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3645 Blackhawk Rd This request void 1'8 mottt~,s from pl~ 1314 Date of this Request Fire No. I, as C'Eicensed Electrical Contractor ❑ Owner, do hereby request inspection of the above electri- cal wiring installed at: Street Address or Route No. (10~ _1s~ , City ~r" Section Township I Range County Which is occupied by_ r - I (Name of Occupant) Is a roughin inspection required on this job? No ~ Yes ❑ Ready Now 0 Will Callen- Power Supplier~4~, "Address Electrical Contractor Contractor's License No. ( ognpany Nam Mailing Address 1~---~ ect catftractor r er Makin4 This insta 1 tion) Authorized Signature Phone No.'5~ (Electr al Contractor or owner Making This instailation) STATE BOA CORY This inspection request will not be accepted by the State Board unless proper inspection fee is enclosed. Minnesota State Board of Electricity Griggs Midway Bldg. - Room N191 C52 i 3 EB-00001-02 1821 University Ave., St. Paul, Minn. 55104 - Phone 297-2111 ^ ;REQUEST FOR ELECTRICAL INSPECTION S CHECK BELOW WORK COVERED BY THIS REQUEST 91314 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For Home ❑ ❑ Range ❑ Temporary Wiring ❑ Duplex ❑ ❑ ❑ Water Heater ❑ Lighting Fixtures ❑ Apt. Bldg. ❑ ❑ ❑ Dryer ❑ Electric Heating ❑ Commercial Bldg. ❑ ❑ ❑ Furnace ❑ Silo Unloader ❑ Industrial Bldg. ❑ ❑ ❑ Air Conditioner ❑ Bulk Milk Tank ❑ Farm ❑ ❑ ❑ pList List Other ❑ ❑ ❑ Heree1S Hereers COMPUTE INSPECTION FEE BELOW Service Entrance Size: # Fee Feeder ee `ejs Circuits: # Fee 0 to 100 Amps. 0 to 3t,_ ` ert , a C1 0 to 30 Amperes 101 to 200 Amps. 31 to 1 " AmpC cs` 31 to 100 Amperes Above 200 Amps. Above I mps. Above 100 Amps, I Transformers Remote Control Circ. Partial or other fee Signs Special Inspection Minimum fee ' Remarks {1 TOTAL E I, the Electrical Inspector, hereby certify that the above inspection has been made. (Rough-in) Date (Final) Date This request void 18 months from CITY OF EAGAN Remarks Addition S(MC-U On 17 Lot Blk Parcel 10 01700 020 78 Owned` n,. t Street 3645 Blackhawk Rd. State Eagan,MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SUR F. STREET RESTOR. GRADING 1 255-1 vS~ 10 SAN SEW TRUNK 1968 248.5o 8,28 30 SEWER LATERAL C , 1978 1957 20 39c; ?0 1 WATERMAIN WATER LATERAL WATER AREA 3y i 1977 67 .110 45.09 1 Water Stub /0(. 1971 200.00 10.00 20 STORM SEW TRK 7 1983 934.00 62.27 15 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC 27 .0 9185 10-10-73 PARK S RESIDENTIAL BUILDING ` Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 U Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey Recd _ Y - N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions 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 Reqd _ Y _ N 1 set of Energy Calculations Addition - indicate if on-site septic system On-site Septic System _ Y _ N 3 copies of Tree Preservation Plan if lot platted after 7/1/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date ! D / .6- Construction Cost Site Address ZL c4 -_'~-),4 WK_ (R'S ;r-5; q 4W Unit/Ste # Description of Work ~,Q ~Q U (9 / I \ Od 6A-) Multi-Family Bldg - Y l N Fireplace(s) _ 0 a 1 _ 2 Property Owner 'J d ~PJ~Q~~ $N Telephone # Contractor U A-11V G M Address t P y ~J(f4 CI F-1 'Y-IC City State 1,g A{ _ Zip ,f'S Telephone # (~v r1) ~79 ~i' COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Telephone # ( ) 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. Applicant's Printed Name ppli is Signature OFFICE USE ONLY Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of_ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 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 p w 1 K I (Z.,- - 31 New ❑ 35 Int Improvement ❑ 38 Demolish (Interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Valuation 7 i' 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 \J+ 1 Width REQUIRED INSPECTIONS Footings (new bldg) Final/C.O. Footings (deck) Final/No C.O. Footings (addition) _ Plumbing _ Foundation _ HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests -Final Framing _ Siding _ Stucco _ Stone Fireplace _ R.I. -Air Test -Final _ Windows (new/replacement) Insulation _ Retaining Wall Approved By Building Inspector Base Fee Surcharge _ Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total I I 8144 I ~ PjecIP4-PT1 IeoAe a R~rnlh. C'AR l~aa: h 17 0!0-77 O p\d jI oc' a Ilo.s 147 /LOS /sa-s ! 010-le a 70 6 S 2 /Z 's ° SDI.? Is/.L Lsr / 1 L.&ROY 1. a LUGILL~ POND a y oyo-lt N 03~'I~ ~ I I°°I cos 7S.c s. 4 s. a ,v10NTE. p 7 V / I HILLCREST 17EVBLOI~M~NT O f 230 Lr- ROY I. d.I.-LJC~LLM PC1vt7 J g / O 010-19 13 So L / 1 011-75 2-7 l f Ofo-8~ h NILICgEl10EV[6o*. ~~"j ✓oh//.fOn Ler01, I I"C. c / „s Lvths/ M• d l.uc► w Pond ~S Ro : 1 N.riy K. tAr~/dn. Olo~{o P' t s oho-•!S I bd IL..C04 r9T vav. Y 0Sro/ S/ctO V .3 ASSESSABLE FRONT FOOTAGE FOR LATERAL BENEFIT. FROM TRUNK WATER MAIN n- I 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) _ CITY OF EAGAN J 3830 PILOT KNOB RD - 55122 651-681-4675 ` New Construction Reauirements Remodel/Repair Requirements > 3 registered site surveys showing sq. ft. of lot, sq. ff, of house 2 copies of plan and all roofed areas (20% maximum lot coverage allowed) 1 set of energy calculations for heated additions > 2 copies of plans (show beam & window sizes; poured fnd. design; etc.) 1 site survey for exterior additions & decks i set of energy calculations > 3 copies of freie eservation plan if lot platted after 7/1/43 DATE: 15 CONSTRUCTION COST: ~ILJU~ DESCRIPTION OF WORK: A VAW STREET ADDRESS: 3VS fly c LOT: BLOCK: S- SUBD./P.I.D. Name: Vv-~~ Phone #:2 ~C51 PROPERTY t First OWNER Street Address: City State: Zip: Company: SELA ROOFING & REMODELING, INC. Phone Z_ ~y1tP CONTRACTOR ST. LOUIS PARK, MN 55418 (area code) Street Address: ID #QQQIQSQ License # 65 Exp. City State: Zip: ARCHITECT/ ENGINEER Company: Name: Telephone area code ( ) Street Address: Registration City State: Zip: Sewer & water licensed plumber (required for new construction aniv): Penalty applies when address change and lot change is requested once permit Is Issued. i hereby acknowledge that 1 have rend this application, state that the info n correct, gree to mply with all applicable !tote of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLYbr-xz Certificates of Survey Received Yes N No i` 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-plex ❑ 17 Garage ❑ 22 Porch/Adds. (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 ❑ 24 Storm Damage ❑ 05 3-plex ❑ 10 8-plex ❑ 15 Lodging ❑ 20 Pool ❑ 25 Miscellaneous WORK TYPE ❑ 31 New ❑ 35 Tenant Impr ❑ 39 Gas Line Only ❑ 43 Siding/Soffits/Fascia ❑ 32 Addition ❑ 36 Move Bldg. ❑ 40 Gas Insert ❑ 44 Windows/Doors ❑ 33 Alteration ❑ 37 Demolish Bldg. ❑ 41 Wood Stove ❑ 45 Fire Repair ❑ 34 Repair ❑ 38 Demolish (Interior) ❑ 42 Reroof 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 Valuation: $ Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Park Ded. Trails Ded. Other Copies Total: SAC Units % SAC VILLAGE OF EAOAN SEWER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NC.: } 206 Eagan, MN 55122 DATE: 10NO/73 Zoning: R-1 No. of Units: 1 Owner: John Kaysen Address: Site Address: _____3645 Blackhawk Road _ Plumber: Wenzel Plumbing & Heating Inc. I agree to comPlr with the Village of Eagan Connection Charg,275.0_ pd Ordinances. Account Deposit: 15.00 pd Permit Fee: 10.00 pd Surcharge: .50 pd By: Misc. Charges: _ Date of Insp.: Total: Insp.: Date Paid: err 1TY Of EAR V 1M MWO PMW 3830 Pilot Kra Rrtsd 7~ } P.,0. sox $1199 PER1MtT NO:: , MN 55121 ORTt: Nd, of Units Owner Kay-getl T Ste /dress: 3645Blackhawk Reid fO 0176-6 M pj.* t,. Wenx p u bing Mew too : 0 . t Opd Size: v ~ & Reeder NoQ a m aP ly W46 RIECIUMEt> by 3.50 a me Total: p teeter i By flote Pcad. of Insp., fns~p.: Receiat 66941 Z:~ CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road 79`2 P. O. Box ?1199 PERMIT NO.: Eagan, MN 55121 DATE: 10-2 ' Zoning: No. of Units- I Owner: zrj -V-,jrLq~-n Address: Site Address: 5 3" rii~}~aa,d._ .,s ac3 r }17t'0 020 78 Plumber, S~rI Motor No.: Connection Charge, Size: Account Deposit: IS • 00,T)d Reader No.: Permit Fee: 10. 00pd i agree to am* with the City of Eogon Surcharge: tkdinonoa, Misc. Charges: ' 5 f ' f pd Ty° Total: 63 ~0 met€r By Date Paid: Dote of Insp.: Insp.. `i 3 w t v i r~ i CITY OF E A G A N ~ 1,10TE: PAYMENT' 01F FEE AT APPROVAL OF PERMIT. * APPLICATION FOR PERMIT * INSPECTION OF SEWER AMID/OR WX= ` imTmL.ATIONS WII.L NOT BE scm - SEWER AND/OR WATER CONNECTION UIED UNTIL PERMIT HAS BEEN APPROVED. * * lease Print) 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: Lot Block Subdivision or Tax Parcel ID ) IF EXISTING STRUCTUME, DATE OF ORIGINAL BUILDING PERMIT ISSUANCE: PRESENT ZONING/PROPOSED USE: (Nbn Year ) Q CaxMMCIAL/ MAIL/OFFICE R-1 SINGLE FAMILY Q INDUSTRIAL R-2 DUPLEX (Twv Units) Q INSTITUTIONAL/GOVERNMENT C] R-3 TOWNHOUSE (Three + Units) ( Units) R-4 APARTMENT/CONDOMINIUM ( Units) , 2) • ~ X1 NAME:- ADDRESS:-,5(©C~S 1~-~CK L CITY, STATE, ZIP: _~.~~r~t}~_~~~_~-~ ~ PHONE: 4 ~L~• _ l-lq 2 3) u NAME- i. For City Use 4-g; t~ Plumbers License: ADDRESS: (Jp K Active Expired CITY, STATE, ZIP: A 600 "\j j -a' ~ - Not recorded PHONE: MASTER LICENSE# Staff Initial 4) .aa. • 104- NAME: C9' ' Iq S rte ADDRESS: S CITY, STATE, ZIP:__-AcaAj AA '-D - PHONE: ,:~tNG"4 , -5) WITI)wTv CONNECTION TO CITY SEWER CONNECTION TO CITY WATER OTHER 6) ! - • r PLEASE HOLD APPROVED PERMIT FOR PICK-UP BY ONE OF ABOVE PLEASE MAIL APPROVED PERMIT TO 1, 2, 3,(4 ABOVE (Circle one) FOR CITY USE ONLY PERMIT # ISSUED j Pd w/Bldg. Permit FEES: $ $ SEWER PERMIT (INCLUDE SURCHARGE) $ ~D S $ WATER PERMIT (INCLUDE SURCHARGE) (O S~~ $ WATER METER/COPPERHORN/OUTSIDE READER $ $ WATER TAP (INCLUDE CORPORATION STOP) $ $ SEWER TAP $ $ ACCOUNT DEPOSIT - SEWER $ (2 $ ACCOUNT DEPOSIT - WATER C' . c) $ WAC $ $ SAC $ $ TRUNK WATER ASSESSMENT $ $ TRUNK SEWER ASSESSMENT $ $ LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: TOTAL RECEIPT RECEIPT DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? YES 'IF YES, THEN A "PERMIT FOR WORK WITHIN PUBLIC ROADWAY" MUST BE ISSUED BY THE ENGINEERING NO DIVISION. LIST AS A CONDITION. Q SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE: i Cam, ~C~ ~ ~ ►~ovr ~ l ~ er7~k~4)v ~ l U ' 0~ 7O 0 0 i CITY OF EAGAN Remarks Addition SP.c3t1013 17 Lot Blk Parcel 10 01700 020 78 Owner` I <G'.t 3645 Blackhawk Rd. State Eagan.MNK122 Street t. Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING 1971 9 5•~0 „ 95010 SAN SEW TRUNK ° 1968 248.50 8,28 0 SEWER LATERAL 3C14 197p WATERMAIN WATER LATERAL WATER AREA 9.39 i 1 7. 0 .0 1 Water Stub /oG. 1971 200.00 10.00 20 STORM SEW TRK '7 1983 34. 62.27 15 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. i 1 X✓~~ BUILDING PER. SAC 27 - 9185 10-10-73 PARK ' R eC f , o~~d .~t G.. 144 WAIVER OF HEARING No. 00 Special Assessment Authorization I/We hereby request and authorize the City of Eagan, MN (Dakota Co.) to assess the following described property owned by me/us: 3645 Blackhawk Road (Parcel1WVmwG0!1 78) for the benefit received from the following improvements:- - - ITEM QUANTITY _ RATE AMOUNT PROJECT NO. Lateral Benefit from Trunk Water Main 233 F.F. $11.88 $2,768.04 28 Part 3 TOTAL $2,768.04 to be spread over 15 years at an annual interest rate•of 8.5 o against any remaining.:unpaid balances. The undersigned, for themselves, their heirs, executors, administrators successors and assigns, hereby consent to the levy of these assessments, and further, hereby waive notice of any and all hearings necessary, and waive objections to any technical defects in any proceedings related to these assessments, and further waive the right to object to or appeal from these assessments•made.• pursuant to this agreement. tC Dated: i - ,3 n Kaysen J4net Kaysen STATE OF SS COUNTY OF -L~.&,/A ) on this 1= day of before me a Notary Public within and for said County, personally appeared jcd,t ~ 7 to me personally known to be the person-5 describe in and who executed the foregoing instrument and acknowledged that executed the same as..-.- free act and deed. id ELIZABETH A. WITT OTARY PUSUC - MINNFsOTA .No t ary P 1 i c This Docum tee • TA COUNTY ugc, Si 1 •te,tool APPROV 3908 Sibley emorial Highway Eagan, Minnesota SS122 ' _ (612) 454-4224 gan Pu lic Wores erector Revised: 8-30-82 i ~.tb $ 9 B aI 7 G 010-t7 wnp,\ae ~ uo.s rit :'ir xr At C~°sar. CQEJT /sz John ~./vn<> Ks ys Cr/7 c , z /ZO,s LUX ~ TD~.S is.1 css ~ o ~anov 1. J6 1_uctt-La avrra r 'e iy atio-16 tl r 10•17 640 S Irv i, i ~ iLO iff I ~ 4~s 7 s.' HILL-CREST c>EVELC>PMI=NT f! Hof ~O =~i L_r-ROY 1. 4LLJCt LLirz P47Np F/o a d x' w d Olo-t9 33 So t ' i' 7 1 011-75 2 -7 Leroy 18. ' 3a138-G~ ✓ohnfo17 Luc11tQ Pond I 030 to f 1' i t Ni~y K0 00 7Soi", iN,LA-e7tc9t- voz-v a , . t o ~ .r' ♦ j a ZCi 3 • V S0 - -70' cc".wm ASSESSABLE FRONT FOOTAGE FOR LATERAL BENEFIT. FROM TRUNK WATER MAIN n- r Q L.. r y y Y. M , O O V t1 4 IN. U U ~1 ~ ~ _ A 1 a O r b F. V r, f ~ I i_ I j m~ It I, f I- f I I I I I li rl i -r:pH.~Y- 14~Y~k. - n.tt.~<,ay»'x~ ryt . r ~~d: I CITY OF EAGAN Addition ' Remarks (1,u Lot Blk A Street- Parcel- 10_`~ O_`R ImProvement State Ea STREET SURF. to Amount Annual Years STREET RESTOR. ~ Payment 'Receipt GRADING Oat 971 9 .5a;. F, 95.55 10 SAN SEW TRUNK SEWER LATERAL 1 68 2l~8. 0 8_._28 0 WATERMAIN WATER LATERAL WATER AREA Water Stub -33~ 1 7 . 0 STORM SEW TRK /0(1. 1 1 200.00 .0 1 STORM SEW LAT 7 1 83 10.00 20 34. 2 27 15 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK 27 .0 U t/ 10-10_ f R74o e: 0' ~Id g (/n yl~ 9740 ' J1fi1,111'YI_l1~ir_ 1AhI1.1 II:N!' w, hn r'nnnlrieratlctn'nC qnX a ~ Vi.w..., p- }!.~-O'i_~ ~'(~-.a:'r••:v~~ (91.aU) Dollar and otl(r good and valuable r,onnidernt:fon, tacel.pt of which is hershy acknowledged a _gtI. kA Anil ftlJrltr•n rlilh) hugbancl Agri wife ar`tr;. as Grantor(s) do hereby grant f` N... to the Township of Eagan, Dakota County, Minnesota, the right to lay, i maintain, operate and repair utility lines through and over the following denrribed real estate; Y T' I y (fix S1 Ir i~.rri~ rl r .l0,i)rME [L ,t crtc Y.:. The said Township of Eagan shall have the right to do whatever may be s nocenna ~ • ry for the enjoyment of the rights herein granted, including the ' right of clearing said right of way and of ingress and egress' to and from (x acid tract of land for the purpose of laying, maintaining, operating and ai. repairing said utility linen. It in further understood that all damage to crops, fences, and the like cr; . cAUaed by the laying, operating, maintaining or repairing of said utility r Y', linen shall he paid by the Township of Engnn and that in consideration thereof, the said Grantor(s) for l ' -xhCmneYCg, tl,n Theirs, executors rs and annigns do hereby release said Township of Engmn, its enccess x r ore, and nsnigne, from all claims for any and all damages resulting to the above doecri.bed tracts of land by reason of the laying, operating, maintaining „ yr or repairing of said utiiity lines, z' EXEMPT FROM STATE DEED TAX STAMPS. {T IN WITNESS WHEREOF, the Grantor(s) he Ve hereunto met _ ~F thicr hands and 6;n1_ thin day of 197___Q. 5 ~i t L) (1 r STATE OF MINNESOTA) Thi; instrument wns drnhed by y, k Stallond 6 Hnuge, AVerneyi• e s . At.lnw > COMITY OF DAI(OTA 2340 Dnin lower On thin ? A day of 197before me a ,,MInneaP e~Cunty,parg-onnlly Minn. 55402 within and for said appeared *f • Ilirnvanu nt,ib S rrl n CI i n .li hrrnhand and wife 1 !~h to me known to be the person Y 3ar dvncrlbed in, and who execu kid the forepoinq instrument, and acknowledged ar;ca, that t lie-y- cxecurd the same as _ ,frog act and earl. ~y r rk ,r tf.. 1.9J. + F s4 ~ ~ ~ (f I l / r V } I t % iFfZt~' .^Y 4'44j~'Ty4. - i7 Yk 7,ir, C'-fir 't r e4 P fi i~ :r A twenty font rerpetunl ennement and n GO font tempornry conntritction ennement $a-~ t:. n v r r and Ar•ronA t I I v following dcncrlbcd inil d: That part of Section 17, Township 27, Range 23, Dakota County, Minnesota, over And ncronn the following dencrihed property: Cotrtmencing At a point 304 feet South and 620 feet rnnt of the center of nnid Section 17, thence tiortheasterly 90 15' a dl9tnnce of 67 feet; thence Northenrntorly 330 30' n dintnnce of 327 fe-t to the cr'ntrt of the road; thence Southennterl.y on the rond a rlisranco of 301.6 fret; thence Southwosterly 730 n dintnnce of 362 feet to the point of beg1.till ing. r{. Iliv nnid perpetunl easement being 10 fort oil each side of the following drrscrthrd liar, noel tie nnid temporary construction casement being 30 feet on either side of the Collowing described line: r•orrnnencf.nf; tit the Northennt corner of the Scntthennt Qtuirtrr of Section 17, r lowti,ilp 27, Rnngv 23, milcotn County, I'lhim'notn; thrtlrr• Southrrly Aloof,, flit, yN 3: Cit•rt I the of fm id .^,er1:fon 17 for n dlnt.rtnr•e of 270 feat, thence WrntorIy nl.ottf•, n Ilse ptirnllel to the North line of nnid rTN of Srr•tion 17 for n dlntnnce of 1/,71fret thence do f.le rtlng to the Ir ft nt at, rtnglr of 7n 30' for it dInt;nv, of 7f,/r f,•r•t. Io tlir olnt nC be tnttin throe, nlon mt retrnni on of t:itin nnmr• iwtrS~ y~,•' lln, for it ill -if:mce of. 350 fe,•t nn,l tlrerr• tennfnnting, 4nld t,•mlrornrv rrnt•;trn,- ; 'kY~ tlwt ,:r•! in,nt to vxplre Irrly 1, 1971 , 3110 2044 ' Ill U'rtt,ll'Y tarlR RAfl1P11•,Nl' - in consideration of One ($1.00) Dollar and other good and valuable consideration, receipt of which is hereby acknowledged iiirovns~, Chiba anll tfllnrgn_ h bn,_ ban anA_aito as Orantor(s) do hereby grant a; to the Township of EAgnn, De6ta County, Minnesota, the right to lay, r maintain, operate and repair utility lines through and over the following y. described real eatotal k The said Township of Eagan shall have the right to do whatever may be necessary for the onjoymnnt of the rights herein granted, including the right of clearing said right of way and of ingress and agrees to and from said tract of land for the purpose of hying, maintaining, operating and 'Rtt repairing said utility lines. It to further understood that all damage to crops, fences, and the like ' caused by the laying, operating, maintaining or repairing of said utility lines shall be paid by the Township of Eagan and that in consideration' thereof, the said Grantor(s) for tW1MstelUX, ____thQjzheire, executors s~ik and assigns do__ hereby roleamn said Township of Eagan, its successors, ` and assigns, from all claims for any and all damages resulting to the above t: mss, described tracts of land by reason of the laying, operating, maintaining or repairing of said utility lines, F.XRMPT FROM STATE DEED TAX STAMPS, r IN wInnas witt=F, the Grantor(s) hater hereunto sat th cr hands 1 and ealr this day of r; 19 7___Q. 0111 \ (1 l A ~ .1 STATE OF MINNESOTA) Thh Instrument wM drafted by a,Sfolland 6 Nnu9a , A►torneyt-lit-law COUNTY OF DAKOTA ;?4 ) 2340 Oa+in lower inneep in On this ~ Y of n. 55402 %..,t da o , 197before me a iy pyibliC within and for sA d Count y, personally Appeared LLj=.v&AU~h~lu~. w "11Mtl_5;11 11n. hushand and wife to me known to be the pntnon described in, and who e,cecu t ad the foroy oing instrument, and acknowledged {:+y~*• that t hem exacu2-.d thn name an .t cif 1 ft;,* act and oed. `T 4ii e` F' •i F ~ •ra a,. t+•# h _ A twnty foot perpetual easement and a 60 toot to r' saaement over and across the following described land~rY construction The southeast Quarter (sE~) of Section 17, Township 27, Range 23, Dakota County, Minnesota. Yr`~ L The said perpetual easement bein described line, and the said temg 10 feet on each aide of the following rary fees on either side of the following daneconsribedtruclinstion being 30 K 3,~ta Commencing at the Northeast corner of the southeant Quarter of section 17, Township 27, Range 23, Dakota County, Minnesotal thence /nutheely along the East line of said section 17 for a distance of 220 feet, thence Westerly along ' g ' a line parallel to the North line of said SEJ of section 17 for a distance of 1671.2 feet; thence deflecting to the left at an angle of 7030' for a distance ' of 23.4 feet to the point of beginning; thence along an extension of this sa+no line for a distance of 330 feet and there said to } construction easement to expire Jul 1 terminating. ' Y , 1971. temporary - -.ry; ~ rx Y'y '{f rS=IF ~FV b I r. i 4t! ryrY, 396 206 UTA-ors' In consideration of One (51,00) Dollar and other good and valuable consideration, receipt of which is hereby acknowledged JOHN MYSEN and :l ~ rte KAYSEN, husband and w!!o of Orantor(a do . , ) hereby grant yf to the Township of Eagan, Dakota Count y. Minnesota, the right to lay, 1 maintain, operate and repair utility lines through and ovwr the following..,.,` described real astah r y ` The said Township of Eagan shall have the right to d o whatever may be . necessary for the enjoyment of the rights herein granted, including the right Of clearing said right of way and of ingress and egress to and from said tract of land for the purpose of laying, maintaining,operating and repairing said utility lines. It is further understood that all damage to crops, fences, and the like caused by the laying, operating, maintaining or repairing of said utility lines shall be paid by the Township of Eagan and that in consideration thereof, the said Grantor(s) for them sal ve4 theirheirs, executors and assigns do_~. hereby release said Township of Eagan, its successors and assigns, from all claims for a , ny and all damages resulting to the above described tracts of land by reason of the laying, operating, maintaining or repairing of said utility lines. EXEMPT FROM STATE DEED TAX STAMPS. IN WITNESS WHEREOF, the Grantor(s) ha avehereunto set t-.--~ hand a s this - day of 19 STATE OF MINNESOTA) This In1Irumenl w eralled by Slalland A Hn . ) ae. u9e, 111rrnc rJ-Ar.law COUNTY OF DAKOTA ) 2340 Din Tu%,er ~ Minn. $5 02 On this s day of innenP/plis,` " 197_Qr, before me a within end for sad County, pernnnnlly appeared to me known to be the pnrson dr•ncrthed in, And who execu tcd the foronoing instrument, and ncknnw1ed17n+1 + ~ j s. .~.3F1 sir. , F Ya$' ' - r. SvV Y a•4 yT; TweNT~ _ AIKe t Perpetual easement land nary construction oanemone over and acsoss the end r Gb followlns dinorlbed4 Dakata The Scuthenit Quartos County, Minnescee. of Section 17, Townahi , P 27 ,ltan8e?Z3 ;L " e ' The said tual ' followl-ng denertbdpline, andethemiaid bt~mp ry const K` B ^feet on each sidb o!' being 30 feet on either side of the follnt►ing describeduliiot% easement ,.r• Commending at of Sec the Northeast fie! Section 17 corner of the Souast ~t Township 27, Ran the 23 Dakda Cou Quarter.,(SEk) southerly alo Be line of said nty, Minnesota; thencs "w 11 thence Westerly talong he aline Section 17 ng the 0 feeE~ Of Section 17 fora for a dietaries of 22 parallel to the North line of. 17 at SO an o distance.of 1671.2 feet, thence deh ctinnot thence agora O 7 30"$br a astance of 23.4 fleet gdtoEthe.lefe y there terminating, Said to R extension of thi• name linefor aodis~tancenofe3S0e~aetirig' cep mporary construction easement to ex iri. and. P July 4!-1971 r " ~ + 3 9 7404 2 ll'1'I1.1 J'Y_i.lttl!_._I'A!if/tilSN'I' y', - /._U (t~r ~.~~v• ~~G".r .((f -f ~I .A~_. f ~ ~J.~-r~ (,lA•_PJrrr~y,~~ Jn consideration nt Una 01,00) DOIIAr end other good and valuable { rrlnslderAtien, rec.oipt of which is hereby acknowledged JOIIN KAYAIlN Anrl -Se.sy ti'' .i,~,r r 1 KAYMMI Iturd (;nd And wi re as Grantor(s) do hereby Brant • M~. .q•* f f~. to the Township of,pAgnn, Dakota County, Minnesota[, the rigfrt to lay, mnitttnin, operate And ropair utility lines through and over the following y. y desrribed rent estate; °r. The said Township of Eagan shall have the right to do whatever may be j. nacesnary for the enjoyment of the rights heroin grAnted, including the right of clearing said right of wny And of ingress and egress to and from ,i said tract of lend for the purpose of laying, maintainin g,operating and rerair{nR said utility lines. It is further undnrstood that all damage to crops, fences, and tits like ceased by the InYin R, operating, maintaining or repairing of said utility lines shell be paid by the Township of Eagan and that in consideration = _ =gym thereof, the said Grantor(s) for thr•msel vc' titeirheirs, executors and nnsfgns de • x 'y hereby relonse said Township of Eagan, its ■isceaasora, r And Aasigne, from all claims for any find All domegen resulting to the above Y ys?fi described tracts of land by reason of the laying, operating, maintaining or repairing of said utility lines. EXEMPT. FROM STATE DEED TAX STM{PS. ~Y IN WITNESS WHEREOF, the Grantor(s) ha Avehereunto set th(!~ hand S r-- this y of 19 STATE OF MINNESOTA) This instrument w drafted by StalL+nd A Hnugo, / It,,,nr:Ys• ss, AI•LAw COUNTY OF DAKOTA ) 1340 Vain I,.„rn Oil tIlIq dny of _ Mileapplit, Minn. 554M Far y•. 197.8 , before me s ~Qdry Pr~hll.c aq. within and for sA(d Count Y, personally appeared x{R' .1 01tN_=51'.N_1I1(1~ - 1iAY^Cti--l►unllunti_nnd_witc__ tn me !mown to be the person doner{hr•d In, and tuhn exocu trd the fnrepoinR inntrument, And ncknnwlrdjX*d 1.11011 ire y:.:. r•xr•r•Itr•d tiro AArtir act and c t~d, lIj- x .r h AM" 74 9 r IVIr I~A z p-yrr. 1. • I^ v. f ` t"wtn feet over and d pt,rpetunl tenement And n 60 foot trmpornry rnnntrur_tion annrmr ~t ncronn tlin' s. following doncri.hod lnnd. nt Hint pert of Section 17, 'Cownnhip 27, Rnnre 23 ht, and ncronn the following dcncrlhnd propert ' iCOtn County, ltinnenotA, ovar South And 599 feet Ennt of the contor of nnid Seection117;Athence point r 4th4e0 ast feeet 90 15' n dintnnce of 137.75 feet; thencn_ Northnnnterl 31) rly dint foot to the center of the town rond; thenc° Southonnterl n finidree of 32 tnnce of 7;'i font; thenrn Wontorly 448 toot to tho yon nid ond ndi in-` ° point or hrginninR. 'Ihe nnid porpotunl. onnonwilt hnl.ng 10 font nn onrli mint, of the followinn cion- rrihod line and do nnid tompornry ronntruction onnement boinR 30 feet on oit•her n(do of the following dencribod lino. tT CrxranPncing At thn Northennt corner of the Southennt Qunrter of Section 17, 1'nwnnhip 27, Rminn 23, I)nkotn Count Minnnnotn; 1 . fnnt lint- of nnid Section 17 for A dintnnro of 220reat,Qti4rn1cnlWomenrl tAl 1i A lino pnrnllol to the Nor•tis linn of nnid lily of .17oction 17 for n dintnncnofg ~i 1471.P. font; thenrt, dnflacting to the left At nn Angle of 7° 30' for a eiintnnce of 23'4 font to thn point of beginning; thence Along An oxtennion of thin nnme t a lint, for n dintnnce of 350 feet And there terminntin ntruction ennement to expire July 1, 1971. R• SAN trmporA ry con- S W:- 4 1, _ CASH RECEIPT CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 19 RECEIVED aaQ//,, FROM _ V--"~^ i t ; AMOUNT $ ~ & _DOLLARS loo CASH ©1CHECK l FOR T FUND CODE AMOUNT f Thank You BY White-Payers Copy Yellow-Posting Copy Pink-File Copy _ _ .i. a. ...i: i ?i . , :.y,_ ~ i . ~ . '~i , ~ ~ _i ~s i...~: r r ,f ~r f, ~ '~~~"tom' O'-3"^ f r 1 Use BLUE or BLACK Ink r For Office Use City of EaRd , Permit Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received:" Phone: (651) 675-567 I I Fax: (651) 675-5694 1 Staff: I I 2013 R,ESIDENTIALBUILDING PERMIT APPLICATION Date: Site Address: Unit Name: Phone: Resident/ 6C 4-S Owner Address ~ City /Zip: T~x,= ~1 G C~I~ W Applicant is: Owner 1/ Contractor Type of Work Description of work: /Z-w 04, Construction Cost: ®co e, UCH Multi-Family Building: (Yes / No ) Company •f-[<.9 Contact: Uwe. T^ Contractor Address:' O LQ •.o-"\ City: ,>_A ti L State: ' Q Zip: S-S- Phone: License : t✓U 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. Gall Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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 authorised b a building permit issued in accordance with the Minnes to Buildin Code m completed within 180 d o permit is an' Appl' ant's Printed! Name Applicant's Signature a'~ Page 1 of 3 "`FFF111 1, bpi\ For Office Use // (t q L 7 _ : , m i +�> Permit#: ( 7�L%`7 "� ,,1 t ‘,... ��, Permit Fee: i.c?r & CL_ Date Received: / 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX:(651)675-5694 ►t u ,_..'. .. „° Staff: �� buiidinginspectionsC_dcitvofeatan.com L APR 02 2018 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: - ie) Site Address: e ` . Unit#: 3 Name: ' v ::a ç - -'t Phone: %LA D .. 6-111 r Resident/ ° Owner Address/City I Zip: 3k44E5 N *..6 i .r,. . 1,410 i € Applicant is: Owner Contractor ,`,. z I Type of Work Description of work: "ti t (I .t t i r It•Xlcat~ ZL gL/9d Construction Cost: t, to is Multi-Family Building: (Yes I No ) Company: t(t- .�- '• 00044,%'), Contact: c t IAddress: f )$ ` tt.“1c. ( Contractor # : tea City: 'irt � , t r :3 IState: Mk)Zip: . tl::, Phone: ". . Email: ae,cmIc ti . i va- .. , f . c. ..,, License# ',5e..)--7a 5 Lead Certificate#: - ICY"(C f , . If the project is exempt from lead certification, please explain why: 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: t Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE Plans and supporting documents that you submit are considered to be public information Portions of the Information maybe I classified as nonpublic if you provide specific reasons that would permit,the Cit r to conclude that they are trade secrets You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.cltvofeaaan,com/subscrtbe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.000herstateonecali.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x r .A.,.. ::r _'.o.c{ .c. `e.w Applicant's pted Name Appli can S ture — M} -:>6 i t/z- 6lockifvq-Ji! (2._0(. DO NOT WRITE BELOW THIS LINE —.). t; —> i SUB TYPES e 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 A Repair Egress Window Water Damage ____ Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION Valuation Oga 44 Occupancy jr,11. .--,/ MCES System -, Plan Review V Code Edition A SAC Units (25% 100% V) Zoning R -,l. City Water Census Code kil 311 Stories - Booster Pump ..,- #of Units / Square Feet - PRV ...- #of Buildings 1 Length - Fire Suppression Required Type of Construction Y-43 Width ..- REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings (Deck) Final I C.O. Required Footings (Addition) 4 Final I No C.O. Required ---k Foundation Ck Foundation Before Backfill HVAC Gas Service Test Gas Line Air Test Roof: Ice&Water _Final Pool:_Footings Air/Gas Tests Final Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In Air Test Final Siding:_Stucco Lath Stone Lath Brick EFIS Insulation Windows Sheathing Retaining Wall: Footings Backfill Final Sheetrock Radon Control Fire Walls Fire Suppression: Rough In Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: , Building Inspector RESIDENTIAL FE Base Fee 73 7r Surcharge Plan Review 1 7/7 ?-`--'-' MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant Copies ,2,4 Q Adji TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA163893 Date Issued:09/15/2020 Permit Category:ePermit Site Address: 3645 Blackhawk Rd Lot:002 Block: 078 Addition: Section 17 PID:10-01700-78-020 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Dustin Salmon 3645 Blackhawk Rd Eagan MN 55122 (651) 755-5866 Blt Services Inc 11871 Jamestown ST NE Blaine MN 55449 (651) 755-5866 Applicant/Permitee: Signature Issued By: Signature