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3665 Blackhawk Rd l i i t CITY (7F EAGAN I CASHIERi JS TERMINAL NO: 771 I DATE: 01/04/00 TIME: 1504s37 IDs NAME: 0MCO CONSTRUCTION j 3210 9001 3665 BL.ACKHAWK 363.25 3422 `_'7001 3665 BLACK HAWK 236.0 2155 9001 3665 BL.ACKHAWK iio50 i I i Total. Receipt Amount s 00.86 j CR12084 IC USER IDs JAN r f PERMIT # ~MECHANICAL PERMIT CITY OF EAGAN RECEIPT# 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: CONTRACT PRICE: PHONE: 454-8100 ~ Site Ad_tress' BLDG. TYPE WORK DESCRIPTION x Lot Block _S-;,/Sub ` Res. ' New Mult. Add-on ~ Name Z' Address rrcr r t;. Comm Repair ...s Other c City. Phone FEES Name- r fi. RES. HVAC 0-100 M BTU -$24.00 c Address- Flax r'; w- . * ADDITIONAL 50 M BTU - 6.00 , p City •-t °Phone' Ir 3 (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PERMIT) - 1.50 EA. TYPE OF WORK COMMAND FEE - 1% OF CONTRACT FEE Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES T. .TQW-NHOUSE & GO:NDQS - RCS;. 3 TE.APPLIES,; _ Boiler M BTU $ MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Wo*+4eMer f ATc, $ REMODELS 1 Q... M BTU PtI~C'd~. ; r` MINIMUM CUfii{MERt✓IA FEE w : 20.00 ` , Air Gond. M BTU STATE: SURCHARGE PERTERMIT - .50 Vent. CFM $ (ADD $.50 SIC IF PERMIT PRICE GOES Gas Piping Outlets' # BEYOND $1,000) " Other i FEE: J` S/C: SIGNATURE OF PEFMITTEE TOTAL'd # FOR: CITY OF EAGAN CITY OF EAGAN Remarks Addition 'afNti= ~.,,,07 r+ Lot Rik Parcel Ig7M Q-30 Z Own 'J-4''~ CLt"r+x Street 3665 Blackhawk R.. State Enaa* ' ~4 C Improvement Date Amount Annual Years Payment RelWipt Deete STREET SURF. STR EET A ESTOR. GRADING SAN SEW TRUNK SEWER LATERAL 12711 -?-Q- WATERMAIN WATER LATERALvtSWQ 1 2 0 00 137.50 20,1 WATER AREA STORM SEW TRK 7 3 1983 1756.00 117.07 15 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 26o BUILDING PER. SAC 200,01C 2973 PARK f PERMIT # qj -7 MCEIi T DATE Crrytl►lErB3ikN 36M PUMT KW* V l~l(~lEli lllL,10 551 „ ' Please a plete%or sin% femur dwellings, bwnhomes and condos when permito., are required for ofth untt, backflowf prove Me r for irrlg system SITE ADDRESS: tt~ 5°c C- ~v lh~ OWNER NAME:. 1--e TELEPHONE (ARE ) INSTALLER NAME TELEPHONE* (ARVA W6E) STREET ADDRESS: CITY: STATE: XI' P'TtC SYSTEM, roMr*furb (requires two sets -of plans and MPC license) i irrt des 540'.00 Courtly fee _ Note: Additional nt fees may apply • MODIF1CAUMIAL.TMTlON TO J„ TIT r1 L3iV L UNO MST, tNCtrl>MG: Adding hWnw to lower WftW or atom additions, exclud water softeners and water ham. Abandonment of septic system, Water turnaround -*AibV dwelling tfiit SW meter if needed - $118) OUW. RPZ: new inst ttiorNtepairff tl t 't± r~V' $ Yt ? l n ii motion system rernettaddtiaaal: water fterr water heater 75Lf€! State Surcharge $ ;gip i t*rsby acbWwWft* #W l have read We aPMkaQw, the infi xrna#onis corfeci, and agme to Corrrply vvikh a" aP f ;E80Wt t>IMf M*. it Is Ow grppticant's reetmwiNity to notify tha property owner#w #t City of Eagan assumes no Uab ty for any dorm d + rtai operatioaai and maittwwm activib" to the faciAfts contuded _ undw this perms right o 51 TUBE E RM E 1102 1 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY or- ]RAW N C, f o g In 927 3830 PILOT 651-681-46 5- 55122 Nowc2mn RemoddPAnair > 3 rimed she surveys showing sq. R of tot, sq. R of house 2 copies of plan and d roofed areas t maa lmum last wean allowed) 1 set of energy calculations for heated additions > 2 copies of plats (show beam & window sizes; poured Ind. design; etc.) 1 she surrey Ior ea *W additions & dech > 1 set of energy calculations > 3 copies of tree nervation plan h lot pitted attar 711193 DATE: %_,~2. 3 - ' Y CONSTRUCTION COST: g2, S-00 0 o DESCRIPTION OF WORK: _ 1 e o ~P 7 C(ii P STREET ADDRESS: 3 c lc s- ,3111- c k 14i s c ,iiC LOT: BLOCK: SUBDJP.I.D. ' Y~ Name: &,d 4e- /moo kL Phone e3,3 el PROPERTY Last Fist OWNER 1l Street Address: 3~~5 /3Aw c/ 4 Ce w K City 1= Sate: zip: s S- l a Company:_ p/o, C b 5 ry, c7~ -o Phone z SrS3 7l (area code) CONTRACTOR Street Addres/s• F ©0/ arl L'~c~h G~c License# .33 Exp. 3 'boo0 city ! 1~ a f h state: eju zip: s--~ Y ARCHITECT/ ENGINEER Company: Name: Telephone ( ) Street Address: Registration City state: Zip: ' Setter & w licensed plumber (new rcon ft; n onhrf: Telephone t Penally appiles when addreaa change and lot change Is requested once permit is Issued. hereby aclatowiedge that t have read this fin, stab that the Wormadon is correct, and to aN iCabde Slats of MbnesW StaMn and Cit of Fagan Ordinances. a 4 Signature of Applicant: OFFICE USE ONLY 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.) )1Q02 SF Dwelling ❑ 07 5-plex ❑ 12 12-plex ❑ 17 Garage ❑ 22 PorcWVAddn. (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 * Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) 0 Basement sq. ft. Census Code (Allowable) %i lkJ Main level sq. ft. SAC Code Q,j,_- 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 Sprinkiered APPROVALS Planning Building Engineering Variance Permit Fee 3(03 . Valuation: $ Surcharge -0 Plan Review a 3 Cn 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: i 0 SAC Units °h SAC -7 el CITY tip tN1LY am, AD It a ` 2000 VZMMIM P T MS~DM TT.~L~ CZ'1X GF RAGi4bT 3830 PXtM IQ= " NAG", MR 55122. 6~t1-C91~-~5~5 n FIB"xnpl kit ; Ainr dwir A tbYitfih4M1 m wW t~Y tiR am mgAW Ax "ch W!F! i ~x p fey undrd s~rri~titfilr sys#em M # AftrMc to dxkft awing - "**M" f $ X1m Both tub 3.{0 x Floor sit 3.00 x $ L3a twtlet " mra~m » 3100 x Hot 300, x 3.00 x Laurift1my 3.00 x 3.00 x b . nea~troue+tsla~l ' " MrC 1w 7 .C?0 x :r X00 x $ RP2 ear l' x R 9:5t} x 4 Show 00 x r` 30 Q0 x ` V{hW cset 3,04 VIMIbet t 3.04 x ~oaar 5.00 x $ vftwsotww V11It 30 t x $ V1gor tuff'wro lxt 35.00 x T~ fib' 1hIII it itis of a1 ts, LA. wwW tom, WSW tlftW*&M 06-- ♦rrwrir w+r+wwr rrfa.rr 'rsrrns ors-,nwrwr iM wwsw.~wr asLr+ t+r.~ +,wwrw.. ar..wsr»rr+f+Ywre..+...~~•r.- ---w-....-.....--wr wwrw..w w.nw w♦ wn. ~►.~.tt~w~rs aa~~at~~,~ao~y,+~a~~r IHIi It is ws rrr avail + to n ft ~ ~ a* to Cft of ~ r* IWby trx my d # p~Ad by ~t try na I > oa%WMat **,Ifte to ft *W** *QtWa **%Ww t* WrrA W" CRY -prOpaW69K 't~taAei~rtt S" AWRE ' DER A AI : TELEPHONE t. , t CCflE) tt+ At tTER N": TELEPHONE fir. .w.- tAIWt COW r" STREET ADDfIESS: 4-ime. 94 CCI«Y: STATE: ii ZIP: "c S*NATU OF RMITTEE k: ~ s 1 ~ ; } J u.. ~t, r MY USE ONLY j WT BL i _ PERW#: 39 1~i 1 130 StMD. f5eglo)a rc~r nAT~: ~ l aq CITY Or SAG" B-0 PILOT 8 RD JAW ]!fit 55122 : 6S2-SS1--46?5 if y j we ire VAC i t a sixrgk ami -dvvelti t cx coado ; M H`V'AAC: 0.200 M S T iJ ADDrMNAL 50 M- BTU Chas oudou (tai tit of one requkeed @ $3.00 en.) S St~rchc ToW Cmphft this sowoo if y+M Wgdtligg A .I.., or ` as e4sdnS s~ ~y d V"hwa, m undo. PU if it is a new item, Aeration, or mpair. New A.arstian Rc*r, . o A~ rond t in Air Fee $ 34.E $~gG U r_ TOW $ S0 .C'aU fi r bgpeoims S E1 RESS: OWNER NAM: ( PHONE E MMM SMIMT ADDi 3S• crry: STA f An lho"AlAo"09 MY USE ONLY L BL REMIT SUBD. RECEIPTW APPROVED BY. , IiNSMTOR RECEIPT DATE, 2404 DliCIECtZ~ ,CAC} C#TY C?!' 3830 ,-V RD 6~1-6B1-~~?!I pwsiw cx►nplft liar: all Ilhtdu Inge n~-l~rr la~lei m . a~ ~ ra~.i~r ~It DA`. 'wow 'T'YPE: New cm s ructiraa 'U . T improvanw koiw►c'V.,G.TJmk Pry tgtY~+a a 'er i fain, is 014&- 471 ft ftpoaiow J pe mw&' ani "cox fwork: ~Srwud=tkncwai!ahtlisticm = gem x.1°fo S Pie StMe e hat es eulaoi S." 06411090 TOTAL Dw fa SMAM S: , OWNER NEE: P IJNE . TENANT NAM (iWROVEhG°N'I S ONLY). WAS THM A EREVI US tENANT W IMS SPAR, Y , N.- INSTALLFt; T'~y ADIDMS. (ARF STATE,:, Aw. r SIGNATURE OF PERmn-TFsE EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PEP14IT FOR WATER SERVICE CONNECTION Date: unn 10, 1970 Number: 444 ro 017v0 03c% Billing Name:1. Pond Site Address:5 B1aPkhawk Rn , Owner: L. I. Pond Billing Address 3665 Blackhawk Road Plumber; doing own work I Location of Connection Meter Size 5 " Connection Chg. 2 O79'q~pd 6/10/70 Acct. Dep. 15.00 pd 6/10/70 Meter No. 681 863 Permit Fee 10.00 pd 6/10/70 Copperhorn 7.00 pd 6/10/70 Meter Reading 111100 Meter Dep. Meter Sealed: Yes Add'1 Chg.- No Total Chg. I Inspected by Date Building is a: Remarks; Residence xx Multiple No. Units Commercial Industrial By; Other Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do t1m proposed work in accordance with the rul and regulations of Eagan Township, Dakota County, inne a. By: L. T. Pond Please notify the above office when ready for inspection and connection. EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454.5242 PERMIT FOR SEWER SERVICE CONNECTION DATE : _ June 10, 1970 NUMBER 597 OWNER: L. I. Pond Address 3665 Blackhawk Road PLUMBER doing own work TYPE OF PIPE cast iron DESCRIPTION OF BUILDING Industrial Commercial Residential Multiple Dwelling No, of units xx I Location of Connections: Connection Charge NOT CONNECTING AT THIS TDIE. Permit Fee 10.00 Dd 6/10/70 Street Repairs Total Inspected by: Date Remarks: By Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the s and regulations of Eagan Township, Dakota-County, inne By v . t- T. 1~ PnNrl 3665 Blackhawk Road Please notify when ready for inspection and connection and before any portion of the work is covered. i', ' v Municipal Notice of Well Permit Application Dakota County Environmental Management Department Water and Land Management Section 14955 Galaxie Avenue West Apple Valley, MN 55124 Tel (612) 891-7011 Fax (612) 891-7031 DATE: December 13, 2000 TO: Tom Colbert/Wayne Schwartz - EM Fax (651) 681-4694 FROM: Water and Land Management RE: Well Permit 00-H177660 Well Type: Sealed Municipality: Eagan Environmental Specialist: Luehrs The Water and Land Management Section of the Dakota County Environmental Management Department has received the following permit application for the well described. If you require further review of the application or if you have any questions or concerns about it, contact the Environmental Specialist listed above or our office at (612) 891-7011. If there is no response from your office within 24 HOURS (excluding weekends and holidays), we will assume that you have no objections to the issuance of the permit. Please note that permit issuance is always conditioned on the permit applicant's observance of and compliance with all applicable state, county, and municipal laws and codes. Well Contractor: Don Stodola Well Drilling Co. Date application received: December 12, 2000 Anticipated Drilling Date: Time: Anticipated Grouting Date: Time: Property Owner: Leroy I Pond Well Owner: Leroy I Pond WELL LOCATION: PLS Coordinates: 1/4, ne 1/4, nw 1/4, se 1/4, Sec 17, Town 027, Range 23 Street address: 3665 Blackhawk Rd PIN Number: 10-01700-030-78 WELL INFORMATION: Diameter: 4 Casing depth: 220 Total depth: 250 Static Water Level: Aquifer: COMMENTS: BLUE CROSS RDAcF Owner Into Land Use Building property, Comments Sales f Value jqNWK,RD CKHAWK'RD . 0 7K m;4 ! 'D FOX ; CR E ST-R I DG 100170003078 55122 , . FLACKHAWK RD -la? OBINLN x N&E -.MONTERE 3665 BLACKHAWKRD DEER ,PQI CKHAWK RD. DR ROBIN LN KYLLO w or~ 7~..t+ ta x &V 10 01700 0000 00000000 CUR;`: s-~ wmw~~ W AKwAWK RD 17 2723 Ei=TION 17 TWN 27 RANGE 23 PANN BE A - Locate By - PT OF S 2/3 OF NW 1 /4 OF SE 1 /4 BEG CEN Map Click Street Address t Tax Pin TN RD 440 FT S OF N LINE W 514.4 S 257 FT - - - E 591.2 FT TO CEN RD NW ON CEN 268.2 FT Parcel Locator - 3665 Locate Parcef ; INNS i- t 0' mav • A&x R MAX BLACKHttiWK RD ( 17 027 23 73 I I i I i RESIDENTIAL 2~ 1, 75 BUILDING PERMIT APPLICATION CITY OF MGM 3830 PILOT KNOB RD - 65122 ~~591 e51.881-4676 OnConstnwilon Reauirements • 3 mgb*W site swveys showing sq. ft of lot sq. R or houas; one roofed areas • 2 copes of plan (2096 max6num lot coverage awed) • 1 set of Energy Celmledons tot t►oW ON= • 2 m on of plan stnoft beam 3 window poured found design, etc.) • 1 site wrvey for aftriar adddaa 3 dedrs • 1 set of Energy Caiadabm • lydoeb d horns served by septlc system for addtrioos • 3 copies of Tree Preservation Plan if iot ~ after 711193 • Rrn Joist Detail 00" selection sheet MWP wkh 3 or less u*) 1A q lQ „ DATE VALUXION JOB SITE ADDRESS IF MULTI-FAMILY BUILDING, HOW M )MY UNITS? PROPERTY OWNER TYPE OF WORK r f FIREPLACE(S) 0 -.1 2 APPLICANT PHONE#'~1G~ a ~ftd If" 611181"1 ADDRESS 9020 Ziila street 11P CODE PAGER # Coon Rapid' 89LFMNE ;F y FAX # a3- ' NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY Energy Code Category MINNESOTA RULES 7670 CATEGORY 1 (check one) - Residential Ventilation Category 1 Worksheet Submitted Energy Envelope Calculations Submitted _ MINNESOTA RULES 7672 - Now Energy Code Worksheet Submitted Plumbing Contractor. Phone Plumbing System Includes: Water Softener Lawn Sprinkler Fee: $90.00 Water Heater No. of R.I. Baths No. of Baths Mechanical Contractor Phone 0 Mechanical System Includes: _ Air Conditioning Fee: $7t}.04 Heat Recovery System Sewer/Water Contractor. Phone P j: f} All above inionnation must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the information Is corn see to comply with all applicable State of Minnesota Statutes and City of Eagan dInances. Signature of Appilcont Certificatea of Survey Received _ Tree Preservation Plan Received Not Required Upd*d 1101 OFFICE USE ONLY ❑ 01 Foundation ❑ 07 06jAex ❑ 13 16-plex ❑ 20 Pans ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Bart. Alt - Multi O 03 01 of_ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) 0 33 Ext. Alt - SF ❑ 04 02-piex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screened) ❑ 36 Muld ❑ 05 03-plex ❑ 11 10-piex ❑ 19 Lower Level ❑ 24 StDrm Damage ❑ 06 04-plex ❑ 12 12-piex Plbg Y or_ N ❑ 26 Miscellaneous ❑ 31 New ❑ 35 int Improvement ❑ 38 Demolish (interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)' ❑ 43 Reroof ❑ 46 WindowslDoors ❑ 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning _ City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bidgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) Final/C.O. Footings (deck) _ Fin"o C.O. Footings (addition) _ Plumbing Foundation _ HVAC _ Drain Tile Roof Ice & Water Final _ Other - Framing _ Pool Ftgs _ Air/Gas Tests _ Final Fireplace _ R.I. -Air Test -Final _ Siding _ Stucco _ Stone Insulation _ Windows (new/replacement) Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge, Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other ' Total Use BLUE or BLACK Ink - ~ For Office Use ' I A-1 7 lb } b of Eatin I Permit ~ Permit Fee: 3830 Pilot Knob Road I / Eagan MN 55122 i Date Received: J Phone: 675-5675 (651) I Staff: Fax: (651) 675-5694 2010 RESIDENTIAL PLUM] BING PERMIT APPLICATION Date: Site Address- ~/i Tenant: Suite RESIDENT / OWNER Name: yn PD n Phone: Address / City / Zip: CONTRACTOR License B&D Plumbing, Heating & A/C City: 4145 MacKenzie Court NE St. Michael, MN 55376 lone: uonraCi~l lac 7 64zw? i ii ~t crnarl: TYPE OF WORK _ New L Replacement Repair Rebuild _ Modify Space Work in R.O.W. Description of work: PERMIT TYPE RESIDENTIAL Water Heater Water Softener Lawn Irrigation Add Plumbing Fixtures RPZ PVB) (_Main X Lower Level) Septic System Water Turnaround _ New Abandonment RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn irrigation (includes $.50 State Surcharge) $50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround" (includes $.50 State Surcharge) *Water Turnaround (add $166.00 if a 5/8" meter is required) $100.50 Septic System New ($10.00 per as built) (includes County fee and $.50 State Surcharge) $90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ 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.ciopherstateonecall.org 1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; -the work will be in accordance with the approved plan in the case of work which requires a review and ap royal of plans: x1'1 X`. Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In _Air Test Gas Test Final Use BLUE or BLACK Ink For Office Use Permit / `T b I ity of il 1 Cajan Permit Fee: 5~ "uv 3830 Pilot Knob Road Eagan MN 55122 j Date Received: , Phone: (651) 675-5675 I Fax: (651) 675-5694 Staff- - - - - - - - - - - - - - - - - - J 2010 MECHANICAL PERMIT APPLICATION 0 SiteAddress; Dater Tenant: Suite RESIDENT / OWNER Name: Phone: CONTRACTOR B&D Plumbing, Heating & A/C License 4145 MacKenzie Court NE City: St. Michael MN 55376 ( t me:` L 10 ContacIt 2hW 1• GIY Email TYPE OF WORK New Replacement Additional Alteration Demolition Description of work: 6 NOTE: Roof mounted and ground moun (ed mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. PERMIT TYPE RESIDENTIAL COMMERCIAL Furnace New Construction _ Interior Improvement Air Conditioner Install Piping Processed Air Exchanger Gas _ Exterior HVAC Unit _ Heat Pump Under / Above ground Tank L_ Install / _ Remove) " When installing/removing tank(s), call for inspection by Fire Other Marshal and Plumbing Inspector RESIDENTIAL FEES: $50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge) $90.50 Fire repair (replace burned out appliances, ductwork, etc:) (includes $.50 State Surcharge) $ 0 TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x1% $50.50 Minimum (includes State Surcharge) Permit Fee - If Permit Fee is less than $1,000, surcharge is $.50. - If Permit Fee is > $1,000, surcharge increases by $.50 for each Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). TOTAL FEE CALL BEFORE YOU DIG.' Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.ora 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 wit the approved plan in the case of work which requires a review and approval of pl Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By:. Date: Required Inspections: -Under Ground - Rough In -Air Test Gas Service Test -in-floor Heat -Final Exterior HVAC Screening Inspection Use BLUE or BLACK Ink y I For Office Use ~e~U~ CY~ " Permit City of Ea ~Il d I Permit Fee: ' ~ 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 I Staff: I - - - - - - - - - - - - - - - - 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: r7, ~r'I Site Address: 3 Z i J- )34, e k ~L /C Tenant: Suite RESIDENT / OWNER Name: / 6 4O t /,P", Phone- 4S v YS~'- ',-3 3 Address / City/ Zip: 131,A 44/it' R Applicant is: Owner x Contractor TYPE OF WORK Description of work: P-4 A'0 o 7f" 4 c l4c vin o &M jr A Construction Cost: Multi-Family Building: (Yes / No CONTRACTOR Name: ~ JC'6) License#: Z3 :3 Address: ` /Jw ,J r _ City: S / X o Ul ) C State: Zip: Phone: /off --5-V e/ U ~ Contact Person: oe"iw is, Aipm'~' h 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 maybe classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org I hereby acknowledge that this information is complete and accurate; that the work will be in conform wit~the or ' in and codes of the City of Eagan; that I understand this is not a permit, but only an application fora permit, and work is t start tape it; that the work will be in accordance with the approved plan in the case of work which requires a review and approval Ian . x Clll ~S (//~'i ' r✓~ Applicant's Printed Name A scant' i ture Page 1 of 3 c Z®o DO NOT WRITE BELOW THIS LINE ga SUB TYPES _ F undation _ Fireplace Porch (3-Season) _ Storm Damage _ Single Family _ Garage _ Porch (4-Season) - Exterior Alteration (Single Family) _ Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) 01 of Plex Lower Level _ Pool Miscellaneous Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* _ ition Move Building _ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows - Demolish Foundation Replace - Repair _ Egress Window Water Damage Retaining Wall *Dernolition of entire building - give PCA handout to applicant DESCRIPTION Valuation O'ao Occupancy /,026- 2 MCES System Plan Review Code Edition- SAC Units - (25%_ 100% d) Zoning City Water Census Code 413 y Stories Booster Pump # of Units Square Feet PRV - # of Buildings - Length - Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition)l Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: Ice W r 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 Meter Size: Radon Control Erosion Control Reviewed By: , Building Inspector RESIDENTIAL FEES Base Fee 3,3 3&w' /;e4.4t R-fi t / *11, Surcharge Plan Review oZ o`~0 5l ~y MCES SAC l f City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type: Plumbing Permit Number: EA105150 Date Issued: 0612812012 itj of 0n Permit Category: ePermit R Site Address: 3665 Blackhawk Rd Lot: 003 Block: 078 Addition: Section 17 PID: 10-01700-78-030 Use: Description: Sub Type: e - Water Softener Work Type: New Description: Water Softener Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Jamie Ripple 1313 Danita Circle Shakopee, mn 55379 952-445-4803 Fee Summary: PL - Permit Fee (WS &/or WH) $55.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 Total: $60.00 Contractor: - Applicant - Owner: Appliance Connections Inc SUSAN BAST 1313 Danita Circle 3665 Blackhawk Rd Shakopee MN 55379 Eagan MN 55122 (952) 445-4803 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 EAGAN TOWNSHIP DAKOTA COUNTY, MINNESOTA I/We hereby request of the Township of Eagan permission as follows: 1. To connect the sanitary sewer service line from my residence/ commercial building at 3665 Blackhawk Road to the sanitary sewer lateral located on Blackhawk 2. 3. It is understood that I/we will not hook up and use the service until I/we have paid to Eagan the necessary connection fee for such hookup. It is further understood that in the event that I/we do hook up and use said sanitary sewer service before paying the required connection fees, that I/we will be required to pay the Township a sum in addition to the connection fee of $100.00 I/we also understand that I/we will also be required to pay to the Township in addition to the fees required above the normal inspection fee for each inspection by the Eagan utilities d rtment. Dated: June 10, 1970 Signed: 77777TTTTT''''' d~ 41° City of Evan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: qb01-,<4 Date Received: Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: /07.307/3 Site Address: -3(5 , L iK h It �C p Resident/' Owner Unit #: J Name: S PS ,g 4/ '"T Phone: Address / City / Zip: 36 e S &./96 #rnv j( D 45;9,v/ M1 Applicant is: Owner % Contractor Description of work: 7 — 4 © P ! ,c/ - r / 71-CPe Construction Co-r.e-- Multi -Family Building: (Yes / No ) Company: ®R7// i / ' e- p p'4/4CContact: p 2ZGk Address: 7777 L 7-G) D7-- City:' P.QL/ State: AA.-- Zip: Phone: J5 / License #: 06 634( 319 ( 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 DNo If yes, date and address of master plan: Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. the information may be classified as non-public if you provide specific reasons that would permit the conclude that they are trade secrets. tions of City CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.ora 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 Fes, ,,rxz ci O Applicant's Printed Name A fie •arican s Si s nature Page 1 of 3 Use BLUE or BLACK Ink . eel r For Office Use -7 • Clty 0e.. s Permit#: lygiCiiils`ii ,le ,Eaffall _ 3830 Pilot Knob Road `' ' Permit Fee: /2� 6' Eagan MN 55122 Date Received: y-'-7' Phone:(651)675-5675 Fax:(651)675-5694 Staff: ir(;) 2017 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: —, Unit#: Name: 4"'1,,A 3r Phone: 4'5'1 F.. '1 41- 13g LI ,, Resident/ Owner:` Address/City/Zip: "'50t„5 13 11 c.. K ck„.., I4.-. Applicant is: Owner X Contractor Type,cit Vifcrk.,, Description of work: A J I1,,. re frNex ,,.I Construction Cost: Multi-Family Building: (Yes /No Company: I Vt eJ'+ tif'SI (RtiVet&ettiAsstontact cJlevlrr1 000ti e,' Address: E 3-4\4 ` te` 1eaa✓ `;s.§w'e #- City: t‘te c ContraCtor o ? , State: ( f‘ Zi . p' _1,L 1. Phone:1(iV-4..J( �- Email: ` tek .► non C.,evo.— License#: -1 C.,C S , c Lead Certificate#: / If the project is exempt from lead certification, please explain why: tip Ct+l Ccs, i t ft. \ 1 6 '4 A t-t) COMPLETE THIS AREA ONLY IF CONSTRUCTING A 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: '. ,n„ t. " '., Phone: - y Mechanical Contractor:1 ,.At, „T ,. ,4�� \ ,k. Phone: V Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE'Plaits and supporting documents that you submit are considered to be ptthlic information.Portions of the infgrr tion maybe classified as nonpublic ityoiliprowde speetfJc r arsons that would permit the City to ,-econclude that they are trade secreta. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Cat 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. 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 .,. Applicant's Printed Name ' Applicant's Signature Page 1 of 3 66„3. . d c, ifr v ii50 aWRITE BELOW THIS LINE / LC:/so 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 7(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 Occupancy .,, - MCES System Plan Review Code Edition 0 s''' SAC Units (25% 100% ) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required 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 Foundation Before Backfill Nx. HVAC_Gas Service Test Gas Line Air Test Roof:_Ice &Water _Final Pool: Footings Air/Gas Tests _Final XFraming .4_30 Minutes 1 Hour Drain Tile Fireplace: _Rough In _Air Test Final Siding: Stucco Lath Stone Lath Brick EFIS c.. 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: 11/ , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review "66't #° MCES SAC 1 f rt. City SAC Utility Connection Charge S&W Permit& Surcharge Treatment Plant Copies TOTAL tr tA I ily 2 ° (--) ''' ' Page 2 of 3 Use BLUE or BLACK Ink For Office Use Perrn it#: /171550`2" ** City of EaIan Permit Fee. (e - 1) ("C 3830 Pilot Knob Road )- Date Received: 9-7 -/ Eagan MN 55122 7 Phone; (651) 675-5675RECE1117 n Staff: buildinuinspections(acityofeaban.corq sEpi7 2011 2017 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: / I / Site Address: Tenant: Suite#: Name: Phone: Resident/Owner t Address/City/Zip: Name: 4tt c*!4t,ck I ' !C t!-/ License#: Contractor Address: *tt c!. City: iks State: Zip: Phone: I Contact: !,A Email: Type of Work New Replacement Repair Rebuild y Modify Space Work in R.0 W Description of work: _ RESIDENTIAL Water Heater Water Softener Lawn Irrigation ( RPZ/ PVB) Permit Type Add Plumbing Fixtures( 7. Main/ Lower Level) Septic System New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes State Surcharge) $60.00 Lawn Irrigation (includes State Surcharge) $60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge) *Water Turnaround(add$280.00 if a 3/4"meter is required) $115.00 Septic System New(includes County fee and State Surcharge) TOTAL FEES $ 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. wwwArioststateone(,all,org 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.cityofeanan.cornisubscribe. 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 1. Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: Date: Required Inspections: Under Ground Rough-In Air Test Gas Test Final Meter Related Items: Meter Size Radio Read Manometer Staff: 1 For Office Use %I M4// � � � , %SO9a� LV✓,,51 '6 Permit#: .�'� 9.c., N,,,„, 4,,,,. .6,'' ,0 E AG A N Permit Fee: b/ -° )1r,, ,1"5,....r1_, �� I '' C.,'"'-'1.(c RECIEUE! Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 �' I (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: `:� � buildinginspectionsacityofeagan.com JUL 2 0 2018 L 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 07/20/2018 Site Address: 3665 Blackhawk Road Unit#: Sue Bast 612.669.7250 Name: Phone: Resident/ 3665 Blackhawk Road Owner Address/City/Zip: Applicant is: Owner X Contractor —. I landscape retaining walls Type of Work Description of work: Construction Cost: 25000.00 Multi Family Building: X(Yes /No ) Maltese Contracting Contact: Tom Bever Company: 12105 285th street Lindstrom Contractor Address: City: Phone: 651 .307.35`7kail: maltesecontracting@gmai State: Mn zip: 55045 License#: 4802146 Lead Certificate#: If the project is exempt from lead certification, please explain why: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING i 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: I 1 Mechanical Contractor: Phone: k Sewer&Water Contractor: Phone: I Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-.ublic if ou rovrde s>ecifc'reasons that would ®ermit the Cit to conclude that the 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.cityofeagan.com/subscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval • ns. XTom Bever . x Applicant's Printed Name Applica s Signature • DO NOT WRITE BELOW THIS LINE S 6&7 , qCX r 1 4 &I- /50 9 .2 -7 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 y. Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation9Arg_k_r7Occupancy L. - MCES System Plan Review Code Edition Lk , # S SAC Units (25%_ 100% '' ) Zoning 1 City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction vb Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) Final/ No C.O. Required Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Hood 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 x Retaining Wall: X Footings k Backfill Final Sheetrock Radon Control f Fire Walls Fire Suppression: _Rough In_Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: /111_,/, Building Inspector RESIDENTIAL FEES Base Fee O "1 - Surcharge °' Plan Review MCES SAC Irj°-11/ City SAC Utility Connection Charge /(..;, 0 t2 0 S&W Permit& Surcharge I Treatment Plant Copies TOTAL Page 2 of 3 LOT SURVEY CHECKLIST FOR RETAINING WALL / ,C)9 / / BUILDING PERMIT APPLICATION Address: 3�,�� B/ haa* Applicant Name: S a- DATE OF : //7/�9 LATEST REVISION: d a **Permits required for Retaining Walls 4 feet high or greater. O Z a DOCUMENT STANDARDS 0 ❑ • Registered Engineer signature and company y 0 0 • Building Permit Applicant 0 0 • Address p' 0 0 • Legal description ;H' ❑ ❑ • Lot lines/Bearings&dimensions ❑ V 0 • North arrow and scale 0 0 • Street name //-�,, ,J'U0 • Show all easements of record and any City utilities within those easements GSI/ % S - ❑ • Setbacks of proposed structure and side yard setback of adjacent existing structures ELEVATIONS O /' ❑ • Property corners O fd' ❑ • Top of curb at the driveway and property line extensions(only if wall is within 30 ft. of curb) O JO ❑ • Elevations of any existing adjacent homes ❑ y ❑ • Adequate footing depth of structures due to adjacent utility trenches ❑ ❑ • Waterways(pond,stream, etc.) ❑ f3' 0 • At the foundation of the building and/or nearest structure PONDING AREA(if applicable) ❑ �° ❑ • Easement line ❑ 7' ❑ • NWL ❑ Jd' ❑ • HWL ❑ )2' 0 • Pond#designation ❑ yff ❑ • Emergency Overflow Elevation ❑ 0 • Pond/Wetland buffer delineation Y • Shoreland Zoning Overlay District YI • Conservation Easements RETAINING WALL INFORMATION 0 ❑ • Location of Retaining Wall on property .2' ❑ 0 • Top&bottom elevation at each end of wall and any change in elevation in between ❑ ❑ • Type of material(i.e. modular block, boulder,et ❑ ❑ • Directional drainage arrows with slope/gra•'- t° Reviewed By:,diek/ Date 7// G:FORMS/Building Permit Application-Retaining Walls Rev.5-4-09 VEC 18-127-Wall Location Sketch(1275x1650x16M jpeg) . 4 a. / 5-.0 0 -7 Q© ir 1. , i „ , a» v w , w w »,�. a „�.e: , f } rt„ - ,,,,,,,,,41,00,-- ,_. .._..,,_ _,.,: ...- .,,,r..., ;60,00.0._,, ::,.,,,s,,,, ,i,rt,,,.„,.,.;.:;p.",,,,,,t,:°:,}i,1,7:),,,,_.i.1....:;,,,,,,,,:,!:,,,.. .: » a Terry Zelenka From: Ronald W.Vickery, PE <rvickery@vickeryeng.com> Sent: Monday, September 10, 2018 9:59 PM To: Terry Zelenka Cc: thomas bever _ Subject: VEC 18-127 3665 Blackhawk Road Eagan, MN - SRW Plans Follow Up Flag: Follow up Flag Status: Flagged (K:6 40 q Categories: Red Category 1 )7 9 9 rY Terry—I discussed the field modifications of the geogrid lengths that were performed at the end of the referenced upper wall with Thomas Bever, and the modifications should be acceptable. Please let me know if you have questions or need anything else. Thanks, Ron Ronald W.Vickery,PE Vickery Engineering&Consulting,LLC 4441 Village Woods]rive Eden Prairie,MN 55347 Phone: 952-465-8272 www.vickeryeng.com —Engineering 5olutions for an unstable World- 1 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA152790 Date Issued:10/31/2018 Permit Category:ePermit Site Address: 3665 Blackhawk Rd Lot:003 Block: 078 Addition: Section 17 PID:10-01700-78-030 Use: Description: Sub Type:Residential Work Type:Replace Description:Boiler Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - Susan Bast 3665 Blackhawk Rd Eagan MN 55122 (651) 454-8334 Wenzel Heating & Air Conditioning 4145 Old Sibley Memorial Hwy Eagan MN 55122 (651) 894-9898 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA174783 Date Issued:02/22/2022 Permit Category:ePermit Site Address: 3665 Blackhawk Rd Lot:003 Block: 078 Addition: Section 17 PID:10-01700-78-030 Use: Description: Sub Type:Fireplace Work Type:Wood Burning Fireplace Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Susan E Bast 3665 Blackhawk Rd Eagan MN 55122 (615) 669-7250 Chimney Doctors P O Box 240722 Apple Valley MN 55124 (952) 888-5252 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA178613 Date Issued:08/25/2022 Permit Category:ePermit Site Address: 3665 Blackhawk Rd Lot:003 Block: 078 Addition: Section 17 PID:10-01700-78-030 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. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the water damage. 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: This permit shall be null and void if work does not start within 180 days of issuance, or if work is suspended for 180 days or more after started. 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 - Susan E Bast 3665 Blackhawk Rd Eagan MN 55122 (952) 895-4524 Aspen Contracting Inc 4141 NE Lakewood Way Lees Summit MO 64064 (877) 784-7663 Applicant/Permitee: Signature Issued By: Signature