1636 Blackhawk Lake DrCASH RECEIPT
; CITY OF EAGAN
aetErreo
3830 PILOT KN46 ROAQ
EAGAN, MINNESOTA 55122
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Thank You
& OOLLARS
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O CASH, I? CHECK
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INSP?',CTI(3N RECORD
CiTf t3F EAGAN PER?i?' TYPE; fi ?? It 01146
3830 Pilot Knob Road Fermit Nurnber: 0,?13446
Eagan,.Minnesc>ta 55123 , Date issued: 0 4 12 x 1 9 4
(612) 681-4675
-° S#'1'E At3QRESS: E. t# 1 ARRL#CANT:
? 0, ??? AWK I At t- r'jk k• ? ? a:? -? ?ti ?: ?? ?- ?
: i"a,R. ACE? ??JK c1 urN :ija p
? ?i's??T ?7VG??PEs
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TYPE OF WORK:
N f:.w
? ? NW,* I I 1 ? ) w-t u
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? StWER & WATER PeAM4`t .OFE'fC`f-
Se
t ?i TY QF EAGAN
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?? ' PEAMtT flATE
Att?l'ER #
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3830 Pilot Knob Rd.
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C?tip PERr?t't # ?*
Eagan, M1+t.551 22
1897 ;
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DATE lytA? 11, 1992 ; .
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? PRV ?..?.: 13005'fER?'PUMP
; SITE ACJbRESS1.636 $SACRIiAWK LAKE DIt , FERMt'T REQUESTEfl
LUT 1 'SLOCK 1 SEClSUB BLAG?MAWK GIEN: 39A
X SEWER X UVATER ? 7AFS '
APPLICANT:
- GOMM7IND . X RESIDENT1AL:
; ADpRESS:
' CITY, STA7E ZIP %-NEW EXfSTIhlG
PNONE:
Lawn Sprinkler Meters are ta be kr#statled `
?NZEL Pm
PLUMBER: Ahead of tlornesfic RAeters on Water i.ine; .=:
ADDRESS: 1959 RA Credit WII.L NOT be given foc Qetiuct Meters; °;
'
i CITY, STATE EA? .M13 ZIP ?°5122
? PHONE: 452-1565
i AGRfE TU Y iN17H Ci7Y C1F
i OWNER: t,tENS?tAI?N PROFF,RTII?S EA O
'i ADDRESS: 14340 PILO'F KNClB 1tA
; CITY, STATE APPLE VALLEY MN Z{P 55124
` PHQJ?E: 423-1179 StGP1ATU WHEN ME'fEFi ISStJE[?
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' PI.EA aLLC)W TWO INORKlNG DAYS FOR PR ,
_
OCESS(NG. CALL 454-5220 FOR tNSPECTtdAIS, Ff3R STOROk '
i SEWER PERMfFS, GONTAC3' EPICatNtEEft1N1G 17Ep1'
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Y 7"??:: °???T#^.re?e:'4?,.?„ "?' n . ,T'", taCF'Mi',,;,;.5?' .r•a?,?,v,;.
; SEWER &JNATER PERM9T
' CiTY OF EAGAN
; 3830 Rilot Knob Rd.
Eagan, MN,r55122-1897
;? .
DATE MA"R 11, 1942
OFFICE tJSE ONL:Y METER # PERMIT DATE 03j 11/92
CHIR # PERMIT # 4
METER SIZE B.P. RECEIPT # C 017755
iSSUE DATE B.P. RECEIPT DATE 03/12f 92
? PRV T BOOSTER PUMP
SITE ADDRESS ???? BL?CKRAWK LAKE DR
' LOT i BLOCK 1 SEC/SUB ?????? CLEN 3RD
APPLICANT:
ADDRESS:
CITY, STATE ZIP
PNONE:
PLUMBER: ??NZEL PL$G
' ADDRESS: 1959 SHA;4NEE RD
CITY, STATE EA??N MN ZIP 55122
PHONE: 452'1565
OWNER: WENS14ANN PROPEiR.TIES
ADDRESS: 14340 ???? ?OB RD
' CITY, STATE ApPLE VALLEY tIN ZIP 55124
PHONE: 423"1179
PERMiT REQUESTED
X SEWER X WATER - TAPS
COMMIIND
X NEW
X RESIDENTIAL
? EXISTING
Lawn Sprinkier Meters are to be Instatied °
Ahead of Qomestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
1 AGREE TO COMPLY WITH CITY OF
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPEC710NS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEP7.
DATE: MAR 16, 1992
RE: 1636 BLACKHAWK LAKE DR (WENSMANN PROPERTIES)
X Your Sewer & Water Permit for the above property has been completed. It wilf be held at the
' Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CAIL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be compieted 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.
COMMERCfAI PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Qirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DtGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED SY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
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(gtxfittxaf? ?? ?rrupariry
ttrp of (Eagan
lorpartmrnt of luitding iwrrtian
This Certr'ficate issued pursuant to the requirements ojSection 306 ojthe Uniform Building
Code certifying that at !he time ojissuance this smicture was in compliance with the various
ordinances of the City reguladag building con.rtr4tion or use. For the following:
uxaus;fic.u.oo ? DWG/GkR ?,hmicr(o. 03
?r?m? ?P?' TYPe R3/?'11 zooins n?urria R12 7YP"C?mt ?
Owneraf Bwlding ?' %M ??''` R? Addre? i4?i0 ? I?B ?y ? VATtcaw.?+
Builcling ,? 16 ?IAWK LAKE I7RIVF?4? L 1, B 1, ?.?4DtHAWIC (?T 3?
naic 4/2A/Q2
offia-
&uuiog
POST IN A CONSPICUOUS PLACE
?,
Add,rps?: 1636 g r?y,?? T,AKF; DtuVELot I Blk 1 Sec/Sub B,r?? ? 3RD
These items were/were not complete at the time of the final inspection.
Da e• 4?29?92 Yes No ? Tnsppctor:
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 plurabing
system and the shut-off of water supply to the outside lawn faucet before
freeze potential exists. &
PECTCLED WVEN
White - City copy Yellow - Resident copy Pink - Contractor copy
3 as/?? - --
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574 ? A,, & ? ?
Request Date
3 ?? 9 2 F+e No. Rough-in tnspection
Required?
? Ready Now ? Will Notify Inspecior
Cres ? No When Ready?
I)C licensed contractor D owner hereby request inspection of above electrical work at:
Job Address (Street, Box or Route No.) Giry
1636 t3lackhawk Lake Drive
Section No. Township Name or No. ange No. Counry
T Dakota
Occupant(PRINT) Phone No.
Wensmann Properties 423-1179
Power Supplier Address
4w D
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Eiectrical Contracror (Company Name) ContractorS licsnse No.
Joos Electric Co. CA00961
Mailing Address (Contractor or Owner Making Installation) .
2104 Great Oak i.ve, Burnsville, MN 55337
Authorized Signature (ContractorlOwner Ma - g Installati ?--? Phone Number
431-4755
MINNESOTA STATE BDARD OF ELECTRIY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Hoom S-173 BE ACCEPTED BY THE STATE BOARD
1827 University Ave., St. Paul, MN 55704 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION es-ooooi-oe
?? ? See instructions tor completing this form on back oF yellow copy.
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` i ?'1 Ct t" ?'1 !? *1:
v jf? ?? :1 1 4 °x° ttalow warx c;overed ay rn,s Nequesr
ew Ad Rep. TypeotBuilding AppliancesWired EquipmentWired
X Home X Range Temporary Service
Dupiex Water Heater Electric Heat+ng
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) Contractor's Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 1 0 to 200 Amps1 Q 18.1 1 pto 100 Am
Transformers Above 200 Amps 100 Amps
SignS Inspector's Use Only: T07A? `
Irrigation Booms
J GJ. ??
U
Speciai Inspection
Alarm/Communication THIS INSTALLATION MAY BE OR D DISCONNECTED IF NOT
Other Fee COMPLETED WITHIWIDR40NPWP. (
I, the Electrical Inspector, hereby Rough-in
? Date „
certify that the above inspection has
been made. Final Date ?-- ? Y-
OPFICE USE ONLY ' - -
This request void 18 months from
PERMIT
CfTY 4F EAGAN
3830 Pilot Knob Tioad
Eagan, Minnesota 55123
(612) 681-4675
PERMIT TYPE:
Permit Number:
Date Issued:
I Control No. 0013
?
BUILDII4G
0@0003
03j11j92
SITE ADDRESS:
1636 BIACKHAWK LAKE pR
LOT: 1 BLOCK: 1
BLACKHAWK GLEN 3RD
REMARKS:
FEE SUMMARY:
?D) 77? .?
Base Fee
Plan Review
Surcharge
SAC
SAC %
5AC Units
5ubto'Ca1
vaLuaTraN
$734.@0
$477.1,@
$63.50
$700.00
100
1
$1,974.60
$127,P100
S & W PERMII'
S & W SURCHARGE
ACGQUN`f DEPOSIT
IICENSE SEARCH
MISCELLANEQUS
Total Fee
$3,590.10
CONTRACTOR: - App.licant - 5T. bWNER:
WENSMANIV PROPERTIES 14231179 0001 56 WENSMANN PROPEF2TTES
14340 PILOT KNqB RD 14340 PILOT KNOB RD
APPLE VALL.EY MN 55124 APPLE VALLEY MN 55124
(612) 423-1179 (612)423--1179
$3@.0@
$.50
$30.00
$5.09
$1.550.00
CtTY OF EAGAN
1992 BUILDING PERMtT APPLICATION
. 681-4675
'OAR 0 3 RECO
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy-of energy 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 ance ermit is issued.
Date ?? j_;?_ Valuation of work ?
Site lacation: W10
STREET STE #
j
Tenant Name : L
'e. KbM,r?J_%A
LOT ?_ BLOGK ?? ? P.I.D. #
[Les
cription of work:
.
The appl i cant i s: Owner ? Contractor 0 Other (Describe)
Name L&jfb ? PCoAA,',? I C-S Phone qZ3 - l t 7 z ?
Property LpsT FIR*
Owner Address l q ?L10
,-0-?-1??? l?fivo,? ?-,D-
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7
STE #
STREET
City State Zip
Company Jy4-v'c 43 4Lvove_.- - Phone
C011tt'aCtOC Address License #nQDj41c;?'t-4
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water 1 icensed plumber ,,,"go l Mec.i : . 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 o Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: '
BUlLDING PERMIT TYPE
0 01 Foundation
(M-02 Single Family
? 03 Two-famiiy
O 04 Multi-fam. T.H.
0 05 Apt. Bldg.
WORK TYPE
?90 New
? 91 Addition
? 92 Alterations
OFFICE USE ONLY
? 11 Res. Add./Porch
0 12 Corrm./Ind. New
? 13 Comm./Ind. Add
? 14 Comn./Ind. Rem.
? 15 Public Fac.
? 06 Garage/Accessory
0 07 Fireplace
? 08 Deck
? 09 Basement Finish
? 10 Swim Pool
13 93 Remodel
? 94 Repair
? 95 Tenant
0 96 Move
? 97 Demolish
Finish ? 99 Undefined
GENERAL INFORMATION
Occupancy 3 A'l-
Zoning
Const. (Actual)
(Allowable)
# of Stories
Length ?
Depth !Z G.33
APPROVALS
Planning
fngineering
REQUIRED INSPECTIONS
? Site
? Wallboard
Basement sq. ft.
lst F1. sq. ft.
2nd Fi. sq. ft.
Sq. Ft. total
Footprint Sq. ft.
On-site well
On-site sewage
8uilding
Variance
O Footing
? Final
C] Framing
O Draintile
Permit Fee
3
Surcharge ? ?
Pl an Rev i ew
Li cense
MWCC SAC 7,90
C i ty SAC /00
Water Conn. &95
Water Meter gs
Road Unit 3?10
TreatmQnt P1. 300
Pai°k-$@t1".?Ic., Pcr4,;13 0
Tr'a i'1 s--0dd,_q/_jt,?YfryYe}?
Copies
Other
Total:
vatuecion:
Bs,?, -?-
$ I?'?
/6k? y : 3?y
q? -2-
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7 ? ?o
vx,2:2ly ? 3,?2 ?do
2?k?
l, s'k c. S; 9, ?s ,k.ss
99y,?.?3
5?/9'4?
? Insulation
? Fireplace
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1?1 9/.S-1
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? 16 Agricultural
? 17 Building Move
El 18 Demolitian
0 20 Miscellaneous
MWCC System y 3
City Water
PRV Required Ya
Booster Pump
Fire Sprinkler
Census Code
SAG Code ,
Assessments
SAC %
SAG Units
-?EP F3 uo c. W-- E-L.. . 8 3`.3, S
SEt?ENT C L. 831 17
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I hereby certify that this survey was prepared by me or
under my direet supervision and that I am a duly Registered
Land Surveyor under the -laws of the State of Minnesota.
Date :
??k-tiew ?47, 14?W LeRo4.2
y H., ohlen
Registered Land Surveyor No. 10795
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. OWNER
"U„ CO'!-,liTATIGN
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R iwo'S
SITE ADDRESS L- -;
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CONTR.ACTOR
c
? ADDRESS
PHONE
DETERMZNE WOP.KI".G SOUARE FOOTAGE OF EACR.
1. Total exposed wall area .... ,6cn4V? sq, ft. x_?
'2. Total rooffceiling area . sq, ft. x
Total exposed wall area above floor " ?
--• a- Tote?l wa1l-:windou,= area _..._..._..._.. . ..._... . .
- -. --- ? G_'?
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- -. ^: - lb:X_?a_To:tal- door- ar.ea ......
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"-s: ?:Total-':sl?d,,,ing :81ass. door. ar.ea•..........._. . ?.. ?
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,,-?
. .... ?- ?;
-- 1- ?a-ta1 ;fireplace. wa1.I. ar.ea .......,.....,........,.. .
,,
..... --?"t?
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, a. ?e: ? :TotaL- Vall:_framing- area -(average° 10Z) .._. . . . ? ? ??
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.f= .-.':Tota1 .ner. wall- area :above.,flooL .......__....... ? ',?
' /?'//%
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g. Total zim joist area ..........................
To[al e:cposed foundation area
h. Total foundation window area ............ ....... ?
i . 'i.__.1otal net_.foundation area- above, grade
i?ete-:DeCerniYrieeac'ti wal.'t•.segment .
b • J C/ ? ftUre . j..E. _ ! " ?..!
x IfjJn
C. A p ?
g tlUtt . 7??- _ ?'?r?? ? .
e. x trUrl
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f. ? t?J ?7 X"U'?
x nutt
h. ? x f?U??
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x flUff
?3 . ...............................Total = ' ,
If item 93 is the sane as, or less [han item #1, vou have met the intent
of SBC 6006 (c)2.
Page 2 of 2
. • a
Total esposed roof/cei?ing area
J. Total skylight area ....................... --
k. Total roof/ceiling franing area (average 109).. /?
1. Total net insulated roof/ceiling area .........
Determine "U" value for each rcof/ceiling segmeat.
j . ? x IlUlt ?
?
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k. x flUff
x rrUrf ? ?--? 71r? _ 77, /
4. . . . . . ._. . . ... . . . . - - -.... . . . Total_ 4 :'J/u
If total of #4 is'the same as, or less than #2, you have met the intent
• -- --r+?. .::of -:SBC? :6C06(c)1.
. .--?'= YA:lternat'piBu?lding3:nveloge.,Design
' To utilize the total"envelope system r.iethod, the values established by
the sum of items #3 and #4 shall not be greater than the sun of itecs
#1 and #2. - --
__ i • ?? + 2. 3• - - 4. . . . - = _
i
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CiTY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
1636 BLACKHAWK LAKE DR
l.C1T: 1 BLQCK: 1
BLAGKHAWK GLEN 3RCl
P.I. N. : 10-14352-910--01
C?'0,.,
BUIL.qING
023445
0Q{27f94
DESCRIPTION:
6e r e ? , ?? f "? a a?a,a°";s,
,?
?_ °?,?g
? a _a :
;me?;e?'
...o:e
REMARKS:
FEE SUMMARY:
E3ase Fse
Surcharge
5ubtotal
CONTRACTOR:
Type pEGK
??a ?. l• d?, t? g. :l?S?,r k T y p e N E W
$30.00
.50
$30.50
? J
APPLICANT/PERMITEE SIGNATURE
COPY .60
rotal Fee $31.00
OWNER: - Appla.cant -
PasT sGprr
1636 BI.ACKHAWK LAKE C1R
EACAN MN 55122
(612)687-8959
?ISSU D B : SI NATURF- t
~ CITY OF EAGAN
?j [?
'?9? BUI?.DING PERMIT ,?PPU??ON tC'11?????t??
681-4675 APR 2 51994
SINGI.E &MULTI-FAMiLY 2 sets of pl ans, 3 registered site surveyS, I copy ?? the?r?? r .
calcs.
CtJMMERGIAI 2 sets af architectural & structural pians, )s?et of '
sqeciflcations, ) copy of energy ca'l+es.
Penal ty appl i es ; 1) when erni t i s typed, but not pi clced up by st wsarking; day of .: =h
1n which request is made, address is changed crr 3} 1ot change #s requested ??e -Wmit
,i issued.
, ????? ,..?.,? ? ?r 1 ?.1 ..:??.?:. ??? ???? ? ?? ?? ??? ???? ?dress: r § ? . ?. _
sTMT
?????? Name: (?ommercial only)
? .
? LOT ......?.....r, $LOCK ..,?..,...,,. SUBD. P.T.D.
???rj tign gf ,ork:
'ffie appl i cant is: JO thNner 0 Contractor QOther cvner{toa
Name Phon+e to -07
P'ro3?eCty LAst FsRss
t3wner Address
STRE€r
City ?ae 4' an. State ?A4 _ Z 10
?Cotnpatty Ptmne
r: s
?ontPutCiY Address Ligense t
:
? City State Up
r Company, . Phone
' A1`c11i#ntJ
Name Registr-at
ion ?
;? .
Address •
City State . >Zio
" ?Sewe r & ter l teensed pl umber P?????? t?ime? for-& water permi ts i s two days once arei has bien aproved .
?. i hereby ackrrowledge that I have r+ead this agplication anti state t1tat the fnformat3cn' is
. correct and agree to camply wi th al l Applicabi e Stat? of ?? ??tota Sitatu??? aod C?ty, ofrt <<.
1agarr Ordinances.
?Si?gnature of Appl icant:
?
OFFtCE USE ONLY
BUILDiNG PERMIT TYPE
? Ql F4undation E3 06 Duplex O 11 Apt,/l.o+dging
13 QZ SF Dwg. O 07 4-Plex O 12 Multi. Misc.
? 03 SF Addition ? 08 8-Plex CI 13 6aragejAccessory
13 04 SF Porch CI 09 12-Plex ? 14 Fir+epiace
0 05 SF Misc. 13 10 Multi. Add'1. 0 15 Deck
WORK TYPE
E] 31 New ? 33 A3terations ? 35 Tenant Finish
Cl 32 Addition E3 34 Repair 17 36 Move
CEN€RAL INF+C}RMA'i'1C1N
Const. ?actual
(A7 owab3e?
tlBG UccuQancy
Zoning
# of Storfes
Length
Depth
APPRC)VALS
Basement sq. ft. ?
lst F1. sq. ft. ?
2nd F]. sq. ft.
Sq. Ft. tatal
Foatprint Sq. ft. ?
On-site we1i
On-site sewage
Bulldin
Er?gi nee?ri ng Vari ance
REQUtRED 1NSPECTI4NS
L7.Site P3 Footing
0 Wal l baard M Fi nal
? Frami ng
CI Draintile
C] Insulation
0 Fireplace
Perntf t Eee vatustia,:
Surcharge
Plan Review
Eicense
MWCC SAC
City SAC
Water Cann.
Water Meter
Acct. flepas i t
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Treatment Pl.
Road Unit
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Trails Ded.
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C] 17 Swim Pool
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D 21 MiscellaneousQ 37 Demolish
14dCC System
City Water
PRV Required
Booster Pump
Fire Sprinkler
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CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
:..........,, :................: ......................
FOR CITY USE ONLY
PERMIT #
RECEIPT # / L5
DATE: 3 / g
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
--------------- --------- ---------------------------------------------
WORK DESCRIPTION FEES
NEW CONST Z ADD-ON MINIMUM
ADD ON
REPAIR
OWNER NAME :
SITE ADDRESS : ,/G?
LOT : ,/_ BLOCK SUBD .(??CI??Iq%lLcu?'? ??? 3?
INSTALLER: GENZ-RYAN PLUMBING & HEATING COMPANY
ADDRESS: 14745 South Robert Trail
CITY: Rosemount
ZIP: 55068
PHONE #: 423-1144
HVAC 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS - MINIMUM
OF 1 PER PERMIT
DWELLINGS &
$15.00
24.00
6.00
3.00 ?
SUBTOTAL: $-?3 0")
STATE SURCHARGE: .50
TOTAL : S 33 a "'
SIGNATURE OF PERMITTEE
COW?R:G;I1???IDU:S;?'RlAI.:.' PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS,
:... ....
. ::::::::::::::::::......::.:
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FOR:
FEES
1% OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
YROCESSED PIPING = $25.00
$25.00 MINZMUM FEE.
CONTRACT PRICE x 1$ $
STATE SURCHARGE $
TOTAL: $
(SIGNATURE)
CITY OF EAGAN
?
3830 PILOT RNOB ROAD
EAGAN, ZN 55122
PHONE: (622) 454-5100
PERMIT #
RECEIPT # /0,4
DATE:
`?A2:::::
...?:....:. ...:? .....:.:. . ;:: PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
- TOWNHOMESfCONDOS WfiEN PERMITS ARE REQUIRED FOR EACH UNIT.
-----------------------
UORK DESCRIPTION -------------------------- ---- ---------------------
COMPLETE THE FOLIAWING: ------
N0. FIXTLTRES EA. TOTAL
NEW CONST ADD-ON MINIMUM 15.00
ADp flN SHOWER 3.00 3_ l?Q
REPAIR ? WATER CLASET 3.00 q.ga
BATH TUB 3.00 .?' 0 4
? LAVATORY 3.00 ?
OWI3ER NAME: A / //%afJ3
? KITCHEN SINK 3.00 ,9 G?
SITE AD)RESS LAUNDRY TRAY 3.00
: HOT TUE/SrA 3.00
W
IAT:BIACK SUBD FIAOR DRAIN 3.00 ?. 07J
r GAS PIPING OUT.
INSTALLER : ?? ?'????'Lt'?L? ? (MINIMUM - 1) 3.00
/<
SZ
A4ul
4
'
? ROUGH OPENINGS 1.50
<
ADDRESS : f ut'
-
X OTHER
WATER SOFTENER 5.00
CITY: ZIP: $"5_/a-e2-- ? PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
PHONE #: ?f.?S? ?/S(o S
SUBTOTAL $
ST. SURCHARGE .50
OF PERMITTEE '
TOTAL: s AI'? _50
ERGIALfiNDtTSTRIA`, ; PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND
MULTT-FAMILY BUILDZNGS WHEN SEPARATE PERMITS ARE 230T REQUIRED FOR EACH
DWELLING UNIT.
CONTRACT PRICE: FEES
OWNER NAME:
SITE ADDRESS:
IAT: BLOCK SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
18 OF CONTRACT FEE.
STATE SL'RCFiARGE - $ . 50 F-OR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRAC.T PRICE x 18 $
STATE SURCHARGE $
TOTAL:
$
(SIGNATURE)
FOR:
CITY OF EAGAN
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115814
Date Issued:09/30/2013
Permit Category:ePermit
Site Address: 1636 Blackhawk Lake Dr
Lot:1 Block: 1 Addition: Blackhawk Glen 3rd
PID:10-14352-01-010
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 .
Elizabeth Hess
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 -
Scott R Post
1636 Blackhawk Lake Dr
Eagan MN 55122
Sela Roofing Remodeling
4100 Excelsior Blvd
St. Louis Park MN 55416
(612) 823-8046
Applicant/Permitee: Signature Issued By: Signature
City of aaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
RECEIVED
JUN 122014
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2014 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date: 6/10/2014 Site Address: 1636 Blackhawk Lake Drive
Tenant:
Scott & Julie Post
Suite #:
Name: Scott & Julie Post Phone: 651-253-0318
Address / City / Zip: 1636 Blackhawk Lake Drive. Eagan MN 55122
Name: Air Masters Heating & Cooling
Address: 112 Concord Exchange South
State: MN Zip: 55033
Contact: Kim Greene Email: kim@airmastersmn.net
License #: MB003371
City: South St. Paul
Phone: 651-455-6324
New X Replacement Additional Alteration Demolition
Description of work:
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
RESIDENTIAL COMMERCIAL
Furnace New Construction Interior Improvement
Air Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump Under/Above ground Tank ( Install / _ Remove)
RESIDENTIAL FEES
Other
$60.00 Minimum Add or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Residential New (includes $5.00 State Surcharge)
COMMERCIAL FEES
' $55.00 Permit Fee Minimum
$70.00 Underground tank installation/removal
i *If contract value is LESS than $10,010, Surcharge = $5.00
**If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005
***If the project valuation is over $1 million, please call for Surcharge
= $ 60.00 TOTAL FEE
Contract Value $ x .01
_ $ Permit Fee
_ $ Surcharge*
_$ TOTAL FEE
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance
with the approved plan in the case of work which requires a review and approval of plans.
x Kim Greene
Applicant's Printed Name
.
Applicant's Signature
FOR OFFICE USE
Required Inspections:
Reviewed By: Date:
Underground Rough In 4 Air Test Gas Service Test In -floor Heat ' Final HVAC Screening