2268 Clark St
3795
BUILDING PERMIT
To be used for
Site Address ?18TK ?DC.
Lot ? Block c' Sec/Sub.?
o,..,.,. ? ?.
i
ITY OF EAGAN
:nob Rood Eogon, MN 55122 N2 4203
PHONE: 454-8100
Receipt #
? J ..•,
Date '' { , 19 ?
Erect ? Occupancy
ii i1 I S 9 th Alter ? Zoning
Repair ?
? Fire Zone
Enlarge E] Type of Consf.
Move ? ,# Stories
Demolish ? Front ft.
259 Grade p Depth ft.
Approvais Fees
;':•?• Assessment Permit t ---
? 2 2 2 c Woter & Sew. Surchorge ? •
Police Plon check
Fi re SAC
Eng. Water Conn. _
Planner Water Meter
Council
tion and staYe thot gldg. Off.
vith oll applicakile
` APC
Total
)rdinances., r
y :
of
ac Nome
3 Address_ ,ri< ??t?
o n
Cit Phone -
? c)L . .. . F•.
p Name
ZpV -Xi?OT?:•. _ !: ,
UQ Address -
iuoc:iinrtton 01-
I hereby ocknowledge that I have reod this
the information is correct and agree to c
State of Minnesota Statutes .ond Gity rof I
Signature of Permittee
A Building Permit is issued to:
all work sholl be done in occoidonce with ?
Building Officiat ' ' " -!
on the express condition thaY
Stotutes ond City of Eacan Ordinances.
PMek # Gah Isnd POwk?
Plumbing
Mechanicai
INSPECTIONS DATE INSp.
Rouph-In
Flnd
Footings Dote Inap. Date Imp•
Fourdation Plumbing
Frame/lns. Mechanical
Final
Remarks:
PERMIT #
? PLUM8ING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNaB ROAD, EAGAN, MN 55122 DATE: _
PHONE: 454-8100
Site Address
SeciSub
Phone
? Name s
3 Address ?
p City Phone
FEES
COMM/INO FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWIVHaU£E $, COM1}DO - RES: ftA,'?'E ,APPUES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $2a.00
S'fATE SURCFtARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
OF EAGAN '
BLDG. TYPE
Res.
Mult.
Comm.
V
7
New
Add-on
Repair
:TE THE FOLLOWING:
TOTAL /
er Closet - $3.
Bath ubs - $3.00
Lavato - $3.0o
Shower - 3.00
Kitchen Sin $3.1
Urinal/Bidet - (
Laundry Tray - $3
Whiripool - $3.00 \ _
Gas Piping Outlets - .50 _
(MINIMUM - 1 PERMIT)
Softener - $5.00
Well - $10.00
Private Dis - $10.00 -
Rough O enings - $1.50 -
FEE: ?
STATE S/C: '
GRAND TOTAL• -
--
;:?-- - - - --
Y
CITY OF EAGAN Remarks
Addition River Nills Qth Lot 6 Blk 5 Parcel 4e' 64400 060 05
OwnerzaO?i • Street 2268 rlai'k St5tate Eaqan,MN 55122
/
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK .a ' 973 148.72 9.91 15 Paid
* SEWER LATEFiAL - 976 2101.66 700.55 Pdl
WATERMAIN
* WATER LATERAL 976 3
WATER AREA
STORM SEW TRK
* STORM SEW LAT 976 3
CURB & GUTTER
SIDEWALK
STREET LIGHT 1980 67.80 13.56 5
Additional sewer tr. Br svlle 180.00
WATER CONN. 205.00 2544 3-24-76
BUILDING PER. # - 386
SAC
PARK
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55722
651-681-4675
Naw Construttlon Reauirements A
• 3 registered site surveys showing sq. ft of l06 sq. @. of house; and all roofed areas •
(20% maximum lot coverage allowed) .
• 2 copies of plan showinp 6eam & window skes; pou2d found desgn, etc.) .
. 1 set ol Energy Calculations •
• 3 capies of Tree Preservation Plan i( lot platted after 7/1193
. Rim Joist Detail OpUons selection sheet (bldgs with 3 nr less units)
DATE IDCK tg. 2-061 ?
JOB SITE ADDRESS_ 2z643 et4tK_ ST
IF MULTI•FAMILY BUILDI
PROPERTY
HOW MANY UNITS?
$ I13,75
TYPE OF REPLACE(S) _ 091 _. 2
APPUCA PHONE# 65`?? '02'71`/9
ADDRESS 2-267 '24-4-RK je', ZIPCODE SS/ZL
PAGER # CELL PHONE # FAX #
NEN' RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULF.S 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
- New Energy Code Worksheet Suhmitted
Plumbing Contractor: _
Plum6ing System Includes:
Mechanical Contractor:
Mechanical5ystem Includes:
Sewer/Water ContracSor.
All above information must be submitted prior to processing of application.
Phone #
v(
I hereby acknowledge that I have read this application, state that the inform ion i orrect, and agree to comply
with aN applicable Stote of Minnesota Statutes and City ot Eogan Or ' n s. n
Slgnature of Applicant
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
' Updated 1/01
2 copies af plan
1 set of Enefgy CalcWations for heated additians
1 site survey for exterior additbm & decks
Indicate if home served by septic system far add'Aare
Phone
Lawn Sprinkler
No. of R.I. Baths
Phone #
Fee: $90.00
_ Water Softener
_ Water Heater
_ No. of Saths
Air Condiliorung Feco
_ Heat Recovery System n ? ? ?
iui
\ ?Y,)
OFFICE USE ONLY
? 01 Foundation 13 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex 13?17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex p 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bidg. ? 42 Oemolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof O 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bidg only) - Give PCA handout to applicant
Valuation 3+12OU Occupancy U-r MC/ESSystem
Census Code 3ag Zoning _9-1 _ City Water
SAC Units 01 Stories f Booster Pump
Nbr. of Units C'J Sq. Ft. PRV
Nbr. of Bldgs I Length 1,1. Fire Sprinklered
Type of Const 7112,r1/ Width 10.
REQUIRED INSPECTIONS
_ Foatings (new bldg)
Footings (deck) FinaUNo C.O.
X Footings (addition) Plumbing
? Foundarion
_ Drain Tile
Roof _? Ice & Water k Final _ Other
? Fr?B _ Pool _ Ftgs _ Au/Gas Tests _ Final
_ Fireplace _ R.I. _ Air Test _ Final _ Siding SNcco Stone
_ Insulation _ Windows (new/replacement)
Approved By
Building Inspector
Base Fee
Surcharge
Plan Review
MClES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
FinaUC.O.
?
HVAC
/6 =
26'-1 ? ?
. C//
CITY of EACAN
BLJILDING PERMIT
Ownex --........ pe X.,....... ??.?,?? .............
Addreas (Presan!) ..:Y.R.CK............ ki .....j?.?.x..!?? ...:.....?....1fd,!V1
Svilder ----------- ---'-.........s?!..R-?Y/..f.° ...................................................
Addrass ..............................................................................................
DESCRIPTION
m ;.
N2 3860
3795 PiloY Knab Road
Eagan, Minnesofa 55122
454•B100
na:. ..av .....
$loriea To Be Used For Fronf Deplh Heigh! Est. Cot1 P mi! F Aemazks
1.??? ? ?tr c?ar. 4e ?J6 ?y?so xo c
Tbis petmit does nat aulhorize the use af slreefs, roads, alleys or sidewalks nor does it give the owaer or Lis agea!
the right !o creale any siivation which is a nuisance or which presenls a hasard !o the heaith, safefp, coaveaienee aad
general welfare !o aepone in the eommunifp.
THIS PERMIT MUST BEy1_ I?1.7.EPT ON THE PREMISE WHILE THE WORK IS IN PROGAESS. /
This is !o ceslifP. !hal.L-dsD/Q ----------- Z2P.F/ ............ has pezmission Yo erect a........,Qt?l.t,?l d/.L /.y......................... _upen
3he above descri6ed premise subjecY !o the provisions of all applicable Ordin s for ihe Cily of Ea azi.
.
......... .... ..' '
........
y?...?.?.... .. ?-.---. ./!.:??------°----- ---......-'------- . Per ..C----?FZ?pd^ZL---- ?f?.-°-°.°--.-...-
Ma or Suilding Inapeclos
4 -S je,??Y
.
C1TY OF E?1G:iN
??^5 P.i7.ot lnob Foad
" Eaz=,.n, ?iinnrsota 5J122
PE£MST NO.: 814
Tiie City oi Eagan herzby gr&nts to ^Ray N. Welter Aeating 00
op 4637 Chicago Ane. So.
?, }IEATING
Permit for: (Dwmer) Windsor Dev• 6orP•
a'; 2268 Clark St. pursuant to appiication da-ced 4/8/76 '
F'--e ;_; ic,e $20.00 &,ted this 14th aay of AF'ril „_.. 'I 9 76 ?
.50 s?
Tui-ding Inspector
S•Zecb.?rica7_ Perrits:
t,id Tot, L ?
czLr cr, Far;!,ni /4 loi??Do 6/?o Qj'
,
3?,, ?:,- Pi J ot; ?'n::b Hr . ad
?
Y•^'R,:Lm 663
T'.,e Cit;y of ia.gan hereLy gre.its to _Thompeon Plwnbing Oo.
12201 Minnetonka Blvd., Minnetonka
a PL[7[ID G it for: (Owner)-- Windsor Dev. Corp.----------
Clark St. &
a-t 8 MedazAve. pin•suant to ap»lication dated 3/24/76 ,
Silled:
Fee kax$: $40.00 duted 1;his 26 dr,y oi March , 19 76 ?
1.00 e/c Statement #692 ?
Luilc;ir.g T_nspe^toi
PQsclza?!i.caJ_ Per?,ii;s:
Bic `t'oial s
jG (? ??/dCJ aoe)
CITY Ob' EAG2.1
3795 Pilut Iinob Road
Eagi=, NI_r.nesota 55122
PEFi'?i'ST NO.: 56
The City o£ Eagan hereby grants to Carey Water Cbnd. Oo.
of 8800 Loqan Ave. So.
a Water Softener Pe:7it fore (Owner) F. Baker _
at 2268 C1grk St. , pursuant to application dated 7/26/76
Fee Paid: S5.00 dated this 28 day of sulv
.50 s/c
Building Inapectov
Meehanical Permits:
Bid Total:
cirr oF Eaca,w
3795 PiIM Knob Raad Eagan, MN 55122 N2 4203
PHONE: 4548700
BUILDING PERMIT APPLICATION Receipt
To be used for BASEMENT ALTERATION $4,000. Date Jan. 3 1 y 77
Site Address 2268 CLark St, Erect ? Occupancy
Lot 6 81ock 5 Sec/Sub.R3V2I' H3115 9th Alter gl] Zoning
Parcel # Repair ? Fire Zone _
l
E T
f C
t
V
n
orge ? ons
ype o
.
w Name Floyd Baker Move ? # Stories
z
Address 2268 Clark St.
Demolish ?
Front fi.
0 r.,, R.onn o",..,a 90- 259 Grode ? Depth k.
? Nome _
?
Address
Name _
Address
I hereby acknowledge that I have read this applicotion ond stote
the information is correct and a9ree to comply wi h all applic
Stote of Minnesota Statutes? nd C dinances,
_Building Offiaat?i?? ,; -/ • Assessment _
$ignoture of Permittee
A Building Permit is issued t
all work shal e done in occ donce I applicoble State o4
Water & Sew.
Police -
Fire
Eng.
Planner _
Council _
Bldg. Off. _
APC
Fees
Permit 17.UV _
Surcharge 2.00
Plon che[k
SAC
Water Conn.
Woter Meter
Totol ? -/ -
on the express condition ihat
Stotutes and City of Eagan Ordincnces.
PILLRAE.OF EAOAN WATER SERVICE PERMIT
3795 Pilot Knob Road PEAMIT NO.: 1935
Ea9an,MN 55114 DATE: 3/26/76
Zoning: RIZ . No. of Units: 1
Owner: WiI1da0Y DlV. CDIP.
Addrese:
Site Address: 2268 Clark St. B5 1tFi 9
Plum6eZ71o mP80n Plumbin CO.
Meter N n 205.00 ?
Connection Charge.
Size: `S?? . Account Deposit:
-
Readir, No.: m'7
10.00l1ed
f64T
Permit Fee:
1 °? . to comply wkh
? tM Village of Eayan Surchazge: . 0 billed
?2544-
O.d'
"s. Miec. Charge?
( Total:
By Date Paid:
Date of Insp.: Insp.:
YILtAG8 OF EA6AM SEWER SERVICE PERMIT
3795 Pilot Knob Road PERMIT NO.: 2692
Ea9on, MN 55142 DATE: 3 26/%6--
Zoning: .R.1I No. of llni[s:
Owner: WindSOY Dev. Corp.
Address:
Site Address: 2268 Clark St. L6 85 RH 9
Plumber: ThampBOn Plumbing co.
--inT? l? -a-scx?
I ogrse ro wmply wifh tha Village of Eogan Connection Char?e 0.00 ? 2544
Ordinoncas. Accoun[ DeposiL:?D__biil?d_#692
Permi[ Fee: l
Surcharge: -??-bille8 ?69Z
BY: Misc. Charges:
Date of Insp.: Total:
Insp.: Date Paid:
?
DEVELOPMEN7 CORPORATION
March 18, 1976
Mr. Dale Peterson
City of Eagan
3795 Pilot Knob Road
Eagan, MN 55122
Dear Mr. Peterson:
.7
? -y?" i!0
I
R
h 4q
I ? r916
Enclosed please find a check in the amount of $1,030.50 for
permit and hook up fees on:
Lot 6, Block 5, River Hi11s 9th
2268 Clark St, Eagan
We will build a Mode1 75-11 Elevation D which wi11 include
the following:
Patio door dinette - no deck
.Appliances
Rear walkout w/1Ox12 slab
vVet bar rough-in plumb.
A1location of funds per check stub.
Aroposed plot plan is also enclosed.
Thank yoU for your cooperation.
Sincerely,
WINDSOR DEVELOPMENT CORPORATION
t'L?
Warren R. Anderson
Vice President
WRA/ks
Enclosures
Double bowl marble vanity
Fireplace lower level
Ceiling vault LR w/false beams
SUI'i'E 192, 4660 WEST 77TH STREET, EDINA, MINNESOTA 55435 • PHUNE (612) $31-0717
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MASTER CARD
OWNE
STRUCTURE AND ?j
LAND USED AS
Permit
No.
Issued Issued To
ConTractor Owner
BUILDING
PLUMBING ??_Q_ ,??2•q?7
PSP l0 6H?,
CESSPOOL - SEPTIC TANK
WELL
ELECTRICAI
HEATWG
GAS INS7ALLING
SANITARY SEWER
OTHER
OTHER I
Items Approved
(Initial)
Date
Remarks
Distance From Well
FOOTING SEPTIC
FOUNDA710N CESSPOOL
FRAMING TILE FIELD FT.
FiNAI
ELECTRICAL
HEATING DEPTH
OF WELL
GAS INSTALLATION
i
SEPTIC TANK I
CESSPOOI I
DRAINFlELD I
PIUMBIN6 y
WELL
SANITARY SEWER
- ? A
. Violations Noted
on Back
COMMENTS:
Jeanette Morcomb
From: Russ Matthys
Sent: Wednesday, February 20, 2002 8:25 AM
To: Jeanette Morcomb
Subject: 2268 Clark Street
Please Iook in house/parcel file for any indications of previous flooding or other issues. Please call Kevin or Marge
McClurg at 882-0349 to let them know what you find, if anything. Thank you.
Russ
a-
.
?c'tl'?
? ?
. Use BLUE or BLACK Ink
r
For Office Use I
/
('IiIb~V O1 EaynPermit#:~ 06 C ~
1IllJJ,. I - ~v
J I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 app M Date Received: ,
Phone: (651) 675-5675
Fax: (651) 675-5694 I Staff:
C/
2012 RESIDENTIAL BUILDING PERMIT APPLICATION cp
Date: Site Address: Unit
Name: / Flf>~ ~C G ✓,~ls Phone: 6 s✓I'- ~ f?Y 09,S _A6
RESIDENT / Z 6
OWNER Address /City /Zip: ~
Applicant is: X Owner Contractor
TYPE OF WORK Description of work: 494??
Construction Cost: soe Multi-Family Building: (Yes / No X )
Company: Contact:
CONTRACTOR Address: City:
State: Zip: Phone:
License Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
- - - - - L
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. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call 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.gopherstateonecall.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 Minnesota State Building Code must be completed within 180
days of permit issuance.
x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
--:~41DO NOT WRITE BELOW THIS LINE ~ a 76
SUB TYPES
Foundation Fireplace Porch (3-Season) - Storm Damage
Single Family Garage Porch (4-Season) Exterior Alteration (Single Family)
Multi! Deck Porch (Screen/Gazebo/Pergola) Exterior Alteration (Multi)
01 of Plex Lower Level Pool Miscellaneous
Accessory Building
WORK TYPES
_ New Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof Demolish Interior
Alteration Fire Repair Windows Demolish Foundation
_ Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation `TdGG Occupancy -'l MCES System
Plan Review Code Edition SAC Units
(25%_ 100%_4Z Zoning Jj~t City Water
Census Code Lzl~t~ Stories Booster Pump
# of Units Square Feet 3Ci PRV
# of Buildings Length Fire Sprinklers
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final / C.O. Required
Footings (Addition) Final / No C.O. Required
Foundation HVAC _ Gas Service Test Gas Line Air Test
Drain Tile Other:
Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In -Air Test -Final Windows
Insulation Retaining Wall: _ Footings _ Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: , Building Inspector
RESIDENTIAL FEESQ
Base Fee /03
Surcharge
Plan Review ee' 7
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies G
TOTAL
Page 2 of 3
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s ~ L®1NG lip#'PECT[O
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24 -
A Vi .1114-1
,A
i
411°
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit #:�
Permit Fee: /V"
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: --M7) 24, 20 /.6 Site Address: 2 2-6g ef44-12 tt 5 l . 4/1d4e.Unit #:
;..., ®411#1
011ynet*
Name: /1 ie -Ili -) .4 i P ( i (..)6 ,— Phone:
/ /'
Address / City / Zip: 2 2---,‘ Zs e44 -A k ..5-7-. 6/ -6/�i'l d , .,—.5---/z. 2
Applicant is: X Owner Contractor
ork.
Description of work: 5-09/406-:-
Construction Cost: / 61,00 , Multi -Family Building: (Yes I No Y )
Company: Contact:
Address: City:
State: Zip: Phone: Email:
License #: Lead Certificate #:
If the project is exempt
from lead certification, please explain why:
In the last 12 months,
Yes No
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
If yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Fire Suppression Contractor:
Phone:
Phone:
Phone:
Phone:
NOTE P! ' ` d sup - o cium nts y submit are const ##
o e a � � u nforri'atioof
the info 'inn ma ®; iassifi no Y b 3 if you rovide specific t the City t
that ,tre trarkeePrets.
CALL BEFORE YOU DIG. Call 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.gopherstateonecall.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 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 Minnesota State Building Code must be completed within 180
days of permit issuance.
Applicant's Printed Name
App icant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA178093
Date Issued:08/01/2022
Permit Category:ePermit
Site Address: 2268 Clark St
Lot:6 Block: 5 Addition: River Hills 9th
PID:10-64400-05-060
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.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
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 -
Thuy-linh N Vuong
2268 Clark St
Eagan MN 55122
The Roof Guys
7630 145th Street, Suite 110
Apple Valley MN 55124
(952) 997-4777
Applicant/Permitee: Signature Issued By: Signature