4170 Ethan Dr?k.??tik#Yri,t?lC:k%KmX;?t:?cit:gt„kY;;;?>R;'°; N?cYR'?c`?'kY,t'M?:vri%?Y•W.,y:?ic'.+,:
CT.'CY 0? Ei:?1GFtd
Cf1SFixtfi: 79 Tc:F'MZNAl. i4(.":: r'v;J
9PiTO 0,9!c'.c'/9:a "Ti•i;:, :1.0:ifis.:5
1,` e _
NAitif-;c _ NA4i E:Y Et:;nIB FRB COh!S'CK:UC'rInr<
:f
*
:J02 900 41711 i Ti !YV r%1'1 ' .]WlAV
3210 `idOt]:' 41701 cl,-1?1rd PFt 1q;iH:)7'.35
3966 `.•?;i".ii 417fJ G['P;.1t: DR J.C o„C;0
aye? 9c1ii:L Wri E.,NP,h? IIr; 949.78
R273 9•^'FO 4170 i:l'F{AN I)R iyi7:i`.3oSC
3446 9001 Fi:E'O f'_'IIi'-SN T, < 10.50
Pt55 9001 Wq eYFAN Dr 0o510
1743 5220 400 ErPAr: nrc . 50.00
;??J'j 510Q). 41.70 ED F+r-„N nr,: . 78.00
3863? ' 9220 070 E7F141d D;i 463.UC1
fF'.:1r"':i0'_7 " m'M
J;;::F' IiF:: Jr1td *iF [,CNf7:NfJf:_
"!7i:'T `P'U.'
CT'Y (,P F:AGAN
n4TNIRI :iS i' G.i;ri,t?p;
. .. f;f.ic -- "
i:'tj
Y':1TI:, 0`-Y/?.'.c/9j '; :LMEi T 119456
?Da
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Sr'' 6^[`.r?0 4:!.rtl F'T'Flh.f.? 'n,i 1'J.4. CIIJ
3712 WC; Wl? ET!.^.IN T:?i . 50,.013
2965 9PRII 4470 W.J.CO
l
Tn;al Recaip# Flmr:n+,. 4;922,63
USE:R ZIi.
JA??
?8'"R:k??e?':kM%Y•:{Ck.+k„YCYr?9'Y,r::;?tk$?:? k°.:x4?k>K:yM?:?.:;:7?.tt7k?kk
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
5830 PILOT KNOB RD - 55122
• 651-681-4675 r?
CTu remeMi o,._
New ConshucNon Reauiremenh ? model/Reoah ReB9 a ?
D 3 registered sBe surveys showing iq. fl. of lot, sq. ri. o( house 2 copfes of plan
cnd gp roofed areas (20% maximum lot coveraae atlowed) 1 fef of energy calculaNom for heafed addlflons
D 4 eopias ol plans (show beam i window s(zes; poured fnd. desfgn; efc.) 1 site survey tw exfedor addmons 3 decW
D 1 set of energy calculaNons
D 9 coples of hee presenafbn plan q l01 plaNed afFer 7/1/93
DATE: I ( 3 I9--:;t CONSTRUCTION COST: -sZ3G, DDO• vD
DESCRIPTION OF WORK: WF;?IAI SI??El I.F? fKAlI ( WfeS)DEIV I 10'L-
STREET ADD E S:, 4m l.C? ?lEfft TJRI,
LOT: ? I BLOCK: SUBD./P.I.D. Ik: DYi F-
Name: 94W/1.? -Pt'S Gn0.TC?DP- Phone
PROPERTY Last fl'St
OWNER
Sheet Address:
City State: Zip:
Company:?APikll ?s. (--b Uk), Phone#: tD(2 43 v"'J' I?f' 1
t N(;, (area code)
CONTRACTOR 3
Sheet Address: ?.a.?? ? E. SD . license # D'? xp.
C(ty 1Mldf 1?1?i??l?,S State: MLIJ Zip: ci54J29
ARCHITECT/ ?
ENGINEER Company: PL-?'???? ? , l NG• Name:
Telephone #: area code
? Sheet Address:? W6&?ML)P1Re Registration C
? Ci}y ?1Qt1? State: ?-N Zip: ?12-7-
Sewer S wafer Ileensed plumber (reauired for new conshucNon onN): ?u ` 1 ?? R
Penalfy applies when address ehange and lot change Is requested onee permH is issued.
'--l'4 Q -??3 ?
I hereby ocknowledge that I have read this applieation, sfafe that the Information is cortect, and agree to comply wHh all applicabl
State of Minnesota Statufes and CiFy of Eagan Ordinances. n. A ^/ n n
SignaFure of
Certificates of Survey Received ?r' Yes
Tree Preservation Plan Received - Yes
OFFICE USE ONLY
_ No
_ No Jcj?ot Required
11 ?
OFFICE USE ONLY
BUILDING PERMIT TYPE
.
? 01
02
0 Foundation
SF Dwelli ?
? 06
7 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.)
, ng 0 5-piex ? 12 12-plex ? 17 Garage ? 22 PorchlAddn. (4sea.
0 03 1 of _ plex ? OS 6-plex O 13 16-plex ? 18 Deck O 23 Porch (screened)
? 04 2-plex ? 09 7-plex ? 14 Apartments ? 19 Lower Level 0 24 5torm Damage
O 05 3-plex ? 10 8-plex ? 15 Lodging ? 20 Pool ? 25 Miscellaneous
WORK TYPE
? 31 New ? 35 Tenant Impr ? 39 Gas Line Only ? 43 Siding/5offits/Fascia
? 32 Addition ? 36 Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors
? 33 Alteration ? 37 Demolish Bidg.• ? 41 Wood Stove ? 45 Fire Repair
? 34 Repair ? 38 Demolish (Interior) O 42 Reroof
' Give PCA handout to applicant for demolition permit
GENERAL INFORMATION
Const. (Actual) TI/l? Basement sq. ft. ? Census Code
(Allowable) l Main level sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. V No. of Bldgs
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width ` Footprint sq. ft. ? Booster Pump
PRV
Fire Sprinklered
APPROVALS
Planning . Building ? Engineering Variance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment Pi.
Park Ded.
Trails Ded.
Other
Copies
Total:
SAC Units
valuation: $??
cf?,5`
1:3°S e 12?11 x ZS ? I d zS
/
"1%??X-?f J0
,z/7Z9?
u,? ?3 ?"X IG v
4 q -p- a. (?3
/)
.
% SAC
ENEk2GY CODE WORKSHEET FOR 1. & 2 FAMILY DWELLINGS??-J??
- CITY
?ITH ADDRESS '
COMPLETED BY: 0$e PfIONB N DATE
BIIYLDZNG CLASSTFZCATION: ? cate,q^iy 1(ntandard ) or catagory Z(muat includo ventilation)
2fINZMUM CRZTERIA
Foundation Insulation-R10 Y7alla C h'indoNU Roof Attic Tnaulation:
(See caUle on re verse side
Slab on Grade Ineulation-R1 0 Eor allowable pe rcentages) R49-47i[h Rccic No fleel
Floor over unheated spaces- R24 R3e-1Jith A.ttic Raised Iieel
Foundation Windowe 1/2" R38 & R5-Solid RaEcezs
ineulated Glasc.
-}lood or Vinyl Frame
? ST6P 1 Window 4 Door Area ST6P 2 Calculata area aa a percent of wall
A. ToCal Window & Ooor At'e a in Sq. Feet
I NZNDOWS (Including Foun 93tion Windowe)
:
NittDOW MALNPACTt]RC NAf(6: C. From S[ep ] divtda box A(Yltndow 4 Duoi
_
I Areal 6i box 0(CO[al wall area) llme_ 100
??? \ eqiia:7 [tic windcw and door area as a
WINDOW LfA27UPACT[JRE TYPS' arcznc of wall area (Lo;: C).
? p
FfZtiDOH MA2i[7PACTURH ? PACTOR :
JQ 12
X 100
R O. QuantiCy
?
rq CL.Area
= C
P.?X_=---
? Dimensions
g 4? N ' 11'
y}}??
STeP J ' IDaoign Yeatuzen
w
I
X
H
u??t
? ? ?+ P'r.A.HIl7G '..?P?.
x
Z'IA
I2I 4 X 1 h Ig S:AtIDARD FRhMItIG _?ctuds 16" O.C.
?.t?4
I
A
, ? ApVrV1CED FRAhtING r.euds 24" o.c.
X
'V
-
-
/LQN X I1_O?
_? -11 ? CFVITY ID7SULATLON R?
„
SHSATHTtiC TYPS:
I I N
` " LE55 Tf1AN < R-5
X
I ??Oh x 5
,414 R-5 , oR hIOR^c
5
X U-FACTOR t?
? Fcom Che Cable, (reveTCU side) determine the
i p?R
; maximum percanc window 4 door area for the
cione selected a
the t vaLue
d
e
n
en
er
design op
in Box D below based on Che winclow mEg. U-
? Ea«or:
D X Q5 n
TbCal Area of A= ?q.ft. -
Windows & ISoors
8. To[al Yfall Area in Sq. Fc. The :- value from che Ca61e in Bex D shall br.
caual to or greaeer [twn the t in 0ox C
Wall Total Height Area
perimeter
1 O
? I-ota1 Acea of Walls
-
?` -?_-
-
0
ONE- & TWO-PAMILY RFSIDF•.N'C"[AL DCJlT.D(NG PR£>C7ifP'IYVE (CCIOK-BOOK)
API'ROACI i
MAXIMUM WINUOW AND DUOR AREA AS A PERCt:NT OF OVERALL WALL
AREA
Frqm Mlnn Rulee RAtt 7670+,Q475, eubDatt 2, ytem F
Cavlt Exterior Wlndow U-Factor
Framin Inaulation Sheathin 0.49 0.36 0.31 0.27
STANDARD R-13 Z R- 7 13.4% 17.8% 21.39'c 24.3%
STANDARD R-13 R- 5 12.4% 16.4% 19.7% 22.Sqo
STANDARD R-15 > R- 5 12.9°h 17.1% 20.1% 23.4%
STANDARD R-18 -19 < R- 5 12.19'0 16.0°r6 16.8% 22,0%
$TANDARD ft-18 -14 R- 5 14.096 18.6°/v 21.8% 25.3%
ADVANCED R•18-19 <[L - 5 12.9% 17.1% 20.1% 23.4%
ADVANCED R-18 -19 >_ R- 5 34.5°le 19.2% 22.5% 26.1%
STANDARD R•21 < R- 5 12.8% 17.0% 19.9% 23.1%
STANDARD R-21 > R- 5 14.5% 19.396 22.59'0 26.1%
ADVANCED [Z•21 < R- 5 13.6% 18.1% 21.2°/0 24.6%
ADVANCED R-21 R- 5 15.09'e 19.9% 23.2Yo 26.9%
ditlonel ulculals valura
STANDARD R•17 < R- 5 11.9% 15.79'0 18.4% 21.5%
STANDARD R-17 ? R- 5 13.8% 18.4'/0 21.5% 25.0%
ADVANCGD R-17 < R• 5 12.6% 16.8% 19.6% 22.9%
ADVANCED R•17 > R- 5 14.396 14.0% 22.29'0 25.79'0
Notea:
Window erea equals rough opening minus Inetal?atlon clearances.
Window U-factor must br determined by either the National Fenestration Rating
Council etandard 100•91, or ASHRAE 1993 Handbook of Fundamentals, Chapter 27,
Table 5. .,
PoeW FaM Note 7671 0+? pp..?
n tran
GMot Ca
Phwm I ph" 0
r@ Y•
•
LOT SURVEY CHECKLIST FOR RESIDENTIAL
. BUILDING PERMIT APPLICATION
PROPERTYLEGAL: LaT /D /
DATE OF SURVEY:
n
LATEST REVISION. `
DOCUMENTSTANDARDS
y e C. • Registered Land Surveyor signature and company
e ? ? • BuddingPermRApplicant
a/ ? ? . Legai description
Ey' ? ? • Address
ip, ? ? • North arrow and scale
V ? ? • House rype (rembler, walkout, split w/o, split entry, laokout, etc.)
yi ? n . Direclional drainage arrows with slape/gradient °h
00/ ? ? • ProposedlepsUng sewer and water services 8 invert elevaUon
m/ ? ? • Sueet name
a/ ? ? • Driveway
UK' ? ? • Lot Square Footage
m/a ? • Lot Coverege
ELEVATIONS
Existin
? o
? ? - Sewer service (or Propased)
corners
eR
Pro
? ? y
•
p
m/ ? ? • Top of curb at the driveway
* ?/
v . Elevations of any existing adjacent homes
e to adjacent utilfly trenches
d
* o u
Adequate foo6ng depth of structures
Prooosed
kl ? ? • Garege floor
5K ? ? . Firstfloor
o' ? ? • Lowest exposed elevation (walkouUwindow)
M/ ? • Property corners
? • Front and rear of home at the founda4on
PONDING AREA (if aodicadel '
? ? ? • Easement line
? ? ? • NWL
? (v ? • HWL
? q/ ? . pond # designation
? ? ? • Emergency Overflow Elevation
DIMENSIONS
? ? ? • Lot Iines/Bearings & dimensions
?? ? • Right-of-way and street width (ta back of cutb)
?? ? . Proposed home dimensions induding any proposed decks, overhangs greater than 2', porches, etc.
(i.e. ali strudures requiting permanentfootinga)
V ? ? • Show all easements of record and any Cily utiliCes within those easements
V p ? • Setbacks of proposed structure and sideyard setback o-adjacent ebsting structures
ov? • Retaining wall requirements, A any
Reviewed:
Date
Mareh 19BB
CRAIG/BLO6PRMT FM
*
t It
* PIONEER
* ang neari
?* 7?*
BENCH MARK
TOP OF PIPE
ELEV.=974.31
?V I
i M
?
?
to yi
Certificate of Survey for
914.2
4170 ETHAN DRIVE
9I3.8
LLJ
?
F.?c;,
?
a\)9?
•3 ? 9?
c I I
2422 Enterprise Drive
Mendota Heights, MN 55120
(651) 881-1914 FAX:681-8488
uxo SORYEYpqS , CINL ENGNEERS E-mail: PIONEER@PRESSENTER.COM
NNEflS• L/JIDSCAVE ARCHIIECLS 625 Highwoy 10 N.E.
Bloine, MN 55434
(612) 783-7880 FAX:783-1883
E-mail PIONEER20PRESSENTER.COM
MANLEY BROS. CONST.
V_') 9
N89'S6'46"E
'4 53.49 902.4
i.? 6.67
- ------f'?°,
i ? 26.33 71.4 ^i
Q
8.pp ?
?o t?.oo y?
?SERNCE 11 ?J
EI,EV.= 904.4 ?914.8 ?
/
l ( M1 &0c
"o 00i
. ? ? ? .^?4?nn/
S?
BENCH MARK
TOP OF PIPE
ELEV.=915.84
?
i ? 806, fi 1
'?43 ?Nr
Osaik ?
v,A r A?? ..C
?
J;y w??9 C? f?
? s
:
9-z/-•99 '
n?47 ?,1VGLNEERIlVGA I3EPT.
90
LOT AREA =78,466 SQ.FT.
COVERAGEEA15.0;767 SQ. FT.
HOUSE TYPE- RAMBLER W.O.
I
157.07 I
00.4-----
? 10
? TREE LINE I
901.0
--N 10 1!
v,>
6
co
U)
?
? X 907.7 i?1
f-
F-a I
JJ
a
03'9,
?
? ozl
? ¢w
?? zwl
<
<51 LT Fe N C? \\?? 10
h
?
PROPOSED HOUSE ELEVATION
NOTE: PROPOSED GRAOES SHOVM PER GRADING PLAN BY: E.G. RUD
NOTE: BUILDING DIMENSIONS SHOWIJ ARE FOR NORIZONTAL ANO VERTICAL LOCATION
OF STRUCTURES ONIY. SEE ARCHITECNAL PIANS FOR BUILOING AND
FOUNDA7ION DIMENSIONS.
NOTE: NO SPECIFlC SOILS INVESTIGATION Mq5 BEEN COMPLETED ON TMIS LOT BY THE
SURVEYOR. THE SUITABILITY OF SOILS TO SUPPORT TNE SPECIFIC HOUSE
PRQPOSEO IS NOT THE RESPONSIBILITY OF THE SURVEYDR.
W
?
M
G
O
O
U)
880.8
LOWEST fL00R ELEVATION: CGLI9
TOP OF BLOCK ELEVATION: 9/7' 7
GARAGE SLAB ELEVATION: 917,3
TOB @ LOOKOUT ELEVATION:
NOTE: TMi5 CERTIFICATE DOES NOT PURPORT TO SHOW EASEMENTS OTHER THAN % 000.00 DEN07E5 EXISTING ELEVATION
THOSE SHOWN ON THE RECOROED PLAT. ( 000.00 ) DENOTES PROPOSED ELEVATION
DENOTES DRAINAGE AND UTILiT1' EASEMENT
NOTE: CONTBACTOR MUST VERIFY DRIVEWAY OESIGN. - DENOTES ORAINAGE Fl.OW OIRECTION
NOTE: BEARINCS SHOWN ARE 9/.SED ON AN ASSUMED DANM • DENOlES MONUMENT
-B DENOTES OFFSET HUB
WE HEREBY CERTIFY TO MANLEY BROS. CONST. THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A
SURVEY OF THE BOUNDARIES OF:
LOT 10, BLOCK 1. OAK BLUFFS
DAKOTA COUNTY, MINNESOTA (THIS LEGAL WILL BECOME VALID, UPON FILING THE PLAT)
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR ENCHROACHMENTS, EXCEPT AS SHOWN, AS SURVEYED BY ME OR
UNDER MY DIRECT SUPERVISION THIS 14TH DAY OF SEPTEMBER, 1999. // '
cir.ticn- inNFFR FNGIN RI . P.A.
SCALE : 1 INCH = 30 FEET
19.06
EIVF'fl Sra 9 1 iaae
r
CITY USE ONLY
LOT 1 C-) BL RECEIPT #: ? I 1-D- -J C-)
SUBD. (2 0, RECEIPT DATE: ? I - es - 9 /
?
MECHANICA[, PERMIT # 3 CF,
1999 M£CiiA1VICAL P£fZMIT (BESIDFN1'IlFL)
C17'Y OF SIkfiAN
3830 PILOT KNOB RD
ERfiAN 31N 551 £E
(651) 6$7-4675
Date:
Complete this section onlv if you are installing HVAC in a single family dwelling, townhome or condo under
construction and not owner /occuoied.
• HVAC: 0-100 M B T U
ADDITIONAL 50 M BN
• Gas outlets (minimum of one required @$3.00 ea.)
State Surchazge
Total
$ 30.00
6.00
.50
$ cyG•52?
Complete this section onlv if you aze remodeling, adding to, or repairing an existing single family dwelling,
townhome, or wndo. Please indicate if it is a new item, alteration, or repair.
New Alteration Repair _ Other
Reminder: Call 681-4675 for inspections.
Furnace _ Air conditioning
_ Air exchanger _ Other
$ 30.00
State Surcharge .50
Minimutn Total Due $ 30.50
SITE ADDRESS: y/70 ?tt Y-AC4--r- /D''"'I'le
OWNERNAME: PHONE#: -
, s (AREA CODE)
INSTALLER NAME: ?ouY?? /72CU?iiz i c?? rxorrE a: lr/? - y?D' SG3/
(AREA CODE)
STREET ADDRESS: -?
CITY: STATE: /U i--L ZIP: SS.3 7??
SIGNATURE OF PE ITTEE
L I?i n BL ? CITY USE ONLY
?
SUBD.
EACH #
1999 PLtTM$IN6 PEfiMiT (iiu1DENTIAI.)
C11'Y OF FrRfiRP
3$30 PILOT KNOB 3iD
EA6AN, MN 55122
(651) 6$1-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground spnnkler system
FIXTURES
TOTAL
B2!h tub $ 3.00 X 1 - $ 3• Cv
Floor drain 3.00 x ! _ $ 3• ev
GeS i in Outlet ` minimum -1 3.00 X = $
Hot tubls a 3.00 x = $
Kitchen sink 3.00 x = $ 3. ?
Laund tra 3.00 x I = $ "_ oo
Lavato 3.00 x 3 = $ . CD
Minimum fee aiteretlons to existin dwellin 30.00 x = $
Private Dis osal S stem new/refurbished ' re uires MPC iic. 75.00 x = $
Private Dis osal 5 stem abandonment 30.00 x = $
RPZ new installation/re air 30.00 x = $
Rou h o enin 1.50 x = $
Shower 3.00 x = $ ?O
Under round s rinkler if dwellin is under construction 3.00 x = $
Under round s rinkler if existin dwellin 30.00 x = $
Water closet 3.00 x = $ , oU
Water heater 3.00 x = $ , ?O
Water softener if dwellin under construction 5.00 x = $
Water softener if existin dwellin 30.00 x = $
Water turnaround 30.00 x ---- _ $
State Surchar e 50 --> ----> ---> $ .50
Total -> --> ----> •---' $ 1 SD
Reminder. Call for inspections of alterations, i.e. water heaters, water softeners, etc.
------------------------------------------------------------------------------------•----------•-------------• • •--------------------------
I hereby aGcnowledge that I have read this application, state that the infortnaUon is cortect, and agree to comply wifh all applicable City of Eagan ordinances.
It is the applicanPS responsibility to notify the property owner that the Cily of Eagan assumes no liabiliry for any damages caused by the City during its
normal operalional and maintenance activities to the tacilities construcled under thispertnit within City pmpertylright-of-way/easement.
SITE ADDRESS:
OWNER NAME: :
INSTALLER NAN
STREET??BB?E
cirv: ?1i1'1)_?
S
RECEIPT#:
RECEIPT DATE:
PERMIT# -:5??
(AREA CODE) .
TELEPHONE#: '?'/7, t'?O
(AREA CODE)
STATE: ZiP: ??5.? 7-x)
SIGNATURE OF PERMITTEE
!"
#$%&'()' *+*,
-./$%'"&0-1K3$2>$,+
-./$%'53/4-.1 678897@
<*%-'!==3->17:?@9?@:7;
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:O;-.9'Q99 3
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#(//-,%=1
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M-.< +'F + N*)9')9 9% .8'-.9'.9O;*.9)'P* K*+'!3'D99 ' D'-$$'8$99?*+G'. F' ?9+*+G8'*+'.98*)9+ *-$'K F98'H,*++98 -': - 9'
# '4'#-89'Q99'T"33T53L33'3V3!L53V"
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_-$;- * + ''"33L33
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1'K9.9<>'-%&+ P$9)G9' K- '1'K-W9'.9-)' K*8'-??$*%- * +'-+)'8 - 9' K- ' K9'*+D .F- * +'*8'% ..9% '-+)'-G.99' '% F?$>'P* K'-$$'-??$*%-<$9': - 9'
D',*++98 -': - ; 98'-+)'M* >' D'X-G-+'Y.)*+-+%98L
(??$*%-+ S/9.F* 99 ':*G+- ;.9188;9)'#> ':*G+- ;.9
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA138583
Date Issued:09/07/2016
Permit Category:ePermit
Site Address: 4170 Ethan Dr
Lot:10 Block: 1 Addition: Oak Bluffs
PID:10-53400-01-100
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
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: 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 -
Thomas J Hentges
4170 Ethan Dr
Eagan MN 55123--490
Window Geeks Llc
1200 Center Pointe Curve
Mendota Heights MN 55120
(612) 315-1481
Applicant/Permitee: Signature Issued By: Signature