2816 Beam LaneviLLacE oF EnGnN ? WATER SERVICE PERMIT l
3795 Pitot Knob Road PERMIT NO.: 1578 i
Eagan, MN 55122 DATE: 9l3/74
Zoning: Rl No. of UniEs: 1
Owner:
Address: _
Site Address: ?
Plurnber: Samw
Meter No.: 23169537 Conneetion ChargeM0*00 0-
Size: i" uncksae1l Account Deposit: 15. OA
Reader No.: 585474 • permit Fee: 10.00
I agree to camply with tbe Yilloge of Eagon
Surcharge: `
. 50 _
4rdinoaees. Misc. Charges: 54.40 a.f. ].ri
' . TMter .
Date Paid:
Date of Insp.: Insp.:
vIcu?lE --)F E?aAN SEWER 5ERVICE PERMiT
3795 PilotKnobRood PERMITNO.: _2 3 3i3
Eogan, MN 55122 DATE: 9/3/74
Zoning: R7- No. of Units: 1
QWIle1C- R^}ert Ginsburg
Address: Site Address: 2816 Beam I,ane
Plumber: same ?
i ageee to eomply witb the Villoge of Eagon Connection Charge: 9
Ordinnnees. Account Deposit: $
$
Permii Fee:
Surcharge: ?
gy; Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
1
o?.o?
15.00
0. 00 ?
. 50 . 4x
\
4118
Request Date .;
?-???? Fire No; •? ough•in Inspection
equired? ?
? fieady Now ilINotity Inspecior
Wh
R
d
?
g Yes ? o en
y
ea
! -licensed contractor p owner hereby request inspection of above electrical work at:
Job Address (Streei. Box or Route No.J
a qa?r .8 F,4?, E City
r46w
Section No. Township Name or No. Range No. Gourriy
;4 kor-4
Occupant(PRiNT)
C ??1 ?1. F.S /? d 13 ?n. Phone No.
4?? -? ?
Power Supplier
A
V J ?
Address
Electrical Contractor (Company Name) ConVactor's License No.
C? KRiS'TANSwU
Mailing-Address (Contractor or Owner Making lns4allation)
t2??1 rvELJ,@-6 GERC.L.a ?, Rrn?z>lv m?v s5314
- Pfione Number - - -
MINNESOTA STATE 90ARD QF ELECTRICiTY C ? tH1S INSPECTI4N flEQUEST WIIL NOT
Griggs•Mitlway Bldg. - Room 5-173 BE ACCEPTED BY THE STATE BOARD
1821 Urtfversity Ave., St. Paul. MN 55104 UNLESS PROPER 1NSPECTION FEE IS
Phone (612) 642-0800 ? ENCLOSED.
740 REt?UEST FOR ELECTRiCAL INSPECTION Ee
? -ooomSee insiructions for cpmpleting this iorm on back of yeilow copy. 1-1 8 "X" ?low b?rk Covered by This R?uest I ew dci Fiep: TypeofBuitding RppliancesWired EquipmentWlied
Home Range Temporary Service
Duplex Water Heater Electric Heating
Comm.tlndustrial Furnace
Farm Air Conditioner
Other (specity) Contrector's Remarks: .
Compute lnspection Fee 8etow:
# Qther Fee # Service Entrance Size Fea # C+rcuits/Feeders Fee
Swimming Poai 0 to 204 Amps O to 700 Amps
Transformers Above 2Q0 Amps Above 100 Amps
Signs inspectort use onry; ? j?, TOTAL ?"??
irrigation Booms ?t:.? ?0?-- ? , (?
Speciai Inspection ? ??
AiarmtCommunication THIS IN$TAILATION MAY BE ORDER SCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
i, the Electrical Inspector, hereby Rou9n-in oate
cectify that the above inspection has F;nai aaie
been made. t"' Y+ ?
OFFICE USE ONIY
ThiS request void 18 months irom
Yv-7?, _ 7 7t " .'''". 'i.. . .
PERMIT#^ i, PLUMBING PERMfT RECEtPT #
CiTY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55123 DATE: ?
?- CONTRACT PRiCE: PHONE: 454-8100
Site Address. -.?.?A?_,?,,, ?
tot __ J'_ -Block ? SeclSub
Name -
?o Address
c Ciry phone
., Name
3 Address
O City Phone4L?PT
0 -.
FEES
COMM/IND FEE -1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPUES
TC7WNHOl15E & COND6 =- RES.-RATE ARP
LIE
5----
?
.
,.?..
MINIMUM - RESIDENTIAL FEE
' - $12
00 ;
i
.
MINIMUM - COMM/IND FEE
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $ t000.00)
}
SIG UR RMITTEE
BLDG. TYPE WORK DESCRIP710N
Res. New
Muit. Add-on
Comm. Repair
Other
,
RES. PLBG. ONLY - COMPLETE THE FOLLOWWG:
NO. FIXTURES TOTAL
Water Closet - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $100
UrinallBidet - $3,00
Laundry Tray - $100
' Floor Drains - $1.50
?=?afer Heater - $1.50
Whirlpool - $3.00
Gas Piping Outiets - $1.50
(MINIMUM - 1 PER PERMI'n f
Softener - $5.00
Weii - $10.00
Private Disp: - $10.00
Rough Openings - $1.50
FEE:
STATE SlC:
FOR: C{TY pF EAGAN GRAND TOTAI: /
?„? ??
.?,?'.h,..Yux.?....ss ..ryL. .., ,.... } ? - ..... . . . . . _.? r .>, .., .-.....
?. CIi'Y t!F EA?'iARi Remarks
'Adcttcksn Cauntr Iiome Hei hts Lot 5 Eik 7 10 Z??? 050 0?
Ownef Street 2816 Beam Lane sface Eagan, MN 55?21 .
i+?t?vem+ent Date Amount Annual Years Payment Rece'rpt L?tt?
S1'FiE£l` StfRF.
--
S7'REEfi RESTOR.
?`+RAC3ttVCs ~
N sEW TRttntK 1968 $140. 00 $3 . 33 30 PAIi)
,
ER1.A'CERAL & STUB 1972 3205.65 $160.28
WATERAAaIN
20
iuA'rER La-rERAL & Stub 1972
WATrtR AREA r
sTORM SEW.jRK 1984 495.00 33.00 15
sMAM s€w LAT
CURB & Gt17TER
SlDeNYALK
_ STFiEE''i L1GHT
WATER CONtd. $Z$O.OQ 11:543
i13#L:f3tAlG PER.
SAG
PAR3C ?
' ;?
EAGAN-• 't"OONNa H 1 P No. 199
B Ut L.D1 NG PERM 1'f'
Ownes ------- •-•------------------------------------ ••---------•-•-- ------•-•--------------------- Eagan Township
Address (pres-•-•---...--- --•--•-......---•-•----•------ ••---•----•-------------- Town Hai1
Builder ..... •%??• • -- - -•-•----•-A----- •- --- ...?°-
Date _.._-•-•.-.- ......
Address -------- •............ ,.•------ •-•-••-----------•----------•-•-•--------•-
DESCRIPTION
5tories To Be Used For Fronf Depth Heigkt I Est. Cost Permit Fee Remarks
J.? LOCATION
ar
4?
AddiYion or 7.'raci
I
This permit does not aulhorise ihe use of' streets, roads, alleys ar sidewalks nor does it giv64he ownez or hSs agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general weifare to anyone in the communi#y.
THIS PERMIT MUST BE T E PR/? WHILE THE WORK IS IN PROG SS. .
This is to certify, that._.__???? .?GL{f'.{sQ/,.?_.has permission fo ereat a.-- --- -•-••••--••-•-•- .............. ...-•--••-.. npan
!he above describ remzse --#he rovisians of the Building Ordinance for Eagan T ship adopfed April 11,
1955. ?
Cha -•-•- Per ---- -----------------------•--•--...--••_•-._.._..._...------•- _. -°..... ...............•-•-•--.....
............... - •- ---•-- --•-.............. a_..,-•-°-•----
irman of Town a $uilding Inspector
EACAN TOWNSHIP
BUILDING PERMIT
owner ...... . ..
..--• .....................
Address (preseni) ...... 13
Buildex ..,..•-::?!r.'?''--------------------------- •-------------- .............
Address ----•-..............
............... ----
.._,...............
DESCRIPTION
N° 802
Eagan Township
Town Hall
?.`"?`'3-. ?.....--?
Date ......
5tories To }3e Used For Fronf Depth Heighf Est. Cost Permii Fee Remarks
?EK.,[?-s-+? ? j? e?-/ ? ? ? ?-a-zi ??.7
LOCATION
sireet, tioaa or otner Description of Location Loi Block Addition or Tract
?. ? / ? ?--•--?,.-..? ?.?-.,..? ? ? ??:t..?.? ?`.?, ??.?--"
This pesmit does not suthorise 3he use o# streets, roads, alleys or sidewalks nor does it gine the ownez or his agent
the right to create any situafion which is a nuisance ox which presenfs a hazard 3o the heai#h, safefy, convenience and
general welfare fo anyone in 3he communifp.
THIS PERMIT MUST BE KEPT N TIAE PREMISE VHHILE THE WORK IS IN PROGRESS. '-?
This is to aertify, thai...... X!_... .-•-...-• --•--• .................has permission to erect a._..----__" ?'".'?_.,.:_.._.._.....---.........upon
the above describe premi subjecf to the p isions of the Buiiding Ordinance for Eagan Township adapted Apri1 11,
1955.
-?'?'" ?- --- `? - - -
............. ........ .......................r"..,....1:.`::......._.?--- ... per ............... -........... . ........ .............................. -..............
----..
Chairman of Town Boazd Buildin Inspec3or
?. ?
?CITY OF EAGAN
I 3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT
2816 BEAM I.ANE
L.OTz 5 BLqCKs 7
Cqt1NTRY HOME HEIGMTS
P.I.N.: 10--18300-050-07
.
DESCRIPTION:
srnrNG/snFFxr,rFascIA
rmit Type 5F (MiSC.)
r*. TYPe REPAIR
REMARKS:
FEE SUMMARY:
?a
ra
M? ?x
?
vALuATxaN
aase Fee
Surcharge
Tatai Fee
$99.00
4.0fb
$103.00
.$ U q FJ YJ [J
?? X ?
?
`?'
?
? ?.
L.v1141 rsI?L.ivts: _ APPlicant - S7. LIC. VVVIVtrt:
PANELCRAF7 qF MN INC 17216628 0002179 GZN56ERG CMARtES
3118 SNELLIPdG AVE S 2816 BEAM LN
MINNEAPOLIS MN 55406 EAGAN MN 55
I (612) 721-6628 (612)454-3429
-?Nfa 9214my
APPLICANT/PERMITEE SIGNATURE IS : I UR
-- --- - --- ---- -- - - -- --- -- --- --
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE: BUILpING
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: 025248
(612) 681-4675 ? ? ? ? ? ? ? ?
SITE ADDRESS:
LoT: 5 sLacK:
2816 BEAM LAME
COUNTRY HQME HEIGHI`S
PERMIT SUBTYPE:
sF (MIsc. )
REPazR
aEsc??PTIo?v sIaINGIsnFFIrlFascza
INSPECTION
FRAMING .. .
ROUGN IN PLBG
ROUGH IN WTC FINAI.
?
?
?
? 4?
c??.
g?
,
4 O ? ?
?. ? . . . . . . . . , , . . . . . . ,. , . ., ,...,. . . , „ . . . ? ,.. . ? ,.esr...,? ??.
APPLICANT:
7
PANEC.CRAFT ClF MN INC
(612) 721-6628
TYPE OF WORK:
CA 3 452
PERMIT TYPE: ??I?az??
Permit Number: 02524$
Date Issued: 03/20/95
?---
' ? CITY Of EAGAN
3830 Pilot Knab Road
Eagan, Minnesota 55123
(612) 6814675
SITE ADDRESS:
p f . N.. , A. o
DESCRIPTION:
REMARKS:
FEE SUMMARY:
Vi 1 i._ U1_"t TTO)''i
: _ . . ri .: F... ..
CONTRACTOR: - , p:.- c p;_ --
t .1, P; ? t r: ENV'i Nt) r : ONS`(" 17810:` 1 7
1_81i ...,t N _, v 0-
M1. r,l NEAPDI _ L" S h9 N '. 510?
' 1 '! 7S'( 0c::..
, .t 000
.,,...&-...
'r N`: : U; ; i:, r OB
' i.. _ .__ AM !.. ,,?
t' ;; t; n; ;`,i M N t; `i '' :l
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
StTE ADDRESS:
3_ 7:.'? !? ,.
,.. r. __ AM L, , N :
nouNINY ?,,, , . :1 . , , ..
PERMIT SUBTYPE:
r MI..i L: . .1
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
7310 _ u. _ . `. M CA''.! .
k o l . . s..: `[:; !.. ',T E; i<. ,.
.. , i..l N.3 RY HOM;,,. .. ,i. GHT "::
11::?„C', c:f:
. r?? ,_. E?? t.. ????? ?? t. 3}?? ?::_ ?°•: i
:'''r l. 1" Ei'> i'i "!" :l: (.l j',i
?
^ `"'?
tv , ? : ??
??rr??ti.H?? ? :
! . hPr' EE BN4I ;L F. (? CONS''r
(612) ;t 0917
TYPE OF WORK:
'.,? :' t' . .. ..
ALTERAi Tl.l (',)
1 E.., Ii" 11ON WINi1(tl:r ' _Pi i'.,.
• ?? •
.
F I N'I'p? t, ??
STATE RESIDENTIA,L CONTRACTOR/REMODELER
LICENSING INFORMATION
PERMIT #
1. I have made application for license to the Department of Commerce.
Date of Application
Residentiai Building Contractor
Remodeler
Signature Date
2. I am exempt because I am aong specialty remodeler.
ignature ate
3. I am exempt because my annual gross receipts are less than $15,000.
Signature l3ate
4. I am exempt bocause contracts on individual projects in ag,gregate do nat
exceed $2,500.
Signature Date
Questions regarding the Iicensing law should be directed to the Department of
Commerce, 133 East Seventh Street, St. Paul, Minnesota 55101, (612) 296-6319
Licensing Information, (612) 296-2594 (Enforcement).
Y ?PE_e?
?
? . ?
f??????? kD
,"N PERANT i"YPE.
POO KiVbAood
kUM Rerrni# Nurrrk?ber:
_
m?? 5523
v >;. L?? le?u?l.
? M
!lC. K
CAi- TT FF EsY VIRtF CO!'9 f"p r
P
1
0
2) 7 61 .v.
_
(6
9 4
''t ?
c a.wrr?h .. ?i?
4WSUBTYPE: , r . . . . . - -_
? ? T1fPE OF WtJRK:
A U rF ?Aff cl H
WINDr?" REPAACE
Foundebm
Fmnft
PAO&V
P4ugh PbZ
._ .?,.. ?? ...
INSPE+?TION kECORD'
? OM OF: EAGAN PERMIT TYPE:
Perm+t Number:
? -(012) 6814675 MJ I ? ?? i N6
55122-1 897 Qate lssued:
13
o 0,1 "t AtA t Ah34`
? (.000TRY 140#t'. •1il I CAk4 9 's
? ?MPE;
?14 1
? p
f . APFLICAWT; .
? TYFE 4f V1lflRK: ;
j . V t 1' A .1 ' ?
i,1 t '.,t I; 1 1` 1 1 ON '.:, eJB'1: 1 1 /E"Ati4;.'1?!};;
Pernit Ma. wr"#1oiw aNS Toipitonr 0
ELECTRiC
" Pt,
HNAG
kw*wdm Dift kwp. CvwAwnte
FCNJ'T1N£i$
FUUPlD
FfiAM1Nf'a
ROOFIid(a
Rt3iltiH
PLUMBiNG .,
PLO13
AtR TEST
ftOUGFi
HE11'f1t1C3
GAS 8VC
TEST
lIdSUL
avP aoARD
FiREPU1Cf
FWEPLACE
/UN TEST
FINAL. PLt6ti
FWAI. illli ' ORSAT
TEST
( -
SLDG FINAL 1
GMTii.f.
? FO"
OEM FTO
DOCK FINAL
SINGLE & MUL7T-FAMTlY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
C"ERCIAL Z sets of architectural & structural p1ans, 1set crf
SpE.?Cif$Cdtifl11Si I Copy tff e11e1^gy C81iCS.
FPenalty appl ies : 1} when permi t i s typed, but not pic?Ced up by i ast ?r€?rkfng ?lay of mc?ntla
ch request is made, 2) address is changed t?r 3} 1at change is requestetd +?nce permi?.
ued.
Yatuatir?n onco
of wc?rk aaress: ?to
Lalue
ST,?ET WITE # _
Tenant Name: (comnercial only)
?
LOT ..,,..a....._. $LOCK .?_. SUBD. 11P.I.D.
1 nm.a ,,,- 4 v,.- 4 ev" „f w.,,.U . t"t I Y-Y% C(N .1: j1-- , i 6. <,r Tr'. 1
?he appl i cant i s: D Owner ?SHantractor C7 'Ather (ootefibe) '
. A .
Name L Phone
I"?Coperty. L11ST,
FIRST
OAli'#$t .. .:; ,
,
. _Address 29)(o
STREEt $'?E 0_ . ... ..
elty W1,A Stdt@ •,.1cl??..,....... zi`p
CotnpatlJr ? Phot#e ?Q-
t
Co"itt'aGtot' Addressz?ks?QA Li c+ense _ Exp-
Ci ty S'? ate q?? ?.?.,,..,..,..?. ??
CQmpany
Arcf"tftect/
ERIgirie@t' Name Regi stration f
Address '
City State Zip
Seaver .E? water l i censed pl tnnker Processing ?ime #'or
--sewer & water permi ts - i s--two days orECe area has been apPraved.. . _ . . _ . _ . ,,_ .. ry.._ ._. _ _ .._.:. t hcreby -acknowledge that I have read thi sapp1ication and statt thit the %6rmit+on is
correct and agree to com iy with all appTficab7e SLate of Minnesota Statutes_ and City of
Eagan 4rdinances.
Signature crf Applicantst.
REAG:IYATE ?
- PERMIT #
CiTY OF EAGAN
1993 BUILQING PERMIT APPLICATION.
681-4675
SINGIE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, l set of
specifications, 1 copy of energy calcs.
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date ? /• 1 /9 3 Yal uati on af work ?,7
Site Address: 2O/(0
STREET SUITE #
Tenant Name: (commercial only)
IAT ? BLOCK ? SUBD.
?
` P . I . D . 0 '
t
7
rt?, C
Descri tion of work: v?nbq."D v"
The applicant is: 12 Owner ? Contractor ? Other (a*scribe)
Name C?ofN burg 926 Phone y5`?- ?`lZ9
Property LAST FtRST
Owner
Address 2S/G1 i%. L.-44-r-e-
STREET STE *
City 219TAxd State /Z-YW Zip Ssr??
Company dd l'c?e '9vviRo_ 6x-n:yy-Phone '701: 0 9-'(?
C011tCaCtOr Address Cicense # ?J? Exp.
City lp'E/? State Zip :,.r5
lo / - 0311
Company Phone 1/
Architect/
Engtneer Name itegistration #
Address o?4 -
City State 1WW Z i p
Sewer & water licensed plumber . Processing time for
sewer & water permits is two days once area has been approved.
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.
Signature of Applicant:
OFFICE USE ONLY .?
BUILDING PERMIT TYPE
?
O 01 Foundat i on O 06 Dupl ex ? 11 Apt./Lodgk ? !& S:Bainent F i n i sh
O OZ SF Dwg. ? 07 4-Piex ? 12 Multi. Misc. O 17 Swim Pool
13 03 SF Addition ? 08 8-Plex 0 13 Garage/Accessory ? 18 Comn./Ind.
O 04 SF Porch 13 09 12-Piex ? 14 Fireplace ? .19 Comm.jInd. Misc.
19 05 SF Misc. 17 10 Multi. Add'1. O 15 Deck 0 20 Public Facility
O 21 Miscellaneous
WORK TYPE
O 31 New P 33 Alterations O 35 Tenant finish ? 37 Demo]ish
CI 32 Addition 0 34 Repair 0 36 Move
GENERAL INFORMATiON
Const. (Actual) Basement sq. ft.
(Allowable) lst F1. sq. ft.
UBC Occupancy ? 2nd F1. sq. ft.
Zoning Sq. Ft. total
# of Stories Footprint Sq. ft.
Length On-site well
Depth On-site sewage
QPPROVALS
Planning Building
Engineering . Variance
REQUIRED INSPECTIONS \'"'
? Site 0 Footing JO Framing
? Wallboard [p Final ? Draintiie
MWCC System
City Water
PRY Required
Booster Pump
Fire Sprinkler
Census Code
SAC Code
C',.'-- a ?" d
G-?- ?
Assessments
q.3 0
?
0
.?--
C! Insulation
E3 Fireplace
Permi t Fee 126, n" vetuan«n:
Surcharge
Plan Review
License
MWGC SAC
City SAC
Water Conn.
Water Meter
Acct. Depasit
S/W Permi t
S/W Surcharge
Treatment Pl.
Road Unit
Park Ded.
Trails aed.
Copies
Other
7ota1:
s
sac %
sac un;ts
PLEASE COMPLETE FQR SINGLE FAMILY DWELLTNGS. ALSO, FOR T4WNH4ME5 AND
CONDOS WHEN PERMTTS ARE REQUIRED FOR EACH UNIT.
_--_-------------------------------------- ----•--------------.- ____--_---_._____-------------- ..._._.,:.___.--•-------------••---•----
NE W CONSTRUCTION
?A-7 D-ON AJC
? ADI3-ON FURNACE
I?ATE K' ?? ? 3
FEES
H;VAC: 4-100 M BTU $ 24.00
ADDITIONAL 50 lVi BTU 6•00
GrAS OUTLETS (MXNIMUM I @ S3.00 EACH)
ADD-ONiREMODEL (EXISTING coNSTRUCrioN) $ 15•00
STATE SURCHARGE •$0
TC3TAL .??
SITE ADDRESS:BI6 fS ect m- Zia
OWNER N
INSTALLER:
1'ELEPHONE #: 2 - i cJ 3 `; 2 9'
ADDRESS: I V
CIT"Y: l?o r, STATE: .s ZIP CODE:
TELEPHONE #: ?? ?
SIGNATURE OF P R ITTEE
iyya 1vjLr,L.nAni%.ti.ju rr.iuvii i tnr.oai,jv,. ?- s.l ,
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN MN 55122 .
(612) 6$14675
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA155802
Date Issued:06/04/2019
Permit Category:ePermit
Site Address: 2816 Beam Lane
Lot:5 Block: 7 Addition: Country Home Heights
PID:10-18300-07-050
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
C R Ginsburg Jr
2816 Beam Lane
Eagan MN 55121
(507) 530-3303
Professional Exteriors Inc.
5376 260th St
Wyoming MN 55092
(763) 434-1500
Applicant/Permitee: Signature Issued By: Signature