3386 Rolling Hills Dr• r i? '
(9tr#if iratir of (Orrupaury
Citp of Cagan
?r?Ri ld wing inwrttm
This Certif!cWe issued pursuant to the requirements of Secdon 306 of the Uniform Building
Code certifying that at the time of issuance this structure uw in complkwe with the various
ordinances of the City regulating building consouedon or use: For the following.
use anion SF DWG/GAR W& Krn4 Nm 728
Owup,,,y Thv R3/Ml Zbeins Da&W R l tya r,.,.. ?
o,wof p,uj,g SEVETSON HUES INC Addm 2 500 W r- Y RD 42, B' VIII E
} yrr nw 8/7/92
POST IN A CONSPICUOUS PLACE
INSPECTION RECORD I Control No. 0575
CITY OF EAGAN PERMIT TYPE: HU 11'. 111 MIS]
3830 Pilot Knob Road Permit Number. 0*07;. Vk
06105192
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: LOT- a e H jyj:x_ , APPLICANT:
'386 NOC[ING HILLS OR ':FVFPSON "ONUS TNC.
hUR DAK HItI.S 2ND (61:) 896--9144
PERMIT SUBTYPE:
f tJtJu
TYPE OF WORK:
tofu
RPHARKSt PKV 9 tM W CONTRAiCYOR ? STAR Pk.80
k
Permit No. Permit Holder Date Telephone ti
S/W
PLUMBING 7 7-
H VAC
ELECTRI
ELECTRIC
Inspection Deft Insp. Comments
Footings I
Foundation
Framing / , lz
Roofing
Rough Plbg.
Rough Htg.
lsul.
?_ ? QZ
QS 1 7'/
Fireplace
Final Htg.
Orsat Test rr
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter CN. _c? Z \ ?, _ _ }
c
+
a?[
d w
EngrJPlan 3
?
`
t
Bldg. Final /- 92
Deck Fig.
Deck Final
Well F
Pr. Dosp.
sy
?f
OY
Address: 3386 RDLLIW HILT .S DRIVE Lot 18 Blk 2 Sec/Sub BUR OAK H,Lg am
These items were/were not complete at the time of the final inspection.
Date: 8/7/92 Yes No
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.
aecnw wrtn
White - City copy Yellow - Resident copy Pink.- Contractor copy
a ?s rd- ?o
J 5700z/8
Re
st D
t d a=° ye 3
que
a
e Fire No.
o/ Rough-in Inspectio
Re a n `_
0 Ready Now W11I Nobly Inspector
.
'` \W
Z Yes 0 No hen Read,?
W
I licensed contractor ? owner hereby request inspection of above electrical work at:
Job Address (Street: Box or511. No.)
33 $4
/
l City
C a
Ca
,
m 'q /I
Section No. Township Name or No. - Range No, County
Occupant (PRINT) Phone No.
r-sc omcS 2 8r'/o- 75/
Power Supplier Address
AISP 3oao axwel? New r-f SSosS
Electrical Contractor (Company Name) Contractors Licari a No.
? Ee i'c GAO /79/
Ma01ng Address (COneador of Owner Making Installation)
Authorized name coauactml0w brig installation) Phone Number _2 ;-9pm7
8 -p 8 3
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REOUEST WILL NOT
Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55180 - UNLESS PROPER INSPECTION FEE IS
Phone (612) 60341680 ENCLOSED. I
g/C}? REQUEST FOR ELECTRICAL INSPECTION
? See instructions for complefinq this form on back of yellow Dopy.
j "I?r9e/ow Work Covered by This Request ? °
J157 .0
New Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building L? Dryer Other (Specify)
` Comm./Industrial Furnace
Farm Air Conditioner
Other (Spedty) Contractor's Remarys//?
Compute Inspection Fee Below: ?garlaC> ?J. Ui
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps * O to 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
Signs Inspector's Use Only: TOTAL '
Irrigation Booms /? • OG SQ
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECT
Other Fee ' COMPLETED WITHIN 18 MONTHS.
I, the Electrical inspector, hereby Rough-in oaten ??a ?/?
I
certify that the above inspection has
been made. Finat Date
OFFICE USE ONLY
This request void IS months from
al7
I
a. I _p?hC? 00
dam' Ci?'
ire No. Rough-in Inspection
Required? x.ady Now 0 Will Notify Inspector
Yes o When Ready?
'Xlicensed contractor ? owner hereby request inspection of above electrical work at:
Jab Address ISVast . 1,,m Route NoJ City
38? t)«
a "t
Section No. Township Name or No. Range No. Cou
AK 0 771-
Occur (PRINT) Phone No.
?? r> I?N _ M'J9 VN h'SZ - 73 YS
Power Supplier Address
Electrical Contractor (Company Namel
4
Z
? Co iractor5 License No.
i C-
)
/-t C 7X,C
.1
Marlin AdtlR55 IConiractor or Owner Making Ina[dllation)
?
/
0 %o yv / o?« «<y RIV 5,5/ z
Aulhoriz ignalure ICOnuactar,Owner Making Installation)
a." Phone Number
953-10'166
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room S-173 /y BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul. MN 55106 UNLESS PROPER INSPECTION FEE IS
Phone (612) 802.0800 I ENCLOSED.
ELECTRICAL INSPECTION E13-00001-D8
nfor ompleting this form on back or yellow mpy.
by ?
0. O
ork Covered by This Request
mr-e- Blow W
New A c! REV. Typeof Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other-(Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify)
Compute Inspection Fee Below.: Contractors Remarks:
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 Inspector's Use Only: TOTAL
c
Irrigation Booms /j-p) /5
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDER ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in Date
certify that the above inspection has
been made. Final Date
OFFICE USE ONLY
This request win 1a months from
S7 yQ j o
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651.681-4675
New Construction Reaulrements
• 3 registered site surveys showing sq. ft. of lot, sq. 11. of house; and all roofed areas
(20% maximum lot coverage allowed)
2 copies of plan showing beam $ window saes; poured found design, etc.)
• i set of Energy Calculations
• 3 copies of Tree Preservation Plan I lot platted after 711/993
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE -:?( - L - Cj a
SITE ADDRESS
TYPE OF
APPLICANT
l 1/s n,'--
re.
United Construction Ine•
RemodellReoair Requirements
• 2 copies of plan
• 1 set of Energy Calculations for heated additions
1 site survey for exterior additions It decks
• Indicate if home served by septic system for additions
VALUATION-1 7 ?L,O0
MULTI-FAMILY BLDG _Y _N
FIREPLACE(S) _ 0 _ 1 _ 2
c?:f a.bl( 0-711
STREET ADDRESS 1 I GJ J.U&U LiJL... CITY STATE ZIP
TELEPHONE # Chanha§sRFP # ?15a- #
PROPERTY OWNER ?Cwrc C' TELEPHONE 0 Coil' / "y- 61*
-----------------------------------------------------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MI " 11
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted • yq 4154 ?or)c h e
• Energy Envelope Calculations Submitted U
AUG 0 7 2002
Plumbing Contractor: Phone # _ --
Plumbing system includes: _ Water Softener _ Lawn Sprinkler By--F9F
Water Heater No. of R.I. Baths
No. of Baths
Mechanical Contractor. _
Mechanical system includes:
Sewer/Water Contractor:
Phone #
Phone #
Fee: $70.00
--------------------------------------------------------------------------------------------------------------------------
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
----------------- _ -_--__- _---- - °- °_'
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
Air Conditioning
Heat Recovery System
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 & Water _ F inal _ 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
/x CITY,QF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
DESCRIPTION:
PERMIT a
PERMIT TYPE
Permit Number:
Date Issued:
3386 ROLLING HILLS OR
LOT: 18 BLOCK: 2
BUR OAK HILLS 2ND
Building Permit Type SF DWG
l Building 'Work Type NEW
UBC Occupancy R-3 M-1
Construction'Type V-N
Zoning -- R-1
Building Length 56_
Building Width 50.
REMARKS: (' D Q a L
PRV S S W CONTRACTOR - STAR PLBG
BUILDING
000728
06/05/92
FEE SUMMARY:
VALUATION
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Subtotal
$650.00
$422.50
$51.50
$700.00
100
$1,824.00
$103,000
MISCELLANEOUS $1,610.50
Total Fee $3,434.50
CONTRACTOR: - Applicant - ST. LI OWNER:
SEVERSON HOMES INC 18904744 000130 SEVERSON HOMES INC
2500 W COUNTY RD 42 2500 W COUNTY ROAD 42
BURNSVILLE MN 55337 BURNSVILLE MN 55337
(612) 890-4744 (612)890-4744
L_
165
I hereby acknow dge that I have read this application and state that the
information is co rect and agree to comply with all applicable State of Mn.
Statutes nd of Eagan Ordinances. Th
APPLI NT/P MI7 A UR E 1 ANYY. IGNAT IRE
Control No. 0575
J
12f
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, I set of
specifications, I copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by
I last working day
s made or lot chan a is re nested once ermit
of month in which request is issued.
a? / T? Valuation of work 7er /Q
Date MW / ? .0'0
/
Site Location: 3?V 2OLL-1"vo N) LIZ C?1IV6
STREET STE #
Tenant Name:
LOT BLOCK SUBD. P.I.D. #
_ M
boo- ON) e- N)aS 2-l?00
Description of work:
The applicant is: ? Owner 14 Contractor ? Other (Describe)
Name R Yqt.? -'GN ?Pho ne
Property LAST FIRST
Owner
Address
STREET STE #
City State Zip
Company a5'069so; j U`JMi-_"s Ti?C Phone 0-?174?
Contractor Address c`ZS?? (?. QouNw 12oro ')a, Svl`G 165 Licens e # 000
City 17U12}JSIJILL? State YN? Zip 5533
Company ?c,- yWs NF3 T`?L Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber 77la2_ PL0'^^18INb Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have re this application and state that th e information is
correct and agree to comply with applicabl a of Minnesota Statu tes and City of
Eagan Ordinances.
Signature of Applicant:
BUILDING PERMIT TYPE
? 01 Foundation
X 02 Single Family
? 03 Two-family
? 04 Multi-fam. T.H.
? 05 Apt. Bldg.
WORK TYPE
OFFICE USE ONLY
? 06 Garage/Accessory
? 07 Fireplace
? 08 Deck
? 09 Basement Finish
? 10 Swim Pool
? 11 Res. Add./Porch
? 12 Comm./Ind. New
? 13 Comm./Ind. Add
? 14 Comm./Ind. Rem
? 15 Public Fac.
? 16 Agricultural
? 17 Building Move
? 18 Demolition
? 20 Miscellaneous
9 90 New ? 93 Remodel ? 96 Move
? 91 Addition ? 94 Repair ? 97 Demolish
? 92 Alterations ? 95 Tenant Finish ? 99 Undefined
GENERAL INFORMATION
Occupancy F ,-Z M -1 Basement sq. ft. MWCC System YEs
Zoning _F;?-_I_ 1st F1. sq. ft. City Water
Const. (Actual) y. ri 2nd Fl. sq. ft. PRV Required
(Allowable) V-N Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. Fire Sprinkler
Length _S_C;7 'On-site well
- Census Code -TT
Depth so, On-site sewage "_. SAC Code o/
APPROVALS
Planning Building a pS Assessments
Engineering _ Variance
REQUIRED INSPECTIONS
? Site
? Wallboard
? Footing
? Final
? Framing
? Draintile
? Insulation
? Fireplace
wcC SAC Fees: valuation: s 103, OOo-
Permit Fee GS0.00 GARAGE; 3Z x z2 = Ivy
sac x Surcharge 5- 17_ K
Io0 x Plan Review 4 Z7, SO
6ieens eMWU-Sat '?OO,oo
?- ---?
ESMT; 6i3ox /G,=lb,99j
City SAC 100,01) Z6, 7,z ?Zs
SAC Units Water Conn. 2J x Z6 _ 5z0
I Water Meter 9 , o0
Road Unit
o o 6 x _ ;2 Lf
c
Treatment Pl. pp,oo 2112 X 15= 19 050
*,u A2rmtr 30,Oo IS"f ?FLOOP?;
.Ac?f,De, 3o.oo
61W a4, „SO j$SM7 r2?2
Other R)4 1 12
?y3? S?
T
t
l 1 S"3= G7,N/?
o
a
:
SGR'cEN{'>o
Rs= s? °?
aox 1 = Zoo *A
/02, 3 Qb
SURVEYOR'S CERTIFICATE SEVERSON HOMES INC,
R L ID L IV -6 HILLS D IR VE
06483)
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A=13°13'22°
77.70
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D-
LOT
DRAINAGE a UTILITY D.. b
5I EASEMENT PER PLAT DEPT
I- EAGAId EST I EE
o I - _1...
1?'j
-1116.93 p=1 3° 13 22
iN,_
IP K _
- 1Vi.1 h?•?LIr,Y I Il1w
NOTE: BUILDING DIMENSIONS SHOWN ARE FOR HORIZONTAL NOTE: NO SPECIFIC SOILS INVESTIGATION HAS BEEN COMPLETED
a VERTICAL LOCATION OF STRUCTURE ONLY. SEE ON THIS LOT BY THE SURVEYOR. THE SUITABILITY OF
ARCHITECTUAL PLANS FOR BUILDING a FOUNDATION SOILS TO SUPPORT THE SPECIFIC HOUSE PROPOSED IS
DIMENSIONS NOT THE RESPONSIBILITY OF THE SURVEYOR.
- DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE: 1 INCH = 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR s 5?r (6 FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR =g 96, g FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK=95,q Z FEET
WE HEREBY CERTIFY TO SEVERSON HOMES INC. THAT THIS IS A TRUE AND CORRECT.
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot. 18 1 Block 21 8UR OAK HILLS 2ND ADDITION,according to the
recorded plat thereof, Dakota County, Minnesota.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS IST DAY OF JUNE 1992.
PROPOSED GRADES SHOWN WERE TAKEN
FROM THE GRADING, DRAINAGE a
EROSION CONTROL PLAN FOR OUR
OAK HILLS 2ND ADD., LAST
DATED 8-4-88
O
M
o . ? C$5/.s)
PROPOSED ?I5
DRIVEWAY
I.
?SS3.S? ITi
GARAGE
24.0 ,? -
m
rn PROPOSED
N / HOUSE
I
20.0 / N 1
i DECK
=?-'--- 26.0
SIGNEO. JJAMF$ R. HILL, INC
B\ C
JOHN C. LARSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 19828
U)
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James R. Hill, inc.
PLANNERS / ENGINEERS / SURVEYORS
2500 W. CTY. RD. 42 0 BURNSVILLE, MN. 55337 9 612-890-6044
EXTERIOR ESVELOPE AVERAGE "U" COMPUTATION
OWNER Sg?VQZZOtiJ 1??w? ?IJG
SITE ADDRESS _ 33Vbts?r.l, ?•`I+ ?? ?2??G r
CONTRACTORDATE (?-1 la PHONE ?O 4`?Wy
Determine working square footage of each.
1. Total exposed wall area'...... z sq. ft. x
2. Total roof/ceiling area ...... sq. ft. x _ "n ti = C
Total exposed wall area above floor = z 1 S Z-
a. Total wall window area..... ....... .. .... J1 7-
oR
b . Total door area .. ...... ... -7
4. Total sliding glass door area .................. F2,914-
?. Total fireplace wall area........
a. Total wall framing area (average 10%)...'......... /
?Z
f. Total net wall area above floor ................. .
_
g. Total rim joist area ............................ . / g a ,oo
Total, exposed foundation area g
h. Total foundation windc,4 area.. ..
i. Toal net foundation area above grade ............
Determine "U"'value of each wall segment.
a . 11 z, t1q X "u" 3 z- = 2G., oco
b. 37'77 X "U"
C., 37-.0,4 'x "u" 7
? S
= ZZ
d. X "u" _
e. 17 g c, 7 X ..U.. L7S = ` _%?
f. l o Z .(d3 X uUu 03 =i,e
9• 11,23,8-oo X ?Uu C) = S
X "ull
=
i. Isib X fu„`m?_=.. llv
.. ......:.Total
Tf item #3 is the same as, or less than item >rl,-you have met the intent
of SSC 6005(c)2.
Total exposed roof/ceiling area
J. Total skylight area............
k;. Total roof/ceiling framing area (average 1uR).. 1`4
w,?a
1. Total net insulated roof/ceiling area.......... 11 ,Irk
Determine "U" value for each roof/ceiling secaient.
X .,U.,
.-•
k. 125, G/o X "U" oS (01?,0
„U„ oZ2i Zti. L? (V
4 ..................................Total L
If total of -t4" is the same as, or less than r2, you have net the intent of
sac 6006(c)).
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the
sua of items 0 and .`.4 shall not be greater than the sum., of itenns 01 and -12.
1. 257 , `{-? + 2.?2,'? _ ???Z rte,
3. Z5 , Z- 4 7,
1993 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
AnD-ON AIr
ADD-ON FURNACE
DATE Lo
FEES
HVAC: 0-100 M BTU $ 24.00
ADDITIONAL 50 M BTU 6.00
GAS OUTLETS (MINIMUM 1 @ $3.00 EACH)
ADD-ON/REMODEL (EXISTING CONSIRUCnON) $ 5.00
STATE SURCHARGE .50
TOTAL ?
SITE
H&-
OWNER
INST
TELEPHONE #: ?Z_?cl ' 78 ?L
12481 Rhode Island Ave. So.
ADDRESS: gage Mel 55378-1177
CITY. 894.0005 STATE: ZIP CODE:
TELEPHONE #:
1993 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681.4675
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 CONTRACT FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF F FEE.
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (IMPROVEMENTS ONLY)
INST
ADDRESS:
CITY: STA
TELEPHONE #:
ZIP CODE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
CITY OF EAGAN
L-/--F lp MECHANICAL PERMIT
SUBD. ?l DD o7 (612) 651-4675
RESIDENTIAL
RECEIPT # C. O (96 ?3
DATE-(.74 q -2-
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, COMPLETE FOR
TOWNHOMES/CONDOS WHEN SEPARATE PERMITS ARE REQUIRED FOR EACH DWELLING UNIT.
OWNER: FEES
SITE ADDRESS:
33 S\v I ADD ON/REMODEL (EXISTING
CONSTRUCTION ONLY) $ 15.00
INSTALLER: HVAC: 0.100 M BTU 24 00
PHONE #: °li3 cD ADDITIONAL 50 M BTU 6.00
ADDRESS: \ W t GAS OUTLETS - MINIMUM I @ $3 EA. 3, c9?
CITY: Sc??] aL ZIP:?`lg SURCHARGE: $ .50
SIGNA TOTAL:
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIALIMUSTRIAL 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:
L
CITY OF EAGAN CITY USE ONLY
?
p / 7 PLUMBING PERMIT
SUBD. (612) 681-4675 RECEIPT
DATE :2 4a 7
RESIDENTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
------------------------
WORK DESCRIPTION ------------------------- ----- ----------------------
COMPLETE THE FOLLOWING: -----
NO. FIXTURES EA. TOTAL
NEW CONST REPAIR/ADD ON 15.00
ADD ON I SHOWER 3.00 75
REPAIR WATER CLOSET 3.00 LP
4 BATH TUB 3.00 3
J 2. 1AVATORY 3.00 ?-
?
OWNER NAME: S? ye-r-5-o 12 /? ?+ ES -7 KITCHEN SINK 3.00
LAUNDRY TRAY 3.00 3
SITE ADDRESS: HOT TUB/SPA 3.00
-
-
-
WATER HEATER 3.00
WATER 7
DRAIN 3.00 3
GAS PIPING OUT.
SG? {?/ Li / ?:IY/ CJrr[.r•,
INSTALLER: (MINIMUM - 1) 3.00
-3 ROUGH OPENINGS 1.50
`!
ADDRESS: 7 roo
r. S. ?. OTHER _
WATER SOFTENER 5.00
CITY: pl rGr Lttk e zip: 4' 3 7 ? - _ PRIVATE DISP. 15.00
3.00
G SPRINKLER
PHONE: y 7- I W. TURNAROUND 15.00
IGNATURE OF PERMITTEE
STATE SURCHARGE .50
TOTAL: S -3 5 .C
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS:
TENANT NAME:
SUITE #:
INSTALLER:
ADDRESS:
CITY:
PHONE
FOR:
CITY OF EAGAN
CONTRACT PRICE:
1% OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE!
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL:
(SIGNATURE)
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117735
Date Issued:10/22/2013
Permit Category:ePermit
Site Address: 3386 Rolling Hills Dr
Lot:18 Block: 2 Addition: Bur Oak Hills 2nd
PID:10-15501-02-180
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 .
Jason Ball
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 -
Kevin A Mckenzie
3386 Rolling Hills Dr
Eagan MN 55121
(651) 253-6750
Action Roofing & Siding Llc
1315 Southview Boulevard
S St Paul MN 55075
(651) 457-2642
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA132612
Date Issued:08/25/2015
Permit Category:ePermit
Site Address: 3386 Rolling Hills Dr
Lot:18 Block: 2 Addition: Bur Oak Hills 2nd
PID:10-15501-02-180
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Fireplace (new)
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Kevin A Mckenzie
3386 Rolling Hills Dr
Eagan MN 55121
Twin City Fireplace & Stone Company
6521 Cecilia Cir
Minneapolis MN 55439
(952) 232-1840
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA132752
Date Issued:09/02/2015
Permit Category:ePermit
Site Address: 3386 Rolling Hills Dr
Lot:18 Block: 2 Addition: Bur Oak Hills 2nd
PID:10-15501-02-180
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Kevin A Mckenzie
3386 Rolling Hills Dr
Eagan MN 55121
(651) 253-6750
Home Energy Center
2415 Annapolis Lane N #170
Plymouth MN 55441
(651) 766-6763
Applicant/Permitee: Signature Issued By: Signature
For Office Use y,C
Permit#:
EAGAN
Permit Fee: ! 7 r`0/0
Date Received:
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff:
buildinqinspectionscityofeaqan.com MAR 0 ( 2018 L
2018 RESIDENTIAL BUILDING PERMIT/ APPLICATION
2
Date: 3-7 I S Site Address: 3 39 14-04,c.1 !7/LL P`GjGid= Unit#:
Name: I ` L U ti'\) Lv I Phone: Z.S 3 ^ 7.S
Resident/
Owner :. Address/City/Zip: 3 3 0 Co' 'AL1 Ne H!i_ S 012
Applicant is: /44M Owner XC Contractor R— I
Type of Work
Description of work: it AS C M L%NT i'✓( '/.S Yf
Construction Cost: 3 i 60 0 Multi-Family Building:(Yes /No )
Company: F LA12-TEN7 (C-`J LL L Contact: -Fa'N3/ ?�'-(gI4/z(7
Address. Li q o City: J (N7- /? JL
ontrar 5
State:f l i°�J Zip: (3 .S J 0 LI Phone: (0 51-Z`17— Email: I ONl Iii L- (A 12-p lz y, co,
/'
License#: )G 6 3 6 Lead Certificate#:
If the project is exempt from lead certification, please explain why:
l� is €1,JEri, r aN 19
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
F n.
NOTE Plans and supporting documents that tharyOdsubmit are considered to be public information.informatioddzportrdna of the informitien mayibi
classified as non-public if you provide specific reasons that wouldPermit the City Citstd'eoncludeViat°they are bade,secrets.
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.citvofeagan.com/subscribe.
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.
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.00pherstateonecall.orq
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
accord ce with the approved plan in the case of work which requires a review and approv I of plans.
x N71 o{v
Applicant's Printed Name Appli is Signature
i 1- 141 /5 t-ID NOT WRITE BELOW THIS LINE ti 7'// ---
SIdB.TYPES
Foundation _ Fireplace —
Porch(3-Season) _ Exterior Alteration(Single Family)
Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
Multi _ Deck — Porch(Screen/Gazebo/Pergola) Miscellaneous
_ 01 of_Plex •�--'Lower Level _ Pool _ Accessory Building
WORK TYPES
New _ Interior Improvement — Siding _ Demolish Building*
Addition — Move Building _ Reroof _ Demolish Interior
7' Alteration _ Fire Repair _ Windows _ Demolish Foundation
C_ Replace — Repair Egress Window _ Water Damage
_ Retaining Wall *Demolition of entire building—give PCA handout to applicant
DESCRIPTION
Valuation , V06.— Occupancy ''2.0-- 1 MCES System
•
Plan Review Code Edition .y4i.4 2.0 fr SAC Units
(25%_ 100%)") Zoning .-t City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction V/ Width
REQUIRED INSPECTIONS •
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
_ Footings(Addition) _ Final/No C.O. Required
Foundation )o HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice&Water Final Pool:_Footings Air/Gas Tests Final
p Framing Drain Tile
Fireplace:_Rough In ____Air Test Final Siding:_Stucco Lath _Stone Lath Brick
20 Insulation Windows
_ Sheathing Retaining Wall:_Footings—Backfill Final
— Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In Final
— Braced Walls Erosion Control
j Other:
eviewed By: /0`1 1�e Y/i , Building Inspector
ESIDENTIAL FEES
Base Fee . 2 0 ›f •/1-
Surcharge
fiSurcharge
Plan Review ZO `" 59
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
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