1463 Blackhawk Lake DrCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 1463 Blackhawk Lake Dr
Lot: 12 Block: 2 Addition: Blackhawk Ridge
PID:10- 14400 - 120 -02
Use:
Description:
Sub Type:
Work Type:
Description:
Census Code:
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Pella Windows & Doors Turnkey Sales
15300 25th Ave N #100
Plymouth MN 55447
(763) 745 -1400
e- Windows/Doors
Windows/Doors-New/Replacement
House
434-
Applicant/Permitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Total: $90.00
- Applicant -
Construction Type:
Occupancy:
Owner:
Arnold H Fick
1463 Blackhawk Lake Dr
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
Building
EA078509
06/25/2007
ePermit
A framing inspection is required when installing a Bay or Bow window or if the opening is altered. Smoke detectors are
required in all sleeping rooms prior to final
inspection. When wall studs or ceiling joists are exposed, hard -wired detectors are required. Battery operated types are
acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector.
$88.50 0801.4085
$1.50 9001.2195
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 with all applicable State
Issued By: Signature
For Office Use
I..
11 Permt
41 O Layn
i.b
City
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 Staff:
Fax: (651) 675-5694 -
2008 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: "1 Site Address: I / K~ 13 G , )Ci~t~ ~d 1 '
Tenant: Suite
RESIDENT / OWNER Name: H Phone:
Address / City / Zip: r I' t 5 122
~O'ry
V
-npion License
CONTRACTOR Name: P51-365-1340
Address: 3f'7R Dodd Rd #100
acaan kIN 55123--133
City: State: Zip:
Phone: Contact Person:
TYPE OF WORK _ New _?Repla ment -Repair Rebuild M dify Space Work in R.O.W.
Description tion of work:
PERMIT TYPE RESIDENTIAL
Water Heater Water Softener
Lawn Irrigation Add Plumbing Fixtures
L_ RPZ / _ PVB) Main - Lower Level)
Septic System Water Turnaround
New
Abandonment
RESIDENTIAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge)
$30.50 Lawn Irrigation (includes $.50 State Surcharge)
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge)
*Water Turnaround (add $136.00 if a 5/8" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
TOTAL FEES $ 150
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.
121
Ap icant's Printed Name Applicant's Si
FOR OFFICE USE Reviewed By: Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final
i
5-716
CITIi OF EAGAN Permit Na 4790
383DiFqt'Knob Road Meter No: /1D3 /.3 ? 0.3
P.Cf;'_?ax 21199 Reader No: r/ ?? S b 6
Eagan, MN 55121
Plumber_ Star Ylumbing Date: T-Z 1-88
Owne? ColZegt City Const. '
Site Address: 1463 Blackhawk Lsks Dr. L12
Size: V8 Och .
Date: rel- Z. 5= S S
Conn. Chg: 550. eooa Zoning R].
Acct Dep: 15 < OOpd No. of Units: 1
Permit Feec _ 10. a0pd
Surcharge: • 50t)d I agroe to comply with !he Clfy ol Eagan.
Tr. Plant 204 • 04'Dd ., Ordin e
Meter. 67 Uf?pd ?
Misc.: gy
?
WATER SERVICE PERMIT
This request void
78 months fro-
E 12 7,00
Request Uate
? Fire o. Rouph-in Inspection
Required?
Ready Now Will Nolify. Ingper.-
t
Wh
P _ [4Yes ? N. or
en Ready
? Licensed Electrical Contractor I hereby request irtspection of above
Owner electrical work installed at:
Sveet Address, Box or R t No.
1 ? ? ftc r9w?C" ?•? ?'c ioi City
ection o. Township Name or o. Range No. Coui? ?
Occupant (PRINT) Phone No.
Po r Su lier
fJI?C? 244 Address
AJ
Elec r al?onV? t?ICompany Na? 1,
?
? Con clor' icen O
i
_.
MailinpAddress (Contractor r Owner Making Instailat 1
OR
Authorize tu e ont r/ er Ma g Instal ation) Pho e NumbPr
v
MINNESOTA S'rATE BOARO OF ELECTRICITY TNIS INSPECTION REQUEST WILI NOT
Griggs_Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD
UNLESS PROPER INSPECTION FEE IS
1821 Universitv Ave.. St. Paul, MN 55104
Phnnn tailt aaj_nRnn ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTlON Ee-ooooi-os
?. ?
, See instructions for completing this form on back of yellow copy.
?2+J 5 ""X" Bebw Work Covered by This Request 1_,454?
Hdd Rep. Type of Building Appliancea Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Liyhtin,y Fixtures
Apt. Building Dryer Electric Heatin
Commercial 81dy. umace Si!o Unloader
Industrial Bidg. Air Conditioner Bulk Mflk Tank
Farm o:ner neclfv otnf,r (snor;;fv)
ther Spncify Other Othiar
Cqlnpute /nspecrron Fee Below
F. Service Entrance Size 7t Fee Feeders/Subfeeders k Fer. Circuits
? U to 200 Am s 0 to 30 Am s U tr) 30 Am s
Above 200 Am ps 31 to 100 Amps 31 to 100 Am s
Swimming Pool Above 100_Am s Above 100_Amps
Transiormers Irrigation Booms +(} Partia Fee
Signs Special Inspection T fA
)
Remarks p? ?
l K?1
Rough-in ? D:ite ?y?/ ? t ?cal
? ?if? / +r Inspector, hereby
certify thet the above
Final t e
inspection has been
made.
CITY OF EAGAN
' N2 15 2 3 4
-
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454•8100
` /.? C}???
b
BUI
L
DING PERMIT Receipt # T i
To be used for SF DWG/GAR Est. Value $112,000 Date JUNE 22
Site Address 1463 BLACKHAWK LAKE DR OFFICE USE ONLY
Lot 12 Block 2 Sec/Sub. BLACKHAWK RIDGE On Site Sewage Occupancy R-3 M-1
MWCC System X_ Zoning R-1
Parcel No. V-N
On Site Well (Actual) Const
x
COLLEGE CITY CONSTRUCTION
Name
City Water
X(Allowable)
V-N
z 6970 i51ST ST
Address PRV Required # of Stories __
? _
City APPLE VALLEYphone 431-1211 BoosterPump Length _69,
Depth 55 ,
_
°C
.o Name SAME S.F. Total
-
v Q Address Footprint S.F.
??- City Phone APPROVALS FEES
~ km
WW
Name Engr./Assess. _ _ Permit 614.00
=
-
Address
Planner
Surcharge
- 56.Od
x
Q W City Phone Council _ Plan Review _ 307.00
Bide. off. sa,c, city 100.00
I hereby acknowledge that I have r thi appl i and state that the Variance _
SAC, MWCC _550 .00
information is correct and agree co ly wi a ppiicable State of Water Conn. 550.00
Minnesota Statutes and ." of ?gan rdin n e
`?
Water Meter
67.00
,
? ?
Signature of Permittee L Road Unit ?---0-0
A euilding Permit is issued ta_CO LEGE CITY CONST Treatment Pt 204.. (Q
on the express condition that all w k shail be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances. Parks _
2
773.00
Building Official -Anw, A-1r?,
L? - TOTAL ,
BLDG. PERMIT NO
01-321?`j"'"`"?1?'g`.?t /L-
01-3422 Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2195 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.
TOTAL
. • ,?-, ,. -???....,,,,....P?.??.,_
CASH RECEIPT.
, :?
CITY- Of? E?AN
• ` 3830 PII.OT KNOB ROAD
?
EAGAN, MINNESOTA 55122
DATE ? ....?" i 18 J
r+EcervW 4'L ? . .' , ? - . . . ?`-
?
f.. .
AMOUNT
& DOLLARS
,ao
?f Thank You
Bv
?-
; +nn,ue-Pa"rs copr
? . a vex?w-P?f+s ?r
Plnk-Flle Copy
Y-o /- b
.
t4
?
CITY OF EAGAN Permit No: 9790
`3830'Pilat Knob Road Meter No:
?.0. Box 21199 Reader No:
Eagan, MN 55121
,
Owner. , Coiiogs Cgty +Const.
Date:
Size:
Date:
Site Address: 1463 $lar.kba.k I.ake Dr LI2,B2 B sclr.ha ga
Plumber. S?? ?ltvabla$
Conn. Chg: ?-50 - OW Zoning: Ri
Acct. Dep: 3d No. of Units: g
Permit Fee: 10•0010d ?
Surcharge: •5opa
1 agree to comply with the City oi Eagan
Tr. Plant z?? •??? prdinances. "
Meter. t+7 . tit??.t
Misc.: a „
gy
WATER SERVICE PERMIT
CITY OF4AGAN Permii No: 10933
363NP116t Knob Raad g/p NQ: 84952
P.O. Box 21199
Eagan, MN 55721 ?r, ?.
Owner. ?+ollege Citp CoalEt,
Si#e Address: 1463 ??ckba@'k Lake
Plumber: St$? Plumbing
MWCC: 55()"00pd ZonFng• ?
City Chg: ?'?`?' No. of Units:
Acct. Dep: 3• pd
t ? I i agree ta comply with #he Gity of Eagan
Permit Fee: Ord+nances. "
Surcharge:
Misc.: , By
SEWER SERVICE PERMtT ?
Dr Ls 2
Date: _ 7-21"98 Date: 6-22 '45
CITY flF EAGAN 1
3830 Pilot Knob Road, P.O. Box 21-198, Esgah, MN 85121 f PHO N E: 454-8100
BUIL'DING PERMIT Receipt
To be used for ?Est. Value Date •%???' ?? 4 a ,18 .;?s
Site kddress ;
Loi Btock
Parcel No.
W Name
? Address _
City t ,
A' ?: ` J'Phone
Name ' ??-
? ` Address
City Phone
Name
Address
City
Phone
I hereby acknowledge that 1 heve read this appliCation and state that the
informatfon is correct and agree to comply with all applicable State of
,AAinnesoEe Statutea and City of Eagan Ordinanees.
Signature of Permittee
k Building Permit is issued to: ,_. c . i' ."
on the express condition thet all work shall be done in accordance with al I
applicable State of Minnesote Statutea and City of Eagan Ordinances.
Building Official
SeC/Sub. '5t.ACtCiit- ?Y. R I ?
f;l.n Wh5;7'FL'C-ClOtv
???!f-',• ?C)ISt :n,
OFFICE USE'ONLY
On Site Sewege Occupancy
MWCC Syatsm X Zoning
On Site Well (Actuaq Eonat V-N
City Water _Y, (Allowable) V'-14
PRV Required # of Storie8
Booster Pump Lenqth 69'
Depth 551
S.F. T4tal
Footprint S.F.
APPROVALS FEES
r' i 4'• ??
Engr./Assess. Permit ?
Planner Surcharge 5?1'11"i
307`4 "
Council Plen Review
Bldg. Off. SAC, City
Variance BAC, MWCC
WaterConn. `1; •'''
Water Meter `'' i • '?' `
RoadUnit ?"?a•??? ?
Treatment P1
Parks ?; -
TOTAL
PW" IIo. Pwok Flolder Dsb Tohphom #
PWmbirg
H.V.AC. /D
cPAce- r1'a5-?
Electnc
Saftener
1wpo"on Deee insp. Comments
Fovtings I /
Footing4 II
Foundstlon
Framing ?
AooEing
Rauph Pft ?
Rough Htg ?
IaWI.
Fireplace
Final Htg.
Final Plbp.
Bldg Finat
Cert Occ. 0WM- TO s? f?6oui
l
Temp. LP
!-
Deck ftg.
DlS& Fi?tal
WeN
Pr. Disp.
-- -• +..s*n s-Wrsiri'?tl?g .-
7
PERMIT ?
PIUMBtNCi PERMIT RECEIPT l .??Q
'
. ClTY OF EAGAN
3830 PILOT KNOB ROAEf, EAGAN. MN 55122
pATE:
d
GONT.RACT R RICE PHONE: 454-8100
Site?Address BLDG. TYPE WORI?`.OESCI?IPTION ?
Lot Block ? 'L Sec/Sub Res. ? New '..._. ? ?
? M ult. Add-on ,
Name Comm. Repair
(D
- Address Other
?
?
c
City _,.s
? Name 3 Address '
;p _ City.
Phone l "". x -1
Phone?`' =
FEES COMM/IND FEE - 1% OF CONTRACT FEE
F?PT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPUES
ININtMUM - RESIDENTIAL FEE - $12.00
MIiViMUM - COMM/INp FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
SIGN/kTURE OF PERMITTEE
FOR: CITY OF EAGAN
RES. RIBG. OMLY - COMPI.ETJ?.THE FQ4L00INlNG:
NQ FIXTURES ? TOTAL
_.aLWater Closet - $3.00 ?,.?.._
?._Bath Tubs - $3.00 S ,
Lavatory - $3.00 ?
•-=-.k-Shower - $3.00
_?_Kitchen Sink - $3.00 3
Urinall8idet - $3.00
ZLaundry Tray - $3.00
_LFloor Drains - $1.50
--J_Water Heater - $1.50
Whiripool - $3.00
_.?._Gas Piping Outlets - $1.50 "
(MINIMUM - 1 PER PERMIn
Softener - $5.00
Weil - $10.00
Private Disp. - $10.00
?_Rough Openings - $1.50 ' ` -
- FEE 's
-?;
STATE.*fC:
GRAM[E,"TAL:
,_},
PERMf"f f
MECHANICAL PERMIt RECEIPT #
. . ' ? CIT1f GF EAGAN ,
?
:?--
3830 PILOT KNOB ROAD, EACiAN, MN $5122 DATE -• ---
CONTRACT PRICE•t--\, ",>) PHONE: 454-8100 =
Site AddressU BLDQ. TYPE WORK ?IPTMN
Lot_./_2- Block ? Sec/Sub ? ,.____
Aes ? Nery
171
Add-on
. Mult
m Name ` Comm. Repair
? Address ?J.?,. • Other
c Cii
? W:301
x
J FEES
Name ' • RES. HVAC 0-100 M BTU
• c Address ADDITIONAL 50 M BTU
ES HVAC INCLUDES A/C ON NEW
3 k (R
0
` Ci .,Js,t? (?.f
i
?' - ?- Phon
`?
, ? - ,
GOM ??i 1, _s??!1) ,, .: • _
.7
_ GAS C1UfLETS (MINIMUIIif =1 PER PEFiiY?l? -
.50 EA
COMM/IND FEE -196 OF CONTRACT FEE
TYPE OF WORK BLDGS. - COMM. RATE APPLIES
APT
Forced Air 1r'? M BTU ?- .
TOWNHOUSE & CONDOS - RES. RATE APPUES
Boiler M 8TU MINIMUM RESIDENTIAL FEE -- ALL ADD-ON &
REMODELS - 12.00
Unit Heater M BTU MIIdIMUM COMMERCIAL FEE - 20•00
Air Cond. M BTU STATE SURCHARGE PER PERMIT. - •80
Vertt CFM (AOD $.50 S/C tF PERMiT PR1GE'GOES
Gas Piping Outlets # BEYOND $1,000)
.
Other
FEE:
S/C:
TOTAL•
SIGNaTVRE oF NeKnm"7tt -? -
FOR:'CIT( OF EAGAN . .
, _ .: ; . ; ? ?, .:s:,..._ ... ? • . _. .f: .: .
CITY OF EAGAN {? w^ ; ?
3830 Pilot Knob RoAtd, P.O. Box 21-199, Eagan, MN 55121 PliONE: 454-8100 t:!
BUILDING PERMIT ` Receipt # " ?"
To be used for Sr iW4:;/?;Ak Est. Value $I 12•000 Date Jti$p, 22
Site Address 1463 F-LACi4HAIWX i.AKE U12
Lot 12 Block t Sec/Sub. 11LAC3:KAWK R i tiGE
Parcel No.
? Name G0.LL1--(-"E CI'!`Y (;0AIFTRI7L1I0;ti
z Actoress b?'7G i S1ST 5T
° City Al'PLE VALLEYPhone?_ 431-1211
, o Name
? a Address
? City Phone
v¢
?y W Name
FW
0 ? Address
Q W City Phone
r
I hereby acknowledge that I have read this applk;atioa and state that the
information is correct and agree to comply wit aIt.Applicable State of
Minnesota Stattltes and Cit? of Eagan Ojrdinanes.
Signature of Permittee f??
" ? P:C;L C iTY C??E.;T
Abuilding Permit is issued to: t:
on [he express condition that all work shail be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan OrdinanCes.
Building Official
OFFICE USE ONLY
On Site Sewage Occupancy
AAWCC System X_ Zoning R-1_
On Site Well (Actual) Const V-44
City Water _X (Allowable)
PRV Required # of Storfes
Booster Pump Length 69 o
Depth _._ "? ?! _. •
S.F. Fotal
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit 614.00
Planner Surcharge 56•00
Council Plan Review 307•00
Bidg. Off. SAC, City 1U0• 00
VarianCe _ SAC, MWCC 550+00
WaterConn. 550ow '
Water Meter 67.001
Road Unit 325•W
Treatment P1 204.0
g
Parks
TOTAL 2,173.00
4
,f • i ?
y '?. • ? ` ! . i
. ?L
. r 1
i
(gert`f `ra`e of Orrupaiiry
r.,. ,
Cirp of
lgrpartmrtc# uf guitding jnspprtinn
This Certifrcate rssued pursuant to the requirements af Secfian 306 of the Um'form Build ing
Code certifying that at the time of issuance this structure was in compliance wuh the various
ordinances of the City regulating building construction or use. For the following.•
uu clmffiatkm SF DWG/GAR eug. Pe,,,,i, xo. 15234
o-paocy Type R3/Pi1 7eningDislrid Ri rrpe const. ?
?r of Bufldiog 0M= r-M LCTTM. 6970 15IST ST, A.V.
ewta; re? LARE AR ?ity L 12, B2. ffi.? R?
, ,. ?1463?BLAMVW
,? 1).k: .TArA1ARi' 6, 1989
Bw7 ' g Official
POST IN A CONSPICUOUS PLACE
? A
.
1988 BUILDING PERMIT APPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLING3 16 13 4
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SUAVEYt 1 SET OF ENERGY CALCUUTIONS
NOTEs ADDAESSES FOA CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE 41HICfi
IS DESIRED. NO CHANGE$ WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSi?ED.
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF UNITS
INCLUDE 2 SETS OF PLANS, CEATIFICATE OF SURYEY - CHECK WITH BLDG. DEP .,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL ?
INCLUDE 2 SETS OE ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
ADUE?F . .
To Be Used Eor: ?? m ,/ 7 ,.1 Valuation: , . ?iT' Date: ?? -c?{?
Site Addre9s
Lot Block •E
Parcel/Sub ? ? ??•? ? ,', ..-, ;,u '???g ?.,
Owner / j
Address
City/Zip Code
Phone
Contractore"'-=-l i `? ?' ° . '??: •'?'';i= _,;? -
.?
Address ? 9) U JS)
City/Zip Code 'r,j
Phone
?
Arch./Engr.
Address
0 r, OFFICE USE ONLY
On site sewage Oecupaney
MWCC system ? Zoning
On site well Aetual Const v- N_
City water ? Allowable
PRV required # of stories
Booster Pump Length p
Depth _54 = IO"
S.F. Total
Footprint S . F .
APPAOVALS
Engr/Assess
Planner
Council
Bldg. Off.
Variance
FEES
Permit C, N. 0 c3
Surcharge ? .,, 4 c:,
Plan Review ao , , _ _
SAC, City Ib010:?
SAC, MWCC
Water Conn
Water Meter
Road Unit
Treatment F1 : •>?_
Parks
Copi es
- -- -- ? TOTAL
City/2ip Code
Phone #
_. ' 1JA L_ tA A1 1 O I-l
G.?-LA?=?( 2 ''? L j r1 "7 ?
Lf U ??1? = 10360
.?
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RESIDENTIAL
BUILDING PERMIT APPLICATION
cinr oF EacaN
3830 PILOT KNOB RD, EAGAN MN 55122
851-681-4875
RemodeYReoalr Reaulremenla
• 3 registered site surveys showinp sq. ti. of lot, sq. fl. of house; and Iu roofed areas • 2 oopies of plan
(209'o maximum bt coverage albwed) • 1 set of Energy Calculatbns for heated addAbns
. 2 copies oi plan slmwhg beam & window sizes; poured found design, etc.) • 1 sile survey tor e0rior addiUons & decks
• 1 set of Energy Calculations • Indicate 1 home senred by septic system br additlons
• 3 coples af Tree Preservation Plan i1 bt platled after 711/93
• Rim Jofst Detak Options selecW sheet (btdgs wdh 3 or less units)
DATE VALUATION
??? ?
SITE ADDRESS `?lc 3 A c? MULTI-FAMILY BLDG _ Y _.!?.N
NPE Of WORK lk ey FIREPLACE(S) _ O_jK 1_ 2
APPLiCANT
STREET ADDRESS Ifl.;1a-6 ?rzl.., ?r _CITY --s STATE?DP
TELEPHONE # 763-5?? CELL PHONE #
FAX # 10 ?sa- 933-106 y
PROPERTYOWNER 4nolW TELEPHONE# 6-6-1-4152 -" V
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ ?'sN
(?l submission type) • Residential Ventilatlon Category 1 Worksheet Submitted • nergy Code Worksheet
• Energy Envelope Calculations Submitted ? MAY 16 2002
Plumbing Conhactor: _N_
Plumbing system includes:
Mechanlcal Conhacfor:
Mechanical system includes:
Sewer/Water Conhactor:
Air Conditioning
Heat Recovery System
Phone #
Phone #
Fee: $90.00
Fee: $70.00
I hereby acknowledge that I have read this application, state that the informatlon is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordlnances.
Signalure of ApplicaM
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
? Water Softener
? Water Heater _
No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
OFFICE USE ONLY
O 01 Foundation O 07 05-plex 0 13 16-plex E3 20 Pool 0 30 AccessoryBldg
? 02 SF Dwelling 0 08 06-plex O 16 Fireplace 0 21 Porch (3-sea.) 0 31 Ext. Alt - Mufti
0 03 01 of _ plex 0 09 07-plex ? 17 Garage 0 22 Porch/Addn. (4sea.) ? 33 Ext. Alt - SF
0 04 02-plex 0 10 08-plex O 18 Deck O 23 Porch (screened) ? 36 Multi
0 05 03-plex O 11 10-plex ? 19 Lower Level 0 24 Storm Damage
0 06 04plex O 12 12-plex Plbg_Y or_ N 0 25 Miscellaneous
O 31 New ? 35 Int Improvement ? 38 Demolish (Iriterior) ? 44 Siding
0 32 Additbn ? 36 Move Bldg. 0 42 Demolish (Foundation) ? 45 Fire Repair
0 33 Alteration 0 37 Demolish (Bldg)* O 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (EMire Bldg only) - Give PCA handout to appHcant
Valuation Occupancy MC/ES System
Census Code Zoning Ciry Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insularion _ Retaining Wall
Approved @y , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply 8 Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Totai
RESIDEAIT'tAL
. BULLDING RERMt'T APPLICATI4N
J ? ? cmr oF ?a?
? 3830 PIL4T KNOB Rd - 55122
?9-681-+?75
• a mgiscwed s1Ee ewvap shoAg s4. R a bt. sq. 4t ot houm: ane d roofed areaa • 1,,;opd ol q.n . (20% nVjrthm lof Worage @Ilowed) . . . + 1 eet+l?Er?lr? ? ? ? ' • 2 copin of plan ahoWMD
tem 8 wk?dm skM Pomd b04 d880. Mc.) . • 1 silm aawy for eac?a ad?io+a?.? ?s _
. 1 set of Enerp Calaietl=
. 3 coOe+ of Tree Prmrvalm Pfan 0 lat plallad der 711183
. Rim.loeet oeta0 Opuana sWedbn stieet (Wdss with 3 a Mn wft) ?
DATE VALUATIQN 8,600.00
JOB S1TE ADDRESS L463 Blackhawk Cake Drive >
IF MUITI-FAMILY dUlLDIKG. #iO1Af MANY UWITS?
PROPEFtTY 4WNE ' - - TYPE 4F WORK Inst 11 10 Glasswalls Units FIREPi.ACE(S) r._. 01_ 2
APPtiCANT MONWRAY INC PMONE4 161-_W_^$ 25
801 BaanE Rvenue Narth Golden Valle MN . I,?'!.C?-` 55427 ADDRESS
PAGER # CELL PHONE #" ._ .. ? FA% # ^M34t5-8977 -
NIEW RESIDENTIAL BUILDING_ONLY - FII.L OUT COMPLVE?f .-
_
Energy Cade Category _ MIN?A MLFS 7670 CA1'FGORY I. _
(check cne) - Residential VeMilation CatewiY'1 Wo*~ SWmOod ,
_ Enengy Envelope Galcukftns SdDmItter! I .
. biINNESOTA RUM 7672
? - Now Energy Code Worksheat Submitted
Plumbing Centractoc fhorm #:
Plumbing System Includes: WaEer Softener ?,.., La.wn Sprinkler Fee: $90.80
Water Heater _ No. of R.I. Bahs
No. a#' Barhs
MachartkaF Conl,acior Phan*4 :.
Mechanjcal System IncEudes: _ Air Canditianing Fc?: ,170:00
_ Heat Recovery Systcm .
Sewer/Water Conhactor:
Phons ? „ _ ..
,4q above inforrnation must be submii#ed prbr ta proceasin9 flf apPlicad0n•
l hereby acknowledge th4t f have read fihis applicatitxt, state that the
with ail applicable State of Minnesota Sfiatutes and City of Eagon1
is
, cndqyee to compiy°
? . ?. .
slgnan?re of
_.._.,,,..
Certificates of Survey Raceived ^ 1'ree Preservation Pisn Roceived y N+a?
11?
,
.. /?
? -- ---?•-W--?--?
OFRCE USE :ONLY
0 01 Foundatlon 007 p5 plex . 0'i3` f8-oex 020 Pool p.?p flklg
D 02 SF Dweli€ng 13 OB 06-plex fl i8 FW%gwe D 21 -Porch (34ae.) a': 31 ft Ait -WIN
[f 03 01 of - plex p 49 87-plex C] 17 Gwop 0 22 PormWAd*, (44sa.) 13 33 '.ft A#» SF
004 02-plex 0 10 08-Plex C] 78 :Dsck C] 23 Pondr (somm4wo C] `-
? 05 03-plex O 91: '! 0-pioc Ci `'t6 L.o?rer' EAVII a 24 Sbm Dwep
0 os oa-aex 012 12-plax Fft-Y orN ? z? wwe?r
Q 31 rew 13 35 Inr inpa,rowMA E3 3$ ?pntgdor)
[3 44 : 5lllil?
0 32 Additlon E] 38 Mwe ft• ". O 42 f7srnoiish (FowWatlon) 0 45 Fh*Rapok'
? 33 AiteraEion 0 37 Denokt (Bkfg)} p 43 Reroof 0 dS : WidOwalDoors
0 34 Replacortfent 'Qsn? Mntbv Bk? 4edy) - tiNa PCA harldtW bd apcan# ,
Yaluatlan CccupancY ? MCIE$:"1em
Census Code
?oNnfl City *Mer ' .
5AC Units 8oaswr Purnp
N#N. of Units 3q. ft. Pfw. '
Nbr. of B1dgs Fko 8pdnMw9d
Type o# Const -- Width .
REQUtfiML?-1??1SPECTfiO?i
_ Footings (new l?ldg) FiineYC.O.
_ Footings (deck) ?( Finll7i"?tb C,Q.
Footings (addition) P6mbing
_ Fnundatiaa HVAC
` Drain Tile -
Roof i Ice & Water pam
Pool _ Ftgs Airlt3es.Tem ??inel
_ Firtplace Air Test _ Fimtl ? Sidin,g Stwco 3tone
_ Insulati4n _ Windows (nearhepl?tcet?nt) .
49mved gY &AdkV;ftp%Wr
BaSe Fee
Surcharge
Plan Review PLA?` O)vs
MCIES SAC
City SAC .
Water SuPpIY 8 St+xa" .
S8W Permit 8 Surciarge
TteatmenE P(ant
Plumbing Permit .
'
Mecharticai Pemtit F
Lic.vrise Search " .
Gopies
C3ther ? .
,
TQtal
N 2000 BUILDING
PERMIT APPLICATION (RESIDENTiAL)
cinr oF Racani
3830 PILOT KNOB RD - 55122
651-681-4875
> 3 roylslorvd tlto wnwys showinfl sq. tL d bt. =4 B. ot houae
and go rootad aaas (209L mmdmum lot cove?aaa dl?tefi
> 2 coptoa ot plarn (show boam 8 wNxow sizas: Poured hnd. doaign: atc.)
> 1 set a ansrgy calcuknau
> 3 coplas o1 tree presarvaMon pian if lot plaftad aBar 7/1/93
DATE:
2 copies ot plan
1 sst a amrgy cdcukftns fot haaled qddMons
1 aite wrvay fot axlada addNons & cioCks
CONSTRUCTION COST: aa-
DESCRIP'TION aF WORK: !I& P/Q e+e- exi Shn2 de l..k- i7c arlo !x-d d a- t d S ??' ?1 u? i?l? siQ vi S?
STREET ADDRESS: 14?63 e 1 Ve-
LOT: 12-_ BLOCK: ?._ SUBD./P.I.D. ?6'
PROPER7Y
OWNER
COMRACTOR
ARCHITECT/
ENGINEER
Nome: F1 C.k- Af1.0a LD Phone #: ,40 -1S2 ' F°'F
Wt Fint
Street Addreas: /4 L 3 l? I a LG- K u? ?Q ?{ DRrvC
City c? State: AA? ZiP: ?-?--
Company. v L-41 t= ? Phone C
(area code) •
Sheet Addreas: Llcense # ExP•
City
State: ZiP:
Company: o c`4; C4- Ncme:
?
Telephone ?: ( )
Skeet Address: ReSlbnation #:
C.ity
State: ZiP:
Sewer/water licensed plumber (N installina sewer/waterl: Phone 41 U
I hereby acknowledga Ihat I have reed this applica8on, slate iNat ihe informafion is cor?ect, and aqree b comply wilh aM appNodble State
of MMneaota Staiutea and City of Eagan Ordinances.
Siynature of Applicanfi L
OFFICE USE ONLY RECF??.T?I??'
Certificates of SuNey Received Yes No S E P g- 2000
Tree Preservation Plan Received Yes No t-?Not Required BY:
OFFICE USE ONLY
y
BUILDING PERMIT SUBTYPES
0 01 Foundation ? 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.)
? 02 SF Dwelling D 08 06-plex O 17 Garage ? 22 Porch/Addn. (4-sea.)
? 03 01 of _ plex ? 09 07-plex 11 18 Deck ? 23 Porch (screened)
0 04 02-plex O 10 08-piex ? 19 Lower Level O 24 Storm Damage
? 05 03-plex ? 11 10-plex Plbg Y or_ N 0 25 Miscelianeous
? 06 04-plex ? 12 12-plex O 20 Pool 0 30 Accessory Bldg.
WORK TYPE
! t
? 31 Ext. Alt - Mult
? 33 Ext. Alt - SF
0 36 MuIN
O 31 New ? 36 Move Bldg. ? 43 Reroof
? 32 Addition O 37 Demolish (Bldg)" ? 44 Siding
OD 33 Aiteration 0 38 Demolish (Interior) ? 45 Fire Repair
? 34 Repair ? 42 Demolish (Foundation) ? 46 Windows/Doors
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code # of Stories sq. ft.
No. of Units Length Sq• ft•
No. of Buildings Width Footprint sq. ft.
Const. (Actual) i-'-A/ Basement sq. ft. Census Code y3
(Ailowable) Main level sq. ft. MClES System
UBC Occupancy sq. ft. City Water
Zoning P-? sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
D Stucco/Ston e
APPROVALS
Planning Buiiding Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
SNV Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
***************?*****?****?************
CITY OF EAGAN
CASHIER: JS TERMINAL N0: 763
DATE: 09111100 TIME: 08:36:25
ID:
NAME: ARNOLD H OR JUDY M FICK
3210 9001 1463 BLKHWK DR
3430 9001 1463 BLKHWK DR
2155 9001 1463 BLKHWK DR
Total Receipt Amount:
CR137185
USER ID: JAN
60.00
0.25
0.50
60.75
- - - , ?,.
I I
. ?.*'? `... ? .
* 2422 Fntrtpii^e C?Hvn
* PIONEER Meridota Il6(fiits, MN 55170
engi* eering .. ? (612) 681 1914
Certiticate of Survey tor:_.
.?
?,JL) QiiI
,
;
862.0
'o a ?
? ,; ??°',• ? i? /?a °'? ?Cr
>.
eb `
(b
BS7J? ... • ? °a ? ti?' I °o °? p
C
.
?\
?
6Si•.
?
,
y,-
.
...`.? -4 i
?..
I ?
?
\-Vnp
.
.
.
?• Da
900.0 penules exislin flPval!'orl
90.o Uc?lolesproPo,??d E/evaliorr
Ease?'? lertf
--- -- L)enOles Urulljq ef"ufiliZrrow.(
---.- UP?ioles Ut4ir?a P Flow : • o Denoles ir,orlumetif ?
8enr•i15 shown (jt•Q assuf>>eu
EAGAN
,.
?n
G
DEPT
I -'QUPUSEU NUUSt E1Et/A7-jC)jVr,
lowesf Floor Elevabon =^
Top ot 8/oc4 Elevaho(j : _
..?'iarpj,j 5la6 E'/evvfior) = g?.3
L OT 12 ,. . BLOCK 2, SLACW14AWk R100F
U-4K0rA CaUNTY, MINNESOTn SUeJECT 7D EASEMENIS oFREeoaU
1 helrhY ccrllly Ihnl thls Survn.Y, pMn n? raporl wo?s ??/r? p• lpy ni isnrlnr tny ?l(roct eupcivislon an<I Ihai I am duly finqistr.jr,l I nnrl Surveynr
on(lnr IlIn Inws al Ihe Stote ol Mlnnesots. Doled thts_ilSQ_ ?? 1.of n D, 19
I -?
Scale 1 40t? j - /-;iK . ?e M?4
n r.ll
r ,
r,
4)1 4a\
-
APFLI?ATION FOR PERMIT
SEWER AND/QR WATER CONNECTION
,yfR-1 SINGLE FAMILY
ity oF cngan
PLZASE PRINT
1) PROPERTY ADDRESS:
LF7GAL DESCRIPTION;
IF EXISTING STRL?CTL1RE, DATE OF ORIGINAL BL?ILDING PMRMIT ISSLiANCE:
PRESENT ZONING/PROPOSID LSE:
j COPM+lERCIAL/RETAIL/OFFICE
Q INDCSTRIAL
? INSTITCITIONAL/GOVERNMENT
2) : ' 120W1'R'rN NANIE :
ADDRESS:
CITY, STATE, ZIP:
?x?.R ...................a......,.,....
*
* NOTE: PAYMElP OF FF.E AT TIM OF *
; tPPLxcMort = tuW Corr ;
; srizvtE aPPRUOL oF pEruT. *
. .,
* xrWEcriaa CP sUM Arn/at wuTER *.
* zrsraLCATioris wns. Wr sE Sr.EDtn.M *
*t [?NPIL PII2NIIT HAS BEQ4 ApPRWID.
:+?*,t,?***+t* #**tr *,?+*rtt *+*tts*,r+?ar****
Mon Year
? R-2 DLPLEX (Ttao Lnits)
? R-3 TOWDII-iOC?SE (Three + Cnits )( Lnits )
Q R-4 APARTMENT/CONIDOMINIC'M ( L'nits )
PHONE:
3) : ?+• NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
# i/yl3 ?._
4 ) 1167% 4 5 ' : " N .i? ?;,
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
For City Lse
Pltunbers Li.cense:
Active
Expired
Not recorde(f
Staff Initia
5) C?TCONNECTION TO CITY SEWER ER-6CONNECTION TO CITY WATER F-1 OTHER
6 ) 7 ?? - Rf"
********,t*************?** *******,r**.*?*************,r,t***,?r*******************?*********************;
* THE GOLD COPY OF THE WILL BE SEUr DIREICTLY TO PUBLIC WORKS Zn FACTT.rrz?mF (OTIIt PICK-LiP. ?
* PLF.ASE ALLOW 'IWO WORKING DAYS FOR PROCESSING. SONIDONE FROM ZiM CITY WILL cONPAL'T YOU IF TFERE ?
* ARE ANY PROBZ.IIMS. ;
?***************************************************************************************?*********;
F4R CITY USE ONLY '
PERMIT # ISSUED ' .
Pd w/Bldg. Permit FEES:
$ $ SEWER PERMIT (INCLUDE SURCHARGE)
$ $ WATER PERMIT ( INCL[JDE SURCHARGE)
$ $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLLDE CORPORATION STOP)
$ $ SEWER TAP
$ ACCOUNT DEPOSIT - SEWER
$ ACCOL NT DEPOS I T - WATER
WAC
SAC
$ S TRLNK WATER ASSESSMEIVT
$ S TRLNR SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRLNK WATER
WATER TREATMENT PLANT SURCHARGE
$ $ OTHER:
TO TAL ?77 4 ?
RECE PT RECEIPT
DOES LTILITY CONAIECTION REQLIRE EXCAVATION IN PLTBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR WORK WITHIN Pt?BLIC
Q ROADWAY" MUST BE ISSLED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY :
TITLE:
DATE : 21 -2 -lCl
r EyYtR10R Et"LOPE AVERAGE "11" C010"•ITATION
U4dtIER
?
5Ii'E ADURESS .4
1 ?^
COttTtt?lCT4R pcc-CGF? G!"rV dlAl?fr' pATE -?-,Of PNONE
,....
Uetermine working square footage af each. .
1. Total exposed wall area ...... Z--?o* sq. ft. x_,1?,,,
.2. Total rovfJceiiing area ...... I?'TG? sq. ft. x,04
Total exposed watl area abvve f1aor n
a. Total wall windnsr area ........................... 'Z. 7,3
?
b, Total doar area .........,.................0...... ? ;15-
c, Total sllding glass door arpd.? ...............t. D-
d, Total f9replace wall area .... ........ o
„
? e. Total wall framing area 17 0
f. Total net wall erea above flavr ...............:. I z 6o ?u,C•
g. Total r1m ja3st area ............? ............... i9 Z
Total' exposed foundation area a (U Q-
h. Total ioundatian window,area...........:......... a
i. 7flal net toundation area' abvve grade .......::...to 4•.
. . . , .
determine -"t!" -vajue of eacte wall segment.
a. X "Uu •' d ? '7 7.1 C?
?
b.
C: ? . . Z NUN CJ
d. O
x Run o ° 0
e. ?1'7C) X"u° , OqZ p._15. b4-
S. ? 2(c." t? lL "ti" 043
. ?
x 6run .0 4„ a ? $.
h• 4i' ; x Hu11 ' Q a ?
i. ? o?- X"u'' , a-t =
. ..s.
3 .....................................Toka1 5
I f i kem 13 1 s the same as,' vr less than i tem 11, yau ?ave met the intent
of SE3C 6006(C)2.
, + • ?• ? ? ...
, .,., • '
; Total..pxpvsed rnof/ceil ing area
, . r
J. Tatal skyllght area.....:....................:.. ?
k. Total rooF/ceiling framing area (a4rerage 10??..,__???
i. 1'otal neC insulated roofJcelling area...•........ ??f, ?
pekermirte "U" vaiue for each roof/ceiling segment. .
. •
? • ? x "u" ? a o
x "U"
t: "f??Z. x p?,?. 0 4z..
4 ..................................Tvta1 ? Z, .5 If total of 14 is the same As, or 1ess than 12, you have met the intent of
SE]C 60flC ?c ) ? . ' Altecnate Suildirrg Enve]ope Oesign
To uttiize the totat envelope system methad, the values estabiished by the'
swo of items 13 and 14 shal.l rcot 6e greater than the sum oF items [Irl and €2.
1. + 2. ? -
. ' ' ' .
3.' + 4. . ?.
.' , . . .
JVJn L,C vA L UE ANA!. Y s15 cJF L 14.12 -(""?Z&fl A k'4H ?
W114DOW AIMA :
Typ,i Qft Wi N.00 W :
TNE 1.4l,,vDorU f„/iIITS //AVL $Lfn! TFSr4'p FOP, " fi2'?,VA1-tA•i.0 "rHlY ANIiG AS E.4190
A$oJ ? 4ND iy4y 61 As?i4w?? ?! 4tJiriN [SAra) V..""c. af ' Z•
lqc?N??+?? il?R 1r16M 5 ,
?q, = i ??y ? i P! ? ? .
?OOf w .ej 4?
FouWDaT roN WiNao w ARZA : TYPE oF `h,11N0ay? :
7H L vvi Nno;v r1d.rs 144 +t L $tW T"iL Src D r- oot'R-4 VALIAC, I"HLY A4 a AS ? I b 7 L0 Aeova. wLLO
rr»r, 8r AssrtINLu A Oisf(t•JCAr?IW?a Vau+IL Orc •R,"w ?uc4- tivanJq
Aa.R RIU+•+s ,
LIq== I/t+ym. r I? ' _? ' Fewr??q?. t?oorwq4 = 0
S1. I D JO; (?L A5 5DbC] P. Ak,'?X1 : TYpt op 00007-4:
?-
St.iD/kl ci 411.459 4000AS 4IhvIC Ri1L,G+4 Tl.:1T LO* FoR"R.'= 1l'.1 L-&%ty T!1`Y &JUI.rAhrligx
AbbboC A 1i4 M-P-1 66 A.:$.7F + -4N14. D A f?1.sfreJ J4 ...sA('[) VA1. K G a1 4.4Nlotia?
.410 PFI/.MS ,
L11; ¦ ?!'?a s J? :?'-,?? Fvd ri. w c. s?.,?._.?..
TYP G ? F DbaK :
D641Z uNl-rs HAYL bt-iLr4 Tcsrta wMU 1PouNc 'ro MAv+c 04+4
'R"-VAL. t4jL Q r - -Ijil,,, ? id"1+{ Q / /ti/ 9; ^ 1 A R IA+r Ms,
1 ? ?+ 4J
FoOTAq l4?
5PEctAL5 : 7?ypE ;
.5rN c
?
!
'• •? ?AND r?.r. . VALUr ANAt,.Y3t5 dF ??? 9j2ffzcPi6lwu .??c..r??•?a
jaisT/ Fw.?+m,Nic, ARe x,
v? LU& I"T? 11 10R aI ft fILM
SoFTwooQ
?;f PS,b M vVAe.LPaAMQ
? '?--
,?? ...r I NTER ioa. AIA Fil-M
TaT A L " R?.?? ?Al.u..IE
LAj.? 11
.
? ?,?,_? .- • ? `
. ToT A l. FoarAc 6 -
?NSu.?A'TED AREa j5crWcca TNL VOISTS
Mx" . VALki.r
,(a/ 114TERtpg AiR lrILM
A-4-... b"Ipg
jh46Ltl.n 7r0N
OlCqYFSGIM WALLAoAitD
V A Pd rt aA R 4ILIL
Nrr- R. lo?Z AtR !`tL Nt
,4,:!'.3& ToTA L YA?LLL
, ,,. {
Torp?lo RQDTA4L
r ?
7'?'??l4MIb
pik?rI
?+lM l? ?E ? ollu7f. ?'i
f'\- I'IIYU LA VA LU," A NA Ly',5 !5 OF /V66!
Sru c / Fi<ptj fN? ?A? iL 04, :
s Ec-r 1a$4 s
" Fj•• - VAL. u d-
.??LLINTEK1uR AJR Fr0-t
. •.? ?? S4f r vVoop
ivi
Z•V F' Z? ??SHlAl?{1',/Cr ?JI L ?' ? ..?...?
.??.. ..
? ...?.....? V A Ab+i? b ARRi"
MrlltlOk AIR,. f?L•M
Jo•?? ?orAL' R?; ?w????
"ti?1 ? 1 /'e...i ¦ I I !O 0 z.
TarAi. MeaorAc,? 1-70
Z w S U. L a TE. D A!t e+? ?&rWLe N 5TLADS
'.R.._ vAiu, d
=ure,aIoa ?iOL ff&.M
s ?4YP5u.+,n y?/aA.1.00aeo '
4.?. ?°? ? asu ?,+'r ?o•r ?R,?9 ?
M!. a T k i H Q.?G'
tio7 AP
?
`.=._.... ,..? Y?? v o ,e. ?,? ?,?. ? c ?e..
Rff&rLR.1C't, AIn. l?lt-M
?- 2.&To f A I. Nw L YA 1. uA 416.
A"%* UL.+*. s j ? ? • {D r ? . I
r1 L-1 ioMJ?t, Ri
raTAL PoorACR.
UArt?
_ . .. _._ . . _._ r ---•--•--?...._ _..
.. T-\ ANut.4 YA4 u( ,q N' ,a. e. Y s r:) O 1 Sf GTi 0 WS
Y /I Lu e
_lNtf-Rlori. A1R. Fl L M
.r
-- 92-- -??--- 1 u S U l. AT 1ON(R'I't ?
. . r --.1?U 0 ??s M I.A T , si c,,
? . ;
? ?_ld'l l? S r v r ? ? 4 ?.A P
. ,
?-
`
• gif Tri-KIo R At+L p 1i.. &I
, ?.?.. ........_.
IE. ? 7-4-,13 `
r- 'Y -r arA L q..?' 1?.4t-U f.
U-j '24-. 1 _
?
. i'OrAL "rAc, li 19 z4
FouNra q-r s oN W?LL, AFEn (A?oVL czR^ax..,)
.
" R.r yA l. I.L F_
,(Olrr N rF R,OR A,R hL rN
.?
I b5 - a coHC,R r rc pLocac
( rr . ?.
I.?o ? r- "s" &A t , .,4 (R.l? ?
EXTLk10l;L A12 RILM
TAL ,(A L LLf-
OL l_..? p
,
N5Illr? 9-1 ENbA41b
? roT?? ?rAc,L ? c d-
p?t? ?•3v-??14 kv I p _. P-i
?
? PIONEER
? engi* eerir
* ?c * Certiticate of Survey for:
i f)
r1911F
2422 Ftitri{irisn C)rivr
Mendvta lleights, MN 551211
(612) 681 1914
?
,
,
862.0 ? ?
?? /
'?
W*P W--
. ?
> ?
h o` .. \
. .
,
.
4?
-' ?
,
? a+
*
. (OO
I
0
? • 'tiq y ? ? ( 9C ,?'? .
? •?,? ?'? ?,q 4° ,a 4h. ?•?
/ , ??o ? ? ? , ?? ?•° pi
\ \ \?, •' ? ?( fi
v t}
\ n ?
?
r?
\ c?? ? 4r
?
S \ 1?-
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA110247
Date Issued:04/30/2013
Permit Category:ePermit
Site Address: 1463 Blackhawk Lake Dr
Lot:12 Block: 2 Addition: Blackhawk Ridge
PID:10-14400-02-120
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.
Ashley Orman
130 Plymouth Ave N
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Arnold Tste H Fick
1463 Blackhawk Lake Dr
Eagan MN 55122
(651) 452-8084
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117068
Date Issued:10/15/2013
Permit Category:ePermit
Site Address: 1463 Blackhawk Lake Dr
Lot:12 Block: 2 Addition: Blackhawk Ridge
PID:10-14400-02-120
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Elizabeth Hess
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 -
Arnold Tste H Fick
1463 Blackhawk Lake Dr
Eagan MN 55122
Sela Roofing Remodeling
4100 Excelsior Blvd
St. Louis Park MN 55416
(612) 823-8046
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA126192
Date Issued:08/18/2014
Permit Category:ePermit
Site Address: 1463 Blackhawk Lake Dr
Lot:12 Block: 2 Addition: Blackhawk Ridge
PID:10-14400-02-120
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Arnold Tste H Fick
1463 Blackhawk Lake Dr
Eagan MN 55122
Apex Energy Solutions
1509 Southcross Drive West
Burnsville MN 55306
(651) 688-2739
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA146984
Date Issued:11/29/2017
Permit Category:ePermit
Site Address: 1463 Blackhawk Lake Dr
Lot:12 Block: 2 Addition: Blackhawk Ridge
PID:10-14400-02-120
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
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: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Arnold Tste H Fick
1463 Blackhawk Lake Dr
Eagan MN 55122
(651) 452-8084
Apex Energy Solutions
9655 Newton Ave S
Bloomington MN 55431
(651) 688-2739
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA177406
Date Issued:06/29/2022
Permit Category:ePermit
Site Address: 1463 Blackhawk Lake Dr
Lot:12 Block: 2 Addition: Blackhawk Ridge
PID:10-14400-02-120
Use:
Description:
Sub Type:Air Conditioner
Work Type:Replace
Description:
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
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 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 -
Deborah Hodges
1463 Blackhawk Lake Dr
Eagan MN 55122
Bonfes Plumbing Heating & Air Service Inc
455 Hardman Ave
South St. Paul MN 55075
(651) 228-7140
Applicant/Permitee: Signature Issued By: Signature