3987 Peridot Path
Use BLUE or BLACK Ink
r I
I For Office Use
I I
Permit
City of Ea
Ea~
I Permit Fee: d L-
3830 Pilot Knob Road j I
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675 I I
Staff: I
Fax: (651) 675-5694 L -----------------I
INFLO INFILTRATION PERMIT APPLICATION
Plumbing / Sewer & Water
Date: JO WE Z~3, ZiDI ) Site Address: 39"67 pEai i5oT _PA-"+(
Tenant: Suite M
Name: 4C~G l il-t w L C--C Phone:
RESIDENT / OWNER p, Address/ City/ Zip: J g Pcg► DaT n
hal
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: ~~G t> 0N 5 V VMP (Dump
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. www.gopherstateonecall.org
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.
x _ ec , T-}+ FOW L... r-p- x " qnj_e~
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: -Under Ground -Rough-In -Final
CiTY OF EAGAN Remarks Sew & wtr permits and wtr & sew Conn, pd. on 6-3-69
Addition Cedar Grove #6 Lot 11 eik 7 Parcel 10 16705 110 07
Owner i"!'•' f"? '' ,== f? street 3987 Peridot Path state Eagan,M 55122
,.4-,.?-1
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
* SEWER LATERAL 19- 1970 1472.00
O
' lu?c ?
WATERMAIN
# WATER LATERAL 1970 20
WATER AREA
* STORM SEW TRK 1970 20
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN. 210.00 1 8 .. ...6--9-69
PER.
sAC 200.00 1478 6-9-69
PARK
Cities Diai
itv Control
The following image represents the best
available image from the original page.
Every effort was made to capture the content
from the original page.
EAGAN TOWNSHIP
BUILDING PERMIT
.-..-:_ ",
own.: ..:
•
-- -- - = .?:?./.. ° - -- -- . ..... :.._ _...: ?
Addrecc (PresenS) .?E7_z......... '/.S------------------------------- ---
Buildet .......
Addreas .....
DESCAIPTION
N° 2030
Eagan Township
Town Hall
Dafe ---._.. 7.. ?G .`i------.......
5fories To Be Used For _ Froni Dapth Heigh! Esl. Cosi Permit Fee l Remarks
_
LOCATION
This permit doea aot auihorize the use of sfreeis, roads, alleys or sidewalks aor does if give the ownar or his agenf
the right fo creale anp sifuafion which is a nuisance or whieh presenls a hazard to the healih, safefy, convenience and
general wel4are 2o anpone in the communify.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRES$.
This ia So cerfifp. lha2. c. -'` --r ' - .•...- - ?• ---.has permission !o erecf a.... .':.... ? ............. ..-.-.`?.:..:.. ' {::......-......upon
..??-c_..=.:...d/?=-:.... the above described premise subjeef fo the provisions of the Building Ordinance far Eagan ownship adapfed April 11,
1955.
?1,....
-"_..._........... ........... t.t......._.------ -................ Per _--....__.... --.........r....fca•.:S.F...?.
Chairman of Tnwn Boasd Building Inapecior
1 13
;?1 D ?
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55122
651-681•4675
Naw Construction Repulrements
• 3 registereG sile surveys showing sq. ft, of bt, sq. tt. of housa; end ILI mofeU areas
(20% maxMUm bl caverage allowetl)
. 2 copies of plan showing beam 8 window sizes; pouretl found deslgn, etc.)
. iselofEnergyCaLuletbns
• 3 COpies Of Tree PreSBrvatbn Plan if bt plBtlBd afler 7/1/93
• Rlm Joisl Defail Options seledbn sheet (hldgs wfth 3 or less un8s)
DATE 2-
SITE ADDRESS 31677
NPE Of WORK h E' --SIiJ e-
APPLICANT
MULTI-FAMILY BLDG _ Y ±-N'
_ FIREPLACE(S) _ 0 _ 1 _ 2
STREETADDRESS /3re) :L?ZI- ?'C?? C? CITYSTATE? ZIPTS?
TELEPHONE #qI L ` S'7 ? CELL PHONE # I? (2 FAX #
l022- L
PROPERTY OWNER ?i PCref P/t TELEPHONE #
------------------------------------- ----------- ------- ---------------------------- ----°°-°
COMPLETE THIS SECTION FOR -NEWff RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 MINNESOTA RULES 7672
(J submission type) . Residential Ventilation Category 1 Worksheet 5ubmittetl • New Energy Code Worksheet Su6mitted
• Energy Envelope Calculations Submitted
Plumbing Conhactor:
Plumbing system includes:
Mechanical ConhacFor:
Mechanical system includes:
Sewer/Water Conhactor:
_ Water Softener _
_ Water Heater _
No. of Baths
Air Conditioning
Heat Recovery System
Phone # -r-t
Lawn Sprinkler
No. of R.I. Bathsi ?
u? C?- ? 1 2C'2 IuI
I
_ Phone # ?iL
_- - ?'ee: $70.?1
Phone If
I hereby acknowledge ihat I have read this applicaTion, state ihat the Informatlon Is correct a d agree to comply
with all applicable State of Minnesota Statutes and City of Eagan Ordin?r?ce
Signalure of Applicant
...............................................
OFFICE iJSE ONLY
Certiflcates of Survey Received ^ Tree Preservation Plan Received _ Not Required _
Updated 4102
/??. 7-5
pemadeVHeosir Aeaulrements
. 2 copies ol plan
• 1 set of Energy Calculatlons for heated addkbns
• 1 site survey for eMerbr additlons & decks
. Intlicate I home serveG 6y septic system for addttions
VALUATION 4? 7G U
OFFICE USE ONLY
? 07 Foundation
? 02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
O 05 03plex
? 06 04-plex
O 07 05-plex ? 13 16-plex
O 08 06-plex ? 16 Fireplace
? 09 07-plex ? 17 Garege
O 10 08-plex ? 18 Deck
? 11 10-plex ? 19 Lower Level
? 12 12-plex Pibg_Y or_ N
? 20 Pool
? 21 Porch (3sea.)
? 22 Porch/Addn. (4sea.)
? 23 Porch (screened)
? 24 Stortn Damage
? 25 Miscellaneous
? 30 Accessory eldg
? 31 Ext. Alt - Multi
? 33 Ext. Ak - SF
O 36 Mutti
? 31 New ? 35 Int Improvement O 38 Demolish (Interior) ? 44 Siding
O 32 Addition ? 36 Move 81dg. ? 42 Demolish (Foundation) ? 45 Fire Repair
O 33 Alteration ? 37 Demolish (Bldg)* ? 43 Reroof ? 46 WindowslDoors
? 34 Replacemenl Demolition (EMire 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 b1dpJ _ FinaVC.O.
_ Footings (deck) _ FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation HVAC
Drain Tile Other
Roof _ Ice & Water _ Fina1 _ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
? Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
Building Inspector
ve
«".9„ :
e ?.?F,"„".,"..?.?
•u_'.1:• ?, ?;,_',':.
? i;?ti-:
?
_ c'dy of eagan
MEMO
TO: DIANE DOWNS, UTILITY BILLING CLERK
FROM: ED KIRSCHT, SR. ENGiNEERING TECH
DATE: AUGUST 25, 1993
SUBJECT: STREETLIGHT ENERGY COSTS
CEDAR GROVE NEO. 6(141 LOTS)
This memo is to inform yaur department to begin to invoice the energy costs at the single
family rate effective August 1, 1993 to the property owners in Cedar Grove No. 6 Addition
as listed below:
Block 1, Lots 1 1
Block 2, Lots 1-8 8
Block 3, Lots 1-16 18
Block 4, Lots 1-11 11
Block 5, Lots 1-9 9
Block 6, Lo1s 1-53 53
(Lats 54 through 61, Block 6, should not
be biiled at this time)
Block 7, Lots 1-12 12
Block 8, Lots 1-18 18
Block 9, Lot5 1-11 11
TOTAL 141
The City is currently being bi{led by Dekota Electric for streetlighting in the above listed
subdivisian.
?`?.?,?•y ?? ? ? ?? / ?
Ed Kirscht Sr. Engineering Teeh
ca Mike Faertsch, Asst. City Eng.
EK/je
? ----- . .. _,_.;?x'??o•._ , ... .
CHICAGO TITLE INSORANCE
4620 west 77th Street
TO: EAGEN
Edina, MN 55935
Phone: 835-3100
DATE: 08l17/78 ADDRESS 3987 PERTIIOT PATH
FROM: LiONNA
FILE NO.: M46318
FILE NAME: gMITH RONAL.D L.. DYS: PLAT:
COUNTY: LiAKOTA PLEASE CFECK TO SEE IF TEIERE ARE ANY
LEVIED/PENDING ASSESSMENTS
ABS:RACT TORRENS
LF'GAL DEsCRIPTION:
LOT 11 RLOCK 7 C'Fiif)V2 C;RfivF f. kk*A******#******dA******R**k***sY**R*p*N****A*R*R*****i'*?F{AR**R**!?R!•
PLCASE FURNISH THE FOLLOWING LEVIED ASSESSMENT_INFORMATION ON THE ABOVE
DFSCRIBED PROPERTY:
Tyl-e of Improvement Balance Due Original Amount
NUNE
PLEASE FURNISH THE FOLLOWYNG PENDING ASSESSMENTS THAT ARE ESTIMATED AT
THIS TIME: IJONE
ALSO REQUESTING ANY ASSESSMENTS CERTIFYED TO THE AUDITORS AT THIS TIME
AND INTEREST:
Signed: Assessment Clerk, Date: Auqust 28, a978 _
AMOUtdT OF UNPAID WATER BILL, IF ANY: $
9??, ,•,,y,?r
7gJ8
EAGA,N TOTdNSHTP
3795 Pilot Knob P,oad
St. Paul, Mfnnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE:Juna 3, 1969
OWNER:Cedar Grove Const. Co.
PLUMBER Stein, Inc.
NUMBER 412
Address 11-7-6 3987 Peridot Path
TYPE OF PIPE Cast iron
DESCRIPTION OF BUILDING
IndustriaZl Commercial` Residential Multiple Dwelling No, of units
X
Location of Connections:
Permit Fee 7.50 pd.
Total
Connection Charge 200.00 pd.
Street Repairs
Inspected by:
Date
Remarks
By. Chief InspecCor
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Toemship, Dakota Counl=?e? ,
By
Please notify when ready for iaspection aad connection and before aay portioa
of the work is covered.
? P"
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PEM4IT FOR WATER SCRVICE CONNECTTON
Date: June 3, 1969
Billing Alame: Cedar Grova Const. Co.
Ocmex: Cedar Grove Const. Co.
Plumber: Stein, Inc.
NO ' Total Chg.
Building is a:
Residence X
t4ultiple go,
Commercial
Industrial
Other
Number• 286
Site Address: 11-7-6 3987 Peridot Path
Billing Address 7343 Concord Blvd. E.
Meter
210
Meter No -5S ?+ Permit Fee 7.50 Pd•
Meter Readinge? ooa MeCer Dep.
Meter Sealed: Yes_ Add'1 Chg.
Inspected by
Date
Remarks:
Sy:
Chief Inspector
In consideration of the issue and delivery to me ot the above permit, I
hereby agree to do ttm proposed work in accordance with the rules and
regulations of Eagan Tocanship, Dakota Cou t, Minne"ta.
By:?
Plea3e notify the above office when ready for iuspection and connection.
iiw
CItV OF ei9gta
3705 PILOT KNOB ROAD. P.O. BOJ( 21199
EAGAN. MINNESOTA 55121
PHONE: (612) 454-8100
DATE: Novenbes 1, 1983
DAKdrA COUNTY ABSTRACT CO.
1250 Highway #55
P.O. Box 456
u__tings, MN 55033
SPECIAL'ASSESShIENT'SEARCH
BEA BLOM9U157
hlova
THOMASE6AN
JAMES.^. SMIiH
JERRY THpMAS
1HEODORE WACHiER
Caa+ca Mempyrs
THOMA$ HEDGES
GN Ao*mnaia
EUGENE vaN OVERBENE
Gty CWk
PE= Cedar Grove # 6, Iot 11, Block 7
3987 Peridot Path, Eagan, MN 55122
Parcel # 10 16705 110 07
Enclosed herein is the search which you requested made on the above described property.
Kind of Improvement Runs Beginning Original'Amount Balance Due
I further certify that according to the records of said office, the following improve-
ments are contemplated or pending after having been approved, and are now in the process
of planning or completion. '
Kind of Improvement Approrimate date ot Completion Approximate cost
NONE
WAIVER:
Neitlier the City of Eagan nor its employees guarantees tlic accuracy of the above in-
formation which was requested by the persoii or persons indicated. Nor does tlie City
or its employees assume any liability for tlie correctness tiiereof. In consideration
for thc supplying af the indicated information in tlie above form, and for all other
considerstion of any naturc whatsocver, any claim against the City or its employces
rising there from is hereby expressly waived. Levied assessments to be paid to the
County Treasurer at Hastings, M. 55033
Very Lrul2?_
? ? THE LONE OAK TREE...iHE SYMBM AND GRONRH IN OUR COMMUMITV
Enclosed herein is the search which you requested made on the above described pronert_
Kind oi Innrovemenc YPq.- Beeinnins Orisinal ?.ccounc Balance Due
NONE .
I further certiFy that according to the records of said office, the following 3mprove-
ments are contemplated or pending after having been approved and aze now in the proce:
of planning or completion.
- Rind of Imnrovement Annroxiaate Da[e of Comvletion Aooroximate Cost
.M . _
- ;_ .. NONE;, . . _ _ . , ' .. . . . . .. _ ,
... .. r",.... -_ . . , _-
WAIVER• . . . " •' . - .. '".`- -
heither the City ofEagan nor its employees.guarantees the accuracy of the above infoi
mation vhich was requested by•the oerson or persons indicated. Nor does the City or :
employees assume any liability for the correctness thereof. In consideration for the
supplying of [he indicated information in the ahove form and for a21 other considerat:
of any nature whatsoever, any claim against the City or its employees rising therefroi
is hereby expressly waived. Levied assessments to be paid to the CITY OF EAG.VV, •
"}'?`''"• 3830 Pilot Knob Road, P. 0. Box 21199. Eagan, MN 55121. -
Very,truly yours,
.:.:..... ....
? ' Vti.• ' -'?Q '..!? _
" - SPECIAI. ASSESS*fENT DIVISZON
• _ - , _ ', . . _ . . ',:. , , . ?.'r- .' : . - ? y +.
....
,..;,. , .. . • , .. . ? _ . . -
. .. . . .
' 1HE [ONE OAK TREE...THE SYMeOI OF STRENGTH AJJD GROWfH IN OUR GOMMUNIN
Stewart Title .
Co of MN li RE' Cedar Grove #6
Sui[e 107 i Iot 11 Block 7
101 West Burnsville Parkway j 3987 Peridot Path
Burnsville MN 55337 ? • • -
cirv use oNLv
L ?_ BL ~I RECEIPT #:& ZZZ1Z
SUBD. doGC. 'COTlL ? ? DATE: `-'?
g/a3/F c. o
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 6814675
Piease complete for: ? single family dwellings
? townhomes and condos whcn permits are required for each unit
pIXTURES EACli ?Q. TOTAL
Shower 3.00 x =
Water Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen Sink 3.00 :c =
Laundry Tray 3.00 :c =
Hot Tub/Spa 3.00 :c =
Water Heater 3.00 x _?_ _ •oo
Floor Drain 3.00 :c =
Gas Piping Outlet ' minimum -1 3.00 :c =
Rough Openings 1.50 :c =
Water Softener 5.00 x =
Prrvate Disposai ` DakWa Cty. license 65.00 =
(new and refurbished systems)
U.G. Spdnkler * home under const. 3.00 =
Alterations ' ro existiny 20.00 =
Water Turn Around 20.00
STATE SURCHARGE .50
TOTAL ZO•,?O
SITE AD
OWNER
INSTALLI
STREET ADDI
CITY:
PHONE #: (
? Z-/O-?7
a
STA'
ZIP:
)RESS:• FOWLER KIETH ?
3987 PERI00T PflTH
ERGRN , 55122
NAME: H 454-4497 W
OFFICE USE ONLY
L BL RECEIPT #:
SUBD. DATE:_
1996 PLUMBING PERMIT (CQMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675 "
Please complete for: . all commercial/industrial buildings.
. multi-t2mily huildings when separate oermits are no required for each dwellina
unit.
DATE: CONTRACT PRICE:
WORK TYPE: NEW CONSTRUCTION ADD ON REPAIR
DESCRIPTION OF WORK:
IS WATER METER REQUIRED? _ YES _ NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
WATER FLOW: GPM. ARE FLUSHOMETERS TO BE iNSTALLED? YES NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESULI' IN A DELAY OF METER ISSUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM7 _ YES _ NO.
IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINY:LER PERMIT.
FEE: $25.00 minimum fee or 1% oi contract price, whichever is greater. State surcharge of $.50 per
$1,000 of pgnnjt fee due on ali permits.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL
SITE ADDRESS:
TENANT NAME:
OWNER NAME:
INSTALLER: _
ADDRESS: _
cirv:
PHONE #:
METER SIZE: " DATE:
STE. #
. _ ; .
" STATE: ZIP:
SIGNATURE:
APPLICANT
OFFICE USE ONLY
INSPECTOR:
Use BLUE or BLACK Ink
For Office Use
Permit
non
City of Ea
Permit Fee.
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675
I I
Fax: (651) 675-5694 I Staff: fi7 I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit
Name: Phone: _i:~/
Resident/ f
Owner t Address / City i Zip:
j Applicant is: Owner Contractor
Type of Work Description of work:/ /CGAXjI2,V(/),v bol-✓-5
I
j Construction Cost: Multi-Family Building: (Yes / No
Company: C r A~tS'7ti) 4 / 15~ o/*kYZ.S LZ,L a;%
Contact: .~9D/Z/
Contractor Address: 13-72- &AJ City: Gay
State: /,71 ^J Zip: Phone: 7W43
License Lead Certificate
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:
_w ~m
NOTE: Plans and supporting documents that 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.
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
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 permit issuance. )
X_ x
Appli nt's Printed Name Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA172486
Date Issued:10/04/2021
Permit Category:ePermit
Site Address: 3987 Peridot Path
Lot:11 Block: 7 Addition: Cedar Grove 6th
PID:10-16705-07-110
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Softener
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$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 -
Keith H & Elaine Fowler
3987 Peridot Path
Saint Paul MN 55122--293
(651) 454-4497
Milbert Company (culligan)
1801 50th St E
Inver Grove Heights MN 55077
(651) 451-2241
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA173404
Date Issued:11/10/2021
Permit Category:ePermit
Site Address: 3987 Peridot Path
Lot:11 Block: 7 Addition: Cedar Grove 6th
PID:10-16705-07-110
Use:
Description:
Sub Type:Fireplace
Work Type:Gas Insert
Description:
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 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 -
Keith H & Elaine Fowler
3987 Peridot Path
Saint Paul MN 55122--293
Fireside Hearth & Home
2700 Fairview Ave N
Roseville MN 55113
(651) 633-2561
Applicant/Permitee: Signature Issued By: Signature