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4557 Ches Mar Dr aTr af FAGAH WATER SERVICE ? PERMIT 3795 Pilof Keob Raed PERMIT NO.: Eogen, MN 55122 DATE: Zoning: No. of Units: Owner. , Address: Site Address: Pf umber: Meter No.: Connection qhcrge: Size: Account Depos7t: Reoder No.: Permit Fee: I opre* to eon+ply wie6 t6a Cky of Eepen Surchorge: Ordlneeeea. Mfsc. Charges: Total: By Dote Pnid: Date of (nsp.: lnsp,; CITY Oi EAGAN SEVNER SERYICE PERMIT 3795 Pilot Kneb Road PERMIT NO.: - Eagen, MN 55122 DATE: Zoning: No. of Units: Owner: Address; Site Address: '. I PI umber: 1 e9ree M oawpFy witii f6s Cily of Eagen Connettion Charge: Ordinanm. Account Deposit: Permit Fee: Surctwrye: BY Misc. Charges: Dote of Insp.: Total: Insp.: Dote Paid: BUILDING PERMIT 3795 'Ibt Kno? Road Eaten, MN 55122 PHONE: 454-8100 Receipt # 5ite Addrcss Lot Block Sec/Sub. Pcrcel # C oc Name _ W ? AWrQss ? i . . , . . .., CI P1p/1E p Name F`. Zu o? Address u Name _ Address I hereby ecknowledge that I have read this application and state thot the information is correct and ogree to comply with oll opplicable Store of Minnesoto Stotutes and City of Eagon Ordinances. Erett p Alter ? Repoir ? Enloroe D Move ? DCmOllifl ? Assessment _ Woter & Sew. POI iCC Fire Enp. Plonner Council Bldg. OFf. _ APC Occupancy Zortinp . Fire 2one Typa of Const. # Stories ? Permit Surctarpe Plon check SAC Water Conn. Woter Meter Road Unit Total Sipnaturc of Permittee I /1 Bullding Permit Is issued to: on the expreu condition thwt oll work sholl be done in occordonce with oll oppliooble State of Minnesoto Statutes ond City of Eepon Ordinonces. Buitdiny Officlal Permit No. Permit Holder Misc. Permit No. Holder Plumbing ?9L ;-AZ L ? 43 H.v.a.c. I? g t4srv 4 Ax Z-b-B'3 w.u Water D'np. Sewar elm.ic w z?looq t-le-$3 Inapection Dsb Insp. Other F??ings ?- V-g3 b {? - Foundttion Framinp be Rouqh PI6p. c.l) Rouph HVA Inwlation eVf W Fcn.i PIbg. Finsl HVAC 3 Final M Wrbr D*wibe Locatlon: YVell ` Snwer 1 Pr. DbP. i Receipt r MECHANICAL PERMIT CITY OF EAGAN Fill in numbered spaces Type or Print legibly Permit No. -?. ? • Fee . . S/C Tot. ? 1. Date 2. Installation Cost ' r? -- 3. Job Address Lot ? i Blk. ?' Tract ,• '" 4. Owner 5. Contractor Phone 6. Address ? 7. City State Zip 8. Building Type: Residential 0 Commercial ? Institutional ? 8. Work Description: New 0 Add O Alter ? Repair ? 10. Describe Fuel Type 11. No. EQuioment 9TU - M. Ea. Forced Air No. Equipment CFM Ai dli H Mfg, r an ng: Boilers Mfg. Mech, Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. , • Signed : - ~ for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 Receipt Permit No. ? -•% , ;' ? ? Fee S/C Tot. 1. Date 2. Installation Cost 7,, , 3. Job Address - Lot .' Bik. -? Tract 4. Owner ' ' ??. ? ,? ? .=„? 5. Convactor ? ? ? i/ ? ? Phone 4 6. Address ?? i ? : ? F , l ;'? , . ? • ? , 7. City State Zip - 8. Building Type: Residential 0" ? Commercial ? Institutional ? 9. Work Description: New ? Add ? Alter ? Repair 11 10. Describe 11. No. -" Fixtures Water Closet No. Fixiures Cesspool/Drainfield Bath tubs $eptic Tank Lavatory Softner - Shower Well ? Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certity that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Flnal Inspections: Date Insp. _ Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 ? CITY OF EAGAN Remarks Addition Ches Mar 2nd Addn. Loc 17 Blk 2 Parcel 10 17101 170 02 / Owner ?` ?`/ Z " Street 4557 ('hec Mar nri ve state-EagaIl., NIN 55123 } - I _ ; , r r1111 Improvem nt ' Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 1973 152.76 7.64 20 68.83 A012160 5-4-83 * SEWER LATERAL ? 1592.65 WATERMAIN * WATER LATERAL WATER AREA ? 1977 152.76 10.18 15 81. 0 A012160 -4-8 ?e STORM SEW TRK 1979 * STORM 5EW LAT 1978 CURB & GUTTER SIOEWALK STREET LIGHT Road Unit 240.00 33761 1-4-8 WATER CONN, 420.00 9UILDING PER. SAC n it PARK ?ertifirtttr af (Orrupttnrg Citp of (Eagan grpttrimeni of BuilDing Jnsvrriiun Tnu ct.ri}iratt utrud passaqnt to tbr +rqwrmenu of Sertian 306 o f the Uni f o+m Building Corlt artifying that at !!x time o f irtuatue tbir strtuture wat in tom fliantt witb !bt variow ordinarurr of thr City rrgulating braldisg tmutrtutian or e1e. For tht following: ???,b0 SF DWG/GAR Mae.han,Na. 7741 o-wayrry R3 'hpc? V FkmZooe NA zo,,;,wn?, Rl Michael Bukovich Add„s4112 Skvlark Lane, EaQan e„odftAdd. 4557 Ches Mar DriveLoo?,YLot 17,Block 2,Ches Mar 2 )6n& BY` ?o? ? av April 26, 1983 .a., ?. , ?,...???. ...?. This request voitl C> 18 months frnm t"'J 2 ! 6 Q4, Ll? ? b Zt Cl1ES Mar z'^ d 3 3 Sz ( q2,o 6 RAque$t ?ate ? _? ? ? Fire No. Rough-in Inspec[ian retl, ?Ready Nuw??'ill Notity Inspec t h R _? es ?NO or W en eady ?icansed Elecvicai ConVactor J hereby raqaest inspection of ebove wner electrical work installad at Sve?e} Address-, B7oz or Ro te No. p? ?C C?FZ> L City ' CL ? ecLOn o. Township Nome ar No. Rango No. County ' ? Occnt IPRI T?? ? L, c V Pho e No. ?S Z-? z 3 7 Power $upp?l/ier? ? b 2 tp 4 A-a Addregs ?}?-? lQi - v -- Electrical Convactor (ComOany Name) Contrac[or's ' ense No. Mailing Address IConlractor or Owner Makinp Instailationl A? ? Authorizetl Sign ture I nV or/? Ma Installatio ? Pho Number sa - a3,7 MINNESOTA STqTE BOAPD OF ELECTRICITV THIS INSPECTION REQUEST WILL NOT GrigBS•Midway Bldg. - Boom N491 ' 8E ACCEPTED BV THE STATE BOAXD 1821 Univarsity Ave., St. Paul. MN 56104 tINLESS PPOPEN INSPECTION FEE IS ? P?.,...e 181L 49]?ttt ENCLOSED. REQUEST FOR ELECTRICAL INSPECdION ? 2 76'0 4,-, 0 Sea instruetions tor comoletin9 this torm on back of Vollow copy. "X" Below.4Vork Covered by This Request ?.} EB-00007-03 3385? New Atltl Hep. Type of 0uiiding Appliances Wired Equipment Wiretl Home Range Temporary Service Duplex ' Water Heater Lightin,y Fiictures . Apt. Building Dryer Electric Heatin Commercial Bidg. Fumace Silo Unloader InAustrial Bldg. Air Corxlitioner Bulk Milk Tani< F2?m Other oecify Iher (SOecify) ' t er ISUnci y Offier Othor Compute lnsUection Fee Below v Fee ServiceEntranceSize H Fee Feadars/Subfeedars # Fee Circuits 0 to100Ams 0 to30Ams Oto30Am aQ 701 to 2U0 Amps 37 ta 100 Amps $1 31 to 100 qm s Above 200 qmps - Above 700_Amps Above 100_AmPs Transiormers - RemoteControl Circ. sio P rtial' Fee Signs Speciallnspection $ TI Remnrks . a l qL FEE A-41 ? . ? ? the Electrical ipector, hereby rtity that [he above auoction has been s request vo rnontlis from ' 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) ' CITY OF EAGAN a? -?l--- 3830 PILOT KNOB RD - 55122 651-681-4675 New Conzhuction R aulrements Remodel/Reooir ReauiremeMs D 3 regfsfered sNe wrveys showing sq. H. of lot, sq. N. of house 2 copies of plan ? and ail rooled areos (20%, maximum bt coveraae allowed) 1 set of energy calculations torheated addNlons ? 2 coples of plans (show beam S window sizes; poured fnd. design; etc.) 7 site suney for exterlor addNions 8 decks > i sef of energy calculaHons > 3 copies of hee preservWfon pion H lot platted alfer 7/7)93 DATE: 'kq A? CONSiRUCi10N COSi: ?'+a DESCRIPTION OF WORK: 4?? aAxc?iZe ?Te-z,r $TREETADDRESS; `I S S ? LF.x.S ? ? LOT: BLOCK: ?- SUBD./P.I.D. #: Name: PS V y- OJ L` ` m'; Y-a- Phone #: ?e SI LI $'?- ?z 37 PROPERiY Last First ` OWNER Street Address: C- ?- S ,?-a? P City Eaq2•? State: mN1 Zip: Company: m-a? ?.., ?N ?,?.?? -a U }-or c Phone #: (e ,'i- CONTRACTOR ?ly'1 .- q (oGG ? (crea code) Street Address: Ld"42 License # ?OL'1° 3 Exp. "3 ?2? City ? S2-J 2G`e State: ?r? Zip: 5 5') -1 15 ARCHlTECT/ ENGINEER Company: Name: Telephone #: area code ( Street Address: Registration #: City State: Sewer 8 water Iicensed plumber (reauired for new constructfon onlv): Penaity applies when address change and lo} change Is requested once permif ts tssued. Zip: I hereby acknowledge that 1 have read this applicatlon, sFate that the informatton is correct, and agree to comply wtih all applicable State of Mfnnezofo Sfatufes and City of Eagan Ordinances. p Slgnature of Applicant: OFFICE USE ONLY ificates of Survey Received _ Yes _ No °reservation Plan Received _ Yes _ No _ Not Required cirr oF EAcnN „ 9795 Pilot Knob Rmd Eagan, MN 55122 N? 7741 ` PHONE: 454•8100 BUILDING PERMIT Receipl # Te ba uwd fer SF DYTG/GAR Est. Vulue $70,000 pate 1-4 , 1 983 Site Address 4557 Ches Mar Drive Erecr CM Occuponcy R3 Lot 17 Block 2$ec/Sub. CheS MdY ZriCl Alter ? Zoning R]- porcel # 10 17101 170 02 Repoir ? Fire Zom NA U M1 Ch321 BUkOV1Ch Enlarge ? Type of Conat. a w ' Name Move ? # Stories ? Address 4112 Skvlark Ln Derrwlish ? Length 62 Ci Eagari 55122 Phom 452-1237 Grode p Depth-3-k- Sq. Ft.- ? T111Q25 COT15'tY'l1CtlOn CO Aporevals Fees a Name ou Addreu Z0936 Holyoke Ave ? u ? r:... Takavi 11 a F504d--- ati9-97 dd Name _ Address I here6y acknowledge thut I have reod this ap0licotion ond stote that fhe informalion is corrett ond ogree fo wmply wifh oll upplicoble $tafe of Minnesota Statutes and City of Eogan Ordirqnces. Siqnoture of Permittee - A Building Permif Is issued to: all work sholl be done in acco Building pfficiol Sfate of Assessment Permit 34b.UU Water & Sew. Surchorge 35.50 Police Plan check 173_00 Fire SAC -sqS-nO Enp. Water Conn. aan _ nn Pionner Woter Meter Fn _ nn Councll Road Uni1 240 nn Bidg Off. . APC Totol 1? 799 _ Sfl on the express condiNon ihar Stotutes and City of Eagan Ordinonces. aTy GF rAi;zN Include 2 sets of plans, 1 site plan w/elevations & BUILDING PERM1'r APPLICATZON 1 set of energy calculatiaris. To ? usea rror valuation 20 • Date i a- zQ 5ite Address Cy\ E'S Aacv- bi^ OV E CFFICE USE. ONLY Lot slocx ;L sec./sub.Ckks /?a?"Z? Erect . X p-C,4,ancy T-.?-?P--?--^--^--^ Parcel #: { 0 ?-I ( bt (Z O 0 Z Alter Zoninq Repair 9 Owner: (` cUl0. F? U- k o V i c V? Enlaige _Type of Const. 27 y,`? Nbve # Stories Acklress: lZ Sk?l{.?0.??- ? Deimlish _ Front ?2 ft. Ci+_y/Zip Caie: E-0?0.? v S1 Z. Z Grade Depth 36 ft? Phone #: 4-?aZ- ) 2 3? _.......,.s.. r ,. c?c Contra<:tor: T,_Ik ?5 C_°ov?-A?,. Aaaress: zo 2 36 4-8l ,? kf AV e-City/Zip Code: ?EViIIL S-``'aU Phom P,YCh./Fng. . Address: City/Zip Code: Phone #: Water/Sewer Surcharge 3vr ? - Police Plan CheckS * Fire SAC 6 _ glq, Water Conn• 4/S0 ey Planner Water Meter Council Road Unit _:a y? Bldg. Off. P,FC ZC7I'F1L I 16ig , z ? ? . EXTERIOR ENVELOPE AVERA6c "U" COMPU7HT1DN SIiE RDDP,ESS 4557 t4 C0N7AAC70R-r/?p? TrJL,1 DATE PHOhE 2d44- Determine working sGuare fnotage of each. : 1. Total exposed wall area .,.... sq, ft. x .17 = 2. Total roo; /cei ting area .. . . _ tz-s?- ? sq, ft. x .05. _ Total exoosed wall area above floor a. Total wa11 wtndow area ................. ....... b. 7ota1 door area .. ...................... ... • c. 7oLa1 slidino glass door area ................... `d. Total fireplace wall zrea ................. e: 7otal wall framing area (avera9e lOM)...'.. :.. f. Total net v+al l area above floor ................ Je?? 1=y; q 7 g. Total rim joist area ..................... ,... fS Z,oo 7ota1 ezposed foundation area F-?- h. 7otal-foundation v,indow area..................... Z,G i.,7oal.net foundation area above grade ........,... Deternine "U"•value of each wall segment.:. X ?lull U.-' X „U" ,G,G. = fI?SS ?f.a_ X -'U„Sr = S.? . d.`?-2,0D X liulj__ C-'? ,.e, /?G•??b x V. ..T r) , X uUu e 05 ' SJr?/ ._ . . .. . ! 9•_ x „u,l ? . . .. h. X uUu - iS? _ ???J ' . • . _-..X 3 . ..... :..........................:Total ° 16 1 e5' ? If item =3 is the same zs, or iess tnan item rl, you nave met the in.ent of SBC 6006(C)2. 7otal er,posed roof/ceilino area = /A a6 ?q(??? j. 7oial'si:ylignt ar2a................... .......... ---- k. To.tal roof/cEiling `raming area (averz qe,lOH)r. 1. 7ota7 net insulated rooi/ceiling area. ...:.:..: Determine "U" va?ue for each roof/ce i]ing seomert, X k. x,,U„ x u„ 4. . :. , . . Totai lf total of =4'is ihe same as, or less fhan 02, you have net the',intent of SBC 6006(c)1.. - ' Alternate Building Envelope Design To utiiize tnz total envelope system method, the values esta6lished by thA sum of items r3,and `'4 shall not be greater than . the sum of items Yl;.and #2.: +12: s. 6'°?I ± a.. , , _ e1? September 14, 1977 Dave Gabbert 3755 Larchwaod Drive Minnetonka, MIN 55343 Dear Dave: I have listed below the total assessmants on the following additions: Che, Mar lst Addition A,"r0iN; lot 7, blk 2 $1178.98 Lot 3, 61k 2 1178.98 lot 9, blk 2 1178.98 HES-MAR 2W Addition---? " lot 1, 61k 1 $2825.51 lot 2, blk 1 2729.21 lot 3, blk 1 2553.03 lot 4, blk 1 2659.66 lot 5, blk 1 2704.14 lot 6, blk 1 2657.97 lot 7, blk 1 2653.13 lot 1, blk 2 2664.80 lot 2, blk 2 2958.53 lot 3, blk 2 3177.42 lot 4, blk 2 3006.24 lot S, blk 2 2984.55 lot 6, blk 2 2913.39 19t 7, blk 2 2720.39 lot 8, blk 2 2731.55 lot 9, b2k 2 3093.44 lot 10, blk 2 2728.14 lot il, blk 2 2575.13 lot 12, hlk 2 2636,78 lot 13, blk 2 2660.62 lot 14, blk 2 2632.17 lot 15, blk 2 2576.95 lot 16, blk 2 2634.85 lot 17 lilk-2' 2654.35 lot 18, b1r-2J 2644.39 All the lots in ches Mar 2nd addition also have an unpaid balance for Sewer trunk of $114.61 and Water area of $142.58. If you additional information please contact me at the City Hall. Sincerely, . Ann Goers Assessment Clerk _ _ _r, _ _~.~.~~_..._Mm_.. . . r _ . - _ ~ % , , , f . ~ ~ f ~ I I i t i i ~ ( ; ; ~ } ~ 1 , ; z , ~ ~ ~ , , ''~~.-c>, i ~ , _r ~ . ~ ; ,r~ 4: M t ~ 1 ; 4 Yl , y-? ~IV ~ ~`4`,. Y~4 i ~'3 ~+y ;,.P ) i I.~ ~ r f ~ ~ + , . '~~4'4~ ~t~,~ ~,F~~ ; ' 3 ~ .i /w;~ _ _ ;L _ _ _ - - ~ _ b ~ 1 ~ 4~ ~ 4; ~i , , ' ~i ~ ~ ~ , ~ , d; ~ _ _ _ _ _ . _ _ _ _ , ~ . y ~ - - _ _ ~ ~ ; ~ ~ ~ , ~ ~ ~ ~ ~ ~ ~ ~ l~~_ ; ~ v ~ ~ ~ ~ . ~ ~ , I .w . ~5 ~ . ~ 1 z;~. M{~ t,~ ~ i ~ r ~ 1~ . ,id , "'f q . ' ~ j ~ ~ ~ , ~ ~'C ~ ; ~ . , ; , ~ i f ~ r~ - _ _ _ _ , i ' ~ i i ! ~ j ~ i , 1 1 ~ ~ ~ f t ~ ~ t 4{ . ~ ~ i . . ~ i , 1 ~ ~ ~ ~ 4 j ~i ~ S ~ ' ~ ~ ! { ~ ~ ~ { ~ 3 i ~ ~ ~ ; , ~n . ' ~ ~ _ . . . . . . . . . . . . . . . . . . . . V, . . . . . . . ~ S~ t ~ d ~ ~ iD J ~ ~ w-.- _ . , 1 ~ ~ i ~ n 1' . 1:.~ _ . . . ' . i ~ { ~ ~ ~ ~ ; ~ ~ t ~ . i 1 ' t ~ ~ r w ~ _ ~n~~i ; ~ _ _ ~~z ~ ~ ~ ~ ~ _~~r ~ ~ a~N ~ m .r .~r ~ ~ _ ~ ~ ~ ~ ~ „ ~ t ~ ~ ~ ~ ~ + . ~ 4 . . 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I , j~ w y^^ (w ' ~',,y1~/°~°'"',!~ 't ~'tY~~~,~~ { t'~~~~f . ~ ~ , . . ~~~,I . ~ r .f ~ . . 1. . . . _ , . . . ~ _ ~I r ~ ~ ~ . ~ . . . , . . , f~ ~ ' ~I ~ ~ . . . ~ ~ _ _ i ~ I ~ , , , , , , 8~, ~~ti1'; t.,.., ~....._1:, ~,l.,.a_.., ~ J.'x~ I~ . ~ . . . ~ . Ll . r ; - , . . . ; . . _ _ ~ ! , . - , , . . r t ~ iJ ~ . r;~, ~!'"G,r~ I ~';~i . pi~ ~ ; : „ . . ~ ~ ~ t.. ~ y~p . _ _ 4 i . - . ] t ~ a ^ ¢2. '..~..r~„ , . . _ ~.~.~1 w,d, ~.7 C.,*k.~w~n.i.o Lea~sa - . _ ...~....,,,..,...~..,.....~.,,..mam...~~.. ~.~..w~ 1 - - ~ ì ý ü þýüýû ÿþþ ýüûúûúù øýýþþüü÷þÿ á òý ÿ ÿþõ úù ø÷ ì ÷ý á ùø÷ öø÷ Ýý ì ÷ý ë óè ÷ á ù íù÷ýø Üü úÞùý ì ÷â ýø Þù ý æá øéðù ù ÷ ÷ þ ýüæ áý ä ý Þù øýó ü ðýø æ ý çååæ åæå ôø úù ýü ý çæ ãæã Ûýùýûæ óò õñð ÷÷ý õ ý ýõ ü ï ýÝ ý ôæìýâ óâ á òý ï þýüýòô ë è øýó ü ý ýâ ý ý÷÷ýý ý ý ðý ýýü ÷øó ýý÷÷ý úý ðò ýúýù ýáøðþýüýíý æ ÷÷ýé úüýù ù øúüýù PERMIT City of Eagan Permit Type:Building Permit Number:EA113062 Date Issued:08/28/2013 Permit Category:ePermit Site Address: 4557 Ches Mar Dr Lot:17 Block: 2 Addition: Ches Mar 2nd PID:10-17101-02-170 Use: Description: Sub Type:Reroof 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. Carbon monoxide detectors are required by law in ALL single family homes . William Krech 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 - Roberta A Gerhardt 4557 Ches Mar Dr Eagan MN 55123 (651) 261-0351 Krech Exteriors Inc 5866 Blackshire Path Inver Grove Heights MN 55076 (651) 688-6368 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA176227 Date Issued:05/06/2022 Permit Category:ePermit Site Address: 4557 Ches Mar Dr Lot:17 Block: 2 Addition: Ches Mar 2nd PID:10-17101-02-170 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 - Nannette Albright 4557 Ches Mar Dr Eagan MN 55123 (941) 915-3143 Custom Remodelers 474 Apollo Dr Lino Lakes MN 55014 (651) 784-2646 Applicant/Permitee: Signature Issued By: Signature