3322 Rolling Hills Ctoft.- Q.?
WVrtificatc of ccnoattcv
Of M
?" of laxishm
This Certificate issued pursuant to the requirements of the Uniform Building Code
certifying that at the tine of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
Use Clasaifkatim SF DWG Bldg. Permit No. 1407
Occupancy Type 1 Zoning District R1 Type Comet. VN
Owner of Bn;ming rIITIELSTAEUr BFDIHERS Addmss 785 SLIM M MM, FAGM
BW&W-Address 3322 ROLLING Ha LS JOM LACality L5, B5, BUR OAK HaIS 21m
10/27/92
o.vw
Building
POST IN A CONSPICUOUS PLACE
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
Control No.
-9- `J L-. %
001401'
09/08/97
(612) 681-4675
SITE ADDRESS: L O I , ke I or- r. , S APPLICANT:
13,'2 ROLLING NILLr, CT MITTEI STAEOT BROTHERS
OUR OAP I1I I.L S 2NQ (612) 466-9125
PERMIT SUBTYPE: TYPE OF WORK:
`.f 01,111 "pw
r110 11 NCi 1 1 1 F RAM I NO
I N`-111 A I 111H I I I F f NAL
f Ile FVI hi l
RFMAPP S : 5 A W CONI RAC TOR -- NVOONAI D P1136
Permit No. Permit Holder Date Telephone #
SIW
PLUMBING cY
HVAC .7y
ELECTRIC • (? ?/? +?'I
ELECTRIC
Inspection Date Insp. Comments
Footings I
Foundation
Framing
Rooting
Rough Pibg. r,
Rough Htg.
IsuL
Fireplace
Final Htg. p o?S r1
Orsat Test
Final Pibg. Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Final l0 2
Deck Ftg.
Deck Final
Well
Pr. Disp.
Address: 33 22 RDLLM HILLS COMLot 5 Blk 5 Sec/Sub BUR OAK HILLS 2ND
These items were/were not complete at the time of the final inspection.
Date; 10/27/92 Yes No TnqpPotor, 99
Final grade (6" from siding)
Permanent steps - garage fI-ol
Permanent steps - main entry
Permanent driveway v
Permanent gas
Sod/seeded grass j/
Trail/curb damage
Porch V
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing
system and the shut-off of water supply to the outside lawn faucet before
freeze potential exists.
White - City copy Yellow - Resident copy Pink - Contractor copy
SEDGWICK HEATING & AIR CONDITIONING CO. resH RECORD JOB NO.
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 • (952) 881-9000
ADDRESS
OCCUPANT -
-C-SOLD BY L? ?fvl O- W7-!. N
MAKE G i v,-o `,-
r
SERIAL NO. _5 / .
THERMOSTAT -?' c5G C
VALVE /
?'I dii1.Z /d,?-1
LIMIT _(71
•'I
LIMIT SETTING !
FAN SETTING
"v -
PILOT TYPE J? ( .r c
IGNITION MODEL ?/ 5 ,
PILOT TIMING
PRESSURE " C'? ?
INPUT CFH J
STACK TEMP. 3
FORM 23 (REV. IiM)
PERCENT CO,
PERCENT 02
PERCENT CO CI
CITY-, ei V
11i
OWNER ??p
INSTALLED BY /Ul 1i2L
MODEL
INPUT C./ O C
VENT SIZE I
?1s7
TYPE OF LINER
LINER SIZE
FILTERS: SIZE NUMBER
WIRING
TEST TAG
LIGHTING INST.
DATE TESTED ! I-
COMPANY TESTING •? ?? I l
NAME OF TESTER
FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY - CITY
n /077Q0
'
Request Date Fim o. Rough-in Inspecti n
Required?
C1 Reatly Now
Will Notify Inspector
n R
Wh
d
?
Yes ? No a
ee
y
1 - icensed contractor ? owner hereby request inspection of above electrical work at:
J D Address 'Street. Box or Route No.) City
Section No, Township Name or No. Range No. COunty
Occupant IPRINTI
r
' Phone No.
2
eo
L 7 2
Power S polls, n
S 7` .Qpc. Atltlrass
ea
Electrical Contractor (Company Name) Contractors License No.
sC/? mac.
Mailing Address (Contractor or Owner Mak'mg Installation)
t
Au onzeo Signs re (COmractmormer Making Installation) Pho a Number ??yy??
O W
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room 5-173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) $42-0NO ENCLOSED.
•, 6 Y REOUEST FOR ELECTRICAL INSPECTION "q EB-ry000017-0e
? See instructions for complating this form an beck of yellow copy.
K 4.7 7 "X" Below Work Covered by This Request `l
ew Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm /Industrial Furnace
Farm Air Conditioner
Other tspenly) Contractors Fisher":
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circufts/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps If I Above 100 -Amps
Signs Inspectors Use Only: TOTAL
Irrigation Booms ??
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE O I C NECTED IF NOT
Other Fee COMPLETED WITHIN 18 MO 1 r
I, the Electrical Inspector, hereby Bough-in
?b
certify that the above inspection has
been made. F;nal re
OFFICE UBE ONLY
This refusal void 18 months from
2007 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 4 651-675-5675 FAX # 651-675-5694
New Construction Reaurantents
3 registered site surveys shaving sq. ft. of lot, sq. tt of house; and ell roofed areas
(20% maximum lot coverage allowed)
I Soils Report If proposed building is to be pWcetl on disturbed sal
2 copies of plan shoving beam 8 window sizes; poured found design, etc.
I set of Energy Calculations
3 copies of Tree Preservation plan h lot platted after 711 N3
Rim Joist Detail options selection sheet (buildings with 3 or less units)
!Annegasco mechanical ventilation form
Remadel/Reoair Reauirements
2 copies of plan shoring footings; beams, joists
1 set of Energy calculations for heated add lions
l she survey for additions It decks
Addison - irdfcate 90n-site septic system
w '•W
1 s c-na y N
1131o. & or= r ^nairlararl nuhlic infnrmatinn unlass you state thev are trade secret and the reason.
F te
e Address ?c? o ?? 1nC Construction Cost
±!i 1yl?'C unit/ste #
RQQ???
,P--
Description of Work VVLAo,/VS \Cto0o
Multi-Family Bldg _ Y N Fireplace(s) _ 0 2
Property Owner ? ??S=A 44 ? /
C ?Q nn /
(}(Q3) t{ ?? - t
Telephone If
Contractor GV\oa--V- LCL-IL` \1nCQVVS ,A
W l"Cl
Address ii`AL50 LLLv ,Ac-
State mV\ !
?
? )yAVc
Zip `J icD sty ! o nl n
Telephone # (1Sa) 8°t 1- 34 C0
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Category I _ Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
(J submission type) Submitted Submitted
. Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and 'codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only 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 juhich [equireS a r d
approval of plans. I Il l LS o-0 U
Liss& 4-'?7 ?-a q- on
Applicant's Printed Name
DO NOT WRITE BELOW THIS LINE
Sub Types
? 01 Foundation
? 02 SF Dwelling
? 03 01 of_ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
Work Types
? 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi
? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. AR - SF
? 16 Deck ? 23 Porch (screen/gazebolpergola ) ? 36 Multi Misc.
? 10 08-plex
? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 12 12-plex ? 25 Miscellaneous
? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
-Demolition (Entire Bldg) - Give PCA handout to applicant
Descriotlon: Water Damage _ Yes
Valuation
Plan Review _ 100% or _ 25%
Census Code
SAC Units
# of Units
# of Bldgs
Type of Const
Occupancy MCES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
_ Foundation
_ Drain Tile
Roof _ Ice & Water - Final
Framing
Fireplace _ R.I. _ Air Test - Final
Insulation
REQuIRED INSPECTIONS
_ Sheetrock
_ Final/C.O.
_ Final/No C.O.
_ HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding _ Stucco Lath _ Stone Lath -Brick
_ Windows
Retaining Wall
Approved By: Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
PERMIT
CITY'"OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDING
001407
09/08/92
SITE ADDRESS:
3322 ROLLING HILLS CT
LOT: 5 BLOCK: 5
BUR OAK HILLS 2ND
DESCRIPTION:
-Building Permit Type SF DWG
Building`Work Type NEW
UBC Occupancy R-3 M-1
Construction `Type V-N
1 Zoning R-1
Building length ( 51
Building Width 52
t, i.l
REMARKS: L- Z) 2 O -1 a?
S & W CONTRACTOR - MCDONALD PLBG
FEE SUMMARY-
Base Fee
Plan Review,
Surcharge
SAC
SAC %
SAC Units
Subtotal
VALUATION
$727.00
$472.55
$62.50
$700.00
100
1
$1,962.05
$125,000
MISCELLANEOUS $1,610.50
Total Fee $3,572.55
CONTRACTOR: - Applicant - ST. LI OWNER:
MITTELSTAEDT BROTHERS 14569125 000344 MITTELSTAEDT BROS
785 SUNSET DR 785 SUNSET DR
EAGAN MN 55123 EAGAN MN 55123
(612) 456-9125 (612)456-9125
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 Min.
Statutes and City of Eagan Ordinances.
L-
Control No. 1025
bow 141V 11"
APPLICANT/PER ITEE IGNATURE ISSUED EfY: SIGNATURE
PERMIT #
REACTIVATE
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION
681-4675
7106 3 1 IZEco
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 guest is made or lot change is re nested once ermit is issued.
Date $ / 3/ /
9- Valuation of work /3?'
J,
Site Address: 3?ia'a /?ClL4,rJ /Yet Cr:
STREET SUITE R
Tenant Name: (commercial only)
LOT _
1 BIACR t 2 -_?,
BUBD. 4SX4
P.I.D. M
2
Description of work: toe.. A;7'4,?
The applicant is: ? Owner E?Contractor ? Other (Describe)
Property Name Phone
LAST FIRST
Owner
Address
STREET STE N
City State Zip
Company 7- 221Q& Phone 9135 /L?
Contractor Address '78:5 Sc???s License # #0 Exp.
City State Zip _ /?3
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
Sewer & water permits is two days once area as 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
_
k9. 02 SF Dwg.
? 03 SF Addition
? 04 SF Porch
? 05 SF Misc.
WORK TYPE
)I 31 New
? 32 Addition
? 06 Duplex
? 07 4-Pl'ex
? 08 8-Plex
? 09 12-flex
? 10 Multi. Add'l
? 33 Alterations
? 34 Repair
GENERAL INFORMATION
? 11 Apt:/Lodging u E2.16 ,Basement Finish
? 12 Multi. Misc. ? 17 Swim Pool
? 13 Garage/Accessory ? 18 Comm./Ind.
? 14 Fireplace ? 19 Comm./Ind. Misc.
? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
M
? 35 Tenant Finish ? 37 Demolish
? 36 Move
Const. (Actual) V- N Basement sq. ft.
(Allowable) y - N Ist F1. sq. ft.
UBC Occupancy R3 M-1 2nd F1. sq. ft.
Zoning Sq. Ft. total
N of Stories Footprint Sq. ft.
Length On-site well
Depth se On-site sewage
APPROVALS
Planning Building
Engineering Variance
REQUIRED INSPECTIONS
? Site ? Footing
? Wallboard ? Final
MWCC System YES
City Water YES
PRY Required
Booster Pump
Fire Sprinkler
Census Code Jot
SAC Code C) I
Assessments
? Framing ? Insulation
? Draintile ? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC %
SAC Units
?? y vetwtiom 8_-125
l z„S o
y?z. s 61 ARA4E; 22 X27-= 484 X/(== 1244
Ssrnr ayy24=51761?167- °fzI(.
L.
`3oK?y = fan
925 XSass
IsT Fl ba4l
t.]srn7=
Lo ter, -7 '2.S
? X f?= to
97- IK2u= 7-y
13 C?3.
3 rb, 4 21
c ? e'A?T
u?su?
7K2r ?`?
J X y-?r
SEP-04-192 FRI 10:23 ID:JRNES R HILL INC TEL N0:612 890-6244 #415 P02
"i4
SURVEYOR' CERTIFICATE MITTELSTAEDT BROS. CONST.
879.8 9/.25
/ n 9•I•) I
(?- -? N 9e08I10" I`- ' /30
s DRANgpe
E43 ENT PERTPLIATx`818 ?B7HT
W I la
?7L?T 5
88(15 x ?C9 9.?' _ (878.5) 878.8 3QOOB???
?_ 1 1 48.0 -?- -
I
I PROPOSED ???ppp
1 HOUSE
L N O / MZ N
tti _ ?' J
n ? -..' (s7y.5) I yI
b aAR.Q_ 1 I
DE
TOP OF P MN MARIPE N I 879./ a -- 8778 3000 '
ELEV.:879.19'-` n B ? ((i97,?' I ? `?1 ?gEppC?1p? qp?
MAM(
PROPOSED
x875, ?? RNEWAY $ ?ELEY.=87'5.93 .
876.6 ' ?? I r
34
13.43
+? Il L-? Ca'
87W
t
102- =?---_-
R a' o o? ?yN
878.4 'Lt00!4y -- -32.14 _ GINFERING DEPT
SO°21'48°E a7z6
-o
M
B ROLLING HLLS COURT 8720
NOTE: BULDNB DIMENSIONS SHOWN ARE FOR HORIZONTAL NOTE NO SPECIFIC SOILS INVESTIGATION HAS 8@I COMPLETED
6 VORTICAL I,.OrEET10N OF STRUCTURE ONLY. SEE ON THIS LOT BY THE SURVEYOR, THE SUITAILI?TYy OF
dIMENINDU. r1AN5 FOR BUILdNO 8 FOUNDATION SOILS TO SUPPORT THE SPWFK HOUSE MIDPOM IS
In DENOTES PROPOSED SURFACE DRAINAGE NOT THE RESPONSIBILITY OF THE SURVEYOR.
0 DENOTES IRON MONUMENT SET SCALE:1 INCH - 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - $ 78- / FEET
XOOO.O DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - g7 /. f FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK -8 79• L FEET
WE HEREBY CERTIFY TO MITTELSTAEDT EROS. CONST. THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lai 5, Block 5, BUR OAK HILLS 2ND ADDITION, according to the recorded
pht thereof, Dakota County, Minnesota,
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS. EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUP RVISION THIS 17TH DAY OF AUGUST ,1992.
PROPOSED GRADES SHOWN WERE SIGN D: J R. HILL, INC.
TAK 4 F`lOMrMHTHE 111 0a N INO, PLAN
9118pO? HMILELS qEND ADDITION eo
MPT DAtED 2-SAIIiB.B ASSOC'INC
uwieu -S 99 JOHN C. LARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19826
T ID o A
James R
Hill
inc
O F= r-3 ? W O G m O N q ,
•
•
-
O r m
m O
° Z Ph
m N
V) ID 7,
°
' D
m
?
`
LANNERS /ENGINEERS /SURVEYORS
T A O A
m
y c
fl
7
m
<
- N 2500 W. CTY. RD. 42 • BURNSVILLE, MN. 66337 • 812,890.8044
R=95% JAMES R HILL INC 09-04-92 10: 25AM P002 #02
,
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION DATE./,
OWNER
SITE ADDRESS
n?1 W44? .f.
CONTRACTOR I I I i i ELtr,Tr? AT [+4 /li1Tk A,5 rw esr11 ,. ro? I ty
ADDRESS_?g SmA., r ?n Env,r.J PxoNE ys? qJ
DETERMINE WORKING SQUARE FOOTAGE OF EACH
1. Total exposed wall area ... 3g2-O7, 3 sq. ft. x .11 . ??
2. Total roof/ceiling area ... JL/ 7 g, 0 sq. ft. x •026
Total exposed wall area above floor - 1 911e..
a. Total wall window area ......................... 129LIg
b. Total door area ................................ q, 4
c. Total sliding glass door area .................. L 3,
l0
d. Total fireplace wall area ...................... 0
e. Total wall framing area (average 10%) .......... 10 2,
f. Total net wall area above floor ................ i %,? 21L
g. Total rim foist area 34,1.2
Total exposed foundation area
h. Total foundation window area ................... 11,3
i- Total net foundation area above grade .......... 100.0
Determine "U" value of each wall segment.
a. '256.9 x ,fu„ . y2 - /07 q
b. 34, N X Tfull . 07
C. X "u" y2 - 2G.'7
d. 0 X "U" Q 0
e._ 3en .'7 x "u" .11 33.3
f. I STl I X "U" Qq 3y - 92. /
g• 34.1.2 x tuft .oy4 - /5 9
h. 11,21 x ,lull 47 - q, 7
i. I QQ? Q X "U" 01011, -71o
3 . ...............................Total - 4 0
If item 03 is the same as, or less than item 01, you ave met the intent
of SBC 6006 (c)2.
-I-
Page 2 of 2
Total exposed roof/ceiling area - I q 1 $
j. Total skylight area ........................... 0
k. Total roof/ceiling framing area (average 10%).. y 2, y
1. Total net insulated roof/ceiling area ......... 8 $, G
Determine "U" value for each roof/ceiling segment.
j• n X null in 6
k. 92,x/ X "U" .0259 ° 2,'/
1. X „u„ .O1r8
4 ..........................................Total - it/
If total of 64 is the same as, or less than 92, you have met the intent
of SBC 6006(c)1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by
the sum of items 03 and 04 shall not be greater than the sum of items
01 and Q2. ,
1. + 2.
3. + 4.. .. .
-2-
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Requirements
• 3 registered site surveys showing sq. it. of lot, sq. fL of house; and all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan stowing beam & window sizes; poured found design, etc.)
• 1 set of Energy Calculations
• 3 copies of Tree Preservation Plan if lot platted after 7/1193
• Rim Joist Detail Options selection sheet (bldgs with 3 or less unb)
DATE 5Ig [0k
SITE ADDRESS
TYPE OF WORK-
APPLICANT
APPLICANT
STREET ADDRESS
TELEPHONE #1d
PHONE #
MLTI-FAMILY BLDG _Y )CN
FIREPLACE(S) _ 0 _ 1 _ 2
W j STATE ANZIP0571?
FAX #'?' O?Qr'l
PROPERTY OWNER I I'1Q TELEPHONE# j' bX& ? l 1
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ A
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor:
Plumbing system includes:
Mechanical Contractor: _
Mechanical system includes:
Sewer/Water Contractor.
Water Softener
Water Heater
No. of Baths
Air Conditioning
Heat Recovery System
Phone #
0 9 2002
Fee: $90.00
Fee: $70.00
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Orqlylances.
Signature of Applicant
OFFICE USE ONLY
? /,'It '5
/ rJ O a--
RemodellReoair Requirements
• 2 copies of plan
• 1 set of Energy Calculations for heated additions
1 site survey for exterior additions & decks
• Indicate if home served by septic system for additions
VALUATION (D OW
Phone # I.
Lawn Sprinkler
No. of R.I. Baths
Phone #
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required
Updated 4102
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi
? 03 01 of- plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 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
? 32 Addition p $6 , Move Bldg. ? 42 Demolish (Foundation) ? 45 -Fire Repair,
? 33 Alteration ? ' `3r Demolish (Bldg)* ? 43 Reroof ? 46 • Windows/Ddors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy , t M0ES System ,
Census Code Zoning City Water
SAC Units Stories po?steer PuSnp
Nbr. of Units . Sq. Ft. PRA
t I
Nbr. of Bldgs Length Fire Sprinklered
Type of Consf Width
, REQUIRED INSPECTIONS r r • • • . ' I'
Footingg (new•bldg) _ Final/C.O. '
_ Footings (deck) _ Final/No C.O.
Footings (addition) _ Plumbing
_ Foundation _ HVAC
_ Drain Tile Other
Roof _ Ice & W ater _ Fi nal _ Pool _ Ftgs _ Air/Gas Tests _ Final
Framing _ Siding _ Stucco _ Stone
Fireplace _ R.I. - A ir Test _ Final Windows (new/replacement)
Insulation _
_ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
L--2L- BL Jr CITY OF EAGAN
/J / d PLUMBING (612) 6PERMIT
SUBD. inn. ?(?i?5 612 681-4675
RESIDENTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
CITY USE ONLY
RECEIPT # C 0,?210yj
DATE QJ Q 9 ?-
ALSO, FOR TOWNHOMES AND CONDOS
WORK DESCRIPTION
NEW CONST
ADD ON
REPAIR
OWNER NAME: 2?
SITE ADDRESS: 3392 Ro4Ufi 9AACAA
INSTALLER: a4ark) Domd
ADDRESS : /F271 CITY: L(ck1A/A ZIP: S?Oy
PHONE: 3J3
COMPLETE THE FOLLOWING:
NO. FIXTURES EA. TOTAL
REPAIR/ADD ON 15.00
SHOWER 3.00
a- WATER CLOSET 3.00 G-
/ BATH TUB 3.00 3
LAVATORY 3.00 q
J KITCHEN SINK 3.00 3=
1 LAUNDRY TRAY 3.00 3=
HOT TUB/SPA 3.00
/ WATER HEATER 3.00 3
FLOOR DRAIN 3.00 3-
GAS PIPING OUT.
(MINIMUM - 1) 3.00 3
3 ROUGH OPENINGS 1.50 4.<Q_
_ OTHER _
WATER SOFTENER 5.00
PRIVATE DISP. 15.00
_ U.G. SPRINKLER 3.00
_ W. TURNAROUND 15.00
Uo,So
STATE SURCHARGE .50
az v y
)),,
'7w
SIGNA 0 RMITTEE TOTAL: N
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 f:
INSTALLER:
ADDRESS:
CITY:
PHONE #:
FOR:
ZIP:
CONTRACT PRICE:
1% OF CONTRACT FEE.
STATE SURCHARGE m $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL:
(SIGNATURE)
CITY OF EAGAN
L 5 B 5 MECHANICAL PERMIT RECEIPT # l0 7o'v2 SUBD. (612) 681-4675 DATE 9 9?
RESIDENTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, COMPLETE FOR
TOWNHOMES/CONDOS WHEN SEPARATE PERMITS ARE REQUIRED FOR EACH DWELLING UNIT.
OWNER: M;7 ADD-ON A/C 11 ADD-ON FURNACE?
SITE ADDRESS: ADD ON/REMODEL (EXISTING $ 15.00
<13 3 a? 6 ?[s Cf CONSTRUCTION ONLY)
INSTALLER: HVAC 0.100 M BTU 24.00
PHONE #: 12481 Rhode Island Ave. So. ADDITIONAL 50 M BTU 6.00
, 1719 5537ts-lizz
ADDRESS: Savage
GAS OUTLETS - MINIh4UM 1 @ $3 EA.
0
_----t7'0
CITY: ZIP: SURCHARGE: $ .50
SIGNATURE: TOTAL:
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAIANDUSTRIAL BUILDINGS. ALSO COMPLETE FOR
APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR
EACH DWELLING UNIT.
WORK DESCRIPTION: 11 CONTRACT PRICE: FEES
1% OF CONTRACT FEE.
STATE SURCHARGE IS $.50 FOR EACH
$1,000 OF PERMIT FEE. $
PROCESSED PIPING - $25.00
MINIMUM FEE - $25.00
TOTAL.
SITE ADDRESS:
TENANT:
SUITE #:
INSTALLER:
ADDRESS:
CITY..
PHONE #:
SIGNATURE:
ZIP:
CITY SIGNATURE:
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 3322 Rolling Hills Ct
Lot: 5 Block: 5 Addition: Bur Oak Hills 2nd
PID:10- 15501- 050 -05
Use:
Description:
Sub Type: e - Furnace
Work Type: Replacement
Description: Furnace
Comments: Quesetions regarding electrical permit requirements should be directed to Ma rk Anderson, State Electrical Inspector,
952- 445- 2840Crystal Gemuenden 8910 Wentworth Ave S Bloomington, MN 55420 952- 881 -9000 Crystal.Gemuenden @Se
viceExperts.com
Fee Summary:
Contractor:
Sedgwick Heating & Air
8910 Wentworth Ave S
Minneapolis MN 55420
(952) 881 -7739
Surcharge -Fixed
ME - Permit Fee (Replacements)
Total:
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
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
$0.50
$30.00
$30.50
Owner:
Bradley T Champlin
3322 Rolling Hills Ct
Eagan MN 55121 -2351
Permit Type:
Permit Number:
Date Issued:
Permit Category:
9001
0801
Issued By: Signature
Mechanical
EA075889
11/15/2006
ePermit
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117858
Date Issued:10/24/2013
Permit Category:ePermit
Site Address: 3322 Rolling Hills Ct
Lot:5 Block: 5 Addition: Bur Oak Hills 2nd
PID:10-15501-05-050
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, 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 -
Bradley T Champlin
3322 Rolling Hills Ct
Eagan MN 55121--235
(651) 454-4894
Crew2 Inc
2650 Minnehaha Ave
Suite 100
Minneapolis MN 55406
(612) 276-1680
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA136863
Date Issued:06/03/2016
Permit Category:ePermit
Site Address: 3322 Rolling Hills Ct
Lot:5 Block: 5 Addition: Bur Oak Hills 2nd
PID:10-15501-05-050
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 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 -
Bradley T Champlin
3322 Rolling Hills Ct
Eagan MN 55121--235
(651) 905-9676
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA161034
Date Issued:04/30/2020
Permit Category:ePermit
Site Address: 3322 Rolling Hills Ct
Lot:5 Block: 5 Addition: Bur Oak Hills 2nd
PID:10-15501-05-050
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Bradley T Champlin
3322 Rolling Hills Ct
Eagan MN 55121--235
(763) 464-1964
Milbert Company (culligan)
1801 50th St E
Inver Grove Heights MN 55077
(651) 451-2241
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA163378
Date Issued:08/28/2020
Permit Category:ePermit
Site Address: 3322 Rolling Hills Ct
Lot:5 Block: 5 Addition: Bur Oak Hills 2nd
PID:10-15501-05-050
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and house wrap and leave on site.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 10,000.00
Fee Summary:BL - Base Fee $10K $191.75 0801.4085
Surcharge - Based on Valuation $10K $5.00 9001.2195
$196.75 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 -
Bradley T Champlin
3322 Rolling Hills Ct
Eagan MN 55121--235
(763) 464-1964
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA174315
Date Issued:01/18/2022
Permit Category:ePermit
Site Address: 3322 Rolling Hills Ct
Lot:5 Block: 5 Addition: Bur Oak Hills 2nd
PID:10-15501-05-050
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 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 -
Bradley T & Holly M Champlin
3322 Rolling Hills Ct
Eagan MN 55121--235
(763) 464-1964
Crossroad Construction
17121 Lincoln St NE
Suite 100
Ham Lake MN 55304
(763) 434-0202
Applicant/Permitee: Signature Issued By: Signature