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3729 Wescott Hills Dr ~ . CITY OF EAGAN - 1 s e+ '3 ~ i M?~~kCWt" 3830 Pllot Knob Road, P.O. Bcx 21-199, Eagsn, MN 55121 ~ G=' ``'t n~ n":" OK PHONE: 454-8100 I BUILDING PERMIT Receipt~ ! To be used for 'r I!'.•t,i 6Ak Est Value ~ 134, GA) pate Z` ,19 , J Site Address 719 rvi 5!';,1 Tf ' t,L;.~ Qk OFFICE USE ONLY ~ ,...~1:s-•1 j On SRe Sewape Occupancy Lot Block Sec/Sub. ry_ MWCC 3ystem Zoniny 1 I Parcel Na V_!~ ~ On Site Well (Actual) Const a Name iriC CityWeter y (Atlowable) Y-N W Address ' ' ~ I.L li'.Y +!U PHV Required ~ of Stories ~ p 431 •7 506 Booster Pump Length JU City Phone S4' Depth , p Name S.F. Total ~ ~ Address Footprint S.F. ~ City Phone APPROVALS FEES Engr./Asseas. Permit ~~4• ~ = Name planner 5urcherge Address Council Plan Review . i W City Phone 100.J Bldg. Off. SAC, City I hereby acknowledge that I have read this application and state that the Variance SAC, M WCC 55c, .uj information is Correct and egree to comply with all applicable State of Water Conn. • 50. Minnesota Slatutes and City of Eagan Ordinances. Water Meter Signature o( Permittee ` Roed Unit f' 'N.`,'1}ij't.7?'if: A Building Permit is iasued to: ~ Treatment P1 on the express condition that all work shall be done In accordance with all applicable State of Minnesota Statutes and Ciry of Eagan Ordinances. Parka ~ TOTAL Building Official - Pennit No. Pormit Holder Det* TeNphone, #t Plumbing l?.cl Y/ H.V.AC. O / 40 Electric Softener Inspectwn Det* Insp. Comments Footings I 7 ~ a~z Footings II Foundation Framing ,f"_ Roofing Rough Pibg. Rough Htg. S~ Isul. Fireplace Final Htg. .1 Final Plbg. „ Bldg. Final Cert Oca 7ilA Temp. LP I Deck Ftg. Deck Final Well ~ Pr. Disp. ~ fgtr#ifiratr ,af Mrru~aury titp of eagan ErmrtmrnY a# ludDmg 3tsprrtiurc This Cernficate rssued parsuaret w 1he requinneents of Sectlon 306 ojthe Unifornt Building Code certijying that at the tilne of issuance 1hv structure ms tn cwnpliance with t/re mrious ordinances of the City regaluting buildtng consnvction or use. For rlte follvwing: uie Chudmfiw SF DWG/GAR ~ ~t No 15380 O-VPuiq .ry,a R-3 M--1 ZDMEDWAO R-1 TM ,~041111 V-N owea of &"M MCDONALD CONST Add„a 1212 BLUEBILL BAY btD NdIdirigAddR„3724 WESCOTT flILLS DR,,,, L2, B3, SUNRISE HILLS SEPTEMBER 27, 1988 ate: Bwldms OffloW POST IN A CON5PICUOUS PU1CE PERMIT 11 PLUMBING PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: S CONTRACT PRICE PHONE: 454-8100 Site Address BLDG. TYPE~ WORK DESCRIPTION Lot Blqck Sec/Sub Res. ? New - ~ Mult. Add-on ~ Name Comm. Repair ~u Address Other c Ciry Phone RE3. PLBG. ONLY - COMPLETE THE FOLLOWING: NQ. FIXTURES TOTAL ~Water Closet - $3.00 S ~ Name ~gath Tubs - $3.00 ~ 3 Address Layatory - $3.OQ _ . - , ~ • - - O City - Ptsone - -Shower - $3.00. Kitchen Sink - $3.00 = FEES Urinal/Bidet - $3.00 ~ COMM/IND FEE - 146 OF CONTRACT FEE ~Laundry Tray -$3.00 = APT. BIDGS - COMM RATE APPUES ~-Floor Drains -$i.50 TOWNHOUSE & CONDO - RES. RATE APPLIES Water Heater -$i.50 ? MINIMUM - RESIDENTIAL FEE - $12.00 Whirlpool - $3.00 MINIMUM - COMM/INO FEE -$20.00 _,~-Gas Piping Outlets -$1.50 STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT) (ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5.00 BEYOND $1,000.00) Well - $10.00 , v Private Disp. - $10.00 ~Rough Openings - $1.50 SIGNATUKE O PERMITTEE FEE STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL• 3 • ' _ PERMIT # MECHANICAL PERMIT RECEIPT # CITY OF EAGAN ~ 3830 PILOT KNOB ROAD, EAGAN, MH 55122 DATE CONTRACT P I • PHONE: 454-8100 - Site Addr~ss BLDG. TYP WORK DESCRIPTION Lot =k DIock ~r' Sec/Sub Res New ~ m Name Mult Add-on Address • ` - ~t Comm. Repair c City 'Phone Other FEES Name - RES. HVAC 0-100 M BTU - $24.00 c Address ' i" ADDITIONAL SO M BTU - 6.00 3.1 p City Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PEhMin - 1.50 EA. TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU 1 : . MINIMUM COMMERCIAL FEE - 20,00 STATE SURCHARGE PER PERMIT - .50 Vent CFM Gas Piping Outlets # BEYOND $1/pC p lp) PERMIT PRICE GOES Other , . , FEE ' % ' • . f S/C: ' SIGNATURE OF PERMITTEE . ~ TOTAL• - FOR: CITY OF EAGAN INSPECTION RECORD ~ CITY OF EAGAN PERMIT TYPE: J3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: I L t.i t APPLICANT: : . r~r r . i,, ~.rn1 r tiFl !v: np MnnrI lot, PERMIT SUBTYPE: TYPE OF WORK: INSPECTION . A 1 1 iitd t t I J ~ • ~ PemNt No. PwmR Hokler Dab TN~pho~s • ELECTRIC PLUMBING HVAC Impsctlon Deft Insp. Comments FOOTINGS FWND FRAMING ROOFING ROUGM PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST 1lS.IL GYPBOARD FIREPLACE FiREPLACE AIR TEST FINAL PLBG FlNAL tIT(3 ORSAT 7EST BLDG FINAL BSMT R.I. BSMT FINAL dECK FTG DEC1C FINAL INSPECTIUN RECORD 1 CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: R! + Eagan, Minnesota 55123 Date Issued: ti (612) 681-4675 SITE ADDRESS: ; , : APPLICANT: , ~ i €11 I i , iolt a~+rer ~~r.1~. ~••I ii i 1 ~ l r. s ~a, PERMIT SUBTYPE: TYPE OF WORK: INSPECTION DA • DA 1 ! tJ 1)1 L~ ~ Permn No. PrrmR HoWW DaES TNsphm • S/VN PLUMBING ~ HVAC ELECTRIC ELECTRIC Inepwtion Do1s Insp. Comm0nh I Foofings I FOUtId8t10f1 FlBflllflg AOOfiiQ Rough Ptb9- Rwo K9• Isul. FlrepleCe Flrrel Htg. I I ~ Orset Teet Fnal Pbg. Pbg. Inspector - NotHq Plirnber Conet. Me1er Engr.JPlan Bldp. Fnel h~g• ~ 3 ~S ~ ~s~ ~ H;o. Dedc Final & Well Pr. Disp. Ae _ _ CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: , r~ .•N t~~ n~ f ~ APPUCANT: ~ Illl.tti t!!Z ~i, i~~ ~ i,•~t tl~~; ~ PERMIT SUBTYPF: TYPE OF WORK: INSPECTION D • D ~ F- L ~ I Parmit Holder Dab Telaplwne 0 PLUMBING HVAC I Inspection Date Insp. Comments FOOTINGS FOUND ~ I FRAMING ROOFING Y~p/Qp T 7 I ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING I GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAI PLBG FINAL HTG ORSAT I TEST I BLDG FINAL DOMESTIC METER IRRIGATIdN METER FLUSH MAINS coNOUCrivirv TEST HYDROSTATIC TEST i BSMT R.I. . BSMT FINAL DFCK FTG ' DECK FINAL INSPECTIDN REC4RD ITY OF EAGAN PERMIT TYPE: ~ 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: ~ (612) 681-4675 SITEADDRESS' • APPLICANT• ' • Llt ',i u I I 'rl ~ I i~, uk r;1 I.111;, l! •.iINF~l'•.f It( I I '1 (6 1:`) PERMIT SUBTYPE: TYPE OF WORK: i~. ~ , ~ , . , ~ ~ , . ~ • ~ ~ INSPECTION . I ~ . PsrmR No. PKnNt HoldW De% TeIephone = ELECTRIC PLUMBING HVAC Inspeetlon Dab YIsp. Commenb I FOOTINGS ! FOUNU FRAMING ROOFIN(i ROUGH PLUMBINf3 PLBC AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FlNAL DECK FfG ! DECK FlNAL INSPECTION RECORD /CITY OF EAGAN PERMIT TYPE: ~ 3830 Pilot Knob Road Permit Number: t3 o Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: APPLICANT: <;fOT t 14 i! ( S 111t •sr,~; ~.I Ii ~ i k ~ :i I I PERMIT SUBTYPE: TYPE OF WORK: D • D• F L ~ PermR No. PonnN NoWer Daft Telephons # ELECTRIC PLUMBiNG HVAC inspretlon Dab Insp. Comm~nb FoorNGs 1O~Y FOUND FRAMING ROOFINCi ROUGH PLUM8ING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIfiEPLACE AIR TEST FINAL PLBG FINAL HTG aRSAT TEST BLDG FINAI j BSMT R.I. BSMT FINAL DECK FTG DECK FlNAL No Co tiNTIL CITY OF EAGAN N_ 15380 ENG APPROVES 3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121 PER DIANE ' PHONE:454-8100 BUILDING PERMIT Receiptu ~S 1 37' To be used for SF DWG/GAR Est. Value $134, 000 Date .IGLY 25 ,19$8_ Site Address 3729 WESCOTT HILLS DR OFFICE USE ONLY Lot 2 Block 3 Sec/SubSUNRISE HILLS OnSitaSewage _ Occupancy R-3/M-1 . Parcel No. MWCC System X Zoning R-1 On Site Well _ (ACtuap Const V-N a Name MCDONALD CONSTRUCTION, INC Grywater X (Allowable) V-N i 1212 BLUEBILL BAY RD PRV Required _ x ot Stones AddfCSS 0 City BURNSVILLE phone 431-7566 Booster Pump _ Lengih 70, Depth 34' ¢ Name SAME S.F.Total 0 oa Address FootprintS.F. u : City Phone APPROVALS FEES w w Name Engc/nssess. Permit 684.00 ti Planner Surchaige 67.00 x a Address Maw City Phone Council PianReview 342.00 Bldg. Ofl. SAC, City 100.00 ` I hereby acknowledge that I have reatl this application and state that ihe Variance SAC. MWCC 550. ~Q mbrmation is correct and agree to comply with all applicahle State of Water Conn 5$0. QQ_ MinnesotaStatutesandCrtypY~ nOrdi ce%pap ~ WaterMeter _6].00 SignatureofPermittee _~1~ RoatlUnit 3ZS..QO_ A ewldmg Permrt is issued~ o: CDONALD C_ON$TRUf.TIOIV- Treatment P1 204.00 on t he ezpress contlition that all work shall be done in accortlance wit h all applicable State of Minnesota Statute5 and City ot Eagan Ordinances Parks BuildingOfficial TOTAL 2.889•00 PLUMBING (RESIDENTIAL) ~ Permit Application ~ City Of Eagan 3830 Pilot I{nob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 Please complete for: Single Family Dwellings Townhomes and Condos when perntits are requaed for each unit Date 03 Site Address 3 1 0~ I ~ti/ z- Sc-, i~ I Is U TUnit # Property Owner Telephone # ( ) Contractor NL.fS ~a•~ P~~•~ ,S'~n•t~~' Address a a a City State f~ f1--7N Zip ~ S S i°2a Telephone #(G r ~ C. i~ Y" Pa S~ The Applicant is _ Owner Con[ractor _ O[her Septic System New _ Refurbished Submit 2 sels of plans and MPC license $ 100.00 Includes County fee. AddiHonal consultant fees may apply. Alter ti ns To Existing Dwelling Unit, Including $ 50.00 ~ Adding fixtures to lower levels or room additions, excluding water softener and water heater _ Abandonment of septic system _ Water turnaround 518" meter if needed -$121.00) Other: _ RPZ _ new installatlon _ repair _ rebuild $ 30.00 _ Lawn irrigation system _ Wa[er softener _ Water heater $ 15.00 _ replacement _ additional S[ate Surcharge $ 50 d.-s< Total $ S' I hereby apply for a Residential Plumbing Permit and acknowledge Ihat the informa[ion is complete and accura[e; that the work will be in conformance with the ordinances and codes of the City of Eagan and wi[h the Plumbing Codes; that I understand Ihis is not a permit, but only an application for a permit, and work is not to start without a pemtit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. . ~c ~ s ~ h , ~ ~1?~- Applicant's Printed Name ApplicanYs Signature ~ • RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 0-i ~ 3830 PILOT KNOB RD, EAGAN MN 55122 _1~ 651•681-4675 ~ NewConstructionReaulremente RemodellReoairReauirements~ • 3 registered sita surveys showirg sq. fl. of to6 sq fl. of house, aid all mofed areas • 2 wpies of plan (20% maximum bt coverege allowed) • 1 set of Energy Calculations for heated atlditions • 2 copies of plan showing beam 8 vnndow s¢es; poured lourb desgn, etc.) . 1 site survey for e#enor additions 8 decks • 1 sel of Energy Calcula6ons . Indicate il home served 6y septic system toradditions • 3 wpies of Tree Presenation Plan if bt platted after 711193 . Rim Joist Detail Option5 seleclion sheet (bldgs wiih 3 or less units) DATE II I U7 IC)Z- VALUATIONa /Qr 000 SITE ADDRESS 3_7 a-'1 0401 OdS blt MULTI-FAMILY BLDG _Y XN TYPE OF WORK PQV'rM, FIREPLACE(S) _ 0_ 1_ 2 APPLICANT ~l)~ ~~O~~I TviG - STREETADDRE55 3G43 WOD(JL IGbtiS TV'cJ CITY STATE MkZIP 5SiZ3 TELEPHONE #(QS/-6H -07YP CELL PHONE # 612 R7S-3i? 7 3 - Fax # 6Sl 11? 32 iS PROPERTYOWNER ~~kq~ l'Ia/L1 Al~hid TELEPHONE# (OPI-031M COMPLETE FOR "NEW^ RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MIYNF,tiO'C:\ RULL.S 7670 Cr\TEGORY l MINVLSO"1'A RULLS 7672 (J submission type) . Residential Ventila6on Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: _ Phonc # Pluinbing syslcm inclu(Ics: _ Watcr SoCtcncr _ L.awi Sprinl:lcr rcc: $90.00 Walcr Hcatcr lVo. of R.I. Ball)s No. of Batlis Mechanical Contractor: Phone # IMcchswic.il systcm includcs: Air Condiuoning Pcc: $70.00 _ [-IcaL Rccovcry Systcul ~ Sewer/Woter Contractor. Phone ~ ; ZC: / ~ I L ; I hereby acknowledge that I have read this application, state that the informatio I correct, ane to c I mply with all applicable State of Minnesota Siatutes and City of Eagan i nces. - ~ S(gnafure of Applicant OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY • . ? 01 Foundation ? 07 05-plex O 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Mul6 ? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck % 23 Porch (screened) ? 36 Multi ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding X 32 Addition ? 36 Move Bldg. ? 42 Demolish (FoundaGon) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors O 34 Replacement •DemoliNOn (Entlre Bldg only) - Give PCA handout to applicant Valuation Occupancy MCIES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const . Io Width T REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) 2( FinaUNo C.O. _ Footings (addition) _ Plumbing Founda[ion H VAC Drain Tile Other kuuC _ Ice & Nater _ Final _ Pool _ Ftgs _ Air/Gas Tesu _ Final _X Framing _ Siding Smcco Stone _ Fireplace _ R.I. _ Air Test _ Final _ W indows (new/replacement) _ Insulation _ Retaining Wall Approved By 1 Z , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC Wt ts Supply & Storage /Yl'r 2y0X 3a S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total . . . , . K4Z2-30O~NGiNEfRING ~OMSi1LTiHO Elt61NEfAS PIAHHEflS cnd LAHD IUAYEYd!!COMf~f~NY, INC, ¢o1 1C00 U37 14fi1lf S7AEZ7, BUAH-'YILLE . YINHE=OTA 3:_37 PCe~"~i~'z crz~e oly S`UrYe y ~~~s~7"~.a2+'crt • LCI7- 2, BLOCK 3. SUNRISC ADD/770N, 0AK07A COUN`Y, MINNESQTA ( a9s.s_ ) DENUfz E;C!_TNG (899S ) GEVOT='S FROFOSED EL!EVAT10N INCICi; 7-:-Z 01Rc~ lON Si1R.r=ACZ l-NAGc V O~~ ~9 ~ \~J Lil 10 r1-- 0 19 9 ~.0 ~ N•_ Ln 0 3 LE g (6? a ~ t-~p 1S~ ~ ~y\ c ~ ~eg, y ol t 0~'„ Q° (99955, 10 (89 / Ul 0 'p .5~ 2b ~ o (g{b~~ \ ~j, 0g-~.i) ~ W FJ>5 a 30' FRONT BUrLDING 7s SE773ACK UNE A rl~ ` ~ ,I '1 1 l `•---~A I Aer:by 4a~s !•=i.~:i:i {,s_ eartify that thia ia a t:ne and cor^ect repraaentitia"b~tlY~~~'~'of land as aho+m'and described heraon.- Aa praparad by mn on thii 14 daqr Ar .~~.-v , 19 85Y . . Hinn. llrg. fto. /~osf . , 1988 BUILDZNG PERMIT APPLICATION - CITY OF EAGAN, SINGLE FAMILY DWELLZNGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL HE ALLOWED ONCE BQILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL ONITS FOR SALE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COPMERCIAL INCLODE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: SFD /G/}R Valuation: 1341. 000 ' Date: M JUL 20kW Site Address 3-)29 WeSCaN;IIs Dr. OFFICE USE ONLY Lot ? Block On site sewage_ Occupancy -J M-1 MWCC system ? Zoning R-I Parcel/Sub SuAri5e 14~11S On site well _ Actual Const v-N City water ~ Allowable V•N Owner ML'ji.Awjd C'.asf,n,rF.i ~ T,y PRV required _ lf of stories Booster Pump Length Address 121Z Nu~~~l -8pDepth 34' • S.F. Total City/Zip Code B"rnfsV;1Je , 55337 Footprint S.F. Phone y 31- '754.fo APPROVALS FEES Contractor HeDnmpj[4 CCI.if'.. TivG Engr/Assess Permit Gg~.00 Planner Surcharge G 7, 00 Address SRnqe rez AboV2 Couneil Plan Review 3q2.0 o Bldg. Off. /71z5 SAC, City 1 pa, City/Zip Code Variance SAC, MWCC 55 D,DO Water Conn 0.00 Phone Water Meter /o~.p O Road Unit 25oOo Arch./Engr. Treatment Pl o,o O Parks Address Copies I TOTAL ~ City/Zip Code Phone fi . , C AT- AG . . 3f X3-z : qqZ Q4 2 x I`I 3~'X2~ 98~ ly x 9 ~z6 I I I 4 ILf U~ Z f' ~T T-Lbbrl~- ~X xZ = zX ~ xz ! i2 w 3~~x2 - i2 iic~6 x yq = S~i3y ~ lJr; ZGX a~' : ~18e .34.- ~024 X `Iq ' S017~ 133Sb~ a MC DOIqALD ~ aoe~ - PLANHEAS and6lAHD SJURVEYOBS E~GiNE~A1NG CCHSULTIHO COMPANY, INC. 1163¢O~ < 1000 GST 1461R S7AE:7, BURN=VILL-, YINNE:0T~1 5:33? PH 4:2°aOQCt C4C rZ z~'Z Ctz~e o~ S'~i'Ye c~ j~a4~l ~~cr~~~cTZ • LDT 2, BLOCK 3. SUNRfS[ hv_L.S A001770N, DAKCFrA COUN-rY , MINNESOTA ~ B98.5 ) DENCrlF-5 E>ClSTNG E1 2''1070N ( ss9 s ) GE,\JOTrS PROFOSED Pi E-VAT10N -Ar'-' INpIG; -1:-Z GlPc~ lON 017 SUR.T--ACZ:_ JRAINAGc 899,a= _ F~NI~i;E;1 GA sA6E %-:.~JR ~UA?70N , ~ (e98' ~ ` N r/' sa9 19 ° o p9 " ~ n~. _ ~gq95~ G '1.D 9 - AW ~ 30.0 \ 0 1 SCAI.E cagg,°~ o nS•~ ~ QL9y5) 1 _ Z \~p ~F1 ,O ~gyg 5) 10 /0 , ~ ~ i..~' 1~ s / ~ ? 'y~~~lL ~ R ~ 26 ~ o ~~b~~ \ ~69*5~ ~ ~ ~~b11 Qo ~ 30' FRONT BUILD/NG ~e o SETSACK UNE Zo000 ~ b ~ LUJ ZE ~ • N _ By Dnt "^'AV~1V •.~dt1 f I Aersby ca~rtify that thin in a t:ne and correct npnnentati~aa land as ahovn'and described heraon.• Aa prepared by fie on this -z_64 da9' Hinn. Rage Ho. /~sf ~:XTERiOR EIIVELOPEi AVEl2AQEul~1i1[IU UEP11R'lI~IC11T ° C017PUTATIOt1 "v (`Po be su6mitted tivitli building permit applioation) One or Two Family Uwelliiig Owner D 7J All Otlier 8fte Addreee oT L L Contraotor LU NegcF uill% U Date Plione LIIIEAL FEET OF 11 • EXPOSED Y7ALL ~ f t. above grade TOTAL EXPOSED WALL Af2EA 3Q, FT. OPAqUE WAI,L CotISTRUC'Ploll s "U" Value x Area Detail °°pU': n .o4.?J' x 3q.-FT. il<r" x FT,(U)(A) trom JMEEE ~~U~~ attaclted p° x 3q, FT.A M(A) sheeta npn X s@• FT. _ (U)(4) IIpu X sq. FT. ~ a (U) (A) x 8q. FT. _ (U)(A) wi~iDoWSI $fUll Vulue x Area llnice & Type ~N~IL- C~~~yyp~- npn 7 Sq. F'r. _H41F13 (U) (A) u x sq. FT. IIUII x s4 e'r = (~)(n) npn ' • _ (u)(n) x Sq, FT. _ (U)(A) ' WO[191 liUll Value x Area Italce. & Type S uUn I ZI r x sQ. F~P, (~)(A) u ° n~u X SR. FT. ",O•= rol (u)(A) n npu X $R. FT. (U)(A) - x SQ. FT. ' - (U)(A) znrnt.s ~~'ZSQ• F"r•_ _7cj'~ ~L_(U) (A) G1 ~ TOTAL (U)(A) VALUE9 AVEItAUE "~U Z I~i?jZ UIVIUED DY TOTAL {7AI,L AREA AVE[2AQE i!Uiv'- - •115 r lese for 1&2 fainily dwellinge 1200F/CEIL~4Q TOTAL AREAt (Q~ , betail referenae flUll 02-1 ~ Irom ' upu ~ x SQ. FP.~((-„ z11$3cu)(n) attaclied slieete, (U)(A) beecribe openiiige •flu 11 x 9Q. FT. _ . iu roof. --^~~pu x sq. F'P. = (U)(A) x sq. FT. (U)(A) TOTAL (U) (A) VALUE3 DIVIDCD BY C2 z 155 _a rALST~ ~ TOmA. ROOF/C~EiL-IAOA11EA AVERAOE ~'U,., p25 fdr. ventilated r~ I~~ Ib7'I . . 13. L~ ~ , ~ - 7 XCl$t 3) = 8e', o ~o ~54x ( 5Zt5'z~ Z~Z~) =15Zc~-`f- ~,8~ ~ ~~~x I~~! 13z, S ~ 1 3 xc~o I i~XZ-=o Z ~ 5 I 3- 2oXcoa = 3 3 X I= 33~~ ( zgx~ = ~I~~~ 1= II~~ I ~X3(o = 70X1= zoX taa =~+X z= 88, o I 5- Zax&o = 55,vX 1= !515 I 1 ZvX (00 = I I XZ = zZ, a I Z-I~oX~ ~ Ia~SXi = 1a,5 l I Z-z4k 3c~ = 1~1~SX z=~ V- W/ z4,i-, = 35, o I,G-SS P,uwF /07, z- z YA Z ~a ATR1Um = z,o N ~ZS ~Iq ~'7~5',75 I I~ ~ v Z~3Z,~"1 I ll ~ , ' --Y7ALL SECTION-- , , Determining ~~U~~ valuea at Roof; Wallt Rimo and Conc. Block ROOF/CEILIIJ(i B VALUE ~ 1.) Interior Air F'ilm 0.61 2.) 5/8,, ayn. aa. .56 3.) Insulation 00 4.1 5.) Exterior Air Film .61 ~ 2 3 ISTILL) upn = 1/R= 4O-2 I '1'OT/lL (R)=4W5 gO WALL R VALUE 9 6.) Interior Air Film o,68 • 7.) 1" Gyp. Ba. .45 8.) Insulation /9,oa 10. ) ~IIL ni~e~S iding Z6 ¢ l0 11.) Exterior Air Film ,17 nU" = 1/R= TOTAL (R)=Z~~D I --G ~ n IL RI17 R VALUE ~ 13 12.) Interior Air Filin r0~,(g , 13.) Ineulation ,ao 14.) 2" Fir Rfm Joiat 1,$8 ~ ?s 15 . ) 13V 1~7 ~Ii~ Zn4- 16.) 14aconite Siding ,67 170) Exterior Air Film .17 n , dQ • iipii = 1/R= TOTAL (R) = 2'4 j'TT U . , ~ • FOUtiDA'PIOII R VALUE 18.) Interior Air Film 0.68 ZI . . ~g 19.) . 20. bD tt , U 21.) k~"--6encrete ~~eeEe e ~ 70 22.) ~/L'1 pL`( Zl 23 23.) Exterior Air Film ,17 e „U„ _ ,iR= TOTAL eR>= zl,a9 ~ . dN , , CITY USE ONLY L BL ~ RECEIPT r~~~(D ~I SUBD. SUn r; S42~ r1 115 RECEIPT DATE: 6' )O' OC) PERMIT# 10370 2000 PI.UMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOS RD EAGAN, NA7 55122 651-681-4675 Please complete for: ? single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH # TOTAL Alterations to existing dwelling - minimum fee $ 30.00 Describe: Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas piping outiet ' minimum = l 3.00 x = $ Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x = $ Laund tray 3.00 x = $ Lavatory 3.00 x = $ Septic System newrreturnisned • requlres MPC Ile. 75.00 x = $ Septic System abandonment 30.00 x = $ RPZ new installation/repair/rebuild 30.00 X = $ Rough opening 1.50 x = $ Shower 3.00 x = $ Underground sprinkler if dwelling is under construchon 3.00 x = $ Underground sprinkler if existing tlwelling 30.00 x $ Water closet 3.00 x = g Water heater 3.00 x = $ Water softener if dwelling under eonsWcdon 5.00 x = $ Water softener it exiseine dwentng 30.00 x = $ Water tumaround 30.00 x $ State Surcharge 50 $ .50 Total $ d a Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. t hereby acknowledge that I have read this application, state that the infortnation is correG, and agrea to wmpy with all applieable Ciry of Eagan ordinances. Il is the applicant's responsibility to notiy the property owner that the City of Eagan assumes no liability for any damages caused by the City during its nortnal operational and maintenance activities to the facilities constructed under this pertnit within Ciry property/right-af-way/easement. SITE ADDRESS: 3 7°2 / w~L&GV 11i6 (04. OWNER NAME: IZI a4,4 TELEPHONE (AREA CODE) tNSTALLER NAME: TELEPHONE zr3 7:53 - 3 / (AREA CODE) STREET ADDRESS: ~I S CITY: ~L(q STATE: ; ZIP: ~ ~~e<6~ SIGNAT E OF PERNIITTEE -,FERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 3 2 5 6 4 (612) 681-4675 Date Issued: 0 7/ 17 / 9 8 SITE ADDRESS: 3729 WESCOTT HILLS DR LOT: 20 BLOCK: 3 SUNRISE HILLS P.I.N.: 10-72982-020-03 DESCRIPTION: REROOF Buildirig Permit Type STORM DAMAGE Building Work Type REPAIR Census Code \ 434 ALT. RESIpENTIAI ~ , REMARKS: FEE SUMMARY: CONTRACTOR: - Applicant - sT. LIC OWNER: BERWALD ROOFING 17777411 2001508 NEWHNLL ZEKE 2440 N CHARLES ST 3729 WESCOTT HILLS DR NORTH ST PAUL MN 55109 EAGAN MN 55123 (612) 777-7411 (651)681-0388 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 Mn. Statutes and City of Eagan Ordinances. L J APPLICANT/PERMITEE SIGNATURE ISSUED BV: SIGNATURE 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PII.OT KNOS RD - 65122 681-4675 ~ New Construdion Reauirements RemodeUReoair Requirements ? 3 registared ske surveys ? 2 copies of plan ? 2 copies oi plans (inGude beam 8 window saes; poured fnd, design, etc.) • 2 site surveys (exterior addkions & tledcs) ? 1 energy wlalatians ? 1 energy calwlations for heated additions ? 3 copies of tree preservalion plan if lot platted after 717193 required: _ Yes _ No DATE: 7/1++/98 CONSTRUCTIONCOST; $8.593•40 SCRIPTION OF WORK: Replace storm damaged roof v STREET ADDRESS: 3729 wescott Hi11s Dr LOT: a O BLOCK: 2) SUBD./P.I.D. S LLV1 Y+ S-Q- 0V\ ~ Name: Newhall Zeke Phone681-0388 PROPERTY Lut Fvst OWNER Stree[ Address: 3729 Wescott Hills Drive City Eagan State: MN Zip: 55123 Company: Bervrald RoofinF Co., Inc. Phone#: 651-777-7411 CONTRACTOR ? Street Address: 2440 North Charles Street License # 20015088 City North St. Paul State: MN Zip: 55109 ARCHITEC7/ ENGINEER Company: Phone Name: Registration k: Street Address: Ciry State: Zip: 3ewer & water iicenscd plumber (new construction ony): . Penalty applies when address chang and lot change is requested once permit is issued. I hereby acknowledge that I have read this appiication and state that the infortnation is correct and agree to comply with all applicabl State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ~ v OFFICE USE ONLY RECEIVED Certificates of Survey Received _ Yes _ No , Tree Preservation Plan Received _ Yes _ No _ Not Required $y; OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging 16 Basement Finish ? 02 SF Dwelling ? 07 4-plex ? 12 Mu{ti Repair/Rem. ? 17 Swim Pool 0 03 SF Addition ? OS 8-plex ? 13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. ? 10 = plex ? 15 Deck WORK TYPE ? 31 New Alterations ? 36 Move ? 32 Addition 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bldg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: ' % SAC SAC Units C'LTY UF LAGAN CASHIEfF^ JS TrFFAfINAI._ tQO: 761 DRTE: 01/30/98 T7:MFN 13:37:00 IU~ NAME: LNTCHCf; fiEMOLiEI_SNG INC 3210 3001 3729 WSCTT HL..S 20u25 3422 9001 3729 WSCTT HLS 137.96 205 9001 3729 IaISCTT HLS 7.00 ^ 1 To+.al fieceipt Ainaent,: 357.21 CFifJB`.:iBE) i USF_F 2D: JAN ~k~XtX~~kxY ~CXc~~C~Xc~Cr~~e~C~CkcXc~kc~Cx~x~Xckc~C~k~CYFkc%~%~~~CV~~C~~ PERMIT CITY.,OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 031257 (612) 681-4675 Date Issued: 01 / 3 0/ 9 S SITE ADDRESS: 3729 WESCOTT HILLS DR LOT: 2 BLOCK: 3 SUNRISE HILLS P.I.N.: 10-72982-020-03 DESCRIPTION: B'uilding Permit Type SF ADDITION Building Work Type NEW Census Code ~ 434 ALT. RESIDENTIAL ( 1 r !i REMARKS: A SEPARATE PERMIT I3 REQUIRED FOR RNY PLUMBING OR ELECTRICAL WORK FEE SUMMARY: VALUATION $14,000 Base Fee $212.25 Plan Review $137.96 Surcharge $7.00 Total Fee $357.21 CONTRACTOR: - Applicant - ST. LIC OWNER: IW43 TCHER REMODELIN6 16880758 2003599 NEWHALL MARK WOODLAND TR 3729 WESCOTT HILLS DR cAGAN MN 55123 EA6AN MN 55123 (612) 668-0758 I hereby acknowled9e that I have read this application and state that the information is correct and agree to comply with all applicable State ofi Mn. L Statutes and City of Ea9an Ordinances. J ~ c -~O~V~ ~ APPLICANT/PERMITEE SIGNATURE ISSU BY: I NATURE 312-9 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) cirv oF e,acaN 3830 PILOT KNOB RD - 55122 ~ A~ 681 -4675 New Construction Reauirements RemodeVRenair Reauirements ? 3 registered srte surveys ? 2 copies of plan • 2 copies of plans (inUude beam 8 wintlow s¢es; pouretl fiE. tlesign; etc.) ? 2 sita surveys (extenor aCORions & decks) ? 1 energy ealculations ? 1 energy calculations for heated atltlitions ? 3 copies of tree preservation plan if lot platted after 7/1/93 required: _ Yes _ No ~7 J DATE: CONSTRUCTIONCOST: C-) OO 0 DESCRIPTION OF WORK: STREETADDRESS: LOT I` BLOCK SUBD./P.I.D. ~ IIY~h i~ 0 i~, PROPERTY Name: Phone _ OWNER StreetAddress:-37d-~ G~-SC.'~s~~ln~(S ' Ciry: Fo-~j a vti State: Zip: ~5~ Z 3 CONTRACTOR Company: 1,Uk/I.ei- Phone Street Address: -,3 UVJ&J T!', License zoo 359 9P City: State: fijt7 ZiP; SSlZ,3 ARCHITECT/ Company: 1 Le,hs brH7q v, y Phone #4iS- 579 7 ENGINEER Name:~ IG!'c Registration Street Address: ~City: Vvei State:Vnh. Zip: 55379 Sewer 8 water licer.~ed plumber (new construction only): . Penalty applies when address change and lot change are ~equested once permit is issued. I hereby acknowledge that I have read this application and state that the information is correct agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY i Certificates of Survey Received _ Yes _ No 007 Tree Preservation Plan Received _ Yes _ No _ Not Requir e: i OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation o 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish 0 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool fi' 03 SF Addition ? OS 8-plex ? 13 Garage/Accessory ? 20 Public Faciliry ? 04 SF Porch o 09 12-plex ? 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. 0 10 _-plex ? 15 Deck WORK TYPE ? 31 New o 33 Alterations ? 36 Move ,z( 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC/WS System ~ (Aliowable) Main level sq. ft. City Water ~ UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. -.l3-/ Depth Footprint sq. ft. SAC Code v/ Census Bldg i Census Unit v APPROVALS Planning Building Engineering Variance Permit Fee Valuation: tu, 000, l Surcharge Plan Review License 19z Q{ ~ r S - Z g Q0, ~ MCNVS SAC m a;~ City SAC WaterConn. ~qL ~!{Sy= Iv~ Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: v. % SAC SAC Units . e MC DOI~ALD CpHSULTiNO EH61HEf!IS CO/.~ST ~4NGiNEERING PIAHHEAS oed LAHD ~URVEYOfIS COMPANY, INC. 1634.01 ~ K700 G57 IS6E1 57AE:7, BURN=VILL°_, YIHHE:07T 5:337 pH 4=2-v0pp Cer~z~'z crz~e o~ ~~-Ye c~ cl .~h~cr~~c~crc• LgF 2, 6LOGK 3. SUNRISC HI_!S ADOr77CN, DAKUTA COUNTY, MINNESQ~TA ( a9is ) DENOTES E'iC157NG EL,-~'AT70N ( s99-s) CEVOTES PPOFOSED Fl rV,4T70N A-` )NolcA-,z-; cIRtc70N 017 suR?=Ac,c- DPaIrvaGc- FlNI5HE:j- GA: AGE =:-~R ELEVA770N 9',y~• aG~ a 1q o o~~ 2 ; CQ ~ 'o 6. 3p ~ \ ~ ~j9a~) \ 0 1 AL.E J` ;gegol ~LO 3~ L L 4 A0, ' \ ~ Z S " i^Q y6 5~ ~ 10 O ~c ? ,•-.1' ~4\ „ 1 J \ ,s o (899 5) O ~Fl`~ Q ~ pM`TpC' ~5~ ~ ~ . 0 30' FRONT BUILD/NG SETHACK LJNE .036E Ap $ lla ~ Y 't asd56 EAGAN E1VGI~ p I her:by caMify that thia ie a t:~ie and corrsct repraaentitionElSjjW*EMof ljnd as aho+m' and deecrihed hereon.• Aa prapared by me on this -z6r4 day oa su-Y , 19 ~ . - Hinn. !loge He. CITY C!= ':_Prr.~ r'E'RMINAi_ N0;. 85 p'',T'::• 10/22/97 7.41 :0:79„1' r.nMr_~r. ief~~r.~i-Ni•ips~r.~ i_rz~ t -».I'l ?f?t)' 3729 ,•'rSi:QT'" 'T :i2. 2:7 2155 'aU,Oi. -,;,P,:, Np_Er-Or- ;.,t nr, 7'nQ' !"fPC"ninr. nliOl/nl. 5„25 ri yp)l: c . 77P i %1m7V ~ CITY OF EAGAN PERMIT 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 031002 (612) 681-4675 Date Issued: 10 / 21 / 9 7 SITE ADDRESS: 3729 WESCOTT HILLS DR LOT: 2 BLOCK: 3 SUNRISE HILLS P.I.N.: 10-72982-020-03 DESCRIPTION: (ADDITION) Building P,ermit Type FOUNDATION Building Work Type NEW Census Code ' 434 ALT. RESIDENTIAL l ~ ! ~ / . ~ .t . REMARKS: FEE SUMMARY: VALUATION $6,000 Base Fee $112.25 Surcharge $3.00 Total Fee $115.25 r CONTRACTOR: _ qpplicant - Sr. LIc OWNER: WALDENWOOD ' 14744150 0002302 NEWHALL MARK 24925 GLEN RD 3729 WESCOTT HILLS DR SHOREW000 MN 55331 EAGAN MN (612) 474-4150 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 Mn. L Statutes and City ofi Eagan Ordinances. ~ d R,,~APPU NT/PERMITEE SIGNATURE ISSUED UY: SIGNATUR ~E~~ ~I Q o~ 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) I ~.Jr• ~ CITY OF EAGAN 3830 PILOT KNOB RD - 55122 681 -4675 New Construction Reauirements RemodeVRenair Reauirements ? 3 registered site surveys ? 2 eopies of plan • 2 copies of Dlans (include beam & window sizes; poured fnd. daaiqn; etc ) ? 2 ske suneys (exterior atltlitions 8 tledcs) ? 1 energy calculations • 1 energy calculations for heated atlditions • 3 copies of tree preservation plan H lot platted aftar 7/1/93 required: _ Yes _ No DATE: lo^ r, -,q-7 CONSTRUCTION COST: D 0 DESCRIPTION OF WORK: :R>crr ^»S ~°°'n ncld'n, STREETADDRESS: V c~I -L-cI VNFSco"Cr Ff I L-LS D2-1 `14- LOT BLOCK ~J SUBD./P.I.D. PROPERTY Name: Phone OWNER StreetAddress: 501L Ciry: lo~j State: Zi : L~LL~-E~ -f4-7 Z coNTw?C7oR Company: ~Phone #:g-74- 1 f Sc-) Street Address: `~~(~S 6LF,•( ~ . License I"~aZ City: State: Zip: 5-53 ARCHITECT! Company: VJk-D4.4y-kpuD Phone ENGINEER Name: Registration Street Address: City: State: Zip: Sewer 8 water licer.-ted plumber (new construction only): Penalty applies when address chanc= and lot change are, equested once permit is issued. ~ i hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicabL- State of Minnesota Statutes and City of Eagan Ordinances. Signature of Appiicant: L~/vl" OFFICE USE ONLY D @~~ v~ Certificates of Survey Received _ Yes _ No QCT 171997 Tree Preservation Plan Received _ Yes _ No _ Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 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 o 13 Garage/Accessory ? 20 Public Facility ? 04 SF Porch ? 09 12-piex ? 14 Fireplace ? 21 Miscellaneous ? 05 SF Misc. ? 10 = plex ? 15 Deck WORK TYPE 0 31 New ? 33 Alterations ? 36 Move X 32 Addition o 34 Repair ? 37 Demolition GENERAL INFORMATION FnC"f-~`r ~ T~x.,~tn~~ oNU( Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Main levei sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump -47~- Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Dt Census Bldg I Census Unit 0 APPROVALS Planning Building f~M Engineering Variance Permit Fee Valuation: $ 1,10000. 00 Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SIW Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total:-," ' • SAC SAC Units' McooN.a~.o ~ . ,~d 8 E Co~,ST `i tn COHS11lTiHO EH61NEfA5 /NG4NELIlING PLANNEAS ond LAHD iUAYEYOfIS ~L COMnf~NY1 INC. r634o1 ~ 1000 UlST 146ttt S7AE:T, BIJAHSVtLL_, 1lINNE=flTJ1 S:'_3? pH ~=2-dOQp . ~a~ cl .L~~cri ~p +CTL • LO7- 2, BLOCK 3. SUNRISC HI_L5 qpOR7pnJ, DAKUrA COUNT~ , MINNESCT~A ~ 398.5 ) DENUfES E<!_Ti/VG EL~+/q~'70N ( s~ s) CEVOT"c5 PFcOFOS~ EL!~'VATJON INOIC.i; i~; G1REC.`iON O~ SURt=/.~Cz DRA1NAGc F)NISM~ GAKAGE P:..OOR E~ ~VATTOIJ (ese~~ ~ , '0 ~ BY o'XI~ ° z9O o e,_ Z \ C 1~ \ ~ \ ~ ~ ~0 9 LDING I PECTIONS DEPT. ~ w~o .0 "o~_ ~ iALE : l'e?O - , u, / - ~~-,r<• ` ~95) ~ ~A~ 3.0 `eg8.ol ~ \ \ ~Lo~ Zyo P\ ,L,,~ ~O ; ; - ~ ~~~e° (99B•55) ~10 . ~Q r, 14 s / J ` ~ c 1 yb0 'o ~~{61~ N~ ~ ~ ~gq2s)y s~! . Yu ~ Fj~ 30' FRONT BUILDING SE784CK UNE yoc).°. 36 'lr-'. N69 Dat EAGAN ~ t~v*"T ot I her:by ceMSity thdt thia in n t=~se and ccrrect t~eprasantTitionERj lind a: ahovn" and descrihed herton.• Aa prepared by me on this -z6r4 da5' 0 S~'-Y • 19 8iY . . • ~~8~ - Ninn• Rlge Ro . . Exterior Envelope Thermal Transmittance Worksheet SITE ADDRESS 1Z°1 4,6co{( ~~tt-C_,S D2 CITY WALDENWOOD EGEAN NAME OF PERSON COMPELETING FORM DATE JOSEPH G. DURAND 10/14/97 ASSEMBLY AREA U-Factor U-Factor Sq. Ft. x Area ~ Insulated Area 172.800 022 3.775 o Framing Area 19.200 .025 .482 o Skylight .000 ~ Other .000 000 ~ .000 ~ 000 .000 .000 Totals A 192.000 1~ B 4257 „ Average U-Factor B 4.256792254 /A 192 .022 UNWIM o Re uired U-Factor (from Energy Code): lummmi .026 m Insulated Area 2 496.941 046 22.996 Framing Area 2 55.215 .105 5.824 Windows ' 126.547 .290 36.699 Doors .000 .136 .000 Rim Joist 33.000 .043 1.432 ~ Fireplace Wall .000 ~ Above Grade Foundation Wall 29.340 048 1.400 Foundation Windows .000 ~ PATIO DOOR 40.000 310 12.400 .000 y .000 0 000 a .000 x .000 W .000 Totals E 781.043 F 80.750 Average U-Factor F 80.75049524 /E 781.043473 IfflilM .103 ongim Re uired U-Factor from Energ Code): .110 SWAM= If C is greater than D, or G is greater than H, revise the design as necessary to meet the envelope criteria of the Energ Code. 1) U-factor for skylighl and window musl be delermined by the Nalional Fenectration Rating Council Standard 100-91 or ASHRAE 1993 Handbook of Fundamentals, Chapter 27, table 5. 2) Thermal Trensmittance of opaque components (including integralry insulated masonry and metal stud framing)- use part 7670.0450, subpart 4. , Form for use with Minnesota Rules part 7670.0475, Subp.2 1& 2 Family Residential "Cookbook" Method SITE ADDRESS CITY 3729 WESCOTT HILLS DR. EGEAN BUILDER DATE WALDENWOOD LTD 10/14/97 Minimum Criteria: Rim Joist: R-19 insulation Foundation Windows: Insulated glass, 717' air space, wood or vinyl freme Entry doDrs13l4 inch solid vrood with storm or better STEP 1 Window 8. Door Area STEP 2 Calculate area as a percent of wall Total Window & Door Area Sq. Feet Box A(window & door area)divided by Box B(total WINDOWS (including foundation windows): wall area) times 100 equals the window and Dimensions Qty Area door area as a percent of wall area (BoxC) 11.583 5.416 1.000 62.734 Bax A 126.547 x100= 16.835 9.916 5.416 1.000 53.705 Box B 751.696 Box C 2.333 4.333 1.000 10.109 0.000 0.000 0.000 0.000 STEP 3 Design Features 0.000 0.000 0.000 0.000 ASSEMBLY OPTION 0.000 0.000 0.000 0.000 0.000 FRAME WAIL: 0.000 STANDARD FRAMING ~ 0.000 ADVANCED FRAMING 0.000 0.000 CAVITY INSULATION R- 18.000 Total Window Area 126.547 SHEATHING: DOORS: LESS THAN R-5 ~ 0.000 0.000 0.000 0.000 R-5 OR MORE 0.000 0.000 0.000 0.000 0.000 WINDOWS(EXCEPT FOUNDATION WINDOWS): Total Doors Area 0.000 U-FACTOR U- 0.290 Total Area of Windows & Doors 126.547 From the table, determine the maximum percent BOX A window 8 door area for the design options selected Total Wall Area in Sq. Ft. , and enter the value in box D below: Wali Total Perimeter Height Area 44.000 17.084 1.000 751.696 18.800 0.000 0.000 0.000 0.000 BOX D 0.000 0.000 751.696 BOX B Box C must be less than or equal to Box D Assembly R and U-Factor Forms ASSEMBLY ROOF (cb FRAMING ASSEMBLY ROOF INSULATION Material Describe Thickness R-Value Material Describe) Thickness R-Value Interior Film Coefficient .610 Interior Film Coefficient .610 5/8" Sheetrock .560 5/8" Sheetrock .560 3-1/2" Truss 6.870 12" Insulation 44.000 Insulalion Balance 31.166 Exterior Film Coefficient .610 Exterior Film Coefficient .610 Total Assembl Thermal Resistance 39.816 Total Assembl Thermal Resistance 45.780 Assembly U-Factor 1lTotal R 025 Assembly U-Factor 1lTotal R .022 ASSEMBLY WALL (cb FRAMING ASSEMBLY WALL INSULATION Material Describe Thickness R-Value Material Describe Thickness R-Value Interior Film Coefficient .680 Interior Film Coefficient 680 1/2" Sheetrock .450 1/2" Sheetrock .450 5-1/2" Stud 6.870 5-1/2" Insulation 19.000 1/2" O.S.B. Shtg. .700 1/2" O.S.B. Shtg. .700 Redwood siding .610 Redwood siding .610 Exterior Film Coefficient .170 Exterior Film Coefficient .170 Total Assembl Thermal Resistance 9.480 Total Assembl Thermal Resistance 21.610 Assembl U-Factor (1/Total R .105 Assembl U-Factor 1lTotal R) .046 ASSEMBLY WALL RIM ASSEMBLY EXPOSED BLOCK WALL Material (Describe Thickness R-Value. Material Describe Thickness R-Value Interior Film Coefficient .680 Interior Film Coefficient .680 5-1/2" Insulation 19.000 5-1/2" Insulation 19.000 1-1/2" Joist 1.890 12" Conc. Blk. 1•110 1/2" O.S.B. Shtg. .700 Redwaod siding 610 Exterior Film Coefficient .170 Exlerior Film Coefficient .170 Total Assembl Thermal Resistance 23.050 Total Assembl Thermal Resistance 20.960 Assembly U-Factor (1lTotal R) .043 Assembly U-Factor (1lTotal R) .048 • ~ / pNT_- & TWO-PAMILI' Ri:SIDEN"ITAi. BUTf.DING PRLSCRII'TIVL (COOK-BOOK) : nPPROACH , MAX[A4UM IVINDOW AND DOOR AREA AS A PLRCGh'T OF OVERALL WALi_ ARL•A From Minn P.ules part 7670 0-175 subpart 2, item P ' Cavit Window U-Factor Framin Insulation Sheathin 0.49 0.36 0.31 0.27 STANDARD R-13 > R- 7 13.4% 17.5% 21.3% 24.3% STAIv'DARD R-13 > R- 5 12.4% 16.4% 19.7% 22.5% STANDARD R-15 > R- 5 12.9% 17.1% 20.1% 23.4% . STANDARD R-18 < R- 5 12.1% 16.0% 18.8% 22.0% STANDARD R-18 > R- 5 14.0% 18.6% 21.8% 25.3% ADVANCED R-18 < R- 5 12.9% 17.1% 20.1% 23.4% ADVANCED R-1S > R- 5 14.5% 19.2% 22.5% 26.1°/a STANDARD R-21 < R- 5 12.8% 17.0% 19.9% 23.1% STANDARD R-21 > R- 5 14.5% 19.3% 22.50/o 26.10/6 ADVANCED R-21 < R- 5 13.6% 15.1% 21.2% 24.6% ADVANCED R=21 > R -5 15.0% 19.9% 23.2% 26.9% Additional calculated values STANDARD R-17 < R- 5 11.9% 15.7% 18.4% 21.5% STANDARD R-17 > R- 5 13.8% 15.4% 21.5% 25.0% ADVANCL•D R-17 < R- 5 12.6% 16.8% 19.6% 22.9% ADVANCGD R-17 > R- 5 14.3% 19.0% 22.2% 25.7% Notes: Windocv area equals rough opening minus, installation clearances. 1Vindocv U-factor must be determined by either the National Fenestration Rating Council standard 100-91, or ASf-IRAE 1993 Handbook of rundamentals, Chapter 27, Table 5. r Iv C:CTY OF F_AGAN CASi"III".F.,' S Tf.RMINF1I._ N'OC c:i nAYH, ioizJi96 'iTNE, il.:5004 mAM!_;; MAhK NE'dHALI_ 38!0 9001 3729 WCSCOTT HI 29.25 ai`S:i 9001 3r'29 IAII.E;rp7i' FI'[ 0.50 MP) Rf'C.a+Pt Mi.!/1,', F9,75 ("i(lE.i,!l!.IJ us:r:.P zPc OaI Q PERMIT ~ CITY OF EAGAN 3830 Pifot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 2 9 0 7 7 (612) 681-4675 Date Issued: 10 / 21 / 9 6 SITE ADDRESS: 3729 WESCOTT HILLS DR LOT: 2 BLOCK: 3 SUNRISE HILLS P.I.N.: 10-72982-020-03 DESCRIPTION: ~ ~(PORCH FOOTINGS) Building-Permit Type SF (MISC.) Building Wo.rk Type REPAIR Census Code ~ 434 ALT. RESIDENTIAL ^l - . ~ REMARKS: FEE SUMMARY: VALUATION $800 Base Fee ' $29.25 Surcharge $.50 Total Fee $29.75 t CONTRACTOR: OWNER: - Applicant - NEWHALL MARK 3729 WESCOTT HILLS DR EAGAN MN 55123 (612)985-4220 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 Mn. ~ Statutes a~~y of Ea a Ord'n ~ r / 'APPLICAN7/PERMITEE SIGNATURE ISSUED B SIG ATUF 1q, ~ CITY OF EAGAN 3830 PILOT KNOB RD - 55122 qq 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Construetion Reauirements Remodel/Reoair Reauirements ? 3 registered site surveys ? 2 copies of plan ? 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ? 2 site surveys (exterior additions 8 decks) ? 1 anergy calculations ? 1 energy calculations lor M1eated addilions ? 3 copies of tree preservation plan if lot platted afler 711/93 requlred: Yes No DATE: CONSTRUCTION COST: DESCRIPTION OF WORK: STREET ADDRESS: e 61 16i~ G~S ' LOT ~ BLOCK ~ SUBD.lP.I.D. 1 A1k/~fQ . PROPERTY Name: Phone OWNER Street Address: City: ~-l State: J~ Zip: CONTRACTOR Company: Phone Street Address: License City: State: Zip: ARCHITECT/ Company: Phone ENGINEER Name: Registration Street Address: City: State: Zip: Sewer & 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 information is correct and agree to comply ' all applicabie State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ~ OFFICE USE ONLY Certificates of Survey Received _ Yes No OCT 1 7 1996 Tree Preservation Plan Received Yes No OFFICE USE ONLY , -i BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish 0 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool ? 03 SF Addition ? OS 8-plex ? 13 Garage/Accessory ? 20 Public Facility 0 04 SF Porch ? 09 12-plex o 14 Fireplace ? 21 Miscellaneous ,4r 05 SF Misc. ? 10 = plex ? 15 Deck WORK TYPE i~i~ ~ pp ~ e~ !>~1I 'V ? 31 New 33 Alterations ? 36 Move ? 32 Addition ? 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MClWS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bldg ~ Census Unit AJ APPROVALS Planning Building Engineering Variance Permit Fee Valuation: Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SIW Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units S'GIe(2kul - h coPr. ~s~, AaolF'`S Qa ( ~ ~ ~"L ' ~ durk il~•ali~~ I I 203 LITTLE CANAOA NOAO aeruu'reu 'ru 372U IUc uu I t II i I I:: hr SAIUTPAUL '\iI1111C:~t)Iil AIINNESOTA 53117 . TE1.: 612-490-9266 FAX. 612 490-9263 ~ , • ~ . reuJr:ci . Rccuwiueind.ii 3~'~~l 1Vc:;iul t Ili I Is I~i' ~ROFEStiIONALENGINFERINGCONtiUI.'1'AN'fS I'ti-tin. ".linn.•..ol,l IryCORPONATED AIIL'Ll:it 1. IqQl, DATf: : ['Li' k31165 I N'I'P.ODUC'T I qN 'I'his reporY concerns our uhservations of pier fuunil.it iun:; fur a four season porch attached fo the single faunily re:;iilUncc ui 3729 P'cscott Hills Drive. Ea_nr,. Plinne:tot&. 1N.: undef>:tnuiii vnu hnve experienced froal lieave of [he isolated pier fuundat iwnn for the uo rch. Accordinglv. vou ftu-uished us the foI luu- in_ Lac6:eic,und infonnatinn: 1. l'he dtvelline is consti'ucted nn u prcpa red pad o i' uneinuu rcLl fill soils. The fill soils ure predowinaunil>• cla>. 3. The four season porch was construcled th rcc v ea rs aieu. , Founclation pier excavations eztended 4,;" below _radr. 1'lie piers were consiructed by excxvei[ini inlo llic sul,yrade: suil:; and I'illinK the excxvalion with cuncrete. I'ier escavation were ~ belled on Lhe bu[tom. 3. 1'ou experienced frosl henving uf lhe purch _;on_, lruclinn. 'fherufore, you excavateJ a trench and installed 4" perfointe(l drain tile tu provide a drain 1'or water accuinnlatine <it Uie bol[om of the piers. 'I'he dreiin li le wUs uxlendcd tu dr<iin Lu daylighl on Lhe backslope behind lhe house. 4. Y'ou experienced frost heavine of lhe porch founclntion IasL yeni• after the drain [i Ic Itfid bee;n inslril lud. On July 24. 1996, you authorized our services lo muke obz,ervatinn; of the purch pier construction, explure lhc suh2radc ;oi I conditions and to provide recowmendntions to currect L liu ~i"rch licnvine. CONCI.USiONS AND RI':CoMMI:NI)A9'ION; Elased on our observations. vour bacl:ground inl'ormatinn i;f thr norch nier cunstruction and our hanil augur bortngs iulo ndj,icenl >,ubgrade soils we have the following conclusions and rr.cuuunendaiiuns: 1. 'I'he piui fOUnilaliuns for Lhe porc:h a rc henv in,! tluc tu "ndfrueze". Adfreuze occurs vvhen saturdiled sc;il, (reczu. adhered tu the betow gr,iile consl rucl iun iind hc;ive wi th t he build-up of ice lensine in the soils. Prcventiun of adl'rcece requires precenting woisfure f'ruw ewcumul.il int ad iacent to thc foundation structurus nnd providine a b.irricr un tLe surf,icc of the foundalion lo prevenl moisI w e trum frcuvin_ It) the structure. , Fncc "fwu Wo encounlered well consolidated fill soils in our hand aueer boring whicli we iudced Lo be compelent to sunnort the nier foundNlion londiries. The fill was mostly a mixture a sand}, Ie;in clay. Icnn clay nnd clayey sand with lenses of sillv snnd .ind sand. tve did nol encounter saturated soils. }kiwever. wnler nccumulnling in the subgrade soils may migrale through the eranular lenses in the fill. t. Our obscrvntic,ns of the surface drainlge condilions indicated grndc reversal and excavations above the piers which would rillnn'water to accumulate ad,jacent to the pier construction. It would be potisible for waler to accumulate above the piers. I'recie t<, the sui,purt columns and lift the columns. a. We recommend replacing the existing pier construction with piers having fenlures depicled in the attached detail. The surlacc gr;ide surrounding the pier construclion should be r;loned to direcl surCace water awaY from thc picr consliuclion. OCiSLRVATIONS We ohserved lhe porch constructian, subgrade soil conditions, ancl @rnde bele,w the porch on .iuly 26. 1996. The four season porch was attached to the rear or wesl side af Lhe house at the first floor Icvel. I'he norch cslended over the basement walk-out level rind was suPPorted n1 Lhe norlhwesl and southwest corners on columns and isolnled Pier fvundnl iuns. Wc merisured the porch to ex[end Id' out from the west wnll of Che dwelline and it was 16' tvide. The porch did nnt lizicu a sys[cm of gultcrs and downspouts lo cullccl and direct roof runaff wa[er away from the porch foundntion. nur ohservNlions of Lhe supporl syslem for the deck indicnlcd the columns eslended below grade to bear on the isolated niers. Gach nnlside corner oC the porch was supported on two 5" X fi" treated «•ooden I;tnclscape limbers .l' on center. The grade surroundina the butLom uf I.lic columns was G" tu i" lowcr than the surroundina Inndscare erade. Jn addition, the landscaped grade in the lrea of lhc no rihwust c•o lunin a Ppcared to be reversed and would permit Gurface wnler to drain Lowards the pier construction. Ihe top nf Lhe picrs was not exposed above grade Lo observe. 1Ye Prubed nloneside the piers al the southwest corner with a hand ;iuker and encounlered well consolidated clay soils. We put down a hand nueer borinK adiacent to the piers at this location lu 4' helrnc eroile. 5t`e encounlered well consolidated fill consislina of rj mixture of snncly lean clay, lean clay, clayey sand and Lhe Cilt had Icnsc: ul' silly sand and sand. We judged the soils lu be mois[ hul Ihey n•cre nol salur;ited with water. P<«e Ti~FUC Wc ohserved a coil of 4" slotted PVC drain tile below the deck and ;issumcd il tens ? rcinnnnt from [he tile sys[em you inslaIlecl. We luuked tor the dayliahted end of lhe tile system on the backslone hchind Uie housc, but we did not locate it. The drain tile should havc heen installed bcdded in ernnular material ncar the isolated Iliers to pcrmit w;iter mierating around the piers to percolate into thc dr.iin Lilc. RGMARKS PhotoKrnphs obtained durinR our observations will be held in our filc fnr futurc reference. If you have nny questions regarding lhis renoit .ind our recommendalions, please give us a cnll. PROP1.',SSInNAI. P;NGINi IN ~ CONSUI.'1'AN'1'S. 1NC. ~~'"JGG~CL~.zl / .I ihn F. Gislrison. r P.E . ;taff linrzincur !FG/fln } • ~ ~ • , ` ]O] I IiT1.E CANADA ROAO SUItEilO SnINt Pelrl. ? E. ~ MINNCSOTA ] 1111 ~ TF.1: 613-I90.0166 ~ iAC' 61:490-0}ES HnPEStiI(INAL F.,\CINF.F:RINI: CONti11i,1'ANl'S IN( nNl`OPAl1iU TYPICAL RESIDENTIAL ISOLATED FOUNDATION DETAIL ( NOTE, EACH CONOITION WILL HAVE SOME VARIATION ) WOODEN PIER ORA88 OPTION ~ *2" MIN. PATIO OPTION e" MIN ql CONCRETE WITH FLEXIBLE SEALANT COVE IIIINIMUM 30' ~ SONOTUBE ~R PVC WITH BITUTHE E WRAP I BACKFILL 48" MIN, CONCRETE PIER - E" DIA. ~ I NOTE: TOP OF PIER MUST BE AD DRAIN TILE TO REM~VE CROWNED FOR DRAINAGE SATURATION WATER 1/2' REBAR I ~ I CONCRETE FOOTINO SOIL BEARINQ - MINIMUM 1600 PSF PERMIT Cl& CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: a u z L e2 N e Eagan, Minnesota 55123 Permit Number: 020316 (612) 681-4675 Date Issued: 0 2/ 0 9/ 9 3 SITE ADDRESS: 3729 WESCOTT HTLLS ?R LOT: 2 BLOCK: 3 SUNRSSE HILLS P.I.N._ 10-72982-020-03 DESCRIPTION: 16'x 16' DECK ZNCL ~ tiuildi'rig Permit Type SF PORCH Building',Work Type NEW UBC Occupany R-3 ~ Construction Y~ype V-N / Buildinq Lenqth ~ ;t.q ~ Building Width ~ 14 \C / c:~~'~,~~/ REMARKS: FEE SUMMARY VAt_UFlTION $10,000 Base Fee $117_00 Surcharge $5.00 Total Fee $122.00 CONTRACTOR: OWNER: - npplicant - NA NEWHALL MARK ' NA 3729 WESCOTT HILLS DR NA NA 99999 EAGAN MN 55123 (612)469-5572 i hereby ,.acknowl.edqe th.at I hava re,ad Lhi, applic,illon , nd ~.t.j tv th. t t.'*-irilorind Liori is corroct and aqree to comply wii.li all apptic..bl:~ t.,i", 0 1 Mn. 1;LA tui.r, ind Ctty oi Faqun 0r diri,iucc. - J ~ P~~ q 1~~" AP LICANT/PERMITEE SIGNATURE ISSUED Y: GNATURE r REACTIVATE _ CITY OF EAGAN PERMIT N ' 1993 BUILDING PERMITAPPLICATION $121-OL . ~ ~ 681-4675 CIO 0'~A 2- ~ f~B ir r fit98 SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, ] 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 permfit is issued. Date 4/ /9-3 Yaluation of work ~ OO~~ Site Address: 77' IVi /4- ~ ~ SiREET SUI7E Y Tenant Name: (commercial only) IAT EIACK a SUBD. P.I.D. * Descri tion of work: The applicant is: llr-O~wner 1:1 Contractor 0 Other (oeecr;be) Name c'iv- A a Phon`v 2'-SS7o7 Property LAST F10.5T Owner qddress -2; 7,!2 (~,L~c-~n ~ STREET STE N City ~ClEz-t State 10141' Z i p ~ 5 Company Phone Contra ctor Address License # Exp. City State Zip Architect/ Company Phone Engineer Name Registration N Address City State Zip Sewer & water licensed plumber . Processing time for sewer & water permits is two days once area has been approved. I I hereby acknowledge that I have read this aPplication and state that the information is correct and agree to comply with all applicable Sta of~1 iyrfiesota Statutes and City of Eagan Ordinances. • ~ Si9nature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodg"m ''-0'16 B ement Fihish ? 02 SF Owg. 0 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool ? 03 SF Addition O 08 8-Plex ? 13 Garage/Accessory ? 18 Cortm./Ind. E& 04 SF Porch ? 09 12-Plex ? 14 Fireplace O 19 Comm./Ind. Misc. ? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public facility ? 21 Miscellaneous WORK TYPE P 31 New 0 33 Alterations ? 35 Tenant Finish ? 37 Demolish ? 32 Addition ? 34 Repair O 36 Move GENERAL INFORMATION Const. (Actual) V-&I Basement sq. ft. MWCC System (Allowable,) v- lst fl. sq. ft. City Water UBC Occupancy 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump d of Stories _T Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code y 3q Depth 04 On-site sewage SAC Code G.ws.~.s Bld~ / - APPROVALS Planning Building ~"c" S3 J" Assessments En9ineerin9 Variance SGRE"~~i' ?oecrl~ REGIUIRED INSPECTIONS AL-so 16 A Dc-tk O Site 0 Footing ER Framing ? Insulation ? Wallboard 19 Final ? Draintile ? Fireplace Permit Fee V,i,,,t;a,,: S~~ D O r Surcharge Pl an Rev i ew paazH License MWCC SAC ~ y X! _(`Z ` City SAC Z x Z! I Water Conn. ~ J Water Meter Acct. Deposit ~CJ2 X y5 = g6 y~ S/W Permit S/w Surcharge p<ZA-- p O~ Treatment Pl. Road Unit Park Ded. ~~7 G Trails Ded. Copies Other Total: SAC % SAC Units ...~.rr.rn.. MCDONALD - COHSlll7iH0 fH61NEEAS ~r~T "NG1NECRING PLAHHEAS nnd LAHO ~UAVEYOQS COMPANY, INC. 1634.01 ~ 1000 GS7 I46~ 57RE:7, BURNNILLE, Y~HNEiOTa ~:'_37 p41 ~=2-~OQp ~I .,L~escr~2icrc• LO7- Z, BLOCK 3, SUNRfSC HfiLS ,4pDrT7pl,l, DAKQTA COUNT'e, MINNES0-1'A ( g9ss ) DEN07'ES EXlSTiNG ELCVqTJON ( s5~ s) GE~VOTTcS PPOFOSED EL-r_VAT70N G'RECiION OP- SuRr-AC.E JRAlNAGE 899.8j FINISI-}ELj GA: AGE Fi..DOR EL-g-VA770N (e9~ ~ Ul Io e6Z coN Z :ALE ,r, s.o .3O _I i z s `5~ • o~`~ a ~ ~gq9.5~ ~io ,•'.1~'t~ (69 95~ O ~ ~\9 li~y s 1b.o Q i s30. - (g9 q25~ ~ ° ~eqy,ll AN o ~ ~ t~ , Qo ~ . 30' FROIVT BUILDING SETR4CK UNE OOpO '•E f`!, ~r• ~ N6~3~36' B D F-AGAN ENGIpiNG'p~i ,~ot I her:by cartify ihat thia ia a t:ue and cor^sct rnpreaentat o l+nd as ahoxn'and deseribed hereon.• Ae prepared by fne on this --z6,4 daqr os ! 8S' . . - Hinn. loge Ro. FOR CITY USE ONLY PERMIT # ISSUED ,~7 A Pd w/Bldg. Permit FEES: $ $ SEWER PERMIT (INCLDDE SURCHARGE) $ $ WATER PERMIT (INCLODE SURCHARGE) $ $ WATER METER/COPPERHORN/OC'TSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ~.~•G'a ACCOUNT DEPOSIT - SEWER $ $ ACCOONT DEPOSIT - WATER $ • S L' Z1 $ WAC $ C S C' • C% (f $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ TOTAL 9S- sJ V- 9 s ~~r- 7 RECEIPT RECEIPT# - DOES LTILITY CONNECTION REQUIRE EXCAVATION IN P[)BLIC RIGHT OF WAY? Q YES IF YES, THEN A"PERMIT FOR WORK 6JITHIN PUBLIC Q ROADWAY" MOST BE ISSQED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SDBJECT TO THE FOLLOWI[VG CONDITIONS: APPROVED BY: TITLE: DATE: - - - - . ------•T~ _ . . APFLICATION FOR PERMIT ~NbTE: PAYMESlr OF FfE pT TIME OF . : aePLIcATzoN oos Nar ccea- ; SfI1V1E APPRCJAL OF PF7il1IT. : SEWER AND/OR WATER CONNECTION t' INsesrI«aoF Mqm nrD/oR wA'rm z itasracv.Tiors waa, riar ee scEWtm ; t,f . • ~[Tfl'IL PQ3MIT HAS BFIIi APPROVm. ~ ..c • ?FilY . ' e:~»~~~~~~~i~~~~~~~? ~C.. ~'sty oF ecig. an (PLEASE PRINT 1) PROPII2TY ADDRFSS: WC. r, uQ~ N- i u~' Ir/ 1- I T Fr;AT DESQtIPTION; s (Lot B ock S ivision or Tax arcel ID 4 IF EXISTING STRCCTYIRE, DATE OF ORIGINAL BI7ILDING PERMiT ISSUANCE: Mont Year PRESEDPI' ZONING/PROPOSID USE: Q CONilMERCIAL/RETAZL/OFFICE I vj'R-1 SINGLE FAMILY Q INDT-ISTRIAL ~ R-2 DC'PLEX ('iwo L'nits) Q INSTI'I[;TIONAL/GOVIItrA7ENT Q R-3 TOWNlIOC'SE (Three + Cnits) ( Units) Q R-4 APARTMENP/CODIDONIINIGM ( Units) 2) NAME: C t ADDRESS: U • CITY, STATE, ZIP: PHONE: 6, I For City Use 3) NAME= )lrn ~i'ln 4 Pl rLme s License: ADDRESS: ~ s' ' G Active Expired CITY, STATE, ZIP: ~ (J Not recordec PHONE: MASTER LICENSE p' Sta Initia 4) •W " • N11ME: ADDRESS: CIT'Y, STATE, ZIP: PHONE: C 5) is a •r• •a~~ ..~a~ G3"EONNECTION 'Ib CITY SEWEF2 CONNECTION 'iO CITY WATEF2 O QTHII2 - 6) ~ . ftexca~'' * * THE GOID COPY OF TfE PII2NQT WIIS, SE SENP DIRDCTLY TO PUBLIC WORKS 70 FACILITATE MEPER PICK-L~P. ; *k PLE7ISE ALTAW 1W0 WORKING DAYS FOR PROCESSING. SOF'IEONE FROM TfE: CITY WILL ODNPACP 7C(xJ IF TfIII2E ; * ARE ANY PROSLf21S. > ~~**.**•***sr+*+***r*,r*r~:+~*r++«*:*~r•*.++,r*r*+~**~,rx+*+**+****+*r*++***+:+.:**~*+r+*+*a**r*r*.**ar; RESIDENTIAL BUILDING ~I-r0-Oo Permit Applicatioo ~ City Of Eagan 3 I 3830 Pilot Knob Road, Eagan Mn 55122 ' Telephone 9 651-675-5675 FAX # 651-675-5674 New Conswction Reauirements RemodeVReoair ReauiremenLS OKce Use Onlv 3 registered sile surveys showing sq. ft. of bt, sq. ft. of house; and ait roofed areas 2 copies of plan Ced of Survey Recd (20% maximum lot coverage allowed) i set of Energy Calcula6ons for heated addilions Tree Pres Plan Recd 2 copies of plan showing beam 8 window sizes; poured lound design, elc. 1 site survey for additions & decks Tree Pres Not Reqd isetofEnergyCalculaUons Addition - nro'katetlar-sdesepticsystem _ On-srteSepGcSystem 3 copies of Tree Preservation Plan if bt platted a8er 711l93 Rim Joist Detail Options selection sheet (bldgs with 3 or less uniLs Date /03 Construction Cost 3 o ~ C7 oo U c7 Site Address 3-72-c1 wesC`.Oft 41<< S 4)Y w2- UniUSte # Descrip[ion of Work _~U-4~T rl v1 t S k blulti-Family Bldg _ Y_ N Fireplace(s) _ 0 Z 1 _ 2 Praperty Owner mcw ki- QµJ ~~l ( tAL{/(/ ~/t/w4~ Telephone #(~o S~ ) t~ 0 J- U 3 g~ Contractor Vi~l(ii'IP~V' ICQ~I'~'10~1/dLGl,~(r(C. Address c~Gj9",3 .~iJ()l.llcr.H~k Tra~ f City Cli-~a4-L- State ~ rl~ hZip ~5,7/2,3 Telephone#(6(L) ~75-3S~ 73 d,-Il tFvw.a- (o$(- 6 tfL? -(7?S,? COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilahon Category 1 Worksheet . New Energy Code Worksheet (Jsubmissionrype) Submitted Su6mitted • Energy Envelope Calculations Submitted Licensed Plumber Telephone ) Mechanical Contractor Telephone # ( ~ Sewer/Water Contractor elephone ) i ~ I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; - that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permir that the work will be in accordance with the approved plan in the case of work which requires a review and approval ofplans. ?Hu) Vti't pu~~isv- Applicant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ? 01 Foundalion ? 07 OS-plex O 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 E#. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? OS 03-plex ? 11 10-plex 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Pibg.XYor_N ? 25 Miscellaneous Work Types ? 31 New ~ 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addilion ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement 'Demolition (Entire Bldg) • Give PCA handout to appliwnt i Valuation Occupancy R"3 MCIES System - Census Code ~Y?y' Zoning 13'I City Water - SAC Units ~ Stories Booster Pump - Nbr. of Units Sq. Ft. ~ PRV - Nbr. of Bldgs ~ Length - Fire Sprinklered ~ Type of Const ~ Width - REQUIRED INSPECTIONS _ Footings(new bldg) FinaVC.O. _ Footings (deck) ~ Final/No C.O. _ Footings (addition) Plumbing _ Foundation ~ HVAC Drain Tile Other Roof _ Ice & Water _ Finai _ Pool _ F[gs _ AidGas Tests _ Final ~ Framing _ Siding _ Stucco Stone ~ Fireplace _X R.I. _k Air Tes[ 9 Final _ Windows (new/replacement)~ ~ Insulation _ Retaining Wall Approved By , Building Inspector - - - ~ Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Use BLUE or BLACK Ink r For Office Use 1 I I City Ol II Permit#: 1 !q .15 I Permit Fee: 3830 Pilot Knob Road I t 1 Eagan MN 55122 Date Received: ' 3L-)r 13- 1 Phone: (651) 675-5675 I Q~` I Fax: (651) 675-5694 I Staff: I 2013 RESIDENTIAL BUILDING PERMIT APPLICATION 1 Date: q 36 13 Site Address: 3JZc( (.tkaJCc)~" T7Z GCs ~ Unit Name: K GC /I Phone: d Siff Resident/ 372q Owner Address / City / Zip: ~t/~ f cy~f T71 ~l f ~l l lie- Applicant is: Owner /t Contractor Type of Work Description of work: _ ffim 7°Gy Construction Cost: 1,51000 d.~ Multi-Family Building: (Yes / No L) Company: Contact: PJ4 ✓ 1 1,)I/ k ke~ 3 4 3 JT ~-u, City: u Contractor Address: Du~~ f -14 State: -PA iA Zip: 5512-3 Phone: !o I 'Z_ 75 36'77 License Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 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: 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 W conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call 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.org 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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Bui ' g Code must be completed within 180 days jooff permit issuance. Applicant's Printed Name Applicant's Signature Page 1 of 3 373 9 0-e& ,4,f & DJ/L DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation Fireplace _ Porch (3-Season) _ Exterior Alteration (Single Family) Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi) Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous 01 of - Plex Lower Level Pool Accessory Building WORK TYPES New interior improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation -low Occupancy G f 2 MCES System Plan Review Code Edition &V? SAC Units ' (25%_ 100%_z Zoning IZ t City Water Census Code Stories Booster Pump # of Units / Square Feet PRV # of Buildings 1 Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final I C.O. Required Footings (Addition)(C Final / No C.O. Required Foundation HVAC _ Gas Service Test Gas Line Air Test 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: _ Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector ccam~,, RESIDENTIAL FEES I/ a~ -aft- Base Fee Surcharge Plan Review 6:2 MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA118050 Date Issued:10/25/2013 Permit Category:ePermit Site Address: 3729 Wescott Hills Dr Lot:2 Block: 3 Addition: Sunrise Hills PID:10-72982-03-020 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fixtures:Master bath remodel Mike Schiltz P.o. Box 22172 Fee Summary:PL - Permit Fee (miscellaneous)$55.00 0801.4087 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 - Mark A Newhall 3729 Wescott Hills Dr Eagan MN 55123 Hessian Plumbing Services Box 22172 Eagan MN 55122 (651) 681-8252 Applicant/Permitee: Signature Issued By: Signature • E PG A Ili , 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651) 675-5675 I TDD: (651) 454-8535 I FAX: (651) 675-5694 build inninspections(dicitvofeaaan. com Date: JUL 2 9 2020 r For Office UseC#4'9 2 �. Permit Fee: q6. 0 ` ; ( 1 Permit* Date Received: Staff: 2020 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: Unit #: Resident/ Owner Name: / vv "-'%/f�(� %AtheA Phone: 07— Z(o'32-07 Address / City / Zip: 37 q &Agd Mil pry. Applicant is: Owner % Contractor " I <(lu/i LC ! S Type of Work Description of work: .K1 redintUALA /ft VY-i P 1 u.ee_ uv Construction Cost: MI 00 ® Multi -Family Building: (Yes _ / No A) Contractor Company: f4 Y t— � v�N b44JI i contact: Pit ( Add3 (ress:a4 3 �VVG L 1 IP -€ i City: 3 StateM't Tip: 5512 3 Phone: 612 8375 337Frnail: L 0 s-ca.1lncvr\ 1 Cat. License #: e L 0 35619 $ Lead Certificate #: If the project is exempt from lead certification, please explain why: Tjc.Ac- 0-r"e/16hfa-C_.. In the last 12 months, Yes No 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? If yes, date and address of master plan: Licensed Plumber. Mechanical Contractor. Sewer & Water Contractor. Fire Suppression Contractor. Phone: 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. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.comisubscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit Issuance. C L BEFORE YOU DIG. Call Gopher State One Call 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.aooherstateonecall.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 y4tout a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approvgLef-ins. x Pcw I f O-iC-4/1;e'v— Applicants Printed Name Applicants Signature DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Fireplace Single Family _ Garage Multi _ Deck 01 of Plex Lower Level WORK TYPES, New Addition 4 Alteration _ Replace _ Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100%4 Census Code #of Units # of Buildings Type of Construction Porch (3-Season) _ _ Porch (4-Season) _ _ Porch (Screen/Gazebo/Pergola) Pool _ Interior Improvement _ Move Building _ Fire Repair Repair Vrts. Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Accessory Building _ Siding _ Demolish Building* _ Reroof _ Demolish Interior Windows Demolish Foundation _ Egress Window _ Water Damage `Demolition of entire building - give PCA handout to applicant Occupancy --= MCES System Code Edition Aj.Jy02-0 SAC Units Zoning City Water Stories Booster Pump Square Feet PRV Length Fire Suppression Required Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Foundation Before Backfill Roof: _Ice & Water _Final Framing 30 Minutes 1 Hour Fireplace: (Rough In (Air Test Final y. Insulation lC �l Sheathing Sheetrock Fire Walls Braced Walls Shower Pan Reviewed By: RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Radio Meter Read Copies TOTAL Meter Size: Final / C.O. Required Final / No C.O. Required HVAC _ Service Test Gas Line Air Test _ Hood Pool: _Footings Air/Gas Tests _Final Drain Tile Siding: _Stucco Lath _Stone Lath _Brick _ EFIS Windows Retaining Wall: _ Footings _ Backfill , Final Radon Control Fire Suppression: _Rough In _Final Erosion Control Other: Building Inspector Wtiff-lA" tat,OO) .J a,00 tfutir\velA) s`' IZAVocAii 2Y9L20 Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA162837 Date Issued:07/30/2020 Permit Category:ePermit Site Address: 3729 Wescott Hills Dr Lot:2 Block: 3 Addition: Sunrise Hills PID:10-72982-03-020 Use: Description: Sub Type:Fireplace Work Type:Gas Fireplace (new) Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 - Mark A Newhall 3729 Wescott Hills Dr Eagan MN 55123 (952) 513-7706 Glowing Hearth And Home Llc 100 Eldorado Dr. Jordan MN 55352 (952) 492-9276 Applicant/Permitee: Signature Issued By: Signature