3782 Greensboro Dr? CASH RECEIPT ?
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
. DATE •/? ? ' > ,? 19
REC6IVED'.
FROM
AMOUNT $ ; I
& DOLLARS
?oo
? CASH Q CHECK
FOR . ' ."" " ' . ? .i• ?' .
White-Payers Copy
Yellow-Posting Copy
Pink-File Cqpy
Thank You ?
BY '' i
SLDG. PERMIT N0
.
?
?
:•.
v
?
,
„ , ,..- ?_r'7. ?:`:' ?,e.,y i, rri . -r.v •` '
?
01-3210 Bldg. Permi*_ ?'',• ; :? ;?
01-3422 Plan Check
01-3445 Surch./ndm.
01-3446 SAC/Adm. •i 7?
01-2155 Surcharge
17-3860 Road Unit
20-2275 SAC L ?-
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permi
20-3743 Sewer Permi
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL
INSPECr
CITY OF EAGAN ? 3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
? SITE ADDRESS: e
? . . „? ? ? ?? ? trc r.
,?:F i r?.r??_il??? C?hP . ;. , ,, i i
PERMIT SUBTYPE:
J I!,. ,
? I i #'fir IraR;
?
p..c
0
:CORD
PERMIT TYPE:
Permit Number:
Date Issued:
aiiti i,rMG
H.'sN'! 1 -
01,1" l J<)r.i
APPLICANT:
TYPE OF WORK:
IV f' kl
i?? ,? ?? ? ?,,,,?? i11 CRfiNNli r?+???i
r 1 NAI
PFaar?r SF f*ARAI F' Vi ka l rkFpu 1rrr 1) fOii r I r r tR r{ Ai uOaO
;,,
Permk No. Permit Holder Date Telephone M
ELECTRIC
PLUMBING
HVAC
Inspectlon Date Inep. Commenta
FOOTINGS
FOUND ,
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEAI'ING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HT(3
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FlMAL
DECK FTG
OECK FlNAL
?-n
p-V
'•- ? CITY OF EAGAN p? p
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 t ? ? Gr? ?? c
`?
PHONE:454-8100
BUILDING PERMIT Receipt #
To be used tor SF D;1G1G". Est Vaiue $91,000 Date OCTOBER 30 , 1986
SiteAddress 3782 GREENSBORO I1R Erect 13 Occupancy R3
Lot 3 Block 2 Sec/Sub. GREFNSB0::0 1tiT Remodel ? Zoning u 1
Parcel No. Repair ? Type of Const 74
Addition ? No. Stories 45
oc E'EATURE BUILDERS Move O l.ength
W Name 3 ?
= 15513 L' OGARTO LN oemo?ish ? Depth
3 Address Int. Impr. ? Sq. Ff
° Ci? T?`zIZLI,-phone ??5--?4A? Install ?
= o Name S)V"L
0 Q
-K
Address
~ City Phane
?Q
? W
Name
? ? Address
i W Citv 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 Ciry of Eagan Ordinances.
Signature of Permittee FEA'I'LJRF, LUILBEks
A Building Permit is issued to:
all work shall be done in accordance with all applicable State of Minneso
Assessment Permit $ 406.00
Water 8 Sew.
P
li Surcharge 45.50
Plan Review 203.00
o
ce
Fire SAC 575.04
Eng.
l Water Conn. 500. 00
63 . 50
W
M
t
anner
P ater
er
e
290.00
Council
Bldg. Off. 10 3 0 ?i Road Unit
Tr. PI. 156.00
APC Parks
Var. Date Copie
Total ? r " • 0 ?
on the express condition that
City of Eagan Ordinances.
PormM No. Pwmlt Ho1dK Dtle T.bphons N
Plumbinp
4-
H.V.A.C.
ElecMe
sonen«
Inapeefbn Dsb Inep. Commafh
Faotlnyal
FooUnpsll
Foundstion
Framtep //2
8
U)W-
l
Roolfnp
Rouyh Plby. -? "G 7 ?' a LYS.
RoughHtq. -3-f 7
l^",l. rs a ?,v
Fir.a.ce pD
FInN Mt9•
Final Pibp.
?
&dp. FMN ?e ??' L'' ?• t?(J
Grt. Oce. ?
1
?-c?•
o.ck Ftg.
Dock Frmy.
WaM
Pr. Dbp.
CONTRACT PRICE
Site Address
Lot Block
m Name
.g Address
c City
t.. - ? : - ? • . ?`, z. r
. . . , . , j' , . , . .
PERMIT # =^ i
PLUM8ING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: eunuc. Aew_ninn
? Name
c Address
p City Phone _
FEES
COMM/iND FEE - 1% OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - $10.00
6AIAlINAI IM - rt1KAKA /INf) FFF _ 9f1('1(1
I (ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
FOR CITY OF EAGAN
BLDG. TYPE
Res. ?
Mult
Comm. _
Other -
NO. F1XTLlRES
water Closet - $3.00
Bath Tubs - $3.00
Lar+atory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
UrinaUBidet - $3•00
Laundry Tray - $3.00
Floor Drains - $1.50
WORK DESCRIPTION
New Add-on
Repair
$1.50
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE
STATE S/C:
GRAND TOTAL•
TOTAL
t
Site
, PERMIT #
• MECHANICAL PERMIT RECEfPT
CITY OF EAGAN ,Alr
3830 PILOT KNQB ROAD, EAGAN, MN 55122 DATE:
PRICE; PHONE: 454-8100
? Name _
?a Address
c City f
L Name
3 Address
p City Phone
TYPE OF WORK
Forced Air &4WO M BTU 2"/.
Boiler M BTU
Unit Heater M BTU
Air Cond. M BTU
Vent CFM
Gas Piping Outlets #
Other
FEE:
S/ G:
TOTAL:
BLDG.TYPE
Res. x
Mult
Comm.
Other
WORK DESCRIPTION
Naw A.
Add-on
Repair
RES. HVAC
ADOITIONAL
(RES. HVAC 11
APT.
-1 PEI
MINIMUM COMMERCIAL FEE
STATE SURCHARGE PER PERMIT
(ADO $.50 S/C iF PEfiAAiT PRiCE GOES
BEYOND $1,000)
- $24.00
- 6.00
- 1.50 EA, ?.
aES
8
- 12.00
- 20.00
- .50
SI RE OF PERMITTEE
_"??tir• ' - 6_4z...1t , ~ ?A'(/<-6l?'
FpR: CITY OF EAGAN
k
490
r OF EAGAN $EyyER SERYICE PERMIT
I PilNM Knob Road
Box 21199 PERMIT NO.:
m, MN 55121 1 OATE: - -
ng' ,.°?a.?t No. ot Units:
ur?
Pr
I ayrse to comply wRh the CMy o( Eayan
Ordinances.
BY
Date of Insp.:
Connectlon Charge: 47 5. 40rci
Account Deposit: _ 15, f`onr
PermltFee:_
Surcharge: S )? ?
Misc. Charges:
_ Total:
L In8p" Date Paid:
..
r-
? cmr oF EAGnN WATER
3e30 Pilot Knob Road SERVICE PERMIT
' P.10. Box 21199 PERMIT NO.:
! Eagen, MN 55121 DATE: 12 - 2
I Zoning: r. i
Owner. No. of Unib: ?
Feature n l?i?Q
Address: '
Site Addess: 37 :: ? C'r nA„ s],.,,-n "r { ve
. 71 B') rT aRQhcolrn
Plumber:
Meter No.: Connection Charge: 0-1
Size: Account Deposit: - 15 011nd
Reader No._ Permit Fee: 1 f1 t?i1nr?
I agrss to compy with the City of Eagan Surcharge:
Ordinances. Mlsc. Charges:
Tota1: -- pd meter
BY Date Paid:
Date of Insp.:
lnsp.
CITY OF EAGAN . WATER SERVICE PERMIT
3830 PWit Knob Road
P.O. Bpx 21199 PERMIT NO.; 8 2,'' S
Eaoan, MN 55127 DATE: 12 - -
2oning: T-I No. of Units: 1
Owner. Featura Rldrs.
Address:
Site Addess: 3 7 %.
Plumber.? ??To?-'
Meter Np.:
Reader No.: Q ?D 7 ? ?,g
I agree to complp with flN
GMMancea.
5C, 0. anc'
Misc. Charges:
CITY OF EAGAN
Police -
Fire
, 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 -
/ ? .2-5'3
BUILDING PERMIT PHONE: 454-8100 Receipt li «'
7obeusedtor SF DWG/GAR Estvalue $91.000 Date OCTOBER 30 ,1986_
SiteAddress 3782 GREENSBORO DR Erect 81 occupancy R3
Lot 3 Block z sec/Sub. GREENSBORO 15T Remodel ? zoning Ri-
Parcel No Repair ? Type of Const v
.
Addition
?
No. Stories
W Name FEATURE BUILDERS Move ? Length 45
15513 LOGARTO LN oemoiisn ? oepth ?F
3
° Address Int. Impr. ? Sq. Ft
city B' VI LLEphone 435-8443 Install ?
=o I Name SAME nPProvI
?a Addres5 ASS@SSfI1Bnt.
`- Ciry Phone Water & Sew.
.?
F w
Name
z
? Address
a w City Phone
I hereby acknowledge that I have reatl this application and state that the
mformation is correct and agree to compty with all applicable State of
Minnesota Statutes an" of Eagan Ordinances.
Signe[ure of Pelmitte&? ,?
A Buildin9 Permit is issued ta: FEATURE BUILDERS
all work shall be done in accordance with all applka tate of Minnesf
8uilding Oflicial
Planner
Council
Bmg.ott.10/30/8
APC
No 12825
Fees
Permit $ 406.00
Surcharge 45.50
PlanFeview 203.00
SAC 575.00
Water Conn. 500 . 00
WaterMeter 63.50
RoadUnit 290.00
rr. Pi. 156.00
Var. Date Copies
Total $2.239.00
on the express condition that
Ciry of Eagan Ordinances.
r7
REQUEST FOR ELECTRICAL INSPECTION ea-ooaoGi-os
/ See inatructwns br completuq tAis fwm on bnek of Yellow copY. ?Q?/0
-7532 "X" Be/ow Work Covered by This Request
NUy+IAIMI VeD. - Tvoe of BuilEma Aooliontea Wired Equivmenl Wiren '
water
ndustrial B
0 Fee ServiceEnirenceSiza k Fea Fexders/Subfexders k Foe C"cwta
D 0 to200Am s 0 to30Am s 3(oCTQ Oto 30An+s
Above 200 qm ps 37 to 100 Amps z<Ud 31 to 100 A s
Swinming Pool Above 100_Am s Above 100_Am s
Transtormers rngation Booms Partial.'Other Fee
signs aUeciai inspecuon g TOTAL FEE
emarks Z'
I
PouBh-i^ Dale I, ffie Electncal
`?' Inspaclor, hereby
cerliiV ?hat the above
Final Date inapectian has been
rapuasl volA 18 montlq Irom
This ropuesl voiA ?2p/P?
18 month5 Irom ? ?
e 77632 L.? /?????>??!-?-?„
Re.quesc Date
?
- fire No. Rwgh-in Insnecuon
Requiretl7
?fleady Nuw?,W?ll Notdv Inspec-
pr Wh
P
f2yes ?NO en
eatly
9 Licensed Electncal Convactor I heroby requeat ina0eetion ot above
Owner electrieal work instnlled et:
Sireet Address, Box or Route 160-)
eaion o- TownsMO ame or o. ange No. County
a
pani IPflINTI Phone Nn.
r SuOPfi
e
r Address
/
?
le tncal Contraclor (COm any amel, (?^? C iracAOr'S License No.
?
"
Lug 1 S
Mailing ddress IConUa or or Owner Making Instail ionl
3
, i? 1
lo /l/Owner Making Installationl
AuthFSi;at Com,apl,
'
o
' ( J
MINNESOTA STATE BOANU OF ELECTRILITY TMIS INSPECTION PE4UE3T WILI NOT
Grippe-Mitlway BIdB• - poom N•191 gE ACCEPTED BY THE STA7E 80ARD
IINLESS PflOPEfl INSi'ECTION FEE IS
1821 Universitv Ave.. St. Peul, MN 55704
Phonel6121842-OBOO ENCLOSEO.
??, ?g-81p REQUEST FOR ELECTRICAL INSPECTION *Ift E8-00007-05
? Sea inatn.e[iona for completinp this torm on Oeek o/ vellow copv.
p-rqnr7 "X" Be/ow Work Covered by This Request ?
Nwv!Adtll NeD.I TyOe of BuilE.ng I ApptionCee Wired I i Equipment Wired I
H%
ce
k Fee ServiroEntreneeSfxe IX Fae Fenders/SuOfeeders ? Fee Cirewtn
U to 200 qm 5 0 to 30 Am s 0 to 30 Am s
Above 2 0 qmpy 31 to 700 Amps 31 to 100 Am s
Pool
Swimmin Above 100-Am s Above 10D_Am s
me
Transforrs rri ation 8ooms Purtial-'Othor Fee
Signs Specialinspection TOTAL FEE ?
emarks ( / 'j ?
(J4
••• - ,tn.EiecsTicel
?sDector, hereby
cerlity that fhe aEOVe
Final D ^ e nsDaction hee been
1d..
repueet
78monihstromid /1-/ ?'??? ?s y
C 63052 z- 3, 6a, h,?--??
Re eit Date Fire No. RouOh-in Insvection
P pwred? ?g..?,
?Feady Nowv? ill Noufy, Inspec-
1 as ?NO `o? When ReadY
.19,Licensetl Electncel CoMractor 1 hereby repueat mepection oi ebove
? Owner , BIBGtrieal work instelled at:
Streat Atldress, Box or Poutesla. Crt? 1
ecuon w ownship ame or No. ange No. Cwnty
Occ 1 ift (PRIN?? U)?C'7' ?.1'ZS P7- S
pher, Adtlress
Ele rical Contractor (Cmn6Bny Name) ? C tra tj?s-Linsa o.
?
Man A?ress IContr ctar or Ownar Makmp In Haiwnl
Authoriz Sie?atu ICbntra or ei Mak?ng Inslallabon) P Number
MINNESOTA STATE BOAHD OF ELECTqICITY THIS INSPECTION qEDUE57 WIIL NOT
Gripps-Midwav Bldp• - Room N•181 BE ACCEPTED BY THE STATE BOAND
1827 Univarsitv Ave., 8t. Paul, MN 66104 UNLESS PXOPEfl INSPECTION FEE IS
Phenaf619 6620800 ENCLOSED.
(I I II III I II II I II ?i REQUEST FOR ELECTRICAL INSPECTIO? a7
Minnesota State Board of Electricrty -?
1821 Universiry Ave., R/ 3-12?'?P?I, MN 55104 ?
* ? "8 1 ??* Pnor,e (612) 642-oeoo F-R,
Home Apt. Bldg.' Other:- New Addn
Commrcwl
e Industrial Farm Remod Re air
Air Co
nd. Hfg. Equip. Water Hfr. Load Mgmt. Other.
D er Ran e Elec. Heat Tem . Service
"X" above the work mvered by this requert. Enter remarks in fliis space and on the 6ack of the white copy only.
Calcubte InspecFion Fee - This Inspechon Request will not be accepted wrthout fhe corcect fee:
Olher Fee il` $ervire Enirance Size Fea S Circvils/Feeders Fee
Mobile Home Park Stall 0 to 200 Amps 0 to 100 Amps
Sfreet Lig./Traffic Sig. Above 200 Amps Above 100 Amps
TmnsformedGenerafor INSPECTOfl'SUSEONLY T T L
$ign/Outline Lig. Xfmr.
Alarm/Remafe Conirol
$Wimming Pool ? I hereb ceni ?hot I mz ecled the elacmm n deembed herein on ?he darea sbkd
Irtigafion 8oom Roughln Dare
eaol Ins
ection
$
p
p
Invesfigatrve Fee /
`
THIS INSTALIATION MAY BE ORDE ED DISCO NECTED If NOT COMPLETED WITHIN 18 ONTHS.
2 5 9 0 O1O FOI OPFlC USE O LY This request wid 18 months hom vahdafion dale pnnied in ih box ?
lv?3o?? ? 0 7
? ? ??D
PLEASE PRINT OR TYPE J tiJOS.
Requmt D k9
? Rough-in insp tion reqai?ed2 " Yes ? No
d
ll
h
h InspM?on Oiher Than Roagh-In. ? Reody N. ? Will Call
d
D
k R
?
j en reo
??
?You must co
t
a inapecror w y
o
eo
I, litensed wnhacfor ? owner hereby request inspedion of ihe above elecfrital work ot:
Job dresv (Stmet, Box, ar R.W. No )
379 G ? h Ciry Zip Code
Secbon No. Townsh,p Nome or No Range No Fim No Coun /? nn
Oc<o Phone No lJ
Power Supplier Address
EI rnyy
r(C panY Name? Con tlor Lm. No. Master 4c No ?Plant Ele t OnIY)
??
?
\
?
Moilin AEdre?a?Commcbr orQrnerPeAormsnglnslallabon)
WCO 6e'?5 S .
ssi?
I-Ad
Authonx naNre (Conlmqo PeAorminp InsmllaM1On) Phone No.
EB- 1MI0 6195 STATEBOAIiD COVY-SEEINSTRUCTIONSONBACKOFYELLOWCOW
?0q ?
RESIDENTIAL
BUILDING PERMIT APPLICATION
GTY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Conewction Reauirements
• 3 regislered srte surveys snowing sq. R. of;ot sq, ft, ot house; and all roofed areas
(20%maximum lat coverage allaxed) . 2 copies of Dlan showing beam & win0ow sizes, poured found design, etc.)
• 1 set ot Energy Calculanons
• 3 copies o(Tree Preservation Plan il lot platted after 7/1793
. Rim Jomt Detad Options selectron sheet (hldgs with 3 or less unifs)
DATE j01V0')-
?
SITE ADDRESS ???? ?ree-s?a rr? /`?`'• ?f MULTI-FAMILY BLDG _Y LN
TYPE OF WORK1(?L(' r,F ? R?/?odCP FIREPLACE(S) _ 0_ 1_ 2
APPLICANT cz l
STREET ADDRESS YV/I s/a vU /'q CITY Q ?STATE?_?ZIP ?/? ?
TELEPHONE #GS/-gy?-'I Y60 CELL PHONE # (!O? - y/y- 8'i?t FAX #6sI'
PROPERTYOWNER??f" " p eI 6 " )( TELEPHONE# 6SI_6$6-S;-?q
COMPLETE FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MIN'NL:50"l':1 RCI.1:5 7670 C:\"fEG0121' 1 _ bII\"VESOT.\ RL'LES 7672
(J submission type) • Residential Ventllalion Category 7 Worksheet Submitted • New Energy Code W orksheet Submitted
• Energy Envelope Calculations Submittetl i
Plumbing Contractor: __^
Plumbing system includes:
Mechanical Contractor:
Mccluviical sytitcai includcs:
Sewer/Water Contractor:
-- Air Conditioning
-- Hr<d Recovcry• Syslcm
Phone #
Phone #
Fcr. 570.00
I hereby acknowledge that I have read this application, state ihat ihe information is correcf, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagon Ordin ces.
?
Signature of Applicanf I
__.._-------------._..---°.._--°°--------.__________----°------------- ------
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updaled 4102
_ Watcr SoFtener
_ Water Heater
No. of Baths
RemodeUReoair Reouiremanh
• 2 copies of plan
• t sel of Energy Calculauans for healeC adtlitions
. 1 site survey for exlenor addiEons & decks
• IiMicate if home served by septc system for atltlitions
Phone #
Lawn Sprinklcr
No. of R.I. Baths
VALUATION a'660•8Z)
S Ll . TJ
Fee: S90.00
PERMIT
? 'CItY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
PERMIT TYPE:
Permit Number:
Date Issued:
3782 GREENSBORQ OR
LOT: 3 BLOCK: 2
GREENSBORO 1ST
P.I.N.: 10-30900-030-02
DESCRIPTION:
IN-GROUND
?uildin?-?Pe?rmit Type
?rBulkdifig°GFqr„,k TYPe
Census Code
?
, .
r -
?.
3b 4 ?.
POOL
SWIM POOL
NEW
329 NONBLDG STRUCT.
?t
U 6..i
i•^ _-=`,?;,.?m:.:e? .cr ;? 1
? . a ..,_
REMARKS:
SEPARATE PERMI7 REQUIRED FOR ELEC7RICAL WORK
BUSLOING
028011
06/21/46
FEE SUMMARY:
VALUATION
Base Fee
Surcharge
Total Fee
$237.25
$8.00
$245.25
$16,000
CONTRACTOR: - ppplicant - sT. LIc.OWNER:
ALL POOLSIOE SERVSCES INC 14836600 0007284 REIOUX KAREN
121 E COUNTY ROAD C 3782 GREENSBORO DR
ST PAUL MN 55117 EAGAN MN
(612) 483-6600 (612)686-5299
? . .
I hereby acknowledge that i have read this application and state that the
informotion is.,corxect,and agree to comply uitEt all.applicable_9taGs of Mn,
? Statutes and City of Eagan Qrdinances.
.(---
PPLICANT/PERMITEE SIGNATURE ISSUED 6Y: SI TURE,
? 55122
`$o? C? 3830 PILIOT KNOB RDN
1996 BUILDING PERMIT APPLICATION (RESiDENTIAL)
681-4675
RemodeUReoair Reavirements
? 3 registered si[e surveys ? 2 copies of plan
? 2 copies of plans (include beam 6 window sizes; poured ind. design; etc.) ? 2 site surveys (exterior addRions 8 decks)
? 1 energy celculations ? 1 energy caleulations for heated addilions
? 3 copiee of hee preservation plan 'rf lot platted aRer 7I11/93
required: _ Yes _ No
DATE: ?T e/E /3 . J 99Co CONSTRUCTION COST: 4600
DESCRIPTION OF WORK: Co,?s; R 4)6_ !i/aW !.v-erirouAlv 1/.215a k.v,as PooL
STREET ADDRESS: o
LOT ? BLOCK Z SUBD./P.I.D.#:
PROPERTY Name:ydQR F_ Al E I L)U2( Phone #:
OWNER `"`T ""`T
StreetAddress, -37 s" )e6EI?s80219 Asr"u'L -
City: State: 147111 Zip: SSla 3 _
CON7RACTOR Company: ADOL S/Dk- ' Phone #: ??3166?0
Street Address: License #:
City: // r 7-,4 6- State: ?ffAl Zip:
ARCHITECTf Company: Phone #:
ENGINEER
Name: Registration #:
Street Address-
City: State: Zip:
Sewer 8 water licensed plumber:
change are requested once permit is issued.
Penalty applies when address change and lot
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 Ordfnances.
Signature of Applicant:
OFFICE USE ONLY
Certificates of Survey Received
Tree Preservation Plan Received
_ Yes _ No
----------?...,e»
Yes No --T
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16 Basement Finish
0 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch o 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
,?11" SF Misc. ? 10 = plex o 15 Deck
WORK TYPE
? 31 New ? 33 Alterations ? 36 Move
0 32 Addition ? 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. MCIWS System
(Ailowabie) Main level sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. 3Z9
Depth Footprint sq. ft. SAC Code o/
Census Bldg /
Census Unit o
APPROVALS
Planning
Building
Engineering
Variance
Permit Fee
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S!W Surcharge
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Valuation: $ ??" o0o ?
% SAC
SAC Units
F4cEl
---
+ '- - 1 - ?--- ? i-I- ? ' ? !- -
_ I_ I LI !__I
. II I
II ? ? --- -
I ? L- -:-
i
I 4i- I j--1I
- ? ? - ? '- ?- -'-?-?? -' -
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--
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?
a'
ZD
?
10-6' plnin Parceh (68-pp9-5)
1f Plain Ponel (0&0145)
1-3' Ploin Ponels (OB-011-5)
42' Radius (omers 108•141)
17-Tumbuckk 8raes (OB-114)
1-Steel Hordwore Ri1(08-2D4)
1•1806 Shaight [oping Set 6' Rodius (10•001)
1-1' Rodius Coping Corner Set (10•138)
1-Ymyl Liner (see options below)
b' Step- Remave 6408-Opq-51 8' panel and
1408-014-5y 6' ponel. Inun 1{01-006) 6'step,
2408-016-5) 4' panels and 1408-214)
turnbutkle bra[e.
8' Step• Remove I406-009-5) B' panel ond
1-108•014-5) b' panel. lrxert 140I-00118'step,
2408•017-5) 3' paneh aid 1408-114)
twnbuckle bm[e.
Repluce 4-8' ploin ponels (08-009-5) with:
I•8'skimmer ?nel (OB-011-5)
2•8' inlet punels (08-0105)
1-8' light panel (08012-5)
;
1e' IU' I s•s• I
z` v¢Rmxmrtc
oA snen ,
*Oiagonnls given to 90° point of comers. ''? ? ? TMiS?ocu?rn rs roe iuusmomenµMys
, ihaedigdimvu,nu?o.opiy nhrlwphiwm75 rwc,mk?mMM?m.,?orexnro?.,,.h?<ha,.?mi.dm?nWrme., ?
• powdPaof .t? o?hnrev,esmqnw.,m
i?senrre.?gqasrodm,mmumsmndord.M.esdennolpool M'AK? k.?mrta?ro?n?he?ndM„ ?
k'i
d,w
1. All wrnml dimanians me han lilrer mwsiom on aN pool. I Sod b hv,e mimmvm 6mn cMs ^9 ?ords w.Idm a.e b 6e usad wi,h ? o leose P?uc d by iwp o.e amiWobk a tlK rer?`e0rnn. dw eny connociamode
?wb„ols
Odlw 2?k ? al poo ^9 roPac?y of 2000 PS f 3 f?<amron sldl5? ?' le. I? ?he monulvcvreJS insmeiwn? arcl Nr wn ? w, a e_ i deokr a. mmmn,,....?....u. _._??..`? °^H ik
l ai 4o1 6" a6o.. ihan oool oll ma?.,a _.. . . .
?
1986 BQILDING PERFIIT APPLICATIOA - CITY OF EAGAN
HOT6: ALL CONTRACTORS MOST BE LICENSED iIITH THB CITY OF EAGAN
SIHGLE F9MILY DiIELI.ING4
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 7 SET OF ENEHGY CALCULATIONS
MOLTIPLS DWELT.naGS _ RESIDENTIAL RSNTAL II9ITS FOR SALB DNITS
INGLUDE 2 SBSS OF PLANS, CERTIFIC9T8 OF SQR48Y - CHSt,S SiITH BLDG. DSPT.,
1 SET OF ENERGY CALCULATIONS
COPIlMBRCret:
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANASCAPE BOND
To Be Used For: Valuation: ?-? Date: ? Q (
Site Address S ff'?` ? b.y ,
Lot 3 Block -2-
Parcel/Sub ZIAtI.41-14- /?y 0404'y,'
Owner "„ a .
Address / SS/ 3 - 'o?n.L?b roCM _
City/Zip Code
Phone y3s-BNy,g
Contractor 4'-J?
Address AumA. o-a, e-Q,-?w-?,
a,
City/Zip Code Y3 j?'-Syu3
Phone ?
Arch./Engr.
Address
OFFICE USB 08I.Y
Erect ? Occupancy
Remodel _ Zoning ?
Repair _ Type of Const .?.?
Addition # of Stories
_
Move Length 45
Demolish _ Depth 3(0
Int.Impr. _ Sq Ft
Install _
APPROVALS FEFS
Assessments Permit
Water/Sewer Sureharge 4 S,SO
Police Plan Review Z03 ,
Fire SAC 5 -7S •
Engr Water Conn 500,
Planner Water Meter co-?.5-P
Couneil Road Unit 2qo
Bldg Off Treatment P1 15(0,
CaPC Parks
Variance Capies
lY)TAI,
City/Zip Code
Phone #
iQOTE: 9DDHESSBS FOR CORNER LOTS - CONTRACTOH/HOMEOfiNER MQST DfiSIGNATS WHICH ADDRSS3
IS DESIRED. NO CMGSS WILL SE ALLOSiED ONCE BDILDING PEAMIT IS ISSDED.
29"X Zv' ?P?ZX ?? 3Pq7?? T
_ ,..
20 ?.l 4-. ZSc? K S? ` I?Z4o
2o x 22 = 4`?? 12 `?28a
p K?o _ I oox 8 ? 8°°
24-?- ZE) `6 7 ZY, 44 ` Z`j scO8
K.
T
?o,So¢
??, -17(.r
TRI-LAND C0.
SURVEYING
SERVICES
4655 NICOLS ROAD
EAGAN. MINNESOTA 55122
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GRE ENSBORO
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SCALE:I"=40'
PROPERTY DESCRIPTION
LOT ? , BLOCK C- ,
GREENSBORO Ist
xeordinp to the recorded plat ihersof
DAKOTA coumy, Minnesota
LEGEND
o DENOTES IRON MONUNENT
o DENOTES WOOD HUB SET
DENOTES EXISTING SPOT
ELE VATION
DENOTES PROPOSED SPOT
ELEVATION
? DENOTES DRAINAGE DIRECTION
1 hareby csrtify thot tAis aurvey,plon or
rsport was preparad by me or under my
direct supervision and fhat I am a duly
Reqistered Land Surveyor under ths
Laws of the State of Minnesota.
Bradley 4i.? wenson, Mn. Req. No.13235
Date
PROPOSED GARAGE FLOOR ELEVATION = 9 ?
PROPOSED FIRST FLOOR ELEVATION =
PROPOSED BASEMENT FLOOR =
E LE VATI ON
NOTE' VERIFY ALL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS ,
? ?;
C1TY Uk 4U1tNSVlLLE . ' .
' • ' ' E1fTERIOR £NVELUPE AVERA:E "U" L0:4YUTA2IO:I . .
. ?f?Q,?g_ _ y Address uww.?. Yhone?3S'?Cy?(,?'
• . 16rec ? - - T--
a? Additloe?LPO.,,a.Pr?d?LdDate. 10124/$6
.¢T,al Descriptlon o: Propercyt Lot3 Hlock
?iLYO.?,n.?i-ai+?Q' Olt' ? `?-°'din,. • ° B
:![e Address s
Al'ERACE LItiFhL FEET OF g?IT ti0.
• E%POSED 1.'ALL AREA ADOVE fRADE .
! G ?
fain levcl ' '
Lincal ft. of framed wall aSove grade?y?x height of vall 1j--=-
:Lm joist area ? L! (?
Lfneal ft. of rim x lieiRht of rim ? T ? `?
rr i :
' wer 2eve1 • `' 'a D
Lineal ft. of framed vall above grade= heiSht of vall
Liacal ft. of masonry vall above grade x Leight above gzade Z'' ???-•
. . ' TOTAL vall a=ea above grade inelvdin8 v3adws aad doore • •?.?...11L
? ' , . • ' . . . . ' ' .•/ . 1
• ? ? SaA'D0WS: Area z "11" valu
?
'
' ?OGcls9
-
pe
. , ?j
? ?•
I:
lake E't
N aq
.
89•
b'Q.
w ' M 84'
? . w sq.
•p -. M .?? sq.
M w , ?Q•
. .M .r sq.
w « ' 84•
a sq.
w , a s4•
sq.
? .. ,?' .. M ?• sq.
?-r'r?
.a
v
a
v
k
a
_ ' • 'M , w O Z - ? SR•
L
I' . ? nD.. . . '
..? . ? . ?
.. sq. fi. . •
. . . ? '.
' -p00R5: Area z va ue -- x "0" • ?
8xke t typc Y 00 tj" eq. fi..
ft' " x .?l??
sq•
sq. £t. X ? D
? w 'w SQ..tf. •
' • , - 77 ? ..
.?, , .
OYAOU£ k'ALL COT:STRUCTIO1; Area 'x °U" value r , . . , •' . •
.•e •
. , FRAl1ED WALL (total asca less - . . • ': • .. ? - r . • , • •. :
opening, frnming members in ' ' ' .•• .. ' +
Detail refer-y?all. rim joist a:ea b masonry) .r '• - •??
' mce from 6q. ft. J --x?+- •?^.
attaehed x
. . (I
' 54- f=
FrAU?inp t?rmbers in v?ll
Yltcets • 3x
Rim iotct nren sq. ft. O , .,u. ? n'
. «
, ',? sonrv nre? ?beva rr?1c sq, fi:'
. , - . - • ?+?' y :- '• ' ?;,?.. .. . ..: . .
IOTAL 1lall Arca Including w?, ?:., ? • TMAL (U) (A)
Nindovs E Donra ?,a.?..L?J - •. . e?."'r. .
• ?
i.uet AV(:. '•'0° • ? =
rcrcni. <u) (n) vn ' ? , . ,
oi??Iu`e.n :v ro•rai.-u,??.i, nnr•n .
A1•Ii1L?CE "U" l:intinum .17 nr 7ees for 1 b 2 famlly duellings . •
llinimtr.n .22 ur luss lur .11 odicr buildings
__.' '. _.,.. .._i ...... .... ...,lrt??rd aLove do not n:reC[lic Energv C.oJc rc0.tdroir?n[5, t
' b.n.L }'6i lVb\ •
If~avJqLC vaSL RCaa
" • tur fr.a?Yiv.t men?beru . R-Value
FiLl4CNC HF.'`1UER5 TN SJALLS
ToD l'i?
Fxt rto- nLr filn -
fj
'Siding _
Slieathing
? Soec wooa s /2
4" .acy W+n ? ' .
•. . ?
, II ? '1/R
? " . • R2M JOIT ST AR4 - ' " . . . . _. .
$xteriot air film - ------^"?'-
I ' t .
siaina ' ' y 'S. •
' Sheathing . _ ?• '
. . . . . ' 1.88 .
1"softvn ' '
. I P I ' • ?.
In[erior nir ffl, - -
. . . . ? TOTAL R. 2 3_ y;6
o - I,x n . ?j `9
}7ASO:IRY NALL . •
Es[ezlor air Eilm ---?17(? .
12" eoncrete Dloek Insulation ? Intcrior air f11n .- - '68 • TOTAL R - 13.13
. C,
.. _ . ,,, •? - -
.17
?l..z.R
.45
°1
. ,, . .
Y•UOF CE:LLIN .
.Outsid"ir ftlm .61 .
Insu2acion "jL/
Dryc+all .45
Interior air film .61
^ iOrAL xa
D ? 1/B . 9. ' . az
]l,. .
: 1go )
Outside ait film •61
Insulation '
74^ Dryvall • ' _. .. , '. .45 ' .
Jaterior air fiim
. . ' . ,-- . TaTAL R =.??. .
; .' . .
. ?
. ? :.
: • ?.
Outside air fiim •17
---------------- -
R ilr "y ft yr' ' --- -33
Insulat2on
4•ood decl-ing
Iuterior air film' .61
-------------------------------
•• .
TdfAL P.
. . . . . ?a lIR " • . . ..IIo . ,
COOF/CGILUC: ? 0 ? 2•
TOTA7. AREA: ?? . s9. ft. . . ; , •. ' .
Dettiil reCcrentc • "U' x sq. ft. x sq. fc. (u)(n)
[rom above. {U)(t.)
Destiibe openings U x sq. f[. (u)(F.)
in roof °iU" x sq, ft.
.,U.l x sq. ft. 0?)(:.)
. ..U.' x sq. f [. (U)(a)
.• - "Ulr x sq. ft. (U)(a)
. . . . TOTALS/022?-sq. -ft.?O•y ????
T07AL (U) (A) VAi.UF.S i' .U' 2. pVC.
plV7MD RY 70TA4 T,OOF/ -
CF.ILIWC AP.EA • ' '
\Vk:RAC! "U" .OS tor vrnCl3eted ronfs .10'tor nll oc!:cr consttuction _ ' _ rOTF.: 7[ avcrage "U",vilucs .5 aalcul.1ted a"re du no[ neeC thc t:no.crgy Code requircrcrnte, th"Altcrnate
tinvelnpe Des:gn° JS inC:ca[ed on 7'aga3?-nay Le,wrQ..• ., '
S
.rl??. ....
? .
, . . , . . . j . : .
lnsulation shall have a minimum R-Value of 7.5 and?muat . '
extcnd horizoutully (as illuatrated)'or veztically a • distance equlvalent to [he design frw[ llaep tkta[*is:
Zone 2- 3 feet 6 iaehes ' ' .
7nsulation Fh•ill have o cinimua R-Value of 7.5 around [he ?
pcrinro:cr of alab on grade floozs. '
Slab oa $Tade
? . - aaSa i '
? .. .
? ? 1, . ' ' • ' • q8E TOt\L ENVCLOP6 CALCUIAT104 }IETIIOD .
TAe reSulntlons statc that alternatlva overall "U" vnluxs for building sxctions ir¢ petnlssab!a
' L[ !t fe sho•:n that the total bullding cnvelope Aeat loss/p31n does not excced thai of aa[milar Dutlding that meets the regulation "U" value In this case, ve vill consldec
only Uie valls and roo[/ceiling eriteria, assuming [na: the rcnainder oE the build!.np r..ceta
rcgulattvo requirenxnts. .
A. 'TOtal he.nt loss a% desio,ned (valle and roof/ceilinq) BTU/hr. dey,rce Y.
. {talts - UoAO ? Avxrag°- •'U° of . . .
vall esse=bly x average vall area sq. fc. -
.
Roof/Ceiling ° DoAo ' ?•v2=aRe S.U.
of eeiling z average ceilSng axea sq. ft.
SOTAL S. To[a2 beat loss if designed [o meet ttke regulation ninimum (Walls and roof/ceilin3) '
Yalls - oAo - Minimum required • • .
"U° value of vall x average vall area sq.'ft:
. . . . , . .`::i . ?Roof/Ceiltng ° U p o ^ Lfinimum required
. . ? ..U" value of . . , ''. . . . ?.s .. ft..° .
' ' . .. eeiling z average ce?iv8 area . 9• '. . .
? ' . . • - . ,guTN' ._- -'
. ?;: _ • .
. . . .._____- • .'; r• .
.. . ?. . ' _ . ::.: ',; . _ ___ _ • _. . . . for
. . .. 1'he folloving table may be used ss a S?Cral S? wenelovest determining allouable percentage of crall openin8s . ` • • .
"U" valve is es[ablished. , _ ,. . • -
f
- . .
,
,
. ! . .
' .. . . . .. ' ' "..'._-?;' . .
_ . . . : . .. - :' • ' '•. X 1DD 'Zc ,'_ . ..
0 enin area (s , ft.) »? ;:• . • opening in wall
Opening 6 vall area above grade (sq. ft.)
' The following table mny be vsed as a?meral.SuiIIe.llne•for " •
determining allovable pezcentage of xnof apeaings vhen lrn:est _ •
°0" value is establisUed. . . • 3 +s'? : •• . . . .
. . . - . . ..':;, ,
. S RnoE ? 2 3 4 S 6 .. . .
Opening 0 . . . ' . . .
ll3nimum .. • .. .
. R-Vnlue nC 25.1 29_0 '34.3 42.2 55.3 .
n ue Roof 20.0 22.3 .. .
X100-
--x, OCenTap arc' (•'q ft ) . opeinp, in vall ' Opening 6 roof/ccilinr arca '„
• Prepa:ed by: Aennis J. Lunski
fluilclinq Ins?°ctor • City oF IIurnsville
II
CITY OF EAGAN
APPLICATION FOR PERMIT
SEWER AND/OR WATER CONNECTION
*RYPF': PAYSKPNT OF FEE AT TIME OF
APPLICATION DOES WT CONMMM , .
APPROVHL OF PII2MLT,
INSPD(.TZON OF SEQ2 ADID/CR FIIi'LER
TTSSTAT.T,ATTOr]$ TiTTIL NO'j BE $CE]ED-
ULID UDTPII, PERNIIT AAS Bffid
APPROVID.
-----------------------
P ease Print)
1) PROPERTY ADDRESS: 3782 Greensboro Drive
LEGAL DESCRIPTION: Lot 3 Block 2 Greensboro lst Addition
Lot Block Subdivision or Tax Parcel ID )
IF E.`QSTING STRL'C.ZURE, DATE OF ORIGZNAL B[IILDZNG PERMIT ISSCANCE: "
(hbn ear)
PRFSENT 7ANING/PROPOSID L'SE:
? C(XTMERCIAL/RETAIL/OFFICE ?
IbIDCSTRIAL ?
INSTIIUTIONAL/GOVII2NENT ?
?
2) R-1 SINGLF. FAMiLX
R-2 DOPLEX (1G,lo Units)
R-3 'II]WDIIi00SE (Three + Units) ( Onits)
R-4 APARTMEN'P/COfIDOMINIOM ( Units)
NAME: Northrup Mechanical Inc.
ADDRESS: 7640 146th Street
CITY, STATE, ZIP: Apple Vallev, MN 55124
PHONE: 432-0175
3) ' c ?'• NAME:
_ NnrthrnD Mpnhanical Tp
ADDRESS: 7640 146th Street
CITY, STATE, ZIP: Apple'Valley, MN 55124
PHONE: 432-0175 MAS'1'ER LI(ENSE# 2443M
YlURIDeTS L1C2RSE?:
P.Ct1V2
Fbcpired
Not recorded
St?tial
4) •• 'c?? ?..?di?;
NA`E: Feature Builders
_ ADDRFSS: 15513 Logarto Lane '
CITY, STATE, ZIP: Burnsville, MN 55337
PHONE: 435-8443-
'5) '? i 1 M' • JI' : D • 9• ' pi
X? CON[QECTION 1U CITY SEWEFt rA CONNECPION TO CITY WATER E( OTfIER
6) ?? • • r ? PI,EASE $OLD APPROVID PEREIIT FY)R PICK-UP BY ONE OF ABOVE
PLEPrSE MAIL APPROVID PERMIT TO 1, (D 3, 4, ABOVE
? ?' (Circle one)
7) ? rz Gt" "/ - Stan Northrup ? 12/11/86
'F'OR CITY USE ONLY
,
PERMIT # ISSUED
Pd w/Bldg. Permit FEES:
$ $ (o SEWER PERMIT (INCLUDE SURCHARGE)
$ $ ( b -S? WATER PERMIT (INCLDDE SURCAARGE)
$ $ WATER METER/COPPERHORN/OL'TSIDE READER
$ $ WATER TAP (INCLL'DE CORPORATION STOP)
$ ? SEWER TAP
$ ACCOUNT DEPOSIT - SEWER
$
ACCOUNT DEPOSIT - WATER
$ O $ WAC
$_ -i'7?DO $ SAC
$ S TRUNK WATER ASSESSMENT
$ $ TRUNK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRUNK SEWER
$ $ LATERAL BENEFIT/TRLNK WATER
$ $ R
WATE
TREATMENT PLANT SLRCHARGE
$ S OTHER:
--
TOTAL
? ?16 7
RECEIPT -RECEIPT -
DOES UTILITY CONNECTION REQLIRE EXCAVATION-IN PUBLIC RIGHT OF WAY?
Q YES IF YES, THEN A"PERMIT FOR WORK WITHIN PLBLIC
Q ROADWAY" MUST BE ISSLED BY THE ENGINEERING
NO DIVISION
. LIST AS A CONDITION.
SOBJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY: -
TITLE:
DATE :
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA137726
Date Issued:07/19/2016
Permit Category:ePermit
Site Address: 3782 Greensboro Dr
Lot:3 Block: 2 Addition: Greensboro 1st
PID:10-30900-02-030
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
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 -
Laura C Johnson
3782 Greensboro Dr
Eagan MN 55123
St Paul Plumbing & Heating
640 Grand Ave
St. Paul MN 55105
(651) 228-9200
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA149158
Date Issued:05/09/2018
Permit Category:ePermit
Site Address: 3782 Greensboro Dr
Lot:3 Block: 2 Addition: Greensboro 1st
PID:10-30900-02-030
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
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 -
Laura C Johnson
3782 Greensboro Dr
Eagan MN 55123
(612) 251-5268
Custom Remodelers
474 Apollo Dr
Lino Lakes MN 55014
(651) 784-2646
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA164151
Date Issued:09/21/2020
Permit Category:ePermit
Site Address: 3782 Greensboro Dr
Lot:3 Block: 2 Addition: Greensboro 1st
PID:10-30900-02-030
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 -
Laura C Johnson
3782 Greensboro Dr
Eagan MN 55123
(612) 251-5268
Property Claim Solutions LLC
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature