4486 Mallard Tr NSETeVER.& WATER PERMIT
CITY OF EAC;AN ?
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE ''?lql 'S,1991
METER # -
CHIP # -
METER SIZE
ISSUE DATE
OFFICE USE ONLY
PERMIT DATE 0, 2"% ' j
PERMIT # l ? 17 i
B.P. RECEIPT # = S
B.P. RECEIPT DATE
XXx PRV - BOOSTER PUMP
qL8•.
SITE ADDRESS ' o. I'•' -llar d TY •
LOT -' -'BLOCK 1 SEC/SUB Thomea t.a3ce 4loods
APPLICANT: TeeeFh Ai_ Miller '?rhr "nc
ADDRESS: _1613 3 C e d a r Av S•)
CITY, STATE T "`• "`,- ' ?- ^T) ZIP
PHONE:
PLUMBER;
ADDRESS: I47h.5 So Re'ver. [?`r _
CITY,STATS.;os3Innunt, ..4rG ZIP iPHONE: ? 2 3-1 14 4
OWNER: -
ADDRESS: _
CITY, STATE
PHONE: -
PERMIT REQUESTED
_ SEWER WATER _ TAPS
COMM/IND RESIDENTIAL
'_ NEW _ EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
? -;.Zf -s1
GREE TO COMPLY WITH CITY OF
GAN ORDINAPICES
ZIP
51GNATURE WHEN METER ISSUED
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING DEPT.
?I
CASH RECEIPT
CITY QF EAGAIV
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
.
?
DATE ? 19 ?
aecerveo
sAOM
?
aMOUNT a J; l.}Li
& DOLLARS
,m
p CASH 1kCHECK
Li C?
i
FOR t
;?-
? +nmita--Pevere coay ?
ve?w?Posuny copy
Pink-Fil8 Cqpy
Thank You
BY , --
SEWER & WATER PERMIT
CITY OF EAGAN
3830 Pilot Knob Rd.
Eagan, MN 55122-1897
DATE Tu r, 9 1
?/ OFFICE USE ONLY
METER#`Y4T 4(0PERMITDATE 07124/91
CHIP # PERMIT # 12171
METER SIZE S B.P. RECEIPT # C 14616
15SUE DATE g- o -3'g4 B.P. RECEIPT DATE 07 23 /yl
xXX_ PRV _ BOOSTER PUMP
SITE ADDRESS 1 A i 1 a rd T 2' ,
LOT ABLOCK I SEC/SUB ThomRS La1ce:'oo&s
APPLICANT: _i ?? i 1 1 e.- ' o n?.t I t2c _
ADDRESS; .- :; 13 3 G e d a r Av S o
CITY,STATE T'armYneton, .tn ZIP '? )24
PHONE: 431- 2 0 C 1
PLUMBER: ' , t_ ?? - Pys ri
ADDRESS: t 4 745 S a ? e11e r t ?' r?
CITY, STAT?Z o s el o u n t. Mn ZIP
PHONE: 4 2 3- 1 144
OWNER: -
ADDRESS:_
CITY, STATE
ZIP
PERMIT REQUESTED
X SEWER `' WATER - TAPS
- COMM/IND x RESIDENTIAL
X NEW - EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
I AGREE TO CO PLY WITH CITY OF
EAGAN ORDIN?CESn II
PHONE: Q1%anN I vnc W11f7GM MG 1 Cn 1.7JVGY
PLEA5E ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEWER PERMITS, CONTACT ENGINEERING QEPT.
9 MILLER CoNST.-431-2001 CITY OF EAGAN -
• 3830 Pilot Knob Road, P.O. 8ox 21-199, Eagan, M
P HON E: 454-8100
IIL.DING PERMIT F7arainf A
Est. Value f121,000
5ite Address 4466 1'10 lIALL
Lot I I_ 34ock 1 Sec/Sub.
Parcel No.
W Name Jv3arq rs MiwAu WMT
o Address 18133 CFDAR Al/B s0
City EARM1ICMN Phone 431-2001
Name
Phone
Address -
City
Phone
acknowlege that I have
on is correct and apree
Signature of Permitee - -?'
A Building Permit is issued to:
on Ihe express condition that
applicable State of Minnesota
Building Official
ition and state that the
all applicable State of
?
Occupancy
Zoning
(Actual) Const
(Allowable)
# oi Stories
Length
Depih
S.F. Total
S.F. Footprints
On Site Sewage
On Site Well
MWCC System
Ciry water
PRV Required
Booster Pump
APPROVALS
Planner
Council
Bldg. Off.
Variance
? 1?•?4 13
JULY 29 19 91
OFFICE USE ONLY ?
8-3. 144 FEes i
!D i
VlM Bldg. Permit 3 719.00
1111- Surcharge 60.30
67,5 Plan Review ?3600
00 '
100
-31-- snc, city .
- sac, Mcwcc 5?'? ?
Water Conn 660.00 ?
95•00
water Meter
xx koct. Deposrt 30.100
S/W Permit 30*00 .
.30
- S/W Surcharge 276900
Treatment PI 370,00
Road Unit
- Park Ded.
_ Copies
? ??
- TOTAL ?
Permit No. Pertnit Holder Date Telephone #
WATER 1,2?
SEWEfi
PLUMBMG ? 341 ?03
H.V.A.C. l
ELECTRIC
Inspection Date Insp_ Comments
Footings I v 9! ?
Foundation
Framing • Z ? g p.S
Raofing
Rough Plbg. ?? 3•-l'
Rough Htg. g QS(? ?/ (J?? + ?? ?
Isul. ?
Fireplace
Final Htg.
Orstat Test
w
Fina1 Plbg. Plbg. Inspector- Notffy Plumber
ConSt. Meter
Engr./Plan
slay. Final
9.?71
l[??
Oeclc Flg.
Deck Final J 7 ?3 lG?f
Well
Pr. Disp.
?. ?
Y
'? ?. '?? ` .. . . , ,' ?'? n . ' .V . _ . ' . ?
se
fgtrti#iratr of (IDrrupartry
Citp of (Eagan
EFpwrtqiM1# of %dbhW JI[SppC#tD1t
This Certificale issued pursuant to the requrrements ojSection 306 ojrhe Urriform Building
Code certe; fying that at the time of issuance this structure was in compliance with the various
ordinances of the City regulating building anrtsbuction or use. For !he following:
use camrmdoo $E' nr_/r.eu &ag. Pe,m;, No. 1944
OocuPancY Type S??T- ToninB Disuict pp Type ccmK VN
Owoer of BuildinJOSM MMU,1,ER CMM Addrtas r--?a s?
Building Add= i.oalityL!I,.$ ?
oac« 0T2710I
- e?aa?na' o?
POST IN A CONSPICUOUS PWCE
DATE:
JUL 24, 1991
RE: 4486 N MALLAftD TR (JOSEPH H MILLSS CONSTRUCTION IHC)
X Your yStwer & Water Permit for the above property has been completed. It will be held at the
Publib Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
Ci,ALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMEHCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by BiII.Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES - TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN OM POLICY.
Secretary, Building Inspections Dept.
Address; GCFgb NpRIH MALS,ARp TRAII, Lot I ] Blk I Sec/SubgHCMAg ],A((E "n$
These items were/weYe not complete at the time of the final inspection.
?/27/91 Yes No
F,inal grade (6" from siding) ?
Permanent steps - garage ?
Permanent steps - main entry ?
Permanent driveway
Permanent gas y?
Sod/seeded grass L/
Trail/curb damage ?
Porch
Basement finish
Deck ?
Please verify with tha builder the removal of roof test caps from the plumbing
system and tha shut-aff of water supply to the outside lawn Eaucet heEore
freeze potential exists.
PECRIFOMRP
White - City copy Yellow - Resident copy Pink - Contractor copy
BUIIDING PERMIT
To be used for SF DWG/GAR
Site Add(ess 4486 NO MALL
Lot 11 Block 1 SeGSub
Parcel No.
W Name JOSEPH M MILLER CONST
a Address 18133 CEDAR AVE SO
City FARMINGTON phone 431-2001
o Name SAME I
g¢ Addre55
City Phone
? W Name
?? Atldress
a W CitY Phone
I hereby acknowlege that I have reatl this application and state that ihe
inlormation is correcl and agree to comply wilh all apphcable Slate of
Mmnesota Stamtes an ?ry of Eagan r ina `
c
Signature ot Permnee
A Bmldmg Pertnrt is issued to: CORST
on Ihe express condition that all work shall be done in accordance with all
applicable Slate of Minnesota St tules and City ol aga,n Ortlinances.
Building Offiaal
? S
Receipt #
Est. Value $121,000 Date_
D TRAIL_
THOMAS LAKE WOO S
CITY OF EAGAN
3830 Pilot Knob Road, P.O. 6ox 21-199, Eagan, MN 55121
PHONE: 454-8100
Occupancy
zoninq
(AClual) Const
(AllowahlB)
s ot stories
Lenglh
Depih
S.F. Total
S.F.footpnnls
On Sita Sewage
On $ite Well
MWCC System
Cily Wafer
PRV Reqmred
Boosier Pump
APPROVALS
Planner
Council
Bldg. OH.
Variance
N° 19448
9 1s 41
OFFICE USE ONLY
R-3, M-1
PD
FEES
$ 713.00
60.50
463.00
100.00
650.00
660.00
95.00
30.00
30.00
.50
276.00
370.00
Vn Bldg. Permil
_yn-
67.5
36-
XX
XX
_XX_
Sumharge
Plan Review
SAC, City
SAC,MCWCC
W eter Conn
Watar Meter
Acct Deposit
S/4Y Permil
S/W Surcharga
Treatment PI
Road Unn
Park Ded.
Copies
70TAL ?
$3,440.00
5 °?5°s??
/
p 31
?7 9/ ?? '?e ?.
?
Requesl Oate 8-6-91 Fne No Rough-in Inspectmn
Requned+ ? Ready Nov,?]JOItlMloldy Inspector
? G No When Reatll
1 uhCensed contractor ] owner hereby request inspecnon of above electncal work at
'oibWI'ft NXLtARD TRAIL C"y EAGAN
Secuon No TownsM1ip Name or No Ranqe No Counry DAKOTA
"`ul6iRMILLER CONSTRUCTION Phone No 612-431-2001
P°`"elAK'l'STA ELECTRIC, ASSOC "aa'e. FARMINGTON, MN
Elettncal Comractor ICOmpany Namei Conlractor5 Licensa No
MIDLAND ELECTRIC, INC. 041610
Maibng Aoaress iCOnnactor or Owner Mamng Installationl
7630 145TH STREET WEST, APPLE VALLEY, MN 55124
AutM1On<ed Si
? r ontretloOwn a' nsianauon)
Phone Number
? 612-432-6688
8
MINNESOTA STITE BOPFO OF ELECTRICITY THIS WSPECTION FEOUEST WILL NOT
Gngqa-Mldway Bltlg - Poom 5473 - ' BE ACCEPTED BY THE STATE BOARD
1831 Universrry Ave, 51. Paul. MN SSiDG . l1Nl.ESS PPOPER INSPECTION FEE IS
Phene(612)642-0800 ENCLOSED
F/8' /G?, REQUEST FOR ELECTRICAL ![JSPECTION
? Iii, See msVUCtons lor compleling Ihi5lorm on OecX al yallow copy
O'l1 779 "X" Below Work Covered by This Request
??i;? 7098
ew Add Rep, TypeofBwlding ApphancesWued EquipmentWired
./ ? Home ange Temporary Service
Duplex Water Heater Elechic Heating
Apt Bwlding Dryer Other (Specity)
Comm /Intlusirial urnace
Farm Air Conditioner
Otharlsyemlyl ConVactors Ramarks
Compute Inspection Fee Below
# Other Fee # Service EniranceSrze Fee # CirwitslFeeders Fee
Swimming Pool ( 0 to 200 Amps ta 100 Amps tr?
Transtormers Above 200 _ Amps Above IDO _ Amps
Signs inspeaors use omy TOTAL
Imgauon Booms
_ Special Inspedion ?
AlarmiCommumcation THIS INSTALLATION MAV BE OHDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 78 ONTHS.
1. the Electncal Inspector. hereby
ceridy thai the above inspecLOn has
been made. Rooqn-m
F,,,ai Date
oa? l
OFFICE USE ONLY '
This reqves; witl 18 months irom
S ?a ( S RESIDENTIAL
7 BUILDINC PERMIT APPLICATION
CITY OP EACAN
3830 PILOT KNOB RD, EACAN MN 55122
651 •681 •4675
New Constructlon Reuuirements
. 3 regisleretl site surveys showing sq ft. of bt, sq. fl, of house; and all roofed areas
(20°%marimum lot coverege allowed)
. 2 toDies of plan showirg beam 8 windaw srzes; poured found Gesgn, etc.)
• t sel of Enerqy Caiculahons
• 3 co0ies of Tree Preservatian Plan A lot platted aRer 711/93
. Rim Joist OeWd Options selecGon shee[ (bfdgs with 3 or less units)
DATE
SITE ADDRESS TTifb N MRI al 7X
TYPE OF WORK I E' f?1?? Ilf-
APPLICANT /?1,? 51-r ;'(pw OcleI/f;
G
MULTI-FAMILY BLDG _Y z
_,/ N
_ FIREPLACE(5) _ 0 _ 1 _ 2
STREETA8gRESS cJJr ?)fy CITY L??? ??STATE?P?
TELEPHONE # V516 08?y CELL PHONE #65I ?69 3 1??s FAX #
x o sl7u 15
PROPERTY OWNER ?D f?2?1 GL? J+ee'4 TELEPHONE #
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Cate9ory
(v submission type)
Plumbing Contractor: ___
Pluinbing systcm includcs:
1IIVNl•:SO"G\ RCLI:S 7670 C:\TEGORI" 1 bIINNESO"C\ RCLES 7672
. Residen6al VenGlation Cacegory 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculalions Submitted
I 1 ?^?j 1 C 7?J) ??:
Phonc
_ W ater Sof[ener _ Liwn Sprinkler ? Fee: 590.00
_ Water Heater _ Noi'bf12.I._Baths_ _
No. of Baths
Mechanical Contractor:
Mcctlvnic.d sNslciti includcs:
Sewer/Water Contractor:
:\ir Condiuoning
Hr<u Rccovcry Systctii
I hereby acknowledge that I have read this application, state that the
with all applicable State of Minnesota Statutes and City of Eagan Orc
Signature ot Applicanf
OFFICE
RemodelfReuair ReuuiramenM
• 2 copies of plan
• 1 sel of Eneyy Calculations for heatetl additions
. 1 site survey Mr exterror additions 8 decks
• Indicate d home served by sepGc system for addiEons
VALUATION 6420
Pcc: 570.00
is correct, and agree to
Phone #
Phone #
Certificates of Survey Received - Tree Preservation Plan Received - Not Required _
Updated 4102
53?5 RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Constructlon Reculrements
. 3 registered site surveys showirg sq. R of lot, sq. ft. of hause: and all roofed areas
(20% mazimum lot coverage allowed)
. 2 copies of plan showing bearn 8 vnndow saes; poured found design, etc )
• 1 set of Energy Calculations
• 3 copies of Tree Preservation Poan if lot platted afler 717/93
• Rim Joist Detail OOtions selection sheel (bldgs wiU 3 or less units)
DATE 712 -,;" lbs-
-?S
RamodeUReoair Recuirements
. 2 copies of plan
. 1 set of Eneyy Calculaliore kr heated additions
. 1 site suney for exterior addihans & decks
• Indicate'rf home served by septic system for addihons
VALUATION /?$O• 25
SITE ADDRESS `f4 Yri (o f?, f0odIll +ra 'I ? MULTI-FAMILY BLDG _ Y _ N
TYPE OF WORK yQ -?L FIREPLACE(S) _ 0_ 1_ 2
APPLICANT &GG ?rtvt?aP??rv`
STREETADDRESS (21Zb ?'v2??.(oad CITy ?v?rnsv??(2 STATEMa ZIP SS33-7
TELEPHONE #
CELL PHONE #
FAX #
, / `'V A ? ? r
TELEPHONE# I0S ?"`{j4 029C)
PROPERTYOWNER +e? I
---------------------------------------------- --------------- ------------------------ ----------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESO'1'A RLiI.ES 7670 CATEGOI2Y 1 MINNI:SO'fA RiJL1:5 7672
(J submission type) • Residential Ventilation Category l Worksheet Su6mitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor:
Plumbing systcm includes:
Mechanical Contractor.
Vlcchanical systcm includcs:
Sewer/Water Contractor:
_ Air Conditioning
_ Heat Recovery Syslem
Phone #
Phone #
Fce: $90.00
Pcc: $70.00
-------------°---------------------------°----------------------...---------------°----------------------°------------
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances_
Signature of Applicant (>' ^
OFFICI; USI: ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _
_ Watcr Softencr
_ Wa[cr Heatcr
_ No. of Baths
_ Phone #
Lawn Sprinkler
No. of R.I. Baths
I?) : it ti 3 ?_ 7002 Not ? "wred _
? Update'4/02
? •,? ??- --_ -
CITY OF EAGAN
3830 PIIAT RNOB ROAD
EAGAN, MIlV 55122
PHONE: (612) 454-5100
..... ...
.:.... ...?.??:;:?
????E?
?,
?
PLEASE COMPLETE IIPpER PORTION ONLY FOR SINGLE PAMILY DWELLINGS 6
TOWNHOMES/CONDOS AHEN PE1ttSiTS ABE REQIIIRED FOR EACH i1NIT.
WORK DESCRIPTION
NEW CONST ?
ADD ON
REPAIR
OWNER NAME: JOE MILLER CONSTRUCTION C0: INC.
SITE ADDRESS:
e ????
LOT: BLOCK SUBD. [.f/1v/N[!,0 rJ5-aAe_ G?00(d
INSTALLER: GENZ-RYAN PLUMBING & HEATING C0.
nDDxESS: 14745 South Robert Trail
CITY: Rosemount, MN ZIP: 55068
F<:ONE
SIGNATURE
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
ADD-ON MINIMUM 15.00
I SHOWIIt 3.00 ?
? WATER CIASET 3.00 ?
BATH T[JB 3.00
? IAVATORY 3.00 "y
? KITCHEN SINK 3.00 3
? IAUNDRY TRAY 3.00 0
HOT TOB/SPA 3.00
? WATER HEATER 3.00 ?
? FLOOR DRAIN 3.00 .3_
GAS PIYING OUT.
(MINIMt]M - 1) 3.00 3 ?
? ROUGH OPENINGS 1.50 ?v
oTHER
WATER SOFTENER 5.00
PRIVATE DISP. 15.00
_ U.G. SPRINKLER 3.00
' tl
SUBTOTAL
ST. SURCHARGE .50
TOTAL: $ V,!l
PLEASE COMPLETE THIS PORTION FOR ALL COHIiERCIAL/INDUSTRIAL BIIILDINGS AND
MULTI-FAMILY BIIILDINGS WHEN SEPARATE PERMITS ARE NOT REQIIIRED FOR EACH
DWELLING IINIT.
,. ,
CONTRACT PRICE:
OWNER NAME:
SITE ADDRESS:
LOT:
INSTALLER;
ADDRESS:
CITY:
BLOCK _ SUBD.
FOR CITY IISE ONLY
PERMIT #
RECEIPT # `
DATE:
FEES
18 OF CDNTRACT FEE.
STATE SURCHARGE - $.50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMOM FEE.
CONTRACT PRICE x 19 $
STATE SURCHARGE $
TOTAL:
$
ZIP:
PHONE #:
FOR:
(SIGNATtJRE)
423
CITY OF EAGAN
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
.
?4?G??:A"1:3:amq
FOR CITY IISE ONLY
PERMIT #
RECEIPT #
DATE:
.. ........... ..............
RES?DE1?TxZAL.: PLEASE COMPLETE IIPPER PORTION ONLY FOR S G
....
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
-------°---------
WORK DESCRIPTION
NEW CONST ?
ADD ON _
REPAIR
OWNER NAME: __T( 'e? ?
F
SITE ADDRESS: ? ? e
? ?4 lN68G?P
LOT?? BLOCY. SUBD.
INSTALLER: \ S?F ?CC?` ? ? ? `(1
ADDRESS: V• 0• 1 ?? ???c1 ? tiCS _
CITY: V_ ? ZIP:
PHONE # • " `Y O- ?CJO a'a
FEES
Y DWELLINGS &
--------------
ADD-ON MINIMUM
Hl1AC 0-100 M BTU
ADDITIONAL 50 M BTU
GAS OUTLETS - MINIMUM
OF 1 PER PERMIT
SUBTOTAL:
STATE SURCHARGE:
$15.00
24.00
6.00
3.00
.50
TOTAL: S?v
OF PERMITTEE
COMM?RGTAY, ?IJbUSTRTA?.?. PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDZNGS,
1.......:.. :. ' .
APARTMENT BUILDINGS, AND MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE
NOT REQUIRED FOR EACH DWELLING UNIT.
-------------
CONTRACT PRICE:
OWNER NAME: _
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE
FOR:
CITY OF EAGAN
FEES
18 OF CONTRACT FEE.
STATE SURCHARGE _ $.SO FOR
EACH $1,000 OF PERMIT FEE.
'rRdCr.SSED FiPING = $25.00
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1% $
STATE SURCHARGE
TOTAL:
(SIGNATURE)
UNDERGROUND SPRINKLER SYSTEM
PLUMBING PERMIT
Date: /D - S"- -? / Permit #
Date /%/9/
Receipt # 103 3Co
_ Commercial: $25.50 + water tap if aequired. (City installs all taps up to 1"). If
adding new service, a water permit will be required, as well.
_ Faosting residential: $15.50 (Plumbing permit not required if backtlow preventor was
previously installed).
_ Residential develonments: Fee to be d;.termined by building inspections department.
May require payment of water permit, plumbing permit, WAC, and water treatment
plant fees. LIlj 611
(Address to be sprinklered)
Homeowner/Plumber: ? e-'2? ?-?_J
Phone #: LA , R-e/ 9 P" S!
Street Address: o? 0 J73 O I$ox?l9
City, State, Zip:
Owner Name:
Street Address:
Phone #:
Irrigation Contractor. ???",? ?-•n.K???-?
Phone #: fgl -.26 9 Z
z
I er b acknowledge that I have read this s?pplication and state that the information is
e d ee to Apjqly with all applicable City of Eagan Ordinances
x
cc: Engineering Department
CZTY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MN 55122
PHONE: (612) 454-8100
p3p3iBINC
FOR CITY USE ONLY
PERMIT #
RECEIPT #
DATE: 8 9
?Mm37TSAI:IAl PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS &
TOWNHOMES/CONDOS WHEN PERMITS ARE REQUIRED FOR EACR UNIT.
----------
-----°----------------- -----------------°-
WORK DESCRIPTION ---------------------------
COMPLETE TNE FOLLOWSNG:
N0. FIXTURES EA. TOTAL
NEW CONST ADD-ON MINIMUM 15.00
ADD ON _ SHOWER 3.00
REPAIR WATER CLOSET 3.00
BATH TUB 3.00
LAVATORY 3.00
OWNER NAME: KITCHEN SINK 3.00
LAUNDRY TRAY 3.00
SITE ADDRESS: HOT TUB/SPA 3.00
WATER HEATER 3.00
?? C/1.,C• ??
LOT:? BLOCK ?
UBD. -
FLOOR DRAIN 3.00
/ GAS PIPING OUT.
INSTALLER:
P_.-a (MINIMUM - 1) 3.00
? ROUGH OPENINGS 1.50
'?P SG
ADDRESS: /?TA7 ? ?'1Axf!lep OTHER
W
TER
ER _
00
5
?
CITy; Zip; A
PRIVATE DISP .
15.00
U.G. SPRINKLER 3.00
PHONE #: ?SJ?)??7 •-
SUBTOTAL S .7'"
ST. SURCHARGE .50
SIGNATURE OF PERMITTEE ?
TUTAL:
COMMERCIAT; INDUSTR3kLE; PLEASE COMPLETE THIS PORTION
I FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS A
_.,.., . <...
.,: . . >
MULTI-FAMILY BUILDINGS WHEN
SEPARATE PERMITS ARE NOT REQiIIRED FOR EACH
DWELLING UNIT.
--°__-__
_______---__
---°----- °____------ °------------------°
CONTRACT PRICE: --°°--------__
FEES
OWNER NAME:
SITE ADDRESS:
LOT: BLOCK _ SUBD.
INSTALLER:
ADDRESS:
CITY: ZIP:
PHONE #:
FOR:
CITY OF EAGAN
18 OF CONTRACT FEE.
STATE SURCHARGE _ $.SO FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 18 $_
STATE SURCHARGE $_
TOTAL:
(SIGNATURE)
RC-Ae?-Tv
1991 BUILDING PERMIT APPLICATZON
CITY OF EAGAN
SINCLE FAMILy DWELL'.'NGS !S[TLTIPLE DWELLZNGS CO:RCIAL
2 SETS OF PIANS :+ 2 SETS OF PIANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - 6 STRUCTURAL PLANS
1 SET OF ENERGY CALCUTATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APYLIES iiHEN: TYPING OF PERMIT IS REQUESTED, SUT NOT PICKED UP BY IAST WORKING DAY
OF HONTH IN WHICH REQUEST IS MADE.
IAT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALIAWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MI1ST SHOW A LICENSED PLUMBER.
To Be Used For: &&i._ Valuation:-L'90 Date:
Site :iddress
Lot LL Block ?
Parcel/Sub ?
Ow[1eY
Address
City/2ip Code
Phone
" Contracto?
(J?
Address 1le
City/Zip Code :y?. s? a-7
Phone y d' or) I
Arch./Engr.
Address
City/Zip Code
OFFICE USE ONLY
Occupancy
#6ftal Const
Allowable
# of stories
Length ?
Depth
S.F. Total
Footprint S.F.
On site sewage_
On site well
MWCC System _
City water _
PRV
Booster Pump
APPROVALS _
Planner _
Council
Bldg. Off. D=T9i
Variance
FEES
Bldg. Permit N ?
Surcharge
Plan Review
SAC, City
SAC, MWCC
Water Conn.
Water Meter
Acct. Deposit
S/w Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trail Ded.
Copias
SIIBTOTAL
Penalty
Lot Change _ /
TOTAL _? i?
v
Phone # f
Iti 5 L
Sewer/Water Licensed Contr.
J,yU 4 agrees that all vprk shall be done in accordance with
(Si ture of Contrac or)
,
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
* -N *
* PIC7NE
? engine
* + ;?*
F' i c.
5819428
P.O2
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Certificate of Survey tor: ?VL ?lLL?? ?OME?G
?
2422 Enterprise prive
Mend01a HeigNts, MN 55120
(C121091-1914'
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?< 900.n Dennfe ?- exisfrn E(eVc?fiarl PROP?SEd NauSE ?LEVA7`IV?NS_
l_?enofes propo.??d Elcv_nfion
-•Ornofes brcrlacre ((/lilrfy Epsemenf l.cnvest F/oc,r 4/evcxfion
•--- np.no{es Drc.inle F7ow Arrows 76p nf L3/ocl! E/evqfion= 960?^
(?ea,?fFC rr7onUmer){' Gai•a?e 5/ab [leva1/vh=r-254.7
o ,--.-
!?ecxr';r??is shnt.vrt are assumed Sub,iect fo ttoscmen{s ,ol"rPr?nrn'
LOT !1 , BLOCK 1, THOMAS LAKE WOaDS ?
?t'n Ca'NrJ' ,?S1rNNE507"q
ghy certlfv d+at Ihiv gp.vzy, plan Crr report was pr?P/p arxA hy rt.a or Uader my direct SUpervi310n and fhat I em r.?qly Regislered ( and :iurveyor
?1a?.s vf lhe StaM of Minnesota, OatBd thl9.. 1ZM day o! - a,,4? A.D. 19
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f 199P BUILDING'PERM AP CATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS
2 SETS OF PLANS
3 REGISTERED SITE SURVEYS
1 SET OF ENERGY CALCUTATIONS
new home
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, SUT NOT PICKED UP BY IAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER IATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER. r_
?! tl L 1 F RECp
To Be Used For:
` Site Address xx
MULTIPLE DWELLINGS
I
CO?4fERCIAL
2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
(CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCUTATIONS 1 SET DF ENERGY CALCS
_# OF RENTAL UNITS
# OF FOR SALE UNITS
Valuation:aspopilt
No. Mallard Tr
Lot 11 Block 1
Parcel/Sub Thnmas Lake Wnod
Owner
Address
City/Zip Code
Phone
Contractor T,
Address lR1'tl cPja,- a,, s„
City/Zip Code Farmingt-nn? Mn 55024
Phone 411-2001
Arch./Engr.
Address
City/Zip Code
Phone #
I Z l1 OoD
Occupancy
Zoning
Actual Const
Allowable
# of stories
Length
Depth
S.F. Total
Footprint S.F
Date: July 15,1991
OFFICE USE ONLY
R 3 M-1
PD
V-N
V-N
6'l T
z
36'
On site sewage_
On site well
MWCC System ?
City water i2-
PRV r
Booster Pump _
APPROVALS
Planner _
Council
Bldg. Off.
Variance
FEES
713
?a
Bldg. Permit •
Surcharge 60,5a
Plan Review (i3,dp
SAC, City 100.00
SAC, MWCC SD.DO
Water Conn. /p?
Water Meter 95.00
Acct. Deposit 30.00
S/w Permit 3D,GD
S/W Surcharge ,So
Treatment Pl. a'71,.o?
Road Unit 390.0
Park Ded.
Trail Ded.
Copies
SUSTOTAL
Penalty
Lot Change
TOTAL
?/S '? I ?
agrees that all work shall be done in accordance with
( nature of Contrac or)
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
VA A?Q?? ?? i
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aAre.AL-;;-:
= 7 oy
= xi2. (.zu) -
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?8? x ?5= lv?.oa
E)SMT,
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3K 28= `f5L
3 Y?- (60?
xv%z- -7
=60
95cl x iti = 131 Nz (6
Is7 Fu,or?.
axs= iL
`16?1 x 53 = 6135P7
ZN7p ?Loo2
3y x?s" SS?
I%2x-7= la
S&o x53= 195 ,580
120,563 ak
1 2 i oov ?
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Certi(icate of Survey for: -J-l1_F. __/.-/ILLEl1___r7_Q%_`_'! G5
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2472 Entcrpfise biive
Men(luta I Ici9hls, MN 55120
(612) 681-1914
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NaRTH
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D?IE ? ? ! ' ? ?'? r l
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Bg
4,900.0 Uertofes eXisfrn F(ev<?(ic?rl
? 9oo.v Uenofes proro??a+ Eftval ion
O[noles Urarncre {Ulilrfy F_c?semenf
-- Denoles Dt,a,nb e F?low`lIrroi.vs
o flenok mcmciment
E3Pur•in?5 showtT cv-e as-sumed
.
G,?
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t,i'll P;rP17
PRUPOS?U 110VSE ELEVAT 1 UN5
lawesf (loor f./evcrflorl= -_95<•4-----
,Q--
lop a('glack F/eva/i0n:--960
Garcle Slab Clevcrlion=T__959, 7_--
Sub,iecf fo Easemen/s of^record
LOT ll , BLOCK 1, THOMAS--L-AKE-WOO9?
DAKOTA CWNTr, MlNNIF507R ?o no V o REQUIW 13rmn
i ticipnvi cetcuy uwt thrs stirvev, ni,ri or repmt wa5 P??rr/p ?ie?l bY me or unJer my dlrectsn(wrvisinmxml'thal I a?n dulV nepi5lered t anU SurveVor
under ihn lawt al Ihe Slnte ol Minnesolx. Daled IIds.1_?9 dnY ?I 19_p/4 .
5 cvle : l ±ncl1 , 4 0 61W
:l -- -°- ---- ----??=?r??-"-`?- ? ? - -- ?
#121/4
Owner
1 51[e Address
Contractor
Phone
Bullding Classffication: Type AI (Single Family G Duplex).
NOTE: Complete pages 3 and 4 first. (pther)
GENERAI. INFORMATION
l. Bullding Perimeter x ft.
Sq-5O`j
5?4 VA NNA {-(.
hone Date
Type A2(Residential)
? (3 stories or less
(Over 3 stories)
2. Wall height (9round to eave) /` ft. •
2.
3. l. x 2: (above) gross wall area 7.,3 4 ig ft.
4. Building dimensions (L) X(W) =?_ft.Z roof 6 floor area
5. Square foot area of rim joist - Floor joist size (2 x 0 ? )
? b Y X Perimeter - Rim joist area _ftZ
12
6. Doors - A?ea a 0 ?
Thickness in. U factor_.M.f7
Type of Construction Perimeter
- Manufacturer
ft.
7. Total door's perimeter -1? ft.
8. Windows: Manufacturer State approved
U factor
TYPE SIZE AREA (Ft.2)
• EACH
9. Total ft.2 Glass ig
10. Fireplace area; Width X height = X
NUMBER OF TOTAL PEET 2
UNITS
F[.Z
11. Exposed foundation: Height X Perimeter j(p 1 X ZJ( _ !1 2j Ft.2
COMPLETION OF THIS FORM IS REQUIRED FOR ALL N€W CONSTRUCTION, hIAJOR REMO ELING AND BUtIDINGS BE
MOVED WHERE ENERGY, OTHER THAN THE MIN119AL CODE ALLOWANCE, IS USED.
•' MINNESOTA STATE ENERGY CODE CALCULATIONS
BASEU ON CHAPTER 5 OF THE
_ MODEL ENERGY CODE - 1983 EDITION
Adoption Effective I/I/
12.,
13
Framing Area = 10% of gross wall area.
Gross wall area
Windoo-r area A 2?) r) ft.2
Rim joist area A 7-) L ft.2
? 2
Ooor area A ft.
0 ..? 2
area A J'> ft.
Exposed foundation A ft.Z
Framing area A -)-,:F74 ?y>-1 ft.2
Net wall area A / 'r7t7 ft.
U framing area =!oq!5? U x A= ZZ.z?P
Uwall = U x A =
?OTAI . . . . . . . . . . U x = ZZ5 _
(136) 'i
14
15
15A.
156
s
Gross wall area z 0.11 (A-1 single family S duolex = allowable U x A/Code
W. above} .
x 0.23 (A-2 other residential)
x .23 (Other buildings)
x 2S (Over 3 stories)
Z52 BTUH Must be larger than
A x U Code_ ? ?I _ = • 0 ?• _13B above
_4
Ceiling framing area (Af) equals 10% of ceiling area ?. or the same as)
?ft.Z
Gross ceiling area =(L) x (W) _
Joist area (Af) = 10% ceiling area ft.2
15C. Net ceiling area (Ac) (15A - 156) _ ?.7 f? ft.2
U ceiling x A C= ,02, Z,) x25A= ld,P"O
U framing x A f= i03 x_.?2_
15D. TOTAL'U x A ................................. . . ?. O
16. Ceiling area (15A) x 0.026 (A-1 single `amily & duplex - code allowable U x A
x 0.033 (A-2 other residential)
x 0.06 (other)
a BaUYI I4ust be larger than 15D (above)
A(15A) !?? x U(code)= `7.07 F (or the same as)
NOTE: Use U and A values obtained from pages 1, 3 and 4.
CERTIFICATION: I hereby certi(y that I have calculated the "U" factors and "R" values
herein and that the building here described meeCS or exceeds the State of Minnesota
Energy Conservation Act. ' te Signature
ft.2
U wi ndoais = •44:2 U x A= .7 P
U rim joist =, b U x A=Re 6)&_
U door area =/14_ U x A=_. J'A Z
U fireplace =i 1 U x A=i(D, 450
U foundation =/V ?/ U x A - . 7,OD
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&3ox
, 1 Z?°o
4X?,d / l
;w-z-oX4g ' 1 !
ZoX4 9--, )!
;4x4g
? b0o, c?/SV 3z
Z $(oAe. pr? z l
? 0
r?T? ?B
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,
Ii.... ,...-e..i. ,. s.l u? 64 . Mi I . ? . a L... I' .. l
t+Att'
SECTION
y ?
.. STUD
SEC7ION
L
t- ?A
, SECTION. .
R1M
JOIS7
U VNLUE CALCULAIIUNS '
R YAIUE U VALUE
Ineide air fllm ,68 '
In[ertor uall .45 (Nall) U . ? +
Ih4UiAC(oR I900
Sheething Z, O(p
Std(ng
• ??
--'
outa(de air Ellm .17
R TOTAL Z.3
InsLde.ait fllm .68
Interior wall :4?7
/y7' stud R= -k?a8[O67 (Ftaming) U,? ? .
Sheathing ?,10(0
Slding
• ?to?
,?-:
Outside aLr Ellm .17
R TOTAL 57 3
Inslde air Eilm R= .68
Intertot well
Insulation (Well ) U : R .
Z
tng 1
Exterior wall co
Exterlor air f11m R e.17
?
R IOTAL , .
Interior air H lm R= .68
isulatton I1400 "
I Inch soEt wooJ
R=1,$8 (Rim ' ? 1
.? s
JOISt} .
ieath Lng Z-? ?fl ' ?(?? I
Ktettor Wall covering • w f
xtertor air k11m f2= ,17
,
R TOTAL z-A
i
.i
iterlor air filn R= .68 ,
nsulatlon 11'e)e
oJnda[lon I47-9 (Fdn.) U i
rterlor air Illn R= .17 ' -/
R TOTAL 1 ??' 4I?? iOy(o
xposed Bluck
?.V.,•`C?rade 3.
,.?..., ,
CEILIIIG WITII VEfI1EU A IC SPACE ABOVE .
Ceiling .?7(D
Air F11m 0.6)
Total R 45,r7g
1
U = ? roZZ
FLAT ROOF OR CAiHEURAL CEILIN(3 '
R'YaTue R `JALUE
F RAI U IIG CE l l l l!G
0.61
0.17
Inslde air fllm 0•61
Ceilina
Jo1st (Stud)
lnsulaHan
Air space "-
Roaf decking
InsulaHon
Bu11t-up rooP
outslde Air film 0.17
iotal
I U
R
41ndoH infiltratlon .5 cfm/lineal foot of crack
iestdential door 1nf11tration 0.5 cfm/square foot ar door and minlmum code requlremenp ;
•lon-Fesldential door 1nf11tration 11.0 cfm/1lneal 'foot of crack ?
16 12W cancrete block no insula N on =.41 R 2.1 '
16 12o toncrete block insulated cores =.26 R 3.8 '
lb• 12" ligiitweiglit block - .32 R 3.1 •
Jb 12u lightrieight block lnsulated`cores . :12 R 8.3 •
1 iingib glass = 1.13; with storm wlndow .54 n
1 doubl8 glass = .55
1 triple glass = .41
,
A1) pxlertor walls and ce111ngs must have a vapor barrier (0.10 perm max.)a
Japor 6arrier must be on the 1nslde (heated sidq) af wall, •
lapor barriers of the polyethelene thln f11m have no R value.
? R Y UE -T1ALUE
FRAMIfIG CEILING
? 0.61 Air Film 0.61 ? [O, D . lnsulation
JOISt
0.6)
z. I b
. - ? OZ3
4. ? ? .
, ? ?
PERMIT
City of Eagan Permit Type: Mechanical
3830 Pilot Knob Rd Permit Number: EA076526
Eagan, MN 55122 . Date Issued: 01/25/2007
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 4486 Mallard Tr N
Lot: 11 Block: 1 Addition: Thomas Lake Woods
PH) 10-76100-110-01
Use
Description:
Sub Type: e - Furnace
Work Type: Replacement
Description: Furnace
Comments: Quesetions regarding electrical permit requirements should be directed to Ma rk Anderson, State Electrical Inspector,
952-445-2840Karissa Binder 222 Bar dman Ave N South St. Paul, MN 55075 651-457-8781 karissa@binderheating.co m
Fee Summary: Surcharge-Fixed $0.50 9001.2195
ME - Permit Fee (Replacements) $50.00 0801.4088
Total: $50.50
Contractor: -Applicant - Owner:
Binder Heating & Air Conditioning Robert J Teel
222 Hardman Ave N 4486 Mallard Tr N
South St Paul MN 55075 Eagan MN 55122
(651) 457-8781
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.
Applicant/Permitee: Signature Issued By: Signature
Use BLUE or BLACK Ink
i, 1-----------------,
i
-7 I
City of . i Pertnft P
Perrnlt Fee: 0. C)f 7 j
3830 Pilot Knob Road
Eagan MN 55122 I Date Received: / _/b
Phone: (651) 875-5875 I
Fax: (851) 671.5694 j start: L'I
-----------------J
2011 RESIDENTIAL PLUMBING PERMIT APP IC4TioN
Date•/~ V Site Address: as
Tenant:
suits
RESIDENTIOWNER 'Narne'. Phone; (551 9a
Addroee I City / Zlp:
CONTRACTOR Narrie; MILBERT COMPANY INC.dba CULLIGAN WATER
Address: 1801507" ST EAST Clty, : DIM. GROVE *H=.
State: MN 11p. 55.077'
Phons: 65.1.45f-2241
Contact BILL.MILBE}"t' Email:
TYPE OF WORK _ New _ Replacement _ Repair _ Rebulld _ Modtfy Space _ Work in.R.O.W.
Desert tltin of Worts r
PERMIT TYPE RODEN77AL•
,Water Softener
Water Heater
Lawn hrf lign Add Plumbing Fixtures Main I _ Lower Level)
ga L_ RPZ I_ PV9)
• -v Septic System Water Tumaround
-Now
-Abandonment
RESIDENTIAL FEES:
$55.00 Minimum Water Hetater, Water Softener, or Water HoaterLnA Softener (Includes $5.00 State Surchirge)
$35.00.Lawn In1gatlon (incIddes $5.00 State Surcharge)
$55.00 Add Plumbing Fixtutes, Septic System Abandonment. Water Tumaround• (Includes $5.00 State Surcharge)
'Water Turnaround (add $168.00 Ita 516' meter Is required)
i
$105.00 Septic System V_M~ ($10.00 per as built) (Includes County fee ind $5.00 State Surcharge)
$85.00 Fire Repair (replace burned out appllances, ductwork, etc.) (Includes $5.00 State Surcharge)
TOTAL FEES $ t/
CALL BEFORE YOU Dfd Call Gopher State One Call at (551) 454-0002 for protection against underground utnity damage.
Call 48 Hours before you intenq to dig to redelve locates of underground utllides: www.oooherstateonecall.ora
1 hereby adurowledge that this k4 mation Is owplete and accurate; oat the work will be In oonforrnahoe with IM ordinances and codes of tit City of
Eagan; that I understand this is a permit. but only 'an applicition'for a permit, and work Is riot to start without a permit that the work will be M
d
a"an,* 0 the approved pia In f I cased work whkit requires a,revlew and appw
Applicant's Printed Name pp I an ipna un
Ko R p,F' ,,Q"~ ~
rei wR.40s_`d. ~i4~fdq -
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA167511
Date Issued:03/18/2021
Permit Category:ePermit
Site Address: 4486 Mallard Tr N
Lot:11 Block: 1 Addition: Thomas Lake Woods
PID:10-76100-01-110
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 leave on site. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
*Roof permits issued between December and March will be inspected in the spring.
Valuation: 10,000.00
Fee Summary:BL - Base Fee $10K $191.75 0801.4085
Surcharge - Based on Valuation $10K $5.00 9001.2195
$196.75 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 -
William L & Nicole M Anderson
4486 Mallard Trl N
Eagan MN 55122
(612) 490-0837
Bayport Roofing And Siding Llc
2240 Edgewood Ave S, Suite 201
St. Louis Park MN 55426
(612) 235-7663
Applicant/Permitee: Signature Issued By: Signature