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4104 Blackhawk Rd
Cs '0,Y OF Ak EAGAN R INSE,30-TA 5542"2, J • ~6/ ~CS~IO~ Li f Fd' Q~SLI.AS ~ o0 CA31 F" Q° HECK POR Amour4T All INSPECTION RECORD. " GWY OF EAGAN PERMIT TYPE: 3834 trot Knob Road Permit Number: .~,E"an, Minnesota 55123 Mete issued: : a 9 (612) 681-4575 SiTE ADDRESS: 10 "i 1 H V 0 t: K i H APPLICANT: PERMIT SUBTYPE: TYPE OF WORK: REPAIR FkAi41w0 r1 AI. Arlt l!~ 1hh~rr INIII, oil ntN PLAAQW "we BAMW Dow bwp. PAS r i iA MIP r IVA r f.. p M CW*RnN ft ow A Request Date Fire No. Rough-in Inspection i f Required? Ready Now 0 Will Notify Inspector El Yes No When Ready? I Gf. -q3 I IAlicensed contractor D owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) City 4i,o4 " Lcki4 w' TZD F- AG4)~ Section No. Township Name or No. Range No. County -IMko i 14 Occupant (PRINT) Phone No. Power Supplier Address .-D. F-A" WUr66J Electrical Contractor (Company Name) Contractor's License No. Mailing Address (Contractor or Owner Making Installation) +4 _ g , v , Q,;~'i! Authosiz ignature (Contractori(?wner Maki nstallationi Phone Number MINNESOTA STATE BOARD OF C CITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room 5-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. ~ESee QUEStT~FOR~EpLECTRI~CA~LbINSPEICTION EB-oo ot~a r_ 73647 K `X" BeloW Work Covered by This Request ` , . ew Add Rep. TypeofBuilding Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other {Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Contractor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps r 8 p Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only: TOTAL j Irrigation Booms j 35 Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORD D DISCONNECTED IF NOT Other Fee (j COMPLETED WITHIN 18 M THS. I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final Date been made. OFFICE USE ONLY This request void 18 months from CITY OF EAGAN Remarks Addition Section 20 Lot Blk Parcel 10 02000 010 7$ Owner Street State 3 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. LET RESTOR'. WINg PA 197 76.20 02 I© *aid GRADING y . TIT 1940,8 180.00 . 20 25 4,W S WATERMAIN WATER LATERAL 1977 53-15 - 3.16 000966b" 2- ^$Zt WATER AREA 7 3$0. GO $25.33 "037Q. 0 171 STORM SEW TRK STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 230.00 6435 6-20-77 BUILDING PER. SAC 525.00 16133 10/2/79 PARK EAGAN TOWNSHIP N~ toil BUILDING PERMIT Owner .......----1.__.' ---s- Eagan Township Address (present)__ Town Hall 1 . Builder __.1....... q Address Dale ../...f~,~ DESCRIPTION Stories To Be Used For Front Depth Height Est. Cost Permit Fee Remarks LOCATION Street, Road or other Description of Location Lot Block Addition or Tract Glb 7 This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that--i-1-.1 . _ has permission to ............................upon the above described pre e subje othe ovisions of the Building Ordinance for Eagan Township adopted April 11, 1955. .--------•---:.IC~.. Per ..-----.----:.__1~~ Chairman of Town Bo rd Building Inspector EAGAN TOWNSHIP ' N° 1238 _ BUILDING PERMIT I~ f Owner ?...._..j,..r` Eagan Township Address (present) ._..__.e Town Hall Builder •---•----r---------------•---•-•-•---••---•-•---------•-•-----•- Date Address DESCRIPTION Stories To Be Used For Front Depth Height Est. Cost 'Permit Fee ,y Remarks _ LOCATION Street, Road or other Description of Location I Lot ' Block Addition or Tract 1010 7S ~ ~0r~ Q 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 B EP~T O TH PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify. • that_.__ -•--has permission to erect a ~ upon r" = the above described pre- is' subject it he provisions of the Building Ordinance for Ea a Township adopted April 11,. 1955. Per t......................................... Chairman of Tnwn Boar Building Inspector k '09. I i I EAGAN TOWNSHIP N° 97 9 BUILDING PERMIT l Owner --6 & Eagan Township Address (present) P2- Town Hall Builder 4;1716,3 j Address Date DESCRIPTION Stories To Be w~_.Used For Front Depth Height Est. Cost Permit Fee Remarks li •~y~ t,~, a af~ .a9~6~ t c . 7 LOCATION Street, Road or other Description of Location Lot Block Addition or Tract ©/d 7rs- 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 ONq~THE/PREMIPE WHILE THE WORK IS IN PROGRESS. This is to certify, s~-atrs._.i_.___4_-________haspermission to eseea _ : that_~L ~ upon the above described premise subject to the provisions of the Building Ordinance for Eagan Township adopted April 11. 1955. i?s........ . Per - -i-- 46 Chairman of Tnwn Board Building Inspector 4 r i II EAGAN TOWNSHIP N° 950 BUILDING PERMIT Owner Eagan Township Address (present) ....................................r_--•- Town Hall Builder - - ~ Date - Address DESCRIPTION Stories To Be Used For Front Depth Height Est. Cost_ Permit Fee Remarks LOCATION Street, Road or other Description of Location { Lot Block Addition or Tract 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 O THE PREMISE WHILE THE WORK IS IN PROGREgS. This is to certify, that = has permission to erect a -~j upon the above described premis ubjec tot ,provisions of the Building Ordinance for Eagan Township adopted April 11, 1955. ~ - ~ Per L~.._ ~ 4----- Chairman of Tnwn Board Building Inspector I CITY 49 EAGAN WATER RVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: _ 2UT Eagan, MN 55122 DATE: Zoning: PI No. of Units: Owne.. T Wflrttaatt Address: /O 09002 © j 7$' Site Address:;- lei_11 l eek'ht_W) tO,, ~ Plumber: 1itaMe] I1?~sktrtry ttt3 HeAt tl Meter No.: 25752179 Connection Charge: 231 100 Pd Size: 5/> Account Deposit: 1.500 d- header No.: 896903 Permit Fee: _ 10*60 Pd 1 agreg.to comply w+th the City of Eagan Surchorge: .So too Ordinances., Misc. Charges: 60.0 .ti'lt?'ttll±. ' Total: By Date Paid: Dote of insp.: Insp ~Idel LOT COMBINATION AGREEMENT WHEREAS, Laura L. Allen (hereinafter "Owner") is the owner of two adjacent parcels of real property located in Dakota County, Mnnnesota. The first parcel (hereinafter "Parcel A") is legally described as follows: Commencing at a point 435 feet East and 506 feet North of the Southwest corner of said Southeast-Quarter, thence North 33 degrees 54 minutes 28 seconds East a distance of 302.65 feet, thence North 58 degrees 54 minutes 28 seconds East a distance of 249.38 feet, thence South 86 degrees 32 minutes 2 seconds East a distance of 190 feet to the actual point of beginning, thence North 86 degrees 32 minutes 2 seconds West a distance of 190 feet, thence North 58 degrees 54 minutes 28 seconds East a distance of 30.77 feet, thence East and parallel with the South line of said section 164.09 feet to its intersection with aline that bears North 1 degree 43 minutes 38 seconds East from the actual point of beginning, thence South 1 degree 43 minutes 38 seconds West 26.22 feet to the actual point of beginning, according to the United States Government Survey thereof and situate in Dakota County, Minnesota. The second parcel (hereinafter "Parcel B") is legally described as follows: Commencing at a point 435 feet East and 506 feet North of the Southwest corner of said Southeast-Quarter, thence North 33 degrees 54 minutes 28 seconds East a distance of 302.65 feet, thence North 58 degrees 54 minutes 28 seconds East a distance of 172.35 feet to the actual point of beginning, thence continuing North 58 degrees 54 minutes 28 seconds East a distance of 77.03 feet; thence South 86 degrees 32 minutes 2 seconds East a distance of 190 feet, thence South 1 degree 43 minutes 38 seconds West a distance of 201.97 feet, thence North 78 degrees 33 minutes 32 seconds West a distance of 112.95 feet; thence North 42 degrees 33 minutes 32 seconds West a distance of 205.25 feet to the actual point of beginning, according to the United States Government Survey thereof and situate in Dakota County, Minnesota. WHEREAS, the City Council of the City of Eagan has required that Parcel A and Parcel B be combined into one tax parcel in order to prevent tax forfeiture. NOW, THEREFORE, the Owner hereby agrees as follows: 1. The Owner agrees to allow the Dakota County Treasurer/Auditor's Office to assign one tax parcel identification number to the area consis:aja of PLIA d Pa rcel B. Dated: & L. Allen r JOYCE M -W STATE OF MINNESOTA) NOTARY PUBLIC k0" MY COMMISS.(_:1a ) ss. EXPIRES JAN. 31 COUNTY OF ZQZ ? The foregoing instrument was acknowledged before me this -/today of 2002, by Laura L. Allen, a single person. r18' Not blic THIS INSTRUMENT WAS DRAFTED BY: SEVERSON, SHELDON, DOUGHERTY & MOLENDA, P.A. 7300 West 147th Street, Suite 600 Apple Valley, Minnesota 55124 (952) 432-3136 (MGD: 206-20135) 2 CITY USIC, ONLY LOT 13L IT RMD. ' 26 AEA MIPT ; RECra" DATE: 2000 I CA& VZ T 2 R~ L - * `-O a e 39", phi "60 w f~.~ - Complete this section I i yont we ii slling *VAC' in 'a single family `dwelling, townhowe or condo MUM19ft Kid so HVAC. 0-100r M 13;TXT 30.00 AD ONTAL 30 M BTU 6.00 Go outlets minimum of one ~ Moked ~ $3.00 ea.) Stme Etch 50 } Com44ate this section go& if you sreOKWO U , I* tj9dft an exis* sigle-family dwelliW, townl ome, or condo. P indigo if it is a ne w it+am; alteration, or dir. ...Y. , NOW Alttson tder ~ „ F Air ca~ulitioning Air a whaageir Odw Fee S 30.00 Stow S ` ' e .50 Total S 30,E Aamb der: Call br hapedt r SITE ADDRESS: J4L tvNNEk NAIE• PIgIiE # ' f. (AREA 4L INSTALLER NAME: o PPrQrtE - --I» (A"ACOM STKgn:: CITYY STATE: ZIP• SWNAfUU OF, E . MY USE ONLY. I r L BL mi'l' 6 $Ut313. I~EGEIPT~: «s a tOVW eY: , r s 'r© Er r Qa : CZVY eo Po ZZOT M" show. W'55122 651.6$1-4675 PWNW rwmp mwttwwrdly bu#dbW `u to Pew am m* t°` v 4nft. DATE. WORK TYPE: Now c on*uctim kJj%R U.G. TV* Procemd Piping`. Waan tr~tl3Arg/frde vl ~ artt i6S1-6d f6i'+' tirr S+ct Cr by fi" mot et' "'i no eder. ~tioe c►f work: Few. 1% of caft" pr QR $3000 MIWMUW fe% Whichever is _ • (j~;t~f `se~nloval/itu~ ~ fly , Cc usa pricer: S - x 1%-s Trim) z. Sty barge y alikuba at fQK.eaft S1,OW Eg TOTAL $ SrMADDRESS: OW Mt NA1(E: PHONE#. T TENANT NAME (IMPROVEI MM oN1.Y): WAS THERE A PREVIOUS TENANTW T SPkf W Y r H NAW: INSTALLER A13$F.F. S PHC #f: , (AMA L") CITY: STATE, SIGNATURE PERMI"1'T8E PERMIT' 5 CITY OF EAGAN 3 3830 Pilot Knob Road PERMIT TYPE: Eagan, Minnesota 55123 Permit Number: (612) 681-4675 Date Issued: SITE ADDRESS: DESCRIPTION: i REMARKS: FEE SUMMARY CONTRACTOR: OWNER: 1 f APPLICANT/P RMITEE SIGNATURE ISSUED Y: IGNA RE , REACTIVATECITY OF EAGAN PERMIY # 1993 BUILDING PERMIT APPLICATION 681-4675 MAR 2 3 RECD SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, l set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date -3--2.3 n`L3 / J Valuation of work to Ob-0 Site Address: -I y~ 11`t B l a.zk h ww k Ad .S 5 -22 STREET SUITE Tenant Name: (commercial only) LOT BLOCK ' SUBD. r- P.I.D. # Description of work: The applicant is: ❑ Owner - 14 Contractor ❑ Other (Describe) Name p l i e~ L *-P P v Phone Property LAST FIRS Owner Address STREET STE # City State Zip Company s / c tie Phone 4, L's 0x.31 Contractor Address V2 C elm z, 14u v License # 113 ~ Exp. 3 City State M Zip Architect/ Company Phone Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this a lication and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY - , k 1- BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging D ~ s m n Vf-i sh ❑ 02 SF Dwg. ❑ 07 4-Plex ❑ 2 Multi. Misc. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-Plex 3 Garage/Accessory ❑ 18 Conan./Ind. ❑ 04 SF Porch ❑ 09 12-Plex 14 Fireplace ❑ 19 Comm./Ind. Misc. ❑ 05 SF Misc. ❑ 10 Multi. Addl. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE D 31 New ❑ 33 Alterations ❑ 35 Tenant Finish D 37 Demolish ❑ 32 Addition 34 Repair ❑ 36 Move GENERAL INFORMA ION Const. (Actual) Basement sq. ft. MWCC System (Allowable) 1st F1. sq. ft. City Water UBC Occupancy 2nd F1. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code Depth On-site sewage SAC Code APPROVALS Planning Building Assessments Engineering Variance REQUIRED INSPECTION i1=1i9ea-A PAM _ . N e-:-W &A*A4e dmm a"''' ' ~4 I 1ation ❑ Site ❑ Footing ❑ Fram?ng ❑ Wallboard ❑ Final ❑ Draintile ❑ Fireplace Permit Fee 00 veiuation. $ O Surcharge Plan Review License _ MWC SAC 4z f~ 9 ~ I!, Z sow City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF FAGAN j 3830 PILOT KNOB RD - 55122 / e L 651-681«4675 Never Construction Reaukements at medei/Repair Reavkemer#s 3 registered site surveys showing sq. ft. of lot, sq. ft. of house 2 copies of plan and all roofed areas (20% maximum lot coverage aN WIld) t set of energy calculations for heated additions D 2 copies of plans (show beam b window sties: poured fnd. design: etc.) 1 site survey for exterior additions i decks ➢ 1 set of energy calculations 3 copies of tree preservation plan If lot platted after 7/1/93 DATE: ~cr 9Q CONSTRUCTION COST: Z" DESCRIPTION OF WORK: r$~1~04 STREET ADDRESS: ' B Age. LOT: BLOCK: ,,2--"SUBD./P.I.D. r Y". Name: Phone f~J PROPERTY Last First OWNER Street Address: City State: ,~4 Zip: 6; Company: ~17 r E V1 L. Phone LLZ ~ _3 (area code) CONTRACTOR n~ Sheet Address: ~ 1 t~_ Z.~' / ~ License # ~ Ems..,, f City State: Zip: I ARCHITECT/ ENGINEER Company: Name: If Telephone area code ( ) i Street Address: Registration City State: Zip: Sewer & water licensed plumber (required for new construction Snivl: Penalty applies when address change and lot change is requested once permit b Issued. I h reby acknowledge that I have read this application, state that the information Is correct, and agree to comply with all a abi SIS& . of Minnesota Statutes and City of Eagan Ordinances. ` Signature of Applicant: OFFICE USE ONLY Cer ificates of Survey Received Yes No Tree Preservation Plan Received Yes No Not Required`; '5,`, OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 4-plex ❑ 11 10-plex ❑ 16 Fireplace C l 21 Porch (3-sea.) ❑ 02 SF Dwelling ❑ 07 5-plex ❑ 12 12-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea. ❑ 03 1 of _ plex ❑ 08 6-plex ❑ 13 16-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 04 2-plex ❑ 09 7-plex ❑ 14 Apartments ❑ 19 Lower Levei ❑ 24 Storm Damage ❑ 05 3-plex ❑ 10 8-plex ❑ 15 Lodging ❑ 20 Pool ❑ 25 Miscellaneous WORK TYPE ❑ 31 New ❑ 35 Tenant Impr ❑ 39 Gas Line Only ❑ 43 Siding/Soffits/Fascia ❑ 32 Addition C] 36 Move Bldg. ❑ 40 Gas Insert ❑ 44 Windows/Doors ❑ 33 Alteration ❑ 37 Demolish Bldg.* ❑ 41 Wood Stove ❑ 45 Fire Repair ❑ 34 Repair ❑ 38 Demolish (Interior) ❑ 42 Reroof Give PC:A hay iduut to appiicant roe demoilitiu i poi r i iii GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. SAC Code UBC Occupancy sq. ft. No. of Units Zoning sq. ft. No. of Bldgs # of Stories sq. ft. sph" rity At low Length sq. ft. Width Footprint sq. ft. ate APPROVALS Planning Building Permit Fee 1 Surcharge Plan Review License MC/BS SAC City SAC Water Conn. Water Meter Acct. Deposit SAN Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other . Copies Total: .SAC Units % SAC Lot Blk PID # 10-02000-010-78 Sewer/water permit # 26746 Plat Date 11/27/95 Receipt # 50177 CITY OF EAGAN 1995 SEWER & WATER CONNECTION CHARGES EXISTING RESIDENTIAL PROPERTY Sewer connection charges Water connection charges Sewer availability charge (SAC) $ 950.00 Pd. Wate vailability charge (WAC) 50.00 Date previously paid 10/02/79 Date p viously paid Receipt # 16133 Receipt Account deposit 15.00 Account depos 15.00 Sewer permit and surcharge 50.50 Water permit & su arg 50.50 Water meter 115.00 Subtotal $ 1,015.50 Treatment plant 372.00 Tap Subtotal $1,302.50 Total $ 65.50 Tap taI Sewer & water connection charges Sewer av bility charge (SAC) 950.00 Date previo usty paid Receipt # Water availability rge (WAC) 750.00 Date previously pai Receip Account deposit 30.00 Sewer & water permit and sur a 100.50 Water meter 115.00 Treatment plant 372.00 Subtotal $2,317.50 Taps) A plumbing permit is also required. It will be issued only to a plumber licensed with the City or to the homeowner if he is actually doing the work. - OFFICE USE ONLY Property owner LARRY ALLEN PRV No Address 4104 BLACKHAWK RD No. of taps None Phone no. 454-2875 Assessments MOO Plumber WENZEL PLBG Waiver /.16 I-P P)w city of eagan 3830 PILOT KNOB ROAD, P.O. BOX 21199 VAC ELLISON EAGAN, MINNESOTA 55121 Mayor PHONE: (612) 454-8100 THOMAS EGAN DAVID K. GUSTAFSON PAMELA McCREA THEODORE WACHTER Council Members THOMAS HEDGES City Administrator EUGENE VAN OVERBEKE City Clerk May 19, 1988 TO WHOM IT MAY CONCERN: The pending assessment on parcel #10 02000 010 78 is for Project 488, Black- hawk Road and storm sewer improvements. The dollar amount of this pending is $3502. The projected date of the Final Assessment Hearing is Fall 1988 or Spring 1989. When City Council approves this final assessment, it will be levied. There are no other pending assessments on this parcel. Sincerely, Deanna Kivi Assessment Clerk THE LONE OAK TREE ...THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY PHONE: 645.5826 HARRY N. RAY Atowzy and CoumdLoz at -law 1731 SELBY AVENUE ST. PAUL, MINN, 55104 November 18, 1970 Mrs. Alice Bolke Eagan Township Clerk Eagan Town Hall 3795 Pilot Knob Rd. St. Paul, Minnesota 55111 Re: Jack Hoffman 4104 Blackhawk Rd. Dear Mrs. Bolke: This will confirm our telephone conversation on Tuesday, November 17, 1970, at which time we advised you that Mr. Hoffman would like to appear before the Assessment Committee in connection with the road assessment levied again8t his property. Would you be kind enough to advise Mr. Hoffman and this office the date and time for his appearance. Very truly yours , t, Ery, Ray HNR:js June 12, 1989 Re: Project 488, Blackhawk Road - Final Assessment Adjustment Parcel 10-02000-030-77 Parcel 10-02000-010-78 Parcel 10-02000-030-78 Parcel 10-02000-030-79 Parcel 10-02000-011-75 Dear Property Owner: When the improvement for Blackhawk Road was authorized as a result of the public hearing held on February 3, 1987, the feasibility report used to estimate the proposed costs and related special assessments incorrectly referenced your property as qualifying for a postponement of a portion of your proposed special assessment subject to the execution of an agreement in accordance with Special Assessment Policy 86-3. In preparing the final assessment roll, it has been discovered that your property does not meet the qualifying criteria as required by this Special Assessment Policy, a copy of which is enclosed for your information. Therefore, the proposed final assessment amount may be higher than what was anticipated by the feasibility report presented at the public hearing and subsequently carried as a pending assessment until the final assessment hearing scheduled for July 5, 1989. I apologize for any problems that may have resulted from this error in the original feasibility report pending assessment roll. However, staff is not authorized to waive the criteria necessary to quality for a partial reduction of the special assessment. Sincere , Thomas A. Colbert, P.E. Director of Public Works TAC /7J Enclosure I i r BXRIBIT 1 SPECIAL ASSESSMENT POLICY 86-3 CITY OF EAGAN ASSESSMENT AGREEMENT UNDEVELOPED/AGRICULTURAL ZONING PROJECT NO(S). THIS AGREEMENT dated this day of , 1988, between the CITY OF EAGAN, (called City), and (called Owner) of , (address); WHEREAS, the City proposes to assess the following described premises in Dakota County, Minnesota, owned by Owner: (legal description) I for the following improvements pursuant to City Project(s): WHEREAS, assessments would normally be based upon the total frontage area of. said premises; and/or WHEREAS, the present use of said property is. homestead for a single use; and WHEREAS, the highest and best use of the property may be at a different zoning, higher density or more intense use than presently exists; NOW, THEREFORE, upon consideration of the mutual covenants herein, the parties agree as follows: 1. The City agrees to assess said property for the Project and purposes described above at its present singular use, in accordance with Special Assessment Policy No. 86-3. 2. The Owner agrees for himself, his heirs, executors, administrators, successors, and assigns, that if the actual use of said property is changed in the future to a use or zoning category which is greater than its present use, the City may reassess or levy a supplemental assessment at such time based on the assessable units (frontage and/or area) postponed under this referenced proJe~t at the appropriate zoning classification assessment rates, according to City policy, in effect at such future time. 3. a. The Owner for himself, his heirs, executors, administrators, successors, and assigns waives any and all objections to the City's right to reassess the property in conjunction with the Project if the actual use and/or the zoning for the property is changed. Further, the owner waives any and all objections to the present assessments agreed to herein and to the proceedings related thereto. b. By executing this Agreement, the owner does not waive the burden of the City to establish the benefit received by the property under the Project at the time of the change in use or zoning. 4. The undersigned hereby agree that this agreement may be recorded with the Dakota County Recorder and that the Owner shall execute any and all documents necessary to implement the recording of this agreement including the delivery of the owner's Duplicate Certificate of Title to the affected lands if necessary. 5. The undersigned agrees that this agreement shall run with the affected land and binds the heirs, successors and assigns of such land. 6. The undersigned heirs, successors and assigns of such land, includes all of the person, firms or corporation that hold an interest in the-assessed land described above, including the fee title owners, contract for deed vendees or vendors or holders of any other interest under contract for deed, option or otherwise. 7. Other conditions: The undersigned have read and understand the above agreement and hereby bind themselves to it in all respects. OWNER: CITY OF EAGAN : By-. _ By: Its: Mayor By: _ Attest: Its: Clerk By: APPROVED: Public Works DeJ>artment Its t -2- city of aagan 3830 PILOT KNOB ROAD, P.O. BOX 21199 BEA BLOMQUIST EAGAN, MINNESOTA 55121 Mayor PHONE: (612) 454-8100 v 6 0 THOMAS EGAN JAMES A. SMITH JERRY THOMAS THEODORE WACHTER Council Members L/.~ ~,(~fJ, 1 THOMAS HEDGES City Administrator EUGENE VAN OVERBEKE City Clerk TO WHOM IT MAY CONCERN: In response to your question regarding the septic system and well on the property located at: 4104 BLACKHAWK RD I would like to state the following: 1. Eagan has no local codes which govern these systems except for the initial inspection at the time of installation. 2. Eagan has no health inspector to verify the condition of septic systems or wells. If you have, any further questions concerning this matter, I can be reached at 454-8100. Sincerely, Steven T. Hanson Construction Analyst STH/js P.S. There are no requirements for distance from the septic system to the house on existing systems since we do not inspect them. THE LONE OAK TREE ...THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY I 4104 Blackhawk Rd. St. Paul, Minnesota 55111 January 14, 1971 Assessment Committee Eagan Town Hall 3795 Pilot Knob Rd. St. Paul, Minnesota 55111 Gentlemen: We ask you have a review of the assessment recently levied against the property at the above address since the same is unfair, unreason- able and not uniform with other property owners in the vicinity or based on the same unit. We would like to appear before the Assessment Committee as soon as possible. Yours truly, ffman 19 tvAIVE.et OF HEARING PE'QUEST FOP, UTILITY IMPROVEMENTS I/we hereby request of the City Council, City of Eagan, Miranesota, utility improvements on and over property owmed by me/tips as follcus: (Mention type of improvement, e.g. water, sanitary sevar, etc.) LATERAL BENEFIT FROM TRUNK WATERMAIN q-ie location of said utility improvements shall be generally as &llc*!- SECTION 20, Parcel 10 02000 010 78 77,03 feet at 6.90 per front foot = 531,51 assessed over 10 Years at 81% interest I/Wa hereby waive notice of any and all hearings necessary for the installation of said improvements and further consent to any as:~evxr >s necessarily levied by the City of Eagan for such improvements. IAle further agree to grant to the City of Eagan any easemca-its ne:-::.::° sary for the installation of such improvements. It is further understood that this request shall be reviewed by the City Council of The City of Eagan or its agent and I/We will be given reasonable notice as to whether this request is possible under present utility planning as to timing, location, etc. Dated: Aumst 10, 6 '4,,r, _ - , . Signature Address Regaest accepted by - Date' .0-/v -7k City of Eagan 'd Request referred to City Administrator: Date s Copies: 1. City Administrator 2. Applicant Y 61+333+1030 JUN-18-98 THU 09:23 AM LIND, JENSEN & SULLIVAN FAX NO. 612+333+1030 P.01/09 r RLES PAYNE Fs ASSOCIATES 1700 FIFTH STREET TOWERS 150 SOUTH FIFTH STREET MIIV` EAPOUS, MINNESOTA 55402 TELEPHONE (612)344-1300 FAX (612)333-1030 FACSIMILE TRANSMISSION COVER SHEET Please deliver the following page(s) to: NAME: Bill Bruestle FAX NO.: 681-4694 FROM: Chuck Payne SENT BY: CAP DATE: June 18, 1998 TOTAL PAGES, INCLUDING THIS PAGE: 9' CLIENT AND FILE NO.: Larry and Laura Allen v. Farmers Home Mutual Our File: 991281 MESSAGE: Per our conversation of 06/16/98, would you carefully review the statement, making any corrections, initial said corrections, initial and date bottom of each page, signing and dating last page. Please fax to John Cook, the attorney for Farmers Home Mutual at 334-5955 ASAP. Thank you for you time. ORIGNAL BY MAIL Confidentialift Notice The documents in this telecopier transmission may contain information from C&71es Payne &Assoxiatm La which is confidential and/or legally privileged. The information is intended only for the use of the individual or entity named on this transmission sheet. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or taking of any action in reliance on the contents of this telecopied information is strictly prohibited and that the documents should be returned to the sender immediately. If you have received this telecopy in error, please notify the sender by telephone immediately so that he or she may arrange for the return of the original documents at no cost to ,you. IF YOU DO NOT RECEIVE ALL PAGES PLEASE CALL THE SENDER IMMEDIATELY. 612+333+1030 JUN-18-98 THU 09:23 AM LIND, JENSEN & SULLIVAN FAX NO. 612+333+1030 P.02/09 STATEMENT OF WILLIAM BRUE__ STL1? This is a recorded statement being taken on 16 June 1998 at approximately 1:45 p.m. at the Eagan city offices of William Bruestle. Q William, will you acknowledge the fact that you are aware that this tape is being made and is being made with your permission and consent? A Yes. Q Could I have your full name please, spelling your last name? A William G. Bruestle, B-R-U-E-S-T-L-E. Q What address would you like to use for purposes of this statement Bill? A 3830 Pilot Knob Road. Q Is that in the City of Eagan? A Yes. Q The zip code here? A 55122. Q What is your current age? A 55. Q Could you tell me what your current job position is? A Senior Building Inspector for field work. Q For the City of Eagan? A Yes, for the City of Eagan. Q Could you please describe for me your background training, a building become anything that would have prompted you to inspector? A Well, I worked in this field since 1963, up until 14 years ago when I had an opportunity to come and work here for the City of Eagan and I became an inspector. Q What types of construction were you involved in prior to becoming a building inspector with the city of Eagan? A Commercial, light industrial and houses-additions-porches- decks. 612+333+1030 JUN-18-98 THU 09:23 Aft LIND, JENSEN & SULLIVAN FAX NO. 612+333+1030 P,03/09 Q So would you have worked for a number of contractors, as well as possibly having been self-employed? A Ya. Q Have you also done trade union work as well? A Right. Q Is there additional training and education that you are provided for or required to take by the City of Eagan for purposes of keeping up on your codes and compliances, etc.? A Yes. We are certified. We have a winter seminar which is three days and a spring seminar which is a full day each and then there is one in the fall. We have to maintain at least 24 credits in order to keep our certification every three years. Q Is that? A Every three. Q We are here today discussing a matter having to do with the Larry and Laura Allen residence. That street address is 4104 Slackhawk Road in the City of Eagan. is that correct? A Correct. Q Prior to the commencement of this statement you provided me with an opportunity to review the file that is maintained here in the City. In addition to a particular record of complaint that you are providing at the time of this statement, is that correct? A That's correct. Q Could you tell me a little bit about how or what type of a policy the City of Eagan instituted or prepared that would have resulted in this record of complaint and how that came about? A Usually, if anybody calls in and complains we will go out and handle it in the field. We don't have a housing inspector in the City of Eagan so we do it through the building inspections. You have to call 6/6/96, to go out and take look at this house and they said they had structural damage because of a storm. That is what lead me out there. 612+333+1030 JUN-18-98 THU 09:23 AM LIND, JENSEN & SULLIVAN FAX NO. 612+333+1030 F.04/09 Q Bill, would this be the storm that there were high winds that would have occurred on or about the 19th of May, 1996? A Correct. Q So it is your recollection that the date on the complaint in this complaint, is this prepared in your handwriting? A Yes, it is. Q This would be about a two week or there about period of time after the storm had actually come through your City? A Right. Q Were there a number of other homes that were also, um, that you would have received complaints from the homeowners on having to do with either questions or damage? A Yes, there was. Q What is the purpose of someone like yourself coming from the City to a homeowner's house to inspect damage? A O.K. Our main purpose is to make sure that the house is liveable and help the homeowner over a rough spot. Q In this particular situation, would you have been contacted by the homeowner, the Allen's in this case? A Yes, they are the ones that contacted us. Q Did you have occasion to meet with either Mr. or Mrs. Allen at their home? A Mr. Allen. Q The report that you have provided dated 6/6/96, would that be the date in which you actually went out and met with Mr. Allen? A Yes, that would have been the date. Q Could you tell me what you observed when you went out to the Allen residence? A well I observed that there was no shingles missing off the roof. I asked Mr. Allen if they had any trouble with the doors binding or windows binding inside the house because he shifted through-from the had mentioned that the frame had wind. And after a thorough listening of him and my construction practices which I have had, I feel that the house 3 G , f~ , 612+333+1030 JUN-18-98 THU 09:24 AM LIND, JENSEN & SULLIVAN FAX NO. 612+333+1030 P.05/09 had not shifted because of the wind, but had probably settled over a period of time. Q Did you have an occasion to inspect the inside premises of the home? A No, I didn't. Q Could you tell me basically your observation of, is this a older home site, is it possible an old farmstead, do you know anything about the nature of the construction that would have taken place? A Well from what I understand, it is an older house built roughly a 100 years ago and chances are it was a balloon frame and that house after a few years could have been leaning like it was at that point in time. Q Was it your observation that the house, in fact, does lean or list? A Yes, it does. Q Is that noticeable in a listing? A Probably with a trained eye you could see it. Q So there is no evidence of any shingles, no evidence of either windows or doors binding or being inoperable? A No. Q What was Mr. Allen's representation to you as far as why he believed it was from the wind? A He said that there was move ent ,the foundation. I didn't find any movement in thou'dation, it was a wood structure from the foundation and I didn't see anything. Q Did you see any evidence of any the margins on any siding having shifted? A No, no margins shifting. Usually if that happens, you have a tight spot on the top and a loose spot on the bottom and that wasn't even evident. Q So your inspection was completely of the exterior of the premises? A Right. 4 //u~ 612+333+1030 JUN-18-98 THU 09:24 AM LIND, JENSEN & SULLIVAN FAX NO, 612+333+1030 P.06/09 Q Do you have any reason to believe that the house had possibly been added on to over a period of time? A it looks like there could have been a number of additions on to the property and house. Q What type of foundation do you believe that the main house was constructed on? A Well if it was a loo years ago, it is probably block and cement or not block and cement they were blocks or stones. Q That would be like a boulder and cement foundation? A Yes. Q Prior to the commencement of this statement, you had an opportunity to review a report that has been prepared by Guy Engineering that is dated June 21, 1996, an Evaluation of Extent and Causation of Reported Conditions at 4104 Blackhawk Road in Eagan is that correct? A Correct. Q This report was prepared by Jeffrey Jillson. Having had an opportunity to review that report can you comment on its contents and also comment as to whether or not you agree with the findings? A The contents was pretty much what I had looked at, except the interior of the house, but the assessments of what took place, I pretty much agree. Q Is there anything that you would disagree with the engineering report from Guy Engineering? A No, not really. Q Is it your opinion sir that the extent of any listing or leaning of this house is strictly a result of settling and not as a result of the reported wind damage on 5/19/96? A That's true. Q Let me ask you Bill, have you had any other contacts aside from this contact today with anybody having to do with this litigation or possibly representing the Allen family? 5 r,~ 612+333+1030 JUN-18-98 THU 09:24 AM LIND, JENSEN & SULLIVAN FAX NO. 612+333+1030 P.07/09 A Yes, probably about a month ago, a person came here from Sieben, I don't know what the rest of the name is of the law firm. Q was it clear that they were from the attorneys representing the Allens? A Right. Q What took place at the meeting sir? A Same thing that took place here they reviewed the forms, the files, the complaint form wasn't accessable at that time. Q Did you advise the representative of the Allen's law firm that there actually had been a record of a complaint and that you had actually gone to the premises and provided the representative the Allens' law firm the same opinion that you are providing here today? A Right. Q was any type of a recorded statement whether it be hand written or tape recorded taken from you at that time? A Not that I know of. Q Bill is there anything about the practices of the City of Eagan within the building inspection department, or your own personal dealings with the Allen residence, anything having to do with this particular matter that I have not touched on that you think is important? A No, I think that you have covered pretty much everything. Q Bill, when you conducted the inspection of the Allen residence, did you tell' Mr. Allen what your opinion was at that time? A Yes, I did. Q And what specifically did you,tell him? A I told him that prior to that storm, the leaning of the house was probably existent, had been there for a while, it could have been settling or just built that way. 6 C 612+333+1030 JUN-18-98 THU 09:24 Aft LIND, JENSEN & SULLIVAN FAX NO. 612+333+1030 P.08109 Q is there any question in your mind that Mr. Allen knew what your opinion was when you met with him after your inspection on the date of June 6, 1996? A Yes, he did know what my opinion was. Q Did Mr. Allen agree with your opinion? A He didn't have much to say. Q But your opinion to him was clear at that time? A Right. Q Very good. Bill again I would ask you to acknowledge the fact that you are aware that this tape has been made and it has been made with your permission and consent? A Yes. Q Upon having this tape transcribed with an opportunity to read it and finding it true and correctly stated, would you be willing to sign it as a true statement and if necessary testify accordingly? A Yes. Thank you very much. The time is now 1:55 p.m. DATE NAME 7 612+333+1030 JUN-18-98 THU 09:25 AM LIND, JENSEN & SULLIVAN FAX NO, 612+333+1030 P.09/09 RECORD OF COMPLAINT Date Complaint taken by Type of building Name Address Legal description Phone number Complaint Action taken Comments .ce.~Z'~ .~r~CrZ a - ~ ~(i r r~•~, -7" "viz~L~~Z~ ~.C.... ~ ~iGc~-C:l.~~~ _ Signature Loth Blk PID # 10-09000-010-79 SewerJwater permit # Plat Date Receipt # i CITY OF EAGAN 1995 SEWER & WATER CONNECTION CHARGES EXISTING RESIDENTIAL PROPERTY Sewer connection charges Water connection charges" Sewer availability charge (SAC) $ 950.00 Wate vailability charge (WAC) $ 50.00 Date previously paid Date p iously paid Receipt # Receipt # Account deposit 15.00 Account deposi 15.00 Sewer permit and surcharge 50.50 Water permit & su arg, 50.50 Water meter 115.00 Subtotal $ 1,015.50 Treatment plant 372.00 Tap _ Subtotal $1,302.50 Total $ 1,015.50 Tap _ taI Sewer & water connection charges Sewer av ility charge (SAC) $ 950.00 Date previo paid Receipt # Water availability rge (WAC) 750.00 Date previously pai Receipt Ef", Account depositp 30.00 Sewer & water permit and sur a 100.50 Water meter 115.00 Treatment plant 372.00 Subtotal $2,317.50 Tap(s) tal A plumbing permit is also required. It will be issued only to a plumber licensed with the City or to the homeowner if he is actually doing the work. OFFICE USE ONLY Property owner PRV r4 Z& y~ I Address No. of taps Phone no. Assessments 14 Plumber Waiver T 2004 RESIDENTIAL BUILDING PERMIT APPLICATION i City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Requirements Office Use Only 3 registered site surveys showing sq. ft of lot, sq. ft of house; and all roofed areas 2 copies of plan Cart cf 'Survey Reod - Y - W (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan R eon - Y _ rJ 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree.Pres Required Y N 1 set of Energy Calculations Addition - indicate if on-site septic system On-site Sep'jc System f Y - N 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail options selection sheet (bldgs with 3 or less units j Date / /641 Construction Cost 1 C/ / 6 Site Address !4 o (a k hta w /td Unit/Ste # Description of Work ~/l) S Multi-Family Bldg _ YN Fireplace(s) _ 0 _ 1 - 2 Property Owner La U ~A ~9 l 1 n Telephone # (10 1) K~ S(dln Contractor &Kelf Address ) q050 a City State /MW Zip Telephone # (q 5Z COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y N If so, 25% plan review fee applies. Licensed Plumber Telephone # ( ) ) Mechanical Contractor Telephone Sewer/Water Contractor Telephone # ( ) I hereby apply for a Residential Bu_i itand acknowledge that the information is complete and accurate; that the work will be in conrmance with the ordinances and codes of the City of Eagan and the State of MN Statutes; 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. ted Name plicant's Signature Applican s t6 OFFICE USE ONLY Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of_ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg_Y or _ N ❑ 25 Miscellaneous Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish Building* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered, Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) _ Final./C.O. _ Footings (deck) _ Final/No C.O. Footings (addition) _ Plumbing Foundation HVAC Drain Tile Other Roof - lee & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests -Final Framing _ Siding _ Stucco Stone ` Brick Fireplace _ R.I. -Air Test -Final Windows Insulation Retaining Wall Approved By: , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total ~7 2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION- City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 I Please complete for: single family dwellings & townhomes/condos when permits are required for each unit Date Site Address ~l ~ ~h(/► Y y 12d, Unit # Property Owner ~~vV 41' 1 i Telephone # Contractor Street Address bber+ T70 ' City Stated 1 Zip Telephone # Bond Expires: The Applicant is Owner Contractor Other Add-on or alteration to existing dwelling unit $ 30.00 furnace -Additional -Replacement air exchanger air conditioner New Replacement other State Surcharge $ .50 r n. i Total JUN 2 8 2004 $ 5' SZ) B I hereby apply for a Residential Mec yca ermit 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's Printed Name Applicant's Signature 2004 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date / / Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address City State Zip Telephone # ( ) Bond Expires: The Applicant is Owner Contractor Other Work Type New Construction _ Underground Tank Install Remove **see below Interior Improvement _ Install Piping -Processed -Gas Nature of Work: **When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector Permit Fees: $70.50 Underground tank installation/removal $50.50 Minimum (includes State Surcharge) or Contract Value $ x 1% _ $ Permit Fee • If ep rmit fee is $1,000 or less, add $.50 $ State Surcharge If e~rmit fee is over $1,000, add $.50 for every $1,000 permit fee $ Total Fee I hereby apply for a Commercial 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; ihat 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's Printed Name Applicant's Signature Approved By: , Inspector Date: 2004 RESIDENTIAL. PLUMBING PERMIT APPLICATION CITY OF EAGAN 31630 PILOT KNOB ROAD, EAGAN 165122 651-675-5675 Please complete for modifications to existing residential dwellings. Date ! Wile Street Address t4l oq glAckkWk R! • Unit # i*.tctperty owner ~l ! 4~.t . _ _ Telephone # (W) COMMA" Tlehone # 40 A rm city - o-m zip . Tie Applicant is: owner Contractor ----Other Alterations to existing dwelling 50.00 Add fixtures to rooms, excluding water softener and water heater Septic System Abandonment Water Turnaround (add $121.00 if a 518" meter is required) - -n- - -10ther: L~'i' I t'i VL Water Softener L Water Heater $ 15.00 replacement additional Lawn Irrigation System RPZ_ new _ repair rebuild $ 30.00 $ .54 Slate Swrcharge FF 7. Total VfJUN 2 8 240 $ l hereby apply for a Res' ermi 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 l 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 I the event *a plan is required to be reviewed and approved. Applicant's Printed Name Applicant's Signature. i i 2006 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. It. of house; and P11 roofed areas 2 copies of plan showing footings, beams, joists Cen of Survey Recd Y _ N (20% maximum tot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd _ Y _ N, 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required _ Y -4 1 set of Energy Calculations Addition - indicate if on-site septic system On-site Septic System _ Y - N 3 copies of Tree Preservation Plan if lot platted after 7/1/93 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form Date 4 / lo,~, Construction Cost C) Site Address Unit/Ste # Description of Work W~~C>~JS Multi-,Family Bldg - Y N Fireplace(s) - 0 _ 1 _ 2 Property Owner hl m, l i L au) e ~ Telephone # ( (4;51) I ~J~ 2 Contractor ( -ttr`~~ W I~~ Address Hu Vc C'1 u Vtckc,_ C)e- City h,01Q a UCt 1' ~ State ~/I In Zip 5 Telephone # 13 y b o COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 Energy Code Category • Residential Ventilation Category 1 Worksheet - New Energy Code Worksheet (4 submission type) Submitted Submitted • 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? _ Y - N If yes, date and address of master plan: Licensed Plumber Telephone # ( ) Mechanical Contractor Telephone # Sewer/Water Contractor Telephone I hereby apply for a Residential Building 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 State of MN Statutes; 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 ~ n n~ 2 approval of plans. D r" LL~ Applicant's Printed Name scan s at - 008 By for for dEw Q ' Perrnit # l M of Eajan 50 ' 3830 Pilot Knob Road S EP 0 4 2009 1 Permit Fee: Eagan MN 55122 1 i Phone: (651) 675-5675 1 Date Received: i Fax: (651) 675-5694 Stan: l i 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 3/"SR Site Address:' "I I D q 9 `(.C tk_klii U Tenant: Suite RESIDENT / OWNER Name: Phone: LOS[ ~t31 0101 Address / City / Zip: CONTRACTOR Name: _P I U,.~i ~ License + (Cl S Address:,;?S SlA BlUd. City: 'A-s &_j- State: Ad Zip:. Phone: W Q- OL02 A I t~,a Contact Person: TYPE OF WORK New Replacement - Repair Rebuild ~ whilodify Spaoe _ Work in R.O.W. - Description of work PERMIT TYPE RESIDENTIAL Water Heater Water Softener a_Lawn Irrigation -Add Plumbing Fixtures RPZ / 4_ PVB) L Main Lower Level} Septic System Water Turnaround New _ Abandonment RESIDENTIAL FEES. $50.50 Mini urn Water Heater, Water Softener, or Water Heater Aad Softener (includes $.50 State Surcharge) . $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonmerrt Water Turnaround* (includes $.50 State Surcharge)' *Water Turnaround (add $165.00 if a 518" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $80.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ I hereby acknowledge that this information is complete and ace, rate; that the work will be in conformance with the ordnances and codes of the City of Eagan; that t understand this is not a permit, but only an application for a permit, and work is not to start wdtlwut 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 x x Appticanrs Printed Name App firs S tore FOR OFFICE USE Reviewed By: Date: F' Required Inspections: Under Ground -Rough-in Air Test -Gas Test Final PERMIT City of Eagan Permit Type:Building Permit Number:EA112865 Date Issued:08/26/2013 Permit Category:ePermit Site Address: 4104 Blackhawk Rd Lot:001 Block: 078 Addition: Section 20 PID:10-02000-78-010 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 . Elizabeth Hess 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 - Laura L Allen 4104 Blackhawk Rd Eagan MN 55122 Sela Roofing Remodeling 4100 Excelsior Blvd St. Louis Park MN 55416 (612) 823-8046 Applicant/Permitee: Signature Issued By: Signature