642 Witham Lane
(gtrfi#ira#t uf (Oxrupanry
' . Citp of (tagan
~ uf lkdIdftg 3aaprriiwt
T his CerAJlaaie Luued pursuan! to llw npwmartr ojSectiae 306 ojlhe uniJonri &dldirrg
Code artijybV tJiat at rlu dw ojtssuana thts.wruawre m.s tre cnnrplicira w7lh tlw i+arious
onfiwnca ol dse City regdadiW bulldi~g oonowdioa or usa For the foUowirig:
uR awwraw. SF nr_ f= sk Pa r4,, 18938
OMW-TTAW-R3~L-~~ R1 ,yMCm. VN
a,w,cms,q Mn~ MISM n'r=- 1212 ffiItEBIIL BAY ED., BMISVIIIE
L3, B3, OOV@TM PASS 2ID
r
6/28/91
,
PO.aT Ml A CONSPICUOUS PLACE
,
INSPECTION RECORD
CITY QF EAGAN PERMIT TYPE: ~
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued: ~
(612) 681-4675
SITE ADDRESS: APPLICANT:
.i til IIinM i nrir
PERMIT SUBTYPE: TYPE OF WORK:
INSPECTION .
i
~
aWMn ra. a«,nn Hoia.r o.a Tobpnorw s
srw
PLUMBING
HVAC
EIECTRIC
ELECTRIC
Mtpwdon psft Msp. Commw+h
Footkgs I
Foundation
Freming
p1oo&v
Ra+9h Plbp•
Roigh Htg.
Isul.
Flreplace
FNfel HIy.
OrSEd Test
F'mel Plbg. Pb4- irmpeca - NotifY m?r?bw
Const meter
Engr./Plan
&dp. Final Der,ic Fig.
peck Fivl ~
WeN
Pr. Disp.
CITY OF EAGAN i J j~$
~3830 Pilot Knob Road, P.O. Box 21-199, Eagarr, MN 55721
611I1LDING PERMIT PHONE:454-8100 ;
Receipt # _
Tobe for SF DWG/CAR Est. Value ;113,000 Date wP2 24 ,199L 'Uqg
Site Address 642 W'ITlIAK LN
LOt N~ BIOCk 3 SeC/Sub. ~VEMY pASa OFFICE USE ONLY
Parcel No. ~ occupancv R-3 Jg.--1 FEES
Zoning -9=3
g Name MCDON~ ~TRWTI0N INC (Actual) Const ~ Bldg. Permit 685.00
~ Address 1212 8LUE8ILL BJ1Y iiD (Allowable) g ~
o
Cjty SIlIWSVILLB PhOne "8-7~1 # ol5tories Surchar e
Length Pian Review "s .00
~ Name SAM oevm 30 snc. ciry 100.00
Address S.F. Taai _
~ City Phone S.F. Faotprints _ SAC, MCWCC 650•00
F On Sile Sewage _ Water Conn 6~
W~ Name on siie wen ~ water Mecer 95.00
~ ; Address Mwcc sysrem ~ ~
i W Clty Ph0118 City Water x Acct. Depogit
PRV Required S/W Permk
I herehy acknowlege that I have read this application and state that the 8ooster Pump - S/W Surcharge 050
information is correct and agree lo camply with all applicable State ol
Minnesota Statutes and City of Eagan Ordioances. Treatment PI 276.00
Signature of Permitee APPROVALS 37O•~
Road Unit
A Building Permit is issued to: MCDONALD OOMTRLIMON pe""ef - PaMc Oed.
on the express condition that all work shall be done in accordance with all Co+ncd ~
applicable Stale of Minnesota Statutes and City ot Eagan Ordinances. gldg, pn, _ Copies
BuiWingOfficial ~Mance - TOTAL 3o398.00
Wrtnit No. Permk Holdw Drift T*Npborw At
'Y
WATER 2Ae.
SEY&R
R.uMem 44~13 9 4q 9/ h15 - 18v
H.vAc. ~ s/3 / GU -(~oa.ZZ
ELECrRIc
Imp"tfon aw conwmnts
FooOngs I Ya
Foundation
Framing
Rooh~9
Rough Pibg- •~i-OF .ll'
Raigh H!9• •
isLr. Aaok- bdt ...s _ cc ltte
Fveplece
Final Htg. -
Orsfat Test
Final Pbg. Ptbg. Inspector - Notily Plurnber
CoVst. Meter
Ergr./Plan
eiao. FxW - z -g D
Dedc Ftp.
Deck FMal
WeM
Pr. Disp.
SEWER & WATERPERMIT OFFICE USE QNLY
CITY OF EAGAN ~-J a~7f 04/25/91 3830 Pilot IQ~hob'~Rd. I - -0~~- - 1'~- ' , - + , ME~ER ~ PERMIT DATE
Eagan, MN 55122-1897 CHIP # PERMIT # 11945 'I
METER SIZE B_P. RECEIPT #i C 13054
" ISSUE DATE 4 ( B.P. RECEIPT DATE 04 24 91 I
DATE Apr i 1 1 C~ 1 Q9'j
X PRV _ BOOSTER PUMP
c
SITEADDRESS 6112 withar? Lane PERMITREQUESTED
LOT ! BLOCK3-SEC/SUB Coventiry Pass IT ~
LOATER TAPS
`
APPLICANT: M ~ Cc ~1 r~ 0~1 VSEWER
ADDRESS: ,-\e t 1I - COMM/IND ____I-_~SIDENTIAL
CITY, STATE ~'r-NSVi tIe , "N ZIP 3533-7 I/~Eyv - EXISTING
PHONE: ~og~s' ~10bI '
Lawn Sprinkler Meters are to be Installed
PLUMBER: S'lLAr pIL-+ 1 Ahead of Domestic Meters on Water Line.
ADDRESS: ~ 01 M,~.ux~dS Rr~„1c~ Trr ~~FCe Cred' VV4 pf be given for Deduct Meters.
CITY, STATE MN ZIP _~SUD
PHONE: $.~4 _ iI I 4 9 r''-~--
OM PJ~Y41TH CITY OF
OWNER: 'S~4wjP A=, ~1~.pIjc An~ A ES
ADDRESS:
GITY, STATE ZIP
PHONE: SWHEN M R ISSUED
PLEASE ALLOW T1N0 WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
t SEWER.PERMITS, PONTA ; ENGINEERING DEPT.
- . _ . ~ ..r .
SEWER t...WATER PERMIT ' OFFICE USE ONLY
CIT'V OF E71GAN M~ R# PERMIT DATE Ul} 5
3830 Pilot Knob Rd. ` ~ ` ` ~ ~ Eagan, MN 55122-1897 CHIP # PERMIT # 11045
;
MESER SiZE B.P. RECEIPT # C 13c; 51
~ y
DATE --a.F c, ISSUE DATE B.P. RECEIPT DATE O4 1241 t
f
x PRV - BOOSTER PUMP
SITEADDRESS 642 1`11thari T 3?1e PERMITREQUESTED
LOT 3 BLOCK3.-SEC/SUB ro.ventny Pasa II I
VSEWER 4-+tlITATER _ TAPS
APPLIGANT: Cr .~S{f V."rji,ftr. )
ADDRESS: eOMM/IND -A--RE'SIDENTIAL
CITY, STATE ,lry1SU0-i1s~ ~ 7IP5s 3:1:7 EXISTING
PHONE: f~S!R =`7LZbI
Lawn Sprinkler Meters are to be Installed
PLUMBER: <-AAr_ Ahead of Domestic Meters on Water Line.
ADDRESS: I cl. I g Credrt.WltL f~f~T be given for Deduct Meters.
CITY, STATE ZIP
R I ~+2`='~~~; r• ~`.,f l ~ 5 c~{~1(~ ~
PHONE: ~BLi=-y IL4-9.r
COMPCX'WITH CITY OF
OWNER: S.A,..4te A (An.r LA,f"} AA~A"V_ RDINANCES
ADDRESS:
CITY, STATE ZIP
PHONE: SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
I
~ CASH RECEIPT
CITY OF EAGAN i ~
3830 PIIOT KNOB ROAD
EAGAN, MINNESOTA 55122 '
! DATE ~ / 1Y ~
11
„MOUNT s
,
d DOLUIRS
? CASH ~CHECK +m
~
FUND OBJECT AMQUNT
Thank You ~
BY
wh"-pm-
~
13054 '
ralloMr-fb8tl~q copy
Pink--FN* C.apyr
4 Z 4 8
Repu -Flre No Ro m I ion
W~I Inspector
p u ? Heatly N.
• , es ? No hen Rea0Y7
I ' ensetl contractor O owner hereby request inspection ol above electrical work at:
.bb Oorass SIr Bov r Ro 1 oN
qn N Townslii Name N enge No County
•
u nl(P NT) Ppone o. ~
Power S M reu
Elect hactor ( ompany Na ) § a
l l
\J
Mtdm JMt01 0, ¢r MOkmg InslalluUO •
AuOar eE SipnaWre Contrect r ne M kmg Installalion)
NINNESOTR ST E BORRO OF EIEGTRItiTY ' THIS INSPECTION REOUEST WILL NOT
Grl9ps'YlEwey Bkq. - Room Si]J BE ACCEPTED BY THE STATE BOAPD
1Bt1 VnlvanHy 11w, St. Psvl, MN 551M UNLESS PflOPER INSPEGTION FEE IS
PMna (812) 841-0800 ENClOSEO
REQUEST FOR ELECTRICAL INSPECTION fes-ooom-ae
See inslmclims lor complaung IMS brm on back oi yellav copy. ?/O
?
M
p y~ " "X" Below Work Covered by Tbis Request ~
642,18
ew Rep Type of Building AppliancesWuetl EqwpmeniWuetl
Home ]Range Temporary Service
Duplez Water Heater Electric Heating
Apt Bwldinq Dryer Other (Specity)
Comm./Indusirial rnace
Farm Air Contlrtioner
Olher (spacJyl CamracrorY Remarks:
Compute /nspection Fee Below:
B Other Fee # ServiceEntrenceSize N Cirads/Feetlers ee
Swimming Poo) 0 to 200 Amps to 100 Amps
Transtormers Above 200 _ Amps Amps
SigpS Inspeclor5 Use Onty. TO AL
Irrigation Booms 7
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTMS. I, the Elecirical Inspector, hereby Rougn-in ~ oace 7-?
certity lhat the above inspection has oaie
been made.
OFFICE USE ONLY /
This request voq 18 monfis Imm
- - -
CITY OF EAGAN r No ~18938
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55721 ~
PHONE: 454-8100 i
BUILDING PERMIT Receipt #
To be used for SF DWG/GAR Est Value $113, 000 Date APR 24
Site Address ~ 642 WITHAM LN
Lot 3 81ock 3 Sec/Sub. COVENTRY PASS 2N OFFICE USE ONLV
Parcel No. occuPancy R-31ML-1 FEES
Zaning R-1
w Name MCDONALD CONSTRUCTION INC (qcmaqConst ~N eidg.Permit 685.00
; AddreSS 1212 BLUEBILL BAY RD (qllowable) V-N
~ City BURNSVILLE Phone 688-7061 xolsmries Surcharge 56.50
lenglh -6L6-' Plan Review 445.00
iF Name S~ oevtn 33' snc, ciry 100.00
g¢ Address SFTOtaI - SAGMCWCC 650.00
~ City Phone S.F. FoolpnNS -
On Site Sewage _ Water Conn 660.00
~Q
Name on sie weo 95.00
Fw X ~?aterMeter
~ ; Address MwCC System
aw City Phone cnywater X Acc~.Depost 30.00
PRV Required x SMf Permit 30.00
I hereby acknowlF9e thal I have read this application and state ihat Ihe Booster Pump - SIVJ Surcharge .5
0
information is cohe~ and aqree 1o comply with all applicable State of
Minnesota Statutes~ tl City of Eagan Ord~ ances. Treatment PI 276.00
Signalure ol Permite\ 4 APPROVALS Road Unit 370.00
A Building Permit is is5u d to: CDONALD QNSTRUCTION Planner - park Ded.
on the ezpress conditibn [hat all w rk shall be done in accordance wrth all Counnt
applicable Sta[e ot Mmnesota Statutes and City of Eagan Ordinances Bltlg. OfL _ Copies
n
NNih aifl,j V Vanance - TOTAL 3,398.0
Building Official
Address: 642 WI1H[NSI,ANE Lot 3 Blk 3 Sec/Sub !;OVENI$Y PASS 2ND
These items were/were not complete at the time of the flnal inspection.
D t: 6 28 91 Yes No ,S
Final•grade (6" from siding) ~
PQrmanent steps - garage f
Permanent steps - main entry
Permanent driveway ?
Permanen[ gas
Sod/seeded grass
Trai1/curb damage ~
Porch
Basement finish Lll~
Deck
Pleasa verify vith the buildar the removal of roof test caps from the plumbing
system and the shut-off of water supply to the outside lawn faucet before
freeze potentSal exists, ~
uc.aeor.n~
White - City copy Yellow - Resident copy Pink - Contractor copy
DATE: APA 25, 1991
RE 642 NTTHAM LN (MCDONALD COpISTRUCTION INC). ,
X Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL Pl~'18LIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
- Y6ur Sewer & Water Permit tor the above property cannot be completed for the following
reasons:
_ Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until fuAher notice.
- COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confvmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITV DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept. .
2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings &[ownhomes/condos when permits aze required for each unit
~L
LU)
Date ~ y / (5 c- FEg 1 6 2006
Site Address 6'4a w~ T~--~ L vL. Unit #
Praperty Owner cl 5 ~ Cl- Telephone # ( (oS ( ) y Sy - (.90
ANGELL AIRE, INC.
Can[ractor tt.~~~ ,,I A n cnuth
-1"CCJ3771Grn
Burnsville, MN 55337
Street Address ~ tion,• 049 7dR-5900 City
E2x:952-748-5202
State Telephone# ( )
Band j(0 7 Expires: < U 6~
The AppGcant is _ Owner ? Contiactor _ Other
Add-oo or alteratian to existing dwelling unit $ 30.00
? fumace _Additional V'Replacement _ New
air exchanger
air conditioner
~ heat pump
other
State Surcharge $ 50
Total $ 3 o' so
I hereby apply for a Residential Mechanical Peanit and acknowledge that Ihe informafion is complete and acwra[e; that the work will
be in conformance with the ordinances and codes of [he City of Eagan and w•ith [he Mechanical Codes; tliat I understand this is not a
permit, bu[ only an application for a permit, and work is not to start without a penni[; that the work will be in accordance with the
approved plan in the case of work which requires a review and approval of plans.
Applica Yrinted Name Applicant' ignature
2005 COMMERCIAL MECHANICAL PERAIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete Cor: commerciaUindustrial buildings
multi-Camily buildings when separate pennits are not requ'ued for each dwelling unit
Date
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
~ •
Contractor
StreetAddress Gz~ ~ ' City,^
11
State Zip ~~'"~~P'I4lepfiune~l ( )
Bond Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove "see below
Interior Improvement _ Install Piping _Processed _Gas
Nature of Work:
"When insfalling/removing undeiground tank, call for inspection by Fire Marshal and Plumbing fnspector
Yf l'rtli[ I~' ¢¢S: 570.50 Undcrground iank inslallationlremoval
$50.50 Afinimum (includcs State Surchargc)
or
ConiractValue $ x 1% _ $ PermitFee
$ State Surcharge
ICpe77nit fee is less than 51,000, add $.50
If permit fee is more thao $1,000, surchazge
is $.50 for every $I,000 owed.
$ Total Fee
I hereb}' appl}• for a Commercial Mechanical Permit and acknowledge that Uhe information is complete and accurate; tiat the work
will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; [hat I understand this is
not a permit, but only an application for a pertnit, and work is not to start without a perntit; that [he work will be in accordance with
lhe approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name Applicant's Signa[ure
Approved By: inspector Date:
Required Inspections: - U.G. _ R.I. - Air Test - Gas Scrvice Test _ Infloor Heat _ Final
1991 BU ~ I 0XZCATION r '
/ CZTY OF EAGAN
SINGLE FAMILY DWELLINGS ?NLTIPLE DWELLINGS COMMERCIAL
2 SETS OF PIANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCUTATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
OF RENTAL UNITS
_it OF FOR SALE UNITS
PENALTY APPLZES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLAWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MIJST SHOW A LICENSED PLUMBER.
C~XC~~rS ~ut.,
To Be Used For: Si le Valuation: Date: 'I-19 -9 I
Site Address ('42 Wre+l,--, L,nsje I) 3I Z)DO ~ OFFICE USE ONLY
Lot .3 Block 3 FEES
Occupancy R-3 M - t Bldg. Permit 686~0z)
Zoning IZ -I Surcharge SD
Parcel/Sub C~veN~i"U P~S ~ Actual Const Plan Review 4S',o J
Allowable V _ N SAC, City OD.O
Owner Mc~o.~qld Co,.js'EttnC'Eloa TNC • # of stories SAC, MWCC $U, 00
Length Water Conn. 6r60,03
Address 1-)12T31ye6ll $,4'„ 'Rd Depth 33~ Water Meter ',aJ
S.F. Total Acct. Deposit D.*O
City/Zip Code ~,.rasvil~Pf 5S33-7 Footprint S.F. S/w Permit 0•00
S/W Surcharge , Sp
Phone (oerQ,-70(0l On site sewage_ Treatment Pl. br~
On site well Road Unit O,OO
Contractor MWCC System ? Park Ded.
City water ? Trail Ded.
Address PRV ~ Copies
Booster Pump _
City/Zip Code SUBTOTAL
APPROVALS Penalty
Phone Planner Lot Change
Council TOTAL Q .n
Arch./Engr. Bldg. Off. '7ZY9/ S
Variance
Address '
City/Zip Code
Phone #
/~X( agrees that all work shall be done in accordance with
(Sigyatu If Co~tfactor)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
VAW,6~
t4 ~ .
Ga2AGS
ZZ X12=- Z~c(
z y _L4 Y 0
~yy x ~5= I1~?~~
~ ?'?'1 T,
3yx~~ _ ~8,~ x t4 = l3e0 1~
P~~tM - 3 s~
x ~2 = 192 x 40 ~~1680
N ows E
ZG X 3 y=?~~ b x53- 52 258
~ ND flevrc.
ISX14~= ~I`t3
3y 103
,5ZI
x 53 =
Pioneer- Eneinrerins 6819488 p,02
r
~ * * 2422 Eirterprise Orive
~ PIONEER Mendotn Heights, MN 55120
*engifng^.-- - - (612) 681 - 1914~
Certificnte of Sunvey fori LP0'vJ#A~
~
NoRrH
1~?iT~aNr ~A~?c""
95, oo Se9 ° ~s "E'
a
0~' M r~"
~ O~
3Z. ~
~
l, 17.0 ii,o e Is,I'Je
Z~ ~ N tl~i ~i.s3 V1
~ PRnaosac ° I en
0 ~ `N
.n1 n I m"~ G~R•
Q~ I m t~wJSE I K'
N
e ~
i N
~ I~_~oL _ P 34,e ~i.o
~ ~.O PencN - ^ .
I 524~~1 I ~ -
'
5 D c,'P.,:
3.
9-4;: ev seq 039-3/ ••'e5
~
I~ G~ .0~a
x 900.0 Denofes exisfin~ elevafion
~ goo_o Uenafes proposeral e%vatio `UWP.sf fJe.or [l¢vpf;on Sz5.7 3 .
Denof¢s braina~e i Ufi~~y Epsemenf ~p ot^l31a~k E/v,valion '33.~3
Denofes Oraina~3e ;~low ArrowS rarage S/ob E'levalion ~33.1
o D¢notes mw? urrYen f _ -
Bearin~s shown are ossumed o Denofes Nub
,Lor _3 8cock 3 , CoUENraY pAss ,z"-°,4
oAKora couNrY, M1tiNf5RTA Subjecl !o easemenfs orrecord
I hCrMpy cer[Ily Iha[ thii SurveY. Plsn nr repnrt wae re red bY m or uncer my direct snr?'Id Iha[ I Jin nuly Rrpiste.ed Lxnd Survoy0r
under fNr, lewf ol the Stet4 vf Minne50ir. Dpted thhsy of A.b. 19W.
6ca ilef
~inch , 40
HPR- 1 5-9 1 FR I 1 8 _ 1 9 PLFi NCU~ I NSIJRANIZ: E i7FF u12j/~ 2
• 1 MINNESOTA STATE ENERGY CODE CALCULATIDNS
: dASED ON CHAPTER 5 Of THE
. MODEL ENERGY CODE - 1983 ED1710N , Adoption EFfect ve I/l/84
Phone Date'
Slte Address
Contractor~ Phone
Bullding Classlffcation; 7ype A1 (Single Family 6 Duplex)*~Type A2(Residentfal)
; • storles or less
NOTE; Complete pa9es 3 and 4 flrst. (3
(Other) (Over 3 stories)
GEN6RAL INFORMATION
1. Buiiding Perimeter7a~~~Mft.
- ~
2. Uall height (ground to eave) ~ ft.
z' 3. 1, x 2. (above) gross wall area ~ 7i ft. ~
4. Bulldfng dlmensfons (L) X(W) ft.2 roof 6 floor area
5• Square foot area of rlm Jolst Floor Joist size (2 x 7 } ~
1C>T X Perlmeter - Rfm o st area - I 04, 5 f,tZ
`Tz
6. Ooorg - Ared 7h(ckness In. U factor ,-1
Type oF Construct o~ - Perimeter ft.
Manufacturer •
7, Total door's perlmeter ft.
8. IJindows: Manufacturer__ State approved
U factor
TYPE SiTE AREA (Ft.2) NUMBER OF TOTAL FEET ~
q • EACH UNITS
1
9. 7ota1 ft.Z Glass_ 29?j.b
10, Fireplace area; Wldth X helghe ~ X Ft.2
II. Exposed foundation; Height X Perimeter #(D 1 X Ft.2
C011PLETION 0F 7H15 FORM I$ REQUIRED i0R ALL E CONSTRUGTION, MAJOR REMODEIING AND BUILDING$ BEIN
HOVED WHERE ENERGY, OTHER THAN THE MINIMAL CODE ALLOWANLE, IS USED.
r-~ry~- i y-y y r K I 1`. : 1 9 PLpNCrJ/ I NSIJ F'.ti1tJ CE 0 F F P. 03
,,IZ, F.raming area + 10% of gross wa11 area. 49
13. Gross wall area ~21 97 ft.2
Nindow area A ft.2 U U x A*
windows
- Rim Jo1st area A ~n4fft.2 U r1m Jo1s,t • U x A iZ
y.~ 2 a .
Door area Aft. U door area • i ~ U x A• i~
OV4.
fC area A ft.Z Uk14*04'es n r u x a
Exposed founAatlon A t?- ~,ft.2 U foundation U x A~ ~U
Framing area At,]I( q U,D) ft.2 U framing area U x A= ZGJ~
Net wall area A 1~9~Z~'j ft. U wall n p U x A=
(138) 70TAl. . . . . . , . . . . U x A ¦ ~~2J~
~
14, Gross wall area z 0.11 {q-1 sing]e family S duolex • allowable U x A/Code
(13. a6ave)
x 0.23 (A-2 other residential)
x .23 (Other buildings) ,
x ,28 (Over 3 stories) .
A ~7 ~l~ca I ZC2 + _ q BTUN Must be larger thar
x U Code; ,•_6~' - ~ f~~~~..~F. 13B above
„15. Ceiting framing area (Af) equals 10% of ceiling area ' C or the. same as}
15A. Gross ceiling area + L x(W) ft.2
158 Joist areA (Af) • 10% cetling area ¦ ft.2
15C. Net celling area (AC) (15A - 15B) ~(7(po ft.2
U cei3ing x A c_ 1~LZ x 16,(69t~)
U framing x A f= 5 x
15D. TOTAL'U x A . , ~ ~j
16. Ceiling area (15A) x 0.026 {A-1 single `amily & duplex - code altowable U x A
x 0.033 (R-2 other resldential)
x 0.06 (other)
ip Z,(p B~UH Must be larger than 150 (above)
A(15A) x U lcode)= .J F (or the same as)
NOTE: Use U and A values obtained from pages 1, 3 and 4.
LERTIFICATlOH; 1 hereby certlfy that I'have calculated the "ll" factors and "R" values
herein and that the buliding here descrtbed meets or exceeds the State of Minnesota
Energy Conservatlon Act. Date ~ 3lgnature
. ,
"wa~K SEI~~r"
6 nX( 21) 105,0 %
~
154X(~4 34 + 2i z~)~
I l 78. ~ . . .
,
~ ; ~rox~ - ~-o
~z15X 5
I. ZXZ c~T; 3,?S X 1= 3, 75 ~
~ ~w?s- ~ = ~-1.27x~ ~ ~~~Zs .
1 o S .
I CP3~ = Z~ ,ok o
~ p
~-T'y . . _ . . . . .
. ' . . . .
zIlo
~r, . . . .
, 14~, 0
A F' K- 1,9 - 9 1 F_F_ I 1 3: 2 Ei _ P L A N C O/ ~ F{,~.,E O F F F. Ei S
. . . AIUE U VALUf ,
.68 '
WALL • Interior vsll ' ~4y ~
SECTION (Well) U ¦ R A
Insulntion lqio • ,
Sheathing ~,OCO
-r~ Slding ,(p( •
~ Outdlde alr Etlm .17 -M
. i
, R TOTAL 23 .0
IneLde.elr ftlm E ,68 ~
SrUD ~ Interior vall ~j
SECTION 6tUd R= ~k-„jg ~~(praroing) U. R .
Sheathing ~2,p(p '
~ Sldlng •(07 095
~ • .
Outside a!r ftlm ' .17
4
R TOTAL ( O.
' - Innide air, film R° .68
2ND wALL Interior valt
SECTION. . IneulatSon'
(Wail ) U + R '
• . . . - : Sh'eathing 2,
`="'r~ ~ Eztet[or ~wall cover,ing'
ExCat Lor llr f llro ` R..17
R 7OTAL' . •
< .
~.-Intertor a lr film R= .68
R[M ~ - [nsula'tton
~otsr 1~,. '1} inch soft uood R=1.88 _ (Rtm
~ - - ~ Jofgt)
. . ' Sheathing _ . ) Z , 0(p , O4l
. ` - = 6xterlot.'wa~l cn4ering .CO~ _
Exterior air f llm Rz .11 ~ . - .
" ~ . ~R~TOTAL~, 2-4.-iw'.~
Interior Ati fllm R- .6$
. :
iInsuie_tlon~lI36RL'i445~J i~•00
' , .+`z' QI..'~•., ~..i•-Cdn:)~ ,U.+t'~'_ ,
= £xtetlor etr~fllm R• ,17 - _ '
- ' , ~R 7'OFAti
• ' _ 1\ . t l - , ' . . - ~ - .
_ ; xpos'ed
- - - - - _ _
' PERIVIIT r
CITY OF EAGAN C R,Z.91G~
3830 Pilot Knob Road PERMITTYPE: euzLozNs
Eagan, Minnesota 55123 Permit Number: 0 2 3 5 3 8
(612) 681-4675 Date Issued: 0 5/ 0 9/ 9 4
SITE ADDRESS:
642 WITHAM LANE
LOT: 3 BLOCK: 3
COVENTRY PASS 2ND
P.I.N.: 10-18401-030-03
DESCRIPTION:
BuildingPermit Type DECK
Building Work Type NEW
~
~
~
~.5//i
`~L
~ (J f
;
L~L1~:
REMARKS:
FEE SUMMARY:
Base Fee $30.00
Surcharge $.50
Total Fee $30.50
CONTRACTOR: OWNER: - Applicant -
LENTSCH CHRIS
642 WITHAM LN
EAGAN MN 55123
(612)454-8835
I hereby acknowledge that I have read this application and state that the
infiormation is correct and agree to comply with all applicable State of Mn.
L Stat tes a City of Eagan Ordinances. ~
R~~~I ~Jfy(f
1 0
APPLICANIPERMITEESIGNATURE n ISSUED
Y. IGNATU E \
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: auzLoiNG
3830 Pilot Knob Road Permit Number: 023538
Eagan, Minnesota 55123 Date Issued: 0 5/ 0 9/ 9 4
(612) 681-4675
SITE ADDRESS: Lo r: s 8 L 0 C K: 3 APPLICANT:
642 WITHAM LANE LENTSCH CHRIS
COVENTRY PASS 2ND (612) 454-8635
PERMIT SUBTYPE: TYPE OF WORK:
DECK NEW
INSPECTION . D.
FOOTINGS FINAL
I ~
L ~
' CITY OF EAGAN REC~ENED
1994 BUILDING PERMIT APPLICATION MQy 0 4 1994
681-4675
2A"
IM.1~0 - -
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structura] p]ans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date /}~'<i''f / OL Valuation of work
Site Address: GillT!-{f?iw LiYN6
STREET SU1TE #
Tenant Name: (commercial only)
LOT 3 BLOCK= SUBD. C~~~Tp_y'~u'1-' F.I.D. ~F
7 ^~d k}cjG~_
Descri tion of work: U U11, l+~1 v4 /}T OaA ~ 6_
The applicant is: R(Owner CI Contractor ? Other (Describe)
Name LENriXH L'k2i s7nlfeT Phone ys`f"&P69
Praperty Lasr FIRST C( f-~35 c111V_
Owner qddress (o yZ ~'L/
STREET STE #
City of/tty`/ State M~ Z i p JSl 2S
Company Phone
Co ntractor Address License # Exp.
City State Zip
Architect/ Company Phone
Engineer Name Registration #
Address '
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I ha read this Plication and state that the information is
correct and agree to comply all a li ble State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: ~
GO-
OFFICE USE ONLY ' BUILDING PERMIT TYPE p
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
O 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? 08 8-Plex 0 13 Garage/Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex 0 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. E3 15 Deck O 20 Public Facility
O 21 Miscellaneous
WORK TYPE
El 31 New ? 33 Alterations ? 35 Tenant Finish O 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MWCC System
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy 2nd F1. sq. ft. PRV Required
Zoning Sq. Ft. total Booster PumP
# of Stories Faotprint Sq. ft. Fire Sprinkler
Length On-site well Census Code 75/
Depth On-site sewage SAC Code a/
Census Bldg ~
APPROVALS Census Unit o
Planning Building Assessments
Engineering Variance
REGIUIRED INSPECTIONS
O Site f;~ Footing ? Framing ? Insulation
O Wallboard fRl Final ? Draintile p Fireplace
Permit Fee vaiuacio,: S
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
SAC Units
Ploneer Ensineerlns 6619468 p,02
n
2472 Enlerprixe brlvE
* PIONEE Mendote Ileights _MN 55120
e4n99 ~ (612) 681 • 1914 ~
Certificate of Survey tor:_
L~
NoRrH
{~/iTrl~y~? 4 An/c-
95. 00 SB`~ °j~g '3/
a
C~. 3 °
• ° s
• Q ~ ~ ' ~
3Z. ~
i
,1 17:e n o , ¢.J3. ~ ~
=y N ~1'~ i;.i; + r
«T R PR~1POyFD ~ M
a~~1A ~ ' 11 0.^j
a~ I r ~eib?ff. N
O L a 34,e is.o 0
'1~1`
~ ~ •o p.wcM
~ ~5 $Z ~ 25, g '
~ .z..°
9c. 4w 5;89 •30'3i °E
P
= 900.0 Denofes eyistinj Qlrvafion PROp05 _D=b l2QE,,.F-LUAU06-
i goa.o Denofes proposed e/evation Lowesf F~oor Elevofion 13z5,73
Denofes braina e i Ufili~t~ Easemenf Top of^B/a~k E/evalion 833•'h3
Del?ofeS Drain2 i~/aw T-Jrrows G'dra~e S/ab Elv,volion "~33•I
o Deno f es mailur'err f
Bearmjs shown are ossumed n Denoles oflnSd Nub i
,LoT 3,BLock 3, CovErvraY pAss z"-°Q ~
DAKOTA COVNTY, M1NN~50~ 5ubjecl !o easemenfs (*'record
I hCreby eQrtlly thet itii{ {urvlV, Plrn Or report wpf Pre rM bY mg7or un~r my dieect lapE• ian rnd that 1 Dm Auly RrpistP-ed La,,d Su.•ey0r I
vnder 1he Iows oI th9 StH* of Minnesolt. DDteC ehlf sy oF IP_ A.D. 19 .
Q/~/~~~CQ'I~ : Jinch • ~ o~ ~ r
A EqT..SIY.IC,/11_S.Rpf1.Nf1.1~!?] ^
ke /V~7.
CITY OF EAGAN FOR CITY USE ONLY
3830 PILOT KNOB ROAD
EAGAN, MN 55122 PERMIT # 5S
PHONE: (612) 454-8100 RECEIPT #
PLMBZNG, I?ERMTT DATE: a
REBiDENTSAL:' PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS 6
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
NEW CONST X, ADD-ON MINIMUM 15.00
ADD ON J_ SHOWER 3.00 , 6
REPAIR WATER CLOSET 3.00 TOO
~ BATH TUB 3.00 3,Q0
LAVATORY 3.00 IS no
OWNER NAME: N1C/oOY1Q f
,~11 GORS~/'uG~iO~ ~ KITCHEN SINK 3.00 3,00
II, LAUNDRY TRAY 3.00 3•0^
SITE ADDRESS: G YOQ YU~~a~, ~~nP, HOT TUB/SPA 3.00
WATER HEATER 3.00 3,0
veh 1) Q S FLOOR DRAIN 3.00 a,QQ
LOT:~ BLOCK ~ SUBD. ~
1 ~I GAS PIPING OUT.
INSTALLER: IVC~ -IQUYhA1h-~-J'1G_ ~ (MINIMUM - 1) 3.00 alon
c~jyn / C ROUGH OPENINGS 1.50 ~S~
ADDRESS : 1~ /~Cp I C+?ti YI P /..AE° vd . _ OTHER _
/ WATER SOFTENER 5.00
CITY:&#ajq tll/ ZIP: ~~Q1 ~J _ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
PHONE
SUBTOTAL s-o
~e ST. SURCHARGE .50
SIGNATURE OF PERMITTEE SJO , ~O
TOTAL: S
COMME9bIALf3NDUSTRIAL':_ PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
. . . . . _ . ,
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE: FEES
OWNER NAME: 1% OF CONTRACT FEE.
STATE SURCHPBGE - $.50 FOR
SITE ADDRESS: EACH $1,000 OF PERMIT FEE.
LOT: BLOCK _ SUBD. $25.00 MINIMUM FEE.
INSTALLER: CONTRACT PRICE x 18 $
A?DRESS: STATE SURCHARGE $
CITY: ZIP:
TOTAL: $
PHONE
(SIGNATURE)
FOR:
CITY OF EAGAN
` CITY OF EAGAN FOR CITY USE ONLY
3830 PIIAT KNOB ROAD
EAGAN, MN 55122 PERMIT # f
PHONE: (612) 454-8100 RECEIPT # '
M~Ci~ANICtIT: pERMS'T DATE: ~
RESIlJEN7'IAL_ PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUZRED FOR EACH UNIT.
WORK DESCRIPTION FEES
NEW CONST ~ ADD-ON MINIMUM $15.00
ADD ON _ HVAC 0-100 M BTU 24.00
REPAIR _ ADDITIONAL 50 M BTU 6.00
GAS OUTLETS - MINIMUM 3.00
OF 1 PER PERMIT
OWNER NAME: 0 Q_ ( c:.I ~ l r v ,~T
SITE ADDRESS: oC ~'r 1 1 ~•In G VYl hG Y~ ~ STATExSURCHARGE: 0`1
LOT: ~ B/LOCK ~ SUBD. TOTAL: ^ $~v
INSTALLER:
~
ADDRESS: /SI NATURE OF PERMITTEE
CITY: ~`~{Yl1Y~~,TC1-~ ZIP:
PHONE ~C)
0OMMERCIALJINDiISTRIAL:: PLEASE COMPLETE THIS PORTION FOR ALL COMMERC IAL/INDU S TRIAL BUILDINGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY SUILDINGS WHEN SEPARATE PERMZTS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
°
CONTRACT PRICE: FEES
OWNER NAME: 18 OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
SITE ADDRESS: EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING = $25.00
LOT; BLOCK _ SUBD. $25.00 MINIMUM FEE.
INSTALLER: CONTRACT PRICE x 18 $
ADDRESS: STATE SURCNARGE $
CITY: ZIp;
TOTAL: $
PHONE
(SIGNATURE)
FOR:
CITY OF EAGAN
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA143211
Date Issued:06/07/2017
Permit Category:ePermit
Site Address: 642 Witham Lane
Lot:3 Block: 3 Addition: Coventry Pass 2nd
PID:10-18401-03-030
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Includes Skylight
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Daniela E Voller
642 Witham Lane
Eagan MN 55123
(651) 746-9081
T. Dunham Construction
831 Ventnor Ave
Eagan MN 55123
(612) 189-0480
Applicant/Permitee: Signature Issued By: Signature