3319 Heritage LanecIrir oF EAGaN
. 8796 Pilat Knob Road Eagon, MN 651"
PHCNE: 434-8100
BUILDING PERMIT
.,,
Te ba uad fer !
Site Addreu
i
Lot Block _
Parcel .# oWe Name
Z
g Addre
? o Name _
?
u? Address
H r:,..
Receipt #
• Date -- , - - - 19
Name
/lddress
r? 7
Erect ?j Occuponcy
Alter ? Zonir?g '
Repolr ? Fire Zone
Enlarga ? Type of Const.
Move ? # Stories
Demolish ? Length
Grade p Depth Sq. Ft.
Assessmenf
Wnter 8 Sew.
Pol ice
Fire
Eny.
Plcnner
Council
Permit
Plan check
SAC
Water Conn.
Woter Meter
Road Unit
I hereby acknowledge thot I have read this appiication ond stote that gldg. Off.
the informotion is correct and cgree to comply with cll opplicable ?pC Toto1
Stote of Minnesota Statutes and C+ty of Eogon Ordirionces.
$ipnoture of Permittee
A 8uilding Permit is issued to: on tha expresa conditian Ihnr
pll worlc sholl be done in accordarxe with nll opplicabla State of Minnesota Statutes ond City of Eapon flrdinances.
Bulldiny Offic{al
Permit Nv. Permit Holder Misc. Permit No. Holder
Plumbing ? ? t? ?p?Z
H.V.A.C. VQ
Well
Weter
Diap.
Sewer
Electric q ??c MAS?t i-- 6 -t -g'Z
Inspection Date Insp. Other
Footings
Foundstion ?
Freminp 2
Rouph Pibp.
Rough HVAC
Insulation
Final Plby. , t ?
Final HVAC
Final ?
Water Desaibe Location:
VYall
Sewer
Pr. D'isp.
CITY OF EAGAN Remarks
Addition MGRA_F. ADDTTTON Lot 9 Blk 1 Parcel 10 48000 090 01
Owner'J,. ,•. street 3319 Heritage Lane scate Eagan, MN 55121
Improvement Date Amount Annual Years ? Payment Receipt Date
STREETSURF. 197$ $95.84 89.58 IO •?O 103 "o2S- S
STREET RESTOR.
GRADING
SAN SEW TRUNK 1968 Paid Under Letender Ad itio
* SEWERLATERAL 1973 Paid Under Letender Ad ltl0
WATERMAIN
WATERLATERAL 1977 P 1C1 under L tender Addi 1021
WATER AREA
STORM SEW TRK 1979 411.84 27.46 15 -/ /-2. 9d5 -,F5
* STORM SEW LAT 1973
CURB & GUTTER
SIDEWALK
STREET LIGHT
ROAD UNIT 240.00 #29766 4-23-82
WATER CONN, 420. OO "
BUILDING PER. 7194
SAC
PARK
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fea
Fiil in numbered speces S/C
Type or Print legib/y Tot
1. Date 2. Installation Cost
3. Job Address Lot4_Bik. , Tract
4. Owner • . S?
5. Contractor • Phone
6. Address
7. City ?-J State Zip
B. Building Type: Residential 0
8. Work Description: New 11
Commercial ? Institutional ?
Add 6 Alter ? Repair ?
10. Describe ? • ?- Fuel Type
11.
No. Equipment BTU - M. Ea.
Forced Air No. Equipment CFM
i
Mfg. A
r Handling:
Boilers
Mfg, Mech. Exhaust
Unit Heater
Mfg, Oth
Air Cond. er
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough F inal
Inspections: Date Insp. Date Insp. y
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464-8100
? - o '4'0?
? " -dd
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
Fee
Fill in numbered spaces S/C
Type or Prini /egrb/y
Tot.
1. Date 2. Installation Cost
3. Job Address Lot'9_Blk. ? Tract r
4. Owner
5. Contractor Phone
6. Address
7. City State 2ip
8. Building Type: Residential 0 Commercial ? Institutional ?
9. Work Description: New O Add ? Alter D Repair ?
10. Qescribe Fuel Type
11.
No. Eauinment BTU - M. Ea.
Forced Air No. Equiament CFM
Mfg. Air Handling:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg, Othe
Air Cond. r
Mfg.
Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed: for
Rough Final
Inspections: Date Insp. Date/,0-77- nsp. cf IJ ce
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-6100
` I
Racefpt MECHANICAL PERMIT Permit No.
' CITY OF EAGAN
Fee
' Frll in numbered spacea S/C
Type or Print /egibly T
ot.
1. Date ' 2. Installation Cost
3. Job Address '
Lot_-?Blk. i
/ Tract --
4. Owner ?
5. Contractor - • - ' ' ? -Phone
6. Address
7. CitV State Zip
8. Building Type: Residential [} Commercial ? Institutional ?
9. Work Description: New 9 Add ? Alter ? Repair 0
I 10. Describe
1 11.
Type
No. s7ui ment 9TU - M. Ea.
Forced Air No. Equiament CFM
Mfg. Air Handling:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Othe
Air Cond. r
Mfg.
Gas, Piping Outlets
12. I hereby certify thai the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 464$100
CITY OF EAGAN WATER SERVICE PERMIT
3745 Filot Knob Road PERMIT NO.:
Eogan, MN 55122 DATE:
Zoning: , No. of Units:
Owner:
Address:
Site Address:
Plumber: ?
Meter No.: Connection Chcrge: '
Size: Account Deposit:
Reader No.: Permit Fee:
I agree to eomply with the City of Eagan Surcharge:
Ordinanoes. Misc. Chorges: • `. r 4
Totol:
BY Dote Ruid:
Date of Insp.: ;
I nS
p,
CiTY OF EAGAN
3745 Pilot Knob Road
Fagan, MN 55122
Zoning: --
Ovner:
Address:
Site
Plumber:
SEVYER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units: Ve„C:l po1t 1
I agrea to eomply with the Clqr o{ Eagae Connection Chorge: ?. ??•??? ?
Ordinanees. Account Deposit:
Permit Fee: 1 _ -?i; oc?
Surcharge:
By Misc. Charges;
Dcte of Insp.: Total:
? Insp.: Dote Poid:
a.----
CITY OF EAGAN N? 7194
9795 PIfM Knob Reed Eogan, MN $4122 -
? PHONEs 454-8100
BUILDING PERM17 Receipt
7e 6e uud 1er SF LNAl/IIIYI F.r V..1... $55.000 !)..re AM++1 23 10 82
Site Address JJi7 rcaiLagc aai=
Lot 9 Bloek 1 Sec/Sub.IbRae Additi0i1
P„cei # 10 48000 090 01
a Nome L'Ni?L VVxCiE/N1LL
; Address 2616 40th AVe. So.,
b _ Mnl . 770_l.709
? Neme ?Cler
?? Addreu
? r:.., oU....e
Nome
Address
1 hereby acknowledge that I have reod this applicatian ond stote that
the inlormation is correct and ogree to comply with oll opplicoble
51ate of Minnesota Statyf?b7aryd City o.4 Eagan OAdiqQhces.
Sipnoture of Pertnitte?/
A Building Permif Iz issued to:
oll work sholl be done in occordance with oll
Erect ](( Occupancy R 3
Alrer ? Zoning R'IL
Repolr ? Fire Zone NA,
Enlorga ? Type of Const. V
Move ? # Stories
Demollsh ? Length 60
Grode ? Depth24--Sq. Ft. -
Aoororels Fees
Assessment
Water 8 $ew.
Police
Fire
Erp.
Planner
Council _
Bidg. Off.
APC
Permit /1j7S_iNl
Surchurge 27.50
Plan check 149 • 00
sac 525.00
Water Conn. 420 • 00
Water Meter 60. 00
Rood Unit 240-01)
Tot,, $1719.50
on tha express conditlon thnt
Minnesota Sfa"es ond City of Eagan Ordinances.
Buildinq pfficial
(ger#ifirtttt nf (Orrixpttnry
Ctp of (tagan
EP}iFil`IlttPtlt Df IfiltOriQ 3tfS}TPtfilttt
Tbit Catifiurtt ittutd purtu4nt to the +tqairtmenu of Srction 306 of the Uni)orm BuiJding
Cade arti jying tbat ae t!x timc of itnwnce tbit ttructure wat in tom pliarsa wrth the variow
ordinarua of thtCity rrgulatnfg buildin$ cmwrartion or utt. For the follawiug:
u„cwdfi.,+,,, SF DWG/GAR ela`e?t N. 7194
o?? TYeeR3-rywc?me V Fq„7- NA zoaa?« Rl
o.a84,;qNorman Vogelpohl ,,,,„,2616 40th Ave. So., Mpls.
LvJ-vt_ er:
?a September 13, 1982
Q?
.o., i. . ?...?«?. .,.?.
This re:nuest voitl /.J f
?18m7'9'946 -_.
L-1 tF,., f ) w F-AE 444 \ 30z9 Z
00
Reques pate
/
?i
I
I
I Fire No. Rough-in Inspect,on
Repulred? ,
t]ReaAy NowWill NoGfy, Inspac
-
?
ZYJ
$ L?
5 v Yes ?NO ?ar When Ready '
Licensetl Elec[rical Cuntractor I hereby request inspection of above -Owner electrical work insialled a<: Street Address, Baz orq1 ou[e No Cijy
..
. -3 •_ "??L?. . ..
ecbon o. Township Name.or No. . ftang¢ No. . C('unt? ? ,?.
Oc an? (PFINT) ? .
L Phone No. .?._,....,..
P?oy ?er Su
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' ?6? ?CiOd ?( w '
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evic
a
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n
tor
ICOm
pany Na?g
U
ac
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? Comrac
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:
LiCense No. '
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(
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$
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`?C-?'?W? 1
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Mailing AA ress (Con ractor or Owner M2kinp InstailatioN
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1
6-? a ".
AuAhorizedS' ture ontractor/Owner-Making Installatiunp
I
Phone Number '
Sctc-35Vs
MINN.ESMAATE 80AflD'OP ELECTFICITY THIS INSPECTION flEQUEST WILL NOT
Griggs-Mitl y Bitlg: - Hoom N•191 BE ACCEPTED eV THE STqTE BOARD
1821 Universi[Y A.veSt. Paul; MN 55104 UNLESS PFOPEP INSPECTIDN FEE IS
Pti„.o 16121 297.2111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION
?' 79 9 4 6? saa i°ytructions for cnmpleting ehis furm on hack ot yellow copK
X' ' Below Work Coenered by This Reryuest
EB-00001-03
3oZ? Z
NeW Atld Rep. TypB O7 BUilAing AppllanCBS Wired Eqalpment WIrBtl
Home Range Temporary Service
Duplex W2ter Heater Liqhtiny Fixtures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Furnace Silo Unbader
Industrial BIdG. Air Condi[ioner Bulk Mi Ik Tank
f-.hrm otner Soeatv a,ur Isuucifv)
tier $Uecity 01her pther
ComputelnsUecUon Fee Below
b Fee ServiceEntranceSize # Fee Frteders/Suhieeders H Fee Circui[s
0 to 1 UO Ant ?s 0[0 30 qm s ' 0 ta 30 Am s
101 to 100 Amps 37: to 100 Amps 37 ta 700 Am ?
Above 200 quripy qbove 100_Amps Ahove 100_Amps
Transionners RemoteControl Circ. Partial,'Oth ?
Signs Special InSpeCtion
'
r
`
Renia.ks • ??;? TOTAL E?
Q7
I. Ihe ElocVical
? 1 w Inspactor, hereby
flllill
? LBll1Iy IM1PL (M1¢ TIIOVB
- -
oeciiun has been
/?1 0 made.
,-.
.?
This requast voitl
18 months t« mi
Th;s elissel w;d
rnms rrom 7127
u.
Ne0 t a
f / Fire No. ftnuInspectian
Nequired?
ReaOy Now ? Will Notity In50ec-
10 ff ? ?Yes No lor When fleatly
Licensed Eleclricai Contracto, 1 hereby raquest inspaction ai above
Owner elec4icel woB installed at
Stree[ AAdress. Box or Rou e No. _ C it?
cImn o. Township Name or No. Range No. County
Occup?n{?J?PqINT?
(?.CC?3J1/ PhonLe,No.?- p
T.5 77O
Power Sup0lier Atltlress
Elec Contractor (Company Nan 1
USS?J? ?? ConVa tor*s License N
?O??f
Waili Address ontractor or Owner Making Instaila fon
?s- ?.
Authw ign IContracmr wner Making InsWllation) Phon?: Number
?f
NINNES A STATE BOAPD OF ELECTNICITY THIS INSPECTION HEQUEST WILL NOT
BE ACCEPTED BY THE STATE BOAPD
Griggs-Yitlway Bldg. - Room N•191
1021 UniversilY Ave., St. Paul, MN 55104 UNLESS PHOPEN INSPECTION FEE IS
Ph. 1872) 297-2111 ENCLOSED.
??( ?+? QUEST POR ELECTRICpL INSPEC710N Es-o1ocwi-a
See instruclioris for completin4lhis form on back of Yellow copy.
6' 3 712.7 "x- Be/ow Work Covered by Thrs Request ? v
Add pep. Type ot Builtlioe AODliantee WiraU Equipment Wired
Home Range ' -, Temporary Service
Ouplcx Water Heater Lightiny fixtures
Apt Building Dryer Electric Heatin
Commercial 61dg. Fumace Silo Llnloader
Inciustrial 81dg. Air Conditioner Bufk Milk Tank
Fafm Other sPecrfY Other ISpecifyl
? Rr SGCCifY OthCr Oth,r
Comnute Insnection Fee Below 0 Fee ServiceEnhence5ize k Fee nders/SUbleeders N Fee Circuits
Fa
1 U to200 qm s- 0
to 30 qm s 0 to 30 Am s
A6ove 200 qmps 37 to 100 Amps 31 to 700 A 5
Swimming Pool Atwve 10?_Am s Above l00_Amps
Transiormers Irrigation Boorci5 Partial-'Other Fee
Special Inspection I ? ,_,-SL
I, tFs E`_ecSrif,? l
inspactar, hereby
xarlily that the a6ove
mspection has been
made.
4b? Clty of Eapn
3830 Pilot Knob Road
Eagan MN 55122
Phone: (657) 675-5675
Fax: (651) 675-5694
M 8 0 20oq
? -- --i
i Pe?n u: '
?
? PermitFee:? i
I ?
? Date Received: ?
? I
? stan: i
I -----------------
2008 RESIDENTIAL PLUMBING PERMiT APPLICATION
Date: `' 11-D 1 Site Address:
7enant:
Suite #:
RESIDENT/OWNER Name: AjrL{'hY HUIIIP TrehEff1b Phone: VJS(-7J??
Address / City / Zip:
CONTRACTOR Name: License #: uhamplon
Add re ss: 651-365-1340
3670 Dodd Rd. #100
MN 55123 1338 State: Zip:
City: "ap
,
0
Phone: Contact Person:
TYPE OF WORK _ New VReplacemeni _ Repair _ Rebuild Modify Space _ Work in R.O.W.
paIr
DesCri tlon oi work:
PERMIT TYPE RESpENTlAL
Water Heater Water Softener
_ Lawn Irrigation _ Add Plumbing Fixlures
L__ RPZ /_ PVB) (_ Main _ Lower Level)
Septic System _ Water Turnaround
New
Abandonment
RESIDENTlAL FEES:
$50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (inGudes $.50 State Surcharge)
$30.50 Lawn Irrigation (inciudes $.50 State Surcharge)
I
I
$50.50 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (inciudes $.so State Surcharge)
'Water Turnaround (add $136.00 if a 518" meter is required)
$100.50 Septic System New ($10.00 per as built) (includes Counry fee and $.50 Sta;e Surcharge)
$90.50 Fire Repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Suroharge)
TOTAL FEES $??• ?l.L_
i nereoy acKnowieage tnat tnis mtormauon is compiete ana accurate; mac me warrc mn oe in wn?' ... a.Io? ? I I 1 ?1. -.. 1o.1...... ..........-.... -. ..._ _.., _.
Eagan; that I understand ihis is not a permit, but only an application for a permit, and work is not to start without a permit; that ihe work will be in
accordance with the approved plan in the case of woilt which requires a review and approval ot plans.
_ Gl?T1P?,?l.g??? x
Applica Ys Pnnted Name Applicanl's S. . a Ye _
!
3??'13 H9
CITY OF EAGAN
BUILDING PERMIT APPLICATION
Include 2 sets of plans,
1 site plan w/elevations &
1 set of energy calculations.
To Be Used Fbr.? Valuation Date
Site PrldresS 50
Lot / Block Sec./Sub.
Parcel #: f c) q8wo at('? p(
Owner: /)oPe-% Uva??\pG0
Address: 'oZu I?o qU /Q:16.
CitY/zip Code: tkpA`a" `
Pnone # : -7 a--`1 - la""19 ?O
Contractor: 0 (e) P`Lr
Pddress:
City/Zip Code:
Phone #:
Arch./Eng.
Address:
City/Zip Code:
Phone #:
OFFICE USE.ONLY
Erect X Occupancy
Alter Zoning
Repair Fire Zone p
Enlan7e Type of Const.
_
Move # Stories
Deniolish Front (op ft.
Grade Depth ?y ft.
APPROVAIS F'EES
Assessaients Permit
?4ater/Sewer Surcharge v 7
Police Plan Check?
Fire SAC
Ehg. Water Conn. ?
Planner Water Meter /?U _43
council Road unit ,? yrj?
Bldg. Off.
APC
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EXTERIOR ENVELOPE AVERAGE "U" CDMPUTATION
041NER
SITE AODRE55
CONTRACTOR V-LL&d (,' ?1L f^o (f L DATE PHORE 7Zq •?71i?'
Determine working square foota9e of each.
1. Total exposr?d wall area .,.,., sq. ft, x_ ?11 a u n
2. Total t'OOf/C.f_+1 I{ilg dYEi'. . , . , . ?i d "9G- $Q. Ft. X - -sW • ?
7oYa) expoied i'f1Il area above floor •(7Gd. Qa .
a. Total wall window area ........................... . L 2 8.ed
b. Total door area ................................. 3 7.0/
c, Total sliding ylass door area ................... Q v.o z
-?-
d. Total fireplace wall area........................
e, Total ;vall frarniny ar^a (average 10%),,,,,,,,,,,, (?,z_4tJ
f, Total net wall area above floor .................
g. Total rim joist area ............................ _( O°, 0
Total cxposed foundation ar?a = J¢0 6) _
h, Total foundatio-; window area..................... --
i. Toal net foundaiion area above grac;e ,..,....,... f,g•o 0
Determine °U" value of eaclj raalt segment,
a._ I26:6F ? X 11 Un 74<<ld
b,?*L7-8I ! X IIUN f l7 • 4 9i
C. O.OL X nUu <SS? • ?Z.fJr
a. -- z ^u° ----
e. R r,Un ,/Z
f, fZG%?,?7____ X „VI 07 = ??-?b
2, 40 X °U° .d( . ,G ( a
h. c? x IOUp
6. 60 X "U" .??? = 0. t1
3 ............. ?.? ?....... ...... Total • ?
If item 13 is the sarrta as, or less than item !1, you have met tie fntent
of SBC 6006(c)2.
• ?
?otal exposed roof/ceiling area = q G D. O d
j. Total skyliqht area.............................
k. Total roof/ceiling framing area (average 10%),..
_I
t. Tota1 net insulated roof/ceiling area,.......... c3 ( 0_c)
Determine "U" vaiue for each roof/ceiling segment.
; X flull ?
k. X "Ul. .
t. q 6G.0d X °v' 'oC = 4 .6a
4 ............. Vo.6b.,..,........ Tota1 • ?q .a?
If total of 04 .fs the same as, or less than 12, you have met the intent, of
SBC 6006(c)l.
Alternate Building Envelope Design
To utilize the total envelope system method, tne values esta6lished by the
sum of items A3 and #4 shall not be greater than the sum of items #1 and 02.
1.310•0-F+ 2,---49,04 - 3Sg.n8
3. 23/• ?-r --- + 4•49.o0
$804 MelaN Lana 8903063
Burnrville, Minnesota.
WEPJA CO. PIyAN SERVICE
ED ANDERSON
qRCHITECTURAI. OESIGNING ANO PLqNNING
Q}fICB:
4449-Fa+ftAosC'7 3+7 Otfke:
Burnsville, Minnesote el?.?? 8964636
Use BLUE or BLACK Ink
I For Office Use
4 6 q 3
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Ila
C'
Permit Permit Fee: V SZ~ I
fly Ed of Ea
3830 Pilot Knob Road
Eagan MN 55122 j Date Received:
Phone: (651) 675-5675 I Staff: I
Fax: (651) 675-5694 1 1
2011 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: (t TCZ N Unit
Name: Phone:
RESIDENT / z
OWNER Address / City / Zip:
t
Applicant is: Owner /1 Contractor
Description of work: " 510~1
TYPE OF WORK,
c)
Construction Cost: Multi-Family Building: (Yes / No )
1<
Company: (~~nfi~~7/1 ~If)~ Contact: ` Mn- ~
CONTRACTOR Address: ~ ) 6A City: ~4j
State: ~L Zip: c1 Phone: _ 7,0 -7
License ~&0 / 7 4 % -
Lead Certificate 1
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor:_ 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
a µ conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 4540002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.oopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will 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 Building Code must be completed within 180
days of permit issuance. ;
x~,~
x
Applicant's Printed Name App icant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA165047
Date Issued:10/15/2020
Permit Category:ePermit
Site Address: 3319 Heritage Lane
Lot:9 Block: 1 Addition: Mcrae
PID:10-48000-01-090
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Adam Trenberth
3319 Heritage Ln
Eagan MN 55121--171
(651) 331-8470
Action Roofing & Siding Llc
1315 Southview Boulevard
S St Paul MN 55075
(651) 457-2642
Applicant/Permitee: Signature Issued By: Signature