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3053 Cherrywood Ct Use BLUE or BLACK Ink - - - - - - - - - - - - - - - - - - CRy 01 Ealan X117\1 Permit#:. Permit Fee: 3830 Pilot Knob Road j Date Received: Eagan MN 55122 j Phone: (651) 675-5675 Staff: Fax: (651) 675-5694 1 I 2010 RESIDENTIAL BUILDING PERMIT APPLICATION` X053 C~r~ C- Date: l ~ Site Address: Tenant: Suite RESIDENT I OWNER Name: Voy-A", Phonel,051-LI 54 I irlAddress / City /Zip: I Applicant is: Owner Contractor TYPE OF WORK Description ofworic: rnS~ ~5 Construction Cost: 3000. 0() Multi-Family Building: (Yes / No CONTRACTOR Name: Y'YY\Q 1 License Address: w (r city: aC Stater"'! rte, Zip: Phone: _..._-C r Contact: i' Email: i. COMPLETE THM AREA ONLY IF CONSTRUCTING A NEW `BUILDING In the l- st 12. months, has the City:bf Eagan_1ssued 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: rrr' CALL BEFORE YOU DIG. Cali Gopher State One Call 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.aooherstateonecali.oro I hereby acknowledge that this information is complete and accuratethat the work will'be in conforinance 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,approvedplan in the casesrFworic which-requires-a review and approval of plans. x k 4~(/I VC X Applicanrs'Printed Name . . _ '~/i►ppliican a~re_._._. , Page ,1 of 2 CITY OF EAGAN Remarks Addition Oslund Timberline Lot 29 Blk 4 Parcel 10 55300 290 04 Owner. Street 3053 Cherrywood Ct, State Eagan, MN 55121 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. STREET RESTOR. GRADING SAN SEW TRUNK 40 1968 00.00 0 PAID SEWER LATERAL It 1970 $1210.00 $60.50 20 PAI WATERMAIN WATER LATERAL WATER AREA STORM SEW TRK * STORM SEW LAT 1970 20 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC 6638 10-25-72 PARK INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: I I II I 3830 Pilot Knob Road Permit Number: 0 s 0 Eagan, Minnesota 55122-1897 Date Issued: 01" 7"lyS (612) 681-4675 14 SITE ADDRESS: I •i t 1 1,11111 APPLICANT: t lit t~Nl'410UI1 1 1 i ttl;t~ I I ,lltr•f1 I t#NII I I MIIF Ft I I NI PERMIT SUBTYPE: TYPE OF WORK: i INSPECTION TYPE DATE INSPTR. INSPECTION TYPE .DATE INSPTR. F L Permit No. Permit Holder Date Telephone s ELECTRIC PLUMBING HVAC Inspection Deft Insp. Comments FOOTINGS FOUND FRAMING ROOFING $/a ~l ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FTG DECK FINAL INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: r• Eagan, Minnesota 55122-1897 Date Issued: ~6I~F ! (612) 681-4675 SITE ADDRESS: APPLICANT: PERMIT SUBTYPE: TYPE OF WORK: i,; 1;.;. , , INSPECTION TYPE DATE INSPTR INSPECTION TYPE .DATE INSPTR. F t ili t i I I i.14 1 I t Y s l i 1, .~i ! uY►~ I F Permh No. Permit Holder Dab Telephone M ELECTRIC PLUMBING HVAC Inspection Dab Insp. Comments FOOTINGS r~ FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG i FINAL HTG ORSAT TEST BLDG FINAL [1// BSMT R.I. BSMT FINAL DECK FTG DECK FINAL 7-17 '~079 290 Reques to / Fire No. Rough Inspection Required Inspection Other T n gh-In (You must call inspector when ready) ❑ Ready Now Will Notify Inspector ❑ Vas ❑ No Date Need I licensed contractor Downer hereby request inspection of above electrical work at: Job A ress (Street Box or u NoJ ~~pp~~ Ciry e~~ r/ j(fCY~ L~ a 2i~ .4,G1 Section No. Township Name or No. Range No. Co my an (PRINT) o No. - 19 a, teD ,2. P Supplier E1Z Address El 'cal Contractor ( mpany Name) C sure License No. ~40-Zv Z Mai- Address (Aontractor or Own kin nst ti ) t > Authori ed ,nature ontractor t ng Installation) Phone Number NESOTA E BO RD OF TPICI V THIS INSPECTION REQU ST WILL NOT rigge-M y Bltlg. - qoo 8 III III III I I III ( II II BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St I, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone(612)642-0800 ENCLOSED. EB-00001-09 REQUEST FOR ELECTRICAL INSPECTION ' L% See instructions for comp!- "0 this form on back of yellow copy. rO~ ` "X" Below bYOrk GVered by This Request Ne Add Rep. - Tppe of Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Furnace Other (Specify) Farm Air Conditioner r. Other (specify) Commoor's Remarks' Compute Inspection Fee Below: # Other Fee # Servi ntrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 Amps Above 100 -Amps Signs Inspector's Use Only TOTAL ~+Jl Irrigation Booms ZC~;SV Special Inspection Alarm/Communication THIS INSTALLATION MAY BE RED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in a Date certify that the above inspection has been made. Final Date OFFICE USE ONLY This request void 18 months from PERMIT #RECEIPT DATE: 2008 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EALenx 3650 PILOT KNOB RD KAGM, MN 55122 651-01-4675 Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, backflow preventer for irrigation system f SITE ADDRESS: .23053 l 1~ nf-rna lx C*, OWNER NAME:: 1~1 rk~rrl4 _li TELEPHONE x{77.2 (aEl (A EA CODE) INSTALLER NAME: C- ` I TELEPHONE (AR A CODE) STREETADDRESS: a CITY: CaM 'iO,DI [ ~ STATE: 03 ZIP: -SSq 4~ _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply • MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: - Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 - Abandonment of septic system. Water turnaround - existing dwelling unit 5/8" meter if needed - $118) Other: RPZ: new installation/repair/rebuild $ 30.00 - lawn irrigation system Replacement/additional: _ water softener -V/Water heater $ 15.00 ~11 State Surcharge i $ .50 Total ``L $ 117, S~) I hereby acknowledge that I have read this application, state thatthe information is correct, and rea to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes n ability for an enrages caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within . y p e /rightof-way/ asement. I A. G SIG AT' [RE OF PERMITTEE 1/02 CITTOF'EAGAN PERMIT C 9-4ff 41-~ 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 026040 (612) 681-4675 Date Issued: 07/17/95 SITE ADDRESS: 3053 CHERRYWOOD CT LOT: 29 BLOCK: 4 OSLUND TIMBERLINE P.I.N.: 10-55300-290-04 DESCRIPTION: (ROOFING) B41 ding-I,Permit Type SF (MISC.) twuil didg, W;&,Ck Type REPAIR Y St~t YI tt ' „ ^ w r t € i , Cry tq PF TP xa~:r(~i ~ P 'y•a REMARKS: FEE SUMMARY: VALUATION $2,000 Base Fee $62.25 Surcharge $1.00 Total Fee $63.25 CONTRACTOR: - Applicant - fE{~ JAMES 3053 CHERRYWOOD CT EAGAN MN I hereby acknowledge that I,have:-read this application"and state that the infcrmatia,l is currect.and'alree _Go ogmiply w th° al°l app;3lcab,l- State of 17n. Statutes and City of Eagan Ordinarnces. APPLICANT EE SIGNATUR SSUED B SIG 4 TURE1- - INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: B U I L D I N G 3830 Pilot Knob Road Permit Number: 026040 Eagan, Minnesota 55122-1897 Date Issued: 07/17/95 (612) 681-4675 SITE ADDRESS: P'I'N'' 10-55300-290-04 APPLICANT: LOT: 29 BLOCK: 4 3053 CHERRYWOOD CT CORDELL JAMES OSLUND TIMBERLINE PERMIT SUBTYPE: TYPE OF WORK: SF (MISC.) REPAIR DESCRIPTION (ROOFING) INSPECTIONTYPE .DATE INSPTR. INSPECTION TYPE DATE INSPTR. ROOFING r ~ E 0 44 "CITY OF EAGAN 3830 PILOT KNOB RD - 55122 jbw 5 BUILDING PERMIT APPLICATION (RESIDENTIAL) B81-4675 New Construction Reoulremerds Remodel/Repair Reouirements ♦ 3 registered site surveys ♦ 2 copies of plan ♦ 2 copies of plans (include beam & window saes; poured fnd. design; etc.) ♦ 2 site surveys (exterior additions & decks) ♦ 7 energy calculations ♦ t energy calculations for heated addtions ♦ 3 copies of Use preservation plan H lot plotted after 7//93 required: _Yes _ No nn11 DATE: - / CONSTRUCTION COST: r2 s os , 55* DESCRIPTION OF WORK: '3 0 t~h// STREET ADDRESS: 51; ~f 1 g, 6--arj ~ _ rr LOT IQ BLOCK SUBD./P.I.D. -11AUh PROPERTY Name:,' Phone f~ ~f77~ OWNER Tr ietT Street Address- c?O City: --/state: Zip: CONTRACTOR Company: Phone Street Address: License # City: State: Zip ARCHITECT/ Company: Phone # ENGINEER Name: Registration # Street Address- City: State: Zip: Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received Yes No Tree Preservation Plan Received Yes No PERMIT CR.00 U CITY OF EAGAN 3830,Pilot-Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 2 5 7 5 6 (612) 681-4675 Date Issued: 06/06/95 SITE ADDRESS: 3053 CHERRYWOOD CT LOT: 29 BLOCK: 4 OSLUND TIMBERLINE P.I.N.: 10-55300-290-04 DESCRIPTION: t;ai-1din} Permit Type GARAGE/ACCESSORY Building W-ork Type ADDITION Bu ~ ray s ~ r'- 1 ..f Ca REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK FEE SUMMARY: VALUATION $8,000 Base Fee $137.25 Surcharge $4.00 Total Fee $141.25 CONTRACTOR: - Applicant - ST. LIC OWNER: CONWAY CONST 14575431 0002867 KORDELL JAMES 11491 S SMITH AVE 3053 CHERRYWOOD CT W ST PAUL MN 55118 EAGAN MN (612) 457-5431 (612)454-4773 I hereby acknowledge that I have read 'this application and state that the -information is correct ,and agree to comply with a11'applicable=State,;'qf Mny s.," r" x " tatu es anii City of Eag "n' 1, n ,Lolpa APPLICANT/PERMITEE SIGNATURE ISSUED BY: IGN UflE INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: B U I L D I N G 3830 Pilot Knob Road Permit Number: 025756 Eagan, Minnesota 55122-1897 Date Issued: 06/06/95 (612) 681-4675 SITE ADDRESS: P.I.N.: 10-55300-290-04 APPLICANT: LOT: 29 BLOCK: 4 3053 CHERRYWOOD CT CONWAY CONST OSLUND TIMBERLINE (612) 457-5431 PERMIT SUBTYPE: TYPE OF WORK: GARAGE/ACCESSORY ADDITION INSPECTION TYPE .DATE INSPTR. INSPECTION DATE INSPTR. FOOTINGS FRAMING FINAL REMARKS: A SEPARATE PERMIT IS REQUIRED FOR ANY ELECTRICAL WORK P t OFFICE USE ONLY BUILDING PERMIT TYPE Fr - ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodging ❑ 16 Basement Finish ❑ 02 SF Dwelling ❑ 07 4-plex ❑ 12 Mufti Repair/Rem. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-plex 13 Garage/Accessory ❑ 20 Public Facility ❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous ❑ 05 SF Misc. ❑ 10 _-plex ❑ 15 Deck WORK TYPE ❑ 31 New ❑ 33 Alterations ❑ 36 Move v"2 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MCMS System (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. 73 Depth Footprint sq. ft. SAC Code o/ Census Bldg i Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit SNV Permit SNV Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units i i i i i - 3 1 I I ' j Gam. so' ! j 1 0 I 3 F~P)4G6 DeTION X02. li SCALE: V14' ~ f C 7.. APPROVED BY DRAWN BY ' I' DATE: {-qS " 'MD t.11n C~•'^'''Tr:~si/~~'t.~~f ..:5•.~e'.... EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: October 25, 1972 NUMBER 117 D. Anderson Realty for ~m13~~/iN OWNER:James F. Kordell Address 3053 Cherrywood Court, Eagan 55121 PLUMBER All-State Plumbing Co. TYPE OF PIPE HEavy Cast Iron DESCRIPTION OF BUILDING Industrial Commercial Residential Multiple Dwelling No, of units xx Location of Connections: Connection Charge 260.00 pd 10/25/72 Permit Fee 10.00 pd 10/25/72 Pa s c Street Repairs Total Inspected by: Date Remarks: By. Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota All-State Plumbing Co. Please notify when ready for inspection and connection and before any portion of the work is covered. PERMIT City of Eagan Permit Type: Mechanical Permit Number: EA107399 Date Issued: 10/10/2012 of 3 a R Permit Category: ePermit Site Address: 3053 Cherrywood Ct Lot: 29 Block: 4 Addition: Oslund Timberline PID: 10-55300-04-290 Use: Description: Sub Type: e - Furnace & Air Conditioner Work Type: Replace Description: Furnace & Air Conditioner Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson, State Electrical Inspector, (952) 445-2840 Fee Summary: ME - Permit Fee (Replacements) $55.00 0801.4088 Surcharge-Fixed $5.00 9001.2195 Total: $60.00 Contractor: - Applicant - Owner: Genz Ryan Plumbing & Heating Rita H Kordell 2200 West Highway 13 3053 Cheirywood Ct Burnsville MN 55337 Eagan NIN 55121 (952) 767-1000 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. Applicant/Permitee: Signature Issued By: Signature For Office Use / , l5-- i,i i , :::: Date Received: 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 V (651)675-5675 I TOD: (651)454-8535 I FAX:(651)675-5694 Staff: buildinginspections@citvofeaoan.com L 2018 RESIDENTIAL BUILDING PERMIT APPLICATION Date: O/�j _g)I Site Address: 305 -- Chftrl'l t.i fl'r/ C4- Unit#: I , y _,J Name: C11 ACA omit c Phone: Resident/ __' Owner Address/City/Zip: �3 ivy ij(.t art C _ Applicant is: Owner Contractor iP\ 01 7 1 b /4 Type of Work Description of work: 10 k6li!'1 Til - e 14 Aft r tc o h Construction Cost RLccb Multi-Family Building: (Yes I No ) • Company: 34-orwarci Witiercrerikot Contact 7/13 53 7'11/49 Contractor Address:5331 Logelatlal Ave Y City: ery l State: Zip:,' 54/2 q Phone:7k ' ?)-yl'1/f Email: A• _ , • .ai... License#: C f�� . Lead Certificate#: J'/j� 2/4/34,--Z if the project is exempt from lead certification, please explain why: 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: Fire Suppression Contractor: Phone: NOTE:Plans supporting documents that you submit are:considered tope publicnformation Portions of the Information maybe , classinedes non-publiclf you provide spec/t!c'reasons that"would peanut the;Clty to'Conclude :that they ire'tradesecrets, ,. :_ .,, You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.comisubscribe. Exterior work authorized by a building permit issued In accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL.BEf ORE YOy BIG. Call Gopher State One Call at(661)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.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. Adr Ap icant's inted Name Applicant's Signature 3D53 ckr C-+- / D11 DO NOT WRITE BELOW THIS LINE f r SUB TYPES Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family) — Single FamilyN _ Garage — Porch(4-Season) _ Exterior Alteration(Multi) Multi J\ _ Deck — Porch(Screen/Gazebo/Pergola) _ Miscellaneous _ 01 of_Plex ___ Lower Level ` Pool — Accessory Building WORK TYPES New — Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building ,_ Reroof _ Demolish Interior Alteration _ Fire Repair _ Windows _ Demolish Foundation I Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building–give PCA handout to applicant DESCRIPTION / Valuation "-i ,4 Occupancy fl\A MCES System Plan Review Code EditionIrs,).;.r?ts'` SAC Units (25%_100%Y) Zoning City Water Census Code t ' Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction —9-6— Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required Footings(Addition) y Final/No C.O.Required — Foundation Foundation Before Backfill I HVAC Gas Service Test Gas Line Air Test Hood Roof:_Ice&Water _Final Pool: Footin s Air/Gas Tests _Final — Framing 30 Minutes 1 Hour Drain Tile — Fireplace:_Rough In Air Test _Final /v Siding: tucco Lath _Stone Lath Brick_EFIS — Insulation Windows Sheathing Retaining Wall:_Footings Backfill r„Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In_Final — Braced Walls Erosion Control Shower Pan Other: — Reviewed By: . _ lir , Building Inspector RESIDENTIAL FEES f ,� Base Fee Vi111-0‘) {�'` Surcharge Plan Review ilh MCES SAC City SAC Utility Connection Charge S&W Permit&Surcharge Treatment Plant I 4? t?° Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA152517 Date Issued:10/18/2018 Permit Category:ePermit Site Address: 3053 Cherrywood Ct Lot:29 Block: 4 Addition: Oslund Timberline PID:10-55300-04-290 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: 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 - Chad Brooks 3053 Cherrywood Ct Eagan MN 55121 (612) 759-3210 Shelter Construction Llc 7040 Lakeland Ave N Brooklyn Park MN 55428 (612) 849-8082 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA171403 Date Issued:08/16/2021 Permit Category:ePermit Site Address: 3053 Cherrywood Ct Lot:29 Block: 4 Addition: Oslund Timberline PID:10-55300-04-290 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Chad & Tiffany Brooks 3053 Cherrywood Ct Eagan MN 55121 Renewal Andersen 1920 County Road C West Roseville MN 55113 (641) 264-4088 Applicant/Permitee: Signature Issued By: Signature