1387 Amaryllis Lane
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number; .
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
PERMIT SUBTYPE: TYPE OF WORK: t-F R n.f. 10N
INSPECTION TYPE DATE INSPTR. INSPECTION TYPE DATE INSPTR.
~ I
Permit No. Permit Holder Date Telephone #
ELECTRIC
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
I
L-
r CITY OF EAGAN Remarks
Addition Wilderness Run 2nd Addition Lot 2 Rlk 2 Parcel 10 84351 020 02
OwnerLALI z I)a~~' ~~1'~ I Street 1 ~R7 Amatwll iG Lane- State Eagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK jL2 1973 $175.00 $8.75 20 PAID
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA Pa d w4kh wgkt sr connection A/77
11 TORMSEW TRK 983 X34.56 X5,64
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
SEW CONN 1974 $240.00 $48.00 5 PAID
WATER CONN. $280.00 5368 2-15-72
BUILDING PER. #3785 1490 10-75
SAC
PARK
CITY of EAGAN Na 3785
BUILDING PERMIT
3795 Pilot Knob Road
Owner Eagan, Minnesota 55122
"Jn "
Address (present) ../..3G y....... 454-8100
Builder 1110-----/
Date
Address
DESCRIPTION
Stories To Be Used For Front Depth Height Est. Cost Permit Fee Remarks
LOCATIONS
Street, Road or other Description of Location I Lot Block I Addition or Tract
This permit does not authorise the use of streets, roads, allays or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS.
This is to certify, that-A... has permission to erect a....... ,./.................................._upon
the above described premise subject to the provisions of all applicable Ordinances for She ,-;Y--Oil; p' ~ Per . ~--:fit......................................
= Mayo Building Inspector
EAGAN TOWNSHIP
BUILDING PERMIT N° 2643
Owner Eagan Township
Address (present) Town Hall
Builder :21,.4.:Qt?^..:`.
g Date ----x 17
Address ~
.
DESCRIPTION
Stories To Be Used For Front Depth Heigh! Est. Cost 'Permit Fee Remarks
1o s ,i
ao F LOCATION
Street. Road or other Description of Location Lo! Sloek Addition or Tract
This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safely, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE KEPT-ON THE PREMISE WHILE THE WORK IS IN PROGRE S.
This is to certify, that ......5.4.F:-a-~...:-Y-~:-.r ..............has permission to erect a...... ............a..~.~...~:................_upon
the above described premise subject to the provisions of the Building Ordinance for Eagan owashlp aflopled April 11,
1955.
py ~c e 2
~ Per
Chairmed of Town Board Building Inspector .43
MASTER CARD
LOCATION 7
OWNER
~LsAfAl
STRUCTURE AND
LAND USED AS
Issued To
Permit No. Issued Contractor I Owner
BUILDING -;~4/~ J-
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING 1 v~ o
GAS INSTALLING -H~
SANITARY SEWER
OTHER
OTHER
Approved
047-- Items (Initial) Date Remarks Distance From Well
FOOTING SEPTIC
FOUNDATION CESSPOOL
FRAMING -r-r~ TILE FIELD FT.
FINAL
ELECTRICAL
DEPTH
HEATING OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING ~L
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
❑ NO EVIDENCE OF NON-COMPLIANCE ❑ NON-COMPLIANCE. BUILDER DOES NOT
OBSERVED. INTEND TO COMPLY.
E] ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS. ❑ COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
x~
❑ REINSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CERTIFICATION - 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 beat variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
❑ ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR DATE
COMMENTS
z3
Cities Digital Quality Control
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available image from the original page.
Every effort was made to capture the content
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EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date: February 25, 1972 Number: 76W 2'
Billing Name:Tilsen Construction Co. Site Address: 1387 Am ^11;c
Owner: same Billing Address
Plumber:Luecken Excavating
Location of Connection Meter Size-~ Connection Chg. 200:60 pd 2/15/72
pad
Meter No. :;2i/7 Permit Fe 10.00 pi 5/30/72
!).50 pd 1.40P2
Meter ReadingL_ Meter Dep.
Meter Sealed: Yea Add'1 Chg.
NO Total Chg.
Inspected by
Date
Building is a: Remarks:
Residence xx
Multiple No. Units
Commercial
Industrial By:
Other Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota..
By: ;O- c.~1
Luecken Excavating
Please notify the above office when ready for inspection and connection.
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE: February 25, 1972 NUMBER 946
OWNER•Tilsen Construction Co. Address 1387 Amaryllis _Q LJ R.,~-
PLUMBER Luecken Excavating TYPE OF PIPE Heavy Cast Iron
DESCRIPTION OF BUILDING
Industrial Commercial Residential Multiple Dwelling No. of units
xx
Location of Connections: Connection Charge -0-
Permit Fee 10.00 d 0 2
.50 pd 30/72
Street Repairs
Total
Inspected by:
Date
Remarks:
By
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Tamship, Dakota County Minnesota
Luecken Excavating
Please notify when ready for inspection and connection and before any portion
of the work is covered.
MASTER CARD
LOCATION j /_7~,
OWNER
STRUCTURE AND
LAND USED AS
Issued To
Permit No. Issued Contractor Owner
BUILDING J"'
PLUMBING
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAL
HEATING
GAS INSTALLING
SANITARY SEWER
OTHER
OTHER
Approved
Items (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
r
Violations Noted
on Back
COMMENTS:
COMPLIANCE INSPECTION REPORTS
TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS
PERMIT NO. DATE OF INSPECTION
CONDITIONS OF CONSTRUCTION AT THIS INSPECTION
❑ NO EVIDENCE OF NON-COMPLIANCE ❑ NON-COMPLIANCE. BUILDER DOES NOT
OBSERVED. INTEND TO COMPLY.
❑ ACCEPTABLE SUBSTITUTIONS OR
DEVIATIONS. ❑ COMPLETION OF CERTAIN IMPROVEMENTS
WILL BE DELAYED BY CONDITIONS BEYOND
CONTROL.
NON-COMPLIANCE. BUILDER WILL COMPLY
WITHOUT DELAY.
ITEMIZED AND DESCRIBED AS FOLLOWS:
❑ REINSPECTION REQUIRED DATE OF REINSPECTION
REINSPECTION REVEALED
CERTIFICATION-] certify that I have carefully inspected the above in which 1 have no interest present or prospective, and that I have reported herein
all significant conditions observed to beat variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require-
ments for off-site improvements relating to the property inspected.
❑ ALL IMPROVEMENTS ACCEPTABLY COMPLETED
BUILDING INSPECTOR DATE
COMMENTS:
' ` {{I' •gPr~dR S I
v
'7 TOWN OF EAGAN
63795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT NO. 189
The Board of Supervisors hereby grants to Nail &_Wg bard Hgatine &
pir f!MAi+ieming C-of No bilwllima Ave.. St. Pal 55104 - 29 a LMLTjnv Permit for; (Owner) _ Tilsen Construction Co.
at _U$3, C11WIX 1391 Amarylis & 1362 id1dgr LH= QM174plication dated
Fee Paid; h „ $80.00 Dated this 11th day of ~8WU , 197_L,
2.00 a/c
Building Inspector
Cities Digital Quality Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
J LLi , ~
TOWN OF EAGAN
3795 Pilot Knob Road
Eagan, Minnesota 55122
PERMIT NO. 1t
The Board of Supervisors hereby grants to 0. F. "A'.7duvL & 3011
of -7cntan"".•r :-rue, S.U. 1-'al X1117
'Tt
a .-U. !'I-L! _Permit for: (Owner) ML .en Cv mstruo,iur. 0:,.
at _ -<<L X33 1l'h7
. 701 y E 7
pursuant to application dated
Fee Paid: _ „uJ.OJ Dated this day of ~ ~Lir Y ;;;rcY 197
1' .
.00 NC
Building Inspector
• 3
;A UMB; 4 KSt:K%X Kk; S~MYS ~W~~S: k~ k R;~ ~ k K 8 XM~~~
CITY OF EAGAN
CASiNTER. F.: TERMT.NAI... NO: E.-,71.
DATE; O5/2O/98 TIME: 1 5.50.18
TD:
NAMED:1NNY D ANDERSON
324.0 9001 1391 AMARYLTS L 7 4.75
2:1.:55 9001 133? AMARYLTS c_ 1.n05
t~R
Total Reoe:ip% Amount: '.5.80
USER 11.1" NANCY
~:~kt~StnXl~M`;<~F$S7k:SiY<MM7,<%FM:3:;i ~ilOn7l;h:1:7kk~Y,(7$iq°,7'4Y.:;iY~7"
~
--CITY OF EAGAN PERMIT
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55122-1897 Permit Number: 032070
05/20/98
(612) 681-4675 Date Issued:
SITE ADDRESS: 1387 AMARYLLIS LANE
LOT: 2 BLOCK: 2
WILDERNESS RUN SECOND
P.I.N.: 10-84351-020-02
DESCRIPTION: R E R O O F
,k~
Bafbi`IM4 Permit Type SF (MISC. )
Bu~3i#,n9v tlprk Type ALTERATION
XN'Pent~Yis, D3i:d; ~;al 434 ALT. RESIDENTIAL
2f L ~
mT.R^R
d.' 4
g
_ w w' ~s k ii8_
Via. .n~w`ar:.
~£'9~Y4. ~I ~~9figr~ rtv,
nSU S.i w'.~°.-^t N:°
IN ,
REMARKS:
FEE SUMMARY: VALUATION $2,100
Base Fee $74.75
Surcharge $1.05
Total Fee $75.80
CONTRACTOR: n~/NFR - A p p l i c a n t
~1N6E7FSbN DONNY
1387 AMARYLLIS LANE
EAGAN MN 55123
(612)452-1217
, f y A
lT@k"L~'35 aC~t~'k6d~.e~a tt~ ia~,°iQ
ir}farmatipn: ie carrcctl w
N tcs bbiu tF'p1~fs`"Sa gMkn r'.
StatUtesq Ottd' h.,~. it (}tl d~{ Ci DE Y~ a Sri i r a- i " ak y~aaks.icm as e@'~ fa i r 4 g'sa ~{5' ~a £ sg~e,
? _ £41 S~ 'y °4T4 C 5 ~I4b +38L S5~A~'3R~S:.q.,~
N
_ e: e-g3 b a`a'£ws &s~*"" x~ Sin
APPL NATURE ISSUED BY. SIGNA URE
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN 7
3830 PILOT KNOB RD - 55122
681-4675
New Construction Requirements Remodel/Repair Requirements
♦ 3 registered site surveys ♦ 2 copies of plan
♦ 2 copies of plans (include beam & window sizes; poured fnd, design; etc.) ♦ 2 site surveys (exterior additions & decks)
♦ 1 energy calculations ♦ 1 energy calculations for heated additions
♦ 3 copies of tree preservation plan if lot platted after 711/93
required: _ Yes _ No
DATE: ,/_S V CONSTRUCTION COST;` 00
DESCRIPTION OF WORK: 7P. roC~
K STREET ADDRESS: 9 s%f qty/,G r, r
LOT:- BLOCK: SUBD./P.I.D.#: YV, P-rn~~5 5-e gnu
Name: /-Dm 11 W Phone ~ L~Cj~T/_
PROPERTY Last First
OWNER /6 ~
Street Address: / ~ UT~I G/,~!7 e
city Lae a trt State: Zip: 55 1 3
Company: Phone
CONTRACTOR
Street Address: License #
City State: Zip:
ARCHITECT/
ENGINEER Company: Phone
Name: Registration
Street Address:
City State: Zip:
Sewer & water licensed plumber (new construction only): Penalty applies when address chang
and lot change is requested once permit is issued.
ith all
applicabl
I hereby acknowledge that I have read this application and state that the info tion is cor777
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received Yes No
Tree Preservation Plan Received Yes No Not Required
OFFICE USE ONLY
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 ❑ 13 Garage/Accessory ❑ 20 Public Facility
❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous
P-05 SF Misc. ❑ 10 =plex ❑ 15 Deck
WORK TYPE 5- 0z 00 F
❑ 31 New '0,33 Alterations ❑ 36 Move
❑ 32 Addition ❑ 34 Repair ❑ 37 Demolition
GENERAL INFORMATION
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. <I
Depth Footprint sq. ft. SAC Code
Census Bldg i
Census Unit _1L
APPROVALS
Planning Building 142~ Engineering Variance
Permit Fee Valuation: $ 2 io r
Surcharge
Plan Review
License
MC/WS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total:
% SAC
SAC Units
CITY USE ONLY
PERMIT M A6 L RECEIPT DATE: M I
ItESMENTIAL 1H$CII mCAL PERMIT APPLICATION
CITY OF Eke"
3630 PILOT KNOB RD
EAGAA MN 55128
651-661-4675
Please complete for. ➢ single family dwellings
5~ / townhomes and condos when permits are required for each unit
Date: CJ -,-j9/ n
SITE ADDRESS: 1397 ! //`S
OWNER NAME: / TELEPHONE M 217
(AREA CODE)
INSTALLER NAME: / e TELEPHONE M 5' -1~;Q -GQ Z
AREA CODE)
Alt
STREETADDREESS: ~T/rjnJ ~
CITY: a 7lJ STATE: ZIP: 5JS[ a y
0
Place a check mark next to the ermit work type
New residential dwelling unit under constructionand not owner/occupied $ 70.00
Add-on, modificatio r alteration to existing dwelling unit 50.0000
• furnace replacemen D I~] 1
• air exc anger
• air conditione UG
LL~t
other
Nature of work:
B~/yC~? fYll PBY__
State Surcharge
Total $ J v
Reminder: Call for inspections.
SIGNATURE PbT ERMITTEE
Updated 1/01
CITY USE ONLY
4
PERMIT M RECEIPT DATE:
APPROVED BY: INSPECTOR
COMMI$CIAL MECH"CAL I OURT AfTLICATION
CITY OF 3:mm
3630 PILOT KNOB RD
EAGM, MN 551 EE
651-681-4675
Please complete for: all commercialfindustrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNER NAME: PHONE
(AREA CODE)
TENANT NAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME:
INSTALLER:
ADDRESS: PHONE#: -
(AREA CODE)
CITY: STATE: ZIP:
WORK TYPE: New construction Install U.G. Tank
- Interior Improvement Remove U.G. Tank
Processed Piping
Specify Nature of Work:
When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and
Plumbing (inspector.
Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater.
Underground tank removal/mstallation = minimum fee
Contract price: $ xl%=$ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
SIGNATURE OF PERMITTEE
Updated 1/01
Use BLUE or BLACK Ink
r - - - - - - - - - - - - - - - - -
I For Office Use I
I
E Z-O
City of Ea IR Permit#:
6b,;~5
I Permit Fee:
3830 -Pilot Knob-Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 i Staff:
2012 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: ~^Unit#:
Name: D (O Q Al .v ~ 42 9 F0 N Phone: X J /-G f I 2 -1 2( 7
RESIDENT /
OWNER Address / City / Zip: ' 2 77 (Lf! l S A /}ilJ -S-1
23
Applicant is: Owner A Contractor
TYPE OF WORK Description of work: OV F7 A fv h PL 5 d> e HQU5e_-f-AM &iA
Construction Cost: t ~0~• Multi-Family Building: (Yes ! No
Company: e_5- A V-e (-4A / fi l-?i-UleP j Contact: V D is
Z_ T70G4
CONTRACTOR Address: `y % `7 C o ,#,t w(2- u- Ave City: ~~t P A U
State: Zip: 6y`14 Phone: 6/2-S-01-1672
License WX ~ 7 J ®l Lead Certificate #:&Al- 10 S57 7 l
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
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.aol)herstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuaanncce.
x VL,-An V o S_ E7 Z- x
Applicant's Printed Name Appl cant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA148479
Date Issued:04/02/2018
Permit Category:ePermit
Site Address: 1387 Amaryllis Lane
Lot:002 Block: 002 Addition: Wilderness Run 2nd
PID:10-84351-02-020
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: 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 -
Donny Anderson
1387 Amaryllis Lane
Eagan MN 55123
(651) 452-1217
Custom Remodelers
474 Apollo Dr
Lino Lakes MN 55014
(651) 784-2646
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA162409
Date Issued:07/14/2020
Permit Category:ePermit
Site Address: 1387 Amaryllis Lane
Lot:002 Block: 002 Addition: Wilderness Run 2nd
PID:10-84351-02-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Donny Anderson
1387 Amaryllis Lane
Eagan MN 55123
(651) 439-3331
Schwantes Heating
6080 Oren Ave N
Stillwater MN 55082
(651) 439-3331
Applicant/Permitee: Signature Issued By: Signature