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1595 Blackhawk Lake Dr Use BLUE or BLACK Ink F _ - urC~ffice Use City of Eap I Permit I ~~-w I 3830 Pilot Knob Road r I Permit Fee: Eagan MN 55122 $5I~Cta u I I I Date Received: ~ Phone: (651) 675-5675 1 Fax: (651) 675-5694 Staff: 2010 MECHANICAL PERMIT APPLICATION Date: f Site Add` mess:( )l~~~~ 1Lc~ c ` Tenant: lS l 1~ h 4.J~ rt ~C ~ Suite 5~ RESIDENT/ OWNER Name: Ct~ 1 QC Phone: Address /City / Zip: C i Di ~ ^ C' ' w CONTRACTOR Name: BURNSVILLE HFATING R,XC, INS, License Address: 3451 W. Burnsville Parkway City: Suite 120 State: Zipurnsville, MN 55337 Phone: c', c~ L '~i Contact: (~L t~~ Email: TYPE OF WORK New Replacement Additional Alteration Demolition Description of work: NOTE:' Roof mounted an ground mounted -c anical equipment {s requ,ifetl to be s#000, f~yGity Code. Please contact the Mechanical kris~ector for. inf&mation'oit pertni e f c eEnill ttletl tl5. , RESIDENTIAL COMMERCIAL PERMIT TYPE Furnace _ New Construction Interior Improvement Air Conditioner _ Install Piping _ Processed Air Exchanger Gas Exterior HVAC Unit Heat Pump Under / Above ground Tank C_ Install / _ Remove) When installing/removing tank(s), call for inspection by Fire Other L Marshal and Plumbing Inspector RESIDENTIAL FEES: j` $50:50 Minimum Add-on or alteration to an existing unit (includes State Surcharge) ~A-- 1-n $90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x1% $50.50 Minimum (includes State Surcharge) Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. - If Permit Fee is > $1,000, surcharge increases by $.50 for each Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). TOTAL FEE 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 t e approved plan in the case of work which requires a review and approval of plan Applicant's Printed Name Applicants Signature FOR OFFICE USE Reviewed By; Date: Required Inspections: Under Ground Rough In Air Test Gas:Bervice Test 1n-fioor Heat ' rural Exterior HVAC Screening Inspection 'fow^w+^~.-rmeoI::R'+A14;veuch•«n!: rr-,b h y.~~*u+T#),w :xn.~'.wrr--. •;'xko+~.rK.:!,~.,+..e~..K~.-, w...,: ..,7:"r;"wurJYJ'.(`a►ors{7t'*R:vT"'Ra"faa~'a.,.;.c~..: ;'~r*rea.-q^v +-•,rj:~'+-.per,'. " 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 $1' IM CAR Est. Value 192 tpOQ Date- -AUG 8 Site Address 1535 B►_.ACIMAWK LAKE DR OFFICE USE ONLY Lot 9 Block 2_ Sec/Sub. Parcel No. Occupancy B-•3_-Him1 FEES Zoning __R-1 w Name . ROS D B111 I CORP (Actual) Const Bldg. Permit Address 8146 R(MSTEAD CT (Allowable) ' Surcharge DC} 96•o City C AE Et Phone 458-3408 # of Stories Length Plan Review lIr25.t~ ,0 Name MX Depth _ I SAC, City ldQ.flt? k U Address S.F. Total SAC, MCWCC 65C►.t~3 "City Phone S.F, Footprints F On Site Sewage Water Conn 660.E LOU W Name On Site Well - 95 f.w Water Meter • Address MWCC System F Qz Acct. Deposit 306 aw City Phone City Water_ PRV Required_ S/W Permit 30• I hereby acknowlege that I have read this application and state that the Booster Pump SiW Surcharge • information is correct and agree to comply with all applicable, State of Minnesota Statutes and City 61 Eagan Ordinances. ~ Treatment PI 276# Signature of Permitee APPROVALS Road Unit 370+~ A Building Permit is issued to: R.OS 0 M X NG CORP Planner Park Ded. on the express condition that all work shall be-clone in accordance with all Council 1.00 applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies Building Official Variance TOTAL1.0 5• l r Permit No. Permit Holder Date Telephone # wATr= ;t Y~ SEWER PLUMBING H.V.A.C. ELECTRIC 0 n / ELECTRIC Date Insp. Comments Footings I Foundation Framing (r . Z g D~ Roofing Rough Plbg. Rough Htg. Z2,6~ Aur "'0111,41 Isul. Fireplace vl7l~~ Final Htg. Orstat Test Final Plbg. Plbg. Inspector - Not Plumber Const. Meter Engr./Plan Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. Trrttftrat a of (Orruvtturg Citp of eagan arpadmMt of Building 3wertim This Certificate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following. Use Classification S~ Bldg. Permit No. --19-5536 Occupy Type R3/" 1 Zoning District 94 T (CCoonst YK ~r~/~ i Owner of Building WSEWOM MW 1M Address' 8196 cr, curet+ Budd) Address 1545 HL4C Z L= 1ilVE P.ocaityLQ, 1 1/25/Q 1 Date. J Bolding Officiat" POST IN A CONSPICUOUS PLACE Address: 1595 BLAMAWK LAKE DRIVFLot 9 Blk 2 Sec/Sub BLArKHAWK GLEN 3RD These items were/were not complete at the time of the final inspection. 11/25/91 Yes No Final grade (6" from siding) Permanent steps - garage Permanent steps - main entry Permanent driveway Permanent gas Sod/seeded grass ✓ Trail/curb damage Porch i/ Basement finish z/ 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 MKO White - City copy Yellow - Resident copy Pink - Contractor copy SEWER & WATER PERMIT 'r - IwiCE LAS ONLY 'C ClPTAGAN r ; METEfi # PERMIT DATE 08/09/91 $830 Pilot Knob Rd: 'Eagan, MN 5555122-1897 GHiP i 114,2 70 PERM#~# 12206.„=-C 14 METT, SIZE ek: u R.P. REOPPT r# - ISSUE DATE _J REGEW PATE _ 41 ?,.PATE AUG 8t 19911 r x V BOOSTER PUMP 16, SITE AWRESS -1,595 BLACKHAWK LAKE DR PE }MI1 fiEbU BTED LOT 9'4RL.IJCK 2 SEC/SUB BIAkKHAWK GLEN 6RD X SEW ]tff WATER APPLICAN.t $ ADDRESS: - ComMfIND _X---.-RESIDENTIAL CITY, SPATE ZIP. -X- NEW - EXITING . Lawn Sprinkler Meters are oQ oe trtstafled R: FIVE STAR PLU"ING INC Ahead of omestivgleters on ~V°ater Line. ES9 E96$ JASMINE LN S Credit NOT be~jive educt tens. e,ITY COTTAGE GHOVP,HN ZIP 5"5016 STATE PHONE: 459-8.180 s 1 AGREE10 COMPLY WITWC1TT60 OWNER: ROSEWOOD BUILDING CORP ~ EAGAN ORDINANCES j' I APPRESYS: y 8196 UOMESTEAb CT' s CITY, SATE COTTAGE GROVE: MN ZIP 5016 `S1+-NATURE EN METER ICED P NE: 458-340a . » " P "EAS 1MDAwOR141NG DAYS FOR/P46C?E NG. CALL 454-5220 FOR INSPECT10t~S.+fflil`ST SEWEiPERMITS, COWACT ENGINEERING DEPT. '~a m SEWER & WATER PERMIT OFFICE USE ONLY CItY CAP aGAN METER # PERMIT DATE 3830 Pilot Knob Rd. Eagan, MN 55122-1897 CHIP # PERMIT # METER SIZE B.P. RECEIPT # j DATE"' ? ISSUE DATE B.P. RECEIPT DATE PRV BOOSTER PUMP SITE ADDRESS PERMIT REQUESTED LOT ` BLOCK SEC/SUB i SEWER WATER . TAPS APPLICANT: ADDRESS: - COMM/IND RESIDENTIAL CITY, STATE ZIP NEW EXISTING PHONE: Lawn Sprinkler Meters are to be Installed PLUMBER: _ I• _ i Ahead of Domestic Meters on Water Line. ADDRESS: Credit WILL NOT be given for Deduct Meters. CITY, STATE ZIP PHONE: i AGREE TO COMPLY WITH CITY OF OWNER: t . ; EAGAN ORDINANCES ADDRESS: CITY, STATE ZIP PHONE: SIGNATURE WHEN METER ISSUED PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. DATE: AUG 9, 1991 1595 BLACKHAWK LAKE DR (ROSEWOOD BUILDING CORP) x -!~t Your Sewer & Water Permit for the above property has been completed. It will be held at the Public Works Garage (3501 Coachman 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 DIGGIN -,-CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC. - REQUIRED BY LAW. CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. 6 111 &A-61 4~w_k_~ d C ° Request Date Fire No. Rough-in Inspection / Red? Q Ready Now ill Notify Inspector J es No When Ready? 1,..2licensed contractor D owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route _ city Section No. Township Name or No. Range No. County f Occu (PRINT) Phone No. Power Sup r } Address _ Electrical Contractor (Company Name) Contractor's License Mailing Address ( ontractor or Owner Making Installation) f Authorized Sign ure (Contractor/Owner Making Instal lion) Phone Number 14 tL 14 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. REQUEST FOR ELECTRICAL INSPECTION EB-00001 oa ► See instructions for completing this form on back of yellow copy. 4 C" Below Work-CoveWd by This Request VrTewAdd4,,Rejp1:- TypeofEluilding Appliances Wired Equipment Wired ome Range Temporary Service uplex Water Heater Electric Heating pt. 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 Above 100 Amps Signs Inspector's Use Only: TOTAL Irrigation Booms Q • '7C•/ Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MO S. I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final e ILZL 'I been made. OFFICE USE ONLY This request void 18 months from 0- 01®013 9 s - YL -3f-l ;two Requ st bat Fire No. Ro gh-In Inspection Required Inspection Other Than Rough-In You ,Kt call inspector when ready) ❑ Ready Now %Will Notify Inspector Yes ❑ No Date Read I ❑ licensed contractor L_ owner hereby request inspection of above electrical work at; Job Address (Street, Box or Route No.) City 15 Ia L~ . -r, f~- a au,~ Sectio No. Township Name or No. Range No. County rA. Occupant RINT)f Q.~" ~ 9,SL Phone No. Power Supplier Address Electrical Contractor (Company Name) Contractor's License No. Mailing Address (Contractor or Owner Making Installation) Authonz i ture (Contract orfOwner g Insta ion) Phone Number r 5 - 046 6 iCiTY THIS INSPECTION REQUEST WILL 829u 612) 642A 0800 St~Pau,MN8551104 !>II~!{IIII{01 !{f!lI11IIIIIIII{IIIIIIINI) EBE ACCEPTED BY THE STATE NCLOSED. PROPER NSPECTIONFOEEIST 6-/ j REQUEST FOR ELECTRICAL INSPECTION EB-00001-os 10- See instructions for completing this form on back of yellow copy hUp7 T L V "X" Below Work Covered by This RequestNew At1id Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contractor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps E~~t-jLboVer 100 Amps Signs Inspector's Use Only. TOTAL Irrigation Booms i~ Special Inspection A~- Alarm/Communication THIS INSTALLATION MAY BE ORD DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 M S. I, the Electrical Inspector, hereby Rough-In Date - certify that the above inspection has Final Date-7 been made. •C , OFFICE USE ONLY This request void 18 months from f ~J 2006 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Re air Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas 2 copies of plan showing footings, beams, joists Cert of Survey Recd r N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd Y N 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required _ Y N 1 set of Energy Calculations Addition - indicate if on-site septic system On-site Septic System. _ Y -!J 3 copies of Tree Preservation Plan if lot platted after 7/1/93 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form Date5 /3/ Construction Cost Site Address t!5~~~C K wt< y~ ! Unit/Ste # Description of Work Tell. 1- o Multi-Family Bldg - Y X N Fireplace(s) - 0 - 1 _ 2 Property Owner ( ~ r✓ei- r ~ c~S Telephone # (GS r) ~(r 4 -1G Contractor 1,` C Address 3 3 City ~ State Zip `5 53 /G Telephone # (7G 3) ~'i 2 7-?a9 " 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 (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? - Y , N If yes, date and address of master plan: Licensed Plumber Telephone # ( ) Mechanical Contractor Telephone # ( J 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 DO NOT WRITE BELOW THIS LINE Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of _ Alex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex ❑ 25 Miscellaneous Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish Building* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Description: Water Damage Yes Valuation Occupancy MCES System Plan Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) _ Sheetrock - Footings (deck) _ Final/C.O. - Footings (addition) _ Final/No C.O. _ Foundation _ HVAC Drain Tile Other Roof _ Ice & Water _ Final - Pool _ Ftgs _ Air/Gas Tests -Final - Framing - Siding _ Stucco Lath _ Stone Lath -Brick Fireplace _ R.I. -Air Test -Final _ Windows - Insulation _ Retaining Wall Approved By: , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total CITY OF EAGAN PATE. 01/05/99 TIME: W5059 Ds NAME 1._F C Y 10C 3EW 9001 095 610.00 205 900i 095 BI CK14P4f'l L,K0.50 t f 1 Total r-.~~Pi'E?a.~:A'~; Amount: R 5 t~.~a,~0 WC1:.2 USER y!Do NANCY •~r: ~'F f+#~'i~•T.'i`••~##:T?4'. rt: ~f{:r;•: `e`N..K: ~%),'~..'i ?~.T. r+,#~+TTxf: '.''~;.~p,~~ CITY OF EAGAN PERMIT PERMIT TYPE: 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 Permit Number: (651) 681-4675 Date Issued: SITE ADDRESS: DESCRIPTION: i REMARKS: FEE SUMMARY: CONTRACTOR: OWNER: APPLICAN ITEE SIGNATURE UED BY: SIGNATURE 1998 R OING P WT APPLICATION # OF EAGAN "1 X4678 *~Vs ,qI mobamd aft woveys 2 cWm of plan + 2 e of s Onsdt~ t & wkWm ads; #*oM*d.°dw~p: aitc) ♦ 2 a" Wr A" {fit $*wsm & *&&S) : i any askut"m # i air calowwuaft for heat # A attitlepimerifrr rItatPlot sftw7717 mquww. Y" Na CONSTRUCTION =4 DATe SMETADMESS: Name: / II&A, Pbwe Fitt PRO TY lAW OWNEK Street Ate: vp- City sow Phwt cmpmy: CC)XMCToR City - State: 3. ArAj ARCHn T! E?4GRR CamPany Name: t / Re i~trzrti # tj a City Pt r. SOW R r t►r e~~t~uc~an bt chm%p Is r"uosftd arm permit bsuW. 1 Wmft #e"Wftt #W t hm vvW V* sratm std `fie ' is and sW" to mn" t fftft St of ~ ~ smut" std yOf Crtur Si na a of AWiaar* OFME U 0MY fit Cavi of Survey R Yes No Tim Pnoerv&Wn Man Recehied Yes. No ,.r.,..w Not R OFFICE USE ONLY BUILDING P T TYNE 17 Qt Four dati in Q 06 ouplex 07 .11 Ap 9i 16 B sernent Finish f}2 SF Drying Q 07 telex D: 12 Mull Repair Rem. 4 17 :Swim Pool Q3 SF Addition D 08 .$-plex V 13 Garage/Awessmy 13 20 Public Facility 44 SF Porch 13 09 1 -plex' E3 14 Fireplilm © 21 M' llaneous 3 45 SF Mist. 0 '10 ; .-plex Cl 15 peck V ORK '1 YP ? 31 New 33. a ns 0 38 Move 0 32 Addition C"l 34 Repair 0 37 Demolition &W-RAL *IF0f%% Ponst., (Actual) Basenent sq. ft. MCNVS System (Alltable) 1?1G3 "Main level sq, ft. city water UBC Occupancy sq. ft. Fire Sprinklered,x.....,_ Zoning PRV # of Stories sq. tt, Booster Pump Length- sq ft•Census Code. Depth Foetp ►t sq. ft. SAG Ccxte I Census ..;,:L..,. CAMSUS unit AP'#~Ftt'?VALS Ptanning Suiding Engineering Variance ' , Permit Fee Velum: Surcharge Flan RAwiew JVICANSSAC City SAG Ifyater Cahn. Water Meter Acct. Deposit ;_S Pernnit SNV Surcharge Trewimnt PI. Paris d: Trails [d.. Other Ccipies Total: SAC SAC Units .T PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: N G Eagan, Minnesota 55122-1897 Permit Number: 0 2 I5691 (612) 681-4675 Date Issued: 05/26/95 SITE ADDRESS: 1595 BLACKHAWK LAKE DR LOT: 9 BLOCK: 2 BLACKHAWK GLEN 3RD P . I . N 10-14352-090--02 DESCRIPTION: (INCL DECK) Building Permit 'Type SF PORCH Building Work Type NEW REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK FEE SUMMARY: VALUATION $6,000 Base Fee $81.00 COPIES 1.50 Surcharge 3.00 Total Fee $85.50 Subtotal $84.00 CONTRACTOR: OWNER: _ A p p l i c a n t - GRABOWSKI GARY 1595 BLACKHAWK LAKE DR EAGAN MN 55122 (622)454-0665 I hereby acknowledge that, I have read this application and state that the information is correct an agree to comply with all applicable State of Mn. 5tatu s and CI of ~gr Ordinances. `APPLICANT/PERMITEE SIGNATURE ISSUED 81. SI URE . ' V CITY OF EAGAN I ~j y 3830 PILOT KNOB RD - 55122 91 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL) 881-4675 ♦ 3 registered aft sways ♦ 2 copies of plan * 2 copies of plans Oviude bearn & window sixes, poured Ind. design, eta.) ♦ 2 s11o surveys (exteriot addftft & docks) I energy c abAdicns ♦ 1 energy calculatbns for heated addillons ♦ 3 copiesx of bw prawrvation plan if lot platted after 711193 rsgrirsd Yes No DATE: CONSTRUCTION COST: ~.r ~ aiii~■ on ■r. n Mwwn•rr DESCRIPTION OF WORK: G'~~`l~~t G vz°t~c gym/ !G! y.~C STREET ADDRESS: LOT BLOCK SUBD./P.1 D. PROPERTY Name: 6.0-460-41- 9&yq a*'d a ilA Phone t OWNER LW POST Stmt Address• Rld~z 4y 4.t City: laqaw't State: , ud zip., CONTRACTOR Company: Phone : Street Address: License City: State: w zip, ARCHITECT/ Company: Phone ENGINEER Name: Registration R• Street Address• City: State: zip* Sewer & water licensed plumber. Penalty applies When eftess grange and lot change are requested once permit is issued. I hereby acknoaiWp that I have read this application and state that the information is correct and sum Ito comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. f Signature of Applicant: OFFICE USE ONLY R E C E Certificates of Survey Received, Yes No MAY 2 3 1995 Tree Preservation Plan Received „ Yes No F OFFICE USE ONLY BUILDING PERMIT TYPE' © 01 Foundation a 06 Duplex o 11 Apt./Lodging a 18 Basement Finish a 02 SF Dwelling o 07 4-plex o 12 Multi.Repair/Rom, a 17 Swim Pool ❑ 03 SF Addition o 08 8-plex a 13 Garage/Accessory a 20 Public Facility ,~jw- 04 SF Porch o 09 12-plex a 14 Fireplace o 21 Miscellaneous o 05 SF Misc. a 10 -plex o 15 Deck ~ 6g WORK TYPE a 31 New o 33 Alterations a 36 Move *.32 Addition o 34 Repair a 37 Demolition GENERAL INFORMATION Const. (Actual) , Basement sq. ft. MCNVS System „ (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinkl'erred Zoning sq. ft.~ PRV, # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code r Census Bldg Census Unit a APPROVALS Planning Building Engineering Variance Permit Fee Valuation: Surcharge Plan Review License MCtWS SAC City SAG ~pyy ~N Water Conn. Water Meter Acct. Deposit 12- x « _ /may x 30, Z4 SMI Permit SAN Surcharge Treatment PI. Road Unit S Z.o Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units OR'S CERTIFICATE Rustwlup kj"I"'t"b REVISED 7-22-91 (MOVED HOUSE) S ASop, j, poe • {8110 y w kt2~' ` QtN 78 +5 lp 40 pGGN PAR PLAT ; D EkSE N N g w Cl Z 0 . ; OPOsE,4 w o 'o n M lo rs) Q ep~ `r` 1 f 10.0 GE SSO th paA Solo Fµ aoN SEO po~r ~o V r I INCH = 50 FEET 3o0oO,~~ syyy ~p. cn . • T a r- W ]4CMD p O a mes R. Hil n c. 0 o y a ° PLANNERS / ENGINEERS / SURVEYORS t6 rlil N Q ~ m rA e 2500 W. CTY. RD. 42 • BURNSVILLE, MN. 55337 612-890-6044 41 Nf q - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ria~~ tivc ices Nu:oie =90-bd44 #908 P01 RVEYOR'S CERTIFICATE ROSEWOOD BUILDERS 1 ale s Vi NOTE: BUILDING ONTAL ONS TICA N ARE NOTE: NO SPECFIC SOILS INVESTr.ATION HAS BEEN COMPL.22TED ' FOR HORQONfAL Q VERTICAL LOir- ATION OF STRUCTURE ONLY. SEE ON THIS LOT BY THE SURVEYOR. THE SUITABILITY OF ARCHITECTUAL PLANS MR BUILDING SOILS TO SUPPORT THE SPDCIFIC HOUSE PROPOSED IS A FOUNDATION DIMENSIONS. NOT THE RESPONSIBILITY OF THE SURVEYOR me DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET 0 DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 83?.5 FEET X000.0 DEI+~ OTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 82q,~ FEET (COO.^u) DENOTES PROPOSED E~EVA r iGN PROPOSED TOP OF SLOCK - a3'7.j FEET WE HEREBY CERTIFY TO ROSEWOOD BUILDERS THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: •Lot 9, Block 2, BLACKHAWK GLEN 3RD ADDITION, according to the recorded plat thereof, Dakota County, Minnesota. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS !A TH DAY OF JUICY 1991. ~APPROVE~ FOR SIENNA SIGNED JA R. HILL, INC. CORPORAT T IN ' BY: RY: JOHN C. LARSON, LAND SURVEYOR nATEn, MINNESOTA LICENSE NUMBER 19828 o~`°0WO an1 sR.H~ inc. 0 :9~~~` Nv>m~ o Z Z ~o ~trvrv~RS i r=rvurrvr~s i ~unvCYVK~ N O m Cn " 2500 W. CTY. RD. 42 a BURNSVILLE, MN. 65337 • 612.690.6044 a a ? CITY OF EAGAN N® 19 5 3 6 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454-8100 Receipt # t, l To be used for SF DWG/GAR Est. Value $192,000 Date AUG 8 19-9-1L Site Address 1595 BLACKHAWK LAKE DR 9 OFFICE USE ONLY Lot Block 2 Sec/Sub.BLACKHAWK GLEN 3 Parcel No. Occupancy R-3-L-1 FEES Zoning _ R-1 W Name ROSEWOOD BUILDING CORP (Actual) Const V-N Bldg. Permit 962.00 o Address 8196 HOMESTEAD CT (Allowable) V-N Surcharge 96.00 City COTTAGE GROVEPhone 458-3408 # of Stories - Length 601 Plan Review 625.00 ZF Name SAME Depth 56' SAC, City 100.00 Address S.F. Total SAC, MCWCC 650.00 City Phone S.F. Footprints - F On Site Sewage Water Conn 66Q. 00 W W Name On Site Well - 95.00 E W Water Meter x i Address MWCC System -X 30.00 i Acct. Deposit <W City Phone City Water -X_ PRV Required S/W Permit 30.00 1 hereby acknowlege that I have read this pplication and state that the Booster Pump S/W Surcharge .5o information is correct and agree to co with a applicabl State of Minnesota Statutes and Cit f Eagan nances Treatment PI 276.00 Signature of Permitee APPROVALS Road unit 370.00 A Building Permit is issued to: ROSEWOOD BUILDING CORP Planner Park Ded. on the express condition that all work shall be done in accordance with all Council 1.00 applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies Building Official ~ f1~k I LL' Variance TOTAL j,899- 50 Ike l"I BVI VCATION CITY OF RAGAN 2 SETS OF PL NS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL I REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - b~ STRUCTtT . PLANS I SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIF'ICAT ONS 1 SET OF ENERGY CALCULATIONS 1 $ET OF ENERGY CALLS # OF RENTAL UNITS 0 OF FOP, SALE UNITS SALTY APP >WONr TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WOMIN'G DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. $OTE: ADDRESSES FOR CORNER LOTS CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDR S IS DESIRED. PROCESSING TIME FOR SEWER & WATER PERXITS IS TWO DAYS ONCE A PERMIT KAS BEEN COX= . PEP T MUST SHOW A LICENSED. PLVKBER; F To Be Used rbr 1e, Valuation:"' ~ M Date: 12-%its Address OFFICE USE ONLY ~g y~0or~ Lot Bloc FS Occupancy ~.3 L- Bldg, Perx1t bZ,oa Zoning Surcharge .o Parcel/Stab aWl- (~I Actual Coast V-.N. Plan: Review Allowable Y-/y SAC, City Owner 00 s # of stories SAC, MWCC ell Length ~ Water Meta Adc;ress 4 e,~ Depth S6: Water M~a~a<x S. F. Total Acct. Deposit City/Zip Code, ~S`" Footprint S.F. S/w hermit ! Tre Surcharge Phone On site sewage Treatment P1. On site well Road Unit 2 C6vtractor f MWCG System Park IIed. City water Trail Ded. Address PRV Copies ,011 Booster Pump city/Zip C040 SUBTOTAL APP$~ Penalty sne Planner Lot Change council TOTAL i . jEngr. / Bldg. Off. h '7- 6 v Variance Address city/Zip Code phone Sa /Mate used Contr. z, a s#a that all work ahall be dare iz "cordance with (Signature o con r&ctor) all applicable State 0f Kitft1ffiSt1ta StatutOg and city of -Eagan, Orditu es. } GA 2 6 7 o V. 1,5 = l0orv r2 2 Yf Zee IST ~3 t'~► 'a 7Z ~ R 9 21 ~ 9 t, yy2 1 R 3, JUL-22-'91 MON 08:27 ID:JANES R HILL INC TEL NO:612 890-6244 4908 P01 ' f + ~ t 'SURVEYOR'S CERTIFICATE ROSEWOOD BUILDERS i k j NOTE: BUILDING DIMENSIONS SHOWN ARE NOTE NO SPECIFIC SOILS INVESTIGATION HAS BEEN COMPLETED FOR HORIZONTAL & VERTICAL LAC- ON THIS LOT BY THE SURVEYOR. THE SUITA11L RY OF ATION OF STRUCTURE ONLY. SEE ARCHITECTUAL PLANS MR BUILDING SOILS TO SUPPORT THE SMIFIC HOUSE PROPOSED 13 A FOUNDATION DIMENSIONS. NOT THE RESPONSIBILITY OF THE SURVEYOR I DENOTES PROPOSED SURFACE DRAINAGE O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 837.5 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 82q,6 FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - 839.3 FEET WE HEREBY CERTIFY TO ROSEWOOD BUILDERS THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: -Lot 9, Block 2, BLACKHAWK GLEN 3RD ADDITION, according to the recorded r plat thereof, Dakota County, Minnesota. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS IS TH DAY OF JULY 1 1991. APPROVEn FOR SIENNA SIGNED- JA S R. HILL, INC. CORPORATION f" BY: BY JOHN C. LARSON, LAND SURVEYOR DATED, MINNESOTA LICENSE NUMBER 19828 -nmT o N W 0 W c- James R. Hill, inc. Om~~ ~,r v D o M o $ rn > us I" m I111}UVIVr_R5 / F_14Qd1VEEF %5 / %5UKVCTVK%b n O m y 2500 W. CTY. RD. 42 a BURNSVILLE, MN. 55337 a 612-890-6044 G SURVEYOR'S CERTIFICATE ROSEWOOD BUILDERS REVISED 7-22-91 • ! ( MOVE Q HOUSE 1 S2,60,57 ~2 • I• A ' ~ 3S.pp E (81to 0 1,6y~ o N ?-8-'" 95 80 Ur I LIT j)Ftp,%%NGf- 5,peR POIC r' N 5 FOE ~r1 J w 1 \ Z a opo ~ ~ to- 0+ N C / \0.0 0 15 GAGA (ml SOP,, i"01A -4 osv-D 1$0 0%1\z, ~10 V o rod i INCH= 30 FEET r/- 300 `644 ~ ~ 1^ 4hh~ V/ c- w0 James R. Hill, inc. O m m W x C o c- D O 10 p Op 0 D O I -1 v rn m z -n m . Z rn PLANNERS / ENGINEERS / SURVEYORS N~ o m 2500 W. CTY. RD. 42 • BURNSVILLE, MN. 55337 • 612-890-6044 N - _ _ _ _ _._w.. _ _ _ _ uy. vt EXTERIOR ENVELOPE AVERAGE fault_ COMPUTATION. OWNER: _ DATr~:/ Allb-rv ITE ADDRESS: LR 2, PLA ; M",k G S CONTRACTOR: ~S5~w~1> ~v► leL 'n±7 & . PLAN # Determine working square footage of each 1. Total exposed wall area..... 3 o3- sq.-ft. x .11 = 33Lff o7 2. Total roof/ceiling area..... ~lOt7 sq. ft. x .026 = Total exposed wall area above.floor= a. Total wall window area b.• Total door area...... 37f(ol c. Total sliding glass door area d. Total fireplace wall area - e. Total wall framing area (average 10%)....... _ 3a it f. Total rim joist area ?-S~f g. net wall area above floor 352 h. wall area above floor......... i, wall area above floor J. frame wall area at foLmdation Total exposed foundation area= k. Total foundation window area 1. Total net foundation area above grade ae'S Determine fault value of each wall segment (e.g. window, door, each separate wail section) X fa u ft _'O f 7 X "u C. 8a X ft u n t` 7 = 37 d X fault = e. 3a~ x fault f. X fluff :04 g. 23,S2t X atufa ,o+~ h. X fault _ 1 X fault = J. X tuft If item 713 is the sami k X fluff = as, or less than item 41, you have met the: 1 , ~p X as u" intent of SBC 6006 (c 3. .................................Total = Zg d ~rte- - -s--- - els i I i i :TOTAL EXPOSED ROOF/CEILING CALCULATIONS: Total exposed Jq roof/ceiling area........ sq ft j) Total skylioht area:...... sq ft x "U" Q Total roof/ceiling framing area (Average 166 sq ft x "U" 025 1), Total net insulated roof/ceiling area....... ! t0 sq ft x "U" .a 4. TOTAL j) thru 1) .~S If total of y4 is the same as, or less than #2, you have met the intent of 2 MCAZ 1.16008 A and 0. ALTERNATE BUILDING ENVELOPE DESIGN To utilize the total envelope system method, the values established by the sum of items #3 and #4 shall not be greater than the sum of items N.1 and #2. 1. + 2. 3. + 4. _ LINEAL FEET EXPOSED WALL BLOCK: 1 3o KNEE: WALKOUT:. FULL 1: FULL 2: 104 FIREPLACE: RIM: ZOL4 SQUARE FEET EXPOSED WALL AREA BLOCK: x .5 KNEE: x 5 = WALKOUT: f x 8 =~rv FULL 1: (v~ x 8 = (~~2 FULL 2: Igo x 8 FIREPLACE: x - RIM: 4'T x 1 v TOTALS 7 SQUARE FEET EXPOSED CEILING moo WINDOWS: DOORS: 3 7 PATIO DOORS: vD0 y - Z(~o I a~0~f BASEMENT UNITS: SKYLIGHTS: 2,~~~ lill ~,~(p • 17'4 f us e l % of opaque Ws 1 1 Brea fO+r R- VALUE fv'ame ccrstruC.f ion CONST'RUCT'ION-- FRAMING - - ~--~(D 1. INTERIOR AIR FILM 0.68 fl 2. BD .45 3. 5 12 SOFT WOOD 6.8 4. 25M M:n~~ 2.06 5. SID -ING .41 BASIC 6. OR R FILM 0.17 WAIL = 10.8 ® U= .09 Fir.. #1 TLWTW or FRAME WALL -NET T. 1. INTERIOR AIR FILM 0.68 ~J g4 "1/2" .45 1 3. 6'r INSUL. 4. 25/32 HEATh'ING 2.06 5. SIDING .6 .1 3 6.- EXTERIM AIR FILM 0.17 TOTAL 22.98 U= .04 n 1. INTERIOR AIR FILM • 0.68 -~1 2. 6" I SSUL. 19.00 SEALE9, 3. WO RIM JJOIST 1.89 -7\ / 4. 25/32 SHEATHIM 2.06 5. SIDING i ® 6. EXTERIOR R 4 TOTAL 24.42 ► v~. O U= .04 d BLACK N~4LL i j• • +G` 1. INTERIOR AIR FILM 0.68 • 2. 3. - 5.00 PROTECTIVE BARRIER 5. 6. MZ=OR AIR FILM 0.17 TOTAL R= .13 U= .14 SLAB ON GRADE - Al /t! /11 l . ~ t - II ~ -s ~ G 43 04 to ; NOTE : INDICATE TYPE, "R" VALUE. DEPTH AND PLACEMENT OF INSULATION. t ROOF-CEILING CONSTRUCTION R VALUE 1. INTERIOR AIR FILM CL r'l 2. 5/8" GYP. RD - 3. 3. INSULATION 4400 4. EXTERIOR AIR FTTM 0. 61 Tam' 45.80 vnvT / U _ .02 FRAME VELD A HEAT FWW 1. INTERIOR AIR FILM 0.61 {-1 2. r' 58 3. NSULATION 8.35 4. EXTERIOR AIR FILM 0.61 ~ FIG. #5 40.15 U = 0.024 s CONSTRUCTION < r w a ~ - 1. INSIDE AIR FILM 0.61 r . i 2. 3. 4. 5. OUTSIDE AIR FILM 0.17 FRAME 1. INSIDE AIR FILM 0.61 Lo o --O 2. FEAT FLAW UP VENTED 3. 4 .5. FIG. #6 U = 4 r-15 1. INSIDE AIR FILM 0.61 2. 3. f r, UUTSlDE . 5. R FILM 0-17-- TOTAL U r NON VENTED NOTE: USE ADDITIONAL SIFTS IF MORE SPACE IS NEEDED FOR DETAILS AND CALCULATIONS. HEAT FLOW UP FIG. #7 CITY USE ONLY t~ L BL RECEIPT #:Q SUED.RECEIPT DATE: 1999 PLUMBING I'EMff (MMENnAL) CITY OF EAGAN 3630 PILOT KNOB RD EAGAN, MN 55188 (651) 661-4675 Please complete for: ➢ single family dwellings ➢ townhomes and condos when permits are required for each unit ➢ backflow preventer for underground sprinkler system - - - - - - - - - - - - - - - - - - - - - FIXTURES EACH # TOTAL Shower 3.00 x Water Closet 3.00 x - Bath Tub 3.00 x = Lavatory 3.00 x Kitchen Sink 3.00 x = Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 x = Floor Drain 3.00 x = Gas Piping Outlet * minimum -1 3.00 x Rough Openings 1.50 x - Water Softener * for dwellings under construction 5.00 X = Water Softener * for existing dwelling 30.00 x = U.G. Sprinkler for dwelling under const. 3.00 _ U.G. Sprinkler for existing dwelling 30.00 = Alterations to existing residence 30.00 Water Turn Around 30.00 = Private Disposal System * MPC lic. 75.00 (new and refurbished systems) Private Disposal Systems * Abandonment 30.00 = RPZ (new installation/repair) 30.00 = STATE SURCHARGE .50 Reminder. Call 681-4675 for inspections of water heaters, water softeners, alterations, etc. TOTAL - ---t Ih 1 hereby acknowledge thaave read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement. SITE ADDRESS: (S (5 OWNER NAME: e S INSTALLER NAME: TELEPHONE 4P STREET ADDRESS: ~a d 0 ~C 0. CITY: y ~46i1 !ri J' C ~((1(3 STATE: ZIP: SIGNATURE OF PER EE CD/PERMIT FORMS/RPLBG PERMIT (RES) - 1999 Zv T73i CITY USE ONLY CITY OF EAGAN LRE 3830 PILOT KNOB ROAD EAGAN, MN 55122 MIT # PHONE: (612) 454-8100 EIPT # IV L -_&9 '73 E I?DTIAT` PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION FEES NEW CONST K_ ADD-ON MINIMUM $15,,_00 ADD ON HVAC 0-100 M BTU 400 REPAIR ADDITIONAL 50 M BTU _-6: 0_ GAS OUTLETS - MINIMUM OF 1 PER PERMIT OWNER NAME : SUBTOTAL: $ SITE ADDRESS: STATE SURCHARGE: .50 ~ aJ -5-0 LOT : BLOCK SUBD . a TOTAL : INSTALLER: r ADDRESS : SHAWNEE ROAD • EAGAN, NiN 55122 SI Lic NATURE OF PE ITTEE r. CITY: ZIP: PHONE a OI?M.AI.IAUSTRA.> 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 +a EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT # 0,540 i±T?: DATE : 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 J_ SHOWER 3.00 3ec~ REPAIR WATER CLOSET 3.00 ,t*t~ -Z_ BATH TUB 3.00 L.t+ LAVATORY 3.00 OWNER NAME:P~(,rh9lfr.~ KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 3, SITE ADDRESS: )(tGk tyl/ HOT TUB/SPA 3.00 ` -,&Z- 0494, ~,pl _7 WATER HEATER 3.00 tfip LOT: ! BLOCK oG SUBD, FLOOR DRAIN 3.00 Zrt> GAS PIPING OUT. INSTALLER: (MINIMUM - 1) 3.00 1 ROUGH OPENINGS 1.50 QADDRESS :_f OTHER p97t'J &)f 3.11y 3;tV WATER SOFTENER 5.00 CITY: _ ZIP: PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 PHONE SUBTOTAL L'`7=67 J ST. SURCHARGE .50 SIGNATURE OF PERMITTEE TOTAL: OMMERCiAIjiNDUSTRIAL; 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: 18 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 INSPECTION RECOJMJV WV OF EAGAN PERM"S" TYPE: ,3830 Pilot Knob Road Permit Nufter: I Wigan, Minnesota 55122-1897 Date issued; oh "41 ~ 9 (612) 681-4675 AMIRESS: " " APPLICAI : 1 {k t. ar 0 lit; K . 1696 lit All Y'#tf~11#~ t AI( f. 1) 1~ rIPAtlrttt$~VI ~AIl t, At: C, HAM tt t. U N $ R V1 MMT SUBT'YP'E: TYPE OF WORK:. s'f is +_k ft c I i -7 "1 ;11f711w'Piti`~ t'#~'tt~Th~~+ INA 1 RVMAOV'a A "I-t VAifA it'i I}MI t 1't V Qk1'1RV 0 FOV ANY #.`t.i c#`h`'i:.CAI ORV ..t t1a l~IiieNlRo1 I~gMS !lriIhopMr# E.E1'IRhC PUL,tJ' . NVAC POW* oft VAP. COFM"fft IOOTMS FOUM" 45- at x mom CiYP 11Ci11RD , FVWRAM MTW FML PL C, l~IrAt tlTti OFWff TEST BLDG FKAL BSMT R.L BSMT FRAL DECK FTQ DECK RN& INSPECTION ECM CITY OF EAGAN PERMIT TYPE:,,.► r c 3830 Pilot Knob Road Permit Number: 014.4? Eagan, Minnesota 55122-1897 Date Issued:" (651) 681-4675 SITE ADDRESS: ~ a ~APPLICANT: ftt ACVHAWt (9t k s i1 ..r}{!k1?,X PIEP 1 ` J USTYPE; TYPE OF WORK: F Ai+ Nf1 IAt`."41) ATtON I 14A I KAP! ttfVT Wf0 11Y WAYNI" HtIFfV rAf I 444 f r, ,r fytrlrt t -f 1'! TRJ CAI Pf P1411' P.Wl TNIrc fTr1 I o- i ,3a Ftm* Hokier Deft HvAC kwo FOOTINGS FOUND^ ` FRAMING ROOFING I`1CN.1G1-t PLUfJf9Fh8ti C PLBG AIR TEST EA 1 ~ GAS SVC TEST INStn- GYP BOARD FIREPLACE FIRE FINAL PLBG FIN4 HTG ORSAT TEST SLOG FINAL DOMESTIC I METER' IRRIGATION DETER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CASH RECEIPT E CITY OF EAGAN f 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 ~DATE 19 k nECerveo se caoM AMOUNT $ t i i & DOLLARS P- loo 0 CASH CHECK i k ~ Y A - CD AC E' FUND OBJECT 1 AMOUNT Thank You ~i Y 14880 lk -Pay9rs ye Copy Yelbw--posting (,opY Pink- File Copy PERMIT City of Eagan Permit Type:Building Permit Number:EA118305 Date Issued:10/30/2013 Permit Category:ePermit Site Address: 1595 Blackhawk Lake Dr Lot:9 Block: 2 Addition: Blackhawk Glen 3rd PID:10-14352-02-090 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required by law in ALL single family homes . Matt Kral 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 - David R Haas 1595 Blackhawk Lake Dr Eagan MN 55122 (651) 994-1038 Midwest Exteriors Plus Inc 6451 Sycamore Ct N Maple Grove MN 55369 (763) 427-9696 Applicant/Permitee: Signature Issued By: Signature