641 Hillside Dr{ R? ye • ?r
?e?ti?icate of Cccupanc?
? ???
?? ? ?? ?o"ti"
This Cenificate issued pursuant ta tlie nequinements of the Uniform Building Code
certifying that at the time of usuance this stn+ctrtne was in campliance with the various
orrliriances of the City regulating building construction or use. For the fotlowiag:
use classiecat;on: SF DC sag, Pamit ro. 22027
Oc-p-r Trpe RUM zoning DiTMKC RI Type coau. VN
owner or eaRding S'1EPH-AN MMES Addma 1754 IPM 17R, E1CM
Buddin8 Addren 641 HILI.SIIE 1RIVE L-UrFty L 14, B3, BUR QAK kIIII.S 2ND
?
l IJr!? I Iv/y ?-
Bw,aing official
-?
P06T IN A CONSPICUOUS PLACE
! INSPECTIUN RECORD
CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 - Date Issued: - ?
(612) 681-4675
SITE ADDRESS:
;I io I t i' 1 L1t i)J
i 1i i'l 1; i f 14 k. t4 1 1 4', :' N t)
PERMIT SUBTYPE:
?C\
I 4 ht t k i t i, ; 13
P?Oi F
I t z 1,' i r
MIi13: t
TYPE OF WORK:
1; 11111 lri16,, 1 1 11 1 rtAI
Permlt No. Permft Holder Date Telephone M
S/W
PLUMBING
HVAC
E4ECTRIC
ELECTRIC •
Inspectlon Date Insp. Comrnents
Footlngsl
Fourtdation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test "
Final Pibg. Plbg. Inspector-Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Ftg. ? O
v cJ? o ' ?
Deck Final
E .2/
rd'
?GoLlI -c ;, u,yS-
Well FT rsg SS?Cr '?" ?9 Gt1s?
? ? y?•-P
Pr. Disp. G .,?-c,? N/5•???
. ,
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
4N RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
SITE ADDRESS: 11111
',; ? I I, f IIE 11?t
?? ???,r i? i ? i . .•?a??
PERMIT SUBTYPE:
TYPE OF WORK:
(NSPECTION ., . ..
irf'
I : F}kV
b bf p l !9R c!f N-oCE:1 i'I Ho-i
14 y t0f, %, APPLICANT:
. ! ? I 7? '?t? tlllf'll
I1-
Permit No. Permit Holder Date Telephone N
5NV
PLUMBING
HVAC ?O / ? 9l??•
ELECTRIC? 09fr? ' 0 S' 9? ? ack7
ELECTRIC
Inspactlon Date Inap. Comments
Footings I
Foundation
Framing
?v
Roofing
Rough Plbg. - Z- ? N
Rough Htg.
J5ul. 10-13 9J
Fireplace
Fnal Htg. *1Q J ?
orsat Test
Final Plbg. / JJ q?
7 U J?
? Plbg. Inspectot - Notify Plumber
?
const. Mece,
Engr./Plan
eldg. Fnal 4?7 h Q
Deck Ftg.
Deck Final
Weil
Pr. Disp.
Address 641 rm r sIDE D rvF Zip 5512 1
Lqt _T_ Blk 3 Sub sux onx HILLs zrID
THESE I'TEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: Yes No Inspector:
Final grade (6" from siding) v
Permanent steps (garage)
Permanent steps (main entry) ?
Permanent driveway ?
Permanent gas ? P
Sod/Seeded grass
TraiUcurb damage
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shuboff of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in rightrof-way or installing underground sprinkler system. ?
White - Ciry Copy Yellow - Resident Copy Pink - Contractor Copy
M o s o 7
?r?
Request Date
10 / 0 5
93
1 Fire o. Rough-in Inspection
Require
tl' NOTICE. You Musl Call Elecincal Inspedor 11
in Inspxtion
'
/ Ves
? No
x Is Requ
Iretl
IR licensed contractor ? owner hereby request inspection of above elec[ncal work at:
Job Address (Streat, Bax ar Route No ) Ciry
641 Hillside Dr. Eagan
SBCtion N. Township Name or No Ra`ge No CouMy
County
Occupant(PRINT) Phone No
StephAn Homes 681-9777
PowerSupplier Atldress
NSP 3000 Maxaell Ave., New Port
Eledncal ConVactor(Compeny Neme) Contrapor5 licanse No
Joos Electric Co. AM01895
Mailing Address (Contracror or Owner Makmg InslallaLOn)
2104 Great Oaks Drive, Burnsville, MN 55337
Aufhonzetl Signatura (ConlractorlOwner Making In ion
? 7?jep Phane Number
431-4755
MINNESOTA STATE BOARD OF ELECTRICITY ? THIS INSPECTION FiEQUEST WILL NOT
GdggsMiCway BICg. - Hoom S4]3 BE ACCEPTED BV THE STATE BOARD
1821 University Ave., St. Paul, MN 55100 UNLESS PROPER INSPEGTION FEE IS
Phone(612)fi62-0B00 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION
? See insVUCtions lor compleling this form on back of yelbw wpy
M 0 9 6 0 7 =X" Be/ow Work Covered by This Request
ol! E13-00001-08
e Add Rep. TypeofBuiltling AppliancesWired EqwpmentWrted
Home X Range Temporary Service
Duplex Water Heater Electric Heating
Apt BUilding Dfyer LOad Management
Comm./Industnal }[ Furnace Other (Specdy)
Farm Air Condilioner
Olher (specRy) Contraclor5 Remarks
Compute InSpection Fee Below:
# Other Fee # ServiceEntrence5ize Fee # Circuits/Feeders Fee
Swimmmg Pool 0 to 200 Amps $, 0 to 100 Amps 64
Transformers Above200_Amps Abova100-Amps
Signs Inspectors Use Only ?r ) TOTAL
Irrigation Booms $82 • 50
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 M THS.
I, the Electrical Inspector, hereby
certify that the above inspection has
been made. Ro.qn,n
F,,,ai oete
OFFICE USE ONLY
This request void 18 months iram
?7-1
2006 RESIDENTIAL BUILDING rExNUT arrLicATioN ?
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
NewConshuctionReouirements RemodeVReoairReauirements ?- J?0n _.__ .. .
3 registered s te surveys showing sq. ft. of lot, sq, tt. ot house; and all roofed areas 2 copies of Dlan showing footings, beams, joists 000 LSurvey 2cd '"-Y„_N
epoA?. .?" __N
(20°< maximum bt wverage allowed) 7 sat of Ene?gy Caieulations for heated additions SoIIs R Y.
1 Soils Repor. if proposed buiiding is ro be placed on disturbed soil 1 sile survey for addiUons 8 decks Tree Pres PWn iecd ?Y?==N,
2 coples of plan showing 6eam & window sizes?, poured tound design, etc. Adtlftion - Indlcate if on-ske sepfic sysfem Tree Pre's Ret red' ?.=N
t set o( Eneqiy Calculations On-site Seplic qstem
3 copies of Tiee PreservaUon Plan if lot platted afler 7!1l93
Rim Joist Detail Options salection sheet (buildings with 3 or less unfts)
Minnegasco mechaniwl ventilation form
_ Construction Cost
5 I y
Date ?-4-
Site Address lC„'I ? I I I sllcy? ? UnidSte #_
Description of Work
Multi-Family Bldg _ Y?N Fireplace(s) _ 0
Property Owner APJnCl 1 J Q L402M!?, Telephone # a`°,? I)LI.J -I l':?? ? -? _
Contracior ?Z/Ze// GGCtG'a/ k12 ;S?GcG.7
Address ,5 GY7 /7??m?p? ?/?'• il/, city
State ?Zip ;?500?? Telephone#((p57)!?,??•?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDI IJG
Minnesota Rules 76 ?
Minnesota Rules 7670 Cateeorv 1
Energy COde CetegOry . Residential Ventilation Category 1 Worksheet • New Energy Code orksheet
(J sibmission rype) Submitted Submitted
• Energy Envelope Calculations Submitted
In fhe la>t 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_ Y _ N If yes, daie and oddress of master plan:
Licensed Plumber Telephone #( )
Mechanical Contractor Teiephone #( )
Sewer/'JJater Contractor Telephone #
I hereby apply for a Residential Building Permit and acknowledge that the information is comi ete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan anr the State of MN
Statutes; I understand Uus is not a permit, but only an application for a permit, and work is no to start without a
permit; that the work will be in accordance with the approved plan in the case of work which rec ires a review and
approval ofplans.
Applicant's Printed Name Applicant's Signature
A CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE:
Pertnit Number:
Date Issued:
?j
BUIIDING
022027
09/21/93
SITE ADDRESS:
P.I.N.: 10-15501-140-03
DESCRIPTION:
641 HIIISIDE OR
LOT: 14 BLOCK: 3
BUR OAK HILLS 2ND
Be£ildirij'_,Permit Type
Building W'ork Type
UBC Occupancy-,,
Construction Type
2oning i-?
Buildzng Length )
Building Width ?
? t
SF pWG
NEW
R-3 M-1
V-N
R-1
44
49
f 00?
REMARKS:
PRV 5& W PLBR - WEN2EL PLBG
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
subtotal
VALUATION
$89,000
$590.00
$383.50
$44.50
$750.00
100
1
$1,768.00
MISCELLANEOUS $1.744.50
Total Fee $3,512.50
CONTRACTOR: - Applicant - s7. LIC. OWNER:
STEPH-AM WOMES 16$19777 0001457 STEPH-AN HOME3
1754 ORAKE DR 1754 DRAKE DR
EAGAN MN 55122 EAGAN MN 55122
(612) 681-9777 (612)681-9777
I hareby aoknowledge that Y have read this application and state that the
infiormation is correct and agree to cornply wiCh all applicable State of Mn.
Statutes and City of Eagan Ordinances.
IL -
-fiRI4 R.qa. 114),
APPLICANT/PERMITEE SIGNATURE 'ISSUED B SI NA7UR
REACT,IVATE CITY OF EAGAN
PERMIT # u?'-???=;?'?`?1993 BUILDING PERMITAPPLICATION ?g?JZ•`D
:1WII ? 1 5 1993 681-4675 . ? ~
9 - Z?
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural pla,ns, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month-
in which request is made, 2) address is changed or 3) lot change 1s requested once permit
is issued.
Date - F / Valuation of work 90?,Oa?
+?
?
k
l
r
a*
v
(
Site Address:
STREET SUITE M
Tenant Name: (commercial only)
IAT ? BIAC& ? SUSD. ?0'0?W Al
AMP P.I.D. N '
Descri tion of work: ?
The applicant is: ? Owner Contractor Other (Deseribe)
Name Phone
Property LAST FIRST
Owner
Address
STREET STE t
City State Zip
Company Phone Cij'y2J7
Contractor Address ?01,04?t A/7 1/ C- License #1$67 Exp.3 -#tSs
City .0k/ State Zip
Company Phone
Architect/
Engtneer Name Registration N
Address
City 5tate Zip
Sewer & water licensed plumber W t iJ 2J Processing time for
sewer & water permits is two days once area has been appraved.
I hereby acknowledge that I have read this.aPplication and state that the infarmation is
correct and agree to comply with al applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: ?
OFFICE USE ONLY
BUILDING PERMI7rrPE ?
? 01 foundation ? 06 Duplex 0 11 Apt./lodging
2?02 SF Dwg. ? 07 4-Plex ? 12 Mu1ti. Misc.
O 93 SF Addition ? 08 8-Plex ? 13 Garage/Accessory
0 04 Sf Porch ? 09 12-Plex ? 14 Fireplace
0 05 SF Misc. O i0 Multi. Add'1. p 15 Deck
WORK TYPE
IR 31 New ? 33 Alterations O 35 Tenant Finish
? 32 Addition D 34 Repair ? 36 Move
GENERAL INFORMATION
?'`"?'? •`"?; ,'? ,'?'".::. „?] lfrBasemeni?firftsh
0 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
Const. (Actual)
bl
All ./" N Basement sq. ft. MWCC System YE5_
awa
(
e) V-rJ lst F1. sq, ft. City Water YE5
UBC Occupancy M"I 2nd F1. sq. ft. PRV Required ?
Zoning R-1 Sq. Ft. total Boaster Pump
8 of Stories Footprint.,Sq. ft. Fire 5prinkler
Length yy 7 On-site well Census Code _F0 _1
Depth 49, On-site sewage • SAC Code of
APPROVALS ?
?
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
? Site O Footing ? Framing O Insulation
? Wallboard ? Final ? Draintile ? Fireplace
Permi•.t Fee v,iuac;p,: g 8`I,O?o
Surcharge
Plan Review G?eabE;
0-Ox22= 4u
o X /6.= `7oyo
License
MWCC SAC 3sanT'
-'
?`f7?22="5Z8
City SAC ZZx 29 . 638
Water Conn. ?-
Water Meter
Acct. Deposit
+Loul? 116G XISc ??4R0
S/W Permit
S/W Surcharge q3srr?7? ??` ?
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
r
?3?Z?f
Copies
other
l
T
t g g 358
:
o
a ?
SAC % I00
SAL Units =
1 /
1 /
/
?..
?..
v _
It?
JJ LC? • GG
7
?-
?<3
/ / y1
?
? --?_
? r
? uYl L,?.? E a?F-?,
? Ix x
(
e?. wA
V? 0 l?r, 84a,?kx? I . ?._..
q.t. V
??,7 EM $y A2.o a '1.Z,fl? E
ptz?P?5C-5
N ? N
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,,
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N
i ?? p 1B'o ], ? ? . I5
m cA
l ??/f?'?V H
M
?41 LI...SiOE pg.I
Z'cO i:.(. ...
DAKQ?P. Co?JN^f? .
7•/?tr..4wt??o-: A
LRAC3Ab`3 gNGIRTEERI%G D?PT
p,w 9?AR.?i.145 ASSJ t+RED
?,kSf'E. ?IR4N N?DI.tJMrcNT
I hereby certi£y that thie survey was prepared by me or ,
under my direct supervisi.on and that I am a duly Registered
Land Suxveyor under the laws of the State•of.Minneaota.
D at e : 5.,.
LeRoy H. ohlen
Registered I,and Surveyor No. 10795
U LOT SURVEY CSECRLIST FOR RESIDENTIAL
w
' 'w
?
?
SUILDIN PERMIT APPLICATION
m
m?
S
¢ ?
?J
PROPERTY LEGAL: f l(J 4
W< N Date of Survey:
U ]
< z I DOCIIMENT BTANDARDB
8'?? 0 • Registered Land Surveyor signature and company
g-'?? ? • Building Permit Applicant
2--t ? • Legal description
? e ? • Address
0'"0 ? • North arrow and bar scale
Br-? ? • House type (rambler, walkout, split w/o, split entry,
lookout, etc.)
9--?0 ? • Directional drainage arrows with slope/gradient ?.
? 2-"? • Proposed%existing sewer and water services
' ? • Street name
P ? • Driveway
ELEVATIONS
Existina
? 0'?'? • Sewer service
p? ? ? • Lot corners
6? ?? • Top of curb at the driveway
? Cl-?[] • Elevations of any existing adjacent homes
Pronosed
p? ? ? • Garage floor
E1? ? ? • First floor
R? ? ? • Lowest exposed elevation (walkout/window)
C? ? ? • Property corners
?? ? • Front and rear of home at the foundation
PONDING AREAS (if anolicable)
? M-?' ? • Easement line .
? []- ? • NWL
? 2? ? • HWL
? ? ? • Pond # designation
? ? ? • Emergency Overflow Elevation
8' ? ? •
.fd? ? ? •
;e- o ? •
0-, ? ? -
j}' o 0 '
p V'D .
Lot lines
Right-of-way and street width (to back of curb)
Proposed home dimensions including any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
structures requiring permanent footings)
Show all easements of record and any City utilities within
those easements
Setbacks of proposed structure and setback of adjacent
existing homes
Ret
Reviewed
October 1992
yv^? GM1 l'l/R V
_ EXTERIOR ENVEIAPE AVERAGE "U" COMPUTATION
ii
0'r'N ER :
SPTE ADDRESS:
CONTRACTOR:
DATE: PHONE:
DETERMINE WORKING SQUARE FOOTAGE OF EACH:
1. TOTAL EXPOSED WALL AREA ,. IBlle sq ft x"U" .1I
2. TOTAL ROOF/CEILING AREA .. 1299 sq ft x"U" .0710 - 33•77
3. TOTAL EXPOSED WALL AREA CALCULATIONS:
Tota1 exposed wall
area above floor. ... ?(P41 sq ft
(t)
a) Total wa11 window area:
?7F3Lo glazed. . . //7 sq ft a "U" .55
` glazed. . . - sq ft x "U" - - -
b) Tota1 door area .... 33 sq fc x "U" •`??O m /] Z9
c) Total sliding glass door area:
glazed. .. sq ft x "U"
? glazed. .. sq ft a "U" ?- f
d) Total f/place wall area ' sq ft x "U"
e) Total wall framing area •
(Average 108) . . . . . sq ft x "U" • ?% _ /z-1', ] 7
f) Total net wa11 area above
floor (insulated) . . . /1f7/?,9 sq ft x "U" -?y - 59.D7
g) Total rim joist area. . 12 A' sq ft x "U" 7, OD
Total foundation area
(exposed)
117
s
ft
"U"
///
4'
?/f*
, . , , . , . q x ,
h) Total foundation
window area . . . . . . ? so ft x "U"
i) Total net foundation
area above grade. . . . sq ft x "U" • ?? m ?o?• $?
TOTAL a) thru i)
If Item #3 is r.he same as, or less than Item #1, you have met the intenC of z MCAR
1.16008 A and 0.
Page 1
?
,
/:, TOTAL EXPOSED ROOF/CEILING CALCULATIONS: - - • Total exposed
roof/ceiling area . . . ?? sq-ft
J3 Total skylight area NA_ sq ft x"U"
k) Total roof/ceiling framing "
area (Average 108). sq ft x "U"
1) Total net insulated
roof/ceiling area . . . 11j4,L sq ft x "U"
TOTAL j) thru 1) ? a?0• 7/
If total of Item #4 is the same as, or less than Item #2, you have met the intent of
2 MCAR 1.16008 A and 0.
ALTERNATE BUILDING ENVELOPE DESIGN
To utilize the total envelope system method, the values established by the sum of
Items m3 and n4 shall not be greater than the sum of Items ml and m2.
I . 199.7(o + z. 33.77 a3-?es?
z. _ 0?eni.59 + 4.
C E R T I F I C A T I 0 N
I hereby certify that I have calculated the "U" factors and "R" values herein and
that the building here described meecs or exceeds the State of Minneso[a Energy
Conversation Act.
?..
- zi
(Signat re)
(Date)
Page 2
PERMIT ???3;x 's
°CITY OF EAGAN ,J
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55123 Permit Number: 6 2 3 4 5 3
(612) 681-4675 Date Issued: 0 4/ 2 8/ 9 A
SITE ADDRESS:
641 HILLSIDE DR
LOT: 14 BLOCK: 3
BUR OAK HILLS 2ND
P.I.N.: 10-15501-140-03
DESCRIPTION:
Building Permit Type DECK
Building Wa.rk Type NEW
?.
? -
, ,
\, G
/
? r Ir
REMARKS:
FEE SUMMARY:
Base Fee $30.06
Surcharge $.50
Total Fee $30.50
CONTRACTOR:
OWNER: - Applicant -
ROLF MARIA
541 HILLSSDE DR
EAGAN MN 55121
(612)687-7995
I hereby acknowledge that I have read this application and state that the
information is correct and agree to cnmply with a11 applicable 5tate of Mn.
Statutes and City ofi Eagan Ordinances.
J
APPLICANTIPERMITEE SIGNATQHb?
fia1t(1 kPl'ki Il.l,[1
-`--' ISSU SIG ANRE ----
' • CITY OF EAGAN =J6
1994 BUILDING PERMIT APPLICATION
681-4675 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date GLQr', I /'16 / 94 Valuation of work ?a?«s ly
Site Address: (o 4t hillst ok 9'r';ve ??agor-^ MN Wl a i
STREET SUITE N
Tenant Name: (commercial anly)
LOT 14 BLOCK 3 SUBD. VR(k UAK 144CLS T
Actct; i-,r P. I D. #
n
and
Descri tion of work:
The applicant is: I? Owner ? Contractor ? Other (Describe)
Name PAAR1A L. KVW RFyy,qLpp CON7RFkAJ Phone qSy- 6575 (H
Property LAST ?IRST 667 _ 7qg5-Crul
Owner (.4r 14-?rr,'de
Address
STREET STE #
?N
Zip
City State
Company Phone
Co ntractor Address License # Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address '
C9ty State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
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.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging
13 02 SF Dwg. ? 01 4-Plex ? 12 Multi. Misc,
? 03 Sf Addition O 08 8-Plex ? 13 Garage/Accessory
? 04 SF Porch O 09 12-Plex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'7. EY 15 Deck
WORK TYPE
)?l 31 New ? 33 Alterations ? 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Planning
Engineering
REGIUIRED INSPECTIONS
?.Site
? Wallboard
Basement sq. ft.
lst F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft, total
Footprint Sq. ft.
On-site well
On-site sewage
Building
Yariance
0 Footing
0 Final
? Framing
? Draintile
? Insulation
? Fireplace
Permit Fee
5urcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
5/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trai7s Ded.
Copies
Other
Total:
vatuestm: $
. ,
? -
..w .
? 16 Basement Finish
? 17 Swim Pool
O 18 Comm./Ind.
O 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
0 37 Demolish
MWCC System
City Water
PRY Required
Booster Pump
Fire Sprinkler
Census Code X3 Y
SAC Code d/
Census Bldg i
Census Unit o
Assessments
5AC %
SAC Units
?
;
i
?
I
i
,
;
i
I ?J
I
?
?
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V Q
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5 ,?-3° ?
lo Q$ z4"
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Ta ry 1?,,,_ oa.w. e,_. , 8 53 .to
?PSEt??N't C-L. 9445, IF
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p.?..? B?C?.2.ti,145 ASSJNCE4
p ae?rES ?rzQ,? r?:p???rn?Nr
I hereby certify that thie eurvey Yias preparefl by me or ,
under my direct supervision and that I am a duly.Registered
Land Surveyor under the Xaws of the State•of•Minneaota.
Date • 5, ll,
LeRoy R. ohlen
Regzstered Laryd Surveyor No. 10795
.. ,.?<.,.n......,.....?....?. _.. .. . ... .. .. . . . . . . . ..... . ....
/
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C,x 8 K'1,'F
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pLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMTTS ARE REQUIItED FOR EACH UNTT'•
-------- --- -
NO. FIXTURES FeACH TO
? SHOWER 3.00
.3 d D
-T WATER CLOSET
- 3.00
00
3 :3.00
1d D
BATH TUB
7
-T LAVATORY .
3.00 ??J. DO
/ KITCHEN SINK 3.00 3, 00
LAUNDRY TRAY 3.00 .3.U0
HOT TUB/SPA 3•00
? WATER HEATER 3•00 ?,
? FLOOR DRAIN 3.00 , DO
C;2- GAS PIPING OLTTLET • m;?um -j 3.00_ , 0
ROUGH OPENINGS
13 1.50 ? 50
_
WATER SOFTENER 5•00
PRIVATE DISP. • DaiLcry. lic. 15.00
U.G. SPRINI{1,ER ' home under oonst. 3•00
ALTERATIONS • to cmisting 15.00
WATER T'URN AROUND 15.00
STATE SURCHARGE .50
'35, 00
TOTAL:
SITE ADDRESS:
OWNER
/
CITY: (i? irrJ STATE: /?m/ ZIP CODE:
PHONE #: ( (? /o2) 4sv2 -15& 115?
SIGNATURE OF PERMITTEE
1993 PLUMBING PERNIIT (RESIDENTIAL)
CTTY OF EAGAN '
3830 PII.OT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMHMRCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-
FAMILY BUP DINGS WI-EN SEPARATE PERMTTS ARE NOT REQUIRED FOR EACH
DWELLING U:?:T.
_ NEW CONSTRUCIION
ADD ON
_ REPAIR
WORK DESCRIPTION:
CONTRACT PRICE: $
FEE: l% OF COA'TRACf FEE.
STATE SURCHARGE $.50 FOR FACH S1,000 OF PUMq FEE
MINIMUM FEE: S 25.00
CONIRACT PRICE X 1% $
STATESURCHARGE $
TOTAL S
SITE ADDRESS:
TENANT NA]11E: STE #
OWIv'ER NAME:
WSTALLER:
ADDRESS:
CIT'Y:
PHOA'E #:
STATE: ZIP CODE:
FOR:
CITY OF EAGAN APPLICANT
1993 PLUMBING PERMIT (CObXEItC7AI,)
CI1Y OF FAGAN
3830 PII.OT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTT.
X NEW CONSTRUCTION
,aDD-ON A/C
ADD-ON FURNACE
DATE
September 29, 1993
HVAC: 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OLTTLETS (MINIMUM 1@ 53.00 EACH)
ADD-ON/REMODEL (EXtsTItvG CoN57RVC7'ION)
STATE SURCHARGE
TOTAL
FEES
$ 24.00
6.00
3.co
$ 15.00
.50
4?L .1f 6
SITE ADDRESS: 641 Hillside Urive
OWNER NAME: steph-An Homes TELEpHONE #: 6ai-9???
WSTALLER: Kleve Heating & Air Conditioninq Inc.
ADDRESS:
CTTY
Eden Prairie
TELEPHONE #: 94 i-42 i i
13075 Pioneer Trail
STATE: "'N ZIP CODE: 55347
1993 MECHANICAL PERMIT (RESIDEIVTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
`??? ..., .._ , ,<.. .
1993 MECHANICAL PERMIT (COM1V'IMCIAL)
CITY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMMERCIALJINDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTEER MULTI-FAMILY BUILDINGS WI-tEN SEPARATE
PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNTT.
DATE:
CONTRACT PRICE:
NEW BUILDING
INT'ERIOR IMPROVEMENT
WORK DESCRIPTION:
F'EES
1% OF CONTRACT FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF PERMTT FEE.
TOTAL $
, STTE ADDRESS:
OWNER NAME: TELEPHONE #:
TENANTT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:
CIT1': STATE: ZIP CODE:
TELEPHONE
SIGIv'ATURE OF PERMI7TEE CITY INSPECTOR
C[TY USE ONLY
LOT ? BL
SUBD. dt/[_ [?/al
RECEIPT #:
RECEIPT DATE:
1998 MECHANICAcL PERMIT (RESIDEN1'1AL)
Cfl't' OF EAfikN
8950 PILOT KNOB BD
£AfiAN MN 55122
(61E)6$1-4675
uate: 5-a?-c18'
Complete this section onlv if you aze installing HVAC in single family, townhomes or condos under
construction and not owner /occupied ,
• HVAC: 0-100 M B T U $ 24.00
ADDITIONAL 50 M BTU 6.00
• Gas outlets (minimum of one required @$3.00 ea.)
• State Surchazge: .50
• TOTAL:
Complete this section onlv if you aze remodeling, adding to, or repairing existing single family dwellings,
townhomes, or condos. Note: Mechanical permit is not r,?uire_d for alteration/add-on to ductwork in
existing residential units; but is required for the following:
Install fumace
X,
Install air conditioning
Install air exchanger, i.e. Vanee system, etc.
Minimum fee applies to all remodel or add-ons of existing residences
State Surcharge
Other
20.00
0
Total: $ 20.50
SITE ADDRESS: ?QQ' I !-ri 11 Si d e D r
OWNER NAME: PHONE #: 754' , 4o57 S
INSTALLER NAME: PHONE #: 431- 7043 9
STREET ADDRESS: .3 ;k pen n v C K -e
CITY: S7'ATE: ZIP: rJJ?I?
su[,e k' C(?'?-- -
SIGNANRE OF PERMITTEE
JS/FORMS BLD/MECH PERMIT (RES) • 1998
CITY USE ONLY
L BL RECEIPT #:
SUBD. RECEIPT DATE:
APPROVED BY: ,INSPECTOR
1996 M£CHA1VICElL P£itMIT (COMMEftCIAL)
CI1'Y Of £AcfiAN
3$30 PILOT KN08 RD
EA&i4N. MN 551EE
(61E) 6$1-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: 1% of contract price OR $25.00 minimum fee, whichever is greater.
Processed piping - $25.00
CONTRACT PRICE x 1 %
PROCESSED PIPING '
PERMIT FEE
STATESURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TENANT NAME (IMPROVEMENTS ONLY):
INSTALLER:
ADDRESS:
CITY:
PHONE #:
STATE:
ZIP:
($.50 per $1,000 of netmit fee due on all pecmits.)
PHONE #:
SIGNATURE OF PERMITTEE
City of EapIl
3830 Pilot Knob Road
Eagan MN 55122
Phone:(657)675-5675
Fax: (651) 675•5694
Date: 01 15 0?
Tenant: l: rul 01 Q
- - - - - - -----------,
,. ?
j Permit It: ?
? Partnit FeB: ?
i ?
? Date Received:
i ?
G ?
? StaN: -----
?----------
2008 MECHANICAL PERMIT APPLICATION
9iteAddress: 610 1'???JIVII? JfjVI.
Suite #:
? ?Qrr(f07q5_ Ph
??
RE5IDENT/OWNER one:
Name: ?-'
?
?? Mr, JJ',`' !
Address / City / 2ip:
CONTRACTOR Name: VY).15- Vicr, rl ii"o I I1/)6 Licen e?i:
Add,egs: 1-ZO(G CJI. BrlGK Pr o f?
ik/jo1/? zi
JJ?1?
S'i?KPpee' s
p:
tate:
oitr:
P
P
Pf'I 5`F)56 9
erson:
?
Contact
Phone:
TYPE OF WORK _ New -IReplacement _ Additional _Alteration _ Demolition
Description of work:
RESlDENTlA1 COMhIERC/A1
PERMIT TYPE Fumace - New Construction _ IMerior Improvement
Air Condmoner _ Instell Piping _ Processed
Air Exchanger _ Gas _ Exteri0r HVAC Unit
' HVAC units must be screened
_ Heat Pump Under / Above ground Tank L_ Install /_ Remove)
Other " When installinghemoving tank(s), call for Inspection by Fre
- Marshal and Plumhin Ins tor
RESIDENTfAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fir2 rBpBir (replace bumed out appliances, ductwork, etc.) (includes $.50 State Surcharge) ?
TOTAL FEE
?
$
. .
COMMERCIAL FEES:
$70.50 Underground tank instailation/removal OR Contract Value $ x 7°k
$50.50 Minimum (includes State Surcharge)
$ Permit Fee
- If Pe1mit Leg is lesa than $7,000, surcharge ie $.50. ?
- If Pertnit Fgg ia> $7,000, surcharge increases by $.50 for each StatB Surcharge
$ i,000 Permit Fee (i,& a$1,001-$2,000 Pertnit Fee requlres a$1.0 hg? , 6 2aos
TOTALFEE
I hereby acknowledge that Nis infartnati0n is complete 9nd acCUfete; Ihat 6tiwrk will be In confartnenCe wlin e orainances ana caaes oyme ciry m eayair, u,xi
1 understand Ihis is not a permk, but oNy an applicatlon for a permit, and rk is not to start without a pertnh; Ih t ihe work will be fn accordance with Ihe approved
plan in Ihe case of xrork which requires a review and approval oi plans. BY
x L`Y N.1a 'Ae1 r\VmoeY x V?IASA y u.?WU'? ? . ApplfcanYs Printed Name Applicant's Signatu
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA121131
Date Issued:03/14/2014
Permit Category:ePermit
Site Address: 641 Hillside Dr
Lot:14 Block: 3 Addition: Bur Oak Hills 2nd
PID:10-15501-03-140
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 or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Zibrowski Christopher
641 Hillside Dr
Eagan MN 55121
(507) 951-6908
Pella Northland
15300 25th Ave N #100
Plymouth MN 55447
(763) 355-1300
Applicant/Permitee: Signature Issued By: Signature
' , ' r For Office Use
::: ea "q 41%.,,,,,:i ,,,,,, E AG A N409
:�♦ „ ECEIVE1) Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 MAY 3 O 2nm Staff:
buildinginspectionsCa�citvofeagan.com
2019 RESIDENTIAL BUIL T APPLICATION
Date: c/30`h Site Address: 61i I 1'"l; lIStc'C P( Unit#:
Name: C t1 1,5 2 ;to r‘ wS k Phone: ( 6h-) 7A7” 6/11
Resident/
Owner Address/City/Zip: by / PI 114,e1 c Dr Bina vn 9Yl rV /
Applicant is: Owner Contractor g_ i
1lr„�z Cd... 1 -; )(�
,2/Iii 4 '�IA
roVI
Type of Work Description of work: We.w Deck I D.A1 f-)c�'t5 Jov11J (try,k oo eL4. �n �f,c-i ,,.� w.��
Construction Cost:, ; i �00 J Multi-Family Building: (Yes /No i/ )
Company: Holly Hvw\e gv.-1,,,z\;ovx5 Contact: IOGIU khsavN.
Contractor Address: 15P\ Avei-IoCity: .;-I- Pe,.,1
State:mIV Zip: 5c1O Z Phone:(h6I)706" ° , Email:t-oily rtov\e, RElno�A',ov�e JO Wa,�t.Cv
License#:Bc.7cox 2 Lead Certificate#: PAT I`FZc 22 n- I
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 they are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.com/subscribe.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
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.aopherstateonecall.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.
Applicant's Printed Name App icant's Signature
i
DO NOT WRITE BELOW THIS LINE 60 471/ N;1/ Id6 De - /55971
SUB TYPES
_ 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*
AdditionMove Building _ Reroof. _
_
Demolish Interior
4_Alteration _ Fire Repair _ Windows _ Demolish Foundation
_ Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation P Occupancy '(L MCES System
Plan Review Code Edition A ;, 1 5 SAC Units
(25%_100%)L) Zoning i City Water
Census Code I v Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction 7/5—
Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) l Final/No C.O. Required
Foundation Foundation Before Backfill l HVAC_Service Test Gas Line Air Test_Hood
Roof:_Ice &Water _Final Pool:_Footings _Air/Gas Tests _Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick_EFIS
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: , Building Inspector
RESIDENTIAL FEES
Base Fee iv6/(301I 0
Surcharge (�
Review
Plan , ti/
MCES SAC nk
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant 2i 0 X/s' 0Radio Meter Read /
6/
Copies
TOTAL
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