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1490 Blackhawk Lake DrDate: City of Eaaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink Permit #: [ 4q.1 -3q Permit Fee: 676 Date Received: Staff: 2011 RESIDENTIAL BUILDING PERMIT APPLICATION 16 /1 1 13V �3/ckj� / lo.4 0 - Site Address: a!N Unit #: J RESIDENT / OWNER Name: Q(1 f ,O 066 I%l Phone: 651- 687-67p-5-9 Address /City /Zip: P190 eta k_ Lnl 5 -5 -1F --P U Applicant is: IF Owner N' Contractor TYPE OF WORK Description of work: f )c -c + _ e 0 5a( -i(7 5 Construction Cost: /0 Multi -Family Building: (Yes / No x ) CONTRACTOR Company: &xxrn Lc. Co . Contact: P+puc.. fc--1 /?9t ti Address: )61-t/ 0c4.4.441 -P__ I4v _ City: j WS/` $1-, 100.4.,,i State: /4/1 Zip: 55 I I f3 Phone: 6 s-/- 4/.S = 17-9LJ License #: Lead Certificate #: Does this project require Lead Remediation? 0 Yes 0 No (see Page 3 for additional information) If no, please explain: In the last 12 months, Yes No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.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. x /7Z!` e � i✓n Applicant's Printed Name x Applicant's Signature Page 1 of 3 City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675-5675 www.ci.eagan.mn.us PERMIT City of En Permit Type: Permit Number: Date Issued: Permit Category: Building EA089738 06/17/2009 ePermit Site Address: 1490 Blackhawk Lake Dr Lot: 3 Block: 2 Addition: Blackhawk Ridge 2nd PID:10-14401-030-02 Use: Description: Sub Type: e-Reroof Work Type: Replace Description: House & Garage Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: If there is no ice protection inspection prior to final, the contractor must meet the Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes. nspector w/ a ladder and flat bar. Fee Summary: Valuation: 3,000.00 BL - Base Fee $3K Surcharge - Based on Valuation $3K $88.50 0801.4085 $1.50 9001.2195 Total: $90.00 Contractor: Capstone Bros Contracting Inc 216 North River Ridge Cirle Burnsville MN 55337 (952) 882-8888 - Applicant - Owner: Patricia A Dobbins 1490 Blackhawk Lake Dr Eagan MN 55122 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Applicant/Permitee: Signature Issued By: Signature CITY' OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: SITE ADDRESS: PERMIT SUBTYPE: APPLICANT: TYPE OF WORK: INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. 7 7 Permit No. Permit Holder Date Telephone # SAN PLUMBING HVAC ELECTRIC ELECTRIC 9 `i f 8,*J //AMB.75 C.0 ��'7X p t/ -- 5.),0 i �/� jYt7r GI a,c., .. j%/9.1 d 7 O' Inspection Date nsp. Comments Footings I %/43 ,,,,,4-) Foundation y/203 /, ,w gri' C4O -6-- °UO co rig-,ice e VZQ - # . c.4.4,7_,2 c#44 Framing s -2D 9 3 ps Roofing Rough Plbg. / /, � '? {fa�1 Rough Htg. 1.--;20-p %> L Isul. 5/4243 Fireplace s/�,/1,3 .PO viii F�`� Final Htg. Orsat Test Final Plbg. gii.Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan COQ--p/ekiri 1716 73 S Bldg. Final / _J3 .7.,./4 > 426' aJ v(°'k(er¢;) ^c;04- 7 /-5-3 f Q, Deck Ftg. , Deck Final Well Pr. Disp. 7-51 - A,� I/ ,i i 7 7 P Wertificate of Z'ccupanct) witij o east's Zepartment of ZuiThhg 3n6pectiou This Certificate issued pursuant to the requirements of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: Use Classification: SF 1G R3/M1 206 /� Bldg. Permit No. 50 PD/R1 VN Occupancy Type Zoning District Type Const. Address 4376 HICKORY HILLS, PRIOR- LAKE 14%ti4.A4IMAWK LAKE DRIVE L3 B2, WC:MAWit RID 2M Bui mg Address `„ Locali Owner of Building' " Building cial Date: Ci POST IN A CONSPICUOUS PLACE ress 1490 BLAGOIAWK LAKE DRIVE Lot • 3 Blk 2 Sub BLArCK HAWK RIDGE 2ND Zip 5512 2 THESE MS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Dat• /5 / 9 9 � Yes No Inspector: S t Final ade " from siding) ,/� Permanent steps (garage) r./ Permanent steps (main entry) ✓ Permanent driveway .4 Permanent gas ✓ Sod/Seeded grass i/ Trail/curb damage Porch ,/ Basement finish L.// + ,' Deck (0 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. 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 L 34234 �/i2,�9 - 4744.5- /3/(eix Request Date r� S--1 B -{. �� Fire No. Rough -in Inspection Required? s r No ❑ Ready Now,! Notify Inspector When Ready? I nsed contractor D owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No.) t qq4 -1j t a C• \R h i C.v _ Dr- Ci _tr) Section No. Township Name or No. Range No. Count Occupant (PRINT Phone No. (+4--) —s__:,..7 Power S ie C IST t C-- Address`,,,.. CICO t A t x('1"'3 n Electrical Contractor (Company Na et Qs L+11 C_ Cep WC C actor's License No. x-0(1 . Maung A ress (Contractor or Owner Making Installation) t.2 5 Authorized Si ure (Contractor,Owner M )ng Installation) u Phone N /4.0 --3SSS MINNESOTA SAT BOARD OF ELECTRICITY Griggs-Midw dg. - Room S-173 1821 Universit Ave.. St. Paul, MN 55104 Phone (612) 642-0800 THIS INSPECTION REQUEST WILL NOT BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS ENCLOSED. (:)04i3 REQUEST FOR ELECTRICAL INSPECTION ► See instru tions for completing this form on back of yellow copy. 3 42 3 4 5//7 Below Work Covered by This Request Cf� E181-08 Nevi Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service I1'yv/�j Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Cont actor's Remarks: Compute Inspection Fee Below: # Other -I Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Poo!1 �0 to 200 Amps 18' 0 to 100 Amps �00 Transformers Above 200 Amps Abo e 100 Amps Signs Inspector's Use Only: `� 7 2. O� THIS INSTALLATION MAY BE OR . D DISCONNECTED COMPLETED WITHIN 18 MO TOTAL SQ '18 Irrigation Booms Special Inspection IF NOT Alarm/Communication Other Fee , I, the Electrical Inspector, herebyRough-in certify that the above inspection has been made. ♦ Dates,/4f.r7„ 7 2 Final Date ► Y OFFICE USE ONLY This request void 18 months from PERMIT CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 PERMIT TYPE: Permit Number: Date Issued: SITE ADDRESS: DESCRIPTION: REMARKS: FEE SUMMARY: CONTRACTOR: L OWNER: APPLICANT/PERMITEE SIGNATURE CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55123 (612) 681-4675 INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: SITE ADDRESS: PERMIT SUBTYPE: APPLICANT: TYPE OF WORK: INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. REACTIVATE iIERMIT # RECEIVED 1? 9 8 1993 CITY OF EAGAN 1993 BUILDING PERMIT APPLICATION � 681-4675 SINGLE & MULTI -FAMILY COMMERCIAL 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month. in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date / / /3 Valuation of work / j e cI a, CO .- ,?v eld er Site Address: Tenant Name: JL -go Ji. I/ A ...' 2. P,x, STREET (commercial only) SUITE S LOT --3. BLOCK SUBD. �f / .vi Shi'Aif�Al Ai/ryc3 e 2 P.I.D. # • Description of work: jt'f GJ )e.g7 The applicant i s : ■ Owner ®--Cintractor • Other (Describe) Property Owner Name Ive,1I -ST'U`B- Phone LAST FIRST Address STREET STE # City State Zip Contractor Company /?,1't/ //ft'.- . Phone 4/S/7- .3-0 r7 _ Address /3 76 ii --y A/,',/Js License # c'O/y O? Exp.3/3'/9V City /-ic) r Aske State yip Zip "S',..\-3 77, Architect/ Engineer Company 0if//tet q'e c,�q yv Phone `/'/ 7 r 6-0 4/ 6 Name ,'i5 0%' eft-(. Registration # Address City PIP /c' 3 /#A. State ,v . Zip 6--7;s77-_ Sewer & water licensed plumber sewer & water permits is two ,74t// ?f,- /°/& Z.`i, fp. . Processing time for days once area has been approved'. I hereby acknowledge correct and agree Eagan Ordinances. e4,m ature of that I have read this application and state that the information is to comply with all applicable State of Minnesota Statutes and City of Applicant: ,„:,/,..-4 -- • BUILDING PERMIT TYPE 01 Foundation 0, 02 SF Dwg. ❑ 03 SF Addition ❑ 04 SF Porch ❑ 05 SF Misc. WORK TYPE Z31 New ❑ 32 Addition OFFICE USE ONLY ❑ 06 Duplex ❑ 07 4-Pl ex ❑ 08 8-Plex ❑ 09 12-Plex ❑ 10 Multi. Add'1. ❑ 33 Alterations ❑ 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length 6,4f, Depth sv APPROVALS Planning Engineering REQUIRED INSPECTIONS ❑ Site ❑ Wallboard ❑ 11 Apt./Lodging ❑ 12 Multi. Misc. ❑ 13 Garage/Accessory ❑ 14 Fireplace ❑ 15 Deck ❑ 35 Tenant Finish ❑ 36 Move Basement sq. ft. 1st F1. sq. ft. 2nd Fl. sq. ft. Sq. Ft. total Footprint Sq. ft. On-site well On-site sewage Building Variance ❑ Footing ❑ Final ❑ Framing ❑ Draintile 11. ❑16Bas ❑ 17 Swim Pool ❑ 18 Comm./Ind. ❑ 19 Comm./Ind. Misc. ❑ 20 Public Facility ❑ 21 Miscellaneous ❑ 37 Demolish MWCC System YES City Water y PRV Required Booster Pump Fire Sprinkler Census Code SAC Code II U rte Assessments Yas ❑ Insulation ❑ Fireplace Permit Fee Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % 100 SAC Units Valuation: $ Int 000 - GARAGE_ 3zn Z2 7°11 zx2.1 = 412 ESMtr .rp-4 x / 4, -p---- 2 4 A26, 624 R360 1s -r Loo!2 3° Kai z 720 29x26_62,1 11936 l)( c:2 10 Zxc1- /' 2 nfb Fr�ol� ; 13-11X5`17 '7 �1 Q$ 24,c 2/2.- 909 1N XI fel -0 Li $,q ROBE ENGINEERING COMPANY, INC. 1000 EAST 1461h STREET, BURNSVILLE, MINNESOTA 55337 PN 432-3000 CONSULTING ENGINEERS PLANNERS and LAND SURVEYORS 8,41. /1/ gem5S #56Z9.0/ 8K. 19! F. CERTIFICATE OF SURVEY Legal Description: LOT 3 BLoe& 4 B/-9C&/�46t/.�/OGE 2ivn A1�.t�/Trr' AP1.i Al UAA • SCALE : 1' = 30' 30.00 (8�:5 (.%2,4 ) 86Z.77 860, o8 863./0 DENOTES EXISTING ELEVATION DENOTES PROPOSED ELEVATION INDICATES DIRECTION OF SURFACE DRAINAGE = FINISHED GARAGE FLOOR ELEVATION = BASEMENT FLOOR ELEVATION = TOP OF FOUNDATION ELEVATION .SENc yM4CK : ,4 // . - Bt4(( 4fv/<- L4k6 oR/vg "Mel' /40x LAS C//ZCLE. Tao ELEV, = 847. 06 30 FT. FRONT f3U1LDINC SETC.QCK LINE Nue 4 862.05 (8-61.-n ® 26.no / t —1- t Tf �1 1 A/ 87°03'28"66- 150.00 (13-7-, 9' (067.9) 1 • ° 445.96 /5/ 6¢ /vg7'D '/("W L / / y ORAbv e 4N0 V 77L/ T Y E4S9MENT I hereby certify that this is a true and correct representation of a tract c land as shown and described hereon. As prepared by me this 6 T day c ATR/ , 19 93 Minn. Reg. No. /6o/5 1 I VD VD 0 le 0 °o v 0y��p0r0 Di D 0 LOT SURVEY CUCZLIST FOR RZSIDZ TIAL *UILDI$O PZ*XIT APPLICATION narniX.47,2211 --ZdT Zz./.(415 Pocvx!NT fTANAs Date of Surveys • Registered Land Surveyor signature and company • Sui'lding Permit Applicant • Legal description • Address • North arrow and bar scale • Nouse type (rambler, walkout, split w/o, split entry, lookout, etc.) • Directional drainage arrows vitt slope/gradient t. • Proposed/existing sewer and water services • Street name • Driveway jtTOATIONs 2xisti!q • u o • fro D 0 • • IrD D • LI D15'D • • 0'D D • 8`0 D • Sewer service Lot corners Top of curb at the driveway Elevations of any existing adjacent homes yr000sed Garage floor First floor Lowest exposed elevation (walkout/window) Property corners Front and rear of home at the foundation 'W. -DING AREAS 1if ammlieablel Easement line NW'L HWL Pond designation Emergency Overflow Elevation D1X!NsZQNs Lot lines Right-of-way and street width (to back of curb) Proposed Dome dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. all structures requiring permanent footings) Show all easements of record and any City utilities within those easements Setbacks of proposed structure and setback of adjacent existing hoz Retaining �equ *manta, if any Reviewed: Name "P'/?__3 ENERGY CODE DESIGN DY ACCEPTABLE PRACTICE To Determine Compliance with the Minnesota Energy Code (Section 602 of the State Amended 1983 Model Energy Code) This form is only applicable to detached one -and two --family dwellings. The requirements herein are based on Table No. 6-11 in lieu of the criteria specified in Sections 602.2.1, .2 and .3. Building Address ja ! -3 B /GOr- Z B 94/0// _. Contractor or Owner 441-.0!' J0 gom e S �" .' /F ea, Building Element "R" Values Area (sq ft) % of E`xt. Walls . Ceilings besign4C) Req'd 38 Walls (exterior) DesignW, Req'd 20 W02_ Floors (over unheated (w/o fdn) spaces) Design 21,c� Req+d 20 *Windows (in bldgs w/o �a Design OA Req'd 12 sliding glass door) *Windows lid ows (in bldgs with a 19004 Design a.5 Req'd 10 ng glass door) (glass) Foundation Walls Design J/A Req'd 5 (when insulating full depth of foundation wall) Design ((.2 i eq'd 10. (when insulating only to frost depth and footings extend below) Slab -cin -grade floors, Design tl//\ Req'd (See Figure No. 3) **Doors (1-3/4" metal faced) Design -1.4'5 Req'cl 3 * All windows shall be double glazed or have storm windows ** Conventional doors other than metal require a storm door (glass) CERTIPICATICN I hereby certify that I have completed the aboveinformation and that it complies with the (Minnesota State : er Signature BSD 3-89 CC/SN(/6593 Date . Fig 93 1993 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. )( NEW CONSTRUCTION ADD-ON A/C ADD-ON FURNACE DATE 5 /1,3 /4 3 014.1111.1111,..11.•1111.011411.11.4•100•111.1.61.10.4.11041..........41.111,11.1041.11.1....111•1•• FEES HVAC: 0-100 M BTU $ 24:0000 ADDITIONAL, 50 M BTU 6 GAS OUTLETS (MINIMUM 1 @ $3.00 EACH) ADD-ON/REMODEL (EXISTING coNsmucrioN)• c.70 $ 15.00 STATE SURCHARGE .50 TOTAL QO SITE ADDRESS: 14 10 1.."AA.) L 11.. Or, OWNER NAME: ti Veit) 1-1-0 v". 4 S INSTALLER: Oa t I ‘_i ADDRESS: t tA.) 1 244-' 4 - CITY: 5 A. JA5P TELEPHONE #: Q 43c 1 TELEPHONE #: 447-. 52 c<1 STATE: AA 0 ZIP CODE: 5S- 318 ATURF,OF PERM1' thE 1993 MECHANICAL PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI -FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. .101004111.111001.1•11.....0111041111.101111•1•11111400.11104%. DATE: CONTRACT PRICE: $ NEW BUILDING INTERIOR IMPROVEMENT WORK DESCRIPTION: FEES 1% OF FEE $ PROCESSED PIPING: $25.00 MINIMUM FEE: $25.00 STATE SURCHARGE $.50 FOR EACH $1,000 OF rawfw FEE. TOTAL SITE ADDRESS: OWNER NAME: TELEPHONE #: TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER. ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE #: SIGNATURE OF PERM1FIEE CITY INSPECTOR 1993 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. NO. FIXTURES EACII TOTAL / SHOWER 3.00 3. °° _2i_ WATER CLOSET 3.00 C. • vo BATH TUB 3.00 3. LAVATORY 3.00 G i cso / KITCHEN SINK 3.00 3.00 / LAUNDRY TRAY 3.00 / HOT TUB/SPA 3.00 3. °O WATER HEATER 3.00 3. 470 FLOOR DRAIN 3.00 1."'' —%— GAS PIPING OUTLET • minimum - 1 3.00 3. es 3 ROUGH OPENINGS 1.50 4.50 ' WATER SOFTENER 5.00 PRIVATE DISP. • Dak.Cty. lic. 15.00 U.G. SPRINKLER • home under const. 3.00 ALTERATIONS • to existing 15.00 WATER TURN AROUND 15.00 (6, so STATE SURCHARGE .50 TOTAL: SI 1'h ADDRESS: ` L i 0 N4IN f L A c. Vc. H Aw 1c LA. k- &r OWNER NAME: 5+e -v e_ 4,J F i2D0,(Cke /-4 opt e 5 INSTALLER: S ictze.r' P t """` b i'/Qt) ADDRESS: 5'4 Cj / 140 tk S �' CITY: PCL)( LI &. STATE: je4r ZIP CODE: 5-S73 9°1 PHONE #: (61a_ ) L{ �i — '® SIGNA E OF PER Tl'1'hE 1993 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 PLEASE COMPLETE FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI- FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. NEW CONSTRUCTION ADD ON REPAIR WORK DESCRIPTION: CONTRACT PRICE: $ FEE: 1% OF CONTRACT FEE. STATE SURCHARGE: $.50 FOR EACH $1,000 OF MINIMUM FEE: $ 25.00 PERMIT CONTRACT PRICE X 1% $ STATE SURCHARGE TOTAL FEE. SITE ADDRESS: TENANT NAME: STE. # OWNER NAME: INSTALLER: ADDRESS: CITY: STATE: ZIP CODE: PHONE #: FOR: CITY OF EAGAN APPLICANT Certificate of T OWNER'S DUPLICATE CERTIFICATE Certificate No. 83853 Transfer from No. 8 0 5 9 8 17olume Forty Document No. 215905 Originally registered the 18th page 59 District Court No. day of April State of Minnesota, ss County of Dakota. .Y/6 6J. la cert' j, //rte Meritor Development Corporation 605 West Travelers Trail ofthe City of Burnsville County of Dakota and State of Minnesota is now the owner of an estate, to wit: fee simple following described land situated in the County of Dakota Lot Three (3), Block Two (2), in BLACKHAWK RIDGE 2ND ADDITION, according to the recorded plat thereof. of and in the and State of Minnesota, to wit: 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 XXXc?1JX 1yP4d(6XXXXXXXXXX X1X,X x361GXXr NXXX the laws of the State of Pennsylvania. XXx}¢jXXXXXXXXYcXrKdll(XXXXXXXXXXXXX)Exumn 1. Y/c( ejj ne)reo7 1 have hereunto subscribed my name and axed the seal of my once, this 17th day of May 19 89 JAMES N. DOLAN Registrar of Titles In and for the County of Dakota and State of Minnesota. (Seal) MEMOIUAL of Estates, Easements or Charges on the Land described in the Certificate of Title hereto attached. DOCUMENT NUMRER KIND Of INSTRUMENT DATE OF REGISTRATION DATE OF INSTRUMENT AMOUNT RUNNING IN FAVOR OF SIGNATURE OF REGISTRAR MONTH DAY YEAR HOUR MONTH DAY YEAR A.M. P.M. 215904 Declaration f Protective Covencnts and other lands) May 17 1989 3:00 4 27 '89 - The Public James N. Dolan 124147 'ight of Way Plat No. 9-51 (Parcel 418) Minnesota Department of Trarsporation Aug. 27 1982 1 - - - - (Access control n above & Dther lards) James J. Foutchis 126524 W.D. Jan. 24 1983 3 1 14 '83 $2,00J, 00.00 (Subject to Access contro. on above & other lands) James N. Dolan 239209 Pressure Reducing Valve Agree nt (and other Lancs) Between City of Eagan and Feb. 26 191 10: 6 12 2' '9C - Meritor Development Corporation James N. Dolan C -==' City of E$li 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Date: (0-1 (o( Permit #: 16 Permit Fee: ✓o CH - Date Received: Staff: 2009 MECHANICAL PERMIT APPLICATION Site Address: ( ?)V1 C - KQ L- J Tenant: Suite #: RESIDENT / OWNER Phone A`lV--52-1 54 Address / City / Zip: 4C0 `J1�1C1� `� � '-tk L ' p CONTRACTOR TYPE OF WORK PERMIT TYPE Dan Wohlers Southside Htg. & A/C License MALI— O5'A q 8 6950 W. 146th St., #106 Apple Valley, MN 55124 State: Zip: (952) 431-7099 New Replacement 0 .. ,......,4 Person: CY1.1.i kA. Additional Alteration Demolition RESIDENTIAL Fumace i7�ilr Conditioner _ Air Exchanger Heat Pump Other COMMERCIAL New Construction _ Interior Improvement _ Install Piping _-. Processed Exterior HVAC Unit Gas Under / Above ground Tank ( Install / _ Remove) •* When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) 53. So TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR $50.50 Minimum (includes State Surcharge) - If Permit Egg is Tess than $1,000, surcharge is $.50. - If Permit Fee is > $1,000, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). Contract Value $ _$ _$ x 1% Permit Fee State Surcharge TOTAL FEE 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 plant. x L,.hi-errs Applicant's Printed Name Applicant's Signature Date: CityofEaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Permit #: Permit Fee: Date Received: Staff: 2009 RESIDENTIAL PLUMBING PERMIT q APPLICATION 5 -2u -col . Site Address: 1(4( 0 gic�G .�.GL LUQ Imo. LAE_ KX_ Tenant: PetA D(b k i `h Suite #: RESIDENT / OWNER )Z— 321- 5LI to. Name: Pari" Ar,b f o. N Phone:'Q o" Address / City / Zip: IL -10i 0 g i(•t C.Ic Lc tic(_. �ib'v"Vic, i ISS /Z2_ CONTRACTOR Name: Sk,i'nKir"out S P\ (A t n:14 t I ft C . License #: 058(.0E5 Address: ) )L Ea S+ 5-44A ,S.Ii-ed SiA,l -i i 6/ ( City: C S k e State: NI Ni Zip: 55-31g Phone: f j2 -3121-61 2 i Contact Person: iCIL TYPE OF WORK New /Replacement Repair Rebuild Modify Space Work in R.O.W. — Description of work: PERMIT TYPE RESIDENTIAL ( Water Heater Water Softener Lawn Irrigation Add Plumbing Fixtures ( 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 $50.50 Add Plumbing *Water Turnaround $100.50 Septic System $90.50 Fire Repair (replace (includes $.50 State Surcharge) Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) (add $165.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee and $.50 State Surcharge) burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ 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 nof,planns. tt�,lCk c n tat `) Y�'E'w"r �✓ x LSzI t I'i CCM { S x la Applicant's Printed Name Applicant's Signature FOR OF 4111 City of kali Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: t i l 55 Permit Fee: 374 7, Date Received: ( 3 Staff: � J 2013 RESIDENTIAL BUILDING PERMIT APPLICATION l� f 1- 3- Z013 Site Address: 14\0\0 'S\ v.440_ ry y Unit #: Resident/ Owner 1 Address / City / Zip: $ Applicant is: Owner Phone: Contractor Contractor Description of work: auwAsk.1 %1G - z i . i /C ire µ /!ter% Construction Cost: Multi -Family Building: (Yes / No Company: ... ore lL6 m ,-Zeg,b, •-la't\6 Contact: ,p\nv WA...- Address: :`\yAddress: 5920 Pig14 .Sg& 4) .-i r'/e,4/0O City: Affif adky State: MK) Zip: 55)Z'f Phone: q- "43/"' /67D License #: EC/ ZS Lead Certificate #: 1.7/ — ZO(s 1 0 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 'per,\$e C.QC,r 1,4-1S 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: Mechanical Contractor: Phone: 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. CALL BEFORE YOU DIG. can 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. J111:A\er. Applicants Printed Name 0 )( I"L )k '(t DO NOT WRITE BELOW THIS LINE L i013g SUB TYPES Foundation Fireplace ,. Single Family Garage Multi _ Deck 01 of _ Plex — Lower Level Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall DESCRIPTION Valuation Plan Review (25%_ 100% ✓ ) Census Code #of Units # of Buildings Type of Construction Porch (3 -Season) Porch (4 -Season) Porch (Screen/Gazebo/Pergola) Pool Interior Improvement Move Building Fire Repair Repair ove L/3 REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Ice & Water _Final /414 Framing Fireplace: _Rough In Insulation Sheathing Sheetrock Reviewed By: Occupancy Code Edition Zoning Stories Square Feet Length Width Air Test –r— Final RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Siding Reroof Windows Egress Window _ Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous _ Demolish Building* _ Demolish Interior Demolish Foundation Water Damage *Demolition of entire building — give PCA handout to applicant ;0407 PD MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Meter Size: Final / C.O. Required At Final / No C.O. Required HVAC _ Gas Service Test Gas Line Air Test Other: Pool: _Footings Air/Gas Tests _Final Siding: _Stucco Lath Stone Lath _Brick Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Erosion Control , Building Inspector 5290 h- / Yv)/ a ,70'-'Y# _ 1>oSp /3y Page 2 of 3 01/04/13 01/02/13 John 952-431-1670 Open permits Zoned PD Lead NAT -20671-0 Built in 93 Scope ? LL 1490 Blackhawk Lake Dr Lower level finish James Barton Design Frame in new storage space Create a family room Replace center bearing wall with a new beam What is a "2 ply 1000Isb300-118" Provide dimensions 15'-6" span, with 600#/ LF 4650# on each end Provide framing detail above Kitchen wall does not stack directly above Roof Toad? NO, wall does not go all the way to the ceiling Verify existing footing is adequate for new point Toad 19"X19" or 16"X21" Close in mech room Provide comb air calc Relocate shut off valves New energy wall at foundation ? What is existing insulation What is new insulation Main level floor plan? New kitchen cabinets Larger island Longer cab on Lvrm wall New stove ? Kitchen hood? Open any exterior walls ? Soffits? Left a message for John 1/4/13 @ 12:10 PM ��108738 11/90 ,CLk AY DA PFR,wir t /O $7$r Client Project Name: Job#: Quantity 1 drop beam Rosboro X -Beam 5.5" X 11.875" Description: Shipping R F r �1VCD APR 0 9 2013 2/28/2013 11:33 AM Page 1 of 2 Designer 1 SPF tI 2 SPF 16'8" 16'8" X 5 1/2" 11 718" r User Inputs Design Method: ASD Load Sharing: No Spans Type: Girder importance: Normal Span 1: 16-8-0 Application: Floor Temperature: Temp <= 100'F 'Bearings Piles: 1 Decking: Not Checked Brg 1: 5.5" SPF Material lype: Glulam Defl. LL Span: L / 380 Brg 2: 5.5" SPF Material Name: Rosboro X -Beam Defl. LL Cant: 11180 Depth: 11,875 Deft. TL Span: L / 240 Width: 5,5 Defl. TL Cant; L/ 100 Analysis Details Material Properties Name E Fb Fb_lop Fcp Fv Density Layup Label Rosboro X -Beam 1.8E6 2400 1850 650 205 35 24F -V4 OF/ nF Resistance Factors Moment Factor Shear Factor Comp Perp Factor Cr -Bending Cr -Shear Load Sharing CI Ct (E) 0.986010139599686 1 1 1 1 No 1 1 EI (Including Ct (E)) Bare El 1,381512E+009 Composite El 1.381512E+009 Ct (E) (temp. factor for E) 1 Load Combinations Checked for Strength (Factors include importance factor) Comb. No. Description Pattern Count Cd -Duration D L 1 0 1 0.9 1 0 2 D+L 1 1 1 1 0 0 W C O 0 O a Load Combinations Checked for Deflection (Total Loads: Dead + Live Loads) Comb. No. Description Pattern Count Cd -Duration 0 L 1 D 1 0.9 1 0 2 D+L 1 1 1 1 S 0 0 W C O 0 O 0 Load Combinations Checked for Deflection (Live Loads) Comb, No. Description Pattern Count Cd -Duration 1 L 1 1 0 L S W C 1 0 0 0 Powered by 1„7IStruct`" 12.4,156 A1CriAlEP (1 a 10 738 Client Protect Name: Job#: Quantity 1 drop beam Rosboro X -Beam 5.5" X 11.875" Description: Shipping 2/2812013 11:33 AM Page 2 of 2 Designer: Bearing Calculation (MR: Max Reaction) Brg. No. Input Length Req'ed Length Reaction MR Load Comb. MR Load Case MR Dead MR Live Uplift 1 5.5 2.25 5099 D+L L 1274 3825 0 2 5.5 2.25 5099 0+1 L 1274 3825 0 Maximum Moment at Each Segment (zero moment to zero moment) for the Worst Load Case Combination Load Case Segment Len. Moment Top/Bottom Left End -X Cd Cv CL Resist. Mr Mrorig Ratio Factor 0+1 L 15-11-4 20316 Bottom 8-4-0 1 1 0.986 0.986 25491 25853 0.797 Maximum Shear at Each Member Mem No. Span No. Brg No. Max Combination Load Case Cd Res... Max Shear Vr Ratio Fac... 1 Spn 1 2 Yes 0+1 L 1 1 4466 11539 0.387 Maximum Deflection on Span and Cantilever for Total Load (Dead + Live) Def. Span Desc. Combination Load Case Max Deflection Span ID Span -X Span Analog Length L / Allowable L/Actual Ratio Critical Span D+L L 0.6724 Spn 1 7-11-11 15-11-4 240 284.4 0.84 Maximum Deflection on Span and Cantilever for Live Load Only Def. Span Desc. Combination Load Case Max Deflection Span ID Span -X Span Analog Length L. /Allowable L/Actual Ratio Critical Span 0+1 . L 0.6724 Spn 1 7-11-11 15-11-4 240 284.4 0.84 Powered by Q iStructr" 12:4.156 AiDsl _CtIJ€ r%SR3.S City of Eagan PERMIT City of Eaan Permit Type: Building Permit Number: EA107835 Date Issued: 10/30/2012 Permit Category: ePermit Site Address: 1490 Blackhawk Lake Dr Lot: 3 Block: 2 Addition. Blackhawk Ridge 2nd PID: 10-14401-02-030 Use: Description: Sub Type: e-Windows/Doors Work Type: Windows/Doors Description: House Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: Valuation: 4,000.00 BL - Base Fee $4K $103.25 Surcharge - Based on Valuation $4K $2.00 0801.4085 9001.2195 Total: $105.25 Contractor: Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 - Applicant - Owner: Patricia A Dobbins 1490 Blackhawk Lake Dr Eagan MN 55122 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 city otEtan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLU or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: Staff: 7 pc 002 L _1 INFLOW & INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: `�! '`[} Site Address: Tenant: Suite #: PLUMBING (Within the building envelope) Sump Pump Repair FEES $60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of can be found by visiting www.citvofeaqan.com/inflow, or City Hall at 3830 Pilot Knob Rd. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utili 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with th codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is no permit; th Lthe work will be in accordance with the approved plan in the case of work which requires a review and ap a ontractors y damage. Call ordinances and to start without a oval of plans. Applicant's Pri9t tI Names Applicant' Signature City of Eagan PERMIT City of Eaan Permit Type: Building Permit Number: EA123078 Date Issued: 05/28/2014 Permit Category: ePermit Site Address: 1490 Blackhawk Lake Dr Lot: 3 Block: 2 Addition. Blackhawk Ridge 2nd PID: 10-14401-02-030 Use: Description: Sub Type: Reroof Work Type: Replace Description: Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: 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. Amanda Peters Fee Summary: Valuation: 4,000.00 BL - Base Fee $4K $103.25 Surcharge - Based on Valuation $4K $2.00 0801.4085 9001.2195 Total: $105.25 Contractor: JNS Builders LLC 2325 Endicott Street St. Paul MN 55114 (651) 646-0221 - Applicant - Owner: Patricia A Dobbins 1490 Blackhawk Lake Dr Eagan MN 55122 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 City of Eagan PERMIT City of Eaan Permit Type: Building Permit Number: EA124482 Date Issued: 07/02/2014 Permit Category: ePermit Site Address: 1490 Blackhawk Lake Dr Lot: 3 Block: 2 Addition. Blackhawk Ridge 2nd PID: 10-14401-02-030 Use: Description: Sub Type: Siding Work Type: Replace Description: Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: 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: Valuation: 4,000.00 BL - Base Fee $4K $103.25 Surcharge - Based on Valuation $4K $2.00 0801.4085 9001.2195 Total: $105.25 Contractor: .Ins Builders Llc 2325 Endicott Street St. Paul MN 55114 (651) 646-0221 - Applicant - Owner: Patricia A Dobbins 1490 Blackhawk Lake Dr Eagan MN 55122 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 City of Eagan PERMIT City of Eaan Permit Type: Plumbing Permit Number: EA130439 Date Issued: 04/24/2015 Permit Category: ePermit Site Address: 1490 Blackhawk Lake Dr Lot: 3 Block: 2 Addition: Blackhawk Ridge 2nd PID: 10-14401-02-030 Use: Description: Sub Type: Residential Work Type: Replace Description: 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. Applicant: Jamie Rippel 12850 Chestnut Blvd Shakopee, MN 55379 Fee Summary: PL - Permit Fee (WS &/or WH) $55.00 Surcharge -Fixed $5.00 0801.4087 9001.2195 Total: $60.00 Contractor: Appliance Connections Inc 12850 Chestnut Blvd Shakopee MN 55379 (952) 445-4803 - Applicant - Owner: Patricia A Dobbins 1490 Blackhawk Lake Dr Eagan MN 55122 (651) 687-0254 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 City of Eagan PERMIT 41' City of Eaan Permit Type: Building Permit Number: EA146042 Date Issued: 10/05/2017 Permit Category: ePermit Site Address: 1490 Blackhawk Lake Dr Lot: 3 Block: 2 Addition: Blackhawk Ridge 2nd PID: 10-14401-02-030 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 Construction Type: Occupancy: 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 Fee Summary: Valuation: 4,000.00 BL - Base Fee $4K $103.25 Surcharge - Based on Valuation $4K $2.00 0801.4085 9001.2195 Total: $105.25 Contractor: Scherer Brothers Lumber Company 9401 73rd Ave. N Suite 400 Brooklyn Park MN 55428 (952) 277-1600 - Applicant - Owner: Patricia A Dobbins 1490 Blackhawk Lake Dr Eagan MN 55122 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