665 Hillside DryY r'? ??•! s?- . _..+?
Wertificate nf Cccupanc4
(Otv of Cfagau
???? ? ?? 3wo-Velr6w
This Certificate issued pursuant to rhe requirements of the Unifornt Building Code
certifying that at the time of issuance thu structur+e was in canpliance with the various
ordinances of the City regulating burlding construction or use. For the following:
uu Classiacacion: 'F DW Bw paw 1,im 20228
?-p-cyType R3 1 RI VN
I?QTffi.STAF?DT EQ?l6•??J(?1'ST. S[?TTy?RIVE, EAGAN
Owncr of Building Addre.gs OIU
S??W Local? I' , s??? 60
Bu' ' g Addresc
" ?_ 03/I5/43
,
Building Oflicial
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
i t
t i I+' i l?? UF
' i ilPERMIT SUBTYPE:
i?il i f N"'.
PERMIT TYPE:
Permit Number:
Date Issued:
APPLICANT:
TYPE OF WORK:
RI I AN
t 1 NAl
F
L
Permk No. Permft Holdor Dato Telephono N
ELECTRIC
PLUMBING
HVAC
Inepectlon Date insp. Commenta
FOOTINGS
FWND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FlNAL C
a J
CI'i`Y OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS•
wIIs
' 1 c1 t' : i? d t 7' ' f2 I 01' k
f I I 1 i ; I D E f0I4
PERMIT SUBTYPE:
i; ',
!""i111'N(l
1N :111 A( I.rihl
t a E? t-i•I A{: f
RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
00 4. APPUCANT:
tF?l?'l
c T AF 11 I N001N( I
f r?r. '41 .",
TYPE OF 1NORK:
f- RAFM1 I Nr;
i [Nfi!
N C LJ
Ei+/ I I ts l Nr?,
H1ilA/91
rf'M A If a?;: kFcF I P ? 9
PRV s& w P i ek MCnOwar n ri r;c,
?
Permk No. Permlt Holds? Osste TNephone #
S/W
PLUMBING
HVAC ? ? ? 7 ? (S9 `Od Os
ELECTRIC
EIECTRIC
Inspectivn Dab Insp. Comments
Footings I »
J"i
Foundafio,
Framing ? 5 ?
Roofing
Rouo P?bg.
Rough Htg.
/-?
Isul.
<
F?replece
1 _ S3
-5-?3 3v?,/_ ?
Fnal Fltg. .7
O?sat Test
Rnal Plhg. Plbg. Inspector - NotHy Plumber
Const. Meter
ErgrJPlan
8ldg. Final
Dedc Ftg.
Deck Final
weu
Pr. oisp.
Address 665 HILLSIDE ??2IVE Zip 55122
I.dt ' 17 Blk s Sub BuR oAc xrrts zrID
THESE ITEMS WERE / WERE NOT COMPLETE AT THE T1ME OF THE FINAL INSPECTION.
Date: QVIS q Yes No Inspector: LzJ
Final grade (6" from siding) ?
Permanent steps (gazage) ?
Permanent steps (main entry) V/
Permanent driveway ?
Permanent gas
Sod/Seeded grass ?
TraiUcurb damage ?
Porch ?
Basement finish ?
Deck ?
Please verify with the builder the removal of roo£ test caps from the plumbing sys[em and the shuboff of water supply to
the outside lawn faucet before freeze potential exisu.
Contact engineering division at 681-4645 before working in right-of-way or imtalling underground sprinkler system.
White • City Copy Yellow - Resident Copy Pmk - Contractor Copy @
nMe) 7R
//CYc
aS_ c," .ld, 00
Request Date Fi N. Rough-in Inspection
Fl wreE?
? Reetly Now ?Hill NoM1y Inspectar
7 ? ypg E w When flaetlyl
IXlicensed contractor :1 owner hereby request inspechon of above electrical work at:
JaD Adtlress (Street Box or Route No.)
G it?s- d ? v Ciry
a?-.?
Section No Townsmp ame or No Ranga No Counry
OccupanflPRMT) Phona No
EG S?.?i -
PawerSUppher Aatl
re
ss
/
M?`
/
?
Elecincal ConVapor (COmpany Name) Con ?actor5 License No
s ? G. 040 9
MaJing AMress IGOnvactor or Owner Mak?ng Installation?
Aulnonie0 SignaWre I onVatlovpwner Makmg InstallaUon? P?one mber
I,rp't
D
MINNESOTA STATE BOARD OF EIECTPICITY
Gngqs-Miawey BIOg. - Room 5473
tBY1 Unrverslty Aw., SL Paul. MN 55100
Pnona (Btx) 5,12-0800
THIS WSPECTION REQUEST WILL NOT
BE AGCEPTED BY THE STATE 90AP0
UNLESS PROPER INSPECTION FEE I$
ENCLOSED
?/9? REOUEST FOR ELEC7RICAL INSPECTION ?6?A E&OpOpLOB
ji? See msimclions fOr campleting t?is tortn on back o1 yellow cropy x
6 9 5 7 8
- X"'Befow Work Covered by This Request
e Adtl Rep. 7ypeotBmlding ApphancesWired EquipmeniWired
Home Range Temporary Service
Duplex Water Heater Electric Heahng
Apt Bwlding Dryer Otheo-(Speaiy)
Comm./Indusirial Fumace
Farm Air Conditioner
Other(specdy) Conhaclor5 Remarks
Compute Inspection Fee Below.
k Other Fee # ServiceEniranceSize Fee # Circm[s/Feeders Fee
Swimming Pool 0 to 200 Amps/ d 0 to 100 Amps
Transformers Above 200 _ Amps A e 10 Amps
Signs inspecmr5 use oniy r TOTAL
Irngation Booms
Special Inspection ?X
Alarm/Communication THIS INSTALLATION MAY BE ORDER D DI ONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MON
I, the Elechical Inspector, hereby Rough-in oa? ? O•G
!
certity thai the above inspection has
been made. Final ?a ,9?
OFFICE USE'JNLY
This reQUest witl 18 months irom
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PIL07 KNOB RD, EAGAN MN 55122
651•681•4675
New Constmdion Reuuiremanta
. 3 registered sAe surveys showing sq ft. of lot, sq tt of house, and all moFCM areas
120 % mazimum lot ccverage allowea)
. 2 coDies of plan showug Oeam 8 window s¢es, poured founC Desgq elc.)
• 1 set of Energy Calculations
• 7 copies ol Tree Preservalion ?lan d bt Dlarted afler 711193
. fiim Joist Celail ODGons selection sheet (hlGgs with 3 or less units)
DATE
-? - ? - ci),
SITE ADDRESS MULTI-FAMILY BLDG _ Y ? N
TYPE OF WORK -]^ C> •??/'c?F' FIREPLACE(S) _ 0 _ 1_ 2
APPLICANT
STREET ADDRESS 9 7(nQ -'Ilce- /1/ CITY AY/?!W /' STATEl?>.+? ZIP
TELEPHONE # 7C3 -S?//•-o3n?/CELL PHONE #
FAX #
PROPERTYOWNER /1Vf'tN TELEPHONE# 651- v5%- 7170
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ N[[.N\'r:S0"l'.1 RULES iFiiO C:1"1'EGOI21' t _ IMi\ VlSO'1'.1 HliLP:S 7672
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
. Energy Envelope Calculations Su6mitted
Plumbing Contractor:
Plucubing system icicludcs:
Mechanical Contractor:
NIcclcmic.il scstcm includr,:
Sewer/W ater Contractor:
-- 3ir Coudiuonicig
-- Hcat Rccovcr}' Syslcin
Phone #
Phone #
rec: .y7o.oo
SEP 0 3 2002 M!
I hereby acknowledge that I have read ihis application, state that the information i cHrrect, and agree t mply
with all applicable State of Minnesota Stotutes and City of Eagan Ordinances.?
SignatureolApplicant l?/
__'-___---------°-°----°---°---..
OFFICE USE ONLY
Certificates of Survey Receroed _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
_ Water SoC[cncr
Watcr Heatcr
No. of I3aths
RemoEellReoair ReauiremenM
. 2 copies of pian
• 1 set ot Ener9y Calculations for heated a0aihons
. isitesurveytorextenoradEibons&decks
. Indicate d home served 6y septic system for additions
_ PlIORI' # ,
I.awrt Sprinklcr
No. of R.I. Baths
VALUATION
I --I I .-1 ':?
Fcc: $90.00
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16•plex ? 20 Pool ? 30 Accessary Bldg
? 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Mutti
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Eut. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Mutti
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
0 32 Addition C3 36 Move Bldg. O 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout 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 Bidgs Length Fire Sprinklered
Type of Const W idth
REQUIRED IN SPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ PlumUing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final Pool
Ftgs
Air/Gas Tests Final
_ Framin8 _ _
_
Siding Stucco Stone _
_ Fireplace _ R.I. _ Air Test _ _
Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Building Inspector
Base Fee
Surcharge
Plan Review
MClES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
,
?•- CITY OF EAGAN PERMIT
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
CR39445
PERMITTYPE:
Permit Number: guILoztiG
0 2 5 3 B 6
Date Issued: 0 4/ 14 / 9 5
SITE ADDRESS:
P.I.N.: 10-15501-170-03
665 HILLSIDE ?R
LOT: 17 BLOCK: 3
BUR OAK HILLS 2ND
DESCRIPTION:
64jilding`,P„ermit Type DECK
Building Wd,rk Type NEW
,-.
?
?
°
, .?.i
REMARKS:
FEE SUMMARY:
Base Fee $30.00
Surcharge $.50
Tatal Fee $30.50
CONTRACTOR: OWNER: - Applicant -
REIS ALLAN
665 HTLLSTOE DR
EAGAN MN 55121
(612)454-3118
I hereby acknowledge that I have read this applicatinn and stats that the
infiormation is correct and agree tQ comply with,all a.pplica4le State of Mn.
L Statutes and City of Eagan Ordinances. ,
c
APPLIC NTlPERMITEE SIGNATURE ISSUE BV: SI ATURE
.,
? 1995
New Constmatian ReaufremeMs
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
?? ??
,e
??? ?'??,? ?-?i?.
? 3 registered alte eurveys ? 2 eopies M plan
? 2 copies oi pians (inUude beam S windaw sizea; poured fitl. desfgn; etc.) ? 2 sRe surveys (exterior atlditions 8 dedcs)
? 1 energY ealwlatlnns ? 1 energy calcula6ons 1or heated addRions
? 3 copies of tree preservetion plan N lot platted after 7!1/93
required: _ Ves _ No
DATE: ?? ? ??? 5 CONSTRUCTION COST? ??UU? ? O?
DESCRIPTION OF WORK: ? ?-?? ,
STREET ADDRESS: ?o ?9 S (-I i I J S ? o'??z ? Q.\ U`z
LOT ?? BLOCK 3 SUBD./P.I.D. #: ?Q? C7?? ?r ?15 2 ???
td I SSDI l?0 03
PROPERTY Name: 1?`r- ? 5 i?1 \\ (?N Pnone #: ?? SU - 3???
OWNER `"" ""`?
StreetAddress• ??? ?'f???d - '??1??
City: ??? ??'? State: ?]? Zip: 5?? Z?
CONTRACTOR Company: N??}"" Phone #:
Street Address: License #?
ARCHITECT! Company: ?,?1
ENGINEER
Name:
Sewer 8 water licensed plumber:
change are requested once permit is issued.
City: State: Zip•
Phone #•
Registration #?
Street Address?
City:
State: Zip:
Penalty applies when address change and lot
1 hereby acknowledge that I have read this application and state that the infortnation is correct and agree to ccmply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: ?.? ?
OFFICE USE ONLY G°?C?C???NI??
Certificates of Survey Received _ Yes _ No ppR 1 D 1995
Tree Preservation Plan Received _ Yes _ No --------"'"""
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation o 06 Duplex
0 02 SF Dweliing o 07 4-plex
0 03 SF Addition o 08 8-plex
0 04 SF Porch o 09 12-plex
? 05 SF Misc. 0 10 _-plex
WORK TYPE
d? 31 New o 33 Alterations
0 32 Addition ? 34 Repair
GENERAL INFORMATION
? 11 Apt./Lodging o
? 12 Multi RepaidRem. ?
? 13 Garage/Accessory o
0 14 Fireplace a
c%K 15 Deck
? 36 Move
0 37 Demolition
Const. (Actual) Basement sq. ft.
(Allowable) Main level sq. ft.
UBC Occupancy sq. ft.
Zonin9 sq. ft.
# of Stories Sq, ft.
Length sq.ft.
Depth Footprint sq. ft.
APPROVALS
Planning Building
Engineering
Variance
c
o/
?
O
Permit Fee Valuation: $ /Z00 ?
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S!W Permit
S/W Suroharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
c -
A g? c rR
?t ' T1y ?? . tt
. ? ,.? . .,
? :. . ?.....
16 Basement Finish
17 Swim Pool
20 Public Faciliry
21 Miscellaneous
MC/WS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bidg
Census Unit
% SAC
SAC Units
• if ? - _ ?-. _ ? _ -
! --
"URVEYOFt'S CERTIFICATE ?ITTFLSTQEDT BROs coNST
/
o ?
, A
I LL/ ???
5 ? pRP?S I e
es? ?
;5)?? ? LOT 17 ?
85, , I \
w
Z
3592 2625- ,-C)
I'" WO
? 13.0 d P
'
14 O I
3v?S
' ?
/
N
in PROPOSED
? ,
HOUSE/ ?' I
M
O
XC m I
8633 65/ 4?/ ? N
/ I N
m
GA R, 281 283
? m 666 5 l-gpNCH MAA(
tl/09
' 2625 -- 4 F i
u. ._26'LS -
--
i0P OF PIPE
aEV:865 2t
V
p / 856 ?
?FF:
P JF
ELEV=86»9-?? I
,
POSEDI 5 g
? I
P
R
J
I
5I
I
D
R
VE1VAY
`
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1
(?idol? ?, -
- -
a
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- sss< -10000 S24°51'25" E -' e fi"
A65 8 862.3
L645 _
o
r
- --DRIVE
HILLSlOE
-----
-- .--
_
aeso 8624
SCALE I INCH = 30 FEET
)ames R. Hill, inc.
PLANNERS I ENGINEERS / SURVEYORS
2500 W CTl' qD. 42 • BURNSVILLE, MN 55337 • 612•890•6044 '
k . _ _ .. PERMIT
CITY OF EAGAN pERMITTYPE: suI L otN a
3830 Pilot Knob Road
Eagan, Minnesota 55123 Permit Number: ?D z 0 2?'s
(612) 681-4675 Date Issued: 0 1/ L 4 J 93
SITE ADDRESS:
6 65 IiII.LSIDc (7R
LOT: 0097 BLOCK: 0603
BUP, OAK FIJ.LLS 2ND
P.1.Ne? 10-15E01-170-0'
DESCRIPTION:
Bui,ldiriq herniiC 7ype :>P OWG
Building'Wurl, lype NEId
UBC Occ:upancy u-3 M-1,
Construction l"ype V--M
Zaninq R - .t
Builciing Len,yth
Efuildi.ng WidLh
Q?
REMARKS:
qec!_rPr %(9 raV s& w FLOR - Mcoorarai_D i=i Br
FEE SUMMARY:
VAI.UATTON 101,000
Raso: Fe, e
1'Lr311 R CV1£JW
Surcharge
SFtC a
SAC Uilit.s
Subi'otal
'#.b?ld.0u
?1157.'35
00
1C?@
1
_..._.. -- ?.1 , 861 e 15
hITSCliLLrllvFpUS ____ ?1z74?!.541
'ToLal (=eE $3?605.95
CONTRACTOR: - Appiicarit - sT. i_zcOWNER:
MIl7FLS'tAEDI' BP,OTI-IERS 14669125 0003n4' PnIiTL-L.STAk"UT BROS CONST
785 SUNSET UR %s35 SUNSE7 liR
Ef36++N ?lN 55723 ERGRN hln! 55:123
(6l2) 1755 -91'i'6 (6:12)456-9125
I hei•eby acknowledge Lhat S have read this appl.ication and state that the
infor°matian is correct ?,nd agree tn comply wi.th a11, app.licable 5tnte o'f Mn.
SP'atutes and L'ity of Eagan Ordinancese
I L-
?
? APPLICANT/P2RAAIT?F?8SGNATUR? - ED . GNATURE -
i
PERMIT N,
REACTIVATE
?? tAl
CITY OF EAGAN $3,
1992 BUILDING PERMIT APPLICATION
681-4675
a- ,
re?.? ^_?a
SINGLE 8 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 permtt is requested, but not picked up by last working day
of month in which re uest is made r lot chan e is re uested once ermit is issued.
Date 93 Valuation of work
Site Address: /..r/a SL S46eq- hzde5-
STREET SUITE R
Tenant Name: (commereial only)
IAT _1/7
1
BIACR 3
SUBD.
1
P.I.D. iF
Descri tion of work: C9c_ ? Y
The applicant is: ? Owner Eff Contractor 0 Other (Descrlbe)
Name Phone
Property LAST FIRST
Owner
Address
STREET STE M
City State Zip
Company //2?2? Jz2212=/!T d92i-. Lnvo-z- Phone Y56,912 5
Contractor Address _7g-.,5r 54v5?7' AZ License # DW311513 Exp. 9O
City '49i, State /Zi.v Zip 3?3'/:23
Company Phone
Architect/
Englneer . Name Registration #
Address
City State Zip
Sewer 6 water licensed plumber Processing time for
sewer 8 water permits is two days once area as een approved.
I hereby acknowledge that I have read this applicat9on 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: - 44-
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging co 46 ea ", merj, 60kish
19 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 Swim Pool
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory 0 18 Comm./Ind.
O 04 SF Porch ? 09 12-Plex ? 14 fireplace ? 19 Comm./Ind. Misc.
? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck O 20 Public Facility
? 21 Miscellaneous
WORK TYPE
IX 31 New O 33 Alterations O 35 Tenant Finish ? 37 Demolish
? 32 Addition O 34 Repair O 36 Move
GENERAL INFORMATION .
Const. (Actual) V- N Basement sq. ft. MWCC System `(E5
(Allowable) v- N, lst Fl. sq. ft. City Water
UBC Occupancy R-3 ?-I 2nd F1. sq. ft. PRV Required YE.?s
Zoning r{-i Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. fire Sprinkler
Length qZ? On-site well Census Code
Depth S I' On-site sewa ge S A C Co de ?0/
APPROVALS
Planning Building ?s I-i1-93 Assessments
Engineering Variance
REQUIRED INSPECTIONS
11 Site ? Footing ? Framing ? Insulation
? Mallboard ? Final ? Draintile ? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Mater Conn.
Water Meter
Acct. Deposit
S/N Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC % 100
SAC Units _L
I vetust;m: $_ 1OI.9 ODC)
C1AFtq6E,
Z4KL2-' S2$
CiSMT;
lsr Fi.«,z;
'&SMr,r32o
P?v 10f'2:Z
?f lilk_
2%zx89z=?a! .
41 xz4_ 98 9 x 16 = 8?84
4 xrv_ (56)
5v9'/z= 98
z%z x 8'/z= 21
z2X iriz= 253
5x14= ?o
?3 o K 15; 191?6?
SURVEYOR'S CERTIFICATE MtTTELSTAEDT BROS. CONST.
EA?Alq
NOTE: NO SPECIFIC 90LS I104tTqAT10N
NOTE: BUIIDINfi DI/DJf10NS SMOVYN ARE HAg BEEN ODMPLlM ON TFN$
???L'1?T mLAT 8Y THE SURVEYOR TIE
ATION Oi lT1111C71J11L OI?LII. SEE SUITAS161TY OP Sqla 10 pi"
AACM11{ICfYAL RAIN !OR lUIlDU1G ? THE SPECliC MOUK MID/Ow
8 FdNDWtOM DIMl1r10l1S. 19.NOT TIE REM?ON7N.Tf OF
DEPT
poG°owo M CQ LU) ? n L`]'U
o DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE; 1 INCH @ 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = BGG.B FEET
X000.0 DENOTES EXIS7ING ELEVAT!ON PROPO5ED I.OWEST FLOOR - Bs9 ( FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - 847-7- FEET
WE HEREBY CERTIFY TO MITTELSTAmT ffiOS. CONST TNAT THIS IS A TRUE ANO CORRECT
REPRESENTATION OF A SURVEY OF THE FtOUNDARIE5 OF.
Lot 17, 81ock 3, BUR OAK HLLS 2ND ADbiT10N, occordinq to the recorded
ph1 theraof, Dakofa County, Mlnnnsota.
IT DOES NOT PI,!RPORT TQ SHOW IMPROVEMENTS OR ENCRG:+CHMENTS, EkCEPT HS SHOWN. AS
SURVEYED BY ME OH UNDER MY DIRECT SUPERVISION THiS 4TH DAY OF JAN. , 1992.
PROPOSED GRA(ES $HOMiN WERE
TAKp! FRpM THE qp?p INO1 DIIAIN-
M[ 1 LIqf10N OO?fT110L PLAN
1^OR Om alf NM1! 2NO AOOITtON
P1??'AII?Q_,?'! x A?sa
RILAB 9 ASSOC.ING
LA4T DAr?O -
(n
_
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0 tD
W m
;
b m
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02 p
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W'V I ? ? ? ? 2
o mp -
i
- ? > I " O
z ?p "' z
O m 1 tl y W co
N . I I
HILL. INC.
('
JOHN C. LARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19828
James R. Hill, inc.
PLANNERS / ENGINEERS / SURVEYORS
2500 W. CTY. RD. 42 * BURNSVILLE, MN. 65337 o 612-890-6044
- ""i!'- I?_
S6HiJ
SURVEVOR'S CERTIFICATE
Wr-1ELsruFDT BRUS. CONST.
?
0 0
•-l" ? /
0
1 M
? 5 f ?
?t I ?
I ?F
es I
LOT I 7 \
7
851
W
a
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Z I ?
I
`V" 855
'
859.2 ?2625
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PLANNERS / ENGINEERS / SURVEYORS
2500 W CTY RD. 42 • BURNSVILLE, MN 55337 • 612-890-6044
LOT BIIR9EY CSECICLIBT !OR REBIDENTIAL
BIIILDING BRMIT 7?ppLIC71TION
? PROBERTY LpALi
?
Date of 8 eys
? ? ?
?S44MENT BTxNDARDB
'?'?r
? 0 • Reqistered Sand Surveyor signature and company
?? 0 • Buildinq Permit ]lpplicant •
D
' 0 • Legal description
0 0 0 • Address
?
' 13 0 • North arrow and bar acale •
- 0 • House type (rambler
split v/o
walkout
split antry
' ,
,
,
,
lookout, etc.)
0
I 0 • Directfonal drainaqe anows with slope/qradient =.
D
? 0 • Proposed/existinq sewer and water services
P 0 • Street name
0 • Driveway
LLEVATIONS
0 0-?
[)
• Existina
Sewer service
H? 0 0 • Lot corners
0- 0
? D 0
0 • Top of curb at the driveway
• Elevations of any existinq adjacent homes
Proflosea
D 0 0 • Garage floor
fl 0 0 • First floor
0 0 • Lowest exposed elevation (walkout/vindow)
II? 0
/ 0 • Property corners
i
D 0 • Front and rear of home at the foundation
POND2NG AREAB (if apulicable)
D C? ? • Easement line
0 0 • NwL
0 D • xwL
0 f? 0 • Pond # desiqnation
D D D • Emerqency Overflow Elevation
DIMENSIONS '
? D • Lot lines
• Right-of-vay and street width (to back oP curb)
0" 0 0 • Proposed home dimensions including any proposed decks
overhangs qreater than 21, porches, ,
etc. (i.e. a21
? structures requirinq permanent footinqs)
D ? • Show all easements of record and any Cfty utilities within
' those easements
M
0 0 • Setbacks of proposed st cture and setback of adjacent
existing home
D D/D • Retaining r nts, if any
/ Z
-?
- Reviewed: -
Na e / Dat
October 1992
wEx A?i+e
This form is anly applicable to detached one-and-two family dwellinqs. The
requi7rements herein are based on amended Section 502.2.1.7 in lie oP the
criteria apeciPied in Sections 502.2.1.1, .2 and .3.
Building Address: LOT ??) , 'R L QG4? -3 L?u,Z dAK___}/ic-?S ID/ 77oA'
Contractor or Owner:
!'12" Values
Ceilinqs
Walls* (exterior)
Design-q?-Required 38
Design2 Required 2_Q
Floors+
(overheated spaces)
Windows**
Foundation Walls
Slab-on-qrade
floors
Doors
Foqtnotes:
Desiqn2l Required 20
A.rea fsa ft1
(withog?' foundatior1)
Des ign4j7 Required 2 U/ 117 1 S, 9f p
Design134 Required 5
(when insulating full depth of foundation wall)
Design_Required 10
(when insulating only to frost depth & footings ?
extend below)
Des ign 9-,LRequired
Desiqn/q Required 3,
* For the insulated cavity of opaque walls, floors, and rim joists.
** Maxiaaum window area must not exceed 12 percent of the area of
exterior walls, not including foundation walls.
CERTIFICATSON
T hereby certify that I have completed the above information and that it
complies with t'Minnesota State Enerqy Code.
Siqnature .l ? Date: / '7 93
I :
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
PLt1"SPG;;PE"
FOR CITY USE ONLY
PERMIT
RECEIPT #
#
DATE: /
PLEASE COMPLETE UPPER PORTION ONLY FOR SZNGLE FAMILY DWELLINGS &
,.. ....... .•..
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH IINIT.
------------------------ -------------------°------------------------------
WORK DESCRIPTION COMPLETE THE FOLLOWING:
N0. FIXTURES EA.
NEW CONST ADD-ON MINIMUM 15.00
ADD ON ?- _ SHOWER 3.00
REPAIR _ WATER CLOSET 3.00
BATH TUB 3.00
LAVATORY 3.00
OWNER NAME: KITCHEN SINK 3.00
LAUNDRY TRAY 3.00
SITE ADDRESS: 4!:? e?,J' HOT TUB/SPA 3.00
WATER R 3.00
LOT:? BLOCK -S- SUBD. FLOOR DRAIN 3.00
2 GAS PIPING OUT.
INSTALLER: LL?'Q _ (MINIMUM - 1) 3.00
?E ROUGH OPENINGS 1.50
ADDRESS: /OaI / ' /?/tqRtE R OTHER _
WATER p1"?/ Zip;
?/??? ? PRIVATE DISPER 155.00
.00
CITY: -
U.G. SPRINKLER 3.00
PHONE
SIGNATUIiE or•
SUBTOTAL
ST. SURCNARGE
TOTAL:
TOTAL
? O t::7
.50
?jra
.i `
qpMMHRC:ZAli4NDtCSTRIAL_: PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS A
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
----------------------•
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
CITY OF EAGAN
ZIP:
FEES
1% OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18
STATE SURCHARGE
TOTAL:
(SIGNATURE)
sa 0 9
1993 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH IJNIT.
y NEW CONSTRUCTION
_ ADD-ON A/C
ADD-ON FURNACE
DATE
HVAC: 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLET$ (MINIMUM 1 @ $3.00 EACH 13
( FT?, r-'`Gtt ? 1 171 r` a t- •? ?''
ADD-ON/REMODEL (Exis7'ING CONSTRUCI'ION)
STATE SURCHARGE
TOTAL
SITE
; 0/,2.. Ve_.
FEES
$ 24.? .
1,0v
$ 15.00
' 5
OWNER NAME: 1s /'?:t ext? 3 YO -f. /%LEPHONE #:
INSTALLER: Burnsville Heatin? & ?iG InR
12481 Rhode Island Ave. So.
ADDRESS: Savage MN 55378•1122
894-0005
CTI'1': STATE: ZIP CODE:
TELEPHONE
l ? ?J
SI ATU OF PERMITTEE
PLEASE COMPLETE FOR ALL COMvIERC1AI4NDUSTRIAL BUILDINGS. AISO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMTTS ARE NOT REQUIRED FOR EACH DWELLING UNTT.
DATE:
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
CONTRACT PRICE: $
FEES
1% OF C?NTI2i?1:C,"T' FEE
PROCESSED PIPING:
MINIMUM FEE:
STATE 3URCHARGE
TOTAL
$
$25.00
$25.00
$.50 FOR EACH $1,000 OF FEE
$
Si-i'h' ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IMPROVEMEN7'S ONL1)
INST
ADDRESS:
CITY:
TELEPHONE #:
STATE: ZIP CODE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
1993 MECHANICAL pERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AIdD
CONDOS WHEN PERMTTS ARE REQUIItED FOR EACH UNTT. ,
NO. FIXTURES EACH TOTAL
I SHOWER 3•00 3 -
a WATER CLOSET 3•00
L BATH TUB 3.00 3
_
3 LAVATORY 3•00 ?
/ KITCHEN SINK 3.00 3
i LAUNDRY TRAY 3.00 3
i HOT TUB/SPA . 3.00 3
L WATER HEATER 3.00 ?
-
_
/ FLOOR DRAIN 3.00 ?
/ GAS PIPING OUTI,ET • minimum - t 3•00 3
3 ROUGH OPENINGS 1.50 •?
WATER SOFTENER $•00
PRIVATE DISP. • Dak.Cty. lic. 15.00
U.G. SPRINKI.ER • nome uoder oonst. 3•00
ALTERATIONS • w etisting 15•00
WATER TURN AROUND 15.00 ?
STATE SURCHARGE .50
TOTAL:
90
STTE
OWNER
_t? -
C1TY:_ Z, a AMIV14 STATE:_
PHONE #: OW-) ? 5?? 7 3 _3?L
1993 PLUMBING PERNIIT (RESIDEIV774I.)
C1TY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
a 1A/Yir ZIl' CODE: _2??
PLEASE COMPLETE FOR ALL COMIvIERC1Al,/INDUSTRIAL BUIL,DINGS. ALSO FOR MULTI-
FAMILY BUILDINGS WHEN SEPARATE PERMTTS ARE NOT REQUIItED FOR EACH
DWELLING UNTT.
_ NEW CONSTRUCl'ION
ADD ON
REPAIR
WORK DESCRIPTION:
CONIRACI' PRICE:
FEE: 1% OF CONTRACT FEE
STATE SURCHARGE $.SO FOR EACH $1,000 OF rtRMr{' FEE.
MINIMUM FEE $ 25.00
CONTRACT PRICE X 1%
STATESURCHARGE
TOTAL
SITE ADDRESS:
$
$
$
TENANT NANZE: STE. #
OWNER NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
STATE:
ZIP CODE:
FOR:
CITY OF EAGAN APPLICANT
1993 PLUMBING PERMIT (COMMERCIAI.)
CITY OF EAGAN
3830 PIIAT KNOB RD
EAGAN MN 55122
(612) 6814675
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
3830 P OT KNOB RD 55122 :1 c' ? "-
651-681-4675
New Construction Reauirements
? 3 registered sile surveys showing sq. lG a/lot, sq. ft o/house
and a!1 roafed areas f20% maxtmum lot covereve ailowedl
? 2 copies of plans (show beam & window sizes: poured tnd. design; etc.)
? t set ot energy plalatlons
? 3 copies of tree preservation plan if lot platted aker 7/1193
DATE: I I I Sy,? 99
DESCRIPTION OF WORK:
Remadel/Reoair Reauirements
? 2 mpies of plan
? t set of enargy plalations fw heated additions
? t site wrvey for ezterior additions & dedcs
CONSTRUCTION COST:
0,1000
-? n
STREET ADDRESS: Csz rk ?-4?'
LOT: BLOCK: SUBD.lP.I.D. #: C7?4? Z ' -4+°6? -
Natne:_ / 1' l ('?F (l? _ _ Phone ii:
PROPERTY OWNER Street Addrcss: (.9 L9S Sldu -2L??
' ----
City ??? Pvt-? _ --- - State: fy\t"') Zip:
Company:_ _ Phone #:
CONTRACCOR
Stree[ Address:__ ___ License # __ Exp.
City State: -- ---- Zip:
ARCHITECT/
ENGINEER Company:______ ___ Phone #: __----
Naine: ----------- ----- Registration #: -- ---
Strce[ Address:______ _ -----
City - ----- State: ---- 7'P' -------
Sewer & water licensed plumber (reauired for new constructlon onlv):
Penalty applies when address change and lot change is requested once permit is issued.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all appiicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY ILE - h C? _ .. i i
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 02 SF Dwelling ? 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 1 of _ plex ? OS 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened)
? 04 2-plex ? 09 7-piex ? 14 Apartments x 19 Lower Level ? 24 Storm Damage
0 05 3-piex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia
? 32 Addition O 36 Move Bidg. ? 40 Gas Insert ? 44 Windows/Doors
><? 33 Alteration ? 37 Demolish Bidg. ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
GENERAL INFORMATION
?
Const. (Actual) 5•^ Basement sq. ft. Census Code 43?t'
(Allowable) S' • ? Main levei sq. ft. SAC Code 6 L
UBC Occupancy tL-3 sq. ft. No. of Units _I
Zoning ? sq. ft. No. of Bldgs _[L
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS ? •
Planning
Building
Engineering
Variance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
Valuation: $
% SAC
CSTY f?F EAGAN
CA51-I:[EFie fi TERMTNAL. N0: 335
DAl'Ea 0306/99 TSMCe i`':;:0M45
ID;
AlAME- FlI_AM S ftiEIS
3210 9001 665 H:CLI_SIriE PP. E0.00
205 9001 665 FIIL.I_S:I:DE DF' 0.50
11
Tota:l. Rr-,cei.pt Amount e 60.50
M03990
lJS1=K If?: tJANCY
?
PERMIT
City of Eagan
3830 PILOT KNOB RD
EAGAN, MN 55122
(651) 681-4675
Site Address:
665 Hillside Dr
Lot: 17 Block: 3
Addition: BUR OAK HILLS 2ND ADD
Description
Sub Type: LowerLevel
Work Type: Alteration
Description: & Fireplace
Census Code:
Permit Type: Building
Permit Number: EA034690
Date Issued: 03/16/1999
UBC Occupancy:
Canstruction Type:
Zoning:
Square Felt:'%,,,
ReIllat'1{S: Plan reviewed by Craig Nnvaczyk
Seperate permit required for any plumbingwork.
Call (612) 445-2840 regarding electrical permit and inspections.
Fee Summary:
Contractor:
4
State Surcharge - Fixed
Permit Fee - Fixed
ST. Lic.:
651-454-3118
Owner:
Allan Reis
665 Hillside Dr
Eagan, MN 55121
?
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.
0.50
60.00
$60.50
- Applicant -
Applicant/Permitee: Signamre I ed By: Signature
? JfN 29 '93 12:41PM L.AR50N ETIGINfERING OF hN
Laraan Enginee?Ing pf Nlnn"otp
3524 Laboro Road
WhNo 6au I.aka, Minneeefa $5110
612 4814120 Fax: 612 481-8201
5 Larson
Jaauary 29> 1993
MITTELSTAEDT SROTHER5 CQNSTRUCTiON
Atta; Dean Mittalstaedt
785 Sunset DrivE
Eagau, MN 55123
P.2
RE: House Inspoction - Basement W
665HiUsideDrive C3&k
Eaga,n, Minnesota
I.EM CommiWon #93061
Dear Dean:
At your request I have iaspected the crackad masonry basement wall at 665 Hillside
Drive in Eagan, Miaaesotn,
The masoary wall cracked due to a lack of curing time allowed for the wall prior to back
filiing aad in inadequate lateral braciag.
In addition, it is my opinion that the mortar joints in the block wall had initially frozen
to a point where the permanent bond of the morcar to tbe block is in question for future
structural capabi3itiee in resistiag the lateral easth presaunes agaiast the wall.
in order to restore the structural integrity of the wall I rocommend the wall be returned
to the original position, grouted solid and number five rebar at flPty six inches on center
placed vertically in the wall. The rebar should be centered 'm the taelve inch wall.
if you have aay further questions regarding this matter please give me a call.
/? ,
Dou R Flughes, P. .
DRH;j]
cc: Dale Schoeppner - Building Iaspector, City of Eagan
R-95% 01-29-93 11:42AM P002 1t03
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PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA177398
Date Issued:06/29/2022
Permit Category:ePermit
Site Address: 665 Hillside Dr
Lot:17 Block: 3 Addition: Bur Oak Hills 2nd
PID:10-15501-03-170
Use:
Description:
Sub Type:Water Heater
Work Type:Replace
Description:Tankless 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 -
Adam & Sara Rodriguez
665 Hillside Dr
Eagan MN 55121
Homeworks Services Co Dba Homeworks Plumbing Htg
1230 Eagan Industrial Rd, Suite 117
Eagan MN 55121
(612) 400-9020
Applicant/Permitee: Signature Issued By: Signature