4664 Parkcliff DrCASH RECEIPT ?
?
CITY OF EAGAN
3830 PILOT KNOB ROAD
EAGAN, MINNESOTA 55122
oare
,C-CEIVEo
FROM .7TL, i) ?<<
AMOUNT $
? CASH I CHECK
DOLLARS
?a
?
,4- I c? L4--
l LO-1 • '- I ?,J I
FUND OBJECT AMOUNT
Thank You
BY
V 84,89 WhNe-PaY? ?PY
Vellow-Postlng Copy
DATEw JULY 16, 1990
? , ? •
RE: 4664 PARKCLIFF DR (STEINWAND BUILDERS. INC)
x Your Sewer & Water Permit for the above property has been completed. It will be held at the
Public Works Garage (3501 Coachman Road) until the meter is picked up. BE SURE TO
CALL PUBLIC WORKS (454-5220) FOR YOUR PERMANENT WATER TURN ON.
Your Sewer & Water Permit for the above property cannot be completed for the following
reasons:
Your Sewer & Water Permit for the above property has been completed, but the meter cannot
be issued or occupancy allowed until further notice.
COMMERCIAL PROJECTS ONLY: Please pay for meter at City Hall. Meter size must be
confirmed by Biil Adams or Dirk House (Plumbing Inspectors - 454-8100) before issuance.
WARNING: BEFORE DIGGING, CALL LOCAL UTILITIES- TELEPHONE, ELECTRIC, GAS, ETC.
- REQUIRED BY LAW.
CONTACT COMMUNITY DEVELOPMENT DEPARTMENT FOR WATER TURN ON POLICY.
Secretary, Building Inspections Dept.
CITY OF EAGAN 1$43'
? ?. .?.:.? •,
3830 Pilot Knob Road, P.O. Box 21-199, Eagan, MN 55121
PHONE: 454-8100 ?
BUILDING PERMIT Receipt #
To be used for SF M/GAR Est, value =1 S1 ,Q00 Oate JWM ZT , 19 90
Site Adiess T'„' i """""` ` ` "" PARKCLI" Lot Block Sec/Sub.
Parcel No.
¢ Name a 1LL"AAY DNiLu6" 9 im
Z 2204 COMNBLLY CIR
o Address
City SURNSVILLE Phone 8 S-S SS
,o Name SAM
? City Phone
U?
W W Name
? ; Address
i W City Phone
I hereby acknowlege that I have read this
Signature of Permitee
A Building Permit is is
on the express Condit
Building Qtficial
state that the
able State of
)nc snau ne aone in accordance witn an
ites and City of Eagan Ordinances.,,r--
OFFICE USE ONLY '
pccxUparicy A.-3 N-i 4
FEES j
Fl
Zoning
818.?
(Actuaq Const .? Bldg. Permit
(Allowabte) 75.50
- Surcharge
8 ot srories
??
P
R
i ?2 ??
3
?e?? lan
ev
ew
?j 1???
Oepth SAC, Cily ?
S.F. Tolal _
SAC
MCWCC bW. 00 ?
S.F. Footprints - , 62S
00 :
On Site Sewage _ Water Conn *
?
??? ?
On Site Well Water Meter ?
MWCC System
?
ncot. o?it 30•00
;
Ciry Water -
'i
30.00
PRV Required _ S/W Permit ?
Booster Pump - ?yy Surchazge ' ? °
252.00 '
APPROYALS TreatmentPl t9
35?.00
Road Unit i
Planner
C
il - park Ded. ?
ounc
sag. on. -_
-
Copies ?
3 348 00 ''
1 • i
Variance - TOTAI ?
• pemit µp, Peemit Holder Date Telephone #
WATEFi
SEWER
PIUMBING
?• G??.S? 7i5???
H.VAC.
ELECTRIC
Inspection Date InsQ. Comments
Footings I ?
Foundation ' c- (
Framing ?
Boofin9 ?
Rou9h PIb9• All
Rough Htg.
Isul.
Freplace
Final Htg.
- ?
?ev
Final Plbg. ?
Cpngt. Meter Plbg. Inspector - Notify Plumber
Engr.lPlan
Bidg. Final - ?-? ?
Deck Ftg.
Deck Final
Well
Pr. Disp.
? • ? • ,? A
CIN
? Name ?
? Address
c City
'P:' 3830 PILOT KNOB ROAD, EAGAN, MN
YPE WORK DES
CR
G
PT
O
Sec/Sub BLD
. T
?
I
I
N
''
Res.
- New
Mult Add-on
Cvmm. Repair
Other
? Name
3 Addre;
O C'ty -
TYPE OF WORK
Forced Air
Boiler
Unit Heater
Air Cond.
Vent
Gas Piping OuHets ri
Other
? .
M BTU
M BTU
M BTU
• M BTU
CFM
FEE
S/C:
TOTAL•
FEES
RES. HVAC 0-100 M 8TU - $24.04
ADDITIONAL 50 M BTU - 6.00
(RES. HVAC INCLUDES A/C ON NEW
CONSTRUCTION)
GAS OUTLETS (MINIMUM - 1 PER PERMIT)
- 1.50 EA.
COMM/IND FEE - 146 OF CONTRACT FEE
APT. BLDGS. - COMM. RATE APPLIES
TOWNHOUSE & CONDOS - RES. RATE APPLIES
MINIMUM RESIDENTIAL FEE - ALL ADO-ON &
REMODELS - 12.00
MlNIMUM COMMERCIAL FEE - 20.00
STATE SURCHARGE PER PERMIT - .50
(ADD $.50 S/C IF PERMIT PRICE GOES
BEYOND $1,000)
j
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
, • . • CITY OF EAGAN PERMIT #
CONTRACT 3830 PILOT KNOB ROAD, EAGAN, MN 55122 RECEIPT:
PRICE PHONE 4548100 DATE: -'
Site Address l , 77 % '
Lot 7 Blodc ? Sec/S b
Jl, .??
? Name r, ? f .;• ?? ?fi ?
? Address , ".' /=nv/i
c City Phone O' -G l
Name
c Address
? City ?. , 6, !?• Phone 92L 5'y
FEES
COMM./IND. FEE - 196 OF CONTRACT FEE
APT. ?DGS. - COMM. RATE APPLIES
TOW OUSE & CONDO - RES_ RATE APILIES
MINIMUM - RESIDENTIAL FEE $12.00
MINIMUM - COMM.IND./FEE $20.00
STATE SURCHARGE PER PERMIT .50
(ADD $.50 S!C PER EACH $1,000 OF PERMIT FErt)
?1?. ???.??s?y?' ?-,?w
SIGNATURE OF PERMITTEE
FOR: CITY OF EAGAN
Res. •L New _
Mult. Add-on
Comm. Repair
Other
, RES. PLBG. ONLY - COMPLETE THE FOLLOWING:
NO. FIXTURES TOTAL
' Wa1er Closet - $3_00 $ OJ
4- Bath Tubs - $3.00 -;,
Lavatory - $3.00 12 0,7
? - ? snower - $3.00
I(itchen Sink - $3.00 . OJ
UnnaUBidet - $3.00
T Laundry Tray - $3.00
3, eJ
? Floor Drains - $1.50 1 J
? Water Heater - $1.50 .
- -) J
T Whirtpool - $3.00 . O o'
? Gas Piping Outlets - $1.50
(MINIMUAA - 1 PER PERMin
Softener - $5.00
Well - $10.00
Private Disp. - $10.00
? Rough Openings - $1.50
1
U. G. Sprinkler System - $12.00
PERMIT FEE: ?l ? • OJ
STATES SIC: ? J
GRAND TOTAL: ?/7 ti J
i dr• °
Cgtr#i#tra#t of COxrupanry
Citp of Cagan
Wpaiucnd of
?ui[ding ?tc?rr?inti
This Cerlifuate issuad pursuant to the nquFrunenls oJSe,cAion 306 ojJhe uniJorm Buildrng
Code oadfXng rhat at tJre lime oJrssuartcr thir stn=ne wcrs in compliaaoe with tlre ?arious
"16=wa ojthe G}1j' re8ulatin$ bruMr8 conslruclion or us;m For Ifie following.
u-a-"cw--sp-BW{rw? Bkf& Pa Mx 18037
O-a-c7'4vc R4.1m I zim owm RI Type ..- - VN
Oweec at Rmlft Add.2204 ?xtlLM 1 YCMR- Ai1RN.SVIT7 F.
puc (lf.'RM r.. 199()
POST IN A CONSPICUOUS PLACE
CITY OF EAGAN Remarks
Addir.ion PARKCLIFF 3RD Lot `7 Rik 1 Parcel 10 56702 070 01
owner str@et 1i 61, p,ark c:l; ff Drive scace Eagan. MN 5 5123 _
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK 73-25
SEWERLATERAL
?
WATERMAIN 1984 3
5 •0• 7.04 5
WATER LATERAL
WATER AREA 7, 9 I?. 3 • 2 73.25
STORM SEW TRK 984 42 . 71 12 . SIa.
STORM SEW LAT
-
3
98
98
56-73
CURB & GUTTER '
SIDEWALK
STREET LIGHT
WATER CONN.
BUILDING PER.
SAC
PARK
?
?
-- - . ,__-_ ... ?t . _. __. __.? ..-Y,M,, ,?-•
SEWER & WATER PERMIT OFFICE USE ONLY
CITY OF EAU,+N ? MErER ##375 G•frl_ z PERMIT DATE
3830 Pilot ICnob Rd, cHiP #??? PERMIT #
Eagan, MN 55122-1897
I METER SIZE 5-lit k6c'e_ tu)B.P. RECEIPT # C.? 4t39
? ISSUE DATE V'70 B.P. RECEIPT DATE 06I2
' DATE 16. ] 9 : 0
}---..
E
? SITE ADDRESS
? LOT 7 BLOCK 1 SEC/SUB 1'ARKc.LIFF 3Rti
I. ,A2
` APPLICANT: L
ADDRESS:
ZIP
4 GITY, STATE
? PHONE:
_ PRV - BOOSTER PUMP
PERMIT REGIUESTED
X SEWER ? WATER - TAPS
i COMM/IND X RESIDENTIAL
It NEW - EXISTING
Lawn Sprinkler Meters are to be Installed
Ahead of Domestic Meters on Water Line.
Crsdit WILL N(3T be given for Deduct Meters.
?-,..? . . --?•-ir'-? . .
PWMBER: !" ek/N c- IL EZ 1Y1-A {r •
ADDRESS; SV .'?/?, C c Z,_i s?"'151
CITY, STATE I` /7??• ZIP
PNONE: ;??? ? ? ?`•''=? - ? e:? ? G"'
I AGREE TO COMPLY
OWNER: STEIN4IANU BUI DL?. ING _ EAGAN ORDINAN('ES
_-w
ADDRESS: 7204 CONNLLLY CIR
CITY,STATE P-URNSVILLE, Mr? Zlp_ 55317
PHONE: ''?5-5g55 IGNATURE WHEN METER ISSUED
.
PLEASE ALLOW TWO WORKING DAYS FOR PROCESSING. CALL 454-5220 FOR INSPECTIONS. FOR STORM
SEW@R PERMITS, CONTACT ENGINEERING DEPT.
f
>E ONLY
PERMITDATE
PERMIT # 11526
B.P. RECEIPT # . ^t!.'3e
B.P. RECEIPT DATE 06 l-- "?
)OSTER PUMP
PERMIT REGIUESTED
?L SEWER -XL WATER -TAPS
_ COMMlIND Y, RESIDENTIAL
X NEyy/ _ EXISTING
PLUMBER: % /14 sr - - (
ADDRESS: ~ '
CITY, STATE ZIP ??yr
PHONE:
CITY, STATE BURN ZiP -?=
PHONE ?'???5-5955
PLEASE ALLOW TWO WaRKiNG DAYS FOR PROCESSI
SEWER PERMITS, CONTACT ENGIMEERING QEPT.
, , . , . _.?._ .? . . .. :,s.
Lawn Sprinkler Meters are to be Installed `
Ahead of Domestic Meters on Water Line.
Credit WILL NOT be given for Deduct Meters.
, , ? •, , _ _
. ?'?' ` r-- . /.: ._? ; ? :.? i??.,s,<4 i?ti,'^t_.•
I AGREE TO COMPLY WITH C
EAGAN ORDINANCES
SIGNATURE WHEN METER ISSUED
CALL 454-5220 FOR INSPECTIONS. FUR STORM
CITY OF EAGAN NO 1$037 '
3830 Pilot Knob Roatl, P.O. Box 21-199, Eagan, MN 55121
BUILDING PERMIT PHONE:454-8100 Receipt # ? o C? ELL C7(,
1
iobeusedfor SF DWG/GAR Est.Value $151,000 Dale JUNE 22 , 19 20
SiteAddress 4664 PARKCLIFF DR
Lot 7 Block 1 SeGSu6. PARKCLIFF 3RD
Parcel No.
W I Name STEINWAND BUILDERS}INC
a Address 2204 CONNELLY CIR
City BURNSVILLE Phone 895-5955
fF Name SAME
$a Address
? City Phone
W W Name
?? Address
aw City Phone
I hereby acknowlege that I have reatl this applicanon and state that the
information is correct and agree lo comply with le State of
Minnesota Statutes and City of Eagan Ordmany? ./? 1-1
Signawre of Permnee
OFFICE USE ONLY
Occupancy R-3 M-1 FEES
Zoning R=1
(ACtual)Const V-N BIdg.Permit 81$.00
(nllowatle) V=N
Surcharge 75.50
8 of SlOnes
72'
Plan Review
532.00
Len91h
Depih 36' SAG City lOn- nn
S.P. Tolal - SAC, MCWCC 600.0
0
S F. Footprinls _
On Site Sewage _ Water Conn
0
625.0
On Srte Well Waler Meler 90.00
MWCCSystem xx
30
00
Cny Water ? /ccc Depasn .
PRVRequired - S/WPermit 30.0n
Booster Pump - S/W Surcharge - Sh
7rea1menl PI 252.00
APPHOVALS RoadUnit 355.00
A Buildinq Permit is issu4 to: STEIPT?AND BUILDERS INCI Planner - parkDed
on the express condrtion that all work sh I be done m accordance with all CouncA
applicable State ot Minnesota Statutes and Cit of Eagan Ordinances. eldg. Ofl. _ Gopies
0
8mlding Ofhaal n Variance - TOTAL 3,508.0
?
.?"`I
;i s/sU
?
?
7s 0°
@ 62757 • ;?
,z
Request Date
?
.? Q
b Fre No nn Inspeciion
Re wratl> `/
L Ready Now lywill Nohfylnspector
I Wnen Readyv
-
? es ? No
Ilicensed contractor ? owner hereby request mspechon of above electncal work at:
JoD A? (Street.B o ute No 7p r? (?C
C
G??
Section No
• TownsM1ip Name or No Ra ge No Gounry
T
?C
A •
?
Occvp nt{PRINT)
00 IIJ p 0 IL Phone Na-
[.?a 3- 339 7
Power Sappher
40-hA -E?? ?c Adtlress
' 3on ?-
incai Conlractm (Company Nama)
L ss 1F--? ? ..TaC- Contractor§ Lwense No
D aLo -
Mabn aaress (COnVaMOr or Owner Making instaliau n)
AutM1 nxetl SignaWre ?CO roupwner Makm s?allalion? Phone Number
..,. t? n,. ?Ak?6
MINNESOTA $TATIAl Aflp OF ELECTRICITY ? THIS INSPECTION REOUEST WILL NOT
GdggsMlEway 61Eg. ?Loom 5413 BE ACCEPTED BV THE STATE BOARO
1821 Unlversity Ave. SI Paul. MN 55106 IINLESS PROPER INSPEGTION FEE IS
Phone(612) 662-D800 ENCLOSEO
?? L?'/gQ REQUEST FOR ELECTRICAL INSPECTION ?a Es-ooomo7
? See msimctions for crompleling Ihis form on Oack ot yellow copy ??-E?'
R62757 `X" Be/ow Work Covered by This Request
e AdA Rep- ?_ TypeofBmltlmg AppliancesWiretl EqmpmeniWired
Home Range porary Service
Duplex Water Heater Heating
Electric
Apt Building rye $
r (Specity)
Comm /Indusirial j urnace
Farm Air
Condihoner
Ofher (speoily)) mrador5 Remarks
Compute Inspection Fee Below:
# Olher Fee # ServiceENranceSrze Fee # Circuits/Feeders Fee
Swimming Pool o to 200 Amps ? 0 to 100 Amps a
Transformers Above 200 _ Amps Amps
Signs InspectorY Use Only
?r•
? TOTAL .p
Irngation Booms ,
U '! g
Speaal Inspection
Alarm/Communwaeon TNIS INSTALLATION MAV BE ORDERED DISCONNECTED IF NOT
Other Fee 5-,P.{{, COMPLETED WITHIN 18 MON
I, the Electncal Inspector, hereby
tif
th
th
b Roughan oate
y
cer
at
e a
ove mspection has
been made. oate ?
-
OFFlCE USE ONLY
TM1is request witl 18 manlhs irom
7/a/ S
8 3 6 8 2 4 qei (2?
Request Date
? ? ? Fire Na -in Inspeclion
eqwretl'+
etly Now ? Will NoLty Inspector
d
+
R
WM1
? Yes _ No y
en
ea
IXl-kcensed contractor ? owner hereby request inspection of above electrical work at:
Job oC S
o
(o e1 ar Route No )
CL FF IdG
C Qry
,
Section No Township Name or No pange No ry
Occupant(PRINT) Phone N.
9 7
Power Supplier M ss
Elecn¢ai Gonirector(COmOany Name) Conhactor5 ce se No
L?r?. oa6o -(
M
n
n
ntl
?C
m
m
O
M
k
I
u
i
g
aress
a
O
.ac
r or
wner
mg
ns
a9on) /I
a
381n s?[3L? `? N?E7Mz+ ru.4L ?Jt c g,l A? EA6AJ ss(?.
A honzetl Sgnalure (CO tractou0wne M ng Installanon)
-- ?T_c n? (AV+ Phone Number `
L83 -9
MINNESOTA STtXj&ARD OF ELECTHICIW- ? THIS INSPECTION REOt1EST WILL NOT
Grlgqs-Mitlway Bltlg. - Noom S-173 8E AGCEPTED BV THE STATE BOARO
18P1 Universlty Av¢., 51 Peul, MN 55104 UNLESS PROPER MSPECTION FEE IS
PMne (612) 642-0800 ENCLOSED
7?,a/5o
C? 36824
REQUEST FOR ELECTRICAL INSPECTION
? See ?slrucLOns jpr com0levng lhis form on back oi yellow copy
')l" Below Work Covered by This Request
Ea.oooo,.o,
e AO3 f,ep Type of Building AppliancesWrted EqwpmentWired
Home Range Temporary Service
Duplex Waier Heater Electric Heating
Apt Building Dryer Other (Specify)
Comm /Indushial Fumace
Farm Air Condihoner
Olher ispeaily) Contreclor§ qemeMs
Compute Inspection Fee Below:
# Other Fee # ServiceEnhanceSize taiga # CircwtslFeeders Fee
Swimming Paol 0 to 200 Amps 0 m 100 Amps
Transtormers Above 200 _ Amps Above 100 _ Amps
SignS Irwpec[or9 llse Only. ? TOTAL ZZtl
Irrigahon Booms
? ?-
Special Inspecllon
larm/Communication THIS INSTALLATION MAY BE ORDER DISCONNECTED IF NOT
Other Fee J COMPLETED WITHIN 18 MONTFiS.
I, the Electncal Inspector, hereby
if
h
h Rouyn-io oaie
cert
y t
at t
e above inspection has
been made. F,,,ai oai G/
?- ?a
OFFICE USE ONLV
rnis reauast void 18 monms irom
RESIDENTIAL
BUILDING PERMIT APPLICATION 72 r,
CITY OF EAGAN I
3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
New Construttion ReauiremeMs
• 3 registered site surveys shaxing sq. ft. of lot, sq R of house; and all rooted areas
(20% maximum IW wverage aNowed)
• 2 wpies of pian showing beam 8 window saes; poured found design, elc.)
. 1 set of Eneryy Calculations
• 3 copies of 7ree Preservation Plan if IW piatted after 711193
. Rim Joist Detail OpGons selectbn sheet (hldgs with 3 orless units)
Remoda4Reoair Repuiremen4s
• 2 copies of plan
• i set o( Energy Calculations tor heated additions
• 1 site survey tor ezterior adddions & decks
• Indicale d home served 6y sephc system for additions
DATE 7- f 7- 0,)--
VALUATION I 6 S `_?
?
SITE ADDRESS LI ?Jo `I '??wlc c,;Sl M? , MULTI-PAMILY BLDG _Y _ N
TYPE OF WORK F'F( _n_C,nnG FIREPLACE(S) _ 0_ 1_ 2
APPLICANT N-T 1, S' OU5 Zlk-e
STREETADDRESS aaooo- L-A „j (r -L:rr- CITY ?a11????(c STATE?'?^k ZIP 550
TELEPHONE# 0Y.S4-250S-B0SEjCELLPHONE# ?12--Olin?Sol'3 FAX# 9tA -4G,9-6G53
PROPERTYOWNER VIA-A,j..,, TELEPHONE# 651-45J--68`??{
----------------------------°-------°----------------------------^---------------------------
COMPLETE THIS SECTION POR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672
(4 submission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Su6mitted
• Energy Envelope Calculatlons Submitted
Piumbing Contractor: __ Phone #
Plumbing system includes _ Water Softener Lawn Sprinkler Fee: S90.00
_ Water Heater _ No. of R.I. Baihs
_ No. of Baths
Mechanical Contractor: Phone #
Mechanical system includes: _ Air Condiboning ?? 2 n M•? .00
_ Heat Recovery System D I K IJ U
Sewer/WaterConhador: Pho ; , ???? 1 7 ?002
- -
-----------------------•-°-----°°---°---------------°°--°-°---------°---- -- - - --°-°----°°
y- --
I hereby acknowledge that I have read this application, state that the information is &a?rect; o comply
with ail applicable State of Minnesota Statutes and City of Eagan Or
Signature of Applicant ?-- ? --
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4/02
OFFICE USE ONLY
? Ot Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex 0 10 OB-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-plex ? 11 tp-plex 0 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 72-plex Plbg_Y or_ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demalish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings(new hldg) FinaUC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Foo[ings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & W ater _ Final _ Pool _ Ftgs
Air/Gas Tests _ Final
_ Framing _ _
Siding Smcco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulatian _ Retaining Wall
Approved By , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES 5AC
City SAC
Water Supply & Storage
S8W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
[
1 '6t
1990 BIIILDING PERMIT APPLICATION
CITY OF EAGAN
SINGLE FAMILY DWELLINGS MULTIPLE DWELLINGS COMMERCIAL
2 SETS OF PLANS 2 SETS OF PI.ANS 2 SETS OF ARCHITECTURAL
3 REGISTERED SITE SURVEYS REGISTERED SITE SURVEYS - & STRUCTURAL PLANS
1 SET OF ENERGY CALCULATIONS (CHECK WITH BLDG. DEPT.) 1 SET OF SPECIFICATIONS
1 SET OF ENERGY CALCULATIONS 1 SET OF ENERGY CALCS
_# OF RENTAL UNITS
_# OF FOR SALE UNITS
PENALTY APPLIES WHEN: TYPING OF PERMIT IS REQUESTED, BUT NOT PICKED UP BY LAST WORKING DAY
OF MONTH IN WHICH REQUEST IS MADE.
LOT CHANGE IS REQUESTED ONCE PERMIT IS ISSUED.
NOTE: ADDRESSES FOR CORNER LATS - CONTRACTOR/HOMEOWNER MUST DESIGNATE WHICH ADDRESS IS
DESIRED. NO CHANGES WILL BE ALLOWED ONCE BUILDING PERMIT IS ISSUED.
PROCESSING TIME FOR SEWER & WATER PERMITS IS TWO DAYS ONCE A PERMIT HAS BEEN COMPLETED.
PERMIT MUST SHOW A LICENSED PLUMBER.
?,?- ?auK z o aECa
T
B
U
d F
r
o
e
se
or:/
lValuat ion:Date:
Site Address ?plo / Alw&)t5r L72. OFFICE USE ON Y
o00
Lot ? Slack
? FEES
Occupancy
Parcel/Sub _ V'kCCiFF--3rd. p.lu`v' Zoning R-1
Actual Const d-T-I
Sldg. Permit
$??•co
?
'
- 1411
l Allowable 1/-N Surcharge 7?0
Ownerpwn
or
dri rw
e # of stories Plan Review 3Z„D0
Length ?- SAC, City p,DO
???„
Address II.35 ?
y pk. Depth jez' SAC, MWCC p?0l7
? S.F. Total Water Conn , ?
City/Zip Code?a G??l i??'-? ?Z Footprint S.F. Water Meter ? Da
I Acct. Deposit 3 O.DO
Phone F-87T On site sewage S/W Permit 3o,Do
'p
Contractor?W11W -);4 1D?7?S?7W, _
On site well
MWCC System ? S/W Surcharge
Treatment P1. ,SO
Z$Z, QO
?? d City water ? Road Unit
Address
i N. PRV _ Park Ded.
City/Zip Code&QNNvSUI S`533y Booster Pump Copies '
SUBTOTAL
' APPROVALS Penalty
Phone P9? Planner TOTAL ? .(
/
Arch ?t
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/? rh 1rij?y rbL ?F11 Council
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Variance
Address /?U
City/Zip Code /v'-,`yPq jf'/?
Phone #
,
GARAwe
3zu2y r76 S
zx ?o =(2
'? 14 8 x i5 -
Va LuA?r 10 N
4 , YF ,?? ?
))z2o
yo ua? ? r ?,?o
lotic?o = ?oo
I'z2 x9`'! = i-rl
Is? ??oor2
65rnT???2.0
LSA{S =?
IZ x?l
Z,V
?UXZ-? ? IIZ-?
Z ? ?3 ? ZL
fly(?X51= 58y?f/ ?
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.
CITY OF EAGAN ?
E%TERIOR ENVELOPE AVERAGE 'U' COMPUTATION
OHNER: *D
3ITE ADDRESS: ?)? l'J??
CONTRACTOR: DATE: ??-O -G{ C7 pHONE: g5?qs` st S
Determine wrking square footage of each:
1. Total exposed wall area ,,,Z ( sq. ft. x .11 = "??e>
2. Total roof/ceiling area ... I LEo sq, ft. x .026 Z.v7?
Total exposed wall area above floor -'L?7aG'
a. Total wall window area ............................ 17 (?n,;9,0
b. Total door area ...................................
c. Total sliding glass area .......................... C-- 5,4 -1
d. Total fireplace wall area ......................... 5 I
e. Total wall framing area (average 10%) .............
f. Total net wall area above floor ................... 2\51-4
g. Total rim joist area .............................. ? D 2
Total exposed foundation area -
h. Total foundation window area ....................... 0
i, Total net foundation area above grade .............. 777
Determine 'UT value of each wall sepent:
a. i iC,. x fpr
b. -4 r}.. x 'U'
c. x 'U'
d. x IUI
e: o , x 'U'
f. '7_IS11x 'U'
9. x f0t
h, p x 'U'
i. I I(a x ' U'
3 . .................................................
If item #3 is the same as or less than item 91, you have met the intent of SBC
6006(c)2.
Total exposed rooF/ceiling area = I 2(1-- C
L?
_.-
?-
<?0
J. Total skylight area ............................... C
k. Total roof/ceiling framing area (average 10%) ..... 1 Z?
1. Total net insulated roof/ceiling area .............. h ?G,
OVER
Determine 'U' value for each roof/ceiling sepent: ?°' •
J . `?,
x OU' •- `? _ ? -i .??? •-
k• x, U, 0.;Z
i. d! 5(c, fUl
4 . ....... .....................x. s .............. Total
If total of f14 is the same as or less than @2, you have met the intent of SBC
6006(c)1.
Alternate Building Envelope Design
To utilize the total envelope system method, the values established Dy the sum
of Items 113 and 04 shall not be greater than the sum of Items {11 and 02.
1. + 2. -
3. + u. -
2
CLAIII VOUCIIF.R - REFUND RT;QUF,ST
CI7Y Of FAGAii
CLAIPSAN CEDAR VALLEY HEATING
ADDRESS 4770 NICOLS ROAD
EAGAN, MN 55122
L?ration 1429 DEERWOOD & 4664 PARKCLIFF
L7,BI,PARKCLIFF 3RD & L17, B1, ENGSTROM'S DEERW00?
P,ereirt No./Date 97852 - 7/I1/90
Rrncon fcr Refund OVERPAYMENT ON TWO PERMITS
T}•pP of Refund Electrical Permit 01-3211 $ _
FlumbinR Fermit 01-3212 $
Tiechanical Permit 01-3213 $ 4.00
Surcharqe 01-2155 S
Water Connec[ion Permit 20-3713 S
Sewer Connection Fermit 20-3743 , $
Account Deposit 20-2252 , $
U[ility Account Over-rayment 20-2250 $
Other: $
$
TOTAL $ 4.00
I declare under the penalties of law that this account, claim or demand is just and
tha[ no part of it has been naid.
?
SULY 11, 1990
Signature Date
2004 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
1,`_70 C) ()
New ConsWdion ReauiremenGS RemodeVReoair Reauirements ?fice Use'6iitu
3 registered site surveys showirg sq. ft of l04 sq. R oi house; and all rooted areas 2 copies of plan Cert of Su[vey Recd _ Y_ N
(20% maximum bt coverage allowed) 1 setof Energy Calculations for heated additions Stee PresAJ6a HeCdii„r?;
2 copies of plan shovring beam & window sizes; poured found desgn, elc. 1 site survey for additions & decks T(e? Pr89Requved
1 set of Energy Calculatlons Add'dfon - IMkate i(on-sde septic system Onsife Sep"tic $ys(em? _ Y-_=N
3 copies of Tree Preservadon Plan if lot platted after 711193
Rim Joist Dehail Optians selechon sheet (bldgs wBh 3 or less units
t L
Date / b-1 !?
/ Ga`1
onstruction Cost 2- 740 ?
C
Site Address /Vr '
/ UniUSte #
Description of Work /'il5t?'er
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 (01 _ 2
Property Owner (' /7?U? J ?D'?v(J' Telephone # ( (a lo"Kl,Y
Contractor
Address W ifl cA) . +J'l (3 City p?"`?S?/L??
State Zip j?J37 Telephone tJ
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateaorv I Minnesota Rules 7672
Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submission type) Submitted Submitted
• Energy Envelope Calculahons Submitted
Have you previously constructed a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
Telephone # (
--
Telephone #(?r J= ?r? f P r, in r?
? ?`, ?.? L'. ll L1 S
?
Telephone # (
I.,II .?HIV i. v: /Illbi I I'1
I hereby apply far 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 nd work is not to start without a
permit; that the work will be in accordance with the approved plan in he case o rk which requires a review and
approvalofpl s. ? .
ApplicanYs Printed Name ApplicanYs Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex ? 18 Deck O 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y Or_N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building• ? 43 Reroof ? 46 Windows/Doors
? 34 ReplaCement •Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinallC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addirion) _ plumbing
Foundarion HVAC
_ Drain Tile Other
Roof _ Ice & Water _ F inal _ Pool _ Ftgs _ Air/Gas Tests Final
_ Framing _ Siding _ Stucco _ Stone _ Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ Insularion _ Retaining Wall
Approved By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatrnent Plant
License Search
Copies
Other
ToWI
Building Inspector
p . _ .,,,
A0 l4i
iRESIDENTIAL BUILDINGs
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
New Construction Reauiremenis
3 registe2d sAe surveys showing sq. k. oi lot, sq. ft of house; and all roofed areas
(20°k maximum lot coverege allowed)
2 copies of plan showing beam & window sizes; poured found design, etc.
1 set of Energy Calculations
3 mpies of Tree Preservation Plan if lot platted after 7l1193
Rim Joist Detail Options selec4on shcet (6uildings with 3 or less unifs)
Minnegasco mechaniql venlilaGon fortn
RemodeVReoair ReauiremenGs
2 copies of plan showing footings, beams, joists
1 set o( Energy Calalations for heated additbns
1 site survey for additlons & decks
Add'rtion - iiro'kafe Hon-s8e septlc system
'??,Jf mSQ S/.?
+,--r 0
?
01`116e u66 ain
CeA of Survey ReW.;: -:- _ Y._ N
TreePresPlanRecd Y-r=N.
Tree Pres Required, Y=_ N
On-site Septis System °: "?. _ Y°_ N
Date t / /0
SiteAddress yC,? Coostruction Cost
f=/= p k Unit/Ste #
Description of Work ?1 CL / ? I
Multi-Family Bldg _ Y? N Fireplace(s) _ 0 _ 1 _ 2
Property Owner C 1? ? t S ?/ U c..? ? 4 Telephone # ( C $'r
Contractor ??q
Address G?S ? l /?c z 5%.
State dL_) T City nzf'Sz-'?^ v ?••, T
ZiP S-Sv t yj Telephone # ( 5?Z-z) -171 3 -z- /g2o
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(4 submissiantype) Submitted Submitted
• Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master pian?
_ Y _ N If yes, date and address of master plan:
Licensed Plumber
Mechanical Contractor
Sewer/Water Contractor
?r!?11M
MAY 1) 9 2006
Telephone #(
Telephone #(
Telephone #(
-J#1
I hereby apply for a Residential Building Permit an'?tcnowledge 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
pernut that the work will be in accordance with the approved plan in the case of wark which requires a review and
approv ?plans.
? ? LF
pplicant's Printed Name
DO NOT WRITE BELOW THIS LINE
,. . . ,
Sub Tv nes
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
O 04 02-plex ? 10 08-plex P 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-piex ? 25 Miscellaneous
Work Tvaes
? 31 New ? 35 Int Improvement ?. 38 Dem(ilish Interior ? 44 Siding
? 32 Addition ? 36 Move Building . ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement `Demolitlon (En6re Bidg) - Give PCA handout to applicant
DeSCfiptI0I1: Water Damage _ Yes
Valuation oDb ?'- Occupancy _)2-3 MCESSystem
Plan Review 100% or 25%
Census Code 1-131( Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const f3 Width
REQUIRED INSPECTIONS
Footings(new bldg) _ Sheetrock
? Footings(deck) FinaUC.O.
_ Footings (addition) ?YJ FinaUNo C.O.
Foundation HVAC
Drain Tile Other
Roof Ice & Water Final Pool Ftgs Air/Gas Tests Final
_ Framing _ Siding _ Stucco Lath _ Stone Lath _Brick
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
_ InsulationA , _ Retaining Wall
Approved By:
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
6uilding Inspectar
TRI-LAND C0.
SURVEYING
SERVICES
1875 PLAZA DRIVE
EAGAN, MINNESOTA 55122
CERTIFICATE OF SURVEY FOR:
STEINWAND BUILDERS, INC.
?
LEGAL DESCRIPI?RCCORDING-TUTHE BL.OCKI, PARKCLIFF 3rd ADDITION
O RECORDED PLAT
OF DAKOTA COUNTY,MINNESOTA
N q55 43
134° ? ?1a
SCALE: I"=3 ' ?r????4???'?? ?•
? ??'???v%?
13 t
.i%
.a
q
?L
cN
/
T
'OT6
e
/ \ T
.Y-is ss LOT 7
/ o
? \ vy
/ c 9ce.zi'
/m"
3 ?CO 4 9?
9 /
q ?
R
.?
90
\ 99 m .<CI
\X 0
z
3.o S., Sr•-. ?
'S
?.:T .. s ......_ cl?
z
TRI-LAND C0.
SURVEYING
SERVICES
1875 PLAZA DRIVE
EAGAN, MINNESOTA 55122
'OT6
LEGAL OESCRIPTION: LOT-7-,BI-OCKL, PARKCLIFF 3rd ADDITION
ACCORDING TO THE RECORDED PLAT
N THEREOF DAKOTA COUNTY,MINNESOTA
??.43
SCALE: I44=30'
C?
T
,?6
LEGEND
CERTIFICATE OF SURVEY FOR:
STEINWAND BUILDERS, INC.
I
.?? /? \`
?o ? \
?
?.e
V,
y ` M
````/!\ \.J ? V
? \\
\ 5
2'?
976./ ? 6`0
OpA
? O6 r?
v?
o DENOTES IRON MONUMENT
o DENOTES WOOD HUB SET
DENOTES EXISTING SPOT
ELEVATION
DENOTES PROPOSED SPOT
ELEVATION
? DENOTES DRAINAGE DIRECTION
I hKeby ee?fify ihat this survey,plan or
report was prepand by nK or under my
direct suparvision and that I am o duly
Repisfered Lond Surveyor under the
Laws oi the Stafe of Minnesota
97
?R
/ ?.
02
T?
-• - ?
n? ? 1\? ?J I? ?2• O?
?
:4Nt' ER lq
PRoPOSGD }=JLL civ.s?rlFiNT- WALY-oU"r
INVERT ELEVATION AT SERVICE EXTENSION=
PROPOSED GARAGE FLOOR ELEVATION • `180 ?
PROPOSED FIRST FLOOR ELEVATION
PROPOSED BASEMENT FLOOR = 9?2 °
ELEVATION
NOTE ' VERIFY ALL FLOOR HEIGHTS WITH
FINAL HOUSE PLANS
Bradlsy •nson, Mn. Req. No.15233
Date : L ky /c7 L
WID
01 19 2018
For Office Use
•
ib Permit E AN �
Permit Fee: / ,
Date Received: 11-'1
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810
(651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: i J
buildinginspections(a).cityofeagan.com
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 11/14/2018 Site Address: 4664 Parkcliff Dr Eagan unit#:
Name: Chris & Cheryl Young Phone: 651-272-6896
Resident/ 4664 Parkcliff Rd Eagan MN 55123
Owner Address/City/Zip:
Applicant is: Owner X Contractor
Type of Work
Description of work: Masterbath remodel
Construction Cost: $28463.00 Multi-Family Building:(Yes /No X )
company: Serda Remodeling LLC Contact: Freddie Serda
Contractor
Address: 7807 138th St W Cay: Savage
State: MN Zip: 55378 Phone: 952-261-8208
Email:
pfreddie@serdaremodeling..c��o//m//
License#: BC639151 Lead Certificate#: 1 ( 30 3 6a 12_ 000(91
If the project is exempt from lead certification,please explain why:
Built in 1990
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:
Fire Suppression Contractor Phone:
NOTE:Plans and supporting documents Mat you submit are considered to be public information. Portions of the information may be
classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.cityofeagan.com/subscribe.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
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.orq
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.
xFreddie Serda
Applicant's Printed Name • icant's Signature
/ 93/00
i ,moi, (K. 1)1
DO NOT WRITE BELOW THIS LINE
���
SUB TYPES
_ Foundation _ Fireplace — Porch(3-Season) _ Exterior Alteration(Single Family)
'e Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi)
_ Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex _ Lower Level _ Pool _ Accessory Building
WORK TYPES
New — Interior Improvement _ Siding _ Demolish Building*
_ Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows _ Demolish Foundation
Replace _ Repair _ Egress Window Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION -7 _
Valuation tG,06Q r Occupancy :.-14Z6-- 1 MCES System
Plan Review Code Edition M/I 2 2/,� SAC Units
(25%_100%_) Zoning r2 - ( City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction U v Width
REQUIRED INSPECTIONS
Footings(New Building) Meter Size:
Footings(Deck) Final/C.O.Required
Footings(Addition) ()n Final/No C.O.Required
Foundation Foundation Before Backfill >O HVAC_Gas Service Test Gas Line Air Test Hood
Roof: Ice&Water _Final l Pool:_Footings Air/Gas Tests Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick EFIS
y, Insulation Windows
Sheathing Retaining Wall:_Footings_Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression: Rough In_Final
Braced Walls Erosion Control
(° Shower Pan Other:
Reviewed By:: 7-.3 m ' Ic 1
,Building Inspector
RESIDENTIAL FEES
Base Fee A %' 7177 J"v7 &-(---
Surcharge
Plan Review C ,D /Q
��
MCES SAC
City SAC
Utility Connection Charge
S&W Permit&Surcharge
Treatment Plant
Copies
TOTAL
Page 2 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA153592
Date Issued:01/04/2019
Permit Category:ePermit
Site Address: 4664 Parkcliff Dr
Lot:7 Block: 1 Addition: Park Cliff 3rd
PID:10-56702-01-070
Use:
Description:
Sub Type:Residential
Work Type:Alteration
Description:Fixtures
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Fee Summary:PL - Permit Fee (miscellaneous)$59.00 0801.4087
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 -
Christophe R Young
4664 Parkcliff Dr
Eagan MN 55123
JW Plumbing LLC
14930 Dallara Ave W
Rosemount MN 55068
(612) 759-0691
Applicant/Permitee: Signature Issued By: Signature