1498 Blackhawk Lake DrAddress 1498 SLA MAWK LAKE DRIVE
Zip 5512?
LDt Blk 2 Sub BIAMIAW FJDGF, 2ND
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: .,?L/2 1 A3 Yes No Inspector: ?
Final grade (6" from siding)
Permanent steps (garage) ?
Permanent steps (main entry)
Permanent driveway
Permanent gas ?
Sod/Seeded grass
TraiUcurb damage
Porch ?
Basement finish
Deck p/
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply tA
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
7 2 ; ??is
Req6 s ate ?? pp?? y
6 ? Flre No. Rough-in Inspection
ired?
Yes r No
?eady Now C) Will Notity Inspecror
When Ready?
I icensed contractor D owner hereby request inspection of above e{ectrical work at:
Job AddF?(S?L Boy.Qr?te Np,) ?? ? ? ??
i ,? %? ? /
? ??i a,? ryC ?? !4 f2, Cit? A 5??
Section No, 7ownship Name or No. Range No. Co +?
[?.?C7
OccupaM (PRINT) Phone?lp,.?
V
Power Supplier . Address
Elec I Contractor (Company N ) ? Contractor's License No. ?.
i ?
Mailing Add s fC ntractor or Own Mag InstIlatlon
7 11( 6 ) A?A
-
Authonze Signa re ContractoriOwner Making stallation) Phone Num
r
?---
MIW&KTA STATE BOARD OF LECTRICITY ? / THIS INSPEC710N REQUEST WILL NOT
Griggs-Midway Bldg. - Room S-173 6? + 17{ 5???? BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul. MN 55104 . UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REGIUEST FOR ELECTRICAL INSPECTION
? See instructions for completing this form on back of yellow copy.
l- -s R 7 R2 X" Below Work Covered by This Request
E8-00001-08
9?2/5
ew Add Rep. Type of Building AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./lndustrial Furnace
Farm Air Conditioner
Other (specify) Contr toRgmarks c s
:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits(Feeders Fee
Swimming Pool 0 to 200 Amps to 100 Amps
Transformers Above 200 Amps Above 100 Amps
SignS Inspector's Use Only: ,/'1
? T
L
Irrigation Booms i
0,GCJ ?
Special Inspectlon
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF IVOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough•in r Date ., ,..?
certity that the above inspection has
been made. Final
OFFICE USE 'JNLY
This request void 18 manths from
:t
. . . +." ; ? 'Y . . s
?
4 ? . a*0 A R f+owtRo# 7-?rlR
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Qf,extiftcate atCccupancV
Mt? of ??an
Zeoartment of 13u't[biug ???ectioa
?
;
This Certificate issued pursuant to the requirements of the Ilniform Building Code
certifying that at the time of issuance this structure was in compliance with the various `
ordinances of the City regulating building constructeon or use. For the following:
SF DWG 17'45
Use Classification: Bldg. Permit No.
Occnpancy Typr mi Zoning District M Co '
Owner of Building £F= H ` Address
B`ilding Address - ??? ???W T ?? - Lceality , s -
r
t f _.. --?' _?•`` 05J21 j93 ?-"
Date:
Building Official `- POST IN A CONSPICUOUS PLAGE
41Tlf OF EAGAN PERMIT 7YRE:
' • 1830 I'iicrt Knob Road
Pesmit Number:
Eagan, Minnesflta 55122-1897 Qate Issued:
(612) 681-4675 . ?
? SFTE AC?ClRESS: ? L 0 T 4 RLOCKt AR'PLICANT:
;. , . ?$40- tit.At'k11A4.4k, 1.#iXt td67 #3t??k5% 0?
BLAt:KHA#«tK -IRC06f_ 2ND 6"6.:_.4416
,c
SUBTYPE: TYPE OF WORK:
? . ? ?
?'-
I '€I$Y
'i£S"1'
ildSttL
GYP BOARD
ftAEPtACE
Fra?PLAce
AIR TEST
F94At PLBG
FMtAt H'fG
ORSAT
TEBT
BLDG FlNAt.
BSMI" R.i.
BSM7' FIiJ/AL
laECK FTC3
LtECK FtNR!
C.T.TY OF EAtaAN
CAsaH:[EFi: '.3 1'hRi`tlNfil... NOW 4FJ
ItA7EW Q6/i3/9i TI1'{Ev 15sCl3e4c?'.
ZD?
NraMEu sHaRON r+aBSraN
321.0 9001 ???? BL.aca;HwK i.. 50.00
2J.55 9001. 1.498 BLAU,4a14K% L 0.50
,.?i43Q 9001. j.498 BI_?CKH14i L. 0 n 25
c{
r.?
TQ+aI F?ecei???t Antvl.?rNt u ,:t.?rc
CRC375209
tJ5l:: R :[D". NANCY
CITY OF E/4CAN
I 3830 Pilot Knob Roac!
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PEPMIT
PERMIT TYPE: v ... ?.' ? ?
Permit Number:
Date Issued:
DESCRIPTION:
? _. ... ?- .J? e __ . ?. ..- t ..
e •?
REIVIARKS:
FEE SUMIVIARY:
.....,...?.....-?..,.......?,?..?..,:.ic., ....?....
CONTRACTOR:
r
r
.: , , ...,.......,?......?..?.....w.?.?..:,.. ?c.. .,,._,._..
4WNER:
.
ISS BY: SIGNATURE
. • 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
3 fl aCITY OF EAGAN
3830 PILOT KNOB RD - 55122
681-4675
New Construction Reauirements
lo/?z
? 3 registered site suroeys ? 2 copies af plan
• 2 copies of pians (indude beam 8 window sizes; poured fid. design; etc.) ? 2 sits surveys (exterior additions 8 dedcs)
? 1 energy calculations ? 1 ene?gy calcuiations far heated additions
? 3 copies of tree preaervation plan if lot platted after 7/1/93
required: _ Yes No DATE: CONSTRUCTION COST:
DESCRIPTION OF WORK: z5el,?, ZL
STREE1' ADDRESS:
??
LOT ? BLOCK
Z' SUBD.IP.I.D. #:
?i
PROPERTY Name: ,ewei S Phone
OWNER ?
Street Address: / y? ? ???C,&
CitY: State: Zip:
,
Company: Phone #:
Street Address: License #:
City: State: Zip:
Company:
Name:
:e ._?p eY'R
Phone #:
Registration #:
Street Address:
City: State: Zip:
Sewer & water licer.aed piumber (new cpnstruction only): . Penaity applies when address change
and lot change are o•equested once permit is issued.
1 hereby acknowledge that I have read this application and state that the information is correct and agree to comply with atl applicable
State of Minnesota Statutes and City of Eagan Ordinances. n
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
Signature of Applicant:
Yss No
Yes No
Not Required
CON7RACTOR
OFFICE USE ONLY
BUILDING PERMIT TYPE
o 01 Foundation ? 06 Duplex
0 02 SF Dwelling a 07 4-plex
? 03 SF Addition o 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. a 10 _ plex
WORK TYPE
31 New
? 32 Addition
? 33 Alterations
0 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
ARPROYALS
a 11 Apt./Lodging a
? 12 Multi Repair/Rem. o
n 13 Garage/Accessory ?
? 14 Fireplace n
6X-15 Deck
a 36 Move
0 37 Demolition
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Planning Building
?
. • ,
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
MCNVS System
City Water
Fire Sprinklered
PRV
Booster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Engineering Variance
.?
Yily
ar
i
?
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/VN Permit
S/V1/ Surcharge
Treatment PI.
Road Unit
Parlc Ded.
Trails Ded.
Other
Copies 41?5
Total:
Valuation: $
?I
I
°k SAC
SAC i3nits
M
? _ ..... .... . .. .m.,
DE5 ?GAi B UiLDERS lA)c.
. . CONSULTIN(3 ENOINEEAS.
/RhO?aE PIANNEAS ond IAND SUAVEYORS ' # 5381.0 I
xy,?;EHG;INEERING :.: ,...?.:.::.
COMPRNY, iNC.
_?:..
1000 EAST 1461h STREET, BURNSVIILE, MINNES07A 55337 PH 432-3000
CERTIFICATE OF SURVEY
Legal Description: Lo-r 4, sLocK Z, 13LACK14AYVK RIpGE 2NtJ ADDlTlofll,
- '2AKoZA covAv7Y, M WNESOTA.
DENOTES EXISTING ELEVATION
(9516.5 ) DENOTES PROPOSED ELEVATION
INDICATES DIRECTION OF SURFACE DRAINAGE .;
95?•83 - FINISHED GARAGE FLOOR ELEVATION
4-9 9. /Z = BASEMENT FLOOR ELEVATION
_95716 = TOP OF FtJUNDATION ELEVATION
SCALE : 1' = 30'
30 Fr FQONT BU/GO/NF
? ,SETBACK L/rt/E
? (85¢'? 87° 09" /6,"Gt/
? `? ' ' ! 5 t . 6 4 ?, oD
? °
? ?6s o - ?i - tr?
ol ?Ss 3_? h ZZ ?.
N .? 33 ? •
9,?o 10
w
N
?
z767 ?56.s? x?8S6.o? r ?\
%3 66? / v?j S "
? ?y1
?
°
`?
Ip?/? v ?56 ? 0q 23•67 d?- I r' a
1 N ? s s',
?•s
) . \o
?
¢ ? 1
?i ?
!o
t'+
r.i
Y d}:e rz ?Im!/. REO U I
gAGAN ENGl'kF.F."RING DErT ,DRA/N,A6E-AvD
UT/G/TY 64S6W61/7'
I hereby certify that this is a true and correct representation of a tract of
land as shown and described hereon. As prepared by me this 3rJ day.of
19 9z. • .
,-? Minn. Reg. No. 6?;?
r
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
1 i t t_ 0 l, it ,
B l.. !.: t r3 A 11A .i,'., (.. r" -' N I?l
: U f 1 t?r 17 N 3i
DESCRiPTION:
?
C I ? ` ?? ??
s,?,.
REMARKS: {Q
0,3??!?' 1 ?
P R v ,:.a
?
? g
?S'12f 1 ? ? ?? ? 11111F
l
g
FEE SUMMARY:
i'' .?.. i: i 2 i'i ? v f.
i" t" q e
r:
CONTRACTOR:
V (`s ! . l, I ol 1` 1 C1 i'?1
0 0
cr ... 5 .. 5 0
3? i' ;:7 t?t , w? t?
J? ta? GJ
?.
r ' r' 1 4 , 0
OWNER: ;:, o o:1, i c., c'l ri i. ....
11 r'? pa '.. F. t=i i? (", (::
4 1, fl 8 `. NC3 8 C.(, 1'i
L:, i S ri i ihi 716 N y."? 1;? 1 :.. ....
(' 6 J. ;:? ) 6, .:+ ; j ...." .:', 6 0 0
? ? . . . . _ . _ .
1 r'1 et° eb'_,' `1 h a>v 0 i e, ' a ca'. ts t i ? . ? p
r, r ? fOr,Tr a C: a. o,-I a. ;? cor, I ,:: cr a ra 0 ?~ ? ? tc?, ? cs rrr ;w ?
` i.. E1't ij 11 ' p- s , ai n {.i Cv i t y :' pf„ ? aqati C) t~ rl 111 ?441 c 0 s ?
,r. 11.._. „ 0 t?1 rz;
tY! J. `a C f. I,. ?. (, #'.t E Cl l.!
Control No. .s
?tJ 2'? 6
fiNIA tulflP fu
APP A T/PERMITEE SIGNATURE ISSUED EIY. 8IGNATURE
PfRMIT #
REACT IiIAH
lq4.4
CITY OF EAGAN
1992 BUILDING PERMIT
681-4675
APPLICATION
ACT 3 0 RECD',??
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested o e ermit is issued.
CrI
Date ?S.? Val uation of work
` 17
Site Address: N1.,-e-
?
SIREET
SUlTE f ^
Tenant Name: (commercial only)
IAT ? BIACK ? SUBD.(????
l (??l P.I.D. ?
Descri tion of work: - _1,,'tA
The appl i cant i s: 11 Owner [7 Contractor ? Other (Describe)
? .?
Name _ i u. ??z ? C? ,-P s ? Phonv
Property ,
LAST F;RS;?
OWtI@r Address rc(-'f_
STREET STE #
City State ?'k-w_ Zip ?51 Z
ComPan?? ? '- _?, BY;?.???-"?
Y e h Phone ?
Contractor Address ?
?( cense # Exp.
?
City - ?t-ae Zip -?'T(? :z
Company Phone
Architect/
Engineer Name
? ?Regi strat i on #
Address
City State Zip
Sewer & water licensed plumber . Processing time for
sewer b water permits is two days once area has been approved.
I hereby acknowledge that I h ve read this application and state that the information is
correct and agree to comply th all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Appl icant:
OFFICE USE ONLY
BUtLDtNG PERMIT TYPE
O 01 Foundation O 06 Duplex ? 11 Apt./Lodging
Jg 02 SF Dwg. O 01 4-Plex D 12 Multi. Misc.
? 03 SF Addition O 0$ 8-Plex 0 13 Garage/Accessory
? 04 SF Porch O 09 12-Plex O 14 Fireplace
? 05 SF Misc. O 10 Muiti. Add'1. O 15 Deck
WORK TYPE
pf 31 New O 33 Alterations O 35 Tenant Finish
O 32 Addition ? 34 Repair El 36 Move
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
#! of Stories
Length
Oepth
APPROVALS
Planning
Engineering
V.t-I
?1- h!
Pp R - ?
53 `
52•
REGIUIRED INSPECTIONS
? Site
C] Wallboard
vetuecion:
A&..9(6,51 30` X 24` ='72 r,
;z Kl?.?
?
?q (o X
Basement sq. ft.
lst F1. sq. ft.
2nd F1. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
O 37 Demolish
MWCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
Building LL ,-y97,
Variance
? Footing
O Final
YEg
y-c- 5
?of
oL
? 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.
Cop ies
Other
Total: _
SAC % ? p
SAC Units
,BS'30 X 2 a =
?
344 x 14
so =.
14 au
..----?-----?
O Framing
O Draintile
fS?ln
c??1G
N?
__---
14u3
J,-SrAT M ? L((t`3
z)k 7-
! ?`...? `? A 1;
Assessments
a Y
ay
? ?• ? 1
6?asementFinish
O lT Swim Pool
O 18 Comm./Ind.
? 19 Comm./Ind. Misc.
0 20 Public Facility
O 21 Miscellaneous
+1,13b
zI, 645
1"]',?.
.??
B ?iLDnRS
a '?z???:•. E
+
:<.::
CONSUtTING ENGINEERS,
k ?RO;OE PLANNEAS 4nd IAND SUAVEYOAS
''?'?'>??•
# 5381,D!
?:h?:
ENGINEERING
u{.;
INC
COMPRNY
.:,..:.
,
.
1000 EAST 1461h STREET, 6URNSVILLE. MINNESOTA. 55337 PH 432-3000 .'<'?
`z
CERTIFICATE 4F SURVEY
Legal Description: LOT 4, BLAGK 2? BLACKFfA1NK RIPC-aE 2ND ?(DDITIDiIl,
? 1?AKoTA COv?7'Y? M MlNE507,4 •
DENOTES EXISTING ELEVATi4N
(956•5 ) DENOTES PROPOSED ELEVATION
,..,.----- INDICATES DIRECTION OF SURFACE DRAINAGE ; a
956-83 = FINISHED GARAGE FLOOR ELEVATION
9¢9, /2 = BASEMENT FLOOR ELEVATION
59 7/6 = TOP OF FOUNDATION ELEVATION
SCALE : 1" = 30'
3v Fr, F,W.vT Ba1G,p1AvF
,f'ETBACK G/NE
30, 00 L...,`i ! ?
?
o ? ?J o .,
87 `j, ?16 W 8(o/v,o
i ? (18 s4 s
,?-
? ?J o f 2z 33
$ ?
9,?y °o a w ( 0
?/
4-7
66?
? 'ci ''i 4 4)
'? D °• ??ss? A. /oy ,? ?0 / k8S6 1ri 8 0 , f ? a'V
367267 d? ?$SS_5j / ? + ??l
?s?`gl ? ? ? ?-•, ` ? ?
41 66 •?/9 \ I
2O 10
?J
";•v?4? 4 a £. ? ? ,
?k
u: .
Ve REQUI
.??!.. DRA/N?J6E AND
.yVi '?t?.? •.? z ?:: e. N ... ?."1 .e :4
? 13 & .?!: T I?,
? A. .j
U7-11-177' E,45FJl96V7'
I hereby certify that this is a true and correct representation of a tract of
land as shown and described hereon. As prepared by me this day.of
1997-_ • ' ;:;
? , ,
Minn. Reg. No. l6 ?85 °;'`
g1, a/z 4 ' la 4 0 & 0 ? I , ??.
14750 Galaxie Ave. Suite 104
Apple Valley, Minnesota 55124
(612) 432-2044
Lo-r 4, &-ac-4h Z /
BI.AGK1w1•4WK R?bC-E 2No AQa?X/ ?
EXTERTOR FrNELOPr AVERAGE "tT" C01,?Ti7TATTON
AIVE PIAN' NUTNU3ER
N
• Deter,!nine vaorkin, square foo'tage of each
1. Total exposed wall area...... ?? sq.ft. X .11
2. Total r. oo?/ceiling area...... 15Z6cs sq, ft . X .026 ?
Total exposed wall area above floor =18>2>0
a. Total wall Urindow area . . . . . . . . . . . . . . . . . . 19 4,
b. Total door area ......................... 5D #Zj
c. Total sliding glass door a.rea........... d. Total fireplace wall area .............. -'
e. Total wa11 frarring area (average 10%) ...? ?_9??
f, Total net ti>>a11 area above fioor......... I p<
g. Total rim joist area . . . . . . . . . . . . . . . . . . . .^.S?2 191
Total exnosed founda'tion area = '? ? ?,5
h. Total foundation itirindow area............
i. To tal net Foundation area above grade.., lao
Determine "U" value of each wall seggnent
a. X nU" .52
= 1 t'a l,O°-? '
b • X nUrl .139
C. }(' itUl( .72 _ t w 6
d. - x. "U" .68
= ----
e x nUrr ? o96
f.
14oq 6?}?i I'Uit )'
. 0't,? q
- 0_?
??
. g. 0%.S X ttUn .041
h. - x rfUrr .52
= --'
1• t ?? X ,rUn .082
3. TOTP.L . . . . . . . . . . . . . . . . . . . . . . . . . . . . ?, •?,'"?
??
,
_
If itern #3 is the sazne as, or less thar. ?em #1, you have
met the intent of SBC 6006 (c) 2.
-1-
i Total exposed. roof/ceiling area
Total gross rocf/ceiling area = ? t'lk"
j. Total slVlight area ................... -"-'
k. Tc?al roof/ceiling framing ar.ea. . . . . . . ? s oz '(41Z
1. Total net insulated roof/ceiling area, t°° ,?
Determine "U" va.lue for each roof/ceilina-; scgnent
j. ...... x 11 Uf 1 w ? . ......
k• X ffUll ,024 - 3? IG,7 ?l
.1. 13-7.».d. &1 A 1IU
77f1 .022 _ 30,7. k
4. `I'OZ'P.L . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
If total of #u is the sar.le as, or less thari #2, you have
met the intent oi SBC C006 (c) 1...
"'a utilize the total envelope systan method, the values
established by the sum of items #3 and #4 shall not be
greater tha.n the sun oi items #l and #2.
1. + 2. _
3. + 4. _
Ma.terials T'r.e „ 1 resistance "R"
Exterior air.........
Siding material ......
Sheathing ............
? Insulation...........
Sheetr.ack............
Interior air.........
Studs ...............
R-I.m .................
Conc»ete blocks......
-2-
i
4
U
? W
? W
a m
ffEr/??
?
Itl
0
?o
?/?
? 0
e' 0 0
0
?i?aow ? a
0
LOT BIIRVEY CHECRLSST FOR RESIDENTIAL
BIIILDING PERMYT
EROPERTY LEGAL:
DOCUMENT STANDARDS
Date of Survey:
• Registered Land Surveyor signature and company
• Building Permit Applicant
• Legal description
• Address
• North arrow and bar scale
• House type (rambler, walkaut, split w/o, split
lookout, etc.)
• Directional drainage arrows with slope/gradient t.
• Proposed/existing sewer and water services
• Street name
• Driveway
ELEVATIONS
ExistinQ
0 Q
? ? • Sewer service
? ? • Lot corners
v Top of curb at the driveway
o ? • Elevations of any existing adjacent homes
Proposed
C?' ? 0 • Garage floor
?- /? ? • First floor
CY ?
? Cl • Lowest exposed elevation (walkout/windaw)
Q
D
? ? • Property corners
0 ? • Frant and rear of home at the foundation
PONDZNG AREAS (if_applicable)
D B"" 0 • Easement line
o d o • rrwL
? [3? ? • xwL
? ??? • Pond # designation
13 U U • Emergency Overflow Elevation
entry,
DIMENSIONS '
C? D 0 • Lot lines
?D 0 • Right-of-way and street width (to back of curb)
0' ? o • Proposed home dimensions including any proposed decks,
overhangs greater than 211 porches, etc. (i.e. all
structures requiring permanent footings)
C?0 ? • Show all easements of record and any City utilities within
those easements
C?'?0 0 • Setbacks of proposed structure and setback of adjacent
existing hom
0 D""0 • Retaini wa r irements, if any
- Reviewed:
Na e ? a e
October 1992
Ar
Volume No. C'er I • • Ica
teo oI
e
OWNER'S DUPLICATE CERTIFtCATE
Cerrrlicate No. 8 3 8 5 4 Docurnent No. District Court No.
7 rar7,s(cr from No. • 215 g0.
X'olurne Forty 8 0 5 9 8 0??nal?? registered ???e 18th dvy of Apri 1 » 59
Stat;e of PZi"nesota,t ss
COUnty of Dakota,. ce??C6, p1eritor Development Corporation
605 West 7ravelers Trail
oF 1he y of
County olftDakota and Srate of Burnsville
Minnesota
is now the owner of an eslnte, to wrt:
fee simple
/ollowinq described land situated in the County of Dahota
lot four (4), Block Two (2),
in BLACKHAWK RIDGE 2ND ADDITION,
according to the recorded plat thereof.
of and in the
and State of blinnesota, ro wit:
Sufiject to the encumGrances, liens and interest noted by the memorral underwritten or endorsed hereon: and subject ro the folloct"ing ri2hts
or encumbrances subsrsting, as provided in 1_acus 1905, Chapter 305, Section 24, namely:
1. Lrens, clarms, or rights arisrng under the laws or the Constitufion o( the United Staies, which the statutes of this stare cannot require
lo appcar of record;
2. Any real property tax or special assessrnent for whrch a sale of the land has not been had ar the date of the certificnte of tide;
3. Any lease for a period of not exceeding three years, when there is actual occupatron of the premises under the lease;
4. Al( rights rn public highways upon the fand;
5. Such riqht of appeal or right to appear and contest the application as is allowed by law;
6. The ri_qhts of any person in possession under deed or contract for deed from the owner of the certificate of title;
7. Any outstandinq mechanres lien rrghis which mny exist under sections 514.01 to 514.17.
7-hor thc said ,f leritor Development Corporation is a corporation organized and existing u? der XXX? ?(?RX'?iF)(R?(XXXXXX XX A?f3(
????(?'RXXXX the laws of the "tate of Pennsylvania. XX4('?kXXXXXXXXXh?kR??C`XXXXXXXXXXXXXX?R`?;ORV•
! have hereunto subscribed my name and atTixed the seal of m,y olTice,
thrs 17th day of pqay 19 89
JAMES N. DOLAN
Regrsrrar of Trtles
In nnd for the County of Dahota and Stnte of Mrnnesola. (Seal )
ME3101HAA. ,:,r,l:.; Iv L.,. ."
of F,R[aleR, F.axemenlx or CharpeR on lhe /,and descrrbed in [he Cer[ifica(e of T7lte hereio a[tached.
DOCUMENT KIND Oi DATE OF REGISTRATION OATE Oi1NSiRUMENT
NUMBER INSTRUMENT MON7H DAY YEAR
A.M. HO
UR P.M
P.M.
MONTH
DAY
YEAR
FAMOUNT
RUNNING IN FIIVOR OF
SIGNATURE OF REGISTRAR
215904 Declaration f Pr tec ive Coven nts and o he lan )
P1a 1 198 3:0 4 2 189 - The Public James N. Dolan
124147 ight of Way lat N . 9-51 (Par el 4 B) Minnesota Department of Tra poration
Aug. 27 1982 1 - - - -
(Ac es con rol n ab ve & th r lan s) James J. Foutchis
126524 W.D. Jan. 4 983 3 1 14 183 $2,00 , 0.00 (Subject to Access control
on above & other lands) James N. Dolan
' 239209 Pressure R ducin Va lve gree nt and the lan s) Between City of Eagan and
Fe . 2 19 )1 10: 6 12 2 19 - Meritor Development Corporati n lames N. Dolan
?. qD. D d 2006 RESIDENTIAL BUILDING rERmiT aPPLicaTloN
City Of Eagan 'Y?
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements
3 registered site surveys showing sq. ft. of lot, sq. R of house; and all roofed areas
(20% mazimum lot coverage allowed)
t Soiis Report if proposed building is to be placed on disturbed soil
2 copies of plan showing beam &window sizes; poured found design, etc.
1 set of Energy Caiculations
3 copies of Tree Preservation Plan 'rf lot platted after 7i1193
Rim Joist Detail Options selection sheet (buildings with 3 or less units)
Minnegasco mechanical venUlation form
RemodeUReaair Reauirements
2 copies of plan showing footings, beams, joists
1 set of Energy Calculations for heated additions
1 site survey for additians & decks
Addition - indicate K on-site septic system
use o??v
Cerf of 5urvey Re?J; Y lV
Soils Re? ' 'f N
Tre6 pres Plan Keod 1? N
Tr?e Pces;Requrr?tl; `Y N
?n sife:Sept?c 5ysfem .' ??, _ N
Date ? /
Site Address 1? /
I "( ? ? Construction Cost I 12S f -
? ? ?' C ? ? u in? ? 1? I(,2 ,? ? ? v? Unit/Ste #
. ?,.
Description of Work .?
Multi-Family Sldg _ Y_ N Fireplace(s) _ 0 2
Property Owner
1a ?3? 5-C w s'" s r
Telephone # ( (p
Contractor ? ?.?%??`' LLC? d'G?"
Address
State /V, _
Zip 'i? City
Telephone # (j 67) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Gategory 1 _ Minnesota Rules 7672
Energy Code Category
0 Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet
(4 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
Mechanicai Contractor
Sewer/Water Contractor
Telephone # (
Telephone # (
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. '
M a..v-k
Applicant's Printed Name Applicant's S gnature
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA125902
Date Issued:08/06/2014
Permit Category:ePermit
Site Address: 1498 Blackhawk Lake Dr
Lot:4 Block: 2 Addition: Blackhawk Ridge 2nd
PID:10-14401-02-040
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 .
Barbara Bessent
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 -
Jason S Sever
1498 Blackhawk Lake Dr
Eagan MN 55122
Minnesota Exteriors
8600 Jefferson Hwy
Osseo MN 55369
(763) 391-5514
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
5� r For Office Use
.,'k,'rte;, •
Permit#:
r Permit Fee:
4e<rsys°~ RECEIVED Date Received: //`029—/7
3830 Pilot Knob Road ( Eagan MN 55122 NOV 2 9 2017 Staff:
Phone:(651)675-5675 ( Fax:(651)675-5694
buildinginspectionsOcitvofeagan.com Isv1
2017 RESIDENTIAL BUILDING PERMIT APPLICATION a c, I/
11/28/17 1498 Blackhawk Lake drive 1/6
Date: Site Address: Unit#:
Jason Sever612-246-5135
Name: Phone.
Resident/ 1498 Blackhawk Lake Drive i
Owner Address/City/Zip:
f
X
Applicant is: Owner Contractor
Type of Work i
Description of work: Master bath remodel
Construction Cost: 26,500 MultiFamily Building:(Yes /No X ) s
: Beautiful Kitchens & Baths Michael Noding
Company: contact:
P.O. Box 8 t,_ Biglake k
Ci
Contractor Address.
MN . 55309 763-286-22448kbathsC mail.com
State: Zip. Phone: Email:
License#: bc071832 Lead Certificate#: nat-866697-2 a
If the project is exempt from lead certification,please explain why: k
Building Built after 1980
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? g
Yes No If yes,date and address of master plan:
is
, Licensed Plumber: Phone: I
t
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression 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 rf you provide specific reasons that would permit the cit to conclude that the are trade secrets-
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeagan.com/subscribe.
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.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against undergroun.utility dam..- Call 48 hours before you
intend to dig to receive locates of underground utilities. www.copherstateonecaltorq
I hereby acknowledge that this information is complete and accurate;that the work will be i. -., ommance.; ordinal es and codes of the City of
Eagan;that I understand this is not a permit, but only an application for a permit, and ,ork is not to 45 i • a it;that the work will be mll
in
accordance with the approved plan in the case of work which requires a review and appro - ans.
x Michael Noding President x tir ESE
Applicant's Printed Name Applicant's Sig'. ure
Page 1of3
DO NOT WRITE BELOW THIS LINE
c I4C ,
)4 .,L L4L /Lf7(M7
SUB TYPES
_ Foundation _ Fireplace —
Porch(3-Season) _ Exterior Alteration(Single Family)
)4,_ Single Family _ Garage Porch(4-Season) Exterior Alteration(Multi)
_ Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex Lower Level Pool Accessory Building
WORK TYPES
_ New _ Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows _ Demolish Foundation
_ Replace Repair _ Egress Window _ Water Damage
_ Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation Occupancy iL,., MCES System
Plan Review Code Edition '0 SAC Units
(25%_100%)c) Zoning b City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O. Required
Footings(Addition) X Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice&Water _Final Pool: Footings Air/Gas Tests _Final
Framing A 30 Minutes 1 Hour Drain Tile
Fireplace: Rough In _Air Test Final Siding:_Stucco Lath Stone Lath _Brick_EFIS
f` Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: 12 , Building Inspector
RESIDENTIAL FEES 361k
Base Fee is
Surcharge ,\14,,,, (161 '
Plan Review
6,1A
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies ,'--- i)
TOTAL .. r `
00 Page2of3
Use BLUE or BLACK Ink
r
For Office Use I
Cityof Eaaall ::::;ee:
ai
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 Staff:
buildinginspectionsOcitvofeagan.com
2017 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: J r/5-(7 Site Address: `7
Tenant: Suite#:
Resident/Owner
Name: l/ SDA..) gIQ J--fid-., Phone: ( "�y �o cS/v3'S
Address/City/Zip: /vg k �/tc�Yc 1— -�.� 4 �uvt Gl1/-/ 3"'.57°2?/,�
II
Name: a-0X l�,,,,�bT l,L.e License#: /631,2,7 e),5-47(../
Contractor Address: /7cxf f / 7 n,c� /- L r City: .4;15,- [�
State: 1(/u' Zip: 3 .fid 5j Phone: (fes l 2 -2 7.� ^7
Email: l(
Contact: a
ewX Replacement Repair Rebuild )(Modify Space _Work in R.O.W.
TYpe of Work —New — p — - t
'
Description of work: k� 2 1 2* //�X'IP--"9/
rtu
t?a
RESIDENTIAL f 111
Water Heater
Water Softener
Lawn Irrigation( RPZ/_PVB)
Permit Type Add Plumbing Fixtures ( Main/ Lower Level)
Septic System
New Water Turnaround
Abandonment
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 $
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.qopherstateonecall.orq
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaaan.com/subscribe.
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 o
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 o = . s.
�- ak x .1.01PP' /1 _
A• •11'cant's Printed Name App/i,r'ant's Signature
FOR OFFICE USE Reviewed By: Date:
Required inspections: Under Ground ; Rough-In Air Test Gas Test _Final
Meter Related Items: Meter Size Radio Read Manometer Staff:
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA175330
Date Issued:03/29/2022
Permit Category:ePermit
Site Address: 1498 Blackhawk Lake Dr
Lot:4 Block: 2 Addition: Blackhawk Ridge 2nd
PID:10-14401-02-040
Use:
Description:
Sub Type:Water Heater
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jose Bazan Medina
1498 Blackhawk Lake Dr
Eagan MN 55122
Champion Plumbing Llc
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature