4820 Weston Hills Dr
Wei.tificate of Cccupauc~
witv of Cpagan
2"wttment of e.~~~ 380ted"
Tltis Certif cate issued pursuant to the rrquinments of the Uniform Building Code
cerrifyirtg lhat at lhe tinte ojissuanct this structurr was in compliance with the variouc
orrlinances ojt/te City regulating building construction or rrse. For the following:
use c1"s=ion: SF DiJG/GAR Bwg. Nm,;, xo. 27368
O-W-Kr TyPe R-3 U-1 zwu,a D;stric, 8-1 Type con5i. Vn
owwrofeuikh,g HOHES BY CHASE Addmu 1668 E CL1FF RD., BURNSVILI.E, MN
BWiding Ad*m 4820 WESTON H1LLS DR L,.w;~y L6, Bl, P1NES EDGE 1ST
/ - f Date
, Bmiding odyieW /,ff
POST IN A GOPlSPICUOl1S PLACE
V INSPECTION RECORD
CITY'OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number. c+.' /+r r-~
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675 "
SITE ADDRESS: APPLICANT:
14F510M Hri I~. FIR
ri t i tI
PERMIT SUBTYPE: TYPE OF WORIC:
INSPECTION . .ATE INSPTR.
I~~~~ 14+t . ~ ~~itd~~rt t? ~r?~
I ftF1Nl.Nri f•~~+~I I fJ;
fN`.tll.Al II1N I 1l~I I'Ir;~ t
1. ~00rill i tt 0M,11 114 tfit,
t I i#A1 F'i ki~~ I i hlAl
Pf P4ARK5` p12V f,l
• ~ n s 611
~ ___~i
Permlt No. Permit Holdsr Date Telephone S
e ~ ELECTRIC ~D OD 49P
~ PLUMBING
HVAC l//~f q(/ y
Inspectlon Date Insp. Comments
FOOTINGS ~
FOUND
~J
FRAMING
l
ROOFING
ROUGH ^
PLUMBING
PLBG
AIR TEST
ROUGH ~
HEATING
GAS svc
TEST
INSUL
GYP BOARD
FIREPLACE
~O
FIREPLACE
AIR TEST .7D lstiQ - ~ ~ (s_
FINAL PLBG 1 ~
~
FINAL HTG
ORSAT (
TEST
BLDO FIN yi_ zQ~~ ~
BSMT R.I.
BSMT FINAL
DECK FTG 17-2
v )G~ '
DFCK FIt,A! ~ t
1 •
III) FROO ~REET FOR ELECTRICAL INSPECTION~i ~
RlinnesoW State Board of Electricity
1821 Universiry Ave., Rm. S- 8 t. Paul, MN 55104
D D 3 0 * gnone (st2)sa2-oeoo (p y'(o
Home Dupez Apt. Bldg. Other: New Addn
Commercial Industrial Farm Remod Re air
Air Cond. Hig. Equip. Wafer Wr. Load Mgmt. Ofher.
Dryer Ran e Elec. Heat Tem . 5ervice
"X" a6ove the work covered 6y this request. Enter remarks in this space and on the back of the white copy only.
Calculafe InspecFion Fee - ihis Inspection Requesf will not be accepted without the correct fee: Olher Fee # Service Enlrance Size Fee aF Circuils/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 fo 100 Amps 80
Street Ltg./Traffic Sig. Above 200 Amps 00 Amps
Transformer/Genera}or INSPECTOP'SUSEONLY TOTAL
$ign/Outlina Lig. Xfmr. OV 00
Alarm/Remote Conhol
Swimming Pool I hereb ceni~ hot I m: ecrod ihe dzcm allaeon Jad heCin oo the duk: smrod
Irrigation Boom Raugh-In p.L
Special Inspeclion
Investigative Fee Fin.1
THIS INSTALLATION MAY BE ORDERED DISCONNECTE IF NOT COMPLETED WITHIN 19 MONTHS.
270- 0^K O ~ O~USE ONL Th/i~s request ~oid 18 monHu from volidafion dote pnnkd in fhis bOx
eL O~
J
~
PLEASE PRINT OR TYPE
~'Wi0 Call
Requast D a ' Ro~gh-in inspafion requiredY 14Nes ? Impeclion OlherThan Rough-In: ~ Reody Nowi'~
r.
G 9p lYoo mwi <oll the Inspecmr when ready~ ~ate Ready:
I, licensed con}raclor owner hereby request inspeciion of ihe above eleclrical wark at:
Job Address (Streel, Box, or 0.ook No.) Ciry` Zip Code
y~ZO -S7aH ~c~s L /fGAN
Secnon No. Townehip Name or No. Range No. Firc No. Coun
Ka779-
Oc nt p Pha
om~s /~Y acy ~5 ' ~3~7
Po upplier Addrtss
K~TF7 ELECTR'rC /f~ /N6TdN
Elean Conlmclm (Campny Name~ Cantmcbr G~nse No. Maslar Lic Na (Planl Elee. Only)
/s~•9d BC7~iC ~z
Molling Pddmss ~ConfimMror Owner Pedo mg Insmllan~
D/ Tmts v~ da~
AoMariz nalure (CoM r or e erf Inakllation) Phon o.
/-yi8a
EB-ODOOlA-106195 STATEBOABOWPY-SEEINSTi1UCTONSONBACKOFYELLOWCOPY ^
Ad~ress 4820 WESTON HILLS DR Zjp $$12_
IAt 6 BIk 1 SUb PINES EDGE 1ST
THESE ITEMS WERE / WERE NOT COMPLETE AT THE T1ME OF THE FINAL INSPECI'ION.
Date: ~~(J 9 Yes No Inspector.
Final grade (6" from siding)
Petmanent steps (gazage)
Permanent steps (main entry) L/
Permanent driveway
Permanent gas
Sod/Seeded grass
Trail/curb damage
Porch
Basement finish ~
Deck
Please verify with the builder the removal of roof lest caps from the plumbing system and Ihe shut-off of water supply to
the outside lawn faucet before freeze potential exists.
ContaM engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. ~
White - City Copy Yellow - Resident Copy Pink - ConVaclor Copy
I PERMIT e~eos~~59
CItY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: eux Lo=NG
Eagan, Minnesota 55122-1897 Permit Number: 0 2 7 3 6 8
(612) 681-4675 Date Issued: 0 5/ 14 / 9 6
3E ADDRESS: 4820 WESTON HILLS DR
LOT: 6 BLOCK: 1
PINES EDGE iST
P.I.N.: 10-57690-060-01
DESCRIPTION:
Rfuildin~.Permit 7ype SF DWG
,Buiiding~41p-rk Type NEW
UeiCOocupancy- R-3 U-1
Cnn'struction ~~~e V-N
i~ Zoning R-1
Bullding` Leffgth61
r Buiiding W3dth ~ 44
x
~wrt4 b~u3idlri'gr s'taries l, 2
1,963
101 1- FAM. DETACH
REMARKS:
PRV S& W PLBR - VALLEY PLBG
FEE SUMMARY:
VALUATION $164,000
Base Fee $1,207.25 MISCELLANEOUS $1.923.50
Plan Review $603.63 Total Fee $4,716.38
Surcharge $82.00
SAC $900.00
SAC % 100
SAC Units 1 ,
Subtotal $2,792.88
' CONTRACTOR: - Applicant - ST. LIC.OWNER:
HOMES BY CHASE 18955337 0001619 HOMES BY CNASE
1668 E CLIFF RD 1668 E CLIFF RD
BURNSVILLE MN 55337 BURNSVILLE MN 55337
(612) 895-5337 (612)895-5337
I:heretry acknoWledge that T have rea=d this applicativn and st.ate that the
inforinetion is correat and agre:e to comply with al;l applicable State of Mn.
Statutes and Gity o'f Eagan Ordinances. '
APPHGANF/PEAMI IGNATURE ~ ISSU D :51 NATU E '
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) ~
6814675
New Construction Reauiraments RemodeVReoair Reauirements
? 3 regislered site surveys ? 2 copies of plan
? 2 copies ot plans (induda beam d wiMow eizes; poured ind. design; etc.) ? 2 sNe surveys (exterior additions 8 dedcs)
1 energy alaletlons ? 7 energy calculations tor healed additions
? 3 coples of hee preservatlon plan H bt platted efter 711f93
requlred: _ Yes _ No
DATE: CONSTRUCTION COST:
DESCRIPTION OF WORK: SZ~ ~R ~"z e l
STREETADDRESS:
LOT ~ BLOCK SUBD./P.I.D.
PROPERTY Name:T° .~-/r~7'~ler-~~' Phone 7S J'~~: S2 ~7
OWNER `"`T ""S`
Street Address:~~~~
City: State: Zip: ~T-
CONTRACTOR Company: Phone
Street Addr License
City; State: Zip.
ARCHITECT/ Company: Phone
ENGINEER
Name: ~ Registration
Street Add ss•
City: State: Zip:
Sewer 8 water licensed plumber. Penalty applies when address change and lot
change are requested once permit is issued.
I hereCy acknowledge that I have read this application and state that the informatio s correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY ~~C~[~~M[~~
Certificates of Survey Received _ /Yes No ~S~'~$ y&~~~~
Tree PreservaUon Plan Received _ Yes No~
~ ~
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
,,c"2 SF Dweliing o 07 4-plex o 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-piex o 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch ? 09 12-plex o 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. a 10 = plex ? 15 Deck
WORK TYPE
,11,~37 New o 33 Alterations o 36 Move
0 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actuaq --L-7-- IV Basement sq. ft. MC/WS System
(Aliowable) i? Main level sq. ft. Zyy City Water ~
UBC Occupancy -3 u-f Z,!'-° sq. ft. z'0 Fire Sprinklered
Zoning 12-/ sq. ft. PRV ES
# af Stories Ze/S.cwr- sq. ft. Booster Pump
Length (~o.s sq. ft. Census Code. /o/
Depth Footprint sq. ft. 961 SAC Code oi
Census Bldg /
y~ Id,11 Census Unit /
APPROVALS
-r
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review ~ 5 ~
license l~7x 7= ~z
MC/WSSAC Z2xSD ' /i/6O Zy~~o , oo
City SAC yx z9 =//!o ~/x Lg
Water Conn. Z~(D x is =
Water Meter'
Acct. Deposit
S/W Pertnit
S!W Surcharge
Treatment PI.
Road Unit Z ~ -
Park Ded.
Trails Ded. Sr ~ z2x
Other 31-b7 =07
Copies JJ r /13
Total: 70 6 x /6 =
% 5AC - ~ ~l z llo
SAC Units I ~f(~o
~
. • i
k
F*r 2422 En terprise Drive
Mandoto Herqhle, MN 55120
uwo a~K.au r~,L c~a.ccn: (81?) 8$1-1914 FAX 881-9488
n0 naer ng W+o ~+K~• L'W~/i°E A~mt[cn 625 Highway 10 N.E,
8lnine, MN 55434
it * (e12) 7e3-1880 FAX:783-1883
Certificate of Survey for: HOMES BY CHASE
4820 WESTON HILLS DRIVE
~j oLl Uo~° ~ ~ i
BENCH MARK
TOP OF PIPE ~
ELEV.=957.68 - ~ ~
~
EXISTING
I \ ~
30 595.9 HOuSE 954.7
09041'52"W .0 127.00
30.00 44.33 453.9 951•1 i
'O r-^-ir--"---~~--~` ~ 20 F
~ 956.5 1953.8
~ 953.2~a ~ w
o a .68 N UZ ~ ~
18.00 1 '°ww w
i
o M b a~ k N
y~N o y+ c~S ' I
~ I 955.9 p o~~\u°~ J ~ d~ 4
O a . p f
(n ~ CO a- ti 953.6 x
~1 I ~r 9' 953.6
~
T -W ~ ~C-__--- 26. 3 ~ I
~ 01j ~ 957.7 In 956.7 iIn
~ x 70 i~ l 20
_J ~61T .
In
956.2
Q~ 955.6 13 ~ 30.00 44.33 954.0 953.9 3l 956.9 ~
'S89°41'52'W 127.00 (qh~'
~ 30
X A G A 1~ 7 ~
%REVIEWED ~
BENCN NIARK
IOP OF PIPE ;
tIEV.=957.85 - 3Y
IATE y~S~ J~i6 ~EAGaT (''rIIV~' EIiTGr DEpA; ~
MOi£: PRO003ED GRADES SNOXN PER CRAOINC PIAN BY: Gt EFA PROAOSED FIOUSE ELEVATION f
~
NO
TE~ ~ BViL~NC DIMEUStONS SIOVM nRE FOIt HOM20NuL aNO vEntItK LocAnow SO ~EVATION.
OF S1Ni1CNRE3 ONLV, SEE ARCHIiECTUAL PLANS i'OR BUILDINQ ANO LOWES7 fL00R E
vouNOnnoN oiMtNsaus TOP Of BIOCK ELEVATiON: 9 SB [
NOTE: NO SPCCMIIC SOIlS MVESTICAnON HAS 9EfN COuPLETED ON TW6 LAT BY hiC ~
suaVEron. Tr+E swrAeiurr ov soILs io suvvaer T„e s+eanc nouse GARAGE SLA6 ELEVa7i0N: 951~.4PROPOSGO IS NOT TF1E RCSPON3101UT`/ OF 7ME SuRVEYOR. ~
NOIE: THiS CEN71FlGAlE DOES N0T PURPORT TO SHOW EASfMENI`5 O1MER TMAN x~0~ } ~Q ES ELEVATION
p
71lOSC "..HOYM ON THE RfC~0E0 PUY, pF-NOIES DRAMAGE AND UnuTV EASEMEwT i
NOTE: CONTRACIOR uVSi y[qiF1' ORrvEWAY DESiUN. ~ OENOTES OR+uNIU;E FLOW DiRECTtra j
NOfE! BEMINGS SnDWN ANE BASEO ON AN ASSUYED DATuu ---r-- OENOTE$ MONUMENT ~
DENO7ES OFFSEt nUB ~
WE HEREBY CERTIfY t0 HOMES BY CHASE THAT THIS iS A TRu£ AND CORRECT REPRESENTATiON Of A ¢
SURVEY Of 'fME BOUNDARIE$ OF: k
~
<
LOT 6, BLOCK 1, PINES EDGE 1S7 ADDITION ~
DAK07A COUNTY, MINNESOTA
tT DOES N07 PURPORT To SHOW iMPROVEMENTS OR ENCNROACHMENTS, EXCEFT AS SNOWN. AS SURVEYEO 0Y ME Utt E
UNDER MY DiRECT SVPERVISiON THIS 11TH OAY OG APRIL, 1996.
GNED: PIONEER ENCi ERty. P.A. ~
SCAIE : 1 INCH a 30 FEET 4
9)5 94400.09 SWK REVI5E9 4-12-96 FUP MOUSE .lohn C. Larson. L.S. Reg. No. 74628 I
i
€
, • LOT SURVEY CHECKLIST FOR RESIDENTIAL
. BUILDING PERMIT APPLICATION
~ PROPERTY LEGAL: d T(~~i~(
Q DATE OF SURVEY:
LATEST REVISION:
y DOCUMENT STANDARDS
<z~
? • Registered Land Surveyor signature and company
? • Building PermRApplicant
~ ? ? • Legal descdptlon
e- ? ? • Address
Q~ ? ? • North aROw and scale
9-111 ? • House type (rambler, waikout, split w/o, split entry, lookaut, etc.)
e- ? ? • Directional drainage arrows with slope/gradient %
Q'~ ? ? • Proposed/epsUng sewer and water services & invert elevafion
C-i~ ? ? • Street name
? • Driveway
ELEVATIONS
'stin
Wo'~? ? • Sewer service (or Proposed)
? • Property comers
r~ 9 ? • Top of curb at the driveway
? • Elevations of any ebstlng adjacent homes
Pro°osed
0"- 0 ? • Garage floor
[R~'o o • First floor
ol? ? • Lowest exposed elevadon (walkouUwindow)
~ ? ? • Property comers
o • Front and rear of home at the foundation
PONDING AREA Qf aoolicable)
? p~ ? • Easement line
? ? • NWL
? Of"/ ? • HWL
? ? ? • Pond # designadon
? M-' ? • Emergency Overflow Elevation
DIMENSIONS
G-~ ? ? • Lot IineslBearings & dimensions
cy, ? ? • Right-of-way and street width (to back of curb)
c2r, ? ? • Proposed home dimensions including any proposed decks, overhangs greater than 2',
porches, etc. (.e. all structures requiring permanent footings)
Cf- ? ? • Show all easements of record and any Cily utili6es within those easemenLa
d-' • Seffiacks of proposed structure and sideyard setback of adjacent exassting structures
? ? • Retaining wall requirem , if any
ReviaWea: G
ame Date
January 1996
CRAIG7 WdBLOGPRMT.FM
. . . PARCEL ~4- 76
MH STA. 4+36 ~
-
-
- ,
-
;
'
8" PLUG
HYDRANT
8"x 6" TEE ' j
I 4 11'-6"DIP, CL 52'
S= 0+50 GND. EL 956.4
INV= 947.6; 6 7 I
CS= 957.6i ; S= 0+37 S= 1+37
I N V= 946.9 S= 2+ 3 7
i; INV= 946.1 INV= 945.3
r V ` j-8„ -1 1~,4 BEND CS= 956.9 i; CS= 956.1 ; CS= 955.3
. ~
,
-
J
-
V r o -
,
;
r
~ -I 4+p
<
I 00
(1
•
i
. 8"X6"TE , -
, ,
6"GV S= 0+35 S= 1+25 S= 2+12 c_
5= 0+24 INV= 946.9 INV= 946.2 INV= 945.5
INV= 947.8 ' j CS= 956.9 CS= 956.2 CS= 955.5
GVS 957.8
4 ~
~8.-11 4 BEND
, ' ~
-
MH STA: -2 32.36 - -
- Mu S A. 3+32
3 a - -
_ - -
_ ~ I
P ,
N OTE:
8f 1NM 5Y OTNERS LOTS 2,3,4,5 Eg--,AER COPPER
SER\IJE€S TG MAINTAIN 2' SEPA}Z4~ION
~FROM STORM SEWER AT CROSSING.
1
- i i
E'LEMENTRY SCHOOI',}~/(18~ '~,p p~p~/+
-..Sdi~~NV yv" }r
~Cp oF
p~r~ UTIL(TY ! CCAT/0,is
TFII^
1 ~~p ~FITrl,
. . , WYl ~ Qnrn J Q
. . I_, n: ,_J t
~.;.°D
LS DR - I VE
i62.56 :
21.30 r . ~
~U^.:.' PURf'OSE~
MH RE: 857.82 U . .U~ . .
~iivG IT SHOUl.D VC
. . . 4 BLD=
THESITE..
MH :
" RE=958.88 QN
3 BLD=17.08 RE=957.03:
.......5...qtD=t4.23:.........:.........
.
. . . . MH R
.RAISE:WM: TO 951.75 B
--AT STORM:WICROSSING : . ~ EXISTING GROUND ~
~ • • INSULATE •TH 64 L.F.- • • ~ ~
4"z 4'z 8'- RIGID STYROFOAM F]NISHED GRADE
.
. .v~: . . . , : . . . . . . . : . . : : . : : ~ : . . . . . . . . . : . . . . . . . . . . ~L---- -
o MiN•
: . ~ . . .
. . . . .
.
.
- .
. .
. 8 ~ 1 P. - CC 52 _ . _ . . . . . .
: : : . . .
. . - - - - - -
948.53 • : . . : : :
. .
. . :15"RCP : : . . .
104'-8."PVC S4R: 35 400'-8"PVC SDR 35 ~ O.hO% :
. : . : . . . . .
26 100'. 8"PVC S[JR 35 . 0.4074.
. . . . . . .
....::~:0.40%
. 1& 2 Fauuly llesidential "Cookbook" Methoa
SCIE ADDRE55 cih'
r c~ a
BOILDER Date ~
;
Minimum Criteria:
Rim Joisc R-19 insulauon Foundaton Vrindows: InsulateA glass. I!2" air space. wood or vinyl frame
Enay doors: 1'/a inch solid wood with storm or better . ~
STEP 1Wandow & Door Area STEP 2 Calculate area as a perceat of wall ;
Total Window & Door Area in 5q. Feet Box A(window 8c door area) divided by Boz B(to[al
• WINDOWS (including foundation windows): W+a11 ama) times 100 equals the window and door area
Dimensions Qnty. Area as a percent of wall area (Boz C). i
~ p X n 4 Nrfr.r.z,i - B07CA
SZ ~r~ cp x 1~= ~ I
l
5: 7 S ..rrr ~i Box lJ ~
R
. .S x
, S7CEP 3 Design Features ~
ASSEMBLY OP'TION ~
1 v x 3l ~ / C i
x FRAIvIE WALL: ~
x
STANDARDFRAMING
x I
x ADVANCED FRAMIIdG I
I
x cpvrrYatSUtn'noN R- ~
. i
x i
SHFA'CUdG:
DOORS: LESS THnN R-5 ;
R-5 OR MORE ~
WINDOWS (ezcept fouodauon windows): ~
~ Y X 7~ U-FACTOR
Total Area of '
Window & Doors A ~
From the table, determine the maximum percent window ~
Total Wall Area in Sq. FL & door area for the design opcions selected and enter the
Wall Total Perimeter Height Area _ value in boz D below:
D I
F~ ?J C f; ~
Box C must be less Wao or equal to Box D
Total Area $ i
of wall
~
- , .
F. The 6uilding must not exceed the maximum window and door area as a
percentage of overall exposed wall area listed below for the combination
of framing technique, R-value of insulaHon within the insulated cavity,
sheathing R-value, and window U-factor. Other components must meet
the requirements of this subpart.
MAMM[JM WINDOW AND DOOR AREA
AS A PERCEN'I' pF OVERALL EXPOSED WALL
Cavity Window U-Factor
Framine Insulation Sheathine 0.49 0.36 0 31 027
STANDARD 2g 7 13.49'0 ; 17.8qo . 21.39'o 24.3%
STANDARD R-15 21A_5 129% 17.19'e . 20.1% 23.4°0
STANDARD ' <R 5 t
a 160%18.8% ' 22.0%
. . t.
5TANDARD R-18 2R-5 13.5% 18.6% 21:8% 25.3°e
ADVANCED.. . . , . _11=18 '
20_1"/e. 23.4`o '
ADVANCED R-1S 2R-5 13.5% 19.2% 22.5% 26.10%
, STANDARD R-21 ; <R 5
-
'G."1709'0-''. 19.99'0 23.1/0
0
STANDARD R-21 ZR-5 14.0% 19.3% ' Z2.5% 26.1%
-ADVANCED ; g-?l ; <R 5 ; ?:.181921.20/9 24.6%
ADVANCED ' R-21 . zR_5 . 14.0% 19.9% 23.20/o 26.9%
. Subp. 3. Perfornnance criteria. The combined thermal transmittance (Uo)
factors for walls, roof/ceilings, and floors over unheated spaces must be less than or
~ equal to:
; A. 0.110 Btu/h ftz °F for wa1Ls; '
B. 0.026 Btu/h ft2 °F for roof/ceilings; and
C 0.04 Btu/h ft2 °F for floors.
' STAT AC17N: MS § 216C.19
HIST: 18 Sft 2361
7670.0480 Repea(ed, 18 8R 2361 '
Muut Ru]es Chapter 7670 26 Jurte 1994
. , CITY USE ONLY
L ~ BL / RECEIPT
SUBD. DATE:
7996 PLUMBING PERMIT (RESIDENTIAL)
, CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 6814675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES EAStL L~LQ TOTAL
Shower 3.00 x '3-
Water Claset 3.00 x -25_
Bath Tub 3.00 x i._,,,„~ = 3-
Lavatory 3.00 x 3 = a-
Kitchen Sink 3.00 x 3-
Laundry Tray 3.00 x 1-
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x 3-
Floor Drain 3.00 x 3-
Gas Piping Outlet • minimum -1 3.00 x 3-
Rough Openings 1.50 x =
Water Softener . 5.00 x =
Private Disposal ` Dakota Cty. license 50.00 =
(new and refurbished systems)
U.G. Spflnklet ' home under const. 3.00 =
Alterations * to existiny 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .50
TOTAL 3 9 ~
SITE ADDRESS: ~~a0 w e ) L i 'J, IIi 11~
OWNER NAME: 4,
INSTALLER NAME: L)
STREETADDRESS: A-`
CiTY: ~ uf c~a , STATE: v-- ZIP: S s s s~
PHONE
~"`AA
I
r \
OFFICE USE ONLY
L _ BL _ RECEIPT
SUBD. DATE:
1996 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: P ali commercial/industrial buildings.
~ mulG-family buildings when separate pertnits are aQt required for each dwelling
unit.
DATE: CONTRACT PRICE:
WORK TYPE: _ PJEIh CGNSTRUCTION _ ADD ON _ REPAIR
DESCRIPTION OF WORK:
IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED? YES NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? YES NO.
IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT.
FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per
$1,000 of permit fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTA!
SITE ADDRESS:
TENANT NAME: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
PHONE SIGNATURE:
APPLICANT
OFPICE USE ONLY
METER SIZE: DATE: INSPECTOR:
/ _ •
CITY USE ONLY
L BL / RECEIPT
SUBD. ~ DATE:
1996 MECHANICAL 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
x New consVuction Add-on fumace
Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date:
FFFS
? Minimum Fee: Add-oNRemodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each) /.?-00
? State Surcharge •50
TOTAL
SITE ADDRESS' V926 1AL57° 17L/-r &'de
OWNER NAME: 'Am,es Q ~ Glase PHONE ~S 53.~~
INSTALLER NAME•
STREET ADDRESS: 21„2 !D CITY: STATE: In&, ZIP:
PHONE ((ol~_ ) y~J - /~o .?e2
i
CRY USE ONLY
L BL _ RECEIPT
SUBD. OATE:
1996 MECHANICAL PERMIT (COMMERCIAL)
• CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? all commerciaVindustrial buildings.
? multi-family buildings when separate peRnits are IIQt required
for each dwelling unit. DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: ?$25.00 minimum fee QC 1°k'of contract price, whichever is greater.
? Processed piping - $25.00
? State suroharge of $.50 per $1,000 of 2miji fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME: TELEPHONE
TENANT NAME: (IMPROVEMENTS ONLI)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
~ PHONE
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118941
Date Issued:11/12/2013
Permit Category:ePermit
Site Address: 4820 Weston Hills Dr
Lot:6 Block: 1 Addition: Pines Edge 1st
PID:10-57690-01-060
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Jeff Pelant
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Steven M Tjornhom
4820 Weston Hills Dr
Eagan MN 55123
(952) 994-9025
Legacy Restoration Llc
14000 25th Ave N
Suite 110
Plymouth MN 55447
(763) 354-7660
Applicant/Permitee: Signature Issued By: Signature