3245 Rolling Hills DrINSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: 1 1 '`' r4
3830 Pilot Knob Road Permit Number: 7 1 '
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: ` - ' ' 1 " 1 1' d" 1 `
f° f;uL11NC; i)11_t:, IAN
HIM OAK HILLS
APPLICANT:
i i, 'i I 11,f 1.1 1?I I i,A1 I I V
1612) HqH-11/4
PERMIT SUBTYPE: TYPE OF WORK:
1,41
Permit No. Permit Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
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
12
BSMT R.I
BSMT FINAL
DECK FTG
DECK FINAL
RF,t TI4ktTlE FOR DECK 6/15/89 CITY OF EAGAN
45681611$ 3830 Pilot Knob Road,.,P.O. Box 21-199, Eagan, MN 55121 w
PHONE: 454.8100
BUIL7ING PERMIT Receipt
To be used for Est. Value Date 119
Site Address Al OFFICE USE ONLY
Lot Block Sec/Sub. On Site Sewage Occupancy
MWCC System Zoning "
Parcel No. W
ell
On Site (Actual) Const
cc Name City Water (Allowable)
W
3
Address PRV Required * of Stories
City Phone = ! - Booster Pump Length
Depth
'
0 Name Z? S.F. Total
0 U Address Footprint S. F.
City Phone APPROVALS FEES
a
WW
Name Engr./Assess. Permit
Planner Surcharge
U Z
aW Address
City Phone Council Plan Review
Bldg. Off. SAC, City
I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC
information is correct and agree to comply with all applicable State of Water Conn.
Minnesota Statutes and City of Eagan Ordinances. Water Meter
Signature of Permittee Road Unit
A Building Permit is issued to- Treatment P1
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. Parks
Building Official TOTAL
Permit No. Permit Holder Date Telephone #
Plumbing
H.V.&C.
Electric
Softener
Inspection Date Insp. Comments
Footings I
Footings II
Foundation
Framing
Roofing C a chit ?i?.yt
Rough Plbg.
Rough Htg. P,
Isul. 0
Fireplace
Final Htg.
Final Plbg.
Bldg. Final
Cert Occ.
Temp. LP
Deck Ftg.
Deck Final I/X
Well
Pr. Disp.
T' '
Tatif iratir of Orrupattry
4Citp of (Eagan
loppartmMt of W1tiaing .r>tim
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following..
Use CIAMOi adm
Mg. Permit No. 15 217
O-P--y Type `•• •• Zoning Disuin Type Cons!
Owner at Bw7ding cjou Bz Ml (l 1'+. ' Address r i : I : si `',
Building Address -
Budding
Due: A! a A 30, 1988
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN
3830-Pilot Knob Road
P.O. Box 21199
Eagan, MN 55121
'1o? ].e;
Site Address:
Plumber:
Permit No:
B/P No:
coon at .
7111s Drive L13 R4 Purr.
550.00 t
MWCC: !?Opd
100.
City Chg:
Acct Dep:
Permit Fee: _ p
Surcharge:
Zoning
No. of Units: 1
I agree to comply with the City of Eagan
Ordinances.
SEWER SERVICE PERMIT
CITY OF EAGAN Permit No: Date: ry - 21-82
3830 Pilot Knob Road Meter No: ?? -?6 g 3 Size: bad
P.O. Box 21199 Reader No: >215-j2 L -3 " Date: 9-/2-900
Eagan, MN 55121
Site
11.5 Rolling Hills Drive L13 B4 Burr Oak H1.1.1E
Conn. Chg: 55.0.000 Zoning: -
Acct Dep: No. of Units:
Permit Fee:
Rl
Surcharge: • 513p`. I agree to comply with the City of Eagan
Tr. Plant 00P'3 Ordinances.
Meter.
ey
WATER SERVICE P MIT j
CITY OF EAGAN N° 15 2 17
3830 Pilot Knob Road, P.O. Box 21.199, Eagan, MN 55121
BUILDING PERMIT PHONE: 454.8100 Receipt # e y </
Ol ccc777
To be used for SF DWG/GAR Est. Value $95,000 Date JUNE 17 -19-0-8-
Site Address 3245 ROLLING HILLS DR
Lot 13 Block 4 Sec/Sub. BUR OAK HILLS
Parcel No
a Name COLLEGE CITY CONSTRUCTION
w
Address 6970 151ST ST
o City APPLE VALLEYPhone 431-1211
p Name
cz°+< AddreCity_
W Ww Name_
i z. Address
ai City_
aW
I hereby acknowledge that I
information is correct an
Minnesota Statutes a Cit,
n and state that the
applicable State of
Signature of Permitt
A Building Permit is issued to: C LEGE CITY CON$T
on the express condition that all w rk shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Off icial_L D4-: Na AI-11, ? -
OFFICE USE ONLY
On Site Sewage Occupancy R-3 M-1
MWCC System X Zoning R-1
On Site Well (Actual) Const V-N
City Water X (Allowable) V-N
PRV Required * of Stories
Booster Pump Length 54,
Depth_ 48'
S.F. Total
Footprint S.F,
APPROVALS FEES
Engr./Assess. Permit 554.00
Planner Surcharge 47.50
Council Plan Review 277.00
Bldg. ON. SAC, City 100.00
Variance SAC, MWCC 550.00
Water Conn. 550.00
Water Meter 67.oD
Road Unit 32 5. GO
Treatment P1 204.00
Parks
TOTAL 2,674.50
K 2 39? I(;e/s??
A"
Repuasl Date
q _ ag -9a Fire No Rough,ri Inspection
R2 Yes ?
? es No
early Now p Will Re Inspec or
when en Ready?
licensed contractor D owner hereby request inspection of above electrical work at:
Job Address (SIreet. Box or Rwt
16P
oI11 Yl 6
Qi d rJ
Senion No. Township Name or No. Range No. ry
O" M I \, Phone No.
Power Supp Address
Elec c tractor IC parry Name
?c-4Y ?? c? CHo lmotor5 License No.
of ?aa
Mailing Atltlres Contrar own eking Installatwp?
?1 . 11L,r1/v1?0
Au1h i Sg azure lCo ratlorrpwnerlMaking ,hnsta^llation_l
?. )
MINNESOTA STATE BIDAi 1 F EL CTHICITV THIS INSPECTION REQUEST WILL NOT
Grlggs-Midway BIOe. R o BE ACCEPTED BY THE STATE BOARD
1821 University Ave., ul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Floors (612)642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
ll?
9394 see instructions for completing his term on pack of yellow copy
K Z ?-
X" Below Work Covered by This Request
New Add Rep. Typeot Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Othen.(Specify)
m
C0- /industrial Furnace
Farm Air Conditioner
Other (specify) Ccntracto4 emarks:
t? ??oifchon A(?
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Above_100._ Amps
Signs Inspectors Use Only: / TOTAL
Irrigation Booms
Special Inspection (
Alarm/Communication THIS INSTALLATION MAY BE ORDE DI NNECTED IF NOT
ED
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in Date
certify that the above inspection has
been made. Final Data Y
a'
OFFICE USE ONLY e
This request void 16 months from
2005 RESIDENTIAL BUILDING PERMIT APPLICATION nn
City Of Eagan `i' l? Il u Ll !I
3830 Pilot Knob Road Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694 fl I? L,AYp? I ?I
New Construction Requirements
3 registered site surveys showing sq. fL of lot, sq. fl. of house; and all roofed areas
(20% maximum lot coverage allowed)
2 copies of plan showing beam B 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 Detall Options selection sheet (buildings with 3 or less units)
Remodel/Repair Requirements F Office Use Only
2 copies of plan rofSurveyR
1 set of Energy Calculations for heated additions Tree Pros Plan Recd _Y _N
1 site survey for additions & decks Tree. Pres. Required _Y _N
Addition. indicate Norr ge septic system Onsite:Septic System _Y _N
Date / 17 / C S
Construction Cost t LkgOp
Site Address \
r l Unit/Ste #
Description of Work Q2,-4 a C_evs t
Multi-Family Bldg Y 1, N Fireplace(s) 0 _ 1 - 2
D
Property Owner A. '
A4 ti 5 Telephone # (10SO '-JS-) - SJ"
Contractor ? ?t c)Y S
s i
Address 27 L l i C\v?t?vs ?? City,
State M?A zip SS ( 3 Telephone # (zSf)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code Category • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
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 which requires a review and
approval of plans. hSl-2 5elvi`?
t,f ,re
Mika :L
Applicant's Printed 1 dame Applicant Sig tune(
OFFICE USE ONLY
Sub Types
? 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 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement "Demolition (Entire Bld g) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) - Final/C.O.
_ Footings (deck) - Final/No C.O.
Footings (addition) - Plumbing
_ Foundation _ 14VAC
Drain Tile Other
_
Roof _ Ice & Water Final _ Pool _ Ftgs _ Air/Gas T ests _ Final
_
Framing _ Siding _ Stucco - Stone _ Brick
Fireplace _ R.I. - Air Test - Final _ Windows
Insulation _ Retaining Wail
Approved By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
?g T] q 3830 Pilot Knob Road, Eagan Mn 55122
o I Telephone # 651-675-5675 FAX # 651-675-5694
New construction Requirements RemodelRteoair Requirements Office Use Only
3 registered site surveys showing sq. R. of lot, sq, it of house; and all roofed areas 2 copies of plan _ Gen of Survey Recd
(20% maximum lot coverage allowed) t set of Energy Calculations for heated additions -Tree Pres Plan Recd
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks. _ Tree Pres Not Reqd
1 set of Energy Calculations Addition - indicate iron-site septic system _ On-site Septic System
3 copies of Tree Preservation Plan If lot platted after 711W
Rim Jost Detail Options selection sheet (bldgs with 3 or less units
Date 41 / 1L- / 6 ? Construction Cost T? 7 It
Site Address 2 `lS 1& 14 f 4 ,1,1 15 Or Unit/Ste #
` - 4
?
l
?D
1--
Description of Work -t/
P.?J l o c-e (6 nzi Y r /
[fi/Jd
--mm e x / Z[' ,
rn
t u / //c
wf>
i
Multi-Family Bldg _ Y Z
N ?
Fireplace(s) _ 0 _ 1 - 2
//
Property Owner L- jgzlet DQC1t3 Telephone # (??/) G/S? S 9? 3
Contractor Q P" e tf, (r-
Y !- >r ]P l/ /Q(? S
,
pp
Address 7 t??? C f9 4bL0 Al City S? Ptuf
State ! ( Zip /rS/Q Telephone # (6.?-7) 9?-3 SO
COMPLETE THIS AREA ONLY IF
Energy Code Category Minnesota Rules 7670 Cateeorv 1
• Residential Ventilation Category 1 Worksheet
(J submission type) Submitted ?
• Energy Envelope Calculations Subm`tfl
?r ?? t,: 1 :. ?, ICI
Licensed Plumber 11 "- 73
Mechanical Contractor A 1';1
Sewer/Water Contractor
A NEW BUILDING
_ Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
Telephone #(
phone #(
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 which requires a review and
approval of plans.
577 e?ele, ( (,ar /Sr9 LI
Applicant's Printed Name
/X???? ?A
Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessary 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 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 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 *Demotition (Entire Bldg) - 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 Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
- Footings (new bldg) _ Final/C.O.
- Footings (deck) Final/No C.O.
- Footings (addition) _ Plumbing
_ Foundation 14VAC
_ Drain Tile _ Other
Roof - Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Franung _ Siding _ Stucco _ Stone
_ Fireplace - R.I. -Air Test - Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
SSoo'?3' RESIDENTIAL <? q. -7,5/
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Reaulrements Remmygebalr Reauirements
• 3 registered sire surveys showing sq. ft. of lot, sq. ft. of house; and L roofed areas • 2 copies of plan
(20% maximum lot coverage allowed) • 1 set of Energy calculations for heated additions
• 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 site survey for exterior additions & decks
• 1 set of Energy Calculations • Indicate 9 home served by septic system for additions
• 3 copies of Tree Preservation Plan ff lot platted after 7/1193
• Rim Joist Detail options selection sheet (bldgs with 3 or less units)
DATE O /Vu_r //,, :7-
SITE ADD
TYPE OF
4ULTI-FAMILY BLDG _YI
FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT WDUVk?perT- C.fCTe?YrIOr ;
STREET ADDRESS IfiS2 461a&0 4a CRY _STA
TE M ZIP S
TELEPHONE #,?5- 6"q 6 $D CELL PHONE # ?? AYL? 3;2ry5- FAX # 06
PROPERTY OWNER I-41 JA PALd S TELEPHONE #Z-5'/
COMPLETE THIS SECTION FOR a NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted R • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted Ill ll -,S' ?(] rl
AUG 3 0 7002
Plumbing Contractor: Phone,#,'
Plumbing system includes: Water Softener Lawn Sp ' er Fee: i $90.00
Water Heater _ No. of R. Naths
No. of Baths
Mechanical Contractor: _
Mechanical system includes:
Sewer/Water Contractor:
- Air Conditioning
- Heat Recovery System
Phone #
Phone #
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 Ordinances. P
? MI
Signature of Applicant ,
OFFICE USE ONLY
VALUATION
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required
Updated 4102
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of-plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
Valuation
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
? 20 Pool
? 21 Porch (3-sea.),
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneousli
? 30 Accessory Bldg
? 31 Ext. Alt -Multi
? 33 Ext. Alt - SF
? 36 Multi
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors
'Demolition (Entire Bldg only) - Give PCA handout to applicant
Occupancy MC/ES System
Zoning City, W ater
Stories Booster Pump
Sq. Ft. PRV
Length Fire 'Sprin klered
Width
REQUIRED INSPECTIONS
- Footings (new bldg) _ Final/C.O.
- Footings (deck) _ Finat/No C.O.
Footings (addition) _ Plumbing
_ Foundation _ HVAC
_ Drain Tile Other
Roof _ Ice & Water - Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
- Framing _ Siding _ Stucco _ Stone
Fireplace _ R.I. - Air 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
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or _ N
Building Inspector
*5?
54 >oI
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. ft. of lot, sq. ft. of house; and all rooted areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing beam & window saes; 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 units)
DATE (/ ' (? D I
Remodel/Repair Requirements /
• 2 copies of plan j4 q ,
• 1 set of Energy calculations for heated additio
• l site survey for exterior additions & decks
• Indicate if home served by septic system for additions
VALUATION
SITE ADDRESS 3J q5- ; O0#07!? &d? MULTI-FAMILY BLDG _ Y _ N
?
TYPE OF WORK oo,g FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT
STREETADDRESS /aay?NicnfltT five -
TELEPHONE #1453)}07 -69 59 CELL PHONE #
ii`II? STATEAN-ZIP515'33
FAX# (?52t)&ES-8TH6
PROPERTY OWNER 4Q,t"k 9( Cie, D(AV, S TELEPHONE# (6S0152 -fZU
-----------------------------------------------------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category MINNESOTA RULES 7670 CATEGORY I _ MN4 ? Irk RULES 7672 _SU
d4)Wariks eet
(d submission type) • Residential Venfiladon Category 1 Worksheet Submitted • (((??Y+ ne g
p if 1.
• Energy Envelope Calculations Submitted °
I Auc 0 9 2002 I !;!
Plumbing Contractor: Phone #
Plumbing system includes: _ Water Softener Lawn Sprinkler --y---tee;-_ 1Zl)rU
Water Heater _ No. of R.I. Baths
No. of Baths
Mechanical Contractor.
Mechanical system includes:
Sewer/Water Contractor:
- Air Conditioning
- Heat Recovery System
Phone #
Fee: $70.00
Phone #
----------------------------------------------------------------------------------------
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 Ordinances.
Signature of Applicant
OFFICE USE ONLY
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 Porch/Addn. (4-sea.) ? 33 EM. 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 ? 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 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 Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED IN SPECTIONS
- Footings (new bldg) Final/C.O.
_ Footings (deck) _ Final No C.O.
_ Footings (addition) _
_ Plumbing
- Foundation HVAC
- Drain Tile _ Other
Roof _ Ice & Water _ Fi nal _ Pool
Figs
Air/Gas Tests Final
_ Framing _ _
_
_
Siding
Stucco
Stone
- Fireplace _ R.I. _Air 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
`MM?***#:t; %cK:k?CMA:#M*W:eM":h:>`.wM, ;:?.kc*x:A:*%bFN?MM?:
CITY OF
EPC N
-CASHIER: JS TtRri:[NA4_ tJa 7>9
DATE: 10112/99 71 E: OF';`O%
IL+a
NAME; CQRNERSTONE. CONSTR UCTION
300 9001 3245 ROLLIN 'iIL :45.25
3422 9001 3245 ROLL.I.N AM 146.99:
M 9001 3145 ROLLM HIL ?O
j. ,
Total Fgc pipt, Amnun . 317.66
Wi.1.m -
USER ID: N
Mk:YFM?kwr;::MMkCU-***M:kM?kir Y??;M:kM.?c;xa??:MM?*k:+kalt?eMMv
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Construction Reautremerds Remodel/Repair ReautremeMs
D 3 registered site surveys showing sq. H. of lot, sq. ft. of house
and,gj roofed areas (20% maximum lot coverage allowed)
? 2 copies of plans (show beam A. window sizes; poured Ind. design; etc.)
D 1 set of energy calculations
D 3 copies of free preservation plan @ lot platted after 7/1/93
DATE: /C4,Ly / 7 7
DESCRIPTION OF WORK:
Name: ?rJpj
4 2/9'[?/f Phone#: &S7- 19? -"963
Last ,,//?? First
Street Address: ?.7 Sf /5pl/'j;g?' Z1,5
STREETArD?DRESS: 3? /Qol??4'll??? Dwye-
LOT. ?J BLOCK: SUBD./P.i.D. 3u,r 0 eLV- 41
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
City State: /"- nJ Zip; ,
Company: C ieXZ Al-F1Td vL 6VW57? Phone #:&51 --,.72 " M9
(area code)
Sheet Address: /-o%/ /f re- License # .6 5""7 Exp.
City )O f2w State: /l^,? Zip:
Telephone #: area code (
L L q
2 copies of plan
1 set of energy calculations for heated additions
1 site survey for exterior additions b decks
COST: ?S b
Name:
Street Address: Registration C
City State:
Sewer 3 water licensed plumber (required for new construction only):
Pentilly applies when address change and lot change is requested once permit Is Issued.
Zip:
I hereby acknowledge that I have read this application, state that the Information is correct, d agree to comply with all applicabl
State of Minnesota Statutes and City of Eagan Ordinances. Cy,
Signature of Applicant
OFFICE USE ONLY
Certificates of Survey Received Yes No U61
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 .6f 22 Porch/Addn. (4-sea.
? 03 1 of _ plex ? 08 6-plex ? 13 16-plex A' 18 Deck ` d 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage
? 05 3-plex ? 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 ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bldg.* ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) ? 42 Reroof
Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
a, sq. ft.
sq, ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building _?G
I ( -Y-.
Engineering
Census Code
SAC Code
No. of Units
No. of Bldgs
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
34
of
I
_U
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SNIT Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies 35
Total:
Valuation: $0 ?'3sS
) l t- I ?, I 4? 4r Ir Sy 2 ? 0;?S
Ut?k {x?f = fr2o0
i
SAC Units
% SAC
.ER
yyieering -
LAND SURVEYORS -CI V IL ENGINEERS
LAND PLANNERS, LANDSCAPE ARCNI TECTS
2422 Enterprise Drive
Mendota Heights, MN 55120
(812) 881-1914
Certificate of Survey for:
_L?iE?GITY GOIJST(IVGTI_?I
QoLLI1JG? HILLS D91VE
M r.c:E1.894.9
rJ v 11 6"C- 0
0
100.00 ?qb'
0
`b'l? m r---
el
,
r
3 ?\ ?S
M AtiB
?
?
? I
cO I I 013
I Zz.oo 2 I 18
qA.
9 M
I ? "? l?Rr. ° I
r 40
I
I
W
? M 0 Z4.o
W,
M
I 'A N Pr°p°Se? M 1_ 1`I S
00 f I IdoAlt t I CJ
66.0 - 2;.o I
-
--r f rJ•
00 . 54 . w
\A
?
I
°"C At
.r
49 I $a) I
I \ I
'
I
\ I
I I
I ?
I
ti
•
5iy0ralna1e And tlfi ty laSew -iJS
o.ti
e ----
L Q
?
I p p•',l.
S 1° 21 'SCI of
Y 900.0 Denotes eliWinElevation
r soo.o Denotes prop d Elevation
----- Uenoles VraiRapje I lltditJ Easement
Uenoles Drglna a Flow Arrows
o Denotes monument
8mrinfs shownarr assumed
PROPOSED 14ou.96 ELEVATIONS
lowest Floor Elevation
Top o1 Block Elevafiarf _
Garoge Slab Elevation = 897.0
LOT /5,. aLocK 4 , guR OAK W?.LS
DAKOTA COUNTY I MlaNasOTR S[/gjaIcy TO EAfr1VfE1Vr5
I hereby certify that this survey, plan or report was prr. red by m or under my direct supervision and that 1 am duly Registered Land Surveyor
under the laws of the State of Minnesota. Dated this ?? day of A.D• 19
ref
Scale : 1 M . 40
A S O QR ROBERT B. SIKI L.T.
R NO. IA6
11
6122227706
O.CT-06-99 01:20 PM CORNERSTONE CONSTRUCTION 6122227706
I I
MEacheck COMPLIANCE REPORT
1993 CABO Model Energy Code Permit q I
MFCcheek Software Wi7sion 2.07 Relea3c 4 I I
I _ I
I ChecY,ed by/Date I
CITY: tat. Paul
S'PATZ: Minnesota
1IDD: 7.391
CON°TRIICTION TYP. ',. Single k'ami ly
U.Sl'E: 1U-6-1999
(;OMPT,IANCB: PASSES
RegLdred UA = 312
Your HonH* = 2 )1
13.3% Better Than Code
Area or Cavity Cont. Glazing/Door
Yerilneter R-Value R-Vnl.ue U-VRluc: UA
_____________________________ -_-- __-_--__---__--__-____
ClFTI.INGS 1576 44.0 0.4 43
WAL, t,S: Wood Frame, 16" O.C. 1488 19.0 2.0 77
BSMT: Coro. 8.0' ht/7.5' bg/8.0' innul 832 13.0 2,0 43
BSMT: conc. 3.0' ht/2.?j' bg/3.0' i.nsul 144 13.0 2.0 10
GLAZ.LNG: Windows or Dcaors 283 0.31D se
DOORS 60 0'090 5
FLOORS: Over Outside Air 168 :30.0 2.0 5
COMPLTANCE ST.ATFNM-NT: The proposed buildin7 design deyCT7bed here is
'
coneiatent with the buildiTICI Elam;, specifications, and other calculat.ivris
submitted with the permit appli Lion. The posed bu.ilding ha3 burn
desigzled to me _ Ie Tc:cF.1i emy ?t 3 CABs Mcjd,,1 Energy Codee,
Bui lCd«,r/Designer Date
II p ?e?, (9 (??i LIB
S ?`? ?e
P. 01
7-5a•uu+
?1 0U+
7s•U0
+
9,674.5Ur:
SINGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
i SET OF ENERGY CALCS.
1989 BUILDING PERMIT APPLICATION
CITY OF EAGAN
i321?
MULTIPLE DWELLINGS
2 SETS OF PLANS
REGISTERED SITE SURVEYS -
(CHECK WITH BLDG DIV.)
1 SST OF ENERGY CALCS.
Occupancy
Zoning
Actual Const
Allowable
i of stories
Length It) Y.)
Depth f
S.F. Total
_
Footprint S.F.-
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS i OF UNITS
NOTES ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED..
SEWER A WATER PERMIT FEES AND ACCOUNT DEPOSIT FEES WILL BE INCLUDED WITH THE BUILDING
PERMIT FEE. PROCESSING TIME FOR SEWER AND WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS
BEEN COMPLETED INDICATING A LICENSED PLUMBER.
PENALTY APPLIES WHEN: PERMIT IS NOT PAID FOR IN SAME MONTH IT IS REQUESTED.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
To Be Used For: i1 ECje Valuation: Date: Aq9
Site Address 3<- 2 oLC?n/s X/LES ? L
`Ia?/H?, /?rN
Lot JL_ Block
Parcel/Sub 019X iLe.S
Owner -M K 79 y/S
Address 3ays' 2aLcivG- H.LCS ?2
City/Zip Code _? 6 AjJ /?9N SS/ell
Phone W) ur(p -&/6f (h) yc>Z - S?-9.;
Contractor sogm AS 6wN1g-x
Address
City/Zip Code
Phone
Arch./Engr. -';Al?Z As e)L)eVC-1f
Address
City/Zip Code
Phone 0
On site sewage
On site well _
MWCC System
City water
PRV required
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off.
Variance
COMMERCIAL
2 SETS OF ARCHITECTURAL
6 STRUCTURAL PLANS
1 SST OF SPECIFICATIONS
1 SET OF ENERGY CALCS.
FEES
Bldg. Permit '?
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Acet. Deposit
S/W Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Copies
SUBTOTAL
Penalty
TOTAL
** 9
* Pion
* engir
>k
LAND
LAND PLANNERS• LANDSCAPE ARCHITECTS
2422 Enterprise Drive
Mendota Heights, MN 55120
(612) 681-1914
Certificate of Survey for:_60U?-E4!5-6IT`L4-05TQUC-00L
Qou-INeg NILLS DR1Var
0
e4 1.C:EI 894•
0
11 6"E
IOo.00,1
Co
gq1 ofi
a°b
W
-' to
r
app
MN
ua
00)
?9f
.I
0
1 z3 ° 2
I
° l
A
, I ? 8913
I N L4.0 r 4"•
I ? ? P/oP e5te1 M I
I ? (?loust N ?O `s
I ,91 a?l
I \ $D?
I
I I
I ? I
I I
??Oralrwt?e and v?iliiY Ea?M?-?J,
L- - - - - - -
I p p,3?e
z 1 ° Z1 3ZI
= 900.o Denotes existino Elevation
• soo.o Denotes propd3 d Elevolion
---"-Denotes Drain4e jutdif Easement
-? Denotes Drama e Flow AArrows
o Denotes monument
8earils shown are assumed
ti
PROPOSED 140U5E ELEVATIONS
towesf Floor Elevation =
Top of Block Elevation =
Coro j2 Slab Revafion = 897. 0
LOT /3 , SLOCl? 4 guR 0AK 9ILLS
DgKoTq Covmtr 1 MINIJCSorn ,
sU81Cc7 To EAfEME/VTs
I hereby certify that this survey, plan or report was pre red b?mr under my direct supervision and that 1 am duty Registered Land Surveyor
under the laws of the State of Minnesota. Dated this /(0 day of A.D. 19
6804R 6 40 i eef
ROBERT QB.SIKl 4S. . NO. 1,a
O?
N rt`
?w
1.19
1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTEt ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRr''
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS U OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used For: J I, Grn , / Valuation:- Date:
Site Address -?-2 VS-0 lqv { I, /-y;
Lot ),7 Block I Dr ;1i G
Parcel/Sub lJ ti/ OC4 ?)>1)r
owner/7... k /Ja r f
Address-? ya .
*1 ...2)
City/Zip Code 25-?q?Jj -R yr1
Phone 'iITa - -3/ 6-
Contractor.. C" ?. C.drf.r
Address 6'70
City/Zip Code /°l ?„ ?? Lw //c?? Sld y
Phone G? ) )a ) 7
Arch./Engr. SQ m e- gJ Co n / .
On site sewage Occupancy ?Z 3 /?7•/
MWCC system Zoning
On site well Actual Const
City water _? Allowable
PRV required # of stories _
Booster Pump Length _
Depth
S.F. Total
Footprint S.F.
APPROVALS
Engr/Assess
Planner
Council
Bldg. Off.
Variance
Address
City/Zip Code
FEES
Permit S'S 1/
Surcharge ?/ 2 So
Plan Review .2 2 h
SAC, City /00
SAC, MWCC Ssc>
Water Conn 5ao
Water Meter (I ')
Road Unit 3 72_
Treatment P1 20 1/
Parks
Copies
TOTAL
Phone p
Gay;
zzx2a /vo k /Y
uaff
!3 F Z
1
?/a0G ?G
* PIDIN
If engir
>k * **
. CIVIL ENGINEERS
LAND PLANNERS. LANDSCAPE ARCHITECTS
(612) 681-1914
Certificate of Survey for:_LQu.E(?? GIT`/ GD?SrQUG?ON
?ot t.INea NIt.LS Dt:11IE
0 1 c: El • 894.9
M rJ 11 b"E - ° 0
100. Cot
ie
.. 14.e 89
9?• 1 ? M I
?` 9 I I CgRr. N 1
re?` UI M' a O.ol___. 6n ?+. I°
M 14.o r 'P 0
?I M Prepesfd N
1-loos[ I
,, r I rd
M 11j.o_ _ bS.D i t
-?j•o-1 11s
% N 5¢.o ea
g9? Sti I ?°I? AB I
I I
1 ?
1 I
1 i
. f..
d 1146i4y ewdwteAl,1Is
5iy?raiMl?e 01 ??
?i I e Zt •lZ .
900.0 Denotes exfslin? Flevofion
yoo.o Dujoles prop d Flevoli0"
-- Denotes Oraina e E Ut,71l Ea
Denoles Drginale Flow /Irmw r
.
o Denoles monamenl
8 eartifils shown are
2422 ERlelprise 00ve
Mendota I leights,_MN 55120
PROPOSED 00U56 &LV,g7loNS
Z o e f Floor Elevation
fBlock Elevation
42fr z Slab Elevation : 397• U
LOT P5 , SLOC!(4 , SUR N'A? ?t L L S
DAKOTA COUNt r f M/NNA'BOTA S(101EC! To EA1 FMENTS
1 hereby certify that this survey, plan or report w;;;,r e red by mrgolr under my direct supervision and that t am duly Registered Land Surveyor
under the taws of the State of Minnesota. Dated this day of 1 $[?..a! A.D. 19
f eef ///
Scale : 1 Inc e 40
6049 9M Inn ; 5 ROBERT B. SII< 1 L.S. R .. NO. I
it
3vYe. W.M.I'41w 9F£C'.C.d-•._+.'?n'E4` „?- `YF"3 .. ,. i -. ??.T r _I° '. .
,
EXTERIORENVELOPE AVERAGE "U" C014PUTATION
DVMER 01_. /9e .
SITE ADDRESS
/???/S'
CONTRACTOR (oLL Co?? DATE 'G"5-8?-PHONE
Determine working square footage of each.
1. Total exposed wall area..,.... ZOi9_ sq. ft. x
°
2. Total roof/ceiling area l'??3 3 f sq. ft. x .07,(-)
.'Total exposed wall area above floor Z of
a. Total wall window area ........................... 2 S 7
b. Total door area ........:................... ..... s 4 _
C. Total sliding glass door area .? ...............to A110
-
d. Total fireplace wall area ........................
e. Total wall framing area (average ........
f. Total net wall area above floor .................. iI4 -7-
Total. rim foist area ............................
Total-exposed.foundation area a
.....
h. Total foundation window ;area ................
1. Toal net foundation area above grade ............ 9d
Determine,"U" value of each wall segment.
a. 25'1 X "U" .3A'10
Coo- 'X "U.", 3 bb ° ( d
d X "U•
e, 1 X "U" .092
a ._.,.1.
--LO
f. 1392 " X
131 i X 0110 . o d
h. O .. X "U"' °
i O , - X NUN, $019 a
.
zzz.
C?LAbb
If item 03 is the same asp or less,than item 11. you have met the intent
of saC 6006(c)2.
-.,+.n+:-aw 0.L4'.Y]- as r a..,p :.. .. vz no..ryY.*+-.ii.n ?:.:+iN'®++•••.' •.. ^...r •t
Total..exposed roof/ceiling area 1 333
?. Total skylight area .............................
k. Total roof/ceiling framing area (average 10X),.,
1. Total net .insulated roof/ceiling area..:........ Determitte "U" value for each roof/ceiling segment.
?. V . x bull
k. x '"U" '04-
X . S ?(o
4 ..................................Total
if total of 14 is the same as. or less than 12. you have met the intent of
SOC .6006(c )1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the
sum of items 13 and 14 shall not be greater than the sum of items 11 and 12.
1._ + 2.
3.' + 4. ?.
Imo/
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
BUILDING
027199
03/27/96
SITE ADDRESS: P.I.N.: 10-15500-130-04
LOT: 13 BLOCK:
3245 ROLLING HILLS DR
BUR OAK HILLS
4 APPLICANT:
STOVE & FIREPLACE GALLERY
(612) 898-1174
7
PERMIT SUBTYPE: TYPE OF WORK:
FIREPLACE NEW
DESCRIPTION (GAS)
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDING
027199
03/27/96
SITE ADDRESS:
3245 ROLLING HILLS OR
LOT: 13 BLOCK: 4
BUR OAK HILLS
P.I.N.: 10-15500-130-04
DESCRIPTION:
`t,...- (GAS)
Bulding.,Permit Type
Building Wo.tk Type
Census Code,
1
FIREPLACE
NEW
434 ALT. RESIDENTIAL
REMARKS:
FEE SUMMARY:
Base Fee $25.00
Surcharge $.50
Total Fee $25.50
CONTRACTOR: - Applicant - ST. LIC.OWNER:
STOVE & FIREPLACE GALLERY 18981174 2003208 DAVIS MARK
1278 COUNTY ROAD 42 3245 ROLLING HILLS OR
BURNSVILLE MN 55337 EAGAN MN
(612) 898-1174 (612)452-5963
f i
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 Mn.
L Statutes and City of Eagan•Ordinances.
APPLICANTIPERMITEE SIGNATURE
-&Ija %.gjl11
ISSUED Y: S NAT RE
RD 11.5U
181 CITY OF EAGAN
199 3830 PILOT KNOB B RD - 55122
1996 FIREPLACE PERMIT APPLICATION
681-4675
DATE: 2 Z2 `? Cp
DESCRIPTION OF WORK: STALL MW FIREPLACE: _ WOOD BURNING GAS
_ INSTALL GAS LOG ONLY IN EXISTING FIREPLACE
INSTALL GAS LINE ONLY IN EXISTING FIREPLACE
OTHER:
AREA TO BE INSTALLED IN:
STREET ADDRESS: ti
LOT BLOCK 4- SUBD./P.I.D.
APPLICANT: (circle one only) OWNER
Name: Phone #: Y??e_ f5?Z>
WT HUT
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.
PROPERTY
OWNER
FIREPLACE
INSTALLER
Signature:
Street Address- 0
City:
Company:
Signature:
State: Zip:
,--e r xA6r, Phone #: `2Q% \ 1'7q
Street Address: CR4 -47 " License #, ? -Qaszc`?
City 3 s t AIFQ /\,Nr State: N\,_ Zip•-I;:-7?
GAS LINE Company:
INSTALLER
Name:
Signature: -
Street Address:
City:
Phone M
State:
Zip:
.
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 14 Fireplace
WORK TYPE
? 31 New o 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Census Code. _
SAC Code
REMARKS: Chimney/flue must be inspected before
FEES
Permit Fee
Surcharge
Other
Copies
Total:
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
dy"1?00
New Construction Reauirements Remodel/Repair Requirements O?icei?ise:Onty
3 registered site surveys showing sq. ft of lot sq. it of house; and all roofed areas 2 copies of plan edof 5u slr. ?;!1-
(20% maximum lot coverage allowed) 1 set of Energy calculations for heated add'Nons?pi r as ".?.I.
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks grae Regol'Y
l set of Energy calculations Addition - indicate if on-site septic system thiife1ePb.Syste,Jn
3 copies of Tree Preservation Plan 9 lot platted after 711193
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date_ / _! Q Construction Cost ?r LV6
Site Address // /
e??n4 4/& 0r Uir lSte #
01 W-&- cgel?j
Description of Work _ e 15( e
Multi-Family Bldg _ Y X N Fireplace(s) _ 0 _ 1 _ 2
Property Owner G /
LvtrJa I?dtt!(S Telephone #(?SI) YS? 5q6
Contractor Z I Im 12,-, r'
? /4
Address
7 S -
6 I rye" /
let,U XL
City 1? 5G 0 11//
Ile
State ,
M14 Zip Telephone # (? ) `q S 5
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet
(+) submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
t??2Telephone#(
Mechanical Contractor
Sewer/Water Contractor
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 which requires a review and
approval of plans.
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
Sub Types
? 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 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch(screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation b 45 Fire Repair
? 33 Alteration ? 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg) - G ive PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
Footings (new bldg)
Footings (deck)
Footings (addition)
_ Foundation
Drain Tile
Roof Ice & Water _ Final
Framing
Fireplace - R.I. _ Air Test - Final
Insulation
Approved By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
REQUIRED INSPECTIONS
_ Final/C.O.
_ Final/No C.O.
Plumbing
_ HVAC
Other
Pool _ Ftgs _ Air/Gas Tests _
Siding _ Stucco - Stone - Brick
_ Windows
Retaining Wall
Building Inspector
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 3245 Rolling Hills Dr
Lot: 13 Block: 4 Addition: Bur Oak Hills
PID:10- 15500- 130 -04
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
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
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
Total: $90.00
Applicant/Permitee: Signature
- Applicant -
$88.50
$1.50
Owner:
Mark B Davis
3245 Rolling Hills 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
EA092232
12/04/2009
ePermit
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA169022
Date Issued:05/12/2021
Permit Category:ePermit
Site Address: 3245 Rolling Hills Dr
Lot:13 Block: 4 Addition: Bur Oak Hills
PID:10-15500-04-130
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. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
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 -
Jonathan P & Laura L Groeneweg
3245 Rolling Hills Dr
Eagan MN 55121
(952) 412-2548
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:EA176400
Date Issued:05/16/2022
Permit Category:ePermit
Site Address: 3245 Rolling Hills Dr
Lot:13 Block: 4 Addition: Bur Oak Hills
PID:10-15500-04-130
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
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. When a weather barrier is installed or
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 -
Jonathan P & Laura L Groeneweg
3245 Rolling Hills Dr
Eagan MN 55121
(952) 412-2548
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
Applicant/Permitee: Signature Issued By: Signature