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4043 Johnny Cake Ridge CtAddress SCAnni 4 C?k-p-- "n e, C1` Zip 55127 Lot g TFF- Blk ? Sub nGk?brookP? 5 THPSE 1TEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION. Date: Yes No Inspedor: ?Fz Final grade (6" from siding) Permanent steps (garage) Permanent steps (main entry) Permanent driveway Permanent gas Sod/Seeded grass TraiUcurb damage Porch Basement finish ` Deck Please verify with the builder tt?e removal of roof test caps from the plumbing system and the shutoff of water supply to the oufside lawn faucet before freeze potential exists. Contact engineering division at 6814645 before working in rightof-way or installing underground sprinkler system. ? Whitc - City Copy Yellow - Resident Copy Pink - Contractor Copy 1 4- Siteaddress 4043_ 1Le? ,_ot3OV BlockdZ sued. Crkt.e,kkt On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be submitted prior to issuance of a Certificate of Occupancy. _ This structure: is consUucted to meet minimum requirements of the Mn Energy Code, Chapter 7670 OR ? This structure: will be constructed to meet more resVictive requirements of Chapters 7672 or 7674 APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTINGTYPE Water Heater ? n /kl,e '(o s-2 c( S-6 Fumace ,? lri7qe LG -Z ?`? 1 S°?+ 1?:•u.Y Dryer EXHAUST SYSTEM LOCATION TYPE MODEL CFM's VENTED rES No Kitchen kitchen Bathroom 1 Bathroom 2 X4` ?- Q F J? 41 r, v p Bathroom 3 (.IL. Bathroom 4 ` Other FIREPLACE S LOCATION GAS WOOD MANUFACTURER MODEL BTU'S VENTING DIRECT ATMOS MAKE-UP AIR MODEL TYPE CFM's ? - -- '!f r.-... 11> v I hereby acknowledge that the above information is correct and re ' m ts. Si ure CompanyName agree to comply with the Minnesota Energy Code and City of Eagan D?? O This form is the responsibility of the General Contractor. PERMIT# S r e 'Y Ci RECEIPTDATE: 2002 ft"'?1??tAL ????BING PL''ftMIT 1Q[PPIJCATIQN CI1'Y OF EA6AN S$SO PILOT HNOB RD EAfiAN, MN 55122 651-681-4675 '?7 ? 1r} 5 P Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, backflow preventer for irrigation system L ? SITE ADDRESS: S 112 OWNER NAME: : TELEPHONE #: (AREA CODE) INSTALLER NAME: ?M?M,f' z'Lt't? TELEPHONE #: ?e/a (T?(? STREET ADDRESS: V.) L? U.?? 1-h(4 4 (pREA CODE) CITY: ?-C? ? STATE: Y`'L yJ ZIP: ? _ SEPTIC SYSTEM, new/refurbished (requires rivo sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply • MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 _ Abandonment of septic system. _ Water turnaround - existing dwelling unit (+ 518" meter if needed -$118) Other: n 11 ? lt? I ? ? _ RPZ: new installationlrepair/rebuild AUG 2 7 2002 $ 30.00 _ lawn irrigation system B Replacemen addition I: _ water softener _ water heater $ 15.00 State Surcharge $ 50 so "5 Total $ " ? I heieby acknowledge that I have read this application, statethatthe information is correct, and agree to complywith all applicable City of Eagan ordinances. tt is the applicanfs responsibility to notiTy the property owner that the City of Eagan assumes no liability for any damages caused hy the City during its noimal operational and maintenance activities to the Bcilities construded under this permit vithin C@y ro rty righFOf-way/e sem nt. ??? ?? SIGNATURE OF PERMITTEE 1/02 C) A- a ? RESfDEN?IAL? 3?- ? BUILDIIVG PERMIT APPLICATION t CITY OF EAGAN 3830 PILOT KNOB RD - 55122 851-881-4675 -iQ lr?6 QO.SZ) New Constructlon Reaufremenls RemodellReoairReauiremeMs • 3 registered site surveys showing sq. R of bt, sq. ft of house; an?ll roofed areas • 2 copies of plan (20% maximum kt coverage albwed) . 1 set of Energy Calculatlons for heated additions • 2 copies of plan sh(ywing 6eam & windax sizes; poured found desgn, etc.) . 1 site survey for ezterioradditions & decks 1 o b 1l • isetofEnergyCalculations . Indicate'rfhomeservedbysepticsystemforadditions • 3 wpies of Tree Preservation Plan i( lol platted aher 711/93 • Rim Joist Defeil Options selection sheet (hldgs with 3 or less unils) r- ?/ DATE 5- a gVALUL410N / I u, v v o JOB SITE AD IP MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTYOWNER t?- 1*c TYPE OF WORK FIREPLACE(S) _ 0 r 1_ 2 APPLICANT PHONE# ADDRESS Yc PAGER # CELL PHONE # ZIP CODEs s- FAX # NEW RESIDENTIAL BUILDING ONLY- FILL OUT CO n Energy Code Category MINNESOTA RiJLES 7670 CATEGOR D IJ ?? D (check one) - Residential Ventilation Category 1 Worksheet mRQ?lY 2 8 ZDOZ - Energy Envelope Calculations Submitted MINNESOTA RULES 7672 By - New Energy Code Worksheet Submitted PlumbingContractor. Vu11'_4 Phone#: f} z y92 2 t zl Plumbing System Includes _ Water Sof ner _ Lawn Sprinkler Fee: $90.00 Water Heater No. of R.I. Baths No. of Baths MechanicalContractor: .,,,) tt--?Phone# 6J-2- 9?43roons;-- Mechanical System Includes: Air Conditioning Fee: $70.00 Heat Recovery System Sewer/Water Contractor. t„a,,? ( Phone #'76.3 qz ,'.7 9 ?9- All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that with all applicable State of Minnesota Statutes and City of Eagan ;ertificates of Survey Received V Signature of Applicanf Tree Preservation Plan is correct, and agree to comply ? Not Required N, Updated 2002 `ti-1U(' .1) OFFICE USE ONLY ? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg Y 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 07 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? OS 03-piex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex O 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous X 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair O 33 Alteration ? 37 Demolish (Bldg)' 0 43 Reroof ? 46 WindowslDoors O 34 Replacement `Uemolition (Entire Bldg only) - Give PCA handout to applicant Valuation Iiovu oC9 O' Occupancy 1?, 3 -14.. MC/ES System Census Code L) Zoning ?_ City Water ? SAC Units ?L Stories 1 Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs ? Length ? O Fire Sprinklered Type of Const Vill) Width REQUIR INSPEC 10 Footings (new bldg) .O. - Footings (deck) _ FinaUNo C.O. Footings (addition) _ Plumbing Y Foundarion ? _ HVAC 7 Drain Tile Other RooF IceBc Water Final Ftgs Air/Gas Tests Pool Final _ Framing _ _ _ _ Siding Stucco _ Stone _ ? - Fireplace ?( R.I. X Au Test )[ Final Windows (new/replacement) Insulation ? Retaini?nv Wall Approved By 7 Z , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total 04Aa-0 ? ?? 7 }C 5 ''l = J DD) S/l ? N?k kLY /\ q y7x / ? 7, i s ?- ?Q???_. +? 'iY ••••••ooVy.u.?r?L3G.l:? ,? !?L'?check S'o4tw&a ? , Ar(f . '+p^W „ `( 4 , ? ? COt3NTY Dakatiaq , , P STAT?:,=M„rinaeot ZOISB r ? CON3TRIICT?OR TY I1P.TE S?I2's26?70 ' DATS OF 9 AL7dN'S ?}. TITI,E DIAMOND' PROJECT : TN'FQRMA p 6AxBRO0Kr^. - j x i- `?r? COMPLYANCE: PAs r ° Required 7C7A nF Youz Home m 4'04 ,°' 22.3? Better°Th x..:/. i• ' 1 ? x ? CEYLYNGS r WALLB ; i?7ood P`?ai ? r , GLAZI29G Wincl6w; b0OR9 ?a . &LP3 FLOORS LTn?] , . HVAC EQQZPN7ENT CAMPLIANCE $'I'F.fii y cona ? h .,'eubmitte@ yrltls i .-.?? 2-,:. • -`c ;19r # t I A, , , r?? fi. 4? . ^? ? a ?. ; ? ,jaJ? C ..•„i ?' h x r ? p3,?-?k???""c"?' . n,, c :a ox:^ Cav?ty aCont `? Glasing/Dpor m??c?°, ' R V'alue ?R val?xa V-'Value "rn r- --c-----°---- 1&87 Bm 0 : .,^ 0'.0 1975 19 0;° 2Y0 i 0.350 38 0.350 'i0:0: ---------------------- ro? '? ?$?^'?i.t t ?'"p,? t 's v?°t ?'d k ,ti ;k !?' s ? ? r*: ^x ., j4 • o r ,x S? a eu +mz^ t"x ? + 3, _ `P ?' .i p tX ; e ? P? ? ??? Z 1W ? e ?r y?.( ??F? ^R ' 4F. ? =? i 4 ??*? Y , ? ? .aw ? o x ... ? ' t 1 3 i LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION PROPERTY LEGAL: ?° t n '&'IBo k, '--? C?G2 klc?fm DATE OF SURVEY: ? LATEST REVISION: rn C A L c? DOCUMENTSTANDARDS Y a O z` a ¢ id/i7 ? • Registered Land Surveyor sgnature and company . 'i// u ' ? • 8uilding PermitApplicant ? ,? ? . Legaldescnp6on L?jrJ ? • Address U ? ? . North arcow and scale ?/? I ? . House type (rambkr, walkout, splA wla, split entry, lookout, etc.) ?l ? ? ? • Directional drainage arrows wAh slopelgradient % ? ? ? • Proposed/existing sewer and water services & invert elevation / ? ? • Street name ? u • Omeway r?/ ? ? • Lot Squa2 Footage ?f ? ? • Lot Caverage ? ? • Benchmark ELEVATIONS Existina ? ? • Sewer service (or Proposed) ?T ? ? • Property comers ??/ [i • Top of curb at the driveway and property line extensions Li r?/ ? . Elevations of any existing adjacent homes 1 G? ? • Adequate footing depth of structures due to adjacent utility trenches ? ? ? • Waterways (pond, stream, etc.) / Prooosed fil ? • Garage fioor Nf/ n ? • First Boor ?f ? ? • Lowestexposed elevation (walkouUwindow) ? / [/ ? • Praperty comere ?f ?? • Front and rear of home at the foundatlon / PONDING AREA ('rfaoohcable) r.? Y( n • Easement line i.:I ?/ ? • NWL ? ? . HWL ? iW j ? . Pond # desgnation ? ?V? ? • Emergency Overilow Elevation DIMENSIONS X ? • Lot IinesBeanngs 8 dimensions t ? • Rght-of-way and sVeet width (to back of Curb) A,r? n n • Proposed home dimensions including any proposed decks, overhangs greaterMan 2', porches, etc. ? (i.e. all structures requiring permanent footings) ? • Show ail easements of rerqrd and any City utildies within those easements i/?? • Setbacks of proposed sUUCture and sideyard seffiack of adjacent existing shuctures k? rl ? • Retaining wail requirements, if any Reviewed: Name 1 Date Surveyor's Certificate SURVEY FOR :PULTE HOMES DESCRIBED AS ;Lot 8, 81ock 2, OAKBROOKE STH ADDIION, City of Eagan, Minnesota and reserving easements of record. MAY 2 8 RECD R E,V - El???:? ?.?? ? T?EP"t'. dS'IL7 4???F 92 1" 0 x q24.o ' 921.1 `?, Z ° 2233 Pfo9b1ad ? *?j: cTo N e Rort? p0 ? ?.. ?N o garo9 BP?w titi. 'Q O R ( ,./ ° 7.5 1 " . `t o43 921,3 ..'.. ? ?N ?+ 18.50 '\?.65 .? 2 D +q2?.b JQHl?`NY ;`CA,,KE o ? ?453„ ?RIDGE 9z2,o i9zs.? s? '?RpAD 3:1 ?¢o a? ReWndng w? ? Reqwre? N• ? • t• fo??a?.a?. ?a?k f? sasvre ?e.s-,?iv? f/De?, # 17951 PROPOSED ELEVATIONS Top of Foundation = 425.5 Garage Fioor - q29,9 Basement Floor -qi-7 5 Aprox, Sewer Service = Proposed Elev. Existing Elev. _ Drainage Directions - Denotes Offset Stake = . HEDLUND PLINNINC dNCINd6RlNG SURi2'Y/NG 2005 Pin Dak Drfve Eagan, MN 55122 - Phone: (651) 405-6600 Fox: (651) 405-6606 x 93y o L 0 T SQ. F00 TA GE = 3,545 HSE SQ. FODTAGE = 2,367 L0T COI/ERAGE = 677o ,:.. ; `Q C PoG?oVo RE???R?D SCALE: t Inch a 30 leet BENCHMARK, C,0 TNH *tqpf2 Elw: q3V9 MIN. SETBACK REQUIREMENTS Front - House Side - Rear - Garage Side- JOB N0: I HEREBY CERTFY THqT THIS IS A 7RUE AND CORRECT REPRESENTATION 0213-047 OF THE BOUNOARIES Of THE ABOVE DESCRIBED PROPERN AS SURVEYED BY ME OR UNDER MY DIftECT SUPERVISION ANO DOES NOT PURPORT TO BOOK: PAGE: SHOW IAIPROVEMENTS OR EN OACHMENTS, EXCEPT 5 SHOWN. on? IS,? j . CAD FILE: ??`? 7 ? F E D. LINOGREN, LAN aURVEYOR ?- t-MINNEXTA LICENSE NUMBER 14376 OOkbfoOkfl 5 L ? PERMIT City of Eagan Permit Type: Building Permit Number: EA104817 Date Issued: 06/12/2012 ~it~ of QR Permit Category: ePermit Site Address: 4043 Johnny Cake Ridge Ct Lot: 8 Block: 2 Addition: Oakbrooke 5th PID: 10-53764-02-080 Use: Description: Sub Type: e-Reroof Construction Type: Work Type: Replace Description: House & Garage Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee $4K $103.25 0801.4085 Valuation: 4,000.00 Surcharge - Based on Valuation $4K $2.00 9001.2195 Total: $105.25 Contractor: - Applicant - Owner: Krech Exteriors Inc Ramdas R Rao 5866 Blackshire Path 4043 Johnny Cake Ridge Ct Inver Grove Heights MN 55076 Eagan MN 55122 (651) 688-6368 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 PERMIT City of Eagan Permit Type:Building Permit Number:EA124885 Date Issued:07/14/2014 Permit Category:ePermit Site Address: 4043 Johnny Cake Ridge Ct Lot:8 Block: 2 Addition: Oakbrooke 5th PID:10-53764-02-080 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. 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: 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 - Ramdas R Rao 4043 Johnny Cake Ridge Ct Eagan MN 55122 Property Claim Solutions Llc 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK ink r-----------------� I For Office Use � � /02 G��/ � ��� �� ��, ��, ��r�� VI 1�. j Permit#: � � 1 1 �a. �v � � Pertn�Fee: /�, 3830 Pilot Knob Road AUG 2 � Z��4 a g /� �`� Eagan MN 55122 � t, � Date Received: Phone: (651)675-5675 � �=' � � Fax: (651)675-5694 ';,'`;:. .-----.---_---- �. Lstatt_ 2014 RESIDENtIAL PLU BING PERMIT APPLICATION Date: � 1 `1 Site Address: V � � �.." i � �� . Tenant: t; ����-/ 1 ' Suite#: _ _ �:�,� � /�� (� �� �������, Name: Phone: (D.J���� ( �l/��� „ � - , ; � ; Address/City/ZiP� . v . �-�.�-.n�,._ : �� �. � � � � :��q� �C� �; � iVame: �i�ense � � Y. � Address: � �r • City: �= � � `��1�"+���' /' � � � State: 1-,�Zip: �. � Phone: l��� 5� /1 �� !� � ;� � : Contact: Email: � ,,���,���. _ ,� _ , U�� .�„� ` ; � � �.����� ;� _New �Replacement _Repair _Rebuild r Modify Space _Work in R.O.W. � ;� � � ' `` < Description of work: _ _ r; � ; RESIDENTIAL ; ' Water Heater � � �Water Softener ; � ' �awrr trrigation(_RPZ 1_PVBJ ������� � Add Plumbing Fixtures�Main/_Lower Level} � � Septic System � � ff New � Water Turnaround � � � _ � Abandonment � � ; r �� — �.���.: .. � �.,� . � .�.r:�,�: -� � � RESIDENTIAL FEES: � � � � $60.00 Water Heater,Water Saftener, or Water Heater and Softener(includes$5.00 State Surcharge) � � �r"sD.�iO Lawn irrig�fivn(incivaes$�.�r�:xnir�i�r�u���Stat�Su�c��r��} � $60.00 Add Plumbing Fixtures, Septic Svstem Abandonment,Water Tumaround"(includes$5.00 State Surcharge} � , "Water Turnaround(add$200.00 if a 518 meter is required) � � $115.00 SeqtiC SYStem New($10.00 per as built)(includes County fee and$5.00 State Surcharge) / �\ � � TOTAL FEES$ l0�'� `� � b�.a�.�..�,��,. ...�,�,.� . . .� _ _ ,..����� CALL BEF�RE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against untlerground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities: wwvv.gapherstateonecali.arq I hereby acknowledge that this iriformation is complete and accurate;that the work will be in confo�rnance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a p ' 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 revie and ap oval of plans. X t� ��o�� . Applicant's Printed Name Appli nYs Signature ,. ,. . , �t'3i������.� � ` R��ilst���3�',._; : ��'��,; �e�.��r�.���c��ns ; ,�;rt,�+�c����r�c��� .�,,.�ttt���� tr� ; ..�..�„��T��t ��"3"�� �`i�a[ l��t�r��1a���� : �Il��t����;..�.,,�=�,-�,w �at������f� �f�� PERMIT City of Eagan Permit Type:Building Permit Number:EA128002 Date Issued:10/22/2014 Permit Category:ePermit Site Address: 4043 Johnny Cake Ridge Ct Lot:8 Block: 2 Addition: Oakbrooke 5th PID:10-53764-02-080 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 by law in ALL single family homes . Lisa Nyberg 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 S Barenbaum 4043 Johnny Cake Ridge Ct Eagan MN 55122 Property Claim Solutions Llc 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA142098 Date Issued:04/13/2017 Permit Category:ePermit Site Address: 4043 Johnny Cake Ridge Ct Lot:8 Block: 2 Addition: Oakbrooke 5th PID:10-53764-02-080 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 S Barenbaum 4043 Johnny Cake Ridge Ct Eagan MN 55122 (651) 994-0283 Krech Exteriors Inc 5866 Blackshire Path Inver Grove Heights MN 55076 (651) 688-6368 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA152858 Date Issued:11/05/2018 Permit Category:ePermit Site Address: 4043 Johnny Cake Ridge Ct Lot:8 Block: 2 Addition: Oakbrooke 5th PID:10-53764-02-080 Use: Description: Sub Type:Residential Work Type:Replace Description:Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener). Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087 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 - Thomas S Barenbaum 4043 Johnny Cake Ridge Ct Eagan MN 55122 Tony's Appliance 2090 County Road 42 West Burnsville MN 55337 (952) 435-2442 Applicant/Permitee: Signature Issued By: Signature