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4182 Countryside Dr
)wrier ;ite Address 3u1Iding 4OTE: 1. x 2. Lc .ontractor .�], 64 `'- Classification: Type AI (Single Family & Duplex) Complete pages 3 and 4 first. SENERAL INFORMATION I. Building Perimeter' € o . t f 2 . Wall height (ground to eave) S. Square foot Doors Area 91t Thickness Type of Construction Manufacturer Total door's perimeter Windows: Manufacturer U factor TYPE Total ft. Glass MINNESOTA STATE ENERGY CODE CALCULATIONS BASED ON CHAPTER 5 OF THE MODEL ENERGY CODE - 1983 EDITION Adoption Effective 1/1/84 ` (above) gross wall area 7 25,1,ft. 4. Building dimensions tL) — X (W) area of rim joist -,Floor joist size (2 x ? X Perimeter = Rim -SIZE • "2.19175 12 (Other) • ft. r. 2 Fireplace area: -Width X help t = X in. U factor ft. AREA (Ft. EACH Phone H LL_AL.ic 14 0 i APO joist area 14.47 Phone Type A2(Residential) Perimeter NUMBER OF UNITS • Date (3 stories, or less) (Over 3 stories) ft. roof & floor area State approved 3 1i ft ft, TOTAL FEET 2 Ft. 1. Exposed foundafiori; +'fHeight X Perimeter (' 7 X /70 = / , (rO Ft. 2 OMPLETION OF-THIS FORM 1S FOR ALL NEW CONSTRUCTION, MAJOR REMODELING AND BUILDINGS BEIN OM WHERE ENERGY, OTHER THAN THE MINIMAL CODE ALLOWANCE, IS USED. K:1 j j e ' Request Date 4/17) / 90 Fire No. Ro{ in Insp ion R..Ty d? :Yes ❑No ❑ Ready Now Will Notify ns ify Inspector I Xicensed contractor El owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) 4182 Countryside Drive City Eagan Section No. Township Name or No. Range No. County Dakota Occupant (PRINT) St. Charles Homes Phone No. 891 -2211 Power Supplier Dakota Electric Address Farmington, MN 55024 Et trical Contractor (Company Name) Midland Electric Inc. Contractor's License No. 041610 Mailing Address (Contractor or Owner Making Installation) 14055 Grand Ave So, Suite E, Burnsville, MN 55337 Authoriz e (Contractor /Owner Making Installation) A/� �%�0� Phone Number 892-68 New Add' Type of Building AppliancesWired 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 P001 / 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Abgve.4 _ Amps Signs I nspector's Use Only: THIS INSTALLATION MAY BE ORDERED COMPLETED WIT IN 18 MONTHS. / /'�� ` [ / f , 0 • f / (! DISCONNECTED TOTAL 66 Sp Special Insp Sp ec i a l I seems ection IF NOT Alarm /Communication Other Fee 1, the Electrical Inspector, hereby certify that the above inspection has been made. Rough-in / r 1 D � � y Date e, 1 q Final 1I / OFFICE USE ONLY r / r 4,11 This request void 18 months from MINNESOTA STATE BOARD OF ELECTRICITY Griggs- Midway Bldg. — Room S -173 1821 University Ave., St. Paul, MN 55104 Phone (612) 642 -0800 G 3 r_ REQUEST FOR ELECTRICAL INSPECTION ► See instructions,Jor completing this form on back of yellow copy. "X" Below Work Covered by This Request THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. 1 raffling area = 101. of gross w a i l area. Gross wall area 7-49 Z ft. Window area A . 7.1 4 1 , 75 ft. U windows = / ' 3 C U x A = 71', 11 Rim joist area A [ a \'47 1 ft.2 U rim joist = U x A � �. ?g Door area A '4 2 1 1c4 UxA= ft. U doo area � � mo o ..; 'Z C ry �� �..".. area A` - 4 ft. U = ,41 UxA_ 11,7ivii. Exposed foundation A 1 05, f3U ft. U foundation = ,. / U x A _ 211 IZ*• Framing area A 04 /3(8 /75) ft• U framing area = , Q U x A _ 2.1 i j + Net wall area A 7.9e3ie Ze; ft. U wall r 0 43 U x A= (13B) TOTAL . Gross wall area x 0.11 (A -1 single family & duplex = allowable U x A /Code (13. above) )A. Gross ceiling ,area (L) (W) )B Joist ,area (Af) 1Q% ceiling area = ,C. Net ceiling area (Ac) (15A 15B) U ceiling x A c=� a,"Z to A x 0.23 (A -2 other residential) x .23 (Other buildings) x .28 (Over 3 stories) Z- , 6/ x U Code I Ceiling framing area (Af) equals 10% of ceiling area U 'framing x A.f TOTAL U x A e p z- 3 Signature 1/D `Hy 22,, 11 BTUH Must be larger than : 7 ZZ.18 . 138 above (: or the . same as) ft.2 ft. . 9'1 0 1J,7 /10 Z, 5 3 I 1TE: Use U and A values obtained from pages 1, 3 and 4. RTIFICATION: I hereby certify that I have calculated the "U" factors and "R" values rein and that the ,building here described meets or exceeds the State of Minnesota ergy Conservation Act. ft.2 Ceiling area (15A) x 0.026 (A. -1 single family & duplex - code allowable U x A x 0.033 (R -2 other residential) x 0.06 (other) ' 2 Z(p 6r� BaUH Must be larger than 150 (above) A (15A) , x , U (code)_ ZS ' F (or the same as) c3�a1 G ` ,C6' e/ Cadote Ro -in Inspection Re fired? ❑Yes o 94 7f Ready Now El Will Notify Inspector When Ready? Request Date - J 3-2 v - n !, V 9 0 Fire No. I licensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) 4182 Coun.titg i L . Diz,ive City Eagan Section No. Township Name or No. Range No. County Dako .fa O apant (PRINT) Si.. Cha2Qe home4 Phone No. 891-2211 Power Supplier Dakota c.t z c Address f aAm.ington, MN 55024 Electrical Contractor (Company Name) PLLcJ-Land E-Qec.t/L.i.c Inc. Contractor's License No. 041610 Mailing Address (Contractor or Owner Making Installation) 14055 Gland ,4ve So, Suite C, Buin4v-i-Lf, ON 55337 Authorize• (Contractor /Owner Making .liar• ) i/ . ii Phone Number 892 -6688 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 Transformers Above 200 Amps Above 100 Amps Signs I nspector's THIS COMPLETED Use Only: r ' ' i + 00 INSTALLATION MAY BE ORDER SCONNECTED WITHIN 18 MONTHS. TOTAL 15.5n Irrigation Booms Special Inspection IF NOT Alarm /Communication Other Fee 1, the Electrical Inspector, hereby certify that the above inspection has been made. R -in /t) y/ 1 f Date Final ( + f$ ate 2 . ° OFFICE USE ONLY This request void 18 months from MINNESOTA STATE BOARD OF ELECTRICITY Griggs - Midway Bldg. — Room S -173 1821 University Ave., St. Paul, MN 55104 Phone (612) 642 -0800 G _ I c REQUEST FOR ELECTRICAL INSPECTION ► Srae instructions for completing this form on back of yellow copy. X" Below Work Covered by This Request THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. DEB - 0000001 -07 I i 4> ‘„ .. 1 3 l -i- .4 J::o1 q x-( 441.5- 4 '/t 5 1- 314 -3 0 = 14z,11(403 ... - I l1Z )< l °- ..: roP Cot 5x z 6 11 140,X(ao /),o =' - X40 _, Z41 = -z#7,14,7 i s ay - J . 243 L5& Ad / . Type of Building / Equipment Wired Request Date Fire No. - .u. -in Inspection red? Yes ❑ No El Ready Now ill Notify Inspector When Ready? I licensed contractor D owner hereby request inspection of above electrical work at: Job Address (Street, fff:02G Box or Route No Township Name or N rte Range No. City , County Sect] No. Oc at RINT omeA Phone No. 67 9,U Power S plia' Address Elec cal ontractor ompany Name) � 1 v,� ,,,�11 ., Contractor'$ License'. No. A7r Mailing Address (Contractor or Owner M -king Installa . n) it /lids Authorized Signature (Contrac Owner g Installation) Phone u b New 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) Contractor Remarks: � Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee Circuits /Feeders Fee Swimming Pool 0 to 200 Amps at to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only: ., ( 26 THIS INSTALLATION MA = OR , ' - i pISCONNECTED COMPLETED WITHIN NT y Rough-in , '�� TOTAL 3 4 10 3c �f Irrigation Booms Special Inspection IF NOT Date , , Alarm /Communication Other Fee I, the Electrical Inspector, hereby certify that the above inspection has been made. Final Date OFFICE USE ONLY This request void 18 months from MINNESOTA STATE BOARD OF ELECTRICITY Griggs- Midway Bldg. — Room S -173 1821 University Ave., St. Paul, MN 55104 Phone (612) 642 -0800 924 REQUEST FOR ELECTRICAL INSPECTION ► See instructions for complo•.ag this tom on back of yellow copy. "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 /05` L t i L l itli W i es t V L LU Willi SNAI t ABUV R VALUE R VALUE FRAMING CEILING 0.61 Air Film 0.61 . © Insulation C: .. Joist Ceiling 0.61 Air Film 0.61 'Z • RP Total R . 7 ,tom Z. u R . c.72Z FLAT ROOF OR CATHEDRAL CEILING R Value R VALUE FRAMING CEILING 0.61 Inside air film 0.61 Ceiling Joist (stud) Insulation Air space Roof decking Insulation Built -up roof 0.17 Outside air film 0.17 Total R 1 R = indow infiltration .5 cfm /lineal foot of crack ,sidential door infiltration 0.5 cfm /square foot or door and minimum code requirement :ii- residential door infiltration 11,0 cfjn /lineal foot of crack 12" concrec.,e,btO0 ngf!}nsulation = .47 R 2.1 12" concrete.Diuck insulated cores = .26 R 3.8 12" lightweight block ,32 R 3.1 12" lightweight block 'insu = .12 R 8.3 single glass = 1.13; with storm window .54 double glass .55 triple glass = .41 11 exterior walls and ceilings must have a vapor barrier (0.10 perm max.). ioor barrier must be on the inside (heated side) of wall. +por barriers of the polyethelene thin film have no R` value. 4. Address: 4182 COUNTRYSIDE DRIVE Lot S Blk 1 Sec /Sub COUNTRY trtiow These items were /were not complete at the time of the final inspection. DATE: JANUARY 17, 1991 Yes No INSPECTOR: /O Final grade (6" from siding) V r ,,, Permanent steps - garage Permanent steps - main entry 1/ Permanent driveway 3" Permanent gas Sod /seeded grass Trail /curb damage 1,//— 110 ` Porch d Basement finish Deck V 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 freeze potential exists. White - City copy Yellow - Resident copy Pink.- Contractor copy L o5 BL SUBD. NEW CONST ADD ON REPAIR , - Qe re. t WORK DESCRIPTION: OWNER NAME: SITE ADDRESS: TENANT NAME: SUITE #: INSTALLER: ADDRESS: CITY: ZIP: PHONE #: FOR: WORK DESCRIPTION CITY OF EAGAN CITY OF EAGAN PLUMBING PERMIT (612) 681 -4675 RESIDENTIAL CITY USE ONLY RECEIPT #70 DATE PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL REPAIR /ADD ON 15.00 _ SHOWER 3.00 WATER CLOSET 3.00 BATH TUB 3.00 h , � � �� u - LAVATORY 3.00 OWNER NAME: J �).<51 KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 SITE ADDRESS: 41 C bu� h � s e 1 2 r HOT TUB /SPA 3.00 WATER HEATER 3.00 _ FLOOR DRAIN 3.00 MATTHEW DANIFE S, INC. GAS PIPING OUT. INSTALLER: (MINIMUM - 1) 3.00 15185 CAROUSEL WAY ROUGH OPENINGS 1.50 ADDRESS: OTHER WATER SOFTENER 5.00 CITY: R06EMCTP ZIP: 55068 PRIVATE DISP. 15.00 423 -3730 _ U.G. SPRINKLER 3.00 PHONE #: W. TURNAROUND 15.00 STATE SURCHARGE .50 SIGNATURM OF PERMITTEE TOTAL: $ COMMERCIAL PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL /INDUSTRIAL BUILDINGS. ALSO FOR MULTI- FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: 1% OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 1% STATE SURCHARGE TOTAL: $ (SIGNATURE) Trairoat•r ertt. Ma as o / • 1 Ali U I& t _.. ounty Mull / r, Dakota rfn UTILITY EASEMENT IN CONNECTION WITH EAGAN CITY PROJECT *541 AND CONTRACT 488 -36 WITNESSETH: That the LANDOWNER, in consideration of the sum of One Dollar ($1.00) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does hereby grant and convey unto the CITY, its successors and assigns, a temporary construction easement and a permanent easement for drainage and utility purposes, over, across and under the following described premises, situated within Dakota County, Minnesota, to -wit: The East 20.00 feet of Lot Five (5), Block One (1), Country Hollow, according to the recorded plat thereof. 895391 THIS UTILITY EASEMENT, made this 4rz( day of , 1989, between PROGRESS LAND COMPANY, INC., a Minnesota corporation, herein referred to as "LANDOWNER" and the CITY OF EAGAN, a municipal corporation, organized under the laws of the State of Minnesota, hereinafter referred to as the "CITY ". Together with a temporary construction easement over, under and across the East 50.00 feet of said Lot Five (5). See also Exhibit A attached hereto and incorporated herein. Said temporary construction easement to expire upon completion of construction of storm sewer but no later than December 1, 1990. The grant of the foregoing temporary construction easement and permanent easement for drainage and utility purposes includes the right of the CITY, its contractors, agents and servants to enter upon the premises at all reasonable times to construct, reconstruct, inspect, repair and maintain pipes, conduits, mains or ponds and the further right to remove trees, brush, undergrowth and other obstructions. After completion of such construction, maintenance, repair or removal, the CITY shall restore the premises to the condition in which it was found prior to the commencement of such actions, save only for the necessary removal of trees, brush, undergrowth and other obstructions. And the LANDOWNER, its heirs and assigns, does covenant with the CITY, its successors and assigns, that it is the LANDOWNER of the premises aforesaid and has good right to grant and convey the easement herein to the CITY. IN TESTIMONY WHEREOF, the LANDOWNER has caused this easement to be executed as of the day and year first above written. STATE OF MINNESOTA) ss. COUNTY OF COZ _) On this Zrdday of . S )re , 1989, before me a Notary Public within and for said County, personally appeared L f'Qn a sret.t Is 1M to me pe sorb l ly known, who being by me duly sworn, did say that he is the FrUAokkrut of the Corporation named in the foregoing instrument, and that the seal affixed to said instrument is the corporate seal of said corporation, and that said instrument was signed and sealed on behalf of said corporation by authority of its Board of Directors and said lAir n \T: L cY acknowledged said instrument to be the free act and deed of the corporation. CINDY GRAPJW N y r Y Pl P L7 ---M t EI;OTA DA TA COUNT! MY CC■i.MiS+t»i EYPiRES 32383 APPROVED AS TO FORM: y t 0417 Attorney Office A's Date : 6 J7.1 APPROVED AS TO CONTENT: Public Works Department Date: CQ - 2. s - r. THIS INSTRUMENT WAS DRAFTED BY: McMENOMY & SEVERSON, P.A. 7300 West 147th Street P.O. Box 24329 Apple Valley, MN 55124 (612) 432 -3136 JPE -2- PROGRESS LAND COMPANY, INC., a Minnesota corporation By: _ Its: JelecTsc'`p ,(hd A qi ) tiArZtASCA..0 Notary EQibl is Parcel Files Cover Sheet Unique ID: 4030 4182 Countryside Dr 101827505001 ��''' ''''' CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT To be used for SP DWG/GAR Est. Value $135,000 Receipt # Date HA& 12 Site Address 4182 C 081428 Y 8 I 88 811 Lot 5 Block 1 Sec/Sub. "MIT" 11 Parcel No cc w z 0 ft 0 ZI- c.)‹ cc ww tz x- 00 ccz w Name ST CHARLES HMS Address 7085 UPPER 136TH ST W City APPLE VALLEY Phone 8914211 Name Address Phone Name Address City Phone 1 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. • • ,,A Signature of Permitee ST CHARLES HONZ A Building Permit is issued to; - 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 OFFICE USE ONLY Occupancy 8 "* 3 1444 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 4 1759 762.00 67.30 493.00 100.00 600.*) 623,00 Water Meter 90.00 Acct. Deposit 30.00 50.00 .30 252.00 333.00 Bldg. Permit Surcharge Plan Review SAC, City SAC, MCWCC Water Conn FEES , 19 90 xx xr xx S/W Permit S/W Surcharge Treatment PI Road Unit Park Ded. Copies TOTAL 4,407.00 r Permit No. Permit Holder Date Telephone # WATER SEWER PLUMBING H.V.A.C. ELECTRIC �7 /�r7 � / � L�L/�G?2 �?� 2.1( 3/ • � //44 0.4/2 I/J62, e0 ' � tic< ' $ la to °v /a - 00 0 IQ f! rycr�r 1444 (e &✓1 • Op/4o / 0 , Inspection Insp. Cl Comments Footings I ? / Date 0 ,✓� Foundation /i‘ /4p Old %lye, ev,/ g�� � 05,0 ( Framing i/72 /�C} /, / Roofing / Rough Plbg. '..7 -7r 1 �d Rough Htg. j/ re Y/// 7y� / iff 4 '✓ a4 Z. e:40 4,9,....a... lsul. ; �/ - / 2z /- 7 .. ems/ 1 Fireplace 4 A W S Final Htg. 7/747 Zi.)06i - C Final Plbg. Y-2 A /l C> G 71� /Ric N Corot. Meter r/7� /...--$Ik�� 1�� r- Not Ism_ m j24 Engr. /Plan Lv / Bldg. Final 9/ . /die Deck Fig. [CC Deck Final Wet Pr. Disp. CONTRACT PRICE: Site Address Lot Block — 0 m c m O Name Address City Phone Name Address City Phone 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: ,' PHONE: 454 -8100 Sec /Sub TYPE OF WORK Forced Air / CO, M BTU $ Boiler M BTU $ Unit Heater M BTU $ Air Cond. M BTU $ Vent. CFM $ Gas Piping Outlets # / $ Other $— FEE: S /C TOTAL: MECHANICAL PERMIT CITY OF EAGAN RECEIPT # BLDG. TYPE Res. ✓ Mult. Comtn. Other FEES RES. HVAC 0 -100 M BTU ADDITIONAL 50 M BTU (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIT) 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) SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN - $24.00 - 6.00 PERMIT # WORK DESCRIPTION New Add -on Repair 1.50 EA. FOR: CITY OF EAGAN WORK DESCRIPTION New Add -on Repair CONTRACT PRICE Lot o) CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 PHONE 454-8100 Site Address 9I Yc (? 4 U/ZI fR /Side_ _Bock L;, i Name e Address '7 5 City E A RLUMB(NGe PEIlirli€T eh A w'Ve c Sec/Sub Phone Name sr OhAeleS No Address City Phone a.e . p . ATi lP OF PERMITTEE e s FEES COMMAND. FEE - 1% OF CONTRACT FEE_ -AFT. 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 $.50 S/C PER EACH $1,000 OF PERMIT FEE) BLDG. TYPE Res Mult. Comm Other For Office Use Only PERMIT # //X 6 9 RECEIPT # 9 290 DATE: 4 //9 RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL Water Closet - $3.00 $ ; C7 Bath Tubs - $3.00 Lavatory $3.00 Shower Showwer r O - $3.00 � ,, C? —� Kitchen Sink - $3.00 3. UrinaVBidet - $3.00 Laundry Tray - $3.00 _.Floor Drains - -;,$1 50 _ ter Heater= $1.50 Whirlpool - $3 00 _3_ Gas Piping Outlets - $1.50 (MINIMUM -1 PER PERMIT) Softener - $5.00 Well - $10.00 Private Disp. - $10.00 _3 /Rou Openings - $1.50 U. G. Sprinkler System - $12.00 PERMIT FEE: STATES S /C: GRAND TOTAL: CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681 -4675 SITE ADDRESS: 41“: COONTRYSIOf OR t't1tfINt Uf1t tOW PERMIT SUBTYPE: INSPECTION RECORD Ei , APPLICANT: PERMIT TYPE: Permit Number: Date Issued: TYPE OF WORK: Control No. LJN1'TNt Y HOMES CREATIONS (612) 464• -9160 1:3Ul1t 1Nid p•17s6 10/30/92 ALTERATION INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. Pr. Disp. Well Deck Final Deck Ftg. Bldg. Final Engr. /Plan Const. Meter Final Plbg. Orsat Test Final Htg. Fireplace Isul. Rough Htg. Rough Plbg. Roofing Framing Foundation Footings I Inspection Date m m 2 m CD m m y c -1 H n CO CO 5 5 z //- /:/- f < J2 Permit No. /4 47 Insp. Permit Holder Plbg. Inspector — Notify Plumber /1/35 2. Gr Comments Date Telephone # 4) t, SEWER & WATER PERMIT CITY OF EAGAN 3830 Pilot Knob Rd. Eagan, MN 55122 -1897 DATE trc.h 12 , 199t, RE: 4182 COUNTRYSIDE DR Your Sewer & Water Permit for the above property has been completed. It will be held at the Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO CALL PUBLIC WORKS (454 -5220) FOR YOUR PERMANENT WATER TURN ON. Your Sewer & Water Permit for the above property cannot be completed for the following reasons: Your Sewer & Water Permit for the above property has been completed, but the meter cannot be issued or occupancy allowed until further notice. COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be confirmed by Bill 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 DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. SITE ADDRESS 4182 COUNTRYS IDi DR LOT BLOCK 1 SEC /SUB COUNTRY ROLL0 APPLICANT- 1 Charles :toes ADDRESS Upper 1.36rh St. Wpst CITY, STATE PHONE PLUMBER Ll .Vlurhi z. ADDRESS: 9 Shawnee Pn CITY, STATE art, ZIP PHONE• 15( 3 1 ZIP OWNER: • Charles ADDRESS TU85 Upper • CITY, STATE Apple t lal.� cy, MH ZIP PHONE ? "d DATE 03/16/90 � O / FFICE USE ONLY 7 - METER # ' 7 �O B:J � PERMIT DATE CHIP # _t3 /4C 3 7 /9 PERMIT# - =i_;,. METER SIZE / 4c c- 4 f B.P. RECEIPT# G 67! ISSUE DATE (, - 7 -yo B.P. RECEIPT DATE 03/1, PRV BOOSTER PUMP PERMIT REQUESTED SEWER WATER TAPS COMM /IND RESIDENTIAL NEW EXISTING Lawn Sprinkler Meters are to be Installed Ahead of Domestic Meters on Water Line. Credit WILL NOT be given for Deduct Meters. I AGREE O COMPLY WITH CITY OF EAGAN ORDINANQES SIGNATURE/WHEN METER ISSUED PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454 -5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. WALL SECTION STUD SECTION 2ND WALL • SECTION.. RIM JOIST • f Inside air film Interior wall Insulation Sheathing Siding Outside alr film R TOTAL Inside air film Interior wall 60 4i .40 stud Sheathing Siding Outside air film R TOTAL Inside air film Interior wall Exterior air film R TOTAL Interior air film Insulation - 11 inch soft wood R TOTAL Interior air film Insulation Foundation Exterior air file R TOTAL " Block R VALUE .68 .4 . 19,00 z , o(v .17 Z3,o� .68 R= .1Q2%'(p,5; (Framing) U. i ,Z,O(O .(v? .17 ( 0 +5 R= .68 iii ulation Sheathing Exterior wail covr i R = .17 Sheathing 2,000 Exterior wall covering ,(D7 Exterior air film R= .17 R= .68 5.00 1.70 R= .17 z4-. 4 U VALUE (Wall) U - R • (Wall ) R 2. (Rim Joist) 1 U s 1 (Fdn.) U = G = . i 1 i Date / `• / C) Construction Cost Site Address C / /�,, ��r, {j- 51 d i- l� - Unit /Ste # Description of Work / - r�p� (C — { -ems Multi - Family Bldg _ Y _ N Fireplace(s) i Property Owner �Gk-c‘ Telephone # (Z0 - () y� — �,,2. Contractor ( /�'" 1 ✓GS, ( • v .2G7 7 Address 25` l / - _ ,e _ City State Gf'tit-) Zip 6&2'-/ Telephone # (1t;,1) j j --,j LoOicif 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 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 -5694 Remodel /Repair Requirements 2 copies of plan 1 set of Energy Calculations for heated additions 1 site survey for additions & decks Addition - indicate if on -site septic system Office Use Only Cert of Survey Recd Tree Pres Plan Recd Tree Pres Reqd On -site Septic System Y N _Y N _Y N Y N COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category (/ submission type) Minnesota Rules 7670 Category 1 • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? fee applies. Licensed Plumber Mechanical Contractor Sewer /Water Contractor Telephone #( Telephone #( Telephone # ( Minnesota Rules 7672 • New Energy Code Worksheet Submitted Y N If so, 25% plan review 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. Applicant's Printed Name -- )/4 Applicant's Signature Sub Types OFFICE USE ONLY ❑ 01 Foundation ❑ 07 05 -plex ❑ 13 16 -plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06 -plex ❑ 16 Fireplace ❑ 21 Porch (3 -sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of _ plex ❑ 09 07 -plex ❑ 17 Garage ❑ 22 Porch /Addn. (4 -sea.) ❑ 33 Ext. Alt - SF ❑ 04 02 -plex ❑ 10 08 -plex ❑ 18 Deck ❑ 23 Porch (screen /gazebo) ❑ 36 Multi Misc. ❑ 05 03 -plex ❑ 11 10 -plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04 -plex ❑ 12 12 -plex Plbg or _ N ❑ 25 Miscellaneous Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows /Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to 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 Base Fee Surcharge Plan Review MC /ES SAC City SAC Utility Connection Charge S &W Permit & Surcharge Treatment Plant License Search Copies Other Total Approved By , Building Inspector `CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681 -4675 SITE ADDRESS: DESCRIPTION: REMARKS: C, G ?Pig 7 FEE SUMMARY: Base Fee Surcharge Total Fee APPLICAN /PE MITEE SIGNATURE PERMIT 4182 COUNTRYSIDE DR LOT: 5 BLOCK: 1 COUNTRY HOLLOW Permit Type Work Type $35,00 $35.50 CONTRACTOR: --- Applicant -- WHITNEY HOMES CREATIONS 14549150 4160 LANTERN LN EAGAN MN 55123 (612) 454-9150 PERMIT TYPE: Permit Number: Date Issued: BASEMENT FINISH ALTERATION R -3 1 10(.4 / rSSUED SI NATO E Control No. 1255 BUILDING 001726 10/30/92 OWNER: GANNON MICHAEL 4182 COUNTRYSIDE DR EAGAN MN 55123 (612)687 -9622 SINGLE & MULTI - FAMILY COMMERCIAL 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which re•uest is made or lot chan•e is requested o ce •ermit is issued. Date /0 a 9.,z 7 y / / Valuation of work /'? Cre? `� Site Address: Tenant Name: _ ►4 . .. , . / k, — /,,,,? STREET (commercial only) SUITE R LOT ^_ BLOCK SUBD. � 1 Nr R .p P.I.D. # Description of work: ; •\ \, � ti�titi� . The applicant (Describe) i s : • Owner • Contractor ■ Oth Property Owner ( r Name : G��4..0A. ; t_L�.:, aft,. �a , G: Phohe ( LAST FIRST -) Address i4 ( 1_ ,, ,L , - 'i ,+32. u a.,l �, 7,,2 STREET \ City State � / STE Zip /.,), Contractor Company \ 111111111111L © t/y /- Q/5 Phone Address 2 - 1(n L�� • �� s �w �ti ■F License # EXE01 Exp. City k c,■ State v_- _ Zip , .c7.-Q2 Architect/ Engineer Company Phone Name Registration # Address City State Zip Sewer & water licensed plumber sewer & water permits is two . Processing time for days once area has been approved. I hereby acknowledge correct and agree Eagan Ordinances. Signature of o comply have read this application 'th all ap ica JR State �,\ vi., : � w (_ and state that the information is of Minnesota Statutes and City of \\ • . Applicant: PERMIT # REACTIVATE 141 CITY OF EAGAN 1992 BUILDING PERMIT APPLICATION 681 -4675 BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 02 SF Dwg. ❑ 03 SF Addition ❑ 04 SF Porch ❑ 05 SF Misc. WORK TYPE , Ar 31 New ❑ 32 Addition GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Engineering REQUIRED INSPECTIONS ❑ Site ❑ Wallboard ❑ 06 Duplex ❑ 07 4 -Plex ❑ 08 8 -Plex ❑ 09 12 -Piex ❑ 10 Multi. Addl. ❑ 33 Alterations ❑ 34 Repair ❑ Footing ❑ Final OFFICE USE ONLY Basement sq. ft. 1st F1. sq. ft. 2nd F1. sq. ft. Sq. Ft. total Footprint Sq. ft. On -site well On -site sewage Building Variance I II 1 ❑ 11 Apt. /Lodging 1'16 Basement Finish ❑ 12 Multi. Misc. ❑ 17 Swim Pool ❑ 13 Garage /Accessory ❑ 18 Comm. /Ind. ❑ 14 Fireplace ❑ 19 Comm. /Ind. Misc. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 36 Move ❑ Framing ❑ Draintile MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code $ Kf t -.' #'7 Assessments ❑ 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 3::", 0° Valuation: $ STATE RESIDENTIAL LICENSING PERMIT CONTRACTOR /REMODELER INFORMATION # 1. I have made application for license to the Department of Commerce. Date of Application Residential Building Contractor Remodeler Signature Date 2. I am exempt because I am a one specialty remodeler. Signature Date 3. I am ex pt bec se annual l i ✓ gross receipts are less than $15,000. A t- t 4 /C ° 13 as Si!, ature D. e 4. I am empt because contracts on individual projects in aggregate do not exceed $2,500. Signature Date Questions regarding the licensing law should be directed to the Department of Commerce, 133 East Seventh Street, St. Paul, Minnesota 55101, (612) 296 -6319 Licensing Information, (612) 296 -2594 (Enforcement). I 14 1990 BUILDING PERMIT APPLICATION CITY OF EAGAN 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. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. To Be Used For: Single Family Valuation: Lot Site Address 4182 Countryside Drive 5 Block 1 Parcel /Sub Country Hollow Owner St. Charles Homes Address 7085 U. 136th St. West City /Zip Code Apple Valley, MN 55124 Phone 891 -2211 Contractor Address City /Zip Code Phone Same as Above Arch. /Engr. Planco Drafting & Design Address Washington Ave. S.E. City /Zip Code Eagan, MN 55122 Phone # 452 -0724 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 REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. MAR 0 9 RECO Date: March 7, 1990 35 000— OFFICE USE ONLY Occupancy Zoning Actual Const Allowable # of stories Length Depth S.F. Total Footprint S.F. On site sewage On site well MWCC System 1/ City water PRV li Booster Pump APPROVALS Planner Council Bldg. Off. Variance FEES `R - M -I R -1 n v-/.1 Bldg. Permit /(, .00 V - N Surcharge 6'7, SD Plan Review 1 { ° 15,0( yy " SAC, City I00100 SAC, MWCC ( Water Conn (- ,2- Water Meter 910,00 Acct. Deposit 30,00 S/W Permit 3 Q,CO S/W Surcharge ,50 Treatment Pl. 232,0 Road Unit 355,1 Park Ded. Copies SUBTOTAL Penalty TOTAL BUILDING PERMIT To be used for SF DWG /GAR CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121 PHONE: 454 -8100 Est. Value $135,000 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 'IL i.Y,: i A Building Permit is issue. . HARLES HOME on the express condition that al work shall be done in accordance with all applicable State of Minnesota Statutes and r�City } { of Eagan Ordinances. -U Building Official Niti R.J2,1{A. t' \ Use Classification Occupancy Type 3f dwg/GAR t 3M 1 Zoning District Ow= of Building ST GW LES ITIES Balding Address 'I 1ft2 r_ttINTRYSITE DRIVE Building Official RI Adds= Locality Planner Council Bldg. Off. Variance POST IN A CONSPICUOUS PLACE Receipt # Date MAR 12 Site Address 4182 COUNTRYSIDE DR Lot 5 Block 1 Parcel No cc w z 0 O 0 zi- OU 1- U w Viz_ UO ccz w Sec /Sub COUNTRY HOLLOW Name ST CHARLES HOMES Address 7085 UPPER 136TH ST W City APPLE VALLEY Phone 891 -2211 Name SAME Address City Phone Name Address City Phone Occupancy R -3 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 41' X XX XX Igrrtifiratr of ®rrupattrij Citp of Cagan Brparttnenf of wilding 3nsprrfion This Certificate issued pursuant to the requirements of Section 306 of the 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: Bldg Permit No 17596 Type Const V[N •r rWhi r• T. BI, cwrTRY ►�+1 JAt19AllY 17, 1991 N2 17596 c> G:3 OFFICE USE ONLY M -1 R -1 V — N Bldg. Permit V —N Surcharge 49' Plan Review SAC, City SAC, MCWCC Water Conn Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI Road Unit Park Ded. Copies TOTAL FEES VALiEY[s I 1 9 9 762.00 67.50 495.00 100.00 600.00 625.00 90.00 30.00 30.0() .50 252.00 355.00 3,407.00