3731 Blackhawk Lake CtCity of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 3731 Blackhawk Lake Ct
Lot: 11 Block: 2
PID:10- 14352- 110 -02
Use:
Description:
Sub Type: e - Furnace & Air Conditioner
Work Type: New
Description: Fumace & Air Conditioner
Comments: Questions regarding electrical perm
952- 445 -2840.
Fee Summary:
Contractor:
Sedgwick Heating & Air
8910 Wentworth Ave S
Minneapolis MN 55420
(952) 881 -7739
Addition: Blackhawk Glen 3rd
ME - Permit Fee (Replacements)
Surcharge -Fixed
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
- Applicant -
equirements should be directed to Mark Anderson, State Electrical Inspector,
Owner:
Bradley S Haukness
3731 Blackhawk Lake Ct
Eagan MN 55122
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$50.00 0801.4088
$0.50 9001.2195
$50.50
Issued By: Signature
Mechanical
EA086470
09/30/2008
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
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SEVifER-&,?'?VATER PERMIT
CITY OF'??GAN
3830 Filot Knob Rd.
EagdFi, MN 55122-1897
DATE FEB 14p 1991
OFFICE USE ONLY
METER# PERMITDATE 02l19191
CHIP.# PERMIT #
METER SIZE • • B.P. RECEIPT # C 12119,
ISSUE DATE
1
B.P. RECEIPT DATE 4/4
-t PRV _ BOOSTER PUMP
SITE ADDRESS 373t BLACK}iAYi1G I.AY.15 (aT
LOT 11 BLOCK 2 SECl.SU6 BP.ACICHAWK 6IAN 3RSD
APPUCANT:
ADDRESS:
CITY, STATE ; ZIP
PHONE: ? -?
PLUMBER: HURE PLURBYNG
ADDRESS: 1970 GHR15TEttSI3N AVE 5TE .15
CITY, STATE w§T pAItL 104 ZIP 551ifE
PHONE: 455-3066
. PERMIT REGIUESTED
X SEWER X WATER - TAPS
COMM/IND
It NEW
Y RESIDENTIAL
_ EXISTING
Lawn Sprinkler Meters are to be Installed Ahead of Domestic Meters on Wate`r Line.
Credit WILL NOT be given for Deduct Meters.
I AGREE TO COMPLY WITH CITY OF
OWNER: pATUSTPOK bESIGNEx HOt+YE6 EAGAN ORDINANCES
ADDRESS: 4151 M8 DR 5TB 100
CITY, STATE EAC&I UN ZIF 55122
PHONE: 454--037 SIGNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING'DAYS FOR PROCESSING. CALL. 454-5220 ,FOR INSPECTIONS. .FOR STORM ;
SEWER PERMITS, CONTACT ENGINEERING DEPT. • '
SEWER=OYIfATER PERMIT OFFICE USE ONLY '
CITY?F,tWQAN METER # ' PERMIT DATE 02f19
? y
3830 Pilot ob Rd. .
18w ' CHIP #
EagA, MIV 5 PERMIT #
%
METER SIZE B.P. RECEIPT
DATE 1 ' ISSUE D ATE B.P. RE PT D
E ?L?1 .
? PRV - B00 R P.UMP `
SITE ADDRESS ?_73 ` $uck -ua
PERMIT REGISTED •
j
LOT 11 BLOCK 2 SEG/SUB O ??. G? 3?
RSEWER ? WAR _ TAPS
APPLICANT:
ADDRESS:
NTIAL
COMM/IND i RESIDE
CITY, STATE '?.???/`' /"???' ZIP X NEW
?'? - EXISTING
PHONE`. ry.f? r?'c x' -' °? .
: Lawn Sprinkler Meters are.to be Installed .
PLUMBER: JANECi?Y P t!M I G Ahead of. Dornestic Meters on Water 'Line:
,
ADDRESS: 720 PQNT7.?lC PL ' .
edit WILL NOTlbe given fc?r Deduct Meters. ;
CITY, STATE MEND()'YA -11EI $ MN ZIP 55I20
PHONE: 454-9297
^ • ,
I AGREE T OMPLY WITH CITY OF
OWNER: DAf? ROM DBSIG1?It. ?iO?$ EdGAN ORDI
CES i
ADDRESS: 1 E*0 DR 5TE 100 ?
'
CITY, STATE ? ZIP. 551102 :
PHONE: 434-8737 SIGNATURE WHEN METER SUED
PLE ALLOW TWO WORKING DAYS ;F.OR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR ORM
S ER PERMITS, CONTACT ENGINEERINGDEPT. .: ,
,.. , .
,
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8 DOlU1RS
? CASH ? CHECK
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CITY OF EAGAN N! ? ?? ? ? •.. ?
3830 Pilot Knob Road, P.O. Box 21-199, Eagan,nMN 55121
PHONE: 454-8100 ?AV
BUILDING PERMIT . Receipt #
'
Tn ha used for 8P DAiG16A1t EsL Value si 10•0w Date l7[D 14
19 '
Site Adjess - - -- '-----'---.__ ?..? --
Lot Block Sec/Sub. ?'*+
Parcel No.
? Name ??R0lt tlBfl?x ?8
? Address
? 'Ciry Phone 454-5737
¢ IUame -
Add(ass _
City
Phone
wil {'1?8
? W
53 Adcl[2SS ,
c W - CitY Phone,
i herdby acknowlege thal I have read this application and state that ihe
iniwma?ion is correct and agree to comply with all applicable State oi
Minnesota Statutes and City of Eag,.an Ordmances.
.?,-_;,?V??' •_ ,w?. ;k.?.r _.:;:.?4.Tn,? ..?,,.,ea.
Signaiure of Permitee
A Building Permit is issued to: UVLSUM DKSI?U NO
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
OFEICEf WS ONLY' ;
1?EES
Oi?upancy
zoning
(Acluat) Consi ? Bldg. Permii 675.00 •,
(Allowable) - 55a00
# ol Stories Surcharge ,
Length Plan Review
?
Depth - SAC, Gity '
F
TOtal
S
.
. sac, Mcwcc ;
S.F.Foolprints _ 6".00: ;
On Site Sewage _ Water Conn ?,-:
??? s
On Sile Well ?- Water Meter -?
30+? ?
MWCC Syslem ?-
Acct. Deposii
city water ?- ?.00
PRV Required _ S/W Permit ? ;
.
Booster Pump - SNV Surcharge ;':
a
k,
?'?
2
+
•
1
Trealment PI
APPROVALS
Road Unit
Planner - Park Ded.
Council
Bldg.Ofi. Copies ? e
3
374
,
.
Variance - TOTAL
„a
•• w pe/111ft HO: pM1MHOMM Di{! T~0?IR #
WATt R • /9
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Fourdaiion
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'.i?OF EAG?
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St? . YIW ??*` K\I
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6pn, MFnnesota 55122-18!47
? (612) 681-4675
SITEADDRESS:
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'SEDtaWICK HEATING & AIR CONDITIONING CO. HEATING JOB Nc?
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(612) 881-9000 TEST RECOEiD
r
ADDRESS 3 1 ^ ?CITY
-}- , -?
OCCUPANT OWNER
SOLD BY INSTALLED BY
-MAKE
SERIAL NO. SZ? ??fXJ
THER
VALVI
LIMIT
LIMIT SETTING ?
FAN SETTING
i
. LL-
PILOT TYPE
IGNITION MODEL
PILOT TIMING
PRESSURE P
INPUT CFH ERCENT C02
PERCENT OZ
?/C3
STACK TEMP. Z;?Sa PERCENT CO
FORM 235 (REV. 11189)
MODEL ??d`K? - `v ^ ?
INPUT
LI r/
VENT SIZE !
TYPE OF LINER
LINER SIZE
FILTERS: SIZE NUMBER /
WIRING
TEST TAG ?
LIGHTING INST.G
DATE TESTED ?
COMPANY TESTING
NAME OF TESTER _
4-
FORM DISTRIBUTION' WHITE COPV - JOB FILE V YELLOW COPY - CITY
EDG'WICK HEATING & AIR CONDITIONING CO.
op ppop-
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(612) 881-9000
ADDRESS -3??a
OCCUPANT
SOLD BY ?PeC Lc"?.?
MAKE - 4..C4
SERIAL NO. ?9Q ? do29??
THERMOSTAT So- W7[ ?
VALVE
LIMIT _S /C?'st?? C1
LIMIT SETTING
FAN SETTING -
PILOT TYPE 4wk t : T
IGNITION MODEL M /S
PILOT TIMING t„ N?7G n F
PRESSURE .3. ? W.?. PERCENT COz
INPUT CFH 2? PERCENT OZ
STACK TEMP. -.--.-- -3% PERCENT CO
FORM 235 (REV. 11/89)
HEATiNG JQB NV-
TEST RECORD
CITY T?
OWNER
INSTALLED BY ? 1-Jf'cG( .
?
MODEL 3(- / S?
INPUT Ati()
VENT SIZE -'I
TYPE OF LINER.?4
LINER SIZE 4;
FILTERS: SIZE I? x e2 ? NUMBER
WIRING
TEST TAG
LlGHTING INST.
DATE TESTED
COMPANY TESTING
NAME OF TESTER r~!;r"?jr'CL?,?,
?
FORM DISTRIBUTION: WHITE COPY - J08 FILE YEILOW QOPYP.-„QIT;{,u?.•°' ' '
SEWER kWATE13, PERMIT
CIT1P O? ?1GAN
3830, Pilot Knob Rd.
Eagan, MN 55122-1897
DATE FEB 14, 1991
OFFlCE USE ONLY
METER # a A PERMlT DATE 02 / 14 /,91
CHIP # Q °tD 1166 ,S-I PERMIT # 118OA
METER SIZE B.P. RECEIPT # C 121 1 S
1
ISSUE DATE AS'91 B.P. RECEIPT DATE 0211419
-X- PRV - BOOSTER PUMP
SITE ADDRESS 3731 B1ACKF[AWK LAKE CT
LOT 11 BLOCK Z SEC/SUB BLACKHAwK GLEN 3RD
APPLICANT:
ADDRESS:_
CITY, STATE
PHONE: -
ZIP
PLUMBER: NURR PLUMBING
ADDRESS: 1970 CHRISTENSEN AVE 5TE 15
CITY, STATE W ST PAUL MN ZIP 55118 PHONE: 455-3066
--Z- SEWER X WATER ._ TAPS
- COMM/1ND -X- RESIDENTIAL
PERMIT REGIUESTED
X NEW - EXlSTING
Lawn Sprinkier Meters are to be Irtstatled
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
I AGREE TQ COMPLY WITH CITY OF
OWNER: llAHLSTxOM DESIGNER HOMES EAGAN O INA CES
ADDRESS: 4151 KNOB DR 3TE 100 ?
CITY, STATE EAGAN HN Zip 55122
PHONE: 454-8737 SIGNATURE WH - METER ISSUED
,_ ;..... ?"'? _ ?? f' . . `? 4
AUASE ALLOW TWO WOrhKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
;? .
SEWER PERMITS, CONTACT ENGINEERING DEPT. -
Address: 3 7 3 1 BLA„?'IQIAWK LAKE CT. Lot 11B1k 2 Sec/Sub BZAGQIAWiZ QEIV 3RD
, •
Th?se 3.tems wera/were not complete at the time of the final inspection.
t4 16/91 Yes No '
Final grade (6" from siding)
Permanent steps - garage L"..,
Permanent steps - main entry ?
Permanent driveway
Permanent gas
5od/seeded grass 1f
Trail/curb damage
Porch
Basement finish ?
Deck
Please verify with the builder the removal of roof tast caps from the plumbing
system and the shut-off of water supply to the outside lawn faucet before
freeze potential exists. ?
KCIM"?p
White - City copy Yellow - Resident copy Pink.- Contractor copy
?
?
. ?. . (Urttfiratt nf Orru?aury
- Citp of Cagan
- _ ? ioPvawPtI# df Ineqto iwP1'ftm
This Cern0cate issued pursuant to tke requirements of Sescd'on 306 of the Uniform Building
Cade certifying that Qt tke trnre of issaance rhis structure was in camplircxce with tke various
ordinanees of the City regudatirtg bui&(ing construction or use. For the followncg.•
tim clmaiawm SF 17WG/C,ffit mdg. Pmmk rm 18710
r
o? ?. ?I?iC.S1.??M L1?5IQ? HM Add= 4151 IQ?B ?VE; EAC',AN
Mfflwm 1A-'K-E rJ0[JRT?ty L , ,
ada.m 37331,
4/36J91
Bouft O6Q
POST IN A CONSPICU4US PLACE
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JoeNo. 6??9-7
8910 WEN7WORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 TEST RECORD
ADDRESS `S 7-7/, ?r?'ck?'?u, k
OCCUPANT vl''? '? I,.(,,* U/C0
SOLD BY -f?Z d r C+J C?
C1N i.-'?' 7
OWNER ?, --tv ?-
INSTALLEn Rv ?2 '7
MAKE (-x N L'7 C)
SERIAL NO. ?'?- ! 0 S?p 60? Li
" D cc)
THERMOSTAT
VALVE
UMIT
LIMIT SETTING
FAN SETTING
PILOT TYPE -: I ? c
IGNITION MODEL t
S ?
PILOT TIMING
v
PRESSURE PERCENT CO2
?
INPUT CFH PERCENT 02
U
STACK TEMP. PERCENT CO
MODEL 1117 A" ? ? I? ;?7/
? ?G
(NPUT
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2
VENT SIZE
tf v C
TYPE OF lIP1ER
LINER SiZE
FILTERS: SIZE NUMBER `
WIRING Xci 17.r gfi'
TEST TAG
LIGNTING INST.
_f--o
DATE TESTED /r} y-
COMPANY TESTING
NAME OF TESTER
KORM 235 (REV. 11189) FORM DISTRIBUTION: WH{TE COPY - JOB FILE YEILOW COPY - CITY
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? INVOICE
IaJrlCko? 4e'? ,Jrct 3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
.?ity oF eagan 454-8100
Equal Opportunity/Affirmative Aciion Employer
To: 5589
r ?
DAHLSTRpM DESIGNER HOMES Date: 02/26/91 _
4151 KNOB DR STE 100
EAGAN MN 55122
L J
PLATILOCATION: AMDUNT
DESCRIPTION
Addreas chan e after ermit was i sued 20.00
1587 Blac awk k Drive o 3731 8 Court)
` TOTAL $2 0.00
r,u`' -
Invoice Prepared By: Marlynn Greenwoad '----'Community Development _
name department
,CPW4198 Total Due Upon Receipt - Thank You
r
` CITY OF EAGAN N 0 18710 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
BUILDING PERMIT
To be used for SF DWG JGAR Est. Value
Receipt # ?. e 1c,' I I
110 , 000 Date FF.R 14 , 1991_
Site Address 3731 BLACKHAWK LAKE CT
Lot 11 Block 2 Sec/Sub. BLACKHAWK GLEN
Parcel No. RD
W Name DAHLSTROM DESIGNER HOMES
? Address 4151 KNOB DB STF. 100
City EAGAN Phone._ 454-8737
o Name s?
? 1;,4 Address
? City Phone
W W Name
I'-
? ; Address
<? City Phone
I hereby acknowlege 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. `
5ignature of Permitee
A Building Permit is issued to: T1AHT.STRnM nF.ST GNFR 14C1MR',
on the express condition that all work shall be done in accordance with ali
applicabie State of Minnesota Statutes and City of Eagan Ordinances.
7 f yy?
Building Official
OFFICE USE ONLY
Occupancy R-3 _A=,1 FEES
Zoning R?1
(Actuat) Const v-N Bldg. Permit
0
675.0
(Allowable) V-N Surcharge
00
55,
# ot scories -
Length 76 ' Plan Review 438 _ 00
Depth 6' SAC, City 100 • 00
S.F. Total - SAC, MCWCC
0
650.0
S.F. Footprinls -
On Site Sewage _ Nlater Conn
O
660.0
On Site weil Water Meter 90 . 00
MWCC System X
Acct. Deposit 30. 00
City Water x--
PRV Required x S/W Permit 30.00
8ooster Pump - SIW Surcharge - 5n
7reatment PI
0
276.0
APPROVALS Road Unit 370.00
Planner - Park Ded.
Council
BIdg.O(t. _ Copies
374. 50
?
Variance - TOTAL ,
Request D f ///}}] Fire No. Rough-in Inspection
Required?
VjikC U No
O Ready Now i I Notify Inspector
When Reade
I?ficensed contractor p owner hereby request inspection of above electri work at: p0
Jo?dreu (91!eet Bo?t?ibµY No.) ?[/?
i3 /11
1 "(Y- CI?
Section No. TName or No. Range No. Counry
Occ (P I ) +_jM _ # 14 E Phon N `
Power Suppli
r Address
EI ' al CaMrect (Corqpany E ??
u ) & Co dor ?cen e
Meili tlre (Co ctor pOwner Making Install tion)
• ? ? , ?
AutMd Sign ur (Contractor/Ow
er Making Instal 2i n) )
?1
2-
h •?
mty1? -6030
/`i
MINNESOTATATE BOARD OF ELECTRICLW THIS INSPECTION REQUEST WILL MOT
GrIggs-Midway BWg. - Rovm 5-173 BE ACCEPTED BYTHE STATE BOARD
1821 Universlty Ave., St. Peui, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phqna(612) 642-0800 ENCLOSEO.
311, 5 jI ;ESee QUsEST? FORoEp E CTfRI?CA? ?NSPEICTI?ON
/
"X" Bebw WoMr Covered by This Request ??•? `(dG ???
ew Ae1d Rep. Type of Building AppiiancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dr er Other (Specity)
Comm./Industrial p 'Furnace
Farm Air Conditioner
Other (specily) Contractor's Remarks:
Compute Inspection Fee Below:
# Other Fee # Service Entrance 5ize e # Cirouits/Feeders ee
Swimming Pool 0 to 200 Amps to 100 Amps
Transformers Above 200 Amps Above 100 Amps V
SIgnS Inspector's Use Only: TOT#L
Irrigation Booms ?
Speciallnspection t. a
IA[arm/Communication T
THIS INSTALLATION MAY BE ORDE DISCONNECTED IF N
Other Fee -
r7
COMPLETED WITHIN 18 MONTH p h -cS c/
I, the Electrical Inspector, hereby Rou9h-in Date
certi that the above ins ection has ? p
been made. Final DateI ""
V -- `l/
OFFICE USE ONLY
This request wid 18 monMS irom
Osyol i
0-1 Om987 0
? ?
,?
Z/
Requ t Da e///±±±
L/ ??? Fire No. RougKin Inspec'r;pn Required Ins ection Other Than R ugh-In
(YOU u call inspector when ready) ? Ready Now Will Notify Inspecfor
?
?
Yes
No Date Ready
i? licensed contractor Vowner hereby request inspection of above electrical work at:
Job Ad s(Street, Box o1 ROUte ?)
CY' ?/ V a c )"k 14AeCf. City
Section No. Township Name or No Range No. County
OcC RINT)
0a8rajie-Z CLLIcP1e5y Phone No.
Power Supplier Address
Electrical Con ractor (Company Name) Contractor's License No.
Yo 4o wi I ejY
Mailing Address ( on cror or Owner Making Installation)
Vv
Author¢ Signature (C tracror' ner M
Installelion) Phone Number
P qs2.-6(079
MINNESOTA STATE BOAR ELE ICRY THIS INSPECTION REQUEST WILL NOT
R
9
M
G
S
8 I
I ?II II I
I ( I
) II I III
I I I
I II III II I IIII III )
RD
gO
I
829
U
versRy Ave., St
. PauI
55704
MN I I I UNLESS OPER INSPECTION
E
Phone(612)642-D800
?
?! . ENCLOSEp
°-t°o- T
A114.1
REQUEST FOR ELECTRICAL INSPECTION EB-00001-09
loo. See instruclions for completing this form on back oi yeiiow copy.
Below Work Coaered by This Request
Ne Add* Rep. Type of Building Appiiances Wired Equipment Wired
Home Range Temporary Service
Du lex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./industrial Furnace Other (Spec'rfy)
Farm Air Conditioner
Other (speciry) Contractor's Raffiafk? Compute Inspection Fee Be/ow: SerrvLp?1 I Q.4 i
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 10 Am s
Transformers Above 200 Amps bove 10 Am s
SIgt1S Inspector's Use Only: TOTAL !F_O-
Irrigation Booms
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WiTHIN 18 THS. .(
I, the Electrical Inspector, hereby Rough-in
certify that the above inspection has
been made. Flnal ( Dete -
OFFICE USE ONLY /
This request void 18 monlhs from
7s
F 4 4 ?9 2 2 ?
F est Dat
? Fire No. Aough-in Inspedion
Required?
? Ready Now
? Will Notify Inspectw
?
When Read
? Yes ? No y
1El?<ensed contractor p owner hereby request inspection of above electrical work at:
Job LWdress (Street, Routa No.) City
Section No. Township Name or No. Range No. Counry
RINT Phon No.
Power S Atldress
f
1-_
/ . y T
Elecffi a Contrador (Company Name)
•
• Contractors License No.
Mailing d s(C tra Ow aking Installation)
•
? L
Authori d Signature (Contra r/ ner ing Installation) Pho e um r
_
MINNE50 T BOARD OF ELECTRICITY I ? THIS INSPEGTION REQUEST WILL NOT
Grigge-Midway g. - Room &173 BE ACCEPTED 8Y THE STATE BOARD
1821 Universlty Ave., St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
? lo- See mstrudions fo ;completing this form on back oi yellow copy.
?4 4.6 g 1. -`X" Below Work Covered by This Request
EB-00001•08
e Add Rep. TypeofBuilding AppliancesWired EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Other (Specify)
Comm./Industrial Furnace
Farm Air Conditioner
Other (specify) Contractor5 Remarks:
Compute lnspection Fee eelow: 13;1
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 Amps Ab 0 Amps
SignS Inspecsort Use Only: TOTAL _
1 Irrigation Booms j ?
?
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical tnspector, hereby Rough-in Dete
certify that the above inspection has
been made. F;nai
• ?;: ! D.? c?
?
OFFlCE USE ONLY ' ? This request wid 18 months from
G5817
2004 RESIQENTIAL PLUMBINC3 RERMIT APPLICATit?N
CITY C)F EAGAN
3834 PILOT KNOB ROAD, EAGAN AAN 65122
651-675-5675
Please camplete for modifications to existing residentiai dweNings.
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Date o g / /_1 / o t
Site Street Address 3781 Q fckc_"auik L-ake Co?r-t 1JRit?
Property Owner Q rckd_1 f_? izl0-k-A t S 5 Telephone #( 6 r Z) Y/V 8S-6 3
Contractor Telephone # ( )
Address City state ZiP
The Applicant is: Owner _ Contractor _Other
Alterations to existing dwel(ing $ 50-00
_Add fixtures to rooms, excluding water softener and water heater
Septic System Abandonment
r Tumaround (add $121.00 if a 518" meter is required)
W
a
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: AAo jVrv?bl-n r a a
LOtherO
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r a ?-
.
Water Softener _ Water Heater $ 15.00
_ replacement _ additional.
Lawn Irrigation System RPZ_ new _ repalr _rebuikl $ 30.00
State Surcharge $ .50
Total
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of fhe City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work wifl be in accordance with the approved plan in
the event a plan is required to be reviewed and approved. /
18 r-cj I t ? lk u.? e sS L??
Applicant's Printed Name Applicant's Si a ure
?0587?
2004 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: single family dwellings & townhomes/condos when pernvts are required for each unit
Date
Site Address 3 ] Unit #
A" ni S-s ? z ?--
Property Owner Telephone # I t3 21
Contractor ?
Street Address Cih'
State Zip Telephone # ( )
Bond #• Expires:
The Applicant is ?/ Owner Contractor Other
Add-on or alteration to existing dwelling unit $ 30.00
furnace _Additional _Replacement
air exchanger
air conditioner New. _Re lacement
other
State Surcharge $ .50
Total $ 30 b?
I hereby apply for a Residential Mechanical 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 with the Mechanical Codes; that I understancl this is not a
permit, but only an application for a permit, and work is not to start without a pe 't; that the work will be in accordance with the
approved plan in the case of work which requires a review and approval of pl
9 11'P'm J?/'a2sS .?.?.?s.?
Applicant's Printed Name Applicant's Signature
2004 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for: commerciaUindustrial buildings
multi-family buildings when wparate permits are not required for each dweping unit
Date / /
Site Street Address Unit #
Tenant Name (if appl;eabie) Previous Tenant Nsme
Property Owner Telephoae # ( )
Contractor
Street Address Cih,
State Zip Telephone # ( )
Bond #• Egpires:
The Applicant is Owner Contractor Other
Work Type
_ New Canstruction _ Underground Tank _ instail _Remove'""see be/ow
_ Interior Improvement _ Install Piping _ Processed _Gas
Nature of Work:
'I *"When instaliing/removing underground tank, call for fnspectlon by Fire Marshal and P/umbing lnspector
Permit Fees: S70.50 Underground tank installation/removal
S50.50 Mtnimum (includes State Surcharge)
or
ContractValue $ x l% PermitFee
• If permit fee is $1,040 or less, add $.50 ? $ State Surcharge
If permit fee is over $1,000, add $.50 for
every $1,000 permit fee
i L' _f__ C_ $ Totai Fee
?„eVy appry Lvr a t-vmmercisi mecnamcai rermit and acknowledge that the information is eomplete and accurate; that the wark
will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; 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.
Applicant's Printed Narr?e Applicant's Signature
Approved By: , Inspector Date:
RESIDENTIAL BUII.DING C i ?? --7?
Permit Application ?
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauiremenis RemodeVReaair Reauirements Oifice Use Oniv
3 registeBd site surveys showing sq. ft. of bt, sq. ft. ot house; and ail roofed areas 2 copies of plan Cert ot Survey Recd _ Y_ N
(20% maximum lot coverage albwed) t set of Energy Calculations for heated addiHons Tree Pres Pian Recd _ Y_ N
2 copies of plan showing beam & wirxiow sizes; poured found design, etc. 1 s'de survey for additlons 8 dedcs Tree Pres Reqd _ Y_ N
1 set of Energy Calalations Addibon - indicate if on-site sepfic system On-site Septlc System _ Y_ N
3 copies of Tree Preservatlon Plan 'rf lot plalted after 7/1193
Rim Joist Deta10pbons seled(on sheet (bldgs wiUh 3 or less unit9
Date '?` ?
c7F? r--7/?-?M.? ? ? OU
Construction Cost `-R /
Site Address dr Jtd.ul LQ, ?.t, LN?)Yt" UniUSte #
Description of Woric Rfff2' ? w-?--O- L-t
Multi-Family Bldg _ YK N Fireplace(s) _ 0 2
Property Owner ?M(' * _C.?,Q.,?Qv-? ?t(?l? ?h?SS Telephone # (((?,S( ) ?1? ? - ?Ov?q
Contractor $ CpriStY'UC ' rvices 6&A4t4_Z &4"
e S
Address 6015 Lyr? e ciry
NZ419
state _ Mintte ol1S, MN 'Lip Telephone # ((pID4
L"AA i - -7 ? 3
u
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672
Energy Code Category . Residential VenBlaUon Category 1 Worlcsheet • New Energy Code Worksheet
(4 submission type) Submitted Su?*+?nP+ -,
. Energy Envelope Calculations Submitted
???
Have you previously constructed a building in Eagan with a similar plan? ? S'[ P? 61 Z?Q?o, plan review
fee applies. ?L JI
Licensed Plumber Tel one #(_ ? -- --
Mechanical Contractor
Telephone # (
Sewer/Water Contractor
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 plan in the case of work which requires a review and
approval of plans.
"a c, S ;
Applicant's rinted Name Applicant's Sign ture
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex O 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
0 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) O 33 Ext. Alt - SF
? 04 OZ-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) 13 36 Muiti Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N 0 25 Misceilaneous
Work Types
0 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition 0 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration 0 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
O 34 Replacement •DemoliUon (EMire Bidg) - 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) _ FinaUC.O.
_ Footings (deck) _ Final/No C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Paol _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insularion _ Retaining Wall
Approved By
------------- , Building Inspector
Base Fee
Surcharge
Plar? Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
? . , RESIDENTIAL BUII.DING
Permit Application
?j 13 as City Of Eagan ??
3830 Pilot Knob Road, Eagan MN 55122 17 /Y7 /0-3
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauirements ? RemodeUReaair Repuirements Qffice Use Oniv
3 registered site surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas 2 copies oi plan Cert of Survey Recd _ Y_ N
(20qo maximum lot coverage allowed) 1 set of Energy Calculations for heated additio Tree Pres Plan Recd _ Y_ N
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Not Reqd _ Y_ N
1 set of Energy Cafculations ? Addition - indkate if on-s'rte sepfic system On-site Septic System _ Y_ N
3 copies of Tree Prnservatlon Plan ff lot platted after 711/93
Rim Joist Detail Options selection sheet (bldgs with 3 or less units
Date Construction Cost 6 aD
Site Address Unit/Ste #
Description of Work CO?'\Ve-(+ 3 St!aSon orc? 'in e Vv 1l?ijv\d?f-LA
Multi-Family Sldg _ YX, N Fireplace(s) X 0 _ 1 _ 2
Property Owner fiCukj Telephone # (6Sj
? 6 ? - sZ
Contractor _ y lo ?'k e- Q7,v ?i
Address City
State Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cate?orv 1 Minnesota Ru1es 7672
Energy Code Category * Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet
0 submission type) Submitted Submitted
• Energy Envelope Calculatlons Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies. _, '
- ?
Licensed Plumber
Mechanical Contractor
, 1,, ',
Sewer/Water Contractor _ ,z _ --- -. _---
. ? ..._
Telephone # (
Telephone # (
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 plan in the case of work which requires a review and
approval of plans.
'6 r-GJ le- j ? aukvi tL5-s ?%?jm AJ??
Applicant's Printed Name Applicant's Si e 1-1
OFFICE USE ONLY
Sub Types ' k
? 01 Foundation ? 07 05-plex 0 13 16-plex ? 20 Pool ? 30 AccessoryBldg
O 02 SF Dwelling ? OS 06-plex O 16 Fireplace 0 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage X? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck O 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
Work Types
0 31 New
? 32 Addition
x 33 Alteration
0 34 Replacement
Valuation ?
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
_ Footings (new bldg)
_ Footings (deck)
_ Footings (addirion)
Foundation
Drain Tile
Roof Ice & Water
_X Framing
? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 37 Demolish (Bldg)"" ? 43 Reroof ? 46 Windows/Doors
*Demolition (Entire Bldg) - Give PCA handout to appllcant
Occupancy MC/ES System
Zoning City Water
Stories Booster Pump
Sq. Ft. PRV
Length Fire Sprinklered
Final
Fireplace _ R.I. _ Air Test _ Final
?C Insulation
Width
REQUIRED INSPECTIONS
FinaUC.O.
?C FinaUNo C.O.
T Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
_ Retaining Wall
?
Approved By Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
cicy sac
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
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1990 SUILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCULATIONS
MULTIPLE DWELLINGS
2 SETS OF PLANS
REGISTERED SITE SURVEYS -
(CHECK WITH BLDG, DEPT.)
1 SET OF ENERGY CALCULATIONS
# OF RENTAL UNITS
# OF FOR SALE UNITS
FE8 -1 -
C4MMERCIAL
2 SETS OF ARCHITECTUR.AL
& STRUCTURAL PLANS
1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST I5 MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS I5
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROGESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
To Be Used For : Valuatio Date :?'?',??
-? 49976???
Site Address -A44*.,C- _S131 NrAIM11 La? ?QFFICE ?SE ONLY
Lot lt Block e'? FEES
G c.-E)? 2; A ii---) Am`
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Owner P?¢JL5TiQ0?'1
Aadress z//,S'/ Kxliod !ah', cSvfTE ?140
City/Zip Code 6t,,g..V ?niy s.si?.Z
Phone F 73 7
Contractor
Address
City/Zip Code
Phone
Arch. /Engr . Sr, 1-
Address
City/Zip Code
Phone #
occupancy R-'.S M-1
Zoning R -I
Actual Const y-/•!
Allowable V-N
# of stories
Length ? S'1z
Depth S.F. Total
Footprint S.F.
On site sewage_
On site well
MWCC System r/
City water
PRV ?
Booster Putttp _
APPROVALS
Planner
Council
Bldg. Off. 5,' Z _13.4i
Variance
Bldg. Permit (07S,00
Surcharge 55• oa
Plan Review 413 $, 00
SAC, City 00100
SAC, MWCC SO,O 0
Water Conn (p-0'0'0
Water Meter 110,00
Acct. Deposit 0,00
S/W Permit 30,06
S/W Surcharge ?5o
Treatment P1. 2 , 09
Road Unit D o0
Park Ded.
Copies
SUBTOTAL
Penalty
TOTAL ..s'a . D
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FEB-12-191 TUE 11:33 ID:JAf1ES P. HILL INC TEL t•JU:E12 884-9518 #y54 F-'Us
BUINYIYOR'S CEIITIFICATE
BLACKHAWK LAKE COURT
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PLANNERS / ENGINEERS 1 Sl1RVEYORS
I n.n, Ieucc evF c. qi OnUINGTON. MN. 55431 • 612-8$4-3020
FEB-12-'91 TUE 11:32 ID:JAMES R HILL IIdC TEL N0.612 884-9518 #954 F02
1"VEYOR'$ CERTIFICATE
SiENNA t,vrcrv+vft1 wr.
REVISED 2-12-91 1'0 SNDW
PROrOlEO HOUSE fOR
OAI&STMOM DOW*= MDWS
NOTE: BUILOtNG OIMFNSIONS SHdWN QRE Ft7R HORIZaNTAI.
9k VFATICAL tOCATION OF S7RUCTURE ONLY. SEE
ARWITBCTUAL PI.ANS F'OFi BWLDIFIG & FOUNDATION
pIMEN514N3. COMPLETE NOTE: ON Tli15F1 TSBYSTHE SU7RYEYOR TFE SUTA81LITf OFD
SOIL SUPPORT NOT ST E RES ONSIBiL TY pOFF?HEHOSUERVEYOaED `S
+------ OENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET SCALE: 1 INCH - 30 FEET
* DENOTES IRON M4NUMENT FOUND PROPOSED GARAGE FLDOR -03G.o FEET
X000.0 DEIdOTES EXISTING ELE?? ONON pPROPOSED ROPOSED OP OF BI.OCK -?3`.4 F?'
(000.0) DEN07ES PROP4SED
WE HEAEBY CERTIFY TO SiENNA CORPORATION THAT THIS IS A TRUE ANO CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES 4F:
Lot tl, Hlock Z, BLACKHAWK GLEN 3RD ADDITFoN, according to the recoxded
plat thereof, Dakota County, Minnesota.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACNMENTS, EXCEPT AS SHOW?N. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERV1510N THIS DAYOF
AP!'ROVL• D f(?R S l CNNA SIGNED: .?J9tdIE?;?• HILL, INC.
CORPORA710N --
? •?.:?;,-;:'i' ?' i.. t ?•../'??'??.?4??'
BY:
py ; HAROLD C. PETERSON, LANO SURVEYOR
MINNESOTA LICENSE NUMBER 12294
nwTrn.
James R. Hill, inc.
PLANNERS / ENGiNEERS / SURVEY4RS
9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 9 812-884-3029
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:TOTY? ARER 50.111t8iRl U 5.505
- P"e 3
CftY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT
CIUQ011
PERMIT TYPE: B U I L D I N G
Permit Number: 025308
Date Issued: @ q r04/95
3731 BLACKMAWK LAKE CT
LQ7a 11 BLOCK: 2
BLACKHAWK GLEN 3RD
P.T.N,: 10-14352-110-02
DESCRIPTION:
Building'Permit Type BASEMENI" FINISM
8uilciing Wark Type AITERATION
REMARKS:
A SEPr1RATE PERMIT TS REQUIRED FOR flNY PLUMBING OR ELECTRICAL WORK
FEE SUMMARY:
sase Fee $35.00
Surcharge $050
Tota1 Fee $35o50
CONTRACTUR: OWNER: - a p p 1 i c a n t-
MAUKNE55 BRADLEY
3731 BLACKMAWK LAKE CT
EAGAN MN 55122
(612)943--9186
?
I hereby acknawledge that I have read this applieaCion and state that the
infarmation is correct artd agree to ccrmply with all appaaicabl.e State crf hirt.
? 5tatutes and City of Eagan Ordinances. ?
• APPLICAN ERMITEE 51GNATURE ? ED-??1 S? ?A? U ,? ? ?
? CITY OF EAGAN
3830 PILOT KN06 RD - 56122
1995 BUILDING PERMIT APPLICATIQN (RESIDENTIAL)
Q81-4675
? 3 mostsred sft owreys ? 2 oopios af pion
? a oopia a ptans (indude bwm a window •ixes: voured tna. desipn; .tc.) ? 2 slae surv.ys (.xtwior adftoa. 3 deks)
? 1 anew cakulatlons ? 1 energy caIpuNtions iar tmW sddkma
i 8 copin oi tne proarvation aan if tot plaiEed aRer 711198
. fptdrod: _ Yes _ No
DATE: CONSTRUCTION Ct3$T:
DESCRIPTIDN OF WORK:
STREET ADDRESS: 3-73 A,JL_
!4T = BLQCK 2 SUBD.lP.I.D. #:
!? I y3SZ l l c? o Z
. _....,.,. .? ?.._
PROPERTY Name: M0.U kn f-SS 47 ? l?-K Rhono #?- -LO22
owwER ,M
S#reet Address; 73) ?/'?, --
City: E.,-cu v? State: ? A/ Zip•_?.`??...,.?..?..?
coN'rMcTOtt Company: , Phctne
Street Address: Livense #•
City: ? Stme: Zip•
ARCHITECT! Company:
ENGlNEER
Name:
Phone #'
Regis"tion #•
Street Address•
Gity: State: ? Zip'
Sew 8 water lioennd plumber: Penft sppiles when eddrass charooe and bt
change are requeded onoe permit is issued.
I hereby adcnowfedge that 1 have read this appNcation and state that tht infomation is oom7 sQree to corMly wi#h e8
applicable 3tate of Minnesota Statutes and City of Eagen Ordinanoes.
OFFtCE USE CNLY
Certificates of survsy Reveived
Tree Preservation P1an Received
Signature of Applicant:
Yes No
? Yes ? No
.144
RECEIVED
MAR 2 8 1995
OFFICE USE GNLY
BUiLDiNG PERMIT TYPE
0 01 Foundation o 06 Duplex
o 02 8F Dweliing o 07 4-plex.
0 03 SF Addition a 08 8-piex
o 04 SF Ponh 0 09 12-plex
0 05 SF Misc. a 10 --plex
WORK TYPE.
a 31 New 9?- 33 ARerafions
0 32 Addition o 34 Repair
GENERAL INFORMATIOM
0 11 Apt.lLodging cW 16 Basemerrt finish
0 12 Mufti Repair/Rem. a 17 Swim Poa
a 13 GarageJAacessory o 20 Public Fecitihr
0 14 Fireplace o 21 Miscellaneous
0 15 Dedc
0 36 Move
0 37 Qemoifion
_ y
Coqst. (Actueq _ Basemerrt sq. ft. ? MC/VIVS Systsm ?
(Ailowable) Main level sq. #t, „ City 1Nater
UBC Oca,pancy ? s4. ft. Fie Sp1rdrred
Zoning _ sq. ft. _ ..?. PRV ?
# of Stories sq. ft. ? 8ooder PwnP
Len9th sq. ft, ? Cmm Code. A
z
Depth Faotprint sq. ft. ? SAC Code ?._
ConvA "
Ganous Unit _ d -- -
APPROVALS
Planning r Building ? Engineering Ywignce
a
Permit Fee Veluation: $
Surcharge
Plan Review .
License . MCNVS SAC
City SAC
Water Corm.
Water Meter
Acct. Deposit
SNV PermK
SIW Surcharge .
Treatmerrt Pl.
Road Unit
Park Ded. •
Trails Del.
Other Copies
Totai:
% SAC
SAC Units
C11Y USE ONtY
L ? BL ?2 . REcaPr v j?43qNi ;
suBO. QaTE:??`
1"5 PLuMgiMG PEWIr (RESoENTIAa.)
cirr oF EAGAN
3830 PtLOT ECId46 RQ EAGAwo lilN 56122
(612) 6814675
Plesse compfe#e for: ? single famify dwellhQs
? tanmFromea and anndas when peffnitsara roqt*ed fdr eaqh unk
FIXBURES EACH 40. TO7"AL
Shovrer 3.00 x
Water Closet 3.00 x
Bath Tub 3.00 x
Lavatory 3.00 x
Kitchen Sink 3.00 x ? 3i
Laundry Tray 3.00 x
Hot Tub/Spa 3.00 x
Water Heater 3.00 x
Floor Drain 3.00 x
Gas Piping Outlet mtnimum -1 3.00 x ??, ¦„?,,,,?
Rough Openings 1.50 x :
VYater Softener 5.00 x
Private Disposal '" Dakota cty. ictiense 20.00
U.G. Sprinkler * tme unaer const: 3A0
?
?
Atterations ' to swons 20.00
Water Tum Around 20.00 ?
STATE SURCHA#tGE jt1
TOTAL
StTEADDRESS: 373 I QI/gC..f`
-...??. .. ?.•..-„?,
14P1Y:-W-
IIVSTALLER NAJIIAE: 6'-Vyv'° r'
STREET ADDRESS:
CITY: STATE: PA A) _ Z1P: ..R,.,.???.?.. .
?
PHONE 0: { 612 Y?2- 60 72
Pbae oompete fiDr: r d
DATE:
FEE:
$26.00 tftitmm 1ee or fi% o1' .ml il ,litiaR .Suft smawgo qf lm-w ;
$1,QOO o# gNM iee dtn +cn slkpN III
;
!'7? e4
CITY USE ONLY
L BL ? RECEIPT #:
SUBD. AL, 957- DATE•.=LL.2?
1985 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PIL4T KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for. ? single family dwetlings
? townhomes and condos when permits are required for each unit
New construction
Add-on fumace
Add-on air condifioning Fireplace conversion (#Q existing fireplaae)
\4M
Date:
0
? Minimum Fee: Add-oNRemode! (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24•00
Additional 50 M BTU 15•00
? Gas Outlets (minimum of 1 required aQ $3.00 each)
? State Surcharge .50
TOTAL CCD
SITE ADDRESS• •?k'q ?) I ????Q•?- ' 1=???-.l.g.n?
OWNER NAME: PHONE
INSTALLER
STREET ADDRESS: ti22:XQ1 "t-J 1 -t M L-'! "L --
CITY: ----? i STATE: _ ZIP:
PHONE #:
cmr usE oNLv
L s? RF.CEtPr 8:
SUBD. DA'TE:
1995 MECHANICAI. PERMiT (CbMMERCIA?L)
CITY 4F EAGAN
3830 PILOT I{Nt)B RD
EAQAN, MN 56122
(612) 681,4675
Please complete for: ? all commoncialrindustrial buikiings.
? mutti4bmlfy buiidings wtren sepamte peimits ars tld required
far eacM dwelting unit.
DATE:
CfJNTRACT PFttCE:
WORK TYPE: NEW GUNSTRUCTION INTERI4R tMPR4VEMENT
DESCRIPTI4N 4F W4RK:
FEES: ?$25.00 miMmum fee g 196 d# conbvd price, whichnrsr is gr+eaier.
? Proeessed piping - $25.00
• State w?rcharge of $.50 per $1,000 of 91MR 'Ibe due on e0 permits.
CONTRACT PRICE x 1 %
PROCESSED PlPtPIG
STATE SURCHARGE
TOTAL
SITE ADDRESS:
aWNER NAME: TELEPM4NE
TENANT NAME: (waRavEmrnm oN.Y)
INSTALLER:
ADDRESS:
CITY: STATE: ZIP.
PHONE #: . ,..
SIGNATURE:
SIGNATURE OF P?R??'fEf CtTY INSPECTaR
`CITY OF EAGAN
3830 PILOT t'1308 ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
.•WJ..?{?•}}i:O:J:iSi?iiii?ii'r:i:..i::?S:::i•'.?..?i:4:
FOR CITY USE ONLY
PERMIT # a S-5 60
RECEIPT # /o
DATE: 3
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
----------
-----WORK DESCRIPTION FEES
NEW CONST
ADD ON
REPAIR
? ? 4-,., e??z.- e_o'_x_"e.
OWNER NAME :
3731 SUBTOTAL:
SITE ADDRESS: ?? ?. STATE SURCHARGE:
LOT : BLOCK ? SUBD. TOTAL :
INSTALLER: -NIVI1 ,K
ADDRESS: HEATING & AiR CONOIT10N1NG C0.
A. RTH AVE. S0.
p,'IidNEAPOUS,
CITY: €01-n?""J ZIP :
PHONE
ADD-ON MINIMUM
HVAC 0-100 M BTU
ADDITIONAL SO M BTU
GAS OUTLETS - MINIMUM
OF 1 PER PERMIT
DWELLINGS &
$15.00
24.00
6.00
3.00
?, dD
$?
.50
$ %t7 so
SIGNATURE OF PERMITTE
PLEASE COMPLETE 'IiiIS pURT10N r`uR Ai,L COAIXERG Itiij iivDUSTRIAL SLTILDIhGS,
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPAR.ATE PERMITS ARE
NOT REQUIRED FOR EACA DWELLING UNIT.
CONTRACT PRICE: ,
OWNER NAME:
SITE ADDRESS:
LGT: BLOCK
INSTALLER:
ADDRESS:
CITY:
ZIP:
PHONE # :
FEES
1$ OF CONTRACT FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
PROCESSED PIPING = $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1$ $
STATE SURCHARGE $
TOTAL:
$
(SIGNATURE)
SUBD.
FOR:
CITY OF EAGAN
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
:..s::.?.??.,€??..:: ?A wl.?
PLEASE COMPLETE
? UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
;;x:,..:....:....::..,,..:::..:..
TOWNHOMES/CONDOS
WfIEN PERMITS ARE
REQUIRED FOR EACH UNIT.
-----------------
------
------
------------------------
WORK DESCRIPTION ----- -------------- --------- COMPLETE THE FOLIAWING:
N0. FIXTURES EA. TOTAL
NEW CONST ADD-ON MINIMUM 15.00
ADD ON ? SHOWER 3.00 3
REPAIR WATER CLOSET 3.00
I BATH TUB 3.00 3
I LAVATORY 3.00 q_
OWNER NAME: , KITCHEN SINK 3.00 3
/
,
?- ? LAUNDRY TRAY 3.00 ?_
SITE ADDRESS: ?73 /
`
ll. ? V HOT TIJB/SPA 3.00
_i WATER HEATER 3.00 3
?-_ SUBD.
RL4CK
LOT:
4 cLnOR DRAZN 3.00 ?_
_
_
- ' GAS PIPING OUT.
INSTALLER: fil u- v' r I
i k rn q? ki, (MINIMUM - 1) 3.00
.?_
3 OPENINGS
ROUGH 1.50 'rG
ADDRESS: I ?-2D 7'iSf CjxSeK (f'? OTHER
WATER SOFTENER 5.00
00
CITy; 2IP; PRIVATE DISP. 15.
U.G. SPRINKLER 3.00
PHONE #
-'r- .?o 6 o
AACI
FOR CITY USE ONLY
PERMIT 0 RECEIPT # /D U 31
DATE:
SUBTOTAL
ST. SURCHARGE .50
SIGNATURE OF PERMITTEE e?
TOTAL: v
PLEASE COMPLETE THIS PORTION FOR ALL COMMERC IAL/INDUS TRIAL BUILDINGS AND
:.,,..._.. . .....: . .: .
MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FQR EACH
DWELLING UNIT.
CONTRACT PRICE:
uwilEn iviiiln :
SITE ADDRESS:
LOT: BLOCK SUBD.
INSTALLER:
ADDRESS:
i% OF CONTFcAi.T FEE.
STATE SURCHARGE _ $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1$ $
STATE SURCHARGE $
CITY: ZIP:
TOTAL: S
PHONE
(SIGNATURE)
FOR:
FEES
CITY OF EAGAN
S U R V E Y O R' S C E R T I F I C A T E sIENNA CORPORATION
REVISED 2-12-91 1O SHDW
PROPOSEO HOUSE FOR
DAHLSTROM DESIGNER HOMES
2•13-91 DfiST. ELEV.
2-18-9Y'tHOtJSE'I.AGTiON 1
NOTE: BUILDING DIMENSIONS SHO'WN ARE FOR FIORlZONTAL
9 VERTICAL LOCATION OF STRIJGTURE dNLY. SEE
ARCHtTECTUAt PLANS FOR BUILDING 8 FOUNDATION
DiMEN510NS.
NOTE: NO SPECPIC SOILS INVESTIGATION HAS BEEN COMPLETEO
ON THIS LOT 87 THE SURVE70R. TFE SUITA8IL.IT1f OF
SOIL.S TO SUPPORT THE SPECIFIC HOUSE PtiOPGSEO IS ?
N07 THE RESPONSIBI[.ITY OF THE SURYEYaR
+-- DENOTES PROPOSEO SURFACE DRAINAGE ? / .
O
•
X000.0
(000.0) DENOTESARON MONUMENT SET
DENOTES IRON MONUMENT FOUND
DENOTES EXISTING ELEVATION
DENOTES PROPOSED ELEVATION SCALE: 1 INCH'=
PR4POSED GARAGE F1.00R -
PROPOSED LOWEST FLOOR -
PROPOSED TOP OF BLOCK - 30' `FEET
03G.o FEET
07-9.3 FEET
t3(-•4 FEET
WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot• II, Hlock 2, BLACKHAWK GLEN 3RD ADDITION, according to the recorded
plat thereof, Dakota County, Minnesota.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS DAY OF ,19 .
APPRQVCD FOR S1CNNA SIGNED: JAME,S,R. HILL, INC.
CORPORATIOPI ' ' . • r•,
BY:
QY : HAROLD C. PETERSON, LAND SURVEYOR
nnTr. nt MINNESOTA LICENSE NUMBER 12284
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James R. Hill, inc.
PLANNERS / ENGlNEERS 1 SURVEY4RS
9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 o 612-884-3029
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SURVEYOR'S CERTIFICATE
BLACKHAWK LAKE COURT
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SIENNA CORPORATION
REVISED 2-12-91 TO
SHOW PROPOSED HOUSE
FOR OaHLSTROM
DESIGNER HOMES
2-13-91 EX IST. ELEV.
KA.: _ 2-18•91(FqUSE LOCATIOi
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P L A N N E R S 1 E N G I NEERS 1 SURVEYORS
9401 JAMES AVE. S. • BLOOMINQTON, MN. 55431 o 612-884-3029
? 2007 RESIDENTIAL PLUMBiNG PERnniT aPPUCaTioN ?
CITY OF EAGAN CW
3830 PILOT KNOB ROAD, EAGAN MA155122
651-675-5575
P}ease complete for modiflcations to existing residentiai dwe{Nngs. Do not combine inside and outside
`hc'. ??:'lE :?Y?C}?I(;?ttlQfl' St?C;.3rc3tc 2m)il?1ai4o!iS c"3fid C;4:i -flltS afe rPQUIf°d.
Date ! 1
Site Street Address _171?? Unit #
Property Owner Telephone #?S' ) t-Sa-
Contraator I l ? Tefephone #
Address l...e S- i Statel2W)\3 ZiP n ?
The Applicant is: _ Owner 8 Occupant Licensed Plumbing Contractcr
Septic System _ New _ Refurbished Submit 2 sets of plans and MRC license Inctudes County fee
$ 100.00
Per as-buiit $ 10.00
fire Repair (reptace bumed oat fixtures, etc.) $ 90.00
This fee a lies wherE extensive lumbin re airs are made to a buildin .
Alterations to existing dweliing $ 50.00
_ Add plumbing fixtures to main level Itawer Level. This fee inEtudes
instaftation of a water softener acidfor water heater at the same time. tf you are
3nstalling oniv a water softwor and/or water hea#er, do not compte#e this section;
move to the next seetion and ptace a chedcmaric next to the appGanre(s) you are
insta{tFng.
_Septic System Abandonmerrt
_Water Tumaround (add $136.00 if a 5/8" meter is required)
Other:
Water Softener ? Water Heater $ 15.40
_ new _ reptacemen#
?Lawn ttrigatian _RPZ PVB -?',new _repair _rsebu{!d $ 30.00
State Surcharge $ •50
Total $ 30
1 herebY epplY fa a ResideM+a1 Plumbing Permit and adcnowtedge that the infotmat+on ts compiece an(i aocuraie; mai me wflnc w+u ve
in conformance with the ordinances and codes af the City of Eagan and the plumbing codes; that 1 understand this is not a pemiit, but
only an applicadon for a permit, work is noi io start without a permii ar?d +nrork uriN be in acxortiance with the approved plan in the even#
a plan is required to be reviewed and approved. 1---) ?-
bp? 1 ,(5•?=?--?-??--?'-' `
ApQlicant's Printed Name Appticant's Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114512
Date Issued:09/16/2013
Permit Category:ePermit
Site Address: 3731 Blackhawk Lake Ct
Lot:11 Block: 2 Addition: Blackhawk Glen 3rd
PID:10-14352-02-110
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 .
James Hunter
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 -
Bradley S Haukness
3731 Blackhawk Lake Ct
Eagan MN 55122
(651) 452-6079
Hoffman Weber Construction Inc
3515 48th Ave N
Brooklyn Center MN 55429
(866) 970-1133
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA167050
Date Issued:02/19/2021
Permit Category:ePermit
Site Address: 3731 Blackhawk Lake Ct
Lot:11 Block: 2 Addition: Blackhawk Glen 3rd
PID:10-14352-02-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Graham P Mink
3731 Blackhawk Lake Ct
Eagan MN 55122
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA169403
Date Issued:05/25/2021
Permit Category:ePermit
Site Address: 3731 Blackhawk Lake Ct
Lot:11 Block: 2 Addition: Blackhawk Glen 3rd
PID:10-14352-02-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Graham P Mink
3731 Blackhawk Lake Ct
Eagan MN 55122
(203) 524-3435
Angell Aire Inc
12253 Nicollet Ave S
Burnsville MN 55337
(952) 746-5200
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA177953
Date Issued:07/26/2022
Permit Category:ePermit
Site Address: 3731 Blackhawk Lake Ct
Lot:11 Block: 2 Addition: Blackhawk Glen 3rd
PID:10-14352-02-110
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
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. When a weather barrier is installed or
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 -
Graham P Mink
3731 Blackhawk Lake Ct
Eagan MN 55122
(203) 524-3435
Twin Cities Siding Professionals
664 Transfer Road
St. Paul MN 55114
(651) 255-2844
Applicant/Permitee: Signature Issued By: Signature