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1620 Blackhawk Lake Dr ~pQ For Office Use / j Permit ✓ c 1 City of Ear a a Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 I Date Received: Q-) r t Phone: (651) 675-5675 Fax: (651) 675-5694 i staff-----------------I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: S " ` Site Address: / Tenant: t4t4f Suite z J Ste' ^ 7~ 7Z " RESIDENT /OWNER Name: 4- Phone: 6 (00? Address I City I Zip: ~,Sy Applicant is: Owner X Contractor TYPE OF WORK Description of work: r Ss C e, Construction Cost: j Multi-Family Building. (Yes / No' ) CONTRACTOR Name: _7a4 - License 2 b ~ ~ Address: //V6 57J (71P d l City: A~pQ h 04 d,} State: Zip: Phone: ~fS~ g 1 3~1(J(a Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted (4 submission type) • 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? _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. 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 rk 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 a va of ns. X 16 (2 Applicant's Printed Nam A i nt' Si attire Page 1 of 3 DATE: 8/30/89 RE-1620 BLACKHAWK LAKE DRIVE, L5, B1, BLACKRAWK GLEN 3rd or xx Y r Sewer & Water Permit for the above property has been completed. It will be held at the iblic 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 reascas: 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. CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. DATE: 8130/89 RE: 1620 BLACKRAWK LAKE DRIVE, LS, B2, BLACKRAWK GLEN 3rd xx Y ur Sewer & Water Permit for the above property has been completed. It will be held at the blic Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO CALL PUBLIC WORKS (4545220) FOR YOUR PERMANENT WATER TURN ON. Your Sewer & Water Permit for the above property cannot be completed for the following reass: ~o 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. CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. r CITY OF EAGAN N2 16 9 5 0 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454-8100 Receipt # &3X9 To be used for SF DWG/GAR Est. Value $155, 000 Date AUG 17 tg89 Site Address 1620 BLACKRAWK LAKE DR 5 Block 1 Sec/Sub. BLACKHAWK GLEN OFFICE USE ONLY Lot Parcel No. RD Occupancy R-3 M-1 FEES KEYSTONE BUILDERS CORP Zoning R 832.00 w Name (Actual) Const -V--N Bldg. Permit o Address 201 BRIDGE ST (Allowable) V-N Surcharge 77.50 City SHOREVIEW Phone 483-8256 # of Stories - Plan Review 416.00 Length 6. Name SAME Depth 3' SAC, City 100.00 Address S.F. Total ~F SAC, MCWCC 575.00 City Phone S.F. Footprints - Water Conn 580.00 On Site Sewage ww Name On Site Well - 90.00 ~ W Water Meter 3 Address MWCC System X_ 30.00 T 02 a City Phone City Water Acct. Deposit PRV Required MC S/W Permit 20.00 1 hereby acknowlege that I have read this a pli tion and state that the Booster Pump S1W Surcharge 1.00 information is correct and agree to c It applicable State of Minnesota Statutes and Ci Ea r Treatment PI 228.00 Signature of Permitee APPROVALS Road Unit 340.00 A Building Permit is issued to: KEYSTONE BUILDERS 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 - 1.f'4v11 Lid , Variance - TOTAL 3,289. 0 REACT-IVATE FOR DECIK - 7/24/90 RSON - 452-7465 CITY OF EAGAN~ 1 g} 5 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING s PERMIT Receipt # $1550W 17 To be used for SF M/CAR Est. Value s Date * 1989 Site Add ess 1620 $LAGKmwx LAKE DR OFFICE USE O LY Lot ~ Block 1 Sec/Sub. BLACKHAWK GLEN Parcel No. 307- Occupancy FEES Zoning R-1 KEYSTONE BUTLI)SRS, CORP 832.00 w Name (Actual) Const N Bldg. Permit 3 Address 201 BRIDGE ST (Allowable) V-bT Surcharge ~7• Q City SHOREVIEW Phone 483-»8256 # of Stories Length _64•f Plan Review 416*m 18-1 100.00 p, Name SAME Depth - SAC, City -Address S.F. Total SAC, MCWCC 57%oo rc=F . City Phone S.F. Footprints - On Site Sewage Water Conn 5* W w Name On Site Well _ yy Water Meter 9O•00 AA ¢Z Address MWCC System Acct. Deposit 33rQQ am City Phone City Water PRV Required XX S/W Pe~mit 2D" I hereby ecknowlege that I have read this application and state that the Booster Pump S/W Sutcharge 1.00 information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Treatment PI 228.00 Signature of Permitee APPROVALS Road Unit 344.90 KEYSTONE BUILDERS CORP Planner A Building Permit is issued to: Park Deb. 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 3,289.50 Variance TOTAL Official, I Permit No. Permit Holder Date Telephone # WATER L - ~l A r a i' f~ c SEWER PLUMBING ELECTRIC Inspection Date Insp. Comments ~JJR Footings I Foundation ~ d'~ S Hof wcB~ Framing Vim' ©s Roofing 9/6 y f" Rough Plbg. -o Rough Htg. Z~ g Isul. Fireplace f~ ' uG Final Htg. .11-30 Final Plbg. -,je If Const. Meter Plbg. Inspector - Notify Plumber I Engr./Plan Bldg. Final Y Deck Ftg. Deck Final /G~c~ ICJ Well Pr. Disp. (Urttf tratr of (Orrupaur citp of eagan lorpwftmt of sw1bing Jwrrtinn 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: yR f 5F DWG/GAR 16950 Use a.,sir..ion ( Bldg. Permit No. b Occupancy Type R3/141 Zoning Distrid RI 1~pe Coost. Owner of BuildiagKEYMM M13D Ii. Address 201 SUM ST., SEi0REVIl;W j BnMi Address 1620 N AL ma, LAKE mmLoddity L% BI, N AMW IMM 3RD ; - Dow DEMMR---1140 I989 Buildivig Officaylp POST IN A CONSPICUOUS PLACE I~ e SEWER &WATER PERWT Offm USE ONLY WY OFEAW4N r"? R # PERMIT PATE 3010 3830 Plot Knob Rd. c IP e~ O w l a PEraMIT # E1 $37 ft, MN 55122-1897 03529 METER SIZE f pC S.P. RECEIPT # DATE AUGUST 30, 1989 ISSUE DATE S.P. RECEIPT DA L2 PRV OOSTER PUMP SITE ADDRESS 1620 BLACKHAWK LAKE DRIVE PERM REfl TF.CI - WT 5 BL, OCK i SE&SUB BLACKHAWK GLEN 3RIl► g SEWER % WA R TAOS ; APPLICAtdT: KEYSTONE BUILDERS CORP ADDRESS: 201 BRIDGE ST COMM/IND X FtESIDEN tAL CITY, STATE SHOREVIBW, !IN ZIP X NEW EXISTING PI KN+IE: PLUMBER: LAKESIDE PLLflI$ING Lawn Sprinkler Meters >r to be Installed Ahead of Domestic ors on Water,,Line. AgWESS: - 12469 ZINRAN AVS Credit WILL, NOT tie given Dediact Mebm . CIT1f STATE SAVAGES M ZIP 55398 PHONE. 74!J=22Q1 i AGREE TO COMPLY CI TY VF OWNER: EAGAN ORDPIANCES ADDRESS: CITY, STATE ZIP NINE: SIGNATUR WHEN M i''98uw a. , PLFAft ALLOW ftO WORKII+ia WAYS FOR PROCE$SIM CALL 4M-SW FOR ##SPE .401 MWERIM 1,!F CON'f t1EPT. R1NG _ ~ 5~; ~ € , , t •.i-~ - i - i. ~ A.. 1 5. f i. I ~ ~ ~ ~ - 4 - SEWER & WATER PERMIT OFFICE USE ONLY CITY OF EAGAN METER # PERMIT DATE 8/32111! 3830 Pilot Knob Rd. 10837 Eagan, MN,55122-1897 CHIP # PERMIT # METER SIZE B.P. RECEIPT # DATE ISSUE DATE B.P. RECEIPT DATE ' f PRV -BOOSTER PUMP I f SITE ADDRESS PERMIT REQUESTED LOT BOCK ` - SEC/SUB SEWER -WATER TAPS APPLICANT: z; k f ADDRESS: COMM/IND - RESIDENTIAL CITY, STATE ZIP _ NEW - EXISTING PHONE: Lawn Sprinkler Meters are to be Installed PLUMBER: Ahead of Domestic Meters on Water Line. ADDRESS: Credit WILL NOT be given for Deduct Meters. CITY, STATE ZIP PHONE: r I AGREE TO COMPLY WITH CITY OIL OWNER: 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. Request Date ire No. Rough-in Inspection wired? ❑ Ready NowXWill Notify Inspector Yes ❑ No When Ready? I' licensed contractor ❑ owner hereby request inspection of above electrical work at: Jo A ress/(S~treet, B or Route No_) r Z., c' ection No. Township Name or No. Range No. Cou y G 74 Occupant (PRINT) Phone No. JVt,_'1 ~~J_t A.) tC9 LL"r_ , 91!? _31- 9 ~ 4 Po er Supplier Addre ti ~ C 5 ?'vim 1 I 1~ C' Electrical Contractor (Company N e) y Contractor's U nse No. > ~V el' Mailing Address (Contractor or Owner Making Installation) N ~ AS ~~S I I Z Autho Signature (Contractor/O r Mak" In allation) Phone Number 4 V% ~ 41- MINNESOTA STATE ARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD L1821 University Ave., St. Paut, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED-. ~ I ~S J REQUEST FOR ELECTRICAL INSPECTION Ee-ooool~01 10- See instructions for completing this form on back of yellow copy. iF 4: 3, 0 X" Below Work Covered by This Request ew AdcrRep. TypeofBuilding Appliances Wired EquipmentWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) ontracto0s Remarks: Compute Inspection Fee Below. 4 --y -4/04 # Other Fee # Service Entrance Size Fee Circuits/Feeders Fe Swimming Pool 0 to NQ m o 100 Amps l Transformers Above 200 Amps Above 1o0 Amps ~ Signs Inspector's Use Only: ~ TOTAls/y~ Irrigation Booms Special Inspection i Alarm/Communication Other Fee - i I, the Electrical Inspector, hereby Rough-inDat .fry certify that the above inspection has Final Dat e~ been made. OFFICE USE ONLY This request void 18 months from l Vr' 3 0, 2005 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. /~/Oas Date Site Street Address 41'1e&29:'y_ Zr ve Unit # G5/' 3f1= V5,4,G 14 Property Owner 1&1!, 4 pmw'- Telephone # Vj,~rl) i ft-_N7 ( ) Contractor Telephone # Address City State Zip the Applicant is: Owner , Contractor -Other Alterations to existing dwelling $ 50.00 Add plumbing fixtures. This fee includes putting in a water softener and/or water heater at the same time. If you are installing only a water softener and/or water heater, do not complete this section. Move to the next section and check the appliance(s) you are installing. -Septic System Abandonment -Water Turnaround (add $125.00 if a 5/8 meter is required) Other: Water Softener Water Heater $ 15.00 new _ replacement Lawn Irrigation i,,_ RPZ `PVB Xnew -repair _rebuild $ 30.00 State Surcharge $ .50 I Total $ so I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a permit, work is not to start without a permit and work will be in accordance wi roved plan in the event a plan is required to be reviewed and approved. MAY p 05 Applic is Prin ed me VA?p lic Sign re By G, fi1~` r Pleum carr te for= skoe farrtily dweillrgs, tot haurnes and condos when permits are re for each OPJ~ w pmve nter for irr, system f "MADDRESS: z) OWNER NAME: - TELEPHONE* (APX--A U3M) _ i INSTALLER NAME: TELEPHONE (AREACIIDT STREET ADDRESS: CITY: STATE: ZIP: UPTI C SYSTM, t w/t+ftftW*d ("Ir h" "ts of pins and MPD tieense) includes $40.00 Ccxinty fe® ` Notts: Additional Mn8 may DIY IIr ODIFICAT-$OW ,„TERAT l TO ;3MG DVVEUJWUNiT,,;INCLUDINIM: Adding fiacd tres to lower levels or roft ad,d+dons, ex 9 softnem and water liters. Abandonment of septic sum. Wator and - *vellirg unit ( 5fW meter If needed - 81 IS) I FWZ_ ( tiv nr ira +rtra/repttir/ralld .ffD l tlon system ` •i ,(i" Vii : ,...wr x\ t7Ci1 " i $ J.1Sft4~ T I 1 hmby ae wledps tlwt 1 have read Ntls but, state fast ittf is ow v4 and agree to coritr+4}t vAth art iYpf ft fir itfL eR! re ttte a~s lb ft m r r the propel owner # W the City of Eaw no tiab ty for *ny da operation aM tt r4ormi m aaftiMs -to facsttles wratrtuded under.ttt e t t n d prvpert triytht o SI E OF PERM TEe ! V02 A~ PERMIT JK: CITY OF EAGAN PERMIT TYPE: BUILDING 3830 Pilot Knob Road Eagan, Minnesota 55123 Permit Number: 021960 (612) 681-4675 Date Issued: 09/15/93 SITE ADDRESS: 1620 BLACKHAWK LAKE DR LOT: 5 BLOCK: 1 BLACKHAWK GLEN 3RD P.I.N.: 10-14352-050-01 DESCRIPTION: CHANGE TO GAS ONLY Building Permit Type FIREPLACE Building Work Type ALTERATION REMARKS: FEE SUMMARY: Base Fee $25.00 Surcharge .50 Total Fee $25.50 CONTRACTOR: - Applicant - OWNER: BEL-AIR HTG 18812073 SEVERSON RICHARD 850 W 106TH ST 22 1620 BLACKHAWK''LAKE DR BLOOMINGTON MN 55420 EAGAN MN (612) 881-2073 (612)452-7465 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. A P CANT/PER EE SIGNATURE ISS D Y. SIGNATURE REACTIVATE _ CITY OF EAGAN PERMIT 4 1993 BUILDING PERMIT APPLICATION 681-4675 0 6~1 9 d/ SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, 1 set of specifications, 1 copy of energy talcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month. in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date /53 Valuation of rk Site Address: (o Z- 0 STREET SUITE # Tenant Name: (commercial only) LOT BLOCK SOB . /14ic P . I D . Description of work: The applicant is: ❑ Owner ❑ Contractor ❑ Other (Describe) Sd- `7 Name Phone. 4 Property LAST FIRST Owner Address STREET STE N City State Zips JZ z Company - G r--~ Phone -90 Contractor Address License # Exp. City State Zip Company Phone Architect/ Engineer Name Registration # Address City State Zip Sewer & water licensed plumber 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: OFFICE USE ONLY BUILDING PERMIT TYPE ❑ OI Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-Plex ❑ 13 Garage/Accessory ❑ 18 Comm./Ind. ❑ 04 SF Porch ❑ 09 12-Plex ❑ 14 Fireplace ❑ .19 Comm./Ind. Misc. ❑ 05 SF Misc. ❑ 10 Multi. Add11. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE ❑ 31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 32 Addition ❑ 34 Repair ❑ 36 Move. GENERAL INFORMATION Const. (Actual) Basement sq. ft. MWCC System (Allowable) 1st F1. sq. ft. City Water UBC Occupancy 2nd Fl. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pumpp of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code Depth On-site sewage SAC Code APPROVALS Planning Building Assessments Engineering 'Variance REQUIRED INSPECTIONS ❑ Site ❑ Footing ❑ Framing ❑ Insulation ❑ Wallboard ❑ Final ❑ Draintile ❑ Fireplace Permit Fee Vatuation: Surcharge Plan Review License MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Copies Other Total. SAC % SAC Units 1999 BUILDING PERMIT APPLICATION (RESIDE TIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4875 NOW conftumb2n 922WM Remodel/ ants ➢ 3 registered site surveys showing sq. ff. of lot, sq. ff. of house 2 copies of plan and gj roofed areas (20% mmdm nn W1 covefaae aYowed) 1 set of energy calcu kNts for heated additions 3 copies of plans (show beam & window sizes; poured Intl. destm, etc.) 1 site survey for exte"or ad+dffions & decks ➢ 1 set of energy calculations 3 copies of tree preservation plan 2 lot puffed offer 711/93 DATE: 10 CONSTRUCTION COST. DESCRIPTION OF WORK: STREET ADDRESS: ~ ~0 0-10 LOT: BLOCK: j SUSD.JP.I.D. ~ ~L Name: Phone PROPERTY Last Est OWNER Street Address: City State: V- Phone Company: (area cad ) CONTRACTOR Street Address: License # Exp. City State: ti ARCHITECT/ ENGINEER Company: Name: Telephone area code StreeT Address: Registration City State: Zip: Sewer & water licensed plumber [reauked for now condruction anhr): Pjenaity applies when address change and lot change Is requested once permit is issued. ;;hereby acknowledge that i have read this application, state that the Information is correct, and agree comply with all applicabi State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 4-plex ❑ 11 10-plex ❑ 16 Fireplace ❑ - 21 Porch (3-sea.) ❑ 02 SF Dwelling ❑ 07 5-plex ❑ 12 12-plex ❑ 17 Garage ❑ 22 Por hIAddn. j4-e. ❑ 03 1 of plex ❑ 08 6-plex ❑ 13 16-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 04 2-plex ❑ 09 7-plex ❑ 14 Apartments ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 05 3-plex ❑ 10 8-plex ❑ 15 Lodging ❑ 20 Pool ❑ 25 Miscellaneous WORK TYPE ❑ 31 New ❑ 35 Tenant Impr ❑ 39 Gas Line Only ❑ 43 SidinglSoffitslFascia ❑ 32 Addition ❑ 36 Move Bldg. ❑ 40 Gas Insert ❑ 44 Windows/Doors ❑ 33 Alteration ❑ 37 Demolish Bldg." ❑ 41 Wood Stove ❑ 45 Fire Repair ❑ 34 Repair ❑ 38 Demolish (Interior) ❑ 42 Reroof " Give PGA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. SAC Code UBC Occupancy sq. ft. No. of Units Zoning sq. ft. No. of Bldgs # of Stories sq. ft. MC/ES System Length sq. ft. City water Width Footprint sq. ft. Booster Pump PRV. Fire Sprinklered APPROVALS Planning Building Engineering Variances Permit Fee Valuation: $ Surcharge Plan Review License MC/ES SAC E City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SM Surcharge r Treatment P1. Park Ded. r; Trails Ded. 'Other Copies Total: SAC Units % SAC t 1989 BUILDING PERMIT APPLICATION CITY OF EAGAN V"" SINGLE FAMILY DWELLINGS MULTIP 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 CALCS. (CHECK WITH BLDG DIV.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCS. 1 SET OF ENERGY CALCS. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNIT'S # OF UNITS NOTEt ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.. SEWER & WATER PERMIT FEES AND ACCOUNT DEPOSIT FEES WILL BE INCLUDED WITH THE BUILDING PERMIT FEE. PROCESSING TIME FOR SEWER AND WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED INDICATING A LICENSED PLUMBER. PENALTY APPLIES WHEN: PERMIT IS NOT PAID FOR IN SAME: MONTH IT IS REQUESTED. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. To Be Used For : ~i t IC- G FAm+,y c~-KcValuation. Date-. WD AUG 17 10 Site Address OFFICE USE ONLY Lot Block Occupancy R-,3 Zvi-1 FEES Zoning - Parcel/Sub _ lark ha u, h _ Actual Const VI Ni Bldg. Permit s Allowable 'V-N Surcharge Owner c_k +San ,5ei.1erS0u7 # of stories Plan Review { Length- y SAC, City1 C Address Depth 3 SAC, MWCC >Y15 - S. F. Total Water Conn 5 FO- City/Zip Code Footprint S.F. Water Meter qC'° Acet. Deposit 3c Phone On site sewage S/W Permit 2c, - On site well S/W Surcharge I - Contractor eu <4one Su., erS r MWCC System Treatment Pl. 2'z E5- . City water Road Unit L4 Address PRV required Park Ded. Booster Pump Copies' City/Zip Code !!~)vyeo/e4d SUBTOTAL APPROVALS Penalty Phone y5y 3 '~•Z -5~~ Planner TOTAL, Council Arch./Engr. Bldg. Off. Variance Address City/Zip Code Phone # M UAT/c j x C, i L- ~r x r 1 c'zuC ? ~E !L 1C- Zvi; ILlC't $ U h V E Y O R' S CERTIFICATE SIENNA CORPORATION REVISED 8-15-89 TOSHOWA PROPOSED HOUSE FOR KEYSTONE BUILDERS ' YYA , Y L ~ y D 9 DENOTES PROPOSED SURFACE DRAINAGE i O DENOTES IRON MONUMENT SET SCALE: 1 INCH = -30 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = g3~. FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 80'?~ 3 FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 531.9- FEET WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: Lot -5' , Block I , 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. DAY OF 19-- APPROVED FOR STENNA SIGNED: JAMES R. HILL, INC. CORPORATION BY: BY: HAROLD C. PETERSON, LAND SURVEYOR OATEDt MINNESOTA LICENSE NUMBER 12294 cn -4 pp_ co M O ?~~p O W 0 maD ~ o James R. Hill inc. v m m N 71 F- >D o m z m Z Z ANNERS /ENGINEERS /SURVEYORS Z~ 0 C~ 70 N m JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029 N O N ON SURVEYOR'S CERTIFIC TE 832.5 Q~ SIENNA CORPORATION .Q~ REVISED 8-15-899TO TOSHOW A SH PROPOSED HOUSE FOR KEYSTONE BUILDERS \ 832.6 w° ~ X90 BENCH MRK TOP OF PIPE A) `S Oa' ELEV. /9'/ =834.82-- 834.4 r 883A4 wry/ ~s90 s~/99 8S~ ao 834.7 ` ~~3~ AROp dl A \ \ OR OS p835. M 3jC/Y\~. 834. 835.1 x `2/ A Se 203 8tG qy Y a) O Op \ \ ° `J s ~F ` tL y Os / Gq~q /~O a .8 n7~ a ~y\ \ 83 9 5.4 ~O . 838.3 i A0 9S / ` / 36.3 / Fkl x 838.4 ~ x 839.6 , cl) x837.9 ~l 841 x x 844.2 x 840.8 s 4u ~0 Mh r v Ito 0) ti ~b s CD / N c w, s LOT 5 .V. REtak ~ k:. ~ DRAINAGE 8 UTILITY- EASEMENT PER PLAT 1&0, 10 SCA LE- I 1 NCH = 30 FEET V' 7 0 4 <88 Z. S (A-7,0----76.48 N 30 2 V 22" W Ci n1_1A\ An/ 1111 f\ 17- r-) I I N1 it-Avvi\ I 111_..1_ 1 f-AL ' l I ►~Ji V cn M o M T oW O g :X) co o o James R. Hill, inc. f- D N N r m n 65 D m z 0 - m z Z PLANNERS /ENGINEERS /SURVEYORS -n OD Z 0 C/) OD -~u N (D < OD m 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029 I N ' N t0 O N ex-r RIOn ENVELOPE AVERAGE "U" COMPUTATION s OWNER tt SITE ADDRESS CONTRACTOR DATE PHONE - .Determine working square footage of each. sq. ft. x .11 = 1. Total exposed wall area f t. x .025 2. Total roof.ceiling area Total exposed wall area above floor a. Total wall window area b. Total do= zza------ door-area............ . c. Total sliding glass d. Total fireplace wall area e. Total wall framing area (average 10%)..••••..•...•._• f. Total net wall area above floor g. Total rim joist area..... Total exposed foundation area ..h. Total foundation window area r<_, i. Total net foundation area above grade Determine "U" value of each wall segment. a X "U" _ 00 t b.? X "U" ' - C. +Q X "U" ! X "U_" d . X "U" ~ r X "U" _ 1 - ' X U. h. ; i. '`X "U" t%" ........Total ~f 3 . If item 13 is the same as, or less than item M1, you have met the intent of SBC 6006(c)2. .Total exposed roof/ceiling area _ i j. Total skylight area r" k. Total roof/ceiling framing area (average 10~)............. r> 1. Total net insulated roof/ceiling area Determine "U" value for each roof/ceiling segment. j. X U. 1. V X "U" ..........Total LIA If total of X14 is the saute as, or less than #2, you have met the intent of SBC 6006 (c)l. . Y Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of items #3 and N4 shall not be greater than the sum of items #1 and #2. 0'1 / ` PLAQ . Li u EA L FT, EXPOSED WALL C.~sF, F • woo s ;:u L L I TZ t M ' - 3Loc.K. x S = x 5 w.o.: I:uLL ,i k 8 ~:uLl.. Z" k S - _ - w Goo 7-o OrA L M5cLF-f-- EXpc5r-- W D WS L1 D oo e..S PATIO DRS . t t do f 3SH4 u u r+S - :,rr, r: c,us WALL L: V: 1=i. o rpoqu^ w411 nrr•.t for . lr-try. cuu:.t rust 1um 001•.1 t r,t:: i:.~r h-•l.t to -----1!J t. I•t 1; tn: . _ (1,1:') Arm tic - 6. Lytt-rive iii film u.17 Tall to-as FIG. 11 Tbl'VI114 OF • fltAttt: WALL I. biteflOt' Air Mm ft. fill exlt•riat air lilt.,. r1G. 12 r......9 Wirt gal _n_ 5. ,d•t•,~.... kz. `t•ll._...-~/~•i ~ -`J 0. trrSo,_r sir f t itl_ 7'0 t a t ~ , Z1 , 1 •Z '1~ ..:•.r 1. t~'..'"::t elr lilt t'f:n ATICH aAr tr •n: r+ i.;~-~~ t;, S:xta^rir.t~:•r•:i•It~w- 0.17 ';•ULA • ~ _ -•1.13 i V=..1~ • mow- _ . • ..-_-.w i~~_ • • • • ~ ~ • • • 111 q. • a- 14 r lit lit • ! t l ;l,m:: intllcate ty•.c, •!t" value. •lQatll &M n •7f'/CrILINC Construction R-Valt~c • 1. • Interior air filer 3 z U. ~ ! 4. Exterior air filn (still) 0. I [til1l'{ -rated L Hcac f low 1. Interior air film 0.61 P 2. Sri 7,. 1- 4 x •1 sy 8.5- • 4. CxtcLie= •it MR REI Total Cz v Cq 4.1 r2c. 45 • • • 02-4 .~_:•.~.:t.•.•...-_.~_~==~ 1. Inside air file 0.61 Z. • 4o n f1 rift, S. Outside air film 0. 17 Ell t; Total 1 2 LO , LG 1. Inside air film 0.61 • 2. vented 3- i:eet f lov up • S Outside air film 0.1 • ..ZIG. 16' , : • ' = ; Total • • 3 5 1. Insides air filut j~~•-i~r'-„• S. Outside alt film 0.17 • • • YQ:~-~~ Kotei use additional thests if were zpaca aeaded tar doWls and ealculatiens ' veac • • • flow up PL.AQ 4~r LiuFAL FT. ExPOSED WALL ~ 3LoG ~ : ~f.~ W.0~ ;:u L L t FvLL 2 ; . ~ E~ Sc . ~~r~os D WAi.L. AREA X 57 ~:vLL Z ; to k S = F - To 7-A L V' S Q•,~t • E 1C OS pD GEI L i U W DwS L~1 D ooQs ?ATI 0 BPS ® SS H4 U u i +s ~t~r • WAM. ",rrrVmn , t: ~c~ l..t• of ci•~~~►►^ +uI 1 nr~•~ for . lrlr:v., l:cav-t rucl iun ('t.►r.t ► sm, i;u► 1%-V.-l lot i• 111~t•I.i•.I.-`1.1 1 i tn: il,l;►) Zoo& SIC - 4. l:itteri•.r ait file u.17 V~ ♦0dl FIG. it TGt'VI11q OF • FltAttt: WALL 1. late r int•-Air ! 1 1 n • . • _ 0. f•It 1. $5 f'~L_Tf. _.N_._ Trop Ext.c_r ic►t air Yi 1-1.1 n. vi rIG. 12 - it, ZZ.'f8 lnte-t i.►r ait f ilr► _It•c;•► '~•l.l_..-_I~~• d. t:.t!•rf.or air l_t 1►,_ l'+ i - - - - Tot %1 '•i i u 1.QLK 1. It► :t A f r f i l•► x,11: (.tt `1. -07 1TICH cy r' G. 1lYt►.ri•_r._._i r ! i•Ic•►-_ 0. t i c srat► ml IMADE 4-0A 40 /if fh i y L tit lot 3' • ► - It and "t :%rrt:: Indicate ty •e. "it" v.lue. •lent 160r/CEILINC Construction A-Valt~ j. 1. • Interior air film • 0 G 1 ] . s~ 3. IAj,5uI., a. txturior air filn (still) R• 0• r.~h-~; ~u11, „ • - Total _nted 13cac f lov ' 1. Interior air film 0.61 vp • • 4. Lxtctior Pic 111n (st,111 1 • ' ' Total 2 v O. I IZC. 15• • .OZ~ • CvA. y.,t✓CT♦ •p` - - ~ ?nsidc air fills - --•--r 2. 3. S. outside air film 0.17 ti 1 t Total 1 2 3 4' 1. Inside air film 0.61 • 2. Lee( flov up • vented 3• ` • 4. • S. Outside air fila 0.1 Tonal • ..nc. 16'..'...: • • • • 3 5 Inside air fils+ • • • /•~f t ± elm -i-; :r.•;••.: " S. outside ,ir tiles 0.17 • Total 00 0 • YQ:~-PZ2TZa votes use additional sheets if more space &ceded for details and ealculatians • • seat • flov up `ter t• • i J 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 ISIREQUESTED 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: DECK Valuation: Date: 7/24/90 Site Address 1620 BLACKHAWK LAKE DRIVE OFFICE USE ONLY Lot 5 Block 1 FEES Occupancy Zoning Parcel/Sub BLACKHAWK GLEN 3RD Actual Const Bldg. Permit Allowable Surcharge Owner RICHARD D SEVERSON # of stories Plan Review Length SAC, City Address SAME Depth SAC, MWCC S.F. Total Water Conn City/Zip Code Footprint S.F. Water Meter 452-7465 Acct. Deposit Phone On site sewage- S/W Permit SAME On site well S/W Surcharge Contractor MWCC System Treatment Pl. City water Road Unit Address PRV Park Ded. Booster Pump Copies City/Zip Code SUBTOTAL APPROVALS Penalty Phone Planner TOTAL N/C Council Arch./Engr. Bldg. Off. " &'/i.4 Variance Address City/Zip Code Phone # • SIENNA ,/Q R' S C E R T I F I C T E 632.5 CORPORATION REVISED 8-15-89 TO SHOW A { ` ~p PROPOSED HOUSE FOR KEYSTONE BUILDERS 832.6 40 i~ x \ 3 q~. / . 34.1 Is, ` BOP OF PPE '0 Oa' AA \ ELEV.-834.82---_ 833.5 834.1~ ry, 2S9p 60 ? 8S ~ 40 834.7 ; \ct}3~ \ OAQOAVV \ oa 834.9 R/L/~ 635.1 ~ ~ h'p~ psF G.9,Q \ /2 e\35.9 ro ~ 835.4 O ~g 838.3 lV 8jG a6. 4>@3 v~, ' 3 I x 36.3 f/S l o+ 8 N ANN IV6 cr o c 40 8355) \ ?~s@ 838.4 x839.6 x837.9 l 1 841 x x 844.2 x 840.8 ~ ~ \rJ Mh Nv N 0 (70 s cD h i IV,M mod`. ~ N m w/ s LOT 5 .V• REC)UI11ED p.R DRAINAGE B VTILI T Y.< ~s /rE41SEMENT PER PLAT \ Q.O SCALE- I INCH= 30 FEET (As "o)---76.48 N 30 21' 22" W - r l A (,1/1_1 n\A111 '_III n rr l I~~n i fALC)1 I IJI V N incm o -n ~°W 0 ~ mes R. Hill ~F 0N ° - o~y Ja, N 0 M@ n~ ? V5 5> 2 M Z (D 0 - -0 o , m ? Z PLANNERS / ENGINEERS / SURVEYORS -n M z G) OD -D CD co < N m 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 •612-884-3029 N H m O N :r INSPECTION RECORD t.01 T l tt i Ntl 41W O GAN PER WT TYPE: Imm Pilot "ob toad Parrett Number. 0111 9 G O Ea rs, Minntsota135123 Issued O q I 1!f 104. DOW ; (612) 6814645 w e . ADDRESS: 81. (fis K : 1. ~4PRLICr~tN"T: ff ;?tb 6L,ACKl1AWJ( LA U 00 0 F I r.A TP ii`#6 #OF~^tltblIT SUBTYPE: TYPE OF WORK: A 1. P .,R A T 0 14 01 01,Pt1ON ' (14 NG 10 (Axi 0141,y dl P~ - F~ ~ yyI I y• ` wa1r 1Mii it ~ soft PLUMN" 14VA ELEMW !LECTRtC FOOWW I Foumaftn - ~A Rauh till. i Pbg. P14 k"Pocw - Y Kwfdw C*r* .flier oft I~ D" PC. DO& F" Pr. DhgL t' a a~0 RM T' . ;dR 1V :.r (ww;y} ry' MECHANICAL PERMIT RECEIPT # ` CITY OF EAGAN r G 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE:` PHONE: 454-8100 Site Address BLDG. TYPE, WORK DESCR09ION Lot Bloc ec/Sub Res. New Name r Mult. Add-on 1.0 Comm. Repair m Address c City Phone ° Other 4 FEES Name RES. HVAC 0-100 M BTU -$24.0 c Address' ADDITIONAL 50 M BTU - 6.0 RES. HVAC INCLUDES A/C ON NEW City J41 Phone • t- CONSTRUCTION) ' - _ GAS OUTLETS (MMIMUM 1 PER PEfiMIT) 1.5 EA. TYPE OF 1AfORK ComM/IND FEE - 1% OF CONTRACT FEE Forced Air M BTU $ APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES Boiler M BTU $ MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Heater M BTU REMODELS - 12. 0 Air Cond. M BTU MINIMUM COMMERCIAL FEE - 20. 0 Vent. CFM STATE SURCHARGE PER PERMIT - 0 (ADD $:50 S/C IF PERMIT PRICE GOES Gas Piping Outlets BEYOND $1,000) Other FEE: S/C: SIGNATURE OF PtAMITTEE TOTAL: FOR: CITY OF EAGAN PERMIT #r.~ C PLUMBING PERMIT CITY OF EAGAN RECEIPT # 3830 PILOT KNOB ROAD, EAGAN, MN 55122, DATE:'; CONTRACT PRICE: PHONE: 454-8100 . Site Addr ss BLDG,Y-PEWbRK DESCRIPTION Lot BIoC11 Sec/Sub Res. New -F- Mult. Add-on Name J-1)", t ~f; *t l Comm. Repair a~ ro Address Al~ Y Other c City< Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING: FIXTURES TOTAL Name Water Closet - $3.00 1 Bath Tubs - $3.00 ' Address Lavatory - $3.00 p City Phone Shower - $3.00 _ Kitchen Sink - $3.00; FEES -Urinal /Bidet - $3.00 COMM/IND FEE - 1% OF CONTRACT FEE Laundry Tray - $3.00 APT. BLDGS - COMM RATE APPLIES Floor Drains - $1.50; TOWNHOUSE & CONDO'- RES. RATE APPLIES Water Heater - $1.50 MINIMUM - RESIDENTIAL FEE - $12.00 Whirlpool - $3.00 MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outletsj- $1.50 v STATE SURCHARGE PER PERMIT - 50 (MINIMUM - 1 PER PERMIT) (ADD $.50 S/C IF PERMIT PRICE GOES Softener - $5.00 BEYOND $1,000.00 , Well - $10.00 Private Disp. - $10.00 x j =Rough Openings - $1.50 SIGN"'TORE OF PERMITTEE FEE: ` STATE S/C: FOR: CITY OF EAGAN GRAND TOTAL: f~ }ter a:. per. .-c+ iM •wyi~ ~*7 J GASH RECE)PT CITY 0 AGAk,- 3834 PILL? "k ROAD 1 `l EACAN; MINNESOA 55122 DATA AMcaL*rr x DOLLARS f~l4SP1 1 CHECK k 01 e I~ FUND OBJECT AMOUNT f r hen i Use BLUE or BLACK Ink r For Office Use I i i I j Permit 1 1~ Ron City of EaEd Permit Fee: . -19-310 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694-p- I Staff: cy~ 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: '~~ltl.,ZdG Site Address: 14a2.0 8CAC4kA&6)V, y6 UnitM F_ Name: RA- l Phone: Resident/ Owner Address / City / Zip: 5ANMr Applicant is: Owner X Contractor Type of Work Description of work: llr_-,~vV>` V` ~ Cep y\. 'e ter 6A eTS - l.e u~ i ~r 110 5 Construction Cost: Multi-Family Building: (Yes / No ) .~,,J l- ' Company:►ce,)~ R-~s ,1G Contact: c~5's sjl~%SJF_>y Address: ~J 7yoq LA.LL(2A LAJ i'Z City: 514-o42r_-Vi'AELJ Contractor State: kQ Zip: !55 / 2(,- Phone: L51 - lt(S -772-18 15co License -WO (v (P 3 71 Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 40 U3 Wks &ZL~4 J"i I1~ Rc p Cl 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 they are trade secrets. A 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 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. x-A .65 5 tra~ x Applicant's Printed Name Applicant's Signature Page 1 of 3 110 131ac.,LK6k0I(- LCAIL Or DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration (Single Family) Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi) _ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous 01 of Plex Lower Level Pool Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* _ Addition _ Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation ~iIDOO Occupancy MCES System - Plan Review Code Editions-i7 SAC Units (25%_ 100%-,/-< Zoning j'!7 City Water Census Code 4.7 Stories Booster Pump # of Units I Square Feet PRV # of Buildings I Length Fire Sprinklers Type of Construction Z3 Width - REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC _ Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final g Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough In -Air Test -Final Windows Insulation Retaining Wall: _ Footings _ Backfill _ Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: , Building Inspector RESIDENTIAL F S 3 o/0 (pG Base Fee 103, Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge- Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA114104 Date Issued:09/11/2013 Permit Category:ePermit Site Address: 1620 Blackhawk Lake Dr Lot:5 Block: 1 Addition: Blackhawk Glen 3rd PID:10-14352-01-050 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Luanne Yang 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 - Patrick Hoyt 1620 Blackhawk Lake Dr Eagan MN 55122 New Life Contracting Inc. 814 Grand Avenue St. Paul MN 55105 (651) 224-3442 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA131735 Date Issued:07/06/2015 Permit Category:ePermit Site Address: 1620 Blackhawk Lake Dr Lot:5 Block: 1 Addition: Blackhawk Glen 3rd PID:10-14352-01-050 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Patrick Hoyt 1620 Blackhawk Lake Dr Eagan MN 55122 (651) 688-7747 Controlled Air 21210 Eaton Ave Farmington MN 55024 (651) 460-6022 X253 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA139986 Date Issued:11/17/2016 Permit Category:ePermit Site Address: 1620 Blackhawk Lake Dr Lot:5 Block: 1 Addition: Blackhawk Glen 3rd PID:10-14352-01-050 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) 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 within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Kevin T White 1620 Blackhawk Lake Dr Eagan MN 55122 (608) 514-2000 Cedar Valley Exteriors Inc 13501 Balsam Lane #120 Dayton MN 55327 (763) 755-2221 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA167402 Date Issued:03/12/2021 Permit Category:ePermit Site Address: 1620 Blackhawk Lake Dr Lot:5 Block: 1 Addition: Blackhawk Glen 3rd PID:10-14352-01-050 Use: Description: Sub Type:Residential Work Type:Alteration Description:Basement Fixtures Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$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 - Kevin T & Emily E White 1620 Blackhawk Lake Dr Eagan MN 55122 Norblom Plumbing 1465 Selby Ave St Paul MN 55104 (612) 827-4033 Applicant/Permitee: Signature Issued By: Signature