1438 Blackhawk Lake DrCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 1438 Blackhawk Lake Dr
Lot: 9 Block: 3 Addition: Stoney Point
PID:10- 72600 - 090 -03
Use:
Description:
Sub Type: e- Reroof
Work Type: Replace
Description: House & Garage
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Property Claim Solutions LLC
4655 Nicols Rd, Suite 202
Eagan MN 55122
(651) 994 -2028
If there is no ice protection inspec
acceptable in lieu of inspections.
Applicant/Permitee: Signature
PERMIT
City of Eaan
Permit closed without required inspection(s). Letter sent to applicant on 02/25/2009.
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total:
- Applicant -
Construction Type:
Occupancy:
on prior to final, you must meet inspector with ladder and flat bar. Pictures are not
$88.50 0801.4085
$1.50 9001.2195
$90.00
Owner:
Tresa Anne Jackson
1438 Blackhawk Lake Dr
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Building
EA083516
06/12/2008
ePermit
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
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AMOUNT
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100
? CA.9H ?l CHECK
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Thank You ;
BY
?-
e. g. rs •' Nmtes-Payers c.opy Y'-
Nbw-Poslirg Copy
iik-Flle (lopy
Na A???
,
01-3210 Bklg: Pecmit
01-3422 Plan Check
01-3445 Surch.lAdm.
01-3446 SAC/Adm.
,
01-2155 Surcharge
,75-3860 Road Unit
20-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
28-3855 Park Ded.
A o?z W
TOTAL
CITY OFEAGAN Permit No:? 1030'? ? Date: 10'°13°$8
3830 Pilcft Knob Road Meter No: Size:
P.,O. Box 21199 Reader No: " Date:
Eagan, MN 55121 ? . .? _.,
Owne? .':?lsi.??am I}Q3igu
Site Address: 1438 331ack.havk !A`Kua- °,".t1.!'1ve- L9 B3 StAm Pt?1nt
Plumber. ?Urr p1m},?nst
Conn. Chg: 550`00P(i
Acct Dep: ?' o cpd
Permit Fee: ?id`
Surcharge: • 5GPd
Tr. Plant Z 'GCpC •
Meter. 57 .c0nri ,
Misc.: PRF 711. MI3:"^"
Zoning: RI
No. af Units: I
1 agree to comply with the City ot Eagan
Ordinances.
By
WATER SERVICE RERMIT
,
CITY OF`EAGAN Permit No: 11144 Date: I0"13"11$
3838 Pilot Knob Road B/P No: 87125 Date: 9-7"88
P.b. Box 21199 m
Eagan, MN 55121
Owner. IrhlsLxers
Site Address: 1438 'B3.ackhavk Lake Drivo L9 R3 Ste+r,ev 'sot?. `
Plumber. 11mr` Pl?bing
MWCC: 550•00pd Zoning• -1
City Chg: 00pd No. of Units:
Acct Dep: g' Oopd
1. LKtp I agree to comply with 1he City of Eagan
Permit Fee: Ordinances.
Surcharge: . 50p
Misc.: PTtV REt3T3TRFD gy
I'esipn.
SEWER SERVICE PERMIT
?? .... _ .. . e., ? ?
CITY oF EAGAN
3830 Pilat Knob Road P
er1Wf4 y? ??y??...?? 1'Y7A9??Wl?,y,?r
?.' _r
Eagan, Minttesota 55123 We Miued:
(612) 681-4675
• w
SITE I?DDRESS: ? ?.? ? : _? ?? ? «??. i? , , APPUCANT:
,
I ?3ts 111 111:k1IAWK i Ah:l; f11"j ARN`f'tiE'hl. R IC HF1R1J • .
i 4146 . '.r
PEI?I[Tla 6?Uq`BTtY?xPb,E1: 1 TYPE 4F W?I?,: ??1?±1? . ?
}???L. ?'1 ?:..57 I. 3 ! T'N I;?{1 ? . 11i:[M?. .. ?a . . ?
£ . _ . . . . . ' .:. ? . ti .. . .. ? . . . ? .
f1 P l l1$V
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OUGH .E N Pl.'Ll+?i I` 1 l4t1 I.
".X ` 3
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i??'_?#?i?k'-•; '?? f'?F?1<iti? !'h't;'11I1 l'; AI'tt 1rt.a1tlt1'+i,-!a 1 riP P,fdV F•'i.t1Mk3.fNF'3 CJIi W.1JI:CTii;
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Fba1 Fft
C,tsnmt. AA&er
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En9N'.t?an z
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Bldg. Fina# _.. . ?:.
Deek Fig. - _..
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Deck Fenel
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_ ., . . . . _ . ; . .. , . . . -... -+s?asr .. ^.+".?1_-^?+'?w.•,??- -. . _ T -. . ._.- _. .-.-.y_.?
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT Receipt
To be used for 8? ?/C" Est. Value ?79ow Date UPT 7
Site Address 1434 ?? ?? Dit
Lot 9 Block 3 Sec/Sub. ?? ?INT
Parcel No.
,r Name "WA-nft MIGM WWar 1W
z Address 4151 IUM M #100
° City RAW Phone 43"737
aoName SAM
.
? ? Address
? City Ohione
?-Q
VW WW Name
_ za Address
a W City Phone
I hereby acknowledge that I have read this application and state that the
information is correci and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
A Building Permit is issued to:_ ??TM L"x0111112 NOW11
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official_
OFFICE U$E ONLY
On Site Sewage Occupancy
MWCC System x Zoning
On Site Well (Actual) Const
Ciry Water X (Allowable)
PRV Required x # of Stories
Booster Pump Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit
-
Planner Surcharge • -??-,?,.?.
Council Pian Review
100'
Bldg. Off. _ SAC, City °
Variance SAC, MWCC -Y%-.Oo
Water Conn. MA
WaterMeter
Road Unit 3l?.00
-
o
C
Treatment P1
Parks
????
TOTAL .'
` Permit No. Permit Holder Date Telephone #
Plumbing C/a
;
H.V.A.C. p 7 ? 9 9/001
Electric 7 0s`?
Softener
Inspectfon Date lnap. Comments
Footings I ?
Footings II
Foundation
Framing
Roofing
Rough Pibg. ? _ _
Rough Htg.
Isul. 0 l-7 STcV
Fireplace
Final Htg.
Final Plbg.
Bldg. Final
cert. occ.
Temp. LP '
Deck Ftg.
Deck Final
Weil
Pr. Disp.
3 . ?.' ? 1' . .
CONTRACT PR[GE:
Site Adcress 7 °
Lot Block - ' c Sec/Sub
?-t?7° .??.??,.• t?
4
? Name
? Address
? City Phone _'
Name
?
c Address '
o Ciry Phone -
FEES
COMM/IND FEE -1% OF CONTRACT FEE
APT. BIDGS - COMM RATE APPUES
-: TOWNHOUSE & CONDO - RES. RATE APPUES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/lND FEE - $20.00
' STATE SURCHARGE PER PERMIT - .50
{ADD $:50 S/C, PERMIT PRIG6 GOES
; EEYOND $1,oOL
SIGNA URE OF PERAAITTEE
? FOR: CI'T'Y OF EAGAN t
Res.?...?? New. ?• ,
Mult. Add-on ?
Comm. Repair ?
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
FIXTURES f' TOTAL 7!t Water Closet - $3.00
Bath Tubs - $3.00 ? - -
Lavatory - $3.00 'P
?Shower - $3.00
Kitchen Sink - $3.00 ?
T_Urinal/Bidet - $*U `
Laundry Tray - $3.00 ?_..._ Floor Drains - $1.50
TtWater Heater - $1.50 -?
Whirlpool - $3.00
7-Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
,Private Disp. - $10.00
? Rough Openings - $1:50
FE£:`
. ` S7ATE S/C:
GRAN4'TOTAI.;,,.?.•`3? : ?
PERMIT # '
; MECHANICAL PERMIT
8'''J?
'28 s a?
• ,
CITY OF EAGAN RECEIPT # _
3830 PILOT KNOB ROAD, EAGAN, MN 55122 pATE:
CONTRACT PRICE: ?aZ, ?I/C?• C1O PHONE: 454-8100 ?
Site AaJ,dress ?
L
t y Bl
k
/S
S
b BLDG. TYPE WORK DESR?TIdN I
?
o
ac
q--? -
ec
u New
Res.
Mult. Add-fln
Name Comm. Repair
?
c Address
City _
Phone Other
Name FEES
RES. HVAC 0-100 M BTU -$24.00
c Address ADDITIONAL 50 M BTU - 6.00
p City Phone (RES. HVAC INCLUDE$ A/C ON NEW;
CONSTRUCTION)
50 EA
GAS OUTLETS (MINIMUM - 1 PER PEkiAlT) - 1
TYPE OF WORK .
. .
COMMI/IND FEE - 196 OF CONTf1AAC'T FEE
Forced Air M BTU ?•(,•+L' 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 - 20.04
. STATE SURCHARGE PER PERMIT - .50
Vent. CFM (ADD $,50 S/C IF PERMIT PRICE G4ES
Gas Plping Outlets # BEYOND $1,000)
Other ?
FEE
S/C: SIGNATURE OF PERMITTEE!
Le?
TOTAL•
FOR: CITY OF EAGAN
CONTRACT PRICE
Site Addcess , '' =
Lot Bfock
_ Sec/Sub Res. 'r New '
? Mult. /1dd-on
-
aD Name tw/? C. Comm. .'Repair ,
<
g Address 1 C1? Other '
?
c City ?? Lz+? yke Phone RES. PLBG. ONLY - COMPLETE THE FOL,rOWING: ,
- NO. FIXTURES* TOTAL
Name Water Closet -$3A0 S
c ,
Address Bath Tubs - $3.00
Lavatory - $3.00
3
p
City C( `r? --• Phone
Shower - $3.00
Kikchen Sink - $3.00
FEES UrinallBidet - $3.00
COMM/IND FEE - 1% OF CONTRACT FEE Laundry Tray -$3.00
APT. BLDGS - COMM RATE APPLIES Floor Orains -$1.50
TOWNHOUSE & CONDO - RES. RATE APPUES Water Heater -$1.50
MINIMUM - RESIDENTIAL FEE - $12.00 Whirlpool - $3.00
MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets -$1.50
STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMff) ?..- oo
"
(ADD $.50 S/C IF PERMIT PRICE GOES k
Softener - $5.00 .? •
BEYO 0 $1,000.00) Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
SIGNATUFiE OF PERMITTEE
01, FEE:
STATE S/C:
FOR: CITY OF EAGAN GRANO TOTAL• •--t-'
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 1_5 i7?
BUILDING PERMIT PHONE: 454-8100 Receipt
To be used for ?? ?/G" Est. Value $a7i0M Date 1111" r ,18 1
Site Address 1438 SLACMVK L+AKE Dl
Lot g Block 3 Sec/Sub. STMY POINT
Parcel No.
,r Name DAMJTRM MXGM NMSP I05
3 Address 4151 KIOS L1IR #iGO
° ClIy &AW Phone $34-$737
°C ?
o 1,,Name
? ? Address
? City Phone
v?
Ly W Name
FW
Address
cc WZ City Phone
c
I hereby aCl?nowledge that I have read this application and state that the
information ig correct end agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Permittee
'A Building Permit is issued to: DAJIIOOTROM D?IGIOM IIOM
ori the express condition that all work shall be done in accordance with all
appticable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
OFFICE U3E ONLY
On Site Sewage Occupancy A"'3 U-1
MWCC System ? Zoning it'1
On Site Well (,4Ctual) Const
City Water X (Allowable) ?
PRV Required = # ot Stories
8oosterPump Length 601
Depth 36*
S.F. Totel
Footprint S.F.
APPROVALS FEES
SZ2??
Engr./Assess. Permit --
-
Planner 5urcharge 4y.
Yo
--
-
Council Plan Review 261
.To
Bldg. Off. SAC, City ?
Variance _ SAC, MWCC
-TS-0
00
Water Conn. .
00
67
Water Meter 0
Road Unit 32S•00
??000
Treatment P1
Patks
TOTAL M
P '
CITII1DFIEAGAN Permit No: 10007 ?- Date: 10-13--88
31%11ilot Kdob Road Meter No: 41'141 /tm Size: "q
P.O. Bdx 21199 Reader No: .40 of? ? Data
Eagan, MN 55121
Owner. Dahlstram Aesign
Site Address: 144R RtAr hai Akp 1i? ,.g t g 83 Stoaey Pointi
Plumber. M,rT p1,tmhing
Conn. Chg: 550.DOpd
Acct Dep:- 15. OOvd
Permit Fee: 10 .OQgd
50
Zoning: Ri
No. of Units:
Surcharge: • pd 1 agree to comply with t City of Eagan
Tr. Plant_ 204.00pd Ordinances.
Meter. .__ A I?nppd
MISC.: bDT7 ?Dpf1TtTT?RT •- ??'
WATER SERVICE PERMIT iVuM i(v7,
CITY OF EAGAN
, 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 N0 15575
?
BUILDING PERMIT PHONE: 454-8100
Receipt
To be used for SF DWG/GAR Est. Value $87, 000 Date SEPT 7 ,19 88
Site Address 1438 BLACKHAWK LAKE DR
Lot 9 Block 3 Sec/Sub. STONEY POINT
Parcel No.
? Name DAHLSTROM DESIGNER HOMES, INC
z Address 4151 KNOB DR #100
? City. EAGAN Phone 454-8737 _
¢o Name SAME
.
? Q Address
P City_ Phone
?s
? W
W W Name _
-
H
Address
?Zw CityPhone __
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.
Signature of Permittee
A Building Permit is issued to: DAHLSTROM DESIGNER_ HOMES
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
BuildingOfficial_ ?' ?LnuP1??,,?rn?_
1 \
OFFICE USE ONLY
On Site Sewage Occupancy R-3 M-1
MWCC System X Zoning R-1
On Site Well __ (Actual) Const V-N
City Water _X- (Allowable) V-N
PRV Required X # oi Stories
Booster Pump __ Length 60 ' _
Depth 3 '
S.F. Total
Footprint S.F. _
APPROVALS FEES
Engr./Assess. Permit 522 . 00
Planner _ Surcharge 43.50
Council Plan Review _ 261.00
Bldg. Otf. SAC, City _ 100.00
Variance SAC, MWCC 550.00
Water Conn. 550.00
Water Meter 67 . 00
Road Unit 325.00
Treatment P1 204.00
Parks
TOTAL 2,622.50
(Itrtifiratit uf (Orruvttnry
Citp of (tagan
Erpartmr»t n# iuildircg 3Wrrunn
This Cenifccate 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 oj the City regulating building construction or use: For the following.•
use classifiration ' • Bldg. }ermi[ No.
Occupancy Type Zoning District Type Coost.
Owner of Building Address . . ,
Bwlding Address I.ocality
DatG
&Wding Offidal
POST IN A CONSPICUOUS PLACE
I This request void
18 months from
E 19 7
9,5 S
Request Dattf_ ; -r
- Fire o. Rough-in Inspection
He uired?
[:]Ready Now ill Notify, Inspec-
73 ?? ? ?es ? No tor When Ready
J?f`6lcensed Electrical Contractor I hereby request inspection of above
? Owner elactrical work installed at:
Street Address, Box or Route No. C ity
zj? - - ?G,?k?i? ?1C. ,•-?
ecti i o. Township Name or No. Range No. Countyn
OccVO?T NT) ' Phone No.
L i e ? SS - 7-3
Power Suppliar Address
k-
Zok;
Elec[rical Contractor (Company Name) n Co rar.tor's License No.
?v?Gi?s ?- ?L? '?'`• `? r ? ? --?
Mailing Address (Contractor or Owner Makiny Instaila?tip n)
rl??0 c?vse GO' . L:?L???
Authori Signature ntractor/Owner Making Installat onl Phone Number
? 3l - O ?2t
MINN40A STATE BOARD OF LECTRICITY THIS INSPECTION HEQUEST WILL NOT
Griggs-Midwey Bldg. - Roo -181 BE ACCEPTED BY THE STATE BOARD
1821 Universitv Ave.. St. P 1, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
E?1??3 7
REQUEST FOR ELECTRICAL INSPECTION
jl? See instructions for completing this form on back of yellow copy.
"X" Below Work Covered by 7his Request
w EB-00001-06
'r ?-
??> j .?
d eD- Type ot Building Applinncea Wired Equipment Wited
Home ange Temporary Service
Duplex W ter Heater Lightin,y Fixtuies
Apt. Building Dryer Electric Heatin
Corrunerciai Bldg. ur ace Silo Unioader
Indiistrial Bidg. ir Conditioner Bulk Milk Tenk
Farm Otner Pec:1 v .ther (suer:itv)
t er Specify Other Oiher
Compute /nspection Fee Be/ow
q F ServiceEntranceSize H Fee Feeders/Subfeeders # Fee Circuits
U to 200 Am s 0 to 30 Am s 0 tn 30 Am s
Above 200 qmps, 31 to 100 Amps ? 31 to 100 Am s
Swinuning Pool Above 100_Am s Above 100_Am 5
Transformers Irrigation eooms p Partial, Other Fee
L I I 5igns ' I ISpecial Inspection ?g?^ ? TOTAL?F,? i
R ema rks is?
i? ,
G •??,I the Elec''1?cic.a?
nspector, hereby
ce ify that the above
Final
r D`?l? spection has baen
mede.
rhla request void 18 months irom
? •. • CASH RECEIPT
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122 ?
L _ DATE
REceNED 1
AMOUNT I $
•
19 & DOLLARS
,oo
? CASH . CHECK
MR
L
FUND OBJECT AM UNT
LL_ ;??7 C?
?-
is
Thank You
?.
BY
N° 8 3 WhR?Payers CoPy
Yellow--Posting Copy
Pink-File Copy
,
X CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
?kj zj qj
BUILt7TNG
024691
10j11J9A
SITE ADDRESS:
P.I.N.: 10-72600-090-03
DESCRIPTION:
143$ BLACKHAWK LAKE DR
LOTs 9 BLOCK: 3
S1"ONEY POINT
Btrilding' Permit Type
Building Work Type
-Square Feet?
BASEMENT FINISH
NEW
294
?
t &a x
REMARKS:
SEPARATE PERMITS ARE REQUIRED FOR ANY PLUMBING OF2 ELECTRTCAL WqRK
FEE SUMMARY:
Base Fee
Sureharge
Lic. 5earch Fee
Tntal Fee
$35. 00
$.50
$5.00
$40.50
CONTRACTOR: - A p p 1 i c a n t - 5T . Lz C. pWNER:
ARNTSEN, RICHARD 14700057 0005246 TAWANA WALES
4224 LAKESIDE AVE N 1438 BLACKHAWK LAKE DR
BRQQKL.YN CENTER MN 55429 EAGAN h1N 55122
(612) 470-0057 (612)688-2902
I hereby acknowl.edge that I have read tni.s app.lication and state that the
in'formation is carrect and agree ta camply with al.l applicable State af hln.
Statutes and City of Eagan Ordinances. ?
?
?
Jma w, -I
I T/PERMITEE SIGNATURE ??`??? ISSUED BY SIG R
CITY UF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
INSPECTION RECURD
PERMIT TYPE:
Permit Number.
Date Issued:
BUTLAZhlG
ez4ssa.
10/11/94
SfTE ADDRESS: ? OT: 9 BLOCK :
1438 BLAGKHAWK L.AKE C1R
STOh1EY PflIld7
PERMIT SUBTYPE:
BASEMENT FINISN
3 APPLICANT:
ARNTSEN, RICHARD
(612) 470-0067
TYPE C3F WORK:
NEW
INSPECTION
FRAMI14G .. .
INSULATI(lN .ATE INSPTR.
ROU6H IiV PLBG FINAL
REMARKS: SEPARATE PERMITS AaE REQUIRE[7 FpR A€dY FLt1P48TNC OR ELECTRTCAL WdFiK
. ,
? '
.
; . . . ._. . ?
??? ?? ?GAN .
. 1994 BuILDr?? PIERMIT A?PLICAMON
6$1.4675 .F .
,
SINGLE & MULTI-fAMILY 2 sets of plans, 3 regist-ored,siti!: urVs,???;. .erg?
calcs. 4CT 0.5 Ct)NN+IERCIAL P sets af architectural & stru?tit ' ir
SpeCiFiCat'Id1is, 1 cbpy of er?ergy cik . .
Penalty applies: I) when p?t'mit is ?typed, but nat picl?ed up by,-1ast ?rkinq4i!;?f tortt?
in which request 9s made, 2} address is changed or 3) lot c?arige i? once ?ra1t
is issued.
Date [?C_ T ? Va] uat i on of trork
..
5t?? Address: / aGt?
STR6ET . ?`!'? .
'?en?n? Name: (cr?rmAercial vni3+) -- - - --- -- ` .
, s, , n,«...;..y ,.?+a?---..?.,...•??-:
LQ? ?_ BI.OC? „?3tI8D. ? Y F.I.,.?. s? ..
D??cri tian of work: 2!2/? ?
:
The aPRI i cant i s: CI awner XContractor C`I Other Meacrrbe)
Name
Property LAST FIRST ` .` . .
Owner Address 1`? ? e' A?
STREEx + :
City 5tate, Z 1.'D
Company f?d,M?" I?- •`???.,,????? Pbone ?6?7
e ¦ r. - Y - rt e rsy x i?t P Pnn w
Contractor address 1q;Z2 tl &eC?/.a?'?? ?l L i??? ?c?..?
cI ty state CoElpariy s?A dd??
Architec#I
Engin??r Name R?istr?? f ,
Addre5s - - - - - - i n.,.r??r?.+?i...r.i....rM?•n?qtl." C7t3? st8te
Sewer & water licensed plumber JIAl Ai.,.?Al? ,,,,, .,;aE,ry, . Pr?e???r?? ti10 for., ,
sewer &water perm4ts i.s two days once area has been ikpproverS.
- ,w
I hereby actcr?owiedge t#at I have read this appl#cation and state th4?fthe iftf4mti?nr ft ?•'? ::
eorrect and agree to tompiy with a7l appl icable State of Nli?iftalt#dtes Aidlci`t?
fagart 0rdinances. ?
Signature of Applicant: kb J?? Ars
t)FFIGE USE +DNLY
BU#LDING PERMtt TYRE
? Ol Foundation L] 06' Dupi ox 13 11 Apt, JLodgi ng 15 Basement F9 ni sh
13 02 sF Dwg. ? ? 07 4-Plek 0 12 Muiti. Misc. ? 17 Swim Poal
?03 SF Additfon ? 08 8-P1e* 0 13 Garage/Accessory O 18 Comm.flnd.
G 04 SF Parch .Cl 09 12-Plex ?14 Flreplace ? 19 Comm./Ind. Mise.
0 05 SF Misc. . ? 1A `Multi9 Add11. 0 15 Dec# Ca 20 Pubiic Facility
O 21 Miscellaneous
W+DR K TYPE
931 New O 33 A1 terati ons ?35 Tenarrt f i nish 0 37 Uemvli sh
13 32 Rddttion a 34 Repair- ? Ll 36 ftve
GENERAL INFORMATIOfi1 ,
.
Const. (Actual ? .,
Basement'Sq. ft
. A4'?
M1?tC System
(Allowable
UBC Occupar?cy lst Fi. sq4 ft.
2nd Fl. sq. ?'t. ? 23Y ?iater
Required
Zonin
? Ft. total
M Sooster Rur?tp
tQries
0 of tprint
Sq, ft. ? Fire Sprin?ler
Lengtt?
E?
th t?-site ?,.+•
?? C?tsus Cade
?
ep t?n-si te
ge ? SAC Ccde
AI?PR`C)YALS Census
Census Ur??t
?
Flanning Buiitting Assessments ?
Enginreering Variance
REQUlRED INSPECTIC)NS
Q.$fte ? Fo Oti11g. , C3 F1"?ing ? IriS11latioT1 '
Q Wa77bvard 11 Final E3 oraintile Q Fireplace
Permi t Fee
Surcharge
PI an Review - -
License
MaICC SAC - I
Gity SAC . ?
Water Cvnn. - - '
Water Meter acct. Deposit
5/W Permit
S/W Surcharge
Treatment Pl.
R$ad Unit .
P'ark Ded. .
Trails Ded.
Co ies
?3t ?er --
Total:
SAC 96 .
SRC Units
t i
' 1988 BUILDINQ PERMIT gPPLICITION - CITY OF SAGAN ?-
?
SINGLE FAMILY DWELLINQ.S
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF $URVq, 1 SET OF ENERGY CALCiTLATIONS
NOTEs ADDRE3SES FQR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DBSIGNATE WHICB ADDRESS
IS DESIRED. NO CHAATGES WILL BE AI.LOWCD ONCS HOILDING PERMIT I3 IS3UED.
MULTIPLE DWELLINGS RENTlI. QNITS FOR SALE UNITS # QF DNIT3
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIQNS
COMMRCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS .
?
To Be Used For: SFD IER
Site Address f ? 30 IQG-+CKAku*
r.ot 9 Biock 3
Valuation: 87, oao = pat.--- ?,"? AU6 3 1?9'
.
Parcel/Sub J1'7;-AJJ<y AI,v 1-
Owner ???*J7X$),,e /)4SY 6nK,2 1w1e
Address V/f'/ 6 I?ll A, P . P/cqj
City/Zip Code jed'd??
Phone 00'73 7
Contraetor
Address ?/SI &m66 ,0A , -of/ba
City/Zip Code 44yo) Zfi Z 1-
Phone yj7L ?737
Areh./Engr.
Address
City/Zip Code
On site sewage Oecupaney R=-??
MWCC system s/ Zoning
On site wel2 Actual Const
V-N
City water &e
d].lowable
PRV required ? # of stories
Booster Pump Length
Depth 361-
S.F. Total
Footprint S.F.
APP?
rigr/Assess
`?Planner
Council
Bldg. Off.
Variance
FEE3
Permit 2 O
Suraharge ?F , Sb
Flan Aeview 2 (pit 00
SAC, City I QQ0,Cp
SAC, MFiCC e?, 00
Water Conn v
Water Meter ,DO
Road Unit ?oo
Treatment Pl Dy? ?o
Parks
Copiea
TOTAL
I-so
?
Phone #
VA ?t? ?-f t br.t
GA -
Z O X2 d= 400 x 114 3r?1
33?/2Xl,? _ 's 3?
?oXZo = 4av
ZO K i g?. 3 60
13= l6gyK
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? 3i a x 49! (o4i 9 0 ??_ ..
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g6638
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CI'-j-:`9,•?, NC?FlGAlkR ?kv'X-),/ooc
SURVEYOR'S CERTIFICATE
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30
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- 29.97 _ e57.e6
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- I- 30--
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N ?
ROPOSED /.0 ?
HOUSE'
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a
0=90°00'00" °°. ?
R=10.00
L=15.71
858.9x ra 858.9 ?
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056A'' ; 22.00-'??. 36.33
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60.00 ___N 89613158"
N ? N
LAKEVIEW CURVF,;-, ??
?--- DENOTES PROPOSED SURFACE DRAINAGE POIIOVO REMIUlftirs/
O DENOTES IRON MONUMENT SET SCALE. 1 INCH FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR =$W.8 FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR =059.5 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = SloI - S' FEET
WE HEREBY CERTIFY TO DAHLSTROM oESiGN . THAT THIS IS A TRUE AND CORRECT =
REPRESENTATION OF A SURVEY OF THE B4UNDARIES OF:
Lot s, Block 3STONEY POINT according to the recorded
piat thereof, DAKOTA Caunty. Minnesafia.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS (o" DAY OF St& , 19Yb•
SiGiVED: J 'LL, iivC.
?? .
Cf
BY:
HAROLD C. PETERSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 12294
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James R. Hill, inc.
PLANNERS / ENGINEERS / SURVEYORS
9401 JAMES AVE. S. • BLOOMINGTON, MN. 65431 • 612-884-3029
,-.
?-{
N 83°03103" W.
-'+? `..ese.a
?? ?i -
? ? ? LOTn'l 9
DRAlNAGE d UT/UTY
? f EASEMENT PE PLAT
.: .:.,r,,... 'ss9.x I
? ?
GARAGEo
N
n ion AA
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER
S ITE ADDRESS ?L4? T, fp"p?I?yT ?a/,?J J
CONTRACTOR 42!E_Q&1J4'R DATE A?91 M PHONE fL.J^y?Qr-37
/?k,y, ?'? /'?K •
Determine working square footage of each.
1. Total exposed wall area. .... ._ GZ sq. ft. x
2. Totai roof/ceilinp, area...... /445_ 0sq. ft. x ?K_ 3 f,
??2(c
Total exposed wall area above floor= 3.7Z. C'"j
a. Total wall window area. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14o_ 4 /
b. Total door area ............................................ -::Z t"l 7
c. Total siding olass door area ...............................
d. Total fireplace wall area.............................
....
e, Total taal l f raming area (average 10%) . . . . . . . . . . . . . . . . . . . . .
f. Total Tl(? t Wall ar.ea SriOVP. f 1oor. . . . . . . • . . . . . . . . . . . . . . . . .. . ?
g. Total rim joist area ...................................... rJ
Total exposcd toundation zrea= /_.?'?;q? Q?
h. T'otal ioun3aticn door area ................................ ---"?f
i. Total foundation window area (includes sliding doors).....
j. Tatal net foundation area above grade ..................... +
k. Total wall framing"area (average ].O%) . . . . . . . . . . . . . . . . . . . . . l. Total net zaall framinG area ..............................
• Determine "U" value of each wall segment
a.
o._ 3 XifUll
r
C. 43 = .3 - 8
d. ! X"U"
e. / / 'C . / r?XI IU
7111 . r ? ? V? • ?
?..LitiiL.? ?.rL?
f. fb2_4_a!)v,U,. - . 6A =4n 9pi?,
,
g •_.L2.0....-z-X„U„ . a ..5
h. X"U" --.-?- = --??
i. x„u„ 3 3
x„U„
k. I(4- 6c) X'IUII n?
?-5•-- '
?
3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . T o t a 1
If item #3 is the same as, or lesr; tt;an item #l, you liave met I:he inter.t of S3C 6006 (c)2.
1 •
Total exposed roaf/ceiling area = z
. ,
m. TotaT skylight area ................................
n. Total roof/ceiling framing area (average 7%) ......
o. Total net insulated roofJceiling area .............. ??4 673. c?
Deterinine "U" va].ue for each roof/ceili,ng segmenC.
?
n. 1?31? x„U„
o. ? Aru-- a ? Z-.S
4 .................................Total
If total of #4 is the saine or, less than #2, you have met the intenC of SBC 6006(c)1.
Alternate Building Envelope Design
To utilize the total envelope system method, the valiiey esCaLlished by the 5t11fk
of items #3 anci #4 5ha11 not bc ereater thitn the st»ii oi iteiii #1 and #2.
1.- 211 -31Z } 2. ..3 7. &q - ZS i. 16
3. Z 3 0.2 ?' + 4. 3 (P ...?./
-?-/ CC
?
CITY OF EAGAN
APPLICATION FOR PERMIT
, -.
SEWER AND/4R WATER CONNECTION
?***#*#*?*****##*****#********#**?*#
? • M
* r10TWI: P.AYMF:NT"OF FEE AT T'M QF
* APPsc.PazON nM Norr ao?sri? ?
* APPRavAw oF PMU4rT. . *
nv,WECTIoN oF sEHM AM/cR WAM
?ivrULAMoNS wIM Wr BE scHma-
ULID UNTIL PII2NIIT HAS BEM
APPxwm.
P ease Print
` 1) PROPERTY ADDRESS : &a P k Lq K,t a,. •? .
LEGAL DESCRIPTION: '
Lot B
-- , ock Su ivision or Tax Parcel
. ID ?•
IF EXISTING STRL'C'IZJRE, DATE OF ORIGINAL &JILDING PF?tMIT ISSL'ANCE: ' "
. Mon ear . ...
PRESENT ZONING/PROPOSID L'SE: - -
CONAMCIAL/RETAIL/OFFICE ? R-I SINGLE FAMILY . .
Q IMLISTRIAL (j R? DL'PLEX (Trx? L?nits)
n INSTI=ONAL/GOVF.RM= t. .
? R-3 7OWNf30USE (Three + Units )
( Lfiits )
R-4 APARZMEVT/CONIDOMIIVIL'M ( Units )
2) Q'Ei4T?'rr7
'
NAME'!.'l},,,k{ ,?S ?i"l? t,. ?-?S f G ? ' ? I'?? -CS
ADDRESS: -
CITY, STATE, ZIP:
PHONE: .
,. ?,. For City Lse
•
3 ) ?
NANEs .
??
-?
Plumbers License:
ADDRFSS: 1???Q? '? p1iCt.1V2
`
CITY, STATE,-ZIP: ?
...?...?
' PHONE: '?
.
MASTER LIC?NSE# 3S'?t5 /?/t '- F:pired
Not recorded
Staff InTit'ial
4) ?a • • • i?+•? .
NAME: . .
ADDRESS: . • - " ' .
CITY, STATE, ZIP: •
' PHONE: . „
•$) ?? ral: • 24 • : a • •
' - ?? .
'. fZ--CONNDCTION T0 CITY SE.WEEt ? CONNDCTION TO CITY WATER C( OTHM '.. . •
6} PLEASE HOLD APPROVID PE2MIT F'OR PICK-C?P BY ONE OF ABOVE -•-
? PLEA.SE MAIL APPROVED PEEtMIT TO 1, 2, 3, 4, ABOVE
' (Ciscle one) 7) r _ rztlu_? ? .?
/?? f? .
.',-FOR ,CITY USE ONLY
PERMIT # ISSUED
L. 7
Pd w/Bldg. Permit
$
$
,
$ :?
?
$
S
$
$
? ?• C -- l ?'- -t?
?
$ '
$
$
$
$ -
$
--- ??.i7? ?? ..
RECEIPT
FEES:
$
$
$
?
--?
. I
.
SEWER PERMIT (INCLUDE SLRCHARGE)
WATER PERMIT (INCLUDE SLTRCHARGE)
WATER METER/COPPERHORN/OLTSIDE READER
WATER TAP (INCLL'DE CORPORATION STOP)
SEWER TAP
ACCOUNT DEPOSIT - SEWER
ACCOLNT DEPOSIT - WATER
$ WAC
$ SAC
$ TRUNK WATER ASSESSMENT
$ TRUNK SEWER ASSESSMENT
$ LATERAL BENEFIT/TRLNK SEWER
S LATERAL BENLFIT/TRLNK WATER
•?I4?1???NT PLANT SURCHARGE
P(1 t1NU14'
TOTAL
- ;.
RECEIPT
DOES UTILITY CONNECTION REQLIRE EXCAVATION IN PUSLIC 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 CONDITIONS:
APPROVED BY:
TITLE:
DATE :
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AISO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
NO. FIXTURES EACH TOTAL
? SHOWER 3.00
WATER CLQSET 3.00
BATH TUB 3.00
-T- LAVATORY 3.40
KITGHEN SINK 3.00
LAUNDRY TR.AY 3.00
HOT TUB/SPA 3.00
WATER HEATER 3.00
FLOOR DRAIN 3.00
GAS PIPING 4tJTLET • minimum -2 3.04
ROUGH OPENINGS 1.50 %
WATER SOFTENER 5.00
PRNATE DISP. • naLcxy. uc. 20.00
U.G. SPRINKLER • homc unaer consc. 3.00
ALTERATIONS • t0 20.00
d
R TURN AR4UND 20.00
STATE SURCHARGE .54
TOTAL: ao
srrE ADDRESS: f Y-3 ?'G a14. c /__ th<
OWNER NAME:
INSTALLER: 4-" 'a S 11- --o
,
ADDRESS • C_ v r --CITY: ?; 4 STATE: ZIP CODE:
PHONE #: ( ? ('Z-) ?' ?- ` ? `:;-> -z ?
1994 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 6814675
1994 PLUMBING PERNIIT (C4MMERCIAL)
CITY 4F EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR ALL CO1VIlViERCIAL,JINDUSTRIAL BUILDINGS. AiSO FOR MULTI-
FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NaT REQUIlZED FOR EACH
DWELLING UNIT.
NE'W CONSTRUCTTON
ADD ON
REPAIR
WORK DESCRIPTIUN:
CONTRACT PRiCE: $
FEE: 1% oF corrrRAcr FEE.
STATE SURCHARGE: $30 FOR EACH $1,000 OF ?.. : FE?,
MINIMUM FEE: $ 25.00
?
CONTRACT PRICE X 1% $
STATE SURCHARGE $
TOTAL $
SITE ADDRESS:
TENANT NAME: STE. #
OWNElt NAME:
INSTALLER:
ADDRESS:
CITY:
PHQNE #:
FOR:
CITY OF EAGAN
STATE:
ZIP CUDE:
APPLICANT
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA112979
Date Issued:08/27/2013
Permit Category:ePermit
Site Address: 1438 Blackhawk Lake Dr
Lot:9 Block: 3 Addition: Stoney Point
PID:10-72600-03-090
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments: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.
Carbon monoxide detectors are required by law in ALL single family homes .
Larry Pratt
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 -
Tresa Anne Jackson
1438 Blackhawk Lake Dr
Eagan MN 55122
This N That Maint Inc
655 Fuller Ave
St. Paul MN 55104
(651) 214-9671
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA148516
Date Issued:04/04/2018
Permit Category:ePermit
Site Address: 1438 Blackhawk Lake Dr
Lot:9 Block: 3 Addition: Stoney Point
PID:10-72600-03-090
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Tresa Anne Jackson
1438 Blackhawk Lake Dr
Eagan MN 55122
(651) 485-4243
Blue Ox Heating & Air Llc
5720 International Pkwy
New Hope MN 55428
(612) 238-9709
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA165028
Date Issued:10/15/2020
Permit Category:ePermit
Site Address: 1438 Blackhawk Lake Dr
Lot:9 Block: 3 Addition: Stoney Point
PID:10-72600-03-090
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 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 -
Cameron & Lauren Hall
1438 Blackhawk Lake Dr
Eagan MN 55122
Archer Exteriors
324 Concord Exchange South
South St. Paul MN 55075
(651) 775-7017
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA177417
Date Issued:06/30/2022
Permit Category:ePermit
Site Address: 1438 Blackhawk Lake Dr
Lot:9 Block: 3 Addition: Stoney Point
PID:10-72600-03-090
Use:
Description:
Sub Type:Water Heater
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Bart Winkler
19099 Orchard Trl
Lakeville MN 55044
(612) 532-6998
Paul Bunyon Plumbing Llc
5718 International Pkwy
Brooklyn Park MN 55428
(612) 822-5292
Applicant/Permitee: Signature Issued By: Signature