1623 Blackhawk Lake DrCITY OF i::.Al,;:(°tt,,l
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i_T,,_, M,< <':"sNC.,p
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l.ot. -, h` Block Sec/?yb Res. 42` New
MWIi. Add-on
Naine> Comm- Repair ?
, m ? Address Other _
c City ,4lf` t4j Phone
Name
.
c Address
p Ciry Phone'??
:FEES
GdMM/IND FEE - i% OF CONTRACT FEE
APT. BLDGS -- GOMM RATE APPLIES
TOWNHOtJSE _& CQNDO --? RES. RATE APPLIES
MtNIMUM - RESIDEN?'fAL?fE - - _.-- $12.00
NIlNIMUM - COMIV1/1ND FEE , - $20:00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 SfG IF PERMII' F'RICE GOES
` BE?YOND.$1,OOQAA) _
_-
SIGNATURE OF PERMITTEE
; FOR: CITY QF. EAGAN
.
RES. PLBG: ONLY - COMPLETE`TH.E FOLLO I
N? FiXTURES T 1
Water Closet - $3.00
Bath Tubs - $3.00
--t-Lavatory - $3:00
?Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
=Laundry Tray - $3.00
-?Floor Drains - $1.50
Water Heater - $1.50 „
? Whirlpool - $3.00
--Gas Piping OutVets - $1.50
?, (MINiMIfM - 9 PER PER?ICL')
_?Softener - $5.00
Well - $10.00
?rPrivate Disp. - $10:00
Rough Openings - $1:50
FEE:
STATE SIGt
GRAND T.OTAL: ?
i
?:
,. _
. ., .. .._ . .
. _ ..,. . , ? .
PERMIT#/. -2
, , • _
MECHANICAL PERMIT
,
'' •' • CITY O RECEIPT #
F EAGAN SepCenrtb+3'C
, 198?
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT P E: $4600 •00 PHONE: 454-8100
Site Addres - $c '?? ? rive
4 BLDG. TYPE WORK DESCRIP ION
Lot
_?o k 2 Sec/Sub r x New x
Res
.
De?ndable Heating and-irc Mult. Add-on
?
? Name
Address 2619 Coon RaPids Blvd.
Comm. Repair
s
y
c Caori itapids Phone 7'?7°'SOkCt
City Other
Name ?iume. Ca?truction FEES
RES. HVAC 0-100 M BTU
-$24.00
c Address 2119 Vib??num Trail ADDITIONAL 50 M BTU - 6.00
Burns'?l??'? Phone $27"$171
Cit (RES. HVAC INCLUDES A/C ON NEW
p y CQNSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PEFtMM - 1.50 EA.
TYPE OF WORK CQMMIIND FEE - 10/oOF COJVTRACT FEE
?•??
Forced Air 120 20 ?/I BTU AP7 BLbGS. - GOMM. RATE APPLIES
. TOWNHOUSE & CONDOS - RES. RATE APPLIE
I Boiler M BTU ? MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
Unit Heater M BTU ? REMODfLS , 12.00
Air Gond. M BTU $ MINIMUM COMMERCIAL FEE - 20.00
3 b-&-t-h a-n STATE SURCHARGE PER PERMIT - .50
Vent.
CFM
$ PERMIT PRICE GOES
?????, ?? ?,u
????
?.??
Gas Piping Outlets # $
BEYOND $1,pp0)
Other $
FEE: 31.50
SIC: .50 SIGNATURE OF PERMITTEE
_ TOTAL: 32.0f)
FOR: C1TY OF EAGAN
?.?'T 77"? ?""'? ? ?1 #•,d ?'? c. , ? '_`? ? ?
?.r
EiP.;F
?
?? . . _ , ? _ ` .
.: ., ? ??????OT K'NOS ROAD . o. .. , . ..
r>' ? r
y EAGAAI, MIddIVE??J?5122 ?.,
?
DATE
AMOUNT I $ J%; e
??
& DQLLARS
loo
O CASH 0 CHECK
t?
. ?Y .. ?`? ? 1 /? :.?5.??•.v'?ll.. -Y.f"?
FUND , OBJECT AMOUNI?
4 z':
R ?
Thank iott,-
Whft--P"- copy
r+ato-PoW+g coW
?
Pink-F#eOo"
..._i _ ._ .... _. . _ .. ,._ . .?._a''?..':_J
" BLDG. PERMtT NO. - I
0 C-)'F-
01-3210 Bidg. Permit 818 Ov
?- 4C?9 0U
? 01-3422 P1an Check
01-3445 Surch./Adm.
? 01-3446 SACJAdm. -s S c
? 01-2155 Surcharge g5 -)E)
? 75-3860 Road Unit
20-2275 SAC 544 50
s
20-3865 Water Conn. 5"5 o oc)
20-3868 Water Trmt. ? + co
? 20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
r 79-3866 Sewer Conn.
28-3855 Park Ded.
TOTAL 3' 11 C) .1`' o
G'
?
?
?
,
Th`? ? k
NT
?I
vr < _
Wh'?te-Payers tkapy
Y81bYa--PGStiw fbpy _
PWlF--File Capy
;? ?r ?
.?,.? ,' 9? . , .'"RO. Bsx 21-199, Eagan, MN 5S1 1 t , ? ' °
3830 Pilot Knob+Road,
? PHON-E:454-$100 '
BU[t.DING'PERMIT Receipt # ?+ 3 7
To be used for Est. Value Date
Site Address OFFICE USE ONLY
Lot BIoCk Sec/Sub. On Site Sewage % Qccupancy
MWCC Sys,tem Zorring
Parcei No. ° -
OnSite Well (ACtwai) ConsY
ac Name
C'sty Wates
(A4towable)
. ,
g
w Addr@SS :• PRV Required # of Stories ?
? t3#y Phone Booster Pump Length t
Depth
? NSme ? S.F. Total
Address Footprint S.F.
` '
i- City Phone - APPROVALS FEES
?
v W
NBme ` Engr./Assess. Permit
y? W
?
Pfanner
Surcfiarge . , .
_ ?
? Address
'
Council
Plan Review
t W Gt
ty PhQR?
Bldg. Off. SAC, City
i hereby acknowledge that I have read this application and state that the Variance SAC, MWCG °
information is correct and agree-to comply with all applicable State of Water Conn.
Minnesota Statutes and City of Eagan Ordinances.
Water Meter
Signature of Permittee Road Unit
A Building Permit is issued to: Treatment P1 '
on the express condition that all work shall be done in accordance with all parks
applicable S#ate of Minnesota Statutes and City of Eagan Ordinances. *
Building Official TOTAL ?
1% ` Permit Mo. Permit Holder Date Telmphone #
p?unobjn9 ??i ? ? z g y
1 N.. •
H.V.A.C.
Electric
t ? ? 5 K)
Softener
inapection Date Insp. COminentS
Footings I
Footings II
Foundation
Framin
g
Roafing
Rough P1bg.
Rough Htg.
Isul.
Fireplace `
Final Htg. ?
Final Pibg.
Bldg. Final
cert. occ.
Temp. LP
Deck Ftg.
Deck Final
Wetl
Pr. Disp. ,
Cfi'aY4 F EAGAN
3$SO?Rot Knob Road
Box 21199
Eagan, MN 55121
Owner.
PermiE No: 9872 Meter N9:
Reacter No?? a -37A 12Y7
?.
Date: ?.8,,22-88
Sixe: ?
Oate: - '
Site Address: 1 Q3 Rt ,gnkhavk Iake Dr ve I.4 $2 BZSek.trawk
Plumber.-_ *t*ha=QCn Ft,.mb,ing Glen I1I
Conn. Chg: 5?50. 3. O0pd Zoning: ?'
Acct Dep: No. of Units:
Permit Fee: 7 Q _ nf?Dd
Surcharge: _ _ S(3.d ! agree to comply wiih the Glty oi Eagan `
Tr. Piant 204 _ t1(1,nA Ordina 67 00,d 17/-/
Metec ?/L
Misc.:---P?-MQ??3???? By
WATER SERVECE PE MIT
This request void C//?/??
18 months from ?
E 19 8 ? 44?//2_z?)dc.??c??
Request Date Fire No. Reqghe?n2lnspertion E]Ready Now ?Will Notify Inspec-
? ? ? ?° Yes ? No [or When Ready
? Licensed Elec rical Contractor 1 hereby request inspection of above
? Owner electrical work installed at:
Street Addres?? ??Route??42K??1?/Z Z?t? ?? City
ecUOn o. Township Name or No. Range No. County
OccuGant(PRINT)? Phone No.
Power Supplier Address
Electrical Contra tor (Cmpany Name)
. 7?0?'? L???? Cont ac or's License No.
Mailing Address (Contract r r Owner Making Instail tion)
1??oi ,?i?1r?L???
Authorize ggnature (Contractor/Ow%? er M king Install'on1 Phone umber
???
MINNEdOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD
1821 Universitv Ave.. St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
IRMWa-one (612) 642-0800 ENCLOSED.
REQUEST FOR EL ` . ?CTION EB-00001-06
See instructions for comp eting this form on back of yellow copy.
? ? ?lr ??-?-
E f9 $0_' 4 "X" Below Work Covered by This Request
Add Rep. Type of Building Appliances Wired EquiUment Wired
Home Range Temporary Service
Duplex Water Heater Lightin,y Fixtures
Apt. Building Dryer Electric Heatin
Corrunerciaf Bldy. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Suik Milk Tank
Farm Other peciiy Other (Specify)
t er SVecify Other Other
Compute /nspection Fee Below
p Fee ServiceEntranceSize tt Pee Fee.ders/Subfesders 4 Fee Circuits
0 to200 Am s 0 to30Am s 0 to30Am s
Above 200 Amps 31 to 100 Arnps 31 to 100 Am s
Swimming Pool Above 100- Amps Above 100_Am s
Transiormers frrigation Booms Partial, Other Fee
Signs Speciai inspection
S
'
TOTAL
Rerriarks /
?
???
66
? ?
i
Rough-in Date 1, the Electr?ca
, . Inspector, hereby
certify that the above
I final : j?1er inspection has been
?F 1.Y" r mede.
This request void 18 months from
This re4uest void ,?--
18 mpnths from
E ? q R AR , t 4;
Request Date '
? ? Fire No. Rough-in InsUection
Required?
?Ready Now ?SNill Notifv. Inspec-
to
Wh
R
d
pg-y ?No r
en
ea
Y
? Licensed Elec[rical Contrector 1 hereby repuest insDeciion ot above
? Owner electrical work installed at:
Street Address, Box or oute No.
Z,4IZ City A/
ection o. Township Name or No. Range No. County
Occuuant 1P INT} Phone No.
Pawer p?r
7;? Address
pa y
Electri a Contr ctor (C mn N• e)
? L'G Contractor"s License No.
Mailing Address (Contractor or pwner Making Inst
????? ailation)
4?Y
Authoriz gnature (Coniractor/Owner Ma ing I stailation) Phon Number
MINI`*£SOTA STATE BOARD OF ELECTRIC{TY THiS 1NSPECTION REQUEST WILI NdT
Griggs-Midway Bidg. - Room N.191 BE ACCEPTED BY THE STATE BOARD
7821 Universitv Ave.. St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
j REQUEST FOR ELECTRICAL INSPECTtON E6-00001-06
ij'?j
? ? See instructions for com?plitting this form on 6ack of yellow copy.
E"l 9 8 0 8 "X" BeJow Wl'?,..? overed by This Request
Add Rep. Type ot Building Appliaocas Wired EnuiUment Wireki
Home Range Temporary Service
Dupiex Water Heater Lightiny Fixtures
Apt. Building Dryer rlu Heatin
Commerciai Bldy. Fumace ntoader
industrial Bidg. Air Conditioner Milk Tank
E
Farm Otnrr SPP(:?ry Isu??,.,fvl
ther SVecify
Other 1,h
' Comoute lnsvection Fe
e Below
It Pee Service Entrance Size tt Fee Feeders/Suhfeeders # Fee Circuits
?Q a 0 to 200 Amps 0 to 30 Am s 0 t? 30 Am s
Above 200 Amps 31 to 100 Arnps 31 to 100 Am s
Swinuning Pool Above 100_Amps Above 100_Amps
Transformers Irrigation Boorris Partial- Other Fee
? ' I Signs
Rernarks
Rough-in
Final
Tfiis request void 18 months
Speciai in ection $ ?`,? TOTA
? L
? d
ate , the E?
?n10?
#CerlifV nspector, hereby
that the above
Yt? ?l nspection has been
1(?" made.
EPpartritPlt# of lllilbiltg J2tS.pPt'tiDri
,
This Certicate issued pursuant to the requirements of Section 346 of the Uniform Buttding
Code certifying that at the time of issuance this structure was in comptrance witk the uarious
ordinances of the City regutating building construction or use. For the following.•
Usc Classifipdon SF DWjGAR B(dg. Rrmit No. I5705
Occupancy Type R3ti1i Zoning District Ri TYPe Coost. Yf7
Owner of Buitding MCK Address 2119 ???? ??, EAGAN
s?;w; aa? 1fi23 ffi?At? L\ ,1?7i.i MYi:.jq,win,1!•FL f72LI7Lt7MItlriiI a74ar'+N 3LVJ
a
- f DAtC: ? 43,, 19TJ
t j Bui6 ing Ot6cia
f
?
POST IN A CONSPICUOUS PLACE
?
>?'?.?'?}1. ", - . - _ . . ?_ . _ • u
. ,_ ? . - .. .. ,. - . . r ?,k
17
??
'§
:?
?_
;? ?
;: :
'??
°;a°?
HOUSE HEATING TE57 RECORD
' ?
a
•
t 't 11
ADORESS /
?
,? ,
APT.
FLOOR CIT7SUdURB
OCCUPANT OMR/ER
NEAT LOSS DATE MT4 INST.
SOLD S1' INSTALLED Blf "
Elect?ital rlerk Gos lino By
TYPE OF HEAT GA FA _?S_Mw STEAM SPACE HTR. UN17 H'fR. OTHER
. GAS OESICH CONVERSION
MAKE MAKE OF BURNER
_ ? ,..
0.4.1 !.? 7! ??,?-t'•7.--(`-__,l
ld04101
S«iol
Masc. BTU Ratiny
tNPUT lAAKE OF FUR144CE•
i
1dedel
CONTROLS ?,
THERI?AOS,TAT M.o, Pi„y v.,,# Si:• 41
Volv• KINO OF L1NER SIZE NONP
L i m i t Oroh Mood
g m
LIT1f Seftlfl9
r'ilfN• Sli•
FO/1 So"Ifla (DtITMr LOC011011 Ifl/I{e ONt11de
Pi1or Trpe f Q+;mn.y Constrveiion
Pilot Meko Spillaqe ?
Piiot moe.i sonok. eornb -` wi.i„9 /
Pilor Tinning 0?oft ~ T..r ?oa
L.W. Cuf Of( Dow Prosaur• l.iqhtiny lnst.
:
?
Pr•$ sw.
Percont C0?
Dae• T•ared
inpur CFH P«e•nt 02_?? ?` ?', -, Comoonr T•stinp d
Sack t•mp. (?=`?? ?Pwe?nt CO *--Nnne of ToatM
Certificate of Compentency_ #
? CIT.Y OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
DESCRIPTION:
REMARKS:
RECEzPr # C, 0 I -?(Q?Ss
FEE SUMMARY:
Base Fes $25.00
Surcharge ;.50
Lic. Search Fee 15.00
Total Fee $30.58
suxLnING
000451
fD5/06/92
CONTRACTOR: - APPlicant - sT. LIC. OWNER:
BUELQW CaRPENTRY 18848343 0806676 ANDERSON biARD
8201 GIINTON AVE S 1623 BLACKHAWK LAKE DR
BLOOMINGTON MN 55428 ERGAN MN
(612) 884-8343 (612)686-9423
i' hereby acknow.ledgo, that I- 'hi
information is car?ect, and ag?
Statutes and Ci;ty. 9 f E-49,40 Orl
?
?
r?rad t?e,.?t -appl attat?:on ar?d ???t? t??? tt??
to c4mply w1th al?: ab14 .S tate
?
ISS D BY: SI RE
r.., ,
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
1623 BLACKNAWK LAKE DR
LOT: 4 BLQCK: 2
BLACKHAWK GLEN 3R0
Control No. 0383
PERMI7 f CITY OF EAGAN
1992 BUILDING PERMtT APPLlCATION
681-4675
(
p
A PR 3
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, l tapy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 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 uest is made or lot chan e is re uested once ermit is issued.
Date 0 !? /.29 Yal uat i on of work 4700.00
Site Address:_ ? 6a 3tiLccc k F-lcLw k LakE bg,
STREET STE t
enant Name : wiq R b 14 1v 06 R o ti
LOT ? BLOCK ? SUBD???/?g?/ P.I.D. #
Descri tion of work: C u - T' e a N
The applicant is: O Owner U Contractor O Other ccescr;lme>
Name ftNSDERSc3tv w?3R b Phone 4$2- cL{'a3
Property LAS7 F1RST
Owner Address 1&a3 13LQck14a L-jK t_4k?? [)ko.
STREET ' STE *
City FAG4ti State ? N Zip !M a?
Company ? ue Losa _Cf}I? PENrR !4 Phone SQ k-$343
Contractor Address 1?Li NTo w 14ue. S, License #000607b Exp.3- /-4
C i ty 6 Co o m N G--t-e &J S t a t e i?1 11.J Z i p SS??I a 0
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: ?- ..?-
BUILDtNG PERMIT TYPE
El 01 Foundation
O 02 SF Dwg.
O 03 Two family
? 04 Multi-fam. Z.H.
O 05 AAt. Bldg
0 06 Garage /Acce s sory
? 07 Fireplace
0 08 Deck
E3 09 Basement Finish
O 10 Swim Pool
? 11 Res. Add./Porch
E3 12 Comm./Ind.
t . _+ ,
L] 13 Public Fac.
O 14 Agricultura7
Q 15_Miscellaneous
WORK TYPE
? 31 New
P-32 Addition
? 33 Alterations
? 34 Repair
? 35 Tenant Finish
O 36 Move
GENERAL INFORMATION
C] 31 Demolish
O 99 Undefined
Const. (Actual
? Basement sq. ft. MWCC System
(Allowable lst F1. sq. ft. City Water
UBC Occupancy 2nd Fl. sq. ft. PRV Required
Zonin9 Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft, Fire'Sprinkler
length ?3- Qn-site well Census Code yC4
Oepth On-site sewage SAC Code
APPROVALS
Planning Building Assessments
fngineering Variance
REQUtRED INSPECTIONS
E3 Site 14 Footing ? Framing O Insulation ,
? Wallboard ? Final ? Draintile E3 Firepiace
Permi t Fee '5<<'L' wiuat;on: sSurcharge Pian Review
Cicense ?.
MWCC SAC
City SAC Water Conn.
Water Meter _
Acct. Deposit .
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit Park Ded.
Trails Ded.
Copies
Other
Total : ???- -
SAC 9i6 SAC Units
-AV"?. YO RIS C R T I F I C A T E SIENNA CORPORATION
- REVISED 7=/-T=rj' TO SHOW A PROPOSED
HOUSE FOR HUME CONSTRUCTION.
A? r ? Z
4Ckyq?
??B3J
. ?' . 9,.00 kA
i8 ? 8 4?'S8?
ro 5 ? 14ss o
3-7.s
!>, (8?8,9
33 ? )
I ?? '?' o N? arc? c S?
M / No17 6?p
L N
? oo ro PROPO ? 26.0 ? ? ' °• ` ' /
Gq
? NOLSF D
?: • R'4 GE
66.33
8"'t,2? c%j
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28
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A ED
?
By
Date
B,?G ENGIN ,RING DUT.
i
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---- ?
13 5.00 --?'
IIt
P.R.V. REQUIRED
. . ? inc
a m
es R. H?i . PLANNERS / ENGlNEERS / SURVEYORS'
9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029
S 0°19'19" E
-?-
L_ `I i
CITY OF EAGAN No 1549g
.?'.'3830 Pilot Knob Road, P.Q. Box 21-199, Eagan, MN 55121
PHON E: 454-8100
BUILDING PERMIT Receipt #__?& 1.3 1
To be used for SF DWG/GAR Est. Value $175,000 Date AUGUST 19 ,198$
Site Address 1623 BLACKHAWK LAKE DR
Lot 4 Block 2 Sec/Sub.BLACKHAWK GLEN 3R1
Parcei No.
m Name HUME CONSTRUCTION INC
? Address 2119 VIBURNUM TR
° City EAGAN Phone 688-2004
,o Name SAME
? a Address
P Gity Phone
"W Name
1- cc
W W
_ z. Address
Q W City Phone
I hereby acknowiedge that i have read this appiication and state that the
information is correct and agree to compiy with ali appiicabie State of
Minnesota Statutes and City f'agan Orr? ces.
Signature of Permittee
A euiiding Permit is issued to:_ HUME CONSTR . I INC
on the express condition that all work shail be done in accordance with all
appiicabie State af Minnesota Statutes and City of Eagan Ordinances.
Buiiding Official 1 f 1'''F" .XJ L?_?
OFFICE USE ONLY
On Site Sewage Occupancy R-3 M-1
MWCC System X Zoning R-1
On 5ite Weli (Actuai) Const V-N
City Water X (Ailowable) V-N
PRV Required X # of Stories
Booster Pump Length 66'
Depth 32'
S.F. Totai
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit 818.00
Planner Surcharge 87.50
Council Pian Review 409.00
Bidg. Off. SAC, City 100.00
Variance SAC, MWCC 550.00
Water Conn. 550.00
Water Meter 67.00
r Road Unit 32500
Treatment P1 204.00
Parks
50
110
3
TOTAL .
,
? t
s
198$ BUILDIATG PERMIT kPPLIGATI4N - CITY OF EkGAI+1 SiATGLE FAMILY DWELLINGs /f q t
INCLUDE 2 SETS OF PLANS, 3 CERTIFTGATES OF SURBEY, 1 SET OF ENERGY Cl1LCULATIONS
N02Es ADARESSES FQR CORATEa LOTS - CONTRACTORIHOMEpWNER Mi73T DESiGATATE teFHICS AD13RESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDIbTG PERMIT I3 SSSiTED.
MtiLTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF tiHZTS
_........r....... ?..?..,...._
INCLUDE 2 SETS OF PvLANS, CERTIFSCATE OF SURVEY - CHECK WITH BLD`:. DEFT.,
1 SET OF ENERGY CALCUL.ATIONS ,
,
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,' ? jw ,? ??
?
1 SET OF SPECIFICATI4NS AND 1 SET OF ENERGY CALCUL.ATIONS '?
To Be 0sed For: 7silG Valuation; e? „? _ Date: 45j'o
.
Site Addres? ? ?
Lot Block ?
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Owner ?U%?L ???i?UC 710????? `
Addresa
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CitytZip Code ,'/ n"z Z z
Phone
Contraetor lltl'*?E
Address
City/Zip Code 209011,q S971 2
Phtme 6s6' 2ca
Areh./Engr. fV • S6 woe-%??
Adaress
---- _9 1 _A4AV I
CitylZip Code Y
Engr/Assess
Planner
Coune3l
Bldg. Off.
Varianee
tkscupaney _N M • 1
Zoning R-!
AetLal Canst ? V•N
Al],owable
# of stories
Length `.
Depth 3?,'- !,141,.
S.F. Total
Footprint 5.F.??.
FEES
.,._...?
Permit ?
Sureharge
Plan Review ?jo,,,60,
SAC, City I DQ, gg
SAC, MWCC CIS ,1 ,g2
Water Conn 5 O ,
Water Meter
Road tTnit , oC33
Parks
Copies ?
TaTAI.
Treatnent Pl .,&g4192
?
Phone # `,
VA LuA-r l
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SA-'?ev&NT
I`2 x 2- ( Z y)
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SURVEYOR'S CERTIFICATE
SI ENNA GORPORATION
REVISED 7-/ 3 - g ri TO SHOW A PROPOSED
HOUSE FOR HUME CONSTRUCTION.
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DENOTES PROFOSED SURFACE DRA .Vo 1-1
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O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET
• DENOTES lRON MONUMENT FOUND PROPOSED GARAGE FLQOR - 839.2 FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWES7 FLOOR - 831.5 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - 839.6 FEET
WE HEREBY CERTIFY TO H U ME C 0 N S T R U C T 10 N 7HAT THIS IS A TRUE AND CORREC7
REPRESENTATIQN QF A SURVEY OF THE BOUNDARIES OF:
Lat 4, 61ock ? 2, BLACKHAWK GLEN 3R0 ADDlTiON,accordtng to the recorded
? plat, thereaf, Dakota County, Mlnnesota.
`•.'. IT.DOES NOT'PURAORT TO SHOW iMPROVEMENTS OR ENCROACHMENTS, EXCEP7 AS SHOWN. AS
` SURVEYED BY fVlE 4R UNDER MY DIRECT SUPERVISION THIS) 3? DAY 0 F...7.w..-4-k Y ,19$?
SIGNED: JA LL, INC.j
' BY: ?
HAROLD C. PEl'ERSON, LAND SURVEYOR
MINNESOTA LICENSE NUM6ER 12294
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James R
PLANNERS / ENGINEERS / SURVEYORS
9401 JANIES AVE. S. • BLOOMINGTC)N, MN. 55431 • 612-884-3029
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S lJ R 1/ E Y O R' S C R T I F I C a4 TE SIEPJNA CORPORATION
REVISED 1=/3gP TO SHOW A PROPOSED
HOUSE FOR HUME CONSTRUCTION.
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R.V. ?EQ?IRED
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James PLr'?NN EI?S / ENGII?IEERS / SURVEYORS
9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029
;? 70 y 7?0
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John Bnord f ey
? architecturo?I consultants tnc..
_ OOOB bL 3T. 3.E. OSSEO, MN. 65369 M1. (E12)-114-9772
EXTERI4R ENVELOPE AVERAGE "U" COMPUTAT
Plan ''`.
GLAZED
7
ControCtor••- e--1?4=7-"
Site Address: ?-O'r ? EiL
1)TOTAL EXPOSED WALL AREA 3° sq f?x U''?
2)TOTAL EXPOSEO ROOFfCE1l.iNQ AREA_ sq. ft. x"U"
WALL AREA CALCULATIONS: .
TOTAL WINDOW AREA
70TAL DOOR AREA
TOTAL GLASS DOOR AREA
Date 05"
GLAZED
?-? sQ.ft.x?U??'?=
.?? Sq.ft.zlUlo.v? _, '
? sq.ft. x 'U" -fZ- _ ? (=,
??.
?Z5
Zn??
--7 ?
__..---
sq.f t. z "U"
sq•ft.x"U"'
L-sq.ft.x 'U"
sq.ff.x'U"? Ilt- _ ? o
_--5q.ft.z"U" y -
3) T AL
?OTAL FIREPLACE WALL AREA
70TAL WALL FRAMING AREA
NET INSULATED WALL AREA
TOTAL RIM JOIST AREA
TOTAL FOUNDATION AREA (EXPOSED)
TOTAL FOUNDATiON WINDOW AREA
If ifem 3 ls 1he some os,or less ihan item i, you hove mei ihe infent of
2 MCAR 1.16008 A ond O.
ROOF/CEILINt3 CALCULATIONS?
TOTAL SKYLIGNT AREA -?"- cQ.ft.x"U" -
TOTAL ROOF/GEILlNG FRAMING AREA ? 1S aq.fl.x?U41' °? = 3•s
NET INSULATED ROOF CEILING AREA sq.tt.x?Uis ,° _ 4) TOTA . ° +
H item 4 Js the some as,or less than Jtem 2, you have met the iMent of ?2 MCAR 1.16008 A and O.
ALTERHAT£ BUII.OfNG ENVELOPE DE310N
To utilize the fofdl envelope system method, fhe sum of ttems I ond 2 shall '•
be greater thon the sum of Items 3 and 4. ;
. 1) +2) _
. - 3) +4) _
1 hereby certffy fhdt ths buflding here described meets or exceeds the State of Minnesoto
Energy Conservotion Act.
(signed) .??'
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CONSTRUCTION
FRAMING SECTION
I interior air fiim 0.68
2 -? " ,_,
3
4 St lnches of soft wood
LSI 5c e%,.4o64-aa+E ?,g1
Z o 1.
5 1io1=k , bl
6 exterior air film 0,17
.
- TOTAL R
U = I/R ? °2
SECTION (INSULATED)
I inferlor air film 0.6
2 , 4S
3 S? ? SL-} .?-'U.
-- I`ti, -0
4 zr'{ sL R""-4e w-E Z o 6
5 's I JA' 14!? • b 1
g exferior air film 0,17
TOTA L R 4.3 -1"1
U = I/R - - 22!!+-_
DIST SECTION
I interior air fJlm 0.68
2 re.-\4+ 19...
3 on
4 r..5 13r
5 ?1 =1- I?? ?Sl
s exferior air film 0,17
TOTAL R lCe I
U = I/R Q o
4TION SECTION
I interlor air film 0.68
2
3
r{ Qxterior air film -
5 0 17
- TOTAL R 1's
? U = 1/R_ 'T
CONSTRUCTION •
CEIUNG SECTION (INSULATED)
(I iinferior air film 0.61
- ( 2 5/is 05"
(4 extertor air /ilm (stifl) 0.61
TOTAL R
• U = ._I/R _ - C;>ZZ
_ CEILING FRAMING SECTION .
j ? Pnterior olr film 0.61
(2 ??'B SFr?,tcc.? +Sl?
I 3 •??.o-??.I ?.sa.l?.. ??
(4 interior air film 0.61
(5 Sli inches of soft wood 4.P5
. TOTAL R
. U = 1/R DZlO
CEILING SECTION (INSULATED).
_ ( I lnferior air film 0.61
- (2
- - --- ( 3
(4 exterior air fllm (stlll) 0.61
, . TOTAL R
U = i /R
CEILING FRAMING SECTION _
I,lnterior air film 0.61
_ (2
(3
VENTED
(4 interlor air film 0.61
(5 Inches of soft wood ,
.TOTAL R
..U = I/R
EXPOSED BEAM CEILING SECTlON
(j interiQt air fflm 0.61
(2
(3
(4
(5 exferior air tilm 0•I7
TOTAL R
L = I/R
CITY OF EAGAN Permit No:_
3830 Pi{ot Knob Road Me1er No: _
P.O. Bax 21199 Reader No:
Eagan, MN 55121
?., .
Date:
Size:
Oate:
Owner. ? -
. ,;
Site Address:
Piumber. E,t. •?.-t:
Conn. Chg: Zoning:
Acct. Dep: No. of Units:
Permit Fee:
Surcharge: 1 agree to comply with the City of Eagan
Tr. Plant Ordinances.
Meter.
Misc.: ' gy
WATER SERVECE PERMIT
CITY OE EAGAN Permit No: Date:
3830 PiJol Knab Road B/P Ido: Date:
P.O. ,:Box 21199 ?
Eag`an, MN 55127 ?
Owner:
SiteAddress: +*`,`? =` < °`? {=??.a?? ?.a?:? '??°ive `a '3"' ?i3?c?-}•;?T?3.
Piumber: 711
MWCG: Zoning- - - ? ,
City Chg: No. of Units:
Acct Dep: ?- -- ---- I agree to comply with the City of Eagan
Permit Fee: Ordinances.
Surcharge:
Misc.: BY
SEWER SERVICE PERMIT
APFLI?ATION FOR PERMIT
SEWER AND/OR WATER CONNECTIQN
ity oF eagan
* NOTE: PAYMUTP OF FEE AT TIME OF *
*k APPLICATION DOES NOT CON- *
* STITVIE APPRGVAL OF PERMIT. ?*.
t
; zNsPncrraa oF sEWEa Arn/oR wAzEt *
*.
* iNsrALIATTOrts HnrIa, Nar ss sc.IDar.,ID *
*t i!N1ZL PIItNIIT HAS BEFSI APPRCJVID. *k
************,r*************************
??,
1) PROPII2TY ADDRFSS :
TB[;AT, DESCRIPTION:. -
Lot B ock S vision or Tax Parcel ID
IF EXISTING STRtiCTLlRE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE:
mont Year
PRESENT ZONING/PROPOSID LSE:
? COMMEF2CIAL/RETAIL/OFFICE R-1 SINGLE FAMILY
? INDT-ISTRIAL ? R-2 DLPLEX ('ifiao t?nits )
? INSTITC1TIONAL/GOVERNMENT ? R-3 TOWNHODSE (Three + Units )( Lnits )
Q R-4 APARTMENP/CONDOMINIUM ( Lnits)
2) *33?iU0 NANIE :
ADDRESS: 12201 MINNETONKA CLVD ?
CITY, STATE, ZIP: • 55343
PHONE:
3) lUffl :l'• NAME: TbQ,op$nM PLLIMBItdC CO_. INC,
ADDRESS: 12201.MINNETONKA BLVD
• MASTER LICENSE #
Active
Expired
Not recorded
Sta?Initia.?
CITY, STATE, ZIP,
•
PHONE
4) ?? ?ffiNA •,i??:
NAME:
ADDRESS:
LITY, STATE, ZIP:
PHONE:
s ? ? ar • ?+? ? . ? a?t
5)
?CONNECTION TO CITY SEWER MCONNECTION TO CITY WATER ? OTf-ER
6)
?************************************?*************************?************************************
* THE GOLD COPY OF THE PII2MIT WILL BE SENT DIRECTLY TO PUBLIC WORKS TO FACILITATE MEIM PICK-UP. *
* PLEASE ALLAW Ztn10 WiDRKING DAYS FOR PROCFSSING. sONIDONE FROM Tfis CITY WILL COIVTACT YOU IF Zg1ERE *
* ARE ANY PROBLEMS. *
?******?**********************************************************************************?********;
:?FOR -CITY USE ONLY
PERMIT # ISSUED Pd w/Bldg. Permit FEES:
s $ /?•,S2j
$
$ $
$ $
$ $
$
S ? 52? • ?? $
$ $
$ $
$ $
$ $
$ ? ? ?` ?Z1 $
$ $
$ /?7?4o s ? /t ??-?
. ?6 -73 7 P6 7 o 6
_R.FCETp'I' „ RiCEIPT it
SEWER PERMIT (INCLUDE SURCHARGE)
WATER PERMIT (INCLLDE SL'RCHARGE)
WATER METER/COPPERHORN/OLTSIDE READER
WA.TER TAP (INCLLDE CORPORATION STOP)
SEWER TAP
ACCOLNT DEPOSIT - SEWER
ACCOLNT DEPOSIT - WATER
WAC
SAC
TRLNK WATER ASSESSMENT
TRLNK SEWER ASSESSMENT
LATERAL BENEFITjTRLNK SEWER
LATERAL BENEFIT/TRUNK WATER
WATER TREATMENT PLANT SURCHARGE
OTHER:
TOTAL
DOES UTILITY CONNECTION REQLTRE EXCAVATION IN PUBLIC RIGHT OF WAY?
F__j YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
ROADWAY" MLST BE ISSUED BY THE ENGINEERING
ID NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE :
UNDERGROUND SPRINKLER SYSTEM
PLUMBING PERMIT
Date: Permit #
Date %' ?
Receipt # O?JI-0 /- -
? Commercial: $25.50 + water tap if required. (City installs all taps up to 1"). If
adding new service, a water permit will be required, as well.
Existing, residential: $15.50 (Plumbing permit not required if backflow preventor was
previously instalied).
? Residential developments: Fee to be determined by building inspections department.
May require payment of water permit, lumbin permit, WAC and water treatment
plant fees.
?
(Address to be sprinklered)
Homeowner/Plumber:
?e ?i?? P?w
Phone #: A?
Street Address:
City, State, Zip:
Owner Name: IA)ar?*V- 4rt;er-icov
Street Address: /W-3,,,
Phone #: _9'k?-2 _
Irrigation Contractor: C'c°
Phone #:
I hereby acknowledge that I have read this application and state that the information is
ect and agree to comply with all applicable City o€ Eagan Ordinances
?.
?
: ~Engineering Department
a.??e.,e ?
Job. rvo. -- ?a ? o
DEPENDABLE l?E[1TI??1G & AIR CO??IDTTIONING INC.
-IEAT LOSS CALCULATIONS
)wners Address La -7- y 6 L- 0C...K a-- Buifder ^AE
/d-?Y-cJ K LA-K4_ Job Name I'"N 0 G 7, t_
Location
?- F I. ?)`f ?z\_ R m. Lgth. - v Wdth. Hgt 9
Wind ows and Doors - Crack age and Area
Desig. Width
of ane Height
of ane No.
I hts Lin. ft.
crack Area
1
.
t.
? .? / / ?- r
/
7
) ?- ? ? ) 1 ? r-'1
? .2`? 4v 1 ?6 4v
Z- i v - ?c / Z v g
I
coef btu
infiltration (Desig, ) 0 3 5-1, / 0 /s-0
infiltration (Desig. )
Infiltration (Desig. )
Giass ;Desig. ) f j y (m ? ? ?
Glass (Desig. j
Giass (Desig. )
Exp. Wail j
Net Exp. Wall i 3S7 ? & 7)
Net Exp. Wall
Ceiling / ?"D(v 2,
Floor
Total Btu
Required sq. ft. E.D.R. or sq. ins. W.A. Leader Area I -) u, 1? v Cj
Rm.
J S S.. L9th. Wdih. Hgt.
Wind ows and Doors - Crack age and Area
Desig. W'dth
of ane Hei9ht
of ane No.
I hts Lin. ft.
crack Area
. ft.
coef btu
Infiltration (Desig. I -2oZ f S°t,,?
Infiltration (Desig. 1
Infiltration (Desig. ?
Giass (Desig. i-S-)--
ass esi : Z.o-O
Glass (Desig. 1
Exp. Wall
Net Exp. Wall
Net Exp, Wall
Ceiling p -
Floor
Total Btu
Required sq. ft. F.D.R. or sq. ins. W.A. Leader rea
GI-73°
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date 1 / I / 05
Site Street Address ?? pcwo1? wv-e- ;X Unit #
Property Owner Telephone #
Contractor BW1,',eS fTelephone# ((og)?.2"b
Address ?305 (.yV\ ?•?-- City Stater-LIIVl Zip '` 1"0'2
The Applicant is: _ Owner ?Contractor _Other
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures (excludes water softener and/or water heater--complete next
section if installing these appliances).
_Septic System Abandonment
_ Water Turnaround (add $125.00 if a 5/8" meter is required)
Other:
Water Softener ( Water Heater $ 15.00
_ new replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total $ ?s
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the wark will be-in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
?? ?ar& (
Applicant's Printed Name Applicant's Signature
? ;r1 .JA N 2 4 ?,n
05 ?
?
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA113186
Date Issued:08/30/2013
Permit Category:ePermit
Site Address: 1623 Blackhawk Lake Dr
Lot:4 Block: 2 Addition: Blackhawk Glen 3rd
PID:10-14352-02-040
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Luanne Yang
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Anne L Weber-smith
1623 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