3865 Big Timber Tr
PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA080462
Eagan, MN 55122 . Date Issued: 10/15/2007
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 3865 Big Timber Tr
Lot: 5 Block: 2 Addition: Gardenwood Ponds 4th
PID 10-28803-050-02
Use
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not
acceptable in lieu of inspections.
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Royalty Remodelers Romack S Franklin
4411 Slater Rd 3865 Big Timber Tr
Eagan MN 55122 Eagan MN 55123
(612) 414-8199
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature Issued By: Signature
L BL CITY USE ONLY RECEIPT I t a
SUBD. RECEIPT DATE: i 3 -T/
PERMIT # C 0 li
Z/
1999 PLUMBING PERMIT (RESIDENTIAL)
CITY OF i'A6AN
3830 PILOT KNOB RD
EAWkN, MN 551 S$
(651) 681-4675
Please complete for: > single family dwellings
> townhomes and condos when permits are required for each unit
> backflow preventer for underground sprinkler system
FIXTURES EACH # TOTAL
Bath tub $ 3.00 x = $ C-0
Floor drain 3.00 x = $
Gas piping outlet ' minimum -1 3.00 x = $
Hot tub/spa 3.00 x - $
Kitchen sink 3.00 x = $ aeo
Laundry tray 3.00 x - $
Lavatory 3.00 x - $
Minimum fee alterations to existing dwelling 30.00 x = $
Private Disposal System new/refurbished " requires MPC lic. 75.00 x - $
Private Disposal System abandonment 30.00 x $
RPZ new installation/re air 30.00 x = $
Rough o enin 1.50 x = $
Shower 3.00 x = $
Under roundsprinkler if dwelling is under construction 3.00 x = $
Underground srinkler if existing dwelling 30.00 x - $
Water closet 3.00 x = $
Water heater 3.00 x = $
Water softener if dwelling under construction 5.00 x = $
Water softener if existing dwelling 30.00 x = $
Water turnaround 30.00 x _ $
State Surcharge .50 $ 50
Total $ sa
Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc.
1 hereby ackriovWedgethat I have read this application, state that the information is correct, acid agree to comply with all applicable City of Eagan ordinances.
It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its
normal operational and maintenance activities to the facilities constructed under this permit within City property/right-of-way/easement.
SITE ADDRESS: :L_~7r
OWNER NAME:: TELEPHONE ~SS - lobo??
(AREA CODE)
INSTALLER NAME: C- Z- TELEPHONE bS) 14Z3 ° (1 LI Lf
STREET ADDRESS: (AREA CODE)
CITY: STAT VLA Q ZIP:
SIGNATU OF PE Ml7TEE
1999 BUILDING PERMIT APPL16ATION (RESIDENTIAL)
CITY OF EAGAN
~y 3830 PILOT KNOB RD - 55122 ~l (651) 681-4695
Now Construction Reouirements Remodel/Reoair Rgquirements ~
♦ 3 registered site surveys t 2 copies of plan
2 copies of plans (include beam & window sizes; poured fnd. design; etc.) i 1 site surveys (exterior additions & decks)
♦ 1 energy calculations ♦ 1 energy calculations for heated additions
i 3 copies of tree preservation lan if lot platted after 7/1/93
required: _ Yes , No
DATE: 16 - - CONSTRUCTION COST;
DESCRIPTION OF WORK: N CD ns-_~Cl A C-~a o ta
STREET ADDRESS:
LOT: BLOCK: _ - S D./P.I.D. _t40_v1W MA2 1/) Q'd S
Name: Phone
PROPERTY Last Fast
OWNER
Street Address:-
city
City State• Zip:
5
Company: Phone #:C /A,~-4 '
CONTRtiNCTOR
Street Address: License # 2an&!5`~_ap- 20-
City State: 7VN Zip: ~
ARCHITECT/
ENGINEER Company:, Phone
Name: Registration . .
Street Address:
City State: Zip'
1
Sewer & water licensed plumber (new construction only): Penalty applies when address
change and lot change is requested once permit is issued. '
l.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 Ordinances.
Signature of Applicant:
OFFICE USE ONLY
.t d
Certificates of Survey Received Yes No . °y OCT 1 9 1999
Tree Preservation Plan Received Yes No g of Re ulr4` w'
OFFICE USE ONLY
BUILDING PERMIT TYPE
Cl . 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish
Z 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repair/Rem. ❑ 17 Swim Pool
b` 03 SF Addition ❑ 08 8-plex ❑ 13 Garage/Accessory ❑ 20 Public Facility
❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous
❑ 05 SF Misc. ❑ 10 plex ❑ 15 Deck
WORK TYPE
r 31 New ❑ 33 Alterations ❑ 36 Move
32 Addition ❑ 34 Repair ❑ 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. 17 41N~ Census Code -
{Allowable} Main level sq. ft. SAC Code 1
UBC Occupancy sq. ft.z Census Units_
Zoning -7 = L sq. ft. r Census Bldg
# of Stories sq. ft. MC/WS System
Length sq. ft. City Water
Width Footprint sq. ft. Booster Pump
PRV--___-_
Fire Sprinkiered
APPROVALS
Planning Building Engineering Variance
39
Permit Fee Valuation: $
Surcharge
l Plan Review
License 17y l~i~
AC ~ ~ 5( may= ~~L>> G 2
Cit SAC
Water Conn. G-~~x f~ - J o
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pl.
Park Ded.
Trails Ded.
Other i
Copies
Totals: 5
% SAC
SAC Units
r
9J- ~ Od
' ENERGY CODE WORKSHEET FOR l & 2 FAMILY DWELLINGS
SIT} ADORESS~~ 5 CITY
COMPLETED BY IU.~ PRONE # RATE
BUILDIIJG CLASSIFICATION: ❑ category 1 (standard) or ❑ category 2 (must include ventilation)
MINIMUM CRITERIA
Foundation Insulation-R10 Walls & Windows Roof Attic Insulation: table on reverse side
Slab on Grade Insulation-R10 foreallowable percentages) R44-With Attic No Neel
Floor over unheated spaces-R24 R38-With Attic Raised Heel
Foundation Windows 1/2° R38 & R5-Solid Rafters
insulated Glass.
-Wood or Vinyl Frame
STEP 1 Window & Door Area STEP 2 Calculate area as a percent of wall
A. Total Window & Door Area in Sq, Feet
WINDOWS (Including Foundation Windows);
WINDOW MANUFACTURE NAMEt' C. From Step 1 divide box A (Window & Door
WINDOW MANUFACTURE TYPE; Area) by box B (total wall area) times 100
equals the window and door area as a
WINDOW MANUFACTURE U FACTOR: perk~--e~n}~t^^of wall area (box C)
R• O. Quantity sq.ft.Area BOX A J~ x 100 =
Dimensions C = Box BA,~' .
X, 1 STEP 3
ZI Ow Design Features
-Vi
N X _4
t } ASSEMBLY
q ,O X~~/~ j FRAMING TYPE:
3~ x Ste,"f-, if
STANDARD FRAMING ~y studs 16" o.c.
Z)~~q X ADVANCED FRAMING studs 24" o,c.
X CAVITY INSULATION 11--
X
SREATRING TYPE:
1
X LESS TIlA1J < R-5
X R-5 > OR MORE
X U-FACTOR U
DOORS: From the table, `
(reverse side) determine tle
maximum percent window & door area for. the'
p x design options selected and enter the t- value
in Box D below based on the window mfg. U-
.~e ! factor:
I(~ D
Total Area of A=-C~q,ft. ~-~--J
Windows & Doors J
B. Total Wall Area in Sq. Ft. The i value from the table in Box D shall be
equal to or greater than the t in Box C
Wall Total Height Area
Perimeter
'Total Area of Walls B= G ft
--=--r=-------
F. The building niust not exceed the maximum window , and door
a
area as a
.percentage of overall exposed wall area listed below for the combination
of framing technique, R-value of insulation within the insulated cavity,
sheathing R-value, and window U-factor. Other components must meet
the requirements of this subpart.
MAXIMUM WINDOW AND DOOR AREA
AS A PERCENT OF OVERALI. EXPOSED WALL
Cavity Window 11-Factor
-Framing insulation Sheathin8__ 0.49 0.36 0.31 STANDARD R-13 _R-7 13.4% 17.8% 21.3% 24.3°0
STANDARD R-15 2:R-5 12.9.0 17.1% 20.1;0 23.4°6
STANDARD R-18 <R-5 11.1% ;16.0,0 18.8°~ 22.0°0
STANDARD R-18 2R-5 - 13.5;0 18.6;0 21.80% 25.31%
ADVANCED RA8 <R-5 11.100 20.1;0 23.411/0
ADVANCED R-18 ?R-5 13.5;0 19.2% 22.5°x6 26.1"6
STANDARD 9-21 <R-5 11.8°0 17.0;0 19.9;0 23.1°6
STANDARD R-21 >_(t-5 I4.001110 19°6 •
.3. 22.50° 26.1°,°
ADVANCED I:-21 <R-5 11.8°0 18.1% 21.2°0 24.6%
ADVANCED R-21 aR-5 14.0°0 19.9,0 23.200 26.9°0
Subp. 3. Performance criteria. The combined thermal transmittance (Uo)
factors for walls, roof/ceilings, and floors over unheated spaces must be less than oi-
equal to:
A. 0.110 Btu/h ft2 T for walls;
B. 0.026 Btu/11 ft2 or, for roof/ceilings; and
C. - 0.04 Btu/h ftz T for Floors.
STATAUTFI: MS § 216C.19
HIST: 18 Sit 2361
7670.0180 Repealed, 18 SR 2361
Minn. Rules Chapter 7670 26 ltln'. 1C)QA
I
~ LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
zLz L--.t/ ~~gNls 7-11
PROPERTY LEGAL:T
DATE OF SURVEY: -
LATEST REVISION:
DOCUMENT STANDARDS
I
❑ ❑ Registered Land Surveyor signature and company
❑ Building Permit Applicant
/ ❑ ❑ Legal description
ae / ❑ ❑ Address
ry/ ❑ ❑ North arrow and scale
r/ ❑ . ❑ House type (rambler, walkout, split w/o, split entry, lookout, etc.)
cu' ❑ ❑ Directional drainage arrows with slopelgradient %
❑ ❑ Proposed/existing sewer and water services & invert elevation
❑ ❑ Street name
❑ ❑ Driveway
❑ ❑ Lot Square Footage
❑ ❑ Lot Coverage
ELEVATIONS
Existin
❑ ❑ Sewer service (or Proposed)
IV ❑ ❑ Property corners
6 ❑ ❑ Top of curb at the driveway
❑ V ❑ Elevations of any existing adjacent homes
❑ ❑ Adequate footing depth of structures due to adjacent utility trenches
Proposed
❑ ❑ Garage floor
ra ❑ ❑ First floor
q~ ❑ ❑ Lowest exposed elevation (walkout/window)
❑
❑ Property corners
❑ ❑ Front and rear of home at the foundation
PONDING AREA (if applicable)
❑ ❑ Easement line
r,✓ ❑ ❑ NW L
[ ❑ ❑ HWL
❑ ~b Pond # designation
c3
❑ Emergency Overflow Elevation
DIMENSIONS
❑ ❑ Lot lines/Bearings & dimensions
❑ ❑ Right-of-way and street width (to back of curb)
❑ ❑ Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent footings)
❑ ❑ • ' Show all easements of record and any City utilities within those easements
Setbacks of proposed structure and sideya d setback of adjacent existing structures
❑ ❑ Retaining wall requirements, if any ,
Reviewed:
ame / Date
March f 999
CRAIG/BLDGPRMr.FM
CERMnCATE OF SURVEY
for M32-2089-99
JOE MILLER HOMES
8$il•
moo,
i
37 - 1
799'
N W On
\ ~p p t~ Q A ~ a~ SN
ti?j~
1001
1P 8' cD
(D
01
.•Z o o 1
pl co c0a r; 30.001
o w 11Nd~
0'V Lo
42- 00
~D I
10 w
53 E ~87~• 27 I
211.49
S~~ESZ
I
~J
i
E.,Ui = ! 9411 5', ~'1';
D
REI F.
Date J }t ~ ~y yw9 ~j
...ia ..l.♦ ~j7•.,,7Y11+..y'-0~.7a4wi~ ~ ~ ,LJ.t::1id~~
Top curb to Gar slab 25 Top block =
Lowest bsmt fir
Scale: 1" = 30'
3865 Big Timber Trail
DESCRIPTION
I hereby certify that this survey, plan, or Lot 5, Block 2,
report was prepared by me or under my direct GARDENWOOD PONDS FOURTH
supervision and that I am a duly Registered Dakota County, Minnesota
Land Surveyor under the Laws of the State
of Minnesota. Plat bearings shown
o Denotes iron monument
Existing j Proposed
Date S Reg. No. 8140 - -
R 15V z z 067 9
BRANDT ENGINEERING & SURVEYING
1600 West 143rd Street, Suite 206
Burnsville, MN 55306
(612) 435-1966 M32-2089-99
I
CITY OF EAGAN
CASHIER: JS TERMINAL NO: 762
DATE: 05/01/00 TIME: 14:01:11
ID:
NAME:. BUTCH SPRENGER
3210 9001 3865 BIG TMBER 60.00
2155 9001 3865 BIG TMBER 0.50
Total Receipt Amount: 60.50
CR128672
USER ID: JAN
s 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN CQ i {d y jib(
3830 PILOT KNOB RD - 55122
651-681-4675
New Construction Reauirements Remodel/Repair Reauiremenis
> 3 registered site surreys showing sq. ft of lot, sq. ff. of house 2 copies of plan
and go rooted areas (20% maximum tot coveraae allowed) I set of energy calculations for heated additions
> 2 copies of plans (show beam & window sizes; poured fnd. design; etc.) I site survey for exterior additions & decks
> I set of energy calculations
> 3 copies of free preservation plan If lot platted offer 7/1/93
DATE:- CONSTRUCTION COST:
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT: BLOCK: Z SUED./P.I.D. Gardeowood Ponds uffi
Name: A ~J C ! 1 k c [Z Phone Co S t o S - O`-1 ti CC
PROPERTY last n1st
OWNER
Street Address: ' 'T CA r ~
city A-mJ state: /V Zip: 1 2 3
Company. _ Phone
(area code)
CONTRACTOR
Street Address: License # Exp.
City State: Zip:
ARCHITECT/
ENGINEER Company. Name:
Telephone C ( )
Street Address: Registration
City State: Zip:
Sewertwater licensed plumber (if installirre seweriwateir Phone
I hereby acknowledge that 1 have read the application, state that the ormation and agree too comply with aN applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received Yes No 5
Tree Preservation Plan Received Yes No Not Required
OFFICE USE ONLY ;
BUILDING PERMIT SUBTYPES
❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 21 Porch (3-sea.) ❑ 31 Ext. Aft - Multi
❑ 02 SF Dwelling ❑ 08 06-plex ❑ 17 Garage D 22 Porch/Addn. (4-sea.) O 33 Ext. Aft - SF
❑ 03 01 of i plex ❑ 09 07-plex 18 Deck ❑ 23 Porch (screened) ❑ 36 Multi
❑ 04 02-plex ❑ 10 08-plex 19 Lower Level ❑ 24 Storm Damage
❑ 05 03-plex ❑ 11 10-plex Pibg Y or - N ❑ 25 Miscellaneous
❑ 06 04-plea ❑ 12 12-plex ❑ 20 Pool ❑ 30 Accessory Bldg.
WORK TYPE
❑ 31 New ❑ 36 Move Bldg. ❑ 43 Reroof
~ 32 Addition ❑ 37 Demolish (Bldg)* ❑ 44 Siding
0 33 Alteration ❑ 38 Demolish (Interior) ❑ 45 Fire Repair
❑ 34 Repair ❑ 42 Demolish (Foundation) ❑ 46 Windows/Doors
* Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
SAC Code h I # of Stories sq. ft.
No. of Units Length sq. ft.
No. of Buildings 1. 1 Width Footprint sq. ft.
Const. (Actual) Basement sq. ft. Census Code L.
(Allowable) Main level sq. ft. MC/ES System
UBC Occupancy sq. ft. City water
Zoning sq. ft. Booster Pump
PRV
Fire Sprinklered
MISCELLANEOUS INSPECTIONS
❑ Stucco/Stone
APPROVALS
Planning Building rokh/ Engineering Variance
Permit Fee Valuation: $
Surcharge
Plan Review
License
MC/ES SAC Y
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
CERMFICATE OF SURVEY M 32- 2089-99
for
JOE MILLER HOMES
A
5~„
2 •00" ~ry
131 96~•O.
P 5) 0, I C 8 30.00
O,
t) 0
0 )AV
r-3 Ln
- N83'45'53 E 7~•2~1
211.49 /~j
I
I ~
LU)
Top curb to Gar slab
Top block = _rM6,0
Lowest bsmt flr
Scale: 1" = 30'
3865 Big Timber Tral
DESCRIPTION
I hereby certify that this survey, plan, or. Lot 5, Block 2,
report was prepared by me or under my direct GARDENWOOD PONDS FOURTH
supervision and that I am a duly Registered Dakota County, Minnesota
Land Surveyor under the Laws of the State Plat bearings shown
of Minnesota. o Denotes iron monument
Lx isting Proposed
Date S Reg. No. 8140 1600 West 143rd Street, Suite 206
Burnsville, MN 55306
(612) 4-35-1966 M32-2089-99
CITY USE ONLY 3
LOT S BL RECEIPT ` C\
SL'BD. Qoj\'- was°~) RECEIPT DATE: l
1999 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAIN
3$30 PILOT KNOB RD
EAGAN MN 55188
~~/l (851}661-4675
Date: l
Complete this section yml if you are installing HVAC in single family, townhomes or condos under
construction and not owner /occupied
• HVAC,: 0-100 MB T U $ 30.00
ADDITIONAL 50 M BTU 6.00
• Gas outlets (minimum of one required @ $3.00 ea.)
• State Surcharge: .50
• TOTAL: j
Complete this section only if you are remodeling, adding to, or repairing existing single family dwellings,
townhomes; or condos. Please indicate if it is a new item, replacement item, or repair.
6
New , Replacement Repair Other
Furnace Air conditioning
Air exchanger, i.e. Vanee system, etc. Other
Reminder: Call 681-4675 for inspections. $ 30.00
State Surcharge: .50
Total: $30.50
SITE ADDRESS:
r
OWNER NAME: e PHONE
INSTALLER NAME: le P PHONE Coo
STREET ADDRESS: ~ A/L) doe
CITY: - STATE: ZIP:-5 0
S NATURE Of--PEkMITTEE
JS, FORMS BLD„b1ECH PERMIT (RES) - 1999
CITY USE ONLY
L BL RECEIPT
SUED. RECEIPT DATE:
APPROVED BY: , INSPECTOR
1999 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3$30 PILOT KNOB RD
EAGAN, MN 55188
(651) 6$1-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: 1 % of contract price OR $30.00 minimum fee, whichever is greater.
Processed piping - $30.00
CONTRACT PRICE x I%
PROCESSED PIPING
PERMIT FEE
STATE SURCHARGE ($.50 per $1,000 of pemrit fee due on ail permits.)
TOTAL
SITE ADDRESS:
OWNER NAME: PHONE
TENANT NAME (IMPRovEMENTs ONLY):
INSTALLER`
ADDRESS: PHONE
CITY: STATE: ZIP:
SIGNATURE OF PERMITTEE
CITY USE ONLY
L SL RECan 0.
4 SJtS~ItU fiT t7f
IN,
2000 VL F PZ IT (Rats XWf~'~ '.A
CITY OP ZAt i41Q
3830 PTWT MM M
FJU"., M 35122
651-681--4676
ft > sin* dwetli V*
> fow*ooOm Land oondw why ps"Y s are ua*umd for each tam
rar er for untle►wow4 sp**W sysWn
sni t t~a► *x* ft tweftV rninftn ' fi y 3t3.M
gb $ 3.tH3 x
Fitatx t9raiitt
c
00
Gas " i cutlet n**n mr -1 .Ott Y ~ .
Hot tukN 3.00
Kitchen sink &00 x
f Laundry tr 3.00 x
Levsi 3.00 x
S stem to u MnC He. 75.00 x "
stem awrdoftcners 30.00 x
PZ MWi tiettoivhapair/rebuid .fIO x' $
. 9.50 X.
Shower 3.00 x :
Unde t'ound sprinkler If ewe ' is en !!i consttut w 3.00 x
t1 round s "nkW if ex;sthtq dw ffing 30.00 x
V%ter ctaset 3.nt}
Walter heetet 3.4 ? Y $ 11 11 1
%Awtw st tec if qwl!lwq under *msftWw 5.00 x
iNaw sca tier' . N ""N ion" 30,00 X
t 90.00 x
uer Si} .50
S
MT
a r: #f fat' i~ oi: fa~1rrar c»s, lie. vootme- a tem wowA t ifc.
-sttfti ft,eomici~is o#,"at'ic 9'+i-i► 3i to It the to~s respomOft to notify the ;petty owner that ft City of Eagia saw." no Way ir' y i~~Wttw cxy ftft f
attd wd ncs actP ktw to the hxMfts t acted unOiw 0* permit tAhin cly wa t-af a t.
WE ADDRtft-
aMER N TELEPHDWR
STREET ADDRESS:
on y: S°T'A M; zip:
S*NATUFt ',OF F*PMT'T
PERMIT
City of Eagan Permit Type: Plumbing
Permit Number: EA106620
Date Issued: 08/30/2012
Permit Category: ePermit
Site Address: 3865 Big Timber Tr
Lot: 5 Block: 2 Addition: Gardenwood Ponds 4th
PID: 10-28803-02-050
Use:
Description:
Sub Type: e -Water Heater
Work Type: New Description: Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments: Tony Boerner 2090 County Road 42 W
Burnsville, MN 55337
952-435-2442
Fee Summary: PL -Permit Fee (WS &lor WH) $55.00 0801.4087
Surcharge-Fired $5.00 9001.2195
Total: $60.00
Contractor: -Applicant - Owner:
Tony's Appliance Romack S Franklin 2090 County Road 42 West 3865 Big Timber Tr
Burnsville MN 55337 Eagan MN 55123
(952) 435-2442
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.
ApplicanvFermltee: Nignature issued tiy: NIgnature