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1435 Blackhawk Lake Dr
CASH'PlECEIPT CITY OF EAGAN 3834 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE r ~ ~ ' 19 ~ " ' c t k ~ AMOUNT $ . ] C f & DOLLARS ❑ CASH 'fJ CHECK FUND dBJECT ` T r , X`G a: yy 41, ~Jt j' r CITY OF EAGAN Permit No: r+~ Date: a-22-68 3830 Pilot Knob Road Meter No: Size: P.008ox 211119 Reader No: Date: ,Eagan, MN 55121 Owner. 3W4 Site Address: 1435 Blac`rjawk lAk-B U .B2 Stony Point Plumber. C}~...?,erp Conn. Chg: 550.00Tau Zoning: Acct. Dept-.5•k~C#1 No. of Units: Permit Fee: 1.40.00x.4 Surcharge: • 5070 1 agree to comply with the City of Eagan Tr. Plant 2(A • k1~ Ordinances. Meter. Misc.:4TIP~ By WATER SERVICE PERMIT CITY OF EAGAN Permit No: 10017 Date: A-~ - ` 3830 Prot Knob Road B/P No: 86746 Date: *-t O..itA P.O. B9x 21199'6 E89an, MN 55121 Owner Suns NA* must. i Site Address: ! kl S B 7 #w1rh.*.k "-it* I'm ~ 9' Stogy ftdp4 - - Plumber: OIL-BerSt - MWCC: 550, 00ed Zoning. s1 City Chg: 100*00od No. of Units: . Acct. Dep: 15. 00pd 10~00pd 1 agree to comply, with the City of Eagan-.-- Permit Fee: Ordinances. Surcharge: . 50pd Misc.: wm ogq-, pA= By SEWER SERVICE PERMIT CITY OF EAGAN ~ R 3830 Pilot Knob Roid, P;O. Box 21.189, Eaian, MN 55121 1 U ` PHONE: 454.8100 BUILDING PERMIT Receipt To be used for : T F ?nK /'.AR Est. Value lt) + Date AUGUST 18 ,19-Ag~- Site Address 1435 Bl-k-M€AW LAka 71R IVOFFICE USE ONLY Lot I Block 2 Sec/Sub. '2()N~a` M1 VT Site Sewage Occupancy MWCC System X Zoning" Parcel Na On Site Well V--14 (Actual) Const Name ' lY:tS113°R ~A ;,57`R[`117 City Water (Allowable) V"N ~ . . t.sr ~„1.[1~ CLIFF :fkT VP,, #224 PRV Required of Stories O Address-2121 City ACaAN Phone Booster Pump Length 3 5~-~~ 5 Depth ao NameS.F. Total Address Footprint S.F. City Phone APPROVALS FEES w a Engr./Assess. Perm-604*00 W w Name S4.at1 Planner Surcharge _is Address 301 ,00) Q W City Phone Council Plan Review Bldg. Off. SAC, City l01D.('* 550.00 hereby acknowledge that I have read this application and state that the Variance SAC, MWCC information is correct and agree to comply with all applicable State of Wafer Conn. ai3•{'` Minnesota Statutes and City of Eagan Ordinances. Water Meter 6T • C "I Signature of Permittee Road Unit/~'-~ A Building Permit is issued to, Treatment Pt ontheexpress condition that all work shall be done inaccordancewithall ` Parks applicable State of Minnesota Statutes and City of Eagan Ordinances. $275 . 5 1 Building Official TOTAL Perm w no. P*#MK'H*klar t> Talophoni i Numbing j r H.v.A.C. Electric t3oftener InWeetlen Data Insp. Comments Footings 1 Footings 11 r Foundation Framing Roofing Rough Mo% Rough Htg. Isul. !0? Fireplace Final Htg. Final Plbg.. Bldg. Final 1 Cert. Ooc. Temp. LP Deck Ftg. Dock Final Well Pr. Disp. l~ERi~MT # PLUMBING PERMIT RECEIPT # CITY OF EAGAN _ 3830 PILOT KNOB ROAD, EAGAN, MN $5122 DATE: CONTRACT PRICE: PHON . 454-8100 Site Address i ' f` " r' - 1oBLDG. TYPE WORK DESPRIPTION Lot / -Block Sec/Sub Res. `.r New Mult. Add-on Name r t; / r.;'! wr Comm. Repair Address- 7 T Other H City T { t ` Phone RES. PLBG: ONLY - COMPLETE THE FOLLOWING: NQ, FIXTURES TATM -Water Closet - $3.00 Name Bath Tubs - $3.00 c Addr a4'1 LG ~b = Lavatory - $3.00 p City Phone Shower - $3.00 Kitchen Sink $3.00 FEES Urinal/Bidet - $3.00 -'r COMMAND FEE - 1% OF CONTRACT FEE _LLaundry Tray - $3.00 APT. BLDGS - COMM RATE APPLIES Floor Drains - $1.50 `-e TOWNHOUSE & CONDO - RES. RATE APPLIES Water Heater - $1.50 MINIMUM - RESIDENTIAL FEE -$12.00 Whirlpool- $3.00 MINIMUM - COMM/IND FEE -$20.00 _7EGasjP1ping Outlets -41.50 5- STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT). (ADD. $.50 S/C IF PERMIT PRICE GOES / Softener - $5.00 BEYOND $1,000.0 Well - $10.00 Private Disp. - $10.00 lofV Rough Openings - $1.50 SIGNATURE OF PERMITTEE FEE: X41' STATE :I/C GRAND TOTAL: t FoR: CITY OF EAGAN f J8~ PERMIT* M MECHANICAL PERMIT RECEIPT # . pi CITY OF EAGAN y ~o 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 For Office Use Only: Site Ad7e ss 4Ae'6 pw - BLDG. TYPE WORK DESCRIPTION At lock c/Sub Res. 1✓f New FIC.2 U{.i Name Q ia` h L Mult Add-on m Addr s a6 Comm. Repair i 11 Other c City,} ►~.511►.a~ lli~ Ph ne 919 5 p FEES Name RES. HVAC 0-100 M BTU -$24.00 c Address ADDITIONAL 50 M BTU - 8.00 (RES. HVAC; NSTRUCTION) INCLUDES A/C ON NEW p City Phone 't CO GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA TYPE OF WORK COMM/IND FEE - 1% OF CONTRACT FEE Forced Air M BTU yG~O APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12.00 Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES Gas Piping Outlets # s4 BEYOND $1,000) Other $ FEE: ,2 ~ S/C: fts"A SIGNATURE OF PERMITTEE TOTAL FOR: CITY OF EAGAN INSPECTION RECORjus CITY OF EAGAN PERMIT TYPE. : 3830 Pilot Knob Road Permit Nader: Eagan, Minnesota 55123 aete Issued: (612) 681-4675 SITE ADDRESS: 4: ~j i ; tt 1 s_e c r: APPLICANT t/4:st. f$4.A4w4tH AWK f.At'1. 410 4~1t►LJF:`~'f 64f `.ii)47ATTty►3 COMSt` I()Nf Y t'El4N1 (612.) r84• 112 PERMIT SUBTYPE: TYPE OF WORK: F=kAMIN6 RIM01i IN 11(.1,36 f'of)m 1.14 swu 4 fNA1. tr S i - a afi r=' f " i s * k,S ' t t r ~ i w~~ i f t-t ~ {`Zh r r ~ G n ~ Y F - ~4 ~ y.-•' i ~~i ~ d x y ,C s + t 4 Y p'era~ 1Wo. t~ei~it trotr.ter ~iaf~ ~ . , PL NVAC SACTAC i E WTFOC - o boo ittsp. Commerds Fbo*ngsl Roaft IsIA. SWIM First Filg, Omm Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter Engr /ftn 810. Final Deck Ftg. Deck Fines Well °r. Disp. :a ,C . «►it i t. S & W approves. CITY OF EAGAN ? 5 '64 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 3 PHONE: 4548100 BUILDING PERMIT Receipt # r To be used for 57 DWG/GAR Est. Value $109 * 004 Date AUGUST 13 ,19~ Site Address 1435 BLACKHAWK LACE DR1V E OFFICE USE ONLY Lot 1 Block 2 Sec/Sub. STONEY POINT On Site Sewage Occupancy MWCC System K Zoning R-1 Parcel No. On Site Well (Actual) Const V10 = Name SUNSHINE CONSTRUCTION City Water X (Allowable) Y-_ 6z Address 2121 uL1 FP URIVE, #224 PRV Required X * of stories ti City EAGAN Phone 452--0995 Booster Pump Length 2 Depth .52 Name j Name SAME S.F. Total ci o Address Footprint S.F. P City Phone APPROVALS FEES t ~ v m Engr./Assess. Permit WW Name F Planner Surcharge 54* «fi _ z Address Z Cit i Phone Council Plan Review 302.00 ac W Y a Bldg. Off. SAC, City 100400 I hereby acknowledge that 1 have read this application and state that the Variance SAC, MWCC± inforr"tion is correct and agree to comply with all applicable State of Water Conn. Minndsota Statutes and City of Eagan Ordinances. Water Meter V. ~ Signature of Permittee Road Unit _ 325, A Bulging Permit is issued to: SUNSHINE CONSTRUCTION Treatment P1 204, on theexpress condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Parks TOTAL $2 Building Official F f Y -6A 50 r 4. . NO G.O. until S & W approves. CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N0- 15464 -S ,Q --I BUILDING PERMIT PHONE: 454-8100 Receipt # ''.,o To be used for SF DWG/GAR Est. Value $109,000 Date AUGUST 18 19-m- Site Address 1435 BLACKHAWK LAKE DRIVE OFFICE USE ONLY Lot 1 Block 2 Sec/Sub. STONEY POINT On Site Sewage Occupancy R-3/M-1 MWCC System X Zoning R-1 Parcel No. _ On Site Well (Actual) Const V-N cc Name SUNSHINE CONSTRUCTION City Water X (Allowable) V-N W „ PRV Required X # of Stories 3 Address 2121 CLIFF DRIVE, #224 O City EAGAN Phone 452-0995 Booster Pump Length 52_ Depth 52- o Name SAME S.F. Total _ o a Address Footprint S.F. City Phone APPROVALS FEES Engr./Assess. Permit $ 604.00 U w Name WW Planner Surcharge _ 54.50 Z5 Address a m City Phone Council Plan Review 302.00 Bldg. Off. _ SAC, City _10_0 -.0-0 I hereby acknowledge that I have read this application and state that the Variance _ SAC, MWCC _550.00 information is correct and agree to comply with all applicable State of Water Conn. 550-00 Minnesota Statutes and City Eagan rdinances. ~ Water Meter 67.0 Signature of Permittee Road Unit -325. 0 A Building Permit is iss d t S NE _CONSTRUCTION Treatment P1 _204-0 0 on the express condition that all wor hall be ne in accordance with all parks applicable State of Minnesot tutes an i of Eagan OrdiQances. - TOTAL Building Official /BLDG. PERMIT O. ~-/Jv Bldg. Permit©~ 01-3422 Plan Check 01-3445 Surch./Adm. 01-3446 SAC/Adm. 01-2155 Surcharge J 75-3860 Road Unit4 20-2275 SAC cly4z "o-to 20-3865 Water Conn. 20-3868 Water Trmt. O 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. 28-3855 Park Ded. TOTAL D CITY OF EAGAN Permit No: 9875 Date. 6-22-88 381"ilot Knob Road Meter No: 4147 q6 Z 7,2 - Size: P.O. E1ox 2119 Reader No: 4 7~D Data 9 S'- Eagan, MN 55121 Owner. Sunshine Const. Site Address. 1435 Blackhawk Lake Dr. Ll B2 Stony Point Plumber- 01--here Conn. Chg: 550.OOpd Zoning: R1 Acct. Dep. 15.0Opc, No. of Units: Permit Fee: 10-0026 Surcharge: . SOpd I agree to comply with the Ea Tr. Plant 204.00pd Ordinances. Meter. 67 000 Misc.:- P VR REOOI rD gy 111 WATER SERVICE PER IT Pptvr`-~ bl" (Ur#iftratr of Mrrupattry Citp of ceagan This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following..- Use C9assi&xtion Bldg. Permit No. .t e Occupancy Type Zoning District Type Const. Owner of Molding t' Address Building Address Locality ? ? Date Building Official POST IN A CONSPICUOUS PLACE 3 4 0 - S 61 ® OFFICE SE ON Y This request void 18 months from validation date printed in this b ~(D Q PLEASE PRINT OR TYPE ~ ~O Reqv t Dale Rough-in inspection required! Yes o Inspect on her Than Rough-In: jg Ready Now Will Call (You must call the inspector when ready) Data Ready: I, licensed contractor ❑ owner hereby request inspection of the above electrical work at: Job Address Street, Box, or Route No.) City ~n Zip Code Section No. Township Name or No. Range No. Fire No. County Ocapo /ZO &/~a Phone No W~~ Power Supplier Address Elag"I Contractor (Company Name) C Contractor License No. Mader Lic. No. (Plonf Elect. Only) ,M I 717d Pitefisoule Mailing Address Con or or er Performing InsOllation), Author! n re (Contractor er Performing Instal n) Phone No. V r+lO~ OOOOIA-10 6/9 BOARD 66PY • SEE INSTRUCTIONS ON BACK OF YELLOW COPY REQUEST FOR ELECTRICAL INSPECTION & d , 'r VIII II III II II) II III II IIIIi III II III II III V III VIII Minnesota State Board of Electricity Paul MN 55104 1821 University Av Rm. , * 0 3-4 0 8 6 1 4* Phone (612) 642-0800 ame' Duplex Apt. Bldg. Other: New Addn TAir omial ndustrial Farm Remod Repair, Equip. Water Htr. Load Mgmt. OtheV r:` eG / . Dryer Ran a Elec. Heat Temp. Service "X" above the work covered by this request. Enter remarks in this space and on the back of the white copy only. Calculate Inspection Fee - This Inspection Request will not be accepted without the correct fee: Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps Street Ltg./Traffic Sig. Above 200 Amps Above 100 Amps Transformer/Generator INSPECTOR'suSE TOTAL Sign/Outline Ltg. Xfmr. Alarm/Remote Control Swimming Pool I he Lrlilh.l ins stied the a ethical into lofion described herein on the dates stated Irrigation Boom Rough-In Dare Special Inspection Final Do Investigative Fee THIS INSTALLATION MAY BE ORDERED DISCON NOT COMPLETED WITHIN 18 MONTHS. E 85888./i.- Request Date Fire No. gh-in Inspection Ic,~ s C l d? ❑ Ready Now VWill Notify Inspector e ❑ No When Ready? I ~licensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) City Section No. Township Name or No. Range No. County I!) '~4 kc-, Oocupa PRIM) Phone No. Power Supplier Address Electrical Contractor (Company Name) Contractor's License No. Mailing Address (Contractor or Owner Making Installation) MI j T - ~Cc C c~~ . Num Authorized 'nature (Corltractor/Owngf Making Installati Phone MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Grlgge-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 65104 UNLESS PROPER INSPECTION FEE IS Phone (612) 542.0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION L• EB-00001 .07 ► See Instructions for completing this form on back of yellow copy. E 65 S 8 U , X" Below Work Covered by This Request New ,Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Contractor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps Z .Lx i,3 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only: TOTAL Irrigation Booms SCr' Special Inspection _ Alarm/Communication Other Fee IS I, the Electrical Inspector, hereby Rough-in Date W certify that the above inspection has Final oaf been made. ' 7, OFFICE USE ONLY This request void 18 months from PERMIT ek- ' CITY OF EAGAN It e 3830 Pilot Knob Road PERMIT TYPE: B U I I 1 ~ ~I N G Eagan, Minnesota 55123 Permit Number: 024161 (612) 681-4675 Date Issued: 07/18/94 SITE ADDRESS: 1435 BLACKHAWK LAKE OR LOT: 1 BLOCK: 2 STONEY POINT P.I.N.: 10-72600-010-02 DESCRIPTION: (ROOFING) Building Permit Type SF (MISC.) Building Work Type REPAIR REMARKS: FEE SUMMARY: VALUATION $4,000 Base Fee $63.00 Surcharge $2.00 Total Fee $65.00 CONTRACTOR: - Applicant - ST. LIC. OWNER: MIDWEST RESTORATION CONST 17842772 0005267 BUDION JOE 1121 80TH AVE NE 1435 BLACKHAWK LAKE DR MINNEAPOLIS MN 55432 EAGAN MN 55122 (612) 784-2772 (612)452-5446 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. h~ APPLICANT/PERMITEE SIGNATURE ISSUED B : SI ATU INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: BUILDING 3830 Pilot Knob Road Permit Number: 024161 Eagan, Minnesota 55123 Date Issued: 07/18/94 (612) 681-4675 SITE ADDRESS: LOT . 1 BLOCK.- 2 APPLICANT: 1435 BLACKHAWK LAKE OR MIDWEST RESTORATION CONST STONEY POINT (612) 764-2772 PERMIT SUBTYPE: TYPE OF WORK: SF (MISC.) REPAIR DESCRIPTION (ROOFING) INSPECTION TYPE DATE INSPTFI. INSPECTION TYPE DATE INSPTR. FRAMING ROUGH IN PLBG ROUGH IN HTG FINAL • CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION ~ ~ ~0 681-OWS SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy,of energy talcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy caics. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date .7__ Valuation of work Site Address: STREET SUITE E Tenant Name: (commercial only) LOT BLOCK SUBD. P . I . D . ~k Description of cork: ROOF &5PAIR I i SHIIV64 The applicant is: ❑ Owner )_4 Contractor ❑ Other (Describe) Name &D410Af Property LAST FIRST Owner Address STREET WE City RA/ State HAI _ Zip" C »I ~ T9 Phoneg _ ca~'T c~• Company ~/~'k, , .r 619- Contractor Address/Lag P1 1.iAtj /0 6~f, License #(a Exp.`. City 01AJJY= }Pnl State -,HA/ Zip Architect/ Company Phone Engineer Name Registration 0. Address City State Zip 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 'cation and state that the inflation is correct and agree to comply with appli a e to of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwg. ❑ 07 4-flex ❑ 12 Multi. Misc. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-Plex ❑ 13 Garage/Accessory ❑ 18 Comm./Ind. ❑ 04 SF Porch ❑ 09 12-Plea ❑ 14 Fireplace ❑ 19 Comm./Ind. Misc. ❑ 05 SF Misc. ❑ 10 Multi. Add'l. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE ❑ 31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual Basement sq. ft. MWCC System (Allowable 1st F1. sq. ft. City Water UBC Occupancy 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code Depth On-site sewage SAC Code Census Bldg APPROVALS Census Unit Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ Site ❑ Footing ❑ Framing ❑ Insulation ❑ Wallboard ❑ Final ❑ Draintile ❑ Fireplace Permit Fee yaiuftip,= $ 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. Copies Other Total: SAC % SAC Units CITY USE ONLY 7 L BL RECEIPT #:LP1L_D SUM DATE: 1996 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: ► single family dwellings ► townhomes and condos when permits are required for each unit New construction Add-on furnace Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc. Date: AeAPB /906 If FEES ► Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00 ► HVAC: 0-100 M BTU 24.00 Additional 50 M BTU 6.00 ► Gas Outlets (minimum of 1 required @ $3.00 each) ► State Surcharge .50 TOTAL D SITE ADDRESS: glliae~#ullr /J OWNER NAME: A,OLOiJ PHONE INSTALLER NAME: 11U)eJ1 !:Pa1 1k STREET ADDRESS: CITY: STATE: 4y zip: ~~370 PHONE ( 6-Z3-~0,7 CITY USE ONLY . L BL RECEIPT SUED. DATE: 1996 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 (612) 681-4675 Please complete for: all commercial/industrial buildings. ► multi-family buildings when separate permits are n2t required for each dwelling unit. DATE: CONTRACT PRICE: WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT DESCRIPTION OF WORK: FEES: $25.00 minimum fee QI 1% of contract price, whichever is greater. ► Processed piping - $25.00 ► State surcharge of $.50 per $1,000 of tong fee due on all permits. CONTRACT PRICE x 1% PROCESSED PIPING STATE SURCHARGE TOTAL SITE ADDRESS: OWNER NAME: TELEPHONE TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS: CITY: STATE: ZIP: PHONE SIGNATURE: SIGNATURE OF PERMITTEE CITY INSPECTOR CITY OF E A G A N * !,UrE• PAYMFU OF FEE AT TIME OF APPLICATION DOES NOT OONSTITU~ * APPROVAL OF PERMIT. APPLICATION FOR PERMIT INSPECTION OF SEWM AND/OR WMM ; TNsnu T.AT ms WILL NOT BE scmm - SEWER AND/OR WATER CONNECTION UNTIL PERMIT HAS Mm * APPROVED. ; ~h r P ease Print) 1) PROPERTY ADDRESS: _:?67y L7~ALCf//~cJiC ,L~ ~2 " LEGAL DESCRIPTION: _ L~o T- / Al ~7~inlf li ~~iNT " (Lot/Block/Subdivision or x Parcel ID ) IF EXISTING STRCt'TLRE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: PRESENT ZONING/PROPOSED USE: (Month/Year) CONQmCIAL/RETAIL/OFFICE- R-1 SINGLE FAMILY Q INDUSTRIAL R-2 DUPLEX (Two Units) INSTITUTIONAL/CZVOWENT R-3 TOWNHOUSE (Three + units) ( Units) p R-4 APARTMu/CONDOMINIUM ( Units) 2) w NAME:_ Su A/,SH 11V P-- ADDRESS:- CITY, STATE, ZIP:_ C ,d & , AfAl PHONE: 3) u I: al• For City Use NAME: DL - 6E,2~Y Plumbers License: Active ADDRESS : 4/,0g2 4-T s Expired ~T CITY, STATE, ZIP: S Not recorded PHONE:_ y,3~ . 90 75' AASTER LICENSE# -369/ Arz t Initial 4) • ; I~1• NAME:- Ac qlt-' ADDRESS: ' CITY, STATE, ZIP: PHONE: CONNECTION TO CITY SEWER CONNECTION TO CITY WATER OTHER , 6) 1 ' ' • I' Q PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1,C03, 4, ABOVE Tom' (Circle one) 7) r. r• • ~ f7-~ r FOR CITY USE ONLY PERMIT # ISSUED yf ,-,7.3 Pd w/Bldg. Permit FEES: 42 $ SEWER PERMIT (INCLUDE SURCHARGE) ( a'~ $ WATER PERMIT (INCLUDE SURCHARGE) $ $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER $ $ ACCOUNT DEPOSIT - WATER $ .5~~/) • Cr7~ $ WAC $ rt' • - $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ v~ Ch c~ $ WATER TREATMENT PLANT SURCHARGE $ ` $ OTHER: $ / 2 7 C~ $ TOTAL RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC Q ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CbNDITIONS: APPROVED BY: TITLE: DATE : Z -j 1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN SINGLE FAMILY DWELLINGS ` INCLUDE(PSETS OF PLANS,a CERTIFICATES OF SURVEY, SET OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER-MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS To Be Used For: _:5MtiALLA&&y Valuation: Date: Site Address / 3 S / *ja- e- OFFICE USE ONLY Lot Block On site sewage Occupancy-3 MCC system Zoning Parcel/Sub On site well Actual Const V. PA City water Allowable Vim- Owner :!5;„1.W„VX 63&<T PRV required # of stories Olt Booster Pump Length 5 T~ A y Depth Address gi,21 ~ii,b Aei kr' S.F. Total City/Zip Code Footprint S.F. Phone Y4;2 '©95 APPROVALS FEES Contractor Engr/Assess Permit+ ~O Planner Surcharge Address Council l Plan Review o Bldg: Off.~lt8 SAC, City 00+ City/Zip Code Variance SAC, MWCC 100 Water Conn Phone Water Meter _(e2. Road Unit ~,t Arch./Engr. t. Treatment P1 p d Parks Address V.4f~fTv~. 'lily Copies- City/Zip Code A.~ I. aIWJ TOT SS3/~/_ Phone # y-j0~ VALkkAlIONk _ 6A RAGE Z2 X22 y84 X /4r 6,9/76, 13A`~C t~~ NT 30 )t 5Z= 15~o k I zoz Ira i s-r 31'/zx s Z : 1638,:, I (0(~2. X 4~;'~Iy38 108y9W IN, i EXTERIOR ENVELOPE AVERAGE 'U' COHPUTATION OWNER: SITE ADDRESS: ,0( oil i CONTRACTOR: SATE: c [Z- PHOHE: Determine working square footage of each:" 1. Total exposed wall area sq. ft. x .11'; r.,. 2. Total roof/ceiling area sq. ft. x .026. f •r Total exposed wall area above floor = 2, < < a. Total wall window area b. Total door-area 1 c. Total sliding glass area • d. Total fireplace wall area e. Total wall framing area (average 10%) f. Total net wall area above floor g. Total rim joist area Total exposed foundation area h. Total foundation window area i. Total net foundation area above grade Determine 'U' value of each wall segment: a. 1 x 'U' - b. X #Us _ c e X out e x 'U' I rrx . g. 2 ♦ x 'u' . _ 3. Total = r 9 If item 03 is the same as or less than item #1, you have met the intent of SBC 6006(c)2. Total exposed roof/ceiling area = l J. Total skylight area k. Total roof/ceiling framing area (average 10%) 1. Total net insulated roof/ceiling area.......... OVER Determine *U* value for each roof/ceiling segment: k. '2. x I U, 1 01, tag -42 _ 1. ('52n x lut . . . . . . . 66.0 . . . . . 00.0 . . . . ■ . . • • . . . Total 4.' r If total of 04 is the same as or less than #2, you have met the intent of SBC 6006(c)l. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of Items 03 and #u shall no{ftt' be greater th~~ayn the sum of Items #1 and #2. -7 :#7 CITY OF F.AGAN l ~r N INDIUM "U" VALUE A.NTD R-FACTOR AT ROOF, WALL, RIM A`D CO;dCRETE BLOCK, Provide insulation baffles in every' ROQF CEILING, rafter space. (p) VP s Q lra-('evuo ' fitR F1 Lim ~ Cv I . • Q 51Y &V Z'D. r C ~ 1NSUt_A jloN ~ ~ EX jE.1Z;or- Alr FILM IcUcc j1Z = TdTA>r (P la %/A L C { . • i~t~r- Also FILM 10SULATION SizJ' IC?.,0 I to tt ~X =1oP- Art FILP'1 % ~-j j TOTAL (R) --2 R1 M 1-04 (70. VAU ~~r 2 FI>z TCt11 FIST S~ - 11- rs 15 501:.7 ;v t;• C'ch~rcl-CE sto1NG i to-7 Li AF- FILM ri url • as / TTP C 6Q 11r1L~ IN TEt7 IZ Atu FILM . ~Og O° o' . I`1 C • Eh c(~l0, AIR FILM n it n (4- 76JAk Floors over unheated spaces must have minim'u-m•R-factor -of R-20 (tuck-under garages). Floors o•:er outdoor air (overhangs) must Have a mininum R-factor of R-33. ' ~y.~.l..~.. Mf`'k''"~:., .~~..,.....rn.~.._}~+.~,r` ~:»i~~ s..~.sav..rar...rr ` t ` . fir„ cY, .r .r r 1$ 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan, 3830 Pilot Knob Road, Eagan NIN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan showing footings, beams, joists Cert of Survey Recd _ Y_ N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Soils Report Y N 1 Soils Report tf proposed building is to be placed on disturbed soil 1 site survey for additions & decks Tree Pre, Plan Recd Y _ t~ 2 copies of plan showing beam & window sizes; poured found design, etc. Addition - indicate if on-site septic system Tree Pros Required Y _ N 1 set of Energy Calculations on-site Septic Systam Y; N, 3 copies of Tree Preservation Plan, if lot platted after 711M Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form Plans are considered public information unless you state the are trade secret and the reason, Date Construction Cost Site Address z/~_ C ,C~ Y/Gtr Z-C )-tea ~ unit/Ste # Description of Work Multi-Family Bldg ~ Y C~ N Fireplace(s) _ 0 _ 1 - 2 Property Owner Telephone # )(o g q ~l Contractor Address City State Zip 't'elephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules_ 7670 Category 1 - Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (d submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Y _ N If yes, date and address of master plan: Licensed Plumber Q~ Telephone ) Mechanical Contractor Telephone Sewer/Water Contractor Telephone # ( J 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 M-N 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 a roval of plans. Applicant's Printed Name Ap icant's Signature r DO NOT WRITE BELOW THIS LINE Sub Types ❑ 01 Foundation ❑ 07 05-plea ❑ 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-piex ❑ 10 08-plea 18 Deck ❑ 23 Porch (screen/gazebo/pergola) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex ❑ 25 Miscellaneous Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish Building- ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant Description: Water Damage Yes Valuation ' Occupancy MCES System Plan Review 100% or 25% Census Code 1-t~ df Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const f ; Width REQUIRED INSPECTIONS _ Footings (new bldg) _ Sheetrock Footings (deck) Final/C.O. Footings (addition) Final/No C.O. _ Foundation _ HVAC _ Drain Tile Other Roof _ Ice & Water _ Final - Pool _ Ftgs _ Air/Gas Tests _ Final Framing _ Siding _ Stucco Lath Stone Lath -Brick Fireplace R.I. -Air Test _ Final _ Windows Insulation _ Retaining Wall Approved By: Building Inspector Base Fee Surcharge Plan Review MCIES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total \l 00 W ~ I E 8 UTIVT T EASEMENT Po ~as~a O 0 ss 3 z I LOT as8j11>2j \2`0 8 f aszo.F -N ~y/ \ m N (855 y '30 M "1 7' 6574 - ag5.8 I n tdJ CO \ 0) 4T fl /0 / esas f \Qc° tu / i j / I y r / 887.6 / O 1, ~a .7 to Ba? S A O O (86~ U) ` ` 11 t 14.17 52.33 c~ N~Q o 0 . es7~~i = qry a p~ 50 /40 t 5_` 00 to S6.8 N I 45 p 32 U) I - - - - - - - - - - - - - - - - - I For Oltice Use i non Permit ~ it of Ea Cy V I Permit Fee: i`I I 3830 Pilot Knob Road Eagan MN 55122 I Date Received: Phone: (651) 675-5675 I C I Fax: (651) 675-5694 i Staff: 2008 RESIDENCTIAL° BUILDING/ PERMIT APPLICATION Date f Site Address" Tenant: Suite RESIDENT /OWNER Name: G C2~ Phone: Address / City /Zip: 3 S ~A/Ce 4 A,,-k 46k, Applicant is Owner Contractor TYPE OF WORK Description of work. /4 6 n P Construction Cos : f ?o C) Multi-Family Building: (Yes ! No CONTRACTOR Name: License Address: City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category I Worksheet New Energy Code Worksheet Category Submitted Submitted submission type) • Energy Envelope Calculations Submitted 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 maybe classified as non-public if you, provide specific reasons that would permit the City to conclude that the are `trade secrets. 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 approgofl . x f C o x Applicant's Printed Name A icants Signature Page 1 of 3 E ~W~~. , ~ - ~.~_~W_.~W . ~ 11 ~1 ;I ,.I 'i t<? r i,'1 i ~_i ~ - l ~ - . _ 97 _ . „s ~ . 61 ~ w ~ N 4° ~ f~ n IV E - >v o~ 5 ~'I ~ ~ ~a ore 1 c l 1 ~ `r` ':I G ~ my S J --a D 74 ~ i. N A_ 4 ~Z I! m cDi a m ~ f'''i c I i ~ ~ ~ r__ n~ ~ I " v v! c: i ~ y~ `I+ ( J 'v O z ~ @ y ~ .V i I \ \ " 8S8 I ~ `r"- ~3~ ~ ~ I - ~ c o v m o o l S2 8 ~ m I ° o ~ I 0 m 00®0 ~ cn m - _ i _ _ _ ~ _Z Z ~ _ ~ N pROp x ~ v \ 1 0 ~ ~ ~ cn oS ro ~ CAS y D~~~~ o ti HODS FO ~ ~j ~m ~n mrnmmm 11 w F ~c 0~ zzzzz w ~ ~ r m 00000 p w v -mo z~+ 0 -n mmmmm .Q w v 1. m0 ~r~-~ ~cncncncn w 'kI m rn0 vm__m o I~ Z~ n~DO 7JX~~77 ~ 1 0 ~q N 29.6 0-~ 0~0 0 ~ ~ o Rq~ ~ ? 'i o0 cN m-~zZV Q _,A, E N 8s v~mc Oz~~0 ~ ti 8~8) ti~ ~ i; ~0 vO~N m zZm ~ 'N em' 22 0/~ 0' ~ ~ oD n ~ ~ r c C ~ u v r~ 33 / W Il o_ r~OZ mm3~~ cu ~ I,, ~ DN~m m mmA o ~ ri~ - m~ -i I ~~ZZm o I ~ A i 0 O m ~m y-~~D a~ ~ I W m m u~< zOWZ OzOmm 0~~~ r -c o c m m Z o c m~ ~~ccn z z o I ~iqy; ~ m m m.~ z ~ o ~ ~ ' ' ~ !'I ~ z m z o o D ~ o' o _ ~ D ~ ~ c - ~ ~n~ D z z o ~ .N ~ m ~ ~Q O DZm'{ O e~ a ~p ~ zm R-I~z m N o i~ ~ C tw -i n ~ O" ~ ~ W - m , ~ 9® ~ o I,;i m Z D ~ ~o A~ ~ / z~ ~ cv o0o y 3 cn = z = ~ cn m 4 m0 z - mrnm 0 ~ ~ G) fp ~ ' 1 •o ~ ~ ~ Z { ® m ~ _o ooD ;1 Wz 0~ ~ D m ~ ~ it m - ~ -d ~ D s my" m ~ m D ~ ~ W !l ~ x m= 0~Or ~ 1 ~ x,,., D 0 cn m m m rn m t*9 y I N~ ~ cm 0 D ~mm, o ~i ~ z rrr_ ® y `i ~m~ c OOOz -c'~ tn~ 0 0000 e; Oz~ ~ ~ n ~JJ772 , ~'1 ~ 0 II II II II ~ ~ 1 I ~ 'I ~ 0 ~ m os °0 ~ W is ~ ~ n ~ ~~N ~ ~ _ ao ? o~ ~ o m m ~rn C m m -n ~ t*t tees ~ , mmmm ~ r_; mmmm ~ ~ f;! u~ ~ -i -I -I -i ~ ~ • If l . Z , ~ t7 I c.~ 4 - ~ ~ co c~ ~ 's'I L;q ;'i . ~ _ - ~ _ _~~._.._r TT - - - - - - _ , .~~,T. . u , . - , ~ , . _ - h~ _ _ w,_ _ y i ~ ~ a - ~ V ~ ~ ~ m - ~ , ~ ~ A ~ ~ I hereby certify that t: ~ r, ~ 1-~,I ~ ! ® ~ ~ ~ ~ I, 1 E-; ~ 7 this plan, specification ar ~ F- f~;- i ~ "j (~'1 ~ ~ ~ ~ ~ ~ ~ report was prepared by ' ~I ~ ~ i Il P j , ~1 N O f~l ~ ~ ~ me or under m direct 9 ~ i` j~ 'I ii ~ ~ ~ ~ ~ 0 ~ ~ C7 , ~ supervision and that I I:;i j ~ 4~~ ~ ~A T - ~ ~ , am a dul Re istered `I - ~ m ~ m - D m ~ ~ LOT 1 FLOCK 2 STONEY POINT DAKOTA COUNTY MINNESOTA 4; Prafessfoynal En ineer W i - ~ `j I lx under the laws of the ~ i ~;j 0 N ~ ~ ~ ~ ~ O ~ ~ '1 ~ State of Minnesota w ~ , ;::I j - O f~1 (A , ~ r {I: i d 9401 JAMES AVE. S. ® O~OOMINGTON, MN. 5, ~ Date Reg.No._ ~1 t r r i City of Eaaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651).675-5694 RELY jE1012 tIlt111%D Use BLUE or BLACK Ink For Office Use Permit #: 2 2 L Permit Fee: Date Received: Staff: 2014 RESIDENTIAL PLUMBING PERMIT PPLICATION Date: 3-71.3-4 Site Address: 1 435" 1 DA .737Qz Tenant: • `Re , e st esienQwrte . ''�;�; Name: .c Phone: g Address +City / Zip: �.,� / �' ��'l I rV0 33 -kc Co tractor �` `State: n b xy . , Milbert Company Inc dba Cullign Water License #: WC643176 Address: 1801 50th Street East City: Inver Grove Hgts. 55077 651-451-2241 ' IVI N Zip: Phone: Contact: William R Milbert Email: Ty hof O — New Replacement Repair Rebuild Modify Space Work in R.O.W. _ Description of work: _ _ _ Permit Typ ra a �e RESIDENTIAL Water Heater XWater Softener Level) Lawn Irrigation (_ RPZ / PVB) Add Plumbing Fixtures Main / Lower _ Septic System _ Water Turnaround New Abandonment RESIDENTIAL FEES: $60.00 Water Heater, $60.00 Lawn Irrigation $60.00 Add Plumbing "Water Turnaround $115..00: Septic System Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) Water Turnaround* (includes $5.00 State Surcharge) fee and $5.00 State Surcharge) TOTAL FEES $ (includes $5.00 minimum State Surcharge) Fixtures, Septic System Abandonment, (add $200.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County 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 l understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be In accordance with the approved plan in the case of work which requires a review and approval of plans. x ?m1/In— Apphcan ts' Printed Name x Applicant's Signature City of Eagan PERMIT City of Eaan Permit Type: Mechanical Permit Number: EA132375 Date Issued: 08/11/2015 Permit Category: ePermit Site Address: 1435 Blackhawk Lake Dr Lot: 1 Block: 1 Addition: Stoney Point PID: 10-72600-02-010 Use: Description: Sub Type: Residential Work Type: Replace Description: Furnace Comments: Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary: ME - Permit Fee (Replacements) $59.00 Surcharge -Fixed $1.00 0801.4088 9001.2195 Total: $60.00 Contractor: Standard Heating & Air Conditioning 130 Plymouth Ave. N Minneapolis MN 55411 (612) 824-2656 - Applicant - Owner: Laurie Haenke 1435 Blackhawk Lake Dr Eagan MN 55122 (651) 214-9650 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 Oct. 13. 2016 1:27PM 41[111 CityofEaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-0675 Fax: (651) 675-5694 r No. 0360 P. 2 Use BLUE or BLACK Ink For Office User� Permit #:/ 39-2 Permit Fee: ! O5.2 S Dale Received: 10 134 / Co Staff: 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 10 —13-1 (v Site Address: /1435— r51 eta—Ina-WIC— /_a.k.e 1' ri lhe Unit #: Resident/ Owner Name: JJ O 1". Phone: ,S0-7.-- 2:72-0381 Address / City / Zip: (5 �>� CLS V+7e Applicant is: Owner )ontractor Type of Work Description of work: r-- — ro G't" , Construction Cost: Multi -Family Building: (Yes _ / No %a Contractor nlact: \ X�5 Company: 3 �'r c& Address: S Ar4+1 onePhone: Lax‘42 L, City: m pi S 2 t]j 5-1--‹� '' 3c, ��,rornin.e.rtf State: �r1Zip: 5S�/ p 2. -; 14S-- Email: i''I ill '- I -/-1) c c 1 GcrtSl rU.0 col License #: j1 C W (,.f) CA -I g 3 Lead Certificate #: If the project Is exempt from lead certification, please explain why: In the last 12 months, Yes No COMPLETE THIS AREA ONLY IF CONSTRUCTING ANEW BUILDING has the City of Eagan Issued a permit for a similar plan based on a master plan? If yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer 8 Water Contractor: Fire Suppression Contractor: Phone: Phone: Phone: _ Phone: _ NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public If you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.ciooht rsteleonecall.orq I hereby acknowledge that This information Is complete and accurate; that the work will be In conformance with the ordinances and codes of the City of Eagan; that I understand this Is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be In accordance with the approved plan In the case of work which requires a review and approval of plans. Exterior work authorized by a building permit Issued in accordance with the Minnesota State Building Code must be completed within 100 days of permit Issuance, Applicant's Printed Name ApplIc ;; gnature Oct. 13. 2016 1:27PM No, 0360 P. 1 Ole ur PROMINENT EgaNg�h seg •�uCTlO u 1 n• 2855 Anthony Lane South, Suite 130 Minneapolis, MN 55418 • P: 612-345-4799 F: 612-886-2907 FAX To: Fax: e}-9 oc Ea9cur\-, cos at Prominent Construction, LLC. From: Pages: H Phone: Dates Re: cc: ElUrgent a For Review El Please Comment Lk)l Comments: ease Reply Please Recycle 4--c+ctil cost o,E e% 1-11-99 PERMIT City of Eagan Permit Type:Building Permit Number:EA170550 Date Issued:07/08/2021 Permit Category:ePermit Site Address: 1435 Blackhawk Lake Dr Lot:1 Block: 1 Addition: Stoney Point PID:10-72600-02-010 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 - Joseph & Margaret Klenner 1435 Blackhawk Lake Dr Eagan MN 55122 (507) 272-0380 Krech Exteriors Inc 5866 Blackshire Path Inver Grove Heights MN 55076 (651) 688-6368 Applicant/Permitee: Signature Issued By: Signature