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1720 Monterey Lane.• ' ? z ?. ? , . ? Date: Site Address: Lot IName - " . Address ;e r+-:;Urt?i City Phone: Receipr No Sirigle Residential No. Multi Res., Comm./Ind. ? New/Alter. / Repai r Cost of Instollction Permit Fee $urchorge CITY OF EAGAN 3796 Pilot Knob Reed Eogan, Minnesota 55122 Phone: 454-8100 E, ATTN r, _ PERMIT ,- 17l`1 Block Sub/Sec. T?Z??eVleW Acres -1icliae.', J. t?'lanagan 50 Phone: I Total sd on the express condition that all worlc shcll be done in acoordonce with oll appiicable State of ond City of Eagan Ordinances. Building ' CITY OF EAG1?N ? g 3795 Pilet Knob Raod Eegen, MN 55122 N° 4733 ' = PHOIdE: 454-8100 BUILDING PERMIT Receipt .# Te be used for Est. Velue Date . 19 Ske Address Erect ? ` Occuponcy Lot Block Sec/Sub. AcXE F Alter ? Zoning Porcel # Repair ? Fire Zone Enlorge ? Type of Const. W. Nome Move ? # 5tories z qddress Demolish ? Front ft. Ci ? Phone Grade ? Depth ft. 0 ? Name ?u Address Assessment - - & S W ~ P ew. ater hone Ci Police ? W Np^'e Fi F re 2 ? Address Eng. a W G Phane Planner Counci I Permit Surcharge - Plan check _ SAC Water Conn. Water Meter I hereby ockrrowledqe that I hove reod this opplicotion and state that gld9, pff. the information is rnrrect ond ogree to comply with oll applicuble State of Mlnnesoto 5totutes and City of Eagon Ordinonces. APC Totol - Signature of Permittea A Building Permit is issued to: on the express condition that all work shall be done in accordance with ell applicable State of Minnesota Statutes and CitY of Eagon Ordinonces. Building Officicl -V r«mir # Dat. iawa p...?n?.. Plumbing f f3 ;L- /p - 7 lu,?ykti; Mechaniccl ? ?p ? • y INSPECTIONS DATE INSP. Rouqh-in finol Footings Date Irup. Date Irup. Foundation ? 4 Ak.4* Plumbing Frome/ins. Mechanical f inal i I Remorks: 717 ??? ? ?,, Ic A-1 :2 ' /-!r-- ;,/ ?,' .? ? • ???? > >?,/ , ? ?'av? ?ld7 ? ?t r 77 `? ?J3?'?r'l CITY OF EAGAN • • 3795 Pilot Knob Road ' Eagon, Minnesofa 55122 Phone: 454-8100 . :T r';.,f`T-``r• 1` "Zl ' PERMIT No. - C?/5/79 1^1`,? Date: Receipt No.: $ingle I ??2? wantere•? Residential Site Address: ' 4 °i?qevin? .F.c? - I Lot Block Sub/$ec. Multi Res., Comm./Ind. Nome - New/Alter./Repair - ? ?2 w. t'7ET)1-.-;??r;•:. 3 Address Cost of Installation O City Phone: Permit Fee Name Surcharge . i P Address 0 0 u City Phone: ToYal This Permit is issued- on the express condition thot oll work shall be done in accordance with all applicable Stote of Minnesota Statutes and City of Eogon Ordinances. Building Official CITY OF EAGAN Remarks Addition Rid e Vi w Acres Lot 1 BIk 4 parcel 10 64000 010 04 Ownes???' -Street 1720 on Lane ? State Eagan, MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. - 1977 2279.25 227,93 10 1823.41 A005780 -6-78 STREET RESTOR. GRADING .?O SANSEWTRUNK 1968 10 . . 33 30 63.37 A005780 -6-78 ?3 SEWERLATERAL & Stub 1972 $2359.00 $117.95 20 1533.35 A005780 -6-78 WATERMAIN *WATER LATERAL & Stilb 197 WATER AREA 138.68 A006017 5/19/78 STaRM 5EW TRK -M/ 19$3 561. 00 37.40 15 STORMSEWLAT 1,011 1978 515.20 51.52 10 480.86 A005780 4-6-78 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 250-00 - - BUILDING PER. -T4-733 sac 500.00 9565 4-7-78 INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: t I 1 1 H I I 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: ?? ? ? ! ? • ` ? ?": (612) 681-467,5 1 ? 1 A-0 ll Fe L1 Ll L' ?i^ i i SITE ADDRESS: ? ? ? ? ? ? ? ? ?? ? ? ? APPLICANT: MOMi t ht= i t ANf flt`RF.r, 1 Nt! t?r PERMIT SUBTYPE: TYPE OF WORK: iA 13 nI I ? J 111 1:+'14 11, 1 7o N Ut kM?i I', f jfft'19 NAMIitif Permit Holder Date Tetephone # PLUMBING HVAC Inspectfon Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUM8ING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METER ? IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK FINAL CITY OF EAGAN WATER SERVICE PERMIT 3795 Pilot Knob Road PERMIT NO.: Eogan, MN 55132 DATE: - • i Zoning: No, of Units: Owner: Address: Site Address: _ .. J Plumber: _ ' • ' ' Meter No.: . Connection Charge: ; Size: Account Deposit; Reoder No.: Permit Fee: 1 a9? ?comPlq with the Citr of Eagan 5urcharge: r j Ordinances. Mix. Charges: :uetfY' Totol: SY Date Poid: Dote of Insp.: I nsp.: SEWER ? TY OF EAGAN 515 Pilo! Knob Road SERVICE PERMIT PERMIT NO.: gan, MN 55122 DATE: ning: No. of Units: ner. [ dress Address: mber. 9?? ? complp wifh the City of Eogon Connection Charge: ?rdinances. Account Deposit: Permit Fee: Surcharge: _r By Misc. Charges: Daie of Insp.: _ Total: Insp.: Dote Paid: This request void 18 months &om - - ?/ ? 5263 D2.e of this Request 1, as ? Licensed ElecVical Contractor wner, do hereby request inspection of thp above electri- cal wiring installed at: L? 13+ -70?- Street Address or Route No. Section Township Which is occupied Is a roughin Range ° on ffiis job? No ? Yes a Ready Now ? Power Supp(j?fC./ll?Cf-??/ AddF'ess v ? t/ Electrical Contract??c??/?-?--` Contractor's License No. _ (COmpany Name) Mailing Address (Electrical Contractor or Owner Making This InstallaHOn) Authorized Signature Phone Nq; .?-, (Electrical Contractor ol Ownei Making Thls InsCallatlon) 5 j? n?? ?? (!, ?D (/'??? This inspection request wi11 not 6e accepted hy the I! (!?l fr,1 lt, SWte Baard unless proper inspection fee is enclosed. Minnesota State Board of Electricity , niversity Ave., St. Paul, Minn. 55104-Phone 645-7703 REQUEST FOR EIECTRICAL tNSPECTION CHECK BELOW WOAK COVERED BY THIS REQUEST 1?/' 03 ? 26 Type of BuAding New d. Rep. Check Appliances Wired For Check Equipment Wired Fo: Home ? ? Range ? 7emporary Wiring ? Duplex ? ? ? Watet Hea[er ? Lighting Fixtures ? Apt Bldg. ? ? ? Dryei ? Elec[ric Hea[ing ? Commeicial Bldg. ? ? ? Furnace ? Silo Unloader ? Industrial Bldg. ? ? ? Au Conditioner ? 8ulk Milk Tank ? Farm ? ? ? Lis[ 1 List Othec ? ? ? } Herergl HereersL COMPUTE INSPECTION FEE BELOW Secvice Entrance Size: ik Fee F &S Fee Cucuits: u Fee 0 to 100 Am s. O.to 30 Am eres Nt 31 [0 100 Am exes Above 200 Amps. ve Above 100 Amps. Transfoimers 1 1 Remote Control Ciic. Paxtial or other fee - Signs Special 1ns ection Minimum fee $5. !-? Remazks TOTALFEE I, the Electrical Inspector, hereby tha e bqve inspection has been ma¢4. /t_- 7'} (Rough-in) / Date (Final) r Date j-.'G ` ? Z This request void 18 months from cirr oF EAraN 3795 Pilot Knob Road Eagon, MN 55123 N2 4733 PHONH: 454-8100 BUILDMIG PERMIT APPLICATION 51 000 Rece;pt # 9565 $ , . To 6e used fer Sf Dwlg. & Gaxgiv Value Date APtil 7, 1 q 78 . Sita Address 1720 MOntereV Erect Oc<uponcy I Lor 1 Bixk 4 Sec/sub. Ridgeview Acres qlrer ? Zoning RL - Repair ? Fire Zone 3 10 purcel # 64000 Qj„Q 04 e ? Enl e of Const V T arg . yp m Name !JiChael J F18n8ean Move ? #'Smries i ? Address 222 W. Wentworth Demolish ? Front 44 ft_ O . St. 455-6671 x 260 Paul Grade ? Depth 44 rr. c phone p Name Capp Homes Apvovale Fees ?r ? Address ? r:... Name _ Address 1 hereby acknowledge that I have read this a ication and stote that the informution is mrrect and agree t?o,?o y wit?yM opplicable State of Minnesoto Statutes qn?Qlty?yf n?0jqjf(ances. Signature of PermiMea A Building Permif is issu all work sholl be done ir Assessment Water 8 Sew. Polite Permit 142.UV _ Surchurge 25.50 Plon check Fim snc 500.00 Eng. plonner Council Water Conn. 250•00 WaterMeter 60•00 Road Unit 75.00 Bldg Oft -- . . APC Total 1052.50 J FAn8g8n on the expres condition thot applicable State ot Minnesom Statutes and City of Eagan Ordinances. Bu(Iding Officiol -14 L?3) Dnre -1/ 3 - > 5r $UILDIPdG PERMIT APPLICATION Ihclude 2 sets of plans, 1 site plan W/elevations and 1 set of energy calculations. ? .?.. To be used far Valuation 5ite Addresc: / Lot B1 ock Sec, Sub. ? _ 11' .qGyr Es Ommes /jG???f L J ? ??,?a9 6,c Address ?' " / O? . a,2 i Contractor Address 3SSS`' /iA w?iff3 A?C- cf Parcel Numbe ^ ?? j?g?000 0/4 Dif Te2ephone ??,??-c?s7_a3?> Telephone Arch./Eng. Telephone Address OFFICE USE Erect Occupancy ? Alter Zoning ? Fepaiz Fire Zone 3 Enlarge Type of Const. G? Move fl of Stories ifettolish Front Grade Oepth OFFZCE USE - Oate of Approval & Initial FEES Assessment y/3f7'Sr Pezmit Water/Sewer Sssrcharqe 2 6 -? Police Plan Check Fire SAC 5o.n _ v.9 Lrn4• t^?ater Gonn. 1? - Planner 6•Iater Metet L O Crouncil Hldg. Off. A.P.C. TOTAL N olf 6414 Q ?eav?•?^ f -- Y" W J G 3 / ? -?'?/- /S"? '? ?v al 0 ? ? 0 .ftI1,1n L. L ? a ? 107- h??D G= /e,rc V; ?v i? . 1 BEA BLOMQUIST WYOR THOMwSEGAN hWRKPARRANTp JAMES A. SMITH THEODORE WACHTrR COUNCII MEMBEflS .a CIT? ?OF; ; EAGAN g ?? $7ps PI1.OT- /(NO6,ftOAD': ?. "?Ti ` . AGAN,'°KdINN E E50TA ? . ..,?}z 4? PNONE 461l100?? . '?W? rveg,,,s? .' } a, x TNOMAS ME W ES WTY A[#AIN157RF70N EVGENEVAN OVERBEKE dTY CLEPI( April 13, 1982 Michael J. Fianagan 1720 rYrnterey Ime, Fagan, MN 55122 Re: House at 1720 Nbnterey Iane, Fagan (IDt l, Block 4, Ridgeview Acres) Ffnal Inspection Required $y Law State of Minnesota, 2 MCAR Section 1,0101 - 2?1CAR Section 1.18901 City of Eagan, Ordinance 36 Dear Mr. Flanagare: To complete our files a final inspection is needed on: Plumbing Heating Structural X Final inspections are necessary to provide the greatest possible protection for the present or future occupants pertaining to li£e sa£ety and environ- mental health. Please contact us immediate7y for the inspections checked above. City o£ Eagan gui,lding Inspeetors THE IONE OAK TREE ... TME gyMBOL OF STRENGTM ANDGROWTH IN OUR COMMUNITY 9EA BLOMQUIST MAYQP TNOMASEGAN MARK PARRP.NTO JAMES A. SMITH THEODORE WACNTER COIINCIL MEMBER$ auiy 23, 1981 Michael J. Flanagan 1720 Monterey Lane Eagan, MN 55122 , -' ? - , CITY OF EAGAN s?.974S PILOT KNOB NOAO'_ b'. ` EAGAN. MINNESOTA ' 155122 .P ? Y? MIONE ?3?-SIOO . . ^., -. ? •- _ e:? ' a<r/ ? , : Y Re: 1720 Monterey Lane,'Lot 1, Hlock 4, Ridgeview.Aeres Addition Final Inspection Required By Law State of Minnesota, 2 l.SCAR Section 1.0101 - 2 adCAR Section 1.18901 City o£ Eagan, Ordinance 36 Dear Mr. Fianagan: To complete our files a final inspection is needed on: Plumbing X Heating X Structural X TMOMASMEDGES Crv aoMinisrWoR EUGENEVnNOVERBEKE CITY LLERK Final inspections are necessary to provide the greatest possible protection for the presen? or future occupants pertaining to life safety and environ- mental health. Please contact us immediately for the inspections checked above. City of Eagan Building Inspectors TH£ LONE OAK TREE ... TNE SVMBOL OF STRENGTM AND GROWTH IN OUR COMMUNITY. FERMIT ? CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMITTYPE: $usLozrvc PermitNumber: 033011 Date Issued: 0 8 J 2 6 j 9 B SITE ADDRESS: P.I.N.: 10-64006-010-04 1720 MON7EREY LANE LOT: 1 BLOCK: 4 RIDGE VIEW ACRES DESCRIPTION: REROOF/STORM DAMRGE Bu,i?h"<,permit Type STORM DAMAGE B4].i1ipq?"WQLrk 7ype REPAIR (A"ensWs `Cade434 ALT. RESTDENTIAL g? ? a? s ,-s g? ?Ge„', m ?'?'? "?'^t € 4 ?"3rqa: { ii f'? u? `?'% gg,Y ?, yM&? tkt' REMARKS FEE SUMMARY: ?+? Tp??±?{R "rN,.....a''? - ??. ?i?. Fl'7T?'?AE'R5.`CA?S'BES7 INC. 17070100 2@1397@3 ?WNER: . ?=s? 2400 INTERLflCHEN DR 222 1720 MONTEREY LANE SPRING PARK MN 55384 EAGAhI MN 55122 (612) 707-0100 (651)586--8362 f x hareay infarmat„ ?_? a trft'?s`+ ?. > r We te,a`d 'aPP;.€ic`ata,on a,hd 0G4ti rMat the ] `ta camply'-witf? wl I `OAP13ca,b1s St?te-utp9n,,, APPLICANT/PERMITEE SIGNANIiE IS 0 BY: SIGNATURE ? ?? 199$ BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PII.OT KNO;RD - 55122 0 ? 9 New Conshuetion Reauirements RemodeUReoair Reauirements 3 registereC sBe surveys ? 2 mpies of plan 2 copies of plans (inGude beam & window sizes; poured fid. design; etc.) ? 2 site surveys (exterior additions & dedcs) 7 energy qlalations ? 7 energy ealculations Mr heated add'Rions 3 copies of tree preservation plan if lat platted after 711/93 required: Yes Na DATE: `?v c? ? Cl r DESC ION OF W STREET ADDRESS: ? LOT: BLOCK: SUBD.lP.I.D. Name: v`-' (-? Phone #: l9 SlS' PROPERTY Last Firsc OWNER Sueet Address: CiTy State: Zip: Company: Phone#:'?oy-\ -(7(dC? CONTRACTOR 1 ? 2 Sneet Address: License tl City . Y??1`J ??Dn I)Gv' L State: Zip: ARCHITECT/ ENGINEER Street City State: Sewer & water licensed plumber (new construction only): and lot change is requested once permit is issued. Zip: Penalry applies when address chang 1 hereby acknowiedge that I have read this applicatlon and state that the infortnation is correct and agree to compty with all applicab! State of Minnesota Statutes and City of Eagan Ordinances. ?? Signature of Applicant: OFFICE USE ONLY Certficates of Survey Received _ Yes _ Na Tree Preservation Plan Received _ Yes _ No _ Not Phone #: Registration #: CONSTRUCTION COST; ( O S l ? ? OFFICE USE ONLY BUfLDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? OS 8-plex ? 04 SF Porch ? 09 12-plex ? 05 SF Misc. ? 10 = plex WORK TYPE 0 31 New ? 33 Afterations ? 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning ? 11 Apt./Lodging ? ? 12 Multi Repair/Rem. ? 0 13 GaragelAccessory ? ? 14 Fireplace ? ? 15 Deck ? 36 Move ? 37 Demolition 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscellaneous Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building MC/WS System City Water Fire Sprinklered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit Engineering Variance Permit Fee Surcharge Plan Review License MC/WS SAC City 5AC Water Conn. Water Meter Acct. Deposit S/W Pertnit S!W Surcharge Treatment Pi. Park Ded. Trails Ded. Other Copies Total: Valuation: $ % SAC SAC Units 2005 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. 4?5 ,5o Date_? o /I cl /0 S_ Site Street Address L 1? Unit # Property Owner c1`2 L. ?i Telephone # (?s ( -S 36 2 H.P. PIPEWORKS Contractor ?M DODD ROAD Telephone # ( ) Address (651).365 13,40 City State 2ip The Applicant is: _ Owner 't_?Contractor _Other Alterations to existing dwelling $ 50.00 _ Add plumbing fxtures. This fee includes putting in a water softener and/or water heater at the same time. If you are installinp onfv a water softener and/or water heater, do not complete this section. Move to the next section and check the appliance(s) you are installing. _Septic System Abandonment _ Water Turnaround (add $125.00 if a 5/8" meter is required) Other: _ Water Softener YvWater Heater $ 15.00 _ new _4<_replacement Lawn Irrigation _RPZ _PVB _new _repair _re6uild $ 30.00 State Surcharge $ .50 Total $ I5, sv I hereby apply for a Residential Plumbing Permit and and accurate; that the work will be in conformance Eagan and the plumbing codes; that I understand this permit, work is not to start without a permit and work the event a pian is required to be reviewed and approvg acknowledge that the information is complete with the ordinances and codes of the City of is not a permit, but only an application for a will be.in accordance with the approved plan in PIC ,}`t1d.01' n uJ 4_,,QYS Applicani' Printed Name N?J' 4 IS.S0 ; i y ~ i = " ~ a ) i. ~ ; ! ~ { ~ ~ Y.. . 4 t X . ~ . . . ~ . . ~ t ~ i . ~ . . . . . . . . ~ . . y . l . . . ~ k ; ~ £ , f ~ . . , . .n . . . . 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I .m..~,a ..w~ o , m z ~ ; . i , ' z . . : ! i , , : . . ~ ~ ~ . . . , E. . . . . c,r . , . «a~ a`. ~ ~ ~ z ~ ~ ~.M. . .~..w.._.n. ~ . ~ ~ ( ~w . . . . I ¢ ~ ~ r ~ { . .i . Y v. . ~ ~ . . . . . . . . . ~ ~.^py . . . . . . ~ ? . . ~ ,.J 1 ~r ~ ~ . . ~ I ~ E i ~ ~ ~ ~ ; , ; ; ~ , r,. : y s 5 ~ ~ * ~t~ s ~ ~ , ~ ~ ~ e s `t , a.y...~_ t , a ,.re..m ....«.,..«,.e....w..~,., i . . g , . ~ j ~ i ~ ~ ~ 's ~ . . . 5 : . ~ ` r q ' . ~ ~ . ~ ; . ~ z . ; y ~ ~„g# : gy h e: ' , . ~ ~ t~ I ~ ; ~ , , , . a ~ . , . . ~ . ,:h . __m.~... . . K~, v,~- .,k.,~ .w,.,~ , ,,..~~..o 1, ~~r.~, a ~ ~ ~ ~ ~ ~ . . M.t,..,,,.~~,_ ~ ~T. br.Ww~.__ sw.~~~,~.w,~~-:._„ w~ .o~.W~~_ ~.,.:We ~w~-' ~...~,w~N~_~ ~,,s.,.~,,. .....:,w. , s > ~ k - . ~ ~ , s; d'". 3r,.:.'; p : _ _ ~ . ~ , ,i , ; . . . . _ . . . _ _ _.r , . . . . . , - ~ . . . . _ . . , _ _ ' ~j -:;s r. ~ ~ i ~ F ' ~ ~ = $~.F < r ~ , t :t ~ I I ~ PERMIT City of Eagan Permit Type:Building Permit Number:EA128287 Date Issued:11/03/2014 Permit Category:ePermit Site Address: 1720 Monterey Lane Lot:1 Block: 4 Addition: Ridge View Acres PID:10-64000-04-010 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - 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 by law in ALL single family homes . 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 - Hao Liu 1720 Monterey Lane Eagan MN 55122 Window Concepts Mn 291 Eva St St Paul MN 55107 (651) 905-0105 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA145479 Date Issued:09/11/2017 Permit Category:ePermit Site Address: 1720 Monterey Lane Lot:1 Block: 4 Addition: Ridge View Acres PID:10-64000-04-010 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. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). 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 - Howard H Liu 1720 Monterey Lane Eagan MN 55122 Polar Builders Inc 1103 West Burnsville Parkway Suite 110 Burnsville MN 55337 (612) 432-1597 Applicant/Permitee: Signature Issued By: Signature