3719 Blackhawk Lake Ct
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA086975
Eagan, MN 55122 . Date Issued: 10/20/2008
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 3719 Blackhawk Lake Ct
Lot: 14 Block: 2 Addition: Blackhawk Glen 3rd
PID 10-14352-140-02
Use
Description:
Sub Type: e-Windows/Doors Construction Type:
Work Type: Windows/Doors-New/Replacement
Description: House
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: A framing inspection is required when installing a Bay or Bow window or if the opening is altered. Smoke detectors are
required in all sleeping rooms prior to final
inspection. When wall studs or ceiling joists are exposed, hard-wired detectors are required. Battery operated types are
acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector.
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Renewal Andersen John A Burrows
1920 County Road C West 3719 Blackhawk Lake Ct
Roseville MN 55113 Eagan MN 55123
(651) 264-4777
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
Eagan. Permit Number: EA093041
Date Issued: 03/11/2010
OR Permit Category: ePermit
41 it~ of E3
E
Site Address: 3719 Blackhawk Lake Ct
Lot: 14 Block: 2 Addition: Blackhawk Glen 3rd
PID:10-14352-140-02
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 S3K $88.50 0801.4085
Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195
Total: $90.00
Contractor: - Applicant - Owner:
Renewal Andersen Jolm A Burrows
1920 County Road C West 3719 Blacldiawk Lake Ct
Roseville NIN 55113 Eagan NIN 55123
(61)264-4777
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
CASH RECEIPT
OF- WW"'.
CITY OF EAGAN' • {
3830 PILOT KNOB ROAD i
EAGAN, MINNESOTA 55122
DATE ` a I • 19
.
`I
RE=
AMOUNT S ~j J J U r ~y
F (G & f J DOLLARS
Im
0 CASH CHECK
a F
t; A"
FUND OBJECT AMOUNT
Thank You
By
C 13932 ,
c
SEWER: & WATER PERMIT OFFICE USE ONLY
CITY 'OF EAGAN METER PERMIT DATE 06/14/91
3830 Pilot Knob Rd.
Eagan MN 551,22-1897 CHIP # PERMIT # 12059
METER SIZE- -B.P. RECEIPT # C 1349
DATE ISSUE DATE . B:P. RECEIPT DATE 06/12/ 91.
PRV,- BOOSTER PUMP
SITE ADDRESS 371-9 13.lackhauyk Lake' Cf • _ PERMIT REQUESTED
LOTS BLOCK -SEC/SUB. 21 a dittlay r 0.3 Pn T T -T
i !SEWER cWATER -TAPS
APPLICANT: f\lbr r ,mot
ADDRESS: ► .i..,.,~ p u 1~J COMM/IND t!!- 'RESIDENTIAL
CITY, STATE - , h +e J ZIP ` 5- NEW EXISTING
PHONE: '7 (a 9
Lawn Sprinkler Meters are to be Installed
PLUMBER: -+-~ar d•~ik,, ~c': Ahead of Domestic Meters on Water Line.
ADDRESS: C~ Credit WILL NOS be given for Deduct Meters.
CITY, STATE ZIP
PHONE:
AdFfeE~rTO':COMPLY"WITH CITY OF
OWNER: EAGAN ORDINANCES':
ADDRESS:
CITY, STATE ZIP
PHONE: SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER-PERMITS, CONTACT-ENGINEERING DEPT. '
4J ~j
i~~"- 3re
HOUSE HEATING TEST RECORD
ADDRESS 3:7 15 ~Iqe_1_401k 1-f APT. FLOOR CITY SUBURB
OCCUPANT (1 OWNER 8{'_~'-~~'S ~
HEAT LOSS DATE HT 5. INST.
SOLD BY INSTALLED BY
Electrical Work By Gas Line By A_: Y .1
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION ,
MAKE MAKE OF BURNER
Model Model
Serial Max. BTU Rating
INPUT MAKE OF FURNACE
Model
CONTROLS
THERMOSTAT Heat Plug Vent Six*
Valve KIND OF LINER SIZE NONE
Limit Draft Hood C t'C egularor
Limit Selling - Filters Sise mbar
Fan Setting Chimney Location Inside Outside
Pilot Type r C`P Chimney Construction ~rU
Pilot Make
Pilot Model Smoke Bomb Wiring
Pilot Timing Draft 7, Test Tag
L.W. Cut Off _ Door Pressure 5- Lighting Inst. (Pressure 6 Percent C02 Date Tested /
Input' , Percent 02 Company Testing
Stack Temp. 2 Percent CO Name of Tester
Form 235
INSPECTION RECORD
CITY OF EAGAN
3830 Pilot Knob Road Permit Number: 02 7 I
Eagan, Minnesota 55122-1897 Date Issued: 03/14196
(612) 681-4675
SITE ADDRESS: 10"1", 14 H O( APPLICANT:
i , W Ar t {IAWK 1. AI% CI HU14"1)IT- 1)(111IN
k{ !►i.-h 11Aida: irk f Nt F7I) (6 12 1 L1 L4;k;O
PERMIT SUBTYPE: TYPE OF WORK: -77^
114'•1 Mi 111 i 1 t+11 li At TER. ATION
1'{414f1 ~1 fWit) 1.AIA ON
k9)1.11i11 1 ti 4.1 ~~;ii 1' 1 NA1
RT, 4A1tk',.; A `-fA1AVA1{ { rVH11 1'i PUW11:10 t) f'OV AN` V11014E 1"111 Oft IF f:cJ,RTCAk WORK
Perndt No. Permk Holder Date Telephone N
ELECTF11C
PLUMBWG
HVAC
lnoa De% Insp.. Comments
FOOTINGS
FOUND
FRAMING
ROOFING "
ROUGH A
PLUMBING -,X-74
PLUG
AIR TEST
ROUGH
HEATING
GAS
TEST VC
INSUL
GYPSOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT .
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL _ 1"7 AtS
DECK FTG
DECK FINAL
INSPECTtON RECORD'
CITY OF EAGAN PERWT TYPE:
3830 Pilot Knob Road„ {yr; 7 ~A
a
Eagan, Minnesota 55122-1897 Crate lad:
(612) 6814675
SITE ADDRESS: APPLICANT.-
LOT C 14 I11. o i- K f 2
'3719 81.ACKHAW UAK€" CT VAIJ Y POOLS INC
RlACKHAW 61.FN 3RD (Fi11) 694--1,480
PERMIT SUBTYPE: TYPE OF WORK:
SWIM Floot. NFw
OESCRIPTION (rM 40"W
Fg0` TNG~ FINAL. ,
ljTCE rt{ 33~ r f fi~ ar ? F
t,
t Z4
-I 'egg
femo Nor I E1wdor Tdkphana #
ELECTt~lG
wrow
is 1*
FRAMIMQ
"WPM
(?tie
Fem. HMMM
tiliiVr..
TEST
BLDG FINAL
BSW FLL
BBMT FINAL
DECK FTG
DECK FINAL
JL/
r
r t g
Ij ; .t ~^'~w ~r~X+►+~,Af kk, Y P i'~ a p,~;I f .;a Y,?_. '
3830 Pilot Knobf Road, w 0. Sox 21 1 ~o t~,.Ji> '3512V
'
PHONE: 454-8100
To be used ictr
Est. Value s om Deb f!
9_ MMM
Site AddrBS ai t .l it CT
Lot _ Brock . " c/Su ~3FFtC81J&E, MY-
am imp MY-
`ftrcel.No, Occupancy S-3 !IIA l$
Zoning
Name- - (!(eii af) As. U 8%. Permit '
Address` ' , °(Ailowabls) a $urbarge
..of stories
City Phone
t.etgth Plan Review
Name" -Depth SAC, City 1tlt~.~0
Address S.F. Total SAC, MCWCC
City - Phone S.F. Footprints _
On Site Sewage Water Conn
Name On Site Well Water Meter
"to MWCC System Acxt.~r
city Phone city water
PRV Required SIW Pentat
1 hereby I have read this application and state that the Booster Pump S►YY AIR.
information is oor hr►d agree to com y with. atl applicable State of
Minnesota Statutes "ity of Eag nces. Treatment PI ow
Signature Of Permits - APPROVALS Road that
A Building Permit is echo: Planner Park Dad. .
on MO. express condat all work shall be done in accordance with all Council
applicable State of Mk isota Statues and City of Eagan Ordinances; C*pM
Bldg. OH.
Building Official Variance Tt7rAf: ~,I;
Pw" lea Penn& Holder owls Telephone #
WAM o1D5~j G r 9
sEVWR
PIUMBIldti 7 S 5/ /019 - 00,/(0
/ I - air 9 S/ 4/ C&I
HMAC. + 'fl~i0~G0~
ELECTRIC
hopeclon Dave COnllnMte
11
Foundation
Framing 7l 7 Gc)
Rough P1* f e
Rough Flip. '7/7/P c ~ Q Mai
laud. l! 7 4
Replace
Final
Oraw Test
Final P14 Plbg.Inspector - "fyPlumber
Cont. Mater
EngrJPlan
8klg. Final ,Z
Deck Fig. bl
Deck Final
Well
Pr. Disp.
CITY OF EAGAN ND 19231
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE: 454-8100 Receipt # C ~ t 'V
To be used for SF DWG/GAR Est. Value $156,000 Date JUN 12 tg 91
Site Address 3719 BLACKHAWK LAKE CT
Lot 14 Block 2 Sec/SubBLACKHAWK GLEN 3 OFFICE USE ONLY
Parcel No. Occupancy R-3 MM=1 FEES
MCDONALD CONSTRUCTION INC Zoning N
W Name (Actual) Const Bldg. Permit 836.00
o Address 1212 BLUEBILL BAY RD (Allowable) v=N Surcharge 78.00
City BURNVILLE Phone 688-7061 # of Stories
Length 661 Plan Review 543.00
to Name SAME Depth 40' SAC, city 100.00
O¢ Address S.F. Total SAC, Mcwcc 650.00
~ City Phone S.F. Footprints 660.00
On Site Sewage Water Conn
°C Name On Site Well Water Meter 95.00
E W
_3 Address MWCC System .X
CC W City Phone city water _g _ Acct. Deposit 30.00
PRV Required X S/W Permit 30.00
1 hereby acknowleg at I have read this application and state that the Booster Pump SSW Surcharge .50
information is corr t d agree t cc ly with all applicable State of
Minnesota Statutes a ity of Eag n Or i nces. Treatment PI 276.00
Signature of Permitee APPROVALS Road Unit 370.00
A Building Permit is is (upe to: M OLD CO STRUCTION Planner Park Ded.
on the express conditat all work shall be done in accordance with all Council
applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies
Building Official . I A I z Variance TOTAL 3,668.50
Tp1~11
DATE: JUN 14, 1991
RE: 3719 BLACKRAWK LAKE CT (MCDONALD CONSTRUCTION INC)
K Your ftwer & Water Permit for the above property has been completed. It will be held at the'
P~~bJlC Works Garage (3501 Coachman Road) until the meter is, picked up. BE SURE TO
LL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Bill Adams or Dirk House (Plumbing Inspectors- 454-8100) before issuance.
i
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
-
Secretary, -Building-Inspections Dept.,
SEWEFE.& WATER PERMIT" OFFICE-USE ONLY
CITY OF EAGAN' a 14/ c,1
3830 Not Knob Rd. METER # ~ 7 ga- PERMIT DATE 11 61
CHIP # 5113 PERMIT # 12059
Eagan, MN 55122-1897
METER SIZE S ' -e S S B.P. RECEIPT # C 13932
DATE ISSUE DATE 6 - B.P. RECEIPT DATE 061121 91
_X_ PRV - BOOSTER PUMP
.'.,719 Blaexrawk Late Ct .
SITE ADDRESS PERMIT REQUESTED
LOT Vi BLOCKS-SEC/SUB Plan-Icb T.k-G1en TrT
- SEWER CATER TAPS
APPLICANT: Mcbr. )AICA CC '77ac .
ADDRESS: 1 Z~ Rl •_,ck RJ - COMM/IND RESIDENTIAL
CITY, STATE ZIP J~ NEW T EXISTING
PHONE: 4P, 7 t~,
Lawn Sprinkler Meters are' ;to be Installed
PLUMBER: Ahead of Domestic Meters on Water, Line.
ADDRESS: P Credit WILL NOybe givenjor Deduct Meters.
CITY, STATEI~r~ ZIP
PHONE:
I ,gO E, COMPLY , C OF
OWNER: ~r<lr j i A,- 9 aP EAC7 N NANCES"
ADDRESS:
CITY, STATE ZIP
.PHONE: SIGNA Uf "ETER ISSUED
v'
PLIAtEA, iLOW'tWO WOAKING BAYS FOR PRESSING. CALL 454-5220 FOR INSPEC NS. FOR STORM
SEWER PERMITS, CONTACTENGINEERING DEPT. :
Clip of 'eagart
ar tund of Wmld-m ittoputhm
This Cerafuaate issued pursuant to the requiremet of Section 306 of the Uniform Budding
Code certifying that at the time of issuance this structure was in compliance with the. various
ordinances of the City regulating building construction or utia. For the following: ,
the mdon SF BETIGM Hide. p mk ti, 197,31
OccupancyTm 1#jm1 ZooiagDbewt R1 Type ccost VN
OwtrsofBwldiog ~ ~ 12 2 i t ~tiX g~w 1~--~~rnt~
BWVM 3719 N LAKE C7CJIJRT L 14, B21 &MW GUN 3RD
" 1221
euaa;og~
POST IN A CONSPICUOUS -PLACE
J"
Address : 3719 BT Ar,.[MM LAKE Gr Lot 14 Blk 2 Sec/Sub BLAr RAWR GLEN 3RD
These items were/were not complete at the time of the final inspection.
8/22/91 Yes No Tnspectore
Date..
Final grade (6° from siding)
Permanent steps - garage L~
Permanent steps - main entry
Permanent driveway
Permanent gas
Sod/seeded grass
Trail/curb damage j,
Porch i~
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing
system and the shut-off of water supply to the outside lawn faucet before
freeze potential exists.
NEMLED"M
White - City copy Yellow - Resident copy Pink.- Contractor copy
0 ~qf-)-017
Req est D e Fire No. Rou h-In_Jnspection Required Inspection Other Tha gh-In
(You m call inspector when ready) ❑ Ready Now Will Notify Inspector
I V Yes ❑ No Date Read
i ❑ licensed contractor 2towner hereby request inspection of above electrical work at:
Job Address (Street, Box or RoUte.No.) City
Section No. Township Name or No. Range No. County
OccupanltPRiN r~ Phone No.
Power Supplier Address
Electrical Contractor, (Company Name) Contractor's License No.
Mailing Address (Contractorgr Owner Making Installation)
Authorized Signature (Contractor/Owner king Installation) Phone Number
[ cYc &
MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT
Grig-Mildway Bldg. - Room S-12 BE ACCEPTED BY THE STATE
1821 IS
UNLESS nee University
2 642Ave., St P ul, MN656104 1111 ENCLOSED. PER INSPECTIONFOEER
REQUEST FOR ELECTRICAL INSPECTIONS EB-00001-09
pop- See instructions tut rompleting•this form on back of yellow copy. a
f
X Below Work Coed by This Request V Ne 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) C ntractor's Remarks.
r
7
~t i 1'7 ~ r f ' r .s
Compute Inspection Fee Below: 1
# 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 t\ !~l
Special Inspection -
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLET 18 MONTHS.
I, the Electrical Inspector, hereby Rough-in L~ Date
certify that the above inspection has Final / D t
been made.
OFFICE USE ONLY '
This request void 18 months from
yOFFICE USE ONLY This request void 18 months from validation date printed in this box.
I IIII~I~ II ~~~I II III II III II III II III it III I III~.C ~ ~
* 0 4 8 9 2 7 6 6 ~
PLEASE PRINT OR TYPE
R est Dat Rough-in inspection required$ ❑ Yes o Inspection Other Than Rough-In: ady Now 0 Will Call
(You must call the inspector when ready) Dote Ready
I, censecl contractor ❑ owner hereby request inspection of the above electrical work at:
Job Addre(Street, Box, or Route City Zip Code
tq Gconv
Section No. Township Name or No. Range No. Fire No. County
Occupy ~ I Pho N I ?R(o
Power Supplier Address
Electrical Contra r C Inc. C actor license No. Master Lie. No. (Plant Elect. Only)
1 So. 19th Avenue
Mailing "d coif "1tllf
Au rued Signature (Co cior or ing Installation) rne No.
E 1 A-11 8/9 STATE BOARD COPY - SEE INSTRUCTIONS ON BACK OF YELLOW COPY 3
Sr9 J REQUEST FOR ELECTRICAL INSPECTION
4 Q (U( Minnesota State Board of Electricity
c8 U l-`a.►~ 1821 University Ave., Rm. S-128, St. Paul, MN 55104
Phone (612) 642-0800
1-1 Home Du lex A t. Bldg. Other: - - New Addn
Commercial Industrial Farm Remod Repair
Air Cond. Ht g. Equip. Water Htr. Load Mgmt. Other:
Dryer Range Elec. Heat Temp. Service
eXn above the work covered by this request. Enter remarks in this spce a~ndp on the back of the white copy only.
~5 -PCL Lc-cv-
Calculate Inspection Fee - This Inspection Request will not be accepted without the correct Fee:
Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Street Ltg./Traffic Sig. Above 200 Amps ove Amps
Transformer/Generator INSPECTOR'S USE ONLY TO
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
Swimming Pool
I here certi that I ins t elechi otion described herein on the dates stated
Irrigation Boom Rough4n Date
Special Inspection final Date
Investigative Fee C
THIS INSTALLATION MAY BE ORDERED DISCO NECTED IF NOT C LETED WITHI 8 M NTH
PERMIT # RECEIPT DATE: i
USIDENnAL PLUMING Pfflt= 'L1CATIDN
CITY OF EAGrM
3$30 PILOT KNOB RD
E4HuM JI1N 55122
651-661,4675
Please complete for. D single family dwellings
➢ townhomes and condos when permits are required for each unit
D backflow preventer for irrigation system
SITE ADDRESS: \1~0.CtiC~nt2 , Loy., pL>L~
OWNER NAME:: TELEPHONE _ (OTC- cZ, ~(o
(AREA CODE)
INSTALLER NAME: E_&SOYS TELEPHONE q5& C : ENj_% D&2
STREET ADDRESS: 605 12th Avenue bd°ti (AREA CODE}
CITY: STATE: ZIP:
Place a check mark next to the permit work type
_ New residential dwelling unit under construction and not owner/occupied $ 90.00
Add-on, modification or alteration to existing dwelling unit, including: $ 50.00
abandonment of septic system
• new installation/repair/rebuild of RPZ
• lawn irrigation system
• water turnaround
~Q pf
Nature of work: 2sw~a( le
_ Septic System, new/refurbished - $ 225.00
• includes County & Consulting Inspector fees .
• requires MPC license
-a
State Surcharge $ 50
Total $
Reminder. Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc.
I hereby acknowledge that I have read this application, state that the information is rrect and agree to comply with all applicable City of Eagan ordinances. It
is the appiicant's responsibility to notify the property owner that the City of Eagan sumes no liabili for any damages caused by the City during its normal
operational and maintenance activities to the facilities constructed under this pe ithin City roperty/ri f-wayleasement.
SI NAT PER TEE
Updated 1/a1
MY OF EAGAN PERMIT . Ceo $03c? 7
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 0 3 0 7 3 0
(612) 681-4675 Date Issued: 09/03/97
SITE ADDRESS:
3719 BLACKHAWK LAKE CT
LOT: 14 BLOCK: 2
BLACKHAWK GLEN 3RD
P.I.N.: 10-•14352-140-•-02
DESCRIPTION:
(IN GROUND)
Suildinq•=.P.ermit Type SWIM POOL
Building Work Type NEW
Census 'Code 329 NONBLDG STRUCT.
REMARKS:
FEE SUMMARY:
VALUATION $12,000
Base Fee $187.25
Surcharge 6.00
Total Fee $193.25
CONTRACTOR: Applicant - OWNER:
VALLEY POOLS INC 18941480 BURROWS JOHN
651 CLIFF RD 3719 BLACKHAWK LAKE CT
BURNSVILLE MN 55337 EAGAN MN 55122
(612) 894-1480 (612)688-2964
I hereby acknowledge that I; hav read this applicat'i€n and state that the
information is correct 'and <agr'ee to oomply with all applicat~le State of Mn.
Statutes and City of L'agan'Ord.inances.
APP CA T/PE IT SIGNATURE 4S ED B'. SIG ATUR
. : 3 0 97 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
681-4675
New Construction Reouirements RemodeLfRQOair Reouirements
• 3 registered site surveys ♦ 2 copies of plan
♦ 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ♦ 2 site surveys (exterior additions & decks)
♦ 1 energy calculations * 1 energy calculations for heated additions
♦ 3 copies of tree preservation plan if lot platted after 7/1/93
required: _ Yes _ No
'1~~
DATE: CONSTRUCTION COST.
DESCRIPTION OF WORK: - - CS`-A-LC j yVa ezm.d S.w~ m : v AUV L
STREET ADDRESS: _ 8iAf,-t1AWg Lac.
LOT 14 BLOCK SUBD./P.I.D. AIL
PROPERTY Name: ~GlJltj dS,arzAN Beek-OW S Phone
OWNER WT "M
Street Address: X19 Y (AQJ1-f4AWf- 45- c t
City: EA a► A 0 State: M N Zip: 255 19,2 ,
CONTRACTOR Company: VAil 21- Dot) L '"X P c- Phone %9L/-jt/W
Street Address: k i Cb If (u. License M
City: 76-y~ C. a' It IC State: V Y) Al Zip:
ARCHITECT/ Company: Phone
ENGINEER
Name: Registration M
Street Address:
City: State: Zip:
Sewer & water licensed plumber (new construction only): Penalty applies when address change
and lot change are requested once permit is issued.
I hereby acknowledge that 1 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.
Signature of Applicant 44
OFFICE USE ONLY 0 v
D
CerFificates of Survey Received Yes No INS 2 g 097
Tree Preservation Plan Received Yes No Not Required
OFFICE USE ONLY ,
BUILDING PERMIT TYPE
0 01 Foundation ❑ 06 Duplex a 11 Apt./Lodging o 16 Basement Finish
0 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. 17 Swim Pool
0 03 SF Addition o 08 8-plex a 13 Garage/Acoessory ❑ 20 Public Facility
❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous
0 05 SF Misc. ❑ 10 _ plex o 15 Deck
WORK TYPE
31 New ❑ 33 Alterations o 36 Move
o 32 Addition o 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code 0/
Census Bldg
Census Unit
APPROVALS
Planning Building Al- Engineering Variance
Permit Fee Valuation: $ O
Surcharge
Plan Review
License
MCANS 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
Z
P1 MIER 7472 Fllret gist! Utive
Lalo Menrlnfa Ileigllls, MN 5512[1
erg * eel"'Ing.. - _ -
* * r 16121681 1914
F.
f
tiertilicAte of 5drvey fer:._ V,, ,0 CONST:
I
i- F"Em W E D
PY FtW 1dadtA /Y1L- -j
DATE ~ 1 Ndat tl
BUILDING INSP HONS DEPT.
~t?
' t3an u~ ~ 34:33 3z.v ~
I I 4 t ~ ( ~ 111
V
lF I r ~ ~ 16.0 - - ij• 83~ ~ A
I .
X11 I 3', = I 4
4J;::i
T, 10
-IMP
h ..W. - - "D
Ila
900.0 derfobs exisfin Clevolibri r , Q p~E IREC)
uS,E LEVA710N
• 9bo.p derrofe5 ro~eG! EeVpjrar +J
_ p f. l 1 Bowes aar E~evcx fnn s~,r4V
Uhrtvf e Ura►,rrv e Ulr1►~ F_ctrserrrer f T
. o; 8locl/ Elevcrtir~r~ 83cmI&
- dertoles Drcrfrr e I7ow ,4rrows GcrraeSlv6 t-levalian 93e.6
beriofes morlutneo a IJeno~{es dtf sff dub
8edrirJJs shown ore assumed ,'uPd {U ~cr~err rerr,>rs oj,',qPCt71r'd -LOTIA 0%. W
U4~oT/~ CovNrv, 1'hNnrESOTj JVK CAM ADVIROM
•
F hnrr•by certify drat This survey flan or [[rind was pinpgrnd by me nr irnr4rr niy rllrrrl snhnrvisfr+n and 111-11 f ani rlnry Fhgistr~nrf t.and 5ttrveynr
ur+~ler the laws of the Stale of Mionexola, bated this Sf1•` day of j e- 17 fg
Searle:
07
~ It, Mr III fl. SIItIf It 1 frf r Rr}. InR91
or ~ PERMIT
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 027150
(612) 681-4675 Date Issued: 03/14/96
SITE ADDRESS:
3719 BLACKHAWK LAKE CT
LOT: 14 BLOCK: 2
BLACKHAWK GLEN 3RD
P.I.N.: 10-14352-140-02
DESCRIPTION:
Ruilding Permit Type BASEMENT FINISH
Building Work Type ALTERATION
Census Code 434 ALT. RESIDENTIAL
REMARKS:
A SEPARATE PERMIT IS REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK
FEE SUMMARY:
Base Fee $50.00
Surcharge ~$.50
Total Fee $50.50
CONTRACTOR: OWNER: - Applicant -
BURROWS JOHN
3719 BLACKHAWK LAKE CT
EAGAN MN 55122
(612)375-3762
I hereby acknowledge that I have reed this application and state that the
information is correct and agree to comply with all applicable State of Mn.
Statutes and City of Eagan Ordinances.
APPLICANT/PERMIT E SIGNATURE ISSUED B : SIGNATURE
CITY OF EAGAN -0 0,-
3830 PILOT KNOB RD - 55122
Iqlff01996 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
New Construction Requirements Remodelh?epair Reauirements
♦ 3 registered site surveys ♦ 2 copies of plan
♦ 2 copies of plans (include beam & window sizes; poured fnd. design; etc.) ♦ 2 site surveys (exterior additions & decks)
♦ 1 energy calculations ♦ 1 energy calculations for heated additions
♦ 3 copies of tree preservation plan If lot platted after 7/1193
required: _ Yes _ No
DATE: -2 _ CONSTRUCTION COST: Loj L ,
911
DESCRIPTION OF WORK: bw9 enut,,r
STREET ADDRESS: 371 -431 gtk -iat k- Lra~ct bt
LOT BLOCK T _ SUBD./P.I.D. n r It ~1 t~ I vIQ )
w~ 37S - 376a
PROPERTY Name: 1kn Phone ~$g d
OWNER i MT --k_j 7 I C RA'ackl-~~c~~
Street A ress
City: i~ zip: 5~l a
State:
CONTRACTOR. Company: Phone
Street Address: License
City: State: Zip:
ARCHITECT/ Company: Phone M
ENGINEER
Name: Registration M
Street Address-
City: State: Zip:
Sewer & water licensed plumber. Penalty applies when address change and lot
change are requested once permit Is Issued.
I hereby acknowledge that 1 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.
Signature of Applicant:
OFFICE USE ONLY W E C9 IFE V E D
Certificates of Survey Received Yes No MAR 1 1996
Tree Preservation Plan Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging --R-'-16 Basement Finish
❑ 02 SF Dwelling o 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool
a 03 SF Addition ❑ 08 8-plex ❑ 13 Garage/Accessory ❑ 20 Public Facility
❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous
❑ 05 SF Misc. a 10 - plex o 15 Deck
WORK TYPE
❑ 31 New ~3 Alterations ❑ 36 Move
❑ 32 Addition ❑ 34 Repair o 37 Demolition
GEINER-AL INFORM- ATION
Const. (Actual) Basement sq. ft. MC/WS System
(Allowable) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.
Depth Footprint sq. ft. SAC Code o/
Census Bldg
Census Unit
APPROVALS
Planning Building Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MCMIS SAC
City SA;
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
1991 BUILDING PERMIT APPLICATION ~-l
CITY OF EAGAN
C
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 1
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: o Valuation: Date: /,-It) - 91
Site Address 3-719 $ OFFICE USE ONLY
Lot [L Block FEES 44
Occupancy M-1 Bldg. Permit 0 310 0
Zoning Surcharge 78,0o
u
Parcel/Sub B1,tck~V, C({,~~__ Actual Const V-1~ _ Plan Review Sef,3.0
~ II Allowable _ V ~N SAC, City / O a
Owner _CL~r.~A~C`I (1nN~ C. # of stories SAC, MWCC lOv
Length Water Conn. bO,D~
Address 1212 1R(Lke6; j, Ac,. Depth 4o Water Meter 00
S.F. Total Acct. Deposit 30,0
City/Zip Code jilr . SS 33~ Footprint S.F. S/w Permit ,oo
S/W Surcharge 15V
Phone (.SE--76to On site sewage- Treatment P1. x76,00
On site well Road Unit 3 a,u 0
Contractor S r1n F oys Oc..1NE~ MWCC System Park Ded.
City water Trail Ded.
Address PRV ✓ Copies
Booster Pump
City/Zip Code SUBTOTAL
APPROVALS Penalty
Phone Planner Lot Change
Council TOTAL
Arch./Engr. Bldg. Off.-z 9!j
Variance
Address
City/Zip Code
Phone #
i -bagrees that all work shall be done in accordance with
re Contractor)
all apricable State of Minnesota Statutes and City of Eagan Ordinances.
VA Lu
GAaA&E
9oxi2;4n
k22 ; y(.Iv
6 ~o X 1 = lozov
O'S M,r
Lr0
~►~6 ~-1~I = 1b~~l~l
122y ~ 5-3 = ~,~r~r72
c. x
70Y U -n
2422 Etamprise Drive
* PIONEER
~ - - Mr!"dnta I10911t:, MN 55120
eng (each rig (6121681.1914 -
AT;'
Certificate of Survey for:. ~c RO~~ ~"D CO N
NOW of
\1O ° 2 93 0a N 9? `40'41 "E
34 33
Ilan rU"F o 0
7A;3900
7.
44.o 4,e
~ o a ~
0
raao~4~ - ~N N l z a a~~•3
• 835; a ' ' ~ ~'s3 3L,a
Z $ 3. z2 D '497.'
RED
r 900.0 Demotes exislin Elegy aliorl ~►sE LEV47 ON
yea.o !Ji?riofes profa , edIPvafiori Lower doori'vcr parr 83~,4b
l*note.i Dra,na Uflli~ Fasemei7f
rop of Block EIQvUlion 839,1
Denoles Drvin e glow Arrows Gara f e Slab (levat ion $3$, $
0 Derfofes MMUMenf Q Oeno~es d t~set #ub
BearirlS shown are assumed SU~ekil to Easerner~ fs ol" Record
LOT IA BLOCk Z , 91A CKHAWK 67t LN 3rJADVI T -10N
B"fUrll COUNW, 1t11,VNrSpTA
1 hereby certify that this survey, plnn nr rnpOrl was tucpnred by rue or under my tlitpct 5rgte+visinn and ilml i nur duly nonktnrexf Land Surveyor
under the laws of the State of Minnesota. Dated this S day of A. D. lg
_Scale- 1. ---1~3~
tirtr;t=rxr p, sricrr:+r I .'aFf:. Nrt. 14ti91
BASED ON CHAPTER 5 OF THE
MODEL ENERGY CODS 1283 ED IQH
Adoption Effective
owner Phone Date - ~Ok 1 ?2 V -OP rr^^
sate Address I-►OT N. 13L~ e.kHA+k t~ +?RD A
Contractor. Phone
Building Classification: Type Al (Single Family & Duplex)
Type A2 (Residential, 3 stories or less) (over 3 stories) (other)
NOTE: CoMplete -„p ge 3 and 4 first.
GENERAL I F3MATIQU N
1. Building Perimeter g ft. 1) rzk 2 wall height (ground to eave) N ft.
3. 1. X 2. (above) gross wall area Z-- sq.ft.
4. Building dimensions (L).-. ----x (W) _Osq.ft.roof & floor area
5. Sq. foot area of rim joist - Floor jo s size (2 x )
D X (Perimeter) _ t.
12
6, . Doors - Area
Thickness in U. factor-
Type of Construction Perimeter ft.
Manufacturer
7. Total door's perimeter 1 ft.
S. Windows: Manufacturer State approved
u factor
TYPE SIZE AREA (Sq.Ft.) NUMBER OF TOTAL
N EACH UNITS 5Q FEET
s•
~r - - ~
9. Total sq. ft. Class
a.o. Fireplace area: Width X Height X1, _ sq. ft.
11. Exposed foundation: Height X Periiteter -Ito', X ~ 0- cj. ft.
COMPLETION OF THIS FORM IS REQUIRED FOR ALL NEW CONSTRUCTION, MAJOR
REMODELING AND BUILDINGS BEING MOVED WHERE ENERGY, OTHER THAN THE MINIMAL
CODE ALLOWANCE, IS USED.
-1-
-JUN"- 7-S )l FR_I_ 9 oe _RL-AHCO.- I MSURA"CE OFF I CE P k3
Framing area 10% oj. gross wall area.
13. Gross wall area ~ CO sq. ft.
window area sq. f't. U windows = 1 +J~ UxA =
Rim joist area A 1 11152 0sq. ft. U rim joist= ± UxA =
Door area A (Psq. ft. U door area= UxA! =
Other doors area A~sq.ft. U other doors= l UxA = r,'
Exposed fndn A 90A
s ft. U foundation= ~ UxA =
Framing area j'ogt s ft. U framing aream r UxA =
Net wall area U wall= o4 UxA
(13H) TOTAL UX =
14. Gross wall area x 0.11 (A-1 single family & duplex) = allowable UxA/Code
(13. above)
x 0.23 (A-2 other residential)
x .23 (other buildings)
j x .28 (over 3 stories)
A x U Code BTUH must be larger than or same
OF. as 138 above
15. Ceiling framing area (Af) equals 10$ of ceiling area
15A. Gross ceiling area = (L) x (w) - sq,ft.
15B. Joist area (A f) = 10% ceiling area = sq.ft. _ 1?,+ 15C. Net ceiling area (A C) (15A - 158) _ W 4 sq.ft.
U ceiling x AC = _ EL.,►~ x
U framing x A£ -
15D. TOTAL U X A
16. Ceiling area (15A) x 0.026 (A--1 single family & duplex)
allowable UxA/Code
x 0.033 (A-2 other residential)
x 0.06 (other)
BTUH must be larger than or same
A(15kh), x U Code ()-Z ~ , °F. as 15D above
NOTE: Use U and A values obtained from pages 1, 3 and 4.
I hereby certify that I have calculated the "U„ factors and
FIR" values herein and that the building here described meets or exceeds the
State of Minnesota Energy Conservation Act.
Date Signature
-2-
- T U J 4 7-9 1 FR 1 g PL ANCO, T NSURANCE OFF I C E
P _ ~4
-749
34 + 'i-4 f- 49 ~10) - I ib~ - ~o
~,)4- I
Jjox
cm OF EACAN
~i a=t'i., -"o
075KV99 Tj VA i2 A A, T.."
i., '
WAM&
1210 DOM
.GNIC - f - 461 01 at .r,. 121. Q
TOW NUCKY i
UVER TV 24,
3 7 b 9 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) S~5
/ CITY OR MEAGAN
1,7 3830 PILOT KNOB RD - 58122 ' 7<'
651-681.4675
New Conshuction Renuiremenk
3 registered she surreys showing sq. ft. of lot, sq. ft. of house 2 copies of plan
and gQ roofed areas (20% maximum lot coverage aRowgM 1 set of energy calculations for heated additions
A 2 copies of plans (show bean a window sizes; poured Ind. design; elc.) 1 We survey #w exhrivr oddiilorrs h deck
Y . 1 set of energy calculations
D 3 copies of free preservation plan I loi plaited aller 7/1/93
2Z-&AT~ CONSTRUCTION COST: ~'~~S.a•~_
DATE:
DESCRIPTION OF WORK: G ra 1 `Oh`L
STREET ADDRESS:
LOT: BLOCK: SUBD./P.I.D. #t':
Phase #I: ~S-~f _
Name: c I1J L~✓~tc J ~a r.P 4
PROPERTY Lost PM
OWNER L
Sheet Address: T7~
City GA14P1 State:! Zip..
L ~qs--~o Y
~ Phone
Company: ~ idop6to
(area code)
CONTRACTOR f~
Street Address: ~S Ak i.O a. License 6 919'1Xy >rxp•
City g ArpiS 117,1 11 State..-Ilk Zip:
ARCHITECT/
ENGINEER Company: Name:
Telephone area code ( )
Street Address: Registration #f<:
City Stater Zip:
Sewer & water licensed plumber (required for new construction oMr1:
P?natly applies when address change and lot change Is requested once pem* Is ksued.
1 hereby acknowledge that I have read this application, state that the information Is correct, and agree to comply wtih all appilcabl
state of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant.
USE Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No Not Required
OFFICE USE ONLY
BUILDING PERMIT TYPE
❑ 01 Foundation ❑ 06 4-plex ❑ 11 10-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.)
❑ 02 SF Dwelling ❑ 07 5-plex ❑ 12 12-plea ❑ 17 Garage ❑ 22 PordVAddn. (4-sea.
❑ 03 1 of _ plex ❑ 08 6-plex ❑ 13 16-plex ❑ 18 Deck ❑ 23 Porch (screened)
❑ 04 2-plex ❑ 09 7-plex ❑ 14 Apartments ❑ 19 Lower Level Je24 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) M-" 42 Reroof
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
Permit Fee JL2, 9S Valuation: $
Surcharge S
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
% SAC
9 - MY WIM"M
'"VILOTIC"COM
Pleat C*rVkft IDC SM
E - - F~
Sleor ~t
!
w"Clow
Ulh Ttb:
r
Kites Sk
Loun" T s. z
.00
H Tampa
V1j1~~t~e~t' Hestw. a a '
F1{JVI DIa111 loo x ~ ~ r
w+.'
Gas Pilo*mwmm -t
Rcu cgs 't.' r
Mter W
arr.p.p;~ynya ~..r+wi." u~S
Privrate Disposal " Dakeft W los"m 66.E _
(now wW r
U.G. S file
Alteret ' b sAmv 20M
VVaW Turn Amund 20J"
TI.
SITE MESS.
OMER NAME- 41-t I i6ih
INSTAMER
W 00
STREET ES8• . ,
1 '0 *o go"
CITY:
STATE al
PHONE ~~1~ ~
'WTTe
oroWm MY `
L ~+a++
p
SUED.
`T E3
Y
W: 4R
M
Oft
DAB
IS MAR MEM R J R' flX IF 60,' PIS, IS:
%%Tmnd# Am
VIAi:6, YOU ' :
,
NO.
Yes *Hkx M-'
MR, fvvuit tta' V
' 11T'fflftT S
FEE: > WA * 1 't . " i' 6 ? "
COQ PRICE x'1% 4
S TA %1VOIAM
TMAL F
WE A"U&-
TEN Pte. .9F
oviffiltok NAME
VISTAL#.EM f ' l
.
~M
f"cm
ii or.,
-
~My
MUM S 1kT . F`
PERMIT CITY OF EAGAN
REACT14ATiF" t 1992 BUILDING PERMIT APPLICATION
681-4675
ra h 1 g REM
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, I copy of energy
calcs.-
COMMERCIAL 2 sets of architectural & structural plans, I set of
specifications, I copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot than a is re nested onceermit is issued.
Date Valuation of work O Q
Site Address:
~9~~<~/,~~a
STREET SUITE 9
Tenant Name: (commercial only)
z / BLOCK ~ sva r~ P.I.D. e
Description of work:.
The applicant is: Owner O Contractor ❑ Other (Describe)
Name 6( )egnLj'5 'CL~ Phone 5< -69 3
Property LAST 1RST c.~ 334- ?3
Owner Address 37 /9-
STREET STE
City State Zip Company Phone
Contractor Address License # Exp.
City State Zip
Company Phone.
Architect/
Engineer Name Registration #
Address
City State Zip "
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area as been approved.
I hereby acknowledge t t I have read this application and state that the information is
correct and agree to co ply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY, Y> ti
BUILDING PERMIT TYPE
0 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish
❑ 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 17 Swim Pool
❑ 03 SF Addition ❑ 08 8-Plea ❑ 13 Garage/Accessory ❑ 18 Comm./Ind..
❑ 04 SF Porch ❑ 09 12-Plex ❑ 14 Fireplace ❑ 19 Comm./Ind. Misc.
❑ 05 SF Misc. ❑ 10 Multi. Add'l. 15 Deck ❑ 20 Public Facility
❑ 21 Miscellaneous
WORK TYPE
31 New ❑ 33 Alterations ❑ 35 Tenant Finish 37 Demolish
❑ 32 Addition ❑ 34 Repair ❑ 36 Move
GENERAL INFORMATION
Const. Actual) Basement sq. ft. MWCC System
(Allowable) 1st F1. sq. ft. City Water
DBC Occupancy 2nd F1. sq. ft. PRV Required
ZZonfng Sq. Ft. total Booster Pump
SStories Footprint Sq. ft. Fire Sprinkler
Length On-site well Census.Code
Depth On-site. sewage SAC Code
APPROVALS
Planning Building ~;i Assessments
Engineering. Variance
REQUIRED INSPECTIONS
❑ Site Footing ❑ Framing ❑ Insulation
❑ Wallboard Final ❑ Draintile ❑ Fireplace
Permit Fee vstuetian: g
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Pewit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Coppies o
Other
Total:
SAC %
SAC Units
* PIONEER 7'177 I'ntetltrise i7tivt!
~t - Mendota IIeights, MN 55120
* eng Weer ng
Ar * k (6121681-1914
Certificate of Survey for: ' e PONA O CONST.
t _r
"OPT if
$`lQ 20-3. ,op N 89 °40 4i "E ~o` ~3~
3d-. D
13o.o'V'~ Ur o 0
X334
N I I pvtv~P
O J I o~ 10.o Q T, 93R, ~
[1 f 04.0
D I 4e _14,
"t
o D
s ~ . O
4-
I, III's
3ZIO
283.r~o°40'
. soo.o Denofes exisf~n llevaf iort ZRQ- SEQ 1 ~ usF t~r<~ 7 ION
r 9bo.p Dertofes ro gyred F/eva~rvr
_ f loweS oor E evcy ion 63►.46
UI~II U 1-es Ui Uill (1Ir t AA F_asemQr~f TOP <Block Eleva lion s bb
Denoles Drain flow arrows Garra f e Slab flevcy fio, 8
O derfof eS moNumenf - 0 OenoYes 4t rsel lub
Bearrn s shown are assumed Ste' to Ecisen- ils of '.gpcor--d
LOT14 , BLOC' P% J
Z 91ACJVMWK 6LI 4 3 ~d A DO/ 7 ION
041~aT4 COVNry, MJNNE-SOTA
1 hp►ehy certify that this survey, flan or report was re
P pared by ere nr ruiner my direct enpnrvitinn anrt tiral i am eluly rtngiStnrnd I-arid Survaynr
under the iaws or the State of Minnesota. Datod this 544" day no n 19
Sale : IL'10 = p , ff F - ~ -
- - - - - - - _ - ~l ~ i~i~ Ir?lriFU 1 rl, SltttCl l t :•ftF-r. Flf1. 14891
7
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114093
Date Issued:09/11/2013
Permit Category:ePermit
Site Address: 3719 Blackhawk Lake Ct
Lot:14 Block: 2 Addition: Blackhawk Glen 3rd
PID:10-14352-02-140
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 .
Luanne Yang
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 -
John A Burrows
3719 Blackhawk Lake Ct
Eagan MN 55123
New Life Contracting Inc.
814 Grand Avenue
St. Paul MN 55105
(651) 224-3442
Applicant/Permitee: Signature Issued By: Signature
f
Use BLUE or BLACK Ink
r
For Office Use
City of Ea Permit#:
d Via I Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 DateReceived:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
- - - - - - - - - - - - - -
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: f7 / v?0 Site Address: 37/ q (~1 Q ~_~h `Cry) t- SS nit N
Name: C a r 0; (`p U s Phone: - qlo
Resident/ i O
Owner Address/ City/ Zip'
C,4N.
Applicant is: _k", Owner Con(rdctor
d
Type of Work Description of work: R l 0 t- t jrs J_ _s, 34a
Construction Cos C~00 Multi-Family Building: (Yes / No
Company: Cont
~'9 City:
Contractor Address:
State: Zip:..- Phone:
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
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) 4540002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x ` , lLit o s, cc) 14 2S x
Applicant's Printed Name Applicants Signature
Page 1 of 3
DO NOT WRITE BELOW THIS LINE l ~cp~j
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
Valuation %1®419 Occupancy MCES System
Plan Review Code Edition AW? SAC Units
(25%_ 100% Zoning P10- City Water
Census Code wj 3 Stories Booster Pump
# of Units / Square Feet PRV
# of Buildings I Length Fire Sprinklers
Type of Construction - Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall: _ Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: ,Building Inspector
-X 6,
RESIDENTIAL FEES
Base Fee ~3 i
Surcharge
Plan Review 7 9
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA119996
Date Issued:01/08/2014
Permit Category:ePermit
Site Address: 3719 Blackhawk Lake Ct
Lot:14 Block: 2 Addition: Blackhawk Glen 3rd
PID:10-14352-02-140
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.
Andrea Preusse
4145 Sibley Memorial Hwy
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 -
John A Burrows
3719 Blackhawk Lake Ct
Eagan MN 55123
(612) 803-0768
Wenzel Heating & Air Conditioning
4145 Sibley Memorial Hwy
Eagan MN 55122
(651) 894-9898
Applicant/Permitee: Signature Issued By: Signature