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3737 Blackhawk Rd RESIDENTIAL 5 IDS9 BUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 Y 651-681-4675 New Construction Reauirements RemodeUReoair Requirements • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan (20% maximum lot coverage allowed) • 1 set of Energy Calculations for heated additions • 2 copies of plan showing beam & window sizes; poured found design, etc.) . 1 site survey for exterior additions & decks 1 set of Energy Calculations . Indicate if home served by septic system for additions • 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 i~ ~l y ~d Z VALUATION 'j/ SITE ADDRESS MULTI-FAMILY BLDG _Y TYPE OF WORK FIREPLACE(S) _ 0 4 -2 APPLICANT -S'404-, STREET ADDRESS 426 AUK CITY STATE16/ZIP 5 SS79 TELEPHONE # ~J CELL PHONE # SII~ FAX # PROPERTY OWNER Eb~C f ffrJ~r~tf=~© TELEPHONE # COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672 (4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted • Energy Envelope Calculations 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: Ph Mechanical system includes: Air Conditioning D f7 70.00 Heat Recovery System tJ n ? JUN 1 4 700 Z Jllj Sewer/Water Contractor: P '~e # I hereby acknowledge that I have read this application, state that the ' orma on is correct, aricl free t comply with all applicable State of Minnesota Statutes and City of Eagan O i an s. Signature of Applicant OFFICE USE ONLY Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _ Updated 4/02 OFFICE USE ONLY ❑ 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 (screened) ❑ 36 Multi ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Pibg Y or _ N ❑ 25 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 Windows/Doors ❑ 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 Bldgs Length Fire Sprinklered Type of Const 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 Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total N CITY of EAGAN ~ 3557 BUILDING PERMIT { 3795 Pilot Knob Road . - X77 Minnesota Owner 55122 Eagan, Address (present) 454-8100 Builder _ - 7s~ Date .....Z.. Address DESCRIPTION Stories To Be Used For Front Depth Height Est. Cost Permit Fee 22- Remarks ~-e-%t-e- z „ LOCATION -j Street. Road or other Description of Location ` Lot Block Addition or Tract C-~.- 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 KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, that-..` has permission to erect a-..4. ~ .:...,r .....t upon the above described pre ise subject to the provisions of all applicable Ordinances for the City of Eagan. l~ ~ Per Mayor Building Inspector ~5 a NORTH cu O ct h Z 4-' ~ ~ yt-t C ttafr$-' t 30P y t~'-11 - Cy ~ ~ . .L/4 C.t<~~At~~~' ~~'AP PLOr VL.AN PAYER'S COPY CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 CASH RECEIPT DATE 19 RECEIVED r- FROM AMOUNT &_-DOLLARS 100 R CASH CHECK FOR -7 i FUND CODE AMOUNT g Fin A Y n ~ % ~~1 ref ~ 6 kh r 1 `f f/' d; s wed? O "i~ . A 0,00 ` 704, + ®JLV 'PC KIP horn I t- Pkr !f, ~J T ee - a MASTER CARD LOCATION Q Q Y ~f OWNER STRUCTURE AND LAND USED AS x ~~j, a ddyl ~[~X ~J~r ~d Issued To Permit No. Issued Contractor Owner BUILDING 55~ t r PLUMBING CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER OTHER OTHER Approved Items (Initial) Date Remarks D'stance From Well FOOTING^ zD- 7 S~i~ll SEPTIC FOUNDATION CESSPOOL FRAMING TILE FIELD FT, FINAL ELECTRICAL DEPTH HEATING OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER Violations Noted on Back COMMENTS: COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. DATE OF INSPECTION CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ❑ B EVIDENCE OF NON-COMPLIANCE ❑ NON-COMPLIANCE. BUILDER DOES NOT OBSERVED. INTEND TO COMPLY. ❑ ACCEPTABLE SUBSTITUTIONS OR ❑ COMPLETION OF CERTAIN IMPROVEMENTS DEVIATIONS. WILL BE DELAYED BY CONDITIONS BEYOND ❑ NON-COMPLIANCE. BUILDER WILL COMPLY CONTROL. WITHOUT DELAY. ITEMIZED AND DESCRIBED AS FOLLOWS: i I ' I I F-1 REINSPECTION REQUIRED DATE OF REINSPECTION I'I C REINSPECTION REVEALED I CERTIFICATION-1 certify that I have carefully inspected the above in which I have no interest present or prospective, and that 1 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. F1 ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR DATE COMMENTS: EAGAN TOWNSHIP BUILDING PERMIT 10 2296 Owner . r_~ An- Eagan Township Address (present)' '/f5~'`;~ Town Hall Builder . ho Date Address DESCRIPTION stories To Be Used For -Front Depth Height Est. Cost 'Permit Fee Remarks 'x71 e S7 `f ems- 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 PROGRESS w_ dbviw 1.C. This is to certify, that... _ 371 has permission to ~--p............ ..:r.......... on . the above described premise subject to the provisions of the Building Ordinance for Eagan Towwnship adopted April 11, 1955 . C. . Per :_L_i~. hairman of T,,wn Board Building InsPec to ~ MASTER CARD LOCATION Ja I 7 f~, OWNER a STRUCTURE AND LAND USED AS W Issued To Permit No. Issued Contractor Owner BUILDING Z 6 P f- ~~1~/'4•~ h ]-a~ ~/d s c PLUMBING •16 CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER OTHER i OTHER i . Approved Items (Initial) Date Remarks Distance From Well FOOTING L SEPTIC FOUNDATION P P Moves CESSPOOL FRAMING TILE FIELD FT. FINAL ELECTRICAL DEPTH HEATING I OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL SANITARY SEWER 9{ Violations Noted on Back COMMENTS: i J 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 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 1 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: 23 EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: Aggust 120._1970 NUMBER 620 OWNER: Parranto Bros. Address 34=F Blackhawk Road, St. Paul 55111 PLUMBER Wenzel Pluj mbing d Heating TYPE OF PIPE cast iron DESCRIPTION OF BUILDING Industrial Commercial Residential Multiple Dwelling No, of units xxxx Location of Connections: Connection Charge----2 Permit Fee 10.00 pd 8/13170 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 rules and regulations of Eagan Township, Dakota County, Minnesota By Wenzel Plumbing & Heating, Inc. 1955 Shawnee Roads St. Paul, Minn. 55111 Please notify when ready for inspection and connection and before any portion of the work is covered. r EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PEP1IIT FOR WATER SERVICE CONNECTION Date: August 12, 1970 Number: 469 4441-Blackhawk Road Billing Name:Parranto Bros. Site Address: lot 4 Blackhawk Acres Owner: Parranto Bros. Billing Address nmmerr-C i;tdi g_ Plumber: WenzelP lumbing S Heatins. Inc. Location of Connection Meter Size 5/8" Connection Chg. 260 OO pd 1/12/71 Meter No. 6818625 Permit Fee 10.00 pd 8/13/70 Meter Reading 11i,00 Meter Dep. Meter Sealed: Yes Add'1 Chg. NO Total Chg. Inspected by Date Building is a: Remarks: Residence xxx Multiple No. Units Commercial Industrial By: Other Chief Inspector In consideration of the issue and delivery to me of the above permit, I j~ hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota. 4 By. Wenzel Plumbing & Heating, Inc. Please notify the above office when ready for inspection and connection. I~ ~U a DATE INVOICE NUMBER AMOUNT OF INVOICES TOTAL AMOUNT a GROSS WITHHOLDING STATE HOSP. NET PERA TAX - - INC. TAX PAY EARNINGS - - - D E D U C T I O N S TOWNSHIP OF EAGAN PLEASE DETACH BEFORE CASHING THIS IS A STATEMENT OF PAYMENT AND EARNINGS AND DEDUCTIONS G b 2007 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 Remodel/Repair Requirements Office Use Only New Construction Re uirements 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas 2 copies of plan showing footings, beams, joists Certof Survey Recd =Y = N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Soils Report Pres Plan Recd - Y N. 1 Soils Report if proposed building is to be placed on disturbed soil 1 site survey for additions & decks Tree System _ - Y _ -N 2 copies of plan showing beam & window sizes; poured found design, etc. Addition - indicate if on-site septic system Tree er SeRequired 1 set of Energy Calculations 3 copies of Tree Preservation Plan if lot platted after 711!93 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Minnegasco mechanical ventilation form Plans are considered public information unless you state the are trade secret and the reason. Date _ I? _ / ~O l GVy f Construction Cost Site Address 3,-TV7 ZA464-NiJ 4 1440 Unit/Ste # Description of Work p jU1 ~'u) 4Vt r Multi-Family Bldg _ Y x N Fireplace(s) _ 0 1 _ 2 Telephone # Lf ( ` Property Owner Contractor ` t J~C JKCO Address City State Zip Telephone # ( ) 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 in the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Y - N If yes, date and address of master plan: Licensed Plumber Telephone ) Mechanical Contractor Telephone # ( ) Sewer/Water Contract or 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 as permit; that the work will be in accordance with the approved plan in the case of work which requires a review a approval of plans. Applicant's Printed Name t+Ap ican' Signature DO NOT WRITE BELOW THIS LINE 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 (4 ❑ 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/pergola) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex ❑ 25 Miscellaneous i Work Types ❑ 31 New ❑ 35 Int Improvement ❑ 38 Demolish Interior tv 44 Siding ❑ 32 Addition ❑ 36 Move Building ❑ 42 Demolish Foundation ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish Building* ❑ 43 Reroof $1/1' 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) - Give PCA handout to applicant Description: Water Damage Yes Valuation 01V Occupancy MCES System Plan Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width I REQUIRED INSPECTIONS Footings (new bldg) _ Sheetrock Footings (deck) _ Final/C.O. Footings (addition) _ Final/No C.O. _ Foundation _ HVAC Drain Tile Other Roof - Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests Final Framing Siding _ Stucco Lath _ Stone Lath -Brick _ Fireplace _ R.I. _ Air Test _ Final Windows Insulation _ Retaining Wall Approved By: i2=-, Building Inspector Base Fee i Surcharge Plan Review w C MC/ES SAC City SAC ? Utility Connection Charge S&W Permit & Surcharge Z~--~ l Treatment Plant License Search Copies Other Total TOWN OF EAGAN 3795 Pilot Knob Road St. Pahl, Minn. 55111 MI MIT NO.: 50 The Board of Supervisors hereby grants to Wenzel Plumbing-S Neatiz:*. 'Luc. of 1955 .Shawnee hoad, St. Peal 55111 a Plusmbing r es Permit for: (Owner) Parramto Aron. at qt 4 BLOCti-i,'I-I!, 3 pursuant to application dated 8/10,/70 Fee Paid: $20► Dated this 10th day of August , 1970 -Building Inspector / 1,Pt !i CITY OF EAGAN Remarks Addition Blackhawk Acres T Lot Blk 1 Parcel- 10,14300 041 00 OwnerA e4K J n nr~i~ et 3737 Blackhawk Ed. State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1971 526.50 52.65 10 Paid 167, STREET RESTOR. GRADING SAN SEW TRUNK o 1 68 100.00 3.33 0 Paid ?SEWER LATERAL 1271 1564.00 78.20 20 Paid WATERMAIN WATER LATERAL 1971 20 WATER AREA Paid ith water onnection 71 STORM SEW TRK ~ 1983 516.00 34.40 15 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 26o.oo 3145 1-12-71 BUILDING PER. SAC 200.00 3145 1-12- 1 PARK Use BLUE or BLACK Ink For Office Use Permit pt AD of Ea i I Permit Fee: :7-0 I 3830 Pilot Knob Road I Eagan MN 55122 I Date Received: I Phone: (651) 675-5675 Staff: Fax: (651) 675-5694 1 l~ - 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: '3-7 9 L A-~14 a W V 12CA -b Site Address: Unit Name. 6' it2.&+G 1 v O IVI,If ~'!50 AJ Phone:&5; I L1% a"ZG RESIDENT / T -7 B~1VMe ~0 0" 4-0 OWNER Address/City /Zip: Applicant is: X- Owner Contractor Description of work: TYPE OF WORK Construction Cost: Multi-Family Building: (Yes J No~ i14 h11iLY!► 1 W~~r Contact. L . nCONTRACTOR ? Address: State: 1► t Phone: IV~) icense 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 masterplan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting g documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 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 authorized by a building permit issued in accordance with the Minnesota State Building Code must completed within 180 days of permit issuance. - 0t x6E--.t r'(5-; e 7 t t t z-:;, J x Applicant's Printed Name Appli ant' Sig a re Page 1 of 3 DO NOT WRITE BELOW THIS LINE U7tS U~ SUB TYPES 3 - 37 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 PGA handout to applicant DESCRIPTION Valuation Occupancy' MCES System Plan Review Code Edition aa~'J SAC Units " (25% 100%Zoning City Water Census Code K 3~f Stories Booster Pump # of Units 1 Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: ^Stucco Lath Stone Lath -Brick Fireplace: -Rough In -Air Test Final Windows Insulation Retaining Wall: _ Footings _ Backfill Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By: Building Inspector RESIDENTIAL FEES d J 3~ ,,1,~~~ DU Base Fee yU Surcharge' Plan Review MCES SAC City SAC Utility Connnc.tion Charge S&W Permit & Surcharge Treatn -.t Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA119361 Date Issued:11/25/2013 Permit Category:ePermit Site Address: 3737 Blackhawk Rd Lot:041 Block: 0 Addition: Blackhawk Acres PID:10-14300-00-041 Use: Description: Sub Type:Reroof & Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and house wrap and leave on site. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Fee Summary:BL - Base Fee $8K $162.25 0801.4085 Surcharge - Based on Valuation $8K $4.00 9001.2195 $166.25 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 - George B Thompson Jr 3737 Blackhawk Rd Eagan MN 55122 (651) 454-3625 Legacy Restoration Llc 14000 25th Ave N Suite 110 Plymouth MN 55447 (763) 354-7660 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA121778 Date Issued:04/15/2014 Permit Category:ePermit Site Address: 3737 Blackhawk Rd Lot:041 Block: 0 Addition: Blackhawk Acres PID:10-14300-00-041 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 . Jeff Pelant 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 - George B Thompson Jr 3737 Blackhawk Rd Eagan MN 55122 (651) 454-3625 Legacy Restoration LLC 14000 25th Ave N Suite 110 Plymouth MN 55447 (763) 354-7660 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink r For Office Use I I ~D1cc,,a~ Permit I St7 I City of Eano~ q0 I Permit Fee: I 3830 Pilot Knob Road Eagan MN 55122 Date Received: Phone: (651) 675-5675 I I Fax: (651) 675-5694 I Staff: I 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 1~1 &i Site Address: ?171-73q Unit 1~ ~w 1 Name: l fytir:;1 Phone: Resident/ ~ Owner Address / City / Zip: M31 ~~OPWIC 9b OV .I Sq Z-Z- Applicant is: Owner Contractor Type of Work Description of work: ~i Z ~ Construction Cost: J Multi-Family Building: (Yes / No Company: Contact: Contractor Address: City: State: Zip: Phone: License Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING ANEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? i _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: i Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 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 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 Ap ica is Si n lure Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA122828 Date Issued:05/20/2014 Permit Category:ePermit Site Address: 3737 Blackhawk Rd Lot:041 Block: 0 Addition: Blackhawk Acres PID:10-14300-00-041 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. 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 - George B Thompson Jr 3737 Blackhawk Rd Eagan MN 55122 (651) 454-3625 Legacy Restoration Llc 14000 25th Ave N Suite 110 Plymouth MN 55447 (763) 354-7660 Applicant/Permitee: Signature Issued By: Signature ° :l r , For Office.Use ° ! d I q f• `� °� . .° Permit#:. E ii. G A .�-e Permit Fee: ��U- ()Li w 3830 PILOT KNOB ROAD I EAGAN,MN 55122-18.10 Date Received: (651)675-5675 I TDD:(651)454-8535 I FAX: (651)675-5694 buildinglnspeclionsPcityofeagen.corn Staff: L J ' g 2018 RESIDENTIAL PLUMBING PERMIT APPLICATION Date:/:J—\( Site Address: 3 r3 44L 4 � t.74)1/4___ (yam Tenant: cl (J • pirntvol.",, r °° .���—ill Suite#: €t� ig. `� Name: 0.eI _,.` Ir%L,►EPhone: ( r.t �.0 e�� : •�1 I� e� 7t4 t ,. I ry C :fit .Iti d MI : Address/City/Zip: 1 TT- j �_ 6+ -. '`. .,0,•113 0 4,0.,,i` +:*t. {- Name: MILBERT COMPANY dba CULLIGAN WATER 1 T `t �**��rr�4" '' , f`�: License#; C641376 ' ..4.:0 •�'� z,t'N AAddress: 1801 50TH STREET EAST �`'� � �"ae ,sift;{ ��tQr}IA„ � �lr City: INVER GROVE HEIGHTS AT :0,,v�11.0ik 4. ,' ,k, `f,A. State: MN 55077 1Tift3 �� ZIP Phone: 651-451-2241 6 i *41,0` Contact; BILL MILBERT }, qt. q t Email; •Ioria.abas@culligan4water.com kit f l")i,.,, , twii •{ j _New Replacement Repair ' : $k t [ . t P Rebuild Modify Space Work In R.O.W. �r} : Akt3t F„4 tc : Description of work: 74,r: } 4 } r /k wt ,,,fft° RESIDENTIAL tfkkitaieliAitiipA 10,0.7:44,444�sc�- ,t'.'�` <r t _____Water Heater : �; � •.rP z k;ry;,r �'!� Lawn irrigation RPZ/ Softener Qa {�.0 'e,•r x' X Water j :(fx ( PVB) A�, �<} ;�xk; nk, ,.40 ` Septic_ System _Add Plumbing Fixtures ( Main./ Lower ',i 4:i.. S 5 1 fl}i •k t Level) }'Y s�k�h tk�,r ), � i, jki,V,ks-' tK 1 'r +�t{{{ tti t1 New Water Turnaround afgat'k.de3�.,-_, ,.;<,�. <.r 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) $115.00 Septic System New(Includes County fee and State Surcharge) TOTAL FEES$ 60.00 CALL BEFOREYOU DIG. Call Gopher Slate One Call al(651)454-0002 for protection against underground utility damage.Callll'48 hours before you Intend to dig to receive locates of underground utilities. www•eopherstateonecail.orq 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 webslto at www.cltvofeagan•com/subscribe. 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 acc rdancewil e approved p n hhe cas f.work whl requires a review and appro al of pia s. x X41 : 2 t�c ..),Ft0--------- . Applicant's Printed Name x C Vl. 4 t �f `�IK�` t`r '} rrf;t F ; v Applicant's Signature 6 p0� 11 F,,I f( 0aiila. ` . /ill fn ` ). t �i 1 tj R:t) t '00:11 t I {t IAt p i ik'w/ 'S, ft �,. T �t 4l � �l L ��l� S Y �J�4 !U��' 1 k�.r�, �}.}1 S�1.)�I�.Yt �U�#.L a/`F l�.t f pl r� f 4 ,r . 1 F1 FLS E :•P4 f ; / h +yr y t K!.,� Ffl t �` �•a v )4 fiv:.• ;a}f�'�.,-.�t.�r�;;)�Li���}�L•�'}r'us,�r �ur,�r .r;'(74 r t rt 1 s!'S�t �y}�:},6yl @. 0 e B�! - }}} Yrt a�.t.�.1 f'h k.T',l+Y }y ysn,,:{ltt�"•.r���i�'�'�f,`ta 35�,^i v > }ilf4 1,` Ili 4:1/ ,, S4Y'l:,4. c.ytopyl �i(�d� `iY ik rr_c.Y� - r: °,.� .e7v 3�at@ `})�' ll?r•i}�,s'<,!i?. �RegUl�',ed;Ins.ti ctfo s�' k` �.},+ � x.,1-r- � �...,, r1.L , ��g t.,',0 tE t4�J�t� v ftp?`ta�=x. >.: � t '�/�n�fdiIIyio ti, ,}., ,`{ e0.1 ?;$4tlal'',7+'lfr�l ak(5- i si {s 4 0 r:` ` S .,th , �_aF `�2 s4* a:c. ,v .rte$trr4'tt.. • A��it-..L��. okx:��l��'1 �+'^^1�.c�;����4 . �fT�a j� °�:mr�r�1,'(.i yi-. .�4 T�C��"I�Pl-ty{3'� '��vAlrF�� { ��%�ir;�'��`f�r"i� l�r{.,��`� ���t i.tf�.:. �ht Yt,1 g,!1tR�laxe'cllltem's'iAT 1T,t t RI. at` �f,',N 5tak�t(!�+ y4r`44: S t,s104i ,; ti e ` iki.Ore=, ` ' { �r jf,,,, Sh.iy 'cit .,, M t.de8:1 e.t' .t�>q,,IAatl[O,f,A adti,o,1as ,A ;(,-?,tw ',wh: 4�tjP *k0,,,b ,,``t+ mss l c ,,., r f,M a n ormtipr i iii:Pvii4 t'attrveAtA A frikk }k$;-44 i,1 i PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA151456 Date Issued:08/24/2018 Permit Category:ePermit Site Address: 3737 Blackhawk Rd Lot:041 Block: 0 Addition: Blackhawk Acres PID:10-14300-00-041 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). 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 - George B Thompson Jr 3737 Blackhawk Rd Eagan MN 55122 Benjamin Franklin Plumbing 5718 International Parkway New Hope MN 55428 (612) 238-9709 Applicant/Permitee: Signature Issued By: Signature