The URL can be used to link to this page

4322 Fox Ridge RdCITY OF EAGAN Fiemarks Addition SUN CLIFF FIFTH Lot 17 Rlk 2 Parcel 10 729''f 9 170 02 x Owner street 4322 Fnx. Rir3ge Roarl stateRq,gan , N1N 55122 Improvement Amount Annual Years Payment Receipt Date STREET SURF, t 357.37 2 3 • 3 5 STREET RESTOR, 19 6 1622.2C 324.44 5 GRADING /03S 1986 502. S 100.52 5 SAN SEW TRUNK ' 1970 49.84 , SEWER LATERAL 25TUO /036 198 582.46 116.49 5 WATERMAIN WATER LATERAL WATER AREA ? 1973 15 STORM SEW TRK S70FiM SEW LAT , 1965 86.95 . / 986 739.56 147.91 5 CURB & GUTTER 510EWALK STREET LIGHT 103 7 1996 529.1 105.8 5 WATER CONN, BUIIDING PER. SAC PARK ? CITY OF EAGAN L ' 3830 Pilat Knob Rcad, P.O. Box 21-199, Eagan, MN 55121 ?`- PHONE: 454-8100 BUILDING PERMIT Receipt # To be used tor -Sr' U?'???(;A.R Est Value $61,000 Date AP i-t jL 7 86 SiteAddress 4321 F'C1X RIDGE RD Erect it Occupancy R3 Lot 17 Block z Sec/Sub. SUid C.LII'F STN Remodel ? Zoning Parcel No. Repair ? Type of Const. ? Addition ? No. Stories i?i?Vll l1F,i(5 i)EVEL CU Move ? Length 50 W Name ng z 1ti31 ?t!iJRISL•' CT Demolish ? Depth o Address Int Impr. ? Sq. Ft. Ci?, ???i?A -Lii phone 4 5 2- 8 9 3 4 Install 0 Z o Name ??m ? a Address ~ City Phone ? ? W Name ? ? Address < W Ciry Phone I hereby acknowledge that I have read this appi in}ormation is correct and agree to comply wi1 Minnesota Statutes and City oT Eagan Ordinar Signature of Permittee ? A Building Permit is issued to: GItAND all work shall be done in accordance with all epp Building Official .00 Water & Sew. Surcharge " "' ' ''" Police Plan Review?g8.00 Fire SAC -'375• UG auvnmwsLatcuiaL uIc Bld . all appiicable State of __ g Var. CO Water Conn. 500 . OQ 63 50 Water Meter . Road Unit 290.00 4f4/36 Tr.PI. , 156.00 Parks Copies Total $2 . 0 f3 9. G 0 on the express cond'+tion that I City of Eagan Ordinances. PsrmN No. Pwmwt HoWer DaN TMephom N PtamWny ? Cc.L?? eZ (e I H.V.A.C. Ebctrle SoN?ne? Inspactlon Date Insp• Commanb FooUnysl ? Footlnpsll v Plb y. ''-,l -1-6 Rouqh Ntp. ? Insul. Fkeplaee FinN H19• mp-(Z Flnal Plbp. Bldq. Final Grt. Occ. Deck Ftq. Dock Frmq. WNI Pr. D{ap. ? 1 r--?-- / ? Y _ + R , PERMIT # • ' MECHANI CAL PERMIT I 1 ?'' ) RECEIPT # • • CITY OF EAGAN MN 55121 DATE ?-? J`? (!r PILOT KNOB ROAD EAGAN " , 3830 , CONTRACT PRICE: PHONE: 454-8100 Site Address " BLDG. TYPE WORK DESCRIPTION Lot?! Block Sec/Sub ? ? Res. New m Name ? Add ? Address ' Mult -on Comm. Repair c City - Phone h er Ot Name FEES ? 3 Address RES. HVAC 0-100 M BTU -$24.00 p City Phone ADDITIONAL 50 M BTU - 6.00 ADD-ON AIR COND. 0-24 BTU - 12.00 TYPE OF WORK ADDITIONAL fi M 8TU ' 6•00 i Forced Air M BTU GAS OUTLETS - 1.50 EA. COMM/IND FEE - 1% OF CONTRACT FEE I Boiler M BTU MINIMUM - RESIDENTIAL FEE - 10.00 Unit Heater M BTU MINIMUM - COMM/IND FEE - 20.00 Air Cond. M BTU STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C tF PERMIT PRICE GOES Vent CFM i BEYOND $1,000.00) Gas Piping Outlets # ? Other ? FEE: I i S/C: i SIGNATURE OF PERMfTTEE I TOTAL• ' FOR: CITY OF EAGAN PERMIT # Gep 3 a- RECEIPT # DATE CITY OF EAGAN PLUMBING PERMIT 454-8100 FEE S/C MINIMUM RESIDENTIAL FEE -;10.00 + $.50 TOTAL MINIMUM COMMERCIAL FEE - $20.00 + $.50 1. Bldg. Type: Res X Comm Inst 2. New A_ Add Alter Repair 3. Total Bid Price 4. Job Address OiiL?? ?OX I? jO Lot ?.? Block c;t? Sec !!5"n [!4l Fr- S'?h 5. Owner (Erwv? 6. Contractor k?vaeJ %7e ?CUa?iv.?. il?lw/..?5'3$07 (Name) , (Street) (Ciry) (Zip) 7. Contractor Phone # NO. FIXTURES i-Water Closet - $3.00 ./--Bath Tu bs - $3.00 ,;?Lavatory - $3.00 Shower - $3.00 :TKitchen Sink - $3.00 -Urinal/Bidet - $3.00 NO. FIXTURES _L Laundry Tray - $3.00 /--Floor Drains - $1.50 ,L-Water Heater - $1.50 Whirlpool - $3.00 :EGas Piping Outlets - $1.50 -/-Softener - $5.00 NO. FIXTURES _Well - $10.00 Private Disp Syst - $10.00 ?Rough Openings w/o Fixtures - $1.50 COMM./IND. RATE - 1% OF TOTAL BID PRICE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE. Signed: for Approved Inspections: Date Rough Insp. Date Final Insp. 0 nob Road wa? sErtwcE PEwwur P. a?. Box 21199 PERMIT NO.: Eagan, MN 55121 D/?TE: ZO^i^o: No, of Units: ? Owntr. _ /1ddr? Slh /?I?flSf: ^ ? 70 "? ` - ?' Plumber: TO. Met?r No.. ??? ??; Stza: ?looourrt Deposit: . Reoder No.: Permit Fee: 1 NrM eo oe?pl?r wMi? tiN Ckp ef E4y?w Surcfiarge: Oediw?woas. Misc Chorpes: By Date of Ir?ap.: CITY OF EAGAN 3830 Pilot Knob Road P. O. Box 21739 Eagan, MN 55121 Zonirq: Owrisr. Address: Site /lddms:'r '^-? n•.a •j? ^o?d Pltwr+ber. 1 y?w eo eaeoy wNb tM Ci1r ef !?¦ OedlrwaM. By Dote of Insp.; Insp.: Torol: Dat? Pald: SEMIER SERYICE PERMR PERMIT NO.: DATE: _ _ No. of Units; Cannsction Chor?e: 4 7=-. +?'i Accaxvt Drposit: S _ ,?!±„r Nmt ?: SUrf.F1OIQQ: . M1x. darp? . Tal?d: . Dot? P?a1d: ? cl QF fAGAN WATER SERVICE ? 3?.O Pilot Knob Road - ! P. O. Box 21199 PERMIT NO.: Eagan, MN 55I121 DA?: , ZO^d^D' No. of Unlts: Ovmer. /F,ddr?ess: 5ttb Addras: , _ _ -` ;' i ` ? _ • _ ; Plurr?ber. Mefer No.. 370 7 7 rer• Size:.?LY" Reoder No.: Q.?/1/ ? S S 7I T ? I e!? to ao?u?l?r ??MI? Nw p?r ?f o?..?... ?u I?"U f TotoL• . By _ Dote Paid: Date of Insp.: IMp.: CITY OF EAGAN 383 Prlot K metei ' CITY OF EAGAN N2 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHONE: 454-8100 lp(?? BUILDING PERMIT Receipix Tobeusedfor SF DWG/GAR EstValue $61,000 Date APRIL 7 117 4 6 9 86 SiteAddress 4322 FOX RIDGE RD Erect Occupancy R3 Lot 17 elock 2 Sec/Sub. SUN CLIFF STH Remodel ? 2aning Rl Parcel No Repair ? Type of Const._17 . Addition ? No. Stories w Name GRAND OAKS DEVEL CO Move ? Length ? 1881 SUNRISE CT Demolish ? Depth 48 o Address EAGAN 452-8934 Ci Int Impr. ? ? Sq. Ft. ry Phone Insta11 ic SAME o Name Approvals Fees $ Q Address ASSessment Permit 316.00 ? Ciry phone Water & Sew. Surcharg ??? ?'U0 ?a Police PlanReview t= Name Fire SAC 575.00 6i Address Eng. WaterConn. 500.00 aw ciy Phone Planner WaterMeter 63.50 Council Road Unit 290.00 Iherebyacknowledqethatlhavereadthisapplicationandstatethatthe Bldg.Off. 4 4/86 Tr.PI. 156.00 information is correct and agree to comply with all applicable SNate of Minnesota Statutes and City of Eaga dinances. APC ParkS Var. Date COpi6s - Signature of Permitte " ? 7otal $2 .089.00 . GRAND O CS E L CO A Building Permit is issued to: on the expiess conditlon that all'work shall be done in accordance with all applicgtbT"tat innesota S tutes p Ci ty of Eagan Ordinancea . 8uilding Official This rep;iest pid 18 mbnths frA Renuest D e .{? Fire No. Rauph'in InsVection Pequired? OAeetly Now Will Nmity Inspec- LJ Yes ?NO or When Peady ensed Elechical ConVnctor I hereby repuest inapaction of ebava Owner electncal work installad at Siree[ ddress, Box or Rou Na, ? ?a- ?oJc Cit ecuon o. Townshio Name or No. Hanye o. Counly O u ,et (PPINT) Ph g?? -r y P SupO ier? ' Atldress EI rical Connactor I V ?vG??eName • s?n ??rlC Conirarior'S License No. Mai n A?dJdress IConV? c?to7r or Owner Making I?ny`? /iJla?ti?onnl /J -'7 lL/ /S W /3 ?^-WC?L 'C? Awhorized ' na ure IContr ctor Ow er7M ion _ l P? N?,r C? ? MINNESOTA STATE BOAHD OF ELECTNICITY THIS INSPEGTION 0.EQUE5T WI LL NOT qE ACCEPTED BV THE STATE BOAPD Griggs-Midway Bldg. - Raom N•191 1821 University Ava., 5t. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS ank.,..e lalni 2a7_9111 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION „ ea-oucwi-oa ? Sea instructions lor comDletirq this form on beck of vellow copy. -,. "X" Below Work Cavered by This Request AAtl Pep. Tyoa ol eoiltline ApPliancm Wiratl 'EnuiVmanl WireA Home Range Temporary $ervice Duplex Water Hea[er Lightiny Fiztures Apt. BuilAing Dryer Electric Heatin Commercial Bldy. Fumace Silo Unloeder. InAustrial 81dg. Air Conditioner Buik Milk Tank Farm olner vam v 71ner ISner.Ifyi [ er ueci Y ther 011,Lr Compute lnspection Fee Below p' Fee ServicaEnbenceSize p Fea fenders/5ubleeders N Fee Circuits 0 to 200 Am s 0 to 30 Am s oZ 6 0 to 30 Fln! Above 200 q?nps . 31 to 700 Amps 31 to 100 qm s Swimming Pool Above 700_Ain s Abave 100_?+m s Transiormers. Irngation Booms Partial.'Other Fee Signs Speciallnspection $ TOTAL FEE Nemarks - flouBh-in Onte I the Electncnl ? . ? oector, peraby cartify that Ihe above Final ?Jl? inspection has baen ( mnde. Thie reouest voiE 18 monIhe lrom )- 9D. GG' 41? City of EalaIl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 ,,?y793 -----------------; ? - ? j Permit k: I ? Pettnitfee: ? Date Heceivad j i ? i stan: i i i - J 2008 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: ??.;)? A,-,? ,J?! G / TenaM: SuNe #- RESIDENT I OWNER Name: 0m)1, Phone: Address I Ciry 1 Zp: Applicant is: _ Owner _ Contractor TYPE OF WORK Description of work: U' d 71? Conshuction Cost: `7 Y 231s, Multi-Family Building: (Yes _ / No ? CONTRACTOR Name: i Address: 5roLli C4 City: ce l1(?C7! er _ State: ?ziP: Phone:?Jl'?i? ContactPerson: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . pegidenGal Ventilation Category 1 Worksheet • New Energy Cade Workshee[ Category suwnmed sutrnined (4 su6missfon type) • Energy Ernelope Calculatioiu Submitted - In the last 12 months, has the Ciry of Eagan issued a permk tor a simtlar plen based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical ContreMOr: Phone: Sewer 3 Water Contractor: Phone: -- q, _,.,... .... . f nereby acknowledge that this infortnalion Is complete and accurate; that Me work will be in coMOrtnance with the ordinances and codes of the City of Eagan; that I un rst d this is rrol a permit, but only an applicalion for a pertnit, and work is not to start without a permih1hat the work will be in accordance wi me ved pl In the case of work which requires a review and approval of pl / ? x 1 ? x Ap li ant's Printe ame ApplicanYs Signature Page 1 of 3 City of EapIl 3830 Pilot Kno6 Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 04 11 - o& C".P." -----------------, ? For OHice lJs(e? I ? Permit #: ? Permit Fee: ? I ? Date R? ved:? ?/D • b8 I I Statt: WI? ? I ? -----------------? 2008 RESIDENTIAL BUILDING PERMIT APPLICATIoN Date: 7'14 - b'D Slte Address: q3 ZZ Fo)l IC04G Q? Tenant: Sulte #: RESIDgNT / OWNER Name: bAY 1}> JJf5W LI/J ° 71,7 Phone: 9S2 - 5/$ Y• /yZ3 Address /City /Zip: q32,2, r Kd Applicant is: X Owner _ Contractor TYPE OF WORK Descriptian af work: C 0t'15iQxL+ l\tLiJ A 0<k_ ? . Construction Cost:# zOo0 Multi-Famity Building: (Yes No _j CONTRACTOR Name! License #: Address:43q;+_ ? City: State: Zip: Phone: Contact Person: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING ~ _ Minnesota Rules 7670 Categorv 1 Minnesota Rules 76'72 Energy Code • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet CatCyOty Submitted Submitted (4 submission type) • Energy Emelope Calculations Submitted In the last 12 monThs, has the City of Eagaa issued a permit tor a similar plan based on a master plan7 _Yes _NO If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documenis that you submit are considered fo be public information. Portions of the information may be Classified as non publlc if you provide specific reasons that would permit the City to concfude ihat the are trade secrets. I here6y acknowledge Ihat this irrformation is complete arid accurate; that the work will be in conformance with ihe ordinances and codes of the Ci{y of Eagan; that I understand this is not a permit, but onty an application for a permif, and work is not to start wittiout a permiY, that ihe vrork will it??in accordance with the approved plan in the case of work which reqLires a review and approval otplans x DAJ1D /rOwl.?N1 ? x r ` AppllcanYs Printed Name ApplicanYs 5ignature Page t of 3 } DO NOT WRITE BELOW THIS LINE SUB TYPES ? Paundation ? 05-plex ? 16-plex ? Accessory Bullding ? Pool ? Single Famlly ? 06-plex ? Flreplace ? Porch (3-season) ? Ext. Alt. - Multi ? 01 of _ Plex ? 07-plex ? Garege ? Porch (4•season) ? Ext. AN. - SF ? 02-Plex ? OS-plex ? Deck ? Porch (screeNgazebo/pergola) ? Multi Misc. ? 03-Plex ? 10-plex ? Lower Level ? Storm Damage ? 04-Plex ? 12-plex ? Miscellaneous WORK TYPES New ? Interior Improvement ? Siding ? Demolish Bullding" Addition ? Move Bui lding ? Reroof ? Demolish Interior ? Alteretlon ? Fire Repair ? Windows ? Demolish Foundatlon ? Replacement ? Egress Wlndow ? Water Damage ' Demolition (entire building) - give PCA handout to applicant DESCRIPTION: Valuation Occupancy MCES System Plan Review Code Edition 'Z.sH 7 SAC Units (25%_ 100% Zoning City Water L Census Code ) 3 Stories Booster Pump # of Units Square Feet PRY # of Buildings Length Fire Sprinklers Type of Const. Width ? REQUIRED INSPECTIONS Footings(new bldg) Sheetrock ? Footings (deck) Final/C.O. Pootings (additlon) ? Flnal/NO C.O. Foundation HVAC Drain Tile Other; Roof: _Ice & Water _Final Pool: _Footings AidGas Tests _Final Freming Siding: Stucco Laih _Stone Lath _Brick Fireplace:_R.I. AirTest Final Windows Insulation - Retaining Wall Reviewed By: / Building Inspector -------------- RESIDENTIAL FEES: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utllity Connection Charge S&W Permit & Surcharge Treatment Plant Copies Total Page 2 of 3 C. R. WINDEN 3 ASSOCIATES, INC. • IAND SURVEYORS iwL 646•3646 1381 EUSTIS 5T., ST. PAUIP MINN. 35100 For: GRAND OAKS DEVELOPMENT 3 S/ • ? ?G?l" ??'?Y? Scale: 1"=30' _ O O? ? O ?0 ., o ? qt h d ` 1 q ? 19306 - 10 o Denotes Iron - Monument " Searings Are Assumed ? •! \ q?/ / 'Oroh ? 2 ?o ?n Q' ? ?f if s s` ?`a 3p ?? ?23 ? ?\s OOp6„£ aQ°r a` NOTE: O Denotes Wooden Stake Proposed Garage Floor E1.= 917,2 (4iG,4) Denotes Proposed Finished Ground SI. --.*- Denotes Direction Of Surface Drainage VerticaI Datum - N.G.V.D: 1929 / s' •?? , 50; s00 ? .o N ? /?•p i/J v . ? O ? oe 0??? o \ Lot 17, Block 2, SUN CLIFF FIFTH ADDITION, Dakota County, Minnesota. M!E NERE11' CERYIFT iMA1 TMIS IS A TRUE AND COlRECT RE?RESENiATION Of A SURVET Of THE WUNDARIES Oi THE LAND AWVE DESCRI{ED AND OF THE IOCATIOH Of ALl WIl01NG3, (f ANY TNEREON, ANO ALL VISIStE ENGROACNMENTS, If AN1', fROM OR ON SAID lANO. De1eI tAis 3deY o{ dune, A.O. IABS C. R. WINOEN iASSOCIAiES, INC. _ ...... yY?/ - Swr.oyor. MinnewN Roqislrolion No. 772G 2006 RESIDENTIAL BUILDING rExn-uT arrr.icaTioN City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone 9 651-675-5675 FAX # 651-675-5694 New Conswc6on Reauiremenl5 3 registered site surveys showing sq. ff. of lot, sq• R ot house; and gl_I roofed areas (20°k manimum lot cove2ge allowed) 1 Soils Report rf proposed buid'mg is lo be placed on disNrbed soil 2 wpies of pian shovnng beam &windowsizes; poured found tlesign, etc. 7 set of Eneqy CalcuWtions 3 capies oi Tree Preservation PWn it lot plaried atter 711193 Rim Joist Detau Options selection sheet (buildirgs with 3 or less units) Minnegasco mechaninl ven6lafion form RemadeUReoair Reauirements 2 copies of pWn showing footings, 6eams, joisfs 1 set of Energy Cakulations for heated additions 15ite survey for addidons fl tlecks Addifion • indkefe iI on•sne sepfre system ?23002 ? eU , cei ? Cerf of Survey Recd ' Y? N Soils Repod, ?.y t 'Y `N 7nePt85PIsnsReW ` r ,?' 'N. iree Pres Raq?lred = ;Y, -FI OnsiteSe'pGcSYstem Date ?/ L o Ibl SiteAddress r? Construction Cost '7 1?d ? (rl`?-l?Ai UniUSte # Description of Work T ee Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 2 Property Owner OtiV I tl dft lb?- NtiwI i? Telephone #( 6 Sl ) 99 ?+ -7 2r6 Contractor (i(/iQ-?/dQGGCLbP ?G?;s?u??d?7 Address State /7) /1,? Zip / City Telephone # (/p57) y ? 1-/- y ?J a'-O COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Catezorv 1 Minnesota Rules 7672 Energy Code Category . ResidenUal Ventilafion Category 1 Worksheet • New Energy Code Worksheet (J submission type) Submitted Submitted . Enargy Envelope Calculadons Submitted In ihe lasi 12 months, has the City of Eagan issued a permit for a similar plan based on a masTer plan? _ Y _ N If yes, date and address of master plan: Licensed Piumber Mechanical Contractor Sewer(Water Contractor Telephone #( Telephone # ( Telephone #( I hereby apply for a Residential Building Pernrit 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; I understand this is not a pemut, but only an application for a permit, and work is not to start without a permit; that the work will be in accardance with the approved plan in the case of work which requires a review and approval ofplans. ' Applicant's Printed Name Applicant s Signature 1986 BOILDING PE[8QT APPLICATION - CITY OF fiAGAN HOTE: ALL COIiTRACi08S MOST BE LICENSSD WITH THE CITY OF EAGAB SINGLE F9FIILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SURVEY, 1 SET OF ENERGY CALCULATIONS MQLTIPLE DTiELLINGS - RESIDENTIAL RENTAL t1NITS F08 SALS 09ITS INCLUDE 2 SETS OF PLANS, CEBTIFICATE OF SQRVSY - CHEC% iiITB BLDG. DEPT., 1 SET OF EPIERGY CALCDLATIONS INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS, $2,000 LANDSCAPE HOND To Be Used For: Site Address Lot ? B1 c Parcel/Sub ? Owner ? Address City/Zip Code Phone Contractor Addres City/2 Phone Areh./Engr. _ Address City/Zip Code Phone # _?_ Valuation: Q p ?} -??- aa ? o?ICE n1 , Date: " I ? I ?0 10 --r Ereet n Occupaney R 3 Remodel ? Zoning 2•1 Repair ? Type of Const ? Addit3on # of Stories Move Length 50 Demolish ` Depth 46 Int.Impr. Sq Ft Install APPROYAL4 FSES Assessments Permit 31(n Water/Sewer Surcharge, 30.-2? Police Plan Review 15 6. Fire SAC S"1 S Engr Water Conn 500- Planner Water Meter ro3.a Council Road Unit Z9 O Bldg Off?- -$? Treatment Pl I SCo, APC Parks Variance Copies TOTAL NOTE: ADDRSSSES FOR CORNER LOTS - CONTRACTOR/HOMEOHNER lfOST DESIGH9TE flHICH ADDRESS IS DBSIRBD. NO CHANGES AILL HE ALLOWED ONCE BOILDING PERMIT IS ISSi1ED. EXTERIOR ENVELOPEr AVERA6E 'U' COMPUTATTON GRAND OAKS pEVELOPMENT COMPANY ' MQDEL a AREA Ll U X AREA - ? kEQUIRED 1. TOTAL WALL AREA 1600 X .11 198 2. TQTAL ROOF AREA 1196 X. 026 31.096 ACHIE VED AREA U U X AREA A. WINDUW 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 O 0 0 E. WALL FkAME AREA 180 .041 7.38 F. NET WALI AREA 1164.1 .049 57.0409 0. RIM JDIST AREA 119.52 .0436 5.211072 H. FOUND WINDOW AREA' O 0 ' 0 I. FOUNA AbOVE GRADE ° 96.48 .135 13.0248 3. TOTALti WALL AREA 1800 iB5.50S'.6 . J. SKYLITE , O; . ,. O .. O' K. ROOF FRAME 114.6'.: .032 3.8272. L. NET ROOF AREA 1076.4 ?' - .'025 .' 26.91 4. 70TAL ROOF AREA 11,96 30.7372. SUM 1.+2. 229.096 " . SUM 3.+4. 216.2398 ?-?„ r , ' (?' qk ? ?`????Q/?f ? v For: GRAND OAKS DEVELOPMENT Q OQ 4T- d ? / -o q \ ?O C. R. WINDEN 3 ASSOCIATES, INC. lANO SURVEYORS Tel 645•3646 1381 EUSTIS ST,, ST. PAUL, MtNN. 5310! 35 / Scale: 1"=30' o Denotes Iron Monument Eearings Are Assumed t?ti . \'/ h0 ,o /.` s NOTE: GDenotes Wooden Stake Proposed Garage F1oor EI.= 917'2 (91G,4) penotes Proposed Finished Cround Si• - .:? Denotes Direction Of Surface Drainage VerticaI Datum - N.G.V.D: 1929 Cri sF \? S 6Sn?3 os??'o 2 ?. ??5, .• ? ! P Q Q/ ?? / / w ? \ a`vq, oQr `? ? ?', /o - ti Qt 4,o . i QJ \? ., ,o t7Q' /1 \ Lot 17, Block 21 SUN CLIEF FIFTH ADDITION, Dakota County, Kinnesota. WE NEREIY CERTIFY TNAT TNIS IS A TRUE AND CORRECI RE?RESENiAiiON Of A SURVEr Of TNE {pUNDARIES Of TME IANp ASOVE OESCRISED AND OF TME IOCATION Of All WIIDINGS, Ii ANY, iNEREON, ANO All VlSIGLE ENCROAC1iA4ENTS, If ANII, fROM OR ON SA10 IAND. Da1ed ?Ais 3deT o{ tJun? A.D. IABS C. R. WINDEN i ASSOCIATES, INC. -4evised=9-io-8G ._ :--_...:.. 1, Sur.qor, MinhewPo RaOiNrofiow fio. 972G wan ; APPLICATION FOR PERMIT CITY OF EAGAN SEWER AND/OR WATER CONNECTION *RYP6: PAYMF'DTP OF k'F.E AT TIlM pF APPLZCATION DOFS NOrP aDDS1'I1TJrE ApPROVAL OF PERI+IIT. INSPDCTION OF SE,WQt ADID/OR MM ItEiTI T??ATIONS 4TIId N0T BE 9QHE4- iILID UN1ZL PEEtI•IIT HAS BEEN APPROVFD. xx,.xxx,.xxxx,.xxxxxx,.x-xx==?...._... «-_ P ease Print) 1) PROpERTY ADDRESS: LEGAL DESCRIPTION: IF EXISTING STRCCIL?RE, DATE OF ORIGINAL BL?ILDING PERMIT ISSL'ANCE: i " (MOn Year) PRFSENf ZONING/PROPOSID t'SE: • . ? CM24ERCIAL/`RErAIL/0FFICE a R-1 SZNGLE FAMILY 0 INDT-ISTRIAL f-I R-2 DL'PLEX (1tA Dnits) f-I INSTI7L'TIONAL/GOVII2NMENp 0 R-3 7nWNEiOC?SE (Three + Units) ( Units) q R-4 APARTT=/COAIDOMINIDNI ( -Units ) 2) ADDRESS: CITY, STATE, ZIP: . PHONE: 3) u ?• ?• NAM- For Cit Lse Plimibers License: ADDxESS:_ fo /D C t? e e@C L. c? P Acti.ve ; cixY, srATE, zIP:? o-f N Expired /?'Jn •?'cS 3 f 7 rrot recoraea PxoNE:-'L/'?.:2 -a ?/ MASTER LI(gISE# StaTf?In t1a1 4) •?« • ? r?,r?:?? ADDRFSS: CITY, STATE, ZIP: PHONE: . 5) ? v ? t r •?• : a • a? . ?. ? coNcgx:rioN To ciTr sEwm ? mMncrzoN zv czTSr wp.xEx p oMM 6) u • c- • r ? ? PLFASE FiOLD APPROVID pIIiMT FOR PICK-OP BY ONE OF ABOVE PLEASE MAIL APPROVID PERMIT TO 1, 2, gO 4, ABpVE . n' n (Circle one) FOR CITY USE ONLY PERMIT # ISSDED 7, / z 91114 F ? Pd w/Bldg. Permit FEES: $ SEWER PERMIT (INCLC'DE SLRCHARGE) $ $ ?D - J-0 WATER PERMIT (INCLUDE SURCHARGE ) .. $ $ WATER METER/COPPERHORN/OCTSIDE READER $ $ WATER TAP (INCLLDE CORPORATION STOP) $ $ SEWER TAP $ 16-1?o $ ACCOLIVT DEPOSIT - SEWER $_ 1,5-i?0 $ ACCOONT DEPOSIT - WATER $ J?OCl (l?' $ WAC $ :57s,? $ sAc $ $ TRLNK WATER ASSESSME[VT $ $ TRC'NR SEWER ASSESSMENT $ $ ' LATERAL BENEFIT/TRUNK SEWER $ $ LATERAL BENEFIT/TRCNK WATER $ ?S?G U $ WATER TREATMENT PLANT SURCHARGE $ $ OTHER: $ / J-2- Y ! S? $ , TOTAL e RECEIPT RECEIPT DOES LTILITY CONNE CTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY? Q YES IF YES, THEN A" PERMIT FOR WORK WITHIN PUBLIC Q NO ROADWAY" MUST BE DIVISION IS ISSLED BY THE ENGINEERING . L T AS A CONDITION. SUBJECT TO THE FOL LOWING CbNDITIONS: APPROVED BY: TITLE: DATE: 2 ? ?-7 ? a• ? cty oF es??c;n • 1-2 3830 PILOT %NOB ROAD. P.O. BOX 21194' • • 6En BtOMptnsT EAGAN, MINNESOTA 55121 . ' Wlatr . PHONE (612) 454$100 iFqMaS EGAN • JAMES A. SrtnRN , JERRY 7F!'JMAS DATE: ?ril 3, 1986 . nK??E'?/ER . " ' 1NCMA51+"cDGES ' Gtr Aannsna'er . ' , fUGENE VAN pVERBEK °PECIAI. ASSESSfE`IT SE4RCH G'V ct" RE: Sun Cliff Sth • Uni.versal Title Insurance Co Lot 17 Block 2 14031 Burnhaven Drive Burnsville r1N 55337 - 4322 Fdx Ridge Road -• Enclosed herein is the search which you requested made on the above desczibed propert: Sewer Trunk 25 1970 $ 49.84 $ 16.01 $ 3,44 Street 15 1985 357.37 309.73 58.84 Sew't?r Lateral 5 1985 257.00 154.20 72.98 Watennain 15 ' 1985 64.55 . 55.95 10.62 Water Area 15 1973 68.60 4.62 5.30 Storm Sew ZYunk 15 1985 106.94 92.70 17.60 Storm Sew tsunk 20 1971 214.60 42.92 . . 25.02 I further certify that according to the records of said office, the following improve ments are contemplated or pending after having been approved and ate nov in the proce. of planning or completion. Rind of Imvrovemen[ Annroximate Date of Comnletion Aoaroximate Cost WAIVER: . . heither the ,^.ity of Eagan nor its employees guarantees the accuracy of the abava lnfo mation vhich was requested bythe nerson or persons indicated. Nor does the City or : employees assume any liability for the correctness thereof. In consideration for the supplying of the indicated infoiviation in the above form and for all other considerat: of any nature whatsoever, any claim against the City or its employees rising therefro: is hereby expressly craived. Levied assessments to be paid to the CITY OF EAG.a.Y, 3830 Pilot Knob Road,' P..O. Box 21199, Eagan, MN 55121. .Very,tzuly yours, • . ?.?,.? ??.?. ' _.. . . _ . . . SPECIAI. ASSESS:fENT DIVISIOV • ?_ 1HE LONE OAK iREE...iHE SYM80L OF SiRENGTH AND GROWTN IN OUR COMMUNIIY • . ' ??? c??y oF esac?c?n 2-2 3830 P40T Kru08 aCAD. P.O. BOX 27199' • • 6en eiOHansi EAGAN. MINNESOTA 55721 . ' ?+wa PHONE: (612) 454d700 tiiOnn0.S EGaN ' UMES A. $MIiN . hRRV iMOMAS DATE: April 3, 1986 , Woocr.e V/nCHtER .. . 1HC`naS9E06E5 ' Gnv ?+.srtaev - . . - - ° ECIAI. ASSESS`tEVT SE.aRCH EWENi VAN OVERBEKf w•C? Universal Title Easurance Co RE: Stui Cliff Fifth 14031 Burnhaven Drive Lot 17 Block 2 Burnsville MN 55337 - 4322 Fox Ridge Rnad •? Enclosed herein is the search which you reques[ed made on the above described propert: Kind oi Inorovenen[ yPa.- Beeinnine Orisinal Ncounc Balance Due Storm Sew I,at 15 1985 $ 86.95 $ 75.37 $ 14.32 Street Restor 5 1986 1622.20 1297.76 519.92 San Sew Iateral 5 1986 502.58 402.07 161.08 Water Iateral 5 1986 582.46 465.97 186.68 Storm Sewer Lateral 5 1986 739.56 591.65 237.02 Sei.vices 5 1986 524.15 423.32 169.60 . ?"? . I further certify that according to the records of said office, the following improve- ments are contemplated or pending after having been approved and are now in the proce: of planning or completion. _ Kind of Imvrovement Avvroximate Date of Comnletion Annrosimate Cost DIONE WAIVER: , • Keither the ^.ity of Eagan nor its employees guarantees the accuracy of the abovr infoi mation vhich was requested bythe person or persons indicated. Nor does the City or = employees assume any liability for the correctness thereof. In consideration for the supplying of the indicated information in the above fozm and for all other considerat' of any nature whatsoever, any claim against the City or its employees rising therefzoc is hereby expressly waived. Levied assessments to be paid to the CITY OF EAG.LV, 3830 Pilot Knob Road; P. 0. Box 21199, Eagan, MN 55121. ' .Very.truly yours, -?: . . . . . SYECIAL ASSESS:2ENT DIVISION • ? ? THE LOYE OAK TREE...1HF SYMBOL OF STRENGTH /VJD GROWfH ?N OUR COSiMUNITY • •• AFFIDAVIT OF PUBLICATION PUBLIC NOTICE NOTICE OP PUBLIC HEARQIG PRUPOSBD VACAT[ON OP DRAIIiAGB ANU U7V.CfY EAS6MENf C17'Y OF EACAN DAICOTA COUNf1; NINIYE,qpTp NOTICE !S HEREBY CIVBN THAT iHE 6ty Counal of the City of Bagan, WkaW County, Minnnota, wfll meet a[ the City Hall, 3830 Pilof Rnob Rwd, Eagan, MinnesoW 55122, on 7Lndag March 4, 1997, a[ 7:00 pm-, or ss soon Neieafter az poaeble. The Durpose of the meetinQ wf116e to hoW a public hesring m Nc vacation of a easemmt tying wer, u?er and across the fWlowing Aescribed property in Ihe City of Eagan, Dakota County, Minnesota Wration of all dninage aM utiGty easn meirta within Lot 1, glock 5, SunCIi1T 2nd Mditlon, Dakoh Counry, Minnesoq, Wt liu beneath Lot 17, Bloclc 2, SunCliff FiM Addltion,WkohCounry„Minnesofa - Dakd: Feb. 11. 1997. EJ. VanOverbeke, Eagan CitS Clerk Datoh County, Minnesoh 330 5051 STATE OF MINNESOTA )SS County of Dakota ) NANCY J. GUSTAFSON, being duly swan, on oofh says fhat she is on authori:ed ogenf and employee of the publisher of the newsDaDer known as Dakota Counfy Tribune, and has full knowledge 04 the lach which are stoted below: (A) The newspaper hos complied with all 04 the requiremenfs consfitufing auolificotion as a legal newspaper, as Oravided by Minnesoto Sfofute 331 A.02, 331 A.07 ond other opplicoble laws, os amended. (B) The printed ? which is oetoched was cut from the columns oF said newspoper, and was prineed ond published onte each week,lor successire weeks; iT wos first pu6lished on Thursday, the 1?)1"?. doy C J_ -_ _, 19 ?, ond wos thereahn printed and published on erery Thursday to ond including Thursday, the 9`0' ! ?'.\ day ofe-? 19 c_?_ . ; and primed below is a copy of the lower wse alphobet hom A to Z, both inclusive, whith is hereby acknowledged os being the sixe and kind of type used in the composition and publicafion oF the noeice: .?1-1..i,•t„iki...,,., ? BY: -(?yy?--Secmtory TITLE?e Rdblishn ? Subscribed and sworn b before m6-414 this ?o -Vtl day of? ?Oxo"s, 19 ?? . ? Nmary Public ? \J ? ?, CARGL 3. NAVERLAND -j?'? hO7AA., : „?IC • MINNESOTA ??- t.:vccr•._:.o,Exoires.p?.st.za00 i. EAGAN CITY COUNCIL MEETING MINUTES; FEBRUARY 4, 1997 PAGE 3 Item 3. It was recommended to accept the resignation of Brian Distad from his position of temporery part- time Recycling Intern. Item 4. It was recommended to approve the hiring of Chris Larson as a temporary seasonal Boot Hockey Official. Item 5. It was recommended to approve the termination of David Sorby from membership in the Volunteer Fire Department as recommended by the Executive Board of the Volunteer Fire Department. (This item was continued to the February 18 City Council meeting.) Item 6. It was recommended to approve Pat Trembley, Mike Morotr, Bill Knoll, Steve Plaschko, Joe Werden and Jon Stevenson as apprentice members of the Eagan Fire Department. Item 7. It was recommended to approve the hiring of John LeMieux as a seasonal street maintenance worker. B. Sesignation. APC Alternate position It was recommended to accept the resignation of Shawn Hunter as the alternate to the Advisory Planning Commission. C. Pet Shop License Renewals - Heartland Pets 1960 Cliff Lake Road• Walmart1360 Town Centre Drive• Werivorld 3390 Coachman Rd #206 Pet Food Warehouse 1296 Town Centre Drive (revisited)It was recommended to approve renewals of pet shop licenses for Heartland Pets, 1960 Cliff Lake Road; Walmart, 1360 Town Centre Drive; Wetworld, 3390 Coachman Road, #206; Pet Food Warehouse, 1296 Town Centre Drive, as presented. D. Tobacco Sales License - Tobacco Etc 1430 Yankee Doodle Rd It was recommended to approve a tobacco sales license for Tobacco Etc., located at 1430 Yankee Doodle Road. (Councilmember Wachter opposed) E. Temoorarv Beer License - Mens Ciub Partv at West Publishing to be held Saturday, March 1. It was recommended to approve a temporary beer.license for the West Publishing Mens Club Party on Saturday, March 1, 1997. F. Final Planned Development - Decalla Properties LLC for Lot 2 Block 'I Rahn Ridge 2nd Addition It was recommended to approve a Final Planned Development for Lot 2, Block 1, Rahn Ridge 2nd Addition located west of Rahncliff Road, just north of the new Hedlund Engineering building. G. Street Name Change - Gity of agan oton Drive !o Q=nmark Avenue It was recommended to approve the changing of the street name "Hampton Drive" to "Denmark Avenue" at the southeast intersection of Lone Oak Road and Interstate 35E. H. Eutension for recording conditional use pgrmits for Richfield BlacktpR, It was recommended to approve a 60 day extension of the time for recording Conditional Use Permits for Lot 5, Block 3, Letendre Addition No. 2, located east of Highway 13 and north of Letendre SVeet at 3206 Sibley Memorial Highway. 1. Vacate Easements. Receive petition/schedule oublic hearinq (Lot 17. Block 2. Suncliff 5th Addition). It was recommended to receive a petition to vacate a drainage and utility easement for Lot 17, Block 2, Sun Ciiff 5th Addition, and schedule a public hearing to be heid on March 4, 1997. J. Vacate Easements Receive petition/schedule public hearinqjLot 1 and 2 Block 3 Eagandale Corporate Centerl. It was recommended to receive a petition to vacate a drainage and utility easement for Lots 1 and 2, Block 3 Eagandale Corporate Center, and schedule a public hearing to be held on March 4, 1997. Agenda Information Memo February 4,1997 L VACATION - fLOT 19. BL. 2. SUN CLIFF 5' ADDNI ACTION FOR COITNCIL CONSIDERATION: To receive a petition to vacate a drainage and utility easement for Lot 17, Block 2, Sun Cliff 5th Addition, and schedule a public hearing to be held on March 4, 1997. FACTS: City staff has received a request to vacate an existing drainage and utility easement over the above-referenced parcel as described. Staff has reviewed this application and found it to be in order for favorable Council action of scheduling a public hearing to formally present and discuss the merits of this request. ATTACHMENTS: Location map, page Easement vacation description & sketch plan, page Agenda Information Memo February 4, 1997 J. VACATION -(LOTS 1& 2. BLOCK 3. EAGANDALE CORPORATE CTR) ACTION FOR COiTNCIL CONSIDERATTON: To receive a petition to vacate a drainage and utility easement for Lots 1& 2, Block 3, Eagandale Corporate Center, and schedule a public hearing to be held on March 4, 1997. FACTS: City staff has received a request to vacate an existing drainage and utility easement over the above-referenced pazcel as described. Staff has reviewed this application and found it to be in order for favorable Council action of scheduling a public hearing to formally present and discuss the merits of this request. ATTACHMENTS: Location map, page Easement vacation description & sketch plan, page 4 0 01'ecitV oF eagan THOMASEGAN Mayor PATRICIA AWADA SHAWN HUNTER Aprii 13 1994 SANDRA A. MASIN , . THEODORE WACHTER Council Members MR GREG KUHN THOMAS HEDGES City ndminisharof 4322 FOX RIDGE EAGAN MN 55122 E. J. VAN OVERBEKE CiN Clerk Re: Maintenance ot Pu61ic Right-oi-Way (Lot 17, Blxk 2, Sun Clitt Sth Addition) Dear Mr. Kuhn: Several weeks ago, you and I spoke regarding your desires to remove and/or cover the existing established vegetation on the east side of your property adjacent to Blackhawk Road. I indicated I would discuss the issue with the Parks Department personnel and get back to you. Your recent phone call reminded me that I had not met your expected time line. For this I apdogize. I went on vacation and Just didn't have a chance to fdlow-up on this issue prior to your calling. I tried to return your phone call on April 12, but receiving no answer, felt that this letter of response might be the surest way at this poirrt. On July 10,1990, the Ciry Council adopted an amendment to Section 7.08 of the Eagan Ciry Code regarding 'Regulation of Grass, Weeds, Trces and Landscaping°. A copy of that Ordinance is endosed for your information. Please refer to Subdivision 2"Duty of Property Owners To Establfsh Turf Gress Within Street Rights-of-Way. This states that "suitable turf grass" must be established from the edge of your property Ilne to the edge of street surfacing. The blanket placement of a mulch materlal merely for the control of vegetation is not an acceptable type of material and is not considered °suitable turt grass'. Mulch may be permitted in certain circumstances where necessary to malntain and/or minimize loss of moisture around trees arW within shrub beds. However, a blanket placement of this material would be considered a violation of this Ordinance. I hope this response provides you with the information you needed in helping you make your landscaping decisions. I appreciate your contact with the Ciry of Eagan allowing us to research this matter and respond to your questions. Agaln, I apologize for the delay in this response. Sincerely, ; teLto+ca Thomas A. Colbert, P.E. ?v Director of Public Works TAC/jj Attachment: Ordinance cc: John VonDeLinde, Superintendent of Parks MUNICIPAI CENTER THE LONE OAK TREE MAINTENANCE FACILITY 3830 PILOT KNOB ROAD EAGAN, MINNESOiA 55122-1897 THE SYMBOL OF STRENGTH AND GROWTH IN OUR COMMUNITY 3501 CDACHMAN POINi EAGAN. MINNESOiA 55122 PHONE: (612) 681•4600 PHONE: (612) 6814300 FAX: (612) 681-4612 Equal Opportunity/AffirmaTlve Actlon Employer FAX: (612) 681 -4360 TDD:(612) 454-8535 TDD:(612) 454-8535 SEC. 7.08 REGULATION OF GRASS, WEEDS, TREES, AND LANDSCAPING Subd. 1. City to Control Landscaping and Irriqation. A. In no cases ahall prohibited species be planted within street rights-of-way. Prohibited spec3es are defined as the following trees: Gingko (female only) Box elder Non disease resistant elm species Non hybrid cottonwood epecies B. The City shall have control and supervision of planting shrubs and trees upon, or overhanging, all City streets or other public property. The City shall establish and enforce uniform standards relating to the kindg, types, and sizes of trees to be planted, installation standards, and the placement thereof. Said standards shall be on file in the office of the City Forester. establish suitable turfgrass, from the line of such property nearest to such street to the centerline of such street within a period of one full qrowing season from the completion of final grading or date of occupancy, whichever is sooner. Subd. 3. Duty of Property Owners to Maintain Turfgrass within street Rights-of-Way. Every owner of property abutting on any street shall be responsible for the maintenance of suitable turfgrass from the line of such property nearest to such street to the curbline of such street. If the grass or weeds in such a place attain a height in excess of six inches, it shall be prima facie evidence of a failure to comply with this subdivision. Subd. 4. Duty of Property Owners to Maintain Trees Within Street Rights of Way. Every owner of property abutting city street rights of way shall in accordance with standards on file in the office of the City Forester maintain, trim, fertilize and irrigate all living trees or remove any dead or non-conforming trees, from the line of such property nearest to such street to the centerline of such street. It is the lawful duty of citizens to follow such City standards, except in those cases where the City has declared certain boulevards to be under the maintenance jurisdiction of City departments. Subd. 5. City May Order Work Done. If any such owner or occupant fails to assume the responsibility of this Section, and after notice given by the City has not within seven days been complied with, the City may perform such work, keeping accurate account of the cost thereof for each lot, piece, or parcel abutting upon such street. Subd. 6. Assessment. When maintenance work is performed by the City as prescribed herein, the City Forester shall forthwith upon completion thereof, ascertain the cost of such maintenance work. The City Clerk-Treasurer, may at the next meeting, present such information to the Council and obtain its approval thereof. When Council deems fitting, it may extend these maintenance costs as herein stated as a special assessment against abutting land, and such special assessments shall, at the time of certifying taxes to the County Auditor, be certified for collection as other special assessments are certffied and collected. Section 3. Eagan City Code Chapter 1 entitled nGeneral Provieions and Definitions Applicable to the Entire City Code Including 'Penalty for Violation"O and Sections 6.99 and 7.99, entitled nViolation a Misdemeanor" are hereby adopted in their entirety by reference as though repeated verbatim. fails to assume the responsibility of these requirements, the City may proceed to order the work done in accordance with Subdivisions 5 and 6 of this Chapter. 5. Overhanging branches of all deciduous trees, planted within street rights of way shall, at the time of maturity, be at least 13 1/2 feet above street surfaces and at least 8 feet above the ground for all other public places. This requirement includes trees that are planted on private property, but overhang within public areas or rights of way. 6. The City may establish a master plan for street tree planting. The plan shall identify those streets which have been designated by the City Council for the planting of said boulevard trees. In accordance with the master plan, responsibility for the planting and maintenance of boulevard trees shall be the responsibility of the City of Eagan, except for new sub-divisions where the developer shall be responsible for planting boulevard trees. The planting and maintenance of trees within residential street riqhts of way, not included in the City's master street tree planting plan, shall be the responsibility of the abutting property owners. In such cases, the property owner shall first obtain, from the City Forester, a written permit to plant, in accordance with Subd. S.A.C. of this Chapter. E. The City shall establish and enforce uniform standards for the pruning, spraying, fertilization, irrigation or other maintenance of trees planted or located within the public right of way. Such standards shall be kept on file in the office of the City FoTester. F. It is unlawful for any person to deface, destroy, or tamper with, any trees or landscaping on public property, including trees within street rights of way. G. A tree within a public right of way shall not be used for signs, permanent liqhting, television antennas, or other inappropriate uses. H. Removal of trees and shrubs from public property, shall be by City permit only. Subd. 2. Duty of Property Owners to Establish Turfgrass within Street Rights of way. It is the primary responsibility of any owner or occupant of property abutting on any street to C. Any owner or occupant of a lot or land parcel abutting a public street shall, prior to the planting of trees and shrubs or installation of irrigation systems, within the street right-of-way, abtain written permission from the ty. Permits, when so issued, shall identify the species to be planted, size, location thereof, and timeline for installation. The City shall retain the suthority to regulate, authorize or deny any request for said permit in the interest of ensuring the qeneral orderliness of improvements within street right-of-ways. D. The placement of trees and shrubs in public places, and streets rights of way shall be in compliance with the following City standards: 1. Trees shall not be planted within ten feet, horizontally, of any sewer line, water line or driveway, or within four feet of any public trail or sidewalk. 2. The placement of trees and shrubs within public right-of-way shall not disturb any ground within two feet, horizontally, of any gas lines, electric lines, phone lines, or cable television lines, except in those specific cases where utility easements provide for wider setback requirements. 3. Any new trees planted within a street right of way shall be spaced no closer than 20 feet apart and must be at least SO feet from the back of curb in an urban section or 20 feet from the edge of pavement in a rural section. 4. Trees, shrubbery, and other plant materials shall not be planted or maintained, on public or private property, in such a manner as to obscure or impede the visual sightlines required to ensure the safe and efficient circulation of vehicles and pedestrians on streets, intersections, trails, and sidewalks. Trees, Bhrubbery or other plant material shall not be planted as to block the visibility of any regulatory, warning, or street identification sign, or block the illumination of street lights. The City shall have the authozity to determine the minimal amount of required setback nnd clear zones.in such circumstances. Property owners in violation of said requirements shall be given written notice, which notice shall be given by mail to their last known address, ta remove, relocate, or trim all related plant materials in compliance with the directives qiven therein. If any owner or occupant Section 4. Effective Date. This ordinance shall take effect upon its adoption and publication according to law. ATTEST: J. Its. Cl Date Ordinance CZTY •-ci' ? V y: i'nomas A. Its: t7ayor Date Ordinance Published in Leqal Newspaper: Julv 26. 1990 7Q979 17o 0a' OF 3830 PILOT KNOB ROAD. P.O, BOX 21199 EAGAN. MINNESOTA 55121 PHONE: (612) 454-8100 August 25, 1987 Re: Dear Property Owner: Boulevards BEA BLOMQU15T Mayor THOMAS EGAN JAAAES A. SMRH `AC ELLISON THEODORE WACME2 Cwncll MemDers nHonvs HeoGes CM /+dminiShWOr EUGENE VAN OVERBEKE Ctty Clerk Recently, several of you have expressed concerns regarding the maintenance (or lack thereof) of the public property portion between the west curb line of Bl ackhawk Road and your east (backyard) property line. Many of you have been informed of the City's ordinances requiring adjacent property owners to maintain pub'ic boulevard property similar to your front yard areas from your front property line to the curb on Fox Ridge Road. xowever, several of you have felt tha.t the existing bou'evard section of Blackhawk Road is excessive. This public right-of-way was acquired by the State of Minnesota to facilitate the construction of I-35E and the Blackhawk Road overpass. Now that these road improvements have been completed, the excess right-of-way required by the state has been reconveyed to the City. Correspondingly, the City could consider vacating and turning back this excess right-of-way to the adjacent single family property owners along Fox Ridge. This would provide each of you with greater property ownexship and flexibility to perform whatever landscaping or other similar improvements would be desired on an individual basis. If this process were to occur, it would require a public hearing before the City Council. Each of you would be so informed by mailed notice of that public hearing. In the meantime, under existing City ordinances, it is still the property owners responsibility to maintain all property between curb lines. We are aware of your present concerns and would appreciate your patience, understanding and continued maintenance of these areas while the City pursues the various alternatives discussed in this letter. Sincerely, ?,i „"e".."'.." /4e4-4 Thomas A. Colbert, P.E. Public Works Director TAC/af THE LONE OAK TREE. . THE SVMBOL OF STRENGIH AND GROWfH IN OUR COMMUNIN j ro r ,?. ?2 f 5 ? S? oF eagen 3830 PILOT KN08 ROAD, P.O. BOX 21199 EAGAN. MINNESOTA 55121 PHONE: (672) 454-8100 July 14, 1987 MR & MRS WILLIAM G KUHN L322_F0X..RIDGE_ RD ' EAGAN MN 55122 Re: Complaint - Berm Along Blackhawk Road Dear Mr. Kuhn: BFA BLOM9UISf Mayor 7HOMP5 EGAN .lAMES A. SMI1H VIC ELLISON niEOOOaE wncrnEa Coundl Membars 7HOMhS HEDGES Cily Pdministralor EUGENE VAN OVERBEKE c:n a? The "eye sore" berm which you make reference to in your July 6 letter was constructed for two reasons. The berm is intended to provide a"sight and sound" buffer between the development and the users of Blackhawk Road and I-35E. The City requires the berming as a condition of the development. As far as maintenance of the berm is concerned, that responsibility lies on the development which ultimately transfers to the individual property owners. If you have any further questions or concerns, please do not hesitate to contact me at 454-8100. Sincerely, Vch4ae PFoertsc stant City Engineer MPF/jj THE LONE OAK TREE. .. THE SYMBOL OF STRENGTH AND GROWfH IN OUR COMMUNIiY • ?r I ---- -----???. -- I - ?j? (g7 -- ' 'v'L c?? -? ---- -? ??--: - -- - - ? -- a- --- -- -- - ? - ?-?-?e_f rvNL ?ior_K?---`l - ------------ ---- ----?---- -- - ---- ---- ? '-• -- ?i1Sl._ `-'-?=_-V?6MQ=-?-c.Jr?? ?I? ?c\??_a?=?` --T==--t,a? --- ----- ? --- - - ? - P G - - -- - - -t - ----?- --- '- --- _ M,a 'TIM -?- ?- ? i ' t ? cl --- -- ?C?SS-?oS- _S?A 11I - ?`1 ( 1 -?u1.t?-a-a??_?aCl?_hac,? , --- - -- •---- -?-!?- '?- O`--\--.cl?-.r??._ . .? d _ a?_ - -- ---- -- - - ?--- ':7-cu-? V`?-' - . -- ? ? - - C?. -- ----- - --0, L oc9t?-- - -?WU -- ? J r .? ; . ? . - - - Co?c HQ ??- ?v n?o (-U ?I c L -)-? o c'`A`l (?, rvrl no a r\- A-? ?r 1 o+ ? HEAT LOSS CALCULATION ?_-0-° YEMP. DIFF, CCuuamw Namw TYOt Comtnbtbn •' IQ Dwlw Name Sttwt _ City and Doort-Gaekaan aM Mr Na W?Ot? nlO?q ?^??? 1?M Ne. 01 llnMl lt L b OIlM?" Ary? tl 3 to ? o ? Cwf. Btu Inldtnlion d Gl1° O OO Exp. wall 13 o'L X Q Nn e.P, w.u 3 Int. wall c.irnq x o Z O f bor Toul Btu. ?S?FI.1 OAe?RaomlLaqtASS WidM iNi t W indoM and Ooas -G?d ay? and Ar M Ne oW.61M e?qny Ne.e/ N?MM. ry? A.N. ? r 1 q? ? i y Zt? V OoN. 9tu inrnr,twn 401 i roo Gua ( OG Eap. wall X 1 Nkl erP, wall ? Int. rwll ???ing g x? a o a r k" Wh"dewt Stann SM Mbtb . Inw. Gi1Nq IM. F1oor Windowr and Doors-GaduP lind Arm Ne. wq1h « MOW" NO. M L LIwM N. .,?. CaN, Btu Infikration ?? Gi.. I ? Exp. wall /p -- g Net Otp. wNl Int. wmll Gflinp v i CeO Floor I TA Topl9tu. bql.1.mh"M RaomI Lon A 10 WIdM FNi t W indowr d Oaon -Gaekap aid Ara Mo. WI+M N M NN?1?? ?1 Ms. e1 ?I?Y1/t. Aw ? . M. CoN. Btu !JQ v Gler d zlico Exp. rpll 20 NM exp. wsll 7 Int. wdl Gilin9 !U?t /U 00 3 3v FWw OO 2-0 rnui etu. 11 ToulBtu. ? 5 f 1.- Room r L h Width Q H&WO ( STI.1 L. . oornILogo WidTh ? WmAnws xM Ooors-Gadclp and Arm Windom Daas-Oakur and Arr Nn W???? M'NhI ??IIwN I11 IM NO.O/ L n LNNIM. N A- II. -2,1 12 0 CoN. Btu IMdtraUOn ? Gu,s I SO SlX7 ExP.wall a_yyc Not inip. wall Int. wsll Ceilnwl '?F O Flpr Tolal Btu. 12(aOe M?. ?? 3 (e lq- co.e. oft IIIfIIGnpll Q Glm Exp. wNl Not wP. wdl Int. wwll Giliny ? 01- )1r. Pioor q ToW ltu. I `f o'Z kcf ? ? z ? HEAT LOSS CALCULATION 5v ° rEMP. DIFF.. wm. _G? vc, d Tro. awnmcuon M ? nY - winaow. St«r, s.h DrMr N?m? ._ Walls . Im. SaNt ----.--- Giliiq Ina. Cifv Floor - and Daort-G&tkap and yo n? MM OI M rae. er L ?? unrI h, OIM{? wI? n. CoM. Btu I nf dtrat ion Gup Eap. wall S, rjX Ne exp. wall q,4 7 Int. wall Giliiy ?9 F loa .? i otai nw. [ ? FI.-? RoomlLwqth Iol- WidM ?lo Ihiyht g Windoxn wd Duors-Gackaw and Arr No ??mM e?NM fto. ry e~ N. • h. i 2v ?- CoN. Btu Inliltration ;;t ? G4a - Exp. wall d Z . Ncl eKP. wall s Int. wall ts+lmy 2. l 93 3 t I«w / 3 I nul etu. ? a(_n I O ?? ? 2,,b?oom ? L?rq1A Q WidM 14 • S FMid?t ? WmAnwi srM Doas-Gacka! oe and Arr N.. W?nrn Hryp? Ne.el n1 ?? l? 1? L?Iry. N MN AI . M. ' Ca'] BtV Inf dtratton G4ss E¦a. w.u S. x 23 Ho1 erp. well Int, wall ce+iiny / x 1 , 3 fla? lpi7 fopl Btu. I q7kl Window Mld AfY Ne. wNM O? M?y?? N Ma. W l Llwl M. Am . ft Cwf. Btu Infihrition GlM Exp. wNl Not exp. well Int. wall CNlinp F laar Toul Btu. fl.l NaamlUn A Width IMi t Windowt and Doon-Gadtaw md Ar? Me. WMm a NNM? Ms. M • ?MW h ?wr Caw. Btu I?ihntbn G Iw Exp. waU NM? ncP. wall IM, wall Gilirg fbw Toul Btu. ? FI.I Looth WNM t Windowt aid Doon-G?dcp? ond Arr Me. M'? w?? 1`N.M LMWh. 4 N CDO. ON Infihratqn Glas ? Exp. wall Not acP. wall Int. wall Gil'ap Floor II Tobl Btu. z/ 3, 91 ( PC'i"2(,/? IDCr 3?S S?o ?v?s? 4?? in?i?` q71 T? ?-?, J ti ??- lass PERMIT City of Eagan Permit Type: Building Eagan. Permit Number: EA095482 Date Issued: 08/18/2010 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 4322 Fox Ridge Rd Lot: 17 Block: 2 Addition: Sun Cliff 5th PID:10-72979-170-02 Use: Description: Sub Type: e-Windows iDoors Construction Type: Work Type: Windows Doors-New ; Replacement Description: House Census Code: 434- Occupancy : Zonin,: Square Feet: 0 Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes. Fee Summary: BL - Base Fee S3K $88.50 0801.4085 Valuation: 3.000.00 Surcharge - Based on Valuation S3K $1.50 9001.2195 Total: $90.00 Contractor: - Applicant - Owner: Crew2 Inc Sharon Shaky a 260 l\Iinnehaha Ave 4322 Fox Ridge Rd Minneapolis NIN 55406 Eagan NIN 55122 (612) 276-1680 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 Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature Use BLUE or BLACK Ink r..- - - - - - - - - - - - - - - - I For Office Use Permit O I City of EaRan I Permit Fee. L~ y ~V I I 3830 Pilot Knob Road Date Receive Eagan MN 55122 b Phone: (651) 675-5675 I - - I- I Staff: Fax: (651) 675-5694 I INFLOW t & I TRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: ~ ~41 Site Address: Y-1DE~ tD CAC14N MN ~Sf2Z Tenant: Suite RESIDENT OWNER Name: 51f (A~--q ' ` Phone: 6,12_ 22G--1`?46 I Address / City / Zip: ~7U) V-t D5?i~- ~9-D 6464-N M ~-f ~ J2L Name: License CONTRACTOR Address: City: State: Zip: Phone: Contact: Email: PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK Sump Pump Repair Repair Other: Other: Description of work: DESCRIPTION FEES $55.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.cityofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org 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 fora per 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 whic s review and approval of plans. X Si~'t~ sK p11 x Applicant's Printed Name Applicant's Sign ture FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground -Rough-In -Final Use BLUE or BLACK Ink r For Office Use City of Ea ~n Permit Permit Fee: 3830 Pilot Knob Road I I Eagan MN 55122 Date Received: f~ Phone: (651) 675-5675 I I Fax: (651) 675-5694 1 Staff: I I I 2013 RESIDENTIAL BUILD,I~NG PERMIT APPLICATION Date: om I Site Address: ~a X f C; e Unit Name: J 0. a ✓t ~~g 1L Yct Phone: 621 a ~ °Z~O ~ aag Resident/ l, ``__11 Owner Address / City / Zip: r, `t x k-A a_00L4 t mm_rtT_ K_ Applicant is: Owner {Contractor Type of Work Description of work: ~ Ke e,,dt~yw S Construction Cost: l a 000 ~ Multi-Family Building: (Yes / No x ) Company: _ p`e s r c~ ~ I l c9u51 v~oG lU Contact:?to ?2 O ~b Contractor Address: ~C eve i°1 City: C~r~ T State: Y` Zip: !g5L4 p)-~ Phone: ~ Art, I I ey C ~-5 License Lead Certificate If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 11 I ~ A~ ~c t- I q -7 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 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: r _ 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. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org 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 plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. r-7 x LWL (f VK P.y1yy4~/`'~ x Applicant's Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Plumbing Permit Number:EA136186 Date Issued:04/28/2016 Permit Category:ePermit Site Address: 4322 Fox Ridge Rd Lot:17 Block: 2 Addition: Sun Cliff 5th PID:10-72979-02-170 Use: Description: Sub Type:Residential Work Type:Replace Description: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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Fee Summary:PL - Permit Fee (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 - Sharon Shakya 4322 Fox Ridge Rd Eagan MN 55122 (612) 226-9778 Champion Plumbing 3670 Dodd Rd., #100 Eagan MN 55123 (651) 365-1340 Applicant/Permitee: Signature Issued By: Signature -X -C 1el NI V ED For Office Use I,2,� ..... Permt:e( LIAR 19 2019NI3 . R E Permt �� Date Received: 3-11( 1 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Staff: t'/ buildinginspections(a�citvofeacian.com L 2018 RESIDENTIAL BUILDING PERMIT APPLICATION-/ a. Date: 34 at//� Site Address: `/3a.A i k lerdye Rd Sr, 6u/A4 ‘:ri aUnit#: Name:Gros ti it vi 5-__A r?ec K Phone: (e0q) 64) -- 3 6/S"l Resident) Owner Address/City/Zip: y.?Q a r—R(1^ Rd S1- /911f/ Nf A/ r51 c a- Applicant is: Owner )(--Contractor Type of Work Description of work:*- e Jc76 dei-et I/ £ ' 7%/t f Cie t1Space, t,/q1/ftp Construction Cost: ,2,3 Sd Multi-Family Building: (Yes /No)s--') Company:A/it'r'Laz, G✓gy`r°r-/,✓pr/C S Contact: J�'o- >.,y//arc Contractor Address: fid' Re7//to fiGw 44 City: to„.:), _r-.14%.,../ State:/144/Zip:6-5—V6. Phone:r0a- 95--=/da EmaiI:juso4s0ariJPriZull-tom+/t`s.-Gvr l i-,t,,o,,i License#:86,391�3q5~ Lead Certificate#: ,i�/9T- /U 70 G 3 oZ If the project is exempt from lead certification, please explain why: /1/4-:-/- /Ai il6 VP COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING 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: Fire Suppression 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. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. Exterior work authorized by a building permit Issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit Issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you Intend to dig to receive locates of underground utilities. www.00pherstateonecall.orq 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 plans. x 3 coo or//a1Pe- x Applicant's Printed Name piicant's Signature / 5779‘ 7 DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation Fireplace Porch(3-Season) Exterior Alteration(Single Family) * Single Family Garage Porch(4-Season) ___ Exterior Alteration(Multi) Multi — Deck Porch(Screen/Gazebo/Pergola) Miscellaneous — 01 of_Plex — ____ _Lower Level Pool Accessory Building WORK TYPES New - Improvement Siding Demolish Building* _____ ____ Addition Move Building Reroof _ ____ _ Demolish Interior Alteration Fire Repair Windows Demolish Foundation Replace /it Repair Egress Window Water Damage Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION ... Valuation 2/1)°6 Occupancy .1.P6-•I MCES System — Plan ReviewCode Edition t9/.i SAC Units — (25% 100% 1 -'-' Zoning PD City Water -- Census Code hf It-i Stories — Booster Pump --- #of Units / Square Feet —. PRV #of Buildings i Length — Fire Suppression Required —• Type of Construction 1Z8 Width REQUIRED INSPECTIONS Footings(New Building) Meter Size: Footings(Deck) Final/C.O. Required _ Footings(Addition) Al- Final I No C.O. Required Foundation Foundation Before Backfill HVAC Service Test Gas Line Air Test Hood ____ Roof: Ice&Water Final Pool: Footings Air/Gas Tests Final _ Framing 30 Minutes 1 Hour At" Drain Tile Fireplace: Rough In Air Test Final Siding: Stucco Lath Stone Lath Brick EFIS insulation Windows _ _ Sheathing Retaining Wall: Footings Backfill Final Sheetrock Radon Control Fire WallsFire Suppression: Rough In Final _ Braced Walls Erosion Control _ Shower Pan Other: 41 Reviewed By: ,./ , Building Inspector , I RESIDENTIAL FE Base Fee , _ Surcharge - Plan Review MCES SAC City SAC Utility Connection Charge _ S&W Permit&Surcharge Treatment Plant Radio Meter Read Copies CQ .25,, TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA155498 Date Issued:05/20/2019 Permit Category:ePermit Site Address: 4322 Fox Ridge Rd Lot:17 Block: 2 Addition: Sun Cliff 5th PID:10-72979-02-170 Use: Description: Sub Type:Residential Work Type:Replace Description: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 - Graham C Schenck 4322 Fox Ridge Rd Eagan MN 55122 (309) 242-3459 Homeworks Services Co Dba Homeworks Plumbing Htg 1230 Eagan Industrial Rd, Suite 117 Eagan MN 55121 (612) 400-9020 Applicant/Permitee: Signature Issued By: Signature