1361 Easter LaneCITY OF EAGAN Remarks
Addition) Wilderness Run 5th Addition Lot 2 RIk 4 Parcel 10 84354 020 04
Owner B K k Street 1361 Easter Lane State Eagan, MN 55123
DaW
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNKS 1973 $132.60 $6.63 20 PAID
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA Pai with t connection 12/71 4
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. $560.00 12449 12-19-74
BUILDING PER.
SAC $800.00 12449 12-19-74
CITY OF EAGAN
3? Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
1 .1 A,+ s i s 1 !t ff i
i> i t iii is t.E. . JAIN 9111~1
PERMIT SUBTYPE:
TYPE OF WORK:
kt ; 1 ...
lit) II_DtN11i
A, / I Oa
INSPECTION TYPE DATE INSPTIR. INSPECTION TYPE DATE 1NSPTR-
I H AkV'i. IN4 1 11011 ; 1161 tA111t-R 11,11
L
---------------------------------------------------
PERMIT TYPE:
Permit Number:
Date Issued:
K 1.00 t.: , APPLICANT:
i??f ) ?I'.i 14ii49
Permit Holder Date Telephone #
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
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
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
?ITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS: 1411 111 1?1 APPLICANT:
IANI ? i
l 1 ? ?i!, i i 4f 1 4.
IJ11 U! 1'14t Is ON `. III
PERMIT SUBTYPE:
TYPE OF WORK:
,., 1; ,
14111 t 0 I N41
0'3261 cA
a7 /21 /4R
F
I
mANKS; 9MITHQ, W.IN0014S, SOFFIT 17111~ 'To `AORM nANAOF _ 1I,jf . 1NcI t10FS I q63 IF AS IVK I N
Permit Holder Date Telephone #
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
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
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL.
BUILDING PERMIT
To be used for
Receipt #
Est. Value Date ,19
Site Address
Lot Block Sec/Sub.
Parcel No.
me I W Name _
3 Address
o City-
Phone "
c Name
0 Address
IE City Phone
city
acknowledge that I have read this application and state
{ -
OFFICE USE ONLY
On Site Sewage _ Occupancy
MWCC System Zoning
On Site Well - Type of Const
City Water (Actual)
(Allowable)
# of Stories
Length
Depth
S.F. Total
Footprint S.F.
APPROVALS
Assessments
Water/Sewer
Police
Fire
Engr.
Planner
Council
Bldg. Off.
APC
Variance
TOTAL
A Building Permit is issued to: on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Official
CITY OF EAGAN r
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
FEES
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Permit No. Permit Holder Date Telephone Jt
Plumbing
H.V.A.C.
Electric
Softener
Inspection Date Insp. Comments
FootingsI
Footings II
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg.
Final Plbg.
Bldg. Final
Cert Occ.
Ozop .o -
M
We
l 0 1IA/??.3s? o3c o?P
^1 1 l2,.
Ci'[t of ;ae:;ar
3795 Piz of 1,nob P._,ad
Irg& :Minnesota. 55122
FEDJvJT N0, 541
The City of Eagan hereby Frants to Thomson Plumbing Co.
of 12201 Minnetonka Blvd.
a PLUMBING 11
ermit for: (C;,mer) MARELL CONSTRUCTION _
1365 E. Sigfrid, 1395-57 E. Sigfridt St., 1361-63 ^anter lane and
at 1382-84 E. Balsam , pursuant to application dated _ 12/19/74
Billed
Fee $140_00 dated this 19th day of December 19 74
3.50 s/c
Building inspector
Mechanical Permits:
Bil Total:
CIZi OF EACAN
3795 Pilot ht;ob Road
2 Eagan, Minnesota 55122
PERMIT NO.: r.7n
The City of Eagan hereby grants to Ray y t7 1 er Heating r A/r M.
of A6;7 rhi aao Avenue So
a C Permit for: (Owner) MAIMtt ONST
1361 ?Faeter Lane anc:
at I pagt- na1 _gam pursuant to application dated _ 2/11 and 19/13/74
Fee Paid: snn_nn dated this IU day of ?roG- 19 ?a
2.^n sic
Building Inspector
Mechanical Permits:
Bid Total:
z
CITY 0: EAGAN
.1795 Pilot KLob Road
Eagan, Minnesota 55122
PEIUvaT NO.: a9n
The City of Eagan hereby grants to Ray N, llp3ter Fna fn2 & A/r ro.
of 46?gg Avenue So
a r m Permit for: (owner) I aRMT, CONS
36 63 Faster Lane and
a _tzs,?-_xa &.aat RatQam , pursuant to application dated 12/11 and 10/13/74
Fee Paid: san_nn dated this j2 _day of nec. 19 ?4
2.00 s/c
Building inspector
Mechanical Permits:
Bid Total:
VILLAGE OF EAGAN WATER SERVICE PERMIT
3795 pilot Knob Rood PERMIT NO.: 166
Eagan, MN 55122 DATE:
Zoning: PUD No. of Units
Owner: "arei i ran
Address /'C'at fh °2/ ?I a?? _. '
Site Address: 1.161 -611 T?.aSter Jane
Plumber: Th9?P1 n h'ng Co ion nn .,?;a
Meter No.: _ 38652 Connection Charge: 280.00 paid
Size: 3/4 Account Deposit:
607870
Reader No.: - Permit Fee: 10.00 billed
50
h
S billed
I agree to comply with the Village of Eagan pre:
urc
? qq,
?
C me e
Ordinances. Karg
Misc.
Total:
By Date Paid:
issued 1/22/75 Insp
:
Date of Ins p.: .
VILLAGE OF EAOAN
7795 Pilot Knob Road
Eagan, MN 55171
SEWER SERVICE PERMIT
PERMIT NO.: 2S2R 2423
DATE: 12/19/74
2
Zoning: Uln) No. of Units:
Owner: c.i?'?>> ronatruction CO.
Address:
Site Address: r Lane
Plumber: Thmm?ann Plumbing CO.
400.00 pd
400.00 pd
1 ogno to comply with the Village of Eagan Connection Charge:
Ordiiwnces. Account Deposit: 10 00 p e
Permit Fee: n0 bi e
Surcharge:
Hy: Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid: -
CITY OF EAGAN N! _ 13 6 01
- 3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, M N 55121
PHONE: 454-8 100 --) 3 ?f 1
BUILDING PERMIT Receipt
To be used for DECK Est. Value $1,970 Date ,19
Site Address 1361-1363 EASTER LANE OFFICE USE ONLY
Lot 2 Block 4 Sec/Sub. WILDERNESS RUN 5 On Site Sewage Occupancy
MWCC System _ Zoning
Parcel No. On Site Well Type of Const
City Water (Actuall
a: Name (Allowable)
IN # of Stories
3 Address Length
o City Phone 423-4800 Depth
S.F. Total
M
0 Name DAROLD BAILEY FootprintS.F.
ua Address P•0. BOX 35 APPROVALS FEES
City ODESSA Phone 273-2207 Assessments Permit $37.50
Water/Sewer Surcharge 1 Of)
ww Name Police Plan Review
iZ Address Fire SAC, City
o'o Engr SAC, MWCC
?W City Phone Planner Water Conn.
Council Water Meter
I hereby acknowledge that I have read this application and state Bldg. Off. Road Unit
that the information is correct and agree to co plywith all applicable APC Treatment Pl
State of Minnesota Statutes aatlCi y of line ?a. Variance Parks
Copies
Signature of Permittee TOTAL $3A-90
A Building Permit is issued to: DAROLD BAILRI'
on the express condition that
all work shall be done in accordance with all appli b1 State of M inn
lsotA a Statutea and City of Eagan Ordinances.
Building Official ?
/????
.. CITY of EAGAN
BUILDING PERMIT
..............................................................
Owner
DESCRIPTION
a,A _ V
N2 ._3500
3795 Pilot Knob Road
Eagan, Minnesota 55122
454-8100
Data ...?.? -?? - 7
Blorias To Be Used For Front Depth Heigh! Est. Cost Permit Foe Remarks
. _7(v y.3,?v
s? ,?? a r G
?
LOCATION /a X. -5-0
Street. Road or other Description of Location I Lot Block Addition or Tract
This permit does not authorize 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 certify, thaL.. .....Ll..? .........--.has permission to erect a..... -: :..•.._°....`.iz?. `....t on
the above described premise subject to the provisions of all applicable Ordinances for the City of Eagan.
................................................ .?.'?C.`..`----.. y.............------. Per ....-----'---....._ ............... ....................
Mayor Building Inspector
MASTER CARD
LOCATION GLlS reo;/ _ / 3(/ / -do --,? .25 ,'-I c) fe
OWNER Marre.?
STRUCTURE AND
LAND USED AS /1 .../J I.. ]C
Permit
No
Issued Issued To
Contractor Owner
BUILDING
PLUMBING
CESSPOOL - SEPTIC TANK 5771 1 .)y rhV y?r?IWO r?
WELL
ELECTRICAL
HEATING
GAS INSTALLING
-
74
d
A&Ir?
SANITARY VAVR
OTHER
OTHER
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING 0te SEPTIC
FOUNDATION CESSPOOL
FRAMING ?- y- ? TILE FIELD FT.
FINAL
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER
Violations Noted
on Back
COMMENTS:
/it 1987 BUILDING PERMIT APPLICATI N - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3
OF SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS - RESIDENTIAL RENTAL UNITS FOR SALE UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
To Be Used For: -? V
Site Address
Lot Block /
Parcel/Sub
Owner
Address I I
City/Zip Code Phone v { ?C?
Contractor
Address ' ( Qf go
City/Zip Code
Phone
Arch./Engr.
Address
City/Zip Code
Phone #
0 0
Valuation: Date:
A s
On Site Sewage_
MWCC System
On Site Well
City Water
APPROVALS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Council
Bldg Off
APC
Variance
5-r/-002
Occupancy
Zoning
Type of Const
(Actual)
(Allowable)
# of Stories
Length
Depth
S.F. Total
Footprint S.F.
FEES
Permit 3 7 '0-
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Road Unit
Treatment P1
Parks
Copies
TOTAL
-\
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE: BUILDING
Permit Number: 0 3 2 6 2 0
Date Issued: 07/21/98
SITE ADDRESS:
P.I.N.: 10-84354-020-04
1361 EASTER LANE
LOT: 2 BLOCK: 4
WILDERNESS RUN 5TH
DESCRIPTION:
SDG WNDW
BLill8i'hg Permit Type
Building Work Type
riCensus Code..
l
x
SOFFIT
STORM DAMAGE
REPAIR
434 ALT. RESIDENTIAL
REMARKS:
INCLUDES 1361 EASTER LN
FEE SUMMARY:
CONTRACTOR: - A p p l i
DAHL CONST, BOB
7473 DICKMAN TR E
INVER GROVE HTS MN 55076
(612) 451-1010
cant - ST. LIC OWNER:
14511010 0002798 DAKOTA COUNTY HRA
2496 145TH ST W
ROSEMOUNT MN 55068
(651)423-8106
'L-
I hereby acknowledge that I have read this
information is correct and agree to comply
Statutes and City of Eagan ordinances.
APPLICANT/PERMITEE SIGNATURE
application and state that the
with all applicable state of Mn.
ISSUED BY: SIGNATUFIB"
1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
RD -
3830 PII.OT KNOB B RD 55122
' 681-4675 z
New Construction Requirements Remodel/Repair Requirements v
`_t al- °i Y
? 3 registered site surveys
? 2 copies of plans (include beam & window saes; poured fnd. design; etc.)
? 1 energy calculations
? 3 copies of tree preservation plan it lot platted after 711193
required: _ Yes _ No
DATE: -7 R ?7
DESCRIPTION OF WORK:
2 copies of plan
2 site surveys (extenor additions & decks)
1 energy calculations for heated additions
CONSTRUCTION COST;
- WD(A.)S -
TOT ADDRESS: 130(- 13i?3 VAS*V, ( -A7NJ& '? 1 a--?
LOT: ?- BLOCK: '-4 SUBD./P.I.D. #: 1
UJ-j-aJ-A- ??-0 LX vl CL ?
6eV41 PRTU-Sai 9z3- ssto6
Name: ytlc om ?t IBC Phone #: DAVE- W&U Z - 1"23
PROPERTY Last First
OWNER _ I n , n ^? (_ , . I
Street
city 22-ZA1W-u0,jt-JV - State: (VtN Zip: S SO?o2?
Company: T,?A l}r-- c_?xtSr. _ Phone #: 45
CONTRACTOR
Street Address: JS uCkwtrArl lz r E-- License #
City -7r_ 61, 1? State: OA) Zip:
r
ARCHITECT/
ENGINEER
Company:
Street
City
Phone #:
Registration #: _
State: Zip:
Sewer & water licensed plumber (new construction only): Penalty applies when address char
and lot change is requested once permit is issued.
to comply with all applica
and agree
I hereby acknowledge that I have read this application and state that the informat
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant -
OFFICE USE ONLY
Certificates of Survey Received _ Yes No
SSO 7(o
Tree Preservation Plan Received - Yes - No .- Not Required
CITY OF EAGAN
CASHIER: S TERMINAL NO: 809
DATE. 07/21/98 TIME: 15:32:49
111,
NAME; DAHL. CONSTRUCTION
3210 9001 1361 EASTER LAN 74.75
2155 9001 1361 EASTER LAN 1..50
Total Receipt Amount: 76.25
CRO9r128
USER Ili: NANCY
PERMIT
MY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT TYPE: BUILDING
Permit Number: 032619
Date Issued: 07/21/98
SITE ADDRESS:
P.I.N.: 10-84354-020-04
1361 EASTER LANE
LOT: 2 BLOCK: 4
WILDERNESS RUN 5TH
DESCRIPTION:
REROOF
3
eLtildirPg Permit Type
,$uilding ULork Type
-`Census Code
r
s E.
REMARKS:
THIS INCLUDES 1363 EASTER LN.
FEE SUMMARY:
VALUATION
Base Fee $74.75
Surcharge $1.50
Total Fee $76.25
CONTRACTOR: -
DAHL CONST, BOB
,073 DICKMAN TR
INVER GROVE HTS MN
('612) 451-1010
SF (MISC.)
REPAIR
434 ALT. RESIDENTIAL
$3,000
Applicant - ST. LIC OWNER:
14511010 0002798 DAKOTA COUNTY HRA
E 2496 145TH ST W
55076 ROSEMOUNT MN 55068
(651)423-8106
I hereby acknowledge that I have read this application and state that the
information is correct and'agree to comply with all applicable &tate of Mn.
Statutes and City of Eagan,Ordinances.
APPLICANT/PERMITEE SIGNATURE
ISSUED BY: SIGNATURE
J
?? IoI 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF RAGAN a?
3830 PILOT KNOB RD - 55122 +
681-4675
New Construction Requirements RemodeVReoair Requirements - ?'
? 3 registered site surveys ? 2 copies of plan
• 2 copies of plans (include beam & window saes; poured Md. design; etc.) ? 2 site surveys (exterior additions & decks)
• 1 energy calculations ? 1 energy calculations for heated additions
• 3 copies of tree preservation plan if lot platted after 7/1193
required: _ Yes No
-
DATE:
7 ZO g `? CONSTRUCTION COST; V logo
~`
DESCRIPTION OF WORK:
$71TADDRESS: I3?I- (3i?? ?A L 46dZ,
LOT:
a BLOCK: SUBD./P.I.D.
Name: 4 Wom G. 406- Phone #: DAV4- W_aj.Q Z - l l $
PROPERTY Last First
OWNER
?
?(
Street Address:
1
'O ?1 -
City 21_0s&IM0JI-rr State: AkN Zip: S S??
Company: IDAyh- Cco Sr Phone #: 45 [ -(oi0,'1.I??? ?A I.
n 7 ?q b l? j
CONTRACTOR -1'
'(i
# L f f
i
?
Street Address: C (
f
tvtr1 cgr\I I
cense
r L
City 7C _ L 11 R State: jA4/0 Zip: S 7(0
ARCHITECT/
ENGINEER Company: Phone #:
Name: Registration #:
Street Address:
City State: Zip:
Sewer & water licensed plumber (new construction only):
and lot change is requested once permit is issued.
Penalty applies when address Chang
I hereby acknowledge that I have read this application and state that the infortnatio i correct and agree to comply with all applicabl
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 - Not Required
ram fynjxie Av muc ;oath
Blcoxin?,t:m., "inr.P3ota 51-7.52
DELMAR H. SCHWANZ
LANOSURVEVOR
Reg lstered Under Laws of The State of M in nesota
10014 MAIN STREET P.O. BOX M • ROSEMOUNT, MINNESOTA 55088
4?[
D
a1
a
z
X
l`
O
J
• SURVEYOR'S CERTIFICATE
/75. OO
n
t
1..ert. , 17
C5S 0-
PHONE 812 423-1789
1~
N?
ot, to
d
?
pry ? ?,?>
I7q 0457
SC4-LE' 1"=yo'
for ?
/ /t0
' A/.?
?\ S ,t
I hefreby certify thAt this is s true and correct ropmomtation
of a survey of Lot 2, Block 4, '9IIDE1?Id1 S RUN FIFTH ADDTTZL`2i,
Dakota County, Vinnesota.
Also shoning the location of a proposed building thereon.
4-23-74
w/? s6 0
rr
V
?',
MINNESOTA ftE01STRATION NO. 9625
07/03/2014 00:05 r633237464 MERIT BLDG CO PaGE 01/10
(� lec��- c.c,�.�1
�Q...C�4�- �C� "���3 a�-,��"`���w
� Use BLUE or BLACK Ink
� Forofficeusa w�^^^^__�
I
• � � (� � � ��7C 1 I
C��� �� 1J��LL� 1 Permitdk
�
�j �
� Permlt Fee= '�S �
3830 Pilot Knob Road � • ?J ( �
Eagan MN 55122 I Date Recefved: �
Phone:(851)675-5675 j I
Fax:(651)675-5694 I Staff: �
L----___._..._---------�
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
� Date. 7 f 3�2 Q�� Site Addresa: � �J�� " � 3 �3 ,d a'J•�r'e.�" �O�.i��. Unik#:
Name: I�� I� �4-O�. l��"V C �� Phone: �.OG ( `�O�rJ� t�.��"��
Address/Cily/Zip: I 2 2,� TC�W sr"1 l Aa f"�t,'C�Q. �,. vQ��F r a�C, m�r -
� �� � �3
Applicant is: Owner Contractor
Description ofwork,�' '�� � �
Construction Cost: � � • �m 4 � Multl-Famlly 6uilding:(Yes � 1 No )
Company: 1 I lEC�� �� ! 0�\,�Contact:
3a� r �.f /� '��� �.��� �
Address: 2 y���� 1�A �,.�1l�L��' �.�.��n
+ ��W� �1 L t
State:��Zip: 55�3� Phone: ��0�-.�..�' Email: .!�1�Cw(Y�" �L'"1�'` (�iL.c4! �tlti�, 4
Llce�se#: � � � Lead Certificate#: L 3 � i � �
If the project is exempt from lead ce�tification, please explain why: (see Page 3 for additional infarrnation) ���"�
COMPLETE THS AREA ON�.Y(P CONSTRUCTING A NEW BUILDMI�G
In the last 12 months,has ihe Clty of Eagan issued a permit for a slmilar plan based o�a master p1anZ
_Yes No If yes,date and address of maste�ptan:
I�icensad Plumber: Phone:
Mechanical Contractor: Phone:
Sewer 8 Water Co�traator: Phone:
: �
CALL BE�OR�YOU p�G• Call Goph�r State One Cdll dt(851}45A-OOD2 for protection against underground uNllty damage. Call 48 hours
before you irrtentl to dig to reCelve locates of underground utilities. www-gooherstateonecall.or9
I hereby acknowledge that this Iniormatfon Is comvlete and aoeura4a:that the worlc wlll be in co�fOrmanCe with the ondlnances and code5 of the Clty of
�agan; that I understand this is not a permit, but only an appllcation for a permit, and work Is not to start without e permit; that the work wd11 be in
acCOrdBnCe vhth the approved plan In the case of wOrk whlch requlres a review and approval Of p��nS-
Exterlor work authorized by a building pertnit issued in accordance wlth the Mlnne9ota Stdte Building Code must be completed withln 180
d�ys o1 pemllt Issuance.
X 1 � � �
Applican Printed Name Applicant's gnature '
Page 1 of 3