4293 Fox Ridge RdCITY OF EAGAN Remarks
Addition SUN CLIFF FIFTH ?ot 4 Bik 3 Parcel 10 72979 040 03
Owner Street 4293 Fox Rzdge Road Siate Eagan, M 55122 IX
Improvement Date Amount Annual Years Payment Receipt Dete
STREET SURF. 23.83 0q.13 j //S cZ
STREET RESTOR. Q' 1986 1622.2C 324.44 5 /?.2? . 2-0 61113
GRADING
San Sew Lat 1986
- 502.5 100.52 5 ?o •Sd`` ? r/ 3 /' s'
SAN SEW TRUNK 1970 49-84 . 1 ,Q
SEWER LATERAL s-?! .?O L?D/ISW 1?-Ie4
Water Lateral , 198 582.46 116.49 5 ? eo
WATERMAIN n-r 1985 . 55 5?,??r ?rQ ??c- • ?fS- ??
WATER LATERAL
-
WATER AREA 1971- d Ln "/z
0 1985 ?? -7o Cd ?3/45 X: 5:G
STORM SEW TRK rcJ ?,Cf ? ??5a 3 /$"??
STORM SEW LAT ?_
96795-
5. O
5' 3
e????--? t?
-3
Storm Sew L a t O 198b 739.56 147.91 5 73 „J o/31G3 /S d?
CURB & GUTTER
SIDEWALK
STREET LIGHT
Services 0.3 1986 529.15 105.83 5 3 ./' 3.7ZB II ,? 11
WATER CONN. ?? ??
, BUILDING PER. 11147
SAC 525.00
PAR K
• . . . . ..,?.. .
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 i"t
, - PHONE: 454-8100
BUILDING FrERMIT Receipt #
T_.__ SF DWG/C-AR $66,000 -_._ NOVEh1BER
Site Address -
Lot 4 Block
Parcel No.
Erect C] Occupancy
Remodel ? Zoning R 1
Repair ? Type ol Const 11
Addition ? No. Stories
Move ? Length
Demolish ? Depth 52
Int Impr. ? Sq. Ft.
Install ?
Name SAME
I hereby acknowledge that I have read this application and state thatthe
information is correct and agree to comply with all applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Assessment
Water 8 Sew.
Police
Fire
Eng.
Planner
APC
Var. Date
Water Conn. ;""'J • uv
Water Meter 63.00
Road Unit 280.00
Tr. PI. 132.00
Parks
Copie {
T.,.,1 . . 50 ,
A Building Permit is issued to: '' """`•" vru%.2 ua: v c:,., ?..lf on the express condition that
all work shall be done in accordance with all applicable State oi Mlnnesota Statutes and City of Eagan Ordinances.
Building Official
. Pxmit No. Pormit Holdor Daft TM*phon* N
Plumbiny ? d
H.V.A.C.
' EWelft
sonww
In.,,.c,io„ o.,e Imp. comment.
woang. i
Fooanys II
Foundarion
Framiny
Roaflny
Rouyh Pibp. <
Rouyh Hta• !
a WG ?
Inaul. ??y 4 IFK/
Flreplace
Flnsl Hty.
Flnal Plbp. Q, ar
Bldy. Ffnal
CMt.Oec. ?
Doek Fty.
? Oeck Frmp. -a-
' WNI DacrIM LowUon:
I Pr. Disp.
?
I
Rodipt MECHANICAL PERMIT Permit No.
CITY OF EACAN -
Fu
Pill in numbered specet S/C
Type or Print leyib/Y Tot. i -
1, Date ? 2. Installation Cost 1
3. Job Address L_: , l.ot Blk. Tract t .?
4. OwnK
?.
5. Contractor Phone . ,
6. Address ?
7. City 5tate A Zip . _ r
8. Building Type: Residential 0` Commercial O Institutional O
9. Work Description: New q Add 0 Alter ? Repair ?
? 10. Describe ? , . . Fuel Type
E 11.
No, Equinment BTU • M. Ea.
Forced Air No. Equipment CFM
Air Handlin
:
Mfg.
Boilers g
Mfg. Mach. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
Gas, Piping Outleu
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : a for
Rough final
Inspections: Date Insp. Date Insp.
This is Your permit when numbered and approved.
Approved CITY QF EAGAN 454-8100
Receipt / PLUMBING PERMIT Permit No.
CITY OF EAGAN
Fse
' Fill in numbered spaces S/C
Type or Prinf /egibly
Tot.
--?
1. Date 2. Installation Cost
3. Job Address -Lot ?- Blk. Tract
! ,4. Owner ?
5. Contractor - ; l i•• Phone
6. Address
7. City , State C? ZiP ?-
8. Building Type: Residential C1?
9. Work Description: New O
10. Describe
11.
Commercial ? Institutional ?
Add ? Alter ? Repair ?
No. Fixtures
Water Closet No. Fixtures
Cesspool /D rai nf ield
1 Bath tubs $eptic Tank
f Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with ali ordinances and codes governing this type of work.
Signed : .
for
? Rough Final
tnspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-6100
Receipt PLUMBING PERMIT Permit No. " - CITY OF EAGAN Fee ?
Frll in numbered spaces S/C 1
Type or Print legibly Tot. ?
1. Date 2. Installation Cost
3. Job Address ITCI-93 " r Lotv Blk. _
4. Owner _
5. Contractor
6. Address _
7. City
8. Building Type: Residential ?
9. Work Description: New ?
10. Describe
11.
Phone
State Zip _
Commercial ? Institutional ?
Add O Alter ? Repair ?
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
Bath tubs Septic Tank
Lavatory Softner
Shower Well
Kitchen Sink
Urinal/Bidet Other
Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is irue and correct, and 1 agree to
comply with all ordinances and codes governing this type of work.
Signed : for
Fiough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
Tract f 1
CITY OF EAGAN WATBt SERVICE PERMIT
3830 Pilot Knob Rosd
P. O. Bok 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoninp: No. of Unitr.
Owner: - -
Address:
Slta llddress:
Plurriber. '
Meter No.: Connectior? Charpr.
Size: Account Deposlt:
Readx No.: Permit Fee:
1 yne 1o aawqh? wNh !IM City of f.eww Surdhoroe:
OrJiosoam Mlsc. Chorpes:
Total: '
By Do" Pnid:
Dote of Irup.: Irup.:
CITY OF EAG4N SEWER SERVICE PERMIT
3830 Pilot Knob Road
P. O. Bax 25199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zonirp: No. of Unlta:
OWRlry c
/lddrcss:
Slts /lddress: - r { F. , ? S t?t
Plun+ber:
?-
I ym te seaiply wNb Nr Clhr oi apr¦
OrdI
8y
Dote of Irop.:
CITY OF EAGAN
3830 Pite: Knob Rosd
P. 'Q. Box 21199
Eagan, MN 55121
Zoninp:
Owner.
llddreas:
Slte Addroas: .
Plumber.
Mottr No.:
Stze: SI p`f
Fox RidRe ;4aArw4 B3 Suz
t??;
tf 5th
I yree fe emPy, wilr "WiWof Lrp?vSrchorQac . Si?pc;
?? ?EQ?•3?'' Mlac. CF,orpes: _ 1 3? .0Opd TP
Total:
BY Dota Poid:
Dots of Insp.:
s
Conrnctfon Chonpe:
/looount Depodt: ` ` ^ ?:% j? •
Pom-at Fee: ? , * . ogp:.a
Surdwrgs: 501-5t'
Misc. CMrpes:
Totol:
DaM Piold:
WATO SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
BUILDING PERMIT
Receipt
7obeusedtor SF DWG/GAR Est.vawe $66,000 oate NOVEMBER 27 iy 85
Site Address 4293 FOX RIDGE RD Erect Occupancy R3
4 3 SUN CLIFF STH Remodel
Lot Block Sec/Sub. ? Zoning Rl
Parcel No Repair ? Type of Const. V
.
Addition
?
No. Staries
$
Name
GRAND OAKS DEVEL CO
Move
Demolish
?
?
Length
Depth 50
52
o Address 18$1 SUNRISE CT Intlmpr. ? Sq.Ft
Ciry EAGAKo,e 452-8934 ?nstall ?
o Name SAME
i
? ? Atldress
? City Phone
a
F W Name
u c Address
a z
w
Ciry Phone
Assessment
water & Sew.
Police
Fire _
Planner
Council
N2 p 347
Permit +' »1 • vv
Surcharge 33.00
Plan Review 165.50
SAC 525.00
Water Conn. 500. 00
Water Meter 63 . 00
RoadUnit 280.00
Tr. PI. 132 . 00
I herehy acknowledge that 1 have read this application and state that the i
intormation is correct and agree to comply with all applicable State of Bldg. Off. 11 ?2 fi/8.
Minnesota Statutes and City of Eagan Ordinances. APC
Signature of Permitte? ~f '
A Building Permit is issued to: GRAND
all.work shall be done in accordance with all ipp
CITY OF EP.GAN
3830 Pilot Knob Raad, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100
w Var. Date - Copies
Yotal $2•029.50
EL CO on the express condition that
of inneso 5t tutes and City of Eagan Ordinances.
Building Official
ihis requesl void
18 mon hs from ?,5-j?
U !'
9 ???
?
CB ??``5 9 3 S ?? ?r3 3; ?. ?1 s?? 5 ?. zra
Rn?uest Date
?? Fi?e. No. Fouph-in Insuection
R 4?.ed?
?Aeady Now
Will Notily.lnYpec-
Wh
H
?No
?y? en
ead
XlLicensed Elec[rical Contrac[or . I hareby request inspection of ebove
? Owner elecVical work installed at
Street AdAress, Box or Route
,? ?/?- . Citv
C lu
ectwn o. Tpwns?ip Name or No. RanHe No. Cnunty
Occ ntIPRINTI
???-N,? Phonu No.
?
Powe Suoolier Address '
Elec ical Convacmr.
(Ca vany Namel
Contr+r.tor s Liccnse No.
MailinA A.ddres?COntrac[or or Owner MakinQ Instailatio
AuffioLetl [i ature Cm[ractor "er Mnkzing
Insta la 'rd P c Number/
?o'
?'? ?
?
??C?' ` ' `?V/ ?/-• CJ
MINNESOTA STATE BOAPD DF ELECTAICITY THIS INSPECTION REQUEST WILL NOT
GrigBS-Midway Bidg. - Noom N-791 gE ACCEPTED BY TME STqTE BOAHD
1821 UniversitY Ava., St. Peul. MN 55104 UNLESS PROPEF INSPECTION FEE IS
Phone (612) 297-2111 ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ee-oaooi-oa
?? /? ?'y S^ee instructi0ns f0, COmpleting this form on beck O} yBllow Copy. ?? CC ?
0
j.-S?,/ ? y S p{ "X" Below Work Covered by 7his Request
Mew{AHcfj Rea.I Tvaa oi euildiny I AaPliancea WirW -I Euuiument wtred ?
I I I 1 Duolez I I Water Heater I I Linhtinq Fiztures I
ic
I I I I Industrial BIAo. I I Air Conditioner I I Bulk Milk T&nk I
Fee ServiceEntnance5ize k Fee FeAtlers/5uhfeatlers N Fee Circaits
0 ta 200 qm s _ ? 0 to'30 qm s ? 0 to 30 An+ s
_ = Above 200 qmpy, ° 31 to 700 Amps 31 to 100 qm s
Swimming Pool Above 100_Amps Above 100_Amlts
Trans*ormers Irngdtion Boorcis SO PartiaVOther Fee
Signs speciai inspecUOn
$? TOTAL
.U(/
I. tha EI cvical
/{ IOSpBCIOq y
I
cer?ify [hai ?he above
Final paie
3-3,?? i^s0ection has been
made.
Thia roquest voi0
-1c)\6g 2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City OfEagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
-? a.o6
New Cansiruction ReouiremeNS RemodellReoair Reauiremenis Office?E7se?Or?v'
3 registered site surveys showing sq. k. of lot, sq. fl. of house; and all roofed areas 2 copies of plan Cert of Suivey Recd
(20% maximum lot coverage allowed) 1 sel of Energy Calculations tor healed additions Iree Pr6 Yleh Recd
2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks i[e0 f'res REqUirCd ? V N
lselofEnergyCalculations Addition - irrdlcateifonsitesepficsysfem Ot[-site3eplieSySi6m. _ . _Y._N?,
3 copies of Tree Preservation Plan if lot platled aNer 717/93
Rim Joist OeWil Options selection sheet (buildings with 3 ar less units)
Date ? / D / ?S ?j
Site Address ? 11,?.2 /? ? ConstruMion Cost
?Gl Unit/Ste #
Description of Work P0o'i- r01nS?
Multi-Family Bldg _ Y2L, N Fireplace(s) _ 0?? 1 _ 2
Property Owner ' DaG k ee I?Pr Telephone #(?oSr )?fS?F /53 I
ContraMOr S e I ?
Address
State City
Zip Telephone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Ca[eeorv 1 Minnesota Rules 7672
Energy Code Category , Residential Ventilation Categary 7 Worksheet • New Energy Code Worksheet
(J submission type) Submitted Submitted
• Energy Envelope Calculations Submitted
In the last 12 months, has the Ci1y of Eagan issued a permit for a similar plan based on a master plan2
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information 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; T understand this is not a permit, but only an application for a pertnit, 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 plans.
(B LaL We e (-W--
Applicant's Printed Name
`L" %A-?
Applicant's Signature
1985 BUILDING PERMIT APPLICATION - CZTY OF EAGAN
NOTE: ALL CONTRACTORS MUST BE LZCENSED YfITH THE CITY OF EAGAN
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL
& STRUCTURAL PLANS, 1 SET OF
SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS
$2,000 LANDSCAPE BOND
SINGLE FANILY DWELLINGS
INCLl1DE 2 SETS OF PLANS
3 CERTIF'ICATES OF SURVEY
1 SET OF ENERGY CALCULATIONS
/
To Be Used For: '0 94' . Valuation: (°(, g5t Date: / (- 2 / -c p 5
Site Address a 4r--"(A6?, V
? .
Lot W Block ?
Parcel/Sub ,I.M ^
Owner X
Address
City/Zip Code
Phone
Contractor ()Q.l?'?.d
Address 'ZL?? Ce-
City/Zip Code
Phone
7
Arch./Engr.
Address
City/Zip Code
Erect X
Remodel
Repair ,
Addition
Move ^
Demolish ?
Int.Impr.
Install ^
APPROYALS
Occupancy
Zoning
Type of Const
!1 of Stories
Length
Depth
Sq Ft
FEES
Assessments Permit
Water/Sewer ? Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council Road Unit
Bldg Off /-? z69s 'h-eatment Pl
APC Parks
Variance Copies
I TOTAL
?
?
Phone I1
/gX
(7 . ? • o/ eJ?'l????i?
FOR: GRAND OAKS DEVELOPMENT
NOTE:
O Denotes Wooden Stake ?
Proposed Garage F1oor S1. 9l2,7
(91z.4) Denotes Proposed
Finished Ground 61.
-.*- Denotes Direction
Of Surface Drainage
Vertical Datum - N.G.V.D. 1929
c?/27ir??? S U?i;', ;?c?. FOSemen f
,r
? LL
o,
v
0
N
1/)
v
OI
?
S 970 10'43.. E
???'t- ? - ? •
--• ? ?T ?
Z5.7
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N ?
? pl
V v ? 14
a
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J?T 2G,3
i
i
i
?
r. ?
N ?
I
P 1
m
?
?
?
-, ?
N g28?
Scale: 1"=30' 11?,
o Denotes Iron IIV
Monument
Bearings Are Assumed
?
-Ti
I
I
_ Ln ?
l! _
?
Syrr*ver. MigInewN tayisrrotien Ne.7726 C. R. WtNDEN 3 ASSOCIATfS, INC.
Lot 4, Block 3. SUN CLIFF FIFTA ADDITION,
Dakota County, Minneaota.
WE MEREIY CERTIFY TMAT TMIS IS A TRUE AND CORRECT RE?RESENTATION OF A SURVEY OF TNE
WUNOARIES OF TME tAND AWVE DESCRIIED ANO OF TNE IOCAiION OF All WILDlNGS, If ANY,
iMEREON, ANp Alt VIS16lE ENCROACMMENiS, li ANY, fROM OR ON SAID IAND.
Dalod Zlth day .1 October A p 1985 C. R• WINDEN 8 ASSOCIATES, INC.
6r
IANp SURVEYORS ToL 646•3646
`
1381 EUSTIS ST., ST. PAULP MINN. SStO• p
3a3 i?
? i
C~.
?
?
o v ?
P (
?
?
4 tn V
V
o ? Q
\
?
waf n
, ..,
?XTERIOR ENVELOPE AVERAGE
Y .'U COMPUTATION
, GRAND OAKS PEVELOPMENT COMPANY •'
MODEL Q AREA ; U U X AREA
w
kEQUIRED
1. TOTAL WALL AREA 1800 X .11 198
2. TOTAL ROOF AREA 1196 X. 026 31.096
AL'HIEVEA
AREA U U X AREA
A. WINDOW AREA 186.66 .5 93.33
B. DOOR AREA 39.8 .077 . 3.0646
C. SLIDE OLASS AREA 13.44 .48 6.4512
D. FIREPLACE AREA 0 0 0
E. WALL FftAME AREA 180 .041 7.38
F. NET WALL AREA 1164.1 .049 57.0409
0. RIM JOIST AREA 119.52 .0436 5.211072
H. FOUND WINDOW AftEA° 0 0 U
I. FDUND ABOVE QRADE •- 96.48. . .335 13.0248
3. TOTAL4 WALL AkEA. 1800 185. 5026
J. SKYLITE . ,, 0'. 0 0'
K. ` ROOF FRAME"' 119.6* .032 3.8272
L. NET ROOF AREA 1076.4 ?' , .'023 .'26.91
4. TOTAL RODF AREA ' 11\96 30.7372 ..
SUM 1.+2. 229.096
SUM 3.+4. 216.2398
, _. _._.. ...??? ._
? ` ' ? • • ? ? • I 0 ' 0 1?1' • 1? /• ?1• • q•
' ?I' ! ' S• • ?-? • h • • M: • ' ?? 1 1 1 71 • • I
11 ? 1 •?
CITY OF EAGAN
_ APPLICATION FOR PEE2MIT SEWER ANID/OR WATER CONNECTION
(Please Print) p
1) PROPERTY ADDRFSS: --rn ? ?. ?./l. o U? n n r? '
i,F1;AT• DESCRIPTION: L n -f- y //, -,d,- 7' /, T-r-.C` ?
IF EXISTING STRLCTURE, DATE OF ORIGINAL BOILDING PEEtNIIT ISSLANCE:
PRESENT ZONING/PROPOSID USE:
R-1 SINGLE FANffLY
R-2 DC'PLEX ('IV1o L'nits)
R-3 'ROWNHOC'SE (Three + C'nits)
R-4 APARTMENT/CODIDOMINItM
COMN1EftC IAL/RETAIL/OFFICE
INIIIC'STRIAL
INSTI'IC'TIONAL/GOVII2IVMETIT
( Units)
( Units )
2) ?
rraM: C--5r-a rd
aDDRESS:
CITY, STATE, ZIP:
PHONE: L j -
3) • c?•
NP,ME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
ZdtC_i-,rrc',e Lcs7a
,?Sn3c?dk7 /7Z/I - 3 5-ol
'/ - ?2 / 2_1 MASTER LICENSE #
For City Ose
Plwnbers I,ietSnsE
O
• •
4)
NAME:
ADDRESS:
CITY, STATE, ZIP: ?
PHONE:
5) i? ? a • a?• ? • a? alb
? COiVI=ION TO CITY SEWER OPCONNECTION 'IC) CITY WP.TII2
D OTHER (Please Describe)
6) u • • i
? PLF.ASE HOLD APPROVID PERNIIT FOR PICK-L'P BY ONE OF AHOVE
Ig PLEASE MAIL APPROVEP PERMiT 70 1, 2, '.? 4, ABOVE
( 1 (Circle one)
7) vc-a!? ? k??•'':
?
(Nbnth Year)
F O R C I T Y U S E O N L Y
PE°HIT °- ISSUED
FrrS: $
$
$ (113?p
$
S
$ zSlGO
$ /S-U
$
s
S
$
$
$
S /?. UCJ •
$
$
5__`.:i.°. ???RMTT (INCLiiiE SU?C`i?RGE)
WATER PERf1IT (INCiuDE JLRCHARGL)
WATER METER/COPPERHORN/OUTSIDE REaDER
WAT°R TAP (INCLUDE CORPORATION STOP)
S :;dE3 : ??
: ......r.'1..._ ....._ 0=
AG.OUNT ?vPOSIT - PIAT°R
wAC
SPC
TRuVK tJA?°R ASSESS:lE\T
TRli:IK SEWER A55ES5ME?iT
Li,TE?,nL BE:tEFIT/TRUNK SE:•i"R
LATcR.1L BENEFIT/TRIJNK TJAT°R
WATER TREATiNIENT PLANT SURCHARGE
OTHER:
TOTAL
/r U U s? 7
$ AMOliNT PAID/RECEIPT
DOES UTZLITY CONNECTION REQUIP.E EXC?.VATION IN PUBLIC RIGHT OF WAY?
YES IF YES, THEN A"PERPIIT FOR WORK WITHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
? NO ENGINEERING DIVZSION. LIST AS A CONDI-
TION.
SL'EJECT TO THE FOLLOWING CONDITIONS:
APPROVED BY:
TI:LE:
DATE:
- ?z7
?
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA126284
Date Issued:08/19/2014
Permit Category:ePermit
Site Address: 4293 Fox Ridge Rd
Lot:4 Block: 3 Addition: Sun Cliff 5th
PID:10-72979-03-040
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Blake W Keeler
4293 Fox Ridge Rd
Eagan MN 55122
(651) 454-1531
Glowing Hearth And Home Llc
100 Eldorado Dr.
Jordan MN 55352
(952) 492-9276
Applicant/Permitee: Signature Issued By: Signature