4007 Blackhawk Rd
CITY or, SEWER S99VICEPERMIT
3795 Pilot Knoh. Rind ~ PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: 722 No. of Units:
Owner: e t It C"mrt. -M-
Address:
Site Address: 400.7 -Plmekb am* tom. TJ- R7 CG 7
Plurnber:
2/2B/77 #,3 5365 100.00 pd
agree'fo-oow0y with the City of Eagan Connection Charge: 37S.00 Pd
Ordingntee. Account beposit:.
Permit Fee:
Surcharge: By Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
CITY QF,EA"N WATER SERVICE PERMIT
379S-PHot kftb Raad PERMIT NO.:
Eagan,. MN 55122 DATE:
Zoning:' I No. of Units:
Owrlef: _
Address:
Site Address: 00 BIACkh+ Mk__ t 3 _i _Z
;Pj"r:
Meter 'f4.: Connection Charge: 220,00 Pd
Size: Account Deposit:
Reader iNo.: Permit Fee: _
1 egre®:to-&am* with Nye City of Eagan Surcharge:
Ordiwandes. Misc. Charges: ,
Total:
By Date Paid:
.Date oF. w-,p,: Insp.. r
wzy-:_,',~
CASH RECt#P r
CITY F "EA N.
X;A
3795 RELOT KNOB RQAD ~
EAdV, NI~IE54TA51
-i
AMOUNT
VoK,
E] cksfi
y
_cops..."
f 27 f .a ` `
` CITY EAGAN
3795 PUot Knob Road Eagan, MN $5122 Na 4 2 2 6
PHONE: 454-8100
BUILDING PERMIT $33tOOO Receipt # `
Sing. Fafn 'twig, t~. Gaxg.
To be used for Date Feb' 2$ , 19 ' 77
Site Address 4007 blackhawk Rd.
"
Erect ] Occupancy
'R 1
Lot 13 Block 7 Sec/Sub. -x;1";._7 Alter ❑ Zoning
Parcel # Repair ❑ Fire Zone
Enlarge ❑ Type of Const. V,
a Name Marel1 COnSt. CO. Move
f- 3 10$t3Q m dale Ave. So. ❑ # Stories
Address. Demolish Q Front ft.
0 City _Bloomington Phone Grade ❑ Depth ft.
Name_ Harp I CcmSt- Ca-I Approvals. Fees
0 '
Qv Address 10800 i:~rt3dale Ave. S• Assessment Permit _
uF B
I I Phone Water & Sew. Surcharge 16.50
City
Police Plan check -
Name Fire SAC 475.00
uz Address Eng. Water Conn. -94-00
W City Phone - Planner - Water Meter
Council
I hereby acknowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to comply with all applicable 809 50
State of Minnesota Statutes and City of E6gon Ordina~Kes. APC Total
Signature of Permittee
A Building Permit" is issued to; 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 a --F * -
s^ r
Permit Date Issued Pennittee
Plumbing
'Mechanical
INSPECTIONS DATE INSP.
Rough-In Final
Footings Date , Insp.Dote Insp.
Foundation Plumbing
Frame/ins. Mechanical
Final
Remarks:
017"x. ~f EAW4
3795 pilot Knob Rand
Eagan, Mionesoto 55122
Phone: 454-8100
PtMeING PERMIT No. 78
Date: March 21 1977, Receipt No.: _,SU +amak~+t 41 #ttd _
Single
Site Address: 4407 $18ckhay+ik Pd. _ Residential x
{
Lot 13 Block 7- Sub/Sec. ~G 7 Multi Res., Comm./Ind.
Name Hirell 0011st- 06. New/Alter./Repair. Address Cast of Installation
city BlOOMingtvn Phone: Permit Fee 20.00
Name ' VLOW 1 Pltuubi nc1 Cb Surcharge . 50
Address
V qty MMj Il! i Phone: 1~ota1 _ 2E?. S4iillex
This Permit is 'issued on the .express condition that all work shall be done in, accordance with off applicable State cif
Minnesota Statutes. and city of, Eagan Ordirmnces.'
Building .€3ffieiol~C~
3745 Pilot 'Knob Road
Eagca : Minnesota 55122
Phone. 454-0100
867
3 ,867 HEATING P1ERMtT' No.
' March 24, 1977 05522
Date: - Receipt No.,
4007 Bla►ckhawk Road Single
Site Address: Residential
~
;k.
Lot 13 Block 7 Sub/Sec. CC 7 Multi Res., Crnnrrr./kW.
Marell 0onstruction 00. new
- New/Alter./Repair
e Address 10800 Lyndale Ave. 6o. Rm 124
Cost of Instatfation
City B1OC i e tc>ri 20.00
Phone. 'Permit Fee
RIKy W. Welter fleatinq . .50
Ncpne Surcharge _
Address 407. ACago live.
v Minneapolis 20.50
City Phone: Total
This P&rrnit is issued 'on the. express :condition that all work shall be done in accordance with all applicable Stafe-;Of
Minnesota Statutes and 'Citjr of #*rt Ordinances.
Building 0l`llcial _
x
Receipt --r MECHANICAL PERMIT Permit No.
CITY OF EAGAN Fee r;
Fill in numbered spaces SIC
Type or Print legibly
Tot. r'
1. Date 2. Installation Cost
3. Job Address Lot - % Blk. 7 Tract
4. Owner
5. Contractor Phone/ "
6. Address
7. City State f Zip
8. Building Type: Residential] Commercial ❑ Institutional ❑
i
9. Work Description: New Add [3 Alter ❑ Repair ❑
10. Describe 'Fuel Type
11. No. Equipment BTU - M. Ea. No. Equipment CFM
Forced Air Air Handling:
Mfg.
Boilers Mech. Exhaust
Mfg.
Unit Heater
Mfg. Other
k Air Cond.
_ Mfg.
Gas, Piping Outlets
i
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed: for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved- CITY OF EAGAN 454-8100
Receipt 24351 MECHANICAL PERMIT Permit No. _ 2,175
CITY OF EAGAN Fee f>
Fill in numbered spices S/C
*7 1 t
Type or Print legibly Tot.
4, l
1. Date 2. Installation Cost
_ r
3. Job Address --7
t~Blk. i Tract
4. Owner x=11 ' ~~.c_ u i C
5. Contractor Ayn,;Z~ Phone
6. Address > ~-x n^~
7. City t< Gt F^ State Zip i
j
8. Building Type: Residential Commercial ❑ Institutional ❑
9. Work Description: New M Add ❑ Alter ❑ Repair ❑
10. Describe Fuel Type
11. No. Equipment BTU - M. Ea. No. Equipment CFM
Forced Air Air Handling:
Mfg.
Boilers Mech. Exhaust
Mfg.
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outlets
V
12. 1 hereby certify that the above information is true and correct, and I agree to
comply w' a,11 o~dinan 4ces angjodes governing this type of work.
' ,Signed : k s 1 t , 1 ((n.,~.'✓ for
1 a Rough Fin I
Inspections: Date insp. Date ?6 Insp.
This is your perMit when numbers and approved.
Approved iTY OF EAGAN 464.310
i
CITY OF EAGAN Remarks
Addition CEMR GROVE #7 Lot 13 Rik 7 Parcel 1,1- .16600 3 30 97
Owner Street 4007 Blackhawk Road State_agAn. PIN 51511122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF, (3 1- 1971 1.175.57 117. 5A 10 Paid
STREET RESTOR.
GRADING
SAN SEW TRUNK 1970 5$.18 2.08 28 Paid
* SEWER LATERAL 1971
WATERMAIN
* WATER LATERAL 111- 1971 1,615.00 80.75 91111 Paid
WATER AREA 110 1977 160-00 10-66 149.34 A004301 6-27-77
* STORM SEW TRK 1971 20
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 220.00 5365 2-28-77
BUILDING PER. 2
sac 475.00 5 2-28-77
PARK
EAGAN TOWNSHIP
N? 292'7
BUILDING PERMIT
Owner
Eagan Township
Address (present) Town Hall
Builder i
Address Date
DESCRIPTION
Stories To Be Used For Front Depth Heigh! Est. Cost 'Permit Fee Remarks
iJ LOCATION c • r
Street, Road or other Description of Location f Lot Block Addition or Tract
! 3, b 5~ Cc cs `
/3//i
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 PRE ISE WHILE THE WORK IS IN PROGRESS.
This is to certify, that 4~ . ;.has permission to erect a..~.i t
Upon
the above described premise subject to the provisions of the Building Ordinance for Eagan T wnship ad pied April 11,
1955. ooA
Per 9........"
~Q Building Inspector
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 N2 4226
PHONE: 454-8100
BUILDING PERMIT APPLICATION $33,000 Receipt #
To be used for Sing. Fam Mg. W. Garg. Date Feb. 28, 19 77
Site Address 4007 Blaekhawk Rd. Erect t Occupancy I
Lot _..1.3_- Block 7Sec/Sub. -CG-7- Alter ❑ Zoning R1
Parcel # Repair ❑ Fire Zone _
Enlarge ❑ Type of Const. V
Name Marel 1 Cons t. Co. Move ❑ # Stories
3 Address 10800 Lyndale Ave. So. Demolish ❑ Front ft.
City Bloomington Phone Grade ❑ Depth ft.
Approvals Fees
O Name ma-ell ronst.-Co.
ou Address 10800 Lyndale Aye_ S. Assessment Permit 98.00 _
UI- city Bloomington Phone Water & Sew. Surcharge 16.50
Police Plan check
W Name Fire SAC 47 5.00
T3 Address. Eng. Water Conn. 220.00
¢W city Phone Planner Water Meter
Council
I hereby acknowledge that I have read this application and state that Bldg. Off.
ogee to comply with all applicable $09.50
the information is correct aYic
State of Minnesota Statuteity o gon Ordina es. APC Total
_
ture of Permittee
Signa
A Building Permit is issued to: Lc t L" on the express condition that
all work shall be done in ordonce wi op State of Minnesota Statutes and City of Eagan Ordinances.
Building Official G'ti
BU?'''=)Zr,11G PEPMIT R.PPLIC.A{I011
r rn 7' n r ADD rIA"-V'-"A-
& ^aLC's'id_1 ?'.~il~?)r'? I M.IT'TATTED
(T /16L
.i::1~: _~dCCJ>;na} Ci'- USE
TiS`.iIt'oJi'"20 C(';;;i
0 7 TELEPI."o" ;.E izO .
CO?:l s`c.-'c 'CI.P. TELEPHOPIi, 1117 .
tlat.~ Iuclu.lir2 s .te plan, building plans, and energy calculations 1.,-ith this
anoli.catirn
Signed
OFFICE USE
VALUi1TI0: ~
SAC
t`,'ii.~. i,:.l CJi.u.lunl.t.: 1.~.^il ../C
' 1,4TER METER
C
T+J:C.I,DIitG F!?R-.`9' I "'•E 67 1 6
'
S-11TT HAI? E PEA
PI'lil CY.12ICK FEE
PAPM DT DicATm:.i I`EE
r.TSI•sIZ
APP1.0 2%T,S
ASSESS ~ZNT CLEF.I.Z BUILDING DEPT. POLICE DEPT.
T7T,TER & FrTvTV R D:JFT . FIRE DEPT. PARK DEPT.
1
C~ t V
~ Mi'n Ott" 784 6066
4 uauraaAw 6875 N.W-Y No 65 N E
~
_ M~nneapobi Mnrnewta 5543:
C]114 afwaawtwo
=ANC. _ South Othcev 8906510
d 4 Mi. ,poi 6nganrK~nq • .S.a Twow Land Sw-y, g • Lord Pi-nu ( 1101 Cliff Rued
BU-1s 0te, Ml-"Wtg 55337
3
Certificate of Survey for /~7,~d~/~t'
0 L~~ir/oT~ 5 _SE% 1-eo.✓ ~/.r/rvlE.+lT l
Z- 7-1-1
~ I Lo r-ice
I
o
t ~ X87 S3 -~uJ {
{ I
\ /30 ,Q~ r
I 1 ~ Q~
Q
8 8'
lot
6
/l/87 ° ~3 ~4~ '6CJ
SOT /3 B,IDC~ 7 CE~~~~,~1/E ~f/D 7
1 hereby certify that this is a true and correct representation of a survey of the boundaries of the above
described land, and of the location of all buildin~s~^►hereon, and all visible encroachments, if any, from or on
said land. As surveyed by me tfiis~' _~oy of.~i'✓c!C -A. D. 197 .
SUBURBAN ENGINEERING, INC.
Engineers Surve~ors
by
DAK 544
i
ZONING - NOTIFICATION OF INTENT
Foster Family Homes
Day.Care Homes
TO: {y fqA c-
(unicipality or Political Sub-Division)
9S A (o-F.-~GG~ alo f~-~
(Street Address)
E CQ e toy ZT t Z'l-.
Cit '(State) (Zip)
FROM:Dakota County Social Services
_ 357 9th Avenue North
So. St. Paul, MN 55075
APPLICANT: et
(Name)
4-00:2 acts fzc"fA
(Street)
(Ci ) State) (Zip)
Number of Natural Children under 18 in home: 0p 2 3 4
(c rcle number)
Number of Foster-Children-included in license: 1 2 3 4 5 6 7
circle number)
Number of Natural Preschool Children in Home: 0 D 2 3 4 5
(circle number)
Number of Day Care Children included in license: 0 1 2 3G4 5 6 7 8 9 10
(circle number)
DATE OF NOTIFICATION: -
451-6426
Business Offices
4'54-3800 .
w Sales Office
'
7343 CONCORD BLVD. EAST, • SOUTH ST. PAUL, MINNESOTA 55075
December 29, 1972
Village of Eagan
3795 Pilot Knob Rd.
St.,Paul, Minn. 55111
Attn: Lorna
Dear Lorna,
As per our phone conversation of yesturday with Alice Bolke enclosed
find our checks covering building permits on our 172 plan and water
and sewer permits for the properties listed below:
Cedar Grove No. 7 Bldg. Permit W & S
Block 3 Lot 2 l Z> @ 66
Block 5 Lot 13 nd 16 ..00 @ 21.00
Block 7 Lot 13 and 14
Cedar Grove No. 8 .
(Block' 1 Lot l
k \ Block 2 Lot 1 through 6
8 through 11
Block 3 Lot 6 through 12
Block 4 Lot 1 and 2
4 through 16
y Block 5 Lot 2, 3, 5'and 7
Block 6 Lot 15 through 18'and 21
Block 7 Lot 1 and 3
Block 9 Lot 5' 6 7 and 11
r 13 Block 10 Lot 1, 3, 4, 5, 6, 7, 9, 10, 11,
12, 13, i4, 15, 179 18 and 24
y;N
r.
Sincerely,
i
J anne Johnston
1 ~
JJ/hs
Encl.
C
Alldrlc
Community Fuildrr
2006 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes/condos when permits are required for each unit
Date
Site Address`? Unit #
t _ f
Property Owner Telephone # (r)
Contractor
O'CONNOR ONE HOUR
Street Address 1904 VERMILLION STREET City
HASTINGS, MN 55033
State Telephone#
Bond Expires:
The Applicant is Owner Contractor Other
Add-on or alteration to existing dwelling unit $ 30.00
furnace -Additional -Replacement New
air exchanger
air conditioner
heat pump
other `
State Surcharge S .50
{?t"1 = ~ ,
Total $
s
I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; 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'
Applicant' Printed Name Apply nfs nature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117033
Date Issued:10/14/2013
Permit Category:ePermit
Site Address: 4007 Blackhawk Rd
Lot:13 Block: 7 Addition: Cedar Grove 7th
PID:10-16706-07-130
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Robert Antonsen
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 -
Mark A Peters
4007 Blackhawk Rd
Eagan MN 55122
Antonsen Construction Inc
411 marie Ave Ste B
South St Paul MN 55075
(651) 340-1791
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA142144
Date Issued:04/17/2017
Permit Category:ePermit
Site Address: 4007 Blackhawk Rd
Lot:13 Block: 7 Addition: Cedar Grove 7th
PID:10-16706-07-130
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jerry V Petersen
4007 Blackhawk Rd
Eagan MN 55122
(507) 450-6467
One Hour Heating & Air
11825 Point Douglas Rd S
Hastings MN 55033
(651) 437-4177
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA142145
Date Issued:04/17/2017
Permit Category:ePermit
Site Address: 4007 Blackhawk Rd
Lot:13 Block: 7 Addition: Cedar Grove 7th
PID:10-16706-07-130
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jerry V Petersen
4007 Blackhawk Rd
Eagan MN 55122
(507) 450-6467
One Hour Heating & Air
11825 Point Douglas Rd S
Hastings MN 55033
(651) 437-4177
Applicant/Permitee: Signature Issued By: Signature