4010 Blackhawk Rd, . -J?
+:' w • ?.x
CtL'ttfiCQte of CCC1tpQIiC?
Kit? of Ofagan
Zepartment of Zuitbing ?u??ec#ion
This Certificate issued pursuunt to the requirements of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various
orrtinances of the City regulating building corrsrruction or use. For the following:
Use (,'lassification: SF DC Bldg. Permit Pto. 23151
. t7ccupancy 7j/pe R3 11 Zoning District F'il Type Const. V1j
o,.ncr or suiiaing IVEW DZFMTClN BM naaress 1635 COON RA,PMS ?if ._ttD, !Yxg+t R.aptnS
Building Address 40 I0 BLACKRAW, ROM
Dwe
Buildiag OfFiciay /
POST IN A CONSPICUOUS PLACE
Address 4010 Br.AQU1A4K R An Zip 5512 2
Le?t •? 2 Blk j Sub nEE41awx
THESE 1TEMS WERE / WERE NOT CC?MPLETE AT THE TIME OF THE FINAL INSPECTION.
--
Date:
Yes
No
Inspector:
Final grade (6" from siding) i/
Permanent steps (garage) V?
Permanent steps (main entry) ?
Permanent driveway
Permanent gas
Sod/Seeded grass VII"
TraiUcurb damage
Porch V"
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.
Contact engineering division at 681-4645 before working in right-of-way or instaliing underground sprinkler system. `
?Q
White - City Copy Yellaw - Resident Copy Pink - Contractor Copy %V
? 63 548 a ,? ?`Q2v
Request Date Fire No. ?. Fugn-in Inspection
o ed?
? / Requir
o
"
?Ready Now ? Will Notify Inspector
n Read
?
Wh
1 Yes '?No
1 y
e
I'xlicensed contractor D owner hereby request inspection of above electrical work at:
Job Address (Street. Box or Route No.) City
k-?
Section No. Township Name or No. Range No. County
&'k
Occupant(PRINT) Phone No.
Power Supplier Address
Electncai Contracror (Gompany Name) Contractor's License No.
G 4r-
Mailing Address (Contractor or Owner Making Installa6on)
sc;U5 2_-7-i,-, ,4V'-e, J O.. rip)3? Al S-S f /
Author¢ed Signature (ContractonOwner Making Installation) Phone Number ?j
7v
MINNESOTA STATE BOARD OF dLECTRICITY .. THIS INSPECTION REQUEST WILL NOT
Griggs•Midway Bldg. - Room.S-Y73 BE ACGEPTED BY TNE STATE BPARD
1827 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
???/Q? REQUEST FOR ELECTRICAL lNSPECTION
J ? See instructions for compl2tin this form on back of ellow copy.
?R *? S Q, R "X" eelow Work Covered by This Request
EB•00007-08
s?? ??q7p5
?
ew Add Rep. _ Type of Building Applianc'esWired EquipmentWired
Home Range Temporary Service
Water Heater Electric Heating
AB%
lding D ryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) Contractor's Remarks: ? >i/? /c
Compute Inspection Fee Be/ow:
# Other Fee # Service Entrance Size Fee # Circuits(Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps '
Transformers Above 200 Amps A Amps
SIgnS Inspector's Use Onry: x O
, TOTAL
Irrigation Booms ?/ ?..Q?, ?
Special Inspection
AlarmlCommunication THIS INSTALLATION MAY BE ORDERED DiSCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby R°ugn•'" Date
certify that the above inspection has
been made. F, nai ? Date
/?'-?'
OFFICE USE ONLY
This request void 18 months irom
?"M
4 5
Cg
Request Date Fire No. spection
y NOTICE: You Must Call Electrical Inspector
If A Rough-fn Inspection
i
R
? No
es red.
Is
equ
I icensed contractor ? owner hereby request inspection of above electrical work at:
Job Address (Street, Box or fioute NoJ Ciry
4y00 6?--AC HAu a kfj. G?G-'A;J
Section No. Township Name or No. Range No. County
??K ri A
Occupant (PRINT) ,Lf ! ?en ? P Phone f•Jo.
??? ?a-7 06
Power Supplier Address 1?3 0?
(
TO P ?- - ?
Electrical Contractor (Company Name) Contracior's License No.
f_°, A :X%3`33
Mailing Address (CoMractor or Owner Making Installation)
?F- ? ALOA ? t+???F ???1/?i°?!f?tlV 141r,)
Authori ed
Con ctor/O ner Making fnstallation)
tur
e (
Phone Number
r
?? -? 18
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BYTHE STATE BOARD
1821 University Ave., St. Paut, MN 55104 . UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
?J g??, REQUEST FOR ELECTRICAL INSPECTION
l_ ???? See instructions for completing this form on back of yellow copy.
M "X" Below Work Covered by This Request
E8-OOQ01-
.:
t ?
ew d Rep. TypeofBuilding AppliancesWired EquipmentWired
' Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm.llndustrial Furnace Oiher (Specify)
Farm Air Conditioner
Other (specify) Contraotor's Remarks: s ?
, 0fpF b Iv' F w ?0 L iT{l
Compute lnspection Fee Be%w: 150 4, c ?
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 10 Amps
Transformers Above 200 Amps Above 100 Amps
SignS InspectoPS Use Only: OTAL ?
Irrigation Booms ? ?
? ? a7?
Special Inspection
AlarmlCommunication THIS INSTALLATION MAY BE ORD CONIVECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Rough•in k oatt4
t
certify that the above inspection has
been made. Final
??
Date ?
?
OFFICE USE ONLY
This request void 18 months from
i -
T
0-S 1-003
9,5
Request D te ?
??S ?? Fire No. Rough-In spectlon Required
(You m t call inspector when ready) tnspection Other Than ugh-In
0 Ready Now Will Notlfy inspector
Yes ? No Date Ready
i? licensed contractor 5Lwner hereby request inspection of above electricai work at:
Job Address (Street, Box gppoute No.)
??xxzw??
?Qlo 10 City
Section No. Township Name or No. Range Na County
Oac t (PRINT)
Ar?Q rckOnG.. phone No.
Power Supplier Address
Electrical ontractor (Company Name) Contractor's License No.
Malling Address (ContracCOr or Owner Making Installation)
? V l.r--
Auth
. rize S' natura (Contractor wn akin Installh'',
-??f<?,1
Ph
e Number
ICITY
LESS SEDOPERNSPECTONBOEEIS
University SMN 8 510A IIII?????I??II11??7???il?llllllfl?I?f?fIl?Ilii??fl UN' T
Phone
REQUEST FOR ELECTRICAL INSPECTION
' , See instructions for completing this form on back of yellow copy.
K"X" Below Work Covered by This Request
EB-00001-09
4/U1?-?_/
New Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (Specify)
Farm Air Conditioner
Other (specify) Contractor's s:
Compute Inspection Fee Below: j
# 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
SI 11S Inspector's Use Only: L7
T
Irrigation Booms ?
?L/
Special Inspection
Alarm/Communication THIS INSTALLATION MAY B RDERE DISCONNECTED IF NOT
Other Fee COMPIETED WITHIN 18 M T S.
I, the Electrical Inspector, hereby
it Rough-in oat
cert
y that the above inspection has
been made. Final Date
OFFICE USE ONLY
This request void 18 months from
PERMIT
i
`CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
! SITE ADDRESS:
PERMIT TYPE:
Permit Number;
Date Issued:
4010 BLACKHAWK RD
k.OT: 2 BLQGK: 1
DEERHRWK
P.T.N.: 10--19910-e20-01
04e? 5 Rld g/3-1
BUILDING
027791
06/07/96
? DESCRIPTION:
Permit Type
40,r, k 7 y p e
I REMARKS:
I FEE SUMMARY:
Base Fee
Surcharge
Total Fee
CONTRACTOR:
?
I hereby acknawl
atnfivrtnation is. ?
? Statutes and Gi2
$45.00
.50
$45.50
APPLICANT/PERMITEE SIGNATURE
bbbl- _
DECK
ldEW
434 ALT. RESIqENT'IAL
OWNER: - Applicant -
BARANONA CARL.QS
4010 BI.ACKNAWK Rq
EAGAN MN 55122
(612)452-9137
!SS D B SIG T E
- ?- CITY OF EAGAN
3830 PILOT KNOB RD - 55122
1996 BUILDING PERMiT APPLICATION (RESlDENTIAL)
681-4675
New Construction. Reauicements
@ginodeUReRair Reauirements
Y K ' PJt,??
? 3 registered site surveys ? 2 copies of plan
? 2 copies of plans (include beam & window sizes; poured ind. design; etc.) ? 2 site surveys (exferior additions & decks)
? 1 energy calculations ? 1 energy calculations for heated additions
? 3 copies of tree preservation plan if lot platted after 7/1l93
required: _ Yes , No
DATE: CONSTRUCTION COST:
DESCRiPTiON OF WORK:
STREET ADDRESS: ???D_ &6(lhatje kd
LOT BLOCK _I_ SUBD./P.I.D. #:
t 1
AlXd
Z
6
Q
f?f?? ???Z 913
7
PROPERTY YV? G
Name: S Phone
OWNER 1A5' "RS'
LIQID ,
Street Address:
City: 1?5LqaAt, State: Zip:
CONTRACTOR Company: Phone #:
Street Address: License #:
City: Sta#e: Zip:
ARCNITECTI Company: Phone #:
ENGINEER
Name: Registration #:
Street Address- - -
City: State: Zip:
Sewer & water licensed plumber:
change are requested ance permit is issued.
Penalty applies when address change and lot
I hereby acknowledge that I have read this app(icafion and state that the i ormation is correct and agree to compiy with a!I
applicable State of Minnesota Statutes and City of Eagan Ordinances. ,
Signature of Applicant: ?i"'?`??• ? "' ?' "`???fi?
OFFICE USE ONLY
Certificates of Survey Received Yes
Tree preservation Plan Received Yes
[R[ECENEDD
No
? M AY 3 1 1996
No
OFFICE USE ONLY
BUlLDING PERMIT TYPE
0 01 Foundation ? 06 Duplex
0 02 5F Dwelling ? 07 4-plex
? 03 SF Addition o 08 8-plex
0 04 SF Porch o 09 12-p{ex
? 05 SF Misc. a 10 _; plex
' WORK TYPE
' ? 31 New ? 33 Alterations
o. 32 Addition o 34 Repair
GENEFtAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# af Stories
Length
Depth
APPROYALS
? 11 Apt./Lodging ?
? 12 Multi Repair/Rem. o
? 13 Garage/Accessory o
0 14 Fireplace o
)w 15 Deck
? 36 Move
0 37 Demolition
A ,a A? ? , ..+sz.,
16 Basement Finish
17 Swim Pool
20 Public Facility
21 MisceNaneous
Basement sq. ft. MC/WS System
Main levei sq. ft. City Water
sq. ft. Fire Sprinklered
sq. ft. PRV
sq. ft. Booster Pump
de
C
C
sq. ft. .
o
ensus
Footprint sq. ft. SAC Code ?
Census Bldg
_
Census Unit 62
Planning Building
Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCNVS SAC .
City SAC .
Water Conn.
Water Meter
Acct. Deposit
SNV PeRnit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
?
? e ? ' ` ??---- --- -
,
?'?-- a b' `
?
t
,
??-
?
311;?i?
?
. ?
:
? --- ? ' .
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;
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,
ta v ?
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,
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lqqq I
4 ? CITY-OF EAGAN
! 3830 Pilot Knob Road
? Eagan, Minnesota 55123
(612) 681-4675
- ,? -? -? -e--?--
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
? U 1-9 - r ?? ?-?
023151
@3f28/94
SITE ADDRESS:
4010 BLACKHAWK RD
LqT: 2 BLQCK: 1
ClEEF2HAWK
P.T.N.: 10-19910-020-01
DESCRIPTION:
sF awG
NEW
R-3 M-1
V-N
R-1
42
49
1
??
? ?
agan
I REMARKS:
s & w PLBR - FxRsT cHCarcE PLBG
' FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Lic. Search Fee
5ubtotal
vALuArxoN $89,000
$590.00 MZSCELLANEOUS
$383.50 Tatal Fee
$44.50
$800.00
100
1
5.00
`v1 9 823 • 00
1 828.50
$3,651.50
CONTRACTOR: ~ ApPlacant - sr. Lxca OWNER:
? NEW tJIRECTIpN HpPiES 17572700 0008386 NEW pIRECTIqIV HOMES
1635 CqC1N RAPIpS BLVD 1635 CQfliV RAPIDS BLVp
? COON RAPIDS MN 55433 CQqN FtAPIDS MN 55433
, (612) 757-2700 (612)757-2706
`eby ac k nO-lwle dc?e. t
R?a`ti6 n i-s ta?r,???.
ite s 6-nd t?: c?.? ???:?art t7
--v
t(VIA R.:A1 l1-9
( SS ED B SI NATUR
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: s uILDItv G
3830 Pilot Knob Road Permit Number: 023151
Eagan, Minnesota 55123 Date Issued: 0 3 i 2 8/ 9 4
(612) 681-4675
SITE ADDRESS: Lo rt: 2 BLa c K: i APPLICANT:
4010 BLACKHAWK F2D NEW pIRECTTON HQMES
pEERMAWK (612) 757--270e
PERMIT SUBTYPE: TYPE OF WORK:
S F DWG
NEW
INSPECTION
FOOTTPIGS ., .
FOUNpAT'ION ..
FRAMING FtOpFING
INSULATION FZREPLACE
RpUGH IN PLBG RQUCaM IN HTG "
FINAL PLBG FINAL
REMARKSs S& W PLBR - FIRST CHQIGE PLBG
7-1
4
C? OF 9A.. L;J t J"o
fofvalty appli8s; 1) wh4fl Q@1'qtit 1 140 0,
iS tyj??, bL4t ?1fcked, uo by -last wor"kint°ol"Y
ill #??ch. ?BQt1$$t iS made, +C} Sftdl^eSs? IS_ chaCtged or, 3) lot? L??l"S,_
µ .
?rluatian crf r?€tr ,C??
k
?t
Site Ad+dress: ;:
gt'REEt' +: , ?t?TE ?
14,ndnt Natle: (Commel"CiBl QTfly.) ., ' d.1fr*+e?+k 0: .
WT
GK ?
ISLO
$?38D • .??C?r" ?Ihc+.v?t?. ? •
?' . ? . D . ?k `
_•
{w?i. . ? Y r !M
. . -
. . . . ?' ? ?
, . , . ?
}
??.
icant is: t? twner ? ?ontractor ? fther (aft??lt*
Name
PM'
"ity
?ast
?t?tst
Oiltno!`
Address
' sTFM
;
t
City
State Zip
?
Company ?
?.
? , ;??3t'?'?'????t' Address ?,.?„ ?I '? ,??..., ??• .... ?
k
? .
. .. /?
V I ty ' . .. .
. . State.W?W????M??Ww+!YWw'wAeqYl?, Zi?,F"
V
. .. .. .
. .
Y?any .
. .. . . . . . ' . . , _ _, *. _ M1
. .. ? "f ????? .. .. ' , ? 4 . ... .
,
•S
NW'' fleoti?tratiVy? •f:1 . ? S ..
. ? MdrCss { ? ' . " . . .. .
C1 ty z#?{
St?tt?
/'? ?
?
`Y Sefi?tor & 1+1??er ljCefiSed plttmbt'r ' 3r OAt<<e_ .?.. P1oC'alitiW'.??°`:
s?r- A rraCer P+et^ari ts f stwrs aays once area as be ' ap#rov ?
f hereby acknowledgs that T have read this ap licatior? an?f stat?e tf?at.the As
correct ard agr.ee to c '??r r?ith :all ap?rl icab?e State of Rinn??o Statute$ and: ?i ty of
? f"#rt Ordirtances.
, 'tf#na:ture of App11can
r
- - - . ? - . - .. . . . . . ? . . .g
.
. OFFIcE usE ONLY
BUILDING PERMlT TYPE
CI 01 Foundatfon 0 06 auptex. C] 11 Apt./lodgfng
Z 42 SF Drrg. ? 07 4-Pl ex ? 12 t+tuul ti . Mi sc.
o as sF addition o as a-PI ex o i? Garage/Accessory
D 04 SF Porch C] 49 12-Plex ? 14 F1replace
C! 05 SF Misc. 0 10 Mu1ti. Add'l. 0 15 Dock
Wt)RK TYPE
Q 31 New C! 33 A1 terat i ons CJ 35 Tenant f i n i sh
El 32 Addition ? 34 Repair- D 35 Novo
GENERAL INFORMATION
Const. (Actual } Vp? Ba$ement sq. ft. rG?z
{Allowable) Ist F1. sq. ft.
UBC Qccupancy R-3 ?-/ • 2nd F1. sq, ft.
Zoning -Sq. Ft. tfltal
# of Staries Faotprint 5q. ft. ?
LengtM On-site well
Depth On-site sewage
APPRC}YALS
Planning Buildin
Engineering Variance
REQUtREQ Ih1SPEGTIONS
? .Site
? Wal l board
PT Foot i ng
A Final
M Fram# ng
0 Draintile
B Ir?sulation
C] Fireplace
Permi t Fee
Surcharge
Ptan Review
License
M4VCC SAC
City SAC
Water Cpnn.
Water Meter
Acct. Deposit
S/W Permit
S/W SurGharge
Treatment P1.
€toad tJnit
Park Ded.
Trai}s t?ed.
C?pi es
4ther
TOta'I :
veuttlcm g? ocob
iss
2yX?
r(o3go
?..
1, t
#'? - ;? ? ?„.?• ?i `?
Q 16 ?semeAt Finish
13 17 Swim Poctl
0 18 Conm. JTrad.
C! 19 Comn./Ind, Misc.
0 20 Publ ic Faci 1 ity
O 21 P4i scel'? ?neous
0 37 Demoi ish
aWCc syst,em
City Water
PRV Required ?
p ?
Booster Pun
?'ire Sprirtl?ier ?
Census Gode
S?AC Cade
Ceasus Bl dg
Census Unit /
Assessments
2 a
x-4'l6 j S p ya
? ?a92- 00y
? Zb
_ Zy -
??---
?/gG ksy?. 6ys??f
5AC %
SRC Units
•R - '
r .
' IAT itTRYZy CgZC]CS.ZBT :0R ]tE6IDZNTZIIL
2IIILDZId pZRI+lZT "PLICJITZON
"OPERTY ZEeA._
ato- z ?'z
?
Dat* ot i sps 7 ? CoC
DQCIIMENT 6TlrNDLlzr?a
/??"4l'= c3 Z ? ??{
0'rD' D • Reqisterea tand Surv*yor siqnature and eompany -
tYD 0 • Suflding permit Appliesrit °
D- 0 D • Iwgal dorcription
0'D 0 • addrsss ?r ? 7 f? y??
H? 0 D • North arrcw and ba,? scale Seq?c_ , r?a.c
Mr' G O • House type (ramblsr, valkout, split v/o, split tntry,
lookout, •tc.)
D?D D • Directional drainaqe arrows vith siope/qradisnt 4.
0' D 0 • Proposed/existir,q sawar and vator sorvicar
fl'? 0 0 • 5treet name Z' D 0 • Driveway
ELEVl,TZONS
U"' D D • 5ewcr service el,"D 0 • Lot ccrners
0,13 D • Top of curb at the driveway
D D, 0 • Elevations of any existinq adjaeent bomer
pro? -
H' D D • Garage floor .
2'-'0 0 • Fisst floor
W"0 0 • Lowest expesed slevation (walkout/windoW)
0 D • Property corners
D" D D • Front and rear of bcme at tiie foundation
PONDSMG 71RE!?S (3f aflplf bie)
D 0?0 - Ensement lins 0 D? D • Nwi, D ? 0 • xwi, .
0 B'0 • pond f desiqnation
D 8, D • Emerqeney Overflov Zlevation
DZKENBIOMB
D 0 ? Lot lines
D D • Riqht-cf-vay and stroet width (to back of curb)
?O D • Propesed bome dimcnsions inciudinq any proposed •dteks,
overhangr qreater than 21, porches, stc. (i.e. all
structur*s requiring permanent footinqs)
tJ?D D - Shcw ail easements of reeord and any City utiliti*: within those sasements V""0 0 • Setbacks oi propesed strueture and setbnek ot adjacent
existing h .
D 0?' • Retaini requirements, if any
Reviswed: ' - , :5??E-,7/
Na e / Le
OeLabar 2992
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l.._. .._, ._,. ._... .._ _.... ?.. _ ?... ....._
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Gwner ?l4??1-?ONF? ?L?irL'h?L.v' Pnone r.;.-a
Sita address Contractor Phone
_nti a1 )
? i ?e ..; Single Femil i ?
?
g Y? ; Type a2 ( Resi d°
°uild;n C1ass; -
? (3 stories or ess
•tnva r ? _zzr'.es)
' GcNERAL INFORM,"'i :ON
1. Buildino Ferime:=r 1'ap Tt.
; t3 _ ? .
2. Wail heicht (g;rour.d to eave; ?;..
2
3. 1. x 2. (Ebove) gr:,ss wai
4. Building dime?s-tc::s (L) 'A'i x('r1) L(o' Z'L' _? tci"j r? Z^" f'
? ?. r..o ?& oor area
5. Square -fcot are_ of rim jo:st - Floorjois'. s;ze (2 x lU? ) ^
.?.p ? x Per:?e«r = Ri?? -?ist are? = 11Lt????"1 ,=?c
12 . 6. Goors - Araa
ihickaess in. U Tact:r
TL Pe o= ..cr,<_ zruc zior,r ,?-k ClaA INsOI Perir.:e-ter 7, 't
I •:a_rn?? aCL1.II'=:? qcc C, ^i1 r In-'; tration Ra tes-Res . Doors :
C;;I/sq. or" door area/iable Va.
?. ?otal door's
8. t•Jindows: ?ianu:a-_;srer Gj-?r`1H?, ? State approved ?(r?
U`actor,3 °n;r Infil?razion RaLe: ?o3 CF;4/-t, c= operabTe sash crack/Tab1e Plo. 5-3"
iYPE ARE-I. 2) 'tL+iq9ER Or iOiAL Fz-i 2:.
, (Match CT Value)- E;=.C:? UPJIiS -
ZO ?? 3't (???"'' _.a• 1 17 ? "] ? ? 1 i1
?°t -Prn ttr rr-; y
Z `1 b 71 ?A ,'+O 3 ?? ? t?S)
Zo?V? y- ? I %f- 0 1-i
. 2 `f '3li N L.'?.!'_,7 I tn.
.
,
9. -o ?al _--.' wiZcc;?
. _. 2
._ . ,
. . .._.. _. _ ( ..-
Iti. ? I} a ? 1 Cc _.. .^.?'?._. n......? ?t ... ..?1. .- ?1 ? x
II. ?Y?GSG? :I J:::__ -O1Cit_ X ???°1" ;( 4•L.?U - -70 ?--/
., - .,
' V("'• ? _i :U,t ?J:` z i ...iS7--;,,I(.. ,'?nUJft .`C_,'?C:.^.'I._L Sl??.^. :
r 7r ''i !'Itl•:. __ JC
,. i. 1:?1 . _.... _..?"... _ .._.. 1?
? ? .
,
.
. 'i?.7 ! _ . .. _.-.. _ ? ' ' - • . .. L. _ ? . , ? ? 1
, , ? . ..o.. i .-..,, . . . , . .. . .. . ._
.. , . . .. .,
? . .......... .
.. . ?...:.;. .:.. ..._.
.. . . r,
. . .. m . x.- ..
. , . ,.. s. .a-wr uw..-+¢.:.....,.. ...w,»« ...w+.rr.»...-+-.-.,+.a..,++wo -..»„e....,.......-.
~ • ' ?
' • , ?
12. =ramira area = 1 Q; oT aross :vai1 are?.
??. Gr!oss wa1T area r?. 2
\diRCGW Q:"9a n
1'?.
.y l? 2
T± .
U =
:yS RCca15
U
X
A -
_ IY? Z
Mim JO15i 3Y'Q3 N l t 1 "? `
(J ' ?J
r:Z ;,OiSt = 1G1-I
U
X
A
= 41
Caor area ?
U
Iccr area •
U
x
A
-
Fireplace ar•e? ?
jt.?
U
aireoiacs n
U
x
A
-
Expvsed foundati on .4 `1 U ft.z U founda.ion ? t U x A -
?N3?11T19 area n
I-?-I
?'???
F?. ?
ll p
T:':T.lI1^Q 3T'23
u
:<
n 1 `
° 1to 1
Net wal 1 area A U :vai i = 1 0 U x A _ ?? , '51-'
5
(13B) iOTAI . . . . . . . . . . U x A ¦ 15311
TG. Gross'wall area x 0.11 (A-1 singie family & dupl2x = aTlowabie U x A/Code(13. above) .
x 0.23 -Z other residential)
x .23 ?.4Other buildinvs)
x .28 (Over 3 stories) ?
5iUH - Mus '. he 1 arger than
A 1?', t j r? u x Ll Code6 I I = 2??' ? IF. 138 abave '153? 15'
1S. Ce'ling framing area (Ar) eyuals 10a of ceiling area I -y. Giross ceil ing area = (L) A'Z . X (?,?) rt.Z
`Ea JO1St a1"°_a (nf) = IOo CZil1T1C zT'Ed' II??? M • t`•2 '
15C. Net ceil'ng area (AC) (15A - 153) "-.Z
!1 c_il ing x A C= Q? n??"• x I ?'17 ?3 = 2?,? 0
U frami ng x A?_ ? io2I-o x
1Eu, i07;l tl x A ........................................ 16. Cei 'ir,c area ( iEA) x 0.025 (A-i sinale fzmily S d-upi_x - c3dz ailowabie !.l xf'l
x 0.033 (n-2 o*her-residentia1; .'
x 0.06- (other)
?pZt? ,'Nust be loarger tran 1150 (a?-,ove)
c
1
.4 ?154
V
'31,?27 26??31
::: S
i _ ?. _ -
? ?• ?.(o?
, .
PLEASE C4MPLETE FOR SINGLE FAMILY DWELi,INGS. ALSO, FOR T4WNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
-------------------------- ---------- ----------
? 1v1EW CONSTRUCTION
ADD-ON A/C
ADD-QN FI3RNACE
FIREPLACE INSERT
DATE
HVAC: 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS (Mnvrnrttnvt 1@ $3.00 EACH)
ADD-ON/REMODEL (EXIsTnvG CoNSTtUCrioN)
STATE SURCHARGE
TOTAL
S? ?DREsS: 140 I O 3?GK NAvJ14 ?h .
OWNER
FEES
24.
6.00
3 P'
$ 20.00
.SQ
Z-7 , 5"o
?...?.?
[oivE #: -757- Z7o0
?
INSTALLER: AfO LQ.D G-'C?`Tl tiT G
ADDRESS: foSIO d. rt (ACq .?L gWA -
Crry: STATE: ? Ill ZIP CODE:
TELEPHONE #: `_j -7 O -d 603
SIGNA F PERM E
1994 MECHANICAL PERMIT (RESIDENTIAL)
CITY QF EAGAN
3830 PII.OT KNOB RD
EAGAN MN 55122
(612) 681-4675
.?.
PLEASE COMPLETE FOR ALL COMMERCIAL,/INDUSTRIAL BUILDINGS. ALSO COMPLETE
FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMII.Y BUILDINGS WHEIY SEPARATE
PERMITS ARE NOT REQUIRED FpR EACH DWELLING UNIT.
----------------- - - - -
DATE: CONTRACT PRICE: $
NEW BUILDING
INTERIOR IMPROVEMENT
WORK DESCRIPTION:
FEES
1% OF ..;"?:?M?:' FEE $
PROCESSED PIPING: $25.00
MINIMUM FEE: $25.00
STATE SURCHARGE $.50 FOR EACH $1,000 OF FEE.
TOTAL $
SITE ADDRESS:
OWNER NAME: TELEPHONE #:
TENANT NAME: (nMPxovErErrrs orR,Y)
INSTALLER:
ADDRESS:
Cj'I'Y: STATE: 2IP CODE:
TELEPH(aNE #:
SIGNATURE OF PERMITTEE CTTY INSPECTOR
1994 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122
(612) 681-4675
GITY USE ONLY
L RECEIPT #:
?
SUBD. ? /G• DATE:
1995 NIECHANi+CAL PERMIT (RESIDENTtAL) G1'TY OF EAGAN
3830 P'1LOT 1'CNflB RD
,p, y4. EAt3AN, MN 55122
(612) 6$1-4675
Piease compiete for: ? singie family dweflings
? townhomes and condcys when permits are required itvr eacM unit
New construction Add-on fumace
__Add-on air condftionirtg ? Fireplace c:anversion (to existing fireplatre)
Date: z?/T7/9',T ?
,
EEES.
? Minimum Fee: Add-on/Remodel (ex#stinp residence on1y) $ 20.00
? MVAC: 0-100 M BTU 24.00
Additionat 50 M BTU 6.00
? Gas Outlets (minimum o# 1 required a $3.00 each) ?
? State Surcharge
ToTaL
.50
?
SITE ADDRESS:._..?.y°?0..__?{? ? ???? ?? •
C?WMER NAME:
:?.?'/'??
: PWONE #: ?
1NSTALLER
STREET ADDRESS: Cilll: Qggnl STATE: ? ZIP: zaL2 ?
PNUNE 6,,---
M? ??Pf' -R1VI1T'E'E__`
C!T! USE ONLY
L B! REGEiPT V.
SUBD. DN?TE:
1995 MECHAWtCAL PERAAIT (CQMMF.,RC1AL)
CfTY 4F EAGAN .
3$30 PlLOT KMC1B RD EAGAN, MN 65122
(612) 6814675
Piease r:omplete for. ? ali cammercialfindustriai buiicfirtgs.
? multafamily buildings vrrhhen m"rate permits are M required
for each dweiling uni#.
DATE: C4NTRACT PRIGE:
W()RK TYPE: NEW CONSTRUCTIGtN 1i;1TERItJR 1MPR+C3VEMENT
DESCRIPTION OF WORK:
FEES: ?$25.00 minimum fee Qt 1% of oontract price, whicherrer is gmter.
? Processed piping - $25.00
? State surcharge of $.50 per $1,000 of U%Mt fes due on sO pamib.
C4PfTRACT PRlCE z 1 %
PROCESSED PlPING
STATE SURCHARGE
TOTAL
si i E AuDRtSS:
OWNER NAME: TELEPHCINE #:
TENAIVT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS: . .,
CiTY: STATE: ZIP:
PHONE #:
SiCNATURE:
S1GNATURE faF FERAAiTTEE CITY iNSPECTC}R
401?dtV oF eagan
P,aTRICIA E. AWADA
Mayor
PAUL BAKKEN
PECGY CARLSON
CYNDEE FIELDS
MEG TILLEY
Council Ivfembers
THOIviAS HEDGES
Ciry Administrator
Municipal Center:
3830 Pilot Knob Road
Eagan, MN 55122-1897
Phone: 651.681.4600
Fax: 651.681.4612
TDD: 651.454.3535
Maintenance Faciliry:
3501 Coachman Point
Eagan, MN 55122
Phone: 651.681.4300
Fax: 651.681.4360
TDD: 651.454.8535
www.cityofeagan.com
THE LONE OAKTREE
The symbol of sirrngth
and growth in our
communiry
September 10, 2001
Carlos Barahona
4010 Blackhawk Road
Eagan MN 55122
Dear Mr. & Mrs. Barahona:
City staff has continued to follow up with the United States Post Office, Eagan
branch, on your behalf in an effort to persuade the mail delivery personnel to
allow movement of your post office mailboxes from the west side of Blackhawk
Road to the east side for addresses 4010, 4056, 4060 and 4064 Blackhawk Road.
The request was initially denied and then reconsidered at a later time. Scott
Vikers, &om the Eagan Post Office, contacted me inquiring about the possibility
of installing a bigjer 1DCDU group box at the same location where it currently
exists at the intersection of Taconite Trail and Blackhawk Road.
Please contact me by phone (651-681-4687) or e-mail (tstntve@ci.eagan.mn.us)
and let me know if a group mailbox for your home mail delivery in that location
would be acceptable to you in lieu of your individual box on the west side of
Blackhawk Road.
Since ly,
? ?U?
Tom Struve
Public Works Coordinator/Administrative Assistant
TS/jj
Estoblished in 1962
LtyT' SURVEYS C+QMPANY9 'NC. F gONO No 36709
LAND $URVEYORS
BEGI3TERED UNDER LAWS OF STATE OF MINNE$OT
7601- 73rd Avenue North ?0-309
Minneapolis. Mlnneaota 55428
?#Cp??itt"s .??l(C?.'
NEN DIRECTION HOMES Rirst floor elev. e`?''•4
Property located in Section
20, Township 27, Range 23,
Dakota County= Minnesota
Property address: 4010 Blackhawk Drive
D?Erz\vUt?t?
t?s6.69
r?,,.,_.O, N • WI R.ES
-?
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? • '
?x.
M 887.4
? 887. So . n?
T L }:
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?*.
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SCALE I" = 20
o Denotea Iron Monument
o Denotes Wood Hub Set
For Excavotion Only
x000.0 Denofes ExittinQ Elevation
onr;o Denotes Proposed Elevation
•E- Denotes Surface Drainaqe
f' `j 2kProposed Top of Block
Proposed Garoqe Floor
??' t• Z Proposed Loweat Floor
Type of 8uildinq - ,
?
3
-DRrvF-
Cr.0JG GufzES
cArGH
BA'Si hl
mn 886.5zTc --10z.Zs--
PowE(L
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0 < 88?95 '
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\0-
ry
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vi
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j - vo
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? $89 2 K 5/
i ^
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4 86?,Z ?
?• - _ gea.9
j 1.47
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tjpz,v E
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0
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01.0 G g903? -- 9711 - _
Bo K `q°
` I r ^ A r ? ` ?
i ^
Lot 2, 18A-&A;,J
TM onlr ooertents ahown an from plata of ncord or iniortnatlon provided by
client
INw hweby cwtiry thM thls le a true wd caroct repreasntAtion of a aurvey of the
baundmfsw of ths Pbo" dsecrtbed Iand and tt?e location of ali bufldinpa uM vfa-
ltsa.ncnoeictWr?.t,ta, Itany, tron, or «, aWa Wa. sigraed ?1C. -' ???,?-•''?"'' .? -? ?.f ??
3urv?eyed by ua thla 17th ? of March 19 94
Ray ond A. Prdsch Minn. Req. No. 6743
R Cv I1? c?e? 11
.
?
4%
1994 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD
EAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR SINGLE FAMII,Y DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNTT.
--------------- - ------------ -----------
NO.
?
I
?
--?-
?
SITE ADDI
OWNER N.
INSTALLE:
ADDRESS:
CTTY:-.-SG?
FIX7'URES
SHOWER
WATER CLOSET
BATH TUB
LAVATORY
KITCHEN SINK
LAUNDRY TRAY
HOT TUB/SPA
WATER HEATER
FLOOR DRAIN
GAS PIPING OUTLET • minimum - i
ROUGH OPENINGS
WATER SOFTENER
PRIVATE DISP. • neI.cty. uG
U.G. SPRINKLER ' home uader oonst.
ALTERATIONS • co edswng
WATER TURN AROUND
STATE SURCHARGE
TOTAL:
EACH TOTAL
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
3.00
1.50
5.00
20.00
3.00
20.00
20.00
?
+? Y
? .,
.??
?'.
.50
11`+?? (/^??
8? . f 4...? I{,,, '
-
ZIP CODE: -J-? 7 ?
PHONE #: (Co / OL) q,/ j--5
.
?
SIGNATUR P
r ,
?
1994 PLUMBING PERNIIT (COMMERCIAL)
CITY OF EAGAN
3830 PII.OT KNOB RD
EAGAN MN 55122
(612) 6814675
PLEASE COMPLETE FOR ALL CONIMERCIAL,/INDUSTRIAL BUILDINGS. AISO FOR MULTI-
FAMILX BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH
DWE ING UNIT.
NEW CONSTRUCTION
ADD ON
REPAIR
WORK DESCRIPTION:
T, .
CONTRACT PRICE: $
FEE: 1% OF CONTRACT FEE.
STATE SURCHARGE: $.50 FOR EACH $1,000 OF R? FEE.
......... .........
MINIMUM FEE $ 25.00 .......... ... ..
CONTRACT PRICE X 1% $
STATE SURCHARGE $
TOTAL
SITE ADDRESS:
TENANT NAME:
OWNER NAME:
INSTALLER:
ADDRESS• C
CITY:
PHONE #:
$
1o
,
t
L?=
, aA
^ UG% Q '-
STE. #
ZIP CODE:
S?.
FOR:
CITY OF EAG APPUCANT
? _ . . IN
, is ?°`=Y OF EAGAN
? 3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
?. (612) 681-4675
SPE C' TION RE
C01?D
" PERMIT TYPE:
Permit Nurttber: ow`' 7 7 91
Date Issued:
?'WE AQ RESS- tY .. .f , r? . ; 10 1 14 k) 10 . 0 .x 0 . Ol
'
? 4010
€t,????AM(
? .::.
PERMIT UBTYPE: ?
r
? APPLiCANT:
HAti AtsONA
(6J :?) 4?,Ft ' " 913J,
TYPE OF WOR1C:
?? ? ,
Pemmt NC. Pertnit ikrtder f}oft Teiephone #
El.ECTR6C
PLllMBltV,Q
HVAG
Nraipet2tiot Gnte imap. Commeets
FOdTiNGS
FCfL1t1C1
FRAM1PtG
ROOFitdU
RQUQN
PLUMBING
PLBQ
AtR TEST
ROUGH
HEATiNG
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG 1/e??
d
DECK FINAL
a`fl f
?W ?i
4
1 Plr~
, Psm* e ?i V
? D*e,
L (41 M_
. ?.'. l?i??:? /1PPL??V'?''?R T•
?
!
f?? ??. '-.. . ii [, H# K. K i i.AWt P D ? az
t.? { 6.oJ Il - ff Cf IO!l 14 0 x'1 f..
of
TYPE
WORK b
V¦
.
,? ? . . s+i : ,,. .. . ? ' . .
UOUNi.} i'i 1 t- QON . .. .
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- S .
R fj (16 i"l I U 14 T $a
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y y.g? i. ?"?F? y ?. i pry'c i! f ??if f.? 1 {?
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?s f. 1!„ i'z ? # (" fi? ?r A.1 {:k f .
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-40
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA107745
Date Issued:10/24/2012
Permit Category:ePermit
Site Address: 4010 Blackhawk Rd
Lot:2 Block: 1 Addition: Deerhawk
PID:10-19910-01-020
Use:
Description:
Sub Type:e-Windows/Doors
Work Type:Windows/Doors
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Chelsea Laughlin
2211 11th Ave E, Ste #130
North St. Paul, MN 55109
651-770-9011
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Carlos A Barahona
4010 Blackhawk Rd
Eagan MN 55122
Window World AKA Probuilt America
2211 11th Ave E, #130
N St. Paul MN 55109
(651) 770-5570
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA111704
Date Issued:07/09/2013
Permit Category:ePermit
Site Address: 4010 Blackhawk Rd
Lot:2 Block: 1 Addition: Deerhawk
PID:10-19910-01-020
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 .
Amanda Hanson
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 -
Carlos A Barahona
4010 Blackhawk Rd
Eagan MN 55122
(612) 709-9145
Prominent Construction Llc
5100 Edina Industrial Blvd
Suite 207
Minneapolis MN 55439
(763) 486-6003
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA130550
Date Issued:04/30/2015
Permit Category:ePermit
Site Address: 4010 Blackhawk Rd
Lot:2 Block: 1 Addition: Deerhawk
PID:10-19910-01-020
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
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: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Patricia Barahona
4010 Blackhawk Rd
Eagan MN 55122
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
r.... ... ..... .__ ... . . .... ._ , .. .. .. ........ . __. ...._. .. ,.... .... . ._. _ ........ . _ .. .. .. .
;?�- `��� ���-;� Use BLUE ar BLA�K Ink ��
� �. ___� _�� �- _ ���
► For Qffice Use �
,al� �:i 20,� ; . 1�,�s�,� �
` ' .��l�
Perrn►t#:
CI�� o� ����� � ������. ;��. �� �
3830 Pilo#1Cnc�b R+�Bd � � ��
Eagatt MN 5S'122 j Dat��er�eived: �
F'hvne»{651j 675»56?5 I 1
�a�c:��ss�3 sz�-s�sa� � st��: �
i i
.f�—....... .... --�..�� . .. ...�:�..J�
�0�1� RESIDEI''�ITIAL �3UI�a1NG PERMIT APPL.ICAT`IC�N
�e: ��,����� sne aaa�es�: '���0 13�•r�� H,�w,� ft�� un�:�;
..� , �. . .� �.x,v�� � �._ � ,..� ����x�, � , � .., �.�... ._, .�. ��, �
� t
# Narne: '��+�:.,lt�.. �*..� Phcane. �.2�'�_�:�' � (''�� ..�
$ ReSid811fi1
� . ` � �' , �
� Uwner # �ddress r city�Zip: �►7 :�.e r �
�
` Applicar�t is: Uwne� �Contractor
w... . ,�.n, ... M, ti�,. �. v -x�: �� ,,��F... .,. , � ��� , ....
Type o�1fi�ork
Description ofwork:�,�l'��. i�-'�C'Ca-+LV�g.��''�AT�/L- ��MK(R /��J/�(,� ,�ATi�' f.larR
� w� ' , .`�E'.�i 1,�� `� Multi Fam�ly Suitd�ng {Y�s /Nn�j
...£x....r��.. ..��s. :�, r, Construct�c�n Cost', ,x �
x�.�ah.��r. .,.� .. , .,.,. _,�_.� �,�x�.x x.,�, �.� _ �.. . ,
�^�-- �
� Com an � Can#act: 1�� �.�
p Y�
Address. � �� � Cit�r: ���"L� �ry�,�.�'� �
Corrtrac#t�r �
��4{�..���G.��. ���✓� .Pl1g�P..1��� .�S���C���.�+C�`-'�s'+��`v� 74.+r f �^�,����a���R�ti�*tr�V►�. ��.i.
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If the pcc�ject i$exempt from lead cert�#ic�tion, please explain why° �
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i GQMPLE7E TF#IS AREA UNLY IF CCyNSTRU�TING A NEW�UILD1Nt� '
= In the last i2 months,tt�s#he City ot Eagan istued a permit f+�r a s�cnitar plan bas�d`on�master plan?
Yes No I#y�s,dat�and add�e�s t�f master pt�n: �
� Licensed Plurnber: Phone: , �
� Mechanical Contractor; Phane: �
k ;�.wver&Water ContractQr: Phone, �'
_ .Fire Suppressi�n Contractor; Phone:
�.i -AI�TE.Plans and supprrrtingr docurrrents thaf y��sU6mit are consiclere�d fv be publlc fnformatfon. Partfon��of��
� ##r�f»farmat�on may be class�fled as»�n-pu�rlic!t yo�pravfde sp�ciffc reasons#h�t wo�rld�m1f the�`fty tr� �
���� _ _ .,,�., r rz. . :,�<��At corr�lude fh�t�he are�ia�le sec'rets �x .,v, , . . ��.__ _ � , . ,��
�,ALi�BfFQFtE YOU D1G, Gafl GopherState t)ne�alt at{65#}454•OCf02 for protection�gainst underground utility dam2�g�. Csll 48 hours
before you intend#o�iig to r�ce�ve bcates at underground utilities. .qop�rerstateonecall.orp
I hereby acknowledge t�aat this informa#ion is complete and�ccurate;that the worlc wili be+n cxinfc�rmance with the crrdi�ances and�des of the Crty of
Eegan; #hat 1 understand this is not a permit,but anly an application fo�a permit,a�►d work i� nflf#o star�wikhou#a permiF;#hat the wc�rk wili be in
aixorclance with#he approved plan in the case af+,�rorosk wh'rch requires a review an�f�ppravai uf p�ans.
Exterior work��tharited by a building permit�ssued in a+o-�rdance with the Minnesota Stat�e Buitding Gode eomple#�c[wfthin 1$0
days o#permit issuam�.
_,
x �t��l� ��t,��'�� _
Applicant's Printed Name Appiicant's Sign e
Page#of 3�
_._. � � _ ____ _.
L�K �`'L�- /.��-�� �
`"7D�C� ��f���l� DC1 NflT WRtTE SELCIIN THIS LINE /
/
�
SUB TYPE^�
Foundafion � Fireplace Parch(3-Season) Exterior Ali�ratian(Singte Fami�y}
'� � Single Famity � �rage ! Porch�4-Seasor�} � Eacierior Alteration(Multi)
I Multi DeCk Porch{Scr�nlCazebofPergala) � Miscell�aneous
_ 01 a#�Plex � Lower Level � Pao! Accessory Buiiding
Wt3R}�'TY�ES 1 . .
" "�• :�`, ::'F i..�.,.^ � .� ,�A..,,.,•A �,, ';,
_ New � Interior Improve�nt S��i1�g'� ' qe�r+oiish Bui[c�i�"" . ' �
� Adtlition _ Move Buitding � Reroof __,, i}ennolish lr�teri+pr
Atteration Fire R�p+air , Windows C�emolish Foundation
� Replac� ____ Repair � Egress Window � Vf�'a#�r Damage
R�taining Wall *t}�re�oletion of entir�building-glv�PCA handout t�eppifcant
. .�� �,�,�,o�
�atiart��° ;': °,.'`;.''�'��•� '� �lccupancy .��2G- / MCE�System —
P{an Heview / Code Editic�n 'Zd�7 SAC'Urtits `�
{25%____ 100% Y ) ZOtli�ig �–�� C�t'�/W�t�!' r
�ensus Co�le y 3 k �tor�es `�' 8ovster Pump �'
#of Units � Squar�F�et � PRV �
#af 8uiltSings 1 Length — F�re Suppression R�quir�t! —`
Type of Construc#ion ___� Width '�
REDUiRED INSP��TIONS
Footings(New Building) Meter 5ize:
Footings(Deak) Finai!�,fl. Requi�ed
Faotin�s(Additian) � Final I Nc�C.{). Required
Fou�tti�tion HVAC�Gas Serv'sc�fiest G�s 1�'sn�Air Tes#
Roof:,_ice&Water ^Finai Pool:_,_,Footings ,�,,Air/Gas Tests ,�_,,,,Final
� Framing Drain Tile
Fireplace:_Rough in _Air 7est ,,,�Fina! � Siding:�,,,,Stueco Lath _.,,,�Stone Lath ^Brick
� Ir�suiation Windows
Sheathing R�tain�ng Wa!!.,,,_Footings,,�„�,,,S��kfili_Final'
Sheetrock Radc►n Cor�tro!
Fire Walls Fire Suppfession:_„_„:f�augh in��ina1
�iraced Walls Erosiar�Cantral
{�ther�
�I Reviewed By: ,Buiidin�inspector
�,ESIDENTIAL FEES
Base Fee 7 3�
Surcharge
`�'lan Review y 7 94
MCES SAG
Gily SAC
Uttli#y Gonnection Charge
S&W Permit&Surcharge
Treatmen#Piant
Copies `� � Z�
TOTAL
Use BLUE or BLACK Ink
r-----------------
I For Office Use � �,
� � Permit#: / ��/�—� �"'� ,
Clty of �� a� � _ ;
� � Permit Fee: �� � ;
3830 Pilot Knob Road � � '
Eagan MN 55122 i Date Received: �
Phone: (651) 675-5675 i �
Fax: (651) 675-5694 I Staff: �
�-----------------I
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION ����
Date: Site Address: �� �� � ��-���,f�-�-�2�-� �`� '�
Tenant: ����� �� 6 k � Suite#: �''�
�tesid�en#�()�►r�er ; Name: f�_���^I c t �Y � °,- �/�,.c�}' Phone: �I
Address/City/Zip:_ �0 � � � t �C��,�-�-(� ,
�
=� Name:��C✓l � ��v k�<�� ����-/ rx� �. t1��� License#: s� � O�' �i� �
Address: � ��x �� City: V��r l� i �°1
C�n�ractor � —r I
State: � � � Zip: ��U �� Phone: � r�'d` ��"� � Z ��
Contact: � � EmaiL• � !2� � G t� � � C - �O r�
�T�I�e'�Df�l�Clc �.� —NeW ��eplacement _Repair _Rebuild _Modify Space _Work in R.O.W.
' Description of work:
RESID TIAL
: Water Heater
Water Softener
Lawn Irrigation(_RPZ/_PVB)
P�����T��� Add Plumbing Fixtures�Main/ Lower Level)
Septic System —
New Water Tumaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge)
$60.00 Lawn Irrigation(includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic Svstem Abandonment, Water Turnaround'(includes State Surcharge)
''Water Turnaround(add$210.00 if a 5/8"meter is required)
$115.00 Septic Svstem New(includes County fee and State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orp
1 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 approva f plans.
___.----.._�.. -_. .
X �` � C �r� � X
Applicant s Printed ame ApplicanYs Signature
:�C�R OFf�CE USE ' `Reviewsd By: Date: ` .
Required Inspections; Under Ground Rough-ln Air Test Gas Tes# Fir�al
Meter Related Items: Meter Size Radio Read Manorneter 5taff.
Use BLUE or BLACK Ink I'
�----------------� li
I For Office Use �,./
�
' � Permit#:��� �'�-''
Clty of�����
' _��- e�t5 �
3830 Pilot Knob Road � Permit Fee: � ,
Eagan MN 55122 � I '
Phone: (651)675-5675 � Date Received: � ,
Fax: (651)675-5694 ► � ',
� Staff: �
�-----------------� I
2015 MECHANICAL PERMIT APPLICATION II,
❑ Please submit two(2)sets of plans with all commercial applications. I
Date: Site Address: v/ � �� ( ����� �� I
Tenant: �� �'� C'"�� �}� Suite#:
' ���
F�����? : w : (� y�
��� Name: t'�-f ri G�� !'`j�..y,��0 ri. �tj- Phone:
i�
F�t�S[der�#fC�Vn� T— �
# 1�
' Address/City/Zip: �0 J l� tr 2� �
. Name: Y�/ ���L f� � License#: �� � Q� 1' �
�Q /' �
o� Q' , �. `. f.. ,Gl
• O � K r�t L
' Address. lo City: «� C O
GOCI�C�C'�{��
�..: : �I �
�s��
, � � '' State: � d� Zip: �S���� Phone: � ��' � ��`�3 �U �
�
; , ���; ., >� . - Contact: � �- Gi � Email: � `t � � �!!�t � C, c a Iti
` : �� New Replacement Additional Alteration Demolition
��. �a�
' '�`ypg��yy���� Description of work
��
a �.:
��, , a�3 ... `��°��, ,� . �a� � �"� .� ������
NQ'�t�Roof mvun��a�t�t�� \r��i�n�t�#�ted m�c���n��aF�qu�p�t�r�t 1�r���r�.to I�;��r�n�d I�y����r�;
C'r�+de P[eas�can���t��� k�arwi��l Insp�ct��fr�r��t�i�rma��p��i�p�t�i�,t�d screen�ng rnetFto�s, ,�'
__.... �. ,+. , __- . , w ... .,�._ �
�..
� :
; �a� RESIDENTIAL COMMERCIAL
� � Fumace New Construction Interior Improvement
�
� —
���,����=��� _Air Conditioner Install Piping Processed
° ��. �
�• y� _Air Exchanger Gas E�erior HVAC Unit
> �
� � � , _Heat Pump _Under/Above ground Tank (^Install/_Remove)
;� � �,���,
��� Other
�.. �.
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge
$100.00 Residential New, includes State Surcharge =$ TOTAL FEE
COMMERCIAL FEES Contract Value$ x.01
$60.00 Permit Fee Minimum, includes State Surcharge
$70.00 Underground tank installation/removal =$ Permit Fee
*If contract value is GREATER than$2,010, Surcharge=Contract Value x$0.0005 -� Surcharge"
If the project valuation is over$1 million, please call for 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 ���G1- �� f��f!/l � x
Applicant's Printed N me Applicant's S' ature
a�� ����a���� �� ��` �� �� � . - �� � "
�� c G� a�`�'a� - ��.
,. � x
R�t}�t�Bd��sp�:Gtl� � ' � � R��I��tM�a{� �y � ��� = C�af�
������ �����
t��iiergrc�und . `�c��c�h In ,,,�,,,A�r.Tes# ��s 5erv�c�Tesf ,;�„�„It�fl�or H�at� ��tn�[; I,�,,,H���'�creemric� y�� `
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA140705
Date Issued:01/17/2017
Permit Category:ePermit
Site Address: 4010 Blackhawk Rd
Lot:2 Block: 1 Addition: Deerhawk
PID:10-19910-01-020
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Patricia Barahona
4010 Blackhawk Rd
Eagan MN 55122
(612) 709-9145
Minnesota Rusco
5558 Smetana Dr
Minnetonka MN 55343
(952) 935-9669
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA146932
Date Issued:11/27/2017
Permit Category:ePermit
Site Address: 4010 Blackhawk Rd
Lot:2 Block: 1 Addition: Deerhawk
PID:10-19910-01-020
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 500.00
Fee Summary:BL - Base Fee $500 $40.00 0801.4085
Surcharge - Based on Valuation $500 $0.50 9001.2195
$40.50 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 -
Patricia Barahona
4010 Blackhawk Rd
Eagan MN 55122
(612) 709-9145
Crew2 Inc
2650 Minnehaha Ave
Suite 100
Minneapolis MN 55406
(612) 276-1680
Applicant/Permitee: Signature Issued By: Signature