3601 Lemieux Cir? LOT SURVEY CHECKLIST FOR RESIDENTIAL
' BUILDING PERMIT APPLICATION
PROPERTY LEGAL: },O?' ZS ??? 13 C I? I???'I WIbJC? M'l ?
DATE OF SURVEY:
LATEST REVISION:
m
?
c
m
s
v
O z ¢ DOCUMENT STANDARDS
?? p . Registered Land Surveyor signature and company
sy p ? . Buiiding Permit Applicant
? ? ? • Legal description
? ? p • Address
)21- p ? . North arrow and scale
,pJ p ? . House type (rambier, walkout, split w/o, split entry, lookout, etc.)
? ? . Directional drainage arrows with slopelgradient %
?? p . Proposed/existing sewer and water services & invert elevation
? ?
? p
? •
. Street name
Driveway (grade & width - in RNV and back of curb, 22' max.)
? ? ? . Lot Square Footage
? ? ? • Lot Coverage
ELEVATIONS
Exisfin
p ? . • Property corners
,Q ?? . Top of curb at the driveway and property Iine extensions
,X p ? • Elevations of any existing adjacent homes
,g' ?? . Adequate footing depth of structures due to adjacent utility trenches
0' ? ? • Waterways (pond, stream, etc.)
Proposed
? ? ? • Garage floor
? p . Basement floor
? ? • Lowest exposed elevation (walkout/window)
? ? ? . Property corners
'00 ? . Front and rear of home at the foundation
PONDING AREA (if applicable)
p ? p • Easement line
? ? p . NWL
p ,H' ? • HWL
? ,e ? • Pond # designation
? g p . Emergency Overfiow Elevation
? Z ? • Pond/Wetiand buffer delineation
y ( ?N } • Shoreland Zoning Overlay District
Y ?? • Conservation Easements
DIMENSIONS
,2r ? ? • Lot lineslBearings & dimensions
,!r ? ? . Right-of-way and street width (to back of curb)
any proposed decks, overhangs greater than 2', porches, etc.
ions includin
di
h
? ? p g
mens
ome
. Proposed
(i.e. all structures requiring permanent footings)
? ? ? • Show all easements of record and any City utilities within those easemenfs
? ? ? • Setbacks of proposed structure and s" ard setback of adjacent existing structures
?f ? ? . Retaining wall requirements:
Reviewed By: Date
G:/FORMSIBu ilding Permit Application Rev. 11-26-04
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
? .ck
New Construction Reauirements RemodeURenair Reauirements
3 reuisteredsitesurvnw ?w?w;M.??_A -? _. -° •• - - 2 copies of plan
1 set of Energy Calculations for heated addi6ons
3l06--PLAN REVIEW OVERCHARGE 1 sitesurveyforadditions&decks
REFUNDED - $420.39 Addition - irMicaferlon-sitesepticsysfem
? . _ - ---_--' i.-...,..?y.,..mrdorlca7unR5).
1(5aL+: cTo.so
Y'(1P ??5a5: ?0 5??
------------- Vr__i
Oifice Use Onlv
Ced of Survey Recd
'Y -_ N'-
Tree Pres Plan Recd _Y "fJ
Tree Fres Required Y `^<
On-site Septic System _ Y_ N
\nr'. 11' In ?Gt")?' ? Cl?7oZ5 ca"
Date ov
Construction Cost 20? , 42WC7. -"
Site Address 36p0x L$F?I? ?VX GI' R . Unit/Ste #
?
Lau
rl rrw??s b-?'rs .
Description of Work A?? ??jT. ft1,J1J E4C*4V:!$?
Multi-Family Bldg 16/Y _ N Fireplace(s) _ 01 _ 2
Property Owner R"u c4k.'S, Telephone #(4192 )""1 .30p 0
Contractor '(:4!211 GLAUG CcIJS'f
Address 1500 LA( 77P?Tlt 51r? City $1711.l^
State N{o Zip Telephone #(152 )Q41 • 300 D
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category a Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
In the last 12 months, as 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 12LA1JD1M t_jr.9j}. Telephone #(15'L)445 ? 4le41 Z
Mechanical Contractor ff.I.A.1jGT.& P194JA, Telephone #(q52) 445 - 4(o12
Sewer/WaterContractor _LAFsiC.FL Lc4ET!lJ Telephone #(?5Z)412• 231fo
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_arr, application for a permit, and work is not to start without a
permit; that the work will be in accordance withtithe approved p(an in the case of work which requires a review and
approval of plans.
„
Applicant's Printed Name pplicant's ignature
_??••-
d 4V tt0l"
F-
OFFICE USE ONLY
Sub Types
? 01 Foundation
? 02 SF Dwelling
A 03 01 of,& piex
? 04 02-plex
? 05 03-plex
? 06 04-plex
Work Types
j( 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
? 13 16-plex
? 16 Fireplace
? 17 Garage
? 18 Deck
? 19 LowerLevel
Plbg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
0 22 Porch/Addn. (4-sea.)
? 23 Porch (screen/gazebo)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation
Plan Review _ 100% or Z2
Census Code
SAC Units B/
# of Units O/
# of Bldgs
Type of Const 13_
5%
Occupancy /3- 3 MCES System ?r
Zoning City Water ?
5tories Booster Pump -
Sq. Ft. ?Q 1?7 PRV
Length 7 1/ Fire Sprinklered -?"
Width 749
? Footings (new bldg)
_ Faotings (deck)
Footings (addition)
? Foundation
Drain Tile
Roof. -t Ice & Water ? Final
Frammg
? Fireplace k4 R.I. f Air Test # Final
? Insulation
Approved By: _
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 07 05-plex
? 08 06-plex
? 09 07-plex
? 10 08-plex
? 11 10-plex
? 12 12-plex
REQUIRED INSPECTIONS
FinaUC.O.
? Final/No C.O.
_ Plumbing
_ HVAC
Other
_ Pool Ftgs Air/Gas Tests Final
_ Siding _ Stucco 4n Stone _ Brick
_ Windows
_ Retaining Wall
Building Inspector
6-(?) 2!??