4064 Blackhawk RdThis request void 7/? 'L b'i `S l ? c???JA ct to K ?kbc? ?,..? 3-7 18 months f4et .?SLGLQ ?
Date of this June 15, 1981 Fire No. T(3O1 7
I, as)QUcensed Electrical Contractor O Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Route No. 4064 B1 ackhawk Road City
Section Township
Range County
Which is occupied by not occupi ed - Langenfel d& Sons, Contractor
(Name of Occupant)
Is a raughin inspection required on this job? No 0 Yes 55C Ready Now ? Will Call WX
Power Supplier Oakota E1 ec Address Farmi n.gton
Eiectrical Contractor S. P. & H. ELECTRI C Contractor's License N040008
(Company Name)
Mailing Address
Authorized
tl [tcaic.'_ onor or owner
? ?? DORM 'LOIOPY
Ea , Hasti ngs iNiV 55033
dr Qwn aking This Instatiatton)
Phone No. 437-$535
This inspectian request will not be accepted by the
State Board unless proper inspeetion fee is enclosed.
Minnesota State goard of Etectricity
Griggs Midway Bidg. - Room N191
7821 University Ave., 5t. Paul, Minn. 55104 - Phone 297-2171
EQU?"'T FUR ELECTRICAL INSPECTION
CHEGK ?LS;MRK COVERED BY THIS REQUEST
Eg.00001-02
?s & U'a,
T 13017
Tyge of Building-New Add. Rep. Check Apptian ces Wired For Check Equipment Wired For
Home >M ? ? Range El Temporary Wiring ?
Duplex ? ? ? Water Heater ? Lighting Fixtures ?
Apt. Bldg. ? ? ? Dryer ? Electric Heating ?
Commercial Bldg. ? ? ? Furnace ? Silo Unioader ?
Industrial Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ?
Farm ? ? ? List List
Other
?
?
? Others?
Here Others?
Here
COMPUTE INSPECTION FEE BELOW
Seivice Entrance Size: # Fee FeedersBcSubfaeders: # Fee Circaits: # Fee
II&LI Am s. 0 to 30 Am eres 0 to 30 Am eres
10 0 ? s. ~ `", 31 ta 100 Amperes 31 to 100 Am eres
A 0 Amps: Above 100 Amps. Above 100 Amps.
Tr for 7t Remote Control Circ. Partial or other fee
Signs Special Inspection Minimum fee
Remarks
TOTAL F E ? C?
3]. 5
I; the Elecirical Inspector, hereby cer ' at t veOnspection has bee m?'"`
(Rough-in) Date ?j 114
(Final) _ , Date i-y
This request void
18 months from
CITY OF EAGAN
3795 Pilot Keob Road Eagan, MN $5122
PHONE: 454-8100
BUILDING PERMIT APPLICATION
Receipt #
N2 6634
To be used for SF 1??/GAR Est. Value 63,000 Dote 5-1 , 19_.81...._
Site Address 4064 B1 khaWk Rr7 Erect ? Occupancy -- R3
Lot 3 Block Z Sec/Sub. BlaCkhaV& VbOdS Aiter ? Zoning Rl
10 14390 030 OZ ° Repair ? Fire Zone
Parcel #
Enlarge Q 7ype of Const. Vri
W Name Wal ]Y Haf? ad Move ? # Stories ?- 2
Z
0 Address Demolish ? Front 62 ft.
Ci Phone Grade p Depth 38 ft.
ix ?.JQm I,angenfeld Construction
Approvals
Fees
oo e
? Address Box 483, 1317 VernLillion
Hastings 437-8007
Name _
Address
I hereby acknowledge that I have read this application and state that
the information is correct and agree to comply wi h all applicable
State of Minnesota St utes d City of Ea gob-OrdiFtances.
Signature of Permi `,
Buiiding Officiat Asses
Lan. CO
A Building Permit is issued to:
ll pica Sta of
all work shall be done in accordonczl?12-?.
AQ'snt!?.-qQ-$1,-
Water & BeTg 4.-30--A
Police
Fire
Eng.
Planner
Counci I
Bldg. Off.
PermiY -L-» • vv
Surcharge 31.50
Plan check 79.50
sAC 525.00
Water Conn. 335.00
Water Meter 60. 00
Road Unit 185.00
I Total 1,375.00
`vil on the express condition that
StaYutes and City of Eagan Ordinances.
CITY OF EAGAN
?- 3
? 3795 Pitot Knob Road Eague, MN 55122
PHONE: 454-8100
?
BUlLDING PERMIT Receipt #k
To be used for Est. Value Date
NO- 6634
19
. v?...
Site Address ?.
Erect 0 ?
Occupancy
Lot Block SeclSub. Aiter ? Zoning
Parcel # Repair ? Fire Zone
Enlarge ? Type of Const.
W Nnme Move p # Stories
z Address
3 Demolish p Front ft.
?
Ci, Phone
Grade ?
Depth ft.
ce Name Approvals Fees
O
Ou Address
Assessment
- Permit
F' Cit Phone Water & Sew. Surcharge
?
t
Police
PI4n check
Z Name Fire SAC
P
? Address Eng. Water Conn.
U
4W Ci phone Pionner Woter Meter
Council Rood Unit
1 hereby acknowiedge that i hove read this applicotion and state that gldg. Off.
the informotion is correct ond ogree to comply with aN opplicable
Stote of Minnesota Statutes ond City of Eagan Ordinances. ApC Totai
Signature ot Permittee
A Building Permit is issued to: on the express condition thot
! ail work shall be done in accordonce with ali appiicoble State of Minnesota Statutes and City of Eagon Ordinances.
, Building Officia!
r y
Peneit # Dats iseued ?, PeemiMee '
Plumbing {'j i,t.? Q Yti. 'P ( <J- ?(
Mechanical
0-_}t' Ccc?? 713ca('1 7-1. ?-( c
INSPECTIONS
FOOtingS
Foundation
Finai DATE INSP.
iumbing
Mechanimi
Rough-In
Uate tnsp.
Final
Date Insp.
Remarks: ?t f
?
CITY OF EAGAN Remarks -3/
Addition Lot 3 Blk 1 Parcel #,L(j 14390 0-40 Q],
0 ?ner-1011.
screet_ _4064 Blackhawk Road State Eagans MN 55122
ImIAovement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADtNG
SAN SEW TRUNK 1970 Pa1C1 Urid parce2 060 75 S CtiOtt 20
SEWER LATERAL "- 1982 24~ 04_ "12q,$,Q Ip 873.64 A014099 6-19-84
,
WA7ERMAIN
WATER LATERAL
b 'n
os s
WATER AREA 1977 233.33 15.56 15 C 00 Z°I 315
STORM SEW TRK t 1982 1381.52 138.15 10 $967.07 A014099 6-19-84
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT ?.. ?
oa Unit 185.00 24455 5-1-81
WATER CONN, 335.00 24455 5-1-81
BUILDING PER. 6634
sac 5 00 44 5 5- -81
PAR K
!
IK ?
3
C?
?
?
CITY OF EAGAN
BUILDING PERMIT APPLICATION
Include 2 sets of plans,
1 site plan w/elevations &
_ 1 set of energy calculations.
To Be Used For r: Valuation .?` e7 ? Date
Site Address: OFFICE USE ONLY
?
Lot ? Block Sec./Sub: 1 Erect Occupancy
Parcel #: c-2/ Alter Zoning ?-) -
Repair Fire Zone _
Owner : W???? Enlar9e Type of Cons t.
?'-r`r--• _ Nbve # Stories
Address: ? DemIish Front ? y- ft.
City/Zip Code: Grade Depth 3r ft.
Phone #:
APPRUVALS FEP',S
Contractor: Assesssments ? Perniit
??--J?_
Address • Water/Sew?er : Surcharge --
' :• Polioe " Plan Check ?3
City/ZiP Code: f?4 snn,a Fire SAC ,S"zS ?-
Phone #: ~ Erig. water Conn. 333?0-
?.?
Planner . rWater Meter 6 D--
Arch./Eng.: Council Road Unit
Bldg. Off.
Address : p,pC ?
City/Zip Code:
Phone # : IUTp,i,
rtificate far:
Wally Hafataud • . ? ?, {
DELMAR H. 3C ?IVANY ., ? ?,
i.ANDgURVEY?'tA '
RMistaid Unda uvrscf T11? ltib? ? Itlitnn?wu ,
2878 - 146TH 8TREET W. - QOX M 11aiEMOUNT, MOMIOWTA 98M mMONH 612 423-77N
' SURVEYOR'$ CERTIF1CA1
-7 VeJ
. r ,
go ?
?G'31 I
= ? ? ?` ? ? i • ??? ;? '
8? ra :
U'n,.r? ?wmw I h,
144?
L
sF. ?
.-
?,
?,y ?a? y,?y w
I L1'F??'L?Li '' ;r`,U??.1.f,2' tx`?.k?{t t16..4? ib ?. t?e GNad '?s?' ????8??fi?a{r30sa 0f
r.ot 3, ? tY? r? 1 , Bi?kCKIiAWY, WOO13S, aoa3ording to the recorded p1at
thereo_f, Dakota !%omtya Nfi.nneaota. ,
Daterl_ Octvber 20 ? 1980
.?
? ' I? (?/ ' iIf J
IGISTRATIONNO 8625; t
r _
1,
2.
Determi.?e working squa?rit faotAge o# each. '
q
Total eXp.?S,O wa1l a't'es ...,? ? _..,.....?,??-...» sq. ft. Ta
?
Total s-oaf/cei?ing arei ..... _.?. ??...? ?1?•?.--.?,,, sQ* ft# x ? ¦ ?,???,'? ,,.
TE) ta 1eXpO Sed MNR ll area &WM4M OW't
a e n16 s, s. s a a. 7 0- - F+ 4
a. Total waT l w1ndrnr area . .... . s ?
a A. s •.e r e•.a.mNqaK?loi?sl??t4?+• • ? ? ?
b. T01tal dcflr are8
?. Total ??????? ???ss.<door ap`"" •aer16?,-fr'?f?.iswi??o?.aa?? " ? ??? ?-
d, Foi.U l 1 ireplOi.e R'a4qy • a/ $? e a r v b s ce 6 A A G i ? 4'a t ? ? 1 ? • . . ?, .
e. 1'otai waii fra?ing area a?era",'t??,?`..:..,,.
fi r. Total net wa 11 are& above floor .... a ?. A ?;.. .... .. ?
g. Total rim joist aree . . .i . . . . . . g s ? ? . ... ???-.... 4 ...
. ?
Total ex???? fowidation
'p?i?7? A?k?.rs'??isia??ts??A??wsa-s• .??.
'rotal io??da4ion !1
i. Toai M 1
. e?+ filifnVKi tio(j arGa 6i{/ofo
De termi ne "U" Vai " Of eimth rMll, lwlprr?t.
ti. , .
? ?sj? x q-
^2 ? x
C. ,____.._._...._....0 cl._...., x NU~..+s?.r?e?ir?+?l??.; .
d X -U* '7 ? Z
e • _ ._ _._._! 140 Q7- X "?" ' ? • ?.- "` ?--. I 1 '
_ .?._.,......,
2 Lo b % x %u"
A IOilM
t FA
M6/
?t
?.'.v"...,..?.......?.?r+,. ».. ._?.??.__..--.
'?6??l ,, ?? ?
1 . . . . . . . . . . . . . . . . . . . . . . . ,. . . . ? . , ._?..?.-
If item 03 is the same as, or 1e%s thata itft Oto Yvu havP met? tit- in;:erlit
6 00 5(r:?2. .
91
14,
.:?-.?..-
?-
;
4 ls? L} ?
?-.
.'?
.?...??.?,.?.._...
Tot:s l gross mf /q11 ?
.? e i o?.?. '?..?^. l S 5'iy!!ghF +E t$i q9 a a M b? Y?? RY• i? It ? r?`'??' 1 M 1 f ? 9?} i t ?? Li l, ?,_,?l?
?:. Tatal roof !ce ilirr3g fr°am1?,c? ??°-? :???.:N , , . . ... . ?'?.5. {??
1,. '1c?fi?1 net instilate9 roof/ceiiirg
D?,iemine "Ulova?ve for' 00c* °????i?? ???L?
__..?..?._.. _,.-e._...,_v... ??'? .?..,?,.,_ ?_.....
%°.,_.._._..._.
k.
'Y . , . . . . . . . . , , .. . , To![. wGS l
'i#' tota1 f?f i? the !?ame tsA f!r l E'SS ?itak4 02, yoit haYE Itte? the intP_ilt of
Tv Liti 3i et` ')e tJfi,i31 envelcappe s:y`Stmi a?thee., the va11ots establ4shed kv the
,kpp of Ite-i.s P z-?nd #4 shaali rtot: be gree:er ???ft the sun of ftem 11 and M
?r
+ ?' ? .w._..,A..._.?.... ?.?..??,. "? ....?..?.?,,.._...,?
rv
- _ __,._ ._ .__? +
_ _ .__.._...,.n.. 4?
?.?. ?
.,......a,_.?.._ ..__..?,.._._ ?.
x??73* T A ?z
R 7Ct FtZ`i tS-? ??.T
N : els. rip' '4 t t ? 1' ?'i,t
•);?f?k?.r:° #.?,?f`.
u $o A? ?r ?, ' t r ^i'tk
?'. ?l At
rs ? # y
•,.n+?..4??k?. ` ;y? 'fr ,, '!
.....ad.' ? ` '. x
V.?.»,.?.?.
t
41
?
r?
PLEASE SIGN AND RETURN ORIGINAL COPY TO THE CITY.
Special Assessmen Department
wAXIVEa O. HU-=Na
ELQtJF'?ST FOF GTILITY nOi'wTJEMENTS
I/'v.n hcreby reguest of the City Cowncit, City o¢ 13agan, +
K!,-,.,zezcta, utility ir,.proveqnFnts on and over prcpe.t-tY 0113e3 by as
:.:llc::s: (Mer..+-.:on tyge cf improvement, e.q. wat..er• sanitary seke:, ctc.)
LATERAL BENEFIT FROM SEWER AND WATER AND STORM SEWER TR1N_.
5"ae ln--ation of srid utili.ty 3mpmvemsnts ehall bc3 genErail1 ss x:.i;.?•'-
Blackhawk Woods Addn. Lots 1, 2, & 3 of Block 1
TOTAL ASSESSMEi3'TS $60I3,11,
If not paid in 30 days will be spread for 10 years at 8% interest.
I/1-13 hereby waive notice of any and all hearings necessary Car tY.e
i.zstalla.tt,on of eaid i.-npzovcments and further eonsent to e-ny as. c:.? '?r.:•s
nec..saa.=ily lEvied by ths City of Eaqzn for such ia+proccaentz-
I/t-ie furthsr agree to qzant to the City of Eagan txay ezsem:nts .^._
sazy for the installati,on of such impzvvements.
It is further understood that this request shall be'rnviewe3 by the
Cilzy CoLacil of The City of Eagaa or ita aqent and I/We will be g+yen
ream.iab?e notice as to whether this request ia possible uader FseEent,
uti? ity plar.ning as to timing, lo , etc• ,
/ j
? ,
???t_
D:.±ed: 3-2-81 X ?_
Siqaature
( a41
Tyd?e?s
F:eTses` accer-ted b D3ta
Cl-ty of Eagan
Raquest referred to City Administratcr:
Date
Copies: 1. City Adninistrator
2. Applicant
city oF eagan
PATRICW E. AWADA
Mayor
PAUL BAKKEN
PEGGY CARISON
CYNDEE FIELDS
MEG T'ILI.EY
Council Members
THOMAS HEDGES
Ciry Adminiscrator
Municipal Center.
3830 Pilot Knob Road
Eagan, MN 55122-1897
Phone: 651.681.4600
Fax: 651.681.4612
TDD: 651.454.8535
Maintenance Faciliry:
3501 Coachman Point
Eagan, MN 55122
Phone: 651.651.4300
Fax: 651.681.4360
TDD: 651.454.8535
www.cityofeagan.com
THE LONE OAKTREE
The symbol of strengch
and growrh in our
communiry
September 10, 2001
Robert O'Neil Jr.
4064 Blackhawk Road
Eagan MN 55122
Dear Mr. & Mrs. O'Neil:
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, from 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 (tstruve@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.
Sincerely,
l jYh ),?
Tom Struve
Public Works Coordinator/Administrative Assistant
TSijj
2005 RESIDENTIAL PLUMBING PERMIT APPLtCATION F O
CITY OF EAGAN
3830 PfLOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date 2sv / o5f
Site Street Address y ?V,' 0L 1nC,,Unit #
Property Owner Telephone # ( Us1)
Contractor ?•-C-S ??,?+??+?CJ? ??,J?i? °i',T-1?(' ?KV ?GE--? _71? Telephone # (1l1SI ) I2`?
Address Z-qir\c117\dV-? ,,k.- City S 1?VlJk State V'V'Nr"', Zip
The Applicant is: _ Owner ? Contractor _Other
Alterations to existing dwelling $ 50.00
_ Add plumbing fixtures. This fee includes putting in a water softener and/or water
heater at the same time. lf rou are insfallinp onlv a water softener and/or water
heater, do not complete this section. Move to the next section and check the
appliance(s) you are installing.
_Septic System Abandonment
_Water Turnaround (add $125.00 if a 5/8" meter is required)
Other:
_ Water Softener ? Water Heater $ 15.00
_ new ? replacement
Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total $ ?
I hereby apply for a Residential Plumbing 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 the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
kl' "Nn?k-& ?4-U-01r1? VN\VV--- ? ?J&tivQ--
Applicant's Printed Name Applicant's Signature
Add
ess:
Stth
r
.
?-- -?
.
'
4 K •
IC+1e#?r ??a ` Connectian-CFiarge
Size: Account Deposit
_Rebde`r Na::- . f'ermit Fee.'- , s.`=?•.?
1 =o#rge, ;omP4! rrw Oe QtY-of ;Eo43*n Sur.eharge •? V7i;
a2m. ?AA9sC:
? ?{ Vt#Fl: ,?_ y ?-
_
. . . . . . ._ ,. ,:..-; .?.,.. : , s . ..: ? ., . _ ..... . ....... „
wto
m? . ?' .. ?
x
? CA
'P6K4MIT_.W
EagQni
171A _ 5-7122 ?DATE
171 n? ' ? ? `No. of Unats:
Owner. 'Frc`tt2L I,atif,*ei'!-f e1.d
k?
Site :Addres'st 4f~'?r ??-ACk.?22i??; ?'ta?3c:? Ik ??,I.-1??.3??.,'hA1s#k
' . 51110 ?I 2445;
*9r. to coniPljr with tlie C#ty ef ,Eogon " Corxncction Charge: 4?5 `t?-?-
t?rdinp+wes.' ,?ttcoeint f?e?sa:
PerrnRfee.:?? - 3Q.flQ?s-2
1: SUfGhQ(ge
?a ?.I'°.? 9ri._, •.?
•?
F ' .,I???r.?? ?;` '??`'yti:.
?
^:-T.
?
f( i??. ? '.,.? ?? ,
?f` 3 -?Arc.
., Mle" "IL POftMtt'
PM"
OM OF RM
.? . y, C .u, . .. .
AJ/!?A! ?Y iPfC ?
r? ?
Ty? t?ff' Pi"'? ....??__? T#t
1. Date 6J?I??I 2. Installation Cost
K.0,4?-c: K
3. Jbb Address ??-?( K.fNik. K??t 3 Bik. _? Tract `?` `?}c'i?:
4. Owner
q3
5. Gontractor
c.. ,I Q g
6. Address
7. City ° j*:,S ?State M i? Zip
8. Buitding Type: Residential & Commercial CJ Institutional ?
9. Work Description: New 19 Add ? Alter O Repair ?
. ,t ? ,s
10. Describe Fuel 7ype ?%`,-;?',C -! 11.
w 9TU - M. Ea.
,Force Air "'Jit ?_.
? No. Eaaipment CFM
AiY Handlin
:
iVlfg, 4'•x.,?';sa? g
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
.4 Gas, Piping Outlets
r
12. I hereby certify,that the at}ove information is true and correct, and I agree to
comply wAAlt ordt"naP9ds an codes gov,grning this type of work.
Signed.;* -w` r for ' Rough Final
' Inspections: Date insp. Date insp.
? This is your permit when numbered and approved.
o Approved -, ___ CITY dF EAGAN 454-8100
Rsseip# PLUMBiNG PPRM17 Permit No.
CITY OF EAGAN '
Fee
Fill in numbered spaces SIG -
Type or Prini /egi$ly a
Tot.
1. Date 2. Installation Cost
, f ? ?it-fiC !C F1 r1 tt k,
?_?)L? f:,? z
3. Job Address t` % KH t?',?Lot Bik. Tract
4. Owner
'V377-2l S'
5. Contractor Phone
t
6. Address /4-ll E'
7. CitY,i/
LL:Ti . State Zip
8. Building Type: Residential $l Commercial ? Institutional 0
9. Work Description: New §0 Add O Alter ? Repair ?
r 10. Describe
I 11.
Mo.
3 Fixtures
Water Closet No. Fixtures
C
Bath tubs esspool/Drainfield
Se
ti
T
k
Lavatory p
c
an
Softne
Shower r
W
l
Kitchen Sink e
l
Urinall6idet h
O
/
Laundry Tray t
er
Floor Drains
Drinking Ftn.
S
? lop Sink
Gas Piping Outlets
12. I hereby rtif ?h
yat the abpve information is true and correct, and I agree to
compty ww ht ' di?anq,W an?l codesge?erning this type of work.
? `?.?
r J.?'
Si9n for
? Rough Final
. inspections: Date Insp. Date Insp.
'This is your permit when numbered and approved.
Approved ?CITY OF EAGAW 454-8100
?'?„
?
6ilcOe5 4&t LITHOIN U.S.A.
Receipt PLUM'iING PERMIT
CI7Y OF EAGAIN
Fill in, numbered spaces
Type or Print legi,b/y
Permit No.
Fee
S/C
7ot.
1. Date '6- 7_ 11 2. Installation Cost
3, Job Address4bb4.LAc.xreiku,.)iC? ot a Bik. ? Tract
4. Owner ? A N 9
5. ContractorC ?? rv+m? us J?? ; W nA c:S? Phone- ? IJ'? ??'
6. Address C r'1 L, S7
7. City ? V?- S• State V-l Vo . Zip j j'-1 t!
8. Building Type: Residential P • Commercial ? Institutional ?
9. Work Description: New ?d Add ? Alter ? Repair O
10. Describe &Jt"4 ???.?..,
11.
No. Fixtures
Water Closet No. Fixtures
Cesspoot/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. 1 hereby certify that the above information is true and correct, and 1 agree to
comply with all ordinances and codes governing this type of work.
?gn?td:?v?-.a.?.? ??-?? for
Rough Final
inspec#ians: Date lnsp. Date insp.
Thia is yourri mit+rvhei? nurrbered and approved.
,..?.-?--
AAProved l,?_ Cil"t' OF EAGAI'd 454-8100
?
p
!
?
CASH RECElPT
,?.
CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAfV, MINNESOTA 55122
'
f
DaTe £ ' 19
RSCEIVSD
FROM - i
AMOUNT $
C?.??? 1.
?
8a DpLLARS
100
? CASH [] CHECK
?f
°
pOR
{ .
AIA OU
? `? •y? ?``?
?D -?,?
.2 01 .j ,' -3
ThankTou/?,
e?--° BY -?-? --?
,
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Mits-PaYers CyvF?Y
, YOtaW-Pcxsttog CopY
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Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - -
I For Office Use
Permit d
City of Eq, I
I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 i Staff:
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: L Site Address: Unit
Name: Phone: ~S(
Resident/
Owner Address /City /Zip:
I
i Applicant is: Owner Contractor
2,
Type of Work Description of work:
1 Construction Cost: ~a Multi-Family Buillding: (Yens / No
Company: \ S Contact: t -JI-9 d`u
r
Address: YV`~- City: ~J' j VW ~If~
Contractor I
State: Zip: 57'50 y2 Phone: & 0- - aS - 55 6~
Lead Certificate 1V
_~c 69 License X9 5-5-),
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
R the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
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.oopherstateonecall.ong
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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Build' g Code must be completed within 180
days oaf pan it isAuanee:
x ` ~z d` 0 _A_U_Z_ x
Applicant's Printed Name Applicant's Signatu
Page 1 of 3.
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA131360
Date Issued:06/16/2015
Permit Category:ePermit
Site Address: 4064 Blackhawk Rd
Lot:3 Block: 1 Addition: Blackhawk Woods
PID:10-14390-01-030
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
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 -
Robert J Oneil Jr
4064 Blackhawk Rd
Eagan MN 55122
(952) 926-6018
Krech Exteriors Inc
5866 Blackshire Path
Inver Grove Heights MN 55076
(651) 688-6368
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA143349
Date Issued:06/13/2017
Permit Category:ePermit
Site Address: 4064 Blackhawk Rd
Lot:3 Block: 1 Addition: Blackhawk Woods
PID:10-14390-01-030
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 -
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 -
Anthony J Hopland
4064 Blackhawk Rd
Eagan MN 55122
Fireside Hearth & Home
2700 Fairview Ave N
Roseville MN 55113
(952) 985-6675
Applicant/Permitee: Signature Issued By: Signature