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1626 Oakbrooke DrAddreSS 1E25 OAKBROOKE DRIVE L.ot 6 Blk 4 Sub Zip 5512? OAKSROOKE 4th THESE ITEMS WERE / WERE NOT COMPLETE AT TAE TIME OF THE FINAL INSPECI'ION. Date; I Yes No Inspector: Final grade (6" From siding) Permanent steps (garage) ?jLOG? Se:Y[C?'s Acodia- Permanent steps (main entry) Permanent driveway Permanent gas Sod/Seeded grass Trail/curb damage Porch Basement finish Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply W the oufside lawn faucet before freeze potential exists. Contact engineering division at 681-4645 before working in righPOf-way or installing underground sprinkler system. ` ?W White - City Copy Yellow - Resident Copy Pink - Contractor Copy tTJ p Site address: /GRba?1`)M?l?P _?? ??e-Lot _14' Block 4t Subd On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the foliowing information be submitted prior to issuance of a Certificate of Occupancy. _ This sUucture: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670 OR ?iThis structure: will be constructed to meet more restricGve requirements of Chapters 7672 or 7674 APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTINGTYPE Water Heater ? I?47a?sr? Furnace ? rI? , ? c? . .7CJ & nreC?' Dryer EXHAUST SYSTEM LOCATION TYPE MODEL CFM'S VENTED YES No Kitchen kitchen Bathroom 1 liki Bathroom 2 Bathroom 3 Bathroom 4 Other i FIREPLACE S LOCATION GAS WOOD MANUFACTURER MODEL BTU'S VENTING DiaECT ATMOS .+?MP?? ? G,L?s Cc?o ? oo? ? MAKE-UP AIR MODEL TYPE CFM's I hereby acknowledge that the above informaGon is correct and agree to comply with the Minnesota Energy Code and City of Eagan requvements. Signature - PU i CompanyName 5)`a4i C)? Date * This form is the responsibility of the General Contractor. LOT: ? BLOCK: L-4 °" `SUBD./P.I D # ' U A V1X0-1&-L ? 2000 BUILDING PERMIT APPLICATION (RESIDElNTIALI" 'i I CITY OF EACAN ? 3830 PILOT KNOB RD - 55122 651-681-4675 ?a???.} New Constructlon Reauirements "f"" --,4 yl aL? -1 Remodel/Repair Reauirements ? 3 registered sRe suneys showing sq. If. of lot, sq. ff. of house 2 copies of plan and all roofed areas (20%, maximum lot coveraae allowedl 1 sef of energy caltulatlons for heated additions D 2 copies ot plans (show beam 8 window sizes; poured fnd. design; etc.) 7 stte survey for exTerior additions 8 decks D 7 set of energy calculations ? 3 coptes of hee preservation plan N lot plaNed affer 7/7/93 ? Rlm Jolsf Detail Options selecHon sheet (6uildinas wNh 3 or less unffs) DATE: 1O?I ?S?/ 0? CONSTRUCTION COST: "? b?' ? DESCRIPTION Of WORK: !l e5 il&n}1 rq If muNi-tamily bldg., how many units? ? STREETADDRESS: 1[v 64 0AIC6IQoai« )D?lll?e Name: Phone #: PROPERTY Last First OWNER Street Address: City State: Zip: Company: A/ r/ G/le,M 4 sPhone #: (area code) CONTRACTOR SheetAddress: 13$5-mt,40kh?S Ucense# /3Ex0. City 11t4dd-4 State: MW Zip: NGINEER / Company:JAM 1f 7TS ?e[ Oo?-e- Name: Telephone #: ( Sheet Clly Registratton #: State: Zip: Sewedwaterlicensedplumber(ifinstallingsewer/water):YO)LL-Cv/ L-UA(129?G Phone#: ?( `Q ) t"a-zlzl I hereby acknowiedge that I have read this application, state that the information is correct, and agree fo comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: vu? ?-t.0' Certificates of Survey Received y Tree Preservation Plan Received _ OFFICE USE ONLY Yes _ No Yes _ No k Not Required ? DEC 18 Zp00 ? OFFICE USE ONLY ? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool >?02 SF Dwelling ? OS 06-plex ? 76 Fireplace ? 21 Porch (3-sea.) ? 03 Ot of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 05 03-piex ? 11 10-plex O 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous )(31 New ? 32 Addition ? 33 Alteration ? 34 Replacement VALUATION Census Code SAC Units Nbr. of Units Nbr. ot Bldgs Type of Const -l--o-l- --?? v Pi ? 30 Accessory BYdg ? 31 Ext. Alt - Multi ? 33 Eut. Alt - SF ? 36 Multi ? 35 Int Improvement ? 42 Demolish (Foundation) ? ? 36 Move Bldg. ? 43 Reroof ? ? 37 Demolish (Bldg)' ? 44 Siding ? 38 Demolish (Interior) • Demolition (Entire Bldg only) permit - Give PCA handout to applicant _ Occupancy e"3 MC/ESSystem Zoning City Water Stories Booster Pump Sq. Ft Length ?-6?/ Width -,57A2' INSPECTIONS REQUIRED x Footings: New Bldg _ Footings: Deck Footings: Addition ? Foundarion ? Frammg APPROVALS Planning K Insulation FinaUC.O. FinallNo C.O. x Fireplace: )( r.i. Pool _ frgs Building ?C air tesf ? fmal _ air/gas tests _ fmal Engineering PRV Fire Sprinklered 45 Fire Repair 46 Windows/Doors _ Wmdows - new/replacement _ Siding _ Stucco/Stone Root ice & water final Variance s Base Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S&W Permit & Surcharge Treatment Plant Park Dedication Trails Dedication License Search Copies Other Total: d?r4s?i 1,2s? X 1 ? = 1h wa .) /Y 5`1 = ?'Vviio 4 4? IV ?- 3 Z.jqn (,i"' #?--K,rb? lq 710.>,L NOU-29-2099 03:13 PULTE HOMES MNcheck COMPLIANCE REPORT Minneeota Energy Code MNcheck Software Version 3.0 651 45G =>/Lf r.uc, r,c Permit # Checked by Date COUNTY: Dakota STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 11-20-2000 DATE OF PLANS: 8/14/00 TITLE; TYLER ELEVATION #4 PROJECT INFORMATION: OAKBROOKE SINGLE FAMILY COMPLIANCE: PASSES Required UA = 520 Your Home = 442 15.0-% Better Than Code Area or Cavity Cont. Glazing/DOOr Perimeter - R-Value R-Value U-Value ------------------------------------- CEILINGS 1656 --------- 44.0 -------- 0.0 -------------- WALLS: Wood FYame, 161, O.C. 2049 19.0 2.0 1 WALLS: Wood Frame, 16" O.C. 243 9.0 2.0 BSMT: Conc. 8.0' ht/7.3' bg/7.3' insul 640 11.0 0.0 BSMT: Conc. 7.0' ht/7.01 bg/7.0' insul 224 11.0 0.0 GLAZING: windowa or poors, Above Grade 378 0.350 1 DOORS 38 0.350 FLOORS: Over Unconditioned Space 352 38.0 0.0 SLAS FLOORS: Unheated, 42.0" insul. 72 5.0 HVAC EQUIPMENT: Furnace, 92.0 AFUE ----------- - ------------------------------- COMPLIANCE STATEMENT: The proposed building ----------------- design deacribed ------------- here is consistent with the building plans, specific ationa, a nd other calculations submitted with the permit application. The propoeed building hae been deeigned to meet the requirements of the Minnesota En ergy Code. - Builder/Designer Date / "' D/vo TOTAL P.02 JOB INITIATION ORDER DATE: 7/31/00 JOB NO: 0320-206-04 ,J COMMUNITY: Oakbrooke SF BUILDING ADORE 1626 Oakbrooke Drive MODEL NAME: Tyler MODEL# 1R2R1 LOT: 6 LOCK: 4 UNIT: ADDITION: 2nd Phase CITY: Eagan STAT MN ZIP: ? ELEVATIO •-GARAGE: RIGHT BUYERS NAME: Donald & Mary Lockwood CURRENT ADDRE 13820 Echo Park Ct. CITY: Burnsville STAT MN HOME PHONE: 612-432-1598 BUSINESS PHONE: 651-646-8969 BUSINESS PHONE: SALES REPRESENTATNE: John P. Van Beynen HONE: 1 18281 Tyler ?k 1 0 Lot premium $2,000 1 19021 FUtL VIEW ALUM CQMB DOOR $150 1 14160 3RD CARPET UPGRADE $2,775 1 15087 CERAMIC TILE FOYER $750 . 1 40026 LAMINATE KITCHEN/DINETTE $7,625 2 17000 ADD'L ELECTRIC.OUTLET Garage $100 5 17024 CEILING ELECTRIC OPENING BR1,2,3 Den, FR $500 1 32012 T.V. JACK-CABLE READY Loft $50 2 32020 ADD'L PHONE JACK Loft, Den $100 1 36019 WATER LINE FUTURE ICEMAKER $125 1 36039 WATER SOFTENER LOOP $240 1 21021 . GAS FIREPLACE - CERAMIC W/WOOD $4,250 - 1 22001 - 3RD CAR GARAGE-ELEV#1 $6,795 1 22016 INSULATE - 3 CAR GARAGE $1,010 1 29006 CAST IRON'KITCHEN SINK $425 1 14007 1 ST CARPET PAD UPGRADE $245 $0 . . $0 ? P M $0 - $0 $0 TOTAL $241,130 THIS CONSTITUTES A CONTRACT B TWEEN TH SELC D THE PUCHASER (S) FOR THE ABOVEITEMS. APPR OVED BY BUYER (S): : APPR OVED BY BUYER (S): APPR OVED BY SUPERENTIDENT: ? APPR OVED BY SALES: 1 ZIP: #### Builders License # 0001371 • LOT SURVEY CHECKLIST FOR RESIDENTIAL ? BUILDING PERMIT APPLICATION L PROPERNLEGAL: 1?7- / &ffZ/' y ?A??Q?k? 4'TN /?vLnTLG,I? h DATE OF SURVEY: H iL LATEST REVISION: Ic? ' c? I? d ? C OOCUMENTSTANDARDS 0 O ?? Registered Land Surveyor signature and company ?p ? • Building PermitAppiicant W?a ? : Legal description d/o ? . Address df ?4 ? • North artow and scale p? p? • House type (rambler, walkout, split w1o, split entry, lookout, etc.) ? • Directional dreinage arrows with slape/9redient % o'?b ? • Proposed/ebstng sewer and water services 8 invert elevation ra??a ? Street name ?j? ? : Driveway m'/? ? Lot Square Footage ? ? ? • Lot Coverage ELEVATIONS ? Existina d ? ? • Sewer service (or Proposed) ? ? • Property corners q? ?? • Top af curh at the driveway e ?? • Elevations of any ebsting adjacent homes aR'?' ? Adequate footing depth of structures due to adjacent utifity Venches Prooosed / e'/ a o • Garage floor r? ? ? o • Firstfloor i d w) lk U d l tl ? ? w n o on (wa ou e eva • Lowest expose q/ ? ? • Property corners q/ ? ? • Front and rear af hame at the founda4on PONDING AREA (if aodicable) / a ef ? • Easement line o ?/ ? • NWL ? co" ? • HWL ? p? ? • Pond # designa0on ? q? ? • Emergency Ovefiow ElevaUon ? DIMENSIONS r' o? • Lot lines/Bearings & dimensions o ? • Right-of-way and sUeet width (to back of curb) (9/o ? • Proposed home dimensions induding any proposed decks, overhangs greater than 2', porches, etc. / (i.e. all structures requiring permanent footings) rd o? • Show aA easements of record and any City utiGdes within those easements ? o ? • Setbacks of proposed structure and sideyard setback of adjacent existing strudures ?o ? • Retaining wall require ments, if Reviewed: March 1G89 cnAoaeLocvnMr.cM , .. Surveyor's Certificate SURVEY FOR :PULrE DESCRIBED AS : Loc s, Block 4, OAKBROOKE 4TH ADDITION, City of Eagan, Dakota County, Minnsoto ond reserwng easements of record. ;-6.. ?60 ,??,? ? oaz. i = 9,164 = 11 788 207o P \\?? 2ea ? . ? ?o ytiy `.?9, +e'' ' ?' `?O' ?'?•? , ?57 ? LOT SQ. FOOTAGE HSE. SQ. FOOTAGE LOT COVERAGE _ Plan # 18281 PROPOSED ELEVATIONS Top of Foundation = 999.8 Garoge Floor = 944•9 Basement Floor = qql,g Aprox. Sewer Service = Proposed Elev. = 0 Existing Elev. Drainage Directions =- Denotes Offset Stake = . SCALE: i inch - 30 feei Front -25 House Side - Rear -15 Garage Side- JOB NO: L?/ND ' HEREBY CERTIFV THAT THIS IS A 7FiUE AND CORRECT REPRESENTATION OOR-557 OF THE BOUNDARIES OF THE ABOVE DESCRIBEO PROPERTY AS SURVEYED IfEDBY ME OR UNDER MY DIRECT SUPERVISION AND DOES NOT PURPORt TO BOOK: PAGE: PLdNN1NC BNGINB6RlNG SURVEY/NC SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN. 2005 Pin Ook Drive ' Eagan, MN 55122 DATE 11 i 16 I oD CAD FILE: Phone: (651) 405-6600 (7 JMIF D. LIND EN, L D SURVEYOR Fax: (651) 405-6606 f?(?1V. IZ ZI ?' NN OTA LICENSE N BER 14378 OAKBROOKE ? ? : ?J 495.9 ?A?y 'o \ ?oae G? RB ,. ?e i.l ?[ -^?? ?a ? , ew.i '• -•p".Y'rr???il.T .'i" i. ? ,/ r-' ss?l? .. 2F S(APESxruTMt$ AtEEA E"'-FM 3?1 A 1?er?rrise WALC. MAY '[3 Er ?aF? ti 5 ?'p0 4 1 ?\ i V I_j' 9 'O r " • ?'? \??` \5 i i ? i ? . L mA2?Dl'A?1 Z"/e ? Guoe AcROss Ler. 14 1212) BENCHMARK, TNF/@ 13 £ltu= 495.03 A MIN. SETBACK REQUIREMENTS ? ma 'oo ? s Jce+ ,?0 999k O ?- ?4,, d / -Q,? \ iqZECE1VP-C a.f:.. . ..::[ CITY USE ONLY PERMIT #: , RECEIPT DATE. MIDENTilkL M£CiMICAL PEfiM1T !lPPLICATION ctrYoF EwsaP 3830 Pnor sxos Ru £AHlkA MlY 551 YE 651-681-4675 Please complete for: D singie family dweltings townhomes and condos when permits are required for each unit Date: I07 SITE P.QQRESS: 4 OW NER TELEPHONE #: DE) INSTALLERNA`I}Ec????G TELEPHONE#: (A /J STREET AD RESS: ? W'f ? CITY: 1 STATE: 0174__? ZIP: S S 32'4 6 r?aco a wc?n wa.n ncwi av w.c ? New residential dwelling unit under constructionand not ownerloccupied $ 70.00 Add-on, modification or alteration to existin dwelling unit $ 50.00 • furnace replacement • air exchanger • air conditioner • other Nature of yyork: State Surchar e $ 50 Total s Reminder: Call for inspections. . ? ? ATURE O ERMI EE Lipdated 1101 CITY USE ONLY PERMIT #: APPROVED BY: INSPECTOR RECEIPT DATE: COMMEEtCIi41. MECEA1VICAL PEPMiT AppLICmiON C1Y'YoF ERSAlv 3$30 ?lLOT KROB itD EA6AN,IHN 5518E 651-6$1-4675 Please complete for: all commercial/industrial buildings I multi-family buildings when separate permits are not required for each dwelling unit DATE: SITE ADDRESS: OWNER NAME: TENANT NAME (IIvIpROVEMENTS ONLY): PHONE #: - (AREA CODE) WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: ADDR.ESS: PHONE#: - (AREA CODE) CITY: STATE: ZIP WORK TYPE: _ New construcrion Install U.G. Tank _ Interior Improvement Remove U.G. Tank _ Processed Piping Specify Nature of Work: When insta!ling/removing underground tank, ca!! 651-68I-4675 for inspection by Fire Marskal axd Plumbing linspector. Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater. Underground tank removaUinstallaHon = m;nim,,.,, Fee Contact price: $ x 1%= $ (Base Fee) State surcharge TOTAL $ calculate at $.50 for each $1,000 Base Fee SIGNATURE OF PERMITTEE i Updated 1/Ol CITY USE ONLY L _ 61 BL ? RECEIPT#: SUBD. OCI KYI YOO KC''i I-i'ib RECEIPT DATE: ? -U PERMIT# 2000 PLUNBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT IQI08 RD EP,GA2I, MPt 55122 651-681-4675 Please complete for. ? single family dwellings ? townhomes and condos when permRs are required for each unit ? backflow preventer for underground sprinkler system FIXTURES EACH # TOTAL Alterations to existing dwelling - minimum fee Describe: $ 30.00 Bath tub $ 3.00 x = $ ? Floor drain 3.00 x = $ Gas piping ouUet ' minimum • 1 3.00 x Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x $ ? Laund tray 3.00 x Lavatory 3.00 x = $/ ~ SEpUC $ stem new/refurblshed • requlres MPC Iie. 75.00 X = $ Septic S stem abandonment 30.00 x = $ RPZ new installationlrepaidrebuild 30.00 x = $ Rough opening 1.50 x = $ ..S Shower 3.00 x Under round s rinkler Hdwalling is under construction 3.00 x = $ Undergroundsprinkler rfexistingdwelling 30.00 x = $ Water closet 3.00 x = $ - Water heater 3.00 x = $3 ? Water softener if dwelling under oormvuction 5.00 x = $ Water softener itexissin9 dweuin9 30.00 x = $ Water tumaround 30.00 x - = S State Surcharge .50 -> -> -? $ .50 TOtal $ Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. I Ae?eby ecknowledge thet I hsve read this apphption, state that the intoonation is correc[, end agree to comply wRh ell epplicable City of Eegsn ordinances. It is the applicanYs respansibility to notify the property owner that the City of Eagan aasumes no liabllity for any damages caused Cy the City during its nortnal operational and maintenance activities to the facilities consWCted under this ?emift within City propertylright-of-wayleasement. SITE ADDRESS: OWNER NAME: : INSTALLER NAME: tll'J STREET ADDRESS: CITY: ?? !' /'? , '/(/'e TELEPHONE #: (AREA CODE) TELEPHONE#: (AREA CODE) TE: c ZIP: -5&a5/z OF PERMITTEE CITY USE ONLY PERMIT #: RECEIPT DATE ?? Q1 M1DENTIAL M£CHANICAI. PERMiT Ai'PLIC!lTION crrYoF Ea?snx 3830 Paor xxoa Rn £AHAft btN 55122 851-6$1-4695 Please complete for: > single family dwellings townhomes and condos when permits are required for each unit Date: 51s'Z3f 0 I SITE ADDRESS: `Ua( 0 OQY.-bYDOy-.tyc• OWNERNAME: ?C?Y1U?I? LoUCwoo& TELEPHONE#: 6 f 0& zI3a -I5 R? (AREA CODE) INSTALLER NAME: '-? Y1Svl I(Q. TELEPHONE #: 7 Sa. (AREA CODE) STREET ADDRESS: `94$ I ?CY'Qx ?s LUE\C9-. V?:k ) . S_ CITY: S 0 Ct r4 4- STATE: F-kP ZIP: J"rJ 3 Place a check mark nezt to the oermit work tvoe New residential dwelling unit under constructionand not owner/occupied $ 70.00 x Add-on, modification or alteration to existin dwelling unit $ 50.00 • furnace replacement • air exchan er , • air condition • other Nature of work: A"A44_e., y^-?C State Surchar e $ 50 I Total $ SO •'o d Remi»der: Cal! far inspections. :v) ` SIGN.A I URE OF PERMITTEE Updaied I,01 CITY USE ONLY PERMIT #: APPROVED BY: RECEIPT DATE: INSPECTOR COMMEftCIi41. MECHANICAI. PERMIT APPLICATION CTfYoF gAfiAN 3$30 f'ILOT KNOB gD Ekfii4BT,MN 55122 651-6$1-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit LATE: SITE ADDRESS: OWNER NAME: PHONE #: - (ARLA COUE) TENANT NAME (IMPROVEMENTS OVLY): WAS THERE A PREVIOUS TENAN'T IN TH1S SPACE? Y N. NAME: INSTALLER: ADDRESS: CITY: WORK TYPE: New construction _ Intenot Impiovement _ Processed Piping Specify Iv'ature of Work: ,, Instal] li. G. 'Canlc Remove U.G. Tank When installing/remnving underground fank, cal[ 651-681-4675 for inspection by Fire Marshal ai+d Plumbixg Iinspector. Fees: 1% of conuact price OR $50.00 minimum fee, whichever is greater. Underground tank removallinstallation = mviimum fee Conhact price: $ x 1%= S (Base Fee) State surcharge calculate at $.50 for each $1,000 Base Pze TOTAL g SIGNATURE OF PERNIII'7 EE PHONE#: - (ARFA CODE) STATE: ZIP: Updated 1/01 Use BLUE or BLACK Ink For Office Use j Permit* L' 1 City of Eaaan I . . ~s Permit Fee: 3830 Pllot Knob Road Eagan MN 55122 j Date Received: 3 j Phone: (661) 675-6675 I Fax: (681) 675-6694 1 Staff: , 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 9 1,3 Site Address: ) tarter lame- Unit Name: 011~, Phone: (,gM- ZS~/~ HLBw ~ ''t Address / City /Zip: ) 1 Z~, t i, ht ll!~=~i=if I 1 I'1 3' 1, II. i.j•I ` Irii il`Ifi Owner Contractor ; Applicant is! W 1 Lie ~r- oar l~ Description of work: ,,.Ti. Y, P t 1,;,4 ,'r ~ ~ "T~le' o•~r a' f a1`o air 2~ 1 • s"5~~ I~r ;..:,,';:,•„1 i•IJ'il'r;l Construction Cost: Multi-Family Building' (Yes No ) i i l , Inp lnly t I'I .oli li'I CompanY G toYw~et1 IS Ctrl Je+t/• Contact: ),M1! c h1 5 ~K Address: t S . ~rr erg ~e~r. P Q d. City: 10.5 4 r a state: Zip: Phone: Gzb'1 D~ X757 rc,rl`i License i:SC G, to ~ Lead Certificate 1V 4J: - J 0 NA 7 J - L If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan Issued a permit for a similar plan based on a master plan? Yes -No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: ..;?li4 Jtf r, ~'})"f~ <l l ;Ih I a'' 1., '1~ : + i I ,.,.G : 'tt', Id, i ~i! :ra 1l.!'se "::yl.li I V~:~','! . rtr g: ' . , J 'W fr *tl ~ { II'~ ,~l'!. 1•'M . 'I'•i . . I !/~•.rr f,.j.~i• fEj ~t MIN;, :..t-.. ,•.u•,e:r,': 1:. t ..-..~u'' . cn i 'i a r @. . !1l ,e 'Ic;1,i. li r,, . l H.. „I:II .'1'.i!i• 6, i -9. ? !tia:,~1,u I(,l iilf•c! ; ri=1,a.I:. il; r) lilt I s; I ~ • ~;;i:(e~l ~ I ~ ; ~ it f , I a I •~•J f 11, 1I L,,, ii't I: I a, !a?; I t • cJ ja,~ t... i. d'( ~Iti lY~ ~ .rt . ,n I t 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.ora 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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of parmlt Issuance- x IIV\ 1i r NN e%, C: 1 x Applicants Printed Name Applicant's Signature Page 1 of 3 b0/ZO 397d 31X3 WO1S00 S-1-13NN00 THZ8E17ZS9 LZ:TT ETOZ/H/69