3298 Rolling Hills Dr
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.. INSPECTION RECORD l Control No. r ; ?7 J
CITY OF EAGAN PERMIT TYPE: bII 11 11"
3830 Pilot Knob Road Permit Number: 001 3;'
Eagan, Minnesota 55123 Date Issued: 08 12 7 / 9R1
(612) 681-4675
SITE ADDRESS: LOT; 40 p 1. oC 1, , APPLICANT:
z."?K RGLL INQ "ILLS DR MITTF.LSTAEDT BROTHERS
OUR OAK N 11. L 5 2ND (612) 566-912x,
PERIIJI,[T RY1BTYPE: TYPE OF WORK: N?
INSPECTION TYPE
t o??1 I t0i DDATE INSPTR. INSPECTION TYPE
FRAMING DATE INSPTR.
1"%IIII AI TON FINAL
r Ii$ER1 Ar(
RFMAPt a ! ': & W CONTRACTOR - MCDONALU PLOD
Permit No. Permit Holder Date Telephone
S/W
PLUMBING
HVAC r sw nOC0
ELECTRI
ELECTRIC
Inspection Date Insp. Comments
Footings I ?4?2-
Foundation 9_ fj 11Z
` ?O 4 c C
Framing ? -4Y
Roofing
Rough Pibg. 9,23_?2
Rough Htg. f
?l
Isul.
Fireplace 9J? ?- !LS(? /r/2 /
Final Htg.
Orsat Test ft
Final Plbg. ! O 3 K Plbg. Inspector - Notify Plumber
Const. Meter
EngrMan
Bldg. Final /
Deck Fig.
Deck Final
Well
Pr. Disp.
f3' 4 4.
wertihcate of cccupanc?
Wim of an
This Certificate issued pursuant to the requirements of the Uniform Building Code
certifying that at the tinee of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
Use Clasaifatim: W Bldg. Permit No. 1322
OC-P-7 Type - I Zwing District R1 Type Coast. VN
oww of Bt i&m N=.qTAM MM WS AMR= 785 SUNSET ER, EWM
BWic jag Ad&,= 32% ROLI.IlM MIS DRIVE i floury L40, B2, BUR OAK EDITS 2ND
19/27/92
<" Dom
BwMnOfficW
POST IN A CONSPICUOUS PLACE
Address: 3298 ROLLING HILLS DRIVE Lot 40 Blk 2 Sec/Sub BUR OAK HILLS 2ND
These items were/were not complete at the time of the final inspection.
Date: 92 Yes No TnspPrfnr,
Final grade (6" from siding)
Permanent steps - garage
Permanent steps - main entry
Permanent driveway
Permanent gas
Sod/seeded grass
Trail/curb damage
Porch
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.
.ecwm.xE.
White - City copy Yellow - Resident copy Pink - Contractor copy
0 0579 9 4 4 1 ?D &k VA c?
Rea Date Fire No. Ro g ,In Irrpec4.on Required Inspec' her Than Rough-In
Q (You must call inspector whe eatly) eatly No ? -I N Ty Inr
J ? Yes o Date Ready
I " ensed contractor ? owner hereby request inspection of above electrical work at:
Job dress at. Ed r Route No.) City
Section No. Township Name or o Range No. Count
Occu nt WRINT)
N li
on
1
Y
I LA 4
,
POyler Supplier Address
EI sl Contractor (Company Name) Con, ctor's License No.
24
Mailing Address IConiractor or wner Making Installation)
94R I
b
sI
Authorized Si re (Contractor) wner eking Inatalleti ) Phone Number
14
1
p??? jfyj??
'Obb
M N TA STATE So 0 EL CTRI ryIApI'? p N 1Yy1ryIIN? NN'(,p1 HIS INSPECTION REQUEST WILL NOT
e Bldg. - 'f
m , MIN INN 11 IN VIII MIII I N ?? ?? N? nll ?aE ACCEPTED THE STATE BOARD
1821 University Ave.. SL Paul, MN 55180 II'ILI Ifll I1 1 11 N III 1 UNLESS PROPER R INSPECTION FEE IS
E IS
PM1One f612] 642-8888 FNCI OSFD.
REQUEST FOR ELECTRICAL INSPECTION
10- »ec?°
See Instructions for completing this form on back of yellow copy- _
057 944 "X" Below Work Covered by This Request {
Nev A ep. ype of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (Specify)
Farm Air Conditioner
Other (specify) 'tractor's Remarks'.
Compute Inspection Fee Below.
# Other Fee # Service Entrance Size Fee ircuits/Feeders Fee
Swimming Pool 0 to 200 Amps Amps
Transformers Above 200 Amps Above
100
-Amps
Si ns Z
;
Inspectors Use only: TOTAL
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in
Date
certify that the above inspection has
been made. Final oate?_
OFFICE USE ONLY -
This request void 18 months from
A, 072
Request Dale Fire No. Rough-in Inspection
Required?
? Ready Now '11f?Nill Notify Inspector
/_ Wh
R
d
?
(/ - es G No en
ea
y
I licensed contractor ? owner hereby request inspection of above electrical work at:
Jab Aotlress ISW., Boa or Route No.) City
3 z dv?
Section No. Township Name or No. Range No. C6unty
occupant lPRhNT/I/ / / g Phone No,
Power Supplier Address
Electrical Contractor (Company Namel Contractors License No.
,r?so?f141L G z
Maaing Address Oo Vador or Owner f?t akiallation)
"oyv R
Authori Signature IConiractor;Owna, Making Inetallalion) P on Number
MINNESOTA STATE BOARD Of ELECTRICITY THIS INSPECTION REOUEST WILL NOT
Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
4? Eaaoom-0e
REQUEST FOR ELECTRICAL INSPECTION ,I°. 1
,J O ^ P See instructions for c*npAicg !hi, form on back of yellow copy.
I'?_lU1 'X" Below Work Covered by This Request LW
e Add Rep. Typeof Building Appliances Wired Equipment Wired
Hume Range Temporary Service
Duplex Water Healer Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other Ispecityl Contractors Remarks'.
Compute Inspection Fee Below:
# - Other Fee # Service Entrance Size Fee # Cincuils/Feeden"
Fee
Swimming Pool 0 to 200 Amps ?' 0 to 700 Amps
Transformers Above 2D0 Amps Above 100 Amps
Signs Inspectors Use Only. TOTAL
?
Irrigation Booms /
_Xo y
? „J C/
Special Inspection l
Alarm/Communication THIS INSTALLATION MAY BE ORO ONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in • Date f
certify that the above inspection has
been made. Final ata
DX `_,'irr
`
OFFICE USE ONLY
This request void 18 monms from
F PERMIT Control No. 0989
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: BUILDING
Eagan, Minnesota 55123 Permit Number: 001322
(612) 681-4675 Date Issued: 08/27/92
SITE ADDRESS:
3298 ROLLING HILLS OR
LOT: 40 BLOCK: 2
BUR OAK HILLS 2ND
DESCRIPTION:
,'Building Permit Type SF DWG
I Building'Werk Type NEW
USC Occupanoy R-3 M-1
Construction'Type V-N
Zoning R-1
Building Length 1 62
Building Width 52
z,
}4 ,} n
REMARKS: C cie `J
S & W CONTRACTOR - MCDONALD PLBG
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Subtotal
VALUATION
$751.50
$486.48
$66.00
$700.00
lee
$2,005.98
$132,000
MISCELLANEOUS $1,610.50
Total Fee $3,616.48
CONTRACTOR: - Applicant - ST. LI OWNER:
MITTELSTAEDT BROTHERS 14569125 000344 MITTELSTAQEDT BROS CONST
785 SUNSET OR 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 Mn.
Statutes and City of Eagan Ordinances.
L_
APPLICANT/PE MIT I IGNATURE TI S ED :SIGNATURE
PERMIT #
REACTIVATE
13Z2-
CITY OF EAGAN
1992 BUILDING PERMIT
681-4675
APPLICATION
`? _? rte' aTtJAsc?
AUG 2 0 RECQ
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
talcs.
COMMERCIAL 2 sets of architectural & structural plans, I set of
specifications, 1 copy of energy talcs.
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 than a is requested once permit is issued.
Date 9 / 1j / 9 Valuation of work S8' 949-V
Site Address:_ 3a5?8 1&VLt,,'ez S hez,
STREET SUITE N
Tenant Name: (commercial only)
LOT BLOCK SUBD. .'?
P.I.D. 0
Description of work: 4 L-1
The applicant is: 4* Owner Contractor O Other (Describe)
Property Name Phone
LAST FI
RST
Owner
Address
STREET STE M
City State Zip
Company /19j ?Srq??i- y C®,.xr Phone V 5?-, ftyA'
Contractor Address 28:6 License # 3,s*3 Exp.
City State ACA( Zip
Architect/ Company Phone
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: ZOOOrd ?4ele,'-/
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./lodging
1?9 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc.
? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'l. ? 15 Deck
1146-Basement Finish
? 17 Swim Pool
? 18 Comm./Ind.
? 19 Comm,/Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
P 31 New ? 33 Alterations
? 32 Addition ? 34 Repair
? 35 Tenant Finish
? 36 Move
? 37 Demolish
GENERAL INFORMATION
Const. (Actual) V -N Basement sq. ft.
(Allowable) _ m 1st Fl. sq. ft.
UBC occupancy_I 2nd Fl. sq. ft.
Zoning ?( Sq. Ft. total
N of Stories Footprin t Sq. ft.
Length {a2 On-site well
Depth 5?-, On-site sewage
MWCC System E5
City Water YES
PRY Required
Booster Pump
Fire Sprinkler
Census Code L a:1
SAC Code a1
APPROVALS
Planning Building
Engineering Variance
Assessments
REQUIRED INSPECTIONS
? Site ? Footing ? Framing ? Insulation
? Wallboard ? Final ? Draintile ? Fireplace
Permit Fee v,tmtim: g )39, DOG-'
Surcharge GARA?6
Plan Review lAPPEP LOOELS
License 22, y30.:, (60 ?3smT I3o?(
MWCC SAC
City SAC c X 2 (20) I'?t y R '- 19
Water Conn. I'lixq = f ?(
Water Meter G qc x I /0124 o ( x a?i ??
Acct. Deposit ?JSiYiT,
S/W Permit 135LX53=71968
S/W Surcharge m'i4 X 2H = 5?6
Treatment Pl . a4 Y 3,0 = wa,
Road Unit / Y. 0 1311 ?9 Z
Park .
TrailseDed. i3?5= 1915(00
Coppies
Other ?4 x3? , ?? Lc
Total: 1 ?c6 ! JL_
SAC % S3% 3i3,5?6f
SAC Units ,-T (G?tED" uN 12 n114HzDAr.?c`
14x2H= 33(x,
13 > 9 S-1 I'7
g53XZO. c?10??,
.:.n..:.. ,„,:.. F11.JU-1T. Oc WCL 1.J.4? a?..'r'u ,?.? i-. ??.?_ -.._ _._..
SURVEYOR'S CERTIFICATE MITTELSTAEDT BROS. CONST.
Imo,
NOTE: BUILDNW DDII81POONySp?SHOWN ARE
FOR Of B LIUCTBUI? TONI'?Y. SEE
' ARCH1I MAL PLANK MR BUILDING
e FOUNDATION DIIAKININONS. .
DENOTES PROPOSED SURFACE DRAINAGE
0 DENOTES IRON MONUMENT SET
O DENOTES IRON MONUMENT FOUND
X000.0 DENOTES EXISTING ELEVATION
(000.0) DENOTES PROPOSED ELEVATION
EAGAN ENGINEERING DEPT
NOTE: NO SPECIM BOILS WYCITIMON
BY TINE
LOT THE 25MON T
THE ?M
is Nor VJWAOW
THE
SCALE: 1 INCH - 30 FEET
PROPOSED GARAGE FLOOR - 6R4,3 FEET
PROPOSED LOWEST FLOOR - BSG,L FEET
PROPOSED TOP OF BLOCK - '2195, 4- FEET
WE HEREBY CERTIFY TO MITTELSTAEDT BROS. CONST. THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF
Lot 40, Block 2, OUR OAK HLLS 2ND ADDITION, according to the recorded
plat thereof, Dakota County, Minnesota.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 17TH DAY OF AUGUST 1992,
I PROPOSED GRADES -SHOWN WERE
TAKEN FROM THE GRADING, DRAIN- SIG D: J R. HILL, INC.
AGE AK NIL EROSION CONTROL PLAN
FOR OUR CAN HILLS 2ND ADDITION
PKPWD BY MERILa 9 ASSOC, INC
LAST DATED 2-3-88. B
JOHN C.LARSON,LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19828
i
N
0 F AO O p O <
- r m
z I?1 m
0 cW0 L' V> J
L
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James R. Hill, inc.
PLANNERS / ENGINEERS / SURVEYORS
2500 W. CTY. RD. 42 • BURNSVILLE, MN. 55337 • 612.890-6044
, IIVU-YJ? JG VJLL' l??r_ 1'J. Jf'1?ILJ ?., ,_LL ??i?
SURVEYOR'S CERTIFICATE
11 r 1
,
?
/'7 ? --
o?
LOT
,O
896.8
i V
N?
1
14
X14.0 /
GARAGE
IQO 0. 20.0
2.9 @Q 4,o)
PROPOSED
DRIVEWAY
1
N
N
BENCH MARK
TOP OF PIFE
ELEV. a 890. TO
alp 70.7 `
w?? eszs x'28°57'}811 "890.1
esus Re 9n40.00 ~ BB0 ?
? M
891.6 889.1 ?\F
1m 'I S tO 0 co
A 0 I I p m X
N O O Ln
D
M
O Z A M
-4 0 'v I O >
y m x 2
M O
A U1 >
z
?D
n Z
O N 0
rn
In
N W
( I ?
SCALE: I INCH = 30 FEET
James R. Hill, inc.
PLANNERS / ENGINEERS / SURVEYORS
2500 W. CTY. RD. 42 9 BURNSVILLE, MN. 55337 • 612.890-6044
LA.
` 0 1 i 44?
F C
BENCH MARK
TOP OF PIPE
ELEV.= 893.38
MITTELSTAEDT BROS. CONST
s
?s0
II I
y
40
l
I
,0)
4 5) °4 3
3
J 1892.6
I
1
I
I
v,4,0) (`694,7) 892.026.41
d"
' (y43 L)
893.2
891.6
48.0 ( /1'
? ED /NN
HOUS rf
HOUSE
24.0 I
0
C?u4.?J I
I
I
1
891.9 I i ^?pJ
N?e °s
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION DATE
t.
OWNER TH6 tY r.y! -+w7
SITE ADDRESS ?a9R ?,. ?u D
CONTRACTOR I!1 t 1?L4?TpE nr {Zj?-TN 2s., /W4r9-a{--rIatJ NG
ADDRESS_7 S S 0,j PHONE
DETERMINE WORKING SQUARE FOOTAGE OF EACH.
1. Total exposed wall area ... ?;oZ rj, 3 aq: ft. x -11 3
2. Total roof /ceiling area ... 14I g, 0 sq. ft. x •026 - L?ZJ
Total exposed wall area above floor - '1 QI&j.
a. Total wall window area ......................... 2 /
q
b. Total door area ............................... ,
c. Total sliding glass door area ..................
d. Total fireplace wall area ...................... p
e1 Total wall framing area (average 10%) .......... 3a 2
7
f. Total net wall area above floor ................ _
.
I SIT 212
g. Total rim joist area ........................... 3/1112
Total exposed foundation area - JJ1,
h. Total foundation window area ..... 11, 21,
i. Total net foundation area above grade .......... 10O.D
Determine "U" value of each wall segment.
a •- 2 5? 9 X "U" d 2 - 107, 9
x "U" 017 2"T
C._ 63,/, X .,U„ - . 4? 2 - 2G,7
d. O X flute - d
e•_ 3a2 .'7 X "U" .ll - 33.3
f._ Ig42.2 X "U" 3N - 92. I
g• 34tJ.2 X flute 1041/ 9
X ,fD., .47- - 4, 7
i._ I fb, o X „U., .n h z
3 . ...............................Total 9you If item 43 is the same as, or less than item met the intent
of SSC 6006 (c)2.
-1-
Page 2 of 2
Total exposed roof/ceiling area - /y -*7 $
j . Total skylight area ........................... p
k. Total roof/ceiling framing area (average 10x).. S 2, y
1. Total net insulated roof/ceiling area ......... ; g 5. L
Determine "U" value for each roof/ceiling segment.
J. n x "o" n 0
k. 9 2,I/ x "U" .02 SS 2
?/
.
1. 1 3 Q S L R "U" . 02 t B 2
_
4....... .
..
.......
.......
.....
....
...... .Total
If total of 04 is the same as, or less than 92, you have met the intent
of SBC 6006(c)l.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by
the sum of items #3 and 04 shall not be greater than the sum of items
Q1 and 92.
1. ---- -- -- + 2.
3. + 4.. .. .
-2-
igc.?
L YD Bl nolq, CITY USE ONLY,,.
SUBD./SINE ?e
?' ?' #DD579?
RECEIPT*
DATE:
1995 MECHANICAL PERMIT (RESIDENTIAL)
^'0 CITY OF EAGAN
1114,7195 3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: single family dwellings
? townhomes and condos when permits are required for each unit
New construction Add-on furnace
Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date: ' lib
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @ $3.00 each)
? State Surcharge .50
TOTAL c 0
SITE
OWNER NAME: t6ms k( -" PHONE M L
INSTALLI
STREET ADDRESS:
r ' ?/??
CITY: L ? U STATE: ZIP: 5S A9
PHONE #: ((Da) ?' ) 0 - UMb
CITY USE ONLY
L BL
SUBD.
RECEIPT #:
DATE:
1995 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? all commercial/industrial buildings.
? mufti-family buildings when separate permits are = required
for each dwelling unit.
DATE:
CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION
DESCRIPTION OF WORK:
INTERIOR IMPROVEMENT
FEES: * $25.00 minimum fee Qr 1% of contract price, whichever is greater.
Processed piping - $25.00
• State surcharge of $.50 per $1,000 of permit fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:-
CITY:
PHONE #:
SIGNATURE:
TELEPHONE #:
STATE: ZIP:
SIGNATURE OF PERMITTEE
CITY INSPECTOR
L 1 y _ BL of CITY OF EAGAN
n ?? PLUMBING PERMIT
SUBD. ?GUr (612) 681-4675
RESIDENTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
CITY USE ONLY
RECEIPT . D ZC) ° 5-4
DATE 4?2ckz /r
ALSO, FOR TOWNHOMES AND CONDOS
WORK DESCRIPTION
NEW CONST
ADD ON
REPAIR _
OWNER NAME:
SITE ADDRESS: c2= 223
INSTALLER: Q 1 l _yn `'
ADDRESS: 'Z?? 4,dt/w LJ'I.
CITY: L,??ifiG? 2 ZIP: S??D,t?lzL
/:? ?? J J
PHONE
COMPLETE THE FOLLOWING:
NO. FIXTURES EA. TOTAL
REPAIR/ADD ON 15.00
SHOWER 3.00 3
WATER CLOSET 3.00 ?C
BATH TUB 3.00 3
LAVATORY 3.00
/ KITCHEN SINK 3.00 3
/ LAUNDRY TRAY 3.00 3
/ HOT TUB/SPA 3.00 3
WATER HEATER 3.00
/ FLOOR DRAIN 3.00
GAS PIPING OUT.
(MINIMUM - 1) 3.00 3
ROUGH OPENINGS 1.50
OTHER _
_ WATER SOFTENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
W. TURNAROUND 15.00
5S
STATE SURCHARGE .50
TOTAL: $
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS:
TENANT NAME: _
SUITE #:
INSTALLER:
ADDRESS:
CITY:
PHONE
FOR:
CITY OF EAGAN
CONTRACT PRICE:
1% OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1% $
STATE SURCHARGE
TOTAL:
(SIGNATURE)
Z?,".:;)_
? B CITY OF EAGAN
/I
L MECHANICAL PERMIT RECEIPT #
MD. G r u c /?- GY ` (612) 681.4675 DATE d ?2_
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: ADD-ON A/C ADD-ON FURNACE[]
SITE ADDRESS:
,3
0 I h, ADD ON/REMODEL (EXISTING
CONSTRUCTION ONLY) $ 15.00
INSTALLER HVAC: 0-100 M BTU 2400
PHONE #: 12481 Rhode Island Ave. So. ADDITIONAL 50 M BTU 6.00
Savag
ADDRESS: e, 1019 M31TITZZ
894-0005
GAS OUTLETS - MINMUM 1 Q $3 EA.
00
CITY: ZIP: SURCHARGE $ .50
SIGNATURE TOTAL
J
PERMIT
COMMERCIAL
Sa
COMPLETE THIS PORTION FOR ALL COMMERCU?UINDUSTRIAL BUI LDINGS. ALSO COMPLETE FOR
ENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR
EACH DWELLING UNIT.
WORK DESCRIPTION: II CONTRACT PRICE I FEES
1% OF CONTRACT FEE.
STATE SURCHARGE IS $.50 FOR EACH Ir
$1,000 OF PERMIT FEE. $
PROCESSED PIPING - $25.00 5$
MINIMUM FEE - $25.00
OWNER:
SITE ADDRESS:
TENANT:
SUITE #:
INSTALLER:
ADDRESS:
CITY.
PHONE #:
SIGNATURE
TOTAL:
ZIP:
CITY SIGNATURE.
5
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA168123
Date Issued:04/09/2021
Permit Category:ePermit
Site Address: 3298 Rolling Hills Dr
Lot:40 Block: 2 Addition: Bur Oak Hills 2nd
PID:10-15501-02-400
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.
*Roof permits issued between December and March will be inspected in the spring or when weather warms up.
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 -
Craig & Angela M Selander
3298 Rolling Hills Dr
Eagan MN 55121
Roofs R Us
941 W 80th St
Bloomington MN 55420
(612) 282-8092
Applicant/Permitee: Signature Issued By: Signature