3728 Greensboro DrPLUMBING PERMIT
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122
PHONE: 454-8100
4) Name _
?o Address
c Ciry _
Name _
Address
City
Phone
.
?
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE 8 CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $2Q.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
I A
CITY OF EAGAN
PERMIT # ?
4??j
RECEIPT tl
DATE:
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
Water Closet - $3.00 ?
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Ki!chen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whlrlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
?` Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE:
STATE S/C:
GRAND TOTAL:
? PERMIT #
MECHANICAL PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: _
T PRICE: ?•, PHONE: 454-8100
m Name
Addre
H
E Ciry 1
Name
L
,r
3 AddresR
p City ,I ?-- Phone
TYPE OF WORK
Forced Air M BTU
8oiier M BTU $_
Unit Heater M BTU $_
Air Cond. M BTU $
Vent.
CFM -
Gas Piping Outlets #
Other $_
'
FEE
S/C:
TQTAL:
BLQG.TYPE
hes.
Mult
Comm.
Other
WORK DESCRIPTION
New
Add-on
Repair
FEES
RES. HVAC 0-100 M BTU -$24.00
AOQITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PEkMIn - 1.50 FA
COMM/1ND FEE - 1°r6 OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE 8 CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
REMOOELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
FOR: CITY OF EAGAN
' • ' ` ' PERMIT # X//
• PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE PHONE: 454-5100
?
$ite AddrPCa / I) d : ? 44.e &rL
t ? Bl
L
k S
/S
b
oc
ec
u
o
a'
m Name -??
?o Address
c City ` Phone '
Name
3 Add s
p %iPhone k?/ `.2 o
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLtES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PEFi PERMIT - .50
(ADD $.50 S/G IF PERMIT PRICE GOES
BEYOND $1,000.00)
.
SIGMATUFE OF PERI'v11TTEE ?
r -
I FOR: CITY OF EAGAN
BLDG. TYPE WdRK DE SCA P.?tON
/IRes. New V
" Mult. Add-on
- Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOILOWING:
NO. FIXTURES
Water Cfoset - $3 00 TOTAL
Bath Tubs - $3.00
Lavatory - $3.00
ShoweP = $3.Q0
=Kitchen Sink - $3.00 -I
Urinal/Bidet - $3
00
.
?Tray - $3.00
Laundr, s
,,
Floor Drains - $1.50 ?
Water Heater - $1.50 /SO
Whirlpool - $3.00
_?Gas Piping Outlets - $1.50
•? a
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
_2Rough Openings - $1.50
FEE:
STATE S/C: . `S U
GRAND TOTAL:
CITY OF EAPAN 14251
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH ON E: 454-8100
BUILDING PERMIT Receipt ?
To be used for Est. Value r'6 0 Date - ,19
SiteAddress
Lot Block Sec/Sub. i;
Parcel No.
Phone 4}1 "AUU 1
¢
o Name .
? ` Address
? City Phone
Phone
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.
Signature of Permittee
A Building Permit is issued to:
on the express condition that all work shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building Offici2l _ _____
O FFICE USE ONLY
On Site Sewafle Occupancy
MWCC System •` Zoning ?
On Site Well (Actual) Const
CNy Water k (Allowable)
PRV Required * of Stories
Booster Pump Length
Depth "
S.F. Total
Footprint S.F.
APPRaVALS FEES
i.. ?1.
Engr./Assess. Permit I
Planner
Council Surcharge
Plan Review
1
Bldg. Off. SAC, City '
Variance SAC, MWCC
Water Conn. ?
Water Meter ` ? • I
Road Unit - ?
Treatment P1
Parks I
? f ` • • :' d
1 '
TOTAL .
- Permit No. Permit Holder Date TNephone ?k
Plumbing
.
EIBCtrIC ?? ?%? ?'?'" 12 .. ,??? ?Q•/'? "W"J
Softener
Inspection Date Insp. Comments
Footings I Mq ?B
Footings II
Foundation
Framing l r ^ - •
Roofing
Rough Plbg.
Rough Htg.
Isul.
Fireplace
Final Htg. 7 ?
Final Pibg.
Bldg. Final
Cert Occ.
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
I BU(LDING PERMIT
I To be used for DL'CK
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
Receipt #
i Site Address 3128 CBEENSD0RO DR
Lot 3 Biock b Sec/Sub. GREENSbORO 2ND
Parcel No.
W Name ?BERT b KI1Tt3RYN Ef/ltrl90ND
I
; Address 3728 GREENSBORO DR
, 0
City EAGAN Phone 456-0926
?
i
o
Name $AME
00191 Address
, City Phone
yVj W Name _
?
? ; Address
z
s W City -
I hereby acknow
I? inlormation is co
Minnesota Statub
Signature ot Pern
A Building Permit
on the express a
I applicable State c
Building Official -
Phone
ege that I have read this application and state that the
rrect and agree to comply with all appiicable Stale of
,s and City of Eagan Ordinances. {
chall be done in accordance with all
and City of Eagan Ordinances.
Occupancy
Zoning
(Actuaq Const
(Allowabie)
;Y of Slories
Length
oepm
S.F. To1al
S.F. Foolprints
On Site Sewage
On Site Well
MWCC System
Ciry Water
PRV Required
Boosler Pump
APPROVALS
Planner
Council
Bldg. Oif.
Variance
I1
177 0 0
-, 19 90
FEES
OFFICE USE ONLY
?
1•50
27.00
?
25.00
a
?
.50
i1
I
Bldg. Permit
Surcharge
Plan Review
snc, cty
SAC, MCWCC
Water Conn
Water Meter
Acd. Deposit
SNV Permit
S/W Surcharge
Treatment PI
Road Unit
Park Ded.
Copies
TOTAL
Permit No_ Permit Holder Date Telephone !i
WATER
SEWER
PLUMBING
H.V.A.C.
EIECTRIC
Inspection Date Insp. Comments
Footings I
f Wnd8ti0f1
framing
Roofing
Rough Plbg.
Rough Htg.
Isul.
Freplace
Fnal Htg.
Final Plbg.
Const. Meter Plbg. Inspector - Notify Plumber
Engr./Plan
Bidg. Final
Deck Flg. ? v
APO
DeCk Final
Well
Pr. Disp.
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21 •199, Eagan, MN 55121
PH ON E: 454-8100 ,
BUILDING PERMIT Receipt #
Tobeusedfor Est.Value Date -' ,19 u7
Site Address _
Lot Block
Parcel No,
a Name JUSEPH MiLL£R C+ONST
z Address 16133 r,eO" AvE :i0
? Citjr ;,;' iNGTON Phone 1'31--20U1
SA??
. o Narre F
? ? Address _
? City Phone
rQ
? WW
W
Name
F
?
Address
U
`W City ? Phone
I hereby aCknowledge that I have read this application and state that the
information is correct and agree to comply with all appiicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signatyre of Permittee
A duilding Permit is issued to: JOS?•, P!i M 1 LL,kili+
on the exprass condition that all wak shall be done in accordance with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
8uilding Official -
372$ C;RBENSHOAO 1R
4
Sec/Sub. GkEEnSB0i20 Z?Vll
OFFICE USE ONLY
On Site Sewage OcCUpancy " S
MWCC System h Zoning ? i
On 5ite Wel1 (Actuaq Const
City Water x (Allowable)
PRV Requfred # ot Stories
BoosterPump Length
Depth 4`'
S.F. Total
Footprint S.F.
APPROVALS FEES
` ?C?4•S(}
Engr./Assess. Permit ?
Planner Surcharge
Council Plan Review 191. 5(}
BIdg.Ofl. SAC,City 100•00
Variance SAC, MWCC 525•00
Water Conn. 525.00
WaterMeter 67•,00
Road Unit 3nvi-oU
iBU•?
TreatmentPl
Parks
TOTAL ' s' . 312 . QL}
BLDG. PERMIT N0.
`; P,)
' , - rD r
01-3210 Bldg. Permi
01-3422 Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge
17-3860 Road Unit
2275 SAC
0-3865
f Water Conn.
3868
'20 W
T
- rmt.
ater
20-3716 L:ater Meter
20-2252 Acct. Dep.
20-3713 Water Permi
20-3743 Sewer Permi
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
CASH RECEIPT ?
CITY 4E f?i4GAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
1
DATE 19 _
REGEI V ED .
FROM
AMOUNT ? I
& DOLLARS
?oo
E]CASH [] CHECK
FOR
sv ` /1 l..-({.- ?k_
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
Thank You .
CITY QF EAGAN Permit Na 10289 pale.
3830 RNot Knab ROad B/P No: %FQ,LL? Dat@: I U-?-?'? i
P.0. Box.91199 , ` ' .
Eaya`h;•MN 55121 Owner.
- - r C
Site Addr@SS: _'' 3('rpAn c1,nrn jrj,yE T'j R4 r^ pi
nnwec: _ YI1At4111??.
ciry cn9: ' Before digging.ca!lriecahg#ii?ies _
acct oep: _ TELEPHONF • Fi Fr?'?*ee?Rfr ?C
Permit Fee: f§cWplr with the City of Esgan
Surcharge: REQUIRED O'•nin/"'l W
Misc: gy.
SEWER SERVICE PERMIT
CITY OF ZACiAN Pe9139 3830 Pllpt Knob Road rmh No: 1 ?-9-° 7
Meter No: Dgt?
P.O. Bnx 21199 ' F S i ze:
Eagan,'?MN 55121 R?der No:
Date:
Owner. Joe
SitCAddrace• 27n0 _ '
onn. Chg: Ct Dsp;
rmit Fee;
rcharge: Plant
l ??1a??1Y wit?? the Cit
ol E
eter
c.: y
agan
„`
• „, ?II
BY .
WATER SERYICE pERMIT
f - --
CITYOFEAGAN PermitNO: L '1z??," Date: t;l_c
3830 pifbt Knob Road B/P No: -11 Date: -•?
P.O. "x 31190 • -
Eagan, lY1N 55121
Owner. _ -Lvi l l er !'.e-w -
Site Address: ` _ 'r? wr,.t.?,T,•. ._ . ._? t ? ? ,: -. _ _ , _ --
MWCC: ?=7:v'"•? Zoning.
City Chg:
No. of Units:
Acct. Dep:
Permit Fee:
•-
I agrse !o comply with the Clty of Eayan
Surcharge: Ordinances.
Conn. Chg: 525 _ r1t; ;);: Zoning:
.
Acct. Dep: I 4- No. of Units: l
Permit Fee: 1 Q
Surcharge:
Tr. Plant 12,41 _ ni:l,j I agree to comply with the Clty of Eayan
Ordlnances.
Meter.
Misc.: gY
WATER SERVICE PERMIT
CITY OF EAGAN Permit Na 9131) pate 19° J-,?
3830 Knob Road Meter No: Size:
P.O. Box 29199 'Reader No: Date:
Eagan, MN 55121
RESIDENTIAL
r BUILDING PERMIT APPLICATION
CITY OF EAGAN
r
3830 PILOT KNOB RD - 55122 k I I 3r?J
651-681-4675 4
NawConsWCtion Reauirements RemodellReoairReauirements
• 3 regislered stte surveys showiig sq R W bf, sq, ft o( house; ancbg roofed areas • 2 copies of plan
(20% mauimum lol wverdge albwed) . 1 sel of Energy Cakulatiore for heated addNOns
. 2 oupies of pian show(ing beam Q windax s¢es; poured tound design, etc.) . 1 site survey for extedor addNOns & decks
• 7 set of Energy CabuWtlons . IFvdicate iF home served hy sep6c system for additions
. 3 copies af Tree Preservatlon PWn H bt platted after 7M193
. Rim Joist Detail Options selection shcet (Eldgs w(dh 3 or lass units)
DATE ?7LJa
JOB SITE ADDRESS Z "7.2R Gca.e,ns(Ne, +,
IF MULTI-FAMILY BUILDING, HO1WI MANY UNITS? -
PROPERTY OWNER? a ?J ?tE nc?Q.C..
TYPE OF
FIREPLACE(5) _ 0 _ 1 _ 2
APPLICANT PHONE#
ADDRESS 1q ZIP CODE E-r 7? '7
PAGER # CELL PHONE # G/Z - `V96 - `I 8b I FAX #
NEW RESIDENTIAL BUILDING ONLY- FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RUL.ES 7670 CATEGORY 1
(check one) - Residential Venlllation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
_ MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Plumbing Contractor: _
Plumbing System Includes:
Mechanfcai Contractor. _
Mechanical System Includes:
Sewer/Water Contracfor.
_ Air Conditioning
? Heat Recovery 3ystem
All above information must be submitted prior to processing of
I hereby acknowledge that I have read this applicatioh,
with all applicable State of Minnesota Statutes and City
Slgnature of
_ Water Softener
_ Water Heater
_ No. of Baths
VALUQION . OR
Phone #:
Lawn Sprinkler
No. of R.I. Baths
that
and agree to comply
Fee: $90.00
Phone #
' Fee: $70.00
Phone #
Certificates of Survey Received - Tree Preservation Plan Received _ Not Required _
upwaceu vo1
This reques[ void
IB rrqnfis Irom ?? S/r? / ? I l[ ?
D 726 4,?3
flq?uesyyy Daje .
/, / Fue No. Fouph-in Insuerbon
Ra
s'
?Readv Now?ll Notdv Inspec'
o
Wh
R
? j ?No
e r
en
eatlY
?Lice4
used Electncal Convactou I hereby request ins0ecbon al ebova
? Owner eleclncal work installed et
Srteet Address. Box or Roate No. CilY
-?'10 ??'?.
ecbon o. TownshIp Name or No. PanUe No. Counly
OcwG?nt (PflINT) Phone No.
GE
Power Supplier ?+dtlress
? C? G
RiPt9h-7'-4
"/r/ ~ 7+b// r,IG SSD 3
Electncal Convactor IComD.nY Nemel n
(rar,lor's License No.
Co
???/ L ?
}
`'
Mailine ?+d ress IContracmr or Owner Mabnp Instailavonl
? SO C? Ca?. C? O U S U/ IIf Y 7
Au horaed S?g?ature ICOnvacinr?Owner Ma?ng Installalwn) Ph ne Number
v,.?. . 'cJ - 1G!
/MINNES$TqTE BOABD OF EIECTAIGITY THIS IfVSPECTION NEQUEST WIIL NOT
?Griqga.Midwey Bldg. - Poom N-191 BE ACCEPTED eV THE STqTE BOANO
1821 Univerettv Ava.. St. Paul. MN 55104 UNLESS PflOPEH INSPECTION FEE IS
ENCLOSED.
Phone 16121 642-0800
REQUEST FOR ELECTRICAL INSPECTION ea-ooooi-os
+7,2654 c ' Spee insbuc4ms lor completup this form on beck of Vellow caov.
?- '"1!" Be/ow Work Covered by This Request
Aan Neo TYOa ot ewia,ng Aooluance. Wved Equiument wi.ed
Home Range Temporary Service
Duplex Water Heater Lightiny Fixtures
Apt. BwlAmg Dryer Elecnic Heatin
Cominercial Bldy Fumace Silo Unlonder
Industrial Bldg. Air Condiuoner Bulk MiIk Tenk
Farm om«, o«??? ? o,ne, tsu????fv)
1?n ucc.? y Ot er Oth,ar
Comnute lnsoectron Fee Below
p Fee SarviceEntrance5ixa fl Fee Feaders/Svbleeders a Fee Circwts
pe 0 ro200Ams 0 to30Ams O 0 tn30An
Above 200 Ampa 31 to 100 Amps d 31 ro 100 Amps
Swinvning Pool Above 100.-Amps Above 100_Am s
Transiormers Irrigation Booms OS' Partia6"Other Fee
Signs Special Inspection
Rema rks
Q
TOTAL
71`_2 00
RouBn-in D11e / the Elect
? (j`?/,?A? nsoector, hareby
? cartdy that the above II
Final ? Uatt' nspechon hes Eeen
t ??,?4 S ede.
Rtln reauest voiE 18 months trom
CITY OF EAGAN N°_ 14 2 51
3830 Pilot Knob Road, P.O. Box 21 -199, Eagan, MN 55121
v _ PHONE:454•8
BUILDING PERMIT 100 . y?0?/
/
Receipt#_
7o be used for SF DWG/GAR Est. Value $66,000 Date OCTOBER 5 ,1987
Site Address 3728 GREENSBORO DR OFFICE USE ONLY
GREENSBORO 2ND
Lot 3 glock 4 Sec/Sub On5ite5ewage _ Occupancy R3
. MWCC System X Zoning Rl
Parcel No. Vn
On Site Well (Actual) Const
a Name JOSEPH MILLER CONST Ciry Water X (Allowable) Vn
3 Address 18133 CEDAR AVE SO PRV Required _ # of Stories
°
City FARMINGTON phone 431-2001
Booster Pump _
Length 39
Depth 46
?
.o
Name SAME
SF 7otal
?Q AtldfBSS FootprintS.F.
c
P
City phone
APPROVALS
FEE5
u w
W Name Engr./ASSess. Permit $ 384.5C
33
OC
Gi Address Planner Surcharge .
x
.
a w
CITy Phone
Council
Plan Review
192 . SC
eldg Off SAC
City 100.OC
I here6y acknowletlge that I have read this applicaUOn and s[ate that the Variance ,
SAC, MWCC 525.OC
mformation is correc[ and agree to comply with all applicable State of Water Conn. 525.OC
Mmnesota Statutes and of Ea$an Ocd' 4nces. 6
Water Meter 7 . OC
SignatureofPermittee - RoadUmf . lOS_OC
A Bmlding Permit is issued to: JOZEPH MILLER N T Treatment Pl 180.OC
ontheexpresscontlitionthatallw kshallhedonemaccordancewithall
apPhcable State of Minn [a Statutes an rty obE
a9an Ordinances. Parks
j'
BuildingONicial K/ TOTAL $2.312.OC
a
CITY OF EAGAN N2 ' 77OO
_ 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
"
BUILDING PHONE: 454-8100 10 M(L['1 I
PERMIT Receipt #
7o be used for DECK Est. Value $1, 000 Date APR 11 19 90
Site Address 3728 GREENSBORO DR
Lot 3 Block 4 Sec/Sub. GREENSBORO 2ND
Parcel No.
w Name ROBERT & KaTHRYN HAtaMOND
0 Address 3728 GREENSBDRO DR
City FAGAN Phone 456-0926
zo Name S.?
g Q Address
? City Phone
?
Ww Name
r
Address
<W City Phone
I hereby acknowlege ihal I have read this application and slate that the
inlormation is correct and agr e to comply with all applica6le State of
Minnesola Stamtes and Cny of agan Ordina S.
/
SignaNre of Permitee ?/V • ? ?/?/
A Bmlding Permn is issued ro: LU122M OR KA7NRVN HAMMt7TA1
on the ezpress condrtion that all work shall be done m accordance wrth all
applicable State of Min/nesota StaWtes andy City 11of Eagan Ordmances.
Bwlding ONicial fisj'? ! 1 I I r?
Octupancy
Zoning
(ACtual) Const
(Allowa0le)
# ofStories
Length
Deplh
S.F. 7ota1
S.F. Foolprints
On Site Sewaga
on sne wen
MWCC System
City water
PRV Required
eooster Pump
APPROVALS
Planne/
Council
BIdg.Olf
Variance
OFFICE USE ONLY
30'
16'
FEFS
Bldg. Permn
Surcharge
Plan Review
SAQ City
SAC,MCWCC
Water Conn
Water Meter
Atct. Deposil
SIW Permit
S/W Surcharge
Trealment PI
Road Unit
Park Ded.
Copias
TO7AL
25.00
.50
1.50
27.00
657J3 A ,
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
\1
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694 - -
-7d oa
New Construction Reauirements RemodellReoair Reouirements
3 regisfered site surveys shwriig sq. ft. of lof, sq. ft of house; and all roofed areas 2 copies of plan F
(20
Ya marimum lotcoverage allowed) 1 set af Energy Calculations for heated addltlons
2 copies of plan showing beam & window sizes; poured found desgn, etc. 1 site survey tor additions & decks Effl-
3 lsetofEnergyCalcuWtions Addifion-indicffieHonsitesepficsystem copies of Tree Preservafion Plan tt bt platted after 7/1/93
Rim Joisl Defail Options selection shcel (bldgs wiN 3 ar less unifs
Date a%_ /jULLA / Construction Cost 1-44 ^
SiteAddress c..Jf:^-1 UniVSte #
7
Description of Work ISS(, <• Q-Gn
Multi-Family Bldg _ Y_ N F7replace(s) _ 0 _ 1 _ 2
PropertyOwner -b( ]y-Z..Q\ }?nC,?\C.L\ Telephone#((,0$1
RMA HOME SERVICES, INC.
Contractor Home Deopt Installed 5ales
Address 3200 Cobb Galleria Pkwy.Ste. 4200 ?ity
State Atlanta, GA 30339 Telephone #( )
763-542-8826 BC-20268257
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateeorv 1 Mimiesota Rules 7612
Energy Code Category . Residential Ventilation Category 7 Worksheet , • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously
fee applies.
Licensed Plumber
Mechanical
uufal? ed a building in Eagan with a similar pian? _ Y _ N If so, 25% plan review
?I?fI.? I?,n
Sewer/Water Contractor
Telephone #(
Telephone #f
Telephone #(
I hereby apply, for a Residential Building Permit and aclrnowledge that the informarion is complete and accurate;
that the work 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 pemut, but only an application for a permit, and work is not to start without a
pemut; that the work will be in accordance with the approved plan in the case of work which requires a review and
approval ofplans.
CL-a." ?nSCSN
Applicant's Printed Name
(dd?.?wcr??
pplicant's Signature
,
.
Installed
Siding and Windows
LIMITED POWER OF ATTORNEY
c;uuN rY ur c;utstt
STATE OF GEORGIA
KNOW ALL PEOPLE BY THESE PRESENTS:
THAT I, David N. Katz, a resident of Montgomery County, Pennsylvania
("Principal"), and a licensed contractor of RM.4 Home Serviccs, Inc., DBA Home
Depot Installed Sales located at 660 Mendelssohn Avenue North, Galde;. Vallep, MN
55427, having a license number of BG 20268257, do hereby appoint, name and
constitute Elder-Jones Building Permit Service, Inc. ("AgenY') as my true and lawful
attorney-in-fact and do authorize and grant said attomey-in-fact for me and in my
name, place and stead the power to execute, acknowledge, sign and deliver (in such
form as may be required by the municipality) a permit application, or any other
instrument(s) which may be necessary and appropriate, in order to obtain the proper
permit(s) from the City of Eagan, Minnesota for the installation, maintenance and
repair of windows and siding (the "SVork").
The powers conveyed to the Agent by this Liinited Pov?e: of Attorney are
limited solely to the express powers delineated herein and apply solely tu the GVork.
This Limited Power of Attomey shall expire and automatically be revoked on the 21st
day of May, 2004, which date is one year from the execution hereo£ Further, the
powers conveyed by this Limited Power of Attorney may be revoked by Principal at
any time by express revocation and shall also be revoked by the Principal's death,
disability, incapacity or incompetence.
IN WTTNESS WHEREQF this Limited Power of A±±orney is execurtcd thic
21st day of May, 2003
David . Katz
S WORN TO AND SUBSCRIBED BEFORE ME by David N. Katz on this
21 st day of May, 2003.?
_??g9pau !
Notary Pfthlic in for the State o eorgia
My Commission Expires: 7anuary 21, 2006
396816.v3
Proudly sold, furnished and installed by RMA Home Services, Inc., a Home Depot authorized contractor.
3200 Cobb Galleria Parkway, Suite 200 • Atlanta, GA 30339 • Phone (770) 779-1300 • Fax (770) 984-0709 • Toll free (800) 79-DEPOT
: . ! lqo 0
1990 BUILDING PERMIT APPLICATION
, CITY OF EAGAN
I ? ?SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PLANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATZONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
# OF RENTAL UNITS
# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED °LUMBER.
To Be Used For:
? ? 1 R
Valuation: 1000 ? Date:'
Site Add'ress 32J96rE21'7S60('O 1C:
Lot 3 Block 'y
_
Parcel/Sub 6?2££Ar'?"t''ft"aa%" 4pa.
Owner /??£.LrA?•%/,,m,o?o'f/G??y,:1.?,cy.r„w
Address 3721 ??fAd'e-G' -/,X '
City/Zip Code 'j.J
Phone yl??
Contractor /v o?) 'E--
Address
City/Zip Code
Phone
Arch./Engr. Aj -4?
Address
City/Zip Code
Phone #
USE ONLY
FEES
Occupancy
Zoning
V?
Actual Const Bldg. Permit
Allowable Surcharge 15
?
# of stories P1an Review
Length 30? SAC, City
Depth 16' SAC, MWCC
S.F. Total Water Conn
Footprint S.F. Water Meter
Acct. Deposit
On site sewage_ S/W Permit
On site well S/W Surcharge
MWCC System _ • Treatment P1.
City water _ Road Unit
PRV Park Ded.
-
Booster Pump _ Copi.es ?
?
SUBTOTAL
APPROVALS Penalty
Planner TOTAL o( ? "
Council
Bldg. Off.
Variance
? ? ?...,
1" Rl - L.AN D C 0.
SURVEYING
SERVICES
1260 YANKEE DOOpLE ROAD
EAGAN, MINNESOTA 55122
SITE PLAN FOR:
JOE MILLER GONST.
LEGAL DESCRIPTION: Lor-3-,BLocK.4?GREEN5BORO sgcoNaAoo.
ACCORDING TO THE RECORDED PLAT
THEREOF p<1KOTn COUNTY,MINNESOTA
?
y?c
/
9
9
:
3
o?
o nj
N?
N 640z8'18"E /
46.12
?- . ylo? L7
5? ?5
i 1
LOT 3 ,
1
'0.1 ,
2 '
' J--?--
I
SGAt-E : I"=3d
2
Z
w
- o;
v ,
? --??I---?'
r1
? r
S m? m /
?_ ? J~ o
?noRo 2,4°3a 3?
//5 pp R? 739 M
GREEn?SBoRo
1_EGEND
o DENOTES IRON MONUMENT
? OENOTES WOOD HUB SET
DENOTES EXISTING SPOT
ELEVATION
OENOTES PROPOSED SPOT
ELEVATION
? DENOTES DRAINAGE DIRECTION
Bradley ?f(renson, Mn. Rep. No. 15235
Date ? ?/ ?/91.30/
I hueby certify that thic survay, plan or
report was prepored by me or under my
direct supervision and that 1 am a duly
Repistered Land Surveyor under ihe
Laws of ihe Siote of Minnesotq.
DRf
INVERT ELEVATION AT SERVICE EXTENSION=
PROPOSED GARAGE FLOOR ELEVATION=.
PROPOSED FIRST FLOOR ELEVATION = .
PROPOSED BASEMENT FLOOR = .
ELEVATI'OW
NOTE ? VERIFY ALL FLOOR MEIGHTS WITH
FINAL HOUSE PLANS
/ V25
- CITY OF
SINGLE FAMILY DWELLINGS
INCLODE 2 SETS OF PLANS, 3 CERTIFICATES OF SQRVEY, 1 SET OF ENSRGY CALCQLATIOHS
NOTE: ADDRESSES FOE CORNER LOTS - CONTR9CTOR/HOMfi01iNER MDST DESIGAAiE WHICH ADDRESS
IS DFSIRED. NO CH9NGFS WILL BE ALLOWSD ONCE BQILDING PfiRMIT IS ISSDED.
HIILTIPLB DWELLINGS - RFSIDENTI9L RENTAL DNITS FOR SALE ONIRS
INCLUDE 2 SETS OF PLANS? CEATIFICATE OF SIIRYEY - CHECg WITH BLDG. DEPT.p
1 SET OF ENERGY CALCULATIONS
C0LMMRCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS, ? OCT
$2,000 LANDSCAPE BOND 61987-
To Be Used For: `"n Oli) 4'81YL4 Valuation: -1+? Date: 9 -IS'A-7
Site Address 37a
Lot 3 Block ?Y •
Parcel/Sub ?Ap?/?r{/,??,??
Owner
OFFI
?? D?JO
On Site Sewage_
MWCC System 1/1
On Site Well
City Water ?
Address City/Zip Code
Phone
Contractor
Address is OWq
City/Zip Code '4
Phone
Arch./Engr.
Address
City/Zip Code
APPROVAIS
Assessments
Water/Sewer
Police
Fire
Engr
Planner
Council
Bldg Off > i0 2
APC
Variance
Occupancy ?
Zoning
Type of Const
(Actual) V- N
(Allowable) V_14
I6 of Stories
Length 311 _
Depth 4{6
S.F. Total
Footprint S.F.
FE&S
Permit .50
Surcharge 00
Plan Review a, o
SAC, City l00.00
SAC, MWCC 2 ,00 '
Water Conn 5.2?,00
Water Meter 69,00
Road Unit 30 ,00
Treatment P1 I$D,00
Parks
Copies
TOTAL
rll'?
Phone ll
(ts /-GUU
TRI-LAND C0.
SUFtVEYING
SERVICES
1260 YANKEE DOODLE ROAD
EAGAN, MINNESOTA 55122
w
5r
LEGAL DESCRIPTION: LOTBLOCK-4- , GREENSBORO SaconioAoo.
ACCORDING TO THE RECORDED PLAT
THEREOF DAKOT.4 COUNTY,MINNESOTA
N 64°28'l8"E /
46.12 4
9
9
:
3
o?
0?
LO1
SITE PLAN FOR:
JOE MILLER CONST.
tio
? l
? J I
1 ?
51 ,.
-
0
J?
? ?.
3
`
,
1
SGALE : 1"=30'
;2
Z
?
? ?-
? o_
,. ?
` i
_ -=- o
'(IO?cO
?
o
1150O R=26739 JC?+`???
M as= ???es? ? ?m-?s
GREENSBORO
{_FGE!V4
o DENOTES IRON MONUMENT
o DENOTES WOOD HUB SET
DENOTES EXISTING SPOT
ELEVATION
DENOTES PROPOSED SPOT
ELEVATION
? DENO7ES DRAINAGE DIRECTION
I hereby certity that this survey, plan or
report was preparsd by ms or undar my
direct supervision ond that I am a duty
Reyistared Land Surveyor undsr fhe
Laws of the Stote of Minnesota.
DR??
INVERT ELFVATION AT SERVICE EXTENSION=
PROPOSED GARAGE FLOOR ELEVATION =
PROPOSED FIRST FLOOR ELEVATiON =
PROPOSED BASEMENT FLOOR =
ELEVATI"ON
NOTE ? VERIFY ALL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
Brodley J?(/?renson, Mn. Rep. No. 15235
ri
Dare ? 9/30/
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
.... .
N07.'': PAYMFTtC OF k'EE AT TIME pg
APPLICMION mES NOr CO10TITUTE
APPR()VAL OF PFI2FIIT.
IasrncrioN oF sOM Arro/ox MWM
rnSTar.ramrONS WIIS, NCr BE SCEED-
ULID UNTIL PII2MIT HAS HffiN
APPROVID.
T*********#**?***f**,r********?:***:*
P ease Print
1) PROPERTy ADDRESS: ,37a0 (2-rcr,?-s (o?o I?h •-
LEGAL DESCRIPTION: 3 q -
vision or
IF EXISTING SIRCCMRE, DATE OF ORIGINAL BUILDZNG'PERMIT ISSL'ANCE:
PRESENP ZONING/PROPOSID L'SE: ?n Year -
q COME[2CIAL/REI'AIL/OFFICE SINGLE FAMILY .
p irroesxRIAL Q R-2 DLPLEX (Tygo Llnits)
? INSTI7SJTIONAL/G0VaUZENT ? R-3 ZOWN30USE (Three + Units) ( t?nits)
. [? R-4 APARTMENT/COAIDOMINILTI ( Units)
2) ••• ?
N11ME:
a,DDREss:
CITY. STATE, ZIP: j?a+...v? ?oJ ?tJ
rxorE: y3i-aoo !
3) For City Use .
NANE: rxo?X-c. /7lp rrc. Pltmbers I.iceIlse:
AwnxEss: a, 4), A ?ii ea
CITY, STATE, ZIP: y7eJ R Not recorded
PHONE: S,5 `? .3Lo?.i MASTER LICENSE# M?oG S?
. St In1t1a1
4) •• • i?• - --
NAME: 4s (2 ) .
. ADDRFSS: •
CITY, STATE, 2IP:
PHONE:
'?+' : a • a• aR
?G6NNEX..TION TO CITY SEWER [a--tpNNwrION TO CITY Wp,TER ? pTfIER
6) ?? ' •• [?3-PIZy,gE HOLD APPROVID pERMIT FC)R PICK-UP BY ONE OF AHOVE
[] PLEASE MAIL APPROVFD PERMIT T0 1, 2, 3, 4, ABOVE
(Circle one) '
7) m?- ?. ?7
FOR -CITY USE ONLY
PERMIT # ISSUED
/ ? .
Pd w/Bldg. Permit FEES:
$ SEWER PERMIT (INCLUDE SURCHARGE)
$ WATER PERMIT (INCLUDE SORCHARGE)
$- 6 7' C- z? $ WATER
METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLUDE CORPORATION STOP)
$ $ SEWER TAP
ACCOUNT DEPOSIT - SEWER
'I ACCOUNT DEPOSIT - WATER
$
WAC
$ L
SAC
$ $ TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRUNK WATER
$ $
WATER TREATMENT PLANT SURCHARGE
$ $
OTHER:
$ Gv 7! $
TOTAL
RECEIPT Z -
-
R E;?EIPT IF
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
? YES IF YES, THEN A"PERMIT FOR WORK WITHIN PUBLIC
Q
NO ROADWAY" MUST BE ISSOED BY THE ENGINEERIIVG
D
IVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TITLE:
DATE: j ?'/ y /y2
?-?%d
LJ- B? CITY OF EAGAN
? n a j MECHANICAL PIItMIT RECEIPT # a S°
SUBD. ?1?.?Xro-K.o c? (612) 651-4675 DATE ? 8'
RESIDENTIAL
PLEASE COMPLEPE UPPER PORTION ONLY FOR SINGLE FAMII Y DWEI.LINGS. AISO, COMPLETE FOR
TOR'NHOMFS/CONDOS R'HEN SEPARATE PERMTI'S ARE REQUIRED FOR EACH DR'ELLING UNTf.
owxEt: ? , -4- ?t, m onc? FEES
STfE ADDRFSS: ADD ON/REMODEL (FMSTING /?r/c,
CONS7RUCI'ION ONLl)
S 15.00
INSTALLER: HVAC: 0.100 M BTU 24.00
PHOWE #: 12481 Rhode Island Ave. S0. ADDITIONAL SO M BTU 6.00
nnDxEss: avage, MN 55378?1122 Gns ovTI,ETS - MNIMUM i@ Sa En.
CI1'Y: ZIP: SURCHARGE $ .50
SIGNATURE:? ??- 77-? ?1/7 a TOTAL:
?
COMMERCIAL
PLEASE COMPLEI'E THIS PORTION FOR ALL COMMERCLWINDUSTRIAL BUILDINGS. ALSO COMPLEfE FOR
APARTMENT BUILDING5 OR OTHER MULTI•FAMILY BUILDINGS R'AEN SEPARATE PERMITS ARE NOT REQUIRED FOR
EACH DWELI.ING UNIT.
R'ORK DESCRIPI'ION: CONTRACI' PRICE
196 OF CONTRACT FEE. FFFC
STATE SURCHARGE IS $.50 FOR EACfI
$1,000 OF PERMTT FEE
$
PROCFSSED PIPING • $?,5.00
MINIIIIUM FEE - $25.00
$
OWNER: TOTAL: $
SITE ADDRESS:
TENANT: (.'
SUTPE #:
INSTALLER:
ADDRFSS:
CI1'P: ZIP:
PHONE CITY SIGNATURE:
SIGNATURE:
Amwhii
AdmomElhi-
city oF eagan
THOMASEGAN
Maycr
September 15, 1997
Stephen Dowling
3728 Greensboro Drive
Eagan, MN. 55123
PATRICIA AWADA
BEA BLOM9UIST
SANDRA A. MASIN
THEODORE WACHTER
CouncilMembers
THOMAS HEDGES
Ciry Administrator
E. JVAN OVERBEKE
Qty Clerk
RE: Block 4, Greensboro 2nd Addition - Drainage Easement L 3, a ? ?' ?j
Dear Stephen:
As you are aware there has heen a drainage problem in certain back yards within Block 4, Greensboro
2nd Addition. In efforts to provide some assistance to the property owners experiencing the problem
I stopped out to take a look at the problem. During my visit I noticed that your use of the reaz
drainage and utility easement reduces the ability of the reaz yards to drain to the east. The purpose
of the five foot drainage and utility easement is to facilitate the drainage of the area and to allow for
the installation and maintenance ofutilities. Although this easement area is your property, it has been
dedicated as a public easement for the purpose of drainage and utilities. Therefore, the City is
requesting that you remove any items within the easement that may reduce the drainage and restore
your rear property line to allow for drainage.
Please contact me at 681-4646 if you have any questions.
Sincerely,
Craig E. Knudsen
Engineering Technician
MUNICIPAL CENTER
3830 PILOT KNOB ROAD
EAGAN MINNFSOTA 5522-18a'
PHONE (612)687Atn0
FAX (512)G81-4o12
iDF) (612)454-852"
THE LONE OAK TREE
THE SVMBOL OF STRENGTH AND GROWTH IN OUR COMMUNIN
Equal Opportunity /Affirmahve Aciion Empioyer
MAINiENANCE FACILITV
3501 COACHMAN POIPoT
Enc;Ant MiNNESOrn 55122
PHOPJE (612) 681-4300
FAX (612)681-4360
iDD (612)454-8535
city oF eagan
THOMASEGAN
Moyor
PATRICIA AWADA
BEA BLOM9UIST
SANDRA A. MASIN
THEODORE WACHTER
June 26, 1998 Councll Members
THOMAS
Mi. Steve Dowlin HEDGES
g Clty Administrata
3728 Greensboro Drive
Eagan, MN 55123 E. J. vnN OVERBEKE
ciri aerk
RE: LOT 3, BLOCK 4, GREENSBORO 2ND ADDITION - DRAINAGE AND UTILITY EASEMENT
Dear Steve:
I was unsuceessful in hying to contact you by telephone today, so I am sending this letter. I received your
voice mail and confum that I was one of the people walking azound in the back yard. Part of the walking
around included investigating the details of what was installed privately by yow neighbors. One of the
items I discovered is that the dramage pipe is smaller than I believed was installed. Itivas also installed at
a shallower depth than I had anricipated. Using this new information, it appears that it would be
beneficial to stay the course of my previous letter and complete the regrading of the easement within your
yard.
The regrading should be completed as directed in the previous letter. Thank you for your continued
cooperation.
Sincerely,
Russ Matthys, P.E. ?
City Engineer
Cc: Mayor and City Council c/o Thomas L. Hedges, City Administrator
Thomas Colbert, Public Works Director G:IICORR/RM/Proj7262ndARrtn
MUNICIPAL CENTER
3830 PILOT KNOB ROAD
EAGAN, MINNESOIA 55122-1897
PHONE. (612) 681 d600
FAx.(612)681-4612
7DD(612)d54-&535
THE LONE OAK TREE
THE SYMBOI OF STRENGTH AND GROWfH IN OUR COMMIININ
Equal Opportunity Employer
MAINTENANCE FACILIN
3501 COACHMAN POINT
EAGAN, MINNESOTA 55122
PHONE. (612) 081-0300
FAl(: (612) 681-4360
TDD: (612) 454A535
city oF eagan
THOMASEGAN
Mayor
February 20, 1998
Mr. Stephen Dowling
3728 Greensboro Drive
Eagan MN 55123
PATRICIA AWADA
BEA BLOMQUIST
SANDRA A. MASIN
THEODORE WACHTER
Counal Members
iHOMAS HEDGES
Ciry Atlminisiwtor
E. J. VAN OVERBEKE
CiN Clerk
RE: lOT 3, BLOCK 4, GREENSBORO 2ND ADDITION - ENCROACHMENT INTO THE
DRAINAGE AND UTILITY EASEMENT
Dear Mr. Dowling,
The City of Eagan regulates the placement of obstructions wiihin pubiic easements and right-of-
way. This is iMended to protect and promote the safety and general welfare of property owners
and the general public within the City.
Please be on notice that your property located at 3728 Greensboro Lane has been found to be in
violation due to the placement of obstructions within a public easement. Your property is in
violation because shrubs and landscaping are impeding the flowage of overland drainage within
the 5-foot wide drainage and utility easement at the rear of your lot. Removal of the shrubs and
regrading of the landscaped area by the property owner is required.
Should the work specified in this notice not be completed within 30 days of the date of this notice,
the City will assume and perfortn the work and invoice you for the cost. Any unpaid charges will
be assessed to your property. Removal and replacement of any other objects, such as the split-
rail fence, found within the easement is not the responsibility of the City of Eagan. The City shall
not be required to assume any responsibility for any damage that occurs to objects within the
easement.
Piease contact me with any questions regarding this notice. My dired telephone number is 681-
4837. Thank you for your cooperation.
Sincerely,
V-1I r , ?L
Russ Matthys
City Engineer
cc: Mayor & City Council Go Thomas Hedges, City Administrator
Thomas Coibert, Public Works Director
MUNICIPAL CENiER
3830 PILOT ?NOB ROAD
EA6AN, MInWESQfA 55122-18U7
PHOPIE (6I2) 681 4600
FAX (612)681-4612
fOD (612)454-8597
THE LONE OAK TREE
THE SVNIBOL OF STRENGTH AND 6ROWiFI IN OUR COMMUNITV
Equal Oppcrtunity/Affirmafive Action Empioyer
MAWTENANCE FACIUN
3501 COACHMAN POINT
EAGAN. MINNESOiA 55122
PHONE (612) 6864300
FAx (6) 2) 681-4360
iDD (612) 454-8595
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA157739
Date Issued:09/05/2019
Permit Category:ePermit
Site Address: 3728 Greensboro Dr
Lot:3 Block: 4 Addition: Greensboro 2nd
PID:10-30901-04-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard 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 -
Mitchell P Grengs
3728 Greensboro Dr
Eagan MN 55123
(651) 261-6648
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA164619
Date Issued:10/05/2020
Permit Category:ePermit
Site Address: 3728 Greensboro Dr
Lot:3 Block: 4 Addition: Greensboro 2nd
PID:10-30901-04-030
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 -
Mitchell P & Kathleen M Grengs
3728 Greensboro Dr
Eagan MN 55123
(952) 234-5678
Ralow's Roofing & Remodeling Inc
8609 Lyndale Ave S
Bloomington MN 55420
(952) 210-4988
Applicant/Permitee: Signature Issued By: Signature