have read this application, state thaf fhe Informatlon is conect, and agree to comply with all applicable
State of Mlnnesota Sfatufes and City of Eagan Ordlnances. ~ _
Slgnature ot Applicant: - -
~
OFFICE USE ONLY
~ 23;
Certificates of Survey Received _ Yes _ No S~ ~
Tree Preservation Plan Received _ Yes _ No _ Not Reqwred
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwel~ing ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 1 0' _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? OS 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/So~ts/Fascia
O 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.' ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S!W Permit
S/4V Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Olher
Copies
Total:
SAC Units
°/a SAC
L ~ B~ "1 CITY USE ONLY RECEIPT#. ~"I d~~
d
SUBD. ~Oi ~ RECEIPT DATE: 3' ~ ~
PERMIT i! J ~ ~ I
2000 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT IQiOB RD
EAGAN, IM7 55122
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES EACH p TOTAL
Alterations to existing dwelling - minimum fee $ 30.00
Describe:
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas piping outlet ' minimum - ~ 3.00 x = $
Hot tub/spa 3.00 x = $
Kitchen sink 3.00 x = $
Laundry tray 3.00 x = $
Lavatory 3.OD x = $
Septic System newlrefurbished ' requires MPC Ile. 75.00 x = $
SeptiC SyStem abandonment 30.00 X = $
RPZ new installation/repair/rebuild 3~.00 X = $
Rough opening 1.50 x = $
Shower 3.00 x = $
Underground sprinkler ff dwelling is under construclion 3.00 x = $
Underground sprinkler if existing dwelling 30.00 x = $
Water closet 3.00 x = $
Water heater 3.00 x = $
WatEr SOftBner If dwelling under construcUon 5.00 X = $
Water softener if exlsting dwelling 30.00 x = $
Water tumaround 30.00 x - _ $
State Surcharge 5D $ 50
Total $
Reminde~: Cail for inspections of alteratians, i.e. water hea2ers, water safteners, etc.
-
I hereby adcnowledge that I have read this appliwtion, state that the infortnation is correct, and agree to compy with all applicable City of Eagan ordinances.
It is the appliwnYs responsibility to notify the property owner that the City of Eagan assumes no liability for any damagas caused Dy the City during ils
nortnal operational and maintenance adivities to the facilities construc[ed under this permit within City property/right-of-way/easement.
SITE ADDRESS: 7 ~.7J ~~5~ ~/~~`'Jl ~ ~
OWNER NAME: : ~~l~ ~Ti5~,11/ ~~D TELEPHONE ..SZ -~~~Y
(AREA CODE)
INSTALLER NAME: ~2- 'u/v'T~l~L TELEPHONE#: C~'/2~ ,s.~~-~5~~
(AREA CODE)
STREET ADDRESS: ~v C~~/~~GLS
CITY: ~~r~VU~ ~TATE: ~ ZIP: ~
SIGNATURE O PERMITTEE
i
. I
~ z/aa
~tNU~~ i CITY OF EAGAN
1 ~~~ir
APPLICATICN FOR PERMIT
SEW^cR AND/OR WATGR CONNECTIODi
(PLEASE P9THi)
1) PP.OPEI~I1' ADDRESS: _ f,~3 l.l~L° S'f- (.~}!.tlQ
rrrar, o:sc~~rTc.r: _ L-Z ~~=Z !{~A1Ck ~~/I~~CF
(Lnt/B1 Subaivision or Tax Parcel I.D. Ntm~er)
l: r'~I::'~:C ~TRC;CI?T:2E, DaT 0_° ORIGiidAL ri.;II,Dl`:G P~_~ST ~SS~;?~C :
~ P~.=S.'__ ~ ~^.;7i_~:/~:."C).°CS:~. ~9 R-1 S~iGLW r^P~nSry
? R-2 GUP~i (ZS~~ ~~IZTS)
? R-3 TG[v'~IIiGY;SE (TFLRF" + U^II;S) ( Wi 2':S)
? R-4 p~ppR?T.•F•;T/C~`IDOi-LLVIL~1 ( CJiIITSi
? CONME..'RC7AL/FtE.Tr1IL,/OFFICE
? ~L'STRL~L
? INSTITf~TIONAL/C~~'E.4~~~+'fET1T
2) AppI,rC.~'j' (PLEASE PRINiJ
I~ a o~J f+nrnF~ IN~,.
ADDRESS: ~
crrY. ~sra~, zr~: )ICn)~l>~! / F A1 55 ~~7
' PHO~: 4~~Z- /4. ~ ~ ~
3~ p~;ffi~ PLEASE PRIN[) FOR CITY USE OHLY
r~'~: .~TAr~ ~.r ~mk~- rNG
PlU'!BEFlS LICENSE:
ADDRESS: IOlR M(~( )A `~,P/AX~~ ~C-/T [Z] Active
CITY~ STATE, ZIP: r~inX',77~~J _/~N ~,`~4~ ~ Ezpired
i[n~-" Not of Retord
PHO~~IE:~7-~~49 PLUM9ER LILENSE N ~~~C~~~ ~
~ arr initia
Q) p~,'[,~aj~rr~Cr,.T.~ P6 ASE PRIH!)
~~~U~ ,~1L~
~o~s: l~~r~~-+~~ ~-~k~ ~ r~
CITY, STA'PE, ZIP: ~ ~
PHd:IE: l~ 7,~J - t'iO77
S) INpICl,TE WHICH PFPh1IT IS BEII'~ RE~UES'PID:
~ Cb.`.'I'1ECI'ION 'It~ CZ11' SETi7ER
~ COCI~IE~fIC,I 'I1~ CITY WATER
? CrI'I?.'',ft (PLL"ASE DFSCRIIIE)
6) ~CDIG,
~ O`~: ~
? PL.:`SE i?OLD r1PPRWED PER~LiT F17R PICi~-UP BY O:VE OF ABG~,~
°LE35E ;~*AIL APPRC7VID PER1IIT 'It7 1, 2, Q 4 ~'1BOVE
(Circle one)
7) SI~:a'IL"~E: D~'I'E: L°4~~~~
61~iR:e~~j~ i~ i!~c ~ls~a f~ a ti sas=a ~ s o~~'sar~ ~ a~~.e ~r~:~~:lt:~ s a=S ~~sast• a
F O R C I T Y U S E O N L Y
PERtitZT ISSUED
F°rS: S s~ S°_i•iE~ noo~irm (i_ICL:;DE ~G~CHnRG~1
s .n Sa WATER PERA1ZT (INCLUDE SURCHARGL}
k S ~ 3-~ WATER METER/COPPERHORN/OUTSIDE RE.aDER
5 Wr1T:.R TAP (I\CiUD~ CO!?PORATIO~ S:O2}
S SE:•7Ep Tn,P
S is.---~ ACCOUNT GEPOSIT - SE~:ER
S / s°-° ACCODUT DEPOSIT - WAT°R
X x s o.--~ wac
-
~ Q`-• _ ~ S s-as e-v SAC
$ TBU~IK ?~IATED ASS°_SSi~IE;iT
5 TRUNK SE:1ER ASSESS~tEVT
S LATE°.AL BENEFIT/TRUNK SE?•:ER
S LATERAL SENEFIT/TRUNK ~JATER
$ OTHER
$ TOTAL
S A:~IOU~T PAID/RECEIPT -?o a a
DOES UTZLZTY CONNECTZON REQUIRE EXCAVATZON IN PUBLIC RIG~IT OF WAY?
~ YES IF YES, THEN A"PERMIT FOR WORK WITHI[V
PUBLIC ROADWAY" MUST BE ZSSUED BY THE
NO ENGINEERING DIVISION. LIST AS A CONDI-
TION.
SUBJECT TO TfIE FOLLO'.~ING CONDITIONS:
APP20VED BY: o~' Q-
TITLE: lJ D ~ ~
DaT°_: /.3-- cY<L
~s~. w ~ a...ci. .c ~ ~ ~w w,+ w ~ w s~+ w~ w.+~ w~s w ~ ~ w~ ~ s~ a.?~ ~c+ ~c~ w ~ r~ ~
RESIDENTIAL BUILDING I
Permit Application ~
~ ~ ~,a ~ City Of Eagan I
3830 Pilot Knob Road, Eagan MN 55122 ~ 5g
Telephone # 651-675-5675 FAX # 651-675-5694 ~
New Construclion Reouiremenis RemodeVReoair Reouiremenis OPoce Use Onlv
3 registered site surveys shaving sq. ft of lot sq. ft. of house; and all roofed areas 2 copies o( plan CeR of Survey Recd
(20%masimum lot coverege allowed) 1 set of Energy Calalations tor heated additlons Tree Pres Plan Recd
2 copies of plan showing beam 8 window sizes; poured found desgn, etc. 1 site survey for addNOns 8 decks Tree Pres Not Reqd
lsetofEnergyCalculatlons Addrtmn-i~icatedar-sdesepticsysfem _Oo-sileSepticSystem
3 copies of Tree Pmservatlon Plan if lot platted after 711193
Rim Joist Detail Options seleclion sheet (bldgs with 3 or less units
^~7 V~ ~
Date ! / ~Z/ Z / ~onstruction Cast ('J~ i CJ C~ ~
Site Address 'Y 7~j ~ w QS~ ~~n~ ~ ~ UniUSte #
DescriptionofWork ~2~~e qr.Cl f~Q~S~-Qw~=~.,,~ W~~n'L[1tJl
Multi-FamilyBldg _ Y~ N Fireplace(s) _ 0~1 _ 2
r(~ !
Property Owuer SG Q ~ ~ 11'Zz L T11n 1M ` Telephone # (CD ) ~I r?' 'Z - '~j ~j
Con[ractor ~KTe~~~~V~ 4=r~~,~c nnpt~~~
Address q~OU ~~OVV~iv~c;`n,.. 1-r~crW~.~/~ ~y~v4 City~ppw~~~h So~n
~
State MV~ Zip SS''~3 1 Telephone #('~(SZ) I 50"j
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy COde Category . Residential Ventlla6on Category 1 Worksheet r'N1e~3 Energy;CO'de Woik3lieet
(dsubmissiontype) Submitted ~~yubmitted~ ~ ~'i ~5 ' I~
• Energy Envelope Calculations Submitted JU , ~
~ z
Licensed Plumber Telephon ~ )
P - -I
Mechanical Contractor Tele hon BY ~
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.
1~U~~ I~~~S
ApplicanYs Printed Name ApplicanYs Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation O 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 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 Plbg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition O 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteralion ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 ReplaCement 'Demolition (Entire Bldg) -Give PCA handoul to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaVC.O.
_ Footings (deck) _ FinaVNo C.O.
_ Footings (addition) _ Plumbing
Foundation H VAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tes[s _ Final
_ Framing _ Siding Smcco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacemen[)
_ Insulation _ Retaining Wall
Approved By , Buiiding Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
~i
~ ForOifice~Use ~
City of E~~a~ I Permil # ~~'S j
~ d ~
~ Permit Fee. ~
3830 Pilot Knob Road
Eagan MN 55122 I Date Recerved: ~ j
Phone: (657) 675-5675 ~ ~ ~ ~
Fax: (651) 675-5694 i Sian i
20os RESIDENTIAL BUILDING PERMIT APPLICATION
Date: SiteAddress: `~733 (,~JfJT(,~i:-eY Ti~i
Tenant: Suite
RESI~ENTlOWNER Name: / Phone;
Address / City / Zip: y7 3 3 (~.1 fSTLJi~./ T/~~ t-~_ ~4~
Applicant is: _ Owner x Contractor
TYPE OF WORK Description of work:
~!p oa
Construction Cost: D~o~~• Mulli-Family Building: (Yes No
CONTRACTOR Name: ~+'.E.~~a~I'Z. License#. ~ ao(~3aalo
Address: So/ ~:..>.?oc/G d.,ut
City: <f~~~ U~9!/tV State:~• Zip: SS13~f
Phone: 9fa-y~d i9~9 ContactPerson ~~~-or~
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residential Venttlation Ca~egory 1 Worksheet • New Energy Code Worksheet
Category suemined submined
Submission type) • Energy Envelope Calculations Submitted '
In the last 12 monihs, has the City of Eagan issued a permit for a similar plan based on a masier plan?
_Yes _No If yes, date and address o( master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and sup'portin`g documents that you.submit are considered to 6e public information. Portions of
the information may be classified a§ non-public il you provide specific reasons that woWd permit fhe City to
" conclude that the are trade secrets.
I hereby acknowledge Ihat [his information is complete and accurate; lhat [he work will be in contormance wilh ihe oitlinances and cotles of Ihe C~ty of
Eagan; Ihat I understand this is not a permit, but only an application for a permit, and vrork is not ro start wit rmrt; ihat the work will be in
accordance with Ihe approved plan in Ihe case o1 work which reqwres a ieview and approva~ ot plans.
X ~~jJ lo /}il x '
ApplicanYs Printed Name ApplicanYs Sig ature
Page 1 of 3
� `AGM : • .g ; PERMi f r 5
,' 1 r 1 Y 'i t 3,3
1121 GATE; , '� l ,
',"-l'iteAiiidielit*t'c,''' '..,',:.,,,.,.,? ' •Iii �n (� i ' t r
A 7'v t o t F I6 Cnnett gage l7W# Q • 5 - --=- � ' . ,,_. , ; uirtit Deposit: •,'-' V `. _a ' s, •
'header 'No.; , s r ' Permit Fee ' 4,4) p ci .
:
+ e� *s of .. Surcharge: .5A t', 'x
y, •
s s 4v, ✓ 2 V :;Pate told
a 7
RI, N Units:
—12 - 419 e : f< a �
' Of * C� : i $ '1' G ,
sr.to fEo°° 1; . 4
• Account! Deposit: . +3
Permit -Rae:
�
�y 1 1 Q M
! e`er *tot:
't -l.02 i
,� g
a
__ CEIVED4 ���
G A NMAY15 Z0�8 For Office Use r�
' ' " ' Y /41/9/7 411-"Pi0
�'* � � ""r Permit#: 41 7.
']
E A
' - 0
Permit 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:
buildinainspections on-cityofeacian.com
2018 RESIDENTIAL�/ BUILDING
I PERMIT APPLICATION
Date: d Site Address: -1 3 • WI`Cit 1.{ Unit#:
'� 22' , Name: G � t14. t�ke,(i`— f�UiC�SYYit Phone: ��2"LN g" j�3 '
'..p."4„.3/4',.•'.. € 4 Address/City/Zip: U1 33 }).. '1,;0„' eitek -- �L
, r ,4 Applicant is: Owner Contractor
Description of work:
'- C pal—bey'
T Construction Cost: 6� Multi-Family Building: (Yes /No )
Compan _ t r$5Ju� dFi-S l4! Co. : 1 c t ""
„4:44.1q,,-,-:.: &
v , ° Address: , -3" ,►z- e ' Cit GLOaXL,
= State:Vniv Zip: ' '-.ne j`3g -U59a Email: Grit,o e1Y7Gt4.l;c7}` '
ag i, , Licens- •. • (p ��� Le. • ertificate#:
If the project is exempt from lead certification, please explain why:
/304.f /ti g y
lM
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:
a> Phone:Fire Suppression„Contractor: iu # y. y „....,...,,,,f,
a., a °'' rF
a• >e'
'!v }' r d'f';':'
t })a9 a :,': v7 :-/1'
1 ,fic. : 'u'
You maysubcribetoeceiveanctronc " r
notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaqan.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 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.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 fora 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.
x 1CL Ct.-Yfl o -'6, ,c � i `� � �r�`
Applic n 's Printed Na / Applic•(s Signature
U7 s/ / i / 611 ---1— . r / 17 c''
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 Ak Deck Porch (Screen/Gazebo/Pergola) Miscellaneous
01 of Plex Lower Level Pool Accessory Building
WORK TYPES
_ 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 36V19 9 Occupancy 1/Z l MCES System —
Plan Review / Code Edition AO/9 SAC Units
(25%_100% y ) Zoning PiCity Water
Census Code /y 311 Stories Booster Pump --
#of Units I Square Feet f 7A, PRV —
#of Buildings / Length /4' Fire Suppression Required .....---
Type of Construction Width /6
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
- Footings (Deck) Final /C.O. Required
Footings (Addition) ite Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof: _Ice &Water _Final Pool: Footings _Air/Gas Tests Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace: _Rough In _Air Test _Final Siding: _Stucco Lath _Stone Lath _Brick_EFIS
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:
Reviewed By: , Building Inspector
RESIDENTIAL FE / 7A 0 AR e-/t 4 /f'f3W or
Base Fee 8"
Surcharge ,�.l/
Plan Review 5 ss-' ��G a pA//o (c-AomiT1) 4� '
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies J Q Af¢
TOTAL /
Page 2 of 3
_____ 7 3 .3 At 7 1L f Ng 1 7c(a . y. /C�
IC�BE
�a coksULTlNa (HOIN((R$ i
f•,
ENGINEERING PLANHt1.S and LAND SUAVEYORS •
COMPANY, INC. -
.1000 CAST 14401 STREET, BURNSVILLE , MINNESOTA 5533T PH 432.3000 J'•
Cef..i tiCacit -arse. _
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�ILDING INSPECTIONS Div. ,a.18 ,:�\k.---V / p ,
V ;
LI AT 14 O4'' / A) ') 45PN
14 7�y a�' �,hea��&/
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es.,8 \.ter-+' ., , , e
a.oJ OFr3orE51nYy Et�JAflo.1 �i / \ ' / ; /y'�y'�ANN/yJ
,o D .-1=rZ rroR. CLeaAr7o • - Tri//ti
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hereby certify that this is a true and correct representation of a tract of
nd as cho++n' and described hereon .. As prepared by me on this Z"_ day of
.etiAA y , 19 el .
/�u ro7.;. / /firth. Reg. No,