2205 Liberty Lane
. F4EA7"LUSS-HEIATGAIN ANALYS3S REPORT /
! Dc: snt.es coMaanv, INC. ??S' ,?/?E,Lr`J LN
? 27DO F,AINNEHAF{A AVE
MIMNFAPC!i.IS, MN ?
(612)71"''00 FAX (612J728•8779
? GUSiOME!2 NAME. 00 lf($.- &4thS.ic?[.NEA'ifNG hn;ahng Cooling
PtAN N/1M e:Hl _ DiEDR!CH BUILpERS 4 PLEX ? Outside db -20 95
J06 RRJR=SS Insitle Ub 70 75
!'Ai CUi.AIr0 BY Design 7'D 90 20
Datly Ranpe - M
OATL- _! _?i 17eu3moB?r-12-20?2 ____ Inside Humd - 50
33 1YaE'C1? r CON57 T?PE= HTM AREA OR ? BTUH
XPOSURI" CR R VAI.UE HTG CLG LENG i Ff? aNTG CLG
a--•:.-.
Cc ?_'_' ?_-r..: ---• mcss.
GK0. ,.
i(C)hbove Grade R79? ? ?3oq@ ?
tXf?OSrD (q)Retow Grade No !ns
? WFtLI.S I(E)6e{pya GtSde R-11 ? 7070 ?
? ??,..?..._.- ?_....,.__...
V`i!M[JC7VYS 3AUbieCirWqnd` 49.8 ? 222'-- ~ti4M11?,
d GLHSS ?2A 1 Pane storm YJocd^+ 428
? 4 ?
?^COf2S(_Hl C;? , 5D Trple?ow?e Wootl _? 281 } --` , p.
WtNpOLyS - NOttTH 19.0 ?65 1235
S GLA5:i FASTI WESi ' 56.0 57 ? 3192
DG(?R8 (Ci 6) 'SOUTH 32.0 100 ? 3200
t
DOORV._,._._._..._. MEi? _....._...___._..?. - 28.8 71 42V 1210 319
-
NF'? ~??? (C)Above Grade R19 "? 5.4 ? 1.4 r1084 ^ 5054 1518
EXAOSCD (D)DelowGrade Tvo Inx ! 5,7
Whi.lS I(E)BelowGr2deR-1t 46 ? 00 1076 4950 0
n
?1 ) 2.1 ? 1 A 1262 .. . 2892 .? -??-- 287_ --
°-- -•- ?--...._....._ (U)kt6 48_ 2,3 0 G d
.?.».
{M) BSPhT FL.OOR".?. ?-2.2 1133 -?.2A93 ? 0??
cIOORS (N)Af3qVEGARAGE 4.3 ? 0.7 143 647 ! 104
_(O) Sl.A6 ON GFL4pE 369 0 0 1 0
?...._....._..-.
_.,_.... aJ..._._..-----...._._._.--- -
INFIL7Rp ..-. .+*:pN ? a-
$370 13.b
_-.-..,_--?.-.?:: ?:--- =;_•?--? . aR.,,?. ?_?: -_
St!H- 1 p i A!. 71!-ATL055 & IAEAT GAIN 37219 ^ 12245
'-°--------- -----`° ................. ------------------------ ---------------------- ---••-------- _.._.. --------..---°
'JEP:71I,q710NJCOMBJST;ouniR 3286 730
--- ----.._._.._.._...?_..,_......-•----- --._?.._..... ._ ._.?----------------- ?---------- ----------_._.__._... .._._----?-- -
rOYaL HE.4rtGSS-s7uw 40506
._.-s.a<...az?...,?„__-?- - ° - --?•_.
PEOFL£ a' 3pG gTUH 6 1000
Af'Pi_. UGF 7, El"C @ 7200 BTUH 1 7200
..?...._._.......__............. -----?-•-- -•-- -.-_ __._....,.,-•---------- -----°---`------------------- ............ _........ -'-------- -_._
NE"I SFNS19LE ff'TUN GAlN 15075
IYUCi B'I'UI !:PRESH AIR GAIN p
..._..._---------------------- •------- ......___.,?-- ------------- ------------------ ._-'--?----------------------------- __. _-_._-----
---?---
TO7AL SENoIBLE GAiN ?5975
1 OTFL GGQLiPlG GAiN-87UH (SEAE3I81.E+ LATENT) -----?----?--J' ? ?986s
. HEATLQSS-HEATG141N ANAL.YSIS FtEPORT
W
hl
S
e
rC
cv?iCA TING
L'tCDKICH SIJILU ER$ 4 ALEX
WAL!_S VJIND4W5 DUaRS CEILING FLOOR INFIlJVENT 70TAL5
5AScMCNf 5508 2232 D 0 2493 3128 13359
k'ain Flonr 5237 0779 1210 2692 641 6527 27148
ROOM ;A 0 0 0 D 0 0 0
ROOM 4 0 p p p C G 0
ROOM 6 Q 0 0 0 D D Q
kOOM, 8 0 G 0 0 0 D 0
ROOhl 7 0 0 0 0 0 0 0
ROOM 9 0 0 0 0 0 0 p
ROOM 9 0 0 0 0 0 D C
ROOM tp C G 0 0 0 p Q
RLDoM 11 o o a o 0 o a
ROOM 12 0 0 0 b 0 0 0
ROOM 13 0 0 U 0 D 0 p
ROOM/{ 14 0 0 0 D v 0 0
7OTALS 10803 11011 1210 2892 3133 15856 40505
14FA7IsA1N WALLS WIN()(77W5 DOORS CElIING FLQpR INPlLNENT TO7ALS
f3ASttJE1d" 144 1410 0 0 p 607 2161
l.M3„•tFf00r 1373 6217 318 1282 104 1548 10814
RUO(H 3 0 0 0 0 0 0 0
ROOM d 0 0 0 0 0 0 p
ROOM ^ G G D 0 0 0 C
fii70M ° G 1) 0 0 D 0 0
ROOM 7 0 0 0 0 0 0 0
p'JOtiI 8 4 0 0 0 G f! 0
?!7CW 9 0 0 0 0 0 0 0
ROOM 10 G 0 0 0 0 0 0
HOON! 11 0 0 p p o G 0
ROOM 12 0 0 p 0 1) 0 C
RQOM 13 0 0 0 0 0 D D
ROOM 14 e 0 0 4 6 0 0
'107P•I.S 1548 7827 319 1282 104 2125 75975
SMOLE +lAi EN7 =TOTA: (SENSIBLE & LATEN7) SEN51E3LE
P.D.S[MEW 21$1 540 2702
Main F;an 10914 2f03 73517
P,VOM .3 0 0 0
fi001A f G 0 9
ROOM 5 0 U 9
ROOM 6 0 o p
,°.UOY / G 0 0 M
ROOiA 8 0 0 q
k::OM 3 0 Q 0
ROOM +0 0 0 0
ROOM 11 0 0 0
Rounn ;s o n o
ROOM 13 0 U 0
P,UOM ia 0 0 0
70TAE.5 15975 3994 19909
HEATLOBS-fiIEATGAiN AtdALYSlS REPQRT
_.:.>_- ???-x ?,:.=.???w?v _.?: ? •_-?,. ?--.- --- ?., _?.?.?.?--_?:? . .._
1170 h )Pr"S -SbG49d.i IEH7l,'JG
S;lEDRtCH 301.DERS 4 FLEJ[
RU0A4 NA14E EXP WALI. BG WAI_L SG WL INS CEIL Ii7
Eli45EM[W 785 00 134,5 8.0
i.9ain Flw, 1t)0.D 00 0_0 80
ROOM ' 00 00 00 00
HOOtv14 0.0 0.0 0.0 p.0
ROOM 5 b.O 0.0 0.0 00
ROOM 6 UA 0,0 0.0 0.0
FtOUM r (1,0 0.0 0.0 0,0
ROOM 3 0,0 0.0 0.0 0.0
ROOM B 00 0.0 0.0 0,0
ROOM +') 0.0 0.0 0,0 00
ROOfvI 11 00 0.0 0.0 00
RCOM 12 fto 0.0 0.0 0.0
;=''A 1' 0.0 0.0 0.0 0.0
ROOM 14 0,0 0.0 0.0 0.0
ROOM hAM: N VJINp E WIND W WIND S WiiVp DuOk5
i;4GFMEM 300 150 0.0 0.0 0
A,f,ain Ffnot 350 00 42.0 300,0 42
fiOdN '', 0_0 0.0 0.0 0 0 0
ROOtut 4 11,0 00 0.0 0.9 0
ROOM .1; 0.0 00 0.0 0.0 Q
ROOM 8 C 0 00 0.0 0,0
O
ROOM ' 00 o.o 00 0.0 0
hOOM 5 O,J 0,0 00 00 0
k?X>fv1 N 00 00 0.0 00 0
ftt.)OM t:, G.p 0.0 0.0 OA 0
R{7G7v1 11 00 00 0.0 00 0
ROOM 12 00 0.0 0.0 C D 0
ROOM " 0.0 0.0 0.0 0,0 P
rY?CM 14 00 00 0.0 0.0 0
ROOM NAMF CEIL 5F BSMT FL PSSMTfGA SLABIGRD INFtC SF
BAfiEMLNI 0 1133 0 0 300
Im7ain FICa 1282 0 149 0 1282
ROOM 3 0 C 6
F20(?M d 0 0 0 6
RJOtA b 0 0 0 0
ROOM 6 J O O 0
ROOM1A 7 1) 0 0 0
Rai]Pd A 0 0 0 0
ROOM S D 0 a U
ROOM 1o p D 0 U
ROOM ! ? ?J D 0 G
ftOOld ?2 D 0 0 4
r,oou 13 o 0 o C
ROOnA 1,4 r) 0 0 0
PEOpLE
2
4
0
0
0
h11,lcherk COMPLIANCE P.EPOF.T
hiinnesota Eneryr; Cade
MNcheck Software Varsion 3.0
cauriTy: Dakota
STATE: Minnesr,ta
ZONE 2
CONSTRUCTION TYPE: Multifamily
DATE: 1-3-2003
TITLE: EAGAN HEIGHTS
PROJECT INFORh1ATION:
PLAN tJ02-0801Y2
COMPANY Ir1FORh7ATIODI:
DIEDP.ICH E+UILDERS
NOTES
LOTS (.2-
COh1FLIA.NCE. FASSES
F.equired UA = 993
Your Horne = E71
12.3% Ea_tter Than Code
i
I
Perrnit tt ?
I'
I
Checked by/Date ?
I
6- /ep'er
y ZW
Area or Cavity Cont. Glazing/Door
Perimeter P.-Value P,-Value 1J-ValuF UA
- -----------
C:EILIN3S Raised ------
Tzuss -------- ----------
9942 -------
99.0 ------
D.il ----------- ----
109
UJA.LLS. 4dood Frame, 16" O. C. 3913 19.0 2.0 219
Tois'- Ae-EFr : 642 10.0 2.0 52
BSMT Conc. 8.3' hti7,8' bqi8.3' insul 1909 10.0 0.0 111
B:;h1T'. Conc. 3.5' hti3.0' bg/3.5' insul 491 10.0 0.0 39
GLAZI[IG: Windows or poors , Abave GrarSe 841 0.350 299
DOOFS 198 0.350 52
---- - ----------------------------------------------------------
COh1FLIA.NCE STATEMENT: The pruposed building desiln described here is
consistent with the building plans, specifications, and other calculations
submitter{ wir,h rhe parmit apFlication. The proposed builr(ing has been
dFSigned to meet the raq_uirernents of the Minnesrta Eneryy Cr,de.
Builder/DesignerT??..= ?e f?? Date ?-25 a?
Minna?jDta Energy
MNcheck Software
EAGAN HEIGHTS
DA.TE: 1-3-2003
Code
b'ersion 3.0
FLAN REVIEW AND INSFECTION ISSUES
This list of items may bF helpful far
use as a guide for enforcing the pqinn
Group r, Division 3 Occupancies, one-
The iterns rnar4:ed caith * apply only ta
residential dwellinls.
FLAN REVIEW ISSUES
Plan F.eviewers and Buildiny Inspectars
n-sota Energy Code. The items apply to
and two-family residential dwellings.
detached une- and two-family
FOUNDAT I OhI I td SULAT ION
- foundation wall insulation R-5 minimum
- foundation insulation extends from top of wall down to top of the footin7
- exterior faundation insulation is covered by a protective coating finish
COtdCRETE SLAB OR UNDER-SLAB INSULATION
- slab on grade perimeter insulation R-5 minimum
- slab insulation extends from top of slab to design frost line or toF of
footing
- flours over unheated space R-30 minimum
WINIXJ4JS / DOORS / SKYLIGHTS
- av?raga U-value is 0.37 maximun
foundation windows)
- window U-value consistant with
- window and door area consistent
for windows and glass doors (excludes
building plan and MNcheck Report
with building plan and hiNcheck Report
h1ECHANICAL VEPITILATION ISSUES
- residential mechanical vantilation sy:=tem provides adequate ventilation
per cnde requiremente*
- furnace efficiency is ccrosistent with MNcheck or buildinl desiyn plan
- protection against excassive deprzssurization is installed per code
requirements"
EidVELOFE INSULA.TIOtd FOR PLA,DI REVIErJ
- interior basement insulation k-5 minimum (if ne exterior insulation)
- ceilings with attics P.-38 or consistent with building plan and MDlcheck
Feport
-wall framing and insulation level is consistent with building design
and MNcheck Report
INSFECTION ISSUES
CrJNCEA.LED IDISULATION
FRAMIt1.; A.ND SHEATHING
- wind wash barrier installed at attic edge
- exterior wall corners framed so that insulation can be installed after
e;cr,erior sheathing is installed
- intersections of interior partition walls and exterior, walls are framed :
that insulatiun can be installed between the partition anri exterior
sheathing after erterior sheathiny is installed
- qaps between framinq less than one-half inch are eliminated by securing
frarning together or are insulat_ad at the tirna of assambiy
- all penetrations between conditioned and unconditioned spaces made
prior to frarninl inspection are sealed
INTEP.IOR AIR BARF.IER
- all fire stops are air sealed
- FiPP?-, ducts, wires, equipment and flues and chimneys through the interic
air barrier are sealed
- a sealed continuous interior air barrier is installed on the warm side oi
the building envelupe at ceilings, walls, and floor rim joist areas*
- air barrier behind tub and shower is sealed and prutected
- recessed liyht fixt,ures are sealed
EN'JELOFE INSULATIt7N
- basement insulation F.-5 minimum
- wind wash barrier on wall seFarating house and yarage is sealed
- loose fill insulation is prevented from enteriny the eaves
- insulation on skyliyht shafts and walls exposed in attics is supported
on the unconditionec] side
ATTIC INSULATIOtd
- attic accESS panEl insulated to R-38 for ceiling panel and R-19 for
wall panel
- attic card attached to frarning near access openiny
- nut,ification of attic F.-value and date of installation posted near bui
permit inspection card
This is a summa n1 only. Dther requirements may appiy, See the Minnesota
Energy Code. Questions? Call the Department of Fublic Service Inforrnation
Center at 651-296-5175 or 1-800-657-3710.
?+ w c, I sas?
RESIDENTIAL BUILDING ?
Permit Application ?
City Of Eagan
(p 150 7
D 1s aq
a -7 0•S(9
3830 Pilot Knob Road, Eagan MN 55122 Pr q ?SZ
Telephone # 651-675-5675 FAX # 651-675-5694
,-,,e??e
NewGonsWCUonRenui2menis RemodeVReoairReauiremenis ? a3 OtficeUseonlv
3 registered site surveys showing sq ft. of IoL sq. ft. ot house; and all roofed areas 2 copies of plan CeR of Survey Recd Y N
(20% maximum tot coverage allowed) 1 set of Energy Cakulatlons for heated additions Tree Pres Plan Recd _ Y_ N
2 copies of plan showing beam 8 window sizes; poured found design, etc. 7 sile survey for addi6ons & decks Tree Pres Nol Reqd _ Y_ N
1 set of Energy Calculatlons AddNOn - irMkafe i/on-sde sep6c sysfem Oo-si[e Sep6c Syslem _ Y_ N
3 copies of Tree Preservation Plan if lot platted aRer 7/7193
Rim Joist Detail Op6ons selection sheet (bldgs wiN 3 or less units
Date --Z-/ 71 / 0?7
Site Address L,b
e,a y Lan-c Construction Cost ? ?? ,oaZi
F4gQn rnh Unit/Ste #
Description of Work J\lo „-3 C l'MSk-ru tAi o n
blulti-Family Bldg ? Y_ N Fireplace(s) _ 0-Z 1 _ 2
Property Owner Telephone # ( )
Contractor 1,' 2[lr%ch T-'1
l0l-e.^4 e
/?
Address I58'f7 c'
State MY) ,
Gron?, -?n-4-h City o mot n4
Zip JN50(og Telep6one #(jo$y )??a [a 930
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy COde CategOry . Residential Ventllation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelopa Calculations Submitted
?i? I ??
Have you previously constructed a building in Eagan with a sil?m I r pl'an? N If so, 25% plan review
fee applies.
??
?.?8 ?m?n T?umb;?n I ?one #?(,?ta,) 29D• ?174?.
Licensed Plumber u
L,- ---- .?
MechanicalContractorL,.?chl?.xs 27, " Telephone#QSa) 41-61-'7099
Sewer/WaterContractor Telephone#(9s2) "V`y1y9
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; [ 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.
i/it L/?• E,?ir?ll?usl _ '
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation
? 02 SF Dwelling
X 03 Ot of#plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
Work Types
]?
'
31 New
/
? 32 Addition
O 33 Alteration
? 34 Replacement
? 13 16-plex
? 16 Fireplace
? 17 Garage
? 18 Deck
? 19 Lower Level
Pibg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screen/gazebo)
0 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 Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bidg)•' ? 43 Reroof ? 46 Windows/Doors
•Demolition (Entire Bidg) - Give PCA handout to appliwnt
Valuation I 'L9? o (2 L)
Census Code c) 2
SAC Units
Nbr. of Units ?
Nbr. of Bldgs /
Type of Const V/Aj
Occupancy nJ " 144- MC/ES System
Zoning CityWater
Stories 0 Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Width
REQUIRED INSPECTIONS
? Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Foorings (addition) _ Plumbing
X Foundation _ HVAC
_ Drain Tile
Other
Roof Ice & Water Final Pool Ftgs Air/Gas Tesu
Final
?C Framing
Fireplace )[ R.I. ? Air Test _
Siding Stucco Stone
K Final Windows (new/replacement)
? Insulation Retaining Wall
Base Fee
Surcharge
Plan Review
MC/ES SAC
city sac
Utility Connection Charge
S&W Pertnit 8 Surcharge
Treatment Plant
License Search
Copies
Other
Total
? 07 05-plex
? 08 06-plex
? 09 07-plex
? 10 OS-plex
? 11 10-plex
? 12 12-plex
-7? Approved By I-z_ , Building Inspector
?/o? X 1S?'
M40V dzSG ? ??=
.s --?,04 I ? yl 30
??:''dI't; ?
M? rL
8-ov
3? /7b
_ y"
7A
1n
--?--
1
Address: 2205 Liberty Lane
Zip: 55123
Lot: 12 Block: 02 Subdivision: Eagan Heights Townhomes 3rd
THE FOI,LOWING ITEMS WERF./WERE NOT COMPLETE AT FINAI. INSPF,(TION ON a?-
Yes No Comments
Final grade - 6" from siding
PerTnanent ste s- ara e
Permanent ste s- main ent
Permanent drivewa
Permanent gas
Sod/Seeded lawn
TraiUcurb damage
Porch
Lower level finish
Deck
Fireplace
. V erify with your builder that roof test caps from the plumbing sys[em have been removed.
• T urn off water supply to the outside lawn faucets before freeze potential exists.
• Call the Crty's Engineering Department at 651-675-5646 prior to working m right-of-way or installing
urigation system.
V BIDLDING INSYFCTOR: t lZ
CONTRACTOR:
Diedrich Builders
13224 Grand Oak Ct
Apple Valley MN 55124
Site address: [4?-r. Lot j-):- Block ? Subd. j?y? 4/5
On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air
tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be
submitted prior to issuance of a Certificate of Occupancy.
j? This stnicture: is consWcted to meet minimum requirements of the Mn Energy Code, Chapter 7670
? OR
_ This structure: will be consUucted to meet more restrictive requiremenGs of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTII'S VENTINGTYPE
Water Heater
Fumace
Dryer
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
veS r+o
Kitchen kitchen ,Q,M ?MAP`rv
?
Bathroom 1 1?1 ?
Bathroom 2 G v ? ? (177 v
Bathroom 3 o,? 1+ ' )p
Bathroom 4
Other
FIREPLACE S
LOCATION
GAS
WOOD
MANUFACTURER
MODEL
BTU'S VENTING
DiRECT ATMOS
_ ( t? -??-G1..- 0,1?
I hereby acknowledge that the above information is correct and agree to compiy with the Minnesota Energy Code and City of Eagan
6 -A -OS
Date
CompanyName
• This form is tlhe responsibility of the General Contractor.
G q b 9 0
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
4ls.so
Date ?_ Il ll S
Site Street Address ? Z C7 rJ G/ S??{y L? Unit #
Property Owner Teiephone #( Z-
1-vnlda??r`UI14- W%f Telephone # ( yS2)
/
Contractor
/s State .?'J4Y Zip > S/a V
?
? dl "'? Cit
%S
? {S 11
'?
y
i
?
7
Address
1
Contractor _Other
The Applicant is: _ Owner /
Alteretions to existing dwelling $ 50.00
Add plumbing fixtures (exciudes water softener and/or water heater--complete next
_
section if installing these appliances).
_Septic System Abandonment
Water Turnaround (add $125.00 if a 5/8" meter is required)
Other:
?Water Softener _ Water Heater $ 15.00
_ new _ repiacement
ELaw:Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
$ /-!;-- S o
Totai
I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
ApplicanYs Printed Name
Applicant's Signature
ii n 0 5 2005
alcAl .ao1, asoma
City of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 676-6675
Fax: (651) 675-6694
Use BLUE or BLACK Ink
For Office Use
Permit #: t L /^1 "✓ "'L tP
Permit Fee: _S S ' 0 0
Date Received: __u / 4 1 V27
Staff: W
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Unit #: r �✓•'300'
gi77J
Date: 1/ // / /,'7 Site Address:
Name:„�
Address / City / Zip: 2 7 L -Lt th LOIAC
Applicant is: Owner `\ Contractor
Q\CC5CL
Description of work �-(1eikr
Construction Cost `1 600
Multi -Family Building: (Yes
Company:
/ No )
Contact: 40161/1
City:
Y Y I61/1
Address: tNS EAS-(01:4V—
State:
ASZ(_fl/U E 0
State: T n
City: 5' Pau(
Phone:
License #: (A Lead Certificate #: f A r'9 d—) l L ^
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a penult 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:
!Idltt ': n0,1$,$$
n tlofl ma
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. aopherstateonecalLQr9,
I nereby acknowledge that this information is complete and accurate; that the work will ba in conformance with the ordinances and codes of the City of
Eagan: that I understand this is not a permit, but only art application for a permit, and work is not 10 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 by a building permit issued In accordance with the Minneso = B-'Iding Code mpt be completed within 180
days of pe it issuancee-
x ,,[ fhb
Applicant's rated Name
x
Applicants Signature
G7�
Page 1 of 3
Date:
C!ty of Eaaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (661) 675-6676
Fax: (651) 676.5694
Use BLUE or BLACK Ink
For Office Use
Permit*: I V
,Qgg,a5
Permit Fee:
Date Received: 5111 1 f
Staff:
2014 RESIDENTIAL BUILDING PERMIT APPLICATION 0,9.0
3...19.LAi__ Site Address: \°'r \\ -x \oe / Unit#:
:.;;
; ;' �'I::;:!;` . `;''ii:i
:Th
tiki ier','I;;:..:
.;crlc: ?i. .... !:_
Name: �� t r` �� , � 1. 1 � � %* t Phone: � (lla � J
p (9� - QQ// ' 8
Address / City /Zip: (-lei r �► tdJc ta-u_._,,,,,,r,-, n� J51,QC&`
Applicant is: Owner Contractor
ja a iII .,. ,'
"'''' "" ;. `
Description of work: J' \ (KL—
Construction Cost: • 1
as 0 Multi -Family Building: (Yes )O / No _)
!iii si .
';:,!:!'!:,;x:,:, ,-,•:,1:;''::"'' ,
a; : ;•:;,. ;;: ,i::,;,>:,.::
.............. .:':
_
Company: 5
to 1\64S5 Contact:
Address: W..-6‘..
.-6 .. (.6"\-\.<3.1/4' • City: ')k 1'a J `
State'
_ Zip: 1 1 Phone: (951- l�' cc ~ V .
l�
Licensel Q #: /5� 1 Lead Certificate #: _O� �[\ — 1oa\- i
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
_Yes _No If
COMPLETE THIS
has the City of Eagan
yes, date and address of
AREA ONLY IF CONSTRUCTING A NEW BUILDING
Issued a permit for a similar plan based on a master plan?
master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE:0ans:ind:s400t169: 0..4o%l)'►tents.;that.y_oy subiliiraje consider d :‘be,'Aubl c r►iorir ation. ;'Portions :of n:
•
e n fom tton.,.., .,,......Y..be.::ctissifeds n n-purcrf ycu;pd�{ eaP,.te;cresonsawdpetrrnt;;t e:
,.,,,,,.,.........,.,.,.6Nidethattbe.' ;ePeria..g.e�" ,
CALL BEFORE YOU DIG. CaII Gopher State One Call at (661) 464.0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.000herstateonecalLorg
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 by a building permit Issued In accordance with the Minnesota Std Building Code must be completed within 180
day permit Issuanc
x
Applicant's Printed Name
x
App nt's ignaturo
Page 1 of 3