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4411 Slater Rd sms SEItYlCE PERMI'T CITY OF EAGAN ~~T ~ ; ~ 3$30 Pilot Koob R°ad P P. O. Box 21199 DATE: Eage^. MN 55121 W. of Unies: ; Zoning: oyyMf1 Add"ss' 4411 Slatet Ttaac' Sit~ Addrsm S• ttiT ^lu~1 ~2Crr! : - a n'' Pfumbrr ~ r f~_g_.•;s . Cawwction(]+oMO: N No* V&b the Cft of M/•a Nooount aP06W' ~ Pennlt F+e: Surei?orw: N1itC. Charo" By T°ed' p~ cF IroP.: p~ Poid: Irop~ CITY OF EAGAN WATER SERVICE PERMIT ~ 3830 P{lot Knob Road pE~1T NO.: P. O. Box 21199 Eagm. MN 58121 DIhTE: ZonlnD: No. of Units: I ~ i _ us^_nn :ioaes Owrwr. /lddras: Sib Mdras: 4411 later P.w-,; I23 7~2 Plumber. Star Plumbia Gonnaction G+a?ots 5G0 . ~JGnd M'+" N°.: 15 ze: llOvd Reoder No.: Permit Faap°''t: 10 QOw 1 Mn. Ha p11 wo 60 GeY of v+Nn Surdwroe. . 50'Dd Mbc. Cha~s: 156. E1^pd T? Totol: b? . 503•r1 mAtQr BY DOte POId: Daft of Irop.: I^q" d- . • - WATER SERVICE IPERMtt ~ CIT1f OF EAGAN 3830 Pilot Kncb Road PERMIT NO.: P. O. Box 21199 pATE: I Eoan,'NIN 55R21 No, of Unlts: 1 f~ ~ina: ??.L18C0?'~ i"~• ~ aMnMfl '1 3 Pe ~ ~ ,.t. Addr*W 4411 Sx'' Add^am ~t3T ' Piumbec ~s on Cho?ge• 15.0Op( ?,MWr ~~i~, lO.Ctlp~51u: Rooder No.: • 1,, 6 7) ~ gpile„t.eenph aM' 00 * pk*s Poid: B1f I^q" Dote 10 ~30 f p~ ~ - - - - . . a, . . . - z . . ~ . . -.-..r---~-- 3830 Pilot Knob R d' P.O. Bo 2GA -799, Eagan, MN 55121 t`2 120,17 PHONE 454-8100 BUILDING PERMIT Receipt M To be used for SF DWG/GAR Est Value $51,000 Date .-T11NF. Q SiteAddress 4411 SLATER RD Erect 11 Occupancy K3 Lot- 2 3 Block -2Sec/Sub. CINNAt+i[]N RTD{W, A6model ? Zoning R.i Parcel No. 3RD Rppair ? Type of Const ;Additian ? No. Stories ¢ Name RUSCON HOMES Move ? Length 36 z 14530 PENNOCK AVE Demolish ? Depth 46 o Address Int Impr. ? 5q. Ft _ City A•V• Phone 432-1433 Instau ? Z. o Name SAME ApPra?ab Fam Address Ass833ment Permit $ 2$6.00 City Phone Vyater &,Sew. Surcharge ?5-.50 Police Plan Review14-1~ 00 W W Name PRUBE ENGR/I?1ARIC NAGSI. - Fire SAC 575.00 _ mi Address 5A''E Eng. Water Conn.';Q,I . OQ ~.s W City Phone Planner Water Meterki -1.. 50 ' Council Road Unit 29tl 00 t hereby acknowledge that I have read this application and state that the Bldg. Off. 6/9 6 Tr. PI. 15 6_ 00 ~ iniormation is correct and agr to comwith all applicable State of Var. Date Minnesota Statutes and C~ty TI'garli an ces APC Parks Copies Signature of f~ermittee ~ Total $ 2,039 . OU A 8uilding Permit is issued to: RUSCON 0mE$ on the express condition that all work shall be done in accordance with all applicable State ot Minneso~a Statutes and City of Eagan Ordinances. Building Official ' Pwmlt No. Pinrit Nold~r DaM TiNpAone M ~ PhrmWn9 r - ~ IH.V.A.C ~ C~ Ifr73 B~ - s~.. ' Impecgon DaN Imp. Comm~nb ft~ 1 6 6 77 Foounq. u 11 Foundelfon 11 IFrsminp - ~ RooNny JRouqh Plbp. Rouyh Mtp. Imul. ~ IFlnM HtY• ~Jo 7 Ld~ IFlnal Plbq. sft. c.n. ooC. Jo.-k Ftg. Dwek Frmp. I Ylfdl DMCribe LoCatlon: Pr. Disp. .;u ~r':i' . _ i~~~.;~. ;r'^~i"r•'~r,'h~:~i .i~'.;;~jy. :;~~.v±.,_~ ..;s-:. r _ PERMIT # ' L PIUMBING PERMIT RECEIPT # ' GTY OF EAGAN 3e30 PILOT KNOB ROAD, EACAN, MN 55121 DATE: CONTRACT PRiCE PHONE: 454-8100 Site Address &r ~,~~1 ''`7 BLDG. TYPE WORK DESCRIPTION Lot Biock Res. New m Name Mult Add-on y Address Comm. Repair c Clty - ' h 'i Phone < Other Name 7o H o-S FIXTURES TOTAL ~ Water Closet - $3.00 ~ ~ Address ~ Bath Tubs - $3.00 p City l? Ile Phone < 3-2 < ~ Levatory - $3.00 - Shower - $3.00 ~ Kitchen Sink - $3.00 FEES COMM/IND FEE - 1% OF CONTRACT FEE Urinal/Bidet - $3.00 ' Laundry Tray -$3.00 MINIMUM - RESIDENTIAL FEE - a10.00 Floor Drains -$1.50 MINIMUM - GOMM/IND FEE - 20•00 ' VNater Heater -$1.50 STATE SURCHARGE PER PERMIT - •50 Tyyhirlpool -$3.00 (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets -$1.50 BEYOND $1,000.00) Softener - $5.00 Wefl - $10.00 I Private Disp. - $10.00 Rough Openings - $1.50 SI ATURE OF PERMITTEE FEE STATE S/C: ' FOFI: CITY OF EAC'aAN GRAND TOTAL• . . . ~ , PERMIT #I ~ OL r MECHANICAL PERMR RECEIPT #k qTY OF EAtiAN 3830 PILOT KNOB ROAD, EAOAN, MN 55121 DATE CONTRACT PRICE PHONE: 454-d100 Slte Address _ BLDG. TYPE WORK DESCRIPTION Lot - BIoCk SeC/SSibr Res. New m Name rvLN"LcL :`iECi-ijY.dl(;A~. ` Mutt Add-on ~ Address 3600 Keanebec Drive Comm. R ir c ~ City Phone _ ~ Other Name wscu;i N m~s FEES c q~~~ 14530 ennoc t Ave. RES. HVAC 0-100 M BTU - a24.00 il: 0 Ci~ ~ pp e Va eyPhone ADDITIONAL 50 M BTU ; - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 TYPE OF WORK ADDITIONAL 6 M BTU - 6.00 80,000 24.00 GAS OUTLETS - 1.50 EA. Forced Air M BTU COMM/IND FEE - 194, OF CONTRACT FEE Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 ar Cond. M BTV ; STATE SURCHARGE PER PERMIT - .50 Vent CFM (ADD a50 SIC IF PERMET PRICE GOE.S 1.50 BEYOND $1,000.00) Gas Piping Outleb # Other FEE 'S.SU sfC. .50 SIGNATURE OF PERMITTEE TOTAL• `~r'.1)() FOR: CITY OF EAGAN CITY OF EAGAN Remarks Addition CINNAMON RIDGE 3RD ADDN Lot 23 Rik 2 Parcel 10-17402-230-02 Owner Street 4411 SLATER ROAD State EAGAN NIN 55122 ~ Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. ~ 1985 1012,2 202.44 STREET RESTOR. GRADING SAN SEW TRUNK - 102.22 6.81 1S * SEWER LATERAL - ' 1985 2834.53 566.90 WATERMAIN *YNATER LATERAL 1985 WATEA AREA 1973 F131,44 j STORM SEW TRK - 1979 381.69 19.08 20 * STORM SEW LAT 14$5 CUFiB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK ;e~°ns~l ad 17 C 1~7 3 8 L a 3Q,~.p 39 - Reques[ Uate Fire No. RouAh-m InspecUOn Cl/ - I~ Neqwr > ? ~ReaAy Now iil Nnufy Inspec- / ~ rya lor When qeadv Qltflcmnsed ElecM1mal ConUacmr I hereby repuast inspection ot ebova ? Owner elechicel work inslalleE et: Sveet Address, Boz ar ~Rav^te No. Gtv d ectwn o. TownsMp Name or No. Range No. Co~ Occuoant PflINTI Phone No. PawJe \SuOPl//qier Atldress iC.~c~~ • Elech cal Con ac~or ICOm any Name) Convnr,to License No. ~ MiIinO A Jress IConVactor or Owner Makmg Instadat onl ~ . ~ s.3 2' Aulhori w Co racm Own Makmg Installa 1 Phone Number i /A MINNESOTA STAT BOARD OF ELECTNI ITY THIS INSVECTION HEQUEST WILL NOT Griggs-Midway Bldg. - Noom N-191 gE ACCEPTEO BY THE STATE BOAHD 1821 Universitv Ave., St. Peul, MN 55106 UNLESS PHOPEN INSPECTION FEE IS Pn..no 16121297.2111 ENCLOSED. ~r3 J 8-111 REQUEST FOR ELECTRICAL INSPECTION ee-ouooi.oa ~ Seo inatrmtions for comoletinp this form on beck ol yellow co0v. C 1 8 7 3 8 "'X"' Be/ow Work Covered by Ihis Request 4ne ReO. Type oi suiiaine AVOliancea WveE eauiumant wi.ed hbme Range Temporary Service Duplex Water Heater Lightiny Fixtures Api. BwlAing Dryei EleClrie HeBtm Commercial Bldy. Fumace Silo Unloader Industnal 61dg. Air Conditioner Bulk Milk Tank Farm 1n, PL(:i v inc~ ISnen~vl t M17 VeC,fy fh<;r OIM1U, ompute Inspectmn fee Below N Fee Servica EnhenceSixe A Fee Fexde,s/5ubleeders u Fen Circuits 1 (7,00 U to 200 qm 5 0 to 30 Am s 4' Z.00 0 in 30 Am s Above 200 qmps 31 to 100 qmps 31 to 700 Am s Swimming Pool Above 100_Amps Above 100_Am - Transiormers IrrigaLOn Booms rQ Partial: Ot r ee SignS Special InspeCtion $ TQTAL HeerNrks ~ 3 Pouah-in r Date I, the Elactnwl 6-`ab insoector, hereby certify that the aCOVe Final r D(1(?' inspectwn bas bean ~ / /U - metle. ThlereQUesivolUlBmonthatrom ' ` CITY OF EAGAN e • 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N2 12087 BUILDING PERMIT PHONE: 454-8100 Receipt q To be used for SF DWG/GAR Est. vaWe $ 51 ,000 Date JUNE 9 1986 SiteAtldress 4411 SLATER RD Erect CN Occupancy R3 Lot 23 elock 2 Sec/Sub. CINNAMON RIDGE Remodel ? Zoning R1 Parcel No: 3RD Repair ? Type ot Const. y~ Addition ? No. Stories w Name RUSCON HOMES Move ? Length z 14530 PENNOCK AVE oemolish ? Depth4fi. o Address Int. Impr. ? Sq. Ft ciry A.V. Phone 432-1433 Instau ? i o Name SAM Approvals Fees nddress nssessment Permit ~ Z86.00 " Ciry Phone Water&Sew. Surcharge 25.50 ~Q Police PlanReview 143.00 ~w Name PROBE ENGR/MARK NAGEL Fire SAC 575.00 ~ ~ Address SAME 'i Eng. WaterConn. 500.00 a w Ciry Phone Planner Water Meter 63 . 50 Council Road Unit 290.00 Iherebyacknowledgethatlhavereadthisapplicationandstatethatthe gldg.ofl. 6~9~86 T~.PI. 1$6.~0 mformation is carect an*agrto om p with all apphcable State of Minnesota Statutes an i ce APC Parks Var. Date Copies Signature ot Perminee Total 2. 0 3 9. 0 0 A Budding Permit is issued to: RUSCON OMES on the eapress condition that all work shall be done in accordance with all applicable State 'nne a StaWtes an Ciry of an Ordinances. BuddmgOffiCial i~ ~ ~ 411 U 1986 BQILDING PEHtQT APPLICATZON - CITY OF EAG9N NOTE: ALi. CONTAACfORS M[IST BE LICENSED iiITH THE CITY OF EAGAN SIflGLE F9MffLY Di1ELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SU[iVEY, 1 SET OF ENERGY CALCULATIONS MpLTIPLE DWELLINGS - AFSIDENTIAL AENTAL IINITS FOR SALE IINITS INCLUDE 2 SETS OF PLANS, CEATIFICATE OE SQRVEY - CHECB WITH BLDG. DEPT., 1 SET OF ENEHGY CALCULATIONS CDlMHCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND To Be Used For: r, Valuation:~~-2~~Date: -T-- Site Address ~'~I /1 U/ ct ie2 f,sJ OFFICE USE ONLY Lot Block QLY"U~rF-~ Z Erect ~ Occupancy Q3 Remodel Zoning Parcel/Sub Repair _ Type of Const ~-k/ Additlon Ik of Stories Owner Move _ Length Demolish - Depth Address Int.impr. Sq Ft install City/Zip Code Phone ~~7- ~L~A-5 APPR09A[S FEES Contractor ~j Assessments Permit Zu(~ ~ Water/Sewer Surcharge Z5,5 ~ Address XX',~~~ Police Plan Review J</3 ~ Fige SAC ST City/Zip Code V ~J En r Water Conn 5~00 Planner Water Meter 6 3.~ Phone Council Road Unit 9vo ~ Bldg Off Treatment P1 Arch./Ep r. (~J APC Parks ~9-~~ Variance Copies Address /TMgL ~ City/Zip Code ehone ll HOTE: ADDRESSES FOR CORNER LOTS - CONTAACTOR/HOMEOHNEA MUST DESIGNATE WHICH ADDRESS- IS DESIRED. NO CHANCES BILL BE ALLOWED ONCE BDILDING PERMIT IS ISSQED. / • 4-1 50~C:) 80 nOB` COHSllLT1N6 Eli61NEfAS ENGiNEER1NG PIRNHE9S and IAHD ~llRVEY011S COMPt~NY, INC. ~ 1000 EJ~ST 146Ch 57AE:7, BLIRNSVILLE, Y(HHE:07A 32337 PH ~=2'300~ C4eTZZZ CtZL! e ~c if LOT 23, BI-ocK 2, CW/NANioiV RIDGE 3 RD ADD/T/O/V, DAKOTA COUA/i M/NA16,50TA, .S g?o 36' /!"E 90.' 26.00 - ' ~ - NoRrl~i DRA/NAG.&F,9`U)'iL/T F9 Y I LDT \ ~ g I . `S, % .SF~N cN T 2 O" B!//G O/NG ~ % ~ ~ \n°7 N ¢o y<v r ~ (y v 5 I q`Vi ~'~•s, fA-pAr,~~ ~ ip - 00.1 a ~ o ti ~~s3~ !9i5,5 ~ ,~)ENOTES EX/ST/NG ELELAT/UN ( 9iS. G'ENOTES /~RO,~OSE1~ ELEI~i4T/ON /NG/CAiE~ D/RELTiQ/V O/= SURFi4CE OR.4/NAGr 9~7,So = F/N/Sh''ED 6ARA6E FCOC2 ELEI/.9T/oiV I hereby cartify that thia in a t:ue and corr=ct r'aPmeeatition of a tract ot land aa aho+m'and deacribed heraon.• Aa PraPnrnd by me on this ~ diY ot .fvnt , 19 P~ . ~ lfinn. ltes. No. /~~s' . . . r~~- . - - EXTERIOR ENYELOPE RVERAGE "U" COMPUTATION . . _ . . • . ~ ~ _ , ~ . OWNER < • . . - - _ - • - - : ~`K.~ . : • - - - - - - - ..'S_4 - _ SITf AODRE55 _ . - _ , . , _ _ . :Z - 1-113" CONTRACTOR DATE . , PHDNE A • Determine working square footage of each. 1. Total exposed wall area Z sq. ft. x ell 2. 7ota1 rooflcei7inq area sq, ft. x.OZb Total~exposed wall area above floor = Iro~'i 7: Z a. Total wa1T windaw area b. Total door area 8R ' . . c. Total sliding glass door area - ~ d: Total fireplace wall area /4/_Z e. Total wall framing area (avera9elOA • f..Totai net wali area a6ove floar LZ 7(~,f~ ' g. Total rim jeist area q q4-_ Total exposed foundation area h. Total foundation window area - i. Taal net foundation area above arade AS,Z - Determine "U" value of ezan wal] see-_nt. a. /29 Z "L" • 33 - = 2.o b. X „U„ .13 = 24,24 c. xloU„ 33 = Z9 04 . d. - X „ull ~ ~ - e. x"U" li I Z . f. / 270, R x„U„ , n4,3 _-)4 G g. 90" ro X „U'l .04 = a3s ~ h. - x l.ull i. qz)y7 X liull 3 Total If item 13 is the same as, or less than item fl, y(u-have met the intent of 53C 0'005(c)2. .J = .~F. / . ~-~-~:_t; . . . . . / ` . - ` f'. _ . . X~ _ Total exposed roof/ceiling area = ' ~4 . ~ Total gross roof/ceiling area = 5G4_ . • . _ j. Tota1 skylight area . ~ k. Total roof/ceiling framing area C. 4 1. Total net insulated roof/ceiling area....... 17 7 Determine "U" value for each roof/ceiling segment. . . ~ • X liuu . k. Xituss z, 74 z,.. 12.az"NsUL. ovfs-. 1. :Z 77, G x„u„ ,L."e 3,1t. . 4 ..................................Tota1 = I/ Z - If total of 14 is the same as, or less than #2. you have met the intent af SBC G006(01. . . . To utiitzed the total envelope system method, the values.established by the sum of items #3 and 04 shall not be greater than the sum of itens 61 and f2. 1. + 2. _ 3. + 4. _ MATERIALS Therm. Resistance "R" Exterior Air 5lding Haterial . co5 ~Iw ~~e. 3heathing Z•oc. • Iasulatioa SheetroCk .45 ('i' Interiox Aix .17 Studs S.5 ¢;I pEA i" Rim I.5 Conc. Blks. 1.28 +~z: is2! . . . ~ . ~1***1!?f*x>#***w~>ttfYftY*f2f*****9aF * ! . CITY OF EAGAf~ * ~F~ * * APPxovAu. oF PM;tb=. * * APPLICATION FOR PERMIT * . * INSPEX.TZON OF SE~ES+h~I2 ADID/O2 FiA'IEF2 *F _ *f TnMnr.TamTONS WIIS. WT BE SCAFI>- * SEWER AND/AR WATER CONNECTION ~mm UwB. PERrIIT HAs sEm ~ ; nnrxovm. * * * . * . . **t+~*t*#,t,t~*k*:x++*r,tyi:,t+t**~:x~,t+t P ease Print ~ 1) PROPERTY ADDRESS: Z/"//J ~ ~{g'~-~C LEGAL DESCRIPTION: 1-2- -'j 13 Z - Lot Block Subdivision or Ta Parcel ID ) IF E}ffSTING STRCCIS7RE, DATE OF ORIGINAL B[,'ILDING PERMIT ISSL'Af1M: ' Year) PRFSEPlP 7ANING/PROPOSID L'SE: (Mon CD CCkM!%ERC?A~/a-ETATT./ngp2CE ~ R-1 SINGLE FAMILY Q ZAIDCSTRIAL Q R-2 DL'PLEX (Ztoo Onits) n INSTI'IL'TIONAL/GOVERNMENT ~ R-3 TOWN-IOUSE (Three + Units) ( Onits) ~ R-4 APARTMENI'/CONIDOMINILTM ( Units) 2) NA`'E: Ruscon Hames, Inc. ADDRESS: 14530 Pennock Rve. CITY, STATE, ZIP: Apple Valley, Mn. 55124 PHONE: 432-1433 3) u c~• ~ME. c>~ For City Use Pltmibers License: ADDRESS: O/~ Active f5cpired CITY. STATE, 2IP: Not recorded PHONE: MASTER LICENSE# Sta In1t1a1 4) ffier*71Y•:./ I 191: NAME: ADDRFSS: , CS71', STATE, ZIP: PHONE: - .5) u r~ • . • ' ' ot • o~ U"vY~~ B'*CONNECTION 1U CITY SEwER commCTION ZU CITY WA7£R 0 OTfER 6) " ~ PIESE HOLD APPROVf•D PERMIT FY)R PICK-C~P BY ONE OF ABOVE ~ Q PLFIISE MUL APPROVID PERMIT TU 1, 2, 3, 4, ABOVE (Circle one) 7) r r. ~ - . y. ~ •r w ~ ~ u ~ r • • • o ia• , n r~a~• . . • a• r ~ ~ ~ r. . i>. ~ - r,r. •.na~ ~ ~ ~ ~ n • M1 . . FOR -CITY USE ONLY : PERMIT # ISSL'ED 7 Pd w/Bldg. Permit FEES: $ $ SEWER PERMIT (INCLUDE SURCHARGE) $ Af) - SLn $ WATER PERMIT (INCLUDE SURCHARGE) $ $ WATER METER/COPPERHORN/OC'TSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SES9ER TAP $ $ ACCOONT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ ~ C • ! l' $ WAC $ $ SAC $ $ TRL'NK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ ` LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL SENEFIT/TRC)NK WATER $ $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ $ TOTAL ~ RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? O YES IF YES, THEN A"PERMIT FOR 4VORK WITHIN PUBLIC ROADWAY" MLST BE ISSUED BY THE ENGINEERING ~ NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDZTIONS: APPROVED BY: TITLE: DATE : ' Please send copy for water meter to : Scherer Plumbing Rt. 1 Box 304 Shakopee, Mn. 55379 Copy for sewer and water connection goes to Star Plumbing Thank Yau Ruscon Homes, Inc. 2007 RESIDENTIAL BUII,DING PERMIT APPLICATION City Of Eagan ~ 3830 Pilot Knob Road, Eagan MN 55122 ~ Telephone # 651-675-5675 FAX # 651-675-5694. New Conslruc6on Reauiremenls RemodeVFteoair Reouiremenis Office Use Onlv 3 registered sile surveys showing sq. fl. of l04 sq. fl. of house; and all raofed areas 2 copies of plan showing footings, beams, joists Cerl af Survey Recd Y _N (200/a mazimum lot coverage allowed) 7 set W Energy Calculalions }or heated addilions Soils Repod Y N 1 Soils RepoA if proposed building is to be placed on dislurbed soil 1 sile survey Mr additions & decks Tree Pres Plan Recd Y N 2 copies of plan showing beam 8 windax sizes; poured found design, etc Addifion- iMicale dorrsde sepiic syslem Tree Pres Required Y _N lulofEnergyCalculations Oo-siteSephcSystem _Y_N 3 mpies of Tree Preservation Plan if lot platted after 711193 Rim Joisl Detail Options selection sheel (buildings with 3 or less units) Minnegasm mechanical ventilation torm Plans are considered ublic information unless ou state the are trade secret and the reason. Date i / 45-l017 _ Construc[ion Cost sv&_10 ° o Site Address y4111 S /77'lP 1- UniUSte # r Description of Work ~ h blulti-Family Bldg _ Y J N Fireplace(s) 210 _ 1 _ 2 Property Owner ~(e j 2~ler Q Telephone # ( (,T/ ) R$r z103 Cantractor Address 4411 f&WgQXd City State Z?B^ ~IfJ1(` Jr5= Zip Telephone #(6S/ )$Sc2-/(L 0 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minneso[a Rules 7670 Ca[eeorv l Minnesota Rules 7672 Enetgy Code Category , Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submilled In The last 12 monihs, has ihe City of Eagan issued a permiT for a similar plan based on a master plan8 _ Y _ N It yes, date and address of master plan: Licensed Plumber Telephone ~ Mechonical Contractor Telephone ~ Sewer/WaterContractor Telephone J 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 Statutcs; I understand this is not a pcrmit, but only an application for a pcrmit, 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 revicw and approval of plans. ~ . ~ . A plic/ant's Printed N z App i ant's Signature E' ~MNP~o I~