545 Hawthorne Woods Dr? . ? l il \ AJi L t/ i A. V 1 \ 1\L t/ V Z_L I
`CITI( OF EAGAN PERMIT TYPE: ? Il+ + ?? ? N4 ?
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued: c+r, ; ?? I
(612) 681-4675
SITE ADDRESS: ` ` " I " "" 1' APPLICANT:
Jila. •?i M
•-? 11 r,6lT1-11714 Mf lJni.ill?. tiia ? l ,
IiAW l fl???3Nf IJ??[1l'1?? .'NIl ( E, 1:'! ??Ni, ? a, , .• ?
PERMIT SUBTYPE:
.
TYPE OF WORK:
INSPECTION .. . D
w tl 1
P i f+;?i 1 I t:?, 1 I I+Il1t
Nf.MA". 1i PRV '; L W PI.BR - M&W WAFf:R 11,,, SEI
. ?
(? J
Permft No. Permft Holder Date Telephone i
ELECTRIC
PLUMBI y? 9s 00po- a
HVAC
Inspsctlon Da e Insp. Commenta
FOOTINGS -151,f 1- ?P4
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
-
GAS SVC
TEST
INSUL y/Z2 ?
GYP BOARD
FIREPLACE ZL ?r ?
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
.?
ORSAT
TEST
BLDG FINAL
85MT R.I.
?
BSMT FlNAL
DECK FTG
DECK FINAL
1,Y..
Wertificate of Ccc"anc?
IKtt4
..?
MCOW:tMent of
This Certificate issued pursuant to the requirentents oj the Unifvrm Building Code
certifying that at the time of issuQnce rhis strucrure was in compliance wirh the various
ordinances of tlre City regeilating building corutruction or use. For the fo!lowing:
u. a?ir,..do.: g' DW aws. Pemin No. 26228
o.v..,7 iYM R3/0 ! zo,,;4g Duu;a R 1 rra c,,,,. 9si
owner or suaaing J S IiM Add,,.4371 MT IM IN. F.AGM
suiwing naae. 545 HAWIfME WOOD6 I7i2IVE Lom;4..28, S2, AMMME tiloC06 2rID
x !o/
euaaing owww ?
POST IN A CONSPIC110US PIACE
/66 f" REDUEST FOR ELECTRICAL INSPECTION
7 0 II See insimdions for completing this form on Oack of yellow copy
"X" Below Work Covered by This Request
EryB-0 00G1-09
?? /
Ne Add Rep. Type of Building n4s Wired Equipment Wired
Home r Temporary Service
Duplex Water Heater Electric Heating
t. Bui lding Dryer Load Management
omm./Industrial Fwnace Other (Specrfy)
4 rm Air Conditioner
her (specily) Conlraclor's Remarks
Ot
Compute Inspec(ion Fee 8elow:
# Other Fee # Service Entrance Size Fee # CircuitsJFeeders Fee
Swimming Paol 0 to 200 Amps /S? 0 to 0 Amps
Transformers Above 200_Amps Above 100 -Amps
Si ns Inspecror's Use Only TOTAL
Irrigation Booms
Special Inspection ?
Alarm/Communication THIS INSTALLATION MAV BE ORD SCONNECTED IF NOT
Other Fee COMPLETED WITHIN48-#70NTHS.
I, the Electrical Inspector, hereby Rough-in Date el`_ G
(
certify that the above inspection has
been made. F'"ai , oete
OFFICE USE ONLY
This requesi voia 18 months fmm
0
-485 ?y9/?
N)
0 ?
Repues Date
o
r Fire N. Rou nspect?(n Reqmred InsOechan Other Then Rough-In
(Vou must call inspeclor when reatly) ? Reatly Now ? Will Notdy Inspecror
Ves ? N. Date Read
I?hcensed contractor ?owner hereby request inspection ot above electrical work at.
Job Adtlres,s /(Street, Box or Raute No )
? C?ly
'?/ Q! el. 'G!
/
Secvon No. Township Name or No Renge No County oako?a
Occupant(PRIM) Phone N.
07 yr?s 6 ?6 - D 2
aower suoalier
'of? aaares/s
Elec[ncal Conlracmr (COmpany Name) ConlracWrs Lmense No.
H c C14 v l/s"3
MaAirg Adtlress (Conhatmr oro
?g?er Making Inslellation)
/
/
, (f /O? AGf /- T yJ
O ¢C. ?-/
Authonzetl SgnaWre ( Vacl wner Ma Installanon) hone Number
YYSS.j`33
MINNESOTA TE BOAflD OF ELECTR THIS INSPECTION REOUEST WIIL NOi
Grigge-Midw Bldg. - poom 5-128 6E ACCEPTEO BV THE STATE BOARD
1821 Univereily Ave., St. Poul, MN 55109 II
e?, m.o? roM UNLESS PROPER INSPECTION FEE IS
cv?i nern
Address MM 545 xAwn3oR[E WUODS nRIVE Zip 5512 3
Lot 28 Blk 2 Sub AAW1fIORNE [wOODS 2rID
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: Yes No Inspector: `"? e
Final grade (6" from siding)
Permanent steps (garage) ?
Permanent steps (main entry) ?
Permanent driveway ?
Permanent gas
Sod/Seeded grass
TraiUcurb damage
Porch
Basement finish ?
11
Deck 7
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of watet suppty to
the outside lawn faucet before freeze potential exists. Contact engincering division at 6814645 before working in righhof-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink • Conlractor Copy
2007 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New ConsWC6on Reouirements
3 regislered site surveys shovnng sq. K of lot, sq. ft. o( house; and ali roofed areas
(20 h macimum lot coverage atlowed)
1 Soils Report if pmposed building is to 6e placed on disWrbed soii
2 copies of plan showing beam & windmv sizes; poured found design, etc.
1 set of Energy Cafalahons
3 mpies of Tree P2servation Plan if bt plaHed after 711/93
Rim Joist Detail OpUOns sdection sheet (6uildings vrith 3 or less uniis)
Minnegasco mechanical ventilation form
RemodeVRePair Reauirements OKCe Use Onlv
2copiesofplanshowingfootings,beams,joists CeRofSurveyRecd _Y _N
1 setof Energy Calculations fa heated additions Sals Report _Y _N
1 site survey for addiUOns & decks Tree Pres PWn ReW _ Y _ N
Addigon-indreateifon-siteseptlcsystem TreePresRequired _Y _N
Dn-siteSepGCSystem _Y _N
plenc arn rnnciricrnrl n11HlllC infnrmafiinn iinless vou state thev are trade secret and the reason.
. ?..? .....................:..... .._..?....
/ ?
Da[e 0 / c;W _....""" _"'_
Construction Cost
?
Site Address ?}7'? /
UniUSte #
Description of Work
Multi-Family Bldg _ Yvl-l--N Fireplace(s) _ 0 2
Property Owner d"? Telephone #( )
?
Contractor
Address ? ? C??
?
??
State -7
?i s/
Zip '?fl Telephone#( J ) &- 1FlBG
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 _ Minnesota Rules 7672
Energy Code Category • Residential Ventilation Category 1 Worksheet ? New Energy Code Worksheet
submission lype) Submitted Submitted
. Energy Envelope Calculations Submitted
In ihe last 12 months, has the City of Eagan issued a permiT for a similar plan based on a master plan?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Confractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
T herehv annlv for a Residential BuildinR Permit and acknowledge that the information is complete and accurat
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State oY MN
Statutes; 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 apprq?ved plan in the case of work which requires a review and
approval of plans.
Applicant's Printed 13ame
DO NOT WRTTE BELOW THIS LINE
Sub Tvpes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - MuIG
? 03 Otof_plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn.(4-sea.) ? 33 Ext.Alt - SF
? 04 02-plex ? 10 08-plex ? 78 Deck ? 23 Poroh (screenlgazebo/pergola) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex ? 25 Miscellaneous
Work Tvpes
? 31 New ? 35 Int Improvement ? 38 Demolish Inlerior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Afteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement `Demolition (Entire Bld g) - Give PCA handout to applicani
D¢SCrIptIOII: Water Damage _ Yes
Valuation Occupancy MCES System
Plan Review 100% or 25%
Census Code Zoning Ciry Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUII2ED INSPECTIONS
_ Footings (new bldg) _ Sheetrock
_ Footings (deck) _ Final/C.O.
_ Footings (addition) _ Fina]/No C.O.
Foundation
? HVAC
Drain Tile Other
Roof
Ice & Water Final _ Pool Ftgs Air/Gas Tests Final
_
_ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick
_ Fireplace _ R.I. _ Air Test _ Final ? Windows
_ Insulation _ Retaining Wall
Approved By: , Building InspecYor
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
!
-?" CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
c;2 W45
auzLoswG
azezza
08J11J95
SITE ADDRESS:
545 HAWTHORNE WQpC1S pR
LOT: 28 BLQCKa 2
HAWTMORNE WOODS 2ND
p.I.N.: 10-32151-280-02
DESCRIPTION:
Bpi`,ilding=,.,permit Type
,#,u3.}.-d'a.hg 14;rk Type
.? -G?fitStruct i on ;TyP§,,e
- z
9Tt,?n,[J;.
E3tl.ild?rtg Lfan,gth; '?
lW i'ld i n„? ?idth.?
3
aal?d1a? ?tar.iss
B
e
? ;.?';y
ta h Sii
n ?
?. ?
;?3 ?v
5F DWG
NEW
R-3 U-1
V-N
R-1
70
34
2
2,089
p; y? cjYm{? g$-;
c? ri'
REMARKS:
PRV
FEE SUMMARY:
S& W pLBR - M& W WATER & SEWER
Base Fee
Plan Revi.ew
Surcharge
SflC
$AC %
SAC Units
Subtotal
VALUATION
$1,202.25
$420.79
$81.50
$850.96
100
$2,554.54
$163,000
MISCELLANEQUS $1,892.50
COPY .50
Total Fee $4,447.54
CONTRACTOR: - Applicant - sT. l zC. OWNER:
J S HQMES 16869092 0084849 J S HOMES
4371 BENT Ti2EE LN 4371 BEN7 7REE l,N
EAGAN MN 55123 EflGAN thN 55123
(612) 686-9042 (612)686-9092
L
, . _ _ ° _- - . - _ '. .- -- ` - • ')
T Yiereby `aek,rresw3:edge, that I,.haye "read this .appl.,iQati:itn and,'s ta tle ChH,C•'the ,e
iriforrriation is 'o6?r,reet°an,dc agr'ee tlo coinpJry:w.at_fi. ai.l appl,i,6ab?e `5tinte afMn.a= ;
Statutesiand Cit"p,of Eagan Ord,ihancgs..-? . ?
,
APf ICAN ERMITEESIGNATl1RE
?
ISSUED BY. SI I IATURE
`" (/ INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITEADDRESS: P.I.N. ` 10-32151-280-e2 APPLICANT:
LOT: 28 BLOCK: 2
545 HAWTWORNE WOODS DR J S HOMES
WAW7NORNE WOODS 2N0 (612) 686-9092
PERMIT SUBTYPE:
5F qWG
TYPE OF WORK:
NEW
auzLozNG
026228
08/11/95
INSPECTION
FOOTINGS D. .
FpUNC7ATSON .A
FRAMING ROOFZNG
INSULATION FIREPLACE
ROUGH IN PLBG ROUGH IN HTG
FINAL PLBG FINAL
fi'EMARKS: PRV S& W PLRR - M& W WATER & SEWER
-77]
„
?
{ CITY USE ONLY O
L ? BL ?41-, RECEIPT #: ?
sueU/raur-u. 4r?.42?'L DArE: 9'00 9S
1995 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? singie family dwellings
? townhomes and candos when permits are required for each unit
FIXTURES EACH NO. TOTAL
Shower 3.00 x S
Water Cioset 3.00 x
Bath Tub 3.00 x
Lavatory 3.00 x q
Kitchen Sink 3.00 x r = 3
Laundry Tray 3.00 x r = 3
Hot Tub/Spa 3.00 x =
Water Heater 3.00 x ! = 3
Ftoor Drain 3.00 x 1 = 3
Gas Piping Outlet * minimum - 1 3.00 x I
Rough Gpenings 1.50 x 15 _ ,u a
Water Softener 5.00 x =
Private Disposal " Dakota Cty, license 20.00 =
U.G. Sprlnkler' home under const. 3.00 =
Alterations ' to existing 20.00 =
Water Turn Around 20.00 5?"r, yO
STATE 5URCHARGE .50
TOTAL
SITE ADDRESS: 545 Hawthorne Woods Dr (Lot 28, Blk 2-Hawthorn Wds II
OWNER NAME: JS Homes
INSTALLER NAME: Mcoermott Mechanical Inc.
STREET ADDRESS:12231 Nicollet P,venue South
CITY: Burnsville
PHONE #: ( 612
STATE: MN ZIP: 55337
L BL
SUBD.
OFFICE USE ONLY
RECEIPT #:
DATE:
1995 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MM 55122
(612)681-4675
Please complete for: . all commercial{industrial buildings.
w multi-family buildings when separate pertnits are p41 required for each dwelling
unit.
DATE: - CONTRACT PRlCE:
WORK TYPE: _ NEUV CONSTRUCTION _ ADD ON _ REPAIR
DESCRIPTION OF WORK:
IS WATER METER REQUIRED? _ VES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED7 YES NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER I5SUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? YES NO.
IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT.
FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per
$1,000 of pzma fee due on all permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
51TE ADDRESS:
TENANT NAME:
OWNER NAME:
INSTALLER: _
ADDRESS:
cirv:
PHONE #:
METER SIZE:
STE. #
SIGNATt1RE:
OFFICE USE ONLY
" DATE:
STATE: ZIP:
APPLICANT
_ INSPECTOR:
ry p /? L BL CITY USE ONLY RECEIPT #: h° i/Y/L
o? b ov
SUBm. vd DATE: gOzok-
1995 MECHANICAL PERMIT (RE5IDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required foreach unit
? New construction Add-on fumace
?
Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date: !Flz e /S s?
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
3?
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL
SITE ADDRESS: Yy s f?4.r ?4 s? " 7- ,.) >.?) a r?_
OWNER NAME: T-i s Xa ..K 4 s PHONE #:
INSTALLER NAME• M u cl F- a n, r' X? K ? 4 2^( ?_
STREET ADDRESS:tZ' I-1 t I'-' , T. • ?%? r
CITY: STATE: ZIP: 5 s 3 z 7
PHONE#:( ) R`1o?9dtsY
51UN ?MIT I E- --
CITY USE ONLY
L _ BL
SUBD.
RECEIPT #:
DATE:
1995 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Piease compiete for: ? all commerciaUindustriai buildings.
? multi-family buildings when separate permits are = required
for each dwelling unit.
DATE:
CONTRACT PRICE:
WORK TYPE: _ NEW CONSTRUCTION
DESCRIPTION OF WORK:
INTERIOR IMPROVEMENT
FEES: w $25.00 minimum fee QC 1% of contract price, whichever is greater.
• Processed piping - $25.00
? State surcharge of $.50 per $1,000 of pertnit fee due on all permits.
CONTRACT PRICE x 1%
PROCESSED PIPING
STATE SURCHARGE
TOTAL
SITE ADDRESS:
OWNER NAME:
TELEPHONE #:
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS:_
CITY:
PHONE #:
STATE: ZIP•
SIGNATURE:
SIGNATURE OF PERMITTEE CITY INSPECTOR
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
ril 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681 -4675
??
c.?Q.t?? ?-ll
? 3 ragisteied aite surveys ? 2 copies of plan
? zcopbs aplon. (mauee eaem a wnaoW size8; vcurea fia. aesign; ecc.) ? zsna 6uryeYg (exterior oeamon. s aeas)
? 1 energy eakulations ? 7 energy cakuletions for heeted additions
? 3 eopiea of Uae qsservation plan iF lot pletted afier 7/1/93
required: _ Ves ? No
DATE: 4/ s I-/ ?5 CONSTRUCTION COST:
DE6CRIPTION OF WORI
STREET ADDRESS:
LOT 2 Y BLOCK ,,2-
PROPERTY Name:
OWNER
SUBD./P.I.D.#: '?2 /?'l 1`T7?,<-,
Phone #:
u,.
iRfi
Street Address,
City: State: Zip:
CONTRACTOR ComPanY: ? S a,21--+-ej Phone
-
StreetAddress: 457/ YS?Nr ? License#• o?D49`f`?
City: State: Zip- ?y3
ARCHITECTI Company: Phone #•
ENGINEER
Name: Registration #'
Street Address,
City: State: Zip:
Sewer 8 water licensed plumber. ??i? ??? /? / S2?'?? . Penalty applies when address change and lot
change are requested once pertnit is issued.
1 hereby adcnowledge that I have read this application and state that the infortnation is correct and agree to comply with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY G`l / V LC?iI?OM6' `U?
Certificates of 5urvey Received Yes _ No AUG 0 3 1995
Tree Preservation Pian Received _ Yes _ No ---------------
OFFICE USE ONLY
BUILDING PERMIT TYPE
0 01 Foundation o 06 Duplex
ep,'-'02 SF Dwelling o 07 4-plex
0 03 SF Addition o 08 8-plex
0 04 SF Porch ? 09 12-plex
0 05 SF Misc. 0 10 _-plex
WORK TYPE
M`-31 New o 33 Alterations
n 32 Addition o 34 Repair
GENERAL INFORMATION
Const (ActuaQ
(Allowable)
UBC Occupancy
2oning
# of Stories
Length
Depth
?_1»:??PL1??
Planning
0 11 Apt./Lodging ?
0 12 Muki RepaidRem. ?
0 13 Garage/Accessory ?
0 14 Firepiace o
? 15 Deck
0 36 Move
0 37 Demolition
W
.,
,? _ ?.
16 Basement Finish
17 Swim Pool
20 Public Facility
21 Miscellaneous
;r- q Basement sq. ft. l 3 Zo MCNVS System (7?,-
Main
level sq. ft. i,3u? City Water a?
-3 ?-? ?
Z sq. ft. 14108 Fire Sprinklered
sq. ft. PRV
2? 2?.?f sq. ft. Booster Pump
70 sq. ft. Census Code. /D/
7 Footprint sq. ft. 21,0 ss 4 SAC Code
Census Bldg /
Census Unit /
. Building Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Pertnit
S/W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
w
Valuation: g /l0 3, o0 0?'
0A/N
yzrX 5'/.s =
?
?
32x 3s
s11?7
/7(0
S!a ?
3?y _
? zgo
i
_ / z rCo
13 5? r•
?-
/?? r l T 20 !?/ s°
L,s-
.33x/7
(izx 9? ; <108> _ ZtX 32- : 67v
SD ?? (o fy xsy = 2x ? " y°
-, s?, g3z .33x? "?_
Total:
?
% SAC
SAC units
T?
-719K/6?
231?
LOT SURVEY CHECKLIST FOR RESIDENTIAL '-
. BUILDINGPERMITAPPUCATI N
J ? PROPERTY LEGAI:
J N
? a ?
D E OF SURVE :
m LATEST REVISION:
DOCUMENTSTANDARDS
sr'0?13 0 • Registered Land Surveyor signature and company
4,'?O ? • Building Permit Applicant
B"?C] 13 • Legaldescription
W-" o o • Address
G/o 13 • North arrow and scale
W--o
?0 a
13 • House type (rambter, walkout, splk w/o, split entry, lookout, etc.)
---? • Directional drainage arrows with slope/gradient %
M
r ? • Proposed/existing sewer and water servlces & invert elevation
? ??
+? ? ?
? •
• . Street name
D
i
4 r
veway
ELEVATIONS
Existina
O'?'O ? • Sewer service
W'--13 ? • Property comers
W'13 E3 • Top of curb at the driveway
GK?0 ? • Elevatlons of any ebsting adjacent homes
P ose
O'?'o ? • Garage floor
W' ? ? • Frstfloor
Er' ? o • Lowest exposed elevadon (walkoutlwindow)
W,'?-o ? • Property comers
W"'o o • Front and rear of home at the toundatlon
PONDING AREA (if aoolicable)
0 Ql?? E3 • Easement line
? G-? O • NWL
? 9' c3 • HWL
11 Q-'0 0 Pond # designatlon
13 2'? 0 • Emergency Overflow Elevation
DIMENSIONS
Er'o 13 • Lot IinesBearings & dimensions
4-?
? ? • Right-of-way and street width (to back of curb) •
11 ? • Proposed home dimensions including any proposed decks
overhanOs greater than 2'
? ,
,
porches, etc. (.e, all structures requiring permanent footlngs)
O • Show all easemenis of record and any Cily utilitles wi[hin those easemenfs
? a ?
? Gr' ? • Setbacks of proposed structure and sideyard setback of adjacent ebsting strvctures
'
• Retaining wail requireme
any
Reviewed: O
Name / ate
Juy 1995
3 RI. r.u.1,
' 21+49
V?\ N •?
26.5 ? . 4
? . -I/16 BEND 54.0 • 4C0'
O
00? S9WOt59 s47;w 99
893.7
• 7l0.0? ?I? Q J B93.534 28 > < 2
t?p??0 6"-I/16 BEND
? SAN. M.H.7 46.0' , M.H. 6
? . 38.5` 4 RT. P.O.C. 20+50
48.0?
• t S&WOt82 80A,
- a42;w33'
S&WOt68 895J 27 - I o
, s42;32, 6"GATE VALVE , ? ( S9wo+3!
901.4? 6"x6"TEE 62.0 ? s49,w57'
? 895.2
6u I/16 ?\63.0S9W0+5/ pRESSUFE REDUCING FACIUTY END ?
?t42,w32 8(2)6 GATE VALVES TO BE : J
909.6 INSTALLED BY CITY OF EAGAN- \q,
: REF.It NOTICE TO CONTRACTORS'? NOTE- ryh
? UPPER R16HT. '
62.? Q . ?.p
=8"x8"TEE ? ?O =o
j 8"x6" REDUCER 26
? 25 79.0' co J s
6"- i/ I6 B E N D 32.0 = 61.0? •4' T P.O.C3 y.
19+13 35.5` 6" GATE ? S O+lo
VA4VE s 46; w66'
55.0_??- 2 897.9
J
r
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' CITY OF EAGAN PROJECT N0
92-UU
{. 3 F
JT $CALE .
• . . . " ?. ?r
SMEET ? ?. t .4,?l•?°a
BAR SCALE SANITARY SEWEP. / WATERMAI?T
p? aooK PAGE Hawthorne Woods Dr. - Sta. 9+70 to 21'+78 6 C /
.
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EXTERIUR EtJVEIOPF. A+/Ef:AGE "U° COi1f'UTAlIOf!
0411IER •
$ITE ADORE55 Lc9'r ? ?i !i? i4? 1v n n ? ?0,;?,J. ?d;.,.•?;-?? /,/_ ;, r
coNrRacrart 3' , S HoMES •, INc . nnrE S- 3-?PS PfIONE 686 - qoyz
Determine working square footage of each.
l. Total exposed wall area ..... Zg&Z sq. ft. x.II = 3 4.8z
• 2. Total roof/ceiling area ..... ?(SO sq_ ft. x.0 z b = z9.9o
v+L
7ota1 exposed wall area above floor = Z 5 7G °'
a. Total wall window area ........................... Z4-7.44
b. Total door area................................... 5-1- ,76
c. Total sliding glass door area ................... 34,38
d. Total fireplace wall area ........................ 00.00
e. Total wall framing a rea (average i0%).._:........ z5-I_60
f. Total net.wall area above floor ................. z 318.4o
g. Total rim jvist area ............................ za oo(,
. ? Total ekoosed foundation area
h. Total foundation window area ...........:......... `.bS6.012
i. Toal net foundatton area abcve grade ............ 13 °'
Deter-mine "U" value cf each taall segment.
a. ?q-7.44
b. 57•?IS
c: 34.38
d
e.
go-oo
Z 5"7-60
x itu^ .33 = ? L 65
X „ui, .07 = 4.04
X „u,o. .4? = 1.5.8? .
X „uii .04 = 3.Zo
x flu,, .Oq = Z 3.1 B
f. 2-31B .4c) X„u,i .04 q z.-74
y, 2-86. cd x „ull .b4 - ? 1.44
n._ 56. oc xPluto ,33 = I 6-- 48
i. 134 -60 x -'U'l lS - Zo-?C-)
3 .....................................Tota1 = ? 70.6¢.
If item n3 is the same as, or less than item kl, you have met tlie intent
of S6C 6076(c)2.
Total exposed roof/ceiling area = < «
3. Total skyligfit area ............ ............ ... No NE
k. 7ota1 roof/ceiling•framing area (zverage lOX).._ Il5
1. Total net insulated roof/ceiling area........... loa s
Determine "U" value for each roof/ceiling segment.
?-
` X "U'l _
J•
k. IlS x liu" _02 = 2.3?
1; 1035 X ltult .oZ = ZO.-7o
4 ..................................Tota1 = z 3.oa
I` total of Ir4 is the same as, or less than =2, you have met the intent of
S5C 6006(c)l.
Alternate Building Envelope pesign
io utilize the total envelope systen n_?hod, the values estz5lish=d by the
suM of itwns ;3 and '4 shall not be greater than th_ sum of items ;1 and B.Z.
i. + 2. _
3. - + 4. -
CITY USE ONLY
PERMIT RECEIPT DATE: ZI NJ
ftESIDENTIAL MECHANICAL PERMIT APf'LICATION
CITY OF PAfiRN
S$SO PILOT KPO$ RD
EkfiAN MN 5512E
651-681-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: ? g ??
SITE ADDRESS:
@.
OWNERNAME: RoSlCKi TELEPHONE#:
INSTALLERNAME: Z.e_? 1`(l.°CLJ%CCL( TELEPHONE#:
STREET ADDRESS:
CITY' STATE:
D1- <MnA, Mer4 ..nv* rn rhn narmif wmlr Yvnw
ZIP: 575_Aqa
New residential dwelling unit under constructionand not ownerloccupied $ 70.00
Add-on, modification or alteration to existin dwelling unit $ 50.00
. furnace replacement
• air exchanger
• air conditioner
• other
Nature of work: ?? riJE ?Q [ ?f r I(
State Surcharge $ 50
Total $.-6
Reminder: Ca[I for inspections.
(AREA CODE)
s/- fa -1s(s_
(AREA CODE)
S1JRE OF PERMITTEE
Updated 1101
CITY USE ONLY
PERMIT #:
APPROVED BY:
INSPECTOR
RECEIPT DATE:
COMMERCIAL MECHANICz?L PEftMIT APPLICA1'ION
CI1'Y Of £A6AN
3$30 PILOT KNOB itD
EAkfiA1V, MN 55] 28
651-6$1-4675
Please complete for: all commercial/industrial buildings
multi-family buildings when separate permits are not required for each dwelling unit
DATE:
SITE ADDRESS:
OWNERNAME: PHONE#: -
(AREA CODH)
TENANTNAME (IMPROVEMENTS ONLY):
WAS THERE A PREVIOUS TENANT IN THIS SPACE7 Y N. NAME:
INSTALLER:
ADDRESS:
CITY:
PHONE #: -
(AREA CODE)
STATE:
WORK TYPE: New construction Install U.G. Tank
_ Interior Improvement _ Remove U.G. Tank
_ Processed Piping
Specify Nature of Work
When installing/removing underground tank, ca[I 651-681-4675 for inspection by Fire Marshal and
P[umbing Iinspector.
Fees: 1% of contract price OR $50.00 minimum fee, w6ichever is greater.
Underground tank removallinstallation = minimum fee
Contract price: $ x 1%= $ (Base Fee)
State surcharge calculate at $.50 for each $1,000 Base Fee
TOTAL $
SIGNA"i'URE OF PERMITTEE
Updated 1/Ol
2004 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122 ?? 4?_b
651-675-5675
Please complete for modifications to existing residential dwellings.
Date 'Pri_ /
Site Street Address a Wk?ro,_x? WG?J S
?/ r
Unit #
Property Ownere?_ Telephone # ( )
Contractor _ y1 b?er LLC Telephone #
Address Lo?? ? I Le? ? 5 City s2h?25-e State 'Y Zip ?- 3
The Applicant is: _ Owner (/Contractor _Other
Alterations to existing dwelling
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
W ter Turnaround (add $121.00 if a 518" meter is required)
er
Ani ?
S c?ysl
WA_
?,,? ?p
ral?.+w( !
Sof
$
50.00
WaterSoftener WaterHeater
_ replacement _ additional $ 15.00
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge $ .50
Total $ ?' 6v
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
?????? ? ? ?
Applic' ant's Printed Name ApplicanY Signature ? ppR 2 9 20?4
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MPI 55122
Telephone # 651-675-5675 FAX # 651-675-5694
-S,g0.od
c,-? q-- l ?
New Conslruction Reauiremenls RemadeVReoair ReauiremenGS Office Use Oniv
3 registered site surveys showing sq. k. of lot, sq. ft. W house; and all roofed areas 2 copies of plan Cert of Survey Recd _Y _ N
(20% maximum lotcoverage allowed) 1 setof Energy Calculations for heated additions Trea Pres PWn Recd _Y _N.
2 copies of plan showing beam & window sizes; pouretl (ound design, etc. i site survey for addiUOns 8 decks Tree Pres Required _ Y_ N
lsetofEnergyCakulations Add'rtion-indirafei(onsitesep6bsystem On-siteSepticSystem _Y _N
3 copies of Tree P2servation Plan if bt plalted after 7/1193
Rim Joist Defail Options selection sheet (bidgs wiN 3 or tess units
Date -?Y l4 l b< Coustruction Cost o,2 r Doo
Site Address V\C_ ?-l1 O UniUSte #
Description of Work ?-? ??? l S ? y, J?.S e- ?VN C- L',f
Multi-Family Bidg _ Y V N Fireplace(s) _ 0 y 1 _ 2 '
Property Owner j< -e ?4-- ? e 1?. r
x, ut- (-ct R o 5) ?? I \ V Telephone # (6 ?/) (o g6 ^ (X`2
Contractor ?? ?-? ? ? r ?C' ?G^ ?O Y?--?`r C+ I 0 ??
Address c-l,?\ G` -6, o 4 City Wf-(o54--2 vN
State Zip ,SS'O Telephone # ( 6(? ? ? c-'-7
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672
Energy Code Category . Residential VenGlation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constructed a building in Eagan with a similar plan8
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Y_ N If so, 25% plan review
Telephone #(
I hereby apply for a Residential Building Permit and ac ation is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; 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.
9e0 Ag A / d ?,so aA
Applicant's Printed Name
ApplicanYs Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? , 07 05-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Att - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ex[. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg,-(Y or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
0 32 Addition ? 36 Move Building ? 42 Demolish FoundaGon ? 45 Fire Repair
w 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Uemolltion (Entire Bldg) • Give PCA handout to applicant
Valuation ;- 0 0!7 Occupancy MCES System
Census Code _ L7"?i ? Zoning City Water
SAC Units ? Stories Booster Pump
# of Units O Sq. Ft. PRV
# af Bidgs / Length Fire Sprinklered
Type of Const Width
_ Footings (new bldg)
_ Footings(deck)
_ Footings (addition)
Foundarion
Drain Tile
Roof Ice & Water Final
? Framing -
_2( Fireplace _ R.I. _ Air Test _ Final
?r Insulation
REQUIRED INSPECTIONS
FinaUC.O.
6 FinaUNo C.O.
Plumbing
li HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests Final
_ Siding _ Stucco __ Stone _ Brick
_ Windows
_ Retaining Wall
Approved By: 6 Q`f' / 9-° Building Inspector
Base Fee
Surcharge
Plan Review
MClES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
I ..
?
* pIonieeA
? `eng neer
****
°
LAtJD SURVEYpiS • CIVR E
LAND PUNNEAS. LANDSCAPE
2422 Enterprise Drive
Mendota Heights, MN 55720
(612) 681-1914 FAX:681-9488
625 Highway 10 N.E.
Blaine, MN 55434
(612) 783-1880 FAX:783-1883
Certificate of Survey for: J& S HOMES. INC.
545 HAWTHORNE WOODS DRIVE
EAll P1 N
REViE ED
3Y
)nTE
K ?
21
(qoz. s)
gt 4, 1
N81 c?20'57"W
6- e?iz?eL?
NOTE: PROPOSED CRAOES SHOYM PER CRAUING PLAN BY: MFR
NOTE: BUILOING DIMENSIONS SHONN ARE FOR HOFtIZONTAL AND VER7ICAL LOCATION
OF STRUCNRES ONLY. SEE ARCHIiECNAL PLANS FOR BUILDING AND
FOUNDATON DIMENSIONS. '
NOTE: NO SPECIFIC SOILS INVESTGA710N HAS BEEN COMPLETEO ON THIS LOT BY THE
SURVEYOR. 7HE SUITABIUTY OF SOILS TO SUPPORT THE SPEqFlC HOUSE
PROPOSED IS NOT iHE RESPONSIBILIIY OF iHE SURVEYOR.
,-BENCH MARK
E?EV? 9 2 53
?
?
/
?
3c
^
`
?
NI
p?
ol
3
?
s.3W I
?I
O
?I
l
?
o
0lLFoMo
p o ?l??t"
tt
PROPOSED HOUSE EL
LOWEST FLOOR ELEVATION: EVATION
132141
TOP OF BLOCK ELEVATION: 90 ?1-0
GARAGE SLAB ELEVATION:
N01E: TMIS CER71FlCnTE UOES NOT PURPORT 7D SHOW EASEMENTS OTHER 7HAN X 000.00 DENOTES EXIS7INC ELEVA710N
THOSE SHOWN ON THE RECOFtDED PLAT. ( D00.00 ) DENOlES PROPOSED ELEVATION
NOTE; CONTRAC70R MUST VERIFY DRIVEWAY DESIGN. --- DENOTES DRAINAGE AND UTILItt EASEMENT
- ' DENOIES DRAINACE ROW DIRECTION
NOTE: BERRINGS SHOWN ARE BASED ON AN ASSUAIED DATUAI -0 DENOTES MONUMENT
B DENOlES OFFSET HUB
WE HEREBY CERTIFY TO J& S HOMES, INC. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A
SURVEY OF THE BOUNDARIES OF:
LOT 28, BLOCK 2, HAWTHORNE WOODS 2ND ADDITION
DAKOTA COUNTY, MINNESOTA
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR
UNDER MY DIRECT SUPERViSION THIS 31ST DAY OF JULY, 1995.
SCALE :. 1 INCH = 30 FEET
94188.04 swic
PIONEER E 6INEERIN P.A.
?
Larson, L.S. Reg. No. 19828
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 545 Hawthorne Woods Dr
Lot: 28 Block: 2 Addition: Hawthorne Woods 2nd
PID:10- 32151- 280 -02
Use:
Description:
Sub Type: e - Air Conditioner
Work Type: New
Description: Air Conditioner
Comments:
Fee Summary:
Contractor:
Controlled Air
21210 Eaton Ave
Farmington MN 55024
(651) 460 -6022 X253
Quesetions regarding elec
445 -2840
Chris Musta
21210 Eaton Ave
Total:
Applicant/Permitee: Signature
PERMIT
City of Eaan
Permit Type:
Permit Number:
Date Issued:
Permit Category:
cal permit requirements should be directed to Mark Anderson, State Elec
ME - Permit Fee (Replacements)
Surcharge -Fixed
- Applicant -
$50.00 0801.4088
$0.50 9001.2195
$50.50
Owner:
Michael J Rosicki
545 Hawthorne Woods Dr
Eagan MN 55123
Mechanical
EA089678
06/15/2009
ePermit
cal Inspector, (952)
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply
h all applicable State
Issued By: Signature
C!ty of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
Permit Fee:
Date Received:
Staff:
2014c�,�/
RESIDENTIAL BUILDING PERMIT APPLICATION
t -
Date: FA /--C9 Site Address: '7` r�r: C ll� V` ;r Unit #:
Name: /, U\f`G'. O( t L
Resident/
Owner
Type of Work
Address / City / Zip:
Applicant is:
Description of work:
Svt
Phone: S / —3Y3
Av0 Woo.
Owner 6 Contractor
✓u'VNI-Q C(C d (0- (-0
Construction Cos 000
Multi -Family Building: (Yes / No )
Contractor
Company: c SJCCC�C Contact:
Address:5-19 ` \ L 5 City: CZ b\C
State:V� Zip: 50
License #:
Phone:
Lead Certificate #:
-oiz??
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
Ac ('
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
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 wit 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 Buil ng Code must be co ' pleted within 180
days of permit issuance.
x
Applicant's Printed Name A icant's Signa ure
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA145176
Date Issued:08/28/2017
Permit Category:ePermit
Site Address: 545 Hawthorne Woods Dr
Lot:28 Block: 2 Addition: Hawthorne Woods 2nd
PID:10-32151-02-280
Use:
Description:
Sub Type:Reroof & Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and house wrap and leave on site.
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: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 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 -
Michael R Fretschel
545 Hawthorne Woods Dr
Eagan MN 55123
(612) 867-0256
Beissel Window & Siding Co
1635 Oakdale Ave
W St Paul MN 55118
(651) 451-6835
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA162010
Date Issued:06/22/2020
Permit Category:ePermit
Site Address: 545 Hawthorne Woods Dr
Lot:28 Block: 2 Addition: Hawthorne Woods 2nd
PID:10-32151-02-280
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Michael R Fretschel
545 Hawthorne Woods Dr
Eagan MN 55123
(612) 867-0856
Homeworks Services Co Dba Homeworks Plumbing Htg
1230 Eagan Industrial Rd, Suite 117
Eagan MN 55121
(612) 400-9020
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA162010
Date Issued:06/22/2020
Permit Category:ePermit
Site Address: 545 Hawthorne Woods Dr
Lot:28 Block: 2 Addition: Hawthorne Woods 2nd
PID:10-32151-02-280
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Michael R Fretschel
545 Hawthorne Woods Dr
Eagan MN 55123
(612) 867-0856
Homeworks Services Co Dba Homeworks Plumbing Htg
1230 Eagan Industrial Rd, Suite 117
Eagan MN 55121
(612) 400-9020
Applicant/Permitee: Signature Issued By: Signature