The URL can be used to link to this page

1620 Blackhawk Hills Rd-- -- 8 OCyLIAflS ?. IOD ? GASH k eHEcK. I. ? S' ke AddreSs ? a?? IVame ?Civ t Phone. PY ., ? CAy -4??'?,? - Phon 1 0 TYPE oF woRK Fomeci Air y &k2 M BTU $ dQilar M BTU $ Urlit-Heater M BTU $ Air Cond. M BTU $ ? VeM CFM $ !CasPiping Outlets # $ ?{ Lll ? 'ha?. d S k? nJfnd Comtract , k. . ,?. . ,? ? ??'T? M ? .$ , .... . ? .. - ,, d .w, .c , a. i._. . .. . . i . . ... ?.. ?'+OflSt._„?,...,:; ,.r. MUIt. Cbi11f1'1. ? O18f FEES RHS. HVAC 0-1 BTU ADDITIONAL 50 BTU (RE$. HYAC INClUDE3 A/C ON NEW = - - ,- -_-: ?_ ?- , TOWNHOUSE & CONDOS - RES. RATE APPtiES MIWIMUM RESIDENTIAL fOEE - AlL A[}D4* A REMODELS (INCLUDES GAS PIPIN{,) c? GAS OUTLETS (MINIMtiM • 1 PER PEFtliIiT- NEw coNST.) COMMAND FEE • 1% OF CONTRACT FEr: APT. BLDGS. - COMM. RATE APPLIES MINIMUM COMMERCIAL FEE STATE SURCHARGE PER PERMtT (ADD $.50 S1C PEFt EACH $1000.00 OF PERMIT fEE) w > . ?c+u c., ?.? ? I r-Urs: c.i I Y ur t:AUArv CITY OF EAGAN Remarks i, Owner i ';?: , ; ' Y ,?-P". - `,+"-; _ ?.. - --- Street Uxw ot 7 Blk 1 Parcel 10 14380 070 01 Blackhawk Road State Eagan, NAI 55122 Improvement Date Amount Annuai Years Payment Receipt Date STREETSURF. 3 0 1976 26 6.3 269.63 1 1887.50 - 8 STREET RESTOR. GRADING SAN SEW TRUNK 1970 517.56 20.70 25 Paid * SEWERLATERAL 1972 5305.45 265.27 20 3448.56 005166 -18-78 WATERMAIN * WATER LATERAL 1972 WATER AREA Tl 1977 160.00 10.66 15 138.68 C005166 8-18-78 * STORM SEW +RJL 1972 STORM SEW LAT STM SEW TRK CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. • SAC PARK N/S/? 5 7 Request Date ? I ? ? Fire No. Rough-in Inspecti n Required9 ? Yes N. eady Now C WIII Notify Inspector When Ready? I icensed contractor p owner hereby request inspection of above electrical work at: Job dress (Street. Box or oute No.) ll 01L?e #X4)41 W il Ciry qi l P, c - _ /V Section No. Township Name or No. Range No. County Occup (PRI T Z ? Phone No. PowerSuppher Address Elecincal Contractor (Company Name 1 ? CoMractor+i License No. a? ? o r ? a Mading Adtlre (CoMractor or wner Making Instali tion) L? v ?lY Authori Signature (Cont?act lOYki ng In sta atio )(?? ? Phone Number -I 1417! MINNEI(OTA STATE BOARD OF ELECTRICITY l THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bidg. - Room 5773 8E ACCEPTED BV THE STATE BOARD 1821 Unlverslty Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone(612)642-0800 ENCLOSED. -C,, REQUEST FOR ELECTR?ICAL INSPECTION (? ` ? See inshuctions la cwnpleting lhis torm on back oi yellow copy. 1-1244J J "X" 8elow Work Covered by This Request EB-00001-08 ? ew Add_ §ep. TypeofBuilding AppliancesWired EquipmentWired home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specffy) Comm./lndustrial Furnace Farm Air Conditioner Other (specity) Cantractor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Erkrance Size Fce # Circuiis/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 _ Amps SignS Inspector§ Use Only: TOT Irrigation Booms '' ? ---? Special Inspection Alarm/Communication THIS INSTALLATION MAY 8E ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTH I, the Electrical Inspector, hereby Rouyn-in Date certify that the above inspection has been made. Final ` Data •?d ? OFFICE USE ONLY This request void 18 months Irom EAGAN TOWNSHIP BUILDING PERMIT ? . ? ? ... Owne= ....... K •---------•, '-------------------- C Address (Pseseni) ....... J. .................................. ---. Buildes .... Ix . -•-..::....-= ....----•-•...:..-..=_ :.......................•--...._._....... Address .---....? ......................................................... DESCRIPTION 11T° 2162 Eagan Township Town Hall Date .. Il1, j. `/ ?? ........................ 5tories To Be Used For Fron! Depth Height Est. Cos! Permi! Fee Remarks e'?J / ?'• • G J •ZT r ? ? ? A ' 4` LOCATION t. Road 46r othez Description of Location .oi niocx waauion or -rrae: '7 ??-`---f„c-?_.-_ __: ??_ /?°?c?- .:? -,_,C.. This permit does not sutho=ize the use oi streels, roads, alleps or sidewalka nor does it give 3be owner or his agent !he right to create any sifualioa which is a nuisance oz whicb presents a hasard to the heallh, safetp, coavenience and general welfare !o anyoae in the communiip. TIiIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. •fy, lhat---? ............... ? ......... has permission to erect a...... :?: . . . . . . ....u on This is !o cerh -- ---•- ................... --- - A 3he above described premise subje !o ihe provisions of the Building Ordinance for Eaga- Townshi?adopied April 11, 1955. .. -- --• `'- - -- .-< '.= •-- .:...............•••---•--••-•-- .-•.......................•--•:•-• -: ........... ................. Per ............ =----•1 ?---f------:.... ? -- ?---- - : ? Chairmaof Tnwn $oard Buildiag Inspector c!, f; Eagap Township Dakota County; Minnesota Appfication for Buildiag Permit PERMIT NO. ::.. Dafe l............ Type of building or wozk contemplated. Circle correct descrip3ions. esadenfial Commercial Industrial Other........................................................................................................................... - ;uild ' Enla:ge Alter Repais Install Move Wreck OL%er ................•••----•----•----------------•------•--••------..-•--•- "6z a Dimeasioas.._., ??.?._....--•.......::.?i_---Cos3.:.-•---....,l------------------- G ? Details or remasks--------- ............................................................... .................................. '•• -:_=-`: .............. .-=-`=_ =-`-_--•....._ ----•---•--------------•-....--•------ Location Number Street Between what crosa slreeis Saze Est. Valualion - -- - - I I I /,S'c Lot I Block I Addi3ion Resrrangement or Tract " --f .=---- . 15?•`• .............................................. Address ....... ............................................. -•J"............ Owner ..:?.! = :.----- =-l ....... . Contractor ..... ••--•--------•-••-- Address .............................. The undersigned hereby makes apblication for a permit to $ do work as herein specifaed, agreeing to do all vPOrk in strici Total fee collecied. accordance with the buildin? o= nce . opted April 11, 1955 by fhe gan Tomnship/?},?atd of S e Ysoss. Permit fees are not ?? refundable. ----•- --..?--------------------? .1.......?:..,.: ::................... signe-= ---a ------------ :? , ? d 2005 RESIDENTIAL BUILDiNG PERNIIT APPIlICATiQN City Of Eagan ? 3830 Pilat Knob Road, Eagaa MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Coristruction Reauiremems RemodpAlRenair Reauirements Offia Use nlv 3 reyistered site surreys showing sq. ft. of lof, sq. ft. of house; and all ma(ed areas 2 copies of pfan Cert af Sunrey Reod _ YN (20% mwimum IM coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres PEan Rec d ?:.:. Y_ N 2 copies of plan showing beam & window sizes; poured found desig n, etc. 1 site survey for addifions & decks Tree Pres Required. ' _ Y_ N 1 set of Energy Calculadons Addrtion - frtdkate if on-sle septic systern On-erte Septic System ' _.Y _ N 3 copies of Tree Preservation Plan ff lot platted after 711193 Rim Joist Detail Options selectian sheei (build'mgs with 3 or less uniis) Date Construction Cast Site Address lozo ?/?F?,'a. Unit/Ste # ? 27_. Description of Work g r1 :G? Qrto L_ Multi-Family Bldg ? Y t? N T-' Fireplace(s) ^ 0 _ 1 _ 2 Property Owner Telephone # (46S1 Contractor ? Address £ CitY U.)Q?-?*?"'" - Stata ? Zip 5"21 Telephone # (?? ) :7 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 Minnesota Ruies 7672 Energy Code Category . Residential Ventilatoon Gategory 9 Worksheet ? • New Energy Gode Worksheet (4 submission type) Submitted Submitted • Energy Envelope Galculations Submitted Wave yau previously cons#rucfed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. . Licensed Plumber Telephone # ( ) Mechanical Contractor SewerlWater Contractor Telephone # ( Telephane # ( I hereby apply for a Residential Building Permit and acknowledge that the information is camplete and accurate; that the work will be in conformance with the ordinances and codes of the City af Eagan and the State of MN Statutes; 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 approve plan in the case of wark which requires a review and approval of plans. , I Applieant's Printed Name pplicant's Signature 4FFICE USE ONLY Sub Types 0 01 Foundatipn ? 02 5F []welling 0 03 01 of _ plex 0 04 02-plex 0 05 03-plex ? 06 d4-plex Work Types ? 07 05-plex ? 13 16-plex 0 20 Pool ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 09 07-plex ? 17 Garage 0 22 ParchlAddn. (4-sea.) ? 10 08-plex ? 18 Deck ? 23 Pare.h (screen/gazebo) ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 12 12-plex Plbg Y or_ N4 25 Misceilaneous jUUeor. 0 30 Accessory Bldg 0 31 Ext. Alt - Multi C.7 33 Ext. Alt - SF ? 36 MuEti Misc. ? 31 New ? 35 In€ Improvement ? 38 Qemolish Interior ? 44 Siding X 32 Addition O 36 Move Bu6lding ? 42 Demolish Fflundatian ? 45 Fire Repair ? 33 Alteration 0 37 Demoliah Bu+ldin g" ? 43 Reroof ? 46 WindowslDoars E3 34 Replacement 'DemoliEion (Entlre Bldg) - Give PCA handout to applicant Valuation C',:?o ? Occupancy MCES 5ystem Gensus Code Zoning -/ Cify Water - SAC Units Stories - Boaster Pump - # af Units -? Sq. Ft. / PRV -- # of Bldgs --- Length ? Fire Sprinklered - Type of Const ''- Width 3 _ Footings (new bldg) ? Faotings (deck) _ Footings (addition) Foundation Drain Tile Raof _ Ice & Water _ Final _ Framing _ FirepIace _ R.I. _ Air Test _ Finat Insulation Approved By: _ --------------- - Base Fee Surcharge Plan Review MC1ES SAC City SAC lltility Gonnection Charge S&W Permit & Surcharge Treatment Plant l.icense Search Copies Other Tvtar REQUIRED TNSPECTIONS _ FinalfC.O. _ Final/No C.O. ? Plumbing HVAC Other xv, Fool Ftgs * Air/Gas Tests Final ? Siding _ 5tucco _ Stone ? Br2c Windows ? Retaining Wall Building Inspector / ? .. 1999 BUILDiNG PERMIT APPLiCATION (RESIQEWTIAL) cIrir aF eacaN 3830 PILvr iaMas RD - 55122 ? ?g? ?--?-- 651-6$7-4675 I I - NM condmcWa lieauiremards , D S regis6erod sb surveys ihowing sq. fl. of bt, sq. R of house 2 capin of pNn and al raoled sreas (m'G maximum Fg:gcvne allawed) 1 set of ansrgy cdkuMkow for heaM addWons D 2 aopies of pFsns (show !eam 8 wlndaw stzn; Ranred Ind. design; etc.) 1 sh stsvey for exipiarsddNbns & decka A 1 set of enargy ctrlculatiOns R 8copks of tme prnetvaiion pbn if bt plalEed alter 7M193 DATE: // I( f /,v? CONSTRUCTION COST: -- DESCRiPTION OF WORK: SME? ADDRE55: l?G? a f3 IA e??,? L4T: BLOGK: SUBDJP.l.D. #: k.C? L,",rk L`?i Name• XOAs -47 4 s.s e ?- i?u 1 lfjn "', Phone #: -i- PtO'ERTY LM Fff d - - OWNER street Address: l ? a e/? C,I#y StatQ. ziP. 5-5,1-1 A Company: Phone #: " ^ /? f area codey CONTRACTOR Strsst Address: License #,,I .. S ? 3U City ?26, Sta#e: 23p; y ARCHRECTI EMGINEER Company:_ 1??i????,-? ??? •'`'`-' ^ G "?" ? k Name: Tolephone #: 9treet Addt'ass: Regls#ratioa M City State• Zip: gewer & rmW ikwsed plum6er [new„rgMbctlon anivl: TWephomt AnuSnY aPpllas wtron addmas change and bt change Is requestad onsae permit ie Issuad. i hereby acknowledge tiW 1 hsve riad thia appdkatlon, ahfie thst ihe MiormOoo is vonect, ad agm to oumply wth dl aWMa61e SW of Mlinresota Mdds ad Cl of Eagan OMinencea. nature of App1haM: OFFICE USE QNLY Cec fificates of Survey Receiyed Yes No Tree Preservaton Plan Received Yes Nv Not Required ??? I ZI ? w a QFfiCE USE OIi1LY BUILDING PERMIT TYPE ? 01 Foundation E3 06 4plex 0 91 1 0-plex 0 16 fireplace 0 02 SF Dwelling 0 07 5-piex 0 92 92-plex Ct 17 Garage 0 03 1 of „_,,, plex Cl 08 6-ptex O 9 3'! 6-plex E3 18 Deck 13 04 2-plex CI 09 7-plex 13 14 Apattments 0 19 Lower Level CI 05 3-plex 13 10 8-frlex O 15 Lvdging E3 20 Pool WORK TYPE JK 21 Pvrth (3-sea.) 0 22 Pord'tlAckN't. (44". 0 23 Parch (screered) 13 24 &torm Damage ? 25 Miscellaneous )K 31 New - E3 35 Tenarrt tmpr CI 39 Gas Line t3nly O 43 SidinglSofffrtslFascia E3 32 Additian ? 36 Move BIdg. CI 40 Gas Insert E3 44 Vltndowslt]aors E3 33 Alteration [] 37 Demofish Bldg." 0 41 Wood StaWe D 45 Fire Repair 0 34 Repair E3 38 Demolish (lnterior) E3 42 Remof ` Give RCA handout to applicarrt far demolition permit GENERAL fNFQRNIATIDN Const. (Actual) Basement sq. ft. Cersue Code (Allawable) Main Ievel sq. ft. SAC Code UBC Occupancy sq. ft. ? No. of lJnks 7aning sq. ft. No. of Bldgs ? # af Staries sq. ft. MGJES System ..? Length sq. it. Chy Vlfater Width Footprint sq. ft. Boas#ar Pump PRV ? Fwe Sprinklered APPROVALS Planning Building Ergineering Variance Permft Fee Valuaton: $ 5urcharge . ? Pfan Review Ucense AACIES 5AC City SAC Water Conn. . Water Meter Acct. Deposit S1W Permit SNV Surcharge Trestment PI. Park Ded. Trails Ded. Other Copies ? Total: 1-17 ?4. ?? . ? SAC Units 9'a SAC u ?/ r •- ; •? .,? ? ?? ? ? ?' M?'t? . ? ?? ?,?i? ?? - '?' • •? ? _ •=j 4? ?? ? _ ? N1' 45 I ?? - • 30 t?'?s ' ??iliry `? ? ,? ? /?= Arsr1A ?f 6or'? Lsi Z.f+t.l?, T 3T, R. Z3 u7?F?e? !a 2 . N . iso .` • ? ?? ` `. • ? i ?P ?69 OUTLaT c . ??. , ?ocoe ?j? o c?•?s ? sz? ?: ia$ ----------_-..?stirf--..4_?-..-- ? _ . . . _ . - lIP1 ' - hTi• ? .? WiJ;? f ar+?rr?1 ? ?/ r r 7 1 -_- ?r. ? . h ._ SO / ? / ? ? 1 1 ? r ( ? M• f ? '` JO ?" l? ` r ?.ec,?' l?IkdL•?1• ' , wi . ?. ? 1p,??s ?I?i?Qy r ? {? ,, ? - `.F / i e e+u ?y ? v` 9L r ? UT L . ? ? O ? ?\ - ?• ?? %rL a ?-? \ <p N ? r?o AP%* 44P,. 4c .. , ? ? ?? ?? ???? ?? ???? ? commeme I Eagan B.1 I Eagan opcrNard ? Permko Ownet? I ftgso AmomSehm I lEagen Pr? ? Eqpn e? W........._.._:?.,....._.,.? ....... ..............__..._. . Pa(C? ?? 1101438007001 ???? BLAGKHAWK HILLS AQ Wner 1 WMUSSEN - WLL _ ? . 1 _. _. R . Search PID ? 1620 BLACKHAWK HLLS RD ?? ? ? ? ??????n 911 Ffi ?i C O U N T Y ENNnRQNIUIENTAL MAhIAGEMENT DEPARTIVIENT GROUNDWATER PRaTECTIQN SECTIaM 94955 Galaxie Avenue • Apple Valley, IVIN 55124 952.891.7557 • Fax 952.691.7588 • www.co.dakota.mn.us MLINICIPAL BVOTICE OF WELL SEALING PERMIT APPLICATION DATE: April 29, 2404 Ta: Tam ColbertJWayne Sehwanz (EM) RE: Well Permit #: 04-H212720 Munieipality: Eagan Fax #: (651) 675-5694 We11 Type: Domestic Egvirommental Specialist: Rutten The Water and Land Management Sectian of the Dakota County Environmental Management Departrnent has received the following permit application for the well deseribed. If you require further review of the application or if you have any questions or concerns about it, contact the Environmental Specbalist listed abave or our office at (952) 891-7011. If there is no response from your office within 24 HdURS (excluding weekends and holidays), we wilt assume that you have na objectians Xo the issuance of the perrnit. Please note that permit issuance is always conditioned on tha permit applicant's ohsarvance of and caznpliance with all applicable state, county, and rnianicipal laws and codes. Well Contractor: Date Application Received: Anticipated Drilling Date: Anticipated Groating Date: ProPerty Owner: Well Owner: WELL LOCATION: Associated Well Drillers Inc 4/28/2004 Time: Time: William R Rasmussen William R Rasmnussen PLS Coordinates: 1/4, NE 114, SW 1/4, SW 1/4, Sec 16 Town 027 Range 23 Street Address: 1620 Blactchawk Hills RD PIN Number: 101438007041 WELL INFQRMATION: Diameter: 4 Casiag Depth: 302 Total Depth: 303.6 Static Water Level: Aquifer: COMMENT5: L f &L ? CITY OF EAGAN CITY USE ONLY SUBD. p(?)N681-75 RECEIPT ? ? ( O ! DATS 5 ? / ? 2r RE8ID8IiiTIAL PLEASE CtlMPLETE UPPER FORTION ONLY FOR SINGLE FAD[ILY DWELLINGS, ALSO, FOR TDWNHOMES AND COND05 WHF"N PERMITS ARE REQUIRED FOR EACH U1+IIT. ------------------------- --------------------------------------------------------- WORK DESCRIPTION COMPLETE THE F'OLL(}WING: ND. FIXTURES EA. TOTAL NEW CONST AEPAIR/ADD UN 15.00 ADD ON _ SHOWER 3.00 REPAIR WATER CIASET 3.00 BATH 'CUB 3.00 t)WNER NAME : SITE ADDRESS : INSTALLER: ? AAARESS: r S CITY• .,.,_ 2IP: FHONE ? 6 s- ?Z? - SIGNATURE OF PERMIT E COMMFRCIAL IAVATOEtY 3.00 KITCHEN SINK 3.00 _ IAUNDRY TRAY 3.00 _ HQT TUB/SPA 3.00 _ WATER HEATER 3.04 FIAOR D1tAIN 3.00 GAS PIPING OUT. ? (MINIMUNI - 1) 3.00 R4UGH OPENINGS 1.50 ? OTHER WATER 50FTENER 5.00 PRIVATE DISF. 15.40 U. G. SPRIAi1CLER 3. Q?0 r.5 •? W. TURNAROUND 15.00 STATE SURCHARGE .50 TOTAL: PLEASE COMPLETE THIS PORTION FQR ALL COMMERCIAL/INDUSTRIAL BUiLBING5. ALSO FOR MULTI-FAMILY BUILDINGS WHEN $EPARATE PERMITS ARE NOT REQUIRED FOR EACH nWEZLING UNIT. WORK DESCRIPTION: OWNER NAME: SITE AUDRESS: TEATTANT NAME : SllITE #: INSTA.LLER: ADDRES3: CITY: PHONE FOR: CITY 4F EAGAN C43NTRACT PRI CE : 1% 4F CONTRACT FEE. _ STATE SURCHARGE - $.50 FOR EACH $1,000 QF PERMIT FEE. $25.00 MINIMUM FEE. CONTRACT PRICE x lx $ STATE SLIRCHARGE TQTAL: $ $ (SIGNATURS) CITY USE ONLY LOT ? BL ? RECEIPT #: C) ? SLJBD. Vt Ct, ?;A RECELPT DATE: 1?- -?-01? MECHANICAL PERMIT # 1999 ,MECE"CAL PERMTf (RESIDENTIAI) cirY oF EAeAx 3830 PnW0T xxo$ gn EAtfit4N MN 55] 2Q (651) 6$1 4675 Date• f y Complete this section gu_lr if you are installing HVAC in a single family dwelling, tawnhorne or condo er cgnsiruciion and nat Qwner /occupied. s ii"VAC: 0-1OOivf BTU ADDITIQNAL 50 M BTU • Gas outlets (minimum of one required @$3A0 ea.) State Surcharge Total S 30.00 6.00 .sa ? $ Camplete this section o, nlv if you are remadeling, adding ta, or repairing an existing single family dwelling, townhame, or condo. Please indicate if it is a new item, alteration, or repair. New Alteration ? Repair _ Other Reminder: Call 88I-4675 for inspections. Y Furnace Air exchanger SITE ADDRESS owrER rr.vME: _ INSTALLER NAME: S'E'REET ADDRESS: CFFY: I V1 ? ,Air conditioning Other $ 30.00 State Surcharge .50 Zmum Total Due ?t ? /?/' ((5 ? PHONE #: ? (ARF-A ?C?,1DE) • f?C ?? PHONE #: ? (AREA CODE) STATE• ZIP: T"Q ovaze" ?- 5IG ATURE O P ITTEE ? ?::i CI''!'Y #JSE ONLY L BL RECEIPT SUBD. RECEIPT DA7E: APPROVED BY: , INSPECTOR MECMANICAL PERMIT #: 19991VI£CHM1CAI.'PER141ff (COM1Vt£R,CIAi.) CTl'Y f1r EA6u4N S$SO P1LOT KNOB fi.D £A6M, MN 551 22 -: , (651) 6$1-4875 Please comptete far: aII commercialfindustrial buildings multi-family buildings when separate permits are io required #Qr each dwelling unit I7ATE: C4N'1 RACT PRICE: WORK TYPE: New consttvction Install U.G. Tank Interior Irnpravement Remove U.G. Tanlt (Minimum Fee) Processed Piping (Mirnitnum Fee) **NOTE: When insta]ling/reznoving underground tank, call 651-681-4575 far uspection by fire marshal and plumbing inspector. DESCRIPTI4N OF WORK: F'EES: 1% of contract price PA $30.00 minimum fee, whichever is greater. CONTRACT PRICE x 1% PERMTT FBE STATE SURCHARGE TOTAL ($.50 per $1,000 of nic fee due on all pexrnits.) SITE ADDRESS: OWNER NAME: TENANT NAME (IMPROVEMENTS QNLY): PHOIVE #: - (AREA COL3E) INSTALLER: grAADRpNUTIWG po nla r+ Mh{NEAQ0L15.4,AN 554u:.23Sb ADDRESS: PHONE #: - CITY: STATE: ZIP: SIGNATURE QF PBRMITTEE . - , ' CITY OF EAGAN 1992 SEWER & WATER C4NNECTION CHARGES EXISTING RESlC1ENTIAL PROPERTIES Sewer i n charges Wa#er connecti SAC $80Q Wafer nnectio? Da 'ously paid Date pr Re Receipt # Acc 15.00 A cxount depos?t Sew >permftand arge __15.? -?flfater permit ? sur Weter meter Su $830.50 Treatment pla ee ?iurnbing mit and s + Total + Water tap Total wer & water connection charces SAC $ 800.00 Date previously paid Fieceipt # Water connection 675,00 Date previously paid Receipt # Accaurrt depvsit 30.00 Sewer & water permit and surcharge 30.50 Water meter 95.00 Treatment plant fee 300.00 Plumbing permit and surcharge 15.50 Subtotal $1,946A0 + Sewer & water taps Total 675.00 15.QD 15.50 95.0L) 300.00 15,50 1i6A0 PRV )?$ No. of taps - .ZLe Assessments Waiver OFFICE l3SE ONLY Property owner RAsMUSSEa Telephvne no. Address 1620 BLAOUKHAWK H1LL5 RI3 Lot j B[k 1 Sect g?CKHAwK HILLS P I D # ??I?y Z . . . , SPECI AL AS SESSMENT SEAItCH SUMMARY AS OF: 05 j21 f 1992 FROPERTY ID: 10-14380-070-01 S/A# ASSESSMENT DESCRIPT. YEAR '1'Nd RATE TOTAL ANN.PRIN. PAYOFF CD 100124 SAN SW TRK 1969 25 8.0000 517.56 0.00 0.00 CL 100137 S/W L SM T 1971 20 8.0000 5305.45 0.00 0.00 CL 100310 STREE'F 1975 10 8.0000 2696.39 0.00 0.00 CL 100399 WATER LAT 1978 10 8.0000 160.00 0.00 0.00 CL 100732 SS TR 297 1982 15 12.5000 1.610.00 0.00 0.00 Pp ------ SUMMARY OF LEVIED 0.00 0.00 0.00 ****** 1992 P&I CERTIFIED 0.00 ------ SUMMARY OF DEFERRED 0.00 0.00 0.00 ------ SUMMARY OF PENOING 0.00 0.00 0.00 ------ SUNIlKARY OF CLOSED 10289.40 Press ENTER; or F1, F4, F5, F7, F8 I I _' C ITY QF EAGAN SEWER & WATBR CONNECTION CHARGES - 1990 EX:LSTING PAOPERTIES SAC $ sOQ . QO WAT CO?INECTION $ 62 . ?0 Prsvio Ly Pd. ? Pre 'ously Pd. Receipt Re ? ACCOUNT DEPOS 15.00 ACCO ?''? 15.00 SEWER PERMIT & CHARGE 15.50 WA TEAR R 15.50 SUBTOTAL $ 730.50 WATE 90,00 + SEWER TAP X '?REA 252 .?0 TAL PLBG?AR 12.5Q SI3BT $ 010.50 R TAP ? SEWER & WATEbt COHNECTr013 CHARGES SAG $ 700.00 Previously Pd Receipt # WATER CONNECTxON $ 625.00 Previously Pd Receipt # ACC4UNT DEP45IT $ 30.00 SEWER & WATER PERMIT & SURCHARGE $ 30.5(} WATER METER $ 90.00 TREATMENT PLANT FEE $ 252.00 PLUMBING PERMTT & SiIRCHARGE 12.50 SUSTOTAL $1,740.50 + SEWER & WATER TAP5 TOTAL $1,740.50 4FFICE USE ONI.Y ASSE5514ENT5 NO PRV ND # TAPS NONE WAiVE& ND PROPERTY UGINER WILLIAM RASMiTSSEN TELEPHQNE # 687-9118 ADDRESS 1620 BLACKHAWK HILLS RD L 7 B 1 SECT. $LACKHAWK HILLS P.I.D. # 10 14380 070 01 .., . , • . SPECI AL ASSESSMENT SEARCH SUNlMARY AS OF: 05/14/1990 PROPERTY ID: 10-14380-070-01 5/A# ASSESSMENT DESCRIPT. YEAR TM RATE TOTAL ANN.PRIN. PAYOFF CD 100124 5AN SW TRK 1969 25 8.0000 517.56 0.00 0.00 CL 100137 S/W L SM T 1971 20 8.0000 5305,45 0.00 0.00 CL 100310 STREET 1975 10 8.0000 2696.33 0.00 0.00 CL 100399 WATER LAT 1978 10 8.0000 160.00 0.00 0.00 CL 100732 SS TR 297 1982 15 12.5000 1610.00 107.33 0.00 PP ------ SUNIlMARY OF LEVIED 0.00 0.00 0.00 ****** 1990 P&I CERTIFIED 0.00 ------ SC7MMARY OF DEFERRED 0.00 0.00 0.04 ------ SUNIlMARY OF PENDI1dG 0. 00 0.00 0.00 ------ SiTMMARY aF CLOSED 10289.40 Press ENTER; or F1, F4, F5, F7, F8 Aadl ess : 1630 Blackhawk Hills Roac1, Eagan Owner : Sohnson GENTLEMEN: Date July 31. 197$ Order No. TD 25730 PLEASE COMPLETE THIS PENDING AND/QR SPECIAL ASSESSMENT SEARCH AND KINDLY RETURN IT TO US ALONG WITH YOUR STATEMENT OF CHARGE5 T0: .?Cr ?.m..? ARANTY , INC. 14QRj'[{ gT?ABSTR 204 sky,,,ay North American National Bank Compiex Si. Paui, Minnesota 55101 Telephone: 227-9451 : 17'$ On all that tract or parcel of land lyinq and being in Dakota County, Minnesota, described as follows ta-wit: Lot 7, Elock 1, in Slackhawk Hills Additaon SPECIAL ASSESSMENTS ? ? This is to certify that I have examzrced-the--records in the office of the Clerk, Village/City/Township of Eagan I Dakota County, Minnesota, and from such searc certi y t at t e o1 owing specia assessments appear unpaid with respect to the abave degcribed tract or parcel of land: (If-none, write "NONE".) Total Amount Unpaid Originai Subsequent to Kind of Improvement Term Beginning Amount Interest Gurrent Year Street Surf. 10 1976 2696.39 1887.50 Water Area 15 1977 160.00 138.68 Starm Sew Lat 20 1972 5305.45 3448.56 r= _- - ` PENDING ASSESSMENTS I 'I further certify that accor ' s o£ said office, the improvements are cantemplated or pending in council, and are now in of planning or completion: (If none, write "NONE".) Kind of Tmprovement IJQ1VF -c? L'Q ? f 9?8 Z?' following the process Approximate Date af Approximate Cost firmation or Campletion of Improvement Dated this 3 day of Charge 19 7R . Vi3.lage/City/Township of c;tX ()f F. gan *Note: The abave total amounts unpaid subsequerat to current year may be paid between: ,7anuary 2nd and May 31st with no interest June lst and September 30th with 1/2 year interest October lst and December 31st with full year interest hTC-TT l 1 C øó ÿ þ ý ÿþþýüûúüúûü ùýýþþüøûï ç ðçêþý é ð ôà ì ëé ÿþ üûúùø à õ ô ø à ï Ú ï úùø ï üã ü õüòû ç ò õüòû Ú Ü ò ð þ éáñü ùýò é ò î ÷ß æèëèìëé õù ü ð þ å æèè ôóóò ñð øø òÙùò üòûþ÷ ÿ û þ éÛñü õ ð ôàç ùïõ éÿ þ ïõ îí ð ûù ô þ ð ð ä ð øø ð ð ã ò þ òøùôð øø û ãï ü öùãÿ þ â è øø ß ò þ ü ü ùþ ü ñü õ ÿ ÿþ þýýüûúû ùüüýýïñ ê òêçýü ÿðÿôá ìâ þý ýüûúë æ÷ ýüûú ö üûúëúÿ áý ÷ ý ìâìåýúÿû Ý ñýÿ ù ñýÿ æ ò æúÿ ý æÿæ è ÿç þÿ ççôô ý æð ú úú æÿþð ÿ òý òð ú ôÞÿÿ ÿæÿÿ é ý ÿ ÿúÿýæ ú é ÿ êééì ÷ù ý ðÿ ÿ êéé Üÿýÿâþé öúô óò úúÿ ÷÷ ý ç ÿ ÿ ââïðÿðÿçéßÿðÿôá ë ïÿú ÿ ÿïõ îßí ð ûÿô ðÿ ðÿç ÿð ÿúúÿÿ ÿðÿðæ òÿ ÿÿ òúûôðÿÿúúÿÿ æï ÿÿý ÿ÷ûæ ÿ ÿå ÿ é úúÿÞ ò ÿý ýû ÿý ñü ïð ÿ ÿþ þýýüûû ùüüýýïñ ê òêçýü ÿðÿôá ìâ þý ýüûúë æ÷ ýüûú ö üûúëúÿ áý ÷ ý ìâìåýúÿû Ý ñýÿ ù æð ú úú æÿþð ÿ òý òð ú ôÞÿÿ ÿæÿÿ é ý ý ÿ ÿúÿýæ ú é ÷ÿ òè ÿ ñý ûÿô æÿòûðò é ÿ êééì ÷ù ý ðÿ ÿ êéé Üÿýÿþé öúô óò úúÿ ÷÷ ý ç ÿ ÿ ââïðÿðÿçéßÿðÿôá ë ïÿú ÿ ÿïõ îßí ð ûÿô ðÿ ðÿç ÿð ÿúúÿÿ ÿðÿðæ òÿ ÿÿ òúûôðÿÿúúÿÿ æï ÿÿý ÿ÷ûæ ÿ ÿå ÿ é úúÿÞ ò ÿý ýû ÿý PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA126644 Date Issued:09/04/2014 Permit Category:ePermit Site Address: 1620 Blackhawk Hills Rd Lot:7 Block: 1 Addition: Blackhawk Hills PID:10-14380-01-070 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater 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. Dean Kamrath 13791 Jonquil Ln N Dayton, MN 55327 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 - Sara E Sternberger 1620 Blackhawk Hills Rd Eagan MN 55122 Adam's On Time Plumbing & Water Heaters Llc 13791 Jonquil Lane N Dayton MN 55327 (612) 205-6060 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA132402 Date Issued:08/12/2015 Permit Category:ePermit Site Address: 1620 Blackhawk Hills Rd Lot:7 Block: 1 Addition: Blackhawk Hills PID:10-14380-01-070 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Sara E Sternberger 1620 Blackhawk Hills Rd Eagan MN 55122 (612) 309-1706 Pella Northland 15300 25th Ave N #100 Plymouth MN 55447 (763) 355-1300 Applicant/Permitee: Signature Issued By: Signature For Office Use t • Pe /510'SV16 rmit#: * ; t{c2. e Permit Fee: RECipzi777-I Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 TDD: (651)454-8535 I FAX:(651)675-5694 Staff: buildinginsoectionsacityofeagan.corn jin- 1 9 20 18 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 7/11/18 1620 Blackhawk Hills Rd Site Address: Unit#: Name: Sara Stem berger 612-309-1706 Phone.l( 414Resident/ owner Address/City/Zip: 1620 Blackhawk Hills Rd, a*azz4"-MN 55122 ApplicantX is: Owner Contractor Excavate ext foundation wall to tootinginstall drain tile and piaton board,install sump pump and lie in drain tile Description of work: . -1140/t. i) r iern€3-1,r,ea 5 p,7 e 4.61 ace I e_ Type of Work 85X Construction Cost: 6850. Multi-Family Building: (Yes /No ) Company: BRS Enterprises Contact: LynetteWrubel rubel Address8530 Eagle Point Blvd. #100 City: Lake Elmo : Contractor StateMN Zip: 55042 Phone: 920-659-4147 Email: lynette@basementrepairspecialists.com : BC686374 License tt: Lead Certificate#: If the project is exempt from lead certification, please explain why: Age of home 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: Fire Suppression 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-•WOG if u .vide • reasons that would ' it the O to conclude that the are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.corrdsubscribe. 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. CALL BEFORE YOU DIG. Cali 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. wovw.gopherstateenecall.erg 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 Lynette Wrubel Applicant's Printed Name Applicant's Signature ifichiAu) ( N I0� l l / s() 2/7 _, DO.NOT WRITE BELOW THIS LINE / SUB TYPES Foundation Fireplace Porch(3-Season) Exterior Alteration(Single Family) C" Single Family _ Garage Porch(4-Season) Exterior Alteration(Multi) Multi Deck Porch(Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPES New interior Improvement Siding Demolish Building* Addition Move Building Reroof Demolish Interior Y' Alteration Fire Repair _ Windows — Demolish Foundation Replace Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation /�h. o-- Occupancy MCES System Plan Review Code Edition /j Z40/5'- SAC Units (25%_100%)10 ) Zoning J2.– 1 City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction V Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings (Deck) Final I C.O. Required Footings (Addition) / Final/No C.O. Required Foundation ) Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Hood Roof: _Ice &Water Final Pool: Footings Air/Gas Tests _Final Framing 30 Minutes 1 Hour cti Drain Tile Fireplace: Rough In Air Test Final Siding:_Stucco Lath Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall:_Footings Backfill Final Sheetrock Radon Control Fire Walls Fire Suppression: _Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: %6'01 I9 A Li, , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit& Surcharge Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA151443 Date Issued:08/24/2018 Permit Category:ePermit Site Address: 1620 Blackhawk Hills Rd Lot:7 Block: 1 Addition: Blackhawk Hills PID:10-14380-01-070 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 - Sara E Sternberger 1620 Blackhawk Hills Rd Eagan MN 55122 Kaufman Sheet Metal Roofing 2521 24th Ave S Minneapolis MN 55406 (612) 722-0965 Applicant/Permitee: Signature Issued By: Signature -an 6 E AGA N #^{ For Office Use �j}�/ 1(-)j 4, 11 r; .. Permit#: /'--''' vt / c5 % t, Permit Fee: 7 1p Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 FAX: (651)675-5694 Staff: buildinginspections(a citvofeagan.com L 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 10/30/2018 Site Address: 1620 Blackhawk Hills Rd Unit#: Name: Sara Sternberger Phone: 612-309-1706 Resident/ 1620 Blackhawk Hills Rdx Owner Address/City/Zip: Applicant is: X Owner Contractor Type of Work Description of work: Replace existing deck Construction Cost: $30'000 Multi-Family Building: (Yes /No X ) Company: Contact: Contractor Address: City: State: Zip: Phone: Email: License#: Lead Certificate#: If the project is exempt from lead certification, please explain why: c_/ 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: Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the Information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. 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. 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.gopherstateonecallorq 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,andis 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 app • a'if plans. x Sara Sternberger Applicant's Printed Name • icant's Signature DO NOT WRITE BELOW THIS LINE )6 £ g2 ,„4,fi1gi - H rII 'GI SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) _ Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) _ Multi )4 Deck _ Porch(Screen/Gazebo/Pergola) — Miscellaneous _ 01 of Plex — Lower Level — Pool Accessory Building WORK TYPES New — Interior Improvement _ Siding _ Demolish Building* T Addition ^ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair Windows _ Demolish Foundation Replace _ Repair T Egress Window _ Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation q p I 3t9 Occupancy fklit, ` MCES System d Plan Review Code Edition 1,,, \) ),,0 C.4' SAC Units (25% 100%\i ) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction V 0 Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: X Footings(Deck) Final/C.O. Required Footings(Addition) X Final/No C.O. Required Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Hood Roof:_Ice&Water _Final Pool:_Footings Air/Gas Tests Final Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test Final .Siding: Stucco Lath Stone Lath Brick—EFIS Insulation Windows Sheathing Retaining Wall:—Footings_Backfill Final Sheetrock Radon Control — Fire Walls Fire Suppression: Rough In_Final — Braced Walls Erosion Control — Shower Pan Other: — Reviewed By: "1/ , Building Inspector RESIDENTIAL FEES Base Fee SurchargeriTi'IN'. il‘dil Plan Review P &pLj,JL/ MCES SAC City SAC Utility Connection Charge ---, g / 3-6 S&W Permit&Surcharge ( .\-/ ( Treatment Plant Copies TOTAL Page 2 of 3 Property Map /c. -90-D-- \ 1600 1596 1625 1592 1588 1650 ,y 1615 1.6 ' 1605 '5+ 1595 1640 /Po o ri il ()rvecey .—_,., F'<141)161 OPIP N. ir moose. \ • � � 1610 . i ' 1620 / 1 - lv / SC7 41411 ��` _ vievei r-------------------____ , \\(1)\.I\ ,-,: 7.0.4/ October 30, 2018 5a r c_. ,3�6p r,0 l�_1 eiV' 1:2,257 PLS Lines 0 0.0175 0.035 0.07 mi 16 I; 14tc 1��A�,)K 01.(Is C<. i I , t Sixteenth Line o 0.03 0.06 0.12 km Meander Line Parcels Map data©OpenStreetMap contrbutors,CC-BY-SA Dedicated Right of Way Water Dakota County Dakota County PERMIT City of Eagan Permit Type:Building Permit Number:EA159736 Date Issued:01/14/2020 Permit Category:ePermit Site Address: 1620 Blackhawk Hills Rd Lot:7 Block: 1 Addition: Blackhawk Hills PID:10-14380-01-070 Use: Description: Sub Type:Fireplace Work Type:Gas Fireplace (new) Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 L Taylor 1620 Blackhawk Hills Rd Eagan MN 55122 (952) 492-9276 Glowing Hearth And Home Llc 100 Eldorado Dr. Jordan MN 55352 (952) 492-9276 Applicant/Permitee: Signature Issued By: Signature