1631 Blackhawk Lake Dr, CITY (?F EAGAN ??!
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ''? ''?
PHONE: 454-8100
BUILDING PERMIT Receipt # ?-•-To be used for SP QWCjGAR Est. Va1ue $2 50*t300
Site Address ???? ??CKHtWK LAKE DR
Lot 2 Biock 2 SecJSub???KMWK(;L9N 311
Parcei No.
W Name ?#I _ -I+?"?A?'RRt'?T?E?
3z Address 785 StUi+1SEI Dg
0 City EAG? Phone 456--9125
,o Name SAME
04
Address
U" City Phone
?
yVj W Name
? ; Address
a W City Phone
I hereby acknowlege that i have read this application and state that the
information is correct and agree to compiy with ali appiicabie State of
Minnesota Statutes and City of Eagan Ordinances. .
,. ...Signature of Permd@e Z/
t+ Building Permit is issued to: MIMISTAET}'T` BRt?YCCH?,``RS
on the express condition that aii work shali be done in accordance with all
applicabie State of Minnesata Statutes and City of Eagan Ordinances.
8uilding Officiai
Date -1011 11 , t 9-91_.
OFFICE USE ONLY
Occupancy R"'" 3 M-1 FE ES
Zoning _Y"
(Actual) Const - -? Bidg. Permit 815+?00
(Ailowabie) At-if Surcharge 75.?
# of Stories
h
L -
?Q
r
P?an Review ?
engt _
Oepth 38' SAC, City too+?
S.F. Totai - SAC, MCWCC !k-50,?
S.F. Footprints _
On Site Sewage _ Water Conn 6W•?
On Site Weli Water Meter 95.?
MWCC System x
? Acct. Deposit 30#
?
Water
City
PRV Required x S/W Permit 30,?
Booster Pump - 51W Surcharge a ?
Treatment PI 276.
?
APPROVAIS Road Unit 37Q*00
Pianner --- park Ded.
Councii
Bidg. Off. _ Copies
Variance - TOTAI 3?630*?
.^ ..
i
{
y?
Cttp of Cagan
?r??#uc?ttf uf ??i1?i? ??ts,p?rrfiapxt
?.
?7iis Certificale issued pursuant to the requirements oJSection 306 of the Uniform Building
Code certcfYing that at !he time o, f issuance thir structure was in compliance with the various ,
ordinances af the City regulating building constructiox or use Forthe following. ?
use cklsdrx.dm sF =rMR ?. Pxmk No. 19277
O-UP-CY Tra R3M1 zoius ms+a Ri rype eOW VN
Ow= arswgmng MII.TIISfAMT BRODiEEt.S Add= 7$5 SJKW DRT.VE, EAGAN
? 1631 ?IAi?C LA?E I7??? 12, B2, NA? (?t 3im
? $f ??? 1
iluildin 4DIrim'?POST !N A,CONSE?1GUWS FiArE
INSPECTION RE?ORD
PERAAIT TYPE:
- Permit Number:
Date Issued:
tc t.l .t 10 1 td f?
A[3DRESS:
r: k3 !A C kk HN W, l.a: tE N A? t t
,'. '.
, M1T SUBTYPE:
Of(A
? ??? ,-?
, ARPLICANT:
'?id#?f?{)Et'?;f fitL.tlf?`y
(61,1) G1ri o.? rv (43 TYPE OF iA/ORK:
wt: w
i f. id A4
?..
g.. .: .
Fourdsoon
RNMV
FOO&o
? ?-
RXO M9•
kw.
FWGPIWO
FbW Hig.
O?M Test
Firvsi P". P". msmcw - PiotitY KEM"
Gonet. Meter
Enwimm
mt. RW
t}edc F4
DeCk F1ne1
?
far. ?.
igl r4 J
*1-19,39 7
RSSIDf NTIAL
BUILDlNG PERMIT APPLICATiQN
CITY CF EAGAN °
3$30 PlLOT KNOB RD - 55122
851-681-4675
New C sn? n Reauirert?ents
• 3 registered site suroeys showing sq, fC of lot, sq. fG of house; and g roofed areas
(ZO°h rtaxirrium bt cwerage anowed)
• 2 copie,s o( plan showirg beam & arindow sizes; poured found design, etc.)
• t set at Energy Calculations
• 3 oopiees of Tree Preservation Ptan 8 lot platted after 7/1193
• Rim Jast Detait Opti?ons selecGon sheet (bidgs with 3 w less units)
?
Remode{tReoair Reauirem?? C , ; ? ' , ' ? 1
• 2 cop? at plan ?? l.?
. 1 set of Energy Cak:u{abons for t?ated additiom
• 1 site sutvey fcx exterior additim & decfts
DATE VALUATl4N (EXCLUDING IANQ)
14B StTE ADDRESS ?fo31 ?lAc?l,l?? l?
,
tF MULTI-FAMItY BUILDiNG, HOW MANY UNITS?
PRC')PER7Y OWNER I f P?'1 /' A, II tPS
TYPE OF WORK -7-f * O
APPLICANT
ADDRESS -1,229 7 N+ t,
FiREFLACE(S) ..,_,O ;..,...I _„2 ,...,.,3
PHONE #
_ Z!P CC}DE,49P???7
PAGER # CElL PHONE #C 2 ' ZD 774q59 FAX #
NIE1' RESIDENTIAI. BUILDlNG ONlY - FlLL OUT CC)MRLETELY
Energy Code Category _ MiNNESOTA RLILES 7670 CATEG(3RY 1
(check one) - Residential Ventilatian Category 1 Worksheet Submitked
- Energy Envetppe Caiculations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Woticsheet Submitted
Ptumbtng Contractor. Pha»e #:
Plumbing System Includes: ? Water Softener _ La.wn Sprinkler Fee: $94.00 `
? Water Heater No. of R.I. $aths
No. ot Baths
Mechanicai Contractor. _ Fhone #
Mechanical System Includes: Air Conditioning Fee: $74.40
Heat Recovery Systern ?,.....?.
SewerlWater Conhactor. Phone #
,
Atl above information must be submitted prior to processing of applicafion.
I hereby acknowledge that 1 have read this application, state that the information is correct, cr?ec'"t6-d-omply wifih
crll applicable State of Minnesota Statutes ond City ot Eogan Ordinances
Signature of Appltcant
Certificates of Survey Received 4 Tree Preservatian Plan Received _ Not Rsquired ?
a?.
updacaa uot
>a,
;?
OFFICE USE ONLY
? 01 Foundation O 07 05-piex ? 13 16-ptex p 20 poqi C] 30 Accessory Bldg
0 02 SF Dweiling ? OS 06-piex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - MutO
0 03 01 of , plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Ait - SF
17 04 02-ptex (] 10 68-plex ? 18 Deck ? 23 Porch (screened) 0 36 Multi
? 05 03-plex Ct 11 10-piex ? 19 Lower Level 0 24 Stoan Damage
? 06 04-ptex 0 12 12-piex Pibg_Y or _ N 0 25 Miscellaneous
13 31 New ? 35 int Improvement ? 38 Demolish (Interiar) ? 44 Sfding
0 32 Add'+tion D 36 Move Bldg. ? 42 Demolish (Foundation) 0 45 Fire Repa+r
CI 33 Alteration 0 37 Demolish (Bldg)" ? 43 Reroof O 46 Windows/Coors
? 34 Repiacement "Demolition (Entire Bldg only) - Give PCA handbut to appiicant
Valuation Occupancy MCiES System
Census Cade Zoning City Water ?
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprinktered
Type of Const _ Width
REQUfRED fNSPECTiONS
- Footings (new bldg) FinaUC.O.
, Footings (deck) FinaUNo C.O.
- Footings (addirion) Plumbing
?
^ Foundation HVAC
Drain Tile
^
Roof _ Ice & Water i Final Other
? Framing _
_ Pool Ftgs Air/Gas Tests Final
? Fireplace - R.I. _ Air Test _ Final Siding ? Stucco` Staue ?
? Insulation _ Windows (newlreplacernent)
.
- -------------
-- Approved 8y , Building Inspector
--
--------
8ase Fee ---------
----------------?-__--_?-_----•----------?_w_?_______..w_?_??_____
Surcharge
Plan Review
v+ciES sac
City SAC
'Nater Supply & Storage
S&W Permif & 5urcharge
Treatment Piant
Plumbing Permit
Vlechanical Permit
'4.icense Search
Copies
`3ther
t?l
Address: 1631 BALr-'IQiAWK IAKE DRIVE Lot 2 Blk 2 Sec/Sub BLA'.,HIIAWK GLEN 3RD
These items were/were not complete at the time of the final inspection.
Date : $/22/91 Yes No ?
Final grade (6" from siding)
Permanent steps - garage ?
Permanent steps - main entry ?
Permanent driveway
Permanent gas
Sod/seeded grass ?
Trail/curb damage ?
Porch
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing
system and the shut-off of water supply to the outside lawn faucet before
freeze potential exists. 4
nccrcieo wrcx
White - City copy Yellow - Resident copy Pink.- Contractor copy
? .., . _?-,....,r ....?sv?-• .r r r;..,.,,.,?,?r;r,.,, r. .s-,.. _•,? . . , . . ,
. ?.
-, - ? -
SEWER& WATER PERlkOT ? OFFtCE t,lSE OIVLY '.
CIn OF EAGAM ? ME7ER #4/1/4? q0 7 3 7 PERMtT DATE 06/19/91
3830 Piio# K'nob?Rd. ?i? # ? ? ?'D 9-0 pERMtT # 12073 ?
Eaganr:llN 551 2=1897 , ? ..
? METER SIZE `? `e" BP, RECEIPT # G 14026
DATE Jl`ne ??, 19 }?- ISSUE DATE 9B.P. F?L?lPT DATE C76 / t8j?31 .
??_,PRV -BOOSTER PUMP
SITE ADDRESS 163.1 Blackhafia7}';. L'c3ite` l.inLve PERMIT REQUESTED
LOT = BLOGK ? SEC/5UB j:3Zac1.'y`tatr7y AGleizrs 3x'd
? SEWER X WATER ? TAPB
APPLICRNT:T;' t =e?-s?.ae?t 3r+?c . Cc?sisfi;r?zctior? Inc.
ADQRE,SS: 7 8` Sk`y1set ''rive COUM/FND ? PkSIDENTiAL .
CITY, STATE'='F-2a31? T??4. 55123 Z!P 5 5 123 X NEW `EX1S7'ING
PHONE: 456-- 9i25
Lawn Sprmkier Meters are to be Instalfed
' PLUMBER: Ahead of Domestic Met,ers on Wa#er Line. ?
: ADDRESS: 4` 600 ,}='nne!)ec i-`r ?-??' it WILL NQT be given for Deduct Meters. ;
CITY, STATE??dc?e ?'t ,, "•°..lv ZIP -122
PNONE: a
L AGREE TO PLY WITN CITY C1F
' OWNER: EA N A S
ADDRESS:
CITY, STATE ° ZIP .? ..,_ -SitN TURE W N ETER 1$SUEp
PHONF,.
?,
P!E r .' ??! ?? ..?
?b?Cl?UI?O VI'IORKI?? DA'?(S ?t?R P'??Cf3SINC. CALL 4545220 P¢R INSPECTi(7NS. FtfR STORM
SEWER P RM(TS, CONTACT ENGINEERING DEPT.
? x
SEVI(EER & VYATER PERMIT
I CITY OF EAGAN
3830 Pilot K-mob Rd.
Eagan, MN 55122-1897
I DATE "• '-
OFFICE USE ONLY
METER # PERMIT DATE CHIP # PERMIT # 12. Ot 3
METER SlZE B.P. RECEIPT # c- -1
ISSUE DATE B.P. RECEIPT DATE
PRV - BOOSTER PUMP
'SITE ADDRESS = PERMIT REQUESTED . .. ....: , LOT - BLOGK SEC/SUB = •' `
? SEWER ? WATER TAPS
a
APPLICANT: ADDRESS: {-COMM/IND -RESIDENTIAL ;
' CITY, STATE -ZIP ? NEW ? EXISTlNG
, PHONE: %
PLUMBER:
I ADDRESS:
CITY, STATE ZIP PHONE:
OWNER: _
ii ADDRESS: _
' CITY, STATE
I PHONE: ?
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
?
( AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES
ZIP
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
' SEWER PERMITS, CONTACT ENGINEERING DEPT.
= DATE: 3UN 19, 1991
1631 Bi.ACKHA6IK LAK.E D& (MITTELSTAEDT BROTKERS CONST INC)
RE'o
x'`;rYour Sewer & Water Permit for the above property has been completed. It will be held at the
Publie Works Garage (3501 Coachman Road) u'ntil the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNiNG: BEFORE DIGGING, CALL LOCAL U7ILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- RE01.14ED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WpTER TURN ON POLICY.
Secretary, Building Inspections Dept.
CO1+TROLS
eeO??
THERMOSTAT Heat Plug Vent Size
Valve KIND OF LINER ? SI?E NONE
Limit ?
Drah Hood Regularor
Limit Setting Fi Iters S4ze Number
Fan 5etting Chimney Location 1 side Outside
v
Pilot Type Gi`Qw -/V
Chimney Constructi
on
Pilot M6ke
Pilot Mode1 Smoke Bomb Wiring
Pilot 7iming Draft TesT Tag.
L.W. Cut Off Door Pressure Lighting Inst..
Prossure Percent C02 Date Tested
Input CFH Pereent O Com
an
Testin
Z p
y
g
-
Stack Temp. ? Percent CO Name of Tester LV
?'4 A
Form 235
?S ?'a
H 7?1995 4 L3_5,? s
,?' AM ?
,
Fiequest Date Fire No. Rough-in Inspection
e uired?
Notify Inspector
? Ready Now )"W?'
? No Ready?
hen
I licensed contractor ? owner hereby request inspection of above electrical work at:
ob dress (Street,Box or Route No.)
! V? c.? K L,,4Krz A,1.?u? City
f?
Section No. Township Name or No. Range No. County
D " -(
Occupant(PRINT)
??- tc.c, E Ps Phone No.
o
Power Supplier
??_?..TILt Address
N G- T-61U
E?lec'trical Contractor (Company Name)
`
• ? ? /7-/?... Contracror's License No.
?--+
V 4 0 /' / ! V
Mailing Address (Contrector or Owner Making Installation)
/ 9S`3 SH cJ-JIJ
Author Signature (Conhar/wn ^ ak,n ' st ation)
. Phon ber ??
Z Z ?
MINNESOTA STATE BOARD OF ELECTRICITY V THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room 5-173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55704 UNIESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
?Q J? j REQUEST FOR ELECTRICAL INSPECTION
? ? See instruetions for completing this torm on back of yellow copy.
71954 `X' BeloW- Work Covered by This Request
ea-oooo,-os
ew Add ep. y TypeofBuilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
c-omm./Industriai ' Furnace
Farm Air Conditioner
Other (specify) Contractor's Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # CircuitslFeeders Fee
Swimming Pool ? 0 to 200 Amps 1 QD ? 0 to 100 Amps Q,
Transformers Above 200 Amps Above 100 Amps
Sigf1S Inspector's Use Only: TOTAL
irrigation Booms S0
Special Inspection ?
Alarm/Communication THIS INSTALLATION MAY BE RDERE ONNECTED IF NOT
Other Fee ? COMPLETED WITHIN 18 VOVJTkS.
?
I, the Electrical Inspector, hereby Rough-in , -? ?
certify that the above inspection has
been made. F;,,al Date
, ?
OPHCE USE ONLY This request void 18 months from
CITY OF EAGAN
' 3830 Pildt Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
PERMIT ? ? ?IM
PERMIT TYPE: g u x t, pING
Permit Number: 023660
Date Issued: 05/23 j g q
1631 BLACKHAWK LAKE pR
LO7: 2 BL.OCKs 2
BLACKHAWK 6LEN 3RD
F' . I . P6 . : 10-14352-020--02
DESCRIPTION:
ermit 7,ype t]ECK
T y p e NEW
REMARKS:
FEE SUMMARY:
WP
?
h?
?a
q '? k
n,?
.a^.E;s
Base Fee $30.00 COPY .50
5urcharge .50 Total Fee $31.00
Subtatal $30.50
CONTRACTOR: - A p p 1 i c a n t-- s T. LI C. OWNER:
SUNBURS7 BLDRS 16865832 0008582 SUN8UR5T BLCIRS
4270 SUNRISE RD 4270 5UNRTSE RD
EAGAN MN 55122 EAGAPI MN 55122
(612) 686-5832 (612)686--5832
. ? ?
APPLICANT/PERMITEE SIGNATUFILR 1 ED : SIGNATURE
- . _ ?- _
?, . CrtY t?? EAGA? ???EM"
1994 ButLDING PERM1"T APPE.tCAT#ON
MAY t 7'
6? -TV E 6, -, . , .. . . .
. . . /? •'r?'?_ w?1?rw?ai?k?.+aiFiM; ?kti - - .
i SINGLE & MtL;TI-FAMIlY 2sets af pl ans, 3 regi stered si?? ??rveys, I topy, oF
k. calcs. ,
COMMERCIAL 2 sets o? architectural &str-ucturaTI pians, I stt of
ta _ Sp$CificatiOiiS, x Cflpy of ef1eT'gy CailCs.
_ Penalty appTies: 1} when p+ar'mit is tyied, but not picked up by T??t wotking4a,.?f.t???? in which request fs made, 2} address is charr+ged or 3} lot change is roqc??ited oms.?it
?ssued.
Date /7 Va1uation of wark ?? ?t?. ?v
r
aite Actdress : r? 3J 4 4/k rtAe
srRUr susre #
, Jenant 1dame: (+eotmerci a1 ortty)
; `y'. ' . . . , . . . . - - .. . ..
fIV? «.,..:.....:? ?a?n?? . ? : [EBD. P. I.D. #
? ?Y? I?
?}#sGT'igtif}T1 of "'t?l"?:
T'he appl,icant is: 0 t?wner 12"OContractor CI Other c????f1W
Name
? 'P!rop+"?y ??sr gIaSr Qwnet' Addre s s 4- 4 ?. DR
sTRrET "E 0
; Cityr Statte A*?j. z fp
? C+ompaAy 8L` Ftons'
? Co#'trgiGtt3r Adc3ress ?Ja Zv Licer??e U 22.-, to .
k..
Gity ? St8$e !l4V ziP
f
`iCt3mpany Phott4
Engine@I' Name Registrattofi #
k
Addr8 S S '
?
? City State Zip
+.
?
,
S"er & water licensed plumber : Processing, tift fot"
'
? sewer & water permits is two clays once area has een appraved.
I hereby acknowledge that I have read this a plicatic?n .at?d state that tte infc??atia?n, is .
correct and aqree to comply with a11 applfca?le State of Minnesota Statutes an+d Ctty of,:
?. , Eagan Ard i nanees .
=Signature of Applicant:
OFFIGE USE t?Nl.Y
BtlILDING PERMiT 7YPE
Q Ol Fourrdat fiorr 13 06 Qupl ex
Cl 02 SF Chwg. ? 07 4-Plex
Cf 03 SF Addition CI 08 8-Pfiex
Cl 04 SF Rorcfi Q 49 12-Plex
C! 05 SF Misc. CI 10 multi. Add'1.
WORK TYPE
p 31 New 0 33 Alterations
0 32 Addition ? 34 Repair
GEh1ERAL tNFORMATtUN
? 11 Apt./lodgfng
? 12 Multi. M1sc.
17 13 Garage/Accessory
C] 14 Firepiace
,125 Deck
C] 35 Tenant Finish
D 36 Moue
?`.
C! 16 88sen@nt F i ni'sh
Q 17 Swim Pool
Q 18 Comm./Ind.
C] 19 Comn. /Ind. Mi sc.
? 20 Pub19c Facil ity
C3 21 Mfiscellanenus
0 37 pemolish
Const. (Actual
? Basement sq, ft. MWCC System
(Allowabie lst F1. sq. ft. City Water
UBC Occupancy 2nd F1. sq. ft. PRV Required.
Xoning Sq. Ft. tatal 6ooster Pu?p ?
# af Stor?ies ? Footprint Sq. ft. Fire 5prinkler
lengtn On-site well Census Code
Depth On-site sewage SAC Ca?de
1
C
Uni
APPROVALS ensus
t
?
Planning Building Assessments
Engir?eering Variance
REQUIRED fNSP ECTIC7?NS
Ci.Site ? Footfng 0 Framing 13 Insulation
Q Wallboard Finai p Draintfle ? Fireptace
Permi t Fee vatwtiom
Surcharge
Pian Review
Lfcense
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies .,S.o
Qther
7ota1:
SAC 96
SRC Units
?
.A11tEY0A'$ CERTIFICATE
. '
L_?,J i
1 ",7
I I
;l? rY
l0 20.40
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16.10. ?! t+i
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*
BEHCH MARK
TOP OF 1 RpN
(040 ,U)
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? f? . I--- ill, i nc.
ERS / ENGINEERS / SURVEYURS
o;ui JAMES AYE. S. • BLpOMINOTCIN, MN. 55431 v 612-884•3028
SIENNA CORPOftA'CK?N
WK4 po s?{ow
ftA-rS?RCON9T,
I r '? '? I F=
l_.k-? 1 I •.?
REViSEO 6•I1-91
1 E X 157. ELEV. )
115.00 ?- owl
'p? _
! j
BUILDING PERMIT
To be used for SF DWG/GAR
Est. Value $150,000
N° -19277
Receipt # c- ? ?j C^ ') ('
Date JUN 17 , 1 g 91
Site Address 1631 BLACKHAWK LAKE DR
Lot 2 Block
Parcel No.
2 Sec/SubBLACKHAWK GLEN :
W Name MITTELSTAEDT BROTHERS
? Address 785 SUNSET DR
0 City EAGAN Phone 456-9125
,o Name SAMR
?Cc Address
? City Phone
?
WW Name
?
? ; Address
a W City Phone
I hereby acknowiege that I have read this application and state that the
information is correct and agree to comply with all applicabie State of
Minnesota Statutes and City of Eagan Ordinances. -
5ignature of
A su+lding Permit is issued to: MITTELSTAEDT BROTHERS
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
OFFICE USE ONLY
Occupancy R-3 M-1 FE ES
Zoning R-1
(Actual) Const V-N Bldg. Permit 815.00
(Allowable) V-N
Surcharge 75.00
# of Stories
Length -
7a!
Plan Review
529.00
Depth 38 snc, city 100.00
S.F. Total - SAC, MCWCC 650.0
0
S.F. Footprints -
On Site Sewage _ water Conn 660 . 00
On Site Well - Water Meter
0
95.0
MWCC System X
Water
City X Acct. Deposit 30.0
n
PRV Required X S/W Permit 30.0
n
Booster Pump - S/W Surcharge _ 5n
Treatment PI 276.0
0
APPROVAIS RoadUnit 370.00
Planner --- Park Ded.
Council
BIdg.Off. , Copies
Variance - TOTAL 3,630.s
n
c
1 ? .
r.. t +
1991 BUI NG PE I AP ICATION
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 - & STRUCTURP,L PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET dF 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 REQtTEST IS MABE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESI DD-RE SSr IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT
XMWVn V
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE RM S BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER. ??
To Be Used For: ?laL ?j?;?.? Valuation: /J?0,('Q() '? Da .
Site Address
!? .
Lot ? Block `?..
Parcel/sub 6- AW HA,.,,? ?? 3'
Owner
Address
City/Zip Code
Phone
Contractor 141rTeL?-zAaA7-
Address -7g!? !S,UA,es? ?2
City/Zip Code AAv,
Phone 4 6?? -r'l /V 6
Arch./Engr. _
Address
City/Zip Code
OFFICE USE ONLY
Occupancy .'3 M°t
Zoning K - ?
Actual Const V - N
Allowable v .-/'l
# of stories
Length -?7U
Depth
S.F. Total
Footprint S.F.
On site sewage_
On site well
MWCC System ?
City water ?
PRV
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off.
Variance
FEES p
00
i5
Bldg. Permit o
i
Surcharge
O
r75,0
Plan Review 29 10?
SAC, City i001 00
sAC, riwcc 6
Water Conn, 6 D10 Q
Water Meter ,C)?
Acct. Deposit D,vJ
S/w Permit 30,4v
S/W Surcharge ,,SU
Treatment P1. 2.r7,pc?
Road Unit
c
100,0
Park Ded.
Trail Ded.
Copies
SUBTOTAL
Penalty
Lot Change
TOTAL
Phone #
agrees that all work shall be done in accordance with
(Signature of Contractor
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
?A'R A
..?----
r??? 14574
i sT
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1139 (,5667
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SU#IYEYOlt'!i +CEATIFICATE
siENNa CoapaaATiaN
REVISm 6-10-91. TO SHOW
PROPOSED HOU3 E FQR
MtTTEL$TAEbT dRbS. CONST.
N07E* NO SPECFIC SOILS 1NVEST13ATION HAS 6EEN COMPI.ETED
ON THIS LOT BY THE SURVEYOR. TFE SUIYABILITY OF
SOILS TO SUPWRT THE SPECIFIG HWSE PNOPOSEb (S
NO7 TNE RESPONSISIUTY oF THE SURVEYOR.
?
• ? Ra? "? o REOu I
N07G; B;;;L"uING pMEN5IONS SNOWN ARE
FOR HORIZC?? 6 _ _I?tTCAI. !AG-
ATIqN bR s T???E pMLY. $tE
ARCHITECTUAL aL.A?fOR QUII,DING
O? F4uNO??TIM? p OHS.
-? - DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR s i??4o,$ FEET
X000.0 DENdTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - i33z,(- FE&
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLdCK = ?540-7 FEET
WE HEREBY CERTIFY TO S I E Nt,!I-, THAT 7HIS IS A TRUE ANp CORRECT
REPRESEN TATION OF A SURVEY OF THE BOUNpARIES OF :
Lot 2, Blpck 2, HLACKHAWK GLEN 3RD ADDiT1 0N, according to the recorded
plat thezeof, Dakota County, MinnesQta.
IT DOES NOT PURPlJRT TQ SHOW IMPRQVEMENTS GR ENCROAGHMEN7$, EXCEPT AS $HQWN, AS
SURVEYEp BY ME OR UNDER MY DIFtECT SUPERVISION THIS 2 I 57 DAY OF J u NE , 1988.
APPItOVEp FOR SiENNA
CQRpQRATfDN
DY:
Dnrrr),
BY
JA L, INC.
C,
HARdLD C. PETERSON, LAND SURVEYQR
MINNESOTA LICENSE NUMBER 12294
EJAA 1'lE'S R. HI ll If Ic,
NERS / ENGINEERS SURVEYOf?S
MES AVE. S. 0 BLOOMlNGTON, MN. 55431 • 812-884-3029
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REVISED 6-II-91
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,_--- ----- o- 100.00 a= 9015'45" A" R-sie.ge -• -._.?...~? -?_
M 13LACKHAWK LAKE ??IVE °
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PLANNERS / ENGINEERS I SURVEYC7RS
a401 JAMES AVE. S. 9 BI.L70MINOTtaN, MN. 55431 a 812$84-3029
DATE ?d?/3 ??`?
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER
SITE ADDRESS bll" uc1
CONTRACTOR (?iTT E L S T ncztT' S . Ok)sT.
annxESS 7g 5 LJ2-:_ PHONE ti 16o -a i 2 5 - -
DETERMINE WORRITTG SQUARE FOOTAGE OF EACH.
1. Total exposed wall area .... 2,'7 471 sq : f t. x .11 =107.01
2. Total roof/ceiling area .... /!SLI sq. ft. x•026 ? O- o
Total exposed wa11 area above floor s 22 21
a. Total wall window area ......................... .2y g.5
b. Total door area ................................ q,n
c. Total sliding glass door area .................. yp,o
d. Total fireplace wall area ...................... o
e. Total wall framing area (average lOx) .......... 2'79.0
f. Total net wall area above floor ................ / g?-P/,5
g. Total rim joist area ........................... 2(d?5,-?
Total exposed foundation area s r7
h. Total foundation window area ................... I?? _
i. Total net foundation area above grade ..........
Determine "0" value of each wall segment.
a. 3y 8,5 x„Ull . y 20 Sl G.q
b. :?4 x?,Ult , 07 s 2, 7
c. e.(p gflUff
d. D R "U" o
e• 27q p Ifrflt '??
n u
f. J ?621,5 xf,vf, ?Dy3I! a 79, /
s• 21o3 x '?u" , a yq
h. 13 x flUff , y1oq ° (o,o
i. 66 x flUff 0$2 = 5, y
3 . ...............................Total 2 g g•?7
??;•?, . ,e,-.?A . _
If item #3 is the same as, or less than item #1, qou have met the intent
of SBC 6006 (c)2.
-1-
Page 2 of 2 -?.
Total exposed roaf/ceil{:,g area m //S4/ _
j. Total skylight area ............. ......... . p
k. Tota1 roof/ceiling framing area (average 10%).. r7 Z,/
1. Tota1 net insulated roof/ceiling area ......... / pgJ, q
Determine "U" value for each roof/ceiling segment.
j , ._ X ifU,t
k. '72 , ! R "U'' , O Z
?
? = 1 : 9
_
,
g fluff , D2?g = 2 3, lo
4 ?r??
?
.......................... ... ............. Tota1'
If total of #4 is the same as, or less than #2, you have met the intent
of SBC 6006(c)1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by
the sum of items #3 and #4 shall not be greater than the sun of items
#1 and #2. r
1. + 2. ` . _
3. + 4.
-2-
CITY OF EAGAN FOR CITY USE ONLY
3830 PILOT KNOB ROAD
- ? EAGAN, MN 55122 PERMIT #
PHONE: (612) 454-8100 RECEIPT #?
DATE : //
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRE D FOR EACH UNIT.
------------------------ --------------------------
WORK DESCRIPTION ----- --------------------
COMPLETE THE FOLLOWING: ------
N0. FIXTURES EA. TOTAL
NEW CONST ADD-ON MINIMUM 15.00
ADD ON I SHOWER 3.00 _Tr Q?
REPAIR ? WATER CLOSET 3.00 •d 0
BATH TUB 3.00
LAVATORY 3.00 a40
OWNER NAME: KITCHEN SINK 3.00 3,DD
?UNDRY TRAY 3.00 3,00
SITE ADDRESS: HOT TUB/SPA 3.00
R
R
LOT :_? BLOCK ? SUBD..17?./?,P???1?Lf],?.rl-aC? n DRAIN
FL00^ 3.00
?? OD
' GAS PIPING OUT.
INSTALLER: (MINIMUM - 1) 3.00 DD
? ROUGH OPENINGS 1.50
ADDRESS : 1?574 I,aiz&/ , OTHER
WATER SOFTENER 5.00
CITY: ZIP; ?2_ i PRIVATE DISP. 15.00
j
PHONE U.G. SPRINKLER 3.00
#;
SUBTOTAL
$
ST. SURCHARGE .50
SIGNATURE OF PERMITTEE
TOTAL: S -5?? 'DO
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWELLING UNIT.
--------------------------------------------------
CONTRACT PRICE: ----- -------------
FEES ------- ------
OWI3ER NAME :
SITE ADDRESS:
LOT: BLOCK SUBD.
1$ OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #;
CONTRACT PRICE x 1$ $
STATE SURCHARGE $
TOTAL:
$
(SIGNATURE)
FOR:
CITY OF EAGAN
,M
CITY OF EAGAN FOR CITY USE ONLY
, 3830 PILOT KNOB ROAD
EAGAN, MI3 55122 PERMIT #
PHONE: (612) 454-8100 RECEIPT # l?
DATE :
PLEASE COMPLETE UPPER PORTTON ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
------------------------ ---------------------------------..-..__.._---------------
WORK DESCRIPTION FEES
NEW CONST X
ADD ON
REPAIR
OWNER NAME : % i43 z ; ?S
S ITE ADDRES S: 'BLfl C ,Zy,
r
?4 LOT : ?,_ BLOCK ? SUBD. L????
IN S TALLER : L-) z / v vi- L /F{ 7-z- - -/ 4 lC
ADDRESS :
CITY: ????a-r? ZIP:
PHONE # : `) S c)- o c' (v 5
ADD-ON MINIMUM $15_,00
HVAC 0 -100 M BTU ?4__
ADDITIONAL 50 M BTU 6.00
GAS OUTLET5 - MINIMUM ?
OF 1 PER PERMIT
SUBTOTAL: $ ,)7 60
STATE SURCHARGE: .50
TOTAL: $
S NATURE OF ERMITTEE
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
::..::.... :::...:..::....:::::......:.<.........:.:. . ?.: ?::::::....
APARTMENT BUILIIINGS, AND MULTI-FAMILY BUILI32NGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
-------------..---------`?--???----..???--r.-r------??--a----rr.--r-rr---..??---r-----
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:,
LOT: BLOCK SUBD.
INSTALLER:
ADDRESS
CITY: ZIP:
PHONE #:
FEES
1% OF CONTRACT FEE.
STATE SURCHARGE - $ . 50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING - $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1'k $
STATE SURCHARGE
TOTAL:
$
$
(SIGNATURE)
FOR:
CITY OF EAGAN
?
2005 RESIDENTIAL BUII.DING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Conshuction Reauirements RemodeVReoair Reauirements Office'Use Onlv
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cert af Sunrey Reod _ Y _N
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Pian Recd _ Y
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required _ Y _ N
1 set of Energy Calculations Addition - indicate ifon-site septic system On-site Septic System _ Y _ N
3 copies of Tree Preservation Plan ff l01 platted after 711193
Rim Joist Detail OpGons selection sheet (buildings with 3 or less units)
J
V?/
D v S
_
ate c Construction Cost
Site Address UnibSte #
Description of Work
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 2
PropertyOwner 1•YY1?????1?tOCJ • Telephone#?pS?
Renewal By Andersen
Contractor 1920 County Rd. "C" West
Address Roseville, MN 55113 City
State 651-264-4777 Telephone # ( )
License #20130983
COMPLETE THIS AREA ONLY IF CONSTRUCTtNG A NEW BUILDING
- Minnesota Rules 7670 Categorv I 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 Plumber
Telephone # (
Mechanical Contractor
Sewer/Water 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
approv of plans. , [
fl! 242 05 'Applicant`s Printed Name Applicant's Signature
?
OFFICµE USE ONLY
Sub Types
O 01 Foundation
0 02 SF Dwelling
0 03 01 of _ plex
O 04 02-plex
? 05 03-plex
0 06 04-plex
Work Types
? 07 05-plex ? 13 16-plex ? 20 Pool
O 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 09 07-plex ? 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 ? 25 Miscellaneous
? 30 Accessory Bidg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
0 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
0 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 Sldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
? Footings (new bldg) _ FinaUC.O.
_ Footings (deck) _ Final/No C.O.
` Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Ice & Water
' Roof Final Pool _ Ftgs _ Air/Gas Tests Fina1
_
_
_ Framing _
_ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. i Air Test _ Final _ Windows
_ Insulation _ Retaining Wall
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
vv! vd? yvi.t 111V .%.b.Q(/ ?
• rnb. ? o? a t 1 g4tta tt?t+(?I?hf, ??' ?IYdlt?l3P( •
?e al
_ . . ':
. . June 7, 200i " _ - -
- aty of fiagm
3836 PiIot Knob Road .
?gan, MN 55222 . TO Wbom It May Comcern: .
EIder Jones is authOrized to pttll buiIdin
Eldcr roncs to g P?fs for Renewai {?y Atcdazsez?_ ?icase ?Ilow
Providc t?us Perv?icc for us in F??n. `ITtiR
,
date bcyond 616I01; ett thori28ticin is vaiid for $Tty
to theCity_ until a?`tUewal by Andersen man?g? e4reWY revakes it in wri
dne
I rcquest this authoM'Atiaa be $ ' .. vur building Pcxmita any fu? p?? ?? If thc? arc ? delay in thes prvccssing of
t coIItacted at 7b3-S02-47Uf. .. Y?fieulona. , I can Ue
.-
Your immqdiatc aftntion to t4is mattcr is ? m-grm_
Sinoaizsly,
ymond -?t, i?au
tistatIation Maztagcr
Rcnowal by Andcrscn CorPoratitvn t??: Ksm?-FTc}e:r T?ne? -
• 4 ?. ?? ? .
? MWY ?
,
ws/ce
RecEive? Ii-me Jun. 7. 1:07P}d
2004 RESIDENTIAL BUII..DING PERMIT APPLICATION
City Of Eagan -Sr7O_ 0 O
;; 3830 Pilot Knob Road, Eagan MN 55122
(o qg ? Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements RemodeliReoair Reauirements
3 registered site suroeys showing sq. ft of lot, sq. ft. of house; and all roofed areas 2 copies of plan (20°lo maximum lot coverage allowed) 1 set of Energy Calculations for heated
additions
2 copies of pian showing beam & window sizes; poured found design, etc. 1 s+te survey for additions & decks ?
1 set of Energy Calculations Addition - indicate if on-site septic system
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date (!N? / 4
Cons tion Cost
Site Address Unit/Ste #
T
Description of Work 0 -?i l 1
Multi-Family Bldg _ Y? N Fireplace(s) _ 0 _ 1 _ 2
Property Owner 1 Telephone # (64?)
14 ( A i
/
Contractor i
Address ?? S 1 City
State l?v Zip SV,20 J Telephone #(?-1)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category Mvnnesota Rules 7670 Category 1
• Residential Ventilation Category 1 Worksheet
(4 submission type) Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a simiiar plan?
fee applies.
Licensed Plumber
Mechanical Contracfior
Minnesota Rules 7672
• New Energy Code Worksheet
Submitted
Y_ N if so, 25% plan review
Telephone # (
Sewer/Water Contractor Telephont ?,( J(J
I hereby apply for a Residential Building Permit and acknowledge that the infft=k
that the work will be in conformance with the ordinances and codes of the City of :
Statutes; I understand this is not a permit, but only an application for p d u
permit; that the work will be in accordance with the approved plan ' th , e of ork
approv of plans.
Applicant's Printed Name A plicant's
ga-V-I?F?d accurate;
and the State of MN
not to start without a
requires a review and
OFFICE USE ONLY
Sub Types
0 01 Foundation
? 02 SF Dwelling
O 03 01 of _ plex
0 04 02-plex
O 05 03-plex
? 06 04-plex
Work Types
? 31 New
? 32 Addition
0 33 Alteration
O 34 Replacement
Valuation
Census Code
SAC Units
# of Units
# of Bldgs
Type of Const
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addition)
Foundation
Drain Tile
Roof Ice & Water Final
, Framing
_ 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
? 07 05-plex ? 13 16-plex O 20 Pool
? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 09 07-plex ? 17 Garage ? 22 PorchiAddn. (4-sea.)
? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo)
? 11 10-plex ? 19 Lower Level 0 24 Storm Damage
? 12 12-plex Plbg_Y or_ N? 25 Miscellaneous
? 30 Accessory Bidg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
O 37 Demolish Building* ? 43 Reroof ? 46 Windows/Doors
"Demolition (Entire Bldg) - Give PCA handout to applicant
Occupancy
Zoning
Stories
Sq. Ft.
Length
Width
MCES System
City Water
Booster Pump
PRV
Fire Sprinklered
REQUIRED INSPECTIONS
_ Final/C.O.
_ Final/No C.O.
_ Plumbing
HVAC
Other
` Pool Ftgs _ Air/Gas Tests Final
_ Siding _ Stucco _ Stone _ Brick
? Windows
` Retaining Wall
Building Inspector
CASH RECEIPT
?
CITY OF EAGAN !, w
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
1 s
DATE 19 ?
r.,
aECewEO q f ?"' "*,
AMOUNT
& DOLLARS
100
? CASH t(CHECK
?z 1n cc ,;^p
FUND OB.)ECT AMOUNT q
? ..
Thank You p .
I t {" ?
C? 14026 W,it*-Pa,m C-opy ?
Yetim-easting cq)y
Pink-Fcle c4ay
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115321
Date Issued:09/25/2013
Permit Category:ePermit
Site Address: 1631 Blackhawk Lake Dr
Lot:2 Block: 2 Addition: Blackhawk Glen 3rd
PID:10-14352-02-020
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 .
Audrey Flattum
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 -
Timothy S Phillips
1631 Blackhawk Lake Dr
Eagan MN 55122
(651) 454-4609
Storm Guard Restoration
1355 Geneva Avenue North, Suite 201
Oakdale MN 55128
(651) 738-1698
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA122200
Date Issued:04/29/2014
Permit Category:ePermit
Site Address: 1631 Blackhawk Lake Dr
Lot:2 Block: 2 Addition: Blackhawk Glen 3rd
PID:10-14352-02-020
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.
Dean Kamrath
13791 Jonquil Ln N
Dayton, MN 55327
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
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 -
Timothy S Phillips
1631 Blackhawk Lake Dr
Eagan MN 55122
Adam's On Time Plumbing & Water Heaters Llc
13791 Jonquil Lane N
Dayton MN 55327
(612) 205-6060
Applicant/Permitee: Signature Issued By: Signature