4155 Blackhawk RdCITY OF {EAGAN WATER' SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.: 2919
Eagan. MN 55122 DATE: 10/26/79
Zoning: RLL No.. of Units: I
Owner: mequ r.a O-bm, _
Address: z oo
Sltp Address: 43 s'i
Plumber: Same, (Y 1v'tt2 WP 1Z 1}
Meter No.: 2 748855 Connection Charge: 272.00
60
Si: e Account Deposit: *
Reader No.: 11E63 29 Permit Fee: }0 '0O
I agree to comply with the City of Logan Surcharge:
Oklinnnaes. Misc
Charges::
00 ter.I
Qt
.
Total:
_ _
?'An Sat.
3
By, . Date Paid: Z
. ?}(}, t3P3 3.
Dote ,of Insp Insp : --
c» it AN SEW R S Y IIQ PERMIT
3795 Piton Knob?'Rtoad RMIT NO.:,
-
Eagan, MN $5132 DATE: *
Zonin T? T ; -
g
PlaY.af Units: j .
Owner 7 > r
-, 7 VIM
Addre9
Site Addre.s
Plumber:
f 'dgfte to comply with the City of Eagon tormettrop ,Chargo:' 1. ^ , f C p
,
flrdinam es Accoan,t • Deposit:
Permit Fee: ] 0 anti ,
Surcharge: ) z r•
' R $ .. {-- Cha!'ges
-t6 cif 1rE Kf Total ?3
?}a t' Date. Piiid = r h
t# •
CASH RECEFPT
CITY OF
EAGAN
.
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE .. ,
.'Y
19
R6'cEwetl -
FROM. ,.. -,
AMOUNT
& DOLLARS
? CASH [] CHECK
FUND CODE AMOU}T
Thank 4
BY
EAGAN TOWNSHIPS 395
ING PERMIT
Owner ------------------ ` Eagan Township
Address (present
--• - - t ---`-•-r-•-•-------__.L• Town Hal
--
,t-
------------- -----------------
Builder ________________ -...'?
Address ---------------------- --------------------------- Date r f
-------•--------------------••--------
DESCRIPTION __
Stories To Be Used For Front Depth Height Est. Cost Permit Fee Remarks
/71 LOCATION ./I'
treat, Road o gih r Description of Location Lot Block aaauion or ijaci
This pe it 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 N PREMISE WHILE THE WORK IS IN PROGr
1 o
This is to certify, tha.?'. +,?= -----------has permission to erect a--- i<t t-• upon
the at) describe r bject to the provisions of the Building Ordinance for Eagan To ship adopted April 11,
19
- Per ----------------------------------------------------- •-----------------------------------------------
Chairni f Town Board Building Inspector
- -----------------------------------
CITY OF EAGAN Remarks
Addition Art Rahn First Addition Lot 15 Blk 1 Parcel #10 11900 150 01 x
Owner & a;Cr F Ll_-' e`Ei Street 41? Blackhawk Road State Eagan, MN 55122
?? t?76"?
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 7 i
STREET RESTOR.
GRADING
Jq7
SAN SEW TRUNK //
SEWER LATERAL 5
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK 78 7 2.1 157 4
5
STORM SEW LAT -
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 305.00 223377 12/12/80
BUILDING PER.
SAC
PARK 280.00 20704 9
12
180
.
.
BEA BLOMQUIST
MAYOR
THOMASEGAN
JAMES A. SMITH
JERRY THOMAS
THEODORE WACHTER
COUNCIL MEMBERS
CITY OF EAGAI
3795 PILOT KNOB ROAD
P.O.BOX 21199
EAGAN,MINNESOTA
..:55122
PHONE 454-8100
March 3, 1982
Dakota County Government Center
% Auditors Office
Hastings, MN 55033
Attention: Peg
RE: Parcel # 10 11900 150 01
i
THOMAS HEDGES
CITY ADMINISTRATOR
EUGENE VAN OVERBEKE
CITY CLERK
Lot 15,'Blick 1, 'Attu Rahn Addn.
Dear Peg:
The attached corrected need to be processed for the 1981 tax
statement.
Please send a corrected statement for this correction.
Thanks.
Sincerely,
Ann Goers, Assessment Clerk
THE LONE OAK TREE ... THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY.
CITY OF :1GA
DATA FIDCESSING FORM - LOCAI, IMPROVEILaa ASSESSMENTS
F PREVIOUS HATCH fl CURT BATCH # DATE -
}LI LOT 16LK C 0/'Y FACTOR ('R ASSN: OP,.IGIaAL NErl PRINCIPAL C RF :T YE-;-R BEG DIST P
P$S I N;.%M // PRINCIPAL AM:1UHT PAID At40T:IT YR TO A P
FACTOR A1• r Y
.
t 2 3-7 12 L -lc 19 22 2.!. 25 27-Y 37-40 41-50 51-60 1-C ,j 1/1 78 79 ri1_
13
21
23
26
70
72 77
6
6
6
6
F j
6
F
i 6
6
r' I
i 6
F
1
1 6
F
6
q6
C-) L
Municipal Notice of Well Permit Application
Dakota County Environmental Management Department
Water and Land Management Section
14955 Galaxie Avenue West
Apple Valley, MN 55124
Tel (612) 891-7011 Fax (612) 891-7031
DATE: April 23, 2001
TO: Tom Colbert/Wayne Schwan - EM
Fax #: (651) 681-4694
FROM: Water and Land Management
RE: Well Permit #: 01-H163383
Municipality: Eagan
Well Type: Sealed
Environmental Specialist: Rutten
The Water and Land Management Section of the Dakota County Environmental Management Department
has received the following permit application for the well described. If you require further review of the
application or if you have any questions or concerns about it, contact the Environmental Specialist listed
above or our office at (612) 891-7011. If there is no response from your office within 24 HOURS (excluding
weekends and holidays), we will assume that you have no objections to the issuance of the permit. Please
note that permit issuance is always conditioned on the permit applicant's observance of and compliance with
all applicable state, county, and municipal laws and codes.
Well Contractor: Kimmes-Bauer Well Drilling
Date application received: April 19, 2001
Anticipated Drilling Date: Time: -_
Anticipated Grouting Date: Time:
Property Owner: Maynard Ohm
Well Owner: Maynard Ohm
WELL LOCATION:
PLS Coordinates: ne 1/4, sw 1/4, sw 1/4, se 1/4, Sec 20, Town 027, Range 23
Street address: 4155 Blackhawk Rd
PIN Number: 10-11900-150-01
WELL INFORMATION:
Diameter: 4
Casing depth: 152
Total depth: 159
Static Water Level:
Aquifer:
COMMENTS:
............... _. ___............_.._.__...................
....:.'_..
KATHRYN CIR
_.__............_. _.,...... ,' .
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117558
Date Issued:10/21/2013
Permit Category:ePermit
Site Address: 4155 Blackhawk Rd
Lot:15 Block: 1 Addition: Art Rahn
PID:10-11900-01-150
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
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: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Nancy M Ohm
4155 Blackhawk Rd
Eagan MN 55122
All Craftsmen Exteriors Llc
1020 East 146th St
Ste 226
Burnsville MN 55337
(952) 898-4680
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA122440
Date Issued:05/07/2014
Permit Category:ePermit
Site Address: 4155 Blackhawk Rd
Lot:15 Block: 1 Addition: Art Rahn
PID:10-11900-01-150
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Basement Fixtures
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fixtures:sink, toilet, shower
Nancy Ohm
4155 Blackhawk Road
Fee Summary:PL - Permit Fee (miscellaneous)$55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Nancy M Ohm
4155 Blackhawk Rd
Eagan MN 55122
Applicant/Permitee: Signature Issued By: Signature
Date:
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
M&Y062016
r
Use BLUE or BLACK InIcZ-
A
For Office Use
Permit#: /06V;;20
Permit Fee: /2.7' & '
Date Received: —� _, �� I
Staff:Ow - — I
2016 RESIDENTIAL BUILDINGjPERMIT APPLICATION
6 - l6 Site Address: `f1 S"6--- tC.r 44uaL
Unit #:
Rt/
Owner
.., ._ ,..,
Name: /iaM(D5/ Oh 144 Phone: ‘S% — 4/5V— a7S'
Address I City / Zip: 4/6-S 847 -CAL -44 4/
Applicant is: Owner y Contractor FJ:).
Type of Work
Description of work: )44//6,9411 P�t4, /
Construction Cost: ' Se,61e>. Multi -Family Building: (Yes / No .)
Contractor
Company: Contact:.. 'me,r S Vitt Pi/"
Address: 899 Randolph Ave. City:
St. PEW, MN 55102 9
State: Zip: 651-Mn65 Email: alai ely eR 4i 1 dorm
License #:'3l -.}O 7 V a 4 Q Lead Certificate #: 4/47 —/'qT f 9 6 -
If the project is exempt from lead certification, please explain why:
In the last 12 months,
Yes No
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor:
Sewer & Water Contractor:
Fire Suppression Contractor.
Phone:
Phone:
Phone:
NOTE: Plans and supporting documents that you submit are considered to be public Information. Portions of
the information may be.cla'ssified 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.goaherstateonecalt.oro
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 S ; Building Code must e completed within 180
days of permit issuance.
x 9P A U1 /`S It/ 32 e f'
Applicant's Printed Name Appli
t7/Zrased t769SSL9:01
Vs Signature
Page 1 of 3
:woad 62:TI 9T2 -SO -AN
lifid '1t "' i o NrWRITE BELOW THIS LINE
/.6q4e
SUB TYPES
Foundation
'' Single Family
Multi
01 of Plex
WORK TYPES
New
Addition
Alteration
Replace
Retaining Wall
DESCRIPTION
Valuation
Plan Review
(25%_ 100% P)
Census Code
# of Units
# of Buildings
Type of Construction
Fireplace
Garage
Deck
Lower Level
_ Porch (3 -Season) _
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola) _
Pool
Interior Improvement
Move Building
Fire Repair
_ Repair
V5
Occupancy
Code Edition
Zoning
Stories
Square Feet
Length
Width
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: _Ice & Water _Final
'd Framing
Fireplace: _Rough In Air Test _Final
)I) Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Siding
Reroof
Windows
Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
Miscellaneous
Accessory Building
Demolish Building*
Demolish Interior
Demolish Foundation
Water Damage
*Demolition of entire building - give PCA handout to applicant
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
)d Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Pool: Footings Air/Gas Tests _Final
Drain Tile
Siding: _Stucco Lath Stone Lath _Brick
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Fire Suppression: Rough In _Final
Erosion Control
Other:
Reviewed By: 1-6 14'\ 1 kI y,4 , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
f;n.-40,11,1 Fere-
04,0D 0,03
Page 2 of 3
City of bp
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
MAY 1 .9 2616
Use BLUE or BLACK Ink
For Office Use _566
Permit #:
Permit Fee:
Date Received:
Staff:
2016 RESIDENTIAL PLUMBING
/PERMIT APPLICATION
Date: Site Address: "//66 �' C//ECIC /l etici C lam. O ez/
Tenant:
J
Suite #:
Name: ,.�//� `J C y O h Phone: foe/ • 'may" x'38
Address / City / Zip: �///., S f l /AA 40(.0.4..0004r b."¢ ja k 11/./,
Name: 4g//. P/&,114 .j f!c Y,) cFei f , ..Lee- License #: P/M038% oZ
Address: l 93,2 3.i, /a jay c city: SYtl�crU
State:/NV/ Zip: t3-s/e5 Phone: Z.10,6-7 CO' 99 /a 3Z
Contact: `/i • 5TOQoL Email: a- i - c /f C cC eee-C,'d
New XReplacement Repair
Description of work:
'4 4
Rebuild
Modify Space _ Work in R.O.W.
AIPP
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ / _ PVB)
Septic System
New
Abandonment
Water Softener ,/
Add Plumbing Fixtures (/� Main / _ Lower Level)
Water Turnaround
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 System Abandonment, Water Turnaround* (includes State Surcharge)
*Water Turnaround (add $280.00 if a 3/4" meter is required)
$115.00 Septic System New (includes County fee and State Surcharge)
TOTAL FEES $ (0 C2
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.gopherstateonecall.org
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 • p = ns.
%i%d
/� , � DO'
Applicant's Prin
Name
AP
Use BLUE or BLACK Ink v1(
' E
For Office Use I
I
e / , y�( tri
city of Permit#: y
Permit Fee:_47
3830 Pilot Knob Road
Eagan MN 55122 v }Pi T'i }j� Date Received: .tp .S
Phone:(651)675-5675 �
Fax:(651)675-5694 Staff: P)
L
CO2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: eO 15] i `1 Site Address: 1-i 6
1 55 1.aacka,wQ
k .pctic4 Unit#:
- Name: N)c C J Or- ' Phone:a�S 1) 757-S 4 US i.
i Resident/ 1
IOwner Address/City/Zip: 1-0 5 c GkotLk w24(44it � 6-1 an to AJ SSI.2-2 i
g Applicant is: Owner e< Contractor
Type of Work Description of work: 0 eck
g s
Construction Cost: �t OO Multi-Family Building: (Yes /No ) I
.0 .. . .__. Company: DUrand Co 4('i)t iU1 S t°rU t'5 Contact: S' w til i U Cc.e ioi
Contractor ' Address: SIJ e a O 4+ r U i e0 t>r�'I City: (.0'1 . ee - Lake
i State: fY\' Zip: S'S1li7 Phone:(is CO i
� 24-2ZSoEmail: aUrar,JCn5.414.4 on ru;CeS9�,.,,w,•J t
,
1 t License#: lo-lio 5cil a Lead Certificate#: f r 0 i Sr ) V--1 f
p If the project is exempt from lead certification, please explain why: !
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 1
In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? I
Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
1 I
1 Mechanical Contractor: Phone:
( 1
1 Sewer&Water Contractor: Phone: f
i
Fire Suppression Contractor: Phone:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of
I 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. wwe,actorteTslaieonecaii ora
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 Building Code must be completed within 180
days of permit issuance.
x 5h"WA Do ret^I x _
Applicant's Printed Name Applicant's Signature
Page 1 of 3
• 6,-/ big d DO NOT WRITE BELOW THIS LINE /(7-,, L7c7c)
SUB TYPES
_ Foundation Fireplace Porch(3-Season) ` Exterior Alteration(Single Family)
° Single Family Garage _ Porch(4-Season) Exterior Alteration(Multi)
Multi 13 Deck Porch(Screen/Gazebo/Pergola) Miscellaneous
01 of_Plex Lower Level _ Pool Accessory Building
WORK TYPES
/0 New Interior Improvement Siding Demolish Building*
_ Addition _ Move Building _ Reroof Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
— Replace Repair Egress Window Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation ' 3r3. " Occupancy a'12r.. MCES System
Plan Review Code Edition yo.4 20 iS" SAC Units
(25%_100%'t° ) Zoning PP City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction VS Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
XFootings(Deck) Final/C.O. Required
Footings(Addition) Final/No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test
Roof:_Ice&Water _Final Pool:_Footings _Air/Gas Tests Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath Stone Lath _Brick_EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan �J Other:
Reviewed By: T[/ / , Building Inspector
RESIDENTIAL FEES JD x(g ' 7 pc-
Base Fee y --
Surcharge
Plan Review
MCES SAC ZI2 5g. �T
City SAC (vg / c
Utility Connection Charge
S&W Permit&Surcharge Jr U V
Treatment Plant
Copies
TOTAL
Page 2 of 3
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