4546 Oak Chase Rd11N ?Y L' ?.11V1r it??,vnL
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
E an Minnesota 55122-1$97 Date Issued:
a
(651) 681-4675
. ?y
SITE ADDRESS:
"nw -" I
tai APPLICANT:
l ht, t l ?,1itid!'?F}b
PERMIT SUBTYPE:
TYPE OF WORK:
wil i i r, r14«
03 ar>:r4
wtla f>/?1 9
Rl r I1nRn
ta F t> n t rr
P F irunr
Permn Holder oats rslepnone a
SEWER/
WATER
PLUMBING
HVAC
Inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
?
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
OYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TES7
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
• CITY OF EAGAN Remarks 1
,ydditiv.-,. 0AK CHASE 51'H ADDN Lot 5 pik 1 Parcel 0*_53504-05d-01
Owner ' street 4546 OAK CHASE ROAD state EAGAN hiN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 2Z
SEWER LATERAL ZZS
Z(tD
WATERMAIN
WATER LATERAL (
WATER AREA 1984 155.00 155.00 C008422 4-26-33
STORM SEW TRK 1984 272 50
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
faEd? /D - A?7DO - D//- 71
• CITY OF EAGAN
,addiciR•, _ OAK CHASE 5TH ADDN
Owner_
Lot 5 Rlk 1 Parcel 10-53504-050-01
Street 4546 OAIC CHASE ROAD State ?GAN MN 55123
Improvement Date Amount Annual Years Payment Receipt Date
STREETSURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 19-Z-0 1984 41.78 8.36 5
SEWER LATERAL $ Z1 1994 117-82 23- 56 5
Z
WATERMAIN
*WATER LATERAL 90-96 5
WATER AREA 1994 9.41
C008422
*STORM SEW TRK 1984 5
#STORM SEW LAT 1984 5
0 SEW TRK 1984 272.50 272.50 C008422 4-26-83
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
BUILOING PER.
SAC
PARK
PERMIT # O ?
(0 M
RECEIPT # 3 31
MINIMUM
DATE. 6 ?4 MINIMUM
LGAN FEE elo
PERMIT
n 31s c • ?
FEE - $10.00 + $.50 TOTAL C;)
. FEE - $20.00 + $.50
1. Bldg. Type: Res ?? Comm Inst 2. New ?- Add Alter Repair
3. Total Bid Price 37 ? v 4. Job Address yS ??G ?? K? A j'?"
Lot -? Block ? Sec ?,x?•? '' ,? ?? 5. Owner ?k?Jsa?.r
No r wu? ?, ?? t fW • f f? o?- {,.a l? ??? 7
6. Contractor ffu1.`+'f dA"Q. ,1401
(Name) ?y 7_ ? ? ? (Street) ICitYI (ZiP)
7. Contractor Phone #
RESIDENTIAL HEATING - 01-100,040 BTU's -$24.00. Each additional 50,000 BTU's or fraetion -$6.00
RESIDENTIAL COOLING - 01-24,000 BTU's -$12.00. Each additional 6,000 BTU's or fraction -$6.00
MODIFICATIONS/ALTERATIONS -$10.00 minimum fee
? HEATING X VENTILATING HOT WATER STEAM AIR CQND.
AIR PIPING PRaCESSED PIPING AIR HAND. EQUIP. RtFRIG.
-L RES. GAS PIPING OUTLETS -$1.50 TANKS: L.P. UNDERGROUND OTHER
COMM./I . RA - 1% bf O AL BID PRICE PLUS $.50 STATE SURCHARGE FOR EACH $1,000 OF FEE.
Signed: for
Approved Inspections: Date Rough Insp. Date Final Insp.
t
, ' I {
PERMIT # CITY OF EItGAN FEE
PLUMBING PERMIT j Z
RECEIPT # 454-8100 S/C
r MINIMUM RESIDENTIAL FEE - $10.00 + $•50 TOTAL
DATE. MINIMUM COMMERCIAL FEE - $20.00 + $.50
1. Bldg. Type: Res ?- Comm Inst 2. New x Add Alter Repair
3. Total BVrice 4. Job Address yy-y?
Lot S Block ! Sec ?'`?` 5. Owner
6. Contractor !' ?xL .: i !/l fJ? r/ ? / Iv l G iay?> ?! :.J. i9c-'[ . ? ,? A?i??L ?,..??'•
(Name) (Street) (Clry) (ZiP)
7. Contractor Phone #
NO. FIXTURES
a Water Closet - $3.00
-7-Bath Tubs - $3.00
TLavatory - $3.00
Shower - $3.00
?KdChen Sink - $3.00
`Urinal/Bidet - $3.00
NO. FIXTURES
/ Laundry Tray - $3.00
TFloor Drains - $1.50
^LWater Heater - $1.50
Whiripool - $3.00
TGas Piping Outlets - $1.50
-Softener - $5.00
NO. FIXTURES
-Well - $10.00
Private Disp Syst - $10.00
?Rough Openings w/o
Fixtures - $1.50
COMM./IMD. RATE - 196 OF TQTAL BID PRICE PLUS $.50 STATE SURCHARGE FOR EACH S1,000 OF FEE.
Signed: for
?
Approved Inspections: Date Rough Insp. Date Final Insp.
PERMIT #
PLUMBING PERMIT RECEIPT # Q_-'
CIT1f OF EAGAN
3830 PILOT KNOB ROAD, EAGAN, MN 55121 DATE: ?? G -??
Site Address L 222-
Lot 4. Block ? Sec/Sub
? Name
?c Address
c City
? Name
c Address
p City Phone _
FEES
COMM/IND FEE - 1% OF CONTRACT FEE
MINIMJM - RESIDENTIAL FEE - $10.00
MINIMUM - COMM/IND FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000.00)
FOR: CITY OF EAGAN
BLDG. TYPE WORK DESCRIPTION
Res. x New
Mult Add-on
Comm. Repair
Other
NO. FIXTURES
1-Water Closet - $3.00 TOTAL
$ _
Bath Tubs - $3.00 'qamw
I Lavatory - $3.00
Shower - $3.00
Kitchen Sink - $3.00
Urinal/Bidet - $3.00
=Laundry Tray - $3.00
Floor Drains - $1.50
Water Heater - $1.50
Whirlpool - $3.00
Gas Piping Outlets - $1.50
Softener - $5.00
Wel1 - $10.00
Private Disp. - $10.00
=Rough Openings - $1.50 ,
FEE STATE S/C: 5 t'
GRAND TOTAL• ? y• ko
z.?- : • : a ?
BUILDING PERMI
To be used foF S r?
CITY OF EAGAN F` ? n
3830 Pilot Knot? Road, P.O. Box 21-199, Eagan, MN 55121 x'4 -•
PHONE: 454-8100
T Receipt #
11594
Site Addriess 1 4546 OAK CHASE RD Erect C? Occupancy H3
Lot 5 Block 1 Sec/Sub. UAIC C}IASE 5`I'H Remodel ? Zoning Ri
Parcel No. ~ Repair ? Type of Const V
Addition ? No. Stories 79
s Name •70=-fh: ON-4,FiLAIdD C0I4STRUC'TIM1Q'e 13 Length
= 13311 t?4UI?GA.?1 ?V E 50 Demolish ? Depth 92
p Address Int. Impr. ? 5q. Ft
City U.RiVSV44W - ii94-9300 Install O
o Name SAME Approvals
Z
$ ¢ Address Assessment
Ciry Phone Water & Sew.
Police
FW Name Fire
? ? Address Eng.
W
i City Phone
Planner
Council 3/4166
I hereby acknowledge that I have read this application and state that the Bldg. Off. 3/ 8/ 8 6
information is correct and agree to comply with all applicable State of
Mtnnesota Statutes and City of Eagan Ordinances. APC
Ver. Date
Signature of Permittee
Permit ±
5urcharge
Plan Revie
Water Conn. SUU. UU
Water Meter63,50
Road Unit 290.00
Tr. PI. 156.00
Copies
Total $2,428.50
A Building Permit is issued to: C:liNS".L ri:C1C'1'IOF+ on the express condition that
all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Building
• PKmM No. Pamit Nolder Dab T~ona N
Plumbiny
H.T.A.C.
7
? ` - ?iM T
-3,; s
/ -
son??.
Inspac8on Dab Insp. Commsnb
Footlnys I
Footlnysil
Foundatbn
Frarrdny
Rooliny
Rouyh Plbp. 1?
-,/ - i
??
41JV J71
Rough Htp. i?
FM*plaos f,
Flnal Hty.
Flnd Plbq.
Bldg. Flnsl
Ce". OCC. ? 7 8
Dock Ftq.
Dock Frmq.
WNI
Pr. Dhp.
CITY OF EAGAN
3830 Piio? Knob Road WATER SERVICE pSAUT
P. O. Bo-- 21199
Esg?n, MN 55121 pE?IT NO.:
DATE:
Zoniny;
Owner: No. of Uni ts: ?-
??. ..onst.
$iM
Addrcss: se , oad T:? G1. ? ? ;se .!t11
Plumber: '.. - _ ?• -- ? -1h in ? - .
Metar No. - Qvs- _
ion Chorge:
Slu: ', oCR
Recder?No.: S 5a/ ?t:
I ? lil Cd 1!l.0t)p4'
ar" ft ffim P, RtE*(i?8+b?- ELE ?- `?- 5 0,1 . . -, r?
QUIREL?'?' 5L. ??:?1,r
e,, ai• ,: - .,; ??? . .. ?. ? ?,-
p?e ? 1 Data Paid:
r?sp.:
In,p.:
CITY OF EAGAN
3$30 Pilot Kno6 Raad NwER SERVI[E PE"ff
- P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE;
Zoning: No. of Units: '
Own?r.
Add?ess:
Site IWd?ess; . . ?
Plumber.
?n?eeo *on* wim ON Cfty of ffe"n Connsction Chorpe; =
Aocount Drepoait:
P'ern* Fee:
; gy Su?dwrge;
r: Dote of Irap.: Miac. CMroe:;
? Insp.: Totol:
Datr Poid:
CITY OF EAGAN
3830 Pilot Knob Road
P. O. Box 21199
Eagan, A'.N 55121
t Zoninp:
Qwrer. ' •? , ?: _ , .:' "
, Addrtss:
-Site I Plunber.?.
rc
Na..
!tSiu:
?
; Reodar No.:
1 NrM ee eerroly wiNh !iw Cilp af Ee96w
;. QIUM/IiN.
By
Dat+e of I nsp.:
WATER SERVICE PERIIAI4
PERMIT NO.:
DATE: _ No. of Units: Cor?nection Chorqe:
/ltaouM Deposit:
Permit Fee:
Sufcharge: ,
Misc. Cho?pes:
Total:
pote Poid:
?,up.:
CITY OF EAGAN
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55721 N°- 11594
PHONE: 454-8100
BUILDING PERMIT Receipt# bG Va'7
7obeuaedlor SF DWG/GAR Est.Value $134,000 Date MARCH 11 19 86
SiteAddress 4546 OAK CHASE RD Erect C] Occupancy R
Lot 5? elock 1 Sec/Sub.OAK CHASE 5TH Remodel ? Zoning
Parcel No. Repair ? Type of Const V
Addition ? Na. Stories 19
W Name JOHNSON-REILAND CONSTRUCTIOWve ? ?ength
z
13301 MORGAN AVE SO Demoiish ? Depth ?-
3 Address Int.lmPr ? SQFt.
° Crry BURNSVVA& 894-9300 Install ?
x SAME Approvals Fees
. o Name
u a Address
?
?
City Phone
r?
F W
Name
Address
a W Ciry Phone
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 ga r inances.
Signature of Permittee
Assessment _
Water & Sew.
Police -
Fire
Eng.
Planner
Cquncil 3/4/86
sid9. on. 3/8/86
APC
Var. Date
Permit '' ??" . ""
Surcharge 67.00
Plan Review 259.00
SAC 575.00
Water Conn. 500.00
Water Meter 63 . 50
Road Unit 290.00
Tr. PI. 156.00
Parks
Copies-_ -
r....,i 4<1-3 O
A Building Permit is issued to: _ JOHNSON-REILAND CONSTRUCTiON
all work shall be done in accordance
Building Official
on the express condition that
Statutes and City of Eagan Ordinances.
14,P1 REQUEST fOR ELECTRICAL INSPECTION ea-oooot.oa
' See instructions tof comoleting this /orm pn hack of y611ow coOV. 06! ?
?' ?-° 6`? 8 "'1f" Below Work Covered by 7his Request
Add pep. Tvpa ol Hui10ing ApPliances Wirea EquiVment WireA
: -ltme Range ' Temporary Service
Duplez Water Heater Liyh[iny Fixtures
Apt. Buitding Dryer Electric HeaLn
Commercial Bldg. Fumace Silu Unloader.
Indiis[rial Bldg. Air Conditioner Bulk Milk Tank
Farm Otne. oeci v ct ner (sncary)
t er Specify t e? O1her ompute lnspection Fee Below " ' tl Fee ServiceEnirenceSize tt Fee Feaders/Subfeeders N .F e Circuits
0 to 200 qm s 0 to 30 qm s ? 0 to 30 Am s
Above 200 qm ?s 31 to 100 qmps 31 to 100 Am s
Q9 Swimming Pool Above t00_Am s Ahove 700_AmPs
? Transiormers ?rri ation Booms .Partial.'Other
Signs Specialinspection
TOTA
Re.
m.ks / L E
.17? i
Nough-in . :?te? ?. ?ha EI tn
? t?'?? Inspector, ?ereby
certify thet the ahove
F?^a? inspaction has been
p ? made.
TAIS reauest roltl 18 monlhe Irom
This rn0ues? void q-10 (ol q12
,e bhs C -5from
? , - ? -
628 ?l7
I D-ate ? Fire No. Rooph-in Inspection
Reqwred?
?Reatly Now ? Will Notity_ Inspec-
44 . t 4t ?yes ?NO ?or When Neatlv
censed Elec[rical ConVador I hereb reV Ouest inspecllon of above
Owner electrical work insfalleA at
Sire t Addres , Boz or R0142 No.
}r
?i Gty?? ?
aaion o.
Nange o.
To nshio ame or No.
I
'County
O ' t IPflINTI
c ? o -N s o y D Phone
8#`y-
3
Pow r uoPlier AAtlress
Electrical Contractar IComDany Name) .
KF.NDRICK ..FC'.TR _ Cunt dctor's License No.
Ma,l,na A14540 „om)
Auffior r Vj r Ow lionl
. f Phone Number
MINNESOTA STATE BOARD OF ELECTqICITY TNIS INSPECTION REQUEST WILL NOT
GriB9s-Mitlwey 91dg. - Boom NA91 . BE ACCEPTED BY THE STqTE BOAND
UNLESS PqOPEN INSPECTION FEE IS
1.421 University-Ave.; Si: Peul, MN 55106'
PMna 16121 297-2111 ENCLOSEO.
1999 BUILDING
-?) 14 (,°`?), ?-4
New Construction Reauirements
PERMIT APPLICATION (RESIDENTIAL)
CITY OF EAGAN
3830 PII.OT KHOB RD - 55122
(651) 681-4675
! j
RemodeURenair Reauirements
? 3 registered site surveys
• 2 copies of plans (inGUde beam 8 window sizes; poured fnd. design; ete.)
? 1 energy calculations
? 3 copies of tree preservation plan rf lot platted afler 711/83
required? _Yes _ No
DATE:
DESCRIPTION OF WORK:
? 2 wpies of plan
? 7 site surveys (exterior adddions & decks)
? 7 energy calculations for heated additions
4f
CONSTRUCTION COST: J?7AZ°iAtf' dP.45cX
STREE7 ADDRESS: CZ sE &0122
O cic_ A
LOT: ? BLOCK: SUBD./P.I.D. #:
Name:?G/?E Phone #: ? 52 - oleO - DS.ri?
PROPERTY Lmt ' First `
OWNER p
Street Address:_
City /Axl State: /7w Zip:
Company: f?/}Phone
CONTRACTOR
Street Address: License # Exp.
Ciry State: Zip:
ARCHITECT/
ENGINEER Company: Phone #:
Name: Regishation 4:
Street Address:
Ciry State:, Zip:
Sewer & water licensed plumber (new construction only): _
change and lot change is requested once permit is issued.
Penalry applies when address
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances. f"? •.
?
Signature of Applicant: ? G -
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No
RECEIVED
MAR 0 4 1999
_ Not Required BY:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex ? 11 Apt./Lodging 11 16 Basement Finish
? 02 SF Dwelling ? 07 4-plex ? 12 Multi Repair/Rem. ? 17 Swim Pool
? 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Facility
? 04 SF Porch ? 09 12-plex ? 14 Fireplace ? 21 Miscellaneous
? 05 SF Misc. ? 10 _-plex ? 15 Deck
WORK TYPE
? 31 New ? 33 Alterations ? 36 Move
? 32 Addition ? 34 Repair ? 37 Demolition
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of Stories
Length
Width
APPROVALS
Planning
Basement sq. ft.
Main level sq. ft.
sq. ft.
sq. ft.
sq. ft.
sq. ft.
Footprint sq. ft.
Building
Engineering .
Census Code
SAC Code
Census Units
Census Bidg
MC/ES System
City Water
Booster Pump
PRV
Fire Sprinklered
Variance
Permit Fee
Surcharge
Plan Review
License
MC/ES SAC
City 5AC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
Total
Valuation:
% SAC
SAC Units
PERMIT
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55722-1897
(651) 681-4675
SITE ADDRESS:
"r.:f.?l?l.: 7.0 -SS'S0 4-0 I>V,-() 1
DESCRIPTION:
. i 0 I< f9 D Fi I1 F4 (3 F_
I+E Pr,TF2
43<i 01, 1'. RES:I:UEiltil'TAI.
?t} z t
PERMITTYPE: [suI_1 0 111 G
Permit Number. 0 3 a 17: 2+7
Date Issued: 0:3 ! m S! 9 9
c;?:,Ab Ordl( CH A:-;icr)
L(ii: fr? fil.:tJ(: K^ . i .
OFii. CI -Ifi S F? 6111 .
' ? ?,rR ar?F
?'u.iltlin-q.aerm; 5.. I V17f.:
r?let?sti6 CCt1t3 ?
Jf' k l
i ?
. ?
??,? ?,? J.L •_.
REMARKS
FEE SUMMARY:
CONTRACTOR:
OWNER: -
K I. l N L
Q Fl
F?fr;if,h1.
{ f; 5 1) 68 01--4?15 ti6
appJ.i c ant. _-
;aTCtiA?6
Y Cf-lFSE Rp
P1RI 55119
] ho reby a c{,nnwj.c ct€+a trtir:t; 7 h=.avA r,=o d th:? ?p p ticaa ti oii zr?; sCa ta E.no?. ?hc
informatian i.scc+rreet arnd rrqree LrscamplV'wa.t?hall opR1+.cPls.fe SGate af P1n.
:L??Lu';ns arirl Gity af "taqan t)r?tn?rtcc?s.
L
APPLICANT/PERMITEE SIGNATURE
ISSUED BY: SIG ATU I?--
I
//S? 1985 BUILDIAG PERMIT APPLICATION - CITY OF EAGAN
NOTE: ALL COHTRACTORS MUST BE LICENSED MITH THE CITY OF EAGAN
COHIiERCIAL
INCLUDE 2 SETS OF ARCHITECTURAL INCLUDE 2 SETS OF PLANS
& STRUCTURAL PLANS, 1 SET OF 3 CERTIFICATES OF SURVEY
SPECIFICATIONS AND 1 SET OF 1 SET OF ENERGY CALCULATIONS ?
ENERGY CALCULATIONS '
$2,000 LANDSCAPE BOND
To Be Used For: S?G ?91?"1, 9f?/?J,1., Valuation: Date: 2-// $6
SINGLE FAMILY IriWELLINGS
Site Address 7S ??S &'°'^' C4? f OFFICE USE ONLY
?I ?
Lot S Block /
Parcel/Sub tlW 44Q," 117yTf/' .400
Owner A'/CAi/O Ce'YSl'
Address 1-3-id/ AfMli{l-n/ f}?B' `i.
City/Zip Code '/?`!ShcGG?
Phone ?`I`/-73D0
Contractor !6kw- 4;05
Erect X
Remodel ,
Repair ?
Addition
Move ?
Demolish
Int,Impr. ?
Install T
APPROVALS
Occupancy
Zoning
Type of Const
# of Stories
Length
Depth
Sq Ft
Addrez
City/2
Phone
Arch,/
Addres
City/2
Phone
FEES
Assessments
'- Permit
Water/Sewer Surcharge
Police Plan Review
Fire SAC
Engr Water Conn
Planner Water Meter
Council 3• 4 8?* Road Unit
Bldg Off ? Treatment P1
APC Parks
Variance Copies
TOTAL '?
- ------?
'i kl?
05o x 58 - 4-`I ?sCf7
? c?, x.?8 - 4 4 S9 g-
54o x?= 3 l 3Z?
TZo
133?0?
3 D
?
r7?
i
CERT/F/CATE oF .9.hvwr
? ?
?
?
, i
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N 13??$ /? \
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1
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Scale: 1" = 30'
\ 3 ?
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DESCRI PTI OfJ
/ NfA'fBY C£F17FY 7HAT TH/S SiA?VFY, fLAN OR REPORT
:"'S f.'=wFAn£D BY [<'E OR UNSE-R klY 0/kfCT SYe -,"F.Yl3/4.Y
A::D T,Y4r I AM A:YJLY n'EG/ST£RFO LAND S[JRVEYLIY
Ulo'pfR rH£ LAI%'T Df' THE 57ATE U`' M/Nh'ESOTA.
( ( ?;-? .`?i'./: i?! "/? ..-'-- -. ..?• ,?
car£ /? ?? ? ( °6 6 Rfs. ,Np 8140
Lot 5, Block l,
OAY, CHA.SE FIFTH ADDITION
Dakota County, I•1innesota
Plat bearings shorm
o Denotes iron monument
baandt angineaeing P. our?eej0ncj
9705 woodr trail
burntuilia, minnaroto 53337
':4•\°° ??
(012) 435-1900
?.. . :
_ ,?... ?. , .--.
. A
. ?- j?AUrMi?jV
?evJ
EXiER10R ENVEIAPE AVERAf.E "U" COHI'UTAtION I
a,ne r_.?nsbVsm/ ? ?i7cA?clo Ce.?sr naaresg AMoi Hs,""a+? irvd s, Phone ?9`? ??3oa
Legal Deacrlption of Property: l.ot'? Block ? Addition0/FC?el1?R5@' pete Site Addrese
AVP.RAGE LINF.AI. FEFT O°
E!IPOSED I:ALL AREA ABOVB CMOF. PERl1I? 110.
llain level I.Sneal Et. of framed vxll aAove gcadc x height of vall
Aim jaist atee Linenl Et. of rim l9 2 x heiqht of tim • P! S.. 1(09
Lover level " Q .
Lineal ft. of [rnmed wnll above grade W x height of vall ?•? -- 8•0
S? 3
Lineal ft. of wnsonry uall above grade oj-x helght ebove grxde • fe"'1 9tF
iOiAL Wall erea ebove grade Sneluding vlndova and doora - Z 34 15P
WIND0VS: Area x "U" v.11ue
Nake a cyve P1IJEGRACT G5M'T'S sq. Et. 202, _"u" .352- '?I,IO [u?(n)
sq. ft. x (U)(A)
aq. ft. x (lp(A)
.? . sq. f[. x "U•• . (11) (A)
sq. [[. x 'lul. tl!) (A)
. .. sq. ft. x'•U•' (V)(A)
. . sq. ft. x "U" ? (U)(A)
u u ??
sq. f[. x vV" (U)(A)
sq. Ft. x "U" (U)(A)-
eq. ft. x "U" (V)(A)
sq. ft. z "tl" (U)(A)
?• ?!?
? sq. Et. x nUv (U)(A)
. ?. ?. eq. [t. x 'b° (U)(A)
aq. Et. x "U" (U)(A)
n ?. eq. ft. x u0^ (V)(A)
. ?. ?? ??
aq. ft. x Ull (U)(A)
sq. Et: " ' x "U° (V)(A)
u r. sq. f[. x n0•r (U)(A)
tf00RS: Area x "U" volue 11ake b type ?_? sq, Et. 3 a"0" O.q ?(U)(A)
PINECA?ACT 0 1V eq. [t. 6 x"U" . O t0)(A)
9y. tc. x "u" - (u)(a)
sq. [t. x "U'-? (U)(A)
OPAQUE MALL CONSTRUCiION; Area x"U" value aOB ? 2 '
FRAMED WALL (to[al aree lese
Detail reEer opening, Eraming members in ence Erom aall, rim loist erea 6 maaonry) actacbeJ --MfEr- W?? sq. ft. x .0q3 • (?8•5 (U)(A)
aheets _Framine membeca Sn vall sq, ft, (e)(A)'
Rim ioist area sq. ft.?x "U"O • (1!)(A)
_Hnsonrv area abovr erad eq. Et.??_x 1(U) (A)
Zv35 l01 .00
TOiAL Wall Are.a IncluAing 2 J'7 p
• 4Lndoae 6 Doore Z.73 t07AL (U)(A) 6.?T8
TOTAL (U)(A) VALVES 2?'?a s AVG. ^il" i 4
D[VtDED BY tOtAL IJALL ARF.A s
AVLRACE "V" ltinimum ,'i-y"or lese fot 1 b 2 Eamilq duellings NSnimum .22 or leas for all other bulldinge
NOiEs Lf nveraRe "V" vnlvea ea celculated above do oot meet the BnerRV Code requicemente, the
"Alerne[e EnveloDe Design" ss !ndlcated on Page 5 may be used..
SSd1nR .
Shea[hing
34' eo[[ vocd ?
1y"_'!ry vnll
Interior air (ilm ' .68
WALL SECT10N5
41: Uee lOX o[ opnque vall atea
(o[ [raming members
fRANEO WALL
6xterior ali ESlm
SSdinR
Sheathing
6"
i8K' batt insulatlon
N" dry vall - --
Interlor aLr film '68
TOT ., e _ 13203 .
u . l/a V - . 043
RIH JO1St_AI?',A..
Extedor air Lilm
Siding
Sheathing _
1li" soft vood
Ine lat nn ? •
In[etior air film
rege z
R-Velue
-11
_
•67
--a.o6....
(O'N
45
4e7
Ar0&
19.00
.45
•67
A.ob '
1.88
13. 4D
.68
i7:'AL R ? 18•4'?
u-i/n u- •054
lUSONRY WALL .
Ex[eclor air film •17
12" concre[e block ( ?sep
lneulatlon
Interlor elr tllm .68
? TOtAL R • 13.? O
U- 1/R U? i ?75
FRALIINC MEMBERS IN NALLS
Ezterlor aic film
- i0'[AL R- 10 4 9 I
u - i/n u - . DAZ-
IoD Viev
? •
i
:
ROOF CfILINC
Outeide air i m .61
------"-
Inaulatlon 44 oo
tnterior eir film .61
TOiAL R - 45.*78
U - 1/R
Fmr`c
U . - 027.
Outaide air film .61
\ Inaulation tcz--......'_'--_'_"__. . .,.. . ..
Jf' Drywall .45
3 s? ?.roeo ?8
Intetior a1r film .61
SOiAL' R ' 7Z •37
V- 1/R U? ?D
Outaide air film .17
------
Buil[_.up..toofinv. . ..... ... .___•..??. _
f• Insulotlon Nood deeking
Interiar air film •
.61
i07A4 R ?
0-1/R p.
ROOF/CEILING:
TOTAL AREA: I? 1 V
Detall referenee ?
---reo ?. x R,. «. 188 . 4,51 a?)c„
from above. p" .OZ-=,. x sq. ft./69o (L')(A)
Descri6e openings ?in rooE .?U? x sq, ft. (U)(A)
x nq. Et. (U)(A)
ull x eq.
[t. (?')(n)
??
. ?.? x eq. [t. (U)(n)
??•? a BQ. [[. (U)(A)
TOTAL (U) (A) VALUES TOTALS I S7(J Aq. ft. .Ip (U)(p)
DIVIOED BY TOtAL ROOF/ 441&1 OZ 7, AVC..
. , CEI6INC ARFA `aU
, 78 AVCRACE "U" .BS'(or ventllated roofs
.10 ter all other eonatruction
l70TES lE averase "U" values sa ealculated above do not meet the Enq.ergy Code tequirements, the
"Alternate Envelopa Deslgn^ se indicated on Pege 3 Asy be used.
Page 4
?
Ex[etlor eir [!lm •92
y" plyvood 6If" particlc boerA ,66
Insulntion
lnteclor air f.llm .92
tOTAL R ?
` U - 1/R U '
Slab on grade
' Insulatlon ahnll have a minimum R-Value o[ 7.5 end muet
eztend horieontally (as Slluatratcd) or vertlenllq s
dietaoce equivslent to the deaiga Eroet 1Lne{ CM1a[ !es
Zone 2- 7 fee[ 6 inchea
Inauletion efiall heve s minimum R-Value oE 7.5 eround the
perimeter ot slab on grade floors.
. ••.• . raea 1
? i Page 5
' 7'IIE TOiAL F.NVgLOPE CALCLLATIOH lIETIi00
IY?C ?CRp]ACIOM14 state [M1n[ nlternntlve ovecn).1 values for bui].d1n? sectlons nre permixnn6le
If i[ is shovn thAC che total buildin? envelope hext losa/gain does not exceed thnt of a
slmflar building that meetq che regu
valls anA roof/ceil
regvlation requiremeats. lntion "U" value msxfmuma, to this ease, ue will eonsider
only the ing cr1[eria, esaum(ny [hpt the temainder of the bullAln
t neeta
A. Total hcac Aossna desl¢ned ' -
(volls nnd roof/ceilinr) BTU/Iir. degtee P.
4alla _ paAO . Avcrnqe ?,0-• oG . . '
vnll asacmbly -0 98 ?1Y 2 89• ft.
x nverage voll area 6J4J 2
Roof/CellinR . Up o ' AveraFe "U" tl e
of eeiling •OZ 2 x average ceiling area 1O7O 8 ??•? g `
q. ft. ?
ToSAL -7B. iotal heat losa !f dcelBned to meet [he reg 7 , I?
uAation minimum (valls and roof/ceiling)
Valla . U A ? Nlnimum tequired
0 o
. "V" value of vell IL-
x average vall erea z343 aq, Et ? 1 ??- '73,
Roof/Ce111nR ? U A ,, -?'-?
o a ' linimum reqolred . ??U" vnlue oF
cciling , Qz (? x evereqe celling srca 1678 aq. Et.
r
? rornL
?
Openlnp area (qq ft ) r
opening b wall erea above grade (aq, ft,) R 100 openiwa21 7he Lolloving tnble mny 6e used as e general Putde line for
de[ermininq ellovable percentege of roof openingsvhen loweat
°U" value is establLahed. ?
• X Rvof
Opening 0 1 2
HinJmum
R-Value of
. ---- ' v<.c )7.7
Openlnp areo (ea f[ )
Openinq d roof/,eiling erea X 100 ?
(sq. ft.) x
. openinq Se vell
The folloving table may be used sas genetal guide line for
determining allociable petcentage of U" value ie eata6liahed vail openinga vhen loveat
.
.
CITY Or EAGAN
APPLZCATION FOR PERMIT
SESJER AND/OR WATER CQNNECTION
(PCEASE PRINT)
1) PROPE??Y p,rDRESS:
rFraI. DPSC:?ZI?TT_CV:
?-- -- ---- .............??y..,i vi in.< rarCel L.U. L?U:,--2Z) -
-: SI".=i'?'^ Dai : OF' Ci2IG.?:T.AL :.iII.DS:`:G =_-'S? ISS.;;?.%G.:
CS: A-1 Sz;GS.: F=,,tTI,y
Q R-2 DUr'i,...?i (T.tO L'::ITS)
? R-3 'Iat?iTCi*-l3E (''_':??.? + L':TTTS) { Ui72^_5)
? R?4
Q CCl"l1E.:CLAL/:2F.^'I.?Cc:'IC
Q 'DliSi ZLAL
? L%7STI:L'I`ICXJ.i,/Cn,^=Nn!E-?7r
2J AaP*???-`:? iaiEaat a?t;r?
rr3•'F': l?1 ?!' c; ?dN ?;P ? A ?Pr ? 1 ?'}?z ??
?.
G I i U rr'? -, Pkt ?t'
C= "-', s::: ?'• zIP: I ;_ ?(C c ? -7
PF:?:L.: ( f„ i ' \ 4l _ -n` ..,..
3)
N?<.?':
FDi, Racz5:
` CIi"l, ST?.m, Zip:
PF.CVE:
4) 0.S.L'PF,T:'/G*.-;,mM NFME:
ADDRESS:
CI1"l, 5TAi'E, ZIP:
.. PFUNE:
5)
uvutL-i:i'E 'NHICH PE°.•lIT IS BEINC; RELUESTLU:
CC:?'VEC!'ION 'i0 CITY SEVIER
? CL'`:I:?'EXTZC:7 Tb CITY hTATEFt
? 07LIER (PIFA,.?' DFSCPSBE)
6) Pa.'DICA.:: G::.:
7) SIGz-ATZ,'gE:
FOfl CIiY I15E O4LY
19HJ I C n
PLIIHBER LIC£NSE q
z/84
art tnicia
? PL°,1SE E?OID r1PPf20VfI3 PERMIT FOR PICIi-LM EY ONE OF AP.(^VE
? P-£iSE:?,??',IL APPRCJVEy PER:•LIT TYJ 1, 2,30 Q AGOVE
r (CLCle One)
- - ,
PLUHBERS LICE4SE:
? Active
Q Ezpired
Q Not of Record
LWTE:
M"
F Q R C I T Y
PER`1IT '-` ISSUED
E???
F°ES: $ ?b 5 O
S / o . s--D
$
. $
5 E ON;.Y
$_r:':Ln DrR\1'tI'
WATER pgpsqrm
(I`ICL::DE SURC :?RG2)
(zracLUnL sURcxaRca)
WATER METER/COPPERHORN/OUTSIDE RErIDER
WATER TAP (INCLUDE CORPORATION STOP)
SE:GER TAn
. $ . _ _ L' L7
r-z?) ACCOUNT DFPOSIT - P7ATER
$ j C9-G . ?r-c Wi,C
$ SP.C
$ TRGVK WATER ASSESS.-?E2IT
S TRliNK SESvER 15SES5.•L:iT
$ Lr.TERAL BEivEFIT/TRUNK SE::?R
$ LaTc.Rr1L BENEFIT/TRUNK L•7ATER
$ WATER TREATMENT PLANT SURCHARGE
$ OTHER:
S TOTAL
$ .?tl? Cr' SZ? AAIOCJJIT PAID/RECEI2T i c?/.? 7
/53 o-J ?o k'6? /
DOcS iJTILZTY CONNECTION REQUIRE EXC?VATION IN PUBLIC RIGHT OF WAY?
.YES IF YESy THEN A"PERMIT FOR TAORK WZTHIN
PUBLIC ROADWAY" MUST BE ISSUED BY THE
NO ENGINEERING DSVZSION. LIST AS A CONDI-
TION. .
SUBJECT TO THE FOLLOWING CONDITZONS:
APPROVED BY:
TITLc: !
DATE: /t>,6
?
7?aff?t? Bo,?7? = .%o: iis,?sa
eUl
,t ye?? ?ea?c=??T?€a?!s ?O"
ConNnrAion No.
Referenu 11 Out• Wall I Int:
. ? i Doorr--Cnekage aad Area
?+? t No. et I.Innl f4 Ate.
P V,ne Ilihu at enak p. tt.
?o ati,s
Ccef. Btu
50 w
? lgl-4, vP- /y
/893 yl
. ? i 4
- , i , 4I
SOM'zoN ' kielA/ld 45q4o Opk chp.%:
y <<vei .?.?
ARTMENT OF
_O SHAKOPEE
B6:•S6ib
[NSULATION OoomYigean
1r Kind Ebw Appiied
F1•1 Qa ?-h QO°m I Gen0h q' TA6
vtIF,de.ne aeA Dmro-CrreFaee ond P.rea
tte. th
ef yan* i-0?1?lt
O! Oo :1a ot
IIfOb Llnwl tL
a! eenak At+?
K. !t.
fasf. &u
fa6lkettna ?
cjaNM
56
ire?. , z. a $a
^
I 6 ?/
Cei?ie?
r (03 i S
m
O LSi .
Cod. n
,To y o
IS So )bo
? ?i•? r _
Naa S a
? ,?a+6• f ??,` o
Ci • /yY9 . 7
, , ? u Y
Ares
.??, ?,..
.
?
, ...: 1
. ? . ' ' .'.?
Zoef. &u
l. #+i 2qj (o
o a
i
s
i' I f. L
jt- 6
P ' ' f ' ?d D
.,, . I I
•"'h. &D.R. or . ia?. aJi. i.s?det ur.
,
- . 6VILDING AND INSPECTION DIVISION DEPARTMENT OF I
:OMMUNITV DEVELOPMENT 1215 WEAT OLD SHANOPEE
CALCULATIONS ROAO, BLOOMINGTON, MINISESOTA 55931 BBl-SB71
PS Cuide CO°KTWApp No. INSULATION c
oors ( Reference II Out. Wal) Int. Wdl Ceilioa Roof F7oor II Kind How
n-No 19
Room I L.ength i' Width
Qoara-Crackage and Area
?I?h? No. o[ Llna?l tt. wre?
o b?ne IIe?1• af cr?ek ?a. ft.
Btu
Ao
WII1QOWt ap0 Voofi-6racca ge aua mea
Ne. WIdtA
ot "no HNfpt
s[ paae Nw ot
11glb Lleeal tG
et eraet Aw
p. It
o 5- ?
o D H4,W
Infiltretion 79, y t 1t
Glus
p'/, 7c
E:.?_ •??!E + i ? 8 i ?
-.
Net e:p. wan b ll U
..
-?FrWfN
"_
?Gt1IMg
Floor 3So 0
' d' ', :.D.R. or sq. im. W.A. L.eader area
A"am Rcom L.enath /S Width i7•v Heieht Q
ppors-Craekege and Area
^
14101101 n? a eL
IItbL L1nuI [L
af crack Awa
M. Il.
r.
?
-
- Coef. Btu
:
4 ? ipA po
/S?Z
o _
0
0 m 1. 0
;.?,.
?
?8 13
,,.
;. ..
,.. n .. ........... .
? ., .
Totd Btu.
Requirad p. f!. E.D.R. or p. in*. W.A. Lesder ana
Fl.l RaAa.wni. Raom I leeath 3--j Vidth z U Heisht Cr'
WIOCDM aOa {000[4-41,[\C[S QC 81110 AKa
Ne.
e( ?ee • f 1i
ef ?e? a W
I/fbts Lfeol [t.
e[ eeaet Arna
p. fL
C t? S ?
j Cogf.j u
Infiltntion 3S QNO
Glw W.7 a D n
. wall
Nat .. wal) ?Ip p
-?1!+wIF"
-Cwiliwe-
Flcor ?6Y 74
T a. /
!q. h. LD.R. or aq. ios. WA [.aader ana
F1.TR......,-& Room I Lenet6 w. in W'dt6 j a' Fkiaht p
!!Ad ?1oPrr-CraekaQe and Area
Na 0. . f. Il hts et enet N. !t.
o` n L
Coef &u
Idbltr.tion ? (, a ? o
CI?N 1 L O /D D
Fjw6w&#
I•b t I ? ?•{?
Na- . wr m?J o5 -
* ' SSaB b
.
BUILDING ANO INSPECTION DIVISIOIV DEPARTMEfJT OF
OMMUNITV DEVELOPMENT 2215 WEST OLO SHAKOPEE
CALCULATIONS (3UA0, BLOOMINGTON, MIN14E50TA 55431 881-5811
Pi ? Guide Condructioa No. 1NSU[.ATION
Roon Rcference I Out. Wall Int. Well Cedine 'Roof ?? II Kind -
ero 19_ ---?--
and Area
+ol fL Are,
enck ?a, fl.
BtY
,3 O o0
Mitod Iq. (t. E.D.R. or oq. int. W.A. Leader area -i-
?.
Room Leoath Width Height
t?oon-Creckaae end AreaI -
I.eader arca
Width
Area
Bm
aroa
v
?
,..
: ,. ,.+ .?,„..,..,,......... _ .
?.wnp s Ew uavl ?iGN BC \qp /1? C0
No. Idth
ot ne Haig t
s( D. Na et
0s\b Lleml !t.
ot arwk wrm
p. ft.
Coef. Btu
ln611raGoR
Glats
2_v wa!:
I'1N e:p. wall
IAL WaU -
CeJiaa
Floor _
a ow Otu.
Required p. h. E.D.R. or p. ias. WA. Leader ares :t?=
-
Fl.I Roow I l.ensth W;dd, t?k;a6e
k
Wikadmn aad Doors-Cneka ge aod Ana -
No. of?eo a[ hn? Il?et? eler?cY pr[t.
tu _.
Infiltrstaa -
Glaw "
Exp, waU
Net ap? w.U -
IOt. wall
CeJing -
!'loor
Tad Beu.
. h. E.D.R. wsq. ios. W.A. Leader arca
•
?E• II ConNruction No.
Re(ereoce II Out. Wall Int. WaU Ceiliog Roof Floor
19.-
Tl.ength / Width e3- (o Heieht V II ) 5 FI.I L.ANdI
? ly l ? Y
. ? ?
w?p ,.... - p?
?
?
- pu Voors-
H.I?nt
ol D?ne ?.nCFa
No.e[
Ilfhb ge ana nc
Llnealet.
o[ 0r0C4 ea
Arca
sp. (t.
..,
.
..., ,I..
Coef. Btu
I«4tton _ Sc. l3Ny
e?. 4
so
A so
- .40 :. siW ? i3•
, C? ..N!iII 1.?4,
7 i -
7
i • /S ?
SYY
,.,
? 1 . ? 'idll
sq. fi. E.P.R. or sq. ins. W.A. Lead-r ares
c#e ?
y?lAs jtd. Room Leneth /L R+idth //-L Height ll
W"_ j and Doors--Cnckage and Area
"' {p
?.,
.i?? Ita1n1
at v?n? No. ef
Ilfnb Llmd !l.
of cr?ek wr?a
N. ft.
.
^
.?._ . A 1
Coef. Btu
a c
/ • //. O
:
..s..
?r
0
'.? 'i?. ?t• E.D.R• or W. ins. W.A. Leader arcs
Room Ileooch r3•6 Widt6 /o
? Udrt-Cuckaae aad Arca
e. 0!
11a6U LIP?A fl.
ef v?ek Arw
p. fl.
? ? r•+- p 7
Coef. Btu
t' D
',1'LV;.. I oe
/ D
, .o a
,, fob ` Ilo. (I. ED.R. or aa. ins. W.A. Leader ma
?
1NSULATION
?•L Wkhh
Wmaows am wors--a.racu ge aaa nrea
No. IOte
of We? te 9ht
H We? Nw ot
Ilpb L1e?d eL
of enek ?m
q. fL
Caef. Btu
661«.twp v2d
Glus / 7, 8 O
__
$90
Exµ wall ; t # x /
Net exp. wall 911 1/ ' /
.iaie.-wrall / 5'41
Ceiling
?Fleaa-
rot.t etu. a, o c?
::oquuiTec: w. Ft. E.7.R. or p. ine. V.A. I.esder area
PSO Fl _I ).,.....4 Rmm I Lseath ) L Widt6 iG Hei¢6t s
Windovn an d Doors-Cracka ge aod Area
Na WICl6
of Wes e1g t
Of W" No. o!
11fAt, Llnpl [t.
et nacY ArN
p. rL
120
S*q
fCoef. ?
In6ltratioa y ! ? ? w,
GJw SN b 7Uo
Fsp. waU I D f fa
Net esp. waU / 7? 0
-bwl.+r4 (in 1540
Ceiline e A f 6 4 0
?Glouc_
Total &u. t9 ?!
Raquirgd mi. h. E.D.R. w sq. im. Wr4. l.csder ares
S} Fl. Room l l.eesth Widt6 B Fki?h?
W. ' and D0o"--Cncka`e and Area
aght
Na o ^A ?os llfa
Ilpu nW
ot¢nak Aer
ra.tt
LDG'2 '
L O
i
Coef Btu
u 6
Glaa L, 0 D
Eup, wall Q k $ L4
Nst e . waU ) 7, ? ?
J.ww.ll , 8 9
Ceiliae L .? J C)
-Peer-
I au aRw 3 4 4
Reouired w. k. E.D.R. or w. ias. WA. Leader uea
.
,
?_:.:
City of Eagan
3830 Pilot Knob Rd
Eagan, MN 55122
(651) 675 -5675
www.ci.eagan.mn.us
Site Address: 4546 Oak Chase Rd
Lot: 5 Block: 1 Addition: Oak Chase 5th
PID:10- 53504- 050 -01
Use:
Description:
Sub Type: e- Windows/Doors
Work Type: Windows/Doors - New/Replacement
Description: House
Census Code: 434 -
Zoning:
Square Feet: 0
Comments:
Fee Summary:
Valuation: 3,000.00
Contractor:
Renewal Andersen
1920 County Road C West
Roseville MN 55113
(651) 264 -4777
PERMIT
City of Eaan
BL - Base Fee $3K
Surcharge - Based on Valuation $3K
Applicant/Permitee: Signature
- Applicant -
Construction Type:
Occupancy:
Permit Type:
Permit Number:
Date Issued:
Permit Category:
A framing inspection is required when installing a Bay or Bow window or if the opening is altered. Smoke detectors are
required in all sleeping rooms prior to final
inspection. When wall studs or ceiling joists are exposed, hard -wired detectors are required. Battery operated types are
acceptable if the wall/ceiling finish (i.e. sheetrock) has to be removed to install a smoke detector.
Total: $90.00
Owner:
Gwen Kline
4546 Oak Chase Rd
Eagan MN 55123
$88.50 0801.4085
$1.50 9001.2195
Building
EA082572
04/14/2008
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
Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA112770
Date Issued:08/23/2013
Permit Category:ePermit
Site Address: 4546 Oak Chase Rd
Lot:5 Block: 1 Addition: Oak Chase 5th
PID:10-53504-01-050
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar.
Pictures are not acceptable in lieu of inspections.
Carbon monoxide detectors are required by law in ALL single family homes .
Elizabeth Hess
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 -
Gwen Kline
4546 Oak Chase Rd
Eagan MN 55123
Sela Roofing Remodeling
4100 Excelsior Blvd
St. Louis Park MN 55416
(612) 823-8046
Applicant/Permitee: Signature Issued By: Signature