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3222 Black Oak DrAddress 3222 Black oak Dr Zip 5512 1 Lot I 1 $lk 1 Sub o r c n a r d f1 e i g h t_.y_ THESE ITEMS WERE J WERE N4T CQMPLETB AT THE TIME OF THE FINAL INSPECTION. Date: Yes No Inspeetor: Final grade (G" from siding) Permanent steps (garage) Fermanent steps (main eatry) Permanent driveway Permanent gas Sod/Seeded grass ' ?{p ? j ? ?J?• ?? ?a #??j? TraiVcurb damage Porch Basemcnt finish Deck ioa&t- I S ?. Piease verify with the builder the removal of roof €est caps from the plumhing system and the shut-off of water supply to the outside lawn €aucet before freeze potential exists. C.ontact engineering division at 681-4645 befoee wor3cing in right-of-way or insEalling underground sgrinkler system. ? Whete - City Copy Yeliow - Resident Capy Pink - Contractor Copy RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 New Construction Reauirements • 3 registered sfte surveys showirg sq. 8. of lot, sq. ft. of house; and all roofed a(eas (20% maximum lot coverage allowed) • 2 copies o( plan showing beam & window s¢es; poured found design, etc.) • 1 set of Energy Calculations . 3 copies of Tree PreservaGon Plan ii lot platted after 7l1193 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) RemodellReoair Reauirements ?1_ (? }- . 2 copies of plan `??? . 1 set of Energy CalculaGons for heated addNions .?'>' . 1 site survey for exterior additions & decks . Indicate i( home served by septic system for additions DATE 'Y/10/0 VALUATION JOB SITE ADDRESS ?e?o?o? ?[?rc?? ?o? ?!?'?•?..? !?"-??c%?J -v?? ? o? L IF MULTI-FAMILY BUILDING. HOW MANY UNITS? PROPERTY TYPE OF WORK gg&CAed C1tClC L?fI? S&riR'S FIREPLACE(S) _ 0_ 1_ 2 APPLIGANT ??ILa M ?l?rti PHONE#69-3415IdQ3 -.? ADDRESS oZ &Otk gu.tJ ZIP CODE v-f?Io2 ? PAGER # R/'Ifj CELL PHONE # ,411A FAX # NIEV RESIDENTIAL BUILDING ONLY - FILL OUT COII Energy Code Category _ MINNESOTA RULES 7670 CATEGOR (check one) - Residential Ventilation Category 1 Worksheet - Energy Envelope Calculations Submitted Plumbing Contractor: Plumbing System Includes: Mechanical Contractor: _ Mechanical System Includes: Sewer/Water Contractor. _ MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Phone #: Water Softener Lawn Sprinkler Watcr Heater No. of R.I. Baths No. of Baths ? Phone # Air Conditioning Heat Recovery Systein Phone # 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, d agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinan Signature of Appllcant Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 2002 IT ? , r Y O 12002 Fee: $90.00 Fee: $70.OU OFFICE USE ONLY , - . , ? 01 Foundation O 07 05-plex ? 13 16-plex 0 20 Pool ? 30 Accessory Bidg 0 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi 0 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) 0 33 Ext. Alt - SF ? 04 02-plex O 10 08-plex K18 Deck ? 23 Porch (screened) ? 36 Multi O 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 Aiteration ? 37 Demolish (Bldg)" 0 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation -10 OX20 Occupancy 4d, 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 W idth REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. ;,C Footings (deck) ? FinaUNo C.O. . 7 _ Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other - Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing _ Siding Stucco Stone _ Fireplace _ R.I. _ Air Test _ Final Windows (new/replacement) _ Insulation _ _ Retaining Wall Approved By JE -Z, , Building Inspector Base FPe Surcharge f '?? Plan Review ? ?? ?"'?' ??r , MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total ? C(ER TIFICtA TE OF SUR VEY G ON YEA HOMES Bohlen Surveying & Engineering ' 31462 FoFoge Avenue 4819 123rd Street W. Northfiek. MN 55057 Savage. AN 55378 Prwm (so?> aas-nss B E Phonw(6t2) 885-9212 F? (so7) sas-ns9 F= (612) 895-9259 ? r ? °°?.,.^ ? •• = 30' 3w 51.or Es Zr,i TKC S AREA _..:_...;'-..:; :;:•?r'7'.;T.y.-:,-nj?.--,- ? ' fXCEED 3:1 A RET?trt'L?C. A s PER Ttke GRK0 7.9G. P iA K. i1 E-a? w O Z Ua lil U ? J 0 ? Z x? Z 6y-'h??'/ 11 ? - - AINAGE AND U?1l.ITY ? EASEMENT t c?.&TOP PIEm; R7 (I +/- ns s9exo Me S 89°56' 35" W 130.00 LOT AREA = 13187 SQ FT !"?,ac??=Efl AREta = 2009 ?.F PROPEtrr oESCFdPnoN LOT 11, BLOCK 1, ORCFIARD FEIGHTS ADDITION. C1T'f OF EAGAN. DAKOTA COUNTY, AiINNESOTA. AODRESS 3222 BLACK OAK COURT 1 q ;10 k ?3.tT/? ? `.. f?f? ? Q ? co LLI ? N m 0 0 0 0 a S 89°4 i' 26" W 25.00 PROPOSED GARAGE FLOOR ELEV =899.2 PROPOSED TOP OF BLOCK ELEV.=900.2 PROPOSao ensEMENr FLooR ELEv.=ss 1Z 0 DENOTES SERVICE LOCATION - DENOTES PROPOSED DRAINAGE OOOXO pENOTES PROPOSED ELEVATION OOOXO DENOTES E)(ISTING ELEVATI4M ? DENOrES w000 HuB O OENOTES 1RON PIPE MONUMENT I HEREBY CERTIFY THAT THIS SURVEY WAS PREPARED BY ME OR UNDER MY DIRECT SUPERVISION AND THAT I AM A DULY REGISITERED LAND SURVEYOR UNDER THE LAWS OF THE STATE F MlNNESaTA. . DATE• 12-13-00 ? .r .. Z, - t: f_? REV15ED: 12-28-00 LEROY . BOHLEN, LAND SURVEYOR MINNESOTA LICENSE NO. 10795? ?? 3SU7 he N 89°5?2?55,• E - 1 r------L--- - 10 I 893:7 ? ? m ' _---+?-------- ------- ? I p 24.50 g ? p x . ? M c 12.00 n ? . $ ? . . ? . ?. ? } P _ U') I I V I I ? 1 , ? ? .. i I , ?. . , CQ DRNEWAY GARAGE ; 30 m 9.50 Ul) mPROPOSED HOUSE ? ? i ? ? RWO 0 10? 33 Z = 884A 8"x+ ' EXtsr!tuc w'aT? 04 a9W G47-1-Odflio PERMIT # RECEIPT DATE: WISIDUTIAL PLUbI$IN6? PERM1T APPLICATION crrYo? ?GAN s$so PaoT KxoB ftn EA6A1V, MN 55122 651-6$1-4675 Please complete for: ? single family dwellings D townhomes and condos when permits are required for each unit ? backflow preventer for irrigation system SITEADDRESS: ,!?21 ? v??, & L OWNER NAME: : TELEPHONE #: ? • ' (AREA CODE) INSTALLER NAME: belt- TELEP ONE #: STREET ADDRESS: 0Z/, ? ?LL GL/.C . -?/ d? , (AREA CODE) CITY: )9?"& AIA?7_4? STATE: ZIP: Place a?check mark next to the uermit work rine New residential dwelling unif under construction and not owner/occupied $ 90.00 Add-on, modification or alteration to existin dwelling unit, including: $ 50.00 • abandonment of septic system • new installationlrepair/rebuild of RPZ • lawn irrigation system • water turnaround Nature of work: _ Septic Svstem, new/refurbished - . $ 225.00. • includes County & Consulting Inspector fees • requires MPC license State Surcharge $ .50 Total $? Reminder: Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc. i ble City of Eagan ordinances. I hereby acknowledge that I have read this application, state that the information is correc d agree to comply with all ap' It is the applicant's responsibility to notify the property owner that the City of Eagan su es no liability for any dama caused by the City during its normal operational and maintenance activities to the facilities constructed under this rm' within City pro "ght- -way/easement. SIGNATURE OF RMI EE Updated 1/01 CITY USE ONLY PERMIT #: RECEIPT DATE: REsiDEIrrtAL MECHAvIcAL PEftMi°c APPUcATIaN C1TY O? ?CiAN 3$30 PILOT KNO$ RD EA6AN MN 55122 651-e$1-4675 Please cornplete for: ? single family dweilings townhomes and condos when permits are required for each unit Date: n'ot .1I1 / 0 I 4. SITE ADDRESS: Ja aa 814PA aaK1111j`R ( ( l OWNER NAME: ?0hGL. W f'1'125; TELEPHONE#: (a 1a, 3-77- d lq I taREa caoEy INSTALLER NAME: _Wohlers Southside Htg. & AIC, Inc. . 6350 West 146th Street, Suite ldfi STREET ADORESS: Apple Valley, MN 55124 CITY: STATE: Dlm- m e-lins4 ?sv4 M6Y* t'A tlfn narenit wnYk fvBA ZlP: X New residential dwelling unit under constructionand not owner/occupied $ 70.00 Add-on, modification or alteration to existin dwelling unit $ 50.00 • furnace replacement • air exchanger • air conditioner • other iVature of work: State Surchar e $ •50 Total Reminder: Call for inspections. ?? )? - 1.(1 S[GNATURE OF FERMI"FTEE TELEPHQNE 17 5 a k13 1- 70,941 (AREA CODE) Updated 1101 LOT: BL CK: H `.-l SUBD./P.I.D #: •?? o-o 11 Q r ch at d f/?? hfr ? ? ?BUILDIHG PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651 ' 9 6-4675 ... ? New Construction Reauirements ? 3 registered slte surveys showing sq. ff. of lot, sq. ff. of house and all roofed areas (20% maximum lot covera4e allowed) ;- 2 copies of plans (show beam & window sizes; poured fnd. design; etc.) ? 1 set of energy calculations ? 3 copies of tree preservation plan if lot platfed after 7/1/93 ? Rim Jo1st Detafl Opti s selectlon sheet (buildinqs wRh 3 or less units) ? Name: La First - i , DATE: I Z I CONSTRUCTION COST: 2 oe L/ DESCRIPTION OF WORK: J, If muffl-family bldg., how many units? STREET ADDRESS: <LJ ? G PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER Street City le Remodel/Repair Reauirements 2 copies of plan 1 set of energy cclculotions for heated additions t site survey for exterlor addiHons & decks Phone #: l?L- -37 ?v v/ l ? ?6 ??- State: _ Zip: Company: Phone #: J?? '4)4W-'v (area code) Street Address: License # 4? City State:/giv Zip: Ls Company: s?/`? O (f 463e.L??' q Name: ?0 Telephone #: (? ) ?Ds r 8 7 Registration #: SNeet Address: City State: 14 Zip: ? Sewerlwater licensed olumber (if installing sewedwater)? ?XCaYa 4?hQ jhV - Phone #: ?` 8 , I hereby acknowledge that I have read this application, stchWthat the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. r Signature of Applicant: OFFICE USE ONLY ? v LS Certificates of Survey Received Yes No ?EC 1????? Tree Preservation Plan Received Yes No Not Required t f gy? 1-?m OFFICE USE ONLY O 01 Foundation ? 07 05-piex O 13 16-plex ? 20 Pool [3 30 AccessoryBidg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi O 03 01 of _ plex ? 09 07-plex ? 17 Garage 0 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-piex O 12 12-plex Plbg_Y or _ N ? 25 Misceilaneous y 31 New ? 35 Int Improvement 0 42 Demolish (Foundation) ? 45 Fire Repair ? 32 Addition O 36 Move Bidg. ? 43 Reroof ? 46 Windows/Doors ? 33 Alteration ? 37 Demolish (Bldg)* ? 44 Siding ? 34 Replacement O 38 Demolish (Interior) * Demolition (Entire Bldg only) permit - Give PCA handout to applicant VALUATION Occupancy MC/ES System Census Code ? Zoning City Water SAC Units Stories _ 2- Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs / Length Fire Sprinklered Type of Const 5- -Z,) Width oZ -> INSPECTIONS REQUIRED ? Footings: New Bldg ? Insulation _ Windows - new/replacement _ Footings: Deck FinaUC.O. _ Siding Footings: Addirion ? FinaUNo C.O. Stucco/Stone ?b Foundation Fireplace: _ r.i. _ air test _ final Roof: _ ice & water _ final ?j Framing Pool: _ ftgs _ air/gas tests _ fmal APPROVALS Planning Building Engineering Variance - --- - ---- - --- - --- - ----- - - --- --- - --------- - -- Base Fee Surcharge Plan Review MC/ES SAC ciry sAc Water Supply & Storage S&W Permit & Surcharge Treatment Plant Park Dedication Trails Dedication l.icense Search Copies Other . Total: ??a ? ?-sy = 760 x r6 r-L ` CIER TIFICIA TE OF OUR VEY G ON YEA HOMES 0 Bohlen Surveying & Engineering 31462 Foliage Averwe 4819 123rd Strett W. Piorthfield, I,NV 55057 Savage, AN 55378 Phone: [$07) 645-776$ B E Phane: (612) 895-9212 FaaG ($07) 645-7799 Fau: (B12) 895-9259 s ? ?'• '?'? ` ? i; I" m 30' ? . ?. .?.:,.? ? ..?._?..._.._-_.y. ,?-. ...._. ? 71c 54mfts Io THT'S A+REA ExcEfEa 3: i A RETA,rH=v&C- ._, _ . .. ..w . . : ?.? r . _. _., ? A -s Pirtk -rvttt Qfip%z T. pic, P tA r*,, a"xo ?,R? ?, N 89°5?2?55" E 155.02 swx, - `? itswx i? o 10 ?____-M? e? ???------- ----- m--- ? 10 i 4.0 0.0 1 aas.? Ni 2aso t? .'. ?c ?cv °0 i tC ui 0?0 ORlVEWAY ? $ $ GARAGE ? m ? i w 30 00 ? m 0 ? 1 m $ 3`i CV ?PROPOSED S ? HOUSE m o m Rwo ? x 10 Z ?884.0 4 ?? 1 Q i AINfAGE AND EIT'iL1TY ? ? ? o ? -..a?•?- EASEi4tENT z n EXISTI WATE 1QO s9sx' O ?? a od as?5 ? c°vT4P P = 16E??898x4 ?? he S89°56' 35" VV 130.??0 S 89°4 7' 26 "? W 25.00 LOT AREA = 13187 SQ FT PROPERTY DESCRPTiQIV LOT 11, BLOCK #, f7RCHARD hEIGF9TS A00[710N, CRY OF EAGA3V, DAK4TA COUNTY. LOMSOTA. ADpRESS 3222 BI.RqC OAK COURT PROPUSED GARAGE FLQOF2 ELEV. 899.2 PRQF'OSED TQP OF BLQCtC ELEV =900.2 PRQPOSED BASEMENT FLOOR ELEV.=$91.2 0 DENOTES SERVICE LOCATIONE -al- t}ENQ7ES AR4POSED E?RAINAGE OOaXD DENOTES PROPOSED ELEVA710N {3aDX0 DENQTES EXISTIIVG ELEVATIUN ? pEIVOTES W04D N118 O DENOTES ERON PlPE MCNVUMENT i HEREBY CERTiFY THAT TMIS SURVEY WAS PREPARED BY ME OR UNDER MY DIREC7 SUPERVlSION AND THAT 1 AM A aULY REGISITERED LAND SURVEYOR UNDER THE LAWS OF THE STATE F MINNESOTA. DATE• 12-13-00 REVIsEp: 12-28-00 LEROY . BQHLEN. LAND SURVEYOR M4NNESOTA LICENSE N0. 10795 c47-1-00flaP bi ? W ? ?,u (z C? a ? ? ? ?3'" ? ? ? a ? a ? ? .? Ca/ c1 ? ? ? ? 13 Va ? M40 ? ? ? ?? ? 13 ? 0 LOT SURVEY CHEC!{LISI' FOR RESIDENTIAL. BUiLD1NG PERMITAPPLICATION PROPERTY LEGAL: f e?Uwk-:6 ^ DATE 4F SURVEY: IATEST REVISION: DOCUMENY STANDARDS . . . , . L' CI D • Vo a • 03" a a • ca/? o • ?a ? ? Registered Land Surveyor 5ignature and company Building Permit Appiicant Legal description Address Nortlh aaow and scale House iype (rambler, walkout, split wlo, aplit entry, lookout, eta) Directional drainage arrows with slnpelgradient % Proposed/existing sewer and water sen+ices & invett elevation Street name Driveway Lot Square Faotage Lat Coverage ELEVATIOAIS E)dstinq Sewer service (ar Praposed) Praperty corners Top of curb atthe driveway Etewaftons of any existing adjacent homes Adequate foating depth of structures due #o adjacent utility trenches PfQflOS? Garage floor First floor Lowest exposed elevaifon (walkautMrindaw) Property comers Front and resr of home at tlie taundation PC?NDING AREA (if annficabiel o 0/o • EasemeM line a ra? ? • MWL o r? ? • HWL ? M/ o • Pond # designadon ? V/ ? • Emergancy Overflow Efevation 0'?, a ? a ?? 5Y/ a r? a ?a DIMENSIQNS o • Lut qneslBeartngs & dimensicns ? • Right-ot way and street width (to back of curb) a • Propased home dimensions induding arry praposed decks, ovefiangs greater than 2', porches, etc. (i.e. all structures requiring permanerrtfoatings) ? •' Show all easements of record and any Ciry utilifies within those easements ? • Sethacks of proposed stucture and sitleyard seiback of adjacent existing structures a • Retainina wall reauirement&. it anY Reviewed: Maroh 1998 CRA1Gf8LD'.aPfil4tT. FM PERMIT City of Eagan Permit Type:Building Permit Number:EA151500 Date Issued:08/28/2018 Permit Category:ePermit Site Address: 3222 Black Oak Dr Lot:11 Block: 1 Addition: Orchard Heights PID:10-54500-01-110 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: 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 - William J Larson 3222 Black Oak Dr Eagan MN 55121 (651) 365-1293 Shelter Construction Llc 7040 Lakeland Ave N Brooklyn Park MN 55428 (612) 849-8082 Applicant/Permitee: Signature Issued By: Signature