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4718 Oak Cliff DrCASH RECEIPT ? ? CITY, OF EAGAN ' P. O. BOX 21-199 EAGAN, MINNESOTA 55121 DATE 19 AMOUNT $ .? & ooLLnRs 7oo ? CASH E] CHECK ?K FVND CODE AMOUNT - . . ! ThankYou B y White-Payers Copy Yellow-Posting Copy Pink-File Copy Q CASH RECEIPT CITY OF EAGAN P. 0. BOX 21•199 EAGAN, MINNESOTA 55121 DATE ' 19 : tecc sivec FROM AMOUNT $ I & DOLLARS +oo ? GASH ? CHBCK --- FOR FUNO CODfi AMDUNT ?S . / :-?JG ) Tha4lou -? At) BY_ ?? - &a. 2. . . v ? YVhite-Payers Copy Yellow-Posting Copy Pink-File Copy ..? ? . , . ? CITY OF EAGAN ' 3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121 ?T 1?I 01 ' PHONE: 454-8100 UILDII?K"s PERMIT Receipt # o 1 6r rrJ iav Fe4 VnL.A ?flnfu '1 LjI\IF ,L tl tp (i•} Site Addreaa ? Lot Block _', ?I.J._.r..?J_)r?c-.?1/?Su? l ?J ? , •o " Parcel No. ce Nama - Z Address l 9 City Phone Zo Name ?? Address ? City Phone t°C Name PW _o Address = W City Phone 1 hereby acknowledge that I hove reod this opplication and state that the informofion is correct ond ogree to comply with alt opplitabls Stote of Minnesoto Stotutes ond City of Eoflon Ordinonces. Sipnoturo of Permittee A Bu{Iding Permit is fssued to: all work sholl be done in acco Buildinp Official Erect [`J' Occupancy /11ter ? Zoninp ?.: Repair 0 Fire Zone ? Enlorfla Q Type of Const. JNove Q # Stories Demolish Q Length 6rode ? Depth ?FSq. Ft. Appeovals Fees Asseument - Water & Sew. Pol ice Fire Enq. Plonner Council Bldg. Off. _ NPC xNe . (1 Permit . ) Surcho rye ? Plan check SAC ' Woter Conn. Water Meter Road Unit Tota I on the axpreas wnditlon tMn+ Statutes ond City of Eoflan Ordinances. Parmit No. Permit Holde? Misc. Parmit No. Holder Plumbiny y ? ? a ?? / ?? ¢ 0 H.V.A.C. ? ? O b ??? ? f • W?11 W?ter Disp. Sevwr ENctrio Irqpection pate Insp. Other Footit?qs Foundation Fnminp ouYh P?b9. -1 -? f Rouph HVA ? Inwlation Final Plbg. Final HVAC Final Water ?i? Loeation: Y1fe11 k ' Sewsr . Pr. Difp. Receipt MECHANICAL PERMIT Permit No..? CiTY OF EAGAIV Fee ' Fil1 in numbered spaces S/C - Type or Print legibly ToY. ?') i. Date i? 2. Installation Cost ? ?-/`( ?3. Job Addres ?LotBik. ? Tract 4. Owner 5. 6. Address _ 7. City 8. Building Type: Residential ? 9. Work Description: New ? State Zip Commercial ? Institutional 11 Add ? Alter ? Repair ? 10. Describe Fuel Type 11. OQ No, E.qyi,oment STU • M. Ea. Forced Air No. EQUiament CFM Air Handling: Mfg. Boilers E h M Mfg. ech. x aust Unit Heater Mfg. Other Air Cond. Mfg, _51 Gas, Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to compty with all ordinances and codes governing this type of work. ?o - Signed ; for Rough Final Inspections: Date tnsp. Qate Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-6100 Receipt PLUMBING PERMIT Permit Na CITY UF EAGAN Fee " Fill in numbered spaces S/C ? Type or Print legibty Tot. N: ;!i '• -7 1. Date 2. Installation Cost ` 3. Job Aildress4/:L!r •• ,lAotBlk. 4. Owner; . 5. ContraC 6. Address 7. City _ 8. Building Type: Residential IR 9. Work Description: New ? 10. Describe 11. State Zip Commercial O Institutional O Add ? Alter ? Repair ? No. - Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs 5eptic Tank Lavatory Softner Shower Wel I ? Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. I hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. ? This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 I ,?,- . . . .. _ ,. . . PERMIT # ,2" PLUMBING PERMIT RECEIPT # y' IL L , CITY OF EACAN 3830 PILOT KNOB ROAD, EAGAN, MN 55122 dATE: CaNTRACT PRICE PHONE: 454-8100 ? ? ?'?"f i?<•..1..;li l Site Address Lot ? Bloc? SeclSub ? Name c' , ? Address a.c c . / ?f? " ? ? Ci h . c? P ty one ? Name rl : ._ ? : . ,.. ' c Address ? p Il C;ry c: Phone ;.,-? FEES COMM/iND FEE - 1°1o OF CONTRACT FEE APT. BLDGS - COMM RATE APPLIES TOWNHOUSE & CONDO - RES. RATE APPLIES MINIMUM - RESIDENTIAL FEE - $12.00 MINIMUM - COMM/IND FEE - $2a_00 STATE SURCHARGE PER PERMIT - .50 (ADD $.50 S/C IF PERMIT PRICE GOES BEYOND $1,000.00) SIGNATURE OF PERMITTEE FOR: CITY OF EAGAN BLOG. TYPE WORK DESCRIPTION Res. New Mult. Add-on Comm. Repair Other RES. PIBG. 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 - S3.00 Laundry Tray - $3.00 Floor Drains - $1.50 Water Heater - $i 50 Whiripool - $3.00 Gas Piping Outlets - $1.50 (MINIMUM - 1 PER PERMIT) ?Softener - $5.00 well - $10.00 Private Disp. - $10.00 Rough Openings - $1.50 FEE: ?-- : STATE S/C: GRAND TOTAL: =' S ? ' CITY OF EAGAN Remarks Addition OAK CLIFF ADDITION Lot 1 Rlk 2 Parcel 10 53550 010 02 Owner Street 4718 Oak Cliff Drive State Improvement Date Amount Annual Years Payment Receipt Date STREETSURF. 1981 250.88 25.09 LO STREET RESTOR. GRADIMG i , SAN SEW TRUNK o i 1973 104.12 6.94 15 SEWER ATERAL ?, 541.76 54.18 10 11,6, 'T ?. a e WATERMAIN WATER LATERAL WATERAREA 161.31 LO.].S iS J Dl?d ,?I???T STORM SEW TRK o 1979 350.52 17.53 20 9- /B. 3 oJ_ STORM SEW LAT CURB & GUTTER ' SIDEWALK STREET LIGHT R 260.00 #44237 6-20-84 WATERCONN. 470.00 9UILDING PER. #9195 sAC 525.00 " PARK CITY OF EAGAN WATER SERVICE PCRMIT 3830 Pi{ot Knob Road P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zonin9: No. of Units: 1 Owner: "zjuin PP- dE'L"6on Addross: Sft Address: 471; Oak Cliff Dr;.ve I.? '11'.'. ??au Cl?ff lst Plumber: _ Meter No.: Size: Reader No.: 1 pm te oompfy wkh !he City of Eqyei O.di.ances, Connection Charge: 470-00 d Acoount Deposlt: pc Permit Fee: Surcharge: " M1sc. Chnroes: 63.00 Pdmeter Total: By Dots Paid: Data of Insp.: inap.: CITY OF EAGAN SEWER SERVICE PERMIT `3830 Pilot Knob Road P. O. Box 21199 PERMIT NO.: Eagan, MN 55121 DATE: Zoning: RI No. of Units: 1 Owner: Ozmun 1'ec3erson Address: Site Address: 4718 Oak C11ff DIive L1 B2 Oak G11£f lst Plumber: F'PiIIe P11'.^ 6-2(i--£;lE 4?'?237 00. gc: 1agree ro eanphr wie6 Nbs Citr oE Eagan Cannection Charpe: 425.00 Pd 'Ordinaneeu, IlccauM DepOSiT: 15.00 qd Permit Fee: 10. np pd 5urchorge: • 50 pd $v Misc. CF+oroes: Dote of I nsp.: Totol: 4^sP.: Date Paid: CITY OF EAGAN WATER SERVICE PERMIT 3830 Pilot Knob Road P. O. Box 21199 _, PERMIT NO.: ' Eagan, M;? :.6'Ft11 D^TE: Zoning: = No. of UniFs: ? Owner, G , Address: Ate Adc lhheter No.: .??'??l A ?Ize: _. I':,7'^ Reader N9oT.: 1 ogro@ to semply whh !1* Cihr of Ea9on OrdinaneM. e of insp.: f ,'C'1hi..hr?ection Charge: 470-00 ^d Acoount Deposit: ! J . ` `1 Permit Fee: Surchorge: Mist. CFiorQes: 63 . ?id! tai Totat: _ Dote Paid: ?G C C 5t ?L PwN ??z Iv- ." IM TO ?'Zj O - !-i? ppot-l Guei3 CITY OF EAGAN rr+a,r BUIIS7ING PERNIIT APPLICATION L Include 2? ts of p].ans, ?r 1 Certificate of Survey & 1 set of_ energy cal.culations. S? IL 5r+ou?? aE 3? To Be Used For W G . Valuation ? I b ( /' p 2-' Date Site Adclress: Y 7 1 P &E K C`(r # D,-. oFFzCE UsE oNu.Y Int Elock _;2 sec./sub. + (a i?- / Erect v occupancy Parcel #: 53 cS S(3 ZAlter zoning R- I Repair Fire Zone N /A (/ /u u? - 4- 4.A d' t's L o Enlarge 'Iype of Const. "SL ,?mer: Nbve # Stories ? p Address: /?"/ ?4 /,1-c-c0?% ?•-? Dffolish Front 54 ft. ? Grade Depth 3g ft. City/Zip Cocie: t Phom APPR0VALS EE'EE.S contractor: 03Ipu•? Assessments Perntit 435. ?° Address: Z51- ?L ?-eav? ??-e Water/Sevrer Surcharge 25 o. - 5 Police Plan Check 211. 1 City/zip Code: ?s-e'• ?-? !y s/Y y Fire SAC 5 Z 5. "-° Phone Eng. Water Conn. 4"7o.?? Planner Water Meter Ca 3.°° Arch./Eng.: Council Road Unit ZLCI. °° Bldg. Off. Address: APC - City/Zip Code: Phone # : 'ICnAL o? ? 0 ? ? -7 L Z.L;x i 4 = 2?.x Z4 = 52?x ?t - ?2 x 2e) _ ?R? x 12 ?z? ?(??-7 3G ; ---- ? I d ?, ooc? ,? CITY OF EAGAN 7?7 3830 Pilot Kno6 Road, P.O. Box 21-199, Eagan, MN 55121 1?1 ? 9195 ? PHONE: 454-8100 BUILDIN? PERMIT Receivt # ? T. wed for SF DWG/GAR Esy, Value $101 ? 000 Date JUNE 20 ?q_$A- 4718 OAK CLIFF DR Ad E t Si R O rec ?ress te ccupancy z OAK CLIFF 1ST Lot Block Sec/Sub. Alter ? ?? Zoning ParcelNO. 10-53550-010-02 Repair ? FireZone_v - °?e ? Type of Const. oc Name OZMUN-PEDERSON INC ?o ? # Stories Z Address 15136 GALAXIE AVE pemolish ? Length 54 ? City APPLE VAL phone 431-5000 Grade ? Depth 38 Sq. Ft.- Anerorals Feea A o Name SAME ?? Address ? City Phone Name _ Addres; City - Phone I here6y ocknowledge that I hove read this application and stote that the inlormatian is correcf ond agree fo wmply with oll opplicnble Stote of Minnesoto Stotutes and Gity of Eogan Ordinances. Signoture of Permittea _ A Building Permit Is issued to: oll work sholl be done in acco Building Otficiol Assessment - Woter & $ew. Police - Fire Eng. Plonner - Council _ Bidg. Ott. - APC - Permlt $ 435..r70 Surthorqe 50.50 Plun check 217.75 5At 525.00 Water Conn. 4 7 0. 0 0 WaterMerer 63.00 Raad Unit 260.00 Torol ?2,2.7 5 7ULV-Yr;Ur; ULV lLVI: m fhe express Condifion ihm I op 'coble fa of 'noewfa $tat? City of Eogan Ordinances. n 01 REQUEST FOR ELECTRICAL INSPECTION j1ft es-ooooi-cw ' See instructions for eamoleti.p thia fnm on baek of yellow copy. .y ?vi I(? ? O 54LI. 2 O "R" Be/ow WolA'Covifred by This Request AdA FeP. Typa of BuildinB Applieneea Wired Equipment Wired X Home Range Temporary Service Duplex -Water Heater Y lightin Fixtures Apt. Building Dryer Electric Heatin Commercial Bldg. X Furnace Silo Unloader industnal BIAg. Air Conditioner Bulk Milk Tank Farm Other Peu y Other ISUecityl t er SVemfy Oth¢r Other ompute Inspectron Fee Below p Fee Se,wicaEnlrencBSizo q Fae Feadars/3ubfeetlers N Fxe Gircaita 1 12.D OtoZ00Ams- Oto30qms 14 35.D 1?Jm30Am Above 200 qmpy, 31 ta 100 Amps . Q 21 to 700 qm s Swimmin Pool Above 100_Am s Above 100_Am s Transiormers Irrigation Booms Partial-'Oiher Fee Signs Speciallnspection g 5 ? 2 50 TQ RemarkS . co a. Pough-in . t al ( ?J Inepeebr, heraby eertiiy thet the abova Final e . spectian has been ? made. ?nis requeat rWd 1B monttm fram Th;ry;requesivoia ?y 90? ??L?//(? ? , 1£?n(hs (rom 1/? :,w 0 5n. _r 2 o Lb / l b V So.?o /FleQUes[ Date Fire No. Roueh-in Inspection y 7-23-84 Feqmred? eatlyNow6'L4iIINntify,lnspeo- x$ras ` ? Na tor wnen eaaev Licensed ElecVical Contractor 1 hereby reques[ inspection ai ebove ? Owner alectrieel work inatelletl af: Street Atldress, Boz or Foute No. - Ciry 4718 OAK CLIFF DRIVE EAGAN emion o. 7ownshiD Name or No. anBe o. County I I DAKOTA OccuOantlPqINT1 Phone No. OZMUN - PEDERSON, INC. Power SuD0lier DAKOTA ELECTRIC Atltlress FARMINGTON Elecvical Contractor ICompany Nemel Conirecmr's License No. LAKEVILLE ELECTRIC, INC. A041802-9 Mailing AdJress IContractor or Owner MakinB Instailationl 20480 JACQUARD AVE. W.; LAKEVILLE, iHN 55044 Authorized iB^ature (COntrcmr Owner Mekine Installation) Phone Num6er 469-4939 MINNESOTq STATE BOARD OF ELECTPICITY (r TMIS INSPECTION pEQUE3T WILL NOT Griges-Midwey Blde. - poom N•191 0E ACCEPTED BV THE STATE BOARO 1821 University Ave.. St. Paul, MN 66700 UNLESS PflOPEN INSPECTION FEE IS PF..nn IE121 997.2111 ENClOSEO. ?????' 2005 RESIDENTIAL BUII.DING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone 4 651-675-5675 FAX # 651-675-5694 Telephone #( New Conslrudlon Reauirements RemodeUReoeir Reauirements OfficeUse Onlv 3 registered sile surveys showirg sq. ft. of lot, sq. R. of house; and all roofed areas 2 wpies of plan Cert of Survey Recd _ Y_ N (20% maximum lot coverage allaved) 1 set of Energy Calalations for heated additions Tree Pres Plan Recd _ Y_ N, 2 topies of plan showing beam 8 window strss; poured found design, etc. 1 site suney for addifbns 8 decks T2e Pres Requlred _ Y_ N 1 set af Energy Calculations Addifron - indicate if onske sepUc system Onsile Septlc System _ Y_ N 3 wples of Tree Preservatlon Plan if bt platted after 7/1193 Rcn Joist DefaB Optbns seledion sheet (huldings wilh 3 or less unils) Date Site Address 'f 7 ( -W 6,1 u, i ? Construction Cost q- 41'. UnitlSte # Description of Work Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 _ 1 _ 2 Property Owner K Wi?n a.-,v/ °/? d ( C? ,fT Telephone # Cootractor F- S i Address I? ( State /Vl.? `, nn^ tU? Zip S5 ? City Telephone # (763 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Mincesota Rules 7672 Energy Code Category . Residential Ventilalion Category 1 Worksheet • New Energy Code Worksheet (Jsubmissiontype) Submitted Submitted . Energy Envelope Calculations Submitted Have you previously constructed a building in Eagan with a similar plan? _ Y _ N Ifi so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( ) Telephone # ( 1r I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; 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 T ?of p s. ? a' ?,xrK S a V?tison 3nYs Printe ame ApplicanYs Signature RESIDENTIAL BUILDING PERMIT APPLICATION GTY OF EAGAN 3830 PILOT KNOB RD, EAGAN MN 55122 651-681-4675 New Construcfion Reuuiremen[s . 7 registered site surveys showing sq. N, of !m, >q. R, of house: and all roofed areas 120°5 maximum Iat coverage allcwed) • ? copies of plan showing beam 3 winCOw ;¢=s, poured found design, eta) • 1 set of Energy Calculations . 3 copies of Tree Preservalion Plan if lo[ platted atler 711193 . Rim Joist Detail Cptions Hection she ?Cldgs with 7 or less units) DATE ? RemodellReoair Reauirements . 2 copies of plan . 1 set of Energy Calculations for heated addi[ions • i sde survey for zxrenor additions 8 decks . Indicale,.f home served Sy seplic system `or adtli[ions -7i `?Oc>- VALUATION SITEADDRESS q71v OAK ?GiF/G Qk MULTI-FAMILYBLDG Y ??N TYPE Of WORK IREPLACE(S) _ 0 V? 2 APPLICANT STREETADDRESS?19 1"J-10? )9tZ- CITY )%?Z-"9KtSTATEL?ZIPSS30 TELEPHONE CELL PHONE # lo1a`367-S3S? FAX # PROPERTY OWNER L&?I9M tl-- Lvlll TELEPHONE #tgSJ-cS'`J`7 ADI COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ 1[[NVESO1-_l RCI.6S 7670 C:ATEGOItl' I 1fIVNESOT.A 12I'L1:S 7672 (J submission type) . Residen[ial Ventilation Category 1 Worksheet Suhmitted • New Energy Code Worksheet Submiried • Energy Envelope CalculaUOns Su6mitted Plumbing Contractor: Plumbing system includes: Mechanical Contractor: NIcchanic>d svstcm includc,: Sewer/Water Contractor: _ Water SoFtcncr Wa[er Hca[er Na. of Iiaths -- Air Condiuoning Heal Rccovcr}' Systciti PElOf1C 4 Laivn Spnnkler No. of R.I. Baths I hereby acknowledge that I have read ihis application, state that the wifh all applicabie State of Minnesota Statutes and City of Eagan Orc Signature of Applicant Phone # inpPll OFF[CE U5E ONLY 70.00 ................... -------------- s corr c#,-and-ngi to comply Fee: 590.00 Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Upda[ed 4102 ?.R(?kAc?S7t.'A,,.'?:SCC.ta.M?'4;PFYCi %:YFI??fY,(?%Ai+x;c?ngR.Mh.,? r.:rrv Ot- EaGF,n? GAr:;!;:C!-i;:;; :7.','I TiiE:RtfiNr";I... N(:le 80 DATE.". 02J14`rll e .7..IMEJ1 Wg 08:O9 TI.k. NAttE:: `::'sr;Cl_A kt7iJF7:Nf, 4s I'tEM(y:.':I:.l...:!:NG 7:NG. 3izi.0 J[ri'Ji 408 i.)fiit; MI`F' ?7 167.05 21.55 9001 471f3 [)A!• C:I..F:p: ri 4.50 ot;:.t._ {@C'i:?:I.1:?I) i1lYini.1721:: !.i ?..?r°?? !:F':I. .:i3: l . l1'>Iii.R IYi:: .)AN 2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)? ?q C? CITY OF EAGAN 3830 PILOT KNOB RD - 55122 851-881-4875 > 7 reylslered sNe wrveYS ahowlny sq. fL of lot, sQ. 8. of house and g( roofed dreaa 12076 maximuen bt covamae WloweN D 4 copiea of pWna (ahow beam # wintbw sIzea; poured fntl. desiyn; eteJ n t wl of eneryy cdCWpMqts D J Capies of hee preaervalbn plan if lol plalted aller 7/1/93 DATE: -U U „ DESCRIP'fiON OF WORK: STREET ADDRESS: LOT: I_ BIOCK: CHy 2 coples W plan 1 aei of en6rgY cdcWaMOnt for healetl atlditbns 1 aite wrvey for exleda adtlNbns & decks coNsrnucnoNCOSr: ?- . a SUBD./P.I.D. i: Name: ?j ??- Phone #: pRppERTy W5f Flrtl OWNER Sheet Address: City Telephone #: ( Zip: 1-i L / Companv6 F-I a anneiti12 &?9M@@ENPdB-Me,- Phone #: a12, a 3-?d S? (o 4100 EXCELSIOR BLVD. (area code) CONR2ACTOR ST. LOUIS PARK, MINNESOTA 55416 / 3??^? Sh66tAddreBS: ipgnnn4Qr3 LlcAnSe# Exp. ARCHRECT/ ENGINEER State: Sfate: Zip: Name: Street Address: Regisharion g: CHy Sfafe: Sewedwater licensed plumber (if instaliina sewer/waterl: Phone #: ZiP: I hereby ackrawledye Ihaf I have read this applfcaMon, dafe Nxrt Ihe Intom7;7q nd ree to canply wMh atl aPPBCable State of Minnesota.Stalutes and City of Eagan Ordinances. Siyrwlure of AppRcant FEB i ? 2DOO OFFICE USE ONLY Certificates of S eceived Yes No ' Tree Preservation Plan ecelved Yes - No _ Not Required OFFICE USE ONLY BUILDING PERMIT SUBTYPES ? 01 Foundation O 07 05-plex ? 13 16-plex ? 21 Porch (3-sea.) 0 02 SF Dweiling O 08 06-plex ? 17 Garage O 22 Porch/Addn. (4-sea.) ? 03 07 of _ piex ? 09 07-plex ? 18 Deck ? 23 Porch (screened) ? 04 02-plex O 10 08-plex ? 19 Lower Level O 24 Stortn Damage ? 05 03-plex O 11 10-plex Plbg _Yar_N ? 25 Miscellaneous ? 06 04-plex O 12 12-plex ? 20 Pool O 30 Accessory Bldg. WORK TYPE O 31 New ? 36 Move Bldg. O 43 Reroof O 32 Addition ? 37 Demolish (Bldg)' ? 44 Siding ? 33 Alteration p 38 Demolish (Interior) ? 45 Fire Repair tv ? 34 Repair 0 42 Demolish (Foundation) ? 46 Windows/Doors • Give PCA handout to applicant for demolition permit GENERAL INFORMATION SAC Code No. of Units No. of Buildings Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length W idth Basement sq. ft. Main level sq. ft. sq.ft. sq.ft. MISCELLANEOUS INSPECTIONS Cl Stucco/Stone APPROVALS Planning Building Permit Fee 1 (1 1- D ? Surcharge J-1 Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit SiW Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: ( -? I . -7 sq.ft. 5q.ft. Footprint sq.ft. Census Code MC/ES System City Water Booster Pump PRV Fire Sprinklered Engineering Variance Valuation: $ O 31 Ext Alt - Muiti ? 33 Ext. Alt - SF ? 36 MuRi < SAC Units % SAC 2/84 1 ' ? CITY OP EAGAN - . -'? ? APPLZC11TI0N FOR PERMIT ' SEWER AND/OR WATER COIvNECTION' ' .. . .. . (PLEA:;E PRINT) .. :`? i 1) PROPF?2'PY ADDRESS : LEXSAI. DFSCRIPTION: o4 (LOt/BlockjStbdivision or Tax Parcel I.D. Nunber) If' E{IS:_`:C? STI2I7C_'P.IR£. DATE Oc ORIGINAL ECTILDING P-c.ylT ISS?jANCE: - •, ? thbr.tt?,"Lear) ?s y PRESE^II' -i `i?:/P?3OPOSF?J L?SE: ? R-1 SINGZE FAMII,Y ? R-2 DAPIE{ ('I4x3.UPJIT") fl R-3 '?l?d?!'7[!SF .{;.??F7' + ?Ry-n..5? r •,r..r-> p R-4 APARTPffM'/C'?IDQ?I[A1 UNZTS) (3 cU41EMcuL/xETAii?OF FzCE „ El II3)OSTRSAI, p INSTI'ILJTICf1AL/GdVIISAENP '' 2) . . . . . APPLICIINT PLEASE PRINT) " -.- z' r 7-; , NAME ? : ,?-? "7 x<-rzt, e. q-;_- aDDxESS: crrsc, srATE, zrn: A-le /• .r. s- ra Y ?? pHONE: 3 - /'P 3) PIITNBE?2 PCEASE PRIMT fOR CITY USE ONLY .;!I NAME: ; r>? - - PLUMB S IICENSE / ADDRESS: ?T4YMinfTn ?Active ?;) CITY, STATE, ZIP: Eapired -?--'pg}?p Q Mot qf Pecord .: PIIONE: .u/„ c? PLUMBER LICENSE N ? - . . ."a ni ia , . A) OCr'['PFu%T/CtviVf'.R (PLEASE PRINT) -- - NNM: " ADDRtiSS: /S%3 t, G-<•.-/av.e. /L v'e- . . . rt CITY, STATE, 2IP: A ge fP V?L //-e PtfONG: rj/.3j _ .?ct! o 5) INDICATE WtiZCIi PEl3MIT IS BEIINC; RE7QUE,°'t'ID: Q'COrII4F.CPION 'ID CITY SEVJER - Q'CONNEX.TIODI 'IC) CITY WA7ER E] (7I'f{Fd? (PLi'11SE. DFSCRILiT) _„V-- --- -- - 6) . ,,. _ . ? P1:j-.15E tIOLD APPROVfI-) PcRMiT MR PICF:-UP BY 0NE OE r1B:NF. ? PISILSE MAIL APYROVESJ ?ER:?1Z'I' '1YJ 1. 2, 3; l4iP.BCT7E` (Circle one) 7 LATE: ;,?"2E i ? ) cv? : S , ??aw.;wt?st:,.?. a+.e aa?;..ar,i.+?! rt i5ik?rp?+.i ii.ii '.iM+t?F??}?;T+ hlk ?!M??F? ?! s•l ilyt.adt.?:+?a... F 0 R I T Y U S E O N L Y PERMIT ° ISSUED F_ -? F°ES: $ $ $ c Y Y ??? ?fl S os; ? 5 «7n.?? $ u« ?, ?r Cl $ S S S S SEWER P°?ZA!T_T (IVCLliD: SUP.CHARGE) WATER PERPIIT (INCLUDE SURCHARGE) WATER METER/COPPERHORN/OUTSIDE READER WATER TAP (INCLUDE CORPORATION STOP) SEWER TAP ACCOUNT DEPOSIT - SEWER ACCOUNT DEPOSIT - WATER WAC SAC TRUNK WATER AS5ESSMENT TRUNK SEWER ASSESSMENT LATERAL BENEFIT/TRUNK SEWER LATERAL BENEFIT/TRUNK WATER OTHER $ TOTAL $ 1,2 ?I• AMOUNT PAID/RECEIPT # y? a S? DOES UTILITY CONNECTION REQUIRE EXCAVATION IN PUBLIC RZGHT OF WAY? YES IF YES, THEN A"PERMIT FOR WORK WITHIN ? PUBLIC ROADWAY" MUST BE ISSUED BY THE NO ENGINEERING DIVISION_ LIST AS A CONDI- TZON. SUBJECT TO TIiE FOLLOWING CONDITIONS: APPROVED BY: TITLE: DATE : Y'- r v ? dty oF eagan 3830 PILOT KNOB ROAD, P.O. BOX 21799 BEA BLOM9UI57 EAGAN, MINNESOTA 55121 Mayor PHONE: (612) 454-8700 - THOMAS EGAN JAMES A. SMITH JERRV THOMAS THEODORE WACHTER - CouncY Membars THOMAS HEDGES - City Atlminishotor EUGENE VAN OVERBEKE Ciry Clerk March 25, 1986 Attention: Peg Rimpila County Auditor Oakota County Government Center 1560 Hwy 55 Hastings MN 55033 Dear Peg: This receipt was incorrectly posted to 10-53550-010-01. It should be posted to 1 350 550-010-02? Please make necessary changes to reflect these assessmen[s on 010-01 and issue a revised 1986 tax statement to the property owner. Please let us know [he installments made on these assessments on 010-02, and 6y whom, so we can make appropriate refunds. Sincerely, ?\ILI,.0?)jJ,?UL E. J. VanOverbeke Finance Director/City Clerk Enclosure EJV/dk THE LONE OAK TREE. ..THE SYMBOL OF STRENGTH AND GR01NTH IN OUR COMMUNIN , DAKOTA COUNTY MINNESOTA t RECEIPT, FOR PAYMEN7 OF PUBLIC IMPROVEMENT ASSESSMENTS ? RECEIPT NO.? ?O DATE jZ2 d2 __. - ' , • i. .. r , 77 . ' " ...... ?i ? da,f' el, 4c Zb PIAT PAFCEL NO. I DIO I (?'f'? ?CMECK OIGITI / I Ml1NICIPALITV 1 . T 1 ? li IJI 114I81 119 211 122 231 (24) •' D/P' AUD - INT,4 FROM TO ORIGINAL AMOUNT PRINCIPAL - INTEREST TOTAL PAID . - 3 isi-ea) "' "' ??'?'?'?+??a^ ? (77=4) Prepayment [?-(77 - 51 Paid in Full [D-(18 = 1) Partial Paid E] (IB = 2) if CARL D. ONISCHUK, COUNTY AUDITOR BY: fr YUNICIPALI7Y OF: - BY: 'j ?ade by check, fhis is not a valid receipt ontil check is paid. This Receipt does not include °t the insTallment certified to POSTED BY: the 19 ?MMSANENT COPY UqTE I? ? ?-P 99 RESIDENTIAL PLUMBING 'T ) S'- Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 Please complete for: Single Family Dwellings Townhomes and Condos when peimits aze required for each unit DateV2 / D?? Site Address UniY # b ° Property Owner Telephone # Contractor H p PIPEWORKS , ero O 6 ?D Address G 12 NN 5 3 N Ciry State (651) 365 1340 Zip Telephone # ( ) The Applicant is _ Owner Contractor _ Other Septic System New _ Refurbished Submit 2 sefs of plans and MPC license Includes County fee. Additional consultant fees may apply. $ 100.00 Alteratians to eaisting dwelling _ Add fixtures to lower levels or room additions, excluding water softener and water heater $ 50.00 _ Abandonment of septic system _ Water turnaround (+ 518" meter if needed -$121.00) Other: _ RPZ _ new _ repair _ rebuild $ 30.00 _ Lawn irrigadon system k Water softener -joVater heater 7 $ 15.00 replacement additlonal 7003 State Surcharge $ 50 Total ?? r $ ?? • "' I hereby apply for a Residential Plumbing Permit and acknowledge that the informarion is complete and accurate; that the work will be in confomiance with the ordinances and wdes of the Ciry of Eagan and with the Plumbing Codes; that I understand tlus is not a permit, but only an application for a permit, and work is not to start without a pernut; that the work will be in accardance with the approve;rl plan in the ca,se oF work wlvch iequires a review and approval of plans/ If / 4AIA? fl / A ApphcanYs Pr teti a? e App'licanYs i atur D • i.. 7 . • . . . I.di 1 + 0 iXTE1RI(lR ENVIs1,OPE AVERACE C0MPUTATION - .z . . : i . .; . ._. wner'}?j?t?'"????,??3_?? .---Address f Phone??=? __•)? , - . ?i?.k- y . -gal Ae,scription of Property: Lot7ock Additioq°iA1,! Date?:?¢- ite Address ' I`,7??r.- Y?l_.!? '?' ??1?.°d" ?"?=?•? ?-'- AVERAC,E LINEAL FEET OF EXPOSED WALL AREA ABOVE f,RADE . ain level Lineal ft. of framed wall above grade:?R4, x hefght of wall --? im joist area (? Lineal ft. of x height of rim .nwer.level .. -, Lineal ft. of framed wall above grade ? x height of wall Lineai ft. of masonry wall above gradej)'?x height above grade =•??'-' . TOTAL wall area above grade including windows and doors tINDOk'S: Area x"U" value ?U??Aj 4ake. 3 :tYPe ?; sq. ft. _ (U) (A1 ... ° T^BC^5?a .IC?SK' - sq. ft. X nUn , . . -_._-...-_---- flUll ? (U) (A) ,? . ft ? n - u . ft uU° I f? (U) (A) . ft nU?? ft ol U?? _ . (11) (A)j n . .:„ .. U?? _ . (l12 (;?1`)• ' . ? , ft (• G 11U11 3 ' • ?U?'...\h): 11 11 • L t •1 (11 . 11 • ft 11U11 , = r3s ?/ lUl \??\?In q , ft (U) tAl . ft Uo?= x "U" _ _z. ft. (U) (A) It eq. ft. 7C nDn (U) (A) q. ft. X n[Jn o . u r S cu?'c?a , n.. ?r . sq. ft. -g nUn ...-?[1) ?A) fl?jn n- n sq. ft. X , ,?U,a Et?tA) sq. ft. X q. ft. x "U" ? . ?, . s ?? ?.?.-- DOORS: Area x "U" vaTue , I (U),(A) ft. `X ??U?? : j!ffl (U):NA) Make '& type .?1b? t??.?..? Z,'?'? sq' X *IUI. Un! o ? '-(U).tA) ?? ? M ,3q. £t. ' X n U)t"A? X? sq. ft. X „Un .d6????? OPAOUE WALL CONSTRUCTION; Area x"U" value xU„ _ (U) (-p; sq. ft. Q j x nL??-= D)(A: fU? - U) (A?, , . .., $ ft. x ??U?? ? lletail re€er Q ence from 1U' (A $q, ft. X IZA . .o? ilUn (U? (A attached < sq. ft. j`7 X _ ,? _ (l?).?A sheets sq. ft.?- . XUl?? _ q. ft. (ii),4A 5, ? • 1'OTAL Wall Area Including Windows 6 Doors j-&ZQ=t-?0T0TAL (U) (A) 2 •-tZ' '. ;. TUTAL (ll) (A) VALUF.S AVG. °[1" • _? UIVIDED BY T'OTAL WALL ARGA I I?. K?? AVERAGE "L'" Minimum --1-7- or less for 1& 2 family dwellings Minimum .22 or less for al.l other buildings NOTF.: 1f avr.rage "U" values as calrulated above do no[ meet the Energv Code requirements, the , ' "Alernate Envelope Design" as indicated on Page S may be used. ;,?• , R-Value FI2AMING MEMBERS IN WALLS . To View -?.' -' - 6c,C i'IUNO MHLL air film _ Exker3or _. _ IrGTc: .,ae lUro of opaque Sidinfi _ --.??_ .__- xall area for f'ramin Sheathing members ? ? soft voad ? dr.y wall .45 Interior air film '68 , .?... TOTA L It U = 1/R U ? (2') Sheathing IW batt insulation 11" dry wa12 - - Interior air film - - '?8 TnTA7 R . u = i/a u a .042- RZM_ JOIST AR,? ? >:< Sxterior air film Siding '1' ?L??? Sheathing ... ? 1.88 ' ?t-" soft wQOd .68 . Interior air fi?m - . .------------?=? TOTAL 1i U= 1/R U= MASOA'RY WALL _ Exterior air film 12" concrete 6loeic Insulation _? ?-i-'--'," -- - Interior air film TOTAL R • - ? -. S?l _,e-;s.?• .. - -- :i,. U = 1/R U J. y ? a . ___Outside air film Insulation t)??_??jy?,? 31" Drywall .45 . Interior air film _61 _ U = 1/R Outside air film _ ___ Tnanlatinn . . _ __ _ ..... ? _ ? . . 35" Dryvrall • 45 Interior air film .61 : U = 1/R TOTAL R = u_ ROOF/CEILING: TGTAL AREA: I?.F7Ft ? @Ta{??, ft• : (u) (A) x sq. ft: - tletail reference ? --?-??- i S7F???-?'F- Un ? t?•?.?:? x sq. it. -?.CY`5. s"??-1----(ti?(A)`-; from above. ?--„U,R x sq. ft. _ (U)(A) Describe openings = (L')(A) in raof _ Un x sq. ft. _ (!') (A) f?U,l x sq. ft. (C) (A) 11UII x sq. ft. _ (L?) ?A) TOTALS (U)? TOTAL (U) (A) VALOES „ ,, DIVIDED BY TOTAL RUOF/ AVG. L CEILIt:G ARF.A ?n oZb? W AVERA(?E ^li" ..`?" for ventila[ed roofs ' .10 for all othex construction Nq'fF.: ]f averape , , val.ues as calculated above do not meet the Engeray Code requirements, the "Altcrna[e P.nvelope Design" as indicated on Page 5 may be used. 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S01 . . ...i ~ , ~ . . ~ ' , ~ . . . ~ - ~ . ~ ~ ~ . ~ SCdti8:E ~ ~ 1 s ~ ~ ~ ~ ' . . 3 . ~ , ~ , 'l~~~~ ~ ~ . ~ ~ . . . . . . . . . ~ , . . . ~ ~2..- . . . ~ .JlOB i`AS'J. ~ II..! ~ S ~ ~ ~ ~ ~ , ~ ~ . ~ ~ . , , , ~B`` Use BLUE or BLACK Ink z. r-- ---_-_._--_---I I Foc Office Use' Permit#: &C / I CRY of Evu I Permit Fee: O( 3830 Pilot Knob Road Eagan MN 55122 Date Received: I Phone: (651) 675-5675 Fax: (651) 675-5694 I Staff: I INFLOW INFILTRATION PERMIT APPLICATION Plumbing / Sewer & Water Date: ` (f Site Address: `4 ~j 0 A~^Y-, Tenant: / Suite Name: 1 j S Pf ' r-4 L!~~ Phone: (PS RESIDENT I OWNER j Address / City / Zip: s C7hn~ C, t {-r-- V-1b Name: License Address: City: CONTRACTOR State: Zip: Phone: Contact: Email: PLUMBING (Within the building envelope) SEWER & WATER (Outside the building envelope) TYPE OF WORK Sump Pump Repair Repair Other: Other: DESCRIPTION Description of work: - - FEES $55.00 / Each (includes $5.00 State Surcharge) TOTAL FEE $ *Permit fees will NOT be reimbursed by the City of Eagan. If you plan to submit 1/1 repair costs for reimbursement, two quotes from qualified contractors must accompany this application. A list of contractors can be found by visiting www.cityofeagan.com/inflow, or City Hall at 3830 Pilot Knob Rd. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities, mvw. o herstateonecall.or g 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 rk which requires a review and approval of plans. X 1 Val x Applicant's Printed Name Applicant's Si nature FOR OFFICE USE Reviewed By: Date: Required Inspections: -Under Ground -Rough-In -Final PERMIT City of Eagan Permit Type:Building Permit Number:EA118755 Date Issued:11/07/2013 Permit Category:ePermit Site Address: 4718 Oak Cliff Dr Lot:1 Block: 2 Addition: Oak Cliff PID:10-53550-02-010 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required by law in ALL single family homes . Lisa Nyberg 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 - Kevin J Riedl 4718 Oak Cliff Dr Eagan MN 55122 Property Claim Solutions Llc 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature Use BLUE or BLACK Ink fia~ For Office Use j Permit ffi City of Ea a~ I Permit Fee: (R7 I 3830 Pilot Knob Road Eagan MN 55122 j Phone: (651) 675-5675 I Date Received: Fax: (651) 675-5694 I I Staff: I I 2014 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES EXISTING RESIDENTIAL PROPERTY Address: 41 -71 p OAK CUF7T Lb Z- FOR OFFICE USE ONLY [.V-,7A EDL _PRVrequired Property Owner: Phone: Contact Name: City R-O-W Permit Plumber: U hJpC703/t(J M County R-O-W Permit tom,. 4 Odd _ Plumbing Permit i SEWER WATER Sewer Service Water Service Sewer lateral charge Water lateral charge Sewer trunk Water trunk City SAC @ $1001unit Water supply storage MCES SAC @ $2,485/unit Receipt , Date: Receipt , Date: Treatment Plant @ $828/unit Permit Fee $60.00 Permit Fee $60.00 State Surcharge $5.00 State Surcharge $5.00 TOTAL: &cS 0 0 'Plumbing Permit Required - water meter to be acquired with building permit TOTAL: SEWER & WATER w~ Sewer Service Water Service Sewer lateral charge Water lateral charge Sewer trunk Water trunk City SAC MCES SAC Receipt # Date Water supply & storage Receipt # Date Treatment plant Permit Fee $120.00 State Surcharge $5.00 'Plumbing Permit Required - water meter to be acquired with building permit TOTAL: Number of SAC units is determined by the Metropolitan Council Environmental Services (651) 602-1000. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org Cc: City of Eagan Finance Department PERMIT City of Eagan Permit Type:Building Permit Number:EA122175 Date Issued:04/29/2014 Permit Category:ePermit Site Address: 4718 Oak Cliff Dr Lot:1 Block: 2 Addition: Oak Cliff PID:10-53550-02-010 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . 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 - Kevin J Riedl 4718 Oak Cliff Dr Eagan MN 55122 Property Claim Solutions LLC 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA122555 Date Issued:05/12/2014 Permit Category:ePermit Site Address: 4718 Oak Cliff Dr Lot:1 Block: 2 Addition: Oak Cliff PID:10-53550-02-010 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - 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. 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 - Kevin J Riedl 4718 Oak Cliff Dr Eagan MN 55122 Property Claim Solutions Llc 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA155357 Date Issued:05/13/2019 Permit Category:ePermit Site Address: 4718 Oak Cliff Dr Lot:1 Block: 2 Addition: Oak Cliff PID:10-53550-02-010 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace & Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 Surcharge-Fixed $1.00 9001.2195 $60.00 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 - Kevin M Mckliget 4718 Oak Cliff Dr Eagan MN 55122 Golden Valley Heating & Air 5182 West Broadway Crystal MN 55429 (763) 535-2000 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA163827 Date Issued:09/14/2020 Permit Category:ePermit Site Address: 4718 Oak Cliff Dr Lot:1 Block: 2 Addition: Oak Cliff PID:10-53550-02-010 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State 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 - Kevin M Mckliget 4718 Oak Cliff Dr Eagan MN 55122 (612) 600-2993 Window Outfitters Inc 12605 Creek View Avenue Savage MN 55378 (952) 746-6661 Applicant/Permitee: Signature Issued By: Signature