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3362 Rolling Hills DrINSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: 1 „ 1 1 1.1 APPLICANT: ? 1 1IJ's III t l 'S OR , ts1l14 11AK H t I 1 'NU 'if> PERMIT SUBTYPE: I., : 1!, 11i • 1 ;,1.11 TYPE OF WORK: ItI MAI,h : ,IF I'A14A I I I,1 km 11'. Ally 1,1 VI11Ir} I1 1-(11: ANY V1 IIM1111411 01i i I I ?, I It If Al 1)"14 Permit No. Permit Holder Date Telephone M SNV PLUMBING L2? HVAC ELECTRI ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing Roofing Rough Plbg. A 40 LL /fr??9`/_ OcvzC/Z- - Rough Htg. Y Isul. y Fireplace Final Mg. Orsat Test Final Pibg. Plbg. Inspector - Nottly Plumber Const. Meter EngrJPlan Bldg. Final Deck Fig. Deck Final well Pr. Disp. -?- fu ??Y i . `+ R>E?MAIR FOR MM-,06/24/q3 MCRAM CRAY 688-2195 Trrtifirate of (Orrupaury Citp of (Eagan Mrprbu nt of w rrnm T>6is Cergjicate issued pursuant to the requiremehts of Section 306 of the Un jorm Binding Code certifying that at the time of issuance this structure wins in compliance with the carious ordinonces of the GYty regulating building consouc ion or use For the following- Un c u ism6m SF U R Sk Famit Na 739 O-mpm Thm R3/141 zoo6g ow,;a R l Type CooR I Owwar MLTIIS[.STI?f MM. Addau 785 SUNSET DR, EWM Aeen? 3362 RIVE ? L24, B2, BUR OAK H= 2ND 7/28/42 POST IN A CONSPICUOUS PLACE .? f Control INSPECTION RECORD I No. , j •CITY OF EAGAN x>?A=VAM FM DEa-06/24/93 PERMIT TYPE: t u x I. ti t NG 3830 Pilot Knob Road tiff(IlAEL GRAY 688--2195 Permit Number: 000739 Eagan, Minnesota 55123 Date Issued: 06/11/92 (612) 681-4675 SITE ADDRESS: L074 24 O t or. M APPLICANT: 3362 NO(L INQ HILLS ON NtIVELSTAEOT SPOTHIE"s BUR OAK HILLS ?NO (612) 466-9t2S PERMIT SUBTYPE: TYPE OF WORK: r 1.0141, KEW OfNARkS, RECEIPT # PRV S&IJ PLOR. - MCDUpAte PLO@. Permit No. Permit Holier Data Telephone N WIN PLUMBING ? - HVAC ELECTRIC ELECTRIC Inspection Deft Insp. Comments Footings 1 6?T1 ?'s Foundation Framing K/ Roofing Rough Plbg. Rough Mg. 7 L? lsul, Fireplace Final Hlg. -J "Y /Ifh 6 Orsat Test / ?x Final Plbg. Pibg. Inspector - Nobly Plumber Const. Maier EngrJPlan Bldg. Final r? e Z e! - .v5 u[„ C d Z r Deck Fig. Deck Final Well Pr. Diap. 1' M64627 , /9 REQUEST FOR ELECTRICAL INSPECTION tio See instructions for completing this form on back of yellow copy. "X" Below Work Covered by This Request 19u4y;, E6lxIW1-e)e New Add Rep. Type 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 (spedryl Contractors Remarks'. Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps J KJ 0 to 100 Amps Transformers Above 200 _ Amps _ Amps Signs Inspector's Use Only TOTAL n Irrigation Booms o Special Inspection Alarm/Communication THIS INSTALLATION MAY BE Oq RED ISC 'NNECTED IF NOT Other Fee COMPLETED WITHIN 18 MO ' I, the Electrical inspector, hereby Rough-in Date certify that the above inspection has been made. Final Date OFFICE USE ONLY??EME?T ?r N;5 Z I e??'S This request void 18 months from 1-'t 1. 64 27 ? °° ? ? ? / ,Ca . .ltX? 6 S o lr 02 ?? Request Data Fir No. Rough-In mpsectian Required (YOU must call inspector when ready) In ecdon Other Than Raugh-In Now {?WiB NOIity Inspector y? A Your ? No Da Read I O licensed contractor ? owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No.) 32!6 ?-. Motu 94I Ciry Section No. Township Name or No. Range No. County Ko , Occupant(PRINT) one No. F- ,z s8-2r95_ Power Supplier Atltlress R? Electrical Contractor (Company Name) ense No. .. NQ? ^ v Enl? 5 N 77 Mailing Acid e56 (Contractor or Owner Making In tallabon) AuthorR2tl Signature IComrac oriOwner Making Instella( I Phone Number MINNESOTA 5 TE BOARD OF ELECTRICITY THIS INSPECTION REOUEST WILL NOT Origgs-Midwa Bldg. - Room 5-173 BE ACCEPTED BY THE STATE BOARD 1621 University Ave.. St. Paul, MN 55109 UNLESS PROPER INSPECTION FEE IS Phone (612) 692-0800 ENCLOSED. g"s 10 Oro 1 07 1 a..?a z J Request Date / Q Fire No. Flour h-in Inspection is fired? vas F-- No ? Ready Now (will Notify Inspedw When Ready? I licensed contractor p owner hereby req est inspection of above electrical work at: Job Address (Street. Box or Route No) 33 011 j`o r'Ils Dr. City 6 are Section No. Township Name or No. Range No. County Ogcupam lPRINTI Ll\5 Qd / 1 Y/ ^ 'T / T/1 `7 C r} Ph56 _gias q Power Supp6e baKat? elec. Ad re S s d FaYrn?? )16 h Eleclncal Contrac r (Company Namel Contractorls License No. v?ecfri? C. 9/ Mailing Address IGOntraGlor or Own?r ,a?king Installatg0) /S ?GL il, Al't 5537 Author, S lure ICOntractoeOwner Makin Installation) Phoyn7e??-/ry/umber L/ I} `-X? MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S170 BE ACCEPTED By THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. (p 1w.f? REQUEST FOR ELECTRICAL INSPECTION 0? g /?? 0.1 see ii to, rnmpwinn this Mrmnn hack of yellow cony. _J 5 0711 "X" Below Work Covered by This Request ' Afd Rep. - Typeot Building Appliances Wired EquipmeniWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specilyl Contractors Remarks Compute Inspection Fee Below. # - Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps U 0 to 100 Amps Transformers Above 200 Amps 100 _ Amps Signs Inspectors Use Only. TOTAL r Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY BE„"DERE D NNE ED IF NOT Other Fee COMPLETED WITHIN 18 S. I, the Electrical Inspector, hereby Rough-in /' It certify that the above inspection has been made. Final F Dete '7 i OFFICE USE ONLY This request Mid 18 months from Address: 3362 ROLLM HILLS DRIVE Lot 24 Blk 2 Sec/Sub BUR OAK ATf7.S 2ND These items were/were not complete at the time of the final inspection. 7/28/92 Yes No Final grade (6" from siding) Permanent steps - garage Permanent steps - main entry Permanent driveway Permanent gas Sod/seeded grass V/' Trail/curb damage i Porch ? Basement finish i V -- 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. u qX9 . White - City copy Yellow - Resident copy Pink.- Contractor copy ICS(.e (? 1j RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 _ 651.681-4675 l 1 y New Construction Reaulremente • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and 37 roofed areas (20% maximum bt coverage allowed) • 2 copies of plan showing beam & window sizes; poured found design, etc.) • I set of Energy Calculations • 3 copies of Tree Preservation Plan I of platted after 711M • Rim Joist Detail Options selection sheet (bogs with 3 or less units) DATE c??UIoC?El4l SITE ADDRESS TYPE OF WORK APPLICANT STREET ADDRESS TELEPHONE # h MULTI-FAMILY BLDG _Y N FIREPLACE(S) _ 0 _ 1 - 2 PROPERTY OWNER D?t 1 b4 I U iq TELEPHONE # JW ----------------------------------------------------------------------------------------------- COMPLETE THIS SECTION FOR -NEW,, RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I _ MINNESOTA RULES 7672 (J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Phone # Plumbing system includes: _ Water Softener _ Lawn Sprinkler Fee: $90.00 Water Heater _ No. of R.I. Baths No. of Baths Mechanical Contractor: Phone # Mechanical system includes: _ Air Conditioning Fee: $70.00 iD ? IT Sewer/Water Contractor. Heat Recovery System Phonet nn ---- _-- --- -- ------ ---- hereby acknowledge that 1 have read this application, state that the Informatlon,?prrect, and agree to omply with all applicable State of Minnesota Statutes and City of Eagaa??ci1Inances. Signature of Applicatk l , OFFICE USE ONLY RemodegReoair Reauiremente • 2 copies of plan • 1 set of Energy Calculations for heated additions - 1 site survey for emeror add"eons & decks • indicate r home served by septic system for additions VALUATION `JOM Certificates of Survey Received _ Tree Preservation Plan Received - Not Required _ Updated 4102 OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-piex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Aft- Multi ? 03 01 of-plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 Ext. Aft - 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_Yor_ 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 Bklgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) _ Final/C.O. Footings (deck) - FinaUNo 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. - A r 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 Building Inspector Copies Other Total CITY'OP EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 SITE ADDRESS: r , PERMIT PERMIT TYPE: Permit Number: - Date Issued: 3362 ROLLING HILLS DR LOT:..24: BLOCK: 2 OUR OAK HILLS 2140 Control No. 0609 BUILDING 000739 06/11/92 DESCRIPTION: fbuild Ylg Permit Type SF DWG Building'Work Type - NEW UBC Occupancy R-3 N-1 Construction Type , VIN f Zoning R-1 Building Length r 44 Building Width 46 f v ti up ? =. REMARKS: /} 2 // 7 RECEIPT # ? O+y d- PRV S&W PLBR. NCOONALD PLBG. FEE SUMMARY: VALUATION $93,000 Base Fee Plan Review Surcharge SAC SAC 8 SAC Units Subtotal $608.00 NISC FEES $395.20 Total Fee $46.50 $700.00 100 1 $1,749.70 $1,610.50 $3,360.20 CONTRACTOR: - Applicant - ST. LI OWNER: NITTELSTAEDT BROTHERS 14569125 000344 NITTELSTAEDT BROS CONST 785 SUNSET OR 785 SUNSET DR EAGAN NN 55123 EAGAN NN 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 Nn. Statutes and City of Eagan Ordinances, L_ f1 a? 244-?' A PLICAN E EE SIGNATURE ISSUED ' IGNATURE PERMIT S _ CITY OF EAGAN 1992 BUILDING PERMIT APPLICATION 681-4675 * 33 40.20 JUN 0 1.? SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies when typing of permit is requested,,but not picked up by last working day of month in which re guest is made or lot than a is re uested once permit is issued. Date to / / ?l2 Valuation of work 966ga9 e Address: R34z /lALLiw1? f7/?c U/L STREET STE W Tenant Name: LOT 2 BLOCK Z SUED. }?'1 P.I.D. / - uw?L O/Aw'f2 4Z Description of work: yze? . Ac-?&/O-A The applicant is: ? Owner Contractor ? Other (Describe) Name Phone Property LAST FIRST Owner Address STREET STE # City State Zip Company /7?/r7;2r,7z_ 5i-n-ew7- A? (,D.. Phone 'Y_,56 siiws Contractor Address '?'5 su.v9?r u/L. License #_g2Pay6L Exp. City Cfi6"-br1 State z9&' ip Company Phone Architect/ Engineer Name Registration Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area 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: v¦ ¦vr v?¦r. v¦??¦ BUILDING PERMIT TYPE ? 01 Foundation ? 05 Apt. Bldg ? 09 Basement Finish ;K02 SF Dwg. ? 06 Garage/Accessory ? 10 Swim Pool ? 03 Two family ? 07 Fireplace ? 11 Res. Add./Porch ? 04 Multi-fam. T.H. ? 08 Deck ? 12 Comm./Ind. WORK TYPE 031 New ? 34 Repair ? 37 Demolish ? 32 Addition ? 35 Tenant Finish ? 99 Undefined ? 33 Alterations ? 36 Move - GENERAL INFORMATION ? 13 Public Fac. ? 14 Agricultural ? 15 Miscellaneous Const. (Actual) V- N Basement sq. ft. MWCC System `(cs (Allowable) -7- N 1st F1. sq. ft. City Water UBC Occupancy 2nd Fl. sq. €t. PRV Required Zoning R-I Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length -- On-site well Census Code Depth y?T On-site sewage SAC Code D/ APPROVALS Planning Building Assessments Engineering Variance REQUIRED IN SPECTIONS ? Site ? Footing ? Framing ? Insulation ? Wallboard ? Final ? Draintile ? Fireplace Permit Fee (j 0'86 J vaLwt(an: s 43, o Surcharge u Y6 el view P n R 36,45 , Z4) C7AKA&F-. apx22 N40 X G60o la e MWCC SAC v • 00 BS T; ay v 4q : Ibs6 City SAC Water Conn. ??• do GAS, o a 8 u ! ??fz I?? Water Meter 90z x 4 Acct. Deposit 30, u? 290 -z J4 = /69yo S/W Permit X10, oQ , S/W Surcharge 15T- ;-400A., Treatment Pl. Road Unit 310-1 ..v3 ;go. ev. > s?nr= 121o Park Ded. .2,c/4, S?_ Trails Ded. rxty . aq O rs (' z ?4vz = 14 the Total: I'hx14'Jz II-Cl 53- ,b LIM. SAC % 100 SAC Units i 9-L016 DATE AP g ' EXTERIOR ENVELOPE AVERAGE IIU" COMPUTATION OWNER nn /? TIM A E2 Ls oic X-L SITE ADDRESS S?3 (oa l4?LL?a? KILLS k12. ERr? 9? CONTRACTOR M ITTE L ST R Ea Y' &V I M E/ Z!5 ' CB N e0-rf1j 1 -T`1A0.J l .J G . ADDRESS'Ze5 SuA 5ic-r )\a, d g,.wJ PHONE q 6& 41 a 5 DETERMINE WURKING SQUARE FOOTAGE OF EACH. 1. Total exposed wall area ... 2 1 xelo sq. ft. x •11 m 9 2. Total roof/ceiling area ... ? Z g17 sq. ft. x •026 d 3„+? Total exposed wall area above floor a 21 S® a. Total wall window area ........................ _ 230's b. Total door area ................................ 4k1 c. Total sliding glass door area .................. y 2 d. Total fireplace wall area ...................... - e. Total wall framing area (average 10%) .......... /f{(o f. Total net wall area above floor ................ g. Total rim joist area ........................... I(o O Total exposed foundation area a 1190 h. Total foundation window area ................... i. Total net foundation area above grade .......... Determine "U" value of each wall segment. a. 2 W. 5 X "u" , S 'Z 9/'1 b. yQ X "U'l , 0 7 2. S C. !/2 - R 117i11 • 41,2 ? / /. d R /lull a e. / S4v R /lull , ?/ ° 20.5 f. / 31 1. 5 X 111111 .0 q3V 59.1 g• //_O X I1u11 6YV v 7,0 X flint I a ..? i. X Ifutl O gZ - / 3 . ...............................Total D 1, 2- If item #3 is the same as, or less than item 41, you hav he intent of SEC 6006 (02. -1- Page 2 ',of 2 Total exposed roof/ceiling area - / 2 $ 7 J. Total skylight area ........................... - k. Total roof/ceiling framing area (average 10%)..p 1. Total net insulated roof/ceiling area ......... / 2o&. Determine "U" value for each roof/ceiling segment. J. - B nU„ _ k• (ZO.4/ X "U" . 02.55 2.07 1• 12a1 x "u" 0 21 R ' 24, .3 4 ................................... ..... ?? ? .Total I If total of 04 is the same as, or less than A2, you have et the intent of SBC 6006(c)1. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of items 03 and 114 shall not be greater than the sum of items #1 and 112. , 1. + 2. 3. + 4. -2- •I.I ? ?.? v. t_i. ?.?•V? 1M•lnl ll?J I.. I.I LL al r•_ iLL i•-. ?il? V?V _r?1 1YV Jli IrJa SURVEYOR'S CERTIFICATE MITTELSTAEDT BROS. CONST - ROLLING ----------- H 1 LLS DR 1 NOT BUILDING DIMENSIONS SHOWN ARE F T OR HORIZOWAL 8 VER ICAL LOC- a 859.1 8 3.3 R .450.00 80 ATION OF STRUCTURE ONLY. SEE AARF ITEC UAL PLANS MR BUILDING S rot 21 - C7" I 6°59' 52 11 T R H ION . 3 0.4 OE I 660.6 , p'0 r 54.96 8 SS q? Cas94?;; a I a N 1j7/ti 0 TOP OF PIPE BENCH MARK p / TOP OF PIPE $ 1? =861.94 = 802.49 - -, 862.4 882.3 /d=+2.5 x [ % 20.64 = 20.33 q20.65' _ c\/ O "'1 1 GAR. 00 C??L 5 x882.3 O 14.5 O N A/ P i W PROPOSED /// 'A 11 HOUSE / / 24.49 _• ?_" 1 ? ? -? • 18.79: 44.0 _ 858.7 14-\J 1 864,0 ll x 859.8% r? G r ? W co N I ?0% ITt LOT 24 NOTE NO SPECIFIC 90A,S INVESTIGATION HAS SKN 0 ON TM LOT 1Y THE YOR, THE sU1TAMI.ITY OF rp IMmv*v DRAINAGE 8 UTILITY IS NOT 0 HOUSE ?PO?Y F EASEMENT PER PLAT 6 THE SURVEYOR. 4751 75.721 9.1- N 630 211W i Q ° 06059 52 l^?D' IF, "F: AL F- IRK Rs620.00 ?. r l?-? I I ?I i1 1 f E ?. R r V +---- DENOTES PROPOSED SURFACE DRAINAGES®® T7 O DENOTES IRON MONUMENT SET `-- -- SCALE 1 INCH - 30 FEET ! DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 84.z•6 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - ®S_r• I FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - 81.3. L FEET WE HEREBY CERTIFY TO MITTELSTAEOT BROS.CONST. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 24, Block 2, BUR OAK HILLS 2ND ADDITIO? ,q 01 in R rt k? ? F recorded PIOt Thereof, Dokoto County, Minneaoto. _,I ipr, I I?tj"` /-rr4 IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACI SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS %I ST PROPOSED GRADES SHOWN WERE TAKEN FROM THE ORA DINO, DRAINAGE 8 EROSION CONTROL PLAN FOR OUR OAK HILLS 2ND ADD., LAST DATED 8-4-88 y 'I _n D F= tD O W O O I rr??? to - 0 N m N CS I I G I y 1 p N > (n > 2 `t O Z M O Q Z > j Z T m _U Z - O m Ii 111 z W R. HILL,lylij Ig1 DEPT JOHN C. LARSON, LAND SURVEYOR MINNESOTA LICENSE NUMBER 19828 James R. Hill, inc. PLANNERS / ENGINEERS / SURVEYORS 2500 W. CTY. RD, 42 9 BURNSVILLE, MN. 55337 0 612-890-6044 I' AY-OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT PERMIT TYPE: Permit Number: Date Issued: J?7 y/ BU LOING 024803 11/04/94 SITE ADDRESS: 3362 ROLLING HILLS OR LOT: 24 BLOCK: 2 BUR OAK HILLS 2ND P.I.N.: 10-15501-240-02 DESCRIPTION: ildinq'., ermit Type ilding Wo,r_k Type BASEMENT FINISH ALTERATION (? DO REMARKS: SEPARATE PERMITS ARE REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK FEE SUMMARY- Base Fee $36.00 Surcharge $.50 Total Fee $35.50 CONTRACTOR: OWNER: - Applicant - GRAY MIKE 3362 ROLLING HILLS DR EAGAN MN 55121 (612)688-2195 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. APPLICANT/PERMITEE SIGNATURE ISSUED e : SI TURE 14103 CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION 681-4675 4_3K. Rio rn if to/ /1-I SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 co of ener calcs. --------------- COMMERCIAL 2 sets of architectural & structural plans l?sye?t ofz 1J0 specifications, I copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date ID 7 Valuation of work Site Address: a?6z dal\;n? ?4'\\ s_ `Q r. ??i'1? SS12l STREET SUITE # Tenant Name: (commercial only) LOT BLOCK SUBD. bWU C'G ? P.I.D. # Uwrg-\fvEI eers?c^??t Description of work: ?rl?s( SG ?5 +?• i\ The applicant is: Owner ? Contractor ? Other (Describe) GLIz 8& za5s Name Phone Property - LAST FIRST Owner Address s_?5 6Z_ 0)1+ 4G STREET STE # \\ City 4E416.lccJ State iY1N Zip Company Phone Contractor Address License # Exp. City State Zip Company Phone Architect! Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area 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: - OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 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 WORK TYPE -16+4? 0 33 Alterations ? 35 Tenant Finish ? 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual e Basement sq. ft. (Allowabl 1st F1. sq. ft. UBC Occupancy 2nd F1. sq. ft. Zoning Sq. Ft. total # of Stories Footprint Sq. ft. Length On-site well Depth On-site sewage APPROVALS Planning Building Engineering Variance REQUIRED INSPECTIONS ? .Site ? Footing ? Framing ? Wallboard Jq Final ? Draintile D/ U Insulation ? Fireplace Permit Fee VaLustion; Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surchargge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: $ ?3 s". -- 16 Basement Finish 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 37 Demolish MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code Census Bldg Census Unit Assessments SAC % SAC Units REACTIVATE RECENE CITY OF EAGAN PERMIT 993 BUILDING PERMIT ?? -- J J N 18 1993-- 681-4675 C APPLICATION SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month. in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date Valuation of work Site Address: 2> ?0I??NG AtI a7 Z. STREET SUITE / Tenant Name: (commercial only) LOT BLACK L QQ? SUBdSU CQ-0-4 P.I.D. # Description of work: '?2c The applicant is: Owner El Contractor ? Other (Describe) Name ;z C.,?t M CttP, Phone (C,Z)69s--z1gS Property LAST FIRST Owner yyII 1 Address STREET STE f City Go'? State IL Zip SS (Z I Company Phone Contractor Address License # Exp. City State Zip Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area 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: ?` OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 02 SF Dwg. ? 03 SF Addition ? 04 SF Porch ? 05 SF Misc. WORK TYPE P 31 New ? 32 Addition ? 33 Alterations ? 34 Repair ? 35 Tenant Finish ? 36 Move t If - I. N_ *- ? 16 BasementTAnish'',,: ? 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. ? 20 Public Facility ? 21 Miscellaneous ? 37 Demolish GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable) 1st F1. sq. ft. City Water UBC Occupancy 2nd F1. sq. ft. PRY Required Zoning Sq. Ft. total Booster Pump 4 of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code Depth On-site sewage SAC Code APPROVALS Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ? Site ? Wallboard a ? Insulation ? Fireplace ? 06 Duplex ? 07 4-Plex ? 08 8-Plex ? 09 12-Plex ? 10 Multi. Add'l Footing Final ? 11 Apt./Lodging ? 12 Multi. Misc. ? 13 Garage/Accessory ? 14 Fireplace x;15 Deck ? Framing ? Draintile Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surchargge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: vatustkn: $ SAC % SAC Units .%fEYOR'S CERTIFICATE MITTELSTAEDT BROS. CONST. 0 E?9.I l? , _ ROLLING H ILLS OR yifi1E: BUILDING DIMENSIONS SHOWN ARE NIA FOR HOR TA T L4 IZON L L B VER ICAL LOC- O $ " ATION OF STRUCTURE ONLY. SEE ARCHItECTUAL PLANS FM BUILDING 450.00 R „ B F / T S Ste 2( 7 e 8 I 5 rJ2 =0 It pU 10A 10N DIMENSIONS, 30.40,1 9LA C ' . 6 860.6r BENCH MARK TOP OF PIPE _ $62.49 -.? N ?l l J s 882.3 ? $?.2 . ? % 662.4 c---- Y-------- 2 :_ 2A.64 ?• 20.33 0 6?5?1 CD A L 2 41 I w PROPOSED W HOUS I to 44.0 t4'`-19 -1679_ 859.8 y gSY. 140 Ix vr ,rY/r 1I u LOT 24 IT! I DRAINAGE 6 UTILITY EASEMENT PER PLAT L BENCH MARK TOP OF PIPE 2 861.94 O O 0 7 2 c0 0 W N m N _?J 1 NOTE; NO SPECIFIC SOILS INVESTKIATIOH HAS BAN OOM= TlgS SurrA/? TYY of TO M OM HE IIEC oun BED NS*LrrY OF THE SURVEYOR. 75~.72 ` C I?8` 3 1,1 1 1• 10 l? "1rJ n A '--AN 9.541_- 06059 52 NLI ; ?j I n rnrK R1i N 63 21'47 W A 8.620.00 1vI IS P:AL ,-A -. __, DENOTES PROPOSED SURFACE DRAINAGE l c•e s' o ? `-'- O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 8?.Z•b FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - esx• I FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - g a 3,?- FEET WE HEREBY CERTIFY TO MITTELSTAEDT BROS.CONST. THAT THIS IS A TRUE AND CORRECT REPRESENTA71ON OF A SURVEY OF THE BOUNDARIES OF: Lot24,Block 2, BUR OAK HILLS 2ND ADDITIO, Of?COr(?;n"7 • recorded plat thereof, Dokoto County, Minnepoto. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACH NTE f A SURVEYED BY IRE OR UNDER MY DIRECT SUPERVISION THIS 21 ST A PROPOS ED GRADES SHOVM WERE TAKEN PROM THE GRADIN6,0111AINA0E 9 E"ON CONTROL PLAN FOR BUR OAK HILLS 2ND ADD., LAST DATED 8-4-86 x M ?T (0 o m 1af, ? 0 N h I I y N 1 = Z O 2 A O O z O T M _ rn O > m i i( ii c OAR, m (6691 0 i 'Y 882.3 14.5 P ' R. HILL,?N '.-, .. JOHN C. LARSON, LAND SURVEYOR MINNESOTA LICENSE NUMBER 19828 James R. Hill, inc. PLANNERS I ENGINEERS J SURVEYORS 2500 W. CTY. RD, 42 1 BURNSVILLE, MN. 55337 0 612-890-6044 L Al BL o2 CITY USE ONLY RECEIPT #: L!? SUBD. AX& 61 f n4 DATE: 5 14MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 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 x Add-on air exchanger, i.e. Vanee system, etc. Date: May 5. 1997 ? 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 TOTAL 50 $20.50 SITE ADDRESS: 3362 Rolling Hills Dr. OWNER NAME: Michael & Diane Grav PHONE M 688_2195 INSTALLER NAME: FREDRICKSON HEATING & AIR CONDITIONING, INC. STREET ADDRESS: 3650 Kennebec Dr., #1 CITY: Eagan STATE: MN ZIP: 55122-1001 PHONE #: (612 ) 452-2775 O CITY USE ONLY L _ BL RECEIPT #: SUBD. DATE: 1996 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: all commercial/industrial buildings. ? multi-family buildings when separate permits are not required for each dwelling unit. DATE: WORK TYPE: CONTRACT PRICE: 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 permd 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 BL - CITY USE ONLY RECEIPT #: ID ?Q (J SUBD. Z?+ 1a& Z RECEIPT DATE: `3//0/5 9 1999 PLummNea PEmu (RESIDENTIAL) CITY OF EAEiAN 3830 PILOT KNOB SD EAGAN, MN 55122 (651) 681-4675 Please complete for: ? single family dwellings > townhomes and condos when permits are required for each unit backflow preventer for underground sprinkler system -----------------------------------_----------------------------- Alterations to existing residence ------------ 30.00 ----------------------------- ----------------- r 0 c 0 Water Turn Around 30.00 = Private Disposal System MPC lic. 75.00 = (new and refurbished systems) Private Disposal Systems Abandonment 30.00 = RPZ (new installation/repair) 30.00 = FIXTURES EACH # TOTAL Shower 3.00 x = Water Closet 3.00 x = Bath Tub 3.00 x = Lavatory 3.00 x = Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet ' minimum -1 3.00 x = Rough Openings 1.50 x = Water Softener for dwellings under construction 5.00 x = U.G. Sprinkler for dwelling under const. 3.00 = STATE SURCHARGE .50 Reminder., Call 681-4675 for inspections of water heaters, water softeners, alterations, etc. TOTAL a ------------------------------------ --------------------------------------------------------------------------- I hereby acknowledge that I have read this application, state that the information is coned, and agree to comply `wviu5 all appli:--bla Cily of Eagan ordinances. ------------ it is the appiicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement. SITE ADDRESS: 3,T62- A-e l -) ///'r/S #°'/? z ? 2!e OWNER NAME: /Ic INSTALLER NAME: rpf(OR 1 (-( co / CC" ll e-lovw TELEPHONE #: STREETADDRESS: /JP-1 z5_ - CITY: 1 V-e/l (??B?p ?SjATE: I}?tnlM ZIP: s? iI _ SIGNATURE CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1999 ?3 v? Lc,W ?j CrrY OF EAGAN SUBD. B rdr ?R ?J 7CHANICAL 681POWU RESIDENTIAL RECEIPT # /'0Co ','J- DATE 4V,--2-,3 9 a- PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, COMPLETE FOR TOWNHOMES/CONDOS WHEN SEPARATE PERMITS ARE REQUIRED FOR EACH DWELLING UNIT. OWNER: ¢. S ec?f ?YDS, FEES SITE ADDRESS: 3 36 ©??i i p I /s r, ADD ON/REMODEL (E)QSTING CONSTRUCTION ONLY) $ 15.00 INSTALLER: HVAC: 0.100 M BTU 24.000) PHONE #: 12481 Rhode Island Ave. So. ADDITIONAL 50 M BTU 6.00 ADDRESS: Savage, I VIN GAS OUTLETS - MINIMUM 1 Q $3 EA p 0 CITY: 1 ?IP: SUTCH"GE: $ SO _ SIGNATURE: t / TOTAL: $ 3 a V 61 COMMERCIAL PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIALfMUSTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. WORK DESCRIPTION: CONTRACT PRICE: FEES 1% OF CONTRACT FEE. STATE SURCHARGE IS $•50 FOR EACH $1,000 OF PERMIT FEE. $ PROCESSED PIPING - $25.00 MINIMUM FEE - $25.00 OWNER: TOTAL: ' $ SITE ADDRESS: TENANT: SUITE #: INSTALLER: ADDRESS: CITY: ZIP: PHONE #: CITY SIGNATURE: SIGNATURE: 1 1 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES. AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.. - ----------------- - ------ NO. FIXTURES EACH TOTAL _L SHOWER 3.00 WATER CLOSET 3.00 BATH TUB 3.00 ! LAVATORY 3.00 KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 HOT TUB/SPA 3.00 WATER HEATER 3.00 FLOOR DRAIN 3.00 GAS PIPING OUTLET • minimum -1 300 ROUGH OPENINGS 1.50 WATER SOFTENER 5.00 PRIVATE DISP. • Da:ciy. uc. 20.00 U.G. SPRINKLER • home undercomt. 3:00 ALTERATIONS • to emoting 20.00 77- WATER TURN AROUND 20.00 STATE SURCHARGE .50 TOTAL: `f SITE ADDRESS: 3`--xG Z, rZo 1 ? 4 G +WI S ?i ?? r e l OWNER NAME: WXr- / INST ADDRESS: Z?Z G Z- CITY: r 1 STATE: ZIP CODE-- 5a l PHONE #: (i;I2) fouA,a ~- l %:~ ?. SIGNA RE OF PERMITTE 1"4 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 1994 PLUMBING' PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN S5122 (612) 681-4675 PLEASE COMPLETE FOR ALL COMMERCIALANDUSTRIAL BUILDINGS. ALSO FOR MULTI FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. NEW CONSTRUCTION _ ADD ON REPAIR WORK DESCRIPTION: CONTRACT PRICE: $ FEE: 1% OF CONTRACT FEE. STATE SURCHARGE. $.50 FOR EACH $1,000 OF FEE. MINIMUM FEE: $ 25.00 CONTRACT PRICE X 1% STATE SURCHARGE TOTAL SITE ADDRESS: TENANT NAME: STE. # OWNER NAME: INSTALLER: ADDRESS: CITY PHONE #: STATE: ZIP CODE: FOR: CITY OF EAGAN APPLICANT      ì  ý    ù ú þýüýû ÿþþ ý üûú ûúù     øýýþþ  ú è þÿ ù íýõ    ÿ  ÿþõ  úù ø÷  öó é á  ùø÷  ö ø÷ öó é ô óéï ÷ý    õù á  ù íù÷ýø Üü úÞùý ì  ÷ â       Þù      ý   æðý üóó÷ ü ûýð ð ýü  þ  ÷ æáýð ðý ÷ ýð  ýýæ áý ä    ý  Þù  øýó ü ðýø  æ ý çååæ åæå ôø  úù  ý ü ý çæ ãæã Ûýùýûæ  óò õ ñð ÷÷ý ï  óý Ú ðð øþ üý ãáùøïýáö ïüõ  ï þýüýòô  ë è  øýó ü  ý ýâ  ý  ý÷÷ýý ý  ý ð ý  ýýü ÷øó ýý÷÷ý  úý  ðò ýúýù ýáøðþýüýí ý æ ÷÷ýé  úüýù  ù øúüýù Use BLUE or BLACK Ink 1-----------------, For Office Use I City of Eap I Permit I 1 1 3830 Pilot Knob Road Permit Fee: l Eagan MN 55122 17sl~ Phone: (651) 675-5675 1 Date Received: Fax: (651) 675-5694 I I Staff: 1 2013 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: Site Address: 33 (Oa. Iw~ ( 1 1L) DY, Tenant: Suite Resident/Owner Name: Y~'UC-h Phone: Address / City / Zip: i n noll t.(f Ieat7 v try 1f License 21-C~Za~ Name: Contractor Address: 04 V P-VI Xi `~l C~lrt S City: 46(61' r)n State: ~-k to Zip: Srp b-,7>--~ Phone: (.Q S 4 -3 1 - 61 X 2,2 Contact: Email: K ~i Ytt.VYiG~~c i 5[t ck leb uwCLI, Y". C OYVA New Replacement Additional Alteration Demolition Type of Work Description of work: ~o NOTE Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL A- Furnace _ New Construction _ Interior Improvement Permit Type Air Conditioner _ Install Piping _ Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under/ Above ground Tank Install / _ Remove) _ Other RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ o ° TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x1% $60.00 Minimum (includes State Surcharge) Permit Fee *If the project valuation is over $1 million, please call for Surcharge 5.00 Surcharge* TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.ciopherstateonecall.org 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, 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. x -L G' Y y) C r k rS L3Y1 x zi-,~ Applicant's P nted Name Applicant's ig ature FOR OFFICE USE Required Inspections: Reviewed By: Date: Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA129857 Date Issued:03/19/2015 Permit Category:ePermit Site Address: 3362 Rolling Hills Dr Lot:24 Block: 2 Addition: Bur Oak Hills 2nd PID:10-15501-02-240 Use: Description: Sub Type:Residential Work Type:Replace Description: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. Applicant: Troy Good 3670 Dodd Rd Eagan, MN 55123 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Jeffrey E Bergman 3362 Rolling Hills Dr Eagan MN 55121 (651) 402-0429 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature r For Office Use -,� �� Permit#: � / 7 / d T .., •�• •+rrEAGANREGEI\.TIfl, 4, Permit Fee: (/ Date Received: /�/b to 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 JAN 1 0 2020 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspectionsecitvofeaoan.com -, 2020 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: //7/20 Site Address: -33C ,e0//,AO .441/5 7)Y Tenant e0 E"rG/n ry Suite#: T. s er Name: Y Phone: 4$1-4/4.2-0 .2g z, t Ar ply' Address/City;Zip: ._,_ . 1 'n/ _ _ l 7 i i'l-itIt 41106";11 Name: �,( •O\ , k AMP CO License#: Address: )\ , Ci I • ., C - , Stater Zip: All Phone: so LI1 A ' tNA � i Contact: \ £ Email: lb \ r V 4��1 a _ ��o1 I;41 I/ . \ 4V —New Replacement Repair Rebuild Modify Space Work in R.O.W. !Fal ", ., , Description of work: _ ,, Tankless Water Heater Lawn Irrigation( RPZ/—PVB) e 4 � k 1t,W S ndard Water Heater r , Add Plumbing Fixtures( Main/—Lower Level) 't Desc pt0 Water Softener ' X_ , Description: . ;;A:010,44-g-1,: Septic System 0,� ,� �,� F Connection to City Water from Well , ..11,k,}4-; � rx tf 4 New Abandonment RESIDENTIAL FEES $60.00 Water Heater,Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 New fixtures, adding or removing piping (includes State Surcharge) $60.00 Septic System Abandonment $100.00 New Residential (fee collected with Building Permit) $115.00 New Septic System (includes County fee and State Surcharge) $60.00 Connecting to City Water from Well*+$290 for Meter and $200 for Radio Read =$550 *Sewer&Water Permit also required for connection charges TOTAL FEES$ CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.000herstateonecall.orq You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. 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 l 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 witl�,the approved plan in he case of work which requires a review and approval of plans. X _ x i ! �oryi Thilij-eaftc Applicant's Printed Name Applicant's Signature Page l of 2 PERMIT City of Eagan Permit Type:Building Permit Number:EA163409 Date Issued:08/31/2020 Permit Category:ePermit Site Address: 3362 Rolling Hills Dr Lot:24 Block: 2 Addition: Bur Oak Hills 2nd PID:10-15501-02-240 Use: Description: Sub Type:Reroof Work Type:Replace Description:Includes Skylight 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 - Jeffrey E Bergman 3362 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:Plumbing Permit Number:EA178087 Date Issued:08/01/2022 Permit Category:ePermit Site Address: 3362 Rolling Hills Dr Lot:24 Block: 2 Addition: Bur Oak Hills 2nd PID:10-15501-02-240 Use: Description: Sub Type:Fixtures Work Type:Replace Description:Bathroom(s) 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. All tiled shower bases require a water test. Fee Summary:PL - Permit Fee (miscellaneous)$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 - Jeffrey E & Jennifer Bergman 3362 Rolling Hills Dr Saint Paul MN 55121--234 (651) 686-9021 Clearwater Plumbing & Heating 19260 Mushtown Rd Prior Lake MN 55372 (952) 440-3779 Applicant/Permitee: Signature Issued By: Signature