Loading...
1580 Blackhawk Lake Dr R Use BLUE or BLACK Ink /y p For Office Use l 7 :-R 1 of E I Permit ( ''7 !1 y 11 t,n I Permit Fee: ' v I 3830 Pilot Knob Road Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: l_ - - - - - - - - - - - - - - - - 2011 RESIDENTIAL BUILDING PERMIT APPLICATION Date: I ( _Site Address: 15Q -5&Xk&9V- LL Dr" 9&'X0Lr7 . I'rll 1~~.... Tenant: Suite RESIDENT / OWNER Name:12,muc nn 1V ej,- Phone: (~5►' ~3-?7f ~ Address / City / Zip: L~~gC~'~hrt- pr' eta an. tT1N 5t5 Applicant is: Owner Contractor TYPE OF WORK Description of work:.. MrtS'i-+<~/ ! 0.rYt 't't W'e-bA) h,rlmwe ~_S Construction Cost: Multi-Family Building: (Yes / No CONTRACTOR Name: License Address: City: State: Zip: Phone: Contact: Email: 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: 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. 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.aopherstateonecall.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 f p lans. accordance with the approved plan in the case of work which requires a review and apn...' xr x Applica s Printed Name Applic s Signature Page 1 of 3 I DO NOT WRITE BELOW THIS LINE 7 / 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 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 MCES System Plan Review Code Edition w 7 SAC Units (25%_ 1000/0Z Zoning City Water Census Code 3y Stories Booster Pump of Units 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: Afwt~ Building Inspector R=441 64 RESIDENTIAL FEE 55-4 (!S,) Aa Base Fee Surcharge Plan Review ~Gr.. MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 Use BLUE or BLACK Ink j For Office Use I Permit q77-,~;21 City of EaEdn j Permit Fee: roc I 3830 Pilot Knob Road I I I Eagan MN 55122 Date Received: r I I Phone: (651) 675-5675 staff: j Fax: (651) 675-5694 2011 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 11,51I ( Site Address: MRV R[QL:jaAJ((_ T~P- L~QRG~ y. M A) I Tenant: Suite RESIDENT I OWNER Name: Pol.t-e-yo, 4.r ti Phone: (-2D_r77!,& ~ Address / City_ / Zip: CONTRACTOR Name: License Address: City: State: Zip: Phone: Contact: Email: TYPE OF WORK _ New _ Replacement _ Repair _ Rebuild _ Modify Space - Work in R.O.W. Description of work: bAj1L%MdVn C' RESIDENTIAL / PERMIT TYPE a S ner ~ Water Heater Lawn Irrigation RPZ PVB) Add Plumbing Fixtures C_ Main Lower Level) Septic System Water Turnaround _ New Abandonment 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) 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.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 appr plans. x x a h ~ App lica Signature lame App FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final SEWE" AT'ER PERMIT P IC E USE ONLY OIF CITY dF fAdAN METER # PERMIT DATE' 10/10190 3830 Pilot Knob Rd. 11671 Eagan, MN-15122-189,7 CHIP 8 4 PERMIT # , ' METEf't`SIZE B.P. RECEIPT # DATE OCT 9* k990 ISSUE DATE 2 f' 96 B.P. RECEIPT DATE 1010919 PRV -BOOSTER PUMP SITE ADDRESS 1580 BLACIGUW'K LAKE DR PERMIT REQUESTED LOT 17 BLOCK SEC/SUB BLACKHAWK GLEN 39 T E' A SEWER WAVER -TAPS, APPLICANT: ADDRESS: COMM/INDRESIDENTIAL CITY, STATE ZIP NEW EXISTING PHONE: Lawn Sprinkler Meters are to be Installed PLUMBER: Ahead of Domestic Me rs on Water Linda ADDRESS: Cre it WIL NOT be giv for Deduct Meters:. ~ s A CITY; STATE Zip S§378 PHONE: 894-7600 w_. I AGREE COMPLY WITH CITY OF OWNER: KEYSTONE BUIL019RS COIF EAGAN ORDINANCES ADDRESS: 201 BUDGE ST _ CITY, STATE SHOREVIEW, MN ZIP 8126 PHONE: $3- SIGNATUREVkN METER ISSUED. PLEASE ALLOW TWO WORKII DA S FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. SEWER~& WATER PERMIT OFFICE USE ONLY CITY-OF EAGAN METER # PERMIT DATE 3830 Pilot Knob Rd. ; C 71 Eagan, M05122-1897 CHIP # PERMIT # I METER SIZE B.P. RECEIPT # DATE sCT ISSUE DATE B.P. RECEIPT DATE PRV - BOOSTER PUMP SITE ADDRESS 15 ~ BLA4:i i' W", PERMIT REQUESTED LOT 1. BLOCK -t-SEC/SUB TLAU 1=AV.e GLEN 3RD SEWER WATER TAPS APPLICANT: ADDRESS: COMMIIND RESIDENTIAL CITY, STATE ZIP X NEW EXISTING ' PHONE: Lawn Sprinkler Meters are to be Installed PLUMBER: # Ahead of Domestic Meters on Water Line. ADDRESS: l c'7 a Z t ~ 14"At , V Credit WILL NOT be given for Deduct Meters. CITY, STATE ZIP d PHONE: 39 -"76-0c ' I AGREE TO COMPLY WITH CITY OF OWNER: °Y T 3 E BUILDERS L`OPP EAGAN ORDINANCES ADDRESS: 1-01 BR10CE ST CITY, STATE StCtt E, , i' ZIP 551 -:5 PHONE: 4tA 3--x 156 SIGNATURE WHEN METER ISSUED PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. OCT 10, 1990 DATE: RE: 1580 BLACKHAWK LAKE DR (KEYSTONE BUILDERS CORP) X our Sewer & Water Permit for the above property has been completed. It will be held at the Public Works Garage (3501 Coachma~ Road) until the meter is picked up. BE SURE TO CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON. Your Sewer & Water Permit for the above property cannot be completed for the following reasons# Your Sewer & Water Permit for the above property has been completed, but the meter cannot be issued or occupancy allowed until further notice. COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance. WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC. - REQUIRED BY LAW. f CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building,.Inspections Dept. Address: 1580 BLAUMAWK LAKE DRIVE Lot17 Blk 1 Sec/SubBLACK M G Vq 3RD These items were/were not complete at the time of the final inspection. DATE: JANUARY 7, 1991 Yes No INSPECTOR: Final grade (6" from siding) Permanent steps - garage / Permanent steps - main entry Permanent driveway I Permanent gas Sod/seeded grass Trail/curb damage J Porch / Basement finish / Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. White - City copy Yellow - Resident copy Pink - Contractor copy Request Date Fire No. Rough-in Inspection Required? ❑ Ready Now Will Notify Inspector I Yes ❑ No A When Ready? Ix licensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street, Bo r Route No.) City 15 16 I.Ac /4- GAS` Section No. Township Name or No. Range No. County 0A V, O Occupant (PRINT) Phone No. `Z tl1 %,(i L~ Power suppAplieer Address D07A E4C~'C74ie' C~ MAJ h AJ 550 :2 Electrical Contractor (Company N e Contractors License No. Mailing Address (Contractor or Owner Making Instaila] n) 0 44 55112 Autho Signature (Contr r/Own king Installation) Phor(e Number l -11 A MINNESOTA STATE OARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1621 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0600 ENCLOSED. { REQUEST FOR ELECTRICAL INSPECTION 'r« B-oooot-o~ jo~ See ins_tructons foircompleting this form on back of yellow copy. F 49,686 X" Below Work Covered by This Request ew Md R TypeofBuilding Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Contractor's Remarks: Compute Inspection Fee Below: 26, 0-o j G # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 00 pm s -f„ 0 to 100 Amps . f Transformers Abov-e-MU Amps Ps tK; Signs Inspector's Use Only: S Z C Irrigation Booms L~ L Special Inspection f Alarm/Communication Other Fee 1, the Electrical Inspector, hereby Rough-in Dat _ certify that the above inspection has Final Date been made.& OFFICE USE ONLY This request void 18 months from R A AL S Request Date Fire No. Rough-in Inspection Required? O Ready Now ❑ Will Notify Inspector [ `'yes ❑ No When Ready? I ❑ licensed contractor owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) Gty Is . 0 (-1,64)9~ ~ ti i k- E A 6 Section No. Township Name or No. Range No. County Occupant (PRINT) Phone No. • k tD ij'K Wj C3~~lo Power Supplier Address Electrical Contractor (Company Name) Contractor's License No. p l,,J V--N e (Z.~ Mailing Address (Contractor or Owner Making Installation) Authorized Signat ontractor/Owner Making Installation) Phone Number tT.r~~L 1 _ C MINNESOTA TE B ARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midw 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. I 111-9191 REQUEST FOR ELECTRICAL INSPECTION EB-00001-07 ► See instructions for completing this form on back of yellow copy. S~ t "I -A x L ♦ ! `y G -X" Below Work Covered b This Request New Ad Rep. TypeofBuilding Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Contractor's 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 Aboye 100 Amps Signs Inspector's Use Only: TOTAL Irrigation Booms 1D S 0 Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN IS MONTHS. I, the Electrical Inspector, hereby Rough-in Dat: ~ r certify that the above inspection has Final Date been made. OFFICE USE ONLY This request void 18 months from 2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 '%mAse complete for: single family dwellings & townhomeslcondos when permits are required for each unit Date; Site '.A'' , G Aa.4W Unit # Property Owner ....G... J Telephone # ((,S/) Contractor !lli~ t A~ Ma Street Address =53 UU MR am j~~ ~-l City State Telephone # ( ) Bond / y Expires: The Applicant is Owner Contractor Other Add-on or alteration to existing dwelling unit $ 30.00 furnace Additional JL/Replacement air exchanger air conditioner New _Replacement other State Surcharge $ .50 Total $ I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; 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 tit #i accordance `with the approved plan in the case of work which requires a review and approval of plans. = flu.) LU ~ fl U Applicant's Printed Naive Applic s Signature APR 0 ~ 2005 By 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 53122 Telephone # 651-675-5675 Please complete,for: commercial/industrial buildings multi-family buildings when separate permits arc SI?1 required for ewh dwelling unit Date / l Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # { ) Contractor ftm =A IBM Street Address State Zip ) Bond 9xpires: The Applicant is Owner Contractor Other Work Type New Construction Underground Tank _Install _Remove **see below. _ Interior Improvement _ Install Piping -Processed -Gas- Nature of Work: **Men Inatallinglremoving underground tank, call for Inspection by Fire Marshal and Plumbing Inspector Permit Fees: $70.50 Underground tank installation/removal 550.50 Miia = (includes State Surcharge) or Contract Value $ x 1% _ $ Permit Fee • If permit fee is $1,000 or less, add $.50 $ State Surcharge If DeCM t fee is over $1,000, add $.50 for every $1,000 remit fee $ Total Fee I hereby apply for a Commercial Mechanical 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 with the Mechanical Cues; 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. Applicant's Printed Name Applicant's Signature Approved By: Inspector Date: CITY OF EAGAN NO 18440 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # e- t0~31 To be used for SF DWG/GAR Est. Value $149,000 Date OCT 9 199.0__ Site Address 1580 BLACKHAWK LAKE DR OFFICE USE ONLY Lot 17 Block 1 Sec/Sub. BLACKHAWK GLEN 3 FD Parcel No. Occupancy R-3 M_1 FEES Zoning R-1 W Name KEYSTONE BUILDERS CORP (Actual) Const L-N Bldg. Permit 811.00 o Address 201 BRIDGE ST (Allowable) VVN Surcharge 74.50 City SHOREVIEW Phone 483-8256 # of stories Length 811 Plan Review 527.00 Zo Name SAME Depth 6' SAC, City 100.00 Address S.F. Total uF SAC, MCWCC 600.00 City Phone S.F. Footprints Water Conn 625.00 On Site Sewage W W Name On Site Well 90.00 w Water Meter ~z, Address MWCC System -X_ 30.00 aw City Phone City Water X Acct. Deposit PRV Required X S/W Permit 30.00 I hereby acknowlege that I have read this application d state that the Booster Pump S/W Surcharge .5o information is correct and a~gqree to comply with all plicable State of Minnesota Statutes and Ci(~fbf ag n X nceS. Treatment PI 252.00 Signature of Permit++~~~~ APPROVALS Road Unit 355.00 A Building Permit is issued to: t YSTONE UILDERS CORP 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 ! y, 11'i,.(I Variance TOTAL _3,_495-00 r Y 1990 BUILDING 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: FD 6A R Valuation: 1'49, dC)O Date: 10 C'L Site Address 1 [~~~b 1x, OFFICE USE ONLY Lot Block FEES Occupancy -3 Zoning p © o Parcel/Sub _ 1,~Kr)v1'A OA ual Const Y- N Bldg. Permit Allowable V-N Surcharge 04,St? Owner # of stories Plan Review G?Mo0 n Length sre_ SAC, City 100,30 Address 21/,zy~f~ Depth (~,r] SAC, MWCC 00,00 S.F. Total Water Conn (17-Si City/Zip Code s41 r"-(6'j Footprint S.F. Water Meter 190,00 93- Acct. Deposit 0,Oa Phone L/ Z j b On site sewage- S/W Permit 30,00 On site well S/W Surcharge 0P Contractor~lc MWCC System Treatment Pl. City water Road Unit Skoo ~ Address 2-,L-1 6 /-1 PRV Park Ded. 1 Booster Pump Copies City/Zip Code 5V1u/J~ ► SUBTOTAL r APPROVALS Penalty Phone b 3 S 2 ' Planner TOTAL Council Arch./Engr. Bldg. Off. t9 Variance Address City/Zip Code Phone # r VA ~-U` /~~C' t tJ . X27,33 2y &s G f- X? ~ x.Y r) 2 11,6 616f Na(.5i5,7 ix6= 9 ; Sy x2(: '?Z$ ly~to= (R`I) ZJcZ - y ~ X ~ x, s - C I?3 Zo 9~( X65=- ~ 3 G U 3S r I OCT-09-'90 TUE 09:16 In:JAMES R HILL INC TEL NO:612 854-9518 #541 P02 SURVEYOR'S CERTIFICATE KEYSTONE BUILDERS RIVE L 833.2 r AW r e3s.r 8331 o Aga 41` 54N R=450-86 ~ R'033.$ 33 4) 833.7 ,nR C~2 s 1 10 in 0 I p rV,~ \0 0 BENCH MARK ^ 83 4R9 F TOP PIPE y~ 24& v~ ¢ 1 . . • 832.L3 ELEY YO o O ^I 33.5 , IV) a R• ° O BEN TOPCOF P PE 833.4 1 ry 60 Ei.EV9 835.48 ` 835.4 83 1 fl 1T-` -V21.89 1.33 - - - 1n w 833.91 Q 25.80 ~ 3Q8 30 M r ~ / M O % M ~f1, N 830.1 O P HOUSE 12x.4 828.0 1 0 .0 ;81 W25.9 L2 F / ( 1750- 14.0 V) 0 8279 N 1 ~ in ~ 10 r w LOT 17 911 pG~ @P~R P ~ {Yj14,1~ 9 PS ~ Y ~1~ .z- ~ 3 a:. loo 96~ G DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 836,3 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 0Z(3-(,P FEET ET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - ff R.V. RE( t WE HEREBY CERTIFY TO KEYSTONE BUILDERS THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 17 Block I BLACKHAWK GLEN 3RD ADDITION, according to the recorded plat thereof, dakoto County, Minnesota, IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 5 TH DAY OF OCTOBER , 1990 APPROVES FOR SIENNA SIGNE R. HILL, INC. CORPORATION 4Y; B JOHN C. LARSON, LAND SURVEYOR DATED, MINNESOTA LICENSE NUMBER 19828 r"-~Mkoo(D0 7Q- a mesR.Hi inc. O r 0 0 v L D O o ~ 0)> m m Z PLANNERS / ENGINEERS / SURVEYORS -n ZO rl m ~ O m 9401 JAMES AVE. S. BLOOMINGTON, MN. 55431 • 612-884-3029 o w e VE:L OPG AVCnAC;E U. CoMp JTATICN EXTERIOR FN OWNE r1 ~LaGK ~ ~t,acK,NAv►'~K ~c.E.r1 SITE ADDRESS L6T CONTRACTOR t PHONE DAT .E _ Determine working square footage of each. sq. ft. x wall area ' 07) 1 Total exposed . da .025 = v. ft. x p q• 2. Total roof.ceiling area s Total exposed wall area above floor X44 Total wall window area a• a,•..........•••••• b . TC==l doet .atAA c. Total sliding glass door area. . wall area.. d. Total fireplace e- Total wall framing area (average 10%).• f. Total net wall area above floor • • y g• Total rim joist area- - Total exposed foundation area M, r window area..... ' ..h• Total foundation zacie•..•••••••••'"•' i. Total net foundation area above g Determine "U" value of each wall segment. ~ r = X «U» r _ 0 X "U" C.- \ X «U« d. . G - U-e• X g• X MU" h. X U. 1. l l .............:......................Total I: item N3 is t)jc same as, or loss than item 11, you have met the intent of SBC 6006(c)2. . ' .Total exposed roof/ceiling area OP • Total skylight area rf..: k. Total roof/tailing framing area (average 10%)........ ;a 1. Total net insulated roof/ceiling area Determine "U" value for each roof/ceiling segment. X .U« X .U.. k. I J X NUN Total Gr+~? a ,Ca If total of #4 is the same as, or less than t2, you have met the intent of SBC 6006 (c)1. Alternate Building Envelope Design To utilize the total envelope system method, the values esstfabliisshe~lby thN2. and sum of items N3 and #4 shall not be greater than the sum its 1. f - 3. + 4. - l PL..A Q 4iF L r m EAL FT, EXPOSED WA L L SLOG k. L' \lq (fjoc' FULL I TZ 1 M : 252 Sa.. ;'-r, x.PoSaD WAU... AR.' EA X 57 4w E.F. Oo -ft l a °o X~ = x'12 W. 0. BULL ?.'j X 6 A m5a..;:ts Ex oS~.D r~.i Uu ~ 4 wDwS T,).Zs u ?A-ric, tits , r =Or/CCZL1'-4c • Construction R-V Interior air film . O.Gl /yam 2. 5t h'( S . SR 11(1''•' 3. U. Lxturior air film (still) 0. 1-02 FMS ` • Hcat flow 1• lotnrior air t, ila 0.61 _~ttd 2. 678-0 3 UL, • 4. r.xtrt_ i c%-. riii tri (sti 1 ' Total 2. 9 x,15 0.61 ......v.... _ _ ~ ~ 1. ?naidc air- Ella Z 1• S. Outside air film 0.1 ~ ~ n = Lil~ zot,a~ • IC.~~►~•► F . 1 Z 3 4' 1; 2n~ sideI tilm 0.61 xCat floe vp • ~•ventLd • ' • S Outside air files- OM • % ' Total 3 5 ' v 1. in,V: air film 0.61 • •N i.. 40 - - - • . S. Outzide air film o . 17 M • ~ • YG:J-Q't?TLD'• . • ~t~;~s vso additional abeets Lf •oro zpaec • aeaded for vstails and tolculatims • Neat • • . flow up L: Ua% l.1 c : ciolwi w4l 1 Ar••a for cc,u:.t rvct lun i@.u r.•-.~., t,, s1C 4. fatteri.:p fir MIN u.17 Till U~ .01 FIG. it TGl'Y2111 OF A.R1t • l1Wte HALJ. 1. lntertd.r air Mn 2. ~ii~ ^e . 6. Extr•ri(Ittair x.11 rlc. 12 Tula'-ti ~ Z-Z 3. Zt~..ID..._K.~•r...~.~s.•~ _._.._..._.I.~ eg~ -01 ' o r ,n. • •1~ G. I:.ct.•ri'r•r .•.r•:1.1H - - V-Z.i .am ' laJ11~ cltl raaUt: aaalla, • • ..j • / ir - . . j % 0 lit • r 1'lt:. 14 lIt i lit lzf~, Itt lit . . 60 Cap • • r t ;*m:: tnil lcatt ty•,C. •!t" vilua. 4100th and . ~1um ~ i nth rm i., ~ o SITE ADDRESS ~~a U`CUnit # Permit # u t¢ -~ccncen . it.3. (~,c.cRrx~ to Jd L B l Sect./Sub. INSPEC ION INSPECTOR DATE COMMENTS R7 AZ2, 9 W INSPECTION INSPECTOR DATE COMMENTS J • ,60a+ti+i'° jeplo CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT # -1 'mm» > DATE : / RrlA' PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLLOWING: N0. FIXTURES EA. TOTAL NEW CONST ADD-ON MINIMUM 15.00 ADD ON SHOWER 3.00 REPAIR WATER CLOSET 3.00 _ BATH TUB 3.00 _ LAVATORY 3.00 OWNER NAME: JZI/ KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 SITE ADDRESS : _73 k yQtokl s{ A HOT TUB/SPA 3.00 r~ WATER HEATER 3.00 LOT: BLOCK SUBD. FLOOR DRAIN 3.00 GAS PIPING OUT. INSTALLER; YY1 e _ (MINIMUM - 1) 3.00 _ ROUGH OPENINGS 1.50 ADDRESS: vl a l OTHER WATER SOFTENER 5.00 CITY: Lit'- 44 h~ zip: PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 PHONE r ® 5 Zb X SUBTOTAL $ ° ! \ ST. SURCHARGE .50 IGNATURE OF TEE 4-50 TOTAL: ~ ?OMMEROIAL/1DUSTRIALs 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 Bnmrftw of String jnvtdtn "mC,entif witeisaW p=wW to *e cequ mnm*of won 3W of tke Umfw= Big codeo"fyft #W wAe&Wofk=a=A.sstr wuw Rusinc p&nw witht " " &-&nanc of Ae CVy:regrrAmft buf &g wnsirr%o*n or use loo.- t foltvwing. -T----- 201 saw > raam : nua &VOW , POST IN A CONSPICUOUS PLACE I, PLUMBING PERMIT For Office Use Only CITY OF EAGAN PERMIT # CONTRACT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT# PRICE PHONE 4548100 DATE: .40 -Ir Site Address 04 BLDP. TYPE WORK DESCRIPTION Lot Se ub Res.? New •x_b,:. Mults Add-on Name 9J'r~S p G ~i~ G Comm. Repair Address /d9,,~Sty -other r RES. PLBG. ONLY - COMPLETE THE FOLLOWING: c City R,,0C4 Phone NO. FIXTURES `TOTAL ys~'° % +~rf.l fC Water Closet - $3.00 $ Name _ Bath Tubs - $3.00 Address R Lavatory - $3.00 a! . as City Phone _.2 Shower - $3.00 .A4) Kitchen Sink - $3,00 Urinal/Bidet - $3.00 FEES / Laundry Tray - $3.00 COMM./IND. FEE -1% OF CONTRACT FEE / Floor Drains - $1.50 / ,[u APT. BLDGS. - COMM. RATE APPLIES'- Water Heater - $1.50-? TOWNHOUSE & CONDO - RES. RATE APLLIES Whirlpool - $3.00 T MINIMUM - RESIDENTIAL FEE $12.00 Gas Piping Outlets - $1.50 dl3 MINIMUM - COMM.IND./FEE $20.00 (MINIMUM -1 PER PERMIT) STATE SURCHARGE PER PERMIT .50 Softener - $5.00 (ADD $.50 S/C PER EACH ,000 OF PERMIT FEE) Well $10.00 Private Disp. -$10.00 r - Y Rough Openings - $1.50 , aoa SIG URE OF PERMITTEE U. G. Sprinkler System - $12.00 PERMIT FEE:' V FOR: CITY OF EAGAN STATES S/C: GRAND TOTAL: low MECHANICAL PERMIT For City Use Only CITY OF EAGAN PERMIT # 1 4 .1 21 3$30 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT DATE PHONE 454-8100 DATE: 1/~cL 124 BLDG. WP WORK DESCRIPTION Site Address Res. New Const. Lot I k Sec/Sub Mult. - Add-on 47 Repair Name Other Address City Phone FE;3: ~r RES. HVAC 0-100 M BTUG * 24.Ob+ Name ADDITIONAL 50 M BTU - 6.00 (RES. HVAC INCLUDES A/C ON NEW Address ~s1. CONSTRUCTION Phan TOWNHOUSE & CONDOS - RES. RATE APPbtt MINIMUM RESIDENTIAL FEE - ALL ADD-ON & REMODELS (INCLUDES GAS PIPING) - 12.00 TYPE OF WORK GAS OUTLETS (MINIMUM -1 PER PERMIT- o:ZA Forced Air : W M BTU $ NEW CONST.) - 1.50 EA, Boiler M BTU $ COMM/IND FEE -1% OF CONTRACT FEE Unit Heater M BTU $ APT. BLDGS. - COMM. RATE APPLIES MINIMUM COMMERCIAL FEE - 20.00 Air Cond. M BTU $ STATE SURCHARGE PER PERMIT . - 50 Vent CFM $ (ADD $.50 S/C PER $1000.00 OF PERMIT FEE) Gas Piping Outlets # $ Other tom And. Contract Price x 1% $ RMITTEE PERMIT FEE: S/C: OR; Cl OF E GAN TOTAL: JO ~/q ~ R L p r CITY OF EAGAN 3830 Pilot. Knob Road, P.O, Box 21-199, Eagan, MN 55121 18440, PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for SY I /GAR Est. Value $149,000 Date 9 19 _ Site Address 1?31o SLACKM 1 AU DR 77 N OFFICE USE ONLY Lit Block Sec/Sub. SLACKHAW FEES Parcel No. Occupancy Zoning 'Y$'= WILDERS CORP yll' +T 811400 w Name (Actual) Const Bldg. Permit 2M ST o Address 01 IE1RZl (Allowable) Surcharge 74.5 City B I Phone 483-.8256 # of Stories 527.00 Plan Review i Length i2 Name SAME 100,C)o Depth SAC, City 0< Address S.F.Total - 600.00 a SAC, MCWCC a City Phone S.F. Footprints 00 On Site Sewage Water Conn °w Name On Site Well 90.00 Fw Water Meter oo Address MWCC System 30.00 Acct. Deposit M7 W City Phone City Water 30*00 PRV Required SM Permit I hereby acknowlege that 1 have read this application and state that the Booster Pump . S/W Surcharge information is correct and agree to comply with ail applicable State of v Minnesota Statutes and City bf ag n rci ances. 252.00 PI Signature of Permitee i APPROVALS Road Unit 335*00 A Building Permit is issued to: XkYSTME ° ILDBR~S C(3RP 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 3,493.00 Building Official r Variance TOTAL, Permit No. Permit Holder Date Telephone # WATER C r llc le4o SEWER PLUMBING H.V.A.C. aye % 'r ~h' ~Ir ELECTRIC 414 Inspection Date Insp. Comments Footings I lQJ 0 III Foundation Framing !/11,1990 UJ6 Roofing !l~JS/91l7 we Rough PIbg. 1/ '00 AYW Rough Htg. Isul. 9 ha b5 Fireplace Final Htg. Final Pibg. . Q. J' Const. Meter Pibg. Inspector- Notify Plumber Engr./Plan / Bldg. Final Deck Ftg. Deck Final Well Pc Disp. CASH RECEIPT CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 5512/2 90 DATE r j 19 FROM AMOUNT $ q & DOLLARS '0 O CASH CHECK FOR ?440 t =412 IE&D k_ FUND OBJECT- 'AMOUNT y " Thank You BY -Payers Copy C 10,631 Yellow- P ti Copy Pink--File Copy PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA103281 Date Issued: 03/13/2012 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 1580 Blackhawk Lake Dr Lot: 17 Block: I Addition: Blackhawk Glen 3rd PID: 10-14352-01-170 Use: Description: Sub Type: e-Fireplace Construction Type: Work Type: Gas Fireplace (new) Description: Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: Improvements to the home may require smoke detectors in all bedrooms. Chimney flue must be inspected prior to concealin,. Carbon monoxide detectors are required bn law in ALL single family homes. Fee Summary: BL - Base Fee S3K $88.50 0801.4085 Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195 Total: $90.00 Contractor: - Applicant - Owner: Glowing Heath and Home LLC Roger G Oettinger 100 Eldorado Dr. 180 Blacldiawk Lake Dr Jordan NIN 55352 Eagan NIN 55122 (952) 492-9276 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 Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature Use BLUE or BLACK Ink For Office Use .c4*10 . Cil &L',,,r-i, llPermit#: . , �- ���✓ 41' . City ol E �� Permit Fee: g / 7�/ SO 3830 Pilot Knob Road Eagan MN 55122 F,,;:CE1VED Date Received: � - '.--- Phone: (651)675-5675 Fax: (651)675-5694 MAY 0 9 2017 Staff: J 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 5/4/17site Address: 1580 Blackhawk Lake Drive Unit#: Name: Angie Craig Phone: 651 .788.5339 Resident/ 1580 Blackhawk Lake Dirve owger Address/City/Zip: Applicant is: Owner X Contractor F 1 F y k Exterior updates, remove brick& replace with stone, add 2 gables and posts I T e of Work s Description of work: Yp I [,,,m, Construction Cost: 10,000 Multi-Family Building: (Yes /No X ) Company: Murphy Bros Contact: Jamie 1613 93rd Lane NE Blaine Address: City: I Contractor 1 State: MN Zip: 55449 Phone: 952.217.2484 Email: jrosenlund@mbros.com I LicenseNAT-57232-2 #: BC003416 Lead Certificate#: If the project is exempt from lead certification, please explain why: i I COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 1 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: 1 Licensed Plumber: Phone: Mechanical Contractor: Phone: i Sewer&Water Contractor: Phone: i Fire Suppression Contractor: Phone: 1V©7-E: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. 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 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. ^'1 x Jamie ' x �'~- Applicant's Printed Name Appli, is Sigoiture Page 1 of 3 � e6 4//-2.6, c� ONO WRITE BELOW THIS LINE ii-o-7 3. . SUB TYPES Foundation Fireplace Porch(3-Season) *. Exterior Alteration (Single Family) 14 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 7(4 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 j,1 GYM Occupancy /1, _ / MCES System Plan Review Code Edition ,,aiy SAC Units — (25%_ 100% V ) Zoning p p City Water -- Census Code 4 3 it Stories -' Booster Pump — #of Units / Square Feet 5? PRV .. #of Buildings / Length 3i-4 Fire Suppression Required Type of Construction ,X la Width /2-8 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_Gas Service Test Gas Line Air Test ,, Roof: v' Ice&Water , (Final Pool: _Footings _Air/Gas Tests _Final Framing ✓30 Minutes 1 Hour Drain Tile Fireplace: _Rough In _Air Test _Final It Siding: Stucco Lat .41-Sto,e 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: 1 ; , Building Inspector RESIDENTIAL FEES A3 f►fUiyi Po4GN /},,)/7/p4 ,i 1 c .5-o eh t X92 Base Fee / - Surcharge PAZeWi GA1M 9i4*&APW 1 S'o*a� Plan Review / 43 1t I.d pt _ MCES SAC 1 iJ, a G/11344 /�G 'r .2(J'�"/off 3l Aez City SAC / T « Utility Connection Charge 5/0/�� 1/4122 S&W Permit& Surcharge1/1190�a ,a l Treatment Plant Copies Q i (. ' aS TOTAL Page 2 of 3 f OCT-09—'90 TUE 09:16 ID:JAMES R HILL INC TEL NO:612 884-9518 R1 ree 5 ... 4 14 ?705 SURVEYOR'S CERTIFICATE KEYSTONE BUILDERS LAb R A IVE ea3.E Vol f IX 533.1 p �+ e33.1 t I!¢QV c 533.5 ttv O 533.1 61121 59 E{r� S 11 C9 531.#7 123.5 t 534.5 r ,. ✓' y 10 NI e f 1 G ...•'-•' • .„,,,09 I e ? ..... 14 > t▪ lie-`ly" Abu 2- P .. fb ►r�} , / acv.°:as 3 X COWIA �{ 'FESi � .sem; Rood . ecneli IAAI1x , 11 o fI Q TOP 4F PIPE 3 _5 OV M ti Q EWE* 'x I 7W+ 7)ZN L S`131 ,.1'd: f'.. N .Y. "21:4 -1- 18.33- 1-,: .', -- -- _ -tkI 833.SI t 4 1en r„` % o 5301) 0 HOUSE , aD / 1 414 eE4.01 0 26. 1 _ e _ _ • ,it.; / F x•23.4 `.� f •E7.4 t46 'ID•.21" 524.7 to L. 1 t. If CI) ti) \ k '.0) -- 527.8 G y t LOT 17 to 1 t EAC AN Trt 71 ! BY:_____bb.... ,11 It -''''' irf-,...wf ,,,, •-.:, i, x ...P. : 4, ,, PIATI: 5/./_2/12._ t cP .....- -, ,r.- .0, ‘ Tge. : . ......91._ ,4,,::::_fryi 9(4_ _......' 0. '''' 't..' . 7::x.1...481•- ,:a,.1 4ri... ;n4^» +� ""e DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH- 30 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR-- $363. FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR- 6af3.0 FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF 8L - -VII.- eir R.V. E :::'i -0 CA WE HEREBY CERTIFY TO KEYSTONE BUILDERS THAT THIS ISA TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot 17, Block I BLACKHAWK GLEN 3RD ADDITION, accord Ing to the recorded plot thereof, Dakota County,MInriesota, IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 5TH DAY OF OCTOBER ,1990 APPROVED RIR SIENNA SIGN=0. I R.HILL,iNC. CORPORATION • DY: B : C' JOHN C. LARSON, LAND SURVEYOR DATED! MINNESOTA LICENSE NUMBER 19828 1 q o Q ' oJarnesR. HiIinc. L7m .pm � T , Oc. D o `a Q v ' a' 1 5 ' Fil m z PLANNERS I ENGINEERS ! SURVEYORS ..1. "I 0 -J 8 Zto w O rn rn 4 .‹ I 9401 JAMES AVE.S. •BLOOMINGTON, MN. 55431 • 612-884-3029 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA170606 Date Issued:07/12/2021 Permit Category:ePermit Site Address: 1580 Blackhawk Lake Dr Lot:17 Block: 1 Addition: Blackhawk Glen 3rd PID:10-14352-01-170 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener 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 - Richard L Jr Perry 1580 Blackhawk Lake Dr Eagan MN 55122 (651) 795-1407 Milbert Company (culligan) 1801 50th St E Inver Grove Heights MN 55077 (651) 451-2241 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA177202 Date Issued:06/20/2022 Permit Category:ePermit Site Address: 1580 Blackhawk Lake Dr Lot:17 Block: 1 Addition: Blackhawk Glen 3rd PID:10-14352-01-170 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the water damage. 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 - Richard L Jr Perry 1580 Blackhawk Lake Dr Eagan MN 55122 Estate Claim Services Llc 6701 Penn Ave S, Suite 201B Richfield MN 55423 (651) 309-1114 Applicant/Permitee: Signature Issued By: Signature