4173 Countryside DrParcel Files Cover Sheet
Unique ID: 4023
4173 Countryside Dr
101827502002
CITY OF EAGAN
3 . Pilot Knob Road, P.Q. Box 21 -199, E4gan, MN 55121
PHONE: 454 -8100
Receipt #
Date V 9 19
oFFIce SE, - ONLY
FEES
To be used for
Est. Value
4
Site Address 4173 ID R
Lot Block Sec/Sub xOLIO
Parcel No.
()U
U¢
t
u, w
aW
.NarnP
JQt MI
7r La.
Hddres" ......... � �... ..
irldI ltC'6to
Phone
City
Name
Address
City
Phone
Name
Address
City
Phone
252.
155.30'
I hereby acknowlege 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.
Signature of Permitee`
A Building Permit is issued to :'
on the express condition that all work shalt be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
Occupancy
Zoning
(Actual) Const
(Allowable)
# of Stories
Length
Depth
S.F. Total
S.F. Footprints
On Site Sewage
On Site Well
MWCC System
City Water
PRV Required
Booster Pump
APPROVALS
Planner
Council
Bldg. Off.
Variance
R-1
-WV Bldg. Permit
Surcharge
— 54$ Plan Review
SAC, City
SAC, MCWCC
Water Conn
Water Meter
X Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI
Road Unit
Park Ded.
Copies
TOTAL
724.00
62 000
470.00
100.00
625.00'
y
Permit No.
Permit Holder
Date
Telephone #
WATER
SEWER
PLUMBING
// /
%( (7 - J , Zi /. 12/ /1-->:.�
/ #4 C
1.5"--
pf'ii;.
/00*
! jez,a,< 4 ,2, 4 , 1 _,
H.V.A.C. 02( � /
/4--'7
'7
> u/ . F ac,--
( cr ...
ELECTRIC V 39//:6
ia/n K 1 l ei.
/4i ho
(lCl/ 9 612
Inspection Date
Insp.
Comments
Footings I
fjaA
_
Foundation
Framing
' 7/y/
4I
Roofing
Rough Plbg.
i-21_9(
, g / �
/ i l 7 1 p t $ U.d f
Rough Htg.
iji/ /91
Isu
7/9
'4r-
Fireplace
f' 9
GR •
Final Htg.
Em .,, ap tw
Final Plbg. 2-7/..
4
/-7 /
Const. Meter
Plbg. Inspector - Notify Plumber
Engr. /Plan
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
- / Q-j C
6
c.,16 .'s / ay? ' -`
y
Name
Address
City
Phone
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping Outlets #
Other
Comm. /Ind. Contract Price
Sec/Sub
- $24.00
6.00
DATE
Site Address
Lot
R- t ` _ C L
Block'
Name:
Address
o City
MECHANICAL . PER
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
PHONE 454-8100
BTU
M BTU
M BTU
M BTU
CFM
For CIty Use Only
FEiiMIT #
RECEIPT# 9999V'9
DATE: / c'
WORK DESCRIPTION
New Const.
Add -on
Repair
FEES
RES. HVAC 0 -100 M BTU
ADDITIONAL 50 M BTU
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION) ;
TOWNHOUSE & CONDOS - RES. RATE APPLIES
- 1UIINIM#JM RESIDENTIAL FEE— ALL ADD -ON &
REMODELS (INCLUDES GAS PIPING)
GAS OUTLETS (MINIMUM - 1 PER PERMIT
NEW CONST.)
COMM/IND FEE -1 % OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
MINIMUM COMMERCIAL FEE
STATE SURCHARGE PER PERMIT
(ADD $.50 S/C PER EACH $1000.00 OF PERMIT FEE)
1.50 EA'
-
CITY OF EAGAN
CONTRACT 3830 P ILOT KNOB ROAD, EAGAN, MN 55122
PRICE PHONE 454-8100
Site Add 41/
Lot
Name
Addr
City
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
Sec/S b
e4C0
Phon
FEES
COMM./IND. FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE $12.00
MINIMUM - COMM.IND./FEE $20.00
STATE SURCHARGE PER PERMIT .50
(ADD $.50 S/C PER EACH $1 0 OF PERMIT FEE)
BLDG. TYPE
Res.
Mult.
Comm
Other
For City Use Only
PERMIT #
P
.,ECEIPT #
pATE: ./c; o
WORK DESC
New Const
Acid-on
Repair
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTA
Water Closet - $3.00
iii ii, Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
IX Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT CONST.)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50 of/i 61)
U. G. Sprinkler System - $12.00
PERMIT FEE: 1 /5/
STATES SIC: .45
GRAND TOTAL:
12. Framing area = 10% of gross wall area.
13. Gross wall area Z 39 /, g ft.
Window area A Z(05.5 ft.2 U windows _ ''MCP U x A . 15:5g,
-• I u x A = 5.4i ,
Rim joist area A � - -f,' 2.. , ° � � ft. U rim a � '
, 2 I U A ='t0•5&
or area A � ,O ft. U door area =
IT TIc, q
ireplaie A gel",( ft. U ixep. ee^ _ ,` U x A = 1'
Exposed foundation A 10w 1 ft. U foundation .0(0 U x A = g' (?'
Framing area A 2;i0/0(/ 61'1 ,6/) ft. U framing area = )015 x A = ZZ 1e
Net wall area A 1 J.. ', O4 ft. U wall = ,17 4 - J U x A =
(13B) TOTAL U x A
A .
14. Gross wall area x 0.11 (A -1 single family & duplex = allowable U x A /Code
. (13. above)
x 0.23 (A -2 other residential)
x .23 (Other buildings)
x .28 (Over 3 stories) .
A z 3c1 5 . 5
I5A. Gross ceiling area = (L)
U ceiling x A c =
U framing x A f=
15D. TOTAL U x A
,02,1
per?,
U Code
15. Ceiling framing area (Af) equals 10% of ceiling area
15B Joist area (A = 10% ceiling area =
15C. Net ceiling area (A (15A - 158) _
x (W)
NOTE: Use U and A values obtained from pages
Date Signature
,C7 ft.
) = • 27 40
or the .same a,s )
e,g ft.2
ft.
16. Ceiling area (15A) x 0.026 (A -1 single family & duplex - code ;allowable U x A
x 0.033 (A -2 other residential) -
x 0.06 (other)
, o2Cv
A (15A) x U code
ust be larger than
138 above '
Must be larger than .150 (above)
(or the ,same as)
CERTIFICATION: I hereby certify that I have calculatA" the "U" factors and "R" values
herein and that the building here described meets or exceeds the State of :Minnesota
'Energy Conservation Act.
Jew
Ad&
Rep:
• Type of Building
Appliances Wired
Equipment Wired
Home
Range
Temporary Service
Duplex
Water Heater
Electric Heating
Apt. Building
Dryer
Other (Specify)
Comm. /Industrial
Furnace
Farm
Air Conditioner
Other (specify)
Cont actor's Remarks:
Compute
Inspection Fee Below:
#
Other
Fee
#
Service Entrance Size
Fee
#
Circuits /Feeders
Fee
Swimming Pool
0 to 200 Amps
9-to 100 Amps
/°
Transformers
Above 200 Amps
Above 1 0 Amps
Signs
I nspector's Use Only:
TOTAL
Irrigation Booms
36
Special Inspection
S4
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
COMPLETED WITHIN 18 MONTHS.
Alarm /Communication
Other Fee . 2C ff ,.
I, the Electrical Inspector, hereby
certify that the above inspection has
been made.
Rough -i f
�►
Date /
tg�
Final /
_r��
OFFICE USE ONLY
This request void 18 months from 4
42641 41 6 ,6a
Request Date
Section No
Township Name or No.
Fire No.
ensed contractor D owner hereby request inspection of above electrical work at:
Job Address (Street, Box or Route No.)
/
nspec
6e . 021(1E
Range No.
❑ Ready Now Notify Inspector
❑ No When Ready?
City
&
Coun
/c , /g5
h N / 1 5771-
0 e P 8
- s crn c G fig a - � /9 ,: .� �'c/
Electrical Contractor (Company Name)
10 M c t /
Cor r� O / 7
Mailing Address (Contractor or Owner Making Installatiortl
n w -
Authorize. Si nature (Contractor /Owner Making Ins .Ilation)
Pho e Nu ber
(-� � a' - 7 Y7�
Occupa t (PRINT)
L'/A10
Power Supplier I A ddress
MINNESOTA STATE BOAR OF ELECTRICITY
Griggs- Midway Bld — Room S -173
1821 University Ave., St. Paul, MN 55104
Phone (612) 642 -0800
REQUEST FOR ELECTRICAL INSPECTION
�� 42641. ► .See instructions for completing this form on back of yellow copy.
"X" Below Work Covered b This R
THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
+e Q EB- 00001 -08
VloRY. , 1-1-05r`
al 32- D -
8,oX( z4 -- = &00 ►a
S . n
(zAti 24+3 -\- s ue ) / O z
Z 5' 0 ____
11( 116114 • V X = 1 L Z 1
(
'BAP, v�D� = (o ► y' X I = lo►
I I II Zo)C 39 = 1► o X fI Us/ ca.
I I I xtoo = /l, o,)f z Z z, 0 •
III zt X coca 4
4.11 tg ztzc'
RE:
4173 1I !'RYS IDE DR (.J
Your Siv a, & t Permit f h
Your Sewer & Water Permit for the above property has been ompleted, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIPROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by 131 f Adams or Dirk House (Plumbing Inspectors.— 454 -8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES— TELEPHONE, ELECTRIC, GAS, ETC.
— REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPAMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
�t101 14, 1990
NILLER HORRS)
e er W a er or
aga
DAT
S ITE ADDRESS' 41 c
Lt7 __ BLQ • s suB C H
APPLICANT:
ADDRESS.
CITY, STATE
PHONE.
PL BE
ADDRESS: -
CITY, STATE A
PHONE: 4 3 2 , -
MET415SIZE
IS8t1Ez ATE / ' �� - . ° °T DATE 1 11.b3 l�
X PRV - BOOST
PE RMIT REQUTED
SEWER WA TAPS
COMMAND RES x IJ�L
NEW
Lawn Sprinkler Meters are "to be
Ahead of Domestic Meters on Water
C redit WILWI T be givenrfor Deduct M
EE TO COMPLY wm4cITY CAF
ER: iliir Homed EAR NORDINA ES
AD[ RE SS. 8 1 - C e d o r' Aral . !I • * ,
CITY STATE IP* rmington, Mg ' ZIP 0 #
43 i # 01 S1GNATUR ii I tEM MET '1SSU ,
FL ` Wt� F�Ct . 1?A S 0f " ` L - -522+D FOR li •,, . FOR S
SE t ER RIIINN Ct �fCT ENGINEERING D : k
Date 10 / / Construction Cost /5, Of i1 . o0
Site Address 4/ 73 , GDLI/7)r'!� S/D ' 12 ? vE
Unit/Ste #
AC,AN HA/. sS/6,3
Description of Work J X /(j 3 - SE- Ai5 Ai P/ X, G k/ i.P P?-Ca'
Multi- Family Bldg _ Y /N Fireplace(s) ✓ 0 1
Property Owner P,4IL L AND M1 G1-1 E LLg e NAP 1 L
Telephone # ((5/ '/64 - g8O 7
Contractor /4 AA)O A C./JAl S7"/<L/C.770 A/ W •
Address /'111 I/ EM LO C f< GT.
City MK L U/LLrE
State A) . Zip 6:50q ci
Telephone # (93) 031 -
New ConsUuction Requirements
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and gn roofed areas
(20% maximum lot coverage allowed)
2 copies of plan showing beam & window sizes; poured found design, etc.
1 set of Energy Calculations
3 copies of Tree Preservation Plan if lot platted after 7/1/93
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651 -675 -5675 FAX # 651- 675 -5674
COMPLETE THIS AREA ONLY IF CONSTRU
Energy Code Category
('1 submission type)
Licensed Plumber
Mechanical Contractor
Sewer /Water Contractor
Telephone #
Telephone #
Telephone #
Minnesota Rules 7670 Category 1
Residential Ventilation Category 1 Worksheet
Submitted
Energy Envelope Calculations Submitted
ING A NEW BUILDING
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
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.
/VA kil) ,f /SWEA c
Applicant's Printed Name
ApplicaCt's Signature
Sub Types
❑ 01 Foundation
O 02 SF Dwelling
❑ 03 01 of _ piex
❑ 04 02 -plex
❑ 05 03 -piex
❑ 06 04 -plex
Work Types
❑ 31 New
X 32 Addition
O 33 Alteration
❑ 34 Replacement
Valuation
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
Footings (new bldg)
Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water
Framing
Fireplace _ R.I. Air Test _ Final
Insulation
9
/739
Base Fee
Surcharge
Plan Review
MC /ES SAC
City SAC
Utility Connection Charge
S &W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
O 07 05 - piex ❑ 13 16 -piex ❑ 20
❑ 08 06 -plex ❑ 16 Fireplace )5< 21
O 09 07 -piex ❑ 17 Garage ❑ 22
❑ 10 08 -piex ❑ 18 Deck ❑ 23
❑ 11 10 -piex ❑ 19 Lower Level ❑ 24
O 12 12 - piex Plbg_Y or _ N ❑ 25
❑ 35
❑ 36
❑ 37
• Final
Int Improvement
Move Bldg.
Demolish (Bldg)*
OFFICE USE ONLY
Occupancy R-3
Zoning
Stories
Sq. Ft. y
Length
Width /9
Approved By
Pool
Porch (3 -sea.)
Porch /Addn. (4 -sea.)
Porch (screen /gazebo)
Storm Damage
Miscellaneous
❑ 38 Demolish (interior)
❑ 42 Demolish (Foundation)
❑ 43 Reroof
*Demolition (Entire Bldg) - Give PCA handout to applicant
MC /ES System
City Water
Booster Pump
PRV
Fire Sprinklered
REQUIRED INSPECTIONS
Final/C 0
Final/No C.O.
_ Plumbing
HVAC
Other
Pool _ Ftgs _ Air /Gas Tests
Siding Stucco Stone
Windows (new /replacement)
_ Retaining Wall
❑ 30 Accessory Bldg
❑ 31 Ext. Alt - Multi
❑ 33 Ext. Alt - SF
❑ 36 Multi Misc.
❑ 44 Siding
❑ 45 Fire Repair
❑ 46 Windows/Doors
Final
Building Inspector
SINGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCULATIONS
PENALTY APPLIES WHEN:
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR /HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
To Be Used For:
Site Address L \ 1
Lot
Parcel /Sub
Owner
Address
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
Block
City /Zip Code
Phone
Contracto
Address
City /Zip Code
Phone -00
Arch. /Engr.
Address
City /Zip Code
Phone #
3 hl art)
1990 BUILDING PERMIT APPLICATION
CITY OF EAGAN
TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
Valuation:
idske.
-- D)trign YA-04
1t521
MULTIPLE DWELLINGS
2 SETS OF PLANS
REGISTERED SITE SURVEYS -
(CHECK WITH BLDG. DEPT.)
1 SET OF ENERGY CALCULATIONS
# OF RENTAL UNITS
# OF FOR SALE UNITS
COMMERCIAL
2 SETS OF ARCHITECTURAL
& STRUCTURAL PLANS
1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCS
Date: ID -30 -q(
2 y 000 OFFICE USE ONLY
Occupancy R•3 M•"1
Zoning R-I
Actual Const V -N
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F.
On site sewage
On site well
MWCC System
City water V
PRV
Booster Pump
APPROVALS
Planner
Council
Bldg. Off.
Variance
4-N
51
sat
FEES
Bldg. Permit 7Z4, oo
Surcharge 62,0o
Plan Review y r1O, Oo
SAC, City /00,00
SAC, MWCC 600,00
Water Conn 625;,Ov
Water Meter 90,00
Acct. Deposit 3o,00
S/W Permit 3o,
S/W Surcharge ,5
Treatment P1. 252,00
Road Unit 35.6,0
Park Ded.
Copies
SUBTOTAL
Penalty
TOTAL
BUILDING PERMIT
To be used for SF DWG /GAR
CITY OF EAGAN N° 18524
3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121
PHONE: 454 -8100
Receipt #
Date
Site Address 4173 COUNTRYSIDE DR
Lot 2 Block 2 Sec /Sub COUNTRY HOLLOW
Parcel No
cc
Q
zr
oU
UEt
i- Q
C.) CC
W
~z W
UU
¢z
a W
Name JOE MILLER HOMES
A�iu3 18133 CEDAR AVE S
City FARMINGTON Phone 431 -2001
Name SAME
Address
City Phone
Name
Address
City Phone
I hereby acknowlege that I have read this application and state that the
information is correct and agree to comply- with all applicable State of
Minnesota Statutes an ity of Eag dinan es.
Signature of Permite Lj / "Y.
A Building Permit is issued to JOE MILLER HOMES
on the express condition th all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
,q t\.Q.1A../
Building Official
7 L r
1
4R
1
Est. Value $124,000
V 1
S'76
6
�23
NOV 9 19 90
OFFICE USE ONLY
Occupancy R -3 M -1
Zoning _R=1
(Actual) Const V —N
(Allowable) V —
# of Stories
Length 54'
Depth 52'
S.F. Total
S.F. Footprints
On Site Sewage
On Site Well
MWCC System X
City Water _X—
PRV Required X
Booster Pump
APPROVALS
Planner
Council
Bldg. Off.
Variance
FEES
Bldg. Permit 724.00
Surcharge 62 .D0
Plan Review 470.00
SAC, City 100.00
SAC, MCWCC 600.00
Water Conn 625.00
Water Meter 90 00
Acct. Deposit
S/W Permit 30_00
S/W Surcharge _ 50
Treatment PI 252 00
Road Unit 355.00
Park Ded.
Copies
TOTAL
3,338.50
le 1,17
Owner Phone Date
M S i t e o Address 1 LoT 2. } ELo.K 2_ C
ccANTRY f -IOL t�
l.C7
b Contractor v0j� E -AV�LE,f2„. C01\..\ Phone
Building Classification: Type Al (Single Family 6 Duplex) Type A2(Residential)
(3 stories or less
(Other) • (Over 3 stories)
NOTE: Complete pages 3 and 4 first.
GENERAL INFORMATION
1. Building PerimeterG7 \J a J f4Tft.
2. Wall height (ground to eave)
3. 1. x 2. (above) gross wall area
4. Building dimensions (L)
6. Doors - Area Ij ?,U
Thickness
Type of Construction
Manufacturer
MINNESOTA STATE ENERGY CODE CALCULATIONS
BASED ON CHAPTER 5 OF THE
MODEL ENERGY CODE - 1983 EDITION
Adoption Effective 1/1/84 '
ft.
Z ) f t .
X (W) —
7. Total door's perimeter ft.
8. Windows: Manufacturer Nk C- t(f7MT i E,
U factor
TYPE SIZE AREA (Ft.
• EACH
\v
r
9. Total ft. Glass z.ce � ,�
10. Fireplace area: Width X height = X
11. Exposed foundation: Height X, Perimeter R 0 I 1
X r5 =
COMPLETION OF THIS FORM IS REQUIRED FOR ALL NEW CONSTRUCTION, MAJOR
MOVED WHERE ENERGY, OTHER THAN THE MINIMAL CODE ALLOWANCE, IS USED.
13i30 ft. roof 6 floor,area
5. Square foot area of rim Joist - Floor Joist size (2 x 10? )
Q X Perimeter = Rim oast area
12 151,5
•
in. U factor 0 e 4. )4
Perimeter
State approved
NUMBER OF
UNITS
#121/4
ft:
TOTAL FEET 2
Ft.
O(p P Q 7 Ft
) ELING AIR BUILDINGS REIN(
•c;•/r7 /vv
H 39112L ig
G
Fire No.
'
), /,
gh -in Inspection
- =. 'red?
ow L. Yes ❑ No
9 9799
$6 ov
❑ Ready Now ill Notify Inspector
hen Ready?
Request Date /
12/12/90
censed contractor ❑ owner hereby request inspection of above electrical work at:
Job Address (Street, Box or Route No.)
4173 Coun -t2yis-ice DA-4:2) e
City
Eagan
Section No.
Township Name or No.
Range No.
County
Dakota
Occupant (PRINT
aoe (rli.Qtc,z. {Comes
Phone No.
431 -2001
Power Supplier
Dakota E.Qec.t2.ic
Address
7 ON 55024
Electrical Contractor (Company Name)
O- i.cJJand ELe.C.t2.Lc Inc.
Contractor License No
041610
Mailing Address (Contractor or Owner Making Installation)
14055 Gland 42)e So, Su.i.t.e 5, /3u2n 1 v-C-e-Qe, ON 55337
Authori nature
ontractor /Owns = Making Installation
/ / .. /
...of jr
Phone Number
892 -6688
Apt. Building
New
Add
Rep.
Type of Building
Appliances Wired
EquipmentWired
Home
Range
Temporary Service
Duplex
Water Heater
Electric Heating
Apt. Building
Dryer
Other (Specify)
Comm. /Industrial
Furnace
Farm
Air Conditioner
Other (specify)
Contractor's Remarks:
Compute Inspection Fee Below:
#
Other
Fee
#
Service Entrance Size
Fee
#
Circuits /Feeders
Fee
Swimming Pool
0 to 200 Amps
/ ?0 to 100 Amps
+ Above
Transformers
Above 200 Amps
100 Amps
Signs
Inspector's Use Only:
? G1^J
THIS INSTALLATION MAY = • RDE D ISCONNECTED
COMPLETED WITHIN 18 'V HS
TOTAL
.� 5 - o
GO !�
Irrigation Booms
Special Inspection
IF NOT
Alarm /Communication
Other Fee
I, the Electrical Inspector, hereby
certify that the above inspection has
been made.
Rough -in (Z,...-19 4���rrrr444444
j2/Z6 4
Final
! •
a
l� i`
OFFICE USE ONLY
This request void 18 months from
MINNESOTA STATE BOARD OF ELECTRICITY
Griggs- Midway Bldg. — Room 5 -173
1821 University Ave., St. Paul, MN 55104
Phone (612) 642-0800
// 7/90 REQUEST FOR ELECTRICAL INSPECTION
► See instructions for completing this form on back of yellow copy.
I 3911
"X" Below Work Covered by This Request
THIS INSPECTION REQUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
EB 00001 -08 I
99 '299
WALL
SECTION
STUD
SECTION
2ND WALL
SECTION.
R
U v&LUL LMLLULAIIUILJ
R VALUE U VALUE
Inside air film .68
Interior wall ' •
Insulation 19.
Sheathing 2,000
Siding • 627
Outside air film .17
R TOTAL
Inslde.air film ` .68
Interior wait
4" stud R= 4.38
Sheathing �,'�, p(0
Siding . ( 7
Outside
Siding .
film .17
R TOTAL ( 0 . 3
Inside air film R - .68
Interior wall
Insulation (Wall ) U -
z
Sheathing
Exterior wall covering
Exterior air film R - .17
R TOTAL
Interior air film R= .68
RIM
C.17 insulation ic1.0
JOIST }1( % '11 inch soft wood R =1.88 (Rim U =
1
Sheathing Z .. O(o
Exterior wall covering .0
Exterior air film R= .17
R TOTAL
,4(9
(Wall) U
(Framing) U
Joist) •
Interior air film R= .68
Insulation 11.
Foundation I.z8 (Fdn.) U
Exterior air film R= .17
R TOTAL ( 3 . 1
Exposed Block
- . ` Grade 3.
0 43
1
-a=
07(0
•
it 12" concrete block no insulation = .47 R 2.1
J 12" concrete block insulated cores = .26 R 3.8
J5 12" lightweight block = .32 R 3.1
Jb 12" lightweight block insulated cores = .12 R 8.3
J single glass = 1.13; with storm window .54
J double glass = .55
J triple glass = .41
CEILING WITH VENTED ATTIC SPACE ABOVE
R VALUE R VALUE
FRAMING CEILING
Air Film 0.61
Insulation 44.0
Joist
Ceiling
Air Film
Total R
1
U=
FLAT ROOF OR CATHEDRAL CEILING
R Value
FRAMING
0.61 Inside air film
Ceiling
Joist (stud)
Insulation
Air space
Roof decking
Insulation
Built -up roof
•
0.17 Outside air film 0.17
Total R
1 =U
• R
4indow infiltration .5 cfm /lineal foot of crack
tesidential door infiltration 0.5 cfm /square foot or door and minimum code requirement
ion- residential door infiltration 11.0 cfm /lineal foot of crack
All exterior walls and ceilings must have a vapor barrier (0.10 perm max.).
vapor barrier must be on the inside (heated side) of wall.
iapor barriers of the polyethelene thin film have no R_value.
0.61
o ZZ:
R VALUE
CEILING
0.61
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA110797
Date Issued:05/29/2013
Permit Category:ePermit
Site Address: 4173 Countryside Dr
Lot:2 Block: 2 Addition: Country Hollow
PID:10-18275-02-020
Use:
Description:
Sub Type:Residential
Work Type:Underground Sprinkler System
Description:PVB
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.
Jason Larson
25 S Sutton Lake Blvd
Jordan, MN 55352
Fee Summary:PL - RPZ/PVB/Lawn Irrigation $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 -
Marjorie R Daniels
4173 Countryside Dr
Eagan MN 55123--162
Jay's Plumbing
25 South Sutton Lake Blvd.
Jordan MN 55352
(612) 868-4102
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA113498
Date Issued:09/05/2013
Permit Category:ePermit
Site Address: 4173 Countryside Dr
Lot:2 Block: 2 Addition: Country Hollow
PID:10-18275-02-020
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Jim Mcevoy
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Marjorie R Daniels
4173 Countryside Dr
Eagan MN 55123--162
Norwest Contractors
8469 Zanzibar Ln N
Maple Grove MN 55311
(612) 859-8517
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA119650
Date Issued:12/11/2013
Permit Category:ePermit
Site Address: 4173 Countryside Dr
Lot:2 Block: 2 Addition: Country Hollow
PID:10-18275-02-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Phil Holmin
3432 Denmark Ave #228
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
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 -
Marjorie R Daniels
4173 Countryside Dr
Eagan MN 55123--162
(952) 388-7234
Holmin Heating & Cooling Llc
900 Park Knoll Drive
Eagan MN 55123
(651) 405-3853
Applicant/Permitee: Signature Issued By: Signature