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3791 Blackhawk Ridge Pl PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA098087 Date Issued: 02/25/2011 OR Permit Category: ePermit 41~ it~ of E3 E Site Address: 3791 Blackhawk Ridge Pl Lot: 22 Block: 2 Addition: Blackhawk Ridae 2nd PID: 10-14401-220-02 Use: Description: Sub Type: e-Windows iDoors Construction Type: Work Type: Windows Doors-New ; Replacement Description: House Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee S3K $88.50 0801.4085 Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195 Total: $90.00 Contractor: - Applicant - Owner: J Carver Construction Shmui l\Icguigan 134 Schletti St 3791 Blacldiawk Ridge Pl St. Paul NIN 55117 Eagan NIN 55123 (651) 645-488 I hereby aeknowledae 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 Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature CITY OF EAGAN N2 18376 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 BUILDING PERMIT PHONE: 454-8100 Receipt # Q f To be used for , SF DWG/GAR Est. Value $177,000 Date SEP 17 ig 90 Site Address 3791 BLACKHAWK RIDGE PL Lot 2'2 Block 2 Sec/Sub. BLACKHAWK RIDGE OFFICE USE ONLY Parcel No. 2ND Occupancy R-3 M1 FEES Zoning PD R^1 W Name MONTGOMERY DESIGN & BUILD (Actual) Const V-N Bldg. Permit 909.00 o Address 3772 RIDGEWOOD DR (Allowable) VN Surcharge 88.50 City EAGAN Phone 681-1773 # of Stories Length 741 Plan Review 591.00 0 ZF Name SAME Depth 501 SAC, City 100-0 U0 Address S.F. Total of City Phone S.F. Footprints SAC, MCWCC 600.00 r On Site Sewage Water Conn 625.00 x Name On Site Well Fw Water Meter 90.00 xO Address MWCC System X (J I aw City Phone City Water Acct. Deposit 30.00 PRV Required X S!W Permit 30.00 1 hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge .50 information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagaa,Or "nances. Treatment PI 252.00 Signature of Permite ~ f 'yam APPROVALS Road Unit 355.0 Q Planner A Building Permit is issued to: Park Ded. on the express condition that all work shall be done in acc nce with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies Building Official 14 0 1 A Variance TOTAL 3,671.00 ~ 4< CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 BUILDING PERMIT Receipt # p 'To,be used for.. Sr DWG/CAR Est. Value $177,000 Date SEP 17 19 90 Site Addre§s 3791 BLACKHAUK RIDGE PL OFFICE USE ONLY Lot 2,2 Block 2 Sec/Sub. BIAC A+aK RIDGE Parcel No. Occupancy R--3 K-1 FEES Zoning PO Pl-1 W Name NONTOWRY DESIGN & BUILD (Actual) Const V N Bldg. Permit z 3772 Address ItIDGEiwi~t?1 (Allowable) Y= Surcharge 88. 3 City EAGAN Phone 681-1773 # of Stories Plan Review 591 00 Length ZF Name SANE Depth ' SAC, City 100.00 c001 Address S.F. Total SAC, MCWCC ( 00,00 ~ City Phone S.F. Footprints•UC} On Site Sewage Water Conn ~ W w Name On Site Well 9o.oo Water Meter s? Address MWCC System Q~ Acct. Deposit 30• a W City Phone City Water t. PRV Required X S/W Permit 4,50 ':1 I hereby acknowlege that I have read this application and state that the Booster Pump S/W Surcharge information is correct and agree to comply with all applicable State 252.00 Minnesota Statutes and City of Eagan Ordinances. _ Treatment PI Signature of Permitee:y' APPROVALS Road Unit 355'0 A Building Permit is issued to: ~31i`~Gt3t%RY DES.I'(;N Planner Park Ded. on the express condition that all work shall be done in accordance with all Council applicable State of Minnesota Statutes and City of Eagan Ordinances. Bldg. Off. Copies 3,671.00 Building Official Variance TOTAL Permit No. Permit Holder f Date Telephone # WATER SEWER PLUMBING H.V.A.C.C " 7 J' :f dCC 1~zJ~ ELECTRIC Inspection Date Insp. Comments ! Footings I Foundation Framing ~`G? t12 Roofing Rough Plbg. 61- Rough Htg. ~~f 7//,4Q Isul. Fireplace Final Htg. ~ -t "7 j J<] ~ f Final Plbg. Const. Meter Plbg. Inspector - Notify Plumber Engr./Plan Bldg. Final, Deck Ftg. Deck Final Well Pr. Disp. I, Address: 3791 BLAGUHAWK RIDGE PL Lot 22 Blk 2 Sec/Sub BLAMAWK RIDGE 2ND These items were/were not complete at the time of the final inspection. DATE: DFCTMERR 27, 1990 Yes No INSPECTOR: Final grade (6" from siding) Permanent steps - garage Permanent steps - main entry Permanent driveway Permanent gas Sod/seeded grass Trail/curb damage Porch 1 Basement finish Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. White - City copy Yellow - Resident copy Pink.- Contractor copy Citp of eagan This Ce? ficate issued pursuant to the requirements of Section 306 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City reguh*g building cons&=&n or use For the following. UxCuusatuo. SE UG4GAR I8376 o-w.-7 Tna Mh, zoning nisuict--P~f Rt Tye C„~, V[►T_ c-of Emma Bmu%Add,. 3791 214C'KBW R7Tff.. Pt.AMlity y92, fig, MACKH1 RTrJW X" DM. POST IN A CONSPICUOUS PLACE '1-8EWER &*ATER PERMIT OFFICE M ONLY C1W OF EAGAN METER # 6 PERMIT D 4 9"- 09125190 3830 Pilot Knob Rd. Eagan, fAN 55122-1897 7-3 ~ PERMIT # 11655 t MEFF MSIZE B.R. RECEIPT # - 9 8 9 119/ DATE SO 17, 1990 ISSUE MATE s d B.P. RECEIPT DATE S K PRV -BOOSTER PUMk SITE ADDRESS 3791 BLACKkIAWK RIDGE PL PERMIT RE IESi b LOT 22 BLOCK 2 SEC/SUB BIaACKHAk?K RIDGE 2ND TX SEWER X WATER TAPS APPLICANT:. X ADDRESS: - ! - COMIVI/IND RESIDENTIAL CITY; STATE ZIP X NEW EXISTING' PHONE: r Lawn Sprinkler Meters are to be Installed: PLUMBER:, Ahead of Domestic Meters on Water Line. ADDRESS: q6l Credit WILL OT be given for Deduct Meters, CITY'; STATE ~ J AGRE TO COMPL ITH,~. OE OWNER: HOPI TCI>irtERY DESIGN,& BUILD EAGA ORDINANCES GQRESS: 3172 RIDGEWOOD DR GITY STATE EAGAN, MN ZIP 55123 PHONE: 681--1773 SIGNATURE WHEN METER.ISSUED PLEASE DAMS FOR P CESiING. CALL X54-20 FOR INSPECTIONS. FOR STORM SEWER PERMITS, ONTACT ENGINEERING DEPT. tr SEWSR,,"ATER PERMIT OFFICE USE ONLY CITY OF EAGAN METER # PERMIT DATE .9 " i't9 3830 Pilot Knob Rd. Eagan;-MN 55122-1897 CHIP # PERMIT # t i s~5 , 0 METER SIZE B.P. RECEIPT # ___t*? ±1 DATE ISSUE DATE B.P. RECEIPT DATE ~ Jain .f = • c PRV BOOSTER PUMP SITE ADDRESS ..r~C AW` t;? ;1 _'1, PERMIT REQUESTED LOT L BLOCK SEC/SUB` J> SEWER WATER TAPS - APPLICANT: ADDRESS: COMMAND L RESIDENTIAL CITY, STATE ZIP NEW . EXISTING PHONE: Lawn Sprinkler Meters are to be Installed PLUMBER: Ahead of Domestic Meters on Water Line. ADDRESS: x Credit WILL NOT be given for Deduct Meters. CITY, STATE ZIP PHONE: `I AGREE TO COMPLY WITH CITY OF EAGAN ORDINANCES LL, OWNER: ADDRESS: a7 i 2 . '1 f,v,+: oz3 -i , CITY, STATE ZIP " 4.3 2 PHONE: SIGNATURE WHEN METER ISSUED f PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL_ 454-5220 FOR INSPECTIONS. FOR STORM SEWER PERMITS, CONTACT ENGINEERING DEPT. `.SEP 250 1990 DATE; RE: 3791 BLACKHAWK RIDGE PL (MONTGOMERY DESIGN & BUILD) A X Your Sewer & Water Permit for the above property has been completed. It will be held at the Public,Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO CALL,gUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON. r Ygcr Sewer & Water Permit for the above properry~ cannot be completed for the following asons: Your Sewer & Water Permit for the above property has been completed, but the meter cannot be issued or occupancy allowed until further notice. COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hai(. Meter size must be confirmed by Bill Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance. WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC. - REQUIRED BY LAW. CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY. Secretary, Building Inspections Dept. 14-10 0 17 37351 ~ ~ ~v Request Date Fire N4. Rough-in Inspection k_NOME: You Must Call Electrical Inspector 9 Required? If A Rough-In Inspection 6- ? s El No Is Required. n& ensed contractor ❑ owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) City L e Ct</veu x 6 a A-) Section No. Township Name or No. Range No. County Occupant (PRINT) Phone No. Power Supplier Address tr al ontra for (Compan Name) Contractor's License No. Mailing Address (Contractor or Owner Making Instal ation) Z /CI Ld Au orized Si ature (Co actor/ ner g Installation) Phon umber MINN SOTA ST BOAR OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - oom S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave t. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. ~~/lCf REQUEST FOR ELECTRICAL INSPECTION I II- See instructions for completing this form on back of yellow copy. / CL 0,7 M 3735 /TTT"`~~~ "X" Below Work Covered by This Request New Add Ref~ Type of-Building T Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contractor's Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only: TOTAL Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY IRE ORDE E DI?CONNECTED IF NOT Other Fee COMPLETED WITHIN 1 THS I, the Electrical Inspector, hereby Rough-in ate O / °a~ certify that the above inspection has Final been made. OFFICE USE ONLY This request void 18 months from r I I For Office't)seF I libijILY of Eapn ~ Permit ~ I I Permit Fee: 4 !X) 3830 Pilot Knob Road Eagan MN 55122 I Date Received: I I Phone: (651) 675-5675 Fax: (651) 675-5694 I Staff. I 1 V I~ 1 2008 MECHANICAL PERMIT APPLICATIO,INi1 JUL 2 3 2008 Date: t D Site Address: 3 ~~{GK /-ilk; t,V / L Tenant: IBY Suite RESIDENT / OWNER Name~A&LV.i f u ~'ti1e. Gt t 4'~c1 ( Phone l '4 3 Address / City / Zip: S A--W - - CONTRACTOR Name: i;r,;; i:: viLLE HEATING & A!C, INC. License 3151 VV. Burnsville Parkway Address: .;to 120 City: Burnsville, N 55337 State: Zip: Phone: ! c~ ILIQ OO C Contact Person: SdL,p L TYPE OF WORK New Replacement Additional Alteration Demolition Description of work: 4 _ NOTE: Both roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector or one of the Planners 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 * HVAC units must be screened Heat Pump _ Under / Above ground Tank Install / _ Remove) _ Other When installing/removing tank(s), call for inspection by Fire 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) $ TOTAL FEE COMMERCIAL FEES: $70.50 Underground tank installation/removal OR Contract Value $ x1% $50.50 Minimum (includes State Surcharge) ~ - If Permit Fee is less than $1,000, surcharge is $.50. Permit Fee - If Permit Fee is > $1,000, surcharge increases by $.50 for each State Surcharge $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). $ TOTAL FEE 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 witho a permit; that the work be in accordance with the approved plan in the case of work which requires a review and approval of plans. 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 PERMIT C CY<)_ CITY -00 EAGAN 3830 Pilot Knob Road PERMIT TYPE: BUILDING Eagan, Minnesota 55123 Permit Number: 0 21913 (612) 681-4675 Date Issued: 09/08/93 I'I SITE ADDRESS: 3791 BLACKHAWK RIDGE PL LOT: 22 BLOCK: 2 BLACKHAWK RIDGE 2ND P.I.N.: 10-14401-220-02 DESCRIPTION: Building Permit Type BASEMENT FINISH Building Work Type NEW UBC Occupancy R-3 REMARKS: FEE SUMMARY Base Fee $35.00 Surcharge .50 Total Fee $35.50 CONTRACTOR: M MN - A p p l i c a n t- 3791 BLACKHAWK RIDGE PL EAGAN MN 55122 (612)452-3349 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 Mn. Statutes and City of Eagan Ordinances. C 7;1~~T/PRMITEE NATURE ISSUED BYi SIGNATURE B~ ~ R T INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: BUILDING 3830 Pilot Knob Road Permit Number: 021913 Eagan, Minnesota 55123 Date Issued: 09/08/93 (612) 681-4675 SITE ADDRESS: LOT: 22 BLOCK: 2 APPLICANT: 3791 BLACKHAWK RIDGE PL MCGUIGAN SHAUN BLACKHAWK RIDGE 2ND (612) 452--3349 PERMIT SUBTYPE: TYPE OF WORK: BASEMENT FINISH NEW INSPECTION TYPE .DATE INSPTR. INSPECTION DATE INSPTR. FRAMING FINAL FIREPLACE i F 'C RtAL i 1 VA1 It ~ LH ~ E f ~ 'ITY OF EAUAN PERMIT # Ci 93 BUILDING PERMIT APPLICATION ~ . S E P G 3 1993 681-4675 } R ^7 SINGLE & MULTI-FAMILY 2 sets of plans, COMMERCIAL 2 sets of architectural'& structural plans, 1 set of specifications, 1 copy of energy calcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month- in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. Date e r/ O 3 / J99 3 Valuation of work Site Address:/7q I-~~ai,~~ I 1 e STREET Su E # Tenant Name: (commercial only) LOT BLOCK _,Pr SUBD. Q] V__k R 14cie- P . I . D . Q td AAI 011 if Description of work: Fivt~ '~..~0.sern The applicant is: V Owner ❑ Contractor ❑ Other (Describe) & 457Q Name WCG Phone Property LAST FIRST - Owner Address 79 I 1B I ae-k a u L Ida e Y~ ~ac_4Z STREET # STE # City _[~Qncz)A State M i~ Zip Company Phone Contractor Address License # Exp. City State Zip Architect/ Company Phone Engineer Name Registration # Address City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read this application and state that the information is ,,orrect and agree to comply with all applicable State of Minnesota Statutes and City of agan Ordinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging a16 Basement Finish ❑ 02 SF Dwg. ❑ 07 4-Plex ❑ 12 Multi. Misc. ❑ 17 Swim Pool is ❑ 03 SF Addition ❑ 08 8-Plex ❑ 13 Garage /Accessory ❑ 18 Comm./Ind. ❑ 04 SF Porch ❑ 09 12-Plex ❑ 14 Fireplace ❑ 19 Comm./Ind. Misc. ❑ 05 SF Misc. ❑ 10 Multi. Add11. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE 31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) Basement sq. ft. KWCC System (Allowable) 1st Fl. sq. ft. City Water UBC Occupancy 2nd Fl. sq. ft. PRV Required Zoning Sq. Ft. total Booster Pump #F of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code Depth On-site sewage SAC Code t APPROVALS Planning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ Site ❑ Footing ,0 Framing ❑ Insulation ❑ Wallboard Final ❑ Draintile ❑ Fireplace Permit Fee Valuation: $ Surcharge Plan Review Livprse MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment P1. Road Unit Park Ded. Trails Ded. Copies Other Total. SAC % SAC Units r 1990 BUILDING PERMIT A ICATION CITY OF EAGAN SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL 2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL 3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS 1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS 1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS # OF RENTAL UNITS # OF FOR SALE UNITS PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY OF MONTH IN WHICH REQUEST IS MADE. LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED. NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED. PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED. PERMIT MUST SHOW A LICENSED PLUMBER. $EP 1 3 RECD *~04k r To Be Used aaFor: Valuation: Date: Site Address V/ Init 1et00t 11 kA OFFICE USE ONLY WOW, WU;fp P..0 Lot Block (i 1~~t 0 00 r~ FEES Occupancy FZ-3 M`1 c7 Parcel/Sub 7AConst F- V- t-4 I Bldg. Permit ,N 1T~~t ~ % 'f Allowable V- N Surcharge C~ Opener WQA # of stories Plan Review Length r7q W SAC, City / •C~O Address ?2 Depth SAC, MWCC 0 10'07 S.F. Total Water Conn 626,130 City/Zip Code Footprint S.F. Water Meter ~0 14)~ Acct. Deposit 30, Phone On site sewage- S/W Permits T On site well S/W Surcharge -0 Contractor MWCC System v' Treatment P1. 252,0 0 City water -Z Road Unit '355,0 Address PRV ✓ Park Ded. Booster Pump Copies City/Zip Code SUBTOTAL APPROVALS Penalty Phone Planner TOTAL Council Arch./Engr. Bldg. Off. Variance Address City/Zip Code Phone # Be) GaRA&Z ► -2- (2q) QX 15, s7- 14z x 2G 10 9 2 a~ • J+ -2 y -L + )~"G?~ _ ~"72 2, 032 - 50+ f Tr r 5, 67 1- it D ><< + 88.51) 591•JJ~ 3, >`71 •UJr~ C s~~ IyS, ZNp ~ (',T z-t 12 ~ x4) Y- C- I r) 67 0 qtr-11 ju i ut 1n :.gib 10: J HMES R HILL !NC- TEL NU:-612884-9518 #44u P02 SURVEYOR'S CERTIFICATE MIMMOMOW DESIGN III OULD. 4, '~.17~ € of eo ~ kp 'kF pr ~Ry ~ `d . to \2 ti`s ssp 4f 25 1~ 1 835.6 54.0 ; i to 60.9 ~1 I .cam-~,- t c+ 9o O t 41.0 d*a 't 10 l LOT 22 1 949A 1N p1 BLS ~ppO 59 wy- .1 .T2 t50 ~T X1.0• • DENOTES PROPOSED SURFACE DRAINAGE 0 DENOTES IRON MONUMENT SET SCALE: 1 INCH ! 30 FEET • DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR - 944.3 FEET X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR - ?36.c. _ FEET (000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - b44,7 FEET WE HEREBY CERTIFY TO MONTGOMERY DESIGN & BUILD THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF: LOT 22, BLOCK 2, BLACKHAWK RIDGE 2ND ADDITION, ACCORDING TO THE RECORDED PLAT THEREOF,DAKOTA OOUNTY,MINNESOTA. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. AS : SURVEYED BY ME OR UNDER MY DIRECT SUPERVISION THIS 10 TH DAY OFSEPTEMBER , 1990. PROPOSED GRADES SHOWN WERE SIGNS ES R. HILL, INC. TAKEN FROM THE DEVELOPMENT . ~ ~ A PLAN FOR BLACKHAWK RIDGE P U 2ND ADD110N PREPARED BY PIONEER ENGINEERING. BY' t~ JOHN C. LARSON, LAND SURVEYOR MINNESOTA LICENSE NUMBER.19828 cn x 'D co M 33 or- c- 0 o D James R. Hill inc. rm8n6 DM* j 0 i m ? 2 Z -4 D ` m Z PLANNERS i ENGINEERS ! SURVEYORS M O y m 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 9 612-884-3029 2 (.o 1K Z K~IgC~J1~ psLc LN p Aut,, N . 'JTCLDTnD CLI I L~I\/C1 nDC AWCDA(]C "11" rInAAMIITfiTT ZX I I\1V1\ LVI L n Y LI\n'VL V -41.11 V 1 `lINV' TG0Ma"RV rCSTnKv 0 01111 v vv 0709 WTA~nTDCC n0 ..+I ~v rrti ✓ l 11LL ✓t\ rA-I rA-\ by ""1 N 5 5 901-000n I'~I-~L iuni~v AAnn Ci AREA tl it V ADCA riv✓LL nL V v nI\Ln DCn11TDCn i\ L W V l l\ L V i TnT1~1 1.111 I ADCA 00Fn i 07n ni\Ln V•.JVV • 1 1 VIV I. Il/1 L ?L" ROOF ADCA iA01j n7(J 0 1 7 L• t t V V n l L L n 1 Y L L • V L J A -HT C\/Cn n V( t L L Y L V A W T K I n r'11.! A D A 0 7 l? 00 n wily✓vrv nIt rl v 1 L 12 Lv D n(\nR ADCA A n 10 5 V f.~'✓v n+t Lrt ~fV . IV r+ CI TnTWI- (11 ACC ADCA i in 9 i 7-0 uLl.✓llr\.I \..+Lnvv ne\Ln t i v vv I n FIRCDI Ar`C ADCA 0i ^ iFJ V 1 L+ LnVL nltl_n -1 .L. t C WA1 1 CD RAC ADCA 009 n09 0e) s_ rrnuL 1 It. 1•tL n11Ln vvv . - IJ .-+L C KICT WAt i ADCA 0A 0n 00 ~r~00 07 1 I N L I r r n L L ll i t L r i L Y L V . V V V V J L n DTM InTCT ADCA i K7 ~ 0A'D: 7 v till•t ._rv.1.u+ nl\Ln 1V+ -rvv + u F01IKID WTKInn1.1 ADCn A n • J v I I vvfv vvtiv✓vrr nt\L v T Cnl if`1n ABn\/C r~RADC 0G. naa 9 1 I VVf/~YV nVYL 4111 ✓L VV •VVV V • TOTAL TT1LL 1iD\{F_1 J.~-+L I QV t I T i E v ROOF FRAME iA~ ~ nom r, I\ ROOF I t L 1 "FL . a. . V V L ~ 0 DnnF AREA A 1770 0 NET 22 7 0 9 n V L + L L 1\ V V 1\ I rL l✓• V . TnTAI DnnC AREA 'DA vrnL Itvvl n1\L u'* SUM OF 1 i` Ar(1CC7 vUAA OF 0.-L Ar. 0vV .}Fnn:.,4,•::::::.:,{•::-:. •f: n•:.:~ n,+».:: n.~'~4•{/~••~,•.,•:. :i: rf»: t: ::::rT:..;• a . . .}:•x~as},rt;}:5:.::'s~:> fn>.:. •nr,.`•.n. .fY.:•:af ..fi4~•5... ,.r:: ~ ..,a ::•:#::ar: :v.. .....::{ati{.i}:a;{{•}:a}:C.. n.:~t •}:>.S: i:t»'•:•.+.•.... .....t.. +}:v::'vi 4 .fi......:.•riT'':ti::' ii:6: . v. n, ::::::.,•:i:•}TV.v:::::•:t•}'•}r:t-:v;.,fv:Y: a;.v,•:tC+ii:>f aVvv:}•: , n4.'',.. r , n-. fvrT::•:}::>}. nr:•}:::::... r•:::: wtG: n.v• 4v yJn 3{~ n..... .....v........ . - . +>.i~}:•}Jr „ a , :,}i: ti:r }':a}v'>C}.y: r,+v,..•, . , ..::.v.,v:::..,, 4v: v.w::::::: nvy: -.:..vriv Yr• .Y::.•f .i :awJ'J:}::::: • n Jfx:.....n....... . n .::•,.,}~e4 . .t•}.n. t•'"{,,p ,yC : 3^ fJ., r•Y• .`:•i:'fi":`~: v.......... v....,..:.?........1 vf.. r..n.n.•. .}}+T. F.... n,.......`v..r~}'•t .a •..~~.adn~, :•}v::•:,:`•`r:•:>v•..F f :'y~.•`y:. :r:T::::::::f •c:C•,• :::............,.....k . F ..'•'sr .~5 :'~FS.'3.. •:>.t•$•: x{r{::~~::>;:S::S;..:.,. : vvy>.a:::: TTf:....,a r.. f .r,::• L:;, ''>q:~':.. a: , n..., ......v..v........ n .:}++>vy ~•':v.. ~ :}.4 n{:?.:na{v: •r• v;>:y+.• • ........4;.. v..... w:::; v, :Y•n ,........n. ' v }.'i•'v.•%'in r$•::: •~I.~. v;.•v..;1~ {:;:iS'S "•'fr+i+i:+:{:.. 4 rr,• rhCv.{•„v.:: ::.h:.;{r: r., .~.Y.v fF•,.'.A..vy} 1 :}•Y.;r:;T.: 2'+ v•±r •i:T :?}lr+•}r}:}:<•:•:i? ' ry:,... a4. • : : r:•:vF' ' . 4n;:vT,' }..~•L•n '•Y.>4fJ •r:i ..~z::~'•S:f .ti; .~".•}.-t:, ~}'•;;•.::.,..:.•J••}~ +•~9~4v,••r.~~vtTr:~, 1993 PLUMBING PERAHT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 6814675 PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. TAO. FIXTURES EACHT SHOWER 3.00 WATER CLOSET 3.00 BATH TUB 3.00 LAVATORY 3.00 KITCHEN SINK 3.00 LAUNDRY TRAY 3.04 HOT TUB/SPA 3.00 WATER HEATER 3.00 FLOOR DRAIN 3.00 _ GAS PIPING OUTLET • minimum -1 3.00 t ROUGH OPENINGS 1.50 WATER SOFTENER 5.00 PRIVATE DISP. • DaLcty. iic. 15.00 U.G. SPRINKLER home under cont. 3.00 ALTERATIONS • to existing 15.00 WATER TURN AROUND 15.00 STATE SURCHARGE _ J •50 TOTAL: SITE ADDRESS: OWNER NAME: INSTALLER: k "A ov l( ADDRESS: / las CITY: STATE: ZIP CODE: 03720 PHONE SIGNATURE OF PERMITTEE y,:,;; r :.7:.: IN n.}}•.,:::•:}r:r : 3aF//•:f~.•~{?+. .wttt?{.1 itrr,.:S:ty ~;P}:t. •}rM:'rr:: is-: irv ,•:l .•+Yn+: ~•'"Sk ..-0"+.C .:tskt a tf ..>Rv Fi'•. •.:•'i. :N ....:n.::::::::.~ :::::::.::::::w::n:v:,v: .....-•v:.}:_--::: .:nv.w.v::.v:;:•::n„n•::i't.}.'•:tih:;t;?.}:t?v:•;Y..r>+•:L.. is}''' }}:tririr: ii?v:•Y:;•:v ir>{:;>v'YV?•;'r'::::i?.. n •a„ n .........,vv...... ...;yi.. v:.. . .K•: ~a #':';:::..s vr:.}::.i•:ii,+ •:r •-n•::;y•: }v:.>:v} ..•}}}\?}i'•isi~:::..r,:+':):i:::;r::::i:::iiS: t: v.•Y..Ir?•Xv. f- r. ..,U :r'i.. •+v t +N•.• n 7: 4:{fir}::;•:?: i";?x•,;.,: RS '%r, x ` I}f. r+v{•:ti i..:..:.,w:::.v::::::::::;n•::n:•:}i••i•;rii:Cii}>}:^}.?Ji: i::•}}r:::::::: v:.:}::. v.; ti'4}r , ' ...:,4 rvt,av,: ?:r,4:i•-v::+•}ii:{. 7... .....r........:.}. •:.,•:.jcv,::::,•k•.n..~„t. ~t• 'trk ,r,~~4,.:::. t•,+.LtC~'}, .tC<~:::;:7`;.. 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';;}r:it:. ...:::::~.:.:::..a;,.. :.v:.,.:r.•.,..,vr::.::+..::::xr •:.:w,?4 nw 1993 PLUMBING PERMIT (COMMERCIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN SS122 (612) 6814675 PLEASE COMPLETE FOR ALL COMMERCIAIJINDUSTRIAL BUILDINGS. ALSO FOR MULTI- FAMILY BUPLDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING U > . T. NEW CONSTRUCTION ADD ON REPAIR WORK DESCRIPTION: CONTRACT PRICE: $ FEE: 1% OF CONTRACT FEE. STATE SURCHARGE: $.50 FOR EACH $1,000 OF VVMr.r FEE. MINIMUM FEE: $ 25.00 CONTRACT PRICE X 1% $ STATE SURCHARGE $ TOTAL $ SITE ADDRESS: TENANT NAME: STE. # OWNER NAME: INSTALLER: ADDRESS: CITY: STATE: ZIP CODE: PHONE FOR: CITY OF EAGAN APPLICANT 1 Permit City of Eapn l ! 3830 Pitt Knob Road ~ Permit Fee: ~ ~ ~ ~ an MN 5572 f Date Received: Phone: (651) 675-5676 i l Fax; (651) 675-5694 f staff: t r r 2048 RESIDENTIAL BUILDING PERMIT APPLICATION j Dom' StEe A.ddress• Tenant: 3u16e RESIDENT ! OWNER Name; Phone: Address City Zip: Applicant is: Owner ° Contractor TYPE OF WORK Description of work: qtr~~ Construction Cost: LM Muhl-Family Building- (Yes NoL ) CONTRACTp I Name: Licerise Address: co: state-rs / N \L Zip: Phone: G `7([.([J30ontact Person: COMPLETE THIS AREA ONLY IF QONSTRUCTING A NEW BUILDING _ Minnesota Ruled 7&70 Catggonr 1 Minnesota Rules 7672 Energy Code • Residential Ventilation Category i worksheet . Now Energy Code Wolcsheet Category Sutxtlit ed submittsd (4 a6miaslon type) . Erwrgy Envelope Calarlabons SubmiilW In the IsM 12 months, has the City of E:aW issued a permit for a similar plan based on a nester plan? _Yes _No If yea, date and address of master plan: Ucensed Plumber: Phone: Mechanical ConVactor: Phone: Sewer & Waller Contractor- Phone: P errs a I porting: dp its that yw.. gab its We cons" d to be pabHc Arxfionrlatio~t. P0. 0, cot iris ilyrrrtalHort"m t:6e c d: YVO PWV on# feast world parr tee. to' .tire ~ tt f hereby aclmowladge that this Inforrnalion is cornpWe and amumte: that the work vAN be in conformance whh Iltp ordnaFm= and codes of the Gly of Eagan; that 1 understand this is riot a pem*, brt orgy an appleation for a permit, and work is not to start without a W n*, that ft work wiN be In 0000rdanee vAth the approved plan in the case of work which requmn a rowlaw WW approval of Vk", X ~t Y~I~dQ~, ~ A -Wicxnrs Printed Name Apptfcsnrs $t9nattlre Page 11 rot 3 NBC Knob Zoom, mw""'w 56,E (8, i 2) 01-4675 (4 A t{ 3 , , 4 ~f TYK gmi- Z' Tilt i-1NAI tlt4P ~ 1 F1~^t'~f'k aY. a .3V/~ ~ ar 4 t b _1~lwitMw _~1~'i~1l.1AIIlu ~ , JmTf"C r , f_.oo1T ~ Lyaa'"~L t'rcvyP 1.~..s y t. t r .j IP pr Orso Tom Pft. { cbnot mew, EEWA%n Fmd A 45,// YAW g. j Vii. r CASH RECEIPT VTY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE 49 { A€GEWE[? AMOUNT $ ^„it p - i - & DOLLARS fro 0 CASH ~J CHECK 1 -70 e _ _ AD r ~ . M Z)04 IP, 4 F fUNV OBJECT MOUNT x r- } Thank y ~j gy, g; 10018, ~ hNrut--payers coo Yellow- ostiry Copy K0`7"a Copy or ice Use On y. MECHANICAL PERMIT PERMIT # f' CITY OF EAGAN RECEIPT # 3830 PILOT KNOB ROAD, EAGAN, MN $5122 f1 / j 3 CONTRACT PRICE: PHONE: 454.8100 DATE. Site Address = 7 91 :Wjt0.:tTf;= Pg." t ' BLDG. TYPE WORK DESCRHMnON LotBlock Sec/Sub Res. ~c New - Mult Add-on Name Ll 21 V l l 1 'Tea 4 Comm. Repair Address ? ' c City ";a Phone Other FEES Name imnlif "Y 11)0 RES. HVAC 0-100 M BTU $24.00 Address ADDITIONAL 50 M BTU - 6.00 p City Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM -1 PER PERMn) - 1.50 EA. TYPE OF WORK COMM/IND FEE -1% OF CONTRACT FEE Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES Boiler M BTU TOWNHOUSE & CONDOS - RES. RATE APPLIES Unit Heater M BTU MINIMUM RESIDENTIAL FEE ALL ADD-ON & t REMODELS - 12.00 ' Air Cond. = M BTU MINIMUM COMMERCIAL FEE - 20.00 Vent CFM $ STATE SURCHARGE PER PERMIT - .50 Gas Piping Outlets # f F~ (ADD $.50 S/C PER EACH $1000.00 OF PERMIT FEE) Other / PERMIT FEE: ) f r. 'I 3 SIGNATURE OF PERMITTEE S/C: r y. TOTAL: { ' FOR: CITY OF EAGAN PLUMBING PERMIT For City Ilse Only CITY OF EAGAN PERMIT # CONTRACT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT# ^I PRICE PHONE 4548100 DATE: Si#e Address t- y BLDG. TYPE WORK DESCRIPTIQN Lot B ec/Sub Res. New Const. ry o Mult. Add-on Name / I , Comm. Repair Other Address c City &Ar Phone /a~ RES. PLBG. ONLY - COMPLETE THE FOLLOWING: / NO. FIXTURES WAL Name Water Closet - $3.00 $ - BathTubs - $3.00 I 3 Address' Lavatory - $3.00 O City 4'~ Phone ' Shower - $3.00 _ _ Kitchen Sink - $3.00 Urinal/Bidet - $3.00 E; FEES Laundry Tray - $3.00 COMM./IND. FEE - 1% OF CONTRACT FEE ~ Floor Drains - $1.50 APT. BLDGS. - COMM. RATE APPLIES Water Heater - $1.50 y TOWNHOUSE & CONDO - RES. RATE APPLIES I Whirlpool - $3.00 MINIMUM - RESIDENTIAL FEE $12.60_ Gas Piping Outlets - $1.50 MINIMUM - COMM.IND./FEE $20.00 (MINIMUM -1 PER PERMIT-NEW CONST.) STATE SURCHARGE PER PERMIT .50 Softener - $5.00 (ADD $.50 S/C PER EACH $1,000 OF PERMIT FEE) Well - $10.00 f PrivateDisp. -$10.00 Rough Openings - $1.50 U. G. Sprinkler System - $12.00 SIGNATURE OF PERMITTEE PERMIT FEE: STATES S/C: 50 FOR: CITY OF EAGAN GRAND TOTAL: * 0 PERMIT City of Eagan Permit Type:Building Permit Number:EA113460 Date Issued:09/04/2013 Permit Category:ePermit Site Address: 3791 Blackhawk Ridge Pl Lot:22 Block: 2 Addition: Blackhawk Ridge 2nd PID:10-14401-02-220 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Luanne Yang 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 - Michael A Zetahmeyer 3791 Blackhawk Ridge Pl Eagan MN 55122 New Life Contracting Inc. 814 Grand Avenue St. Paul MN 55105 (651) 224-3442 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink --------------, � For Office Use I • I / ��Q(, � U(�� O� �n�� I Permit#: �I' I � (l j f� � � � Permit Fee: �` 3830 Pilot Knob Road I � Eagan MN 55122 I Date Received: O � � � I Phone: 651 675-5675 � I � � � Staff: Fax:(651) 675-5694 i ________ _______ I 2014 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: ,��-� 2�� Site Address: �� Y� �ji�vl�i"L�=i�W 1�- l��t'�e �l ��ft-/�f, �JV ��t'.L� Tenant: 1�� t% � DLtl G�-�/� � �!� Suite#: E�eSit�eil#/QWt��r Name: ''°i(��;'�"�� !�'�CG�NI L�Pi/� Phone: �j J� � �.�'�'� Address/City/Zip:��t /�7�17/�/aR f;t�/� �� Z�— ` Name: License#: Cd11tC�CtOr " Address: City: ' State: Zip: Phone: Contact: Email: Type of Work —New �Replacement _Repair _Rebuild _Modify Space _Work in R.O.W. Description of work: I�-L S"fZ Glf �'�%P� ��'�`f�l� � �'v��/ U� �` ' �RE IDENTIAL Water Heater �1 Water Softener Lawn Irrigation(_RPZ/_PVB) P��r�P�' Add Plumbing Fixtures(_Main/_Lower Level) Septic System New Water Turnaround Abandonment RESIDENTIAL FEES: $60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge) $60.00 Lawn Irrigation(includes$5.00 minimum State Surcharge) $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Turnaround"(includes$5.00 State Surcharge) *Water Turnaround(add$200.00 if a 5/8"meter is required) $115.00 Septic SVStem New($10.00 per as built)(includes County fee and$5.00 State Surcharge) TOTAL FEES$ 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. o herstateonecaA.or 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 wor s 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 approva pl s. � � �A , l �{ � �� _ � � l X �� c��! � r�1�� X � ApplicanYs Printed Name Applicant's Signature I� I �a�oFFicE us� ��w�c�sy: �,��t�: Required Inspectiiins: U�der Grt�und > f�uugh-lti Air Test Gas Test Fina!` Meter Related Items: IVf�:te�°�ize �� Ra�i�r�`;l��d`', �taf�; �� ' PERMIT City of Eagan Permit Type:Building Permit Number:EA138133 Date Issued:08/11/2016 Permit Category:ePermit Site Address: 3791 Blackhawk Ridge Pl Lot:22 Block: 2 Addition: Blackhawk Ridge 2nd PID:10-14401-02-220 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Michael A Zetahmeyer 3791 Blackhawk Ridge Pl Eagan MN 55122 (651) 242-0888 Crew2 Inc 2650 Minnehaha Ave Suite 100 Minneapolis MN 55406 (612) 276-1680 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA139181 Date Issued:10/12/2016 Permit Category:ePermit Site Address: 3791 Blackhawk Ridge Pl Lot:22 Block: 2 Addition: Blackhawk Ridge 2nd PID:10-14401-02-220 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) 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 within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Michael A Zetahmeyer 3791 Blackhawk Ridge Pl Eagan MN 55122 New Life Contracting Inc. 814 Grand Avenue St. Paul MN 55105 (651) 224-3442 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA163848 Date Issued:09/14/2020 Permit Category:ePermit Site Address: 3791 Blackhawk Ridge Pl Lot:22 Block: 2 Addition: Blackhawk Ridge 2nd PID:10-14401-02-220 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Stacey Sever 3791 Blackhawk Ridge Pl Eagan MN 55122 (952) 212-3986 Apex Energy Solutions 9655 Newton Ave S Bloomington MN 55431 (651) 688-2739 Applicant/Permitee: Signature Issued By: Signature