3905 Blackhawk Rd
EAGAN TOWNSHIP
BUILDING PERMIT N°. 1983
Owner .Eagan Township
Address (present) .-mac... Z-.•!1l e Town Hall
Builder
Dale x
Address
DESCRIPTION
Stories To Be Used For Front Depth Height Est. Cos! Permit Fee Remarks
LOCATION
Street, Road or other Description of Location 4 Lot Block Addition or Traci
41
This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS.
This is to certify, that ....r_. .:.............has permission to erect a._........._.._ ~pon
the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11,
1955
~^~J•------------- Per
Cha.irman of Town Boa Building Inspector
This reqest void ~j! L~Q~St lsy~J j `7
18 montMuS from ' I t
W- 27122
Request Date Fire No. RRequire ?Inspection [RReady Now Q Will Notify, Inspec-
?-23-82 ❑yes No for When Ready
E] LiYe-&ed Electrical Contractor t hereby request inspection of above
❑ Owner electrical work installed at:
Street Address, Box or Route No. City
3905 Blackhawk Road
I Section No. = e or No. Range No. County
Occupant (PRINT) Phone No.
Maxk Kaxon
Power Supplier - Address
Electrical Contractor (Company Name) Contractor's License No.
Rossow Inc. 40828 8
Mailing Address (Contractor or Owner Making Installation)
F.O. Box 254 Lake Elmo, Mn. 55042
Auth . ed Si ture (Contractor Owner Making Installation) Phone Number
cA rl-~ ??0-5046
MINNE OTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room N-191 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 297-2111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ER 00001
2 7:122 ' 03
See instructions for completing this form on back of yellow copy.
-X- Below Work Covered by This Request
New Add Rep. ~Type of Building Appliances Wired Equipment Wired
X Home Range Temporary Service
Duplex Water Heater Lighting. Fixtures
Apt. Building Dryer Electric Heating
Commercial Bldg. Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm Other Specify Other (Specify)
t er Specify Other - Other
Compute Inspection Fee Below
# Fee Service Entrance Size # Fee Feeders /Subfeeders # Fee- Circuits
0 to 100 AM DS 0 to 30 Amps 0 to, 30 Amps
101 to 200 Amps 31 to 100 Amps 31 to 100 Amps
Above 200 Amps Above 100 -Amps Above 100_Am s
Transformers Remote Control Circ. Partial/Other Fee
Signs Special Inspection $ 10.50
Remarks. L
0.00
Rough-in Date. I ctrical
Inspector, hereby
Final Date certify that the above
/ inspection has been
- 7
GS'!S ma e. _
This request void
18 months from
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 Ng l 9945
PHONE: 681-4675 /t
BUILDING PERMIT Receipt #
To be used for BASEMENT BATHROOMFst. value Date DEC 9 t g 91
Site Address 3905 BLACKRAWK RD
Lot 60 Block 6 Sec/Sub. CEDAR GROVE 6TH OFFICE USE ONLY
FEES
Parcel No. Occupancy 35.00
Zoning Bldg. Permit
Name HARVEY EPSTEIN (Actual) Const - Surcharge .5o
LU Address 3905 BLACKHAWK RD (Allowable) - Plan Review
City EAGAN MN zjp 55122 L of Stories
O g - License
Phone 452-7469 Depth SAC, City
Name JERRY WOLD CONST S.F. Total SAC. MCWCC
0 S.F. Footprints
Address 14500 134TH "E N #139 On Water Conn
On Site Sewage
City PLYMOUTH MN Zip 55447 On Site Well Water Meter
Phone 559-5580 MWCC System
O City Water Acct. Deposit
License # -
PRV Required S/W Permit
I hereby acknowlege that I have read this application and state that the Booster Pump SfW Surcharge
information is correct and agree to comply with a appl" able State of
Minnesota Statutes an;Citygan Ordinan s. Treatment Pf
Signature of Permitee APPROVALS Road Unit
A Building Permit is isE Y TOLD CON T Planner Park Ded.
on the express conditiork hall be done in accordance with all Council applicable State of Min utes and City of Eagan Ordinances. Bldg. Off. Copies
Building Official Variance - TOTAL 35.50
~
..,:-f sa^_.. fs*~r.~7r'+,*. .~if~}y~7~c%sr,. ~°'vr,°:j,_: T.; ...rr..... ~.o
CITY OF EAGAN
j 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121s
PHONE: 681-4675
BUILDING PERMIT Receipt # To be used for RASEl3nT aA1°HltOMEst. Value Date DEC 19 9f
Site Address 3905 BLACKEAWY RD
Lot bt3 Block ' Sec/Sub. CEDAR GROVE 6-T-H OFFICE USE ONLY FEES
Parcel No. Occupancy -
Bldg. Permit 35.00-
Zoning
Name MAPVEY EPSTE I A (Actual) Const Surcharge .50
W 3901.5 BLACt?RAW'K (Allowable) -
Address Plan Review
z
3: City EAGAK MN Zip 55122 # of Stories
Q Length License
Phone 452-7469 Depth SAC, City
.IERRY c~oOLD CONST S.F. Total
cr. Name _ SAC, MCWCC
14-5f)o .134Th AVE N S.F. Footprints
Address On Site Sewage Water Conn
Q City LEI t9Ti I lti IIT« _p `t4+'€7 On Site Well ~CLL Water Meter
MWCC System
Acct. Deposit
Q Phone City Water
c) License # y
PRV Required SJW Permit
I hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances., Treatment PI
Signature of Permitee APPROVALS Road Unit
JEW 7QI, Ct~1et'T Planner
A Building Permit is issued to: Park Ded.
on the express condition that all work shall be done in accordance with ail Council
applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies
Variance TOTAL
Building Official -
SNV Permit No. Permit Holder Date Telephone #
PLUMBING
WAC
- f
ELECTRIC
ELECTRIC
Inspection Date insp. Comments
Footings I
Foundation
Framing
Ruing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Orsat Test
Final Plbg. Plbg. Inspector - Notify Plumber
Const. Meter
Engr./Plan
Bldg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
I
4 7 9 0 4 ~/,q ~i,~, 6,-
Request Date Fire No. Rough-in Inspection
t~ _ Required? Ready Now 0 Will Notify Inspector
V "'I J ❑ Yes X. When Ready?
IAlicensed contractor owner hereby request inspection of above electrical work at:
Job Address (Street. Box or Route No.) City
te 97
Section No. Township Name or No. Range No. County r
Occupant (PRINT) ~`+C!K ~j( 4AI Phone No.
Power supplier Address
Electrical Contractor (Company Name) Contractor's License No.
C_ 42, G'/900-7
Mailing Address (Contractor or Owner Making Installation)
~91115;1101C`V L-)
Authorized Signat ontractodOwrier kin stallatio ) Phone Number
MINN TA STATE BOARD Of ELECTRICIT THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room 5.173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
ryNE
/ REQUEST FOR ELECTRICAL INSPECTION S EB-owoi-0s r
10- See instructions for completing this form on back of yellow copy. F f~
K 47904
4 X" Below Work Covered by This Request, yr 7/
New Add Rep. peof Building Appliances Wired Equipment Wired
ome Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other-(Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) Contractor's Remarks: rCLY f~G
Compute Inspection Fee Below: /,U-p /~j/S Sj/}~ ~,q T $
# Other Fee # Service E # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Above 100 Amps
Signs Inspector's Use Only: TOTAL
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
1, the Electrical Inspector, hereby Rough-in Date
certify that the above inspection has Final Datel" ;
been made. L
OFFICE USE ONLY
This request void 18 months from
~ / s/5/' GAO/G SG
4 3 4 18 4
Request Date s ire No. Rough-in Inspection T~~e.d, Re ,red? Now Will Notify Inspector
Yes " No hen Ready?
I licensed contractor owner hereby request inspection of above electrical work at:
Job Address (Street. Box or ute No.) City
'3505 QCkhaw fc
Section No. Township Name or No. Range No. County
hone No.
LOccu P
rUE
Power Supplier Address '
Electrical Contractor (Company Name) Contractor's License No.
7_
Mailing Address (Contractor or Owner Making Installation)
A on - gnature ICO. acto ' in I ton) Phone Number` 7
MINN SOTA STATE OA D OF ELECTRIC Y THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. oom 5-173 BE ACCEPTED BY THE STATE BOARD
1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION Ea-00001-Da
jp~ See instructions for completing this form on back of yellow copy.
' 4 y "X'' B low Work Covered by This Request
New A' TypeofBuilding Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
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 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Above 100 Amps
Signs Inspector's Use Only: TOTAL/l 4. 1
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION M E ORDER SCONNECTED IF NOT
Other Fee COMPLETED WITHI ONT t
1, the Electrical Inspector, hereby Rough-in Date
certify that the above inspection has Final Dater
been made. of
OFFICE USE ONLY
This request void 18 months from
PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 2 8 3 5 8
(612) 681-4675 Date Issued: 07/23/96
SITE ADDRESS:
3905 BLACKHAWK RD
LOT: 60 BLOCK: 6
CEDAR GROVE 6TH
P.I.N.: 10-16705-600--06
DESCRIPTION:
(ROOFING)
Building Permit Type SF (MISC.)
Building Work Type REPAIR
Census Code 434 ALT. RESIDENTIAL
III
REMARKS:
FEE SUMMARY:
i VALUATION $3,000
Base Fee $74.75
Surcharge 1.50
Total Fee $76.25
i
I
li CONTRACTOR: OWNER: - Applicant -
KWIATKOWSKI DAVID
3905 BLACKHAWK RD
EAGAN MN 55122
(612)454-9504
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
APPLIC MI E SIGNATURE IS B : 1 NA E
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construction Requirements ttemodel/Re lair Reouirements
♦ 3 registered site surveys ♦ 2 copies of plan
♦ 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ♦ 2 site surveys (exterior additions & decks)
♦ 1 energy calculations ♦ t energy calculations for heated additions
♦ 3 copies of tree preservation piaa if lot platted suer 7/1!93
required: _Yes No 00 A
DATE: l zJ OVID CONSTRUCTION COST:
hI~6~~
DESCRIPTION OF WORK:
STREET ADDRESS: 3 ?Q s jlgcKhA(1,i~ rd
LOT BLOCK Le- SUBD./P.I.D.
PROPERTY Name: 1~OW~~ Phone
OWNER
Street Addreesss
City: State: Zip•5l ZZ
CONTRACTOR Company: Phone
Street Address: License #
City: State: Zip-
ARCHITECT/ Company: Phone
ENGINEER
Name: Registration
Street Address-
City: State: Zip:
Sewer & water licensed plumber. Penalty applies when address change and lot
change are requested once permit is issued.
hereby acknowledge that I have read this application and state that the information d agre ply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No
OFFICE USE ONLY -or
"
BUILDING PERMIT TYPE
❑ 01 Foundation ❑ 06 Duplex o 11 Apt./Lodging o 16 Basement Finish
o 02 SF Dwelling o 07 4-plex o 12 Multi Repair/Rem. o 17 Swim Pool
o 03 SF Addition o 08 8-plex o 13 Garage/Accessory ❑ 20 Public Facility
❑ 04 SF Porch o 09 12-plex ❑ 14 Fireplace o 21 Miscellaneous
❑ 05 SF Misc. ❑ 10 = plex o 15 Deck
WORK TYPE
❑ 31 -New ❑ 33 Alterations ❑ 36 Move
o 32 Addition ❑ 34 Repair ❑ 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code
Census Bldg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCM/S SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
{ PERMIT
.CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE:
Eagan, Minnesota 55122-1897 Permit Number: B U I0 L D I N G
(612) 681-4675 Date Issued: 07/30/97
SITE ADDRESS:
3905 BLACKHAWK RD
LOT: 60 BLOCK: 6
CEDAR GROVE #6
P.T.N.: 10-16705-600--06
DESCRIPTION:
(INCL DECK)
Building Permit Type SF PORCH
Building Work Type NEW
Square Feet 156
Census Code 434 ALT. RESIDENTIAL
REMARKS:
FEE SUMMARY:
VALUATION $6,000
Base Fee $112.25
Surcharge 3.00
Total Fee $115.25
CONTRACTOR: _ Applicant - ST LIC OWNER:
KELLY GREEN CONTRACTING 12275656 2006027 STRICKLEN LEW
.683 TUSCARORA AVE 3905 BLACKHAWK RD
ST PAUL MN 55102 EAGAN MN
(612) 227--5656 (612)688-3090
I hereby acknowledge that I have read this application and state that the
information is correct and agree to comply with all applicable State of Mn.
Statutes and City of agan Ordinances.
PLICA /PERMI E SIGNAT RE ISSUED B f-.
SIGNATURE' ~I
i NOW 997 BUILDING PERMIT APPLICATION (RESIDENTIAL) (6401,
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
45 681-4675
New Construction Reauirements Remodel/Repair Reau r me ents
♦ 3 registered site surveys ♦ 2 copies of plan
2 copies of plans (include beam & window saes; poured fnd. design; etc.) ♦ 2 site surveys (exterior additions & decks)
♦ 1 energy calculations ♦ 1 energy calculations for heated additions
♦ 3 copies of tree preservation plan if lot platted after 711/93
required: - Yes No
DATE: k.___.. 41 CONSTRUCTION COST:
DESCRIPTION OF WORK: - Yea-a=y e^ 1.. Lp (4
STREET ADDRESS: - 39 015 m -
LOT 4'0 BLOCK 4_ SUBD./P.I.D. r~✓r~~
e% I
PROPERTY Name: r \G~~V~ ~.p , , Phone
OWNER
Street Address:
City: _ F or- rx,% State: M -V\ Zip:
CONTRACTOR Company: 'Kell i C, neei,\ C9v.-- - Phone* 0,31 ` 1f6Oq
Street Address: " -u" 2oQ f9 19tAe License #,2004e2 a -7d"
City: S)-- . i~ State: VV A Zip:
ARCHITECT/ Company: Phone
ENGINEER
Name: Registration
Street Address:
City: State: Zip:
Sewer & water licermed plumber (new construction only): Penalty applies when address change
and lot change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comp with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant: \C
OFFICE USE ONLY EIVED
Certificates of Survey Received Yes No J U L 1197
Tree Preservation Plan Received Yes No Not Required
OFFICE USE ONLY #4-s
BUILDING PERMIT TYPE,
❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish
❑ 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool
❑ 03 SF Addition ❑ 08 8-plex u 13 Garage/Accessory ❑ 20 Public Facility
❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous
❑ 05 SF Misc. ❑ 10 = plex X 15 Deck
WORK TYPE
31 New ❑ 33 Alterations ❑ 36 Move
❑ 32 Addition ❑ 34 Repair ❑ 37 Demolition
GENERAL INFORMATION qoTF- O 64-26t0 Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code . 0/
Census Bldg 1
Census Unit O
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $ (10 coo. 00
Surcharge
Plan Review
License f'_
MCNVS SAC _
City SAC X
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI. 011 Caw
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
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1991 IIUI i PLICATI#
CITY OF L&W
ae ~arrtrf nts?tt7'~~19f:r ~'~PI.E !lY'A.,~~~ C!l .'i' T.
2 ,8ETS OF PLANS I SETS OF PLANS Z SET OF
AHf II i~C' L
3 RWISTERED SITE SURVEYS ISTZR:ED SITE SURVEYS - A STRV. AL PL $
A SET OF ENERGY CA ZUTATIONS (CHECK WITH BIB. DEPT.) 1 SET QF SPECI CATIC w
I SET OF EMOY CALCULATIONS I SLR' CIS b"tWL C$
OF RENTAL UNITS
# OF FM
SALE UNITS
ALTY APPLIES WM TYPING OF MUT IS REQUESTO, BM IsR PICKS Uip ' LAT. vbvApw AA)(
OF MONTH III WICH RZQUEST IS MADE.
LOT CHANCE IS REQMTED ONCE PERMIT IS ISSUER.
NME'- ADDR$SSES FOR COAXER LOTS CORMC°i'EiR/MlEg43`M MUST MIGN&TE WIC AV4*='I5
MIRED. NQ -QWM M" U. 92=1
PROCESSING T3ME FOR SEWER F 'WATT PERMITS IS TWO DAYS ONCE A POMT RCS aE W CNOLtMe
PBRMIT MUST SHOW A LICENSED PLUMBER.
}
T
* "iW Vv&d Foar : . ~ valuati.an. ~ At3qVW Date:
z
zaz~
Z42
Sit* Address 0 OFFICZ Vol ony
t Block
Occupancy Z148' Pev*it too
Zoning Surchrarga
Psxt al S ► - . 1 'Lv Actual Gvrtat P1400, RAvLi. ' ,
Allowable SA.C$ City
r of stories SAC, MCC
Length Water Conn.
a -
V s P Depth avatar MOer
S.F. Total Acct, DOV09it
Oitylzip' Co-de Footprint s.F. S/w Permit
r. SJW Surcharge.
On site sewage Trae.t at Pl.
~
On site well Road Unit
contr*ctor MWCC System Park Ded.
City wager Trail De4.
Copies
Ppv
Booster Pump
"""....r..w.
P s. J pl11'1L3or IAA t Chang*
Council ~ TOTAL
~Jajr~&', Er Sidi. Q££. t2 t1S
Variance
01 kyjaP Gads
per Lice~ac ~ tr. - ,
agr*es that all vark shall be dono ln;a ccotdemo ~f0
I e of Contractor)
all AW14. le State of Minnat-sate Statutes and City of Eagan Ordinances
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. -
CITY OF EAGAN FOR CITY USE ONLY
3830 PILOT KNOB ROAD
EAGAN, MN 55122 PERMIT #
PHONE: (612) 454-8100 RECEIPT # o2g
#m" DATE: S Z 9f
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
.
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION COMPLETE THE FOLLOWING:
NO. FIXTURES EA. TOTAL
NEW CONST ADD-ON MINIMUM 15.00
ADD ON - SHOWER 3.00
REPAIR / WATER CLOSET 3.00
_ BATH TUB 3.00
LAVATORY 3.00
OWNER NAME: KITCHEN SINK 3.00
~f LAUNDRY TRAY 3.00
SITE ADDRESS: HOT TUB/SPA 3.00
WATER HEATER 3.00
LOT: 0 BLOCK C/ SUBD. 01'L, Ame, FLOOR DRAIN 3.00
GAS PIPING OUT.
INSTALLER: J (MINIMUM - 1) 3.00
ROUGH OPENINGS 1.50
ADDRESS: ? iii OTHER
WATER SOFTENER 5.00
CITY: C✓.~l 5:~1 ZIP: 55`~ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
PHONE '3
SUBTOTAL $ S'
ST. SURCHARGE .50
SIGNATURE OF PE ITTEE
TOTAL: $ i 5 Sc1
COEItTAINTTJSTRA 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
OWNER NAME: 1% OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
SITE ADDRESS: EACH $1,000 OF PERMIT FEE.
LOT: BLOCK SUBD. $25.00 MINIMUM FEE.
INSTALLER: CONTRACT PRICE x 1% $
ADDRESS: STATE SURCHARGE $
CITY: ZIP:
TOTAL: $
PHONE
(SIGNATURE)
FOR:
CITY OF EAGAN
EAUX TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date:-- - f' c Number: 266
Billing Name: Site Address: (~O -6;
Owner: ~,e Billing Address
Plumber:
Location of Connection Meter Sizes`= Connection Chg. 2"m
Meter Now1Z :.s ; X Permit Fee 7.50
Meter Reading '.~00U Meter Dep.
Meter Sealed: Yes Add'1 Chg.
NO Total Chg.
Inspected by
Date
Building is a: Remarks:
Residence
Multiple No. Units
Commercial
Industrial By;
Chief Inspector
Other
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota Count/y, Minnesota. ,
Please notify the above office when ready for inspection and connection.
L
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATENUMBER ~QQQQ
OWNEF. Address!a~%
PLUMBER` zL= TYPE OP PIPE,
DESCRIPTION OF BUILDING
Industrial Commercial Residential Multiple Dwelling No. of units
Location of Connections: Connection Charge 200.00
Permit Fee 7'50
Street Repairs
Total
Inspected by:
Date
Remarks:
By
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County,r Minnesota
P d
Please notify when ready for inspection and connection and before any portion
of the work is covered.
A city of pagan
PATRICIA E. AWADA August 7, 2001
Mayor
CERTIFIED MAIL-RETURN RECEIPT REQUESTED
PAUL BAKKEN KELLY KIELAS-JENSEN
KELLY GREEN CONTRACTING
PEGGY CARLSON 683 TUSCARORA AVE
CYNDEE FIELDS ST PAUL MN 55102
MEG TILLEY RE: BUILDING PERMIT 30540 DATED 7130/1997
Council Members 3905 BLACKHAWK ROAD
Dear Ms. Kielas-Jensen:
THOMAS HEDGES I have read your report to the Minnesota Department of Commerce concerning Building Permit 30540
City Administrator issued to Kelly Green Contracting to construct a 3-season porch/deck at 3905 Blackhawk Road. In your
letter, you state "I completed the deck, and completed the construction, after which the Eagan Inspector
inspected the work and approved the project." This statement is false.
At a meeting with you and property owner, Lew Stricklen, on May 11, 2000, 1 asked that you put
Municipal Center: continuous frost footings beneath the walls of the under deck porch and that you confirm the vent
3830 Pilot Knob Road penetrating through the porch ceiling is rated for zero clearance from combustibles. The rubber membrane
issue was to be worked out between you and Mr. Stricklen.
Eagan, MN 55122-1897
Phone: 651.681.4600 City records indicate that you called for a footing inspection on July 31, 1997. The aforementioned
meeting was logged as a partial framing inspection and a final inspection has not been scheduled as of this
Fax: 651.681.4612 writing.
TDD: 651.454.8535 The City of Eagan considers Kelly Green Contracting in violation of Section 108.3 of the 1997 Uniform
Building Code.
Maintenance Facility: Sincerely,
3501 Coachman Point
Eagan, MN 55122
Phone: 651.681.4300 J. Craig Novaczyk
Senior Inspector
Fax: 651.681.4360
TDD: 651.454.8535 JCNljs
cc: Steven R. Bauer, MN Dept. of Commerce, Enforcement Div., 85 7th Place E., Ste. 500, St. Paul,
MN 55101
www.cityofeagan.com Dale Schoeppner, Chief Building Official
Marilyn Stricklen, 3905 Blackhawk Road, Eagan, MN 55122
THE LONE OAK TREE
The symbol of strength
and growth in our
community
INSPECTION 'Y-OF EAGAN PERT TYPE:
t+b
3830 Pilot Knob Road Permit Number:
E4ao, Minnesota 55122-1897 Efate Issued:
(612) 681-4675 _
Si E ADDRESS: APPLICANT:
0HTRACTINO
cf, ()AR AROVE #6
PERMIT SUBTYPE: TYPE OF WORK:
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ELECT=
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I
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: Mitt DING
3830 Pilot Knob Road Permit Number:
t Eagan, Minnesota 55122-1897 Date Issued:'
(612) 681-4675
SITE ADDRESS: APPLICANT:
CI-1111AP fiROW 6114 V,64-10,04
PERMIT SUBTYPE: TYPE OF WORK:
REPAIR
-~',PECTION TYPE DATE INSPTR, INSPECTION TYPE V)Af E
ROOF I"fi
t
1
Permit No. Permit Hatdar Dare Telephone #
ELECTRIC
PLUMBING
HVAC
Irmpectim Date Imp. comments
FOOTINGS
FOUND
0
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ROOFING
ak~
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PLUMBING
PPLRSTEST
HROUGH
GAS Svc
TEST
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FIREPLACE
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FINAL PLBG
FINAL HTG
ORSAT
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BSMT FINAL
DECK FTG
DECK FINAL
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CITY OF EAGAN Remarks Sew & wtr permits and sew & wtr cone. pd.a on 4-14-69
Addition Cedar Grove #6 Lot 60 Blk Parcel 10 1 70 00
Owner Street 3905 Blackhawk Rd.. State Eagan,n 55122
Improvement Date VAu Annual Years Payment Receipt Date
STREET SURF. L 1 1 106.02 10 Paid
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWER LATERAL 19 0 20 Paid
WATERMAIN
# WATER LATERAL 1970 20
WATER AREA
# STORM SEW TRK 1970 20
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 200.00 1323 4-18-69
BUILDING PER.
SAC 200.00 1323 -1 b-69
PARK
f
PERMIT
City of Eagan Permit Type: Mechanical
Eaaan. Permit Number: EA100828
Date Issued: 09/01/2011
OR Permit Category: ePermit
40~ it~ of E3
E
Site Address: 3905 Blackhawk Rd
Lot: 60 Block: 6 Addition: Cedar Grove 6th
PID: 10-16705-06-600
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: New
Description: Furnace & Air Conditioner
Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson. State Electrical Inspector. (952)
445-2840
Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088
Valuation: 8.270.00 Surcharge-Fixed $5.00 9001.2195
Total: $».00
Contractor: - Applicant - Owner:
Ductworks Heating & Air Conditioning LLC Nlarilvn D Stricklen
6108 Olson lolemorial Hwy 3905 Blackliawk Rd
Golden Valley MN 55422 Eagan NIN 55122
(763) 521-0070
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 Cite of Eaaan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
PERMIT
City of Eagan Permit Type: Building
Permit Number: EA106368
Date Issued: 0812112012
~it~ of 11QR Permit Category: ePermit
Site Address: 3905 Blackhawk Rd
Lot: 60 Block: 6 Addition: Cedar Grove 6th
PID: 10-16705-06-600
Use:
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434 - Occupancy:
Zoning:
Square Feet: 0
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.
Fee Summary: BL - Base Fee $4K $103.25 0801.4085
Valuation: 4,000.00 Surcharge - Based on Valuation $4K $2.00 9001.2195
Total: $105.25
Contractor: - Applicant - Owner:
Storm Guard Restoration Marilyn D Stricklen
1355 Geneva Avenue North, Suite 201 3905 Blackhawk Rd
Oakdale MN 55128 Eagan MN 55122
(651) 738-1698
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.
Applicant/Permitee: Signature Issued By: Signature
390 154,44k1le4VI&
RESIDENTIAL
INFORMATION BULLETIN
AUGUST 2012 IKO-No. R-63
BUILDING CODE REQUIREMENTS AND WIND
RESISTANCE
Recent changes to the ICC's International Residential Code (IRC) and International Building Code (IBC) have
caused some confusion regarding Code requirements for asphalt shingle wind resistance. Specifically our
customers want assurance that IKO shingles conform to those requirements.
The Code requirements are legal regulations related to product/building performance, and are designed to
ensure quality construction and occupant safety. Manufacturers' limited warranties are offered to our
customers and define various aspects of contractual obligations regarding product warranty coverage.
Building codes cannot legislate or mandate levels of limited warranty coverage, as these "contracts" are a
matter between the purchaser and seller/manufacturer of a material.
2 n6. 900~e A106,. 444
Section 1507.2.5 of the Code requires that shingles comply with ASTM D3462, and further, in Section
1507.2.7.1 that they must be tested in accordance with ASTM D 3161 modified to 110 mph, which also
correlates to ASTM D7158 Class F. When considering IKO shingles and wind performance, IKO shingles
comply with these Code requirements.
Section 1507.2.6 of that Code goes on further to prescribe that the shingles shall be fastened with four
fasteners for wind zones less than 110 mph. TKO's product line of three-tab and laminated shingles (such as
our Cambridge series) comply with all aspects of these fastening requirements as well.
Unfortunately this is not the first time that prescriptive building code requirements have been confused with
manufacturers' limited material warranties. This Bulletin has clarified this difference, and assured our
customers that IKO shingles comply with all aspects of the Code and will perform appropriately when applied
in accordance with our printed application instructions.
For additional information on any of TKO's products or application requirements, visit us on the web
at www.iko.com, or contact us in Canada at 1-888-766-2468, or the United States at 1-888-456-
7663.
4#KO
Setting
the Standard
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA130295
Date Issued:04/15/2015
Permit Category:ePermit
Site Address: 3905 Blackhawk Rd
Lot:60 Block: 6 Addition: Cedar Grove 6th
PID:10-16705-06-600
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 -
Marilyn D Stricklen
3905 Blackhawk Rd
Eagan MN 55122
(952) 484-0019
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:EA146522
Date Issued:10/30/2017
Permit Category:ePermit
Site Address: 3905 Blackhawk Rd
Lot:60 Block: 6 Addition: Cedar Grove 6th
PID:10-16705-06-600
Use:
Description:
Sub Type:Fireplace
Work Type:Free-standing Stove (new)
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Marilyn D Stricklen
3905 Blackhawk Rd
Eagan MN 55122
Fireside Hearth & Home
2700 Fairview Ave N
Roseville MN 55113
(952) 985-6675
Applicant/Permitee: Signature Issued By: Signature
RECEIVED
EiG A NI JUN � 6 2a��
3830 PILOT KNOB ROAD I EAOAN, MN 55122-1810
(651) 675-5675 I TDD: (651) 454-8535 I FAX: (651) 675-5694
bulldinginspectionsacityofeagan.com
f' For Office Use
Permit tf: /6 2
Permit Fee: /�®'-v
Date Received:
Staff:
2020 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 6-3-C — Site Address: 3 9 °� 541-4'A*6 r-k.
�i / Unit #:
Name: Wirt yitif 11 re. /ice Phone: ? cj-ra Y CC/
Address / City / Zip: 3 t:) 5— Mc G e 6- `io Li 17cr( e"14144i 512
Resident/
Owner
Type of Work
Contractor
Applicant is: Owner Contractor
Description of work:
icet2em f—ce,1aRE itiw1.
Construction Cost: %_ )7ft:
MultiBuilding: (Yes / No )
Company: ff v t y t/J (Am) I 4 5/ p 4 2 ¥Z? 3
Address: Vt0 9 r A.rl, 10.I'7 0 1— 50 City: ( .0,.7;/1c1✓i
State Zip: 5 4Ic Phone: g1 ;06 l/ Emai 4-7-5 'Oi.e .• pet'rs
' --
� f -
License #: C '�j 69/ Lead Certificate #: Pei.. "J 2 2 c e J
If the project is exempt from lead certification, please explaln why: - e
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
Fire Suppression Contractor. Phone:
NOTE: Plans end supporting documents that you submit are considered to be public information, Portions of the Infbrmatlon may be
classified as non-public If you provide specific reasons that would permit the City to conclude that they are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the Clty's
webaite at www.citvofeaoan.comisubscribe.
Exterior work authorized by a building permit Issued In accordance with the Minnesota State Building Code must be completed within 180
days of permit Issuance.
CALL BEFORE YOU DIG. Call Gopher State One Call at (851) 454-0002 for protection against underground utility damage. Call 48 hour before you
Intend to dig to receive locates of underground utilities. www.pooharstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Clly of
Eagan; that I understand this is not a penult, but only an application for a permit, and work Is not to start without o permit; that the work will be in
aproved plan In the case of work which requires a review and approval of plans,
kfiltotvel
App(Icant's Printed Name
Appilcant's Signature
T /T '3DYa 8L8T99LT99 s2i3a'zznt3sxs wa ZE:TO OZOZ'9Z'unr