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1560 Ashbury CtThfs reQUest voitl 11,318-2 18 nwnthS lmm 1) ` 26Q4/.?/ '7x?/ O SVeet /Address, Box or floute No. ^ City ° ecbon o. TownsMO hlame ur No. qenge No. County Occu ntIPpINT) Phone No. Power Supplier ?.J?N?/?Z/?^-? A[ltlress , / 1 U` `'?' ? .J Eie ncal Comr ac m r IComuanv Nnme) Conv r o i's License No. g q ? y- p MaJine /+dJress ACOnlracior or Ow er Makinu InstailauoN ?P7Y LC?zca. .?. 2???? Au?honz ignatur ncrac r?Own aki g Installatio PhonG Number MINNESOTq STATE qD OF ELECTHICITY THIS INSPECTION PEQUEST WILL NOT ?'.rlg0s•Midwev Blde. - Aoom N-791 BE ACCEPTED BY THE STqTE BOARO 1821 Univarsitv Ave., SL Vaul, MN 55104 UNLESS PflOPEN INSPECTION FEE IS Phone (672) 642-0600 ENCLOSED. ".°•'°° ""°•`- `•,""°"O' I hereby raqoesi inspecbon of above ? Owner electncal work installed at. REQUEST FOR ELECTRICAL WSPECTION es-00001-06 See 4nstrucLOns lar completing tpis farm on back ot Vellow copy. ? 2604 "x" BeloW Work Covered by lhis Request Adtl NeO. Type ot BwICinO '1POIuuncea Wned Equiumenl Wved Home Range Temporary Service Duplex Water Heater Li,yhtmy Fixtures Apt. BwlAing Dryer Electric HeaLn Commeraal Bldy. Furnace Silo Unloader Industnal Bldg. Air Conditioner Buik Milk Tnnk Farm ONer SUec7fv Otner ISper,fyl t er Sueu(y t er Othcr omnute lnspection Fee Below k Fee ServiceEnNancaSize H Fee Fenders/5ubfeeders N Fee Cvcwts a0 U to 200 qm 5 0 io 30 qm ps n 30 Am s Above 200 qmps, 31 to 100 qmps to 100 Am 31 Swimm ing Pool ve 100_Am s ove 700_P.m ,? rgation Boo 1 tial-'Olher Fee Signs SpeciallnspecUOn 7AL E?J. ? iy- flouBh-in p;?`e f I, the Ele el ? InsPector, heraby certtly that tha above Final D?e _/ inspection has been Y maa. TMe reuuast volE 18 montM from CITY OF EAGAN Permit No: 99 3830 Pflot Knob Road Meter No: P.O. Bo;wk1199 Reader No: - Eagan, MN 55121 :?llls Bldrs. Site Addi Plumber. Conn. Chg: ??, Acct Dep:-? Permit Fee: Surcharge: Tr. Plant Meter. E7• Date: 7-30-57 Size: Date: Zoning: RI No. of Units: I agree to comply wlth the Citp of Eagan Ordlnances. sy WATER SERVICE PERMIT CITY OF EAGAN SEWER SERVICE PERMIT 3830 Pflot Nnob Road P.O. BV21199 1??? ? PERMIT NO.: ? Eagan, MN 55121 ]_30-fi7 DATE: , Zoning: No. of Units: 1 ? Owner. 1-71Zis 31drs. Address: SiteAddress: 1560 Ashburv Court 1111 r.' Blackhawk Gleri T_I Plumber: ''Lake Side Z'2umbinfi 6-29-97 75060 100.04pd I agree to comply wRh the Clty of Eagan Connection Charge: SZ 5 11Qpd Ordinances. Account Deposit: 15 L14'a - Permit Fee: 14 OOpd Surcharge: ..50JP: By Misc. Charges: Date of Insp.: Total: Insp.: Date Paid: ___ ? CITY OF EAGAN Permit No:_ :I I '' 3830 PNot Knob Road Meter No: 3 g 71y'1 44 6 P.O. Box 21199 Reader No: 6 -5'p4a,A,6-7 Eagan, MN 55121 Ellis Bldrs. Slte Date: 7-30-87 size: ??P" Rac /r paW,,- ? .._ IZ Conn. Chg: Acct DeP: 525.110pe r a?WWgg: Rl Permit Fee: . ?l ???jFX. QA$ E% Surcharge, ' I t I ?r with the Clty of Eagan Tr. Plant Meter. t'0. l E 7 • ?, + Qr`? ? M isc.: By WATER SERVICE PERMIT 0 CASH RECEIPT 0 CITY OF EAGAN 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 . ? DATE 19 weceivFo FROM11 AMOUNT $ _ I & DOLLAIiS +oo F]GASH CHECK ; POR ''-- 1 - , i BY X White-Payers Copy Yellow-Posting Copy Pink-File Copy Thank You BLDG. PERMIT N0. M 01-3210 Bldg. Permit 01-3422 Plan Check - a 01-3445 Surch./Adm. 01-3446 SAC/Adm. 01-2155 Surcharge `% 17-3860 Road Unit 20-2275 SAC r ? ?r ! r -:; 20-3865 Water Conn. ? 20-3868 Water Trmt. oo ? 20-3716 Water Meter 20-2252 Acct. Dep. 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. 11-3855 Park Ded. TOTAL • CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 BUILDING PERMIT Receipt # To be used for Est. Value Date ,19 Site Address OFFICE USE ONLY LOt Block Sec/Sub. On Site Sewage _ Occupancy ! MWCC System _ Zoning Parcel No. On Site Well _ Type of Conffi City Water _ (Actuaq a W N8n'1@ (Allowable) ? Address * of Storie8 ° City Phone Length Depth " S.F. Total °C 0 Name Footprint S.F. ? ? ` Address APPROVALS FEES 11-C City PhOne Assessments _ Permit ? ic ? W WatedSewer _ Surcharge W NBme Police Plan Review _ ? Address Fire _ SAC, City u = City Phone Engr. _ SAC,MWCC i W Planner _ WaterConn. Council _ Water Meter 1 hereby aCknowledge that I have reed this application and state Bldg. Ofi. _ Road Unit that the information is coRect and agree to complywith all applicable APC _ Treahnent P1 State of Minnesota 5tatutes and City of Eagan OrdinanCes. Variance _ Parks Copies Signature of Permittee TOTAL c A Building Permit is issued to: on the express condition that all work ahall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan ordinences. ?. ' Building Official Psrmit No. Permlt Holder Date ToIophons S Plumbing ^. H.V.A.C. v Electric / Softener Inspaction Date Insp. Comments Footings I ?? ? ??? .?• ??„?? Footings II Foundation Framing S ? Roofing Rough Plbg. 7 ? . Rough Htg. Isul. Fireplace Final Htg. y_y Final Plbg. 1y47 C . ,?- Bldg. Final 04 e a t o., c" E f Cert. Occ. ? .?, ? . t9 • ?3 t ? ta k /- C ?ia? /• //.' T@mp. LP c.rn ? ?a ,Sei ? G?e? Deck Ftg. re o?• sd/t•. Deck Frmg. Well Pr. Disp_ - • PERMIT # PLUMBING PERMIT RECEIPT # ??? ? n CJ CITY aF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: Site Address 01.;;'/, (' -l" y Name ' 4 Address ? m c City -1'.•E> ? < I Phone ^?'" -A - Name 3 Address p City Phone BLDG. TYPE WORK DESCRIPTION Res. ? New -? Mult. Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL ? Water Closet - $3 00 $ . Bath Tubs - $3.00 p ' _ -_lavatory -$3.00 Y _/-Shower - $3 OQ Ki?Ch"en SiFlk - $3.00 COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE 8 CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM - COMM/IND FEE - $20.00 STATE SURCHARGE PER PERMIT - .50 (AdD $.SU S/C IF PERMIT PRICE GOES BEYOND $1,000.00) ' FOR: CITY OF EAGAN Unriav owCi - -?O.vv _LLaundry Tray - $3.00 _I Floor prains - $1.50 % • _L-Water Heater - $1.50 Whirlpool - $3.00 Z Gas Piping Outlets - $1.50 ' (MINIMUM - 1 PER PERMIT) SoRener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE: STATE S/C: -' ` GRAND TOTAL: ? ? ? ? ? , •. - I CONTRACT PRICE: ' Site Address T.;? 4. Lot Block f ? m Name ? Address c City ? Name - ? < < ?t 3 Address ? O CitY + MECHANICAL PERMIT CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 PHdNE: 454-8100 BLDG. TYPE Res. ? Mult Comm. M1.e. Phone TYPE OF WORK Forced Air M BTU Boiler M BTU Unit Heater M BTU Air Cond. M BTU Vent CFM Gas Piping Outlets # FEE S! C: TOTAL: RECEIPT # 7 5 S ,-2 F DATE: /='0 X 7 WORK DESCRIPTION New ' Add-on Repair FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU - 6.00 fRES. HVAC INCLUDES A/C ON NEW GAS OUTLETS {MINIMUM - t PER PERMIT) - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS. - COMM. RATE APPLIES TOWNHOUSE & CONDOS - RES. RATE APPLIES MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8 REMODELS - 12.00 MINIMUM COMMERCIAL FEE - 20.00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES RFVnN) 4t1 nnrn - : -. - ' - -_ - -- _ ? . !. ;„. .. SIGNATURE'OF PERMITTEE - FOR: CITY OF EAGAN CASH RECEIPT ? CITY OF EAGAN ? 3830 PILOT KNOB ROAD =DAT TA 5512 2 ? +9 AMOUNT S-j 1 ejj & ' OOLLARS ? CASH ? CK 'ao POR FUNO COOE MOUNT G? 5Y Thank You ? BY Nc- 76000 WAite-Pavers Copy Vellow-Posting Copy Pink-File CoOY CITY OF EAGAN 3830 Pilot Knob Road, P.O. 8ox 21-199, Eagan, MN 55121 PHON E: 454-8100 BUILDING PERMIT Receipt#7 To be used for SF DWG/GAR Est. Value $105, 000 Date JUNE 29 N_ 13831 So & U 19 87 Site Address 1560 ASHBURY CT Lot 11 Block Z Sec/Sub. BLACKHAWK GLEN 2 Parcel No a Name ELLIS BT3ILDERS INC z Address 13218 JAMES AVE ° City B'VILLE Phone $94-5755 a Name .o 0? Addre. ? CitY- Ww Name PLANCO INC i3 Address 3435 WASHINGTON DR aw City EAGAN Phone 452-0724 OFFICE USE ONLY On Site Sewage Occupancy R3 MWCCSystem ? Zoning R1 OnSiteWell _ TypeofConst _v Ciry Water -X- (Actuaq - (Allowable) ? # of Stones Length 48 DeDth 34 S.F. Total Footprint S.F. APPROVALS FEES Assessmenis _ Permlt $ 518.50 Warer/Sewer _ Surcnarge 52.50 Police Plan Review $ Fire SAC, City 00.00 Engc SAC,MWCC 525.00 Planner _ WaterConn. 525.00 Coundl _ WaterMeter 67_00 I hereby aCknowiedge that I have read this application and state Bltlg. OH. _ Road Unit 4(15 _ Op thettheinformationisconectandagreetocomplywithallapplicable I APC - TreatmentPl 18n n0 State of Minnesota Statutes an s) Cof Eagan Ordina ce Variance _ Parks / / Copies Signature of Permittee .d!S? ?/L? N"'"• TO TAL ?`J A Building Permit is issued to: ELLIS BliILDERS INC ? &, 5!5& L on the express condition that all work shall be done in accordance with all applicab tate of Minr?sota Statutes and City of Eagan Ordinancea Building Official_ r 4 • . ***********#********i****?****#tk ClTY O F E A G A i?S ,*t *?E. PA?'? OF FEE AT TII?1E C . ?. APPLZCATSON DOFS Ndr CONSTITUTE ? a • , * APPI2C3VAL OF PER=. . APPLICATION FOR PERMIT * . . * INSPEX.TION oF SES+]ER APID/CR WAM: •-. ? rt,SrnrramrONS WnL N7r BE S=- SEWER AND/OR WATER CONNECTION ?ULED Uwn PM= BAS BEEN • . * APPttotrED. • - • * --- . _. * ? -• **.???*?****************?*****:3#t P ease Print) 1) PROPERTY ADDRESS : ? /9,5,41 LEGAL DESCRIPTION: Lot Block Subdivision or Tax Parcel ID ) IF EXISTIICG STRC'CIT-IRE, DATE OF ORIGINAL BI.'ILDINr. PE42VLiT TSSL'Fu=: {N.''I:uif'YE.3i } PFcEScNr 7ANING/PROFOSID C'SE: ? Ca=CIAL/REPP,II,/OFFICE _L?R-1 SINGLE FP1v]ILY Q IbIDL'STRLAL f-I R-2 DL'DLEX (Two Dnits) ? INSTIZLITI0NAL/G0VMUZfENT ? R-3 'IGWNf:OUSE (Three + Units) ( Units) R-4 APAR1T=/COIvCCN1INIC'M ( Units ) • ra er , 2) NANE: ?.4- ° , 5'; _ o S? n? • _19: _ . F ?r, c ADDRESS: CI'I'Y, STATE, ZIP: _.S"qL? PHONE: 3) NAME: ADDRFSS: ,4-r/c ir CIT1'. STATE. ZIP: Plumbers License: Active Expired Not recorded PHGNE: YyLl -74 6 n MnSTII2 LIMISr °jd;-P-?w :2 rn t) Staz? tzal 4) NA?E= C . C _ E//?_c ADDRESS __ / 302 / 7 Tt*-?.?-_ Fa7/? , CITY, STATE, ZIP: z>u"-nSu . //r _ rr?,.? _ S-S. ? ? ? PHONE: • 5) ?.uvv?- i•nr. •?• :au •?o.u:.+?-uua? CONNECTZON 1O CITY SEWER ?CONNFCi'ION 'IC) CITY WATER a rJi1?R . .-, ? 6) ??•'' t", y- •'?- ? PLEASE HOLD APPROVFD PIItF1IT FCR PICK-C'P BY ONE OF P.B[n7E ---•- -- : . (? $LEASE MF1IL APPROVID PERMIT 70 1. Z, C4, APOVE (Circle one) 7} -?tr n u•?• ?`_._ (/7iF' j _?Z W DTV, . a, • 13t3 `/ r• U 1987 BDILDING PERMIT APPLICATION - CITY OF EAGAN ? SINGLE FAMILY DWELLINGS INCLDDE 2 SEfS OF PLANS, 3 CERTIFICATES OF SQItQEY, 1 SBT OF ENERGY CALCOLATIOgS NOTE: ADDRESSES FOfi COENER LOTS - CONTR9CTOR/HOHEOiiNER MOST DESIGHATE WHICH ADDRESS IS DESIRED. NO CHANGfiS WILL HE ALLOWED ONCE BIIILDING PERMIT IS ISSOED. MULTIPLE DWELLINGS - RFSIDENTIAL RENT9L ONITS FOR SALE IINITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SORVEY - CHECK WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COiMMRCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE BOND ? To Se Used For: , Y Valuation: Date: Site Address I Sb d Q-?^??. OFFICE USE ONLY Lot Block On Site Sewage Occupaney ?? ? a D MWCC System ? Zoning e-I Parcel/Sub On Site Well Type of Const City Water ? (Actual) Owner (Allowable) Ik of Stories Address Length ? Depth ? City/Zip Code ??.t?y ?5 ?07? S.F. Total Footprint S.F. Phone ?S a- 339? 9PPROV9LS FESS ? Contractor Assessments Permit 51g - Water/Sewer Sureharge 52, Address Police Plan Review 25G y5 Fi-re SAC, City 10cf>. City/Zip Code . Jr?lf Engr SAC, MWCC SLS. Planner Water Conn 525 Phone y- j` 2,5 f Couneil Water Meter r,-7. 0 Bldg Off Road Unit ?5 Arch. /Engr. /, ,?y,?? _?.! . APC Treatment Pl l go. 61 Variance Parks Address ,3 XJ 5 l??.T%?. - Copies ' TOT9L 5 ?- City/Zip Code Phone 7l 5 I , ? L X 22 = 4-b 4 - ?( 2- = Sc? o 0 `?? x 2? ? ?128 x 4? ? 3 20 32 Z4-o x 4a- m MW , I c4 ? cia C V ? SIENNA CORPORATION . ? ? •SURVEYOR'S' CERTIFICATE ?'. .. „? • . ' -+--- DENOTES-PROPOSED SURFACE DRAINAGE SCALE: 1 INCH ¦ 30 fEET O.DENOTES IRON MONUMENT SET pROPOSED GARACE FLOOR a FEET ?• DENOTES IRON MONUMENT FOUNO, pROPOSEO LOWEST FLOOR ¦FEET %000.0 DENOTES EXISTINC ELEVATION pROPOSED TOP OF BLOCK ?' FEET (000.0) DEtI0TE5 PROPD5E0 ELEVATION ' VIE HEREBY"CERTIFY TO -SIENNA CORPORATION THA7 THIS IS A TkUE AND CORRECT REPRESENTATION OF A SURYEY OF THE BOUNDARIES OF: , Lot II, Block 2 BLACKHAWK OLEN f ND ADDITION, according to the recordad plat VALIDoU f?ONaFIL. ING6OFtTHEMPLATSBLACKFIAWKSGLENA2NDEAD0ITI0N) WILL BECOME DECE16Eq IF AN19??AS SURVEYED DY ERVT30?N DAY ENCROACHMENTS, ME OR UNDER MY DIRECT SUPERV1S10N TNIS SIGNED: JAM N LL? INC. REVISED' 6-19287 TO SHOW PROPOSED HOUSE. • l? REVISED 6-22-87 BY. IIAROLD C. PE7ERSON, LAND SURVEYOR 'MINNESOTA LICENSE NUMBER 12294 . • SHEE7 1 OF 2 SHEETS PfiOJBCT N0, eoo?c ? PnaE • JAMES' R. HILL, INC. 85618 (W33y? zz3? 3i planners / Engtneers / Surveyors FILE N0. 8200 Humboldt Avanue Soulh FOL D ER eloom?nOton, Mn. 55 431 812-884-3020 'SWRVEYQR'S: CERTIFICATE SIENNA CORPORATION (G N M N ?R ?RO? J ? . 1 8 ? 0 v o ?. ?oo? ??o M ? ? W M 01', 0 O N' REVISED 6-22-87 ? _J 65618??733y) 22'3/1 ? FILE NO. FOLDER JAMES R. HILL, INC. Planners / Engtneers / Surveyors 8200 Humboldt Arenue Soutb Bbomington, Mn, 55431 612-e84-3029 . p121/4 • •• MINNESOTA STATE ENERGY CODE CAICUlATIONS " ?Z?I r ,. ' BASED ON CHAPTER 5 OF THE MODEL ENERGY CODE - 1g83 EDITION Adoption Effective 1 /84 t Owner T't>J(?-'? '?_y Phone Date,- Site Address Contractor GI^W7 I Phone ? Building C'la,ssificaclon: Type A1 (Single Family G Duplex)_ Type A2(Residentlal)' (3 stories or less NOTE: Complete pages 3 and 4 first. (Other) (Over 3 storfes) ' GENERAL INFORMATION ° ' " , ' '• 61 l. Building Perimeteft. 1 2. Wa11 height (ground to eave) ? ft. - 3• l. x 2. (a6ove) gross wal l area 2?10(010-L? ft? • ? `?? ?. 4. Building dimensions (L) '-?- X(W) - = G?C??j ft.2 roof 6 floor area 5. Square foot area of rim joist - Floor joist size (Z x 117 ) Ic? X Ptr meter - Rim o st area = 2-4 i134- ft2 12 i.3 J 6. Doors - Area Th i ckness?? . i n. U factor! ?_4-7, , i? ? 1, ,, .,,;; ;Type of Construction Perimeter ft. Manufacturer • " I ,;t,• ?;; , 7. ?otal door's perimeter ft. ' . ? ; •i ! i? `.01 ,Ipf 8. Windows: Manufacturer AA'l° State approved" U factor TYPE SIZE AREA (Ft.Z) N EACH 9. Total ft.z Gtass zo??, :] Gj ' , r lir:..,. j I I NUMBER OF TOTAL FEET 2 UNITS I ' ?- ?,?, r ?,r-ia?•I 10. Fireplace area; Width X helght = X = Ft.2 11. Exposed foundation: Hejght X Perimeter .?? X?^= ft.2 COMPlETION OF THIS FORM IS REQUIRED FOR ALL ALT,T CO-F35fiRUCTION, MAJOR REMODELING AND BUILDINGS BEINC MOVED WHERE ENERGY, OTHER TNAN THE MINIMAL CODE ALLOWANCE, IS USED. 12. ' Froming AreB R 1oX of gross xa11 aree t ' • , ?? 8•1-?z? IJ. Gross xall aree P(o, • •• ' - ? ft.Z . Nlndow area 2 . ' - f t. U?+1 ndows ¦ A?P p x' q¦• ? i Rlm Jofst area A 12 ? Z . Doar area ft. Z U ri ? m Jolst •_ 1 04) U x A• r•t;?_ ft. U door erea ¦ 1 U x A¦ I Ai? U? f?r?p1A?"a" area A ft.Z u fbmR h ee- ¦ i? 1 U x A'? Expnsed foundaNon•A ?r'r=;',?I?•', ft.2 ' Framing aree A ?;Gf 67 ft.2 Ilet wall area A_ ,:.? 0 ' ? I ft. ----?I-- ? U faundatlon ¦ i ?`i- U x A¦ 14,71 U framing area a , 09C; . u x A•?-Li -122 u Hett 0?1?? , u x a? . • (130) TOTAI . . . . . . . . . .' U x A ¦??JItZ 14. Gross Hall area k'0,1?L (A 1 single famlly 6 duplex ¦ allowable U x A/Code • (13, above)--";` . , x 0.23 (A-2 ather residenNal) x .13 (Other bulldings) • • x .28 (Over 3 starles) • ' , A ?UUJ BTUII Must be larger t x ' 0F. 130 above 15. Ce111ng freming area (Air) equals•lOx af ee111n9 area' ? a1' ths seme as) 15A. Gross ce111ng area ¦'?L) r------- ? x1W) Z 158 . Jolst area (Af) ¦ 10% ce111ng area • /? 0? 2 . f t. ISC. Net celling area (Ac) (15A - 1501 ¦* ft.Z U ce111ng x A c• '?9 ZZ- x Le)' a U framing x A f' _ 10 Z? 150. TOTAL U x A ........................................ • z Z 1?-? • '??, 16. Ce111ng area (15A) fc"p.02?(p-1 single famlly 6 duplex - code allowa6le U x A . • x 0,033 (A-2 other retldenllai) , • x 0.06 (ather) ' • A(15A1 x?(codels ??' 1? BaUll Iii st be larger than 15D (above , F . ?or the same as) • . C7 7 C.0 • . . , I10iE: Use U and'A valuss obtained from nps 1. 3 and 4. .. .? _ . .j? ? ? ; ? 54X C45 t4ib?t, ZU4-7ca) I,`l Z- L'??i .?, I 1 ? ? IIN :?-w? Z4X4? = 22is X 5= 11215 / ?;?- I?ox? = IZ?Z?X I= I2?z? ? i'!2J Z-`"?X (q? _41I7,?5 ? I° `T I I ZG- ;' 2 02 ? ?15 ?- ?a? ?u1Nc4 42-to_ ? q, NALL SEC?IOH sTUu SEC?ION :ttn uALL SECSIOH &I21 .)0 [ST . . -1rlaLuE U vaLUE inildo air tilm .68 Ideeclor vaiL . ow (pall) U . a . [naulatlon Sheathing Z•p(? 04., Stdlog . „ • 1 Outllda alr [!Im .17 R iOTAL Z3,43 ' Inatde•slt fllm ,68 InCertor vall 8 A" seud (6) R* .6.028 6.50(Framing) U. a . Sheathing ?? Slding 16a7 •49S autslda air Lllm ,17 R ?OiAL Ib,V; Instde air Ltlm Rs .68 Inearlar vall Insulatlan ' (pall ) U . e . Shia ' ? Extertoc vall ring Est.riae air Eilm' A ' a iDTAL tneerlor air tllm Ilm .68 [neulatlon 11 ob ' ly Lneh.eoEt wuvd 1 R=1.88 (R1m ? u s ? s ?OISCJ Sheathing ' x.0(o . .??"I Exterlor xall eavering Exterlos air fllm ? {? ???_ _ ' , R rore?. T4. 41(a ' Inteclor air [ilm Rm .68 ' inautaetcn ' . 'S,[b . Foundaelon L29 ' • (Fdtt.) • U • jL Extatlor alr Ellm, As .17 tOTAL txposed 9luek ? ..?' CEILMA Sllill 'IEf1T fl ATTIf, SpACE ABOVE ' -A '1' Ut UE FMt11tIG CE[LItIG ?. ? 0.61Alr Film 0.61 [nsulation lAGU dolst • , Ce11 ing CRO . f ? f •. ' ' ,• 0.61 A1r F11m 0.61 . ' . `?2,lfn Total R • 1 . . • .d?.3 U ¦ R' , ,D? Fl.4T AqQF OA CATIIE RAI CE LfIIG ' ?R?aTue R 'IAIUE f R,111I11G CE i L! FIG 0.61 Inslde a1r fiim 0•61 ._i_ ? Jnlst ?s u ._._ ? n?ul+?tian - ` . Nna? J?cklnq • lntulatian . Bu11t-up roof 0.17 Outslde a1r film 0.17 Tatal R u . ? - 1lndow infiltratlan .5 cfm111nea1 foat of crack • ? lesidentiat doar lnfiltratian 0.5 cfm/square Faat or doar and minimum cade, requlrement Icn-residzntial daar 1nf11tration 11.0 cf-in/11nea1 foot af crack ' lb 12" c4ncrete block na lnsulatlon ?:47•11 2.1 • 1b 12" concrete 61ack insulated cores ¦.26 H 3.8 15 12" liglitweiaht block •.32 R 3.1 •• ' 1b 12" 119htweight block lnsulated cores ?.12 R 9.3 • • '• 1 single glass • 1.13; with starm.winda,r'.54 ' 1 doubl8 glass ¦ :55 • . • • J trlple glass s ,41 . , , .' tll exterior walls and ceilings must have a vapar harrler (0.10 perm max.). ;apor barrier must be an the inside (heateA slde) of Wall. .•'' '? iaaar barriers of the polyethelene thin f11m havg na R valu9. . ; RESIDENTIAL BUILDING 6053r Permit Application City Of Eagan 3830 Pilot Knob Road, Eagao MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWCtion Reaui2ments RemodeVReoairRequirements OKce Use Onlv 3 registered sKe surveys showing sq. ft of lot, sq. ft. of house: and all roofed areas 2 copies oF plan Ced of Survey Recd _ Y _ N (20°h maximum lolmverage allowed) 1 set of Energy CakulaEons (or heated addiUons Tree Pres Plan Recd _Y. _N 2 copies of plan showing beam & window sizes; poured found desgn, etc. 1 site survey for additions 8 tlecks Tree Pres Not Reqd _ Y _ N 7 set of Energy Calculatlons Addition - indicate if onsde sepGc sysfem On-site Septic System _ Y _ N 3 copies of Tree Preservation Plan if lot platted after 717193 Rim Joisl Defail Optlons selection sheet (hidgs with 3 or less unds Date 9_ / a / / 6 3 Construction Cost ? NO( )(y , Site Address zqsA b Y, 14 UniUSte # Description of Work I1 C??!1 /' ? ?/a i re?? ? L/ e Multi-Family Bldg _ Y_ N Fireplace(s) _ 0? 1 _?l Property Owuer _tl i(/l?(4 ? M<?14,0 Telep6one # ) 7?G? ??? L (O i Contractor ? J' Address City r State ? Zip !!:`S 33 2 Telephone #f15A COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cate '? ?r? 2 (? ??I7r?? r1 f Mi nneso ta Rules 7672 Energy Code Category , Rasidential Ventilation Categor? I? oik'sh f et IJ U L r? • New Energy Code Worksheet (d submissian type) Submitted i'bm r ,? I Submitted • Energy Envelope Calculations itted? N J???3 ( Have you previously censtructed a building in Eagan th a similar plan? fY _ N If so, 25% plcn review Rby- J feeapplies. ----I Licensed Plumber Telephone #( ) Mechanical Contractor Telephone Sewer/Water Contractor Telephone # ( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved pl ' the case of work which requires a review and approval of plans. ? . ApplicanYs Pnnted Name App canPs Signa OFFICE USE ONLY Su6 Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBidg ? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex . ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04•plex ? 12 12-plex Plbg_v or _ N 0 25 Misceilaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair ? 33 Alteration ? 37 Oemolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement 'Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIREDINSPECTIONS _ Footings (new bldg) FinaVC.O. _ Footings (deck) Final/No C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Framing Siding Stucco Stone _ Fireplace _ R.I. _ Au Test _ _ Final _ Windows (new/replacement) _ Insulation _ Retaining Wall Approved By , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S8W Permit & Surcharge Treatment Plant License Search Copies Other Total 2004 RESIDENTIAL BUII.DING PERNIIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan NIN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 1d NewCwisWdbn ReauiremeMs RenodeVReoair Reaufremenis 3 registe2d site surveys showirg sq. R of lot, sq. R of house; and all roofed areas 2 copies of plan (20% mazimum lot ooverage allowed) 1 set ot Energy Calwlations for heated additlons 2 copias of plan slwwing beam & window sizes; poured tound design, etc. 1 site survey for additions & decks 1 sel of Energy Caltmlations Addfflon - intficefe if on-site sep5c syatem ME 3 copies of Tree P2servation Plan H bt platted after 711193 Rim Joist Oe'mil Options seledion sheet (61dgs w%h 3 or less unh Date q / -? / D/ Construction Cost t/:naD J Site Address /510 Unit/Ste # C-1/yl. J l- ' s e / L - C o Description of Work l.7 Q5 - Multi-Family Bldg _ Y _ N Fireplace(s) _ 0 2 Property Owner Telephone # Contractor Address Ciry ? ??r? State Zip Telephone # f- 'jz) 225) '07 S3 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NE1Af BUILDING - Minnesota Rules 7670 Categorv 1 Minnesota Rules 7672 Energy Code Category . Residential VenBlation Category t Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Enveiope Calculatians Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( mmU L Telephone #( il. ?. SEP 0 S 2004 I hereby apply for a Residential Building Permit and aclaiowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a pernut, but only an application for a permit, and work is not to start without a pernut; that the work will be in accordance with the approved plan in e cas f o hich requires a review and approval of plans? i` \ - ? r? A(40 ApplicanYs Printed Name Applican s 5ignature OFFICE USE ONLY Sub Types ? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dweiling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt- Multi ? 03 01 of_ plex ? 09 07-plex ? 97 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt- SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plez ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition O 36 Move Building ? 42 Demolish Foundation ? 45 Fire ReQair ? 33 Alteration ? 37 Demolish 8uilding• ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement •Demolitlon (Entire Bidg) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code 2oning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) FinaUC.O. _ Footings (deck) FinallNo C.O. _ Footings (addition) _ Plumbing Foundation I3VAC Drain Tile Other Roof _ Ice & Water _ Final Pool Ftgs _ Air/Gas Tests Final _ Framing _ Siding _ Stucco _ Stone _ Brick _ Fireplace _ R.I. _ Air Test _ _ Final Windows _ Insulation _ _ Retaining Wall Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge 5&W Permit & Surcharge Treatment Plant License Search Copies Other Total Buiiding Inspector `/ 3579 2005 RESIDENTIAL BUILDING PERNII'C APPLICATION City Of Eagan 3830 Pilot Kno6 Road, Eagan MN 55122 Telephone # 651-675-5675 FAX 9 651-675-5694 70, ev New Consiructlon Reaulrements RemadeUReoair Reauiremenfs ORce Use Onlv 3 registe2d site surveys showing sq. R. of lol, sq. ft. of house; and all roofed areas 2 copies ol plan Ced of Survey Recd _ Y_ N (2096 maximum lot coverage allowed) 1 set af Energy Calculatlons for heated addlGons Tree Pres Plen Recd _ Y_ N. 2 copies af plan shovring beam & window s¢es; poured foumi desgn, etc. 1 5Re survey for addilions 8 decks Tree P2s Required _Y _ N lsetofEnergyCalculations Adddion-indicateifon-sttesepticsystem Oo-slteSepticSystem _Y _N 3 copies of Tree Preservafan Plan tt lot platted after 711193 Rim Jaisl Delall Options selection sheet (buildirigs with 3 or less unlts) / Date ?'_ /? k b?6 ConstrucHon Cost '8' 2, ?-D 6 _ Site Address / 5z o / /`! S!MI,Ky Unit/Ste # Descriptioo of Work /NS??GLC, e/J? ?`6 Q?S Gv/r?Oou-? ? n? ,??,S??j ?7if/? Multi-Family Bldg _ Y ? Fireplace(s) _ 0 _ 1 _ 2 Property Owner f? e Telephone # (?v0V) .2-07' ??QJ?? SC?(?/U)L`?Lb Cootractor f GD?ST ,? Address y- /Q City Ly?-'i-v U? LL ? State ? ^ / Zip Telephone # COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cate¢orv 1 _ Minnesota Rules 7672 Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheef (Jsubmissiontype) Submitted Submitted . Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechonical Contractor Sewer/Water Contractor Telephone #( Telephone #( Telephone # ( I hereby apply for a Residential Building_Permit_and--aclaiowledge that the information is complete and accurate; that the work will be in conform e with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ApplicanYs Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-piex ? 20 Pool ? 30 Accessory Bldg . ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of_ piex O 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous Work Types ? 31 New O 35 Int Improvement O 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement •Demolition (Entire Bldg) - Give PCA handout to applicant Valuation Occupancy MCES System Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS _ Footings (new bldg) Final/C.O. _ Footings (deck) FinaVNo C.O. _ Footings (addition) _ Plumbing _ Foundation HVAC _ Drain Tile Other Roof _ Ice & Water _ F inal _ Pool _ Ftgs _ Air/Gas Tests Final _ Framing Siding _ Stucco Stone _ Bri ck _ Fireplace _ R.I. _ Air Test _ _ Final _ Windows _ Insulation _ Retaining Wall Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total Building Inspector 2007 RESIDENTIAL MECHANICAL rExMiT ArrLicnTtoN City OfEagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complc[e for: single family dwe0ings & townhomes/condos when permits are required for each unit Dat¢ 6 / /J / 4-D 7 , Site Address_ ? 5-& D 41L7 !p l.C /L.,? ?• Uoit # r-^ Property Owner ZQ rn /f? un S Telephone #((p S/ ) 3e S- I37 4, Cootractor ANGEL IRE INC , 2253 Nicoilet Avenue South Street Address BUf1?SVil) City e ep one: 952-746-5200 State fm 9446 59(J1ip Telephone #( ) Bond #: Q SDS O 73 Expires: The Applicaot is _ Owner ? Contractor _ Other Fire repair (replace burned out appliances, ductwork, etc.) $ 90.00 This fee applies when extensive mechanical repairs are made to a building. Add-on or alteration to existing dwelling uoit $ 50.00 V/ furnace _Additional V Replacement _ New ? airexchanger ? air conditioner h t ea pump other D -? State Surcharge $ .50 tJun? 1 4 znal - Total g ,5-0 I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ciry of Eagan and with the Mechanical Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval oF plans. 14ele,"pn„ .? Applicant's Printed Name Applica s Signature I I ForiQlfice Use City of Eapn j Permd# I Permd Fee: 3830 Pilot Knob Road Eagan MN 55722 ? Date Received: ? Phone: (651) 675-5675 Fax: (651) 6755694 i Staff: ? -----------------? 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: J Tenant: Suite ' ? RESIDENT I OWNER .Q.A,? Phone: ( Name: Jc_ AddresslCity/Zip: I 'S (cn 0"M-+? ? Applicant is: _ Owner ),• Contractor TYPE OF WORK Description of work: ? Ta Construction Cost: / /, Multi-Family Building: (Yes No ? ? CONTRACTOR J License #: Name: ` Address: ? IN City: State:Zip: ?S?cl Phone: ?a ??' ?Z Z-??{r v Contad Person: ? 1-.??E'` _ COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Category Submitted Submitted (4 submission type) • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer 8 Water Contractor: Phone: NOTE: Plans and supporting documeriis that you su6mif are considered fo tie public information. Portions oi the information may be classified as non-public if you provide specific reasons that would permit the Cify fo = coridude that the are trade.secrets. I hereby acknowledge that this information is complete and accurate; that the work will be in confortnance with the ordinances and codes of the City of Ea9an; that I understand this is not a permit, but only an application for a permit is not to start without a permit; that the work will be in nnco with the approved plan in the wse of work which requires a review an pproval of ns^ ? ?,?. Ya; - r r f?S x App anYs Printed Name ApplicanYs Signature Page 1 of 3 City of Eagan 3830 Pilot Knob Rd Eagan, MN 55122 (651) 675 -5675 www.ci.eagan.mn.us Site Address: 1560 Ashbury Ct Lot: 11 Block: 2 Addition: Blackhawk Glen 2nd PID:10- 14351- 110 -02 Use: Description: Sub Type: e- Windows/Doors Work Type: Windows/Doors - New/Replacement Description: House Census Code: 434 - Zoning: Square Feet: 0 Comments: Fee Summary: Valuation: 3,000.00 Contractor: Renewal Andersen 1920 County Road C West Roseville MN 55113 (651) 264 -4777 Total: Applicant/Permitee: Signature PERMIT City of Eaan 4/30/08 Notification letter sent regarding expired perm BL - Base Fee $3K Surcharge - Based on Valuation $3K - Applicant - Construction Type: Occupancy: pf Permit Type: Permit Number: Date Issued: Permit Category: A framing inspection is required when installing a Bay or Bow window or if the opening is altered required in all sleeping rooms prior to final Owner: Scott B Church 1560 Ashbury Ct Eagan MN 55122 $88.50 0801.4085 $1.50 9001.2195 $90.00 I hereby acknowledge that I have read this application and state that the informa of Minnesota Statutes and City of Eagan Ordinances. on is correct and agree to comply h all applicable State Issued By: Signature Building EA080702 10/25/2007 ePermit Smoke detectors are Date: City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 2 r Use BLUE or BLACK Ink For Office Use Permit #: 11,--15o Permit Fee: I O ?"S Date Received: ) a f o"'J,3 Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: `". (,o 6 J' Resident/ Owner Unit #: Name: \ �►ZVC229�L� Address / City / Zip: 1 C (ob actlikA.,ty C111 Applicant is: Owner Contractor Phone: 4=5C —345. 5C/za l Type of Work Contractor Description of work: Construction Cost: 95-,)0 . 4) Multi -Family Building: (Yes / No X ) Company: .. r CbadrlA.A i 2:0h. �q7 c 3Ia- s�- tc) Address: City: ecti►ti✓esp—Q, 116 s State: Mk k Zip: S i)°1 Phone: {o' Z` --/ Lf g 9 Contact: Oat/ , A) &lev r License #: �jG2-O73 { 1 Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE Plans and supporting documents that you submit are considered, to be public information. Portions0 the information maybe classified as non-' u rovide specific reasonsrthat would permit the'City;t concatthey are=trade ,secrets. CALL BEFORE YOU DIG. Call Gopher State One can at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.00pherstateonecali.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minn2ta State Building Code must be completed within 180 days of permit issuance. Ir PrO Applicant's Printed Name I Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA177746 Date Issued:07/15/2022 Permit Category:ePermit Site Address: 1560 Ashbury Ct Lot:11 Block: 2 Addition: Blackhawk Glen 2nd PID:10-14351-02-110 Use: Description: Sub Type:Water Heater Work Type:Replace Description:Standard Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Please call Building Inspections at (651) 675-5675 to schedule a final inspection. 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 - Constance J Buck 1560 Ashbury Ct Eagan MN 55122 (507) 340-0065 Champion Plumbing Llc 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature