1355 Balsam St ECIT7•OF EACiAN
3795 Pilof Knob Rood
?
Eagan, MN 55122
Zoning: _
Owner;
Address:
Site Address: _
Plumber.
Meter No.:
Size: -
Reoder No.:
I agree to eomply with fhe City of Eagon
Ordinances.
BY -
Oote of Insp.:
WATER SERVICE PERMIT
PERMIT NO.: -
DATE:
No. of Units:
Connection Charge:
Account Deposit:
Permit Fee:
Surcharge:
Misc. Charges:
Total: '
Dote Paid:
I CITYAOF EAGAN
I ,3795 Pilot Knob Road
Eagan, MP1 55122
Zoning:
Owner:
Address:
Site Address:
i Plumber:
I ogree to eomply with the Citr of Eagon
Qrdinonees.
By
Qate of I nsp.:
SEWER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
ConneCtion Charge: !
Account Deposit:
Permit Fee:
Surcharge:
Misc. CFwrges: I
Totol: I
Dote Paid: I
CITY OF EAGAN
I , • 3795 Pibt Knob Road Eagon, MN 55122 N9 4 709 gj
PHONE: 454-8100
BUILDING PERMIT $40,000.
Te kn umd fer DWig• & GaTP4 Vnl.m
Site Address c .) » n. aaaasa
Lot i0 Block 2 Sec/Sub. kTlt 5
Parcel # 10 84354 100 02
a Name "laLcs• auc
Z Address 10800 Lyndate Ave. So.
o _ oom ng otf _.
c'? Name _
0
Z
?u
q Addre55
s
r ?:...
Name
I hereby acknowledge that I have read this opplication and stote that
the informotion is correct and agree to compfy with oll applicable
$tate of Minnesota Stotutes ond City of Eagon Ordinances.
Receipt # 942'i
... Mar. zz. ,., 78
Erect ['] Occupancy i
Alter ? Zoning Tt1
Repoir ? Fire Zone -??
Enlarge p Type of Const.
Move ? #k Stories
Demolish ? Front 59 ft.
Grode ? Depth ft.
Appro v0l! Fees
Assessment -
Woter & Sew.
Police -?
Fire
Eng.
Planner
Council
Bldg. Off. _
APC
Signature of Permittee I
A 8uilding Permit is issued to: ilS8re11 7flC. on the express condition thot
oll work shall be done in accordance with all opplicable State of Minnes?ta Stotutes ond City of Eagon Ordinances.
Permit A L J? J" _
Surcharge
Plan check
SAC
Water Conn. 2 '-
Water Meter -
Total 885.50
Building Officiol
hnrR # DeN ipwd puwMfM
Plumbing -?a - -;,?p
,
Mechonical 7
tNSPECTIONS DATE INSP.
Rouph-In
Finol
Footings Date Insp. Dah Irnp.
foundotion Plumbing -) $
Frome/ins. _ Methanicol
-
Fincl j
Remarks:
CITY OP EAGAN
i - ' 3795 Pilot Knob Rood
Fagan, Mlnnesota 55122
' Phone: 454-8100
• . ?.1. .
- PERMIT
Date: r 17 8
Site Address: ? ' .. ; : ' . :1 1
Lot ' Blxk $ub/Sec.
No.
Receipt Na.:
Single I
Residential `
Multi Res., Comm. / I nd. I
Nar„e 'reIl Constructic;r_
wf Alter
/ Re
oi r
N
.
p
e
3 Address ' _T,VTldc1 ',_(? .^''+VP_. =.;c , . CoSt of Installation
O
? 7gLOn
Ciry '- Phone:
l n
Permit Fee •
Name P?-Y Iv. Welter F:eatiny
Surcharge
? -
? 37 Chic- .. , .
,yddre ?
?
0
V ? r ^
Ciry Phone:
Totol "
This Permit is issued on the express condition thot oll work shall be done in accordance with all applicoble State of
Minnesota Statutes and City of Eagan Ordinances.
V 8uilding Officiat
CITY OF EAGAN
• - ' 3795 Pilot Knob Road
Eagdn, Minnesoto 55142 ,
Phone: 454-8100
"'. Ur1BI?'dG _ PERMIT
Date: `
Site Address: '- ' S- P. F38 l5 a
No.
r :
Receipt No.: 0 '? -
Single I , .
Residential
I
Lot ? Block - Sub/Sec. Multi Res., Comm./Ind.
Name
/Re
air
New/Alter
.
p
.
;
Address
Cost of Installation
O
City ' Phone: Permit Fee
Nome 5urcharge
?
'g
? Address _
0
r
V
-
:
City Phone: Total ..
. .
t.
This Permit is issued on the express condition that all work shall be done in uccordance with all applicable Stote of
Minne o Stotutes and City of Eogon Ordinances.
Building Ofticiol
Raceipt PLUMBING PERMIT Permit No.
CITY OF EAGAN Fee
f J ? ? Fill rn numbered spaces
Type or Prinr legib/y
1. Date 2. Installation Cost
,
3. Job Address -. '1 r% ?-? •'` Lof ? Bik. Tract
4. Owner
_ ,. ? ?. .
e -
5. Contractori, Phone
,r:9 F'
6. Address ? .. -'
7. CitY 3tatLv Zip
8. Building Type: Residential Commercial ? Institutional O
1
9. Work Description: New ?47 Add ? Alter ? Repair ?
10. Describe
11
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory ? Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. 1 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.
S/C
Tot.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
CITY OF EAGAN Remarks
Addition Wilderness Run 5th Addition Lot 10 Blk Z Parcel 10 84354 100 02
Owner -• street 1355 E. Balsam S-?t 5tate Eagan, NIlV 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK , 19?3 132.60 ''6. b3 20 92.82 A005953 5 9 78
, SEWERLATERAL
WATERMAIN
WATER LATERAL
WATER AREA 1977 160.00 10.66 15 138.68 A005953 S 9 78
STORM SEW TRK 1981 282.49
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONIV.
BUILDING PER. #4709
sa,c 500.00 428 - 2-75
PARK
, RESIDENTIAL
BUILDING PERMIT APPLICATION ? 70,75
CITY OF EAGAN
3830 PILOT KNOB RD - 55122 CQII,d 7'X OI
651-681-4675
New ConsUUCtlon Reauirements RemodellReoair ReauiremeMS Hi/Yi
• 3 registered sile surveys showirg sq. R of l06 sq. ft of house; and ail roofed areas • 2 cqpies of plan
(20°k maximum lot coverage allaxed) . 1 set of Energy CakuWfions far healed additions
• 2 copies of plan shaving 6eam & windmv sizes; poured found design, etcJ • 1 site survey for ezterior additions & decks
• 7 set otEnergy CalculaUons
• 3 copies of Tree Preservalion Plan i( bt platted aker 111193
• Rim Joist Detail Options selection sheet (bldgs wiM 3 or less units) DATE & -/I -C-? I VALUATION (EXCLUDING LAND) -?ar O(JUU
JOB SITE ADDRESS ./,JJ?J j!:? S-f'.
IF MULTI-FAMILY BUILDING, HOW MA Y UNITS?
PROPERTY OWNER ?f?l.IS r d??.lo.?l9y ?
TYPE OF WORK FII
APPLICANT '
ADDRESS L? - /,e_.I <+ • i TY1 ?
PAGER #
CELL PHONE #
EPLACE(S) _0 /-1 _2 _3
PHONE # (05
ZIP CODE S?lo?
FAX #
NE1V RESIDENTIAL BUILDING ONLY - PILL OUT COMPLETELY
Energy Code Category _ MINNFSOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNE50TA RUI.FS 7672
- New Energy Code WorksheetSubmitted
Plumbing Contractor: _
I'lumbing System Includes:
Mechanical Contractor:
Mechanical System Iucludes:
Sewer/Water Contractor:
? Water 3oftener _
Water Heater _
No. of Baths
Air Conditioning
Hea[ Recovery System
All abova information must be submitted prior to processing of application.
Phone #
Fee: $70.00
I hereby acknowledge that I have read this application, state that the information is correct, and agree to complywith
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant / °li4????v `
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Phone #:
Lawn Sprinkler Fee: $90.00
No. of R.I. Baths
Phone #
Updated 1101
OFFICE USE ONLY .
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OB-plex xl?, 8 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 79 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
X' 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)" ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy Q-? MC/ESSystem
Census Code y3N Zoning City Water
SACUnits 01 Stories I BoosterPump
N6r. of Units O Sq. Ft. PRV
N6r. of Bldgs ? Length Fire Sprinklered
Type of Const :75V Width
REQUIRED INSPECTIONS
Footings (new bldg) FinallC.O.
Footings (deck) ? FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile
Roof Ice & Water Final Other
_ Framing _ Poo1 _ Ftgs _ Air/Gas Tesu _ Final
_ Fireplace _ R.I. _ Air Test _ Final _ Siding Stucco Stone
_ Insulation _ Windows (new/replacement)
Approved By &rri G , Building inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
This request void IS months from -A{ o7
Date oj this Request ? 3/???? P 64 433
I, as M Licensed Electrical Contr ctor IJ Owner, do hereby request inspection of the a6ove electri-
cal wiring installed at: C>1? o Z6?? _.y,e --
Street Address or Route No. 15U/J') CityL,?l
Section Township Range County j!???
Which is occupied by
Is a roughin inspection required on this job? No ? Yes ? Ready Now ? Will Call ?
Power Supplier ?S)CA h(ito, pCiAddress T( lQm I(1( tZ?
Electrical Contractonir%/')%:- '5MC_-1?6 (-, Contractor's License No???
Mailing Address
Authorized
(Electrical Cdatractor ar
SVW?E BVARD COPY
or r maKing i nis ins[anaiwn) n
Phone No. a ?0 ^ 7 ? 46
This inspection request will not he accepted by the
State Board unlesa proper inspection fee is enciosed.
Minnesota State Board of Electricity
1954University Ave., St. Paul, Minn. 55104-Phone 645-7703
. REQUEST FOR ELECTRICAL INSPECTION
C'ftCK BELOW WOItK COVERED BY THIS REQUEST
7t,? Q c a7:/
P 64433
Type of Budding New Add. Rep. Check Appliances W'ved Foc Check Equipment Wired For
Hume ? ? Range ? Temporary Wiring ?
Duplex ? ? Water Heatec ? Lighting Futuces ?
ApL Bldg. ? ? ? Dryer ? Elec[ric Heating ?
Commercial Bldg. ? ? ? Furnace ? Silo Unloader ?
Indusinal Bldg. ? ? ? A'v Conditioner ? Bulk Mdk Tank ?
/
List Lis[
O her ? ? ? }
p
Here?sf p
Fleie 5?
nnumrmv r??cnanminv cr.c ncr ?38_?
SefficeEn[[ance5ize: +lk Fee Y LF ? S et, ee Ci[cuits: # Fee
0 to 100 Am s. 0.'. 30 0 to 30 Am eres
301 to 200 Amps. 31 to 10 m 31 to 100 Am res
Above 200 Amps. Above 100 Amps. Above ]00 Amps.
Transformers 1 1 Remo[eConGOlCirc. PartialorotherCee
Signs 1 1 Special lnspection Minimum Cee $5.00
Remarks
TOTAL F , d0 ?
I, the Electrical Inspector, hereby ce at tiyc?b ve ?nspe 'on has been made.
(Rough•in)_ r ' ?.?? Date - 6-?
(Final) e_7) .. 2i - _ ito Date_ Aec /4"? - ---
This request void 18 months from
arr oF encaN
3795 Pilot Kno6 Road Eagan, MN 56122
` PHONB: 4548100
BUILDING PERMIT APPLICATION $40,000. Receipt #
To be uaed for Sf. Dwlg, S Gar&,, Value Date Mar
Sire Address 1355 E. Balsam
Lot 10 Block Z Sec/Sub. WR 5
paroei # 10 84354 100 02
? Name Marel1 Inc
i 10800 Lyndale Ave. So.
3 Address
o _, oomington _,
A Name _
?Q Address
rc
Nome _
Address
I hereby acknowtedge that 1 hava read this opplicotion and state thot
the infnrmotion is correct and agree to comply with all applicable
Stote of Minnesoto Stotutes and City of Eagan Ordinances.
Signature of Permittee _
A Building Permit is issued ta:
all work sholl be done in acco
N! 4709
9428
22. ,0 78
Erect Occupancy I
Alter ? Zoning RL
Repair ? Fire Zone
?
Enlarge ? Type of Const.
Move ? .# Stories
Demolish ? Front 59 ft.
Grade ? Depth 26 ft.
Approvola Peea
Assessment _
Water & Sew.
Police _--
Fire --
Eng.
Planner -
Council _
Bldg. Off. -
APC
Permit 117.7V _
Surchorge 20,00
Plan check
SAC p
p
?
R
Water Conn. ?
?
?
???• VO
Water Meter
Total 885. 50
Lnc, on the express condition that
State of Minnesota Stotutes ond City of Eagan Ordinances.
Building Officiol
. ? -7?
DATE
HUILDIf4G PFRMIT APPLICATZON
Include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations.
To be used for ?JZ 1/ ?JA/f Valuation J? l?'1
? T
Site AddresE: ea ISD aV?
Lot Id Block ? Sec, Sub. Parcel Number /'o a'445'51
Cf/R S
Owner ?,?T eivIl ? h ('
Hddress 14 4OQr ds /,-
Contractor
Address
Arch./Eng.
Address
Erect
Alter
Repair
Enlarge
t+ove
Ilemolish
Grade
OFFICE QSG
I)ate of Approval & Initial
'
? 1/
Asses5ment
B
7
AJater/Sewer
Police
Fire
Eng.
Planner
Council
Rldg. Off.
A.P.C.
Telephone
Telephone
Telephone
OFFICE USE
Occupancy y
zoninq xo• /
Fire Zone ,J
Type of Const. I/
# of Stories
Front C9
Depth 2,1,
FEES
Permit
Surcharge 9 4
Plan Check
SAC sOA?
DTater Conn. ?
47ater Meter - n ?,an r
TOTAI, ? - -j ? ?
?
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6 3 3? RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PIIOT KNOB RD, EAGAN MN 55122
651-681-4675
New Conshuction Reauiremenb
• 3 registerea site surveys showing ;q. R of'ot, sq. tt. of house: antl all mofed areas
(20°6 maximum lot coverege ailowed)
•? xpies of plan showirg beam& windcw sizes; poured found desgn, etc.)
. 1 ;et of Energy CalcWations
• 3 copies of Tree Preservation Plan if lot platted after 711193
• Rim Joist Detaii Options selection shee[ (61dgs with 7 or less units)
DA7E 7- )1-O 2
SITE ADDRESS I33_''? IS0--1964"i- 11- Q_
MULTI-FAMILY BLDG Y N
TYPE OF WORK P-f?Of (6?fjL'-0F7- FIREPLACE(S) _ 0_ 1_ 2
APPLICANT
STREET ADDRESS I10?aO CITY [.°bil STATE Mv?LIP
TELEPHONE # 1la7-? ? ? a? ?CELL PHONE # FAX # 3 P-F-
PROPERTYOWNER TELEPHONE#
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ yf[NNI:SOT.A RCLES 7670 CV"CE(:ORY l NIIVAI:SO"C:A Ltt'LL•:4 7672
(v submission type) . Residential Ventiialion Category 1 Worksheet SubmiCed . New Energy CoCe Worksheet Submittec
• Energy Envelope Calculations Submitted
Plumbing Contractor. ____
P1umUing system includes:
Mechanical Conhactor:
NIcch<utic>tl svstcin include,:
Sewer/Water Contractor:
--------------------------------------------------------------•-°•-------------
I hereby acknowledge that I have read this application, state th the inf
with cll applicable StaTe of Minnesota Statutes and City of Eaga Or r r
Signature of Applicanf
OFFICE USE ONLY
Phone #
Phone #
Fee: $90.00
Fec $70.00
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
_ lVater Softener
Water Hcater
\o. of Bafhs
_ Phone r
I.awn Spnnkler
vo. of R.I. Baths
.\ir Conditioning
Heal Rccocci}, Systcm
RemadeURawir Reauirements
• 2 ::pes af cian
• t se cf °_nergy Caiculations "ror heated addltions
• t;:;z survzy `cr extenor addiUons 8 Cecks
. incicace t hcr, e served oy septic syslem for additions
VALUATION - ? ?
1
Updated 4l02
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA118049
Date Issued:10/25/2013
Permit Category:ePermit
Site Address: 1355 Balsam St E
Lot:010 Block: 002 Addition: Wilderness Run 5th
PID:10-84354-02-100
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
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 by law in ALL single family homes .
Audrey Flattum
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 -
Michelle M Deysach
1355 Balsam St E
Eagan MN 55123
(651) 452-2326
Storm Guard Restoration
1355 Geneva Avenue North, Suite 201
Oakdale MN 55128
(651) 738-1698
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA119089
Date Issued:11/14/2013
Permit Category:ePermit
Site Address: 1355 Balsam St E
Lot:010 Block: 002 Addition: Wilderness Run 5th
PID:10-84354-02-100
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
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.
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 -
Michelle M Deysach
1355 Balsam St E
Eagan MN 55123
(763) 202-2323
Storm Guard Restoration
1355 Geneva Avenue North, Suite 201
Oakdale MN 55128
(651) 738-1698
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA144908
Date Issued:08/15/2017
Permit Category:ePermit
Site Address: 1355 Balsam St E
Lot:010 Block: 002 Addition: Wilderness Run 5th
PID:10-84354-02-100
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
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 -
Michelle M Deysach
1355 Balsam St E
Eagan MN 55123
Lofgren Heating & Air
5708 Upper 147th St W
Suite 106
Apple Valley MN 55124
(952) 431-5811
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA174611
Date Issued:02/07/2022
Permit Category:ePermit
Site Address: 1355 Balsam St E
Lot:010 Block: 002 Addition: Wilderness Run 5th
PID:10-84354-02-100
Use:
Description:
Sub Type:Fixtures
Work Type:Alteration
Description:Bathroom(s)
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.
All tiled shower bases require a water test.
Fee Summary:PL - Permit Fee (miscellaneous)$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 -
Michelle M Deysach
1355 Balsam St E
Eagan MN 55123--170
Wenzel Plymouth Plumbing & Heating Llc
1959 Shawnee Rd, Suite 130
Eagan MN 55122
(651) 452-1565
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA177790
Date Issued:07/19/2022
Permit Category:ePermit
Site Address: 1355 Balsam St E
Lot:010 Block: 002 Addition: Wilderness Run 5th
PID:10-84354-02-100
Use:
Description:
Sub Type:Fixtures
Work Type:Alteration
Description:Bathroom(s)
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.
All tiled shower bases require a water test.
Fee Summary:PL - Permit Fee (miscellaneous)$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 -
Michelle M Deysach
1355 Balsam St E
Eagan MN 55123--170
Wenzel Plymouth Plumbing & Heating Llc
1959 Shawnee Rd, Suite 130
Eagan MN 55122
(651) 452-1565
Applicant/Permitee: Signature Issued By: Signature