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4025 Northview Ter. ? ?? . CASH RECEIPT CITY OF EAGAN ' 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 DATE ' `-- • - 19 t+ECEn/En ? i ? • PROM ! i J•1 1?? ?? ? AMOIYNT ? 8 DOLLARS ioo ? CASH G? CHECK FOR a FUND OBJECT AMOUNT Thank You 8Y t,?5n ? r White--PaYers CoPY Yellorr-POStingCoPY 3 +i • ?.... ?. / Pink-File CoPY CITY OF EAGAN 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454-8100 BUILDING PERMIT Receipt# RTo be used for `Y ) i, l ?.''• ' Est. Value I•: Date JI'NE 78 SiteAddress 4425 2:c;"'}''.";Ij:i? 'C).R!?ACE - Sec/SubEXIN? ??N 2 i` * i:'J I.A.6? Lot 3 Block ? Parcel No. . Name }cE?X9ERG HOMES z Address 8251 E 230T11 SIT o .i?:':F.YILI.P, 4+?1-:'25?+ City ` Phone .0 Narne S.ti: i•. ? Q AddYess P City Phone ? W W y? Name H ?? Address `W City Phone I hereby acknowledge that I have read this application and state that the informationls correct and agree to comply with all appiicable State of Minnesota Statutes and City oi Eagan Ordinances. Signature of Perrqittee \ Building Permit is issued to: onthe express condition that al I work shall be done in accordance with al I applicable State of Minnesota Statutes and City of Eagan Ordinances. Building OFFICE USE ONLY On Site Sewepe Qccupancy MWCC System ?• Zoning On Site Well (Actual) Const v-N City Water - (Allowable) V"N PRV Required # of Storiea Booster Pump Length Depth 341 S.F. Total Footprint S.F. APPROVALS FEES Engr./Assess._ Permit 640•00 Planner Surcharge UU•00 Council PlanReview 320•00 BIdg.Off. SAC, City I00•00 Variance SAC, MWCC 3 50• 00 WaterConn. 550•00 Water Meter k7•90 Road Unit 32 5.W Treatment P1 204•00 Parks , TOTAL ? 1 CASH RECEIPT ? `,,._.. . CITY OF EAGAN ' 3830 PILOT KNOB ROAD EAGAN, MINNESOTA 55122 I DATE ig REctneo } . FF40M AMOUNT $ ? 4 & DOLLARS ,oo 0 CASH [? CHECK wn 1--• ? ? 1 ? - ? ? ? • BY White-Peyers Copy Yeliow-Postln9 CoPY Pink--File Copy Thank You 1N SYL:C;'1'lUN KL(.:UKD L?tTY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, MinneSOta 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: ' 1 k` ,: f N+i ( C?M Pr?; V 1,.e? %.4j PERMIT SUBTYPE: APPLICANT: . - , , . ,;;}? I t 6"=, i? ri s +i 4 q:? Ci TYPE OF WORK: Ic}II" ftirc Is 1"' ?,-?•G? fti?MlfiRK'3: ('F4114141:Y/FtUfi Ptl,iS'f Hr 7M1,'.,PFP>(hl] Fif"rORk 1'lIM('!"AI il+ICi Permit Holder Date Telephone # PLUMBING IiVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLHG AIR TEST ROUGH HEATING GAS SVC TEST INSUI GYPBOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL DOMESTIC METEFi IRRIGATION METER FLUSH MAINS CONDUCTIVITY TEST HYDROSTATIC TEST BSMT R.I. BSMT FINAL DECK FTG DECK f1NAL INSPECTION RECORD C Y OF EAGAN PERMIT TYPE: 830 Pilot Knob ROad Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 SITE ADDRESS: ;,_?#irNVl'ELl;T#'R 1. !A [ Nta 1 Cl id F' AR?V TvW ; PERMIT SUBTYPE: APPLICANT: ? TYPE OF WORK: !t t 1 ts 114 r; A tn.1•3 Fl !(AA /44k INSPECTION .. . DA RFM{1KMI;s C`FRMI"! HFVTFWFI) BY MlKF HAi:CK Permit No. Pertnit Holder Data Telephone # ELEGTRIC PLUMBING HVAC Inspoction Date Insp. Comments FOOTINGS FOUND FRAMING RpOFING ROUGH PI,UMBING PLBG AIR TEST RdUGH HFATIIVG GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL 6SMT R.I. BSMT F{NAL DECK FTG DECK FINAL ` . • t MECHANICAL PERMIT ? • RECEIPT # CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE CONTRACT PRICE PHONE: 454-8100 Site Address ? -? V1"t ';,' rV gLDG. TYPE WORK DESCRIPTION Lot .? Block ? Sec/Sub ?' y ' ? New Res. l L- C X i ti'i L'r 'IdY " Mult Add-on ? Name ;, / Comm. Repair S Address ?s Other c City Phone ? c Name o m P FEES RES. HVAC 0-100 M BTU -$24.00 ADDITIONAL 50 M BTU 6 00 Address - . p City Phone (RES. HVAC INCLUDES A/C ON NEW CONSTRUCTION) GAS OUTLETS (MINIMUM - 1 PER PEkMI'n - 1 50 EA TYPE OF WORK . , COMM/IND FEE - 1h6 OF CONTRACT FEE Forced Air vV < M BTU APT. BLDGS. - COMM. RATE APPUES TOWNHOUSE 8 CONDOS - RES. RATE APPLJES Boiler M BTU MINIMUM RESIDENTIAL FEE - ALL ADD-ON & Unit Neater M BTU ? REMODELS - 12.00 Air Cond. - M BTU - MINIMUM COMMERCIAL FEE - 20.00 ? ? STATE SURCHARGE PER PERMIT - .50 Vent ? CFM PERMIT PRICE GOES Gas Piping Outlets # BEYOND $1 ppp? Other g ' Zd 1 FEE &t4'e_ r-. S/C: SIGNATURE OF PEAMITTEE ? ?. ? TOTAL: i;;r ? . FOR: CITY OF EAGAN PERMIT # /VS a PLUMBING PERMIT CITY OF EAGAN RECEIPT # " Y- ? 3830 PILOT KNOB ROAD, EAGAN, MN 55122 DATE: WORK DESCRIPTION Namw •- ? ci Address z J ? c Ciry Phone Name _ Address Phone FEES COMM/IND FEE - 1% OF CONTRACT FEE APT. BLDGS - 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 Res. New _ Mult. Add-on Comm. Repair Other RES. PLBG. ONLY - COMPLETE THE FOLLOWING: NO. FIXTURES TOTAL Water Closet - $3.00 $ Bath Tubs - $3.00 Lavatory - $3.00 Shower - $3.00 Kitchen Sink - $3.00 Urinal/Bidet - 53.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater - $1.50 Whirlpool - $3.00 Gas Piping Outlets - $1.50 , _„#MINIMUM - 1 PER PERMIT) ?LSoftener - $5.00 Well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 OF OF FEE: STATE S/C: GRAND TOTAL: ? ?? PERMIT # _ , PIUMBING PERMR RECEIPT # CITY OF EAGAN • 3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: 4TRACT PRICE: PHONE: 454-8100 m Name _ w Address c City 11 BLDG.TYPE Res. ? Mult Comm. WORK DESCRIPTION New ? Add-on Repair ? vn Name ? FIXTURES Water Closet - $3 00 TOTAL t . c Address ? v 5 Bath Tubs -$3.00 r p City /_-? XP 1• / -j? Phone fZ ' ' ? S ?Lavatory - $3.00 ' _ ?Shower - $3.00 ?-Kitchen Sink - $3.00 FEES Urinal/Bidet - $3.00 COMM/IND FEE - 146 OF CONTRACT FEE ::Laundry Tray -$3.00 '?- MINIMt.1M - RESIDENTIAL FEE - $1?.00 Floor Drains - $1.50 ' -- MINIMUM - COMMlIND FEE - 20.00 =Water Heater -$1.50 ' STATE SURCHARGE PER PERMIT - .50 Whirlpool -$3.00 (ADD $.50 S/C IF PERMIT PFiICE GOES ZGas Piping Outlets -$1.50 BEYOND $1,000.00) Softener - $5.00 Well - $10 00 . ? Private Disp. - $10.00 Rough Openings - $1.50 SIGNAT URE OF PERMITTEE FEE ? • - sTaTE sic: - FOR CITY OF EAGAN GRAND TOTAL• `? ? , ; - ? ? Y • ' (itrtifiratp of (Orrupaury titp of (Eagan lorprtmrat of %ilating iwprtina 77tis Certt'frcate rssued pursuant 1o the requirenients of Section 306 of the Uniform Building Code certifying tlrat at the time of issuance this structure was in compliance with the Hasious ordinances of the City regulating buildiRg corrstruction or use. For the foUowing.• un cassifinaoo i]NMs:'. mne. Nrmit ?vo. 15273 ooc„o.-v Tya R3r''_' Z..ig awi. Tra ca^st vn o,meT ot euddiq ROOM r?:ki:S ,esg `? ?S 3 t. _ ?> i. T AMII ILE ,- e? nm? 4 ?25 ?'?Il-NIE+' ._:?:'v`,??:. LAX21ity o.Le: ! 9&F3 POST IN A CONSPICUOUS PLACE . CITY OF EAGAN 273 ? 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 PHON E: 454•8100 OIJH.OING PERMIT Receipt # To be used for Est. Value ? ?? • • • Date Site Address OFFIC tot Block Sec/Sub. On Site Sewage MWCC Sysiem Parcel No. On Site Weu ¢ Name City Water W PRV Required = Address o r.ir., BoosterPump .°Co Name ? Q Address ? City Phone ?WWName _ g Address u ZW Gity Phone a l hereby acknaw4edge thaS 4 fiave sead tnis application and state that the information is correct and agree to comply with all appiicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Permittee A Buiiding Permit is isSUed to: on the express condition that al I work shall be done in accordance with all applicable State of Minnesota Statutes and City ot Eagan Osdinances. Building dfficial APPROVALS Engr./Assess. Planner Council Bidg. Off. Vafiance Occupancy ' Zoning (Actual) Const (Allowable) # of Stories Length Depth ' S.F. 7otal Footprint S.F. FEES Pe rmit ' Surcharge Plan Review SAC, Ciry ? SAC, MWCC Water Conn. ' Water Meter Road Unit Treatment P1 Parks TUTAL Permlt No. Permit Holder Date Talephone # Plumbing H.V.A.C. fU / Sh ' ? 214 5 1k Electric Softener inapection Date Inap. Comments Footings 1 Footings II Foundation Framing Roofing Rough Plbg. Rough Htg. Isul. g, z?? Fireplace ' Final Final * Bidg. Final k ?. C@ft. OCC. ? :? %'CCw JGsYt O/%Cr ? Temp. LP Deck Ftg. Deck Final Well Pc Disp. CiTY OF EAGAN Permit No: Data , 1' 3830 Pilot Knob Road Meter ?vo: h/o3 13 8?8 Size: P.O. Box 21199 Reader No: ?P 29 7 Data: 7-7 Eagan, MN 55121 Owner. &Yberg HomQs Site Address: 1.y.n75 i4orthviesa ^^;; •--` ? L > ;j ? J eY?,? _ ? .,i P3L'( Plumber._ !.•+l•avi 7 I P Conn. Chg: 55). QOpr: Acct Dep=_ 15-00pd Parmit Fee: i?. OOpti Surcharge: . 5ind Tr. Plant .010!• 1 Meter. CITY DF EAGAN 3830 Pilot Knob Road P.O. Box 21199 Eagan, MN 5512) . ;,o:t,; OwRer.-?-5 Site Address: MWCC: Zoning: Rl No. ot Units: 1 I agree to comply with !he CNy of WATER SERVICE PERMIT Permit No: j= Date: ` i 5'; Date: B/P No: Homes Zoning* ' No. of Units: Ciry Chg: Acct. Dep: Permit Fee: Surcharge: F? M i sc.: I agree to compty with the City of Eagan Ordinances. SEWER SERVICE PERMIT CITY OF EAGAN Permit No: "72 7 Date: 3630 Pilol Knob Road Meter No: Sixe: P.O. Box 21199 Reader No: Date: Eagan, MN 55121 Owner._, Foxbeiy Homes Site Address: 407.5 WO=thviet TerraGe Lr E2 Lexi? Conn, Chg: S 50. OOpd Acct Dep: 15 . QOnc; Permit Fee: 10• OGpcI Surcharge: • 50pd Tr. Plant 204• 00pd Meter. 67 _ Tr -4 2oning: _ No, of Units: I agree to comply with ihe City ot Ordinances. WATER SERVICE PERMIT BLDG. PERMIT NO. I I?-Of - 3 Y'?, I D C4c, ? hS-% 01-3210 Bidg. Permit 04c) 013422 Plan Check 3?7 01-3445 Surch.lAdm. ? ,01-3446 SAC/Adm. ? 01-2155 Surcharge 75-3860 Road Unit 20-2275 SAC 20-3865 Water Conn. C_7?, 203868 Water Trmt. 20-3716 Water Meter ? 20-2252 Acct. Dep. ? 4 20-3713 Water Permit 20-3743 Sewer Permit 79-3866 Sewer Conn. DO 28-3855 Park Ded. TOTAL ac CITY OF EAGAN N_.. 15 2 7 3 3830 Pllot Knob Road, P.O. Box 27-799, Eagan, MN 55121 BUILDING PERMIT PHON E: 454-8100 Receipt I J r # ?S 9 T-o be used for SF DWG/GAR Est. Value $120,000 Date JUNE 28 ,1988- SiteAddress 4025 NORTNVIEW TERRACE i..r 3 RInrL 2 ce..ie„i,LEXINGTON PARKViEW Parcel No : Name ROXBERG HOMES w Address 8251 E 230TN ST ? Ciry LAKEVILLE phone 461-2254 =alName SAME I V V Address i- City Phone a W Name_ w z Address 3 w CitY_ I heraby acknowled9e that I have read this application end state that ihe information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Ea a Ordin ces. Signature of Permittee A Building Permit is issued to: ROXBERG H $ on the enpress condition ihat all work shall be done in accorAance with all applicable State of Minnesota Statutes and Ciry ot Eagan Ordinances. Building Official-?Z4 R'IiA I A \ e- OFFICE USE ONLY On Site Sewage _ Ocwpancy R-3 /M-: MWCC System X Zoning R-1 on site well _ (ACtua1) const V-N Ciry Water X (Alloweble) V-N PRV Required _ # of Stories Booster Pump _ Length 601 Deuth 34' S.F. Total Footprint S.F. APPROVALS FEES Engr./Assess. Permit 640.00 Planner Surcharge 60.?0 Council Plan Feview _320.00 Bldg. ON. SAC, City 100. 00 Variance SAC, MWCC _550 water Conn. 550. 00 Water nneter 67.00 RoadUnit 325_..00 Treatment P1 204.00 Parks 70TAL 2r816.00 b' REQUEST FOR ELECTRICAL INSPECTION ee-ooooi>-os 1 See instructions lor, compietin9 Ihis torm on back of yellow copy. 72?15 1 "X" Below Work Covered by 7his Request AAtl NeO. TVpa of BuilCing ADOliances Wired Equiumanl WireA Home Range Temporary Service Duplex Water Heater Lightiny Fixtures Apt. BuilAinq Dryer Electric Heann Commercial Bldy. Fumace Silo Unbeder Industrial BIAy. Air Corxlitioner Bulk Milk Tank Farm oink. oec, y otne,isna,lvl ?nnr 5ucr.ify otner Otn.i omuute lnspection Fee Below p Fee ServiceEntranceSize n Fae Feeders/5ubfeeJers K Frte Circuits Uto200Am s 0co30Am s 0m30Am s 1 Above 200 qmpj 31 to 100 AinpS 31 to 100 A s Swimming Pool Above 100_Am s A6ove 100_Am» Transtormers Irrigation Booms Partial.'Ot Signs Suecial Inspection $ TOTALS Remv?ks ( ? II,nsthe E actric I vect eey ? ?Brllfy lhA41hB TbOVO Final Date 4,, w I inspeCtion has EeBn Thiz renuast void /,/s/g? 18 mqnths Imm I hereby repuesl inspection of aCOVe Ownpr electrical work installed at: Street Atldress, eox or floute No. ?zs 27-?-1 UidJ City I ection o. Township Name or No. FanBe o. Cou xt?y xJl? ? Occu 'nt (PRINT) o lhG Phone No. Power Supolier ? o Atltlress . Elec rical Conhactor ICOmpanv Namcl !?S !?? n 96zl? . ConVar.lor's License No. U ? ?S- 3 MailinB /adJress (Conhactor or Ow er Makine lnstalla[ion) ? s cJ. i.3 ~`S ??0C--e n. Aut ized St re (C V ctor?Ow Makiny Inslallationj Ph e Number ?? ?6'-6 3 ? V MINNESOTA STATE BOAND OF ELECTRICITY THIS INSPECTION NEQUEST WILL NOT Gri09a•Midwey BIAU. - floom N•191 BE ACCEPTED BY THE STqTE BOAMD l1NLESS PNOPEN INSPECTION fEE IS 1821 Universitv Ave.. St. Paul. MN 55104 on....e Ia»' an? rwnn ENCLOSED. ???f?? REQUEST FOR ELECTRICAL INSPECTION ee-ooooi-o[s?/ r??? See instroetians Ior complating this torm on beck of yellow copy. F5,f ?r} E'G?? J 1 2 "X" Below Wwk Covered by 7his Requesf hlev? Ad Rep. Type oi Builtline APaliancee Wired EqoiUment Wired Home Range Temporary Service Duplex Water Heater Llghtiny Fixturos Apt. BuilAing Dryer Electric Heaun Commercial Bldy. Fumace Silu Unloader Industrial Bldg. Air Conditioner Bulk Milk Tenk Farm other Soea v -ther lSnncitvl 1 er Sw?cify Other OtM1Ur Compute lnspection Fee Below k Fae ServiceEntrenceSize M Fee fexders/5ubfeeders k Fee Circuits U to 200 qm s 0 to 30 Am s (.[:Yi 0 tn 30 Ani s Above 200_qmps 31 to 100 Amps 31 to 100 Am s Swimming Pool Above 100-/>mps Above 100_.4ml» Transtormers Irrigation Booms PartiaL?Other Fee Signs Sueclal Inspection $ TOT PerrNrks I - ' .(XJ . HauBh-in ?3fP?/ , tha la ' I ' ? J? ?nsoacior, herehy ertify thet the abova Final 7 ?nspection has been ??? mede. / /?1 Thia reauest vold 18 monllm irom This request void ??^i P?' a??+-' ? 18 rvqnths fmm 1 ? E 26912 1-3,8-v M ,Z-? Repues4Date. Fire o. ouph-in InsVection equired? ?.,('' ?Reatly Nuw ?rvrll Nntity 1nspec- R ?Z?r Wh d Yes ?No en ea y ?Licensed Electncal Conhacmr I I hereby request inspec[ion ol above Owner electtical wark installad at: Sheet Address, 9oz or Ro te No. 7 vl-c« ' , Ciry ?C ecimn o. Townshi0 Name or No. Rmnge No. Comf??ty\ I Occup' IPflINT)I_ / I Phone Np. Po uppli¢r r? ? Adtlre55 ? I ? rmcm ? i C? ElecVi I Contractor ICOmDany N' 1 - i Jn ?' 4 C??ntractor's License No. C??4 ICl ?S-3 -yl _ ? e? L r MaJinq AdJr ss (ConVactor or OZI, Making Instaila?ion) seqo-?n r)in Auth etl Signawre CunhucloJ wner kiny Installation) EV Phnne N. er ?.?b 3 (? , ? MINNESOTA STATE BOAPO OF ELECTRICITY THIS INSPECTION REQUEST WIIL NOT Griggs.Midway 91dg. - Noom N-791 BE ACCEPTEO BV THE STATE BOAND 1821 Universicv Ave.. St. Paul. MN 55106 UNLESS PflOPER INSPECTION FEE IS Phone16121fi62-oBOO ENCLOSED. C:f.TY IlF 1=iAGAt,! rqrt.l:l'Ic.Ra JS 1'ERP1IP?AL. NC?: 6913 LA}`E.a 0:`G106: ??fl 'i _!:tR:;a !Sc .`;a4p , M: NF3•ti".° R:f(:I-I:?CiD FO.T'LhiA ;:;f':Lri 9001 4023 NORT'i-nJ7:l=N 50.00 87.55 9001 4025 hlOn.`?'IiWF:!y i:l..`..;f) 7O;r}:1. ;ti?rnip+, AI7i[itdn";;' 30.50 CRO Mp.':)t:, U';fi;F ID° JRN! ? CI7Y OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT ? PERMIT TYPE: Permit Number: Date Issued: BUILDING 031919 05/06i98 SITE ADDRESS: 4025 NORTHVIEW TER LtlT: 3 BLOCK: 2 LEXINGTON PARKVIEW P.I.N.: 10-45035-030-02 DESCRIPTION: Buildin4--Permit Type lBua.l ding W`qFr Type +s"CBYt?`Lls C?DfJe,`??'ti ? ? b. , '°?, ? ? DECK NEW 434 ALT. RE3IDENTIAL [ .--? } r-'}? } ? ? " ?"j _ ?- REMARKS: PERMIT REVIEWED BY MIKE BARCK FEE SUMMARY: Base Fee $50.00 Surcharge $.50 Total Fee $50.50 CONTRACTOR: OWNER: - ppplicant - KUZMA RICHARD 4025 NORTHVIEW TER EAGAN MN (612)726-0884 +..-,. . .. .. _;. .k' ' `Lt $ ... .. . _.. .. ..e a ? . .. }? t , „ . ' . . - Ao.i.. *v .-. " .t. I hereby acknowledge that T have read th3s application and state that Lhe 3nfi0rm '#n is cor;rect and-`.sgt^ee ?rg co?P,l,y,rak?.: apNlicable State of Mn,,: ? Statues andCityo Eagan'Ord1naFlCes. . .. __ _. . ? A PLICANT/PE MITE GNATURE ISSUED BY: S AT E T << , 1998 BUILDING PERMIT APPLICATION (RESIDENTIAL) S?D? S ? ? i( ? ? ? CITY OF EAGAN 3830 PILOT KNOB RD - Sb 122 681-4675 New Construdion Reauirertrents RemodeVReoair Requirements ? 3 registered site surveys ? 2 copies of plans (include beam 8 window saes; poured ind. design; etc.) ? 1 energy calculations ? 3 wpies of tree preservation plan if lot platted after 711/93 required: _ Yes No a? ? DATE: '?I -?-- ?- r ? b • 2 eopies of plan ? 2 sita surveys (eMerior addRians 8 dedcs) ? 1 energy calwlations for heated addftions ? CONSTRUCTION COST; DESCRIPTION OF WORK: STREET ADDRESS: 0 S LOT: BLOCK: 2, I )-e C'll YvU V tt SUBD./P.I.D. #: k ?-- Name: l /?- Phone #: PROPERTY Last FMt OWNER Street Address:YQ2- C I'UJPrLC ?-L? ?.? 4 c2 City 4 e 7724.`I State: V77 v?l Zip: Company: Phone #: CONTRACTOR Street Address: License # City State: Zip: ARCHITECT/ ENGINEER Company: Phone #: Name: Registration #: Street Address: Ciry State: Zip: Sewer 8 water licensed plumber (new construction only): and lot change is requested once permit is issued. I hereby acknowledge that I have read this application and state that the State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No Tree Preservation Plan Received _ Yes _ No _ Not Required Penalty applies when address chang and agree,16 comply with all applicabi 2aM , OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 Duplex ? 02 SF Dwelling ? 07 4-plex ? 03 SF Addition ? 08 8-plex ? 04 SF Porch ? 09 12-piex ? 05 SF Misc. ? 10 _-plex WORK TYPE )!? 31 New ? 33 Alterations ? 32 Addition ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of 5tories Length Depth APPROVALS Planning ? 11 Apt./Lodging O ? 12 Multi RepaidRem. ? ? 13 Garage/Accessory ? ? 14 Fireplace ? ;;r,15 Deck ? 36 Move ? 37 Demolition Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Building Variance y3y U/ ? v Permit Fee Surcharge Plan Review License MC/WS 5AC City SAC Water Conn. Water Meter Acct. Deposit S/W Pertnit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total:''.-°? ;'(': ; ILA,9 Engineering Valuation: $ 16 Basement Finish 17 Swim Pool 20 Public Facility 21 Miscelianeous MC/WS System City Water Fire Sprinkiered PRV Booster Pump Census Code. SAC Code Census Bldg Census Unit % SAC ti SAC Units T 88-109 TRI-LAND C0. SURVEYING SERVICES 1260 YANKEE DOODLE ROAD EAGAN, MINNESOTA 55122 SITE PLAN FOR: ROXBERG HOMES LEGAL DESCRIPTION: LOT-3-,BLOCK-Z-, LEXINGTON PARKVIEW ACCORDING 70 THE RECORDED PLAT THEREOF DAKOTA COUNTY,MINNESOTA 924.79 NORTHVIEW TERRACE 931x49 ?- '924,69 0 SCAI.E:?I"=30' 92459x N 9036'30" W 85.0099339 W.V. 0 ? o F 1 0 M 923.69 929,49 930.69 15.0.Qs - - -?'- - - - - - - 1?0 ? a 24.3S i a 21.67 GARAGE 14 PROPOSED ' m HOUSE I O 14 ? 14' T I O 921J9 O - -?c- - a 2. - ?t CD 926.49 H 926.19 ? - 5 922„29 923r29 I I5? „- :-'?' i N N L ! .? -r 0 e . O ?? O . C_ OD co 3 en ?... :: .. ? ? • _ L_ . ?/z , N 85.00 LEGEND IryVEkT ELEVL1l'ION A7 SERVICE EX7`ENSION= o DENOTES IRON MONUMENT PROPOSED GARAGE F100R ELEVATION= ? * DENOTES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION = DENOTES EXISTING SPOT PROPOSEDBASEMENT FLOOR =''>Z':" ELE VATION ELE VAT I ON DENOTES PROPOSED SPOT ELEVATION DENOTES DRAINAGE DIRECTION NOTE, VERIFY ALL FLOOR HEIGHTS WITH FINAL HOUSE PLANS I hareby certify thut fhia survsy,plan or report was prepored by me or under my direct aupervision and ihat 1 am a duly Reqistered Land Surveyor under ths Laws oi the Stote of Minnesota. r l ?'+Ct ?.? ? _i ,?.-{--•'-•r'?,.R. ;.. __ - Bradley J. Sw , Mn. Req. No. 13235 Dote $;XSX%??? ?F?4:Y?:?:ys'??XX??kX??iS'F%?:?S?YI?;X 1Fl?;i?7k?YXt.'b'X??h`•#?X?X;d"8;:,", C:CTY Cf- EP?,APd C'.Af31-CI:IiT c i ?'I":G:MIidAL. M0 u i'!32 DATE° 0/0/96 '1-Shi;:_: i5e37:55 ID;; N1ME: Fi:[CI-IFl(iTl t`U7_MA :320 9001 +OY.J NOR'i!-IVIEIq 50.00 ei.s:; 9001 402:; NarTi-iUtrt-a 0.50 . '1-eka:t E;!,re9.pt r?inoi.an';: 50.50 CRO'?f?W USC:R :l:li: NFlNCY CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT PERMITTYPE: aur.LozNs Permit Number: 033717 Date Issued: 19 J 19 / 9 8 SITE ADDRESS: p.I.N.: 10-45035-030-02 4025 ' NORTHVIEW TER 40T: 3 BLOCK: 2 I.EXIN6TON PARKbiiF't Vi?-w? DESCRIPTION: BjYi l s i in`g?,„P e i- m it T y p e Buildxrtg Wia.rk Type `'L' ensus Code ?' r f ?(` . . . ?..._,. ? FIftEPLACE NEW 434 ALT. RESIDENTIAI ? _ ? .m.. . .. , __ ? ..? REMARKS: CHIMNEY/FLUE MUST BE INSPECTED BEFORE CONCEALING. FEE SUMMARY: Base Fee $50.00 Surcharge l'otal Fee $50.50 CONTRACTOR: OWNER: -- flpplicant - KUZMA RICHARD 4025 NOR7HVIEW TER EAGAN MN 55123 (651)454-4425 I hereby acknowledge that I have read thi5 application and staYs that the iTifarmaCion is correct and agr:ee to comply with ail applica(aJ.o State afi Mn. ? 9tatutes'and City of tigan 4?rdinanc's. ?I?A ?A ?I ?N 1 APPLICANT/PERMITEE SIGNATURE (JSSUED BY: SIGNA Rll E-?- ? ? -E,6 3830 PllAT KNOB RD 55122 - 9O J 1998 FIItEPLACE PERNIIT APPLICATION 681-4675 DATE:16oT9 PERMIT FEE: $50.50 DESCRIPTION OF WORK: ? Construct oew fireplace _ Alterations to existing Install ess insert onlv Other ),S? JOBADDRESS: LOT: ? BLOCK: Z SUBDIVISION/P.I.D.#: L'rX- 77 APPLICANT (circle one only): OWNE CONTRACTOR I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. PROPERTY OWNER FIREPLACE INSTALLER GAS LINE INSTALLER comPany: w w.p ? Phone #: Sigriature: Street Address: License # Ciry State: _ Install pas line onlv Zip: Company: ( / W Vj-e 2 Phone t1: Street Address: City ??a'-&J State: Y'rw? Zip: ? OFFICE USE ONLY BUILDING PERMIT TYPE ? 14 Fireplace WORK TYPE ? 31 New ? 33 Alurations ? 32 Addition ? 34 Repair GENERAL INFORMATION Census Code. 434 SAC Code Ol REMARKS Chimney/flue must be inspected before concealing. I . 1988 HUILDING PERMIT 9PPLICATION - CITY OF EAG9N SINGLE FAMILY DWELLINGS INCLUDE 2 SETS OF PLANS, 3 CERTIFICATES OF SUAVEY, t SET OF ENERGY CALCUI.ATIONS NOTE: ADDRESSES FOR CORNER LOTS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS DESIRED. NO CHANGES WILL BE 9LLOWED ONCE BOILDING PEAMIT IS ISSUED. MULTIPLE DWELLINGS RENTAL QNITS FOR SALE ONITS # OF UNITS INCLUDE 2 SETS OF PLANS, CERTIFICATE OF SURVEY - CHECB WITH BLDG. DEPT., 1 SET OF ENERGY CALCULATIONS CONIIMERCIAL INCLUDE 2 SETS OF ARCHITECTURAL & STRUCTURAL PLANS, 1 SET OF SPECIFICATIONS AND 1 SET OF ENERGY CALCULATIONS `eD' J UN ? 3188$} . Po Be Used For: !YL ? Valuation: Date: 9/?oZ/a d ,? ,. . . ._ Site Address Lot ? Block Qa4.Weti Parcel/Sub Owner x 0ylP.v9 hlo/YJ'e6 Address City/Zip Code G.LJ/?eU///w ,N SS09y Phone -4i/ -?,r;"4 Contractor :!5Q 42 4 Address City/Zip Code Phone Meh./Engr. eZ?/Q14/p,C) Address City/Zip Code C aQ .1 Phone If -4-.51„Z 1 2 UP'P"1(;C; USh: ONLY On site sewage _ Occupancy R-3 M-1 MWCC system li- Zoning ? -1 On site well _ Actual Const V-N City water J? Allowable V-N PRV required _ ll of stories Booster Pump Length _ Depth 3N' S.F. Total Footprint S.F. APYROVALS FEES Engr/Assess Permit b('j Planner Surcharge o (0010 Council Bldg. Off. Plan Review ?6zg SAC, City Op 320. 10(), dD Varianee SAC, MWCC 00 Water Conn SDOo Water Meter r7,00 Road IInit 325 b0 Treatment P1 20 ,o 0 Parks Copies TOTAL . .. . 1/ACuaMa4 ?.- ??r xzb _ ? ? ?, ? o" N6. ' ? eFqs? ?? - X oZb = 57 2 '? ?i ?e ? I fc l7 s- - `I 6y x 13 = I 2'l?i 2 ?---- 9 q 8 X yg =?t kYo Z .-- rssrnT= ? ?`? X y9= `i q ?2i ? ._--.-- ?i 936L , ,• ., . h . , .} u1TY OF $UILDIN(I UEPARTt7ENT . . F.XmERIOR ENVE7,OPB AYENAa6 "Nlf 0014PUTAT2oN (To be su6mttited with building perroit appliastion) One.or Trro Earoily Dwelling OHpeT All Other :8ite Addreee ?. ? • Cantraotor ROX?? ! Date Plto ne LIiIEAL FEET OF -N • EXPO5ED YIALL f t? 6lbove gPade a?j ? TOTIlL 6XpO3ED WALL AREA SQ. FT. OPAqUE WALL COtIgTRUCTIONt "U+f Value x Area beteil SJ?"[)?s ??u" ? x 3@• -FT. z 310_2?. 101j U)(A) referenoe ? pn ? x s . FT. from npn ? R ? ? ?A) M(A) x 34, FT. atEacl?ed SU)(A) slieets npa X $R• FT. _ (U)(R) X 8Q. FT• a (U) ?A? x 14q. FT. _ (U)(A) WIHDOWSt "U" Value x Area Malce & Type n ii ' U- ?JCO x SQ. FT. 0)(A) n IIpu X 9Q. FT. It x 8q. FT. .. - (U) (A) x Sq. FT. _ (U)tAl DODRBS "U" Yalue x erea 14aha & Type p n 11 L nn x SR. FT. M 0 o (U) (Q) u u n x SR• FT.?° ??)(A) n n n?n x sq. FT. '•___-_.(U)(A) - x BQ. FT. ' - (U) (A) TOTA1.8 3/??12 g@. F'T._ Z(U) (A) TOTAL (U) (A) VALUE9 AYERAUS ??U?? DIVIDED BY TOTAL ti{pI,L AREp AVERAaE IIU" ? •115 or lesa for i&2 family dwellinge ROOF/CEILINat pp ' ToTAL AREAt / / ?. Detail re[arenae from npn L-x Sq. FT.?? 19 (U)(A) attached eheete. apn Q (U)(A) Describe openitige •iiuli x 9Q. FT, _ (U)(A? in roof. Ifufv x 9Q. FT. _ (U)(A) ' x SQ. Prp. (U)(A) TOTAL (U)(A) VALUE$ DIVIbGD $Y ? ro7'I?(.?j,? ', - 54ff (V(A) TOTAL ROOF/CE U AItEA G?/ ?Q AVERA4& OlU ??p25 r ventilated roofa. ? . u°gyr- 50 o g-a x C3z+ I?+? - 0 ?, ?3X ??of? -1- Ztpf2,co)= ? i Q?7X I44- gax i44-= /m z5z wiKX?Our=> -#gg-a?g 15 1 3,7(0 Iz 3I15rzP7 z- 24x?-a = zZ? s X9- = 9n, o z- 2oX?'v = I vX ?=If3, o 3- zq X? = 3 3, -7s x 2-- Z - z?Fxc?a _ 7.oX ?a _ z - ?X an ? z7 15 x ) = z7,s llXz= 22.la ?ZzX I = 22?o =-i I,zjF I 4-X 2 =? 3z?', 2r w/z sr? Z-? ?• .?, ?IZ? ?... Z? , ??? Piz' ?(Z -L4-r.. ?c,Q I ?98 0 GESS CvN? ? 9fo,9$ " ?VK 1 !9, 5z `' u.??s 3zst? TRI-LAND C0. SURVEYING SERVICES 1260 YANKEE DOODLE ROAD EAGAN, MINNESOTA 55122 88-109 SITE PLAN FOR: ROXBERG HOMES LEGAL DESCRIPTION: LOTJ3-,1311-OCK2 , LEXINGTON PARKVIEW ACCORDING TO TH RECORDED PLAT THEREOF COUNTY,MINNESOTA s2a.79 NORTHVIEW TERRACE 931K49 ? ' 924.69 0 n 931 SCALE:?I"=30' x *39 924•59 N 9°*3Q" W 850Q 931.39 w.v 0 M M o I ? I o 923.69 928.49 930.69 15.0'O ---X------- IO'Q ? "a_ 24.33? i p 2I.67 GARAGE N 14 PROPOSED °D HOUSE 14 0 ? 0 ? 14' a I PCD zt.19 a 2' ?r 9 ? i 926.49 926.f9 . 5I 922r29 923r21 1S 3 I I ! -^ ? ?I I I IN L?i-r V I f? v ' ? L} ? ? N N A 3 o E1iGAN ENGi?,•E?,?ING, ,? LEGEND INVER7 ELEVATION A"1 SERVICE EXTENSIUN= o DENOTES IRON MONUMENT PROPOSED GARAGE FLOOR ELEVATION= ? DENOTES WOOD HUB SET PROPOSED FIRST FLOOR ELEVATION= ' DENOTES EXISTING SPOT PROPOSEDBASEMEMT FLOOR = S• _ ELE VATION E LE VATI ON DENOTES PROPOSED SPOT ELEVATION ? DENOTES DRAINAGE DIRECTION NOTE ' VERIFY ALL FLOOR HEIGHTS' WITH FINAL HOUSE PLANS I hxsby certity tAat tAis survsy, plan or report was prepared by me or under my direct suparvisian and fhat i om a duly Reqistered Land Surveyor under ihe Laws oi the Stote of Minnesota. Bradley J. Sxe61`oA, Mn. Rep. No. 18235 Date ' ' --VIALL SECTIOH-- .' Determiaing "1T'l valuee at Roof$ Walli Rimg and Conc. Block I R00 ' 1.) ! 2.) 3.) . a., 5.) F CEILINQ Interior Air A'ilm 5/811 ayp. Bd. Insulation Exterior Air Film (3TILL) ispll s I/R= ? 'POTAL (R)a 4,.18 ? WALL 6.) Interidr Air Film 7.) i" ayp. Ba. 80 Insuletion 90 8u%t,'tR%TC 10,) Masonite Siding 11.) Exterior Air Film R VALU 0.61 .56 qA•ov .6t R VALU 0.68 .45 Z? .17 . ulTu a 1/Ra .CJY43 TOTAL (R)=Z3-01 ?- RIM 12.) Interior Air Film 13.) Inaulation 140 211 Fir Rim.Joiet 15.) VukLrQvsG 160 Maeonite 3lding 17:) Exterior Air Film R VALUP 0.68 19•00 1.88 Z.67 .17 °p° = 1/R= cAp TOTAL (R)= 4',f) .11tj FOUt7DATI0N 18.) Interior Air Film 19.) 20.) R%G+D IPJsu(, 21.) 12" Copcrete Block 22.) . 23.) Exterior Air Film npn a IIR= .? A VALU 0.68 5•? 1. 28 .17 TOTAL (R) = 7-13 CITY OF EAGAN APPLICATION FOR PERMIT *XOTE: PAYMTP OF FEE AT TIME pg ArriscAMorr DOEs rxrr wrsrizcnE APPROVAL OF PERNIIT. nNsPECTIorr oF sEWER r,rro/oR MM TnSmnr.ramrpNS WnL Mr gg SQim- trzM vrrru, PmrffT HAs BEM APPROVID. SEWER AND/OR WATER CONNECTION ?'******k?lf4***ir******##*t?k***f ##!t**Y (Please Print 1) PROPERTY ADDRESS: LEGAL DESCRIPTION: IF E7ff5T2NG STRi:CZL'RE, DATE OF ORIGINAL BL?ILDING PERMIT ISSL'ANCE: ' i PRESENf ZONING/PROPOSID LTSE: (?n Year J [] COMP'ERCIAL/REi`AII,/OFFICE 0 IIv'DC'STRIAL C] INSTIZL,'TIONAL/GOVII2TME-NT ? R-1 SINGLE FAPffLY ? R-2 DLPLEX (1wo Units) ? R-3 ZOWMOUSE (Three + Units) ( Onits) ? R-4 APARTlE]T/CODIDOMZNILfi1 ( Units ) Z? ? ?:'I'??e7?I?/?P, ?d CITY,'STATEr ZIP:- If 1?e 0 PHONE: :a'L ? • 3) • u?:?'• NAME._?g,?? For City Use . Plumbers License: ADDRESS: ? Active CZTY. STATE, ZIP: Expired ! Not recorded PHONE: MASTER LICII+ISE# St?f Initial 4) ?•• • • ??- NAME: _ ADDRESS: CITY, STATE, ZIP: PHONE: ? -5) ? v ? ? r. • ?• : ? • o? - a? CONNECfION T0 CITY SEWEE2 ? CpNmDcpION TO CITY WATER ?(YI'HER_. 6) u r• ?- • i- ? PLFIISE HOLD APPROVID PERMIT FY)R PICK-OP BY ONE OF ABOVE --- -- PLFA.SE MAIL APPROVID PERMIT 70 1,??. 3, 4, ABOVE l/ . „ _ Ir„-..t.. ___? • . . . FOR CITY USE ONLY PERMIT # ISSUED i , 97a 7. ? Pd w/Bldg. Permit FEES: $ $ ID '5--0 SEWER PERMIT (INCLUDE SURCHARGE) $ $ S7'?) WATER PERMIT ( INCLODE SC'RCHARGE ) .. $ $ WATER METER/COPPERHORN/OL'TSIDE READER $ $ WATER TAP (INCLL'DE CORPORATION STOP) $ $ SEWER TAP , $ $ ACCOC'NT DEPOSIT - SEWER $ $ ACCOC'NT DEPOSIT - WATER $ 'C?) d $ WAC . . S ? J c' ' CJ"fl $ SAC $ $ TRL'NK WATER ASSESSMENT $ $ TRC'NK SEWER ASSESSMENT $ $ ' LATERAL BENEFIT/TRLNK SEWER $ $ LATERAL BENEFIT/TRUNK WATER $ S WATER TREATMENT PLANT SLRCHARGE $ $ OTHER: S 71`cl-0 $ f? I' D-Z? TOTAL i RECEIPT RECEIPT DOES LTILITY CONNEC TION REQLIRE EXCAVATION IN PCBLIC RIGHT OF WAY? Q YES IF YES, THEN A"PERMIT FOR WORK WITHI[V P,UBLIC Q NO ROADWAY" MUST BE ISSL'ED BY THE ENGINEERING DIVISION LIST AS CONDITION . . A SUBJECT TO THE FOLLOWING CONDITIONS: APPROVED BY: ? i TITLE: DATE : ? ___Use_B_L_UE or BLACK Ink For Office Use I ii I I 1 . i7G~ s I Permit i of Eap I DECEIVED 3830 Pilot Knob Road Permit Fee: ~4 Eagan MN 55122 APR 2 5 2014 I I Phone: (651) 675-5675 Date Received: ~ I Fax: (651)675-5694 Staff: 2014 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: 4/17/14 Site Address: 4025 North View Terrace, Eagan, MN 55123 Tenant: Suite 3 Resident/ Owner Name.. Richard Kuzma Phone: 651-403-3127 Address/ City /Zip: same Name: K&S Heating, Air Conditioning & Plbg LLQicense MB5216 Contractor Address: 4205 Hwy 14 W city: Rochester State: MN Zip: 55901 Phone: 507-282-4328 Contact: Heidi Brown Email: hbrown@ksheating.com New XX Replacement Additional Alteration Demolition Type of Work Description of work: NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City 3 Code. Please contact the Mechanical Inspector for information on permitted screening methods. N RESIDENTIAL COMMERCIAL I XX Furnace _ New Construction _ Interior Improvement Permit Type XX Air Conditioner _ Install Piping _ Processed j _ Air Exchanger Gas _ Exterior HVAC Unit _ Heat Pump _ Under/Above ground Tank Install Remove) other RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Residential New (includes $5.00 State Surcharge) _ $ 60.00 TOTAL FEE COMMERCIAL FEES Contract Value $ X.01 $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal Permit Fee *If contract value is LESS than $10,010, Surcharge = $5.00 Surcharge* **If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005 ***If the project valuation is over $1 million, please call for Surcharge TOTAL FEE I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x Rick Keehn x 4L~ Applicant's Printed Name Applicant's Signature FOR OFFICE USE Required Inspections: Reviewed By: Date: Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening PERMIT City of Eagan Permit Type:Building Permit Number:EA158356 Date Issued:10/10/2019 Permit Category:ePermit Site Address: 4025 Northview Ter Lot:3 Block: 2 Addition: Lexington Parkview PID:10-45035-02-030 Use: Description: Sub Type:Siding & Windows/Doors Work Type:Replace Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of house wrap and leave on site for final inspection. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. Valuation: 10,000.00 Fee Summary:BL - Base Fee $10K $191.75 0801.4085 Surcharge - Based on Valuation $10K $5.00 9001.2195 $196.75 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 A Kuzma 4025 Northview Ter Eagan MN 55123 (651) 485-1899 Discount Windows & Wares Inc 2823 Hamline Ave N Roseville MN 55113 (651) 633-3308 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA169364 Date Issued:05/24/2021 Permit Category:ePermit Site Address: 4025 Northview Ter Lot:3 Block: 2 Addition: Lexington Parkview PID:10-45035-02-030 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. 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 A & Barbara Kuzma 4025 Northview Terr Saint Paul MN 55123--155 Minnesota Restoration Contractors Inc 12252 Nicollet Ave Burnsville MN 55337 (612) 280-4807 Applicant/Permitee: Signature Issued By: Signature