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1683 Oakbrooke CtPERMIT City of Eagan Permit Type:Building Permit Number:EA128560 Date Issued:11/18/2014 Permit Category:ePermit Site Address: 1683 Oakbrooke Ct Lot:21 Block: 1 Addition: Oakbrooke 5th PID:10-53764-01-210 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. 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 - Gary W Nelson 1683 Oakbrooke Ct Eagan MN 55122 Property Claim Solutions LLC 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature _ ?..-?--w -4- 4 ---1 v Ct 0( . RESIDENTIAL H-W19 l BUILDING PERMIT APPLICATION MP'?7??? ' 3830 PILOT KNOB RD - 55122 ? 7o??Q 10 537br1 z?? G I 651-681-4675 ?n J ' modeVReoalr Reauiremenb ? ? ?70I - R i 50 l0 e remenls New Construction Reau . 3 registered site surveys shaving sq, ft ot lot, sq. ft of house; aiM all roo(ed areas • 2 coPies ot plan , (20°k maximum lot coverage ellowed) • 1 sel a( Energy Calculations (or heated addRions -1 . 2 copies oi plan showing beam 8 window saes; poured fouM design, etc.) h • 1 site survey for exterior addNons & decks . lsetofEnergyCalalations • IndicateHhomeservedbysepticsystemforedditions? 51b2' Q • 3 copies of Tree Preservalion Plan H lot platted after 711193 • Rim Joisl Delal Oplions selaclion sheet (bldgs with 3 or less units) DATE 3I30 I o 1 VALUATION lIO 000 Ikw? 5?i Ok?4,,,g - JOB SITE ADDRESSJU _ IF MULTI-FAMILY BUILDING, HOW MANY UNITS? / PROPERTY OWNER F?vw.c-y TYPE OP WORK ?I-P<!J-_ FIREPLACE(S) _ 0 1 - _ 2 T PHONE#?/s2 s2o° APPLICANT ?utik S ADDRESS 21 s e*+n.u.-c + / w A Y ZIP CODE S sr z,! PAGER # / CELL PHON # 6 / Z y?o s`Y Y/ FAX # 6S1 P""z7 NIEV RESIDENTIAL BUILDING ONLY - FILL OUT COMPLET Energy Code Category _ MINNESOTA RULFS 7670 CATEGORY 1 (check one) - Residential Ventilation Category t Worksheef Submi ? - Energy Envelope Calcuiations Submitted ? MINNESOTA RULES 7672 By ? - New Energy Code Worksheet Submitted Plumbing Contractor: Va I 1S,. ?[V,,1 ? 2-5 Phone #: 9SZ ?f? 2 z t z ? Plumbing System Includes: ? Water Softener _ Lawn 5prinkler Fee: $90.00 ? Water Heater ? No. of R.I. Baths 2 No. of Baths Mechanical Conkoctor. l?rti5a ((r ??'^s u.-.d .4' Phone # gsZ agy oo-o >- Mechanical System Includes: ? Air Conditioning Fee: $70.00 _ Heat Recovery System Sewer/Water Contractor: 66-?rlw / Phone # 76 3 `{2?- Z 53 7- All above information must 6e submitted prlor to processing of application. I hereby acknowledge that I have read this application, state that the with all applicable State of Minnesota Statutes and City of EaganC21s Signature of Applicant Certificates of Survey Received ? Tree Preservation Plan Received _ and agree to comply Updated 1/01 OFFICE USE ONLY " O 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg # 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt- Multi ? 03 Ot of _ plex ? 09 07-plex ? 17 Garage O 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi ? 05 03-plex ? 11 10-plsx ? 19 LowerLevel ? 24 StormDamage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N O 25 Miscellaneous '?P 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding ? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) O 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 46 Windows/Doors ? 34 Replacement `Demolit(on (Entire Bldg only) - G(ve PCA handout to applicant Valuation z dl°p 1 Occupancy MC/ESSystem Census Code Zoning ? City Water SAC Units D? Stories / Booster Pump Nbr. of Units ? Sq. Ft. PRV va^ Nbr. of Bldgs -? ? Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS 2e Footings (new bldg) FinaUC.O. _ Footings (deck) _ FinallNa C.O. , Footings (addition) _ Plumbing -? Foundation _ HVAC -4/l Drain Tile Roof Ice & Water Final Other ? Framing = Pool _ Ftgs =Air/Gas Tesu _ Final Fireplace _Y R.I. VAir Test ?/ Final Siding SNcco Stone ? Insulation ?` T _ Windows (new/replacement) Approved By ule , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC W ater Supply & Storage S&W Permit & Surcharge Treatment Plant Plumbing Permit Mechanical Permit License Search Copies Other Total z Cl?l? e 4z& °d-???D SU 4`tY k l S-' (A/ (o (? a e C?, 87,a?y? Yls?`rsaiU C?o%'.Glf iioks?( I S?(7 YB1? 70 Sv Address 1683 Oakbrnoka !'nnrt ZIp 5$I2 2 Lot 2] Blk I SUb Oakbrooke Sth THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: J. r d"- Yes No Inspector: Final grade (6" from siding) x Permanent steps (garage) X Per[nanent steps (main entry) X Permanent driveway X Permanent gas Sod/Seeded grass TtaiUcurb damage X Porch Basement finish ? Deck Please verify with the builder the removal of roof test caps from the plumbing system and the shutoff of water supply to the oufside lawp faucet before freeze potential exists. Contact engineering division at 6814645 before wotking in righbof-way or installing underground sprinkler system. ? White - City Copy Yellow - Resident Copy Pink - Contractor Copy PERMIT # `( 0 (ag I RECEIPT DATE: 2002 RnIDEPTIi4L PLUM$INfi PERbI1T APPLICATION crrY or EAsM 5830 fILOT KAOB RD EA6kA, MA 551EE 651-8$1-4675 Please complete for: single family dwellings, townhomes and condos when permits are required for each unit, backflow preventer for irrigation system SITE ADDRESS: ) 2 OWNER NAME: : pQjh Y""' "-l,?CeL TELEPHONE #: ? I > 3 6? IAREA 1NSTALLER NAME: CODE?? / ? S? ? TELEPHONE #: ?7 ??- ? ./? (AREACODE STREET ADpRESS: j CITY: STATE: 21P: ? _ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00 includes $40.00 County fee Note: Additional consultant fees may apply + MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING: _ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00 _ Abandonment of septic system. _ Water turnaround - existing dwefling unit (+ 518" meter if needed -$118) Other: _ RPZ: new installation/repair/rebuild $ 30.00 _ lawn irrigation system / t h t ft J / $ 15 00 er ea er ener _ wa Replacemen dditional: water so 4 . State Surcharge $ .50 T l t s ? o a I hereby acknowledge that I have read this application, state thatthe information is correct, and agree to complywith all applicable Cityof Eagan ordinances. It is the applicant's responsibility to noUfy the property owner that the City of Eagan assumes no liability for any dama es caused by the City during its normal operational and maintenance activities to the facilities constructed under this permit within City f- y/ea e nt. ?1? 0 51GNATURE OF PERMITTEE 1102 i _ I PULTE HOMES OF MINNESOTA JOB INITIATION ORDER DATE: 8/5/01 s-nu¢ page 1 JOB NO: 0550-321-01 LOT: 21 BLOCK: 1 UNR: 32101 COMMUNITY: OAKBROOKE PATIO HOMES ADDITION: 5TH ADDRESS: 1683 Oakbrooke Court CITY: EAGAN S7A7E: MN zIP: 55122 MODEL NAME: CRYSTAL WO MODEL#: 17944 ELEVATION: 1 GARAGE: LEFT Bl1YER NAME: Gary Nelson & Eva Radke ADDRESS: 2376 Havest Way CITY: Chanhassen STATE: MN ZIP: 55317 HOME PHONE: 952-401-46993USINESS PHONE: 952-853-0700 BUSINESS PHONE: 651-766-3368 SALES REP.: KATHEE SHELDON PHONE: 651-686-4643 mo?wne.? 1 10055 SPACEMKR MICROWAVE $ 625 $ 625 1 13021 BRASS TRIM BATH $ 325 $ 325 1 13077 WHIRLPOOLTUB $ 1,075 $ 1,075 1 14001 1 ST CARPET UPGRADE $ 840 $ 840 1 14004 CARPET PAD UPGRADE $ 275 $ 275 1 15031 UPGRD VINYL KITCHEN $ 280 $ 280 7 15081 CERAMIC TILE BATH #1 $ 500 $ 500 1 15082 CERAMIC TIIE BATH #2 $ 1,100 $ 1,100 1 15090 CERAMIC TILE FOYER $ 1,275 $ 1,275 1 17005 ELECTRIC DRYER OUTLET $ 100 $ 100 2 17024 CEILING ELECTRIC OPENING MBR &SunRm $ 100 $ 200 1 17944 CRYSTAL W.O. $ 223,990 $ 223,990 1 18015 ELEVATION #1 $ . $ _ 1 19000 UPGRADE EXTERIOR DOOR $ 11100 $ 1,100 1 21021 GAS FIREPLACE- CER,4MIC WIWOOD $ 4,150 $ 4,150 1 23006 2 1/2 TON AIR CONDITIONER $ 2,000 $ 2,000 1 25016 HMLK DRS W/P.F.BIRCH/MAPLE $ 2,500 $ 2,500 1 25021 FRENCH DOOR- PORCH $ 1,025 $ 1,025 1 28044 UPGRADE CABINETS - MAPLE $ 1,650 $ 1,650 1 28056 42 UPPERS - MAPLE $ 400 $ 400 1 32002 CAT 5 PHONE / CABLE / SATELLITE Den $ 165 $ 165 1 35039 4 SEASON PORCH $ 5,825 $ 5,825 1 36038 WATER SOFTENER $ 950 $ 950 I& Builders License # 0001371 THIS CONSTITUTES A CONTRACT BETWEEN THE SELLER AND THE PURCHASER (S) FOR THE ABOVE ITEMS. APPROVED BY BUYER (S): APPROVED BY BUYER (S): APPROVED BY SUPERENTIDENT: APPROVED BY SALES: PULTE HOMES OF MINNESOTA JOB INITIATION ORDER DATE: 8/5101 6-Au9 page 2 JOB NO: 0550-321-01 LO7: 21 BLOCK: 1 UNIT: 32101 COMMUNITY: OAKBROOKE PATIO HOMES MDITION: 5TH ADDRESS: 1683 Oakbrooke Court CITY: EAGAN SrATE: MN zIP: 55122 MODEL NAME: CRYSTAL W( MODEL#: 17944 ELEYATION: 1 GARAGE: 0 LEFT BUYER NAME: Gary Nelson 8 Eva Radke ADDRESS: 2376 Havest Way CITY: Chanhassen STA7E: MN ZIP: 55317 HOME PHONE: 952-401-4699SUSINESS PHONE: 952-853-0700 BUSINESS PHONE: 651-766-3368 SALES REP.: KATHEE SHELDON PHONE: 651-686-4643 naemouna.mm TOTAL FROM PREVIOUS JIO $250,350 1 31011 IAUNDRY TUB SNGL COMPftTMNT $ 325 $ 325 Natural NOTES: THIS CONSTITUTES A CONTRACT BETWEEN THE SELLER AND THE PURCHASER (S) FOR THE ABOVE ITEMS. APPROVED BY BUYER (S): APPROVED BY BUYER (S): APPROVED BY SUPERENTIDENT: APPROVED BY SALES: - 'a Builders License # 0001371 MNcheck COMPLIANCE REPORT Minnesota Energy Code MNcheck Software Version 3.0 Permit # Checked by/Date COUNTY: Dakota STATE; Minnesota ZaNE: 2 CONSTRUCTION TYPE: Single Family DATE: 6-7-2000 DATE OF PLANS: 3/28/00 TITLE: CRYSTAL WALKOUT ELEVATION COMPLIANCE: PASSES Required UA = 447 Your Home = 351 21.5°s Better Than Code Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value --------------------------------------------------------------------------- CEILINGS 1705 44.0 0.0 WALLS: Wood Frame, 16" O.C. 2206 19.0 2.0 1 WALLS: Wood Frame, 16" O.C. 196 10.0 2.0 BSMT: Conc. 9.0' ht/8.3' bg/9.0' insul 141 11.0 0.0 BSMT: Conc. 3.5' ht/3.11 bg/3_5' insul 20 10.0 ?.0 GLAZING: Windows or poors, Above Grade 405 0.350 1 DOORS 38 0.350 HVAC EQUIPMENT: Furnace, 92.0 AFUE ------------------------------------------- -- --- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. T e proposed building has been designed to meet he requirements of t Minnesota Energy Code. Builder/Designer Date t71 ( ? LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION PROPERTYLEGAL: ?-U7' a I Q/ez, & / OQIC?r??kp 5-:1'!n DATE OF SURVEY: J5'-17-g,i LATEST REVISION: ? rn c m U DOCUMENTSTANDARDS Y ¢ °a O z 6 V / ? ? . Registered Land Surveyor signature and company GY ? ? ? • Building Permit Applicant [e ? ? • Legal description M/ ? ? . Address ? ' ? • North arrow and scale f9 I ? ? • House type (rambler, walkout, split wlo, splR entry, lookout, etc.) Vr ? ?? ? • Directional drainage arrows with sbpe/gradient % P ? • roposedlexisting sewer and water services 8 invert elevation Q? ? ? • Street name ? ? ? • Driveway ? ? ? • Lot Square Footage ? • Lot Coverage ? ? • Benchmark ELEVATIONS / Existina 6'/ ? ? • Sewer service (or Proposed) rYp ? • Property comers ?? . Top of cur6 at the driveway and property line eMensions ? V? . Elevations of any existing adjacent homes ? GKI ? / • Adequate footing depth of structures due to adjacent utility trenches ? [?' 0 • Waterways (pond, stream, etc.) / Prooosed G7'p ? • Garage Boor r?f? ? • First floor t?' ? ? • Lowest exposed elevation (walkpuUwindow) ? ? • PropeRy comers ?? • Front and rear of home at the foundation PONDING AREA (if aoolicable) ? U'/ ? . Easement line ? L3/ ? • NWL ? 6 ? . HWL ? ?j ? • Pond # designation ? [?l 0 • Emergency Overtbw Elevation / DIMENSIONS r9'? ? • Lot lines/Bearings & dimensions q? ?? . Right-af-way and street width (to back of curb) ?? ? • Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc. (i.e. alf structures requiring pertnanent footings) g?/ ?? • Show all easements of record and any City utilities wRhin those easements [?jo ? • Setbacks of proposed structure and sideyard setback of adjacent existing 5tructures 0? ?? • Retaining wall requirements, if any Reviewed: 7-, Name ? / Date r Surveyor's Certificate SURVEY FOR :PULTE HoMes DESCRIBED A5 :Lot 21, 81ock 1, OAKBROOKE STH ADDIION, City of Eagan, Minnesota and reserving easements of record. SEP 0 7 RECD a g? ? ! ` RE \V C0o¢ 00? . r ?a A° ?o vo a ?Ag 3?0 ? t Q e?Qu • 3, I -v?O Q,y a?. 0 FENG E oor ?? z9.q 1 9 s_o ? LOT SQ. FOOTAGE = 3,608 HSE SQ. FOOTAGE = 2,047 ? L 0 7- CO I?ERA GE = 57? r?'a,K??y tr,"!l .G e ? ;400o I?oG°oNlo G?' S=? u Ili e-11) F. _ # 17944 r„. PROPOSED ELEVATIONS Top of Foundation =939.o Garage Floor =937,9 Basement Floor = 130,0 Aprox. Sewer Service = 917.0 Proposed Elev. _ (=:> Existing Elev. Drainage Directions =- Denotes Offset Stake = • BENCHMARK, MIN. SETBACK REQUIREMENTS Front - House Side - Rear - Garage Side- SCALE: 1 Inch - 30 faet JOB N0: HEDLUND I HEREB7 CERTIFY TF1AT THIS IS A TRUE ANO CORRECT REPRESENTA710N 01R-374 OF THE BOUNDARIES OF TME ABOVE DESCRIBED PROPERTY AS SURVEYED 8Y ME OR UNDER MY DIRECT SUPERVISION AND DOES NOT PURPORT TO 800K: PAGE: PLANNlNG SNCIN6SRING S11RV6YlNG SHOW IMPROVEAIENTS OR ENCR CHMENTS, E%CEPT AS SH WN. 2005 Pin Oak Driva Eagan, MN 55122 DA7E _?R/L2/DL ?• CAD FILE: Phone: (651) 405-6600 E . NOCREN, LAND %1 VEYOR Fox: (651) 405-6606 NES LICENSE NUMBER 14376 OakbfOOke 5 Siteaddress: 1693 Block ?( Subd. OGCr-6r0DtL 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 following information be submitted prior to issuance of a Certificate of Occupancy. _ This structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670 OR ? This structure: wfll be constructed to meet more restric6ve requirements of Chapters 7672 or 7674 APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE Water Heater Furnace L?ENNa C o?-?-? IP-C.- ( Sz/ODO i/e.1-t- Dryer €-n?LRAz.. cYl1'i ?''v 4? 3c C ieeG EXHAUST SYSTEM LOCATION TYPE MODEL CFM's VENTED YES No Kitchen kitchen Bathroom 1 ?/(Q ?r u?1 d5o v? ?C F -0S Q faj O Bathroom 2 t? F _w V O S? ? Bafhroom 3 sv _ 8p Bathroom 4 SV _ 6-0 Ofher FIREPLACE S LOCATION GAS WOOD MANUFACTURER MODEL 8TU'S VENTING DIRECT ATMOS 4&t- (n?OTe 3 a7 ? MAKE•UP AIR MODEL TYPE CFM's I hereby acknowledge that the above informaUon is correct and agree to comply with the Minnesota Energy Code and City of Eagan requirements. zuw,ew Signature 112?? ?- Date Company Name ' This form is the responsibility of fhe General Contractor. PERMIT Permit Type: Building City of Eagan Permit Number: EA105929 Date Issued: 08/06/2012 Permit Category: ePermit Site Address: 1683 Oakbrooke Ct Lot: 21 Block: 1 Addition: Oakbrooke 5th PID: 10-53764-01-210 Use: Description: Sub Type: e-Reroof Construction Type: Work Type: Replace Description: House & Garage Census Code: 434 - Occupancy: Zoning: Square Feet: 0 If there is no ice protection inspection prior to final, the contractor must meet the inspector w/ a ladder and flat bar. Pictures are Comments: not acceptable in lieu of inspections. Carbon monoxide detectors are required by law in ALL single family homes. BL - Base Fee $4K $103.25 0801.4085 Fee Summary: Surcharge - Based on Valuation $4K $2.00 9001.2195 Valuation: 4,000.00 Total: $105.25 Contractor: Owner: - Applicant - Krech Exteriors Inc Gary W Nelson 5866 Blackshire Path 1683 Oakbrooke Ct Inver Grove Heights MN 55076 Eagan MN 55122 (651) 688-6368 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. Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA109080 Date Issued:02/06/2013 Permit Category:ePermit Site Address: 1683 Oakbrooke Ct Lot:21 Block: 1 Addition: Oakbrooke 5th PID:10-53764-01-210 Use: Description: Sub Type:Residential Work Type:Replace Description:Furnace Comments:Questions regarding electrical permit requirements should be directed to Mark Anderson , State Electrical Inspector, 952-445-2840 Stephanie Vought 3451 W Burnsville Parkway Suite 120 Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 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 - Gary W Nelson 1683 Oakbrooke Ct Eagan MN 55122 Burnsville Heating & Air Conditioning 3451 West Burnsville Parkway, Ste. 120 Burnsville MN 55337 (952) 894-0005 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA110375 Date Issued:05/08/2013 Permit Category:ePermit Site Address: 1683 Oakbrooke Ct Lot:21 Block: 1 Addition: Oakbrooke 5th PID:10-53764-01-210 Use: Description: Sub Type:Residential Work Type:Replace Description:Air Conditioner Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952) 445-2840. Stephanie Vought 3451 W Burnsville Parkway Suite 120 Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088 Surcharge-Fixed $5.00 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 - Gary W Nelson 1683 Oakbrooke Ct Eagan MN 55122 (651) 994-4831 Burnsville Heating & Air Conditioning 3451 West Burnsville Parkway, Ste. 120 Burnsville MN 55337 (952) 894-0005 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA127423 Date Issued:10/01/2014 Permit Category:ePermit Site Address: 1683 Oakbrooke Ct Lot:21 Block: 1 Addition: Oakbrooke 5th PID:10-53764-01-210 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 - Gary W Nelson 1683 Oakbrooke Ct Eagan MN 55122 Property Claim Solutions Llc 2005 Pin Oak Dr Eagan MN 55122 (651) 994-2028 Applicant/Permitee: Signature Issued By: Signature