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3345 Rolling Hills Dr
HOUSE HEATING TEST RECORD ,f ADDRESS 1? APT. FLOOR CITY SUBURB OCCUPANT OWNER HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY Co r?z Li/2- Electrical Work By Cos Line By- TYPE OF HEAT GA FA HW • STEAM SPACE HTR. UNIT HTR. OTHER GAS DESIGN CONVERSION MAKE MAKE OF BURNER Model Dn Modal Serial Z Mas?BTU Rating JCQ,CVS MAKE OF FURNACE Modal VoIVe L_'-' Limit Limit Setting Fan Setting _ Pilot Type . Pilot Make . Pilot Model _ Pilot Timing - L.W. Cut Off Pressure Percent CO2 Input CFH Percent 02 Stock Temp. Percent CO Form 235 Vent Size -77 KIND OF LINER SIZE NONE Draft Hood Regulasor Filters Size i -Number Chimney Location Inside Outside Chimney Construction Smoke Bomb Draft Wiring Test Tog Door Pressure Lighting Inst. Date Tested Company Testing Nome of Tester r?V?` I 6ttifirate of (Oreupanry Citp of pagan ?jrvw tatnd af Wwlbhtg ratan 77ds Cerdj ante issued pursuant to the requirements of Section 306 of the Uniform Building Cock certifying that at the time of issuance Ods saucture mar in compliance with the wrious ordinamsm of the City regulating building const uddon or use For the following. , ux SF DWG/GAR mas l q384 o,v„7rAw R3/M I Z*aialD,b,;ct R l type Caen vN o.w,ta.,,r.c MMONAID cJO1EMX. M 1&,, 1212 BWEML BAY RD, V VnU AAA- 3345 F40LLIM HILLS DtM -- L16, B9, BE OAK RIMS 2ND / 11 Duc 8/29/41 ?a POST IN A CONSPICUOUS PLACE .. q l r., . ?M 7)t' . ,..-fin. '- q,p" C -r r . . . . . . . . . JUN MAWVAM ?DECX 56496/03/92 CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for SIP DWG/GAB Est. Value $102,000 Date JUL Site Address 3343 11rflLL1NG 1 Lot 16 Block SecfSub. Parcel No. W Name !lCDOMW GMSTRUCT10N INC 3 Address 1212 11;1.118L1LL DAY RD City 1!' Y1LLB Phone 688-7061 a Name SAW u e Address P City Phone Name - Address Phone I hereby acknowlege that 1 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 Perrnitee A Building Permit is issued to: 11CD011ALD CM T on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. r .. "} I S3 Building Official <. y 7 `5 9 , 19 91 OFFIC E USE ONLY Occupancy a-3 s "-1 FEES Zoning a- -I-(Actual) Const Vri--- Bldg. Permit 647000 (Allowable) V.W-- Surcharge 51 s00 # of Stories 420 00 Length 76 Plan Review . Depth 30-- SAC, City 100.00 S.F. Total SAC, MCWCC ASO-00 S.F. Footprints - sd0 On Site Sewage Water Conn On Site Well - Water Meter 95.00 MWCC System 1- 30.00 City Water . A• Deposit 30.00 PRV Required . S/W Permit Booster Pump S/W Surcharge .50 276*00 Treatment PI APPROVALS Road Unit 370.00 Planner Council Park Dad, Bldg. Off. - Copies Variance TOTAL $3.3 .50 Permit No. Permit Holder Date Telephone # WATER .2 /, i k. 7 /g SEWER PLUMBING 7%V 9/ Y -?Jl[?U 221x2 v ?,? 9/ ?3fo °? H.v.A.C. ,?/ / GD -(PDT ELECTRIC G f1? 00 611 Inspection Date In p. Comments Footings I 1 5 Foundation S Framing Roofing Rough Plbg. - ??-? Rough Htg. 7 [Sul. 19 Fireplace d q/ aS ?l7(9l Z X, Final Htg_ ?1611- 9C - _ Orstat Test / Final Albg. -z Ptbg. Inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final c2 Deck Fig. ?p F Z Deck Final Well Pr. Disp. ?y CASH RECEIPT CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE n }}11 FI10?1 WW ?.- AMOUNT S 8 DOLLARS 0 CASH CHECK FUND OBJECT AMOUNT Thank You BY C &I I ` `._ L --/ C 141-375 wm.-.fty. c-w Yokm- -Flw*v Con Pw k--Fk Copy SEWER & WATER PERMIT CITY OF EAGAN 3830 Pilot Knob Rd. Eagan, MN 55122-1897 DATE OFFICE USE ONLY METER # 4qy(? Ld'7-7 I PERMIT DATE 7/9/91 CHIP # /(O 1 3958 METER SIZE SG,. S4 S PERMIT # B .P. RECEIPT # 12124 1437 5 ISSUE DATE 8 '240J/ B.P. RECEIPT DATE 7/9/91 x "I PRV - BOOSTER PUMP SITE ADDRESS 14111n, ',ij1 1 g Pr LOT i BLOCK SEC/SUB Bur Oak Hi 1 1 A TT APPLICANT: l c 'A1 f? ?, r.+r + k?c .ADDRESS: ?J,ie"I l `"", Q_A CITY, STATE W41) ZIP PHONE: L`3L -7061 PLUMBER: ?}n+r 1?1 , •.,' ADDRESS: !()I M aL.^iS?--e?r. , , TirrA(P CITY, STATE F'I nn.• ?r _i Mi\i ZIP q20 PHONE: I?A - '-d i y OWNER: ,6 " c A A RP L f Cp,J ADDRESS: CITY, STATE ZIP PHONE: PLEASE ALLOW.TWO`WORKING DAYS FOIE PROCESSING. CALL SEWER PERMITS, CONTACT ENGINEERING DEPT. PERMIT REQUESTED ?SEWER ? ATER TAPS COMM/IND ` RESIDENTIAL L--NEW EXISTING Lawn Sprinkler Meters are to be Installed Ahead of DomwWc Meters-on Water Line. Credit WILL Ngbe given for Deduct Meters. ,Y WITH SEWER & WATER PERMIT CITY OF EAGAN 3830 Pilot Knob Rd. Eagan, MN 55122-1897 DATE 9111 Y - 1 001 ., .? ' 1% OFFICE USE ONLY METER # PERMIT DATE CHIP # PERMIT # 12124 METER SIZE B.P. RECEIPT # C }?' 1 ISSUE DATE B.P_ RECEIPT DAT E KX PRV BOOSTER PUMP 4 S `tl '?1 i i r+ t?i i 7r? SITE,A DR LOT BLOCK SEC/SUB r L' Hi l 7 :,, TT APPLICANT: + - r ADDRESS: -k ?=`. f ,?ti":I fcl CITY, STATE F.,_, r, ' .f+ i I. ?, } ZIP PHONE: - LL PLUMBER: ?' ADDRESS: ' CITY, STATE ZIP $`? 2U PHONE:',. OWNER: Q,; r++,= A f, P12L : nr,j ADDRESS: CITY, STATE PHONE: - ZIP PERMIT REQUESTED L--- SEWER COMM/IND L NEW \)VATER -TAPS RESIDENTIAL EXISTING Lawn Sprinkler Meters are to be Installed Ahead of Domestic Meters on Water Line. Credit WILL NOT be given for Deduct Meters. I AGREE T(YCOMPLY WITH CITY OF tAGA4 ORDINANCES SIGNATURE WHEN METER ISSUED PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. If,G/S/ o?a?9i /G ? f/Da'SO? ' 1771 /I Rap est D e _ Flre No. Rough in Inspection R; ? O Ready Now ill Notify Inspeclor Wh R Ves G No en ea I licensed contractor O owner hereby request inspection of above eleall cal work Job Add y5l e t. x or Route N i Jl City Section No. Township Name or No. Range No. Coun Phon 03/ _ 7`s"i J1 Address' O o an, Wame) EI?blnphko'r Contr for License N s IOonjtor or er Making nstallation) 7 re IContrac rtOwney Making uuddllaV) / one umb? ?? MINNESOTA STAE 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) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-oaool-08 ? See i svuclions for wmpleling this form on back of yellow copy. P I (j / "X" Below Work Covered by This Request " (o J Building Appliances Wired Equipment Wired eater g W o Other (Specify) strial dit c--.rks l : Other Compute inspection Fee Below: # ther O Fee # Service Entrance Size Fee # Circuits/Feeders Fe Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Amps Signs Inspector's use only: TO L Irrigation Booms S Special Inspection 3 Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONtEC TED IF NOT Other Fee r COMPLETED WITHIN 18 PITHS. I, the Electrical Inspector, hereby Rough-in le •7X certify that the above inspection has been made. Final Data ' %L . OFFICE USE ONLY { This request voia 18 monies from /6/?J Request a r Firi, No. Rough-i inspection Raqui tl? s No ? Ready Now iM41111 Notify Inspector When Ready? I l licensed contractor ? owner hereby request inspection of above electrical work at: Job Add 9U (Sire BoKaL80yte .) City Section No. Township Name or No. Re ge No. Coun 0" nt IPRIN) I N Pone No Power Supplier Address EI - al Contracicil (COmp4ny Rtl% 'AF 11 PA CAV-1 ir, TAM M ling or ss t ntra I I Owner Making Installah Aut nzec Si nd re I n actor/Owner Ma al Mo. 9e nl P o er - MINNESOTA STALE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOTa JS?i 1" Grippe-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD /? fj 1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS ? `I Phone (612) 642-0600 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION `" Eaocoo os ? Sae instructions fi{ completing this (arid on back of yellow copy. ` i a aas L ' O 8 5 7 5 X" Below Work Covered by This Request Add Rep. Typeof Building Appliances Wired Equipment Wlred Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other-.(Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Conlractor5 Remark Compute Inspection Fee Below: )(4 Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 01c 200 Amps 0 to 100 Amps Transformers Above 200-Amps AI)ov_e 100 -Amps Signs Inspectorls Use Only: To ^ Irrigation Booms _ w Special Inspection Alarm/Communication THIS INSTALLATION MAY B ERE 1^ ONNECTED IF NOT . Other Fee COMPLETED WITHIN 18 M '. El'"" I, the Electrical Inspector, hereby Rough-in oe ?' , certify that the above inspection has been made. Final Is -'p OFFICE USE ONLY This request void 18 months from c" f t a ?_Va? 7 0 g Request Date ry r / Fire No. Rough-In Inpsetlion Repaired 11'ou must call inspeMrwhen ready) In Ti Other Than Rougi T Ready Now ® Will Notify Inspeclar `? "-1 y ? Yes ? No Data Ready i licensed contractor ? owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No.l 3 3 15 Rollin ?l i I ly DR City ? tiq Section No. TownsniD Name or No. Rarge No. County P/?? / ?(J.. A LL /I Occupant (PRINT) I o• L Ch al h 5 Phone Ni L/•V„?UL Power Supplier 1 , 5P Address Electrical Conan (Com any Na 1 SAT, ??????? Contrai Licens o t#O Z-9a Mailing Address l Contractor or,Ow n3oing lnstalla(i011_.,j m tvw Lq)cwr 11'.( kv _7 7- Authorized Signature (Contra ctonOwn r Making Installation U c?,?- Phone Number Sit z_ 1Z_'73 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 55100 UNLESS PROPER INSPECTION FEE IS Phone (612) 662-0800 ENCLOSED. t 9 ' REOI ZEST FOR ELECTRICAL INSPECTION CVry" Il See';yftioas for completing Ihis form on back of yellow copy. 5 7 "X" Below Work Covered by This Request STM q'4 E&/0y0001-W aa-Z47 e Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management I Comm.llndustrial Furnace Other (Specify) Farm Air Conditioner Other fspecigl Contractors Remarks: 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 f'O Irrigation Booms yQ Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 M HS. I, the Electrical Inspector, hereby Rough-in p?ate? ®s/?f certify that the above inspection has been made. Final - r Date .? I , OFFICE USE ONLY TF.. -......w..n 1. mnnme {.nm Address: 3345 ROLLING HILLS DRIVE Lot 16 Blk 5 Sec/Sub B[)R OAK HILLS 2ND These items were/were not complete at the time of the final inspection. 8/29/91 Yes No K/ - Final grade (6" from siding) Permanent steps - garage V 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. warm nxn White - City copy Yellow - Resident copy Pink.- Contractor copy JULY 30, 1991 DATE: RE: 3345 ROLLING HILLS DR., L16, B5, BUR OAK HILLS 2ND %X Your Sewer & Water Permit for the above property has been completed. It will be held at the public Works Garage (3501 rCoachman Road) until the meter is picked up. BE SURE TO ;QA1LL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON. -'-Your Sewer & Water Permit for the above property cannot be completed for the following reasons: Your Sewer & Water Permit for the above property has been completed, but the meter cannot be issued or occupancy allowed until further notice. COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be confirmed by Bill Adams or Dirk House (Plunj6ing Inspectors - 454-8100) before issuance. P WARNING: 'BEFORE DIGGING, CALL LOCAL UT LITIES - TELEPHONE, ELECTRIC, GAS, ETC. - REQUIRED BY LAW. i CONTACT COMMUNITY DEVELOPMENT DEPARTAAENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. r CITY OF EAGAN N? 19384 3830 Pilot Knob Road, P.O. Box 21- 199, Eagan, MN 55121 PHONE: 454-8100 C / `l 3 -? S BUILDING PERMIT Receipt # $102,000 SF DWG/GAR JULY 9 91 To be used for Est. Value Date t9 Site Address 3345 ROLLING HILLS DRIVE Lot 16 Block 5 Sec/Sub. BUR OAK HILLS 2 OFFICE USE ONLY Parcel NO. Occupancy R::1, 3 M-1 FEES R 1 Zoning = W Name MGDONALD CONSTRUCTION INC (Actual) Cons( VL_ Bldg. Permit $ 647.00 Address 1212 BLUEBILL BAY RD (Allowable) ttT? 51.00 City B' VILLE Phone 688-7061 of Stories surcharge 42 76 Plan Review 0.00 Length th L O Name SAME Depth 30 Cit SAC 100.00 f , y Q Address S.F.Total - G S F F i SAC, MCWCC 650-00 City Phone . . ootpr nts - t C W 660.00 On Site Sewage a er onn ? W Name on site well W 95.00 Fw Address MWCC System XX- ater Meter 30 00 iw City Phone City Water Amt. Deposit . 30.00 PRV Required XX ?? SNJ Permit 1 hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge • 50 information is correct and agree to comply with all applicable State of 276 00 Minnesota Statutes and City of Eagan Ordinances. Treatment PI . Signature of Permits 4Q11,V4 APPROVALS Road Unit X7[1-00 o U U A Building Permit is issued to: MCDONALD CONST Planner Park Ded. on the express condition that all work shall be done in accordance with all Council applicable Slate of Minnesota Sta"es Citty of gan Ordinances. annd Bldg. Off. Copies / , $3,329.50 Building Official Variance TOTAL 90.00 2006 RESIDENTIAL BUILDING PERMIT APPLICATION J? / /q 5 City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirements Remodel/Repair Requirements Cl$ieeil''Jse dniv 3 registered site surveys showing sq. N. of lot, sq. ft. of house; and all roofed areas 2 copies of plan showing footings, beams, joists Certof;Survey Recd _Y N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree i?r@s P,liih R@cd -,Y "N. 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Trea,Ptes Reported '` Y _ N l set of Energy Calculations Addition - indicate if on-sife septic system o0-sita&ppfd System 3 copies of Tree Preservation Plan if lot platted after 7/1193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form Dated/2 / 01 Construction Cost 1 Site Address _??tZ!rj Q-01 1 I NQ? Unit/Ste # Description of Work r Off )T rOOE Multi-Family Bldg - Y K N "'111 Fireplace(s) _ 0 - 1 _ 2 PaTTo N Property Owner Mck fi _?}t1? i " Telephone # ( ) Contractor Ubl cxlty toys Address UA32 V I I IP02Nlk11 V M l U C d City i t \, _rnijNoru4 State AN zip4%U24 Telephone#((051 ) 4(0()°(alo COMPLETE THIS AREA ONLY IF Energy Code Category - Minnesota Rules 7670 Category 1 (? submission type) • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted A NEW BUILDING _ Minnesota Rules 7672 • New Energy Code Worksheet 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 which requires a review and appr kt" oval (o?ftplans. n (? ?y, ,,A??p?/1 ll1 I fi?M V ?iia 1 1d V''" M IC" Ri1a.&.iv Applicant's Printed Name Applicant's Signature 2004 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan [E tv L 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX 4 651-675-5694 '%70 0) New Construction Requirements Remodel/Repair Requirements 6ffigetkeOnlu 3 registered site surveys showing sq. R. of lot, sq. fl. of house; and all roofed areas 2 copies of plan CertaF Suroeyge4d .?Y ...N (20%maximumlot coverage allowed) IsetofEnergy Calculations forheated additions TreePresPlan?IAecd _Y _N ' 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks TreePres rfeitNlred „ N l set of Energy Calculations Addition- indicate iforr-site septic system ohsge Sepicgystem _YN 3 copies of Tree Preservation Plan if lot plaited after 7/1193 Rim Joist Detail Options selection sheet (bldgs with 3 or less units / bq Date P / 13 i Construction Cost 2, 0?z) _ Site Address 7,t1 Ipt-l,-l'JL Unit/Ste # Description of Work trj5j'&L ( '45 57D5 Multi-Family Bldg - Y LIN Fireplace(s) - 0 - 2 Property Owner l(JCitJ g ?," I GI ??? f tVLn J Telephone # Contractor r`?1GL761 ?? Address 500 td. rwli 13 City jyat State AA-) Zip 6? 13 Telephone # (9,?L) 5101 a COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 - ivlinnesota 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, anowork is not to start without a permit; that the work will be in accordance with the approved plan in t,4 case of oj? which requires a review and approval of pl 30(? ` ph_w lJ Applicant's Printed Name 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 01of_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 Ptbg_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 Bldg ) - 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 _ HVAC Drain Tile Other Roof Ice & Water Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ - Siding _ Stucco - Stone - Br ick - Fireplace _ R.I. -Air Test - Final - Windows 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 r t!?;- I cc Sri RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-881-4875 New Construction Reaulremems • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 set of Energy Calculations • 3 copies of Tree Preservation Plan r lot platted after 711/93 • Rim Joist Detail Options selection sheet (burgs with 3 or less units) DATE (01 R- I 02 3?M 5' Pi SITE ADDRES TYPE OF WORK l 0 ?QS 1`? C APPLICANT I n STREET ADDRESS 1 l0 6 K L C QT TELEPHONE # (?b'LaO Q(! () CELL PHONE # L-?-t STATEUO LP 55 ) 1-7 FAX#&i-aga1-Dgbb PROPERTY OWNER I I Ill °I fU ?'a u a?Cy'les TELEPHONE# 6+2- _b210 ----------------------------------------------------------------------------------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ M (d submission type) • Residential Ventilation Category 1 Worksheet Submitted • 7y? - Energy Envelope Calculations Submitted Numbing Contractor: Phone # Plumbing system includes: Water Softener Lawn Sprinkler Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor., Mechanical system includes: Sewer/Water Contractor: RemodegRepalr Requirements 2 copies of plan • 1 set of Energy Calculations for heated additions • 1 site survey for exterior addalons & decks • Indicate N home served by septic system for additions VALUATION ``"0w (, ?? N r??s D>z . - Air Conditioning - Heat Recovery System MULTI-FAMILY BLDG Y vN FIREPLACE(S) _ 0 _ I - 2 Phone # Fee: $70.00 Phone # I hereby acknowledge that I have read this application, state that the Information Is correct, and a ree to comply with all applicable State of Minnesota Statutes and City of Eagan nancpesf. r Signature of Applicant I1'i .?,?id-2- --°----------------------------------------- - -- 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 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 ? 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 INSPECTIONS _ Footings (new bldg) _ Final/C.O. _ Footings (deck) _ Final/No C.O. _ Footings (addition) _ Plumbing _ Foundation _ HVAC _ Drain Tile Other Roof _ Ice & W ater _ 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 Building Inspector - ?5 RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 1 d "? 851-881-4875 New Construction Reaulrements • 3 registered site surveys dgwing sq. ft. of lot, sq. ft. of house; and &Il roofed areas (20% maximum lot coverage allowed) . 2 copies of plan showing beam & window sizes; poured found design, etc.) . 1 set of Energy Calculations . 3 copies of Tree Preservation Plan r lot platted after 711193 . Rim Joist Detail Options selection shoot Ibldgs with 3 or less units) DATE SITE ADDRESS TYPE OF WORK_ APPLICANT _ STREET ADDRESS TELEPHONE # LL? PROPERTY OWNI TELEPHONE # COMPLETE THIS SECTION FOR a NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672 0 submission type) • Residential Ventilation Category 1 Worksheet Submitted New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor. --- Plumbing system includes: Mechanical Contractor: _ Mechanical system includes: Sewer/Water Contractor: Remodel/Repair Reauiremerds • 2 copies of plan • l set of Energy Calculations for heated additions . 1 site survey for exledor additions & decks . Indicate r home served by septic system for additions VALUATION L ULJ? J?4 MULTI-FAMILY BLDG _ Y = N -0-1 2 Lf ?-J CITCY1&LLSTATE qP C351 1-1 FAX # I( I r ??`? C PHONE # Water Softener Water Heater No. of Baths Phone # Lawn Sprinkler No. of R.I. Baths Air Conditioning Heat Recovery System Phone # Phone # Fee: $90.00 Fee: $70.00 --------------------------------------------------------------------------------------------°-------------°------------- I hereby acknowledge that I have read this application, state that the information is correct, angYagree to comply with all applicable State of Minnesota Statutes and City of Eaga din n/// Signature of Applica f _._._._............ _._ ............... _..................?..._ ..r._r _v.e... 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 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 ? 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 Bidgs 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 _ 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 Building Inspector Total PERMIT # (wsa4 CITY OF EAGAN 1992 BUILDING PERMIT APPLICATION 681-4675 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, I copy of energy calcs. Penalty applies when typing of permit is requested,•but not picked up by last working day of month in which request is made or lot change is requested once permit is issued. Date .S / c2O / 92- Valuation of work Site Address: Ll tc% RQLL_I N I L•LS bA 1(19" STREET STE / Tenant Name: LOT _ r BLOCK ? SURD,?1?(IQ ?K ?"'f ?„ly P.I.D. IF l Description of work: EC< The applicant is: R Owner ? Contractor ? Other (Describe) Name -10+14 W. CHAL.d_dS Phone 664-576-7A Property LAST FIRST 2Z 8_56 wq Ld Owner Address 33L/ 5- /-QL.-1 y/ACS ?IZ 222-8/ OLy_e_ STREET STE IF / SS/ 2 city Z A?Cr r1? J State /U zip Company Phone Contractor Address License # Exp. City State Zip _ Company Phone Architect/ Engineer Name Registration # Address City State Zip v 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. J ?a ? C?R-dt-eO Signature of Applicant: t urrwr- Loam vryL.r BUILDING PERMIT TYPE ? 01 Foundation ? .05 Apt. Bldg ? 09 Basement Finish ? 1A PNb c ac. ? 02 SF Dwg. ? 06 Garage/Accessory ? 10 Swim Pool ? ?? l r uural ? 03 Two family ? 07 Fireplace ? 11 Res. Add./Porch ? I5 M1scell-aneous ? 04 Multi-fam. T.H. 0 08 Deck ? 12 Comm./Ind. WORK TYPE 122 31 New ? 34 Repair ? 37 Demolish ? 32 Addition ? 35 Tenant Finish ? 99 Undefined ? 33 Alterations 0 36 Move - GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable; 1st F1. sq. ft. City Water UBC Occupancy - 3 2nd Fl. sq. ft. PRY Required Zoning Sq. Ft. total Booster Pump 6 of Stories Footprint Sq. ft. Fire Sprinkler Length a9x1z On-site well Census Code L13 c1 Depth 1O x15 On-site sewage SAC Code APPROVALS Planning Building Assessments. Engineering Variance REQUIRED IN SPECTIONS ? Site 51 Footing ? Framing ? Insulation ? Wallboard M Final ? Draintile ? Fireplace Permit Fee N IG Valuation: S Surcharge Plan Review License MWCC SAC City SAC Water Cofi i. Water Meter Acct. Deposit S/W Permit S/W Surchargge Treatment P1. Road Unit Park Ded. Trails Ded. Copies SOO / Other Total: p?D G?/?12 SAC % SAC Units f C 1 I ?e??P /veering+. LAND RRRneR9. u P4WAP[ARGNITCCTf Certificate of Survey for:_ MG,o?ALD COA157 •' /OD. /Z M06°51,04 Jr b `o ? u eN 1 D I U N ? 7G ii _ 7422 Enterprise Efri78 Mandate Heights, MN 55120 (612) 681.1914 WORTH 0 7 Wl L4tAMS RPcUNE E.4s 8r.l brut W Q N a4? s s39^ r- - aecx ?.? r e e 4 91.0 91; e Q PRO PosEO r 70.0 ` no N t4ouSE GAe, 24b3 '- x7, IAI? 10 Z4+P ` _ 849,0 10o.c>v N8903$'13'"E O n E7 Nip ? s 900.0 Denoles exishnb Elevalion .. 990o.0 Denoles propoNd Elevation -" " Denoles Drainaje j Utili l Easement ?_ .._ Denotes Or>arr7a e Flow Arrows o Denoles rnonumenl B earinis shown are assn rn ed M ate. " N p_Se /= f? dam R p i° 'r'. i....: r DIE' 105 PAV, REQUIRED PQOPOSEO 91 ELEVATIONS Lowest {-loan E/evaljon 111,114t. Top of 61ock ftevaliwn t 845.6(L? (+orOgtt Slob Revcsfion = 8491), LOT /& _, 8LOCk ? , SUR; OQk l-/ILLS ZND DgttorA COUNTY, MINNrSOr#V s vacr ro E9rFMENrs t hereby certify that this survey, plan or report was pr .pared by me of under my direct superoleiPn and that I am duly Registered Laid Surveyor under the laws of the State of Mlnnesots. Dated this 2 day of A.D. 19?L tSC'Al? 1 me = ?? F Eef 9 ,/ z - 4W/3. 0-3 PORERT S. SIKICN L.S. REG. NO. 14891 V 59, ItIPERMIT APPLICATION CITY OF EAGAN SINGLE FAMILY DWELLINGS 2 SETS OF PLANS 3 REGISTERED SITE SURVEYS 1 SET OF ENERGY CALCULATIONS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL REGISTERED SITE SURVEYS - & STRUCTURAL PLANS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS _# OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. l ? ©© O To Be Used For: s4e 't1 Valuation Site Address Lot Jg Block _5 Parcel/Sub Blur 04y, 14; I s 1L.. Owner Address City/Zip Code Phone Contractor I Address ( 21213 ne?i ?? %. P? City/Zip Code Burn)sw/le ?5533? Phone 6 se--7 O?p Arch./Engr. Address City/Zip Code Occupancy Zoning Actual Const Allowable a of stories Length Depth S.F. Total Footprint S.F Date: --7- 3 - 91 OFFICE USE ONLY /o/ U//y 2(e 3e) On site sewage_ On site well MWCC System ? City water ? PRV Booster Pump APPROVALS Planner Council Bldg. Off. Variance FEES Bldg. Permit Surcharge 15'/ Plan Review y -2,9 SAC, City OD SAC, MWCC /oS0 Water Conn. 660 Water Meter Acct. Deposit .30- S1w Permit 30 S/W Surcharge _$D Treatment Pl. Z?/ Road Unit 32o Park Ded. Trail Ded. Copies SUBTOTAL Penalty Lot Change TOTAL agrees that all work shall be done in accordance with all?applicable State of Minnesota Statutes and City of Eagan Ordinances. yz- ?/ L Y2, 1399,vZ,?? ) GaY 2Z? zy. 3 x ?s- 319G/, /S' 9-0/9 z ? 1)80 VY I . ** *4 Fr101ifli * on`g?*r *?14 Pioneer Ens lneer ins 6819499 P.02 2422 Ente.rpr'rse Drive Mendota Heights, MN 55120 1612) fi raring,. LAMO PLANMER9• LANW4PC ARCHFTCCT9 Certificate of Survey for:- ' `??,AML12 COIV5T-, GL /oo. z N06°5l'54"47 q? 'Itk, O ' u N ? e b O d tl? ? N ?tl; ,{t 1 O .. 8'iq,a _r [nrJ'1r.y ?b.o T1. e o Q PRoPOS,eo a' Np N NauyE i GA14. 24.x3 -°' za3 ?.'r z4.3 `849.0 / pd as 0 N 01e3$'IVE o? NORTH 0 a 7, WIL1.rAM3 FsP6L NE % ?AS.?Mfir./T W N N E?tGAN ENGINEEAINd N/L. L S DOC / ?5 900.0 Denotes existingp Elevation 'E r 900.0 Denotes propoMd Elevation " Denoles Vrair a de j!/ti/d Easement Denotes Vram+ now Arrows o penoles monument y gearinyfs shownare assumed L ®T ?6 QLOCk S , D'AMOtA CO(INTr, MINNVfO7"4q i PROPOSED HOUSE EtEVAIJONS Lowesf F7oar Elevation 344,41, Top of Block flevaf ion r 84-U-(t7 GaraP Vab Lckvafiorl , $4q-;3 Boa ,4K MILLS 21VD sv?l?cr ro I hereby certify that this survey, plan or reoort was Pr spared by me nr under my direct 6oper?isivn and that I am duly Registered La,d 5,11•+eyor under the law, of the State of Minnesota. Gated this 2 day of ? A.O, 5Colle : I inc . 40 f Qe? 4 F / J3• D.7 admis-Z SIKICH L.S. REG. NO. td$91 N MINNESOTA STATE _ENERGY CODE CALCULATIONS BASED ON CHAPTER 5 OF THE MODEL ENERGY CODE - 1983 EDITION Adoption Effective Owner -,?> I?h F 'C?YI G K oo 10. eJ - Phone Date Site Address Contractor__ ` I?QMAV.VO ST, ) NG Phone Building Classification: Type Al (Single Family & Duplex) Type A2 (Residential, 3 stories or less) (Over 3 stories) (Other) NOTE' Complete pages -3 and 4 first. GENERAL INFORMATION IV %? 1. Building Perimeter%f,- W0?,tom A ft. 2. Wall height (ground to eave) V, p Q,ft. 3. 1. X 2. (above) gross wall area Z?S Z 16 ?7) sq.ft. 4. Building dimensions (L) X (W) sq.ft.roof & floor area 5. Sq. foot area of rim joist - Floor joist size (2 X lU Aj-> X ? _(Perimeter) _ ??sq.ft. 12 6. Doors - Area I ?.&4 O Thickness in U. factor a I4 ?41 Type of Construction Perimeter ft. Manufacturer 7. Total door's perimeter ft. 8.. Windows: Manufacturer 1N5Uc. ?r?\`^YYIrtr.' State approved U factor TYPE SIZE AREA (Sq.Ft.) NUMBER OF TOTAL N I I , EACH UNITS SQ FEET 9: Total sq.ft. Glass 10. Fireplace area: Width X Height = X = sq.ft. 11. Exposed foundation: Height X Perimeter '?P I -7 X ( ?- _ _L- COMPLETION COMPLETION OF THIS FORM IS REQUIRED FOR ALL NEW CONSTRUCTION, MAJOR REMODELING AND BUILDINGS BEING MOVED WHERE ENERGY, OTHER THAN THE MINIMAL CODE ALLOWANCE, IS USED. -1- f ' r ?) 12. Framin area = 10% of . g gross wall area. 13. Gross wall area 1-155-r 06 sq.ft. Window area A 12Ssq.ft. U windows = ? UxA = Zr7 V i ryv 1 R m joist area A sq.ft. U rim joist= r UxA = Door area A sq.ft. U door area= f UxA = Other doors area A.11 sq.ft. U other doors=-1-4---7- UxA = Exposed fndn A ? OZ sq.ft. U foundation=-A!?o UxA / G Framing area A ?? ?l 7, sc? ft 5 area=+ 095- U framin UxA 3 = ? . g , Net wall area A ft. U wall= t UxA = (13B) TOTAL . . . . . . . . . UxA 14. Gross wall area x 0.11 (13. above) x 0.23 x .23 X 28 A 2(?jZr ? U Code r (A-1 single family & duplex) = allowable UxA/Code (A-2 other residential) (Other buildings) (Over 3 stories) BTUH must be larger than or same OF. as 13B above 15. Ceiling framing area (Af) equals 10% of ceiling area 15D. TOTAL U x A ............................ 16. Ceiling area (15A) x 0.026 (A-1 single family & duplex) allowable UxA/Code x 0.033 (A-2 other residential) x 0.06 (other) f7??fJ - ?1l5Z. OF. must be larger than or same A(15A)1 ° x U Code - F. as 15D above NOTE: Use U and A values obtained from pages 1, 3 and 4. CERTIFICATION: I hereby certify that I have calculated the "U" factors and "R" values herein and that the building here described meets or exceeds the State of Minnesota Energy Conservation Act. 15A. Gross ceiling area = (L) (W) 1447:)_sq.ft. 15B. Joist area (Ac f) = 10$ ceiling area sq.ft. x -"" = = q?? qq= I? +? 15C. U Net ceiframingling x A f area = (Ac) (OZ15A 3 - x 15B) sq.ft. U ceiling x A = l ??-? ? x Z!= Z?r z? Date Signature -2- ?, ,_ WALL ' SECTION STUD SECTION 1\•I VALUE Inside air film .68 e?1 Interior wall Insulation Sheathing ?iULO Siding 101 Outside air-film .17 R TOTAL Z 5, 0 U VALUE (Wall) U . R Inslde.alt film .68 Interior wall . ?rJ 4" stud R= Ji:38(p,SO (Framing) U . R Sheathing G,p(n Siding Outside air film .17 ?- R TOTAL 10-52 b 2ND-WAL-L- SECTION. RIM JOIST Inside air film R= .68 interior wall .-" Insulation U "---Sheathing -,Exteefor wall covering Exterior air film R-a .17 R TOTAL -` Interior air film R= .68 `I insulation IgICC , 1 'lit inch soft wood R=1.88 (Rim U Joist) Sheathing Z/p? Exterior wall covering , Exterior air film R= .17 R TOTAL Z I ?Cy Interior air film R= .68 Cnsulatlon? F1F,[?(a1711/> h?e0 ?dOQdP.FAon Z?Oq' (Fdn.) U = _ Exte'rio'r air film R= .17 ??JJ 0 R TOTAL (i I aq -y`'Exposed Block \ ?\ -,Cirade 3. .I LING WITH VENTED ATTIC PACE ABOV R VALUE FRAMING R VALUE CEILING 0.61 AirFilm 0.61 3 ?•p Insulation 45.0 4.38 Joi 0.56 Ceiling 0.56 /00.61 AirFilm 0.61 42. 10 TotalR 4(o.70 .OZZj U = 1/R • 07-1 Window infiltration 0.5 cfm/lineal foot of crack Residential door infiltration 0.5 cfm/square foot or door and minimum code requirement Non-residential door infiltration 11.0 cfm/lineal foot of crack Ub 12" concrete block no insulation = .47 R 2.1 Ub 12" concrete block insulated cores = .26 R 3.8 Ub 12" lightweight block = .32 R 3.1 Ub 12" lightweight block insulated cores = .12 R 8.3 U single glass = 1.13; with storm window .54 U double glass = .55 U triple glass = .41 All exterior walls and ceilings must have a vapor barrier (0.10 perm max.). Vapor barrier must be on the inside (heated side) of wall. Vapor barriers of the polyethelene thin film have no R value. IA CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE: (612) 454-8100 Aloe FOR CITY USE ONLY PERMIT # RECEIPT # DATE: 0 9 "PgARM PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS A TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. ------ ------ ------------------------ ----- WORK DESC IPTION -------------°---------- --------------- COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL NEW CONST ADD-ON MINIMUM W 15.00 00 3 O ADD ON SHO ER . REPAIR WATER CLOSET 3.00 x.00 BATH TUB 3.00 LAVATORY 3.00 OWNER NAME: 61 lQ Itic . KITCHEN SINK 3.00 ? IY_ /6 LAUNDRY TRAY SPA HOT TUB 3.00 3 00 3 00 SITE ADDRESS: v / . LOT: J? BLOCK ?SUBD. UN WATER HEATER FLOOR DRAIN 3.00 3.00 3 00 ?-- ? V hC hq GAS PIPING OUT. (MINIMUM - 1) 3 00 3 00 INSTALLER: ] P I(71 U ) . -/ ro Al . . I A al (` ROUGH OPENINGS 1.50 Yz?a 8 J l as ADDRESS : yl? e ve /P . `X7. OTHER - '?yT WATER SOFTENER 5.00 CITY 6 Ma l b ?P ZIP: -PRIVATE DISP. 15.00 h U.G. SPRINKLER 3.00 PHONE #: (f Cam-' ' SUBTOTAL S ? ST. SURCHARGE .50 SIGNATURE OF PERMITTEE TOTAL: l? PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: OWNER NAME: SITE ADDRESS: LOT: BLOCK _ SUBD. INSTALLER: ADDRESS: CITY: ZIP: PHONE #: FOR: CITY OF EAGAN FEES 18 OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR EACH $1,000 OF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x 18 $ STATE SURCHARGE $ TOTAL: (SIGNATURE) CITY OF KAGAN 3830 PILOT KNOB ROAD EAGAN, MN 55122 PHONE (612) 454-8100 FOR CITY USE ONLY PERMIT # RECEIPT DATE: Ix:I:AI PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. -------------------- r ------------------------------------------- WORK DESCRIPTION FEES NEW CONST ADD ON REPAIR OWNER NAME: SITE ADDRES LOT: INSTALLER: ADDRESS:.\ CITY: S? /` ZIP: `5 C1'! _ PHONE 4(? o' (c) c-, a--), 7 SiIGN?1TURE OF PERMITTEE TtIXLPLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, COMMERCIAL"INDUS ..... . APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. ---°---------------------°___ CONTRACT PRICE: OWNER NAME: SITE ADDRESS: LOT: BLOCK SUBD. INSTALLER: ADDRESS: CITY: ZIP: PHONE #: 18 OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR EACH $1,000 OF PERMIT FEE. PROCESSED PIPING - $25.00 $25.00 MINIMUM FEE. CONTRACT PRICE x 18 STATE SURCHARGE $ TOTAL: (SIGNATURE) ADD-ON MINIMUM HVAC 0-100 M BTU ADDITIONAL 50 M BTU GAS OUTLETS - MINIMUM OF 1 PER PERMIT SUBTOTAL: STATE SURCHARGE: DWELLINGS .& $15.00 24.00 6.00 3.00 $ 'q7Ob .50 $,?50 q?d S d TOTAL: FEES FOR: CITY OF EAGAN RESIDENTIAL BUILDING Permit Application City Of Eagan (o Q ?' 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements RemodeVReoair Reouirements 3 registered site surveys showing sq. ft of lot sq. ft. of house; and all 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 additions & decks 1 set of Energy Calculations Addition - indicate if "a septic system 3 copies of Tree Preservation Plan Slot platted after 71153 Rim Joist Detail options selection sheet (bidgs with 3 or less units Office Use Only _ Cart of Survey Recd _ Tree Pres Plan Recd _ Tree Pres Not Recd _On-sfte Septic System Date}' / 16 / 0-3 Site Address 3R45 Food f/ JL. Construction Cost r trot S O !L Unit/Ste # Description of Work t. I f?toZ-E1-/ ?? Multi-Family Bldg - Y +%-\ N Fireplace(s) 0 - 1 - 2 PropertyOwnerr. J ?- ??'7J f 1 _ - Cr??Af Telephone # ( ) Contractor 1 =re?1? LG, ?'-1t/r5 Address Irf7 (_ Cz-?YC?S70- state mlu r- V O/Z- r city +vl /NL s°w Zip Telephone # (6p j) y03 z -? S5 9- COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateeorv 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 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. JJ __ Applicant's Printed Name icant's Signature OFFICE USE ONLY Sub Types Approved By ? 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 )K 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 Pibg_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 O 34 Replacement Temolition (Entire Bldg) - Give PCA handout to applicant Valuation ?U vl? Occupancy A? MC/ES System Census Code 113y Zoning ?2 ! City Water SAC Units - Stories I Booster Pump Nbr. of Units Sq. Ft. 5A- PRV Nbr. of Bldgs Length IoL Fire Sprinklered Type of Const -- Width A; REQUIRED INSPECTIONS _ Footings (new bldg) Final/C.O. t Footings (deck) _ Final/No C.O. _ Footings (addition) _ Plumbing _ Foundation _ HVAC Drain Tile R f I & W Other oo ce a ter F inal A r/Gas Tests Pool Ftgs Final Framing _ _ _ _ Siding _ Stucco _ Stone _ _ Fireplace _ R.I. - Air Test _ Final - Windows (new/replacement) _ Insulation - Retaining Wall 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 / ?z ? 3 slrAS?uQ hru =? gas t iEEq LAND aunvari ,nearing.. LAND ILANHEAa• Certificate of Survey for: -'1LA - ANCHt.een 7422 Enterprise D(Ne Mendota Heights, MN 55120 (612) 681.1914 Mc0,A14LD COAil ?'_ o loo. rZ NBb°51'54 ? B?Q NoR1H WILL s FsP?u NE / EA etiT r t `L ]nVU A / W, ? ? a9 ? '" N a39e V de ? K p e_ PQepD?o_ - r, z4.o a i ? -?? D O I M N GA¢. M `} to 0 a 2¢.'A's _ 27.i .r 1 h q N ?1'a3 - . , -- - ? tv A 64.o r b I Is % N p r -' Q ... L.. 1-:..a 0 eZV_1_IAJO A111- 1- 5 OfeI ?E • 9CO.o Denotes exisliq Elevaton 9o0.o Denoles prop d Elevation -- Denoles Ora' m' q.Oe jvh'h Easemenf Denotes Orurna e f-1001 grows o Detioles monument 8 rarr''t shown are assumed PAN. REQUIRED PROPOSED 14OU5E EI,EVg7JpNS lowest r/oor Elevation °4i-4b Top or Block Elevation = 84S.61O Gara?a slob Elevaton = 8461.;? LOT /6 CLOCk 5 SUR O4K A414.L9 2ND 0,41 A COUNTr= MINNCSOTIq , s!187ECr To fASFMEnyrS I herebiy cerUly that this survey, plan or report was pr ?patad by me m under my direct supervi=7en and that I am duty Registered Le,d $ur•Cyo, under the Iiws of she State M Minnesota. Dated this Z1 /a tlay of A,D. 19_q1iL_ - SCG?'?? ? 1 me = 40i ECf' Gl/ / /2 O1, RnPEA? b. SIKICH L.$. REG. Np. t.ta91 Willis s ENCROACHMENT AGREEMENT (SHORT FORM) FORM 02-LEG-1035 REV. 0i ENERGY SERVICES 10 iN Pipeline Company Nam 1)1,74 //, rI I /i {. <•f ? . x` "' 12 +P' ill! SON A,R' i `r.•; s •'r', +: . >• '. Dab J f . ,!r/. .. pipeline liesilleaeoNSeotion Number j)• lot; .,h ,-, _ /11, /. i y'._ _ none J 4+/''': Legal Description (Seceon. Township, Rarga, Lot Block, Abshaet Address) ? County ! L T 7'?N :C-ZTS? - a i Goes 'ov Aignmem Shown Number MA-trv3-111 Mn. P7M2 eeMq Station Number) +Aq Tract Number 3a3 C1 Telephone Cobb Type of Encroachment Cl Roadway 0 Driveway 0 Parking Lot 0 Access Road 0 Equipment Closing 0 G89 Lim 0 Water Luna ? 0 Fiber Optic Cable 0 Drain Tile 0 Televislon Cable 0 Electric Lim 0 Other AjI lev Dee F l q t /{'¢q Person Dispatched Locift Ticket Number/ late Porn who Celled J-4,4"'7. J07( RagpcVStakod Una o Premed Lair for Doper 0 Marked C.P. Cables D Wlbmwed Exeevallon 0 Painted Lim 0 Gave Locator Depth 0 Exposed Line 0Other Re1lMlki or lnaMleNMe GIYM• Tv ?.+4: f (.' IfI f J f f?G.' ?• A / M? A•! /!//+Y?"r .f •Mtr? Follinn Action: 0 Yea N es ex IoM: MWMEMEMEMEMMaRME ?•' Person met at Lots on: 0 Landowner Contractor 0 Encroaching Pony O Other 3 f, A!r>•' `v j ?? !"' +'•^y'r. 4: 3_ 0 Name Tice Company Address City State Zp ph" ( ) Eno enddng Party: . Com an Name Title ICAAJr+ n ?? OI/r/s r fYl 'Ci ? p y State Zip Phone( ) Address ? . ty ENCROACHMENT DATA SKETCH OF ENCRpACHMENTIPIPELINE PIPELINE DATA ESN. Engineering BMlon Number All, a: !C-3f•r" ® (round OD1YmdbomAWWr Buret 1. Ref rim Point n Prr[ Draw North Anne - NearestCA sip. Foreign Structur 't 2. Reference Pont ESN: ('7'P N1 <- 3. Distance and Direction from Reference -, Point to Foreign Cm li R l.?QtK .. (As Marred along Pt r .. _ _ O North 0 SOUM DEW O WW J . Plpd) ti 4. ewcLdated ESN OF Crossing: t•tY -"*• ! . f'.J1c )? C s' i_ PIPELINE { 6 y'•'rvrgmrn /•" Foreign Structure (Additubirect defence IMrnm Reference , Perot ESN) Size of Foreign Facility: Commit Type: Dealing Condition: Dwea bonded 0Parsally bonded Emossoli Site ONo ,?•• Casing 7ypw. r a & CpAcI6A411ei 1 >-f Pl 0 i `? t}TIC r +J l,. fr. DDis ordw P ast c Other O Stes1 0 dlevm: IS at Coaelrg Type.. - - Note: Label all pipelines shown P/S in the Ditch: .. Plpeam Comation: 0 Like new D Sulam Rum . •. 0 Minor pitting O Moderms PaMg O Severe Paling 1. The Agreement here, premed is subject to the existing sesames rights of the Company. 7. Encroaching Party agrees that the Comp may remove, m Me Encroaching Party's expense, any Agreement items or portion ", If in the Companyn judgment, it is 2. The Encroaching Pant' will ccoamm, maintain, relocate and remove Me Agreement Rem at reasonably necessary to do so In order to operate, construct, seer, nalmain, repeir or no expeme to the Company. replace He facilities located within the ess as, or in order to construct or Inews new Company amore a etch Agreement Items, or porsona thereof, dRwn. Sndtd fa the 3. The Encroaching Party must notffy Me Company m least 48 hews Welds work cwnnrnces arty I Company will nor be liable b the E Party or the Enamoring Party's a;hi the on or mar Me Company's easement No work shell take place withaa the Canpany's staff successors w aselgm for any damages mounting by reason of such remi being Gwen the Opportunity to be presml at to sine t S. The Company reserves tine npM to Ybr epecMCatlons of this Agreement m any " 4. The Encroaching Party shall supply such plans, surveys and c1nmmgs as Me Company does, provided that you wB be given a react a amount of amt a comply, el your M E deems necessary. Er the commuctlon mgr Ageemene expense. with sm mw raqumemenb I 5. The Agreement shell be revocable by the Company upon notice to am Enomdang Party llama. adi the cue r of records. The term and conditions of this Agreement shag constitute S. All Agreement Rems shall be constructed and maintained W comply with all laws end covenants rumhg vWM Me land and be binding upon and Mlve to the beneath a Me parses Indus" standards. hereto, their suomnsaa and assigns. 10. The permission heren premed by the Company is limited to its interest and au voriy In The Exrmchiag Party agrees to indemnify, save and held harmbas the Co 8. T nrPenY, its Me subject lard and the EcrmUm i; Pay' acknowledges pre possible obligation to shareholders and their directors and employees, and Me Conpanys subcontractors against obtain the required permission from other parties of Irdaest or the Govemment. Tin dry and all dorms for dansges, Inkay or death wising by reason of the anwschral Rn Company permits this Rem only to ore extent it may do so by law. use ad Maintenance taken, caused by the sole negligence of Me Company. Your Cortpeny Cosecs /A r. /'o r o 'L. Phone: 11/' S - 1- J +... Z 75'-* ro f Main Eves o an Emapancy: . Company I ackmwMedge that I have reviewed the Cwnd-di Terms and GdEelines of lids Agreement /"•? ,/? 7 y.represenleave well agree to be bound by the provia"herein. with a Comp ? pa ` Company Relrommotve-Slombw rA f!'1 rj faL !? • r.r«y Encroaching Party e, . Si 77i Printed Name Printed N i ms d AOrewmnt Mee I have revleasd the C , Term and I acknov a w se to w wKith h a a Company represwnalire and spree to nebmaunC by tin Iravisiona M pe padamrwres of m)• Company work ?. 1 - ! ....,. Person Met at Locadi ANhprized by Encroaching Panty - Signature Printed Nam. ulmallrll: Urrplnel • Oros RnouRH • ReCOfde m Wllllarm SauM II, 1]1] SOan sounder, Foam Floor, r uaa, Vn l911r Canary . Area Manager Pink -CooMlnmor of MalmnancelLirr Locator - Goldenrod Encroaching Entity ., ENCROACHMENT GUIDELINES 1. FENCES 6. FOREIGN LINE CROSSINGS Fences may not be allowed to parallel the pipeline(s) A. within associated right-of-way. Fence posts will not be allowed within 3 feet of the centerline of the pipeline(s). The landowner accepts full responsibility for future damage to the fence in the event access to the pipeline(s) is required. 2. PIPELINE COVER Any change in the surface grade or elevation on or over the pipeline and easement must be approved by the Company in advance. 3. STREETS, ROADS, PRIVATE DRIVEWAYS, PARKING LOTS, ACCESS ROADS, EQUIPMENT CROSSINGS A. The pipeline must be covered with a minimum of 4.0 feet in the center of the roadway and 3.0 feet in the drainage ditches. The depth of cover shall be maintained across the full width of the easement and shall be measured from top-of-pipe to bottom of road surface. Note: If the pipeline to be crossed is used to transport a highly volatile liquid, the minimum cover in drainage ditches must be 4.0 feet. B. Roads shall not run lengthwise within the easement and must cross such that the angle measured between the proposed road and the easement is not less than 45 degrees. C. A Company representative shall have the opportunity to make an inspection of its underground pipeline prior to the start of any construction. D. An "engineering impact study" must be performed to ensure the additional longitudinal stress due to external loads is acceptable. E. Equipment such as for construction, logging, etc., must cross the pipeline(s) only at approved crossing locations where the cover and longitudinal stresses have been checked by the Company and determined adequate to meet load-bearing requirements. F. Warning tape, McMaster-Carr No. 8288T112 or equal, shall be placed under the paved area along the route of each pipeline. 4. OPEN WATERWAYS Open waterways and drainage ditches must have a minimum of 5.0 feet of cover from the top of the pipeline to the bottom of the ditch. Larger open waterways are defined as streams, rivers or canals and are considered on an individual basis. 5. EXCAVATION A. Plans for excavation and shoring on the easement must be approved by the Company prior to commencing any work. Excavation closer than 2.0 feet to the pipeline shall be done by hand until the pipeline is exposed and shall be done only in the presence of a Company authorized representative. B. Any plowing or ripping of soil on the easement, including agricultural, at depths greater than 1.0 foot shall not be performed without the Companys prior approval and observation. C. When a backhoe is used, the bubket teeth shall be curled under each time it is brought back into the ditch to reduce the chance of teeth contact to the pipe. B. General Requirements 1. An authorized Company representative must be on-site during all excavation and cleanup work performed on the easement. 2. All buried lines crossing the easement must cross so that the angle measured between the proposed buried line and easement is not less than 45 degrees. 3. All buried lines crossing the pipeline shall maintain a minimum vertical separation of 24 inches, with the same elevation depth carried across the entire easement. 4. As a protective measure for buried lines crossing Company easements, vinyl direct buried warning tape, McMaster-Carr No. 8288T12 or equal, shall be placed above the crossing line for the entire width of the pipeline easement. 5. Surface markers shall be installed by the Encroaching Party on each side of the utility crossing and shall exhibit the depth of the crossing. Communication And Electrical Lines (Telephone, TV, Etc.) 1. Such lines shall be installed in accordance with guidelines of the National Electric Safety Code (public utility power and light companies) or the National Electric Code (private power and light companies). 2. Such lines shall be encased in a rigid nonmetallic conduit across the full width of the right-of-way. 3. Such lines shall have a minimum ground cover as follows: 24 Inches for 0 to 600 volts; 30 inches for 601 to 22,000 volts; 36 inches for 22,001 to 40,000 volts; and 42 Inches for 41,001 and above. 4. If the power cable has an exposed concentric neutral, a test point from the ground wire shall be installed by the power company. C. Sewer And Water Lines-' 1. These shall meet all above General Requirements of Buried Line Crossings except metallic conduit. 2. Sewer line crossings are limited to main or tight lines only. Distribution lines, perforated or non- enclosed, are not permitted. D. Subsurface Drain Tile These shall meet the provisions of Paragraph 6.A. of General Requirements of Foreign Line Crossings. E. Metallic Pipe Crossings The Company and the Encroaching Party shall jointly conduct a cathodic protection interference survey. The Company shall determine any modifications needed and the Encroaching Party will cooperate with the Company in the install installation of the modifications. 7. ABOVEGROUND LINE CROSSINGS Utility poles and guys shall maintain a minimum of 20 feet distance from any pipeline. Note: These specifications are subject to change. Please contact the Company prior to commencing your activity. 2006 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) 2 copies of plan shoving 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 (buildings with 3 or less units) Minnegasco mechanical ventilation form e?o, 06 Remodel[Reoair Requirements Office use:onlti 2 copies of plan showing footings, beams, joists Gad of Survey Recd' - _Y _N 1 set of Energy Calculations for heated additions free Pres.Plan Recd'- _Y _N, 1 site survey for additions & decks Tree Pres Required _Y _N Addition - indicate f1 on-site septic system On-sde Septic System.. -Y _N Date l]"I ILInnA Site Address 354fr k61116Q Construction Cost Will 0P t VP UnitlSte # Description of Work 1(p ,l am Multi-Family Bldg - Y - N Fireplace(s) _ 0 - 1 - 2 Property Owner )Obc? Cn q ME) Telephone #((6jt)?p(t?J•?J??? Contractor CrotA ?X'? 1GYS Address < - S;1 C h I a -5 State??(?\(???111??, we- 1'?p119 R1)2Lti, ? City `('S? Jr, Zip ?`lG Telephone#(??)?((?(?-(p1rC( COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv I _ Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (4 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 which requires a review and approval of plans. .`3 MAX Applicant's Printed Name App icant's Si ature UNITED PRODUCTS CORPORATION "Specializing in Exterior Building Materials for the Professional" i Twin Cities Outdate Minaeaota Fargo North Dakota 80 St. Paul • 6511227-8731 Duluth • 2181628-0717 Plymouth • 7631545-1273 St. Cloud • 3201255-5374 Wisconsin Lakeville • 9521469-5656 Rochester 0 5071282-3909 Eau Claire • 7151831-0855 General Office • 651/227-8735 New Berlin • 2621785-9904 www. unitedproductS. COM F? -•- SHORT FORM ENCROACHMENT PERMIT FORM 02-LEG-1023 12188 W /L L /A M S PIPE U NE C O MPA N Y J, J ONE OF DIE WILLUMS COMMAUM INC. 0 PERMITTEE: DATE: ,19 Name: Address: Phone: (AREA CODE) LOCATION Section: Township: Range: County: State: 1 Line Section: Alignment Sheet No. Mile Post: Eng. Stations No. Tract Number: ROW Width: DESCRIPTION OF PERMITTED FACILITY What: , Where: - - J-l c +? t Dial r? This permit is granted subject to the terms and Special Provisions shown below and strictly in accordance with the specifications shown on the reverse side hereof. CONDITIONS 1. The Permit herein granted is subject to the existing easement 7. You agree that WPL may remove, at your expense, any rights of WPL. encroachment or portion thereof, if in WPL's judgement it is 2. Permittee will construct, maintain, relocate and remove the reasonably necessary to do so in order to construct, alter, maintain, repair or replace its facilities located within the encroachment at no expenseto WPL. easement, or in order to construct or install new facilities. 3. Permittee must notify WPL at least 48 hours before work Should WPL remove any such encroachments, or portions commences on or near WPL right-of-way. No work shall take thereof, WPL will not be liable to you or your successors or place without WPL staff being given the opportunity to be assigns for any damages resulting by reason of such removal. present at the site. 8. WPL reserves the right to alter the specifications of this per- 4. You shall supply such plans, surveys and drawings as WPL mit at any time, provided that you will be given a reasonable deems necessary time to comply, at your expense, with any new requirements 5. This permit shall be revocable by WPL in the event of your imposed after the construction of the facility. noncompliance with any requirements, conditions, or specifi- 9. All permitted facilities shall be constructed and maintained cations of this permit, upon notice given to you and/or the to comply with all laws and industry standards. owner of record. 14. The permission herein granted by Williams Pipe Line 6. You agree to indemnify, save and hold harmless WPL, its Company is limited to its interest and authority in the subject shareholders, and their directors and employees, and WPL's land and Permittee acknowledges the possible obligation to subcontractors against any and all claims for damages, injury obtain the required permission from other parties of interest or death arising by reason of your placement and maintenance or the Government. WPL permits this facility only to the of said permitted facilities. extent it may do so by law. Special Provisions: Your local WPL Contact is: Name: Address: Phone: (AREA OODE) In Event of an Emergency: 1-800-331-4020 or 1-918-588-3200 WILLIAMS PIPE LINE COMPANY I acknowledge that I have reviewed, with a Williams Pipe Line representative, the requirements, conditions and specifications of this permit and agree to the provisions thereof. SUBMITTED BY: APPROVED BY: DISTRICT MANAGER PERMITTEE DISTRIBUTION: WHITE - Land, Records & Claims (Tulsa); CANARY - Division Office; PINK - Pbcmitlee. RETENTION: Permanent SPECIFICATIONS 1. FENCES No posts for fences crossing the right-of-way shall be installed directly over the pipeline. Fences installed parallel to the pipeline shall not be closer than 10 feet to the pipeline. 8. BURIED LINE CROSSINGS A. GENERAL REQUIREMENTS 1. An authorized WPL representative must be on-site during all excavation and clean-up work performed on the right-of-way. 2. PIPELINE COVER Any change in the surface grade or elevation on and over the pipeline and right-of-way must be approved in advance. 3. STREETS AND ROADS A. The pipeline must be covered with a minimum of 5 feet in the center of the roadway and 4 feet in the borrow ditch. The depth of cover shall be maintained across the full width of the right-of-way. B. Roads shall not run lengthwise within the right- of-way and must cross such that the angle measured between the proposed road and the right-of-way is not less than 45 degrees. C. An opportunity for WPL to make a pipe inspection must be given prior to the start of any construction. 4. PRIVATE DRIVEWAY Driveways to any one residential dwelling must have a minimum of 31/2 feet of cover over the pipeline. Provisions 3 "B" and "C" pertaining to Streets and Roads apply. Multiple dwelling situations will be considered on an individual basis. 5. TEMPORARY EQUIPMENT CROSSINGS Normal loads acceptable to the State Highway Engineering Department may cross the pipeline where a minimum of 5.5 feet of compacted cover is provided. Equipment such as for construction, logging, etc., must cross pipeline only at approved crossing locations where the cover has been checked by WPL and determined adequate to meet bearing load requirements. 6. OPEN WATERWAYS Open waterways smaller than 3 feet wide at the bottom are defined as "ditches" and must have a minimum of 3.5 feet of cover from the top of the pipe to the bottom of the ditch, or the ditch must be lined using a method and material approved by WPL. Larger open waterways are defined as "canals" and are considered on an individual basis. 7. EXCAVATION A. Plans for excavation and shoring on the right- of-way must be approved prior to commencing any work. Excavating closer than 2 feet to the pipeline shall be done by hand until the pipeline is exposed and shall be done only under super- vision of an authorized WPL representative. B. Any plowing or ripping of soil on the right-of- way, including agricultural, at depths greater than 1 foot will not be performed without WPL's prior approval and, at WPL's option, its observation. 2. All buried lines crossing the right-of-way must cross so that the angle measured between the proposed buried line and the right-of-way is not less than 45 degrees. 3. All buried lines crossing the pipeline shall maintain a minimum vertical separation of 18 inches between the two lines, with the same elevation depth carried across the entire right-of-way. 4. As a protective measure for buried lines crossing WPL rights-of-way, vinyl direct buried warning tapes shall be placed above the crossing line. 5. Surface markers shall be installed by the Permittee on each side of the utility crossing and shall exhibit the depth of the crossings. B. COMMUNICATION LINES AND ELECTRICAL LINES (TELEPHONE, TV, OTHER DATA) 1. Such lines shall be installed in accordance with guidelines of the National Electrical Safety Code (public utility power and light companies) or the National Electric Code (private power and light companies). 2. Such lines shall be encased in a rigid nonmetallic conduit across the full width of the right-of-way. 3. Such lines shall have minimum ground cover as follows: 24 inches for 0 to 600 volts; 30 inches for 601 to 22,000 volts; 36 inches for 22,001 to 40,000 volts and 42 inches for 40,001 volts and above. 4. If the power cable has an exposed concentric neutral, a test point from the ground wire shall be installed by the power company. C. SEWER AND WATER LINES 1. These shall meet all above GENERAL REQUIREMENTS of BURIED LINE CROSS- INGS except metallic conduit. 2. Sewer line crossings are limited to main or tight lines only. Distribution lines (perforated or nonenclosed lines) are not permitted. D. SUBSURFACE DRAIN TILE 1. These shall meet Provision #1 and #2 of GENERAL REQUIREMENTS of BURIED LINE CROSSINGS. E. METALLIC PIPE CROSSINGS 1. WPL and Permittee shall jointly conduct a cathodic protection interference survey. WPL shall determine any modifications needed and Permittee will cooperate with WPL in the installation of the modifications. 9. ABOVE GROUND LINE CROSSINGS Poles and guys shall maintain a minimum of 10 feet clearance from any WPL pipeline(s). City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 3345 Rolling Hills Dr Lot: 16 Block: 5 Addition: Bur Oak Hills 2nd PID:10- 15501- 160 -05 Use: Description: Sub Type: e- Fireplace Work Type: Gas Fireplace (new) Description: Census Code: 434 - Occupancy: Zoning: Square Feet: 0 Comments: Fee Summary: Valuation: 3,000.00 Contractor: Fireside Hearth & Home 20802 Kensington Blvd Lakeville MN 55044 (952) 985 -6675 Chimney /flue must be inspected prior to concealing. Smoke detectors are required in all sleeping rooms prior to final inspection. When wall studs or ceiling joists are exposed, hard -wired detectors are required. Battery operated types are acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector. Andrew Hoffman BL - Base Fee $3K Surcharge - Based on Valuation $3K Total: $90.00 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. Applicant/Permitee: Signature PERMIT City of Eaan - Applicant - Construction Type: Owner: John W Challas 3345 Rolling Hills Dr Eagan MN 55121 Permit Type: Permit Number: Date Issued: Permit Category: $88.50 0801.4085 $1.50 9001.2195 Issued By: Signature Building EA086526 10/01/2008 ePermit PERMIT City of Eagan Permit Type:Building Permit Number:EA119960 Date Issued:01/06/2014 Permit Category:ePermit Site Address: 3345 Rolling Hills Dr Lot:16 Block: 5 Addition: Bur Oak Hills 2nd PID:10-15501-05-160 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors 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 or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . 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 - Brigham J Leslie 3345 Rolling Hills Dr Eagan MN 55121--234 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink �-----------------, � For Office Use I �it Of� � ,(� (� � Permit#: �. �� � � � I 3830 Pilot Knob Road � Permit Fee:�� lJ - �\J j Eagan MN 55122 � Phone:(651)675-5675 MAY � 4 1015 j Date Received:� -�t`''� � I Fax:(657)675-5694 � I � Staff: � � . �����������������J 2014 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: 5J8/15 SiteAddress: 3345 ROLLING HILLS DR, EAGAN, MN 55121 Tenant: Suite#: .;; 5��� �`�u�� �� Name: ERIN LES�LIE � Phone: 715-379-4498 Re�d���i��un�r ���� ����� „ ���� 'g �: Address/City/Zip: SAME = ''�ti�y � ��; Date: City orBaQan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 APR 1 4 7016 Use BLUE or BLACK Ink For Office Use / /�/ I V 4 Permit#: 1 S� C6 Permit Fee: g 0 6 ZI1'24 Date Received: %_ 46 „e/ Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: ?J 3 HS 1? 1 tt'vx /-h // . L) iv't Ea 6t v1 SS (22 unit #: Resident! Owner 1- s Name: Fkl I/1 4- 0 (ii. �i ha gil �.S 1t -e., Phone: �15 7 f I 2'1 SSC. above.. Address / City / Zip:1 Applicant is: 1ZOwner Contractor • Type of Work 00 -,"It. n R it- La WIr{,C� t i Description of work: 0'{, �,.x tS-1-e 6„A^'L 1,3(s+ 1,04)1( Ad t. l i.1 ke V As i' e c. a .e, , t sLk. - l r .. r.4 . S i Construction Cost: (4 S-0 + /` Multi -Family Building: (Yes / No u ) 5 Contractor Company: c if-- Contact: Address: City: State: Zip: Phone: Email: License #: Lead Certificate #: If the project is exempt kt 4 0?.0,-1 from lead certification, please explain why: to 01 j COMPLETE THIS AREA ONLY IF CONSTRUCTING In the last 12 months, has the City of Eagan issued a permit for a similar Yes No If yes, date and address of master plan: A NEW BUILDING plan based on a master plan? Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Fire Suppression Contractor: Phone: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are tradesecrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for pr•tection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www. o•herstateon:call.or I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, a • 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 app al of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x 1'.I i1° I Lzs1t Applicant's Printe'd Name x Applicant's Signature Page 1 of 3 OA NOT WRITE BELOW THIS LINE (- SUB TYPES OA (7 ! L> i0(2 Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Foundation Fireplace Single Family Garage Multi Deck 01 of Plex Lower Level WORK TYPES New_ Interior Improvement Addition_ Move Building Alteration_ Fire Repair Replace — Repair Retaining Wall DESCRIPTION Valuation Plan Review (25% 100% I/1 Census Code # of Units # of Buildings Type of Construction sq I REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Roof: Ice & Water Final Framing Fireplace: Rough In Air Test Insulation Sheathing Sheetrock Fire Walls Braced Walls Shower Pan Reviewed By: RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Occupancy Code Edition Zoning Stories Square Feet Length Width Final TOTAL ",/c) 4$1.4 gogr- Siding Reroof Windows Egress Window 13G06 z/ Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Accessory Building Demolish Building* Demolish Interior — Demolish Foundation Water Damage *Demolition of entire building – give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Suppression Required Meter Size: Final / C.O. Required ;e Final / No C.O. Required HVAC Gas Service Test Gas Line Air Test Pool: Footings Air/Gas Tests Final Drain Tile Siding: Stucco Lath Stone Lath Brick Windows Retaining Wall: — Footings Backfill Final Radon Control Fire Suppression: Rough In Final Erosion Control Other: , Building Inspector Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA139826 Date Issued:11/10/2016 Permit Category:ePermit Site Address: 3345 Rolling Hills Dr Lot:16 Block: 5 Addition: Bur Oak Hills 2nd PID:10-15501-05-160 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors 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 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: 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 - Brigham J Leslie 3345 Rolling Hills Dr Eagan MN 55121--234 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA144215 Date Issued:07/17/2017 Permit Category:ePermit Site Address: 3345 Rolling Hills Dr Lot:16 Block: 5 Addition: Bur Oak Hills 2nd PID:10-15501-05-160 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors 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 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: 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 - Brigham J Leslie 3345 Rolling Hills Dr Eagan MN 55121--234 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA159438 Date Issued:12/17/2019 Permit Category:ePermit Site Address: 3345 Rolling Hills Dr Lot:16 Block: 5 Addition: Bur Oak Hills 2nd PID:10-15501-05-160 Use: Description: Sub Type:Residential Work Type:Replace Description:Standard Water Heater 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 - Brigham J Leslie 3345 Rolling Hills Dr Eagan MN 55121 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA160276 Date Issued:02/27/2020 Permit Category:ePermit Site Address: 3345 Rolling Hills Dr Lot:16 Block: 5 Addition: Bur Oak Hills 2nd PID:10-15501-05-160 Use: Description: Sub Type:Residential Work Type:Replace Description:1 Mitsubishi Mini Split Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 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 - Brigham J Leslie 3345 Rolling Hills Dr Eagan MN 55121 Metro Air 16980 Welcome Ave SE Prior Lake MN 55372 (952) 447-8124 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA162236 Date Issued:07/06/2020 Permit Category:ePermit Site Address: 3345 Rolling Hills Dr Lot:16 Block: 5 Addition: Bur Oak Hills 2nd PID:10-15501-05-160 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors 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: 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 - Brigham J Leslie 3345 Rolling Hills Dr Eagan MN 55121 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA162236 Date Issued:07/06/2020 Permit Category:ePermit Site Address: 3345 Rolling Hills Dr Lot:16 Block: 5 Addition: Bur Oak Hills 2nd PID:10-15501-05-160 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors 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: 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 - Brigham J Leslie 3345 Rolling Hills Dr Eagan MN 55121 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA163411 Date Issued:08/31/2020 Permit Category:ePermit Site Address: 3345 Rolling Hills Dr Lot:16 Block: 5 Addition: Bur Oak Hills 2nd PID:10-15501-05-160 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Brigham J Leslie 3345 Rolling Hills Dr Eagan MN 55121 Lifetime Construction & Restoration 21 Century Ave S St. Paul MN 55119 (651) 464-9920 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA171016 Date Issued:07/27/2021 Permit Category:ePermit Site Address: 3345 Rolling Hills Dr Lot:16 Block: 5 Addition: Bur Oak Hills 2nd PID:10-15501-05-160 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors 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: 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 - Brigham J & Erin K Leslie 3345 Rolling Hills Dr Eagan MN 55121 (715) 379-4298 Crossroad Construction 17121 Lincoln St NE Suite 100 Ham Lake MN 55304 (763) 434-0202 Applicant/Permitee: Signature Issued By: Signature