3817 Kingswood TrAddress 3$1 i<1 w
Lot -3 Blk
THESE ITEMS WERE / WERE NOT pA Zip 5512 a
Sub KlrkaLS4.PdA \00hJS -2?^d
OMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: (,Q Zcj 0Z Yes No Inspector:
Final grade (6" from siding) - - r?'
Permanent steps (garage) ?
Permanent steps (main entry) ?`
Permanent driveway ?'
Permanent gas
Sod/5eeded grass
Trail/curb damage
Porch
Basement finisfi f
Deck Fl HiSl
Please verify with the buildet t`he removal of roof test caps from the plumbing system and the shut-off of water supply to
the outside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system.
White - City Copy Yellow - Resident Copy Pink - Contractor Copy ?
IzES1?N IT AL?° I.?, 30f ,15
a4IQtL0ING PERMIT APPLICAi\T?I?N 5a3? ? qp.r? fl
` CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 5 122
651-681-4675 ? p ?jZ 3? 3 ?? •? ?
?
NewConsWcUonRequirements RemodellReoairReauirementa ?/ ??
. 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas • 2 copies of plan +
(20°k mazimum lot coverage allowed) . 1 set of Energy Calculations for heated additions
• 2 copies of plan showing beam & window sizes; poured (ound design, etc.) • 1 site survey for exterior additions R decks
• 1 set of Energy Calculafions K?? I ??? • Indicate if home served by,septlc sy?tem fqt?d? ns?
• 3 capies of Tree Preservatlon Plan if lot platted after 711193 ?? (?j /
• Rim Joist Detail Oplions selec6on sheet (bldgs with 3 or less unils) -
? /,? 1 O ?- -Q-4V-AI:UATION D`? ?? , C) C) C7
DATE ? - • ,
SITE ADDRESS MULTI-FAMILY BLDG _ Y ? N
TYPE Of WORK fIREPIACE(S) _ 0_ 1? 2
APPLICANT
STREET ADDRESS /4-7 9 W? PaQ 9 1) CITY C_ STATE I/FW ZIP
TELEPHONE # ?( -?CELL PHONE # FAX #
'rV 9h < 65-7 Ze&- byq {?10Rk 6 ?1 7
PROPERTY OWNER 57F?Y6?j R- 5C((l_1 GI4rMA1 ? TELEPHONE #
------------------------------------------ -----------------------------------------------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RiJLES 7670 CA'CEGO12Y 1 MINNrSOTA RULI'S 7672
(^I submission t)pe) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
V'? ? one# 6? ,3 -g'7S?
Piumbing Contractor: ?
PlumUing system includes: ? Water SoFtener ? I.awn Sprinkler Fee: $90.00
Water Heatcr Q iVo. oC R.I. Baths
No. of Baths
Mechanicol Contractor: Phone # ?75?0
Mechanical system includes: _ Air Conditioning Fee: $70.00
_Loe'Heat RecoverytSystem eo!
Sewer/Water Contractor: V?^• ? ? Phone # ?? ? ? ?' ???
---------------------------------------------°-----------------°-°-------------°--°--------------------°------------
1 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 OrS?npnces. -, /1 j ,I
Signature of Applicant
orricr vsr, oNt.Y ? JUN 1 ---?
Certifcates of Survey Received ? Tree Preservation Plan Received Not eqw d?
Updated 4/02
OFFICE USE ONLY
.?
? 01 Foundation ? 07
05-plex
? 13 16-plex
? 20 Pool ? _,
30 Accessory Bldg
$ 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
)( 31 New ? 35 int Improvement ? 38 Demolish (Inte(or) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement "Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy "'3 MGES System
Census Code 0/ Zoning /t ^ ? City Water
SAC Units 0! Stories 1 Booster Pump
Nbr. of Units B/ Sq. Ft. _ PRV
Nbr. of Bldgs a t Length v
3 4 Fire Sprinklered
Type of Const ? Width ? 2--
REQUIRED INSPECTIONS
? Footings (new bldg) X FinaUC.O.
_ Footings (deck) _ Final/No C.O.
Footings (addition) _ Plumbing
Foundation HVAC
X Drain Tile j( Other 4/,w4 Fu--rqr-1'w."y j3.va*ngt 4,;6t7/l/2
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ AidGas Tests _ Final
? Framing _ Siding Stucco Stone
Fireplace X R.[. _(Air Test X Final Windows (new/replacement)
X Insulation ? Retaining Wall
Approved By , Building Inspector
____------------------?_?___
Base Fee _________ ..._____-- ----------------- --
Surcharge
Plan Review 135,Ml-
MC/ES SAC
City SAC r
t ?
43 G?
Water Supply 8? Storage ?
S&WPermit& Surcharge S'C/Lluni /zonGN 114Cq4b`9-30? L13??
Treatment Plant
Plumbing Permit ,6c
Mechanical Permit
License Search
Copies
Other
Total
4?.?y1y
?.
51-e VeI SGN?GNTMAti.??
MECcheck Compliance Report
2000 Minnesota Energy Code
MECcheck Software Version 3.2 Release lb
COi1NTY: Dakota
STATE: Minnesota
ZONE: 2
CONSTRUCTION T'YPE: Single Family
DA'I'E: 05/14/02
COMPI,IANCE: Passes
Maximum UA = 404
Your Home = 373
7.70/o Better Than Code
Ceiling 1: Raised or Energy Truss
Eacterior Wall 1: Wood Frame, lb" o.c.
Window: SC 30X60E:
Above Grade, Vinyl Frame, Double Pane with Low-E
Window: S.S. 72X60E:
Above Grade, Vinyl Frame, Double Pane with Low-E
Window: P.W. 72X60:
Above Crrade, Vinyl Frame, Double Pane with Low-E
Window: 16" TRANSOM:
Above Grade, Viny( Frame, Double Pane with Low-E
Wittdow: HYLITE #LOI05:
Above Grade, Viny] Frame, Double Pane with Low-E
Window: HYLITE #L0505:
Above Grade, Vinyl Frame, Double Pane with Low-E
Window: HYLITE #K0601:
Above Grade, Vinyl Frame, Double Pane with Low-E
Door: ISD 6068: Glass
2'-8" STL DOOR: Sofid
Door: 3' STL W/ (2)SL: Solid
Basement Wall i: Wood Frame, 7.6' htJ6.3' bg/7.6' insul
Slab 1: Unheated, 4.0' insul.
Fumace 1: Forced Hot Air, 90 AFUE
Air Conditioner 1: Electric CeMral Air, 10 SEER
Proposed and Mazimum U-Factor Averages
Gross
Area or Cavity
Perimeter R-Value
Permit Number
Checked ByJDate
Glazing
Cont. or poor
R-Value U-Factor UA
1844 38.0 0.0 46
1895 19.0 0.0 82
25 0.290 7
210 0.310 65
60 0.310 19
40 0.310 12
5 0.510 2
31 0.510 16
4 0.510 2
81 0.310 25
18 0.350 6
39 0.350 14
1398 19.0 0.0 62
20 5.0 15
Proposed Maximum
Average U-Factor Allowed U-Factor
Above-Grade Windows and Glass Doors 0326 0.370
Includes Foundation Windows > 5.6 ft2
38/7 /!/?swo o?
/?.'
eW*b( !? ZZ
COMPLIANCE 3TATEMENT: The proposed building design described here is consistent with the building plans,
specifications, and other calculations submitted with the permit application. The proposed building has been designed to
meet the 2000 Minnesota Energy Code requirements in MECcheck Version 3.2 Release lb.
Builder/Designer Q t-tonqk, Or- vpv2 eDwot zaJc. Date S/,1 OZ
? LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUIIDING PERMIT APPLICATION
PROPERTY LEGAL: L,1 3
DATE OF SURVEY:
? LATEST REVISION:
rn
c
m
c
U DOCUMENT STANDARDS
Y a ?
O Z Q
?
M
? ? • Registered Land Surveyor signature and company
? ?
? ? ?
? • BuikJing PertnR Applicant
? • Legal description
? ? • Address
? ? ? • North arrow and scale
?? ? • House type (rambler, walkout, split w/o, split entry, lookout, etc.)
? ? • Directional drainage arrows with slopelgradient °h
d? ? • Proposedlexisting sewer and water services & invert elevation
? ? • Street name
? ?
? ? ? • Driveway
? • Lot Square Footage
? ? • Lot Coverage
[Y ? n • Benchmark
ELEVATIONS
Existinq
? ? ? • Sewer service (or Proposed)
IP?/ ? ? • Property comers
4`Y ?? • Top of curh at the driveway and property line extensions
?? ? • Elevations of any existing adjacent homes
It3? ?? • Adequate footing depth of sVuctures due to adjacent utility trenches
? ? ? • Waterways (pond, stream, etc.)
Pronosed
ral ? ? • Garage floor
FV ? ? . First floor
P/ ? ? • Lowest exposed elevation (walkout/window)
V ?/ ? ? • Property corners
[9? D ? • Front and rear of home at the foundation
/ PONDING AREA ('rfapplicable)
?" n ? • Easement line
? f_i?7?/ ? • NWL
? 4Y ? • HWL
? g? ? • Pond # designation
? I? CI • Emergency Overflow Elevation
/ DIMENSIONS
?Jl' ? ? • Lot IinesfBearings & dimensions
?u ? . Right-of-way and street width (to back of curb)
i i_i ? • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
/ (i.e. all structures requiring pertnanent faotings)
?U'/ C] ? • Show all easements of record and any City utilRies wRhin those easements
17 /I.-1 I.-1 • Setbacks of proposed structure and sideyard setback of adjacent existing structures
i?Y 1-1 t:l • Retaining wall requirements, if any
Reviewed: - oC 'r" -
Name / Date
. . ...? :?
Height -48 inches obove street levei
Have 6ox extend as far in front of support post as
possible. (This prevents possible snow plow damage).
Address must be on side off box from which carrier
opproaches in letters about one inch high. (Or on
front where boxes are grouped).
Box must be located so carrier can serve
without leaving vehicle.
NOTES:
Moiibox should not extend
beyond back of curb.
18" -1
Ali posts to be a minimum of
18" behind back of curb.
)er U.S.
PUBLIC
? WORKS
OEPARTMENT
City of Eagan
MAIL BOX INSTALLATION
REVISED STANDARD
PLATE
11/99 610
;W . . th
Proposed Mailbox Move for Kingwood Trail, Eagan 55122
RECEIVED
06/25/02
JUN 2 6 2002
To whom it may concern:
EAGAN
ENGINEERING DEPARTMENT
We have reviewed the proposed attached change to the mailbox
location for the three houses located on Kingswood Trail and do not
have an objection to the proposed move.
?w 4 wo Y4 r`"R*i L
?
A61
309
2
NAAdustment Pscude Code.doc 06/25/02
oocid -T.eAl ' .
Proposed garage floor eleq.
Praposed top of block elev.
Praposed lawest level elev_
.. Fa`\\
? -!
v
_,$MP??
+.,
=y; ? c? =iri qi
Lot area = 37,459 squarn feet
House & Deck, porch = 2.880 square feet
Sanitary sewer invert = 879 _ 0 per City Plans
?
N89'36'363E 161.12 V
EXISTING HOUSE 9 h ?
Y + 887.8 v
- --- - ------- ---? 887.9
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KINGSWOOI
esa.s A-134.80
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SEG 16 k 21. TWR 27," RNG. 23
DAKO7A COUNTY, MINNESOTA
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DRAINAGE AND U'fILITY E.4SEMENTS
ARE SHOWk AS 7HU5:
STREET
tA00? i 1 ?tOAD
' 5.oD
5.00
10.oo ll. 10.00
__ ?.._J L_?__
? REafc LwE i
gE11lG 5 tEET iN WN1H, UNLE55 OTHERYtlSE
'INOICA7ED AND ADJOINING 9DE lDT LINES,
AND enNC +o cEE7 IN NoT++. uw.ess
eTHcRwse INpicaTED . +wo noaoIwnc smeer
AND fiEAB L? LIES A$ SNOK'N OP! THE PLAT.
1HE EAST LINE OF iHE NOR7FIEAST
OVARTER OF SECTION 27, TWP. 27,
RNC. 25 WES7 IS ASSUUEO TO BEAR
N00429'07"W.
? G ? OfN01E5 'RIGFIT OF ACCE53"
pEOICRiED 7C1 DN(OTP COUNtY
OENOTESf/Z' YONWtT1TSEi,./ND
NAAKED N17M. ALS 17765.
• UE'N07E5 1?2' MONUMENT FOUNO, -
UNLE55 07HERm5E:mtpG7ED. -
No Ma+u.E*ar swaLa aHom+ aN n+a
pLp7-INpICA1E5 uONUYENTS TO BE SET
ACCORDMG SO MINNESOTA STAN7E5. AND
M111CN SMALL PE tN PIACE M7MfN ONE
YEAR OF 7NE RECORDINC, OF iF115 P4a7.
BFN -N? M? _RK' unD07 D1sk Ne• "1982-BC' iocoted
780 feet northerty oi 1ne 5W tomer
of OuUot B, KWCSWOOD POMD$ PoRST ACD.
ELEV - E50.54 (H.G.V,O. 1929 DA7UM)
111mO
' IAlQD 8?71
Jun e1 UL UG. 9.Up... . . ..... tHbrii1 ru ?.,-.,,-.... .. . ........... . ...._!-..-
1 . ., _
_.,.., .. _ __.. . ....... ..,, , , _ ....... .. ............ .
a
FACSIMIIE CiOVER LEf7ER
PLEASE 17ELIVER THE FOLLOWING PAGES
TO: J7E'"?:. SG VI ? i C I?+ ,4v.,u ^)
FAx: (P?J? ?? L-l Lo `t
DATE: (D -?( -?? • -
NUMBER OF PAGES (INCLUDING COVER): ?
COMMENTS:
??? ?0,?
FROM: C+IS
FAX: Ca S!_ ?t S`Z( • xs!` ?
a
Fuc:
L38)
WAIVER OF HEARING #557
Special Assessment Authorization
UWe hereby request and authorize the City of Eagan, Minnesota (Dakota County) to
assess the following described properly owned by me/us: Lots 1 through 3, Block :L; Lot 13,
Block 2; and Lots 1 through 11, Block 3, Kingswood Ponds Second Addition, (236.48/Lot =
$6385.00 = 27) for the benefit received from the following improvements:
ITEM QUANTITY
Water Trunk 5 lots
Lateral Benefit
Sanitary Sewer 100 f.f.
RATE AMOUNT
$865.00/Lot $4,325.00
$20.60/f.f. $2,060.00
TOTAL
$6,385.00
to be spread over five (5) years at an annual interest rate of 7% against any remaining unpaid
ba}ances.
The undersigned, for themselves, their heirs, executors, administrators, successors and
assigns, hereby consent to the levy of these assessments, and fiuther, hereby waive notice of
any and all hearings necessary, and waive objecrions to any technical defects in any
proceedings related to these assessments, and fiuther waive the right to object to or appeal
from these assessments made pursuant to this agreement.
DATED: OWNER:
HORNE DEVELOPMENT
CORPORATION, a Minnesota
corporahon B . James B. Home
Its: President
WAIVER OF HEARING 9557
Special Assessment Authorization
UWe hereby request and authorize the City of Eagan, Minnesota (Dakota Counry) to
assess the following described property owned by me/us: Lots 1 through 3, Block 1; Lot 13,
Block 2; and Lots 1 through 11, Block 3, Kingswood Ponds Second Addition, (236.48/Lot =
$6385.00 = 27) for the benefit received from the following improvements: I
ITEM QUANTITY
Water Trunk S lots
Lateral Benefit
Sanitary Sewer 100 f.f.
RATE AMOUNT
$865.00/Lot $4,325.00
$20.60/f.f. $2,060.00
TOTAL
$6,385.00
to be spread over five (5) years at an annual interest rate of 7% against any remaining unpaid
balances.
The undersigned, for themselves, theu heus, executors, administrators, successors and
assigns, hereby consent to the levy of these assessments, and further, hereby waive notice of
any and all hearings necessary, and waive objections to any technical defects in any
proceedings related to these assessments, and further waive the right to object to or appeal
fi•om these assessments made pursuant to this agreement.
DATED:
OWNER:
HORNE DEVELOPMENT
CORPORATION, a Minnesota
corporation
B : James B. Home
Its: President
? -?
STATE OF MINNESOTA )
) ss.
COUNTY OF DAKOTA )
On this ,/ 6 day of z"'- , 1997, before me a Notary Public
within and for said County, personally appeared JAMES B. HORNE to me personally
known, who being by me duly sworn, did say that he is the President of Horne Development
Corporation, the corporation named in the foregoing insirument, and that said instrument was
signed on behalf of said corporation by authority of its Board of Directors and said President
aclmowledged said inshument to be the free act and deed of the corporation.
?
Notary Public
APPROVED AS TO FORM:
??`-'_'---
?
City Attomey's, Office
Dated: i?_
APPROVED AS TO CONTENT:
-?? ; -
. .i
Pulilic Works Department
Dated:
THIS INSTRUMENT WAS DRAFTED BY:
SEVERSON, SHELDON, DOUGHERTY &
MOLENDA, P.A.
7300 West 147th Street, Suite 600
Apple Valley MN 55124
(612) 432-3136
MGD/wkt (206-15236)
,
EXHIBIT "D"
KINGSWOOD PONDS SECOND ,ADDITION
,
NORTN
,
??? w,oor oaw H. •ioe? ec• ro??.e . ?
t7o w.? .ouu.Nr e/ In. Hw cwnr s ?ry• ?anw[Mr f[t, wo
0 auei A. xNcs xooo rro ?,oanora FINANUAL OBLIGATION ? wM ??s 1nsi
' DRl1NAGC AND U7L7V CASEMENI$ QLV . p0.!{ (N.GY.0. I920 OA7UY) LEGEND 1 1/1' YaWU[M lqMp,
on+usxwwc?rza
AM SHOMN AS IHUS: /11[ EAST lkK OF ME NpRM[A51 A?
STIICET !5'<5 I W.RIER oF ttc,HN, 21. 7„P. :7, mmimnuu Laleral Benefft Sanllary Sewer ewcNr sn+e.a vnr. a mc
? :•• rurzs i?F.?
•f,? :,L' A1G. IJ Y1ESi IS ASSIIY[D 10 BCIR umuurHrs ro et scr
i
7 I I Z :: ^+ Maa7s'otY. aWv(:vADa w?,varoxm n?.uc wrrNlHrcw?'t?
Inoo Water Trunk +c?u i. inc ircconarw a mrs ouc
s.m / i o
iaoa? iam ? ??q,? t ,f(t ..?? ........:.... ...? ..., d /, i
_>JL I Jr r
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eEn?a e rtcr w .wm, l.ncu onaR..sc ? ? : -' __ sos'4 " ' ,•' I
MdCAI[D ND ADAMMG SO( LOT IA[;
INC KNO 10 RC1 N XDM. IMLCSS Re] ? ]1.10
ORl[NNY MdEF1EO. MO M.1()riM. SIRLCI rI? ¦ • f?!^ ?MM '? 110? • ? ? f %
Mq IKM lOf U[S /S SxUM M M RAl. M : 'T ; ? 'n,••?n ? n??? °" ? ??„=ust. _ soe-rr'art rH33
- -?C \ •? ':•
?i?`.?. ___ $p/'OI7/1.00 - I
iei.7
;. 3. ?
h ` 0.32
? • h??j tr`S =? ?a 92.3 ? ?{c 8 1 '?6ii ?• ? ' ?'' ? 11?.9J {?]I W1 e .r v.i ?n n-? •-"? ,? (+r?m? ?wt a rr?w ?11- ?. I
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soava•arr Zr
?:bf /
-- i ' f•?y ?a?8. ?, ?? ? d"i e?" : ?I ? ? ?`'?- e ?'
?Y 4 k ?6?$??•?s???-??-?aosniM_J ?Gs ?n ?_ L '•i R ',n?..?„?t ( _r A
[ .. 10 ? '..
. m. , r---?aTr--
tl I ??$?.• ? I ?. / .'. ? ydl ?7f Y-"wa- `^?' !" J;14-""" }1 ?
^
r---;,a?----.-'?-:?--' , 3 ?'Za '4r •. j 9
s _:i
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3 1 1 ?'4 • L____'J ..'_ f ?1
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Property Address: .3817 Kingswood Trail
e = Frnmd imm pipe monwmnt Proposed 9araqe floor elev.
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g?nZ =Ec9.stuxl sPot elevation Proposed laaest level elev, gQh
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F.dsting tree Aouse s Deck, Porch = 2,880 squate feet
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This "Certificate of House Location" is issued for the sole ee2.7 a p? .21 ? 0 9 J` ??
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Use BLUE or BLACK Ink
r -�
For Office UseI ' q7- (�(� Permit#: I �
City of Eaaari Permit Fee: l ��
�� -a
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651)675-5675
Fax: (651)675-5694 Staff:
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: .lZ/ /.//.7 Site Address: ? 9/) �Zi Z fere 7 // Unit#:
Name: �G/ v1GG�l/ �< G��- Phone: 6-57-d23 -S 76eF
Resident/
Owner Address/City/Zip: ,3,,/1 fci�707s i /va c 7d7 /
I Applicant is: Owner k2 Contractor
Type of Work i Description of work:
1 Construction Cost: Multi-Family Building: (Yes /No )
Company: te. /C- e777e 0' 0 / ontact: /2 ',--,, 41i/ '1.2./?"`""
�giJ i
i Address: "f 6-')-70O -_,. City: CI/9ej
Contractor "a'<r
State:/11/1/Zip: _S—J7'a Phone: 4Si7)a3-1-705 Email: i k. 47,Z - /d? . . •
I License#: igCl Y/'®?/ Lead Certificate#: r�k' i
If the project is exempt from lead certification, please explain why:
&O1
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?
I
Yes No If yes, date and address of master plan:
. Licensed Plumber: Phone:
t
Mechanical Contractor: Phone:
F
I
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 the 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.Qopherstateonecall.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.
Exterior work authorized by a building permit issued in accordance with the Minnesota - : ilding Code must be completed within 180
days of permit issuance.
Of
x
I l2 0..-&Z icant's Printed Name ••A s Signature
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