Loading...
2153 Cedar Grove Tr lc~ gs~ 1r~,~1. Use BLUE or BLACK Ink For Office Use I Permit#: ~ I = City of Ea an ?'y L~ I ^ 3830 Pilot Knob Road Permit Fee: D ,Sg 1 Eagan MN 55122 I bl I I Phone: (651) 675-567'- 1J i I Date Received: - Fax: (651) 675-5694 1 Staff: 1 t-----------------1 2011 COMMERCIAL BUILDING PERMIT APPLICATION 142.9' B Rev--re- Date: 4 LI5&- Site Address: 153 C C w -o,~ Tenant Name: h I (Tenant is: New / Existing) Suite Former Tenant: PROPERTY OWNER Name: Phon~ Address / City / Zip: 10120s- 3~~, ~p ~ t~~{®a / 2 Applicant is: Owner Contractor TYPE OF WORK Description of work: _ Construction Cost: ITO CONTRACTOR Name: A) Alf PJi License Address: ~36~ ~tJl'ulq S~ 4 d if City: State: 14-2i Zip: .47 Phone: Contact: Email: RCHITECT Name: elwk Registration Address: OS^ City: State: Lhl-t.- Zip: -CE ~ /k ~ ~~-'111'hone: Contact Person: r- - ~GY14-l l~}4-i ` Email: Licensed plumber installing new sewer/water service: 4'- /ir rQ Phone #4V//,?rf,/- NOTE. Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the are trade secrefs. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utili Call 48 hours before you intend to dig to receive locates of underground utilities. wwww.ao0erstateonecall oro ty damage. 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 f w 1 r ~ ® a/r iew and approval of plans. x- x Applicant s Panted Name v~ l Applicants Si re Page 1 of 3 DO NOT WRITE BELOW THIS LINE SUBTYPES ? J S3 ~c~ar C ~,u;~2T~ - Foundation _ Public Facility _ Accessory Building J - Apartments _ Commercial / Industrial _ Exterior Alteration-Apartments _ Lodging _ Greenhouse / Tent _ Exterior Alteration-Commercial Miscellaneous Antennae Exterior Alteration-Public Facility ~Sk agqIW WORK7YPES ✓ New _ Interior Improvement Siding _ Demolish Building* Addition _ Exterior Improvement Reroof _ Demolish Interior _ Alteration _ Repair Windows _ Demolish Foundation Replace _ Water Damage Fire Repair _ Salon Owner Change Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation ~7ll~X 93. ~16 Occupancy l2 3 MCES System Plan iew Code Edition 11007 MSRG SAC Units (25 Re % 100%-) Zoning 4>P _ City Water Census Code Stories tll Booster Pump # of Units - Square Feet 101.1 07: 4 PRV y < <j # of Buildings Length -34/ Fire Sprinklers -e~ Type of Construction N71~- Width .1 REQUIRED INSPECTIONS Footings (New Building) ✓ Sheetrock Footings (Deck) -Final / C.O. Required Footings (Addition) Final / No C.O.`Rquired vl' Foundation Other: Drain Tile Pool: Footings - it/Gas.Tests -Final -Roof: -Decking -Insulation _-Ice & Water -Final ✓ Siding: -Stucco Lath -Stone Lath -Brick Framing Windows MA,;, M2 K 90.x3 &/j-3 1/4 Fireplace: -Rough In -Air Test -Final Retaining Wall pir 1161.1 Y, 90c '%I&. 39 ✓ Insulation ,/Erosion Control A~.p `~~'I X 3! of /S 3ez, G 3 Meter size: ~ Final C/O Inspection: Schedule Fire Marshal to be present: Yes ~o >7~s~ 283. t{~o Reviewed By: &14 L , Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee Water Quality Surcharge N. Water Supply & Storage (WAC) 26pD Plan Review I VI Storm Sewer Trunk MCES SAC a 3GS,D0 Sewer Trunk City SAC /Do. DO Water Trunk S&W Permit & Surcharge _ZI ~~O Street Lateral Treatment Plant r . 40 Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: md,~2✓ 5m?j. 00 Trail Dedication Water Quality TOTAL'S _ o 0 Page 2 of 3 New Construction Energy Code Compliance Certificate Per N1701,11 Building Certificate, p, building ce tifreate stall be posted in a_pcrnwiontly visible location inside »ACe erg u~~,« ro~cYa the building. The certificate sbaltbe completed by the builder and shall list information and vah,es of com nentslistedinTableNllt)t.8. Place your Malliaa Adilmss 4f the EJweltor ltroellia g Unit MODE. +429 B EAt3AN lobo ~~r~ game or lit"xaiial Co"O aci"r IklN t ktnse l f"ta(xr t_ENNAR HOMES Cemmr~nity P1aatU HERMAL ENVELOPE RADON SYSTEM Type; }check All That Apply o ~ Hy( pp!~., , .ncc: it u ~ n, t', r st tit rlrt<71 rn,•d, r r) as ~1 U 3 Insulation Location > o z w U , c w F' u. w cG a' fxher Pleace l?e~rrbe l acre t ors liufireSlalr NA Fnundutiun 1Yat! _ NA 1'eriulefer of Siuh on Crsde ~ Tdun lolst (1 nundatinuj NA r;w extenoc W Yaunat '1~' a l l 2.1 Ceiling, flat 44 NA 13aF Windows nr tantil, vered areas - ~ 38 - - Bunusrooluovcrkarn~, 33 2) ~Q T03 Desl i ibP other Insulated cress :ij VAndows & roars Ilioutina or Coolin t~u_sis ou"We Carnditionod spaces A-yera e U-Ractor (excludes s 7rghis arson door) U: 0.29 Not applicable, all duets locate in conditioned space e Solar Heat Gain Coefficient (SIWC)~ 26-30 R-vahre MECHANICAL SYSTEMS Ma -up Air Select a T)Ve Appliances I1tir;]ung$yst,! in Domesta `t'aix Ill , for t',usiinu Stisten, Not _ uired,permeoh. code ! url Tvpe NAT GAS Flectric R-41 OA i Passive ?tl~nnt;{ctitrrr- LENNOX A C?. (;M11 F1 LE Nt10 Powered Interlocked with exhaustdevice, <tatPl Ml_ 193UH045P24 13ACX018 Describe: I IIUUI w 45,((1() l nr7 in K I Other,d ribe.: Rati h or .5itc I Ic!at 1.t)s: 2,7(,45 9,184 Location of duct or system; Siluctuic'.9 p-ttt3or 92 _I { HSPI'°f Cukulaled EIIYifiane cCalin lotus: 181(4{1 ulirts " round duct OR Mechanical Ventilation System "metal duty Describe any additional or combined heating or cooling systems ifinstailed: (e.g. two furnaces or air combustion Air Satecr a Tvpe urce heat pump with gas back-up furnace}: Not required lx r mech, code Select y p e Passive Heat Recover Ventilator bIRV) Ca aei in efts: Low: Hi : f)tlicr describe: Ene 'Recover Ventilator (ERV) Capacity in cfmr. l owl High; Location of duct or system:- Continaous exhausting fan(s) rated ca i in cfins: 8t1 furnace room location of 114116), do ssrifw, MAIN/MASTER 14ATH cf n% _ ca i continuous ventilation rate in cfrns: $0 "round duct OR Total v®ntilation (inteimittent+continuous) rate in elms: 210 "meW duct i Lennar -429-8 Revere Hayfield HVAC Load Calculations for Lennar Homes Prepared By: Sabre Plumbing And Heating Saturday, August 11, 2012 Rhvac is an ACCA approved Manual J and Manual O computer program. Calculations are performed per ACCA Manual J 8th Edition, Version 2, and ACCA Manual D. 1 lit 1 11111 Will: Project Title: Lennar -429-9 Revere - Hayfield Project Date: 8/11/2012 Client Name: Lennar Homes Company Name: Sabre Plumbing And Heating Reference City: Minneapolis, Minnesota Building Orientation: Front door faces North Daily Temperature Range: Medium Latitude: 44 Degrees Elevation: 834 ft. Altitude Factor: 0.970 Outdoor Outdoor Outdoor Indoor Indoor Grains Dry Bulb Wet Bulb Rel.Hum Rel.Hum Dry Bulb Difference Winter: -11 -12.38 32% n/a 72 n/a Summer. 88 73 50% 50% 75 35 Total Building Supply UK 260 CFM Per Square ft.: SAMMI 0.146 Square ft. of Room Area: 1,785 Square ft. Per Ton: 2 332 Volume (ft') of Cond. Space: 14,950 ' Total Heating Required Including Ventilation Air: 22,645 Btuh 22.645 MBH Total Sensible Gain: 6,766 Btuh 74 % Total Latent Gain: 2,419 Btuh 26 % Total Cooling Required Including Ventilation Air: 9,184 Btuh 0.77 Tons (Based On Sensible + Latent) Rhvac is an ACCA approved Manual J and Manual D computer program. Calculations are performed per ACCA Manual J 8th Edition, Version 2, and ACCA Manual D. All computed results are estimates as building use and weather may vary. Be sure to select a unit that meets both sensible and latent loads according to the manufacturer's performance data at your design conditions. C:Vhvac orolectslLENNAR - 429-R RPVACA- RfAVA rha x Scope Net ft' Sen Lat Net San HSys tg Clg Sy ts Ton rron Area Gain Gain Gain Loss Site Dud Building 0.77.- 1......... 2,332 , . 785 6,766 2,419 CFM CFM CFM ...~T._.__.~_ _ System I 9,184 221645 200 2601 260! 0.77 2,332 1,785 6,766 2,419 9,184 22,645 200 -260! 6x9 Ventdalon 1,207 2,019 3,226 7,707 i Zone 1 j 1.786 5,559 400 5,959 14,938 200 _ t :..._c..._._ 260' 6X9 1 pining/ Living - - 442 1,325 0 1,325 5,906 79 62 1 S 2-Main Floor - Foyer/ Bath / Stairs ~ t 228 329 0 329 3,050 41 _ _ _ _ 15. 1-2 3 Front Cant 1 27 1,025 0 1,025 1,474 20 -A-YReer Floor 48' f-4 _ _..__,w.._._ _ _ 1,088 " 2,880 400 3,280 4,508 60 135: 2-5 r I ii CArWar. nrniartfil[ FMMAR - Q7Q_R Rp%i4krea_ C4n..n rhn OMNI Lennar TH .20: Glazing- 101.5 2,442 0 11 P: Door-Metal - polyurethane Core 2,274 2,274 12F-0sw: Wall-Frame, R-21 insulation in 2 x 6 stud 40 8 982 0 284 284 cavity, no board insulation, siding finish, wood studs 631.7 3,407 0 546 548 16CR-44: Roof/Ceiling-Under Attic with Insulation on Attic 1113 2,033 0 931 Floor (also use for Knee Wails and Partition 931 Ceilings), Vented Attic with Radiant Barrier, Dark Asphalt Shingles or Dark Metal, Tar and Gravel or Membrane, R-44 insulation 22C-10pm-t: Floor-Slab on grade, Horizontal board 54 4,966 0 insulation extends 4' under slab, tile covering, R-10 0 0 insulation, passive, heavy dry or light wet soil Lennar TH-c: Floor- 445 1,108 0 106 1---.1- i06 Subtotals for structure. People: 14,938 0 4,141 4,141 Equipment: 400 460 860 Lighting: 0 0 0 Ductwork: 0 0 0 Infiltration: Winter CFM: 0, Summer CFM: 0 0 0 0 0 Ventilation: Winter CFM: 87, Summer CFM: 87 0 0 0 7,707 6 Exhaust: Winter CFM: 87, Summer CFM: 87 ,707 2,019 1,207 3,226 AED Excursion: 0 0 958 . _ 958 Total Building Load Totals: _ - - 22,645 2,419 6,76 66 A 9,184 Total Building Supply CFM: 260 CFM Per Square ft.: Square ft. of Room Area: 1,785 Square ft. Per Ton: 0.146 2,332 Volume (ft) of Cond. Space: 14,950 111M -A III Total Heating Required Including Ventilation Air. 22,645 Btuh 22.645 MBH Total Sensible Gain: 6,766 Btuh 74 % Total Latent Gain: 2,419 Btuh 26 % Total Cooling Required Including Ventilation Air: 9,184 Btuh 0.77 Tons (Based On Sensible + Latent) Rhvac is an ACCA approved Manual J and Manual D computer program. Calculations are performed per ACCA Manual J 8th Edition, Version 2, and ACCA Manual D. All computed results are estimates as building use and weather may vary. Be sure to select a unit that meets both sensible and latent loads according to the manufacturer's performance data at your design conditions. C:Vhvac projectslLENNAR - 429-8 Revpm- RfAva r,u MULTI-FAMILY PLAN REVIEW FOR COMPLIANCE WITH AIRCRAFT NOISE ORDINANCE Compliance with Procedures to Ensure Submitter: Noise Impact Area Adequate Noise Attenuation: Lennar Airport - MSP International Exterior wall construction: 16305 36th Ave. No. Noise Zone - 4 Vinyl Suite 600 15/32" sheathing Plymouth, MN 55446 New Infill Residence is a "COND" Tyvek wrap 952-249-3000 use in Noise Zone 4 2x6 studs 16" O.C. R-21 batt insulation with 1/2" gypsum board Roof Construction: Plan. Reviewed: Peaked roof with manufactured trusses 24" O.C. _ Roof vents 2\5-6 C~ & ~ F- Shingles Information Submitted: 15# felt Annotated architectural drawings includin : 1/2" sheathing Blown insulation R-44 Windows: Atrium 5/8" gypsum board Swinging Patio Doors: Atrium Entry Doors: Therma Tru Mechanical Ventilation System: Skylights: N/A 2-ton central air conditioning unit Compliance with STC Requirements: Window, Door Frame, Perimeter and Other Seals: All window and door openings are to be caulked Average window/wall area for exterior wall: Q~ z with butyl-based caulk With this window/wall area ratio and STC 40 walls, windows Fireplace Chimney Cap: with an STC 30 can be used to meet the noise reduction N/A requirements; Ventilation Duct Exterior Wall Penetrations: Summa : All exterior ducts will have bends as required by the ordinance Other measures including duct bends and caulking are being taken to ensure minimum transmission of noise through the Door and Window Construction: exterior building shell so that the construction should meet Windows: Atrium (30 STC) the compatibility guidelines. Sliding Patio Doors: Atrium (30 STC) Therefore, the materials and construction as proposed should meet the requirements of the Eagan aircraft noise ordinance. Entry Doors: Therma Tru (29 STC) Skylights: N/A Review Completed (date : Other Exterior Wall Penetrations: Review Completed b : Tom Tamte Sill sealer between plates and blocks Use BLUE or BLACK Ink E-For Office Use t l Permit Fee. city f a PO i 3830 Pilot Knob Road Date Racer, :1 s Fagan MN 55122 t Phone: ?651} 6T5-5675 t _l _ - Fax: t615i1675-SW i Statt t 2013 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Site Address: t...- Sate: Suits Tenant. j 5Z 2-41 _ixc, tarns, ' xi ' # M Prc,pertyOwner Addressfi i~~glsca~',? ss ~:.~t~r Conira~ r N i, r,3 21, ~ Type r Work ! F + ^ `mod Cc~ , r -t r, pate: Censtv ct>o r~ C Ls 3 2.1 4 GE C L tense [ Ly- Address: L S ~3' 1+" E^.e°" jC t'r'G7.' Y T'°i i C-I ~s Cont~c.€-~L FIRE PERMIT TYRE WORK TYPE New Addition System of he3cs Standpipe Alterations Remodel Other DESCRIPTION OF WORK: ~ Commercial ~ Residential ~ Educational FEES Contract Value $ X1% $55.00 MinimuM _ Per^w Fee case call for Surcharge •1f tae pro,F_. va ua?jon is over S.gg urc"arge, TOTAL FEE r ✓ F.rc te_.., 3,4* ^ . ;r»rnent Fire Meter - $245 Ertl y r 1_. TGTAL FEE 'Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to e 4? ~j,~Ve that! n.n ~r--r~Y fGM. [:.fa SUPRre. ,.r ac nos t <<3y~ Yeie t i+,. > !-'rF r inderS e ~ ~ rp a. r he ,:'l~~RF3t t 5 W { iINJ~ ?rt}'...• Y r.,A. I~r c, d.~~• Y' -3 e any apprcwa E a f Applicant's Printed Name Appi cant's Signa® r 3101 FOR OFFICE USE REQUIRED INSPECTIONS I` Hydrostatic Flow Alarm Drain Test V Rough In Trip Pump Test Central Station -Final Conditions of Issuance: Permit Reviewed by:~ Date: ~~.....:w.,._ III 1L4 9/j 151 l0?153%f55 %r~(5`7/c)(S9 ) I to 1%1(, 3 CnCdarv- 6r0w T►- Surveyor's Certificate SURVEY FOR : Lennar DESCRIBED AS :Lots 1-8, Block 3, NICOLS RIDGE 4TH, City of Eagan, Dakota County, Minnesota and reserving easements of record. 33.0 832.8~~~~ 110 11, trr AM4 8(34.6 ai/ N ¢8 fj 832. ) '00^ O N7 ° 83 833. 73.22 833.7 • 3 5~.e14 3 18.7 8 3.7 833. 8 Potlo~ • 1N v G°r°9e 334 (0 33.7 Patlo'i •8330 p1 Garage 833.7 00 at! 21$5 Gar 3 78.78 h/ V, 00 833.4 2153 °9e 13.2. 75. 63 1 at! 2157 Carp9e O O Pro oaed 2149 833.5 HP of n ~ BM 833.5 2781 21 31p 0~ 0eotle 81 Pati .3 5.00 833.5 0prpge GOfp9e 2758 /5. 32. o°°/ 78. ~g 215 at! 833.7 32.0 Garage o Z 1833.1 833.7 Garage n ~ Patio g 833.73 20 8 78 >8 833. 8 4800 1 32. v Potio$ 833.7 7 '22 9.00 832.4 S7 os Bm' a 2. ~ Ems' ~ 832.1 ^ +832^7~ 831.9 Exlstin . Un7t 9 i TOB'1hoine 8335 PROPOSED ELEVATIONS BENCHMARK, Front Offsets Top of Foundation = 834.2 Garage Floor = 833.8 Aprox. Sewer Service = Verify 0 MIN. SETBACK REQUIREMENTS Proposed Elev. = Existing Elev. _ - Drainage Directions = Front - House Side Denotes Offset Stake = • SCALE: 1 Inch = 30 feet Rear - Garage Side - JOB NO: I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION HEDLIiI/ND OF THE BOUNDARIES OF THE ABOVE DESCRIBED PROPERTY AS SURVEYED 12R-0 E: BY ME OR UNDER MY DIRECT SUPERVISION AND DOES NOT PURPORT TO BOOK: PAGE: SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. PLANNING ENGINEERING SURVEYING 2005 Pin Oak Drive DATE __L/ 23/12 Eagan, MN 55122 REV. CAD FILE: Phone: (651) 405-6600 J Y D. LINDGREN, L OD SURVEYOR Nicols Ridge 4th Fax : (651) 405-6606 REV. _4 /_24/13 INNESOTA LICENSE NLIBER 14376 Terry Zelenka From: Ben Johnson [Ben.Johnson@lennar.com] Sent: Monday, July 22, 2013 10:00 AM To: Terry Zelenka Subject: 2153 Cedar Grove Trail - Nails in Hanger Terry, got your message about the corrections on 2153, 1 talked to the framer and he did get those nails in the hanger. Call with any questions. Thanks, Ben Johnson Construction Manager Nicols Ridge - Eagan 16 E ICJ A1 16305 36t 36th Ave. N. Suite 600 Plymouth, MN 55446 www.lennar.com Office: 952-249-3000 Cell: 952-221-0066 Fax: 952-249-3075 Email: ben.iohnson@Iennar.com 1 Tt.telig C -0 - City of Eain Address: 2153 Cedar Grove Tr Zip: 55122 Permit #: 107858 The following items were / were not completed at the Final Inspection on: • Verify with your builder that roof test caps from the plumbing system have been removed. • Turn off water supply to the outside lawn faucets before freeze potential exists. • Call the Engineering Department at (651) 675-5646 prior to working in the right-of-way or installing an irrigation system. Building Inspector: S e "r` -i-k / 9 W . -- 5/-‘1( V t4A,r4w• et/t5 t' 1 IlArc 11- eov;w• G:\Building Inspections\FORMS\Checklists Final grade - 6" from siding Permanent steps — Garage +// r Permanent steps — Main Entry AT/ Pr Permanent Driveway Permanent Gas Retaining Wall or 3:1 Max Slope I v f P Sod / Seeded Lawn 7( Trail / Curb Damage \k Porch IV %- Lower Level Finish M/ i1 Deck N/ A Fireplace IV/ 0 • Verify with your builder that roof test caps from the plumbing system have been removed. • Turn off water supply to the outside lawn faucets before freeze potential exists. • Call the Engineering Department at (651) 675-5646 prior to working in the right-of-way or installing an irrigation system. Building Inspector: S e "r` -i-k / 9 W . -- 5/-‘1( V t4A,r4w• et/t5 t' 1 IlArc 11- eov;w• G:\Building Inspections\FORMS\Checklists New Construction Energy Code Compliance Certificate Per N1101 8 Bu0Ming Certificate. A building certificate shall be posted in a permanently visible location insid the building. The certificate shall be completed by the builder and shall list information and values of components listed in Table N1101.8. Mailing Address of the Dwelling or Dwelling Unit MODEL 429 B cg S +1 ,... Name orResidential Contra mar LENNAR HOMES Community D CesidiestePotted EAGAN MN Mame Number Place your logo here Plan ID THERMAL ENVELOPE (RADON SYSTEM Insulation Location Typo: Check All That Apply d b Foundation Wall NA v X Passive (No Fan Other Please Describe Here Rim Joist (Foundation) Wall 21 Ceilln:, vaulted Bonus room over laragc NA 38 21 101 Windows it Doors beating or cooling Ducts Outside Conditioned Spaces Not applicable, alt ducts located in conditioned space R•valtte Average U -Factor (excludes skylighis and one door) U: 0:29 Solar Heat Gain Coefficient (SNGC): asrnar a. aaa.rra wts..�........ Ir .26.30 Make-up Air Select a Pe Heating System Domestic Water Heater Cooli of required per mech. code Passive Manufacturer LENNOX Rating or Size Input in 45,000 BTUS; Output in 1.5 Tons: Powered Interlocked with exhaust device, Describe: Other, describe: Location of ductor system: AFUE or 92 HSPF14 Efficiency SEER: 13 Calculated cooling load: 18,000 Ctin's Mechanical Ventilation System Describe any additional or combined heating or cooling systems if installed: (e.g. two furnaces or air source heat pump with gas back-up furnace): Select Type " round duct OR " foetal duct Combustion Air -Select a Type Not required per mech. code Passive Heat Recover Ventilator (HRV) Capacity in ems; Low: High: Other, describe: Energy Recover Ventilator (ERV) Capacity in efms: Low: High: Continuous exhausting fan(s) rated capacity in elms: 80 Location of duct or system: furnace room I cation of fan(s), describe: IN ASTER BATH Cfrn's Capacity continuous ventilation rate in efrns: 80 "round duct OR Total ventilation (intermittent + continuous) rate in cfms: 210 metal duct PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA118394 Date Issued:10/31/2013 Permit Category:ePermit Site Address: 2153 Cedar Grove Tr Lot:2 Block: 3 Addition: Nicols Ridge 4th PID:10-50903-03-020 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Softener 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. Jon Hantge 325 3rd Ave. Nw Hutchinson, MN 55350 Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087 Surcharge-Fixed $5.00 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 - Us Home Corp 16305 36th Ave N Minneapolis MN 55446 (651) 442-7295 Tri County Water Conditioning Inc 325 Third Ave NW P O Box 65 Huchinson MN 55350 (320) 587-2950 Applicant/Permitee: Signature Issued By: Signature