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1650 Blackhawk Cove INSPECTION REC+ RD ;!04 8 2, CITY OF EAGAN iER 1` "!'~'1~r 3930 Pilot Knob Road Pw* t sr. Eagan, Minnesota 55123 Da1ar tad: r (612) 681-4675! SITE ADDRESS: LOTS s APPLICANTc i4 *LACtNAMK COW lAiMl1~~1 11 # fA#.#CKflANK MsE!!.• (+812} ~iitL~~' { r RE'l~T~'~f►v~ TYPE OF WORK: 7 1,17 iF~i1111! - 2. -a RIt;NARIF! t RECif»~pt ♦ C*L!!!! AI1T1Eif1 `j2L.Jl,~ fiikii~tOf . P"eeit NO. Pwm *i dor M" 'iigeP WW M sw PLLVANNO HVkt$ ELECTM ELEMIC Dente mw Coa nls ftundaftn Fnntinj~ . P.Wny s-f Afto P6g. Ieal. OrwTed FMd P'bg. Pft. kme*or - Na* Pbxvb r 00M. mew EnW- Ne Imo. RnW Do& ft. Nas Firms ww PY. Dbp. CITY OF EAGAN N°_ 1 1 15 2 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # To be used for SWIMMING POOLEst. Value $10,000 Date OCTOBER 22 1985 Site Address 1650 BLACKHAWK COVE Erect ❑ Occupancy Lot 5 Block 1 Sec/Sub. BLACKHAWK HILLS Remodel ❑ Zoning Parcel No. 1ST ADD Repair ❑ Type of Const. Addition ❑ No. Stories BOB HUNSTAD Move ❑ Length z Name Demolish ❑ Depth Address SAME Int Impr. ❑ Sq. Ft. b City Phone 454-5309 Install Xl MINNETONKA POOLS INC Approvals Fees Name 10820 WAY ZATA BLVD Assessment Permit - Address City MTKA Phone 546-3281 Water & Sew. Surcharge 5.00 Police Plan Review Name Fire SAC uB Address Eng. Water Conn. W City < Phone Planner Water Meter Council Road Unit I hereby acknowledge that 1 have read this application and state that Bldg. Off. 10/22/8 Tr. Pl. the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan, Ordinan es APC Perks Var. Date Copies Signature of PermitteeTotal 5 • 5 0 A Building Permit Is Issued to: MINNETONKA POOLS INC on the express condition that all work shall be done in accordanceapplicable State Minnesota Statutes and City of Eagan Ordinances. Building Official 2~ i ~ EAGAN TOWNSHIP ~ N® 3077 BUI CLING PERMIT Owner - P'j1!!gj Eagan Township Addre f) ~?4~.._„ I ftfc4s~l ........44o4i Town Hall Builder • Da Address .a - DESCRIPTION Stories To Be Used For -Front Depth Heighf Est. Cost Permit Fe Remarks LOCATION 1 G-~` 3 StreeL Road or other Description of Location I Lot Block Addition or Tract /'~To e'L&.'ge .9 1 / C~~ §ca This permit does not authorise 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 E T N THE PRE IS WHILE THE WORK IS IN PRO SEn . • All This is to certify, that...I! T . . . ...............has permission to erect a-_..._...__.... .--..upon the above described remise subject to the provisions of the Building Ordinance for ow ship ad opted April 11. 1955. ' Per C rman of Town Board Building Inspector VILLAGE OF EAGAN WATER SERVICE PERMIT 3795 pilot Knob Road Eagan, MN 35122 PERMIT NO.: _ Cy eQ / Zoning: - 8-1 DATE: .._s _ No. of Units: Owner: De=i8 0tte$4n -hLildeX__-_bUrt_ftafftdd-Owner _ Address: _ o j [ _ /bl site Address: _ - 1550_B18C~~J Plwnl,f•r: Meter No.• - Sao r~o- - Connect n Char Size: -,Fz Account Deposit: Reader No.; Permit Fee: I agr o comply with the Vilbge of too" Surcharge: Ordin c s. _ } A Misc. Charges: A y Total: p.:.. Date Paid Date ot']ns Ev / 1C's ~ 37gE ONOW0.69%. 3E~~ Qt ' a vase adTega s - ' t G ;Oocf 51ce Addte ~ V ~ ~~t 1 as• qis~' O~~ea ~ tE~~• ~~~,te ut lrie /OV/3 81(4 9 0 a Request to , Fie No. Rough-in Inspection NOTICE: You Must Call Electrical Inspector Required? If A Rough-In Inspection ❑ Yes o Is Required. Ready Now I Icensed contractor ❑~oww~ner hereby request inspection of above electrical work at: Job Addres (Str eet, Box or Rou/~~o.)_ _ e qty`` Section No. Township Name or No. Range No. County Occupant (PRINT) ; Phone No. Power Supplier Address Electrical Contractor (Company Name) Contractor's License No. Harrison Electric Inc. CA00808 Mailing Address (Contractor or Owner Making Installation) 2525 Nevada Ave. N. #301 Golden Valle M 55427 Authorized ignatX(a~ne, Making Installation) Phone Number ESOTA STATE BOARD OF ELECTRICITY GQi THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Roam 5-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 e/ UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION ~ f=s•oooo 10, See instructions for completing this form on back of yellow copy. AF M 4 9 'X" Below Work Covered by This Request New Add Re TypeofBuilding ApphancesWired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating z Apt. Building er Load Management Comm./Industrial rnace ~ Other (Specify) Farm Air Conditioner Other (specify) Contractor's Remarks: Compute Inspection Fee Below: IW6 # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps ]O to 100 Amps , Transformers Above 200 Amps Above 100 Amps Signs Inspector' Use Only: TOTA Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATIO"AY BE.,CMDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final t Date 3, been made. 42 '1 t OFFICE USE ONLY This request void is months from This request void 3 T from 66 lf7~j!_ o C) Request Dale Fire No. Rouph-in Inspection ~~77 Required? ❑Ready NoIINotify , Inspec- oL 71 J 'Kyes ❑ No for When Ready Licensed Electrical Contractor I hereby request inspection of above ❑ Owner electrical work installed at: Street Address, Box or Route No. City ection o. Township Name or No. Range No. County Occupant (PRINT) Phone No. 9,0z'e'e T 114, wr f 6 3.0 Power Supplier Address Electrical Contractor (Company Name) Contractor's license No. Mailing Address (Contractor or Owne Making Installation) O0~~ 771Yd-,C4HjCz d u~d 4 7tr - Author'ztpre (Ccygtractor/O ner Making Installation) Phone Number MINNIFSOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room N-181 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Pk.,.,o IR191 297.7111 - ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-00001-03 J' See instructions for completing this form on back of yellow copy. X" 8e(crv',N}ork Covered by This Request 3 S S ] New A" Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Heating Commercial Bldg. Furnace Silo Unloader industrial Bldg. Air Conditioner Bulk Milk Tank Farm Other pecify Other (Specify) Other Specify Other Other Compute Inspection Fee Below # Fee Service Entrance Size # Fee Eeeders/Subteeders # Fee Circuits 0to100Amps 0to30Amps `1Lf'0 0to30Amos 101 to 200 Amps 31 to 100 Amps 31 to 100 Amps Above 200 Amps Above 100 -Amps Above 100_Amlks Transformers Remote Control Circ. .SD Partial/Other Fee Signs Special Inspection Remarks T E Rough-in Date e Electrical gym' ~_J,[7-Y specfor, hereby certify that the above Final C~1e inspection has been /S f I made. Z2 This request void PP~~ 18 mouths from This request void 63 months 7 Request Date Fire No. Rough-in Inspection Reguire Ready Now to'r I Not Read Pew ► 9[~ es ❑ N. I When 1 Licensed Electrical Contractor 1 hereby request inspection of above ❑ Owner electrical work installed at= Street Address, Box or Route No. City 1(,,57v C3L/3e_)Z}+PruJK, d-avE eq& q- J non No- Township Name or No. Range No. County )+ENN J6101 IV Occupant (PRINT) Phone No_ kobe- r t 14uA;StoL<L 9 Power Suppliers Address Electrical Contractor ICompany Name) Contractor's License No. 1✓ t-Ee.T/L i C. c A. k c- CT-1t~U o y! b 15- Mailing Address (Contractor or Owner Making Instailation) 7S t 5t AF?DN A lu S5 00/ Auth ized Signature (Contractor/Owner Making Installation) Phone Number MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Rom N-191 BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS 1827 University Ave__ St. Paul, MN 56104 Phone (6121297-2111 ENCLOSED. 5") b 4 REQUEST FOR ELECTRICAL INSPECTION ER-00001-04 0 See instructions for conole" this fyrm on back of yellow copy. B7r 4 2,1! 5 8 _ I-- Below Work Covered by This Request I D I'm ~fim Add Rep- Type of Building Appliances wired Equipment Wired Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt Building Dryer Electric Heating Convnercial Bldg. Furcate Salo Linloader ft Industrial Bldg. Air Conditioner Bulk Milk Tank Farm they pec-fy then (Soer_ify) r Specity Other Other ompute Inspection Fee Below V Fee Service EntmarmeSize 0 Fee Feeders/Subfeeders C Fee Circuits 0 to 200 Ainlis 0 to 30 Amps 0 to 30 Am s Above 200 Anlps 31 to 100 Amps 31 to 100 Amps a, Swirnning Pool Above 100-Amps Above 100_Amps Transformers Irrigation Boom ..,SD Partial,'Other Fee Signs Special Inspection p~r~ 5 3a7,';D TOTAL FEE r Rough-in r mate ] s,.. . the Efestrical t - /r ryt ~7 Inspector. hereby rtity that the above Final . ate rispecvon has been /--z made. lid This tetwest void t6 months troth CITY Of EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 4548100 BUILDING PERMIT Receipt * To be wed for ` ll b"f T N V00'_ Est. Value S 10 r O f I'J Date Oh:'. OL' ER 22 196 r~ Site Address 1 6 ti o bi ,`y , 4 R WX tiU Erect ❑ Occupancy Lot Block _I_Sec/Sub. E•LAC.KFbi K IZ. Remodel 11 Zoning Parcel No. ~,c~j~ ADD Repair ❑ Type ofConst. Addition ❑ No. Stories ~ Name 50Es'I[;"i'S^7D Move ❑ Length Demolish ❑ Depth Address ','f±NIF int Impr. ❑ Sq. Ft. b City Phone 4!; Install I] Name 1 ' i t dTs"'I'U"• C d► PGUL: T : ,t_. Approvals Fees o~ Address dG ki>iZAT'1 WjVD Assessment Permit `+i • Water & Sew. Surcharge 5.00 City jPhone 546-3281 Police Plan Review Name Fire SAC u~ Address Eng. Water Conn- ~Z City Phone Planner Water Meter Council Road Unit I hereby acknowledge that I have read this application and state that Bldg. Off. Tr. PL the information is correct and agree to comply with all applicable APC State of Minnesota Statutes and City of Eagan Ordinances. Parks Var. Date Copies Signature of Permittee Total -'r- A Building Permit is issued to: ' IN 'TON'Ki'' j , INC on the express ooredKM Ow all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinonci. Building Official - ' c Permit No. Permit Holder Dab Telephons 11 Plumbih0 HNA.C. Electric 0 / d f~s it Softener Inspection Date Insp. Other Footings 1 Footings II Foundation Framing Rooting Rough Plbg. Rough HN. Insul. Fireplace Final Htg. Final Plbg. Final Cert/Oco. Water Describe Lo ion: Well Sowor pp"~ pr. Disp. J'fj CITY Of EAGAN ~ 7922 3795 Filet Knob Real Eagan, MN $5122 i~ (1 ' PHONIC 454-8100 BUILDING PERMIT Receipt To be wed for FINISH BASEMENT Est. Value $7,500 pate April 13 , 19 Site Address 1650 Blackhawk Cove Erect p Occupancy R-3 Lot 5 Block Sec/Sub. Blackhawk dills 1 Alter IU Zoning R-1 Parcel # 10 14380 050 01 Repair ❑ Fire Zone Robert Htutstad Enlarge E] Type of Const. V m Name Move ❑ * Stories Address 1650 Blackhawk Cove Demolish ❑ Length C; Eagan 55122 phone 454-5309 Grade ❑ Depth NA Sq. Ft. o Name Valley Investments Const. Co. Approvals Fess o Address 3770 So. Lexington Ave. Assessment Permit 6A. 00 uF pt Es an 5512 Phone 4,Z4-5191 Water & Sew. Surcharge 4. QO Police Plan check x W Name Fire 3AC K. ;.y; uz Address Eng. Water Conn. t W Ci Phone Planner Water Meter - - - Council Road Unit l hereby acknowledge that 1 have read this application and state that Bldg. Off. the information is co and agree to comply with all applicable APC Total $72.0 State of Minnesota tatufes and City of Ea n Ordinances. Signature of Permi Y A Building Permit is iw4dr to: Valley Investments Const. Co_ on the e,gtress condition that all work shall be done in accordance with p11 applicable State of tAianesoto Statutes and City of Eagan Ordinances. Building Official f~(" ~f~ Permit Na. Permit Holder Mae. Permit NO. Hoidw Plumbing 331 COE I1-E Well .Wager Qitp. Sadder Electric (07 Z~ AtCa% 6 S-2"$.1 eopectlon Dow Insp. Other Footings Foundation Framing Hough Pf HV lnaubnion Final PrM , Pirasl HVAC Final Wear Describe Location- Well Swisar - . Recelpt3-l;;- e2 U O PLUMBING PERMIT Permit No. 31 c~ CITY OF EAGAN Fee a Fill in numbered spaces S/C l ='t Type or Print legibly Tot. 1. Date 4/6/83 2. Installation Cost 3. Job Address 1650 B1aCkhawk. Gwe --S Blk. Tract r' 0 a. Owner. Valley Investments r 5. Contractor Wenzel Mech_ Phone 459_1566 6. Address IWO KenneheC nrive 7, City Eagan state Mn Zip 55122 8. Building Type: Residential X] Commercial ❑ Institutional ❑ 9. Work Description: New ❑ Add ❑ Alter x.] Repair ❑ 10. Describe 11. No, -f.ixtures No. Fixtures - Water Closet Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Bar Sink Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets k. . . I1 that the above information Is true and cormete aru! I iraa to Oil ordinenews and "ea pswrsing this type Of, waark. VOW: for Final 171* Y _A. 1,4 CITY OF EAGAN NG 7922 5795 Fillet Knob Road Bogen, MN 55122 • PHONE: 454-8100 BUILDING PERMIT Receipt #s7k rG) To be wed for FINISH BASEMENT Est Value $7,500 pate April 13 1983 Site Address 1650 Blackhawk Cove R-3 Erect ❑ Occupancy Lot 5 Block 1 Sec/Sub. Blackhawk Hills 1 Alter )ff Zoning R-1 10 14380 050 01 Repair ❑ Fire Zone NA Parcel # Enlarge ❑ Type of Const. V W Name Robert Hunstad Move ❑ # Stories z Address 1650 Blackhawk Cove Demolish ❑ Length NA G Eagan 55122 Phone 454-5309 Grade ❑ Depth -!A-Sq. Ft. o Name Valley Investments Const. Co. Approvals Fees 09 Address 3770 So. Lexington Ave. Assessment Permit u§ Ci Eagan 55123 phone 454-5191 Water & Sew. Surcharge 4.00 Police Plan check Name Fire SAG u-Z Address Eng. Water Conn. <W City Phone Planner Water Meter Council Road Unit I hereby acknowledge that I have read this application and state that Bldg. Off. the information is and agree to comply with all applicable APC Total $72.00 State of Minnesota tatut s and City of Ragan Ordinances. Signature of Perrnitt A Building Permit is iss to• Valley Investme_ is Const. Co on the express condition that all work shall be done in accordance with,. applicable St of Statutes and City of Eagan Ordinances. Building Official ~l '-J ✓ f CITY OF EAGAN Include 2 sets of plans, 1 site plan w/elevations & BUILDING PERMIT -APPLICATION 1 set of energy -3-3/calculations. • To Be Used For ksr: m~ 1 h fs pluation Date 3 -3 f - b -3 Site Address J/,Sp 1~ (_~0 OFFICE USE. ONLY lot Block sec./ Sub. 6l k~k, 1~0I Is I ect occupancy Parcel 10 f `C 3 To 0G O O Alter - Zoning Repair Fire Zone Owner: AA JEF~ , A(s r" Enlarge Type of Const. Move # Stories Address: /6 ST ~A C i~l'fl~ K t 'n Demolish Front ft. City/Zip Code: 1_.A,F" Aj) Grade Depth ft. Phone S7 D ''/l APPROVALS FEES Contractor: VH-Lljif .ivV EST7?tFNi NSi , Assessments Permit _j s Water/Sewer Surcharge - Address: 3774 J=x~~(o~ Police Plan Check _ City/Zip Code: 4 /,A►/ Fire SAC fig- Water Conn. Phone #:~j Planner Water Meter Council Road Unit Arch./Eng.: Bldg. Off.' Address: APC - City/Zip Code: Phone 7~~- IhIlT VILLAGE OF EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 PERMIT NO.: The Village of Eagan hereby grants to Oak Heating A.IC Go. Of t nnI Xan4 A An-, r%r%Q] A a _ HRATTM Permit for: (Owner) nnia nt*mman at 1650 L1AGkhW&C0ve , pursuant to application dated 9Z7/73 Fee Paid: S20,00 dated this5t_ day. of October , 19_ 7 .50 s/o Building Inspector Mechanical Permits: Bid Total. ,6-/ 1~ Iatk~ 1.t l.( Isfi HOUSE HEATING TEST RECORD ADDRESS APT. FLOOR CITY -SUBURB OCCUPANT OWNER HEAT LOSS DATE HTG. INST. / SOLD BY INSTALLED BY Electrical Work By Gas Line By TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER G.AS D GN CONVERSION MAKE v~ MAKE OF BURNER Model Model Serial Max. BTU Rating INPUT MAKE OF FURNACE Model CONTROLS f q THERMOSTAT Heat Plug Vent Size Valve u KIND OF LIN R SIZ N Limit v? Draft Hood ~ Regulator Limit Setting G-~ Filters Size Nu ber Fan Setting 1~ Chimney Location Inside 0 side Pilot Type &WO ~A L Chimney Construction Pilot Make 14 U1 Pilot Model Q1, Cf Smoke Bomb Wiring Pilot Timing !a<-'J Draft Test Tag L.W. Cut Off Door Pressure Lighting Inst. L/ Pressure ' Percent C02 , J Date Tested Input CFH 1i Percent 02 1 Company Testing /0(- 1, a ffY Stack Temp. " v Percent CO t;}I. Name of Tester Form 235 CITY OF EAGAN Remarks 2 l j, , Addition Blackhawk Hills Addn. Lot 5 BIk 1 Parcel 10 14380 050 01 Owner i"s Street 1650 B1 ackhawk Hills - Co~.state_.EMn, . 55122 Improvement Date Amount Annual Years Payment Receipt Date ~TREET SURF. l~ 1976 201 2 20.12 10 eoor STREET RESTOR. GRADING SAN SEW TRUNK 1970 512.09 20-48 25 1 Paid * SEWER LATERAL 137 2 qdl.09,85 270.49 20 Paid WATERMAIN * WATER LATERAL 1972 20 WATER AREA * STORM SEW W lat. 1972 20 STORM SEW LAT STM SEW TRK V 1983 1571.00 104.73 15 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 320.00 98 12-6-73 BUILDING PER. SAC 375-00 b525 7-16-73 PARK - - - - - - - - - - - - - - - - - - I For Office Use r I Permit City of hicin I JJ-~ Permit Fee: ( J 3830 Pilot Knob Road Eagan MN 55122 I Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 3 staff: 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: off ~ ~ 4 Tenant: Suite RESIDENT/ OWNER Name: h jwfie ahl Phone: Address / City / Zip: 16SO 941;e ~ 40141C Applicant is: Owner , Contractor TYPE OF WORK Description of work: L~./Gs Jh> Construction Cost: L~e `To Multi-Family Building: (Yes / No CONTRACTOR Name: 6E4A&_z &014ter License Address: 15,Z &MA40X f City: ' If.L,40tw State: Zip: Phone: AAlu Contact Person: Jz* COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING _ Minnesota Rules 7670 Catenory 1 _ Minnesota Rules 7672 Energy Code • Residential Ventilation Category 1 Worksheet New Energy Code Worksheet Category Submitted Submitted (4 submission type) • 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? _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 the Information may be classified as:non-public if you provide specific reasons that would per the City to conclude that the are trail se ts_ . h the ordinances and codes of the City of I hereby acknowledge that this information is complete and accurate; that the ;zo",0/0"o Eagan; that I understand this is not a permit, but only an application for a pwithout a perm' • at the work will be in accordance with the appproved, plan in the case of work which requires a review -ib x . r7lr~ li' a i re Applicant's Printed Name Page 1 of 3 2004 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Date I I t~ Site Street Address 81atipsh Unit # Property Owner { 1rA John Telephone # Contractor P. A -Ae-,,)nw Telephone # (1051 Address city EanAin state zip The 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) Other: Water Softener _ Water Heater $ 15.00 replacement _ additional Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00 State Surcharge D $ 50 Total $ Emma 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. w Applicant's Printed Name Applicant's Signature PERMIT Control No. 0482 CITY CAF EAGAN ` BUILDING 3630 Pilot Knob Road PERMIT TYPE: Permit Number: 9906918 Eagan, Minnesota 55123 (612) 681-4675 Date Issued: 96/21/92 SITE ADDRESS: 1659 BLACKHAWK COVE LOTS 5 BLOCK. 1 BLACKHAWK HILLS DESCRIPTION: Building Permit Type MISCELLANEOUS Building Work Type ALTERATION REMARKS: RECEIPT * 0918938 DATED 5/21/92 REROOF FEE SUMMARY. VALUATION ;7.090.. Base Fee $90.00 Surcharge $3.59 Laic. Search Fee 15.00 Total Fee $98.50 CONTRACTOR: - Applicant - ST. LI OWNER: SAMPSON-LINDGREN 17215546 000592 HUNSTAD BOB 2228 E 35TH ST 1659 BLACKHAWK COVE MINNEAPOLIS MN 55497 EAGAN MN (612) 721-5546 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 Mn. Statutes and City of Eagan Ordinances. APPLICANT/PERMITEE SIGNATURE ISSUED 6Y: SIGNATURE INSPECTION RECORD Control No. 0482 CITY OFEAGAN PERMIT TYPE: BUILDING - 3830 Pilot Knob Road Permit Number: 000688 Eagan, Minnesota 55123 Date Issued: 05/21/92 (612) 681-4675 SITE ADDRESS: LOT: 5 BLOCK: 1 APPLICANT: 1658 BLACKHAWK COVE SAMPSON-LINDGREN BLACKHAWK HILLS (612) 721-5546 PERMIT SUBTYPE: TYPE OF WORK: MISCELLANEOUS ALTERATION INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. FINAL REMARKSt RECEIPT 0 C®18938 DATED 5/21/92 REROOF PERMIT # CITY OF EAGAN 1992 BUILDING PERMIT APPLICATION 681-4675 CIJ SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, I copy of energy talcs. COMMERCIAL 2 sets of architectural_& structural plans, I set of specifications, I copy of energy talcs. Penalty applies when typing of permit is requested, but not picked up by last working day of month in which request is made or lot change is re nested once permit is issued. Date - / Valuation of work Site Address:l ,~~►4 ~k 144 w j~ e y STREET STE S Tenant. Name: (commercial only) LOT BLOCK D. 0 Description of work: J~~ n u l~ The applicant is: ❑ Owner Contractor ❑ Other (Describe) Name Phone. Property LAST FIRST Owner Address /SAL //4-~~ STREET STE City State zip sl Z Company Phone/ J J_ 5~~ Contractor Address~~ ~ License Exp.l - s _-9 city State Zip 6 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 application and state that the information is correct and agree to comply wit all applicable State of innesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY : • - ; BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 05 Apt. Bldg ❑ Og Basement Finish ❑ 13_Cow/Ind New 02 SF Dwg. 0 06 Garage/Accessory ❑ 10 Swim Pool 13 14 Comm/Ind Add 03 Two family ❑ 07 Fireplace ❑ 11 Res. Add. ❑ 15 Comm/Ind Rem ❑ 04 Multi-fam. T.H. ❑ 08 Deck ❑ 12 Res. Porch ❑ 16 Public Fac. ❑ 17 Agricultural WORK TYPE ❑ 31 New ❑ 33 Alterations ❑ 35 Move Ll 32 Addition ❑ 34 Tenant Finish ❑ 36 Demolish GENERAL INFORMATION Const. Actual) Basement sq. ft. MWCC System (A1 owable) 1st F1. sq. ft. City Water UBC Occupancy R-3 2nd Fl. sq. ft. PRY 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 INSPECTIONS ❑ Site ❑ Footing ❑ Framing ❑ Insulation ❑ Wallboard M Final ❑ Draintile ❑ .Fireplace Permit Fee "AINEW ve[uetian: Surcharge ,3, vv Plan Review License ~.oo MWCC SAC City SAC Water Conn. Dater Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total: SAC % SAC Units STATE OF MINNESOTA STATE OF MN DEPT. OF COMMERCE eau o DEPARTMENT OF COMMERCE =v~, 133 East Seventh St 133 East Seventh St 8t. Paul, MN 55101 St. PaTul, MN 55101 4 (612) 296-6319 (612) 296-6319 BUILDING CONTRACTOR BUILDING CONTRACTOR ID#0003129 ID#0003129 R EMODELER REMOMLER. CORPORATION CORPORATION Issued: 01/27/92 Expires: 03/31/93 ~ Issued: 41/27/92--03/.31/93 TIMOTHY D LINDGREN TIMOTHY D LINDGREN SAMPSON--LINDGREN INC SAMPSON-LINDGREN INC 2228 E 35TH ST 2228 E 35TH ST MPLS MN 55407-0000 MPLS MN 55407-0000 M-OVAS f dft1985 BUILDING PERMIT APPLICATION - CITY OF EAGAN ROTE: ALL CONTRACTORS MUST BE LICENSED WITH THE CITY OF EAGAN COMMERCIAL. SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS & STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY SPECIFICATIONS AND J -SET OF 1 SET OF ENERGY CALCULATIONS ENERGY CALCULATIONS ' $2,000 LANDSCAPE BOND To Be Used For SIr 1Y NG ~4- Valuation: / 1 yor~ Date: Site Address OFFICE USE ONLY Lot Block Erect Occupancy Remodel Zoning Parcel/Sub &'2L"2 Repair. Type of Const Addition 0 of Stories Owner ( Q( I-{Gr /Y D Move Length Demolish Depth Address 16's0 144dg Z&11W,,& GG-!/ Int.Impr. Sq Ft Install City/Zip Code 1? 51 2- Phone f~SLfp APPROVALS FEES Contractor I~1f//VE7UoVe~' ~OGL,}IL~. Assessments Permit Water/Sewer Surcharge Address _/Q ,z / ZdLq J-Lp Police Plan Review Fire SAC City/Zip Code Engr Water Conn Planner' Water Meter Phone Council Road Unit Bldg Off Treatment P1 Arch./Engr. APC Parks Variance Copies Address TOTAL City/Zip Code Phone # r CITY USE ONLY L Bt- 1 RECEIPT#: t'a ~ SUBD. l L 1~41~ RECEIPT DATE:` PERMIT 2000 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3630 PILOT MOB RD EAGAN, it+N 55122 651-661-4575 Please complete for: > single family dwellings > townhomes and condos when permits are required for each unit > backfiow preventer for underground sprinkler system FIXTURES EACH # TOTAL Alterations to existing dwelling - minimum fee $ 30.00 Describe: Bath tub $ 3.00 x = $ Floor drain 3.00 x - $ Gas piping outlet " minimum -1 3.00 x = $ Hot tuts/spa 3.00 x = $ Kitchen sink 3.00 x = $ Laundry tray 3.00 x = $ Lavatory 3.00 x = $ Se tic System now/refurbished * requires MPC lie. 75.00 x = $ Septic System abandonment 30.00 x = $ RPZ new installationtr®pairtrebuild 30.00 x = $ Rough opening 1.50 x = $ Shower 3.00 x - $ Underground sprinkler if dwelling is under construction 3.00 x = $ Underground sprinkler if existing dwelling 30.00 x $ Water closet 3.00 x = $ Water heater 3.00 x = $ Water softener If dwelling under construction 5.00 x = $ Water softener if existing dowelling 30.00 x - $ Water turnaround 30.00 x $ State Surchar a .50 $ .50 Total Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. F i;ereby azi►>o ~ tnai i Have read tti appiicaiaon, a-te that the irsforrnatiori is com¢ct, and apnse to comply-with all applicable city of ~sri ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement. SITE ADDRESS: 4?4e,< 96✓,C Y>~ 2. 4zaw M/✓ 6-5772- OWNER NAME: :TTnai'H*/ , TELEPHONE M d s % 66S-P747 (AREA CODE) INSTALLER NAME: one. 2eoi c2 TELEPHONE 0612- STREET ADDRESS: 70&0 ~s (AREA CODE) CITY: •r!©w STATE: .ILf/l/ IP: Iry SIGNATUR F PERMITTEE 3 h :i. :-:.,.:v{.; ....-4-;]:4:4"?.-.iJ;: E.,ixy,i-ti,a?c.}::r.yy:.w.:: .:gr+:w-,iict}x :.}•m4•.w.x.: ~,ntA.;:.2. ...Tr:..... :.-.•Y.,......~,......3...,:..-::..-...~"+cf.'::}..~}:}":::.}:: a} ,''~'.'::^}:'i<.''.2:4.•n:5F4. ..ii'. `::4:; n.r~x;:.•.,vr •n. ~.-T:4i:4iT?: '.:,::rJ:4;•}.m% k44x.: •..ir:?J}:.ti •:?4~:}Y..-W:::;iF:~.y~ .,Y,.;:•.+:;~.;:.{::~[~ :J:. :.1i..}i:::,. .?'.fv.. .-N..i.:: :r.: ..r:C. ?'C>...4. .R•.{...:.. v:^'S4•. •4 ~:i- JTi .............n..-.-..-. iE•....~:$`.. .....n::::.,... n,-...,-.:.::: i,::~. T'.ivfd:.:.:i::r(:ti~~iY.^$; ~:.4:{•.•:. nF..n:. :0.:•]. : {4X;'2•}:{•: .h~5'~:A~ .•n~.~,.-. :SSAYi}X;•i}:'4n• ,Gfin 'tirE4..:4::4: ~,vnwr:..v . ' ' 4ii:..xv.:v;::; :riy,({• riE:{'J]:;{•:;:::2;2.4::{'2]:: :::?fN•:•:•Ji•:•}}:4:^::;:: . •.w v: 4.4.... 'Q•. r.. . v. - Lv~HM}L~~ ~jt:ti•; ' ....i}R':.}....:.: .};:E Rio ..i?4Y ' Si;ct: -;i~'ri;.a a~`:~4:. .;4:.:.:,;:::i.-~s-}:2:.- :...,:.:.:..}:n::r•:. }~•}s~}'~:• <•:i2. ...........~t'.::.... ; s. ,{•.«>;}~:<z::z¢4:~ :4:0...4::4;^? 4 ...G:L:%O:{:ti4.:•.:v:4:t :.4.0:•:{'; .-~y- - - 2i% . is .:.4::?-.-, : Y•• isdxv:,o,:ry~._ ..>}o:::;% .:,,.,..,:.r.n»:.n,,.nx~:4}:§E;.4' ~x .,:v:,::5•,,,. t;'t;,:fk:.~c<Lx:•..,.r..,:~n.m~f.`2;~,~`n:.~ ' ]]:•'~,~~-''~"x''$:-'.'' :34?: „ • i~~:R:~:x,....?~:k.:,,:.:. 1993 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. - - - - - - - - - NEW CONSTRUCTION ~ `11 \J{ ~ ~ ISf ADD-ON A/C l ADD-ON FURNACE _jS DATE -~1O FEES HVAC: 0-100 M BTU $ 24.00 ADDITIONAL 50 M BTU ^ 6.00 GAS OUTLETS (MINIMUM 1 @ 53.00 EACH) F/4 - ADD-ON/REMODEL (EXISTING CONSTRUCTION) $ 15.00 STATE SURCHARGE .50 TOTAL 60 SITE ADDRESS: Lai h" OWNER NAME: i t f~VYr TELEPHONE INSTALLER: VOGT HEATING & AIR CONDMONIBQ 3260 GORHAM AVE. ` ADDRESS: ST. LOUIS PARS(, MN 55426 CITY: STATE: ZIP CODE: TELEPHONE S GNATURE O ERMITTEE 1i,'kk,. ~t i}•~:r•.. t v. •KR , {•+.^x •C Y; { 'r`,~+.S+t4x .::+x?c'i• i3:,+';'~:g'.,::~:~~'" :ri2`'~,`' S'S::• ~ `aa . ,s. ~ • +}ni.,~~risi::'~~i~:J::i):~ii:ij^i:i~~:~~. .2.-.{M. Q)2i:C{k}• ~~yi.~Y{. ~X-:, "•^^C: •;C _ :-i;_h:.2 Q.~S::v .~?;:xMk• .?kr. ,,vp:`C Y ikY. fir'.. h+ .x:GS:•.:~~5..+-.xSr.$Fy:?o :ri:•.w t`'•>:.ti <}'t,x 'S:i 1993 MECHANICAL PERMIT (COMMERCIAL) CIW OF EAGAN. 3830 PILOT KNOB RD - EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR ALL COMMERCIA14 NDUSTRIAL BUILDINGS. ALSO COMPLETE FOR APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. DATE: _ CONTRACT PRICE: $ NEW BUILDING INTERIOR IMPROVEMENT WORK DESCRIPTION: FEES 1% OF PN7R ' FEE $ PROCESSED PIPING: $25.00 MINIMUM FEE: $25.00 STATE SURCHARGE $.50 FOR EACH $1,000 OF FEE. TOTAL $ SITE ADDRESS: OWNER NAME: TELEPHONE TENANT NAME: (IMPROVEMENTS ONLY) INSTALLER: ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE SIGNATURE OF PERMITTEE CITY INSPECTOR WNW' sm vow$* " 0 i L * ° 40 / L'= 87.65 R= 219.0 V 4- 19000' Lv 4-0. 59 R, 4 9 - _ -r -a-. V P7opoetd woues SC ate 1,0's 100 ~ 4 a~Oh$ t714~w 9Plot 8 A W I harofoy certify that this is a true and correct representation of a "survey of tbe- _.bovndarfars of; Let 5, Block 1, SLACXNAWK HILLS ADDITION, according to the recorded plat. thereof, Dakota County, Minnesota. M334 of the location of all buildings thereon, and atl visible encroach mats, if any, from or on said land. It also shows the location of a proposed building. As 4ttt-veyed by. mo this 11th day of July, 1973. 8 and H. Sunde Land Surveyor Minn. [leg. No. 8612 i MASTER CARD LOCATION ~8 A -A 1,01 ~p~/~ ~IQ dI17k 14d4h OWNER 't'Z!~ STRUCTURE AND LAND USED AS $VD x 3~ l vu PiV Y 47-7, ~ Ito'. ! Issued To Permit No. Issued Contractor Owner lh BUILDING J7 o ?7 ' F D. arreYtd OM u✓M s . PLUMBING I I CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER rJ~ OTHER r f° Q OTHER Approved Items (Initial) Date Remarks Distance From Well FOOTING SEPTIC FOUNDATION CESSPOOL FRAMING r f~_ _ ) TILE FIELD FT. FINAL ELECTRICAL DEPTH HEATING OF WELL GAS INSTALLATION r SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER Violations Noted on Back COMMENTS c COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION NO EVIDENCE OF NON-COMPLIANCE NON-COMPLIANCE. BUILDER DOES NOT OBSERVED. F -1 INTEND TO COMPLY. E ACCEPTABLE SUBSTITUTIONS OR COMPLETION OF CERTAIN IMPROVEMENTS DEVIATIONS. ❑ WILL BE DELAYED BY CONDITIONS BEYOND ❑ NON-COMPLIANCE. BUILDER WILL COMPLY CONTROL. WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: ❑ REINSPECTION REQUIRED DATE OF REINSPECTION REINSPECTION REVEALED CERTIFICATION -1 certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected. ❑ ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR DATE COMMENTS- 2 3 W x'{ t w N zo7! Y 1 1, 77 PAO r 1 ~ n I ' ` h1A: .F ass" } F f 1 ~y IV, r. OW fI ~ry i:.~ N K Nor d Arc- maims aw now NIX y POIA p oil ( r y u ` L A N/ N , r"~ St x= 4' ~crt PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA104152 Date Issued: 05/08/2012 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 1650 Blackhawk Cove Lot: 5 Block: 1 Addition: Blackhawk Hills PID: 10-14380-01-050 Use: Description: Sub Type: e-Windows iDoors Construction Type: Work Type: Windows Doors-New ; Replacement Description: House Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openin,s, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee S4K $103.25 0801.4085 Valuation: 4.000.00 Surcharge - Based on Valuation S4K $2.00 9001.2195 Total: $105.25 Contractor: - Applicant - Owner: Pella Northland Timothy L Johnson 1 300 25th Ave N =100 1650 Blackhawk Cove Plymouth MN 55447 Eagan MN 55122 (763) 355-1300 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 Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA126370 Date Issued:08/22/2014 Permit Category:ePermit Site Address: 1650 Blackhawk Cove Lot:5 Block: 1 Addition: Blackhawk Hills PID:10-14380-01-050 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required by law in ALL single family homes . Jim Mcevoy 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 - Timothy L Johnson 1650 Blackhawk Cove Eagan MN 55122 Norwest Contractors 8469 Zanzibar Ln N Maple Grove MN 55311 (612) 859-8517 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA130237 Date Issued:04/13/2015 Permit Category:ePermit Site Address: 1650 Blackhawk Cove Lot:5 Block: 1 Addition: Blackhawk Hills PID:10-14380-01-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Applicant: Troy Good 3670 Dodd Rd Eagan, MN 55123 Fee Summary:PL - Permit Fee (WS &/or WH)$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 - Timothy L Johnson 1650 Blackhawk Cove Eagan MN 55122 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA137368 Date Issued:06/30/2016 Permit Category:ePermit Site Address: 1650 Blackhawk Cove Lot:5 Block: 1 Addition: Blackhawk Hills PID:10-14380-01-050 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Timothy L Johnson 1650 Blackhawk Cove Eagan MN 55122 (651) 683-9767 Air Rite Heating & Ac Inc 6935 146th Street West, #3 Apple Valley MN 55124 (952) 683-1900 Applicant/Permitee: Signature Issued By: Signature City of Eaaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r j Use BLUE or BLACK Ink 1 For Office Use I \I &4k( � L" L= Permit* i � �'7 CiI1j,� Permit Fee: 1 __ I /'C / c Date Received: k /� (r ' Staff: .+ 2016 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Oct 10th, 2016 Site Address: 1650 Blackhawk Cove Unit #: J Resident/ Owner Name: Tim Johnson Phone: 651-683-9767 1650 Blackhawk Cove Address / City / Zip: Applicant is: Owner X Contractor ) Type of Work Description of work: Remodel Master bath per plan Construction Cost: 30'000'00 Multi -Family Building: (Yes / No X ) Contractor Company: Country Creek Builders Inc Contact: Dan Drenckhahn Address: 23885 Beard Ave City: Lakeville State: MN zip: 55044 Phone: 952-484-9812 Email: dan@countrycreekbuilders.com License #: BC636393 Lead Certificate #: NAT -F109138-1 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: Mechanical Contractor: Sewer & Water Contractor: Fire Suppression Contractor: Phone: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information ' Portions of 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.qopherstateonecall.orq 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 cpmpjted days of permit issuance. xDan Drenckhahn Applicant's Printed Name plicant's Signature / i 0 fe C 1, t) t- O OT WRITE BELOW THIS LINE SUB TYPES Foundation '' Single Family Multi 01 of Plex WORK TYPES New Addition Alteration Replace Retaining Wall Fireplace Garage Deck Lower Level Porch (3 -Season) _ Exterior Alteration (Single Family) Porch (4 -Season) _ Exterior Alteration (Multi) Porch (Screen/Gazebo/Pergola) _ Miscellaneous Pool Accessory Building ?d Interior Improvement DESCRIPTION Valuation ' 3 Plan Review (25%_ 100% )(3 ) Census Code Move Building Fire Repair Repair # of Units # of Buildings Type of Construction Occupancy Siding Demolish Building* Reroof Windows Demolish Interior Demolish Foundation Egress Window Water Damage *Demolition of entire building — give PCA handout to applicant rR'-I Code Edition I/W1r 2t Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Foundation Before Backfill Roof: Ice & Water _Final X0 Framing 30 Minutes 1 Hour Fireplace: _Rough In Air Test _Final Insulation Sheathing Sheetrock Fire Walls Braced Walls `?® Shower Pan MCES System SAC Units City Water Booster Pump PRV Fire Suppression Required Meter Size: Final / C.O. Required 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 _ EFIS Windows Retaining Wall: _ Footings _ Backfill _ Final Radon Control Fire Suppression: Rough In _Final Erosion Control Other: Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL 5-49 S.f • /4r- 0.00 4ice0.00 5 —J Page 2 of 3 GIty otEaQan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use / cl c� �1 41'1'16 Permit #: / Permit Fee: l/ 0 "? Date Received: L Staff: 2016 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 10/10/2016 Site Address: 1650 Blackhawk Cove Tenant: Suite #: Resident/.Owner Name: Tim Johnson Address / City / Zip: 1650 Blackhawk Cove Phone: 651-683-9767 Contractor Name: BoeVaag Plumbing Inc Address: PO BOX 1257 Type ,of Work License t PM 062966 City: Prior Lake state: MN zip: 55372 Phone: 612-270-6872 Contact: Email: New ✓ Replacement — Repair Rebuild — Modify Space Work in R.O.W. Description of work: Remodel Master Bathroom per plan RESIDENTIAL Water Heater Lawn Irrigation (_ RPZ I 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 Tumaround* (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 $ CALL BEFORE YOU DIG. Cali 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.aooherstateonecallorq 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. )(Joe Boe Applicant's Printed Name A • • licant's Signature FOR OFFICE USE Reviewed By: Required Inspections: Under Ground Rough -In Air Test Gas Test Final Meter Related items: Meter Size Radio Read Manometer Staff: PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA178103 Date Issued:08/01/2022 Permit Category:ePermit Site Address: 1650 Blackhawk Cove Lot:5 Block: 1 Addition: Blackhawk Hills PID:10-14380-01-050 Use: Description: Sub Type:Water Heater Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 Surcharge-Fixed $1.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Timothy L & Meribeth Johnson 1650 Blackhawk Cove Eagan MN 55122--121 Champion Plumbing Llc 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature