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1501 Blackhawk Ridge Way 4. • ty l/ INSP9 CTION RECO WEAGAN PERW TYPE: 38311 Plot Kra Road Ott Nwnbor: EMM, A nnesots 55123 tie Wood: X61 A$81-4675 s t 1t` LAtKN , 111041 4491 ~~L~K1~ N~s P*V 4 r . !'eraNt t+~a. P+e~it tMaMltit - sari HVAd - dip d E FOW$dW*n PAI*V P410 P61, ter. -r r-39 .z, uJ,tP Fgepktce OMM Test Ptg. inspecW - hoary Pkwedw Rnw Pibg. A6 - Covet. Meter &VJPlen tom. RnW Do& Ftg t tax t wo . okw. (Infiftra.tt of (Orrupanry Citp of (f agan Mrvartmrut of Nualm jmwrrtwu This Certificate 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 regulating building construction or use. For the following. tse C]asifiaoan SF DWGIGAR BWg. Permit No. 378 PD _ VN THM ,3/Ml Zoning Diarid Type okra JOSEPH KMM 1 S 18133 aMW ANM S, F'ARJINGI i F A&km 1501 MAQMW R.= WAY L4, B I, M AMAW RIDGE Dam 7/24/92 sww+og Ofwa POST IN A CONSPICUOUS PLACE Address: 1501 BLAGUjAWK RIDGE WAY Lot 4 Blk I Sec/SubB)ArUj4& RIDGE These items were/were not complete at the time of the final inspection. Date: 7",2-f" ?~Z Yes No Final grade (6" from siding) Permanent steps - garage Permanent steps - main entry Permanent driveway Al Permanent gas Il Sod/seeded grass ✓ Trail/curb damage dry Porch 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. 4 RECYCLED MKA White - City copy Yellow - Resident copy Pink.- Contractor copy K 8 zeta 0 111/1 q71i(0_j-?-- /,5~ AX ~15 Request ~a e " Fire No. Rough-in Inspect' n CIA ~ ~D Required? Ready Now 0 Will Notify Inspector Yes vo When Ready? 19, icensed contractor D owner hereby request inspection of above electrical work at: City Job Address !Street. Box or ".e/o.),/,, Section No. Township Name or No. Range No. my Occupant (PRINT) _ Phon No. Power Supplier Address Electrical Con for (Company Na e) Contractor's License No. c et K Mailing Adores Con actor of Ow r Makinrf installation) '/J~ ♦ / Authorized Signature (Contract dO er Making Installation) Phone Number MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION EB-00001-08 4 ,8o ► See instructions for completing this form on back of yellow copy. do Q X" Below Work Covered by This Request; ew TypeofBuilding Appliances Wired Equipment Wired Home Range Temporary Service t.Duplex Water Heater Electric Heating Apt. Building Dryer Other {Specify) Comm./Industrial Furnace 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 TUN Transformers Above 200 Amps Above 100 Amps Signs Inspector's Use Only: TOTAL'" Irrigation Booms e s s S Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. 1, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has Final Date J been made. CA-11 el OFFICE USE ONLY This request void 18 months from 4920 1 ,c ? /4:2 ra 114? 515 0-0 J Request Date Fire No. Rough-in Inspecti y 26, 1992 Required? E) Ready Now Q-WI Notify Inspector ('1a C•XEs ❑ No When Ready? I N-eensed contractor D owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) City 1501 BZackHawk Ridge Clay Eagan Section No. Township Name or No. Range No. County Dakota Occupant (PRINT) Phone No. oe l(iiiez Rome,6 454-4663 Power Supplier Addres 220th 3t.3.0. Dakoia E ec.Lzic ta~tm~ng,ton,ON 55024 Electrical Contractor (Company Name) Contractor's License No. l'tidic ncl Uec.bz i_c 041610 Mailing Address (Contractor or Owner Making Installation) 17854-8 agilee Way Lakeviiie, A`N 55044 Authorized i e (Contra er ing Installation) Q Phone Number 892-1444 MINNESOTA STATE BOARD O TRICI THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Rp6m S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. 104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-0800 ENCLOSED. i 1NE5}~ ?_4 REQUEST FOR ELECTRICAL INSPECTION 10. 9 2 ~ 1 See instructions for completing this form on back of yellow copy. "X" Below Work Covered by This Request New Add Rep. ; TypeofBuilding Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial mace 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 1:5 / 0 to 100 Amps 41Transformers Above 200 Amps a 100 Amps Signs Inspector's Use Only: -1 TOTAL Irrigation Booms 5 Q Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MON_TJAS. I, the Electrical Inspector, hereby Rough-in ? i Date cJci certify that the above inspection has Final Date been made._ OFFICE USE ONLY 4' '.,~=gig c This request void 18 months from Control No. PERMIT 330 CITY OFYEAGAN 3830 Pilot Knob Road PERMIT TYPE: BUILDING Permit Eagan, Minnesota 55123 Number: 000378 (612) 681-4675 Date Issued: 04/29/92 SITE ADDRESS: 1501 BLACKHAWK RIDGE WAY LOT: 4 BLOCK: 1 BLACKHAWK RIDGE DESCRIPTION: Building Permit Type SF DWG Building Work Type NEW UBC Occupancy R-3 M-1 Construction Type VN Zoning PD R-1 Building Length 44 Building Width 26 REMARKS: RECEIPT iF PRV S&W PLBG GENZ-RYAN FEE SUMMARY: VALUATION $89,000 Base Fee $590.00 MISC FEES $1,610.50 Plan Review $383.50 Total Fee $3,328.50 Surcharge $44.50 SAC $700.00 SAC % 100 SAC Units 1 Subtotal $1,718.00 CONTRACTOR: - Applicant - ST. LIC. OWNER: MILLER HOMES JOSEPH 14544663 0002431 MILLER HOMES JOE 3459 WASHINGTON DR 3459 WASHINGTON DR 201 EAGAN MN 55122 EAGAN MN 55122 (612) 454-4663 (612)454-4663 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 anti City of Eagan Ordinances. i PLIC NT/PERMITEE SIGNATURE QS6UED BY. SIGNATURE INSPECTION RECORD Control No. _ 0 '13 d CITY OF EAGAN PERMIT TYPE: BUILDING 3830 Pilot Knob Road Permit Number: 000378 Eagan, Minnesota 55123 Date Issued: 04/29/92 (612) 681-4675 SITE ADDRESS: LOT: 4 BLOCK: 1 APPLICANT: 1501 BLACKHAWK RIDGE WAY MILLER HOMES JOSEPH BLACKHAWK RIDGE (612) 454-4663 PERMIT SUBTYPE: TYPE OF WORK: SF DWG NEW Y INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR. SITE FOOTING FRAMING INSULATION FINAL FIREPLACE REMARKS: RECEIPT 0 PRV S&W PLBG = GENZ-RYAN PERMIT CITY OF EAGAN 11 1992 BUILDING PERMIT APPLICATION APR 2 1 RECo 681-4675 ~LEMULTI-FAMILY 2 sets of plans, 3 registered site surveys, I copy of energy calcs. COMMERCIAL 2 sets of architectural & structural plans, I set of specifications, I copy of energy calcs. Penalty applies when typing of permit is requested,-'but not picked up by last working day of month in which re guest is made or lot change is re guested once emit is issued. Date 2 Valuation of work Site Address: STREET STE # Tenant Name: LOT L~ BLOCK P.I.D. # Descri tion of work: The applicant is: O Owner kContractor O Other (Describe) Name Phone Property LAST FIRST Owner Address STREET STE City State Zip Company Phone 66-3 8133 CEDAR AVE. SO. License # Exp. Contractor Address 1 ftRM!Ne!eN, MN 55M City #0002431 State Zip Company Phone Architect/ 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 correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: Qa~~ O r ~"a 0 vrr~vc V~7G VI\Li rnda RMIT TYPE n ❑05 Apt. Bldg O 09 Basement Finish ❑ 13 Public Fae. F Dwg. ❑ 06 Garage/Accessory ❑ 10 Swim Pool ❑ 14 Agricultural Two family ❑ 07 Fireplace ❑ 11 Res. Add./Porch ❑ 15 Miscellaneous V04 Multi-fam. T.H. ❑ 08 Deck ❑ 12 Corm./Ind., WORK TYPE X 31 New ❑ 34 Repair ❑ 37 Demolish ❑ 32 Addition ❑ 35 Tenant Finish ❑ 99 Undefined ❑ 33 Alterations ❑ 36 Move GENERAL INFORMATION Const. (Actual) V- N Basement sq. ft. MWCC System (Allowable) •V - N 1st Fl. sq. ft. City Water UBC Occupancy R'3--1 2nd F1. sq. ft. PRV Required YES Zoning PD R-k Sq. Ft. total Booster Pump # of Stories Footprint Sq. ft. Fire Sprinkler Length ~y On-site well Census Code Depth On-site sewage SAC Code 1 APPROVALS Planning Building ( Assessments Engineering Variance REQUIRED INSPECTIONS ❑ Site ❑ Footing ❑ Framing ❑ Insulation ❑ Wallboard ❑ Final ❑ Draintile ❑ Fireplace Permit Fee 590.00 vahat;an: s 821, 000 ~ Surcharge 1441,50 Plan Review _3 g3 0 GA1 G 2 22xZ2. '#$4'X 16- 9,74L Micense SSMT: U~(x26 j, ~1;1 N'Q 1ST .'A 17,160 7no.o o . Water Conn. 100,a0v0 1s7° ~taoR: 41IX 4 = 11''q Water Meter 00 Z .)c 1 & = ,z y Acct. Deposit 3000 y S/W Permit 30,00 S/W Surcharge .50 2~i x S3= (3, 653 Treatment Pl. 300,00 Road Unit 38C~.oo $ lb 557 Park Ded. , Trails Ded. Copies Other Total: .SAC % 100, SAC Units L MINNESOTA STATE ENERGY CODE CALCULATIONS ` BASED ON CHAPTER $ OF THE MODEL. ENERGY CODE - 1983 EDITION Adoption Effective I/l/84 Owner Phone Date' Site Address ACkq,c{,~~ Contractor 2. L} Phone Building Classification: Type Al (Single Family b Duplex) ~Type A2(Residential) 0 stories or less NOTE: Completa pages3 and 4 first. (Other) I (Over 3 stor(es)- _ _ ; GENERAL INFORMATION ; 1. Building Perlmeter5lli\61~ 6 M~11_ft. N 2. Wall height (ground to eave) ft. 3. l. 'x 2. (above) gross wall area.w t. 4. Building dimensions (L) X (W) Zrd ft.2 roof 8 floor area 5.• Square foot area of rim Joist - Floor joist size (2 x 119? ) - X Perimeter a Rim joist area - , 7✓ ft2 12 1 t 6. Doors - Area Thickness in. U factor) Type of Construct on Perimeter ft. Manufacturer 7. Total door's perimeter ft. 8. Windows: Manufacturer lN1l~, ~'t'Ea State approved U factor TYPE SizE AREA (Ft.2) NUMBER OF TOTAL FEET 2 EACH UNITS I I ~ 9. Total ft.2 Glass 10. Fireplace area: Width X height X Ft•2 11. Exposed foundation: Height X Perimeter cal X IA Ft.2 COMPLETION OF THIS FORM IS REQUIRED FOR ALL AN MAJOR REMODELING AND BUILDINGS BEiNE MOVED WHERE ENERGY, OTHER THAN THE MINIMAL CODE ALLOWANCE, IS USED. 12. Framing :area o 10~ of grass wail area. _ 13. Gross v@1 1 area f t•2 Y Window area A ft.2 U windows = U x A Rim joist area A ft.2 U rim Joist = U x A r Ooor area A * !A 1+0 ft. U door area = U -x A = 1 10 ' area A L~ Z Q' ft. 2 U f PA002% e U x A= + I . - Exposed foundation A ft.2 U foundation = O U x A • Framing area A 'S( '-1`5 ft.2 U framing area x A = Net wall area A : ---ft. U wall U x A (13B) TOTAL . . . . . . . . . . U x ZD 1 14. Gross wall area z 0.11 (A-1 single family S duplex allowable U X A/Code (13. above) . x 0.23 (A-2 other residential) x .23 (Other buildings) x .28 (Over 3 stories) BTUH Must be larger than A O + x U ~4~~ .t _ F. 138 above 15. Ceiling framing area (Af) equals 10% of ceiling area or the. same as) 15A. Gross ceiling area w (L) x (W)_ ft•2 15B Joist area (Af) W"ft ceiling area - ' Zb ft.2 15C. Net ceiling area (Ac) (15A - 15B) ft.2 U ceiling x A cY 1 b2-~.- _ x U framing x A f= x~ ' 150. TOTAL'U x A CO+J 16. Ceiling area (15A),x 0.026 (A-1 single family S duplex - code allowable U x A x 0.033 (9-2 other residential). x 0.06 (other) ra4 BZUH Mist be larger than -150 (above) 5A) lz> U V lz 5 F (or the same as) NOTE: Use U and A values obtained from pages 1,-3 and 4. CERTIFICATION; I hereby certlfy'that'1'have calculated the "U" factors and "R" values fiere n an tk; t the building here described meets or exceeds the State of Minnesota Energy Conservation Act. ' Date Signature C. Zoe ► f~ \A4 Iit 2~X ~v = 1119 11tX(po is . I~ f~ f; tneide air film .68 ' WALL, Interior wall (Wall) U SECTION Insulation Sheathing •~!.*~p Siding 1 Outsldo air Mm .17 R TOTAL Inside. air film .68 STUD Interior wall • 45 SECTION 4" stud Ry ~'a3 (p~~l (Framing) U Sheathing Siding Outside alt' film .17 C5 1 A TOTAL C.~ • y t Interior wall SECTION. Insulation all U « t z Exterior wsll cover Exterior air, film' R -..17 R TOTAL Win- W 4,MT Interior air film Rs .68 ( Insulation t_[• Da ) RIM VA U ~t+-- '1 inch soft wood (Rim , . Jolsr Joist) ' Sheathing Exterior wa~I covering App Exterior air film R= .17 R- TOTAL Z Interior air film R= .68 , ~ Inaulatlatt Foundation (rdn.) U a a Exterior air film R° .17 X61 co II R TOTAL Exposed block ' ._.~Grade R `VALUE ~YLUE FRAMING CEILING 0.61 Air Film 0.61 NCO. Q Insulation AJ Joist . Cp Ceiling . r 0.61 Air Film 0.61 4 x• ~ ~ ~.P Total R 1 0 Z-~ U - if ~ o Z.Z. s ' FLAT ROOF OR CATHEDRAL CEILING R V 1ue R VALUE FRAMING CEILING 1 _ 0.61 Inside air film 0.61 Ceilin Joist ?stud ' Insulation Air space Roof decking ' Insulation _ Built-up roof ` 0.17 Outside air film 0.17 Total R - R~U Jindow infiltration .5 cfm/lineal foot of crack tesidential door infiltration 0.5 cfm/square foot or door and minimum code requirement lon-residential door infiltration 11.0 cfm/lineal 'foot of crack lb 12" concrete block no insulation = .47 R 2.1 1b 12" concrete block insulated cores = .26 R 3.8 J5 12" 1 i ghtwe l gh t block = .32 R 3.1 1b 12" lightweight block insulated cores = .12 R 8.3 J single glass - 1.13; with storm window .54 1 double glass - ,55 i triple glass -'.41 All exterior walls and ceilings must have a vapor barrier (0.10 perm max.). vapor barrier must be on the inside (heated side) of wall. japor barriers of the polyethelene thin film have no R_value. 4. PERMIT CIT)f OF EAGAN BUILDING 3830 Pilot Knob Road PERMIT TYPE: Eagan, Minnesota 55122-1897 Permit Number: 030520 (612) 681-4675 Date Issued: 07/25/97 SITE ADDRESS: 1501 BLACKHAWK RIDGE WAY LOT: 4 BLOCK: 1 BLACKHAWK RIDGE P.I.N.: 10-14400-040-01 DESCRIPTION: Building Permit Type DECK Building Work Type NEW Census Code 434 ALT. RESIDENTIAL REMARKS: FEE SUMMARY: Base Fee $50.00 Surcharge .50 Total Fee $50.50 CONTRACTOR: RIVER: A p p l i c a n t - HENRY 1501 BLACKHAWK RIDGE WAY EAGAN MN (612)886-9682 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. A CANT/P RMITE SIGNATURE'" ISSUED . SIGNATURE 2422 Enterprise Drive Mendota Heights. MN 55120 >iC p~~N~ (612) 6n1-1914•Fox 681-9488 LANG suw+tYORS • OvIL ENGINEERS ~r en+ Br~1~~rtE3Q~'`1 LAND PLANNERS - LAN45CAPE ARCkriECTS 525 Highway 10 NorthOOSt 5joine, w4 55434 * * * tsiz) 783-1860*Fox 783-1883 Certificate of Survey for: Joseph M. Miller onstruc Lon Co. House Address: 1501Blackha k Ridae Way Eagan. MN Model Name: Camfield 3 N 89'13'58" W 8>i, 123.09 ° 5 / I x Si68~3 / d a W4 L*. / ~ w s O t Iv DF c4. c,T. cp x 68 f DS E `1 • IY pROn i.2 qolb 06 coi, 04-0 do / GJ 8g3~rf ✓ / ~Hr j t i J3 J 2t. S0 ~YFC, 4 es/ rS GE <0 s t $e; ~ t ~9 I ~l ~ass.a 1 i~ 1~ T`A 866.6 Q 60. 00 4 c1<~ \ :~y _ WK RID G t s=, Z- n x 900.0 Denotes Exlstln4 Elevation DAns3ncr=n unI Icc P*I rrki,&T1nM PERMIT CITY OF EAGAN BUILDING 3830 Pilot Knob Road PERMIT TYPE: 030519 Eagan, Minnesota 55122-1897 Permit Number: (612) 681-4675 Date Issued: 07/25/97 SITE ADDRESS: 1501 BLACKHAWK RIDGE WAY LOT: 4 BLOCK: 1 BLACKHAWK RIDGE P . I . N 10--14400--040-01 i DESCRIPTION: SHED Building Permit Type MISCELLANEOUS Building Work Type ADDITION Census Code 434 ALT. RESIDENTIAL I REMARKS: FEE SUMMARY: Base Fee $62.25 COPIES (3) .75 Surcharge 1.00 Total Fee $64.00 Subtotal $63.25 CONTRACTOR: TIVER: _ A p p l i c a n t HENRY 1501 BLACKHAWK RIDGE WAY EAGAN MN r (612)886-9682 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. APPLICANT/PERMITEE SI NATU ISSUED BY. S MATURE ( S EN IAL) *-441 ' 1997 BUILDING PERMIT APPLICATION RE ID T O j CITY OF EAGAN 3830 PILOT KNOB RD - 55122 681-4675 New Construction Reouirements Remodel/Repair Reouirements ♦ 3 registered site surveys ♦ 2 copies of plan ♦ 2 copies of plans (include beam & window sizes; poured find. design; etc.) ♦ 2 site surveys (exterior additions & decks) ♦ 1 energy calculations ♦ 1 energy calculations for heated additions ♦ 3 copies of tree preservation plan N lot platted after 7/1/83 required: _Yes _ No DATE: oZ ^ Z -7 CONSTRUCTION COST: roo - o0 DESCRIPTION OF WORK: 67o as'r~c `an m a`` T ~1 STREET ADDRESS: /So/ lr'/a<<f .~/•~u'~ .P~s9 e ,~~IO tTf LOT 44 BLOCK / SUBD./P.I.D. PROPERTY Name: Phone OWNER FMT Street Address: ~M.~ al-Ait-RUJI Lila Q,10 City: L,OM State: , 9,6Z Zip: SSr Z-,? CONTRACTOR Company: Phone Street Address: License City: State: Z I-P- - ARCHITECT/ Company: Phone ENGINEER ~~-Name: _ Registration Street Address: . City: State: Zip: Sewer & water lice?raed plumber (new construction only): Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that l have read this application and state that the information is correct and agree to comply with all app 'cable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: ~:4" 14a OFFICE USE ONLY RECEIVED Certificates of Survey Received Yes No J U L. 2 5 1997 Tree Preservation Plan Received Yes No Not Required BY.- OFFICE USE ONLY r y BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-plex X 13 Garage/Accessory ❑ 20 Public Facility ❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace n 21 Miscellaneous ❑ 05 SF Misc. ❑ 10 _ plex ❑ 15 Deck WORK TYPE ❑ 31 New' ❑ 33 Alterations ❑ 36 Move 32 Addition ❑ 34 Repair ❑ 37 Demolition .GENERAL INFORMATION i Const. (Actual) Basement sq. ft. MC/WS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bldg t Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ 2 , Coe-). Surcharge Plan Review a r. 6Lo x' 4 0r 6 = 1,-7 912 License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies 1 I Total: % SAC SAC Units i i + 2422 Enterprise Drive * * * Mendota Heights. MN 58120 PIONEER ww SURYrMRS • CML ENG*XtRS (612) 681-1914•Fax 681-9488 * angineerrig LAND PLANNERS • LAWSCAFT ARCMTECrs 825 Highway 10 Northeast 8ioins. MN 55434 j (612) 783-18eo•Fox m-1883 * 4C i Certificate of Survey for: Jose h M. Miller nstruc •on Co. House Address: 1501 Blackhawk Ridge Way, E_aaan;MN Model Name: Camfield 3 N 891,358" w 123.09 g ~~r Oil 51 i r ! 1 x 068.3 / v ~ r 'CID B16.1 (q ~ AS~FNr ~ ! N 1.. 4 / s 865.1 / I ~,Db C L=50 9 1%i1- e66.6 8 tpF~ 4 g , 60. C)o f3Lq cj<H q INK RID GE VVA 1 --AK, 900.0Denotes Existing Elevation opnonc~n uni ACC F1 r-«e-rinm 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 GS1-681-4675 New Construction Keaulrements Rem2dol/ReRgli R gyp e~met~s > 3 registered site surveys showing sq. ff. of tot, sq. ti. of house 2 copies of plan and g@ roofed areas (209 maximum lot coverage allowed) t set of energy calculations for heated addit(cns > 2 copies of plans (show beam a window sizer, poured Ind. design; etc.) 1 site survey for exterior addillow & decks > 1 set of energy calculations > 3 copies of tree preservation plan I lot plotted after 7/1/93 DATE: CONSTRUCTION COST: T j 3 DESCRIPTION OF WORK: <-J 4 t~vlfi of STREET ADDRESS: _-5 a 1 I C aw k Rd. 1 A)a LOT: BLOCK: I SUED./P.I.D: CL Name: VPhone: ~0 5 - b8 fo 40 12Y PROPERTY LQW ti OWNER i~.~ 1$ Street Address: City gV2N State: LA J, S Company: LbYI Jl~'t t' Q07~ nQ Phone 4 4/a - 6 4 ~p (area code) CONTRACTOR Street Address: 3 113 d Kopittr ~C81 Ucense R C2.61,13,166 City FAe eLai rl e state: M!y Zip: cSS 3 ~l,~ NCH / !N ER Company: Name: Telephone area code ( ) Street Address: Registration City State: Zip: Sewer & water licensed plumber (reauked for pgw ggpglructian only): Penalty applies when address change and lot change Is requested once pom* Is Issued. 1 hereby acknowledge that I have read this application, state that the Information I c , and o"A comply with all applicabl Sfate of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY S Certificates of Survey Received Yes No AUG 2 oA99 Tree Preservation Plan Received Yes No Not Required- p~ " OFFICE USE ONLY BUILDING PERMIT TYPE 13 01 Foundation ❑ 06 4-plex ❑ 11 10-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 02 SF Dwelling ❑ 07 5-plex ❑ 12 12-plex ❑ 17 Garage © 22 Porch/Addn. (4-sea. 0 03 1 of lex ❑ 08 6- lex ❑ 13 16- lex ❑ 18 Deck ❑ 23 Porch screened 0 04 2-plex ❑ 09 7-plex ❑ 14 Apartments 3 19 Lower Level ❑ 24 Storm Damage 0 05 3-plex ❑ 10 8-plex ❑ 15 Lodging ❑ 20 Pool ❑ 25 Miscellaneous WORK TYPE 0 31 New ❑ 35 Tenant Impr ❑ 39 Gas Line Only ❑ 43 Siding/Soffits/Fascia 0 32 Addition ❑ 36 Move Bldg. ❑ 40 Gas Insert ❑ 44 Windows/Doors 0 33 Alteration ❑ 37 Demolish Bldg.* ❑ 41 Wood Stove Q 45 Fire Repair ❑ 34 Repair ❑ 36 Demolish (Interior) ❑ 42 Reroof * Give PCA handout to applicant for demolition permit GENERAL INFORMATION Const. (Actual) Basement sq. ft. Census Code (Allowable) Main level sq. ft. SAC Code UBC Occupancy sq. ft. No. of Units Zoning sq. ft. No. of Bldgs # of Stories sq. ft. MC/ES System Length sq. ft. City Water Width Footprint sq. ft. Booster Pump PRV Fire Sprinklered APPROVALS Planning„ Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MC/ES SAC = City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment Pl. Park Ded. Trails Ded. Other Copies Total: SAC Units % SAC CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT # /D I!ilIO DATE : S:DEIT,TT PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION FEES NEW CONST ADD-ON MINIMUM $15.00 ADD ON ' HVAC 0-100 M BTU 24.00 REPAIR ADDITIONAL 50 M BTU 6.00 GAS OUTLETS - MINIMUM 3.00 OF 1 PER PERMIT OWNER NAME: SUBTOTAL: SITE ADDRESS: jj%,STATE SURCHARGE: .50 ^ LOT : /71 /l BLOCK f SUBD. TOTAL: $ ~ <)sL INSTALLER: ADDRESS : 410 NEST LAKE STPEET AINNEAPOUS, ti 55403°2998 SIGNATURE OF PERMITTEE PHONE 824-266 CITY: ZIP: PHONE tOiD4ER A ZIND'USTRfWt., PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS, APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: 1% OF CONTRACT FEE. STATE SURCHARGE _ $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. PROCESSED PIPING - $25.00 LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN I L 18L CITY OF EAGAN CITY USE ONLY SUBD. PLUMBING PERMIT (612) 681-4675 RECEIPT DATE RESIDENTIAL PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL NEW CONST REPAIR/ADD ON 15.00 ADD ON SHOWER 3.00 REPAIR WATER CLOSET 3.00 BATH TUB 3.00 f~ LAVATORY 3.00 OWNER NAME: /1 C KITCHEN SINK 3.00 LAUNDRY TRAY 3.00 SITE ADDRESS : 150 1 " /J C HOT TUB/SPA 3.00 3.00 WATER HEATER FLOOR DRAIN 3.00 GAS PIPING OUT. INSTALLER: (MINIMUM - 1) 3.00 ROUGH OPENINGS 1.50 ADDRESS• OTHER =C WATER SOFTENER 5.00 L CITY: ZIP: PRIVATE DISP. 15.00 _ U.G. SPRINKLER 3.00 PHONE W. TURNAROUND 15.00 STATE SURCHARGE .50 SIGNATURE OF PERMITTEE TOTAL: $ .J` COMMERCIAL PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. WORK DESCRIPTION: OWNER NAME: CONTRACT PRICE: SITE ADDRESS: 1% OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR TENANT NAME: EACH $1,000 OF PERMIT FEE. SUITE $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE FOR: (SIGNATURE) CITY OF EAGAN CITY OF EAGAN FOR CITY USE ONLY 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT # DATE : 9~-- PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE ' FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION COMPLETE THE FOLLOWING: NO. FIXTURES EA. TOTAL NEW CONST ADD-ON MINIMUM 15.00 ADD ON SHOWER 3.00 _ REPAIR WATER CLOSET 3.00 'BATH TUB 3.00 LAVATORY 3.00 3 OWNER NAME: JOE MILLER CONSTRUCTION CO. INC. KITCHEN SINK 3.00 SITE ADDRESS: iO / --t LAUNDRY TRAY 3.00 - zi-l HOT TUB/SPA 3.00 ! WATER HEATER 3.00 LOT: BLOCK SUBD. FLOOR DRAIN 3.00 GAS PIPING OUT. INSTALLER: GENZ-RYAN PLUMBING & HEATING CO. (MINIMUM - 1) 3.00 ,33 ROUGH OPENINGS 1.50 ADDRESS: 14745 South Robert Trail OTHER CITY: Rosemount, MN zip: 55068 WATER SOFTENER 5.00 PRIVATE DISP. 15.00 U.G. SPRINKLER 3.00 r.:ONE 612 423-1144 _ SUBTOTAL $ ,37 ST. SURCHARGE .50 SIGNATVRE 0 PERMITTEE TOTAL: Cr?.,tIDtISTA PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OW IER NA`INE: it OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE FOR: (SIGNATURE) -CITY OF EAGAN CITY OF EAGAN FOR CITY USE ONLY , 3830 PILOT KNOB ROAD EAGAN, MN 55122 PERMIT # PHONE: (612) 454-8100 RECEIPT # 4 DATE 4#11'i' ttM'' : 8 q 1!73 PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS & TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT. WORK DESCRIPTION FEES ~I NEW CONST f/ / ADD-ON MINIMUM $15.00 ADD ON HVAC 0-100 M. BTU 24.00 REPAIR ADDITIONAL 50 M. BTU 6.00 GAS OUTLETS - MINIMUM - 3.00 OF 1 PER PERMIT OWNER NAME: ~ ! \Vv (n-~~5~ SUBTOTAL: SITE ADDRESS: ~ C STATE SURCHARGE: .50 ~L.~~~.C~+ i LOT: BLOCK ' SL'BD. TOTAL. $ . 3 INSTALLER: fit' ADDRESS NATURE OF PERMITTEE CITY: ZIP: PHONE = . i~z kz C, 0 !fE :IAL TDO:STRUI? PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/ INDUSTRIAL BUILDINGS, APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT. CONTRACT PRICE: FEES OWNER NAME: 1% OF CONTRACT FEE. STATE SURCHARGE - $.50 FOR SITE ADDRESS: EACH $1,000 OF PERMIT FEE. PROCESSED PIPING - $25.00 LOT: BLOCK SUBD. $25.00 MINIMUM FEE. INSTALLER: CONTRACT PRICE x 1% $ ADDRESS: STATE SURCHARGE $ CITY: ZIP: TOTAL: $ PHONE (SIGNATURE) FOR: CITY OF EAGAN ill I I , ct,a i r,gY 1 r19 r.::1!+:~ f' t_I 'K 2422 Enterprise Drive Mendota Heights, MN 55120 PIONEER I,.AND SURVEYORS • ClVII,: ENGINEERS (612) 681-1914-Fflx 681-9488 engineers g LAND PLANNERS • LANDSCAPE ARCRITECTS e2:5 Hway 10 Nort igh M heost 8lahie, N 55434 (812) 783-1880-Fox 7$3-1$$3 Certificate of Survey for. Joseph M Miller- Construction Co. House Address: 1501 Biackhawk Ridge Way. Eagan. MN Model Name: Comfield 3 N 89'1358" W 123.09 41 01 t] V / p` lr +I ! (f / 5t ~ t / $ft $,77 C~ yC ~C5 Ift-, Ouse 1rc t~qp~ 0 tO a F4': • > 1 i M t sss.f, ~L ~S 0 ~ G8 1 50.Op . ~r, \ \ 11 " t i RLAckH ~7 v~ A WK Rro G WA X 900.0 Denotes Existing Elevation PROPOSED HOUSE ELEVATION X®RE0) Denotes Proposed Elevation Lowest Floor Elevation: 54.4.-V- Denotes Drainage & Utility Easement Top of Block Elevation: $109.63 Denotes Drainage Flow Direction -o- Denotes Monument Garage Slab Etevation:869.3 B Denotes Offset Hub Bearings shown are assumed LOT 4 BLOCK 1 BLACKHAWK MIDGE DAKOTA COUNTY. MINNESOTA I hereby certify that thi- Survey, pl,n or report vVas 'prepared by me t under my diteCt sUpervision and that 1 am duty Registered land $urveyot y a.I c' under the Wrs of the State of Minnesota, Dated this h tiay of r• A.D, 39 , (--.FIS@f( `tu ~r5•o~-f EI'f~, c7,5T't~, / inch...- 3 feet LScale: 0- ROBE , • i L.5, RE-0. NO, 14941 16 39 92187.00 a~ 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PICOT KNOB RD- U12 881-4675 s * j ' 3 registered site sunieys ♦ 2 of plan W 2 copies of plans (tndude beam & window sires: pour pct, ind: design: etch « 2 site surveys exterior additkm & decks n1 f' t anecgy glWlatTOtli t elleW CiIGUIaNOns for belted additiQBE ♦ 3 copies Ot t►ee p vatioR p1aR it tot pled" after 76th r,~ r r ti a x► mquireckYes f~C r 4 a rAJ r ~~','Li ~ ~ ~ , rid' s,f .ik~,' r t ~,~y'• ~^fjS N~y'h'i' M~+`~.~ ~~r; ~ ~ ~ r CONW 4.' p, w i F- i ~1Y iryj. 5 r StateZip:P ~i~; r,?1 K.~t ~ ~t '~~4fi 1. tz i '`i 5: 'hw °'~"`r i+~',`lr re~~if''~~4~ w ` >e~Msrylrnr~'rS~" Sewer 8~ water 6cer~ed plumber (new const .ncbon ontyj Penalty applies when address change x-~.f ~~ri 'yr f4 and lot change are iequested`once permit is issued 1. '.gF 'z f~'t _tj l 11141 - S t' ~L F.. l.'y'. ~ : ~ • , a ~F +~.7~~y'~y~~~~ir I hereby acknowledge that l have read this application and state that the information is correct and agree to comply with all app 'cable State of Minnesota Statutes and City;of Eagan Ordinances.' Signature of Applicant: OFFICE USE ONLY RE cEI`jED -Certificates of Survey Received Yes No J U L 2 5 1997 Tree Preservation Plan Received Yes No Not Required BY: OFFICE USE ONLY BUILDING PERMIT TYPE R o 01 Foundation a 06 Duplex T o 11 Apt./Lodging a 16 Basement Finish o 02 SF Dwelling a 07 4-plex , . o 12: Multi Repair/Rem ca 17 Swim Poole Q 03 SF Addition Q 08 i 8-plex: `a 13 Garage/Accessory 20 Publiic Facilit~r a 04 SF Porch o- 09r' 12-ptex A . o.,14 Fireplace , of 2t Miscellaneous " a 05 ,-SF Misc ~ 10 plex-u j~ I III 1 ~ lttE3a-~ p G .r, a i ~ r- i F' ti4~ ae Conn ~ ~ ti e~a#~~ w ~ ~y y fs s `}r ~ ~ i8ter.M@t8r?ct t. t a r ; s v~; %5►cct: Deposit `M , SlW Permit y. S. Surcharge ~Jreatment Pt Road Unit :Park Ded. Trails' Ded Other Copies Total: % SAC SAC Units µ 71 INSPECTION RECORD Cam` OF EAGAN. 3830 Not Knob Road` PEfT TAPE: ;~3 Eaten,-,Minnosota 55122-1897 errri Numb: , : Efate issued: (612) 681-4675 r° WE ADDRESS: I OT 4 t. ort 1, APPLICANT: r t-ACYRA IF MA WAY ON "Ey ~ OLACK0444V 0100F (fitz) "86-9682 PRE .a' w TYPE OF WORK: 0r cA1PTI014 N ~ ~ a ~Xwlff W, t, r , fi , 1Pet~nit No. Pe►tnk flofMC ' Defe ELEC'TFW PLUM" H ftMpirbll o agile Cosh FOODS lA j1 FOUNP, FPW" /old ' Sf V I rt PLUMOdU PL1 4 AM TEST tit HEATING GAS SVC TEST INS GYPBOARD FIREPLACE (PLACE AIR TEST FINAL PLBG fJ. FINAL HTG ORSAT TEST BLDG FINAL SSW R.I. BSMT FINAL DECK F rO DECK FINAL INSPECTION RECORD CITY OF EAGAN PERIT TYM: 04 :Pilot Mob b Road Permit Number: , i_agam.Knne+sota 55122-1897 Date Issued: t 1 X61 65~=4675 , _ . 44110 84JI, 01 0I i t APPLICANT: „M ?PI S: 04 t x 01,#Ajrr HA WY WAS tt fir," y PSUBTYPE: TYPE OF WORK: NEW t~ f"Al Permit M06, POFM#t l#Otdar Teiephono # ELECTFi a PL,t11IMG hea t Dew CoFAhlm% fooTNIGS FOLD FRAMING POOOFM F[ik+l~8 AAR TU T ROUW a HEATM F Qm TEST INSM GYPBOARD i F FII#CE AIR TESTCE i FINAL PIRG FINAL HTG ORSAT TEST SIDG FINAL SSMT R.I. SSMT FINAL DECK FTG al DECK FINAL . G~' CITY OF E.AGAN CASHIER. JS TERMINAL. NO: Er`99 TRATE-. 08/13/99 TIME: i0:1.2:08 ITS a NAME". LON SMITH ROOFING tz CONSTR 3210 9001 1501 BL.ACKHANK 37.80 2J,55 9001 1.501 BLACV HANK 0.50 3210 9001 36faO WOODTHRUSH 83.2!; 2155 9001 3660 WOODTHF' USH 1.50 :3210 9001 2070 FLINT TAR 153.25 2155 900J. 20'70 FLINT DR 4-.00 28Oe30 Total Receipt Amount USER ID a JAN CITY OF EAGAN CASHIER: S TERMIINAL N(,)-. 58 DATB 07/RB/97 TIME: 0:5206 1D 1: 320 900i 001. RD 5().0Q 4155 9(100 00i BL..C l'•f V RD 0.50 300 900i 001. YKA CK11,1411-f. 62.25 ?05 9001 001 EL_t;F:EW 1°tD :l.0(:) 3430 9001 1.'::OJ. B1 CI-1-INK RD (:)..75 Total h USER !Du NANCY TERMINAL, NOH 58 DATEn 07/28/97 TIME: 00204- 1D 1: 300 900i 1.501. P CK,1411-,. RD 51). 00 205 9001 M1. BLCKHHK RD 0.50 32iO 9001 1501 BLCKHWK RD 62.25 205 9001 15[) j 1~Zfj 43015W Total Receipt Amount- H4.50 USER ID; NANCY PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA104487 Date Issued: 05/24/2012 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 1501 Blackhawk Ridge Way Lot: 4 Block: I Addition: Blackhawk Ridae PID: 10-14400-01-040 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 S4K $103.25 0801.4085 Valuation: 4.000.00 Surcharge - Based on Valuation S4K $2.00 9001.2195 Total: $105.25 Contractor: - Applicant - Owner: New Windows for America Henry Ung 609 W County Rd E 1501 Blacldiawk Ridge WaN Shoreview NIN 55126 Eagan MN 55122 (61)203-0149 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 jg 00 Use BLUE or BLACK Ink --For --O ffi-ce--Use---------- i I x l I CJ J I City of Eatd i Permit#: - I Permit Fee: S~ 3830 Pilot Knob Road /0- Phone: Eagan MN 55122 Date Received: CI (651) 675-5675 I I Fax: (651) 675-5694 i Staff: 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 6Z.-Ls f 2 Site Address: .1 S 0 I B PtwX Unit Name: H ~_{17tz!4 Js oc~ I~ U I,) C, Phone: (e ~o ( 4 (4 RESIDENT / OWNER Address/ City /Zip: J Ut- t~ti.~a~ Aru.a YrtV .SS l~ Applicant is: Owner ontractor Description of work: E` 0~ 4 TYPE OF WORK Construction CostAQ0,e)-1o1- Q7 Multi-Family Building: (Yes / NoK) Company: 0-© h ~~~Co to act: ~S(~ 3 CC) - `7 Lt R` t Address: l3SS 0F_ _tl.)- ScRc~o( City: tJt'A-~~JY1( CONTRACTOR J Q 1 Zip: SCI Z Phone: r 3 1 C9 r State: Y(Q (oS License 3 gbp~a Lead Certificate l 2_9 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to a 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.gopherstateonecali.oM 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 E\-A ~ _ Ps 'IM x Applicant's Printed Name App icant's Sign re Page 1 of 3 Use BLUE or BLACK Ink For Office Use I I Permit City of Ea~, ~ I Permit Fee: 3830 Pilot Knob Road I y Eagan MN 55122 Date Received: j Phone: (651) 675-5675 Fax: (651) 675-5694 i Staff: - - - - - - - - - - - - - - - - J 2012 RESIDENTIAL BUILDING PERMIT APPLICATION Date: I!7 2s Site Address: /50/ & h p wK 'Ri kotj Unit Name: / SOcQLA PS Phone: LEI " l(, ( 4 { RESIDENT I OWNER Address / City ! Zip: SL' I w t~~,Qc ~N• SS►~Z i s Applicant is: Owner >cContractor " _ \ r TYPE OF WORK Description of work: ~C Pst~ t~ U + z { 'L t` -2 0 c, l , U. L o Construction Cost: S 3 Multi-Family Building: (Yes Company: ST_)Ie" VtkW?-Q_ -LL- Contact: 4.Sg-L CONTRACTOR Address: ~3SSC env d~v~_I~o s~~~~. -)D( City: State: b~c~~~c~lgldg- O Zi p: SS lZ-~ Phone: 1° 3 g^ i License (~~3$g 60 Lead Certificate S If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: S 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 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 1.~c k?ice t" LA T klY x Applicant's Printed 'Name Applicant's Sig ture Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA112885 Date Issued:08/26/2013 Permit Category:ePermit Site Address: 1501 Blackhawk Ridge Way Lot:4 Block: 1 Addition: Blackhawk Ridge PID:10-14400-01-040 Use: Description: Sub Type:Reroof & Siding 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. 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 - Henry Ung 1501 Blackhawk Ridge Way Eagan MN 55122 (612) 562-3897 Storm Guard Restoration 1355 Geneva Avenue North, Suite 201 Oakdale MN 55128 (651) 738-1698 Applicant/Permitee: Signature Issued By: Signature