774 Mill Run Path
Use BLUE or BLACK Ink
For Offuce Use /
City of Lap Permit ~~iJ~ I
C~I~ i Permit Fee: / 5
3830 Pilot Knob Road
Eagan MN 55122 J~ Date Received:
Phone: (651) 675-5675
Fax: (651) 675-5694 1 staff:
--J.
2011 RESIDENTIAL BUILDING PERMIT APPLICATION 55-
Date: 1 11 - Site Address: 4 A A4-& LLkk-~' Unit
Name: Phone: ~Q' I 'L7 7
RESIDENT /
OWNER Address / City / Zip: 1 14 M &A
Applicant is: Owner Contractor hh~~
Description of work: ~,~t"g=., N44-
TYPE OF WORK
Construction Cost: Multi-Family Building: (Yes / No) -49 VIL ou;') Company: , Stccontact: C.11~,U LWV-%--## ---I
44 'z I
CONTRACTOR Address: C~V~L~O(JCa City:
state: _ Zip: v~ Phone:
License* 7--;Q [.ead Certificate 6 v S
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
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.popnerstateonecall.orp
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; tha rk will be in
accordance with the approved plan in the case of work which requires a review and approval .
X (~Y~q WWJ1zA- Applicant's Printeld Name (Ak5~ s Si at
Page 1 of 3
-7q 411 w1u,
• DO NOT WRITE BELOW THIS LINE
SUBTYPES /0 U
Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage
_ Single Family XGarage _ Porch (4-Season) Exterior Alteration (Single Family)
Multi Deck T Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi)
_ 01 of Plex Lower Level _ Pool _ Miscellaneous
Accessory Building
WORK TYPES
- New _ Interior Improvement _ Siding _ Demolish Building*
- Addition _ Move Building _ Reroof _ Demolish Interior
-Alteration _ Fire Repair _ Windows _ Demolish Foundation
Replace _ Repair _ Egress Window _ Water Damage
Retaining Wall *Demolition of entire building - give PCA handout to applicant
DESCRIPTION
Valuation Occupancy G (1~ MCES System
Plan Review Code Edition SAC Units
(25%_ 100%V) Zoning City Water
Census Code Stories Booster Pump
# of Units Square Feet PRV
# of Buildings Length Fire Sprinklers
Type of Construction9 Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/ C.O. Requited
Footings (Addition) y Final/ No C.O. Required
Foundation T HVAC Gas Service Test Gas Line Air Test
Drain Tile Other:'
Roof: -Ice & Water `Final Pool: -Footings Air/Gas Tests -Final
Framing Siding: -Stucco Lath -Stone Lath -Brick
Fireplace: -Rough In Air Test -Final Windows
Insulation Retaining Wall: _ Footings Backfill _ Final
Sheathing Radon Control
Sheetrock Erosion Control
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge 0 L9
Treatment Plant
Copies /
TOTAL
Page 2 of 3
I
`7-74'
S,~RVEYaR SIENNA CORPORATION
aS'CERTIFICATE
. .
3410 - 2
as a.t1
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(gg25) - 2:a p
m 30,0 / p.
N 'PROPOSED 146t7SE S ' ✓ .
0
13:79
fol. . `
111
~~1T
REVISED 12=i5-87' TO SHOW . .
PROPOSED HOUSE BY -
KEYLAnD HOMES
Lrly
p}?A(Na pER P 5 "
79.14
DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES-IRON MONUMENT SET SCALE: 1 INCH = 30 FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 892.8 FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR ® 885.1 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK- 893.2 FEET
WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 3, Block 14. BRIDLE RIDGE I ST ADDITION, according to the recorded
plat thereof. Dakota County. Minnesota.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR CRO CHMENTS, EXCEPT AS SHOWN. AS
EMBER .1987
SURVEYED BY ME OR UNDER MY DIRECT SUPERVII l-0'rH S /TH DAY OF DE
APPROVED FOR STENNA SIGNED: AiS R. 1 , INC.
CORPORATION
BY..
BY: H OLD C. PETERSON, LAND SURVEYOR
MINNESOTA LICENSE NUMBER 12294
DATED,
rn -n T W 0 O m James R. HIN
O F C_ O D 0 D
p Z Oa 0 x V5 - 4 - z
.4 a m PLANNERS I ENGINEERS / SURVEYORS
0
A 0) z G)l M 0 zoo m
O m v 9401 JAMES AVE. S. • BLOOMINGTON, MN. 55431 • 612-584-3029
h
O
n
PERMIT
City of Eagan Permit Type: Building
Eagan. Permit Number: EA096942
Date Issued: 11/09/2010
OR Permit Category: ePermit
41 it~ of E3
E
Site Address: 774 Mill Run Path
Lot: 3 Block: 14 Addition: Bridle Ridae Ist
PID:10-14996-030-14
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 openin,s, 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: $90.00
Contractor: - Applicant - Owner:
Pella Windows & Doors Turnkey Sales Brice D Johnson
1 300 25th Ave N =100 774 Mill Run Path
PIN-inouth MN 55447 Eagan MN 55123
(763) 74-1400
I hereby aeknowledae that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and Cite of Eagan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
_VPP
. '.
v Name _-,
? Addre,ss J
c Ciry &u?
L Name .?
c Addres
o citv ?
TYPE OF WORK
Forced Air
PERMIT #
PERMIT L?
?' ? '9
GAN RECEIPT # _
-
EAGAN, MN 55122 DATE: 1 c{'f
-8100
i. TYPE WORK DESCRIPTION
?-. New ?
Add-on
?. Repair
FEES
HVAC 0
RE
00 M BTU 2
-1
S. -$
4.00
4 ! W ADDITIONAL 50 M BTU - 6.00
C
Phone l •/ ,(RES. HVAC IN
LUDES A/C ON NEW
"'CONSTRUCTION)
'
G
S O
T
ETS
M
ER P
(
INIMUM - 1 P
.
A
U
L
ERMIT) - 1.50 EA.
4CaMM/INa FEE - 1o/a OF CONTRAC7 FEE
M BTU 'APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
M BTU ? MINIMUM RESIDENTIAL FEE - ALL ADD-ON &
M BTU $ REMODELS - 12,00
M BTU $ MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - ,50
CFM ? (ADD $.50 S/C IF PERMIT PRICE GOES
# ?? • ->L BEYOND $1,000)
4
FEE J C} 4`
S/C: SIGNATURE OF PERMITTEE
TOTAL:
f
? , FOR: CITY O? EAGAN
PERMIT #
' PLUMBIN(i PERMIT RECEIPT # I
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE PHONE: 454-8100
,• ; ,
Site AddSess
lot - Block Sec/Sub
, , - 4 w
L Name
? Address ? r
c Ciry Phone '
Name
? ' ?'
`•
3 tC b
Address
p Ci1y Phone
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEroH $1,000.00) .. ,.
?
'
'
I
E OF 0 RMITT
NATL'IA
E
FOR: CITY OF EAGAN D, ,
BLDG. TYPE WORK DESCRIPTION
Res. ' New
.
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
Np FIXTURES TOTAL
r Water Closet - $3.00 4
Bath Tubs - $3.00
Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.Q0
Urinal/Bidet - $3.00
Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMI'n
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
Rough Openings - $1.50
FEE
STATE S/C:
GRAND TOTAL•
INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675
SITE ADDRESS:
I. 1 k11N E A I lt
,4 APPLICANT:
itRr i i t? ? ta?,
a t
4??
PERMIT SUBTYPE: TYPE OF WORK:
Mt 11
Permit No. Pormit Ho1dK Deft Telephone M
ELECTRIC
PLUMBING
HVAC
Inspection Dab Insp. Commenis
FOOTiNGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
CiYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
BSMT R.I.
BSMT FINAL
DECK FTG _
DECK FINAL
G z iL. ?vL
?7 s??
WAcrivaIE Fat BAsDmvr FDMsH-PLAN R ,j/ /gg .',
.?cY?: ? 688-2889 ? V EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PH O N E: 454-8100
BUILDING PERMIT Receipt #
Ta be dsed for Est Value Date ,19
Lot ? I Block Sec/Sub. ily, ('.
Parcel No.
a Name
3 Address
° City Phane '
¢
.o
Name
? ? Address
? City Phone
ua
y? W
w
Name
F
g Address
? Ph
? W one
City
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.
Signature of Permittee
A Building Permit is issued to:
on the express condition that all work shall be done in accordance with all
applicable 5tate of Minnesota Statutes and City of Eagan Ordinances.
OF FICE USE ONLY
on sde sewaoe a??upancy
MWCC Syatem Zoning
On Site Well (Actual) Const
Ciry Water (Allowable)
PRV Required * of Stories
Booster Pump Length
Depth
_
S.F. Total.
Footprint S.F.
APPROVALS FEES
Engr./Assess. Permit
Planner Surcharge
Council Plan Review
Bldg. Off. SAC, City
Variance SAC, MWCC
Water Conn.
Water Meter
Road Unit
Treatment P1
Parks
TOTAL
- Psrmit No. Permit Holder Date Talephone ?
Plumbing (";? %1 ??_ ( •?} ??*'s ;`. ?:
H.V.AC. cl J ci??G ?:?
^'' ?/?(l Y/
Electric J? ( ? • ???? ?8 ? G c
3 9 ?) ?°""? ) ?- ?, ?
Softener
Inspectlon Date Insp. COmments
Footings I
Footings II
Foundation
Framing y, ?f
Roofing
Rough Pibg.
Rough Htg
Isul.
Firepiace
Final Htg.
Final Plbg.
Bldg. Final
Cert.Occ.
Temp. LP
Deck Ftg.
Deck Final
W@I I
Pr. Disp.
CONTFiACT PRICE
Site Address ' 77
Lot .?_ Block
? Name
? Address,
c Ciiy
` Name
: . . . PERMIT tl
PLUMBING PERMIT RECEIPT tF ?Cti
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
PHONE: 454-8100
BLDG. TYPE WORK DESCRIPTION
Res. , T- New x
Mult. Add-on
Comm. Repair
PLBG. ONLY - COMPLETE THE FOLLOWING:
FIXTURES OT L
_Water Closet - $3.00 v
_Bath Tubs - $3A0 -?- ? ?
.lavatory• - $3.00 . t'?. L^ u?
3
COMM/INO FEE - 1% OF CONTRACT FEE
APT. BLDGS - COMM RATE APPLIES
TOWNHOUSE & CONDO - RES. RATE APPLIES
MINIMUM - RESIDENTIAL FEE - $12.00
MINIMUM - COMM/IND FEE - $20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOW,$1,0009.0)
.
L' !/4?r -A12
SIGNATURE OF PERMITTEE
'
FOR: CITY OF EAGAN
?_Shower - 53.00
?_Kitchen Sink - $3.00 - f
?
?• E% ?
Urinal/Bidet - $3.00
Laundry Tray - $3.00
?Floor Drains - $L50
?Water Heater - $1.50
Whirlpvol - $3.00
----Gas Piping Outlets - $1.50 e-?
(MINIMUM - 1 PER PERMI'n
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
„ <-Rough Openings - $1.50
FEE: -K371 o e
TATE S/C:
GRAND TOTAL: ??3• ??-'?
"
a . . f
3 •
Ttx#ifira#e of (Orrupanry
' citp of eagan
Erparttttrni uf ilunimg jwrrtian
This Certificate rssued pursuant to the requiremenu of Section 306 of rhe Uniform Building
Code certifying tirat at the ti?rre of issuance thrs structure was in compliance witlt the various `
ordinances oj rhe City regulating building construction or use. For the following.•
uk claasikatm :i I NGGE--FAHI LY/ GARAGE etk Plrm;c No. 14536
r- 3
0-wa-r 7)x ?- ?s DWma ryM COM- V-DI
Ki.f ?0 ; ;,;1=?4aU is'JRhSJiLL.L Phia't
owoaatBa,ldiug ? :' L:. . , - !'• ..i Add`ra' , 4, $kIDLE RIDGE ;
Dau: uAR;,'i+
Bw7ding Officaal
POST IN A CONSPtCUOUS PLACE
CASH RECEIPT
CITY OF _EAGAN
3830•PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
DATE ' - 19 •-
R[Ci1VC0....? /. .. .
FROM . - , . . . . _{ !1
+
AMOUNT
& ooLLwRs
7
oo
? CASH Q CNECK
? <1
J 28 `;, White-Payers CoPY
Yellow-Posting CopY
Pink-File Copy
Thank You
?
B Y r ,. _ ?
.
? ^ .
-- .- .r,..r . - . .
BLDG. PERMIT N0.
tiL4
777
01-3210 Bldg. Permit
01-3422 Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm. ? J
01-2155 5urcharge J J ?'
17 -3860 Road Unit
20-2275 SAC 5/1-7
20T3865 Water Conn.
20-3868 Water Trmt.
20-3716 kater Meter 00
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
11-3855 Park Ded.
TOTAL '=x' I
CITY OF EAGAN Permit No: Date:
3830 Pilot Knob Road Meter No: 3 OS ? ;Z- Size:
P.O. Box 21199 Reader No: Q-t? Date: ?AZ i
Eagari; MN 55121
Owner._ '-:eyland liornes
SiteAddress: '74 '-?::L11°lin
Conn.Chg: :?5.t'• c cgbtllnet IJkJlitiP6 ,?,
ACCt Dep: ? ?'
? ?*U?4
?
Permit Fee: '-'? • t.
Surcharge: •=- Dt f_19 11 R F pava -' ' J" with the Clfy of Eagan
Tr. Plant Ordinancea.
Meter. -?/
Misc.- gy-? ?4?4ti ??R"?
WATER SERVICE PERMIT
i
CITY OF EAGAN Permit No: Date:
3630 Pilot Knob Road g/P No: ' Date: -?"? •? S? i
P.O. Box 2i 199
Eagan„,NIN 55121 • ?
()wnar Kv?13T.d t3ot'tea
bai:
le P-iae8
CC: Zoning- -
Ch9: 100' oor No. of Units:
: Dep: 7:5.00p•.'
_ s,,00p;; I agree lo comply wlth the City of Eagan
nit Fee:
• p Ordinances.
CITY OF EAGAN N°_ 14 5 3 6
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE:454•8100
BUILDING PERMIT Receipc# d
To be used for SF DWG/GAR Est. Value $78, 000 Date DECEMBER 31 -'9 87
SiteAddress 774 MILL RUN PATH
Lot 1 Block 14 Sec/Sub. BRIDLE RIDGE 15T
Parcel No.
a Name KEYLAND HOMES
3 Address 14450 BURNSVILLE PKWY
o City B' VILLE phone $94-2636
o Name SAME
?Q Address
: City Phone
City
I here6y acknowledge that I have reatl this application and state that the
information is correct and ee to comply W all applica6le State of
Minnesota Statutes and ty f Eag Or ? c s.
Signature of Permittee - ? _
A euilding Permit is issued to:_Y__ L__D_HQMES.
on ihe express contlition that all work shall be done in accortlance with all
applicable State of Minnesota katutes antl C" ot Eagan Ordinances.
f•
Building Ofiicial _-
?a+
OFFICE USE ONLY
R3
On Sile Sewage _ Occupancy
MWCCSystem X Zoning Rl
On SHe Well (ACtueqConst Vn
City Water X (Allowa6le) Vn
PRV Required - # of Stories
Booster Pump _ Length 50
oeutn 48.33 _
S.F. Total
Footprint S.F. -
APPROVALS FEES
?
426.50
Engr./ASSess. Peimit
Planner _ Surcharge 39.00
Council Plan Review 213.25
Bldg. OH. SAC, City . 100.00
Variance SAC, MWCC $25.00
water Conn. 525.00
Water Meter ----67.90
Road Una 305.00
Treafinent P1 180.00
Parks
TOTAL $2.380.75
This request void ?/
18 nnnths Irom
E 1397.'l /
8&i74?
? S?CP7U o-?
In?uH?r-??? ??rovc?.?????•
I pFVwred? Ready Now QW?1I Notily, InsDec-
? g 9 ?Ves ?No ???r When Peadv
? Licensed EI¢cvical Conlractor 1 hareby request insuection of ebova
XOwner elecbical work installed at
$treet.9dtlress, Boa m Route N
? City? ?
ecuon o. Township am or No. ange No. Cnwuy
Occuuant (PRINT)
C
e1' Phone No.
6
Yb?g
Power SuODI Address
Eleclrical Convacto CompanV Name) Convar.lor's License No.
Mailing AtlJress IContractor or Owner Making Ins[ailationl
Author2ed ignature IContr 1 LO'ber M' ng tallation) Phone Number
MINNESOTAUTqTE BpA?ND OF ELECTflICITY /, THIS INSPECTION HEQUEST WILL NpT
Griqgs-Midway Bidg. ?Jt om N-791 ?J BE ACCEPTED 9Y TFIE STATE BOARD
1821 Universitv Ave.. St. Paul, MN 56104 UNLESS PPOPEA INSPECTION FEE IS
pF??p(9t21B0? MtiO ENCLOSED.
REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-as
1 Sef, instru46ions for comDleting this torm on beck oi Vallow ropy. 0 1?49 E'1 3'97 3 "X" Below Work Covered by 7his Request
say HAtl ReO. Type ol 8uiltl4ng Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Lightiny Fixtures
Apt. Building Dryer Electric Heatm
Cominercial Bldy. Furnace Silo Unloiidcr
Industrial BIAg. Air Conditioner dulk Milk Tank
Farm omrr oeci v 01ncr ?5ne,:,iv1
[ .1 Specify Clmer Otlier
om?ute lnsoectron Fee Below
p Fee ServiceEntrencaSize n Fea ier.ders/5ubleeders N Fex Circults
0 [0 200 Am 5 0 to 30 qm ps 0 to 30 An! s
Above 200 qmps 31 to 100 Amps 37 to 700 Am
Swimming Pool Above 700_Amps Ahove 100_Amps
Transiormer5 lrngation &oorc's Pdrtial."Other Fee
Signs $Vecial Inspection g
,LT TOT EE
Nemarks
n .. ? a ? .
/A )
I nouen-m / / Ihe klauLiCa'I
('? ?? InsDectar, M1eraby
? • rerlily that ?he above
Finai insoection hes been
..? I mi
reQUeat
This request void
18 monehs 1rom
D 81815 L4
Nep-st Date
iz -Zg_ p
LTIi-ensed ElecVical Convac[or
? Owner
Sveei Address, Box or Hwte Nn.
i? oa
I?Hcadv Now B'Oill NolitV InsPec'I
?Nu tor When NeaAy
I haraby requast inspac[ion of above
elecM1ical work insteiled at:
ounty
Eleclrical
or
N,J
" '?' '°`?""' "• ' ' O ins[albtionV ! Phone Numbcr MINNESOTA Siqit 80 O OF ELECTqICITV THIS INSPECTION NEQUEST WILI NOT
C+??gga-Mitlway Bldg. - qoom N•191 BE ACGEPTED BY THE STq7E BOARD
1821 Universitv qye., St. Paul. MN 55106 IINLESS PROPEH INSPECTION FEE IS
Phone(6121642-OB00 ENCLOSED.
I .
. ? S3 6
7987 BOILDING PEAMIT 9PPLICATION - CITY OF EAGAN
SINGLE FAMILY DWELLINGS
INCLIIDE 2 SEfS OF PL6NS, 3 CERTIFICATES OF SORVEY, 1 SET OF ENERGY CALCOLATIOBS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOiiNER MQST DESIGBATE WHICH ADDRESS
IS DESIRED. NO CH9NGES WILL BE ALLOWED ONCE SDILDING PERMIT IS ISSIIED.
MOLTIPLE DWELLINGS - RFSIDENTIAL REHTAL OAITS FOR SALE OAITS
INCLUDE 2 SETS OF PLANS, CERTIFIC9TE OF SQRVEY - CHECK iiITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF
ENERGY CALCULATIONS,
$2,000 LANDSCAPE BOND
-? -
To Be Used Fo
7St@ Ad edr' sS r
Lot 3 Bloek
.
.
Date:
Parcel/
Owner
Address
City/Zip C0844???a?
Phone d 7r ? ? ?
Contractor
Address
City/Zip Code
Phone
Arch./Engr. ?Y
Address
City/Zip Co?t??,?^
Igagggskmo
Phone 4k ---
??y ? r vr r li.n wn vara.i
6 D
On Site Sewage_ Oceupancy f?-3
MWCC System _k!!? Zoning a2-1
On Site Well Type of Const
City Water ? (Actual) ?- N
(Allowable) V-N
/ ll of Stories
r Length D. 50
7 Depth 98.3
S.F. Total
Footprint S.F.
APPROV9LS FEES
Assessments Permit y2 (..h v
Water/Sewer Surcharge 39.60
Police Plan Review 2
Fire SAC, City Inn 00
Engr SAC, MWCC 5?S100
Planner Water Conn 52C, 00
Council Water Meter 6?,Ut?
Bldg Off 12 28 Road Unit z?l?U
APC Treatment Pl 00?
Variance Parks
Copies
TOT9L
Gs9
7a xZ? ? Nyd xr2= SZBa
rl ous?
? ??,?'?y8= IZVgx 5?= ?238?(
r
?.
?
[ t
'SURVEYOR'S CER7IFICATE /
i
PP?N'?y? °°`2
vN ? 0 8?
SIENNA CORPORATION
3410 - 2
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REVISED 12=15-87 SO
HOW ?
EpSEMEtiT PER P? ?5
o
0s3'ai" E `
79J0 N 68
PROPOSED HQUSE BY
? DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES-IRON MONUMENT SET SCALE: 1 INCH = 30 FEET
0 DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR = 892.8 FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR = 885.1 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK - 893.2 FEET
WE HEREBY CERTIFY TO SIENNA CORPORATION THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lof 3. Block 14. BRIDLE RIDGE I ST ADDfT10N, according to ihe recorded
plat thereof, Dakota County, MinrtesoTa.
IT DOES NOT PURPORT TO SHOW IMPROVEMENTS OR-E CRO CHMENTS, EXCEPT AS SHOWN. AS
SURVEYED BY ME OR UNDER MY DIRECT SUPERVI?tbPfH?S ?TH DAY OF DEAMBER , 1987.
r
nPPRnvrn Fnn srErlrin s,GNEO: Qany?s R. i, wc.
caaPoanrtnri /
nv;
nnrr•ni
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BY:
H OLD C. PETERSON, LANQ SURVEYOR
MINNESOTA LICENSE NUMBER 12294
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James R. HiII, inc.
PLANNERS / ENGINEERS / SURVEYORS
I 9401 JAMES AVE. S. 9 BLOOMINGTON, MN. 55431 • 612-884-3029
REQUEST FOfl ELECTRICAL INSPECTION es-ooooi-os
p See ins[ructions ior comoletinq this form on Dack of yellow copy.
? 0 8-0 7? Co
? 91815 "'X" Be1ow Wak Covered by 7his Request
AAtl Neo. Twe of BuilEine AVOlinnms Wired EqaiVmenl Wired ?
tiil4 Fi%tW
Commercial 01dg. hurnace aiio unwaoer
InAustrial 81dg. Air Conditioner Bulk Mllk Tenk
Othnr Peci Y C11ier ISP?,r.i/Vl
p Fee ,ServimEnhanceSize tt Fea Faedars/5ubleade1s d Fee Circuits
0 to 200 qm s 0 to 30 Am>s D O 0 tn 30 Am.
Above 2 0 qm ps, 31 to 100 Amps Z 31 to 100 Am s
Swimming Pool Abwe 100_Am s Above 100_Amps
Transtormers Irrigation Booms Partial.`Other Fee
JignS ?yeciaiinspecuun 5
emirks 1 ? TOTAL
/ ?
Final
I. ' he EI tri
Inspectoq hereby
c rtily thpi the ebou
spaction has been
ronnoae vniA tB
. .,, .
. . , _ExTERIoa_ ENvEi..orF nvcrinr;r ?'n" coMMIrnnou
s
?
OW..NER:- ----?p---------_ nnn :..
SITE ADDRESS:?_S .L7l0 ?.Y?II)S'' PIMNE=
;.;.
CONTRACTOR: )!<eJ!GnH 1-/Ornat
Determine workiny ;quare fnotaqe oF ear.h
1. Total exposed wall area..... 7L.'L,__.!?(I• I't• x
2. Total roof/ceiliny area.....ft.. x .026
cf;-
Total exposed wall area abnve I'loor=
a. Total wall window area ...........................................
b. Total door area ..................................................
c. Total sliding glass door arr.a ....................................
d. Total fireplace wall area ..............................:......... --
e. Total wall framin area (avera e]0;:: --?--"-
9 9 } . . . . . . . . . . . . . . . . . . . . . . . . .
f. Total r•im joist area .............................................. g.,=,;zx Lonet wall area above floor .................................... __1)12?10 ? ?t
h, QLr wa4-1 area aboue floor...cr.c?4A.:s?<z.?::: ..................
i. *?r?r-wakl area akxv-e floor...Ctc?,.tl..:.fxtC'Z...k)'%r>............
j. f'rame wall area at foundation ................................... '? -
lbtal exposed foundatiun area= _7 ? __ __ __
k. Total foundation window area ....................... --
-- --- ---•--
1. Total net fowidation area above grade .............. 7?/ _
Determine "u" value of each wall segmerit
(e,g. window, door, each sernrate wall ser.Cion)
a._?-----?- x „U,,I??.---=---'74123---
G
b. ? --- x U'-
----=-?--
c . 4;Z x u ?. ...--=-?9-- -----,? ? ? -
d. ? X llull „ __--- : --
e.??l.D-_ X „U"-_?C2?°
f. I Ak,:) x liu„
g. If) IQ s.u._3 X „V, ,oLL--= tl 9,37 '
h. 5 / L/. A x IV. - ' C?--3--- -?-`J?--
1. Xoluot!_ oz = ? OC)
?. --- • _ x 11V__- ------
k. X 11 1.11. - _
X Bull_.__??-= ---
3 . .................................Total -_..L( t
__ . . _...._--,-._??: ?....?,_:,.?...?_.,?:......_..?.__. _?_......?. _......_.... . _ _..
T f i cem ;a3 i s the same
as, or less than item "
#1, you have met the
intent of SBC 6006 (c)2,
?
;:?
'Dctnrior Envelope Average "U" Computatiwl
,.
Total expocecl roof/ceiling area = /c;1 yA
m. 7bta1 skyli.yht area ............................ ---
n. Total roof/ceilirxJ framing area (+iverage 10¢)... i;2y,R
o. Total net insulated roof/ceiling rnrea........... /G)3„Q
Determine "U" value for each roof/cciling segment
Page 2 of 9
? ?.. M. X ..u..
n. ?a4,f3 X $poll .oa
o. i/03.;:Z X „U„ Lrco ,
9 .. .. . . . . . . . .. . . . . .. .. . .. . . . Tbtal = 015. y co
?
Zf total of N4 is the stune as , or less t:han ._._----
N2, you have met the intent of
SHr 60U6 (c) 1.
Alternate Huilding Envel.ope Desipn
To uY.ilize the total envelope'system method, the values established by tlie s•.im of
items N3 and N9 shall not be greater than the sum of items fll and #2. .
l. + 2•
3. + A. ?J`;??/!n = ..'i •.??
.
PLA K.t *
., ? UME.,4 L FT. Ex..posEo wALL
BLpG (L ; aa -r a co f aa ?-,o
?E tacp+a?+a c? = 1041
,
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• • , =ecded for dewils and calculations.
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FOR -CITY USE ONLY
PERMIT # ISSUED
93 -7V
Pd w/Bldg. Permit
$
$
$ ? 7 . (S-0
$
$
$
s
$ `a ZJ'cr'C
$
$
$
$
S
$
$
$
RECEIPT
FEES:
s /n- >o
$
$
$
s 15 -?v
S
S
$
$
$
$
$
S ??• ?v
RECEIPT
SEWER PERMIT (INCLUDE SURCHARGE)
WATER PERMIT (INCLUDE SL'RCHARGE)
WATER METER/COPPERHORN/OCTSIDE READER
WATER TAP (INCLLDE CORPORATION STOP)
SEWER TAP
ACCOUNT DEPOSIT - SEWER
ACCOONT DEPOSIT - WATER
WAC
SAC
TRUNK WATER ASSESSMENT
TRUNK SEWER ASSESSMENT
LATEF2AL BENEFIT/TRUNK SEWER
LATERAL BENEFIT/TRLNK WATER
WATER:TREATMENT PLANT SLRCHARGE
OTHER:
TOTAL
DOES UTILITY CONNECTION REQLIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
F__j YES IF YES, THEN A"PERMIT FOR WORK 6VITHIN PLBLIC
Q
ROADWAY" MUST BE ISSUED BY THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SLBJECT TO THE FOLLOWING COIVDITIONS:
APPROVED BY:
TITLE:
DATE :
? cz-? cG??eac
?!-
,
APFLICATION FOR PERMIT iN=. PAYNENf OF PEE AT TIME OF ;
; nerLIcrMM D= Wr coN- ;
srrn= npeawnr, oe POeuT. ;
w r
SEWER AND/OR WATER CONNECTION ? I^n°f'mcN oe s0km nrn/ox wam ;.
y IIISTMJATIONS WflL NO'r SC' e!'4TYRPII i
. . * L'CII'IL PEWT HHS Sffii APPROVm- :
oF ecagcan
1) PROPERTY ADDRESS: fj/ :',
T,FY:Ai• DESCI2IPTION: . . . . .,?. . . /L? .??./,??. . /f??i? . . . . .
Lot B oc?ub?i.vision or Tax P ce ID
IF EXISTING STRDCTURE, DATE OF ORIGINAL BUILDING PERMZT ISSDANCE:. ?
Nbn Year
PRESENT 7ANING/PROPOSID LSE: ,
Q COD'PIE2CIAL/REI`AIL/OFFICE L-V-' R-1 SINGLE FAMILY
Q INDDSTRIAL ? R-2 DUPLEX (TWo Cnits) ?
Q;INSTI7OTIONAL/GOVERNMENT Q R-3 TOWNHOLSE (Three + Omits) ( Units)
iQ R-4 APARTMENP/COfIDOMID7IUM ( Onits)
.
2) NAME:
ADDRESS: °
CITY, STATE, ZIP:
PHONE:
.
3) '? :?• NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
4)
NAME:
ADDRESS:
CITY, STATE, ZIP:
PHONE:
5)
Active
Expired
? l ? .. Not recorded
Sa'? 730-, » St Ia nf? 1t1ar
n
!5±3?- •+/?41 -OZ /Lr MASTIIt LICENSE
CONNECTION TO CITY SEWER I %A CONNECTION TO
WATER n OTfER
6) **+**??*************:r******?********++:*+*?****?+,***?«******???**************+*+**?***,e***?+*******?
,r
THE GOL? COPY OF THE PERNIIT WIIS, BE SENP DIRFX.Z'LY TO PURLIC WORKS 4U FACILITATE MEPER PICK-OP. ?
* PLFASE ATLOW 1W0 NARKING DAYS FY)R PRaCFSSING. SOMEONE FROM TM CITY WILL CONPALT Y(X! IF 7BME *
* HRE ANY PROSLENIS. . .?.
1
1988 BOILDING PERMIT APPLICATION - CITY OF E9GAN
i `
SINGLE FAMILY DWELLING3 -?/
:
INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OE SURVEY, 1 SET OF ENERGY CALCULATIONS
NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE W$IC$ ADDRESS
IS DESIRED. NO CHANGES WILL HE ALLOWED ONCE BOILDING PERMIT IS ISSUED.
MULTIPLE DWELLZNGS RENTAL ONITS FOR SALE UNITS 0 OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SUNVEY - CHECK WITH BLDG. DEPT.,
1 SET OF ENERGY CALCULATIONS
COI+MERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS;
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
To Be Used ForA n i5 ? b+5e-mC4fValuation: Date: ?d
Site Address 'z/y- MllI Ru11 n'tIl
r.ot siockiTar &,?-lY3
Parcel/Sub
Owner (Tim-'f ik
Address "/?4 A4 i I j 0 I4 'n t'a't/1
City/Zip Code ? S y3
Phone
Contractor
Address
City/Zip Code
Phone
Arch./Engr.
Address
On site sewage Oecupancy
hII+iCC system _ Zoning
On site well _ Actual Const
City water Allowable
PRV required _ # of stories
Booster Pump _ Length
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr/Assess Permit N G
Planner Surcharge
Couneil Plan Review
Bldg. Off. SAC, City
Variance SAC, MWCC
Water Conn
Water Meter
Road Unit
Treatment P1
Parks
Copies
TOTAL
City/21p Code
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? CITY OF°EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
Ck 4104
BUILDING
025741
06/05/95
SITE ADDRESS:
P.I.N.: 10-14996-039-14
774 MTII RUM PATH
LOT: 3 BLOCK: 14
BRIDLE RIDGE 1ST
DESCRIPTION:
B'uilding..Permit Type QECK
Building Wo,rk Type NEW
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REMARKS:
FEE SUMMARY:
VALUATIQN
Base Fee
Surcharge
Total Fee
$30.00
$.50
$30.50
$1,200
CONTRACTOR: OWNER: - Applicant -
JUNG PETER
774 MILL RUN PATH
EAGAN MN
(612)688-2889
I hereby acknowledge that' I have read tHfs application and 8tat:e th'at the
information is correct and agree to comply with a11 applicable State of Mn.
L Statutes and City of Eag:an Ordinances: J
IIT SIGNATURE ISSUED B SIGNAIURE
APPL CANT! ER -
_ ??
? ? ? . ? CITY OF EAGAN
3830 PILOT KNOB RD - 55122
? 1995 BUILDING PERMIT APPLICATION (RESIDENTIAL)
681-4675
? 3 registered sRe suneys ? 2 oopies M plan
? 2 copies of ptana (inGude beam 8 window sizea; poured fid. design; etc.) ? 2 site surveys (exterior edtlRions 8 dedcs)
? 1 energy calwlatlons ? t energy calwlations for heated addftions
? 3 copias of lree preservation p)an ff lot platted after 711/93 '
required: _ Yes 4 No
DATE: b-3//9S CONSTRUCTIONCOST: )0.257pa,vd
DESCRIPTION OF WORK: oj5?ek mN tf?Pc? ?EUEZ. ,?owc? ?Etr?L 7?ria
STREET ADDRESS: 72V 1,1141 euN Y'ATH
tl?
3 BLOCK
LOT /11 SUBD
/P
I
D
#: AX IIJ1 .O64,171.,n/
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.
.
.
.
PROPERTY Name: TU n! C, 2 Phone #:
OWNER `"'T
Al/
7 M"
12
P
-
a
Street Address• j
? ulJ
AnV -
City: F-A&a/y State: Mnr Zip; SS?23
CONTRACTOR Company: Phone #: -
Street Address: License #:
City: State: Zip:
ARCHITECT/ Company: Phone #•
ENGINEER
Name: Registration #*
Street Address,
Ciry: State: Zip:
Sewer & water licensed plumber:
change are requested once permit is issued.
Penalty applies when address change and lot
I hereby acknowledge that I have read this application and state that the infortnation is correct and agree to compiy with all
applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Appliqnt:
(J U
OFFICE USE ONLY LM irCertificates of Survey Received Yes _ No 1995 Tree Pre servation Plan Received Yes No
OFFICE USE ONLY
BUILDING PERMIT TYPE
a 01 Foundation o 06 Duplex o 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex o 12 Mufti RepaidRem. ? 17 Swim Pooi
0 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
0 04 SF Porch o 09 12-plex • 0 14 Fireplace o 21 Miscellaneous
0 05 5F Misc. ? 10 = plex ? 15 Deck "
WORK TYPE ?
,,d-'31 New a 33 Alterations o 36 Move `
0 32 AddiUon o 34 Repair o 37 Demolition
GENERAL INFORMATION
i
Const. Actual
( ) Basement s.
q ft. !
MC/WS System
(Allowable) Main leve l sq. ft. City Water ,
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV ?
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code. p sY
Depth Footprint sq. ft. SAC Code
Census Bldg i
Census Unit f o
APPROVALS
Planning Building Engineering Variance
Permit Fee
Valuation: z
$
Surcharge h,
Plan Review
License
MClWS SAC
City SAC i,
Water Conn.
Water Meter
Acct. Deposit I
SNV Permit
S/W Surcharge
Treatment PI.
Road Unit
Paric Ded. i
Trails Ded. ?
'
Other
Copies
Total:
% SAC
SAC Units
i
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PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd Permit Number: EA080408
Eagan, MN 55122 . Date Issued: 10/11/2007
(651) 675-5675~~~ EPermit Category: ePermit
www.ci.eagan.mn.us lflflUl tflflLLL
Site Address: 774 Mill Run Path
Lot: 3 Block: 14 Addition: Bridle Ridge 1st
PID 10-14996-030-14
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, you must meet inspector with ladder and flat bar. Pictures are not
acceptable in lieu of inspections.
Fee Summary: BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
Valuation: 3,000.00
Total: $90.00
Contractor: -Applicant - Owner:
Hometown Restoration Bruce D Johnson
7308 Aspen Ln N #110 774 Mill Run Path
Brooklyn Park MN 55428 Eagan MN 55123
(763) 494-8695
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: Mechanical
Eagan. Permit Number: EA097055
Date Issued: 11/17/2010
OR Permit Category: ePermit
40~ it~ of E3
E
Site Address: 774 Mill Run Path
Lot: 3 Block: 14 Addition: Bridle Ridae Ist
PID:10-14996-030-14
Use:
Description:
Sub Type: e - Furnace
Work Type: New
Description: Furnace
Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson. State Electrical Inspector.
952-445-2840
Scott Lofren
5708 Upper 147th St W -102
Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
Total: $55.00
Contractor: - Applicant - Owner:
Lofgren Heating & Air Brice D Johnson
5708 Upper 147th St W 774 Mill Run Path
Suite 102 Eagan NIN 55123
Apple Vallev NIN 55124
952 431-811
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 Eaaan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
PERMIT
City of Eagan Permit Type: Mechanical
Eagan. Permit Number: EA097112
Date Issued: 11/22/2010
OR Permit Category: ePermit
40~ it~ of E3
E
Site Address: 774 Mill Run Path
Lot: 3 Block: 14 Addition: Bridle Ridae Ist
PID:10-14996-030-14
Use:
Description:
Sub Type: e - Furnace
Work Type: New
Description: Furnace
Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson. State Electrical Inspector.
952-445-2840
Scott Lofren
5708 Upper 147th St W -102
Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
Total: $».00
Contractor: - Applicant - Owner:
Lofgren Heating & Air Brice D Johnson
5708 Upper 147th St W 774 Mill Run Path
Suite 102 Eagan NIN 55123
Apple Vallev NIN 55124
952 431-811
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 Eaaan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
PERMIT
City of Eagan Permit Type: Mechanical
Eagan. Permit Number: EA097112
Date Issued: 11/22/2010
OR Permit Category: ePermit
40~ it~ of E3
E
Site Address: 774 Mill Run Path
Lot: 3 Block: 14 Addition: Bridle Ridae Ist
PID:10-14996-030-14
Use:
Description:
Sub Type: e - Furnace
Work Type: New
Description: Furnace
Comments: Questions regarding electrical permit requirements should be directed to Mark Anderson. State Electrical Inspector.
952-445-2840
Scott Lofren
5708 Upper 147th St W -102
Fee Summary: ME - Permit Fee (Replacements) $50.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
Total: $».00
Contractor: - Applicant - Owner:
Lofgren Heating & Air Brice D Johnson
5708 Upper 147th St W 774 Mill Run Path
Suite 102 Eagan NIN 55123
Apple Vallev NIN 55124
952 431-811
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 Eaaan Ordinances.
ApplicantiPermitee: Signature Issued Bv: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA175323
Date Issued:03/28/2022
Permit Category:ePermit
Site Address: 774 Mill Run Path
Lot:3 Block: 14 Addition: Bridle Ridge 1st
PID:10-14996-14-030
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
Bruce D & Maureen K Johnson
774 Mill Run Path
Saint Paul MN 55123--168
(651) 485-6835
Walker Roofing Company
2270 Capp Rd
St Paul MN 55114
(651) 251-0910
Applicant/Permitee: Signature Issued By: Signature