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4177 Countryside DrPERMIT City of Eagan Permit Type:Building Permit Number:EA111931 Date Issued:07/18/2013 Permit Category:ePermit Site Address: 4177 Countryside Dr Lot:4 Block: 2 Addition: Country Hollow PID:10-18275-02-040 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Window or Door:Replace 1 door within existing openings. Kara Benson Valuation: 500.00 Fee Summary:BL - Base Fee $500 $40.00 0801.4085 Surcharge - Based on Valuation $500 $0.50 9001.2195 $40.50 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 - Roger Dean Nelson 4177 Countryside Dr Eagan MN 55123 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature Parcel Files Cover Sheet Unique ID: 4026 4177 Countryside Dr 101827504002 BUILDING PERMIT To be used for CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 Est. Value Site Adcljess 4"? Ca YB1 �1* M2 Lot Blockt, Sec/Sub. Rau Boum Parcel No. cc cc 0 CC Name Address City Phone �a61- 3u vw I -w ccW 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 and City 'Of gan Ordjinces. Signature of Permitee A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Mi nesota Statutes and City of Eagan Ordinances,. ,: Building Official """ t":i' RS. 11C Receipt # Date 19 OFFICE USE ONLY S.1 Occupancy Zoning V41 (Actual) Const -11 (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 Bldg. Permit Surcharge Plan Review 444 SAC, City 60000 SAC, MCWCC . Water Conn 625.00 Water Meter Acct. Deposit SNV Permit S/W Surcharge ...A Treatment PI Road Unit Park Ded. Copies TOTAL FEES 769.00 :j 66,30 ". 500.00 a 100.00 Permit No. Holder/ Telephone # WATER SEWER - PLUMBING H.V.A.C. ELECTRIC //eo/ U fPferrmiit (% 4 /qai i /I'� 9tx/X-lir. j/�Datee 163/9° 63 9v f / 31 4f o 4 o ' t � -a 'P/2 -A0 l (� /f� Pte, / //50 A Inspection Date Insp. Comments Footings I / rZj/Qd 4/// Foundation Framing /?/d a Roofing Rough Plbg. f{- ? f6 A/ Rough Htg. s./1/9 45 I ' fsut a'Pa j c Fireplace c -ems 50 OS Anal Htg. S2,94'( gi Final Plbg. .5--Z ,i/ die Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final S -2Y -g/ OS Deck Ftg. Deck Final Well Pr. Disp. CONTRACT PRICE: Site Address Lot MECHANICAL PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 PHONE: 454-8100 `l. a`) c Block -.2"- Name Sec/Sub , Address , i Phone c O Name Address City ./ j Phone. - TYPE OF WORK Forced Air ` M BTU $ Boiler M BTU Unit Heater M BTU $ Air Cond. M BTU $ Vent. CFM $ Gas Piping Outlets # $ Other $ FEE: S/C: TOTAL: BLDG. TYPE Res. _ Mult. Comm. Other PERMIT # ' RECEIPT # ` tf ti `:, �` DATE: 7 J For Office Use Only: WORK ' ESC PTION New Add-on Repair FEES RES. HVAC 0-100 M BTU ADDITIONAL 50 M BTU (RCONSTRUCTION) ES. HVAC INCLUDES ON NEW GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS. — COMM. RATE APPLIES TOWNHOUSE & CONDOS — RES. RATE APPLIES MINIMUM RESIDENTIAL FEE — ALL ADD-ON REMODELS - 12.00 MINIMUM COMMERCIAL FEE 20.00 STATE SURCHARGE PER PERMIT .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000) -$24.00 - 6.00 SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN PLUMBING PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 PHONE 454-8100, Ste kE Dr. BLDG. TYP Res c 71 it k o2 For ©� �,l,�te O�,tly PERMIT #� RECEIPT DATE: Name /144 -//46/;t - WORK / Address /545 City 4 r.0 Sec/Sub Res. Mult sv/ id „- Phone'/23-373b 8 Name Pi? Addre s '9545 City eui://t, (: I. �, 3irc . Phone 14/-33Sr/ FEES COMM./IND. FEE - 1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APLLIES MINIMUM - RESIDENTIAL FEE $12.00 MINIMUM - COMM.IND./FEE $20.00 STATE SURCHARGE PER PERMIT .50 (ADD $.5 S/C PER EACH $1,000 OF PERMIT FEE) /j. n WORK DI yCRIPTION New - Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES Water Closet- $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 / Kitchen Sink - $3.00 Urinal/Bidet - $3.00 J[ Laundry Tray - $3.00 Floor Drains °-.$1.50 Water Heater - $1.50 Whirlpool = $3.00 Gas Piping Outlets - $1.50 (MINIMUM -1 PER PERMIT) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 3 Rough Openings - $1.50 U. G. Sprinkler System - $12.00 PERMIT FEE: STATES S/C: GRAND TOTAL, FOR: CITY OF EAGAN CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: SITE ADDRESS: . t I i•.; t • t•:.; t ! t • t. PERMIT SUBTYPE: INSPECTION TYPE DATE INSPTR. APPLICANT: TYPE OF WORK: 7 7 t • " rc't!,vi INSPECTION TYPE DATE INSPTR. ,'; 7 I't•t • Permit No. Permit Holder Date Telephone # S/W PLUMBING HVAC ELECTRIC II ELECTRIC ^/ i a 3 O d 7 -a t-,�+ 6.1„.„ €6.,...... s1,./4 (/l' Inspection Date nsp.o Comments Footings I `i//`m Foundation iY%i/.cdl /R09 ,p .'I7 "'r, % .., 5 SFraming .11/2,u,, div/25 'f` /�-9i4,RD- e/lz/O Roofing Rough Plbg. Rough Htg. Isul. 4/u0J/ 7 `� fp Fireplace !// Final Htg. Orsat Test Final Plbg. Plbg. Inspector — Notify Plumber Const. Meter Engr./Plan Bldg. Final / a 1�[rye,' Deck Ftg. Deck Final Well Pr. Disp. DATE: 4177 COUNTRYSIDE DR (MATTHEW DANIELS. INC) RE:, Your Sewer & Water Permit for the above property has been completed. WWI be ARE tTO he Works Garage (3501 Coachman Road) until the meter is picked up: CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ( ,- Your Sewer & Water Permit for the abole property cannot be completed for the following reasons: our Sewer & Water Permit for the above property has been completed, but the meter cannot e issued or occupancy allowed until further notice. GbNIMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be Adams or Dirk House (Plumbing Inspectors — 454-8100) before issuance' confirmed by Bill A y WARNING: BEFORE D ING,, CALL LOCAL UTILITIES— TELEPHO , ELECTRIC , GAS ETC REQUIRED BY LAW. CONTACT COMM IITY DEVELOPMENT DEPARTMENT FOR WATER TUR 1 CIN,POLICY- Secretary, Building Inspections Dept. 03/25/2008 15:38 469-4191 PIETSCH BUILDERS REScheck Software Version 4.1.3 Inspection Checklist Date: 03/25/08 tee: ❑ Ceiling 1: Flat Ceiling or Scissor Truss, 8.44.0 cavity + R-4.0 continuous insulation Cormnenta: Above -Grads Walla: ❑ Weil 1: Wood Frame, 16" o.a., R-19.0 cavity + R-4.0 continuous insulation Comments: Floors: ❑ Floor 1: M -Wood Joist Truss:Over Unconditioned Specs. R-13.0 cavity + R-13.0 conUnuous insulation Comments: PAGE 03 1 Crawl Space Wads: L3 Crewt t: Mssoniy Block with Empty CeNs. 3.5' ht / 3.0' by / 3.5' ext, Maui / 3,5' inside by depth, R-10.0 cavity + R-10.0 continuum Comments: Appear b wails of unvsrtrated crawl spaces. Exterior Insulation hire a rigid, opaque. weather -resistant protective covering that covers the exposed (above -grade) insulation extends at least 6 In. below grade. Mr Leakage: ❑ Joints, pe nab*bons. and all other such openings In the building erwelope that are amines of air leakage are sealed. Rapeseed lights are 1) Type IC rated, or 2) installed ureide an appropriate air ht dig assembly with a 0.5" clearance from ocmlivalibte materials. M non -IC rated, fixtures are inetaded with a 3" clearance from insulation. Vapor Retarder: ❑ Instated on the wenn-ln-winter skis of ail non -vented *timed oeekrgs, walls, and floors. Materials IdentMcatlorn: Materials end equipment are Installed in accordance with the manufacturer's knslaHation kwtructlons. Materiels end augment aro tdsnlMsd so that compliance can be determined. Manufacturer manuals for ail Installed heating and cooling equipment and eervlos water heating equipment have bean p rovidect Insulation R-veiues and glazing U-factbrs are dearly marked on the building plans or aped kaitkxts knsuletlon ie knteMed according to me nutoctunera instructions, in substantial contact with the surface being insulated, and in that echbves the rated R -value without compressing the insulation. Duct Insulation: 0 Ducts in unconditioned spaces ars insulated to at least R-5. Ducts outside the building pre Insulated to al Meet R-8.0. Duct Construction: p AM loads, seams, and connections are securely fastened with welds, gaskets, mastics (adhesives), mastto-plus-+m tapes. Tapes and mwgoa aro rated UL 131A or UL 1816. Exceptions: CoreinuousN welded and looking -type longitudinal joints and seams on ducts operating at teas than 2 In. w_fl. (500 Pa). • • The HVAC system provide* a means for bol andng air and water systems. Tetttperature Controls: ❑ Thentrostab exist for each separate HVAC system. A manual or automatic means to partially reetrid or shut off the heating COolkng input to each zone or floor is provided. Service Water Nesting: Pled Title: Data filename: Untk ied.rck House heating test record Owner Address Y/77 (feu City Heat loss Date htg. inst L 7l 117 Sold by CenterPoint Energy Installed by CenterPoint Energy Electrical work by/CenterPoint Energy id Heat type: FA 0 Space heater ear fro' Gas line by C;,/(%J Unit heater Other Gas design Make gn MakeC-"' Model 57riVC-0&)--11 Serial no. l 308 4 03 4%o Input tat ©2006 CenterPoint Energy Controls Thermostat Heat plug Valve Limit Limit. setting Fan setting Pilot type Pilot make Pilot model Pilot timing Pressure: Hi fire / Lo fire Percent CO2 IP< !a Input CFH Percent 02 l < n Stack temp 1 d<;i<3'f Percent CO ,910,14— Conversion Vent size,7 evc CenterPoint® Energy Kind of liner / size 1" Draft hood FG7 rr-. a, Regulator .m?/S j Filters: Size l&x 2S'x 1 Number Chimney location: 0 Inside 0 Outside Chimney construction Wiring V Test tag Lighting Inst v Date tested IL►10/198 Company testing - t -r -•int Ener Tester's name ev. 4/06 ID -61463 City of Eagan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 By EglEr JUN 0 9 2008 For Office lJse Permit #: Permit Fee: l 0 Date Received: Staff: J 2008 MECHANICAL PERMIT APPLICATION Date: (-0I3\ 08 Site Address: LA \ T IIrIli e - J Tenant Suite #: RESIDENT/OWNER Name: fAQr 4'-Ne. SIDtrt Phone: leS1- LAG- q 1 - Address / City / Zip: LA k- l C.0 d e leZriv CONTRACTOR Name: CENTERPOINT ENERGY License #: Address: 9320 EVERGREEN BLVD SUITE B City: COON RAPIDS State: MN Zip: 55433 Phone: 763-757-6202 Contact Person: JOANN ZINKEN TYPE OF WORK New k' Replacement Additional Alteration Demolition Description of work: Stnsta,«Loitt.Ce eti,rr i er- �`C m Me.OgO- 1 4 CIA.rinaa.4 NOTE: Both roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector or one of the = " Planners for information on permitted screening methods. PERMIT TYPE RESIDENTIAL Furnace COMMERCIAL New Construction Interior Improvement Install Piping Processed Air Conditioner _ Gas Exterior HVAC Unit Air Exchanger * HVAC units must be screened Under / Above ground Tank ( Install / _ Remove) Heat Pump Other **When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes out appliances, ductwork, etc.) (includes $.50 State Surcharge) $.50 State Surchar---_____ $90.50 Fire repair (replace burned $ STD •S0 TO— Tam _ COMMERCIAL FEES: $70.50 Underground tank $50.50 Minimum (includes installation/removal OR State Surcharge) surcharge is $.50. increases by $.50 for each Permit Fee requires a $1.00 surcharge). Contract Value $ x 1% _ $ Permit Fee - If Permit Fee is Tess than $1,000, = $ State Surcharge - If Permit Fee is > $1,000, surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 $ 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 witho t a permit; that the work will be in accordapce with the approved plan in the case of work which requires a review and approval of plans. x JOANN ZINKEN Applicant's Printed Name Aicant's Signature FOR OFFICE USE (F#eviewed By: �_ •-Date Required Inspections:Under Ground _ Rough In; ._Air Test Gas Service Test In -floor Hee 40/' City of Eatall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r For Office Use Permit #: go) Permit Fee: • � Date Received: �/ Staff: l./ " 2008 RESIDENTIAL BUILDING PERMIT APPLICATION LH 11 t- w i vv 61 de (Dv vt, CaM Tenant: Suites: bate: Site Address: J RESIDENT / OWNER Name: OR Curt O1y1 01 ilActitv it Niti too ii Phone: '01— (ON — 000 Address / City / Zip: LH 11 (16-1041(11 (9l Cit, Ori f Applicant is: Owner X Contractor TYPE OF WORK Description of work: 1 L X (2--- A. dd.)1 4 t) 4 Construction Cost: Multi -Family Building: (Yes / No X. ) CONTRACTOR Name: I') ?I `( \ It(M ( 0 , ---.41c./. License #: nJC/ 13 5q) Address: 10 (3 1 iD 64 S It CiC-+ y V 0 City: LOSIVII l 12/ State: rvt V' Zip. 660144 Phone:6-122_ Mt- 3 0 Contact Person: j 0.1 t" 0 V 'nil COMPLETE Energy Code Category (I submission type) In the last 12 months, has Yes If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 • Residential Ventilation Category 1 Worksheet — • New Energy Code Worksheet Submitted Submitted • Energy Envelope Calculations Submitted the City of Eagan issued a permit for a similar plan based on a master plan? date and address of master plan: _No Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. I hereby acknowledge that this information is complete and accurade; that the work will be in conformance with the ordinances and codes of the City of Eagan; that 1 understand this is not a permit, but only an application for a permit, and work is not to start without a permit that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x f I Q(oGn PIA I duo). v. Applicant's Printed Name IECIE MAR 2i2008 a Page 1 of 3 DO NOT WRITE BELOW THIS LINE Sub Types ❑ 01 Foundation 0 ❑ 02 SF Dwelling 0 ❑ 03 01 of _ plex ❑ ❑ 04 02-piex 0 ❑ 05 03-piex 0 ❑ 06 04=piex 0 Work Types ❑ 31 New 32 Addition ❑ 33 Alteration ❑ 34 Replacement 07 05-piex 0 13 16-piex 0 20 08 06-piex 0 16 Fireplace 0 21 09 07-piex 0 17 Garage 22 10 08-piex 0 18 Deck 0 23 11 10-piex 0 19 Lower Level 0 24 12 12-piex 0 25 Pool Porch (3 -sea.) Porch/Addn. (4 -sea.) Porch (screen/gazebo/pergola) 0 Storm Damage Miscellaneous 0 0 30 Accessory Bldg 31 Ext. Alt Multi 33 Ext. Alt - SF 36 Multi Misc. ❑ 35 Int Improvement 0 38 Demolish Interior ❑ 36 Move Building 0 42 Demolish Foundation ❑ 37 Demolish Building* 0 43 Reroof *Demolition (Entire Bldg) - Give PCA handout to applicant Description: Water Damage Yes Valuation Plan Review 100% or 25% Census Code SAC Units #of Units # of Bldgs Type of Const _ Footings (new bldg) Footings (deck) Footings (addition) Foundation Drain Tile Roof Ice & Water ▪ Framing _ Fireplace R.I. _ Air Test Insulation Approved By: Occupancy Zoning Stories Sq. Ft. Length Width Final Final MCES System City Water Booster Pump PRV Fire Sprinklered REQUIRED INSPECTIONS Sheetrock Final/C.O. Final/No C.O. HVAC Other , Building Inspector ❑ 44 ❑ 45 ❑ 46 Siding Fire Repair Windows/Doors Pool Ftgs _ Siding _ Stucco Lath Windows Retaining Wall Air/Gas Tests Final Stone Lath Brick Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total 1.14(4)1g 14-144 y 71'17 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) 1 Soils Report if proposed building is to be placed on disturbed soil 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 (buildings with 3 or less units) Minnegasco mechanical ventilation form Remodel/Repair Requirements 2 copies of plan showing footings, beams, joists 1 set of Energy Calculations for heated additions 1 site survey for additions & decks Addition - indicate if on-site septic system Plans are consideredpublic information unless you state they are Office Use Only Cert of Survey Recd Soils Report ^ Y N Tree Pres Plan Recd _Y ^N Tree Pres Required ,_ Y _N On-site Septic System _ Y ^'N rade secret and the reason. Date / / Construction Cost Site Address Unit/Ste # Description of Work Multi -Family Bldg Y_ N Fireplace(s) 0 _ 1 _ 2 Property Owner Telephone # ( ) Contractor Address City State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category (J submission type) - Minnesota Rules 7670 Category 1 • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted Minnesota Rules 7672 • New Energy Code Worksheet Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Y _ N If yes, date and address of master plan: Licensed Plumber Telephone # (, Mechanical Contractor Telephone # ( ) Sewer/Water Contractor Telephone # 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 requiresa review and approval of plans. Applicant's Printed Name Applicant's Signature 03/25/2008 15:38 469-4191 PIETSCH BUILDERS CIREScheck Software Version 4.1.3 Compliance Certificate Report Dom: Data filename: Energy Coda: i.dcstlon: Construction Type: Glazing 11re. Percentage: Nesting Degree °eye: COnstruCtion : 2000 IECC Eagan, Minnesota Mogi, Family 71111 Owner/Agent Designer/Contractor. Compliance: 44.2% getter Than Cote Ma dmum UA: 43 Your UA: 24 1 n Celing 1: Flat Calling or Sdeeor Trues Wall 1: Wood Rune, 18" o.c. Floor 1: All -Wood Joist/Truss:Over gonad Spm Crawl 1: Masonry Rock with Empty Celle Wall height: 3.5' Depth below glade: 3.0' Insulation depth: 3.5' Inside below -grade depth: 3.5' !;.TiVIty Cc: t Gi.+z�ntj A,sa, cr R-V3111r f-'.';,tuc r,r CJUor dillrl rir II -i Ali tnl" 144 288 38 128 44.0 19.0 13.0 10.0 4.0 4.0 13.0 10.0 UA PAGE 02 1 Compliance Statement The proposedbulkane calculations submitted with the �Qn de9dbed hers is consistent with the building plans. specification*, and oft*Permit application. The proposed building hes been designed to meet the 2000 MCC requirements in I. REScheck Version 4.1..3 and 10 comply with the mandatory requirements listed in the REScheck inspection Checklist Project ilUs: Data filename: UnMtled.rdc Report Page Address: 4177 COUNTRYSIDE DR Lot 4 Blk 2 Sec/Sub COUNTRY HOLLOW These items were/were not complete at the time of the final inspection. • DS. D. -: Final grade (6" from siding) Permanent steps - garage Permanent steps - main entry Permanent driveway Permanent gas Sod/seeded grass Trail/curb damage Porch Basement finish Deck Yes v No Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before .A freeze potential exists.taV pECYQEUpoEp White - City copy Yellow_ Resident copy Pink - Contractor copy 03/25/2008 15:38 469-4191 Wear hesters vitt. vwtloal Ribe risers have a heat trap on both the inlet end outlet unless the water heater has an Integral is pert of a circuleting system, dace Yap hot water piper ars Insrdabd Ib the levels In Table 1. Circulating Not Water Systeme: Circulmang hot water pipes are Insulated to the levels In Table 1. PIETSCH BUILDERS Swlmnning Pools: ❑ AM New ewirnming pools have en on/off heeler switch and a cover unless over 20% of the healing energy Is from sources. Pod pwnpa hew a time dock. Healing and C.Opflg Piping insulation: [� HVAC piping conveying %ids above 105 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2 PAGE 04 trap or Lj4 is a a5;5 .�a N 1287 Request Date I I Fire No. Rough -In Inppection Required (You mus call inspector when ready) Yes 0 No Inspection Other Than ough-In 0 Ready Now Will Notify Inspector Date Ready 1 licensed contractor D owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No.) 4-19/l1 r Section No. Township Name or No. Range No. City Coun A 0CuA� Occupant (PRIN Power Supplier Adit- Electrical Contractor (Company Name) Mailing Address (Contractor o iwrrerr Making Installation) ation Authorized Signature�Contractor/Owner Makin Instal Address g )( MINNESOTA STATE BOARD OF ELECTRICITY Griggs -Midway Bldg. — Room S-173 1821 University. Ave., St. Paul, MN 55104 Phone (612) 642-0800 5/(e/F N 1238 Phone No. Contractor's License No. Phone Number THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION See instructions for completing th's form on back of yellow copy. X" Below Work Covered by This Request New Add Rep. Type of Building Home Duplex Apt. Building Comm./Industrial Farm Other (specify) Compute Inspection Fee Below: Other Fee AppliancesWired Range Water Heater Dryer Furnace Air Conditioner Cont actor's Remarks: Swimming Pool Transformers Signs Irrigation Booms Special Inspection Alarm/Communication Other Fee /12(j -c - Service Entrance Size 0 to 200 Amps Above 200 Amps Inspector's Use Only: I, the Electrical Inspector, hereby certify that the above inspection has been made. EB -00001-08 c'r` 0'SS Equipment Wired Temporary Service Electric Heating Fee # Load Management Other (Specify) Circuits/Feeders 0 to 100 Amps Above 100 Amps f� TOTAL Fee THIS INSTALLATION MAY B� ER ! D CONNECTED IF NOT COMPLETED WITHIN 18 late Rough -in K{,74 Final OFFICE USE ONLY This request void 18 months from 03/25/2008 15:38 469-4191 PIETSCH BUILDERS n Table 1: Minimum hesitlat on Thhckn.ss for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sires Hosted WabsrNcn�ir Rtnioub CIrculatlngi blabs and Runout T re (•F) Up to 1" Up to 125" 1.5' to 2.D' Over 2' 170-186 -5 1.0 2.0 140-16 0.5 0.5 1.0 1.5 100.139 0.5 0.5 0.5 1,0 Table 2: Minimum insulation Thickness for HVAC Pipes PIp114 $Yater Typos Fluid Temp. `F) Insulation Thickness In Inches by Pipe Mose 2' Runout 1' and Less 1.25" to 2.0' 2.5" to 4' Healing %mien* Pressure/Temperature 201-250 1.0 l vw Temperature 120-200 0.5 Steam Condsns (tar heed water) Any 1.0 Gaoling Systems 1.5 1.0 1,0 1.5 1.0 1.5 2.0 1.5 2.0 Chilled Water, Refrigerant and 40-65 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTU TO FIELD: (Building Department Use Only) PAGE 05 • I ; Project 1111e: Data filename: Unlglsd.rok 5/08 4of4 6/057/58°4 H 1 Request 0 6 pe -re". reNo. Insp s ❑ No ❑ Ready Now Will Notify Inspector When Ready? I licensed contractor D owner hereby request inspection of above electrical work at: Job AddreBe (Street, Box or Route N Section N/ 7 Township Name /%vr,NVQo Range No. Occupant (PRIN Power S er qp ��•��✓ Address Phone No. ',actor (Compan ame) n Contractor's License No. Owner Making Installat jnerng Installation) OF ELECTRICITY Jom 5-173 Paul, MN 55104 Phone Number W9a-e03&17` THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ► See ins',uctions fo` ^.ompleting this form on back of yellow copy. 8A5o 10 7 X" Below Work Covered by This Request EB -00001-08 f! ee5 ?/ New Add Rep.; Type of Building AppliancesWired 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 / - /3 0 to 100 Amps ,,--o7 Transformers Above 200 Amps Above 100 Amps Signs Inspector's THIS Use Only: INSTALLATION MAY BE ORDERED WITHIN 18 DISCONNECTED 3 f TOTAL so 2 Irrigation Booms IF NOT q�te�( �/O , l� Special Inspection Alarm/Communication Other Fee s59 COMPLETED I, certify been the Electrical Inspector, hereby that the above inspection has made. `OIJJHS. Rough -in ?f / . "t o ( (////� 'l Final �^' Date/6—,*2 d J OFFICE USE ONLY This request void 18 months from RESIDENTIAL l�� BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 k/ 7/' -S 651-681-4675 New Construction Requirements • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all 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 it lot platted after 7/1/93 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE �'I(O'67i Remodel/Repair Requirements- • 2 copies of plan - -7 • 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks • Indicate if home served by septic system for additions U3� VALUATION SITE ADDRESS q/77 Cif a1 irr 5 (c `e-- Z' TYPE OF WORK et J' U U F MULTI -FAMILY BLDG _ FIREPLACE(S) _ 0 _ 1 2 APPLICANT S L( bt.t,r Cc -->+L e D 2 S STREET ADDRESS_7 Li (7 6 COa S v�-�h / CIN fr 6ti / Ur STATE `�J/UZIP TELEPHONE # gS Z-(-/ "g/Z3L CELL PHONE # FAX # PROPERTY OWNER I\ ,C) '5 e v 4 k � S'C)) TELEPHONE # &57--6--00/7 COMPLETE THIS SECTION FOR "•NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category ('1 submission type) Plumbing Contractor: MINNESOTA RULES 7670 CATEGORY 1 • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing system includes: Mechanical Contractor: Water Softener Water Heater No. of Baths Phone # MINNESOTA RULES 7672 • New Energy Code Worksheet Submitted Lawn Sprinkler No. of R.I. Baths Mechanical system includes: Sewer/Water Contractor: Air Conditioning Heat Recovery System Fee: $90.00 I hereby acknowledge that I have read this application, state that the information is correct, and agreeTO clomply with all applicable State of Minnesota Statutes and City of Eagan a .i onces Signature of Applicant OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY ❑ 01 Foundation 0 07 05-plex 0 13 16-plex 0 20 Pool 0 30 Accessory Bldg ❑ 02 SF Dwelling 0 08 06-plex 0 16 Fireplace 0 21 Porch (3 -sea.) 0 31 Ext. Alt - Multi ❑ 03 01 of plex 0 09 07-plex 0 17 Garage 0 22 Porch/Addn. (4 -sea.) 0 33 Ext. Alt - SF ❑ 04 02-plex 0 10 08-plex 0 18 Deck 0 23 Porch (screened) 0 36 Multi ❑ 05 03-plex 0 11 10-plex 0 19 Lower Level 0 24 Storm Damage ❑ 06 04-plex 0 12 12-plex Plbg_Y or _ N 0 25 Miscellaneous ❑ 31 New 0 35 Int Improvement 0 38 Demolish (Interior) 0 44 Siding ❑ 32 Addition 0 36 Move Bldg. 0 42 Demolish (Foundation) 0 45 Fire Repair ❑ 33 Alteration 0 37 Demolish (Bldg)* 0 43 Reroof 0 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) _ Final/C.O. Footings (deck) Final/No C.O. Footings (addition) Plumbing Foundation HVAC Drain Tile Other Roof Ice & Water Final Pool _ Ftgs _ Air/Gas Tests _ Final Framing Siding Stucco Stone Fireplace _ R.I. _ Air Test Final Windows (new/replacement) Insulation Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 New Construction Reauirements • 3 registered site surveys stowing sq. ft of lot sq. ft. of Cause; and M roofed areas (20% maximum lot coverages allowed) • 2 copies of plan showing beam & window sizes; poured found desgn, etc.) • 1 set of Energy Calculations • 3 copies of Tree Preservation Plan if lot platted after 7/1/93 • Rim Joist Detal Options selection sheet (b dgs with 3 or less units) DATE 0 02, JOB SITE ADDRESS 4 yini.vrfv1,5) cid, IF MULTI -FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER °ca1f1 Al anit,i 0:166 n TYPE OF WORK �Vi ,l' -14d 0060/A(41 v-1.1 APPLICANT P1 E%f006l -17,y G ADDRESS • 0 • ( ). 2«�r)t, hew i (Le,, PAGER # CELL PHONE # 70- ®a &-&f(i,/o�� Remodel/Reoelr Reaulrements • 2 copies of plan • 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks • Indicate if home served by septi; system for additions VALUATION II 00t i2 FIREPLACE(S) 0 1 PHONE# (11, ZIP CODE 6s 044 FAX # 6)S2- L --&J L-1(1 I‘. NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY Energy Code Category (check one) Plumbing Contractor. I A - MINNESOTA RULES 7670 CATEGORY 1 - Residential Ventilation Category 1 Worksheet Submitted Energy Envelope Calculations Submitted MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Plumbing System Includes: - Water Softener - Water Heater No. of Baths Phone #: _ Lawn Sprinkler Fee: $90.00 _ No. of R.I. Baths Mechanical Contractor. t 1 n( Mechanical System Includes: _ Air Conditioning Heat Recovery System Phone # Fee: $70.00 Sewer/Water Contractor. Phone # All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant Certificates of Survey Received _ Tree Preservation Plan Received Not Required Updated 2002 ❑ 01 Foundation ❑ 02 SF Dwelling D 03 01 of _ plex ❑ 04 02-piex • ❑ 05 03-piex .: •; «, ❑ 06 04-piex ❑ 31 New O 32 Addition .. 33 Alteration ❑ 34 Replacement Valuation Census Code SAC Units Nbr. of Units Nbr. of Bldgs Type of Const O 07 05-piex ❑ 08 06-piex O 09 07-piex ❑ 10 08-piex ❑ 11 10-piex O 12 12-plex OFFICE USE .ONLY ❑ 13 16-piex c, ❑ 16 Fireplace ❑ 17 Garage ❑ 18 Deck 19 Lower Level Plbg_Y or _ N, ❑ 20 Pool ❑ 21 Porch (3 -sea.) ❑ 22 Porch/Addn. (4 -sea.) ❑ 23 Porch (screened) ❑ 24 Storm Damage ❑ 25 Miscellaneous ❑ 30 ❑ 31 D •33 ❑ 36 Accessory Bldg Ext. Alt - Multi Ext. Alt - SF Multi ❑ 35 Int Improvement 0 38 Demolish (Interior) 0 44 Siding 0 36 Move Bldg. 0 42 Demolish (Foundation) 0 45 Fire Repair —' " ~ O 37 Demolish (Bldg)• 0 43 Reroof 0 _ 46 Wndows/Doors' *Demolition (Entire Bldg only) - Give PCA handout to applicant VI/ Footings (new bldg) Footings (deck) Footings (addition) Foundation Drain Tile Occupancy - Zoning - Stories Sq. Ft. Length Width REQUIRED INSPECTIONS Final/C.O. Final/No C.O. Plumbing HVAC Roof _ Ice & Water Final Framing Fireplace R.I. k,` Air Test °, Final Insulation MC/ES System City Water - - Booster Pump PRV Fire Sprinklered Other Pool Ftgs _ Air/Gas Tests _ Final Siding _ Stucco _ Stone Windows (new/replacement) Approved By 1 , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total PERMIT CITY CSF 'EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT TYPE: Permit Number: Date Issued: Y ry BUILIaING 023250 04/08/94 SITE ADDRESS: 4177 COUNTRYSIDE DR LOT: 4 BLOCK: 2 COUNTRY HOLLOW P.I.N.: 10-18275-040-02 DESCRIPTION: (4—SEASON) Building Permit Type Building Work Type SF PORCH NEW REMARKS: A. A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK FEE SUMMARY: VALUATION $7,000 Base Fee $90.00 Surcharge $3.50 Total Fee $93.50 M'IM9Ms INC -- Applicant -- ST. LIC. 14693044 0002358 9543 BIRCH LN LAKEVILLE MN 55044 (612) 469-3044 OWNER: NELSON 4177 EAGAN DEAN COUNTRYSIDE DR MN I hereby acknowledge that I have read this application and state that information is correct and agree to comply with all applicable State o`f` Mn. Statutes and City of Eagan Ordinances. 4,4 A LICANT/PERMI EE SIGNATURE ( ISSUED BT: SI NATU SINGLE FAMILY DWELLINGS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS 1 SET OF ENERGY CALCULATIONS PENALTY APPLIES WHEN: 1990 BUILDING PERMIT APPLICATION CITY OF EAGAN 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 TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH K QUEST IS MADE. LOT CHANG IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. J U L 18 To Be Used For/AE1AAs'//4 Valuation:Date:// (//Af Site Lot Address �d/dr e s s / Block Parcel/Sub dc044/ Owner ,dx,„ .00* Address City/Zip Code Phone i Contractor /.ev,, , /j.:C Address %y3 .Qkie, /4611`/ ,, City/Zip Code %✓ Kt Lli14. t //%%y..' Phone /‘/-3-4/ Arch./Engr. Address City/Zip Code Phone # /3? � OFFICE USE Occupancy Zoning Actual Const Allowable # of stories Length Depth S.F. Total Footprint S F On site sewage On site well MWCC System City water PRV Booster Pump APPROVALS Planner Council Bldg. Off Variance R-3 M -I V V -N 3", )81 19 ONLY FEES Bldg. Permit /4,9, Co Surcharge 68,50 Plan Review 500/00 SAC, City I OO Ot7 SAC, MWCC &CO, DO Water Conn 6 2,5100 Water Meter 90.00 Acct. Deposit 30,00 S/W Permit 30.00 S/W Surcharge • 50 Treatment P1. Z�r2.CO Road Unit Park Ded. Copies SUBTOTAL Penalty TOTAL I," CITY OF EAGAN N9 18174 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 , �'/ BUILDING PERMIT Receipt # 1 To be used for SF DWG/GAR Est. Value $137,000 Date JULY 19 , 19 90 Site Address 4177 COUNTRYSIDE DR Lot 4 Block 2 Sec/Sub COUNTRY HOLLOW Parcel No cc 0 0 Name Address City PIETSCH BUILDERS, INC 9543 BIRCH LN LAKEVILLE Phone 461-3381 Zo U1 - Name SAME Address City Phone U¢ ww rw U0 mz aw 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 and Cit Eagan Orddijnces. Signature of Permitee e:";04 10J&L . A Building Permit is issued to• PIETSCH BUILDERS, INC on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official X111 q AQIfA. f ew' OFFICE USE ONLY Occupancy R-3 M-1 Zoning 13=1 (Actual) Const V—N (Allowable) V—N # of Stories Length 68' Depth 34' S.F. Total S.F. Footprints On Site Sewage On Site Wet MWCC System City Water PRV Required Booster Pump APPROVALS Planner Council Bldg. Off. Variance XX XX XX FEES Bldg. Permit Surcharge Plan Review SAC, City SAC, MCWCC Water Conn Water Meter 769.00 68.50 500.00 100.00 600.00 625.00 90.00 Acct. Deposit 30.00 S/W Permit 30.00 S/W Surcharge . 50 Treatment PI 252.00 Road Unit 355.00 Park Ded. Copies 1.00 TOTAL 3,421.n0 (grrtifii ati of (!rrupattrJ QCitp of Cagan ElPpartritntit of Busting 3nnprttiin This Certificate issued pursuant to she requirements of Section 306 ofthe Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following. Use anaiwion Occupancy Type Owner of Building Building SF DWG/GAR R3 Zoning District B1 P1FTSCR WARS - Bldg. Permit No. 18174 rya cont Address 95/ 3 BI G1 r N r AKEV1LLE 4177 COi1NTRVS11lR nitor.tity L4, B2, n Bung DatC MAY 24. 1991 POST IN A CONSPICUOUS PLACE V SINGLE & MULTI -FAMILY COMMERCIAL 2 sets of plat calcs. 2 sets of arcl specification: Penalty applies: 1) when permit is typec in which request is made, 2) address is is issued. Date 44?)} / �% / /1401 Site Address: 7". f?,00nu 44/ $/ STREET Tenant Name: (commercial only) LOT BLOCK SUBD. Description of work: Xd,a4sivo ,7 4 The applicant is: 0 Owner Contract Property Owner Name 44T/ c:if LAST F Address 5")2 eee), STREET City /fit'; Contractor Company 41 BP/ Address gpit- city 4 l/ Architect/ Engineer Company Name Address City Sewer & water licensed plumber sewer & water permits is two days once ar I hereby acknowledge that I have read thi correct and agree to comply with all appl Eagan Ordinances. Signature of Applicant:// BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 02 SF Dwg. ❑ 03 SF Addition 3 04 SF Porch ❑ 05 SF Misc. WORK TYPE 0 31 New ® 32 Addition OFFICE USE ONLY ❑ 06 Duplex ❑ 07 4-Piex ❑ 08 8-Piex ❑ 09 12-Piex ❑ 10 Multi. Addl. ❑ 33 Alterations ❑ 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Engineering REQUIRED INSPECTIONS ❑ Site ❑ Wallboard ❑ 11 Apt./Lodging ❑ 12 Multi. Misc. ❑ 13 Garage/Accessory ❑ 14 Fireplace ❑ 15 Deck ❑ 35 Tenant Finish ❑ 36 Move Basement sq. ft. 1st Fl. sq. ft. 2nd F1. sq. ft. Sq. Ft. total Footprint Sq. ft. On-site well On-site sewage Building Variance 0 Footing 0 Final ❑ Framing ❑ Draintile ❑ 16 Basement Finish ❑ 17 Swim Pool ❑ 18 Comm./Ind. ❑ 19 Comm./Ind. Misc. ❑ 20 Public Facility ❑ 21 Miscellaneous 0 37 Demolish MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code Census Bldg Census Unit Assessments 0/ 6 o Insulation ❑ Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC SAC Units Valuation: l ,4-r!/ '/o za Or EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION T"r / 0/Af'R2--tee SITE ADDRESS: LC1 LI BLoc4K Z CONTRACTOR: firT jU f LDi; K DATE: �4%2)70 DETERMINE WORKING SQUARE FOOTAGE OF EACH: 1. TOTAL EXPOSED WAI:,L AREA 2. TOTAL:, ROOF/CEII:,ING AREA 3. TOTAL EXPOSED WAI:J, AREA LCz, -3 SQ. FT. X CALCULATIONS: a) b) c) d) e) Total exposed wall area above floor Total Total Total Total wall window area door area sliding glass door area fireplace wall area Total wall framing area (average 10%) f) Total net wall area above floor (insulated) `:coal rim joist area Total foundation area (exposed) h) Total foundation window area i) Total net foundation area above grade g) If item #3 is the same as, or less the intent of 2 MCAR 1.16008 A and 25. SQ. FT. X ZSZ0,o The,2 rl/ PHONE: SQ.FT. SQ.FT. SQ.FT. SQ.FT. SQ.FT. 2728 227 s.2 SQ.FT. X "U" X "U" X "U" X "U" X "U" X "U" Zi6 1211 _ Ar‘( 0 101 = Z2-, CJ 013= '7,9 77$r3 SQ.FT. X „U„ (04 = r , Z, o 120 SQ.FT. SQ.FT. X t, U „ y--. SQ.FT. X "U" 1i7 0 1Z,z TOTAL:, a) through i) than item #1, you have met 0. PAGE 1 frl 4. TO'.CAL:, EXPOSED ROOF/CEII:,ING CALCULATIONS: Total exposed roof/ (%2 SQ.FT. ceiling area Total skylight area j) k) Total roof/ceiling framing area (average 10°%) 1) Total net insulated roof/ceiling area a SQ.FT. X "U" SQ.FT. X "U" SQ.FT. X "U" 6 = 4. TOTAL j) through 1) If total of #4 is the same as, or less than #2, you have met the intent of 2 MCAR 1.16008 A and 0. 2, ALTERNATE BUII:,DING ENVELOPE DESIGN To utilize the total envelope system method, the values established by the sum of #3 and #4 shall not be greater than the sum of items #1 and #2. 1. 3. +2. _ +4. _ CERTIFICATION I hereby certify that I have calculated the "U" factors and "R" values herein and that the building here described meets or exceeds the State of Minnesota Energy Conservation Act. (Signature (Date) PAGE 2 AIR FLOW • VENTED ritzpsegmegmelsolizeftsgastatbnA_. VENTED CONSIAu&lis g tit CEILIN4 SECTION (INIPl4it(}): 1 Interior air flim 011 3 Q.c1 2 e?ns 4 E to for air' film (still) A.11 TOTAL R =4 1/.0 1/1Z • ._022 CEILING FRAMING SECTION: 1 Interior a film n.fii 2 .Sg 3 ' nsulatian 31. a 'interior air fila (still) A.fii_ 5 3 % " inches soft wood 4.35 TOTAL * •37.11 CEILING SECTION (INSULATED): 1' Interior air film 2 3 4 'Exterior air film (still) 0.61 -TOTAL R • CEILING, i 2 3 a S U • 1/1 • FRAMING SECTION: interior air film 4.t;1 Exterior air fT1m [st111) f.f+I inches soft wood TOTAL R - U• 1/R • • i Inside air.fflm n.f►1 2 3 a S butside air film A.17 TOTAL R = U • 1/R = £-v 4 2 .. K Studs CONSTRUCTION WALL FRAMING SECTION: (1 Interior air ?firs (2 # s-eetroc►c (3 ,5 Inches soft woos (�• 5 ti i--16 R VALUE - • WILL SECTION (INSULATED) (1 Interior air film (2� (3 P 3 ■ lat 1cn {4 25/32 8ildrite Mtg. (5 Stdin {A Exter RIM JOIST SECTION: (1' Interior alr film (3 A !'ood a 25/32 Eildrite E 4�4�� U•1/R•—,043 A.6A . 89 2_Q6 --(fi Exterior air flim FOUNDATION INSULATIOI1 REQUIRED: Min. R-5 on entire wall OR Min. R-10 down to frost depth FOUNDAT I ON SECTION: --{1 Interior alr film O. TOTAL R • 24.6 " • 1/R •° AAR {2 1" Stvro 'mull. 4.0 1.11 n.17 8' Pl'ocic (4 Exterior alr film (S (6 SLAR ON GRADE .\',4 •4.4! ':` N • .• • • tr •' • . . • 4• .. • •.�• %. r,':11 Heated Slabs: Minimum R = 8.5 ff TOTAL R • 5.96 U• 1/R• .17 •. .. ,.a • •. . A • I••�4 .;▪ •a.•.% =t ftet - •• .. •.•.•a I d • •c, Unheated Slabs: Minimum R = 6.2 • 4'• • • •• op .. •,4. • ,!Z•. . •ii. • • Q • • •.• 41 • el,...•..11 .•Q •. • • •• Q•• .w• . • ' •.r�' Page 3 _city of acigcin 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122-1897 PHONE: (612) 454-8100 FAX: (612) 454-8363 October 10, 1990 WARREN ISRAELSON PROGRESS COMPANIES, INC. -14300 NICOLLET COURT SUITE 235 BURNSVILLE, MN. 55337 RE: T.V. Inspection of Sanitary Sewer Dear Warren: THOMAS EGAN Mayor DAVID K. GUSTAFSON PAMELA McCREA TIM PAWLENTY THEODORE WACHTER Council Members THOMAS HEDGES City Administrator EUGENE VAN OVERBEKE City Clerk Enclosed is the invoice from Visu-Sewer for televising the sanitary sewer line between Lots 4 and 5, Block 2, Country Hollow Addition. Because of the incorrect as -built information_ the City received, we feel it is the developer and/or engineering firm thatis responsible for at least 2 of this amount. As I stated in our telephone conversation, the City of Eagan will pay the other 2. Please submit to the City of Eagan a check in the amount of $212.50. If you have any questions pertaining to this item; please call me at 454-8100. Sincerely, Stanley/Lexvo1 Senior Engineering Technician -Construction cc: Joe Connolly, Supt. of Utilities Michael P. Foertsch, Assistant City Engineer SL/j f. THE LONE OAK TREE...THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY Equal Opportunity/Affirmative Action Employer VISU-SEWER CLEAN S SEAL, INC., N59 W14397 Bobolink Avenue, Menomonee Falls, Wisconsin 53051 414-252-3203 FAX 414-252-3195 T t1 tT n j r F r/7,TF An gli F t '11 nn0P4 i t " of Facan 2 D2r T i 1_r't Fn' h Pr,�r7 F?'{„ t -?1t 951";:?: PF- T.17. Tns'per-ticn , f 1.O•+ find ;?orvicPs.. n inir11iT1 TNVnilr ++ c,R CU`'TntMFF TFPMF. 1•,11A llpon :-P-sipt of il•,'oicP \ GPrvir.P -1117 r,:. r,f 1 1/-, pP1 month may y hp r 11 1 ,-T-rl past r111a It do ir it -, member of -41150 MEMO city of eagan 3 Z Ccau1.) %iv I 10.)) TO: THOMAS L. HEDGES, CITY ADMINISTRATOR FROM: THOMAS A. COLBERT, DIRECTOR OF PUBLIC WORKS DATE: MAY 3, 1996 SUBJECT: SANITARY SEWER BACK-UP - COUNTRY HOLLOW ADDITION INCIDENT At approximately 8:15 A.M. on Monday, April 30, 1996, the maintenance division of the Public Works Department was contacted by various residents within the Country Hollow Addition reporting sanitary sewer back-up into their homes. Maintenance employees dispatched to the area discovered that the Country Hollow sanitary sewer lift station experienced a power failure and the pumps were not working. Dakota Electric was contacted and City dispatched a portable generator to the site with one pump being reactivated at approximately 9:23 A.M.. Full power was ultimately restored at 10:13 A.M.. By Tuesday morning, the City had indications that approximately seven home owners experienced a sanitary sewer back-up into their homes to some degree. See attached map for location of impacted properties. CAUSE Preliminary investigations indicate that some type of power spike or surge created a "flash burn" at one of the connection points of the control fuse for the electrical motors. Such a power or mechanical failure should not result in a sewer back-up into residential homes as the City has portable generators and/or auxiliary pumps that can be commissioned to maintain continuous sewer service. Unfortunately, the sewer back-up resulted from a failure in the alarm system to notify the City's maintenance of a lift station malfunction allowing it to respond with corrective action prior to any homes being impacted. HISTORY Unfortunately, a similar situation occurred on June 14, 1994. At that time, five homes were impacted. Similarly, the 1994 sewer back-up resulted from an electrical power outage and the failure of the alarm system to notify City maintenance. Due to that previous occurrence, the Public Works Department proceeded in 1995 to replace all such unreliable alarm systems with current technology of radio telemetry SCADA System City wide. Unfortunately, we were approximately 4 - 5 weeks away from completing the conversion of the alarm system at this location when the second power outage/alarm failure occurred. CORRECTIVE ACTION The Public Works Department has contracted with an Electrical Engineer to review the electrical controls and alarm system to identify any interim measures that can be taken to increase reliability. The Public Works Department will also be accelerating its efforts to complete the conversion to the new fail-safe alarm system. During the interim, the City will be inspecting the facility three times per week testing all controls and alarm systems helping to insure reliability. The City's insurance agent, League of Minnesota City's Insurance Trust "LMCIT' has already been in contact with all of the known affected home owners helping to process any claims they may have. Of the seven homes owners, two of them have indicated the back-up did not result in any damage requiring on-site inspection by the insurance agent. COMMUNICATIONS In addition to numerous phone calls and personal visits with affected property owners, attached is a letter being sent to affected property owners. As significant additional information becomes available, I will forward it to your attention. Please let me know if you would like any further action. Respectfully submitted. Director of Public Works TAC/cb cc: Eugene VanOverbeke, Director of Finance/Risk Manager Wayne Schwanz, Superintendent of Utilities Attachment: Letter dated May 2, 1996 List of Affected Property Owners Location map b 1 bd 1 4.A.lb 05/03/96 14:08 EAGAN MTCE FAC - CITY HALL-DNSTPS 4[1°11° city of eagcin NO.998 P001/001 MAY 001-00.- MAY 2, 1996 NAME ADDRESS CITY, STATE ZIP THOMAS EGAN mayor PATRICIA AWAOA SHAWN HUNTER SANDRA A. MASIN THEODORE WACHTER Council Members THOMAS HEDGES CITY Ac1munistraror E. J. VAN OVERBEKE CITY Clerk RE: FAILURE OF THE COUNTRY HOLLOW SANITARY LIFT STATION ON TUESDAY, APRIL 30, 1996 Dear Name: It is my understanding that your house was involved in flooding from the backup of the city sanitary sewer system on April 30, 1996. The cause of the backup was a failure of the City of Eagan's sanitary lift station which incurred a power failure thus preventing the sewage pumps to function properly. In itself, such a power failure would not cause a sewer backup as the city has portable generators and pumps to maintain continuous sewer service. Unfortunately, the backup resulted from a failure in the alarm system which notifies the City's maintenance division of a problem allowing it to respond with corrective action prior to any of the homes being impacted. Upon receiving the alarm at 8:17 a.m., on April 30th, 1996 the Utility Division dispatched two employees to the scene and they arrived on site within 10 minutes of being notified of a flooding problem of one of the homes in the area. They immediately requested a backup generator to be brought in which was done within an additional 15 minutes. At the same time Dakota Electric was notified that a possible power failure may be resulting in the transformer which controls the sanitary lift station. Dakota Electric dispatched a truck which arrived within 40 minutes of the initial call. The emergency crew connected the generator to the electrical bypass of the sanitary lift station and the pumps were operating within minutes. It took approximately 20 minutes to pump the system down to control any flooding that may have been taken place. Unfortunately approximately seven homes in the area had experienced a sewer back up to some degree. The entire situation was corrected and the station was back on line operating properly by 10:13 a.m. On May 1, 1996 the Utility Division contracted with Jensen Electric Company to inspect and test the control panel at the sanitary lift station. As a result of their inspection, no problem was discovered within the control panel, suggesting possibly what may have happened was a power spike being created within the power lines which may have damaged a fuse. Although a fuse was located which showed that it may have been exposed to excessive power, it was still operable. The Utility Division also traced and verified the operation of the current alarm system which has existed at the station. Further investigation will continue to determine what caused the alarm failure. MUNICIPAL CENTER 3890 PILOT KNOB (OAO EAGAN. MINNESOTA 55122 1897 PHONE. (612) 681 4600 FAX. (612)681.4612 TOO (612) 454.8535 THE LONE OAK TREE THE SYMBOL OF STRENGTH ANO GROWTH IN OUR COMMUNITY E. ual Opportunity/AtflrmotIve Action Employer J MAINTENANCE FACILITY 3501 COACHMAN POINT EAGAN M,NNESOTA 55122 NONE: (612) 681.4300 FAX: (612) 681.4350 '00 (612) 454-853S 612 581 4700 05/07-'96 14:08 EAGAN MTCE EAC — CIT( HALL—DNSTPS NO.996 P002= 0r On June 20, 1994 this lift station experienced a similar problem due to loss of power from Dakota Electric. After reviewing this incident the Division investigated alternatives in system control and monitoring failure alarms which lead to the development of our current SCADA (Supervisory Control and Data Acquisition) system which is utilized at our Water Treatment Plants. In 1995, the city initiated an aggressive program of replacing controls and alarms in our entire system with the most current technology available which has built in redundance of a failsafe mechanism. Unfortunately we were approximately five weeks away from completing the conversion to the new alarm system when the recent pump and alarm failure and sewer backup occurred. The city will make every effort to further accelerate the completion of this alarm conversion and hope to complete the installation and testing within two to three weeks. We feel confident that once this new alarm system is activated there should be no further concerns of similar situations occurring in the future. In the meantime, the Utility Division has taken further steps to monitor the operation of the lift station. The current alarm system will be tested three times weekly and verified as to the status of its operation. Also, we will be adding a light to be installed at the station which will activate during a high sewage level situation. This light will provide a visible alarm that a problem with the station is occurring and therefore allowing the city to be notified by residents whenever the light is observed to be on. We sincerely apologize for the inconvenience you have experienced and want to assure you that the City of Eagan is committed to providing a safe, dependable and trouble free sanitary sewer system to meet all of your expectations. As the work progresses with the new alarm system, I will notify you as to the progress and completion date of that project. If you have incurred any damages the City's insurance company will work with your homeowners insurance company to process any claims and reimbursement payments. If you have any questions regarding processing your claim, please contact the city's insurance agent, Ms. Darlene Boise at 215-4077. S incerely, Wayne Schwarz Superintendent of Utilities WS/nab 1\21 bicounay.124 COUNTRY HOLLOW SEWER BACK-UP Residents Affected (Known as of 5-1-96 3:00 P.M.) PROPERTY OWNER APRIL 1996 JUNE 1994 1. Jess Stacy ✓ ✓ 4179 Prairie Ridge Road 686-0770 2. Joe & Kitty Robertson 4179 Countryside Drive 683-0930 3. Ted Peters 4175 Countryside Drive 687-9267 4. Roger Dean Nelson 4177 Countryside Drive 686-0049 5. Don Dickerson 4175 Prairie Ridge Road 456-0744 6. Tom Bland 4154 Lantern Lane 683-9614 7. Mike Smith 4181 Countryside Drive 452-6357 8. John Wiliems 611 Autumn Oaks Court 454-0037 9. Joe Giacomini 4180 Prairie Ridge Road 683-0787 r cr /1 /1/ ,%(/ ■_ 4Pr41L'96' t_ r, f, rr 4111 SEWER 13,4CKUP ìü íúù þýýüÿûúûúø ÷üüýý øööýüþ íøÿüáõ ëíãîí þý ÿþýüû÷õ ß ø ÿýüû ÷ýüû÷õ ß öõßûó ûáÿ ø ÿ øäåÿûü Ú òÿú óûçó ññóòÿ ó þó é æ õõû ææó ý ûéøææ ûæ é øþóè òÿþüõ æóüñó é úêäàêëëéîëéëî ó÷ ÿñ Üÿêäàêéîéíî Üÿäé òñ ðï ûû õ ö íøÿüø÷ ããøÿü çðöîîä ðöîîíä ïîìíããã ñþüõ ñ ñçñ ûû ññæó óûüõñûûþ æð ÿ øüæ å é ûûßó ÿ ÿü ÿ City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 4177 Countryside Dr Lot: 4 Block: 2 Addition: Country Hollow PID:10- 18275- 040 -02 Use: Description: Sub Type: e- Windows/Doors Work Type: Windows/Doors - New/Replacement Description: House Census Code: 434 - Zoning: Square Feet: 0 Comments: Fee Summary: Valuation: 3,000.00 Contractor: Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264 -4777 PERMIT City of Eaan Construction Type: Occupancy: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. BL - Base Fee $3K Surcharge - Based on Valuation $3K Total: $90.00 Applicant/Permitee: Signature - Applicant - $88.50 $1.50 Owner: Roger Dean Nelson 4177 Countryside Dr Eagan MN 55123 Permit Type: Permit Number: Date Issued: Permit Category: 0801 9001 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Issued By: Signature Building EA090797 08/21/2009 ePermit ùï ÿ þýý ûðûü úýý üÿÿ ýþ òý úóø þýö þýüûúù ó ûúùöø ù ó ã þÛã ûúùãýéý þ öýôü õôöýôü þÛ ý å í ñà õ ÿôñ ôîáþÝ÷ óßæêê õú þý ë îèæêäêä ôïóï öòñ ùù òëôùýôü õ ö ñà õêÿÚòý ú ãöñ ãöñ áàßñàñ ë üúø ë ëì ë ùù ëëé ô ôùúøëùùüþ éã þý òúé í ê ùù÷ ôþ ý ýúþ ý ì þ ë ÿÿ þýüëüûû úþþÿÿýòò ÿþ ïþùøö æ ÿù ÿþýüû ïùþüû úùüû úöêù÷ öê û ò øþ ï þï Þâþû Û ÿßþù í òûùã ò ð ðò ù ßþù ò ùý ùòçó ù ööû óùóùò ÿ û çïóùóû ó ùç ïùýòå ùù ù ßþù ýö óòðò ç í èÞçæçæ øú ÿþùðù èçäçä Ýþ ç ÷öû ùõô ûû ö ù ù ÷ äïþ ïú ïþù ù ã õ÷Þ ìîéî ð ù ýö ððã ù ðûû ðð óùòùù ù òûöðûûý ÿ óõ ÿþ ïó âù ç ûûê ùò ÿ þù þ ÿ þù PERMIT City of Eagan Permit Type:Building Permit Number:EA115836 Date Issued:09/30/2013 Permit Category:ePermit Site Address: 4177 Countryside Dr Lot:4 Block: 2 Addition: Country Hollow PID:10-18275-02-040 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 4,000.00 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 - Roger Dean Nelson 4177 Countryside Dr Eagan MN 55123 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK In l k., IFor Office Use I {{ Permit*. OZ / City �� Eaton Permit Fee: 3830 Pilot Knob Road t I Eagan MN 55122 Date Received: Phone:(651)675-5675 /, Fax:(651)675-5694 Staff: f t 7 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 1-10-2017 Site Address: 4177 Country Side Drive Unit#: Name: Dean & Mary Nelson Phone: 651-686-0049 Resident/ 4177 Country Side Drive Owner Address/City/Zip: Applicant is: Owner X Contractor Type of Work Description of work: Bathroom Remodel Construction Cost: 10,000 Multi-Family Building: (Yes /No X ) Company: Pietsch Builders Inc Contact: Doug Contractor Address: 10633 165th St W city: Lakeville 952-898-3044 Email: doug@pietschbuilders.com State: Mn Zip: 55044 Phone: License#: BC002358 Lead Certificate#: If the project is exempt from lead certification, please explain why: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.00cherstateonecall.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 b a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permitjissuance. f� 4 ^� eP7 x V�1 It 2 is Ap is nt's Printed ame Applicant's Signature Page 1 of 3 p EI 77 Li 111 V J.t NOT WRITE BELOW THIS LINE /y06 OTS SUB TYPES l 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 3(6°, Valuation { Occupancy G,il, MCES System Plan Review Code Edition {,, ..,,}"),I?(s` SAC Units (25% 100%)O Zoning .. City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction 4 Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) 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 7(30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS )c 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: Reviewed By: Ilv , Building Inspector RESIDENTIAL FEES Base Fee Surcharge tIA L Plan Reviewii..) „, MCES SAC (‘1/4( 14y City SAC Utility Connection Charge S&W Permit&Surcharge �/ (-1 lix 5 Treatment Plant ,,,,,,, 0 .7.,,, '''?.,-:;.,., 4,,,1 Copies TOTAL Page 2 of 3 Feb. 3. 2017 9: 39AM Silver Tree Plumbing & Heating No. 0381 P. 1 Use BLUE or BLACK Ink For Office Use #: �"/ (,�'�� City of Eaaaii Permit Permit Fee; ` V 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651)675-5675 Staff: Fax: (651)675-5694 2017 RESIDENTIAL PLUMBING PERMIT APPLICATION Date:2/3/2017 Site Address: 4177 Country Side Dr Tenant: Suite ff: ...: ,:.;.•.'':. ':,-'! Name: Mary & Dean Nelson Phone: `Res,deht!Owr eT`° ` +i' '.:c Address/City/Zip: • Name: Sliver Tree Plbg. & Htg License#: PM058743 Address 3185 Terminal Dr#200 cls,. Eagan state MN zip. 55121 Phone: 6519552987 Contact: RYan Email: ryanb@silvertreepandh.com New Replacement Repair Rebuild ✓ Modify Space Work in ROM. Description of work: Master bathroom remodel • ., ' • • .;•: RESIDENTIAL Water Heater ';..j.: Water Softener lPerrrlt Tib : -Lawn Irrigation(—RPZ/—PVB) Septic System Add Plumbing Fixtures L Main I—Lower Level) "• Water Turnaround ;•:,., —New Abandonment RESIDENTIAL FEES: $60.00 Water Heater,Water Softener,or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation(includes State Surcharge) $60.00 Add Plumbing Fixtures,Septic System Abandonment,Water Turnaround*(includes State Surcharge) *Water Turnaround(add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES$ 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. . .Ryan Baker Applicant's Printed Name Applicant's Signature • :FOR' `F-.FIS ::;�� . > •::'• ,:,;;:,; t�r� P 1 !•"1 .;.:{t,...::;,,,•1•.,`,1+1^• ;r..,.'"., ,, ,.., m ., '.`6...l.,,if'.,.,, .,...•.•..'; ..{�:!';ri`,ti�l.'... .T.. ,..✓'.�'�'"•a �'•�:;• i°,.illi ® t Qn6. :U der:Gf°a ,tl,. R u "�I` ;�;:•.Air:T'e' •:Ga 'St'.. . >Fini"I:`'�'.>'•"'��`�1:�� . ;> nsp$�', .�, .�!. ..s4-..,.9,h-..ti;� ,�1;;• s�7'e ,.p.:: •::,.>.. :'iii-.—,:;4:. f, :1 •Ai" t •`i"i �••et"ri�ela ':l": PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA176545 Date Issued:05/20/2022 Permit Category:ePermit Site Address: 4177 Countryside Dr Lot:4 Block: 2 Addition: Country Hollow PID:10-18275-02-040 Use: Description: Sub Type:Water Softener Work Type:Replace Description: Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$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 - Jed & Jacqueline J Lindman 4177 Countryside Dr Eagan MN 55123 (651) 698-1138 Champion Plumbing Llc 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature