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1376 Balsam St ECITY OF EAGAN Remarks Addition Wilderness Run 5th Addition Lot 8 eik 1 Parcel 10 84354 080 Ol ?. - Owner 1376 E. Balsam State Eagan, MN 55123 s v?. Improvement Date Amount Annual Years Payment Receipt Date STREET SURF, ' STREET RESTOR. GRADING SAN SEW TRUNK ota? 1973 $132.60 $6.63 20 U 9 ? SEWER LATERAL WATERMAW WATER LATERAL WATER AREA pAi ti 4 cnnnpetinn 6176 STORM SEW TRK ^ 1981 246.04 16.40 i STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATERCONN. $320.00 3101 - ' BUILDING PER. 43967 sac $450.00 3101 - ro-4;76 PARK ? ' CITY OF EAGAN 3830 Pilot Knob Road I Eagan, Minnesota 55123 (612) 681-4675 i SITE ADQRESS• INSPECTION RECORD PERMIT TYPE: Permit Number: Date Issued: • r??E I.tll i?l f?hl1 i IIN `>IIf PERMIT SUBTYPE: ; 11E.: ij APPLICANT: 4 14 !,j a0.? TYPE OF WORK: Nf ',rlr 111 t t ON I Nti`i le1l ? N /4 ( F I. () M I hl41 Rr MpHk '; - A'.? P ANA 1( ! t P M f I I ', Iai ,I I I r i=I I I f A I iI ArO r I i?? I U i I A l 1.111 ttll 1 I 11 1 Nii N1-'qhtty N9/.!,</94 NFW !! N? 1 1117F °? f?l ? k) F- ? ? , PermR No. Permit Holder Date Telephone • S/1N PLUMBING HVAC ELECT ? ?O?I y ? ELECTRIC Mapactlon Dats Insp. Comments Footings i Y-Z 71f ( d Foundation Framing c Roofing Rough Pibg. Rough Hig. . Isul . /lu-- AdAlLi Fireplece Rnal Htg. Orsat Tesi Fnal Plbg. Plbg. Inspector - Notify Plumber Consl. Meter Engr./Plen Bldg. Final Deck Ftg. Deck Final Well Pr. Disp. YILLAGE OF EAGAN 3795r--F:IOE iCaob Rood E MN 551]] DATE• 6/8/76 WATER SERVICE PERMIT PERMIT NO.: 1987 ogan. . Zoning: RII No. oF Units: 1 OWnQr: M>rnll Mnahriintjon Address: x' Site Address: -1376113Zl Ram ct _ Plumber: ?"r N( Size: ?-6- Reader No.: -'-Z % `7 ? 1 ay? fo tomply with fM Villoye of Eagon o ? By Dat of ]ns .: Connection Charge: 160 00 Acwunt Deposit: Permit Fee: 10. DOp111ed Surchazge: .50 #875 Misa Charg Total: Da[e Paid: Insp.: - YIILAGE OF EAOAN SEWER SERVICE PERMIT 3795 Pilof Knob Road PERMIT NO.: 2745 Eagon, MN 55123 DATE: 6/8/76 Zoning: RIT No. of Units: 1 Owner. Msrnl l L`ons r i . iDn Address: Site Address: 1 37?F? R_Balsdm St L8 Bl WRS Plumber: Th4mp.son Plumbina Co. 6/3/76 8101 100.00 pd 1 agrM ro eemply witA tha Villoqe of Eagon Connection Chazge:350.00 pd Ordinanees. Account Deposlt: Permit Fee: 10.00 billed . Surcharge: .50 #875 BY: Misc. Chargee: Date of lnep.: Total: Inep.: Date Paid: /0 / y a C? 6 4 6 8' ' /-3/ Request DeJ? FireNO. Roug?-In Inpsedian R iretl (VOU t call inspectar w?an ready) Ins ction Other Th ouph-In ?qeatl Now Will Notiy InaOectar Ves ? No y DateReaE I p licensed contractor 4owner hereby request inspection of above electrical work at ? Job AtlOress (Siregt. Bax or q e No.l , ? Ciy Section No. Townsnip Name or No. Renqe No. Counry Occupan INi; + Phone No. Power Supplier Atldress Eiemricai G va or Co?m?pany ?N?ame?) p ? . ?9??Z'CN&"vY?I.IC/ ltl Contmcmr's Licansa Na. Mailing tltlress ICO lo or Owner MaMing Installa9on) / AWhori ignaWre IC ctonpwner Making Installation) P ne Number u MINNESOTA STATE BOAFyuF ELECTflIpTY THI$ INSPECTION REOUEST WILL NOT Griggf-MlEway Bltlg. - Room S193 BE ACCEPTED BY THE STATE BOARO 1821 Univer50y Ava.. SL Vaul, MN 55101 UNLESS PFOPER INSPECTION FEE IS Phane(61Y) 643-0900 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION 6""? eaooom.oe See instNCtions for complaBng this form on beck ol yellaw copy. 'j? M6 4 716 „ "X .Below Work Covered by This Request ew Atl Rep. TypeoiBuiltling AppliancesWired EquipmeniWiretl - Home Range Temporary Service Duplex Water Heater Apt. Building Dryer Comm./Industrial Furnace . Ir Farm Air Conditioner Otherls4ecilyj Convactor5 FBmarks ? ' .? Se QS0(? Compute /nspectian Fee Below # Other Fee M ServiceEntranceSize Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 AmDs Transformers Above 200 _ Amps Above 100 _ Amps SiJOS Inspedor5 Use Only: T07/??, S? IrrigationBOOms -/?? GCi 0 f? Special Inspection ? AiarmiCommunicatlon THIS INSTALLATION MAY BE ORDE ISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 THS ? t, the Electrical Inspector, hereby certify that the above inspection has been made. Rough,in Finai a ? OFFICE USE ONLY This requasl voitl 18 months imm CITY OF TAGi?:1 3795 Pi1ot I{nob Road Eap;F-n, NI_nneaeca 95122 F2&"9 T l858 The City of Eagai, hereY,y grazits to Ray N. Ptelter Heatinq & A/C ?_. csi' 4637 Chieaqo Ave a 8eating & A/C Permit for: (Owner)_ Marell Const. 13'f6 Sa2sas{ Ln & at 4296-ffa--Vp? pursuant to application dated 6/3D/?6 Fee Paid: $40.06 dated this 9 day o_P _ July ? 19_ 76 1.00 s/c Building Irspector i`4eehanical Permits: Bi@ Totale cITl or EAr;,rJ - • 37.5 Yi),oi: I; rcb Hc<id E.1'n, ,"•ti.r.^?eota ?•5L2 P?i = NO,: 684 T:;e C.it; of La.gan herery grwii;s to Thos?son plumbira Oo. 12201 MinnetOnka Blvd__ Nindsor Dev. Corp. PLUMBING °c--,r,it for: (Chmer) Marell Const. Oo. 4373-INtUalf-rn'• and i'!'8O, 1376 1364 st BAlsam St. ?-u 4 __J pizrsuant to arp ication a.,ed (,naF _ F3il led Feex3nock- 100.00 dated this 8 day of June ? 1Q 76 . 2.50 s/c Luilding Inspecto-r ;_c,•.__-_i.r_e_l Periri+,?: Di3 Tc i a1: '7" PERMIT CR 314is -\?CITV` OF?EAGAN 441,-G 3830 Pilot Knob Road PERMIT TYPE: e u z L o x N G ? Eagan, Minnesota 55123 PermitNumber: 024589 (612) 681-4675 Date Issued: 0 9/ 2 3/ 9 4 SITE ADDRESS: 1376 BALSAM S7 E LOT: 8 BLOCK: 1 WILpERNESS RUN 5TH P.I.N.: 10-84354-080-01 DESCRIPTION: r?'...?.. (INCLUDES B,uilding-.Permit Type o uilding Work Type ? ?? ?,. t -? _ ,- .. ; DECK) SF PORCH NEW ? Iii ??ioL? ? REMARKS: A SEPARATE PERMIT T5 REQUIRED FOR ANY ELECTRICAL WORK FEE SUMMARY: VALUATION $10,000 Base Fee $117.00 Surcharge $5.00 Total Fee $122.00 CONTRACTOR: - Applicant - sT. Lzc. OWNER: JOSEPH CONST, J 14545002 0006020 GREGOIRE DAN 4380 MALMO CIR 1376 BALSAM ST E EAGAN MN 55123 EAGAN MN 55123 (612) 454-5002 (612)452-5424 I hereby acknowledge that I have read this information is correct and agres to comply Statutes and City aF Eagan Ordinances. C:) APPLICANT/PERMITEESIGNA RE application and state that the with aIl appJ.icable State ofi Mn. -i ??o?????,, l, I m. INSPECTION RECOIZD CITYOFEAGAN PERMITTYPE: euzLniNG 3830 Pilot Knob Road Permit Number: 0 2 4 5 8 9 Eagan, M innesota 55123 Date Issued: 0 9/ 2 3/ 9 4 (612) 681-4675 SITE ADDRESS: Lo T: s B L 0 C K: 1 APPLICANT: 1376 BALSAM ST E JOSEPN CONST, J WILDERNES5 RUN 5TH (612) 454-5002 PERMIT SUBTYPE: SF PORCH TYPE OF WORK: NEW DE3CRIPTION (INCLUDES DECK) INSPECTION D, . ., FOOTING3 FRAMING FINAL REMARKS: A SEPARATE PERMIT IS REQUIREO FOR ANY ELECTRICAL WORK ? ? -1 I i4 1 614 CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION 681-4675 ? 4 1 zz.ff SINGLE & MULTI-FAMILY s of plans,, 3 registere site surveys, 1 copy of energy ^.'. G calcs COMMERCIAL Z sets of am-h4te6ttra1_&_st uctural plans, 1 set of specifica ions, copy o en ergy 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 Valuation of work ?LO ( ? Site Address: _1.3J ? ? Ly???..t STREET SUITE # Tenant Name: (commercial only) LOT BIACK ? SUBD. P.I.D. # U Descri tion of mork: ieC LrC1C' The applicant is: ? Owner Contractor ? OtI12Y' (Describe) Name ?/ Phone ?-SZ .Sf1Z{? Property LasT FIRST Owner qddress 13 ?I.6 ee_. ,!3„aL-p,,, S7- STREET STE H City zs;l G?v-? State /"/-? Zip Company Phone QZ.- Contractor Address License # D '6%Z- Exp.-3 ...5' City State /`Z-? Zip Ss/L? Company Phone Architect/ Engineer Name Registration # Address ' City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I hav read this application and state that the information is correct and agree to comply w' licable Sta of Minnesota Statutes and City of ? Eagan Ordinances. Signature of Applicant: BUILDING PERMIT TYPE ? 01 Foundation ? 02 SF Dwg. 0 03 SF Addition IZ 04 SF Porch 0 05 5f MisC. woRK nrPE EV 31 New M 32 Addition OFFICE USE ONLY ? 06 Duplex ? 07 4-Plex ? 08 8-Plex ? 09 12-Plex ? 10 Multi. Add'1. ? 33 Alterations ? 34 Repair ? 11 Apt./Lodging ? 12 Multi. Misc. O 13 Garage/Accessory ? 14 Fireplace ,W 15 Deck ? 35 Tenant Finish ? 36 Move GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Engineering REGIUIRED INSPECTIONS ? 5ite ? Wallboard Basement sq. ft. lst fl. sq. ft. 2nd F1. sq. ft. Sq. Ft. total Footprint Sq. ft. On-site well On-site sewage Building Variance ? Footing ? Final ? Framing ? Draintile ? ?.L 0 ? Insulation ? Fireplace Permit Fee veiuac;m: g A9,o0C> Surcharge Plan Review License MWCC SAC City SAC Water Conn. /y??y = is? X yo = -7 eyo Water Meter Acct. Deposit S/W Permit S/W Surcharge S o yo 7reatment P7. Road Unit Park Ded. Trails Ded. Copies Other Tatal: . _- .. ..,u..? ? 16 Basement Finish 0 17 Swim Pool O 18 Comm./Ind. 0 19 Comm./Ind. Misc. O 20 Public Facility ? 21 Miscellaneous ? 37 Demolish MWCC System City Water PRV Required Booster PumP Fire Sprinkler Census Code SAC Code Census Bldg Census Unit Assessments SAC % SAC Units 're Ave. So. • n, !I nn. 554'?2 - DELMAR H. SCHWANZ lANOSURVEVOR RaqipereE VnCV Laws af Tne Stale o/ MmnYSOU 10.513 SOUTM ROBERT TRAIL P.O. BOX M ROSEMOUNT, MINNESOTA 56008 Cert. J/49 PMONE 812 423-1789 SURVEYOH'S CERTIFICATE ?aLC / "= 6? i - - - - - --- ' ? ---- ?- - 1 ? X rf?7/ ? ---?-?-qt?3 ???-- G?.e p1'??:.JC fT i _i0•' _ ?. ? ?3 31?6? ZdN. 1 ^?0i '?'.I Nr ` ?'.i o•S h ? \ n ? ? D ------ A?° j i Fereby cprtify thnt this i< a true and correct reoreseniation of Lot 8, 91ock 2, 1/TL[IERNE.SS A.'R1 PiCf!? ADDI?'(R9, Pakpta County, !!innesote. Also sho*-fng the lxation of R preDeseci honse and garage thereon. ?-74..76 5 ? _.._•-- ? , ?• MINNESOTA qEGISTRATION N0.8825 ` .J v CITY of EAGAN BUILDING PERMIT owne: ..... /.?..?.??L.'.Cl.I. • ••.• ..... . . . .. :... .. Addrasc (Presenf) °f_1Q..?.Q........- Builder ............................... r-yayyn.P.? ............---.......................... Addreu ................................................ ----............................ -............. .,:. N0- 3967 3795 PiloY Knob Aoad Eagaa, Minnesota 55122 454-8100 Dele ....?4?R?...?..?.?[7b... Bloriea To Be Ueed Fos Fron! Deplh Hefgh! Eei. Cos! srmi! Fw Remarlu ?? g 'sf? T6is pe:mit doea not aulhorize the use of slreels, roads, alleya or sidewalke nor does it give the owaes o[ his ageaf the righ! !o ereate anp siluatioa which is a nuisance or whiah presenls a hatard !o the heallh, safelp, aoavenlenes and general walfare !o anyone in the communily. THIS PERMIT MUST 8 T O ?PAE7Mi SE WHILE THE WORK IS IN PROGRE o This is !o oarlifp. !ha!_? Q??.?1',?f-°°_---.....hasparmissioa !o arecf a... the above described prem?3ej subjec! Yo the provisions of all applicable Ord' for 7h Cily of E an / ..""'_ ...._?...1............!l...... .... .x.cC x. ? ........."""'.......... Par ..........?.?....... ...Gr. .. ................."... M or Suilding Inapecior DATE:/- E'JCLDwi'G PM'iPC !'?i'.^-?SC-'.1T(:i)*, C:313,0h' Let- le BioclcAdd-, tic:, f ee? ? -. Parcel an3 section nurioer Stl'2,t__L2??i'^' f,376? OWi1P,T :ldiiress A ,O Dav2_Li,;,.-x r/ Ac•.ciress Zcne-Ordinance #?'? Lot JS ze X Total area TC-.Le Platt•e3 Unp].atted Bl::L1Ci::!-?.?', ,.?1.22 x 1Gi8i. 3T'E:3 ?C3LOuY?.C,z,r T5 i a of cc-?s .i^1.nt.ion__ Setvaoks: Si;ree+ sidps '? Siclas Pase?n.g: Total asaa Pa-nl;l area setb?l:s: S??, treav sicie Rear LandscaPfl app: c-ra1 Speoial. Assees:seats: S :C charge Water area: Assessed ;f assessed: Corn-ction charga I£ unacss--sed: Co.viection chnrge Lot di,risione kci3itional assessments needed Laterals Not needed Assessed Not assessed Q , V? Waiver of hearing; ? Noed.ed Not needed Assessment clic?),4/, Water & Seiaer Dept Ruilding Dept- Police Dept Fire Dept (Co:1m & Tnd only) ?. Rear Tota1 spaces ,---d? Kdes Bond required - s/? @ w45o.oo = J 16? A ? Ur.assessed ???T_ CF.*ti?'9cate For: . ? !:a.•c 11 Tnc 10""00 Iynda.'e pve, So. Ploomington, !.*inn. 554,2 ? lert. ,y49 - DELMAR H. SCHWANZ LANDSVHVE`/OR - . Re9islereE Untlet Laws of The Stafe of Minnesota 14515 SOUTH R08ERT TRAIL P.O. BOX M ROSEMOUNT. MINNESOTA 55088 PHONE 812 423-1789 SURVEYOR'S CERTIFICATE ? _. ?- - A \\ -_Nk+ 9f`I t - j/C7'J?r?. iNC ?T T-?-? ° --- - f . nrv? j/J_?•'??,";? E7;ir,. -r-V--r? 4 ? ? y. . ? '?7 ,?, BLK I \ ------- ? T hPreby cPrtif,y that tMs is a true and correct reoreseaLation of 1nt 8, 91ock 1, WIid1ERNESS P.IIN FSFTH ADDZ"'T(7N, nakpta County, !!innesota. Also :>he-?nR the lxetion of a prnoo^ed house and garaqe thereon. "_??-76 ?`1l ? ? ?J,?•'?f... ? ?, ??l'r?ii, 1 ? : MINNESOTA REGISTRATION NO 8625 ? MASTER CARD IOCATION ;P S -I W? ? W OWNER '//LA/AiD STRUCTURE AND SI? d 1._ i0O LAND USED AS Permit No. Issued Issued Ta Coniractor Owner BUILDING PLUM8ING ?-???? '?Q/ "1 -- 43 74_ -'' . CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING 86$ GAS INSTALLING SANITARY SEWER OTHER OTHER Items Approved (Initial) Date Remarks Distance From Well FOOTI NG A26 SEPTIC FOUNDA710N CES OOL FRAMING FINAL ELECTRICAL -s-F? ? E?FFC6 ' FT. HEATING DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING WELL -2 - A3 _ 7 C? SANI7ARY SEWER ?,? ? , - Violations Noted on Back COMMENTS: CORRECTION NOTICE DATE:?Z" Z0- ?-6 Site Name Ordinance Nos. and Corrections - CorrecC? For reinspectian Eagan Dept, of Inspection InspeCt01': 3795 Pilot Knob Rd. . ?? Eagan, Mlnnesota 55122 454-6700 Dept.: Owner/Agent Address            ÿ þ ý ýüüû úù ù      øûûüü þìÿñü ø ëó  êû ëììë   ýü   üûúùø÷  ó  â   óùø÷   ÷ó  â   ü  ûñú ê ñ ûñú  üÞ  ø Ú    ü êåâÝÿ üù ý  ßëîà  ñö ïóüõáóâíéèëèìëà ÷ø  üû þ öç éèîèî  öÿõ  ôó ÷÷  æ Ùûñúþõâ þ Ú þ ê ÷ àß  ñüÿ ü û ÿ þ   ïßíëîà   úø   þ     ÷÷      æñ    þ ñ÷ø   ÷÷ ú ü   æ   ü û  ôøæÿ þ å  è ÷÷ á ñ üþ û û øüþ û PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA129009 Date Issued:12/24/2014 Permit Category:ePermit Site Address: 1376 Balsam St E Lot:008 Block: 001 Addition: Wilderness Run 5th PID:10-84354-01-080 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Renae Frienwald 2200 Hwy 13 W Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 9001.2195 $60.00 Total: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Contractor:Owner:- Applicant - Dan P Gregoire 1376 Balsam St E Eagan MN 55123 Genz Ryan Plumbing & Heating 2200 West Highway 13 Burnsville MN 55337 (952) 767-1000 Applicant/Permitee: Signature Issued By: Signature USB 6LUC VI DLN4n Ilill ' r---------------'--� I For Office Use � � ' ��3� (��� ��' �� �� j Permit#: , �� � � � �� � � PeRnit Fee: � 3830 Pilot Knob Road � � Eagatl MN 55122 � Dafe Received: � Phone: f651)675-5675 x��:� ; ^f n�' °'� I Staff: � Fax: (651) 675-5694 �" �` - "" �________________� 2014 RESIDEN�IAL�PLUMBING PERIMIT APPLICATION , � c� � Date:'�����-� SiteAddress: ��� �.P ����J�� `�� , Tenant � � � � �- �' �l� � Suite#: � � .. .... . . _.�.,�..�„�.��.�,�...,,��..�,�. .... .- - - . ._,_,t.n-R�.,.���- � -� (�'� � �1 L1�� �-1�-�--� i. � � z . Name�. , L`"��-C Phone: ������?'���r . �- � �` c i � Address/City/Zip. ��11��-P `� �. � .��- ......��`� � �,��� ��. �,. . .��� .�,,�.., ,�,-„'....�.,..� .. �..��..�.�,��...,�,.-r,.n.,, . . . . , � , * i Name: �'�� 1, . License#: �-i � �-Q��-- I; � y p� l n �,r ,�I � Address: � L1 �t� '�C. �� � _City: � ( L��'� � ����$�$�i� f y � ^ � �' State:��Zip:_�� i L� � Phone� �-�� ''�� ',l-� �� " ::tti::�:•l,�'t:;t ., ' (� � (� l� C� 1.��`�� � CL--�- 'n�-{-' '• r Contact:��,� Email: _ � �., :_ .,,.. ��:a . ��� ..�. . .��.-�,�,,�a�. ..���,.��so,Y k� � � 3 _ ! z � ` � New �' Replacement _Repair Reb�aild Modify Space �Work in R.O.W i ����?�'��� — y � �,, ' � = Description of work: � ;,,:.s:<:->. :�,�.,��.,� „ . .� . . .. n.. _ . . .��..�rpa., . �,����..�,� i; . r � ;..<.: RESIDENTIAL _ 4 4 7 T �; � : Water Heater �� /� ;' � u } `�--'Water Softener � l �awn frrigation(_RPZ/_PW8) '�� ������� t : Add Plumbing Fixtures(_Main/_Lower Level) � � ' Septic System '� � � ' Water Turnaround � � New �'- � �A,�.�.�-�:�,,. ..-�-.��m . ..�.-.,.-�„�.��,�...-�-�-�_. _ "� Abandonment �«r�aa•:�.�a.,*�r��,ery���»���'�...-�-���—._� ....��, _-,. . . . �.n.�. , . . . j9 RESIDENTIAL FEES: � � $60.00 Water Heater,Water SQftener, or Water Heater and Softener(includes$5.00 State Surcharge) !' � s $60.00 L�wn It'figation(includes$5.00 minimum State 5urcharge) ` I! $60.00 Add Plumbing Fi�ctures,Septic Svstem Abandonment,Water Turnaround*(includes$5.�0 State Surcharge) �; *Water Turnaround(add$200.00 if a 5/8"meter is required) ;` i $115.00 SeptiC SYstem New($10.00 per as built)(includes County fee and$5.00��tate Surcharge) � �� �, � TOTAL FEES$� �� � ^ , . ��.�.�,�.,�P.�,��.,�,�.�,�� , .�.��,��: .._. _. .. . .. . . m �,�. � CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for�xotection against u�derground utifity damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www�9opherstateonecall.orq I hereby acknowledge that this irrformation is complete and accurate;that the work will be in coinformance with the ordinances and codes of the City ofi Eagan; that I understand this is not a permit, but only an application for a permit,and work i:s not to start without a permit;that#he work will be in accordance with the approved plan in the case of work which requires a review and approval of F�I ns: _ �(� ^� �f ��` j� x � � � �� � ��d 1�-'�--►`-� X " � Applicant's Printed Name Applica t':s ignature- � ,._,-:.:.:...M, s �:� _ - - - i;• :r.-.�a•:�M�.r ��. f S<c':Lryxs�» 5 �2.: ' .i;:D.-4 x T .'V .l,v _:.iS...e7.. �r2:b,�.� .:�Y�...v -1• ��..`nY; ,r 6 .�....�k.. ...� � 3 > F+� "'.l"? £ � .:,?. �.t}a�� J ' t• n3.'.i .}_. 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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 - Dan P Gregoire 1376 Balsam St E Eagan MN 55123 (651) 452-5424 Genz Ryan Plumbing & Heating 2200 West Highway 13 Burnsville MN 55337 (952) 767-1000 Applicant/Permitee: Signature Issued By: Signature