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1031 Walnut Ridge DrCity of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 6 Use BLUE or BLACK Ink POEWOR Permit #: too/37 Permit Fee: "90, (,/CD Date Rec ived: Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit #: RESIDENT / OWNER Name: foamy 491 vla.0 Phone: Z 16)-24'5 -36 9 r. \,� Address / City / Zip: W3 / V q/ �f i e D/%'e 474,5 a,-.7 Applicant is: Owner 'Contractor TYPE OF WORK Description of work: *? OPP ince kie '"5,k leP r/ y 1 72' c6-1 g 4 lt Construction Cost: 75-6-0 Multi -Family Building: (Yes / No. ) CONTRACTOR Company: / ` `7 dl. -V %I `[. / eii/Ie Contact: Ze4i6i,i AG ic-P1 Address: �I';-74 ler &-... / l/ City: L -,,e - a/0fr-e., State: 44 1v Zip: �� Phone: 76 0.a7 _ `6 License #: (2/0017° - /L'V1©-° 77 Lead Certificate #: "VA/ / -3 O' q, 1 Does this project require Lead Remediation? 0 Yes 0 No (see Page 3 for additional information) If no, please explain: In the last 12 months, _Yes No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. X loamy Applicant's Printed Name Applicant's Signature Page 1 of 3 Date: City of Eaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink Permit #: �l Sp Permit Fee: ���' Date Received: Staff: 2010 RESIDENTIAL BUILDING PERMIT APPLICATION r��Site Address: %Q i'' y T) Tenant: Suite #: RESIDENT/ OWNERName: Ct. t r L—� �-C� t ✓ i Phone: --.0 DI i --36 8C y Address / City / Zip: /6 /,) t;-/r-ui Cij.- _ U j� v -A-y-4-k\ Applicant is: Owner Contractor TYPE OF WORK Description of work: / ea.A.7 0 l:`\ et tom, re --a-6C ti. .t5-,.. 3 eiri if 4, / i / Construction Cost: / - �% Multi -Family Building: (Yes / Noy"') / CONTRACTOR Name: Att ' f "i License #: 0°7-)/ 0 7 Address: 6211S--( -c)-y cc:,r � (?-j---/" City: Pl L �0e State: -1/11A•11 Zip: S : .-3 far Phone: 7& 5 ' Vii ''.1'`? 16 ??, Contact: I- ,cA.n.� - �. Email: COMPLETE In the last 12 months, has No If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? date and address of master plan: _Yes Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City; to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and w► is no to start y'thout a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and appr x 1 f5Y Applicant's Printed Name is Signature Page 1 of 3 INSPECTION IrEC4RD CITY OF EAGAN ~ PERMIT TYPE: ' ' ' ~ 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: ' (612) 681-4675 SITE ADDRESS: ' ~ ' " ~ ~ ~ ~ ~ , APPLICANT: t , ~ ~ ; ~ . f~ t r _ . ~ . , i rtr? r ~ t~!~r r~~. ' , ~ . , . , ~ , - , , . , P~RMIT SUBTYPE: TYPE OF WORK: . . ~~~r~i~: , . :,,r~ ~ hii, +~1 . i ~!~sa + I~ I I'I , , ~i, lii , i ~ , „ i •t • . . ' ~ . ! ~ . ~ i ` 3.1 I ~ . ~ , ~ ~ ~ J ~ Permk No. Permit Holder Date Telephone # ELECTRIC 7~ 9/~'? C! 5°" ~ PLUMBING , ~ ~~.8~ HVAC ~ C ~ J S~a~~.3~(~ Inspestion Da Insp. Comments FOOTINGS '~~a~ FOUND 1~/f r.- / T 7 Tf7'i FRAMING 36'~ J~ Hi ROOFING ROUGH ~ PLUMBING - PLBG AIR TEST ~ ~ HEATING ~ 9, ~ u '~7 ,~~pSiecpZ'L GAS SVC TEST ~ ~e _ p ~ ~~us~~ ~ c.-'~io~ Gar~. ~.w GYP BOARD FIREPLACE ~ V FIREPLACE AIR TEST 0 FINAL PLBG ~ ~ ~1.~%J tL" ! / FINALHTG L7~~ ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL OECK FfG ~~a~ j ! DECK FINAL ~ y ' sl ! ~J , - ~L Address 1031 wALN[rT RIDGE DR Zip 5512 3 I.ot ' 6 Blk ~ Sub t~c~v Pou~ SIx THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: ~(p 9~ Yes No Inspector: Final grade (6" from siding) Permanent steps (garage) Permanent steps (main entry) Permanent driveway ~ Permanent gas t/ Sod/Seeded grass ~ TraiUcurb damage ? Porch 1/ Basement finish Deck Please verify with the builder the removal of roof tcst caps fmm the plumbing system and the shutoff of water supply to the outside lawn faucet before freeze potential exists. Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ~ White - City Copy Yellow - Resident Copy Pink - Contractor Copy PERMIT . . \ CITY OF EAGAN , ~ 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 2 9 5 3 9 (612) 681-4675 Date Issued: 0 3/ 19 / 9 7 SITE ADDRESS: 1031 WRLNUT RIDGE DR LOT: 6 BLOCKs 1 LEXINGTON POINTE 97H P.I.N.: 10-95093-060-01 , DESCRIPTION: ~ 8~~ ldinc~~,,Permit Type SF OWG fBuilding I~J°0.rk Type NEW UBG qccupa~nc~~:~ R3/U1 Construction Typ~e VN _ : ZOFliR9 . ~ . RZ . Building~Lerr~tfi i~ L Buatldirig Wi,dth , > ~ 34 ~ Bui~2dfng stories ~ ~i~~a:ar~ F~et~ 1>628 C`~.nsu~~~C}rd~'' 101 1- FAM. DETACW . ~ tl ~ /~5 ~,1 /'-'~ti=~i~i ~ \i 1)~~ ~t~ o;`' ' - ~`~t, ~~~.`...".7 1~ ~~i~, L.`..._iA:. ~ i'a. ,.a . i ~ ~ 1 REMARKS: S& W PLBR - HESSIAN PLBG FEE SUMMARY: VALUATION $146,000 Base Fee $1,117.25 MISCELLANEOUS $1A539.50 Plan Review $726.21 Total Fee $4,405.96 Surcharge $73.00 ° SAC $950.00 5AC ~ 1~0 , SAC Units 1 Subtotal $2,866.46 CONTRACTOR: - Applicant - ST. GIC OWNER: ~SWENSON CUSTOM HOMES 16838289 2006576 SWENSQN CU5TOM HOMES 1565 CLIFF RD 3-290 1565 E LCIFF RD 3-290 EAGAN MN 55122 EAGAN MN 65122 (612) 683-8289 (612)452-7850 I hereqy acknowl~dgi tirat L have read this application and stats tHat the information is carrect and agree to comply wzth a2i applicable State ofi Mn. Statut'~s and~Gity b~f Eaga~rt Ord~nance~. ~ ~ L ~ ~aln R ~,LI Ih.~ APPIICANTIPERMITEE SIGNATURE ISSUED BY: GN URE a g~~~ 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) ~~r Q~/~ ~ , . CITY OF EAGAN a/aC~ L~'' . 3830 PILOT KNOB RD - 65122 681-4675 ~-R11~ New ConsWdion ReauiremaMS RemodeVReoefr ReauiremeMS J) q_ 1 , ZJ V ? 3 regiatered site suneys ? 2 eopies of plan. ? 2 copies of plans (include beam & window saa; pouratl fid. design; etc.) ? 2 site surveys (exterior addttbns 8 dedcs) ? 1 enarpy calculetions ? t energy calculatlona for heatetl addktons ? 3 eopies of tree preservation lan ff lot platteC aRer 7Hl93 ~ requlred: _ Yes ~ No ' DATE: IX~ - Z-~ , I q~1 CONSTRUCTION COST: ~ OC~O DESCRIPTION OF WORK: N~~ ~?~3fi'l.~c~l oY~ ~~1 ~m i I t_~ STREET ADDRESS: ~ ~ ~ ~ ~ ~'n~-k R ~ C~ . P~ ~ ~f~~.~ll LOT ~D BLOCK SUBDJP.I.D.#: ~~iv~/a Y1 l~ni Q'u"' .,r PROPERTY Name: ~Li1Et~~pt~l P~RAD~EV Phone#: `~5Z ~f~SD OWNER u.. ~ StreetAddress: ~~~5 E. C`i~' Rd~ ~u.i-~ 3-Z~'1U City: F~taC~..r~ State: M~ zip: ~~I~a coNritacTOR Company: SWENSON CUSTnM+~f~MASPhone#: ~2-~gSD StreetAddress: ~5G~5 ~.C~i.~ 1°Zd.~'3-Z~1o~icense#:~~~~57(05 City: ~l~D,Ck.~'l State: M,f~ Zip: 5 12, ARCHITECT! Company: ~1~1 4~lav~C~ cj ~.r~~eu i v~~~ Phone ~"5Z-~ ~SO ENGINEER Name:~YC~f~~.2-~.~ ~u~v-v~SOY~ Registration#: ~5Z3S Street Address: ~ S~S E• C~ ~~~d ~~~u-~-~o 3~2q v Cit~+: ~c~r r~ v~ State: .I Zip: -r~.~~~ Sewer 8 water licensed plumber (new construction ony): \(lY> ~~I lNl b I Yl/1 . Penatly 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 iniortnation is correct and agree to comply with ail applicable Sfate of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ' ~ ~ ~ a ~ ^ OFPICE USE ONLY / / CeRificates of Survey Received Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Required OFFICE USE ONLY ' ~ ~ ro, BUILDING PERMIT TYPE 0 01 Foundation o 06 Duplex o 11 Apt./Lodging n 16 Basement Finish ~02 SF Dwelling ? 07 4-plex o 12 Multi Repair/Rem. 0 17 5wim Pool ? 03 SF Addition o 08 8-plex n 13 Garage/Accessory ? 20 Public Facility a 04 SF Porch o 09 12-plex ? 14 Fireplace n 21 Miscellaneous ? 05 SF Misc. a 10 = plex o 15 Deck WORK TYPE 31 New ? 33 Alterations n 36 Move 0 32 Addition o 34 Repair a 37 Demolition GENERAL INFORMATION Const. (Actual) ~~J Basement sq. ft. ~ ir MC/WS System ~ (Allowable) Main levei sq. ft. ~ 3 City Water ~ UBC Occupancy R-~, J-1 2.~~ sq, ft, ~ ~ 3 z Fire Sprinklered Zonin9 ~ ~ sq. ft. tia~l PRV # of Stories 2- sq. ft. Booster Pump Length 5 a' sq. ft. Census Code. ~ o~ Depth 3~1, Footprirrt sq. ft. ~,~28 SAC Code vi Census Bldg i Census Unit i APPROVALS Planning Buiiding Engineering Variance Permit Fee Valuation: $ ~~I 6, oov Surcharge cvawl~pQ e ~ Plan Review License u ~ ~t ~ a ~ ~ 3~ ~ _ ~s~,.- MCNVS SAC Bas~r.~.1F City SAC WaterConn. 38 x a~ ~gD g i5 - 8 20, Water Meter 5 ~ Acct. Oeposit r SNV Permit ~ Z ` S/WSurcharge 38~,a~ q8~ Treatment Pi. 1 y ~o Road Unit ~ i z 3~, Park Ded. z ~ ~ ~ i~ ~ 5 `l ` ~ Trails Ded. Other 9 v r~~ ~ z v Copies 3 8,r a U q 8 d eX~ 8 Total: ~o X ~ ~i3a ~~~sy : ~~3',-- % SAC 4.~,,.,, y~ SAC Units aaxa0 4`+n 9 u ~ y~~! ic = ~,9vy.- ~ ,f.a, i. . . . . . . ' e . TRI-LAND C0. ~ ~ SURVEYING SERVICES ~ SITE PLAN FOR ~ S'~~~.Q~ LEGAL DESCRIPTION: ~oT~,BLOCK~,irx?~~s~~v pc;N}~2*'~ ACCORDING TO THE RECORDED PLAT THEREOF DAF{OT A_ COUNTY, MINNESOTA A R ~s~ D~. ~ ' C~ ~ ~ ~y Da Z Z q~--~ GAI~7 E GIlVi:c.I~.u'~~ Dt~t`~'T ~ M t~~uo w t 3.~---~- _ _ _ltfR11Y ! ~ i ' _.~.~3' O ~ ~ - ~ ~ ToP P~E.2M q~5,~5 ~ -1------_ _ B~ef : . _ . ~ j Y ~ o~( a. LOT ~ ~ - I 1°; ~ ~ ` ~ ~r~ ~ I~. \ I ' I ~ qE15, b9~ a35.5; \qg2 B; ~ ~ ~ '~`~5._ _ - C9Qn,o31 (asy~ J' ~ i ~ ~ ~ s~ ~Eat aau~'`.,'°~ ~ j t~ot~sE oNe ~ I ~O ' NuB ELF.1L--~-' I T 9B5.~J8 ~ ~ 485 5 ~ ~ 485.$3 985,33 (q~5_a8) ` - - - ~ C ~RAT I 9~3 \585_5~ ~ ~ . ~8s.0 ~ ~ ,_~_~e ~ ~ - p ~a--- _ , ~ ' -d~ 7s.oo ~ °j 10 ~ h ~ ,y t ~ N ~6' 23" ~__k;~ ~~G~N '^'Qt,,~,~- pr~~,-~ ~ h7 , . ' . . ~f .dV . ~ ~ . . . . _ . PI '~`1 ~ ; :.'DATE z-z5 -n-r 7 ' BUILDING INSPECTIONS DEPT. LEGENO ~Q'~~} ~'~V~ 9e~s INVERT ELEVATION AT SERVICE EXTENSi0N=99c~.?S o DENOTES IRON MONUMENT PROPOSED GARAGE FLOOR ELEVATION = 9~S ~ ~ DENOTES WO00 HUB SET PROPQSED FIRST FLOOR EI.EVATION DENOTES EELEV~ATIONPOT PROPOSED BASEMENT FLOOR 7 _ ELEVqT10N ; =%OENOTES PROPOSED SPOT ELEVATION ' DENOTES ORAINAGE DIRECTION NOTE' VERIFY ALL FLOOR MEIGHTS WiTH - FINAL HOUSE PLANS I hKrbr c~rfify tAat tAis aurvey,plon or repolt was preporod by me or undar my dUsct supervision ond that I am u duty Bradl~~ Mn. Raq. No. 13235 Rtlqiltterbd Land Surv~yor undsr ih• ~ Lows of tAe Stote of Minnesota. Oate ~ 2.~Y ~ LOT SURVEY CHECKUST FOR RESIDENTIAL , ` BUILDING PERMIT APPLICATION PROPERTY IEGAL: /l~ DATE OF SURVEY: Y j,`~~ ~ ~ LATEST REVISION: ~ ~ m H DOCUMENT STANDARDS a ~ ~ ? • Registered Land Surveyor signature and company ~ ~ ~ • Buiiding Pertnft Appiicant ~ ~ ~ • Legaldescription ~ ? ? • Addreas ~ ? • North arrow and scale ~ ~ • House type (rambler, walkout, split w/o, split entry, lookout, etc.) ~ ? • Direc6onal dreinage arrows with slope/gradierrt % ~ ? • Proposed/erisUng sewer and water services 8 invert elevatlon ? • Streetname ? ~ • Driveway ELEVATIONS E~dstlna ~p ? • Sewer setvice (or Proposed) ~ ? • Properly comers ? ? • Tap of curb at the driveway ? • Elevations of any ebstlng adjacent homes ra ~ ? • Garage floor ? o • First floor ? • Lowest exposed elevation (walkouUwindow) ef ? ? • Property comers • Front and rear of home at the foundatlon PONDING AREA ~f aoolicablel ? ~ ? • Easement line ? f.i~? • NWL ? fd~ ? • HWL - ? L9~/~ • Pond # designation ~ ~ • Emergency Overflow Elevation DIMENSIONS _ f~~ ? • Lot lineslBeadngs & dimensions - ~ ? • Right-of-way and street widfh (to back of curb) - ? ? • Proposed home dimensioms including any proposed decks, overhangs greater than 2', parches, etc. (i.e. all structures requiring pertnaneM foolings) B~~ ? • Show all easements of record and any City utilitles withfn th~e easements Pl ? • Setbacks of proposed sUucture and sideyarci setback of adjacent e~assdng structures ~ ? ? • Retaining wall requiremen if any Reviewed: N me / ate January 1996 CRAl07 W fl~BLDOPRM~. FM PFOPOSF.D6"D3P.wM B'.6'RFWf.r° • V ! CpISTRVCif.D ~NDf.9 ~ • LER PTF. BiH AOP SEE SNEEi Z N ~ lE%PiC BiH n~~. ~•1j6~ijj'~iM1j j~~_1jRJT~ Fi'i"ti AUUj'il(iRj ' p w _ _ \ _ ~ . - - - LE%INGTOn POirvTE P<RKWm' ~ ~ CoxSTRUGrt]L~NJDE c~ox A*[~ e~ocran ~ ~ U Z ~ ~ X. M ' LE%. PTE.9in PDO. SEE ST<. PLATE ~ 120 ~ a n - CJNNECT i0 Ex. 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' _i ~ ~ <a ocor ~ ; . '..f' . - ; ' . : ; _ : i ' ~ i. ~ . _ i t' 1 . : . ~ . i 1 ~ i . J V y 9 a o r : ~ _ m . . ; . 3 ~ . ~ ~ . . i F_. :I I i 7.00 6.00 '5~00 ~•00 3•00 2•00 I.00 WEST 0•DO FAST R.P. 2435 U u u u c o c~ c i I CITY OF EAGAN ERTERIOR ENYELOPE AVERAGE 'U' COMPUTATION . t i OitNEN: _ ~ W Cf1~501J ~ I I~ C `a.i 3IiE MDRESS: _ I031 In1Qt..n~ur ~tAG~_ BR. CONTRACTOR: ~~A~py151n ~1,`•sI-7tn~ tT1YY~toS DATE: 2 2~-I PHONE: 4'SZ=7~SL~ Determine tirorkieg square footage of each: t. Total exposed wall area Z~'~ ¢ sq, ft. x.11 - 32"1.~4- 2. Total roof/ceiling area S.~ sq, ft. x.026 = d 3 Total e:posed wali area above floor ~ ~8 5 3 a. Total wall window area 2(O 2 b, Total door area 3g c. Total sliding glass area ~ p d. Total fireplace wall area - ~ e. Total wall framing area (average 10~) 2 S f. Total net wall area above floor co5 , g. Total rim ~oist area 2to_~ Total exposed foundation area = 121 ' , h. Total foundation window area 1 1. Total net foundation area above grade ~ Deter~ine ~U' value o£ each Wall segment: a. 2cp2 x 'U' . 30 - 'lb,~ b, x ~U~ ~3 e C.~X'U' 30 = 12 0 d, o x' U' - , a ~ e. 2 S x,U' = 22~ ~ f. ~ x ~U' ,O ~ ~ 6• Zco 3 x~ U~ O I~`-~ h. 7 x' U' 30 - 2. I 1. [~4~ x' U' , U~- = 9. I 2 3 . Total e 2l °o ,~8 If item A3 is the same as or less than item 61, you have met the intent of SBC 6006(c)2, Total expoaed roof/ceiling area - S S ~ Total skylight area O i k. Total roof/ceiling framing area (average 10f) Co 1. Tota1 net insulated roof/ceiling area o~ ~ ~ , OVER ~ iL . Determine ' ~ u . U val e for each roof/ceiling segment. f, O x~ _ p k. //~O x~U' 02~i e ~.QS i~l;,~ . 1. /a39. x ~u~ ,022 - 22.St0 4 . Totel e 'LtO,~~ If total of /4 is'the same as or less than 92, you have met the intent of SBC 6006(c)1. Alternate Building Envelope Design To utill2e the total envelope system method, the values established by the sum ot Items 93 and 94 shall not be greater than the sum of Items At and 02. 7. + 2. _ 3. + 4. _ ~ ' 2 ~ CITY USE ONLY L ~I BL _L RECEIPT ~o~ 7-~~-~ SUBD. ~ RECEIPT DATE: 7' 9 7 1997 MECHANICAL PERMIT (RESIDENTIAL) CITY DF EAGAN 383D PILOT KNOB RD EIIGAN, MN 55122 (612)681-4675 Please complete for. . single tamily dwellings ~ townhomes and condos when permits are required for each unit ~ New construction Add-on furnace Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc. Date: L~ / ~ g ~ FEES ? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00 • HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ~a ? Gas Outlets (minimum of 1 required @$3.00 each) 3, ? State Surcharge .50 TOTAL ~ SITE ADDRESS: ~ ~ ~ ~ ~~~'~'~U ~ ~ ` ~~g'~ OWNERNAME: SGN GN50N /Ydy*~,~ PHONE#: 752'7~~~ INSTALLERNAME: ~ /TD/C/~'~~ /l'T~i ~~~G tjt~L. pHONE#: ~L3'J~ 8B~' STREET ADDRESS: 3~ r~ l s~ w• CITY: ~~~~/`7~ ~ J'~ r STATE: ZIP: ~sb 6~ ~A I ATURE OF PERMI7TEE CITY USE ONLY L CP BL / REGEIPT#; 7~~5~_ SU6~2~+. (,y'~ 7~ RECEIPT DATE: 5~' 1997 PLUMBING PERMIT (RESIDENTIAL) ' ~ CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4B75 Please complete for: . single famity dwellings . townhomes and condos when permits are required for each unit ~ backflow preventer for underground sprinkler system PIXTURES ~ ~4. TOTAL Shower 3.00 x ( _ Water Closet 3.00 x 3 = 9 Bath Tub 3.00 x ~ = G Lavatory 3.00 x = 9' Kitchen Sink 3.00 x 1_ = 3 Laundry Tray 3.00 x 1 = . 3 Hot Tub/Spa 3.00 x = Water Heater 3.00 x = 3 Floor Drain 3.00 x ~ = 3 Gas Piping Outlet • minimum - ~ 3.00 x L = 3 Rough Openings 1.50 x 3 = . Water Softener `for dwellings under construction 5.00 x ~ = S Water Softener ' for existing dwelling 20.00 x = U.G. Spfinklef ' ror dwelling under wnst. 3.00 = U.G. Sprinkler ' for existing dwelling 20.00 Alterations " to existing residence 20.00 = Water Turn Around 20.00 = Private Disposal System ' Dak Cty lic. 65.00 = (new and refurbished systems) - . - Private Disposal Systems' Abandonment 20.00 = STATE SURCHARGE ;SA TOTAL ~d~ I heraby adcnowledga that I have read this appiication, stale that the infortnation is arrect, and agreeto compy~wfth all spplicabre City of Eagan ordinances. It is the applipnPs responsibility to~notiy the property owner that the Ciry of Eagen'assumes noliebilky'~kr.any damages caused by the City during Rs normal aperational and maintenance activities to tlie fadlkies conStruded~undertA~s pertnRvuithin City property/right-of-wayleasement. ~ SITE ADDRESS: HES.aiati ai n~~[,~6C~6-I , ~U ~ r ~41 ~ y ~ 9601 Jefferson Trail OWNER NAME: Invo r p~;e„~m~ INSTALLER NAME: (6~2) 687-8252 TELEPHONE STREET ADDRESS: CITY: STATE: ZIP: _ i~~,~ , SIGNATURE OF P.ERMITTEE ; OFFICE USE ONLY