1607 Johnny Cake Ridge LaSiIRNSrVILLE
Heating & Air Conditioning, L.L.C.
12481 Rhode /sland Ave S, 5avnge, MN i5.378 • 952•890-0005
Orstet Test Report for Job#
.riYiA/Jti1? l
,-7?
City ?'?`i
Date of Install
Type of HT. F/A ? HW Space HT Unit HT
Otlter
Make 1. t ?»c,y
Model
Serial ?a°?=5=}+?U7
input ??,, c;??o ?7c< N
Pilot Type HOT SURFACE /GNITOR
. Pressure ? :5 }+0' C02 C. I
_ Input CFH 02
Stack Temp =-3-I CO 10
Date Tested ?? tn - V 2
Company_
Technician
BURNSVILLE HEATING & A/R CONDITIONlIVG
Address '(0o-7 J-i9?)Ylnu CAe. RlJrn I /jY1e--- Zip 5512Z?_
L.ot D I_ Blk _I Sub 00?c2 (o+I''
TFIESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: /Q')? / C), Qa Yes No Inspector:
Final grade (6" from siding) .?
Permanent steps (garage) .`/
Permanent steps (main entry) ? ?
Permanent driveway ?
Permanent gas ?
Sod/Seeded grass ?
TraiUcurb damage
Porch
Basement $nish
Deck ?
Please verify with the builder the removal of roof test caps from the plumbing system and the shutoff of water suppty [o
the outside lawn feucet before freeze potential exists.
Conqct engineering divisioa at 6814645 before working in rightof-way or instalGng underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contractor Copy
PERMIT # S?? 3 I RECEIPT DATE:
1
8008 RESIDENTIAL PLUM$INfi PEiiMIT APPLICATION
crrY oF EAsm
3830 f'ILOT KAOB RD
EA6AN, MN 551EE
651-6$1-4675
Please complete for:
SITE ADDRESS:
OWNER NAME: :
INSTALLER NAME:
STREET ADDRESS:
CITY:
single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
7 Q3lcnn
TELEPHONE #:
(A EA CO?E)
TELEPHONE #:
(AREA CODE)
STATE: I?Iv( ZIP: ,SS
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100
00
includes $40.00 County fee .
Note: Additional consulTant fees may apply
• MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding fiMures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water tumaround - existing dwelling unit (+ 5/8" meter if needed -$118)
Other:
_ RPZ: new installation/repair/rebuild $ 30.00
_ lawn irrigation system
ReplacemenUadditionaL• (/water softener water heater $ 15.00
State Surcharge $ 50
Total ; $
I hereby acknowledge that I have read this application, state thal the informatlon is correct, and agree to complywith all applicable City of Eagan ordinances. It
is the applicanPs responsi6ility to notify the property owner that the City of Eagan assumes no liability for any damages caused by Ihe City during its normal
operational and maintenance activities to the facilities constructed under this P 1 l ermit within C' ro
. /ri t a se e
?. .PArh' .? ?:Y? Y?F 7tSIGNATURE OF PERMITTEE 1/02
?
Site address, Lot ? Block¢? Subd.??`? vo Isg
On Aprii 15, 2000 the Minnesota Energy Code, Category i Building Requirements for insulation protection, air
tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be
submitted prior to issuance of a Certificate of Occupancy.
This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670
/ OR
This structure: will e constructed to meet more reshictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTINGTYPE
WaterHeater M ?a SI
Furnace ?..a Ca
Dryer
EXHAUST SY5TEM
LOCATION
TYPE
MODEL
CFM's VENTED
Yes r+o
Kitchen kitchen
Bathroom 1
G`h
GNK OM.? F?- S Vo
Bathroom 2 _a siP p 'So ?
Bathroom 3
Bathroom 4
Other
FIREPLACE S
LOCATION
GAS
WOOD
MANUFACTURER
MODEL
BTU'S VENTING
DIRECT AiMOs
( c,I {U 6-/0 f, 7 ?oa
MAKE-UP AIR MODEL TYPE CFM's
that the above informa6on is correct and agree to comply with ine Minnesoza cneryy ?wd aiiu vity ul wayul,
Date
This form is the responsibility of the General Contractor,
La 1- a ? 3l o J_- ! _?f-?'?A? (?
RESIDENTIAK
BUILDING PERMIT APPLICATION
CITY OF EAGAN 1rii1 `P
3830 PILOT KNOB RD, EAGAN MN 55122
651•681-4675
P P
New Canstruction Reauirements RemodeVReoair Reauirements
• 7:egisrerea ;ite surveys showirg sq. ft. of !ot, sq. fl. of house; and all roofed areas . 2 copies of plan
(20°% maximum lot coverage allowetl) . i set of Eneryy Calculations for heated additions C ScSZS'(e, ?(
• 2 cocies of plan showing 6eam & window saes; poured found desyn, etc) . 1 site survey for extedor additions 8 decks
• 1 set of Energy Calculations y? . InOicale if hame serve0 5y septic system for additions
• 3 copies of Tree Preservation Plan i( lot platted after 717193 /(Y? ??
. Rim Joist OeWil Options selection sheet (bldqs with 3 or less units) ?DATE oIl9Iaz- ? VALUA710N"?
SITE ADDRESS 107 MULTI-FAMILY BLDG _Y?N
TYPE OF WORK NG,, FIREPLACE(S) _ 041_ 2
APPLICANT
$TREETADDRESS 5;I5- Nar?kWCSAr- ?PA(tvaZe2CITY"kt?STATE 11N('4Ip SSIZL
TELEPHONE # &51`W--Z57`( CELL PHONE #6I:Z-3(;1-R&A? FAX #
PROPERTYOWNER??I'1? ? TELEPHONE#
-------------------------------------------•---------------------------------------------------
COMPLETE THIS SECTION fOR KNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MIV'VE:SO"C:112UI.E5 7670CA"CE(;0RY l NIINNl:SO'l'.A RT'LL':S 7672
(v submissioa type) . Residential Ventilation Category 1 Worksheet Submitted • New Energy CoCe Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor. ?_? ??cJ?^ Sp?t Phone !t =??2 -°?- rt ZI
f? ',.
Plumbing system includes _ 4Vater So4fener :;La{Y[i(Sprihkl'cig2 Fee $90•00
? Water Heater 'No. of R.I s
No. of Baths
LLi? Mechanicai Conhactor: Phone # ?a - ?R
NIcch;ulic.d scs[cm include,: .1ir Condition ? Pcc: 570.00
- Hcal RccovcSystcm
'?;; Phone fk 7G3-%a9 -a9°3f'
Sewer/Water Contractor: lkdlt Gt.,?,44!Z,._ S19171tZ,C,
------------------------°----------°--------°---°----------°-------•-----------------
I hereby acknowledge that I have read this application, state that the information is
with all applicable State oi Minnesota Statutes and City of Eagan Ordinances.
Slgnature of Applicant
.......................
and agree to comply
OFFICE USE OvLY
Certificates oF Survey Received ? Tree Preservation Plan Received _ Not Required ?
Updated 4l02
OFFICE USE ONLY , . ,
? 01 Foundation O 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
3,( 02 SF Dweliing ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? OS 03•plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 44-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
)( 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 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 q dL90 Occupancy aa?. L& MC/ES System
Census Code Zoning tp 00_ Ciry Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. ? PRV ?
Nbr. of Bldgs Length 3K , Fire Sprinklered
Type of Const _VL%_)
Width ,
REQUIRED INSPECTIONS
? Footings (new bldg) ?C Finab'C.O.
_ Footings (deck) _ FinaUNo C.O.
Foorings (addition) _ Plumbing
Foundation _ HVAC
Drain Tite 0[her
Roof
Ice & 68arer Final Pool _ Ftgs _ Air;Gas Tests _ Final
_
_
Framing _
_ Siding Stucco Scone
Fireplace ?' R.I. 4.4it Test ?,Final Windows (nzw/replace ment)
Y Insulation Y Rztaining Wall
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Ptant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Approved By T Z- , Building inspector
-------- ----------------- ---------------
?w'SPL
r''l rr.aA-' l? 36 x sL1
b*nan-& 1-/ 67? ?! ??O =
() t-6-k-
7? ?f Z
;i 0"°
? O??
71F,! n^..2900 13:53
"777c1-r.?,.;•k CUMPLIANC$ S2EPORT
•.q!„?e?.,-?r,a Enezgy Code
j•P.i.jr?i..?,r?: SOft,'WeLLf! VEYBf.(711 3.0
P. E12.'03
Pexm t
Chec a y Date
r":'•, ?,., , DakotA
Minnesota
2
C'•.'A !?IITtvliCTION TYPS: 3ingle Family
G+n'Tr?, 6-7-2000
nh7r' ,^F PLAI7$: 3/28/00
' T rr•"• 11MBv-R WALICOUT ELFVAT20N 41
PA99E3
F?ar?, i•?d fJA m 393
???„- unrze = 294
?i°•:?'- raetter Thgn Code
Area or Cavity Cont. Clazing/boor
Perimbter R-Value R-value U-value
_.-------------------^----------•-------------------------------
S 1228 4410 0.0 ----..
:'t?' `? ? rk+od Fxame, 16" O.C, 2039 1910 2.0 1
j•7A7::.!;: 57i.od Frame. Z6° o.?.`. 1.99 10.C 2.0
R?'`1 9.0' ht/8.3' bg/9.41 insul 47 11.0 0.0
P:?11' ' r'o''ic. 3.51 ht/3.1 1 bg/3.5 1 insul 20 10.0 0.0
C-rWicdows or Dnors, Above OYada 334 0.350 1
pC„ P?z 39 0.350
HVn?' F,QI;IpMENT: Furnaae, 92.0 AFVE
.. _ _._.."-^--^'--"`-""--_""----"_`---'-'-^----_....-"_---^'----"_
,rn-'a?'3.,i1±prCE &TATE1MfiNT: TF.e propheed building deeign deeorlbed here is
co-?-is•-en.t with thA building pLana, apecificatfons, and other calculakione
evbmzk*_ed with the permit applicatloii. The prnpoeed builriing has been
de-75yr-d ta meet the requirement? of the Minnesota saergy Code.
I
6v1AP?? lejA- lhvv? ,..nArr 0
{
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUII.DING PERMIT APPLICATION
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DATE OF SURVEY: F'f"O?
PROPERTY LEGAL:
LATEST REVISION:
DOCUMENTSTANDARDS
• Registered Land Surveyor signature and company
• Building Permit Applicant
• Legal description
• Address
• North arrow and scale
• House type (rambler, walkout, split w/o, split entry, lookout, etc.)
• Directional drainage arrows with slopelgradient %
• Proposed/existing sewer and water services & invert elevation
• Street name
• Driveway
• Lot Square Footage
• Lot Coverage
ELEVATIONS
Existina
• Sewer service (or Praposed)
• Property comers
• Top of curb at the driveway and property line extensions
• Elevations of any existing adjacent homes
• Adequate footing depth of structures due to adjacent utility trenches
• Waterways (pond, stream, etc.)
/ Prooosed
?J ? ;- • Garage floor
?? ? • Basementfloor
• Lowest exposed elevation (walkouUwindow)
?/? - . Propertycorners .
L? ?? . Front and rear of home at the toundation
PONDING AREA (if aoolicable)
? ? ^ . Easement line
? ?/ ? • NWL
? p,?L • HWL
? 6' /7 • Pond # designation
? '? • Emergency Overflow Elevation
i? ?
Reviewed:
DIMENSIONS
• Lot lines/Bearings & dimensions
• Right-of-way and street width (to back of curb)
• Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent footings)
• Show all easements of record and any City utilities within those easements
• Setbacks of proposed structure and sideyard setback of adjacent existlng structures
• Retaining wall requirements, f
OK
• - Surveyor's Certificate
SURVEY FOR :PULTE HOMES
DESCRIBED AS :Lot 21, Block 1, OAKBROOKE 6TH ADDITION, City of Eagan, Minnesota and reserving
easements of record.
AU G 19 REC`D
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?,u LOT SQ. FOOTAGE = 3,960
HSE. SQ. FOOTAGE = 1,821
LOT COVERAGE = 461'o
# ,794,
PROPOSED ELEVATIONS
Top of Foundation = q27.5
Garage Floor -1? 27 1
Basement Floor = qi8.5
Aprox. Sewer Service =9i5.5*_
Proposed Elev. _ (:::?D
Existing Elev. -
Drainage Directions =
Oenotes Offset Stake = .
SCALE: 1 inch = 30 feet
HEDLUND I HEREBY CER7IFY THAT THIS IS A
OF THE BOUNOARIES OF THE ABO\
BY ME OR UNDER MY DIRECT SUPI
PLANN7NG BNGlNB6R1NG SURV6YIN0 SHOWIIAPROVEMENTS OR ENCROAC
2005 Pin Oak Drive ?
Eagan, MN 55722 DATE J.2 ,(12
Phone: (657) 405-6600
Fax: (657) 405-6606
14376 I Oakbrooke 5
BENCHMARK,
TNN @ Qy66lQ
Eleo= q27,5)
MIN. SETBACK REQUIREMENTS
Front - House Side -
Rear - Garage Side-
JOB N0:
noN 02R-520
=YED
TO BOOK: PAGE:
:? :M. \
PERMIT
City of Eagan Permit Type: Building
Permit Number: EA104822
• Date Issued: 06/12/2012
of ERin Permit Category: ePermit
Site Address: 1607 Johnny Cake Ridge La
Lot: 21 Block: 1 Addition: Oakbrooke 6th
PID: 10-53765-01-210
Use:
Description:
Sub Type: e-Reroof Construction Type:
Work Type: Replace
Description: House & Garage
Census Code: 434- Occupancy:
Zoning:
Square Feet: 0
Comments: If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes.
Fee Summary: BL - Base Fee $4K $103.25 0801.4085
Valuation: 4,000.00 Surcharge - Based on Valuation $4K $2.00 9001.2195
Total: $105.25
Contractor: - Applicant - Owner:
Krech Exteriors Inc Charles A Blixt
5866 Blackshire Path 1607 Johnny Cake Ridge La
Inver Grove Heights MN 55076 Eagan MN 55122
(651) 688-6368
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.
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA127568
Date Issued:10/07/2014
Permit Category:ePermit
Site Address: 1607 Johnny Cake Ridge La
Lot:21 Block: 1 Addition: Oakbrooke 6th
PID:10-53765-01-210
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please leave printed pictures of house wrap on site for the final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Charles A Blixt
1607 Johnny Cake Ridge La
Eagan MN 55122
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA128117
Date Issued:10/27/2014
Permit Category:ePermit
Site Address: 1607 Johnny Cake Ridge La
Lot:21 Block: 1 Addition: Oakbrooke 6th
PID:10-53765-01-210
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
Carbon monoxide detectors are required by law in ALL single family homes .
Lisa Nyberg
Valuation: 4,000.00
Fee Summary:BL - Base Fee $4K $103.25 0801.4085
Surcharge - Based on Valuation $4K $2.00 9001.2195
$105.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Charles A Blixt
1607 Johnny Cake Ridge La
Eagan MN 55122
Property Claim Solutions Llc
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature
For Office Use
% % 1 1 ..;,, EAGAN
% % . �0 * :::e:
(o.�
3830 PILOT KNOB ROAD EAGAN, MN 55122-1810 Date Received: 5-(:). -/87
(651)675-5675 I TDD:(651)454-8535 FAX: (651)675-569 ,.
Email: buildinginspections a(�citvofeagan.com Staff:
Commercial Plan Submittal:eplans(a�cityofeagan.com L
________________7_-
MAY 292018
2018 RESIDENTIAL MECHANICAL PERMIT APPLICATION
Date: 05/24/18 Site Address: 1607 Johnny Cake Ridge Lane
Tenant: Suite#:
Name: Nancy Blixt Phone: 6516883581
-tier
Address/city/Zip: 1607 Johnny Cake Ridge Lane Eagan MN 55122
Name: Burnsville Heating &Air Conditioning License#: 003114
3451 W. Burnsville Pkwy#120 Burnsville
Address: City:
MN 55337 952-894-0005
- 19 State: Zip: Phone:
r' contact: Stephanie Email: smessenger@burnsvilleheating.com
Ary
RESIDENTIAL
Furnace
�' ic ✓ Air Conditioner
7 1IIPer it Type
Air Exchanger
Heat Pump
' 'A14 „ Other
New ✓ Replacement Additional Alteration Demolition
1 '� 'Dk Replacement residential AC
Axa
Description of work:
= fi
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit,includes State Surcharge _ 60.00
$100.00 Residential New, includes State Surcharge =$ TOTAL FEE
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.citvofeagan.com/subscribe.
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 workAis not to start without aa
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.
Applicant's
Messenger J' uJvA . �
Applicant's Printed Name Ap scant Signature
-17
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, �„ _ Vi ,, ,� -' 4 i��� _ �� ��r ® E
Ut d gr u • 7*-,, t _ '" Ser e `G,r l t I t �'I�1' � �`
•
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71
e e •
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� For Ofilce.Use
,..0i s.i I Permit#:.
q''--` .� •
x... .. ;� _ � " Permit Fee; YZ� . D
3830 PILOT KNOB ROAD.I EAGAN,MN-55122-1810DEC 11 7018 Date Received: �°��Il'�
(651)675-5675 I TOD:(651)454-8535 I FAX: (651)'675-5694
.bulldinginspecllons{a,cltyofeagan.com Staff:
L
J
.2018 ` E.SIDENTIAL PLUMBING PERMIT APPLICATION
Date: P04111 0 l9`-�T ih� Ceikcti _c �_.. ,
V
Site Address:
Tenant: 1
�t„t ,b t�(g„ 5 . 4 � � 1
Suite#: Y
` /041
I
'J t` arae; /.I, ►.L/ �> 5�c� J
�ri 0r G' ts !•C$ :t' "' � � t , Phone: •• x:1' 4,,I,i?S.09 }�Ux .;.d: Address/City/Zip: ,, _
til, Name; MILBERT COMPANY dba CULLIGAN WA ER
4 NI
WC641376
rh.:404 4141 License#:p �� Y`�"U"'y+ 'f'° 3r;Fit Address; 1801 50TH STREET EAST
k(z�cgr1'}rCity: INVER GROVE HEIGHTS
zi
r e ,� i ,4 )'n State: MN . Zip: 55077
.',„ y 'tW6Y >a;. Phone: 651-451-2241
�4�rl�k�s��: ` a
FY;tpstt 4,,.:gik 4,.!i.i k'� Contact: BILL MILBERT Email: •loria.abas@culligan4water,com
•
acv to Jt f 4
;;,1s �` ''pff�'.q.r �,.F -.___New _Replacement Repair __Rebuild _-__Modify Space _Work In R.O.W.
'tb,,t14;f'A.gt ;,{4„1,4 Description of work:
r .>5«r p• r< !i RESIDENTIAL --
t e,L,r- ,`rL'l ,, .5 ti,,}., `,,,,r _Water Heater
rP ttt, M,V;6 ,.41'1.*n ; ___Lawn Irrigation(_ PVB) X Water Softener
n r F.., RPZ/
c1`ij�}Jt;�:t��1�i};�PrtitS�tlsv�f'St�,���:
- i n '1'•tisl f�;40 r`04i Septic System Add Plumbing Fixtures (�Main./ Lower
•,_,•-,r,i ti 'f,. Level)
� ,� eAli,q., f. r b`
t�att � �S�¢rjr; New
WaterTurnaround
Abandonment
r _---__
$60.00 Water Heater,Water Softener, or Water Heater and Softener(Includes State-Surcharge) —� ��_�—~
RESIDENTIAL FEES:
$60.00 Lawn Irrigation (Includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment,Water Turnaround*(includes State Surcharge)
'Water Turnaround(add $280.00 If a 3/4"meter Is required)
$115.00 Septic System New(Includes County fee and Stale Surcharge) 60 00
CALL BEFORE YOU DIG. Call G.ept Srato One Call al(651)454-eon for protection against underground uAlllit L Fdama e,
intend to dig to receive locales-of underground utilities. www.oouherstateonecall orn
' You may subscribe to receive an electronic notification from the City of proposed ordinances VST~-Call 4'8 hours before you
webslta at www, recei comisubscribe.
by signing up for an email update on the City's
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
accordancewltp h?approved plan In e cas 6f work !oh requires a review and approval of plans.
ik
x .�.
Applicant's Printed Name x • ,//666 .
rl t Applicant's Signature
(0`S 1 f(� Za T�<�!{r;;F`�1r'd,�(v�;%;4!f,( )r'�S`�i111°5~fAV�"Y}�fis
IR"OO F:IGE USE?'y`; 'ilf tG 4,40,g1Milt;�I(P v�'> ;y l rti PRO ?1 .(i�'i t.i4VY"u,' 4i' it
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