4024 Northview TerI
I
BLDG.
01-3422 Plan Check
01-3445 Surch./Adm.
01-3446 SAC/Adm.
01-2155 Surcharge
r
75-3860 Road Unit
2(1-2275 SAC
20-3865 Water Conn.
20-3868 Water Trmt.
20-3716 Water Meter
20-2252 Acct. Dep.
20-3713 Water Permit
20-3743 Sewer Permit
79-3866 Sewer Conn.
28-3855 Park Ded.
TOTAL
?
?
? i
,
[7
)l7
? CASH RECEIPT ?
CITY OF EAGAN
' 3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
?
•;,
DATE
RECEIVED
FnOM
/ •
-? AMOUNT
;J
& DOLLARS
lao
? CASH E? CHECK
r
8Y i L LtA
WhAe--Payers Copy
Yelbw-Posting Copy
Pink-Fiie Copy
Thank You
CITY OF EAGAN 15496
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 551 21
PHON E: 454-8100 1
BUILDING PERMIT Receipt#
Tobeusedfor =t?' iJivG/C??ti. Est.Value Date r+`::.??'??'i ?-
SiteAddress ?+{'4'+ ?eUx'i::G :.:..° -:,i;?'•C:. OFFICE USE ONLY
Lot f' Block -' SeC/Sub. Ll::: L:;1. ;0:? Y_e,:tXV i_:i On SRe Sewage Occupancy
MWCCSystem Zoning Pfi u-'i
Parcel No.
On Site Well (Actual) Const
x Name ji}?? `:IL.LEEt C011$TRUCT1t?c: CityWater x (Allowable) Y-N
; iL4133 Ci?ii_'4K AVE $
Address PRV Required # of Stories
0
City l ARMIldGTON Phone 431-2001 Booater Pump Length 52 ?
Depth 44?
o Narte SAISE S.F.Total
O Q AddreSS Footprint S.F.
u
°-`
City. Phone
APPROVALS
FEES
? ¢
W
Name Engr./Assess. Permit 708• 00
W
??
Address
Planner
Surcharge ?n? ?
Z
Council
PlanReview 354 00
•
i
W City Phone
Bldg. Off.
SAC, City 1?
?
•
I hereby acknowledge that I have read this application and state that the Variance SAC, MWCC 550• M
information is correct and agree to comply with all applicable State of Water Conn. 550•00
Minnesota Statutes and City o1 Eagan Ordinances. Water Meter C•7•00
_
Signature of Permittee --
Road Unit
325_OD
A'Building Permit is issued to:_ L''= Treatment P1 204:?
on the express condition that all work shall be done in accordance with all
Parks
applicable State of Minnesota StaYUtes and City of Eagan Ordinances. 2 qYS -.50
Building Official _ TOTAL
?, .
PERMIT #
?- MECHANICAL PERMIT
RECEIPT #
CITY OF EAGAN
3830 PILOT KNOB RaAD, EAGAN, MN 55122 DATE:
CONTRACT PRICE: PHONE: 454-8100
Site Add s !?'e BLDG. T Y P E WORK DESCRIPTION
Lot T Block
1
t' - Sec/.Sup Res. ? New
,
•-(.n.? . ?_? ? . ...Ll?
? Name Mult Add-on L.
A
Address
%? ? '? > ? ? ? ?
? • Comm. Repair
c City ? ???rv ' Phone 'V Other
FEES
? Name 4 • " -. 0 RES. HVAC 0-100 M BTU -$24.00
c Address ?'? j?? tio'?'? y• ??? ?r?'?? ADDITIONAL 50 M BTU - 6.00
O ???Y Phone ysy 67f'? (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS
MINIMUM
1 PER PERi
Al
5
E A
(
-
i
n - 1.
0
.
TYPE OF WORK COMMJIND FEE - 1% OF CONTRACT FEE
Forced Air M BTU APT. BLDGS. - COMM. RATE APPLIES
??
B TOWNHOUSE & CONDOS - RES. RATE APPLIES
o
? M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
Unit Heater M BTU REMODEIS - 12.00
Air Cond. ?E0 C, M BTU MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
Vent CFM (ADD $.50 S/C IF PERMIT PRICE GOES
Gas Piping Outlets # $ BEYOND $1,000)
Other $ _
FEE: --.-
., _
?
S/C: SIGNATURE
R EE
TOTAL /1 • ?l? ?
FOR: CITY OF EAGAN
, CITY OF EAGAN •? 549 4 '
" y 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
` PHONE:454-8100
BUILDING PERMIT Receipt
To be ujed4or Est Value t• Date ,19
SiteAddTess ?'°'= •? :+< , vrrw e vae a,nvLi
Lot BtoCk Sec/Sub. '?' On SRe Sewepe Occupancy
- MWCC Syetem Zoninq
Parcel No.
l
On Site We
l (Actual) Const
Clty Water •i (Allowable)
a Name
W
=
Address PRV Required * of Stories
City Phone BoosterPump Length
Depth
a
o Nflme S.F. Total
? ? Address Footprint S.F.
? City Phone APPROVALS FEES
v W Engr./Assess. Permit _
Name
i Planner Surcharge '
Address
? Council Plan Review ?
? W City Phone Bidg. Off. SAC, City i
I hereby aCknowledge that I have read this apPlicatlon and atate that the
l
bl
t
f
S Varience SAC, MWCC
ta
e o
information ia correct and agree to comply with all app
ica
e Water Conn.
Minnesota Statutes and City o} Eapen Ordinances. Water Meter
Sipnature ol Permittee Road Unit
A Building Permit is issued ta Treatment P1
on the expresa condition that all work ahall be done in accordance with ell
Parks
applicable 5tate of Minnesota Stetutea and City of Eagan Ordinances. ' ?
Bullding OHicial TOTAL '
, Permit No. Psrmit Holder Qate Tslephona
Plumbing
H.V.A.C. c,o Ltr4,-
Electric
?
CoZC! 7'• ? ?. ?? ?? ?'('?"?
Softener
Inspection Date Insp. Commsnts
Footings I ?
Footings II
Foundation
Framing
Roofing
Rough Plbg.
Rough Htg. ?s Aef
Isul.
Fireplace
Final Htg. o,? ?
Final Plbg.
Bldg. Final
cert occ. ?-
Temp. LP
Deck Ftg.
Deck Final
Well
Pr. Disp.
`
.
`
? 4
.
, Ttr#if iraft of (Orrupanrg
titp of (Eagan
lePpa1'#wpltf itf s1iaTlto jIB,pP1'tiD1t
Thrs Certificate issued pursuant to the requiremenu ojSection 306 of the Uniform Buildrng
Code certifying thar at dre tinre of issuance this structure was in compliance with the mrious
ordinartces of the City regulatiMg burtding construction or use. For the following:
ux cwsihatioo SF DWGIGAR mde. Rrmic No, _
OccuPu-Y TYPe R3" "! Zonin6 Dutricl PD/F I TYPe Coml
ownff of BUMBS ,R' 1"A7.IFR 0M. Ad&= 18133 al)AR AlrE, FAFWUCIG4
4024 ."Y-:TF7!?*..i ZF??RA?.:' L91 I33, ?III+?:'1?'''v i'?;I?:??Z?"„i
Bwlding Addrtm I.aaliry
OCM= 25• j?:`?
Ihk:
Building Offia4
-
POST IN A CONSPICUOUS PLACE
?SF„ . . . . . . . .. ?' r. . . . _ . . . . . . .. .
PERMIT M i 15 l_' C(
PLUMBING PERMIT RECEIPT #
' CITY OF EA(iAN
3830 PIIOT KNOB ROAD, EAGAN, MN 55122 DATE: ?
CONTRACT PpICE- . PMANEc 454-e100
Block .
? Name
? Addre
c City ?
Name
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDCS - COMM RATE APPLIES
TOWNHOUSE 8 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
OF
FOR CITY OF
BLDG. TYPE WORK DESCRIPTION
Res. New
Mult. Add-on
Comm. Repair
Other
RES. PLBG. ONLY - COMPLETE THE FOLLOWINO:
Nf? FIXTURES TOTAL-
Water Closet - $3.00 $
?Bath Tubs - $3.00
?Lavatory - $3.00
? Shower - $3.00
?_Kitchen Sink - $3.00 ?
Urinal/Bidet - $3.00
?-Laundry Tray - $3.00
-7-Floor Drains - $1.50 ?S
=Water Heater - $1.50 Whirlpool - $3.00
ZGas Piping Outlets - $1.50
(MINIMUM - 1 PER PERMIT)
Softener - $5.00
Well - $10.00
Private Disp. - S10.00
=Rough Openings - $1.50 "?• ?
FEE
STATE S/C: ?
GRAND TOTAL: 'J
PERMIT # _
MECHANICAL PERMIT
'? ' - • CITY OF EAGAN RECEIPT # -
e? 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE:
SiteAd.Oress
Lot ? Block
m Name
m Addre
c City `
? Name
c Addre
O CitY -
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent.
Gas Piping Outlets #
Other
? . .. , _ . . Y ..
?...> , a
G
BLD
. TYPF?. WORK DESCRIPTION
Sec/Sub
1 ' ? L',1 VV Res. New ?
Mult Add-on ,
Comm. Repair
?
Phone ' Other
FEES
HVAC 0-100 M BTU -$24
00
RES
`??= ' ? •? ` .
.
ADDITIONAL 50 M BTU - 6.00
Phone `S? ''?- •''' ,?. ? (RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS-OUTLETS (MINIMUM
1 PER PEFiMIT) - 1
50 EA
.
.
-
M BTU -4- COMM/IND FEE - 1% OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPUES
M BTU ?i TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADD-ON 8
M BTU
M BTU $
?- CFM REMODELS - 12.00
MINIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
?---- . BEYOND $1,000)
FEE
,
S/C: ' SIGNATURE OF PERMITTEE
TOTAL: ? •
FQR: CITY OF EAGAN
CITY OF EAGAN Permit No:00 Date:
3830 Pilot Knob Road Meter No: N/D o Y 0Size: ?
P.O. Box 21199 Reader No: 0? O/ Date:
Eagan, MN 55121
Site Addre;
Plumber
Conn. Chg:
AccL Dep:_
Permit Fee;
Surcharge:
Tr. Piant_
Meter. _
I agree to comply wiih the City of Eagan
Ordinances.
?
By
WATER SERVICE PERMIT
OF J!AGAN Permit No: S Datec C
pRot Knob Road B/P No: ?6b97 Dete: ?
3ox 21199 ??- -
e, MN 55121
No. of Unita
I ayree to aanpy *11b pM ?r
Ordinsncm.
Zoning: _
No. of Units:
SEyVER fiPRYIGE PERMIT
' OF EAGAN Permit No: Date:
i P11o1 Knob Road B/P No: Date:
Box 21199
3n. MN 55121
'r.....f...{- re....?..? t o aA t-a.....
:.C: Zoning• '
Chg: No. of Units:
. Dep: I agree to comply with the City of
nit Fee: Ordinances.
SEWER SERVICE PERMIT
CITY Of EAGAN Permit No: Date:
3830 Pilot Knob Road Meter No: Size:
P.O. Box 21199 Reader No: ?
Eagan, MN 55121 Date:
W r ?
Owner. _ ina = f1 Z ar t ?
Sile Address- "?324 hinrtM.tas. T.r,-..m T o IR'!
Conn. Chg: sso pppd Zoning: F1 '
Acct. Dep:_ 114 kl No. of Units:
Permit Fee:
Surcharge: <<?.3 I agree 1o comply with the Clty of Eagan
Tr. Plant Ordinances.
Meter.
MISC.: e..
89954
?kz'I,
C?C^[.?`??/ ?J C'Z7
Request Data ire No. Rou9h I pectian
Requl
? Reedy Now XWill Notity Irepector
4/4/89 ? Yes No When Ready?
I ppicensed contractor ? owner hereby request inspection of above electrical work at:
.bb Atltlress (Sheet, 9oz or Ro
_ N?o.
u?le Cily
,
`
4024 North?n e rrace Eagan
Sectlon No.
TowreMp Name or No.
Range No.
Ccuny
I I Dakota
Occupant (PRIfJT) PMria No.
Rich Peters 454-6740
Power Suppllar Atltltess
Elecincal Comractor (CompanY Name) Conirac[or§ License No.
Hilite Electric, Inc 040445
Mailirg AdOress (COntrador or Owner Makinq Installatmn)
1953 Shawnee Rd, Ea an, iMN 55122
Autlionz9CS?qnature (COnir r/ r aki
' stallation) Phorie Number
y 452-8886
MI AFPrA d&%LECTRICRV THIS INSPECTION REOUEST WILL NOT
Grlggs-MMwey Bldg. - qoom S173 BE ACCEPTEO BYTME STATE BOARD
1821 Univenity Ave., SI, Peul, MN 55100 UNLESS PROPER INSPECTION FEE IS
Phone (612) 642-0800 ENCLOSEO.
REQUEST FOR ELECTRICAL INSPECTION ^eaooom m
P, See insimctians for compleling )MS fqrm yi bazk of yellow copy.
2 8 9-9 5 4 "X" Below Work Covered by This Request
ew Add Rep. Typeofeuilding AppliancesWired EquipmenlWired
Home Range Temporary Service
Duplex Water Heater - Electric Heating
Apt. Building - Dryer Other (Specify)
Comm./Industrial Furnace
Farm ' $ Air Conditioner
Olher (apecity) ConVador§ Remarks: Compute Inspection Fee eelow: JOb # 20336
# Dther Fee # ServiceEntranceSize Fee # Cirouiis/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 700 Amps
Transformers Above 200 _ Amps Above l Amps
Signs Inspectork Use Onry: T
AL
Irrigation eooms 1 S.$0
Speciallnspection C
Alarm/Communication
O[her Fee
I, the Elechical Inspector, hereby
if
h
h Rough-in owe
cert
y t
at t
e above inspection has
been made. Final
47
wv /
OFFICE IISE ONLY
This request vaid 18 months irom .
CITY OF EAGAN N° 15 4 9 6
3830 P(lot Knob Road, P.O. Box 21•199, Eagan, MN 55121 '
BUILDING PERMIT PHONE:454-8100 ReceiPt# A0017
Tobeusedfor SF DWG/GAR Est.Value $141,000 Date AUGUST 18 ,1 g 88
Site Add-ress 4024 NORTHVIEW TERRACE
Lot 9 elock 3 Sec/Sub.LEXINGTON PARKVIEI
Parcel No.
e Name JOE MILLER CONSTRUCTION
W Address 18133 CEDAR AVE S
°z City FARMINGTON Phone 431-2001
o Name_
oa Address
V
F CiltY_
1- ¢
w W
Name
?
Address
a w City Phone
I hereby acknowledge that I have read Ihis application and state that the
inlormation is correct and agree to comply with all pplicahle State of
Minnesota Statuies and of Eag@n Ordi es.
Signature of Permittee
A Building Permit is issued to: E MIj,LER_CQNGT
on the express condition that all work shall be dOne in accordance with all
aD0licable State o?f Minnesota Statutes and City of Eagan Ordinances.
Building Official 11?iAp ra??rn r
OFFICE USE ONLY
On Site Sewage - OccuDancy R-3 M-1
MWCCSyslem X Zoning pD R-1
On Site well (Actual) Conat V-N
Ciry Water X (qilowable) V-N
PRV Required _ # ot Stories
Booster Pump _ Length 521
Depth 44,
S.F.TOtel
Footprint S.F.
APPROVALS FEES
Engr./ASSess. Permit /08.00
Planner Surcharge 70•$0
Council Plan Review 354.00
Bldg. Otf. SAQ City 100.00
Variance SAC, MWCC $50.00
water Conn. 550.00
Water Meter _67.00
Roatl Unit _3.75_..00
TreatmentPl 204_00
Parks
TOTAL 2,928.50
This repvesi voitl G/g//s.Ci
18 monUs from O ? 3
E 262q_'? 1 G P :
Street Address, 6ox or Route No. Ciry
ZIA
a /?,AwJeCj w ace'
?9 4
ectron o. TownshiD Name or No. Range No. Co tY /
Q ?d?lY
ccvpnntlPpINT1 Phone No.
5131
Power $up1?pligr C I
?a1
w?-4 GiCUI'. « Adtlrress ?
?
?
`
. /
4
A7/9 7
G
Electrical Contraclor Company Namel Contractorps Llcense No.
Moiling Atldress ICOnvactor r Owner MakinB IstailaiioN .
Od ?oun ?oo.cQ gvr,ns?9 k 4? s533
Authorized n ure (Co tr idOwner Mn ' InstallHtinnl Phone Num+or? ?
??D
MINNESOTA STATE BOARINOF ELECTflIGITY THIS INSPECTION pEQUEST WILI NOT
Gri09s•Mitlway Bltlg. - floam N-191 BE ACCEPTED BY T E STATE 60AHD
1821 Universitv Ave.. St. Pnul. MN 55104 UNLESS PHOPEfl INSPECTION FEE IS
0'-. ?siFi9iea2nwnn ENCLOSED.
{?jy Liw.sed ElecIrical Conlrector 1 hareby repuest insoection of above
?/J Owner elactrical work installed at
REQUEST FOR ELECTRICAL INSPECTION ea-oooai-os
? s-?o5q
Y , See inshuctions lor completin9 this torm on beck of yellow copy.
E?G 02 9 3 -?, X" Below Work Covered by lhis Request
Nins FAd Neo. Type of Builtline .°.aotpancm Wired Epuiument WireA
Home Range Temporary Service
Duplax Water Heater Lightiny Fixtures
Ap[. Building Dryer Electric Heatin
Commercial BIAg. Fumace Silo Unloader
Industrial 81Ag. Air Conditioner Bulk Milk Tank
Farm Son, v ISnenivl
t ?e uccify ONer Othi.r
Commite lnsoection Fee Below
N Fee Service Entranca5ize b Fee Feaders/5vbiextlers N Fea Circuits
0 to 200 Am s 0 to 30 Am s iL 0 in 30 Am s
Above 200 qmpy 31 to 700 qmps 31 to 100 Am s
Swimming Pool Above 100_Amps Above 100_Am s
Transiormers Irrigation Booms Partial- OtFee
Signs Special Inspection S
TOT
Memnrks 5(??SO `9
tE
J '?
pough-in r Da tP -? I, tpe ElecLiwl
Inspectar, heraby
cartify tha, the a bova
Findl e 'ns0ection hes been
mede.
tNe repuest vola 18 moniM iram
2004 RESIDERlTIAL PLUV1nBIPJG PEf3Ml3 APPLlCATiOfV
CI'TY OF EAGAid
3830 PILOT KiVOB ROAD, EAGAN nA1V 55922
651-675-5675
Please complete for modifications to existing residentiai dwellings.
15; ?
Date I/ I o2. I 07
Site Street Address y?a?T T
o?f? vi ?w /?•
Unit #
Property Owner. 60/h Telephone # (IKI ) `/ G-W- U?*
Contractor 4 6al/ Telephone # (lpsl ) 48-1I4
Adslrsss Citv ?f Lhl' StateZipW6OX
The Applicant is: _ Owner ? Contractor _Other
Alterations to existing dwelling $ 50.00
_Add fixtures to rooms, excluding water softener and water heater
_Septic System Abandonment
_Water Turnaround (add $121.00 if a 5/8" meter is required)
Other:
Water Softener )C Water Heater $ 15.00
? replacement _ additional
Lawn Irrigation System RPZ_ new _ repair _rebuild $ 30.00
State Surcharge
I $ 50
-
? Totat
$i52
I hereby apply for a Resid2ntial Plumbing PErmit and acknowledge that the information is complete
and accurate; that the worlc will be in conformance with the ordinances and codes of the City of
Eagan and the plumbing codes; that I understand this is not a permit, but only an application for a
permit, work is not to start without a permit and work will be in accordance with the approved plan in
the event a plan is required to be reviewed and approved. ?
chelsh 1IS o?Lr9 L? o dt-?
?
?
pplicant's Printed Name AppiicanYs Signature ? APR 0 5 2004
So 3a s?
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
Naw Construction Reauiremenh
• 3 registared site surveys showing sq. ft. of lot, sq. k. of house; and all raofed areas
(20% maximum lat coverage allowed)
• 2 wpies of plan showing beam & window s¢es; poured faund design, etc.)
• 1 set of Energy Calculaliors
• 3 copies of Tree P2servalion Plan'rf lot platted after 7/1/93
• Rim Joist Detail Options selection sheet (bldgs wilh 3 orless units)
DATE
/ 71 7s
RemodeUReuair Reaulrements
• 2 rApies of plan
. i set of Energy Calculations forheated add'Nons
. 1 site survey for ezterior additions 8 decks
• Indicate if home served by septk system for additions
VALUATION
?ULTI-FAMILY BLDG Y ?N
FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT AZnencqn By,/dtm 6,Zzfyaefor5 Imc,
STREETADDRESS 19.2 H7/VlCallef 4ut. So. CITY& rnsuillt STATE/ti1N. ZIP 61337
TELEPHONE # g 32 - 707-lyls? CELL PHONE # 912- 9/9• ld // FAX #
PROPERTYOWNER Pe?ers , /?ic Ipgrcl 4 /"Jcz?rne TELEPHONE#6s/- YS`L 4 7110
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1
(J submission rype) . Residential Ventllatlon Category 1 Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor:
Pluinbing system includes:
Mechanical Contractor:
Mechanical systcm includes:
Sewer/Water Conhactor:
WaLer Softcner _
_ Water Healer _
No. of Baths
Air Condiaonitig
HcaC Recovery System
Phone #
Fce: $70.00
---------------------------°----------------------°-----------°---°----------------------------------------°---------
I hereby acknowledge that I have read this application, state that the intormation is correct, and agree to comply
with all appiicable State of Minnesota Statutes and City of Eagan Ordin c s.
Signature of Applicanf ?V
--------------°°-----------°-°°°.......--°--°°-•--------------.....___..__----°--------°--'-°----------------°----------°-.......°-°-----
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
_ Phonc #
Lawn Sprinkler
No. of R.I. Baths
Phone #
Fee: $90.00
OFFICE USE ONLY
;
? 01 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 31 New
O 32 Addition
? 33 AlteraGon
? 34 Replacement
Valuation
Census Code
SAC Units
Nbr. of Units
Nbr. of Bldgs
Type of Const
? 20 Pool ?
? 21 Porch (3-sea.) I ?
? 22 Porch/Addn.(4-sea.) ?
? 23 Porch (screened) ?
? 24 Storm Damage
? 25 Miscellaneous
? 35 Int Improvement ? 38 Demolish (Interior) ? I 44
? 36 Move Bldg. ? 42 Demolish (FoundaUon) ? 45
? 37 Demolish (Bldg)* ? 43 Reroof ? I 46
*Demolition (Entire Bldg only) - Give PCA handout to applicant
Occupancy I
MC/ES System
Zoning City Water
Stories Booster Pui p
Sq. Ft. PRV
Length ered
Fire Sprinkl
W idth l
30 Accessory Bidg
31 Ext. Alt - Multi
33 EM. Alt - SF
36 Multi
Siding
Fire Repair
W indows/Doors
REQUIRED INSPECTIONS
Footings (new bldg) _ FinaUC.O.
_ Footings (deck) Final/No C.O.
Footings (addifion) _ Plumbing
Foundarion _ HVAC
Drain Tile Other
Roof Ice & Water Final Pool Ftgs Air/Gas I ests _ Fina1
Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insularion Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Suppty & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
? 07 05-plex ? 13 16-plex
? 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex ? 19 LowerLevel
? 12 12-plex Pibg_Y or_ N
Building Inspector
Total
APFLICATION FOR PERMIT__
SEWER AND/OR WATER CONNECTION
}..
? NOTE: PA]21FNf OF FEE AT TIME OF
i APPLICATIQN DOFS N7P COH- ?
j SfIN1E APPRCJAL OF PERFIIT. :
•
i INSPFLTION OF SETdIt AN1[OR WPIIFR i
:.
? I[1STALIATIONS WIId, N(7P HE SCFD[7L[D ?
? 17CIPIL PEEtFIIT HHS HtIEi APPRUVID. ;
dtV of eticcin
(PLEASE PRINT
1) PROPII2TY ADDRFSS: *a'/ AbrA Vi'tL..J 07cvrr¢cC_
LEGAL DESCRIPTION;
(LOt/kilOCK/SUbQ1V1SlOI1 OZ' '1'VL YdLC21 lU {I
IF EXISTING STRCCTURE, DATE OF ORIGINAL BLiILDING PERMIT ISSC?ANCE:
PRESENT ZONING/PROPOSID USE:
Q COMP'IERCIAL/RETAIL/OFFICE
Q INDLSTRIAL
Q,INSTITUTIONAL/GOVERPAENT
Mnt Year )
SINGLE FAMILY
E_? R-2 DDPLEX (Two L?nits)
? R-3 'IOWN[OLSE (Three + Onits) ( Lnits)
Q R-4 APARTMENT/CONIDOMINIUM ( C'nits)
2) ? NAME: 14 t N'!r 1Iea. C_°e " 7r-'
annREss: r 8133 C-Aa-&? A?c
CITY, STATE. ZIP: r.qkw r?til:a,,.}
?
PxonrE:
3) • NAME: - - P/;? .Hmk" Pte ??•?
ADDRESS : j.,T 4 0 `Zv4 c, 4 `t h 1-4. I?
CITY, STATE, ZIP: 147qP le Prru v G..
PHONE: =(ry 3•,2 y7 y? MASTII2 LICENSE #
? active
Expired
Not recordec
Sta In?itia7
4) ei," '' e ?
NAME: JrJ NeG. /?I S ??
ADDRESS:
CITY, STATE, ZIP:
PHONE:
5) a?17'
EP-20NNECTION 'Ib CITY SEWER ?-EONNECPION TO CITY WATER O OTI-III2'
6)
. ? ?,tJ_a.,.,d,i,? ?}".? ?a???i?? - ? r9 3 /-88?
*?**??.**********?***********************?*?*?,*?****.*?****************************?***,?**?**:?..****k
* THE GOID COPY OF THE PERMIT WILL BE SENP DIRECIS.Y DO PUBLIC WORKS T0 FACIISTATE MEPER PICK-UP. w
,*t PLEFISE AIUDW ZW0 WORICENG DAYS FbR PROCFSSIM. SOAIDONE FROM TM CITY WILL CONrAGT Y00 IF TIIERE
* ARE ANY PROBLEh1S.
?;r*?-x**?**+************+*****+,?*****+?**:+**?***?*******,t,r,r*+????,+***********??.*+******?*****x***?;
. FOR CITY USE ONLY ?
PERMIT # ISSUED j
{
Pd w/Bldq. Permit FEES: I
$ $ /D- S? SEWER PERMIT (INCLDDEISURCHARGE)
$ WATER PERMIT (INCLUDEISQRCHARGE)
$ WATER METER/COPPERHORN/OL'TSIDE READER
$ ?
$ WATER TAP (INCLL'DE CORPORATION STOP)
$ $ SEWER TAP I
. $ $ D t? ACCOLNT DEPOSIT - SEWER
$ $ /.6 ACCOLNT DEPOSIT - WATER
$ $ WAC
$ Ln S OC! -D $ SAC I$ $ TRUNK WATER ASSESSMENTI
$ $ TRONK SEWER ASSESSMENT
$ $ LATERAL BENEFIT/TRU[VK SEWER
$ $ LATERAL BEN°FIT/TRONK WATER
o--z) $ - WATER TREATMENT PLANT SURCHARGE
$ OTHER:
7 I• o6 $ d` /• ?l-Zj TOTAL I?
.fi/-1?9
RECEIPT # , RECEIPT ii
DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RIGHT OF WAY?
F--j YES . IF YES, THEN A"PERMIT..FOR WORK WITHIN PUBLIC
Q ROADWAY" MOST BE ISSUED By THE ENGINEERING
NO DIVISION. LIST AS A CONDITION.
SUBJECT TO THE FOLLOWSNG CONDITIONS: I -
TITLE:
DATE:
? ..
j,?;, , i?,? T
??.,?,?+
.;tir?•?i??
? ?''1 ??. ???i:
? ?,?,?.,• ;u:•
v?=
' ..
. 1988 BIIILDING PERMIT APPLICATION - CITY OF EAGAN .
SINGLE FAMI[,Y DWELLING3
/5 Y??
INCLUDE 2 SETS OF PLANS, 3 CERTIEICATES OF SURVEYo 1 SET OF ENERGY CALCULATIONS
NOTEs ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHIC$ ADDRESS
IS DESIRED. NO CHANGES WILL BE ALLOWED ONCE BOILDING PEAMIT IS ISSUED.
MULTIPLE DWELLINGS RENTAL UNITS FOR SALE UNITS 4 OF UNITS
INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECg WITH BLDG. DEPT.9
1 SET OF ENERGY CALCULATIONS
COMMERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS,
1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS
G /
To Be Used For: Valuation:? Date:
.?. .n ?
Site Address L/(?oL?(z ?/?j.,i,rt.?.?Qf 1
Lot q Hlock 3
Parcel/Sub
Owner
Address
City/Zip Code
Phone
C
Contraetor 0?.
Address •
City/Zip Code.
,? -
Phone
Arch./Engr.
Address
City/Zip Code
Phone 0
U OFFICE USE ONLY
14)1000 -
On site sewage Oecupancy Q-3 M'1
hbICC system i/ Zoning ?
On site well Actual Const ?
City water r/ Allowable
PRV required _ U of stories
Hooster Pump _ Length $ Z•
Depth
S.F. Total
Footprint S.F.
APPROVALS FEES
Engr/Assess Permit 9D$,Go
Planner Surcharge '70.50
Council Plan Review -3 5z4_t?o
Bldg. OfP. ?818 SAC, City O, Ob ,
Variance SAC, MWCC , O '
Water Conn 550,00
Water Meter ' Q>
.00
9
Road Unit .
..
525 , 0J
Treatment P1 7-p4.00
Parks
Copies
TOT9L ?i
S0
VALuAT?
?._v..
ZZ X3o =
9xg =
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3ox2?= ?f_
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BSrnT - 1160
Zxr)= ILI
iiI y x ya = s?52G
ZrvD F't?o2
C3SrnT = 1160
y
___--
lixyxq9-s?o/(
1LI08Ro
TRI-LAND C0.
SURVEYING
SERVICES
1260 YANKEE DOODLE ROAD
EAGAN, MiNNESOTA 55122
SITE PLAN FOR:
MILLER CONST
LEGAL DESCRIPTION: LOT-3-9 BLOCK-3-,1 FXINGTON PARKVIEW
ACCORDING TO THE RECORDED PLAT
THEREOF nAKOTA COUNTY,MINNESOTA
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5
? 915.0
52.
sia3
1 PROPOSED HOUSE
? .60
N
.d
"m
1
t
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.9172
GARAGE
. L - 922.3
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TO REC S
SCALE:II"=30'
O
A zg? ROv ?3630 W
By
E€',GAN ER?rIl`dEEIUIdG D
LE6END '
o DENOTES IRON MONUMENT
o DENOTES WOOO HUB SET
917.6 DENOTES EXISTING SPOT
ELEVATION
DENOTES PROPOSED SPOT
ELEVATION
? DENOTES DRAINAGE DIRECTION
I hreby csrtity that ihis su?vey,plan or
rsport was prspared by ms or undor my
dirsct superrision and ihot i am a duly
Reqistsred Land Survlyor undW tM
Laws of the State of Minnesota.
88-119
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W r W =L
m
1
.o?
A?
a?
o ?
G 924.7
O TBC 924.5
0
T ERR? ?
INVERT ELEVATION AT SERVICE EXTENSIONa PROPOSED GARAGE FLOOR ELEVATION•J1?I
PROPOSED FIRST FLOOR ELEVATION =
PROPOSED BASEMENT FLOOR • ?'
ELEVATION
NOTE ' VERIFY ALL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
Bradley ?jYr*nson, Mn. Raq. No.1523b
Datt: ry?26/8p
RFV A-I'7-RR To Suew NEtn/
? EXTEI2iUR ENVE7,OPE AYE1tIlaEunLll11?(3 llEPARTI•IG11T
_ U C013PUTATION ? S ?--7
/
(To be eubmitted rvith building permit applicatio.n)
Ot:e or 'Tivo Family Dwelling
ILL 1 O t1i e r O wner
6fta AddTesa QT
Coiitrnctor ?o5£p ,?q n ?NGTbN ?ARi? 1 ?? (y
t'ol(JSTDute Phone
LItIEAL FECT OF
EXPOSEU YlAJ,1,
f to sbove grade ? ZqO? •(p 3?
• TOT/lL EXPOSED W11LL AREA 8Q, FT.
oPAqUE WAI,L COtiSTRUCTIUII f f'U" VaLue x Area
Detail -?E upff
reterence - Co?JP . „U„ x s(j•
from R M1? nUu-. n>?O x 9ft.
attached x SQ
npu
sl .
I oote up.II x $Q.
YIIWDOWSt
-. s@.
x Sg.
uun
Hrilce & Tyhe
u n
n of
DOOI2S t
f!Uu Value x Area .
4lalce & Type G?7F??
n hsL1! nun
to .?2cTi?D ??u?u X SR•
it
n „ npu x SR.
_ IlUff R SR.
x Sq,
xoTni,s oIe? se.
TOTAL M(A) VALUE9 AVEIIA(3E apIi
zI8.7q
DIVIDED gY ToTAL ?7AI,L AIIEA Z9U3.<,:)
Av
E1tAQE IIUI
, i 15 r leoe for i&2 fRooF/CEILINa Nellinge
FT. ZZ' --?a (0)(A)
FT. Ip4,?;?7z= - 7.74 M(A)
u) (A )
FT. U)(rt)
FT. _ (U)(71):
FT. _ ?U)(A)
FT* FT. S O_- 7(U)(A)
FT. (U) (A)
FT. (U)(A)
° (u)(n)
FT. 5(v.DO _ .S (U) (A)
FT. (U) (A)
FT. - (U)(A)
FT.` - (U) (A)
F'T.?L?L7?T (U)(A)
t .
TOTAL AIiEAs •
Detail reterence ?
nUn
from xBQ. FT._)Jz6O
n _ ttached (A)
Fm,
Deacribe ope?iit? a - ! (U)(A)
G npu X S@. FT. ----__(U)(A)
in roof. ?rupn X sQ. F'T.- = ?U)??)
x Sg. FT. ToTAI, M(A) VALUEB T
r ?5 z (o z3. (U)(A)
DIVIllED BX Z?.& --
'TO'!'AL 1100F/CEILI174 ?ZEn ? ° ?•? ??V?>
ffZ(O
?VEHAar it •?25 or ventilnted roofe.
Vnlue x Aroa
41 X sQ.
n?tt X sQ.
)iuii x sQ.
x sg.
11 `Ac-?T "
18-3; X (5z+-57--1- Z(o -t 2(0? ? ZS59.Q-$
SCa x S_g3 - 44•!S
r z`1o 3. (o ? -7?
Ue-.
-W x (sZtsz+ZYP -+-z&)
?.,
,. l?7 x?5Z +-s Z f ZCo?.-z?, _
•g3X 5' -
Wr4potos
Ux 14 = z, cp x 3=
I(oX 3(o = 1, o X Z=
zox3? _ ?,o x z =
z?c48 = (o •7 X .3 =
Z4 x 48 = S. o X q=
z.o?cloo ? g,¢ X g ?
- `.S
3' STL. W/2
Zg e;,TL. SE,E- _
lv = PKri v Ae , -
L?ss Co?1e,
?? klvw'S
II ?b?1 S
Z(?- s Z
4-/S
Z(04. (v7 ?
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8. vo '
?a.oo
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1OL5'- 10 --?
7JS. Op
Z1.00
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JLL E?,4..4
2903•(03
to4.5Z
7,64. La7
t8s.ro - (?5Z•Z9.
?S.oo Zz.SJ•?4 ?
r,?r
26 X!-:- o ? 780
AX Z Z_ _ ?08
1x 14 = +4
I•sx !? = Z4
. . ..
Determining "U" values at Roof, Wall, Rim, and Conc. Block
ROOF/CEILINQ
1.) Interior Air F'i1m
2.) 5/8'1 QYP. Bd.
3.) Inaulation
4.1
5.) Exterior Air Film
(STILL)
R VAI,UE
0.61
.56
`9-oo
.61
°U" _ I/R= .OZ) '1'OTAL (R)=46-78>
?
Y1AI,L
6.) Interior Air Film
7•} 1" GYP. Bd.
8.) Insulation
9•) gulL7-P-1"7Z?-
10,) Masonite Siding
11.) Exterior Air Film
R VALUE
0.68
.45
19=D0
2674-
.1?
upn = 1/R= .L7¢3? ZbTAL (R)= Z3-01
. ?
RIhi
12.) Interior Air Film
13.) Insulation
14.) 2" Fir Rim Joiat
15.) g!t
16.) Masanite Sf?ding
170 Exterior Air Film
R VALUE
0.68
19.00
1.88
? 6
.17
npn _ 1/R= .04o TOTAL (R)= Z4-4,4
.__.-
FOUI7DATION '
18.) Interior Air Film
19.)
zo. ) jIgEe? 1?c,a,r,?rf
21.) 12" Concrete Block
22.)
23.) Exterior Air Film
R VALUE
0.6$
l l.oo
1.28
.17
"p" = 1/R= .0769 TOTAL (R)
=f3.13
?
?
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4024 Northview Ter
Lot: 9 Block: 3 Addition: Lexington Parkview
PID:10- 45035- 090 -03
Use:
Description:
Sub Type:
Work Type:
Description:
Census Code:
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 2,000.00
Contractor:
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264 -4777
e- Windows/Doors
Windows/Doors-New/Replacement
House
434-
PERMIT
City of Eaan
BL - Base Fee $2K
Surcharge - Based on Valuation $2K
Applicant/Permitee: Signature
- Applicant -
Construction Type:
Occupancy:
Permit Type:
Permit Number:
Date Issued:
Permit Category:
If altering the opening size, a framing inspection is required. Smoke detec tors are required in all sleeping rooms prior to
final inspection. When wall studs or ceiling joists are exposed, hard -wired detectors are required Bat tery operated types
are acceptable if the wall/ceiling finish (i.e. sheetroc k) has to be removed to install a smoke detector. Kara Benson 1120
Eas t 80th Street, Ste. #211 Bloomington, MN 55420 952- 345 -6047 kara @elderjon es.com
Total: $70.00
Owner:
Richard J Peters
4024 Northview Ter
Eagan MN 55123
$69.00 0801.4085
$1.00 9001.2195
Issued By: Signature
Building
EA074495
07/26/2006
ePermit
I hereby acknowledge that I have read this application and state that the informa
of Minnesota Statutes and City of Eagan Ordinances.
on is correct and agree to comply with all applicable State
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Cilyof Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 875-5675
Fax: (651) 675-5694 •
2011 RESIDENTIAL PLUM
Date: 119_ r 0—Site Address:
Tenant: 124414 -4 -Ar I/
0
RESIDENT/OWNER
CONTRACTOR
Use BLUE or BLACK Ink
ii===1
/og gi
Parrnit #:
Permit Fee: 67
Date Received:
starr:Zyn
ING PERM T APPLICATIO
J
Sults*
Name: `I
Addfess/City /Z1p: Isar 1` e1v'.n/Le.L.
Name:,MILBERT COMPANY INC.dba CULLIGAN WATER
Address: 1801 50TM ST EAST Cid : INVER GROVE 41613.
• Stater MN Zlp; 55.07 ' Phone: 65. ;:45- 2241 •
Contact BILL.MIL.BEIZ`ri . Email:
TYPE OF WORK
PERMIT TYPE
._Nev Replacement Repair _ Rebuild _ Modify Space _ Work Ik.R.O.W.
Description vrorlc:,
RESIDENTIAL
.Water Heater
' Lawn In1gatl¢n L RPZ /
Septic Systein •
'New •
Abandonment ,
,[Water Softener
PV9) Add Plumbing Flxtures (__,Main /_ Lower Level)
.. Water Turnaround
RESIDENTIAL FEES:
555.00 Minimum Water Heater, Water Softener, or Water Heater Est Softener (includes $5.00 State Surcharge) •
$35.00 Lawn Irrigation (inctddes $5.00 State Surcharge)
$55.00 Add Plumbing Flxtut•es, Septic System Pbandonment, Water Turnaround' (includes 55.00 State Surcharge)
'Water Turnaround (add 5166.00 Kama meter Is required) • •
$105.00 Septic System P Y� net (510.00 per as built) (includes County fee and $5.00 Stats Surcharge)
$95.00 Flre Repair (replace bumel out appllances, ductwork, etc.) (includes $5.00 Stats Surcharge)
TOTAL FEES $
ovo
CALL BEFORE YOU DIG. Call Gopher State One Call at (851) 454-0002 for protection against underground utility damage.
Call 46 hours before you Intent to dig to reeeivo+ locates of underground utilities.. yvww.000herstateonecatl.orr
I hereby acknowledge that this intimation N complete and accurate; pat P. wont wa be In conformance %Ail the ordinances and coda of the City of
Eagan; that I understand this Is not a permit, but only an application Yore permit, and work is not to start without a permit that the work will be In
accordance with '% approved plan In the class of work which requires a review and approval of pi'
>< (/ l /�/' -n"- /� ,66.'---.•
• Applicants Printed Nam* 1/
4441
x
APP can a
Signature
e11aOr/WOW,i,{!rt 4 � �t d%t�pMr •
�pa}i��fgr nasnrr"pp"r",
111: r.n t,• .+- Wm ° I , �'u
asui
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA117470
Date Issued:10/18/2013
Permit Category:ePermit
Site Address: 4024 Northview Ter
Lot:9 Block: 3 Addition: Lexington Parkview
PID:10-45035-03-090
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments: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.
Carbon monoxide detectors are required by law in ALL single family homes .
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 -
Richard J Peters
4024 Northview Ter
Eagan MN 55123
American Building Contractors
2960 Judicial Rd Suite 100
Burnsville MN 55337
(952) 707-6959
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA122536
Date Issued:05/12/2014
Permit Category:ePermit
Site Address: 4024 Northview Ter
Lot:9 Block: 3 Addition: Lexington Parkview
PID:10-45035-03-090
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required by law in ALL single family homes .
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Richard J Peters
4024 Northview Ter
Eagan MN 55123
(651) 454-6740
Glowing Hearth and Home LLC
100 Eldorado Dr.
Jordan MN 55352
(952) 492-9276
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA168706
Date Issued:04/29/2021
Permit Category:ePermit
Site Address: 4024 Northview Ter
Lot:9 Block: 3 Addition: Lexington Parkview
PID:10-45035-03-090
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. We encourage you to retain an electronic copy of
photos until the project passes a final inspection.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
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 -
Richard J & Maxine Peters
4024 Northview Terr
Saint Paul MN 55123--155
(651) 454-6740
American Building Contractors
2960 Judicial Rd Suite 100
Burnsville MN 55337
(952) 707-6959
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA169238
Date Issued:05/19/2021
Permit Category:ePermit
Site Address: 4024 Northview Ter
Lot:9 Block: 3 Addition: Lexington Parkview
PID:10-45035-03-090
Use:
Description:
Sub Type:Siding
Work Type:Replace
Description:
Census Code:434 - Residential Additions, Alterations
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. When a weather barrier is installed or
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 -
Richard J & Maxine Peters
4024 Northview Terr
Saint Paul MN 55123--155
(651) 454-6740
American Building Contractors
2960 Judicial Rd Suite 100
Burnsville MN 55337
(952) 707-6959
Applicant/Permitee: Signature Issued By: Signature