1575 Blackhawk Hills Rd
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA080030
Eagan, MN 55122 . Date Issued: 09/26/2007
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 1575 Blackhawk Hills Rd
Lot: 29 Block: 1 Addition: Blackhawk Glen
PID 10-14350-290-01
Use
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not
acceptable in lieu of inspections.
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Sela Roofing Remodeling Cathy Bialas
4100 Excelsior Blvd 1575 Blackhawk Hills Rd
St. Louis Park MN 55416 Eagan MN 55122
(612) 823-8046
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
CITY OIF EAGAN PermhNo: 9072 Date 9-16-87
3830 PIM 1111110
Road Meter Size `r
P.O.009411" Reader Na Date: YL-a A- F2
Eagan, MN 55121 . ,
Owner. Venture Builders
Site Address: 1575 Blackhawk Hills Road L29 Bl Blackhawk Glen
Plumber American S & W/ tern Mech
Conn. Chg: 525.00pd A RI
Acct Dep: 1 .00 pd doCq9Qf -
Permit Fee
Surcharge: - lr0Wo vly with the, City of Eagan
Tr. Plant 180. I 1 es.
Meter. 67
Misc.: By 1
WATER SERVICE PERMIT
This request void
1R months from
E 420
Reques QaIe Fire No. Rough-in Inspection
~I Re~q~uid? Ready Now ❑ Will Notifv Inspec-
~(J ? `L(' Yes ❑No for When Ready
censed Electrical Contractor I hereby request inspection of above
❑ Owner electrical work installed at:
Street Address, Box Route No. /%~►v ~ city,
Section No. Township Name or No. Range No. Coin y
Oc uG t (PRINT) . Phone n.
7 AO-11 70
Power S plier Add s `4
au" e",0.10 I A
Electr al Contractor (Company a e) Contractor's License No.
Mailing Address (Cant ~a}ctor r Owner Making Installation) -6 S 4""-da . X ,
Authorize ignatur ( ntrac Owner ing stallation) Phone Number
e13 "
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD
1821 University Ave.. St. Paul. MN 66104 UNLESS PROPER INSPECTION FEE IS
Ph.,.. rR19r Raj-nRnn ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION w EB-0000/1-06
11, See instructions for completing this form on back of yellow copy...)
E ? 4-- "X" Below Work Covered by This Request
Now Arid Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heating
Commercial Bldg. urnace Silo Unloader
Industrial Bldg. w`o Air Conditioner Bulk Milk Tank
Farm Other Specs y Other lSpecifyl
t Fl-'-'r Specify Other Other
ompute Inspection Fee Below
If Fee Service Entrance Size It Fee Feeders/Subfeeders # Fee Circuits
0 to 200 Amps 0 to 30 Amps 0 to 30 Amps
Above 200 Arttps• 31 to 100 Amps 31 to 100 Amps
Swimming Pool Above 100Amps Above 100_Amps
Transtormers Irrigation Booms Partial. Other Fee
Siign_s -Special Inspection $A660 TOTA E
Remarks~j /oP' 7igr-x,
Rough- in 1" the EI
a V Inspector" hereby
if dk certify that the above
Final O'j►~~„ inspection has been
/ made.
This request void
18 months from
D 144x2
Fire No. Rough-in InsPECUen II Notify InsPec-
d?eady Now
fire
Requestat~ %L Req When Ready
e
P LicE ctrical ontractor I hereby request inspection of above
caner electrical work installed at:
C
Stre t AddTr`/es, Box or Fite ►4ot~~~~~~ l~C~t~
Section No. Township ~Name ~C•o/r No. Range No. Coun
Phone
Occupdn RINT) No.
Pow SUpP ier Address
Contr or 's License No.
Electri al C/ or.4ComPaq • r / I111- / A ~ amel C (j
Mail g Acjslres`(Contract r or OwnejdQa
Phpc~y Iu pber 0
Authori d S ature ! ntractor Owner Making Installation)
THIS INSPECTION REQUEST WILL NOT
MINNESOTA STATE BOARD OF ELECTRICITY BE ACCEPTED BY THE STATE BOARD
Griggs-Midway Bldg. - Room N-191 UNLESS PROPER INSPECTION FEE IS
1821 Universitv Ave.. St. Paul, MN 55104 ENCLOSED.
Phone (612) 642-0800
REQUEST FOR ELECTRICAL INSPECTION EB-00001-06
1 See instructions for completing this form on back of yellow copy.
"X" Below Work Covered by This Request
D 1,444-2
Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric: Heating
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm thr peci v 01her (Sper.ify)
Other (Specify) Other Other
Compute Inspection Fee Below
p Fee Service Entrance Size h Fee Feeders/Subfeeders # Fee Circuits
0to200Amps J 0to30Am s 0to30Amps
Above 200 Amp S c" 31 to 100 Amps 31 to 100 Amps
Swimming Pool Above 100 Amps Above 100_Amps
Transtormers Irrigation Booms Partial Other Fee
Signs Spec lal_Irisection
Remarks $ ~ TOTAL
ell If 1
Rough-in 4l I, the Ele
nsoector, hereby
r certify that the above
Final rte inspection has been
made.
'l
This request void 18 months from -
erdifiratr of Mr,ru MY l
~itp of A agan
. ~p~t~l'triil~ ~ ~ll~~ltt~ .~tS}tplftlnt i ~ ;
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building;
Code certifying that al the time of issuance.this structure was in compliance with the various
ordinances of the City.regulating building construction or use. For the following.•
14879
use cooo a7k~'a`GAk ;.Bldg. It No.
OOMP-Y Type 1 zoo* District p
bEA)G
Owoa of INDIdmg.. BACU Address
1571 .
DaJt ~3, 398$
POST IN A CONSPICUOUS PLACE '
er#tf iral AINrru rcr
Citp .af `agars
ui1~trig nsprrrfina
~rvar#mmi Of
This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building
Code certifying that at the time of issuance this structure was incompliance with the various
ordinances of the City regulating. building construction or, use. For the following.
Use Classification SW DWMAR. Bldg. Perrin! No. 14001
O p..y Type R3 Zoning District TypcCbnst. V
Owner of Budding C~ M' . BiAf, 1••4' Address.)7 t9- W A%;► fir, 101
Bt;dit Addiess 1575 M. Sl FIX 9AWK t"d~X
l ~
M@diog Offtcidli
POST IN A CONSPICUOUS PLACE.',
CITY OF EAGANI Permit No. 9072 Date:-`
3830 Pild! Kfto6 Road Meter No: Size_:
P.O. Box 21199. Reader No.
Date
Eagan, MN 55121
Owner. '~mtxese.$fldera
s: -I BI8 kbav [ is Road L29 BL..XIaeMsx*
Site Addres t r`,
Plumber. .Americsm- 8 4 it dw,"t*= Mince. _
Conn. Chg: 4, 521Zoning:
'Acct. Dep: No. of Units: Z
104 CIO
Permit Fee:
Surcharge: I agree to comply with the ChyotEagan
Tr. Plant ' Ordinances.
Meter. 67.00
Misc.: By
WATER SERVICE PERMIT
CITY OF EAGANj- SEWER SERVICE PERMIT
3830 PII&Xnoo Road 10222
P.O. Box21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: Veaters Bldre. No. of Units:
Owner.
Address:
Site Addiess: 1575.Blackhawk Hills Road L29 Bl Blaekhawk G1ea
r- 'r
an S & V/Midwestern Mech.,
Plumber 3
187 76440 10Q'0 d,.
I agree to comply with the City of Eagan Connection Charge: 52 S - ft pa
Ordinances. Account Deposit: 1 %a'f14.pa
Permit Fee: 1 00Dd
Surcharge: - npd _
By Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
BLDG.' PERMIT NO.11100 /
01-3210 Bldg. Permit 7 Jf
01-3422 Plan Check 7 7
01-3445 Surch./Adm.-
01-3446 SAC/Adm.
01-2155 Surcharge Y-6
17-3860 Road Unit d
20-2275 k SAC / 76
20-3865 Water Conn. 0
~
20-3868 Water Trmt. e c G cc
20-3716 Water Meter r'
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit G~1
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTALS (G' %
CASH RECEIPT
CITY OF EAGA}N
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
w DATE ~7 19
Pti9ccivilco
FROM
AMOUNT v, f I rI
& _DOLLARS
+eo
CASH CHECK
;/fr' , ..;r
FOR
FUND CODE AMOUNT
Thank You ti
BY
76~40
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
N~/~.fd` v r ~ ;~Ej 9
K Cdr.-1 "T
DOLLARS
0 CASH ❑ CHECK ~
WON he ;c.~
FUND CODE AMOUNT - }
c) C
wj c_x)
Thank You
BY
W? 773`4 White-Psyen Copy
Yellow-Porting CwY
Pink-File Copy
CITY OF EAGAN 14001
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 85121
PHONE: 454-8100
BUILDING PERMIT Receipt 0 /1
To be used for 5 F DW(;/GAR Est. Value $920 , Date AUGUST ' 118 ~ 7
Site Address 1 5 V.-LAC K .AWKI I.11 LLS ED OFFICE USE ONLY
Rj
Lot Block Sec/Sub blrW.i`iiAiJPC GI.Et~ 1 On Site Sewage Occupancy
MWCC System Zoning
Parcel No QnSi{gWell °.pf
Citi[1VYta~s,`._ tActtu~q-
a: Name t;,a':. 1A~AS (d►i7owabtei
Address i L1 .y 2::J~ S Lof. itortes
o City I . • . t►. Phone 454-Depth 15
S.F. Total
c Name 1 Lil . cS Footprint S.F.
81 Address LAM AVE APPROVALS FEES
City Phone L 7-t,7(31 Assessments Permit % • 5
Water/Sewer . Surcharge Wit)
W Name Police Plan Review
rcW E Fire SAC, City I • vlJ .
~a Address Engr. SAC, MWCC
~c
W City Phone Planner WaterGonn. v
Council Water Meter b 7. uo
:.r
I hereby acknowledge that I have read this application and state Bldg. Off. Road Unit
thatthe information is correct and agree to complywith all applicable APC Treatment P1 v . Jti
State of Minnesota Statutes and City of Eagan C rdinancgs Variance Parka
I Copies -2 5
Signature of Permittee , - ~'--w .e6,-4~P r TOTAL ~
A Building Permit Is issued to. VLC" il. "f' S~'ILDr,£t i on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
• Permit No. Permit Holder Ditto TeFephoms e
Plumbing $
HN.A.C. 9
Electric
Softener
Inspection Dots Insp. Comments
Footings l f7'lf7
Footings it
Foundation '
Framing
Roofing
Rough Plbg. *17
Rough Htg.
Isul.
Fireplace
Final Htg. -,A-4f~t7 a:- .
Final Plbg. lax
Bldg. Final
Cert Occ. ER
Temp. LP
Deck Fig.
Deck Frmg.
Well
Pr. Disp.
7-91 _ 7~F ~1r*TFi' r ?
rr 3
s PERM
ME PERMIT RECEIPT 7
Cmr K,
3890 PICOT KNOB ROAD, EAGAN, MN 35121 DATE
CONTRACT PRICE: PHONE: 100
she
57 'BLDG. TYPE WORK
Lot A-! Sec/Su
' Z2u - Res. New
m Name rtlt . , # n M , : h r MulL Add-on
Address -,?1,) 3 p/., .it i eL) A r Z7 - . t
Comm Repair
CRY Phone 280 1 120
. j' Other
Name V t N rV U FEES
c Address d RES. HVAC 0-100 M OTU - $NLtIO
City p ' Phone -ADDITIONAL 50 M 61iJ E' 10. i
ADD-ON AIR COND. 0-24 BTt$ ; Is=
ADDITIONAL 6 M BTU - SAO
TYPE OF WORK / GAS OUTLETS 1.84 EA.
Forced Air ✓ M BTU COMMAND FEE - 1% OF CONTRA FEE
Boiler M BTU ; ',MINIMUM - RESIbENTIAL FEE:.; 10.00
Unit Heater M BTU MINIMUM - COMMAND FEE ~i
Air Cond. M BTU STATE SURCHARGE PER .60
Vent._ CFM (ADD $.50 S/C IF PERINR VR , ,
BEYOND $1,000.00)
Gels Piping Outlets # ZkD
Other _
FEE:
S/C: 5f7 I; SIG E OF PERMPITq
TOTAL• i
FOFt CITY OF EAG!AN
PERMIT # S Y ;
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55182 DATE.-
CONTRACT PRICE: PHONE: 454-8100
Site Address . r r f f BLDG. TYPE WORK DESCRIPTION
Lot T Block r! ,/Sec/Sub ,des. x New x _
Mult. Add-on
m Name 'Lt i Comm. Repair
m Address ? K Other
c City Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
flo. FIXTURES TOTA
Name -Water Closet - $3.00
Bath Tubs - $3.00
c Address
3 _%`x-Lavatory - $3.00
O City Phone J-Shower - $3.00
Kitchen Sink - $3.00
FEES Urinal/Bidet - $3.00
COMM/IND FEE -1% OF CONTRACT FEE =Laundry Tray - $3.00 ~Z7
APT. BLDGS - COMM RATE APPLIES I Floor Drains - $1.50 1 _5
TOWNHOUSE & CONDO - RES. RATE APPLIES Water Heater - $1.50
MINIMUM - RESIDENTIAL FEE -$12.00 Whirlpool -$3.00
MINIMUM - COMM/IND FEE -$20.00 -!_Gas Piping Outlets - $1.50 f•-
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - i PER PERMIT)
(ADD $.50. S/C PERMIT PRICE GOES Softener - $5.00
BEYOND $1,960.00) Y ,_Well - $10.00
Private Disp. - $10.00
t
Rough Openings - $1.50
r. M FEE:
SIGNATURE OF PERMITT E 'f `
STATE SlC: 5U
FOR: CITY OF EAGAN GRAND TOTAL:
\µJ
'~jt;{1~~;i~:jlT#~1~r~t:*~'a~'tts!►et'r*~►~3j~~r ~sr'sr~ _
Z
CITY OF EAGAN F~
3830 Pilot Knob Road, P.O. Box 21-1999 Eagan, MN 95121
PHONE: 454.8100
$UILDENG PERMIT Receipt #
Tobeusedfor ; Est. Value $U8 0(A) Date ARIL 21
,19 1)d
Site Address i y i ~SLAGli A y,." 1 LV RD OFFICE USE ONLY
On Site Sewage Occupancy P-3 K- I
Lot 1` Block Sec/Sub.Nl:fiCl:;~➢AWK t:LE.,+ IS'i'
MWCC System X Zoning R--1
Parcel No. On Site Well (Actual) Const
SAG: ti ltli I.1 ` *'i; iq* f:x City Water (Allowable)
W Name
W Address V-16.4 `'AL'AI` 1 PRV Required # of Stories
3' r. j n x r2- `r 5.54 Booster Pump Length 5'
C City r„ . Phone 4)
Depth 50
p Name S.F.Total
0 ` Address Footprint S.F.
City Phone APPROVALS FEES
Engr./Assess. Permit
m Name
Address Planner Surcharge
Council Plan Review •
<z city Phone
Bldg. Off. SAC, City •
1 hereby acknowledge that I have read this application and state that the Variance SAC, MWCC
~ . s"
information is correct and agree to comply with all applicable State of Water Conn.
Minnesota Statutes and City of Eagan Ordinances. Water Meter f' '
Signature of Permittee Road Unit s'
A Building Permit is issued to: Treatment Pt
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. Parks
TOTAL s
Building Official
Pernalt No. Permit Holder Deft Telephone e
Plumbing
h
H.V.Af.C.
419
Electric
Softener
Inspection Date Insp. Comments
Footings I
Footings II
Foundation
Framing z7 t,i_ A, -v ~Jp
Roofing
Rough Pibg.
Rough Htg.
lsul. l i C
Fireplace ,Ds. D-3. Final Htg. -44"
Final Plbg.
Bldg. Final 3 % 4d
Cert Occ.
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
vr;.. +
PER
MECHANICAL PERMIT
rt • CITY OF EAGAN REC3=1PI # ' Zr
8830 PILOT KNOB ROAD, EAGAN, MN 561122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Address BLDG. TYP WORK .4 N
Lot Bloc c/Sub Res. New
Name Mutt Add-on
Address - Comm. Repair
Other
c City Phone. 22- 11620
FEES
Name RES. HVAC 0-100 M BTU --`$24.00
Address 1 156 far :~7L-a~j ADDITIONAL 50 M BTU r - •6.00
- -3' - (RES. HVAC INCLUDES A/C ON NEW
GAS OUTLETS (MIN . UM - I PER PERMIT) ~ i:50 EA
TYPE OF WORK COMMAND FEE - 1% OF CONTRACTfEE
Forced Air 1 BTU a APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
Boiler M BTU MINIMUM RESIDENTIAL FEE r ALL ADD-ON &
Unit Heater M BTU REMODELS - 1200
Air Cond. GIC M BTU MINIMUM COMMERCIAL FEE 20.00
STATE SURCHARGE PER PERMIT .3Q
Vent (3) 60 CFM la (AD $.50 SIC I PERMIT PRICE
Gas Piping Outlets # _ BEY NO $1,
Other
FEE:'
S/C: ' SIGAIATURE OF PERMITTEE
TOTAL:
f M
FOR: CITY OF-EAGAN
PERMIT # 167 9
PLUMBING PERMIT RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: '
CONTRACT PRICE: PHONE: 454-8100 / `1 S
Site Address 1571 Black Hawk Road BLDG TY PE f WORK DESORIPTION
Lot B) S c/Sub Res. V New
Mult. Add-on
m -.Name Thompson Plumbing Comm. Repair
Address 12201 Mtka Blvd Other
c City Mtka Phone _ 933-2521 RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
N FIXTURES OTA
C-V Name Bach Builders Water Closet - $3.00 - _ r 4Bath Tubs - $3.00
AddressA S 1 O River H t e Way Lavatory - $3.00 r c'~
O City Inver Gr Ht Phone 45 7 9 .?44 Shower - $3.00 •O
Kitchen Sink - $3.00 (1Q
FEES Urinal/Bidet - $3.00
GOMM/IND FEE -1% OF CONTRACT FEE I Laundry Tray - $3.00
APT. BLDGS - COMM RATE APPLIES _/-Floor Drains - $1.50 ..~d
TOWNHOUSE & CONDO - RES. RATE APPLIES ---4-Water Heater - $1.50
MINIMUM - RESIDENTIAL FEE -$12.00 Whirlpool - $3.00
MINIMUM - COMM/IND FEE -$20-00 _-,15--Gas Piping Outlets - $1.50
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT)
(ADD $.50 S/C IF PERMIT PRICE GOES -L Softener - $5.00 4Y?
BEYOND $1,000.00) Well - $10.00 -
Private Disp. - $10.00
Rough Openings - $1.50
SIGNATURE OF PERMITTEE FEE:`
STATE S/C: g~
FOR: CITY OF EAGAN GRAND TOTAU
CITY OF EAGAN Remarks O V -01 A`?( q
Addition_ ila4khawk r-lan ,Is,- Lot 9 Bik Parcel 10-14350-240-01
Owner Street- 1575 Blackhawk Hills Roa(itate Eagao NN 55.123 -
Improvement Date Amount Annual Years Payment Receipt Date
STREET SUR F. 1076 253.48 50.70 9
STREET RESTOR.
GRADING
SAN SEW TRUNK 1970 6.7o 25 Pei j)xJAr 1-n eji3x4r,400
SEWER LATERAL B n1074 1986 112.09 22-49 5
Sewer Lateral 1 1972 0 106.12 20
WATERMAIN Bn 1075 1986 92.80 18.56 5
WATER LATERAL
WATER AREA 1072 1986 3o9.4o 61.98
Storm Sew Trk 1073 1986 110.91 22.19
STORM SEW TRK 732 1983 32.57
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
CITY OF EAGAN NI-D 14001
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PH ON E: 454-8100 Receipt # I Z a 40
To be used for SF DWG/GAR Est. Value $92,000 Date AUGUST 3 19 87
Site Address 1575 BLACKHAWK HILLS RD OFFICE USE ONLY
Lot 29 Block 1 Sec/Sub. BLACKHAWK GLEN 1 MSite
Systems X zoning Occupancy R3
R1
Parcel No. On Site Well _ Type of Const
City Water X (Actual)
w Name CATHERINE BIALAS (Allowable)
W # of Stories
Z Address 1712 W 82ND ST Length -
o City I. G. H. Phone 454-4998 Depth 35
S.F. Total
e Name VENTURE BUILDERS FootprintS.F.
Z U Address 1215 HIGHLAND AVE APPROVALS FEES
P City S . ST. PAUL Phone 457-6761 Assessments Permit 475.50
Water/Sewer Surcharge 00
Fm Name Police Plan Review 237.75
v z Address Fire SAC, City 100.00
Engr. SAC, MWCC 52.5. 00
=Z City Phone Planner Water Conn. 925- n0
Council Water Meter 67, 0
1 hereby acknowledge that I have read this application and state Bldg. Off. Road Unit 305 - 00
that the information is correct and agree to comply with all applicable APC Treatment P1 1 go- n0
State of Minnesota Statute*." City of Eagainanc Variance Parks
Signatur Copies
eof Permittee TOTAL $2,4+6T.75
A Building Permit is issued to: VENTURE BUILDERS on the express condition that
all work shall be done in accordance with all applicable S f Minnes ,Stpdu a and City of Eagan Ordinances
Building Official
1987 BUILDING PERMIT APPLICATION - CITY OF KAGAN
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR /HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
'a
To Be Used For: Single Family Res, Valuation: -,1s@B;$B Date: July 17 1987
Site Address1575 Blackhawk Hills Road OFFICE USE ONLY
Lot 29 Block 1 On Site Sewage Occupancy - 3 - -
MWCC System i/ Zoning R - 1
Parcel /Sub BLACKH 4-1K GLEN 1st Addition On Site Well Type of Const
City Water (Actual)
Owner Catherine Bialas (Allowable)
# of Stories a
Address1712 West 82nd Street Length
- - Depth .7S
City/Zip CodelnverGrove Hts „ Mn, 55075 S.F. Total
Footprint S.F.
Phone APPROVALS FEES
Contractor VENTURE BUILDER Assessments Permit S_ s=
Att: Jim Schober Water/Sewer Surcharge 444 -
Addresgp1 F Highland Avanije Police Plan Review r,2_37, -
Fire SAC, City I v), ~G
City/Zip CodeSO, St. Paul, Mn, 55075 Engr SAC, MWCC X~;a C;'°
Planner Water Conn Ara Y c
Phone 457-6261, Council Water Meter 4,7. °G
Bldg Off Road Unit 3,05.
Arch./Engr. Louis L, Bramstedt APC Treatment P1
15057 Forest Blvd. North Variance Parks
Address c,ot ~G) Copies
TOTAL
City/Zip Code Hugo, Mn, 55038
Phone # 426-.4921
-SURVEYOR'S. CERTIFICATE SIENNA CORPORATION .
DENOTES PROPOSED SURFACE DRAINAGE
Q DENOTES IRON MONUMENT SET SCALE: I INCH = 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 8 11, ~,,FEET
XOOO.O DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR =f.u 3 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = p , FEET
WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 29, Block I, BLACKHAWK GLEN 1S7 ADDITION, according to the recorded plat
thereof, Dakota County, Minnesota.
IT DOES NOT PURPORT TO SHOD IMPROVEMENTS OR ENCROACHMENTS, IF ANY. AS SURVEYED BY
ME OR UNDER MY DIRECT SUPERVISION THIS i37H DAY OF 1lcl~f_ 1985•
SIGNED: JAMES ILL, INC.
BY:
HAROLD C. PETERSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 12294
SHEET E OF 2 SHEETS
PROJECT NO. BOOK / PAGE JAMES R. HILL, INC.
8518
Planners / Engineers / Surveyors
FILE NO, 8200 Humboldt Avenue South
FOLDER Bloomington, Mn. 65431 812-884-3029
SURVEYOR'S CERTIFICATE
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PROJECT NO. BOOK / PAGE JAMES R. HILL, INC.
z-z '1> Planners / Engineers / Surveyors
FILE NO.
8200 Humboldt Avenue South
FOLDER Blootnington, Mn. 55431 012-884-3029
RESIDENTIAL
MINNESOTA STATE BUILDING CODE DIVISION
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER L°o Uia /r
SITE ADDRESS
r--~
CONTRACTOR i:'~'n~u;y f J ,1; lnrYf- - 1;rn 6~T DATE PHO14E
Determine working square footage of each.
1. Total exposed wall area .7 yg;-L- sq. ft. x .11 = .2 73.0 2-
=i
2. Total roof/ceiling area /1 sq. ft. x .026
n
G..- byn l'a. lr s9 a Yt er o~ ~ $
Total exposed wall area above floor = ;a ?,sr
qa. Total wall window area
b. Total door area. . . . . . . . . . . . . . . . . . 3s
c. Total sliding glass door area.,4.7pjy,. . . . . . . . ao
d. Total fireplace wall area. . . . . . . . . . .7f,
e. Total wall framing area (average 10%). . . . . . . . . a ~g
f. Total net wall area above floor. . . . . . . . . . . . 93
g. Total rim joist area. . . . . . . . . . . . . . . . . ~Y9S
Total exposed foundation area = .,~o V -
h. Total foundation window area . . . . . . . . . . . 7
i. Total net foundation area above grade. . . . . . . . . 197
Determint "U" value of each wall segment.
a. 026 9 X "U" 50 = I o y ,Sd
Star ~ ,Pr, J~ ► J933' ? ~
b. .2ra X "U" .199.E = 3y8
C. X "U" ~Sp = 10,03
e. .7~SS X flull ►oni _ ~a.38
f. 1y9~ X loull 0y~~ _ ~y,aS
Y
9• ~yg X fluit , DYay = ld oZ
h. X. „U„ , So = 3,
i. 127 X U 1.5-,c/
.Total ~7:" 1y/
If item #3 is the samd as, or less than item #1, you have met the intent of
SBC 6006(c)2.
Total exposed roof/ceiling area = 1)19
Total skylight area. . . . . . . i
k. Total roof/ceiling framing area (Average 10n). . 1/ A- ai
l:' Total net insulated roof/ceiling area. . . . . .
Determint "U" value for each roof/ceiling segment.
J/ 2. is 085-
k. y
C X D f .o 73
1 • / X „0., , 631 - 5,89
4 . . . . . . . . . . . . . . . .Total - 3d, o JY
1f total of item #4 is the same as, or less than item #2, you have met the intent of
SCB 6005(c)1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the sum
of items x3 and 14 shall not be greater than the sum of items #1 and #2. ~
+ 2. 3h+- 3 jig
3. + 4. 30, 10
A ,
ENERGY CALC WORKSHEET
BUIIrDING MATERIALS Insul. Wall Frame'-Mill Ring Joists
Internal Air (_68) ~G r Le L7
" Sheet rock (.5£)
" Fiberglass (R = 3.17/in)
" Fir (R = 1.25/in) f, ~Y--
25 32 Insul. Sheathing (R = 2.06) ~ , 0
Siding
Type: (R= /in) q
External Air R = _ 7
R- ;3_;F o R- 11 R= .2 L ~ 7,3
C-- ,0y39 L-- p8`i~! U-- 16goq
Blocks
Internal Air (.68)
_
°5R I j
12" Block (1.28) J-P
" Styrofoam (5.5/in) u= 0 76,2-
External Air (Block only =.17) 2
A" of f; Lrglass (11.0) 1 f ,
Insul Ceiling Frame Ceiling
Interior Air (.61) _ , d1 - _ _
5/8" Sheet rock (.56) _ ,fG S
" Fiberglass
" Fir (R = 1.3/in)
G I
External Air (.61)
R-- 70 R 3s,)3
U= x193 U=
AREAS:
Total Exposed Wall Area:
Rim Joists Perimeter:
Block Perimeter:
Doors: Type of Doors R -
Sliding Glass Doors Type of Slidinc Ucors R =
Windows Type of Windows R =
Fireplace Wall Area
Wall Framing Area (10%)
Net Wall area above floor
Ceiling
Flat
Slanted
Skylights Type of Skylight R =
6'oy 5 lay /S`► frl
19 x.2 4
1~ X l y
Ay 1,V tr ~ kl-n
I 9 g9
3 ~!G
Y X J r rJ .Si X
,SG , SL
St~Ff ~ 18e~ a, P. 7v
1 _?,b6 = j0732-
03
. •M~'•k*~tit*#irdt~r*ir•r*icitit~rdr*~***itdr~rinktt#k*k#
mmm: ~ M 17M OF UMM
CITY OF EAGAN ~
*
APPROVAL OF PERMIT.
*
APPLICATION FOR PERMIT
• INSPECTION OF SEWER AND/OR WMM
I V =ONS WIIZ NOT BE SCHED--
SEWER AND/OR WATER CONNECTION cLED UNTIL PST HAS WEN
~
APPROVED.
LIM
* *
• P ease rant
' 1) PROPERTY ADDRESS:
LEGAL DESCRIPTION: "
(Lot/Block/Subdivision or Tax Parcel ID )
IF EXISTING STRUCTURE, DATE OF ORIGINAL .BUILDING PERMIT ISSUANCE:
PRESENT ZONING/PROPOSED USE: (Month/Year)
Q COMMERCIAL/RETAIL/OFFICE/R-1 SINGLE FAMILY
Q INDUSTRIAL Q R-? DUPLEX (Two Units)
Q INSTITUTIONAL/GOVEWZ= Q R-3 TOWNHOUSE (Three + Units) ( Units)
Q R-4 APARTMENT/CONDOMINIUM ( Units)
2) 101011(035M
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
3) NAME' For City Use
~aL'e-<- rz&l Plumbers License:
ADDRESS: Active
- Expired
i CITY, STATE, ZIP: Not recorded
PHONE: •,Z~/ZQ MASTER LICENSE#
Staff Initial
4) 07-ima3z
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
ru(CONNECTION TO CITY SEWER CONNECTION TO CITY WATER Q OTHER '
6) • r FYPLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE
MAIL APPROVED PERMIT TO 1, 2, 3, 4, ABOVE
(Circle one)
~ • " • • • 1' a• ' • a I~ It ;H • 91 • pl • D• • • •
• ► a• h / M. • ~y~1 1 1 1 • ~1• •
..FOR :CITY USE ONLY
PERMIT # ISSUED
Pd w/Bldg. Permit FEES:
$ $ /~-5 Z SEWER PERMIT (INCLUDE SURCHARGE)
$ WATER PERMIT (INCLUDE SURCHARGE)
$ WATER METER/COPPERHORN/OUTSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
$ ACCOUNT DEPOSIT - SEWER
$ $ jz C-- ACCOUNT DEPOSIT - WATER
$ 7 S G' $ WAC
$ lam, Z. S (r.. U $ SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ WATER TREATMENT PLANT SURCHARGE
$ f $ OTHER:
$ TOTAL
7739-/
RECEIPT RECEIPT
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC
ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
Q
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: 7~-~
TITLE:
DATE:
CITIZEN'S REQUEST FORM
EAGAN ENGINEERING DEPARTMENT
DATE : c.~ _12 i l I
NAME:
ADDRESS: [S
PHONE :
NATURE OF REQUEST:-M_ J44-A, V, •Pp 4QQ42
i
TAKEN BY: Lu..'
REFERRED TO: L l W-0, ACTION TAKEN:
BY:
DATE:
CTZREQFM.F9
LONG TERM II.
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA107994
Date Issued:11/08/2012
Permit Category:ePermit
Site Address: 1575 Blackhawk Hills Rd
Lot:29 Block: 1 Addition: Blackhawk Glen
PID:10-14350-01-290
Use:
Description:
Sub Type:e - Furnace
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to Mark Anderson , State Electrical Inspector,
952-445-2840
Andrea Preusse
4145 Sibley Memorial Hwy
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Cathy Bialas
1575 Blackhawk Hills Rd
Eagan MN 55122
Wenzel Heating & Air Conditioning
4145 Sibley Memorial Hwy
Eagan MN 55122
(651) 894-9898
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117832
Date Issued:10/23/2013
Permit Category:ePermit
Site Address: 1575 Blackhawk Hills Rd
Lot:29 Block: 1 Addition: Blackhawk Glen
PID:10-14350-01-290
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 .
Matt Kral
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 -
Cathy Bialas
1575 Blackhawk Hills Rd
Eagan MN 55122
(651) 456-9119
Midwest Exteriors Plus Inc
6451 Sycamore Ct N
Maple Grove MN 55369
(763) 427-9696
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA120760
Date Issued:02/28/2014
Permit Category:ePermit
Site Address: 1575 Blackhawk Hills Rd
Lot:29 Block: 1 Addition: Blackhawk Glen
PID:10-14350-01-290
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
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 -
Cathy Bialas
1575 Blackhawk Hills Rd
Eagan MN 55122
(651) 456-9199
Midwest Exteriors Plus Inc
6451 Sycamore Ct N
Maple Grove MN 55369
(763) 427-9696
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA127406
Date Issued:10/01/2014
Permit Category:ePermit
Site Address: 1575 Blackhawk Hills Rd
Lot:29 Block: 1 Addition: Blackhawk Glen
PID:10-14350-01-290
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Andrea Preusse
4145 Sibley Memorial Hwy
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Cathy Bialas
1575 Blackhawk Hills Rd
Eagan MN 55122
(651) 456-9119
Wenzel Heating & Air Conditioning
4145 Sibley Memorial Hwy
Eagan MN 55122
(651) 894-9898
Applicant/Permitee: Signature Issued By: Signature