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3710 Blackhawk Rd OCT-14-2010 14:20 From:AIR MECHANICAL 7637463777 To:651 975 5694 P.1/1 Use BLUE orBLACK Ink (f f I For Office We I uu W~y I # c~~- I City EaV oI 1 %A 1 qO 1 ~ 3830 Pilot Knob Road lY f Eagan MN 66122t~ 44 QAte ROColYacf I Phone: (661) 675-5675 t Fax: (651) 675-5694 2010 MECHANICAL PERMIT APPLICATION Rate5110 baCV-4'' iL ~Si~ ddross: Tonant: 1 • t suits 0: Phone, LOI -Rk RESIDENT I OWNER Name: Address I City / Zip: CONTRACTOR Name: License Address: 16411 Aberdeen Street NE city tern Lake, MN 55304 State: ~ Zi Prone: it's 1 ' -gN-77L)- Contact: Email? TYPE OF WORK New Replacement Additional Alteration Demolition Description of work: NOTE: Roof mounted and ground mounted mechanical equipment Is required to be scroened by City Code, Please Contact the Mechanical Inspector for information on permitted screening methods, PERMIT TYPE RESIDENTIAL COMMERCIAL ~D Furnace Now Construction Interior Improvement k A L , 7 - _ Air Conditioner ~ Install Piping _ processed W1 N&I 4- Air 5xchangor _ Gas _ Exterior HVAC Unit i , Y 1 a ley+'~ a~ Y Howl Pu p _ Under / Above ground Tank L_ Install / _ Remove) r to 4,`4u.+4.~xu Whan {n$lalgnglrOmrnnnp tank(s), call for inspection by Fire Marshal and Plurnbi I for RESIDENTIAL FEES 50-0 Minimum Add-on or $60.50 alteration to an existing unit ' rt:na e $50,50 Fire repair (replace burned out appliancoo, ductwork, etc.) (includes $.50 State Surcharge) s55,00 TOTAL FEE COMMERCIAL FEES: $70.60 Underground tank installation/removal OR Contract value $ X1% $60.60 I m (includes State Surcharge) If Eft is loss then $1,000, surcharge is $.50. Permit Fee If E IIW Fes, Is > $1,000, surcharge increases by $.5o for each Surcharge $1,1300 Permit Foe (i,& a $1,00142,000 Permit Fee roquires a $1.00 surcharge). $ TOTAL FEE QLL_BEFORE Y12U_DIG. Call Gopher State Ono Call at (66114640002 for protection against undorground utility damage. Call 48 hours Were you intend to dig to receive locates of underground utilltlos. www,aorsherotRtnorwcnll.ord 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 worlds not to start without a permit; that the work will be in accordance with the approved plan In Ire Case of work Which requires o rovlow and approval of pla x Trh a. ~wvivkrv . ~ x ~8~ ± Applicant's Printed Name Applicant's Slgnetum FOR OFFICE USE Roviewed By., Data: Required inspections: ,,,,,,,,under Ground Rough In Air Pest _Gas Service Test -in-floor Most ,,,,,,,Final Extet9or HVAC Screening Inspection no= ~XiSTivy S82'21'4090W _ Q73 98 3'9. '1V ~Z~o '5 .f $40,9 $~T r INI 0 32.50„oA 41 c~Y _ ~ °o ~ (ASSD 10 o ~ 4-493;r z / a''PORCH o ~ 2.00 06 m (841"" ,t 2. 1 In,~ J N D 830 ~38.~ 13:83 °o o six✓, $~i 863. z , i L.-.. _ 2.00 \ D -r( U, _';o 6.004. (85/. 3~ ~Si. h I pro N L O ~p • 0~ I 00 X _ 43.00 o C") O 6.00 ~3! p r q m G 32 "M14 cn \ co 10 .67 7 5 ZB' oA~c w .008 6rS2'f7 x33 , 67 0~ (873. I C838 5 48.33 ° O ~.8 10 480.91 (83~s 835 rCJrr.o2 (~44 ©14 og ~Jo"ogfc~S~27 Cn mss, NI S77'12'41"W P r,=84x08 v f4 846,34 5~ /Z"a4eCSS3,~ °p ~I 33.00 19.0 i i-1-~- i G4~G `K 2007 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 permits are required for each unit Date -7 7 Site Address 3 7) Q ~L Unit # Property Owner CL. Telephone # ( b.5l ) z'~~j - t g e7IS Contractor Residential Heating & 6 Lir Street Address 1815 East 41 st Street city lnneapo ls, State (612) 724-1899 Zip Telephone # ( ) Bond Expires: The Applicant is Owner Contractor Other Fire repair (replace burned out appliances, ductwork, etc.) $ 90.00 This fee applies when extensive mechanical repairs are made to a building. Add-on or alteration to existing dwelling unit $ 50.00 furnace _Additional Replacement New air exchanger air conditioner heat pump _ other Z "~O*) 244ucy0 BTU' 5 a 0 E-10 j2 C ,o ILL l - State Surcharge r1a $ .50 18 ZUU1. LU Total JUL $ 5~ I hereby apply for a Residential Mechanical Permit and acknowledge that the info tion is complet and accu te; that the work will be in conformance with the ordinances and codes of the City of Eagan and with t Mechanical C des; that understand this is not a permit, but only an application for a permit, and work is not to start without a e it; that the or ill e accordance with the approved plan in the case of work which requires a review and approval of plans Applicant's Printed Name Ap lic is Sig ature CITY OF EAGAN Remarks , ' C ( Jy ' f L(" Addition Section 17 Lot Blk Parcel 10 01700 030 75 4-) 1 CL. 17 Owner ~ ' / / . tt4t -_3710 Blaekhawk Rd. state Eagan.oMN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. p 52.65 10 STREET RESTOR. GRADING . 2. 2 SAN SEW TRUNK 1 Ti to SEWER LATERAL d & Ser Stub WATERMAIN A WATER LATERAL / 972 C3 159.14 At}14754 10-17-54 WATER AREA STORM SEW TRK Zj 19183 $61.40 37.40 15 456.20 A014754 10-17-441 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 280. 4343 9-24-71 BUILDING PER. 3 ~36 8-75 SAC 240. 4343 51-24-71 PLEASE sign these waiver of hearing notices and return the original to us as soon as P,S ~Ifyou intend to pay this amount please notify us immediately. --71~ ~G c ~h ci,j 0/ - REQUEST FOR UTILITY IMPROVEMENTS I i4e hereby request of the Board of Supervisors, Eagan Township, Minnesota, utility improvements on and over property owned by me/us as follows: (Mention type of improvement, e.g. water, sanitary sewer, etc.) - WATER LATERAL, 19721 3710 Blackhawk Road, 55222 The location of said utility improvements shall be generally as follows: PARCEL 3236-c, Section 17 Ruben Johnson (C.) I/We hereby waive notice of any and all hearings necessary for the installation of said improvements and further consent to any assessments necessarily levied by the Township of Eagan for such improvements. I/We further agree to grant to the Township of Eagan any easements neces- sary for the installation of such improvements. It is further understood that this request shall be reviewed by the Board of Supervisors of Eagan Township or its agent and I/we will be given reasonable notice as to whether this request is possible under present utility planning as to timing, location, etc. f~- Dated: December _1311971 5 X Request accepted by _ Eagan Township Date December 1391 71 Eagan Township Request referred to Town Engineer: Date December 13, 1971 Copies: 1. Township rEAJ CClI d~I(APF- 4 2. Town Engineer t7T f _ 3. Applicant '1~%c ~`/f USCjc' ic~~ I I EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION Date: September 24, 1971 Number: 725 Its o., 76c% g 36 Billing Name:O. Reuben Johnson Site Address: 3710 Blackhawk Road, Eagan 55122 Owner: same Billing Address same Plumber: Wenzel Plumbing & Heating Inc. d Location of Connection ter Size Connection Chg. • p re ~,d'17 Meter No. drub' Permit Fee 10Qom] }g//3} Meter Reading Meter Dep. 15.00 pd Meter Sealed: Yes Add'1 Chg. NO Total Chg. Inspected by Date Building is a: Remarks: Residence xxxx 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 thv proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota. By: Wenzel Plumbing & Heating Inc. Please notify the above office when ready for inspection and connection. I ~ .t EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454.5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: September 24, 1971 NUMBER 886 OWNER: 0. Reuben Johnson Address 3710 Blackhawk Road, Eagan 55122 PLUMBER Wenzel Plumbing & Heating Ir&WE OF PIPE Heavymast Iron DESCRIPTION OF BUILDING Industrial Commercial Residential Multiple Dwelling No, of units xx Location of Connections: Connection Charge 240.00 pd 9/24/71 Acct. Dep. pd 9/Z4//1 Permit Fee 10.00 pd 10/8/71 Street Repairs .50 pd 10/8/71 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 rules and regulations of Eagan Township, Dakota-County, Minnesota By Wenzel Plumbing & Heating, Inc. 1955 Shawnee Road, Eagan 55122 Please notify when ready for inspection and connection and before any portion of the work is covered. CITY of ~EAGAN N:° 3648 BUILDING PERMIT Owner 3795 Pilot Knob Road ' Eagan, Minnesota 55122 Address (present) 454-8100 Builder '7J~ Date .....I ..1:...... Address DESCRIPTION Stories To Be Used For Front Depth Height Est. Cost 'Permit as Remarks LOCATION ° Street, Road or other Description of Location ' Lot Block Addition or Tract This permit does not authorize the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE EPT ON THE PREMISE WHILE THE WORK IS IN PROG ESS. This is to certify, that..........', has permission to erect a. c..._.' ` t::-. . upon the above described premise subject to the provisions of all applicable Ordinances for the City of Eagan. f.........:. Per Mayo Anspector ' r MASTER CARD LOCATION OLa) K SaC I.~ OWNER @ U N k1 DI~q -f 6 STRUCTURE AND LAND USED AS x? q L? ec Issued To Permit No. Issued Contractor Owner BUILDING O/S~ 7 PLUMBING CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER OTHER OTHER Approved Items (Initial) Date Remarks Distance From Well FOOTING ~ Ir- 7 SEPTIC FOUNDATION CESSPOOL FRAMING t/ - 17 ` TILE FIELD FT. FINAL ELECTRICAL DEPTH HEATING OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER Violations Noted on Back COMMENTS: wr COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ❑ NO EVIDENCE OF NON-COMPLIANCE ❑ NON-COMPLIANCE. BUILDER DOES NOT OBSERVED. INTEND TO COMPLY. ACCEPTABLE SUBSTITUTIONS OR ❑ DEVIATIONS. COMPLETION OF CERTAIN IMPROVEMENTS U WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ❑ NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: ❑ REINSPECTION REQUIRED DATE OF REINSPECTION REINSPECTION REVEALED CERTIFICATION-1 certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected. ❑ ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR DATE COMMENTS: a3 _ J 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 (952) 891-7011 Fax (952) 891-7031 DATE: August 13, 2002 TO: Tom Colbert/Wayne Schwan - EM Fax (651) 681-4694 FROM: Water and Land Management RE: Well Permit 02-H192372 Well Type: Sealed Municipality: Eagan Environmental Specialist: Rutten 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 (952) 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: H & H Well Services Date application received: August 12, 2002 Anticipated Drilling Date: Time: Anticipated Grouting Date: Time: Property Owner: Jose R Garza Well Owner: Jose R Garza WELL LOCATION: PLS Coordinates: nw 1/4, nw 1/4, se 1/4, se 1/4, Sec 17, Town 027, Range 23 Street address: 3710 Blackhawk Rd PIN Number: 10-01700-030-75 WELL INFORMATION: Diameter: 4 Casing depth: 200 Total depth: 200 Static Water Level: Aquifer: COMMENTS: v yy, !!~~Y T jj1•{{Ry L73..HM'T1,7-7.`"4Y 7i 51.. ~1.1 _.....:ii::: KY'LtO LN 100170003075 55122 , 3710: BLACKHAWK RD v I^ DER 10 01700 0000 00000000 ROSIN LN i \ s> 17 2723 SECTION 17 TWN 27 RANGE 23 N 90 FT OFW 322.5 FT OF SE 1/4 OF SE 1/4 & PT OF N 90 FT OF SW 1 /4 OF SE 1 /4 LYING E OF CEN TN RD 3710 BLACKHAWK RD 17 027 23 77 - - - ~t • F----------------I l For Office Use City j Permit l /y~~ of EaRdn a C.~.~ I 3830 Pilot Knob Road l Permit Fee. / Eagan MN 55122 j Date Received: j Phone: (651) 675-5675 i I Fax: (651) 675-5694 1 staff: I I I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION Date: O y Site ~ Address: _5 /Z Tenant: r9/-e-X/a 00-(' Suite RESIDENT/OWNER Name:_ (rY,/rr 4- 00 U/Phone: 49 30cY_9g2,6Address !City !Zip: 71CJ J71 o Z'~r,u 2 Applicant is: Owner Y Contractor TYPE OF WORK Description of work: QO(-~' /C Construction Cost: Multi-Family Building: (Yes - / No X) CONTRACTOR Name: Foct,^ c cif 17c_,7a Yc, kf c ..aLicense 2 dG:Z!V 1 Z/ Address: W /o S City: /0/ State: 1 Zip: Phone: 1'12' 90S 3 Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet Category Submitted Submitted {1f submission type) • Energy Envelope Calculations Submitted 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 the are trade secrets. 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/.~ , x Applicant's Printed Name Applicant's Sig Page 1 of 3 ~Q W JUN 4 2009 f j DO NOT WRITE BELOW THIS LINE SUB TYPES - Foundation _ 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* Addition _ Move Building _ Reroof _ Demolish Interior Alteration - Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation 34Ln Occupancy MCES System Plan Review Code Edition IV19 SAC Units (25%_ 100%4) Zoning City Water Census Code 111111 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) Final / No C.O. Required Foundation HVAC Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath -Brick Fireplace: -Rough in -Air Test -Final Windows Insulation Retaining Wall Meter Size: Erosion Control Reviewed By: Building Inspector RESIDENTIAL FEES Base Fee 011D Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL Page 2 of 3 7/f { t F f ca" E I f q f t Fj j ~t i ~ 1 fg ~ E J g~ % 43 V 995.71 1-4 SO z E E E E E E E E ° N e N 25 wv% dpz.aa t~- CA OVIN ec~a e~re9~ 95oQ es.ao J m J'I 16000 ° g - E 3 E i ~ ~ 170AD Y ' W I \ ~ ~ 100.29 ~ ~ I $ 1 g! g zs _ 170 W 27a.9o ro g J $ _ I CA) s E o $ m $ 2DOm ,00.0D 156AD 95.00 95.00 ~.oo 270m - - - i ~ B92bi E .is ~ + - J 100m ~ 770 O m i ~ g I m _ ~J / ~ 859 B7 I! _ I G ;lb X, m t0 > f {D N 1 cn j7 C;n 710 _g { is a' a+ DS ,78.00 [VA g ~ ~ ~ N I f'n 'd 992.95 W _ 291.99 95.00 2~~ ° g ,eoot ^ teooo S f 229.92 W V N_ g J l L'_I I. $ g $ 8 8 ^ 145.99 N 0 22549 $ ~ 'B $ J 8 ~ I ~II N 1SSAS AAA------~~i +90.00 T e v j 8 $ nom r /v g $ J 180.01) $ 8 15996 f W 0O/► (A E GWRr a N W ~f(a +55.49 I i j N .3~, N OJ ,{1 L, 8 $ g $ o C1t , m Q' % ~ i N I I - I 1~9A2 180m 1t _ -7 9989 eke W E _ N I , .90 197 00 197 125 0 A - 414 .b PERMIT City of Eagan Permit Type:Building Permit Number:EA117081 Date Issued:10/15/2013 Permit Category:ePermit Site Address: 3710 Blackhawk Rd Lot:003 Block: 075 Addition: Section 17 PID:10-01700-75-030 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - 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 by law in ALL single family homes . Doug Amundson Valuation: 4,000.00 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 - Erik Gellerstedt 3710 Blackhawk Rd Eagan MN 55122 (612) 715-1252 Precise Exteriors LLC 14023 Fountain Ave N Hugo MN 55038 (651) 206-9168 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA177008 Date Issued:06/10/2022 Permit Category:ePermit Site Address: 3710 Blackhawk Rd Lot:003 Block: 075 Addition: Section 17 PID:10-01700-75-030 Use: Description: Sub Type:Water Heater 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 - Erik Gellerstedt 3710 Blackhawk Rd Eagan MN 55122--112 (612) 715-1252 Clearwater Plumbing & Heating 19260 Mushtown Rd Prior Lake MN 55372 (952) 440-3779 Applicant/Permitee: Signature Issued By: Signature