4057 Johnny Cake Ridge CtBURNSVILLE
Heating & Air Conditioning, L.L.C.
12481 RhoAe IrfnroAAve S, Savage, MN 55378 • 952-894•0005
Orstat Test Report for Job#
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k? Addf2SS ?/XT?' Clty ??<<, r:
`?G-Occu?aM T? ?
?Date of Install
Y Type of HT. F/A ? HW Space HT ' Unit HT
K Olher
?( Make ?-.R,t.nCrX
v
Y.- Model G Ao?T-?
x Wal ruvar,r?r;a{??,
Input Sv vv v
Pilot Type HOT SURFACE /GNITOR
Pressure 3. ? C02 6,,7
Input CFH 576)1000 02 11 j
StackTemp 909! _ CO D
'IC Date Tested -7k; I Qa
Company BURNSVlLLE HEAT/NG & A/R COND/T/ON/NG
?CTechnician ?: ?t?r >
Siteaddress: LLS'??.? L*,X Lot 3?)+ Blocko e- Subd. r4- Ac ?rn?
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 constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670
OR
? This structure: will be constructed to meet more restrictive requiremenls of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANl1FACTURER MODEL BTU'S VENTING TYPE
Water Heater
arc? kf-i .?a y 1
Furnace ?. V 2-? ,?lrr?
Dryer
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
res r+o
Kitchen kitchen
Bathroom 1 FV^ S-. VCp
Bathroom 2 _ a stf 0 ? ?
Bathroom3
Bathroom 4
Other
FIREPLACE S
LOCATION
GAS
W00D
MANUPACTURER
MODEL
BTU'S VENTING
OiRECT aiMOS
1 .cF" A) 6- /0 6 ' I, 7 u6>
MAKE•UP AIR MODEL TYPE CFM's
Q
I hereby acknowledge that the ahove information is correct and agree to comply wilh the Minnesota Energy Cotle and City of Eagan
req'em ntV
? ? 27
Sig } r Date
Comp N* This form is the responsi6ility of the General Contractor.
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITYOFEAGAN m? ?--?q'?'Dp?j '?lU .SU
3830 PILOT KNOB RD - 55122 l\
651-681-4675 fp Q
NewConstruction Reouirements RemodeUReoairReauiremenls
• 3 regislered site surveys showing sq. H. W lot, sq. ft. of house; an?ll roofed a2as • 2 copies a( plan
?
(20%maximum lol coverage albwed) . 1 set of Energy Calculations for heated addilions
• 2 copies of plan showing beam & window sizes; poured found design, etc.) . 1 site survey kr extenor addilions & decks
• isetofEnergyCalculations . Indipte'rfhomeservedbysep6csystemforadditlons
• 3 copies of Tree Preservation Plan i( lot platted after 717/93
. Rim Joist Detail Opfions selection sheet (bldgs wiN 3 or less units)
DATE VALUA'ION ?I D4 000
JOB SITE ADDRESS 4057 `j'ok nw (a1rr = V_',Asv ('aurl'
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY
`I
?
TYPE OF WORK t?eJw1 C.pr\cd?['uc&, CL.2S«t,-liwl FIREPLACE(S) _ 0K1 _ 2
APPLICANT TiJ I?-- \ko6nF? PHONE# U' I
ADDRESS ?oCTIt,v t5,} P4rkwL4 ?U.Aa 1`fa zIPCODE *"
PAGER # _kD\)' _ 3tO9-,"o67 CELL PHONE #
FAX # ??? -'?? °I-(v 82'7
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COM 7ft!d Energy Code Category MINNESOTA RULES 7670 CATEGORY 1 4 2002
(check one) Residential Ventilation Category 1 Worksheet S Energy Envelope Calculations Submitted MINNESOTA RULES 7672 New Energy Code Worksheet Submitted
Plumbing Contractor. V?Uyv,_6i ns.. Phone #: q5a-'19 Z' a ?a 1
Plumbing Sys[em Include? Water oftener Lawn Sprinkler Fee: $90.00
_ Water Heater No. of R.I. Baths
_ No. of Baths
Mechanical Contractor: uJlev6d•11C Phone # 95a-v9?- D[X?S
Mechanical System Includes: _ Air Condilioning Fee: $70.00
_ Heat Recovery System
Sewer/Water Contractor: ?? C, nf'xQ-fl? L Phone # 7(e3 ? qa)R ~ r;-1,38
All above information must be submitted prior to processing of application.
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.
SignaFure of Applicant .` °4/
Certificates of Survey Received _?D Tree Preservation Plan Received _' Not Required `?I'_/
Updaled 2002
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
?<02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 6ct. AIt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Nt - SF
? 04 02-plex ? 10 OS-plex O 18 Deck ? 23 Porch(screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or_ N ? 25 Miscellaneous
$I31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
?O 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolitian (Entire Bldg only) - Give PCA handout to applicant
Valuation ?0, m?7 Occupancy MC/ES System
Census Code 2/ Zoning ?o City Water ?
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. 49 191? PRV ?
Nbr. of Bidgs ? Length ??? ? Fire Sprinklered
Type of Const W idth
REQUIRED INSPECTIONS
-?7 Footings (new bldg) IC FinaUC.O.
? Footings (deck) FinaUNo C.O.
Footings (addition) _ Plumbing
Foundarion HVAC
Drain Tile _ Other
Roof Ice & Water Final Pool Ftgs Air/Gas Tests Final
K Framing Siding Stucco Stone
? Fireplace _)C R.I. _S(Air Test ?'Final _ Windows (new/replacement)
? Insulation
T ' - Retaiuing Wall
Approved By ? ?, , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES $AC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
,as
? #-5
y
?? oz-q L>
? ?? (010
PULTE HOMES OF MINNESOTA
RECAP SHEET
DATE: 3111102
JOB NO; 0550-301-02 LOT: 1 eLOCK: 2
COMMUNITY: OAKBROOKE PATIO HOMES ApDITION: 5th
ADDRESS: 4057 Johnny Cake Ridge Court CI7Y: EAGAN
MODEL NAME: AMBER LO MODEL#: 17921 ELEVATION: 1
BUYER NAME: Tim & Karen Treadwell
ADDRESS: 13045 Penn Avenue South GTY; Burnsville STA7E: MN ZIP: 55337
HOME PHONE: 952-890-8057 WORK; 612-304-0669 WORK; 651-733-0971
ounuc• R0.1_RRfi-4643 r n te Co
JALCJ KC1'.:
y
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4!1a?i 4?? ??FS,::+"• ^v. ? v. 3 tu":.' 4 t +s _ t f ?t??
t at ?+?{?} "?`-"r
+^^,',a `.;?
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1 17921 AMBER LOOK-OUT $
1 18015 ELEVATION #1
1 11027 FIN B'S WlWHT.DRS&TRIM SEED PEARL PAINT
1 25014 CLNST.DOORSIPAINT TRlM SEED PEARL PAINT
1 35027 S.R.O. MBR/DEN
1 28047 UPGRADE CABINETS WHITE
1 14004 CARPET PAD UPGRADE
1 14002 2ND CARPET UPGRADE
1 17005 ELECTRIC DRYER OUTLET
4 17024 CEILING ELEC7RIC OPENING MBR, 2-FM RM, BR#3
1 23005 2 TON AIR CONDITIONER
2 32002 CAT 5 PHONEICABLEISATALITTE THREE PORT OUTLET BR#2 
1 21021 GAS FIREPLACE - CERAMIC WlWOOD
1 35048 BASEMENT LAUNDRY HOOK UP
1 17083 R.I. ELECTRIC - MICROWAVE
1 28055 42 UPPERS - WHITE
1 15031 UPGRD VINYL KITCHEN
1 22027 INSULATE O.H.DOOR - 2 CAR
NOTES: WHITE PAINTED TRIM - SEED PEARL
LER AND THE PURCHASER (S) FOR THE ABOVE ITEMS.
THIS CONSTITUTES A CONTRACT BETWEEN THE SEL
APPROVED BY BUYER (S):
APPROVED BY BUYER (S):
APPROVED BY SUPERINTENDEN7:
UNIT: 30102
STATE: MN ZIP:55122
GARAGE: 0 LEFT
APPROVEU tlY J'ALt6:
J i n,.- 07--2000 13 - 53
P. Ee/03
Mi7c!-s•;tk ('pMPLIANCE R$PORT (
M+..:?>?nta Enezgy Code p"`-E-?--
sr?€tware V'ere$bn .3.a
C:ec e y Date
C=?",fl:CY 7 DakOtA
: ';7V`.E;: Minn@90ta
7!:'1•iF'' 2
?':r?eTPUCTION TYP$: 3ing],e Famlly
p)hTr'r C-7-2000
DA ri- r?F HI,]iL719: 3/28/00
'Tii•G' AMB5R WALKOUT ELEVATION 41
rotqrt'iAjvCE; PA88E8
Po•a.; ; , -d UA m 393
Yr:-" ???me = 294
:5 .11 r3er_ter Than Code
Area or Cavity Cnnt. Glazing/Doox
Perimeter R-tlalue R-Value T3-Value
_----------- _------ __-^-----------.s_------ - -----------------_.____...
1278 46.0 0.0
Frame, 16 O.C, 2039 19.0 2.0 1
T•rnt:' ?:, :ar-od Frame. 16 " O.C. 1199 10.C? 2.0
'??=' ?'? ::7Ii•^. 9.0' ht/8.3 1 bg/9.0 1 inaul 47 11.0 0.4
fi?='ti ?•. ?'n•?.c. 2.51 htl3. z.' bg/3. 51 ingul 20 10.0 0.0
CTn"iTi3, i'7ir.dow8 or. Tkoare, Abave OY3de 324 U.350 1
r'?r„p`38
0.350
t{v"C *;;XIBMLNT: Furr.aae, 92.0 AFVE
_..._..- -•-------^'_------«--------------LL-------_____..._...--" _------- - ...
roM?T,ItArrcE C-TATEMENT: The proposed b+ailding deefgsl deaorlbed here ie
r..on?ic•-aD.t with the building plana, specifications, and otner calculatione
elibn,it*;ed with the permit applieation The prvyosed building haa been
c3P^jgn^a tp mest thc reguirementa of .the Minnasota EneYgy Codt.
? • /?/ -
Adt
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?7=?-----?'-- ^
1,
- LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMIT APPLICATION
PROPERTYLEGAL: L&'? f L3Ir.;.K 2 (?I.?- ? rD 4?'-
DATE OF SURVEY: 3-/- n:
d LATEST REVISION:
rn
c
m
L
v
DOCUMENTSTANDARDS
O z a
¢
? ? • Registered Land Surveyor sgnature and company
d ? ? • Building PermitApplicant
? ? • Legal description
[7/ ? ? • Address
? • North arcow and scale
?? ? • House type (rambler, walkout, split w/o, split entry, laokout, etc.)
? • Directional drainage artows wtth sbpelgradient °k
/? ? • Proposed/existing sewer and water sennces & invert elevatlon
? ? • SUeet name
? ? • Driveway
?o ? • Lot Square Footage
Ft?/? ? • LotCoverage
Ca? Cl ? • Benchmark
ELEVATIONS
/ Existinq
Y/ U ? • Sewer service (ar Praposed)
V ? ? • Property comers
? • Top of curb at the driveway and property line extensans
?E/ ? • Elevations of any existing adjacent homes
C??/? • Adequate footing depth of structures due to adjacent utilfty Venches
? ?" 0 • Waterways (pond, stream, etc.)
Proposed
? ? ? • Garage floor
J? ? ? • First floor
? ? ? • Lowestexposed elevation (walkouUwindow)
? ? ? • Property corners
?? ? • Front and rear of home at the foundation
/ PONDING AREA ('rfaoolicable)
? C+ ? • Easement line
? ¢( ? • NWL
? V ? • HWL
? 4/ ? • Pond # designation
? ? • Emergency OverFlow Elevation
/ DIMENSIONS
? ? • lot lines/Bearings & dimensions
k7' ?? • RighPqf-way and sVeet width (to back of curb)
?? ? • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring pertnanent footings)
P? 0 ? • Show all easements of record and any City utilities wdhin those easements
?0 ? • Setbacks of proposed structure and sideyard sethack of adjacent existing structures
?? • Retaining wall requirements, if any
Reviewed:
I. -
Surveyor's Certificate
SURVEY FOR :PULTE HOMES
DESCRIBED AS :Lot 1, 81ock 2, OAKBROOKE 5TH ADDIION, City ot Eagan, Minnesota and reserving
easements af record.
MAR 19 RECrU
•?? 3- ?_o-? ??4?
. '?XD??4h T. t
.?_.._.. 4
? 1L.T PENGF
% 1 O O p ?
A o 36A? o y o ? O?„ -''
'o
?-n
i D .5? 42y
6.00 proP?sed N ?
aame?sa??
7
3:1 MOAMUM
oe Rotaining Well Will
B@ R8Qld1f8C0
re
Lor
HSE.
LOT
# 17921
PROPOSED ELEVATIONS
ap312 ? 64.
N7 8
1?
?
b1
?
n
q3j ?
' RoP
U 0Lu
SQ. FOOTAGE
SQ. FOOTAGE
COVERAGE _
= 3,177
= 1, 72 7 : -??A?A6??.
547 ?' yV?EWpro DTL 3- 20
=G Z ?
, -
r'<°;1; 1_Li;a ?ii;r`>;'?4a!' i„
Top of Foundation = 031 s
Garage Floor = a3t.1
Basement Floor =G22.5
Aprox. Sewer Service =9iS.5'
Proposed Elev.
Existing Elev. _
Drainage Directions =
Denotes Offset Stake = .
IN?s
HEDLUND
PLANNlNG L'NGINEh'RlNG SURV6Y/NC
2005 Pin Ook Drive
Eagon, MN 55122
Phone: (651) 405-6600
Fax: (651) 405-6606
I HEREeY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATiON
OF THE BOUNOARIES OF THE ABOVE OESCRIBED PROPERTY AS SURVEYED
BY ME OR UNDER MY DIRECT SUPERNSION ANO DOES NOT PURPORT TO
SHOW IMPROVEMENTS OR ENCROACNMENTS, EXCEPT AS OWN.
DATE 3-11_JQ G..
Reo 3•??-O`t E D LINDGREN, LAND S YOF
E A LICENSE NUMBER 11376
JOB N0:
02R-040
BOOK: " PAGE:
CAD FILE:
Oakbrooke 5
BENCHMARK,
ao
MIN. SETBACK REQUIREMENTS
Front - House Side -
Rear - Garage Side-
SCALE: 1 inch = 30 feet
PERMIT
Permit Type: Building
City of Eagan
Permit Number: EA105961
Date Issued: 08/06/2012
Permit Category: ePermit
Site Address: 4057 Johnny Cake Ridge Ct
Lot: 1 Block: 2 Addition: Oakbrooke 5th
PID: 10-53764-02-010
Use:
Description:
Sub Type: e-Reroof
Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434 -
Occupancy:
Zoning:
Square Feet: 0
If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are
Comments:
not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes.
BL - Base Fee $4K $103.25 0801.4085
Fee Summary:
Surcharge - Based on Valuation $4K $2.00 9001.2195
Valuation: 4,000.00
Total:
$105.25
Contractor: Owner:
- Applicant -
Krech Exteriors Inc James L Kaplan
5866 Blackshire Path 4057 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:EA127282
Date Issued:09/25/2014
Permit Category:ePermit
Site Address: 4057 Johnny Cake Ridge Ct
Lot:1 Block: 2 Addition: Oakbrooke 5th
PID:10-53764-02-010
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 -
James A Russell
4057 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:EA128105
Date Issued:10/27/2014
Permit Category:ePermit
Site Address: 4057 Johnny Cake Ridge Ct
Lot:1 Block: 2 Addition: Oakbrooke 5th
PID:10-53764-02-010
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 -
James A Russell
4057 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:EA133360
Date Issued:10/07/2015
Permit Category:ePermit
Site Address: 4057 Johnny Cake Ridge Ct
Lot:1 Block: 2 Addition: Oakbrooke 5th
PID:10-53764-02-010
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 -
James A Russell
4057 Johnny Cake Ridge Ct
Eagan MN 55122
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264-4777
Applicant/Permitee: Signature Issued By: Signature
4 'ø
For Office Use
o Permit Fee: C.�
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 Date Received: 1✓ 3-/9
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 RECEIVED
Email: buildinginspectionsacityofeagan.com Staff:
Commercial Plan Submittal:eplans(&citvofeagan.com JUL 03 L ----J
2019
2019 RESIDENTIAL MECHANICAL PERMIT APPLICATION
Date: I-a-lei Site Address: L-{(35-j c 101nt,w 1:r1,1c , rite, Iii
Tenant: Suite#:
Resident/Owner Name�tVin/.Q,S i-- Vj tA-t&l u4,1 044 5 ) Phone:IPS 1-.\7C, 3,_ 141
Address/City/Zip: 1 I A A Art 1 as
Name:The Snelling Company
License#:
Contractor
Address: 1400 Concordia Ave. city_ Saint Paul
Zip: 55104 Phone: 651-646-7381
State: MN
Contact: Jody Email: info@snellingcompany.corn
RESIDENTIAL
Furnace
XAir Conditioner
Permit Type
Air Exchanger
_Heat Pump
Other
New X Replacement Additional Alteration Demolition
Type of Work �^
.
Description of work: 0,.�P_�1 aYIALL(�- y1-�°#
1IfilA Va c (S. uD gl,A -- r&K.R. Xr-ltio aq noo AT1
RESIDENTIAL FEES V l
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge
$100.00 Residential New, includes State Surcharge =$ V).OD TOTAL FEE
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update
on the City's website at www.citvofeagan.com/subscribe.
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 t. 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 •0 require review and approval of plans.
Philip Krinkie X A , '
Applicant's Printed Name •pplicant's Sig • •re
FOR OFFICE USE
Required Inspections: Reviewed By: Date:
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA166402
Date Issued:01/07/2021
Permit Category:ePermit
Site Address: 4057 Johnny Cake Ridge Ct
Lot:1 Block: 2 Addition: Oakbrooke 5th
PID:10-53764-02-010
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Fixtures
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (miscellaneous)$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 -
James A & Kathleen D Russell
4057 Johnny Cake Ridge Ct
Eagan MN 55122
(651) 283-4224
Weld & Sons Plumbing
3410 Kilmer Lane North
Plymouth MN 55441
(763) 475-0296
Applicant/Permitee: Signature Issued By: Signature