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2132 Cliffhill LaneBUILDING PERMtT To be used for ? ?<• CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 - i Receipt L-? Est.Value Date i 19 ? Site Address ' ? -? '' ?•?_ i: r :: : ?.. i:; Lot Block " Sec/Sub. "'A.P. CLl.rF IST Parcel No. a Name .. . ,.. .`"".. z Address p i, ti - l+?.F / •.; City Phone , o Name +;L?nr:b z 1 . Y-.,. " C 1. : oU Address UP City Phone ` Name I hereby acknowledge fhat I have read this application and state that the information is corcect and agree to comply with all applicable State of Mfnnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Building Permit is issued to: `all work shall be done in accordance with all applicable State of 1 OFFICE USE ONLY On Site Sewage _ Occupancy MWCC System _ Zorting On Site Well _ Type of Consi City Water _ (Acfual) (Allowable) # of Stories Length Depth S.F. Total Footprint S.F. APPROVALS FEES f Assessments _ Permit WatedSewer _ Surcharge Police _ Plan Review Fire _ SAC, City Engr. _ SAC, MWCC Planner _ Water Conn. Council _ Water Meter Bidg. Off. _ Aoad Unit APC _ Treatment P1 Variance _ Parks TOTAL on the express condition that sota Statutes and City of Eagan Ordinances. Pertnit No. Psrmft Holder Date Telephone ?k Plumbing H.V.A.C. E lectric Softener Inspection Data Insp. Commants Footings I 4?/o Footings II Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. Fireplace Final Htg. Final Plbg. Bldg. Final ` cerL occ. a Temp. LP Deck Ftg. Deck Frmg. Well Pr. Disp. . ' . CITY OF EAGAN , 5795 Pilot Knob Raad Eagon, MN 55122 PHONE: 454-8100 BUILDING PERMIT Receipt Ts 6e used far Fc+ Vnhla . Dnte $1tQ /,ddfe55 Lot Block Sec/Sub. ( Parcel # oc Nome :'ac mRn :-pgiE-+4 Tn .. W z Address - , Ci Phone - p Nome Address H t":w, M- Name I hereby acknowledge that I hove read this application ond state that the information is wrrect and ogree to comply with all applicable Stote of Minnesota Statutes and City of Eagon Ordinances. Erect ,0 Alter ? Repair ? Enlarge ? Move ? Demolish ? Grode ? Water & ? Pol ice - Fire Enfl. _ Pianner _ Council _ Bldg. Off. APC - k ' N! 6471 OCCUpOf1CY Zoning Fire Zone Type of Const. # Stories Front ft. Depth ft. Permit Surcharge T Plon check SAC Water Conn. Woter Meter Rood Unit Totol 5iynoture of Permittee I A Buildin9 Permit is issued to: on the express condition that ail work shcll be done in accordance with oll applicoble Stote of Minnesota Statutes and City of Eogon Ordinances. Buiiding Officiol Pwint! ?j DaN Isood PenaiMN Plumbing ' / Mechcnitol INSPECTIONS DATE INSP. Rouph-In Finol Footings Dote Insa. Date Inap. Foundation Plumbing /3 ?,s• rr Frame/ins. MecFanical Finol Remarks: (Strtif tra#e uf (Orrupttnrg ? .;:Citp of Cagan ?. ?rpwbmc# of luilbing 3wertim Tbit Certificatc iuxad pwmww to tIx rcqutreuscwi of Sation 306 of the Uxifom Building Codc cMi ff yixg tbat at tbe timc of isnww tbis mrctx?c was in cow pJiarue witb tbe varroru •rdiuasas o f tlx C.itY rrgalatixg 6oa/di+sg aoiutrxctiox or xu. For tbe f ollowing: -- - -- - F;F nwr; .? Fmok N& 6471 ?2-20-81 .e., m „ co....c„d,. ..^« ... No. crnr oF Eac,aN 3795 Pilot Knob Road Eagan, Minnesoto 55122 Phone: 454-8100 ? - ' PERMIT Dote: 2"3.8^81. Site /lddress: Lot Block Sub/Sec. INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: Single Residentiol Multi Res., Comm./Ind. I Ncme - `c31 I:Ct"r:? S1rlc w/Alt r N /R i . e e epa r 3 Address ' f Inst ti n t ll C os o a o o O City Phone: Permit Fee Name ' Surchor e ? ? g ? Address e 0 V ity hone: ofal This Permit is issued on the express condition that oll work shall be done in acwrdante with all applicoble State of Minnesoto Stotutes ond City of Eagan Ordinances. Building Officiol No. cirir oF .EAGAN 3795 Piloe Knob Roed Eo9ew, Minnasota 55122 Phone: 451-8100 PERMIT Date: 1-1.3-a1 _ - Site Address: - ' Lot 1 Block Sub/Sec. Name `Y `C• :C e Address ? City f?.•- - t- Phone: ,- 1 Nome p. y ? Address c ? • •? City Phone: This Permit is issued on the express condition that oll work sholl be Minnesota Statutes and Ciry of Eagan Ordinances. INSPECTOR NOTIFICATION REQUIRED BY LAW FOR ALL INSPECTIONS Receipt No.: Single Residential Multi Res., Comm./Ind. I New/Alter./Repofr Cost of Installotion Permit Fee Surcharge Total done in occordance with al l applicable State at Buildinfl Official CITY OF EAGAN Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. ?- 1982 1496.30 299. 1496.30 C 10-1-81 RESTOR. GRADING 1981 541.38 108,28 5 433.11 A009940 2 25 81 SANSEW TRUNK 105 5 7?04 42.26 A009940 2 25 81 * SEWERLATERAL s ? 19$1 2541.51 568.ZQ S 2032.81 .21.25/81 WATERMAIN * WATER LATERAL 1981 WATER AREA 944 33 6 * STORMSEW TRK 5y/ 1981 405.09 81.02 5 324.08 A009940 2 25 81 * STORM 5EW LAT I981 CURB & GUTTER 51DEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK CITY dr EAGAN 3705 Pilot Knob Road Eagon, MN 55122 Zoning: Owner: Address: Site Address: Plumber: Meter No.: Size: Reader No.: I agroe to comply with the City of Eagan Ordieances. By Date of Insp.: CITY OF EAGAN 3705 Pilot Knob Roud Eogan, MN 55122 Zoning: Owner: Address: Site Address: Plumber: 1 ogree to eomply with tue City of Eagae Connection Charge: Ordinanees. AccounY Deposit: Permit Fee: Surcharge: . gY Misc. Charges: Date of Insp.: Total: Insp•: Date Puid: . t? WATER SERVICE PERMIT PERMIT NO.: DATE: . No. of Units: -t ci Connection Charge: Account Deposit: Permit Fee: Surcharge: Misc. Charges: Total: - Date Poid I nsp.:- PERMIT NO.: DATE: No. of Units: This request void 18 months from ? 3C '7 Date of this Request 1-20-81 1 20141 I, as O Licensed Electrical Contractor 0 Owner, d he eby request sni' p tei c on of the above electri- cal wiring installed at: Street Address or Route No. 2132 Cliffhill Lane Section City E_ a? Township Range County ko ta Which is occupied by Zachman Homes (Name of Occupant) Is a roughin inspection required on this job? No C] Yes Ck Ready Now ? {y? Cafl p PowerSupplier Dakota Electric, A Electrica! Contractor Sunrise E ectric Inc. (Company Name) Contractor's License No. 39778 Mailing Address i}12p g3rd pyP Nn _ ,YS? Minnn S z? (Electrical Contractor or Qwner Makin9 Th3s Installation) Authorized Signature Keith R Hesli (Electrical Contractor or Owner Makiny This Installatlon?one No. 566-860p S1'ATE BOARp Cpp'? This inspection request wili not be accepted by tha State Board unless proper inspection fee is endoaW. Minnesota State Board of Electricity r t821 Universi YAVe.MStwPa u! Minn. 55104 191 HECK BELOW 111 EB.00001_02 '?EQUFST FOR ELECTRICAL INSPECTION Wp? ?Ype of Building New qd COVERED d. R BY THIS REQUEST T . Duplex Apt Bld [] ? U ? Ran ge Water Heater xx L9u?Pment Wired mpotary Wiring [? . g, Commercial B(dg. I d ? ? ? ? ? ? Dryer ?umace j 8hting Fixtures ectric Heating ? ? n ustrial Bldg. Fazm ? ? ? ? ? Air Conditioner L o Unloader (] Other. ? ist f?rr,a lk Milk Tank * . ? (Final) - This reques v io 18 months from I, the Ele ? ? ' ctrical Ins , TOTAL .- cto er ??,,:-?....?_ . ._ ? ? o ? 1987 BOILDING PERMIT gPPLICATIOH - CITY OF EAGAN SINGLE FAMILY DWELLINGS INCLQDE 2 SETS OF PLANS, 3 CERTIFICATES OF S08VEY, 1 SST OF ENERGY CALCOLAYIONS NOTE: ADDRESSES FOR COHNER LOTS - CONTRACTOR/HOMEOWNER MIIST DESIGAAYS WHICH ADDRESS IS DESIRED. NO CHANGES iiILL BE ALLOWED ONCE SUILDING PBRMIT IS ISSDED. MU[.TIPLS DWELLINGS - RFSIDENTI9L RENTAL OPITS FOR SALE QHITS INCLUDE 2 SETS OF PLANS, CERTIFICARS OF SDRVEY - CHECK SiITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS COl"MRCSAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, > o $2,000 LANDSCAPE BOND 00 To Se Used For: E(?"m Valuation: I Date: ta Site Address t?\u_ (.(•?. Lot ? Block S Parcel/Sub ezj? Owner _60_1s?1A? Address Z-132 - C(,l.kk j..lt'tS. L,hk. City/Zip Code Phone jL'-' Contraetor t9311Q?y?( 2N? Address4oL3:? Euo\ [c2 City/Zip CodeCgC?r•,_.?8?r4 , pV.;V SS??TO Phone qZb - Lq ` Arch./Engr. Address City/Zip Code On Site Sewage_ MWCC System _ On Site Well _ City Water _ APPROVAT 4 Assessments Water/Sewer Police Fire Engr Planner Couneil Bldg Off APC Variance Occupaney Zoning Type of Const (Aetual) (Allowable) # of Stories Length Depth S.F. Total Footprint S.F. FESS Permit Surcharge Plan Review SAC, City SAC, MWCC Water Conn Water Meter Road Unit Treatment P1 Parks Copies TOTAI, -11. - 4-1 Phone # ? CITY OF EAGAN N°_ 13 8 01 - - 3$30 Pilot Knob Raad, P.O. Bax 21-199, Eagan, MN 55121 ' BUIIDING PERMIT PH ONE: 454-8100 Fecaipt # --47?,}? ? Tobeusedfor GARAGE EstValue $8,000 Date JGNE 19 ,1987 SiteAddress 2132 CLIFFHILL LN Lot 3 Block 5 Sec/Sub. CEDAR CLIFF 1ST Parcel No. ? Name BRIAN CROWLEY ? Address SAME 0 City Phone 454-4676 a Name WOODEN WORKS oQ Address 6230 ELM RIDGE CIR ? City CORCORAN phone 478-6413 w w Name F xz. Address aw City Phone I hereby acknowledge that I have read this apDlication and state that the information is correct and agree to comply with all applicable State ot Minnesota Staty\t?e\s and City of Eagen Ordinancea Signature of Permitt9e `a- - --??"-41?1? A Building Permit is issued to: WOODEN WORK all work shall be done in accordance with all applig4ble State of I 8uilding Official OFFICE USE ONLY On Site Sewage _ Occupancy MWCCSystem _ Zoning On Ste Well _ Type of Const City Water _ (ACtual) (Allowa6le) # of Stories Length Depth S.F. Total Footpnnt S.F. APPROVALS FEES Assessmenls _ Permit $79.50 WatedSewer _ Surcharge (i-(lfl Police Plan Review Fire SAC,City Engr. SAC, MWCC Planner WaterCOnn. Councd Wafer Meter Bldg. Oft. Road lJnit I APC _ Treatment P7 Vanance Parks Copies TOTAL $83.50 on the express condition thal AinneButa Statutes a?d City of Eagan Ordinances. 0 SD• y < ?" S?• P,aNC?+ ?J?uu?.,? y13Z C1,:L 1.lt« Zr/ ,. 1 ? S Zq'` -? 1?-rtA . ? ` ? ... UJii>tcj2c ? ? . ..._.. ._ ... . _ _..._ ___ ? EA6AN- ' . ' . ? RE EW d C2 BY_... i Z- I % ?xl? ? , 2?? . -- -?- - CITY OF EAGAN 3795 Pilot Knob Road Eagan, MN 55122 N2 6471 PHONE: 454-8700 BUILDING PERMIT APPLICATION ReceiPt # 7e 6e used fer SF DWG e? vMh,P 33,000 n.,fo 12-22 ?a80 Site Address 21"j2 Cl"1ffY1111 Ln. Lor 3 Block 5 Sec/5ub. Cedar Cliff 1 Parcel # 10 16600 030 05 _ ? Nome- Zachman Homes Inc 3 Address 7760 NLitchell Rd. ° cj E den Prairie,Ab 937=9520 ne p Name ;t Address ~ Ci Phone Fw Nome Address I hereby ocknowledge that I have reod this epplication ond state that the information is correct ond agree to comply with oll applico6le State of Minnesoto Statutes and City of Eagan Ordinances. Erect xy Occupancy R3 Alter ? Zoning R2 Repair ? Fire Zone 3 _ Enlarge ? Type of Const. V Move ? # Stories Demolish ? Front 22 ff. Grode ? Depth 3$ ft, Approvals feea Assessrit _ Water & Sew Police Fire Eng. Plonner _ Council - Bldg. Off. _ APC Permit Y25.UU Surchorge 1h.50 Plan check 49 _ 00 snc 525.00 Woter Conn3D5. 00 Water Meter 60. 00 Road Unit 185.00 Toral 1,23$. 50 Signature of Permittee I A Building Permit is issued to: ZaChI1l3Z1 HOID85 IriC. on the express condition Hwt oll work shall 6e done in accordance th oll appiic Sta?te, of Minnesoto Statutes and City of Eagan Ordinonces. Building Official CITY OF EAC,AN BUIIDING PEf2NIIT PPPLICATION Include 2 sets of plans, 1 site plan w/e]evations & 1 set of erergY calculations. TO ge Used For S ?C ? Valuation _ Site Address: ??I 3?. ?"A t't't 1???? u,t 3$1«-x $ sec./sub. Cc r?-- Parcel #: Ze i/ z qd ??``P 'n5 Qaner: Address_ City/Zip Code: Q Phone # : q 37-9 C7ri ContsactDr: Address: ? '/M Q ? - City/Zip Code: Phone #: Arch. /Fn9 • • _ pddress: City/Zip Code: Phone #: 3. 006 _ Date OFf'ICE USE ONLY Erect occupar,cy Tr' 3 Alter Zoning 2- Repair Fire Zone 3 En1,arqe _ 'Iype of Const. Move # Stories f? Deirolish Front 21 Grade _ ft. ?P? Assessrents Perndt 9 t, a D Water/Sewer Surcharge l'k.sa Polioe Plan Check Y 9 Fire SAC .126;aa Eng. Water Conn. 3oS.00 Planner Water Meter %0 , o m Council Rxd iJnit / 8? o 0 Bldg. Off. APC qVrAL /a3,P? s a ? l CALVIN H. HEDLUN_, Land Surreyor CIv11 Enqinesr 9 04.5 surveitortfs eertificate JOB N0. j41 SURVEY FOR: Zachman H«uea ? OESCRIBED AS: Lot 3, ffiock 5, CEDAR CLIFF. City of Eagan, Dakota County, Minnesota, and reserving easementa of record. 9o4z Io'O sfakas L_T _ -ea. 900.4 "75•00 ?---- ----? OI DECK I NI - 9 03.b 19 903._ ?$ * 22 J"16-'? ? ?1A I OAKWpDD ? , ?e ,=ut. ?, ?r? r M SPL?\'? ? ? I `FOYER b GBr, NI?15 ? 20 ?I? - -y? ? I qa3,6 03.6 W ? ' Ll_ry?_ O I y? J 75. 0 0 cn M 8609 6iraro Avenue Soutp Bloominqton,Mionssotq 55431 Phone: B 8 8-2080 Top of Founda+ion = 904.3 Basemen+ Floor= 901.1 Gera9e Floor • 903.9 ProPosed E ICVS+-lo1'+s C=> Exis+;ng Eleva+ioru - Deno+es Draina9e -? W (P slakes q o I .-r qo0.6 CLIFFHII..L LANE 901.4 q01.1 CERTIFICATE OF SURVEY I hereby cerfity fhat on i I- 26 - So I surveyed the property described abov and thot fhe above plot is a correct represenfotion of sald survey. ?a?.. -4. ae? ciz) Colvin H. Hedlund, Minn. Rap. No. 5942 CALVIN H. HEDLUNW Lantl Surveyor Clvll Enqineer 9609 6irard Avenus South Bloomfaqton, Minnsaota 55431 PDone : 8 8 8-2080 SAW(liewr`s GJOB N0. 141 SURVEY FOR: Zachman Hanea DESGRIBED AS' Lot 3, Block 5, CEDAR CLIFF, City of Eagan, Dakota Cowaty, Minnesota, and reaerving esaements of:record. ! ? l i ? 9 04.2 10 1'J s+akes L:i.T- 4 900.9 _75_oD ?-- ---? I i I ? ? I ? tR?? ? Nj 01= ?b "I ro?AKWtD\ CK I u?. iGar N IS ? M?FOVER b 2o I ~) qo3.b o3.6 W ? ? q I 75.0 o a ? M 90 4.5 •?7r. . Top of Foundc7+i0n = 904.3 Basemen+ Floor: 901.1 Gara9e Floor • 903:9 Proposed Elevations C=> Exis+;ng Elevai'ions - Deno+es Drdino9C -^-r 10 ?sQ S?akes r Q 0 ?z m qo I.7 100.6 CLIFFHILL LANE ?901.4 - 1 901.- - CERTIFICATE OF SURVEY I herehy certify that on f t- 26 - 80 I survayed the property described above and thar, fhe obove plot ia a correct repreaentation of soid survey. ' -4. Colvin H. Hedlund. Minn. Req. No. 5942 CITY USE ONLY LOT ? BL ? RECEIP'f #: O ozp_o 9 SUBD. (1Q,d(anL lJ(?.t,(/ RECEIPT DATE: la zk/Q? 1997 MECHANICAL PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD EAGAN MN 55122 (612) 681-4675 Date: ! Complete this section only if vou are installing HVAC in sinLyle family, townhomc or condos that are undee construction and are not owner /occunied. • HVAC: 0-100 M B T U $ 24.00 ADDITIONAL 50 M BTU 6.00 • Gas outlets ( minimum of one required @$3.00 ea.) • State Surcharge: .50 • TOTAL: Complete this section onlv if vou are remodeling, adding to, or repairinE egistinE single family dwellings, townhomes, or condos. ??u? ? Add-on fiunace _ Add on air conditioning _ Add-on air exchangez, i.e. Vanee system, etc. _ Other Minimum fee apglies to all remndel or add-ons of exisdng residences $ 20.00 State Surcharge .50 Total: $ 20.50 SITE ADDRESS: oVI?/ o;z OWNER NAME: -- -? T 19?'-?l PHONE #: (??? ?! 3 7 / INSTALLERNAME: .5&7X?pHONE #: STREET ADDRESS: CI7'Y: aj,Y72l? STATE: ? ZIP:S5Y3? ??J'?i /L • SIGNATCTRE OF PERMIT PERMIT City of Eagan Permit Type:Building Permit Number:EA114867 Date Issued:09/19/2013 Permit Category:ePermit Site Address: 2132 Cliffhill Lane Lot:3 Block: 5 Addition: Cedar Cliff PID:10-16600-05-030 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes . Marcial Obregon 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 - Gerald L Storey 2132 Cliff Hill Ln Eagan MN 55122 (612) 819-3831 Taylor Brock Corp 6565 City West Pkwy Eden Prairie MN 55344 (952) 888-2000 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA120785 Date Issued:03/03/2014 Permit Category:ePermit Site Address: 2132 Cliffhill Lane Lot:3 Block: 5 Addition: Cedar Cliff PID:10-16600-05-030 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. Joann Zinken 9320 Evergreen Blvd Nw Suite B Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 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 - Gerald L Storey 2132 Cliff Hill Ln Eagan MN 55122 (952) 428-8337 Centerpoint Energy 1240 W River Pkwy Minneapolis MN 55454 (612) 321-5597 Applicant/Permitee: Signature Issued By: Signature House heating test record Owner YV0/2/1 �\ Address i1.52';;i5 �' 1 City q‘340�1 Heat loss Date htg. inst Sold by CenterPoint Energy Installed by CenterPoint Energy Electrical work by CenterPoint Energy Heat type .. FA 0 Space heater Gas line by Unit heater Other Gas design Make Modeli, Serial no. 0 /i�>�3 InputtPS Controls Thermostat 11%2 Heat plug Valve 1-,! / ? Limit t/lev Limit setting Fan setting 1 ,4 Pilot type 74-5 / Pilot make nine' Pilot model '6 Pilot timing g,57.4feL qtr Pressure: Hi fire/Lo fire - S , Percent CO2 Input CFH1 Stack temp '7 9J.7 , Percent 02 ',0 46, Percent CO igim Energy Conversion Vent Size Kind of liner/size -i/e/ Draft hood Z;egi Regulator Filters: SizeIo/2 4/ Number I Chimney locations: .'Inside 0 Outside Chimney construction Wiring Gx Test tag Lighting Inst .'l Date tested -WO/ 1f Company testing CenterPoint, 1nergy iTester's name ///1 CNP 235 (11-2008) PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA135864 Date Issued:04/08/2016 Permit Category:ePermit Site Address: 2132 Cliffhill Lane Lot:3 Block: 5 Addition: Cedar Cliff PID:10-16600-05-030 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Gerald L Storey 2132 Cliff Hill Ln Eagan MN 55122 (612) 819-3831 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature