4074 Limonite LaneCITY OF EAGAN ?
9795 Pilot Knob Raad Eegun, MN 55122 r?
PHONE: 454-8100
BUILDING PERMIT ReceiPt # ?
To be uasd for ;:4^A12F: A11nTTTC1iJ Esf. Value 84.500 Dote T,,.,- 9 , 19_$,l_
Site Address-4Q74 T.imnn4tP T.an Erect ? Octuponty
Lot -11_ Block _53_ Sec/Sub. Gedar Grove 7 th Alter ? Zoning
Porcel # 1016706 1 1G OS Repoir ? Fire Zone
Enicrge .d? Type of Const.
W Name Mi 1 an Hnaak Move ? # Stories
; Address 4074 7.imnnitP I.ane Demolish ? Length_l4_
b
Ci Phone 454-2074 Gmde ? Depth-22-Sq. Ft.
p Name 1i m& Narr:i ?;1:'-. IIIC. AVVrovala Fees
?? Addreu 4540 dak Pond Rnad
Name _
Address
I hereby ocknowledge that I heve reod this epplication and stote that
the inlormotion is correct and agree To comply with all applicable
State of Minnewto Stotutes and City of Eogon Ordirwnces.
Signature of Permittee
A Building Permit is issued to: He1Li & Ha1-iner F3.
all work sholl be done in accardance with all applicable Stote
Buildinp Official *
Assessment _
Water 8 Sew.
Police
Fire
Eny.
Planner -
Council _
Bldg. Off. -
APC
Pennit
Surchorge
Plan check
SAC
Water Conn.
Woter Meter
Rood Unit
Totol - $.52.SO-
on the express condition thal
Statutes ond City of Eagan Ordinances.
Permit No. Permit Holder Misc. Permit No. Holder
Plumbing
H.V.A.C.
Well
Water
Disp.
Sewer
ENctric
Inapeetion Date Insp. Other
Foot??? ,-543 Vp
Foundation
Framing
Rough PI6g.
Rough HVAC
?
Inwlation
Final Plbg '
Final HVAC
Final
Water Describe Location:
Well
?
Sawer
;
Pr. Disp. rt ??
CITY OF EAGAN ' Remarks
Addition CEDAR GROVE #7 Lot 11 elk 5 Parcel 10 16706 110 05
Owner ? '- Street 4074 L].IItonite LdAe State Lla4an, MN 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SUR F,
? STREET RESTOR.
GRADING
SAN SEW TRUNK 1970 58.18 2.08 28 paid
* SEWER LATERAL 1971 20
WATERMAIN
* WATER LATERAL 117, 1971 1,615.00 80.7$ 20 Paid
WATER RREA
* STORM SEW TRK 1971 2O
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 300.00 6026 7-3-72
BUILDING PER.
sac 260.00 6026 7-3-72
PARK
,
/ ..
EAGAN TOWNSHIP
BUILDING PERMIT
Owner ........ ..... ..-----
Address (Preseni) -----• - ?- ??...... /? .......... ...V..«-(-!?X ........................
Builder ?-?-
Address ...... ................. ...-------------------------- ..........................................
DESCRIPTION
N° 2768
Eagan Township
Town Hall
Date L -••...-°••---°-- - ...............
5lories To Be Used Foi Froni Deplh Heigh! Est. Cos2 Pesmit Fee Aemarka
?
?G
LOCATION 9- ?3: cc>
Slreel, Road or other Descr?piion of LocaYion I Lo! Block Addition or Trac2
This permit does not aufhoriae the use of streeffi, roads, alleqs or sidewalks no: does if give the owner or his agent
the righ! Yo create anp situation which is a nuisance or which presents a hazard !o the heal2h, aefety, convenience and
general welfare !o aayone in the communi2y.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGAESS.
This is !o cerlifp, !hal..... ?.._.!?_..5.?-? ....... has permission to ereet a._.!l ....- ..?..../ ....Fi..?:z:r°'.?. -?_.....,,,_upon
the above descrihed premise subject to the provisions of the Suilding Ordinance for Eagan 7ownahip aQopted April 11,
1955.
- ? --..._.?!C?c?v.?.-•--?`......................
...
Chairman of Tnwn Board
Per ............ .. - --- ....._?.?: `-t_....... U ?;??k•,?
•• •• .................................._...
Building Ioepector ,g
A
CITY OF EAGAN Np 8093
9795 Pilof Knob Rood Eegan, MN 55142
' PHONEs 454-8100
BUILDING PERMIT Receipt # 31.1e)
Te bs wad for GARAGE ADDITION Est. Value $4,500 Dote lune 2 , lq 83
Site Address 4074 Limonite Lane Erect ? Occuponcy
Lot 11 glak 5 5ee/Sub. Cedar Grove 7 th Alrer ? Zonin9
Parce1 # 10 16706 110 05 Repoir ? FIre Zone
Enlarge Xg? Type of Conse.
? Milan Husak
Name Move ? ?! Stories
Z
? Address 4074 Limonite Lane Demolish ? Length 14
c; Eagan 55122 phone 454-2074 Gmde ? Depth 22 Sq. Pt.-
? Name Heim & Harmer Bldg. , Inc. APprorols Fees
0
u"
Address 4540 Oak Pond Road
Assessment
Permit 50.610
? Ci Eagan 55123 phone 454-3477 Water & Sew. Surcharye 2.50
Police Plan check
?W Name Fire SAC
_z Address Eng. Woter Conn.
I hereby acknowledge thnt 1 have read this applicotion ond state thct
the informotion is correct and ogree to comply with all applicable
Stote of Minnesota Stotutea d City of Eogon cO?rdin nces.
Signnture of Permittee F?.
/1 Building Permit Is issuedto: Heim & HarmeT Bldg .,
oll work sholl be done in xcordance with all opp/li?oble Sfote ?ir
Buiiding Offfcial /U ?• ? .tl???
Planner -
Council -
Bldg. Off. -
APC
Water Meter
Rood Unit
Total SS? Sn
on the express conditlan that
ond City of Eogen Ordinances.
M • ?
7
T0: iIV OF EAGE:t'
3795 Pilot Knob l:oad
Eagan, Ninne;;ota 55121
PEPMT N0. 221
The Board of Supervisors hereby g:anCs to Cedar Grove Construction Co.
of 7343 Concord Blvd. E., South St. Paul 55075
a HEATING peXmit for: (Owner) same
?C'arne Lane, 4031 ce Lan e e e a.an ?ne 4051? Pum-
ice Lane? Jade Lane, ? Jade lane, ? unon e ane,, ?? Carne ian 'Lane,
?t IF ?n u..i •+o r„P?&,1,?K pi?mira T
, pursuan o app ica ?on dated
anp
6/27/72
Fee Paid: $220.00 I?ated this 3rd day of JiLly , 1972
s c
Building Inspector
10
C, GG , 7
To'ta or EacE:i?
_'795 I'ilot Knob ;'_oad
Eagar., iiinne,,ota 55121
166 6S
PEUIIT N0. 234
The Board oi Supervisors hereby g.ants to Cedar Grove Construction Co. ?
of 7341-3 Ccncord Blvd. E,, Soubh St, Yaul 55075
? PLMMIM PermiC ior: (Cnoner) same
?
a,ne L e, 40?1 Lan , v • , ie ian ,2-rie. 4051? ?-
o` ?y? Jme L?u-le U ,a'..unoni e a. e ; ?? Carne .ian Lane
? Itjl%r'p -.,nf> r pL1:SUc[1 O 8Pp 1CaC OCl C?2CCd ?
G 12%/72
?'ee raid: ?120•00 Uated this 3rd
? 5.57 s c
day of , Jily ) 1972
Building Inspector
. il
Minnesota State Board of Electriciry
04'°?gm?
IIII II III I?!II I I I II?II II II II (II II I I III I IIIil eE°UErv 5?, A e., RE ?I SALt'Pa P MNTION
*? 3?? [3 6 2 3 4* Phone (612) 642-0800 !,l5?97 (tv?
ome Duplex Api. Bldg. Oiher: New Addn
C mercial Ind al Farm Remod Re air
Air Cond. tg. Equip. Water Hfr. Load Mgmt. Other.
D er Ran e Elec. Heat Tem . Service
"k' above the work covered 6y this request. Enter remarks in }his space and on the back of the white copy only.
Calculate Inspection Fee - This Inspection Reqvest will not be accepted wiihout the correct fee:
Olher Fee # Service Ertlrance Size fee # Circuih/Feeclers Fee
Mobile Homa Park Stall 0 to 200 Amps to 100 Amps
Street Lig./1'raHic Sig. Above 200 Amps bove 100 Amps
Transformer/Generator IN5PECTOR'SUSEONLY T
Sign/Outline Ltg. Xfmr.
Alarm/Remote Control
J
Swimming Pool ?
I hare mAi ihat I ins e elechi a lation desoibed herein on the doks staMd
Irrigation Boom Rouqh-In Dota
S
ecial Ins
edion
p
p
Invesiigative Fee _ D-?
THIS INSTALLATtON MAY BE ORDERED DISCON ECTED IF NOT C ETED WITHIN 18 MONTHS.
310 -62 y?
PL EASE PRINT OR TYPE FP; ONLY This requesl void 18 monlhs irom validation dafe prinkd in ihis 6ax
7
l??? '9J lX44
Raq.esf Dote/
f Rovgh-in inspection reqvired2 0 Yes
(You most mll the inspactor when ready) nspecfion Ofher Than Roagh-Im-B'R3dy Now 0 Will Call
Dofe Ready:
I, sed contractor ? owner here6y request inspedion of the a6ove eledrical work at: ?
Job Address (53Box, ar outtN.) ? Ciy Zip Code
Secfion No. Township Name or No. Range No. Fire Na. unry
O¢upont Pho/pe?/p/?f ,n a
• V I ?V
Power Supplier Address
Eledriwl Conimcbr (Comp Nome)
6 ? Co ctor icense No.
? cgI 7 b Moskr Lic. No. (Plonf Eled. Only)
MoiLng Address lConhador or Owner P o ing Inslallotion)
Aufhorized $ naNre (Cantrotl wner Performing Inafollafion) e
EB-00001A-10 6/95 v STATEBOApDCOW-SEEINSTRVCTIONSONBACKOFYELLOWCOPY ?„?f'
2005 RESIDENTIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Please complete for modifications to existing residential dwellings.
Date r / /? / -A ?6'
Site Street Address j/I z'z/ Z1rJp /I/ fzil- z4,?e Unit #
PropertyOwner????•-P__?'?'? Telephone# (axA
Contractor ( ?/i?f? f rC1T d/V l/f?7?t°? Telephone#
Address fxt // City &&44zf? r/JLL? State? Zip? ??c3
?
The Applicant is: _ Owner AContractor _Other
Atterations to existing dwelling
_ Add plumbing fixtures (excludes water softener andlor water heater--complete next
section if installing these appliances).
_Septic System Abandonment
_ Water Tumaround (add $125.00 if a 5/8" meter is required)
Other: $ 50.00
X Water Softener _ Water Heater
_ new ? replacement $ 15.00
_ Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00
State Surcharge $ .50
Total $ r ?
I hereby apply for a Residential Plumbing Permit and acknowledge that the information is complete
and accurate; that the work will be in conforrnance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved.
gd'ez O/Y ??- ' Dr'15;alz z ' 2?
Applicant's Printed Name Applicant's ignatur
RESIDENTIAL
BUILDING PERMIT APPLICATION
? CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4875
New Canstruction Reauiremenb
• 3 registered site surveys showing sq. ft. of lot, sq. ft. of hause; and all roo(ed areas
(20% maximum lot coverage allowed)
• 2 wpies of plan showing beam 8 window sizes; poured lound design, etc )
• t set of Energy Calculations
• 3 copies of Tree Preservalion Plan iflot platted after 711193
• Rim Joisl Cetail Options selectlon sheet (bldgs wdh 3 or less units)
DATE q
/ / 3_"Z?5
RemodeilReuair Reauirements
• 2 copies of plan
• 1 set of Energy Calculations for heated additions
• t sile survey for exterror addi(ions & decks
• Inditate if home served by seplic system tor additions
vaLuarioN ?p?G?D
SITE ADDRESS Gh . MULTI-FAMILY BLDG _ Y -ItV
TYPE Of WORK PLP-SV -"YiC? FIREPLACE(S) _ 0 _ 1_ 2
APPLICANT
STREET ADDRESS laa y7L 5CITYBdrnsr=lle STATE/VAJ ZIP ?
TELEPHONE # C959,W7-AST:ELL PHONE # FAX #(`I6aL)??
PROPERTYOWNERzfe
,l25-e 2!&kohnen TELEPHONE# C 6SJ?C?? -39?9
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNES01':1 AGLES 7670 C.ITEGORY t MINNCSO.
"??\` ?1?L'Ll•:S 7672
(?l submission type) . Residential Ventilation Category 1 Worksheet Submitted • ?
New Ener' ? ?de VYorkShjef Sub i itte?c?T
'
• Energy Envelope Calculadons Submitted 1 ?
?
sEp 1 3 2002
?
Plumbing Contractor: Phone #
Plumb;ng system includes: ? Water Softener Larvn Sprinkler By-?'ee:-?'?99,0, 0_
?Vater Heater
' No. of R.I. Baths -?-`
No. of Baths
Mechanical Contractor: Phone #
NjCCE11IlICal 5N'5LCIt1 IItCIUdtS: All COC1C11L10[lllln Fl`.C: 570.00
_ Heae Recover}, Systetn
3ewer/Water Contractor: Phone #
--------------------------------------------------------------------------------------------------------------------------
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.
Signature of Appllcant ?YA?}1 Q J?.t?\??
OFFICE USE Oti LY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updaled 4102
CITY USE ONLY
L? BL r RECEIPT #:
5UBD. ??1ytbT){.? ?? DATE:
1996 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Ptease complete for: ? single family dweilings
? townhomes and condos when permits are required for each unit
New construction X Add-on furnace
Add-on air conditioning Add-on air exchanger, i.e. Vanee sysiem, etc.
Date:
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $ 20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.00
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL ZCI - SC)
SITE ADDR
OWNER NA
INSTALLER
STREE"
CITY: 6
o ?4 L;
PHONE #:`???#
PHONE #: (
?
?
EAGP.N TOWNSHIP
3795 Pilot Knob Roud
St. Paul, Minnesota 55111
Telephone 454-5242
PERPRIT FOR WATER SERVICE CONNECTIOAt 11'5-7
Date
Bil l:
Owae?
P luml
Connection
Nuumber: $$3
,
iite Address: 0!
Billing tlddress_1?
'?o
Meter Size Connection Chg. 300!00 p 7/3/72
Meter No. Permit Fee 10.00 pd 7/3/72
P 72
Meter Reading Meter Dep.
Meter Sealed: Yes_ lAdd'1 Chg.
IQU i Total Chg.
Builcling is a:
Residence xx
t4ultiple 1!*0. Uni
Commercial
Industrial
Other
Inspected by
Da te
Remarks:
By:
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hezeby agree to do the proposed work in accordance wiCh the rules and
regulations of Eagan Township, Dakota Count , P4ianes a.
By:
Please aotify the above office when ready for iaspection and connection.
,
4
EAGEiN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Tel¢phone 454-5242
PERMIT FOR SEWER SERVICE CONNECTIQN,
U?2(:LL_? NUM$ER 1052
C(3-r 40?y ?? ? ? 5-7,
OWNER, Address {
PLUMBER TYPE OF PIPE
DESCRIPTION OF BUIIA ING
Industriail Commerciall Residential { Multiple Dwellfng I No. of units
Location of Connections:
Permit Fee 10.00 pd 7/3/72
•
SCreet Repairs
Tota 1
Inspected by:
Date
Remarks•
Connectioa Charge 260.00 pd 7/3/72
By.
Chief InspecCOr
In consideratioa of the issue and delivery to me of the above permiC, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Toc•mship, Dakota County, Minnes t
By
Please notifq when ready for inspection and coanection asid before any portion
of the work is covered.
•
.
LOCATION ?.L.>t[.GB-71[6
MASTER CARD
OWNER &JoA
STRUCTURE AND ? LAND USED AS
Permit
No. I Issued Issued To
Contractor Owner
BUILDING - - 1-- : - - -
PLUMBING I ? 9 tI I
---??+
?
CESSPOOL - SEPTIC TANK --
-
i
WELL j
ELECTRICAL ?
HEATING ? 2 I
GAS WSTALLING I
SANITARY SEWER
OTHER 1
0)?
-
OTHER ! I
• _ ITems
FOOTI NG
FOUNDATION
FRAMING
FINAL
ELECTRICAL _
HEATING
GAS INSTALLATION
SEPTIC TANK
CESSPOOL
DRAINFIELD
PLUMBING
WELL
SANITARY SEWER .
Approved I
(Initial) I Date
i
i
..
T-toz
-- • •
.
09
CJ
COMMENTS:
Remarks Distance From Well
SEPTIC _
CESSPOOL
TILE FIELD FT.
DEPTH
OF WELL
?
- S?
Violations Noted
on 8ack
3830 Pilot Knob Road
City of EaVllon
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ?
? F.,or OMce'Usg ?
? Permit#: ?? C:?'? ?
? Permit Fee:
I I
? Date Received: y
Staff: I 2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: /9"(n Site Address: ?1Q ?/'J y^l ZZ-
Tenant:
Suite #:
RESIDENT ! OWNER Name: IMelle.Se, m C?P) C!1I7P_-,--\ Phone:
q ?
Address / City I Zip: ??
&ry1 ori r?
?
Applicant is !/ Owner Contractor
TYPE OF WORK Description of work: 4/ t 4 E?
?A
,?
Construction Cost: Multi-Family Building: (Yes No
CONTRACTOR Name: License#:
Address:
City: State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Cateqory 1 Minnesota Rules 7672
Energy Code . Residentfai Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE; Plans and supporfing,documents that you submit are considered to be publiG information:' Portions of,
the rnformation may be °classified as non-public if you provide specific reasons fhat would per'mit fhe City to i'
conclutlethatthea`re tradesecrefs.?
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the wbrk will be in
accordance with the approved plan in the case of work which requires a review and approval of pl
X_ me?,e?'F' ??'Qp?E'l x
Ap IicanYs Printed Name App " a s ignature
Page 1 of 3
For Office Use
Cy~1 C.~~ j
Permit
City of Ea t) I CIO, I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I
Fax: (651) 675-5694 Staff:
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: C l F 1 io,~ r' L1&3 EI/ C3-f l /t4/,)
~l 2
Tenant: / Suite
RESIDENT I OWNER Name: /1j el/ es'e McLo(1Y1e -y Phone:
Address / City / Zip:/ -Lf l n-i of 2 t ~ t r-/•~1-rC'1 r? ~ '22
Applicant is: //Owner Contractor
TYPE OF WORK Description of work: cLrt~ e
Construction Cost: Multi-Family Building: (Yes / No
CONTRACTOR Name: License
Address:
City: State: Zip:
Phone: Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672
Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
submission type) • Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of pl
Ap licant's Printed Name App ' as ignature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA116738
Date Issued:10/10/2013
Permit Category:ePermit
Site Address: 4074 Limonite Lane
Lot:11 Block: 5 Addition: Cedar Grove 7th
PID:10-16706-05-110
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 .
Reinaldo Cintron
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 -
Mellese Mekonnen
4074 Limonite Lane
Eagan MN 55122
Ralow's Roofing
4351 Parklawn Ave.
Suite 108E
Edina MN 55432
(952) 210-4988
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA132917
Date Issued:09/10/2015
Permit Category:ePermit
Site Address: 4074 Limonite Lane
Lot:11 Block: 5 Addition: Cedar Grove 7th
PID:10-16706-05-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
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 -
Mellese Mekonnen
4074 Limonite Lane
Eagan MN 55122
(651) 334-1278
Farmington Plumbing & Heating
21034 Chippendale Ave
Farmington MN 55024
(651) 463-7824
Applicant/Permitee: Signature Issued By: Signature