3911 Blackhawk RdCITY OF EAGAN Remarks Sew & wtr, permits and Sew & wtr conn, pd. on -1h-69
Addition Cedar Grove #6 Lot 59 Blk 6 Parcel 10 16705 590 06
owner Street 3911 B13.Ckhawk Rd. State E&gari,rN 55122
Improvement Date Amount " Annual Years Payment Receipt Date
STREETSURF. riD'L. 1971 1060.1 106.02 10 P'd
S7REET RESTOR.
GRADING
SAN SEW TRUNK
? SEWER LATERAL 1_970 1472.00 20 Pa1d
.. ....
WA7ERMAIN
g?- WATER LATERAL 1970 20
WATER AREA
# STORM SEW TRK 1970 20
STORM SEW LA7
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 200.00 1323 4-1$-69
BUILDING PER.
sac 200.00 1323 -1 9
PARK
EAGAN TOW N S H i P
BUILDING PERMIT
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Owne: Addresc (P:esen!) ?•'??3-- ?-•-?---•--- ----------•-•.....?et51.L,-?*? ? ?
Buildez .......................... ............ ...................................................... ...
Addresa ...... ................ -...... --._....... .
............ -............... ..................•---••-
DESCRIPTION
N° 1983
Eagan Township
Town Hali
DaYe
-•-••--•-- --•---- ..............
5iories To Be Used For Froni
- Depth Heighf
- Est. Cost Permii Fee
/.r, :..+•-e. ? - Aemarks
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LOCATION
s:ree:, noaa oz o:ner uescn n oi i,ocanon
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This permit does not suthorize the use of sfreets, roads, alleys or sidewalks nor does it give the owner or his agen2
!he right fo create any aituation which is a nuisance or which gresenis a hazard fo 2he heallh, safely, convenience and
general welfare !o anyone in Yhe communiYp.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. ? .
This is !o certify, that-•-.?.r.-•'-- b----• --••---• ..............-._.._.._..---has permission to erecf a._?:_'?'?"`'??.?-•------•-••-• on
P
!he above described premise subject to !he provisions of the Building Ordinance for Eagan Township adopied April 11,
Lot I Block I Addifion or Trac!
1955 ?
-??--_--?- J '
per e .??.?
.................... ...? -......._.....
Ch _._C1 --c? .:,-- ---?----------?----Y?---.
airman of Town Boa? $uilding Inspeclor ?
Clt of Eapn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
2008 RESIDENTIAL BUILDING PERMIT
Date: ? C5Y?;ite Address: V\ COC;.?.Iocf,
Tenant:
RESIDENT ! OWNER Name: `-{:Ec? ''
Address / City / Zip:
Applicant is: Qwner -? a:ontractor
TYPE OF WORK Description of work:
Construction Cost: ,- t,--
Multi- amily Buildi
es / No ?
CONTRACTOR ,
Name: ca
-l:.?? `.,_. o"1
icense #: ,...?
? -<
?
Addres ? ?,? e,
City: ? StatW4iA--LZip: S?'???
Ph
90?? "
' e '°`
?)b -
one: J Contact Person:
-- a
? ?l ef-? 7 -
CQMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Cateqory 1 Minnesota Rules 7672
Energy Code . Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
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 pian:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
r - - - - - - - - - - - - - - - - -+
I F`?.Affi?Y?s? ?
? Permit 7-D ?
? Permit Fee: ?
? Date Received:
I ? I
I Staff: ?
I 1
----------------
APPLICATION
k ?
Suite #:
Phone:
Phone:
Phone:
I herebp acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances anid codes of the City of
Eagan; that I understand this is not a permit, but only an application fcar 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. c^
•r--?
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x_ ? ??? •? ? f .?U "- ' ? !?''?
ApplicanYs Printed,Name pl' nYs Signature ?
t:Page 1 of 3
city oF eagan
PATRICIA E. AWADA
Mayor
PAUL BAKKEN
PEGGY C'.ARISON
CYNDEE FIELDS
MEG TILLEY
Council Members
THOMAS HEDGES
Ciry Administrator
Municipal Center.
3830 Pilot Knob Road
Eagan, MN 55122-1897
Phone: 651.681.4600
Fax: 651.681.4612
TDD: 651.454.8535
Maintenance Facility:
3501 Coachman Point
Eagan, MN 55122
Phone: 651.681.4300
Fax: 651.681.4360
TDD: 651.454.8535
www.ciryofeagan.com
THE LONE OAKTREE
The syrrtbol of strength
and growrh in our
community
December 13, 2002
CATASTROPHE RESTORATION
2489 RICE ST #70
ROSEVILLE MN 55113
RE: REQUEST TO REFUND BUILDING PERMITS 54653 & 52201
TO WHOM IT MAY CONCERN:
In response to your letter dated December 9, 2002 requesting a refund of building permit #54653
to reside the residence at 3911 Blackhawk Road, this permit is being cancelled. You will receive
a refund of $89.25 under separate cover. A$SO.OQ handling fee applies to this refund and the
$3.50 state surcharge is non-refundable.
Building permit #52201 to reroof the residence at 3613 Tanglewood Court was previously
refunded to you in August 2002. See enclosed copy of letter dated August 19, 2002.
If you have any questions, please feel free to give me a call at 651-675-5671.
Sincerely, `
jj2 'L
nice D. Severson
Office Supervisor
cc: Dale Schoeppner, Chief Building Official
On 12110/02, City of Eagan telephone numbers changed. For your information, listed below are
our main department numbers:
Municipal Center 651-675-6050
Administration 651-675-5001
Engineering 651-675-5646
Fire Department 651-675-5900
Maintenance 651-675-5300
Parks & Recreation 651-675-5500
Planning 651-675-5685
Police 651-675-5700
Protective Inspections 651-675-5675
Utility Billing 651-675-5030
CLAIM VOUCHER - REFUND REQUEST
? CITY OF EAGAN
MAKE CHECK PAYABLE TO: CATASTROPHE RESTORATION
2489 RICE ST #70
ROSEVILLE MN 55113
LOCATION: 3911 BLACKHAWK RD
RECEIPT #/DATE: 33471 8/22/02
REASON FOR REFUND: CONTRACTOR REQUEST PERMIT #: 54653
VALUATION: $7,000
TYPE OF REFUND:
Plumbing Permit 9001.4087 $
Mechanical Pernut 9001.4088 $
Building Pernnit Fee 9001.4085 $ 89.25
Plan Review Fee 9001.4222 $
SAC (MC/WS) 9220.2275 $
SAC (City) 9379.4681 $
SAC (Admin) 9001.4246 $
Water Connecrion 9220.3865 $
Sewer Permit 9220.4532 $
Water Permit 9220.4507 $
Account Deposit 9220.2252 $
Water Meter 9220.4509 $
Water Treatment 9220.4685 $
Surcharge 9001.2195 $
Overpayment 9001.2250 $
Curb Box Deposit Refund 9220.2253 $
Construction Meter Dep Refund 9220.2254 $
Other $
TOTAL $ 89.25
I declare under the penalties of law that this account, claim, or demand is just and tha t no part of it has been paid.
SIGNATURE
12/13/02
DATE
CRSI
YOUR "PEACE OF MIND"
GENERAL CONTRACTOR
December 9, 2402
City of Eagan
3830 ?Pilot Knob Rd
Eagan, MN 55122
Please cancel the following permit. The work will not be completed by
CRSI.
permit #EA054653 3911 Blackhawk Rd
permit #EA052201 3613 Tanglewpod Ct
MItlll@SOtB
2489 Rice Stseet,
Suite 70
Roseville, MN 55113
651.734.9433
Lic. #20271061
Wisconsin
101 W. Edison Ave.,
Suite 247
Appleton, WI 54915
920.830.9631
Lic. #695024
IllinoisJNlissouri
(St. Louis area)
94 Weldon Parkway
Maryland Heights,
MO 63043
314.521.0101
Lic. #151
If a refund is sent, please mail a check to the following address:
CRSI
2489 Riee St, Suite 70
RQSeville, MN 55113
If you have any questions, please call Jaci at 651-734-9433.
Thank you,. .... ?.?
?` ?? ? •?
5 ' ..........,.?
Jaci Hauth
CRSI
STORM DAMAGE I ROOFING I SIDING I WINDOWS
.. ., ., . . . . ., _ . . , . . , ??????FFION , REUM ?-
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Road
i
Pe?rrth Nuntw:
?WM, ? tO 55122-1897 Ltate tssted:
#: Ol': 69 SCtt CK x
PLACKH+?WK RD
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Prrmifi Hckmr 00o Talophons #
Pl.UMBlNG
Hi#AC
iar? t}ate lnsp. Commen#s
Ft}Gt'lNGS
FL?U[+v
FRAAAit+}G
ROOFIriiQ ?
ROtlGM
RlUPA81NG
PIBG
piR'fEST
RpUGH
HEATING
GAS 34'C
TES7
INSUt
GYP BOARD
FiREPLACE
FIREPLACE
A!R TEST
FINAC PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IfiRIGATiON
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FfNAL
s4?-5-3
-? CITY 0F EACAN
3830 PiLOT KNOB RD, EACAN MN 55122
a? 651-681-4675
New Conatruction ReaulremeMs
s'
• 3 registered s?e sunreys showing sq, ft. of lot, sq. ft. of house; and ali roofed areas
(20% maximum lot co e alowed)
• 2 copiss of plan showirAbeam & window sizes; poured found design, etc.)
• 1 set of Energy C ' s
• 3 copies of Tree Prese Pian if lot plalted after 711/93
. Rim Jast Detaii Opdons ' sheet (bklgs with 3 or less units)
DATE
SITE ADDRESS ?59 ? k
TYPE OF WORK \- t-79> i
APPLICANT C:atastrn?p- ,atinn SPrvi
STREET ADDRESS 7489 Rirrs
TELEPHONE # 651_734_qd?'I CE PHONE #
PROPERTYOWNER
RemodeUReoair Reauirements /
?? ? . ??
• 2 copies of ptan
• 1 set of Energy Calculations for heated additions
• t site survey for exterior additans & decks
• Indicate'rf home Ierved by septic system for addiGons
VALUATIOV Vo -7:S 5 S • 2-4ZD
MULTI-FAMILY BLDG _ Y -IN
FIREPLACE(S) L(?_a .,_ 1 _ 2
z lnr/
CITY-Rgsg,y.j,le. STATE _AWZI P 5!ij 13
FAX # &F 1 _il t2'2_l171 9_
TELEPHONE # .?Sl^y??' L# 1??
-----............. --............. -- _.---------------- ------------ ------ ----------------
COMPLETE THIS SECTI N ;??"NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNE TA RULES 767 CATEGORY 1 MINNESOTA RULES 7672
(4 submission type) . Resi ntial Ventilation Catego 1 Worksheet Submitted ` • New Energy Code Woricsheet Submitted
• E rgy Envelope Calculations S mitted T ?
D-
Plumbing Contractor: Phone # Al1G 2 1 2002
Plumbing system includ s: ? Water Softener Lawn Sprinkler ? Fee: $90.0
Water Heater No. of R.I. Baths
-- No. of BaChs
Mechanical t
Mechanical
Sewer/Water
RESIDENTIAL
BUILDIWC PERMIT APPLICATION
? tlir Conditioning
Heat Recovery System
Phone #
Phone #
Fee: $70.40
----------------------------------•--------------------------------------....?-------------------------------------------•-
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinanges, A ?
Signature of
OFFICE USE ONLY
.?..
includes:
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
.. a w,
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool 0 30 Accessory Bldg
? 02 SF Dweiling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ piex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) 0 33 Ext. Alt - SF
? 04 02-plex 0 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscetlaneous
0 31 New 0 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
O 32 Addition ? 36 Move Bidg. 0 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)* O 43 Reroof ? 46 Windowslaoors
? 34 Replacement *Demolition (Enttre Bldg onty) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) _ FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addirion) T Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water ? Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing Siding Sfizcco Stone
_ Fireplace _ R.I. _ Air Test _
Final Windows (new/replacement)
_ Insularion _ _
_ Retaiuiag Wall
Approved By , Building Inspector
Base Fee
T
Surcharge
Plan Review
MC/ES SAC
Ciry SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
F'lumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
FERMIT
CITY OF EAGAN
'3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE: ? ?? ILDING
Permit Number: 0 3 3 15 A
Date Issued: 09/ 04/ 98
? SITE ADDRESS:
3911 BLACKHAWK RD
LOT"; 59 Bl,(lGK< 6
CEqAR GRqVE #6
P< I. N, 0 10-15705-590--06
DESCRIPTION:
REMARKS:
FEE SUMMARY:
CONTRACTOR: - Ap plz cant -- ST. LIC. OWNER:
WESTURN CEDAFt SUF'PLY 15410304 20014207 CARLSON I.EIF
705 N hIWY 169 3911 BL.HCKFiP+WK FtD
I PLYMUUT"H MN 55441 EAGAN MN 55122
(612) 541-4207 (651)452-4130
reby ac.knawledge; that I haue read this app:tication and sts
rmation is eor~reet anci agree ta comply with ail appli.cablr
utes ancl City of Eaq:an 0rdinances>
APPLICANT/PERMITEE SIGNATURE I ED BY: SI
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EACtN xowivsxap
3795 PiloC Knob RoAd
St. Paul, Minnesota 55111
Telephone 454-5242
PERit?tT FOR WATER SERVICE CONNECTION
:
Date: Number: 265
. Billing Riame: Site Address: -101i,
,,. . y
Owner ' ? s_.. c??? '[?.? -_? ? Zt? Billiag Address
P lumber :
tion of Connection
Building is a:
Residence___/_
tRultiple No. Units
Commercial
_.._...?
Industrial
Other
Meter Siz ??, Conaection Chg. 2 0.00 ?
Meter No.??i??? ' Permit Fee 7•50
Meter Readingd?Meter Dep.
Meter Sealed: Yes- Add'1 Chg.
NO Total Chg.
Inspected by
DaCe
Remarks:
Bq:
Chfef Inspector
In conaideration of the iasue 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 Towmshig, DakoCa County, Minnesota.
sy:
,
Pl.ease aoCify the above o£fice when ready for inspection and connection.
q . .
EAGI,N TOI+INiHIP
3795 Pilot Knob Poad
St, Paul, Minnesota 55111
Telephone 454•5242
PERMIT I'OR SErJ'gR SERVICE CflNNECTIOAi
DATE:_??????`i'. 3$7
NYIMBER
OWNEF44:;41?' ?(t? Addxess ? •? ,;?? sr,d ,=?? ?f ? ? `
,
PLtIMBER
--- J" L47'.,G 4,('e- TYPE OF PIPE e-1??-Y
AESCRIPTION OF BUIIUING
IndustrialI Commerciall Residential I Multiple Dwelling i No. of units
Permit Fee
7•50
Zocation of Connections;
Connection Charge 200s00
Stzeet Repairs
Tota 1
inspected by:
Daxe
Remarks:
$y
Chief Tnspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accardance wit'h the ru3.es and
regulations of Eagan Tocroship, Daltota Countq, Minneaota
?
By
sf ?
Please notify when ready for iaspection and connectian and before any portion
of the work is covered.
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA115644
Date Issued:09/27/2013
Permit Category:ePermit
Site Address: 3911 Blackhawk Rd
Lot:59 Block: 6 Addition: Cedar Grove 6th
PID:10-16705-06-590
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 .
Jeff Greenlun
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 -
Leif A Carlson
3911 Blackhawk Rd
Eagan MN 55122--173
Perfect Exteriors Of Mn Inc
321 1/2 Walnut St, POB 297
Monticello MN 55362
(763) 271-8700
Applicant/Permitee: Signature Issued By: Signature