1743 Karis WayCITY OF EAGAN
Addition RIDGECLIPFE 7TH
Owner
Lot 9 Blk 1 Parcel 10-63986-090-41
screet 1743 KAIZIS WAY state EAGAN M 55122
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK lb(o 1982 pqlD Un @T ori inal 8TC8
SEWER LATEfiAL
WATERMAIN
WATER LATERAL
WATER AREA
STORM SEW TRK Paid AS Jar
STORM SEW LAT
CURB & GUTTER '
SIDEWALK
STREET LIGHT
ROAD UNIT 250.00 39860 11-9-83
WATER CONN. 450.00
9UILDING PER. $(4rj
sa,c 525.00
PARK
F
Reoeipt " MECHANICAL PERMIT Permit No.
• CITY OF EAGAN
Fea
.
FiII in numbered spaces S/C
Type os Prini /egib/y
Tot. -
1. Date 2. Installation Cost
3. Job Address 17 3 gik. Tract
4. Owner
C-rri_,: ?zc#h son
?' 472--1
5. Contractor ' Phone '
6. Address i I'O' 'PQX 91, Tl'Ot?Tl d
7. City
Mound State "N
Zip
8. Building Type: Residential b Commercial ? Institutional ?
9. Work Description: New ff Add ?
10. Describe `-ero clearance
I 11.
Alter O Repair ?
.?^?:•.:? ?.rr.i.rn
_Fuel Type
No. Equjoment BTU - M. Ea.
Forced Air No. Equipment CFM
Ai
H
dli
Mfg. r
an
ng:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other i-
Air Cond. !;.C3 E._,
Mfg,
Gas, Piping Outlets
12. I hereby certify ihat the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work,
Signed : for
Rough Final
Inspections: Oate Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454-8100
PERMIT #
PLUMBING PERMIT RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE:
Site
Name
? Addre:
c City _
? Name _
3 Address
p CitY -
Sec/Sub
BLDG. TYPE WORK DESCRIPTION
Res. New _
Mult Add-on
Comm. Repair .
Other
FEES
COMM/IND FEE - 1%OF CONTRACT FEE
MINIMUM - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADO $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
?
SIGNATURE OF
FOR: CITY OF EAGAN
NO. FIXTURES TOTAL
water cioset - $3.00 $
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping OuUets - $1.50
' Softener - $5.00
Well - $10.00 Private Disp. - $10.00
Rough Openings - $1.50
FEE
STATE S/C
GRAND TOTAL:
CASH RECEIPT
' " CITY OF EAGAN
3795 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122 V3
DATE 19
RECFIV6D
AMOUNT $ I ?
?
OOLLARS
toe
? CASH CHECK
FO R
White-Payers Copy
Yellow-Posting Copy
Pink-File Copy
Than ro?
BY
BUILDI1IG PERMIT
?N DWG/GAR
CIT1f OF EAGAN
3795 Pilee Kuob Roed Eogon, IIAN 55112
PHONE: 454-8100
$76,000
5ite A41reu 1/"IJ i?<10 n6j
gec e t
Lot Block Sec/Sub.
Porcel # 10-63936-090-01
oc Nome ...r..,,.. .,..,......, ..?.?..?.,..
= /Wdress 1/12 op ne rossroa
9 ;:tka. 55 3 544-7111
?
ZO
pv
u?
?
I hereby acknowledfle thot I hove read this appiication end stare thet
fhe inlormotion is correct ond egree to comply with oli epplicoble
Stote of Minnesote Stotutes and Ciry of Eogon Ordirances.
Sipnature of Permittee -
A Buflding Permit Is issued to:
ell work shall be done in ocw
Buildin9 Officiol
N;'.? 8645
_-
Receipt
i3ovember 9 83
Erect Occupancy, x-3
Alter ? Zoninfl ?
Repolr ? Firc 2one ?
v
Enlarpe ? Type of Const.
Move p # Stories
Demolish
p 4
Length
D
F
Grode ? epth Sq.
t.
Aoorovals Foes
Assessment Permit ?"J1 • UW
Woter & Sew. Surchorpa -?50
Pollce Plon theck
??
Firo SAC
Enp. WoterConn. ' 450.00
_
Plonner Woter Meter -
2 ? ? 0?
i
d U
???
Council ? - Roo
n
t
Bldfl
Off
.
.
?
APC Total I
on the express tonditlon ihat
and City of Eoyon Ordinancea.
? m •P - 43 s a-- - 3,60 y- 13 4 9 F;re.p I a cQ.
Permit No. Permit Holder Misc. Permit No. Holder
Plumbing
H.V.A.C. ?3 Z ?i ?- 3 0
Well
Water
Disp.
Sewer
ElsMric S/
Irapoctfon Date Insp. Other
Foottnps s T
Foundation
Frominq 4,f[
Rouqh Plbp. -9
Rough HVA
Inwlation t -1 ?
Final Plbq. ?
Final HVAC
Final • ?' ?.?J
Waur Describe Location: _
YYell
Sewsr .
• Pr. D'ap.
Receipt
PLUMBING PERMIT Permit No. {_.; l
CITY OF EAGAN
Fee -?_
Fill in numbered spaces S/C Type or Print legibly Tot. - ;-{
1. Date " 2. Instaliation Cost 17 i. .? v
3. Job Address 81k. ? Tracf
4. Owner
5. Contractor Phone
, ,.
6. Address
-?--,,
7. City L, State Zip
8. Building Type: Residential f? Commercial ? Institutional O
9. Work Description: New Q Add ? Alter ? Repair ?
10. Describe
11
No. Fixtures
Water Closet No. Fixtures
Cesspool/Drainfield
/ Bath tubs Septic Tank
- Lavatory Softner
/ Shower Well
Kitchen Sink
Urinal/Bidet Qther ?? ?f ?` ? r•t
? Laundry Tray
Floor Drains
Drinking Ftn.
Slop Sink
Gas Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed: for
r?
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved ??( i? CITY OF EAGAN 454$100
Receipt MECHANICAL PERMIT Permit No.
CITY OF EAGAN
F '
?
Fill in numbered spaces S/C
Type or Print legibly Tot.
1. Date `? • - 1? 2. Installation Cost ^ •
3. Job Address I Lot 81k. Tract
4. Owner S. Contractor • Phone '67
6. Address c : 3
7. City '• State • Zip 554f'7
8. Building Type: Residential C3 Commercial ? Institutional O
9. Work Description: New 0 Add O Alter O Repair ?
10. Describe - , _ . - -' •. Fuel Type
11.
No.
1 EqLipment STU - M. Ea.
Forced Air No. Equiament CFM
Ai
H
dli
Mfg. r
an
ng:
Boilers
Mfg. Mech. Exhaust
Unit Heater
Mfg. Other
Air Cond.
Mfg.
1 Gas, Piping Outlets
12. I hereby certify that the above information is true and correct, and I agree to
comply with all ordinances and codes governing this type of work.
Signed : ?
for
Rough Final
Inspections: Date Insp. Date Insp.
This is your permit when numbered and approved.
Approved CITY OF EAGAN 454$100
CITY OF EAGAN
3830 Pilot Knob Road WATER SERVIC E PERMIT
P. O. Box 21199
PERMIT NO.: 5
Eagan, MN 55121 DATE: - " ' •' '
Zoning: - No. of Units: 1
pwner; ::iaLi.;soi1 Lalczs Jiv
Add?ess:
Site Address: j 143karis ?tiay L) :,i !{:i?L eLl i ?! ?: 7ti:
Piumber: ?::=1 ''lh? ? l1t?
Meter No.: Connection Chcrge: 430•00
? Size: Account Deposlt:
Reader No.: Permit Fee: ? ? • ? ?
I agme to eomply wi16 Me Citr of Eayas $urcharge:
OrAinonqs. Misc. Chorges: - •00 1'd ulLGT
Total:
BY Dute P
id
a
:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road '
P. O. Box 21199 pE??T NO.:
Eagan, MN 55121 DATE:
?
Zoninp: No, of Units:
pN,ner• Tt20"n ?S4i1 L31.S5 D1V
Address:
Stte Address: I743 3Caris W8Y L9 81 :tid,LeCli!":c; 7th
Plumber: -4nze1 Plhg u iitF'
1 agm te esmply wilM !he Gep eF Eqgos C.onnectton a+mga: 425 _(IDjd
Ordinasns. Acoourit Deposit:
Parmit Fee: ? ? •
Surcharpa:
qv Mix. Charpes:
of Insp.: Total:
Dott Pald:
CPI'1' OF Irx=lude 2 sets of plans,
? 1 site plan w/e]evations 5
Plan: BUIInTNC, PERi'LIT N'PI..TCAT70N 1 set of enesgy calcvlations.
-= •?-``??ui?????- -- `y iG?
'Ib C3e Usr3 For Valuation ? Date
Site Pddress: 1`{3 Ka."? ,? OFFICE USE ONLY
Lot _-1 Blodc ? sec./sub.LVL Erect ? Occlpancy
Pdreel $ : (fJ - (0 3`t $ U-p4D - c>( ? Alter Zonin4
- Repair Fire Zone
Q.rner
lu3dress:
City/Zip Code:
Phone #: ' . -
contsactor: - THCIMPSON LAKES DIVISiQN
Pddress: _ 8+??ono . ome ipw wq
1712 HOFKINS CROSSROAp
City/Zip Code= MI'!NETONaA, t .
P}icne n: -rjyy-Z3?3 -
Arch. /L1-)g. :
Fddress=
City/Zip Code:
Phone 4-
Enlarge Type of Const.
Nbve # Stories
Ikemolish Front ft.
Grade Depth y? ft.
Assess7mnts
Permit ?
3
Water/Sewer Surcharge g
Police Plan Check / $O ??
Fire SAC So26 ?
E7ig, Water Conn. ?/lp-D
Planner Z9ater.Meter &-9
Council Road Unit o?6-,!57 av-
Bldg. Off.
APC
7CYPAL ? ??P ? S?
CITY OF EAGAN N? g645
3795 Pllat Kno6 Rood Eagan, MN 55142
PNONE: 451-8100
BUILDING PERMIT Receipt #
Te M used fo. SF DWG/GAR Esr. Volue $76,000 Dare November 91 q 83
1743 Karis Wa R-3
Sife Address 3' Erect },.? Occuponcy
Lot 9 elock 1 Sec/Sub. Ridgecliffe 7th qlter ? Zontny (PD) R-1
Parcel # 10-63986-090-01 Repair ? Fi.e Zone NA
Eniarge ? TvDe of Const. V
W Name Thompson Lakes Division Move ? # Srories
= Add.en 1712 Hopkins Crossroad pe,,,oiish ? Length 40
° Ci tka. 554143 phom 544-7333 Grade ? Depth 40 Sq. Ft.-
Avvroruls Fee.
Name Owner
U Address
? Assessment
Water 8 Sew.
? Cit Phone
Police
F
FW Name Fire
Addrea Eng.
iW Ci Phone Planner
Co,,,,c;i 10-4-83
1 hereby acknowledge ihot I hove read this appiication ond stote thaf Bldg. Off. 11-8-83
Ihe inlormafion is correct and ogree to comply wifh all opplicable
State of Minnesota Sfotutes and City of Eagon Ordirronces. o
APC
Sipnature of Pertnittea
-TPO-IRPS0]
A Building Permit Is issued to:
oll work sholl be done in occordanCe with all
Permit 3014 VV
Surchar9e 38.00
Plan check 180.50
SAC 525.00
Water Conn. 450.00
Woter Meter 60.00
Road Unit 250.00
Totoi $1864.50
_ on the exprets Condition thno
ond City of Eagan Ordinances.
Buildin9 Officiol
REQUEST FOR ELECTRICAL INSPECTION W: Ia" EB- "01'Y3
?9?
' See instructions Ior campleting [his torm on back ol yellow copy.
"1(" Below Work Covered by 7his Request 40 6 L S
N AAtl R.P. Type of Builtling Apoliuoces Wirad Equiumem Wired
?z Home Range
, Tem[mrery Service
Duplex WatecH'eater Lightiny Fiztures
Apt. Building Dryer Electric Heatin
Commercial Bldg. Fumace Silo Unloader
Industrial Bldy. Air Conditioner Bulk Milk Tenk
Fatm Dther Soeci v 1111rl5oecllyl
ther Su?`eifY Other Oihar
Comnute lnspecvon Fee Below
p Fee Service EntrencaSize d fae Fnnders/SubfeaAers B Fen Circuixs
W 0 to 200 Am s 0 to 30 Am s 0 IX7 0 to 30 Am s
Above 200 qm>s 37 to 100 Ainps 31 to 100 A s
Swimminq Pool Above 100-Amps Above 100_Amps
Transiormers Irriyation Booms . u Partial/Other Fee
Signs Speciallnspe
ction
jQ5t1
$ 1
TOT EEE l
'
Rema rks
. `? _?,?
NouBh-in ? Date ?, the mal
J ? ? Inspector, heraby
certily thqt the above
Final ? Q+}:20 S inspection has bean
( 1 metle.
TNarepuestvmEtBmonfhstrom G 4r(j
This request void Id ""~ 9 -g?s 1
78 months fmm
A24746 L 9 I
B!, ,e 1 d9- E/.4e
7''?'
s?o•oo
Repuest Date
Z' I Fire No. : pouPh-in7Inspec[ion
R
eq ?retl ?
Ready Nuw?
Will Notity, Inspac-
f .
?Ves ?Na tor When BeatlY
Licensed ElecVieal Contrecmr
O I
b
'
? Own
r hereb
y raquas[ in
spection of a
ovB
e elecvical work ins telled aY
SVeet Address. Box or Route No. City
1?'?3 ??.s w ?j
Euc,(?'
ecLOn o. Township Name or No. Ranye No. un
t
y
C
o
?
?
?
n
/
rJ(?!-1?a
Occupnn[(PRINT) Phone No.
TiOMP52)f'
Power?$?upPlier
p Adtlress
l
'
f194 f" I NL
b t
EI Vical Contracior (COmOany Name)
?6lt- EifiCC/z{ c. Convacmr's License No.
Mailing Address (Contractor or Owner Making Instailation)
1411 £. Ct-Gfi2 R-fJRD
Au[horized SiB [ure IConvactor/Owncr Making Installa[ionl Phone Number
$40.
MINNESOTqSTATE 80AH0 OF ELECTNICITY THIS INSPECTION REQUEST WILL NOT
Griggs•Midway BId9• - Aoom N-191 gE ACCEPTED 8Y THE STqTE BOAHD
1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS
Phone (812) 297-2111 _ ' ENCLOSED.
CITY OF EAGAN WpTER SERVICE PERMIT
3830 Piloc Knob Road 5251
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE: 12-29-83
Zoning: Rl No. of Units: 1
p,,.,,a,; Thompson Lakes Div
Address: _
? Address:
ber: r No.; ,Reader No.:.
t-'?12
1 agros M oomylr wiM !ha Gry ef Eagon
Ordinoness.
ey ? ? -
Date of Insp.: -
Connedion Charye: 450.00 pd
Account Deposit:
Permit Fee: .,
10•00 ?^'
Surchorga: .80 pd
Miac. Chorpes: 60.00 pd mte
Torol: -
Dote Poid:
. r/? • • ? ? ????
Foz:
U.S. HOME CORPO?/RAT,4/?pION
To?p of Curb /?I,rj W/?Y To af Gurb
kL> 957.721 f E?= 957.39
pc9052'W NO•4(.'19"E
R=302.60 L=x42 4500 I ,(9r, 7.89)
? 5s•;
?
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N 1/° 35'42 WNO°46'i3°E
C. R. WINOEN 3 ASSOCIATES, INC.
IAND surveroRS rOL s4e-3944
1361 EUSTIS ST., ST. PAUI, MINN. 6610•
Scale: 1"=30'
o Denotes Iron Monument
Bearings Are Assumed
(900.0) Denotes ProPosed
{inishcd 9round EI.
r? penote5 d?rec+?o? of
sur?ace d*-Q,nage.
Pt'oposed ?q arog e
{1001 E L = 4Ceo.'73 .
VEr+'cnl DG?NT?
N.G. V. D. 1929
Note: As of this date
RIDGECLIFFE SEVENTH
P_DDITION has not been
recorded.
Lot 9, Block 1, RZDGECLIFFE SELENTH ADDITION,
Dakota County, Minnesota.
To Be Subject To And Together With Special
Sideyard Easerients.
WE NERE6V CERTlFY THAT TH{5 15 A 7RUE ANO CORRECT REPRESENTATION OF A SURVEY OF TNE
60UNDARIES OF iNE IAND A60VE DESCRI6FD AND OF TME IOCATlON Of All 6UIlDINGS, !f ANY,
TNFREON, AND ALl VI51llE ENCROACMMENTS, If ANY, FROM OR ON SA10 tAND.
s*
Deead rhisdar oF NovPmberA.D, 1983 C. R. WINDEN d ASSOCIATfS, INC.
Revised 1l-1-83•cPu. f ?' ?
br l•rtls--elL? ?_?C?.?
Surv*yor. Minnewlo lpese.atree Ne. 7 6
9 CITY USE ONLY
L BL ? RECEIPT #: 5_ 9 0
SUBD. L DATE:
1996 PLUMSING PERMlT (RESIDENTlAL)
GITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 687-4675 _
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES EACH NQ, TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 x =
Laundry Tray 3.00 x =
Hot Tub/S a 3.00 x =
a e 3.00 x =
ie? 3.00 x =
Gas Piping Outlet * minimum - t 3.00 x =
Rough Openings 1.50 x =
Water Softener 5.00 x =
Private Disposal * Dakota cty. license 50.00 =
(new and refurbished systems)
.lnkler " home under const. 3.00
Afterati to existing 20.00 = ?
ater Turn Around 20.00
STATE SURCHARGE
TOTAL
Iv3'%??° 0 %v-o/
SITE ADDRESS:_ R7aH KARIs wRV R4BERT
ERGRN , 55i<2
OWNER NAME:- H 685-970r u 848-5585
INSTALLI
STREET
CITY:
.50
ZO- 5 O
PHONE #: ( )
STATE: ZIP:
OFFICE USE ONLY
L BL RECEIPT #:
SUBD. DATE:
1996 PLUMBING PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for. ? all commercial/industrial buildings.
P multi-family buildings when separate permits are II4I required for each dwelling
unit
DATE:
CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR
DESCRIPTION OF WORK:
IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETERS TO BE INSTALLED7 YES _ NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESULT IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? _ YES _ NO.
IF 50, YOU MUST APPLY FOR A SEPARATE U.G. SPRINKLER PERMIT.
FEE: $25.00 minimum fee or 1% of contract price, whichever is greater. State surcharge of $.50 per
$1,000 of permit fee due on ali permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTnL
SITE ADDRESS:
TENANT NAME:
STE. #
OWNER NAME:
j INSTALLER:
,..
.. ...,i,,i«??„ _, ,•?r;U4r?7.UJJ7YIJV
ADDRESS: A_P.Q
r
CITY: - ... i 9}TATE: ZIP:
PHONE #:
SIGNATURE:
APPLICANT
OFFICE USE ONLY
METER SIZE: " DATE: INSPECTOR:
-----------------
I For pffce Use ?
? Permit#:
? Pertnit Fee:
? Date Received:
? StaffI
I ------------------
2008 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7-1/' 08 Site Address: I 7 y3 /6/N3 L.LI7 4G/99'44 f ??? ??
Tenant:
Suite #:
RESIDENT/OWNER Name: ?C)1if41'-41k T°? ¢ ?'Il Phone: ?l - 33?y 3dg0
Address/ City /Zip: 17Y.3 /kI¢^S j,)f1V
Applicant is: _ Owner g Contractor
TYPE OF WORK Description ofwork: t.- mo-r
Construction Cost: onOK 66900 Multi-Family Building: (Yes_/ No Y? )
CONTRAC70R Name: 4416wgpoep 1410,P19-) 04 License #: P6I 51S 33S
Address: /0 D?Wel
CiTy: UJ? e?.5 State: Z,P: 5 S 3 7 r?
Phone; 763'5S„3 - 13'•1/ Contact Person: I Y C m3
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
_ Minnesota Rules 7670 Cateqorv 1 Minnesota Rules 7672
Energy Code . Residentiaf Ventilation Category 1 Worksheet • New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) • Energy Envelope Calculations Submitted '
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 8. Water Contractor: Phone:
NOTE:, Plans and supporting'documents that you submit are considered to'6e public information: Portions of ';
? the`inforroation may be classi/ied as non-publicrif you provide`sp"ecific reasons that would permit the City `Co
? conclude that the .are tradesecrets: ?I hereby acknvwledge that }his information is complete antl 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 onty an application Por a permit, and work is not to start without a permit; that the work wfll 6e in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x
Applicanfs Printed Name
ApplicanYs Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA161530
Date Issued:06/01/2020
Permit Category:ePermit
Site Address: 1743 Karis Way
Lot:9 Block: 1 Addition: Ridgecliffe 7th
PID:10-63986-01-090
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:One Window/Door
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow
windows, call for framing inspection. Call for final inspection after installation.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 1,500.00
Fee Summary:BL - Base Fee $1500 $62.50 0801.4085
Surcharge - Based on Valuation $1500 $0.75 9001.2195
$63.25 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 -
Kelsey Howard
1743 Karis Way
Eagan MN 55122
(952) 807-2368
Crew2 Inc
2650 Minnehaha Ave
Suite 100
Minneapolis MN 55406
(612) 276-1680
Applicant/Permitee: Signature Issued By: Signature