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1411 Blackhawk Lake DrCity of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 1411 Blackhawk Lake Dr Lot: 12 Block: 1 Addition: Stoney Point PID:10- 72600 - 120 -01 Use: Description: Sub Type: e - Furnace Work Type: New Description: Furnace Comments: Expired Perm Fee Summary: Contractor: Controlled Air 21210 Eaton Ave Farmington MN 55024 (651) 460 -6022 X253 Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Elec 952- 445 -2840 ME - Permit Fee (Replacements) Surcharge -Fixed Total: Applicant/Permitee: Signature PERMIT City of Eaan Closed w/o Required Inspections. Letter sent. 12/10/2008 pf - Applicant - Owner: Daren J Hastings 1411 Blackhawk Lake Dr Eagan MN 55122 Permit Type: Permit Number: Date Issued: Permit Category: $50.00 0801.4088 $0.50 9001.2195 $50.50 Mechanical EA082006 02/21/2008 ePermit cal Inspector, I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Issued By: Signature . , : x?/ d' 1--,21/ ?i / 5?:° Y /->'? / y " 7 _ C D. c". , / i ! I /`/ / -/I''i> ' _/' '? _ 1 / •.? ? ? c3 ??? - E 77013 4 RequASt Date Fre No. _ ugh-in Inspecfion Required? O?Ready Now CM/ill Notity Inspectw Wh R ? No en e I, 1X licensed contractor ? owner hereby request inspection of above electrical w k at: ` ??' Job Address (Street, Box w jute Na.) L `2 City Section No. Township Name or No. Range No. Coun?? Occupant (PRINT) Phone No. ?? ?? ?- / 1 C: r- r'`c i""'1 £' S Power,,S?Pplier( + 4? 4 4 ? ' ? Address C J' Ci Elecvical CoSptractor (Comparry Npme) J ? Contra6aris License No. J Mailing Address (Conlractor or Owner Making Installafion) Authorized?ignature (CoMriactoNO er Making In lation) ? i r / ' roris Number `1r ( • ? ' ? ? I '-? I ? i 5?:-?' . i- . , ? T - MINNESOTA STATE BOApD OF ELECTRICITY Grlggs-Mldway Bldg. - Room 5173 1821 University Ave., St. Paul, MN 55104 Phone (612) 642-0800 THIS INSPECTION REQUEST WILL NOT 8E ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLDSED. ? IRFOUEST FOR ELECTRICAL INSPECTION • ee-ooom-o7 X?` ? Rpgiqstructions for oompleting this form on back of yellow copy. 3 E-4 7 l.T) X° Below Work Covered by This Aequesf i`I ew Add Rep. TypeofBuilding AppliancesWired EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer pther (Specify) Comm.Andustrial Furnace Farm Air Conditioner Other (speci(y) Contractor§ Remarks: Compute Inspecfion Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps L 0 to 100 Amps C;- - Transformers Above 200 Amps 1 Amps SIgf1S Inspectorb Use Onty: TOTAL Irrigation Booms ? --- Special Inspection czi ?l!;_ _ Z?. Alarm/Communication dther Fee I, the Electrical Inspector, hereby RougMin ? oace certify that the above inspection has been made. Fnal bate OFFICE USE ONLY This request wid 18 monlhs from (P / r?? 5' a--- /OCo 4?5 3 6 2?? Request Date i rire No Rough-in Insp on Required? *ady Now ? Will Notity Inspector ; Yes o When Ready? I1-6censed contractor D owner hereby request inspection of above electrical work at: Job Address (StreBt. Box a Route No.) p City Section No. FI.., lM, or No. Range No. CouMy ? II(i Occupant (PFiINT) Phone No. Power Supplier ?? Address /? Electn C n a 1 "C RIS FRANKL m Contractor5 ' ense No. . ? Madmg r t n m I II o ) ALLEY, MN 55124 APP Authonze S?gn e?Co ?ac!o?,Owner Zngiaiiation) : ? ? .? .? .?. Tone umber ?.J MINN TA S BOARD OF E CTRICITY THIS INSPECTION REOUEST WILL NOT Griggs-M ? way Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1921 Universfty Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ee-oooo,-oe ? lo. See instdCtion?4 .?Ompleting Ihis form on back W yellow Copy. J62662 'X° Below Work Covered by This Request ew Add Rep. TypeofBuilding AppiiancesWired EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating ? Apt. Building Dryer Other (Specify) Comm./lndustrial Furnace Farm Air Conditioner Other (speaty) Contractor's Remarks: Compute Inspection Fee Below: frcz Ca # Other F ee # Service EntranceSize Fee '# CircuitslFeeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps ve 100 Amps SignS lnspector5 Use Oroy: ^ TOTAL / f Irrigation Booms AJ .O(J ( f , Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORD ED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 181 ONTHS. I, the Eiectrical Inspector, hereby Rough-in Date certify that the above inspection has been made. Final A's oater OFFICE USE ONLY This request void 18 months from Puur-..?-, v???.?y? .,•4..P - ?+ -=.v ?.-? yy ? t? J Ip ? ????IPT LI7 ¦ V F EA", ? 38M PlLUT KNC?B ROiib EAGAN, MINNESOTA 55122 ? oATF fIKEIVEo FnoM ? • - . ? 1'K. . AMOUNT *7? O CASH F i 1 \ Cc, . c. 2 a. . ' ? _ . .. ., n A. A 'N, 11 ? ? ? 503 1?- VI? ; ' ? Thank You 93D ri c on d"cl sy ? mr1 /V v r -Itiy rec:u 88937 CW' Y?Cm - ? 16' c-&c, h'3w IZ, 11?-1't-e ?,r I?D? t-ede? G-E' U.C FUND OBJECT ^ 0 ZSa c> ?op . 2?t? ;-1? 3 106 a c? p ?1SS ? `? q: ? ? , . , iF»ii,? . F ? CASH RECEIRT . - ? crTY o?-SA",t k 3830 `PILOT KNdB R[5? ; . ;' ? . EAfiAtI±L, MIRIN£S4TA 55in OV1TE AMOUNT ? 0 CJ19H CFC - _I ? ? -? • f-` -?- ( : ? ..., ? :,? } ?; , ..+- ? ?.. r_ I c-- 0;icr : FUND OB.IECT mUw ? a, ? . • ?. ??A?!i t ? 'Thank Yov : T ? ?, . . BY . f • ,? - ?---? - . ?----•?-?•--,.A ? - ?.? .. CITY nF EAG4N Permit No: 10077 Date: 3880:0iilotJ(noFrRoad, Mefer No: ' Size "P O: Box 211i9 .,: "fleader No: Date.; ° _ A Eagan, MN 551Zi . Owner. - W??r ktOm??.s : Site Address: I?rll Blscidimtr?c Latke I)r LI2 ?!I S[qaa* ?lttit ; ;Plumber. ?tar Plumbing _ Conn. Chg: 550. 0Op4 toning: Acct Dep: 15• 00pd, No. of Units: k..` Permit Fee: 10.00fld . Surcharge: "- 50od I agree to comply with..the Ciiy of Eagan . Tr. Plant 204•Oftd Ordlnances. Meter. MISC: pi-q' nW3MnE., BY . WATER SERVICE PERMIT CIT.Y? F?A?AN Permit No: 21237 3810'Pilot Knob Road .,B/P No: 8$338 ', P.O. box 21 499 - , '? Eagan, MN 50+2f . Owner, -WWez Rostes - - - - - - - - Site Address: Date: Date: lfi-I$_RR P01IIt Plumber: Star Pltttabirig MWCC: 550•00pd Zoning• RI Ciiy Chg: 19,0. Qpd No. of Units: I Acct. Dep: - I agree to comply with the City of Eagan Permit Fee: ? . ., Ordinances. Surcharge: Misc.: °"RV REODIRED gy SEWER SERVICE PERMIT Use BLUE or BLACK Ink ' _�r--------------- '�, I For Office Use � ' I ' � Permit#: � �� I , Clty of E��Il � �fi ; I Permit Fee: � , 3830 Pilot Knob Road � j Date Received: � Eagan MN 55122 i � �� Phone: (651)675-5675 � ', � Staff: � Fax: (651) 675-5694 �_________________I il 15 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: �� Site Address: ��1 �`C£ �-�`�1�u�l� ��'� ��-� ��' 1 Tenant: Q_S�d w '� Suite#: �� , - �r _ � �� ' 'r ��` Name: � t?.S�r�u G S Phone: ��#�� #:�'W � �' � � ' ��°�� Address/Cit /Zi �� L � C� � �� '�- � �. i .:.. Y P� C� � � �� s �� Name: � � V` � ia �i License#: �J` �� .� � _ ��Ql�'��'8� ��r��. Address �� f.�1�1,C�'_ �� City: �C�� ' i� �� '�' � ��' �l _� `"'` � � �� r�� '�� State: � � Zip: �1 ��)�l Phone: ��/� ��'�o�� k I��( � . F�I�� l �� Contact: �� . Email: ��CL �'"t�` �` ``�c��i,��,. / ��`st�,. �¢ ,.$ w�� ``� � "� � �� r � � New Replacement _Repair _Rebuild _Modify Space Work in R.O.W. �� << — — — �� f� Description of work: �C�`l tLS � �� S`��`'�-`�u � l^�e� �� _�� a �� ` ��"' �... RESIDENTIAL � C = „ I.. �.� � .� . �3 � Water Heater Water Softener =�� Lawn Irrigation�RPZ/_PVB) ,� ��, � �dd Plumbing Fixtures�Main/�Lower Level) �;��°��, - � � � Septic System � ��'��'��"�!��'��'� �� Water Turnaround x„,�� _New � ��IlG�ll: Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.0o State Surcharge) $60.00 Lawn Irrlgati0n (includes$5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment, Water Turnaround''(includes$5.00 State Surcharge) "Water Turnaround(add$210.00 if a 5/8"meter is required) $115.00 SeptiC System New($10.00 per as built) (includes County fee and$5.00 State Surcharge) TOTAL FEES$ 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.�opherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of p�ans. X —��V �' �1,t, �` � X _ `�� Applicant's Printed Name ApplicanYs Signature ��ia �o��ti�� o�� ii �� _r�� 3��J�� ' �� ' �� : 1�+��BtW� �� ' � x��a: �� , — �� : � a�� x � � � I �� .�� .� � � : � � � �� r € � � � � , �� r�� ;�, �� . � ��u�i m�@1��E3�� :'�v'1��.' { ��{��r'�� 1'r,�� c"� � } ��: •;�; . �� _. � _ . k.._ _ _ _. I� i ' - ?'?°'?!?'=??-ta? -???.:?' . _ - - - ... .. _. ... _ _ . . _ cirV oF EaGaN k..:.rt s s 6? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 .d ? 1i? 4 PHONE: 454-8100 BUILDING PERMIT ReceiRt # To be used fflr S'y DW/GiAR Est. Value #77fwo Date OC"M 17 ,18 a? 'Site Address 1411 ?AC?ll1? L11? ti?' Lot Block t Sec/Sub. ? ?INT , Parcel No. a Name iiAGM WAS$ o Addre?? ' ? City . Phone 431-7557 a .o Name _ ? ` Address City _ W W Name- ~ ZO V Address dW City- Phone I hereby acknowledge that 1 have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and CRy of Eagan Ordinances. Signature oi Permittee A Building Permft is issued to: VAWAAUi 1KJNXj --. on the express Condition that all work shall be done in accordance with all , applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official_ _ r , OFFICE USE ONLY iLi ? On Site Sewage Occupancy MWCC System X Zoning a1 On Site Well (Actual) Const Vvl i I City Water x (Allowable) ? ? PRV Required X # of Stories Booster Pump Length 45 D6pth ? S.F. Total Footprint S.F. APPROVALS FEES $ 432i00 Engr./Assess. Permit 33°50 Planner Surcharge 241•00 Council Plan Review toQloo Bldg. Off. _ SAC, CitY $50'00 Variance SAC, MWCC - WaterConn. 510,00 WaterMeter 67•00 Road Unit 312!?*00 Treatment P1 204-00 Parks #2-* 3YV.30 TOTAL Permit No. Parmit Holder Dats Tslaphone i? Plumbing . n HN.AC. ' ?-r'(p - /? f D Electric GD ` OIL °`' Softener Inspsctlon Date Insp. COmment8 Footings I ? Footings il Foundation Framing ? Roofing Rough Pibg: Q ? Rough Htg. IsuL Fireplace Final Htg. Final PiN. Bldg. Final Cert. Occ. Temp. LP Deck Ftg. Deck Final Weil Pr. Disp. . . a.- .__ _..-__ .. _.,,:... ..t .-,.,...-_ -... ....,ir . : . .. , ., . . -vi( •• • ' PEF3MIT # . . PLUMBiNG PERMIT ?o ' . GTY OF EAGAN RECEIP7 # c 3830 PILOT KNOB ROAQ, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 Site Address BLDG. TYP? W4RK DESCRIPTION lot Block ? Sec/Sub Res. ? New lL` Mult. Add-on Name Comm. Repair ? _6 Address ' Other c Ciry - Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING: ; 1?(O. FIXTURES TOTqL f Water Closet - $3.00 ? Name Bath Tubs - $3.00 3 Address $3 00 i _Lavatory - . - p Ciiy - Phone' 00 i ShoWer = $3 . i Kitctien Sink - $3.00 - W ' FEES Urinal/Bidet - $3.00 COMM/IND FEE - 1% OF CONTRACT FEE ? Laundry Tray -$3.00 -? APT. BLDGS -- COMM RATE APPLIES ? Floor Drains - $1.50 ' `• ? ^ ` " -T- TOWNHOUSE & CONDO - RES. RATE APPUES Water Heater - $1.50 - MINIMUM - RESIDENTIAL FEE - $12.00 Whiripool - $3.00 MINIMU,M - COMM/IND FEE - $20.00 ? Gas Piping Outlets - $1.50 _ STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT) RMIT PRICE GOES (ADD $.50 S/C IF P Softener -$5.00 . BEYQND $1,000.0?1 Z Well - $10.00 Private Disp. - $10.00 =Rough Openings - $1.50 '' SIGNATUfiE OF PERMITTEE FEE: STATE S/C: '° FOR: CITY OF EAGAN GRAND TOTAL: ' ?' "- PERMIT # • MECHANICAI PERMIT CITY 3830 PILOT KNOB CONTRACT PRICE: PHO SRe Address .1411 • a ? ` • Lot /,? Block? ? Sec/Sub .,?.`,: Name F?' 5?'lick$nn Ht . & ?t_C., I.nc. Address 36? K'??c I3r . ? Ciry Phone 452-2775 Name ?'yac?i??r Hame? Inc, a.. c Address 146? lOth Av@ p City BuLttsv?.lle Phone 431-'?55% TYPE OF WORK Forced Air 82,000 M BTU ?, 24. ? Boiler M BTU $ Unit Heater M BTU $ Air Cond. M BTU $__ , Vent . GFM $ Gas Piping OuUets # Other $ FEE "'+? S/C: . 1?.? L`? .. lit) TOTAL OF EAGAN RECEIPT # ROAD, EAGAN, MN 55122 DATE: NE: 454-8100 BLDG. TYPE WORK DESCRIFTtON Res. New ?_. Mult Add-on Comm. Repair' Other FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMI'n - 1.50 EA. COMM/IND FEE - 1°r6 OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPUES TOWNHOUSE & CONDOS - RES. RATE APPLlES MINIMUM RESIDENTIAL FEE - ALL ADD-ON & REMODELS - 12.00 MINIMUM COMMERCIAL FEE - 20.00 STATE SURCMARGE PER PERMIT - .50 (ADQ $-SU-SJ-C=1F- PERMIT PRICE GOE8 BEYOND $1,000) SIGNATURE QF PERMITTEE - FOR: CITY OF EAGAN CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-189, Eagan, MN 55121 .? : ? . PH4NE: 454-8100 BUILDING PERMIT Receipt# _- To be used for rF MC/G/lR Est. Value ?779000 Date OCTOUR 17 ,19 $8 Site Address 1411 nLAG[:i3AWIC [AYE DR Lot iZ Block 1 SeC/Sub. STONEY POxN2 Parcel No. ac Name th'AV? BOtaS z Address 14600 ?? AVI Sp• ? ?300 ° City,t n'!?1'j'Z Phone 43l-7557 . o Na'me •?rA.'r!$ U 4 Ad(?fQSS I.- City Phone m V? F W Name = Z Address ? `W City Phone 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 Minnesotd Statutes and City of Eagan Qrdinances. Si,gnature of Permittee A Building Permit is issued to: jiAM,, 3t=2 _ on the express condition that all work shall be done in accordance with all appiicable State of Minnesota Statutes and City of Eagan OrdinanCes. BuilBing Official OFFICE USE ONLY On Site Sewage Occupancy ? mi MWCC System X 2oning ai On Ske Well (Actual) Const ra City Water ? (Aliowable) Ye PRV Required X # of Stories Booster Pump __ Length 45 Depth ? S.F. Total Footprint S.F. APPROVALS FEES Engr./Assess. Permit ' 482.00 Planner Surcharge ?? *50 241.04) Council Plan Review 100.00 Bldg. ON. SAC, City Variance _ SAC, MWCC 550•00 Water Conn. 550.00 Water Meter 67 *00 Road Unit 3ZI•M Treatment P7 204.0 Parks ? ???' ? TOTAL r , ; f DAY/DATE: ? iDDRESS : TIME: .. « _. ,- , t a ? F AL HTG. FTC.? DECK FTG. AL PLBG. ? FOtINDATION ? - " FINAL/C.O. FRAMING FINAL/DECK ROOFING ADDITION INSULATION FIREPLACE R.I. HTG. POOL R.I. PLBG. GARAGE , OTHER. , FOR ? t? J ?I? BLOG. PE RMIT NO. ? ) I° ' c:? _,? % 01-3210 Bldg. Permit ? - • ? . ? ? 01-3422 Plan Check ?- ? 01-3445 Surch./Adm. ? - ` 01-3446 SAC/Adm. - - 01-2155 Surcharge ?1 i l y j 75-3860 Road Unit ? 20-2275 SAC ? c. 20-3865 Water Conn. -? 20-3868 Water TRnt. 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit ? 20-3743 Sewer Permit 79-3866 Sewer Conn. f- 28-3855 Park Ded. TOTAL ' • ? , ?tT10`? N , ltob flop P.l: Box'"7 9 : . e, ., :?,: --•r:- .«?? f,?,:. ., ? z..ff<?=--?F . - " .... .i. ?..- . . - . . . ... Permif Na 10077 ' De? 11-8--88. Id MeterNq: Siza mc/ Reader Dr plumber- 5tar Plwabinlt , r Conn, Chg;.?53Q-QQ;+d Zoning: 81 ACCt Dep: --: 15 _ OOnd Mo. of Unft ?. PermiE'Fee:-_ 10_00iod , Surcharge 5giid 1 agree to comply with iha Ci1y, ai EAqan Tr. Plant_:_..3A& - OOnd Ordinancea. Meter. Misc.: . , .TT-- ? ... ? ? P WATER SERVICE PERMIT CI'rY OF EAGAN , 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N? 15734 • PHONE. 454-8100 - _ , - ? BUILDING PERMIT Receipt# To be used for SF DWG/GAR Est. Value $77,000 Date OCTOBER 17 19 88 Site Address 1411 BLACKHAWK LAKE DR Lot 12 . _Block 1 Parcel No. Sec/Sub. STONEY POINT , Name WAGNER HOMES z Address 14600 lOTH AVE S0. ,#300 o City B' VILLE Phone 431-7557 , o Name S? ? Q Address ? City _ P OFFICE USE ONLY I On Site Sewage Occupancy R3 M1 I MWCC System X Zoning R1 On Site Well (Actual) Const Vn City Water X (Allowable) Vn PRV Required X # of Stories _ Booster Pump Length 45 , Depth 48 S.F. Totai Footprint S.F. - APPROYALS FEES Engr./Assess. Permit $ 482.00 Planner Surcharge 38.50 Council Plan Review _ 241.00 Bldg. Otf. SAC, City 100 . 00 Variance _ SAC, MWCC _ 550.00 water Conn. 550.00 Water Meter 67 .00 Road Unit 495-00 Treatment P1 904-f10 Parks TOTAL $2,557.50 l'- Q CJ W Name _ Fw _z., Address Q W City _ Phone 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 Cit aga rd?ances. Signature of A Building Permit is issued to:_._W on the express condition that all wore done in accordancewith all applicable State of Minnesota Statutes and City of Eagan Or ar4ces. Building Official ___-_ r. -_? 3) r 40 (gtr#t#tratt nf Orrupttury Citp of (Eagan ? Drpttrtnpni of liitiibitug Jprriirnt This Certifcate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in comptiance with tlte various ordinances of the City regulating building construction or use. For the following.• u? c??swaon SF DWG/GAR Bl?. ?m,;t No. 15734 Occupancy Tyw R-3 M-1 Zoning Disuia R-1 rrpe coost.V"N ow,,WorH„aaing WAGNER HOMES Addea, 14600 TENTH AVE S, #300 gwong pdd. 1411 ffiLAQQIAWK IACCE DR 1.1i?y L12 . S1 . STONEY POINT y :„ , , ' ??: DECEMBER 28, 1988 aing offiaei POST IN A CONSPICUOUS PLACE RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone 4 651-675-5675 FAX # 651-675-5694 New Construction Repuirements RemodeURepair Reauirements Office Use Onlv 3 registered site suneys showing sq. R of lot, sq. ft of house; and all roofed areas 2 copies of plan Cert of Survey Recd (20% maximum lot coverage allowed) 1 set of Energy CalculaUons 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 Addtion - indicate if on-sife septic system _ On-site Septic System 3 copies of Tree Pneservation Plan if bt platted after 711/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less unffs r f? 1 . ? Date %``/ / Construction Cost ?? ? 6-D Site Address 1411 A?jt"w- L e- pie. • Unit/Ste # Description of Work Multi-Family Bldg _ YX N Fireplace(s) _ 0 2 Property Owner ? ??,? d- l:L? Qia ? Telephone # (O lz,L .5 M ve,?C_V"* Contractor gA Address 6 bp City State Zip ?.Z Telephone # 4S L ) ol 9 b g COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cate?ry 1 Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (?1 submission type) Submitted Submitted • Energy Envelope Calculations Submitted Licensed Plumber Tele ont#,( Mechanical Contractor Sewer/Water Contractor ?? : ; ,, Tei ?phone #, 8? - c ?- Telep ? 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 ord.inances 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 pemut, 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 ap ov of plans. _ r--,N _ A'Pplicant's PrilatedrName '" A'pplicant's SIgnatlte OFFICE USE ONLY Sub Types ? 01 Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex Work Types ? 31 New l?, 32 Addition ?? 33 Alteration ? 34 Replacement ? 0 ? Valuation 2-4000 Census Code SAC Units Nbr. of Units Nbr. of Bldgs Type of Const Footings (new bldg) I'` Footings (deck) ! ? Footings (addition) Foundation Drain Tile Roof Ice & Water _ Framing Zoning Stories Sq. Ft. Length W idth 35 Int Improvement ? 38 Demolish (Interior) 0 44 36 Move Bldg. ? 42 Demolish (Foundation): ? 45 37 Demolish (Bldg)* O 43 Reroof ? 46 *Demolition (Entire Bldg) - Give PCA handout to applicant Occupancy 3 ` 4 MC/ES System Final _ Fireplace _ R.I. _ Air Test Insulation Final ? 20 Pool ? 21 Porch (3-sea.) ? 22 Porch/Addn. (4-sea.) ? 23 Porch (screen/gazebo) ? 24 Storm Damage ? 25 Miscellaneous tpl , ? 30 Accessory Bldg 0 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi Misc. Siding Fire Repair Windows/Doors City Water Booster Pump PRV Fire Sprinklered REQUIRED INSPECTIONS FinaUC.O. ? FinaUNo C.O. _ Plumbing HVAC Other _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Siding Stucco Stone _ Windows (new/replacement) _ Retaining W all Approved By 2, , Building Inspector Base Fee Surcharge Plan Review MCIES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License 5earch Copies Other Total ? 07 05-plex ? 13 16-plex ? 08 06-plex O 16 Fireplace ? 09 07-plex ? 17 Garage 13 10 08-plex ?( 18 Deck ? 11 10-plex ? 19 Lower Level ? 12 12-pleX Plbg_Y or _ N t) r?' 001-> ? r '4 . ?* a1?0 NEER * eng * eer ng o. (612) 681-1914 Certificate of Survey for: W4GA/CK HO MCS 73' 29 NoQTt1 I ' I I 15 f1 I •? .5 ? ?/?(?? 21-07 ?tg V_? ? i . ,, t . ? ? ?•. tl, -•IZ?•0? ?_ _ _ _4 M L - - - ? M $ 70.08 d, 9007,Jo.,*g _..m .Ja?=.. _. . _..:. gtAC?NA V1r?A?rDI?1 V E ? 900.0 Denofes exisli'no ElPvvtion • 900.o Denofes prop?d Elevofion Fastment --?---Denofes drorr?q e/ufilTrrowf denofes Ornina t Flow o Denolrs monum trtf B e4rin?s shown orQ assu rn ed LOT 12 , BLOcK l STOAIEY POINT - D?KOTA CDUNTY M?NN?OTA t ? SUBJECT TU EA56MENTS OF QfCORD 1 hereby eertify thet thts survey, plan or report was pre V red by rr,?r e y direct eu - pe?vi on and thet I am 3u1`y ?eg'sterea Land $urveyor I under the lewe o} the 3fete of Minnesote. DAtad this ay of ?S? A.D. 19., SCGle: I 1?ch= 40:reel . 880q,3.D' R08Elit B. SIKICH L.S. REt3. NO. 14891 2422 Enterprise Drive Mendota Neights, MN 55120 PROPOSEO NovsE EtfvA7"loN9 towesf Floor E/evcrti017 _ ?S9.16 Top ot 81ock flevafiorl : gcl. /6 G'orpj,f 5l06 Elevafian = 8 ?• 3 P.R.V. " EQUIRED PLUMBING (RESIDENTIAL) Permit Application City Qf Eagan 3830 Filot Knab Road, Eagan Mn 55122 Telephane # 651-675-5575 FAX # 651-675-5674 Please complete for: Sangle Family Dwellings Townhomes and Condas when parmits are required for each unit Date Site Address Property Owner Contractur Unit # Telephone # ( ) Address Ciry 49=41? State ? Zip ? Telephone # (?"y,r7)-- VIFY?'?.?? ? The Applicant is Owner C vtractor Other Septic System New Refurbished Submit 2 sets of ptans and MPC license InGudes County fee. Additional corisultant fees may apply. ? 7 OD.00 Alterations To Existing Dwelliag Unit, Includiqg _ Adding fPxtures to lower levels or room additions, excluding water softener and water heater ? 50•00 _ Abandonment o€ septic system _ Water turnaraund (+ g/$" mefer iF needed -$'121.00) Other: _ RPZ _ new instailation ? repair ? rebuild $ 30.00 _ Lawn irrigation system ?- ?? ? 4t-V?a#er snftener Water heater 1 ? ????'\I' ? 15.00 ? : _ r?ep4acement _ additional 111 ?.? t Stste Sarcharge n 1 $ ,50 Total I I ktereby apply for a Residential Plumbing Permit and acknawledge that the infarmation is eomplete aud accura.te; that the work will be in conforrnance with the ordina.nces and codes of the City of Eagan and with the Plumbing Codes; tha I understand this is not a permit, but only an application for a permit, and wark is not to start without a t; that the work be in accordance with the approved pla?e ?e of work.w?h requires a review and approval nf plani Applitant's Printed Name ' y-- ?Applicant's Signa 12_',; z15 ? J 90 RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5674 New ConsWction Reauiremen4s RemodeUReoair Reauirements 0(fioe Use OnN 3 registered site surveys showirg sq, ft oF bt, sq. ft of house; and all roofed areas 2 oopies of plan _ CeA of Survey Reod (20% maximum lot coverage albwed) 1 set oi Energy Cakxilatlons tor heated addi6ons _ Tree Pres Plan Recd 2 copies of plan showing beam & window sizes; poured tound design, etc. 1 site survey for additlons & dedcs _ Tree Pres Not Reqd 1 set of Energy Calculations Addition - indicate i/onske septic sysfem _ On-site Sepdc System 3 copies of Tree Preservation plan it lot platted after 711193 Rim Joist Detail Options selection sheet (bldgs wifh 3 or less units Date . ?) / ?. L;/? Construction Cost (oncl) Site Address y-?? k 4-,f- UnidSte # Descrigtion of Work ? ?, ? Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2 Property Owner %,r -, ?. Telephone # 1,5 `? I-A Ln Z.?] Contractor 1 'LA , Address Y>> v c l City L?-i-? x t? ?r, rt C7? State Zip ?-? t:? I 1-l Tetephone#( )Z1??1 1?1?GLy COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category - Minnesota Rules 7670' Categorv 1 (4 submission lype) • Residential Ventilation Category 1 Worksheet Submitted • Energy Envelope Calculations Submitted Licensed Plumber Mechanical Contractor Sewer/Water Contractor Minnesota Rules 7672 . New Energy Code Worksheet Submitted -? _ ?. Telepho Telephon !,#( ?1.! , t Telephone Y I hereby apply for a Residential Building Permit and aclaiowledge 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. ? --?.,_-- _ V Applicant's Printed Name ' Applicant's Signature OFFICE USE ONLY sub ryPes ? 01 Foundation ? 07 05-plex ? 13 16-plex O 20 Pool ? 30 AccessoryBldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireptace ? 21 Porch (3-sea.) O 31 ExL Alt - Multi ? 03 01 of _ plex ? 09 07-plex O 17 Garage 13 22 Porch/Addn. (4-sea.) O 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) O 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Stonn Damage ? 06 04-plex ? 12 12-plex Pibg_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 (Bidg)" ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement *Demolition (Entire Bldg) - Glve 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) FinaUC.O. _ Footings (deck) FinaUNo C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile pther Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AirlGas 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 MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total , `1988 BUILDING PERMIT APPLICATIOb1 - CITY OF F.AGAN ' _. SINGLE FAMILY DWELLINGS INCLUI3E 2 SETS OF PLAI+IS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENBRG'Y CALCULATUNS NOTEs ADDflB3SES F4x CORKER i.OT9 - C4NTRACTQRlHOMEOWNEFt MST DESIGNATE WHICH ADDRES3 IS DESIEtED. Nq CHAAI4ES Wl'LL HE ALLOWEED QHCE EUILDINti PERMZT IS ISSiJEb, MULTIFLE DWELLTNGS REiJTAL QNITS FD8 SAI.E UNITS # OF- UNl"t'3 _- .._.........?.,r INCLUDE 2 SETS OF PL.ANS, CEATIFIClTE OF SpRVEY - CHECK WITS BL.DG. DEFT., 1 SET OF ENERGY CALCULATiDNS CaMII«tERCIAI. . IATCLUDE 2 SETS OF lIACHITECTURAL & STRUGTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF EPIFLRGY CALCULATION'S ,. ' ?' - .00Ti?1988 , To Be Used For: Sin4aa Valuation: -7444**?' iJate s, Ortobe?t 1988 1 !I Site Address a-lachhawh Lahe DAive Lpt 12 Black 1 ParcelfSub S-tvneg Ao.i.fLt Qwner t?elc Hvrnej Address 14600 1 Otlt, Ave So #300 City/xip Code atvuAv.i.Lle, MN. 55337 Phone 439-7557 Contraetor Aarrie Address City/Zip Gade Fhnne Arch./Engr. l.lanca Address 3435 Wa-ih-inatan Dltive Citq/2ip Code 6aaart. Ml/. 55722 Phane # 452-0724 aFFaCE vsE oNt,Y ??food- Qn site sQwag e iDcotxpanay - • MWCC sygtem _?/ 2araing lt-1. Qn site wel?. Avtual ?nBt City water A].].awahle » ? PRV required # of aicaries, Booster Pump ? Length Depth S.F. Tota:l Footprint S.F.? APPROYALS ?._... FBES ......... EngrlAssess Permit ??•? Flanner Surcharge JUL Caunoil PIan Hevi?at ' Bldg. Off. ?;o/f7SAC, City I ._oo. Variance SAC, MWCC tD*`' Water Conn ? 0 WaterY" MetBl^ Road Unit O Treatmen'? Pl D?C? ? Parka ..__.....,.._ Copf.es ?- T$'r'1L ty V , ? V'ALU?'?1o1?i , .h GARAbE ZZ >c z2 =- ?t8 y ,?r ; ? ? ?. q -.74 x 1? -?'? 6 y r , . ? ???T' O' 4t M 3 = ? L13S Z.,, ?5T F?.nra 7 ? ? ? ? <" ?•'? , -? ?????? ? a v? ?; ,?q? 482•0(]t I 3 ? 8.50+ 241• ? 0 lT + L 7.96. - ' Qt3+ ? 2'557-50* ? ? . .?. .. .. f ? * * ?( * plon ? eng * *?c * 9g ? ? 1 ? 51 ?? I ' i i t I i •I I ?-- 3 123•67 • M Paopog6 G ? - V d0 ? I e1 ?O As I 20.OL i_ _ ? 1'i.o 10.0 -I- - - -- i- ? ?,? I ?. ?' I ? ? K $513 70.08 ' ? y3,o ? ? N tl? ?. .?...,..._. A g,MAO,,? ,.,. gLAC?NAVYkA ?DR f vc- r 900.o Denofes exiWino ElevaEion + 9op, 0 Dcnofes propaHd flevatiort --- -`- Denofcs Dravnq e0/f ilr fy Easemenf benofes Oruina e Flow arrows o Denofrs monumthf 8 e4r;nIs shown arQ assurn ed LoT 12 , BLDck I SMAtEY POINT DAKoTA CouNt MINNESO?'A SU?ECT TD EASEMENTS OF oQ. Y, RE't!7 I hereby certtfy thet this survey, pien or report was pre red by rr,?i r e'y dtrect aupervi on and that 1 am duy ?ee-Isterea Lanii tu?veyor I under the laws of the 5tate of Minnesota. Deted this-?-b{-'?'pey of ?S? A.D. 19 - I rnch a 40 ? z L Scole: ?' / /.- WA A ? ROBERT D. StKICH L.S.rREG. NO. 14891 2422 Enterprise brive Mendota Heights, MN 55120 PA (612) 681-1914 Certificate of Survey for: W4G&CK r`O ? NoatII PaoposEV NovsE EcEvArioNs Lowes f Floor Elevotion = M. t6 Top ot Btock flevation :g c/. 16 Garala 5lob Elevafion = 8 0• 3 P.R.i/. RECaUIRED k:XTBRIoit EIiVF.'I,OPEi AVElt/IQEw' "" uliru Jjist'??ti'1h1EliT , (To be submitted witti buildin U C019PUTATION ' ~ • • g permiti epplication) One or ` Two I'amily Dwelling , 0 wner All other vi){?f,?.??},? 6fte Addrese 3?57 K Co n trac to rJAL,, Date ? Plione • ' - LIIIEII.L FEET OF EXPOSED VIALL OPAQUE wni.L Detail rererenae troro attactied slieeta w1t4po ws : f t• aboVe grade a Z ? TOTN, EXPOS?D WN,L ARE'J1 Bq. FT. COtISTRUC`rION t uUu Value x Araa ? iiU if ' X SQ. n-"?-- ? sq• ntiu K s4. X $Q, ftUn x liQ. x ?sQ. iiU 11 Make & Type n n n n DOORSt "U" Value x 1trea t•talce & Type Uu _.._x SQ. a ?? nUa Q• X 8q. x Sq. ToTU.s ?--I 7i sQ. TOTAI, (U) (11) VALl1E8 AVEitAc?E ??U?? UIVIDED BY TOTIIL IIALL ARU I CJ AVEI2AQE tiU it ?/70 --=- • 1 15 vr lese for 1&2 family d%vellinge ROOE'/CEILI1iq t ' TO'PAL AREA t 10,91,44, 'FT. (a) FT. . ) FT. - ?uR) FT. (ll) (A) FT. (A) FT._161 . FT (A) FT. ' (U)(A) ' M (1!) ------» FT. S? ( U ) (A ) FT. (U) (A) FT. . ? FT. ? (A) (U) (A) k'T• I EI .L (u) (A) De tail referenoe I?u?? ?__??,?? Trom . FT. Uj(A) attackied slieete. ??U??? i x SQ. Fm. Deecribe openinge ` ???u ..... .` ??? ?A? -------'nUn x 8R. FT. ? (A) in roof. nU1i XSQ. FT. ? (A) TOTILL (U) (A) VAI,UES DxYIDGD BY • ?T• ?. CU?CA) X sQ W7"?L?j a?a N.? ZZI TOT `Ur? AL ROOF/CEILINQ /n ` '? Vulue x AreQ 11Y?-_?L??ttqtl I (? i??u x SQ. trU?? X ?Q. nU n x SQ. Ea ???v . AVERAaE "U" .U25 for vent?,lated roofa. . , , . /d2?11 r , r _?,?0 `?` ? ?? w&? t;x ,:?? ?? ( 4v4-494 z* (poao ;? = f?7 5.7CG ? ? f -7 -7, *7co lCvlyc °j ?,46 s 03A 144 = 119.67... 4x I - 44, a =1o, ;xi = 1o,5' 2- - z4x?15 z,- 457, o 4 - Flipy'?u I." ?O;p/ ? z ZAK 1715X L =- -3?;- .10 1 l? , ? ?y - 1 ^ ? •`\ f .V/ ?? ir? ??? ?rl . ?j ? ' ^^? _ `:•?{7f ? ? ?(?? ?-.? ? ... ?I I? ?? ' - +Ko qz-,i.-. ? ?1?? 1 AYA- C.??. G?NUr r1 ?I ? lA k - IN-M? I ? ?SZ JVPO?7eo Zf77,7W - Z. •5` AP 75 Ur UUF tlEY1,It1 ?? 11 l! 1. ) Irrteriar Air !'ijm • 00 61 2.) S/8 l+ aYp• lid. 56 ?.? InBUlftbioJt ? 44? . . 30) Exteriar Air Film ` t&T],LL ) „u„ , 'WmAL ..:.?:. (n), ? • S ? .,. ?L - 2 YALu 60 7, y Ititeriar Air FilK 1,1 *a 0.68 n.) yp. Ba, Ineulat?on :4s I9• a? 9• l 10.) ??? t. r 't'-?r1F Masvtrite 81cl.l la? ' . Extex3or Air Film 67 . nuu momnL ? (n)- . i IUI. a vALu 1.2. ) 13. ) InEerior Air fi.1m Ineulstivn 0668 ' ? ??• ? 15. ) P." Fix 111ro ,1viuE Po IG`r'- ki-rv jq.ov 1.88 . 16.? Magvnitg 8iding 210¢ 17:) Exterior Air FiXm ? }7 ? r04-0 TOTAL _-.. , (n)s . FOUt?IJAmIOIJ i g VIWU 180 i9.) Intarior Air Film ' . 0.68 . 200) ?-,rf y t?P??b • t1. ? ' 21 0) 22. ) 1?'? dvnorete B?.valt . 1.28 234 Exterior Air Fi1m . . I 7 .------? IlUtl ? T??Zs? .Or (J T0TAL ..------ (II)a f t ? _• "_? "?i?f ?izm? aud Uana. B].volt APFLKCAT10N FOR PERMIT IF EXISTING STRL'C.'TfJRE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: Mon ear * NOTE: PASMERP OF FFE AT TIME OF * ; ArrLIcazzoN noEs NoT corr : * STINIE APPR(7VAL OF PFI2hIIT. .'? ? * IrSeBMCN aF sEWER nrn/aR Fm,xM w ;. * iNsrAumxors wnL NoT Bs scEouum * * [!Nl'IL PII2MIIT HAS BF.E?J APPRC1VEfl. **,t,r*w,t**:* ***tt*ttttf t,r*:,t*:,r?*tw**** oF czagan (P E PRINT 1) PROPERTY ADDRFSS: IEGAL DFSCRIPTION: PRFSENT ZONING/PROPOSID CiSE: ? CONAAERCIAL/RETAIL/OFFICE Q INDL?STRIAL ? INSTITIJTIONAL/GOVERNMENT , =v,<R-1 SINGLE FAMILY ? R-2 DLIPLEX (Two Lnits ) ? R-3 TOWNiOLTSE (Three +. Units) ( Lnits) Q R-4 APARTMENT/CONDOMINIUM ( L'nits) 2) W-11MORK" .' 4217 NAN1E : ADDRESS : I CITY, STATE,' ZIP: RoynSU ,' l(e- YAW PHONE: y 31 r?SS 7 3) • ? : ?NAME: ADDRESS: CITY, STATE, ZIP: PHONE: ? MASTER LICENSE # rj'/ ,f ,f d f 4) NAME: J rZ ADDRESS: CITY, STATE, ZIP: SEWER AND/OR WATER CONNECTION PHONE: For City Lse P1 ers License: Active Expired Not recordeG Sta£?'In1t ai ************************? *****************************************************?******************? * TM GOLD COPY OF THE PII2MIT WILL BE SENT DIRDCI'LY TO PUBLIC WORKS TO FACILITATE METER PIQi-UP. ? *k PI.EASE ALTAW ZTn10 WORKING DAYS F'OR PROCESSING. SOMIDONE FROM TM QTY WILL COMACT YOL IF TEIERE * ** ARE ANY PROBLEMS. * ***?F* ?k***?k* * * *ic**9r?nlydr?r?kik?k**** **ilr?inlcir**#*?k?k*?tvk*kie*** *irit*?r**int**?k?k?k?k*?k?Y**ilr***?kk?r*ir?k*dr?r**?r*?k*?k+k?k?k?k?k?k?lr'kiry S_s 33 7 r ,? . ?. • a . ?? 5) ? CONNECrION 'I'O CITY SE'WII2 ? CONL+ECTION TO CITY WATER E] OTHER FOR CITY USE ONLY PERMIT # ISSUED ?Gd 77 Pd w/Bldg. Permit FEES: $ $ D , ?)-Zj -? $ $ <Z) $ $ $ $ $ $ $ $ /6-1 $ $ $ $ $ $ $ $ $ $ $ $ $ $ RECEI ZP937 PT RECEIPT SEWER PERMIT (INCLL'DE SURCHARGE) WATER PERMIT (I1+ICLLDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP ACCOUNT DEPOSIT - SEWER ACCOC'NT DEPOSIT - WATER WAC SAC TRL'NK WATER ASSESSMENT TRLNIi SEWER ASSESSMENT LATERAL BENEFIT/TRCNK SEWER LATERAL BENEFIT/TRLNK WATER WATER TREATMENT PLANT SURCHARGE OTHER: TOTAL DOES LiTILITY CONNECTION REQLIRE EXCAVATION IN PLiBLIC RIGHT OF WAY? ? YES IF YES, THEN A"PERMIT FOR WORK WITHIN PLiBLIC ? ROADWAY" MUST BE ISSLED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED By': TITLE: DATE : ? ? ?? 1 RECQRD 07CQMPL.AINT D1TE: COMPIrAINT TAKEN BY: 1??? ( V NAME: , ADDRFSS s f q( ( 44r PHONE HO.: ? CDMPLAINT : #"-L4 ACTION TAKEN: COMMENTS: . TYPE OF BiDI1.DING: V LEGAL DESCRIPTION: ? ,• ? _ SIGNED: G?? ??. 2006 RESIDENTIAL PLUMBING PERMIT APPLICATIQN CITY OF EAGAN . _--. ..,.. . . 3830 PILOT KNOB ROAD, EAGAN MN 65122 651-675-5675 - Please complete for modifications fa existing residential dweflings. ???q () l -9-1 5c) Date ! l Site Stree# Address Unit # Property Owner Telephone Contractar ? Telephone# (?ri f ) SF-> 43q17 Adclress 10 City StateMAL Zip 15 ? J? The Applicant Is: _ Owner Contraatar _Other Septic System New _ Refurbished Submit 2 sets of plans and MPC license Er?cludes County fee $ 100.00 Per as-builf $ i0.00 Aiterations to existkng dwelling $ 50.00 _ Add piumbing fixtures. This fee includes installation of a water softener ancilor water heater at the satne time. If you are insta!ling oR/V a wafer softener andfor water heater, do not complete this section; mave to the nexE sectian and check the appliance{s} you are installang. _5eptic System Abandonment _Water Tumar'ound (add $130A0 if a 518" meter is required) Other: S- Water Softener Water Heater $ 15.00 new __L replacement _ Lawn irrigatlon _RPZ PVB _new -repsir cehulld $ 30.00 M [ c ( :? 5 1? Il V? state surcharge $ .50 AF : 1 2 7001 Total $? J?(? I hereby apply for a Residential Plumbing PerrriiE and acknowledge that the iraforrriation is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that [ understand this is not a perrnit, but only an application for a permit, wark is not to start withcsuf a permit and wnrk will be in accorda.nce with the approved plan in the evertt a plan is required to be reviewed and approved. I i_ a t 1.. .7? Applicant's Printed Name Applicant's Signature CP i - I � Use BLUE or BLACK Ink �,, r----------------� , I For Office Use � ' ', � Permit#: l� U —� I C1ty Of �a�� .-�.�� Permit Fee: � 3830 Pilot Knob Road j �°��r � ? �' � Eagan MN 55122 ', ± _ � Date Received: � J � � �� I Phone: (651)675-5675 ¢ �.,,,,- I �`� I Fax: (651)675-5694 � �� ,';�� ! � �,�� I Staff: � I ' I I � ----------------- 2015 RESIDENTIAL BUILDING PERMIT APPLICATION c�( ��_�c�-lS Date: Site Address: Unit#: /J.f rK� Name: -� L �.�.e.�'�C.+, �S Phone: �S�` �S�— ^7�. 23 Address/Cityl/Zip: 1.'-C ll �lc�.w�rG- lt.�..�- ��' �l �"•' SS/Z.Z Applica�t is: ' Owner �Contractor Description ofwwork: �:-�-s�1.. �� Va•-"�e�� Construction i ost: � ��l��' a° Multi-Family Building:(Yes /No 1C ) Company: ��- (�S'"�"�'"''-�-'-t�""�Contact: �A"-�.� �yr�'�+-� S e.r-�v�..:.� S Address: ��4 ��'"� •A.++�— S City: �- g'T• r�'�+L 1.5� StateV`^� Zip: S�".ao75 Phone: "i�.�--"{L�Z Email: ��ts�Z�..�..-�.� QLv+S�+ - `^- License#: �. �v�lg �as 3 Lead ertificate#: If the project is exempt from lead certification, please explain wh : (see Page 3 for additional information) C,�� ° "1�"� -�1�5 � 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�ddress of master plan: Licensed Plumber: ' Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: ' Phone: 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.qopherstateonecall.orq I hereby acknowledge that this informatioh is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the�,case of work which requires a review and approval of plans. Exterior work authorized by a building,permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. i X M�I,�... �s.,d1.-� X � � ApplicanYs Printed Name ApplicanYs Signature ' � Page 1 of 3 DO NOT WRITE BELOW THIS LINE L��g • SUB TYPES � � � �� °cc'�-�tQ�IC' �`�A �t° Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration (Single Family) � Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Muiti) _ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPES ��h��"` ��'�'"f ��` 1�� _ 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 �G�� Occupancy ,_j.� MCES System Plan Review Code Edition 2,(9(��53L., SAC Units (25°/a_100%�) Zoning �_ City Water Census Code Stories Booster Pump : #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction �— Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) e Final/C.O. Required Footings (Addition) � Final/No C.O. Required Foundation � HVAC_Gas Service Test Gas Line Air Test Roof: _Ice &Water _Final Pool: _Footings _Air/Gas Tests _Final � Framing Drain Tile Fireplace: _Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick � Insulation Windows Sheathing Retaining Wall: _Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression: _Rough In_Final Braced Walls Erosion Control Other: Reviewed By: , Building Inspector RESIDENTIAL FEES BaseFee S tg�� Fj ��O��X �� i� ��°`}- � �a �� ^�� 3� Surcharge Plan Review .,, „ �� c?t.�.-� MCES SAC �� c�ty sac � ZC?C0 O� Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA137215 Date Issued:06/23/2016 Permit Category:ePermit Site Address: 1411 Blackhawk Lake Dr Lot:12 Block: 1 Addition: Stoney Point PID:10-72600-01-120 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 - Daren J Hastings 1411 Blackhawk Lake Dr Eagan MN 55122 (651) 454-9623 Scherer Brothers Lumber Company 9401 73rd Ave. N Suite 400 Brooklyn Park MN 55428 (952) 277-1600 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA151113 Date Issued:08/08/2018 Permit Category:ePermit Site Address: 1411 Blackhawk Lake Dr Lot:12 Block: 1 Addition: Stoney Point PID:10-72600-01-120 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations 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 - Daren J Hastings 1411 Blackhawk Lake Dr Eagan MN 55122 Scherer Brothers Lumber Company 9401 73rd Ave. N Suite 400 Brooklyn Park MN 55428 (952) 277-1600 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA156774 Date Issued:07/18/2019 Permit Category:ePermit Site Address: 1411 Blackhawk Lake Dr Lot:12 Block: 1 Addition: Stoney Point PID:10-72600-01-120 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations 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: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Daren J Hastings 1411 Blackhawk Lake Dr Eagan MN 55122 (651) 792-5900 Scherer Brothers Lumber Company 9401 73rd Ave. N Suite 400 Brooklyn Park MN 55428 (952) 277-1600 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA172163 Date Issued:09/16/2021 Permit Category:ePermit Site Address: 1411 Blackhawk Lake Dr Lot:12 Block: 1 Addition: Stoney Point PID:10-72600-01-120 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. When a weather barrier is installed or Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Daren J & Cheryl Hastings 1411 Blackhawk Lake Dr Saint Paul MN 55122--125 (651) 792-5900 Dubois Design & Remodeling Inc 715 St Croix St Suite 14 River Falls WI 54022 (651) 458-0844 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA175513 Date Issued:04/07/2022 Permit Category:ePermit Site Address: 1411 Blackhawk Lake Dr Lot:12 Block: 1 Addition: Stoney Point PID:10-72600-01-120 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. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the water damage. Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 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 - Daren J & Cheryl Hastings 1411 Blackhawk Lake Dr Saint Paul MN 55122--125 (651) 792-5900 Dubois Design & Remodeling Inc 715 St Croix St Suite 14 River Falls WI 54022 (651) 458-0844 Applicant/Permitee: Signature Issued By: Signature