1670 Blackhawk Cove - Zoning Permit & Plans
Use BLUE or BLACK Ink
For Office Use Permit
Clay Of Eajan
Permit Fee:
3830 Pilot Knob Road I
Eagan MN 55122 I Date Received: D _
r
Phone: (651) 675-5675 s a E.
Fax: (651) 675-5694 I Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: I to-) ( 6L~-L~ V+ pt W14- ~Ve- Unit M
Name: Jf'ty 11-,SA P(LVA Phone: sti- 5"g
Resident/
Owner Address/ City /Zip: 11,010 LOy e . &P,&1A A 5 22
Applicant is: Owner )C- Contractor
Type of Work Description of work: ~✓'L✓SOrJfl~C.~-} /p'~17~ (Tl D
Construction Cost: -7 Multi-Family Building: (Yes / No X-)
Company: Ap, cotJ~ C-no Jc- Contact: bOA&L-1 A
Contractor Address: _40 fiJfiST 11'1T"% 41-X F-1_ city: 51A Rt4SNI 1
State: Zip: G533-1 Phone: 3j-!7i' 4` 3 ' -51 _7S
License b6ta5LAQ 9 Lead Certificate tVPt'(- gM -1.
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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 XNo If yes, date and address of master plan:
Licensed Plumber: il/A Phone:
Mechanical Contractor: /p► Phone:
Sewer & Water Contractor: Phone:
NOTE. Plans and supporting documents that you submit are considered to be public informat4on. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
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.gol)herstateonecall.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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State ildi g ode must be completed within 180
days of permit issuance.
X C% F/ L- ~A a41014
Applicant's Printed Name ica Si ure
Page 1 of 3
DO NOT WRITE BELOW THIS LINE
SUB TYPES
Foundation _ Fireplace Porch (3-Season) - Storm Damage
_ Single Family _ Garage _ Porch (4-Season) - Exterior Alteration (Single Family)
_ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) - Exterior Alteration (Multi)
_ 01 of Plex Lower Level Pool Miscellaneous
Accessory Building
WORK TYPES
_ New _ Interior Improvement _ Siding - Demolish Building*
Addition _ Move Building _ Reroof - Demolish Interior
Alteration _ Fire Repair _ Windows - Demolish Foundation
Replace _ Repair _ Egress Window - Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION as
ValuationQ Cc7- Occupancy MCES System
Plan Review Code Edition 2 ao 7 SAC Units
(25%_ 100%Z Zoning City Water
Census Code Stories f Booster Pump
# of Units Square Feet 3.t0 PRV
# of Buildings / Length /G Fire Sprinklers '
Type of Construction :Za- Width 1
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) Jr Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: Ice & Water Final Pool: -Footings -Air/Gas Tests -Final
Framing Siding: ,Stucco Lath Stone Lath Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall: _ Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: IV, , Building Inspector
RESIDENTIAL FEE 3 ap 3 VrjSo,y A' c0~ d/T 9 Adw
Base Fee
Surcharge
Plan Review ~o1d
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
i1095
ADVANCE SURVEYING & ENGINEERING CO.
5300 S. Hwy. No. 101 Mmuebonks, MN 55345 Phone (952) 474 7964 Fax (952) 225 0502 W W W.ADVSUR.COM R E C E-( V F 0
SURVEYFOR: GNR CONSTRUCTION SEP 2 5 2013
SURVEYED: September, 2013 DRAFTED: September 19, 2013
LEGAL DESCRIPTION:
That part of Lots 2 and 3, Block 1, Blackhawk Hills, Dakota County, Minnesota, lying easterly of a line commencing at
the Northeast comer of said Lot 2; *am southwesterly along the northerly line of said Lot 2, 42.02 feet to the beginning
of the line to be described; thence South 25 degrees 04 mimfts 24 seconds East, 291.00 feet more or less to the shore of
Blaclrhawk Lake and there terminating.
SCOPE OF WORK & LIlMATIONS:
1. Showing the length and direction of boundary lines of the above legal description. The scope of our services does not
include determining what you own, which a a legal matter. Please check the legal description with your records or
consult with competent legal mil, if necessary, to make sure that it is correct and that any mattes of record, such as
easements, that you wish shown on the survey, have been shown.
2. Showing the location of existing improvements we deemed important.
3. Setting new monuments or verifying old monuments to mark the comers of the property.
4. While we show proposed improvements to your property, we are not as familiar with your plans as you are nor are we
as familiar with the requirements of governmental agencies as their employees are. We suggest that you review the
survey to confirm that the proposals we show are what you intend and submit the survey to such governmental agencies
that may have jurisdiction over your project and gain their approvals if you can before beginning construction or planning
improvements to the property.
STANDARD SYMBOLS & CONVENTIONS P
NON Denotes 1/2N ID pipe with plastic plug bearing State License Number 9235, set, unless otherwise noted
CERTIFICATION:
I hereby certify that this plan, specification, report or survey was prepared by me or under my direct supervision and that I
am a duly Licensed Professional Engineer and Licensed Land Surveyor under the laws of the state of Minnesota.
/
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Signature: qa ww& X Yw44,n Typed Name: James M Parker Reg. No.: 9235 /
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Date: September 19, 2013
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