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1579 Blackhawk Hills Rd PERMIT City of Eagan Permit Type: Plumbing 3830 Pilot Knob Rd Permit Number: EA092178 Eagan, MN 55122 . Date Issued: 11/30/2009 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 1579 Blackhawk Hills Rd Lot: 28 Block: 1 Addition: Blackhawk Glen PID 10-14350-280-01 Use Description: Sub Type: e - Water Heater Work Type: New Description: Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Mike Skaja 2090 County Road 42 W. Burnsville, MN 55337 Fee Summary: PL - Permit Fee (WS &/or WH) $50.00 0801.4087 Surcharge-Fixed $0.50 9001.2195 Total: $50.50 Contractor: - Applicant - Owner: Tony's Appliance Eric B Olson 2090 County Road 42 West 1579 Blackhawk Hills Rd Burnsville MN 55337 Eagan MN 55122--121 (952) 435-2442 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 ~~8385 C s3s7 /4~ o 0-9 , &A4t; '~L / Request Date Fire No. Rough-in Inspection Q J) G~ Required? ❑ Ready No. ill Notity Inspector ( ( s ❑ No When Ready? I C licensed contractor downer hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) city /S"? c ' I t t Zoos No. Township Name or No. Range No. County 14 Occupant (PRINT) Phone No. /-I M Z` fV Power Su ier Address Electrical Contractor (Company Name) Contractorls License No. Mailing Address (Contractor o ne aking Installation) ~ S'? r PAuthorized i tur Contr r/Owner I lion) Phone Number is ?s~~ MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room 5.173 BE ACCEPTED BY THE STATE BOARD 1621 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642.0600 ENCLOSED. 7 5 REQUEST FOR ELECTRICAL INSPECTION E13-00001-,008 10- 1 See instructions for completing this form an back of yellow copy. 01 e IS~v 3 8 3 8 5 "X" Below Work Covered by This Request` New-Add Rep' Type of Building Appliances Wired Equipment Wired ~Q Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Contractor's Remarks: Compute Inspection Fee Below: rt, I S I., a S L° ~M~ # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps 100 Amps Signs Inspector's Use Only: Q~b TOTAL Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN IS HS. I, the Electrical Inspector, hereby Rough-in certify that the above inspection has Final Date " been made. Z/ r OFFICE USE ONLY i This request void 18 months from el i 11226/_ Request Date ire No. Rough-in Inspection Requ'red? V Ready Now r] Will Notify Inspector < / /rte / as ❑ No When Ready? I Incensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) r / City Section No. Township Name or No. Range No. County n Occupant (PRINT) Phone No. Power Supplier G v Address 'Al Electrical Colam-rrtr r (Company Name)_ ntractorls License No. -57- S 7 c D g;- 7 q `f Mailing Address (Contractor or Owner Making /I~ tallation Authorized Signature ( or /Owner Making Ins anon) Phone Number 7~ 7 d r6~~ MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Mickvay Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-800 ENCLOSED. I /J REQUEST FOR ELECTRICAL INSPECTION -C~ / I ~ See instructions for completing this form on back of yellow copy. 2 2& X" Below Work Covered by This Request e dd Rep. TypeofBuilding Appliances Wired EquipmentWirea Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm /Industrial Furnace Farm Air Conditioner Other (specify) Contractor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only: TOTAL Irrigation Booms G Special Inspection ~G Alarm/Communication Other Fee '012 1-7"1-, VQJ I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final Date been made. ~FICE USE ONLY L ; request void 18 months from SEWER & WATER PERMIT OFFICE USE ONLY CITY OF EAGAN < PERMIT DATE 4/13/89 3830 Pilot Knob Rd. WATER PERMIT A 10353 SEWER PERMIT # P.O. Box 21199 Eagan, MN 55121 .DETER # B.P. RECEIPT # r 1484 B.P. RECEIPT DATE$q METER SIZE ISSUE DATE _ .RY'defER PlJ10 SITE RESS ( ; R) PERMFf RMQUESM,' LOT LOCK EC/SUB a _ TAPS; SEWER '(WATER APPLICANT: ADDRESS: _ COMMAND .,Z. RESIDENTIAL CITY, STATE D E tti t /?7/' ZIP PHONE: ? & NEW EXISTNNI3 PLUMBER: 4117 ADDRESS: 1 AGREE TO comp1.Y:WITH CRY OF CITY, STATE ZIP SSa6 S' EAGAN ORDMlANCES=: PHONE: 't~3- J l5~ y OWNER: Gfls,s T., c ; "A ADDRESS: G ?ems /4 " 5 1r✓G5 SIGNATURE.UIMH" Ilt~pit~ ISSUED `l CITY, STATE nX raou~ M ZIPS PHONE: `f 3-~ ' lr`l ~►~S PLEASEALLOW TWO WORKING DAYS FOR PROCESSING.; FOR STORM SEWER PERMITS, CWACT IEERIING DEPT. _ BLDG. PERMIT NO. lNA GV 61 O`.IK I ~ U c.V`V1 C,-,4L 1:~Lti 01-3210 Bldg. Permit O -73 01-3422 Plan Check OO C 01-3445 Surch./Adm. 01-3446 SAC/Adm. 5 v~ 01-2155 Surcharge -:TA 0 75-3860 Road Unit b0 20-2275 SAC ct f 20-3865 Water Conn. - ' CD 20-3868 Water Trmt. J Q 20-3716 Water Meter t r c c~c~ rT 20-2252 Acct. Dep. 10, ? 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. 28-3855 Park Ded. TOTAL ' J _ J s DOLLARS r ,ee IX 0 CASH 'LL f - 'E U c c l~ 7C 1 fCT MOUNT C r ht: L BY t 1488 (9rdittratt of Orrupaur y w~ f, ttp of eagatt lar arwtmt 1f Tuning JWntion Y This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure xis in compliance with the various ordinances of the City regulating building construction or use. For the following.- Use Cimficauon %T nm~t',~R _ BWg. Peermit No. 16281 Occupancy Type Emu Zoning 'Dis= RI Type Coast. Vu Owner of Budding SFEA! OMMRLMt+T n 6743 168TH ST. V., RUSMM B>vain nda 1579 EAMM HMU RWD,,ityL28, B1, NAXRW GLEN 1ST u ' ° Date: JUM 12, 1989 J POST IN A CONSPICUOUS PLACE SEWER & WATER PERMIT OFFICE USE ONLY CITY OF EAGAN PERMIT DATE 4/13/89 3830 Pilot Knob Rd. WATER PERMIT # 10353 SEWER PERMIT # P.O. Box 21199 METER # B.P. RECEIPT # G 14AS Eagan, MN 55121 READER # B.P. RECEIPT DATE ,LS19 METER SIZE v ISSUE DATE -P RV - BOOSTER PUMP R~. SITE A 04`11 PciC t~ Ac1 w I~ r 9~~ I PERMIT REQUESTED ~Dt~RESS LOT BLOCK SEC/SUB ' 1r'A° SEWER WATER - TAPS APPLICANT: ADDRESS: COMM/IND RESIDENTIAL CITY, STATE ZIP : -~i PHONE: J+ ' ' X NEW EXISTING PLUMBER: & e'9'. fy-- ADDRESS: I C17 ;1,-rt IZI ° i AGREE TO COMPLY WITH CITY OF CITY, STATE Zip 55r>6 Y EAG1Af~Ni)ORDINANCES: PHONE: V OWNER: ADDRESS: SIGNATURE WHEN METER ISSUED CITY, STATE ZIP ~:aL'G dr PHONE: 1f3 PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. DATE: 4/13/89 • RE: 1579 Blackhawk Hills Rd, L28, 51, Blackhawk el)en 1st. XX Your Sewer & Water Permit for the above property has been completed. It will be held at the Pu Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON. Four-Sewer & Water Permit for the above property cannot be completed for the following reaponet ~ e Your Sewer & Water Permit for the above property has been completed, but the meter cannot be issued or occupancy allowed until further notice. COMMERCIAL PROJES ONLY: Please pay for meter at City Hall. Meter size must be confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance. WARNING: BEFORE DIGGIAG, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC. REQUIRED BY LAW. ;CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. i „ Secretary, Building Inspections Dept. DATE: 4/13/89 RE:' 1579 Blackhawk Rills Rd, L28, B1, Blackhawk Glen 1st $X Your Sewer & Water Permit for the above property has been completed. It will be held at the is Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO ~L PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON. Your Sewer & Water Permit for the above property cannot be completed for the following reasons: Your Sewer & Water Permit for the above property has been completed, but the meter cannot be issued or occupancy allowed until further notice. COMMERCIAL PROJECTS ONLY: Please pay,for meter at City Hall. Meter size must be confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance; r WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC. - REQUIRED BY LAW. CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. - CITY OF EAGAN .w 16281 - 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for SP I?WC/CAS. Est. Value 104+000 Date 4/ 10/89 19 Site Address 1579 Blackhawk Hills izoad Lot `t Block 1 Sec/Sub. j aL'khawk Olen OF'FICe MSE ONLY Parcel No. .,itst Addition Occupancy FEES Zoning 5654.00 (11gn~g QQ. Inc. (ActuagConst Bldg. Permit 654.00 AC100 t Weal (Allowable) -V-N Surcharge 52.00 City Y+t082mauRt Phone 432-1878 # of Stories - 327.00 Length _-Wig Plan Review i00000 z~ Name S.Aw AS QWE✓c4t Depth SAC, City 0, V a Address S. F. Total SAC, MCWCC 575000 ~ city Phone S.F. Footprints - Water Conn W.00 On Site Sewage Lu' W Name On Site Well Water Meter 90.0!'1 s? Address MWCC System x 00 Acct. Deposit 3b.00 aW City Phone City Water _ PRV Required y S/W Permit 20000 I hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge j.0 information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Treatment PI 221111-00 Signature of Permitee t APPROVALS Road Unit 141.t~U A Building Permit is issued to: Spar Const, uct: ion, Inc Planner Park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies .30 Building Official i Variance TOTAL 447. Permit No. Permit Holder Date Telephone # WATER SEWER PLUMBING e vle H.V.A.C. ELECTRIC f t~ul S9 Inspection Date Insp. Comments Footings I / Foundation Framing s Roofing Rough Pibg. Rough Htg. 8 Isul. Fireplace $ /c CD dv d/es 71., CIO-se Final Htg. ' Final Plbg. Const. Meter P1bg. Inspector - Notify Plumber Engr./Plan Bldg. Final it/if Deck Ftg. Deck Final Well Pr. Disp. •ren µn--r-♦ wrryr:.-„s...»~:-~:~".'.r-..m~-.'.. v' .ao+-: a^.'^~' c ~ y m;:r+va4~~ ~^w~cr/r - , x-. PIT PLUMBING PERMIT CITY Of EAGAN IECEIPT-# 3630 PILOT KNOB ROAD, EAGAN, MN 55122 MATE 'r CONTRACT PRICE: PHONE: 4544100 bite Address" BLDG. TYpE/ WORIt. Ilff ' Lot Block Sec/Sub Res. NeW: s-f Mult. Add-on 'fr L Name - Comm. Repair Oilier" l4 Address am W&I 4e S City Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING: N~. FIXTURES OTAL Name Water Closet - $3.00 .00 m Bath Tubs - $3.00 1.00 C Addr Az z - S-! r 4- - Lavatory - $3.00 •op ;Cx p City r+~hone y.3~'r~78 -1 _Shower - $3.00 4Kitchen Sunk - - -$3A0 - fES UrinAIT8idef - $3.00 t COMM/IND FEE - 1% OF CONTRACT FEE _J-Laundry Tray - $3.00 -OO APT. BLDGS - COMM RATE APPLIES - I Floor Drains - $1.50 ~o TOWNHOUSE & CONDO - RES. RATE APPLIES _ I Water Heater - $1.50 MINIMUM. RESIDENTIAL f EE $12.00 Vyhirlpoo6; 340 MINIMUM.- COMMltiVD,FEE -$20.00 I Gas Piping Otrtkts x-$1.50 STATE SURCHARGE PER PERMIT - .50 (MINIMUM - i PER PERMIT) (ADD $.50 S/C IF PERMIT PRICE GOES Softener - $5A0 BEYOND $1,000.00) Well $10.00 Private Disp. - $10.00 =Rough Openings $1.50 D } SIONATURE OF PERMITTEl . SEE STATE S/ (`OIL CITY QE EAGAN jir ...'Y.. • PERMIT # AC- MECHANICAL PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 f Site Addr9ss / BLDG. TYPE WORK D 75!1"ON Lot Block Seg/Sub Res. New Name Mult Add-on Comm. Repair 7@ AdpFeps Other C City"Y-..:,/-~~'~~i! tl hone v,2 fr 1v 7 FEES Name RES. HVAC 0-100 M BTU -$24.00 c Address ADDITIONAL 50 M BTU - 6.00 `C: 6' 7 (RES. HVAC INCLUDES A/C ON NEW p City,;;, ( Phone CONSTRUCTION) GABS OUTLETS (MINIMUM 1 PER PERMIT) - 1.50 EA. TYPE OF WORK , - COMMAND FEE - 1% OF CONTRACT FEE Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE A CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON S Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT .50 .Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # - BEYOND $1,000) Other FEE: - S/C: SIGNA RE OF PERMITTEE TOTAL: FOR: CITY OF EAGAN. CITY OF EAGAN 454-8100 F R DEPT. OF BUILDING INSPECTIONS Correction Notice Located at 15-7 7 B~gc ¢tiQ I have this day inspected this btructure and these premises and have found the following violati ins of city codes governing same: 1 1r t C® 1 When corrections have been made, please call 454-8100 for inspection. -/z ~r Date W"GCW ft of Eagan 00 NOT MMOVE THIS TAQ ~ ` _.r'd ,yam; ~ +•wr-pnF,~~~1R~`n'PP A 7^°4^~JAf~ j.: M. SF ems; ..~f~ CITY OF EAGAN N21 3830 pilot Knob Road, P.O. Box 21.199, Eagan, MN S5121 PHONE: 454-8100 BUILDING PERMIT Receipt_ I Z To be used for DA8211111M F'I1 88 Esi' Value Date- 14 ` t Site Address 1579 Kim to Lot -21-- Block _ I_ Sec/Su OFFICE USE ONLY dVAGUM am ill Parcel No. Occupancy Q FEES Zoning Name JIM ROVE i W (Actual) Const Bldg. Permit o Address IS" DIACMK ri11.Li RD (Allowable) Surcharge fts City RAW - Phone 43" 753 # of Stories Plan ~ Length Name DAVID NMXQ COW Depth SAC, City Address 171410 NA TO 10 S.F. Total SAC. MCwcc City LASMUS Phone "TANIN s;F. Footprints _ Water Conner fin Site Sewage W W Name On Site Well Water Meter za Address MWCC System Acct Deposit City Phone City Water _ PF(V Required SAN Permit I hereby acknowlege that lve read this application and state that the Booster Pump SARI Surcharge . Information is correct and agree to comply with all applicable State of Minnesota Statutes and.C!VbiEagan di Treatment PI Signature of Permitee APPROVALS Road Unit A Building Permit is issued to: "Vie 11 11102 COW P Planner Park Ded. on the express condition that all work shall be done in accordance with If Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies » ! ii t Variance TOM oil Building Official Ca 1 I L : POIWA W PomM H01dsr Deft Taeowm * WATER SEWER KWIC. 3 9 ELEMM rapwsm Dom ft"- con m m" Footings 1 Foundaton Framing Rooft iiwo pltg• Fwapkw Fine) Hg. Cnslet Tom Fine) P1bg. Plbg. Mrpeclor - Notify Pkm+Der Cam. Meter EngrJPlan ft. Finai 47 Deck Ftg. Deck Final we® Pr. Disp. CITY OF EAGAN Remarks 0 1 V -4 I& ~2 49 Addition B1ankhawk Glen 1st Lot .21 If Blk Parcel 10 14350-280-01 Owner Street 1579 Blackhawk Hills Roa4tate Eagan HN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1076 STREET RESTOR. GRADING SAN SEW TRUNK bAIL- 11970 6.70 951 Ed prinr r( divinion SEWER LATERAL Bn1 74 1986 29-49 I Spwp.r T..qt-i--rql 137 1972 106.12 20 WATERMAIN Bn 1075 1986 92.80 18.56 5 WATER LATERAL WATER AREA 1072 1986 309.40 61-99 9 Storm Sew Trk 1073 1986 110.91 22-19 5 STORM SEW TRK 732 1983 32.57 15. STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CITY OF EAGAN NQ 16281 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454-8100 Receipt # CJ , L , To be used for SF DWG/GAR Est. Value $104, 000 Date 4/10189 19 Site Address 1579 Blackhawk Hills Road Lot 28 Block 1 Sec/Sub. Blackhawk Glen OFFICE USE ONLY Parcel No. 1st Addition Occupancy R-3_ M-1 FEES Zoning -R--1 W Name Spear Construction, Inc. (Actual) Const ~N Bldg. Permit 654.00 o Address 6703 168th Street West (Allowable) ~-N surcharge 52.00 City Rosemount Phone 432-1878 #ofStories 327.00 Length '01 Plan Review -100.00 o Name Same -a as owner- Depth -341 SAC, City O a Address S. F. Total SAC, Mcwcc 575.00 r city Phone S.F. Footprints On Site Sewage Water Conn 580.00 W W Name On Site Well Water Meter 90.00 =a Address MWCC System S u~ Acct. Deposit 30.00 M WZ City Phone City Water ~X PRV Required -x _ S/W Permit nn I hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge ~0 information is correct and agree to comply with all applicable State of n Minnesota Statutes I CiW o gar} Ordinan es 1 Treatment PI 998-0 Signature of Permitee APPROVALS Road Unit 340 _ nn A Building Permit is issued to: S ear nS ruct ion, Inc Planner Park Ded. on the express condition that all work shall be done in accordance with all Council .50 applicable State of Minnesota lutes and City of Eagan Ordinances. Bldg, Off. Copies Building Official Variance TOTAL ? WZ-5n r' ~1 q CITY OF EAGAN 0- 19684 6 8 4 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 c- 1 C' BUILDING PERMIT Receipt # I -J f V To be used for BASEMENT FINISH Est. Value Date SEP 16 , t 9_11 Site Address 1579 BLACKHAWK HILLS RD Lot 28 Block 1 Sec/Sub13LACKRAWK GLEN 1S OFFICE USE ONLY Parcel No. Occupancy FEES Zoning - W Name MARK DOBELE (Actual) Const Bldg. Permit 35.00 0 Address 1599 BLACKHAWK HILLS RD (Allowable) City EAGAN Phone 454-0753 # of Stories Surcharge • 50 Length Plan Review Name DAVID SCHWEICH CONST Depth SAC, City Address 17160 HAMILTON DR S.F. Total - City LAKEVILLE Phone 447-8808 S.F. Footprints SAC, MCWCC On Site Sewage Water Conn U o W Name On site well W_ Water Meter Address MWCC System K LU City Phone City Water Acct. Deposit PRV Required S/W Permit I hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge information is correct and a ree to comply with all applicable State of Minnesota Statutes and Ci Y o a an dins s. X Treatment PI t g Signature of Pe...... APPROVALS Road Unit A Building Permit is issued to: DAVID SCHWEICH CONST Planner Park Ded. on the express condition that all work shall be done in accordance with all Council .50 applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies I J join ~t I rn11 Variance TOTAL 36.00 Building Official bX594C3 -S7J 2004 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date r , 3D , 0'1 Site Street Address ~ 5 -i 6 tcc a a-jk/ 'Ft_i j R..1 URN # Property Owner Aftym_ T&A Telephone # ( j Contractor Telephone # (lot IS*) Address Ak S city VA LW tAi Ks State Zip The Applicant is: _ Owner !Contractor -Other Alterations to existing dwelling $ 50.00 -Add fixtures to rooms, excluding water softener and water heater -Septic System Abandonment -Water Turnaround (add $121.00 if a 5/8" meter is required) Other: Water Softener _ Water Heater $ 15.00 replacement _ additional V Lawn Irrigation System RPZ_ new repair ,rebuild S 30.00 Stet f lSurcharie $ .50 I u Tot I hereby apply for a Residential Plumbing Permit and acknowledge- that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. Applicant's Printed Name Applicant's Signature RESIDENTIAL BUILDING PERMIT APPLICATION J CITY OF EAGAN 7 -1 I 3830 PILOT KNOB RD, EAGAN MN 55122 651-681.4675 New Construction Requirements Remode!&j air Requirements 3 registered site surveys showing sq, ft. of lol, sq. ft. of house; and all roofed areas 2 copies of plan (20% maximum lot coverage allowed) • 1 set of Energy Calculations for heated additions • 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 site survey for exterior additions & decks • 1 set of Energy Calculations Indicate if home served by septic system for additions • 3 copies of Tree Preservation Plan if lot platted after 111193 • Rim Joist Detail Options selection sheet (bidgs with 3 or less units) q /G, ~ oa DATE VALUATION _ 9O SITE ADDRESS /577 ,F11 t7 MULTI-FAMILY BLDG _ Y 4=--N' TYPE OF WORK Ortc© FIREPLACE(S) _ 0 _ i _ 2 APPLICANT 4j- ~'r• -IQ STREET ADDRESS 47 ZOd /37L s~ CITY r 1~ STATE ZIP =IN l TELEPHONE # CELL PHONE # 61>d8V -y-A55 FAX # PROPERTYOWNER TELEPHONE# 6Sl-~ 33~ q~ 3! COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category %[[NN ESO'rA RULES 7670 CATEGORY I _ MINNESOTA RULES 7672 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: Phone # Plumbing system includes: Water Softener Lawn Sprinkler Fee: $90.00 Water Heater _ No. of R.I. Baths No. of Baths Mechanical Contractor: Phone # McchauticA system includes: - :fir Conditioning Fee: $70.00 Heat Rccocery System Sewer/Water Contractor: Phone # . I hereby acknowledge that l have read this application, state that the information is correct, and agree taco ly with all applicable State of Minnesota Statutes and City of Eagan Ordinances. ,`l Signature of Applicant ~M-------°----...-------____--....._...__--.....---....r_.... OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received i Not Required _ Updated 4l42 OFFICE USE ONLY ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of _ plex ❑ 09 07-plex ❑ 17 Garage ❑ 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 ❑ 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 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy 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 Width REQUIRED INSPECTIONS - Footings (new bldg) FinaVC.O. - Footings (deck) _ Final/No C.O. 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 (flew/replacement) Insulation _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total 0-0 - RESIDENTIAL ~10 S~ BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55722 6S1-681-4675 New Construction Requirements RemodellRecair Requirements • 3 registered site surveys showing sq. ft, of lot, sq. I. of house; and all roofed areas • 2 copies of plan (20% maximum lot coverage allowed) • 1 set of Energy calculations for heated additions • 2 copies of plan showing beam & window sizes; poured found design, etc.) • 1 site survey for exterior additions 8 decks • 1 set of Energy Calculations • indicate if home served by septic system for additions • 3 copies of Tree Preservation Plan if lot platted after 7!1193 Rim Joist Detail Options selection sheet (clogs with 3 or less units) DATE VALUATION' ~ SITE ADDRESS 22 641& halyl~ /1! J4 MULTI-FAMILY BLDG _ Y _ N TYPE OF WORK f 1( Q -x 0 -S `vP f t) P e t' .0 FIREPLACE(S) _ 0 _ 2 Ct ~ fit ~ ~ CC S ~..i X r~JFi n(~ APPLICANT j i"*'i'Le'll STREET ADDRESS CITY 92011WrI~P STATE ZIP TELEPHONE # 0159 c 0('j4)5S9CELL PHONE # FAX # PROPERTY OWNER Dr r p in TELEPHONE # COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ 1dIti\E.yc)"C.1 RULES 7670 CA FEGORY i _ MINNESUrA. RULES 7672 (,V submission type) • Residential Ventilation Category 1 Worksheet Submitted Trfr CTe7ert7t miffed • Energy Envelope Calculations Submitted I I ~~JJ II~J f S c P 1 8 9002 i~ Plumbing Contractor: Phone - Plumbing system includes: Water Softener Lawn Sprinkler By Fee: 590.00 Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor: r`"Irros rd 02- (-C11/'ln e- V Phone # MCCli nical WAC111 includes; Air Conditioning Pee: $70.00 Hcat Rccovcry Sy'stcni Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ord' ces. 4 Signature of Applicant j~. / - OMCE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required Updated 4102 OFFICE USE ONLY { ❑ 01 Foundation ❑ 07 05-plea ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dweiling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of _ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plea ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi ❑ 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 Fine Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy 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 Width REQUIRED INSPECTIONS Footings (new bldg) _ Final/C.O. Footings (deck) _ Final/No C.O. - Footings (addition) plumbing Foundation RVAC 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 , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total 1989 BUILDING PERMIT APPLICATION - CITY OF FAGAN , SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MOST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF 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~~ 1 0 1969 To Be Used For: Valua\ti,4~n: ---;Z~ Date: _Yf- b y Site Address / ll 729)&e4h k 91 AL Imo,?, OFFICE USE ONLY 1 oy, vv ~ Lot c_r Block I Occupancy-3 M-~ FEES Zoning Parcel/Sub Ark kg=ktok &1e,L 1' AaV;4,c,` Actual Const V-N Bldg. Permit ~SY.00 Allowable y-N Surcharge 5z'00 Owner E- ?eA, C,<<_~~. # of stories Plan Review 7,00 Length 5, 7 SAC, City 100100 Address D is/+ 5/. Zj4 Depth - cf SAC, MWCC 59;5, S.F. Total Water Conn Soo, D~ City/Zip Code--) ~o~;e Footprint S.F. Water Meter 'ID, oZ5 Acct. Deposit 3~,- Phone G/ - 1¢ t-) - I On site sewage S/W Permit On site well S/W Surcharge Contractor CaFr MWCC System ✓ Treatment Pl. 2245, of City water r/ Road Unit Li Address -G4,, aS A., C-Pe- PRV required Park Ded. Booster Pump Copies City/Zip Code TOTAL APPS Phone Planner Council Arch./Engr. Bldg. Off. Variance Address City/Zip Code Phone # NOTE: Sewer & Water Permit fees and account deposit fees will be included in the building permit fee. Processing time for sewer and water permits is two days once a licensed plumber has applied for a permit at City Hall. .z r ZI X Z2 ~~2 X /5- X930 '42xly= Io38g IST F L CC) yl 12 2 V X SD y~+oo ~ND LOOK, XaVZ_ xSo~ Ib~3~5~ C?+rtificate for: Spear Construction Book 135 Page 39 DELMAR H. SCHWANZ LAND GURV11YORS. INC. A 9' i d Ur4w Law d TM ShM 0 MWwAsM 14750 SOUTH ROBERT TRAIL ROSEMOUNT. MINNESOTA 55064 GIV423.1769 SURVEYOR'S CERTIFICATE o g3°' a~ INC N _ r Fehr Ira L) a~ uti V r 0 Denotes iron monument O Denotes set wood hub Denotes existing elevations , / 28 Denotes proposed elevations O fr' Denotes direction of drainage LOCK I ~ BM: Top nut of hydrantat end of 11 Blaekhawk Lake Court = 843.03 sa N z-.. K'~9 M ` ~p Ae M ~t Jo Lot 28, Block 1, BLACKHAWK GLEN 1ST z g3f r ADDITION, according to the recorded M ao I gas plat thereof, Dakota County, Minnesota. u Also showing the location of a proposed Z 0~ I house as staked thereon. i ~ $33•~ • 3i.8Z Ra 1~$' N89-Y~-zJw io9.3q ( e; II-31-t1 ,933yo _ pp Q L A r- r H A W iC I hereby certify that this survey. plan. or report was prepared by me or under my direct supervision and - that 1 am a duly Registered Land Surveyor under the laws of the State of Minnesota. 04-03-89 Delmar H. Schwan Dated Minnesota Ra91sIrMion No. SIMS I CONTRACTOR Bt~v~ Co•~-I LOST L$ Ist4Zk GLV U A+~ ADDRESS_&, PHONE DETERMINE WORKING SQUARE FOOTAGE OF EACH. 1. Total exposed wall area q. ft. x 2. Total roof/ceiling area . 975 sq. ft. x .pub = ZL5 ~u~.. Total exposed wall area above floor d = x a. a. D oral wall=:windov_ area _ t - 3:.7_a_Total-- door area _ -~FCj.o k~. 2t.--:Tofal_s1i4;mg.glass. door. area _ -d.--Total -fireplace_ wall. area _ -p - ' a. i! _:-Tot6L wail_:framing_ area--(-average 10%) /9 .f _ r..Total .net. wall- area abdve•:flooL , 1775, g.¢ g. -Total rim joist area 2159 Total exposed foundation area = Z~fco h. Total foundation window area i.__.Total net..foundation- area- above grade 2r+(p ';4 . = Dete:Deterrilln" , W! --vaYue:mf eacti waU :segment . _a. .--x ffun ell - _ ~~.Q`7 b. o x fluff C. x fluff e 2`; 4 = z. d. J x fluff - s e._ / Q -7 '7e,.- x fluff f . % 7! x ,full 8~ •Z~G . x fluff h. x fluff = O x fluff , l4~r3 = 3D. 72 3 . ...............................Total = Zp If item #3 is the same as, or less than item 01, you have met the intent of SBC 6006 (c)2. , Page 2 of 2 Total exposed roof/ceiling area = l J. Total skylight area Y f k. Total roof/ceiling framing area (average.10%).. o y 1. Total net insulated roof/ceiling area ing Determine "U" value for each rcof/ceiling segment. J_ X „IIfr = -0- k. 9 0' X null ,C,7~ = 2 gel X fruit 4 ..........................................Total = ZZ•~i~;1 If total of #4 is the same as, or less than #2, you have met the intent ._:of-:SBC%-6C06(c)1. Alternater-Buildin-:Enverope_~Design y. To utilize the total-envelope system method, the values established by the sum of items #3 and #4 shall-not be greater than the sum of items #1 and #2. d I. + 2. _ - 3. - 4. -A. = zj I i97 t7~.1f T $ t~' SETS OF PI AS 2 `SETS OFF 49W IL- _Ift OF mmV d, - ammo L7lf s, - 09 Vi'ii~LSdv~.a or J r s L { Tyrmrte' MWIT ;IS ROMSTO-1 IDT CAW _'I'S ISQUEST ar, rt- a 8 owo ~k jy f ~#~T" MUST ` L7~ MIUM, E}~ l} may{ l ~ l 4 ~b rt'"~ _ ra"F Aar T;'. +y ' on: y d I l S ~ ~ f 7 1 { 7 7 v C046, i y'' art: I~ ■~9iiMY M~ ri+.a awiNMw~+4!~+~ ~ igyR'~ 40, ~~y~+ ~fy ///~~Iy'~■~M~f~ [/~~/y/_l1~~~1 ~ Y~~ FMi~l M~Y~Y ni~M' IM}~_Ir' -1 ■,rL~ y~y{~Ly~a~yl ' ' `GI L' AIM 47 ~ !~F" r. ri Wi7ni7. kT ymp (Sy,T~ff ?&Mal PhUft- I j ~ k h city/up co" A 1 'f y Ar 4 a- i 4 w i 7v.k51 P , 4y all applicable State -of X# o~c mmd ruty of 4 :5 s „ ~ r - - ~ ~ M.~~ i F tf~t - - 1. ~ i~'. - _ - 1 ' k ~ _ _ .y> ,f. . ' T ~ r ~ ~ , . SJ { . cj . , j ~ a. -.a - _ r. ai ~i e { y* - ;e . '1~'.- i r. ~ 4 L - [ ~f. y ~ ~ f - S .~a h'~ 1 ~ _ r~ S ~ i _t: . 3.- ' ~ - - I . ti . ~L F Y' . ~ ~ - _ .7 . Y ~ _ CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT # NG' DATE : IgDg PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL NEW CONST ADD-ON MINIMUM 15.00 /5.(`b ADD ON SHOWER 3.00 REPAIR WATER CLOSET 3.00 BATH TUB 3.00 LAVATORY 3.00 OWNER NAME : b~ R 12K V Eb kek KITCHEN SINK 3.00 ,p LAUNDRY TRAY 3.00 SITE ADDRESS: /S -7 !Q l ac-k- I Q(, k /rd HOT TUB/SPA 3.00 ~ _ WATER HEATER 3.00 LOT: CV 8 BLOCK SUBD. &-e'" lky- FLOOR DRAIN 3.00 INSTALLER: a )t t Qs P L'w'h' -Jv3 GAS PIPING OUT. v (MINIMUM - 1) 3.00 _ ROUGH OPENINGS 1.50 ADDRESS: 13 EGko OTHER WATER SOFTENER 5.00 CITY: A UPAISV,'I be zip: _s33 7 PRIVATE DISP. 15.00 _ U.G. SPRINKLER 3.00 PHONE OD- M410 SUBTOTAL S 0-6 b/ ST. SURCHARGE .50 SIGNATURE OF PERMITTEE TOTAL: S / ~50 OMMETALI[+1DUSTRIAL. PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: 1% OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN 461° City of Eaaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office jjUsej Permit* (® 1Q 694 Permit Fee: 110©.9° Date Received: a 1/ ( J Staff: INFLOW & INFILTRATION PERMIT APPLICATION PC Plumbing / Sewer & Water P4 Date: S-- 13 Site Address: / S i % Q C c ('( FI , I Tenant: Suite #: (of(-S.Sta —1 s K I_ 1002 Name: - C) Phone: Name: R p c p r o v. P) r•- r' ,, S i s eJ f'z License #: Address: ?s U� Q u o. ? a City: i g c r\ Contact: O.." PLUMBING (Within the building envelope) SEWER & WATER (Outside the Wilding envelope) Sump Pump Repair Repair Other. Other. FEES $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE$ Cp 0• UO *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.cityofeaoan.com/inflow, or City Hall at 3830 Pilot Knob Rd. 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.popherstateonecall.orq 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. Applicant's Printed Name Applicant's Signature Date: C!ty of Eaian 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: 1153'10 Permit Fee: o7,9 Date Received: Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION �j- Site Address: r , r2 : �, ))11, , ./ Unit #: Resident/ Owner Type of Work Contractor Name: ✓ z 6)r5 cr h Phone: C� /- 59)- -?$Cf Address / City / Zip: / h 7 7 bi//S 6),( Applicant is: Owner (7 Contractor Description of work: ✓ e (4'6 t ) S1y/(.13 tyIN/ow Construction Cost: 3 // 0°‘.9 Company: (-e( e, JZ 640v./ (;n9 Multi -Family Building: (Yes / No / ) _re( Contact: yhu✓' Address: 6'0)-1 £7 '1 e (/✓t (7o State: Al Zip: X6-3 y3 Phone: City: 2,74,1f41 dim 95-1- 3Y, : 'oa License #: V - 516 4'1.1 Lead Certificate #: '114/r f O 7_ 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 No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans 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. 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.gopherstateonecall.orq 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 Building Code must be completed within 180 days of permit issuance. x 5c Gat 4(riev, x Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA125109 Date Issued:07/17/2014 Permit Category:ePermit Site Address: 1579 Blackhawk Hills Rd Lot:28 Block: 1 Addition: Blackhawk Glen PID:10-14350-01-280 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Jolene Mehle 17484 Goodland Path Lakeville, MN 55044 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 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 - Eric B Olson 1579 Blackhawk Hills Rd Eagan MN 55122--121 Dakota Water Treatment 17484 Goodland Path Lakeville MN 55044 (952) 953-4643 Applicant/Permitee: Signature Issued By: Signature City of EaQau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use % j l Permit #: / �� / Permit Fee: /0.' Date Received: Staff: //2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: %//5/G �h Site Address: /5G% ? L C?�G' tT C g/k / 3/dG Unit #: Resident) Wn Name: EJ^/ L 5/ /1/49/,/ 7' Phone: &/ Address / City / Zip: /57 ':�, "e0.-- enApplicant Applicantis: Owner A Contractor � 9 Type bf W ,,: Description of work: `eDp 4 - Construction Cost: [Cl/ °�."'"9 Multi -Family Building: (Yes / No ( ) �����: � Cca. ac#� ftt Company:„c®� 1P — �D/G�:9�i1Contact:U %�L %eG1 /�/ / Address: �� /� (l/®L?� �� / ? � ��”- City: /?�ZP�Gi State: ® Zip: 2J"/5 Phone: %52-371CZOTO Email: (_-P./Ze. e_.,<2eo'r 4 / %l7,-,0.sr...,1`. CO,,, License #: Lead Certificate #: If the project is exempt from lead certification, please explain why: bn._e_. e5 etee_cUe4.—. 7._ /7zr In the last 12 months, Yes No COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? If yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Fire Suppression Contractor: Phone: Phone: Phone: Phone: lel : Plans and o docume That o � � re c nsidered ®:• � O e�p�blic �� •� l�• ' • •� the:informationy bclassified s non ould a Ddu P r. ; .ons that wPer rty to .. ® nc/P.® fat they ark 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.gopherstateonecall.orq 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 wor authorized by a building permit issued in accordance with the Minnesota State; uilding Code must be completed within 180 days of .: 4f uan -� 3OP 40 xi pplicant's Printed Name C/dt. Applicant's Signature Page 1 of 3 4 5 Thank you. Regards, Eric Olson Sent from my iPhone On Jan 6, 2021, at 9:42 AM, Derek Qualle <DQualle@cityofeagan.com> wrote: Good morning Eric, Lets do this. Attached is a smoke/co installation affidavit. Please complete the following and email them back to me: 1) Fill out and sign the affidavit (it doesn’t need to be notarized) 2) Send me a photo of each of the new hardwired alarms hanging from the their wiring (try to get the halls or rooms in the background for context). 3) Take a photo of the bedroom smoke alarm relocated 3 ft from the ceiling fan If everything looks good, I’ll send you back a link to your closed/passed permit. Thanks, Derek Qualle Building Inspector 3830 Pilot Knob Rd | Eagan, MN 55122 Office: 651-675-5689 https://www.cityofeagan.com From: Eric Olson <e05olson@gmail.com> Sent: Monday, January 4, 2021 8:57 AM To: Derek Qualle <DQualle@cityofeagan.com> Subject: Inspection - Permit Number EA163633 Good Morning Derek, You were at my residence last week (Tuesday, December 29) for a kitchen re-model inspection. It was recommended that I replace 2 existing hard-wired smoke detectors and re-locate one smoke detector in 6 a bedroom. This has been completed and the 2 hard wired ones are inter-connected and working properly. Do we need to schedule an in-person re-inspection? I can send photos, and possibly a video of the interconnected hard-wired smoke detectors (although that might be difficult). Thanks and have a great day! Regards, Eric Olson 1 Derek Qualle From:Eric Olson <e05olson@gmail.com> Sent:Wednesday, January 6, 2021 10:27 PM To:Derek Qualle Subject:Re: Inspection - Permit Number EA163633 Attachments:Smoke and CO detectors affidavit for Building permit final.docx Derek, See attached photos and completed affidavit (screen shot image). 1579 Blackhawk Hills Rd. Permit# EA 163633 2 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA164386 Date Issued:09/28/2020 Permit Category:ePermit Site Address: 1579 Blackhawk Hills Rd Lot:28 Block: 1 Addition: Blackhawk Glen PID:10-14350-01-280 Use: Description: Sub Type:Residential Work Type:Alteration Description:Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087 Surcharge-Fixed $1.00 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 - Eric B Olson 1579 Blackhawk Hills Rd Eagan MN 55122--121 Sieben Plumbing 18605 Fischer Ave Hastings MN 55033 (651) 343-6298 Applicant/Permitee: Signature Issued By: Signature