EA186739 - Building - Single Fam - Issued Date 09/14/2023 PERMIT
City of Eagan Permit"':
Building
3830 Pilot Knob Rd ,``;,� %,;a°,r Permit Number: EA186739
Eagan, MN 55122 ®- EAGAN
(651)675-5675
www.cityofeagan.com * E A 1 8 6 7 3 9
Date Issued: 9/14/2023
Site Address: 1591 Blackhawk Lake Dr
Lot: 10 Block: 2 Addition: Blackhawk Glen 3rd
PID:10-14352-02-100
Use: * 10 14352 - 02 — 100
Description:
Sub Type: Single Fam Construction Type: V-B
Work Type: Alteration
Description: new shower and wall surround
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-Base Fee $83.50 0801.4085
Valuation: 2,000.00 BL-Plan Review 65% $54.28 0720.4222
Surcharge-Based on Valuation $1.00 9001.2195
Total: $138.78
Contractor: - Applicant - Owner:
Minnesota Rusco Michael D&Lisa M Sackmaster
5010 Hwy 169N 1591 Blackhawk Lake Dr
Brooklyn Park MN 55428 Eagan MN 55122-124
(952)935-9669
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 Issued By: Signature
--------------I
For Office Use
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® ® I Building Permit#: 186739 I
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% 0 �d I S&W Permit#:
EAG
Permit Fee: 1� V
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Date Received: 9/11/2023
3830 PILOT KNOB ROAD I EAGAN, N 55122-1810
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(651)675-5675 1 FAX: (651)675-5694 I Date Issued:
buildinginspections@cityofeagan.comi---------------------.,
RESIDENTIAL BUILDING PERMIT APPLICATION
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Date: 9/11/23 site Address: 1591 Blackhawk Lake Dr unit#:
Applicant is: ❑ Owner 14 Contractor
Name:
Lisa Sackmaster
Homeowner Address: 1591 Blackhawk Lake Dr city: Eagan
55122 - - mlamsack@msn.com
State: MN Zi Phone: 651 329 872E Email: mla Sa msn.com
Cl I
Demo existing.Install new shower system ehd ,It surround.Minnesota Rusco to i..Nat,,install vapor barri,r,lap,and seal.Install smoke and C .alarms to code.Plumbing penult to be pulled separately.
t Description of work:
Type of Construction Cost: 9679'00 PD, Blackhawk Glen
Work
Type of building: 0 Single Family ElTownhome, of units El Twin Home
MN Rusco Kelliu..�Gugisberg,.....�. m..�
t ,I Company: Contact:
5010 Hwy 169 N New Hope
Building I Address: City: p
Contractor MN 55428 952-935-966 kelli@minnesotarusco.com
State: Zip: Phone: Email.
CR805613 3/31/25
s License#: Expiration Date
Sewer& 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':Plans and supporting documents that you submit are considered to be public information. Portions of the 3
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.gopherstateonecall.org 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.
X Kelli Gugisberg X Ad,��• �u 6
Applicant's Printed Name Applicant's ggnure
----------------
For Office Use 1
1
Permit#: { �� + �
EAGAN
1 Permit Fee:
I (J� I
1 Date Received: ` I
I I
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I
(651)675-5675 1 FAX: (651)675-5694 Staff:
buildinginspections(a ccityofeagan.com ----------------- '
_RESIDENTIAL PLUMBING PERMIT APPLICATION
Date:�9/11/23 Site Address: 1591 Blackhawk Lake Dr unit#:�
Applicant is: ❑ Owner 14 Contractor
i Name: Lisa Sackmaster
i
Homeowner Address: City: g 1591 Blackhawk Lake Dr Eagan
;
I
State
MZig: Phone:55122 651-329-872E Email mlamsack@msn.com
(
New V/ Replacement _Repair _Rebuild _Modify Space Work in R.O.W.
Type of Work —
I Direct replacement of existing shower wet space, wall surround, and plumbing fixtures.
; Description of work:
Tankless Water Heater
Lawn Irrigation (_RPZ/_PVB)
Standard Water Heater
Description V Add Plumbing Fixtures Or/—Main/_Lower Level)
p k, Water Softener
Septic System Description: shower, sinks
(
Connection to City Water from Well
New _Abandonment _
Company: MN Rusco Kelll Guglsberg
Contact:
Plumbing Address: 5010 Hwy 169 N city New Hope
Contractor MN55428 952-935-966 kelli@minnesotarusco.com
State: Zip.. Phone: Email.
I PC805612 12/31/23
License#: Expiration Date:
RESIDENTIAL FEES
$150.00 New Residential or Connection to City Water(includes State Surcharge)
$65.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$65.00 Lawn Irrigation (includes State Surcharge)
$65.00 New fixtures, adding, altering, or removing piping (includes State Surcharge)
$65.00 Septic System Abandonment (includes State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Contact Gopher State One Call at(651)454-0002 or www.gopherstateonecall org 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.
X Kelli Gugisberg x Aa-&
Applicant's Printed Name Applicant's %naiure 61
FOR OFFICE USE .
Reviewed By: Date:
Meter Size (if applicable):
Required Inspections: Under Ground Rough-In Air Test Gas Test Manometer Final