1713 Deerwood Dr
CITY OF EAGAN
3795 Pilot Knob Road Eagan, MN 55122 N2 4448
PHONE: 4548100
BUILDING PERMIT Receipt
{#
,
To be used for :? • Date ` 19
Site Address Erect ? Occupancy
Lot Block 1 {v Sec/Sub. " Alter ? Zoning
Parcel # _ Repair ? Fire Zone _
E
l
? of Const
T
arge
n .
ype
W Name Move E] # Stories
Z
3
Address
> ,.,
1,4 Demolish ?
Front ^i it.
r_... Il?l_ 11 f17'2 v^ri?
Grade fl
Depth h ft.
o Name ?.ri i.c?nsL ?. .• ,.._ ..... ..r,..,._._
Address ? • ?_? ° ` +' ` ??"1 1 _ Assessment
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~ Cit
Ph Water & Sew.
one
y Police
t- ?
FW Name
Fire
? Address Eng.
u
<W City Phone Planner
Council
I hereby acknowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to comply with o!l applicable
State of Minnesota Statutes and City of Eagan Ordinances. APC
Signature of Permittee
Permit _
Surcharge
Plan check
t.
SAC
Water Conn.: `
v V
Woter Meter "r)
Total ) 1 • r) Q
A Building Permit is issued to: Bah 1_ s on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eason Ordinances.
Building Official
- Permit # Deft Imed pe ndflse
Plumbing q -g- G ?/--is/ - 77 ,!? -? ,
Mechanical o e- ii- - 7 7 ,
INSPECTIONS DATE INSP.
Rough-In
Find
Footings Date Insp. Date Insp.
Foundation Plumbing /?2 d ' S
Frame/ins. //-,gyp-?) /y J) Mechanical - f 7,7
Final ' - -1 7? z3
Remarks:
CITY OF EAGAN
3745 Pilot Knob Road
Eagan, Minnesota 55122
Phone: 454-8100
PERMIT
Date: November 14, 1977
Site Address: 1-7-1 ' -nerwood Drive
Lot Block 10 Sub/Sec. CG 8
I Nome '.c'= en Bahes filcir for
•
c
Address
City Phone:
Name Motz Plumbing & Heating Co.
Address c190 - 150th St. West
"c•g?tnittrt 5?r)?Q
E
v
e
0
V
Nc
956
Receipt No.:
Single
Residential Y.
Multi Res., Comm./Ind.
New/Alter./Repair new
Cost of Installation
Permit Fee
Surcharge
City Phone: I Total ` r n
s Permit is issued on the express condition that all work shall be done in accordance with all applicable State of
nnesota Statutes and City of Eagan Ordinances.
20.00
50
Building Official
Date: _
Site Address: 1713 Deerwood Drive
Lot 3 Block 1_G Sub/Sec. _CIG `; n
Nome Wren Bahes Bldr.
Address
C City Phone:
Suburban Heating
Name
ress 2050 White Bear Itve.
P
.,
e
0
V V Ci Pau! ?5101'1 _ Phone:
This Permit is issued on the express condition that all work shall be
Minnesota Statutes and City of Eagan Ordinances.
Receipt No.: 08136
Single
Residential x
Multi Res., Comm./Ind.
New/Alter./Repair. Cost of Installation
20.00
Permit Fee
Surcharge
51
'o.
Total
done in accordance with all applicable State of
e
CITY OF EA"N
3795 Pilot Knob Road
Eagan, Minnesota 55122
Phone: 454-8100
It
HEATING
PERMIT
No. =?
November 22, 1977
Building Official
CITY OF EAGAN Remarks Sold For Taxes
Addition Cedar Grove 8 Lot 3 Blk
owns 4 -1. Street 1713 Deer wood Dr.
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. V-1 DD 1975 615.21 3.52 10 65 ,? ,Lb 7
STREET RESTOR.
GRADING DD 97 620.dl'
52,08
10
ee t-547
7
SAN SEW TRUNK 1970 125.0 0 5.00 25 Paid ?? bss' yot
# SEWER LATERAL
1
1539.10
07.82
Paid
WATERMAIN
# WATER LATERAL 1
WATER AREA ??$ 1977 160-0
0 6 15 149 34 0 04
6 39
A 9-6-77
. .
-
STORM SEW TRK
# STORM SEW LAT 1974 5
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
"
SAC q 7-1. 00 701 L, 5?,. 77
PARK
CITY OF EAGAN WATER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.,.
Eagan, MN 55122 DATE:
Zoning: No. of Units:
Owner: _
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
1 agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By Date Paid:
Dote of Insp.: Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3745 Pilot Knob Road PERMIT NO.:
Eagan, MN 55122 DATE:
Zoning: _ No. of Units:
Owner:
Address Site Address:
Plumber:
I agree to comply with the City-of Eagan
Ordinances.
By
Date of Insp.:
Insp.:
Connection Charge: _
Account Deposit:
Permit Fee:
Surcharge:
Misc. Charges:
Total:
Dote Paid:
This request void 18 months from
Date of this Request 7 1 4173
I, as ? Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri-
cal wiring installed at:
Street Address or Rou No. Z 7/__ -7 "nr i I'D t? ,f? a
Section Township Range
Which is occupied by
Is a roughin inspecti equired on this job? No ? Yes 0\ Ready Now ? Will Call
Power Supplier Address
Electrical Contractor Contractor's License No.??
Mailing Address
Authorized
STATE BOARD COPY
Minnesota State Board of Electricity
1 R54 University Ave., St. Paul, Minn. 55104-Phone 645-7703
REQUEST FOR ELECTRICAL INSPECTION
CHECK BELOW WORK COVERED BY THIS REQUEST 417 3
Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired For
Home ? ? Range ? Temporary Wiring ?
Duplex ? ? ? Water Heater ? Lighting Fixtures ?
Apt. Bldg. ? ? ? Dryer ? Electric Heating ?
Commercial Bldg. ? ? ? Furnace ? oader ?
Industrial Bldg. ? ? ? Air Conditioner Ik k Tank ?
Farm ? ? ? LList t ,
Other ? ? ? o
HeiersI e
COMPUTE INSPECTION FEE BELOW
Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Circuits: # Fee
0 to 100 Amps. 0 to 30 Amperes 0 to 30 Amperes
101 to 200 Amps.
Above 200 Amps. 31 to 100 Amperes
Above l00 Amps. 31 to 100 Amperes
Above 100 Amps.
Transformers Remote Control Circ. Partial or other fee
Signs
S cial Ins ction
Minimum fee $5.
9Kr
Remarks
TOTAL FEE
'
I, the Electrical Inspector, here V i e ection has bean moo.
(Rough-in) Date --/-7-77
/-
(Final) v Date
This request void 18 months from
c el??st( -?4d unc'l2
EAGAN TOWNSHIP
BUILDING PERMIT No
Owner ° 'f'<- `
----..... ------- ...........
......d...?' ................ .? ... ...........
Address Address (Present) ....... £-'e......_iE-.'.:..:....
Builder ................... ............_.----................
Address .... ...............................................................
'------ - ---
DESCRIPTION
2931
Eagan Township
Town Hall
Dale .... 1?.... al--j7.7z.......:.
Stories To Be Used For -Front Depth Height Est. Cos! Permit Fee Remarks
1 %G d e ?u CJ . B 8, C'T yy? C?
LOCATION d i(.
-
Street, Road or other Description of Location I Lo! Block Addition or Tract
1) 3, 9 i S/ 6 J .71 `?, / v i' i:z, i 5, I /0 C c? Y? r (?.
This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent
the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and
general welfare to anyone in the community.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS.
This is to eerrifY, that ......?.,zt,r..:.-?.:?':`.._...R..._.......has permission to erect a..... ..G :.............
the, above described premise subject to the provisions of the Building Ordinance for Eagan To ship ado fed April 11,
1955.
?. ?..?
...............Ch--:-.................----..?.`.-'--- ....?`:..... Per ....---°-'----...°".?'..... -...........--"---............-'---...----...-°°............
Building Inspector
Y? 0
.
CITY OF EAGAN
•
3795 Pilot
Knob Road Eagan, MN 55122 No 4448
PHONE: 454-8100
BUILDING, PERMIT APPLICATION 37,000-00 Receipt #
2NXRRRxRR
To be used for Single family/a araae Date_ A/o 19-7-7-
Site Address 171 3 Deerwood Dr. Erect C Occupancy T
Lot-3 Black 10 Sec/Sub. CG 8-- -- Alter ? Zoning_ R1
Parcel # Repair ? Fire Zone 3
Enlarge ? Type of Const. V
rc N,me T Ora n F Rahl c Move ? # Stories
J Address144 5 Salem Church Rd. #409 Demolish ? Front 64 ft,
rit. IVG 33af s_Phone451- 4022 work Grade ? Depth 2F ft.
Fees
Permit 1-0-8-rII0---_
Surcharge
Plan check
SAC
Water Conn. . 00
Water Meter . 6 n .0_0
Total 89.,5-0--
A Building Permit is issued to: _ on the express condition that
all work shall be done in accordance wit)y all g'y igdble State of Minnesota Statutes and City of Eagan Ordinances.
Name Kolstad Const 4:3:3'U3uc "Pp'.'...
Z
G
4 Rob rt Trail
G6
Assessment --
3
Address 4 S
&
W
IVG Hats Phone-457-4147
City ew.
ater
Police
Police
Name Fire
Address-
? u Eng.
z City Phone
< Planner
Council
I hereby acknowledge that I have read this application and state that Bldg. Off.
the information is correct and agree to comply with oil applicable
State of Minnesota Statutes n City of Eagan Or ncg . APC
Signature of Permittee -
Building Official
t3a
..1
ni?
. . .. .
"o 41zl
Date -
BUILDING PEFIAIT APPLICATIO'_4 L
LOT BLOCK DITIOid ?P Q (- ( )?d?, ? Q
% :CE & SECTION NUMBER IF MIPLATTED
?DL' S;, J?Or PAS
?tn,ER?
n.:'Zsa A41
COI TRACTCR,?
L9?DRESS q n
accuPANCx - USE l C•.,r_? d?Q??
J? Q? I 4 5 I -?10? 2? - work
TELEPHONE NO. 4? 5-/1 /??Ja m?
TELEPHONE 110
Notes Include site plan, building plans, and energy calculations orith ih1.r.
application
Signed T(0/n G ?JWf l?L
OFFICE USE
_
7ALUATIO111
11MTZR iIETER
2TJILDING PER14IT FEE
IT
TRCHI`.RGE FEE
PWM CFECK FEE
PARK DEDICATION? FEE
y75.12
.?00
Gas n?? _.
q
OVIER ?J
^Pcrr..i s:
"SST:SSArMT CLERK BUILDING DEPT. POLICE DEPT._
_mgR & SETTER DEPT. FIIM MPT. PARK DEPT.
RESIDENTIAL
BUILDING PERMIT APPLICATION
?' . CITY OF EAGAN
U 3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construction Requirements
• 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas
(20% maximum lot coverage allowed)
• 2 copies of plan showing beam & window saes; poured found design, etc.)
I set of Energy Calculations
3 copies of Tree Preservation Plan if lot platted after 7/1193
• Rim Joist Detail Options selection sheet(bldgs with 3 or less units)
DATE
SITE ADDRESS /-7/3
TYPE OF WORK -':3 Se!,v,a s
MULTI-FAMILY BLDG _Y _N
_ FIREPLACE(S) _ 0X 1 - 2
APPLICANT Jrr1t?S `?JaAT? ce, 7Z,
STREET ADDRESS / 7 / 3 I?eGJZ csJ®a? h ?-' CITY E c ?sry STATENd'LIP ;5] Z- y
TELEPHONE # lrS/- /sZ 39S/CELL PHONE # FAX #
PROPERTY OWNER TELEPHONE #
-----------------------------------------------------------------------------------------------
COMPLETE THIS SECTION FOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 lIRt1?NFSK7T? 1S 7672
(J submission type) • Residential ventilation Category 1 Worksheet Submitted MAY tteyt Ene gx orksheet Submitted
Energy Envelope Calculations Submitted U 88 LL N
By ??'
Plumbing Contractor: Phone _____
Plumbing system includes: Water Softener Lawn Sprinkler Fee: $90.00
Water Heater No. of R.I. Baths
No. of Baths
Mechanical Contractor:
Mechanical system includes:
Sewer/Water Contractor:
Phone #
Phone #
Fee: $70.00
--------------------------------------------------------------------------------------------------------------------------
I hereby acknowledge that I have read this application, 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 _ Tree Preservation Plan Received _ Not Required _
Updated 4102
Remodel/Repair Requirements C-
• 2 copies of plan
i set of Energy Calculations for heated additions _
V
l site survey for exterior additions & decks
Indicate 9 home served by septic system for additions
00
VALUATION oz:?Ia
Air Conditioning
Hcat Recovery System
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 01 of - plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or_ N
Approved By T Z- , Building Inspector
--------------- - -- - - - ----- --------- - ------------------- - ---- - - - - - - - -- - - - -
loon C., o ) 9 ? x '-/ o = 7, ?- 11o
? 20 Pool
21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 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 Jt Occupancy r t- MC/ES System
Census Code Zoning City Water
SAC Units 01 Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const VA-) Width
REQUIRED INSPECTIONS
- Footings (new bldg) _ Final/C.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. _%Air Test X Final _ _
-
Windows (new/replacement)
Insulation - Retaining Wall
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
(O-)WG
? 30 Accesso'ryBldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
2-000
"7!1WND
Total
k
l
I
I i
21.2._, :V.n7733. 1,1 GO'J..LC i 6J_° < _ I .1
/7/3 De-we
FkANl rr- 4t 6-6 2?I
MATTSON/MACDONALD INC.
STRUCTURAL ENGINEERS
1516 WEST LAKE STREET #102
MINNEAPOLIS MN 55408
(612) 827-7825 FAX (612) 927-0805
FAX TRANSMITTAL
To: John-David Construction From V. Patrick Jeffrey
Attn: Greg QueN Pagex 2
Fax: 651-454-7007 Date: 8/19r402
Re: 1713 Deerwood Drive CC: [Click here and typs name]
? urgent CI For ReWew D Please Comment D Please Reply D Please Recydo
0 comments,
S _ i t _ iCCI. 'M, C" -!-c
MATTSON/MACDONALD INC.
August 16, 2002
STRUCTURAL ENGINEERS
1516 WEST LAKE STREET ;Y102
MINNEAPOLIS MN 55408
(612) 827.7825 FAX (612) 827-0805
Greg Quehl
John-David Construction
2001 University Avenue SE
Minneapolis, MN 55414
:L , oc? CID-
Re: 1713 Deerwood Drive
Eagan, MN
Dear Greg:
As you requested, we have reviewer the beam size for the above referenced project. The beam is
;panning 12'-0" between supports with a •0" cantilever. The canttlevet!is supporting a point load from
the ridge beam. The beam size needed to support this load is 3 - 200. Please follow the guidelines
shown in the UBC for connecting the plies together.
Please call if you have any questions concerning the above.
Sincerely,
MattsonJMacdonald?Incc
v ? ( OvD
V. Patrick Jeffrey, P. E.
MN Registration No. 41317
(ieto234oa)
MEMORANDUM
Date: May 21, 2002
To: All MN Building Officials and Inspectors
?+? ? r ego z?i
From: Roger Axel, C.B.O., Uniformity Committee Co-Chair
RE: Plastic and Composite Decking Materials
The Uniformity Committee.recently voted unanimously to approve the accompanying list
as a starting point for deter(Tning acceptance of plastic and composite decking materials.
The basis for acceptance of a particular product should be that the decking material has
an Evaluation Report recognized by one of the model codes. The decking material must
be installed according to the conditions of use noted in the report.
Most of the Evaluation Service reports reference ASTM testing that address criterion
such as:
• Nail and screw withdrawal.
• Shear, compression, and tension.
• Moisture absorption.
• Flexure and allowable deflections.
• . Modulus of elasticity and rupture.
• Thermal expansion.
• Hardness.
• Abrasion resistance.
• Accelerated weathering.
By requiring the Evaluation Report for the product to be used, at time of permit
application, the code official will be able to avoid potential problems with correction
orders to remove non-complying materials.
The Committee is encouraging code officials to notify me of any new decking products
that they come across during plan review or field inspections. I will then add the product
to the master list as either an approved or unapproved decking material. I am planning on
updating this list on a quarterly basis.
Roger Axel, C.B.O.
Plan Check Engineer
City of Bloomington, MN 55431
OFFICE: 952-563-8960
FAX: 952-563-8949
E-MAIL: raxel@ci.bloomington.mn.us
?r
a
Dream Deck
DuraBord
Ecoboard
Ecodeck
Eon Decking System
Epoch Decking
Epoch Evergrain Decking
Evernew
Everx Extruded Wood Products
E-Z Deck
Fiberon Decking
ForeverDeck
GeoDeck
Gorilla Deck
ITS Recycled Decking
MacLumber
MikronWood Decking
Milldrll ium Lumber
7T
Thermal Industries Pittsburgh, PA
Recycled Plastics Marketing
American Ecoboard Farmingdale, NY
Environmental Bldg. Products Highlands Ranch, CO
CPI Plastics Group Ontario, Canada
Eco-Products Boulder, CO
Epoch Composite Products Lamar. MO
Certainteed Corp. Valley Forge, PA
Quality Wood Treating Co. Prairie du Chien, WI
Pultronex (Corp.
Fiber Comoposites, LLC New London, NC
Plastic Lumber Yard Ambler, PA
Kadant Composites, Inc. Bedford, MA
Homeland Vinyl Products Birmingham, AL
American Recycled Plastics Inc Palm Bay, FL
MacLumber of South Carolina, Inc Bamberg,SC
Mikron Industries Kent, WA
BJM Industr
leg Kittanning, PA
r.
BOCA ER 97-55
None
None
None
None
None
NER-630
ICBO ER-5963
NER-605
None
None
SBCCI ER 2129
BOCA ER 21-67
None
None
None
None
SBCCI ER 2004
None
None
OT
CEDAR C?Ro?t? NO ?
_ !?l? DEERI??CO? D4?iyE?
13.4 16? -13`0
_ 9o.r
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PERMIT
City of Eagan Permit Type:Building
Permit Number:EA116460
Date Issued:10/08/2013
Permit Category:ePermit
Site Address: 1713 Deerwood Dr
Lot:3 Block: 10 Addition: Cedar Grove 8th
PID:10-16707-10-030
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 .
Matt Pietruszewski
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 -
James S Lasser
1713 Deerwood Dr
Eagan MN 55122
Rybak Brothers Construction Llc
2206 East 117th Street
Burnsville MN 55337
(952) 405-8871
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
r_________________
I For Office Use . �
I �
. , 1 �a-`��a- �
� �lt� 0� ���aIl , Pe�m�t#: ,
, �u� i
� Permit Fee: �
� I
3830 Pilot Knob Road �
Eagan MN 55122 � Date Received: �
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
�-----------------I
2014 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: �a'�a'5��� Site Address: �7� � �•�2_!"����d ��
Tenant: Suite#:
Resident/Qwner Name: Phone:
` Address/City/Zip:
: Name: � `�� �1W'�LbG��= ]�ili«. License#: �.��0�-"°�I-
Contractor: Address: �.�5� � �' �'7`� 5T�w city: �� ��"'�-�
State: M� Zip: �°3�� Phone: �17���S—�l�9
`= Contact: �1��� �`e`'`'n�� Email: { fu�6�lri �� � � C�`(
Type Of WOI'k —New _Replacement _Repair _Rebuild _Modify Space _Work in R.O.W.
� o F �-.es r�+-r�- l�A,-a� -w�S�e.r �W J',�l r�a�`' 3f w+-1�e,fa�-
Description of work: � �'/ Y
RESIDENTIAL
jWater Heater
Water Softener
Lawn Irrigation�RPZ/_PVB)
Permit Type
Septic System Add Plumbing Fixtures�Main/_Lower Level)
New Water Turnaround
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge)
$60.00 Lawn Irrigation (includes$5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic SVStem Abandonment, Water Turnaround'`(includes$5.00 State Surcharge)
`Water Turnaround (add$200.00 if a 5/8"meter is required)
$115.00 Septic System New($10.00 per as built) (includes County fee and$5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for pro#ection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.org
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 wiil be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
� x ��`��� C���j X �t� l `�
Applicant's Printed Name ApplicanYs Signature
FOR OFFICE USE Reviewed By: Date:
Required lnspections:' Under Ground Rough-ln Air Test Gas Test Final
Meter Related Items: ` Meter Size Radio Read Manometer Staff:
PERMIT
Clty Of Eagall Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA131762
Eagan,MN 55122 � ' Date Issued: 07/07/2015
(651)675-5675
www.ci.eagan.mn.us l ': � , LL ��
Site Address: 1713 Deerwood Dr
Lot: 3 Block: 10 Addition: Cedar Grove 8th
PID: 10-16707-10-030
Use:
Description:
Sub Type: Single Fam Construction Type:
Work Type: Day Care Inspection
Description:
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: Latisha Porter 612-239-1189
Fee Summary' Day Care Inspection $50.00 1221.4216
TotaL• $50.00
Contractor: �WriCI': - Applicant -
JONAH PORTER
1713 Deerwood Dr
Eagan MN 55122
I hereby aclrnowledge 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