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1531 Blackhawk Lake Dr ® Use BLUE or BLACK Ink g43 p0 For Office use ~ I 1 1 of Eajan i Permit 1 /III Permit Fee: l/I 3830 Pilot Knob Road RFCFIVED I 1 Eagan MN 55122 1 Date Received: 1 Phone: (651) 675-5675 1 Q ?Q~1 1 Staff: Fax: (651) 675-5694 MAR 2011 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: Z-9-tl Site Address: 31 631 ~L ~~wk - Tenant: nn Suite RESIDENT/ OWNER Name: Phone: r!-7c~ 7gZ Address / City / Zip: CONTRACTOR Name: et►•(CVti>~6 I~Ve4tt)a License Address: ~I~f^\5~ Sv1f~-lOl City: State: /VtA Zip:-56--~Ie8 Phone:' Contact: D1-z-, Email: TYPE OF WORK - New Replacement -Repair _Rebuild - Modify Space - Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Softener Water Heater Lawn Irrigation RPZ PVB) X% Add Plumbing Fixtures (_L Main Lower Level) Septic System Water Turnaround New _ Abandonment. K,+~IP,,, tl$s~ ru, a F,Fi,,~ts e X tS RESIDENTIAL FEES: $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) $35.00 Lawn Irrigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge) *Water Turnaround (add $166.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge) $95.00 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) 5"S 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.gapherstateonecall.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 ' of to start thout a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approv ns. x 016 wl,,s /-I q),v"t-1- x Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final use or BLACK Ink 1 rt 1 f=or Office Use -Ak Permit City of Eapn 1 Permit Fee: 3830 Pilot Knob Road X FEB 2 Eagan MN 55122 ` I Date Received: I Phone: (651) 675-5675 staff: t Fax: (651) 675-5694 - - - - - 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: 1411, 51,At-lGRAWIL Lk . DX unit Name: PET6*L * if-(V401,19 1✓46-11- Phone: RESIDENT / OWNER Address I City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work., IS ~t"7.►dcE~,► (.~ttAcwe, e Construction Cost 2Op0 Multi-Family Building: (Yes I No CZ► Company: `~A+npxrklprc. Contact: U MC W Cb CONTRACTOR Address: 4140 &Z NO &UE:- ~4 City: T2vi3V-' State: _ Zip: 151422 Phone: lu l J57-0- 015Z License Lead Certificate gA--c - 2 4 9-AP i - 1 Does this project require Lead Rentediation? 0 Yes ANo (see Page 3 for additional information) If no, please explain: ~1wc 11L l lit COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the fast 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? ,_Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. I hereby acknowledge that this information is complete and accurate; that the work vA be in conformance with the ordinances and codes of the City of Eagan; that 1 understand this is not a permit, but only an application for a permit, and work is not to s rt without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and appr of pia x ~Au ot. AppliicanYs Printed Nate A scant S gna Page 1 of 3 DO NOT WRITE BELOW THIS LINE C~N l Ql_ SUB TYPES Foundation - Fireplace _ Porch (3-Season) - Storm Damage Single Family - Garage _ Porch (4-Season) - Exterior Alteration (Single Family) Multi - Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of Plex Lower Level Pool Miscellaneous Accessory Building r, Arl" WORK TYPES: 1 ~V., Q)l New _ Interior Improvement _ Siding _ Demolish Building* _ Addition _ Move Building _ Reroof _ Demolish Interior Alteratio _ Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage - Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation rc Occupancy z, s C N MCES System Plan Review Code Edition SAC Units (25%_ 100%\ Zoning City Water Census Code Stories Booster Pump # of Units f-~ Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: -Ice & Water Final Pool: Footings Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: _ Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee J Surcharge /C-Plan Review d MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge j~ Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type: Mechanical Eagan. Permit Number: EA092599 Date Issued: 01/19/2010 OR Permit Category: ePermit 40~ it~ of E3 E Site Address: 1531 Blackhawk Lake Dr Lot: 4 Block: 1 Addition: Blackhawk Ridae 2nd PID: 10- 14401-040-01 Use: Description: Sub Type: e - Furnace & Air Conditioner Work Type: New Description: Furnace & Air Conditioner Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson. State Electrical Inspector. (952) 445-2840 Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088 Surcharge-Fixed $0.50 9001.2195 Total: $50.50 Contractor: - Applicant - Owner: Home Energy Center Peter T Dietz 241 Annapolis Lane =170 1531 Blacldiawk Lake Dr Plymouth SIN 55441 Eagan SIN 55122 (61)766-6763 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 Cite of Eaaan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature SEWER & WATER•PERMiT f OFFICE USE ONLY -CITY CIF EAGA* PERMITpATE o{Q~Ig1 3$30 P{{at Knob Rd. WATER PERMIT # SEWER PERMIT # 11969 P.O. Box 21199 METER 911 3 P 5.tE1IPT S 13.x? 5 f 8rt, ANN 55121 sR # C2 a,1 / o 'l 6.P: RECt=tPT"DATE...-0103.191 METER SIZE S/ g S-eeSu S ISSUE DATE 3 1 X PRV -BOOSTER PUMP :SITE ADDRESS 1531 &=Ahawh LAz~ e [)4.Lve PEft ff REQUESTED f LOT LBLOCK ? SECISuB B.lac khaoA fZ:i:.c}e 2nd r Y- SEWER x ;WATER. _,:,:..TAP$ r APPLICANT: dUa ADDRESS: 1 loth Avenue South NINtl1AlD __?L RE KIAL CrTY,,STATE - n~!. Lte. MI{' zip 5-U37 PHONE: _ _x NEW EXMTING C PLUMBER: Stair ! lout Aa-dte4 #3329 ADDRESS: 018 Mound S ! e22ace I AGREE TO COMPLY WrrH,CFTY OF ton, iv 55420 EAGAN OR ANCES: i CITY, STATE' ZIp ` PHONE: - 884-41T9 OWNER: ADDRESS; E W R O 77 Eft UMM, CITY, STATE ZIP S A PHONE: 17 ?4' L -Y ' PWASO ALLOW TWO WORKING DAYS FOR PROCESSING. FOR STORM SCR P MtI~Bf, CONTACT EPIGSIEERING DEPT. f CITY OF EAGAN N 0- 18 9 8 4 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-810132-, BUILDING PERMIT Receipt # C To be used for $F DWG/GAR Est. Value $148,000 Date MAY 1 g91 Site Address 1531 BLACKHAWK LAKE DR OFFICE USE ONLY Lot 4 ' Block 1 Sec/SubBLACKHAWK RIDGE 211D Parcel,No. Occupancy R-3--M-1 FEES Zoning PD R-1 W Name WAGNER HOMES (Actual) Const -Y--N Bldg. Permit 808.00 c Address 14600 TENTH AVE S (Allowable) V-N Surcharge 74.00 City BURNSVILLE Phone 431-7557 # of Stories Length 68' Plan Review 525.00 ZF Name SAME Depth 36' SAC, City 100.00 0s Address S.F. Total SAC, MCWCC 650.00 ~ City Phone S.F. Footprints - F On Site Sewage Water Conn 660.00 W W Name On Site Well 95.00 w Water Meter = Z Address MWCC System X City Phone City Water Acct. Deposit 30.00 PRV Required X S/W Permit 30.00 1 hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge .5 0 information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eaga Or nances. Treatment PI 276.00 Signature of Permitee APPROVALS Road Unit 370.00 A Building Permit is issued M. W NER HOMES Planner Park Ded. on the express condition that all work shalt be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies Building Official - L WO I 9 - Lq Variance TOTAL 3,618.50 CITY O EAGAN 3830 Pilot Knob Road, P.O. Rox 21-199, Eagan, MN 55121 13284 PHONE, 454*8100 'BUILDING PERMIT Receipt # To be used for STr l /G" Est. Value $148,000 Date 181i" 14 i9 91 Site Address 1..531 K A M t-A1r9 DR Lot 4 Block I SeCluut:ALA r $l D OFFICt USE ONLY Parcel No. occupancy R-3 11.1 FEES TtAMR 3 Zoning Narita (Actual) Const Bldg. Permit Address 14t~OQ. `13:b Ai~E (Allowable) AN surcharge 74.1 City 1~iMV11" Phone 431-7537 of Stories 0 Length 1 Plan Review 52 ~ Name Depth sac, city 10S'I:SI!Q Address S.F: Total - City Phone S.F. Footprints SAC, Mcwcc 6'SO= On Site Sewage Water Conn 6tFi[]I . ttltt Name - On Site well Water Meter 95-~ Address MWCC System Acct. Deposit i W City Phone City Water PRV Required _ S/W Permit 3d-(?[1 l hereby acknowfege that I have read thWapplication and state that the Booster Pump S/W Surcharge information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan 'nances. Treatment PI _ 276, f10 Signature of Permites APPROVALS ~I Road Unit 37d.00 A Building Permit is featued to: ~ wleg utv Planner - - Park Ded, on the express condition that all work shall be done in accordance with all Council applicable State of 111wesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies Building Official _ L014 4,14 Variance TOTAL t-50 7771 a CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for SF DWG/GAR Est. Value $148,00) Date M &Y 1 1941- Site Address 1531 BLACtCi"K LAKE DIR OFFICE USE ONLY Lot 4 Block 1 Sec/Sub$LACKHAWK RIDrE 21 ID Parcel No. Occupancy -R-31°-1 FEES Zoning EA 0: Name VAGNEK HOES w (Actual) Const Bldg. Permit. o Address 146030 TENTH AVE 3 (Allowable) V-N City BURNSVILLE Phone 431-7357 # of stories Surcharge 74.00 Length # Plan Review 525. Q~ Zo Name SAS Depth ' SAC, City 100.00 ucc Address S.F.Total SAC, MCWCC 650.00 City Phone S.F. Footprints Water Conn 660+ On Site Sewage 81 5 Name On Site Well - Water Meter 95000 Xz--y Address MWCC System + a W City Phone City Water_ Acct. Deposit30 PRV Required X S/W Permit JQ100 1 hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge • information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Treatment PI 276.00 Signature of Permitee _ APPROVALS Road Unit 370.00 A Building Permit is issued to: WAGNER HOMES 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 Building Official Variance TOTAL 31,618. 5t? l Permit No. Permit Holder Date Telephone # WATER SEWER PLUMBING 3L.( , ELECTRIC Inspection Date Insp. Comments Footings I Foundation Framing 6111 Roofing Rough Plbg. Rough Htg. 71s3~g~ Sri 5 ISUI. ~cT-9 Fireplace It'll Final Htg. Orstat Test ,er : t Final Plbg.4~ - Plbg. Inspector - Notify Plumber Const. Meter Engr./Plan Bldg. Final ~p Deck Ftg. Deck Final Well Pr. Disp. Address: ls~j lack 3 of Blk I Sec/Sub ed These items were/were not complete at the time of the final inspection. A-)z D @ : Yes No Tnspectore Final grade (6" from siding) L/ Permanent steps - garage LI/ Permanent steps - main entry L, Permanent driveway Ll~ Permanent gas Sod/seeded grass L/ Trail/curb damage Porch t/ 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. RECYCLED WPER White - City copy Yellow - Resident copy Pink - Contractor copy Request Date Fire No. Rough in Inspection f Required? Q Ready Now ill Notify Inspector s No When Ready? I licensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No. City Section o. Township Name or No. Range No. Cou Occup nt (PR Phone No. E w Supplier Address Electnca ontractor ( ompany Name) Contractor's License No. Ma ing Address (Contractor or Owner Making stallation) Authorize Signature tContractor/Owner king Installa Phone Number MINNESOTA STATE BOARD OF ELECTRICITY 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. p REQUEST FOR ELECTRICAL INSPECTION EB-00001-08 10. See inst;uctlons fof Tompleting this form on back of yellow copy. "X" Below Work Covered by This Request.. New'Add, Rep. 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: Compute Inspection Fee Below. # Other Fee # Service Entrance Size Fe # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Ab 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-'n Date certify that the above inspection has Final Date been made. OFFICE USE ONLY This request void 18 months from 33 191 4 6 3 -7s Request Date _ Fire No. Rough-in Inspection ,red? Q Ready Now III Notify Inspector Yes ❑ No When Ready? I licensed contractor O owner hereby request inspection of above electrical work at: JobAdAddress (Street, Box or Route No. City / 5-3 Section No. Township Name or No. Range No. County ^ Occ pant(PRINT) Phone No. Power Sup r Address Electrical C ractor (Compan Name) Contr ctor's License No. Mailing Address (Contractor or Ow tea 73 r klnstallati Authorized Si ture (Contractor/Owner Making Insta la n) l Phone Number - 1 MINNESOTA STATE BOARD OF ELECTRICITY 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-00001-08 r, ► See instructions for completing this form on back of yellow copy. X" Below Work Covered by This Request 36 63`f ew Add Rep. TypeofBuilding Appliances Wired Equipment Wired Home jDryer ange Temporary Service Duplex ater Heater Electric Heating Apt. Building Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Contractor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee Circuits/Feeders e Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps 100 Amps Signs Inspector's Use Only: ~~r..O TO~~ Irrigation Booms ' Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 1 ONTHS. I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final { Dacv~ p been made. OFFICE USE ONLY ` This request void 18 months from - f~l~ " ~ - Request Date Fire o. Rough-in Inspection Required? jk] Ready Now 0 Wi11 Notify Inspector T/2/92 G Yes ~ No When Ready? 1 licensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) City 1531 Blackhawk Lk. Dr. Eagan Section No. Township Name or No. Range No. County Da ota Occupdnt(PRINT) Phone No. June Tucek 686-905 Power Supplier Address Dakota Utilities Co. 4300 220th St. Farmington, MN Electrical Contractor (Company Name) Contractor's License No. Total Electric, Inc. 039842 4 Mailing Address (Contractor or Owner Making Installation) 1537 92nd Lane N.E. Blaine, MN 55449 Authorized Signature (Contractor/Owner Making Installation) Phone Number 786-8484 MINNESOTA STATE 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. 7 2, ;ESee QUEStT~ FORoELECTRICAL hINSPECTION EB•00001-08 "X'=^'Below Work Covered by This Request 7 New Add Rep. Type of Building Appliances Wired Equipment Wired X Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm X 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 Inspector's Use Only: TOTAL Irrigation Booms C~~ ~ 15.50 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 Dat been made.r OFFICE USE ONLY This request void 18 months from 2005 RESIDENTIAL BUILDING PERMIT APPLICATION } _ City Of Eagan p ,v CJ 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 ~C New Construction Requirements Remodel/Repair Requirements btficp LM.Onlu Y 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copses of plan Cert of Survey Recd N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd Y - ICJ, 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres RequiredY 111 1 set of Energy Calculations Addition - indicate if on-site septic system On site:Septic S} stem Y _ 4 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) Date S7 O <5- Construction Cost' 3 U Site Address ~Unit/Ste # Description of Work QT R ~ ~ s~J I gyp` Multi-Family Bldg _ Y N Fireplace(s) l ) ~1~rW~7 ) Property Owner Telephone # (65 L4 Contractor N I r 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 (,l 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. ) 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 approval of plans. Applicant's Printed Name Applicant'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 3; 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 (Entire 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 JY 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 TA/ L) ca t.~r Treatment Plant License Search ~r Copies ir~fi Other Total *,S76,2005 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date / 10 / Site Street Address 15 LIZ, Unit# Property Owner Telephone # (~ci ( ) Contractor _ AJ ~ A Telephone # Address City State Zip The Applicant is: X Owner _ Contractor Other Alterations to existing dwelling $ 50.00 X Add plumbing fixtures (excludes water softener and/or water heater--complete next section if installing these appliances). -Septic System Abandonment .Water Turnaround (add $125.00 if a 5/8" meter is required) Other: Water Softener Water Heater $ 15.00 new _ replacement Lawn Irrigation lRPZ _PVB new -repair _rebuild $ 30.00 State Surcharge $ .50 Total $ S -b I hereby apply for a Residential Plumbing 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 plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a plan is required to be reviewed and approved. TDam Applicant's Printed Name Applicant's Signature PERMIT -NTY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 031850 (612) 681-4675 Date Issued: 04/23/98 SITE ADDRESS: 1531 BLACKHAWK LAKE DR LOT: 4 BLOCK: 1 BLACKHAWK RIDGE 2ND P.I.N.: 10-14401-040-01 DESCRIPTION: Building Permit Type DECK Building Work Type NEW Census Code 434 ALT. RESIDENTIAL REMARKS: PLAN REVIEWED BY MIKE BARCK FEE SUMMARY: Base Fee $50.00 Surcharge .50 Total Fee $50.50 CONTRACTOR: OWNER: - A p p l i c a n t r DIETZ PETER 1531 BLACKHAWK LAKE DR EAGAN MN 55122 (612)778--5469 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 Mn. Statutes and City of Eagan Ordinances APPLICANT/PERMITEE I TUBE ISSUE01 BY.SIGNAIMFIE 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF FACUM 3830 PILOT KNOB RD • 55122 $81-4675 Nov Constrwion ReQuir Mnts RemodeURettair figQWMments ♦ 3 registered site surveys ♦ 2 copies of plan # 2 copies of plans (include beam & window sizes: poured Ind. design; etc.) ♦ 2 site surveys (e)derior additions & decks) ♦ 1 energy calculations ♦ 1 energy calculations for heated addition$ 3 copies of tree preservation plan If lot platted after 7/1/93 required: _Yes _ No , DATE: 4 / 1- IqP, CONSTRUCTION COST; = 3,U a DESCRIPTION OF WORK: STREET ADDRESS: C, v, LOT: BLOCK: SUBD./P.I.D. #:.On,ll: Li~S_ILIS~ : Name: Phone (A.1 z.- 'l ~y 6 PROPERTY Last First OWNER Street Address: S 3~ C~ city State: r Zip: l 22 f,J Company: Phone CONTRACTOR Street Address: License # city State: Zip: ARCHITECT/ ENGINEER Company: Phone Name: Registration Street Address: City State: Zip: Sewer & water licensed plumber (new construction only): Penalty applies when address Mang and lot change is requested once permit is issued. I hereby acknowledge that I have read this application and state that the information is correct and agree to Comply with all.ap l State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY 17 Certificates of Survey Received Yes No 11E Tree Preservation Plan Received Yes No Not Required a OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-plex ❑ 13 Garage/Accessory ❑ 20 Public Facility ❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous ❑ 05 SF Misc. ❑ 10 ---.:piex X15 Deck WORK TYPE x-31 New ❑ 33 Alterations ❑ 36 Move ❑ 32 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MCIWS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Buster Pump Length sq. ft. Census Code. 13 Depth Footprint sq. ft. SAC Code Q Census Bldg Census Unit APPROVALS Planning Building Aw Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MCJWS SAC City SAC Water Conn. Water Meter Acct. Deposit SJW Permit S/W Surcharge Treatment Pl. Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units 2472 Enterprise Drive PIONP-M Mendota l leights, MN 55120 * er~g* (5 r1g.. (612) 681--1914, Certificate of Surve r: NORM 1 ~ 4ti.ey sN 3 B o P fl _ b e r Ito ~i M I 4 4 ;Far - ~z.56 to FAQ ~ YI e ~Z I 3o.67N IV. .i • - t .t »s. A < 15-0 M Z Z 10 ~Y s r P RN. soo.o Denote; ex4fin fllevaliOn -EWPO E ' .z E ZEIQN 9eo• o Denotes ro ced F evabbir ~ Q P P. Lower Foor' evafionn - - - - Denotes O dins e O&Y Easement Tod of Block Elevcr lion 45• f Denote-9 Draindlle now Arrows S Car4e Slab UeVal`iOn 9S , l3 Nnofes monument o Ow es Ot ~sel Nub Bearin s own ar i , A own ar55uR1ed Sub~ecl to E~asemerlfs n~ t>?ecor~d LOTt BL acu . BLACWHAWW RIDGE 2ND ADV. DAkoTA COMITY 1 hereby certify that it'll Is a true and correct representatinn of a survey of thr hmrmlmlet nt the ahnve rlntrrihr.l Iyrt . nrvl~of thr- Inrmrion I elf buildings, thereon, and all visible eneronchmints, it any. from or on said land. At turveyerl by me this~~iMy A-O. 19 ~ inch : 401C& - i inrn t n. ;wwi i i. ,z nr~, rrjo.. -taaot 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF FAGAN 9 3830 PILOT KNOB RD - 55122 651-681-4675 > 3 registered site surveys showing sq. ft. of lot, sq. ft. of house 2 copies of plan and 91 rotted areas (2Q%max1rn bt covareae aliftLed) 1 set of energy calculallons for heated oddilianns > 2 copies of plans (show beam & wkrdow sizes: poured fnd. design: etc.) 1 site survey for exterior additions & decks > 1 set of energy calculations > 3 copies of tr presemption plan @ lat-platled afto 7/1/43 DATE: y CONSTRUCTION COST. 02~~ °G nn /n1 , DESCRIPTION QP WORK: SOT G~ STREET ADDRESS: IS I /t AGe1 k t~ LOT:_ BLOCK: SUBD./P.I.D. C_ Name: r £r2 Ti / Phone PROPERTY Last red OWNER r- ~L- Street Address. 3 fem . City 24 r4'v State: Al /y Zip: v~L Company: l t S Phon* 5l' 2S CONTRACTOR (area code) Street Address: ~ W - CCf License A ,!d.,(°~fi~ Exp. City S s ~ 'K State: Zip. 57S . ARCHITECT/ ENGINEER Company: Name: Telephone area code ( ) Stre# Address: Registration: City State: Zip: Sewer & wager licensed plumber (reaulred for new construction ontvt: PeAcity applies when address change and lot change Is requested once permit is issued. I hereby acknowledge that I have read this application, state that the Information is c and agree to comply with aE op**W State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY C t icates of Survey Received Yes No Tta+e:Preservation Plan Received Yes No Not Requrced OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 4-plex ❑ 11 10-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 02 SF Dwelling ❑ 07 .5-plex ❑ 12 12-plex ❑ 17 Garage ❑ 22 Ponch/Addn. (4-sea. ❑ 03 1 of ! plex ❑ 08 6-plex ❑ 13 16-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 04 2-plex ❑ 09 7-plex ❑ 14 Apartments ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 05 3-plex ❑ 10 8-plex ❑ 15 Lodging ❑ 20 Pool ❑ 25 Miscellaneous WORK TYPE ❑ 31 New ❑ 35 Tenant Impr ❑ 39 Gas Line Only ❑ 43 Siding/Soffits/Fascia ❑ 32 Addition ❑ 36 Move Bldg. ❑ 40 Gas Insert ❑ 44 Windows/Doors ❑ 33 Alteration ❑ 37 Demolish Bldg.* ❑ 41 Wood Stove ❑ 45 Fire Repair ❑ 34 Repair ❑ 38 Demolish (Interior) ❑ 42 Reroof * Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. SAC Code UBC Occupancy sq. ft. No. of Units Zoning sq. ft. No. of Bldgs # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/ES SAC t City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: SAC Units SAC ITY USE ONLY 3830 F L04 KNOB ROAD CITY OT EAGAN LDATE: EAGAN, MN 55122~,S/,-cT # PHONE: (612) 45*-& &G- PT # CENTA3<'It C r RSDE#3ZAT; PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION FEES NEW CONST ADD-ON MINIMUM $15.00 ADD ON HVAC 0-100 M BTU 24.00 REPAIR ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 ~ OF 1 PER PERMIT OWNER NAME : ~ l1't~f ~ SUBTOTAL: $ SITE ADDRESS: I STATE SURCHARGE: .50 L^vT : ~ E:.OCK ~ SUED . TOTAL: $4'j-- INSTALLER: JU lS .&_cLy' r3._jze p' `z., /ti''& r ADDRESS : ! elf 01'`t~,+~y Y A- SIGNA E PERMITTEE ' f CITY: psf ZIP: 6`5 PHONE 9"ERC3AL/INDUSTRIAL;.: PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, APARTMENT 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. PROCESSED PIPING - $25.00 LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT # / 5 0? DATE : 5`A 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 ADD-ON MINIMUM 15.00 ADD ON SHOWER 3.00 3 REPAIR WATER CLOSET 3.00 4 BATH TUB 3.00 3 LAVATORY 3.00 3 OWNER NAME: 14 e, v KITCHEN SINK 3.00 3 LAUNDRY TRAY 3.00 _ 3 SITE ADDRESS: S HOT TUB/SPA 3.00 WATER HEATER 3.00 3_ 'iS LLOT:_~__ BLOCK SUBD. FLOOR DRAIN 3.00 L GAS PIPING OUT. INSTALLER: _ ~ ~1 u_y r PI L-c. k 4 4 e,_ (MINIMUM - 1) 3.00 3 1.50 ROUGH OPENINGS ~ t 70 ~ r r` ~'+ey~~+ev ADDRESS: OTHER CITY: We.S~ s VR Kam( WATER SOFTENER 5.00 ZIP: PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 PHONE # : SUBTOTAL ST. SURCHARGE .50 SIGNATURE OF PERMITTEE ~gsc7 TOTAL: $ tZMI~tEIAI2~IUST'RAT! 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 SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD p EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT # L" •1 'j' DATE : -e o2 D` PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION FEES NEW CONST ! x ADD-ON MINIMUM $15.00 ADD ON HVAC 0-100 M BTU 24.00 REPAIR ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 OF 1 PER PERMIT 9.00--- OWNER NAME: WAGNER HOMES INC. -3 SUBTOTAL: $33.00 SITE ADDRESS: 1531 Blackhawk Lake Dr. STATE SURCHARGE: .50 LOT: Irl BLOCK 1 SUBD. add- lut Of H TOTAL: $33.50 INSTALLER: FREMICKSON HEATING & A C , INC ADDRESS: 3650 Kennebec Dr. SIGNATURE OF PERMITTEE CITY: Eagan ZIP: 55122 PHONE 452-2775 i!4IEt A IDtI$;TR A-L PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, APARTMENT 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. PROCESSED PIPING - $25.00 LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN i 119ti - 4" W lqwqlr PERMIT APPLICATION CITY OF EAGAN SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS # OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. To Be Used For: Sing Le f ara . V ~/ome Valuation: $ T9ftr`;'BD(J'~"° Date: 4-24-91 (.includeA .Cot) Site Address 1531 81-ac%haawk Lake DAc ve OFFICE USE ONLY Lot 4 Block 1 FEES Occupancy R 3 M'( Zoning D R-1 Parcel/Sub _ 31-acMawk Ridge 2nd Actual Const \J-N Bldg. Permit 00 Allowable V-N Surcharge '7q,00 Owner Wa_gnefz Home] # of stories Plan Review S'ZS, Do Length SAC, City 1001 00 Address 14600 10th. Avenue South Depth 316' SAC, MWCC 6St> J0 S.F. Total Water Conn (5(1.)0' 0 City/Zip Code Bu1zn~v,i.Ue 55337 Footprint S.F. Water Meter 0a Acct. Deposit 0,00 Phone 431-7557 On site sewage- S/W Permit 0,0 On site well S/W Surcharge Contractor Wagne2 Home] MWCC System Treatment Pl. fob-) City water - Road Unit S1)0'4)0 Address 14600 10th Avenue South PRV V Park Ded. Booster Pump Copies City/Zip Code Burznjv.i Ue 55337 SUBTOTAL APPROVALS Penalty Phone 431-7557 Planner TOTAL / Council Arch./Engr. Planco .inc. Bldg. Off. a Variance Address 3435 Wa~jhiru oa Azi.ve City/Zip Code (Sagan 55122 Phone # 452-0724 ~ e 1 VA s • M U '74.00' >a•i10~' * l~ A :z:)1 j•50:," ` icy `fir 3 a;,t/ t i} X11 3,613-504- 3 °o v$= x_r 12. / Ll 1 II 't 2122 Enterprise Drive * {~~C1111~~p Mendota I1eights, MN 55120 ~t1 Mil3 e g ter- rrg 16121 681.1914 ~ ~t Certificate of Survey for: NORM /19, 43 84 ' ~ I ,v p i a ~ 38.0 ~ e ' v o IRO ~riE ~`r3'^ ~i 3q b mac, 3.33 ,7a NI Iv. 843,E r ~ ~ R= Zfi.zs r- .6,0 ev fiagr4WA r: 9oo.o Denotes ex An! E/evalion PROPOSED E II-IQ r 9eo•o Denotes ro ed Fevalli'ior N P. i owes Foor evatian 33,44 bMofes Uruina Wilih Easement Top of 8/ock Elevation 45. l4 Oenofes Drain e Flow Arrows Gara e Slab flevation r Denotes monument o Deno of Of lsef flub &crrin s shown are assumed Sub/ee'l' fo EcXSemer1ls nj ,qecord LOTA BL act BLACWHAWk' RIDGE 21VD Aoa. MOTA COUNTY 1 herehy certify that this Is a true nod correct representatinn of a survey of the houndmies of the above descOwd lane , ntid of the (oration 1 all buildhigs, thereon, and all visible encronchmdnts, it nnv, trorn or on said land. As wrrveyed by me thisk''day nt- vy' AM. 19C. ScQrlto 1 inch=-4O1%e r ° nrinrn r n. ~nvrr r r..!%. qtr! rare. 14 99i X121/4 MINNESOTA STATE ENERGY CODE CALCULATIONS BASED ON CHAPTER 5 OF THE r MODEL ENERGY CODE - 1983 EDITION Adoption Effective 1/1/84 Owner Phone Date Site Address LDT 14, 'EL"X 1 &4rAWAWk R OAK ZVP 4b1N ~ Contractor 1' Phone Building Classification: Type Ai (Single Family E Duplex)'_Type A2(Residential) (3 stories or less NOTE: Complete pages 3 and 4 first. (Other) (Over 3 stories) GENERAL INFORMATION H 1. Building Perimeter"/ -t d- Cj ft. 2. Wall height (ground to eave) V~ ft. , Cq~ . 2 3• 1. x 2. (above) gross wall area f, , ~i ft. j 4. Building dimensions (L) X (W) ft.2 roof & floor area 5. Square foot area of rim joist - Floor joist size (2 x . Q_ X Perimeter - Rim joist area = 1 ft2 ~5g 6. Doors - Area l p Thickness In. U factor i . Type of Construction Perimeter ft. Manufacturer • I 7. Total door's perimeter ft. 8. Windows: Manufacturer State approved U factor i TYPE SIZE AREA (Ft.2) NUMBER OF TOTAL FEET 2 EACH UNITS 9. Total ft.2 Glass 10. Fireplace area; Width X height = X Ft.2 11. Exposed foundation: Height X Perimeter X 1~ Ft.2 COMPLETION OF THIS FORM IS REQUIRED FOR ALL CON TRUCTION MA0 J R REMODELING AND BUILDINGS BEIN MOVED WHERE ENERGY, OTHER THAN THE MINIMAL CODE ALLOWANCE, IS USED. 12. Framing area = 10% of gross wall area..,..,;, 13. Gross wall area ft.2 Window area A7 ` f t .2 U windows . 'NO U x - A Rim joist area A ft.2 U rim joist = U x A- Door area A ft. 2 U door area - lc'-t- U X A =/0,1 PP;JI 0 ctz- to 2 ffi~8 ~ = U x A = F.i.~$0 Ce area A dz. ft. U Exposed foundation ft.2 U foundation = U x A .0(fI Framing area A Z71( ~00i 15~ _ft.2 U framing area U x A = 547 Net wall area A ft. U wall 10 U x A = 17172- U x (13B) TOTAL . . . . . . . . . . s 14. Gross wall area x 0.11 (A-1 single family & duplex = allowable U x A/Code (13. above) x 0.23 (A-2 other residential) x .23 (Other buildings) R x .28 (Over 3 stories) BTUH Must be larger thar A Zp x U Code • ' - I t'A 13B above 15. Ceiling framing area (Af) equals 10% of ceiling area or the, same as) 01 15A. Gross ceiling area - (L) x (W) _ ~2- ft.2 15B Joist area (Af) = 100/0' ceiling area = ~Z ft.2 15C. Net ceiling area (Ac) (15A - 15B) _ l Q ICU ft.2 U ceiling x A c= ~O-ZS x_21 = 2 ► U framing x A f= x Z 7i = 7- Jq_ Z 150. TOTAL'U x A . /i~' i 16. Ceiling area (15A) x 0.026 (A-1 single family & duplex - code allowable U x A x 0.033 (9-2 other residential). x 0.06 (other) . 0 7'co TH Must be l arger than .15D (above) A (15A) x U (code)= F (or the same as) 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 Zan. a 4 w x ~ = II~z5y 11 = I(I ZXX'26o = IOX3 = Zito 11A zp~('40 = II , o X g= 08,0 ilfl x49 = 1100 o 1~11 gyn.. Vi1 ~,O 2 ° ZA 0 R VALUE U VALUE inside air film WALL Interior wall ~ • 4S (Wall) U . l SECTION R Insulation Sheathing - L p(p 04 zj Siding • (O1 Outside air film .17 R TOTAL Z-3 • I Inside. air film .68 STUD Interior wall 045 SECTION ,41, stud R= (O.S (Framing) U • R j Sheathing 2.0(0 Siding .(01 Outside air film .i7 R TOTAL O Rn .68 Interior wall SECTION. - ; Insulation all U R . z xterior wall cover n , Exterior air. film' R -..17 R TOTAL Interior air film R= .68 Rin insulation 14. 00 JOIST '14 inch soft wood R=1.88 (Rim U R = Joist) ' Sheathing Exterior wa~I covering.(,o Exterior air film R= 7 R• TOTAL 14--1" • 4(p Interior air film R= .68 Insulation \ Foundation (Fdn.) U = R = Exterior air film R= .17 .07(0 R TOTAL 1 i 3 • - xposed Block r ad e 3. ~.rrr~~nrcv nlrlt .)rMI,L MOVYC R YTIll1E VALUE FRAMING CEILING 0.61 Air Film 0.61 3C0- Insulation Joist Ceiling 0.61 Air Film 0.61 KP Total R 4 1 OZ~j U=~ ,oZZ FLAT ROOF OR CATHEDRAL CEILING -~f A-Value R VALUE FRAMING CEILING _ 0.61 Inside air film 0.61 Ceiling Joist (stu ' Insulation Air space i~ Roof decking Insulation ~O.~I~ClgI~~C~r~.~y.~~~ • Built-up roof 0.17 Outside air film 0.17 Total R 1=U R dindow infiltration .5 cfm/lineal foot of crack tesidential door infiltration 0.5 cfm/square foot or door and minimum code requirement •lon-residential door infiltration 11.0 cfm/lineal foot of crack Jb 12" concrete block no insulation .47 R 2.1 Jb 12" concrete block insulated cores = .26 R 3.8 J5 12" lightweight block .32 R 3.1 Jb 12" lightweight block insuPted'cores z .12 R 8.3 J single glass = 1.13; with storm window .54 J double glass = .55 J triple glass = .41 All exterior walls and ceilings must have a vapor barrier (0.10 perm max.). savor barrier must be on the inside (heated side) of mall. lapor- barriers of the polyethelene thin film have no R.value. 4. _ Volume No. Cert*lf 1ae of T*Itle OWNER'S DUPLICATE CERTIFICATE Certificate No. 8 3 8 4 7 Document No. 215190$ District Court No. Transfer from No. 8 0 5 9 7 Originally regrstcrec t re 18th day of April 19 59 l'olume Forty page 59 State of Minnesota,] SS_ CouIity of Dakota. J •er.~ it r_.e~cC~, 1~.cr,„/ 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 wit: fee simple of and in the following described land situated in the County of Dahota and State of Minnesota, to wit: Lot Four (4), Block One (1), 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 laces 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`1V (~X~F3(0XXXXXXXXXXX KX• X''X1<~AXX the laws of the State of Pennsylvania. XXk1~XrXXXXXXXXXXEX'RkHXXXXXXXXXXXXXcCc R~XW. n ditedJ /'///,e)Ien/ 1 have hereunto subscribed my name and affixed the seal of my once, this 17th day of May 19 89 JAMES N. DOLAN Registrar of Titles (Seal) In and for the County of Dakota and State of Minnesota. ME3101UAi, of `.states, Easements or Charges on the Land described in the Certificate of Title hereto attached. DOCUMENT KIND OF DATE OF REGISTRATION DATE OF INSTRUMENT NUMBER INSTRUMENT MONTH DAY YEAR HOUR MONTH DAY YEAR AMOUNT RUNNING IN FAVOR OF SIGNATURE OF REGISTRAR 215904 Declaration f Pro ec ive oven nts ( nd other land ) Ma 17 1989 3:00 4 27 '89 - The Public James N. Dolan 239209 Pressure R ducin Valve gree ent and th Ian s) Between City of Eagan and Fe). 2 19)l 10:46 12 27 '9 - Meritor Development Corporati n James N. Dolan ffII lei t of ari ~z~m~ct~~f ~~ding ~t~s~,rrtt This ca4rwald issued pursuant t~ the rqutrements of Section 306 of Ae Odform Building Code Gat fft that at the time of in umwe thisstrucam was incompliance with the. v4dow ordinances of the City rWdagng kaldmg cmuftucdon or use. For the foUowitty l ` t 18484 R3 1 I'B VN OOMFACYTYPC W V 133 t " MM,- Lk, B1, = M M20 Date: 7/30/91 ppgq IN A CONSPICUOUS PLACE Y SEW .OR . 'J'ERrPEFtIUIIT OFFICE USE ONL* CS'f GRAN PERMIT DATE A'~t?b,f 91 r 3830 Pflot Knob Rd. WATER PERMIT # SEWER PERMIT # ~ P.O. Box 21'599- METER # B.P. RECEIPT # C Eagan, M~ 5512 , READER # B.P. RECEIPT CRATE 05=91 Al r METER SIZE ISSUE DATE X PRV BOOSTER PUMP SITE ADDRESS 1531 &ackhavA Luhe 04ive PERMIT REQUESTt=D LOT _41-BLOCK 1 SEC/SUB Bl"- th r A : icf e 2ru x SEWER WATER _ TAPS tUuaarre APPLICANT: rte ADDRESS: 14660 10th. Avenue South COMWNID X' RESIDENTIAL CITY, STATE i*WwyLl P-, i~? l ZIP 55337 PHONE: X NEW EXISTING' PLUMBER: Stan PdAsub ' - Ma4te/4 #3324 ADDRESS: 1018 'mound Sp4ing l e<urace I AGREE TO COMPLY WITH CITY OF CITY, STATE , ' f ZIP 55420 EAGAN ORDtks[ANCES: PHONE: OWNER: ADDRESS: SIGNATURE WHEN IIAETER,,ISUED CITY, STATE. ZIP PHONE: PLEASE ALLOW TWO "WORKING DAYS FOR PROCESSING. FOR STORIA SEWER P #di78 CflMTACT ENGINEERING DEPT. i 1591 U VUW LAU at RE: You, Sewei'& Watt~r Permit for the above prov&rty h 1 Garage (3507 Coacfrman Roast} until the,rt- twos is {ai4~kod fip x C WORKS (454-52M PON YOUR el EkMA T wATE41 w9 • " f yW . Your S¢wer & Water Permit for the above property,cannq- bu "f3orrvt~tN<t far_fi~~a fq~~~tC}.' reasons: Your Seer & Water Permit for the above, property has been cMptete t, #~t~t.th nae~t k 6i4"'at be issued or occupancy allowed until furttw-notice. GOMIJI~RCIIAL PROJECTS ONLY: Please pay for meter at City Hof, Meter she mti 'fib r confirmed.by Bill Adams or Dirk House (Plumbing Inspectors- 454-8100) beictrf, j strut ra, WARt*NG: BEFORE DIGGING, -,CALL LOCAL UTILITIES - TELEPHONq', *EC1rW,1' CtiA$. ET)P_, REQUIRED BY LAW: ' CONTACT COMMUNITY DE VELOPNIENT`DEPARTMENT_FOR WATER 1~~t t Secretary, Building Inspections Dept. i CASH RECEIPT CITY OF EAGA# 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 5--3 19 i~cerveo AMOUNT $ & DOLLARS loo 0 CASH HECK FUND OBJECT AMOUNT Thank You << BY 13225 Yeuow'-Posiirq ~ Pink-.File COW _ INSPECTION RECORD CITY OF. EAGAN PERMIT TYPE: sm Pilot Knob Road Permit Plumber: + 4 Eagan, Minnesota 55122-1897 bite issued: °3/9" (612) 681-4675 WE ADDRESS: I- 07T-,- 4 Kok K 4 .1 APPLICANT: P~tKt ~i R 1 . 1 01,A( (HAW tAiKF OR -PERMIT SUBTYPE: TYPE OF WORK: 1) IK F w FOOTINGS 4 Rl-*ARi(x PLAN RV IE,Wf1) Y 04IKU OA CV.. r. Pawik We. - POW& NNW, ELECiT"C KVAG t Insp.. ~aunsr►encs FOOT" FC'4t]PpL7 FPIAMW MOOFM t R May r MOM r TEST 1►tsm GYP DOAM E F*IW FRM HTfl OFMW TM BWT R.I. DECK FTfl FILM G CITY OF EAGAN TERMINAL CAsHIEW J13 r{, .y..,...,... yttl IU i Jol 167. 25 `i ~:7 •i i't '1t#.i `..~:f. :1.:.',:: ?_n± .:f !...il c: t!.,tl,;a.;, t•t,ei.:e.i.p iii. t y 7' r-. !..a TD; JAN' r ~;4~1•'t`~:~i;9n~':r~:~c~r a'6~:~'~~K~:?Nk~iK:~:'?k:~?~~~~:~~~3~?i:?k~!:~aK3K:~?~~~: CITY OF" F::A(:,AN TERMINAL. NO: 668 DATE4 04/84/98 TIME: WW45 1% NAME: PETER T DIETZ MO 9001 M.l. rsL_Ci••..!••iW4 LK 50.00 rr 205 9001 03i 1A.CKH0 Lit 0. Total Receipt Amount,". 50.50 USER TDu NANCY i~ ~:~:.:~t:#. ~::~':<~#%~~9~.:~ ~yF~'i:.?k?k:~F:~;::~:~F:?'~`~C~'. s~~?~:5;:~::>}:: iY;~• %it~k?4t?k~k~ PERMIT City of Eagan Permit Type: Building Permit Number: EA106714 Date Issued: 09/06/2012 of 3 a R Permit Category: ePermit Site Address: 1531 Blackhawk Lake Dr Lot: 4 Block: 1 Addition: Blackhawk Ridge 2nd PID: 10-14401-01-040 Use: Description: Sub Type: e-Windows/Doors Construction Type: Work Type: Replace Description: Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: Perry Firkus 2650 Minnehaha Avenue Minneapolis, MN 55406 612-276-1680 Fee Summary: BL - Base Fee $500 $40.00 0801.4085 Valuation: 500.00 Surcharge - Based on Valuation $500 $0.50 9001.2195 Total: $40.50 Contractor: - Applicant - Owner: Crew2 Inc Peter T Dietz 2650 Minnehaha Ave 1531 Blackhawk Lake Dr Suite 100 Eagan MN 55122 Minneapolis MN 55406 612 276-1680 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:EA115528 Date Issued:09/26/2013 Permit Category:ePermit Site Address: 1531 Blackhawk Lake Dr Lot:4 Block: 1 Addition: Blackhawk Ridge 2nd PID:10-14401-01-040 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Luanne Yang 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 - Peter T Dietz 1531 Blackhawk Lake Dr Eagan MN 55122 New Life Contracting Inc. 814 Grand Avenue St. Paul MN 55105 (651) 224-3442 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA158684 Date Issued:10/25/2019 Permit Category:ePermit Site Address: 1531 Blackhawk Lake Dr Lot:4 Block: 1 Addition: Blackhawk Ridge 2nd PID:10-14401-01-040 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Peter T Dietz 1531 Blackhawk Lake Dr Eagan MN 55122 (612) 710-3286 Pella Northland 15300 25th Ave N #100 Plymouth MN 55447 (763) 745-1400 Applicant/Permitee: Signature Issued By: Signature pit -0 For Office Use . Permit#: 5"! �'7C 1/ may C�Permit Fee: / q RE, Date Received. 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-56751 TDD: (651)454-8535 I FAX: (651)675-5694 JAN 03 LULU Staff: buildinginspections(@cityofeagan.com L 2020 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 1/3/20 Site Address: 1531 Blackhawk Lake Drive unit#: Name: Peter Dietz Phone: 612-710-3286 Resident/ 1531 Blackhawk Lake Drive Owner Address/City/Zip: Applicant is: Owner Contractor Type of Work Description of work: Bathroom up-grade Construction Cost: $10,000 Multi-Family Building: (Yes /No ✓ ) Company: Contact: Contractor Address: City: State: Zip: Phone: Email: License#: Lead Certificate#:tl— If the project is exempt from lead certification, please explain why: Replacement of existing fixtures COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. t 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.cityofeagan.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 underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.orq 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 Peter Dietz x Date: 2020.01.03 14:52:51 -06'000' Applicant's Printed Name Applicant's Signature A DO NOT WRITE BELOW THIS LINE /S I E `ACC I1A-t0 /* �G 7 0 SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) 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 0�� I Valuation9( Occupancy MCES System Plan Review Code Edition 7MS SAC Units (25%_ 100%x ) Zoning )j City Water Census Code 1 Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction 1�,� Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings(Addition) Final/No C.O. Required Foundation Foundation Before Backfill HVAC Service Test Gas Line Air Test_Hood Roof:_Ice&Water _Final Pool:_Footings Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test Final Siding:_Stucco Lath Stone Lath _Brick_EFIS 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: 11, , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC 64 , Utility Connection Charge (II S&W Permit&Surcharge V /� Treatment Plant ç\Lc' ),, (j Radio Meter Read Copies I/ ( a, 0-0 TOTAL \INI\l ?-10/ . Page 2 of 3 For Office Use [ E e oo Permit#: 7 / � �� Permit Fee: (1/ 943 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 JAN 0 3 2070Date Received: /— -` (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspectionscitvofeagan.com L 2020 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 1/3/20 Site Address: 1531 Blackhawk Lake Drive Tenant: Peter Dietz Suite#: Resident/Owner Name: Peter Dietz Phone: 612-710-3286 Address/City/zip: 1531 Blackhawk Lake Drive Name: License#: Contractor Address: City: State: Zip: Phone: Contact: Email: Type of Work —New 1 Replacement _Repair _Rebuild Modify Space _Work in R.O.W. Description of work: Up-grade fixtures in bathroom Tankless Water Heater Lawn Irrigation( RPZ/_PVB) Standard Water Heater Add Plumbing Fixtures( Main/ Lower Level) Description Water Softener Description: Septic System New Abandonment Connection to City Water from Well — — 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 New fixtures, adding or removing piping (includes State Surcharge) $60.00 Septic System Abandonment $100.00 New Residential (fee collected with Building Permit) $115.00 New Septic System (includes County fee and State Surcharge) $60.00 Connecting to City Water from Well" +$290 for Meter and $200 for Radio Read = $550 `Sewer&Water Permit also required for connection charges TOTAL FEES$ 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.gopherstateonecall.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.citvofeaoan.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 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. Date:2020.01.03 x Peter Dietz x 15:00:27-06'00' Applicant's Printed Name Applicant's Signature Page 1 of 2