EA184464 - Building - Single Fam - Issued Date 06/13/2023 PERMIT
City of Eagan ® , Permit Type: Building
3830 Pilot Knob Rd e�m®� ®®® Permit Number: EA184464
Eagan,MN 55122 ®® EAGAN
(651)675-5675 1111111111111 IN 11111111111111111111 M
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www.cityofeagan.com * E R 1 8 4 4 6 4 *
Date Issued: 6/13/2023
Site Address: 4616 Black Wolf Run
Lot: 5 Block: 1 Addition: Dakota Path
PID:10-19540-01-050
Use: * 10 — 19540 - 0 1 - 050
Description:
Sub Type: Single Fam Construction Type: V-B
Work Type: Solar
Description: roof mounted solar
Census Code: 434-Residential Additions,Alterations Occupancy: IRC-1
Zoning: PD
Square Feet: 0
Comments: Improvements to the home may require smoke detectors in all bedrooms.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes(Minnesota State
Building Code).
Fee Summary: BL-Plan Review-Fixed $40.00 0720.4222
BL-Solar/Wind Energy $94.00 0801.4085
Surcharge-Fixed $1.00 9001.2195
Total: $135.00
Contractor: - Applicant - Owner:
Cedar Creek Energy Corporation Derek Lumbard
10361 Jamestown St NE 4616 Black Wolf Run
Blaine MN 55449 Eagan MN 55123
(763)450-9767
This permit shall be null and void if work does not start within 180 days of issuance,or if work is suspended for 180 days or more after
started.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature ssued B : Signature
000e# back, Pm'1ai led lol o ECEIVE
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r �Office Use
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For
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® ® ® ® � , i Building Permit#: 184464
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"'Nob" A mNkmI Permit Fee: l�"J ,
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Date Received: 6/8/23
3830 PILOT KNOB ROAD l EAGAN, MN 55122-1810 I I
(651)675-5675 1 FAX: (651)675-5694 I Date Issued: j
buildinginsoectionsCaD-cityofeaQan.com I____________________
RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 05/10/2023 Site Address: 4616 Black Wolf Run Eagan MN 55123 —Unit#:
Applicant is: ❑ Owner 14 Contractor
Name: Derek Lumbard
Homeowner Address: 4616 Black Wolf Run City: Eagan
State: MN Zi
55123 Phone: 952-807-4130 Email.. derek.lumbard@gmail.com
Description of work: Roof Mounted Solar.
Type of 15 649.68 PD, Dakota Path
Work Construction Cost:
Type of building: 14 Single Family ❑ Townhome, of units ❑ Twin Home
Company: Cedar Creek Energy Contact: Trystian
Building Address: 10361 Jamestown St NE City: Blaine
Contractor, MN 55449 7634325261 . permits@cedarcreekenergy.com
State: Zip: Phone: Email.
License#: BC638279 Ex iration Date: 03/31/2024
fewer& Company: Contact:
Water:
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction
License#: Expiration Date:
I understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
NOTE:Plaits and supporting documents that you submit are considered to be public information. Portions of the
information may be classified as non-public if you provide specific reasons that would permit the City to;conclude that they
are trade secrets.
CALL BEFORE YOU DIG. Contact Gopher State One Call at(651)454-0002 or www.aoi3herstateonecall.ora for protection against underground utility
damage. Contact Gopher State One Call 48 hours before you Intend to dig to receive locates of underground utilities.
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.
XTrystian Alperin X tum
Applicant's Printed Name App ant's Signature
FOR OFFICE USE ONLY
4616 Black Wolf Run Eagan MN 55123 184464
Site Address: Permit#:
SUB TYPES
/Single Family _ Fireplace _ Lower Level
_ 01 of_Plex _ Foundation _ Porch
_ Deck _ Garage _ Pool
WORK TYPES
_ New _ Repair _ Siding _ Retaining Wall
Addition _ Fire Repair _ Reroof _ Move Building
Alteration _ Water Damage _ Windows _ Demolish Building*
Replace Egress Window Solar *Demolition of entire building-give PCA
handout to applicant
DESCRIPTION
Calculated Valuation 1 &,-0 Occupancy T?-C-t MCES System
Plan Review 025%A3100% Code Edition MNpcaa,20 SAC Units
Census Code Zoning P®') City Water
#of Units Stories Booster Pump
#of Buildings Square Feet PRV
Type of Construction V3 Fire Suppression Required
Separate Stormwater Management Permit Required
REQUIRED INSPECTIONS
Footings: New Addition Deck Meter Size:
Foundation: Before Backfill Poured Wall Siding:_Stucco Lath _Stone Lath _Brick
Framing: 1 Hour Residential Alteration Roof:_Ice&Water _Final
Braced Wall Framing/Blocking Erosion Control
Braced Wall Sheathing (prior to house wrap) Pool:_Footings —Air/Gas Tests _Final
Interior Braced Wall Panel(s) Retaining Wall:_Footings_Backfill_Final
Firewalls Fire Suppression:_Rough In_Final
Insulation Windows
Radon Control Other:
Drain Tile
Grading Final/No C.O. Required
/ Final/C.O. Required
Reviewed By: �/V, I -, Building Inspector
FEES Al
Calculated Valuation i Lyq /A/ s-fr.jc+kj4-cL
Base Fee
Plan Review
State Surcharge
Met Council SAC
City SAC
Treatment Plant
Water Supply&Storage
S&W Permit&Surcharge
Meter
Radio Read
Other:
TOTAL $ 0.00