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3946 Worchester Dr 10525 Date: CITY OF EAGAN Permit No: 3830 PNot Knob RdYd B/ P No Date: ~ P.O. Box 2~ " Eay~iC; NIN 95121 E t Owner. ''rin.: 0a:.s { - „ s, .o,- r~iue E Site Address: Plumber. i.:v Plumbiu'~ MWCC: ~JND Zoningt City Chg: 100. (1'JFd No. of Units: ~ Acct Dep: ZS . 00p3 I a9me to comply wlth the Citp ot Eagan ~ Permit Fee: ' G . Ofpd i , Ordinances. ~ Surcharge: i ~ Misc.: By SEWER SERVICE PERMIT ,~.:.,.~r~a~ro.~.?--s-- - t•r~wwr~ - r'r['ST,. F' 9377 Date: '~-24- ' CIT1f OF EAGAN Permit No: 3830 Pilot Knob Roaa Meter No: Size: P.O. BoX Zt S99 Reade? No: Date: Eayei'e, MN 55121 Owner. Graiid Oaks 3946 WQ -•)_4y,, r n stl I1471 a nf titnne-. ' Site Address: Plumber ~'ali • ''n, 55~ '~1nd r7 Conn. Chg: Zoning: ~ Acct Dep: 15aOF'j No. oi Units: Permit Fee: 10 OOnd Surcharge: sQld 1 agrao to comply wlth th~ CNy of Eagan Tr. Plant 2 04 - ()ftd Ordinancos. Meter. , I Misc.: By WATER SERVICE PERMIT . . , . _ . : - • . . ti_ y.. ± f. r . ?--~f'• ' CIT1f OF EAGAN Permit Na Dat~ 24 - ' 3890 Pllol*nob Rwd Meber No: 3 97 d Size: " ac 116xi1199 Reader No: I-Q.,~a~~{1L Detg Eagan, MN 35121 IOM,nef Granii Oaks ~ SiteAddress: 3946 WnrchParP±- Zrive 1.9 B1 ??ills of Stone- - ~I ' Plumber Valley Plumhinlirid_e Conn. Chg: 550.0 ~ ~~~pa~~r Zoning: R]. Acct Oep: 15. ~ NO Af Units: 1- - j Permit Fe~ g Ca I OCTUtIlItIE$ I Surchargac TFI EBkiHXF - FI FCTRIC -(~Q&4o complp with ths CFIy o( Eagan ~ u• M Tr. Plant m re~~ eter. - Miac.: ' I WATER SERVICE PER i I - GTY OF EAaAN Permit No: Date- 3830 Plbt Knob RoiVd B/P No: Date: , ,O Ywl1199 • EMpn, MN 55121 Owner. ''r„n-i Qaks SiteAddreas: =946 Wurct:"ter D iv^ 0 "i1 iIJi : •F °n:iPlumber S• a'lle Plumb ir,A ` • r i ~ MyyCC: 550.00 d i ning ' G~, c~ 1ac . oo d e ore igG~n~~a i~ utilrtie,4 ~ AccL i 5. o Qpd L•FAUNE • ELECTRIC - GAS Etr,. ~_0. 0 pd I a rM to canpFy wMh fM qt~r of Ea~an PermR Fe~ REQUIR w Surchargw . ~ p , , - - ~ Misc.: BY SEWER SERVICE PERMIT ~ 1 CASH RFCEIPT ~ e . ~ , ~ CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 ; . DATE 19 I RtCtIV<D RROM AMOUNT $ • oo~~~ws ? CASH CHECK 4:t - ~-~-iLt.,2CL ,~_'`.L:~• _ I FUND CODt AMCUNT, ~ Thank You s,r . . ~7• } i: VYhite-PaYKs OoPV YeIlow-Postfnq Copy P{nk-File Oopy ~ S4DG., pERMIT N0. 01-3210 BILdg. Permit 01-3422 Plan Check 01-3445 Surch./Adm. ~ 01-3446 SAC/Adm. ~G r 01-2155 Surcharge 14^3860 Road Unit 20-2275 SAC 20-3865 Water Conn. 20-3868 Water Trmt. 20-3716 Water Meter ~ 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. 1-1--3855 Park Ded. TOTAL r ~ CITY OF_ EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454•8100 BUILDING PERMIT Recelpt * To be used for ST PW/CAR Est. Value $73,000 Date FehryLx ZT_ ,19 Site Address 3946 WortLester DriVe OFFICE USE ONLY 9 1 HILLS Of S'~!$~11I ~n 8ite Sewaye Occupency bt-3 Lot Block sec/sub. pp~g_~ MWCC System x 2oning Parcel No. On Site Well (Actuaq Conat Vp ac Ilame 'RANQ OAKS DEVZWPMUT Citywater (Altowable) Vn ' W PRV Requfred ~ of Storlea = Address 3%6 smNEaRzu" usivii - ~ City Phone 452-0747 B~ter Pump Length oeptn " , p Name SAM S.F. Total Footprir~t S.F. ~ Address - P City Phone APPROVALS FEES ~ W Engr./Assess. Permit 400•00 W Name 3b,5Q ~ W Planner Surcharge _ Address ~3~.pp Cit x Phone Council Plan Review _ ~ W y Bldg. Off. SAC, City 100000 I hereby ecknowledge that.I have read this application and state that the Variance SAC, MWCC .00_ intormation is Correct artd 'agree to comply with all appUcable 5t8te of Water Conn. 550•00 _ Minnesota Stafutes and City of Eagan Ordinances. -1 ) ~ ~ Water Meter 67 • ~ i r , SiOafdreof Permittee i +n ~"1~~-- Road Unit 323.00 G111ANU OAItS DKV. A Building Permit is issued to: Treatment P1 .204.00. ' on the express condition that all work shall be done in accordance with all , appllcabli State of Mfnnesota Statut and Clty of Eagan OrdinanCes. Parks Bullding Official TdTAL CITY OF EAGAN • r ~ . ~ ! ~ 3830~IIbt Knob Road, P.O. &x 21 •199, Eagan, MN 55121 ^ BUIIDfiNG PERMIT PH O NE: 454-8100 Receipt #t r' ; ` To be used for Est. Velue I J. UOt} Date r e',rua ry 1's , ,1 g Site Address OFFICE USE ONLY r; ; LL:~ -":i'hE $!i! li~n SRe 3ewaye OccuPencY LOt BIOCk ~ SeC/Sub. MWCC Sysiem Zoniny Parcel No. On Site Well (/Ictual) Const yn a Name City Water ~ (AlloweWe) Vt: = Add~e33 ' 1 L ( PRV Required * Of Storlee o Booster Pump Lenqth City Phone Depth , p Name_ S.F.Total ~ ~ Address _ Footprint S.F. ~ City Phone pPPROVAL8 FEES yVj W Name Engr./Aasess. Permit ' Addr883 Planner Surcharpe a Z Cit PhOne Council Plan Revlew ~ W y Bidg. Off. SAC, City ' I hereby acknowledge that I have read this applicetion and state that the Variance SAC, MWCC x, information is correct and agree to comply with all applicable State of Water Conn. Minnesota Statutes and City of Eagan Ordinances. Water Meter v r' Signature of Permittee Road Unit %E ` A Building PermN is issued to: Treatment Pt on the express condition that all work shall be done in aocordance with all Parks applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official ' TOTAL ' j 1.`tl _ Permit No. Pe?mit Holder Wte TNephone x Plumbing' H.V.A.C. • Elec.ric SoRener Inspectlon Ost* InsP• COmfllenb Footinga I Footings II Foundation 3 1401, Framing ~ Roofing Rough Plbg. - ; 5 Rough Htg. Isul. Fireplace Final Htq. Final Plbg. . ~ Bldg. Final Cert. Occ. Temp. LP Deck Ftg. Oeck Finai Well Pr. Disp. , • ~ , j-PERMIT Ii ' . PLl1MBING PERMIT RECEIPT p CITY OF EAGAN ~ J ` 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE PHONE: 454-8100 , Site Address. BLDG. 7YPE WORK DESCRIPTION ` Lot Block Sec/Sub Res. New s ~ Mult. Add-on • j m Name ;'0" Comm. Repair ~ Addre - Other ~ " c City ~~=?~~i Phone RES. PLBCi. ONLY - OMPLETE THE FOLLOWING: NQ. FIXTURES TOTAI C~ . ~Water Closet - $3.00 S Name 42 m /-Bath Tubs - $3.00 3 Address r-2--Lavatory - $3.00 p City Phone Shower - $3.00 -/---Kitchen Sink - $3.00 ~ FEES Urinal/Bidet - $3.00 COMM/IND FEE - 196 OF CONTRACT FEE Laundry Tray -$3.00 APT. BLDGS - COMM RATE APPLIES Floor Drains -$1.50 TOWNHOUSE & CONDO - RES. RATE APPLIES ~EWater Heater -$1 50 MINIMUM - RESIDENTIAL FEE - $12.00 Whiripool - $3.00 MiNIMUM - COMM/IND FEE - $20.00 :;_~_Gas Piping Outlets - $1.50 STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIn ~ (ADD $.50 S/C IF PERMIT PRICE GOES 4-Softener -$5.00 BEYOM01$1,000.00) Well - $10.00 „ Private Disp. - $10.00 Rough Openings - $1.50 SIGNATURE OF PERMITTEE FEE: STATE S/C: p D FOR: CITY OF EAGAN GRANO TOTAL• ....y'~ # ERMIT MECNANI4L PERMIT+. . . : P. , , ' CITY OF EAGAN RECEIPT # 1 _ 3890 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: " CONTRACT PRICE PHONE: 454-9100 ' Site Address x ~ BLDG. TYPE WORK DESCRIPTION Lot `L~ Block _ Sec/Sv ~ k,-, , Res. ~ New ~ Mult Add-on Name ~ Comm. Repair co Address J ~ Other c City Phone y ' FEES ~ ~ Name RES. HVAC 0-100 M 8TU -$24.00 c Address ADDITIONAL 50 M BTU - 6.00 3 Ciry Phone- (RES. HVAC iMCLUDES A/C ON NEW ' I 0 CONSTRUCTION) f GAS OUTLETS (MINIMUM - 1 PER PEFtMl'n - 1.50 EA. TYPE OF WORK COMMl4ND FEE - 196 OF COIVTRACT FEE Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE 8 CONDOS - RES. RATE APPUES 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 i S7ATE SURCHApGE PER PERMIT - .50 Vent CFM (AOD $.50 S/C IF PERMIT PFiICE GOES Gas Piping Outlets BEYOND $1,000) Other FEE I SIC: SIC,lVATURE OF QERMITTEE I TOTAL• ' FOR: CITY OF EAGAN CITY OF EAGAN . : 4548100 ' - DEPT. OF BUILDING INSPECTIONS Cormction Notice Located at I have this day inspected this structure and these premises and have found the following violations of city codes governing same: S74,12-2 ~'I~ ~s..,.G v669'< ~~w'!?~- 047- c- When corrections have been made, please call 454-8100 for inspection. Date Inspector City of Eagan DO NOT REMOVE THIS TAG :i • .....y..._,.. . . . . r'*I ~ k "„r..vc.r•` ,~1~~~~ ~O / ~ ' - . , . MECHANICAL PERMIT PERMIT # CiTY OF EAGAN RECEIPT # L /z 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE ~23 S CONTRACT PRICE .DO PHONE: 454-8100 Site Address BLpG. TYPE WORK DESCRIPTION Lot Block _ Sec /Sub Res. New ~ m Name MufL Add-on Comm. Repair Address ~ c City Phone ` ~ - FEES (D Name RES. HVAC 0-100 M BTU -$24.00 3 Address ~ ADDITIONAL 50 M BTU - 6.00 O CitY (L(k-~ Phone S!j - (RES. HVAC INCLUDES A/C ON NEW ~J CONSTRUCTION) - " C3AS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA. tYPE OF WORK COMM/IND FEE - 1% OF CQNTRACT FEE FOrCed Air M BTU APT. BLDGS. - COMM. RA1~ APPl1ES TOWNHOUSE 8 CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. ~QII~M BTU MINIMUM COMMERCIAL FEE _ 20.00 STATE SURCHARGE PER PERMIT .50 Vent ~ CFM (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # BEYOND $1,000) Other FEE S/C: ' SIGN E I EE TOTAL •S FOR: CITY OF EAGAN , • • ~ ¢ t fg.erti#ixatit of (Orrupanry titp of olagan lepparbtPit# of IddUn jwPtttDit Thts Certifrcale issued pursuant lo ihe rrqrdrements of Sectlon 306 of the Uniform Building i Code cerafying thal at the time oJissuance 1/ris sducture wrrs ire compliance with the wurfous onlfnances of the Ciry regrrlating building construction or use. For the following: v.e aarification SF IXaC'/CwAR e1dS. Rrmit Pto. 14623 0-,W.,,n, .rya R3 Zoninj Duuict PD R I Ty,~ cc" Vn owl, of sQaM GtAM 4AK.S IEVfZOaM ,,,M,,.3988 S1CIEN= Ik2IVE, EAC,AN IkvMvg Addm 3946 1'.= D4tIVE L-hq I9, B), Ha1S CP S1Ct+~ ak: AP'RLL 28, 1988 &aami o&.i P03T IN A CONSPICUOUS PIACE This reque.st void -?1'21,? X 18 nanths Irom 0, ~Q-8 6 91 9 9/ Nxqoest Date Fve No. Ro~h-~n Insuer.uon v R quirotl~ oAe:+dy Nuw WiII Nnu(y 3Inspec- - - ~l~ Y~s ?NO lor Wh~:n PeadV ~ L~censed E1¢cu6cal Convacion I hereby requost inspection ol ebovo Owner elechical work installed ac Street A/JAjress'9. Bo / a or Rov/te, NIo. Gtv j 1~i Woy-C~A'P ecuon o. Townsnio Name or No. Ranpe No. Cow~ Occupa9tIPRINT) /~J Phone No. PaMlier Atltlress C~. / L( ? / ~ ! V ' / EIeGfr l ContraGOr IComOany Name) / Coniractor's Li ~ ~e No. ~~~.~L. Mailmp AtlJ~ess (Contr:icmr or wner Ma mq Instailation) Z, 75 /2~' ~C.t~,~' , /99 /J Au ~h rzed $~H,ature ( nt ac~or Owner Mak~ Installation) Phone Num tkr ~ ~ MINNESOTA STATE BOARD OF ELECTqICITY TNISCINSPECTION HEDUEST WILL NOT Griggs-Mitlway Bldg. - Noom N•191 9E A CEPTED BY THE SiATE BOAFD UNI.ESS PNOPEP INSPECTION FEE IS 1821 UniversitvAva..56 Peul, MN 65104 Phone 16121 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION Ece-ooooi-os Ill, See insRUCHOns lor comoleting this form on bnck of Vellow cocv. -'X" Below Work Covered by 7his Requesf ` ~691 FAtl Nep. TVPe of Builtline AVOliancm WireA Equiumem Wued Home Range Temporary Service Duplex Water Heater Lightiny Fixtures L EAPtB.1,1,dmg Dryei EleCtuC Healui ial Bldy. Fumace Silu Unluader l Bldg. Air CondiUOner Bulk Milk Tank onnei Soeu v Omcr Isucr.iivl cifv ther Oih¢r ompute lnspection Fee Be/ow p Fee SarviceEnlrenca5ize H Fee Faxders/5uhfaeders ~ Fee Cucwts 0 to 200 Am ps 0 co 30 Am s z0 tn 30 Fam us Above 200 Amps 31 to 100 qmps 31 to 100 Am s Swimming Pool Above 100_Amps Above 100_Amps Transrormers Irngation Boorcis SZ Partial.'Other Fee Hema rks Signs Speciai Inspec[ion 5~ q TOTA EE ~ flouph-in the E ctncal J 7 ~nspector, rob, certdy that the . bove Final ~ D,ie7p~ insVection hes been made. TNa request void 18 moNns Irom This reauest void ///~/p(7 / C 18 nnmhs tmm O 4 fV g 'D 5 0 3 9 9# flrzques~ Date ve No. R i wh-reitl> n Inspection ' N Neatly Nuw ? WI11 Nou(y Inspec- ~f `~yes po toe When Readv ? Liceisetl Electncal Contracror I heraby mpuest ins0ection ol obove ? pwner eleclrical work installed at: SVeet AAAress, Boz or Ry u~te No. Citv ~ UJD/°C~/,'~JT ~CJ/P ~AC6/~•~.~ ecuon o. Town511111 Name or No. R;inyo No. Coun OccuU IPflINT1 Phune Nn. Power Supylwr Atldress ElecVfqal Conua mr ICo veny Ne e) C~nhar.m~'.^, Licenae No. Mo linp AdJress IConrtacto Own r Makin InstaiL~lionl i~6/ ~v, . .~I&6zw Auth S~nawre ICOntractor wncr '~4~ ~d Ins~ Ilauonl Phn e Number t 702. MINNE$ STATE 60 O OF ELECTflICITY THIS INSVECTION NEQUEST WILL NOT Griggs idwey BItlBm N491 BE ACCEPTED 9V THE SiqTE 80ARD 1821 UniversitvAve.. t. Veul. MN 55109 UNLE55 PHOPEN INSVECTION FEE IS u.--- ic." - ..e.... ENCLOSEfl REQUEST FOR ELECTRICAL INSPECTION ea-ooooi-os ~ ~ Snee instrvc4ons lor comoleting this fofm on beck ot yollow caov. 0 5 039J "X" Below Wark Covered by This Request AdJ NeO. TVae oi 0ulltlmg Aouliancea Wved Eqmyment Wired ow, Home Range Temporary Service Duplex Watei Heater LiGhtiny Fixtuies Apt Buflding Dryei EleCtnCNeatun Commercial Bidy. Fumace Siiu Unloader 4 InAustrial Bidg Air Conditioner Bulk Milk Tank F2rm 0 1 hv1 per,i v Oihor ISUCr.ifyl ~ er SVecifv Other Oih"r ompute lnspeciion Fee Below N Fee Service EntrenceSize H Fee Fexdets/SVbfaeJers b Pee =Fee U to 200 qm 5 0 to 30 qm>s Above 200 qmps 31 to 100 qmps Swimming Paol Alwve 100_Amps Am~s Transiormers Irngation Boonis Signs SU¢cial inspeClion nem~rks 5 O JG TOT E a .U Roueh-in Dme I, the cUic Insoector, e~eby ertify thai the above Final Da~e {ngpection has baen made. ? TNS request vo1E 18 montlu Irom CITY OF: EAGAN (vo- 14 6 2 3 3830 Piloc Knob Road, P.O. Box 21 •199, Eagan, MN 55121 ~ BUILDING PERMt IT PHONE: 454•8100 Receipt# Tobeusedfor SF DWG/GAR Est.Value $73,000 Date FPhnuarv 73, ,19S8 SiteAddress 3946 Worchester Drive OFFICE USE ONLY 9 1 HILLS OF STONEBRID ~n Site Sewage _ Occupancy R-3 Lot Block Sec/Sub. PD,R-1 MWCC System X 2oning Parcel No. On Site Well _ (ACtual) Const Vn ~ Name GRAND OAKS DEVELOPMENT Citywater X (qllowable) Vn z Address 3958 STONEBRIDGE DRIVE PRVaequired _ #m5tories ; ° City EACAN Phone 452-0747 Booster Pump - Length 44' Oepth 4$" ¢ Name SAME S.F.TOtal .o Footprint S.F. zi- ~ a Address - ~ City Phone APPROVALS FEES ~w Engr/ASSess. Permit 466.00 Ww Name 36.50 ~ i Planner Surcharge x. Address 233•00 Us City Phone Council Plan Review a w Bldg. Ofl. SAq City 100.00 I hereby acknowledge ihat I have read ihis application and state that ihe Vanance SAC, MWCC 550.00 mformation is correct and agree to comply with all applLcable State of Water Conn. 550.00 Minnesota StaWtes antl City of Eagan Ordmances. n water Meter 67.00 Signature of Permittee Road Unit 39 5.00 A Buildmg Permrt is issuetl to: C'RAND OAKS DEV. Treatment P7 204. nn on t he express condihon that al I work shall6e done in accordance wdh al I apphcable State of M/i'n~nesota StaN~[~ and City of Eagan Ordinances Parks BwldingOfficial /Js ~-&-w z a/ TOTAL '1~531_50 *dtV oF eagen PATRICIA E. AWADA Mayor ['AUL BAKKFN PEGGYCARLSON November 18, 2002 CYNDEE FIELDS MEG 77ll.EY Cowcg Members CATASTROPHE RESTORATION 2489 RICE ST #70 THOMhS HEDGES ROSEVILLE MN 55113 CiryAdminisvamr RE; REFUND OF BUILDING PERMIT 54420 TO WHOM IT MAY CONCERN: Municipal C<nc«: In response to your letter dated November 13, 2002 requesting a refund of permit #54420 to 3830 eiloc Knob aoad reside the residence at 3946 Worchester Drive, please be advised that this permit is being cancelled and you wdl be receivmg a refund of $145.25 under seoarate cover. A$50.00 Eagan, MN 55122-1897 handling fee applies to this refund and the $5.50 state surcharge is non-refundable. Phone651.G81.4G00 Fax: 651.681.4612 If you have any questions, please feel free to give me a call at 651-681-4695. TDD: 651.454.8535 Sincerely, Maintenance Faciliry: an Severson 3501 Coachman Point Office Supervisor Eagan, MN 55122 Phone: 651.681.4300 cc: Dale Schoeppner, Chief Building Official Faz: 651.681.4360 TDD: 651.454.8535 www.ciryofagan.com THE LONE OAK'I'REE 'Ilie symbol ofnrength and growth in our communiry + CLAIDI VOUCHER - REFUND REQUEST ' CITY OF EAGAPI b7AKE CHECK PAYABLE TO: CATASTROPHE ROOFINC 2489 RICE ST #70 ROSEVILLE MN 55113 LOCATION: 3946 WORCHESTER DR RECEIPT #/DATE: 32930 8/16/02 REASON FOR REFUND: CONTRACTOR REQUEST PERMIT 54420 VALUATION: $11,000 TYPE OF REFUND: Plumbing Permit 9001.4087 $ Mechanical Permit 9001.4088 $ Building Permit Fee 9001.4085 $ 145.25 Plan Review Fee 9001.4222 $ SAC (MC/V?S) 9220.2275 $ SAC (City) 9379.4681 $ SAC (Admui) 9001,4246 $ Water Connection 92203865 $ Sewer Permit 9220.4532 S Water Permit 9220.4507 $ Account Deposit 9220.2252 $ Water Meter 9220.4509 $ WaterTreatment 9220.4685 S Surcharge 9001.2195 $ Overpayment 9001.2250 $ Curb Box Deposit Refund 92202253 $ Construcnon Meter Dep Refund 9220.2254 $ Other $ TOTAL $ 145.25 I declare under the penalties of ]aw that this account, claim, or demand is just and that no part of it has been paid. ~ 11/18/02 vSIGNATURE DATE ~ CRSI 1 fII ft'OV 4 7007 YOUR "PEACE Of MIND" U GENERAL CONTRACTOR e ~ November 13, 2002 Please cancel and/or refund the cost of the permit for the following. Work was not done by CRSl: EA054420 3946 Worchester Dr Reside A check can be sent to CRSI 2489 Rice St Suite 70 Roseville, MN 551 13 If you have any questions, please call me at 651-734-9433. Thank you, Jaci auth CRSI Minnesota 2489 Rice Street. Suite 70 Roseville. MN 55113 651.734.9433 U azovtosi Wisconsin 101 W, Edison Ave., Swie 247 Appleton, WI 54915 ' 920.830.9611 Lm.#695024 IllIIIOIS/MISSOUfl (St. Louis area) 94 Weldon Parkway Maryland Heights. MO 63043 314.521.0101 Lic. uisi STORM DAMAGE I ROOFING I SIDING I WINDOU'S ~ A I18'1 o2._ • RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 "J T I 651-681-4675 NewConstruction7Calculafions en RemodellReoairReuuirements j • J registered sih sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies al plan (20°b maximuge all ed) . 1 set of~neryy Calculations for heated additions • 2 copies of plabeam 8'ndaw s¢es; pouretl found design, etc.) . 1 site urvey for extenor addiUons 8 decks te if home served by septic system tar adtlitions • 3 copies of Trea Preservation Plan if I platted after 711/93 • Rim Joist Detail Options selec6on sheet Idgs vnth 3 or less units) • 1 set of Energ/VUATION DATE SITE ADDRESS MULTI-FAMILY BLDG Y ll`Pl TYPE OF WORK FIREPLACE(S)SLO1 _ 2 APPUCANT at stro e R es t n rvice/Inc. STREETADDRESS CITY Rnseville STATE-MZIP55113 TELEPHONE # 551-734-9413 CELL P ONE FAX # 651-483-0219 PROPERTYOWNER ~l TELEPHONE# loS l- 4sU--OF?,~-V 1 l COMPLETE THIS SECTI N F R"NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ M[NNFS G\ RUI.ES 76 0 CA"fLGORY I MINNCSO"fA RULES 7672 (J submission type) . Reside 'al Venhlalion Categ 1 Worksheet Submilted • New Energy Code Worksheel Submitted • Ener Envelope Calculations ubmitted Plumbing Contractor: Phonc # _ Plumbiiig syslcm includes: Walcr Softener _ Iawn Spnnklcr Pee: $90.00 Water Heater No. of R.I. Baths No. of Baths Mechanical Contracto Phone # Mecfuariical system i cludes: Air Conditioning ' Pee: $70.00 _ Hcat Rccovcry Syslcm Sewer/Water Contr ctor. Phone # - - ~J I hereby acknowl d / that I have read this application, state that ihe information is correc to comply with all applicable ate of Minnesota Statutes and City of Eagan Ordin es. c Signature of Applica OFFICE USE ONLY CeRificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY ' . . ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) O 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? OS 03-plex 0 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-ptex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applfcant 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 W idth REQUIRED INSPECTIONS _ Footings (new bldg) _ FinaUC.O. _ Footings (deck) _ FinaVNo C.O. _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof _ Ice & Warer _ Final _ Poo] _ Ftgs _ Air/Gas Tests _ Fuial _ Framing _ Siding Smcco Stone _ Fireplace _ R.I. _ Air Test _ Final _ W indows (new/replacemen[) _ Insulation _ Retaining Wall Approved By , Building Inspector - Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S8W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total l RESIDENTIAL a~ S S s~~ BUILDING PERMIT APPLICATION /CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 New Construction Reauiremenh RemodellReoair Requiremenls • 3 registered site surveys showing sq. ft. of lot, sq. ft. ol house; and all mofed areas • 2 copies of plan (20% maximum lot wveroge allowed) . 1 set ot Energy Calculations for heated additions • 2 copies of plan shovring beam 8 window s¢es; pouretl found design, etc ) . 1 site survey for extenor additions & decks • 1 set of Energy Calculations . Indicale if home served hy septic system for addilions • 3 copies of Tree Preservation Plan if lot plaked after 711/93 • Rim Joist Detail OpGOns selection sheet (Wdgs with 3 or less units) DATE CT VALUATION JOB SITE ADDRESS J Iq(P D(L- IF MULTI-FAMILY BUILDIN/G~, HOW MANY UNITS? PROPERTYOWNER M/kZA-4IA'0 TYPE OF WORK 10FIREPLACE(S) _ 0_ 1_ 2 APPLICANT Not.hSt-RIF u~,,,o, Improvement Inc. PHONE# ADDRESS "SImPty the ElleSr ZIP CODE 4972 nco PAGER # ...as UaV645ONE # FAX # 95a APo s "9 a (952) 929-1888 NFW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category _ MINNLSO'1'A RULLS 7670 CA"1'F.GORY l (check one) - Residential Ventilation Category 1 Worksheet Submitted - Energy Envelope Calculations Submitted MINNLSO'1'A RULF.S 7672 New Energy Code Worksheet Submitted Plumbing Contractor: Phone PlumUing SN'stcm Includcs: _ Watcr Soltcncr _ Lauv Sprin_klcr--- -Fcc: $90.00 Watcr Hcatcr _ No. of R.I~i \o. of 13allis r SIC P 1 9 Z002 I'I I Mechanical Contractor: P Ione# Mcchanical Systcm Includcs: _ Air Condilioning I'cc: $90.00 _ I-Icat Rccovcry Systcm Sewer/Water Coniractor: Phone # All above information must be submiried 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 Ordi ces. Signature of Applicanf Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ ' Updated 2002 OFFICE USE ONLY ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Exl. Alt - Multi ? 03 01 of _ plex O 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) 0 36 Multi ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscelianeous 0 31 New ? 35 Int Improvement ? 38 Demolish (Interior) 0 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alleration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors O 34 Replacement 'Demolition (Entlre Bldg only) • Give PCA handout 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-) _ Final/C.O. _ Footings (deck) _ FinaVNo C.O. _ Foo[ings (addition) _ Plumbing Poundatiou _ HV.4C Drain Tile Other Roof Ice & Water _ Final _ Pool _ Ft-s _ Air/Gas Tests _ Final _ Framino _ Siding Stucco Stone Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement) Insula[ion _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply 8 Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total APFLICATION 1=0R PERMIT iNOM pAYMENr OF FF£ AT TIME OF . ; nprLicr.TTOri oots Nor cceN- ; SfI1VfE APPHOVN, OF PIItFIIT. ~ SEWER AND/OR WATER CONNECTION : 2~~CN OF ~~/OR WATlm : irasrncrATT«Ns waa. r,or se scmu[.m ; ' • ~ [!NPIL PQthIIT HAS BFEId APPROVID. ~ t city oF ecicjcan (PLEASE PRINT i) PROPERTY ADDRFSS: ~39Vjo 1~(7aiZC~e s7cr? cl~r~~~~. T_FY=AT• DFSCRIPTION; q ~ {-(j[.,Ls o-F STa.ueb,z'v',lGe Lot B ock S division or Tax Parcel ID IF EXISTING STRi:CPURE, DATE OF ORIGINAL BC!ILDZNG PERMIT ISSUANCE: Nbnt Year PRESENT ZONING/PROPOSID USE: Q COMh1ERCIAL/RETAIL/OFFICE I:Li R-1 SINGLE FAMILY Q INDLSTRIAL E__1 R-2 DL~PLEX (3WO Units) a INSTITUTIONAL/GOVII2NMENT Q R-3 TC7WNHOC~SE (Three + Onits) ( Units) Q R-4 APARTMENP/CObIDOMINIUM ( [lnits) 2) ~ NAME: .S ADDRFSS: AJO ,62 t 2 CITY, STATE, ZIP: A411) PHONE : For City Ose 3) ' NAME= Pl erurt~ s I.icense: ADDRESS: Active Expired CITY, STATE, ZIP: _f~,e-~, w-J, Z Not recorded 0 PHONE: MASTER LICENSE # ~.-cr2~J17-til L, Sta In£~itia~ 4) e ~ ~ ~ plffl / N11ME: -,~a .?~J Qa 1~ S' ADDRFSS: n.r ci C ct t/ e CIT'Y, STATE, ZIP: PHONE: 5) 1CONNECTION TO CITY SEWER ~ CONNECTION TO CITY WATER O OTHII2 6> : ? T~ vvi~~,~ ~ ~ ~ - / 7 - 9.~/ * ,*x THE GOID COPY OF 7HE PERNIIT WILI. BE SIINi` DIRDCIS,Y TO PUSLIC WORKS TO FACILITATE METER PIQC-[JP. ,*t PLEASE ALd,OW 'iW0 WpRKING DAYS FOR PROCESSING. SOA'IDONE FROM TfIE CITY WILL ODDTPALT YOU IF 74ERE * ARE ANY PROSLFSIS. t ~******,r****+****~***+*+«r****r*«**+,t*~,r+****~*+r****+,rr«***«*,r:*,r«***,r***t*r**,r***+~***+~~*+*««r~*; TOR CITY USE ONLY ' . PERMIT # ISSUED .3 ~ 7 . Pd w/Bldg. Permit FEES: $ $ /O "SD SEWER PERMIT (INCLODE SURCHARGE) $ $ lo- 52) WATER PERMIT (INCLUDE S[.'RCHARGE) $ $ WATER METER/COPPERHORN/OC'TSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER $ $ ACCO['NT DEPOSIT - WATER $ $ WAC $ $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ $ -s ~ Gr D TOTAL . P/ e~ a -7 RECEIPT RECEIPT DOES UTILITY CONNECTION REQ[iIRE EXCAVATION IN PUBLIC RIGHT OF WAY? ~ YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MOST BE ISSUED BY THE ENGINEERING ~ NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: .i~ APPROVED BY: TITLE: DATE: I 1988 HUILDING PERMIT APPLICATION - CITY OF EAGAN / SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENEEiGY CALCULATIONS NOTEs ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIAED. NO CHANGES WILL HE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS AENTAL UNITS FOR SALE UNITS I_ 0 OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTORAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: S• f'~,r~~ L Valuation: 44--0e7rr Date: 7- ~ dl~ Site Address Wo~2C~eSfe e cdtZi e OFFICE USE ONLY rI 000 - Lot ~ Block ~ On site sewage Oecupancy ~-3 '11,:Lf-.. MWCC system ~ Zoning D Parcel/Sub STo u e On site well Actual Const V• N City water ~ Allowable V-N Owner ~4,1 ,d C~ lJPRV required _ ll of stories Hooster Pump _ Length Address Depth S.F. Total City/Zip Code ,t~.rJ SS"/Z3 Footprint S.F. Phone 415~2-6,7L/ rJ APPROVALS FEES Contractor Engr/Assess Permit (,6, 40 0 / Planner Surcharge 3(~,So Address Sa~v, r S Qbo~/~ . Council Plan Review Z33, DO Bldg. Off. z~=jz-/g SAC, City lop.o0 City/Zip Code Variance SAC, MWCC 550,00 Water Conn 550-00 Phene Water Meter OD Road Unit 3 a5, o0 Arch./Engr. Treatment P1 204,00 Parks Address Copies I TOTAL S~ 31,50 City/Zip Code Phone li VALUATlol• , GARaU~ ZZXZZ = qky x/Ll= 6~~G SAC~ 1+tiF_NT" 2~~c~lo ~cM= 10,4 o Kl3 13SZo f-J o u Sc ~sJ,-r- ~ 'DVu /x22 =2z 106 x~ 4cl= 5Zd341 7 Z 33y SURVEYOR'S CERTIFICATE GRAND OAKS DEV. C0. ~ 480 I ~ ~ Zs L?' Co 4j I, . 3800 16940 C?~ /o ~'rs S ~6, 44' ~ 1, to' 6 0 d' CY m _ 89i,y~ ~ o ~ o /o i ~Qh f0~ aA~ / ~-26p ~ ciM i O~y~?ps.. - P ry_ p~ ~2 ~ ~ / PY)~4)",~0.-~~0 ~ ~ o - ~j , \ • ` 2s ' S~, ryN_ P~oy4~ J y4~= ~O. v' v O9.1 ~o / 0 22,g3 Q~~ 'r- po 0 ^ n ° ~ a 4i / o 33SO 4 Ag9 IV ~CJ 0~ / ry'(D A, ~ . 6N,F OQL~ / sO J~' O DENOTES PROPOSED SURFACE DRAINAGE ~O O DENOTES IRON MONUMENT SEf SCALE: 1 INCH - 3o FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR -845. I FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR m 545.3 FEET (000.0) DENOTES PROPOSED ELEVATION . PROPOSED TOP OF BLOCK - E98.S' FEET WE HEREBY CERTIFY TO GRANO OAKS DEVELOPMENT CO. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 9, Block I, HILLS OF STONEBRIDGE, according to the recorded plat ihereof, Dakota County, Minnesota. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS I (vTN DAY OF FE'g204,¢.4 , tg$°. SIGNED: J,AM S~ ILL, INC. ) PROPOSED ELEVATIONS SHO4,'N 41ERE TAKEtd FROh1 THE DEVELOPMENT PLAP! 0 FOR HILLS OF STONEBRIDGE, PRE- BY' PARED BY PIONEER ENGINEERING AND HAROLD C. PETERSON, LAND SURVEYOR LAST DATED 10-20-87 MINNESOTA LICENSE NUMBER 12294 m~T ~ James R. Hill inc. ~ ~ oo ° o ~ 0 3n / 1r t c~ ~ c' ~ O ~ o~ o`^ D Z m W PLANNERS / ENGINEERS / SURVEYORS 'i p m cn < 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029 m ~ N O M' ` 1, . ~ CITY OF EAGAN EXTERIOR ENYELOPE AVERAGE 'U' COMPUTATION ONNER: GRAND OAKS DF.VELOPMENT COMPANY SITE ADDRESS: I. -r 9 y Sl0ck I 5;7-0NQRIA&,9- CONTRACTOR: GRAND OAKS DF..Vi::LOPMENT DATE: PHONE: 452-8167 Detcrmine vorking squarc footage of each: 1. Total exposed wall area 1854 sq. £t. x.11 - 203.94 2. Total roof/ceiling area 1077 sq, ft. x.026 = 28.00 Total exposed wall area above floor = 1678 a, Total wall window area 788 b. Total door area 40 ' c. Total sliding glass area 42 d. Total fireplace Nall area e. Total wall framing area (average 10%) 141 f, Total net wall area above floor 7267 g. Total rim joist area 110 Total exposed foundation area = 66 h. Total foundation window area i. Total net foundation area above grade 66 Determine 'U' value of each wall segment: a. 188 X'U` aig =77 Ra b. 40 x 'U' _077f10 :}.OS c. 42 x 'U' .460 = 19.32 d. X 'U' `.2500 - e:-... 141 x 'U' .06998 - 9.87 f. 1267 x lUl .03716 - 4708 g, 110 x 'U' .03528 - 3.88 h. x 'U' .9800 - i. 66 x 'U' .06609 - 4.36 3 . Total 165.42 If item !i3 is the same as or less than item 91, you have met the intent of SBC 6006(c)2. Total exposed roof/ceiling area = 1077 j. Total skylight area 6 k, Total roof/ceiling framing area (average 10%) 707 • 1. Total net insulated roof/ceiling area 96,4 OVER , . Determinc 'U' value for each roof/ceiling segment: j, 6 x 'U' .53 = 3.18 k. 107 x 'U' .02894 - 3.10 1. 964 x 'U' .02205 = 21.26 4 . Total = ?7 If total of p4 is the same as or less than 02, you have met the intent of SBC 6006(c)1. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of Items 03 and 114 shall not be greater than the sum of Items //1 and 02. 1. + 2. - 3. + 4. _ 1 . SINGLE & DOUBLE I'AMILY HOMES " y 1984 ENERGY CODE RE4UZREMENTS On or about March 1, 1984, the following energy code requirements should be calculated and included with a building permit application. 1. Roof - ceiling assemblies - R-38 U= 0.025 Averaqe 2. Exterior wa11s & rim joists - R-20 U= 0.11 Average 3. Floors over unheated spaces - R-20 U= 0_05 Average 4. Exterior overhangs will be considered as e:cterior wall. 5. Foundations (all exterior walls) - Minimum of R-5 insulation. 6. A11 insulated areas must be separated from the heated space by a we11-lapped or sealed vapor barrier with a minimum perm rating of 0.1. A 4 mil. polyethlene sheet or equivalent meets this requirement. A Kraft face R-19 type insulation will be accepted in the rim joist areas. Air chute ba£fles are to be placed in every rafter space. ' . czzr or r•.ncnrr ~ •'i!~` ?II~;I?ID~1 "U" \`ALUG A.\D R-F,ICTOR AT P.OOP, I1ALL, RI@I iu\D CO\CftGTC IILOC1; c7 Providc insulation bafflcs in evcry' i3`_tcr 5pacc. . - . . . Cr'J Ur1~ _ s lt~-(~~lo(~ ~ ~,tt~ F?~~1 . ~ / . ~ ~ S~s' U~P. e~. s~ ~ . 7 ~ fzcr~-----~ ~ ~ `'U" = l~{z = ozS TL)TAL. (R~=ys~y WALL . . . ~ . (7,) VaLC • ~ ~ : ? . • . QQ IC~ (c(~I/~[= Al(Z F[~M . G 8 ' _ . . G) '12!' C, ' f^ I ' ~o ~'~`c SID~r(a . 6 / ;ci-loi Alit FlLP1 . 037/6 ~ . ToTRL (R)=2C.9i. . . ~ IZl m - i2 1z • . ~ 5 i~," 1rsUl.~~Ttc(~~ ' : i ~i, oc 2 FliZ- Plf'~ ',01ST is . i5 ~ ~ ~1 ~ U' ~ =~~~`C~~`MS10~I~(, .(v ( . , • . ' C=.xTcRlD(Z l Rn ~ . i 7.: , . . • .r~7r~8 • .To1P~ ~ . CiZ) VALU~ ~ . . D iN ~c47l~ft Aitc FIU-i ~ . . 0. r tor~ AIR FtLM e GI=.O~GO`J FToors o:e: unhcated :paecs must havc mininua R-taetor ot A-20 (tuck-undcr gara-,cs). Floor; ov;.t' outdoor air (ovcrhangss) oust tiavc a nininum F-Iactor of F-33. , 2007RESIDENTIAL BUILDING pEUMiT arrLicnTiox City Of Eagan 3830 Pilot Knob Road, Eagan NIlV 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Cons Wctlon Re4uiremenLS RemodeVReoair ReouiremenLS OKce Use Onh 3 registued site surveys showing sq. ft of lot, sq. N. of house; and all roofed areas 2 copiw of plan showing (oo6ngs, beams, jois6 CeR of Survey Recd _ Y_ N (20%maximum lot cwerage allaxed) 7 set of Energy CalcuWtlons far heated addi6ons Sals RepoA . L _ Y_ N 1 SoBS RepoRi( proposed buiiding is to 6e placed on disNrbed soil 7 sde survey foraddihons 8 decks Tree Pres Plan Recd _Y _ N. 2 copies oi plan showing beam 8 Mndow sizes; poured found design, etc. Addifion - indicafe Aon-sife sepfic system Tree Pres Required _Y _ N lsetofEnergyCalalations Oo-siteSepGcSystem '_Y _N 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options selecfion sheet (buldngs wilh 3 or Iws units) , Minnegascomechanicalvenfila6onform Plans are considered ublic information unless ou state the are trade secret and the reason. Construction Cost Da[ej-_/ (f l 07- ~(P Q~ SiteAddress 6,103G~t-5/-eZ ~7 /,~/L UnitlSte # Description of Work ~'ew~ ~e 12, ~ Multi-Family Bldg _ Y 71V Fireplace(s) _ 0 _ 1 _ 2 PropertyOwner 45,'MS 6-y• Telephooe#(0S~) /Le7/Z. Contractor Mor-( ~P~wo~Y~~--~ ~i?L Address 77/0 C-G_~ / !¢df_ A/ ~ City State H'J[n.J Zip f}'/T 2- Telephone #(7G,~ ~f 22 ' 2 S7 7 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cate2orv 1 _ Minnesota Rules 7672 Energy Code CategOry . Residential Ventilation Category 7 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted . Energy Envelope Calculalions Submitled , In the last 12 monihs, has ihe City of Eagan issued a permit for a similar plan based on a master plan? _ Y _ N If yes, dafe and address of masier plan: Licensed Plumber Telephone J Mechanical Contractor Telephone ~ Sewer/WaterContractor 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 p it, and work is not to start without a permit; that the work will be in accordance with the approved p n in th c e of work which requires a review and aofpl an rB ~ ~~d `d~-? ~ Applicant's Printed Name Applicant's Signature DO NOT WRITE BELOW THIS L1NE Sub Tvpes ? 01 Foundalion ? 07 OSplex ? 13 16plex ? 20 Pooi O 30 Aaessory Bldg O 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Eut. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 6ct. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo/pergola) ? 36 Mulli Misc. ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous ' Work Tvaes ? 31 New ? 35 Int Improvement ? 38 Demolish Interior O 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteretion ? 37 Demolish Building• O 43 Reroof 46 WindowslDoors ? 34 Replecement 'Demolition (EnUre Bldg) - Giva PCA handout to applicant DBSCfIptlOfl: Water Damage _ Yes Valuation Occupancy MCES System Plan Review 100% or 25% Census Code Zoning City Water SAC Units - Stories ' . Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered . • , Type of Const Width ' REQUlI2ED INSPECTIONS Footings (new bldg) _ Sheetrock _ Footings (deck) _ Final/C.O. _ Footings (addi[ion) _ Final/No C.O. Founda[ion _ HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool Ftgs Air/Gas Tests Final Framing _ Siding _ Stucco Lath _ Stone Lath _Brick _ Fireplace _ R.I. _ Air Test _ Final _ Windows ' Insulation _ Retaining Wall Approved By: , Building Inspector Base Fee Surcharge Plan Review MGES SAC City SAC Utility Connedion Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA161198 Date Issued:05/12/2020 Permit Category:ePermit Site Address: 3946 Worchester Dr Lot:9 Block: 1 Addition: Hills Of Stonebridge PID:10-32990-01-090 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Khammany M Douangmala 3946 Worchester Dr Eagan MN 55123 (507) 382-3773 Milbert Company (culligan) 1801 50th St E Inver Grove Heights MN 55077 (651) 451-2241 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA168396 Date Issued:04/20/2021 Permit Category:ePermit Site Address: 3946 Worchester Dr Lot:9 Block: 1 Addition: Hills Of Stonebridge PID:10-32990-01-090 Use: Description: Sub Type:Reroof & Siding Work Type:Replace Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. We encourage you to retain an electronic copy of photos until the project passes a final inspection. *Roof permits issued between December and March will be inspected in the spring. Valuation: 10,000.00 Fee Summary:BL - Base Fee $10K $191.75 0801.4085 Surcharge - Based on Valuation $10K $5.00 9001.2195 $196.75 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 - Khammany M Douangmala 3946 Worchester Dr Eagan MN 55123 Applicant/Permitee: Signature Issued By: Signature