1361 Balsam St ECITY OF EAGAN
3795 Pilot Kpob Rood
Eogon,' MN 55123
Zoning:
Owner:
Address:
Site Address: ? 7:='
Plumber:
I ogree to eomplp wiFh the Citr of Eagan
Ordinanees,
By
Dote of Insp.:
I nso.:-
SEWER SERVICE PERMIT
PERMIT Na.:
DATE:
No. of Units:
Connection Charge:
Account Deposit: _
Permit Fee:
Surcharge: --
Misc. Charges: -
Totol:
Dote Paid:
lOfT.00 Od
CITY OP EAGAN
3795 Pilof Knob Road
Eagon MN 55122
Zoning: --
Owner:
..., .. . . .? . .
Address:
Site Address:
Plumber:
Meter No.: -
Size:
Reader No.: _
1 ngree to eomply with the Cify of Eogan
Ordinonces,
R?
Date of Insp.:
WATER SERVICE PERMIT
PERMIT NO.;
DATE:
No. of Units:
Connection Charge:
Account Deposit: _
Permit Fee:
Surcharge:
Misc. Chorges: -
Totol;
Dote Paid:
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55127 N L 9232
PHONE: 454-8100 1 %, , ?G• '
..., , ,. ,.
Name
Address `' EAGAN Citv Phone 2-3508
Name
Addres
Phone
City ` ?
City Phone
1 hereby ackrwwledge thot I have read this oppficotion ond state that
fhe intormation is correct and agree to comply with oll eppiicoble
State of Minnesoto Stotutes and City of Eagon Ordinonces.
Sipncture of Permittee
VALLEY POOLS
A Building Permif Is issued to:
oll work shall be done in otcord?nce wjfh dll upp{coble \Statq'6f Mii
' JG ?-
Buildin9 Offitial
4
BUILDING PERMIT
Recefpt # J /?
Fire Zone --
Type of Const.
# Stories
l.ength
Assessment
Water 8 Sew.
Police
Fire
Enp.
Planner
Council
Bidg. Off.
APC
Permit '• "" •
Surcharge 4.00
Plan check
SAC
Water Conn.
Water Meter
Rood Unit
Totul '
on the express condition Ihnr
y of Eogan Ordinonces.
Permit No. Permit Holder Miac. Permit No. Holder
Plumbing
H.V.A.C.
Well
Water
Disp.
Sewer
EWe.ic r t
it,
t
Inspection Date Insp. Other
Footingt
Foundation
Framinp
Rouph Pibg.
Rouph HVA
Inwlation
Final Plbg.
Final HVAC
Final
Water Describe Location:
YVell R
5ewer
Pr. Disp.
CITY OF EAGAN
3795 Pilot Knob Raad Ea9an, MN 55122 N2 4225
PHONE: 454-8100
BUILDING PERMIT : "; j ? iit ?•.: , Receipt
To be uted for 'i.=%. Fem l1w1g. `. .G:2Tg. Dote ~Eb• 28, , 19
5ite Address
?"' '' • t;? j s''m Erect CJ Occupancy
Lot " Block Sec/Su??} ? th _ Alter ? Zoning -"i
Parcel # Repair ? Fire Zone
Enlarge ? Typs of Const.
ac Name ' t r•:' ?• `"• Move p # Stories
3 Address '?t? ??lY' ?r` • ?'?`?° Demolish ? Front ft.
? .-.-. , ",.?...?te..t..,, Grade n Depth ft.
p Nome _
?Q Address
Name _
Address
I hereby acknowledge thot ! have read this application and state that
the information is correct ond agree to comply with oll opplicob!e
State of Minnesoto Statutes and City of Eagon Ordinonces.
$ignature of Permittee - . ; - -
Assessment _
Water & Sew.
Pol i ce
Fire
Eng.
Planner
Council
Bldg. Off.
APC
Permit yr1.UU
$archarge 16,50
Plan check
SAC ?' ' S• 00
Water Conn. 1 D
Water Meter
Total ?04• 5"_-
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applicuble Stote of Minnesota Statutes ond City of Eago-I Ordinances.
Building Official _
Aooreva Is Fees
Po it # pet* Isnd P
Plumbing ?
Mechanical ??/? `'3 ^/S 77
INSPECTIONS DATE INSP.
Rouph-In
Firal
Footings Date Imp. Date Imp.
Foundation ?9 Plumbing 2v5an 1!?20)
Frome/ins. -
?
-- MeChaniool
Final ?
?D
Remarks:
CITY OF EAGAN
3795 Pilot Knob Rood
Eagan, Minnesota 55122
Phono: 454-8100
Date:
laxch 15, 1977
PERMIT
Site Addreu: 1.1161 East fialsam
Lot
INome
.
m
e
?
?
r
3
Bfack Sub/Sec.
..:_._1 rc,,t,tru:ti')n
Address ?:Vnciale Avp .
City ? I_?o:•iriqtCn Phone:
Name RaY N. Welter Fieatin4 & A/C
Address -' r}'ir?F"??= ayenue
No
,E7,
Receipt No.:
Single
Residential
New/Alter./Repair
Cost of Instolfatior
Permit Fee
Surchorge
862
x
20.00
5n
-, -,,.
City - Phone: Total
This Permit is issued on the express condition thot all work shall be done in occordance with all applicable Stote of
Minnesota StMutes und City of Engon Ordincnces. ,
Building Official
CITY OF EAGAN
3795 Pilor Knob Road
Eogan, MinnesoM 55122
Phone: 454-8100
PERMIT
Date:
larch 9, 1977
Site Address:
Lot Block Sub/5ec. _ WR 51'1
No.
Receipt No.: 1.3?`A.
5ingle ?
Residentiol ?.
Multi Res., Comm./lnd. ?
Name - New/Alter./Repair. .
v
3 Address Cost of Instollotion
O
City ='lOOUtirigtOll, A??? Phone: Permit Fee 20. C'n
'?1,7."fcZ?SOI't PZUIt1biI1?J CO. ..rin
` Name - Surcharge
?
.??,. Address
?
? City Phone: Total ?'?'• 5? ri? i ec
This Permit is issued on the express condition thot all work sholl be done in occordance with oll applicable $tqte of
Minnesota Stotutes ond City of Eagan Ordinances.
:
Building Official' ,
' CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-189
, (612) 681-4675
SITE ADDRESS•
INSPECTION RECORD
PERMIT TYPE:
Permit Number:
? Date Issued:
• I nt:
t?r. I P+1 Alq `, i f
E11 ! lil i.IJi IIN s_. I II
PERMIT SUBTYPE:
,. , I, ': .i ,
1 1 EcI 0 1 p. ;
APPLICANT:
t • ; ?? ? ? ?: ? ; ! ,
TYPE OF WORK:
riF,,t ;;itI riI ;r1
KIt+}t t IV6
?it! I 10 1 N ti
s:'t31 rah
Al l i!8 f 96
I Ni
Pt_PAIR
t!x (f OF t N f; l
Pormlt No. Pertnit Holder Dete Telephone #
ELECTRIC
PLUM8ING
HVAC
InspecHon Date Insp. CommenUs
FOOTINGS
FOUND
FRAMING
AOOFING 7g
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP80ARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAI HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FIMAL
CITY OF EAGAN Remarks
Addicio Wilderness Run Sth Addition Lot 11 sik Z Parcel 10 84354 110 02
Owper • " Street 1361 E. Balsam 5} , State Eagan, MN 55123
Improvement Date Amount Annual Years Payment Receipt Oate
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK d 1973 $132.60 $6.63 20 99.45 A004034 5-10-77
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 149.34 A004034 5-10-77
STORM SEW TRK ; n 19
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATERCONN. 220.00 5364 2-28-77
BUILDING PER. #4225
s,ac 475.00 5364 2-28-77
PARK
This request void Lr
18 mwnths Imm
A? 074511 LI I 6a 0-itd Quti 5 6 d
ftequest Date Fire No. Rouph-in Inspection
Requ?retl7
[-]Ready Nuw,O WiU Notity Inspec-
.Illl 231984 ?ves ?No . tor When Reatlv
? Licunsed Electrical ConVactor 1 heraby request insPection ol abova
? Owner - electrical work instsllad at:
Slreet Address, 9ox or Route No. Ciry
1361 E. Salsam E't. Eagan
ecuon o. Township Name ur No. Rsngc No. Counly
Dakota
Occwant IPqINT) Phone No.
Gar Peterseon 452-3508
Power $upplier AAdr¢55
Electrical Conhactor ICOmVany Nemel Contractor's License No.
Corri an Electric Com an 0 39549 8
MailinB AtlJress (Contrar,tor or Ownar Makinp Instailation)
P.O. Box 475 Rosemount MN 55068
Au o zed Signature (C ntrec ?Owner Makinq Installation)
Phone Nombar
7K?a 423-1131
MINNESOTA STATE B P OF ELECTHICIT THIS INSPECTION PEQUEST WILL NOT
Grie9s-Midwey Bldg. - Xoom N-191 8E ACCEPTED BY THE STATE BOAflD
1821 University Ave.. St. Pxul, MN 65104 UNLESS PROPER INSPECTION iEE IS
Phone 18121 297-271'I ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION jj% ee•00001-04
' See instructians tor com0le[ing this 10Fm on back ot yellow cepy.
w (?
/?-p 1174[ .1 ? 1 R" 8elol?iy?r#Covered by This Requesl
AAd Re0• Tyaa oi Builtling AOPtiances Wiretl Equipmant Wired
Home Range Temporary Service
Duplex Water Heater Lightiny Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg Furnace Silo Unloader
Industrial BIAg. Air Conditioner Buik Milk Tank
Fatm ther Demfy Other (Spedfy)
[ Pr pem y Other d8L Olher
Comoute lnsoection Fee Below p Fee ServiceEntr9nceSize # Fea Feedere/Subleetlers Fee Circuits?
0 to 200 qm s 0 to 30 AmDs 0 tn 30 Am s
Above 200 qmpsi 31 to 100 qmps 31 to 100 AMps
Swinming Pool Above 10D_Amps Above 100_Am ,-
Transformers Irrigation Booms -y' Partial-'Other Pee
Signs Speciat Inspection S?
S'u
TOT
Remarks O m
HauBh-in hl
aby
calHe above
!thlt
Final Dxte insobeen
mademiarepteatvoid78monthsfrom U"
(?/JfJl.e?ll7
?
CITY OF EAGAN
3795 Pilot Kno6 Rood Eagan, MN 55722 N2 4225
r PHONE: 4548100
-BUILDING PERMIT APPLICATION $33
000 Receipt #
,
,
Sing. Fam Dwlg. W. Garg. Feb, 28, 19 77
ro be uced fo. Dare
Site Address 1361 E. BalSAm Erect [g Occupancy I
Lot 11 Blotk_Z Sec/SubR 5th Alter ? Zoning Ri .
Parce1 # Repair ? Fire Zone - V -
Enlarge ? Type of Const.
z Nome I`1are11 Const, CO, Move ? # Stories
3 Address 10800 Lyndale Ave, SO. p¢molish ? Front ft.
?
Ci 1122
n Phone
Grade ?
Depth ft.
? N 11 r r r ADVrovals _ Feea
p ame [?7
?? Address 10800 L;mdale Ave Sn_
r C;tvBlommington phone
Name _
Address
I he26y ocknowledge thot I hove read this application and state that
the information is correct and agree to comply with oll applicable
State of Minnesota Statutes and City pf/1)agan?Ordinar¢es. ,
$ignature of Permitree -_I'q(It14yXl?
A Building Permit is issued er?y
oll work shall be don n accordance all
Building Official 14
Assessment -
Water & Sew.
Police -
Fire
Eng.
Planner -
COUnCiI _
Bldg. Off. _
APC
Permit 98.00 _
Surcharge 16.50
Plan check
snc 475.00
Woter Conn. 220,00
Water Meter
Toral 809.50
on the expreu condition that
of Minnesota StatuTes and City of Eagan Ordinonces.
For: L7 Ci
v?? . Sc I.. ?..
DELMAR H. SCHWANZ
LANOSURVEVOA
Raq?stereE U?Oar Lawt ol The Stale of Mmneso?a
14515 SOUTN ROBERT TRAIL P.O. BOX M ROSEMOUNT, MINNESOTA 55088
i r T `,? SURVEYOA'SCER7IFICATE
l._ \) 1 t o
\?.
85.00 N89055'45.. E
9is0
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L_ ?i
? 59.15 ?
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//
/ . - ' ^ ?•tF ?
o,?ROPO5E0? ?qq o O
O
a 0usF? C
200 -
PHONE 812 423-1769
?.r
1 ?:,
39.T5:? Z-
ir3ina; e r'c
I j ? ?:lt
o eaeee:e:r.
'zs.o °- esoo
N89065- 45"E ? '? I rn
o ? ? - - -
/3 CURB LINE
? e
ti
r n C^T !7 .A li L? A N A L`"T ___
:c??rti;y that this is a tr'.i° and correr,t representation of
- t „ cl_:c;t G, k'ILTJEkTI.SS IiIRI rIFLf: Al?ZTIJ;<, accord.ng to the
rec:rd?d pLst *hereof, DaY.ots County, !,'Innesota.
Al.o sno>iinr the location of a propoced 'nous^ thereor:.
r^et_-,rti-_ry :^. 11a77
MINNESOTA REGISTRA1iON NO-8
. ?
CITY OF EAGAN ?7
- 3830 Pilot Knob Road, P.O. Box 27-199, Eagan, MN 55121 lr ? 9232
' PHONE:454•8100
BUILDING PERMIT Receipr #
Te be wad for 1? POOL Est. Value $7,100 Date _ TL?NF 27. 19_$4_
sreAddress 1361 BALSAM E CT
Lot 11 elock 2 Seclsuh. WILD RUN STH
varcel rvo. 10-84354-110-02
„rc, Name GARY PETERSON
Z Address SAME
City EAGAN Phone 452-3508
o Name VALLEY POOLS
?? qddress 651 CLIFF RD
1- City BURNSVILLE phone 894-1480
Name _
Address
City -
Phone
Erect occupency R3
Alter ? Zoning R1
Repair ? Flre Zone N/A
Enlarge ? Type of Const. V
Move ? # Stories
Demolish ? Leng[h_
Grode ? Depth Sq. Ft.-
Aoerevala Feea
Assessment -
Woter & Sew,
Police ,
Fire
Eng.
Plonner _
Countll _
Bidg. Off. _
APC -
Permit v V o. ? v
Surcharge 4.00
Plan check
SAC
Water Conn.
Woter Me1er
Road Unit
I hereby acknowledge thoc 1 hove read this aDDlication and state thaf
the intormotion is correct ond aqree to camplY with oll opplicoble
Sfate of Minnewto Stotutes and City of Ea9an Ordinances.
Signoture of Permittee _
A Building Permit Is issued to:
oll work sholl 6e done in occo
Building Officiol
Totai ?4?) u-
VALLEY POOLS on the express wndition thn+
rxe ?yith II apglicobl $tate of Minnesata Statutes and City af Ea9on Ordinances.
. CITY OF EAGAN Include 2 sets of plans,
1 Certificate.pf Survey &
BUILDING PERNIIT APPLICATION
' 1 set of_ energy cal.culations.
D I
i
l
I I
1??
Date /
/ 2
To Be Used For (7o
Va
uat
on ,
r
.
site Address: CT oFFzce usE otaY
Lot Block 2 Sec./Sub. S??i?aa Erect
---??- Occupancy ?- 3
r R
n
Parcel #: / CJ - d ya Sy- ?ir e Zone
/A
Fir
Enlarye Type of Const. 4
Owner: AR-w TtE Qs ?? w] m # Stories
ove
Pddress: CA Deirolish Front f{
_
Grade :
Depth 1 8
City/Zip Gode: ?[_' q tJ
Phone # : AS a - 3 SQ v APPROVAI.S FEES
Contractor: 0 A Ilc.?.? QT VLS Assessments Pexmit Co8.5°
"
Add
Z Water/Sevrer Surcharge 4 , ?o
ress:
.?
? P
li Plan Check
-- o
ce
City/Zip Code:. ,
`?yuP,vwrll e , h'lal 7 Fire SAC ?
p
Phone #: p cl y_ 1Ll d'?l
? water Conn.
er Water Meter -
Council Rnad Unit
Arch-/En9•: Off
Bld
.
g.
Address: APC
City/Zip Code:
Phone #:
`n7I+p,L 7o?o .5 O
.
i
y
. ?
, :d ,
i±
^! .
. ., «.;
, .?...
ca s
.a `
o . . .t. .. :f.l( ... ?
DELMAR H. SCHWANZ
LANO $U"V! YUN
4leV?1?'e.? •:nOe"w3 0l Inf $I?le O? Minn<?ol?
14515 SOUTH ROBENT TRAIL V.O. BOIf M ROSEMOUNT. MINNESOTA 55068
n
L `t
85.00
? 9'60
SURVEYOR'S CERTIFICATE
N89°55'45-E a?__ _
;
3
° @ ?
L0T a o ?
0?1 'd, T O
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?W i8x3? 5'4• a
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DECK ?
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? p 13 0
p IN NWSL .?i P
?MONE 512 421-l"55
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?
- 20?
i
? ki
O
9z3 p 0 ? 850? ? i
N89°55'45??E
7 ( ? M1e CURB IINE
?c ?
w?''?' f A C`T
.•? .
r ..r??n,]^f!3_°..^.'..<1CIti.'; '-?r
- c?rti.v that tnis i? a tr.?e an^ cTr"=? '
:?..
RjAic' (?i ?1 i '. iCCoT'.? _ „C .GC
: _'.
, , , . !';nneso' ?
r:rcr.^dec' oI--t ?`here.of, Lakota Coun?; . Also sh?.:in(' the locatian of a prcposed housc t::erao:..
1477
... f
44
MINNESOTA NEGISFHA7ION NO-9§2S
?
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
BUILDING
026165
07/08J96
SITE ADDRESS:
P.I.N.: 10-84354-110-02
DESCRIPTION:
1361 BALSAM ST E
LOT: 11 BLOCK: 2
WILOERNESS RUN 5TH
-°t...... (ROOFING)
B'uilding.,,Permit Type
FiBuilding W:ork Type
' Cerssus -COd?e
r , ---,
STORM DAMAGE
REPAIR
434 AL7. RESIpENTIAL
:d rt3 1 ?"
REMARKS:
FEE SUMMARY:
CONTRACTOR: - Applicant - s-r. Lzc.OWNER:
IVES ENTERPRISES INC 17674963 0006478 RICHARDSON DON
1333 OSBORNE RD 1361 BALSAM ST E
MINNEAPOLI3 MN 55932 EAGAN MN 55123
(612) 767-4963 (612)686-7126
? I
I hereby aGknowladge that X,fiave?read this applicaII;ion and state that the
info-rmation i.s correct and agree to comply with all applicable"State ofi Mn,.
Statute,s d City Eagan Ordina:nces.
?
APPLICANT/PE MI SIGNATURE ISSED'e : IG?Uk k
-
? CITY OF EAGAN
I 3830 PILOT KNOB RD - 55122
tf,996 BUILDING PERMIT APPLICATION (RE5IDENTIAL)
681-4675
New Construdion Reauiremenls
? 3 registered site surveys
? 2 copies of plans (inelude beam 8 window sizes; poured fnd. design; etc.)
? 1 energy calculations
? 3 copies of tree presarveUon plan iT lot platted after 7!1193
required: _ Yea _ No
DATE: / ' 6 '
DESCRIPTION OF WORK: he RA'" ?
STREETADDRESS: ael /gry
LOT BLOCK ?I SUBD./P.I.D. #:
PROPERTY
OWNER
CONTRACTOR
ARCHITECT!
ENGINEER
Name: K ?d°14so11 /?o?! Phone #: 712 X?
ust rmst /
Street
City: State: Zip:
Company: ?r5 '614Dril-fS 3!?f Phone #: 27? AF4 3
StreetAddress: &541rte 41License#: Wr
City: State: Zip: 53-y/3.:Z
Company: _
Name:
Street Address:
City:
State: Zip:
Sewer 8 water Iicensed plumber: Penalty applies when address change and lot
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state that the information is /cctnd a e comply with all
applicable Sfate of Minnesota Statutes and City of Eagan Ordinances. ?
Signature of Applicant
OFFICE USE ONLY
Remodel/Repair Reauirements
? 2 copies of plan
? 2 site surveys (exterior addRions 8 decks)
? 7 energy calculations tor heated additions
Phane #:
Registration
Certificates of Survey Received _ Yes No
Tree Preservation Plan Received Yes No
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA114788
Date Issued:09/19/2013
Permit Category:ePermit
Site Address: 1361 Balsam St E
Lot:011 Block: 002 Addition: Wilderness Run 5th
PID:10-84354-02-110
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 .
Trey Gibson
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 -
Donald S Richardson
1361 Balsam St E
Eagan MN 55123
Canopy Construction Llc
11700 Preston Rd
Suite 660-337
Dallas TX 75230
(214) 749-7360
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117326
Date Issued:10/17/2013
Permit Category:ePermit
Site Address: 1361 Balsam St E
Lot:011 Block: 002 Addition: Wilderness Run 5th
PID:10-84354-02-110
Use:
Description:
Sub Type:Siding & Windows/Doors
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Donald S Richardson
1361 Balsam St E
Eagan MN 55123
Sela Roofing Remodeling
4100 Excelsior Blvd
St. Louis Park MN 55416
(612) 823-8046
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA154830
Date Issued:04/15/2019
Permit Category:ePermit
Site Address: 1361 Balsam St E
Lot:011 Block: 002 Addition: Wilderness Run 5th
PID:10-84354-02-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Donald S Richardson
1361 Balsam St E
Eagan MN 55123
(651) 253-0046
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature