546 White Pine Way
INSPECTION RECORD
C" OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
- i i ~i ~ c .4> s• ~
SITE ADDRESS: APPLICANT:
~~H]tl i•iNt ~i~.tti i:, i llrl`~~
PERMIT, $UBTYPE: TYPE OF WORK:
INSPECTION D. .
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6---- - - - - - - - - - - - - - - - - - - - - ~
Permit No. Permit Holdar Date Telephone f
~ ELECTRIC 9 76c) •
PLUMBING 8 G vI
HVAC 006 Inspsction Date Insp. Comrt?enb
FOOTINGS
FOUND
FRAMING y!~ ~
ROOFING
ROUGH ~
PLUMBING - Q
PLBG
AIRTEST
ROUGH
HEATING - pG
GAS SVC
TEST p
INSUL
GYPBOAHD
FIREPUICE FIREPLACE
AIR TEST
FINALPLBG
7 d
1
FINAL HTG I( ~I
ORSAT m I
TEST ~G ~
~ [3LDG FiNAL
, BSMT R.I.
~
I rSMT FINAL
nECK FfG '
ZCK FlNAL
- -1 - -
~
IN5PECTIUN RECORD
C k302 F EAGAN PERMIT TYPE: Knob Road Permit Number: ~ ~'t H,.
Eagan, Minnesota 55122-1897 Date Issued:
(651) 681-4675 ~
SITE ADDRESS• I ' r~ ~ 1;.; F) Nej ~ , APPLICANT•
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1:1 I i"F rNf IJAV • ~ ~ . ~ , : ; r l•i t'r i ~ • .
, if~~ ~ ~~~~r I ~I , i ,~.~a ~ .
PERMIT SUBTYPE: TYPE OF WORK:
; i; ; 3 i.,~ i,i i~•r+
~ ~ ~ i ~ i,~;i • i 1 r~ ~ i.
INSPECTION DATE INSPTR. INSPECTIO „
tii,f; f~.~ f 1,! i
i. . ~ • ~ , ~ . • ~ ~ ~ , i , ~ , ~ . , , , . , ~ . ii Al I
~i
~
PwmAt Ho1eNr Dab TiNphorN •
EWE
WATER
PLUMBING
HVAC
I h,sp.cton o.w rap. comnwnb
i FOOTINGS
I FOUND
I
I FRAMING
~ ROOFING
I
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBC3
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HVDRO''TATIC
TEST
BSMT R.I.
BSMT FlNAL
DECK FTG
DECK FINAL
_ ~ r. . . _ ~ . . .
,
&Mlicate of cccuvanc~
Wi#v of -ftgatt
- ~
This Cenificate issued pursuant to the nqLinrments of the Uniforni Building Code
ctrtifying that at the timt of issuance this structure was irr conipliance witle the various
ordinances of the City rrgrilatiRg bailding constnrction or ust. For the following:
use cbstdkadw SF DfiG/Gl?R e~ Pm" No 28226
O-EP-y Type R-3 U-1 Zoning oaoia R- Tym co". V-N
HOMES BY CHASE Addmn 1668 E CL1FF RD., BURNSVILLE, !Ql
r O,,;)ft AdM= 546 WHITB P1NE WAY L-W;h L9, B4, P1NES EDGB iST
~ ~ !J~./.•~~l/
Da&-
~ POST IN /1 GOPISPIClJOl1S PLACE
Add[eS5 546 WHITE PINE WAY ZIP $512_
IAt V9 Blk 4 Sub PINES EDGE lst
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: Yes No Inspector.
Final grade (6" from siding) V_/
Permanent steps (garage)
Pettnanent steps (main entry)
Permanent driveway VII/
Permanent gas
Sod/Seeded grass ?
TraiUcutb damage
Porch Ll
Basement finish ~
Deck
Please verify with the builder the removal of roof tes[ caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze polential exists.
Contact engineering division at 681-4645 before working in righbof-way or installing underground sprinkler system.
White - City Copy Yeilow - Resident Copy Pink - Contractor Copy ~
~ CITY OF EAGAN PERMIT W(0094 ~
~
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 028226
(612) 681-4675 Date Issued: 0 7/ 12 / 9 6
SITE ADDRESS:
546 WHITE PINE WAY
LOT: 9 BLOCK: 4
PINE EDGE 1ST
P.I.N.: 10-57690-090-04
DESCRIPTION:
Building Permit Type SF DWG
%Building Work Type NEW
~ UBC Occupancq., R-3 R-1
~ Construction Type V-N
Zoning R-1
Building Length 61
Building Width ' 44
Building storiee ~ 2
--_,S.quare Peet 1,987
GerisLs Co,de-101 1- FAM. DE7ACH
~ - ~
z-1, - ~ . . '
REMARKS:
PRV S & W PLBR -
FEE SUMMARY:
VALUHTION $165,000
Base Fee $1,212.25 MISCELLANEOUS $1.923.50
Plan Review $606.13 Total Fee $4,724.38
Surcharge $62.50
SAC $900.00
SAC % 100
SAC Units 1
Subtotal $2,800.68
CONTRACTOR: - Applicant - ST. LIC.OWNER:
HOMES BY CHASE 18955337 0001619 HOMES BY CHASE
1668 E CLIFF RD 1668 E CLIFF RD
BURNSVILLE MN 55337 BURNSVIILE MN 55337
(612) 895-5337 (612)895-5337
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable 5tate of Mn.
Statutes and City ofi Eagan Ordinances.
L
(
APPLICA . h117EE SIGNATURE ISSUED B. fiE
I CITY OF EAGAN
3830 PILOT KNOB RD - 55122 `i1996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675 L
New Conslruelion Reouirements RemodeVReoair Reauirements
? 3 registered site aurveys ? 2 copies of plan
? 2 copies ot plans (InGuda beam 8 window slzes; poured fnd. design; etc.) ? 2 site surveys (exterior additions 8 decks)
? 1 energy calwletlone ? 1 energy calculations for heated additions
? 3 eopies oi trae preservation plan M bt piatted efter 7/1193
required: _ Yes _ No
DATE: CONSTRUCTION COST: Yv h
DESCRIPTION OF WORK:
STREET ADDRESS: Ze,
~
i--
LOT ~ BLOCK ~ SUBD./P.I.D. -
PROPERTY Name:tZ,4~1 Phone ~9S~ 5337
OWNER
Street Address:_,~~
City: ~6)e Ile State: ,7-~- Zip:
CONTRACTOR Company: Phone
Street Address: License
City: State: Zip:
ARCHI7ECTl Company: Phone
ENGINEER
Name: Registration
Street Add s City: State: Zip:
Sewer 8 water licensed plumber: Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the informatio is correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. ~
Signature of Applicant:
OFFICE USE ONLY ~~~ENFED
Certificates of Survey Received _ Yes No
_
Tree Preservation Plan Received _ Yes No~~y,~ - -
~
PA
OFFICE USE ONLY „ A
~
, •
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
6e02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex o 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch ? 09 12-plex o 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
,~31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual) ~A~~X/ Basement sq. ft. 2ZO MC/WS System
(Allowable) Main level sq. ft. /,z&o City Water o-G
UBC Occupancy -3 Z^'-' sq. ft. 2 V25 Fire Sprinklered
Zoning Q-/ sq. ft. PRV lS
# of Slories 2 4~s~r, sq. ft. Booster Pump
Length (vo.s sq. ft. Census Code. /d/
Depth I& Footprint sq. ft. 119097 SAC Code o/
~ Census Bidg
,e ~ ~ Census Unit
APPROVALS y ° 0
At~'
Planning Building Engineering Variance
Permit Fee Valuation: $1IOS, o vo Lld/~IL ' ~loS 0 Y~~
Surcharge ~
~ ivo
Plan Review ~ ~y
License
MCNVS SAC Z 2 t.so /00
City SAC c~X 30 " ( (
Water Conn.
Water Meter
Acct. Deposit /~Zbo x s"y ` Zqf~' x' y
S/W Pertnit
SNV Surcharge ~yo (o ~ 3 9 z
Treatment PI. Z?
Road Unit
Park Ded. 22- '000 . 33,, /o.s
Trails Ded. 411 31 Other ~ ZZo x/S " 22 X 7 i
Copies ~j 300 -70-7~
Total:
~ -
% SAC
SAC Units
I
2422 Enterprise prive ~
/vi QSr-Jr,°,/lCK~a/? Mendola Heights. MN 55120 '
* PIONEER (812) 881-1914 FAX:881=9488 ~
uY1D SLRlEY0A4 • tlNL LNQM~"
* p~f near ne ~.u+o PLrnr[as. unoscMC .ucNIhcn 625 Highway 10 N.E. I
Bipine, MN 55434 ~
~ ~c * * (812) 783--1880 FAX: 783-1893 ~
Cettificate of Survey for: HOMES BY CHASE ~
546 WFiITE PtNE WAY
2
f95E'~~
C.B. S89°41'S2"W 85.00 ssa.a _
~ 954.4 o i o
(R5A4)
,
i i~ I5
,0~~' -JEASEMENT UTILITY
` ~ ~ .
f
STORM SEWER LINE ON PROP. LtNE--_,
~ 956.3 J r 9 6.2 io
x ~ Q
x Q
10 10 ~ 14.510 958.7 C457.5~ g68.5 I~ Vll go- U
w~ p~ 957~ I 50.00 --T 956.5~
G~~~6 0 \ tn I
t A E p Z 1 2 PROPOSED 958.4
I N HousE
9 960..~ ~
R , 61.8 n \ rry c7w
B. 0 10.`,~0
~ N
34 ~ 9 fi/~/LZ o~ o~ CARAG \ry ~ w r
= N
W ~
lA - 13. 14.5~~----- 32.00 ~ 964.4
961.6 , I- / +961.9 C4G~•3) y 2~
80PCOFMPIPARK £ + °o 10 ~ DRPVEW~ 15 ~ T PC O F P iPEK
ELEV.a987.03"'n - - - - - -
L ~ - lR~o,S) ELEV.=963.26
961.3 _
0 959.7 S89°4 *52°W 960.085.00 960.2 ~
N 959.3 C.B. ` NV =950.3
- / -
~°oG°oMo PINE WA~~
EAGAN ~NGIN~ERING DEPT.
NOiE~ PRWOSEO GRADES SHOMN PER GRMINC PLAN BY: PIIXiEER PROPOSED HOUSE FLFVATION
NO1E; BUR.DINC WuENS10N4 SNONN ME fOR nORRONTAL ANO KpiiCAL lOGiION ~pyy~ST FLQOR ELEVA7i0N~ 9 5/~
Oi SiRUCTl1RE5 ONLY. SEE ARCHITECNR PL/~NS FOR BUILDING ANO
FWNDAna+ aµEN5lonS. TOP OF BLOCK ELEVATION: y Gi2'7
NOTE NO SPEQFiC 500.5 It1VES11CAlid1 HAS BEfN COMPLETED oN TMS LOT Sv ME ~(eZ1'f
SURVEYDR. Mf SUITABIUir OF SOILS 70 SUPPORT iNE $PEdFIC HOUSE CARACE SLAB ELEVATION:
PRpVOSEO IS NOT ME RESPONSIBN7V Of THE SLRVEwp.
NOTE: TMiS GLR*incATE DOES NOT PUAPORT TO SMOw EASEMENTS OTMER T„AN X 000.00 OENOTES EXiSTING ELEYAf1014
7H0SE SMOWN ON ME AECOROEO PLAi, ( 000.00 J OENOTES PROPOSEO EIEVATION
NOTE CONIRACTOR MUST VERIiV DRIVEWAY DESGN. DENOTES DRAINAGE nrvD u7iu7Y EASEMENi I
OENOTES ORNHAGE fLON OIRECTION
NOiE: 9EnRINGS SnOxM ARE 8ASE0 ON AN ASSUNEU DATUId ^-i- O[NOYES NONUAIEHT
-g- OENOTES OiFSET nuB ~
WE HEREBY CERTIfY TO HOMES BY CHASE THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A, I
SURVEY OF THE BOUNDARIES OF~
lOT 9, SLOCK 4, PINES EDGE 1ST ADDITION
DAKOTA COUN7Y, AIINNE507A I
iT DOES NOT PuRPORT TO 5nOW iMPROVEOaENTS OR ENCHROACnMENTS. EXCEPT AS SNOWN, nS SUFiVEYED 6Y ME OR
uNDER MY DIRECT SuPERVISION THIS 24TH OAY OF JUME. 1996. - ,ICNEP) PIONEER ENCiNEER~NG, P.A.
SCALE : 1 INCH = 30 FEET
~
97594400.11 SWK John C. Lorenn, L.S. Reg. No. 19828 (
ce•d ~
, LOT SURVEY CHECKLIST FOR RESIDENTIAL
B ILDING PERMIT APPLICATION
PROPERTY LEGAL: 4re- ° - - &
DATE OF SURVEY:
LATEST REVISION:
DOCUMENTSTANDARDS
~ ? • Registered Land Surveyor signature and company
? ? • Building PermftApplicant
fl_~/o O • Legal descripdon
~r 0 ? • Address
woe'o ? • North arraw and scale
Q00,0 ? • House lype (rambler, walkout, split w/o, split entry, lookaut, etc.)
Gioo'cl ? • Directional dreinage arrows with slope/gradient %
? • Proposed/existing sewer and water services & invert elevation
? • Streetname
tY ? ? • Driveway
ELEVATIONS
ExisUna
[+l ~ ? • Sewer service (or Proposed)
mW4"'o ? • Property comers
v13~ ? • Top of curb at the driveway
Cr/ ? ? • Elevations of any ebsUng adjacent homes
o sed
~o ? • Garage floor
?o ? • Flrst floor
q/? O • Lowestexposed elevaHon(walkouVwindow)
V? • Property comers
? ? • Front and rear of home at the foundation
PONDING AREA Gf aoolicablel
? ffie"~13 • Easement line
? ZPO' ? • NWL
? Gi/? • HWL
? G7~~ • Pond # designation
? lY ? • Emergency Overflow Elevation
DIMENSIONS
G ? ? • Lot IinesBearings & dimensions
11 ? • Right-af-way and street widih (to back of curb)
f13 ? • Proposed home dimensions including any proposed decks, overhangs greater than 2',
~ porches, etc. (i.e. all structures requiring pertnanent footings)
~ ? • Show all easements of record and any Cily utilides within those easements
[S ? ? • Setbacks of proposed structure and sideyard setback of adjacent eAssting structures
? P--'13 • Retaining wall requiremen ' any
Reviewed:
ame Difte
Januery 1996
pU10197dBLOCPRAfT FM
&"TEE-- ~N-6"DIPL_CL_ 52 ~
~Y WHITE 4.1
PIN
~ u IN Y
~ i i
6+ 0 I~ G+Co 4 00
' ~
k <<
<c «
I
~ ' r---I .
' ---~t----
S= 0+45 ; • ,
~ INV= 945.7 S= 0+04 ; i S= 0+86 j; S= 1+71 ~
CS= 954.4 INV= 945.6 ~ INV= 946.2 INV= 946.8 I
CS= 954.0 CS= 954.9 CS= 956.0
~ STA; +52 2 ,
MH 4 i
7 4 R
MH ~ STA. 7+ 5 ; I MH STA. 5+34
; 8 1 R
„ 6 ,
1 i I
i r
I ~ 1
' i - 1 • ' L _______i+' T\//1 li
~i,.:: ~Ar.or~~QES Pt~t~7GUA~tAi~ildt
A.•^i 1o r LITY LOG`A`i luit~~- '
-
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; F ; -C!_€~/,~TIQNS._TF IS_DATA I;~ ~ v
1:,='~;f.rATiOi~ PURP0~1:~ 0~!LY RV~;u-
; ; ' PE~;~. S U~ING IT SH, 4LD VE^:; Y"i HEr-
; H; ANT ft':=l-:,MATiO;U OiV THE SIT ;
~
i $"x I TEE
' 9°- "D(P, CL 52
' 10 ;
- ' S= 0+41 GN tL. 958.7 9
:INV= 949.2 I 1 ; I 8 7 ~ i CS= 959.0 ~ S= 1+20 i~ S= 2+05 ; i g= 2+90
; j INV= 950.3 lNV= 951.5
8"-45' BEND CS= 959.8 CS= 961.0 INV= 954.3
CS= 964.3
- ,
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-
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a ~
f I ' I ~ 1}0( p~~3 i
WHITE P1NEI WAY
- - .
;
, -
it
S 0+14
S= 1+05 S- 1+93
INV= 948.8 I: - S= 2+86
~ CS= 958,8 INV= 950.0 INV= 951.3
CS= 959.6 CS= 960,7 ' INV= 954.0
CS= 964.0
MH ~ STA; 10+12 6 7
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CITY P
OWNER PRL~.IFC~ i
• 1& 2 Family Residential "Cookbook" Methoa ~
• I
SfIEADDRE55 • C~ty~
~
~
HUILDER Date I
-40 I
. . ~
.
,i
Minimum Criteria: ~
Rim ]oist R-l9 iasulation Foundaton wndows: Insulattd glus. 12" air spaee, uood or vinyl frame
Entry doors: IM inch solid wood with storm or better ~
STEP 1 Wfndow & Door Area STEP 2 Calculate area as a percent of wall '
Total Window 8c Door Area in Sq. Feet Box A(window. & door area) divided by Boz B(rotal ~
1
WINDOWS (including foundation windows): wa11 area) times 100 equals the window and door area ~
Dimensions Qnty. Area as a percent of wall area (Boz C). ~
a° x BozA 2 77 x100=
X Box B ~o S(o C
~ x ? y
x'~ STEP 3 Design Featurps
G x ASSEMBLY OPTION .
x FRAME WALL:
X -
SIANDARD FRAMIIdG L/ ~r
z . j
x ADVANCED FltAMIING ~ F
X CpVITY INSULA110N
x •
DOORS: SHEATHNG' LESS THnN R-5 EE1,
~x R-5 OR MORE ~
U x 2 v 'Z WMOWS (except foundauon windows): ~
2~ ~ x 7,9 ~ U-FACI'OR LT-
Total Area of ~
Window 8c Doots ~7-2 A
From the table, determine the maximum percent wiodow
7'otal Wall Area in Sq. Ft & door azea for the design options selected and enter the I ~
Wall Total Perimeter Height Area value in box D below: '
,1~ ~
. ~GUD
216,
~
; e
Total Area Boz C must be less Wan or equal to Box D p
or Wali 3os~ B
' . • I
~
F. The building 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.
i
MA)CIMUM WINDOW AND DOOR AREA !
AS A PERCENI' OF OVE211LL EXPOSED WALL
Cavity Window U-Factor ~
Fraaun¢ Insulation Sheathin¢ 0.49 0.36 0.31 027
'
13.4%..: .17$%_.. . 2L3% , 24.3% ~
STANDARD ~ R-15 2R-5 129%'~ , 17.1Ye ' 20.1% 23.4°e '
, _ .
.
.i;; 22.0% r
S7'ANDARD R-18 2R-5 1339'0 18.6% ~ 21.8% 25.340 ADVANCED. R=18:;^:,`:.' ~.:.-<R_5.:-~ 11.19'e .:..;._17.1%.20.19'0. 23.49'e' ,
ADVANCED R-18 2R-5 19.29'0 - 22.5% 26.110
STANDARD. ` 17_0%' ' 19.9qo . 23.19'0 •
STANDAAD R-21- - 2R_5~ . y 14.0g'o1 ' 19.3qo ' 22.5% 26.1% ~
R-21.:'.:-.:'.<RS__:•:eet•:.i;.` .11.8%;.,'181, .21.2% 24.6% , •
ADVANCED R-21 .2R-5 14.0% 19.99'e _ 23.2qe 26.9°/, ~ f
i
Subp. 3. Performance 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 walls;
i
B. 0.026 Btu/h ftz °F for roof/ceilings; and '•i
C 0.04 Btu/h ftZ °F for floors. ~
STAT AUTN: MS § 216G19
H1SL• 18 SR 2361 '
7670.0480 Repealed, I8 SR 2361
;
• i
~
Minn. Rules Chapter 7670 26 June 1994
r
~ CITY OF EAGAN PERMIT
3830 Pilot Knob Road PERMIT TYPE: B u T L01 Nr,
Eagan, Minnesota 55122-1897 Permit Number: 0 34 a 3 6
(651) 681-4675 Date Issued: 02/ 0S/ 9 y
SITE ADDRESS:
546 WHLTE P7NF WAY
• LOT: 9 BIOCK: 4
PINF FO(iE 1ST
P.F.N.- 141 57590-990-09
DESCRIPTION:
, 'L GAS INSERTS
SiY~ PcrmiL' Tvoe FSREPLACP
l~'~rk T V p e F.LTERFTION
-i • i, r'nl •A~ 434 fllT. RESIUENTIAL
~
~
1 ~
V /
REMARKS:
ctizMNFV/Fi iiF MutiT Br TrdsPrr r-En Rr-FORr. r.nrir.fAi rNr,.
FEE SUMMARY:
ad^e Fce $60.00
Surcliarqe $.50
-rotal r-eo $60.50
CONTRACTOR: - npplicdnt - OWNER:
ViERECK FIREPLACF SALES 14405620 MOSBRUCKER BARRY
16151 M/1IN AVE 596 WHfiE PINF WAY
PftTOR LAXF hIN S53%2 EAGAN MN 551~3
(c^,12) 490-5670 (651)423-3550
il • ili„1 iiiiuinann iit ui rrC~ . J iarru n r.nriu~V wiLn ,I1 .nnl ic.ib)r ni
L ~
APPLICANT/PERMITEE SIGNANfiE IS D BY: SIGNATUR~
1999 FIREPLACE PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
(651) 681-4675
Date: l_ ~ijiLC,2 r,4 3 /
Descriptian of Work: ~ Construct nerv fireplace -Ilterations to existing
_ Install ~Las iiesert ni+lv V Install,;us line onlv
Other
Job addrzss: 5WO Wh4e'i P~e, 4jay EctTan /77JU
~ c
Lor. 9_ Block: 7 SubdivisiomT.I.D. PIn /`r~' ad(c(
/0-57 X- O~io-C) Si
Applicant (circle one only): Owner Contractor y Perniit Fee: 560.50
Name: /'lOS,U/Ylaer &(fy Phone' :
PROPERTY Last First
OW\ER ,Q
WLi~ j/Lv W2
Si:ezt :\ddrzss: ~Io /
Ciry ?~Ggan State: jAj zip: ~ a3
Company: VI~-°feC.K r1/t:R1Rc4~Sc{j~sd .xy7C... Phone;>: "~'rbad
F[REPLACE
INSTALLER StreztAddress: 16 /S i An+',.. 14v2z, ~a E.
Ciry 7'i~lOr~-~C~ Stare: /rlA) Zip:
Company: Phonz
GAS LINE
IiNSTALLER S[reet Address:
City State: Zip:
[ 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 StahItes and City of Eagan
Ordinances.
Signature
Z24c/~ rFEB
,
,
:72
OFFICE USE ONLY
I3UILDING PF,RaItT Tl'PE
? 14 Fireplace
WORK Tti"PE
? 31 New ? 33 Al[erations ~
? 32 Addition 0 34 Repair
GENERAL INFORMATION
Census Code. 434
SAC Code 01
RE~fARKS
Chimney/flue must be inspectzd before concealing.
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
J t`C I--~ p~ 3830 P 60T,KNOB~ - 55122 bT ~ O.~
l~ ~ 4>
New Construction ReQUirements RemodeVReoair Reauirements 7
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plans (inGude beam & window sizes; poured fnd. design; etc.) • 1 site surveys (azterior additions 8 decks)
? 7 energy calculations • t energy calculations for heated additions
? 3 copies af tree preservation plan if lol platted after 7I1l93
required: _ Yes _ No
DATE: 3- 4 cl. CONSTRUCTION COST: ~)3, 07S -
DESCRIPTION OF WORK: /7SASe"c~ N
STREET ADDRESS: S~/6 w+i i-rE p„v w.4 .
LOT: BLOCK: ~ SUBD./P.I.D. 1 i x.i~~ f) ~CXe 4 1 S
V
Name: M0.s82ocke¢ 3q22/ Phone#: 4/a3-3SS0
PROPERTY Laat First
OWNER
Street Address: SV 6 w h' 17- 6 p~ n?E
City .C- A 6 .4 n/ State: '1Z Zip:
--)D - S-Z-~ -a25
ll~ ~
Company: Li I-~ 2 EMO,~~ c~?~ Phone
CONTRACTOR
Street Address: S/ 7-7 VJ. /qg r'+ s T License # ,5777 Exp. 60
City 20 410P L E 1/ rt cCE/ Stare: r'! Zip:
ARCHITECT/
ENG[NEER Company: Phone lk:
Name: Registration
Street Address:
Ciry State: Zip:
Sewer & water licensed plumber (new construction only): . Penalty applies when address
change and lot change is requested once permit is issued.
1 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.
Signature of Applicant: s `
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex O 11 Apt./Lodging 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
O 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 = plex ? 15 Deck
WORK TYPE
31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair O 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code ~
UBC Occupancy ;~-3- sq. ft. Census Units
Zoning sq. ft. Census Bldg ~
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building ILZ---~Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
SIV+I Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies ,
Total:
% SAC
SAC Units
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EACAN
• ' 3830 PILOT KNOB RD - 55122
651-681-4675
New CansfiucMOn ReaWremenh Remodel/Reoalr ReaWremenh
? 3 reylstered sIte wneys sIwwlnp fq, ll. ol lot, aq. R. ol house 2 coples ol pton
antl pZi roofetl areas (20% maxlmum lof coveraae atlowetlf 1 set ol eneryy calcWaNOns for heated atltllMOns
> 2 copiea of plane (show beam 3 wlndow alzes; poured fntl. tleslyn; efc.) 1 dte survey tor exfedar additlons & decW
> t sel a enerpy crnculanons
> J coples ol tree preservallon plan If lot platted alfet 7/1/93 ~
DATE: q ! 13I 6ro coNSrnucrioN cosr: SOC~U
DESCRIPfION OF WORK: f4c'k-
STREET ADDRESS: ~ i
LOT: ~ BLOCK: ~ SUBD./P.I.D. 9: 1),neS C.~~ ~-S~n~~ •~h I _
Name: Pnone Ct~ 51- ~-I )-3 -3 5 SD
PROPERTY laat Flrst
OWNER Sheef Address: 60 W hf k PI V)P W4
ay FiCcq 0,0 stare: ?'`'1 IU ~p; 55/,~-~
. Company. Phone
(area code)
COMRACTOR
Sheef Address: lJcense N Exp.
CNy State: Lp:
ARCHRECT/
ENGINEER Company: Name:
Telephone 0: ( )
Sheet Addresa: RegishaHOn q:
CNy State: Zlp:
Sewer/water licensed plumber (if InsWlltna sewer/waterl: Phone
1 hereby acknowledpe Iha1 I have read Mis appikalbn, slafe that fhe Infortnafbn is cortect, and agree fo comply wHh all applicable Sfate
ol Minnesota Statutes and City of Eapan Ordinanees. Q
~ Signalure of Appl(canY.
, OFFICE USE ONLY
Certiflcates of Survey Received _ Yes ~ No '
Tree Preservation Plan Received _ Yes _ No Not Required ` 3
~
OFFICE USE ONLY
BUILDING PERMIT SUBTYPES
? 01 Foundation ? 07 OS-plex O 13 16-plex ? 21 Porch (3-sea.) ? 31 Ext. Alt - Mufti
? 02 SF Dwelling ? 08 06-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Att - SF
? 03 01 of _ plex O 09 07-plex X 18 Deck p 23 Porch (screened) ? 36 MuRi
O 04 02-plex ? 10 08-plex ? 19 Lower Level ? 24 Storm Damage
? OS 03-plex ? 11 10-plex Plbg _Yor_N ? 25 Miscellaneous
O 06 04-plex ? 12 12-plex ? 20 Pool O 30 Accessory Bidg.
WORK TYPE
? 31 New ? 36 Move Bldg. ? 43 Reroof
A 32 Addition ? 37 Demolish (Bidg)' ? 44 Siding
? 33 Alteration ? 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
' Give PCA handout to appUcant for demolition permit
GENERAL INFORMATION
SAC Code __C2[ # of Stories sq. ft.
No. oi Units Length sq. ft.
No. of Buildings Width Footprint sq. ft.
Const. (Actual) ~ Basement sq. ft. Census Code
(Allowable) Main level sq. ft. MC/ES System
UBC Occupancy 12 L,. sq. ft. Ciry Water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
? Stucco/Stone
APPROVALS
Planning Building +?1~~ Engineering Variance
Permit Fee Valuation: i s..~ J
Surcharge T- ~
Plan Review
License ~C (O
MC/ES SAC
City SAC
Water Conn.
, Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI. '
Park Oed. .
Traits Ded. :
Other
Copies
Total:
SAC Units
% SAC
i
2422 Enterprise Drive ~
* /170S/jr,'!/CKz-x1? Mendota Heiqhts. MN 55120 '
* PIONEER W1 (812) 881-1914 FAX:88t-948S
D DYR'~ETd1! . tlMl CNGMCf1H
* nng near ne W+0 RMKF4• urosurc Aowaca 625 Hignwny 10 N.E.
Blpine. MN 55434
(812) 783-1880 FAX: 783-1ad3
Certificate of Survey for: HOMES BY CHASE
546 WHITE PiNE WAY
1 ~I 2 I 3
~as~•~~
~.8. s89°41's2'w 85.00 954.e
~ 954.4
o io
pSOb) ---------t-dl
1; - I~. I5
10 I '-%DRnINACE k UTILITY
~.r' EASEMENT PER PLAT~
STORM SEWER LINE ON PRO?. LiNE--,_ I ~f
? + ~ ~t,~
3 I 956.3 ~r 958.2 i io
M ` x 4 •
Aco ~ 1 I R/ Q
x I t~ 8
10
00~ 14.5b 958.7 95e.5 I~ ~p
p~ 957.{ 50.00 -r 958.5z
p\ to, ~ I
(',O 11
<< V 1' z I tri MOUSEED 858.4
E 961.8 960.~
n I \ ~
28. 010.k0
.1 ' Z~
J G
- 7 i~ ~ i96~q ARAG \N ~ Rr
~ W= -L
13. 14.50~--- 32.00 ~ 964.4
961.6~~. i f +981.9 (4G2•31 9 a~
BENCN FAARN ~ pROP SE~
TOP OF PiPE l
g ~ DRIwAY r BENCH MARK
EIEV.a981.07--' 10 d
n L - - - - - IR(e0.$
r~ Sq,~) o QJ R I E~~v.°_`sss ~e
461.3
0 959.7 S89°00520W 960.085•00 960.2 5? -
N 959.3 C.B. `SERMCE E fE'3
INV.=950.3
In-
Y o R o V a ~~'~it. L~•?~~~INHIIE PINE WA~ ~ .
•
F,AGAIV +i,1GINL':EPIIvG'DF,r
NOTEt PROPOSEO GRAUES SFIONN PEF GRApINC PLI1N 8Y: PIONE(R PROPOSEO HOUSE Ff FyATION
. NOfE: BVM1.DING WuENA0H5 SMOxN ARE IOR nOR1IONiAL AND KNiICAL lOCA710N
Oi S1RUCIURES ONIY. SEE ARPiISECNILL PLANS FOR BUIWMC AND LOWfST FIQOR ELEVA710N: ~I 54•~
FWNDATId+ dMEN510NS. 4 ~2
' TOP OF BLOCK EIEVAnON: 7
NoTE NO SPECFIC SOaS INK311GA11d1 HAS BEEN COMPIETED oN 1Hi5 LOT !Y ME rl (eZ, 3 i
SURVEYOR, rrt SUITABIIITr OF SOIL9 TO SuPPdIT tHE SOEQrIC HOUSE GARACE SLAB ELEVATION: ~
PROGOSEO IS NOT 1NE RESPONSIBRJIV Of 7HE SUµVEVOR. ~
uo7L• TNB CtRrm[ATE DOES N0T PURPORT TO St10`N EASEMENTS OTMfR TnAN R 000.00 OENOYES EXiSTINC ELEVAtiON ~
I THOSE SNOYR7 ON TnE NECORDEO PIAT. ( 000.00 ) oEN0iC5 OFOPOSCO ELCVAnON NOiL [ONfRACTOq WST VEPoiV ORIVEWAY DESGN. -DEkOTES DRMNIIC[ AND uTtRY EASENENT i
- OENOIES ORAJNACE FWN OIRECTION
N01E: BEnRMCS SnOVM AME BASEO ON AN ASSUMEU DnTUM ----0- DCNOTES HONV4fENT i
$ DENOTES OfFSCt nuB
WE HEREBY CERTIfY TO HOMES BV CHASE THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A I
SURVEV OF THE BOUNOARIES OF: i
~
LOT 9, BLOCK 4, PINES EDGE 1ST ADDiT10N i
DAKOTA COUNTV, MINNESOTA
Ii DOES NOT PuRPORT TO SNOW iIAPROVEMENTS OR ENCt+ROACMMENTS, EXCEPT AS SHOWN, AS SuRVEYED 8Y ME OR ~
i
uNDER MY DiRECT SuPERVISION THiS 24TH OAY 0F .riJNE. 1996. ;
I IPIONEER E
NCmEERG, P.A. SCALE : 1 INCH - 30 FEET 975 9a~00.11 SWK Loreon, L.S. Reg. No. 19828
~
L C gL CITY USE ONLY RECEIPT#: 15zy
SUBD. RECEIPT DATE: Sll- 9
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 881-4675
Please complete for: . single family dwellings
. townhomes and Condos when permits are required for each unit
~ backflow preventer for underground sprinkler system -
FIXTURES EAC1i y~ 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 -1 • 3.00 x =
Rough Openings 1.50 x =
Water Softener ' foi dwellings under construction 5.00 x =
Water Softener ' tor existing dwelling 20.00 x =
U.G.Sprinkier 'tordwellingunderconst. 3.00 =
U.G. Sprinkler ' for existing dwelling 20 = •~O
Alterations 'toexistingrosidence 20.00 =
Water Turn Around 20.00 =
Private Disposal System ' oak cry iic. 75.00 =
(new and refurbished systems)
Private Disposal Systems'Abandonment 20.00 =
STATE SURCHARGE .50
TOTAL a0•J c)
I he2by acknowled9a that I have read this application, sfate that the InPonnation is cortect, and egree to comply with all applicable Ciy,
of Eegan ordinances. It is the epPlicanPs responsibility W notify the Droperty owner that tha City of Eegan assumes no liabilityToo-eny
damages causeC Dy the City during ils nortnal operatbnal arW meintenance activifies to the fadlities eonstructed under this pertnft within
Ciry property/rightof-way/easement. -
SITEADDRESS: Wa44
OWNER NAME: V ~ o_r V) Y~. < k-R c~
INSTALLER NAME: ~ vv -0os\v TELEPHONE
STREET ADDRESS: `
CITY: Fa STATE: Y7 ~ ZIP:
~ SIG ATURE PERMITTEE
~
CITY USE ONLY 6a(l 13
L ~ BL ~ RECEIPT
SUBD. DATE: 9 'S F(
~
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 6814675
Piease complete for: ? single family dwellings
• townhomes and condos whEan permits are required for each unit
FIXTURES EACH tLQ, TOTAL
Shower 3.00 x _I
Wa!ec Cleset 3.00 x 3 = a_
Bath Tub 3.00 x I =
Lavatory 3.00 x 3 = q-
Kitchen Sink 3.00 :c 1 = '3_
Laundry Tray 3.00 :c I = 3-
Hot Tub/Spa 3.00 ;c =
Water Heater 3.00 ;c 3-
Floor Drain 3.00
Gas Piping Outlet ' minimum - 1 3.00 :c
Rough Openings 1.50 x
Water Softener 5.00 x =
Private Disposal ' Dakota Cty. license 65.00 =
(new and refurbished systems)
U.G. Sprinklef ' home under const. 3.00 =
Aiterations ' to existing 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .50
TOTAL
SITE ADDRESS: ~ y ~ ~ • ~ - ° u ° ~ i
OWNER NAME:
INSTALLER NAME: Ua I~°•/ P 11 , T_
STREET ADDRESS: U U,.1 Vv -CIN: STATE: +'\1 - ZIP: S s s 1-z
PHONE
OFFICE 1,5E CNiY
L BL RECEIPT
SUBD. DATE:
1996 PLUMBING PERMIT (CQMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RO
EAGAN, MN 55122
(612) 681-4675
Please complete for: P all commercial/industrial buildings.
w multi-family buildings when separate permits are ngl required for each dwelling
unit.
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR
DESCRIPTION OF WORK:
IS WATER METER REQUIRED7 _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETER.'i TO BE INSTALLED? YES NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESUL7' IN A DELAY OF METER ISSUANCE.
WILI YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? YES NO.
IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINttLER PERMIT.
FEE: $25.00 minimum fee or 1% ot 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
TOTAL
SITE ADDRESS:
TENANT NAME: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CITY: STATE: ZIP:
PHONE SIGNATURF.:
APPLICANT
OFFICE USE ONLY
METER SIZE: ' DATE: _ INSPECTOR:
CITY USE ONLY
L 9 BL RECEIPT
SUBD. DATE:
1996 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612)681-4675
Please camplete for: ? sing{e family dweflings
? townhomes and condos when permits are required for each unit
~ New construction Add-on fumace
Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date:
FFFC
? Minimum Fee: Add-oNRemodel (existing residence only) $26:60
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each) 3-eio
? State Surcharge .50
TOTAL 'f 33,sd
SITE ADDRESS- ~y~ P^e ~?r--~,,~
OWNER NAME: PHONE
INSTALLER NAME~~^~~~
STREET ADDRESS:
CITY: . STATE:~ ZIP:
PHONE#: (6rz ) YGo-~oa.z
3fb TTh
C(TY USE ONLY
L _ BL _ RECEIPT
SUBD. DATE:
1996 MECHANICAL PERMIT (COMMERCIAL)
• CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please oomplete for: ? all commerciaUndustrial buildings.
? multi-family buildings when separate permits are IIQt required
for each dwelling unit. DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: w $25.00 minimum fee Q[ 7% of contract price, whichever is greater.
• Processed piping - $25.00
& State surcharge of $.50 per $1,000 of Ronit fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL '
SITE ADDRESS:
OWNER NAME: TELEPHONE
TENANT NAME: (IMPROVEMENTS ONLI)
lNSTALLER:
ADDRESS:
CITY: STATE: ZIP:
~ PHONE
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
j
CITY USE ONLY
L BL ~1 1 RECEIPT ~OJrOOO
SUBD. RECEIPT DATE: 4a5 R
~
1999 PLuMSIN6 PERMIT (RESID£NT1AL)
CITYOFEAfiAN
3830 PaoT Kvoe Rn
EAfiAN, MN 55122
(651) 691-4675
Please complete for: ? single family dwellings
> townhomes and condos when permits are required for each unit
> backflow preventer for underground sprinkler system
FlXTURES EACH # TOTAL
Bath tub $ 3.00 x = $
Floor drain 3.00 x = $
Gas i in outlet ' minimum • i 3.00 x = $
Hot tub/s a 3.00 x
##eran sink ~ r s' N 3.00 x = $ U U
Laundr tra 3.00 x = $ D U
lavato 3.00 x = $ O
Minimum fee alterations to existin dwellin 30.00 x = $
Private Dis osal S stem new/refurbished ' re uires MPC iic. 75.00 x = $
Private Dis osal S stem abandonment 30.00 x = $
RPZ new installation/re air 30.00 x = $
Rou h o enin 1.50 x = $
Shower 3.00 x = $ ~ C~
Under round s rinkler if dwellin is under construction 3.00 x = $
Under round s rinkler if existin dwellin 30.00 x = $
Water closet 3.00 x = ' ~
Water heater 3.00 x =
Water softener if dwetlin under coosvuceon 5.00 x = $
Water softener if'existin dwellin 30.00 x = $
Water turnaround 30.00 x _ $
State Surchar e 50 $ .50
TOtel $ -o-U
Reminder: Call 681-4675 for inspections of water heaters, water softeners, alterations, etc.
I hereby acknowledge that I have read this appliration, sfate that the infortnatlon is correct, and agree to comply with all appliqble City of Eagan ordinances.
It is Ne appliwnfs responsibihtyto notiy Ne property owner that the Ciry of Eagan assumes no liabihry forany damages nused by the City dunng Rs nortnal
operational antl maintenance achvihes to the tacilities constructed under this permit within City propertylrighFOf-way/easement.
SITEADDRESS: 1 lp i-T-P, ~ I N-q- w
OWNER NAME: ~ R- r' U LK-~ r
INSTALLER NAME',i'7' d„~ T r' C TELEPHONE (A I Z-~i~ ~v~ I A
STREET ADDRESS: 0 N Q (A V
CITY: STATE: 21P:
SIGNATURE OF PERMITTEE
CDlPERMIT FORMS/RPLBG PERMIT (RES) - 1999
~ YERIVIIT
City of Eagan Permit Type: Building
3830 P[LOT KNOB RD Permit Number: EA034785
EAGAN, MN 55122 Date Issued: 03/24/1999
(651) 681-4675
Site Address:
546 White Pine Way
Lot 9 Block: 4 Addition: PINES EDGE I ST ADD
fUBC Description Sub Type: Lower Level Occupancy:
Work Type: Altera[ion ~ Construc[ion Type:
Description: ~ Zoning:
Census Code: pddition/Bsmt fin/Decks/Porch Square Fert.25]~, ~
Remarks: PITn reviewed by Wayne Miller.
Separate permit required for any plumbing work.
Call (612) 445-2840 regarding electrical permit and inspections.
Fee Summary: State Surcharge- Fixed 0.50
Permit Fee - Fixed 60.00
$60.50
Contractor: - Applicant - OWner:
C B H REMODELING St. Lic.:
13975 BUNRATTY
ROSEMOIJNT, MN 550680000
, 6126437165
~ I hereby acknowledge that 1 have read this application and state that the information is wrtec[ and agree to comply with all
applicable State of Minnesota S[atutes and City of Eagan Ordinances.
ApplicandPermitee: Signature issh By: Signazure
---rOffice ----e
~ FoU ~
I I
City of EapIl I Pertnit# ~ ~
i Permd Fee: ~
~
3830 Pilot Knob Road
Eagan MN 55122 oate Re 'ved: j
Phone: (651) 675-5675 V5 • ~~(.~X~~ i scarr i
~ i
Fax: (651) 675-5694
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: J-~- V~ Site Address: Wh~ ~c PiY12 wx~
Tenant: Suite
RESIDENT 1 OWNER Name: JPG.r d" L~ c.J<N ~rujQv- Phone: 6C1 y.~ 3 3SO
Address/City/Zip ~y(o Pr~~l
Applicant is _ Owner X Contractor
TYPE OF WORK Description of workRo,~.~ tO wL t1Gn.co LWA &26~~ +V•(JvuKGT
Construction Cost ~ sO f7 ~/~,IlL-Q~l~ Multi-Family Bwlding: (Yes No ~
T-
CONTRACTOR Name: Licenseu: C30I930I0_
F
Address~~~
City: Hq L-G Kt State: '411V Zip"W36L'/
Phone: o12 /pZs y&i'j ContadPerson: Lvnn, X1,764r
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqorv I Minnesota Rules 7672
Energy Code . Residential Venhlation Category 1 Worksheet • New Energy Code Worksheet
Cateyofy Submdtetl Submitted
(4 su6mission type) • Energy Envelope Calculalwns SubmiUed
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:
L.icensed Plumber: Phone:
Mechanical Contractor: `t Phone:
Sewer 8 Water Contractor: Phone:
NOTE: Plans and supporting documen[s 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 permif the City to
conclude that the are trade secrefs.
I hereby acknowledge that this infortnation is complete and accurate; Ihat the vrork will be in confortnance vath the ordinances and codes of the City of
Eagaq that I understand Ihis is not a pertnit, but only an application for a permit, and work is not to start without a pertnit; Ihat the work will be in
accordance wih the approvetl plan in the case o( vrork which requires a review antl approval of pl ns.
x Lo41 f ~VVNn x k
Applicant's Printed Name ApplicanYs Sign' tu e
Page 1 of 3
r
DO NOT WRITE BELOW THIS LINE ~
SUB TYPES
_ Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage
_~K Single Family _ Garage _ Porch (4-Season) _ ExteriorAlteration (Single Family)
_ MuIG _ _ - . . _ Deck _ Porch (Screen/GazebolPergola) _ Exterior Alteretion (Multi)
01 of Plex ' Lower Level Pool Miscellaneous
Accessory Building
WORKTYPES / 6 ffTIf n(~oo6,Lt,?~c2a
- New / Interior Improvement - Siding Demolish Building'
Addition / Move Building Reroof Demolish Interior
V Alteratlon _ Fire Repair _ Windows _ Demolish Foundation
Replace _ Repair _ Egress wndow _ Water Damage
Retaining Wall 'Demoiition of entire butiding -give PCA handout to appltcant
DESCRIPTION
Valuation 1-4 .S &9V Occupancy MCES System
Plan Review Code Edition SAC Units
(25%_ 100%~ Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction ~ Width
REQUIRED INSPECTIONS
_ Footings (New Building) _ Sheetrock
_ Footings (Deck) _ Final ! C.O. Required
_ Footings (Addition) ~ Final / No C.O. Required
_ Foundation HVAC
Drain Tile Other:
_ Roof: _Ice & Water _Final _ Pool: _Footings _Air/Gas Tests _Final
~ Framing _ Siding: _Stucco Lath _Stone Lath _Brick
Fireplace: _Rough In _Air Test _Final Windows
~ Insulation Retaining Wall
Meter Size: Erosion Control
Reviewed By: Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge fTr rT
Plan Review
MCES SAC y ~ ~U O
City SAC 1 /S
Utility Connection Charge 60 OIX
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 546 White Pine Way
Lot: 9 Block: 4 Addition: Pines Edge 1st
PID:10- 57690- 090 -04
Use:
Description:
Sub Type: e - Fixtures
Work Type: New
Description: Main Floor
Meter Size Meter Type
Comments:
Fee Summary:
Valuation: 2,500.00
Contractor:
Thompson Plumbing
15001 Minnetonka Industrial Rd
Minnetonka MN 55345
(952) 933 -7717
Manufacturer
JOANNE OLEARY
15001 MINNETONKA INDUSTRIAL ROAD
MINNETONKA, MN 55345
PL - Permit Fee (miscellaneous)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Serial Number Remote Number
Owner:
Barry J Mosbmcker
546 White Pine Way
Eagan MN 55123
$50.00 0801.4087
$0.50 9001.2195
$50.50
Issued By: Signature
Plumbing
EA089221
05/18/2009
ePermit
Line Size
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA107538
Date Issued:10/16/2012
Permit Category:ePermit
Site Address: 546 White Pine Way
Lot:9 Block: 4 Addition: Pines Edge 1st
PID:10-57690-04-090
Use:
Description:
Sub Type:e - Furnace & Air Conditioner
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to Mark Anderson , State Electrical Inspector, (952)
445-2840
Valuation: 7,790.00
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
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 -
Barry J Mosbrucker
546 White Pine Way
Eagan MN 55123
Wenzel Heating & Air Conditioning
4145 Sibley Memorial Hwy
Eagan MN 55122
(651) 894-9898
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA138900
Date Issued:09/26/2016
Permit Category:ePermit
Site Address: 546 White Pine Way
Lot:9 Block: 4 Addition: Pines Edge 1st
PID:10-57690-04-090
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
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 or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Sandra Tste S Jones
546 White Pine Way
Eagan MN 55123
Sela Roofing Remodeling
4100 Excelsior Blvd
St. Louis Park MN 55416
(612) 823-8046
Applicant/Permitee: Signature Issued By: Signature