1628 Blackhawk Lake DrCITY OF EAGAN Permit No: 10204
3830 PHat Kaab Road Meter No:
P O' B%Z2'1199 Reader No: 010 7 I/-70 S'-
Eagan, MN 55121
?
Date: 12/28/$8
Size: oc -ne
Dae:_zi- ?"k`"
Owner. DARISTIR DE IGNER HOMES
Site Address: ^ i1K LAKE DR., L3, Bl, BLAC
Plumber. -i Ci FN ?RD
Conn. Ghg: 550.00 pd v
Acct Dep: 15.00 pd
Permit Fee: ? d 00 pd
Surcharge: _ 5p pd
Tr. Plant 2piL nO ad
Meter: g*7.Ot?-?d
(Njgc,; PRV REQUIRED
Zoning: Rl
No. of Units:
I agree to compiy with the City oi Eagan
Ordinances.
By-l" "
WATER SERVICE PERMIT
E 1 3 9 06,3 l V`?L?-{?li?QY? ? r ll.? ? ^.' /y / ?'iJ ?
Request D Fire No. Rough-in Inspection
Required?
Ready Now 111 Notify Inspector
?
R
d
?
Yes ? No en
ea
y
Icensed contractor El owner hereby request inspection of above electrical work at:
Job Address (Street, Bax or Rout N City
Se ion No. Township Name or No. Range No. CouMy
Occu n (PRI phone No.
Po r Su r Address
Electrical ntractor (Company Name)
? I CIPA50600s License No.
Mailing Address (Contractor or Ow er Making stallation) -
Autho ' Signa re (Co r r ner Making Installation) Phone Number
MI O A STATE BOARD OF ELr"' ICITY THIS INSPECTION REQUEST WIIL NOT
Griggs-Midway Bldg. - Room S7BE ACCEPTED BY THE STATE BOARD
1821 University Ave, St. Paul, MN UNLESS PROPEH INSPECTION FEE IS
Phone(672)642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION U"• ee-00001-07
?-
to. See instructions for completing this for m on back ot yeNOw copy. 9 c,???? ?
E 73 9`1716 "X" Below Work Covered by This Request
ew Add Rep. TypeofBuilding AppliancesWired EquipmentWired
Home ange Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm ir Conditioner
Other (specity) Contrador's Remarks:
Compute lnspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to ItUNMps
Transformers Above 200 Amps Above 1
Signs Inspectors Use Only: TOTAL
Irrigation Booms r
Special Inspection ??
Alarm/Communication
Other Fee
I, the Electrical Inspector, hereby
tif
th
t th
b
i Rough-in - ' Date ?ral_
y
cer
a
e a
ove
nspection has
been made. pinal Dat _?.
OFFICE USE ONLY
This request void 18 months from
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
D?
New Construction Reauirements RemodeURepair Reauirements Office Use 0nlv
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey Recd _ Y,_ N
(20°h maximum lot coverage allowed) 1 set of Energy Calcufations for heated additions Tree Pres Plan Recd _ Y_ N,
2 copies uf plan showing beam & window s¢es; poured found design, etc. 1 site survey for additions & decks Tree Pres Required' Y_ N
1 set of Energy Calculations Addition - indicate if on-site septic sysfem dn-site Septic Systero Y;_ N
3 copies of Tree Preservation Plan 'rf lot platted after 711/93
Rim Joist DetaH Options selection sheet (buiidings with 3 or less units)
Date /-7 1
Site Address
?,A (?,4.v do n) 65 Construction Cost s-C=-i c-n
dq--,r Je CAKe 6Ri i1Q UnitlSte #
Description of Work ,
c:_2 i G4fS S ??? uc.? ow S
Multi-Family Bldg _ Y '!f N Fireplace(s) _ 0 ^ 1 _ 2
Property Owner `l P fif' q MA-Ay S'?-,f d? A n dA _ Telephone #(,,/S'% )270 - 6% 72-
Contractor d f't'? ? 4J3
Address Z 3-?
State XA A/ j)1,2145r c4,2 DA ( tf-Q
Zip 55/-?7 City b4W 5T C
Telephone #(?S/ 4
COMPLETE THIS AREA ONLY IF CONSTRUCTiNG A NEW BUILDING
- Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy COde Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y ` N If so, 25% plan review
fee applies.
Licensed Ptumber
Telephone # (
Mechanical Contractor
SewerlWater Contractor
Telephone # ( )
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval of plans.
.
Applicant's Printed Name plicant's Signature
?
OFFICE USE ONLY •
Su b Types
? 01 Foundation ? 07 05-plex 0 13 16-plex ? 20 Pool ? 30 AccessoryBidg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) 0 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex 0 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
O 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex O 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-piex ? 12 12-plex Plbg_Y or_ N? 25 Misceilaneous
Work Types
O 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building" ? 43 Reroof ? 46 Windows/Doors
? 34 ReplaCement `Demolition (Entire Bld g) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
^ Footings (new bldg) _ Final/C.O.
_ Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water ? Finai _ Pool _ Ftgs _ Air/Gas Tests Finat
_ Framing _ Siding _ Stucco ` Stone _ Brick
, Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
Approved Sy:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
?
i .'
?• f ? :•? 1 ?'? ;t? S' ''` :'j??' ?_ fti ?L t? ti ?4
? ?, ?T (??}? 1? ? ? /'('rr1C.U' %C ?i? t?"?C. ?l%? U ? 1 `C ?? ?wti"! r?. i'i: t??`i;? 3-`,•
r ? .--•??._?
F?
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L•- ?
F?ctli'T Y l K d
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2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
1 -/0
New Construction Reauirements RemodellReqair Repuiremenis Qft Use flnfv
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Csrt af SurveyRecd Y,T. N
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required iY _N
1 set of Energy Calculations Addition - indicate if on-site septic sysfem C}te'SeptiG Systent Y h,
3 copies of Tree Preservation Plan if lot platted after 711/93
Rim Joist Defail Options selection sheet (bldgs with 3 or less units
Date 1'Z? /?_ / a
Site Address Iip?°???? Construction Cost
4-k,2. ?r Unit/Ste #
Description of Work '1?.?4 loW
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2
Property Owner Telephone # (1??? ) 4c- L
Contractor 41
l S.
Address \L-.6-e I
State •
Zip City ?
Telephone # ( 6S?) 4S.77
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateory 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
0 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone # (
Telephone # ( )
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved p ' t case of work which requires a review and
approval of plans.
7k -? ? ??A
Applicari s Printed Na e Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 Q2-plex
? 05 03-plex
? 06 04-plex
Work Types
? 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
? 07 05-plex ? 13 16-plex ? 20 Pool
? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 09 07-pfex ? 17 Garage ? 22 Porch/Addn. (4-sea.)
? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 12 12-plex Plbg_Y or _ N ? 254 Miscellaneous
Valuation
Census Code
SAC Units
# of Units
# of Bldgs
Type of Const
Footings (new bldg)
Foorings (deck)
Footings (addition)
Foundation
Drain Tile
Roof ` Ice & Water
Framing
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
O 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 37 Demolish Building* ? 43 Reroof O 46 Windows/Doors
*Demolition (Entire Bldg) - Give PCA handout to applicant
_ Final
Occupancy
Zoning
Stories
Sq. Ft.
Length
Width
MCES System
City Water
Booster Pump
PRV
Fire Sprinklered
REQUIRED INSPECTIONS
FinaUC.O.
FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests Final
_ Siding _ Stucco _ Stone _ Brick
Windows
_ Retaining Wall
Fireplace _ R.I. _ Air Test _ Final
Insulation
Approved By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Building Inspector
J 59 S(-i
- " 2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone 9 651-675-5675 FAX 4 651-675-5694
?7D
New Construction Requ+rements
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas Remodel/Repair Requirements
2 copies of plan
cest rat Sutvey Recd
Y hl
(20% maximum lot coverage ailowec) 1 set of Energy Calculations for heated addiiions Vee f'tes P[ara Eecd
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks 7ree ?res Required Y N
1 sei of Energy Calculations Addifion - indicate if on-site septic system Q[?s3ie:SsFtic Sys#em Y,...;N;
3 copies oP Tree Preservation Plan if loi platted afier 711/93
Rim Joist Detail Options seleciion sheet (bidgs with 3 or less uniis
Date I. Y a ' Con}struc 'on Cost
Site Address Unit/Ste #
Description of Work ?
Multi-Family Bldg _ Y_ N 611 Fireplace(s) _ 0 2
Property Owner Telephone # ( )
Contractor
Address City
State /•?? Zip ?Telephone # (j64)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate?or? 1Vlinnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
. Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan? - Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
Telephone # D ?
Telephone #
I hereby apply for a Residential Building Permit and acknowledge that the infor?fi ????ccurate;
that the work will be in conformance with the ordinances and codes of the City of Ea n and the State of MN
Statutes; I understand this is not a permit, but only an application for a rmit, and w r is not to start without a
permit; that the work will be in accordance with the approved plan in of or ich requires a review and
approval of plans.
?
Applicant's Printed Name - Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
Work Types
? 31 New
? 32 Addition
? 33 Alteration
? 34 Replacement
? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
O 48 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Muiti
? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 12 12-ptex PIbg_Y or _ N ? 25 Miscelianeous
0 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Ftepair
? 37 Demolish Building" ? 43 Reroof ? 46 Windows/Doors
*Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy
Census Code Zoning
SAC Units Stories
# of Units Sq. Ft.
# of Bldgs Length
Type of Const Width
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
_ Insulation
MCES System
Cify Water
Booster Pump
PRV
Fire Sprinklered
REQUIItED INSPECTIONS
FinaUC.O.
Final/No C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests Final
_ Siding _ Stucco _ Stone _ Brick
^ Windows
_ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Totat
' CiTY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
?
SITE ADDRESS:
P. I> N o o 10-14352--030--01
' DESCRIPTION:
REMARKS:
? ._
FERMIT
PERMIT TYPE: BUILDx NG
Permit Number: 032482
Date Issued: 07/0$ / 9g
1628 BLACKhtAWK LAKE DR
L(lTa 3 BLqCK> 1
BLACKWRWK CaLEN 3RC?
FEE SUMMARY:
sase Fee
Surcharge
Tatal Fee
CONTRACTOR:
MC DOWELL FtEMqDELING 17226228
A557 36l'H AVE S
I MTNNEflF'OLZS MN 55406
,
$J g VYlV
vaLuATzaN
$74075
-$1e50
$76.25
OWNER: -- Applicant -
KONIGE5 JEFF
1628 BLAGKHAWK LAKE RR
EAGAN Mhl 55122
(612) 6Ei3-5768
ISSUED BY.
p
3 regbhwed ?j' ift,?7???,?. (???? g y,? . ?y .'2 ??y
?y??.,{M ??1s (?F? YOO?Ji Y3 ? ?? M? ii? "'^'?; ?) - !` ? 2#'?46 auveysladlOw . 0 ,
Y . . +??+ ??q
.-?i"? W ? ?OiW1 ?n G ? ?? ? !i Nq+7 . . . . . . . ?
#equiredr ? Yes
s ?? f,TA -Z i+?»? ?.i1?.J????F" C?Ti
. . . . , -.. , s. . . . ,?
Va8 f;UP11ON OF y!YORK:. E _ . E ''/"?w Z
?. , :???' ?t?tEss: ?" Z ??-? <?'?-
? ??'1`': Bt?oCK: SuB?.?.t.D: ?:
,: .
q . . . . . " . - . `U
Name: (=F PhMe #: 56 , T ?
? ER$Y i?c ?'ussc
, QW1w1ER
Street Addreas: $
GitY
{ Cc,m;,au,y: (?`l G?Q4if ?? ?9SA.Q f`G t,a 6 Pboot'#:
C. OlfMACT4R '
,4-tf f- ?? . ke?se #
? Street Adcitess: fG I.?
? City State: A,,....?,?..?...?.:...?.
? 'ARCHIT''ECT/
? ;?INEER CcMpaW ,t(,zrzli P#one #'
r
NRttie:
s
.^}UM Ad&'SS: ' ? .
- City Statc
P ?.
? x1;l0w R w*Wk*nnd pturitbw (rwv constutbon only): R?* "0
? MW,#t thsn'W is rsquesW once p+attnit is Wkied.
?. ; .
twobv;adowwWp tlh8tt 1 tave read thi? ?ppbcaban and stMe OW #he ir*mvft? to 00MU*004,
rftftof iAnneaoba Statutes ani City of Eaqan. OrdMances. ftnature O# Appi?can
? .
t
4fFlCE USE ONLY
SUCLDING PERMIT TYPE
0 01 Founaation o N aupiex 13 11 apt.tLcdging 0 16 Basement F
002 SF t,welling 0 07 4-piex O 42 Mufiti Repa'tr1Rem: ;Cl 17 Swim Pooi
C3 43 5f Adelition E1 08 8-plex CI 13 Garage/Accessoryr 0 20P'ubtic FacRiiy
,a 04 SF Poreh D 09 42-p1ex C] 14 Firep?iam C3 21, Misceft
C! 45 SF Misc. 0 10 ,,,_-ptex G# 15 Uec?c
WC3RK TYPE
` E31 31 N? -G7 33 A!#er'ativrts. CI 36 Mdve
32 Ad+dition fl ' 34 Repair 0 37 Cternoli#on
GENERAL INFC1RMATfiC}N
Const: (Actua!) Basement sq: ft. Mt:NllS System
(ANa+vabte) Main Iey!e# sq, ft. ? CiiY watet'`
- USC C,kcupancY s4.1°t. FWe ??nMeget!
Zorting sq. ft. P"FtV _ .,....?
# of S#ones sq. ft. BoOSte` pump ?
Length sq: ft. ? Cersuss Code.
Depth ? Footprint sq. ft. ?,. SAG Code ?
, Consts Bldg
Census Unit
!k"ROVAL.S ?
Pfanning ? Building Engin+eering 1fariance
Pecmit F'+ee Vatuaticrn: $ Q 00 , ?--...
Surcharge
Plan Review
l.icense ' .
MG/WS mc
,
Ci#y SAC
1tVa#er Conn.
UYat+er Meter .
la?c.c#: Deposi# .
S1iAI P+errnit
StilV Surchsrge
Tr"bmn# Pi.
Parrk Cied.
Trails-Ded.
Cther .
copies`
Totai:
%SAC
SAC Units
I Of -va
CITY OF EAGAN
? 3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT f
PERMIT TYPE:
Permit Number:
Date Issued:
1528 k3l.ACKFiRWK LAKE pR
Lt1T: 3 BLOCK: 1
SLACKHAWK GL.EN 3RD
P.I.fd. a 10--14352-030-01
DESCRIPTION:
BuJ1`ct1n,-g1 Permit Type
Buildini':bJork 7ype
REM4FK§: REVIEWED BY MIKE BARCK
QECK
NEW
434 A.lT. F2ESIDEhITIAI.
?
?? s ? ? ?..
W
. ..F. .o ,.v.. $' '" ?y'. i ? ? s?d
FEE SUMMARY:
Base Fee $5P1.00
, Surcharge
Total Fes $50.50
?32?8$NG
05/2&f98
CONTRACTOR: 91#41?Fnq 5 - ? EFF
1628 BLtiCKHAWK L.AKE DR
R EA6AN MN 55122
(612)683-5768
?
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? OFFiCE USE QNLY
8U1i;.QtNG PERMIT 'f'YPE
0 01 Fourdatron C! 06 Duplex ? 41 Ap#.ILodging C! 16 Baserretvt firilt^t
0 02 SF Dwe#iing 0 07 4-plex 0 12 Mufti R?pairlRom. E3 17Swcint Pco1
0 03 SFAddition 0 08, 8*plex 013 Ga_; ? ? ? u" -U ,',28 P"ubli? ?acllity?
0 04 SF Porc#i 13 09 'f 2-plex 014 Firepkm El °21 M' ?anidds`
Z 05 Sf Misc. 0 9 0 ?-plex 15 Deck :. ,
WORKTYPE . . ,
31 New Cl 33 Afterations Gl 36 Move ` .
D 32 Acic3ition E3 34 Repair 0 37 Dernu?'rtion
tNFARl1A'TI.C3N
?N.:;?MWER???. .
a
. ?:.
Ccrmt. (Actuaf) ? Basemertt sq. ft. iWCiVMS System
, {A b!e} ? .. RAain Wvol sq. ft. , ?. CGhyy Water,
?
sq, ft. ...?....?.?.,,,r Fim Sprintlereti
; . 2oning sq. A. PRU
. .
Of Stories sq. ft. Booster #umP
..,..,..,..,,,.?
Length .
. ? ._... ?. ssl• 'ft. Comus C-ode.
Depth Footprint sq. ft. ? SAC Ct3de ` G? t
+Census Bldg
; . C-onsus Unit ?,?.........?.
? A,PPRt3YALS
Plaming ? Building jMF2 Engjneerino Wariance ?
F'ermit Fee Veluaticm: $
Surcharge
Ptan Reuiew,
Lite'es.e ,
MCJ'VS-SAC
City SA+C ;
itliater Conn.
Water Me#er
Acc.t Deposit
S Permit
fi1111t Stuchacge
1t9es#mett PI.
Park i7w.
Ttaifs Ded.
Othw
CopWs
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BLACKHAWK POINT
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James R. Hill, inc,
PLANNERS / ENGINEERS / SURVEYORS
9401 JAMES AVE. S. 9 BLOOMINGTON, MN. 55431 • 612-884-3029
. . CITY OF EAGAM ? 15938
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 1?? PH O N E: 454-8100
BUILDING PERMIT Receipt #
Tobeusedfor SF DWG/GAR Est.Value $133,000 Date DEC 5 19 88
Site Address 1628 BLACKHAWK LAKE DR
Lot 3 Block 1 Sec/Sub. BLACKHAWK GLEN 3P
Parcel No.
m Name DAHLSTROM DESIGNER HOMES
z Address 4151 KNOB DR #100
3
0 City EAGAN Phone 454-8737
°C Name SAME
.o
? Q Address
? City Phone
?Q
"W Name
wW
?
_ az Address
U
Q W City Phone
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all appli able State of
Minnesota Statutes and Cit??LEag Or nce?
?.
Signature of Permittee ?`" A Building Permit is issued to:_ DAHLSTR0-KJ)E??GNF$__HQM]
on the express condition that ali work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official-'tYR_
?- ?, ?----- ---- - --
OFFICE USE ONLY
On Site Sewage Occupancy R-3 M-1
MWCC System X_ Zoning R-1
On Site Well (Actual) Const V-N
Ciry Water x (Allowable) V-N
PRV Required x # of Stories
Booster Pump Length 81 '
Depth 31'
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. _ Permit 682.00
Planner Surcharge 66.50
Council Plan Review 341.00
Bldg. Off. SAC, City 100.00
Variance SAC, MWCC 550.00
Water Conn. 550. 00
ys- Water Meter 67.00
Road Unit 39 S_ n(1
? Treatment P1 204.00
Parks
S0
88S
?
TOTAL .
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19$8 BUTLDING PERMIT 9FPLIC9TION - CITY OF EAGAN ,
?
? SII3GLE FAMILY DWELLING3
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF EAtERGY CALCFJLf.TIC?AIS
NOTE: ADDRESSES FOR CQRNER Lt3TS - CONTRACTOR/Fi0ME4WfDtER MiJST DESIGNATE WHICH ADDRWS
IS DESIRED. NO CHANGES WILL BE ALLpWED OIdCE SUILDING PERM:LT IS ISSttE#3.
MJLTIPLE DWELLINCS REBITkL t?NITS FOR SALE tIDTZTS # CiF MTS
INCLUDE 2 SETS OF PLANS, CEATSFICA2E flF SURVEY - CHECK W2TH HLDG. I3EPT.,
1 SET QF ENERGY CALCULATIQNS .
, 'C9MMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRt3CTURAL PLANS,
? 1 SET 0'F SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
ov z ? ?811
i
I To Be Used For: JValuation: 133,000 Date:
Site Address t7FFICE USE t?NLY
,
Lot J4 Block On site sewage Occupaney ?'?
N?rICC system Zon3.ng y?
PareellSub *4o i?? f On site we11 Actual Const .?,,...?.?.,?
City water ? A].lowable
? {hwmer oog?j-PRV required ? # aP stories
Booster Pump Length
Address Depth i,....,#.;?c..?.?..
S.F. Total
City/Zip Code Eootprint S.F'.
! -- Phone APPROVALS FEES _
? . Contraetor 1)r?6rtl?+? EngrfAssess Permit
, ;....._.._.?....
' ,vW_g /#? P3.anner Surcharge
? Address YfiS'/ ?? ?}l2. ? Couneil Plan Revie,r ,3
Bldg. Off. SAC, City f
t GitylZip Cade ??, /UAY 9.1""/Z-L.- Varianee SAC, M6dCC
.....,.
j Water Cania Phone f'{?S?-'?'??3? Water Meter r?
? Road Unit
r Arch.lEngr. Treatment Pl 10y
' Parks `
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? Address Cop3ea
? TOTAL
' CitytZip Code ?
Phone # .
0
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SURVEYOR'S CERTIFICATE
REVISED 11-29-88 TO SHOW
PROPOSED HOUSE FOR
DAHLSTROM DESIGNER HOMES.
SIENNA CORPORATION
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?------ DENOTES pROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - $yp.S FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - 83z.1 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK ffi 840.9 FEET
WE NEREBY CERTIFY TO SIENNA CORPOFtATlON 7HAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 3, Block I,,BLACKHAWK GLEN 3RD ADDITION, according to the recorded
plat thereof, Dakota County, Minnesota.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SUc{VGy`p Rv MF nR UNnFR MY nIRFC;T SUPERVI?SI,yO_[aI.,,THIS.2DAY OF NOVEMBER , 19Q$.
nrrnovcn ron s r?N?in SIGNED: J?R H L, INC.
conrORn?r r ori ?
0 Y : . BY:
HAROLD C. PETERSON, LAND SURVEYOR
I)AT'En, MlNNESOTA LICENSE NUMBER 12294
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PLANNERS / ENGINEERS / SURVEYORS
9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-884-3029
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55. 26: TCITAL Lf: 3. 4471
Ynge ;.ti
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Ceiling!Roof I,sulacrc Area: Sq. Ft.
(wi[h a-.t;c oiea) 'R-Value
Fi ug re 2 Ceiling/Roof Framing Area: Sq. Ft.
(with attic arca)
R-Value
Interior Air Film •E1
Insula t ion
Wood riember _
Continuous Vapor Ear-:er 0.00
Interior Finish
Incerior AiT Film .61
To[al Asszmbly R-Value
Assembly U-Value (1/R)
Enier on Page 1
For additional roof assemblies, see pages 3 and S.
?
a
,
Aesembly U-Value (1/R)
Enter on Page 1 ,
' /i c?ure 3
u
?
Exposed Wall Insulated Area:
R-Value
Intatior Air Film .68
Interior Finish
Continuous Vspor Barrier 0.00
Insulation
Sheathing
Exterior Finish
Ext-•rior Air Film .17
Tot.+l Assembly R-Value
Aasernbly U-Value (1/R)
Enter on Page 1
Sq. Ft.
Figure 4 Eavosed Wall Framing Area: _ Sq. Ft.
R-Value
Interior Air Film .68
Interior Finish
Continuoua Vapor Barrier 0.00
Wood t!ember
Sheathing
Exterior Finish
Exterior Air F::m .17
Total Assembly R-Value
Assembly U-Value (1/R)
Enger on Page 1 •
For additional wall assemblies, see paqe S.
L:j
i?
Sq.. Ft.
Exposed Wall Kim Joist Area:
Interior Air Film
Vapor Barrier
Insulation
Wood Member
Sheathing
Extetiot Finish
Extarior Air Film
R-Value
.68
---------------
.17
Total Assembly R-Value
Assembly U-Value (1/R)
Enter on PaBe 1
Notes: 1) Floors over unheated spaces. For floors of heatUdValua chanieally
cooled spaces over unheated spaces, the ovazall ?Or for the floor snall not eh@eo e?all•U floors
or the•floos ?
air, such as overhanqs• t Valu? o!
shall meet the same requirement as ior roofs. 0-0.04.
rade tloors. For slab-on-qza8s• the iasulatiws
21 Slab-on-g sh?ll M??t. •
around the perimetex oi the exF°sed floor extdnd minimum R-Value o! 6.4. Tha insulation musor dova++a='d •ward
from ehbottcm ofttha•slab thanihorisortilly ?n?a? ?
to th
slab for an equivalent distance.
r barriers. The maximum perm rating fQt the °a?r
3? ?a? A minimum of 4 mil polyethelins, or eqw?l,
barrielr is 0.1. r barrisr n?ust b?
is required to achieve this. The va ??d ?d? Q??? zsa?n9
continuous with all joints overlapp ?
membera or blockinq-
4) por notes on foundatioa wall see pa9• 6•
g) For additionsl aasemblies not illustrated use Morksh"t
on page 8. ,
JjE ? LaPosez eosridat?.an wall Area
?Concrete Block or Poured
Concrete Foundation Azea: Sq. Ft.
Wood Foundation Insulated
•, Area: Sq. Ft.
R-Value
Interior Air Film - •68
Continuous Vapor BarrieT 0.00
Foundation Wall •''"i .-
Insulation
Exterior Air Film •17-
To[al Assembly R-Value
Assembly U-Value (1 /R) ?.?
Enter on Page l
1) On1b? L includ?d in a the a ensrQY cslcul?tionsoa yall is
c
2) Ths Energy Code requires that, ii the floor abov• the
basemenc or crawl space is not insulatsd. ths founda-
cion wall must ba insulated. Either the foundacion
eusc have s minimua R-10 insulation •pDlied from tht
top of the foundation to the frost liat or s miniow
R•S insulation aaplied over the sntiss foundasion
wall. Thc R-value spscified is for the insulasion
saterial only.
1) If ridQid foaw insulation is to De applied to the
exterior of rhe foundation wall, the above lradc
porcion mus: be pTOtscted fro• the sun. the westher
and physical abuse.
4) If ridqid foam insulstion is to be aoplied to the
interior, it musc be procecced by minimum 1/2" QYP•
board or equal (as specifisd in section 1712 of the
Uniforn BuildinQ Code).
5) Foundation Mall insulation for vood foundations wust
be installed as specifiod by the NaLional Fosess
Products Associstion's DesiQn Manual.
Wood Foundacion Framed
Area: Sq. Ft.
\
R-Value
[CDaW,stro,
DEAGNEQ9110ME(S
4151 Knob Drive, Suite 100 • Eagan, MN 55122 • 451-8669 • 454-8713
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SIIiGLE FXHZLY DWELLIAGS
2 SETS OF PLANS
3 BEGISTERED SITE SDRVEYS
? SET OF ENNERGI CALCS.
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.?9WHUILDIlIG PE#MTT APPLICATIOA
CITY OF EAGAN
M1LTIPLE DNE INGS COMMERCIAL
2 8ETS OF PLdNS
BMIS1EAEfl 3ITE SURVE2S -
WE= WITa DIM niv. )
f SE3 (r SIEnol CILCS.
2 SETS OF 1RCHI?ECTURAL
& STBUCTORAL PLANS
1 3ET OF SPECIFIC9TIONS
1 SET OF ENERG? CALC3.
Rf3I.TZPLE DWELLINGS RENTAL ONITS FOB 31LE MITS ?i t OF OBITS
1tOTEs 1DDRESSES FOa CORNER LtyTS - COfiTAiCTQR/HOMEOWNER MM DESIGNATE i18IC8 iDDRFSS
IS DF.SIRED. 80 CSANGES iiILL BE ALLOIiTED ONCE HUII.DIliG FEBMIT 13 IS.SOED..
SEWER & W9TEA PERMIT FEES iND tCC00NT DEPOSIT !'EES i1II.L BS INCLODED iiITH THE BUILDINa
PERMIT FEE. PROCESSI'1IG TIME FOR SEWER AAD WATER PERMITS IS TiiO DAYS OIICE 1 PERMIT HAS
BEEN COMPLETED INDIC9TIl+1G ALICENSED pLOMHER.
PENALTi APPLIFS WHENt PERMIT IS NOT PAID FOR IN SAME MONTH IT IS REQUESTED.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
?
To Be Used For: Valuation:
'-;e Address
Lot ? Block ?
Parcel/Sub
r--I?
Owner ?J ???' .D N I ?Y?„S
Address 16,21 City/Zip Code Gm ,SS 12. Z
a'hone z'
Contractor
Address
City/Zip Code
Phone
Arch./Engr.
Address
Citq/Zip Code
Phone #
oM74<
Date: q- jz' liC%
Oecupanay _
Zoning
Aetual Const
_?-
Allowable ?
# of stories
Length
Degth
S.F. Total
Footprint S.F.
On aite aewage
On site well
?
MWGC System
City kater
?
PAV required
Bcaoater Pump
1PP_
P2anner
Counci-I ..,_
Bldg. tyf'ff
Varianee r
?
q- Zo-?a
FE_
Bldg. Permit /Lf
Sureharge
Plan Review ?
SAC, Citq
SAC, MWCC
Water Gonn ?
Water Meter
Aeet. Deposit ,
SlV Permit
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Cogiea
Sti$"t`02AY. _...!_
PenalLg
lflTAL
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-SIENNA CORPORATION
,dEYOR'S CERTiFICATE ?a;A;,?
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P.R.V. REQUrRED
napIN,4GE d UT/LiTY EASEMENTl"., ?
s ( /rPfR PiAr ?
I NC H= 30 FEET
.?„ ?BSG.o `
- 83.64 N O° 13' 39" E
QLACKHAWK POINT ?
N V mw' 7] ? oTAoNo ? m R.Hill
? CJ ?^ " r^ ? O T , O3 y ja mes , i nc.
Z m f7 ? cn D
° a? m Z?> Z m m° m pLANNERS / ENGINEERS / SURVEYORS
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`9401 JAMES AVE. S. • 9LOOMINGTON, MN. 55431 • 612-884-302
?
PERMiT # lqS / Ez_
Please complete for:
S4TE ADDRESS:
Ovrtv'+?`v??R NAME. .
RECEIPT DATE: ?a "U/
WKSllNEINTIAL PLtJMINC PF.tNIIT ?PPLICATION
crrY of EAsLAv
3830 PaoT xivo$ Rn F11 ? ?v. Mx ssYEE ssi-s8i-as?r5 MAY p 1?
? single family dweAings
? townhomes and condos when permits are required for each unit
? backflow preventer for irrigation system
KONIGES, JUDY
t628 BLACKHAWK LAKE DRIVE
EAGAN, MN 55122
(651) 456-5466
TrLtF'HONC #:
r (AREA CODE)
INSTALLER NAME: ' TELEPHOME #:
.
(AREA CODE)
STREET ADDRESS: E6?' ?=) ' : I - 0-3
??50? C,,^a[;FiCLD AVE. SO,
CITY: STATE: ZIP:
Place a check mark npYt tn the eermit wnrk tvna
_ New residentiat dwelling uniC under construction and not owner/occupied 90,00
Add-on, moditication or alteration to existin dwelling unit, including: $ 50.00
• abandonment of septic system
• new installation/repair/rebuild of RPZ
• lawn irrigation system
• water turnaround
Nature of work: \A10,4er k
, I Septic System, new/refurbished - I $ 225,00 I
. includes County & Consuiiing inspectu+ iaes
• requires MPC license
State Surcharge $ .50
5 0
S0
Tota I .
$
Reminder: Be sure to schedule inspections of alterations, i.e. water heaters; water softeners, etc.
I hereby acknowiedge that I have read this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It
is the applicanYs responsibility to noGfy the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal
operational and maintenance activities to ihe facilities constructed under this permit within City property/right-of-way/easement.
?
SIG URE OF PERMITTEE
Updated 1f01
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Permit No. Permit Hoider Date Telephone #
WAiER 'z -24
SEWER
PLU-MBING ; ?-
''1';i''
H.V.A.C.
ELECTRIC
Inspection Oate Insp. Comments
Footings 1 Iue
'if?? fJ 2C?
Foundation
Framing G .
Roofing
Rough Pibg.
Rough Htg.
??'Y1
7-
.?
IsuL
Fireplace ?lil l' Lc.J,?
Finai Htg. ? Z Z
Orstat Test ?
Final Pibg. Pibg. Inspector - Notify Plumber
Const. Meter
Engr./Plan
Bldg. Finai a
Dedc Ftg.
Oeck Finai
Weli
Pr. Disp.
? Forrrrit Nokw DOO T #
Pt: 1MO
,"MAC
hopoctim Da* wtsp: cAunnmsnts
FOf37iNGS
F49UND
FRARAliVCa
F4COFtWIG
Ft€tl$GFl
PIUMStNG
PLBG
SIR TEST
ROUGH
HEATINCA
GAS SVC
TES7
INSUL
GYP BOARD '
FtREPLACE
FIREPLACE
AtR TEST
'
FINAL PLBG
FINAL HTG
ORSAF
TEST
BLDG FINAL
G 0
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MJAINS
'
CONDUGTIVITY
TEST '
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
I11 SPE,N,.?REC?
?"`rtTY OF:EAGAN ? PERM1T TYPE: ? ??: ?_ t?:?t?.??????? ? ° _ _ ? '.
3WQ Pilat Knob Road
Permit-Nvmber.
Eagan, MinneSOta 55122-1897 aate 1ssued:
E. , 012)"14675p.. a :M. : I#r 1 435??_???-???? ? -
w SS: APPLICANT: t
J F, r f
bt.?ACK14AWlr? O5:1," -3Rt)?
Pfu"' St1BTYRE: .
.y ? . . . ? _ ' _
N
TYPE 4F 1NC?RK:
?f 14
lbIace
3,
W
?
Permit No. Permit Hoider Date Telephone #
Plumbin
9 "
A201 w w ?2` @.e . / 41819
H.V.A.C.
Electric / ?.
Softener
Inspection Date Insp. Comments
Footings I
Footings II
Foundation
Framing
Roofing
Rough Plbg: 1.
Rough Htg. Y17 g? U ?e
Isul.
Fireplace f- j I• ?j b
Fina{ Htg.
Final Plbg.
Bidg. Final
Cert.Occ. ,
Temp. LP ?- 2 O ? eCk Lk'
Deck Ftg.
S 3
?° 11
Lr- ?,+?OC?i,y- T?,?,p Td ?S?.
Deck Final f ?2 oaT-? d S
Well
Pr. Disp.
?4??, ITY OF EAGAN Knob Road, P.O. 13ox 21-199, Eagan, MN 55121 .
PHON E: 454-8100 '
BUILDING PERMIT Receipt
To be used for Est. Value Date ,19
Site Address
Lot ` Biock ? Sec/Sub.
Parcel No.
m Name PAX11,.31130H i??SIGNT"' HQnS
3 Address 4151 c',V02 i.iI' #1.00
° City "AC" Phone 454^"'8711,
°C
.o Name
? Q Address
i-` City Phone
W W
w Name
F Address
Q W City Phone
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 Permittee
A Building Permit is issued to:
on the express condition that all work shall be done in accordance with ail
' applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official ___
OFFICE USE ONLY
On Site Sewage OccupanCy -3 h`"`I
MWCC System X Zoning A-1
On Site Well (Actual) Const V-N
City Water (Ailowable) V-14
PRV Required # of Stories
Booster Pump length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit
Pfanner Surcharge
Council Pian Review
Bidg. Off.
SAC, City '} f ?,'?{ * k .(l
?
Variance SAC, MWCC
; '?+?.? + {3=:
Water Conn. ? ,. ..
Water Meter ?F ? •? `.F
? Road Unit ??` ?•?? !
Treatment P1
Parks
3
'"
TOTAL
This CertificaEe dssued pursuant to the requiremen&r of Section 306 of the Unifvnn Building -
Code certifying that at the tirae of issuance.#his structure was in cornpl'+ance with tlre variorts
f ordinanFes of the City reguladng biiiAnAnsMwefton or use. For the failoWing.•
, ??r?
? Use Classi5cation a? ?M BIdB. Aermit No. 1:;77,J?v
o?UP-CY TAX R3/1'?1 zostps Mtri« RI rype cang . }?
Owner of Building ?'??!1 ? ??'?Address `/'51 ? ?? m ?
f A Bui(ding Address ?M NAMIW 1.AKE MM I.ocality L3f B I f ?" CM ?- .?
k A ?
[ Date: MM. Ul, 1989 r.
? Bd.B06. '? .
, POST tN A CONSPICUOUS PLAQE
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•. •
PLUMBING PERMIT
C{'fY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
CONTRACT PRICE: PHONE: 454-8100
Site Address '? ` i ` ? ?--
Lot Block SeclSub
Name
co Address
c City Phone
Name
3 Address
p City Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S!C IF PERMIT PRICE GOES
BEYOND $1,000.00) ,-- ,
SIGNATURE OF PERMITTEE .-
FOR: CITY OF EAGAN
PERMtT #
RECEIPT #
DATE:
BLDG. TYPE .. WORK flESCRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other RES. PLBG. ONLY - COMPLETE THE FOLI.OWING:
NO. FIXTURES TOTAL
3-9--Water Closet - $3.00
?,A? Bath Tubs - $3.00 ' j
''y ?Lavatory - $3.00
i?Shower - $3.00 - ? 'Kitchen Sink - $3.00 f `
UrinaVBidet - $3.00
Laundry Tray - $3.00
! Floor Drains - $1.50
? Water Heater - $1.50 -
Whirlpool - $3.00
_LGas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
' Softener - $5.00
P Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50 °
FEE:
STATE S/C:
GRAND TOTAL.
,
PERMIT #
MECHANICAL PERMIT RECEIPT # '
C1TY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRIGE: PHONE: 454-8100 For Office Use Only:
Site Address N
K
BLDG. TIIPE WOR
DESCRIPT'40
Lot Block Sec/Sub New
Res
.
Mult. Add-on
? Name
-' - Comm. Repair ? -.
m Address
c
City
f?hone Other
FEES
? Name
T - RES. HVAC 0-100 M BTU -$24.00 `
c Address Y? ADDITIONAL 50 M BTU -- 6.00
p City Phone (RES. HVAC INCLUQES A/C ON NEW •
CONSTRUCTION).
50 EA
MINIMUM
1 PER PERMI'n 1
GAS OUTLETS
,
.
-
(
' TYPE OF WORK COMM/IND FEE -;]% OF CQNTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIE5
TOWNHOUSE 8 CfJNDOS - RES. RATE APRL{ES
i Boiier M BTU ? MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
I Unit Heater , IVi BTU $ REMODELS - 12A0
Air Cond. M BTU $ MINIMUM COMMEEtCIAL FEE - 20.00
! - STATE SURCHARGE PER PERMIT - .50
Vent
I CFM ? (ADD $.50 S/C IF PERMIT PRIGE GOES
Gas Piping Outlets # BEYOND $1,000) ,
? Other g
I FEE:
I
SIGNATURE OF PEftMITTEE
S/C:
?
` TOTAL: ?
' ?? FOR: _(CITY OF EAGAN 7
?
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115553
Date Issued:09/26/2013
Permit Category:ePermit
Site Address: 1628 Blackhawk Lake Dr
Lot:3 Block: 1 Addition: Blackhawk Glen 3rd
PID:10-14352-01-030
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 .
Viktar Skirukha
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 -
Jeffrey Rhoda
1628 Blackhawk Lake Dr
Eagan MN 55122
Smart Builders Inc
7001 Garland Ln N
Maple Grove MN 55311
(763) 691-5021
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA119036
Date Issued:11/14/2013
Permit Category:ePermit
Site Address: 1628 Blackhawk Lake Dr
Lot:3 Block: 1 Addition: Blackhawk Glen 3rd
PID:10-14352-01-030
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.
Scott Follese
5182 West Broadway
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 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 -
Jeffrey Rhoda
1628 Blackhawk Lake Dr
Eagan MN 55122
Golden Valley Heating & Air
5182 West Broadway
Crystal MN 55429
(763) 535-2000
Applicant/Permitee: Signature Issued By: Signature
City of kali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
?J 2014 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: C �. 7 "ill Site Address: '.. J_ __'"'_ A.?A.4 � L l\ r,
Tenant:
Suite #:
Resident/Owner
Contractor
Name:
J
r
Address / City / Zip:
Phone:
Name: =cif �ITC.�?ei4Lt' rLwJ7 i' � (� 9 53
( License #:
Address: 35 LS p71 -ca.: - 1 �J
City: C 2y -2_. ,-�..
State: MR) Zip: e) j 2..Z Phone: 55-2. 9 i Z 7370
Contact: „42.4-C.- Email: 'ICI- CGT kt-
New _ Replacement Repair _ Rebuild _Modify Space _ Work in R.O.W.
Description of work:
Type of Work
Permit Type
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ / PVB)
Septic System
New
Abandonment
Water Softener
-Add Plumbing Fixtures ( ain / _ Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
*Water Turnaround (add $200.00 if a 5/8" meter is required)
$115.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One CaII 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.cooherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work wit be in confrmance 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 of t• 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 p'= ns.
Applicant's Printed Name
x
Ap •Ji ant's Si
FOR OFFICE USE Reviewed By: - Date:
Required Inspections: Under Ground Rough -In Air Test Gas Test Final
Meter Related Items: Meter Size Radio Read Staff:
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA128485
Date Issued:11/17/2014
Permit Category:ePermit
Site Address: 1628 Blackhawk Lake Dr
Lot:3 Block: 1 Addition: Blackhawk Glen 3rd
PID:10-14352-01-030
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Jeffrey Rhoda
1628 Blackhawk Lake Dr
Eagan MN 55122
(651) 707-3546
Pella Northland
15300 25th Ave N #100
Plymouth MN 55447
(763) 355-1300
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA142494
Date Issued:05/04/2017
Permit Category:ePermit
Site Address: 1628 Blackhawk Lake Dr
Lot:3 Block: 1 Addition: Blackhawk Glen 3rd
PID:10-14352-01-030
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 -
Jeffrey Rhoda
1628 Blackhawk Lake Dr
Eagan MN 55122
Kremer Brothers Construction Co.
516 Second Street, Suite 202
Hudson WI 54016
(715) 554-2600
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA145348
Date Issued:09/06/2017
Permit Category:ePermit
Site Address: 1628 Blackhawk Lake Dr
Lot:3 Block: 1 Addition: Blackhawk Glen 3rd
PID:10-14352-01-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jeffrey Rhoda
1628 Blackhawk Lake Dr
Eagan MN 55122
(651) 707-3546
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA170418
Date Issued:07/01/2021
Permit Category:ePermit
Site Address: 1628 Blackhawk Lake Dr
Lot:3 Block: 1 Addition: Blackhawk Glen 3rd
PID:10-14352-01-030
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Gas Grill
Comments:Please call for a Rough In and Air Test, prior to the Final Inspection.
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
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 -
Jeffrey & Mary Rhoda
1628 Blackhwk Lake Dr
Eagan MN 55122--124
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature