4311 Jasper Dr
Use BLUE or BLACK Ink
~ For. Office Use'
I
; Permit
I
City of Eapn
Permit Fee: I
3830 Pilot Knob Road
Eagan MN 55122 ; Date Received:
"?ECEIVED I
Phone: (651) 675-5675
Fax: (651) 675-5694 Staff: I
SEP 14 2010
2010 MECHANICAL PERMIT APPLICATION
~.1t
Date .4 at:!5-I0 Site Address:
Tenant: Suite
I
4 1U -7 S
RESIDENT /OWNER Name
lr.
Address /City /Zip.
Dan Wohlers Southsi& Htg. & A/C ~i L:S- C---, -1 °7 9 g `7
CONTRACTOR Name: - 6950 W. 146th St., #106
Address: Apple- Valley, MN 55124 -City:
State: (952) 431-7099 i,1
Contact: t 1 1 ir- Email: l~L~o' k-r3,5ou±hSI de, 0-~~~~ el--
New Rep(acement Additional Alteration Demolition
TYPE OF WORK
Description of work:-
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
RESIDENTIAL COMMERCIAL
PERMIT TYPE %-"Furnace - New Construction - Interior Improvement
L'--Air Conditioner _ Install Piping _ Processed
Air Exchanger - Gas Exterior HVAC Unit
- Heat Pump - Under /Above ground Tank l- Install Remove)
When installing/removing tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES: "'CI-)
$50.50 Minimum Add-on or alteration to an existing unit (includes $3 tate Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) $ TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1%
$50.50 Minimum (includes State Surcharge)
$ Permit Fee
- If Permit Fee is less than $1,000, surcharge is $.50.
- If Permit Fee is > $1,000, surcharge increases by $.50 for each = $ Surcharge
$1,000 Permit Fee (i.e. a $1,00142,000 Permit Fee requires a $1.00 surcharge).
$ TOTAL FEE
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 gooherstateonecall.orn
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 i not to start witho t 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 ?
x OA ~ie-r5 x
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground _ Rough In -Air Test -Gas Service Test -In-floor Heat -Final
Exterior HVAC Screening Inspection
CITY OF EAGAN
3795 Pilot Knob Rood Ea9an, MN 55122
PHON E: 454-8100
BUILDING PERMIT
10. on0
Site
ve
Lot Block Sec/Sub.
Parcel #
W Name ^' -L'r?'
? Address
°
" Name '
0
°ul U Address
F- r:... oL.._,.
Nome
I hereby acknowledye thnt I heve read this application ond state that
the information is correct and agree to comply with oll applicoble
State of Minnesota Stotutes ond City of Ecgan Ordinonces.
Receipt #
N4 6705
Erect ? Occupancy
Alter ? Zoning
Repair ? Fire Zone
Enlarge Q Type of Const. y
Move ? # Stories
Demolish ? Front ft.
Grade ? Depth ft.
aop?ovois Faes
Assessment
Water & Sew.
Police
Fire
En9•
Planner
Counci I
Bldg. Off.
APC
Permit
Surcharge Plan check "
SAC
Water Conn.
Water Meter
Road Unit
Total
Signature of Permittee I
A Building Permit is issued to: on the express condition that
pll work shall be done in accordante with all opplicable State of Minnesoto Stctutes and City of Eagan Ordinances.
Building Offitial
Perwk # peh Itwd PamIffM
Plumbing
Mechonical
FM-c t`k•c T rsl?l
?e. r%-'c_ S S0 7-ZIX`t-?'r( Cv?c??' ??n lF c,
INSPECTIONS DATE INSP.
Rouqh-In
Finol
Footings Date Inap. Dote Irop.
Foundation Plumbing
r m ins. Mechanital
Final ?
17
Remorks:
CITY OF EAGAN Remarks ?edar Grove Acquisition
Addition 2 Lot 15 Blk 5 Parcel l0 16701 150 05
Owner 4?? C Street 4311 Jasper Dr. State Eagan,MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF. 88-5 1985 1266.95 84.46 15
STREET RESTOR.
GRADING
SAN SEW TRUNK
-3E SEWER LATERAL 1?2 ?13 .OO 2. 2 Paid
WATERMAIN
# WATER LATERAL 1972
WATER AREA
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN,
BUILDING PER.
SRC I
PARK
4::?_
EAGAN TOWNSHIP
N°
693
BOJILDING_PE12MBT
Address (preseni)
Builder
Address
DESCRIPTION
Eegan Township
Town Hall
Da:,...... ? - ..
5fories To Be Used For Fron! Depih Heigh! Esi. Cos4 Permi! Fee
??.??I' Remarks
" LOCATION
s:ree:, noaa or oxner uescripnon o: a.ocaxaon i a.os..? i oiocx I AQQIIIOII or iracz
This permii does noi authorize the use of sireets, roads, alleys or sidetvalks nor does iS give the owner or his agent
the righf !o creaYe any siiuaiion which is a nuisance or which presenis a hazard !o the health, safeiy, convenienee and
general welfare fo anpone fin the eommunity.
THIS PEAMIT MUST S?E-? ?KE,PT?,ON THE PREMISE WHILE THE WORK IS IN PROGR?E?S/S.?
This is fo ceriifp, iha.?,?:`?t ??._------has permission !o erec! ?-_.^.!r-??.?f-?_-----.-.--_---__....-_upon
the above described premise sssbjec! !o the prov,isions of the Suilding Ordina a?Tawnship adopfed April 13.
1955. e i . % Chairmen of Town Boerd ` \ //?9uililing Inspector
ClTY OF EAGAN
y 3T95 Pilot Knob Road Eugan, MN SS72'L N? 6765
GHONE: 4548100
' BUILDING PERMIT APPLICATION Receipt # ?6 d
Site Address 4?7-1 Jasper Drive
?or 15 Block 5 secis?b. Cedar Grove 2
Porcel # 10 16701 150 OS
w Name J1?,.3-?' -He°Sbt1T$
? Address 4311 Jasuer Drive
4?...._ ) Cl _? [.7C
p Nome _
?? Addrea
r r;..,
Nome _
Address
I hereby ocknowledge thot I hove read this application and state that
the Information is correct and agree to wmply with all applicable
Stute of Minnesota Statutes and City of Eaqon Ordinances.
Erect ? Occupancy R3
Alter ? Zoning ?'1
Repair ? Fire Zone ?
Enlorge [? Type of Const. ?
Move ? #' Stories
Demolish ? Front 22 ft.
Grade ? Depth 2? ft.
Aowovals Feea
Assessment _
Water & Sew.
Police -
Fire
Eng.
Plonner _
Council _
Bldg. Off. -
APC
Permit vv.vv
s???ha?a 10. 50
Plan check 33. ?
SAC
Water Conn.
Water Meter
Road Unit
Tmm 104.50
Signature of Permittee I
A Building Permit Is issued to: eT mng F Husshti? on ihe express mndition thnt
cll work shail be done in occordance with oll op?p{l}'5/?_?ble State of ' nesata Siotutes and City of Eagan Ordinonces.
Building Offitiol ,Q?YlLrdr p-?'° O1"^J
CITy pF EIGADI Include 2 sets of plans,
1 site plan w/elevations &
? gUILpING pERMIT APPLICATION 1 set of energy calculations.
5-?.L7-$l
Zb Be Used For }?oonn ?oDnioN Valuation Date
5ite Address q311 ?yAs Pt4L 7 fL ,
Int J16 BlOCk S Sec./Sub.
Parcel #: jD f(O'ZG'•> ( f Sd C)??-
Ovmer: NESSgu(:Et 3A^ES E.
Address: 431 I -TWSPfO 0C-.
City/Zip Code: EA"'rU eAIJ
Phone #: ysc/- I6'7 9
Contractor: Sr-LF
Pddress: Ns A6ouc
City/Zip Code: As dP,ovE
Phone #: U 5'-f -1 67 Ct
Arch. /EYx3. .
Address :
City/Zip Code:
Phone #:
?
' OFFICE USE ONLY
Frect OccupancS'
Alter Zoning ?
Repair Fire Zone A/
Enlarge V _ 1ype of Const. -ty
Nbve # Stories
Dscnlish Front ft.
Grade Depth ft.
APPROVALS FEE'S
AS525SI11PS1tS PPSIR1t /ne? ?
faater/Sewer Surcharqe / o
Police Plan Check z 3?
Fire SAC ?
gnj. Water Conn•
Plaruier Water Meter
Council Road Unit
Bldg. Off.
APC
TCfrrL /G 9. SO
it
EAGAN TOlNN S H I P N° 1583
BUILDING PERMIT
..............------..-.--'... Ea9an Township
Ownex .......... ---... ........
j .-.. . -? Address (Preseat) ..__:lj?....._?....(/ / ................. Town Hall
suitaa: ._.....__,?-?'?...
Dafe ..... ---- -?--°°-° .. ................
Addxess ------------------------- ............................... _._.........'_.._...........__.
DESCAIPTION
5fories To Be Used For Fron! Depih HeighS Esi. CosY • Permit Fee Aemarks
-- / ABT7 -?7' 17
' % LOCATION
Sireef, Aoad or oYher Desccipiion of Locafion I Lo! I Blaek i Addition or Traei
/d1 51 e, -4w- 2
This pexmit does not aulhorize the use of slreels, soads, alleys or sidewalks nor does it give the owner or his agen!
the righ!!o ereate anp siluation which is a nuisance ox which presenis a hazard fo the healih, sefeiy, eanvenience and
general welfare So anyona in ihe eommunity.
THIS PERMIT MUST BE $EPT ON TFIE PREMISE WHILE THE WORK IS IN PROGRESS.
Thie is !o eertifp, lhai.._._ L _..?'f(.,t,q,?..?? .........................has permission !o eseet ??..-.-upon
the ebove descsibed pre?ifise subjeet fo the provisions oi the Buildinq Ord'nnance for Eaqan Township adopfed April 11,
1955. ?J
_..°--.....-- .............. ..._... Per .---.........._[Ct?f?-...4.=°.,??.....?'..?-•Q:e. ??_....._....
Chairman Tnwn Haard Building?Inspecfor
? ' Q??
mmnesoca acate noara or C19C[lIC1iY
Griggs Midway Bldg. - Room N791
-40kiversiry Ave., St. Paul, Minn. 55104 - Phone 297•2717
REQUEST POR ELECTRICAL INSPECTION
CHECK BELOW VQRK COVGRED BY TH1S REQUEST
EB-00001-02
A57 7 ?
T 15148
Type o( BuOSling New Add. Rep. Check Appliances W'ved For Check Equipment Wired For
Home ? ? Range ? Tempotary Wuing ?
Duplex ? ? WaterHeater ? LightingFixmres ?
ApL Bldg. ? ? E3 Dryer ? Electcic Heating ?
Commercial Bldg. 0 ? ? Fumace ? Silo Unloader ?
Industrial Bldg. ? ? ? Air Conditionec ? Bulk Milk Tank ?
Farm 11 ? ? List
J Lisi )
Other
?
?
? p
}
Heheig l p
y
Hehelsl
COMPUTE INSPECTION FEE BELOW
Service Entrance Site: a Fre FeedersBSubteeders: # Fce Cucuits: # Fee
to 100 Am s. 0 to 30 Am res 0 ro 30 Am eres 5S00
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Am eres
Above 200_Amps. Above 700 Amps. Above 300 Amps.
Transformers Remote Contiol C'vc. Paitial oc other fee l Sd
Special Ins ection Minimum fee S ' C
? .,
3?
1? e tri
11
? TOTAL FE a'J .?
r. herehu'f2rtifvf4al/thefahnve incnecfinn hac hecn ma r
' • ._,__- _ '_'+
(Rough-in) O ? o o Date ? ?o `?
(Final) O i 00 pate
This request void "
18 months from
'rhil?equest void L. l5 , 56, G 6•."? ?S 77 y
Tru?
18 months from
DateofthirRnquesl/"(6-$?FireNo. T 1?+14v
1, as 0 Licensed Electrical Contractor Owner, do hereby request inspection of the above electri-
cal wiring installed at
Street Address or Route No. bl- k v?- City
Q 4'?
SecUon Township Range County
Which is occupied by 50.m-ES 44-SS ?"T\q.,_
(Name Occupant)
Is a roughin inspection re uired on this job? No ? YesX Ready Now ? Will Call?
PowerSupplier ?5 Address
Electrical Contractor ???E'?- Contractor's License No._
(COmpany Name)
Mailing Address 50?.1v?, ?-L -
I i Con ctar or Owner Making This Instdllation)
Authorized Signature Phone No.
(Eleclric ontractor or Owner Makin9 ns Ilation)
IQ70 ,' ? ???0'9? T nspection request will not be accepted by the
?? f? 1?r'L' [?
L'? CJ L tr State Board unless proper inapection fee is enclosed.
ues[ void 16 1 d G
aCdal
'4509 -- " ?
Request D te ?
4 I..n'2"Jt,' 1(38I
?V Fre No.
' ftouph-?n Inspecvun
fle4uired? JL, '
?fleadv Now ? Will Nntifv Inspec-
[o
Wh
F
. QVes r
en
eadY
Licensed Elec[ncal Convactor - I heraby request mspection of above
? hwner _ - electncal work mstalled at
Street AdAress, Box or Route No. - Cirv
4311 Jasper Ds. Eagan
ecuon o. Townshi0 Name.or No. Range No. Cey{?sy.Ota
U I[
Or.cuUant IPRINT! ' Phone No. .
mr. fdames Hessburg 454-1678
Power Supulier Atldress ' -
N.S.P. Co. Red Rock
.Electrir.al Conuae[or (Company Namel •?. ConVartor's License No.
Corrigan Electric Co. A39549
MailmpRtlJress (Contmctor or Owner Making Instailanon) -. °' .
3,965 145th St. W.. Rosemount, minn. 55068
Aut ed StBnamre ontrac r Owner tiAaktng lnstallaUAn)
.
P.hq,r{P,?W?rpp?i '-
? 4L0 11
' MINNIi50TA •$TpTE?80AA0 OF.ELECTRICI' " ' - - - - ?THIS INSPECT40N REQUESL WILL WOT.: "Grlggs-Midwav Bldg ?L Noom N49/' . -' Bf ACGEPTED BY THE STATE BOA0.6 . `_ 1821* 41n,versNy Ave.:
$t.rPaul, MN 55t04 . . , , UNI.ESS:PROPER INSPECT{OIV FEE IS ,- .
ENCtOSEU.
REQUEST FOR EIECTRiCAL INSPECTION EB-00001.03
? ?' See mstmctions inr comoletiny this torm on bock of yellow copY.
-? J45O ..
XBelaw Work Cavered by This Request ?i
New Add Hep. Type ot 8mlding Appliances Winetl Equipment Wvetl
Homc Range Temporary Service
Duplex Water Heater Liyhtiny Fixtures
Apt. Building Dryer Electnc Heavn
' Conmiercial Bidg. Fumace Stlo Unloadei
InAustnal Bldg. Air CondiLOner Bulk Milk Tanlc
Farm Otner Sorcitv othei ISneuryl
thui ISVecify Othc' Other
Compute lnspection Fee Below
fl Fae ServoceEntrenceSize !1 Fee Fexders/SubfexAers 4 Fee Circwts
0 to 100 Am>s 0 to 30 Am ps 0 to 30 Am os
101 to 200 Amps 31 to 700 Amps 31 to 700 Am s
Above 200 qmps Above 100_Am s Above 100_Amps
Transronners Remote Control Circ. ' Partial%Other Fee
Signs Speaal lnspection $ 10
50 T
Remarks . OTALFE /d,pd
Houph-i D.I.
? I, the Electrical
InsUectoq hereby
co
til
th
t th
b
Final
e r
y
a
e a
ove
'inspecLOn has bean
r w
N ( ?
da.
This requas[ void ?
18 eionths Oom
1999 BUILDING PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
New Construction Reaulremenls
? 3 regisfered sNe auneys showing sq. R, of lot, sq. fl. of house
and aIl roofed areas (20% maxfmum loi coveraae allowed)
: 2 copies of plans (show beam & window sBes; poured fnd. design; etc.)
1 set oF energy calculattons
> 3 coples of hee preservation plan B lot platted alter 7/1/93
DATE: W - L - / l
DESCRIPTION OF WORK: ?>70/n?
STREET ADDRESS:
?
Remodel/Reoatr Reaulrements
I ? -97
2 copies of plan
1 set of energy caiculations for heated addHions
1 ske survey tor wAerlor addMions 8 decks
CONSTRUCTION COST: /n00 ?D
LOT: BLOCK: _ ?S SUBD./P.I.D. #: 0, t, C, 'cn
PROPERTY
OWNER
Name::??M VI2 Phone #: ?,1
Last flrsf
r,
? ? 0nnI,?/ >
?! ?
City ?aa;q State: /?'"? Zip: Z
U
Street
#: iZ 70 7-&y?7
(ar a code)
CONTRACTOR Street Address: [ ! V
`??? ?Cbe License# al MEup. 3/TWO
Cfty State:
ARCHITECT/
ENGINEER Company: Name:
Telephone #: area code ( )
Sfreet Address: Registratfon #:
City
Sewer 8 water Iicensed plumber (reautred for new construction onlv):
State:
Penalty applies when address change and lot change Is requesfed once permit Is Issued.
Zip:
I hereby acknowledge that I have read this applicafion, sfate that the information Is cortect, and agree to comply wffh all applicable
State of Minnesota Statutes and Cily of Eagan Ord(nances.
i/_ I A
Signalure of Applicant:
OFFICE USE ONLY
Certificates of Survey Received _ Yes
No
Tree Preservation Plan Received _ Yes _ No - Not Required
??v • ? . ,
? ?
?--- JAs?ER ?R??E }
--
qooo o '
- - - ?EPaR_ ?RovE '?2,. -- - - - - -- - -- -- - - - - - - - - - -
- ---- - - - EKISI?NFj_ Ner?n?- -- - - i -- - - - - - - - --
- -- - - - --- -- ?2?xy4?--?1440? - - - - - -- - ---
---- -- -- -(aaxa?l - - - - - - - -- -- -- -
- - qDDi?n?nl - ` --
- - - - - - -- - - ? - 484 u' -- - - - - - - - -- - - - -
? `7G - - - -- - -
-- - - ---?a
- - - - ? ?l- ? 6? ??,,,..? ? -- -- - - - - - - - - - -
- - - - - --? 1-°- `? -?, - - - /?? - -- - -- - -- -- - -- - - - - - --
\
- - -? -
- - - - --`?- - -- - -- - - - -- -- - - - - -- - -
?
. . 1 .V • ?I??
?.
, JoN E mArb+G
Q3?? 30.5pPr Ar_
1
Got l5, BlockS, c?e
, . ! .__,_- -------?
? ?6 ? Cs
?? ?1 •
;
. ?
---- ---- - - - - -- -----?
?? ;
"?? 2005 RESIDENTIAL BUII.DING PERNIIT APPLICATION
'Y" City Of Eagan
K 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Cons6uction Reauiremenls RemodeUReoair Reaui2men[s OfFice Use OnN
3 regisle2d sile surveys showing sq. ft of lot, sq. R of house; and afl raofed areas 2 copies of plan CeA of Swvey Recd Y _ N
(20%maximum bt mverage allowed) 7 set of Energy Calculations forheated additions Trea Pres Plan Recd: ? _Y _ N,
2 copies of plan showing beam & window s¢es; poured found dasign, etc. 1 sfte survey for addXions & decks Tiee Pres Requi2d Y_ N
lsetofEnergyCalculafions AddflPort-indicateiforhsNesep6csystem On-siteSepticSyslem _Y _N
3 copies of Tree P2servafron Pian if lot plaBed after 711/93
Rim Joisl Delall Options selacUon sheet (bulldings wAh 3 or less unifs) -
?
Date s?Sf?JU
ConstructionCost
SiteAddress =c? !-14 SS/ZZUnit/Ste #
/
Description of Work r-0
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0_ 1 _ 2
Telephone # ?
oS/
Property Owner ,
Contractor n 42 1?,.
Address (AI(V?,l 3LLLA7 L1Gq 14t'. City _? U ry_,s,i,
State ? dk ZipTelephone#652-) 76, `Z-(?5 T
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv I _ Minnesota Rules 7672
Energy Code Category . Residentiel Ventilation Category 1 Worksheel • New Energy Code Worksheet
(4 submissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
g 3? ?9
9a- ?
Have you previously constructed a buiiding in Eagan with a similar plan8 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Telephone # (
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone # (
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the wark 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.
Applicant's Printed Name
Applicant's Signature
���� � Use BLUE or BLACK Ink
� ForOfficeUse---�-----�
' j Permit#: � � ���� �
��6� �� �`b^� � Permit Fee: �Q�°�"� �
3830 Pilot Knob Road
Eagan MN 55122 j Date Received:���.5� j
Phone:(651)675-5675 1 I
Fax:(651)675-5694 1 Staff: I
� I
�.����_���������__J
2014 RESIDENTIAL BUILQING PERMIT APPLICATION
�te: 7���0/�/' Site Address: �- e � Unit#:
Name: �r�� �2S �,r Phone:�S�— �ISY— /�7v
Resid�ntl
Qyy�g� Address/City/Zip: �3/L ��, �;e- ��r��,.,n 1�yt_ -�S/Z2.-
Applicant is: Owner �ContraCtor
T������ ' Description of work: ��,r-��
Construction Cost: Multi-Family Building:(Yes /No
Q . �,,I'__ �( � j1C. �
Company��,tf l C�f� JJI,cc��I VLGI �V�"Y A-(.17�i'�,� Contact:�/4-f1t.dO h �(J p f?
CO#t'�1�G'�OC Address: ���n ���l � :1 GLC �'"��D City:�(�Yl��t ��f'..--
State:�Zip:��;� Phone:�,,�'�i'�7���°c�"L��/EmaiL•(��(rf�n � /1�1C -GLSGZ-o ��I'Y)
License#:�°��_ �, Lead�e�'ficate#: I�r�� "���Z'',
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 BUI�DING
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 8 Water Contractor: Phone:
N�TE:Plans and su�r�g dt�cc�rmerrts tfit�t`you s�rbr►t�t ar+e ccnsider�t to b+�publ��c Itrfatr►�staic�t. Pat�iotats of
the infc�rt»a�icrn'rr�ay be classi�red as non pub/�c if ycu�r pm�fde speciflc�easons#�at wauld p�n»it Ut��i�
co�a�cl�fe that�lt� ar+e trade secre�s.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0Od2 for protedion against underground utility damage. Ca1148 hours
before you intend to dig to rec:eive locates of underground utilities. www.QOpherstateonecall.or4
I hereby adcrtowledge that ths ir�formation is complete and accurate;that the wrodc will be in�r�fom�ance Mrith the ordinances and codes of the City of
Eagan; that I understand this � not a permit, but only an application for a peRnit, and work is not to start without a pertnit; that the work will be in
accorclance with the approved plan in the case of work which requires a review and approval of plar�s.
Exterior work authorized by a building pertnit issued in accordance with the Minnesota State Building Code must be completed within 18d
days of permit issuance.
x x
Applicant's Printed Name Applicant's Signature
Page 1 of 3