810 Ivy Lane?? ?g2- 2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWcfion Reauirements RemodellReoairReauiremenls
3 registered site surveys showing sq, fl, of lot, sq. N. of house; and all roofed areas 2 copies of plan
(20% maximum lot coverage allowetl) 1 setof Energy Calculations for heated additlons
2 oopies of plan showing beam 8 window sizes; poured found design, etc. 1 site survey for addilions 8 decks
1 sel of Energy Calculahons Add'rtion - mdicafe 'rf ortsife septic system
3 copies of Tree Preservation Plan d lot platted afler 711193
Rim Joist Detail Op6ons selecGOn sheet (bldgs wiN 3 or less umts
OtficeUse`onl
Ced6CSurvgyRea(.? --- Y =11
7're8 Pes PI?fiReW ' t1
TraePrC,SReuired, ?.,Yy
bnsif:'SejiB'cSysJem_ N
Date
Y
SiteAddress Construction Cost
lv -j ?l UniUSte #
Description of Work l e I/'nc ;r? cr J:[ ? 1 C L???V
Multi-Family Bldg ? Y _ N Fireplace(s) y/ 0 _ 1 _ 2
Property Owner W60-91 4in ,j C?vvI-N /=J ??^^C S Telephone # ( )
Contractor f-el U"^FJkS ? 4,-A?6c5-
Address d ni
State L ?? ?, ( ? ? {1 • City
Zip Telephone # 32g? ?
COMPLETE THIS AREA ONLY IF
Energy Code Category Minnesota Rules 7670 Cateeorv 1 _
. Residential Ventila6on Category 1 Worksheet
(J submission type) Submitted
. Energy Envelope CalculaGOns Submitted
Have you previously constructed a building in Eagan with a similar plan2 _ Y
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
N If so, 25% plan review
Telephone #( Q) v H " ?
I hereby apply for a Residential Building Permit and acknowledge that the informat on is complete and acc rate;
that the wark will be in conformance with the ordinances and codes of the City o 43 1VIN
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.
A NEW BUILDING
Mmnesota Rules 7672
• New Energy Code Worksheel
Submitted
Ii1ct tr iU L?v11 4tiS4-i1 /;I
ApplicanYs Printed Name Applicant's Signature
, r --
CITY OF EAGAN
L-&-- B ??? /? ? MECHAATICAL PERMIT RECEIPT #
SUBA ?/? d'?'f?d/1 ? (612) 681-4675 DATE 3(_t(r cVx-?,
- ItESIDENI7AL - - - Ap
-
PLEASE COMPLEI'E UPPER PORTION ONLY FOR SINGLE FAMIIY DR'ELLING3. AISO, COMPI.ETE FOR
TOR'NHOMFS/CONDOS R'HEN SEPARATE PERMTIS ARE REQUIRED FOR EACH DWELI.ING UNIT.
OWNER: FEFS
SITE ADDRESS: ADD ON/REMODEL (FJ?7STING
CONSTRUCI'ION ONLI) S 13.00
INSTALLER HVAC: 0.100 M BTU 24.00
PHONE #: ADDITIONAL SO M BTU 6.00
ADDRESS: ? l l\ t 1.' ?? S ? GAS OU1'LEfS - MWIMUM 1@$3 FA.
crrr: "? ,Q_ zrn:?.?3?8 suxcanxcE: $ .so
SIGNA TOTAL: S l
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAIJIrTDUSfRL1L BUII.DINGS. ALSO COMPLEfE FOR
APARTMENT BUILDINGS OR OTHER MULTI•FAMILY BUILDINGS WHEN SEPARATE PERMIIS ARE NOT REQUIRED FOR
EACA DVVELLING UNIT.
WORK DESCRIPTION:
CONTRACI' PRICE: I FEFS
1% OF CONTRAGT FEE.
STATE SURCfiARGE IS $.50'FOR EACH
$1,000 OF PIIiMIT FEE. $
PROCESSED PIPING - $25.00 Fs
MIlViMUM FEE - S25.oo
PLEASE COMPLETE FOR SINGLE FAMII.Y DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE .REQUIRED FOR EACH UNIT.
NO. FIXfiURE5
? SHvWEi'c
WATER CLQSET
BATH TUB
_? LAVATORY
_L KITCHEN SINK
LAUNDRY TRAY
HOT TUB/SPA
WATER HEATER
_11 FLOOR DRAIN
_L GA5 PIPING OLJTLET • minimum - ?
ROUGH OPENINGS
WATER SOFTENER
PRIVATE DISP. • Dak.cxy. li?
U.G. SPRINKLER • home under mnsL
ALTERATIONS • to ?tmg
WATER TURN AROUND
STATESURCHARGE
STTF AT)DR;
OWNER NA
INSTALLER
ADDRESS:
CITY:_L
PHONE #: (
TOTAL:
/ 21 7?S-
EACH TOTAL
's.00
3.00 C)
3.00
3.00
3.00 300
3.00 G;,
3.00
3.00
3.00 ac?lcs
0
3.00 o v
1.50
5.00 r'
15.00
3.00
15.00
15.00
.50
L?)
STATE: % ? - ZIP CODE: UG
) Y2--s -/l `fv
PLUMBING PERMIT (RESIDENI7AL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
{ ?. . -
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OwNErt: WOODLAND COUNTRYHOMES, INC.
SITEADDRESS: Lb7 (.10 BbbGK3 TME WOOPLANIx NOQrNPHONE:
CONTRACTOR: SIEKMANN CONSTRUCTION, INC. - LIC. k0001436 DATE:
DETERMINE WORKING SQUARE FOOTAGE OF EACH:
1. TOTAL EXPOSED WALL AREA .............. 976.00 sq ft x"U" 0.110 = 107.36
2. TOTAL ROOFlCEILING AREA :................ 1,435.00 sq ft x"U" 0.026 = 37.31 ?
3. TOTAL EXPOSED WALL AREA CALCULATIONS:
Total exposed wall area above floor........ 976.00 sq ft
a) Total window area:
Double glazed ........... ............. 111.00 sq ft x"U" 0.430 47.73
gl a zed ........... .............
b) Total door area :....................................
c) Total sliding door area:
sq ft x "U"
38.00 sq ft x"U" 0.070 = 2.66
Double glazed ........... ............. 40.00 sq ft x"U" 0.430 = 17.?0
gl azed ........... .............
dl Total fireplace wall area :.......................
sq ft x "U"
- 0.00
- 0.00
sq ft x"U" 0.370 = 0.00
e) Total wall framing area
(AVERAGE 10°k) .......... 97.60 sq ft x"U" 0.095 = 9.27
f) Total net wall area
above floor, (insulated) ........................... 689.40 sq ft x"U" 0.043 =
29.64
g) Total rim joist area :............................... NA sq ft x"U" 0.034 = 0.00
Total foundation area (exposed) ..............NA sq ft
h) Total foundation window area .. ............. NA
sq ft x"U" 0.430 = 0.00
i) Total net foundation area above grade..... 0.00 sq ft x"U" 0.045 = 0.00
3. Total a) thru i) 106.51
If item #3 is the same as, or less than item #1 you have met the intent of 2 MCAR 1.16008 A and 0.
Page -1-
4. TOTAL EXPOSED ROOF/CEILING CALCULATIONS:
4.
Total exposed roof/ceiling area . ............. 7,435.00 sq ft
j) Total skylight area ................................ 0.00 sq ft x"U" = 0.00
Total rooflceiling framing area
k) (Average 10°k ............. 143.50 sq ft x"U" 0.039 = 5.60
d) Total net insulated
roof/ceiling area .................................... 1,291.50
sq ft x"U" 0.024 = 31.00
Total a) thru il 36.59
If item #4 is the same as, or less than item k2 you have met the intent of 2 MCAR 1.16008 A and O.
ALTERNATE BUILDING ENVELOPE DESIGN
To utilize the total evelope system method, the values established 6y the sum of Items #3 and Item #4
shall not he greater than the sum of Items Jl1 and tt2.
1. 107.36 + 2 37.31 = 144.67
3. 106.51 + 4 36.59 = 143.1
CERTIFICATI ON
I hereby certify that I have calculated the "U" factors and "R" values herein and that the building here
in described meets or exceeds the state of Minnesota Energy Conservation Act.
(Signawre)
(Date)
Page -2-
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
?.Lr?) r.vv I A11E Siei<mESNra COrasr
TIiF I„1000LAND.'S iVORTH (612) 914 7-2 921
PERMIT SUBTYPE:
OIIPI EX
TYPE OF WORK:
NEW
B Ul"LfI7IV6
Gi41f320
1i/3a/9z
INSPECTION
F6q f.fP'C; ., •
FftAM.CNG .,
J.NSUf.R.TION F1N 611_
FfF.FPI A1,F`
ftGPIAftKti: ft?CE1Pi 4f C 021817 ? 7? W CC1h!TiiRC'fOh( - GCIVZ-i?YftlV PLiiG
?
?
' CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
?u1I,otnir
47fA18?0
11J30/J2
SITE ADDRESS:
f, .1.IV.: 141-7 5 t390-050-0 3
"r.,1V1 IVY I APIc
LOTe 6 P, LOCKe :3
THF. I40 0 0 LAN0 S D!Oii1M
DESCRIPTION:
E3uild"i'ri cj I'ei°mit. '1yp?
Bui J.dirig Wni'Ic l")rfir
UBC OcGnpaney
ConEtruction 1"yre
ZQtll(lg
8u;lding LEngth Building Wi.dth
DUf>lEX
Nf`.W
F?-3 h1--1
i/ - PI
U ()
68
94
-?
REMARKS:
Rl_cL7FT !F c 021817 s aJ w cn1v'rRHCTo 1? - (I EN l-PvRN P L 8 G
FEE SUMMARY:
v,4i.UATlnN
r,r,?s, Fc:c
?' ? d f I i, _: i ?; W
tiLll-cilPiP'r?P,
it) C
5AC ?
5Ai' Unit9
Suij toial
f?pJ(ji.:lN
i 0 G] . 0 0
100
1
713. 00
t.as,0m0
I6 13LE LLANF OUS °'6.L8.5(4
I'oLal Fce $ 'i,:3"L8.S47
CONTRACTOR: -A pp i . i ca nr - s r. i_ iXOWNER:
51"FI<PilaPllV CbNS'f 14472424 0001136 WUOULANp CDUNTRYHOhfES INC
6i54.^. RU3?'7(, ;<i) .,_ &6 'IS RU;T'IC t<U SE
PRItIP i_AItf P4P! 55377 PRJOR l_NKE P41Y 55372
?6 i;-; n<,,7 __2 /12 1 (c,.;T)aar-<nun
Z hereby acknowlzdga that L have read this application and state that the
infiorma t:ion is cnr•rer.t and sgree to coiuply witf, ali applir.rbln 5t_?te o'i PiriStatutes and CiLy oi' Eagan Ordinanr:es.
? -
?n+?n fi ?; rl I T1L,?
APPLICANT/PERMITEE SIGNATURE ? ISSUED BV. SIGNA UR
PERMI7,#
REaCTIYhTt it?o
CITY OF EAGAN
1992 BUILDING PERMIT
681-4675
APPLICATION
43,3?'? .no
SINGLE & MULTI-fAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAI 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 re uested once ermit is issued.
Date pTev. LG- /q.g Valuation of work $88.180.40
Site Address: 810 Ivy Lane
STREET SUItE X
Tenant Name: (commercial only)
IAT,6_ 8LOCK 3 LUBD.The Woodlands Nort P.I.D. * 10 75890 060 03
Oescri tion of work:
The applicant is: O Owner U Contractor ? Other coes«iee>
Name Woodland CountryHomes, Inc. Phone447-2424
Property LAST F,RST
OW(1@f
qddress 6648 Rustic Road S. E.
STREET STE N
City prinr T.ake , State MN Zjp 55372
Company Siek mann Construction, Inc. Phone447-2424
Contractor Address 6648 R„-r;c Road s e License # 0001436 ExP,3/31/93
City Prior Lake, State MN ZjP 55372
Company Phone
Architect/
Engtneer Name Registration 8
Address
City State Zip
Seaer 6 Nater licensed plumber Genz-R an Plumbin . Processing time for
sewer 6 water permits is two days once area as been approved.
I hereby acknoaledge that I have read this application and state that the information is
correct and agree to comply w' h all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
O 01 Foundation
? 03 SF Addition
? 04 SF Porch
? 05 SF Misc.
WORK TYPE
-4 31 New
? 32 Addition
;0;06,6 Du
4-Plex
0 08 8-Plex
? 09 12-Plex
? 10 Multi. Add'1
? 33 Alterations
? 34 Repair
? 11 Apt./Lodging
? 12 Multi. Misc.
? 13 Garage/Accessory
? 14 Fireplace
? 15 Deck
13 35 Tenant Finish
? 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy i
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineertng
Y-P!
;•3 ? -?
_PD
6C3
:q (4
REGIUIRED INSPECTIONS
? Site
? Wallboard
Basement sq. ft.
lst fl. sq. ft.
2nd Fl. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Building 01I-/Z9z
Yariance
I
? Footing
? Final
? Framing
11 Draintile
? Insulation
? Fireplace
Permit fee v,nmt;q,:
Surcharge
Plan Review
License
MWCC SAC
City SAC
Mater Conn.
Water Meter ,
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
S-0r Ovo -
f .
? ?
t 16?wBasement Finish
? 17 Swim Paol
0 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public facility
? 21 Miscellaneous
? 37 Demolish
MWCC System ` c 5
City Mater -Ye3,
PRY Required
Booster Pump
Fire Sprinkler
Census Code _/oz
SAC Code ?L
C:eMS
us
•
.t
WWY?{dS G M If I
Assessments
SAC % too
SAC Units I
, LOT BIIRVEY CSEC1[LIST FOA REBIDENTIAL
? BOILDING PBRMIT IiPPLICIITS
PROPERTY LECiALS
Date o! survop: z?-
CIIMENT ¦T71N1
RD
/ 9
A
Er
A ? : Registered Land Surveyor signature and company
0
? Building Permit Applicant
Q
?- /0 • Leqal description
0 [?' ?
? • Address
?? 0 • North arrow and bar scale
fY 0 0 • House type (rambler, walkout, eplit w/o, split entry,
6'0 0 lookout, etc.)
• Directional drainage arrows with slope/qradient !.
0?0 • Proposed/existinq sewer and vater services
D' ? • Street name
0 0 • Driveway
L"LEVATIONS
Existina
D 0
'/? • Sewer service
-
-?/C?" 0 • Lot corners
H' 0? • Top of curb at the driveway
0? 0 • Elevations of any existing adjacent homes
ProDOSed
? 0 • Garage floor
? First floor
? : Lowest exposed elevation (walkout/window)
?
F . Property corners
? • Front and rear of home at the foundation
PONDING AREAB (if applicable)
0 B/Q • Ea
ement line
0"
/
• ?
L
0 6
? • HwL
0 C? • Pond # desiqnation
D B 0 • Emergency Overflow Elevation
rurarawv?aia?a
l9" 0 0 • Lot lines
??0 • Right-of-way and street width (to back of curb)
[q" 0 0 • Proposed home dimensions iacluding any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
? structures requiring permanent footings)
L9" ?? • Show all easements of record and any City utilities within
those easements
0? • Setbacks of proposed structure and setback of adjacent
existing homes
D 0 • Retaining ??ements, if any
- Reviewed: 7
OCtober 1992
Address 810 IW I,ANE Zip 5?14=
L.ot ' '6 Blk 3 Sub UE WOOMANDs xoM
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPEGTION.
Date: pb/pg/gg Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage) V"
Permanent steps (main entry) ?
Permanent driveway
Permanent gas LI/
Sod/Seeded grass ?
Trail/curb damage ?'
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and ihe shut-off of water supply to
the ouiside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
d f17:?,qp
REQUEST FOR ELECTHICAL INSPECTION
? See instmctions lor compieting tnis lorm on beck oi yellow copy
'X' Be/ow Work Covered by This Request
??gi•',,
ew Acf? e. V TypeofBwlding AppliancesWVed EquipmenlWired
Home Range Temporary Service
Dupiex Water Heater Electric Heahng
Apt. Building Dryer Other-(Specliy)
Comm./Indushial Furnace
Farm Air Conddwner
Olher(specAy) Conhacmr's Remerks'
Compute Inspection Fee Below:
#
! Other Fee # ServroeEntranceSize Fee # Circuits/Feeders Fee
-
l --
Sw
imming Pool 0 ro 200 Amps 0 to 100 Amps
Trensformers Above 200 _ Amps Above 100 _ Amps
Sgns InspetmrsUSaOnry OTAL
Irngatwn Booms ?( ? ?-
Special Inspecti0n ?v
Alarm/Communication THIS INSTALLATION MAY BE ORDE ONNECTED IF NOT
Other Fee I COMPLETED WITHIN 18 MO S.
I, the Electrical Inspector, heteby Rough-in r oefe .??
certify that the above inspection has
been made. F,nei oete y3
OFFICE USE ONLY
Thrs request voitl 18 monihs lrom
g d
flequest 0?a ' Fne No Rough- Inapacnon
ulremd9
Re
? Reatly Now ill
Notdy Inspedor
q
- s ? No W hen Reatly+
I-Xricensed contractor :] owner hereby request inspection of above electrical work at.
Job AOtlress (SVeet. Box or Rome No I
'
C,-? Pry i+
G C
Sedion No Townsnip Name or NIT - Range No Counry
4
Occu antI PRINT) hone No '
Power awpplier
j qdtlrpy
'
Eiecfnca ractor (COmpany Name) Contrecror icense No.
Mailmg AOtlress (C Vactor or Owner Making Inslallabon)
/
Authonz Si emre ICOmraclonOwner Makmg Inslallation? _ Phone Number
3
5z
4
~
W
,
MINNESOTA STATE BOARD OF ELECTPICITY? I THIS INSPECTION REQUEST WILL NOT
Grigge-Mlaway Bldg - Room 5-173 BE ACCEPTED 8Y THE $TATE BOARO
1821 Univ¢rstly Ave., St PeW. MN 5510G IINLESS PROPEF INSPECTION PEE IS
Phone (612) 865-0800 ENCLOSED
CITY OF .EAGAN
. ,
454-8100
DEPT. OF BUILDING INSPECTIONS •
Correction Notice
Located at ?1 O/ v y 1????
I have this day inspected this structure and
these premises and have found the following
violations of city codes governing same:
r'?.. /_1 ZT T,f
.?? r?,.LF cT '? ? ? l- 1_
When corrections have been made, please
call 404wfM0 for jnspection.
-, _
. Y - ? ..
Date
` -`?
Inspector City oi Eagan
DO NOT REMOVE THIS TAG
,_ ..
? e" OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) ss i -as7s
SITE ADDRESS:
,. , .,N E7
. PERMIT SUBTYPE:
?
O
:CORD
PERMIT TYPE:
Permit Number:
Date Issued:
Elt IICd : APPLICANT: "
pl?.taia : I , i
TYPE OF WORK:
Fti1 I t li 1 N1;
AtlI8:N
tv r ?a . ?
•? .
i(i?l I T f•1!? ; Vr"iMl I'11, .
I r1',I?? r', ? I??Pa ; 1 I+tt+
: ' i ; ;?I r,t r I
RfP4ARK'; hFf.r Tf'1 m
C 021817
& W CtIN'lftAC ltiR . OENl-fiVAN 1'1 H[j
?
?
PermN No. Permft Fio kler Dabe Telephons t
S!W
PLUMBING ,1G?3 //
HVAC ? rv 3 ?• D
ELECTRIC 8 /? ^ GriJ
ELECTRIC y
Inspectfon Dete Insp. Co mments
F°ontgs I I io l wt
FDUrdabon
Framing
Roofing
Rough Pibg.
Rough Htg' ? ?/
? ?1'• C
is,i. ?s'r? ? i'?"?S- ? a ?f s ra
Fireplace A3 /f3,-
Fnai Htg.
Orsat Test Xdii
Final Plbg. Pibg. InspeCtor - Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final /(
?v P
r
Deck Ftg.
Deck Final
Well
Pr. Disp.
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA176247
Date Issued:05/09/2022
Permit Category:ePermit
Site Address: 810 Ivy Lane
Lot:6 Block: 03 Addition: The Woodlands North
PID:10-75890-03-060
Use:
Description:
Sub Type:Water Heater
Work Type:Replace
Description:Standard Water Heater
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 -
Sandra K Borsheim
810 Ivy Ln
Eagan MN 55123
Champion Plumbing Llc
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature