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3704 Blackhawk Lake Ct For Office Use City of Ea a 1 Permit H: 2!jU I APR 2 7 -6 3830 Pilot Knob Road i Permit Fee:__ Eagan MN 55122 I I 1 Date Received: Phone: (651)675-5675 Fax: (651) 675-5694 Staff: l 2008 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: ' Site Address: Tenant: V-\ O1 -C l Suite - RESIDENT/ OWNER Name: - - Phone: l!J ~ Address /City /Zip' ~~~V~1-_.1----- CONTRACTOR Name. ~L~-~1 "se _ 1 Address:-L4 o City: State: t l Zip t Phone: Q 0 Contact Person: r TYPE OF WORK - New Replacement _ Repair Rebuild Modify Space Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation --Add Plumbing Fixtures RPZ / _ PVB) Main Lower Level) Septic System Water Turnaround _ New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround' (includes $.50 State Surcharge) 'Water Turnaround (add $136.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) z TOTAL FEES $ 1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work i of to st rt without a permit; that the work will be in accordance with the approv plan in the case of work which requires a review and approval of la s. \1 " h6~1_ L,- X Appli a s Printed Name Applican s Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground Rough-in -Air Test -Gas Test -Final PERMIT City of Eagan Permit Type: Mechanical 3830 Pilot Knob Rd Permit Number: EA087505 Eagan, MN 55122 . Date Issued: 11/19/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 3704 Blackhawk Lake Ct Lot: 17 Block: 2 Addition: Blackhawk Ridge PID 10-14400-170-02 Use Description: Sub Type: e - Furnace Work Type: New Description: Furnace Comments: Quesetions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, 952-445-2840 Chris Musta 21210 Eaton Ave Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088 Surcharge-Fixed $0.50 9001.2195 Total: $50.50 Contractor: -Applicant - Owner: Controlled Air James B Fink 21210 Eaton Ave 3704 Blackhawk Lake Ct Farmington MN 55024 Eagan MN 55122 (651) 460-6022 X253 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. Applicant/Permitee: Signature Issued By: Signature CITY40F EAGAN Permit No: 10002 Date: 3.0-13-8s3 3830 Pilot Knob Road Meter - 3 4.19 ?tf size. 'P.O. Box 21199 der Na Date: Eagan, MN 55121 Owner College City Const. Site Address: 3704 Blackhawk Lake Ct L17 B2 Blackts yic $idge Plumber. Star Plumbing Conn. Chg: 550.00pd Zoning: R1 Acct Dep: 15.00pd No. of Units: Permit Fee: 10.0 pd Surcharge: • . 0pd 1 agree to comply with the City of Eagan Tr. Plant 20 .OOpd Ordinances. Meter. 67 nopd Misc': g WATER SERVICE PERMIT kh4W P/G y 2 4 8 1-7 94 Request Date F e No-.' Rough-in Inpsection Required e ction Other Than Rough-In (You rnus II inspector ready) ❑ Ready Now [3 Will Notify Inspector Yes s ❑ No Dale Read I icensed contractor J owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No-) i~ City Section No. Township Name or No. Range No. Coun 1 Occupant (PRINT) Phone No. Power Supplier Adtlress Electrical Contractor (Company Name) ff Contractor'. License No. Marling Address (Contractor or Owner Making In allation) 43 ~ ~ ~lrt,~w V Lo •~L _ ~`r f Authorized Signature (ContractorPOwne M kmg Insta lla4onl Phone umber MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS ` Phone (612) 642.0800 ENCLOSED REQUEST FOR ELECTRICAL INSPECTION EB-00001-08 _ ► See instructions for completing this form on back of yellow copy, 02486 - " ~ "X" below Work Covered by This Request e Add Rep. Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contractor§ Remarks: Compute Inspection Fee Below: - Sly -±+S Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee wimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only jQ Irri ation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY DE &SCONNECIED IF NOT ~/i Other Fee COMPLETED WITHIN 18 S. I, the Electrical Inspector, hereby Rough-in at7- p -777 certify that the above inspection has Final Date rlL been made. 4+ G OFFICE USE ONLY This request void 18 months from E 57963 Request Date ire No. Rough-in Inspection Required? It Ready Now fl Will Notify Inspector 0 Yes No When Ready? I licensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) City E44,4 C Z4~ j Section No. Township Name or No. Range No. County 4 L Occupant (PRINT) Phone No. Power Suppi' r LPL Address 1¢ G 444 ✓L. Electrical tractor (Company Name) ! Cont ctrorb License No. Mailing Address (Contr or Owner Maki Installation)\'1 Authorized Sign ( mra tor/ r Making Inst Z Phone Number u- 14 y- - W .z- 17LIfl MINNESOTA STATE BOA D OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-00001-07 OJ 1b. See instructions for completing this form on back of yellow copy. ~ E 5 7 9 6 3 X° Below Mk Cove" ted by This Request e tg!* Type of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner r (specify) contractors Remarks: 'list, Compute Inspection Fee Below. # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs Inspectors Use Only: TOTAL Irrigation Booms , Special Inspection Alarm/Communication b.~ G Other Fee f AM I, the Electrical Inspector, hereby Rough-in , I oat G certify that the above inspection has gnat Date been made. OFFICE USE ONLY This request void 18 months from E 57968; I /I R t Dat Fire No. Rough-in Inspection f g- g R iced? O Ready Now Will Notify Inspector Yes p No When Ready? I licensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street, Box r Route No) city Section No. Township Name or No. Range No. Coup Occupant (PRINT) Phone No. Power upplier L Address Electrical Contractor (Company Name) Con/bABork License No. rr rr. t ~eC' / Mailing Address (C7ntr toror Owner Making Installation) Authorized Sign re Contract Owner Maing Inst lation) Phone Number / g~ 12. MINNESOTA STATE OARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room 5173 BE ACCEPTED BYTHE STATE BOARD 1821 University Ave„ SL Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 6420800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION - EB-00001-07 J ► See instructions for oomplatiag this foeM on back of yellow copy. U0 7 b "X" Below Work Covered by This Request ew Add Rep. Type of Building 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 , Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only: TOTAL _ Irrigation Booms C~ Special Inspection Alarm/Communication Other Fee J I, the Electrical Inspector, hereby Rough-in Date A&r certify that the above inspection has Final Dal been made. 7 S71 OFFICE USE ONLY This request void 18 months from CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121N? 15611 PH ON E: 454-8100 n > - BUILDING PERMIT Receipt # c l 7` ~.J~~ l To be used for SF DWG/GAR Est.Value $125,000 Date SEPT 19 ,tg 88 Site Address 3704 BLACKHAWK LAKE CT OFFICE USE ONLY Lot 17 Block 2 Sec/Sub. BLACKHAWK RIDGE On Site Sewage Occupancy R-3 M-1 MWCC System X Zoning R-1 Parcel No. On Site Well (Actual) Const V-N it Name COLLEGE CITY CONSTRUCTION City Water X (Allowable) V-N W PRV Required # of Stories Z Address 6970 151ST ST 3 Booster Pump Length 75' a City APPLE VALLEYPhone 431-1211 Depth 38' 'or Name SAME S.F. Total , o a Address Footprint S.F. U P City Phone APPROVALS FEES CC Engr./Assess. Permit 656.00 Uw w Name Address Planner Surcharge 62.50 it z City Phone Council Plan Review 328.00 a w Bldg. Off. SAC, City 100.00 I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC 550.00 information is correct and agree to comply with all applicable State of Water Conn. 550.00 Minnesota Statutes and City of-Eagan Ordinances. Water Meter --67-0 Signature of Permittee ~ Road Unit 395.0 A Building Permit is is, ed to:_- rOT.T.RGE CIT_Y--CjDNST - Treatment P1 2n4_0 n on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Parks TOTAL 2,842.50 Building Official-. ~ri -,®,.qr^^ ~Y+• :•at~+..=-R7'~A yli°~S -.rT~i~ - -R,~'t~ -n--rr~•,.w'+a.w-~~-'°--~..~~.a~~_~`~.~w~T -....,r. ~.vlsMlf•= CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, UN 55121 F PHONE: 454-8100 BUILDING PERMIT Receipt # i s To be ui&for $J' DWG/GAR Est. Value Z~~a Data S>r!'!;' 19 ,19 8S +~t.., 3704 K A~t'MVK LAM CT OFFICE USE ONLY Site Address- R-3 N-1 Lot 1 Block Z Sec/Sub. XACXJAW 110M On Site Sewage Occupancy R-1 MWCCSystem A Zoning Parcel No. On Site Well (Actual) Const V-* a Name COLL= CITY CM'i RUC' m City Water A (Allowable) V-B z Address 6970 1318T S PRV Required # of Stories CityAPV '1Phone 431-1211 Booster Pump Length 75, Depth 191 Name S.F. Total o .0 z i Address Footprint S.F. I.- City Phone APPROVALS FEES ~ a Engr./Assess. Permit 636.00 Name 62.50 WW Planner Surcharge Address 32~• Q zm City Phone Council Plan Review Bldg. Off. SAC, City 100, I hereby acknowledge that I have read this application and state that the Variance - SAC, MWCC $50, information is correct and agree to comply with all applicable State of Water Conn. Minnesota Statutes and City of Eagan Ordinances. Water Meter 67, Signature of Permittee Road Unit A Building Permit is issued to: CO CITY tAlEifi! Treatment P1 2iS4.iElD on the express condition that all work shat l be done in accordance with all parks applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official- _ TOTAL 2JA Permit No. Permit Holder Date Telephone Phimbing HR A.C. C $ „ u C Electric 5`I IeI6 Softener Inspection Date Insp. Comments Footings I Footings II Foundation Framing Roofing Rough Pibg. we Rough Mg. Isul. Co~~tct~Jo..s ~Z' Fireplace Final Htg. Z ~o Final Plbg. d Bldg. Final Cert.Occ. 2 Temp. LP Deck Fig. Deck Final Well Pr. Disp. PERMIT # 9.,` 1~ _ PLUMBING PERMIT RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE CONTRACT PRICE: NE: 454-8100 Site Address BLDG. TY WORK DESCRIPTION Lot Block Sec/Sub Res. New f.. Mult. Add-on Name Comm. Repair Address Other c City + Phone ` RES. PLBG. ONLY - COMPLETE THE FOLLOWING: FIXTURES TOTAL Name Water Closet - $3.00 $ T ' Bath Tubs - $3.00 3 Address y A Lavatory - $3.00 O City Phone I _i 1 Stik~wre "$3.0 a `I Kiichen'Sink - $3.00 " FEES -Urinal/ Bidet - ta3.00 104 COMM/IND FEE - 1% OF CONTRACT FEE Laundry Tray - $3.00 - APT. BLDGS - COMM RATE APPLIES -l-Floor Drains - $1.50 TOWNHOUSE & CONDO - RES. RATE APPLIES __~-Water Heater - $1.50 MINIMUM - RESIDENTIAL FEE -$12.00 ' Whirlpool - $3.00 ' MINIMUM - COMM/IND FEE -$20.00 Gas Piping Outlets - $1.50 STATE SURCHARGE PER PERMIT - .50 (MINIMUM - 1 PER PERMIT) (ADD $.50 S/C IF PERMIT PRICE GOES Softener - $5.00 BEYOND $1,000.00 Well - $10.00 Private Disp. - $10.00 __~L_Rough Openings - $1.50 `"r t SIGNATURE OF P ITTEE FEE: STATE S/C: t FOR CITY OF EAGAN GRAND TOTAL: ~f PtW ~t r! MECHANICAL PERMIT > CITY OF EAGAN RECEIPT # F 38301PILOT KNOB ROAD, EAGAN, MN 55122 DATEr. CONTRACT PRICE: PHONE: 454-8100 Site Address BLDG. TYPE WC Lot 17 o C/Sub Ctw Res.- NY Name ti-~ l . • Mult Add-t11t : , M1r ,L.r y Address \ 1 4-kln- Othem R~pait ' c City -•a~J`sva Phone FEES Name 3j= RES. HVAC 0-100 M BTU ..t C Address 4'4,v% ADDITIONAL 50 M BTU r p City~1 yu f + ► Phone 1 t (RES. HVAC INCLUDES A/C GW W CONSTRUCTION) GAS OUTLETS (MINIMUM -1 P1:i x ,+rC tl TYPE OF WORK COMM/IND FEE - 1% OF MITAAGI t Forced Air M BTU APT. BLDGS. -COMM. RATE APB s ` TOWNHOUSE & CONDOS - AEI tWtAP4 kI " Boiler M BTU MINIMUM RESIDENTIALFEE 14 -O[N r Unit Heater M BTU MINIMUM COMMIAL FPS Air Cond M BTU 'EF 5- Vent CFM STATE SURCNkI`tiR1` t * (ADD$.54SG IFPeRMf1' fRlr ta"`fl'ES Piping Oudets: BEYOND $1,000)' y r a Gas Other A FEE' SIC: SleNATUA40F P EA. ; 4~~ y 4 s, TOTAL: K 0F FASAISI k, r } K j . ..x-, _a.*.+. 3_, a u.i.<»: r%h.4 n. ri~~•...f~c. is~.sa'lw'tCN1.n.:~....~.i'.. O~ii?rt~~ `''.~}LL•Y~ -CITY OF EAGAN Permit No: 10102 Date: 10-13A-88 3830 Pilqt Knob Road Meter No: Size- P.O. Box 21199 Reader No: Date: Eagan, MN 55121 Owner. C*II,eje C.'it9 coot. Site Address: X711° . 82ackhawk lake- Ct L."r B?l( lladrbzwk W KS Plumber. Star 'Plumbinit 1 Conn. Chg: 55G.00pd Zoning: Acct Dep:'t1C!u' No. of Units: of Permit Fee: ' ©0yr' 1 Surcharge: .51W I agree to comply with the City of Eagan Tr. Plant U:g Ordinances. Meter. 67 . ± i!lvo Misc.: By WATER SERVICE PERMIT CITY OF EAGAN Permit No.- 11144 Date: ;0"'15`-'88 3630 Piloi"Knob Road B/P No: 87536. Date: 9,20-88 P.O. Vdx' 21199 Eagan, MN 55121 Owner. CC1; ge City Coast. il Site Address: ` 7/Oy4 Blaekhawk Y.ake f!t L1-7 R2 81ackhawk PJAH4 Plumber: S*_ar Plumbing I( 1v1wCC: 550.00pd Zoning* i City Chg: i40' OOnd No. of Units: l Acct. Dep: I agree to comply with th+e City of Eagan Permit Fee: Surcharge: - p r Ordinances. II Misc.: By SEWER SERVICE PERMIT d ` EASAN, AANgIN 43A 511 t - - DATE a.( f 9' AMOUNT y y k . E1dl.l.Aas +oo 0 CASH [CHECK i I LID 4~~4, FUW OBJECT AMOUNT Thank You BY Vdaw-P05*9 COPY Pink-+W Copy BLDG. PERMIT NO. t- 01-3210 Bldg. Permit 01-3422 Plan Check ~J 61-3445 Surch./Adm. JJ 01-3446 SAC/Adm. 01-2155 Surcharge 75-3860 Road Unit 20-2275 SAC' It wl~~ 20-3865 Water Conn. C 20-3868 Water Trmt / 20-3716 Water Meter r 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. 28-3855 Park Ded. TOTAL CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454.8100 BUILDING PERMIT Receipt To be used for SF DWG/GAR Est. Value $125.000 Date SEPT 14 - -,19-11-- Site Address 3704 BLACKRAWK LAKE CT OFFICE USE ONLY Lot 17 Block 2 Sec/Sub. DLACKRAWK Rn= On Site Sewage Occupancy IR-3 M--1 MWCC System A Zoning 1-1 Parcel No. On Site Well (Actual) Const V-N cc Name COLLBGa CITY CONSTRUCTION City Water % (Allowable) V-H r Address 6970 1515T ST PRV Required # of Stories Length 81 o' City APPLE VALL$YPhone 431-1211 Booster Pump - 751 Depth 3g a Name SAM S.F. Total .o oo Address FootprintS.F. City Phone APPROVALS FEES W Name Engr./Assess. Permit 436.00 F z Planner Surcharge 62 * 50 _ Address - Plan Review 32S.00 Z City Phone Council <W 100. Bldg. Off. SAC, City 00 I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC 550, information is convect and agree to comply with all applicable State of Water Conn. 550.00 Minnesota Statutes and City of Eagan Ordinances. Water Meter 67- Signature of Permittee _ Road Unit 1%- A Building Permit is issued to: C01AAGE C7 -._G0N9T Treatment P1 204.00 on the express condition that all work shall be done in accordance with all Parks applicable State of Minnesota Statutes and City of Eagan Ordinances. 21$42.50 Building Official TOTAL REQUEST FOR ELECTRICAL INSPECTION .r'.. EB-00001-07 ► See instructions for completing this form on back of yellow copy f?Sf~ yZ E 5 7 9 6 4 "X" Below Worr; Cove9d by This Request hdd 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 .j; 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only: TOTAL Irrigation Booms S rf Special Inspection Alarrn/Communication Other Fee G1 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 E 57964 Request Date Fire No. Rough-in Inspection /0-/3-317 R uired? ❑ Ready Now Will Notify Inspector Yes ❑ No When Ready? 1 4 licensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) , J 1` 0-le City d c ,9~(C .4 ~l. Section No. Township Name or No. Range No. County, 4 O Occupant (PRINT) 000 Phone No. Power Supplier / Address ;a 4 o 1. e Cq oo'►!i 4-o .ti, Electrriic~ Contractor (Company Fie- Conttrrajctor's License NN'o. At OL G~ ~i&C_.. ff 10 0 d / Mailing Address (Contractor or Owner Makl Installation) 30 /OJQifi d -Ov R w Authorized Sig r (Contract wner Making In lion) Phone Number Number er -7 / /b2 '.7 T MINNESOTA STATE OARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1B21 University Ave., SL Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. i 7-~ RESIDENTIAL -3t BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681.4675 Now Construction Requirements RemodeUReoair Requirements • 3 registered site surveys show rig sq. ft of lot, sq. ft. of house; and all roofed areas 2 copies of plan (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions • 2 copies of plan showing beam & window sizes; poured found design, etc.) • i site survey for exterior additions & decks • 1 set of Energy Calculations . Indicate if hone served by septic system for additions • 3 copies of Tree Preservation Plan if lot platted after 711193 Rim Joist Detail options selection street (bldgs with 3 or less units) DATE VALUATION SITE ADDRESS 0~ J~O ,.0.t C• LlJUC_~ MULTI-FAMILY BLDG _Y 74"4N TYPE OF WORK C4 „o, [\n~D~ a 1~` .nrx FIREPLACE(S) _ 0 _ 1 _ 2 APPLICANT Renewal By Andersen, Inc. STREET ADDRESS 1920 County Road "C" West STATE ZIP TELEPHONE # WA CELI Roseville, MN 55113 # PROPERTY OWNER-.S.»rM TELEPHONE #tOS I - q9" aP~35 COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I _ MINNESOTA RULES 7672 (d submission type) • Residential Ventilation Category 1 Worksheet Submitted New Energy Code Worksheet Submitted . Energy Envelope Calculations Submitted Plumbing Contractor: Phone # Plumbing system includes: Water Softener Lawn Sprinkler Fee: $90.00 Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor. Phone # Mechanical system includes: Air Conditioning Fee: 570.00 Heat Recovery' System Sewer/Water Contractor: Phone # I hereby acknowledge that I have read this application, state that the nformation is correct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan dinances. Signature of Applic OFFICE USE ONLY Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required Updated 4102 OFFICE USE ONLY ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-piex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-piex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of _ plex ❑ 09 07-piex ❑ 17 Garage ❑ 22 Porch/Adds. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-piex E3 10 08-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plea ❑ 12 12-piex Pibg_Y or N ❑ 25 Miscellaneous ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 32 Addition ❑ . 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire,Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) Final/C.O. Footings (deck) _ Final/N6 C.O. Footings (addition) Plumbing - Foundation _ HVAC - Drain Tile Other Roof _ Ice & Water _ Final - Pool _ Ftgs Air/Gas Tests _ Final Framing - Siding _ Stucco _ Stone - Fireplace _ R.I. -Air Test -Final - Windows (new/replacement) Insulation _ Retaining Wall Approved By , Building Inspector - - - - - - - Base Fee Surcharge Plan Review MCIES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License-Search Copies Other Total • i.. auv i~ . vv VAA 1 94 a l l -4400 !tl1PUSWAL $r Amon" Im . W uuzi u4 re al Jur,e7, 200 • - Cit3f Of &vm 3836 Pilot Knob Road . Eagan, MN 55122 To Whom k May Concern: Elder Jones is authorized to pull building permits for Renewal by Andersenn_ Please allow Min authorization is valid for any Elder Jones to provide tins service for us in Plagan daze beyond 616101; until a trenewal Andersen . 'manam eo to the Oty_ [Pt+esslY revokes it in writing our u t Us authonzation be aceepted-expeditioualy, as to not delay in the processing of mg pcmhs any furd=. Plcmc. caU me If there are my gmwons. I c'm b contacted at 763-502-4706. Your imm9diatc attention to this matter is appredatied. Sinoekely, and'R. 'Rau tistallation Manager Renewal by Andaman Corporation ('a: Ksrra-Facie Tnnea o~..z G - 7-ra~•tx,~ *,G'3*IHH 0 GAIMA NOWY 'y c"n"0C . 2a, z0m Received Time Jun. 7. 1.07PM ` CITY USE ONLY L BL RECEIPT W. RECEIPT OATE: . -7j„,y7~~ SU9O. PERMIT 167 `l crryOlit 313M XIM 557 651-+1-*s Please complete for; > single hi milt' dwellings D krwnhorms i caondos when pem are mired for earls unit > backlow preventer for under muM SPrinkler system FtXT S iI:ACH ll` TDT' Alterations to axle d+arelliing - min rnurrl fee Describe:4 S 30.00 Bath tub $ 3.00 x Floor drain 3: Gas piping outlet ' rninimunm -1 3.00 x Hot tubls a . 3.00 s Kitchen sink 3.00 x ° Laundry tray 3.00 x " Lavatory 3.00 x ° Sepdc System nowhetwbbhw MPC Ilc. 75.00 x S tic System abarmdonment 30.00 x RPZ new td 30.00 x Rough o wlin 1.50 x ~ Shower 3.00 x Underground s Ider if is undereonstruoqpn 3.00 x - Underground srinkler 30.00 x ~ Water closet 3.00 x Water neater 3.00 .x Water softener if j!Rd winder won 8.00 x Water softener Irex 30.00 x Water turnaround 30.00 x $ State Surchsrgp,, AD .50 Total Reminder: Call for Inspections of alter mtlons, I.e..water heaters, waW simmers, stm 1 riereby adu owied a drat i'have..i t Btis app tics: i die iMari nip caries: ~n+s ID16;j y;Ri: ..__.......xs WMV pmets:r►o IMWY Ili anyd lies MUW bY &MJV ite nre+nal it is the spplieanCs resparalbil lily b nor Vv ply Mat the City of Eagen SW operational and m eves acdviSm to the laclUties ovoW ked under tlt pemit wdgin (qty SITE ADDRESS: €!W NER NAME:: Id.4 TELEPHONE 4 INSTALLER NAME: TELEPt fiE m STREET ADDRESS: _ CITY: TA W rd V. d SIGNATURE OF P i f;i 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) 5774 My OP Me" J 3830 PILOT KNOB R© - 5'5723 ` - 651.681-4875 > 3 registered she surveys showkrg sq. ff. of lot, sq. ft. of house 2 copies of plan and gQ rooted crew (20% nxwJ fum lot covemme atiowed) 1 set of eneW ackviallons for Treaded addBions > 2 copies of plans (show beam i wkWm shm; poured fad. dedgm etc.) 1 do surrey for egkwW e fer a A decks > I set of energy calculations > 8 copies of free preservation plan if lot platted atier 7/1M SEP '15 DATE: ~ f &11^ or CONSMCTION COST: a. DESCRIPTION OF WORK: STREET ADDRESS: _370 4, LOT BLOCK: $1.180 /P.I.D: a Names: c ( Phone 5 r " pa T PROPERTY Last rht OWNER Street Address: ::5 j:2 A Lej= /2.4- 013 1~ City Stexte: 11 ZIp: t Company_..g.M&=~ _ Pho" [d Id- d- n5 -0-0&0 (area code) CONTRACTOR . Street Address: l r 5 ~ ,0 C~t_,e License # ap ( 3_0(1 city Stale: k, Zip: ARCHITECT/ ENGINEER Company: Name: Telephone area code ( ) Streets Addre_s: Re lsti'e~lic~re + : City State' Zip: Sear & water licensed plumber (ream ed for new constructin only): Periaity applies when address change and lot change is requested once permit is Issued. F I hereby acknowledge that I have read this application, state that the infar►riation is camct, grid agree to comply with al OPPOCON Stage of Minnesota Statutes and City of Eagan Ordinances. -hl 07a 4 Signature of Appticaret: OFFICE USE ONLY ECEIVED Certificates of Survey Received Yes No SEP 7 1999 Time:Preservation Plan' Received Yes No ' Nit ReWhvd : BY OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation 13 06 4-plex C3 11 10-plex 0 16 Fireplace ❑ 21: Porch (3-sea.) L~ 02 SF Dwelling ❑ 07 5-piex 0 12 12-plex Q 17 Garage ❑ 22 PordVAddn. (4sea. ❑ 03 1 of _ piex ❑ 08 6-plex ❑ 13 16-plex O 18 Deck ❑ 23 Porch (spreened) 04 2-plex ❑ 09 7-plex ❑ 14 Apartments ❑ 19 Lower Level ❑ 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 ❑ 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) 0' 42 Reroof * Give PCA handorii to appli", it for dvalolition ;rmit 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 f#. Length. Width - Footprint sio~ 1 .•r.. APPROVALS Planning Building Permit Fee ve Surcharge Plan Review License MC/ES SAC , City SAC Water Conn. Water Meter Acct. Deposit SNV Permit ' SNV Surcharge w Treatment Pl. Park Ded.. Trails Ded. Other Copies Total: SAC Units r 1W SAC 1988 BUILDING PERMIT APPLICATION - CITY OF SAGAN SINGLE FAMILY DWELLINGS INCLC2 ~TS OF PLANS ERTIFICATES OF SURVEY (AT 1 S OF ENERGY CALCULATIONS NOTE: ADDRESSES FOR .-CORNER LOTS - CONTRACTOR/HOMEOWNER [FIST DESIGNATE MICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS I,SUUE,D. MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS # OF M=, INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COMMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS mow, To Be Used For: A ~ Valuation1:4 Date: 1 " Site Address374 dtr_h ~ ~ OFFICE USE ONLY ~ e- our Lot rte- Block On site sewage Occupancy Q'3 12--1- L MWCC system Zoning Parcel/Sub ~4ha~/~ i e/ On site well Actual Const- City water Allowable. Owner a a GPRV required # of stories Booster Pump Length Address Depth 3.1 S.F. Total City/Zip Code Footprint S.F. Phone APPROVALS FEES Contractor e m x Engr/Assess Permit (v~~ I Planner Surcharge a Address Na ~J d - S Council Plan Review _'T 97 Bldg. Off SAC, City City/Zip Code 1/w / ft7 ,L1 Variance SAC, MWCC 5-72 Water Cann Phone Water Meters Road Unit j 4z S' Arch. /Engr. q Vn a 4S C 011 Treatment P1 2 OV Parks Address Copies TOTAL -6 City/Zip Code Phone # ~~isx si = ~39,s ~ t a 1st yq ? )z `z 51- 32 v 1 Z~ 8 yo 656•0U+ 62.50+ 328.00+ 19796.00+ 2y842.50* 656-00+ 62.50+ 328.0U+ 1)796.00+ 29842.50* 2422 Enterprise Drive * PIONEER Mendota Heights, MN 55120 engineering.. 1612) 681-1914 Certificate of Survey for: C O L LE (i G C t r~ C-Q {y 7~. o~ od~4~ hIORfN rr ~G~ar►~a~~ ~ tJTil.r~~ / z& m V, IPA Tr r A. 7/ /7423 Ert~ DEPT- if goo.o Denotes extWin ElevaliorIN 0.0,54"I'l PROPOSED HOUSE El.E!/AT10lY5 goo o Denotes prep d Elevation Denotes Drarnq eUfilrl,~?' Easement Lowest Floor Elevaf~on = f 34:37 Denotes Drain e flow ,/frrows Top q /'Block Elevalior) : 9f, 7 o Denotes monelmenf gara j,; Slab Elevalton = _ 1 B ecrrtl; shown are assumed LOT , 9LOCK , &AMIHAWk RIDG'E DAkO-rA COUNTYr MINNESOTA 508JECU 7-0 EASLCNIENTS 4F RE'C©RD 1 hereby eertify that this survey, plan or report was prepared by m"r un r my direct supervi don and that d am duly Registered Land Surveyor under the taws of the State of Minnesota. Dated thisday of A.D. ig SCaIe: 1 40+ l SSo¢ RogEn r . slsc►c►a t_.s. r~EC. Ivo. tnsgt 4p3 EY7RIOR EP'-LOPE AVERAGE "U" GUI" JAVIUM 4 OWNER SITE ADDRESS CONTRACTOR dot-L-C- G 6, r~rrY DATE PRONE Determine working square footage of each. 1. Total exposed wall area ZCo sq. ft. x ZZc. .2. Total roof/ceiling area $ 7 sq. ft. X Y 0,4 •Total exposed wall area above floor m a. Total wall window area 'z. 7,3 b. Total door area ; c. Total sliding glass door area d. Total fireplace wall area O • e. Total wall framing area (average lUX)...:........ 1-70 f. Total net wall area above floor 1 Z 60 ~Lbc• g. Total rim Joist area 1~iZ Total exposed foundation area a (64- h. Total foundation window-area o 1. Toal net foundation area above grade to Determine "'U l value of each wall segment. X ;lull -54( b, to X "U" ;1z'6 = 7 c: 'X "U" v d. 0. X Mu" o s e. -T C) X Pull , O V, 64- f. 2. (C"O X "U" S ? ~ . g X pull .04J -1 h. 0 r X 1'uH ` D a a i. J 04-- X Oou,l , C) 8 . L2•- 3 .....................................Total = 7d.If item 13 is the same as, or less than item #1, you have met the intent of SOC 6006(0)2. Total-exposed roof/ceiling area = f7 8.0 j• Total skylight area..... 0 k. Total roof/ceiling framing area (average 1. Total net insulated roof/telling area...,....... ~~ns~ Determine "U" value for each roof/ceiling segment. 0, X pull 0 ~ O k. X'"U', .off-- - 7.1Z X "24- 4 ..................................Total ~ ~.~t~. . If total of 14 is the same as, or less than f2, you have met the intent of 50C .6006(c)]. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the spun of items 03 and 14 shal.l not be greater than the sum of items Al and 12. 1. + 2. 3.' + 4. VA L Uff A NA L y s 15 DF rG v Q r-j L AUQ A R& A 5 WINDOW /AR9-A : Typji of W)N.aOW Tke \u,,vDo,0 Burt's UAVC ssF".! Tisre'a F04 "►Q':.~lALµ~, -rNdY Amer, As L-ivt&C ABOV9 -qV0 /+f 4V al d~.S141~~Q ~ Q[o/gj1V C3lfG) VA-L4-t- OF lilt .u,p1.1IQ AIR Ir1 L.M S . Oil t Foo f w a, L` ' 4- Fae rAkc s;,,.,, = anmea.owrs~s FoUNDAT I W Wm po w A►ZA : TYPE OF It"114, 0w TM Vvj NQo W LJPIIM /NAVE. OLW rLSTCO FOIL IQ-1 Y4WAX, MLV ARL AS ;.I>.Tt.0 ASV L A" m41e Br A3jIct hrR.a A das~yr! Gswat3 VALujL cIm •j~"ti m~.•c4-4aII+l4 AIR *ILM•r . Uqt= f/'a9m. w If " Foorwg4 + FoorAt,t SL!D1IJC 61LA5S Quog ARLA: 1yPf6 OP DOOR: 51-0014 Q Q L -l5 9 00CgZ 9 4 ^ V C. 6 f. R T LaT R D' Fa it VA L-&% e4, rN CY &JU -Aa e-►tr s a AbOWL A00 M-0.1 B* AOiSIC00612 A VASIrWj4GS,LP1) I1AL.KG C3$L*k"r .419? FILMS L443 = 1l'6►s S. 1 e Fvo r* 4 f- C) DcacoP, AKmA,: Typr. of DoR DOOCZ UtJ)-rs HAYL 6LLm rLSrtO ANO PauNO Tcs HAY& A4 ,R~-VA L.L4a of AIR I+il-Mzo ~•o~" Fbrzn~ E- esp:nt. Fly 5,A N X17' r 8F ► F1 41. ~~L.r~v.yia AND Mu. VAL.Uy AMALY515 i • i . JOIST/ FR^M ar-i c, Aqz j .R•. vA L E INT vIOR AIR FILM 55r '14 -SOP owl TOTAL FoorA46 NSu.LaTE,0 AREA BLTW4Lw THE J-01STS „ I4TER IOC AJA FILM ...._,~VAPOR t5ARR1L !NrER►OK AI2 left. f"1 4SO3& TOTA L`R.-:' VALLLF, R PAr9r7-- l4Af(b aA..M w ~ l~/Iw?b ~'s rN- ANU LA VALUE" ANALy51S OF /VA6L SECTIONS FfAM,N4q t4 R,Q.9~, . „ R.. VA L. u.t •b ~ TwTeK~~R A/K Fi~~-1 ~~IG 1rnSt1M wA~e.eo~~t a I ~ 2ZI Sop r vvooo Z Z~ y5HE4 jNI NCB G ~ ~ f VAF'of, bAaaIta. MrLA TOR. AIIL OF04-M Jo.~~23 ycrAL' R....; VA L%AL 4,1 a TarAL FMrAGL 1-70 N S LL L. AT E- o ARE A B& rW L r Av 5T a 05 - .bl jUTl.el04 /AIR. r►L.M Iq•C? Iu5U..AT ION (R, Z•f~~ SMLATN 104Q --6 L'T121 TIE. s~ a 1y .~b l AP 4 Z-4- YAPVM- ArL,clq AIR- r1trM -e?--tL-1-Tof A1. PJwu YAL LA 9. W-b -W R ! v ~ ~ ~ IS TOTA L ftorA4LL Z(~, p . M ANo LA. YALu t A N A`Ys lb of )dZA\L- 51c-T, ows M (Td 1 5 T r~lt L A; "R' - V A L LL E •~O .rj n4 tER10 R All- irlL M . I. I Ws U LAT ro N C R-Il ) t ok ~5H EA r 1"41 . - • S r o 1, 4 _ LAP _ ~,(TFR to R A rrt PIA- in Z4-,39 Tor A L ' VAI-a 4 x".3.1/ s ) 74-•3rOI TOTA6K~fACI 1~ Z Fouw a A-r low WALL. ARE/, CABovL CIR^o1-D " R" V A L LL C •(v` NrER1oK AIR hL-r1 fr a w t a6q a r rt OL.oc.4 F. r- III' r ~~JCT~.rri0~, A1R FI~.M l Z -1-0 TAL Q,,4 VALu.E. 70TAL rC"rA4i~,f_ \ c 4- M t-~ IaJlfrtO/~y DATt --k 9-5IU,fD ;x APPLICATION FOR PERMIT NOTE: : PAYMENT F.. x. ,*k W FEE AT AT TIM OF * APPLICATION DDES NOT a - f STIT = APPROVAL OF PERMIT. ► SEWER AND/OR WATER CONNECTION * INSPEMON OF s Arn/m Mm t _ * INSTALIATICM w31L Nor BE scmu o y- * UNTIL PERMIT HAS BM APPPDM. CRt OF ea an ~.1r PLEASE PRINT 7 1) PROPERTY ADDRESS : c.s l ~ Q LEGAL DESCRIPTION L, 19 ~ P 1 g, k f f . J2,'Jej Lot oc Subdivision or Tax PPaarccel IV IF EXISTING STRUCTURE, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: Mon Year PRESENT ZONING/PROPOSED USE: COMMERCIAL/RETAIL/OFFICE R-1 SINGLE; FAMILY INDUSTRIAL R-2 DUPLEX (Two Units) INSTITUTIONAL/GOVERNMENT R-3 TOWNHOUSE (Three F`Units) ( Units) Q R-4 APARTMENT/CONDOMINIUM { Units) 2) WIS129NIMUN NAME: ADDRESS: CITY, STATE, ZIP: PHONE: It I For City 3) NAME: Plumbers License: ADDRESS: v 1 Active Expired CITY, STATE, ZIP: ' Not recorded PHONE: L MASTER LICENSE. St In1ti NAME: ADDRESS: CITY, STATE, ZIP: PHONE: 5) w ' E CONNECTION TO CITY SEWER CONNECTION TO CITY WATER OTHER 6) r THE GOLD COPY OF THE PERMIT WILL BE SENT DIRECTLY TO PUBLIC WORKS TO FACILITATE METER PICK-UP. r PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. SONBONE FROM THE CITY WILL CONTACT YOU IF THERE ARE ANY PROBLEMS. OR -:CITY USE ONLY PERMIT # ISSUED Pd w/Bldg. Permit FEES: $ $ SEWER PERMIT (INCLUDE SURCHARGE) $ / $ / WATER PERMIT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ ACCOUNT DEPOSIT - SEWER $ ACCOUNT DEPOSIT - WATER WAC SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER WATER TREATMENT PLANT SURCHARGE $ $ OTHER: G z $ X c z, TOTAL 2 RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES 'IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: AG/ r y,, CLAIM VOUCHER - REFUND REQUEST CITY OF EAGAN CLAIMANT HENUM ELECTRIC INC. ADDRESS 304 BROADWAY STREET JORDAN, MN 55352 Location _..3104 BLACKHAWK LAKE COURT T__17, _B-, BLACKHAWK RIDGE Receipt No./bate 88682/10/27/88 Reason for Refund DUPLICATE PERMIT Type of Refund Electrical Permit 01-3211 $ 57.00 Plumbing Permit 01-3212 $ Mechanical Permit 01-3213 $ Surcharge 01-2155 $ Water Connection Permit 20-3713 $ Sewer Connection Permit 20-3743 $ Account Deposit 20-2252 $ Utility Account Over-Payment 20-2250 $ Other: $ $ TOTAL $ 57.00 I declare under the penalties of law that this account, claim or demand is just and that no part of it has been paid. 2L, A-6 NOVEMBER it 1988 Signature Date i For Ottice Lisa City of Ea I Permit it I E I Permit Fee: `,--.J ~'A I ; 3830 Pilot Knob Road Eagan MN 55122 I Date Received: I Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: j 2008 RESIDENTIAL `PLUMBING PERMIT APPLICATION Date: iZ 2Z~ O8 SiteAddress:-~- 0 4- B[aci< a%k L.aL6 C--~ . EagGtto Tenant: ja ~e S aM CC Li J aT- t H te- Suite RESIDENT I OWNER Name: Ja e 5 c' JLi k6 -Ft P1 L Phone: 6 5( 4 + OZ-3-3 Address/ City/ Zip: 3,704 516LCL'n Qak- L-a(!fe C-. ' Q~ CONTRACTOR Name: VY-Wk ~rf? ~~utMtor a1, 1 License#: 0G0fo { 3 PM Address: 6 ja I ZQ qt^ 6t' W - 4 City: L-0 Vey Ir I e State: Zip: CJ'J~DAr Phone: , Z~i-&q & QQ9 Contact Person: VC10 6r r l5+1 TYPE OF WORK _ New X-Replacement _Repair -Rebuild - Modify Space - Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation Add Plumbing Fixtures RPZ / _ PV8) Main _ Lower Level) Septic System Water Turnaround _ New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) *Water Turnaround (add $136.00 if a 518" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ 5 cJ ~ I hereby acknowledge that this information is complete and accurate; that the work witl 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 a al of plan . x Deloorao Lar5ov Applicant's Printed Name A I' is Signet FOR OFFICE USE Reviewed By. Cate: Requited Inspections Under Ground Rough-in Air Test Gas Test Final PERMIT City of Eagan Permit Type: Building Permit Number: EA106130 Date Issued: 0811312012 itj of 0n Permit Category: ePermit R Site Address: 3704 Blackhawk Lake Ct Lot: 17 Block: 2 Addition: Blackhawk Ridge PID: 10-14400-02-170 Use: Description: Sub Type: e-Siding Construction Type: Work Type: Siding Description: House & Garage Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: 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. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee $4K $103.25 0801.4085 Valuation: Surcharge - Based on Valuation $4K $2.00 9001.2195 18,900.00 Total: $105.25 Contractor: - Applicant - Owner: Minnesota Exteriors James B Fink 8600 Jefferson Hwy 3704 Blackhawk Lake Ct Osseo MN 55369 Eagan MN 55122 (763) 391-5514 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. Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA113696 Date Issued:09/06/2013 Permit Category:ePermit Site Address: 3704 Blackhawk Lake Ct Lot:17 Block: 2 Addition: Blackhawk Ridge PID:10-14400-02-170 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 . Barbara Bessent 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 - James B Fink 3704 Blackhawk Lake Ct Eagan MN 55122 Minnesota Exteriors 8600 Jefferson Hwy Osseo MN 55369 (763) 391-5514 Applicant/Permitee: Signature Issued By: Signature EIVED_} r r .;� For Office Use E AG m • ,• 5 7 / 1 OCT 14 2019 Permit#: O el f 41'�/� �• �` '� 11 Permit Fee: (r-, Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: buildinginspections(&citvofeagan.com 2019 RESIDENTIAL BUILDING PERMIT/APPLICATION Date: / -14/ / Site Address: 3 7O 7 �C '[/ /� ( YLs („eT Unit#: Name: -c 114/1 /N J( Phone: Resident/ Owner Address/City/Zip: 5,4444 it-1 Applicant is: Owner x Contractor Type of Work Description of work: g4,fri'C 1 L L JL1�Dl�L /15172.S`72 13/-17- Construction Cost: fr.")(,00r Multi-Family Building: (Yes /No X) Company: j �� ViObca—& S Contact: / DA (7A Contractor Address: ('792_ C J VLDy $7 S: city: S i i�w/FT IZ. ink( Zi 40'/ZState: 1 p: �SlUgz Phone: 1y7 Email:• G4._\S/2£MG,6 LLFiZS , 6:4rr9 License#:/T L, 6 34/y37 Lead Certificate#: If the project is exempt from lead certification, please explain why: n� /t 7" ; 1),/v /A(' / S - al o /A7 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression 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 permit the City to conclude that they are trade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. 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. 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.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. x i ( j4,VZfl ()Dctc7/c (U1.S/Z xr!% 6�cFl( Applicant's Printed Name • Applicant's Signature DO NOT WRITE BELOW THIS LINE . —/-(3y 01,4c4Am/d LfJfjC c / /6g G'�e1 SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) , Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration (Multi) _' Multi _ Deck _ Porch(Screen/Gazebo/Pergola) Miscellaneous 01 of_Plex _ Lower Level — Pool _ Accessory Building WORK TYPES 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 2 Valuation 3P" Occupancy Olt'1,- MCES System Plan Review Code Edition J # 15SAC Units (25% 100%11/4 ) Zoning 4 a City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction Y jd-1 Width _ REQUIRED INSPECTIONS ��✓✓ Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) Final/No C.O. Required Foundation Foundation Before Backfill HVAC Service Test Gas Line Air Test_Hood Roof:_Ice &Water _Final Pool: Footings _Air/Gas Tests Final \( Framing 1,30 Minutes 1 Hour Drain Tile ' Fireplace: Rough In _Air Test _Final Siding: Stucco Lath Stone Lath _Brick EFIS 4Insulation Windows Sheathing Retaining Wall:_Footings Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression: _Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: 11/ , Building Inspector RESIDENTIAL FEES Base Fee , i \ for-6A/ et cll. Surcharge Plan Review Y ' MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge / 1 (,, /ke �` 2 0 Treatment Plant / Radio Meter Read Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA158783 Date Issued:10/31/2019 Permit Category:ePermit Site Address: 3704 Blackhawk Lake Ct Lot:17 Block: 2 Addition: Blackhawk Ridge PID:10-14400-02-170 Use: Description: Sub Type:Residential Work Type:Alteration Description: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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (miscellaneous)$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 - James B Fink 3704 Blackhawk Lake Ct Eagan MN 55122 Aj Alberts Plumbing Inc 7975 Afton Rd Woodbury MN 55125 (651) 738-0580 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA162508 Date Issued:07/16/2020 Permit Category:ePermit Site Address: 3704 Blackhawk Lake Ct Lot:17 Block: 2 Addition: Blackhawk Ridge PID:10-14400-02-170 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - James B Fink 3704 Blackhawk Lake Ct Eagan MN 55122 Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264-4777 Applicant/Permitee: Signature Issued By: Signature