1607 Blackhawk Lake DrWI
R i?1?4 ?K RY U CONTRACTOR M ?t ?
LF
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P1,1e1 Plb%
Ptap. h"CW - Not Plumber
Gaut, mew
. Find j9-20-97
C / r'Irs
Deck Pq.
Deck Pint
WON
Pr. Disp.
I
W"tificate of ccc"anc?
W
This Certificate issued pursuant to the requirements of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building construction or use. For the following:
Use Classification: SF DWG Bldg. Permit No. 0038
R-3 M-1 R-1 V-N
O-lY Type Zoning District Type Cast.
E &F CONST 172-SW 2ND
Owner of Building Address
1 607 B ACK AWK LAKE-DR , , BLA A D
Building Address Locality
) G t Date: OCT 20, 1992
Building Official
POST IN A CONSPICUOUS PLACE
Address: 1607 BLACKHAWK LAKE DR Lot 7 Blk 2 Sec/Sub BLACKHAWK GLEN 3RD
These items were/were not complete at the time of the final inspection.
Date: OCT 20 1992 Yes No
Final grade (6" from siding)
Permanent steps - garage
Permanent steps - main entry V/
Permanent driveway
Permanent gas
Sod/seeded grass
Trail/curb damage
Porch
Basement finish 1{S
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.
AECYCEED P4PEP
White - City copy Yellow - Resident copy Pink.- Contractor copy
s.:2=
9 ?
C
2/ Y 7
9 /
/
Request Date Fire No. Rough-in Inspection
Required? ? Ready Now f] Will Notify Inspector
'- Yes ? No When Ready?
I ? licensed contractor ? owner hereby request inspection of above electrical work at:
(Streat, Box or Rout N
Job Atldress city
ry
V
Section No. Township Name or No. Range No. oun
A44?t
Occupant (PRINT) Phone N
o.
Pow r Supplier Addre
lectrical tr for (Co any Name Contractor's License No.
c
/H 19
Mailing Address (Contractor or Owner Making I nstallati
Authorized Signatur ( ntr er M in Installation) Phone Number
MINNESOTA STATE BOARD OF ELECTRI?7y 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 ES-00001-08 10- See instructionr for completing this form on back of yellow copy. q ?? `f f +C" _ I - / /'
J 6 2 9 9 4 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
,t,t, Other (specify) Contractor's Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool J 0 to 200 Amps /Q hRO 0 to 100 Amps
Transformers Above 200 Amps Above 100 Amps /
Signs Inspector's Use Only: OTAL 5p
Irrigation Booms MCI-667 J? .6V
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee v COMPLETED WITHIN 18 MONTHS.
1, the Electrical Inspector, hereby
if Rough-in Date
cert
y that the above inspection has
been made. Final
j e
OFFICE USE ONLY
This request void 18 months from
RESIDENTIAL
CJ -? BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Requirements
• 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing beam & window sizes; poured found design, etc.)
• 1 set of Energy Calculations
• 3 copies of Tree Preservation Plan if lot platted after 7/1/93
• Rim Joist Detail Options selection sheet (bldgs with 3 or less units)
DATE
Remodel/Repair Requirements
• 2 copies of plan
• 1 set of Energy Calculations for heated additions
• 1 site survey for exterior additions & decks
• Indicate If home served by septic system for additions
VALUATION to 2f
SITE ADDRESS \ ?`' -?`ac?[ .?1? +c?• MULTI-FAMILY BLDG _ Y . N
TYPE OF WORK FIREPLACE(S) 9,A - 1 2
APPLICANT
STREET ADDRESS 2 R1Ct C\ _S--w CITY (\ ?\C STATE ON ZIP
TELEPHONE # (1-J CELL PHONE it FAX # l_S _ ______ /
PROPERTY OWNER Le- ,?. !kVj\\4YAnc, TELEPHONE #
-----------------------------------------------------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY i _ MINNESOTA RULES 7672
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: y
Plumbing system includes:
Mechanical Contractor: _
Mechanical system includes:
Sewer/Water Contractor:
Air Conditioning
Heat Recovery System
Fee: $90.00
Phone #
Phone #
----------------------------------------------------------------------------------------------
I hereby acknowledge that I have read this application, state that the Information is core
with all applicable State of Minnesota Statutes and City of Eagan Ordinances. I -
Signature of
OFFICE USE ONLY
Water Softener
Water Heater
No. of Baths
Phone #
Lawn Sprinkler
No. of R.I. Baths
1
comply
Certificates of Survey Received - Tree Preservation Plan Received - Not Required - Updated 4/02
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of_ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or - N
Valuation
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
- Footings (new bldg)
- Footings (deck)
- Footings (addition)
Foundation
Drain Tile
Roof Ice & Water
Framing
Fireplace _ R.I.
Insulation
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)* ? 43 Reroof ? 46 Windows/Doors
*Demolition (Entire Bldg only) - Give PCA handout to applicant
Occupancy MC/ES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Width
REQUIRED INSPECTIONS
Final/C.O.
Final/No C.O.
Plumbing
HVAC
Other
Final - Pool - Ftgs _ Air/Gas Tests -Final
Siding _ Stucco _ Stone
Air Test -Final _ Windows (new/replacement)
Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
Building Permit Type
Building Work Type
UBC Occupancy
Construction Type
Zoning
Building Length
Building Width
Control No. 0840
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDING
001038
07/21/92
SITE ADDRESS:
1607 BLACKHAWK LAKE DR
LOT: 7 BLOCK: 2
BLACKHAWK GLEN 3RD
DESCRIPTION:
SF DWG
NEW
R-3 M-1
V-N
R-1
69
54
REMARKS: 1
PRV S & W CONTRACTOR - MIKE SIEFRIED
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Lie. Search Fee
Subtotal
PERMIT
VALUATION
$790.00
$513.50
$71.50
$700.00
100
1
$5.00
$2,080.00
$143,000
MISCELLANEOUS 1 610.50
Total Fee $3,690.50
CONTRACTOR: - Applicant - ST. LICOWNER:
E & F CONST 13342515 0001325 E & F CONST
1729 SW 2ND 1729 SW 2ND
FARIBAULT MN 55021 FARIBAULT MN 55021
(507) 334-2515 (507)334-2515
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.
L
I '?" 6"?440-e-
APPLICANT/PER EE SIGNATURE
ISSUED : SIGNA
I
PERMIT #
REACTIVATE
t *10
CITY OF EAGAN
1992 BUILDING PERMIT APPLICATION WIL 0 e RFCrr
681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, l set of
specifications, I copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re guest is made or lot change is re uested once permit is issued.
Date 7 Valuation of work
Site Address: 1667
STREET SUITE #
Tenant Name: (commercial only)
LOT BLOCK Tl
SUBD. p
T
D
= ..
.
.
Description of work: 4 , lam/
The applicant is: 3Owner ? Contractor ? Other (Describe)
Name < l e / C.-? r 4 C-- Phone t/", 75Z'
Property LAST FIRST
Owner Address 4 ?c_
STREET STE
City State Zip 'A2
Company 14- Phone C S - -7) JJ 4 -f_1
Contractor Address 1 7? i S4L,, License ? `"? ?•.?3?s Exp.=3_91=13
City State Zip
Company t `e l « n ; Phone (? )
?rchitect/
Engineer Name . ?7..; .147' . Registration #
Address
City L- --u fe...-Cot State Zip 5-(.
o 2
Sewer & water licensed plumber Lt $ : e f ?• w'l . Processing time for
sewer & water permits is two days once area has been approved.
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.
±
=-
Signature of Applicant:
"
a
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging
tS 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc.
? 03 SF Addition ? 08 8-Plex ? 13 Garage /Accessory
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace
? 05 SF Misc. ? 10 Multi. Add'l. ? 15 Deck
WORK TYPE
'31 New ? 33 Alterations ? 35 Tenant Finish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) V-N
(Allowable) V_ r4
UBC Occupancy R-3 'M-4
Zoning R•1
# of Stories
Length - Palo
1
Depth
APPROVALS
Basement sq. ft.
1st Fl. sq. ft.
2nd Fl. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
Planning Building
Engineering Variance
REQUIRED INSPECTIONS
? Site
? Wallboard
? Footing
? Final
16 Basementinish
? 17 Swim Pool
? 18. Conan./Ind.
? 19 Comm./Ind. Misc.
? 20 Public Facility
? 21 Miscellaneous
? 37 Demolish
MWCC System YES
City Water
PRV Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code 0L
Assessments
? Framing
? Draintile
? Insulation
? Fireplace
Permit Fee valuation: $ 14 3 A 000
Surcharge
Plan Review C______
License
MWCC SAC 9 x36 = 86H
City SAC IB
Water Conn.
Water Meter $ 7 6 X 1 f?, = 14 J 01(
Acct. Deposit L_ L. e,ue. _
S/W Permit
S/W Surcharge 50-AZ& s ?W X53 = )?t./?
Treatment Pl. a5 x ?y: boo
Road Unit
Park Ded.
Trails Ded.
3Z
Copies MAIM L?
Other
Total: y -g .:. 6o o
SAC % 2.x 14, = 3z
?
SAC Units 11x 2
=?
r?
N
,
9 --- ? ,% X17 dY 6
iLl 6 hX5 ?25
IJUL-07-'92 TUE 17:12 ID:JAI'ES R HILL INC TEL N0:612 890-6244 0994 P01
SORVEYOR'S CERTIFICATE
iA CORPORATION
a TO
Ift 0090 TILL
NOTE: BULDING DIMENSIONS SHOWN ARE ISM NDRIZONIAL
A VERTICAL LOCATION OF 5TAIJCTUAC ONLY. Slit
AITCHITECTUAL PLANS FOR BUILDING d FOUNDATION
DIMENSIONS.
NOTE; NO S"8CrIC SOILS INVESTIGATION HAS BEEN COMPLETED
ON THIS LOT BY THE SURVEYOR. THE >ftfTAOILITY OF
SOILS TO SUPPORT THE SPECIFIC "OUSE PROPOSED 1$
NOT THE RESPONSIBILITY OF THE SURVEYOR.
4 !; J
T„"rM s.
+ DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE; 1 INCH - 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - M 5 FEET
X000.O DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 9 Ji 8 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK -90- FEET
WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 7, Block 2, BLACKHANK GLEE 3RD ADDITION, accor4 inq to the recorded
plat thereof, Dakota County, Minnesota.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXOEPT AS SHOWN. AS
SUPVEYEU BY ME OR UNDER MY DIRECT SUPERVISION THIS 7 TH DAY OF JULY 1992.
SIGNED; JAM" MO-41NC.
BY.
HAROLD C. PETERSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 12294
James R. Hill, inc.
PLANNERS / ENGINEERS / SURVEYORS
9401 JAMES AVE. S. • BLOOMINGTON, MN_ 56431 9 612-884-3028
n ? ? o
2
-U
0 a j3 D
A
C
F
I, 'AJL-07-'92 TLE 17:12 ID:JAWS R HILL INC TEL N0:612 890-6244
#994 P02
I'$URVEYOR'$ CERTIFICATE
L-l! +
J
ao
140.00
SIENNA CQRFJMATNON
1
'1a ..
Lwow-
%
LOT
7
?? r
$o
V
rr
- 00
?` Q 3
tAjJ
716
Z
M
r?
N
r. 44-
R-311,90
o 'N
- DRIVE SCALE' I INCH = 30 FEET
x p 7p ®
0 v
to M
gz
i
0 j
irn (3
40
James R. Hill, inc.
PLANNERS I ENGINEERS I SURVEYORS
9401 JAMES AVE. S. • BLOOMINGTON, MN. 35431 •612-881-3020
P 01
ONE AND TWO FAMILY $L??k J4*dX
ENERGY CALCULATIONS - AVERAGE "U" COMPUTATION Lk 2, 3
OWNER 6f2 i -4 c : r- SITE ADDRESS AU/r HAw/( A/t OY-,,-07_ DATE JzC, / `d2
CONTRACTOR A L. F rL A.) 5 T'E CALCULATIONS BYj?,T,_ _ !_ i t .y Jt PHONE j- 7.5
Determine working square footage of each that applies
1. Total exposed wall area ............ :16c> b, sq* ft. x
2. Total roof/ceiling area...........o sq. ft. x.026 = .4 1. _U
3. Floors over unheated space;.......o sq6 ft. x ,.05 =
4. Roof/ceiling area (no attic space). sq. ft. x .026 ,.
5. Unheated slab on grade............._________ sq. ft. x .16'
6. Heated slab on grade ............... sq. ft, x .12'.
a. Total wall window area ...................
be Total door area .......................... 4
c. Total sliding glass door area............ J o
d. Total fireplace wall area ................
e. Total wall framing area (average 107.).... se?
f. Total net wall area above floor.......... A 9
g. Total rim joist area,.....,....,......... 3 1_
TOTAL EXPOSED FOUNDATION A R E A = he Total foundation window area .............
i. Total net foundation area `above grade.... l?• 4
J. Total unheated slab on grade area........
k. Total heated slab on grade area..........
Determine "U" value of each wall segmento
a* l 39 x fruit 30 = 71.7(7
b. 41 x "U" '07
,_-
r ,r- rrr•+??
C. -1A0 x tru" , 9.8
d, x 'tUtt
e. 300 x fluff
12,
= ...,...r... ?....
x "u" .62 g• 3053' x trust .2+ he x "U"
i. /6 _ x fruit o 7-
x fruit _
J.
k. x 'tu" 7o .............................. TOTAL.... = O
If item # 7 is the same asp or less than item # lp you have met the intent of SBC 6006(c)2.
NOTE: FOUNDATION WALLS
Full Basement (Rambler) entire exterior wall must be not less than R-5.
Half Basement (Split Foyer) entire exterior wall must be not less than R-10.
P 02
Total exposed roof/ceiling area =
Total gross roof/ceiling area =
1. Total skylight area......... .............
in. Total roof/ceiling framing area.........._M,, O
no Total net insulated roof/ceiling area.....I + 4-7-
Determine "U" value for each roof/ceiling segment.
1. x"U" =
M. A- X "U" ..i o ..._.. 3 , _...._
n. 4-16 X stun 2..?..?
?. -",-
8. ............................. TOTAL..... =
If total of # 8 is the same asp or less than # 29 ave met the intent of SBC 6006(c)l.
To utilize the total envelope system method, the values established by the sum of items
# 7 and # 8 shall not be greater than the sum of items # 1 and # 2.
E BL CITY OF EAGAN CITY USE ONL Y
PLUMBING PERMIT
SUBD. (612) 681-4675 RECEIPT
DATE
REBID*ITIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
------------------------
WORK DESCRIPTION ------------------------- ----- ----------------------
COMPLETE THE FOLLOWING: -----
NO. FIXTURES EA. TOTAL
NEW CONST REPAIR/ADD ON 15.00
ADD ON SHOWER 3.00 3
REPAIR WATER CLOSET 3.00
BATH TUB 3.00
`` 3 LAVATORY 3.00
OWNER NAME: I ?^!1C-'i A KITCHEN SINK 3.00 5
' /
L & LAUNDRY TRAY 3.00
SITt ADDRESS : Am 7
i < FC _ct tC C % HOT TUB/SPA 3.00
WATER HEATER 3.00
FLOOR DRAIN 3.00
GAS PIPING OUT.
INSTALLER: (MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50
ADDRESS : L? OTHER
_ WATER SOFTENER 5.00
CITY: & 4 : t I 1 _ ZIP: PRIVATE DISP. 15.00
?? : > ! s '? r
PHONE
? - 5 ?-
3 U . G . SPRINKLER
TURNAROUND
W 3.00
15
00
- . .
STATE SURCHARGE .50
SIGNA F PERMITTEE TOTAL:
COMMET.e,'IAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS:
TENANT NAME:
CONTRACT PRICE: _
1% OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1% $
STATE SURCHARGE
TOTAL:
(SIGNATURE)
CITY OF EAGAN
CITY OF EAGAN
L 7 B ?wmCHANICAL PERMIT
SUBD. JJ ? .. (612) 681-4675
RESIDENTIAL
RECEIPT #
DATE 2i
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, COMPLETE FOR
TOWNHOMES/CONDOS WHEN SEPARATE PERMITS ARE REQUIRED FOR EACH DWELLING UNIT.
OWNER: E & F Const. FEES
SITE ADDRESS: ADD ON/REMODEL (EXISTING $ 15.00
CONSTRUCTION ONLY)
INSTALLER: HVAC: 8.100 M BTU 24
PHONE #t: 507.451-6388 ADDITIONAL 50 M BTU
ADDRESS: Route 4 Box 40
GAS OUTLETS - MINIMUM 1 @ $3 EA. d00
CITY: Owatonna ZIP: 55060 SURCHARGE: $
SIGNATURE: TOTAL: $ 3COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAI/INDUSTRIAL BUILDINGS. ALSO COMPLETE FOR
APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR
EACH DWELLING UNIT.
WORK DESCRIPTION: l CONTRACT PRICE: 1 FEES
1% OF CONTRACT FEE.
STATE SURCHARGE IS $.50 FOR EACH
$1,000 OF PERMIT FEE. $
PROCESSED PIPING -. $25.00
MINIMUM FEE - $25.00
Fs
41,1 City of Eaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or TACK Ink
For Office Userr
Permit #: -\ 10D614
Permit Fee:
Date Received:
Staff:
(Ca J)
Li -
INFLOW & INFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
J
Date: 5/.21)--e03 Site Address: /6 G 2 5757 2-2
Tenant:
Suite #:
Resident/Owner
Name: 6-" '''� < �,1 6_,.., Phone: /-
f -6 7)
Address / City / Zip: / 6a 7 & �✓X1, . -/ e %%>
-.4 4,- -72
Contractor
Name: 7� /7/y- `--)- f ; License #:
Address: 96) %I' /(✓,, City: fes, - U
/
State:/2 -47 Zip: �Sti 7.5 Phone; 6-57 ---7-1,4.7
Contact: (A- �c Email:
Type of Work
PLUMBING (Within the building envelope)
>Z. Sump Pump Repair
SEWER & WATER (Outside the
Repair
building envelope)
Other:
Other:
Description
Description of work:
FEES
$60.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $
*Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit Ill repair costs for
reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors
can be found by visiting www.citvofeaqan.com/inflow, or City Hall at 3830 Pilot Knob Rd.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground 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 ordinalces 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 reres a reviewand approval of plans.
Applicant's Prin, �Jd Name
P 3e
x
Applicant's Signature
FOR OFFICE USE
Required Inspections:
Reviewed By: Date:
Under Ground Rough -In _Final
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114630
Date Issued:09/17/2013
Permit Category:ePermit
Site Address: 1607 Blackhawk Lake Dr
Lot:7 Block: 2 Addition: Blackhawk Glen 3rd
PID:10-14352-02-070
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 .
Laura Gillespie
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 -
Gregory L Hillesheim
1607 Blackhawk Lake Dr
Eagan MN 55122
Able Restoration Group Inc.
17316 Kenyon Avenue, Suite 103
Lakeville MN 55044
(952) 378-5000
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA145970
Date Issued:10/03/2017
Permit Category:ePermit
Site Address: 1607 Blackhawk Lake Dr
Lot:7 Block: 2 Addition: Blackhawk Glen 3rd
PID:10-14352-02-070
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Gregory L Hillesheim
1607 Blackhawk Lake Dr
Eagan MN 55122
(612) 860-0666
Holmin Heating & Cooling Llc
3432 Denmark Avenue, #228
Eagan MN 55123
(651) 405-3853
Applicant/Permitee: Signature Issued By: Signature