3708 Blackhawk Lake Ct.. _,,,.._ . ,...
CITY OF EAGAN , • •k ?? ?; ? ?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
" PHONE: 454-8100
BUILDING PERMIT` Receipt # 0
To be used for SO DWG/GM Est. value $i 13•000 oate JWLY i0 19 41
Site Address 3708 AI.ACKHANK l.AKE CT
Lot 18- Block Z Sec/Sub. BLACKRAWK RXM
Parcel No.
g Name KEYtAVID HOMES
3 Address 16450 a1IRN8V1LLE P'Kii1[
° City 3' VILLE Phone 844-2636
Zp Name S!?
?a Address
? City Phone
?-
W W Name
Address
<W City ' Phone
I hereby acknowlege that I have read this application and state that the
information is Correct and agree:- to comply wit?i a?N' applicable State of
Minnesota Statutes and City o!;@?agan Ordinan?s,.
Signature of Permitee 4-? ! ?F???
A Building Permit is issued to: ?" ?
on the express condition that all work shall/oe done i accordanCe with all
appliCable State of Minnesot Statutes and City of E an Ordinances.
Building OffiCial ''`' 1k
r
OFFICE USE ONLY
Occupancy R-3! M'! FEES
Zoning R-12-a_ PO
(Actual) Const
VII _
Bldg. Permit ? ?,?t
?00
(Allowable) VA - Surcharge - $6' 50
# of Stories ?5000
Length 48 Plan Review
Deplh 41- SAC, Ciiy 100000
S.F. Total - SAC, MCWCC 630•00
S.F. Footprints -
??
?
On Site Sewage _ ater Conn
W ?
on Site well waler Meter 45.00
MWCC System 4X-- ???
City Water ?_ Acc?• Deposit
???
PRV Required - S/W Permit
Booster Pump - S/W Surcharge ? 50
276.00
Treatment PI
ApPR0YAL5 370400
Road Unit
Planner - park Ded.
.' Council
BIdg.Off. _ Copies
; 3 ? ?1 ??
Variance - TOTAL ,?
" Permit No. Permit Holder Date Telephone #
WATER
SE'dUER
PLUMBING
H.V.A.C.
ELECTRIC
Inspeetion Date Insp. Comments
Footings I
Foundation
Framing
Roofing
Rough Plbg. - -?'
Rough Htg.
Isul. g
Fireplace 9/y? q
Finai Htg.
Orstat Test
Final Plbg. 1. Plbg. Inspector- Notify Plumber
Const. Meter
rngrJPlan
Bldg. Final q ? ?
Dedc Ftg.
Dedc Finai
Well
Pr. Disp.
4
' CASH RECEIPT
CITY OF EAGqN `
3830 PILOT KNOB ROAD ` :.
EAGAN, MINNESOTA 55122
OATE
k, r-I N? VIOs
AMOUNT $
& DOLLARS
,m
p CASH 19 CHECK
L-1 E,- ? F ur w?-a.L? ? i i?
4-7 14 VAu :zf 14;+tL Lv ,
FlJND OBJECT AMOUNT
? 1-1 `D?9 t
se - '?
l . "
,... . ... ....: ... ... .. . „. .. -, .. . : , ,. : .
.? ;, . . , .
?. . .
SEWER & WATER PERMIT
CITY OF EAGAN . 3830 Pilot Knob Rd.
Eagan, MN 55122-;§,.97
DATE J.li.'at 1o, 1991
OFFICE USE ONLY
., , 7/10191.
METER #. ' PERMIT DATE
CHIP # ,,.. „ PERMIT # 14128
METER SIZE B.P. RECEIPT # -146"25
ISSUE DATE B:P. RECEIPT DATE
,
• - PRV -.BOOSTER PUMP,
DRES
SITE A 3,708 SLe1CKHAW, LAM :AURT.
',PERMIT REQUESTED
LOT ??
B
?
. K? SEC/SUB BL1CKiiAWK RIDGE
9
9
y
i
E:Fsk'I
At:D HOMBS °? SEWER __)r_'WATER - TAPS
APPLICANT .
ADDRESS: ?4aSd '3MSYII.1.E PKWSt -COMM/IND. "?'RESIDENTIAL.
CITY, STATE' ` $I??''?'`F ZIP 5?"3'?7 EXISTING
PHONE: ,
. ,
$94-2036
. .
are to be Installed
Lawn Sprin`kler Meters
PLUMBER: .
Ahead, of Domestic Meters on Water Line.
ADDRESS:a,1 13845 DAW P?TCH LANE Credit WILL NOT be given for Deduct Meters.
STATE
CITY ?, A aS ZIP 55.178
?.. s t
,
PHONE:`
- ? . I AGREE TO COMPLY WITH CITY OF
OWNER: ?? aS ??????,?
• EAGAN.ORDINANCES ,
ADDRESS;. . . ... ,
CITY, STATE ' ZIP '
PHONE: ' SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO,WORKING DAYS FOR PROCESSING. CALL .454=5220 -FOR INSPECTIUNS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
, . . . y . ' , ._, ,. '
. ?• ,
INSPECTI4N RE C ORD
CITY OF EAGAN PIERtAR TYpe;
3834 Piiot Knob Road : Permit Numt?r. ..' .02 ?! A,. F,
Eagan, Minnesata 551:22-1897 Date Issued: 44 12 4 1" 7 (612) 6$1-4675
SITE ADDRESS• 1? - ? 14 4 v, w ... I Ei ?, v? .> ,., APPLIC??NT' ? L, 0:1' ?
3I0F4 kii AfJ 14RWthi iW14 1: T Itl?''lil.R,E.1:lIF11Ilk iY l Il(yf
PERMIT SUBTYPE: .'? TYPE t)F WtN4K: ?
4?AS1' Mq',W'I' 1' fi N IS14 . '1014 At. 1'?:?tATT+?k
C? - - f;?'.YI, (.. I ?+ T (171s PR"y0?`,0Q10wr1'! .
/
7#M41 I ??,?,a aiI ???+
?> 10 r, t? ? rt i? 1.
.
P+ewnR No.. - f+emdt Hafdar Qete . TalephaAe #
El.EG'TM
?
PLIU
. . . ..
tni _ ifate huqL
1?'1'?Ifa1?? . . . .
FOUMi') _
PRAMING ?? •
RWfRtlG . ,
Pl?J ?kBlt3 0*#7 f9olbsi!
W%ST
WEAiM
GAS BVC
U+1S411
GYPSOARQ
F?IEPI.ACE .. . ?4?Tl? ? - ,
FML FLBQ ?
. .. . .
AL
FIt+fAl H"fO -
OR6AT
TE$T
BLQ(a FINAt
BSMT R.L .
BSMT FINAL
DECFf FTG
DECK FINAL
, ., .
DATE: _
3708 BLACKHAWK I.A1CL COURT, L18, B2, BLACKHAWIE R1DGE
RE:
XX ' • •
_ YnSewer & Water Permit for the above property has been campleted. lt will be held at the
Pu* Works Garage (3501 Goachman Road) until the meter is picked up. BE SURE 1"O
CP,A? PUBI.IC WORICS (454-5220) FOR YOUR FERMANENT WATER TURN OM.
_Yiur Sewer & Water Permit for the abave property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter canno#
be issued or occupancy allowed until further notice.
C MERCIAL PROJECTS ONLY: Please pay for meter at Ciry Hall. Meter size must be
c med by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: iIEFORE DIGGING, CALL LOCAL UTILITIES - TELEPhE4NE, ELECTRIC, GQS, ETC.
r
- RE4UIRED BY LAUU.
CONTACT COMMWNITY DEVELOPMENT DEPARTMENT FQR WATER TURN 4N POLICY.
7/11/91
Secretary, Building Inspections Dept.
AddMss: 370$ gLAaqiAW TAKF. r,OURI Lot t$ Blk 2 Sec/Sub $LAOqL" RIDOE
These items.were/were not cornplete at the time of the final inspection,
9 25 91 Yes No
Final grade (&" from siding)
Permanent steps - garage
Permanent steps - main entry
Permanent driveway p?
Permanent gas ?
Sod/seeded grass ?
Trail/curb damage ?O
Porch
Basement £inish
Deck
Please veri£p with the builder the remnval of roof test caps from the plumbing
system and the shut-off of water supply to the outside lavm faucet before
freeze potential exists. ?
xECrt?ow?etA
White - Gity copy Yellow - Resident copy Pink.- Contractor capy
SEWERy& WATER PERMIT
CI'I"'Y OF=EAGAN .
3830 Pilot Knob Rd. '
Eagan, MN 55122-1897
DATE JULY iC. 1991
SITE A DRESS?;,.._ 370$ BLA?IC?iAWK LA'.E ?OURT
LOT ?8 BL06K 2 SEC/SUB BLAC-`111AWK R1DGE
APPLICANTr KEYLAND HOMES
ADDRESS: 14450 BURNSVILLE r'±CWi
CITY, STATE B`V1LLE ZIP 55337
,
PHONE: 894-2636
PERMiT kQUESTED
?SEWER ?WATER _ TAPS
- COMhA/IND --ZRESIDENTIAL
_ZNEW EXISTING
D.C. MEUCHANICAL Lawn Sprinkler Meters are to be Installed
PLUMBER: Ahead of Domestic Meters on Water Line.
13545 DA?7 PAT?H LANE Credit WILL NOT be rven for Deduct Meters.
ADDRESS: AVAGE ' 55378 ? - g
CITY, STATE ZIP t
PHONE:
I AGREE TO COMPLY WITH CITY OF
OWNER: SAME AS APPLZ::ANT EAGAN ORDINANCES
ADDRESS:
GITY, STATE ZIP
PHOPJE: SIGNATURE WMEN M R ISSUED
F PLEASE/ALLOW TWO:'WORKIN(3 DAYS FOR PROCEStSING. CAI.L 454-5220 FOR lNSPEIP1'IONS. f-UR STORM
SEWER PERMITS, CONTACT ENGINEERyNG QEPT:
;r.??i . . >_
I*
Citp of Cagan
Erpmutraf rrf Nuitdittg Jttprrtiua
?7us Cernficate issu&plrrsuanl Jo !he requirements of Seciion 306 of the Uniform Building 1
Code certi.rl'in%drat at the lime of rssuance 1Jiissducture was in wmpliance with the uarious
ordinances of the City regulating buiJding construction or use For !he foUowing:
vx aWW&Rfim SF pwo?om sw& R=A t;m 10'A49
O-UP-C7 Tm- R.r/m I zoni-9 Disttin RI.a(a_ Type Coast UN
ow= or e?s 1----?AN-D-UMS Aaama 14450 R'VM-:+E P=, 1LVIt T F
B„aa;nsAadnm '?7nR Wrr L.AKF. OYBEFw;b T.IR, AO. RT.AfKHAtaft RM
' euadias oesid 17? Drca
?
POST IN A CONSPICUOUS PIACE
45y?yr
? .?:?88??.?? ? oa
Request Date Fire No. R •in Inspection
I Required? - I J Ready Now„.-'OJill Notdy Inspector
O ? es No When Ready.
? licensed contractor :1 owner hereby request inspection of ove electrical work at:
Job AtlCress fStreet Box or Route ) - Ciry
????" I , ?6??e?
Section No. Townsh?p Name or No. Range No. If? Co
? ? ?
Occupam P T) Phone No.
AZZ> ??--7J-
wer pher%%/J QZ,?
?/?.1f
Electncal C tractor iCompany Name) Contraaors License No.
_/0
Maiiing Atldress (Contractor or Owner Makmg Instananon)
;Yo 7_5-
Autho,ized S,gnat,/e IContractor?Owne, Making Inslallafion? ?Phon Number
0 ?1 n . n c? .. ? I V t?n
L ?_/Y-1 r%• I [Z/!..°- ....-ti I
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WIIL NOT
Griggs-Midway 61dg. - Room S-173 BE ACCEPTEO BY 7HE STATE BOARD
1821 University Ave.. St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL lNSPECTION
? See instruc:ions for completing this form on oacK of yellow copy.
I L,. 8 V
e? Rep. Type of Building
' F;oma
Duplex
Apt. Building
Comm./Industrial
Farm
?-?Olherlspecrfy;
"X" Below Work Covered by This Request
Appliances Wired
Range
Water Heater
Dryer
Furnace
Air Conditioner
Contractor's Remarks.
Compute Inspection Fee Below:
# Other Fee
Swimming Pool
Transformers
Irrigation 8ooms
Special Inspection
Alarm/Communication
Other Fee
I, the Electricai Inspector, hereby
certify that the above inspection has
been made.
Service Enirance Size ' Fee # CircuitslFeeders Fee
0 to 200 Amps 0 to 100 Amps
Above 200 Amps Above 100 Amps
cror's Use onry: D TOTAL_ ,,,,?
, ? ?
THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
COMPLETED WITHIN 18 M-WTHS:"""'"a?'
-?a
?
?•???
EB-00001-08
???-?,.??? /D? ?
Equipment Wired
Temporary Service
Electric Heating
Other (Specify)
OFFICE USE DNLY
This request void 18 momhs from
3 3 8? V(J ?
:1 ?FFI E USE ?LY_This requesf void 78 months from validafion dale printed in this bo„
? e.'A 9
•
??
? ?
PLFASE PRINT OR TYPE ",
??I?1zC
Request Date Rough-in inspedion requiredZ Yes ? Na Inspe t er Than Rough-In: [:] Reody Now D Will Call
(You must call the inspector when/ready) Dute Ready:
I, licensed contractor ? owner hereby request inspecfion of the above electrical work at:
1ob Addrws (Street, Box, or Route Ciiy Zp Code
Sedion No. Tawnship Nome or No. Range No. Fire No. Couny
L7A-lLC) t4
pcapant Phone No.
Power Supplier Address
Electrical Contrador Gomp ny Namej Conhacior License No. Maskr Lic. No. (Plor» Elect. Only)
Mailing Address (Conlraclor or Owner Performing Insiullation) . . /
z- ?- r
? i`-
rized SignaNre (Contractoior er Performi Inslo afi n
! . ?S/ .1?'?- L?/?• / ? Phone No.
??i?"' ]_.-? ?/>; -
EB-OOO61A-10 6/95 ??? STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY
IIIII IIIII?III Ilill I?IIIIIII Iilll IIIII IIIII I?II
* 0 3 3 8 0 8 1?
REQUEST FOR ELECTRICAL INSPECTION 4P
Minnesota Sffite Board of Electricity
1821 University Ave., Rm. -128 St. Paul, MN 55104
Pn?,e ;s,2; saz-oa? 1
?.
Home Apt. Bldg. Other: New Addn
Commerciol nd
Farm
Remod
Re air
Air Cond. E
. Water Htr. Load Mgmt. Other:
D er Elec. Heat Tem . Service
bove the work covered by this reqvest. Enfer remarks in this space and on the back of fhe white copy only.
"k' a
Calculate lnspection Fee - This Inspection Request will not 6e accepted without the corred fee:
Ofher Fee # Service EMrance Sae Fee # Circuiis/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200 Amps ove 100 Amps
Transformer/Generator INSPECTOR'SUSEONLY TOT
5ign/Outiine Ltg. Xfmr. ,
,?--
Alarm/Remote Control
Swimming Pool
ins aNo daxrib herein on 1he datea sta*d
t I i
d
I h
' ib
Irrigation Boom ns
e
erece
o
2ough-in Dote
Speciallnspection - ?
TH Investigafive Fee
IS INSTALLATION MAY
BE OR Finol DI
DERED DISG IF D WITHIN 18 ONTHS.
CITY OF EAGAN N Q 19392
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 5,!k121
BUILqING PERMIT PHQNE:4S4-$1a0 Receipt#/li
• ?
7o be used for ¢F DWG/G? Est. value $113, 000 Date JlfLY lq 19 91
Site Address 3708 BLACKHAWK LAKE CT .---
Lot 18 Block 2 Sec/Sub. BLA^uKHAWK RIDGE OFFICE l1SE ONLY
PBfCeI NO.
Occupancy 1
R-3, M- FEES
?
R- ? ?
Zoning 9 "
W Name KEl'LAND HDMES {aciuaq Const V? Bldg. Permit 685.00
; AddreSS 1445d BURNSVILLE P?W?C (Allowable) VtI _ 56
50
? City ?' 'VI?E ptlone 89?+-2b36 # os 5tories $urcharge .
445
00
4$ Plan Review '
Length
o Name SAME Depth 41 SAC
Cit 100.00
- ,
y
U4
? Address S.F.Total -
SAG, MCWCC ??SO.40
Clty Phone S.F. Fooiprints -
w
t
C 660.00
on Site Sewage a
er
onn
L?u w Name DnSiteWall + 95'00
E - MaterMeter
? Address MwCC system xx
30
00
e W City Phone Ciry water g? Acct. Deposit .
30. QO
PRV Required _ S!W Permil
I hereby acknowlege that I hav read this eppliC tio and state that ti?e Bvoster Pump ?
SM/ Surcharge . 50
iMormation is correct and a to comply wi applicahle State of
??
276
Minnasota Statutes and City 8n Ordinan g Treaimeni PI _
Signature of Permite 7/1 AP?ROYALS Raad Unit 370.00
A Building PermM is issued to: nyLil! H?ME Planner - park oed,
on the express candition ihat all wnrk shatl e dane i accardance with atl Council _ 3.00
applicable State oi Minnesot tatutss and Cit f E'an Qrdinances.
. 91dg. Olf. ??ies
y, 3 401, 00
??
Building pftiCidl Variance - TOTAL
? ?
?,p L M113?- /Sr.Nf,Ki>.Vwr
Ot", A-5rV
RESIDENTIAL BUILDING
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
? -
?? •??,
?:E,as
New Gonstruclion Reauirements RemodeUReoair Reauiremenis Office Use Onlv
3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cert of 5urvey Reod
(20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Not Reqd
1 set of Energy Calculations Addition - indicete if on-site seplic system _ On-site Septic System
3 copies of Tree Preservation Plan if lot platted after 711193
Rim Joist Detail Options selection sheet (bldgs witti 3 or less un'rts
Dat
?? Cost
ti
C
t
e on
ons
ruc
Site Address L_? aC{ l,K,/ ?L nkQ. UniUSte #
Description of Work
Multi-Family Bldg _ Y _ N Fireplace(s) _ 0 2
Property Owner ? im r lo U e A -a i? 5 Telephone # 65( ) L/D C -
Contractor 0 604?
?
Address
City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateaorv 1 M' sota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Wo sheet; •, N Energy Code Worksheet
(q submission type) Submitted Su?mitted
• Energy Envelope Calculations Submitt '
, .
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
one # ( )
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved p in the case of work which requires a review and
approval of plans.
?U 6,e AKO-n5
Applicant's Printed Name
,
? ? -.
Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 a3-plex
? 06 04-plex
Wark Types
? 31 New
)9( 32 Addition
? 33 Alteration
? 34 Replacement
? 07 05-plex O 13 16-plex ? 20 Pool
? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.)
? 09 07-plex ? 17 Garage 0 22 PorchlAddn. (4-sea.)
? 10 08-plex lw 18 Deck ? 23 Porch (screen/gazebo)
0 11 10-plex ? 19 Lower Level ? 24 Storm Damage
0 12 12-plex Plbg_Y or _ N ? 25 MisCellaneous
Valuation
Census Code
SAC Units ?
Nbr. of Units ^
Nbr. of Bldgs
Type of Const
Footings (new bldg)
?L Footings (deck)
_ Footings (addirion)
Foundation
Drain Tile
Roof Ice & Water
?- Framing
? 35 Int Improvement
? 36 Move Bldg.
? 37 Demolish (Bldg)*
*Demolition (Entire
Occupancy _
Zoning _
Final
0 38
? 42
? 43
Bldg) - Give PC
Stories ----
Sq. Ft.
Length
Width
Demolish (Interior) ? 44
Demolish (Foundation) ? 45
Reroof ? 46
;A handout to applicant
MCIES System _
City Water _
.? ? .
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi Misc.
Siding
Fire Repair
Windows/Doors
Booster Pump _
PRV -
Fire Sprinklered ?
REQUIRED INSPECTIONS
FinaUC.O.
FinaUNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
_ Fireplace _ R.I. _ Air Test _ Final
Insularion
Base Fee
-----------------
Surcharge
Plan Review
MCIES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
Approved By
- ??
Building Inspector
* * *-V
? pIpNEER
CertiFicate of Survey far:
?
?
?
?
?
?
?
?
I I
,e??
a` M
a- ?
tk i``
?*_4
D?
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ICC- Y L A ?J r2
_ 49.11 171.23
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T- ,-
4?vDxo6} Zo? r
4f•° ? X" x _
p r? ?Q? N J
r o? E71 ?
r r
( ei? P N o-m N ?
I ?-? ?--- Z
?- -- -• - - -
?
?3-
0
I33. Q(J
Ar99°?$'5-4 °G?,
7477 Fntr.rpiisr. Drive
Mendot., ilcights, MN 55170
(612) 681-1914
NoaT?l
?
-- -- - f
/
?
r C??
?
f
_.. _J
f'QOROSfo NvusE EIEVArioNs
1.owe5f Flndr Eleva??an = 33.56
Top at elock LulevafrOrt = '74-1•??°
G'oraja Slab Cle vcrf?'or1 = -14-1.
. 900.0 Denotes exislin? flevofian
. yoo.o Dtnotes propaf d E{pvnfiafl
---- Oenales Uraraa e(Utilr l Easemenf
`..- Uenoles DrAirtd e Flow rrows
o Deriaf es mQncimtrif
g earinss shown arP assu n2 ed
LO7' L8 , F3LOCK
pnkorA COuNTY? AA,NAfF-soTA
2 ) 8LACIIRA 4 . RIDIIE
UBJECj 7U EAStMElWTS QF i4fC0X?b
f herehy ceiNfy thnl lhis smrvey, Pian os report was prPpnrrd hY mp *i??+d+`r my siirecl suprtrvision and Ihnt 1 ?rin ?tilY Flp9'«PFPd l8nd $Ertveynr
u.rt1er the laws of ehe State of Minnvsvsa. Oa?ed ihis ?day of ?A.D. 19 ?? •,_ 1
r o , /
l
CCaIe• I I?ICEi t N'? -1' ?e? re?Rfrz i?. ei?<rci i ?.?. sxer... rs?,. ?ne??
--
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:. _ { ',
_?_... ..? ....' "_' - .. . h..
---
.
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, .i '• ?. ? ,'. , - ? ? -
X. CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE: BUz LDING
Permit Number: 029422
Date Issued: 01/24/97
SITE AQDRESS:
F . I . N . : 10-14400-180-02
DESCRIPTIQN;
U-11,.1. 4
434 ALTe RESZDENTIAL
?
?
•?&x '3_
k . aY??xS'. ? ?F.Es
REMARKS:
FEE SUM14111ARY:
Base Fee $50.00
Surcharge _ $.5o
Total Fee $50.5O
i
,
,
t
CC?NTRACTOR: _Ap p 1 i can t- s T. LI c OWNER=
BRI7"TR-GMflSE INC 18049454 0008111 EVANS
10908 203Rfl S7 W 3708
LAKEVILLE MN 55044 EAGAN
(612) 894-9454
3708 BLRCKFiAWK LAKE C7'
LOT: 18 BLOCK s 2
BLACKFiAWK RIDGE
(No BEDRoaMs)
rma.t Type BASEMENT FIMTSH
r,.k Type ALTERATION
J E F F
BLACKMAWK LAKE CT
hl N
1997 BUILDING PERMIT APPLICATION (RESIDENTIAL)
lw44 cinr oF E?GAN
3830 PILOT KNOB RD - 55122
681-4675
4,Jr C", . ? ?
?? IfArt
? 8 rogistered site aunreys ? 2 copiss of plan
• 2 copfes of phns pndude bsam 8 window sizes; pourod fid. desiyn; etc.) ? 2 sRs sunreys (exte?ior additfons 8 decks)
? 1 eneryy calculaUons ? 1 enerBY cakxilations lor heated addidons
? 3 oopiea of troe proservadon plan if bt platted aiter 7/1/93
required: _ Yes _ No '
?
DATE: CONSTRUCTION COST:
DESCRIPTION OF 1NORK:
?V4?!A,1 F1 h
?
STREET ADDRESS:
LOT I ?',_ BLOCK
3'70R .91,,,kAjk i A Kt? (!t ? -
SUBD.IP.I.D.
PROPERTY Name: L:Vao-s ??t Ff, Phone #:
OWNER LABT •a•* ?
Street Address: 3206 B/?? ? V k."X_ I-A _ e'f, ---- --
City: State: AW Zip: ?a .
CONTRACTOR Company: S&L -Clu Phone #: 86y- qy5V
Street Address: ?d ?13s ?3p-q5f W_ License #:
City: ?. 4G.,A state: /M &A1 zip: ?Sd ?y
ARCHITECT/ Company: Phone #:
ENGINEER
Name: ? Registration?
Street Address:
City: State: Zip:
Sewer 8 water licensed plumber (new construction only): . Penatty applies when address change
and lot change are requested once permit is issued.
i hereby acknowledge that I have read this application and state that the information is correct and agree to comp y with ail applicable
State of Minnesota Statutes and City of Eagan Ordinances.
'Y
Signature of Appiicant:
OFFICE USE ONLY
Certificates af Survey Received Yes No
Tree Preservation Plan Received Yes No
Not Required JNN ?-k Nyl
: ?3
BUILDING PERMIT TYPE
OFFICE USE ONLY
0 01 Foundation ? 06 Duplex o 11
? 02 SF Dwelling o 07 4-plex a 12
0 03 SF Addition o 08 8-plex n 13
? 04 SF Porch a 09 12-piex n 14
0 05 SF Misc. ? 10 = plex a 15
WORK TYPE NO Ff?„oae--,
*- 31 New )5?- 33 Alterations
0 32 Addition o 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Depth
APPROVALS
Apt./Lodging ffiir- ?, 6 Basement Finish
MuFti Repair/Rem. 0 17 Swim Pool
Garage/Acxessary o 20 Public Facility
Firepiace n 21 Miscellaneous
Deck
n 36 Move
0 37 Demolition
8asement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprirrt sq. ft.
Ptanning Building
MC/WS System
City Water
Fire Sprinklered
PRV
Baoster Pump
Census Code.
SAC Code
Census Bldg
Census Unit
Engineering Variance
?
Zf 3 ?I
?L
?
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit S/W Surcharge
Treatment PI.
Road Unit
Park Ded. _
Trails Ded. Other
Copies
Total:
% SAC
SAC Units
pp-
NEW CONST
ADD OP3
REPAIR
.:....
M uti?{.? PLEASE GOMPLETE UPPER PORTION dNLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/Cf3NDOS WHEN PERMITS ARE REQiIIRED FOR EACH UNIT.
------------------- ------------------.,_-..-----------------------------
WQRK DESCRIPTIDN COMpLETE T"HE FOLLAWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
? SHOWER 3.00
3 WATER CIASET 3.00
-1 BATH TUB 3.00
tA LAVATORY 3
00 .
I?•"'
OWNER NAME: 1 KITCHEN S7NK 3. aa 34°
? l LAiINDRY TRAY 3.00 cf-
SITE ADDRESS : ??C?tS ??.???.??
?'• HaT TUB f SPA 3.00
L(7T; + `6 BLOCK ? SUBD. e WATER HEATER
F'L40R DR.AIN 3.00
3.00 ?
?
INSTALLER: GA5 PIPING OUT.
(MINIMUM - 1)
3.00
ROUGH OPENINGS 1.50
?
ADDRES S:?, b„)cQ?? QTH ER
WATER SOFTENER 5.00
CITY: ZTP: PRIVATE DISP, 15.00
U.G. SPRINKLER 3.00
PHQNE # :
SUSTOTAL $ {"I,("
rI
pn.1fl ST. SURCHAEtGE .50
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAZ/INDUSTRrAL BUILDINGS AND
NNLTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NflT REQUIRED FDR EACH
DWELLING UNIT.
CONTR.ACT PFLICE:
OWNER HAME:
CITY OF EAGAN FOR CTTY [1SE ONLY
? 3830 PILOT KNOB ROAD
2 EAGAN, MN 55122 PERMIT #
PHpNE: (612) 454-8100 RECEIPT # 'S(?
?DATE : o? 9
5TGNATLTRE OF PE?iITTEE
?? TOTAi.: $ LA-1 `LD
SITE ADDRE55:
IAT: BLOCK SUBD.
INSTALLER:
ADDRESS:
CIT'Y:
PHONE
FOR:
CITY OF EAGAN
ZZP:
FEES
1% OF CONTRACT FEE.
STATE S[]RCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25,00 MINIMUM FEE.
CONTRACT PRICE x 18 $
STATE SURCHARGE $
TOTAL:
$
(SIGNATURE)
i
CITY OF EAGAN
3830 PILOT KNOB ROAD
' EAGAN, MN 55122
PHONE: (612) 454-.8104
.: ....
?
"`a;
.::<?:r: :.: :.:k-::.ik i.vn'F.•:ni,Tx'wix+<a<i
FOR CITY USE 4NLY
PERMI'F #
RECEIPT # D a? CF'
DATE: -? f
PLEASE CQMPLETE IIPPER PORTION QNLY FOR ?STNGLE FAMILY DWELLINGS &
TOWiQHOMES/GOND05 WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
FEES ----------------------
------WORK DESCRIPTION------ r ------------------------------
NEW CONST
ADD ON
REPAIR
OWNER NAME : k?.? c.! LA',JD 4p ry. e,3
SITE ADDRE55 : VIa?e-k J4141),t IL4 lV-e df °
,
LOT;? BLOCK ? SUBD.
INSTALLER: MEx7to pIR1" ? ? .
AnnRES s : f6 214 G?? ??i--c.. ?c? • ?. ? .
CITY• art"'a t 4.4A?'c 'A ZIP:
PHONE # :
T
ADD-ON MINIMUM $15.04
HVAC 0-100 M BTU 24.00
ABDITIONAL 50 M BTt3 6.40
GAS OUfiLETS - MINIMUM 3.00
OF 1 PER PERMIT
SUBTOTAL: S 2? 7•0 0
STATE Si]RC13ARGE: .50
TOTAL: $oT -2,50
SIGNATURE OF PERMITTEE
DtJS??IALPLEASE COMPLETE THTS PORTION FOR ALZ COMMERCIAL/INDUSTRTAL BUILDINGS,
APARTMENT BUILIlTNGB, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUTRED FOR EACH DWELLING UNIT.
CONTRACT PRICE:
OWNER NAME:
SITE ADDRE55:
LOT: BLOCK SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHOIVE # :
FOR:
FEES
1% OF CQNTRAGT FEE.
STATE SURCHARGE g $.50 FOR
EACH $1,000 OP PERMIT FEE.
PRDCESSED PIPING = $25.00
$25.00 MINIMUM FEE.
CONTR.ACT PRICE x 1$ $
STATE SURCHARGE $
TOTAL: $
(SIGNATURE)
CITY t?F EAGAN
L? gL ? GITY USE ONLY
SUBD.?,?"UA .CRECEIPT#:
RECEIPT pATE: I/? ? P ; 7
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612)681-4675
Please complete for: • single family dwellings
? townhomes and condos when permits are required for each unit
• backflow preventer for underground sprinkler system
FIXTURES EACH NO. TQTAL
Shower 3.00 x 1 = 3--
Water Closet 3.00 x
Bath Tub 3.00 x =
Lavatory 3.00 x
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Mot Tub/Spa 3.00 x =
Water Heater 3.00 x =
Floor Drain 3.00 x =
Gas Piping Outlet * minimum -1 • 3.00 x =
Rough Qpenings 1.50 x =
Water Softener "for dwellings under wnstruction 5.00 x =
Water Softenef * for existing dwelling 20.00 x
U.G. Sprinkler * for dwelling under const. 3.00 =
U.G. Sprinklsr * for axisting dwelling 20.00 -
Alterations * to existing residence 20.00 =
Water Tum Around 20.00 -
Private Disposal System ' Dak Cty iic. 75.00 -
(now and refurbished systems)
Private Disposal Systems * nbandonment 20.00 =
STATE SURCHARGE .50
s
TOTAL 60
S
I hereby adcnowledge that I have read this appfication, state that the infomiatan is comecc:t, and agree to comply with all applicable City
of Eagan ordinanpes. It is the appEicarrt's responsibilify to notify the property owner that the City of Eagan assumes no liability far any
damages caused by the City during its normal operational and maintenance acdvEtles to the Taalities conatructed under this permit within
City propertylright-of-way/easement.
S[TE ADDRESS: -376
OWNER NAME:
INSTALLER NAME: TELEPHONE #: 75?7;42
$TREET ADDRE S: 22 ? ?A 'f & G (-r -
CITY: fi! ? ' STATE: ZIP:
/--W?
SIGNATURE OF PERMITTEE
M 1 ? ?
1991 BUILD TY OF gAGAN Y1'ER5AL
ICATION riUN g-8 '? ?
F,INGLE FAMILY DWELLINGS MULTIPLE DWELLINGS CO?MRCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For:?c?. Valuation: igww Date: a, l
? ?T .
Site Address
Lot k` Block ?)
Parcel/Sub-0 uAI& -kI
Owner (r"\j 1p
Address
City/Zip Code -?jUkrM(n f
Phone
. ??-
Contractor
Address
City/Zip Code
Phone `
Arch. /Engr. ??? Q lAl?'
Address
?,?9r/Aoo.- OFFICE USE ONLY
.7?
Occupancy R'3 M'1
Zoning P'D IZ -1
Actual Const V-N
Allowable V-N
# of stories
Length y 8
Depth Igi
S.F. Total
Footprint S.F.
On site sewage_
On site well
MWCC System ?
City water ?
PRV
Booster Pump _
APPROVALS
Planner
Council
Bldg. Off. J 73 3?
Variance
City/Zip Code
Phone # 7e--,
FEES
00
G857
Bldg. Permit ,
Surcharge 56.5b
Plan Review 4I'5,00
SAC, City /00,00
SAC, MWCC O?00
Water Conn. (01 0
Water Meter 95+n0
Acct. Deposit 30,0
o
S/w Permit 30,00
S/W Surcharge ,5"o
Treatment P1. 276, 00
Road Unit 0,00
Park Ded.
Trail Ded.
Copies 3•-v?
SUBTOTAL
Penalty
Lot Change ??*
TOTAL -
? ?'1 ' • - i .
agrees that all work shall be done in accordance with
(Signature of Contrac or)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
V A Lu
G a rz a-" E
Vo = y o 0
? 3? x I S = ?,Syo
35M T.
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14 ? I y,nZs
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?3sri? T. =/ o5Z &c 5 3 = r?5(0
X2`6='?2$
I%i? i2 = f ?3
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(o X C ?( = k?l
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32?? ? y = ??53? )
olz I 13? vo 1) 1-11
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* * * 4C
* PIONEEI
* engineer
? * ** .
2422 Enterrrise Orive
Mendota Heights, MN 55120
(612) 681-1914
Certiticate of Survey (or:
?I
V
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31
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KEYLA NP
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1519.00
A/ 89 04B.15-4" l.?.
• 900.0 Denoles exislin flevafion
• 900.o Denotes propc??d £levofion
------Denofes Dra»c? et ufi/i1? Easemenf
- dtnotes Dr4ina e Flow /-lrraws
o Deno/es rnonumtnf
8 e4rls shown orQ assu m ed
PROPOSED NOVSF ELEVA710NS
Lowest Floor Elevation = I 3-2,.56
Top vt Blocl? Eleval;oR = ?i.??
Goru4a 5lob Elevafion
L C) T /$1 9LOCK 2,8LACkHAWk RIDGE
DQKOTA COUNTYl MINNESOTA SUBJECT TU EASEMENTS OF QfCORd
I here6y cei dly that this stnvey, ptan or repo.t was pr'eApired hy me under my direet supervislon and that I am duly RegistPred Land Surveyor
vnder the IAws of the Stete ot Minnesole. Oated this / 7LKday of .? A.D. ig
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SCq` le : 1 iach t 40 f ee f : i; =? . -;%;; '?' Z C? R(7RFR T A. SI{<IC11 1..5. REC+. Nn, 14A7]
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JUL--02-1991 14=14 FROh1 KEY-L.AND HONES IMC. TO 4548363 P.01
. . ?1 .
, REV LAND 14k50 Burnsvil]?e Parkwa7 Bnrn'svilIe,' MK 55337
•• . ?,.?"?`' 612 894-2636 •
• '"
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H ta M' E S'PAX 612 894-6823
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Thsse. ere transwittted en checked beXow s
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' • For epprovsl
,... Approved'a?? anbA??t?d ?
•
. ' F'or.Your use Approve3 as noted . • '
As 'rQquested Rexurtied for eorrections
? +For xiview and comment Qthes
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? A I t T n A'NmI'B 2 M -.1 T
JUL-02-1991 14-15 FROM KEY-LAhlD HDf*ES ] NC. Ti] 4548363 P. 02
• t.A f r.Aiwlti
. . ? OwNER : .?.-_?.------?..r..? .----• .
, . 7
SITE ADpRE55• .. . .
? . prr
COt?'?RAG"?aR • . . , .
" Determine wt?rk;?g sQ?are fcatsge o? ea?h • ,
zvl-
' 1. Total exposed wa11 area...,._„ Cv?.?? ' r-?-?.-
? sq,ft•. x •_ ?2b =. '??"' ? . .?..?.-..
2. '?ota3 roofJCeiling ar?a....- .
, Total exPosed wa11 area abave.flaa?'?__?
Total wail wfndaw area.........................................
......
b.' Total dOn]" itrea, . ? • . . . . . . . . ?. , : . . • : ' ; : _', . . . . . . , .
c. Total 5'?idirig glass doar.are .. , ." ..... . . ...'"..., ....
?. ?Tota1 fir?? .. . . ? . . . ? ?
.
area.•.•....... ' " `
1a?? wall ..
e _ TaUl wa11 framiri9 arsa (averagg 10%) .,.,....,.,., . , . .. ....
. . . . . . . . . . . . . : . ?,
...? •••
f. Total rim jotist area...................
.......... . ...
?. , .
net Y(all drea above ?1oor.. ..-......*... .. . --••. •. •` • .
h. ? wall area above floor, , .,...., ............ .
71 wall 2rea above flt?ar............. •. , .. . .. .
i . fia?emg wal l a?ea at fotinda.O.on . . . . . . . . . . . . . . . . . . . . .
a. _ . Total $xposed faundatiar+.areaA . . . • .
• ' . ?"r ?r .
indow araa............ ....... ....?, .
`
?.. r? 4?? ??ou?a?t?o? r? , _ .
i. Total net roundation area aboyt.-grade...,.•....,,. r .
aetermine 'Iu" va1ue afi each wa1l segment . (e.g, wi•ndaw, door, eaGh'separate wal1 section) . . --
a. . 114 (o ?
c. K
d , ..?.- x
?. ? -z- 7- ql . (o 'x
f . ?'?--?-?----- X
? . ? "7,? 0 x
h. K
3.
„uw
iE urt ?? ? L??
l1ull ? , Q ? •
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X tlu„ XI
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If itant 43 is the 3
$S, D1' 7e55 th3R.,??
11, you he,?e net th
intftnt of SBC.6006
JUL-02-1991 14=15 FROM KE`!-LAMD HOhES ]NC. TO 454W63 P.03
? . Tcatal expasad xooflcroiYing area _ ? '?"do . ' . ? • .
` ?. ??a! skyl3.ght area ..? .................. .......
S.
fraraing a"ea (averaga 10%) .•-;
.. a . -i-ata! not ? i.risu3.atar3 roCf/ctai.linq area. . . ...: . , . : ?: , . • . , • _ .
1>atexmine "u,l value iCci; each rooi/00 iljn9 $agmeii-t , : . . : .
??uil „?••- r ?" . , '-•r•' .
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?-?--CW X ?? TJ" , 0
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G X. t?u- ? ??.. _ ? , . ' . ' •? ' . . 1
$?7• ?'
? ........ ................. Tot;al ?, :? ?j Y • •. . . ••
os #4 ;.s the s=e asr or less t:han 02, YaU have mst the inte)t ot • ? ? .t .' . .
S.'i-7 $o,.-.5 tc? '1 • ' , ' , ' ' , ' ' ,
? • . ?. . ,
A].to:nate 8uildi Bnvelwe Dssi n . , ? . _ • .
•? ? -G; liae tY!e Cotal eZVelope 'systen method, ttxe values estab3.ishe$ by the s•,sa?,.cs? ?.
? t??:s #3 ?^_st J4 s#?a11 r_ot ba greatex '?han ? ?surn ??, xt?sna ??. xtnd ?2. ; . . • . ,
7 , + 2. ?.? fW1 ? ? `? ? b''? ' • . , • ?
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JUL--02-1991 14:16 FROM KEY-LpND HOhES INC. TO 4548363 P.04
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BlACK: - ! `'{ $ x .5 = -7 1Lf .
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k'UI.L 1: 1 L{<6- x8 = 11 0
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movam: X a
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Jl1L-02-1391 14:16 FR7M KEY-L.Ahm HC1hES IhIC.
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JUL-02-1991 14=25 FROM KEY-LAhm HIJMES INC.
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA113464
Date Issued:09/04/2013
Permit Category:ePermit
Site Address: 3708 Blackhawk Lake Ct
Lot:18 Block: 2 Addition: Blackhawk Ridge
PID:10-14400-02-180
Use:
Description:
Sub Type:Reroof & Siding
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.
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.
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 -
Adam N Derryberry Mauer
3708 Blackhawk Lake Ct
Eagan MN 55122
Minnesota Exteriors
8600 Jefferson Hwy
Osseo MN 55369
(763) 391-5514
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA118873
Date Issued:11/12/2013
Permit Category:ePermit
Site Address: 3708 Blackhawk Lake Ct
Lot:18 Block: 2 Addition: Blackhawk Ridge
PID:10-14400-02-180
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Phil Holmin
3432 Denmark Ave #228
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
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 -
Adam N Derryberry Mauer
3708 Blackhawk Lake Ct
Eagan MN 55122
(651) 695-8585
Holmin Heating & Cooling Llc
900 Park Knoll Drive
Eagan MN 55123
(651) 405-3853
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA176420
Date Issued:05/16/2022
Permit Category:ePermit
Site Address: 3708 Blackhawk Lake Ct
Lot:18 Block: 2 Addition: Blackhawk Ridge
PID:10-14400-02-180
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 -
Adam S Nicola Derryberry Maurer
3708 Blackhawk Lake Ct
Eagan MN 55122
(763) 391-5552
Minnesota Exteriors Inc
8600 Jefferson Hwy
Osseo MN 55369
(763) 391-5514
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA177811
Date Issued:07/19/2022
Permit Category:ePermit
Site Address: 3708 Blackhawk Lake Ct
Lot:18 Block: 2 Addition: Blackhawk Ridge
PID:10-14400-02-180
Use:
Description:
Sub Type:Fixtures
Work Type:Replace
Description:Kitchen
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.
All tiled shower bases require a water test.
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 -
Adam S Nicola Derryberry Maurer
3708 Blackhawk Lake Ct
Eagan MN 55122
Spring Plumbing Llc
8220 Ravenrock Road
Rockford MN 55373
(763) 614-7963
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA177936
Date Issued:07/26/2022
Permit Category:ePermit
Site Address: 3708 Blackhawk Lake Ct
Lot:18 Block: 2 Addition: Blackhawk Ridge
PID:10-14400-02-180
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Adam S Nicola Derryberry Maurer
3708 Blackhawk Lake Ct
Eagan MN 55122
Twin City Fireplace & Stone Company
6521 Cecilia Cir
Minneapolis MN 55439
(952) 941-2685
Applicant/Permitee: Signature Issued By: Signature