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4255 South Robert Tr CITV OF EAGAN Femarks $ - Addition Auditor's Subdivision 1142 Lot eik Parcel 10 03900 010 06 Owner . " ~ ~ ! , Street 4255 So. RobeTt Tlail State Eagan, MN 55123 Improvement Date Amount Annual Vears Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK SEWER LATERAL WATERMAIN WATER LATE(iAL WATER AREA STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 6UILDING PER. SAC PARK EAGeO?N `I'OWNS H I P No 775 B9J9LDING PERMiT Ownex '.2- ~ . ~ Ea9an Township . Address (PresenY) .11.1.,...___' Town Hall Builde: .'1L?~C.C~n/----------------------- Dale _~~7 1 Address DESCAIPTION 53or5es To Be Used For Froni Depih Heighi Esi. Cosi Permit 4F:ee Remarks u n LOCATION Sireei, Road or ofher Descr?p;ion of Locafion I Lo! F.lock AddiHon or TaacS I This permif does no1 auihoriae the use of sireeis, roads, alleys or sidewalks nar does it give the owner or his agenf the righ! 1o creaYe any siiualion which is a nuisance or which presents a hazard !o the healSh, safety, convenience and general welfare So anyone in the communify. THIS PERMIT MUST BE ,nKEPT,., ~O,P~7~ ~T E PPEMISE WHILE THE WORK IS IN PROGRESS. This is So ceriify. .......................has permission !o ereci a-------- A= - - ~---uPon the above dESCxibed premise je fo the pr visions of the Buildinq Ordinance for Eagan Toc+nship adopfed April 17, 1 ' 955 . . . ~ ? Per ........_........_._......g.._...p.._......_......_................ . ....f.?..'~. C~~ . Chairman of Tnwn Soard Buildin Ins ector l n L rx ciz.~~ ~k~czc~%~%~Xt %cX~zcX~ ~X %~%~%~%~zc~k~k%~ra&czczc mzc~%~Xm~%%~%~zc %~m Xtzczc~X CITY OF F_AGAN CASHIER: 75 TEFMTNAL N0: 633 DA'iE: 07/27/99 TIMEe iC1:2406 IU;: NAME: SPIENSON CDNS'fI;UCTTON :3^G10 9001 4455 5 fiURI:.Fi't T ~'LJ.L.LJ 205 3001 4255 S ROHEfiT T 7.50 ~ Tota1 PiLCBlp+ Amouni; r. r SE3.'S CR i 142E30 USEfi .T.Li: .1liN CITY USE ONLY r L ~1~ BL ~ RECEIPT#. J UJ SUBD. SU~O I~I1S1~~ RECEIPTDATE: PERMIT # 3-15O -1 1999 PLUMSINf PEtMIT (RESIDEIVTIAL) crrY oF E,tsAN s&so PaoT xAOS Rn £AfiAN, MN 55122 (651) 681-4675 Please wmplete for: D single family dwellings ? townhomes and condos when permits are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH # TOTAL Bath tub $ 3.00 x = $ Floor drain 3.00 x = $ Gas i in outlet ' munimum - 1 3.00 x = $ Hot tub/s a 3.00 x = $ Kitchen sink 3.00 x = $ Laund tra 3.00 x = $ Lavato 3.00 x = $ Mfnimum fee alterations to existin dwellin 30.00 x = $ Private Dis osal S stem newlrefurbished ' re uires MPC iic. 75.00 . x = $ Private Dis osal S stem abandonment 30.00 x = $ RPZ new installation/re air 30.00 x = $ Rou h o enin 1.50 x = $ Shower 3.00 x = $ Under round s rinkler if dwellin is under construction 3.00 x = $ Under round s rinkler if existin dwellin 30.00 x = $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water softener if dwelling under conslruction 5.00 X = $ Water softener if existin dwellin 30.00 x = $ Water turnaround 30.00 x _ $ State Surchar e 50 $ 50 Total S ~p~? Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. t hereby acknowledge tfiat I have read ttiis appficalion, state Ihal the infortnatlon is conect, and agree to comply with all applicable Ciry oi Eagan ordinances. It is the applicant's responsibility to notify the property owner Nat Ne City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to ihe facilities constructed under this pertnit wiNin City propertyinght-of-way/easement. SITE ADDRESS: &Eeza -T2. OWNERNAME::bUf'SIRCTq 40t' (DtkiSQ IIA~L TELEPHONE#: ` (AREA CODE) INSTALLERNAME: Gen/1Z, zLIR'.1 TELEPHONE#: lsr~-I y4 STREET ADDRESS: (AREA CODE) CITY: _ ~r~rnmJ')7- STATEWN ZIP: ~ SIGNATU OF P RMITTEE 1999 BUIR'DING PER1411T APPLICATION (RESIDENTIALI~~S~ ~ ~ CITY OF EAGAN n 3830 PILOT KNOB RD - 55122 651-681-4675 ~ New Conshuclion Reaulrements Remodel/Reoair Reauireenenis ? 3 regisfered sNe surveys showing sq, tt. ot IoT, sq. fl. ot house 2 copies of plan cnd all roofed areas (20% maximum lot coveraae ollowed) 1 set of energy caleulatlons for heated addHions ? 4 copies of plans (show beam 3 window sizes; poured fnd. deslgn; Mc.) 1 sMe survey for exterfor addMlons 3 decks ? 1 sef of energy calculatfons ? 3 copfes of free preservaflon plan H lot platted affer 7/1/93 DATE: CONSTRUCTION COST: DESCRIPTION OF WORK: C" L' rv ~-STREET ADDRESS: 6~2 S S 1 C) e~ P 0 C h 1' / y`3 i LOT: W1 BLOCK: ~ SUBD./P.I.D.#: Name: Phone k: PROPERTY ' Last ~ First OWNER Street Address: ~25-5- SD o~j ~ 14 LaI / City ~~,4' A/ State: 6'// /V • Zip: Company: l t~'///~ I~wP2SOh- ~~lls ~ phone#: (area code) CONTRACTOR ~ Street Address: License #a~oV5SjJ' Exp-~ ~ z0rv City (Te !9. C Y V State: Zip: SS ARCHITECT/ ENGINEER Company: Name: Telephone area code ( ) Streel Address: Registration City State: Zip: Sewer 8 water Ilcensed plumber (reauired tor new construclion onlvl: Penalty applles when address change and lof change Is requesFed once permM Is Issued. I h• ~ acknowledge that 1 have read fhis applicaflon, sfaFe that fhe Informatlo s conect, nd agree f mply wBh all applicabl Sta: ~f Minnesofa Statutes and City of Eagon Ordfnances. Signature ol Appllcant: - ~ . OFFICE USE ONLY Certificates of Survey Received _ Yes _ No ~ JUL ~ 2'.• - Tree Preservation Plan Received _ Yes _ No _ Not Required~ i ~J . , OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex O 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex p 18 Deck ? 23 Porch (screened) ? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? OS 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous WORK TYPE ~0 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia ? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors ? 33 Alteration ? 37 Demolish Bldg.' ? 41 Wood Stove ? 45 Fire Repair JO 34 Repair ? 38 Demolish (Interior) ? 42 Reroof ' Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code ~ (Allowable) Main level sq. ft. SAC Code 0L UBC Occupancy sq. ft. No. of Units Zoning sq. ft. No. of Bldgs Z) # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning Building ~ Engineering Variance PermitFee Valuation: $ Surcharge Plan Review License MGES SAC , City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SNV Surcharge Treatment PI. ~ Park Ded. Trails Ded. Other Copies Total: SAC Units % SAC CITY USE ONLY L BL RECEIPT # O I 0~ SUBD. ZD ' 0..~~OG' C7/0 "0(~P RECEIPT DATE: 1998 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT [INOB RD EAGAN, MN 55122 (612) 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 Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet ' minimum - 1 3.00 x = Rough Openings 1.50 x = Water Softener ' for dwellings under construction 5.00 X = Water Softener ` for ezisting dwelling 20.00 x = U.G. SprinklBr ' for dwellmg under const. 3.00 = U.G. Sprinkler "forexistingdwelling 20.00 = Altefations ' to existing residence 20.00 = Water Turn Around 20.00 = z2d ^ Private Oisposal System ' MPC iic. 75.00 = (new and refurbished systems) Private Disposal Systems * a,bandonment 20.00 = RPZ (new installation only) 20.00 = STATE SURCHARGE 50 TOTAL & - I hereby acknowledge thal I have read this application, state that the information is cortect, and agree to comply with all applicable City of Eaga-n ordinances. It is the applicanPs responsibility to notify the property owner that the City of Eagan assumes no liabdity for any damages caused hy the Ciry dunng its normal operational and maintenance activities to the facilities constructed under this permR wdhin City propeRy/right-of-way/easement. SITE ADDRESS: 1-/ a lS S H UJ i 3 OWNER NAME. L. O U/ S L M U C L i- l L INSTALLERNAME: D/~ 1/,'d'n}, PL(n. TELEPHONE#: 9 541-611 LIS STREETADDRESS: /~~,~j //r G~JJ?j.= CIrr: STATE: ZIP: SSra / SIGNATURE O RMITTEE L~ CD/PERMIT FORMSlRPLBG PERMIT (RES) - 1998 r LotOll_ BlockPIDM Sewcr/watcrpcnnitN I UIQ Piat Date Receipt kMU1I CITY OF EAGAN 1998 SEWER AND WATER CONNECTION 8 AVAILABILITY CHARGES EXISTING RESIDENTIAL PROPERTY Sewer Connection 8 Availability Charges , Water Connection 8 Availability Charges' Lateral benefit @ 2I.30/ff $ N~ Lateral benefit @$21.50/ff ~ Trunk Q $860/wnnection Trunk Q $895Jconnection SAC ~ 1,100.00 Supply-storage (WAC) 807.00 Date p ' Date pai8~_ Receipt # Receipt # ~ Account deposit 15.00 Treatrnentplant 444.00 Sewer permit & surct~ar 50.50 Water meter 111.00 Accountdeposi I5.00 Subtotal Water permit surcharge 50.50 Plumbing pe it &c surcharge 2. Subtot $ Total / $ Pl bing permit & surchazge 20.50 ` Total $ Sewer and Water Connection 8 Availability Charges Lateral Benefit @ $21.30 and/or $2I.50/ff $ /VIA Trunk @ $860 and/or $895/wnnection ~ 17 /S SAC 1,100.00 Date paid Receipt # Supply & storage (WAC) 807.00 Date paid Receipt # Treatrnentplant 444.00 Water meter 111.00 Account deposit 30.00 Sewer and water permit & surcharge 100.50 subcatel 45 v.5o i'k 41 r0iU8 Plumbing permit & surcharge 20.50 Total $ OFFICE USE ONLY Propertyowner ~(3LU~.C, ~ALP.~A711 PRV required yC Address om j(N-th aflf}E'nt,i1f Numberoftaps Phonenumber 4h4 - Availability $x 1771s- Plumber ~ ak-a?UR, City financed Lot Block PlD # Scwcr /watcr pcrmit # Plat Date Rcceipt # CIN OF EAGAN 1998 SEWER AND WATER CONNECTION & AVAILABILITY CHARGES EXISTING COMMERCIAL PROPERTY Sewer Connection & Availability Charges Water Connection & Availability Charges Lateral benefit @ 2130/ff $ Lateral benefit @$27.1 5/ff $ Trunk @ $1,790/acre "Crunk @ $1,875/acre SAC @ $I,100/unit Supply & storage (WAC) @ $2,955/acre Date paid Treatrnent plant Q$444/SAC unit Receipt # Water perntit & surcharge 50.50 Sewer permit & surcharge 50.50 Subtotal $ Subtotal $ Plumbing permit & surcharge 25.50 Plumbing permit & surcharge 25.50 Total $ Total $ Sewer and Water Connection & Availability Charges Lateral Benefit @ $21.30 and/or $27.15/ff $ Trunk @ $1,790and/or$1,875/acre SAC @ $1,100/unit Date paid Receipt t! Supply & storage (WAC) @ $2,955/acre TreaUnent plant @ $444/SAC unit Sewer and water permit & surcharge 100.50 Subtotal $ Plumbing permit & surcharge 25.50 Total $ The number ojSAC unils is defermined by the Metropolitan Council Wastewarer Services (602-1000). OFFICE USE ONLY Property owner PRV required Address Number of taps Phone number Availability $ Plumber City financed kb -o34a~- o~o -oc~, *-CitVoFeagan MUNICIPAL CENTER MAINTENANCE FACILITY THOMAS EGAN 3830 PILOT KNOB ROAD 3501 COACHMAN POINT Mayor EAGAN, MINNESOTA 55122-7897 EAGAN, MINNESOTA 55122 PHONE: (612) 661-4600 PHONE: (672) 681-4300 PATRICIA AWADA FAX: (612) 681-4612 FAX: (612) 681-4360 PAMELA McCREA TDD: (612) 454-8535 TIM PAWLEN7Y THEODORE WACHTER Council Members THOMAS HEDGES Nrnember 5, 1M Ciry Atlmimnsiwtor EUGENE VAN OVERBEKE Ctly Clerk LOUISE E MUELLER 4255 ROBERT TR S EAGAN MN 55123 Dear Ms. Mueller: The Cities of Inver Grove Heights and Eagan are proposing to exchange approxdmately 1 and 1.2 acres of land along State Highway 3 so the highway becomes the new municipal line. This process is done by a resolution passed by both cities and then as approved by the Minnesota Municipal Board. No public hearing process by each city's Advisory Planning Commission is necessary. This process will benefit both cities and property owners by eliminating the need for both cities involvement or approval of any land use change in the future. This could include items such as zoning, platting, and variances. This item is scheduled for the Inver Grove Heights City Council meeting on November 9 and the Eagan City Council meeting on November 17. Attached is a copy of the Resolution and map of the areasto be exchanged. If you would like additional information, please feel free to contact me at 681-4695 or: Tom Link, I.G.H. Director of Community Development, 457-2111 Dale Runkle, Eagan Director of Community Development, 681-4695 Sincerely, V l~fAV^- Jim Sturm City Planner JS/js attach. THE LONE OAK TREE THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY Equal Opportunity/Aftirmative Aclion Employer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eb.16.2016 00:36 *City 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 8755875 Fax: (651) 8754894 Date: 16 1L Friendly Heating 4rd'it:4in80014739 7636570101 PAGE. 1/ 1 yOate Received: FEB 1 6 2016 �� t`C.f ,,%o47, Lstef; Use BLUE or BLACK Ink For Office Use q/// Permit Fee: el( Permit #: 2016 MECHANICAL PERMIT APPLICATION 0 Please submit two (2) sets of plans with all commercial applications. Site Address; 4 Z 55 S QbbeC4 'ETu t Tenant: Suite 8: J 1F '9r :, /::Va.aMh.I;ryY,1y,�;,�l9,.P.. M9 ,• ;i'4? " t �' °`" ,'` "y" , > Name: it g g5 -)a-1.95 �L L e PhOnea661- d Vi -x30, Address / City / Zip: 000 Con itt Po)/1 It. euf v t. -if 3 v . '��'.Af Y" .uj�, %x)tYr14A ern• bl'{'-•/SSr:'afT��.X'w"i'9!'. }'yH ,`ft /►e:•' V,��a '�:.,�fy ' a`%„+fi:+,�,'w°.�;� ,S;`, �.Y.s�A,;.,s'<.°r,`•";1,�.n1;f*,,.,�'�14'i;':V1.,=�•;�; .�.zt Name: .c,tJ AA (y 4t*aam * t \( t'.o6d'1-4ionrr`f'icense#: Address: %'S0g0 Ark t 1rtV( S -F City: �'b� State: AI N Zip: r$ 5 3711 Phone: %.3? 7- 6/6 Contact.Cir KGN J�a �t� Email: �CiPt�Q1t 6uiri' 0 0�� lco tvn2 S�iM1�.,'�;p�Y �T�>�sd,wrr'7t"'n,�'r !d,✓',p•'M.wa„,J N: .A1rcai�.rj+,:�a YJ.ii�.i°�°.:i, '"•:4 �"if'f !.':!.'y;,;r;: �;!?r"ry{ '��:�''!%,�:'• f,�;��` t��'��w.;m''� ��' .:.! New Replacement Additional Alteration Demolition �c'\�o.r 4o rTo rcacair [aov CsTot� Description of work: � oi ■� �.)rv;, n..A v:�'' r .; .��•�� e.Ywf. •(!.,.,;�ti•-r!9Ji'.�• �""'S?'°�"' {hr;.��,, r, r%'r,Y 4 ,: R',✓a3jyV,,,e�'i'i .µ�.•�,k�.�yx7 .:!:`.!,,,r a;,G'n "�''sx'Lfx,: ^•£,. `R: vG L��"Y :•. A.0 '..h r?,Y r Y•M':'} f:i,'d:•�•i'�i;:% ;°r,' ..a,, :LY .b�, `N,• :(nFr",. .';hof ,:nY,;; ixh:': rhr nrW• .y u,•,J.•P.C.a :U .E• : Y"Pc. .f. v. '7 `t'A. h•4,�3Y',M' : „. a.. �. ,.v.•a :."e,'? :h', ^":r• 6: ,4r eV �:A4? ,, tt'c. .�% '+""r�•'vY Y,•::� C�':.':.. �L 6.r • ,�" ���}ft� �y,, fir. y�,� �w L y", a ue. , ,��.. .�kj." ,•YA.N _ r ."., u+ *!slF. a! .?.;. .MR:;... . , ..J•tX4.• ,ryyq'r 1, :.i:1 1�, ..(• �., I i. r.Y:r �,� rvY r.,. :..' ✓ :4!'., �{�,y • ari+ 1 1 • is • 4 •I��� � a..'SIr41 ti,;; a{"�•� ,':a •:a. a„�. r,ni ..c. ,•n '�'���•,... n �'"i.• :•T::• "J`'. ,;.(.� n jam• .xv�, • 7M,y�%y�,V .+ L'.L"''x'•• ,�V}� •:.�. ..... . �1 }YY. � r�ra r�hM!23'f-�d�Wak: .rw!!Yw 1'F'v'�fy"�y •L A�. '• �y�niY'K,FwY:t(j6 i.,';tk ,ti.;,;• ;.+ v;t, �Rr., ,y aha;;;";at �.�'f:?+�;'Yrr i:o-'.7.'�<:'ttl''aF .',:,"j'-' '+y�,'' yy.•+"ti, SIN RESIDENTIAL A Furnace Alr Conditioner COMMERCIAL New Construction Interior Improvement HVAC Unit / Remove) Install Piping Processed Gas Exterior Air Exchanger _ Heat Pump Under/Above ground Tank (_ Install ,_ Other RESIDENTIAL FEES $60.00 Minimum, Add or alteration $100.00 Residential New, to an existing unit, includes State Includes State Surcharge Surcharge = $ TOTAL FEE COMMERCIAL FEES $60.00 Permit Fee Minimum Contract Value $ x .01 = $ Permit Fee $70.00 Underground tank Installation/removal Surcharge = Contract Value x $0.0005 If the project valuation Is over $1 million, please call for Surcharge r. $ Surcharge = $ TOTAL FEE 1 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 le 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 t&ya Applicant's Printed Name City orEaQan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 MAR 18 2D16 r Use BLUE or BLACK Ink For Office Use I \,a Permit #: //5 I f� Permit Fee: <.(//��y9g 1° -3-r6-1 Date Received: Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 3/17/2016 Site Address: 4255 South Robert Trail Unit #: J Res Owner Name: MB and HB Estates, LLC Phone: Address / City / Zip: 1200 Centre Pointe Curve, STE 300 Applicant is: Owner ✓ Contractor Type of Work Description of work: Rehabilitation of home 30000 Construction Cost: Multi -Family Building: (Yes / No ✓ ) tractor Company: MSP Services, LLC Contact: Mike Schaeffer Address: 1200 Centre Pointe Curve, Ste 300 city: Mendota Heights State: MN Zip: 55120 Phone: 651-246-4130 Email: Mike@msphomerental.com License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: N/A 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: BoeVagg Plumbing Phone: Friendly Heating and Air Phone: BoeVagg Plumbing Phone: N/A Phone: NOTE Plans and supporting d© that you submit are.con 8 public information; e information maybe classified as " -public if you proves ec s ttts that w conclude, w ;they are tra secrets, CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage. CaII 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 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 d' g bode st be completed within 180 days of permit issuance. xMicheal T. Schaeffer Applicant's Printed Name i ant's S' - n ture Page 1 of 3 (kik 0412i -I O NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation _ Fireplace $C, Single Family _ Garage _ Multi _ Deck 01 of Plex Lower Level WORK TYPES New _ Interior Improvement Addition Move Building Alteration Fire Repair Replace _ Repair Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100%I) Census Code # of Units # of Buildings Type of Construction Y7 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) _X,,Footings (Addition) Foundation Roof: Ice & Water Framing Fireplace: _Rough In )C. Insulation Sheathing Sheetrock Fire Walls Braced Walls Shower Pan Reviewed By: Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width Siding Reroof Windows _ Egress Window /3&L//5 Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Accessory Building Demolish Building* Demolish Interior Demolish Foundation Water Damage *Demolition of entire building - give PCA handout to applicant ' 0', 3)- t r�` )L/eine ivi-7- -k,,,,—," MCES System fry.) MO ;5" SAC Units City Water Booster Pump PRV Fire Suppression Required Meter Size: Final / C.O. Required Final / No C.O. Required HVAC Gas Service Test Gas Line Air Test Pool: Footings Air/Gas Tests _Final Drain Tile Air Test Final iding: Stucco Lath _Stone Lath _Brick Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Fire Suppression: _Rough In _Final Erosion Control Other: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL �(1)116ov) 5- 1 vifkw Prt-f x ;0 v )4•10 2-L1 xan a (3O 5 t A` 1216,S(3 lig 1 4Rf3 3/17/2016 img018jpg IFGC APPENDIX E (IFGC) WORKSHEET E.1 RESIDENTIAL COMBUSTION AIR CALCULATION METHOD For Furnace, Boller, and/or Water Heater In the Same El co /5 4';Ry S iZhor-44r0; / Step 1: Complete vented combustion appliance information. Furnace/Boiler: 0 Draft Hood 12iFan Assisted ❑ Direct Vent Input:, (not fan assisted) & Power Vent 0000 Btu/hr Water Heater: Id Draft Hood 0 Fan Assisted 0 Direct Vent In ut: (not fan assisted) & Power Vent p3?cvU Btu/hr Step 2: Calculate the volume of the Combustion Appliance Space (CAS) containing combustion appliances. The CAS includes all spaces connected to one another by code compliant CAS volume: j ft0 g 0 3 openings. Step 3: Determine Air Changes per Hour (ACH)1. Default ACH values have been incorporated into Table E-1 for use with Method 4b (KAIR Method). If the year of construction or ACH is not known, use method 4a (Standard Method). Step 4: Determine Required Volume for Combustion Air. 4a. Standard Method Total Btu/hr input of all combustion appliances (DO NOT COUNT DIRECT n 7 po 0 VENT APPLIANCES) Input: Btu/hr Use Standard Method column in Table E-1 to find Total Required Volume (TRV) TRV: COO/ ft3 If CAS Volume (from Step 2) is greater than TRV then no outdoor openings are needed. If CAS Volume (from Step 2) is less than TRV then go to STEP 5. 4b. Known Air Infiltration Rate (KAIR) Method Total Btu/hr input of all fan -assisted and power vent appliances (DO NOT COUNT DIRECT VENT APPLIANCES) Input: Btu/hr Use Fan -assisted Appliances column in Table E-1 to find Required Volume Fan Assisted (RVFA) RVFA: ft3 Total Btu/hr input of all non -fan -assisted appliances Input: Btu/hr Use Non -Fan -assisted Appliances column in Table E-1 to find Required Volume Non -Fan -assisted (RVNFA) RVNFA: ft3 Total Required Volume (TRV) = RVFA + RVNFA TRV = + — ft3 If CAS Volume (from Step 2) is greater than TRV then no outdoor openings are needed. If CAS Volume (from Step 2) is less than TRV then go to STEP 5. Step 5: Calculate the ratio of available interior volume to the total required volume. S Ratio = CAS Volume (from Step 2) divided by TRV (from Step 4a or Step 4b) Ratio =Sa Ba / s = r SO — Step 6: Calculate Reduction Factor (RF). RF = 1 minus Ratio RF = 1 - = Step 7: Calculate single outdoor opening as if all combustion air is from outside. Total Btu/hr input of all Combustion Appliances in the same CAS (EXCEPT DIRECT VENT) Input: Btu/hr Combustion Air Opening Area (CAOA): Total Btu/hr divided by 3000 Btu/hr per in2 CAOA = / 0 ,C0 3000 Btu/hr per int = int Step 8: Calculate Minimum CAOA. Minimum CAOA = CAOA multiplied by RF Minimum CAOA = O x 0 = O int Step 9: Calculate Combustion Air Opening Diameter (CAOD) CAOD = 1.13 multiplied by the square root of Minimum CAOA CAOD = 1.13 VMinimumCAOA = 0 in 'If desired, ACH can be determined using ASHRAE calculation or blower door test. Follow procedures in Section G304. 2009 MINNESOTA FUEL GAS CODE 171 https://mail.google.com/mail/u/0/#Isearch/friendlyheating%40outlook.com/152f55b17372278f?prgector=1 1/1 3/17/2016 Adtek Software Co 105 S Main St - Toluca, III 61369 815-452-2345 - sales@adteksoft.com Sales Consultant: Job#: Date: 02/18/2016 img016.jpg Mike 4255 S Robert Trail Eagan, MN System 11 (Average Load Procedure) Design Conditions Location: Minneapolis/St Paul AP, Minnesota Elevation: 834 ft Input Data: Outdoor Dry Bulb Indoor Dry Bulb Latitude: 44° N Summer: 88 75 Heated Area 1632 Sq.Ft. Winter: -11 70 Cooled Area 1632 Sq.Ft. Daily Range: Medium Design Grains: 24 Heat/Loss Summary (July Heat Load Calculations) Gross Sensible Latent Area Loss Gain Gain Walls 1328 7916 2105 0 Windows 212 8068 5821 0 Doors 42 1190 382 0 Ceilings 1632 4230 2089 0 Skylights 0 0 0 0 Floors 1632 14492 2693 0 Room Internal Loads 0 3090 600 Blower Load 1707 0 Hot Water Piping Load 0 0 0 Winter Humidification Load 0 0 0 Infiltration 9500 793 905 Ventilation 6549 1051 1200 Duct Loss/Gain EHLF=0.041 ESGF=0.037 1852 620 81 AED Excursion n/a 0 n/a Subtotal 53797 20351 2786 Approved ACCA MJ8 Calculations Total Heating 53797 Btuh 16 kw of electric heat Total Cooling 23137 Btuh 102 Linear ft. of Hydronic Baseboard `Calculations are based on the ACCA Manual J 8th Edition and are approved by ACCA. All computed calculations are estimates based on building use, weather data, and inputted values such as R -Values, window types, duct Toss, etc. Equipment selection should meet both the latent and sensible gain as well as building heat loss. Adtek AccuLoad Report Version 7.0.1 Page 1 https://mail.google.com/mail/u/0/#(search/friendlyFeating%40outlook.com/152f55b17372278f?projector=1 1/1 ENE '" AC uaiif in Ng igh ed ;'egions ENERGY STAVen.las rgglones de do stacados Canada enernystaenrc.an-rncan.gc.ca TAR U.S. E.U. energystar,gov National Fenestration Rating Council`' 0011•1010111.110114.6.01.6001 IFINFINIMM.11•01 C R IHED = Zono A l = Qualified/Admis ible JFLDWEN WIND\N OORS Builders Vinyl Double Hung Double -glazing with LowE and Argon fill JEL-A-725-04430-00001 13641276 ENERGY PERFORMANCE RATINGS EVALUACION DE RENDIMIENTO ENERGETIC() _ U -FACTOR SOLAR HEAT GAIN COEFFICIENT I ACTOR U COEFICIANTE::GANANCIA DE ENFRGIA SOLAR 0.31 (U.S./I-P) 11.76 (Metric/Si) 0.32 ADDITIONAL PERFORMANCE RATINGS EVALUACION SUPLEMENTARIA DE RENDIMIENTO VISIBLE TRANSMITTANCE AIR LEAKAGE TRANSMISION DE LUZ VISIBLE INEII: IRATION WAIN 0.55 0.3 (U.S./I-P) 11.5 (Metric/SI) Manutacluief stipules fall Yrs 5lyy ralioys widow, to vpYatee NORC plrstc4ues Iw`4le nliienq woo pralu: noOndi..B. WIC 101109 310 axle 0044 10brei sel of aeneolblis JYI0Iuxb a A, a ,oxix pool Bun MIRK doeo ioI Ieunm io ,.y} pryduc am ioa not waned 111e 101131Ay of any oluyl hr any 'WAIL ,is CYny.111 1010110101010YirdnulKluier'Sndivendie Id one prodded peril a :e inlormato Este *rale es o4 dueus Yaw nuepion and es un damonlon aeicties de N IIC para Iwo( ANr a feruMI8010 alai 4 p100000 41 vn 000 uaada !OIC sal 410101. ado., oa Ln cows lip de ea:owned ,Oeentaies y un Iamara de predict() ospec+lou NIR ne [c>Lomlrade nmen pude y a 418100e que d xrluulo ,ea ade0010 pe 4[ 80:. :;tiro.densulle pc 014210001100mruep113 el USO 8091aw;x este pruducto. _-, www.ntrc.urg This fenestration product has been certified by the manufacturer to meet the air infiltration requirements of Section 116(a) 1, 2008 California Building Energy Standards. American Architectural A: Manufacturers Association Manufacturer of Certified Products Manufacturer stipulates conformance to the applicable standards JELD-WEN Windows & Doors Builders Vinyl Double Hung Class R-PG20 Size Tested 48x77 in Design Pressure = +201-20 psf Conforms To: AAMA/WDMA/CSA 101/I.S.2/A440-08 / AAMA 450 WARNING: Drilling, sawing, sanding or machining wood products generates wood dust, a substance known to the State of California to cause cancer. Use a respirator or other safeguards to avoid inhaling wood dust. "Retain this label and accompanying receipts with your tax materials to claim tax credit, if applicable. See www.jeld-wen.com/taxcredit for full details" 1200308 1 - 032422214 V50052 03/24/14 3/17/2016 img017.jpg L/adS g t o6 (i' ir47/, THE 2007 MINNESOTA STATE BUILDING COD PROCEDURE TO ETERMINE MAKEUP AIR Use the Appropriate Column One or multiple power vent or direct vent applies or no combustion appliances" TABLE 501.4.1 QUANT IT'( FOR EXHAUST to Eslhnate Hous One or multiple fan -assisted appliances end power vent or direct vent appli s° EQUIPMENT IN DWELLINGS : Infiltration One fly vented gas or appliance or one solid fuel appliance° Multiple atmospherically vented gas or oil apphaices or solid fuel appliances° 1, a) pressure factor (cf m!sf) 0.15 0.09 0.06 0.03 b) Conditioned floor area (sf) (including unfinished basements) �G%t,•' ; cl -� ,' , . _ ! �"' t_ 1 FIC. Estimated House Infiltration (cfm): (laxlb) 0 ()4 ((,U 2. Exhaust Capacity a) continuous exhaust -only ventilation system (cfm): (not applicable to balanced ventilation systems such as HRV) b) clothes dryer (cfm) 135 135 135 135 c) 80% of largest exhaust rating (cfm): (not applicable if recirculating system or if powered makeup air is electrically interlocked and matched to exhaust) ; -; d) 80% of next largest exhaust rating (cfm): (not applicable if recirculating system or if powered makeup air is electrically interlocked and matched to exhaust) r, i not applicable Total Exhaust Capacity (cfm): (2a+2b+2c+2d) 3. Makeup Air Requirement a) total exhaust capacity (from above) U -`> -' b) estimated house infiltration (from above) -,, +i Makeup Air Quantity (cfm): (3a -3b) (if value is negative, no makeup air is needed) _ 4, For Makeup Air Opening Sizing, refer to Table 501.4.2 A Use this column if there are other than fan -assisted or atmospherically vented gas or oil appliances or if there are no combustion appliances. e Use this column if there is one fan -assisted appliance per venting system. Other than atmospherically vented appliances may also be included. c Use this column if there is one atmospherically vented (other than fan -assisted) gas or oil appliance per venting system or one solid fuel appliance. o Use this column if there are multiple atmospherically vented gas or oil appliances using a common vent or it there are atmospherically vented gas or oil appliances and solid fuel appliances. 332 https://mail.google.com/mail/u/0/#isearchllriendlyheating%40outlook.can/152f55b17372278f?projector=1 1/1 H a0 w w 1- \)‘')" on, q � i-;641 , REPORT NUMBER: 100970830MID-001 ORIGINAL ISSUE DATE: Nov 19, 2012 REVISED DATE: NA EVALUATION CENTER Intertek 8431 Murphy Drive Middleton, WI 53562 Rendered To: Guardian Energy Technologies 153 Christopher Way Fox Lake, IL 60020 PRODUCTS EVALUATED: FIG005 Spray Foam (1 and 2 inches) EVALUATION PROPERTY: ASTM C518: Standard Test Method for Steady - State Thermal Transmission Properties by Means of the Heat Flow Apparatus Report of Testing of FIG005 Spray Foam (1 and 2 inches) for compliance with the applicable requirements of the following criteria: ASTM C518, 2010, Standard Test Method for Steady -State Thermal Transmission Properties by Means of the Heat Flow Apparatus. "This report is for the exclusive use of Intertek's Client and is provided pursuant to the agreement between Intertek and its Client. Intertek's responsibility and liability are limited to the terms and conditions of the agreement. Intertek assumes no liability to any party, other than to the Client in accordance with the agreement, for any loss, expense or damage occasioned by the use of this report. Only the Client is authorized to permit copying or distribution of this report and then only in its entirety. Any use of the Intertek name or one of its marks for the sale or advertisement of the tested material, product or service must first be approved in writing by Intertek. The observations and test results in this report are relevant only to the sample tested. This report by itself does not imply that the material, product, or service is or has ever been under an Intertek certification program." 1 Guardian Energy Technologies November 19, 2012 100970830M1D-001 Page 2 of 7 1 Table of Contents 1 TABLE OF CONTENTS 2 2 INTRODUCTION 3 3 TEST SAMPLES 3 3.1. SAMPLE SELECTION 3 3.2. SAMPLE AND ASSEMBLY DESCRIPTION 3 4 TESTING AND EVALUATION METHODS 3 4.1. THERMAL CONDUCTIVITY 3 4.2. DEVIATIONS FORM THE METHOD 4 4.3. RESULTS AND OBSERVATIONS 5 4.3.1. STATEMENT OF MEASUREMENT UNCERTAINTY 5 5 CONCLUSION 6 6 CALIBRATION 7 7 REVISION SUMMARY 7 Intertek Guardian Energy Technologies November 19, 2012 Page 3 of 7 100970830MID-001 2 Introduction Intertek has conducted testing for Guardian Energy Technology, on FIG005 Spray Foam (1 and 2 inches) to evaluate the thermal transmission properties. Testing was conducted in accordance with ASTM, following the standard methods of C518 (2010) Steady -State Thermal Transmission Properties by Means of the Heat Flow Meter Apparatus. This evaluation began November 19, 2012 and was completed November 19, 2012. 3 Test Samples 3.1. SAMPLE SELECTION Samples were submitted to Intertek directly from the client. Samples were not independently selected for testing. Samples were received at the Evaluation Center on November 19, 2012 in good condition from the client. 3.2. SAMPLE AND ASSEMBLY DESCRIPTION 2 Samples were cut to dimensions about 12 inches by 12 inch by sample height of 1 and 2 inches. Samples were not conditioned. Samples have a density 1.75 pcf for the 1 inch sample and 1.69 pcf for the 2 inch sample 4 Testing and Evaluation Methods 4.1. Thermal Conductivity The heat flow meter apparatus establishes steady state unidirectional heat flux through a test specimen between two parallel plates at constant but different temperatures. By appropriate calibration of the heat flux transducer(s) with calibration standards and by measurement of the plate temperatures and plate separation, Fourier's law of heat conduction is used to calculate thermal conductivity, thermal resistance, or resistivity. The accurate use of the test method is limited by the capability of the apparatus to reproduce unidirectional constant heat flux density in the specimens, and by the precision in the measurement of temperature, thickness, EMF produced by the heat flux transducer, etc. The apparatus shall not be used at temperatures, thickness or resistances, other than those within the range of the calibration, unless it can be shown that there is no difference in accuracy. Intertek Guardian Energy Technologies November 19, 2012 100970830MID-001 Page 4 of 7 The apparatus must be capable of maintaining at least a 10°C temperature difference across the specimen for the duration of the test, unless a smaller LT is a requirement of a particular test. The specimens tested may also limit the use of the test method and these limitations are outlined in Practice C1045. This evaluation was accomplished using a HFM436/3/1 ER Heat Flow Meter Thermal Conductivity Instrument, manufactured by Netzsch. The HFM436/3/1 ER determines thermal conductivity in accordance with ASTM C 518. Heat flow through a solid, results from having a temperature gradient in the material. Thermal conductivity is a material property, which determines how much heat flows through a given thickness of the material when there is a temperature difference. The Fourier linear heat flow equation defines thermal conductivity under steady state conditions as: where: I=0DT DX W I = thermal conductivity, m•K o = heat flux, m2 W DT = temperature difference across distance LX, K DX = distance between hot and cold plates, m Prior to each series of tests, the HFM436/3/1 ER was calibrated using a sample whose thermal conductivity is known and traceable to national standards. To perform the test, the specimens are placed in the HFM436/3/1 ER instrument, the top (hot) plate is brought downwards creating contact of both plates with the test specimen. The hot and cold plates were then allowed to equilibrate to the required temperatures and their exact temperatures were read from the instrument. The mean temperature for testing is 23°C with a temperature difference between plates at 20°C. The hot plate is at 33°C and the cold plate is at 13°F. Density Measurements were taken using standard ASTM D1622. 4.2. Deviations form the method Only one sample of each thickness was run. The sample not conditioned before testing, but tested when the samples were received. Intertek Guardian Energy Technologies 100970830MID-001 4.3. RESULTS AND OBSERVATIONS November 19, 2012 Page 5 of 7 Thermal Transmission Thermal Conductivity K Value Thermal Conductivity K Value Thermal Resistance R Value Thermal Resistance R Value Thermal Resistance per inch R/in Thermal Resistance per meter R/m Units: Btu-in/hr-ft2- °F W/m-K Hr-ft2- °F/Btu m2-K/W Hr-ft2- °F/Btu/in m2-K/W/m Specimen 1 inch 0.142291 0.02052 6.94464 1.2230 7.03 48.7 Specimen 2 inch 0.143841 0.02075 13.73614 2.4191 6.95 48.2 4.3.1. Statement of Measurement Uncertainty The uncertainty of the Netzsch Thermal Conductivity Instrument HFM436/3/1 ER is estimated to be 1-3%. Duration of the measurement Instrument Instrument Mean Mean Test Information Thickness Thickness Temperature Temperature Temperature Gradient Units: min (in) (m) °F °C °F/in °C/m Specimen 1 inch 0:27:04 0.9882 0.025100 72.29 22.38 41.6 16.35 Specimen 2 inch 0:31:12 1.9762 0.050195 72.25 22.36 20.95 -37.38 4.3.1. Statement of Measurement Uncertainty The uncertainty of the Netzsch Thermal Conductivity Instrument HFM436/3/1 ER is estimated to be 1-3%. Intertek Guardian Energy Technologies November 19, 2012 Page 6 of 7 100970830MID-001 5 Conclusion Intertek has conducted testing for Guardian Energy Technology, on FIG005 Spray Foam (1 and 2 inches) to evaluate the thermal transmission properties. Testing was conducted in accordance with ASTM, following the standard methods of C518 (2010) Steady -State Thermal Transmission Properties by Means of the Heat Flow Meter Apparatus. These results are listed as is and there are no pass fail criteria for this testing. The conclusions of this test report may not be used as part of the requirements for Intertek product certification. Authority to Mark must be issued for a product to become certified. INTERTEK Reported by: Reviewed by: B 'an Bowman Chemist, Verification Center Mark Crawford Chemist, Verification Center Intertek Guardian Energy Technologies 100970830MID-001 6 Calibration November 19, 2012 Page 7 of 7 Equipment: Equipment Number Calibration Date Thermal Conductivity Instrument 1266 Calibrated before testing Scale 1045 February 2013 Micrometer 1248 May 2013 7 Revision Summary DATE SUMMARY Nov 19, 2012 Original Issue Date 441/1° CityofEaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: L 2015 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: itD- - t Site Address: Tenant: Suite #: CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage. Cali 48 hours before you intend to dig to receive locates of underground utilities. www.00pherstateonecall.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 inthecase of work which requires a review and approt{,�I of plans. x n `kt byy . Vv 19st--6(- .(- Applicant's Printed Name x Applicant's Signatl;tre Name: V" \ `, r} 8 ES -51-)1.-6-4 Phone: Address /CitY / Zip: 1C(;b Utsh,�\ i;o , C��� k -e e .-,‹ sY1r\ LCqq c s s Name: 'c -,r Vii cc, _vv,,tD License #: pG cc'i t I _wc_ Address: -5b Ce -` S - City: ( �-s State: J w-' Zip: 45K 0 !. Phone: (0(2- a7 2- " o 0Z - I.:)(2_ s ;0 (;ctoo Contact: o� IN et©4er Email: : 1,tr V.& -Phi ca Q q o t , ctt -- y New ‘..--Replacement Repair Rebuild Modify Space Work in R.O.W. — — Description of work: ,-1---n-i- . 4_ ,(- s g 1''rCV \ 0-CO/Y1 S '''/' " K i /1-G-41 RESIDENTIAL t Water Heater 2-ec-kr`c_. Water Softener Lawn Irrigation ( RPZ / PVB) Add Plumbing Fixtures ( Main / _ Lower Level) Septic System New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, $60.00 Lawn Irrigation $60.00 Add Plumbing Fixtures, *Water Turnaround $115.00 Septic System Water Softener, or Water Heater and Softener (includes State Surcharge) Turnaround* (includes State Surcharge) TOTAL FEES $ (includes State Surcharge) Septic System Abandonment, Water (add $280.00 if a 3/4" meter is required) New (includes County fee and State Surcharge) CALL BEFORE YOU DIG. Call Gopher State One CaII at (651) 454-0002 for protection against underground utility damage. Cali 48 hours before you intend to dig to receive locates of underground utilities. www.00pherstateonecall.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 inthecase of work which requires a review and approt{,�I of plans. x n `kt byy . Vv 19st--6(- .(- Applicant's Printed Name x Applicant's Signatl;tre Use BLUE or BLACK Ink r For Office Use n}'����� Permit#: (`-U v7 X Ll of �N/ Permit Fee: �U 3830 Pilot Knob Road Eagan MN 55122 Phone:(651)675-5675 Date Received: Fax:(651)675-5694 Staff: L 2016 MECHANICAL PERMIT APPLICATION ❑ Please submit t>wo_(2)sets of plans with all commercialcija�p/pplications. 7� / Date: l //IZ-//S% Site Address: �� ,Q.0 Je r 712411L,r�(, S, Tenant: P/NPv/AJr "� Suite#: /,�`] /Name: fl'1€5 If 12 l d g -314116 effitifer /ownE3t "�" Phone: Address/City/Zip: iV© 3 / j ni Pi---) g51-1/5- , Name: / tLicense#: Address: / `Y, /1/ j'V/ �� ice'� 12,t19 Q,/D /. L ��:ra. State: /Z.— 24 I-- 05/ D J V l All Zip: 99.3'7 2,- Phone: Contact: �� Emailj14JhiIhflf)7iZftCO7Jt7/(1 6 i � New Replacement Additional y Alteration 6! Demolition Tyle of Wor Description of work: O1"E: mountedmechanical isi# a bf a „ Code. ; eco ` anni Ins r� 'm tion e ...g ll RESIDENTIAL COMMERCIAL Fumace New Construction Interior Improvement e�itT Air Conditioner Install Piping Processed f Air Exchanger Gas Exterior HVAC Unit Heat Pump{-�, Under/Above ground Tank ( Install/_Remove) Other VG11/T o7C/y V RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit,includes State Surcharge / ' // $100.00 Residential New,includes State Surcharge =$ If' G' , ev TOTAL FEE COMMERCIAL FEES Contract Value$ x.01 $60.00 Permit Fee Minimum $75.00 Underground tank installation/removal,includes State Surcharge =$ Permit Fee _$ Surcharge Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million,please call for Surcharge =$ TOTAL FEE 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]approvedJ plan in the case of work which requires a review and approval of plans. x k� "vL�Name x Applicant's Prints me Applicant's Sin re FOR fteE Required In cbns: Reviewed By t °r ndergro� _ I,o In > r Test ` .�Sergi Test , r- t r .. AC , PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA141024 Date Issued:02/09/2017 Permit Category:ePermit Site Address: 4255 South Robert Tr Lot:000 Block: 006 Addition: Auditors Subdivision 42 PID:10-03900-06-011 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087 Surcharge-Fixed $1.00 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 - Mb And Ty Estates Llc 400 - 4th St S Ste 401-247 Minneapolis MN 55415 Peters Plumbing 20455 Manor Rd Excelsior MN 55331 (612) 803-5066 Applicant/Permitee: Signature Issued By: Signature Terry Zelenka From: Joe Peters <peters15612@gmail.com> Sent: Monday, February 27, 2017 2:50 PM To: Tem, lei ka-- Subject: 4255 south Robert trail Terry, The leak is repaired! Needed a new flare. Thanks, Joe Peters q/ 41--- //‘ 0 IA (1)/ 1 Use BLUE or BLACK Ink r For Office Use I ::::e1 ° " ilfb. Cit of Ea al / - �0 3830 Pilot Knob Road �/ C) Eagan MN 55122 RECEIVED Date Received: I Phone:(651)675-5675 I Fax: (651)675-5694 APR 1 9 2017 Staff: � 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: `- '2.79-/ Site Address: I/ZJ5 OAt,7 �le Z' Unit#: Name: /"/ f7' J7�i {� /�e �. � � Phone: �. .� _ . Resident/ Owner Address/City/Zip: !/6-2- Z . f - SI 4/167-2-z/7 /�/Z5 /i% 5S �J ^ / �- s Applicant is: Owner "Contractor I K- Description of work:�✓L11�,��/irC(�'l2iC���..-. m.._. -..-�.�. �_... ... �..��_._..�., .....3 T of Worlt 3 0 Construction Cost: S/ Multi-Family Building: (Yes /No ) g Company: /Jc 0 4[' '�7z'�'4 c0/-1-1 710/1f -Li)I -L �- Contact: _�. 1 I Address: A7 S '7 // iT� e' City: "1`P.r*7ou4 Contractor { g State��/V Zip: X52 9,Phone: 2-1 -7e22 mail: /Page? ber,oi:'cikwPdvn License#: 6 �7v� Lead Certificate# AA / T L �� � (U /U/ q If the project is exempt from lead certification, please explain why: } / a/c' e, 4/0 . G r %:^ / ,r�o dcr ®r2.h (4e,Lmei �" 1 arm ,� .. Ad ftJ t ; COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING IIn the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? I Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression 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 L conclude that mare 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.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. Exterior ork authorized by a building permit issued in accordance with the Minneso tate Building Code must be completed within 180 days o 'permit issuance. x/6,14. e��7 a/ ktg x Applicant's anted Name Applicant's -ignature Page 1 of 3 z.-42 ='` (Ql<t ./k\ ` -�0h'7c'� D NST WRITE BELOW THIS LINE fiy 7 97 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 ` Occupancy .�tej,- MCES System Plan Review Code Edition Fi:'► S ! r SAC Units (25% 100% !Y, ) Zoning g 1 City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction ll Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) X Final/C.O. Required Footings (Addition) Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Roof:_Ice &Water _Final Pool:_Footings _Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace: _Rough In _Air Test Final Siding:_Stucco Lath _Stone Lath Brick EFIS Insulation Windows Sheathing Retaining Wall:_Footings_ Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final Braced Walls Erosion Control Shower Pan Other: '11Reviewed By: '" , Building Inspector RESIDENTIAL FEES Base Fee6.KAA. '5 ip 14 `' Surcharge Plan Review (900 i .v MCES SAC , ,41%rtf City SAC1. x Utility Connection Charge ,„ '"` S&W Permit& Surcharge 04\ Treatment Plant "` r '- Copies TOTAL Page 2 of 3 STAR QUALITY GLASS FILE / / 648 N. MAIN ST. CAMBRIDGE, MN 55008 WO# W0005666 PH:763-689-1551 FAX:763-689-1555 IR691793 Federal Taxi• 4 -18•8116 P/O#: Cust State Tax ID Taken By: Dianne Cust Fed Tax ID: Cash Sale: C(}00733 Installer: Ship Via: Date: 6/5/2017 Time 113:36.'M SalesRep: Adv. Code: Bill To:JOR4842 _ - - Sold To:JOR4842 JON JORGENSON JON JORGENSON (612) 518-4842 Qty Part Number Description List Disc% Sell Total 2 CLR TIGU-DSB (26 3/4"x 30 3/8") DSB CLEAR TEMP IGU $119.30 0 $119.30 $238.60 THANK YOU FOR YOUR BUSINESS! CHECK US OUT ON THE WEB AT WWW.STARQUALITYGLASS.COM A Payment has been made on this order: Other($255.00). 1 . .5,5745.7 am' x r'° i i l WELL OR BORING LOCATION MINNES A DEPARTMENT OF HEALTH Minnesota Well and Boring H 3 3 0 2 3 5 County Name WELL A BORING SEALING RECORD Mines No. Unique Well No. .447777-- I ;(-c\,.. /Minnesota Statutes,Chapter 1031 or Were,iNo. Township Name Township No. Range No.-median No./rection(sm...Ig.) Date Sealed Dale Well or Bong Constructed Co. t�.n �7W 2...s/ ,5 • IAV 1;Z—'-/-/3' i /4/0 s GPS LO ION—decimal degrees(to tour decimal pl. es)- / e Depth Before Sealing L> ft. Original Depth 'V© ft. Latitude Longitude AOUIFER(S) STATIC WATER LEVEL umerical Street Address or Fire Numb r a I t Well or Boring. tin Al Single Aquifer 0 Multlaquifer 1^7 LI-.13- M156- t 3 M1, Sa (�be r' r' 3 WELL/BORING Measured 0 Estimated Date Measured �S J G J 'f1 r; water-Supply Wet❑Montt.Weil 9 S - act location of well or bort. ch map of well or oring in sect o e • location,showing property 0 Env.Bore Hole 0 Other ft. IX below ❑above land surface .N. lines,roads,and buildings. CASING TYPE(S) ilii 7 ,L, . i : , ai Steel ❑Plastic ❑Tile [3 Other W rel--- - -_A__—.__• = E ��� WELLHEAD COMPLETION ' �_____f__,___j,__•___f__, T ZINN Outside:❑Well House D At Grade Inside: kBasement Offset 1 i t i %mile Pitless Adapter/Unit 0 Buried 0 Wet Pit 1 WeS« ❑Well Pit 0 Buried S 0 Other I'—•-1 Mile--{ , ❑other PROPERTY OWNERS NAME/COMPANY NAME CASING(S) L_o Lit Se_ 14. / /t,(r" Diameter Depth Set In oversize hole? Annular space initially grouted? Property owner's maims address if d.iifferent than welt location address Indcated above "' In.from J to 17 11. 0 Yes Qt]No 0 Yes CV No 0 Unknown in.from to fl. 0 Yes 0 No ❑Yes 0 No 0 Unknown In.from to ft. 0 Yes 0 No 0 Yes 0 No 0 Unknown WEL OWNER'S NAME/COMPANY NAME SCREEWOPEN HOLE 1 —..0 v Ise E. M v e t(e Screen from �� to ft. Open Hole from IL Wet owners malting address If differentntthan property owner's address Indicated above L O V ti 5 t' I-. !'F UeMe r `'7U i oso a OBSTRUCTIONS �(V p e 01 by �o '.-z. cL S4s .,. ,+'.�h L i `d Rods/Drop Pipe Check Valve(s) D Debris 0 Fill 0 NoObstruction L it`PrS U i it e [(f h a J Z_3f J7 Si Type of Obstructions(Describe) J 9 Q t��f1 Cll'i Q i Ve 4- P.i W.4-A lvlcl 1 V!):Vt? GEOLOGICAL MATERIAL COLOR NARONess OR FROM TO Obstructions removed? [ 'Yes ❑No Desert:* f FORMATION — - If not known,indicate estimated formation log from nearby well or boring. PUMP Type Je,is CA llYNC1 ( Removed 0 Not Present ❑Other METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE: No Annular Space Exists 0 Annular Space Grouted with Tremie Pipe 0 Casing Perforation/Removal • ADD IT)C-NALDATAADDED in.from to ft. ❑Perforated 0 Removed TO THS DOCUMENT in.from to ft. 0 Perforated ❑Removed DEC 2 4 2015 Type of Perforator VARIANCE DATE RECF ,� ' , j Was a variance granted from the MOH for this well?❑Yes Ntt No T Frerp.' 'IF"' e _ GROUTING MATERIAL(S) AK�((� C p Q L( ) (One bag of cement=94 lbs.,one bag of bentonite=50 lbs.) ` D A l►vA —•• r s((�l !<tOOKI1 Grouting Material ✓e�1 1Q rpom vt7 ,to S. yards "t bags VAPF . ti- AL') from to ft. yards bags from to ft. yards bags OTHER WELLS AND BORINGS REIIRARKS,SOURCE OF DATA WAtrL 5 iN SEALING Other unsealed and unused well or boring on property? 0 Yes J No How many? SC inNe4.1* 0'CSek 5 , \i 5‘ck, LICENSED OR REGISTERED CONTRACTOR CERTIFICATION This well or boring was sealed In accordance with Minnesota Rules,Chapter 4725.The information contained in this report DU vk> r.7 J C'e TOSS / w e 4.. SA-046s 104 _s is true to the best of my knowledge. Licensee Business Name License or Registration No. SA/'CAA i 0Feb-1'%,wc.‘ v. ;a p; i- is iQa l /z- yy.l5 V Yl d er S4Q�-i-.S, Seci ep�t c Q�a 3 Certld epresentativenature Certified Rep.No. Date 1 [;A lJl MINN.DEPT OF HEALTH COPY H 3 3 0 3 5 Name of r�son Sealing We/rt or Borir HE-01434-14 IC#140.0423 5/13R