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1482 Blackhawk Lake Dr CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 D 0046 - BUILDING PFERMIT PHONE: 681-4675 Receipt # t To be used for SF DWG/GAR Est. Value $127,000 Date JAN 21 19--92-- Site Address 1482 BLACKHAWK LAKE DR Lot 2 Block 2 Sec/Sub. BLACKHAWK RIDGE OFFICE USE ONLY FEES Parcel No. 2ND Occupancy R-3 MM1 Zoning PD RR=1 Bldg. Permit 734.00 Name CARROLL CUSTOM HOMES (Actual) Const V=N Surcharge 63.50 cc (Allowable) =N Z Address - 14355 CIMARRON AVE Plan Review 477.00 V City ROSEMOUNT MN # of Stories Z.Ip 55068 Length 64' License 5.00 Phone 423-6100 Depth 3' SAC, City 100.00 Cr Name SAME S.F. Total - SAC, MCWCC 700.00 S.F. Footprints 675.00 Address On Site Sewage _ Water Conn City Zip On Site Well Water Meter 95.00 Q Phone MWCC System Acct. Deposit 30.00 License # City Water - X 30.00 PRV Required X S/W Permit 1 hereby acknowlege that I have read this application and state that he Booster Pump S/W Surcharge .5 n information is correct and agree comply with all pplicable St of Minnesota Statutes and City of g Ordi n Treatment PI '100.00 Signature of Permitee APPROVALS Road Unit 380.00 A Building Permit is issued to: d'RROLL CUSTOM OMES Planner Park Ded. on the express condition that all work shall be done in ac rdance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies 0 Building. Official i1 Qa~ Variance TOTAL 3,590.0 ~ 1 Address : 1482 BLAr qL*K LAKE DRIVE Lot 2 Blk 2 Sec/Sub BLAaqM RTDGE 2ND biese-items were/were not complete at the time of the final inspection. t : 10/23/92 Yes No Final grade (61E from siding) Permanent steps - garage Permanent steps - main entry Permanent driveway Permanent gas Sod/seeded grass Trail/curb damage VIII Porch Basement finish Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. NEMEDWEN White - City copy Yellow - Resident copy Pink.- Contractor copy III SEINER WATER-PERMIT OFFICE USE ONLY CITY OF EAGAN 01/22/92 3830 Pilot IirCflb Rd, METER Jr PERMIT DATE Eagan, MN 55122-1897 CHIP # PERMIT'# 12501 _ S f' S~~r%Su 5 METER SfiZ> BP. RECEIPT # t ISSUE DRTE B.P. RECEIPT DATE 01 21 / 92 DATE JAN 22, .1992 PRV BOOSTER PUMP SITE ADDRESS 1482 BLACUM LAKE DR PERMIT REC+.UESTED r SLOT .2 BLOCK SEC/SUB BLACKHAWK RIDGE 2ND X SEWER X WATER TAPS APPLICANT: COMM/IND X~ RESIDENTIAL ADDRESS: . CITY, STATE ZIP X NEW EXISTING PHONE: Lawn Sprinkler. Meters are to be 'lnstalled PLUMBER: XAcTTHEW DANIEL$ INC Ahead of Domestic Meters on Water Line. ADDRESS: 15185 CAROUSEL WAY Credit Wi NOT be given for Dedu7M,rs. CITY; STATE ROSEMOUNT MN - ZIP 550$8 PHONE: 423-3730 ORE T PLY WITH CI OF OWNER: CARROLL CCI$T4I-BONES EDI NC ADDRESS: 14355 CIMARRON AVE CITY, STATE ROSEMOUNT MN ZIP 55068 _ P ONE: NATU WHEN M ER S D L W AY ING. CALL 454-5220 FOR INSPECTIONS. FOR `.STORM SEW R PERMITS, CONTACT ENGINEE IINNG DEPT. , RD - . INSPECTION RECORD-- C" OF EAGAN Ph'i' rfft: 3 P Knob Road ,'1 v*trta 55123 POMM Nurlrr: *A" ilid: (6#2) 681-4675 Cllr sst !+tl 2 8 i!&Kl I NC 6 11~+I Ll.. COST" 140"o PER " PE. TYPE OF WORK. V i F Ilk! IlWjj~~ '111 It'', 1@11111lifl, j ~ PMlrt►Ye 1k4rty 171 ~ MVAC. ER CTRtC f5` O° gumnlic t fougnp 1 fqt 6 pAugh . Orse Tit Fuji P ft. PWg. M dor - No* Pko)bor mot. mew EWIftn POW 2 { Lock f-Q. I DeckFftl wa Pr. aw. I K 5 2 7` ~ ~ Request Date - ire o. Rough-in Inspection Requir Ready Now Jel- ill Notity Inspector lao Gd r as G No When Ready? I Kcensed contractor D owner hereby request inspection of above electrical work at: Job Address (Str t. Box or Route o.) City Section No. Township Name or No. Range No. Coun Occupant PRINTI - Phone No. Power Supplier Address Electrical Co tractor C pany Name) Contractor's License No. Mailing Address actor or Own Making Installation) 1)v d"~e~~"d Authorize , ig;q~owner.Vaking Installation) Phone Numbr 0~~ r -7 MI ESOTA ST BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-00001 -08 ~~See instructions for completing this form on back of yellow copy. "X" Below Work Covered by This Request ew Add p: Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other(Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Contractor's Remarks: / * _4 Compute Inspection Fee Below: # Other Fee I # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps i 0 to 100 Amps Transformers Above 200 Amps Above 1 0 Amps Signs Inspector's Use Only: TOTAL y` Irrigation Booms Special Inspection 3o r^ Alarm/Communication THIS INSTALLATION MAY BE ORDE D DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 1 THS.,' - I, the Electrical Inspector, hereby Rough-in a ; Date Cep 2 certify that the above inspection has Final Date GG been made. f d ^ K2- - OFFICE USE ONLY n This request void 18 months from g h-in Inspection Rst ate - ire No. rRou equired? ❑ Ready Now D Will Notify Inspector G Yes E, No When Ready? I ❑ licensed contractor owner hereby request inspection of above electrical work at: Job Addres ( ee,1,Box or MtN city Section No. Township Name or No. Range No. County/ ~j O pant RIN Phone No. L L_ S S"31 Powers her Address i Electncal ontractor (Company Name) Contractor's License No. p M. g Ad Tess (contractor or er Making Installation) VSrf Contractor/Owner Making Installation) Phone rfu4ber /V MINNESO TA STATE BOARD OF ELECTRICITY - THIS INSPECTION REQUEST WILL NOT - Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1621 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0600 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-00001-08 ► See instructions for completing this form on back of yellow copy. "X-" Below Work Covered by This Request New Add Rep. TypeofBuilding Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner ' Other (specify) Contractors Remarks: Compute Inspection 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 lnspector's Use Only: TOTAL Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDE ED DIS NNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in R Date certify that been made. above inspection has Final Dat2°! ZJ 9 11 < OFFICE USE ONLY This request void 18 months from 0< Req',est D e ^ Fire No. Rough-in Inspecti n ,f/)`, R;q~ed? ❑ Ready Now Will Notify Inspector YYes C No When Ready? I ' -~IIcensed contractor D owner hereby request inspection of above electrical work at: Job Add ss Stree Box o to No.) city k L~_ Section Township Name N1o. Ran Na o. Coun API ~L Oc arit (PRINT) P n N O ~ irn~ I I oil Power SLpplier Address El tr cal Contract r (Company Name) Contractor's License o Mailing Address (Contract or Owner Making Installation) If I I' *M~INNE Signature (Contracto !Owner Making In al lion) jPhoumber O STATE BOA RD OF ELEC RI ITY THIS INSPECTION REQUEST WILL NOT riggs-Midway Bldg. - Room 5-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ES-00001 -08 t ► See instructions for completing this form on back of yellow copy.' v /r `X'.Belowi'bUork Covered by This Request ~7D ew Add Rep. Type of Building Appliances Wired Equipment Wired 1F Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building ryer Other (Specify) 01 Comm./Industrial Furnace Farm Air Conditioner Other (specify) Contractors Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps 40, OC Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only: 'r TA ^ Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY BE RDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 HS. I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final Da been made. OFFICE USE ONLY This request void 18 months from ,o~7s'9 Req est Date ' Fire No. Rough-in Inspection ~ Required? ❑ Ready Now D Will Notify Inspector G Yes ❑ No When Ready? ,-5 1 I EL4 ensed contractor ❑ owner hereby request inspection of above electrical work at: Job Addres et, or e City ,ter Sectio No. Township Name or No. Range No. County , O pant (PRINT) Pho Nq. .t.. I+~"/c R Power S . ier Address 'Ij Electn IR-c ntractor (Company Nam } C ctor's License No. Mailing A dress (Contractor or er Making Installation) a u ber Authorized Signature (Contractor caner Making Installati n) r~ ";7 MINNESOT STATE BOARD OF ELECTRI Y THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room 5-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ~ EB~-/00n001-08 ► See instructions for completing this form on back of yellow copy. J O 1, 2 X" Below Work Covered by This Request ew Add Rep. Type of Building Appliances Wired EquipmentWired Home Range porary Service Duplex Water Heater ' Electric Heating t Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Contra or's Remarks: Compute Inspection Fee Below: # . Other Fee # Service Entrance size Fee # Circuits/Feeders Fee w Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps a 100 Amps Signs Inspector's Use Only: TOTAL Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final j Date been made. OFFICE USE ONLY This request void 18 months from i - - - - - - - - - - - - - - - - - - I For Office Use = I City of Ea i Permit I/' I F-9- I Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: - 2008 RESIDENTIAL BUILDING PERMIT APPLICATION r~ Date:- Tenant: Site Address: I4 1 C,-u Suite RESIDENT I OWNER Name: ~c d~ Phone: Address/City/Zip: S_ Applicant is: Owner x Contractor TYPE OF WORK Description of work: ,62.K i ` r) j 3 5 r c. 5" , X Construction Cost:l Multi-Family Building: (Yes / No CONTRACTOR Name: I ti r, ter > t 0 Z- License LC 2- 5 c J r Address: a°~C City:` uyLState: l✓~' Zip: Phone: Contact Person: r ti 4 1 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted submission type) Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes `No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents, that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance #th 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 with t a peftnit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of pla s. {r x Applicant's Printed Name Applic nt's Signature Page 1 of 3 - DO NOT WRITE BELOW THIS LINE SUB TYPES ❑ Foundation ❑ 05-plex ❑ 16-plex ❑ Accessory Building ❑ Pool Single Family ❑ 06-plex ❑ Fireplace ❑ Porch (3-season) ❑ Ext. Alt. - Multi ❑ 01 of ` Plex ❑ 07-plex ❑ Garage ❑ Porch (4-season) ❑ Ext. Alt. - SF ❑ 02-Plex ❑ 08-plex ❑ Deck ❑ Porch (screen/gazebo/pergola) ❑ Multi Misc. ❑ 03-Plex ❑ 10-plex ❑ Lower Level ❑ Storm Damage ❑ 04-Plex ❑ 12-plex ❑ Miscellaneous WORK TYPES ❑ New ❑ Interior Improvement ❑ Siding ❑ Demolish Building' ❑ Addition ❑ Move Building ❑ Reroof ❑ Demolish Interior ❑ Alteration ❑ Fire Repair A Windows ❑ Demolish Foundation ❑ Replacement ❑ Egress Window ❑ Water Damage Demolition (entire building) - give PCA handout to applicant DESCRIPTION: Valuation 399 Occupancy MCES System Plan Review Code Edition SAC Units (25%100% Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers _ Type of Const. Width REQUIRED INSPECTIONS Footings (new bldg) Sheetrock Footings (deck) Final/C.O. Footings (addition) Final/No C.O. Foundation HVAC Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace:-R.I. _AirTest -Final Windows Insulation Retaining Wall Reviewed By: , Building Inspector RESIDENTIAL EES: Base Fee f~ Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total Page 2 of 3 PERMIT Control No. 1131 CITY-OF EAGAN 3830'Pilot Knob Road PERMIT TYPE: ~ LI I L ~ I N ~ Eagan, Minnesota 55123 Permit Number: 001553 (612) 681-4675 Date Issued: 10/01/92 SITE ADDRESS: 1482 BLACKHAWK LAKE DR L.wra 2 BLOCK: 2 BL.ACKHAWK RIDGE 2ND DESCRIPTION: 3--SEASON Building Permit Type SF PORCH Building Work 't'ype NEW UBC Occup;~3rncy R--3 Building 1-Y,.ngth 11_ DuiJ_dincj WJ dt:i-i 14 I REMARKS: C' FEE SUMMARY: VALUATION $7,000 Base Fee $90.00 COPIES µ_...._,,_...,._.y...........___$1.50 Surcharge $3.50 Total Fee $100,00 Lic. Search Fee 5.00 Subtotal $98.50 I CONTRACTOR: - Applicant ST. L I OWNER: CARROLL CUSTOM HOMES 14236100 000308 CARROLL CUSTOM HOMES 14355 CIMARRON AVE 14355 CIMMRON AVE ROSEMOUNT MN 55068 ROSEMOUNT MN 55068 (612) 423--6100 (61,2)423--°6100 hereby acknowlec ige 1. ,h have t~? that. t.i7 =,t 1 have v; read this c~pt~lir;~it:`.ion and ~t~iy information i, c;t)r" e,,(-,t r nd a?r" ce to (:oriipty i applicable, of rjn i ;i~:h i31_t Statutes and Cit.v oi' isagarl Ordinances. Owl A NT/PERMITEE'3 NATU E ISSUED Y: IGNA UR INSPECTION RECORD I Control No. 3 1 CITY OF EAGAN PERMIT TYPE: B U I L D I N O 3830 Pilot Knob Road Permit Number: 00,1553 Eagan, Minnesota 55123 Date Issued: 10 / 01. / 9 2 (612) 681-4675 SITE ADDRESS: L O 1 0 2 BLOCK: 2 APPLICANT: 1482 BLACKHAWK LAKE DR CARROLL CUSTOM HOMES BLACKHAWK RIDGE 2ND (612) 423--•6100 PERMIT SUBTYPE: TYPE OF WORK: SF PORCH NEW DESCRIPTION 3-SEA:aON INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. FOOTING FRAMING INSULATION FINAL. PERMIT # CITY OF EAGAN REACTIVATE _ 1992 BUILDING PERMIT APPLICATION 681-4675 Jn S yrv ~ U VI/ SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, Itergp- calcs. i~; SEP 2 s' COMMERCIAL 2 sets of architectural & structural plans, t of l,. A_,~,; specifications, I copy of energy calcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which re guest is made or lot chap a is re guested once ermit is issued. Date Sazj& / - / Valuation of work Site Address:_ Liz- STREET SUITE N Tenant Name: (commercial only) LOT_ BLOCK SUBD. Nyf~~ P.I.D. 0 5 L Description of work:, x ! The applicant is: ❑ Owner Contractor ❑ Other (Describe) Name Phone Property T t S FIRST Owner Address STREET STE # City State Zip Company ~ . Phone a~ Contractor Address J~ f ; tti~ License COX a d Exp. .A-_3~L CitA'o StatIe Zip Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is correct and agree omply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ~ r . OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging [1,16 Ba ement Finish ❑ 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 17 Swim Pool ❑ 03 SF Addition 11 08 8-Plex ❑ 13 Garage/Accessory ❑ 18 Conan./Ind. 04 SF Porch 11 09 12-P1ex 13 14 Fireplace ❑ l9 Conan./Ind. Misc. ❑ 05 SF Misc. ❑ 10 Multi. Add'l. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE P~ 31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable) 1st F1. sq. ft. City Water UBC Occupancy 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length err On-site well Census Code f{l Depth y On-site sewage SAC Code APPROVALS Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ Site Footing O Framing Insulation ❑ Wallboard Final ❑ Draintile ❑ Fireplace Permit Fee Vatuation: Surcharge Plan Review License ! L/ , MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Coppies Other Total: SAC % SAC Units * * I 2422 Enterprise Drive *;PIONEER Mendota Heights, MN 55120 LAND SURVEYORS • CIVIL ENGINEERS * engineering- LANOPLANNERS•LANOSCAPEARCHI'iECTS 11 (612) 681-1914 *-k Certificate of Survey for: CQrrol_I__-CU S_t01' --__H O.m els- Model Name: 91-565 I I I ~ ~I I 30 30 I N 87°5127" E I 150.01 to I r b! Ott (btoty~ ,e 16 JOR U) I g~H,l *.3 i- I _36.34 I 9 30 00 CS Cn - - 10 f 1 u - I n _ \T' ~o I oo (867. I 2061 I I I o I I 0 C3 D I I cn ---1 2.0 D 5.6 7 I < > I co ° m o II ~ ► RHS o I ~ t~ 0 I ~ 4646• ,°i o % I 00 N _ 80 __--A 01 I I 0 0 0 so, -0 6 0, rn f I I " 1.0 tn D I 2 I I ~ g I I I ~ ~ m I I I I i I f 9 c., 13.00 r I 14.33 I I 10 rs u -~eD--- - - - 0D 30.00 36.34 Rr / I Ar e I I ~/y P,C 1 / k, I (8611:4) -y 150.00 I C~ W I I I S 87° I I D i I I I I I I By D EAGAN ENWNEE ING DEPT L REO R,\/,, • 900.0 Denotes Existing Elevation 9 PROPOSED _HOUSE_ ELEVATION 900.0 Denotes Proposed Elevation Lowest Floor Elevation:860_.5. 6 Denotes Drainage & Utility Easement - - Denotes Drainage Flow Direction Top of Block Elevation: 86866 ---o- Denotes Monument Garage Slab Elevation: 868.33 -B Denotes Offset Hub Bearings shown are assumed LOT--2 BLOCK _ 2 BLACKHAWK RIDGE 2ND ADD. DAKOTA COUNTY, MINNESOTA 1 hereby certify that this is a true and correct representation of a survey of the boundaries of the above described land, and of the location of all buildings, thereon, and all visible encroachments, if any. from or on said land. As surveyed by me this day of ,rror A-D, 19~?- S c a e: 1 inch-30f(,,,1- - r~ORF KICt REO, NO.148 039 90029.02------ Y LIGATION CITY OF RAGAN 1 SETS OF FLANS 2 ' SETS OF PLASS 2 SEA, 0' ;AR,0KTT ` D , MWISTERED SITE SURVEYS RECISTERBO SITE SURVEYS T OF ENERGY CALCULATIONS (CHECK WITH am AEPT:) i SET OF S ln"TION~ I SET OF Macy Cm=UTIONS 1,94T or ImmlW'Y swjxs ' . # OF RMAL UNITS. # . Off` FOR SALS UNITS ,lar LFBS vm: TYPING OF PERMIT IS REQUESTED, WT NOT- I'IOM UP BY I kT;Wt41M DAY OF MONTH IN WHICH ISQUEST IS DE. LOT CHANGE I5 RHQMSTED ONa PMiT Is' ' LSS . A SSES FOR CORNER LOTS - C0NTRACTm/H0MXoWb MST- kT4 WKAtl ~ t$ IS " DE5€IRM. NQ CHANGE& WILL BE &IMR Q= . CESSING TIME FOR SEWER & WATER PERMITS IS TWO DRYS^ON A PUNIT MUST SHOW .A, LICENSED PLUMBER. 6, Z2 To Bo Vved For: , Valuation: 5~.ce. reams Q0o LO; Block Occupancy ftrzat. Zoning Sum ~ Rai ub Actual C-,omt ~F- P3an Rar f eK+ f ' A1 IcrWablo SA, pity . t - # of storiss Length -~~ri7:;Flr?* V$ttC Cam:. re Depth W>4tez Ketex S. F. Total ~ ~cc"t. ttagvi~~t t #ip Code Footprint S. F. polmit S,/Wttg ? kcrx~x+ On site *swag* Tr t,fl, site well Rom :UdK~+t Qmtr4wt"(?A0 tY12"mz&w~ WCC "too Park D". City water: Tm 3 Red. Beaxter 'Pub SUSl l L City/zip codw I Plarmer Lt~ awue Council M. 81,dg. Off. 0=19 z Variance rasa-- Amm-r J&ter Licensed Co r. agraes that all work, .I1 Sara tore i r' ce with, ' . i of c~•ntrac ' al1 applicable State of Minnesota Statutes a City of Eagan t)rd avers. i ArR,Ot (t zy. • fin, iT s W 2G 2 fl 1? l x.'77!' F F I have complied with all application requirements for the State of Minnesota contractor's license, and I have submitted all required information to the Department of Commerce for approval. nature ,Si Name of business ' Date 7 ' f * * 2422 Enterprise Drive Mendota Heights, MN 55120 * PIONEER LAND SURVEYORS • CIVIL ENGINEERS engineering- LAND PLANNERS • LANDSCAPE ARCHITECTS (612) 681-1914 Certificate of Survey for: Carroll _ Custom Homes Model Name: 91-565 I ~ I I I t 30 I I 30 I I N 87°51'27" E I rn I 150.01 W I I 0r gh1,0\ ~lo~ 2 g~1 X Q (8:6 D63 D I g".,30.00 10 N 36_34 _ - - - - Y, I w W i C~ - 20.67 - I867.5 Z I i _ I ~ o I I D I I W 1 i R~S Z Z I 2.0 13.67 X '4I W O N O I D ° m I W i I vry1 a? I ► o Ln 8.0 _ _J I W W I A C N II I- I No 0 o i O 0 r m I D I I I ,.o ~ t7 I I V I I N I I 4 l I I-I .y "1300 14.33 10 i - _ - - Ir I I ~/Y ~PcC 30.00 - -I - - 36.34 - - - I I Rti ~r? A~~ xo 1 I < f 6, D4 150.00 P I r II M I ; S 87023' VW I I I I I SAN EN1 NEE INN DEPT • 900.0 Denotes Existing Elevation PROPOSED HOUSE ELEVATION • soo.o Denotes Proposed Elevation Lowest Floor Elevation: 860.56 - Denotes Drainage & Utility Easement Top of Block Elevation: 86.66 Denotes Drainage Flow Direction --o- Denotes Monument Garage Slab Elevation: 868.33 Denotes Offset Hub Bearings shown are assumed LOT-2_, BLOCK 2 BLACKHAWK RIDGE 2ND ADD. DAKOTA COUNTY, MINNESOTA I hereby certify that this is a true and correct representation of a survey of the boundaries of the above described d'~e_~scribed land, and of the location of all buildings, thereon, and all visible encroachments, if any, from or on said land. As surveyed by me this /~~day of a Oar, A.D. 1991 Scale: 1 -inch -30faat r)BFRT A. SIKICH L.S. REG. NO. 148 1 039 90029.02 HINNESOTA SATE EAIER,rzy QQ(J-,---- QULATION t ,-A~ ( BASED ON CHAPTER 5 OF THE MODEL E RGY CQ_C)E- 1283 EDITION Adoption ;Effective Owner. Phone Date -71 Site Address 7'. K FDt -lc ~s ) Contractor 40V] F,=4!5r Phone: Building Classification: Type Al (Single Family & Duplex) Type A2 (Residential, 3 stories or less) (Over 3 stories) (Other) NOTE: Complete pages 3 and 4 first. GENERAL INFORMATjQN. -Sjn 1. Building Perimeter~~-...~L,t-11 2. Wall height (ground to eave) ft. 3. 1. X 2. (above) gross wall area l"70 t C~4**sq.ft. 4. Building dimensions (L) X (W) a(1sq.ft.roaf & floor area 5. Sq. foot area of rim joist - Floor joie size (2 X d 167 ) X L](Perimeter) _ LO&Q. - 12 6. Doors - Area go~ tv~ip( ! Thickness in U. factor , Type of Construction Perimeter ft. Manufacturer 7. Total door's perimeter ft. 8. Windows : Manu eturer ~..•.f}!~'.~~`°~ t State approved_______~__ U f actor- ► f1" TYPE SIZE AREA (Sq.Ft.) NUMBER OF TOTAL f l ~ ~ t ~~7 EACH UNITS SQ FEET 9. Total sq. ft. GlassA lo. Fireplace area: Width X Height X sq.ft. 11. Exposed foundation: Height X Perimeter t0-X L1t~-10 q.ft. COMPLETION OF THIS FORM IS REQUIRED FOR ALL NEW CONSTRUCTION, MAJOR REMODELING AND BUILDINGS BEING MOVED WHERE ENERGY, OTHER THAN THE MINIMAL CODE ALLOWANCE, IS USED. ~ -1- i 12.. Framing area = 10% of gross wall. area. 13. Gross wall area L~ 44- sq.ft. Window area A 14S7sq . f t . U windows = UxA = -lei Rim joist area A I q.ft. U rim joist= 1624A UxA Door area A 14 sq . f t . U door area UxA = 1 Other doors area Akot q . f t . U other doors= 42- UxA = tj~? I Exposed fndn A % sq.ft. U foundation= -A-_ UxA 1 of V_ _0 Framing area A110► sq.ft. U framing area=% UxA = Net wall area A& 40sq.ft. U wall UxA = 101 _ , (13B) TOTAL UxA 14. Gross wall area x 0.11 (A-1 single family & duplex) = allowable UxA/Code (13. above) x 0.23 (A-2 other residential) x .23 (Other buildings) x .28 (Over 3 stories) I U Code BTUH must be larger than or same OF. as 13B above 15. Ceiling framing area (Af) equals 10$ of ceiling area 15A. Gross ceiling area = (L) x (W) _ -1( 04: sq.ft. 15B. Joist area (A f) = 10% ceiling 'area = l (01 L~ sq. ft. 15C. Net ceiling area (A c) (15A - 15B) _ sq.ft. U ceiling x AC _•w U framing x A f 15D. TOTAL U x A....... 16. Ceiling area (15A) x 0.026 (A-1 single family & duplex) = allowable UxA/Code x 0.033 (A-2 other residential) x 0.06 (other) 4 to- BTUH must be- larger than or same A(15A) x U Code tQfi(~a-feVI~ of, as 15D above NOTE: Use U and A values obtained from pages 1, 3 and 4. CERTIFICATION: I hereby certify that I have calculated the "U" factors and "R" values herein and that the building here described meets or exceeds the State of Minnesota Energy Conservation Act. Date signature -2- i ►I OZO 4 2.0 k Coe2z- e3 AE.:-x ¢ - ► r ro UA, to:5 . ~l t~~ tP(P 0;_o 0 1 0')~ I! ~.-~tc. ~ i mac... ~ ~ ~ ► ~ ~ ISO <;;T 1 t -7 1& 4,141 { -V VA l;t LALLULA4 UTI-5 R VALUE U VALUE Inside air film ,68 WALL Interior wall . 4 ✓ SECTION I~ Insulation 1 CIO S heaching Z I D(O 043 = Siding Outside air film .17 R TOTAL . O ~I Inside air film .68 STUD Interior wall 6+5 SECTION tl ~ stud R= .~.,s*(p,s' (Framing) U • R Sheathing Z.+OCO Siding Outside air film .17 f J R TOTAL (O S 3 Inside air film R= ,68 2ND WALL - Interior wall . SECTION . ~~~`n~crlatlon - (Wall) U R1 = Sheathing Exterior wall covering Exterior air film R = ,17 R TOTAL Interior air film R= .68 RIM Insulation JOIST 'th inch soft wood R=1.88 (Rim U - Joist) Sheathing 0.00 ~ f Exterior wall covering +(pl Exterior air film R= ,17 .r R TOTAL z,4+ 4(p Interior air film R= .68 Insulation. ~.oo Foundation (Fdn.) U = R = i Exterior air film R= .17 \a F TOTAL --7 l "`Exposed Block r 4 LING WITH VENTED ATTIC SPACE ABOVE R VALUE R VALUE FRAMING CEILING 0.61 AirFilm 0.61 • Insulation- . 4.38 Joist 0.56 Ceiling 0.56 _ 0.61 AirFilm 0.61 f Tota1R • . DZ-~J U = 1/R Window infiltration 0.5 cfm/lineal foot of crack Residential door infiltration 0.5 cfm/square foot or door and minimum code requirement Non-residential door infiltration 11.0 cfm/lineal foot of crack Ub 12" concrete block no insulation - _ .47 R 2.1 Ub 12" concrete block insulated cores = .26 R 3.8 Ub 12" lightweight block = .32 R 3.1 Ub 12" lightweight block insulated cores = .12 R 8.3 U single glass = 1.13; with storm window .54 U double glass = .55 U triple glass = .41 All exterior walls and ceilings must have a vapor barrier (0.10 perm max.). Vapor barrier must be on the inside (heated side) of wall. Vapor barriers of the polyethelene thin film have no R value. I Volume No. Cerf*lf Ica eo T*Itle OWNER'S DUPLICATE CERTIFICATE Certificate No. 8 3 8 5 2 Document No. 215905 District Court No. Transfer from No. 8 0 5 9 8 Originally registered the 18th day of April 19 59 Volume Forty page 59 State of Minnesota, SS County of Dakota. j /16 6 h Meritor Development Corporation 605 West Travelers Trail of the City of Burnsville County of Dakota and State of Minnesota is now the owner of an estate, to twit: fee simple of and in the (ollotving described land situated in the County of Dahota and State of Minnesota, to toil: Lot Two (2), Block Two (2), in BLACKHAWK RIDGE 2ND ADDITION, according to the recorded plat thereof. Subject to the encumbrances, liens and interest noted by the memorial underwritten or endorsed hereon; and subject to the following rights Or encumbrances subsisting, as provided in Laws 1905, Chapter 305, Section 24, namely: 1. Liens, claims, or rights arising under the laws or the Constitution of the United States, which the statutes of this state cannot require to appear of record; 2. Any real property tax or special assessment for which a sale of the land has not been had at the date of the certificate of title; 3. Any lease for a period of not exceeding three years, when there is actual occupation of the premises under the lease; 4. All rights in public highways upon the land; 5. Such right of appeal or right to appear and contest the application as is allowed by law; 6. The rights of any person in possession under deed or contract for deed from the owner of the certificate of title; 7. Any outstanding mechanics lien rights which may exist under sections 514.01 to 514.17. That the said Meritor Development Corporation is a corporation organized and existing under XXX)A XhQRX-mofXXXXXXXXXX/XXX-% X')MXREXRIXXX the laws of the State of Pennsylvania. XXXtAK1XXXXXXXXXxwXCNrXXXXXXXXXXXXXXbiXi(bNO1 l- J'~e I have hereunto subscribed my name and axed the seal of my office, this 17th day of May 19 89 JAMES N. DOLAN Registrar of Titles (Seal) In and for the County of Dahota and State of Minnesota. AIEMORIAL "'j., of Estates, Easements or Charges on the Land described in the Certificate of Title hereto attached. DOCUMENT RIND OF DATE OF REGISTRATION DATE OF INSTRUMENT NUMBER INSTRUMENT MONTH DAY YEAR HOUR MONTH DAY YEAR AMOUNT RUNNING IN FAVOR OF SIGNATURE OF REGISTRAR A.M. P,M, 215904 Declaration Af Pro ec ive Covenants and o he land;) Ma 17 198 3:0 4 27 '89 - The Public James N. Dolan 124147 Right of Way lat No. 9-5 (Parcel 48) Minnesota Department of Tra sporation Aug. 27 198 1 - - - - (A ces co trol n ab ve & th r la s) James J. Foutchis 126524 W.D. Jan. 24 983 3 1 14 183 $2,00),(00.00 (Subject to Access contro on above & other lands) James N. Dolan 239209 Pressure R ucin Va ve greem nt and o he lands) Between City of Eagan and Fe t. 2 19.1 10:6 12 2 '9 - Meritor Development Corporati n James N. Dolan h I ~ I it i if CITY OF EAGAN L B 3CHANICAL PERMIT RECEIPT # SUBD. (612) 6814675 DATE o? RESIDENTIAL PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, COMPLETE FOR TOWNHOMES/CONDOS WHEN SEPARATE PERMITS ARE REQUIRED FOR EACH DWELLING UNIT. OWNE pwekhaaj~ U.6 FEES SITE S~,1 r ~ OU3-6-M ADD ON/REMODEL (EXISTING $ 15.00 CONSTRUCTION ONLY) / HVAC: 0-100 M BTU 24.00 / i1~TSTA~i LEL~ ADDITIONAL 50 M BTU 6.00 ADDYM: GAS OUTLETS - MINIMUM 1 @ $3 EA. 06) CITY: ZI SURCHARGE: $ -50 SIGNATU TOTAL: $ ' COMMERCIAL PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIALfINDUSTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. WORK DESCRIPTION: CONTRACT PRICE: FEES 1% OF CONTRACT FEE. STATE SURCHARGE IS $.50 FOR EACH $1,000 OF PERMIT FEE. $ PROCESSED PIPING - $25.00 $ MINIMUM FEE - $25.00 OWNER: TOTAL. $ SITE ADDRESS: TENANT: SUITE INSTALLER. ADDRESS: CITY: ZIP: PHONE CITY SIGNATURE: SIGNATURE: CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, 1-441 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT I:BxIG ;I'IitZ' DATE : 1tSIDENTIAI PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE.REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL NEW CONST X` ADD-ON MINIMUM 15.00 ADD ON , SHOWER 3.00 a C' REPAIR WATER CLOSET 3.00 BATHTUB 3.00 ° LAVATORY 3.00 ° o OWNER NAME: ''`rp ( l_.c~ w• 5 KITCHEN SINK 3.00 3 0 0 T LAUNDRY TRAY 3.00 SITE ADDRESS: y Z -04, kca-0 ic, HOT TUB/SPA 3.00 e l WATER HEATER 3.00 T. -clo LOT:_ ~i BLOCK n SUBD. T FLOOR DRAIN 3.00 3-b o GAS PIPING OUT. INSTALLER : k C li E cr.S yS (MINIMUM - 1) 3.00 3 ROUGH OPENINGS 1.50 ADDRESS : 1 S S OTHER WATER SOFTENER 5.00 CITY:Ok"'r ZIP: PRIVATE DISP. 15.00 . U.G. SPRINKLER 3.00 L3-31'~ca N3 ~ ZONE y SUBTOTAL ~ - ~ t c~.tc ~SLt. ST. SURCHARGE .50 SI NATURE OF PERMITTEE ~.pa TOTAL: $ COMMERCIAL%INDUST1tIAI;i 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: 1% OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. LOT: BLOCK SUE-D. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 18 $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE # (SIGNATURE) FOR: ; CITY OF EAGAN 2004 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan q, 3830 Pilot Knob Road, Eagan MN 55122 r-7 0 I Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirements Remodel/Reoair Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey Recd _ Y - N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd - Y _ N 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required _ Y _ N 1 set of Energy Calculations Addition - indicate if on-site septic system On-site Septic System - Y N 3 copies of Tree Preservation Plan if lot platted after 7/1/93 Rim Joist Detail options selection sheet (bldgs with 3 or less units Date ~ / / C/pnstruction Cost Ot , Site Address ~~Q "~J~l~C.K.•~f10~yJk.. ~(Q 61" Unit/Ste # Description of Work 1 ! Multi-Family Bldg - Y 00 N Fireplace(s) - 0 - 1 - 2 Property Owner Telephone # ( (A51) L494 --3 ~ Ht) Contractor RENEWAL BYANDERSEN Address 1920 COUNTYROAD "C" WEST City State ROSEVILLE, AA4N 55113 Telephone # SI)'o ~94 4-4 3 Z 2013pq B3 NEW BUILDING COMPLETE THIS AREA ONLY IF CONSTRUCTING A Minnesota Rules 7670 Cateizorv I _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in-Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. 1k i f _ E5 Licensed Plumber Telephone # ( ) 6 A4 Mechanical Contract t` Telephone # ( ) Sewer/Water Contrac Telephone # ( ) I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. `h.w CS 6c(\5 0CN Applicant's Printed Name A plicant's Signature OFFICE USE -ONLY Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of_ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg_Y or _ N ❑ 25 Miscellaneous Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish Building* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entice Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) _ Final/C.O. - Footings (deck) _ Final/No C.O. - Footings (addition) _ Plumbing _ Foundation _ HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final - Framing _ Siding _ Stucco - Stone - Brick - Fireplace _ R.I. -Air Test -Final _ Windows - Insulation Retaining Wall Approved By: Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total wai,va,s.v•.y tuv a`.vv rna too all, 4 ~k80 .lYLtl'AL B AiYlJMIM Wuv re al June 7, 2001 City of &pn 3836 Pilot Knob Road EftgM MN 55122 To Whom It May Conc em: Eider Jones is authorized to pall buildin Elder ]ones to b permits for Renewal by Andersen_ Please allow provide this PcivMcc for us in Eagan. Imia date beyond 6/6101; until aanewa! by Andersen autharizaticin is valid for any to the city_ manager eVrWdy revokes it in writing I request this autliorizattioa be accepted-=pedidously, as to not delay in the our building permits any further. Please can me If thew arc any qucstlona. • Y oc brig of contacted at 763-502-4706. Your immgdiatc attention to this matter is a $ted. Sinoaialy, - - r~Znd IL Rau don Manager Renewal by A,ndmen Corporation C'c.: Kara-Fide r on"- ~H p 4,ftM.0 D7 NCA" Innea~ wr Received Time Jan. 7. 117PM- r/ . lbu_61 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Requirements Office Use OnN 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan showing footings, beams, joists Cent of Survey Recd -Y _N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Soils Report _Y N 1 Soils Report if proposed building is to be placed on disturbed soil 1 site survey for additions & decks Tree Pres Plan Recd _Y -N. 2 copies of plan showing beam & window sizes; poured found design, etc. Addition - indicate if on-site septic system Tree Pres Required _Y _N 1 set of Energy Calculations On-site Septic System _Y _N 3 copies of Tree Preservation Plan if lot platted after 7/1/93 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form Plans are considered public information unless you state the are trade secret and the reason. Date _ 7 /07 Construction Cost Site Address t, L.AiI!L -P k,l V'l~,- Unit/Ste # Description of Work F-" F Multi-Family Bldg - Y N Fireplace(s) _ 0 - 1 - 2 Property Owner AA104f J ~j 'T (f'y 17,E - Telephone # 1 ) '.rY 3 Contractor Address City State Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (I submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? - Y - N If yes, date and address of master plan: Licensed Plumber Telephone # ( ) Mechanical Contractor Telephone # ( ) Sewer/Water Contractor Telephone ) I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and a al of plans. 9s,0t__hwo~, Applicant's Printed Name A plica is Si ure DO NOT WRITE BELOW THIS LINE Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of _ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo/pergola) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex ❑ 25 Miscellaneous Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish Building* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant ' Description: Water Damage Yes Valuation Occupancy MCE= System Plan Review _ 100% or _ 25% Code Edition Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) Sheetrock - Footings (deck) Final/C.O. - Footings (addition) Final/No C.O. Foundation _ HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final Framing _ Siding _ Stucco Lath _ Stone Lath -Brick Fireplace _ R.I. -Air Test -Final _ Windows Insulation _ Retaining Wall Approved By: , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other , Total SEWERv& TER PERMIT OFFICE USE ONLY CITY%b EA AN METER # PERMIT DATE 01/22/92 3830 Not Krab Rd. 12501 Eagan, toN 55122-1897 CHIP PERMIT # METER SIZE B.P. RECEIPT # f ISSUE DATE B.P. RECEIPT DATE 01/21/92' DATE ~'3AI~ 22, 1992 X PRV -BOOSTER PUMP SITE ADDRESS 1482 BLACKHAWK LAKE AR PERMIT REQUESTED LOT 2 BLOCK 2 SEC/SUB BLACKHAWK RIDGE 2ND - X SEWER X WATER -TAPS APPLICANT: ADDRESS: COMM/IND X RESIDENTIAL CITY, STATE ZIP X NEW EXISTING PHONE: MATTHEW DANIELS INC Lawn Sprinkler Meters are to be Installed PLUMBER: Ahead of Domestic Meters on Water Line. ADDRESS: 15185 CAROUSEL WAX Credit WI NOT be given for,peduct M rs. CITY, STATE ROSEMOUNT MN ZIP 5506 `v44 ~'f - f 423-3730 PHONE: PA'GREETO,6OMPLY WITH Ci OF OWNER: CARROLL CUSTOM HOMES EAGAN ORDINANCES ADDRESS: A CITY, STATE ROSIEMOUNT MN ZIP 55068 PHONE: 423_0100 SIGNATURE WHEN METER ISSUED PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. CASH RECEIPT CITY OF EAGat~ 3830 PILOT KNOB ROAD a " j EAGAN, MINNESOTA 55122 DATE 19 cnoM AMOUNT $ a 8, DOLLARS too O CASH CHECK FUND OBJECT OUNT 7 ti Q Thank You r BY 016953 - pint(:--Fite Copy CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21.199, lEapn; MN 55121 ' 0 t t t PHONE: 681-4675' _ BUILDI PELRM1'f Receipt' „ 70 be used=tor, s y", twv/ A est. Vaitte $1219 C}i7Q Oate 2 t9 Site Address 1482 1140 MW 1-" 1* Lot 2 Block Sec/Sub. 91ACK "AWK Rt= OFFICE USE ONLY FEES ' Parcel No. Occupancy 8113 *4 Zoning i;4 Bldg. Permit 734.t~1 Name CAR=" USIM S (Actual) Const v- Surcharge 631• Fi Addrm 14333 01$$illRMY AVII (Allowable) ~ Plan Review 477. # of Stories . city W Zip 55068 Length g4 64 • License ',se 33000 PhOW 423-6100 Depth SAC, City 100too S.F. Total - 7 ~C } SAC, MCWCC S.F. Footprints AddtM b93#00 On Site Sewage - Water Conn aty Zp On Site Well Water Meter . 93 ~00 MWCC System 30r0 Ph" City Water Acct. Deposit 30.00 L1C8t1S8 PRV Required SAV Permit I hereby acknowlege that t have read this application and state thall1he Booster Pump SJint Surdw" s so information is correct and agree to comply with ail applicable State of Minnesota Statutes and City of f~agan Ordinancs. / Treatment Pt - Signature of Permitee A * ` /APPROVALS Road Unit 380#00 A Building Permit is issued to: Ckw1„]t. C-VSTOM SO= Planner Park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg, Off. Copies BuitdingOf#iciai Variance TOTAL y~ i Permit No. Permit Bolder h/Date Telephone # SAN JJ c'c~ `f` WAC 3 -WS-7 ELECTRIC Q q r~ r Date Comments Footings 1 k Foundation Framing Roofing Rough Pibg. Rough Htg... i teal. `~~S 4,2 ! F•aeptaoe -2'7 9L ~S F'nai Htg• s dff CNsat Test Final Pibg. Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final l? Z3 Deck Fig. Deck Final wen Pr. Disp. [-=-7- -P -07-9 ,Fier 44 aim This Certi ate issued pursuant to the requirements o the Uniform Building amide certifying that at the time of issuance this structure was in compliance with the various ordinances of the City reguknUg building construction or use. For the following: 4 use clacsrtu~don: M? AGAR B~ t No. Occupancy Type IIishict _ T Coast. Owner of Building' :1 ' ~11 DKM L2, B Address L.ocatity P2, 10/23/92 Date- POST IN A CONSPICUOUS PLACE PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA073264 Eagan, MN 55122 . Date Issued: 05/08/2006 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 1482 Blackhawk Lake Dr Lot: 2 Block: 2 Addition: Blackhawk Ridge 2nd PID 10-14401-020-02 Use Description: Sub Type: e-Windows/Doors Construction Type: Work Type: Windows/Doors-New/Replacement Description: House Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: If altering the opening size, a framing inspection is required. Smoke detec tors are required in all sleeping rooms prior to final inspection. When wall studs or ceiling joists are exposed, hard-wired detectors are required Bat tery operated types are acceptable if the wall/ceiling finish (i.e. sheetroc k) has to be removed to install a smoke detector. Kara Benson 1120 Eas t 80th Street, Ste. #211 Bloomington, MN 55420 952-345-6047 kara@elderjon es.com Fee Summary: Surcharge - Based on Valuation $2K $1.00 9001.2195 BL - Base Fee $2K $69.00 0801.4085 Valuation: 2,000.00 Total: $70.00 Contractor: -Applicant - Owner: Renewal Andersen Andrew J Brotzler 1920 County Road C West 1482 Blackhawk Lake Dr Roseville MN 55113 Eagan MN 55122 (651) 264-4777 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA124030 Date Issued:06/19/2014 Permit Category:ePermit Site Address: 1482 Blackhawk Lake Dr Lot:2 Block: 2 Addition: Blackhawk Ridge 2nd PID:10-14401-02-020 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 - Andrew J Brotzler 1482 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 City of Ea�afl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 RECEIVED AUG 2 9 2016 Use BLUE or BLACK Ink For Office Use � Permit #: 1 2, ,g 1! e 2, Permit Fee: (Qb , O O Date Received: Staff: L Q/ 2016 RESIDENTIAL PLUMBING `P,�ERMIT APPLICATION Date: V1.2Jl./16 Site Address: / `�' �'� L3Lac k i -lac iJZ Lc ke Di" Tenant: J Suite #: Name: y? r) (Ai r L L i a ✓1'I 5 Phone: 6a-6. % ` -18)g Address / City / Zip: So. v» Name: -7 -2n -Ls OL)CI. LA,/ i0L d,-) 131 n 6 License #: UG Li`o /"in Address:a 5 CCS on '1 `/ r d E) % - City: 0%sS c- 0 /y% State: /_ Zip: ) 5 - 369 Phone: /63 -Iy0y ` 3 S Contact / //r? Lin c f a Li 'l Email: S PPEdyP2Ui'n+Dt--C_CwnCaSi- c / New >4, Replacement _ Repair _ Rebuild _ Modify Space Work in R.O.W. Description of work: /Q PLa.L � . GAS i(' ► l C`� Q RESIDENTIAL Water Heater Lawn Irrigation ( RPZ / _ PVB) Septic System New Abandonment Water Softener Add Plumbing Fixtures ( Main / _ Lower Level) Water Turnaround RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes State Surcharge) *Water Turnaround (add $280.00 if a 3/4" meter is required) $115.00 Septic System New (includes County fee and State Surcharge) TOTAL FEES $ Ci. OC) 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. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance wi Eagan; that I understand this is not a permit, but only an application for a permit, and work is o, sta accordance with the approved plan in the case of work which requires a review and approval of x Daryl nUc;i-ctsn Applicant's Printed Name x e ordinances and codes of the City of hout a permit; that the work will be in Applicant's Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA167506 Date Issued:03/18/2021 Permit Category:ePermit Site Address: 1482 Blackhawk Lake Dr Lot:2 Block: 2 Addition: Blackhawk Ridge 2nd PID:10-14401-02-020 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507) 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 - Ryan Williams 1482 Blackhawk Lake Dr Eagan MN 55122 Genz Ryan Plumbing & Heating 2200 West Highway 13 Burnsville MN 55337 (952) 767-1000 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA178811 Date Issued:09/06/2022 Permit Category:ePermit Site Address: 1482 Blackhawk Lake Dr Lot:2 Block: 2 Addition: Blackhawk Ridge 2nd PID:10-14401-02-020 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: This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after started. 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 - Ryan Williams 1482 Blackhawk Lake Dr Eagan MN 55122 Genz Ryan Plumbing & Heating 2200 West Highway 13 Burnsville MN 55337 (952) 767-1000 Applicant/Permitee: Signature Issued By: Signature