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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 . ,. .. ? .1 ?J C? ' _- .. _ ... -. , . 7? ? v , v3 _ - -- -- .- . .'_- • _ .. ?. . ?.?.. . ? _.. . ., ..• .......... . .. ..? .. . . ~ .? , . A . aw.?. -.u.._. _.... _ . ? Ti j y /.;, + . i 4 W? a zlN e. ` -- ? $ ? ' '? _ --- ? - ..___.. . 5 --- _ ? • ; ? _ ?- _- < ? ? ?--?g?-?i ? Nr, ; ! ' ? 1 ; ... i E;n?aJ? . ? . ? ? ? • ? 6 i ? ( ? , - q,?b•??'?a ?? ------- ? T4 - B ? Nj ? ' ? i `I.21 CAN't" j e'1 "". • ? - . _ I?to V? Q w ! r° . 4 1108 ? , , ? ... ,. ..... ..... .... ... ..:...,_ ? ? .?. ,.. ...-... ,.?..... .....,..1 . ,... . . ... .... . ....- ftn.`I ?+ , . ; ? . . ..? .? . -To u ? • 7n L,e? ?07e?. W ? Q 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 'Nor ;F G.0( 6 V 7,6~? MMIW. 9 ro a EA , N R I- VAIE sy. 3 s ~ L®1NG lip#'PECT[O NS D1vIlON %Nil f ? VA 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