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3910 Worchester Dr pTY OF~&~iAN Permit Na 9346 ~t~ 3836P~at Knob Road Meter No: ~Zz 0 2! Size: P.O. Box 21199 Reader Na p 9~ g Datec -8y Eapan, MN $5121 Owner. r«,1'i t}aIlzs SiteAddres& 3910 47orchester Prive L?i ?31 :1i)1s of ::tone- Plumber. Vallev PluLibin SSO . t~Opd Conn. Chg: ~ Acct Dep: 15 .'JO d IR4014"16! Permit Fee: 11). 00 cf E1C, ECTRIC • ~ Surcharge: • SoDAL l a t~ cA~ wNh 1he Clty ot Eagan Tr. Plant ? 0[~, @r~nn Meter. 6~1 a/?~.,~ Miac.: BY WATER SERVICE PE CITY OF ARGAN Permit Na Date: 1- 21- -~s,4~'~ 5• Data I- 2 6 - -3d* P& Knob Rwd B/ P No: P.O: Box 211 Epan, MN 55121 .,Owner. Crand Oaks - SiteAddress: 3910 Worchestcr L'rirre 1,21 B1. !lil].s c-F Plumber. 'Jalle_y Plu1711) i.11;• ' ~n ~ MWCC: - 51 i ning. r 1 ciey cn9: Bjefore digging cai{ Io.;Ncp*tohs: ~ Acct Dw: TELEPHONE - E1ECTR_1~ syrAasa ~o comtslr wNh tM Cfty of ewsn PermR Fee ' '64wK Surcharge: Misc.: BY SEWER SERVICE PERMIT ~ ~ - --~~rr'rC""%'~i"-'•~:~r- '~~~R y . , 9346 Detec 1-27-8~ CITY OF~?GAN Permit Na Size: 9330 Pilot Knob Road Meter N4 Date p,p, 8ox 21199 Reader Na Eagan, MN 55121 C'raud Oa~.s Owner. 1910 ~Jorcheater Prive L21 51 :iills of Stone- Site Address: b= fd g V - Plumber. alleY P1u~bi~~ ~ 550.13 Qpd ZoNng R1 1 I Conn. Chg: ~0 d No. of Units: ' Acct Dep: 10.00 ! Permit Fee: 5~d I agne to comply wltfi the Clty of Eagan Surcharge: 2ak 4~pd _ Ordinancss. Tr. Plant Meter: By ' Misc.: WATER SERVICE PERMIT ~ , _ CITY OF EAGAN Permft No: 1,,~+ s+ Data ! 7 3830 Pilot Knob Road B/ P .Na Date: 1 - ~ F "~.O. Box 21199 Eagan, MN 55121 Owner. SlteAddress: '•'~x.:~,:_:;t~?r ~.rfvc '21 Ri Ti±l' , • Plumber. °lu~cb it.,, , MWCC: 350.i1o n3 Zoning• CitY Ch g: No. of Units: Acct Dep: I agrse to comply wllh the Cily d Eaqan , ~ Permit Fee: Ordinaecss. Surcharge: Misc.: gy SEWER SERVICE PERMIT I • • W fgex#i#iratt pf (Drrupaury ~ titp of eagan ]lrpwrhtcM af liudding JWrrflnn 77iis Cerrificale issued pursuont to the requireme»ts of Secteon 306 of the Uniforin Brulding Code certifyiRg that at the ttrne of issuance this sducrure was in compliance wrth the various ondiriarrces of the City regulati'ng building rnnsduction or use. For the jollowing.• u.e aaeirwuw, 'Tt iJ.JG?G.AR sw Fhmit wo. 14570 OV-v-r 7YvZ R3 ZDains DWjict ft I Tya Cw& Vn owoe d aMin t'14ATID QAKS DEV. A4dmw 398E3 SIi•BR= DR. N. Boiftg A&Vxcu 39 Itt W)MMSIEI'. 1P-,TVF; L-sky L,21, B1, HIUS M, StClEFR?LtiZ Da4: &Wdins OfficW POST IN A CONSPICUOUS PLACE • ~ CASH RECEIPT ~ CITY OF EXGAN 3830 PIL~OT KNOB ROAD EAGAN, MINNESOTA 55122 DATE ~ 19 RECEiVED -I FROM ~A;.jOUNT $ I . F- ~J` & opLLwes oe ? CASH Q CHECK - FOR Ci'~l. \ ~f,~~~ /b ~l_~ { ~'.~Ll r1 ~ ~ r• FLINO CODE AMOUNT Thank You - BY White-Peyers CoPY Yellow-Posting Copy Pink-File Copy ~BLDG. PERMIT N0. -L 01-32I"0 ~Bldg. 01-3422 Plan Check 01-3445 Surch./Adm. ~ 01-3446 SAC/Adm. ~ 01-2155 Surcharge ~j 4-7~860 Road Unit 20-2275 SAC "Zo 20A-3865 Water Conn. ; 20-3868 Water Trmt. 20-3716 Water Meter 20-2252 Acct. bep. ~ 20-3713 Water Permit 20-3743 Sewer Permit ~ 79-3866 Sewer Conn. 14-3855 Park Ded. TOTAL ° r q CITY OF EAGAN 14570 3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121 PHONE:454-8100 . , ~ BUILDING PERMIT Receipt To be used for SI' Est Value $71 o000 Date 7Site Address 3Sr20 iJo1rcheBter DT OFFtCE USE ONLY Lot 71 BloCk 1 Sec/Sub. N1 l1 i O f On Site Sewaee Oocupancy ~ Ston~brid MWCC System Zoning ~ Parcel No. 81? On Site weu Type ot Const ciry water (Actuaq c Name 6rand Daks [3vv (Allowable) Y Izu ; AAdress 3986 Stonebridsce Dr ti * or stories Length ~ o Cih+ Eagan Phone 452-0747 Depth 42 ' &F. Total , 1' NJ1@ Footprint S.F. 0 ~ Addreft APPROVALS FEES ~ City i Phone Assessments Permit _4~~ Water/Sewer _ Surcherge Name ` Police Plan Revlew ? Address Fire - SAC,City _ 00 Engc - SAC, MWCC • .5 50 ~ W City Phone Planner WeterConn. ~ Council WeterMeter 3~ I hereby acknowledpe that I have read this flppllcation and state Bldg. Off. ,i Road Unlt that the lnformation ia correct and aeree to comply with all applicable APC - Treatment Pt ~ State ot Minnesota Statutes and City of Eegen Qrdinanoels. , Variance ~ Parks ~ Signature o} Permittee " _k. • ~ Copiea 'rOTAL 2~• ~ ABuliding Permit is issued to: Grond Oaics Lev on the express conditian that all work shall be done in accordance with a!i applicable State of Minnesata Statutes and City of Eagan Ordinancee. Building Official , PERMIT # PLUMBING PERMI7` RECEIPT ff ~ CITY OF EAGAN 3930 fjLOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Address BLDG. TYPE WORK DESCRIPTION Lot Block SeciSub Res. New A__ Mult. Add-on m Name Comm. Repair ~ Address Other c City , ~~'•-~J~t t Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NQ. FIXTURES OTAL Name i Water Closet - $3.00 $ ~ m -/-Bath Tubs - $3.00 3 Address ~ Lavatory -$3.00 p Ciry Phone Shower - $3.00 -/-Kitchen Sink - $3.00 e~) G' FEES Urinal/Bidet - $3.00 COMM/IND FEE - 1% OF CONTRACT FEE yLLaundry Tray -$3.00 APT. BLDGS - COMM RATE APPLIES ~_Floor Drains -$1.50 f, s C~ TOWNHOUSE 8 CONDO - RES. RATE APPLIES -~Water Heater -$i.50 MINiMUM - RESIDENTIAL FEE - $12.00 Whirlpool - $3.00 MINIMUM - COMM/!ND FEE - $20.00 _.,~Gas Piping Outlets - $1.50 .a STATE SURCHARGE PEFi PERMIT - .50 (MINIMUM - 1 PER PERM1'n _ (ADD $.50 S/C IF PERMIT PR?CE GQES- $oKenevk'- $5.00 " BEYOND $,1,000.00) INell - $10.00 Private Disp. - $10.00 ~ Rough Openings - $1.54 -S CSIGN RE OF PERMITTEE FEE: STATE S/C: FOR: CITY OF EAGAN ' GRAND TOTAL• , - - - . _ . - - • - - . { y~; . r-. "1..r. .R<F,•e. ~ir'.{i~~..r,. ...l4, PERMIT # 7v" . , , MECHANICAL PERMIT . CITY OF EAGAN RECEIPT J C_!' 3830 PILOT KNOB ROAD, EACiAN, MN 35122 DATE: .y x~~ CONTRACT PRICE PHONE: 454-8100 ~uite Add~e,ss 41. ~ BLDG. TYPE WORK DESCRIPTION Lot ~i Block Sec/$ b Res x New X Name ~ v Mult Add-on m ~ Comm. Repair Address Other c City vr, r,•, ~ Phone ~ J FEES ~ Name RES. HVAC 0-100 M BTU -$24.00 c Address i ADDITIONAL 50 M BTU - 6_00 p City ~ Phone - (RES. HVAC INCLUDES A/C ON NEW W~jl CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIn - 1.50 EA. TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE Forced Air BTU O APT. BLDGS. - COMM. RATE APPUES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALl ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20,00 STATE SURCHARGE PER PERMIT - .50 Vent CFM (ADO $.50 S/C IF PERMIT PRICE GOES _ Gas Piping Outlets # BEYOND $1,000) , Otfl@f FEE S ' E 1 t~,, t_ l t~,t/1= i~-? » S/C: SIGNATURE OF PERMITTEE TOTAL• FOR: CITY OF EAGAN . :_._•_:_~.y. . - - - • t~ - - _ _ - - I CITY OF EAGAN No ~ 3830 ~Ilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 - 14570 ' `BUILDING PERMIT PHONE: 454-8100 Receipt* ?0 p/~ - a To be used for SF Est Value $71, 000 Date /"-A (D ,1 g 8~ S1teAddre88 3910 WorchestPr Dr OFFICE USE ONLY Lot 21 Block 1_ SeC/Sub. Hi 11 s of On Site Sewafle Occupency MWCC System X._ Zoniny R- ParcelNa Stonebridge Onsiteweu _ TypedConst City Water -2L (ActuaQ V-N ~ m Name Grand Oaks Dev (Allowable) V-N = Address 3988 Stonebridge Dr N Lenpth Stories 59 ~ ° City Eagan Phone 452-0747 Depih 421 ~ S.F. Total I } p Name Footprint S.F. i 0 ~ Address APPROYALS FEES P C i t y P hone Aasessmenta _ Permft 45R _ n(1 ~ a Water/Sewer _ Surcharpe 3 5. 50 W Name Police Plan Review 229.00 W =n Address Fire _ SAC,CIty -~IOQn Enqc SAC, MWCC ~ W City Phone Planner _ Water Conn. 550.00 Councll _ Water Meter I hereby acknowledge that 1 hava read thfa applicatlon and atete Bldy. Off. _ Roed Unit .00 that the in}ormatlon fs Correct end apree to Comply with all le APC - Treatment P1 2 04 _ n0 State of Minneaota Statutes and C=fE n rd inanc s. ~ Varianca _ Parks Copies Siynatureof Permittee TOTAL 2, 51 8. Sn A Buildfng Permit is Issued to: Grand Oaks Dev on the express condition that all worlc ahall be done in axordance with all applicable State of Minnesota Statutea and City of Eagen Ordinancea. Bufldinfl OHicial CITY OF EAGAN 3830 Pllot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ~ PHON E: 454-8100 BUILDING PERMIT Recelpt i~ To be used for ' Est Value Date 3ite Address ~ t ~<'',F' t c~ i~ OFFICE USE ONLY ~ ! , li { i j+s ~ f On Site Sewaqe ~ Occupency Lot • BIOCk SBC/Sub. MWCC System _ Zoning `4Re OnSiteWell TypeofConat Parcel No. city water _ (Actuen c Name (Allowable) = rles Address Length ~ City Phone 1452"'C747 Depth S.F. Total . p N8m9 Footprint S.F. 0~ Address APPROVALS FEES ~ City PhOne Aasesements _ Permit Water/Sewer Surcharfle ~ ~ W Neme Police _ Plan Review i t ~ Addroaa Fire _ SAC, Ciry ~ EnQr. _ SAC, MWCC ~ W City Phone Planner _ WaterConn. CouncU _ Water Meter I hereby acknowledfle that I have read thls application and state Bld9• Off• _ Road Unlt that the infamatbn ie correct and agree to comply wlth all epplfcabla APC _ Troatment Pt State of Minnesota Statutes and City ot Eaqan Ordinancea . Varianca _ Parka t Copiea Signature of Permittee { • TOTAL A 8uilding Permit is Isaued ta on the exprese conditfon that all work shall be done in accordance with all appiiCable State of Minnesota Statutes and Ciry of Eaflan Ordinancea Building Official ` ~ ~ . Pennit No. Permk Nolder Oate TNophone s , Plumbing ~ -'i • ~ - %/S': ~ . H.V.AC. ~g ~ Electric Softener Inspectlon Wto Inso. Comments Footin9s I Footinga 11 Foundatlon Framing Rooting 41641, 49 Rough Plbg. ~ . ^ v s , a Rough Htg. Isul ~ _ Fireplsce Final Hty. Jgv Flnal Plbg. Bldg. Final Cert. Occ. 2 Temp. LP Deck Ftg. Deck Frmp. Well Pr. Disp. RESIDENTIAL go BUILDING PERMIT APPLICATION CITY OF EAGAN Y5,. `7s 3830 PILOT KNOB RD - 55122 651-681-4675 New Comtrud'qn Rwuirements RemodeNteua'vRwulrements . 3 repistered sfle wrveys show4g sq, ft. ol bt sq. ft of hause; anll rooted areas • 2 capias of plan (2076 mezinim lot cwerape abxed) . 7 set o( Eneigy Calwletbns for healad additbns . 2oopiesofplenshowirg6eam8windaxsizes;pouredfounddesign,eta) . lsilesurvey(ore*riaraddilians&decb . 1 sef d Enefgy CaIwleUons . IiMicate If home serred by septic system Fa addiiions • 3 copies of Tree Preservatbn Plen'rf bt plalted after 7l1N3 • Rim Joat DetaY Opfions selection sheet (bidgs wNh 3 or less unils) DATE L-gZ` eZ VALU/[ION c2L O~O ~ . JOB SITE ADDRESS 3910 WO/Y'i4 -pff{, Aj'r, IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER LV~Q h -V H-fdS TYPE OF WORK~YOr.~, Vt 5i iha FIREPLACE(S) _ 0_ 1_ 2 APPLICANT _114nftl- Crin - 9 PHONE# ADDRESS 9O/r Cf T- G- ~ ZIP CODE SW>> PAGER ~ CELL PHONE ~ 6'0- 2Y .2-.,Q/,e FAX # • NEW RESIDENTIAL BUILDING ONLY- fILL OUT COMPLETELY Energy Code Category _ MINNESOTA RUI..ES 7670 CATEGORY 1 (check one) - Residential Ventilafion Category 1 Worksheet Submitted - Energy Envefope Calculations Submitted _ MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbiny Contractor: Phone Plumbing System Includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00 Water Heater _ No. of R.I. Baths No. of Baths Mechanieal Contractor: Phone M Mechanical System Includes: _ Air Conditioning Fee: $70.00 Heat Recovery System Sewer/Water Contractor: Phone # All above informaQan must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Slgnature of Applicanf ,S~'7 ,J~l+'{ Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 1lOt OFFICE USE ONLY ? 01 Foundation O 07 05-plex O 13 16•plex ? 20 Pool 0 30 Accessory Bldg O 02 SF Dwelling ? OB 06-plex 0 16 Fireplace ? 21 Porch (3-sea.) O 31 EA. Alt- Multi O 03 01 of _ plex O 09 07-plex O 17 Garage O 22 Porch/Addn. (4sea.) O 33 Ext. Alt - SF ? 04 02-plex O 10 08-plex 0 18 Deck 0 23 Porch (screened) ? 38 Multi O 05 03-plex O 11 10-plex 0 19 Lower Level 0 24 Stnrtn Damage ? 06 04-plex O 12 12-plex Plbg_Y or _ N O 25 Miacellaneous O 31 New O 35 IM Improvement O 38 Demolish (interbr) O 44 Siding ? 32 Addition O 38 AAOVe Bldg. 0 42 Demolish (Foundallon) O 45 Fire Repair 0 33 Alteration O 37 Demoliah (&dg)• O 43 Reroof 0 46 WindowslDoors ? 34 Replacement •DemolNlon (Entlro Bldg only) -(iiw PCA handout to appUcant Valuatlon Occupancy MClES System Census Code Zoning City VVater, v SAC Units Stories Booster Pump ~ Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Lengih - Fire•Sprinklered Type of Const . . Width_ REQUIRED INSPECTIONS _ Footin;s (new bldg) _ FinaUC.O. _ Footings (deck) _ FimVNo C.O. _ Footings (addition) _ Plumbing Foundation IIVAC Drein Tile Roof Ice & Waur Final Other _ Fiaming _ Pool _ Ftgs _ Air/Gas Tesb _ Final _ Fireplace _ RI. _ Air Test _ Final _ Sid'mg Stucco Stone _ Insulation _ Windows (new/replacemeat) Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S8W Permit 8 Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total This requesl void 18 wmhs /wm n~ 7 9 6 2 5/.~/ Ren,c sfDale ^ Fire No. Rouph m Insc~mn l G Reqmretl~ ~Heatly NowJG~ Will Nuuty InsPec- z(S 1es ~NO I'or Whvn Reudy Licensed ElecVical Contnctor I hereby reauest insoeetion ol ebove Own¢r eleclricel work installad at' Sveet Atldress. Box or Route N$ Ciry C 3Cf1d U! G o ecuon o. Townsnip Name or No. flanBe No. Cou ity ko-i Occuu ~t IPflINTI Phone No. Po er Supol~er Adtlress ~ ~J ko zra- IL_-a Ele 1nca1 Cnnhactor (COmuany Name) / ConVactm's .icense No. S pC'-rl ! e- ~L ?1C. (D Madmg~AdJress IComroctor or Owner Makinelns[ailaUOn) ~6-7s r,J. 1 13-- m n Aut nzed Signaiure I n1ia<tor/Own Mnbng Installationl Phone NumGer MINNESOTA STATE 60AND OF ELECTPIGITV THIS INSPECTION pEQUEST WILL NOT Griees-Midwey 91de. - Aoom N-191 BE ACCEVTED BY THE STATE BOAHD 1821 Universtiv Ava.. St. Peul. MN 5510E UNLE55 PPOPEF INSPECTION FEE IS PM1nnnI619 647-OADO ENCLOSED. REQUEST FOR ELECiRiCAL INSPECTI J. epe-oooso~t-os ON III, Soa instrvctmns br completuq this larm on beck ol Vellow eopv. D ~LQ 6 2 5 "X'' Below Work Covered by 7his Request AAd Hep. TVOe o1 Bmlaine Aooliancea Wirod Equiomem wven Home Range TemWrary Service Duplex Water Heater Lightiny Fixtures Apt. Bwlding Drye, Electnc Heabn Comrnerwal Bldy. Fumace Silo Unlotider InAustrial BIAg. Air Conditioner 8ulk Milh Tank farm 01ner aeu v Uhrr Isu.,:ifvl t nr uccify Other Oihm ompute InspecUan Fee Below p Fee ServieeEntmnee5ize n Fee Fqpdoes/SUbleutlcrs u Fn~~ Circwls //.Qi~ 0 to 200 qm ps 0 to 30 qm s 0 tn 30 An+>s Above 200 qmps 37 to 100 Amps 31 to 100 qm s Swimming Pool Above 100-Amps Above 100_Amps Trensrormers Irrigation Booms Pertial.'Ot e SignS $peGal InspeClion Reirks 5 g~ TOTA F ~ r • Roueh-in . D/n~ti: I. the ctr' InsPacloqheroby cerlily Ihet the above Flnel Dmeinspection hes been • . (./j mede. ThIS raquasl volE 10 momhn f wm ~pq (~1 U ,i 2005 RESIDENTIAL BUILDING PERMI'T APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 ~ New Consiruction Requirements RemodeVReoair Reouirements ORca Use Onlv 3 registered sRe surveys showing sq. ll of lot sq. fl. ol houu; and all roofed areas ?2 coDies of Dlan Cert ol Survey Recd _ Y_ N (20°,U mazimum lot cove2ge allowed) 1 set of Eneryy Calculatlons for heated additbns Trea P2s Plan Recd _Y _ N, 2 copies of plan shovnng beam 8 window sizes; poured found design, etc. ?1 site survey for addAions & decks Tree Pres Required _ Y_ N 1 set of Eneryy Calculations Adddion - indicate i/on-sde septic system On-site Seplic Syslem _ Y_N 3 copies of Tree PreservaGon Plan'rf lot platted after 717193 Rim Joist Detal Options seledion sheet (buidings wilh 3 or less unAS) DateDS ConstructionCost Site Address h WOV('~k(S4tt.? nVl v-r-. UniUSte # n _ Description of Work fvciW l ?1'~-' I. ~ (tg LS' n l~ ^ Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2 9 1 ^y- Property Owner 0-~n C-tLL~'L1 Telephone#( I~$I 20 loS Contractor l-C ? C tiY~.~~Cl~l~. (~'l GYl Address ~ 4'*6U W I~U.WI`V1~LG City Ru.wltul State Zip sS7,Ole Telephone#(952) -14O-"1"lS0 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Categorv I Minnesota Rules 7672 Energy Code Category , Residentiat Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submissiontype) Submitted Submiried • Energy Envelope Calculations Submiried Have you previously consiructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Telephone # Mechanical Contractor Telephone ) Sewer/Water Contractor 7elephone ) 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. 140 ~-,~L Chv. ApplicanYs Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ? Ot Foundation ? 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. Att - 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 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? OS 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 ? 36 Move Building O 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building' ? 43 Rerooi ? 46 Windows/Doors 71- 34 Replacement 'DemoliUon (Entlre Bldg) - Give PCA handout to applicant Valuation 069~ Occupancy MCES System Census Code ~ Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bidgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Foo[ings (new bldg) Final/C.O. ~ Footings (deck) ~ FinalMo C.O. _ Footings (addition) _ Plumbing Foundation H V AC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests Final _ Framing _ Siding _ Stucco _ S[one _ Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows _ Insulation _ Retaining Wall Approved By: 2, , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies . 2 S AN Other Total ~ ,U'IRVIEYOR'S CERTIFICATE GRAND OAKS DEVELOPMENTCO. WESCOTT RDAD N a o . ~ 100.40 N89°59'25"E cnIL9)~ o o ~ \(907.9) A ~ ORAfNAGE B UTTLIFY EASEhIENT v 5 QY~C g~ PER PLAr LO T 21 I M M I ~ ~ 52.0 M~GAR~'~'fwW o o ~1 V ~ 1 N ON O 0 to I O M a0 p i 6 1~ p 26.0 00 m a ~ O 1 n I ~ ~ l h i Op ~ I i.+:y;: y„~ 26.0 ~ " i •':";or'~; o ~5 0 v 5 ,4a>..m o . N K' 'KK~i' ~ M m /C9 o / 133.48 47 .64 72 ~ R7 30'06"I N89°59'25"E N a 4 ` ~ _ - pRCHESTER DR/VE ~ DENOTES PROPOSED SURFACE DRAINAGE O DENQTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 909. 1 FEET X000.0 PENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = 9ob.2 FEET (000.0) OENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 9oq.Q FEET WE HEREBY CERTIFY TO GRAND OAKS DEVELOPMENTCO.THAT THIS IS A TRUE ANO CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 21, Block I, HILLS OF STONEBRIDGE, according to ihe recorded plat thereof, Dakota County. Minnesota. IT DOES N07 PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMEN7S, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 22ND DAY OF JANUARY , 1988. ' 1988 BUILDING PERMIT APPLSCATION - CITY OF EAGAN " SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOft CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIAED. NO CHANGES WILL BE ALLOWED ONCE BIIILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL IINITS FOR SALE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OE ENERGY CALCULATIONS COhMERCIAL INCLUDE 2 SETS OE ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: f5l,a 7Lc Valuation: 61007 . - Date: /-~2 Site Address 3 e//O OFFICE USE ONLY Lot Bloek On site sewage, Occupancy h- 3 MWCC system ? Zoning pl-I Parcel/Sub On site well Actual Const V-N / ] City water ?Allowable V-N c~ (~c~,~ S ~tV PRV required of stories Owner ~ Hooster Pump Length Address c~7 -~st'p,i1r 6/~ic~ur Depth S.F. Total City/Zip Code 2 ~ Footprint S.F. Phone Nli APPROVALS FEES Contractor ,1~ Qc. k- S EngrfAssess Permit ~/Sg.QO Planner Surcharge 35 50 Address 5 G n, c G s.li~va Council ~ Plan Review z ,0 B1dg. Off. ~ ji LS SAC, City 100.00 City/Zip Code Variance SAC, MWCC 550'W Water Conn 550, Qo Phone Water Meter (.,'l, 00 Road Unit Z5. 00 Arch./Engr. Treatment P1 2,0 u,00 Parks Address Copies I TOTAL o?518. $O City/Zip Code Phone If SURVEYOR'S CERTIFICATE GRAND OAKS DEVELOPMENTCO. WESCOTT ROAD N 0 o ~ 100.40 N89°59'25"E (9119)~ ' o o v ~790-7.9) I ~ DRAINAGE d UTlLIT'Y EASEMENI' ~ 5 ` g~ PER PLAT ~ LOT 21 ~ J ~~i tu ' I M 0 M o _y I p 2 t~ A` (906.8~ C9o8 8~ ~ ~ LI i / I ~ w ON ~O N ~ 5(mm 2.0 \ Y \ ~ O O m ~ j} / ~ a 2s.o ~ - a~ w' ~ ' <1~ O ~ 51 0' ~ m o . ~ 0 5 0 ~CII E° ° M~qo2~_ 47.64 ' 325g~ 2 ~ N89°59'25"E n N aR7°30'06N _ yVORCHESTER OR/ VE ~ DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 909. l FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = 9ob.2 FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 9oq.4 FEET WE HEREBY CERTIFY TO GRAND OAKS DEVELOPMENTCO.THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 21, Block I, HILLS OF STONEBRIDGE, according To The recorded plat thereof, Dakota County. Minnesoia. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 22ND DAY OF JANUARY , 1988. PROPOSED ELEVATIONS SHOWN 41ERE SIGNED: J~~.J~~. ILL, INC. ) TAKEN FR01•1 THE DEVELOPP1ENT PLAPI L/ FOR NILLS OF STONEBRIDGE, PRE- PARED BY PIONEER ENGINEERING AND BY LAST OATED 8-26-87.. HAROLD C.PETERSON,IAND SURVEYOR MINNESOTA LICENSE NUMBER 12294 cn o ~W z _ nc. M „T°°m 0 m - 0 O m ~ ~ m U James R. Hill, i r ~ m ~ < N ~ ~ > o° o°' ~ D oZ ' m ~ Z pLANNERS / ENGINEERS / SURVEYORS m O m [ i) ~ 2 - Z 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029 a N O N , - " ~ Q l.l l CITY OF EAGAN EX7ERIOH CNVELOPE AVERAGE 'U' COMPUTATION OWNER: G12AND OAKS DCVELOPMENT C0. SZTL ADDRESS: 3910 Worchester Dr Eaean MN 55123 CONTRACTDR• GRAND OAKS DGVELOPAIENT DATE: 1-20-88 PHONE: 452-8167 Determine xorking squarc footage of each: 1. Tutal exposed wall area 1940 sq. ft. x.11 = 213.40 2. Total roof/ceiling area 1145 sq. ft. x.026 - 29.77 Total exposed uall area above £loor = 1759 a. Total wall window area 191 b. Total door area 40 c. Total sliding glass area 42 d. Total fireplace wall area - e. Total wall framing area (average 102) 149 f. Total net wall area above floor 1337 g. Total rim joist area 113 Total exposed foundation arca - 69 h. Tota1 foundation window area - i. Total net foundation area above grade 68 Detcrminc 'U' value of cach wall segment: a. 191 x 'U' .414 = ,79.07 b. 40 x 'U' .07700 - 3_08 c. 42 x 'U' .460 = 19 d. - x 'U' .2500 - e. 149 x 'U' .06998 = 10 ,.43 f, 1337 x 'U' .03716 _ 49-68 g. 113 x 'U' .03528 = 3-qc) h. - z 'U' .4800 - - i. 58 X 'U' .06609 = 4.4) 3 . Total = + 170.06 If item 113 is the same as or less than item l11, you have met the intent of SBC 6006(c)2. Total exposed roof/ceiling area = 1145 j. Total skylight area 6 k. Total roof/ceiling framing area (average 10%) 114 ' 1. Total net insulated roof/ceiling area 1025 ~ OVER " Determine 'U' value for each roof/cciling scgment: j, 6 x 'U' .53 = 3.18 k. 114 x 'U' .02894 - 3.30 1. 1025 x 'U' .02205 - 22.60 4 . Total - '29.08 • If total of 04 is the same as or less than 112, yoU have met the intcnt of SDC b005(c)7. Altcrnate Building Envelopc Design To utilize the total envelope system method, the values established by the sum of Items 13 and 114 shall not be greater than the sum of Ztems Oi and 112. 1. +_2.. - 3. + 4. - 2 . . ' SINGLE & DOUIILE L•'AMILY IiOMES - 1984 ENERGY CODE REQUIREMrNTS O.z or about March 1, 1984, the following energy code requirements should be calculatcd and includcd with a building permit application. 1. Roof - ceiling asscmblies - R-3II U= 0.025 Avcrage 2. Exterior walls & rim joists - R-20 U= 0.11 7lveragc 3. Floors over unheated spaces - R-20 U= 0.05 Average 4. Esterior overhangs will be considered as exterior wall. 5. Foundations (all exterior walls) - Minimum of R-5 insulation. 6. All insulated areas must be separated from the heated space by a well-lapped or sealed vapor barrier with a minimum perm ratin'g of 0.1. A 9 mil. polyethlcne sheet or equivalent mcets this requirement. A Kraft facc R-19 type insulation will be accepted in the rim joist areas. Air chutc baffles are to be placed in evcry raL-tcr spacc. !~t ii:'i.IiiU;i "U" l':\LIiG A\l) H-l,1Cl'Ofi AT P.OOF, IdALL, HIil i+d:D CONCi;i:TI: BLOCf: . ' i ' Pro~~idc in~ula~ion ba::lcs in cvcry 'R~OF ra_rcr :?Zcc. VAL . ~ lNSUL~~«Or< <1~1-°G. > (s-nLL, . ! o~~7- ToTAL <rz)= ei I . l~!ALL vALL 9 ~ ~/Z' Gf1? V5 D. . Siz~' . . c ,f •/I/4.~'~~ ~-:f,~%(/ ~ I to ~ u L.X ;~i~loi~ A~~ FI~I~ 7 -7-~~~ . ''U'= ~ _ -;1f ToYAL (R) 107- ,L 11~`IEI'lotz F~~~~ 1=1u'l ; G.~. ' , . 11 6 ~ t'.~ 5 ~~i' ~ 1~~5(1L~~jIC;•i . ~ c~ 0 G FIR- - ~l, ri l.f. OC Ulf TO-TP:~ ~ • ~ Clt~ \/FlLU, . i; II~~ ~E~~IJSZ AItC F~Lf~i ' 17_ oC i - b n ~ II ~e " O - ~~-'C,.~('~`•°~tk?'`~~~-~-f~,-~B n cl=~o(Gv% uUu - I/CZ= •j , -TO~jP.~ ~Cc~=/S~J ' ~ . FToors occc uahca[cd ;:paccs must havc Rininu:a R-factor ot R-20 (tuc!:-undct iara.- cs). Floors oc,.r outdoor air (ovc[han&s) ouct liavc a nininum P.-factor oE F-33. . ***1*******~****#*****ti*#**~~*f***b * * . .CITY OF EAGAf~ * ~~rrTT~ ~°F~ * * arPxovAw oF rF.aruT. : , APPLICATION FOR PERMIT * INSPKTION aF ~/OR MUM * ,*t 2t14I'ATSATTprI$ qTII.L P10iP $E $CFIID-- * SEWER AND/OR WATER CONNECTION ~LIm umm PBMT HAS Em » * APPROVID. r r ~ r * . +*:*,r+****,rw+,rw,r?*r,r*xt,r***rt~x*~*tt P ease Print / 1) PROPERTY ADDRESS LEGAI. DESCRIPTION: GpT oZ t Lo cK / J~ L/c a~ S?oN~°~i,~'i~? + Lot Block Subdivision or Tax Parcel ID4)~7r- . IF EXISTING STRCCIL~RE, DATE OF ORIGINAL B[IILDZNG.PERhLLT ISS['ANCE: ' r (i~bn Y ar . PRFSENP ZONZNG/PROPOSID L'SE: Q M%NRCZAL/REPAIL/OFFICE ~ R-1 SINGLE FAMILY ~ IAIDC'S2RIAL Q R-2 DUPLEX C~nits) e n INSTI'IL"fIONAL/GOV~,'Nf ~ R-3 1UWNIIIOUSE (Three + Units) ( Units) . F-1 R-4 APARTMENP/COAIDOMINZI.TI ( Units) 2) ~ 417 ?<J -On k -a)~ e La ADDRESS:~ ~ ST'o .cj 4J. CITY, STATE, ZIP:_ i7 3 PHONE: y5~-d ~~-17 M~Kc aiZ 0~8d e 3) . ? r For City Use . NAME:_ Plumbers License: ADDRFSS: Active ~ FScpired i CITY, STATE, ZIP: ri S5 3 Z Not recorded PHONE: MASTER LICENSE# St~IRt1d1 4) " ~..i.i~: / rmME: _ G;2a .~N Da K c _ ADDRESS: CITY, STATE, ZIP: PHOf1E: . 5) r• • : ~ • ~ - CONNE.TION TO CZTY SEWII2 ~ CONNDCTION TO CITY WATEE2 0 OQ'fIER ' . . ' 6) ~ • i PI.EASE HOLD APPROVID PERMIT FC)R PICK-UP BY ONE OF I,HOVE (:3 PLEASE MAIL APPROVID PII2MIT TO 1. 2. 3r 4. ABUVE (Circle one) 7) '•'1' •Y' 1: ~ •P ?I~1• . I~ AY9' .q. ~ • • ~ ' M' . •,!7?p 1 11 . 71' ~ JI' • ~ Y . . FOR CITY USE ONLY ' PERMIT # ISSUED - Pd w/Bldg. Permit FEES: $ $ SEWER PERMIT (INCLODE SORCHARGE) $ $ WATER PERMIT (INCLUDE SURCHARGE ) $ L~ ~CnJ $ WATER METER/COPPERHORN/OOTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ 1"5 -rO $ ACCOUNT DEPOSIT - SEWER $ • C~ O $ ACCO[7NT DEPOSIT - WATER S $ wAC $ / S l~ C' D $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ 0'`--4 V. $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ /'a ZC'O $ TOTAL RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ~ YES IF YES, THEN A"PERMIT FOR WORK LVITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: ~ ' Z 7 ' ~~F CITY USE ONLY L o21 BL ~ RECEIPT n 702 C Oe'F L/ SUBD. " ' RECEIPT DATE: 1998 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 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 # TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet ` minimum - 7 3.00 x = Rough Openings 1.50 x = Water SOftenef ' for dwellings under wnstruction 5.00 X = \Nat?r Softener " for nxistina Awelling 20.00 X U.G.,9pLj ~Lkler " for dwellin9 under const. 3.00 -:~ZILQ Sprlflklef ' for ezistinq dwellina7 20.00 Alterafflons ' to existing residence 20.00 = Water Turn Around 20.00 = Private Disposal System " MPC iic 75.00 = (new and refurbished systems) Private Disposal Systems " Abandonment 20.00 = RPZ (new installation only) 20.00 = STATE SURCHARGE 50 TOTAL - I hereby acknowledge that I have read this applicalion- , state that the information is cortect, and agree to comply with all-applicable City of Eagan-ordinances. It is the applicant's responsibdity to notify the property owner that lhe City of Eagan assumes no liability for any damages caused by the City dunng its normal operational and maintenance ac6vi6es to the facilities constructed under this permit within City property/right-of-wayleasement. SITE ADDRESS: O W0 6TC OWNER NAME: INSTALLERNAME: ~Xedv TELEPHONE#: STREET ADDRESS: ;?-D 6F- 17 Ae r(j''^ CITY: 110azz',i STATE: ~/~in• ZIP: SIGNATURE OF PERMITTEE CD/PERMIT FORMSlRPLBG PERMIT (RES) - 1998 PERMIT City of Eagan Permit Type:Building Permit Number:EA111442 Date Issued:06/25/2013 Permit Category:ePermit Site Address: 3910 Worchester Dr Lot:21 Block: 1 Addition: Hills Of Stonebridge PID:10-32990-01-210 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Window or Door:skylight Deanna Ulick Valuation: 500.00 Fee Summary:BL - Base Fee $500 $40.00 0801.4085 Surcharge - Based on Valuation $500 $0.50 9001.2195 $40.50 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 - Ronald L Stahl 3910 Worchester Dr Eagan MN 55123 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA115228 Date Issued:09/24/2013 Permit Category:ePermit Site Address: 3910 Worchester Dr Lot:21 Block: 1 Addition: Hills Of Stonebridge PID:10-32990-01-210 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. Tony Boerner 2090 County Road 42 W Burnsville, MN 55337 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Ronald L Stahl 3910 Worchester Dr Eagan MN 55123 Tony's Appliance 2090 County Road 42 West Burnsville MN 55337 (952) 435-2442 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA154110 Date Issued:02/19/2019 Permit Category:ePermit Site Address: 3910 Worchester Dr Lot:21 Block: 1 Addition: Hills Of Stonebridge PID:10-32990-01-210 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 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 - Ronald L Stahl 3910 Worchester Dr Eagan MN 55123 (651) 256-2065 Blue Ox Heating & Air Llc 5720 International Pkwy New Hope MN 55428 (612) 238-9709 Applicant/Permitee: Signature Issued By: Signature ly‘i\, A• For Office Use �/ , Permit#: --7010 �. .� 0E AG A /c-?)a .& Permit Fee: �� EI VED /� G Date Received: !7 �� 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 SEP 0 9 2019 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspectionscityofeagan.com ——— 2019 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 9-9-2019 Site Address: 3910 Worchester Dr unit#: Name: Stahl Phone: 952-431-1670 Resident/ 3910 Worchester Dr Owner Address/City/Zip: Applicant is: Owner ✓ Co r Type of Work Description of work: lower leve athroom renovation-cosmetic (existing finished space) $100.00 permit requited items Construction Cost: Multi-Family Building: (Yes /No ) Company: James Barton Design Build Inc Contact: James Madsen P Y� Contractor Address: 5920 148th St W #100 City: Apple Valley State: MN Zip: 55124 Phone: 952431-1670 Email: fames@jbdb.biz License#: BC 191023 Lead Certificate#: If the project is exempt from lead certification, please explain why: ffr, �e ;, �..- e.,"•/1 built after 1978 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: 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. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.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.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. James Madsen x Applicant's Printed Name Applicant's Signature T WRITE BELOW THIS LINE .` h(1/.4►ta DO NO �C� .1V SUB TYPES Foundation Fireplace Porch(3-Season) Exterior Alteration(Single Family) Single Family Garage Porch(4-Season) Exterior Alteration(Multi) Multi Deck Porch (Screen/Gazebo/Pergola) Miscellaneous 01 of_Plex 4 Lower Level Pool Accessory Building WORK TYPES New Interior Improvement _ Siding Demolish Building* Addition Move Building _ Reroof Demolish Interior y4,Alteration Fire Repair _ Windows Demolish Foundation lReplace Repair _ Egress Window Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation 2t D 0-0 Occupancy .pyc ) MCES System Plan Review Code Edition -t" I ) SAC Units (25% 100% ) Zoning40"---- City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction Width REQUIRED INSPECTIONS\fo Footings (New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings (Addition) Final/No C.O. Required Foundation Foundation Before Backfill HVAC Service Test Gas Line Air Test Hood Roof: Ice&Water Final Pool: Footings Air/Gas Tests Final If, Framing 30 Minutes 1 Hour Drain Tile Fireplace: Rough In Air Test Final Siding: Stucco Lath Stone Lath Brick EFTS 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: l , Building Inspector RESIDENTIAL FEES Base Fee Surcharge 1(6°411/{y/. Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plantf'I 2 L4/117j Radio Meter Read1/1(1 Copies riV 11( , TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA158705 Date Issued:10/28/2019 Permit Category:ePermit Site Address: 3910 Worchester Dr Lot:21 Block: 1 Addition: Hills Of Stonebridge PID:10-32990-01-210 Use: Description: Sub Type:Residential Work Type:Alteration Description:Basement Fixtures 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$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 - Ronald L Stahl 3910 Worchester Dr Eagan MN 55123 Diversified Plumbing & Heating Inc 125 E Railroad St Norwood Young Americ MN 55368 (952) 583-9646 Applicant/Permitee: Signature Issued By: Signature