646 Hillside Dr??'^? ??•
(gtx#i#irate of (Orxupanry
Citp of eagan
igp}uYU1Ptit Df WwlMltg.%"pdtQtt
Tbis Cernf `iaate issued pursuant to the requirements ojSerdorc 306 of tlre Un?form Bullding
Code cutijying ttiat at tIre tiw ojissuance drs sducture wns in rnm,pliaxm wttle tlre various
ordi?mnaes of !he C+tJ' regxlakn8 buildin8 constrrrcYfon or rue For the follow}ng.
use a..ificedo. SF DWGIGAR eft % xo. 159
Oac+qreeY 'fM 2ming Dimin R I 7ype co•r VN
Owoer al e-eint ?•? t?$ ? Aee" 2500 WST CN !? 42, W'VMU
DM 6/23/Q2
POST IN A CONSPICUOUS PLJICE
?
INSPECTION REC4RD COntrol No. 0164
,--
C ITY O F E A G A N P E R M I T T Y P E: FIUiLQ:c s s
3830 Pilot Knob Road Permit Number. ???169 :
I Eagan, Minnesota 55123 Date lssued: w, /03/ 9 x
j (612) 681-4675
SITE ADDRESS: ? ri t: ?a ct ? ac K: r APPLICANT:
f r.aG HiLt?C#3E? hk 9EVEKSON HOMlS INc
a`'/ Q (FS 12) 09 0.'r 47 44
? PERMI??§,PBTYPE: TYPE OF WORK:
INSPECTION
•, ? ? I .. .
FOOTxNG ..
FkAMINti IMSULA7IUM
r
4lAt I.Bt1AR1) FiNAi. ?
F1FtkPLAC:E
j CiF1lANk ; s aECExPT t
# ?..
M..,
° _ :''T-. _ ?-=?• c ? ! ?` - ,?". r' ? '_
PRV
SYAFt PLBG.
ILd
-
Permlt No. PermR Holder Date Telephone Y
SlIM
PLUMSING
HVAC ? k
ELECTRlCf " ,,5 ?1J ?` • ??`f ?'o?-• ? ? ?
ELECTRIC
Inspectlon Dafe Insp. Commeirts
Footings I //f/
Foundation
Framfng
Roofing
Rough PIAg,
ROUgh Fltg. 45-???.. dJ ?? rt J
Isul.
Fr?lace
Final Htg.
Orsad Test
Fnal Plbg. vq_
! Pfbg. Irispectar - NotHy Plumber
Const. Meter
Engr./Ptan
sldg. Finai b$
Deck Ftg.
Deck Final
Well
Pr. Dfsp.
.?s?? 1.? a•i?
SEDGWICK HEATING & AIR CONDITIONING CO. HE^Ti"c JOBNO
8910 WENTWORTH AVENUE SOl1TH • MINNEAPOLIS, MN 55420 •(952) 887-9000 TEST RECORD
AODRESS w ? ? • ' ? ? D C'' 0 (2, CITY '--* Ar ',?u/? ?\
OCCUPANT OWNER • ""'?/? -"' ?`?v ? "'"V '?+'?
SOLD 8V y Q! t INSTALLED BY
MAKE ?-'' `t) v
SERIAL NO t)?JlJ (l-jI In V?
THERMOSTAT ? • ? xn)
VALVE ?
LIMIT ?
LIMITSETTING
FAN SETTMG
PILOT TYPE
IGNITION MODEL
PILOTTIMWG v Jl.CS- -
PRESSURE'n, PERCENTCO.,
INPUT CFH PERCENT Dp.
n
STACKTEMP PERCENTCO
FORM 235 (REV 11I89)
MOOEL (Ttol MPQ?>60-7;
INPUT (ob0"D
VENT S2E T1!`2
TYPE OF LINER
LINER SIZE
,
FILTERS: SIZE -7? ?.... NUMBER
WIRING ` ??P$C%
TEST TAG
LIGH7ING INST.
DATETESTED I?? It ( '
COMPANV TESTING
NAME OF TESTER
FOFMOISTR18UTiON. WHITECOPV - JOBFILE YELLOWCOPV-CIN
Addrass; Lot q Slk Z Sec/Sub gM ppK kID,Lg ZNp
These items weze/were not complete at the time of the final inspection.
D t: 9 Yes No
Final grade (6" from siding) ?
Permanent steps - garage
Permanent staps - main entry
Permanent driveway
Permanent gas ?
Sod/seeded grass ?
Trail/curb damage
Porch
Basement finish
Deck vo?
Please verify with the builder the removal of roof test caps from tha plumhing
system and the shut-off of watar supply to the outside Lavn faucet befora
freeze potential exists. ?
ucrueowren
Whice - City copy Yellow - Resident copy Pink - Contractor copy
?95 9 ? 4d
Reduest Date ? fire No Rough-in Inspaclion
d'
? Reatly Now kWill NotAy Inspecror
-72 Reqmre
KYes G N.
When Peatly'+
IKlicensed contractor 0 owner hereby requesf inspection of above electncal rrork at
dob Adtlre/ss ! t Box or Fou Na I
? Ciry
(Q /
? G .lG GT?
Se0mn N. TownSNp Name or No Range No Cou
O
Omupanl PRINT7 Ph
one No
l
es- ^
y/
+?-? iD - T
Power Supplier qtltlress
'" ? wAtPII ?1"v`at-
Ele onvactor (COmpany Name) Contrada5 Lroense o
? ` e? ? 7g/
Maihng A ress IComrxmr or wner Making IpslellaLOn)
'
tl L !J
a
nzed5i aWre iGortlractor/OwnerM Inslallationl PhoneNUmOer 4. 7J-.
fDd17
,
MINNESOTA STATE BOAHO OF ELECTRIC Y THIS INSPECTION REOUEST WILL NOT
Griggs-Midway BIEg. - poom 5473 BE ACCEPTED 8V THE STATE BOARD
1821 Unlverslly Ave, SL Gaul. MN 55104 UNLESS PROPER INSPECTIpN FEE IS
Phone (611) 642-0800 ENGLOSED
-J1_5695
REQUEST FOR ELECTRICAL INSPECTION
? Sae mstmcvons lor romplating Ihs form on back o1 yellow copy
")C Below Work Covered by This Request
91F,0?7A1 %SY E8-00001-08
J'4.ww ?
e Add Rep TypeofBuilding AppliancesWued EquipmeniWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apl Budding Dryer Other (Specity)
Comm./Industnal Furnace
Farm Av Conddioner i
Olher (syemry) Convactor5 Remarks' //? ?? 2a $G r
J
/ - 3?- /oa 7 =
Compute lnspechon Fee 8e/ow. =
# Olher Fee # ServiceEnlranceSze Fee # Circults/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amp
Transformers Above 200 _ Amps Abo 100 Amps
SignS Inspecror5 Use Only !
1 TOTA ?
?
Irrigation Booms ?
11 C? rj
Special Inspection
Alarm/Communicanon THIS INSTALLATION MAY BE RDERED DI CONNECTED IF NOT
Other Fee COMPLETED WITHIN 78 S. (
I, the Electrical Inspecror, hereby
f
h
h
i -?/` ?
certi
y t
at t
e above
nspection has
been made. F,nai oate
lf2
OFFICE USE ONLY i
This reques[ wb 18 months Irom
S 7'S 3 ? RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
NewConaWCtian Reauiremenb
• 7 regislered site surveys shawmg sq. R. of lol, sq. R. of house, and all roofed areas
(20% maximum lot crnerage allowed)
• 2 copies of plan showing beam A wmdow s¢es, poured found desgn, etc )
• i set of Eneyy Calculations
. 3 co0ies of Tree Preservation Plan if lot plattad aRer 711193
• Rim Joist Detad Options seletGOn sheet (bldgs wdh 3 or less umts)
DATE 'tS_ I5'0;?
Remode(lReoair Reauirements
. 2 copies of plan
• 1 set of Energy Calculatrons for heateC aCditions
• i site survey for eztenar 2ddilion5 & tlecks
. Indicate dhome served by septic system ior adCdions
VALUATION i ?
7/O
SITE ADDRESS /70Si c/L DY MULTI-FAMILY BLDG Y 4-14'
TYPE OF WORK ? fJ- ? ?r-?rnfl FIREPLACE(S) _ 0 _ 1_ 2
APPLICANT
STREET ADDRESS I 710(`) /3 n m? CITYOV STATE Jf?N`LIP S L
TELEPHONE # CELL PHONE # F A X #
PROPERTYOWNER TELEPHONE# 651--6$8-(?618
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MIVNlS01'ARUI.F.S7fi70CA"CEGORl'1 MIVVt:SO'C.-1R('LF_S'Gi4
(d submission rype) . Residenhal Venhlahon Category 1 Worksheet Submitted • New Ener9y Code Worksheet Su6mrtted
• Energy Envelope Calculations Su6mitted
Plumbing Contractor:
Plumbing sys[em includes:
Mechanicai Confractor:
b4ectilnical svs[eni includes:
Sewer/Water Contractor:
Air Condidoning
Heat Rccovcrt' Systcm
Phone #
Phone #
Fee: $90.00
._---------°°-------•------------------------------------°---------------..__....-----•------°-------------°-----•-•-
I hereby acknowledge ihat I have read this application, state that the information is correct, end agree to comply
with all applicable Sfate of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
OFFICE U5E ONLY
_ Water Softener
_ Water Heater
No. of Baths
_ Phone #
Lawtt Sprinkler
No. of R.I. Baths
Certificates of Survey Received _ Tree Preservation Pian Recerved _ Not Required _
Updated 4102
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. AIt • Multi
? 03 0 1 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Eut. Alt - SF
? Oa 02-plex ? 10 08-piex ? 18 Deck ? 23 Porch(screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower levei ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
? 31 New ? 35 Int Impmvement ? 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 only) - Give PCA handaut 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
_ Foohngs (new bldg) FinaL'C.O.
_ Fvohngs(deck) FinaWo C.O.
_ Footings (addition) _ Plumbmg
_ Foundanon HVAC
_ Drain Tile Other
Roof _ Ice & Water _ F inal Pool
Ftgs Au/Gas Tests Final
_ Framing _
_ _
Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulanon _ Retaimng Wall
? Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8 Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Tatal
PERMIT ?
CITY"OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
Control No. ?4
PERMIT_TYPE: BurLoiaG
Permit Number: 000159
Date Issued: 0 4/ 0 3/ 9 2
SITE ADDRESS:
646 HILISIDE DR
LOT: 9 BLOCK: 2
DESCRIPTION:
B,oildirtg Permit Type SF DWG
Ouilding"'tJork Type NEW
U6C Occupariby.` R-3 M-1
Constructipn Type VN
Zoning r R-1
Building Length ? 56
Building Width -, 50
„?' . .
?
(%
REMARKS:
RECEIPT # ft72 (DI PRV
FEE SUMMARY:
Base Fee
Plan Review
Surcherge
3AC
3AC %
SAC Units
Subtotal
VALUATION $101,900
STAR PLBO.
MISC FEES
Total Fee
$643.00
$417.95
$50.50
;700.08
100
1
$1,811.45
$1,610.50
$3,421.95
CONSTAffjgNR:HOMES INC ? RPP1?18904744 0081 06WJEMSON HOpIES INC
2500 W COUNTY RD 42 2500 W CTY RD 42
BURNSVZLLE MN 55337 BURNSVIILE MN 55337
(612) 890-4744 (612)890-9744
165
I
Z hereby mcknowledge that Z havs read this
infarmaCion is correCt and egrea to comply
Statutes and Cq of Eagan prdinenaes.
AP ICANTIPER EE SIGNATURE
applfcatin» and state that Che
w3th all appYicable State of Mn.
ISSt1ED QY/ SIGNATURE
. • , cinr oF EacaN
1992 BUILDING PERMIT APPLICATION
681-4675
*3 (? d / • ? s?
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 when typing of permit is requested, but not picked up by last working day
of month in which re uest is made ar lot chan e is re uested once ermit is issued.
Date MAac?-i / ? / ga Valuation of work ?,77°
Site Location:
SiREET STE Y
Tenant Name:
LOT ? BLOCK SUBD. P.I.D. #
'Z? ?1Y]D 7 'j'\ qw)
Descri tion of work:
The applicant is: ? Owner 0 Contractor ? Other (Describe)
Name 56VtRS-z? la?nt? 'j'Ne' Phone V910- y7qy
Property LAST FIRST
Owner Address 2-S,21o W Cnv,jv '2w:?o `40,, _Sv r`6 ] zS
STREET STE #
City 9jJQ4')1V9u.`, State mt') Zip s33
Company S 5_VQ2:Sz,., - - jJJMM_ Phone
Contractor Address License #OQ01313"
City State Zip
Company nf VL"-r2[Ig? ?»??? _ Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber ST A2 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 1 appl' a State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING. PERMIT TYPE
? 01 Foundation
19 02 Single Family
? 03 Two-family
? 04 Multi-fam. T.H.
? 05 Apt. Bldg.
WORK TYPE
? 06 Garage/Accessory
? 07 Fireplace
? 08 Deck
? 09 Basement Finish
? 10 Swim Pool
0 11 Res. Add./Porch
? 12 Comm./Ind. New
? 13 Comm./Ind. Add
? 14 Comn./Ind. Rem.
? 15 Public Fac.
? ? 4 ]
? 16 Agricultural
? 17 Building Move
? 18 Demolition
? 20 Miscellaneous
Je90 New O 93 Remodel ? 96 Mave
? 91 Addition ? 94 Repair ? 97 Demolish
? 92 Alterations 0 95 Tenant Finish ? 99 Undefined
GENERAL INFORMATION
Occupancy I3NI-) Basement sq. ft. MWCC System YES_
Zoning ?_ lst fl. sq. ft. City Water
PRV R
i
d ,res
?
Const. (Actual) V-N 2nd fl. sq. ft. equ
re Es
(Allowable) V"N Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length ?6 r On-site well Census Code a/
Depth ? On-site sewage SAC Code o)
APPROVALS
Planning Building Assessments
Engineering Yariance
REGIUIRED INSPECTIONS
? Site
? Wallboard
? Footing
? Final
0 Framing
? Draintile
? Insulation
? Fireplace
wcc sac
SAL X
?0c) x
Fees: veimc;p,: : ld 1.oo n-
GaRAGE; 32 K22=704
Permit Fee (?y3, 0p Zx12 ??y
Surcharge 3o.SO -.1--
Plan Review 680 X!0 fs'ao
city sAC ao,?a
sac un;ts Water Conn. 6? -5 0
Water Meter 95,00
r Road Unit 3630100
rr
Zreatmerrt-Pl. 300,00
.
Read-444 Acei.3aGp. 30, o 0
ParlrBE+ct slLO I1t 30, oa
Gep4es siw s1c. SD
Other
Total :
7..40 j
X2 ?6 = -7 Z f
2oxas- sz=
6 x 4 =`aL
12-72xf5 = I?ja6o
IST F?oo?¢: g?y_ i272 '
1XUc q
1289,cs3= G794?
5?•pre?N
?--?'' loX/2= !'z-=X2Ss 3sae
) o09.i?
550195 ?
SURVEYOR'S CERTIFICATE SEVERSON HOMES
HILLSIDE DRIVE
0
m
?
- 85.00 Ivay-Sa ?? t ?
(854-5) /; o 0 1? ?85z,3?
/ o - ,
0
5? PROPOSED / 5 O
d
m DRIVEWAY ? rciif ?
-7
0 20.0
tiI°"/
s ?,o) i I S?
1?q GARAGE Lp C 8
N a+ N ? 24.0 0
O ? 10A --- m ? p Z
Z 2 m
ROPOSEO / N ?
0 i I two HOUSE I
?O.O '
I O
26.0 m o?ac?c _ is (p
N
J
OD
N
c es?,s ) -?'?
v_ I
LOT 9 ?
?EDRAINAGE d VTILITY
5ASEMINi F'ER PLATl,,\ 5
o O
- - 21.74 -- 6327 -'
S8905105"W S89°38'13'W?
L_I4IJ/-AlV i VL??.?`
?N Ir) r?r?i -i
IVL riL?.i I i?•I?.
NOTE: BVILDING DIMENSIONS SHOWN ARE FOR FIOF120NTAL NOTE: NO SPECFIC SOILS INVESTIGATION HAS BEEN COMPLETED'9 VERTICAL•LOCATION OF STRUCTURE ONLY. SEE ON THIS LOT BY THE SURVEYOR. TFE
SUITABILITY OF
ARCHITEGTUAL PLQNS FOR BUILDING 8 FOl1NDATION SOILS TO SUPPoRT THE SPECIFIC HWSE PROPOSED IS
OIMENSIONS. NOT 7HE RESPONSIBILITY OF THE SURVEYOR.
do - DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET
0 DENOTES IRON MONUMENT FOUND
X000.0 DENOTES EXISTING ELEVATION
(000.0) DENOTES PROPOSED ELEVATION
SCALE: 1 INCH -
PROPOSED GARAGE FLOOR -
PROPOSED LOWEST FLOOR =
P RO POSED,TjFJ•P,=.O15-BL-OC-K-=
30 FEET
gs-7,3 FEET
OSa•3 FEET
4357.'7 FEET-
? Q ?t)? ?-? ?-?
WE HEREBY CERTIFY TO SEVERSON HOMES THAT THIS IS A TRUE AND COkRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 9, Bbck 2, BUR OAK HILLS 2ND ADDITION, accord"mg to ihe recorded plat
ihereof, Dakota Counsy, Minnsscta.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 17TH DAY OF MARCH , 1992.
PROWSED GRADES SHOWN WERE SIGNE : JA R. HILL, INC.
TAKEN FROM THE GRADING, .
pRAINAGE 9 EROSION CONTROL
PLAN FOR BUR OAK HILLS 2ND
ADDITION PREP.ARED BY MERILA B ?
9 ASSOC., INC. DATED 2-3-88.
JOHN C. LARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19828
o < W D
E S -> ?{
D z j
m A p
l l m ? N j
James R. Hill, inc.
PLANNERS I ENGINEERS / SURVEYORS
2500 W. CTY. RD. 42 • BURNSVIILE, MN. 55337 o 612-890-6044
EXTER.^uR TMELO?E nVER?,G'c °U" M!PU':F17iC\
G41NER Si=,.Cm 1)..) I-ncnCS
57E ADDRE53 (,{(o h1)<L-i1ocS, t?s3..tvC% i
CO\7RAC70R j5c -Vey-;S? i.DA7"c 3-a5-92 rHONELl`1N
"` Determine wor;cing square foota5e of each
1. Total exposed wal) area ...... sq. ft. x_:,_,
2. Total roof/cei l i ng zrea .... ..T/L5 sq. ft, x_'n?ti
To•tal exposed wall area above i7ocr = z I S Z,
a. Total wa17 window area .......................... /1 7- .e?,1
b. Total door area ................................. C. ?Di.al Si1dlA] cl555dD?t' uYco ................... 221 64'
d. -ota1 f;replaca wall ar2z........................
- • z. "o?a7 wall ?raming area (averace lOw)............ J?.
f. Total net wall erea above ??loor ................. 1&g2Z
g. Tota] rim joist area .......... ................. oo •
? Total ekposed four,dztion area
h. ioia7 faurdztion ?;;;rdcw arez.....................
i. Toal net foundaticn area abov2 grade ............ --/-j ?O'
. . 'Deternine "U"'value cf each wall segment.
? a. I1 z, c4 X „ull
b. 37•77 X "U„
. c: 32. ? 84 'x 72 s = //, ??•
d. X "U" _
e. 17 g, 07 X,,u„
X ?,U,l
9. I BO , op x„u„
h.
; .-
3 ................
I` item #3 is the
of S3C 6005(c)2,
p3 = ??
X "U"
?X uuu , m?.-.
.....:...............TOtdl a?
sare a;, or less than ite.-ii „l,,you hava met the intent
. 7otal er.posed roo{/ceilino area
j. Total sl:yliyht orea . .......... ....... .. ,
I;, 7ota1 roo-4/cei1',ng framing area (av:rage 1^uN).. 12S?o
1. 7ota1 net insulateG rooi/ceiling area..,........ 11 3?i,Ja_
Deterrriine °U" value rCT' each roof/ceiling S:poent.
. j,y X I.W. k. I?SGJv X?U?? , 05 z /'i..Z o
1I11
; . I .x 11V
4 .................................. 7otal
7f Lotal of 4.4'is the sar: es, or less thar r2, yov have net the in;.ent of
S8C 6006(c)l.
Aliernate
io utiiize the total enveiop
3.: ?ZS,ZZBuilding Envelope Design '
sum of iiecs r'3 and ='4 shail
a sys:e:? ??e;hod, tne values estabiished by tne
r,ot be gra;ter than the swm, ol' ite.rs ?l and =2.
+ 2. 1F2,?? = z n,
-- ? 4.. ?iZ, Zt?. • g??
... . .. _. ?,..
' ` , ,
L 9. B!, CITY OF EAGAN
PIT
SUBD.
A14t_ &k /le& P(612)N661E4675
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
CITY USE ONLY
RECEIPT # L
DATE ? s
ALSO, FOR TOWNHOMES AND CONDOS
WORK DESCRIPTION
NEW CONST ?
ADD ON
REPAIR
OWNER NAME: tJet.1?Cr SG`l`.1 IV40/'7! S
SITE ADDRESS: !i ? f? °S i C'L
41e
INSTALLER: 4/ Y Ik ?"h cl
ADDRESS :fO t?o 14(i 0 i IN+--) Cj"
CITY: pf i Q( LAit t ZIP: s s IS J Z-
PHONE #:_`T`"1-7`CO-I 544' ?
COMPLETE THE FOLIAWING:
N0. FIXTURES EA. TOTAL
REPAIR/ADD ON 15.00
SHOWER 3.00
! WATER CIASET 3.00
/ BATH TOB 3.00 3
1 LAVATORY 3.00 3
? KITCHEN SINK 3.00
I LAUNDRY TRAY 3.00 3
HOT TUB/SPA 3.00
I WATER HEATER 3.00
I FLAOR DRAIN 3.00
GAS PIPING OUT.
? (MINIMUM - 1) 3.00 3
ROUGH OPENINGS 1.50 ALf;C)
OTHER
WATER SOFfENER 5.00
_ YRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
_ W. TURNAROUND 15.00
STATE SURCHARGE .50
TOTAL: S '2_01OC7
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.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS:
TENANT NAME:
SUITE #:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
CITY OF EAGAN
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)
L r'7 B oZ ,/? J MECgA1VICAI, ERMIT RECEIPT # CO
??70 S?
SUBD. (612) 681-4675 DATE -S / 9a-
RESIDENTIAL
PLEASE COMPLETE IIppEg ppRTION ONLY FOR SINGLE FAMII Y DWELLINGS. ALSO, COMPLEI'E FOR
TOR'NHOMFS/CONDOS R'HEN SEPARATE PF,RMT('S ARE gEQUIRED FOR EACH DVVELLING IINIT.
OWNER: FEES
STPE ADDRFSS: ADD ON/ItEMODEL (EXISTIIVG
CONSTRUCI'fONONLI) $ 15.00
INSTALLER: HVAC: 0-100 M BTU DO
PHONE ADDTfIOTTAL 50 M BTU 6.00
ADDRE55: GAS OU1'LETS - MINIMUM 1@ S3 EA. 'a10e
CI7'Y: SURCHARG& $ SO
SIGNATURE: TOTAL:
COMMERCW,
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCWJINDUSTRIAL BUILDINGS. ALSO COMPLEI'E FOR
APARTMENT BUILDINGS OR OTHER MUL1'I•FAMILY BUII,DINGS R'HEN SEPARATE PERMITS ARE NOT REQUIRED FOR
EACH DR'ELLING UNIT.
WORK DESCRIPTION: CONTRACT PRIC&
146 OF CONTRACT FEE FEES
STATE SURCAARGE IS $.50 FOR EACH
$1,000 OF PERMIT FEE.
$
PROCFSSED PIPING - $25.00
MINIMUM FEE - $25.00
a
OWNER: TOTAL: $
S11'E ADDRFSS:
1'ENANT:
3UITE #:
INSTALLER:
ADDILESS:
CI1'P: ZIP: .
PHONE #: CI1y SIGNATURE:
SIGNATURE.
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 646 Hillside Dr
Lot: 9 Block: 2 Addition: Bur Oak Hills 2nd
PID:10- 15501- 090 -02
Use:
Description:
Sub Type: e - Furnace
Work Type: Replace
Description: Furnace
Comments:
Fee Summary:
Contractor:
Sedgwick Heating & Air
8910 Wentworth Ave S
Minneapolis MN 55420
(952) 881 -7739
Quesetions regarding elec
952- 445 -2840
Crystal Gemuenden
8910 Wentworth Ave S
PERMIT
City of Eaan
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
cal permit requirements should be directed to Mark Anderson, State Elec
- Applicant -
Owner:
Daniel J Martin
646 Hillside Dr
Eagan MN 55121
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$50.00 0801.4088
$0.50 9001.2195
$50.50
Mechanical
EA081338
12/05/2007
ePermit
cal Inspector,
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 646 Hillside Dr
Lot: 9 Block: 2 Addition: Bur Oak Hills 2nd
PID:10- 15501- 090 -02
Use:
Description:
Sub Type:
Work Type:
Description:
Census Code:
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264 -4777
e- Windows/Doors
Windows/Doors-New/Replacement
House
434-
Applicant/Permitee: Signature
PERMIT
City of Eaan
Construction Type:
Occupancy:
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes.
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
- Applicant -
$88.50
$1.50
Total: $90.00
Owner:
Daniel J Martin
646 Hillside Dr
Eagan MN 55121
Permit Type:
Permit Number:
Date Issued:
Permit Category:
0801
9001
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
Building
EA092219
12/03/2009
ePermit
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA165707
Date Issued:11/16/2020
Permit Category:ePermit
Site Address: 646 Hillside Dr
Lot:9 Block: 2 Addition: Bur Oak Hills 2nd
PID:10-15501-02-090
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Matthew D & Katie V Olson
646 Hillside Dr
Eagan MN 55121
Anchor Roofing And Exteriors
101 Bridgepoint Way, Suite 140
South St Paul MN 55075
(612) 363-7443
Applicant/Permitee: Signature Issued By: Signature