4254 Malmo Lane NCITY OF EAGAN Remarks
AdditWILDERNESS RUN 6TH ADDITION Lot 6 RIk 4 Parcel 10 84355 060 04
Owner??•1,j..1 a+lU ji, I V Street 4254 No h almo T.ane State Eagan'Minnesota 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 197 161.21 8.04 ZO
SEWER LATERAL
WATERMAIN
WATER LATERAL
WATER AREA 3 2,1 15
STORM SEW TFK 1978 293.94 _19 ..5 5 254.76 A00 488 3 8 7
STORM SEW LAT
CURB 8i GUTTEfi
SIOEWALK
STREET LIGHT
WATER CONN. 250.00 127$7 12-18-78
BUILDING PER. SOH
sAC 500.00 12757 12-18-78
PARK , dtl? *977
-
77
CASH RECEIPT
? CITY OF EAGAN
3795 PILOT KNOB ROAD
?
EAGAN, MINNESOTA 55122
DATE 19
RECEI V ED
FROM
AMOUNT $ I
? CASH ? CHECK
FOR
•,/_?? J f ? .. ! i? . . i, . .. . _ .?. .
/
RUND CODE AMOUNT
Tb?a You
sv
?
White-Payers Copy ?
Yeliow-Posting Copy
ink-File Copy
?exfiftratr uf Orruvanry
Citp of (Eagan
Brpttx#mrn# of Builditcg 3riaprrttnn
Tbis Ctrti ficate i.r.rued pur.ruant to the requisements o f Section 306 o f the Uni f mm Building
Code arti f ping that at the time o f issttanct this ttructure wal in com pliance with the variou.r
ordinunces o f the City regulating building rnnssruction os use. For the f ollouring:
U? Clwdhmtm SF Dwlg & Garage Nag. eerr,;tNo. 5084
O-pancy Type 1 Type Conauucticm Fire Zaoe Zoning Disvict 1
Ow„??&Adin8 Tilsen Hcnnes Add.. St. Paul, M 55116
?
Dat6: February 23, 1979
PO/1 IM A CANLPICIJOY9 ?LACE
Lot
Po?cel #
. 'I : '.: : . A .__: L' /1 :
aWe Nome
Z AddfCSS ? ' `?'r tot'.C'
°c Name
?
o? Address ??. `7:?l'Ilrttr
u? ? ..
Nome
I hereby acknowledge that I hove reod this opplication and stote thot
the informotion is correct ond ngree to comply with oll opplicable
Stote of Minnesota Statutes ond City of Eogan Ordinances.
Permit
Surcharge '
Plon check--7r-,?.?
SAC '
Water Conn.
Water Meter ?
Total ?
Signature of Permittee
' I
`•., ,°,C'S' T??
/1 Building Permit is issued to: on the express condition that
all work shall be done in accordonce with ell cppliaoble Stcte of Minnesctu $totutes and Ciry of Eogan Ordinances.
Buflding Officiol' ? - -
? Alter ? Zoning
Repoir ? Fire Zone
Enlorge ? Type of Const.
Move ? # Stories
Demolish ? Front k.
Grode ? Depth ft.
Aoo:o rab Fees
Assessment _
Water & Sew.
Pol ice
Fire
En9•
Plonner
Council
Bidg. Off. _
APC
. . ? CITI( OF EAGAN
- 3795 Pilat Knob Reod Eagam, MN S5122 N2 5984
'HONEs 434-8100
BUILDING' PERMIT ReceiPt .#
,y• •?,l,.- I??,..-,..... e1- nnn
Permit No. Permit Holder Misc. Psrmit No. Holdsr
Plumbinp
H.V.A.C.
V
w.n
Water
Disp.
Swiwr
EMctric
Irupsction Date insp. Other
Footinys
Foundation
Framinp
Rou? Plbq.
Rouph HVAC
Inwlation
Final Plbp.
Final HVAC
Final '
`
Wour Deatxibs Location:
VUell
Sewer
Pr, Disp. .
G. f OF EAGAN
3795 Pilot Knob Rood
Eagan, MN 55122
Zoning: --
Owner. ^i 1 4y,??, C11t'SstTiu
Address:
Site Address:
Plumber:
1 agree to eomply with the City of Eagan
Ordinonces.
OL
By
Date of Insp.:
Insp.:
SEWER SERVICE PERMIT
PERMIT NO.:
DATE: No. of Units:
Connection Charge: 4 -
Account Deposit:
Permit Fee: ' 1 nr' •' '
$urcharge: Misc_ Charges:
Totol:
Dote Paid:
AN WATER SERVICE PERMIT
CITr OF EAG
3e 95 Pilot Knob Road PERMIT NO.:
Eague, MN 55122 DATE:
No. of Units:
Zoning:
--- ,
ner:
ress:
Address:
=te
mber: ?n?ction Char9e:
eter No.:
Account Deposit:
e: Permit Fee:
[
ader No.:
gree to eomplr wiN? t4?e CitY ? Eagan Surcharge:
Misc. Chor9es:
dlnancea.
Totol :
Date Poid:
y
ate of Insp.: Insp.:
• . cirir oF EAGAN
'. 3795 Pilot Keob Road
Eagan, Minneaota 55122
P6one: 454-8100 PERMIT
Date: 1-4-79
Site Address: 4254 Nb. MR]mD
Lot Block ? 5ub/5ec.'-113exTIMS RUn fth
Name riism BQ1?s _
'?7 S^. ].,?
°e Address ?"1
a
.,t. TaR21 55I25
City _ Phone:
Nome ": alph's Pluvbi,M
.
? Address 990!) .eswiC}C !?vc. ?'S0.
e
0
`?-1"
V City . ?'„?.` Phone: 47
This Permit is issued on the express condition that all work shall be
Minnesota Stotutes ond City of Eagon Ordinonces.
Receipt No.:
Single
Residential
No. 1293
I ..
New/Alter./Repair
Cost o# Installation
Permit Fee
Surchorge
?? . :,; ,
Tota I
done in accordance with oll opplicable State of
Building Official
CITY OF EAGAN
3795 Pilot Knob Rood
Ea9an, MinnesoM 55122
P6one: 454-8100
177'Mr- PERMIT
Dote: '- 14 -"6
Site Address: '') 5? *1?'' ?'?
Lot Block fSub/Sec.Ttil`'erTMS ?? Q:h
I Name ?. st'r ? 17"r-s
?
°c
3
O
?
ccrApm^ItALst PTtrIm
No. 1" r,
Receipt No.: 13415
Single I Y
Residential
Multi Res., Comm./Ind. I
New/Alter./Repair
Cost of Installotion
Permit Fee
Surcharge
20.00
.50 Address
e
0
V . . , .. . .?, -..
City Phone: Totol
This Permit is issued on the express condition that nll work shall be done in accordonce with oll applicoble $tote of
Minnesota Statutes ond City of Eogon Ordinances.
Address ?77 SO' STle1liT?!
^t, ral,ll, rr','tiF r^S,.-r?..
City Phone: ?
Nome n TlTvler & SQt]
Buiiding Official
CITY OF EAGAN N• ? 8483
, 3795 PIIM Knob Reed Eogon, MN 55122
" PHONE: 431-8100
BUILDING PERMIT ReceiPr
T. b. u.ea fe. STORAGE SHE? FN v„i,,, $800.00 n,,., September 20 ?0 83
Site Address 4254 N. Malmo Lane Ere
t
}?
C
c
O M
c . uponty
c
Lot 6 BI«k4_ Sec/Sub. Wilderness Run 6thAirer ? Zoninq R-1
parcel # 10-84355-060-04 Repoir ? Plre Zwe NA
l
E T
f C V
n
orya ? ype o
ons7.
rc Name Lynn C. Hanson Mave
?
# srories
z Address 4254 N. Malmo Lane Demolish ? Length lZ
c; Eagan 55123 pf1e 452-2631 Grade ? Depth 16 Sq. Ft.-
o Nom Ownex Aooro•ol. Fee.
?U Address
1- r:...
Name
Addrass
Assessment _
Woter 8 Sew.
Palice -
Ffre
Eng.
Plonner _
Countll _
Permit t`+•
SurcMrge
Plan check _
SAC
Water Conn. _
Woter Meter -
Rood Unit _
I here6y acknowledge thof 1 hove read fhis appiicatian and state that Bldg. Off.
fhe inlormation is cotrect and ogree to wmply with oll opplicoble 15.00
Stofe of Minnesota Statutes ond 'ty of Eagan Ordi ances. APC Total
$ignoture of Pertnittee ?
A Building Permit Is issued to: Lynn C. Hanson on the express corditlon Ihnt
oll work shall be done in occordonce with all a0vliwble St of Minnewto SJqtutes and City of Eagan Ordinances.
Building Official
CITY OF EAGAN
V
Include 2 sets of plans,
1 site plan w/elevations &
BUILDING PII2MIT APPLICATION 1 set of_ energy cal.culations.
To He Used For S7o,G44E *Ea-Valuation ?io Date q20/3
Site Pddress: 5(Z!N1 N. rs1'fL.rWo L.v OFFICE USE ONLY
Lot G Sloclc tl Sec. /Sub. WAO' Erect ? Occupancy j• ?
Parcel #: lU -$'q-3S S-O 6O - O Alter Zoning
Repair Fire Zone
Osmer: z?NN C A/IYA?S a.W Enlarge _ 7ype of Const. ?
Nbve # Stories
Pddress: y2 s'S/ i!/, I?sA?NS e tiv Demlish Fmnt ft.
City/Zip Cocle: EWG,A.? rsi> 3 Grade Depth ? ft.
Phone #: SfjrSL - 2 f r/ APPROVALS FEES
Contractor: Qcw3 V? 0- (-
Address:
City/Zip Code:
Phone #-
Arch./Fng.:
Pddress:
City/Zip Code:
Phone #:
? Am
Assessments Permit
Water/SEwer Surcharge
Police Plan Check
Fire SAC
Eng. Water Conn.
Planner Water Meter
Council Road Unit
Bldg. Off.
APC
TOTAL /S
cinr oF eac,AN
` 9795 Pilot Knob Raod Eagan, MN 53122 N? 5 ?$ 4
? PXONB: 4548700
BUILDING PERMIT APPLICATION Receipt #
To ba uaed for SG Ualg & Gasage Et, Value 45.000. pate 12-18 1 978
I
Site Address 4254 No. Mairno Ere<t Occupancy ----- 1--
Lot 6 Block 4 sec/sub. Wilderness Run 6th Aire. ? Zonin9
Parcel # Rapair ? Fire Zone
Enlarge ? Type of Const.
z Nnme LYM' HanSOn Move ? # Stories xx
Z
Address 4392 SandStone Demolish ? Front xA2x 7 n•
; 4? ft.
? Ci Faqexi phme 452-2631 Grode ? Depth -
• 1 ApProvah Fees
0
a' Nnme Tl S2ri aICl25
SI1211]Sl
62?] $O Assessment_
U
o .
Address
St. Paul 5 116 698-5501 Water & Sew.
Ci Phone
li
P
o
ce -
?w Nume Fire
?
x5
Address
Eng.
<'Z" Ci Phone Planner -
Council -
I hereby ucknowledge thot I have read this applicotion and stote that gldg_ p{f. _
the informoTion Is correct ond agree to comply with oll applicable APC
State of Minnesota Statutes end City of Eogan Ordirances. -
Signature of Permittee
A Building Permit is issued to: T1].9PS1 HciTI25
oll work shali be done in acwrdance Jw fh uil opp iw le mt oflJiir
Building OFficicl _1 f? j-- a t
Permit
Plan check
SAC 500.00
Water Conn.250.00
Woter Meter 60.00
Toral 960.50
_ on the express condition that
and City of Eagon Ordinances.
7///5/ 104oJ_0
? 10552,
Request Date Frte No Roughm Inspedion
Reqmred?
eatly Now G Will Noldy Inspector
Ve5 ae. When Ready7
I icensed contractor O owner here6y request mspection of above electrical work at.
Job Atldrass ISlreat Box or Pouta No )
j
Iii'
?j / Ciry
/
'i
I?
.6 O
O !/ !
G ,r( ,?J
?
0
SecOOn No TowreM1ip Name or No Fanqe N. Counry
? 0?1L
DccupantIPPIN )
,.? /? PM1Ona No
Pawe? Supphe?
A6tl?ess
Elecincal Conh tm (GOmp y Name]
` Conirector's/?oense No
? ? //4?'s! ?
? NA ?S .'J
v' T X fDd
MaiLng 4oar s I{Contrac?oror0 er Making Inslallation,
___L!' ???
Author¢ g??n ??JJggII Gonirecm?rOwnee Mak?ng Insteilalion) Phone Number ^
???
-
i??
i??//' ? ? ifP
7
MINNESOTA.6TATE BOAFO OF ELECTRICITY THIS MSPEGTION REQUEST WILL NW
Gnggs-Midway Bldg - Roam 5-173? 6E ACCEPTED BV TNE STATE BOARD
1841 Umversrty Ave, 51 Paul MN 55104 UNLESS PROPERiNSPEQION FEE IS
Phone(612) 602-0800 ENCLOSED
REQUEST FOR ELECTRICAL INSPECTION
No See mstmc0ons for compleung cM1is lurrn on bac<ol yellow copy
Q "X" Below Work Covered by This Request
E8-0000f-08 I
x? aq ??
? d"`r
ew `Add K TypeofBuildmg ApphancesWued EquipmentWired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Bwlding Dryer Other (Specity)
? COmm/Industrial Fumace
Farm Air CDntldioner
Offier(54ecAy) Gomractor's Remarks
Compute Inspection Fee 8elow
N Other Fee # ServiceEntrence SZe Fee # Qrcwts/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above IDO _ Amps
Si Jn5 Inspectors llse Only ?.
O , O7AL ?
>?
Irriganon eooms V y
-?'
Speaal Inspechon
AlarmlCommunicauon THIS INSTALLATION MAY BE ORDE ONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Elscirical Inspector, hereby Ro°l oaie
certify that the above inspection has
been made o ,?
OFFICE USE ONLY
This request voitl 18 momhs Irom
RECORD OF COMPLAINT 4? e,9
Date _ 7-- 7q-0(D
Complaint taken by 1r(12
Type of biu7ding ?SF µc i+') e-
Name
Addres:
I.egal descnpnon ?• % I ? 4 10?10e,? a r u Y
Phone number S I ' ? A /-/6 ? zp
Complaint
Action taken rf ? / L?
Commenu ! A Ll?w.?"Y??G?i d)--)
5ignature
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Canslruction Reauiremenp
. 7registered site surveys showirg sq. It. of Iol, sq R of house, an0 all roofed areas
(20°io maximum lot coverage afbwed)
• 2 copies ol plan showing heam & wmdow s¢es; pouretl found design, etc J
. 1 s-et of Energy Calculanons
. 3 copies of Tree Preservalion Plan if lot platted after 711193
. Rim JouSt Defail Op6ons selecnon sheet (hidgs with 3 or less unAs)
DATE 7 Ll I &.2\
SITE ADDRESS
TYPE OF WORI
WLTI-FAMILY BLDG _Y e
VN
FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT nVIOC4 YYIY/lf C(.? (,A •
STREET ADDRESS qSbfp li 54- CITY ?1 ?U STATE /'/??GZIPs,p,i
iELEPHONE #a- d-? CELL PHONE,# c7W=M-&9'() FAX #9(??- `Sd"e ? 0 S?I?
PROPERTYOWNER Z`[/L(GL V a/11664 L,/&2 L TELEPHONE# I/1?I`(?V-16`73
COMPLETE THIS SECTION POR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MI\"NrSOTA RULES 7670 C.CCI:GORY ( YIIN\ ?
(J submission type) • Residential Ventilation Category 1 Worksheet Submitted • New h
• Energy Emelope Calculations Submitted
fjut i 2 2002
Plumbing Contractor: __
Plumbing system includes:
Mechanical Conhactor:
Mcctiuiical systcm includcs:
Sewer/Water Contraetor:
Phone #
Phone #
Pec: 870.00
----°--------------------°---------------°-----°----------...__...-----°---------------------.._..__..._._._.._..----
I hereby acknowledge that I have read this application, siate that the information is correct, and agree to comply
with all appiicable Stote of Minnesota Statutes and City of Eagan Ord?anc?
Signature of Applicant
OFFICE USE ONLY
4Vater So&ener _
Water H: ater
No. of Baths
_ Plione #
Lawn Sprinkler
No. of R.I. Baths
Air Condilioning
-- Heal Recovery Sys[cm
Ize .zS
RamodellReuair Reauirements
• 2 copies of plan
• i set of Energy CakulaM1ons for heated adtlitions
• 1 site suney for exterior additions & decks
. IrMicate if home served 6y seplic system for addihons
VALUATION &. 1900
Certificates of Survey Received - Tree Preservahon Plan Receroed _ Not Required _
Updated 4102
We
nn,xE g a,?'3-90
6UILDING PERMIT APPLICATION
Include 2 sets of plans, 1 site plan w/elevations and 1 set of energy calculations.
To be usea for i7w a;ar jvtpd_I//L
Site FlddresE; ?
Valuation -V,!7 e200 ?
`-
qz'f-j 410 4'Almo - .
o ? Block See. Sub. Parcel Nwnber
oi,mer Clfi
address? ? Ll/Yi- .C.cX?.(?C3"72kJ
Address
Arch./Eng.
Address
Telephone :Vs" -07 (o ,3 /
Telephone /
Telephone
OFFSCE USE
ErE;pt V
Alter
Repair
Enlazge
Move
nemolish
Grade
OFFICE USE
Date of ,A oroval s initial
r
Assessment
Flater/Sewer
Police
FiY2
Eng.
PlanneY
council °
Bldg. Off.
e
A.P.C.
Occupancy .L-
Zoning 1
Fire Zone
Type of Const.
fl of Stories
Front ?-7
Depth Qzz??
FEES
~- D D
Permit
Surcharqe -?--- -- ?+?-_
Pian Check
SAC ? o
G7ater Conn.
[7ater Meter ^ 1 ? _
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2000 STORM DAMAGE PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675
? aooD. o o -
Reauirements
M1 d??r
? 2 copfes ot plan
DATE: A-'?,u?u? a 3 Oa 4441CONSTRUCTION COST: ?
?
DESCRIPTION OF WORK: ? ec?J o u--t b1?JvocY- ` InSukaA iovi If multi-tamlty bldg., how mdny unifs7
IPIDICATE THE FOLLOWIPlG EAUIPAAEfVT TO BE REPLACED AMD BY WHOFA:
_ Plumbing _ Homeowner Qr Contractor Name
_ Mechanical _ Homeowner Qr Contractor Name
"NOte; If somebody omer man me homeowner is pertorming plumbing or mechanical work ihey must apply for appropriate
permit. Only licensed plumbing coniractor or homeowner may complete plumbing work.
STREET ADDRESS: y aS`i \Mc?l. tn L-u?.? P-? ?? , Vv\ N 55
LOT: ? BLOCK: 4___ SUBD./P.I.D.#: ?AltlQ,erneSS Y.UVI ?ilq
Name: ? 0.?,j 10? Jo?I -? Z? ??e? ? Phone #: ? l9 5? ?c Cd l 1(, 4 3
PROPERTY Last First
OWNER
Sheet Address: tia`5N \Mc \v Io I-V. d1?
?
City State: w\ Zip: S S 1 9
Company: Phone #:
(area code)
CONiRACTOR
Sheet Address: Llcense # Exp.
City
State:
Zip:
I hereby acknowledge thaf I have read fhis opplication, sfafe thaf the informaiion is correct, and agree to comply with all applicableState
of Minnesota Sfaiutes and Cify of Eagan Ordinances.
Signature of Applicant:
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4254 Malmo Lane N
Lot: 6 Block: 4 Addition: Wildemess Run 6th
PID:10- 84355- 060 -04
Use:
Description:
Sub Type:
Work Type:
Description:
Census Code:
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Gladstone's Window & Door Store
2475 Maplewood Drive
Suite 110
Maplewood MN 55109 -0000
(651) 774 -8455
e- Windows/Doors
Windows/Doors-New/Replacement
House
434-
Applicant/Pemiitee: Signature
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Construction Type:
Occupancy:
A framing inspection is required when installing a Bay or Bow window or if the opening is altered. Smoke detectors are
required in all sleeping rooms prior to final
inspection. When wall studs or ceiling joists are exposed, hard -wired detectors are required. Battery operated types are
acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector.
Total: $90.00
- Applicant -
Owner:
Zella J Vandervort
4254 Malmo Lane N
Eagan MN 55123
Permit Type:
Permit Number:
Date Issued:
Permit Category:
$88.50 0801.4085
$1.50 9001.2195
Issued By: Signature
Building
EA082444
04/03/2008
ePermit
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.
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City of Eakall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Date:
Use BLUE or BLACK Ink
For Office Use
Permit #: / 9.:0
Permit Fee: /0 r ` 5 -
Date
Date Received:
Staff:
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
rk
Name:
Site Address:
„,c, ( v > ,y--
Address / City / Zip: (442S-1 �� �t Lt i, ),) A
Phone:
Unit #:
Applicant is: Owner x Contractor
Description of work:
Construction Cost: J 7e)0' - CO
Multi -Family Building: (Yes / No ? )
Company: t ,Yl.,,wCc :�� rrcJ>,/ �n . Contact:
Address: ®".�� ccs �, fix. City: I"�GnWtz. fi: >
State: ill AZip: Phone:1 $l -3 /�j 7C Email:
License #: 1/(0 c 1 RV Lead Certificate #:�—
If the project is exempt from lead certification, please explain why:
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:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
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.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. CaII 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
1 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.
Applicant's Printed Name
Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA160525
Date Issued:03/16/2020
Permit Category:ePermit
Site Address: 4254 Malmo Lane N
Lot:006 Block: 004 Addition: Wilderness Run 6th
PID:10-84355-04-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard 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.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
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 -
Zella J Vandervort
4254 Malmo Lane N
Eagan MN 55123
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
flECEIVE
MAY 2 0 2020
BY:
Smoke and CO detectors affidavit for Building permit final
j l{7'Tiave tested all the required smoke detectors and Carbon Monoxide detectors.
i Y
yM4�rNe At S A � � C
-E" :) �p I .on this date x41 i i They arc correctly located as per the
/1/ manufacturer's installation instructions and operating.
There are working smoke detectors in every sleeping room,in every hallway leading to a sleeping room and on every
level of the house_
There are working Carbon Monoxide detectors outside of every sleeping room,within 10'
Permit _E „ 1.Q' as
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