1833 Covington LaneCITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH ON E: 454-5100
???911
BUILDING PERMIT ReceiPt# ''? ? I
To be used for ?Est. Value >1 t -500
Lot Block •? 5ec/5ub." 1'•''" ? i•? ! `1'?'1
Parcel No.
m Name
W C(::tJ Y.M
3 Address ?
o r.itv A?.. ,. c?,,,.,o F:3C--`,9t;0
Rate
OFFI CE USE ONLY
On Site Sewage Occupancy
MWCC System Zoning
On Site Well (ACtual) Const
City Water (Ailowable)
PRV Required # of Stories
Booster Pump Length
Depth
S.F. Total
Footprint S.F.
? cIty rnone APPROVALS FEES
?4• `;
yVj W Name Engr./Assess. Permit
0
? Z
F Address Planner Su rcharge
: ? Council Plan Review
ac z
?W City Phone
Bldg. Off.
SAC, City
I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC
information is correct and agree to comply with all applicable State of Water Conn.
Minnesota Statutes and City of Eagan Ordinances. Water Meter
Signature of Permittee Road Unit
A Building Permit is issued to: Treatment P1
on the express condition that all work shall be done in accordance with all
?.
•J L
kt , ?
?
applicable State of Minnesota Statutes and City of Eagan Ordinances. r 5
TOTAL '
Building OffiCial
. Permit No. Permit Holder Date Telephone #
Plumbing ?- -
H.V.A.C.
Efectric
Softener
Inspection Date insp. Comments
Footings I
Footings II
Foundation
Framing ?-
Roofing
Rough Pibg. .
Rough Htg.
Isul.
Fireplace
Final Htg,
Final Plbg.
Bldg. Final
Cert. Occ.
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
• ? ' ,,
BUILDING PERMIT
Receipt #
12 7?-?
Te be used ior Est. Volue Dot e 19
Site Addreu E
rect 13; Occupancy
Lot Block Sec/Sub. Alter 0 Zoning - '
pnrcel # " Repoir ? Fire Zone
Enlarge p Type of Const.
ae
W Nome
-
Move
?
# Stories
3 Address Demolish Q Length J
U
CitV
Phenw 544-7.>;i:i
6rade
?
Depth Sq.
Ft.
? Nome _
0
?? Address
1- r:...
Name
Address
I hereby ocknowledge that I have reod this applicution and state that
the iniormarion is corred ond egree to tomply with all applicable
Stata of Minnesoto Stotutes ond City of Eagan Ordinances.
Siflnature of Pertnittea
A Bullding Permit is issued fo:
all work sholl be done in accordonce with nll applicable 5tate of Mln
Buildinp dtficiol
cIrir oF EAGaN
3795 NW Knob Road Eagae, MN 55112
PHONE: 454-8100
Assessmenf
Water 8 Sew.
Polite
Fire
Enp.
Pinnner
Council
Bldg. Off.
APC
U.S. Home
Permit
Surcharge
Plan check
SAC
Worer Conn.
Water Meter
Rood Unir - -
7otal
_ on the express conditlon that
City of Eoqon Ordinonces.
Permit No. Permit Holder Misc. Permit No. Holder
Plumbing ? i-7
H.V.A.C.
Water Well
Disp.
Sower
Electric WDl03q'It tIeC, -17'-&3
Inspection Date Insp. Other
FootinSp w.2 _
Foundation
Freming , f?j
Rouph Plhq.
Rough HVAC
Inwlation
Final Plbg. G,,J
Final HVAC L.ly
i
Final G •
Water Describe Location: '
?
YYall
Sewer -
Pr. D1sP.
' ? ?
' ?
PERMIT #
PIUMBING PERMIT
3830 PILOT CITY OF EAGAN RECEIPT #
KN08 ROAD, EAGAN, MN 55122 DATE: r? u
CONTRACT PRICE: PHOME: 454-9100
Site Address 11 BLDG. TYPE WORK DESCRIPTION
'
Lot Block Sec/Sub Res.
New
? • Mult. Add-on `
m Name Comm. Repair
m Address Other
c Ciry Phone RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
' NO. FIXTURES TOTAL
', ,
Name ?c
71
Water Closet - $100 S
3
Address f C
? Bath Tubs - $3.00
?Lavatory - $3.00
p Ciry Phone ?
r X. Shower - $3A0
Kitchen Sink - $3.00
FEES Urinal/Bidet - $3.00
COMM/IND FEE - 196 OF CONTRACT FEE Laundry Tray -$3.00
APT. BLDGS - COMM RATE APPLIES Floor Drains - $1.50
TOWNHOUSE 8 CONDO - RES. RATE APPLIES Water Heater -$1.50
MINIMUM - RESIDENTIAL FEE -$12 Q0, Whiripoal -$3.00
MINIMUM - COMM/IND FEE -$20. 00 Gas Piping Outlets -$1.50 #
STATE SURCHARGE PER PERMIT - . 50 (MINIMUM - 1 PER PERMIT)
(ADD $.50 S/C IF PERMIT PRICE GOES Softener -$5,00 ?i
BEYOND $1,000.00) .- Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
SIGNATURE OF PERMITTEE FEE: J
J ?
STATE S/C:
??
??
FOR: CITY OF EAGAN
.
GRAND TOTAL•
Receipt
MECHANICAL PERMIT
CITY OF EAGAN
FiII in numbered spaces
Type or Print legibly
Permit No. ?
Fee
S/C • %`? .
Tot.
1. Qate 2. Installation Cost
r
1.::: ??,?:?i??:-+?n ,.• ?
3. Job Address Lot ? Blk. Tract .
.:? .
4. Owner
5. Contractor , i 'Rhone 325-4x867
,
6, Address :.F;'r
7. City `'' • State -?• • Zip 55407
8. Building Type: Residential LN Commercial ? Institutional ?
9. Work Description: New 0 Add ? Alter ? Repair ?
10. Describe =10i?ed ai7 ;inf; Fuel Type r- =t E:13
I 11
No.
1 Eqipmeat BTU - M. Ea.
Forced Air 10Fs00L No. Epuipment CFM
Air Handli
:
Mfg. ng
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
1 Gas, Piping Outlets
12. 1 hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : l . . for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAIV 454-8100
Receipt PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fee
Fil1 in numbered spaces S/C
Type or Print /egib/y "
Tot. - -
1. Date -%''•'?? 2. Installation Cost
3. Job Address Lot -? Blk. 1.7 Tract 4. Owner L-?:RIN TNQiVSu:'; !a0? r5
5. Contractor ''SBZEL -MIECH. Phone
s. Address 3600 Kennebec Or
7. City EAgan State Mn
8. Building Type: Residential El
9. Work Description: New [3
I 10. Describe
1 11•
z;p 551,11
Commercial ? Institutional ?
Add O Alter 0 Repair O
No. Fixtures
Water Closet No. Fixtures
Cesspoal/Drainfield
? Bath tubs
Septic Tank
.i% Lavatory Softner
? Shower Well
/ Kitchen Sink
Urinal/Bidet Other
? Laundry Tray - -
! Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
oomply with all ordinances and codes governing this type of work.
i,
Signed : for
Rouyh Final
Inspections: Date Insp. Date Insp.
7his is your permit when numbered and approved.
Approved CITY OF EAGAN 454,8100
?
!3,,1
CITY OF EAGAN
Addition Ri dgecl i ff Fi rst Addn Lot 3 elk -12 Parcel #10 63980 030 12
owner Street 1833 Covington Lane snte Eagan., NW 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
SEWER LATERAL
WATERMAIN
WATERLATERAL 198 1260.79 5 126 ? 79 61 12- -81
WATER AREA _ j
STORM SEW TRK 1982 638.24 S 638.24 C007616 12-23-81
STORMSEW LAT 1982 955.45 5 955.45 C007616 12-23-81
Services 1982 637.75 5 637.75 C007616 12-23-81
CURB & GUTTER
SIDEWALK
STREET LIGHT
Ro nit 240.00 60 1- -8
WATER CONN. 420.00
BUILOING PER. 7762
SAC
PAR K
INSPECTIQN RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
I Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
I SITE ADDRESS: APPLICANT:
11V I I-it. 14114 1 Eo'l!
PERMIT SUBTYPE: TYPE OF WORK:
i
A?,??N i
1 M! li `+
?1IlMAl
t !; nth 1 IV+l
I ltfMAi:t-,. A':f PARr,it III i;Mi i J•. I(riiiili;j p I oil rtwIr s t it iF+li r4t R.I(IErt
I?
?
Pennit No. Permit Holde? Date Telephone #
S/1N
PLUMBING
HVAC
ELECTRIC
ELECTRIC
Inspsction Date Insp. Comments
Footings I
Foundation
Framing
Roofing T
.v
Rough Plbg.
S
Rough Htg.
Isuf.
Fireplace
Fnal Htg.
Drsat Test
Flnal Pibg. Pibg. Inspector- NotHy Piumher
Const. Meter
EngrJPlan
aidy. Finai
DeCk Ftg.
Deck Final
Well
Pr. Disp.
cinr oF Er?aAN WATER SERVICE PERMIT
3795 Pilot knob Rood PERMIT NO.:
Eagae, MN 55122 DATE:
Zoniny: No. of Units:
_
Owner:
Address:
Site Address: `
Plumber.
Meter No.: Connection ChorQe:
Size: Account Deposit:
Reader No.: Permit Fee:
1 agrae to eanply wkh tw Cky of Ea9es Surcharge:
Ordinaeees,
Misc. CF,orges: ,
Totol:
By Dote Pofd:
Date of Insp.: ?nsp,;
CITY OF EAGAN SEINER SERVICE PERMIT
3795 Pilof ICwob Road PERMIT NO.:
Eogon, MN 66122 DATE:
Zonirq: No. of Units:
Owner.
Address:
Site Address: - • •
Plumber:
, .., , .
1 oyme M oowplp wMh tUe Cihr of Eo9en Connection Chorge:
Ordieenoa. /lccour?t Deposit:
Permit Fce: -
Surdiorye:
BY Misc. Chorges;
Darte of Insp.: Total:
Insp.: Dote Poid:
This request void
18 months from
W063448
L3t .g 1.), (Zi I.£,ct i F? (4±
?qyq S
30 roa
request D?1
2
?3 F?re No. Rough-in Inspection
Re ired7
?
?Ready Now V:ill Noeify Inspac-
r Wh
R
es ? No en
eady
rucensed tiectncai Contractor I hereby request inspection of abave
? Owner electrical work installed at:
I Street Address, Box or Route No.
1$33 0\1iNI,T-(3I4 LdNt- Citv
E"N
ection o. Township Name or No. Range o. Cqunty
{1?.1? ...rd
v?vr-rr+ ?
Occupant (PRINTI
0R'1N t N?I"U 5`lJ? _ OQ\A.?? Phorie No,
Power Supplier
Fkb Address
1 „'R"i
Electr al Contractor ICompany Namel
'?'
?
?
d C ntractor's License No.
?
`
.r.-
C;?(Zi.c.
1.?
j '1 SZS = L
3
Mailing Address IContractor or Owner Making Instailation)
LJ +I E ' U'4 Ff ?-O-
Authorized Signature Contr tor Owner MakinB Installationl Phone Number
? ?}L?I • ?SS?S?
MINNESOTA S?TATE BOARD OF ELECTRICITY
Griggs-Midway Bldg. - Room N-191
1821 Univeraity Ave., St. Paul, MN 66104
Phone (612) 297-2111
THIS INSPECTION REQUEST WILI NOT
BE ACCEPTED 8Y THE STq1'E BOARD
UNLESS PROPER INSPECTION FEE IS
ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
, See irrotructione ior complating this torm on 6ack of yellow copy.
w 06?448
""X" Below ork Covered by This Request
EB-00001•04
-2 duu R'
IN" Add Rep. Type of Building Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lightin,y Fixtures
Apt. Buildlng Dryer Electric Heatin
Commercial Bldg. ftC Furnace Silo Unloader
Industrial Bldg. Air Conditioner Bulk Milk Tank
Farm OchPr peci y C+ther ISuec,fyi
t er ueci y Other Othcar
# Fee ServiceEntrenceSize # Fae Feeders /S ubteeders N Fee CircuitS
0. 0 to200qm s 0 to30Am s ??- Oto 30Am s
Above 200 Am ps 31 to 100 Amps 31 to 100 Am s
Swimming Pool qbpye 100_Am s Above t00_Am s
Transformers Irrigation Boorns Partial Other Fee
Signs Speciallnspection
1
$
Remarks 50
30, T AL FE
? o t0
Rough-in Date
I, the Electrical
InsOector, herehy
F?nal
/
Dat? certify thet the above
spection has been
RESIGEI?ITIAL
11
? BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
New Construction Reauiremanh
• 3 registe(ed site surveys showing sq. ft. oF bt, sq. fl. of house; and all rooted areas
(20%mazunum lol coverage allowed)
• 2 coDies of plan showirg 6eam 8 window saes; poured found design, etc.)
• 1 set ol Eneryy Calalaiions
• 3 copies of Tree Preservation Plan if lot platled after 7/7/93
. Rim Joist Defaa Optiore selection sheet (6Mgs with 3 or less unils)
DATE "6•CA •De;:A
SITE ADDRESS
TYPE OF
APPUCANT
_k3?
MULTI-FAMILY BIDG _Y _N
PIREPLACE(S) _ 0 _ 1 _ 2
STREET ADDRESS xr:nEwAL BvAxnLasEN, iric. STATE_ZIP
1920 courr'rY RoAn ^c° wx sT
TELEPHONE #?SI •?yy?-??- RoSEV)1,1.F, MN 55113 FAX #
PROPERTYOWNER ?N `e..v? \ v? V TELEPHONE#L95 I•I?JS?9 o?4S
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672
(4 submission rype) . Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: _
Plumbing system includes:
Mechanical Conhacior.
Mechanical system includes:
Sewer/Water Conhactor.
_ Water Softener _
_ Water Heater _
No. of Baths
Air Conditioning
Heat Recovery System
Phone #
Fee: $90.00
Fce: $70.00
I hereby acknowledge that I have reod this application, state that the i f rmatio ' correct, and agree to compiy
with all applicable State of Minnesota Statutes and City of Eagan Ord' ances.
Signature of Applfcant
OFFICE USE ONLY
Phone #
RemodaVReoair Reauirementa
• 2 copies of plan
. 1 set af Energy CalcWadore for heated additbns
• 1 sRe suney for exterior additons & decks
• Indiple H home served by septic system tor additiore
VALUATION
Lawn Sprinkle
No. of R.I. Ba?s?' ?
L
Phone!#'?
i
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4102
??.?..rv•.+. auu ac.oo rm ?oJ DIl'4460 ltCCltf?1lL4..Hp4CIUlut71SlV
re al
.? ?
7ima T, 2001
citY °f Ha$an
3836 PiIot Rnoli Road
BaBan, MN 55122
To Whom It May Concern;
Elder Jones is authorized to pttll bnMng permits for Rcnewal by Andeisan_ piease allow
F1der Jones to pmvido this sorvittcc for us in Hagan. 'Chis authorIjatian is valid for any
date bcyond 6/6101; wntil a??j by ??II mana?et, ex?Y
to theCity ?vokes it in wticing
-
IreNest this authorization be accTted expedidously, as to not delay in the proeossing of
out buildiaS Pcunits any furthcr. Plcasc caA mc lf Wcro acc any qucstlons., I can he
contactai at 763-502-4746_ , .
Your immpdiatc attmtion to this mattcr is apprectated.
Sincacaly>
ond R Rmi
nstallation Manager
Renowal by Andcrsen Corporation
('r.: Kara-F.Itle.r Jonev
412
QH D
?, ?wC?;AMAl..
, 'y'?eavo4[? ? ? .
WUU Z/ U
Received Time Jun. 1. k01Pld
-? CITY OVEAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(672) 681-4675
SITE ADDRESS:
P.I.N.: 10-63980-030-12
DESCRIPTION:
BUILDING
024531
09/19/94
?? ?ti`? ??j???? 'i..??? '•`"?T3? "? ? ?
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
1833 COVINGTON LANE
LOT: 3 BLOCK: 12
RIDGECLIFFE
(3-SEA5pN)
ilding?-.Permit Type 5F PORCH
ilda.ng Wo?rk,,7ype NEW
?
,...?
i
?..
V
I
REMARKS:
A SEPARA7E PERMIT SS REQUIRED FOF? ANY ELECTRICAL WORK
FEE SUMMARY:
VALUATSON $6,000
Base Fee $81.00
Surcharge $3.00
7ota1 Fee $84.00
CONTRACTOR: -
3AWMORSE CONST INC
4740 .1 42ND AVE N
ROBBINSDALE MN
(612) 533-6352
Applicant - ST. LSC. OWNER:
15330952 0002382 lEVI70N RON
1833 COVZNGTON LN
55422 EAGAN MN 55122
(612)681-9275
I hereby acknowledge thaC I have read this
information is correct and' agree to enmply
Statutes and City o-fi Eagan Ordinaffces.
?
1, ?A a"t?'
APPLICANT/PERMITEE SIGNATURE
application and state that ttre
w3tih a1i appla.cahle Stat2 of Mn,
?1o,.? R.Q11?? 1 m.?
ISS D BY: NA RE
-j
imi
CITY OF EAGAN
1994 BUILDING PERMIT APPLICATION
681-4675
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered ite surveys, cop of energy
calcs.
COMMERCIAL 2 sets of architectural & stru t,vr.41_"aj.5,_1 set of
specifications, 1 copy of ener .
Penalty applies: 1) when permit is typed, but not picked up by last working day of month
in which request is made, 2) address is changed or 3) lot change is requested once permit
is issued.
Date -7_ Valuation of wor 5_V0?
Site Address: 1$n
STREET eBll/N,6 7?N SUITE #
Tenant Name: (commercial only)
LOT SIACK SUBD. P.I.D. #
Descri tion of work:
The applicant is: ? Owner Contractor ? Other (Oescribe)
Name p- I sAovl L<?- I tz> Phone
Property LaST FIRST
Owner "
6
1
JC
O (
115
Address !P
53
4-
+
II
4L
STREET Cew?+6mN STE N
City a State Zip S512-2-
Company Phone
Contractor Address +1 d- b- 4Q-AOWs f-L• Li cense #'Z3 SL Exp.
City ae&d5Del;:_5. State lA,.A ZipS^!r 2Z
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plumber Processing time for
sewer & water permits is two days once area has been approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to com 1 with all applic b e State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
_ , ?- - -
? • • ? ??
FOR:
U. S. HOME CORPORATION
?
P?:*:>
?- /
i
Scale: 1"
p Denotes
Lot 3, Block 12,Ridgecliffe First
Addition, Dakota County, Minnesota.
WE MERE6Y CERTIfY THAT TF1iS IS A TRUE AND CORRECT REiRESENTATION Of A SURVEY Of TME
60UNDARIES Of TME tAND A60VE DESCRI6ED AND OF TME LOCATION OF Atl 6UIlDINGS, If •rtY,
TMEREON, AND All ViSIbLE ENCROACMMENTS. IF ANY, fROM OR ON _SAW IAND..
Detad rAi.?TN day oi JcnA.D. 1983 C. R. WINDEN ; ASSOCIATES, INC.
br
C. R. WINDEN b ASSOCIATES, INC.
IAND SURVEYORS Tot 646•3646
1781 EUSTIS SL, ST. VAUI, MINN. $5106
Survyror, Mienowlo RapiNrolien No. 772
(o
CITY OF EAGAN
3795 Pibf K"b Raod Eagan, MN SSl'12 N? 7762
?YHONEr 454•8100 BUILDING PERM17 Receipl # a???.
To be u"d h._ _SF DWG/GAR Esf. Volue $68,000 pate January 17 19 83
Sice nddress 1833 Covington Lane
Lor 3 Bi«k 12 Sec/S.h. Ridgecliffe lst
Parcel # 10 63980 030 12
rc Nome `iiwuy?uii i,anc? vlvtaluii
i 1712 Hopkins Crossroad
? r,? Mtka. 55343 pA
544-7333
A Nome
?? Addre:
1- r:...
Nome _
Address
I here6y ackrwwledge fhat I have read this ap0licotion ond stote thaf
the information is correct and ogree fo wmply with all applicoble
Stofe of Minnewta Statutez and Cify of Eogon Ordinances.
$iBnolure of Permittee
ltioMpSOTI a es Division
A Building Permil Is issued fo: 4
oll work sholl be done in acmrdance with all opplifpble Sto '
Buildin9 Officiol S?--J`?-? c-' +
Erect Occuponcy
Alter
? PD)
Zonirg ( R-1
Repair ? Fire 2one NA
Enlorge ? Type of Const. V
More ? # Stories
Demolish ? Length 51
Grade ? Depth 46.3 Sq. Pt.-
Approvals Faea
Assessment Permit 337.00
Water & Sew. Surcharge 34.50
Police Plan check 168.50
Fire SAC 525.00
Enp. Water Conn470 _ on
Pianner WaferMeter6 n.nn
Council Rood Unit 94n.nn
Bldg
Off.
.
APC Total 1785.00
if U.S. Home
on t he express condition Ihat
soto Sfatutes and City o4 Eapon Ordinances.
?.CITY OF E71GAN Include 2 sets of plans,
(
?? f.? L,?? 1 site plan w/elevations &
BIIILDIN(; PERNIIT APPLICATION 1 set of energy calculations.
a?. Dwc,_?-- - C3 -
1b Se Used For ?-?? Valuation Date l? 1Z- 8 T
Site Address: OFFICE USE ONLY
r,ot 3 Blocx _%y sec./si?b. l'? srect x occuP??
Parcel g' 0 G> 0 ( L Alter Zonin4
Repair Fire Zone
Raner: Enlarge _ 7ype of Const.
Nbve # Stories
Address Denalish Front s/ ft.
City/Zi Grade Depth y?,3 ft.
Phone #
Contrac
Address: a Division of U.S. Home Corp.
rTrT-ff op ins rossroa
C1ty/Z1FJ COdO: Mi nnetnnkn ? Mi nn- 55343
Ptione # • S " - 13 -S3
Arch. /EYig. :
Address:
City/Zip Cade:
Phone #:
APPE20VAIS F•II?'S
Assessments Pezmit _-? 3 7 'e"
Water/Sewer Surcharge 3 y A?
Police Plan Check ? (o $ ?
Fire SAC s?S =j
Ehq. Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off. ir.
APC
TOrAL ? ?'1 $?? ?0 6 ?
,
1833
? '' ?Q ??j?? C.R. WINDEN 3 ASSOCIATES, INC.
v?????? V IAND SURVEVORS Ttl 645•3646
FOR: 1381 EUSTIS SL, ST. PAUI, MINN. 55108
U. S. HOME CORPORATION
? I
lbu?
?
0
/\0
?f", 6^ \ IV 7G
GO? 21D ?°J ??? F Scale: 1" = 30'
",o "9,GO O Denotes Iron
-1/ G5`
oy?? yb \ r'??6`,<ij,
\ 9 O(?V???
\ V s SF
\ \
? ?6 \ ? L ? ? i ?.J \
o?
i
? o
Lot 3, Block 12,Ridgecliffe First
Addition, Dakota County, Minnesota.
?? p N aa
WE MERE6Y CERTIFY TNAT TMIS IS A 1RUE AND CORRECT REPRESENTATION OF A SURVEY Oi THE
60UNDARIES OF THE LAND A80VE DESCRIlED AND OF THE LOCATION Of All 6UflDINGS, IF ANY,
TMEREON, ANO ALl V15161E ENCROACMMENTS, IP ANY, F.ROM OR ON__SAID- lANO.
Dorad tAi+ 112V day oF J3auc(C C. R. WINOEN 8 ASSOCIATES, INC.
? A.D. IV83
by
Survoyor, Minnosoto Rooistralion No. 7726
, ?J,•? ??ERE
or
1988 L? ?.-,DaING PERMIT APPLICATION - CITY OF EAGAN
/EiALLOWED SINGLE FAMILY DWELLINGS
INCLUDE 2 SETS OF PLANS, 3 CERTIFICSURVEY, 1 SET OF ENEAGY CALCULATIONS
NOTEs ADDRESSES FOR CORNER LOTS RACTOR/HOMEOWNER MOST DESIGNATE WHICH ADDRESS
IS DESIRED. NO CHANGE3 WILL ONCE B[IILDING PERMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL
INCLUDE 2 SETS OF PLANS, CEA
1 SET OF ENERGY CALCULATIONS
CONB4ERCIAL
INCLUDE 2 SETS OF
1 SET OF SPECIFIC.
FOR SALE UNITS
' , •cG'o+ i
To Be Used For: &$ervejyf Vauation:?
Site Addre9s?2?1Gav:,?aA/ OFFIi
/SV6->
Lot 03 Block /.1-
Parcel/Sub /F; J. EC/r??E
1 /
Owner ?CQi?a
Address
City/Zip Code L l?'/?/?
Phone U?o ilk
Contractor C'.
?
Address SQ m C
City/Zip Code
Phone
Arch./Engr. _
Address
City/Zip Code
Phone It
Date:
OF SURVEY - CHECg WITH BLDG. DEPT.t
ECTURAL & STRUCTURAL PLANS,
AND 1 SET OF ENERGY CALCULATIONS
On site sewage_
MWCC system
On site well _
City water _
PRV required _
Booster Pump _
APPROVALS
Engr/Assess
Planner
Council
Bldg. Off.
Variance
P OF UNITS /
Occupancy
Zoning
Actual Const
Allowable
Ik of stories
Length
Depth
S.F. Total
Footprint S.F.
FEES
Permit
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn
Water Meter
Road Unit
Treatment P1
Parks
Copies
TOT9I.
3q, 00
/, p O
.56
.35, SO
.
- ?.
CITY OF EAGAI\ ? r-f ?J? 14 7 91
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
n PHONE:454-8100
BUILDING PERMIT Receipt#
To be used for BASEMENT Est. Value $1, 500 Date APRIL 6 ,19$$
Site Address 1833 OVIN TON i N
Lot3_glock 12 Sec/Sub.RTD FF 1ST
Parcel No.
a Name RONALD LEVITON
w
z nddress 1833 COVINGTON LN
0
City EAGAN phone 830-8900
OFFICE USE ONLY
On Site Sewage _ Occupancy
MWCC System _ Zoning
On Site Well _ (ACtual) Const
City Water _ (Alloweble)
PRV Required _ # of Stories
8ooster Pump _ Length
Depth
S.F. 7otal
Footprint S.F.
olName SAME
o Q Address
a City p
U y?
WW
?i
x?
a=
aw
Name
Address
City _
1 hereby acknowledge that I have read this application and state that the
information is correcl an agree to c mplyy' ith all applicable Siate of
Minnesota Statutes ar`?f ty ot E g? d4nces.=?
Signature of Permittee ?
A Builtling Permit is issued to: RONALD LEVITON
on the express condition that al I work shal I be done i n accordance with a I I
applicable State of Minnesota Statules and City of Eagan Ordinances.
??l(?-w_I
BuildingOfficial ' - I
APPROVALS
Engr./ASSess
Planner
Council
Bltlg. Oft.
Variance
„
FEES
Permit 34.OC
Surcharge 1.0
C
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
park-,Copies .50
rornL 35.50
,-4 U % ?l -?)
2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PIIOT KNOB RD - 55122
651-681-4875
0?
n 9 reglatered alfe wrvays stwwing tq. H. of lot, sq. n. of house ?'J'
and gQ roofetl areas [?nX mmdmum lot covemae allowed)
? 2 coplea of plana (ahow becm 8 wlndow sizes: poured fnd. dealgn; etc.)
> i set of energy calculaXons > 3 coples of 1ree preaervanon plan M lol plaHed atter 7/1 /93
DATE:
DESCRIPTION OF WORK:
STREET ADDRESS:
LOT: ? BLOCK: SUBD./P.I.D. #:
PROPER'[Y
OWNER
Name: L.? L)I0"? ?py ?Q?`y Phone Y: (e o?
Lpst Firbt
Sheet
Remotlel/Reoalt Reaulremenb ?
as?
AS _6 C)
2 copies of plan
t aer of erergy cacutanons ror neatea addinau
1 sfte wrvey for exfedor additlons & tlecks
CONSTRUCTION COST: -J -?w
C?vP
l ?I ?$i Z Z
Ciry L C - A) State: Zip:
Company: Phone#: /?--
(area code)
?/
CONTRACTOR ix44
Sheet Address: D/ Lgr ? 1¢u° s0 tlcense i a0223 iaz Exp. 0I
cBy state: zIp:
ARCHITECT/
ENGINEER Company: Name:
Telephone M: ( )
Sheet Address: Reglshaflon #:
City
State:
Sewer/water licensed plumber (if installina aewer/water): Phone #:
Zlp:
t hereby acknowledge lhat I have read lhis applicatbn, state fhat fhe infortnafion is correcf, an ?q ompiy wHh ail appAopble StatE
of Minneaota Stalutes and CHy of Eagan Ordinancea ?
$ignature of AppliconY.
OFFICE USE ONLY
Certificates of Survey Received Yes _ No MAY 1 5
Tree Preservation Plan ReCeived _ Yes _ No _ Not Required
To: r.oRNA oisaN, orzLZT^r Bzz.t,zNc =iu;
°?- DATX PLTERSON, Q3ILT' IIUILDIM, OFFICIAL
BILL BRANQi, SUPERINTIIVpINT OF PUBISC WORKS
FROM: THOPIA.S A. COLBERT, DIRECI'pR OF PUBLIC WORKS ?i
DATE: NOVFi'IDER 17, 1981
RE: RIIX'?CLZFFE 1ST ADDITION - SES?ER AND UTATER CONNECTIONS
--- On Septemher 10, 1981, a irnmo was distributed listing several lots in
the Ridqecliffe lst Addition which would not be issucd sewer and water
pernlits tmtil sanitary sewer service had been made availahle_ Because
it is not anticipated that gravity sanitary sewer will be available to
provide service to the affected lots until July/August of 1982, Orrin
Thonpson Homs has agreed to install a ter.+porary lift station from Man-
hole No. 37 to the 4" service line for Iat 8, Block 9, Ridaecliffe lst
Addition. Attachecl to this rpzro is a copy of the letter we received
frcm Orrin Thompson Homes whereby they indicate that they will perform
the installation, maintenance and liability of this terrporary lift sta-
tion/force main sanitary sewer until suchitime gravity sanitasy seiaer
can be extended across the future I-35E during the spring of 1982. There-
fore, with this tenporasy system being installed and maintained bv Orrin
Thorrpson Horres, the tPS+gxorary hold on sewer and water pesmits and occu-
pancy for the following lots has now been lifted:
Lots 1-9, Block 7.
Lots 1-6, Block 8
I.ots 1-7, Block 9
Iqts 18-23, Block 9
Iots 10-16; Block 10
Lots 1-10, Block 5
Lots 1-4, Bloclc 6
Lots 1-6, Block 12
Lots 1-17, Block 13
This tesrPorary sanitary force main will still not nrovide service to
the following lots:
Lot 1, Block 8
Lots 1 S 2, Block 9
Lots 18-23, BlocJc 9
Lots 11-17, Block 10
Therefore, the restrictions as referenced in my previous nnna will still
apply to these lots.
These lots are referenced on the attached m3p for your information. If
any probleris arise pertaining to sanitaiy sewer availability, back-ups,
etc., please refer those calls directly to Orrin Thcx*pson Ilomes for the
proper resolution. If youu have any c?uestions to this release of the re-
striction on the building and secver/water permits, please contact me.
Please insure that all personnel in your department are acaare of these
restrictions.
TAC/jacli
cc - Bcb Carlson, Orrin Thca;roson Hores
TO: LORNA OLSON, L7PILITY BILISNr, CL,EE2K
DALE PEPERSnN, CFIIEF BUIIDING OF'FICIAL
BILS, BRANQI, SUPERINTL?iDE1VT OI' PABLIC W0RK5
Ff20D'I: THOi"IM A. COI,BERT, DIREC"POR OF PUBLIC VORKS ayV
DATE: NO=ER 18, 1981
RE: RIDGECLIF'F'E 1SP ADDITION - SE[4ER AND WATER CONNECTION RES7RICTIONS
On Noverrber 17, 1981, a ireiro was foxwarded listing several lots within the
Ridgecliffe lst Addition that had restrictions placed on the issuance of
any sewer, water or occLipancy pennits due to the unavailability of sanitazy
sewer. There appeared to have been a duplication of lots that were refer-
enced for future restrictions as conq?ared to those whose restrictions had
been listed. Please be aware that the follcwing lots only will have re-
strictions placed on the issuance of sewer, water or occupancy permits:
Iot 1, Block 8
Lots 1& 2, Block 9
Lots 18-23, Block 9
Ipts 11-17, Block 10
Please insure that these referenced lots are not granted any perniits that
would allaa their occupancy or use of the sanitary sewer system.
Please insure that all personnel are made aware of this correction as statecl
in this irexrio.
TAC/jach
cc - Bob Carlson, Orrin Thcrrpson Horres
C3, F-, Ja1iZC(
RU: IfJFM OISQd, tTPII..PI"1 IIII=G CIE.'T2K
BUIIDLVG INSPFX.'PION DEPAR1-lEdT
BIIS, BRANQI, SUPERLYIENDENT OF PCBLIC [9pRK5
F%24: 1HCD%S A. COIBERP, DIRECIt7R OF PLBISC MRKS
DATE: SF.P'PII4SER 10. 1981
1M: RIDMECLIFFE 1ST ADDITIIN
Becatise the following list of lots in Ridgecliffe lst Additiai does
not have gravity sewer outlet at this time, the follaaing proc.e-
dures will be in.i.tiated tmtil further notice:
UfIISI1' BILLING
No water tum-ons will be allawed prior to 8-1-82 or tmtil scw-r
is available in these areas, '
BUZIDLNG L'VSPECPIC3I
Building pezmits can be issued for these lots, but the builder
should be inforned at time of pernit issuanoe (perhaps stanping
the 6uilding pernut with "NO OCCS.PAVCY PRIGR To 8-1-82 OP. UNTIL
S%'4ER IS AVAI7ABLE") the restricti.ons rn sewer availability.
b%LqrMqMCE DEPAR?.^QNT
See both utility billing and buildinc- inspecticn above.
The lots with these restrictions are as folla.JS:
Lc7I5 1-9, BI,OC3( 7
LC7I5 1-6, BIOQ!< 8
LOIS 1-7 BIL)GC 9
Lc7t5 18-23 BIOCiC 9
71ri5 10-16 BLCCK 10
IDCS 1-10 BLOCit 5
LC7i5 1-4 BI,OCK 6
7AI5 1-6 BIC)C!C 12
IDTS 1-17 BIDCK 13
and are also indicated m the attached r,iaps. .
jac
Ce
ertifYrate of Mrrupttnry
Citp of Cagan
Brpttrfmrttt nf +?uil,ding Ittaprdinn
Tbir CertitJ[!1[l 1SIkLlI punu4ru to the requirementt of Sntion 306 of the Unilorm Building
Code cMifying that at tbe trnne of isma+vcr tbit ttruuare war ix rompliance with tbc various
ordinaruet of tbe City ngulaiing buifding conssruction or usr. For the following:
uxc?r?em SF DWGIGAR Bmye,,,,,;?No. 7762
?w?rnw R3 'nwc-?? V F?. NA z??uu?.m« Rl
Thompson Lakes DivAaa.„ 1712 Hopkins Crsrd. , Mtka.
e???Ad4. 1833 Covington La. Lot 3 Block 12,Ridgecliffe
lst
ey:
Bw?,O? ? p,i„ Mav 6. 1983
n??.: <„ . _ ... _ ?__. _---. . . _ . 11r.-..,,.1 .1.
Thls repuest void ? ?8'?
18 months Ir om r
D 56195/.? ? ) ?D ,.1,, / e
THIS INSPECTION HEQUEST WILL NOT
BE ACCEPTED BY THE STATE 60AR0
LINLESS PROPER INSPECTION FEE IS
ENCLOSED.
Renuest Oate - ? "
Fire No. `.•"?` , 'c•- r
Fough-n Insuc.( n
1 ?•.
I
I I Re166111
e Z E]ROatly Now ? Will No?ity ?nsuec
?y ?N t Wh fl d
?Li.ensed Elecvical Cwttracmr
1
N10wner 1 hereby raqaest ins pection of above
elecHical work installed at:
SV?eiet Address, Box or Route No. City
ecLOn o. Township ame m N.. panp?e No. Coumy
O pant (PqiNT Phone No.
Po er Sunolier Addrass
Electrir.al Cnntrecmr (Company Nnmel Cnnhactoi's Llcense No.
Mailine AdJress (Commclor or Owner Making Insw llationl
0) lh /e;
Gi Gi ij
?. ized Si nature 1 o vactor/ wner Meking Installation) Phnne? Number
-iNNESOTA STqTE BOAND OF ELECTRICITY
Griggs•MiAway Bldg. - quom Nd91
1821 llniversihAve..51. Pnul. MN 65104
Phone (612) 642-0800
REQUES7 FOR ELECTRICAL INSPECTION
0 Sae inshuctions lor completing tpis torm on beck of yellow copy.
? 66195 "X" Below Work Covered by 7his Req(jest
HdJ FeP. TvPe of BuilEina APpliancea WireA
Home Ev
Ranye Te po
Duplex Water H
_ _ eater i ,
.ommercial Bldg. ! ' Furnace
ndustnal Bidg. Air Conditloner
Fee I ServiceEnuenceSize
vimmi
ansfo
gns
Fee
n to30
31 to 1C
Above t
I"
0
EY8-00'1
00-
?'
aiumen, Wired
y Service
q Fixtures
HeaLnq
loader
Ik Tank
Pecilv)
?P.P. Ci! IIiI4
C) to 30 Amus
31 to 100 ?AmUs
Above 100_Amp
Part ee
S?COt.7 V TA
r
'
tz
he Elecvic
raby
1e certify thnt ihe aba,a
inspaction has been
mede.
0 m037
0 ?'
7? D d?
Reque t patg
?
r/ Fire No. Roe h-In Ins ctio Re
quir Inspectlon O[har Than RougM1-In
/
/ (You m t ca . spector
w
reatly) ? Ready Now ?ylll Notify Inspector
?
? Dete Ready
I? licensed contractor .6pwner hereby request inspection of above electrical work at:
Job Atltlress (Sireel, Box or RNo.)
/9913 ?I'n '?vh L a,r) 4?__ Clty
Section No. Township Name or No. qan No.
9e
Counry
t (PRINI) / Phone No.
opla (d t,evi 70?
PowerSUpplier Atltlress
Elechicel Contmotor (Company Name) CoNraoror's License No.
ry"Ve.o w n ?
Meiling Atlare9s (ConVa0lor or OwnBr Making In6tellallon)
D? pr--
Au1M1 tl SignaNre o actoUO er Making nstallaibn)
w Phone Nomber
!
r
M NESOTA STATE B ApD OF EIECTRICITY
Griggs-Midway Bltlg. - Room S42B Th115 WSFEGTION REQUEST NJILL NOT
?
1821 University Ave., SL Paul, MN 55104 IIII IIIII (I IIIII I
IIIII ?I II III ?II I I II
BE ACCEPTED BV THE STATE BOAFD
Plmne (612) 642-090D . UNLESS PFOPER INSFEGTION FEE IS
vn rn?rn
3 ? REQUEST FOR ELECTFICAL INSPECTION 'ul-; , Ee-aoooi -o?s/
00. Sae Instmetiona for compleling Ihis lorm on back oi ysllow oopy. p a?? ? V
`Z ?e O
?"X" Selow Work Coveran hv rh;c a<.,??a?? vi.
Ne? Add Rep. Type of Building Appliances Wiretl Equipment Wired
Home ftange Temporary Service
Duplex Water Heater Electric Heating
ApL Building Dryer Load Management
Comm./Industrial Furnace Other (Specify)
Farm Air Conditioner .
Other (speclty) Conhaclor's qemarKS-
S
o
3
? 9 S ?
Compute Inspection Fee Below:
# Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200_Amps #boveyp0 _Amps
Slgns mspe ctor's Use Onry_ OT
Irrigation Booms -
?/; Ui ?-
S
i ??
pec
al Inspection
Alarm/Communication THIS INSTALLATION
Other Fea MAY BE ORDER DISCONNECTED IF NOT
COMPLETED WITHIN 16 MONT S.
I, the Electrical Inspecior, hereby RO°9^-in
certif
th
t th
l
y
a
e above inspection has
been made.
i
OFFICE USE ONLY
Tnl9 [aqllB6t VOId 18 l110lifh5 I10lli
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA140919
Date Issued:01/31/2017
Permit Category:ePermit
Site Address: 1833 Covington Lane
Lot:3 Block: 12 Addition: Ridgecliffe 1st
PID:10-63980-12-030
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
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 -
Ronald E Leviton
1833 Covington Lane
Eagan MN 55122
Spotless & Seamless Exteriors
8715 Jefferson Highway North
Osseo MN 55369
(763) 428-1111
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA140919
Date Issued:01/31/2017
Permit Category:ePermit
Site Address: 1833 Covington Lane
Lot:3 Block: 12 Addition: Ridgecliffe 1st
PID:10-63980-12-030
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
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 -
Ronald E Leviton
1833 Covington Lane
Eagan MN 55122
Spotless & Seamless Exteriors
8715 Jefferson Highway North
Osseo MN 55369
(763) 428-1111
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA144581
Date Issued:08/01/2017
Permit Category:ePermit
Site Address: 1833 Covington Lane
Lot:3 Block: 12 Addition: Ridgecliffe 1st
PID:10-63980-12-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Ronald E Leviton
1833 Covington Lane
Eagan MN 55122
(651) 681-9275
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA155720
Date Issued:05/30/2019
Permit Category:ePermit
Site Address: 1833 Covington Lane
Lot:3 Block: 12 Addition: Ridgecliffe 1st
PID:10-63980-12-030
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Includes Skylight
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: 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 -
Ronald E Leviton
1833 Covington Lane
Eagan MN 55122
(651) 587-7945
Mayday Restoration
18062 Judicial Way N
Lakeville MN 55044
(651) 253-4085
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA168863
Date Issued:05/06/2021
Permit Category:ePermit
Site Address: 1833 Covington Lane
Lot:3 Block: 12 Addition: Ridgecliffe 1st
PID:10-63980-12-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Ronald E & Sandra Leviton
1833 Covington Ln
Saint Paul MN 55122--268
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature