3377 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 I . 0010 1;1111b t, ,., , , ¢PPLICANT:
" 11111 1.11.Ii? f'lll. I. ?:i >r11 fr PI! f??!17:1i ti ?e1.e ? 111!
10IR ijAI' 111 f I 'No 61t.,Fitt- 1061.
PERMIT SUBTYPE:
:
TYPE OF WORK:
11111 1 1 11 I 141,
001'3r, 'a
01/04/93
t,
INSPECTION TYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR.
?Pr .??? •,I 1is;! t 1'1'1111
s I t I'1 ;111
fit MAI Y'Sr RECI-I PI M 11"V S & W PI H1+ - FIVE ,TAR 1'104
Permit No. Permit Holder Date Telephone it
Sw
PLUMBING /o?? Ci33. / 7?7
HVAC
ELECTRIC
ELECTRIC
Inspection Date Insp. Comments
Footings 1 I?JC
Foundation 1
17&3
Framing 1
Roofing
Rough Plbg. vxar &4
z - y- 93 ?G?h
Rough Htg.
Isul. Z4 f 3 ?S'
Fireplace '2 3 C^
J
Final Htg. -11 j
Orsat Test It r
Final Plbg. / ?/' Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
9?
Wer i f icate of Cccnpa=4
Wim of cRagan
Tep"twext of lon{tbing a i$oedwn
This Certificate issued pursuant to the requirements of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
Use Qassificatioa: SF DWG Bldg. Permit No. 1959
Ocy Type Zoning District R Canst. VN
Owner of Building INC Address 1212 BAY RD, B VUE
Baild+nB Add. 3377 ROLLM HILLS DRM LocalftLIU, %* BUR M.t HUM M
i
Date: 03/25/93
Building Official
POST IN A CONSPICUOUS PLACE
61
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
q l5b 3830 PILOT KNOB RD - 55122 70,00
651-681-4675
New construction Requirements RemodeUReoair Requirements
. 3 registered site surveys showing sq. h of lot sq. IL of house; and all roofed areas . 2 copies of plan
(20% maximum lot coverage allowed) . i set of Energy Calculations for heated additions
2 copies of plan showing beam & window sizes; poured found design, etc.) . , 1 site survey for exterior addidons & decks
i set of Energy Calc_Iations
• 3 copies of Tree Preservation Plan if lot platted after 7/1M
- Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE - i t I VALUATION (EXCLUDING LANDI I O, no n o w
JOB SITE ADDRESS_ :331f -CSI jI Qq 4.401s I5 L rl Ve
IF MULTI-FAMILY BUILDING, HOW MANY UNITS
PROPERTY OWNER Ron 0 ?0 me6 -FD_L?e
TYPE OF WORK 1-71 ill SY \ 6 j)6i?_ E I(? ?J( .? FIREPLACE(S) t0 _1 _2 _3
APPLICANT PH`'ONE # ?O5I -1v
ADDRESS I I1 WiLs _S C I )''T ZIP CODE 55 [a
PAGER # {a LL PHONE # kri(i- - S FAX # (6 1 L A/0 'OOA'7
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submi D
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672 fl l
U (U
- New Energy Code Worksheet Submitted LI 1
Plumbing Contractor:
Plumbing System Includes:
Mechanical Contractor: _
Mechanical System Includes:
Sewer/Water Contractor:
Water Softener
Water Heater _
No. of Baths
Air Conditioning
Heat Recovery System
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with
all applicable State of Minnesota Statutes and City of Eagan Ordinct??
r
Signature of Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not equired _
_ Phone #: t?
La1vn Sprinkler Fee:
No. of R.I. Baths
Phone #
Fee: $70.00
Phone #
Updated 1/01
OFFICE USE ONLY
? 01 Foundation
K02 SF Dwelling
? 03 01 of_ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Yor-N
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn.(4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
0 36 Multi
.% 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
o2 oa6) U
Occupancy
IC-3 MC/ES System
Census Code y y Zoning R 1 City Watei
SAC Units C? Stories Booster Pump
Nbr. of Units / Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const -? Width
Footings (new bldg)
Footings (deck)
Footings (addition)
Foundation
_ Drain Tile
Roof _ Ice & Water _ Final
Framing
T Fireplace _ R.I. _ Air Test _ Final
Insulation
REQUIRED INSPECTIONS
_ Final/C.O.
Final/No C.O.
?a Plumbing
HVAC
_ Other
Pool _ Ftgs _ Air/Gas Tests _ Final
Siding _ Stucco _ Stone
Windows (new/replacement)
Approved By 611-e, Building Inspector
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
RESIDENTIAL
ynBUILDING PERMIT APPLICATION o 00, 75
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Construction Requirements Remodel/Repair Requirements
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 exterior additions & decks
i set of Energy Calculations • Indicate if home served by septic system for additions
3 copies of Tree Preservation Plan if lot platted after 7/1193
Rim Joist Detail Options selection sheet (bldgs with 33 or less units) r
33 -7-7 Rorl±/ol ?j/! S DATE VALUATION ?C?t ay y?
JOB SITE ADDRESS
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER RcnAIC) Fy ?P_
TYPE OF WORK ?nrpf f-/`Proo47 FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT GcJ?57?.i ?l ced'I7r PHONE# 7G3 sc??-o30y
ADDRESS `17oO ! t`/?iC 'U p/`Lz Mw ZIPCODE SSy//
PAGER # CELL PHONE #
FAX #
NIEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category
(check one)
Plumbing Contractor:
Plumbing System Includes:
Mechanical Contractor: _
Mechanical System Includes:
Sewer/Water Contractor:
- Air Conditioning
- Heat Recovery System
Phone #
Phone #
Fee: $90.00
Fee: $70.00
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
_ MINNESOTA RULES 7670 CATEGORY i
- Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Phone #:
_ Water Softener _ Lawn Sprinkler
_ Water Heater _ No. of R.I. Baths
No. of Baths
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ updated 1/01
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-piex ? 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
Footings (new bldg)
Footings (deck)
Footings (addition)
Foundation
Drain Tile
Roof _ Ice & Water _ Final
Framing
Fireplace _ R.I. _ Air Test _ Final
Insulation
_ Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding _ Stucco _ Stone
Windows (new/replacement)
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
REQUIRED INSPECTIONS
_ Final/C.O.
_ Final/No C.O.
_ Plumbing
HVAC
Building Inspector
Address 3377 ROLLING HnI S DRIVE Zip 5512 _
r
Lot to Blk 4 Sub BUR OAK HnLS 2ND
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: 03/25/93 Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded grass
Trail/curb damage
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681.4645 before working in right-of-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
inn /6T
viii Ck r . c-:2 1
L 8 9 5 -17/y - - j-
,
"t-
/
Re0 est D
1 ata
.
1
?
-2
Fire No.
PagRough= Inspection
?
? Ready Now
-may
ill Nobly InspectoO,
wh
L ea
? No
en y
// k-
1 % ioensed contractor p owner hereby reque st inspection of a ve electrical work et:
Job as Ua^ tre Box Dote N As ? I City
Sem,on No. Township Name or Nc. Pange No. Co
Oc P t 1 Ph e N O
Power Supplier
)V 0 Address
EI c cal Comrac r (C.;nV e) -
Utz
Co clo Li s
N
M it A r s I;^ oacl r Owner Making Instal ation)
n AA
A rued Ignatura C IrectodOwner a - Installat
JVV) um r MINNESOTA B ATE BOARD OF ELECTRICITY
Grlgge-Mldway Bldg. - Room S-173
1821 Universlly Ave„ St. Paul. MN 55106
Phone (612) 812-0800
THIS INSPECTION REOUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
C/?q?
L Cr8495
REQUEST FOR ELECTRICAL INSPECTION
? See iZshuctions Cr completing this form on back of yellow copy.
)C" Below Work Covered by This Request
e 4 $, EM0001-09
e
i?
New d. Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building pr yer Other-(Specify)
Comm./Industrial Furnace '
Farm Air Conditioner
Other (specify) Contractors Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps I JAI 0 to 100 Amps
Transformers Above 200 _ Amps Above 100 -Amps
Signs inspecrors Use Omy: T AL
Irrigation Booms
d
?
Special Inspection T J
T T
/ ff
J
Alarm/Communication THIS INSTALLATION MAY 8 D DISCONNECTE?IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS,
I, the Electrical Inspector, hereby
certify that the above inspection has
ben made Rough-fn ?.
Fine, Date
Da
r
CE USE ONLY
equest voitl 11 months from
PERMIT # 5 RECEIPT DATE: ,3?2 3? 0
RESID01TIAL PLUMBING PERMIT APPLICATION
CITY OF £ACAN
3830 PILOT KNOB RD
EAfiAN, MN 55122
651-681-4675
Please complete for:
? single family dwellings
townhomes and condos when permits are required for each unit
? backflow preventer for irrigation system
SITE ADDRESS: 33
OWNER NAME:: RON J p,
?QUe TELEPHONE #: 091
(AREA CODE)
INSTALLER NAME: Deli' TELEPHONE M
STREET ADDRESS:
CITY:
Place a check mark next to the permit work type
STATE:
ZIP:
New residential dwelling unit under construction and not owner/occupied $ 90.00
_ Add-on, modification or alteration to existing dwelling unit, including: $ 50.00
• abandonment of septic system
• new installation/repair/rebuild of RPZ
• lawn irrigation system
• water turnaround
Level
to
Nature ofwork:
wer
_ Septic System, new/refurbished - $ 225.00
• includes County & Consulting Inspector fees
• requires MPC license
State Surcharge $ .50
t
l
T $ 50.50
o
a
Reminder. Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable Cityof Eagan ordinances. It
is the applicant'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 'Nin City property/right-of-way/easement.
NATURE OF PERMITTEE
(AREA CODE)
Updated 1/01
CITY _. OFEAGAN PERMIT
3830 Pilot Knob Road PERMIT TYPE: O U I L O T N G
Eagan, Minnesota 55123 Permit Number: 0'01959 (612) 681-4675 Date Issued: 01 /0 4/ 9 3
SITE ADDRESS:
3377 ROLLING HILLS DR
LOTz 0010 HLOCKa 0004
BUR OAK H.II.LS 2ND
P.T..N.: 10-15501-100--04
DESCRIPTION:
-?Uildfng Permit Type SF DWG
` Buzlding`,Worl, Type NEW
UBC Occupancy R--3 h1-1
Conetruction "Type V--N
Zoning R-:L
Bu11din9 Length I
Building Width 38
-REMARKS:
RECEIPT PRV S & W PLBR - F7.VE STAR PLBG
FEE SUMMARY-
VALUATION
Base Fee
> Lan Rcvicew
Surcharge
SAG
SAC °
SAC Units
Subtotai
$811.00
$x27.1.5
$74.50
LOtO
___
$2,16?.6E.
$149,0(00
it IS CELLANE00S _1,7_4A.5,,
To-C:aJ. Fee $3,907.15
CONTRACTOR: Alp pIicarit - ST. 1-1COWNER:
NCDONALD CONST INC :16887061 0002376 MCDONALD CONST INC
1212 BLUEBILL BAY RD 1,212 8LUEE3ILL BAY Re
BURNSVILLE IN SS337 BURNSVILLE IN 55337
(612) 688-7061 (612)638-7061
I hereby acknowledge that T have read this application and state that the
information is correct and agree to comply with all applicable State of Mn.
utes and City of Eagan Ordinances.
5t.
APPLIG T/PERMITEE SIGNATURE ISSUED Y: IGNA URE
PERMIT #
1959
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, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re guest is made or lot-change is re guested once permit _is issued.
Date 1A / l / r Valuation of work hlf4 900 " CSC pzW 697-f
Site Address: 3377 &Z41v6 /,?yzf /D,<•
STREET STE Y
Tenant. Name: (commercial only)
LOT BLOCK SUBD. 2_ _R &K A'4,0 _
??L( P.I.D. M
Description of work:
The applicant is: ? Owner pL Contractor ? Other Mmcrnbe>
Name Phone
Property LAST FIRST
Owner Address
STREET STE M
City State Zip
.X-' Phone
Company MLVnAIAL-tb (,QjJ5Tr?u4CTj0Af 7CA
(o9-291 70G/
Contractor
/A/0, fiul-/3/LL 6&42D. License # nz37? Exp.
Address
'p
City &KNSVtUf_ State M'l Zip x.5337
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber. Fives 9f4,e )PIgmt3lV 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: <
1@
OFFICE USE ONLY "._
..
?
BUILDING PERMIT TYPE
? 01 Foundation ? 05 Apt. Bldg ? 09 Basement Finish ? 13 Comm/Ind New
If 02 SF Dwg. ? 06 Garage/Accessory ? 10 Swim Pool ? 14 Comm/Ind Add
? 03 Two family ? 07 Fireplace ? 11 Res. Add. ? 15 Comm/Ind Rem
? 04 Multi-fam. T.H. ? 08 Deck ? 12 Res. Porch ? 16 Public Fac.
13 17 Agricultural
WORK TYPE
X 31 New ? 33 Alterations ? 35 Move
? 32 Addition ? 34 Tenant Finish ? 36 Demolish
GENERAL INFORMATION
Const. ((Actual)
f V-N Basement sq. ft. MWCC System WS
(Ai
owable) y- N 1st F1. sq. ft. City Water YE7
UBC Occupancy R_3 M_1 2nd F1. sq. ft. PRV Required 11/457
Zoning A-1 Sq. Ft. total Booster Pump
i of Stories Footprint Sq. ft. Fire Sprinkler
Length bq• On-site well Census Code /o/
Depth 3-1.1z' On-site sewage SAC Code e/
APPROVALS
Planning Building Assessments
Engineering _ Variance
REQUIRED INSPECTIONS
? Site
? Wallboard
? Footing
? Final
O Framing
? Draintile
? Insulation
? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC % 100
SAC Units 1
Vatuat;an: s-1 4 o0 0
GAaAGE; 32X Z4 = 1168 Ztjm F4 oa1¢;
z x ?2 (a4) 29%
x 38 6Z 4P
z
6/Z X 5 ' (3Z) 14
2
X 2 -
a
2 K t? I1 39z
- 38x28 ib64 85y><53=
z X /y_ 28 445262
02 Y 5z -72rr
I? k 144
5
1
4
.,OR`/yx1lii , /
630
19
t 1Sr
2t
1
i
.
Ori 13
13?FL
O
B'NTc 13 Z2
G X 7- 16
4'k2 1?
!l5 MS?= ?1r7?a2 '
f
P.01
** **
* PIONEER
? eng n? earl
LAND SURVEYORS
I sun or Auumc . i er
Certificate of Survey for: McDonald Construction, Inc.
,`? s ssys
i
\ ?a ?<Q9r ?SY
70•
I \
House Address: Rolling Hills Drive, Eagan, MN
a a0 ?? ?8r3 10
. i i
~j-
, t / Tai
946,z //a
N
X
c
p4 %
f? "+?? ro"1 212 r r-?. JF D fa • ?
/? -tea tY'..b+ Sp /
Yg 6S?j.6 `•egSEp ho SsY / ?Sl, 7,s'
aQ)
2422, Enterprise Driye
Menoota Heights, MN 55120
'612) 681-1914•Fox 681-9488
625 Highway 10 Northeast
Bloine, MN 55434
612) 783-1880•Fox 783-1883
_ ? o ?qaf a ?
OV /A"
Flonsuva LL
. 90o.D Denotes
-QioJD` Denotes
-- Denotes
Denotes
--c- Denotes
-e Denotes
LOT 10 , BLOCK 4
DEPT
PROPOSED HOUSE ELEVATION
Lowest Floor Elevation: 94$..Ty
'fop of Block Elevation: 857•-23
Garage Slab Elevation: $56.'10
are assumed
BUR OAK HILLS 2ND ADD.
DAKOTA COUNTY, MINNESOTA
I hereby certify that this survey. Plan Or raoort was prepared by me or under my direct supervision and that I am duly Registered Land Surveyor
under the laws of the Slste of Minnesota. Dated this l-.s-day of 1DE74: • A•D, 19' 4!.
Scale: !,rr -30faat
R
NO. 14891
\ ?/s
r'i-. ad Nr
Existing Elevation
Proposed Elevation
Drainage & Utility Easement
Drainage Flow Direction
Monument
Offset Hub Bearings shown
CLce
91113.27
C40 D
13 0
0 V0
Q?0 0
H 0
0-? 0 0
LOT SURVEY CHECKLIST FOR RESIDENTIAL
DOCUMENT STANDARDS
Registered Land Surveyor signature and company
• Building Permit Applicant
Legal description
• Address
• North arrow and bar scale
• House type (rambler, walkout, split w/o, split
lookout, etc.)
• Directional drainage arrows with slope/gradient t.
• Proposed/existing sewer and water services
• Street name
• Driveway
entry,
ELEVATIONS
? 0r" '13 Existing
Sewer service
? 0
0
0 0 Lot corners
1 Top of curb at the driveway
? ? Elevations of any existing adjacent homes
Proposed
0 0
13" Garage floor
0 0
3" First floor
0 0
II?
O 0 Lowest exposed elevation (walkout/window)
.
?? 0 0 Property corners
Front and rear of home at the foundation
PONDING AREAS (if apglic blel
D D' 0
Easement line
WL
0 6' D H
HWL
? Er 0
' Pond N designation
D 0
0 Emergency Overflow Elevation
DIMENSIONS
0'0 0 Lot lines
0
V0 Right-of-way and street width (to back of curb)
Proposed home dimensions including any proposed decks
,
overhangs greater than 21, porches, etc. (i.e. all
structures requiring permanent footings)
? D Show all easements of record and any City utilities within
? those easements
0 0 Setbacks of proposed structure and setback of adjacent
0 D--'13 existing hom
Retaini w cements, if any
Reviewed: 1.2J Z?
October 1
992 fiamle / Date
Date of survey: 92,
Owner
Site
Contr
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 )
1. Building Perimeter 2? 0 _5 ft.
U
2. Wall height (ground to save) ?j ft.
3. 1. X 2. (above) gross wall area "l sq.ft.
4. Building dimensions (L) X (W) =?4ti3 sq.ft.roof & floor area.
5. Sq. foot area of rim joist - Floor joist size (2 X )
2 X `h1V(Perimeter) _ ? sq.ft.
6. Doors - Area 117 114b " in U. factor
Type of Construction Perimeter ft.
Manufacturer
7. Total door's perimeter ft.
8. Windows:
U factor
approved
TOTAL
TYPE? 0SIZL,Ep???'( AREA EACH (Sq.Ft.) NUMBER
UNITS OF SQ FEET
L" L?
A
-?{
9. Total sq.ft. Glass
10. Fireplace area: Width X Height = X = sq.ft.
11. Exposed foundation: Height X Perimeter.Lq_X * =114 sq.ft.
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-
MINNESOTA STATE ENERGY CODE CALCULATIONS
BASED ON CHAPTER 5 OF THE
MODEL ENERGY CODE - 1983 EDITION Adoption Effective IILL?/ v?l
12. Framing area = 10$ of gross wal
13. Gross wall area
Window area A l 4?) sq.ft.
Rim joist area A sq.ft.
Door area A- -Sq. f t.
Other doors area '1 A?sq.ft.
Exposed fndn A l1 sq.ft.
Framing area AV5-!is ft.
Net wall area A 1b q.ft.
(13B)
L area.
sq.ft.
U windows = 3 6P
U rim joist= 1Jl l
U door area= 1 14
U other doors=! l-L-
U foundation= 00
U framing area=?J
U wall= 0oi!2
TOTAL . . . . . . . . .
UxA = l4/?
UxA = _ 1V1 6
UxA =
UxA
UxA
UxA
UxA
UxA
14. Gross wall area x 0.11 (A-1 single family & duplex) = allowable UxA/Code
(13. above)
x 0.23 (A-2 other residential)
x .23 (other buildings)
x .28 (Over 3 stories)
'XC/ & / _ BTUH must be larger than or same
A J x U Code I e ?O• OF. as 13B above
15. Ceiling framing area (Af) equals lot of ceiling area
i
15A. Gross ceiling area = (L) x (W) sq.ft.
15B. Joist area (Af) a lot ceiling area = 1 sq.ft.
15C. Net ceiling area (A c) (15A - 15B)
U ceiling x Ac =126/. x ?V2,
U framing x A f x 10117
15D. TOTAL U x A ............................ d,
16. Ceiling area (15A) x 0.026 (A-1 single family & duplex)
allowable UxA/Cede
x 0.033 (A-2 other residential)
x 0.06 (other)
BTUH must be larger than or same
A(15A)(?. 1 `O x U Code :?( OF. 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.
Date
Signature
2-
1, ?? h? X12
46,E
l o,G-7X,. C?2 r ?Zf X3,5 ?3?.? ?&+ S
L?l(1?Do 5 _ _ _
Dew) 5L = ?i ?i ??'?SI.Z
Z? 5a. 44 AL = ? ?l
CEILING WITH VENTED ATTIC SPACE ABOVE
R VALUE R VALUE
FRAMING. CEILING
0.61
r
t
4.
. 5l0
Air Film 0.61
Insulation 45;. o
Joist
Ceiling .50
0.61
_ -s-
. oZ3
Air Film 0.61
Total R 40 . Pj
U = R . CZ-1
FLAT ROOF OR CATHEDRAL CEILING
R-Ge ue R VALUE
FRAMING CEILING
0.61 Inside air film 0.61
Ceiling
Joist (stud
Insulation
Air space
Roof decking
Insulation
Built-up roof
0.17 Outside air film 0.17
Total R
l U
R
Jindow infiltration .5 cfm/lineal foot of crack
residential door infiltration 0.5 cfm/square foot or door and minimum code requirement
ion-residential door infiltration 11.0 cfm/lineal foot, of crack
lb 12" concrete block no Insulation = .47 R 2.1
lb 12" concrete block insulated cores - .26 R 3.8
lb 12" lightweight blockA _ .32 R 3.1
Jb 12" lightweight block Insulated cores - .12 R 8.3
J single glass = 1.13; with storm window ,54
J double glass = .55
J triple glass = .41
111 exterior walls and ceilings must have a vapor barrier (0.10 perm max:).
;apor barrier must be on the inside (heated side) of wall.
+apor barriers of the polyethelene thin film have no R value.
4.
WALL
SECTION
STUD
SECTION
V rnLUC LnLLULHI WIY]
R VALUE
inside air film .68
Interior wall .45
Insulation 19.0
Sheathing z 0X0
Siding .61
Outside air film .17
R TOTAL Z3 • O?j
.
Siding a95
Outside air film .17
Inside-air film .68
Interior wall • 47
4" stud R= JpQ38(p?j (Framing)U. R
Sheath in 2 .060
R TOTAL O , S 3
SECTION.
RIM
JOIST
Interior wall
Insulation all U R .
Exterior wall cover n
Exterior air. film' R ..17
Interior air film R= .68
Insulation Iq• 00
lei inch soft wood R=1.88 (111m
Joist) '
Sheathing 2
Exterior wall covering .101
Exterior air film R= .17
R ,TOTAL Z 146o
Interior air film R= .68
1
UR=
Insulation 1I.a
Foundation I.Z$ 1
M (Fdn.) U = R =
\ b - Exterior air film R= .17 ,?1(p
R TOTAL 13. 3
xposed Block
?.? ??Grade 3.
U VALUE
(Nall) U . R
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NO. FIXTURES EACH TOTAL
SHOWER 3.00 o
WATER CLOSET 3.00 `i
BATH TUB 3.00
LAl VAT=r 3.00 1a, Qn
i KITCHEN SINK 3.00 3 , 00
:s-tar.A `x) L (_c, i Bt)?< 3.00 oo
I#6T-TbJB/SPA- b(k wry u1 ?x ??or t 3.00 3. (x ?
- WATER HEATER 3.00 o0
? FLOOR DRAIN 3.00 , coo
1 GAS PIPING OUTLET • mnimom - i 3.00 0 o
_ ROUGH OPENINGS 1.50 41
? WATER SOFTENER 5.00 a.C»
? (1,U d y ?a 00 3 a?
_ U.G. SPRINKLER • home =der coast. 3.00
ALTERATIONS • to odsting 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE
TOTAL:
.50
.(X .
SITE ADDRESS: 2" I' I V "
OWNER NAME: ?40yr
ADDRESS:o rn1M Ito A nv?PA?Ull\ln_
CITY: I t I "t",,- STATE: M 1J ZIP CODE: ELW ?
PHONE #: (&'iA) 953- 77/7 / `7
7/6", Iz C (&/r m
SIGNATURE OF PERMITTEE
PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN S5122
(612) 6814675
PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL COMMERCLALANDUSTRIAL 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: $450 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
MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NEW CONSTRUCTION
ADD-ON A/C
ADD-ON FURNACE
DATE 1 5'q
HVAC: 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS (miNiguM 1 @ $3.00 EACH)
ADD-ON/REMODEL (EXISTING CONSTRUCTION)
STATE SURCHARGE
TOTAL
SITE ADDRE
OWNER NAb
INSTALLER:
ADD RE
CITY
TELEPHONE
FEES
$ 24.00
6.00
9m
$ 15.00
?xC.50
• \I
l 1 _ y? STATE: \n i i ZIP CODE: ?"
MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-1675
PLEASE COMPLETE FOR ALL COMMERCIALANDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE
PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
DATE:
CONTRACT PRICE:
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1% OF ;;p FEE $_
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF FEE.
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:
CITY
TELEPHONE #:
STATE: ZIP CODE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
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2012-04-16 11:46 » 651975 5694
lityofEaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 6754675
Fax: (661) 6764694
P 2/2
use t:a.ut or Ot1►h. % mita v
For Olace Dee I
Permit!: / 3'CW- Com.
Permit Fee: (b0 -
Date Reoelved:
Staff:
L
2011 RESIDENTIALPLUMBINGPERMIT APPLICATION
Date: L3 Site Address: g 3 `7 1-��G� l\ t� 4111,sb e
Tenant: I Suite 0:
RESIDENT I OWNER
Name: J k4+' Q z_ PhOne:(Q L S3 a (1S3 -
Address I City / Zip: Setith..0 C..S CJO (Ar4-
CONTRACTOR
Name: UliP 1 U A\(a ) License #: O t(2,‘ JC�f 3
S.�1C
.-
Address: a 5 nUL - B L vd City: b 0ih
State: Zip: S5 3S la 6 Phone: % oL Q 14 ld
•M„_b_
Contact: SO1Son Email:
TYPE OF WORK
?CI__ New Replacement
`, Repair _ Rebuild — Modify Space Work in R,O.W.
Description of work: {� 111 l RXJ 1 n5 10.1Awt 1 r ri3I1LTh elYL
RESIDENTIAL
Water Softener
t
PERMIT TYPE
Heater —
_Water
?awn Irrigation L. RPZ / PV6) Add Plumbing Fixtures (_ Main r _Lower Level)
/ Septic System ._Water Turnaround
_ New
Abandonment
RESIDENTIAL FEES:
555.00 Minimum Water
Heater, Water Softener, or Water Heater Heaterrag Softener (includes $5.00 State Surcharge)
(includes $5.00 State Surcharge)
Fixtures, Septic System Abandonment, Water Turnaround" (includes $5.00 State Surcharge)
$35.00 Lawn Irrigation
$65.00 Add Plumbing
'Water Turnaround
$105.00 Septic System
$95.00 Fire Repair (replace
(add $166.00 if a 5/8" meter is required)
New ($1000 per as built) (includes County fee and $5.00 State Surcharge)
burned out appliances, ductwork, etc-) (includes $5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YQU DIG. Cell 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.gooherstateortecalista
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, end work is not to start without a permit; that the work wit be In
accordance with the approved plan in the case of work which requires a review and approval of plans.
x ••Q, Y1 1--arS On x L2�,.0-,,,0h,i
Applicant's Printed Name Appllcal Signature
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: Under Ground _Rough -In Air Test _Gas Test ,"Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA124207
Date Issued:06/24/2014
Permit Category:ePermit
Site Address: 3377 Rolling Hills Dr
Lot:10 Block: 4 Addition: Bur Oak Hills 2nd
PID:10-15501-04-100
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
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 by law in ALL single family homes .
Scott Rise
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 -
Jeffrey Ruiz
3377 Rolling Hills Dr
Eagan MN 55121
Lakewoods Remodeling
9001 E Bloomington Freeway #144
Bloomington MN 55420
(952) 888-5550
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA159400
Date Issued:12/16/2019
Permit Category:ePermit
Site Address: 3377 Rolling Hills Dr
Lot:10 Block: 4 Addition: Bur Oak Hills 2nd
PID:10-15501-04-100
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jeffrey Ruiz
3377 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:EA164694
Date Issued:10/06/2020
Permit Category:ePermit
Site Address: 3377 Rolling Hills Dr
Lot:10 Block: 4 Addition: Bur Oak Hills 2nd
PID:10-15501-04-100
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 -
Jeffrey & Kelly Ruiz
3377 Rolling Hills Dr
Eagan MN 55121--234
(612) 532-9524
Lifetime Construction & Restoration
21 Century Ave S
St. Paul MN 55119
(651) 464-9920
Applicant/Permitee: Signature Issued By: Signature