1802 Bluestone Dr EParcel Files Cover Sheet
Unique ID: 1858
1802 Bluestone Dr E
101670604009
CITY OF EAGAIV
Addition
Owner
Lot 4 ?ik
1?2 E. BlnestOne Drbv?
Ili X6640 040 09 ;
Improvement Date Amount Annual Years Peyment Receipt Date
STREET SURF.
STREET RESTOR. '
GRADdNG
SAN SEW TRUNK 1970 58.18 2.08' ;8. . pid '
# 3EWER LATERAL ' 1971 26' '
WATERMAIN
* WATER LATERAL 1971 1o6a.5.00 80.75 20 P13.d
WATER AftEA
ST!ORM SEW TRK ' 1971 20
STORM SEW LAT '
CURB & GUTTER '
SIDEWALK
STREET UGHT .
WATER CONN. 230.00 ? 1769 10-6-69'.
BUILD(NG PER. ?
SAC
200.00
76 .
10-6-69
PAR K _
i
I
Remarks
f...?...,. .?==-??G3ti=wt+??am;=i•,7;.a:-m: r•-??:: ,?t._: r? ??._??;«?rur?w^n?'V'w^"R1?'S67*'?!?&>35:???11?`a?.'w.?.
Receipt MECHANICAL PERAAIT PermGt M1Vo. 42 ?
? CITY OF EAt?iAIY Fee 65 , 20 ?
Ff/l In rnunbersd speces S/C ??? µ
? 77ylx or PrJnt /ogIbly 7ot.
Avhj 1• Date 2. Insteltation Cost
3. .b1b???/?LU?- ?.'l:??L?ot?Bik. ? Tract
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4. Owner ??I1.1 t''?? ?. ?o° ? s? .?/ A`? !l!?'? ?. ?"/ t`?1e?/?f- /?d , ,???L, ?l ,?,?-?,,
?,
6. Contractor ? ?' LJ,-);l r ?--
Phone
6. Aaddress
7. City_ StBte ZEp
r ?? ? • ?.
8. Suiiding Type: Residential ? Cpmmercial C] Institutional Q `
9.
90.
'' 19.
Work Description: Ntw 0 Add )( Alter O Repair GD
12k k (vay ?r'?1vtl?e'? ,?r
Describe - - r Fuel TYpe
No. Eaulament BTU - M. Ea.
Forced Air No. FSu.igMt.. C",FM
1V4fg. Air Wandling:
Boilers
Mfg. Mech. Eath8us3
E#nit Hoater
Mfg• O
Air Cond. ther
r..
¦u
m,
9.
.
?.
?Lj?? Gas, Plping Outlets
??S?ly ?' " %° ? `'' ::a ,? ?,? /'?r? `i
d
?°
a? '? : v'? ?o /`? '? f?`i?:P;
??! d 1"? ?? ?.Y? I .
? 12 1 heryby certify that the above inf matian 9s true and cormC#, and ? ag
!atmplY " 11 rdjrien)M +?s govevning this tYpe k1#i",ek
.i+gned : _ J -? ? r • 4
for ?
? Rougb Ffrfa 4:A?,
ttispe@tPr?tt?: 1?8te knspy Dane ??r ;` This is yo,VQerrhi;vhttn nuMborsci and appihoved.
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1 ? i .... ?J'?•.?-+ . ,:I,..? _o:r:? ? , . i . . ? L??? '?.i? t?l??a
?ito
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i
REQUEST FOR ELECTRICAL INSPECTION EB-00001 ?04
' See instructions for completing this form on back of yeUow copV.
A? `???? ? ""X'" Be/ow Work C'overedvby This Requesi
Now Add Rep. Type of Building Appliances Wired EquiAment Wired
Home Range Temporary Service
Duplex Water Heater Lighting Fixtures
Apt. Building Dryer Electric Heatfn
Commercial Bldg. Fumace Silo Unloader
Industriaf Bldg. Air Conditioner Bulk Milk Tank
Farm Other SPecify Qther (SUer_vfy)
ther SGec+fV Other Other
nl/lP. I/)SDP.Ct/On FPB
# Fee Service Entrance Size # Fee Feeders/Subfeeders # Fee Circuits
U to 200 Am s 0 to 30 Am s 0 to 30 An.
Above 200 Amps 31 to 100 Amps 31 to 100 A
Swimming Pool Above 100-Amps Above 100____AmFs
Transformers Irrigation Booms Partial,'Other Fee
bigns apeciaiinspecuon $ ?
--,l
Remarks TOTA EE
? n ` U ?n •
Final
1, the ETtfctiieM
Inspector, hereby
?ertify that the above
5lnspection has been
made.
This request void ? (j
18 months from
( c; _ o 0
Request„aa
' Fire No. Rough-in Inspection
Required?
?Ready Now ? Will Notify Inspec-
f ? ? Yes G(No [or When Ready
Licensed Electrical Contractor I hereby request inspection of above
? Owner . electrical work installed.at:
Street Address, Box or Route No. City
1 -;Z- E_ c Q- =?
ecuon o. Township Name or No. Range No. County
6a 7A
Occupant (PRINT) Phone No.
3
i (9
Power Supplier . Address
Elecirical Contractor (CompaaY Name) Contractor's License No.
Mailing A dress (Contractor or OwnerMaking Instailation)
21 /! A/ r `.C
Authori 'gnat tractor/ r aking lnstallation) Phone umber
MINNESOTA STATE BO?p??yvF E.LECTRICITY THIS INSPECTION REQUEST WILL NOT
Grig9s•Midway Bldg. ylfoom N-191 BE ACCEPTED BY THE STpTE BOARD
UNLESS PROPER INSPECTION FEE IS
1821 University Ave., St. Paul, MN 55104
Phone (612) 297-2117 ENCLOSED.
GITY OF EAG::1q
3795 Pi? ot Knob Road
Ea??-,n, ivL.r.nesota 55122
rrE=T NOa;- 8gS
The City of Ea.gan herery Frarits to St-a„AAryA Hwa incr ,e a/? rr?-
?
Of e1 n W-_ rAk.? Af m,t v,_ 55408 -
? .- r?,.,A_ ?_ Permit for: (Owner) u flaa,m ..1r.v,
a.-i, ul"oatone pursuai.l t to application d.ated 6/30/74--:_
Fee Paide __ S5.00 da,ted i,his day o-;? L3v
.5b s/c
t3uilding Ir_spcetor
Mechanical Permitsc
Bic. Tota.l:
r
EAGAN TOWNSHIP
BUILDING PERMIT
Ownei ._._( ?--.L .. . ..... '---'------•••--------
Address (Presen!) •--?•?-•-?`--?".'`'"e-. .......................
Builder ---•••-•••••--•--•-•--••-•---•••-------••-•••--••-••--•-•--•----•---•-•-••••-•---•-...----•-.-•-
Address -••--.--•--•---••-----------•••-----••-._...._..--•---•------------------••-•-•-•-•-•••-•----•
N° 2100
Eagan Township
Town Hall
n8te ..... ?/.s'e?y ......................
DESCRIPTION
Siories To Be Used For Front Depth Height Esi. Cos! ' Permi3 Fee Remarks
11 % LOCATION
Sireei, Road or oiher Descripiion of LocaYion I Lo! I Block I Addiifon or Trac!
'T % I C.:.e- . 7
This permii does not suthoriae the use of sireets, roads, alleys or sidewalks nor does it give the owner or his agent
the righi to create any siluation which is a nuisance or which presents a hazard to the healYh, safety, convenience and
general welfare !o anyone in ihe community.
THIS PERMIT MUST B KEPT ON THE PREMISE WHILE THE WORK IS IN PROGR SS.
, .
This is to cerlify, ?_e_:y-?c?'.= ....?=-•-••••---•-•----._has permission to erect a.... ---••-••- --- --=•---..?°.... upoa
- - -----...-
the above described premise subjeci to 3he provisions of !he Building Ordinance for Eagan ownship a !ed April 11,
1455_
.-------------------??*?` "---i-??-?-.-.-----'`-"='--.........................
Cha an of Tnwn Board
k ,L$
?_....--•-••--•-----...---•••r............................................
Per ---•-------•--- -•-.. ?
Building Inspector
RESIDENTIAL
BUILDING PERMIT APPLICATION
. CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Construction Reouirements RemodeilReaairRepuirements
' • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan
(20% mazimum lot coverage aliowed) . 1 set of Energy Calculations for heated additions
• 2 copies of plan showing beam & window sizes; poured found design, etc.) . 1 site survey for exterior additions & tlecks
• 1 set of Energy Calculations . Indicate if home served by septic system for additions
' . 3 copies of Tree Preservation Plan if bt platted after 7/1i93
. Rim Joist Detail Dptions selection sheet (bidgs with 3 or less units)
DATE _q -3-09 VALUATION r o?. SO .- ?I D
JOB SITE ADDRESS I ? VJ ??? o? ?; .Z 'Jr
IF MULTI-FAMILY BUILDING, HOW MANY UNITS? _
PROPERTY OWNER rUIUMA'11A?tJ?,I 2t9.Y89k
TYPE OF WORK , °?' FIREPLACE(S) _ 0_ 1_ 2
APPLICANT ? PHONE# 661 'rg?
ADDRESS 1 ZIPCODE
PAGER # CELL PHONE # FAX # G? ???' ??? -? ?B 5 G)
NEW RESIDENTIAL BUILDING ONLY - F11L OUT COMPLET ? C?i C? ?[Y? ?'
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 APR 1 ? z(;?'
(c hec k one) - Resi den tia l Ven ti la tion Ca fegory 9 Wor ks hee t Su bmi tt L
- Energy Envelope Calculations Submitted By^'?? ?
MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor: Phone #:
Plumbing System Includes: Water Softener Lawn Sprinkler Fee: $90.00 '
Water Heater No. of R.I. Baths
i No. of Baths +
Mechanical Contractorc Phone #
Mechanical System Includes: Air Conditioning Fee: $70.00
Heat Recovery System
Sewer/Water Confractor: Phone #
All above information must be submitted prior to processing of application.
' I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan rdinances.
Signature of Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 2002
C3FFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 18-piex - O 20 Poal O 30 Accessory Bidg
? 02 SF Dwelling 0 08 06-piex 0 16 Fireplace ? 21 Porch (3-sea.) C1 31 . Exk. Aft - Multi
Cl 03 01 of r piex ? 09 07-plex ? 17 Garatge ? 22 Porch/Addn. (4-sea )' 0 33 Ext. Alt - SF
_-. . . ....
? .04 02,plex DB-plex ... 0 ..18.: .Oeck ?
-,
Q 23_. Pcznch t?cr
ed) _ ?.._. ? .
? ..? .....,:_.
''d 05 03-ptex 11 10-plex -',? ig Ctwwer Levei 0 24 Storm Damage- .
0 06 04-plex ?' 12 12-piex Plbg_Y or y N 0 25 Miscetlaneous ,
? 31 New ?' 35 int lmprovement 0 38 Ciemolish (lnterior) [:] 44 Siding '
? 32 Addition ? 36 Move Bldg. 0 42 Demotish (Foundation) ' Ci 45 Fire Repair
? 33 Alteration ? 37 Qsmolish (B1dg)* Ct 43 Reroof ? 46 ' Windaws/Doors
0 34 Reptacement *Demoiition (Eritire Bidg anly) - Give PCA hsndout to appiicant
Valuation . . Occupancy - MCIES Systern
Census Code Zoning CitY Water '
SAC Units Stories Booster Pump
Nbr. of Units Sq. F#. PRV
Nbr. of Bldgs Length Fire Sprinkiered
Type of Const Width , . _
aECtuIREa INsPEcTiaNs
- Footings (new bldg) FinaUC.O.',
Footings (deck) ? FinaUNp C.O. ,
- Footings (addititin) Plurnbing .
Foundation HVAC rt
? Drain Tile Other r
;
Roof Ice & Water Finat Pool _ Ftgs ? Air/Gas Tests _ Finai
Framing? ? Siding Stucca ? Stone
? Fireplace
R.I. _ Air Test _ Final ? Windows (newlreplacement)
_
_ (nsu(ation _ Retaining Wall
Approved By , Buiid'rng inspeetor
Base Fee
Surcharge
Pian Review
MGIES SAC
City SAC
Water Supply & Storage
S8W Permit & Surcharge
Trea#ment Plant
Piumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
?
EAGliN TOGJNaHTP
3795 Pilot ICnob R.oad
St. Paul, Minnesota 55211
Telephone 454-5242
PERMIT k'OR SEWER SERVICE CONIVECTiON
nATE: SPnt,pmbgrr, 3. 1969 NUMBER ?J 2
... .
OWNEg•sf'Pr??f',?'roVe COtlstT`LCt7.011 Co. Address1802 E. Bluestone Drive ?-?-7
PLUMBER ___St .ein. Inc.,_,,," 2`YPE QF PIPE Cast Iron
DESCRIPTI4N OF BUII,UI1rTG
Industriai Commercial Residential Multiple Dwelling No, of units
xx
-1 Location of ConnecCions:
Street Repairs
Total
Inspected by:
DaCe
Remarks;
ConnecCion Charge 200.00 pd 10 8/69
PermiC Fee 7'50'pd 10/8/69
sy
Chief Inspectar
In considexation af the issue and delivery to me of the above pexanit, I
hereby agree to da the proposed work in accordance wiCh the rules and
regulaCions of Eagan Tox-inship, Aakota County, Minnesata V-?
By
Please xtotifp when ready far inspecti4a and connecCion and beFore any portioa
of the work is covered.
?
` ?.
1.
?
EAGF:N TOWNSHIP
3795 Pi.lot Knob Roud
St. Pau1, Minnesota 55111
Telephone 454-5242
e
PERMtT FOR WATER SERVICE CONNECTION
.
Date: September 3L 1969 Number:
Billing Name:Cedar Grovef Construction Co S ite Address:1802 E. Bluestone 4-9-7
Owner: Cedar Grove Construction Co.
Plumber; Stein, Inc.
Location of Connection
Billing Fddress 7343 Concord B1vd. E.
Meter Siz e _ Connection Chg. • 10/8/69
Meter No. Permit Fee 7•50 pd 1o/$/69
Meter Reading MeCer Dep.
Meter Sealeci: Xes- lAdd' 1 Chg.
NO iTotal Chg.
Building is a:
P.esidence XX
24ultiple 140. Units
Commercial
Industrial
Other
In consideration of the issue and delivery to me of Che above permit, I
hereby agree to do tY-e proposed work in accordance wiCh the rules and
regulations of Eagan Township, Dakota County, nnesota.
By:
Inspected by
Aate
Remarks:
Bq:
Chief Taspector
Please notify the above office when ready for inspecCion and connection.
ft
EAGAN TOWNSHtP
BUILDtNG PERMIT
owner •---t?..... ------ ?- ------•-----•---------------------.......................
,
Address (Presen!) -•-18-?•°-?--••-?--•-- • •-••-•-•--••-.....
.••-••--•--•-?
Builder ••-.....--•• ..................•-.._..__.•-•-••-•--•••-•••-••--•-•-•-•-•--•-•--•---........._._..
Address ..•-••-• ...............................................••-••--...•-•••••..._....•--......•---•
N? 2387
Eagan Township
Town Hall
/
Date ...........................
DESCRIPTION
5tories To Be Used For Front Depth Height Est. Cos! ' Permi! Fse Remarks
LOCATION
Streel, Road or other Description of Locaiion I Lo! Block Addition os Trac!
? ? ? ? . •?'- 7
This permit does noi suthorize the use of s3reets, roads, alleys or sidewalks nor does it give !he owner or his agent
!he righi to create any situation which is a nuisance or which presents a hazard to !he heallh, safety, convenieace and
general we2fare to anyone in 3he community.
THIS PERMIT MUST BEPT ON THF. PREMISE WHILE THE WORK IS IN PROGRE$S. _
This is to ceriify. 3ha2-• •--•........ .................... -•••,--•------•--.•-----•.has permission to eraatr?a- ......... ......... ......--•• ....................upoa
!he above described premise subject fo !he provisions of the Building Ordinance fo Ea ship dopted April 11.
1955. ?
..........•-•---•--.G??.... In -"-?--..._....•---°--••---.._. Per -•...---••-•••-- !-•-•--•-- ?-•• .. ......................•----...............-•-...---••--
of Tnw? Board Building Inspector?
, MASTER CARD
LOCA710N Aff? ?
?
OWNER a
STRUCTURE AND
.,_.
LAND USEb AS ? / ?40 r'
y.
y,9- 7 C'G_
Permit
BUILDING
PLUMBING No. i Issued
L Contractor Owner
I
XI-,1
I?
CESSPOOL - SEPTIC TANK
V'JELL
ELECTRICAL
NEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
• Approved
ltems (Initial) Date Remarks Distance From Well
FOOTING SEPTIC
FOUNDATiON CESSPOOL
FRAMING TILE FIELD FT.
FINAL
ELECTRICAL DEPTH
HEATING OF WELL
GAS iNSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
? I Violations Noted
on Back
I t >
COMMENTS:
I
COMPLIANCE INSPECTION REPORTS
TO BE USED ONIY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
F NO EVIDENCE OF NON-COMPLIANCE
OBSERVE0.
? ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS.
? NON-COMPLfANCE. BUILDER WVLL COMPIY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
F-I NON-COMPLIANCE. BUILDER DOES NOT
INTEND TO COMPLY.
? COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
? REINSPECTION REQUIRED
DATE OF REINSPECTION
0
REINSPECTION REVEALED
CERTI FICATION - I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein
all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
F-I ALL IMPROVEMENTS ACCEPTABLY COMPIETED
BUILDING INSPECTOR
CONIMENTS:
DATE
23
?
Use BLUE or BLACK ink
Lw I
For Office Use
City ~~~~n Permit#:
11911 I
l Permit Fee: I
3830 Pilot Knob Road I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 1 Staff: I
I 1
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: G'. > t ('.a ffi, r't Unit
Jp`w , _u. M~..,. <,,-(/^.ri.n._-~.C:p,.,M._..,,„ .............m-~,~...,.....mm...,~..,,.,.,...,_a Phone..M6)1)-..,.,..3Y(r.~..C'r9.1Ft
Name:
F
Resident/
Owner Address / City / Zip: 12 ' P %.9•f 4t-jY(e 1)v- , r► zv v ; WIN) ) ` 1;z z
s
iApplicantis: Owner ✓ Contractor
_..W ~ Description of work:. ~ ^r..~,,...~/1.,~.
Type of Work
Construction Cost l(~ L~ , L Multi-Family Building. (Yes _I No 6 )
Company: Cit c'.P~.ti te_.tT ~'w 'l 1V;5 Contact.
t
y Address: 411 5.. i,9.'
Contractor ' v"e^f City; a~ f_L.rLi c-
r t f wr'
State: zip. Phone: (it
License P, Li; Li L_ ; 14_-J Lead Certificate I v' ' - Q ( 0 f I
F,r„. .~,..,~.,,~,.~tt,.....~....m...~_,,~wb~,,~,:,.,n._~..~.,~..,....,,._.~..,._..,....,w._~.,...~.~.w.~.~.~,,..,.~Nrv,~.,,..~,_~...a....,...,m,w,.,m._~,.,...,.,~,M„",.,.~.,~..,.,.~,
,~,..K.,.M,.M,...._,..._..~ ....................y
q' If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) k
i
i
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:
s (
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor Phone fi
NOTE. Plans and supporting documents that you submit are oonsidered to be public inforntation. Portions oi"
the information may be classified as non-public if you provide specific reasons that would permit the City to
k 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. wwwLqw!TgtafteoR41in _c~rct
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
x ~ mot _~...C.'t r_ 4'.., f't ~ n
Applicant's Printed Name A l"'s SI nat re
- Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA154137
Date Issued:02/21/2019
Permit Category:ePermit
Site Address: 1802 Bluestone Dr E
Lot:4 Block: 9 Addition: Cedar Grove 7th
PID:10-16706-09-040
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
Valuation: 5,000.00
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 -
Ariel K Garcia
1802 Bluestone Dr E
Eagan MN 55122
(651) 528-9092
Window Concepts Mn
291 Eva St
St Paul MN 55107
(651) 905-0105
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA166196
Date Issued:12/18/2020
Permit Category:ePermit
Site Address: 1802 Bluestone Dr E
Lot:4 Block: 9 Addition: Cedar Grove 7th
PID:10-16706-09-040
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Ariel Kate Garcia
1802 Bluestone Dr E
Eagan MN 55122
(651) 528-9092
Milbert Company (culligan)
1801 50th St E
Inver Grove Heights MN 55077
(651) 451-2241
Applicant/Permitee: Signature Issued By: Signature