1462 Blackhawk Lake Dr ORM Il?'?SP:?CTIC?N ?C
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GITY OF EAGAN PERW"TYMO
38W Pibt Krtob Road
Eagan, Minnesotai 55123
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? (612) 681-4875
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This Cerlifccate issued pursuant to the re9quireinents ojSection 306 of the Unifonre Building
Code cerajying 1Jwt at tJre tfine of issuaxce this structure wrrs in compliance with de warious
ordinartces of the City regulaAing building oonstrucdoa or use For the follottring:
ux amaoe SF BE ewg. twc rb. 1808
0-MR-7 TYv? ??1 Zonin8 Dbuid PD/Ri 'nae c? VN
pwow oc 9u&ftmR(4prTA fYM?S Mimes; 316 QRESTM - 3t' PAilr.
Ad*„ 1462 $t.A.?1Aid L."'y L7. B1 L?XICt1Ai?C gffi;
02/25,(q3
L Baft Official .
POST Xv A CONSPICUOU9 PU1CE
Address 1462 BLACKHAWIC LAKE DRIVE Zip 5512 2
Irot' '` 7 Blk 1 Sub M•ACKHAWK 1uDGE
THESE ITEMS WE12E / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: 02/25/93 Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
4
Sad/Seeded grass
L -'
Trail/curb damage
Porch
Basement finish
Deck v'
Please verify with the builder the removal of mof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
K 8655
Z '?79
Rest Da e
r-
Z Fire No. Rough-in Inspection
Required?
? Ready Now )?(,Will Notity Inspec[or
When R
ad
?
p Xfes r No e
y
I`,'Klicensed contractor p owner hereby reque in pecti f bo electrical work at:
Job Adtlress (Street. 8ox or Route No.) ?
Q Ciry
ra 49
Secti n No. 7owns ip ame or No. ang No. Counry
lJA
Occupant IPRINT) Phone No.
erit d a aar?S Pr, ? ?'o - ?2 6s?
POwer SU ph9r
Rd'?o/a qdQress r
,01-/'?id1 hn
Eieclncal Con aaor (Company Name)
I ll ??e??•-,? y?c Contrador§ License No.
CA0 /1.r3
Mailing Address IContractor or Owner a?ing Install '°n) ? "//?
Gt a.r? (?'u??rrv? <
?0
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2 ! CA Q-
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Authonzed SignatWe (Co. ct wner Makin IlaLOn) Phone Number
MINNESOTA STJE BOARD OF ELECTRICV THIS INSPECTION REQUEST WILL NOT
Griggs-MlAway Bldg. - Room S-173 BE ACCEPTED BY 7HE S7ATE BOARD
t821 University Ave., St. Paul. MN 55104 UNLESS PFOPER INSPECTION FEE IS
Phone (812) 642-0800 ENCLOSED.
///6 ,/??-- REQUEST FOR FELECTRICAL INSPECTION
K?- ? See instruelions for complating this form on back of yellow copy.
'X" Below Work Covered by This Request
es-ooooi-oa
34-
ew, 74dd Rep: ' TypeofBuilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specrty) Contractor§ Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool ? 0 to 200 Amps /2 0 to Amps Q
Transformers Above 200 Amps / A6ove'W Amps
Si
n5 Inspector§ Use Only:
9
Irri ation Booms
Special Inspection
Alarm/Commuriication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 M HS.
I, the Electrical Inspector, hereby Rouyn•,o are 1, -? Q rfy
certify that the above inspectian has
been made. Final 1
at
0
OFFICE USE ONLY ? A
ThiS request voitl 18 mOnth3 from
?iags54
Request Date . Firg NG: Fough-in Inspedion
equired? n(Ready Now 0 Will Notity Inspector
7 Yes 7Pf0o When Ready?
IXlicensed contractor ? owner hereby requi n
Job Atldress (Street. Box or Roule No.)
41
Secnon No. Township Name or No. Range N
eh
GolW
ctilVeboi?#lectrical work at:
City
o. Counry
DuknIa
Phone No.
4/Y
;2 jig -.:ZGS?
7- d ol
q 41ro /-G LClf C-/1
Electrical Con ractor (Company Name) ?
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?Ele
Mailing Atldress (Comract0, or Owner Making Installationi r
? Y6 ?-- ?. e•rcr?s? ?
Authonzetl Signaty4re.4o9tractooOwner MaxASl Inslallation)
MINNESOTA {TATE BOARD OF ELECTP
Griggs-blidway Bidg. - Room S-173
1821 Unirersity Ave., St. Paul, MN 55104
PhOne (612) 642-0800
Contractor License No.
? G C.'O- 1/-1-.s'
La'dre- ?k ?A S"`l-e-
Phone Number
Y3s, 31.2 C
THIS INSPECTION REOUEST WILL NOT
BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
? See instructions for completing this lonn on back of yelbw copy.
?' •? "X" BeId%JNork Covered by This Request
E&00001-08
.,;?.
ew Add Rep. TypeotBuilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other-(Specity)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) CoMractor's Remarks:
Compute lnspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Above 100 Amps
Signs InspectorS Use On1y -, TOTAL
Irrigation Booms
?J
Special Inspection
Aiarm/Communication TMIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby RO°9n-'" Date
certify that the above inspection has
been made. Finai o??
OFFICE USE ONLY ?
This request void 18 months from
RESIDENTTAL BUILDING
Permit Application
City Qf Eagan ?
3830 Pilot Knoh Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Consiruction Requirements RemodeUReoair Reaulremerrts Office llse Onlv
3 registered site suroeys showing sq. ft. of lot, sq. ii. of Mouse; and ali roofed arezs 2 copies vf plan Cert af Survey Recd _ Y_ N
(2096 maximum lot coveraqe altowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Real _ Y_ N
2 copies of plan showing beam & window sizes; poured found des?n, etc. 1 site survey for additlons & decks Tree Pres Not Reqd _ Y_ N
1 set of Energy Calculations Add'rtion - indicate if on-site septic system On-aite Septic System _ Y_ N
3 copies af Tree Preservation Plan if lot platted aRer 7l1193
Rim Joist Detsil Qptions selection sheet {bldgs with 3 or less unit
Date t +
Cvnstructivn Cost 7 OQQ
Site Address y 4lsE 1 Uni#lSte #
Description of Work
Multi-Family Bldg _ Y"It N Firepiace(s) _ 0 _ 1 _ Z
Property Owner Telephone #(?yS 1) 32? ? U so1?
Contractor `? i? C•?,? ?`? n Q?yu.r-
Address a City f \e 3??ZJ(k
State T,r\ iJ i
Zip 5 S~???
Telephone #(kri i) ) 023\) '-> 33 3--
COMPLETE THIS AREA ONLY IF C4NSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Enet'gy Code Category . Residantial Ventilatian Category 1 Worksheet • New Energy Code Worksheet
(4 submission iype) Submitted SubmiUed
• Energy Envelape Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan8 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Meehanical Contractor
Sewer/Water Contractor
Telephone # ( ) '
Telsphone # {
Telephane #{ )
I hereby apply for a Residential Building Permit and acknowledge that the information is camplete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Sta.tutes; I understand this is not a permit, but only an application for a permit, and work is not ta 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.
rn a Qk S 0,,3 L L MdAJL?
Applicant's Printed Name Applicant's Signature
oFTIcE UsE oNLY
Sub Types
? 01 Foundation
? 02 SF awelling
? 03 01 of _ plex
? 04 Q2-plex
? 05 03-plsx
? 06 04-plex
Work Types
? 31 New
? 32 Addition
0 33 Alteration
? 34 Replacernent
Valuatlon
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Framing?
- Fireplace _ R.I. _ Air Test FinaZ
Insulation
C] 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improuemen# ? 38 Demolish (Interior) ? 44 Siding
0 36 Move Bldg. 0 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Dernolish (Bldg)* ? 43 Reroof ? 46 WindowslDoors
"Demolition (Entlre Bldg) - Give PCA handout to applicant
Approved By
Base Fee
Surcharge
Plan Review
MClES SAC
City SAC
Utility Connection Charge
S&1N Permit & Surcharge
Treatment Plant
License Search
Copies
dther
Total
? 07 05-plex 0 13 16-plex ? 20 Pool
? 08 06-plex ? 16 Fireplace ? 21 Poroh (3-sea.)
? 09 07-plex ? 17 Garage 0 22 PorchlAddn. t4-sea.j
? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? 11 10-plex ? 19 Lower Leve! ? 24 Storm Damage
? 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
Occupancy
Zoning
Stories
Sq. Ft.
Length
W idth
MC/ES Systern
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
Building Inspector
- 3ITY OF EAGAN PERMIT
30 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
Control No. 13 2 "u'
PERMIT TYPE: Permit Number:
Date Issued: i ' i . •
SITE ADDRESS:
r
DESCRIPTION:
i'i I_! i. ? iI I, 7'i !7
C; C I.1 i? c7 1-1
?v
B J. (f L. q L, h !s i?
t;i t_1 I1 Ci t i 1 i? W 7. d i: i"I
REMARKS:
( - ! ,, (!
w,,
. ,
, ..
FEE SUMMARY:
?;? (?"l
7 It? .?
CONTRACTOR: ?-tJWNER:
i N )
C. 1',: 110 6.; 1 c,' d c- L hl ut? T 11 c? t/ 63 1e i,.': i"j t h 4z t`) CJ I. l. t? at t' i. t1 P1 a i"'1 d u; t 4e, t- E? t h 'c'? t_ L f1 f;t
r.? 7 C'? " fl1 L.1. t} i'1 ?. ? (:; o G P;. c3 i1 C? a CI, a" i: ? i„ U ?a U I11 l1 1 'w` w 1t: i 1 Z? 11. ? F? f) I 'S L
i i ' :i t: }? (1 t i: a q a t'1 r' Ci :1 11 ci (l i:l :? S ..
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A
--
A E ISSUED B: S NATUAE ?
INSPECTION RECORD I Control No. '!. ;LL) f- ri
CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: ?•? ??: ;:;? '
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
1?171"I;?..?
PERMIT SUBTYPE:
TYPE OF WORK:
k! r I;,I
INSPECTION DATE INSPTR. INSPECTIO •
? ? /5
. ?u Y"? _
?
PERMIT #
,
ctrr oF EaGaN
1992 BUILDING PERMIT APPLICATION
681-4675
?, f? ? f
-?;Z ? 3
N Q Y 1 6 RECD
CA )Jar.111-Iq
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of ertergy calcs. .
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date Yaluation of work
Site Address:
STREET STE *
Tenant Name:
LOT BLOCK _? SUBD. ? I I P.I.D. !
Descri ti on of wor^k: /?? C
The appl i cant i s: D Owner Contractor ? Other (oescrtbe)
Name Phone 0-7 -1
Property LAST FIRST
Owner Address 2343 4 C- 6 cati P&L-D
STREET STE #
C i ty ??64'U State Zi p
Company R&-kU,661W 11?1?:.? ? _- - -------- Phone ? ?ff1-c?<o5a
Contractor Address S-1& e!2 f' License # Exp.?3
City State Zip
Campany Phone 4?S d D7af?-
Architectl
Engineer Name Registration #
Address
City State ?L Zip
Sewer & water i i censed pl umber /4z, Processi ng time for
sewer & water permits is two days once area has een app ved.
hereby acknowledge that I have r thi ap licatian and state that the information is
orrect and agree to comply it all ap ica e ta of innesota Statutes and City of
Ordinances.
[Eagan
ignature of Applicant:
vrrmrc uat WILT
6UILDING PERMIT TYPE
O 01 Foundation ? 05 Apt. Bldg O 09 Basement Finish
JW02 SF Dwg. E3 06 Garage/Accessory ? 10 Swim Pool
? 03 Two family ? 07 Fireplace 13 11 Res. Add./Porch
? 04 Multi-fam. T.N. ? 08 Deck ? 12 Conm./Ind.
WORK TYPE
19 31 New
? 32 Addition
O 33 Alterations
? 34 Repair
? 35 7enant Finish
? 36 Move
[3 37.Demolish
O 99 Undefined
GENERAL INFORMATION
Const. Actual) V-N
(Allowable)
UBC Occupancy- I2-3 M-1
Zoning p?-)
f of Stories
Length 46,
Depth
APPROVALS
Basement sq. ft.
Ist F1. sq. ft. 2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewa%a
Planning Building rn°ay-
Engineering Yariance
REQUIRED fNSPECTiONS
? Site O Footing ? Framing
D Wallboard ? Final O Draintile
O Insulation
? Fireplace
Permi t Fee v.tmt;a,: s? Voo
5urcharge
Plan Rev iew Gn?Ras?:
33 x Zz=
_._.?,.
172(.,
License Z
MWCC SAC
c; ty sAC 7 n z x zb
Water Conn.
Water Meter yb ?C ? 3' ? Y Zg
Acct. Deposit o t K6 .
SJW Permit ISX/S- 2Z??
S/W Surchar e
? .
Treatment Pi
. ?aq3 ??5 ? /6, 39?
Road Unit
Park Ded.
IST ??owt
Trails Ded.
Copies ??
Other Z
Total : ?l1 t k S3= S`?1ia 16 3 .
SAC 96 l00
SAC Un i ts
I 34g
LI??iT oA?? ??uD'?'7a?-•f L??
-7 x 2i .? ILI7 ?xrvy 53= C-1 3#3S o)
1515 x S3 = 60 sq5-
?
Is 3, ?B?
r?% ` .
O 13
O 1 rv ra?
D 15 Miscellaneous
MWCC System Yes
City Water ?-S
PRV Requi red YS s
Booster Pump
Fire Sprinkler
Census Code lol
SAC Code a/
Assessments
? PIDRIEEA
* engineeri
-k * **
Lario suavEroHS • awL
ng urro w.nrmERs •
2422 Enterprise Drive
Mendota Heights, MN 55120
612) 681-1914•Fax 681-9488
625 Nighway 10 Northeast
Blaine, MN 55434
612) 783-1880•Fax 783-1883
Certificate of Survey for: Mendotd Homes, lncorporated
House Address: 1462 Blackhawk Lake Drive, Eagan. MN
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x soo.o Denotes E\ ting Elevation •R•V¦ r
x soo.o Denotes Prop'osed Elevation PROP05ED HOUSE ELEVATION
l.owest Floor Elevation:86Q.55
--- Denotes Drainage & Utility Easement Top o f B k E t ion: 868.66
- Denotes Drainage Fiow Direction -o- Denotes Monument Garage Slab Elevation:868.33
-e- Denotes Offset Hub Bearings shown are assumed
LOT 7, BLOCK 1 BLACKHAWK RIDGE
DAKOTA COUNTf. MINNESOTA
( hereby eertity that this survey, plan or report w?-a?s. .p..,r?epared by me r under my direct supqsCv?isian and that I am duly Registered Land Surveyor
under the laws oi the Stete of Minnesota. Dated this.L?.?#i_ day of I-JO 1? , A.D. 19_1.fG .
• 1 inch _ -,; nfeet
'1 V
B. i CH L.S. REG. NO. 14891
um 92502.00
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CITY OF EAGAN
3830 PILOT RNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
. .. .. Iw=4 k,.y.y .?i.1 . .
ti6:.K•:v::L:• Yri4}ih':.i^:i4?G.?.+:i+?'+'vGV6:4.
FOR CITY USE ONLY
PERMIT #
RECEIPT # d S?-
DATE: 023
:??;? PLEASE COMPLETE UPPER PORTION
.•..0:4?.C.n.J:6.\..i?.iW ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE R.EQIIIRED FOR EACH UNIT.
------------------------ --------------------
WORK DESCRIPTION ---------- ----------------------
COMPLETE THE FOLLOWING: -----
N0. FIXTURES EA. TOTAL
NEW CONST X_ ADD-ON MINIMUM 15.00
ADD ON X SHOWER 3.00 :9
REPAIR WATER CLOSET 3.00
BATH TUB 3.00 ?
? LAVATORY 3.00 42_
OWNER NAME: ? o ic, 1Ao A4 KITCHEN SINK 3.00 3_
LAUNDRY TRAY 3.00 3
SITE ADDRESS : N(. 2i?!,+c ic- k_ a w I', D tZ HOT TUB/SPA 3.00
? WATER HEATER 3.00
?
LOT:BLOCK L SUBD. FL00R DkAIN 3.06
GAS PIPING OUT.
INSTALLER: 1`( c 7- +Z cti-o- i-E t? t+3 3'. (MINIMUM - 1) 3.00 ?
ROUGH OPENINGS 1.50 ? a
ADDRESS: iZ3 p-< QTHER
WATER SOFTENER 5.00
CITY: au?nus Lt ZIP: 37 PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
PHONE 'YoBq
SUBTOTAL $ S a
1? .Z ,4;&-2i ST. SURCHARGE .50
SIGNATURE OF PERMITTEE
TOTAL: $ D r)
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
--------------------------------------------
CONTRACT PRICE: ---------- ---------------
FEES ------- -----
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FOR:
1$ OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMiTM FEE.
CONTRACT PRICE x 1% $
STATE SURCHARGE
TOTAL:
$.
$
(SIGNATURE)
CITY OF EAGAN
. _ +.. .
CITY OF EAGAN
/ MECHANICAL PERMIT RECEIPT #/4 g?1 g?
B
SUBD. (612) 681-4675 DATE T 3 y?
RESIDENTIAL `
PLYA5E COMPLEI'E UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. AISO, COMPLETE FUR
TOR'NHOMESICONDUS WHF.N SEPARATE PERMITS ARE REQUIRED FOR EACH DWELLING UNTf.
RESS: ADD ON/REMODEL (EXISTII?TG $ 15.00
I.RE(( ?s? 1?s i a l`?o•?. `° S FEES
CONSTRUCTIUN ONLl) HVAC: 0-100 M BTU 24.00
ER: nrt ADDITIONAL SO M BTU 6.00
: 2?, so GAS OUTI.ETS - MINIMUM 1@ S3 EA. ( ?j?
ZIP: LSUE.- RCHARG$ ?
OTAL: : s
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAIJINDUSTRIAL BUILDINGS. ALSO COMPLETE FOR
APARTMENT BUILDINGS OR OTIiER MULTI-FAMILY BUII.DINGS WHEN SEPARATE PERMTTS ARE NUT REQUIRED FOR
EACH DWELLING UNTI'.
I WORK DESCRIPTION:
CONTRACT PRICE:
1% OF CONTRACT FEE.
STATE SURCHARGE IS $.SO FOR EACH
$1,000 OF PERMTf FEE.
PROCF•SSED PIPING - $25.00
MINIMUM FEE - $25.00
OWNER
STfE ADDRE5S:
TENANT:
SUITE #:
INSTALLER:
ADDRESS:
CITY:
PH?NE #:
SIGNATURE:
TOTAL:
ZIP:
CTTY SIGNATURE.
S
S
s
?
?
0
V-0
a
?
0
0
?
0
LOT SIIRVEY CSECICLIST FOR REBiDEHTIAI.
BUILDING PBRMIT
PROPE TY ?.EGALs ZTZ&--
CMNT sTAxnARns
Dat• vf surveps
? Registered LAnd Surveyor signature and company
• Building Permit Appiicant
• Legal description
• Address
• North arrow and bar scale
• Hause type (rambler, walkout, splft w/o, sglit
Iookout, etc.) '
• Directional drafnage arrows with alope/gradient t.
• Proposed/existinq sewer and water servicec
• Street name
• Driveway
ELE4ATIQNS
zzisting
fl [] • Sewer service
E3 0 • Lot corners
C) 0 ? Top of curb at the driveway
E3 II • Elevatians of any existing adjacent homes
ProQ„osed
? Q 0 • Garage floor
0? 0 E] • First f]. oor
? 0 0 • Lowest exposed elevation (walkout/window)
D • Property corners
vo 13 - Front and rear of home at the foundation
PC7NDiNG AREAS (ff atiiplicable)
? a' io • Easement line
n ,3 • rrwL
n F ' o • xwL
0 0 Pcnd # desiqnation
0 [1 • Eaergency Overflow Elevation
entx'y,
DIMENSIONS
'
? D? Q ? Lot lines ,
Right-of--way and street width (te back of curb)
• Froposed home dfinensions inaluding any proposed decks,
overhanqs gseater than Z', porches, eta. (i.e. all
f structures requiring permanent footings)
?9 ? ? • Shaw all easements of record and any City utilities within
-/ those easements
II? • Setbacks of graposed structure and setback of adjaeent
existing homes n 0 • Retaining e' ements, if any
- Reviewed: j ?
N e / te
Octaber 1992
Use BLUE or BLACK Ink
r
For Office Use I
37
Cit of Ea n11 Permit
y of ~all I
I Permit Fee: I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
I
Phone: (651) 675-5675 1 I
Fax: (651) 675-5694 I Staff: 1
I 1
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: Phone:
Resident/ I
Owner Address / City / Zip: r
Applicant is: Owner Contractor
1l
Type of Work Description of work: Construction Cost: Multi-Family Building: (Yes / No/ X )
Company: fG'f~~ Contact:
Address: j//~ 6•~:~ ~
city:
Contractor i
State: - Zip: Phone:
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that 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.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved 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.
x le'?V
X ~
Ap licant's Printed Name Ap icant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA137373
Date Issued:06/30/2016
Permit Category:ePermit
Site Address: 1462 Blackhawk Lake Dr
Lot:7 Block: 1 Addition: Blackhawk Ridge
PID:10-14400-01-070
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater & Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Richard D Stephenson
303 Walnut St S
Trenton IL 62293
(651) 325-8719
Benjamin Franklin Plumbing
5718 International Parkway
New Hope MN 55428
(612) 238-9709
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA138745
Date Issued:09/19/2016
Permit Category:ePermit
Site Address: 1462 Blackhawk Lake Dr
Lot:7 Block: 1 Addition: Blackhawk Ridge
PID:10-14400-01-070
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
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.
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 -
Richard D Stephenson
303 Walnut St S
Trenton IL 62293
Executive Exteriors & Remodeling
7308 Aspen Lane N, Suite 130
Brooklyn Park MN 55448
(763) 432-4677
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA146433
Date Issued:10/25/2017
Permit Category:ePermit
Site Address: 1462 Blackhawk Lake Dr
Lot:7 Block: 1 Addition: Blackhawk Ridge
PID:10-14400-01-070
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 -
Jill M Westmoreland
1462 Blackhawk Lake Dr
Eagan MN 55122
(612) 325-8791 X19
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:EA156225
Date Issued:06/20/2019
Permit Category:ePermit
Site Address: 1462 Blackhawk Lake Dr
Lot:7 Block: 1 Addition: Blackhawk Ridge
PID:10-14400-01-070
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 -
Jill M Westmoreland
1462 Blackhawk Lake Dr
Eagan MN 55122
(651) 325-8719
Gladstone's Window & Door Store
2475 Maplewood Drive
Suite 110
Maplewood MN 55109-0000
(651) 774-8455
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA166724
Date Issued:01/29/2021
Permit Category:ePermit
Site Address: 1462 Blackhawk Lake Dr
Lot:7 Block: 1 Addition: Blackhawk Ridge
PID:10-14400-01-070
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jill M Westmoreland
1462 Blackhawk Lake Dr
Eagan MN 55122
Fireside Hearth & Home
2700 Fairview Ave N
Roseville MN 55113
(651) 633-2561
Applicant/Permitee: Signature Issued By: Signature