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1640 Blackhawk Hills Rd 01/13/2011 21:38 6519948701 JANECKVPLUMBING PAGE 01 Use BLUE or BLACK Ink I---- + ` Permit j Gt of Ea I Permit Fee:-~ 38$0 Pilot Knob Road ll(J~ I I ~ l]ate Received: ; I Eagan MN 551x2 I Phone: 1;651) 675-5675 staff: \ - ^ _ I Fax: (651) 615-5694 ` - - r 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION ~ `(f sire Aadrass- / C.D ~ ~6~c ~ G'1v~'t~ _ r° ll ~ ' Date: _ - Suite Tenant: RESIDENT l OWNER Name: Phone: Address / City I Zip: CONTRACTOR Name: --71 "1'1-ec L1 1 -~t q Address:`!~U C1Ys' 1- City:lG~`/tc~L)~ ,1~'~i I~ U Phone: G ~ `7 C? ` 7 State: Zip=~`'~ ,~.~/1 ~ >l Contact: Ur ~1,?c l Email: Lu(~ UTC= ~ A yt e o /'1')S A lF~1~ 'TYPE OF WORK ^ New Replacement _ Repair Rebuild Modify Space - Work in R.O.W. Descri tion of work: PERMIT TYPE RESIDENTIAL Water Softener Water Heater Lawn Irrigation RPZ/ PVB) 4K Add Plumbing Fixtures Main / Lower Level? Water Turnaround Septic System New Abandonment RiESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.0o State Surcharge) $35.00 Lawn Irrigation (includes $5.00 State surcharge) $55,00 Add Plumbing Fixtures, Septic System AbandQt~~, Water Turnaround" (includes $5.00 State Surcharge) "Water Turnaround (add $166.00 if a 5/0" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $15,00 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) L, TOTAL FEES $ CALL_BEFQRE YOU-00 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.ttopherstateol~l.nrg. 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 ht tale Case of work which requires a review and approval of plans. ) D-A rd JO-rvet wl x Applicant's printed Name+ Applicant's Si m Fdswomo .USE f t i~We 1 i1► I 0; ,f~.ilait*:, Itf Itrlyd,ln 1 Ji°ieii C t~Y1t I iOktc~114 . ,,,,,,:.i IC'Y+ $t' Use BLUE or BLACK Ink F--------------- I for Office Use I 6? J 7 j Permit j City of Ea n R1 PermitFee: / w 3830 Pilot Knob Road I I Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 I I Fax: 651 675-5694 1 Staff: I 2011 RESIDENTIAL BUILDING PERMIT APPLICATION / Date: -~l Site Address: 14p_ 6/~L S 9 Tenant: Suite RESIDENT / OWNER Name: C- E 6 ,Td a,8/,ll Phone: ~l `-1165 Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work: lG.~ A6Z4?W 1A,9 Tf>~ dl T-F'~,~ZL J1!'! / iN Construction Cost: Multi-Family Building: (Yes / No ) CONTRACTOR Name: f~?yZ License Address: ~fZ'X44: State: AW Zip: J~77 Phone: - l ~S ~~/off S Contact: /T G L~ Email: 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 the 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.org 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 Ian in the case of work which requires a review and approval o tans. x E X '41 A plicant's Printed Name p is t•s Sig e Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUB TYPES - Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage - Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of _ Plex Lower Level _ Pool _ Miscellaneous Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior 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 Occupancy MCES System Plan Review Code Edition SAC Units (25%_ 100% j/) Zoning City Water Census Code y~ Stories Booster Pump - # of Units =y Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: _ Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee 73 ~i 67 3 Surcharge Plan Review Ai 7 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: Mechanical 3830 Pilot Knob Rd Permit Number: EA091707 Eagan, MN 55122 . Date Issued: 10/21/2009 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 1640 Blackhawk Hills Rd Lot: 6 Block: 1 Addition: Blackhawk Hills PID 10-14380-060-01 Use Description: Sub Type: e - Furnace Work Type: New Description: Furnace Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, 952-445-2840 Nicole Whitley 2200 W Highway 13 Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088 Surcharge-Fixed $0.50 9001.2195 Total: $50.50 Contractor: -Applicant - Owner: Gem Ryan Plumbing & Heating Mary J Robinson 2200 West Highway 13 1640 Blackhawk Hills Rd Burnsville MN 55337 Eagan MN 55122 (952) 767-1000 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 INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 1` 1 f s It I fit` 3830 Pilot Knob Road Permit Number: 0"w' I `f Eagan, Minnesota 55122-1897 Date Issued: cr we ` (612) 681-4675 SITE ADDRESS: 1 `"j o t' 0 0 1 APPLICANT: 1 01 is1 of T- 1 A r. ! ti` { ) !1r i EiFtl It f! r I i {;!t ( N' 1611.! ttt s" 1,14 tIF►:`F Fitt' 11+ 4 }l6;llt~ Ett1 t t~•1 't ':~;"R~/ PERMIT SUBTYPE: TYPE OF WORK: t}41 N111 INSPECTION TYPE .DATE INSPTR. INSPECTION DATE INSPTR. f 11111 114ts'. F' Penult No. Permit Holder Date Telephone M ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG ~3ar DECK FINAL 7 INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: ► " : 1+" r1 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: 1 , ,1 1 , 1 0 ! APPLICANT: PERMIT SUBTYPE: TYPE OF WORK: 1 ~ t`I ~ ' ~ . s l i c l~ rl r (f1 Pd It; I I,01+4 I1`4A it it I,rtP1`4~RA11li ! I rim 1 lot; 1., , i id,, 1 1, t i+": jltlr' 1' 1 11h~)}, 1 V41, 1W I { t I I" 1 t Al 1,W1;F 711 y ~fJ fix, a Permlt No. Permit Hoklor Date Tdaphons # PLUMBING HVAC ELE v y Odo ELECTRIC kwpeotion Date Insp. Foal+ngs I G A`► r -4,42 "r-S Foundation Framing Roofing / Y Rough Plbg. G Rough Hig. Isul Zip Fireplace Fk* Htg Orest'T101 Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter EngrJPien Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. :F . CASH RECEIPT CITY OF EAGAN P. O. BOX 21-199 EAGAN, MINNESOT -55121 -i C1ATE 19 ItUCEIVED ~C, fe.... _ ♦."'/lam" FROM F ` AMOUNT is DOLLARS too ❑ GASH ❑ CHECK FOR , '4 FUND CODE - AMOUNT d / .t/u 7d 50- ,'~.1. y- odd S ~ 'Y de %-Vl- c, ~f R ]p. ~--c1 Than -ou /;7- EY + r'4:-( 47377 1NWEU ION REUOlil) CITY OF EAGAN PERMIT TYPE: flit I 1 `)1 NC 3830 Pilot Knob Road Permit Number: 0142749 Eagan, Minnesota 55122-1897 Date Issued: ~f (612) 681-4675 SITE ADDRESS: ' 1 0 1 , t+ 1, f K : I APPLICANT: 11.145+ if 1. At I,k!At.3K II'! I t ' tc1I t.!f',,. 't'ItpM C1• d)AR St)PP, { Y 'II A+ F IIAt III, ;ItI I" ~ 1:t?) 1~4A- X1 87 a PERMIT SUBTYPE: TYPE OF WORK: HAM("-101 RUPAiR 1~1' ;(:Fi1P'i it)FI T.,O. AND 'RFROOF I<titlF I N~~ 1 TI Permit Holder Date Telephone # PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING a ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 lot PHONE: 454-8100 .;x B", , HERMIT Receipt # RIL.-MOVING To be used for Est. Value ~2'6S0 Date ZS Site Add ess i KACXUW HILLS RD Lot Block Sec/Sub. OFFICE USE ONLY Parcel NO. Occupancy FEES " Zoning DIM GRMMR W Name (Actual) Const Bldg. Permit S4*00 3 Address tAllowable) Surcharge t e City LUM Phone # of Stories Length Plan Review, DICK ROSY' S NUMMU : R Name Depth SAC. City G~ 11, K" AVE 3 Address S.F. Total o SAC. MCWCC City Phone S.F. Footprints On Site Sewage Water Conn V L5 Name On Site Well Water Meter Address MWCC System i 00 Acct. Deposit <W City Phone City Water - 1- 11 PRV Required S/W Permit I hereby acknowlege that I have read this application and state that the Booster Pump SM Surcharge information is correct-and agree to comply with all applicable State of Minnesota Statutes andtilylok Ea a C}rdin . Treatment PI v i.r Y" . w Signature of Permitee f ~J APPROVALS Road Unit DICK !1 OSY' S R2111113DBLING Planner A Building Permit is issued to: 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_ Variance TOTAL Building Official + ' ' Psrmk tto. Pam+it Holdw Dabs Tdephons # WATER SEWER PLUMBING H.YAC. ELECTRIC Mapwam Date Insp. Comments FoofiW I Foundalion Framing Rooitg 7 Rough P%g. Rough Hig. imww. Fireplace Final Hf. Final Plbg. Const. Mkster Pllog. Inspector - Notify Plumber EtWdPlan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. Receipt ` MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee. Fill in numbered spaces SIC Type or Print legibly Tot. y P _ 1. Date 2. Installation Cost f 3. Job Address 31; 7.5 ~c i%., al Lot t Blk.! Tract; 4. Owner ` u:SA 1.~*►'. t_ N S. Contractor s l o HLA s.~ tlC Phone 6. Address 7. City ()AK.0r• U- State t 00 I Zip S51 Building Type: Residential fit Commercial ❑ Institutional O 9. Work Description: New C Add ❑ Alter ❑ Repair ❑ 14. Describe - Fuel Type "T r►5 11. No. Squinment BTU . M. Ea. No. Equipment CFM Forced Air Air Handling: Mfg.. n,~ A Itb; Boilers Mech. Exhaust ' BPtTI4cc~r~r~~, . t Unit Heater G X KAuS Mfg. Other Air Cond. t Mfg. c:?. q Gas. Piping Outlets j i . I horse ew, tilt *e *09, iakmasion Is true earrac% at I avat' a . ts, ig1y M ordiltanees•and dad" pvernfiVVft i"'m of. w . w r►r for pint 1 agww, Date moat. tie.... _ 11"IL T -W h•VOLir permit t*eri ftvAliered and approved: k ` n 0W OF fi~, 4"" t a: • ,a<,weie.c ~Sa$Mp;'a~~C,z_..13.wY..~.Rs.~tiaE U;i CITY OF EAGAN Remarks Addition /Blackhawk Hills Addn. Lot 6 elk Panel 0 14380 060 01 Owner Street 640 Blackhawk Hills Rd. State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. L 1976 23270.30 227.03 10 STREET RESTOR. GRADING SAN SEW TRUNK a~f 1970 355-37 14.21 2 Paid SEWER LATERAL 1972 13 .10 206.91 20 Paid WATERMAIN WATER LATERAL 1972 20 WATER AREA * STORM SEW ,RKlat, 1972 FIS STORM SEWgM TRK L, 1983 1108.00 73.87 1108.00 0007745 7-23-82 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 320-00 8814 19-17-73 BUILDING PER. SAC 375-00 8814 8-17-75 PARK ~yv REGUEST OR ELECTRICAL INSPECTION Ee-ooo-o C 7/411 ► See instructio for oompletiry illis form on back oTyeltovu py. L , 9" F 74 31 "X" Below Wrn1s= o ed by *his equest e TypeofBuilding Applian 9W'Ired EquipmentWired me Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer her (Specify) C dustrial Furnace Farm Air Condi' er Other (specityj Coraractors a rks: Comp to Inspection Fee Belo : 'It I # Other Fee rvice Entrapce ize Fe Circuits/Feeders Fee wimming Pool 0 to Amps 0 to 10o Amps ansform rs Abov 0 Am S Above too Amps S ns Ins ` Use only: TOTAL Ird at n Booms Alarm 6mm_unicati Other Fee I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final Date_ been made. ` OFFICE USE ONLY This request void 18 months from = 7 4 319 N 6 t? r< t.~ ~C~oa Request Date Fire Rough-in inspection 'VI Required? ❑ Ready Now Till Notify inspector - / V ❑ Yes PKNo when eady? I Licensed contractor ❑ owne reb request inspection of a ve electrical work at: Job Address (Street, Box or Route No.) / city D l Ac ,/J ~ ~v SW n No. ` Township Name oq No. Range o. County Cimpa (PRI Phone No. wer Supplier dress lectrical Co tr or (Company (acme) Contractorls License No. A*AAeAs / M ling d ss (Contractor or Owner Making Installation) `v r /4J0 . X/ 55C1,2-3? Authorized ignature (Contractor/Owner Making Installation) Phone Number l/.b - !;So 3 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Grigga-Midway Bldg. - Room 5.173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642.0800 ENCLOSED. a EAGAN TOWNSHIP BUILDING PERMIT N? 3109 Owner L• . . Eagan Township Address (present) ........~i u ,rlrl~rx. Town Hall Builder e.Y.A10CA. /~~.I AA Data Address DESCRIPTION Stories To Be Used For _Front Depth Height Est. Cost Permit Fee Remarks f6 /2 2 LIT- LOCATION h Street, Road or other Description of Location I Lof Block Addition or Tract ~b 6 ~t This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BEEPT ONCE REMISE WHILE THE WORK IS IN PRO S. kA rvw~ . --671 ...................has permission to erect a upon This is to certify. that..... the above describe remise stitbject to the provisions of the Buildi finance for Ea T wns p adopted April 11, 1855 a ` Per _ Cha' man of Tnwn Board Building Inspector .e I - ~~aoo Request Date Fi Rough-in Inspection Required? ❑ Ready Now KWill Notify Inspector -1 ya ❑ Yes XNo When Ready? I licensed contractor ❑ own ereb request ins action of a electrical work at: Job Address (Street, Box or Route No. City D t mil/ Se Ion No. TNo. Rang No. County O Ta becupant T) Phone No. 00 N -S ' 4/ 365 Power Suppii rasa Electrical ctor (Comps Name) Contractor's License No. l4 _O y~L0 F M V Are (Contractor or Owner Making Installation) ~J r rL; r 64016,2- Authorized Signature (Contractor/Owner Making Installation) Phone Number ~.2p S X03 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 Unkw ty Ave., SL Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (812) 842OBW ENCLOSED. 7/~ 41D REQUEST FOR ELECTRICAL INSPECTION AMN EB-00001-07 ► See instructions for completing this form on back of yellow y. 9M19 1.9 6 "X" Below Work Co red by Thi equest New A d Rep. - Type of Building Applian Wired Equipment0red Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer her (Specify) ustrial Furnace Farm Air Con ner Other (specify) Contract rt; arks: Com ute Inspection Fee Bel w: # Other Fee # rvice Entr nce ize ' F e # Circuits/Feeders Fee wimming Pool O t 2 Amp LeNO to 100 Amps transformers Abov 00 s Above 1400 Amps gns In or's Use Only TOTAL Irr ation Booms 2,15 a c Inspection Spa Alarm/Co,-Mat Other Fee Rough -in I, the Electrical Inspector, hereby n certify that the above inspection has Final been made. OFFICE USE ONLY This request void 1a months from VILLAGE OF EAGAN 3795 Pilot Knob hoad Eagan, Minnesota 55122 PERMIT NO._ 429 The Village of Eagan hereby grants to Kjaye ueatina & A/C 043075 Pioneer Trail. Eden Prairie, MN 55343 a „ygT_Tj3C; Permit for: (earner) HaM Linden at :64o nijgkhawc jjjjj_S Dried pursuant to application dated 10/3/73 Fee Paid: S20.00 dated this 17th day of October , 19 73. .50 S/c Building Inspector Mechanical Permits: Bid Total: VILLAGE OF EAGAN 3795 Pilot Knob A.oad Eagan, Minnesota 55122 PEMgIT NO. 392 The Village of Eagan hereby grants to $ y CD,stM,nti n Co. of Lamm, M=dQ4-- Ha=qbtJ's MR 55120 a Permit for: (Owner) ga_r_ry Li ddn at , pursuant to application dated 9/18173 • Fee Paid: $3A.00...- dated this lg~h day of Sept, , 19 73 .50 a/c Building Inspector Mechanical Permits: Bid Total: CITY OF EAGAN No 18807 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454-8100 Receipt # I~ f RE-ROOFING Est. Value $2,850 Date MAR 25 , 194L. To be used for Site Address 1640 BLACKHAWK HILLS RD 6 Block 1 Sec/Sub. BLACKHAWK HILLS OFFICE USE ONLY Lot Parcel No. Occupancy FEES Zoning - W Name BOB GRAZIGER (Actual) Const Bldg. Permit 54_ nn 3 Address 1640 BLACKHAWK HILLS RD (Allowable) Surcharge 1.50 EAGAN 452-6365 # of Stories City Phone Plan Review Length o Name DICK ROBY' S REMODELING Depth SAC. City u< Address 7208 JAMES AVE S S.F. Total SAC, MCWCC City RICHFIELD Phone 869-6024 S.F. Footprints - On Site Sewage Water Conn 1 W Name On Site Well Water Meter F3 Address MWCC System - 013 Acct. Deposit W City Phone City Water - 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 co and agree to comply with all applicable State of V Minnesota Statutes an it f Eag Ordi ` Treatment PI Signature of Permitee U L APPROVALS Road Unit A Building Permit is issued to: DICK ROBY' S REMODEL.ING 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 Variance - TOTAL 55.50 Building Official WATER SERVICE PERMIT Knob Road PERMIT NO.: _ 1308 Eagan, MN 55122 DATE: 9118/73 Zoning: R-1 No. of Units: 1 Owner: =Ar=__Lindett Address: Site Address: x._1640 Bl Wk,-h4 k Hi11S Rd. L6-B1. , 7 Plumber.H & L COnSt. - I Arry Linden Meter No.: Connection Charge: 20. 0 P Size: Account Deposit:. Reader No.: Permit Fee: _].0.40__pSl_9/1$113 I agree to comply with the Village of Eagan Surcharge: .50 Pd 9118/73 Ordinances. Misc. Charges: Total: BY Date Paid: Date of Insp.: Insp.: VILLAW QF EAGAN SEWER SERVICE PERMIT 3795 PHU Knob Rood PERMIT NO.:. 2073 Eagan, MH 55122 DATE: 9/18/73 Zoning: -B--1 No. of Units: 1 Owner: Hdrr'Y Linden - Address: Site Address: -16-4.0 B14Ckhawk Sill_s_IRd_L6-B1 t_~iar Linden Plumber: H & L Cons 1 agree to comply with the Village of Eagan Connection Charge: 375.00 pd 8/17/3 Ordinances. Account Deposit: - Permit Fee: 10- 00-Pd-- VIV-73- Surcharge: By: Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: S9 18/ ~ ~v Request Date - ire No. Rough-in Inspection NOTICE: You Must Call Electrical Inspector n _ R wired? If A Rough-In Inspection y1 (F/ Yes F-1 No Is Required. I O*ensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) City (c- /3L-14C K Section No. Township Name or No. Range No. County Occupant (PRINT) Phone No. Power Supplier Address Electrical Contractor (Company Name) Contractor's License No. /--a-'e (_i-rt ~ CA Mailing Address (Contractor or Owner Making Installation) (ll1 I LL- i A l fl. Authorized Signature (Contractor/0 r Making Installation) Phone Number MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. Y/~V ~ REQUEST FOR ELECTRICAL INSPECTION -4 EB-00001-08 ' See instructions for completing this form on back of yellow copy. M 7 9 918 11o X" Below Work Covered by This Request YY-v New Ada• Rep. - Type of Building Appliances Wired EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contractor's Remarks: P~ t T f~ C : r f Compute Inspection Fee Below: 1, %k < r c ` ~'3 # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps - --10 to 100 Amps Transformers Above 200 Amps , A ove 100 Amps Signs Inspectorls Use Only: d TOTAL Irrigation Booms L,(" 1~0 Special Inspection Alarm/Communication THIS INSTALLATION Y BE RVD DISCONNECTED IF NOT Other Fee COMPLETED WIT Ali I, the Electrical Inspector, hereby Rough-in , r4w Date certify that the above inspection has been made. Final ti Da e~ y>r~ - OFFICE USE ONLY This request void 18 months from wpp-. VILLAGE OF EAGAN SEWER SERVICES PERMIT 3795 Pilb Knob Road PERMIT NO~1H-- Eagan, MN 55122 DATE- 9/18 ~ Zoning: _-R-l No. of Units: Owner: _ _-Har+ rr 1 i nd@i1 Address: Site Address: H r. c'onst,_ HarYV L~*'~° Plumber. 375.40 pd 8/17/3 1 agree to Comply with the Village of iEogaa ConneetiM Chime: Ordinances. Account Deposit: Permit Fee: ~...0-- O 11 R/~: -W-- ' - Surcharge: By: Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: j j' VILLAGE OF EAGAN WATER SERVICE PERMIT 3795 Pilot Knob Rood PERMIT NO.: - -_1308 Eagan, MN 55122 DATE: 9/18/73 - Zoning: _ R-1. - - - No. of Units: - --1 - - Owner; - -wry LindetlL-~_-- - Address: Site Address: M 1640 Bl h Bi]4 L6-81 Plumher H _ & L COnst.r Hiii ; LUA&- - Meter No. a ~ Co S Connection Chargd20.0 Size: Account Deposit: . Reader Nn-~" ! 7 ®s~! Permit Fee:. _10.00_ Vd-91181Z3 1 agree to comply with the Village of Eagan Surcharge: d 9f 18 7 Ordinances. I I Misc. Charges; - Total:.__. U By t------ Date Paid: at o ' n Insp.: - - RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 New Construction Requirements RemodeVReoair Requirements Office Use Only 3 registered site surveys showing sq. fL of lot, sq. ft. of house; and all roofed areas 2 copies of plan _ Carl of Survey Read (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions -Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks _ Tree Pres Not Reqd 1 set of Energy Calculations Addition - indicate ff on-site septic system _ On-site Septic System 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail Options selection sheet (bldgs with 3 or less units xk Date JUN-1-9-2003 _ ^^Construction Costalav# , xs~ Site Address 1690 L L m _s Unit/Ste # 1 Description of Work c• r J'~Q r V GI bhP c 7 o Multi-Family Bldg - Y - N Fireplace(s) - 0 - 1 - 2 Property Owner (5~Q C rJ n Telephone # (GS 1 ) Li J 5 - Z9 Contractoft~~ i A flMLRNG ~aItiI41~B1IN(' Address 4100 EXCELSIOR BLVD. City State ST. LOUIS PARK, MN 55416 Zip Telephone # i 2 ) ~Z3' J LI G COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateizoly 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (4 submission type) Submitted Submitted Energy Envelope Calculations Submitted Licensed Plumber Telephone # ( ) Mechanical Contractor Telephone #i _ Sewer/Water Contractor hone # ( f I hereby apply for a Residential Building Permit and acknowledge Lhgt, 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 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 approved plan in the case of work which requires a review and approval of plans. C, iA Applicant's Printed Name pplic 's Signature J OFFICE USE ONLY Sub Types ❑ 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 (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg_Y or _ N ❑ 25 Miscellaneous Work Types ❑ 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) - 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 _ HVAC Drain Tile Other Roof - Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests -Final Framing - Siding _ Stucco _ Stone Fireplace _ R.I. -Air Test -Final - Windows (new/replacement) Insulation _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total PERMIT # sn' d FiI1A' } al'► i' aaa/~li' BAGM Please complete for single family dwellinge, tovaft ms and combs when pm to >t>r f"uimdU each badcflow preventsr for Irrigation system SITE ADDRESS: .N OWNER NAME:. U, 99A 7ELEPHOIiEEAt INSTALLER NAME: TELEPMN M. STREET ADDRESS: CITY: erlsp STATE. _ SEPTIC SYSTEM, newlr*furbWW (requires two.so% of plans and UPC Iit se) ~ ~ Cttw includes $40.00 County fee Note: Additlonal Ott tees may. apply ~ • MODIFICATION/ALTERATHM To EWTIMfi DWELLN~ UNIT, INCLUDNM t , ~ r :x 1. Adding fixtures to bwer levels or room additions, excluding water sof omm and w#i A Mots: x.00 Abandonment of eeptic 8y$toigf- Water turnaround *xWM dwelling unit 5V meterVneeded - $118) Other: I DFc 41 RPZ: new instaliationlr"ir/rebuld S f 3p.(If1 _ lawn irriclatim, aptern j - . l Replacment/additicinal: water so8ener ,.vier heater . State Surcharge T1" I hereby O&JO ledee that i heave read tMe applea ftn, slue #W ft h*rmaUcmis corred, and agree ic►' p +A ail tr h is the applicenrs respornlti ty iD no* the property ov #W the City of Eften assurroes no Nability6 0vAwd, operadonal and maertenanom eedvWn b ft facititles wiWaded unatr thris permit pr~af [ . AP S ow t RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construction Requirements ftmodetfReaair ReauiremeMs `Jr 3 registered site surveys showing sq. It. of lot, 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 seared by septic system for additions • 3 copies of Tree Preservation Plan if lot platted after 711193 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE r 3 - VALUATION S2 n SITE ADDRESS L1O lGG ]1a~1/1)~ 1~ l 1~s MULTI-FAMILY BLDG _.,.Y N TYPE OF WORK yt~7~t an 1 y rLl FIREPLACE(S) _ 0 - 1 _ 2 APPLICANT 9V AROOFING & REMODELM INC. STREET ADDRESS 4100 EXCELSIOR BLVD. CITY STATE ZIP 1 erg 16 L4 - TELEPHONE #ID #~lWHONE # FAX # 1 1A PROPERTY OWNER C f~_ p I~ `t S 6 il-\ _ TELEPHONE # 15: -2 51 5.6 COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category MINNESOTA RULES 7670 CATEGORY I MINNESOTA RULES 7672 (d 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 - F e:' 00.0 r Water Heater No. of R.I. Baths GAT 3 0 ~;0?' No. of Baths U Mechanical Contractor: Phone # E - Mechanical system includes: Air Conditioning Fee: $70.00 Heat Recovery System 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 Ordinances. Signature of Applicant OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received Not Required Updated 4102 OFFICE USE ONLY ❑ 01 Foundation C7 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 AccessoryBldg ❑ 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-plex ❑ 12 12-plex Plbg Y or - N ❑ 25 Miscellaneous ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 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 _ 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 (newlreplacement) insulation Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MCIES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total CITY USE ONLY S~ PERMIT RECEIPT DATE: 2002 RESIDENTIAL MECHANICAL FERMI' APPLICATION crrY oiF EAeAN 3830 PaoT KNOB RD IEAGM MN 55182 651-681-4E675 Please complete for: ➢ single family dwellings townhomes and condos when permits are required for each unit Date: I 'lJ~ 1 t(S SITE ADDRESS. l(~ l r-~ 11~1.o K C-6 -e*4 OWNER NAME: L)u I& J TELEPHONE* INSTALLER NAME: lam' TELEPHONE* V;Pq 1 STREET ADDRESS: 7 S - Cc%a't CITY: STATE: rLy~_ ZIP: Place a check mark next to the permit work type Add-on, modification or alteration to existing dwelling unit • furnace replacement • air exchanger P EP 19 2002 • air conditioner • other Nature of work: State Surcharge $ .50 Total SIGNATURE OF PERMITTEE 1/02 PERMIT ` CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: BUILDING ' Eagan, Minnesota 55122-1897 Permit Number: 028614 (612) 681-4675 Date Issued: 08/22/96 SITE ADDRESS: 1640 BLACKHAWK HILLS RD LOT: 6 BLOCK: 1 BLACKHAWK HILLS P.I.N.: 10-14380-060-01 DESCRIPTION: Building-Permit Type DECK Building Work Type NEW " Census Code 434 ALT. RESIDENTIAL REMARKS: FEE SUMMARY: Base Fee $45.00 Surcharge $.50 Total Fee $45.50 CONTRACTOR: - Applicant - ST. LIC.OWNER: RENSLOW'S DECKS-N-GAZEBOS 17739707 0008209 GRAIZIGER STACEY 1746 E COUNTY ROAD B 1640 BLACKHAWK HILLS RD MAPLEWOOD MN 55109 EAGAN MN (612) 773-9707 (612)773-9707 I hereby acknowledge that Z have read this application and state that the informs ion is correct and agree to comply with all applicable State of Mn. Statut an City of Eagan Ordinances. APP IC /P LTEE SIGNATU ISSUED B SIGNATURE r- / CITY OF EAGAN / ~S SAO C 3830 PILOT KNOB RD - 55122 1996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Construction Renuirements Remodeltftak Reauirementa ♦ 3 registered site surveys ♦ 2 copies of plan ♦ 2 copies of plans (include beam iii window sizes; poured fnd. design; etc.) * 2 site surveys (exterior additions & decks) ♦ 1 energy calculations ♦ 1 energy catcutaWns for heated additions ♦ 3 copies of tree preservation plan If tot platted after 7/1193 required: _Yes _ No DATE: l =,/X UCTION COST: DESCRIPTION OF WORK: STREET ADDRESS: LOT BLOCK 1 SUBDJP.I.D. r PROPERTY Name: Phone OWNER Street Address -tijlr City: e4 Q A/,-V State: ` Zip:.-- CONTRACTOR Company:' Phone ,c.s~j ! ~70:Z W6 / Street Address: I W6 E 11,16 11,16 A- VA License # OCAJ ~.L~? .L- City: kO44 1A,-),1)e-d State: Zip. ARCHITECT/ Company: Phone ENGINEER Name: Registration # Street Address- - City: State: Zip: Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. hereby acknowledge that I have read this application and state that the inform lion is correct agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY R E COV E D Certificates of Survey Received Yes No A 6 1 96 Tree Preservation Plan Received Yes No r ' - - - - - OFFICE USE ONLY BUILDING PERMIT TYPE 0 01 Foundation o 06 Duplex o 11 Apt./Lodging o 16 Basement Finish o 02 SF Dwelling a 07 4-plex o 12 Multi Repair/Rem. o 17 Swim Pool 0 03 SF Addition o 08 8-plex o 13 Garage/Accessory o 20 Public Facility 0 04 SF Porch o 09 12-plex o 14 Fireplace o 21 Miscellaneous a 05 SF Misc. 0 10 __7plex 15 Deck WORK TYPE W 3~ 1 New a 33 Alterations o 36 Move a 32 Addition o 34 Repair o 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MCNVS System v (Allowable) Main level sq. ft. City Water -'s UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code J Census Bldg Census Unit APPROVALS Planning Building ftl& Engineering Variance Permit Fee Valuation: $ !Z °U - Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SAN Permit SNV Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units ~I mi inn- l >i REALTORS-MLS 47A SIGNAL HILLS-ST. PAUL, MINNESOTA 55118 PHONE: 227.8401 "RED" Outline Depicts Subject OFFERS FOR SALE (SKETCH - NOT A SURVEY) s ty:,' ~J~ a :+e+e $ o = r61 b• •n ~ ~ ' • 'S e 1 Sri ,q D a r ,r0 S i~~i JJT~OT r- ! + y p~~. t2 5"AC KMAwK My4LS ROAD SO, 45 a r " > r t . ~ CTOYr LOT 2 0-< "✓L \ to ~ f- LOCATIONS Eagan- Township~ ZONING a Residential 5 ~ IF1PROVEMENTS : \X -.Sewer and water in street OTHER- INFORMATION: P b~ CHOICE BUILDING LOTS In street ` SPECIFY WATER AND SEWER $ 20,-900.00 INFORMATION FURNISHED REGARDING PROPERTY FOR SALE OR LEASE, FROM' SOURCES DEEMED RELIABLE: BUT NO WARRANTY OR REPRESENTATION Ir,ADE AS TO ACCURACY THEREOF AND SAME IS SUBMITTED SUBJECT TO FORS. OtAISSIONS, CHANGE OF PRICE, RENTAL OR OTHER CONDITIONS, PERMIT CITY-01F EAGAN 380 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 3 3 0 8 0 (612) 681-4675 Date Issued: 08/31/98 SITE ADDRESS: 1640 BLACKHAWK HILLS RD LOT- 6 BLOCK: 1 BLACKHAWK HILLS P.I.N.: 10-14380-060-01 DESCRIPTION: REROOF/STORM DAMAGER Building Permit Type STORM DAMAGE Building Work Type REPAIR Census Code 434 ALT. RESIDENTIAL REMARKS: FEE SUMMARY: CONTRACTOR: - Applicant - ST. LIC, OWNER: WESTURN CEDAR SUPPLY 15410304 20014207 GRAIZIGER ROBERT 705 N HWY 169 1640 BLACKHAWK HILLS RD PLYMOUTH MN 55441 EAGAN MN 55122 (612) 541-4207 (651)688-7079 I 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 Mn. Statutes and City of Eagan Ordinances. APPLICANT/PERMITEE SIGNATURE SUED BY: SIGNATURE 1998 BUILDING PERMIT APPLICATION CITY OF EAGAN aa30 PE.os xROS Rn - saxes 6si•as's New Constructim Reauirnneft - 3 J) ♦ 3 registered site surveys • 2 copra of plan ♦ 2 copies of plons ('include beam & window sites: poured Ind. design; etc.) • 2 ales w days (wftr* addieiolar ! 1 energy calculations ♦ tenergy for lreatiod.ai • 3 copies of tree preservollon plan if of ptatbed after 71!/93 required: _ Yes _ No DATE: fiU6. 2,719-1? CONSTRUCTION COST.', DESCRIPTf FWORK STREET ADDRESS: IG~ ~t LOT. ~O BLOCK: SUBD./P.I.D. CO- i z t Name: Z[ Phan PROPERTY Last First OWNER y Street Address: / ! ~ * Q64a, ffwul4l #/441- city ~ti lq'N State: hw s Zi•'' Company: _ %5 YZLUI Phone 52L10 4 CONTRACTOR ~r Street Address• l Lic ems City 21-1 - !YlH State: zip: ~w...,:~......_. ! - ARCHITECT/ ENGINEER Company: Phone Name: R Street Address: City State: Zip: Sewer & water licensed plumber (new construction ony): by 8pR dWa and lot change is requested once pamtit is issued. I hereby acknowledge that I have mad this application and stale that the Inbrrni MOM Is and. agree 0,ca t gy with all ap e! State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFMCE U$E ONLY AUG 2 7 00- Certificates of Survey Received Yes No 10 III- Tree Preservation Plan Received Yes No Not Req OFFICE USE*NLY BUILDING PERMIT TYPE ❑ 01 Foundation 0 06 Duplex O 11 AptAmdging 0 1$ :BasernyeM Finish JW 02 SF Dwelling C] 07 4-plex D 12 Mufff Repatam. 11 17 Swim Pool ❑ 03 SF Addition O 08 8-plex O 13 Gan Wftc ory► 'Cl 20 Pt"le Feel G#y - O 04 SF Porch 0 09 121:4ex ❑ 14 Fireploae 0 21 MisoegnrWous D 05 SF Misc. O 10 _-Plex Q 15 Deck WORK TYPE A 31 New O 33 Aiteraftm 038 Move O 32 Addition 034 Repair © 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MCANS System„ (Allowable) Main leval sq ft. City Water UBC Occupancy _ sq, ft. Fire. Spinkierred Zoning;.; sq. ft. PRV # of Stories,, ft. Booster Pump Length sq. it Census Depth Footprint sq. ft. ___....r..._ SAG Code Code. Comm Bldg APPROVALS. ~ Census, Unit Planning Building _ Engineering Variance IrrYnlr U Mrli i.+r~ -~~rlrti Permit Fee Mwuadon: $ Surcharge Plan Review License MC/WS SAC City SAC Water. Conn. Water Meter Acct. Deposit S/W Permit SAW Surcharge Treatment Pi. Park Ded. Trails Ded. = Other Copies Total: % SAC SAC Units PERMIT CITY-OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 3 2 7 4 9 (612) 681-4675 Date Issued: 08/03/98 SITE ADDRESS: 1640 BLACKHAWK HILLS RD LOT: 6 BLOCK: 1 BLACKHAWK HILLS P.I.N.: 10-14380-060--01 DESCRIPTION: T.O. AND REROOF Building. Permit Type STORM DAMAGE Building Work Type REPAIR Census Code 434 ALT. RESIDENTIAL REMARKS: FEE SUMMARY: CONTRACTOR: Applicant - ST. LIC OWNER: II WESTURN CEDAR SUPPLY 15410304 2001420 GRAIZIGER STACY 705 N HWY 169 1640 BLACKHAWK HILLS RD PLYMOUTH MN 55441 EAGAN MN 55122 (612) 541-4207 (651)688--7079 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 Mn. Statutes and City of Eagan Ordinances. APPLICANT/PERMITEE SIGNATURE SSUED BY: SIGN TURE 1998 BUILDING PERMIT APPLICATION SIDE ' j • CIITY OF Zd4AH 3930 PLOT 'KN88 RD - 55133 681-467a New Constru n inements ItiiRede!o~t Iwi. # 3 registerod ske surveys # 2 copies of plan # 2 copies of plans (include beam & window sizes; poured Md. design: etc.) # 2 SM arft" Wdeffaredftens' # 1 energy calculations # 1 energy tar ne # 3 copies of tree prrservaMn plan N lot plattbd after 711193 required: _Yes _ No S DATE: GONSTRUGTIOM COS'T'; , SC PTION OF WORK: .r.........r.r~.~. ~t S EET ADDRESS: - LC z `EO I` --A~L.K k~ rn t , LOT: BLOCK: SUBD./P.I.D. G am ' ~'~IZ1 t' Y ice. 1g-£..r r Name: Jl 'ltGY Ptha~te t_ PROPERTY Last First OWNER Street Addresss. City C 0 Static: Company: Uy kJ0 &-thL'&ePLV1 PMne ' 5 1,:..b l o+ CONTRACTOR StredAddress: Q. N02 t#W'~ (2 License# city L%4 uAO t state: „ ARCHITECT/ ENGINEER Company: Pbone Name: ftbuiition Street Address: - City Soft: Sewer & water fiicensed plurnber (new constrimbon ony): P9ena jt 'yMhe s t and lot change Is requested once permit is issued. I hereby acknowledge that I have read this a *kmtlon and staterw i0 1y wim al epplic aw State of Minnesota Statutes and City of Eagan Ordinances. Signature of OFFICE USE ON KIM, 09 LY Q Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required` OFFICE ONLY BUILDING PERMIT TYPE 0 01 Foundation 0 06 Duplex O 11, AW.,odgkV 0 16 Bast Fl eh 0 02 SF Dwelling 0 07 4rplex 0 12 Multi ROPW. I. rt.. 0 17 swil" ~ Pool - 0 03 SF Addition to 08 B-plex 0 13 GwaW . ry 0 20 Public Facility 0 04 SF Porch 009 12-pfex 13 % F fave 0 21 M ous 0 05 SF Misc. 0 10 -plex 0 15 Desk WORK TYPE 0 31 New 0 33 phis 038 Move 13 32 Addition 0 34 Repair 0 37 Dem. n GENERAL INFORMATION Const. (Actual) e+ct, ft. M ystem (Allowable) Main kw n, ft. City Water USC Occupancy h IL Fire Sprir*WW .r..:, „ Zoning .Kilt PRV a of Stories sq.1t.,...,..:.._. Bar Pump_ Length..- sq. ft. Census.,Code. Depth Foo#txirrt eq. ft. SAG Oa le APPROVALS , - Census Unit Planning Building Engineering Variance Permit Fee _ $ Surcharge Plan Review License MCIWS SAC City SAC Water Conn. Water Meter Acd. Deposit M Permit SNV Surcharge Treatment Pl. Park Ded. Trails Ded. Other Copies Total: SAW SAC Units PERMIT CSC ACS`"~~ 4YVF EAGAN 3 (f/ 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55123 Permit Number: 023140 (612) 681-4675 Date Issued: 03/31/94 SITE ADDRESS: 1640 BLACKHAWK HILLS RD LOT- 6 BLOCK: 1 BLACKHAWK HILLS P.I.N.: 10-14380-060-01 DESCRIPTION: (MASTER BDRM/BATH) Building;.Permit Type SF (MISC.) Building Work Type ALTERATION REMARKS: SEPARATE PERMITS ARE REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK FEE SUMMARY: VALUATION $32,000 Base Fee $297.50 Plan Review $193.38 Surcharge $16.00 Lic. Search Fee $5.00 Total Fee $511.88 CONTRACTOR: A p p l i c a n t - ST_ L I C. OWNER: MORRILL CONST 14613109 0003372 GRAIZIGER BOB 25580 XERXES AVE 1640 BLACKHAWK HILLS RD ELKO MN 55020 EAGAN MN (612) 461-3109 (612)688-7079 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 Mn. Statutes and City of Eagan Ordinances ORE APPLICANT/PERMITEE SIGNATURE SSUED B : SI ATUR CITY OF, EAGAN 1994 BUILDING PERMIT APPLICATION r 681-"75 % 3-z SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site sury $4-1_ *AV Of Onaw cal cs . - - : COMMERCIAL 2 sets of architectural & structural plans, 1 set . specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working vf Wnth es n permit in which request is made, 2) address is. changed or 3) lot change is rap is issued. Date Ma&A 9L Valuation of work Mo Y+I.r wrrrai~11i1ril~r.~i1 Site Address: c. &s. STREET S~iTt Tenant Name: (commercial only). LOT BLOCK 8UBD. II, P.Z.b. # Description of work: 7 ~J 1... The applicant is: ❑ Owner Id Contractor ❑ Other (onertbe) Name _ G 1ylatJ-- X30 ~ Phofle AI-M-79 Property LAST FIRST Owner Address 1 210 BYt APdJk, i~ r.r,K// ~S ~f-D :.rraais.r.+ r 1. ~r~1ra.lrIIIII' STREET STE i City State Zip Company 1V1cfe U_ CAI,A(<94Cnjo Phone , ,~I_3siDgi Contractor Address License #~r Exp.t City EL& State Zip 15 0 Company Phone Architect/ Engineer Name Registration p Address City State Zi-P Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this apppplication and state that the inf~ion is correct and agree to comply with al licable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ONCE USE ONLY BUILDING PERMIT TYPE y ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwg. ❑ 07 4-Plea ❑ 12 Multi. Misc. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-P1ex ❑ 13 Garage/Accessory ❑ IS comm./Ind. ❑ 04 SF Porch ❑ 09 12-Piex 13 14 Fireplace ❑ 19 Comer./Ind. Misc. P'05 SF Misc. ❑ 10 Multi. Add'l. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous -r WORK TYPE r~•►~~rotl~~~ ❑ 31 New 0 33.Alterations 13 35 Tenant Finish ❑ 37 Demolish ❑ 32 Addition ❑ 34 Repair- ❑ 36 Move GENERAL INFORMATION Const. (Actual Basement sq. ft. MWCC System (Allowable) 1st Fl. sq. ft. City Water UBC Occupancy 2nd F1. sq. ft. PRY Required Zoning Sq. Ft. total Booster Pulp # of Stories Footprint Sq. ft. Fire Sprinkler Length 4n-site ,well Census Code yYy Depth iln-site sewage SAC Code ai APPROVALS Census Unit -4- Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ .Site ❑ Footing. ® Framing 0 Insulation ❑ Wallboard 0 Final ❑ Draintiie ❑ Fireplace Permit Fee Vatwwf ns s-'3 Z OQe Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Coppies Other Total: SAC % SAC Units Ittol 991 BUILDING PERMIT LICATION 1 CITY OF EAGAN SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS # OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. To Be Used For: k e - PDOT i nO Valuation : o © - GU Date: Site Address l,~C OFFICE USE ONLY Lot Block FEES s~ Occupancy Bldg. Permit 3 Zoning Surcharge S O Parcel/ Actual Const Plan Review el,:~ Allowable SAC, City X Owner rf # of stories SAC, MWCC / Length Water Conn. Address D C~ ~1~ r/S Depth Water Meter S.F. Total Acct. Deposit City/Zip Code Footprint S.F. S/w Permit J~ y-- S/W Surcharge Phone On site sewage_ Treatment P1. On site well _ Road Unit Contractor I - ~ ,/?o e ~ MWCC System Park Ded. City water Trail Ded. Address 12-6 'I-4tnee SV PRV Copies / Booster Pump City/Zip Code `T" f r~ / SUBTOTAL / ~7 APPROVALS Penalty Phone G / Planner Lot Change Council TOTAL S O Arch./Engr. Bldg. Off. Variance Address City/Zip Code Phone # agrees that all work shall be done in accordance with (Signature of Contractor) all applicable State of Minnesota Statutes and City of Eagan Ordinances. F, CLAM V130CHER - REVItNt] RFQTlFST CITY OF F.AGAN CLAIFIAN' ALL=AREAS ELErTRIC ADDRESS E .Q. BOX 28062 MINNEAPOLIS MN 55428 1.nr~tto it 1640 BLACKHAWK HILLS ROAD L6, B 1 . BLACKHAWK HILLS Rrrrlpt tan./Date 97869-7/12/90 RVWtnn fer Refund PER ELECTRICAL CONTRACTORS REQUEST Typr, of Refund FlPctricnl Permit 01-3211 $ 20.00 Plumbing Permit 01-3212 $ lterhnniral Permit 01-3213 $ Surcharge 01-2155 S Water Connnc.tfon Permit 20-3713 $ Sewer Connt+rtion Permit 20-3743 $ - - Ar.rount Deposit 20-2252 Utility Account Over-rnyment 20-2250 $ Dthert TOTAL $ 20.00 I decIarP under the pPnsltie4 of law that this account, claim or demand is gust and th it no part of it has bern P(aaid. AUGUST 15, 1990 SiRnatttrP date A • :t .}r.: }vrao v:: ,v: v: , •'{;rrr:}•,::y:Y%jF: uvi pp, ~ - .vin i;{ . "4 n,•:: .,vnv : .n S ....r..{. a:ir. ;:{.;.}:::.}}r}?i;+tr:~.. ' :..1.; v``~' r,}:vt#'7Yi. v jM. \ r: ;:t•:" ?P~....:.:....Y.. :.,Y,. ; :::.,-:.••ai.... - , .:#`.,~.Y.. r.,: : ~t~' . ty on5..'s}o-Y:$i;?„ ~>;?s:# •Y,at.,:. l s ,r a~5:•: • , : ..:$ti:3~."c: 2.;~:'• $S•F.,:r" ' . ~~a ~ t~:r.- v 3: - : .a`.?S r.:.t. k ; '#'i <3{'F~r:z~ '~L;'•~} •ix... i '.Y. :Y:a ;.xy, v~ +k Y .,r+s ,•^i..~: t ra:."•ts::i^u. `L..t>.•a.a rq'.ft::9:r:'<£.;, ' +2•, , ~.3o"atr.?':i?:4 F '4~.::.y h L_ r {;.y• v:r~ _ s` a::.: - c e ..ti....,<:;.,.x~•. s:, . +tii •i....'i?: •i'..t: C.$:>Yti4'~ti5`t~., ?;<us'..; f. • • . - t _ K 2:b. .arary,:?v,8.'•:Y•: a'. ' +4'•y~-• : i~..,, cc:++•r - - - Y b t : va,< 33 z tmi. is>~S` .ik:; • •:a2 r.3Yt , ~ X! -F r: "xui L.a, 2, 2"'• E ey ~,w.•::y + :if•~r,°9'• ~ ~ > n,E_ }~~[1r:+.+ ~ w 4;. ,Y : n 'v'~ : `~v. dCittit}.1.??-,"-Ni.'"Z n~^r.~:. ......n x.^:nn ,,,{}-Y....... .n7 t.~~`,+~?I~~~~?$ti"'G.2ti91~~it::•h~S'#~~~'~ 1993 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681.4675 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. FIXTURES EACH TOTAL SHOWER 3.00 yrn, ESR %CLO T a.00 BATH TUB 3.00 LAVATORY 3.00 KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 HOT TUB/SPA 3.00 WATER HEATER 3.00 FLOOR DRAIN 3.00 GAS PIPING OUTLET • minimum -1 3.00 ROUGH OPENINGS 1.50 WATER SOFTENER 5.00 PRIVATE DISP. - nai.cry. lip. 15.00 U.G. SPRINKLER - home under const. 3,00 ALTERATIONS - to existing d0.0;3-15--~ WATER TURN AROUND 15.00. STATE SURCHARGE •50 TOTAL: SITE ADDRESS: O OWNER NAME' 1 ~l r- n, ; ? nA , l)r\A INSTALLER: kkP~ ADDRESS: CITY: STATE: !l Y1 ZIP CODE: PHONE (1,ArQ LAM -C~'SO SIGNATURE OF PERMITTEE . b, ...:u.~., ^:t;•s:.:c;xa;etar..::}}•t•:aru t;.:.x.Yth>,.tmr.}.,;;.+:...,:::c..::,. *,.4.'4'+.C... .xs: s'::fi:: !^':'t;:: k t - 2 { } y 'y < „3 s s ar *y \ %?k:y . • sLsy} , S~~,`.~.,~ a . L+2 ~ti d k , x 4. t ? o } ai ax t _ .c.: vt+t Rk}u~{' 7 ~ro.,.'`.'~~'.'W~v.+^.. 3:6{ iy!~.,~a.+t`~' {aibk~ S~{,v+ s:d 9 rc { x '.a. kti ° ~ 7 } H~ - r+c xy n }J4' yn4F~yX~~~' ?R~•'`x, •s ix +e ~ a..~:+.~..•'Y., ` `:.:'xi,:'3,v>:~e {.t a.k e;, Y .a. .c a~ } a"' _a -b i#~ :?a..+.:sk? .b:+~~,•.•,oyE,}X•,:;4~%; '3.~ ".~,.~<;c:'Yegx u ~x'4 ter {s3 ;a,s ~dr5,•. ,I 6 0 f~ ~ $x ,~.w' ~~i:&i~` .LU. ` ' ^~'t~~++?~ a~??.'•~•..:.:: [fie aL •S' Y . .v..w.. M x,,.in YT}..A.. k$. iev}.x n}N'rMn A;nstivrrN.' {`wY "u` .A•} ; otv£ Yv 1993 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-467S PLEASE COMPLETE FOR ALL COM[MERCIAL.INDUSTRIAL BUILDINGS. ALSO FOR MULTI- FAMILY BUI _DINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING E-"--,T. NEW CONSTRUCTION ADD ON REPAIR WORK DESCRIPTION: CONTRACT PRICE: $ FEE: 1% OF CONTRACT FEE. STATE SURCHARGE: $.50 FOR EACH $1,000 OFfER 1' FEE. MINIMUM FEE: S 25.00 CONTRACT PRICE X 1% $ STATE SURCHARGE $ TOTAL $ SITE ADDRESS: I T N "C'IE' OWNER NAME: INSTALLER: ADDRESS: CITY: STATE: ZIP CODE: PRONE FOR: CITY OF EAGAN APPLICANT _ 1! 11, 1i 1P.'__ P'IL..S-.SDi. P^,UL, IVI1MNES0TA 55°! 3 !''-iGNE: 227-3401 S.- - Cii N0'1 aURVrY ~_,e. a X57 , 4 t ~J \ 9a ,5-tp t t c3 '}z fry - `bb -"U a S ''.::C ^ ^ 1. 20,-900.00 I ;,S .C1 L U, t„~, Ur "'!O 'St„"iE is `l1 { D bdr ~ C7 TO Pi;i(: U7:d".2C~~1'!!J!iiCl~'3~a low v gw 4-- Y MASTER CARD LOCATION`, G~ HILLS I l l/ \I OWNER STRUCTURE AND 0 X 4 LAND USED AS L (f ~ Issued To Permit No. Issued Contractor Owner j' BUILDING SP~f" r PLUMBING CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER OTHER OTHER Approved Items (Initial) Date Remarks Distance From Well FOOTING: f. SEPTIC FOUNDATION a , CESSPOOL FRAMING 1 TILE FIELD FT. FINAL -I4~ ELECTRICAL DEPTH HEATING OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL I SANITARY SEWER a► , Violations Noted on Back COMMENTS: COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION NO EVIDENCE OF NON-COMPLIANCE NON-COMPLIANCE. BUILDER DOES NOT OBSERVED. INTEND TO COMPLY. ACCEPTABLE SUBSTITUTIONS OR COMPLETION OF CERTAIN IMPROVEMENTS DEVIATIONS. WILL BE DELAYED BY CONDITIONS BEYOND ❑ NON-COMPLIANCE. BUILDER WILL COMPLY CONTROL. WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: REINSPECTION REQUIRED DATE OF REINSPECTION REINSPECTION REVEALED CERTIFICATION-1 certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected. ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR DATE COMMENTS: 2 9 .QW . II% 2005 RESIDENTIAL BUILDING PERMrr APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Requirements Office Use'Oniv 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Ced of Survey Recd Y -N. (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pries Plan Aecd Y N 2 copies of plan showing beam 8 window sizes; poured found design, etc. 1 site survey for additions & decks Tree Prey Required' ^Y N 1 set of Energy Calculations Addr7ion - indicate if on-site septic system On-sfte Septic System _ Y N 3 copies of Tree Preservation Plan ff lot platted after 711193 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Date l I Construction Cost Site Address /r)~i l /~7G✓ /T' UnitfSte # Description of Work , L Multi-Family Bldg - Y N Fireplace(s) - 0 - 1 2 Property Owner O' Telephone # Contractor Address 4100 EXCELSIOR BLVD. City State ST. LOUIS PARK, MN 59418 Zip Telephone # 91Q. u- I= 6 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaory I Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (d submission type) Submitted Submitted Energy Envelope Calculations Submitted Have you previously constructed a building in pagan with a similar plan? - Y - N If so, 25% plan review fee applies. } Licensed Plumber Telephone } Mechanical Contractor Telephone } Sewer/Water Contractor Telephone I hereby apply for a Residential Building 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 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 approved plan in the case of work which requires a review and approval of plans. Applicant's Printed- Name App leant's Signature OFFICE USE ONLY ' Sulf Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 18-plex ❑ 20 Pool ❑ 30 AccessoryBldg '0 02 SF Dwelling ❑ 08 06-plex ,ff 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of_ Alex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex El 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg y or_ N ❑ 25 Miscellaneous Work Types _ ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding ❑ 32 Addition C/l"❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair ,Z 33 Alteration r4i 11-' ❑ 37 Demolish Building' ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Valuation 000 Occupancy MCES System Census Code 4 Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # 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. HVAC _ Drain Tile Other Roof _ Ice & Water Final _ Pool _ Ftgs i Air/Gas Tests _ Final Framing Siding _ Stucco _ Stone _ Brick Fireplace _ R.I. _ Air Test -Final _ Windows insulation _ Retaining Wall Approved By: Building Inspector Base Fee . Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other - Total NaMmPse 19 2006 08:07 FR LOL INTERNATIONAL 651 634 4290 TO 9612S23lW?8 H.b1ib1 O - lap T; -1--l T- O Excelsior Boulevard 1-T C-.C Louis Park, MN 55416 CONTRACT -v) Office- 952-836-1335Licensed St. Paul: 651-644-0040 - ■ Bonded Fax: 612-823-1078 Insured vwvw.crownmasonry.com CROWN Liij ® ~kx M A S O N R Y PROPOSAL SUBMITTED TO PHONE DATE i' o ~~ir off- Bbz9 ~r /~9los STREETJ JOB NAME 4 u~!~sJc 11s Rd. CM1. STATE and ZIP CODE~/ JOB LOCATION ry 1.2.? a -Ago A4 ESTIMA R CELL PHONE ATTN: JOB PHONE D-499 I Ufa -v 41,10 - WE PROPOSE hereby to furnish material and labor - complete in accordance with specifications below, for the sum of: Payment to 1, / / C made as foilowa 1 *M eA f~ Da H Ilse pq 4 b" dollars SS When Signed 5 Upon Start D Balance to be Paid in Full upon Completion by Owner s All material is guaranteed to be as specified. All WORK to be Estimated Start Date completed in a workmanlike manner according to standard practices, Weather Permitting Specified work and quoted price subject to change upon discovery of tidden defects. All agreements contingent upon strikes, accidents Authorized or delays beyond our control. Owner to carry fire, tornado and other Signature V l~sYiwll necessary insurance. Our workers are fully covered by Workers' Ilve Compensation Insurance. Products and materials may be substituted Note: This Proposal may be for equivalent products due to availability. withdrawn by us if not accepted within days. We hereby submit specifications and estimates for: Page No. of / Pages Rlht, we an J rip /a 611? CO r? dwle sap a411 4,0 CIly p,(,- sli4e co Jl . ~s A ei 1 S ~I S1~~h e b vii, Ic 4 ye4* a Ve rn wc~t s~~~► .~s passf~bJl . Jc Vs 1 I MOTES- SEE REVERSE SIDE FOR IMPORTANT NOTICE. Ali jobs are scheduled on a weather-permitting basis Acceptance of Contract Contract Includes all permits and applicable taxes. Contractor to eieen up & remove all debris from entire yard. The above prices, specifications and conditions are satisfactory and are hereby Contractor to magnetize yard S driveway. accepted. You are authorizer 19 do the ork as specified, Payment will be Contractor not responsible for damage to trams, bushes or shrubs during normal made as outlined above masonry operation. Con tractor not responsible for shaelrock or plaster cracks due to normal masonry Date of Acceptance: operation A late tee of 5% will be imposed on any balance not paid within five (5) days Contractor not responsible for dust ano debris In attics during masonry work, of due date. Owner shall pay all Contractor's collection costs, including attorney's Crown Masonry recommends that homeowners cover their belongings. fees, If Owner defaults on payment. Contractor not responsible for driveway damage. Contractor not responsible for interior damage due to condensation, ice clamming oe Ice backup. Cf Contractor to provide mechanic's lien waiver upon receipt of full payment for Signature V above work. Signature SIC SIC TOTAL PAGE. 01 ~k plc Entry Date:_ Date Permit Pulled: Date Info Taken: Salesperson: f 4m 3 `~Permit 11o Scheduler: Sales Associate: i Customer No: ~ Job No: Appointment Date' ~ I Time: am i pm CustoniefInformation: Caller: Mr. / Mrs. / Ms. ROOFING - Residential Owner's Name Mr./Mrs./Ms. t' u 906; t o Replace? Repair? Age of Roof? Job Address / Street: b q Qe C t r House. Garage: Attached/ Detached ❑ Yes ❑ No Cite: r zip: ❑ Shingle Roof ❑ Tear Off_.# layers ❑ Shake Roof Home No. tlo~ I~ ~ Mrs: ❑ Flat Roof: Rubber ❑ Hot Tar/ Hot Tar & Gravel: ❑ Rolled Work No. 13ri~~ Mrs: Porch ❑ Yes ❑ No Front Rear Side Spouses Work: Mrs: ❑ Gutters / Downspouts: Replace Repair Cell No: Pager: (A so ~ ❑ Trim, Soffits & Fascia: Replace Repair Fax No: :Cg ~ey Work: Directions to Job Site: Comments: REMODELING - Residential House? ❑ Yes ❑ No Garage? ❑ Yes ❑ No Trim, Soffits & Fascia? ❑ Yes ❑ No Cross Street: Siding? ❑ Wood ❑ Vinyl ❑ Steel ❑ Aluminum Hudson Map Code: ❑ Windows ❑ Kitchen Bathroom Additional information: sulation ❑ Room Addition ❑ Skylights When do you plan to have the work one? Have you received other bids? ❑ Y s o ❑ Porch ❑ Deck ❑ Cement Work list bidders names: ❑ Other: Comments: How did you hear about us? ❑ Signs ❑ Yellow Pages ❑ Referral OurTrucks Other: Need Financing? ❑ Yes ❑ No Referral Sy: Final City Inspection Completed: Date Name: Crew Name: Address: Collected: Closed: E PERMIT City of Eagan Permit Type:Building Permit Number:EA132749 Date Issued:09/01/2015 Permit Category:ePermit Site Address: 1640 Blackhawk Hills Rd Lot:6 Block: 1 Addition: Blackhawk Hills PID:10-14380-01-060 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 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 - Mary J Robinson 1640 Blackhawk Hills Rd Eagan MN 55122 (612) 325-3279 Hometown Restoration 1940 Serendipity Ct St Paul MN 55112 (763) 494-8695 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA138310 Date Issued:08/19/2016 Permit Category:ePermit Site Address: 1640 Blackhawk Hills Rd Lot:6 Block: 1 Addition: Blackhawk Hills PID:10-14380-01-060 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:One Window/Door 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: 500.00 Fee Summary:BL - Base Fee $500 $40.00 0801.4085 Surcharge - Based on Valuation $500 $0.50 9001.2195 $40.50 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 - Mary J Robinson 1640 Blackhawk Hills Rd Eagan MN 55122 (651) 675-5675 Monahan Remodeling 3320 41st St E Minneapolis MN 55406 (612) 220-1622 Applicant/Permitee: Signature Issued By: Signature